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Home My WebLink About02-0662 PETITION FOR PROBATE and GRANT OF LETTERS No. To: 21-02-662 Estate of Martina U. Kough also k no wn as Register of Wills for the _J Deceased. County of rl1mhprl::lnn In Social Security No. 1 89- 0 9.. 4 4 73 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your pctitioner(s), who is/are 18 years of age or older aI). the executor in the last will of the above decedent, dated Apr ~ 1 28, 1 'oj 9 B and codicil(s} dated the named ,19_ (Slate relevan! cirCllmstances, e.g. renunciation, death of executor, ('tc.) Decendent was domiciled at death in Cumber land h~___ last family or principal residence at One Langsdorf ~.. Carlisle. PA 17013 (list street, number and ffiuncipality) ~7 J ly 14 2002 Decendenl, then __ years of age, died u, , 19 at Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after excl'ution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Coun.ty, Pennsylvania, with Way 11"20, Decendent at death o\vned property with estimated values as follows: (If domiciled in Pa.) All personal properly (If not domiciled in I'a.) Personal property in Pennsylvania (If nol dornkilcd in Pa.) Personal property in County Value or real c~\ale in Pennsylvania situated a... follows: $ / < :s f'7t:'O . , ( $ $ $ WHEREFORE, petitioner(s) respectfully request~) the probate of the last will and codicil(s) presented herewith and the grant of ICHefs estamentary (lcstamcntary; administration c.La.; administration d.b.n.c.t.a.) themJ1. ~ " ~= ~ ~ ",,0 ;'~ ndj,jLU";b.>-Ic~{___ u~3 n..; J:>/'l-"~",----___ -<L'l+ M./2-~1S, f'rt _ 17-'1 ___ _____ _~l__~_____~____ r f i/~.4.1/ 3h- (. ~~ ;;.., f OATH OF PERSONAL REPRESENTATIVE COMMONWEAI,TH.Of' PENNSYLVANIA ~'" coe ,'TV Of' __..c:UMBERLAND _ j "'b The pt'titioner(s) above-named swcar(s) or affjrm(s) that the statements in the foregoing petition are (TUe dnd L'orrcct to the best or the knowledge and belief of petitioner(s) and that as personal represen- tativc(\) llf (he ahove decedent pctilioner(s) will well and truly administer the estate according to law. swo. fn ".)(.'r.. a.ffirmed and SUbscribed~. e -:/ ~~~~ r' ~ before me lhi" ___~~~_._ day of ~ _. _ f / ~. '= ..~y Jq:>9 2002 ~"j,A F 1f<,,,,),~kuY ~ ;2Jif:d .. ~/(") f)c ~b. ~ .!.~ - / Re~ISle,. ~ 1/. '/') - c2- ~o. 21-02-662 Estate of MARTINA U. KOUGH , Deceased DECREE OF PROBATE A~D GRA~T OF LETTERS AND NOW JUL Y 22 1 ~ 0 0 2 ,in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated April 28, 1998 described therein be admitted to probate and filed of record as the last will of Martina Uo KOllgh and Letters Testamentary are hereby granted to John F. Hawha kf'r ~ (?! L/ .~ . '//'/ 'j:?:<//d:i'1/'/,tJ! )./.~~:~j ,lstero{Wl / FEES Probate, Letters, Etc. ......... $ 235.00 Short Certificates( ).......... $ 15.00 'k-e\'t~R~i~tion ............... $ 9. 00 JCP $ 5.00 TOTAL _ $ 264.00 Filed . JULY. .2.3, . 20.Q2.. . . . .. . . .. . . .. . . . Fran8es D. Del Cuca #06269 ATTORNEY (Sup. CL LD. No.) 10 w. High st~, Carlisle, PA ADDRESS 717-249-1323 PHONE Q.oJ."...--iV Oz;c/?/::/Z7 .-" .~. -.