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HomeMy WebLinkAbout02-0156Estate of Jl~'q~IE A. KOCH aJso known as Register of Wills of CUMBERLAND County, Pennsylvania PETITION FOR GRANT OF LE'i-rERS , Deceased Social Security No. 211-22-0673 CHART ,lq-~ A. Pe~aoner~s), who =s/are 18 years of age or omer, apptyges) (COMPLETE 'A' OR 1~' BELOW:) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is~.the execut or the Decede.t dated AUGUST 22, 1996 named in the last Will of Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution of the documents offered for probate; was not t~e ,,4cam of a killing and was never adjudicated incompetent: [] B. Grant of Letters of Administration Petitioner(s) after a proper search has~ave ascertmned that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationshio Resiaence J (COMPLETE IN ALL CASES:) Au~lcn aadi=onaJ st3ee~s it n~. O~ent was domiciled at dea~ in Cij~r l and = ~n=~ r~s~d~ ~ 770 POP~R C~CH ROAD, C~ HILL, PA (lint s~ n~r ~d m~iap~) D~nt, then 7~ ye~ of age, ~ ~A~ [7~ ,~O~ ~ D~ent at dea~ ~n~ pm~ wi~ es~mamd v~ues ~ follows: (If domidied in PA) A~ ~on~ pm~ (If not domidled in PA) P~on~ pmpe~ in P~nsyN~ia (If not domicil~ in PA) P~ pm~ in ~n~ V~ue of m~ es~ in Pennsylv~ia County, Pennsylvania, with :t~er last family SHORE HEALTH & REHAB. CENTER (LocatJon) $ $ $ NONE situated as follows: Wherefore, Petitioner(s) respecdully request(s) the probate of the last Will and Codicil(s) presented wid3 this Petition and Ihe grant of letters in the appropriate form te the undersigned: T¥,i~a or pnnted name and residence J CHART,lqS REH 2200 PINE STREET ASHLAND, PA 17921 Form #RW-1 Page 1 of 2 Prepared by ~e Pennsylvania Bar AsSOCaatJon 1991 Oath of Personal Representative Commonwealth of Pennsylvania County of DAUP~N The Petitioner(s) above-named swear(s) or afffirm(s) that the statements in the foregoing Petition are true and correc-'f to the be'$:t' of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Peti~oner(s)will well and tru'~t~ccording to law. Sworn to or affirmed and subscribed b~.o~e me this .,2'~'.~:~' . day of CHARLES . RE}{ For the Register- AND NOW, Estate of No. 21-02-156 JENNIE A. KOCH Deceased SocialSecud~ No:211-22-0673 FEBRUARY 11r 2002 Date of Death: JAI~ARY 17, 2002 , ~:~ , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary I~1 Of Administration are hereby granted to CJ:!ARLES A. R]~ in the above estate and that the instrument(s) dated AUGUST 22, 1996 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ..................... $. 50.00 Short Certificate(s) .... $ Renunciation ............ $ Affidavits ( ) ............. Extra Pages ( ) ......... $ Codicil ...................... $ JCP Fee ................... $. 5. O0 Inventory .................. $ Other ....................... $ TOTAL ............. $_ FILED ON 2-8-02 Fo~n #RW-1 Page 2 of 2 Prepared by ~ Pe~ns¥1vama Bar Assobabo~ 1991 MAILED TO ATTY AND EXECUTOR ON 2-11-02 15_00 l~_nO 85.00 Attorney: S. J'OI-]l~ PRTCE~ JR.. I.D. No: 25967 Address: Telephone: ONE NORWEGIAN PLAZA~ P. 0. POTTSVIT.I,F,,, PA 17901 (570)622-1811 BOX 1280 SHORTS SENT TO ~<i5 !~ NEV 8,'88 !FEE FOIq FHI~ WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. COMMONWEALTH OF PENNS'¢LVA!'~L~ DEPARTMENT OF HEALTH VITAL RE':;C~ 35 LOCAL REGISTRAR'S CERTIFICATION OF [:,E,~TH CERT. NO. T 5099642 Se ~x~*~.,,~?_~ _Social~S~'urity No. ~ ]/ ~ ~--,~---~--~ /-'-~ ~-~Li~ Date ef Death~]zJ~ ~-~:~ Date of Bidh ~J_~ / q ~ ~ ,Bidhplace L_X-.~ ~-~E 6~ ,. ~ . , , ~ c/ ' Pennsylvania Mar ta StatW~dzZ~[~*..~Mailing Address ~ Informant ~} ~,~~' '_~~J, Funeral Name and Address of (- Funeral Establishment ~_ ~.,~.~~ Interval Between Part I: Immediate Cause Onset and Death (a) ............. ~'~ ,.. ~'~. Pad I1: Manner of Death Natural ~ Accident ~'] Suicide [7] (b) (c) (d) Other Significant Conditions Homicide Pending Investigation Could not be Determined Describe how injury occurred: 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 forwarded to the State Vital Records Office for permanent filina,---, Name and Title of Certfier 21-02-156' LAST WILL AND TESTAMENT OF JENNIE A. KOCH I, JENNIE A. KOCH, of 366 Ringneck Drive, Lower Paxton Township, Dauphin County, Pennsylvania, being of sound mind, memory, and understanding, make, publish, and declare this to be my Last Will, and hereby revoke all Wills and Codicils previously made by me. ITEM I. I direct my Executor hereinafter named to pay all of my legal debts and funeral expenses, including the cost of my gravemarker and administration expenses of my estate, as soon as practicable after my death. ITEM II. All estate, inheritance, legacy, succession, or transfer taxes, including any interest and penalties thereon, imposed by any domestic or foreign law with respect to all property taxable under such laws by reason of my death, whether or not such property passes under this Will, by operation of law, by contract, or otherwise, shall be paid without any right of reimbursement from any recipient of any such property, without any right of apportionment, and without postponement. ITEM III. I direct my personal representative to sell, at public or private sale, all of my household furnishings. ITEM IV. I give and bequeath all of my property and estate of every kind and nature and wheresoever situate, including all lapsed legacies and