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HomeMy WebLinkAbout03-11-10 (2)J 1505607121 _ REV-1500 E>< D5 o5 ( > - PA Department of Revenue ,~, k ~3~ ;-.. ,..~...,4;, Bureau of Individual Taxes County Code Year Flle Number PO BOX 280601 INHERITANCE TAX RETURN Hanisbum. PA 17128-0601 RESIDENT DECEDENT 2 1 0 9 0 6 1 5 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 7 9 0 9 6 9 5 2 0 6 1 1 2 0 0 9 1 0 2 8 1 9 1 6 Decedent's Last Name Suffix Decedent's First Name MI L O H E N I T Z L O R R A I N E C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW Q i. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Retum Required death after 12-12-82) QX 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST 8E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number D A V I D H S T O N E E S Q U I R E 7 1 7 7 7 4 7r`1/ 3 5 Firm Name (If Applicable) S T O N E L A F A V E R S H E K L E T S K First line of address 4 1 4 B R I D G E S T R E E T Second line of address City Or POSt Office N E W C U M B E R L A N D State ZIP Code REGISTE C LLS U3F~LY ~ ~n ` ~} C ~ C~ _: r'" ., t C!9 S 3 J C ~J ~ ,.. .~ b .... .: DATE FILED ~ 'S3r .,, -_.. G_,; 'f r:~1 ~? -i-i r~r t P A 1 7 0 7 0 Correspondent's a-mail address: D S T O N E a S T O N E L A W• N E T Jnder penaltles of perjury, I declare that I have examined this return, including aaompanying schedules and statements, and to the beat of my knowledge and t is We, correct and . Dedaretbn of prepa(a[other~rgn the persdrlal representative is based on all information of which preparer has any knowledge. ADDRESS Y THAN REPRESENTATIVE ~~~.. S 17 414 BRIDGE STREET NEW CUMBERLAND PA 17070 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 1505607121 J ~~ J 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: LORRAINE C• LOHENITZ 1 7 9 0 9 6 9 5 2 RECAPITULATION 1. Real estate (Schedule A) .................................... 1. .... 1 1 9 0 7 0, 0 0 2. Stocks and Bonds (Schedule B) .............................. 2, .... 6 1 , 9 6 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . .... 3. 4. Mortgages 8 Notes Receivable (Schedule D) .................... .... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ... .... 5. 8 2 0 8 , 6 4 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ... .... 6. 7. Inter-Vivos Transfers & Miscellaneous N -Probate Property (Schedule G) ~ Separate Billing Requested ... .... 7. 1 0 5 0 9 0, 2 1 8. Total Grosa Assets (total Lines 1-7) ....................... .... 8. 2 3 2 4 3 0. 8 1 9. Funeral Expenses 8 Administrative Costs (Schedule H) ............ .... 9. 1 8 2 6 3 , 3 6 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ........ .... 10. 4 5 , 0 0 11. Total Deductions (total Lines 9 & 10) ....................... .... 11. 1 8 3 0 8 . 3 6 12. Net Value of Estate (Line 8 minus Line 11) ..................... .... 12. 2 1 4 1 2 2 , 4 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .............. .... 13. 14. Net Value Subject to Taz (Line 12 minus Line 13) .............. .... 14. 2 1 4 1 2 2 , 4 5 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.0 _ 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 2 1 4 1 2 2. 4 5 1B. 9 6 3 5. 5 1 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 1S 0, 0 0 19. Tax Due ............................................. ...19. 9 6 3 5. 