-" 1'. l~ r ~ r v ;:3 ~ d -f LAST WILL 21-02-662 I, MARTINA U. KOUGH, of North Middleton Township, Cumberland County, Pennsylvania, declare this to be my Last Will and revoke any wills previously made by me. I. I direct that any and all inheritance, estate and transfer taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary estate. II. I devise and bequeath two (2%) percent of my gross estate to my nephew, Douglas E. Beane. III. I devise and bequeath ten (10%) percent of my gross estate and my diamond ring to Sharon Shellenberger. IV. I devise and bequeath the residue of my estate of whatever nature or wherever situated as follows: A. One-half to my sister's children, Thomas Seydewitz and James C. Seydewitz: B. One-half to my brother, R. Eugene Urich, or in the event of his decease, to his children, Jay E. Urich and Jerene Metzler. V. I appoint John F. Hawbaker, Jr, 203 Oak Drive, Mt. Holly Springs, PA, 17065, to be executor of this my Last Will. In the event he fails to qualify or ceases to act, then I appoint Thomas Seydewitz to be executor. VI. I direct that my executor need not file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will this 28th day of April, 1998. YY)il~'" 2{. 'i.~f (SEAL) The preceding instrument consisting of two (2) page(s) was on the date thereof signed, published and declared by MARTINA U. KOUGH, the testator herein, 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. dt;dU-</~ / . ;l / j/ " / /I! ill . l....- '/;;lf~ (//(([<) h.c. STATE OF PENNSYLVANIA SS COUNTY OF CUMBERLAND We, MARTINA U. KOUGH, Frances H. Del Duca and Carol A. Treaster, the testator and witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as her Last Will 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 testator, signed the will as witness and that to the best of Her knowledge the testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. 'wi ~ l.1' ,< ~Jh Testator ~2~ //&2//;2.(<<. ~~tness }, ,.'" .., __ '\ i'(- /! j/( (d (, l A ()(}.!) If' I Witness . SUBSCRIBED, sworn to and acknowledged before me by the testator, and subscribed and sworn to before me by Carol A. Treaster and Frances H. Del Duca this 28th day of April, 1998. ~d h1f,frI;;p"o otary blLC / . ~ NO'!-AAIAL SEAL jSHlfh.EY. p, C~E'IE"GEf1, NOTARY PUBLIC .1 CarU81e OOfl:)u.tl"; Cu' ffi""": , r' ~ M l"'.., "" ',~ '-"lI ,an(. \""'OUl~iY ~ 'I 'VVm~ni:}Bla!;: f:xpklit1J: M.iln:.:h 5, 2nrJO -......."'~...".",.,.....,'."..~, , c CERTIFICATION OF NOTICE UNVER RULE 5.6(a) Name of Decedent: Martina U. Kough Date of Veath: July 14, 2002 Admin. No. 2002-00662 Will No. '1'0 the Register: I certify that notice of beneficial interest required by nil I p 'i. (, (i'I) 0 f the Or"phans' Court Bules was served on or mailed to the following beneficiaries of the above-captioned estate on 7/25/02 Name Address 6622 state Rd., Pama, OR 44134 851 E. Louther st., Carlisle, PA 17013 2023 Players Path, Kingwood, TX 77339 14 F~rn~ nr . F...-=l~r H;:!mprr'ln. ("'T1 flh.1?.1 lX>uglas E. Beane Sharon Shellenberger James Seydewitz Thomas Seydewi tz R. Eugene Urich 139 Greeff Lane, Memphis, TN 38111 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except /) I ~7 L/ ~;~7j/;tft <-?~ --slgna t ure Va te: 7/25/02 Name Frances H. Del Duca Address 10 W. High St. Carlisle, PA 17013 'relephone (71i}-249-1323 Capacity: Personal Representative / Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT_ 2B0601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT DEL DUCA FRANCES H 10 W HIGH STREET CARLISLE, PA 17013 uu____ fold ESTATE INFORMATION: SSN: 189-09-4473 FILE NUMBER: 2102-0662 DECEDENT NAME: KOUGH MARTINA U DATE OF PAYMENT: 09/06/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 07/14/2002 NO. CD 001595 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $16,958.88 I I I I I I I I TOTAL AMOUNT PAID: $16,958.88 REMARKS: JOHN HAWBAKER C/O FRANCES H DELDUCA ESQ CHECK# 1001 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS MARY C. lEWIS REGISTER OF WillS ~ ................... ..... .......OFFiC"iAL"lis.EfoN.l y ........... ...................... ,UJ' COMMONWEALTH OF REV - 1500 2 11 -11 - PENNSYLVANIA INHERITANCE TAX RETURN DEPARTMENT OF REVENUE RESIDENT DECEDENT FILE NUMBER DEPT. 280601 caf.