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HomeMy WebLinkAbout03-0857 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of WARREN A. KIENZLE No. ~ / '- O ~ '"' o~'~..~ also known as , Deceased Social Security No. 103-18-7075 Petitioner(s), who is/are 18 years of age or older apply(les) for: COMPLETE "A" OR "B" BELOW:) [] A. Probate and Grant of Letters and aver that Petitioner(s) is the executor named in the Last Will of the Decedent, dated April 18, 2001 and codicil(s) dated N/A State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: [] B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLr- I I: IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 3 Hemlock Circle, Mechanicsbur.q~ Upper Allen Township, Cumberland County~ PA 17013 (list street, number and municipality) Decedent, then 79 years of age, died October 13, 2003, at 3 Hemlock Circle~ Mechanicsbur.q~ Upper Allen Township, Cumberland County, PA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property ................................................................................ $ (If not domiciled in PA) Personal property in Pennsylvania ............................................ $ (If not domiciled in PA) Personal property in County ...................................................... $. Value of real estate in Pennsylvania ................................................................................................... $ 130,000.00 Total ..................................................................................................................................... $ 130:000.00 Real Estate situated as follows: 3 Hemlock Circle, Upper Allen Township, Cumberland County, PA Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature ]'¥~,,e/d.~or printed name and residence J ~l,,~.~.,,~ /'~,,~./.~. '~i~Js'topher W. Kienzle ~/)~;~ b). ~ 512 Prestwyck Haven, Canton, GA 30115 / PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF THE ESTATE IS NOT COMPLETED, FILE A 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: WARREN A. KIENZLE Date of Death: October 13, 2003 Will No. Admin. No. 21-03-0857 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate. 1. State whether administration of the estate is complete: Yes [] No [] 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: _. 3. If the answer to No. i is Yes, state the following: a. Did the personal representative file a final account with the Court? 'Yes [-] No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes [] No [] d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: /e"/r~-//~' ~/~~~ Signature ~.' :-: Vicky Ann Trimmer, Esquire ~'~ Name (Please type or print) c~ 3401 North Front Street, P.O. Box 5950 ~-- Address .:. .-?_ . ._." Harrisburg, PA 17110-0950 ..... (717) 232-5000 Telephone Capacity: [] Personal Representative [] Counsel for Personal Representative 409511vl Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly admini~t,ef' the e~,tate according, to law. Sworn to and affirmed and subscribed (~,;~,. ~,~. ,~, ,~,z~ before me this ].6th day of '4/'¢J~Christopher W. Kienz~J' October ,2003 ~j~;, /13~J~ C~/~r/~ ~',.~,"-"~/~ Donna M. Otto,lst Deputy .~ n ^ ,~ Illl' I ---11 ' D~'CREE OF REGISTER ' ~' Estate of Warren A. Kienzle , Deceased No. 21-2003-857 also known as Social Security No.: '103-'18-7075 Date of Death October '13, 2003 AND NOW, October 20th ,2003, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [] Testamentary [] of Administration (_c.t.a.; db.n.c.t; pendente lite; durante absentia; durante minodtate C~isto~her Warren Kienzle a/k/a ) are hereby granted to Christopher W. Kienzle in the above estate and that the instrument(s), if any, dated April '18, 2001 described in the Petition be admitted to probate and filed of record as the Fast Will of Decedent. Letters $ 235.00 ~'" ~;/z f"fZ/ .................................. -_' ..... Regi~ter0fV~ills// --_/) .Z_J')-' - Short Certificate(s) .... I0 .......$ 30.00 L~30~a M. Otto 1st Depu~ "' ~ Renunciation ........................ $ Affidavit ( ) ......................... $ Extra Pages (11.) ................ $ 33.00 Codicil .................................. $ JCP Fee ............................... $ 10.00 Inventory & Tax Forms ........ $ Attorney: Vicky Ann Trimmer, Esquire Other .................................... $ I.D. No.: 49679 3401 North Front Street TOTAL .................... $ 308.00 Address: Harrisburg, PA 17110-0950 Telephone: 717-232-5000 l~i]ed Lette~to Attorney DATE FILED: October 20th, 2003 on 10/20/2003. 382230vl 105.805 REV 9186 This is to cerdfy that the information here given is correctly copied £rom an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanem fiting. WARNING: It is illegal to duplicate this copy by photostat or photograph. 9640743 No. ~ Dat'e H10§ 144 I~ev 1/91 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS T~PE/PB,NT CERTIFICATE OF DEATH ~N (Coroner) PERMANENT 1/29-126 BLACK INK ~,[r'enu ........ A, u ....... K~ZJRTeH a. Male "frO3--Iff 7075 ,.October l~, 2003 i t ~ " [7. /~ ~ ~* [~ I ~ ~ ~s~ence ~ I~,fy) TY O ~H I CI~. ~F ~H [F~ILITY NAM~ (fl ~,o~ ~aShluhen. ~,ve sl~eel ~ ~um~) I~S ~CE~NT OF HIS~N~ ~IN?' Cumberland ~.Upper Allen ~.3 Hemlock Circle ~ ..... P,~oR-,.,~ ,.~ ~ :iv c~e) - ~ t · I 114. _ ~ 115. I ! ............. aprx. Io ..... ONO ....... ~ ............. ) ~c~ ....... mME~LE ...... ~mO 4:30 P ~.[=~.Oc~ober 13~ 2003 *"~ ,..~,,,~.,~,N~ . Occlusive Coronar7 ~rter7 Disease COPD n ~ I n n I~m ~ P.~m;m..s,,p,~.~1,~. I~. M. Ira. c~,~ c~ '"' ~ ~ ~ '~ / · ~'t*~.~~.~.~.~m~,~,~,~,~,~ .......................... ~ n~. a~.October 1~ 2003 Oflthebl~olex~l~t~nl~or~voM~tlofl, nmyoplnlofl,~llh~curr~llt~tlme date afldpl~e andduetothlClUle(i)~6375 Basehore Road, Suite =~..=,nn.,a.m~ ............................................................. '....~ ........ : ....................... ~ Hechanicsburg, Pa. 17050 < 21-2003-857 OF WARREN A. KIENZLE I, WARREN A. KIENZLE, County of Cumberland, Commonwealth of Pennsylvania, being of sound and disposing mind and memory and realizing the uncertainties of this life, do hereby make, execute, publish and declare this to be my Last Will and Testament in the manner and form following: FIRST: I hereby revoke, cancel and annul any and all Wills, Codicils and instruments of a testamentary nature heretofore made by me at any time. SECOND: I direct that all of my just debts and funeral expenses be paid by my Executor, hereinafter named, as soon as conveniently possible after my decease. TI-IIRD: I give, devise and bequeath all of my personal effects in accordance with the list attached hereto. Page1 l~.d (~ ~ FOURTH: All the rest, residue and remainder of my estate and whatsoever nature and whatsoever situate which I may own at the time of my decease, I give, devise and bequeath to be split equally among my son, MICHAEL CHRISTOPHER KIENZLE, and my son, CHRISTOPHER WARREN KIENZLE. FIFTH: In the event my son, MICHAEL CHRISTOPHER KIENZLE, shall predecease me, I direct that his shares be split equally among his then living children, and if he has no children, then I direct that his share be split equally among my other then living grandchildren subject to the provisions for a Trust for Minor Children set forth below in Item Seventh. SIXTH: In the event my son, CHRISTOPHER WARREN KIENZLE, shall predecease me, then and in that event, I direct that his share be distributed to my daughter-in-law, JOANNE E. KIENZLE, provided she is still living with and married to my son, CHRISTOPHER WARREN KIENZLE, at the time of his death. In the event that my daughter-in-law, JOANNE E. KIENZLE, predeceases me or is not living with and married to my son at the time of his death, I direct that this share be split equally among the then living children of JOANNE E. and CHRISTOPHER WARREN KIENZLE subject to the provisions for a Trust for Minor Children set forth below in Item Seventh. In the event that my son, CHRISTOPHER WARREN KIENZLE, my daughter-in-law, JOANNE E. KIENZLE, and all their Page 2 ~kO ~,,. ~X~,x, children predecease me or fail to satisfy the conditions contained herein, I direct that this share be distributed to my son, MICHAEL CHRISTOPHER KIENZLE, in accordance with Items Fourth and Fifth hereof. SEVENTH: For minor grandchildren who have not attained the age of twenty-one (21), I direct that their respective shares be given to my son, CHRISTOPHER WARREN KIENZLE, to be held in separate Trusts to hold, manage, invest and reinvest the share so received not limiting the Trustee to investments which are legal in the state of the minor grandchild's residence. The Trust funds shall be used for the following purposes: (a) I direct that the Trust estates be divided as set forth above and that separate and distinct Trusts be created for the benefit of minor grandchildren under the age of twenty-one (21). (b) The income from each share shall be used for the health, maintenance, comfort, general welfare and education of the minor grandchildren. My Trustee, in the exercise of his discretion, shall have the right to withdraw such installments of principal as may be necessary for the health, maintenance, comfort and general welfare of the minor grandchildren and to provide a college and/or professional school education for each of the aforesaid minor grandchildren; the necessity and propriety of such withdrawal and the amount thereof to be determined by the Trustee and his determination shall be final. The income from each share shall be payable to the Trust subject to the provisions set forth herein until each grandchild shall have reached the age of twenty-one (21) years. Undistributed income shall be added to principal. After each of the minor grandchildren have reached the age of twenty-one (21), the income from his or her share shall be paid to him or her directly. (c) When each minor grandchild attains the age of twenty-five (25) years, he or she shall receive one-third of the then remaining principal of the aforesaid Trust; at the age of thirty (30) years, each grandchild shall receive one-third of the then remaining principal of his or her aforesaid Trust; and at the age of thirty-five (35) years, each grandchild shall receive the remaining principal of his or her aforesaid Trust, at which time each Trust shall terminate. (d) If any of the minor grandchildren shall have reached the age of twenty-one (21) years and a business opportunity arises in which he or she decides to become a part, my Trustee, if in his discretion he sees fit, may take from the remaining share of the Trust of said grandchild such amount as he deems advisable, even to the extent of depleting the Trust for the respective grandchild, and at that time turn said amount over to said grandchild. My Trustee shall not be subject to any liability whatsoever as a result thereof. (e) Should any of the minor grandchildren die before full distribution has been made, and should he or she fail to leave issue surviving him or her, then and in that event, I direct that the remainder of the share to which the grandchild would normally have been entitled shall lapse and become void and the remainder shall be paid to the surviving grandchild's brothers and sisters in equal shares. In the event, however, that any of the minor children shall die leaving issue who survive them before full distribution has been made, then and in that event, I direct that the remainder of the share to which the grandchild would normally have been entitled shall be paid to the issue of my grandchild, in equal shares. (f) No beneficiary, nor my Trustee, nor any creditor of the beneficiaries or the Trustee, shall have the right to alienate in any way any part of the income or principal of any individual Trust and payments from the Trustee shall be made directly to the beneficiary or deposited in a bank to his or her credit, free from the interference or control of the creditors of any beneficiary or the Trustee. Page 5 EIGHTH: I hereby grant to my Executor and Trustee with respect to any and all property, whether real or personal, of which I am the owner at the time of my death, or which shall at any time constitute a part of my Estate, or any Trust created hereunder, the following powers, subject to the terms of the Trust herein created: (a) To retain such property as an investment, without regard to the proportion such property or properties of a similar nature so held may bear to the entire amount of my Estate or any Trust created thereunder. (b) To sell such property, at either public or private sale, for cash or credit; to exchange such property and to grant options for the purchase thereof. (c) To retain any legal or non-legal security so long as they deem it to the best interest of the estate to do so, and to make such investments for the purpose of the Trust which, in their judgment, may seem right, safe and proper, notwithstanding the fact that such investments are not legal investments for trust funds in Pennsylvania. The exercise of these powers shall be without liability on the part of my Trustee for any loss which may result from so doing, except for gross negligence on the part of my said Trustee. (d) I direct that my Executor and Trustee shall have full power to sell, lease, repair, mortgage, pledge, invest, reinvest, exchange, manage, control