5 1 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 L 1505607221 1505607221 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 09 0615 DECEDENTS NAME LORRAINE C. LOHENITZ STREET ADDRESS - 512 MARKET STREET - - CITY STATE ZIP NEW CUMBERLAND PA 17070- Tax Payments and Credits: 1 • Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 7.500.00 C. Discount 394.73 3. InleresUPenalty if applicable D. Interest E. Penalty (1) 9.635.51 Total Credits (A + B + C) (2) 7, 894.73 Total InteresUPenalty (D + E ) 4, If Line 2 is greater than line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to requsat 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 +SA. This is the BALANCE DUE. (3) 0.00 (4) 0.00 (5) 1, 740.78 (5A) (5B) 1.740.78 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 property transferred : ........................................................... ........... ^ XD 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 cere7 ............................................ ........... ^ X^ 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 '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, t994 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) peroent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are 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 childtwenty-one years of age or younger at death to or far the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent p2 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-haH (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)j. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (g.98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT OF SCHEDULE A REAL ESTATE LORRAINE C. LOHENITZ 21 09 0615 All roal property owned solely or as a Unant in common must be roported at hir market value. Fair market value is defined as the price at which properly would be exchanged between a willing buyer and a xrilling seller, neitller being compelled to buy or sell, both having roasonable knowksdge of the relevant fads. ITEM I - NUMBER DESCRIPTION VALUE AT DATE _ OF DEATH Real Estate at 512 Market St. New Cumberland, Cumberland County, PA at assessed value ($94,500) times CLR (1.26) _ TOTAL (Also enter on line 1 (If more space is needed, insert additlonal sheets of the same size) REV-1503 EX + (g_gg) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE SCHEDULE B STOCKS & BONDS FILE NUMBER LORRAINE C. LOHENITZ 21 09 0615 All property Joirldyovmed rritl~ right of survlvorahip must be discosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~ 1 $50 EE US Savings Bond Cert #C495647249EE dated Feb 1992 61.96 Face Value $25.00, Int. $31.96 TOTAL (Also enter on line 2, Recapitulation) I S (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-9e) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER LORRAINE C. LOHENITZ 21 09 0615 Indude the proceeds of litigation and the date the proceeds were received by the estate. All property jolntlyowned with right of survNorship must be discbsed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~. 1994 Oldsmobile Cutlass sold to Drake Dougherty 500.00 2 Intl Ladies Garment Union-death benefit 3,455.00 3 SovereignBank-CheckingAcct#0771024401 2,182.37 4 Sovereign Bank-Savings Acct #0354000572 2,071.26 Princ. $2,071.26, Int. $.01 5 Sovereign Bank-Savings Acct #0354000572 -Accrued Interest 0.01 TOTAL (Also enter on line 5, Recapitulation) I : (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE G INTER•VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE LORRAINE C. LOHENITZ 21 09 0615 This schedule must be completed and filedrf the answer to any of queaflons 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCIUDETHENMIEOFTHETPANbFEREE,THEIRRElATIgI6NIPTODECEDENTIND THE DATE OF TRANSFERATTACNACOPYOFTHEDEEDFOR~ILE6TATE. DATE OF DEATH VALUE OF ASSET %OFDECD'S INTEREST EXCLUSION pFMRICJaLE) TAXABLE VALUE ~. Edward Jones Acct #957-13270-1-5 -Transferred mutual 105,090.21 100. 