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HomeMy WebLinkAbout10-06-08J 15056041147 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.2sosol 21 0 8 0 0 0 9 8 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 179280316 01062008 05191913 Decedent's Last Name Suffix Decedent's First Name MI OSSOFF PAUL g (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI CLEVELAND OH 44114 Ftrm Name (If Applicable) NATIONAL CITY BANK First line of address 1900 E. 9TH STREET Second line of address LOC. 01-3810 City or Post Office State ZIP Code ^ 9. Ltttgatlon Proceeds Received ^ 1 p_ Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113 A between 12-31-91 and 1-1-95) ^ ( ) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number MATTHEW E. NAGY 8006228036 ~~ u 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 12-12-62) ® g Decedent Died Testate ^ ~ Decedent Maintained a Living Trust 8. Total Number of Safe De osit Boxes (Attach Copy of Will) (Attach Copy of Trust) P Correspondent's a-mail address: under penatttes of pequry, I tleclare 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. SIG TURE OF PERSON RESPONSIBLE FOR FILINGlR~ETURN DATE ~y~~-~~~.w.~l. ~ic~~ ~tz~T National Citv Bank 9~~~~c~S~ ADDRESS v ' 246 Seneca St. Loc. 46-11015, Oil City, PA 16301 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE U UL1I1 ~ . J; an - Lo-executor 1180 Elk treet Franklin. PA 16323 09/29/08 DATE ~ V VKCJJ 15056041147 Side 1 15056041147 J J 15056042148 REV-1500 EX Decedent's Social Security Number De~e~enrs Name: O S S O F F, PAUL B. 17 9 2 8 0 316 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 1 , 2 7 5 , 6 4 2.14 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 6 3 , 6 0 2 1 5 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 1 7 , 7 7 8 9 4 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 1, 3 5 7, 0 2 3 2 3 9. Funeral Expenses & Administrative Costs (Schedule H) ................................ ......... 9. 7 0 , 516.12 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I} ...................... .......... 10. 3 , 4 8 7 . 4 4 11. Total Deductions (total Lines 9& 10) ............................................................ .......... 11. 7 4, 0 0 3 5 6 12. Net Value of Estate (Line 8 minus line 11) ................................................... .......... 12. 1 , 2 8 3 , 019.6 7 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 Taz (Line 12 minus Line 13) ....................................... .......... 14, 1 , 2 8 3 , 019 • 6 7 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 15. 16. Amount of Line 14 taxable at lineal rate X .045 1 , 2 8 3 , 019.6 7 ig, 17. Amount of Line 14 taxable a1 sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due .................................................................................................................... . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT, 57,735.89 57,735.89 Side 2 15056042148 15056042148 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 08 - 00098 DECEDENT'S NAME Ossoff, Paul B. STREET ADDRESS Essex House, Apt. #339 20 N. 12th Street CITY STATE ZIP Lemoyne PA 17043-1453 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable p. Interest E. Penalty 49,000.00 2,578.95 Total Interest/Penalty (D + E) Total Credits (A + B + C) 4. 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 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. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (1) 57,735.89 (2) 51,578.95 (3) 0.00 (4) (5) 6,156.94 (5A) (5B) 6 ,15 6.9 4 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................................................. b. retain the right to designate who shall use the property transferred or its income :.................................... ^x c. retain a reversionary interest; or .................................................................................................................. x d. receive the promise for life of either payments, benefits or care? .............................................................. ^ x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... [] ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... ^ 