and in any way use and deal with any and all property of my estate subject to the terms of the Trust herein created without any application to any court, judge or justice thereof, for leave or confirmation unless the same shall be expressly required by law and shall be unavailable even by this provision of my Will. NINTH: I order and direct my Executor to pay all transfer, inheritance, federal, estate, death, succession and legacy taxes to which my estate or the transfer of any property hereinunder may be subject and to charge such taxes as part of the expense of administration and to pay the same from my residuary estate. TENTH: I hereby nominate, constitute and appoint my son, CHRISTOPHER WARREN KIENZLE, Executor of this, my Last Will and Testament. In the event that he should predecease me, die with me in a common disaster or for any reason whatsoever be unable to act as such Executor or after his appointment as such Executor be able to continue to act for any reason, then and in that event, I hereby nominate, constitute and appoint my son's wife, JOANNE E. KIENZLE, as Executrix of my Last Will and Testament. It is my Will and I do so direct that neither of my Executors herein named shall be required to file any bond, security or other undertaking for the faithful performance of any duty imposed upon them as such Executors. Page IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding seven (7) pages, at the end of each page of which I have also set my initials for greater security and better \~day of (~x~ ,2001. identification this WAR'I~N A. KIE~Z'L~, ' 1 ~ - -- (SEAL) Page 8 We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testator as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence and in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testator was of sound and disposing mind and memory. ~,~:~/~_.-4~/~~ (SEAL) Re sidingat _~'~/ ~ /L~. ' (SE~) Residing at _ _ ~ (SE~) Residingat Page 9 ACKNOWLEDGMENT COMMONWEALTH OF P~N~NSYLVANIA ) ~(~ L,/~/~'~'~'~ ) SS: COUNTY OF/~/~d--7-- ) I, WARREN A. KIENZLE, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. .kJ~KA~~ x~ (SEAL) WARREN A. KIE~zL~ ,/ Sworn to and ~subscribed before me this_. ,-----~-/~' ~(~day of , .OOl. My Commission Expires: (SEAL) Notarial $oal Margarot L Boyd, Nota~ Public Susquohanna Twp., Dauphin Ooun~ My Commission E×pko$ ,Juno 27, 2004 Member, Pennsylvania Association ot Notaries Page 10 AFFIDAVIT COMkMONWEALTH OF PENNSYLVANIA ) . ss: COUNTY OF and (~:kkk, ~ ~.~& , the ~Vi-t~es~es whose names are signed to the attached or foregoing in~s rument, being duly qualified according to law, do depose and say that we were present and saw Testator, WARREN A. KIENZLE, sign and execute the instrument as his Last Will and Testament; that Testator signed willingly and that he executed said Will as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as Witnesses; and that to the best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ~'{Vitn~ss ,Witness Sworn to and-subscribed before me this/_~_~ ~lay of . 2001./' Notary Public My Commission Expires: Notar a Seal ~ Margaret L. Boyd, Notary Public [ Susquehanna Twp., Dauphin County ~ (SEAL) My commission Expires June 27, 2004 ~ Member, penn.~vania Association et Notaries Page 1 1 LIST OF SPECIFIC BEQUESTS TO ACCOMPANY THE LAST WILL AND TESTAMENT OF WARREN A. KIENZLE List of specific bequests to personal property and/or cash sums and names or persons and/or organizations to whom such bequests are made: I bequeath to the following items: I bequeath to the following items: I bequeath to the following items: I bequeath to the following items: I bequeath to the following items: Date: (SEAL) WARREN A. KIENZLE :153319 _1 WARREN A. KIENZLE METTE, EVANS & WOODSIDE Attorneys at Law HARRISBURG, PENNSYLVANIA 17110-0950 CERTIFICATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: WARREN A. KIENZLE Date of Death: October 13~ 2003 Will No. Admin. No. 21-03-0857 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on October 29, 2003: Name Address Christopher Warren Kienzle 512 Prestwyck Haven, Canton, GA 30115 Michael Christopher Kienzle 122 Sayford Street, Harrisburg~ PA 17102 Notice has now been given to all persons entitled thereto under Rule 5.6(a). Date: October 29, 2003~ Signature Vick¥ Ann Trimmer, Esquire Name 3401 North Front Street Harrisburg, PA 17110 Address (717) 232-5000 Telephone Capacity: Personal Representative ~X Counsel for Personal Representative 383377vl REV-I~00 EX (6--00~' OFFICLAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN F,LENUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 -- 2003 085'7 CouN3~' CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I-- Kiez~z~.e, Wa=z:en A 103-18-7075 Z I.LI DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE U.I 10/13/2003 12/28/1923 REGISTER OF WILLS iii (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER "' I×1 I I2. Supplemental Return ~- 1. Odginal Return [~ 3. Remainder Return (date of death prior to 12-13--82) ,,~ nO~ r-~ 4. Limited Estate J---1 4a. Future Interest Compromise (date of death after 12-12-82) [~1 5. Federal Estate Tax Return Required ~ ~O~ ~ 6. Decedent Died Testate (Attach copy of Will) [~] 7. Decedent Maintained a Living Trust (Attach copy of Trust) 1 8. Total NumDer of Safe Deposit Boxes a. ~ 9. Litigation Proceeds Received '~ ~ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) [~] 11. Election to tax under Sec. 9113(A)(Attach Sch O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULn BE DIRECTED TO: z NAME COMPLETE MAILING ADDRESS uJ O 3401 [',T ~'z:or~t a. FIRM NAME (If Applicable) · "' PO ]~ox 5950 ,,, t,'Ie'c~,e, ]~'~ans & Woods±de o TELEPHONE NUMBER I-Iaz:z::i.$]3uz:g', PA 3.7110-0950 73.?-232-5000 1. Real Estate (Schedule A) (1) 3. 5 9 f 5 0 0 o 0 0~';- OFFICIAL US~;O~¥ 2. Stocks and Bonds (Schedule B) (2) 0.00 3. Closely Held Corporation, Partnership or Sole-Propdatorship (3) 0 . 00 4. Mortgages & Notes Receivable (Schedule D) (4) 0 . 00 -.-r.~ . 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 3.41 ! 180. 14' Z 6. Jointly Owned Property (Schedule F) 0.0 0 O (6) ~-- ~] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 62,3-2 5. ?8 :::::) (Schedule G or L) ~' 362,805 92 ~ 8. Total Gross Assets (total Lines 1-7) (8) · U.J 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 3~ ~ ? 3. 8 . (~ 9 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 2,553.92 11. Total Deductions (total Lines 9 & 10) (11) 36,2?2.63. 