~ CODE I 2002 I 00662 HARRISBURG, PA 17128-0601 YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I- Kough, Martina U. 189-09-4473 Z W DATE OF DEATH DATE OF BIRTH THIS RETURN MUST BE FILED IN DUPLICATE WITH 0 THE W July 14, 2002 January 27, 1915 REGISTER OF WILLS U w (IF APPLICABLE) SURVIVING SPQUSE-S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 0 X 1. Original Return 2. Supplemental Return 3. Remainder Return (_o/_l"ior!(llH~-82J S l- f- ~'. 4. Limited Estate 4a. Future Interest Comprise (date ofdealh after 12-12-82) 5. Federal Estate Tax Return Required li:~t5 - I-- I-- .cl:!.S! 6. Decedent Died Testate (Attach copy of Will) 7. Decedent Maintained a Living Trust (Attach a copy of Tl\Isl) 8. Total Number of Safe Deposit Boxes o Jim 9. Litigation Proceeds Received I- 10. Spousal Poverty Credit (date of death between 12.31-91 and 1-1-95) I-- 11. Election to tax under Sec. 9113(A) 0( L- '-- (AttachSchO) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: E NAME COMPLETE MAILING ADDRESS . Frances H. Del Duca 10 West High Street .., 0 0 FIRM NAME (If Applicable) Carlisle, PA 17013 0- !!! ~ TELEPHONE NUMBER 0 717-249-1323 1. Real Estate (Schedule A) (1) OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule 0) (4) 5. Cash, Bank Deposits & Misc. Personal Property (Schedule E) (5) $155,010.60 Z 6. Jointly Owned Property (Schedule F) (6) 0 i= D Separate Billing Requested ! :5 7. Inter-Vivos Transfers & Misc. Non-Probate Property (7) :;:) I- (Schedule G or L) ii: 8. Total Gross Assets (total Lines 1-7) (8) $155,010.60 <I: U 9. Funeral Expenses & Administrative Costs (Schedule H) (9) $24,929.91 W Ci:: 10. Debts of Decedent, Mortgage Liabilities & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) (11) $24,929.91 12. Net Value of Estate (Line 8 minus Line 11) (12) $130,080.89 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) $130,080.89 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of line 14 taxable at the spousal tax x (15) rate, or transfers under Sec. 9116 (aX1.2) - 16. Amount of line 14 taxable at lineal rate x (16) z 0 17. Amount of line 14 taxable at sibling rate ~ ;: 55.356.18 x (17) 6,642.75 :::>3 ...." 18. Amount of line 14 taxable at collateral rate 74,724.17 x ~ (18) 11,208.71 .. ,. - 0 0 19. Tax Due (19) 17,851.46 2o.D / > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Com lete Address: STREET ADDRESS One Langsdorf Way CITY Carlisle STATE PA ZIP 17241 Total Interest/Penalty (0 + E) (3) If line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 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. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN X IN THE APPROPRIATE BLOCKS Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 892.58 Total Credits (A + 8 + C) (1) 17,851.46 3. Interest/Penalty jf applicable D. Interest E. Penalty (2) 892.58 4. 5. ,. Did decedent make a transfer and: a. retain the use or income of the property transferred: b. retain the right to designate who shall use the property transferred or its income; c. retain a revisionary interest; or d. receive the promise for life of either payments, benefits or care? If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? Did decedent own an individual retirement account, annuity, or other non-probate property? 