0 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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are stilt 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-hall (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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS FILE NUMBER ESTATE OF Ossoff, Paul B. 21 - 08 - 00098 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION NUMBER 1 National City Bank Investment Management Agency Account #46P14785003. The value shown includes accrued income of $1,933.00. The accrued fee of $1,303.08 has been added back to the total value of the account and deducted elsewhere on this return. Please see attached Estate Valuation. UNIT VALUE VALUE AT DATE OF DEATH j 1,275,642.14 TOTAL (Also enter on line 2, Recapitulation) 1,275,642.14 . y COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER ESTATE OF Ossoff, Paul B. 21 - 08 - 00098 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Commerce Bank Certificate of Deposit #102371. Value shown includes accrued interest of 15,317.93 $23.35. 2 Commerce Bank Checking Account #0536042963. Value shown includes accrued interest of 3,955.88 $0.28. 3 National City Bank Checking Account #291274. Value shown includes accrued interest of 3,014.25 $1.13. 4 National City Bank Certificate of Deposit #2675566618. Value shown includes accrued interest 25,049.98 of $49.98. 5 National City Bank Certificate of Deposit #6330584821. Value shown includes accrued interest 10,026.34 of $21.63. 6 Miscellaneous tangible personal property, estimated. 750.00 7 2000 Subaru Outback Wagon 4D, per sales price. 4,500.00 8 AAA -Refund of membership dues. 4.53 9 Verizon -Refund. 35.24 10 Traveler's Insurance -Refund. 348.00 11 U.S. Treasury -Economic stimulus payment. 600.00 TOTAL (Also enter on Line 5, Recapitulation) I 63,602.15 SCHEDULEF COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Ossoff, Paul B. 21 - 08 - 00098 If an asset was made joint within one year of the decedents date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT Barbara Skelly 931 N. Front St., Apt. 205 Daughter A Harrisburg, PA 17102 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT C~F~SCRIPT.lO~ C~F PRO~ERTkY Include name o Inanclal Ins I u Ion an ban account number or similar identifying number. Attach deed forjointly-held real estate. DATE OF DEATH VALUE OF ASSET % OF DATE OF DEATH DECD'S ~ VALUE OF INTERESTI DECEDENT'S INTEREST 1 A 03/29/2007 PNC Bank Checking Account #50-0474-7905. 7,722.64 100% ~ 7,722.64 The value shown includes accrued income of $2.19. 2 A 03/29/2007 PNC Certificate of Deposit #31800300426. The 10,056.30 100% I 10,056.30 value shown includes accrued income of $56.30. ~ I i I I I i I I, I I TOTAL (Also enter on line 6, Recapitulation) 17,778.94 COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Ossoff, Paul B. FILE NUMBER 21 - 08 - 00098 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER FUNERAL EXPENSES: A. 1 Reinsel Funeral Home -Balance due for funeral services. 1,668.30 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions National City Bank Social Security Number(s) / EIN Number of Personal Representative(s): Street Address 246 Seneca St., Loc. 46-11015 City Oil City State PA Zip 16301 Year(s) Commission paid 2. Attorney's Fees John Egan, Esq. as Attorney and Co-Executor 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 John Egan -Reimbursement for court costs forwarded. Patriot News Co. -Legal advertisement. 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 National City Bank -Trustee fee during Estate Administration. 830.00 260.25 1,502.57 40,650.00 25,075.00 TOTAL (Also enter on line 9, Recapitulation) 70,516.12 Schedule H • Funeral Expenses & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN aCt171inislydtiVeCosu continued RESIDENT DECEDENT FILE NUMBER ESTATE OF Ossoff, Paul B. 21 - 08 - 00098 2 National City Bank - 2007 fiduciary income tax letter preparation fee. 180.00 3 Olmes & Dickson, CPA -Preparation of 2007 Federal and PA income tax returns. 275.00 4 Cumberland Law Journal -Legal advertisement. 