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HomeMy WebLinkAbout02-0462 CHESTER T. LUTZ Estate of also known as CHESTER LUTZ PETITION FOR PROBATE and GRANT OF LETTERS 21- 02 - J.../lDz' No. To: Register of Wills for the Deceased. County of Cumberland in the Social Security No. 176-26-1732 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut or in the last will of the above decedent, dated November 6 and codicil(s) dated N /A named ~ 2000 ,- (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h is last family or principal residence at 404 Silver Sprinq Road, Hampden Township (list street, number and muncipality) Decendent, then _~ years of age, died Mav 2 , l!:!l: 2002 at Holy Spirit Hospital, East pennsboro Township, Cumberland County, PA Except as follows, decedent did not marry, was not divorced and did not have a ehild born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: no exceptions Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: None 100,000.00 $ $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary (testamentary; administration c.La.; administration d.b.n.c.t.a.) theron. ~.td. ~ 20 Jack Nicklaus Drive ~ Etters, PA 17319 '6 u " u ]3 u ~ ~u " ,,0 c'';:: ro'';:: S&:: U~ 50 ;;; " on Vi OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I ss COUNTY OF CUMBERLAND j The petitioner(s) above-narned swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate ac ring 0 law. ~ affinY~ and '-1-102-11 ~o. 21-02-462 Estate of CHESTER T. LUTZ, a/k/a CHESTER LUTZ , Deceased DECREE OF PROBATE A~D GRA~T OF LETTERS AND NOW MAY 11 P9 2002, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, 11 IS DECREED that the instrument(s) dated November 6, 2000 described therein be admitted to probate and filed of record as the last will of Chester T. Lutz and Letters Testamentary are hereby granted to Thomas W. Lutz ~ ~ ~ t' Ai t'Jh" ~ ~ Y t'LEVliI isler o~ j y FEES Probate, Letters, Etc. ......... $ 200.00 Short Certificates( ).......... $ 1 2 . 00 ~ ext.r:a. pages;. .. $ ]CP $ TOTAL _ $ Filed...... .~:-.1.3::49P.~................. mailed to atty 5-13-2002 Marlin R. McCaleb (06353) < 00 5.00 220.00 ATTORNEY (Sup. Ct. I.D. No.) 219 East Main Street, P.O. Box 230 Mechanicsburg, PA 17055 ADDRESS (717) 691-7770 PHONE ~ r;'il"~) -) ZS;: l dOt A\J:,.' ZOo . REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS Marlin R. McCaleb ~lliix (~a subscribing witness to the will presented herewith, (~g) being duly qualified according to law, depose(s) and say(s) that I was present and saw Chester T. Lutz the testat or , sign the same and that I signed as a witness at the request of testat~ in h is presence and ~~~~}P(~~) (in the presence of the other subscribing witness(es)). ti4?~ me this 10th day of Marl~al}ne)Mccaleb ~MAY . P9~2 219 E. Main Street, Mechanicsburg, _/~/(7~L//~LI"')/2U ~~ (Address) 'l C LEW Register / . Sworn to or affirmed ana subsc.ribed before PA 17055 (Name) (Address) REGISTER OF WILLS OF OATH OF NON-SUBSCRIB COUNTY G WITNESS and (each) a subscriber hereto, (each) being duly quali . d according to law, dep ". " familiar with the sign ure of "'-,'>-... codicil testat_ of (one of ,subscribing witnesses to) the will " codicil that ", believes the signature on e will -......, ", ""'0. ", " to the best of ""', ., '. , knowledge and belief. "- '. Sworn to or affirmed an~'su~cribed before " me this '0, day of '}).. --.;:-- ", ,. (Name) ""'c , '",- '., (Address) .... Register (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS Emily A. Joerg ~tt"iI (ellill\9 a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that I was present and saw Chester T. Lutz the testat or , sign the same and that I signed as a witness at the request of testat or in his presence and (iIAK1:irc~IICm::e~51t1eJ) (in the presence of the other subscribing witness(es)). g,.~f::JO~r Name) E. Main Street, Mechanicsburg, PA 17055 Sworn to or affirmed and subscribed before me this /d~ day of ~ xi 2002 .~- 219 (Address) I?gairt'p Notarial Seal Marlin R. McCaleb, Notary Public Mechanicsburg Boro, Cumberland County My Commission Expires Dec. 14.2002 Member, Pennsylvania Association ot Notanes (Name) (Address) ..... -, COUNTY CRIBING WITNESS REGISTER OF WIL OF OATH OF NON-S (each) scriber hereto, (each) being duly lified according to la familiar with the . nature of ~ '-. codicil testat_ of (one of t~ubscribing witnesses to) ~.. will .~ ", codicil that ""'. believes the signature ~i1'14e will ."...., ..~. and "'-., " to the best of ~nowledge and belief. ............." '. Sworn to or affirmed and subscrib~fore me this day"Q{ " 19_ "'" (Name) Register "" ~ (Address) ....j . ...J (Name) (Address) '-, LAST WILL AND TESTAMENT 21-02- LlG,2. I, CHESTER T. LUTZ, of the Township of Hampden, County of Cumberland and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last \_ Will and Testament, hereby revoking and making void all former Wills or Codicils by me at any time heretofore made. LAW OFFICES MARLIN R_ McCALEB FIRST. I order and direct that all my just debts and funeral expenses be paid by my Executor or my Executrix, as the case may be, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give and bequeath an amount equal to ten (10%) per centum of my estate unto the WELLSVILLE BIBLE CHURCH, on Andover Road, Route 417, Wellsville, New York, absolutely, for use in the general fund. THIRD. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever situate, in equal shares unto my nieces and nephews, namely: BRIAN GOOD, STEPHANIE GOOD, COLLEEN HOPE and BRAD L. LUTZ, absolutely and in fee simple. Provided, however, that if any such niece or nephew shall not survive me, then I order and direct that the share provided herein for such deceased niece or nephew shall instead be paid over and distributed in equal shares between or among the other shares herein provided for my nieces and nephews, share and share alike, absolutely and in fee simple. LAW OFFICES MARLIN R. McCALEB FOURTH. 1 have intentionally not provided herein for my stepsons, EDWARD POTKAY, GEORGE ROONEY, and PATRICK ROONEY, and 1 hereby declare that their omission herein is intentional and not occasioned by accident or mistake. LASTLY. I nominate, constitute and appoint my brother, THOMAS W. LUTZ, Executor of this, my Last Will and Testament, but if for any reason he shall fail to qualify as such Executor or cease so to serve, then I nominate, constitute and appoint my sister, SARAH GRACE GOOD, to serve in his place and stead, each to serve without bond in this or any other jurisdiction. IN WITNESS WHEREOF, I, CHESTER T. LUTZ, 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 1 have affixed my signature this ~ day of rV 0 .y, , A.D., Two Thousand (2000). .L.~-T(~ (SEAL) The preceding instrument, consisting of this and one (1) other typewritten pages, each identified by the signature of the Testator, was on the date thereof signed, sealed, published and declared by CHESTER T. LUTZ, the Testator therein named, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence, and in the presence of each other, have subscribed our names as witnesses hereto. ;Q CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Chester T. Lutz, a/k/a Chester Lutz Date of Death: May 2, 2002 Will No. 21-02-0462 To the Register: I certify that notice of beneficial interest and estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on May 20, 2002. Name Address Thomas W. Lutz 20 Jack Nicklaus Drive Etters, PA 17319 Wellsville Church of God P.O. Box 155 Wellsville, NY 14895 Brian Good 140 E. Hummelstown Street Elizabethtown, PA 17022-1924 Stephanie Good Apt. 6 Strafford Elizabethtown, PA 17022 Colleen Hope 4618 South Third Street Arlington, VA 22204 Brad L. Lutz 1004 Popular Hill Road Baltimore, MD 21210 Notice has now been given Rule 5.6(a). Date: June ~~, 2002 :\'J ''', to ;r~:eto under Marlin R. McCaleb Attorney I.D. No. 06353 219 East Main Street P.O. Box 230 Mechanicsburg, PA 17055 (717) 691-7770 FAX: (717) 691-7772 Counsel for Personal Representative " \i7. nr;r ZOo LAW OFFICES MARLIN R. McCALEB COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96J RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MC CALEB MARLIN R 219 E MAIN STREET MECHANICSBURG, PA 17055 -------- fold ESTATE INFORMATION: SSN: 176-26-1732 FILE NUMBER: 2102-0462 DECEDENT NAME: LUTZ CHESTER T DATE OF PAYMENT: 07/31/2002 POSTMARK DATE: 0010010000 COUNTY: CUMBERLAND DATE OF DEATH: 05/02/2002 NO. CD 001465 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $10,000.00 I I I I I I I I TOTAL AMOUNT PAID: $10,000.00 REMARKS: CHECK# 9 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS MARY C. lEWIS REGISTER OF WillS C.- Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Chester T. Lutz No. 21-02-462 also known as Date of Death 0 5/0 2/2 0 0 2 , Deceased Social Security No. 1 7 6 - 2 6 -1 7 3 2 Thomas IV. Lutz Personal Representative(s) of the above Estate, deceased, verifies (verify) that the terms appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. INlle verify that the statements made in this Inventory are true and correct. INlle understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: Marlin R. McCaleb, Esquire Signature: !.D. No.: 06353 Signature: Address: 219 East Main Street Address: 20 Jack Nicklaus Drive Mechanicsburg, PA 17055 Etters, PA 17319 Telephone: 717/691-7770 Telephone: 717/938-0669 Dated: //'l~ 29-cJ?.. Description Value (See continuation page(s) attached) (Attach additional sheets if necessary) Total 135,321.67 Note: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Regular Savings 25.00 Acct.#196787-00. Members 1st Federal Credit Union. - principal balance as of 0.0.0. Smith Barney Large Cap Growth 0.95 Fd.. Cl A - Salomon Smith Barney Acct. #724-02676-1-2-015, cash balance in account on 0.0.0. -------------- 69.408.06 PERSONAL PROPERTY: ------------------ 1995 Olsmobile Cutlass Cierra 3.400.00 SL sedan Cumberland County Veterans 100.00 Affairs - Veterans' benefit. Decedent's household contents 510.00 and personal belongings - floor lamp ($55.00); hutch cabinet ($25.00); typewriter ($40.00); chair ($65.00); walker ($100.00); Sony TV ($225.00) . DFAS-Cleveland - monthly 1.247.00 military retirement payment for May. Dresser-Rand - monthly 344.22 retirement payment for May. Ingersoll Rand - monthly 324.75 retirement payment for April. Ingersoll Rand - monthly 324.75 retirement payment for May. -2- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUFIEAU OF INDIVIDUAL