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Home My WebLink About08-20-09 (2) REGISTER OF WILLS OF COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } Gene C. KOONTZ Personal Representative(s) of the Estate of INI INVENTORY CUMBERLAND COUNTY, PENNSYLVANIA deceased, depose(s) and say(s) that the items appearingg situate and all of the real estate in the Commonwealth oTF item of said inventory represents its fair value as of the da outside of the Commonwealth of Pennsylvania except that I verify that the statements made in this Inven- tory are true and correct. I understand that false state- ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorney -- (Name) (Fimt) (Address) (Telephone) EDMUND G. MYERS File Number 21-2009-0095 C~ .n y ~ ~ ' ."7 ~ the following inventory include all of the per~~a~ ets rever ' :; ennsYlvania of said Decedent, that the valuatibm op Re each ; e of the decedent's death, and that Decedent off! re state- which appears in a memorandum at the end of,1F t»' ento~ ~= C7 r c: y. Gene C. K NT ~~: a _ ~ ~' (Supreme Court I.D. No.) 20558 JOHNSON DUFFIE 301 MARKET STREET, LEMOYNE, PA 17043 DATE OF DEATH 01/04/2008 LAST RESIDENCE 5225 Wilson Lane Mechanicsburg, PA 17055 FIGURES MUST BE TOTALED Personal Prooertv Cash ............................................................................................... Personal Property ......................................................................... Stocks/Listed ................................................................................. Stocks/Closely Held ...................................................................... Bonds ............................................................................................. Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ......................................................................... Total Personal Property ......................................... Total Real Property Total Personal and Real Property ......................... DECEDENTS SOC. SEG NO. 174-34-8451 88,683.87 246,733.33 337,417.20 '' 337,417.20; NOTE: The Memorentlum of real estate outsitle the Commonwealth of Pennsylvania may, at the election of the personal representative inrAUtle the value or each item, but such fgures shoultl not be eMentletl into me total of the Inventory. (See 20 Pa. C.S. § 3301(b)) Form RW-0a Rev io-+~-zoos V V REGISTER OF WILLS OF INVENTORY CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-09-0095 DATE OF DEATH LAST RESIDENCE 5225 Wilson Lane DECEDENTS SOC. SEC. N0. 01/04/2009 Mechanicsburg, PA 17055 174-34-8451 Cash Total Cash Stock /Listed 12,047.7710 shares Pioneer Tax Free Income Fund 18,727.0030 shares Delaware Tax Free Pennsylvania Fund A M8T Securities Brokerage Account Account No. ACZ-235738 123.9000 shares Bond Fund American Inc - Com Bedford Grange Mutual Insurance Co. -Return of Premium for Policy HO-7012286 Cash IRS -Refund received on 2008 Individual Income Tax Return MB:T Bank Certificate of Deposit Account No. 31003911470357 MB,T Select Account with Interest Account No. 210708 Pennsylvania Department of Revenue -Refund received on 2008 Individual Income Tax Return PNC Bank Savings Account No. 50-0378-3306 Professional Insurance Services, Inc. -Refund for Dental and Vision Insurance PSERS -Final distribution of pension paid to the Estate 58.00 33.53 78.00 60,130.18 27,069.16 226.00 794.16 181.20 115.63 88.683.87 99,273.53 141,048.07 1,329.45 (Attach additional sheets if necessary) Total Personal Property and Real Estate 337,417.20 REGISTER OF WILLS OF INVENTORY CUMBERLAND COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland COUNTY, PENNSYLVANIA File Number 21-09-0095 DATE OF DEATH LAST RESIDENCE 5225 Wilson Lane DECEDENTS SOC. SEC. NO. 01/04/2009 Mechanicsburg, PA 17055 174-34-9451 121.6910 shares Capital Income Builders Fund -Shares Ben Interest 5,108.59 148.8550 shares Income Fund American Inc - Com 1,973.59 Total Stock /Listed 248.733.33 -2- JERRY R. DUFFIE MELISSA PEEL GREEVY RICHARD W STEWART WADE D. MANLEY C. ROY WEIDNER, IR. ELIZABETH D. SNOVER EDMUND G. MYERS ANDREW P. DOLLMAN DAVID W.DELUCE LAW OFFICES JOHN A. STATLER OF COUNSEL JEFFERSON J. SHIPMAN HORACE A. JOHNSON N C ~H~~~N JBFFREY B. RETTIG ~ \ E LEE SHIPMAN RALPH H. WRIGHT. IR. (1965-20067 ~~ MARK C. DUFFIE 1 1 1L JOHN R. NINOSKY MICHAEL 1_CASSIDY t\ u,:. F;t";v,t alt „5{its ) '\4 t'fl'1 August 18, 2009 Register of Wills Oifice ~_ ~ - N O s ~:_, Cumberland County Courthouse ~ ~ °~ ~ ~, One Courthouse Square ,'~~ rv ~ := '~ Carlisle, PA 17013 RE: Estate of Inez J. Koontz ~~ ~~ n ~ Date of Death: January 4, 2009 ~ --+ ° ` ~~ Your File No. 21-2009-0095 ~ _ ~ " ' `<, Our File No. 15690-1 ~' Dear Register. Enclosed for filing please find the following documents for the above referenced decedent 1. 2 Original PA Inheritance Tax Returns. This is remaining tax due in the amount of $3,712.88. 2. Inventory 3. Two (2) copies of Pages 1 of the Pa Inheritance tax return, which we ask that you time-stamp and return to us in the enclosed envelope. 4. Two (2) copies of the Inventory, which we ask that you time-stamp and return to us in the enclosed envelope. 5. Check in the amount of $30.00 representing the $15.00 filing tee for the Inheritance Tax Return and $15.00 for the Inventory. Should you have any questions, please do not hesitate to contact our office. Thank you for you for your assistance in this matter. Very truly yours, NS N, ~~FI~E, S~,TpE,nW'ART &WEIDNER W' malt "~'Q'~ Y~ Estate Administration Paralegal Enc. 301 MARKET STREET P.O. BOX 109 LEMDYNE, PENNSYLVANIA 17043-O1D9 WWW.JDSW.COM 717.761.4540 PAx:717.761.3015 MAIL~JDSW.COM JOHNSON, DUFFIE, STEWART &WEIDNER, P.C. .4 .a u. x..a ~ .£ .u ,. ~5.. <. M o ¢o a~ 1i~~$~ X11 wd~ N I~ aQ ~o ~~ ~~ oo~ rr~! ~,a$ ~. ~~ ~~~~~~ 0 o ~ M ~~~ I N ~~ w~iw ~~~ op ~~~ 0 W O O r O ~ M JO~° 0 o ~ a ~; W dj O J W ~ p U ~ U G