75.00 Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMNERVITANCEOTAXRETURNAN~ LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF OSSOff, Paul B. FILE NUMBER 21 - 08 - 00098 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 National City Bank -Accrued agency fee. 1,303.08 2 MSHMC Physicians Group -Medical debt. 80.00 3 AARP Health Care -Medical debt. 196.50 4 PA Department of Revenue - 2007 PA-40 income tax payment. 124.00 5 United States Treasury - 2007 1040 income tax payment. 298.00 6 Essex House -Medical debt. 1,350.86 7 Moffitt Heart & Vascular -Medical debt. 88 67 8 Central Pennsylvania Pulmonary Assoc. -Medical debt. 46.33 TOTAL (Also enter on Line 10, Recapitulation) I 3 487.44 REV•7513 EX+ (9-001 SCHEDULE) COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Ossoff, Paul B. 21 - 08 - 00098 RELATIONSHIP TO i SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT I (Words) ($$$) RECEIVING PROPERTY oo Not List Trustee(s) ~ I TAXABLE DISTRIBUTIONS [include outright spousal ~ distributions, and transfers ~ under Sec. 9116 (a) (1.2)] 1 Gregory Culbertson Grandson ~ 21.4285% of the 4096 West Tilden Rd. I Estate Residue Harrisburg, PA 17112 2 Christopher Culbertson Grandson 21.4285% of the 72 Jordan Road ! Estate Residue Arlington, VA 20106 3 Stephen Skelly Grandson 14.2857% of the 826 Montrose St. ~ Estate Residue Philadelphia, PA 19147 ~ I Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropriate, on Rev 1500 cover sheet II NON-TAXABLE DISTRIBUTIONS: . A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI 0.00 REV-1513 EX+ (9A°) SCHEDULE J COMMONWEALTH OFPENNSYLVANlA BENEFICIARIES continued INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Ossoff, Paul B. 21 - 08 - 00098 RELATIONSHIP TO ~ SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT ' (Words) ($$$) RECEIVING PROPERTY Do Not List Trustee(s) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers i ! under Sec. 9116 (a) (1.2)] ! 4 Meghan Skelly Gallis Granddaughter 114.2857% of the t idue t R i E 931 N. Front St., Apt. 5104 s a e es Harrisburg, PA 17102 I 5 Mame Skelly Granddaughter 14.2857% of the 632 Hamilton St. ~ Estate Residue Collegeville, PA 19426 `' 6 Barbara Mae Skelly Daughter i 14.2857°l° of the 931 N. Front St., Apt. 205 I Estate Residue and Harrisburg, PA 17102 ,the joint PNC account. f i i i ! I i i w i f Page 2 of Schedule J TABLE OF CON'T'ENTS ESTATE OF: Paul B. Ossoff DOD: 1 /6/2008 INDEX OF ATTACHMENTS 1 Death Certificate. 2 Last Will and Testament. 3 Estate Valuation for National City Bank Investment Management Agency Account #46P14785003. Death Certificate. 1 4b000154800 Legal H105.805 REV (9110'7) LOCAL REGISTRAR'S CERTtFtCATiON OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph, Fee for this certificart, $6.00 P 13992607 Certification Number This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar The original certificate will be forwazded to the State Vital Records Office for permanent filing. [,oval Registrar _ Date ~a ^tv ~vewe COaaAONWtJSTM OF PENNSYLVANIA • DEPARTMENT OF HEALTH • YRAL RECORDS CEitT)FiCA'rE OF pEATH {Sw in^4uc1lona and ^aampN^ on rwerae) arAre A~ rarween i./~rOewPk.+dr. r.. nrr) Asti ateeaet<.q aun,e .trro,.n prr..r. nen zB 0316 2UO$ PAUL B OSSOFF M 179 • ! - . - o, .zr,~A.r t.penar e.bwn urns usf aor clam pr.,K -rM r.snve.lCRr.swne 0~lra ro.s~ ..r.+l a... ore ~ aelo.ec or: b~ 94 ,.,~ MAY 19, 1913 OtL CITY, PA, ^a:nloupure Qoa. Qwetglr. DPe.bd Oo^n•aaar. - ec..~ro.n ^:q aeA. tc ra.n KF^et{ tint ~uri^+ear r,rm.l ^1MSOeaer.ta ltro.a anyn I~„e Qw. raroa Mrbn~aes.^w,ee ~ ~( 1 "7 ~ ~ R i ~ Pm~~ f~ CUMBERLAND E. PENNSBORO TW b~t, t •G r ~ by `~ aansan.rona.~.n.7 wH 17E te.0ab4er lln^IOeeeswe re.te a,. .err kOelarnrea I2 na, Oee•Otlwr~h 1t Oeeeawn L^oum rSp.rf MOaae Dub ms ar4 u.a^daere: Yrid, ne..~rlne0. t~G.,lwy %w wpr4Vn eeea.e..p yy~~eerbs Ifrilwwl~,~ee,!sw~ U3Iee^atv~! nevalrr/asbmryR~ Ccr^eflaaS.f NIlertlOia~a^11i+erY) WNERIUPERATOR SPORTS J70RE ^rs ~w 12 WIDOWED - 110ewllrlWaveaa.sla~egrbw rs armat 12TH ST. 2O N OM.rbfr. a^OeaM~ ~nra.aa. +>« Pa. u.r~ ,x^pwoeaMtuwan nn ~ . LEMOYNE PA. 17043 ne.6^e~ ~.^~ LEMOYNE rn+z..r t:UMBERLANp Clyl ^.e u tr•t ^ree Oi^. niw.4 a/aq tt brrtierre 1Rt a,ate. run n•+aN DAVID OSSOFF BARBARA MICHAI.KIEWICZ b rr.rre ^r Rw.rgM m. somru Wni.m.r 6bet W /bgebr,>A~ ARBARA SKELLY Z1 N. FRONT 5T. HARR158URG, PA 17101 }1-breyr OSadrn Daw.a ^Drrr tl^ObrO~h+eeari Prw~.ryr7 tnvraesoawMre.ro..w.or+e~rsce.aol nemialCrylr,n r.