TAXES DEf'T.280601 HAnRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MC CALEB MARLIN R ESQUIRE 219 EAST MAIN STREET MECHANICSBURG, PA 17055 ___n___ fold ESTATE INFORMATION: SSN: 176-26-1732 FILE NUMBER: 2102-0462 DECEDENT NAME: LUTZ CHESTER T DATE OF PAYMENT: 12/23/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 05/02/2002 NO. CD 001983 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $3,810.10 I I I I I I I I TOTAL AMOUNT PAID: $3,810.10 REMARKS: THOMAS W LUTZ C/O MARLIN R MC CALEB ESQUIRE CHECK#19 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS DONNA M. OTTO DEPUTY REGISTER OF WillS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HAFIRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MC CALEB MARLIN R ESQUIRE 219 E MAIN STREET MECHANICSBURG, PA 17055 -------- fold ESTA,TE INFORMATION: SSN: 176-26-1732 FILE NUMBER: 2102-0462 DECEDENT NAME: LUTZ CHESTER T DATE OF PAYMENT: 02/21/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 05/02/2002 NO. CD 002200 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $394.45 I I I I I I I I TOTAL AMOUNT PAID: $394.45 REMARKS: THOMAS W LUTZ C/O MARLIN R MCCALEB ESQUIRE CHECK# 23 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS DONNA M. OTTO DEPUTY REGISTER OF WillS LAW OFFICES MARLIN R. McCALEB ;./-!J:J, -Lf~J.. FAMILY SETTLEMENT AGREEMENT, RECEIPT AND RELEASE WHEREAS, CHESTER T. LUTZ, late of Hampden Township, Cumberland County, Pennsylvania, died on May 2, 2002, having first made his Last Will and Testament in writing dated November 6, 2000, which since his decease was duly probated before the Register of Wills of said Cumberland County and Letters Testamentary issued to THOMAS W. LUTZ, the Executor named in the Last Will and Testament of said decedent; and WHEREAS, BRIAN GOOD, STEFANIA GOOD, COLLEEN HOPE and BRAD L. LUTZ are nieces and nephews, heirs and next of kin of the said decedent and the only persons interested in his Estate; and NOW KNOW ALL MEN BY THESE PRESENTS, the we, BRIAN GOOD, STEFANIA GOOD, COLLEEN HOPE and BRAD L. LUTZ, being the distributees sharing in the distribution of the Estate of said decedent, do hereby declare and say that we have examined the Account and Schedule of Distribution of THOMAS W. LUTZ, Executor as aforesaid, for the period ending June 6, 2003, and find the same to be accurate and according to law, and we, BRIAN GOOD, STEFANIA GOOD, COLLEEN HOPE and BRAD L. LUTZ, distributees as aforesaid, do hereby acknowledge that we, this day have, had and received of and from THOMAS W. LUTZ, the Executor of the Estate of CHESTER T. LUTZ, the cash or property set opposite our names in the above stated Schedule of Distribution, in full satisfaction, payment and discharge of all claims we, or any of us, have or may have against each other or against the Estate of CHESTER T. LUTZ, Deceased, and all interest accrued thereon. NOW, THEREFORE, we the same BRIAN GOOD, STEFANIA GOOD, COLLEEN HOPE and BRAD L. LUTZ, distributees as aforesaid, do by these presents, remise, release, quit-claim and forever discharge each other and the said THOMAS W. LUTZ, Executor, his heirs, executors and administrators, of and from our distributive shares of the Estate as set forth in the Schedule of Proposed Distribution aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason thereof, or under the said decedent's Will, or by contract, or under the intestate law of the Commonwealth of Pennsylvania, or by reason of any other act, matter, cause or thing whatsoever, from the beginning of the world to the day and date of these presents, except for any obligations arising under this Family Settlement Agreement, Receipt and Release or under the Schedule of Distribution. AND desiring to avoid the delay and expense of the settlement of said Estate by filing the foregoing Account of said administration in the Office of the Register of Wills of said County and by having the balance in the hands of the Executor, as shown by said Account, distributed by the Court of Common Pleas of Cumberland County - Orphans' Court Division, we LAW OFFICES MARLIN R. McCALEB -2- LAW OFFICES MARLIN R. McCALEB do hereby agree that the within Family Settlement Agreement, Receipt and Release concerning the matter of settlement may be recorded with the same effect upon us as if the same had been reported upon by said Court, and a decree of distribution made on such report by the said Court of Common Pleas - Orphans' Court Division. AND in consideration of the aforesaid settlement being made without the aid of such Court of Common Pleas - Orphans' Court Division, that we, BRIAN GOOD, STEFANIA GOOD, COLLEEN HOPE and BRAD L. LUTZ, distributees as aforesaid, do hereby agree that if any debts or demands other than those included in the aforesaid Account of the said THOMAS W. LUTZ, the Executor of the Estate of CHESTER T. LUTZ, Deceased, shall be hereafter recovered against the Estate of said decedent and be legally payable out of the same, that we will return to the said Executor such amount thereof as may be necessary to pay such debts or demands. The signature page or pages may be executed by the parties hereto in several counterparts (one by each signatory hereto), each of which is an original and all of which taken together shall be deemed and considered as part of the original document herein. IN WITNESS WHEREOF, we have hereunto set our hands and -3- LAW OFFICES MARLIN R. McCALEB seals this ~ day of -S ~yn-t.. I 2003. ,-~b~ Brian Good - Stephanie Good Colleen Hope -4- Brad L. Lutz (SEAL) (SEAL) (SEAL) (SEAL) LAW OFFICES MARLIN R. McCALEB seals this ..JI2 day of j ~ I 2003. (SEAL) Brian Good ~ ~ (SEAL) ni '5~fAl\if\ Good (SEAL) Colleen Hope (SEAL) Brad L. Lutz -4 - LAW OFFICES MARLIN R. McCALEB seals this ~ day of ~ ~) V'-~ I 2003. Brian Good Stephanie Good /-' (J~~ Colleen Hop Brad L. Lutz -4- (SEAL) (SEAL) (SEAL) (SEAL) LAW OFFICES MARLIN R. McCALEB seals this /77'''- day of C;J..