HomeMy WebLinkAbout06-16-10 N
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IN THE COURT OF COMMON PLEAS OF ~,' ~. --
CUMBERLAND COUNTY -ORPHAN'S COURT DIVISION ~ , , ;
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' ~~ ~ ~ `
DOCKET NUMBER: 2009-00187 =~ w -~ ~
IN RE: JANET L. DAVIS, Deceased
PETITION TO DIRECT RELEASE OF FUNDS
AND NOW, comes the Petitioner, DEBRA D. KIRBY, by and through the
undersigned counsel, and hereby petitions this Honorable Court to Direct Release of
Funds, and in support thereof avers as follows:
1. Petitioner is Debra D. Kirby, an adult individual, residing at 627
Allenview Drive, Mechanicsburg, Cumberland County, Pennsylvania 17055.
2. On February 26, 2009, Petitioner was granted Letters Testamentary for the
Estate of Janet L. Davis, decedent, who passed away on death February 11, 2009, by
Glenda Farner Strasbaugh, Register of Wills for Cumberland County, Pennsylvania.
Petitioner is the Executrix of the Estate of Janet L. Davis. A true and accurate copy of
said Letters, together with the Will of Janet L. Davis, is attached hereto as Exhibit "A."
3. Petitioner is the sole heir of her brother, Wayne C. Davis, who passed
away intestate, on February 21, 2009, and who resided at his mother's home at 25
1
Fieldcrest Drive, Mechanicsburg, Cumberland County, Pennsylvania 17050. A Death
Certificate for Wayne C. Davis is attached hereto as Exhibit "B."
4. Janet L. Davis, deceased, was the mother of Petitioner and Wayne C.
Davis, deceased.
5. The clear donative intent found in the Will of Janet L. Davis evidenced a
desire to have heirs take only if they survived Janet L. Davis by thirty (30) days; and,
Wayne C. Davis did not survive Janet L. Davis beyond 30 days, leaving Petitioner as sole
surviving heir.
6. Pursuant to her duties as Executrix, Petitioner discovered a retirement
account (number 35004201002893) in the name of Janet L. Davis and held by M&T
Bank. More specifically, Petitioner received a letter dated April 17, 2009 evidencing said
account at the West Shore Plaza Branch of M&T Bank. A true and accurate copy of said
letter is attached hereto as Exhibit "C."
7. At the time of said letter, the total amount in the retirement account was
$38,601.21. See, Exhibit "C."
8. The West Shore Plaza Branch of M&T Bank is located at 1200 Market
Street, Lemoyne, Cumberland County, Pennsylvania 17043.
9. The retirement account paperwork failed to include a provision expressing
the donative intent of Janet L. Davis to have her heirs survive her by 30 days.
10. Petitioner submits that 100% of the funds in the retirement account should
go to her as sole surviving beneficiary and heir of decedent.
2
11. Petitioner has attempted to negotiate the release of funds from the
retirement account held by M&T Bank to Petitioner without success. Petitioner has
asserted that 100% of the funds should go to her as sole surviving beneficiary and heir,
while M&T Bank has asserted that 50% of the funds should go to the Estate of Wayne C.
Davis, which does not exist and which has not submitted a claim for distribution.
12. In furtherance of her position, Petitioner submitted to M&T Bank an
executed IRA Distribution to Beneficiary Form and Affidavit for 100% of the funds.
Upon submission by Petitioner's counsel directly to an agent at the West Shore Plaza
Branch on or about December 4, 2009, a lump sum payment was requested through
issuance of a check. An original copy of the executed IRA Distribution to Beneficiary
Form and Affidavit is attached hereto as Exhibit "D."
13. M&T Bank accepted the executed IRA Distribution to Beneficiary Form
and Affidavit, but did not accept Petitioner's assertion that she should receive 100% of
the funds.
14. However, M&T Bank has agreed to the release of 50 % of said funds to
Petitioner. See, letter dated March 25, 2010, and included herein as Exhibit "E."
15. On May 19, 2010, M&T Bank released $17,090.82 of the funds to
Petitioner for her share, holding approximately 10% for tax purposes, if any taxes are
due, and leaving $18,974.14 in the retirement account.
16. Among other agents for M&T Bank, counsel for Petitioner has been in
direct contact with M&T Bank, through Christopher R. Rahl, Associate General Counsel
and Vice President.
17. M&T Bank has agreed to release the remaining funds if the Court so
directs, provided that M&T Bank is released from future claims concerning the funds.
See, e-mails dated April 13, 2010, and included herein as Exhibit "F."