~wut q art [] ^...^ ba as ~ w. ~.sem^.^eerbe.ere.re. ^an^-~ trreaerw^,bee..en ^,..Ow )AN. 12, 2Od OALVARY CEMETERY OIL CITY. 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QK' Q~6'a° Q~4 Lt7arA 4el ]s eM•r ^t Wert ttcr nrrrmhR R>•rr ataimeenr~-+elarn. straw eriU ^iid0e ^fbMbbO.emine0 QYr {]na l~•PYV7COw^R []F®9/[~VeYeY. a Oar-tter~ s orrM1bnsy sy tteapr. mrnr, • r.MCaMnr^.nRM.i.raMrerrrrrsarr0~s+r.~.~aa+.ama+tra twr~w.+rM,we^rbwnreFlar~:ar<--"----'_----'------'---,~ ~~ r • ^~~r~r~Mgrr+~aa~s~+~eawa..~'}~.r.a~,+9 Art.r. r.r r• raewrr .e rr r a ^ Asa: +rr o~s~,.l aratsn r +, ~w . s /.a ea~4d r..rwwa._-___________ __ __ r A~I ~ < • ^a^rsrbro.~ ~ Q ZZr ss ~ + aarrrrs.r.rrab,.ye~..rbrwre,wmerr rbe^la.d^ae^^r a,ers relRrs~ne+^e^. ^ fl^w^r rrr.M7C.^r^ ro~,ar al Tjbrliaa a ro ir frle- 'Y~ w ~ 1 ~ 1tS1s1~f) ` ~ O ~ -K /fif-i70Y~ Co9'C>mf~ ~ ~..~_ ooezztfi Last Will and Testament. 2 LAST WILL AND TESTAMENT I, PAUL B. OSSOFF, of Oil City, Venango County, Pennsylvania, being of sound m~,nd, memory and understandings do make, publish and declare the following as and for my Last Will and Testament, hereby revolting and making null and void all Wills or writings in the nature thereof by me at any time heretofore made. FIRST: I order acid direct that all my just debts and funeral expenses be paid by my Executors as soon after my death as may be convenient. SECOND: Ynasmuch as I have made appropriate provisions for mY beloved wife, VIRGINIA B. OSSOFF, prier to the date of making this wi>.1, I make na further provisions for my said wife in this Will. THIRD: I hereby make the following specific bequests: ~„ Category - Jewelry ],. To my daughters, PAULA THERESE CULBERTSON and BARBARA MAE SI:ELLY, or the survivor of them, the gold chain which was given to me by my uife, Virginia 'B. Ossoff, and request them to share or to make such use or disposition of it as they desire. In the event both of my daughters should predecease me, this goad chairs shall vest in my granddaughters, M?.ME SKEL~LY and NIEGHAN SkELLY, or the survivor of them, aril request them to share or to ma4ce such use or disposition of it as they desire. S, Category -' CCS1n5 Z , My co ~ n cull F~c: t.ian sr}a11 be cl i vided f~~]ua I I y bet-.r,eerl m~- ciaught:ers, P,~UL.a 'TI~ERESE (;Ul.,}iEHTSON ~.irtr.{ 1:A{~BARA MAE SL;.E.LI.Y. I t, i s my intent, that this col ]ection shat]. be t:Jit~ide~ci 5o as t_c> r'c:tli;h an ecluitt~ble distri.hi~tiar, as to V3111F'. TO t},is t~r;ri, I ask m~' dHU~;hter.> t.u U1;''0'i;`2008 14:26 FP. )( 12146163647 PaCC PCG OIL CIT''f ~ ED 6A'•fICH ~]i U03; ii05 select specific coins of their o+.~+n choi.cc. In the event, however, that my daughters are unable to agree upon an equitable division, t}zen m•y Executors shall make the division for them using such method or methods ss they deem appropriate. C. Category - Guns 1. 'I'o my grandson, CHRIS CULBERTSON, my 270 caliber BSA-290. 2. To my grandson, GREG GULBERTSON, m,y' 250-3000~L579 #62148. 3. To mY grandson, STEPHEN SKELLY, my Frarichi 20 gauge 5L995. 4. `T`o my grandson, STEPHEN SKELLY, my Remington 51-12 gauge 5110Q30358. 5. To my grandson, CHRIS CULBERTSOIv', my Winchester Model 55-32 WC 9661. 6. To my grandson, GREG GULBERTSDN, my Winchester 92-32 WCF 94227. 7. 'To my grandson, CHRIS CULBERTSUN, ane of my Buffalo Bill rifles. 8. To my grandson, GREG CULBERTSON, one of my Buffalo Bill rifles. 9. To my gz•rindson, STEPHEN SKELLY, my Smith &• Wesson hand gun. 10. To my grandson, STEPHEN SKELLY, my Stevzns Favorite 22 pistol. In the event of the death of any of my children or grandchildren prior to my decease, the items of personal property herein bequeathed to them, with the e~ceptiorl of the gold chain, shall vest ir( and be clis~tributeci to their children, per stir•pes, the ri,~tua.l method of division of the acti.cles tE, tie made in such manger as they shall agree, r'c)l'17T1[; A11 the rest-, I'E'S1(:}Uc and x•emainder of mti• est.r,Le. r.l~e~ther real personal or m.i~eci, and wFleresoevzr situate, T give, ~levise~ and