~ I 2003. Brian Good Stephanie Good Colleen Hope ~J~-;;5= Brad L. Lutz -4- (SEAL) (SEAL) (SEAL) (SEAL) COUNTY OF PENNSYLVANIA) L (.(I\("-':>t~) ss / q day of TuJ'/..e. , 2003, STATE OF On this, the before me, a Notary Public in and for said State and County, the undersigned officer, personally appeared BRIAN GOOD, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. C?--- Notary Public My commission expires: 10 -("7-o~ (SEAL) Notarial Seal Chad Michael Boyer, Notary Public E1izabethtown Boro. Lancaster County My Commission Expires Oct. 17, 2005 LAW OFFICES MARLIN R. McCALEB -5- STATE OF PENNSYLVANIA) LCtI1((t~-er SS COUNTY OF On this, the 2.0 day of ~ ~ Vt~<"'" , 2003, before me, a Notary Public in and for said State and County, 'Sfe.fAAiOl.. the undersigned officer, personally appeared @'fEI'IIhUIE GOOD, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~ Notary Public My commission expires: !a-/7--o5 (SEAL) --..---..-:-: Notarial 8l!.1\1 Chad Michael Boye{l_Nr~. !ll. ~~'iC BllzlIbedllown Boro, WIll! , P!l9!Y My Commission l!xpIl!O' .' I . PIPS LAW OFFICES MARLIN R. McCALEB -6- 1>i!<f,.d D~ t..('-t ......bq STATE OF VIRCIN~) SS COUNTY OF On thi s , the /} wJ day of j~ , 2003, before me, a Notary Public in and for said State and County, the undersigned officer, personally appeared COLLEEN HOPE, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. (SEAL) ~o~c My commission expires: Vanessa Murray Notary Public DIstrict of ColUmbia My Commission expires: April 14. 2008 LAW OFFICES MARLIN R. McCALEB -7- LAW OFFICES MARLIN R. McCALEB .1. STATE OF MARYLAND) go.. !-li/,>"Ore SS COUNTY OF On this, the I'J day of ~ tAl }/ ' 2003, before me, a Notary Public in and for said State and County, the undersigned officer, personally appeared BRAD L. LUTZ, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. " ?[)(!') I -8- //}-b;:2- /~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 1712B-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REV-U01EX AFP (01-03> MARLIN R MCCALEB ESQ M R MCCALEB LAW OFFICE PO BOX 230 MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-10-2003 LUTZ 05-02-2002 21 02-0462 CUMBERLAND 101 CHESTER T Allount Ralli Ued MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure propar credit to your eccount, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=i6"irj-ix--AFP-foFoir-----...-iNHERi"fANCrYAX-ST'AfEMENY-OF-ACCOlirff--.-..------------------ --- ESTATE OF LUTZ CHESTER T FILE NO. 21 02-0462 ACN 101 DATE 03-10-2003 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-10-2003 PRINCIPAL TAX DUE:_ 14,729.63 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-31-2002 CDOO1465 526.32 10,000.00 12-23-2002 CDOO1983 .00 3,810.10 02-21-2003 CD002200 1.02- 394.45 TOTAL TAX CREDIT 14,729.85 BALANCE OF TAX DUE .22CR INTEREST AND PEN. .00 " IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .22CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J I ?- 6.:2-- I Y \.. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 -HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR OISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-10-2003 lUTZ 05-02-2002 21 02-0462 CUMBERLAND 101 MARLIN R MCCALEB ESQ M R MCCALEB lAW OFFICE PO BOX 230 MECHANICSBURG PA 17055 ESTATE OF lUTZ *' REV-1547 EX AFP (Dl-D5) CHESTER T Allount Rellitted ll) (2) (3) (4) (5) (6) (7) .00 5,022.51 .00 .00 130,199.16 .00 .00 (8) DATE 02-10-2003 ATTACHED NOTICE 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 ~ iiEY=is4-j-Ex--AFP--foFiiiY-NciT'icE--oF-YNHEifiTAifCi-y-A'inrppRxisEMENT:--AL.u)'WANcroR'----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CHESTER T FILE NO. 21 02-0462 ACN 101 TAX RETURN WAS: I ) ACCEPTED AS FILED ( X) CHANGEO SEE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule 0) 5. Cash/Bank Oeposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Trensfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 22,636.15 3.477.20 (11) 112) 113) 114) (9) 1l0) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 135,221.67 26.11335 109,108.32 10,910.84 98,197.48 NOTE: If an assessment was issued previoUSly. lines 14. 15 and/or 16. 17. 18 and 19 will reflect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate 16. Allount of Line 14 taxable at Lineal/Class A rate 17. Allount of Line 14 at Sibling rate 18. Allount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due 115) .00 X 00 = .00 116) .00 X 045 = .00 117) .00 X 12 = .00 118) 98,197.48 X 15 = 14,729.63 119)= 14,729.63 TAX C TS: .... n " ,.. J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 07-31-2002 CDOO1465 526.32 10,000.00 12-23-2002 CDOO1983 .00 3,810.10 INTEREST IS CHARGED THROUGH 02-25-2003 TOTAL TAX CREDIT 14,336.42 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 393.21 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 1. 