12. Net Value of Estate (Line 8 minus Line 11) (12) 32 6 13. Ch aritable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (13) 0.00 14. Net Value Subject to Tax(Line 12 minus Line 13) (14) 326 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line14 taxable at the spousal tax 0o00 0 00 Z rate, or transfers under Sec. 9116 (a)(1.2) x .00 (15) · ~- 326~533.33- 3.4,694 00 < 16. Amount of Line 14 taxable at lineal rate x .045 (16) · ~ 0 00 0 00 D. 17. Amount of Line 14 taxableat sibling rate ° x.12 (17) O O 18. Amount of Line 14 taxable at collateral rate 0 . 00 x .15 (18) 0 . 00 X I-- 19. Tax Due (19) 3.4,694.00 · · BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 2w4645 lOOO Decede;tt's Complete Address: $7-t*,EET ADORESS 3 Hemlock Circle CITY I STA~E Z~f7 0 55 Mechanicsburq PA Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 14,694.00 2. Credits/Payments A. Spousal Poverty Credit 0.00 B. Prior Payments 13 f 765.00 C. Discount 724.47 Total Credits (A + B + C) (2) 14,489.47 3. Interest/Penalty if applicable D. Interest 0.00 E. Penalty 0.00 Total Interest/Penalty (D + E) (3) 0. O0 4. If Line 2 is greater than Line I + Line 3. enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 204.53 A. Enter the interest on the tax due. (5A). 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B). 204.53 Make Check Pa able to: REGISTER OF VVlLI. S, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................... ~ ['~ b. retain the right to designate who shall use the property transferred or its income; ......... [--'] ~'~ c. retain a reversionary interest; or ................................ d. receive the promise for life of either payments, benefits or care? ................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................ [-~ 3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? [~] ['~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ [~ r-~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this retum, incJuding accompanying schedules and statements, end 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. ADORESS ~lk~ Prestwyc~-Ha~en' Canton, GA 30115 SmGNATURE OF/pRE~RER O/~R THA~EPRESENTATIVE . DATE ~O~ESS 340t~N. Front Street, PO Box 5950 Harrisburg, PA 17110-0950 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the nat value of transfers to or for the use of the surviving spouse Is 3% [72 P.S.[} 9916 (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 sun, lying spouse is 0% [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 still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate Imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. § 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. § 9116(1.2) [72 P.S. § 9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decadent's siblings is 12% (72 P.S. § 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 2w4646 1.000 REV-1502EX + (1-97) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Kienzle, Warren A 21-2003-0857 All mai property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivomhip must be disclosed on Schedule F. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1. 3 Hemlock Circle, Upper Allen Township, Mechanicsburg, 159,500.00 C~mBerland County, PA. See attached settlement sheet. TOTAL (Also enter on line 1, Recapitulation) $ 159 / 500. O0 2w4695 2,0o0 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (1.97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF FILE NUMBER Kienzle, Warren A 21-2003-0857 Include the )roceeds 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 PNC Checking Account #5070080969 14,718.65 2 PNC Savings Account #5000728408 110,903.60 3 Travelers Checks found at residence 500.00 4 2002 Buick LeSabre 11,800.00 5 Household items and personal property 2,500.00 6 Reimbursement for taxes paid prior to settlement for sale of 757.89 real estated listed on Schedule A. TOTAL (Also enter on line 5, Recapitulation) $ 141,180.14 2W46AD 2.000 (if more space is needed, insert additional sheets of the same size) REV-1510 EX+ (1-97) SCHEDULE G COMMONWEALTH OF PENNSYLVANIA INTER-VIVOS TRANSFERS & INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Kienzlef Warren A 21-2003-0857 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. DESCRIPTION OF PROPE.~< ~ ¥ % OF ITEM INCLUDE THE i'%NVIE OF THE TRANSFEREE, THEIR RELATIONSHIP TO DATE OF DEATH DECD'S EXCLUSION DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE TAXABLE VALUE NUMBER DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPIJCABLE) 1. PNC IRA Account #75200014221 22,030.33 100.00 0.00 22,030.33 Beneficiaries: Christopher W. Kienzle and Michael C. Kienzle 2 MetLife Annuity Contract 40,095.45 100.00 0.00 40,095.45 #940012347 Beneficiary: Christopher W. Kienzle TOTAL (Also enter on line 7, Recapitulation) $ 62,125. '78 (If more space is needed, insert additional sheets of same size.) 2W46AF 2.000 REV-1511 EX +.11-97) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Kienzle, Warren A 21-2003-0857 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Neill Funeral Home, Inc. 9,569.46 2 Stephenson's Flowers 365.70 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 0 o 0 0 Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: 2. Attorney Fees Name: Mette, Evans & Woodside 7,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City State ~ Zip Relationship of Claimant to Decedent 4. Probate Fees 308.00 5. Accountant's Fees 0,00 6. Tax Return Preparer's Fees 0,00 7. Register of Wills - Additional Probate Fees 70.00 8 The Sentinel - legal advertising 108.95 9 Cumberland Law Journal - estate advertising 75.00 10 Jeff Sheesley - moving of household goods 1,300.00 11 Washovia Bank - bank fee 37.50 12 Christopher Kienzle - reimbursement for expenses 1,928.78 Tote k from continuation pages .... 12,955.30 TOTAL (Also enter on line 9, Recapitulation) $ 33,718.69 2W46AG 2.000 (If more space is needed, insert additional sheets of same size) Page 2 Estate of: Kienzle, Warren A 21-2003-0857 Schedule H, Part B -- Administrative Costs Item No. Description Amount 12 incurred to administer estate 13 2004 County/Township taxes paid at settlement of real 19.30 estate on Schedule A. 14 Settlement charges for sale of real estate listed on 12,894.00 Schedule A. See attached settlement sheet. 15 US Treasury - 2003 federal income tax 42.00 TOTAL. (Carry forward to main schedule) ...... 