18. Petitioner agrees to take full responsibility for the release of the remaining
funds from M&T Bank and hold M&T Bank harmless for such release of funds.
Petitioner shall pay applicable taxes, if any are due. It is noted that Petitioner previously
agreed to hold the bank harmless as indicated in the executed IRA Distribution to
Beneficiary Form and Affidavit. See, Exhibit "D."
19. Counsel for Petitioner has consulted with M&T Bank, and M&T Bank has
no objection to the Court directing M&T Bank to release funds as set forth in the
proposed Order.
20. Petitioner submitted an inheritance tax payment in full on November 9,
2009, and to the best knowledge of Petitioner, no further inheritance tax is due. See
Exhibit "G," which is attached hereto, and is a true and accurate copy of the Notice from
the Pennsylvania Department of Revenue stating that tax was paid, and that no tax is due.
21. To the extent that inheritance tax may be due as a result of this Petition,
Petitioner shall pay such inheritance taxes, if any, promptly.
22. To the best knowledge of Petitioner, decedent's creditors have been paid,
and no other creditor has a claim against decedent.
23. As such, Petitioner submits that the funds remaining and currently held by
M&T Bank in decedent's retirement account should be released to Petitioner pursuant to
this Petition and the corresponding Order as the Court may direct.
4
WHEREFORE, Petitioner, Debra D. Kirby, as Executrix, sole heir, and sole
surviving beneficiary of the Estate of Janet L. Davis, respectfully requests that this
Honorable Court direct M&T Bank to release all remaining funds held by it in the
retirement account (number 35004201002893) for Janet L. Davis, Deceased, less taxes, if
any, to the Petitioner; and, hold M&T Bank harmless for future claims concerning the
funds, such that Petitioner shall be considered the sole responsible party by any person or
entity raising such claims, if any.
RESPECTFULLY SUBMITTED
.-- ames W. Kollas, Esquire
~' ~ Attorney ID No. 81959
KOLLAS & KENNEDY
1104 Fernwood Avenue, Suite 104
Camp Hill, Pennsylvania 17011
(717) 731-1600
ATTORNEY FOR PETITIONER
Date: ~.P ~ ~ ~ I ~
VERIFICATION
I, Debra D. Kirby, do hereby swear and affirm that the facts and matters set forth
in the foregoing document are true and correct to the best of my knowledge, information
and belief. I understand that false statements herein are made subject to~the penalties of
I8 Pa.C.S.A. §4904, relating to unswcar.~ falsific~tior to~autharities.
BY: - ~..
ebra D. Kirby,`
...... ~ ...... ..........~. ~~..t.
Sole Strvivin~ Heir and
6
and
REGISTER OF WILLS
CUMBERLAND COUNTY
PENNSYLVANIA
.~. "
CERTIFICATE OF
GRANT OF LETTERS
No . 2009- 00187 PA No . 21- 09- 0187
Estate Of: JANET L DAVIS
/First, Middle, Last)
Late Of : SlL VER SPR/NG TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Security No: 194-26-6236
WHEREAS, on the 26th day of February 2009 an instrument dated
June 18th 1981 was admitted to probate as the last will of
JANET L DA VlS _
/First, Middle, Lastl
late of S/EVER SPR/NG TOWNSH/P, CUMBERLAND County,
who died on the 11th day of February 2009 and
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi 11 s in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
DEBRA D KIRBY
who has duly qualified as EXECUTOR(R/X)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 26th day of February 2009.
Register of ills
putt'
EXHIBIT
~ ~-
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST
~tt~t 3~ii1 ~tt~ C~TPgY~mrnY
of
JANET L. DAVIS
I, JANET L. DAVIS, of Newberry Township, York County, Pennsylvania, do
publish and declare this to be my Last Will and Testament, hereby revok
other Wills and codicils that I may have heretofor made.
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I direct all my legal debts and funeral expenses be paid and sair~ed
Executor hereinafter named, as soon after my death as may be found co~v~nie ~ f ='
-;
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I bequeath my automobiles, household and personal effects, and other 1
property of like nature, not including cash and securities, together with any
insurance thereon, to by husband, GEORGE W. LAVIS, JR. provided he survi
by thirty (30) days. If my husband is not living on the thirty-first (31:
following my death, I bequeath such tangible personally together with the in
thereon to my children living an the thirty-first (31st) day after my death
divided among them by my Executor with due regard for their personal pref
in as nearly equal shares as possible.
III.