105,090.21 funds on March 9, 2009 (w/in one yr of death) to Michaal D Lohenitz, son of decedent as follows: 24,777.126 shs Franklin Inc Fd CIA $34,192.43 2,325.662 shs Franklin Mutual CIA $28,466.10 2,025.378 shs Mutual Discovery Fd CIA $42,431.67 TOTAL (Also enter on line 7 Recapitulation) ~ S 105 090 21 (If more space is needed, insert additlonal sheets of fhe same size) REV-1511 EX + (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER LORRAINE C. LOHENITZ 21 09 0615 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t. Elizabethville Monument Co-monument stone 86.00 2 Maple Grove Cemetery-opening of grave 100.00 3 Hoover Boyer Funeral Home-Funeral expenses 8,338.47 B. I ADMINISTRATIVE COSTS: 1. I Personal Representative's Commissions Name of Personal Represenhadve (s) Street Address City State Zlp Year(s) Commission Paid: Z, Atromey Fees David H. Stone, Esquire 3. Family Exemption: (If decedenrs address is not the same as daimanYs, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent 5,000.00 Zlp 4• ~ Probate Fees Cumberland County Register of Wills 5. I AocountanYs Fees 6. I Tax Retum Preparer's Fees 360.00 7. PA Dept of Revenue-paymt of 2008 PA40 58.76 2 Stone LaFaver 8~ Shekletski-Reimb on advertising grant of fetters in 2 newspapers 216.24 3 Stone LaFaver &Shekletski-Reimb on bank charge 20.00 4 Liberty Mutual Ins.-property insurance 142.73 5 Stone LaFaver &Shekletski-Reimb for adv probate 216.24 6 Stone LaFaver &Shekletski-Reimb on bank charge 20.00 7 New Cumberland Boro-real estate taxes on prop 912.56 8 Register of Wills-probate costs 360.00 9 PAWC-water service at property 23.74 10 Michael Lohenitz-Reimb on paymt of bank box 23.00 11 Notary fee on Edward Jones accounts 5.00 12 Int'I Ladies Garment Union-return of ension check 97.50 TOTAL (Also enter on line 9, Recapitulation) S 18,263.36 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent LORRAINE C. LOHENITZ 21 09 0615 Decedent's Name Page ~ File Number Schedule H -Funeral Expenses & Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 13 PA Water Co-service at property 25.16 14 PA Water Co-water service at property 20.18 15 Electrical and lumber supplies for property 124.27 16 Home Depot-cleaning supplies for property 54.67 17 Electrical and cleaning supplies for property 38.96 18 Posts and screws for property 91.gg 19 Donald Dodson-lawn service at property 100.00 20 Electrical outlets, plywood, nuts, bolts, etc 134.47 21 Electrical hardware 22.50 22 J &W Hardware-supplies for repairs 74.65 23 Ron Stricker-work done to replace beam at prop. 500.00 24 Electrical supplies and oil tank supplies 81.42 25 Donald Dodson-lawn work at property 140.00 26 New Cumberland Boro-trash & sewer serv at prop 101.55 27 Sewer 8~ Trash at property 101.55 28 PPL-service at property 49 87 29 PPL-service at property 66.99 30 Verizon-service at property 40.24 31 PPL-service at property 80.48 32 H BMcClure-service at property 219.00 33 PAWL-water service at property 25.82 34 Comcast-service at property 59.36 35 Register of Wills-filing Inheritance Tax Return and Inventory 30.00 36 Reserve for closing expenses 100.00 SUBTOTAL SCHEDULE H-B7 I 2,283.12 REV-1512 EX + (12.03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS w ~ r ~ c yr FILE NUMBER LORRAINE C. LOHENITZ 21 09 0615 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbunsed medical ezpenaea. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH service fee 45.00 TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additbnal sheets of the same size) REV-1513 EX + (g-0O) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER LORRAINE C_ LOHFNIT7 0~ na nc~c 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 [includeou htappoousaldistribufans, and transfers under Sec. 9116 (a~ (12)] 1 Michael D Lohenitz Linea 1 214,122.45 210 Fairway Drive Etters PA 17319- ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 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 S (n more space Is n88g8p, Insert a001tl0nal Sh88rS Or Ih8 58818 SIZe) r, „ ~.'' ,. ,,.;';, ~, LAST WILL AND TESTA1~ratyT Q LORRAINEi C Lni~NrrZ ); LORRAINE C. LOHENITZ,, ofNew Cumberland, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby revoke all other wills and codic>ys heretofore made by me. FIItST I direct the payment of my debts not barred by a statute of limitation and expenses of my last >Tlness and fimeral from my estate as soon a$er my death as conveniently may be done. >f there be no cemetery lot available for my burial owned by me at the time of my death, I authorize my personal representative to purchase such cemetery lot with a contract for perpetual care, using ~nda from my estate, in such amount as he shall consider necessary and desirable, and I authorize my Personal representative to cause title to or ownership of such lot so purchased to be vested in sack person as my personal representative shall designate. Further, in this connection, I authorize my personal representative to expend fiords from my estate, in such amount as my personal representative shall conffider necessary and :,_. desirable for the erection and inscription of a suitable m~tker`f r mY grave. ,. SE- ('AND I give and bequeath all remaining real estate and personal Property owned by me at the time of my death, together with all insurance policies naming my Estate as beneficiary unto my son, MICHAEL D. LOHENiTZ. G7~vt,c~~x.c. G FO_ ~~ I direct that any and all Inheritance, Estate and Transfer Taxes imposed upon my Estate passing under my W>71 or otherwise, shall be paid out ofthe principal ofmy residuary Estate. In addition to the powers conferred by law, I authorize my Executor, m his absohrte discretion: (a) To retain in the form received, and to sell either at public or private sale any real or personal property. (b) To manage real estate. (c) To invest and reinvest in all forms of property without being can8ned to legal investments, and without regard to the principle of diversification. (d) To exercise any option or rights arising from ownership of investments. (e) To compromise claims without court approval, and without the consent of any beneficiary. ~~ ~ YLYTH Any and all payment or payments of any sum or sums, whether in cash or in kind and whether from principal or income, payable to the said son, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such 2 r-rt.~ C ~ i beneficiary. All shares ofpriacipal and income herein given shall be free from anticipation, assignment, pledge, or obligation of any beneficiary, and shall not be subject to any execution or attachment SEVENTH I nominate, constitute and appoint my son, MICHAEL D. LOHENTTZ, as Executor of this my Last W>7l and Testament. I hereby refieve my Executor from the necessity of posting any security or bond in connection with his duties as such in any jurisdiction in which he may be called upon to act insofar as I am able by law to do so. IN WITNESS WI~REOF, I have hentimto set my hand and seal to this, my Last W~71 and Testament, consisting of five (S) type written pages, the st two (2) of which bear my signature in the margin for the purpose of identification, this ~ y of O c~~~, 2000. w G- SEAL) -or. .~= 3 ' , / 1 '. 7' 1' ~ 7 h F: 1 n ~ I I 'q r l{ a 1 J Yt~" 1 ~'i4a d~ ~ 1 J ~' t v 1 ~ 11 +, 1 { 1 r 1~.:: ,y ~t(~ SI! aHp - r 1 t 7.1~5~: /+' ar i r~ 1 a ,I_ i` 1 1' I n 3~ r,~R` it nil v ii' Inns .~ d'$~ hMw ~,~ w 1.