12,955.30 REV-1512 EX+ (1-97) SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESlDENTDECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Kienzle, Warren A 21-2003-0857 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 Comcast Cablevision 83.62 2 GM Cardmember Services 407.97 3 JF Moore Property Maintenance 198.40 40mnium Financial Receivable Service 155.61 5 Penn Mutual-unearned pension payment 1,222.83 6 PP&L Electric 132.04 7 Waste Management of Central PA 35.39 8 Terminix International 145.22 9 United Water of PA 75.24 10 Verizon 97.60 TOTAL (Also enter on line 10, Recapitulation) $ 2,553.92 2W46AH 2.000 (If more space is needed, insert additional sheets of the same size) R~V-1513 EYe+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Kienz;e, Warren A 21-2003-0857 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Kienzle, Christopher W. Son 183,314.38 512 Prestwyck Haven Canton, GA 30115 2 Kienzle, Michael C Son 143,218.93 122 Sayford Street Harrisburg, PA 17102 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 2W46Al 1.000 (If more space is needed, insert additional sheets of the same size) OF WARREN A. KIENZLE I, WARREN A. KIENZLE, County of Cumberland, Commonwealth of Pennsylvania, being of sound and disposing mind and memory and realizing the uncertainties of this life, do hereby make, execute, publish and declare this to be my Last Will and Testament in the manner and form following: FIRST: I hereby revoke, cancel and annul any and all Wills, Codicils and instruments of a testamentary nature heretofore made by me at any time. SECOND: I direct that all of my just debts and funeral expenses be paid by my Executor, hereinafter named, as soon as conveniently possible after my decease. THIRD: I give, devise and bequeath all of my personal effects in accordance with the list attached hereto. Page 1 ~, ..... FOURTH: All the rest, residue and remainder of my estate and whatsoever nature and whatsoever situate which I may own at the time of my decease, I give, devise and bequeath to be split equally among my son, MICHAEL CHRISTOPHER KIENZLE, and my son, CHRISTOPHER WARREN KIENZLE. FIFTH: In the event my son, MICHAEL CHRISTOPHER KIENZLE, shall predecease me, I direct that his shares be split equally among his then living children, and if he has no children, then I direct that his share be split equally among my other then living grandchildren subject to the provisions for a Trust for Minor Children set forth below in Item Seventh. SIXTH: In the event my son, CHRISTOPHER WARREN KIENZLE, shall predecease me, then and in that event, I direct that his share be distributed to my daughter-in-law, JOANNE E. KIENZLE, provided she is still living with and married to my son, CHRISTOPHER WARREN KIENZLE, at the time of his death. In the event that my daughter-in-law, JOANNE E. KIENZLE, predeceases me or is not living with and married to my son at the time of his death, I direct that this share be split equally among the then living children of JOANNE E. and CHRISTOPHER WARREN KIENZLE subject to the provisions for a Trust for Minor Children set forth below in Item Seventh. In the event that my son, CHRISTOPHER WARREN KIENZLE, my daughter-in-law, JOANNE E. KIENZLE, and all their children predecease me or fail to satisfy the conditions contained herein, I direct that this share be distributed to my son, MICHAEL CHRISTOPHER KIENZLE, in accordance with Items Fourth and Fifth hereof. SEVENTH: For minor grandchildren who have not attained the age of twenty-one (21), I direct that their respective shares be given to my son, CHRISTOPHER WARREN KIENZLE, to be held in separate Trusts to hold, manage, invest and reinvest the share so received not limiting the Trustee to investments which are legal in the state of the minor grandchild's residence. The Trust funds shall be used for the following purposes: (a) I direct that the Trust estates be divided as set forth above and that separate and distinct Trusts be created for the benefit of minor grandchildren under the age of twenty-one (21). (b) The income from each share shall be used for the health, maintenance, comfort, general welfare and education of the minor grandchildren. My Trustee, in the exercise of his discretion, shall have the right to withdraw such installments of principal as may be necessary for the health, maintenance, comfort and general welfare of the minor grandchildren and to provide a college and/or professional school education for each of the aforesaid minor grandchildren; the necessity and propriety of such withdrawal and the amount thereof to be determined by the Trustee and his determination shall be 15hal. The income from each share shall be payable to the Trust subject to the provisions set forth herein until each grandchild shall have reached the age of twenty-one (21) years. Undistributed income shall be added to principal. After each of the minor grandchildren have reached the age of twenty-one (21), the income from his or her share shall be paid to him or her directly. (c) When each minor grandchild attains the age of twenty-five (25) years, he or she shall receive one-third of the then remaining principal of the aforesaid Trust; at the age of thirty (30) years, each grandchild shall receive one-third of the then remaining principal of his or her aforesaid Trust; and at the age of thirty-five (35) years, each grandchild shall receive the remaining principal of his or her aforesaid Trust, at which time each Trust shall terminate. (d) If any of the minor grandchildren shall have reached the age of twenty-one (21) years and a business opportunity arises in which he or she decides to become a part, my Trustee, if in his discretion he sees fit, may take from the remaining share of the Trust of said grandchild such amount as he deems advisable, even to the extent of depleting the Trust for the respective grandchild, and at that time turn Page 4 /l .. · k':;---~ ~ said amount over to said grandchild. My Trustee shall not be subject to any liability whatsoever as a result thereof. (e) Should any of the minor grandchildren die before full distribution has been made, and should he or she fail to leave issue surviving him or her, then and in that event, I direct that the remainder of the share to which the grandchild would normally have been entitled shall lapse and become void and the remainder shall be paid to the surviving grandchild's brothers and sisters in equal shares. In the event, however, that any of the minor children shall die leaving issue who survive them before full distribution has been made, then and in that event, I direct that the remainder of the share to which the grandchild would normally have been entitled shall be paid to the issue of my grandchild, in equal shares. (f) No beneficiary, nor my Trustee, nor any creditor of the beneficiaries or the Trustee, shall have the right to alienate in any way any part of the income or principal of any individual Trust and payments from the Trustee shall be made directly to the