I give, devise and bequeath all the rest, residue and remainder of my E~
my husband, GEORGE W. DAVIS, J~It., provided he survives me by thirty (3l
If my husband is not living on the thirty-first (31st) day following my death,
give, devise and bequeath all the rest, residue and remainder of my Estate
children and their then living issue per stirpes.
I norninate and appoint my husband, Gt;ORGE W. DAVIa, JR., as the Executor of
this, my Last itiill and Testament. If my husband, GEORGE Iti. llAVIS, JR. does not
survive me or is unable or unwilling to net in this capacity, I norninate and appoint
my daughter, i~EBKA hIRts to be Executrix of this, my Last ~~Nill and 'testament.
If neither my wife nor my daughter survive me or is unable or unwilling to act in
this capacity, I norninate and appoint ~~ AYNE t~ llAVIa to be Executor of this, ,viy
Last Iti'ill and Testament. If my son, WAYIvE ~ ~)AVIS does not survive me or is
unable or unwilling to act in this capacity, I norninate and appoint C.C.N.-3. BANS,
N. A. to be Executor of this, my Last ~Vi11 and Testament.
I}v WITNESS WiiE}tl;Or, I hereunto set any hand and seal this ~~'r ~` day of
titr~.~, , 1987.
/ ~
,~ -;~,~._ (SEAL)
~}ANET L. DAvIS
Sighed, sealed, published and declared by the above-named Testatrix, ~ANE'I' L.
}~AVI~, as P.nd for her Last 'v~i11 and Testament, in the presence of us, ;vho, at her
roquest, in her presence and in the presence of each other have hereunto subscriued
our names as witnesses.
AC~ilvUly LEllG~YiEN't'
,i CU .~.i,.~ivi~. vVE~~LTti 0~ FEitiIYS'i Lti'ANIA
ss:
~I ~Ot1NTY Ot~ Cu:~il:~:E,ti.LA1vJ
I
I, JANET' L. DA~'IS, 'Pestatrix, whose name is signed to the foregoing
instrurnent, having been duly qualified according to law, do hereby acknowledge that
I signed and executed the instrurnent as my Last 1~~i11 and 'T'estament; that I signed
it willingly; and that I signed it as my free and voluntary act for the purE~oses
i
therein expressed.
%;" ~ c.~ i
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I ~Ai~i1~T L. DAMS
I
i Sworn or affirmed to and acknowledged before me, by ~AIYI`I' L. D9VIS, the
' `'.- i
'. "~estatrix, this ~ ' day of ~,, ,:; ~ - , 1987. ~
Notary Public I
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CU.~=:~iUN1vEAL'I'Ii OF PENNSi'LVANIA
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cauz~~rY ors cu::~bE~.LAI~~~
atie - and the
witnesses whose names are signed to the foregoing instrument, being duly qualified
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according to law, do depose and say that we were present and saw the 'Testatrix
sign and execute the foregoing instrument as her Last Will and 'Testament; that she
signed willingly and that she executed it as her free and voluntary act for the
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purposes therein expressed; that each of us in the hearing and sight of the
'Testatrix signed the ri'ill as witnesses; and that to the best of our knowledge, the
Testatrix was at that time i8 or more years of age, of sound mind and under no
constraint or undue influence.
Sworn or affirmed to and subscribed to before me Ly -~ - ',
and ~ , - ,_ , ; ~ ,; ,witnesses, this r' `'~ day of . ~c ~ , l ~&'l. i
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LOCAL REGISTRAR'S CERTIFICATION OF ~-EATH
WARNING: It Is +Ilegal to ~tapllcate Chas ~capy by phcatnstat car phcstacpr~rah.
ee hrr Ilu:. ~~rtil~ik~.uc. ti+.,.t1i1
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EXHIBIT
,EV,1r2oo6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
B
A" "TN CORONER'S CERTIFICATE OF DEATH ~ ~-
,NINK (See instructions and examples on reverse)
4i 31-4 61 ~raTF F
1. Name d Decedent (First, mitlMa, lass, suffix)
Wayne C Davis 2. Sex
M
l 3. Social Securlry Number V 4. Uate of Death (Month, tlay, year)
a
e 193 - 46 -~ 4990 February 21 , 2009
5. Age (Last BlmMay) Under t year Under 1 day B. Date of Birth (Month, day, year) 7. Birthplace (City and state w forego maery) Ba. Place of Death (Coach Doty one)
rmmrn Date Nw,n MNwres Hospital: Omer.