~L ~I. f~~ir ~a .i ¢.P iR 1 ti; ~yX~ ~'~~i ~S r Fr~l~ _~ }~5 ~~. a A ~. . ,~.: ..r. .,I" ..... .. COMMONWEALTH OF PENNSYLVANIA ; s3. COUN'T'Y OF ~,r,,, ~;~ I, LORRAINE C. LOHENTTZ, Testatrix, whose name is signed to the attached or foregoing instrument, having been dull, qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Wr71, that I signed it willingly, and that I signed it as my &ee and vohurtary act for the purpose therein expressed. LORRAINE C. LOHENITZ Sworn or armed to and acknowledged before me, by LORRAINE C. LOHEIVITZ, the Testatrix, this ~~T~ day of _ O CTOr3 e ~ 2000. G~-JU(,~ Notary Public My commission expires: Wotadal Seal Barn T. HoMrall Naw CumheMOnd Bap ~~' PubNc MY Commiaebn ExpiresCu ~ j~ ~t Membe- Pennsylvania AssociaNan of Notaries Signed, sealed and published and declared by the above-named Testatrix as and for this Last Wr71 and Testament in the sight and presence, who at her request, in her sight and presence, and in the sight and presence of each other, have lteiermto subscribed our names as witnesses. fL~GLOP ~,~, ~~ 4 t'6J 1 Y ~ ~ +.'.: y~r ~M1U~,Qw V .Sty; a~ .,. G.,~i?,µ , r A Y ': 44 i t ~ I a I J 4 ~ l_ .. .. .., .~.:':, :...tit iglu FJ~wiCH,r ~, ~ r Y ;r,~ ~~ COMMONWRAi.~I OF PENNSYLVANIA : COUNTY OF C ~ ,., ~ 1 Yrs., .~ SS. 4 I ;~t n ~ ~ ~ o w k• We, the undersigned, being the witnesses whose names are signed to the attached and foregoing instrument, being duly qua~~, according to law, do depose and say that we were presem and saw the Testatrix sign and execute the instrument as her Last Will and Testament, that she sued it willingly and that she executed it as her &ee and vohmtary act for the purposes therein expressed; that each of us m the hearing and sight of the Testatrix signed the Last Will and Testament as a witness; and that to the best of our la><owledge the Testatrix was at that time eighteen (1 S) or more years of age, of sound mind and under no constraint or undue in$uence. S 1 Address: ~~2~~~~ WTiNESS Address: ~ ~! ~riga ~ Sfr~ _~/~~. , ~.. L /1JS1~~~7D 7Q -. Sworn or affirmed to and subscn'bed before me~y the above named witnesses, this -~-- day °f ~~.Tt~ .+I ~..C 2000. 1 ~~c.(~~ NOTARY PUBLIC My commission expires: Nobuial seal Bent T. HoweN, Notary Public Mew Cumberland Boro, Cumberland Cowry My Commission Expires May 10. ZOOf Member. Pennsylvania Association of Notaries • ~ REV-485 EX (1-07) 48500041046 SAFE DEPOSIT BOX INVENTORY PA Department of Revenue PLEASE USE ORIGINAL FORM ONLY Soaal Secu ' or Death CerdBcata Number Date of Death _ Coun Code Year File Number 1 7 9' 0 9~ r Cy C1 '2 `0 0 '9 2 1 0 9 0 6 1 5 Decedent's Last Name ~"` -~a.<- SutAx First Name MI L O HEN I T Z L O R R A I N E __. _- - ~ADDRE88 OF DECEDENT STREET. ~ M 512 Market Street New~IC~umberland P"AA~` 17{~~l~De NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX ~ NAME: David H. Stone, Esquire STREETADDRESS: 414 Bridge Street New C~t~erland p]1, STATE: 1 7Lp,~DE: NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE 80X OPENING UU a. NAME: Michael D. Lohenitz RELATIONSHIP: SOn STREET ADDRESS: CITY: 210 Fairway Drive Etters PA STA7E:1 ,7371p~CODE: b. NAME: - _17_ RELATIONSHIP: j STREET ADDRESS: CITY. ~ STATE: ZIP CODE: c. NAME: - - -- RELATIONSHIP: ~ STREETADDRESS: - __ I CITY: STATE: ZIP CODE: i NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED ~ NAME: PNC Bank STREETADDRESS 331 Bridge .Street New Cu~g~rland PPi 1 70~ j TATE: ODE: .."mc ~r rcnaVn aIARINR LAST ENTRY Michael D. Lohenitz DATEi 2 C~t3 OTR/1i T9Tip7 ENT BOX • NUMBER OF BOX / / 269B NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX a. NAME: _Lorraine C. Lohenitz STREETADDRESS: -- _512_Market Street CITY New Cumberland ST~~,` 1'lf(~~~ NAME1,Aa V iT1E HF EM~ tOrie ,Kl Esqu~i"e ~~ WAS A WILL INCI7HE BOX? ^ YES [~ NO H yea, a. Data of will: b. Noma and address of pareonal ropresentatlvs, K nomad In tha will NAME: \TE ANO TIME OF LAST ENTRY 7/1/2009 rf~,- ~.,• . Lohenitz & b. NAME: Michael D. Lohenitz STREETADDRESS: _210 Fairway Drive CITY: ~--- Etters I STREETADDRESS: - - c. Noma and addnaa of attomay, H any ~ NAME: --- ' STREETADDRESS: L 48500041046 ST PA 1 /.31 `j E: __---- CITY: STATE: ZIP CODE: CITY: ~ ---- ~~~-~ STATE: --_~ZIPCODE:• i 48500041046 J N .