bequests, and including any property over which I may have a power of appointment at the time of my death, to my cousin, CHARLES REH, and my brother, ROBERT KOCH, in equal shares. ITEM V. common law, In addition to the powers conferred by the by statute, or by any other provisions hereof, my Executor is hereby empowered as hereinafter set forth: a. To sell at public or private sale, to exchange, to lease, to pledge, to mortgage, to transfer, to convert, or otherwise dispose of, or grant options with respect to, any and all property, real, personal, or mixed, at any time forming a part of my probate or trust estates, in such manner, at such time or times, for such purposes, for such price or prices, and upon such terms, credits, and conditions as shall be deemed advisable or necessary under the circumstances; b. To assent to, join in, and vote in favor of any merger, reorganization, voting trust, plan, lease, mortgage, consolidation, exchange, foreclosure of any corporation or other investment in which the probate or trust estate may hold stock, bonds, investments, or an interest; c. To vote in person or by general or limited proxy with respect to any share of stock or other investment held by the probate estate or trusts; d. To make distribution in division of the probate estate in case, in kind, or partly in both; -2- e. To distribute articles to a minor or to his or her guardian or to any person taking care of the minor to hold for the minor within the limits authorized by statute or rule of law; f. To borrow money from any person or institution, including the corporate Trustee hereunder, for any purposes connected with the protection, preservation, or improvement of the trusts or probate estate; g. To compromise any claim or controversy; h. To apportion between principal and income any receipts and disbursements and to ascertain income and principal in accordance with the statutes and rules of law of the Commonwealth of Pennsylvania; i. To keep property in the name of a nominee with or without disclosure of any fiduciary relationship; j. To employ attorneys, auditors, depositories, and proxies with or without discretionary power; k. To make, execute, acknowledge, and deliver any and all instruments which may be deemed advisable or necessary to carry out any of the powers herein granted or provided by law; 1. To invest and reinvest the principal of the trusts, together with any accumulated income thereon whenever such accumulation has been permitted by the terms hereof, in all forms of property, real, personal, or mixed, including but not limited to stocks, bonds, common trust funds, mortgages, investment funds, -3- insurance policies, and annuities, without being limited by any statute or rule of law concerning investments by Trustees; m. To carry out the terms of any agreement I may have entered into to sell all or any part of any property or any interest I may own in any business at the time of my death; n. To exercise any law-given option to treat administrative expenses either as income tax or as estate tax deductions, without regard to whether the expenses were paid from principal or income. ITEM VI. I nominate and appoint my cousin, CHARLES REH, as Executor of this my Last Will to serve without bond for the faithful performance of his duties in any jurisdiction. ITEM VIII. I direct that my personal representative engage as funeral director, CHARLES HEIZENROTH, 901 Centre Street, Ashland, Pennsylvania 17921. IN WITNESS WHEREOF, I have hereunto set my hand this~ay of~ 1996. -4- The preceding instrument, consisting of this and four (4) other typewritten pages, was on the date thereof signed, published, and declared by JENNIE A. KOCH, the Testatrix named therein, as and for her Last Will, in the presence of us, who, at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. Witnesses: Name Commonwealth of Pennsylvania : : ss County of ~~,~ : I, the Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein ~OC? expr~~ 'SWO~N to or affirmed to and acknowledged before me by the above named Testatrix this .7~z~day of ~sT-- , 1996. Notary Public My Commission Expires: (SEAL) -5- Commonwealth of Pennsylvania : : ss County of ~/~/~ : We, the undersigned witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses and that to the best of our knowledge the Testatrix was at the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. SWORN or affirmed to and acknowledged before me by the above named witnesses this ~-~ay of ~~7-- , 1996. CAROL A. LYTER, NOTARY PUBLIC Harrisburg, Dauphin County ]996 Notary Public My Commission Expires: (SEAL) -6- BUREAU OF ZNDZVZDUAL TAXES ZNHERXTANCE TAX DXYZSZ(]N DEPT. Z80601 HARRTSBURG, PA 171Z8-0601 COMNONNEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE NOTXCE OF INHERITANCE TAX APPRAXSEHENT. ALLONANCE OR DXSALLONANCE OF DEDUCTXONS. AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS '02 i'i/i¥' 24 ROBERT A KOCH APT 1ZZ2 770 POPLAR CHURCH CAMP HILL PA 17011'2502 FXLE NUMBER COUNTY SSN/DC ACN REV-1Slll8 EX AFP C01-OZ) DATE 05-27-2002 ESTATE OF KOCH JENNIE DATE OF DEATH 01-17-2002 21 02-0156 CUMBERLAND 211-22-0673 0211270q Amoun~ Rmm/~ed I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE REV'IS48 EX AFP (01-02) RETAIN LONER PORTION FOR YOUR RECORDS NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOXNTLY HELD OR TRUST ASSETS DATE 05-ZT-ZOOZ ESTATE OF KOCH JENNIE A DATE OF DEATH 01-17-ZOOZ COUNTY CUMBERLAND FILE NO. 21 02-0156 S.S/D.C. NO. 211-ZZ-0675 ACN 0211270q TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET ZNFORMATZON FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. O065975q7Z TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 10-15-1998 Account Balance Percent TaxabXe Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due 705.19 X 0.500 552.60 - .00 552.60 X .15 52.89 NOTE: TAX CREDZTS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID C- AMOUNT PAID TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE NXTH YOUR TAX PAYMENT TO THE REGISTER OF HILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: **REGISTER OF HILLS, AGENT.