HomeMy WebLinkAbout02-12-101505607120
REV-1500 EX (os-05) OFFICIAL USE ONLY
PA Department of Revenue county code rear File Numtx~r
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO 60X,280801 2 1 0 9 0 6 0 0
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
187 22 7462 05 25 2009 11 04 1924
Decedent's Last Name Suffix Decedent's First Name ~ ~ ~ (~'~ ~ n (~
YOUNG L~RETTA V II\Yt
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Security Number
THIS RETURN MIDST BE FILED IN DUPLICATE= WITH THE
R~GIS~'~R OF iNILLS
FILL IN APPROPRIATE OVALS BELOW
~~ 1. Original Return ~- _1 2. Supplemental Return i _ ,I, 3. Remainder Return (date of death
prior to 12-13-82)
~ ~~ 4. Limited Estate ~ -1 4a. Future Interest Compromise ~ i 5. Federal Estate Tax Return Required
--- L--~ (date of death after 12-122) --!
LX ~ g. Decedent Died Testate i- ~ Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) -- ~ (Attach Copy of Trust)
~ ~ 9. Litigation Proceeds Received ; ~ 10. Spousal Poverty Crean (date or death (-~ 11. Election to tax under Sec. 9113(A)
f_--_1 __~ between 12-31-91 and 1-1-95) ~ -I (Attach SCh. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFOR TION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
MARCI S. MILLER 717 540 4332
Firm Name (If Applicable)
HAZEN ELDER LAW
First line of address
2000 LINGLESTGWN RUAD
Second line of address
SUITE 202
City or Post Office State ZIP Code
HARF;ISBURG PA 17110
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REGISTER 0~~..S USE 6MLY
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DATE FILED ~ r
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Correspondent's a-mail address:
Under penalties of perjury, I deGare that I have examined this return, including accompanying schedules and statements, and to the best Of my knowledge and tx?lief,
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.
ADDRESS
J Martsolf
1909 Chestnut St., Grand Forks, ND 58201
SIGNATURE OF PI~ItA niER THAN REPRESENTATIVE
Marci S. Miller
2000 Linglestown Road, Harrisburg, PA 17110
Side 1
L„ 1505607120 1505607120 J
r~
REV-1500 EX
oe~de~~~SName Loretta Young
1505607220
Decedent's Social Security Number
187 22 7462
RECAPITULATION
1. Real Estate (Schedule A) .......................................................................................... 1.
2. Stocks and Bonds (Schedule B) ............................................................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3.
4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4.
5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5.
6. Jointly Owned Property (Schedule F) '~ 5eparate Billing Requested ............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) !_ ]Separate Billing Requested ............. 7,
8. Total Gross Assets (total Lines 1-7) ....................................................................... 8.
9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10.
11. Total Deductions (total Lines 9 8 10) ...................................................................... 11.
12• Net Value of Estate (Line 8 minus Line 11) ............................................................. 12.
13. Charitable and Governmental BequestslSec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................................................. 13.
12,505.31
12,505.31
36,144.26
14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................. 14. 3 6 , 1 4 4 . 2 6
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) x .o0 0 0 0 15. 0 0 0
16. Amount of Line 14 taxable
at lineal rate x .045 3 6, 1 4 4. 2 6 16. 1, 6 2 6. 4 9
17. Amount of Line 14 taxable
at sibling rate X 12 0 0 0 17. 0 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0 0 0 18• 0 0 0
19. Tax Due ..................................................................... ................................................ 19. 1 6 2 6 4 9
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
10,445.73
5,539.05
23,190.32
9,474.47
48,649.57
Side 2
L, 1505607220 1505607220 J
REV-1500 EX Page 3 File Number 21-09-0600
Decedent's Complete Address:
DECEDENT'S NAME
Loretta Young
STREET ADDRESS
100 Mt. Allen Drive
CITY STATE ~ ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
Z. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. InteresUPenalty if applicable
p, interest
E. Penalty
0.00
Total Credits (A + B + C)
Total InterestlPenalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A_ Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(1) 1,626.49
(2) 0.00
(3)
(4)
(5) 1,626.49
(5A)
(56) 1,626.49
Make Check Payable to: REGISTER OF WILLS, 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 properly transferred :.................................................................................. [~ x^
b. retain the right to designate who shall use the property transferred or its income :.................................... ~] ^x
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? ....................................................................................................................... t--~
3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death?......... [ x~ ^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ...................................................................................................................... ~ ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)j.