~ C'. Gl 0 ~ a ,n ~ U .- 3 ~ ~ O ~ -~ rn ~ ~ o a N Z o W y LLO m W F 2 O fA -+ H W u. Y! 0~ O m Y1 yp Y! O~ ~~ a~ W O N .~ ra N .C; O a U d .,~ ro w -~ O a N O~ C1 N O WC m 7 2 O m V v W W 01 N r V' ~O N U ~I R w t~ N tJ'1 01 ~o i rn 0 i o~ r C W N O N qZZ< J W >> yW z a~ ~~ ~~m~ ~~~ ~~ ~ ~o ~ U Z S N Z~ 2 Z O N C.' C1 W W O O O L[1 ~, ,' r In sc wm . a.e -.. l..wew W eve. rirr,w.. lie .~ .~~~ a ~5.:.~~~~ ,:~ :- +; w :ilade the ~~ ~ doy of /7'~~ , iA ttu ysor J1tinrteen'hrcndred and Sixty-Eight (I S) '~iekmertt MICHAEL LOHENITZ sad LORAAIIdE C. LOHENITZ, his wife o! the Sozough of New Cumberland, County of Cumberland, aad State of Pem- sylvania, (3'roAlors A N D ~,OuR~RAl>~ C, i.OH~NITZof 512 Market Street_ New Cumberland, C~nbe~~ enns va a--.--- --- •• •- -- •. tart '-- ~ilries• ,that ACOAetderottoAOj One 1.00 ----- in hand patd, the rocetpL whereojtr hereby ackAOmtedgsd, the aatd OroAtor s do hereby grant and oonaey to the aatd Orontee . her belts and asdglss, ALL that certain house and lot of ground iltoate on Market Street is the Borough of New Cumberland, County of Cumberland, and State of Pam bouaded and.deecribed as follows, to wit: ' HY Market 3traet above Fifth Street is trout; oa the east by Lot No. 122; on the weal by Lot No. 124; and on the rear by i fourteen (14) foot alley, Gontiining fifty (50) feet in front on Market Street aad one hundred and fifty (150) feet ie depth to acid fourtaaa (14) foot allay. HAVING THEREON EAEC.TED a ta%o and oae-half story f:ame dwelling honsa No. 512 Market Street, Nsw Cumberland, Pameylvania. BEING the same prem[se• which George.A. Watkiae, Mlmle C. Watklnl, his wife. and Marian M. Watkins, siagl6 woman, granted,and conveyed unto Michael Lohenite and Lorratae C. Lohenitz, his wife, by deed dated November 20, I95t, and recorded fn the Office for Recording of Deeds of CumberLnd Connty, Pemaylvania in Dsed Book !'D'!, Yo1.15, . Page 268. ,~ ' Thla it a eonwgance.belween husband and wtte. w.. ems. ~~ ~,,,- ,yam='. ut: t '~ ~ ..r, ~_ • i ~ 1 T:l' ~.', .,~•.'~ T' s i~ i ex!C,23ni~ 5 1 1 1 4 I I I tall 111 I~. f~V-..I ~:.~u . t i ( i I , I V ~ i .; i w :! i".I~ .~... - ~ I I ll I ~~ the aatd Orgntor• Wlll' lyurront proPe+'ti/ hereby conveyed. the ~n $titst~ e~<lereof, the aatd Orsntor^ .iQraeidsnt dul .at; ~amr eau{ed this Indenture to bs axeeuted ~by~. -saal~Grrber N sstrdb,Kita..__________~ecrttaryandltstont~vaona_e eJJtsed~7te day and year Jirat above written.. °CPOaOta Si;reed. Sealed and Da7itxred in the preaenea of u ae tenitz 'lnalr nr dtte+t: ~ ~ " ~ ~.• r i ... ~. 1 rrs ne C. Lo etuts ~aatmanmsA! aF ~rnns~launia) are (Lsuntp of ~ 3 ss. . oa.errrr ~~'~'~ o .7'~"'~ .o me, the aabieKbrr, o <lnxo Dom1a118G/ , be/oro psraogelJy appeared a,.~ aau ~oa~yyon •rilth and C'ouaty, who acknouledFrd rear to be tke P ~ ~-~+-~o ~ ~'~POrailen, and that ke~e aacA brln( outhod:ed to do eo, ereouted the /orspoizj Jaatrument for tAe pxrporre thrreln contaJned~ 6y riy~nln( tpNSi'ameSOJ~~ ' .. ..w W1TAS33 my Aond Qi'/ ~~ ~ ~ ~ ~ •• " ~cr: the day~dyrar i/oresoid. ,~.~~'~a (t r/,J~•:,I. c~. c~,KSLk aetfiF~ that t7~e praeise. .aan+-: ~ ~~ ~~ -j3 ~:1 ~L~ ~s ~. s I.1 W 0 W z~ a ~~tl ~ ~~~ S ~~ t. .._ C:. _- ,:i , Ye fra~+tRe hereifn.. ~.sj~;'~~i ~ ~. ., ~n ~!