16,958.88 Yes No 2. 3. 4. ~ ~ B EB 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 besl of my knowledge and belief, it is true, correct, and complete. Declaration of preparer other than the personal representative Is based on all the Information of which preparer has any knowledge. SIGNATURE OF P~SO~ RESP7E FOR ING RETURN ADDRESS DATE <;-~". SIGNATURE OF PREPARER OTH~~S~TATlVE ~--9,~ U~~ ADDRb? ~ {~ ~ ,It V ~ ~ /, /7.?Jj DATE 7 -r:;; '0 "2. 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 no 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 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Martina U. Kough FILE NUMBER 2002-00662 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1. Metlon Bank #180-089694-C 10,000 with accrued interest of 18.11 #180-099441-C 10,000 with accrued interest of 18.09 10,018.11 10,018.09 2. PNC Bank 31100214436 - 6,000 plus accnued interest 2.27 31300216079 -10,000 plus accnued interest 25.92 5003704946 - 30,345.34 plus accnued int. of 4.15 6,002.27 10,025.92 30,349.49 3. Allfirst 87008000087502 -10,000 plus accnued int. of 34.98 87008141176544 - 20,000 plus accnued int. of 72.42 80000002147431 - 35,000 plus accrued int. of 21.94 52547280 - 2,699.41 plus accnued int. of .37 10,034.98 20,072.42 35,021.94 2,699.78 4. Waypoint 7100014499 - 20,000 plus accnued int. of 34.83 5. Refunds 20,034.83 Capital Blue Cross Carlisle Retirement PNC Fumiture 112.45 58.07 12.45 430.00 120.00 6. 7. ladies 14K two~tone diamond wedding band Life insurance policies - for information only Prudential- 4,750. American United Life #01605233640 - 1,643.57 TOTAL (Also enter on line 5, Recaoitulation (If more space is needed, insert additional sheets of the same size) $155,010.80 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Martina U. Kough Debts of decedent must be reDorted on Schedule I. ITEM NUMBER FiLE NUMBER 2002-00662 DESCRIPTION AMOUNT 1. 1.754.00 A. B. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. FUNERAL EXPENSES: Ronan Funeral Home ADMiNISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) John F. Hawbaker, Jr., 203 Oak Dr., Mt Holly SprinQs, PA Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2002 Attorney Fees Frances H. Del Duca 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 8,070.22 8,070.22 Probate Fees 264.00 Accountant's Fees Tax Return Preparer's Fees Cumberland Crossing Retirement Community Cumberland Crossing Retirement Community Cumberland Crossing Retirement Community Sentinel - furniture ad Mountz Appraisal Cumberland Law Journal- legal Sentinel-legal Checks - Allfirst Reserve for 1 st & final account 3,997.40 2,186,70 5.49 17.49 95.00 75.00 80.87 13,52 300.00 TOTAL (Also enter on line 9, Recaoitulation (If more space is needed, Insert additional sheets of the same size) $24,929.91 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR NUMBER Do Not List Trustee(s) SHARE OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. Douglas E. Beane Nephew 2% of gross 6622 State Rd. Parma, OH 44134 2. Sharon Shellenberger 10% of gross 851 East Louther St. Cartisle, PA 17013 3. Thomas Seydewitz Nephew ~ of residue 14 Fernwood Drive East Hampton, CT 06424 4. James Seydewitz Nephew 'Y. of residue 2023 Players Path Kingwood, TX 77339 5. R. Eugene Urich Brother ~ of residue 139 Greeff Lane Memphis, TN 38111 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Martina U. Kough SCHEDULE J BENEFICIARIES FILE NUMBER 2002-00662 (If more space IS needed, Insert additional sheets of the same size) Prepared For: Mr. JOM Hawbaker 203 Oak Drive Ml Holly Springs, P A 17065 Date: 7/22/2002 Item Ring One ladies 14k tWO-lone diam9nd weddillg band. This ring contllins (5) full cut dilU\londs four prong set in white gold. The shaIik of this ring is yellow gold. This ring is a size 8, The piece weighs approximately 1.