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero
(0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements
for disclosure of assets and filing a tax return are 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 zero (0) percent [72 P,S. §9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent,
except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rev160~ F7t+ (8.99)
SCHEDULE B
STOCKS 8r, BONDS
COMAONWEALTH OF PENNSYLVANIA
fNHERITANCE TA% RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Young, Loretta 21-09-0600
All property jobdlyowned with right or survivorship must be disclosed on Schedule F,
ITEM
NUMBER CUSIP
NUMBER
DESCRIPTION
UNIT VALUE VALUE AT DATE
OF DEATH
1 16 shares of Alcatel-Lucent stock 2.41 38.56
2 21 shares of Delphi Automotive Systems stock .O7 1.47
3 61.442 shares of Footlocker stock 10.62 652.51
4 20 shares of PPL Corp. 4.60% PRFD stock 73.25 1,465.00
5 263.871 shares of PPL Corp. stack 31.41 8,288.19
TOTAL (Also enter on Line 2, Recapitulation) 10,445.73
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule B (Rev. 6-98)
~_ _
Rav1fON t3Xa ls-~)
SCHEDULE E
CASH, BANK DEPOSITS, ~ MISC.
PERSONAL PROPERTY
COM,IONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Young, Loretta 21-09-0600
InGUde the proceeds of litigation and the date the proceeds were received by the estate.
All property Jolrrtly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 PNC Bank checking account #5070087124 2,036.02
2 Messiah Village -refund from assisted living facility 3,399.28
3 Mobile X-Ray Imaging -refund 21.79
4 Penn Treaty -partial refund of premium for long-term care insurance policy 81.96
TOTAL (Also enter on Line 5, Recapttulatttin) I 5.539.05
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98)
Rev-1689 EX+ 18-881
SCHEDULE F
coaenoNwEa-rHOFPENNSYLVANw JOINTLY-OWNED PROPERTY
INHERRANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Young, Loretta 21-09-0600
Kan easel was made joint within one year of the decedent's data of doath, It must bs roported on schedule G.
SURVIVING JOINT TENANT(S) NAME
PO Box 12463
Grand Forks, ND 58208
RELATIONSHIP TO DECEDENT
ADDRESS
A. Cathy and Dr. John Martsolf
B.
C.
JOINTLY OWNED PROPERTY:
Daughter and Son-in-Law
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION ANO BANK ACCOUNT
NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR
JOINTLY-HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET % OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
1 A 411312001 Community Bank of the Red River Valley 35,912.90 33.333% 11,970.95
checking account #60411205
2 A 4/13/2001 Community Bank of the Red River Valley 33,658.11 33.333% 11.219.37
checking account X6032935
TOTAL (Also enter on Line 6, Recapitulation) 23,190.32
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98)
SCHEDULE G
INTER-VIVOS TRANSFERS 8~
MISC. NON-PROBATE PROPERTY
COiM~AONNIEALTH OF PENNSYLVANIA
MRiER17ANCE 7AX RETURN
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
Young, Loretta 21-09-0600
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER
INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH
VALUE OF ASSET % OF DECD'S
INTEREST Excl.usioN
(IF APPLICABLE) TAXABLE
VALUE
1 John Hancock IRA #55-2766056 -Betty Brown 626.83 100.000 626.83
and Cathy Martsolf, children and beneficiaries of
account
2 Forethought Pre-Need irrevocable funeral/burial 8,847.64 100.000 8,847.64
account -paid directly over to NeiN Funeral
Home
TOTAL (Also enter on Line 7, Recapitulation) ~ 9,474.47
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98)
REV•1161 F,(+ (10.06)
SCHEDULE H
FUNERAL EXPENSES ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Young, Loretta 21-09-0600
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A, FUNERAL EXPENSES:
Neill Funeral Home -funeral expense
6,334.86
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name(s) of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission paid
2. Attorney's Fees Hazen Elder Law
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees Cumberland Co. Register of Wills