\ /_ .. Y N a .. y e+ '~ w^ C ~ 1D Y ~ o e s ; ~ ~~ ~~ ei 3 ~N#~m zz W :a •. ~ q a W = ~ .~iTe nlD er TM~ BOA06uN OF kiY{ CUa'9,°RUHO Q,+atumonmen1t17 of ~Jenns~4tt,enia v ~ . ~tarszlp of - ~sCtlie OJJtca foi Raoordinf ojDeeda in and for ~~~ ~' '~_ in Deed Book C Xo. e7 j ~°Q.°g .f Etc. ' ' ~ilnsaa my hand and aeal of Oljlca this S,C'~'~ day of ~ Anno Domint 19 G/ ~/acorder TaxDB Result Details DistrictNo 25 Parcel ID 25-24-0813-001. MapSufiix HouseNo 512 Direction Street MARKET STREET Ownerl LOHENITZ, LORRAINE C C/O PropType R PropDesc LivArea 1784 CurLandVal 25000 CurImpVal 69500 CurTotVal 94500 ~ 1, ~,~ CurPretVal Acreage .17 CIGrnStat TaxEx 1 SaleAmt SaleMo SaleDa SaleCe SaleYr DeedBkPage 0023C-00005 YearBlt 1870 HF_File_Date 01/14/2005 HF_Approval_Status A Page 1 of 1 Detailed Results for Parce125-24-0813-001. in the 2004 Tax Assessment Database ~ 1 14~ U?O. av http://taxdb.ccpa.net/details.asp?id=25-24-0813-001.&dbselect=l 8/14/2009 Sovereign MAl MB3 02-10 Court Ordered Processing/Decedent P.O. Box 841005 ..._ Boston, MA 02284 July 13, 2009 Attn: David H. Stone Stone LaFaver & Shekletski Attorneys at Law P.O. Box E New Cumberland, PA 17070 RE: Estate of Lorraine C. Lohenitz Date of Death: 06/11/09 SS# 179-09-6952 Dear Mr. Stone: Per your request, enclosed please find account information as of the date of death for the above-named decedent. For your information, accrued interest in not included in the date of death balance. Please feel free to contact me if I can be bf any further assistance. Very truly yours, . r~~ Nicole Job COP Specialist III Decedent Department (617) 533-1364 Sovereign Bank ESTATE OF Lorraine Lohenitz SOCIAL SECURITY #: 179-09-6952 DATE OF DEATH: June 11, 2009 Account #: 0354000572 Type: Savings Open date: 1/1/1971 In the name of: Lorraine Lohenitz Date of Death Balance: $2,071.26 Int.(YTD) from 1/1/2009 to 6/9/2009 $2,67 Accrued interest to date of death: $0.01 Other Info: Account #: 0771024401 Type: Checking Open date: 1/22/1981 In the name of: Lorraine Lohenitz Date of Death Balance: $2,182.37 Int.(YTD) from 1/1/2009 to 6/9/2009 $0.34 Accrued interest to date of death: $0.00 Other info: Page 1 of 1 Edward Jones Mark D. Bioty . 1433 Bridge Street Financial Advisor New Cumberland, PA 17070 (717) 774-5475 EdwardJones July 10, 2009 David H. Stone, 8squire atone, LaFaver & Shekletaki 414 Bridge Street New Cumberland, PA 17070 Re: 8state of Lorraine C. Lohenitz, Deceased Dear David: As you requested, enclosed are valuations for the account held at Edward Jones by Lorraine Lohenitz. The Historical Date of Transfer Valuation shows the value of the account on March 9, 2009, the date on which Lorraine transferred the account to her son, Michael D. Lohenitz. The Historical Date of Death Valuation shows the .value of the account on June il, 2009, the date of Lorraine's death. If you need additional information, please do not hesitate to telephone me at (717) 774-5475. Very truly yours, ~~~ Mark D. Bioty /ae Enclosures 2 ' m c ~ °° A ~ ~ a Q 0 tC CO V p ~ Cif A W ~ N i _ y ~D S ~ ~ < ~ ~ ~. _~ ~ ~Qr po a z m ! ~' '~ ~ ~ ! ~ ~~ ~. ~ ~ i ~ g ~ ~ ~ g ypxf~ ~ ~ ~ N {!! b9 Vl d- 69 fA d- b9 d! 69 y N ~. .. ~ p ~ ~. m o ~ 2 m q; ~$ ~~ ~ i ~ ~ ~• ~~ ~ Q rY ~ ~ J G ~_ ~~ 3~ ~' ~~ ~~ ~. ~ c ~.~ ~~ ~~ m~ ,. ~. ~~ ~a `~ ~~ ~ ~~ a wm ~' 3 ~~ ~ ~ ~ ~ ~ ~a ~ ~ ~ ~ D w r N_ ~ DD O T O ~ ~ ~ W O ~- m r~ Z 0 V ~ N O J 0 ~. W ~ J 0 ~ ~ ~ ~ ~ ~ W N j m N N ~ sN. O vNi v~i ~ a J ti C ~ C a a a z its d! fA d! 6s fA 6s df 6s fA V! df {!! ds N V N 71 ~ Q ~ ~N, N i9 67 i9 i9 &! &! ili . 6s ils h fA ils d! iA {}! N ~ N o~ S~ ~ ~~~ ~ ~~ w m ds fA d! &! iA ds iN 6f &! bs 6s bs d- d! N ~~..~ O ~~ 8 ~r A~ w AM~ I~ i~ Op a