55
Feb. 7
1954
,
yrs
Harrisbur ,PA
g ^ Inpatient ^ ER! Outpedent ^ DOA ^ Nursing Heine Residence ^Ome~ S
ecity
p
.
Bb. County of Death Bc. Ci!y. Bo Twp. Death Bd, FecBily Name ill not Instkution, gNe street and number) 9. Wee Decedent d Hupanic Origin? No ^Ves 10
Face
Am
Md
S
.
.
erican
ian,
lack, White, sic
(If yea, speclry Cuban, Isaec,M
Cumberland Silver Spring 25 Fieldcrest Drive M
P
exrcan,
uertoRican,etcJ white
1t DecedenYS Usual Occ tron Kind of work done dun most of wo Ille. Do rid stele reined 12. Was Decadent ever in the 13. Decedent's Educatkm (Seedy Doty highest grade completed) 14. Mantel SleM. Married, Never Married t5
Su vlnq Bosuns !It wde
iv
d
~
.
. D
e rrai
er name;
U.S. Armed Forceso Widowed, Divorced (Specily1
Kind of Work Nmd of Businev !Industry Elementary I Bacondary (U12) Cdlega (1-1 or k)
u ^Ves ~ 12 ever married
16. Decetlent's Mailing Address (Street, city I town, state, zq code) Decedent's Did Decedent
Pe
l
i
25 Fieldcrest Dr. Awual Ree~ence , 7a. state
nnsy
van
a _ Lrva m a „c yea. Decadam Lived .n S ,~ S R r i n
~' Q
Mechanicsburg
PA 17050 wr
rownsnipP
I>o Couny Cumberland ,~d ^ A~
Deeed
a,t
Lwedwnhn
, B
l
g
at~ : B"rp
1B. Famer's Name (First, middle, last. suffix) 19. Maher's Name (First, middle. marten surname)
George W. Davis, Jr. Janet Spangler
20a. Informants Name (Type / Print; 2W. InfortnanCS Melling Address (Street. clry /lawn. slate
zip code(
Debra D. Kirby ,
627 Allenview Dr.,Mechanicsburg,PA 17055
21a. Mema1 nl DlsposHion ! ~Gremaaw ^ Donatbn 21b. Dale of Dispositim (Hoorn. day, year) 21c. Place of DisposHion (Name of remetary, crematory w other place( 21C. L .zt~on'C~ry' town. state. zip code) 1 7 0 6 5
^ Banal ^ Hemgval o-bm state Was Cremation a Donatlqn ANhaized
^ - SpeaM by Medcal Examiner l Coroner? vas ^ No
' Mar . 3 2 0 0 9
~ H o 11 i n e r C r e m a t o r
g Y
t. H 011 y S p r i n g S ,P A
21a. re of Funeral icensee (a person acarg as such) 22b. License Number 22c. Name art Address of FaglHy
1~ FD-013163-L Musselman FH~CS, 324 Hummel Ave,Lemoyne, PA 17043
e Nems 23ac ally when cemtying 23a. Te the best of my knowledge, cealn urretl al !Ne INne, dale antl place sIaIM. ISgnaNre arld Iklel 23b. License Number
23c Date Si
nM IMonr^
v
pMaician is rat available al lime ql deem to g
~.,
av vear~
«rtdy cause d deem.
Nems 24-26 must be c eted
shpt W person 24. i une of Deam 25. Date Prwwunced Dead (Hoorn, day, year)
26. Was Case Referred ;e Medical Examiner r
Coroner !or a Reason Other than Crer~aaon o~ Donar
:,n~
wnpprpnnw,ceadeam UNKNOWN P. M February 28, 2009 .
~VBa ^Np
CAUSE OF DEATH (See Inetrudlone sntl sxampNa) r Appmzimate interval.
Nam 27. Pan I: Emer die cfuin d events -Diseases, xryurles, a complicalxns -met dredy carved me dBam
DO NOT emer temknal evens such as cardiac anent Pan II Emer clher significant cnnda~nns rrx+ mnm914 ,>~In ?B. DiC Tobacco Use Contribu•e Ic DearM
.
. I Onset to Deam
respiratory anent, a ventnWlar HtxiHeeon withaA shaNng the etplogy. List ony one cause on each Nna. but not resulting In Ina untlerrying cause giver in Pant Ves Pn,baa
^ ^ Y
r ^ Nc ^ Unkrown
MAMEdATE CAUSE Final disease a r
b
cdi°"°"rte°"'~'"
eam( ->. a. Pendine Investi¢ation ~ zs dFemale
DUB to (a 88 a conaequaine off: I ^ Not pregnam within past year
Serpermaay list mndnnrrs, d ary, b i
^ Pre
nart aI urns o'
t
th
leadin99lo me cause ksled on Noe a. g
;
ee
.