5. Accountant's Fees Drees, Riskey ~ Vapager, Ltd.
6. Tax Return Preparer's Fees
7. Other Administrative Costs
See continuation schedule(s) attached
5,500.00
117.00
200.00
353.45
TOTAL (Also enter on Tine 9, Recapitulation) ~ 12,505.31
Copyright (c) 2009 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Young, Loretta 21-09-0600
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative Costs
1 Cumberland Law Journal -estate legal notice 75.00
2 Cumberland Co. Register of Wilis -inheritance tax return and inventory filing fees 30.00
3 Hazen Elder Law -disbursements 28.05
4 The Sentinel -estate legal notice 219.40
H-67 subtotal 353.45
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
r~v.tsts ex. ttt-0el
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
Young, Loretta 21-09-06 00
NUMBER NAME AND ADDRESS OF RELATIONSHIP TO
DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE
PERSON(S) RECEIVING PROPERTY (Words) ($$$)
Do Not List Trust s
I~ TAXABLE DISTRIBUTIONS [include outright spousal
ti
di
t
ib
f
d t
r
s
u
ons an
rans
ers
under Sec. ~116(a)(1.2))
1 Betty J. Brown Child 50% of the
678 Cumberland Point Circle residue
Mechanicsburg, PA 17055
2 Cathy J. Martsolf Child 50% of the
PO Box 12463 residue
Grand Forks, ND 58208-2463
Total
Enter dollar amounts for distributions shown above on lines 5 thrqugh 18 on Rev 150 0 cover sheet, as appro priate,
III NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
~.~..~~
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08)
REGISTER OF WILLS
CUMBERLAND COUNTY
PENNSYLVANIA
CERTIFICATE OF
GRANT OF LETTERS
No . 2009- 00600 PA No . 21- 09- 0600
Estate Of : LORETTA YOUNG
IF/rst, Mfdd/e, Cestl
Late Of : UPPER ALLEN TOWNSH/P
CUMBERLAND COUNTY
Deceased
Social Security No: 187-22-7462
WHEREAS, on the 6th day of July 2009 an instrument dated
May 14th 1987 was admitted to probate as the last will of
LORETTA YOUNG
lFirs4 Middle, Lest)
late of UPPER ALLEN TOWNSH/P, CUMBERLAND County,
who died on the 25th day of May 2009 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
CA THY J MARTSOLF
who has duly qualified as EXECUTOR(R/Xl
and has agreed to administer the estate according to law, all of which
fully appears of record in my office a t CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VAN/A.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 6th day of July 2009.
* *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
LAST WILL AND TESTAMENT
I, LORETTA YOUNG, of the Borough of Mechanicsburg, County of Cumberland
and Commonwealth of Pennsylvania, being of sound and disposing mind, memory
and understanding, do make, publish and declare this as and for my Last Will
and Testament, hereby revoking and making void all former wills and codicils
by me at any time heretofore made.
FIRST. I order and direct that all my dust debts and funeral expenses
be paid by my Executrices, or Executrix, as the case may be, hereinafter
named, as soon as conveniently may be done after my decease.
SECOND. I give, devise and bequeath all the rest, residue and remainder
of my Estate, real, personal and mixed, whatsoever sad wheresoever situate,
in equal shares unto my .two (2) daughters, namely, CATHY J. MARTSOLF and
BETTY J. CLAUSI, share and share alike, absolutely and in fee simple.
If either of my said daughters should predecease me and leave issue
to survive me, I order and direct that the foregoing residuary share of my
Estate attributable to such deceased daughter shall be distributed unto her
issue per stirpes by representation and not per capita, subject, however, to
the protective proviaioas contained in Item Third hereinbelow.
THIRD. In the event that any person entitled to a distributive portion
of my Estate has not attained the age of twenty-three (23) years at the time
of distribution thereof, I order and direct that each such share shall. be paid
over and delivered unto THE FIRST BANK AND TRUST COMPANY OF MECHANICSBURG, PA.,
as my testamentary Trustee, IN SEPARATE TRUSTS, NEVERTHELESS, to hold, manage,
invest and reinvest for and until the beneficiary attains the age of twenty-
three (23) years, at which time said Trust shall be terminated and the then
remaining net balance thereof shall be distributed unto the beneficiary,
absolutely. During the existence of said Trust, (1) I authorize and empower
Lww os.~ae: my said Trustee to use, consume, expend and apply, from time to time, such
SN ELBAKER.
FLICKER a SILVER amounts of income and principal as the said Trustee shall determine by the
exercise of its sole discretion to be necessary and proper for the education
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SNELBAKER,
FLICKER Q SILVER
of the beneficiary [the term "education" to be construed to mean college or
other post-high school training which is designed to promote the adult pro-
ductivity of the beneficiary or to eahaace his or her quality of life]; and (2)
I order and direct that all assets in said Trust and the income therefrom shall
be free from and not subject to the voluntary or involuntary disposition by the
;beneficiary whether by pledge, assignment, sale, attachment, execution or by an.
other means whatsoever, it being aryy intention that the benefits of said Trust
shall be disbursed only by the discretionary distribution by said Trustee as
provided hereinabove.