24 TOTAL DUE 394.45 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) REV.1470 EX (6-88) INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME Chester T Litz FILE NUMBER REVIEWED BY Deborah Washington ACN 2102-0462 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES J B-1 The value of the charitable bequest has been changed. The decedent's Will contains a specific bequest to the charity. ROW Page 1 """.,5Io".!, COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OEPT. 280601 HARRISBURG, PA 1712B-0601 REV-1500 OFF;Cl#,L us=: Of'lL Y ~ w ,., ~:S;0 u"'''' wc.u ",00 U"'... c.lD C. < INHERITANCE"TAX RETURN RESIDENT DECEDENT FILE NUMBER 21_02 I- Z W C W U W C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Lutz Chester T. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD.YEAR) 05/02/2002 OS/21/1934 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER COUNTY CODE YEAR NUMBER 00462 176 26 - 1732 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~ 1. Original Return o 4. Limited Estate ~ 6. Decedent Died Testate (Attach copy of Wi!l) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (llateoldeatllafler12-12.82) o 7. Decedent Maintained a Living Trust (Attach copy ofTruslj o 10. Spousal Poverty Credit (date 01 death between 12-31-91 and 1.1.95) D 3. Remainder Retum (dBle of dealn prior 10 12-13-B2) o 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposn Boxes o 11. Election to tax under Sec. 9113(A} (Attach SchO) J,i.;~~._~&L-'~ >- z w c z o c. ., w '" '" o u NAME Marlin R. McCaleb, Es uire FIRM NAME 1''''''''1 Law Offices - Marlin R. McCaleb TELEPHONE NUMBER 717/691-7770 COMPLETE MAILING ADDRESS 219 East Main Street P.O. Box 230 Mechanicsburg, PA 17055 z o !ci: ...J :J l- ii: c:( u w 0:: 1. Real Estate (Schedule A) (I) 2. Stocks ami Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointiy Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 6. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (Iotal Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (line 12 minus Une 13) None 5,022.51 None None 130,199.16 None None (6) 22,636.15 3,477.20 (11) (12) (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !;i I-' :J II. ::E o u ~ 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x.O~ (15) x .0 45 (16) 16. Amount of Line 14 taxable at lineal rale 0.00 17. Amount of line 14 taxable at sibling rate , .12 (17) 95,576.15 , .15 (18) 18. Amount of line 14 taxable at collateral rate 19. Tax Due (19) 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~1i~,~t~~1~{~~its~'~J~~~}$'.R _~~~~U!fflj\~~~~~~Q , .CHE.CI<cMATH <.5:'.S ~- " c;-.o~;'C);~<:...;.. ''5 OFFICIAL USE ONLY 135,221.67 26,113.35 109,108.32 13,532.17 95,576.15 0.00 0.00 0.00 14,336.42 14,336.42 (3) 0.00_ (4) 0.00 (5) 3,8 0.10 (5A) 0.00 (5B) 3,8 0.10 Decedent's Complete Address: Lutz Chester T. STREET ADDRESS 404 Silver S ring Road CITY STATE PA Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditsJPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 10,000.00 526.32 Total Credits (A + B + C ) (2) 3. interesUPenalty if applicable O. Interest E. Penalty TotallnterestlPenalty ( 0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enler the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the lax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT . . ZIP 17050 14,3 6.42 10,5 6.32 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCK 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;.......................................................................................... 0 b. retain the right to designate Who shan use the property transferred or its income; ............................................ 0 c. retain a reversionary interest; or.......................................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. if death occurred after December 12, 1982, did decedent transfer property within one year of death wnhout receiving adequate consideration? .................................................................................................:............ 0 3. Did decedent own an "in trust fo~ or payable upon death bank account or security at his or her death? .............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 No [jQ [jQ [jQ [jQ [jQ Qg Qg IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF TH RETURN. Under penalties of perjl6Y. I declare that 1 have examined this return, irduding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and oomplete. Declaration of preparer other than the personal represen1ative is based on aU information of '6t1ich preparer has any knowledge. SIGNA OF PERSON RESPONSiBLE FO III RN DATE /.;z... - .2~ o::z.... ADDRESS omas W. Lutz 20 Jack Nicklaus Dr. Etters, PA 17319 RESENTATIVE Law Offices - Marlin R. McCaleb 219 East Main Street Mechanicsburg, PA 17055 ADDRESS 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 % [72 P.S. S9116 (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. S911~ (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from