bec~ucath as follows: 2 O1/Ui20U2 14:2' F~,;~ 1°1467°3647 PaCC PCG OIL CIT'r' ~ ED BF,''IICH ~U04;'G05 1. One-seventh (1/7) to my daughter, PAUL,, THERESE CULT3ERTSON; 2. Une-seventh (1/7) to my daughter, BARBARA MAE S}i,ELLY; 3 . One-seventh ( 1 /7 ) to m5• granddaughter, MArIlr SIiELLY; 1. One-seventh (1/7} to my granddaughter, MEGHAN SkELLY; 5. One-seventh (1/7) to my grandson, STEPHEN S}iELLY; 6. One-seventh to my grandson, CHRIS CC]LSERTSON; and 7, Cane-seventh (1/7! to my grandson, GREG CUhBERTSON. FIFTH: In the e~•ent of the death of any of my daughters or grandchildren herein named prior to my decease, then the share of my estate to which said deceased beneficiary would have otherwise been enritlE~d shall vest in her or hzs children, per' stirpes, SIXTH: Any share hereunder which becomes di.str-ibutable to a person unt-ier the age of twenty-three (23) years shall be held by FIRST SENEGA BANK, with an office in Oil Gity, Venango County, Pennsylvania, IN TRUS'T', until such person becomes twenty-three (23) years of age, lender the fo}.,lowing terms and conditions: A. hfy Trustee shall, without the necessity ~f arly approval or Order of any Court apply such amounts of income rind/or principal as to m,y Trustee, in its sole discretion and absol.ut.e judgment, seems fit and proper for the care, maintenance, support and cocuplete educt~tion of such person, and shall accumulate any unexpended balance of income. The Trustee may pr~~•, distribute or appli•, the wholN or ~.nv pr,rt of t.h_~~ inr;~~mu ,ztu~ prirrci),al zit anti•time held for su~:h }~eneficiar~-, invluding e,ceumulated ~rlc:ome, to or fclr the support, educ:e.t,ic~n, k~ceaT t.h and welfare of such beneficiary eit}rer by maltiinh pa~•ment ;~ O1,.%Oi;'2UU3 14:21 F~~;~; 1°1467^o364i P(CC PCG OIL CITY ; ED E~~'r'ICH ~OUS;'(i0,y or ciistributian thereof directly to the person or insti,tutiorL. providing such services, to any guardian or legal representative of said beneficiary whereever appointed, to the parent or other pez•son maintaining such beneficiary, to any educ:ationa.l institution for the payment of tuition, books, materials, room and board, or directly to the beneficiary. Should the share of a person under the age of twetlt•y-three (23) years, in the sole and absolute judgment and discretion of Lny Trustee, be or become too small to warrant. continuing st[ch hand in trust, or should its administration be or become impra~~tical for any other reason, my Tx-ustee, in its sole a[ZL1 absolute discretion, may deposit such share in the name of the person under tsoenty-three t23~ years in a savings account s.nd/or savings certificates in a savings institution of their choosing, payable to said beneficiary when he or she attains the age of twenty-three (23) years; SUBJECT, HOWEVER, to the au thor i t•y and power of said Trustee to wi thdrat~ at any tirne or from time t.o time sums from said savings account and/or savings certificates and appl,v the same for the care, maintenance, support and complete education of such. beneficiary. It is my i.nt.ent that in making any disbursements hereunder my Trustees sh~~L.l tape int,cr consliie'ratlorl all sources of income of SUCK [~L`L~tiur~ unriL~r the aKe of twenty--three ('L3 ) years and a.ll ut,1 i~,xt ions of ot.hc~r pF:r•5ons fL~r thE~ support of such ~ ~y Ll c : t 1 ~ 1 F l I' ~- . H. :\s oach hFneficiary attains the age of tr,e~nt.y-r.hreL~ ('L3) ~•ears, his or her trust shall terminate and the principal )1 /O i ,:'2002 14:27 F~,;•'. 1 ^0146783647 NCC PCG OIL CIT''r' ; -ED EA'r'ICH - ~UbEiUC~9 of said trust, and any undistributed income, shall be paid to him or her free of trust, C. Zn the event that any of said benefi~iar•ies shall have died prior to the termination of the trust, the share to ~-•hich he yr she would have been entitled otherwise shall vest in and be distributed to that child or children's issue, per st..irpes, or if no issue, to his or her brothers or sisters, per stirpes. D. All interests hereunder, whether principal or income, While undistributed and in the possession of m,y Executors and Trustee, and even though vested or distributable, shall nut be subject to attachments, execution or sequestrration for any debt, c:ontraet, obligation or liability of any beneficiary, and furthermore shall not be subject to pledge, assignment, conveyance or anticipative, E. The word "issue" as t.rsed herein shall include persons bo>:•n or adopted after the dnCe of execution of this Will and prior to the time fixed for the determination of the class. F. 