Enter P,e UNDERLYING CAUSE Due to for as a cdnaBquenCB off: r
' ^ Nct pregnant, cut pregnant w.INn 42 days
n~hp~sd mB c_ r
(dieeeae a npxy ttbt
evenb reauKKlg n deem) LAST.
r
D of dear
'
ue !o (a as a consequence op:
~ ~
L,, Nol pregnant, but p~egnani ~! daya'o r year
r
~ helots death
^ U^.knngwr ~! pregnan! wNhin ha past year
30a. Was an 0.Vlgpey
n
P
Mr 30b Were autopsy Fubirgs
A
d
P
C 3t Manner of Deam 32a. Dale o! InNry :Hoorn. tlay, vearl 32n. Desc-:be Mow Inryry Occurred 32r mare N mrun Tome %?+n ~reei : c•
a D
orm
a va
oor .c
anoleocn
apie
^ Namrel ^ Nom~cbe ry
O"we Smlanq. arc lS; ~cag-~
of Cause of DearM
,,/,
^ Ves VJ IJO ^ vas ^ Nc ^ AcnOent ~ Pen6ng InvesrgedM 32d. line of Inury 32e. Injury at Wom? 321 II Transponatpn Injury (SoacrtyJ 32g Laation of Inlwy'Sirael, my rcwn. srate'~
7~ ^ SUrerde ^ CWId Nol bB Delerminad M ^ Vea ^ No ^ ~b I Dpemta ^ Pase9ngpr ^Pedaatnan
other ~ SpecAy
33a_ Cenilwr Irflecli only one; 33h. Sx)nature and T Ca
• CenHyklg phyakNn IPtryaxasn certlNmg cause d deem wtren avwtMr pryaician fWe prapurtl deem and mrrpbtaa Nam 231
Coroner
To tlk bMt d my knowledge, death xcurrM due to the cwaNal end manner n states_ _ _ _ ___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^
• Pr
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ounc
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rg p
rye
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an
yuc:an bo
prorxwn:mg Beam and cem
r;ng to cause nt deaml 3:r.. Lx:ense Number "" D:; e S,,ev 'rlomh
J`~ .,:
'~ec~
To tM bast of my Knowledge, deem acurred et the time, date, and place, art due to me cause(s) and manner ore seted_ _ _ _ _ _ _ _ _ _ _ _ ^
• K4eelnlex.minar/coraax - y
;March 2
2009
On du Gale d sxemNution and 1 or hrveatlgNlon
In my opMbn
dMh oeeumed N Hre Hme
detr
and plan
and dw b the eauaa(a) and merc
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34. Addres cl P rson Complet Cause Deam rlte
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as Dale Fled(Momh,daY,year) c
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orbner
6375 Basehore Road, Suite 111
_ y Mechanicsburg, PA 17050
Dlsobsdbn Pemul Na U •~3 d J V
M8T
One M & T Plaza, Buffalo, New Yort 14]4(1
West Shore Plaza
April 17, 2009
6424
JANET L DAVIS
25 FIELDCREST DR
MECHANICSBUR6 PA 17050
Re: Retirement Account Renewal Confirmation
Dear Janet L Davis,
Thank you for renewing your Retirement account with M&T Bank. Please review the
following information regarding your account:
Account Number:
Current Account Balance:
Renewal Date:
Maturity Date:
Term:
Interest Rate:
Annual Percentage Yield:
Daily Percentage Rate:
35004201002893
$ 38,601.21
04/06/09
10/06/09
6 Months
1.140
1.15
0.00312
(NOTE: This letter is issued 10 days after the renewal date. The current account balance
reflects any activity during that 10-day period, including any deposits, withdrawals, and
interest paid.)
On the next maturity date, we'll automatically renew your account for a similar time
period, unless you advise us otherwise prior to that date.
If you have any questions regarding your account, please call the McYLT Telephone Banking
Center at 716-626-1900 or 1-800-829-1924.
Thank you for banking with M&T Bank.