FOURTH. I nominate, constitute and appoint IIlY daughters, namely, CATHY J.
MARTSOLF and BETTY J. CLAUSI (or the one remaining of them in the event that
either should fail to qualify or cease so to serve) to be the Executrices of
this, my Last Will and Testament, to serve without bond or other security as a
condition of qualification hereunder.
If both of my said daughters should fail to qualify as my personal
representatives hereunder or cease so to serve, then and in that ultimate event
I nominate, constitute and appoint THE FIRST BANK AND TRUST COMPANY OF MECHANIC
BURG, PA.,-to be the Executor hereof.
IN WITNESS WHEREOF, I, LORETTA YOUNG, have hereunto set my hand and seal
to this, my Last Will and Testament which consists of two (2) typewritten pages
to each of which I have affixed mY signature this j~ ~ay of A.D
One Thousand Nine Hundred Eighty-seven (1987).
(sEAL)
The preceding instrument, consisting of this and a (1) o her typewritten
page, each identified by the signature of the Testatrix, was on the date thereo
signed, sealed, published and declared by LORETTA YOUNG, the Testatrix therein
named, as and for her Last Will and Testament, in the presence of us, who, at
her request, in her presence, and in the presence of each other, have subscribe
our names as witnesses hereto.
i~
_._ _ i
I
COMMONWEALTH OF PENNSYLVANIA)
. SS.
COUNTY OF CUMBERLAND)
We, LORETTA YOUNG, RICHARD C. SNELBAKER and JANET M. FORRY, the Testatrix
and the witnesses, respectively, whose names are signed to the attached or fore
going instrument, being first duly sworn, do hereby declare to the undersigned
authority that the Testatrix signed and executed the instrument as her Last Will
and Testament and that she had signed willingly, and that she executed it as
her free and voluntary act for the purposes therein expressed, and that each of
the witnesses, in the presence and hearing of the Testatrix, signed the Will as
witness and that to the best of his or her knowledge the Testatrix was at that
time eighteen years of age or older, of sound mind and under no constraint or
undue influence.
Subscribed, sworn to and acknowledged before me by LORETTA YOUNG, the Testatrix
and subscribed and sworn to before me by RICHARD C. SNELBAKER and JANET M. FORR ,
witnesses, this %Y'~ day of "7'n~ ,~.1~s)987/.
Notary Public
CATNARINE E. BOUftlN, NO1ARr -WLIC
MESIIAMICttOR9 IORf). CtlM6ERUNf) COIIN111
MY COMMISSION EIVIREi FEI. t7, ltl0
MomYM'. 3eAlISyMt~lli~ AssotYfioR of NNarkt
uw o~tecs
SNELBAKER.
FLICKER Q SILVER
COMMUNITY BANK
OF THE RED RIVER VALLEY
August 19, 2009
Hazen Elder Law
2000 Linglestown Road Suite 202
Harrisburg, PA 17110
Re: Loretta Young
To Whom It May Concern:
Here is the following information you have requested for Lorreta Young. There are
two accounts that were owned by Lorreta Young.
. ~ . `l t ~,~ ~0~1 IUD
1. Account # 60411205 ~` ~-'``~ 1
Ownership of the account: ~,.hn 4~ 1, pp I
Loretta B Young ~"
Cathy J Martsolf
John T Martsolf
Account balance as of OS-25-09 $35912.90
Account type -Money Market Checking account
Interest earned $99.55
2. Account # 66032935 - ~, ~~ ~ " ~
Ownershi of the accou~lt:
Loretta B Young ~~~ ' `-, ~~
Cathy J Martsolf ~~ a~ y12~1 '
John T Martsolf
Account balance as of OS-25-09 $33658.11
Account type Gold Star checking account
Interest earned $12.78
b~\ ~'d""
` ~~
Q,s
I do not show any changes to these accounts one year prior to the date of death. Should
you have any questions to this information do not hesitate to call me.
Sincerely, ,
~~~~~
Amy Bies -701-780-7735
Your Bridge to Financial Success for Life
P.O. Box 13897, Grand Forks, ND 58208-3697
Phone: (701) 780-7700 Fax: (701) 780-7710
www.cbrrv.com
AUG 3 1 2009