'The Trustee shall receive as compensation for its services such reasonable sum or sums of money as may be CommE~nst.tratE t.ith the duties it performs, and cahich curn~.,en5a t. iC~n . may i nclude a c:ornmission computed on income ~irid c~orptis, ~iud sh:~ll be in accordance with its schedule of c_om~~r•nsat. iun iri r.t~Cect ~~+heri the scrvicey ate ~aer•formed. c;. 't'he '1'~•ttstef~ hercin•above r-amed shall have all of the rights , ~~~,w~ r5 , and privileges , rind also be Kuidea by t}ie S - u ~;' V i ; 'LUUI; 14 : ~~; FA;+', 131467E3647 NCC PCG OIL CIT'E' 3 ED BA''~ICH ~i 00 i i'009 duties and limitations given to it by the "prudent man" statute or statutes of the Commonwealth of Pennsylvania. EI. In the event that FIRST SENECA BANS shall be unabJ.e or decline to act and shall not choose to implement the savings account opti.~n above set forth, I then nominate, constitute and appoint my attorney, JOHN E. ELAN, of Franklin, Pennsylvania; as and for said Trustee, with all the game powers, duties and discretions herein given and conferred to FIRST SENECA BANK. SEVENTH: I direct that all estate, inheritsnce and other takes in the nature thereof, together with any interest and penalties thereon, payable because of my death with z•espect to the property constituting my gross es Gate for death tax purposes, rahether or riot. such property passes under this Will, shall be paid from the principal of my residuary estate. At anY time prior to the vesting of a Future znterest in possession and enjoyment, my Executor or Trustee to whom my residuary estate has been distributed, shall have the discret~.on to elect to prepay all or any part of the death taxes thereon, and such election shall be binding upon all parties in interest. EIGHTH: I hereby nominate, constitute and appoint FIRST SENECA EA~'h, Oil City, Venango County, Penns,y-lvania, and my attorney, JOHN E. EC;AN, as Hnd for the Ctiecutors of this, my Last Will and Testament. In the event, that eitEtrt• of S,~i~i nt~mc~d Executi>rs shall bt; unat~le c~r• rJrc~1 ine t.o ~:c~L, ! c3ir•e~:l. l.hat thF~ r.-r>maininF Executer shall acL alUtlr. ~[N'I'FJ: i clir~ecr: r,hrit t.tr«~ ficiuc:iar-ies herein numiridttd by rnr~ ~h>.tll rrot hc_ required t~~ Ji.vF• E,~rt~.l For the performance of their Fi ol/~~r/20~8 14:28 F~,~4 18146183647 FICC PCG OIL CIT4' ; ED EP,'•rICH ~i U08;~'O~iy f'~-' ~ :vbs. ~• • duties as such fiduciary, and further provide that said fiduc7.aries sha].1 have the authority to sell any and all real estate of uhioh I may da.e seized and possessed at public ox private sale IN wTTNESS WHEREOF, L have hereunto set my hand and seal this z6th day of April 1986. _~~ ( SE.~L ) ~'auJ. B. Ossoff Signed, sealed, published and declax-ed b,y the above-named PAUL B. OSSOFF, as and for his Last will and Testament, in the presence of us, .rho, at his renuest and in his prese~-ce, and in the presence of each other, have hereunto subscribed our names as witnesses- _ Residxn,~ at - ,~ j~ q ~~f . R E s i d i n~ a t ,f ~.~ F ~,~(A A~f.~ i ~~~-! ~- --- _, 1~~~~ { 01;`U rf2003 14:26 Fkt~ 16146723647 ttCC PCG OIL CITY ~ ED Ek'•IICH ~ 003;'GU5 - ........ ~ , . ..y^~~.. j cart^lU;~wEaLTH of pEKNSYLVANIA: 5S. C'OUN"fY OF' VENANGO We , PAUL B . OSSOFF , JDHN E. EGAN and KATHERYN L. CAMPBELL, the Testator and witnesses, respectively, whale names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority, that the Testator signed and executed the instrument as his Last Will and Testament, that he e~:ecuted the same as his free and voluntary act far. the purposes therein expressed, and that each of the witnesses, in the press.