** PAYMENT MUST BE MADE BY 10-18-200Z~. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN, TOTAL DUE ZF PAXD AFTER TH/S DATE, SEE REVERSE FOR CALCULATION OF ADDTTZONAL TNTEREST. = ( IF TOTAL DUE TS LESS THAN $1, NO PAYMENT TS REI~UXRED. TF TOTAL DUE TS REFLECTED AS A "CRED/T" (CA), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR TNSTRUCTZONS. ) .°°I 5Z .89 .00 5Z .89 PURPOSE OF NOT[CE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill tho requirements of Sac[ton Z140 of the Inheritance and Estate Tax Act, Act Z~ of ZOO0. (7Z P.S. Section 9140). Detach the top portion of this Notice and submit with your paylent to the Register of gills printed on the reverse side. -- Make check or money order payable to: REGISTER OF HILLS, AGENT. A refund of a tax credit, which was not requested on the tax return, may bo requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications are available at the Off[ca of the Register of gills, any of the Z5 Revenue District Offices or by calling the special Iq-hour answering service for forms ordering: 1-800-36Z-ZO50; services for taxpayers aith special hearing and or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disalloeance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 171ZB-IOZ1, OR --electing to have tho matter da[ermined at the audit of the account of the parsunal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should ba addressed Jn writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. ZB0601, Harrisburg, PA 17lZB-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of adainistrativety correctable errors. If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty ]s appealable in the same manner and in the the same ttae period as you mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest et the rate of six (6Z) percent per annum calculated at a daiIy rata of .000164. AIl taxes which became delinquent on or after January 1, 198Z will bear interest at · rate which ail! vary from calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 ara: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 198Z ZOZ .000548 199Z 9Z .OOOg47 1983 16Z .000438 1993-1994 7Z .O0019Z 19Dq llZ .000301 1995-1998 9X .000247 1985 13Z .000356 1999 7Z .O0019Z 1986 ZOZ .000Z74 ZOO0 8Z .000Z19 1987 9Z .000247 2001 9Z .O00Zq7 1988-1991 IIZ .000301 ZOO2 6Z .000164 --Interest is caZcuZated as follaas: ZNTEREST = BALANCE OF TAX UNPAZD X NUKBER OF DAYS DELZNQUENT X DAZLY ZNTEREST FACTOR --Any Notlca issued after the tax becomes delinquent will reflect an interest calculation to fifteen (1S) days beyond the date of the assessment. If payment is soda after the interest computation date shown on the Notice, additional interest must be calculated. DEPT. 2&0601 HARRISBURG,, PA 17128-0601 'O2 S JOHN PRICE JR LIPKIN ETAL PO BOX 1280 L,:.~, POTTSVILLE PA 1~g~1 COHHON#EALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 05-27-2002 KOCH 01-17-Z002 21 02-0156 CUHBERLAND 101 Amount Ree/ttad REV-l$47 EX AFP JENNIE A HAKE CHECK PAYABLE AND RENZT PAYHENT TO; REGISTER OF NILLS CUHBERLAND CO COURT HOUSE CARLZSLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KOCH JENNIE AF'rLE NO. 11 02-0156 ACN 101 DATE 05-27-2002 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE 'rNTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. RaaZ Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnersh/p Interest (ScheduZe C) ($) 4. Mortgages/Notes Reca/vable (Schedule D) (4) $. Cash/Bank Dapos/ts/M/sc. Personal Property (Schedule E) (5) 6. Jo/ntly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/M/sc. Expenses (Schedule H) (9) 10. Debts/Mortgage L/ab/1/t/as/L/ens (Schedule I) (10) 11. TotaZ Deduct/ons 12. Net Value of Tax Return 10~030.00 17~598.00 352.50 .00 NOTE: To /nsura proper .00 crad/t to your account, .00 subm/t the upper port/on of th/s form w/th your tax payment. .00 (8) 8,452.00 15. 14. NOTE: ASSESSHENT OF TAX: 1S. Amount of L/nm 14 mt Spousal rate 16. Amount of L/nm 14 taxable mt L/neal/Class A rate 17. Amount of L/nm 14 mt S/bl/n9 rate 18. Amount of L/nm 14 taxable mt Collateral/Class B rate 19. Pr/nc/pal Tax Due FAX CREDITS: PAYMENT R~;C~;TpT DT~.UUNT (+) DATE NUMBER INTEREST/PEN PA/D (-) 0~-15-2002 CD00107~ 9~.68 27,980.50 5,~62.00 (11) 1~.91~.00 (12) 1~,066.50 Charitable/Governmental Bequests; Non-eZected 9115 Trusts (Schedule J) (13) Net Value of Estate Subject to Tax (14) If an assessment was issued previously, lines 14, 15 and/or 16, 17, reflect figures that include the tctal of ALL returns assessed to date. .00 1~,066.50 ~F PAID AFTER DATE INDICATED, SEE REVERSE ~R CALCULATION OF ADDITIONAL /NTEREST. 