Sincerely,
M~.ehe.2e Ca.Qe-~lee~an
Michele Cole-Hector
Customer Service Manager
CONRF.N RNRRSI
EXHIBIT
M&T Banlc IRA DISTRIBUTION TO BENEFICIARY FORM AND AFFIDAVIT
TRAD ROTH SEP. PLAN
(FOR QUALIFIED PLANS COMPLETE FORM BR-594)
1. DECEASED ACCOUNT HOLDER
Name Janet L. Davis
Date of Birth 11/24/1931
Social Security # 194 - 26 - 6236 Date of Death` 02/11 /2009
'Attach death certificate
2. BENEFICIARY INFORMATION
Name Debra D. Kirby
Mailing Address 627 Allenview Drive
City, State, Zip Mechanicsburg, PA 17055
Legal Address (if different than mailing address)
Phone # (717) 697-3778 Date of Birth` 10/14/1956
Relationship to Depositor` Daughter Percentage of Plan 100
Customer Identification DL# 17 629 031
Customer Identification"
City, State, Zip
SS# or Estate Tx ID# 181488148
Current Employer or Nature of Self-Employment"
Dr. Steven Kreiner
`Not applicable if the beneficiary is not an individual, such as the estate or a trust. "Two forms of identification are required if customer is new to M&T Bank and an
If not an individual, attach appropriate Legal documentation. Inherited IRA Beneficiary or Transfer to Spouse Account is being established.
3. DISTRIBUTION ELECTION (COMPLETE SECTION A OR B)
SECTION A: OWNER DIED ON OR AFTER THE REQUIRED BEGINNING DATE (April 1 of the year after owner attained age 70'h)
1. If the beneficiary IS an individual or qualified trust, select one of the following:
a) , Lump Sum -Distribute account in a single lump sum
b) Inherited IRA -Single Life Expectancy -Make periodic distributions based on single life expectancy of the beneficiary's or
owner's remaining single life expectancy
c) Transfer To Spouse -Designate entire account as spouse's own (Available only if the spouse is named sole beneficiary).
d) Spouse Rollover -Rollover spouse's interest in account to spouse's own IRA
(Available whether or not the spouse is named as sole beneficiary)
2. If the beneficiary IS NOT an individual or qualified trust, or if NO beneficiary is named, select one of the following:
a) Lump Sum -Distribute account in a single lump sum
b) Inherited IRA -Single Life Expectancy -Make distributions periodically over the owner's remaining single life expectancy
SECTION B: OWNER DIED BEFORE THE REQUIRED BEGINNING DATE (April 1 of the year after owner attained age 70'/z)
1. If the beneficiary IS an individual or qualified trust, select one of the following:
a) Lump Sum -Distribute account in a single lump sum
b) Inherited IRA -Single Life Expectancy -Make distributions periodically based on single life expectancy of the beneficiary's
remaining single life expectancy
c) Inherited IRA -Five Year Rule -Distribute entire account by December 31 of the year containing the fifth anniversary of the
IRA owner's death
d) Transfer to Spouse -Designate entire account as spouse's own (Available only if the spouse is named sole beneficiary).
e) Spouse Rollover -Rollover spouse's interest in account to spouse's own IRA
(Available whether or not the spouse is named as sole beneficiary)
2. If the beneficiary IS NOT an individual or qualified trust, or if NO beneficiary is named, select one of the following:
a) Lump Sum -Distribute account in a single lump sum
b) Inherited IRA -Five Year Rule -Distribute entire account by December 31 of the year containing the fifth anniversary of the
IRA owner's death
4. FEDERAL INCOME TAX WITHHOLDING CHECK BOX TO INDICATE A CHANGE IN PRIOR INSTRUCTIONS.
Amounts distributed from your IRA may be taxable as income to you in the year received. These distributions are subject to federal income
tax withholding at 10% unless you elect not to have tax withheld. If you elect not to have withholding apply to your payments, or if you do
not have enough federal income tax withheld from your payments you may be responsible for payments of estimated tax. You may incur
penalties under the estimated tax rules if your withholding and estimated payments are not sufficient.
You must check one and only one of the following boxes:
I elect not to have any federal income tax withheld from the distribution(s)
I elect to have % of each distribution withheld as federal income tax. (You must elect a percentage greater than 10%.)
I elect to have a fixed dollar amount of $ from each distribution withheld as federal income tax.
Copy to Pension Services & Customer eR-ass (sroa) w
5. PAYMENT METHOD OF DISTRIBUTION
• Transfer to Spouse -If you are the owner's spouse and elected "Transfer to Spouse" in Section 3, indicate the account number of your
existing IRA or new IRA account
Branch: Attach completed /RA/Roth /RA/SEP-lRA Deposit Agreement (BR-460) for existing accounts or Traditional IRA Simplifier/Roth Simplifier
(BR-450/BR-666) to establish a new plan.