-nee snd hearirYg of the Testator, signed the Will a5 ioitriess, :incl t}iat to the best of their knowledge, the Testatoz- was at that time eighteen years of age or older, of sound a-ind, and under no constraint or undue influence. ~~ ~~• . ter` ~"'_~'. ~ ~.,,J,1R~~~'~' aul S. Ossoff LLB- ~~J ~_ i~-~--_ /_ _,_ hri E_ Egan iCatheryr~ L. Campbe ~~~~~ Subscribed, sworn to and acknow,le~lged before me by Pr~.UL B, OSSOFF, the '1'es to to r , and by JOHN E. EGAN and KATHERYN L. CAMPBELL t~it.nesses, this 26th__ day of _A~r~l _____ 1988, Myr e F. i_epley utar,y Piab.f_ ic:: Fr klin, Venango County, Pennsylvania My eUmn~is5i~~n etir~i,i•es: February 1, 1989 ~i f Estate Valuation for National City Bank Investment Management Agency Account #46P14785003. 3 ~~-___ ~~ L ~-' ~ ~ JCL ~w`~ ~ G~~t. , Estate Valuation , Date o~ Death: 01/06/200$ Estate oz: OSSOFF, PAUL AGENCY Valuation Date: 01/06/2008 Account: #46-P1-4785-00-3 Processing Date: 01/11/2008 Report Type: Date of Death Number of Securities: 30 File ID: OSSOFF, PP.UL AGENCY 1-6-08 46P19785003 Shares Security or Par Description High/Ask Low/aid I~ean &/or Adj`ments Div & Int Security Accruals Value 1) 100 ABBOTT LASS (002824100) CON! New York Stock Exchange 01/04!2008 56.59000 55.00000 H/L 01/07/2008 58.02000 56.00000 H1L 5b.402500 5,640.25 2) 100 ANHEUSER BUSCH COS INC (03522910 3} COM 1Vew York Stock Exchange 01/04/2008 52.69000 51.60000 H/L 01/07/2008 54.35000 51.89500 H/L 52.b33750 5,263.38 3} 200 AT&T INC (002068102} COM New York Stock Exchange 01/04/2008 41.77000 40.84000 H/L 01!07/2008 91.94000 40.98000 H/L 41.382500 8,276.50 4) 100 BP PLC (055622104) SPONSORED ADR New York Stock Exchange 01/04/2008 75.62000 73.58000 H/L 01/07/2008 75.28000 74.35000 H/L 74.707500 7,970.75 5} 200 BRISTOL MYERS SQUIBB CO {110122108} COM New York Stock Exchange 01/04/2008 26.07000 25.69000 H/L 01!07!2008 26.26000 25.78000 H/L 25.950000 5,190.00 0.31 E 01/02 R 01/09 p 0 2/01/08 62.00 6) 200 DOMINION RES IIQC VA NSW (25746010 9) COM New York Stock_ Exchange 01/04/2008 46.95000 46.08000 H/L 01/07/2008 47.71000 45.49000 H/L 46.805000 9,361.00 Page 1 This report was produced with EstateVal, a product or L'state Va?uations ~ Pricing Systems, Inc. If you Nave cuestions, please cont=ct SV? Systems at (818} 313-5300 or w>w~.evpsys.com. (F.evision 7.0.4) Date of Death: 01/05/2008 Estate of: OSSQFF, PAUL AGENCY Valuation Date: 01/06/2008 Account: X46-P1-4785-00-3 Processing Date: 01/11/2008 Report Typ°: Date or Death Number of Securities: 30 File ID: OSSOFF, PAUL AGENCY 1-6-OS 46P14785003 Shares Security Mean &/or Div & Int Security or Par Description High/Ask Low/aid Adj'ments Accruals ~ralue 7) 100 DU °ONT E I DE NEMOURS & CO (263539109) COM New York Stack Exchange 01/04/2008 43.92000 43.00000 H/L 01/07/2008 43.69000 42.57000 H/L 43.295000 4,329.50 B) 2400 GENERAL ELECTRIC CO (369604103) COM New York Stock Exchange 01/04!2008 36.67000 35.98000 H/L 01/07/2008 36.50000 35.91000 H/L 36.265000 87,036.00 0.31 E 12!20 R 12/24 P 01/25/08 744.00 g} 200 HONEYWELL INTL INC {938516106} COM New York Stock Exchange 01/04/2008 60.17000 58.12000 H/L 01107/2008 58.82000 56.87000 H/L 58.495000 11,699.00 10} 150 JOHNSON & JOHNSON (478160104} COM New York Stack Exchange 01/04/2008 66.40000 55.72000 H/L 01/07/2008 67.21000 65.75000 H/L 66.270000 9,940.50 11) 575 JP MORGAN CHASE & CO (46625H100} COM New York Stock exchange 01/04/2008 41.80000 40.63000 H/L 01/07/2008 41.58000 40.16000 H/L 41.042500 •23,599.44 0.38 E 01/02 R 01/04 ? 01/31/08 218.50 12) 608 NATIONAL CITY CORP (635405103) COM New York Stock Exchange 01/0412008 15.20000 14.46000 HIL 01107/2008 15.49000 14.41000 H/L 14.8?0000 9,053.12 Dage 2 Th1S reDOrt Wd5 prOaUC2d W1ti7 i5t3~eGal, G prO~llCt OL LStct2 V31ll2tlOnS & Pricing systems, Inc. If you have questions, please contact FJP Systems at (818) 313-6300 ar www.evcsys.com. (Revision 7.0.4} Date o= Death: 01/06/2008 Estate of: OSSDFF, PAUI4 AGENCY Valuation Date: 01/06/2008 Account: X46-P1-9785-00-3 ' Processing Date: 01/11/2008 report Type: Date of Death Nu=nber of Securities : 30 ` File ID: OSSOFF, ?'AUL AGENCY" 1-5-08 96P14785003 5haxes Security Mean &lor Div & Int Security or °ar Description High/Ask Low/Bid Adj'ments Accxuals Value 13) 100 PEPSTCO II4C {713496108) COM New York Stock ixchange 01/04/2008 76.40000 75.29000 Ii/L 01/07/2008 77.99000 75.70000 H/L 76.207500 7,620.75 14} 824 PI3C FINL SVCS GP.OUP INC (693475105) COM New fork Stock exchange 01/04/2008 63.57000 52.45000 H/L 01/07/2008 69.03000 61.66000 H!L 62.927500 51,852.26 15) 6000 PPL CORP (693517106} COM New York Stock Exchange 01/04!2008 52.05000 50.57000 H/L 01/07/2008 52.94000 51.67000rI/L 51.807500 310,645.00 16) 100 ?ROOTER & rAMBLE CO (742718109) COM New York Stock Exchange 01/04/2008 72.99000 71.70000 it/L 01/0712008 72.67000 71.90000 H/L 72.315000 7,231.50 17} 150 SYSCO CORP (871829107) COM New York Stock Exchange 01/04/2008 30.51000 30.12000 H/L 01/07/2008 30.67000 30.25000 i-I/L 30.367500 4,553.13 0.22 E OI/02 R 01104 P 01(25106 33.00 16) 150 US BANCORP DEL {902973304) COM NEW New York Stock Excha,-~ge 01/04!2008 30.20000 29.38000 T~/L 01/07/2008 30.05000 29.18000 i?/L 29,702500 4,955.38 0.925 E 12/27 R 12/31 P 01!15/08 63.75 Pzge 3 This repot was produced with EstateJal, product cf Estate \~c1L'2t10P_S ~ ?riCiP_g JVSteS1S, ?nC. ?f yOll have ?'C?St10T]S, Dlease CGFItaCt MVP Syst°~S at (813) 313-5300 or w•wrw.e~=DSys.com. {Eevision 7.0.4) -,:~ ;'; '` Date of Death: 01/06/2008 Estate of: OSSOFF, PAUL AGENC'Y' , Valuation Date: 01106/2008 account: X96-P1-4785-00-3 ~.~ Processing Date: O1/1112008 Report Tyne: Date of Death ' Number of Securities: 30 k,~ File ID: OSSOFF, PAUL AGENCY 1-6-08 46P14785003 Shares Security itean &/or Div & Int Security oz Pa?- Description HighlAsk Low/Bid Adj'ments Accruals Value 19} 366 VERIZON COI~iMUNICATIONS (92343V104} COM New Yark Stock Exchange 01/04/2008 43.63000 42.51000 H/L 01/07/2008 93.57000 42.76000 H/L 93.117500 20) 26909.205 ALZEGIANT FDS {01748E740) PA INT MUIQBD I Mutual Fund {as quoted by NASDAQ) 01!04/2008 10.99000 10.490000 0.005$9799 E 01/06 R 01/06 P 02/01/08 15,781.01 282,225.11 158.68 21} 10000 DOYZESTOWN PA H05P AUTii HOSP R HOSP REV (261333CS5) Financial Times Interactive Data DTD: 12/15/1993 Mat: 07/01/20].4 5~ 01/04/2008 100.15500 Mkt 01/07/2008 100.15500 Mkt 100.155000 10,015.50 Int: 0110112008 to 01/06/2008 6.94 22) 8551.993 SSI TAX EXEMPT TR (784118507) PA MUN PTt ?1 Mutual Fund (as quoted by NASDAQ) 01104!2008 10.44000 10.440000 89,282.28 0.00682329 E 01105 R 01106 P 02/01108 58.35 23} 20000 TUNKHANNOGK PA AREA SCH DIST G.O. BDS (899781BL1) Financial Times Interactive Data DTD: 02/15/1998 Mat: 07/15/2015 5.05 01/04/2008 100.03600 Mkt 01/07/2008 100.03000 Mkt 100.033000 20,006.60 Int: 07/15/2007 to 01106/2008 479.75 29) 1200 VAN I{AIJPEN TR INSD MUNS (920928108) COM New York Stock Exchange 01/0412008 14.19000 14.07000 H1Z 01/07/2008 14.25000 14.02000 :~/L 14.1^_2500 16,571.00 Page m This reTJOrt was produced with EstateVal, a product of Estates Valuations ~ ?ric?ng Systems, Inc. _Tf you have questions, pleese contact EVP Systems at (818} 313-6300 0?- S.naw.evpsys.com. (3evision 7.0.9} Date,of Death: 01/0612008 estate of: OSSOFF, PAUL AGENCY Valuation Date: 01106/2008 Account: n46-P1-9785-00-3 Processing Date: 01/11/2008 Report Type: Date oz Death 14umber of Securities: 30 File ID: OSSOFF, PAUL AGENCY 1-6-08 46P14785003 Shares Security Mean &/or Div & Int Security or Par Description High/Ask Low/Bid Adj'ments Accruals Value 25) 700 VAN KP.IJPEN TR IIdVT GRADE IsUNS (920929106) C OM New York Stock Exchange 01109/2008 14.50000 14.38300 H/L 01/07/2008 14.52000 19.37000 H/L 14.493250 10,110.28 26} 3607 VP.24 KAMPEN PA VALUE MUM INCOME (921127108) COM New York Stock Exchange 01/04/2008 13.56000 13.41000 H/L 01107/2008 13.62000 13.50000 H/L 13.522500 48,775.65 27) 10870.807 VANGUARD MUId BD FD INC {9229Q7100) SHORT TRM PORT Mutual Fund (as quoted by NASDAQ) 01/09/2006 15.69000 15.690000 170,562.96 0.00860416 E 01/06 R OZf06 P 02/01108 93.53 2$) ALLEGIANT PA TAK EX MONEY MF.T cUND (EVP0001) 0.00 ACCRUED ON $36,556.28 14.50 29) ~ DRINCIPAL ACM T PRIIJCIPAL CASH (EVP0002J 29,991.39 INCOME ACM + INCOME CASH 6,619.94 30} ACCRUED FEE CHARGEABLE TO PRINCIPAL (EVP0003) 0.00 ACCRUED FEE CHARGEABLE TO P_JCOME -1,303.08 Total Value: $1,267,094.20 Total Accrual: $7,249.86 Total: $1,274,339.06 ?age 5 TINS ~2DOrt w~5 produced Yd1tI? ESta~~Val, a T7rOdllCt 02 EStat? V31L2c~1.On5 & ?t1C2'_7C} jMJStcIRS, I::c. T_ 1jOll I2?'v° ~jL1c5t10r15, D12aSc'' CGn~3C~ ?;~%P 5ys~~ms dt (a1a) 313-6300 or "vF'hrh~.°VpSyS.C^'d. (R~vision 7.0.?)