lax, and the statutory requirements for disclosure of assets and filing a tax return are still ap~licable 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 optive parent, or a slepparent of the child is 0% [72 P.S. s9116(a)(1.2)]. I I 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. S9116(1.2) [72 P.S. S911~(a)(I)). i The tax rate imposed on the net value of transfers 10 or for the use of the decedent's siblings is 12% [72 P.S. S9116(a)(1.3)]. A sibling is defined, under Sectiqn 9102, as an individual who has at least one parent in common with the decedent, Whether by blood or adoption. i '" ~\'.. ~~ \ no ~\/\ ~""'..' " L '\...)' \- 1 I~ ~ \~ ~ ~ "\- \\\ LAW OFFICES :L1N R. McCALEB ~ito. LAST WILL AND TESTAMENT I, CHESTER 1. LUTZ, of the Township of Hampden, County of Cumberland and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former Wills or Codicils by me at any time heretofore made. FIRST. I order and direct that all my just debts and funeral expenses be paid by my Executor or my Executrix, as the case may be, hereinafter named, as soon as conveniently may be done after my decease. \ SECOND. I give and bequeath an amount equal to ten (10%) per centum of my estate unto the WELLSVILLE BIBLE CHURCH, on Andover Road, Route 417, Wellsville, New York, absolutely, for use in the general fund. THIRD. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever situate, in equal shares unto my nieces and nephews, namely: BRIAN GOOD, STEPHANIE GOOD, COLLEEN HOPE and BRAD L. LUTZ, absolutely and in fee simple. Provided, however, that if any such niece or nephew shall not survive me, then I order and direct that the share provided herein for such deceased niece or nephew shall instead be paid over and distributed in equal shares between or among the other shares herein provided for my nieces and nephews, share and share alike, absolutely and in fee simple. , LAW OF'FICES MA.RLlN A. MCCAL..E9 FOURTH. I have intentionally not provided herein for my stepsons, EDWARD POTKAY, GEORGE ROONEY, and PATRICK ROONEY, and I hereby declare that their omission herein is intentional and not occasioned by accident or mistake. LASTLY. I nominate, constitute and appoint my brother, THOMAS W. LUTZ, Executor of this, my Last Will and Testament, but if for any reason he shall fail to qualify as such Executor or cease so to serve, then I nominate, constitute and appoint my sister, SARAH GRACE GOOD, to serve in his place and stead, each to serve without bond in this or any other jurisdiction. IN WITNESS WHEREOF, I, CHESTER T. LUTZ, 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 L day of tV 0 'y, , A.D., Two Thousand (2000). . I '" . _I------ . fl~' / //_. I. :- . '--(1.' ---CO> ~~">--7, . T 0, --::"-> p-- The preceding instrument, consisting of this and one (1) other typewritten pages, each identified by the signature of the Testator, was on the date thereof signed, sealed, published and declared by CHESTER T. LUTZ, the Testator therein named, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence, and in the presence of each other, have subscribed our names as witnesses hereto. ~~/~~~ (SEAL) c Cot/.. /7 (:f iW'M./-fJ q> u -2- n )hJ-0tq _ (/ (/ , REV-1503 Ex. (1-91] *' SCHEDULE B STOCKS& BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Chester T. Lutz SS# 176-26-1732 05/02/2002 FILE NUMBER 21-02-00462 All property joinUy.owned with right of survivorship must be disclosed on Schedule F, ITEM NUMBER 1. 271.634 shares Smith Barney Large Cap Growth Fd., C1 A - Salomon Smith Barney Acct. #724-02676-1~2-015 18.49 VALUE AT DATE OF DEATH 5,022.51 DESCRIPTION Unit Value TOTAL (Also enter on line 2, Recapitulation) $ 5,022.51 flf ITYlrF! ~nW".P. i~ nRArlArl jn~ wirlitinn~1 !l::hMtJ:: nf tllP. ~;:lmA ~i7P\ , SALOMONSMITHBARNEY A member of cltlgroup't 717.780--1700 . 800-237-1700 May 30, 2002 Marlin R. McCaleb, Esquire Frankeberger Place 219 East Main Street P.O. Box 230 Mechanicsburg P A 17055 Dear Attorney McCaleb; Enclosed are the values as of May 2, 2002 for the accounts held at Smith Barney for the Estate of Chester Lutz. Please contact me in the event you need anything further_ Sincerely, . '~~ Florence R. Clifford Financial Consultant FRC/mrl Enclosure SALOMON SMITH BARNEY INC_ 11 North 3rd Street. 2nd Floor, Harrisburg, PA 17101-1702 FM 717.233.2090 VALUE AS OF MAY 2, 2002 FOR ACCOUNTS HELD AT SMITH BARYNEY IN THE NAME OF CHESTER LUTZ Account #724-02676-1-2-015 Retail Account Symbol- SBLCA Quantity - 271.634 Description - Smith Barney Large Cap Growth Fund Price - $18.49 Value - $5022.51 Account #724-66417-1-1-015 IRA Account Symbol- GROW A Quantity-I44.858 Symbol - APPRA Quantity- 1048.508 Symbol- SBLCA Quantity -1318.657 Description - Smith Barney Aggressive Growth Fund Price - $79.61 Value - $11,532.15 Description - Smith Barney Appreciation Fund Price - $13.28 Value $13,924.19 Description - Smith Barney Large Cap Growth Fund Price - $18.49 Value $24,381.97 THE INFCR,,-)..ATicN' HERE-IN' H'l;:,$ BE-EN OBTAiNED FRON\. SOURCES V'i'EBEUEVE TO E-.f RIiiABi.t., BJ1 DO, t'-..