18 and 19 #ill 1,893.68.$2 .00 .$2 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORH FOR TNSTRUCT'rONS. ) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 1,799.00 AMOUNT PAID (15) .00 x O0 = .00 (16) .00 x 0~5= .00 (17) 7,209.50 x 12 = 865.00 (18) 6,857.00 x 15 = 1,029.00 (19)= 1,89~.00 RESERVATION: Estates of decedents dying on or before December 12, 19BZ -- if any future interest in tho estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decadent after the expiration of any estate for life ar for years, the Commonaaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laeful Class B (collateral) rate on any such futura interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CA): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill tho requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S. Section 91q0). Detach the top portion of this Notice and submit aith your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF N/LLSj AGENT A refund of a tax credit, ahich mas not requested on the Tax Return, amy be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-lB13). Applications are available at the Office of the Register of Nills, any of the 23 Revenue District Offices, or by calling the special Z~-hour answering service for forms ordering: 1-800-36Z-2050~ services for taxpayers with special hearing and / or speaking needs: 1-800-~7-30Z0 iTT only). Any party in interest not satisfied with the appraisement, alloaanca, or disallowance of deductions, or assessment of tax (including discount or interest) as sheen on this Notice must object within sixty (60) days of receipt of this Notice by: --arittan protest to the PA Department of Revenue, Board of Appeals, Dept. ZSlOZ1, Harrisburg, PA 171ZS-lOZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should bo addressed in mriting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 260601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sam page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decadent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the dacedent's death, a five percent (SZ) discount of the tax paid is alloaad. The 15Z tax amnesty non-participation penalty is computed on the total of the tax end interest assessed, and not paid before January 18, 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 is charged beginning Nith first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rata of six (6X) percent per annum calculated at a daily rate of .00016fi. All taxes ahich became delinquent on and after January 1, 1982 ail1 bear interest mt a rate which 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 ZOOZ are: Year Interest Rate Daily Interest Factor Year Intares~ Rate Dally Interest Factor 198Z ZOX .0003q8 199Z 9Z .O00Zq7 1983 16Z .000q38 1993-199~ 7X .O0019Z 198q 11Z .000~01 1993-1998 9Z .O00Zq7 1985 13Z .000356 1999 7Z .00019Z 1986 IOZ .O0027~ 2000 82 .O00Zl9 1987 9Z .O00Zq7 ZOO1 9Z .O00Z~7 1988-1991 11X .000301 ZOOZ 6Z .00016~ --Interest is calculated as follows: TNTEREST = BALANCE OF TAX UNPATD X NUNBER OF DAYS DEL'rNQUENT X DAXLY TNTEREST FACTOR --Any Notice issued after the tax becomes delinquent ~ill reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date sheen on the Notice, additional interest must bo calculated. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX nIVISION DEPT. 280601 HARRISBURG,, PA 17128-0601 ROBERT A KOCH APT 1ZZZ 770 POPLAR CHURCH RD CAMP HILL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADdUSTMENT dOZNTLY HELD OR TRUST ASSETS ~ DATE 05-25-2002 ~, ESTATE OF KOCH JENNIE A DATE OF DEATH 01-17-2002 FILE NUNBER 21 02-0156 '07 ?i~\¥ 3i ?~ <:!~ COUNTY CUMBERLAND ,* '-"~ SSN/DC 222-22-0675 ACN 0211270q L:,~. F lmoun~ R~mi~{~d F PA RAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 REV-16gq EX &FP (1~-00) CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS REV-1604 EX AFP (12-00) xx INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE 05-Z$-2002 ESTATE OF KOCH JENNIE A DATE OF DEATH 01-17-2002 COUNTY CUMBERLAND FILE NO. 21 02-0156 S.S/D.C. NO. 211-22-0675 ACN 0211270q ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 0065975q72 TYPE OF ACCOUNT: ( ) SAVINGS CX) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 10-15-1998 Account BaZance Percent Taxable X Amount Subject to Tax Debts and Deductions - Taxable Amount Tax Ra~e X Tax Due TAX CREDITS: .00 0.500 .00 .00 .00 .15 .00 NOTE: TO XNSURE PROPER CREDXT TO YOUR ACCOUNT, SUBMXT THE UPPER PORTION OF THXS NOTXCE WXTH YOUR TAX PAYMENT TO THE REGXSTER OF WXLLS AT THE ADDRESS SHOWN ABOVE. HAKE CHECK OR HONEY ORDER PAYABLE TO: nREGXSTER OF WXLLS, AGENT.~ PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (- AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) .00 .00 .00 .00 PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- Make check or money order payable to: REGISTER OF NILLS, AGENT. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of the Register of Hills, any of the 23 Revenue District Offices or from the Department's Iq-hour answering service for forms ordering: 1-600-361-Z050~ services for taxpayers with special hearing and / or speaking needs: 1-&OO-4qT-3020 ITT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 17liB-0601, Phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (51) discount of the tax paid is allowed. PENALTY: The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency or nine (9) months and one (I) day from the date of death to tho date of payment. Taxes which became delinquent before January 1, 19BI bear interest at the rate of six (61) percent par annum calculated at a daily rate of .000164. AIl taxes which became delinquent on and after January l, 1981 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through ZOO1 are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 ZOZ .000548 1992 91 .000247 1985 162 .000458 1995-1994 71 .000192 1984 1IX .O0030X 1995-1998 91 .000247 1985 131 .000356 1999 72 .OOOlgZ 1986 iOZ .000274 ZOOO 8Z .OOOZ19 1987 9Z .000Z47 Z001 9Z .000147 1988-1991 llZ .000301 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen [15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must ba calculated.  INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 :ILE NUMBER DECEDENTS NAME JENNIE A. KOCH 2102-0156 ACN REVIEWED BY Phyllis Hoch 02112704 ITEM EXPLANATION OF CHANGES SCHEDULE NO, ADJUSTED ABOVE ACN TO ZERO. REPORTED ON PROBATE RETURN SCH F, ROW Pane 1 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: JENNIE A. KOCH Date of Death: January 17, 2002 File No. 21-02-0156 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 February 15, 2002: NAME ADDRESS Charles A. Reh Robert koch 2200 Pine St., Ashland, PA 17921 770 Poplar Church Rd., Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A Date: April 15, 2002 Signature Name: Address: Capacity: S. John Price, Jr., One Norwegian Plaza P. O. Box 1280 Pottsville, PA 17901 Telephone: (717)622-1811 Personal Representative Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I©F:FICiAL USE ONI,Y /7- './/-// FILE NUMBER 21 02 0156 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER KOCH, JENNIE A. 211-22-0673 ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) uJ muJ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ~ 01/17/2002 07/31/1929 REGISTER OF WILLS SOCIAL SECURITY NUMBER uJ IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) [] 1. Original Return [] 2. Supplemental Return ] 3. Remainder Return (date of death pdor to 12-13-82) [] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after 12-12-82) [] 5. Federal Estate Tax Return Required [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes of Will) copy of Trust) -- [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between [] 11.Election to tax under Sec. 9113(A) (Attach Sch O) ~AME S. JOHN PRICE, JR. --IRM NAME (If applicable) LIPKIN, MARSHALL, BOHORAD & THORNBURG, P.C. FELEPHONE NUMBER 570/622-1811 COMPLETE MAILING ADDRESS ONE NORWEGIAN PLAZA, P. O. BOX 1280 POTTSVILLE, PA 17901 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) None None 10,030.00 17,598.00 352.50 None 8,452.00 5,462.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (8) 27,980.50 (11) 13,914.00 (12) 14,066.50 (13) (14) 14,066.50 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) 16.Amount of Line 14 taxable at lineal rate x .045 (16) 17.Amount of Line 14 taxable at sibling rate ~- x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 7,209.50 865.00 6,857.00 1,029.00 1,894.00 20. [] Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: J STREET ADDRESS CITY CAMP HILL STATE PA 770 POPLAR CHURCH ROAD ZIP Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty 95.00 (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 1 Line 20 to request a refund If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 1,894.00 95.00 0.00 1,799.00 1,799.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retaintheuseorincomeofthepropertytransferred; .................................................................................. 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 security at his or her death? ......... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... [] [] 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 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. ~~f PERSON RESPONSIBLFrF,,OR FI!..~IG RETURN '~NATURE OF PERSOIq RESPONSIBLE FOR FILING RETURN ADDRESS 2200 PINE STREET ASHLAND, PA 17921 ADDRESS D TE SI( OF PREPARER OTHER' ~ REPRESENTATIVE ADDRESS ONE NORWEGIAN PLAZA, P. O. BOX 1280 POTTSVILLE, PA 17901 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (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 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 decedent's siblings is 12% [72 P.S. §9116 (a) (1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF KOCH, JENNIE A. SCHEDULE D MORTGAGES & NOTES RECEIVABLE FILE NUMBER 21 - 02-0156 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBEF~ DESCRIPTION PENNSYLVANIA-DELAWARE DISTRICT LOAN FUND, UNSECURED PROMISSORY NOTE # 1004464 ACCRUED INTEREST ON ITEM # 1 TOTAL (Also enter on Line 4, Recapitulation) VALUE AT DATE OF DEATH 10,000.00 30.00 10,030.00 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF KOCH, JENNIE A. FILE NUMBER 21 - 02- 0156 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 NUMBER I 2 3 4 5 6 7 8 9 10 11 12 DESCRIPTION VALUE AT DATE OF DEATH M&T BANK, CHECKING ACCOUNT # 3440016313 ZIEGLER AUCTION COMPANY, LTD, PROCEEDS FROM SALE OF HOUSEHOLD ITEMS & PERSONAL EFFECTS VILLAGE OF PHEASANT RIDGE, SECURITY DEPSOIT REFUND GE CAPITAL ASSURANCE, REFUND OF UNEARNED PREMIUM GE CAPITAL ASSURANCE, REIMBURSEMENT FOR LONG-TERM CARE THE PATRIOT NEWS, REFUND FOR SUBSCRIPTION ERIE INSURANCE, REFUND OF UNEARNED PREMIUM FOR RENTER'S INSURANCE ERIE INSURANCE, REFUND OF UNEARNED PREMIUM FOR CAR INSURANCE BEVERLY ENTERPRISES, INC., REFUND FROM WEST SHORE HEALTH & REHAB 1989 FORD TAURUS (VALUATION BASED ON SELLING PRICE TO UNRELATED THIRD PARTY.) AT&T, REFUND ALLFIRST FINANCIAL CENTER, N.A., GOLDEN AGE CHECKING ACCOUNT # 0010218807 58.00 865.00 308.00 205.00 3,120.00 21.00 43.00 92.00 2,158.00 1,000.00 32.00 9,696.00 TOTAL (Also enter on Line 5, Recapitulation) 17,598.