Branch: Review with customer if changes to beneficiary information (BR-395) or scheduled distribution (BR-853) are required. Complete appropnate
form, if necessary.
• Inherited IRA - If you selected to establish an Inherited IRA in Section 3, complete IRA/SEP Scheduled Distribution form (BR-853)
with distribution instructions and submit with the IRA Distribution to Beneficiary and Affidavit Form (BR-469).
Please note: If no instructions an: given Pension Services will default scheduled distributions as required by IRS
regulations with 10% federal withholding.
Branch: Review with customer if changes to beneficiary information are required. Complete Form BR-395, if necessary.
• Lump Sum - If you selected a "Lump Sum" distribution in Section 3, indicate how payment is to be made:
Issue Check Transfer to M&T Checking Account #
Transfer to M&T Savings Account #
• Spouse Rollover -If you are the owner's spouse and elected a "Spousal Rollover" in Section 3, indicate the account number of your
own existing IRA or new IRA account
Branch: Attach completed /RA/Roth IRA/SEP-IRA Deposit Agreement (BR-460) for existing accounts or Traditional IRA Simplifier/Roth Simplifier
(BR-450/BR-666) to establish a new plan.
Branch: Review with customer if changes to beneficiary information (BR-395) or scheduled distribution (BR-853) are required. Complete appropnate form,
if necessary.
6. BRANCH CERTIFICATION
Branch Representative
Ashley Phillips Branch No.
6123 Date
12/03/2009 Employee Number
06710
7. AFFIDAVIT
STATE OF Pennsylvania
COUNTY OF Cumberland
SS.
I being duly sworn, depose and say that the inf rmation presented in Section 1 and Section 2 above is accurate and complete. I request
Manufacturers and Traders Trust ompany to ay me the benefits due me as the named beneficiary of the deceased depositor's IRA.
F and itZconside~the death istributi n payment(s) due me, I agree to hold M&T Bank, as Trustee of the IRA, harmless from
any d all liaf2ility, cos lodes, exp ses or damages of every kind whatsoever, which may occur as a result of this distribution.
x ~~
Signature of
Dat Notary: Indicate form of Customer Identification
viewed for identification purposes
~ ~
Subscribed and sworn to before me this ~ ~ day of ~ ~ ;1~.1~~ , 20 Q
t NOTARIAL SEAL
CAROLE A ROSE
Notary Public Notary Public
LOWER ALLEN TWP, CUMBERLAND COUNTY
My Commission Expires Dec 6, 2011
Copy to Pension Services 8 Customer
EXHIBIT
LAW OFFICES OF
KOLLASAND KENNEDY
l l04 FERNWOOD AVENUE
CAMP HILL. PENNSYLVANIA 1701 1
WILLIAM C. KOLLAS
JAMES W. KOLLAS
March 25, 2010
OF COUNSEL
MARY KOLLAS KENNEDY
TELEPHONE NO. (717) 731-1600
FAX NO. (717) 731-1460
VIA FACSIMILE AND
U.S. FIRST-CLASS MAIL
M&T Bank
Attn: Ms. Ashley Phillips
Customer Representative
West Shore Plaza Branch
1200 Market Street
Lemoyne, PA 17043
RE: Estate of Janet L. Davis
Dear l~Is. Phillips:
As you know, I represent the Estate of Janet L. Davis and Debra D. Kirby.
daughter and Executrix of Nis. Davis. We have been attempting to collect funds from a
Retirement Account held by M&T Bank with account number 3500401002893. I have
previously provided documentation to you, including, but not necessarily limited to:
death certificates, letters testamentary, and an IRA Distribution to Beneficiary Form and
Affidavit.
Today, I discussed this matter with Chris Rahl, an attorney employed by M&T
Bank. Pursuant to that discussion I request any and all Account Opening Documents
associated with account number 3500401002893 or as may appear related to Janet L.
Davis. It is my understanding that I should expect to receive at least two documents: one
consisting of 2 or 3 pages and the other consisting of approximately 12 pages.
Additionally, according to Debra D. Kirby, she has not received any funds from
the account even though it is quite clear that she is entitled to at least 50% of the plan.
Without waiving Ms. Kirby s position as to her entitlement to 100% of the plan, I request
that 50% of the funds be released to Ms. Kirby as a beneficiary as soon as possible.
Kindly, contact me at your earliest convenience so that this issue can be resolved.
Thank you for your attention and cooperation in this matter. Please feel free to
contact me with any questions.