<J5DWT. Diamond Melee Attl'ibules Shape Jlnd cut: Weight Number of diamonds: Total Weight: Clarity: Color: IteIll Attributes Metal: Finish:. Selting- Condition: Round fuU cut 0.09 to 0.10 cis. each 5 .48 cts. (estimated) 51 H-I 14K yellow and white gold . Polished Prong set Excellent Total Approximate Retail Valne Excluding Tax $120.00 Total Approximate Retail Value for All Items - Excluding Tax: $120.00 Qne hundred twenty dollars and no cents Signature of Appraiser: Page 6 of6 .: CITIZENS BANK Tuesday, August 27, 2002 Account Number Account Title MARTINA U KOUGH 180-089694-C Date Opened: 03/14/1990 Principal Balint from Last as of DOD Posting to DOD $10,000.00 $18.11 MARTINA UKOUGH _ ___ _~te Opened: 06/06/1990 18(}.()99441-C Principal Bal tnt from Last as of DOD Posting to DOD $10,000.00 $18.09 Account Type: TO Account Bat YTD tnt to as of DOD DOD $10,018.11 $218.69 Account Type: TO Account Bat as of DOD $10,018.09 YTD tntto DOD $218.57 Page 2 of 2 ~lWay~qi!lt J LOOK FOR US. WE'LL GET YOU THERE. 07/31/2002 FRANCES DELDUCA 10 W HIGH ST CARLISLE P A 17013 The information which you requested on the account(s) of MARTINA KOUGH (Social Security Number 189-09-4473) is/are as follows: Balance at Date of Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership Was Established 7100014499 CERTIFICATE 12/10/01 20000.00 34.83 20034.83 Account Number Class of Account Date Opened Principal Balance Accrued Interest Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested ~b SENIOR SERVICES REP. P.O. Box 1711, HARRISBURG. PeNNSVUlANIA 17105-1711 Toll Free 1-866-WAYPOINT (1-866-929-7646) . IN YORK AREA 717/815-4500 . www.waypointbank.com / o PNCBAN< July 26, 2002 Frances H Del Duca Attorney at Law Ten West High St Carlisle, P A 17013 scp / RE: Estate of Martina V Kough (Deceased) SSN: 189-09-4473 DOD: 07-14-2002 Dear Ms Del Ollca: In response to your request for Date of Death balances for the customer noted above, our records show the following: Certificate of Deposit Account#31100214436 Established 07-11-2001 MARTINA V KOVGH DOD balance: $6,000.00 + $2.27 accrued interest Account#31300216079 Established 07-25-2001 MARTINA V KOVGH DaD balance: $10,000.00 + $25.92 accrued interest Savings Account Account#5003704946 Established 07-16-2001 MARTINA V KOVGH DOD balance: $30,345.34 + $4.15 accrued interest Page I of2 ~ ~ allflrst Frances H. Del Duca Attorney At Law 10 West High Street Carlisle, P A 17013-2922 He: Estate of Martina U Kouf!h Social Securitv: 189-09-4473 Date of Death: Julv 14, 2002 Dear Sir or Madam: Allfirst Financial Center N.A. 1'0. Box 900 Millsboro, DE 19966 Phone (302) 934-2909 Fax (302) 934-2955 August 6, 2002 Per your inquiry dated July 24, 2002, please be advised that at fue time of death, fue above-named decedent had on deposit wifu this bank !he following: 1. Type of Account Relationship Checking WlInterest Account Number 0052547280 Ownership (Names of) Martina U Kough, Owner Albert G Kough, DECD John F Hawbaker, Jr, POA Opening Date 08128/64 Balance on Date of Death $2,699.41 Accrued Interest $ .37 Total $2,699.78 2. Type of Account Certificate of