\{)T GUARANTEE as ACClJRAcY OR COM.PUm,GS. REV.150S EX+ (2.S7) ESTATE OF Please Print or Type FILE NUMBER 21-02-00462 . SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Chester T. Lutz SS# 176-26-1732 05/02/2002 (All property jointly-owned with the Right of Survivorship must be disclosed on Schedule FJ ITEM NUMBER 1 2 10 11 12 13 14 15 16 17 3 4 5 6 7 8 9 DESCRIPTION Cash on Decedent1s person. Certificate of Deposit (Acct. #196787-40), Members 1st Federal Credit Union - principal balance as of D.O.D. Certificate of Deposit (Acct. #196787-40), Members 1st Federal Credit Union - interest accrued to D.O.D. Checking Acct. #196787-11, Members 1st Federal Credit Union principal balance as of D.O.D. Checking Acct. #196787-11, Members 1st Federal Credit Union interest accrued to 0.0.0. Investment Savings Acct. #196787-05, Members 1st Federal Credit Union - principal balance as of O.O.D. Investment Savings Acct. #196787-05, Members 1st Federal Credit Union - interest accrued to D.O.D. Regular Savings Acct. #196787-00, Members 1st Federal Credit Union - principal balance as of O.O.D. Smith Barney Large Cap Growth Rd., C1 A - Salomon Smith Barney Acct. #724-02676-1-2-015, cash balance in account on D.O.D. 1995 Oldsmobile Cutlass Cierra SL sedan Decedent's household contents and personal belongings - floor lamp ($55.00); hutch cabinet ($25.00); typewriter ($40.00); chair ($65.00); walker ($100.00); Sony TV ($225.0 ). DFAS-C1eve1and - monthly military retirement payment for Ma Dresser-Rand - monthly retirement payment for May. Ingersoll Rand - monthly retirement payment for April. Ingersoll Rand - monthly retirement payment for May. State Farm Insurance Co. - refund of automobile insurance premium. U.S. Treasury - 2001 federal income tax refund. Total of Continuation Schedu1e(s) VALUE AT DATE OF DEATH 132.00 42,239.14 3.43 5,053.02 0.14 21,953.13 1.25 25.00 .95 3,400.00 510.00 1,247.00 344.22 324.75 324.75 158.07 1,744.00 52,738.31 TOTAL (Also enter an line 5, Recapitulation) $ (Attach additional 8%'" x 11" sheets if more space is _needed.) 130,199.16 Estate of: Chester T. Lutz Soc Sec #: 176-26-1732 Date of Death: 05/02/2002 Item # Continuation of Schedule E (Cash, Bank Deposits & Miscellaneous Personal Property) Description Value at Date of Death 18 19 Yeager Personal Care Horne - refund of May rent. Yeager's Personal Care Home - refund of Decedent's deposit. 20 Smith Barney IRA Acct. #724-66417-1-1-015 - (144.858 shs. Smith Barney Aggressive Growth Fund @ $79.61; 1,048.508 shs. Smith Barney Appreciation Fund @ $13.28; 1,318.657 shs. Smith Barney Large Cap Growth Fund, C1 A, @ $18.49). 2,100.00 800.00 49,838.31 52,738.31 MemberslST FEDERAL CREDIT UNION INSURANCE DEPARTMENT 5000 Louise Drive p, O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1161 June 7, 2002 Marlin R. McCaleb Frankeberger Place 219 E. Main Street PO Box 230 Mechanicsburg, PA 17055 RE: Estate of Chester T. Lutz SSIN 176-26-1732 Dear Mr. McCaleb, Enclosed is the information requested in your letter of May 22, 2002 regarding the accounts held with Members 1 st by Chester Lutz. Please do not hesitate to contact me at 795-5131 should you have any questions or require additional information. , ~rr~IY yours, ~ . vA .....anlse . Insurance Products Supervisor Enclosure MemberslST FEDERAL CREDIT UNION INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283.2328 or (717) 697-1161 REGULAR SA VINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner 196787 -00 0911112002 $25.00 $.00 $25.00 None CHECKING ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner 196787.11 0911112000 $5,052.88 $.14 $5,053.02 None INVESTMENT SA VINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner 196787 -05 09/1112000 $21,953.13 $1.25 $21,954.38 None CERTIFICA TES OF DEPOSIT: Account Number/Suffix Date Certificate Purchased Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner 196787 -40 1 YR 04/25/2001 $42,239.14 $3.43 $42,242.57 None tt'~IT~mON ~mse A. Anders Insurance Products Supervisor June 7, 2002 Estate of: CHESTER T. LUTZ Date of Death: 05/0212002 Social Security Number: 176-26-1732 SALOMON SMITH BARNEY Amemberof c't,groupj" 717-780-1700 . 800.237-1700 May 30, 2002 Marlin R. McCaleb, Esquire Frankeberger Place 219 East Main Street P.O. Box 230 Mechanicsburg P A 17055 Dear Attorney McCaleb; Enclosed are the values as of May 2, 2002 for the accounts held at Smith Barney for the Estate of Chester Lutz. Please contact me in the event you need anything further. Sincerely, . .~~ Florence R. Clifford Financial Consultant FRC/mrl Enclosure SALOMON SMITH BARNEY INC 11 North 3rd SUes!, 2nd Floor, Harrisburg, PA 17101.1702 FAX 717-233-2090 .; " . VALUE AS OF MAY 2, 2002 FOR ACCOUNTS HELD AT SMITH BARYNEY IN THE NAME OF CHESTER LUTZ Account #724-02676-1-2-015 Retail Account Symbol- SBLCA Quantity - 271.634 Description - Smith Barney Large Cap Growth Fund Price - $18.49 Value - $5022.51 Account #724-66417-1-1-015 IRA Account Symbol- GROW A Quantity - 144.858 Symbol- APPRA Quantity - 1048.508 Symbol- SBLCA Quantity - 1318.657 Description - Smith Barney Aggressive Growth Fund Price - $79.61 Value - $11,532.15 Description - Smith Barney Appreciation Fund Price - $13 .28 Value $13,924.19 Description - Smith Barney Large Cap Growth Fund Price - $18.49 Value $24,381.97 THE lNFORbJ...AIT!CN~ HEREiN H'l:..S BE-EN OBTAINED FROM. SOURCES ViE GEUEVE TO BE RELlft,BLE, BUT DC NeT GUARA~'.H'Ef iTS ACCURACY OR COM,PtHH--iISS. Rf\l.