beneficiary or deposited in a bank to his or her credit, free from the interference or control of the creditors of any beneficiary or the Trustee. Page 5 EIGHTH: I hereby grant to my Executor and Trustee with respect to any and all property, whether real or personal, of which I am the owner at the time of my death, or which shall at any time constitute a part of my Estate, or any Trust created hereunder, the following powers, subject to the terms of the Trust herein created: (a) To retain such property as an investment, without regard to the proportion such property or properties of a similar nature so held may bear to the entire amount of my Estate or any Trust created thereunder. (b) To sell such property, at either public or private sale, for cash or credit; to exchange such property and to grant options for the purchase thereof. (c) To retain any legal or non~legal security so long as they deem it to the best interest of the estate to do so, and to make such investments for the purpose of the Trust which, in their judgment, may seem right, safe and proper, notwithstanding the fact that such investments are not legal investments for trust funds in Pennsylvania. The exercise of these powers shall be without liability on the part of my Trustee for any loss which may result from so doing, except for gross negligence on the part of my said Trustee. (d) I direct that my Executor and Trustee shall have full power to sell, lease, repair, mortgage, pledge, invest, reinvest, exchange, manage, control and in any way use and deal with any and all property of my estate subject to the terms of the Trust herein created without any application to any court, judge or justice thereof, for leave or confirmation unless the same shall be expressly required by law and shall be unavailable even by this provision of my Will. NINTH: I order and direct my Executor to pay all transfer, inheritance, federal, estate, death, succession and legacy taxes to which my estate or the transfer of any property hereinunder may be subject and to charge such taxes as part of the expense of administration and to pay the same from my residuary estate. TENTH: I hereby nominate, constitute and appoint my son, CHRISTOPHER WARREN KIENZLE, Executor of this, my Last Will and Testament. In the event that he should predecease me, die with me in a common disaster or for any reason whatsoever be unable to .act as such Executor or after his appointment as such Executor be able to continue to act for any reason, then and in that event, I hereby nominate, constitute and appoint my son's wife, JOANNE E. KIENZLE, as Executrix of my Last Will and Testament. It is my Will and I do so direct that neither of my Executors herein named shall be required to file any bond, security or other undertaking for the faithful performance of any duty imposed upon them as such Executors. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding seven (7) pages, at the end of each page of which I have also set my initials for greater security and better identification this k'~b~'day of (~')ki2>x<~ ,2001. WAR'RgN A. KIE~Z~LE~ ! J~"~ Page8 [~0 ~'~[i,~. We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testator as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence and in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testator was of sound and disposing mind and memory. Page 9 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) f'l.'ff. /~.// ) SS: COU:TY I, WARREN A. KIENZLE, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. "'/ '. "~ (SEAL) WARREN A. KIEI~ZLJ~ Sworn to and subscribed before me this / Y ~"day of ~,/j.,'c~.~' ,2001. ~otary Public My Commission Expires: (SEAL) / Notadal Sea' ] Margaret L. Boyd, Notary Public / Susquehanna Twp.. Dauphin County ~ My Commission Expires June 27, 2004/ Member, Pennsylvania Association ot Notaries Page 10 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) (~Ckk~k _~--~_~'~~. , itnes[es whOse names are signed to the attached or foregoing~rument, being duly qualified according to law, do depose and say that we were present and saw Testator, WARREN A. KIENZLE, sign and execute the instrument as his Last Will and Testament; that Testator signed willingly and that he executed said Will as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as Witnesses; and that to the best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Sworn to and-subscribed before me this,/'.~, ~ day of l~otary Public My Commission Expires: Notadal Seat Mar§aret L. Boyd, Notary Public Susquehanna Twp., Dauphin County (SEAL) My Commission Expires June 27, MemOer, Penns¥tvar~ a .Association of Notaries Page 11 LIST OF SPECIFIC BEQUESTS TO ACCOMPANY THE LAST WILL AND TESTAMENT OF WARREN A. KIENZLE List of specific bequests to personal property and/or cash sums and names or persons and/or organizations to whom such bequests are made: I bequeath to the following items:' I bequeath to the following items: I bequeath to the following items: I bequeath to the following items: I bequeath to the following items: Date: (SEAL) WARREN A. KIENZLE :153319 _1 OMB NO. 2502-0265 ~r A. B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.~'IFHA 2.['~FmHA 3.~--~CONV. UNIN$. ' 4. [~VA 5.~--]CONV. tNS. 6. 'FILE NUMBER: I 7. LOAN NUMBER: SETTLEMENT STATEMENT P-137030t 0002980219 8. MORTGAGE iNS CASE NUMBER: C. NOTE: This form ia furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "[POC]" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER; F. NAME AND ADDRESS OF LENDER: Phillip J. Fassl Estate of Warren Kienzle ALLIED MORTGAGE CAPITAL 217 Louis Lane 3 Hemlock Circle CORPORATION Enola, PA 17025 Mechanicsburg, PA 17055 11429 Route 22 East Mountainside, NJ 07092 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1722090 I. SETTLEMENT DATE: 3 Hemlock Circle · Capital Region Land Transfer, Inc. Mechanics~3urg. PA 17055 Janua~ 23, 2004 ~ Cumberland County, Pennsylvania PLACE OF SETTLEMENT Upper Allen Township 3310 Market Street Camp Hill, PA 17011 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Conlract Sales Price 159,500.00 401. Contract Sales Price 159,500.00 102. Personal Property 402. Personal Property 103. Settlement Char~les to Borrower (Line 1400) 7,871.39 403. 104. 404. 105. 405. Adjustments For Items Paid By Seller in advance Adjustments For Items Paid By Seller in advance 106. City Taxes to 406. City Taxes to 107. County Taxes to 407. County Taxes to 108. SchootTaxes 01/23/04 to 07/01/04 882.07 408. School Taxes 01/23104 to 07/01/04 682.07 109, Sewer 01123/04 to 04/01/04 75,82 409. Sewer 01/23/04 to 04/01/04 75.1~2 110. 410. 11. 