Deposit Account Number 80000002147431 Ownership (Names oj) Martina U Ko.ugh, Owner Opening Date 12104100 Balance on Date of Death $35,000.00 Accrued Interest $ 21.94 Total $35,021.94 / 3. Type of Account Certificate of Deposit Account Number 87008000087502 Ownership (Names oj) Martina U Kough, Owner John F Hawbaker, Jr, POA Opening Date 06/19/86 Balance on Date of Death $/0,000.00 Accrued Interest $ 34.98 Total $/0,034.98 4. Type of Account Certificate of Deposit Account Number 87008141176544 Ownership (Names oj) Martina U Kough, Owner Opening Date 06/17/98 Balance on Date of Death $20,000.00 Accrued Interest $ 72.42 Total $20,072.42 This- letter does not include any accounts in which the deceased may have been listed as Power of Attorney, Custodian of Uniform Transfers. Representative Payee. or Trustee under a Written Agreement. For further account information, closures and/or reimbursement a/funds refer to below branch: CARLISLE OFFICE Z WEST HIGH STREET CARLISLE, P A 17013 717-Z40-6703 / . ..--.-..,......,.-. ~ r v - ;::5 4 >-f I - , , LAST WILL I, MARTINA U. KOUGH, of North Middleton Township, Cumberland County, Pennsylvania, declare this to be my Last Will and revoke any wills previously made by me. I. I direct that any and all inheritance, estate and transfer taxes imposed upon my estate passing under my will () r .. ot-herwi&e.. shall be paid out 01: the principal of -my . residuary estate. II. I devise and bequeath two (2%) percent of my gross estate to my nephew, Douglas E. Beane. III. I devise and bequeath ten (10%) percent of my gross estate and my diamond ring to Sharon Shellenberger. .IV. I devise and bequeath the residue of my estate of whatever nature or wherever situated as follows: A. One-half to my sister's children, Thomas Seydewitz and James C. Seydewitz: B. One-half to my brother, R. Eugene Urich, or in the event of his decease, to his children, Jay E. Urich and cTerene Metzler. V. I appoint John F. Hawbaker, Jr, 203 Oak Drive, Mt. Holly Springs, PA, 17065, to be executor of this my Last Will. In the event he fails to quali'fy or ceases to act, then I appoint Thomas Seydewitz to be executor. VI. I direct that my executor need not file bond in this or any other jurisdiction. .. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will this 28th day of April, 1998. m~~ l{. k:ou..f (SEALI __._~____.. Lo'- .-.". , ." -. The preceding instrument consisting of two (2) paqe(s) was on the date thereof signed, published and declared by MARTINA U. KOUGH, the testator herein, 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. CJ;;;j, fCt~ STATE OF PENNSYLVANIA . . . . 55 COUNTY OF CUMBERLAND . . . . We, MARTINA U. KOUGH, Frances H. Del Duca and Carol A. Treaster, the testator and witnesses, respectively, whose names are signed to the attached or foregoing instrument, bein~ first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as her Last will 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 testator, signed the will as witness and that to the best of Her knowledge the testator was at that time eighteen years of~ age or older, of sound mind and under no constraint or undue influence. )-"\1 a.Jr. ".. 1.1' Ie ~.jh Testator ~~AJ' ,- #4//2,_ ~ ness .'.1 afJ flcJPt'J4. h" Ijh.tness , ; " , SUBSCRIBED, sworn to and acknowledged before me by the testator, and subscribed and sworn to before me by Carol A, Treaster and Frances H. Del Duea this 28th day of April, 1998. ~ft~tUOrJL . d. otary J:)lic .' :.' '7-'-""', '-,' ~.:--.....'" .:':''''~~..