~'lEX+IM11 ~ ...~ COMMOOWEALTIi OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Chester T. Lutz SS# 176-26-1732 05/02/2002 FilE NUMBER 21-02-00462 Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Burg Funeral Horne - Cash advances for funeral expense: cemetery 1,279.40 charges: $350.00, cemetery equipment: $150.00; death certificates: $20.00; flowers: $148.40; minister's honorarium: $80.00, obituary: $90.00; telephone charges: $25.00; memorial folders and temporary marker: $60.00; mileage to and from hospital: $56.00, 6 pallbearers: $300.00. Total of Continuation Schedu1e(s) 6,890.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 6,766.08 Name of POlSOnal Representative (s) Thomas W. Lutz Sodal Security Numbe~s) f EIN Number of Personal Representative(s) Street Address 20 Jack Nicklaus Dr. City Etters State FA Zip 17319 Yea~s) Commission Paid: 2002 2. Attomey Fees Law Offices - Marlin R. McCaleb 7,025.00 3. Fami~ Exemption: (If _ofs address ~ not the same as cIalmanfs, atIach explanation) Claimant Street Address City Slate Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 295.00 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs l. Register of Wills - filing Inventory and Appraisement. 28.00 2. Register of Wills - reserve for filing Account, Releases, etc 250.00 3. The Patriot-News - advertising Letters. 102.67 TOTAl. (Also enter on line 9, Recapitulation) $ 22,636.15 (If more space is needed, insert additional sheets of the same size) " " . Estate of: Chester T. Lutz Soc Sec #: 176-26-1732 Date of Death: 05/02/2002 Continuation of Schedule H-A (Funeral Expenses) Item Description # Amount 2. Burg Funeral Home - funeral expense. 3. Golden Memorials, Red Lion, PA - gravemarker 4. York County Veterans Home Guard - graveside service. 6,615.00 175.00 100.00 6,890.00 Ii" .. , REV_1512 EX. (l-9Tj '*' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAj, RETURN RESIDENT DECEDENT ESTATE OF Chester T. Lutz SS# 176-26-1732 05/02/2002 FILE NUMBER 21-02-00462 Include unreimbursed medical expenses. ITEM NUMBER 1. 2. 3. 4. 6. 10. 11. 12. 13. 14. 15. 16. 17. DESCRIPTION Crumay Parnes - medical expense of final illness, account payable. Family Internal Medicine Assoc~ - medical expense of final illness, account payable~ Family Internal Medicine Assoc. - medical expense of final illness, account payable~ Holy Spirit Hospital - medical expense of final illness, accoun payable. 5. Kenneth Small, M~D. - medical expense of final illness, account payable. Keystone Urology - medical expense of last illness, account payable. AMOUNT 72.48 106.43 9.61 521.47 209.14 19.77 55.00 15.99 50.38 29.95 46.84 92.00 5.67 68.70 27.96 10.82 2,134.99 7. Mary Lutz - reimbursement for purchase of reading lamp, account payable. 8. Mobile X-Ray Imaging - medical expense of last illness, account payable. Moffitt Heart & Vascular Group - medical expense of final illness, account payable. Navy Times - subscription, account payable~ PA Neurological Assoc~, LTD~ - medical expense of final illness, account payable~ 9. PA Department of REvenue - 2001 PA income tax, account payable. Quantum Imaging - medical expense of last illness, account payable. Quantum Imaging - medical expense of final illness, account payable. Readers Digest - subscription, account payable. Veri:zon - final telephone bill, account payable. Yeager Personal Care Home - rent for May, account payable. TOTAL (Also enter on line 10, Recapitulation) $ (W more space is needed, insert addrtional sheets of the same size) 3,477.20 If' If. . REV.1513EX.ll.gn . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Chester T. Lutz SS# 176-26-1732 NUMBER 1. 05/02/2002 FILE NUMBER 21-02-00462 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) NAME AND ADDRESS OF PERSON(S) RECEIViNG PROPERTY TAXABLE DISTRIBUTIONS (Include outright spousal distributions) 1. Brian Good 140 E. Humme1stown E1izabethtown, PA St. 17022 AMOU,"T OR SHARE OF ESTATE One-Fourth One-Fourth One-Fourth One-Fourth 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 -,- Nephew 2. Stephanie Good Apt. 6 Strafford Eli zabethtown , PA Niece 17022 3. Colleen Hope 6649 Van Winkle Dr. Falls Church, VA 22044 Niece 4. Brad L. Lutz 1004 Popular Hill Rd. Baltimore, MD 21210 Nephew 1. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS We11svi11e Bible Church, We11svi11e, NY - charitable distribution per Item SECOND of Will. TOTAL OF PART n. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) 13,532.17 13,532.17 STATUS REPORT UNDER RULE 6.12 Name of Decedent: CHESTER T. LUTZ Date of Death: May 2, 2002 Will No. 2002-00462 Admin. No. 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 x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: N/A 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No x b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes x No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may b~~ttac:e~~ ~~s report. Date: June 14, 2004 ~~ Signature Marlin R. McCaleb, Esq. Name (Please type or print) 219 East Main Street Mechanicsburg, PA 17055 Address ( 717) 691-7770 Tel. No. l Z ~ rr~,-' Capacity: Personal Representative x Counsel for personal representative (MAH:rmf/AM3)