411. =112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 168,129.28 420. GROSS AMOUNT DUE TO SELLER 180.257.89 200. AMOUNTS .PAID BY OR IN BEHALF OF BORROWER: 500, REDUCTIONS tN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 2,000.00 501. Excess Deposit {See Instruc?ons) 202. Principal Amount of New Loan(s) 158,249.00 502. Settlement Char~les to Seller (Line 1400) 12,894,00 203. Existln9 loan(s) taken subject to 503. Existin~l loan(s) taken subject to 204. 504. Payoff bt ttrst Mortgage 205. 505. Payoff of seCOnd Mortgage 206, 506. 207. 507, (Deposit disb. as proceeds) 208. 508. 209. 509. Adjustments For items Unpaid By Seller Adjustments For Items Unpaid By Seller 210. City Taxes to 510. City Taxes to 211. County Taxes 01/01104 to 01/23/04 19.30 511. County Taxes 01/01/04 to 01/23/04 19.30 212. School Taxes to 512. School Taxes to 213. 513. 214, 514. 215. 515. 216. 516. 217. ' 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 160.268.30 520. TOTAL REDUCTION AMOUNT DUE SELLER 12,913.30 300. CASH AT SETTLEMENT FROM/TO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER: 301. Gross Amount Due From Borrower (Line 120) 168,129.28 601. Gross Amount Due To Seller (Line 420) 160,257.89 302. Less Amount Paid By/For Borrower (Line 220) ( 160,268.30) 602. Less Reductions Due Seller (Line 520) ( 12,913.301 303. CASH( X FROM)( TO)BORROWER 7.660.98 603. CASH( X TO)( FROM)SELLER 147,344.59 ' The undersignea hereby acknowledge receipt of i~ compJeted copy of pages 1&2 of t~is statement & any ~t~ments referred to herein. Borrower ~ Phillip J. Fa'~l ~j - (,,Es[a~Warren Kienzle Page 2 L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price $ 159,500.00 (~ 6.0000 % 9,570.00 PAID FROM PAID FROM Division of Commission (line 700) as Follows: eORROWER'S SELLER'S 701. $ 4,810.00 to RE/MAX REALTY ASSOCIATES FUNDSAT FUNOSAT 702. $ 4,760.00 to HOWARD HANNA OETWEILER REALTY sE'r'rLEMEr~' SETTLEMENT 703. Commission Paid at Settlement 9,570.00 704. Transaction Fee to ReMax Associates 125.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee 0.4926 % to Allied Home Mortgage 779.55 802. Loan Discount % to 803. Appraisal Fee to Charles A. Lefort POC $350.00b 804. Credit Report to 805. Flood Certificlation Fee to FDSI 7.5C 808. Wire Fee to ALLIED MORTGAGE CAPITAL CORPORATION 15.00 807. Commitment Fee to Allied Home Mortgage 250.00 808. Document Prep,Fee 809. Final Inspection to Dynamic Appraisals 75.00 810. Mortgage Broker Fee Allied Home Mortgage 5340.91 POC L 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 01/23/04 to 02/01104 @ $ 26.010000/day ( 9 days %) 234.09 902. Mortgage insurance Premium for months to Allied Mortgage Capital Cororation 2,338.67 903. Hazard Insurance Premium for 1.0 },ears to Liberty Mutual 367.00 904, 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 3.000 months ~ $ 30.58 per month 91.74 1002. Mortc. lage Insurance months ~ $ per month 1003. City Taxes 12.000 months ~ $ 3.50 per month 42.00 1004. Counl~/Taxes 12.000 months ~ $ 22.72 per month 272.64 1005. School Taxes 5.000 months @ $ 127.42 per month 1,019.36 1006. months ~ $ per month ;1007., months ~, $ per month !1008. Aggregate Adi~stment months ~ $ per month -318.91 1100. TITLE CHARGES 1101. Settlement or Closincj Fee to 1102. Abstract or Title Search to 1103. Title Examination to 1104. Title Insurance Binder to 1105. Document Preparation to ;1106. NotaryFees to Linda McB..._..eth 10.O0 4.00 1107. Attorney's Fees ID (includes above item numbers: :108. Title Insurance to Capital Re.qion Land Transfer, Inc. 1,158.75 (includes above item numbers: .... ~_ ) ; 109. Lender's Coverage $ 158,249.00 1110. Owner's Coverage $ 159,500.00 1111. 100,300,8.1 to Capital Region Land Transfer, Inc. 150.00 1112. Deed Preparation Capital Region Land Transfer, Inc. 113. Overnight Capital Region Land Transfer, Inc. 1114. Closing Protection Letter to Commonwealth Land Title Insurance Company 35.00 200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 38.50; Mortgage' $ 50.50; Releases $ 89.00 1202. City/Count'/Tax/Stamps: Deed 1,595.00; Mortgage 1,595.00 203. State TaxJStamps: Deed 1,595.00; Mortgage 1,595.00 1204. Record Mortgage AssicJnment to Recorder of Deeds 27.00 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to 1302. Pest Inspection to 1303. Sewer (October 2003-March2004) to Upper Alien Township Municipal Authority 559019 200.00 304. Wire Fee Capital Region Land Transfer, Inc. 1305. Electric Repairs to Michaet Kanoff, Jr. 1,400.00 1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) [ 7,871.39, 12,894.00 "- Capital Region Land Transfer, Inc. Settlement Agent ( P~3370301 P.137030127 } NOU-12-2003 21:23 PNCBRNK 412 768 3458 P.01/02 PN CBANK November 13, 2003 Tina L. Otto 3401 Nom5 Front Street P.O. Box 5950 Harrisburg, PA 17 t 10-0950 RE: Estate of Warren A. Kienzle, deceased SSN: I03-18-7075 DOD: 10/13/2003 Dear Ms. Otto: In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account #5070080969 Established 01/21/1969 WARREN A KIENZLE DOD balance: $14,718.23 + $.42 accrued interest Savings Account Account #5000728408 Established 01/14/1997 WARREN A KIENZLE DOD balance: $110,882.97 + $20.63 accrued interest IRA Account Account #75200014221 Established 07/07/1999 WARREN A KIENZLE DOD balance: $22,009.99 + $20.34 accrued interest For IRA or Beneficiary information, please c~l 1-888-PNC-IRAS. Page 1 of 2 NOU-12-200} 21:2~ PNCB~NN 412 ?68 ~458 P.02/02 Safe Deposit Box fi416 Established 07/15/1983 WARREN A KIENZLE Located: MECH~NICSBLrRG BRANCH 2 EAST MAIN STREET MECHANICSBUR.G PA 17055 717-6914035 For Brokerage information, please call 1-800-762-6111. (Account) INV #47385070 Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, Rachelle Wells 1-800-762-1775 P7-PFSC-IM-F 500 first Ave. Pittsburgh PA 152t9 Page 2of 2 Member FDIC TOTAL P.B2 .... __12/09/2003 11:59 FAX 515 457 42:[9 COVA {~002 · 'EXPRES 3 IL ' I~OWEL'r C. ME't-~. RATgffiY'N ~, LEaL DEP~ Me.ifc Inv~sto~ USA I~ce 222 Delam Avenue ~, ~ ' Re: Estate of Warre~ A, ~enzle ~' De~ Sk~adam: O~ fi~ ~pres~ts C~stopher ~c~e, late of 3 H~l~k C~cle, Mech~csb~g~ PA 17055, who died on O~ob~ 13, 2003~ A dea~ ce~c~e iz e~closed for yo~ ~fe~ce. .'