$ -. ..... .' ... ." --, NOTARIAL IlEAL SHlRUlY P.lll.EVEHGII'l. NOTAIlV CallI.,. 1loJough, CU_1IlICI o:;::uc My Conunlll8loh &pI.... M_ 5, ~ /,,/-??-.:L-- '\- BUREAU OF INOIVIDUAL INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 TAXES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLDWANCE OR DISALLOWANCE OF DEDUCTIONS ANO ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER (COUNTY ACN 10-22-2002 KOUGH 07-14-2002 21 02-0662 CUMBERLAND 101 FRANCES H 10 W HIGH CARLISLE DEL DUCA ST PA 17013 *' RE~.l&41 Elt In {n-tlll MARTINA U Allount Rellitted I CHANGEO III 121 (31 141 151 (61 171 .00 .00 .00 .00 155.010.80 .00 .00 181 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV:iSt;rix--AFP--[oFol!rNcirici-oF-YNHiRiTANci.-i'-A:in'PPRAisiiiENt-,--AL.i-OWANCi.-ciR:----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KOUGH MARTINA U FILE NO. 21 02-0662 ACN 101 DATE 10-22-2002 TAX RETURN WAS: I X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule BJ 3. Closely Held stock/Partnership Interest (Schedule CJ 4. Mortgages/Notes Receivable (Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule FJ 7. Transfers (Schedule GJ 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad... Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule X) 11. Total Deductions 12. Net Value of Tax Return 13. Chari~able/Govarn.ental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due NOTE: 191 1101 24,929.91 NOTE: To insure proper credit to your account, submit the upper portion of this forti with your tax payltBnt. 155,010.80 74 979 91 130,080.89 .00 130,080.89 00 = 045 = 12 = 15 = .00 .00 6,642.75 11,208.71 17,851. 46 .00 1111 1121 1131 1141 .00 X .00 X 55,356.18 X 74,724.17 X 1191= TAX CREDITS: ..~"., l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID I-I 09-06-2002 CDOO1595 892.57 16,958.88 TOTAL TAX CREDIT 17,851.45 BALANCE OF TAX DUE .01 INTEREST AND PEN. .00 TOTAL DUE .01 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU MAY 8E DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.I FIRST AND FINAL ACCOUNT OF JOHN F. HAWBAKER, JR., EXECUTOR OF THE ESTATE OF MARTINA U. KOUGH, LATE OF CARLISLE CUMBERLAND COUNTY, PENNSYLVANIA ESTATE NO. 02-00662 Date of Death - July 14,2002 Cumberland Law Joumal- August 2,9,16,2002 The Sentinel- July 24,31, August 7, 2002 SUMMARY Receipts Total Principal- Personal Property Insurance $154,870.70 6,393.57 161,264.27 Expenses 41.906.79 $119,357.48 Balance for Disbursement ESTATE OF MARTINA U. KOUGH - 02-00662 Statement of Assets and Expenses The accountant charges himself as follows: Mellon Bank - #180-089694-C, #180-099441-C PNC Bank - #31100214436, #31300216079, #5003704946 Allfirst Bank - #8700800008 7502, #8700 814 1176544, #80000002147431, #52547280 Waypoint Bank - #7100014499 Refunds - Capital Blue Cross Carlisle Retirement Insurance - Prudential American United Life PNC Bank Bank Credit Furniture Ring (valued at $120.00) The accountant takes credit for the following: Ronan Funeral Home Executor's commission Frances H. Del Duca - Attorney fee Cumberland Crossing Retirement Community Sentinel - furniture ad Sentinel - legal Mountz Appraisal Cumberland Law Journal- legal Allfirst - checks Reserve for first and final acct. Inheritance Tax Inheritance Tax filing Probate Fee Short Certificates $20,057.96 46,394.74 67,740.23 20,064.30 112.45 58.07 4,750.00 1,643.57 12.45 .50 430.00 161,264.27 1,754.00 8,070.22 8,070.22 3,997.40 2,186.70 5.49 17.49 80.87 95.00 75.00 13.52 300.00 16,958.88 15.00 264.00 3.00 41,906.79 STATE OF PENNSYLVANIA :: SS COUNTY OF CUMBERLAND :: JOHN F. HAWBAKER, JR., Executor of the Estate of Martina U. Kough, being duly sworn according to law, deposes and says that the facts set forth in the foregoing statement are true and correct. SWORN and subscribed before me this/c1.ii.!ay of Jf)~. 