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF KOCH, JENNIE A. SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21 - 02- 0156 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A ROBERT KOCH 770 POPLAR CHURCH ROAD CAMP HILL, PA BROTHER JOINTLY OWNED PROPERTY: i : DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM LE'I-rER DATE Include name of financial institution and bank account number DATE OF DEATH DECD'S VALUE OF NUMBER FOR JOINT MADE 3r similar identifying number. Attach deed for jointly-held real VALUE OF ASSET INTEREST DECEDENTS INTERES' TENANT JOINT .=state. 1 A 10/13/1998 ALLFIRST FINANCIAL SERVICES, CHECKING 705.00 50% 352.5( ACCOUNT # 0065975472 TOTAL (Also enter on line 6, Recapitulation) 352.50 COMMONWEALTH OF PENNSYLVAN!A INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL.~& ADMINIS'[RATNE COSTS ESTATE OF FILE NUMBER KOCH, JENNIE A. 21 - 02-0156 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT FUNERAL EXPENSES: KULL HEIZENROTH FUNERAL HOME, FUNERAL HENRY'S FAMILY DINING, FUNERAL DINNER SAUSSER MONUMENTS, MARKER ADMINISTRATIVE COSTS: Personal Representative's Commissions CHARLES A. REH Social Security Number(s) / EIN Number of Personal Representative(s): Street Address 2200 PINE STREET City ASHLAND State PA Zip 17921 Year(s) Commission paid Attorney's Fees LIPKIN, MARSHALL, BOHORAD & THORNBURG, 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 Probate Fees CUMBEKLAND COUNTY REGISTER OF WILLS Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs LEGAL ADVERTISING 4,280.00 136.00 400.00 1,381.00 1,920.00 85.00 250.00 TOTAL (Also enter on line 9, Recapitulation) 8,452.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF KOCH, JENNIE A. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 -02- 0156 Include unreimbursed medical expenses. ITEM NUMBER 1 2 3 4 5 6 7 8 9 DESCRIPTION PP&L, FINAL ELECTRIC BILL UNIVERSAL CARD, BALANCE DUE ON CREDIT CARD BOSCOV'S, BALANCE DUE ON CREDIT CARD VERIZON, FINAL TELEPHONE BILL PHARMERICA, BALANCE DUE FOR MEDICATION BANKCARD SERVICES, BALANCE DUE ON CREDIT CARD ANDREW & PATEL ASSOCIATES, BALANCE DUE FOR MEDICAL SERVICES UNITED STATES TREASURY, BALANCE DUE ON 2001 FEDERAL INDIVIDUAL INCOME TAX LIPKIN, MARSHALL, BOHORAD & THORNBURG, P.C., BALANCE DUE FOR PREPARATION OF 2001 INDIVIDUAL INCOME TAX RETURNS AMOUNT 268.00 303.00 36.00 42.00 92.00 4,012.00 45.00 414.00 250.00 TOTAL (Also enter on Line 10, Recapitulation) 5,462.00 SCHEDULE J BENEFICIARIES RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE ~. TAXABLE DISTRIBUTIONS (include outdght spousal distributions) 1 CHARLES A. REH COUSIN 50% OF THE 2200 PINE STREET RESIDUE ASHLAND, PA 17921 2 ROBERT KOCH BROTHER 100% OF SCHEDULE 770 POPLAR CHURCH ROAD F AND 50% OF THE CAMP HILL, PA 17011 RESIDUE Enter dollar amounts for distributions shown above on lines 15 through 17, 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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER KOCH, JENNIE A. 21 - 02- 0156 LAST WILL AND TESTAMENT OF JENNIE A. KOCH I, JENNIE A. KOCH, of 366 Ringneck Drive, Lower Paxton Township, Dauphin County, Pennsylvania, being of sound mind, memory, and understanding, make, publish, and declare this to be my Last Will, and hereby revoke all Wills and Codicils previously made by me. ITEM I. I direct my Executor hereinafter named to pay all of my legal debts and funeral expenses, including the cost of my gravemarker and administration expenses of my estate, as soon as practicable after my death. ITEM II. All estate, inheritance, legacy, succession, or transfer taxes, including any interest and penalties thereon, imposed by any domestic or foreign law with respect to all property taxable under such laws by reason of my death, whether or not such property passes under this Will, by operation of law, by contract, or otherwise, shall be paid without any right of reimbursement from any recipient of any such property, without any right of apportionment, and without postponement. ITEM III. I direct my personal representative to sell, at public or private sale, all of my household furnishings. ITEM IV. I give and bequeath ~all of my property and estate of every kind and nature and wheresoever situate, including all lapsed legacies and bequests, and including any property over which I may have a power of appointment at the time of my death, to my cousin, CHARLES REH, and my brother, ROBERT KOCH, in equal shares. ITEM V. common law, In addition to the powers conferred by the by statute, or by any other provisions hereof, my Executor is hereby empowered as hereinafter set forth: a. To sell at public or private sale, to exchange, to lease, to pledge, to mortgage, to transfer, to convert, or otherwise dispose of, or grant options with respect to, any and