Very truly yours, ~
r-~ ~ ,
%' James W. Kollas
JWK/car / ~ EXHIBIT
Page 1 of 1
James Kollas
From: CHRISTOPHER RAHL [crahl(a~mtb.com]
Sent: Tuesday, April 13, 2010 1:31 PM
To: James Kollas
Subject: RE: account agreement
It may be best for your petition to note that you have consulted with M&T and M&T has no objection to the Court directing it to make payment as it directs, so long as M&T
is protected from future claims concerning the funds. Perhaps you could include some recitals to this effect in your petition and support them with an affidavit from M&T.
I'm happy to look at whatever you draft.
»> James Kollas <james ct kollasandkennedy.com> 4/13/2010 12:53 PM »>
Chris,
Thank you for sending the documents we discussed. I will review them soon, and then get back to you.
In the meantime, I will share my thoughts with you on what we discussed. Given the feelings of my client and the fact that you would accept an Order of Court to release the funds, a
Petition to the Court might be the best way to proceed. In the Petition, after outlining the situation, I would like to include either a concurrence from you, or, at least, state your position as
being not in opposition to releasing the funds (less taxes, etc) pursuant to a Court Order. Of course, before filing the Petition, I would send a copy ipetition and proposed Order) to you for
your review. Comments?
Obviously, I need to discuss this matter with my client and get her decision. Once I hear from her and review the documents, I will let you know.
Thanks,
James
NOTE. This e-mail may contain PRIVILEGED and CONFIDENTIAL information and is intended only for the use of the specific individual(s) to which it is addressed. If you are not an intended recipient of
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addressed hcrcin.
----Original Message-----
From: CHRISTOPHER RAHL [mailto:c2hl@mtb.com]
Sent: Tuesday, April 13, 2010 11:34 AM
To: james@kollasandkennedy.com
Subject: account agreement
As we discussed, attached is the general deposit account agreement. It's a 2 sided doc., so it's scanned in 2 parts. I marked the liabilities section that we discussed. Please let me
know if you have any questions.
Christopher R. Rohl
Associate General Counsel and Vice President
M&T Bank
25 5. Charles Street, 22nd Floor
Baltimore, MD 21201
P: 410.244.4090
F: 410.244.3817
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4/13/2010
EXHIBIT
NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601
HARRISBURG PA 17128-0601
JAMES W KOLLAS
KOLLAS & KENNEDY
1104 FERNWOOD AVE 104
CAMP HILL PA 17011
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-09)
DATE 04-26-2010
ESTATE OF DAVIS JANET L
DATE OF DEATH 02-11-2009
FILE NUMBER 21 09-0187
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 06-25-2010
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALON_6 THIS LINE _ ---- R_ETA_IN LOWER PORTION FOR YOUR RECORDS ~-- _ _______________
REV-1547 EX AFP (12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: DAVIS JANET LFILE N0.:21 09-0187 ACN: 101 DATE: 04-26-2010
TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 150,900.00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) C2) .0 0 credit to your account,
00 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (3) . of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) •00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 4 2,92 6.64
6. Jointly Owned Property (Schedule F) (6) 58 2.8 9
7. Transfers (Schedule G] (7) .0 0
8 Total Assets (8) 194,409.53
.
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 17. 084.67
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 1, 25 9.42
11. Total Deductions C11) 18,344.09
12. Net Value of Tax Return (12) 176,065.44
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 176,065.44
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 ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) .00 X 00 = .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 176.065.44 x 045 = 7,922.95
17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .0 0 X 15 = .0 0
19. Principal Tax Due (19)° 7,922.95
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-) ~ EXHIBIT
11-09-2009 CD011971 .00 7,922.95 ~
TOTAL TAX PAYMENT 7,922.95
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
~ IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND . SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
CERTIFICATE OF SERVICE
I, James W. Kollas, Esquire, attorney for the Estate of Janet L. Davis, hereby
certify that I have served the foregoing Petition to Direct Release of Funds and the
corresponding proposed Order this date by depositing a true and correct copy of same in
the United States mail, first-class postage prepaid, addressed as follows to counsel for
M&T Bank:
Christopher R. Rahl, Esquire
Associate General Counsel and Vice President
M&T Bank
25 S. Charles Street, 22"d Floor
Baltimore, MD 21201
KOLLAS AND KENNEDY
~..-~
By:
James W. Kollas, Esquire
Court ID: 81959
Kollas & Kennedy
1104 Fernwood Avenue, Suite 104
Camp Hill, PA 17011
(717) 731-1600
j ames@kollasandkenedy. com
Dated: ~D 111r~ ~ 1 ~