2002. ~h~ P{)PO otary Publi NOT-.-. , 81/1"LEVP.~ NOTAIlYPUBUc ' Cara.Ie........^ "1L1Mdr-1U__ 1 14l''' " -.......1Inh ~ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS COURT DIVISION ESTATE OF MARTINA U. KOUGH JOHN F. HAWBAKER, JR., EXECUTOR ESTATE NO. 02-00662 STATEMENT OF PROPOSED DISTRIBUTION Balance for distribution as shown on First and Final Account of John F. Hawbaker, Jr. Distribution to Beneficiaries: Douglas E. Beane - 2% of gross $ 3,225.29 Sharon Shellenberger - \0% of gross Ring 16,126.43 Thomas Seydewitz ~ Y. of residue 25,00\.44 James Seydewitz - 'I. of residue 25,00\.44 Eugene Urich - Y2 of residue 50,002.88 $119,357.48 STATE OF PENNSYLVANIA :: SS COUNTY OF CUMBERLAND :: JOHN F. HAWBAKER, JR., Executor of the Estate of Martina U. Kough, being duly sworn according to law, deposes and says that the facts set forth in the foregoing statement are true and correct. ".c John F. Hawbaker, Jr. SWORe"! and subscribed before me this Ir/;tiday of ~. 2002. MUL-. IHIR P.~NOTARVI'\J8UC ~ CuMbutelKI Countr -.v Q.... . l'aa.........",..o 3004 Z U)<>: <>::> r<!...:I ...:1>< a..U) Z ZZ Or<! :Ea.. :E o , U>< E-< ~Z OD o E-<U ~ DO OZ U<>: ...:I r<!~ :I:r<! E-<m :E ZD HC) :I: C9 D 0 ~ N '" . '" D 0 0 <>: I Z N H 0 E-< 0:: . <>: 0 :E Z ~ r<! 0 E-< <>: r<! E-< E-< U) <>: r<! E-< U) r<! ,,:-\ , ' "-.)1 '::ri:, " \ ','," .-'! ".i. i .~~ ~ .... . ..-.-+.. ') :~ ,'J :~".-J~ -, " [1 L, E-< Z D o U C) <>: ...:I <>: Z H ~ o Z <>: E-< U) 0:: H ~ "" . . ~ I I " \l -\ "" \" .S ~' o I horeby C(lI1:ify ~ ~'fl'1'fJAJn nr,j'..;~'t') 01 tfl& im~ of ~nl~ StaI$mOnI of ~ 0I8lrlllu\i0n. and oflha - time and IllBCi& _lhe _ wi! bIlpr8S\lW1led \C, lhe eo..! b ""'..H.......llII1d allhe I8Il ~ 10 lie wf1IIen ~"lD wid ;- _ ,aI p,opoeed DiItIIbI.Clon, hell _ gMIlIlo eM'! lM'1!llIid cIeimIlnl end 10 INfIlY olher pIftlIIlllnowlllo .. ~ to _ 0( cIIIlm "" InlllNIIlIn lhe __ lIIlI aedllO<, boo..&l.. V, hell' CJ< 00Xl olldn. A COf1Y of ""Id Sl8\OOIllnt WOS 0lCIlJ<lIl<I wIIIlll1<l noIlc<l ;, "~ ~.~~ti!:5~ i "", ~ ie. i I ~ 13,~.9Sj hI ~~iIJ!i~ $,gI!l1jlls1 '0 0 l5.~ ill 00 >''''}j'lS .. ;',15;a-.- ill- . ..- ~ lilll !;: ;, ~ I ];! ~!!J ~ 9 l~ ~ ~ ~ ~ ~ ~ ~ 0,5 ~ 11- .:< ,;::I. ~... ...... ..o~~~;;' cO> .; 4. _ 1<; \( ,..,. I'll :,;:>"$O,,:y,,...~~ .= ~ ~ 2 ?; ,~ ~ ;; 1! \ 'J .j " ~ r <{ U <: ::l z 0" ~ ~ ...J <( W -l W -' rr >- in Ul o ~ I Z . >- (j Z ~ IwiWQ Z I-- 0.. ~ (/) a: ::1 w"' w S 3: -l U I- Z Ul <: w - Z c..J <{ ~ a: U LL STATUS REPORT UNDER RULE 6.12 Name of Decedent: ,rn A t of ," -4 V( ~c.<t:; 1..( Date of Death: 1-,4-c'J.- Will No.: AloN Admin. No.: t-J 2. DO GG 2- Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes fK1 No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. I is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No 1I4 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 li21 No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the. Orphans' Court and may be attached to this report. ~ Date: ~c:.. ~ 'f Si~~-r *~ G./ J"H<J r /./rJ&J.44tE~ Name cJo~ CAf. ;;&. Address ,IdJ-t- /-I~/l 9J'~ .y.fb 76d-7 Telephone No. Capacity: Qi'1 Personal Representative o Counsel for personal representative ~ ~/,,jr7C e.s ~el.))M4 /7~7 OLCf'l /52..3