all property, real, personal, or mixed, at any time forming a part of my probate or trust estates, in such manner, at such time or times, for such purposes, for such price or prices, and upon such terms, credits, and conditions as shall be deemed advisable or necessary under the circumstances; b. To assent to, join in, and vote in favor of any merger, reorganization, voting trust, plan, lease, mortgage, consolidation, exchange, foreclosure of any corporation or other investment in which the probate or trust estate may hold stock, bonds, investments, or an interest; c. To vote in person or' by general or limited proxy with respect to any share of stock or other investment held by the probate estate or trusts; d. To make distribution in division of the probate estate in case, in kind, or partly in both; -2- e. To distribute articles to a minor or to his or her guardian or to any person taking care of the minor to hold for the minor within the limits authorized by statute or rule of law; f. To borrow money from any person or institution, including the corporate Trustee hereunder, for any purposes connected with the protection, preservation, or improvement of the trusts or probate estate; g. To compromise any claim or controversy; h. To apportion between principal and income any receipts and disbursements and to ascertain income and principal in accordance with the statutes and rules of law of the Commonwealth of Pennsylvania; i. To keep property in the name of a nominee with or without disclosure of any fiduciary relationship; j. To employ attorneys, auditors, depositories, and proxies with or without discretionary power; k. To make, execute, acknowledge, and deliver any and all instruments which may be deemed advisable or necessary to carry out any of the powers herein granted or provided by law; 1. To invest and reinvest the principal of the trusts, together with any accumulated income thereon whenever such accumulation has been permitted by the terms hereof, in all forms of property, real, personal, or mixed, including but not limited to stocks, bonds, common trust funds, mortgages, investment funds, -3- insurance policies, and annuities, without being limited by any statute or rule of law concerning investments by Trustees; m. To carry out the terms of any agreement I may have entered into to sell all or any part of any property or any interest I may own in any business at the time of my death; n. To exercise any law-given option to treat administrative expenses either as income tax or as estate tax deductions, without regard to whether the expenses were paid from principal or income. ITEM VI. I nominate and appoint my cousin, CHARLES REH, as Executor of this my Last Will to serve without bond for the faithful performance of his duties in any jurisdiction. ITEM VIII. I direct that my personal representative engage. as funeral director, CHARLES HEIZENROTH, 901 Centre Street, Ashland, Pennsylvania 17921. IN WITNESS WHEREOF, I have hereunto set my hand this~ay 1996. -4- The preceding instrument, consisting of this and four (4) other typewritten pages, was on the date thereof signed, published, and declared by JENNIE A. KOCH, the Testatrix named therein, as and for her Last Will, in the presence of us, who, at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. Witnesses: Address Commonwealth of Pennsylvania : : ss County of ~F~*~/~J : I, the Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law,. do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein expressedy_ E A. KOCH SWORN to or affirmed to and acknowledged before me by the above named Testatrix this ?L~-~tday of ~&~s~ , 1996. Notary Public My Commission Expires: (SEAL) -5- Commonwealth of Pennsylvania : : ss County of ~~/~ : We, the undersigned witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses and that to the best of our knowledge the Testatrix was at the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. SWORN or affirmed to and acknowledged before me by the above named witnesses this ~-~-d. ay of ~_~~, 1996. ,~- CAROL A. LYTER, NOTARY PUBLIC Harrisburg, Dauphin County Notary Public My Commission Expires: (SEAL) -6- Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of KOCH, JENNIE A. also known as , Deceased CHARLES A. REH No. 21 - 02- 0156 Date of Death 1/17/2002 Social Security No. 211-22-0673 The 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 located 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 Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: S. JOHN PRICE, JR. I.D. No.: 25967 Address: Personal RepreserY,~l'~ . ~ , Sig nature'~.~_~,~~' ~_~ ~'~HARLES A. REH Signature: Signature: ONE NORWEGIAN PLAZA, P. O. BOX 1280 Address: POTTSVILLE, PA 17901 Telephone: (570) 622-1811 2200 PINE sTREET ASHLAND, PA 17921 Telephone: Dated: Personal Property PENNSYLVANIA-DELAWARE DISTRICT LOAN FUND, UNSECURED PROMISSORY NOTE # 1004464 ACCRUED INTEREST ON ITEM # 1 M&T BANK, CHECKING ACCOUNT # 3440016313 ZIEGLER AUCTION COMPANY, LTD, PROCEEDS FROM SALE OF HOUSEHOLD ITEMS & PERSONAL EFFECTS VILLAGE OF PHEASANT RIDGE, SECURITY DEPSOIT REFUND GE CAPITAL ASSURANCE, REFUND OF UNEARNED PREMIUM GE CAPITAL ASSURANCE, REIMBURSEMENT FOR LONG-TERM CARE THE PATRIOT NEWS, REFUND FOR SUBSCRIPTION ERIE INSURANCE, REFUND OF UNEARNED PREMIUM FOR RENTER'S INSURANCE ERIE INSURANCE, REFUND OF UNEARNED PREMIUM FOR CAR INSURANCE 10,000.00 30.00 58.00 865.00 308.00 205.00 3,120.00 21.00 43.00 92.00 (Attach additional sheets if necessary) Total Personal Property and Real Estate $27,628.00 ALVIN B. MARSHALL ROBERT N. BOHORAD RICHARD THORNBURG * S. JOHN PRICE, JR. MARK SEMANCHIK DIRK BERGER JAMES C. BOHORAD THOMAS J. CAMPION, JR. ALEXANDER E. LIPKIN (1914-2001 ) · ALSO MEMBER NJ BAR LIPKIN, LAW OFFICES MARSHALL, BOHORAD & THORNBURG A PROFESSIONAL CORPORATION ONE NORWEGIAN PLAZA SUITE 200 P.O. BOX 1280 POTTSVILLE, PENNSYLVANIA 17901-7280 TELEPHONE: (570) 622-1811 FAX: (570) 622-4850 E-Mail: attys O Imbtlaw. com ALL REPLIES TO ABOVE 9 E. CENTRE STREET MAHANOY CITY, PA 17948 (570) 874-4700 1435 ARCH STREET ASHLAND, PA 17921 (570) 875-2121 44 N. BALLIET STREET FRACKVlLLE, PA 17931 (570) 874-4700 April 15, 2002 Cumberland County Courthouse Attn: Register of Wills 1 Courthouse Square Carlisle, PA 17013-3387 RE: Jenme A. Koch Estate File # 21-02-0156 Dear Register of Wills: Enclosed are one Inventory and two Pennsylvania Inheritance Tax Returns for the above-mentioned estate. Also enclosed is a check m the amount of $1,799.00 representing payment of the tax. Also enclosed please fred a Certification of Notice Under Rule 5.6(a). Please file this certification with your office. Sincerely, For Lipkin, Marshall, Bohorad & Thomburg, P.C. :jaj Enclosures 5 ALVIN B. MARSHALL ROBERT N. BOHORAD RICHARD THORNBURG * S. JOHN PRICE, JR. MARK SEMANCHIK DIRK BERGER JAMES C. BOHORAD THOMAS J. CAMPION, JR. ALEXANDER E. LIPKIN (1914-2001 ) · ALSO MEMBER NJ BAR LIPKIN, LAW OFFICES MARSHALL, BOHORAD & THORNBURG A PROFESSIONAL CORPORATION ONE NORWEGIAN PLAZA SUITE 200 P.O. BOX 1280 POTTSVILLE, PENNSYLVANIA 17901-7280 TELEPHONE: (570) 622-1811 FAX: (570) 622-4850 E-Mail: attys @ Imbtlaw.com ALL REPLIES TO ABOVE 9 E. CENTRE STREET MAHANOY CITY, PA 17948 (570) 874-4700 1435 ARCH STREET ASHLAND, PA 17921 (570) 875-2121 44 N. BALLIET STREET FRACKVILLE, PA 17931 (570) 874-4700 April 17, 2002 Cumberland County Courthouse Attn: Register of Wills 1 Courthouse Square Carlisle, PA 17013-3387 RE: Jennie A. Koch Estate File # 21-02-0156 Dear Register of Wills: Enclosed find a check in the amount of $35.00 which represents filing fees for the Pennsylvania Inheritance Tax Return, Inventory, and additional probate fees for the above-mentioned estate. Sincerely, Judy A. Johnson For Lipkin, Marshall, Bohorad & Thomburg, P.C. Enclosures 5 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001074 PRICE JOHN S JR 1 NORWEGIAN PLAZA PO BOX 1280 POTTSVILLE, PA 17901 ........ fold ESTATE INFORMATION: SSN: 211-22-0673 FILE NUMBER: 2102-01 56 DECEDENT NAME: KOCH JENNIE A DATE OF PAYMENT: 04/16/2002 POSTMARK DATE: 04/1 5/2002 COUNTY: CUMBERLAND DATE OF DEATH: 01/17/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,799.00 TOTAL AMOUNT PAID: $1,799.00 REMARKS: CHARLESA REH C/O S JOHN PRICE,JR ESQUIRE SEAL CHECK#010 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS Reg. Form 6.12 {revised July, 1992! STATUS REPORT UNDER RULE 6.12 Name of Decedent= JENNIE A. KOCH Date of Death= January 17~ 2002 File No: 21-02-0156 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate= State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will he 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 X · 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 X 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. J'~'-- ~ John Price~ Jr., Esquire N~me (Please type or print) Capacity-. One Norwegian Plaza, P.O. Box 1280 Address Pottsville, PA 17901 (570) 622-1811 Telephone Personal Representative X Counsel for Personal Representative RULE 6.12 STATUS REPORT BY PERSONAL REPRESENTATIVE (a) (~ (d) (e) (f) Re_oort of uncompleted administration. If administration of an estate has not been completed within two (2) years of the decedent's death, the personal representative or counsel shall lile at such time, and annually' lherealter until the administration is completed, a report with the Register of Wills showing the date by which the personal representative or counsel reasonably believes administration will be completed. Reoort of completed administration. Upon completion of the administration of an estate, the personal representative or his, her or its counsel shall file with the Register of Wills a report showing: (1) completion of administration of the estate; (2) whether a tormal account was filed with the Oq:)hans' Court; (3) whether a complete account was informally stated to all parties in interest; (4) whether final distribution has been completed; and (5) whether approvals of the account, receipts, joinders and releases have been filed with the Clerk of the Orphans' Court. The report required by this Rule shall be in substantially the prescribed form. No fee. No fee shall be charged tor filing of report required by this Rule ~.J2Y_G[.DJ[~ Upon the grant of letters, the Register shall give a copy of this Rule to each personal representative and his, her or its counsel. Failure to file a reoort. Alter at least ten (10) days prior notice to a delinquent personal representative and counsel, the Clerk ol the Orphans' Court shall inform the Court of the failure to lile the report required by this Rule with a request that the Court conduct a hearing to determine what sanctions, if any, should be imposed.