. For death ~ p~s, please ~ us of~y ~d all acco~ w~ch ~e d¢ced~t ~d with yo~ ~li~o~ incl~ing ~% ~, ce~ficat~ ofdcpos~ st~ks, bon~, etc. Plea~ pro~de ~e bal~cas ~s of ~e datg of dca~, ac~ed ~te~st to ~at da~, if ~y, ~d whe~r the~e acco~ were o~cd solely of the accoun~ h~d a dcsi~atcd ben~cia~. For ~ui~ accosts, please ~ovide ~e follo~ i~o~on: 3. ~e value of~e ~ty 4 ~e date Ee ~W w~ is~ ~d ~e ~tial inv~ent 5. Ple~e provide a ~tmg Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Warren A. Kienzle No. 21-03-0857 also known as Date of Death October 13, 2003 , Deceased Social Security No. 103-18-7075 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedenrs death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. INVe verify that the statements made in this Inventory are true and correct. INVe understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Personal Representative: Attorney: Vick)' Ann Trimmer, Esquire Chris. t,opher W. Kienzle I.D. NO.: 49679 X ~-~, ~ ~'~, Address 3401 N. Front Street, PO Box 5950 Dated: Telephone: Harrisbur~h PA 17110-0950 DESCRIPTION VALUE 1. 3 Hemlock Circle, Upper Allen Township, Mechanicsburg, PA $ 159,500.00 2. PNC Checking Account #5070080969 $ 14,718.65 3. PNC Savings Account #5000728408 $ 110,903.60 4. Travelers Checks found at residence $ 500.00 5. 2002 Buick LeSabre $ 11,800.00 6. Household items and personal property $ 2,500.00 TOTAL: ~'~: ,~ ~ IAttachAdditional Sheets If Necessa?) 6~; Z ~ 9~ ~JV~ ~70, NOTE: The Memorandum of real estate outside the Commonwealth of P~ennsylvania may, at-~t~j~ election of the personal representative, include the value of each item, but such figures should.nOt. be: _extendecLiQtg~%~:~a: =,~_~. _~::.of the Inventory -COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003725 TRIMMER VICKY ANN 3401 NORTH FRONT STREET HARRISBURG, PA 17110-0950 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold .......... 101 $2O4.53 ESTATE INFORMATION: SSN: 103-18-7075 FILE NUMBER: 2103-0857 DECEDENT NAME: KIENZLE WARREN A ;)ATE OF PAYMENT: 03/26/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/13/2003 ..... TOTAL AMOUNT PAID: $204.53 RiEMARKS: CHECK# 1029 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH ~ REGISTER OF WILLS REGISTER OF WILLS COMNONNEALTH OF PENNSYLVANZA BUREAU OF ZNDZVZDUAL TAXES DEPARTMENT OF REVENUE ZNHERITANCE TAX DIV[SZON DEPT. 18060! NOT/CE OF ZNHERZTANCE TAX HARRISBURG, PA 17128-0601 APPRAZSEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCT/ONS AND ASSESSMENT OF TAX REV-1647EXAFP(01-05) ~:~'~'-- '~': DATE 05-10-200q r'~,.~ ESTATE OF KZENZLE NARREN A DATE OF DEATH 10-15-2005 F/LE NUMBER 21 05-0857 '04 I'iA¥ -7 ?,:~ :{~COUNTY CUMBERLAND VICKY ANN TRIMMER ESQ ACN 101 METTE ETAL Aeoun~ Remi~ad PO BOX 5950 HBG PA 17~0~ MAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS REV-15~7 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX ESTATE OF KZENZLE NARREN AFZLE NO. 21 0~-0857 ACN 101 DATE 05-10-200q TAX RETURN HAS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: OR/G~NAL RETURN 1. Real Es~a*a (Schedule A) (1) 1591500.00 NOTE: To insure proper 2. S*ocks and Bonds {Schedule B} {2) .00 cradi~ ~o your account, $. Closely Held S~ock/Par~narship Zn~eres~ (Schedule C) ($) .00 sube~ ~he upper por~on q. Mor~gages/No~as Receivable (Schedule D) (q) .00 of ~his fora wi~h your E. Cash/Bank Deposi~s/M~sc. Personal Proper~y (Schedule E) (5) 1~;~80.~q ~ax payaan~. 6. Jointly Owned Proper~y (Schedule F} (6) .00 7. Transfers (Schedule G) (7) 62;125.78 8. To,al Asse*s (8) $62,805.92 APPROVED DEDUCTZONS AND EXEMPTZONS: $~,718.69 9. Funeral Expenses/Ada. Costs~MAsc. Expenses (Schedule H) (9) 10. Debts/Mor*gege Liab111~ies/L1ens (Schedule Z) (10) 11. To~al Deductions (11) ~.272.~! 12. Ne~ Value of Tax Ra~urn (12) $26,555.$1 15. Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 lq. Ne~ Value of Es~a~e Sub~ac~ ~o Tax (lq) ~26,5~.~1 NOTE: Z~ an assessment was lssued previously, lines la, 15 and/or 16, 17, 18 and 19 reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: .00 x O0 O0 15. Amoun~ of Line lq a~ Spousal ra~a (15) = ' 16. Aeoun~ of Line lfi *axabla a* L1neal/Class A ra~a (16) $26,555.$1X 0q5 = lq,69q.00 17. Aaoun~ of L/ne lq a~ S1bling ra*e (17) .00 X 12 = .00 18. Amoun~ of Line lq ~axable a~ Colla*eral/Class B ra~a (18) .00 X 15 = .00 19. Prlncipal Tax Due (19)= lq,69q. O0 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+1 AMOUNT PA/D DATE NUMBER INTEREST/PEN PAID (-) 01-12-200q CD00~q29 7Zq.q7 15,765.00 03-Z6-ZOOq CD003725 .00 20q.53 TOTAL TAX CRED]:T I 1q,69q. O0 BALANCE OF TAX DUEl .00 ZNTEREST AND PEN. .00 TOTAL DUE . O0 IF PATD AFTER DATE ]:NDZCATED~ SEE REVERSE ( TF TOTAL DUE IS LESS THAN $1, NO PAYMENT TS REI;IUZRED. FOR CALCULAT/ON OF ADD/TIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDTT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THZS FORM FOR TNSTRUCTTONS.) RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rote on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section ZlqO of the Inheritance and Estote Tax Act, Act Z3 of ZOO0. (72 P.S. Section 91q0). PAYMENT: Detoch the top portion of this Notice and submit with your poyment to the Register of Mills printed on the reverse side. --Make check or money order payable to: REgZSTER OF NZLLS, AGENT REFUND [CR): A refund of a tax credit, which oas not requested on the Tax Return, may ba requested by completing an "Application for Refund of Pennsylvonio Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of the Register of Mills, any of the 23 Revenue District Offices, or by calling the special 2q-hour answering service for forms ordering: 1-800-362-20S0; servlcas for taxpayers aith special hearing and / or speoking needs: 1-800-qq?-3020 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 2810Z1, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this ossessment should be oddrmssad in eriting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Raviae Unit, Dept. 280601, Harrisburg, PA 171ZB-0601 Phone (717) 7B7-6SOS. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-leO1) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid eithin three (3) calendar months after the dacadant's death, a five percent (Sg3 discount of the tax paid is allowed. PENALTY: The leg tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January lB, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (13 day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rata of .00016q. All taxes which became delinquent on and after January 1, 198Z will bear interest et a rate ahich will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 200q are: Interest Dally Interest Daily Interest Daily Year Rata Factor Year Rate Factor Year Rate Factor ~ lOX .O00Sq& ~'~)'~'~-1991 11Z .OO03Ol ~ 9Z .OOOZq7 1983 16Z .O00q3B 1992 9Z .ooogq7 2002 62 .00016q 198q XIZ .000~01 1993-199q ?Z .000192 2003 5Z .000137 1985 13Z .000356 1995-1998 9Z .o00gq7 ZOOq qZ .000110 1986 lOX .00027q 1999 7Z .00019Z 1987 lOg .OOO27q ZOO0 7Z .O0019Z --Interest is calculatad as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (153 days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated.