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HomeMy WebLinkAbout11-12-10 (3)1505610143 ~~-1500 EX (01-10) OFFICIAL USE ONLY PA C~:?artment of Revenue pennsylvania County Code Year File Number BUre~i: of Individual Taxes DEPARTMENT OF REVENUE PO 60X.280601 INHERITANCE TAX RETURN 21 10 0573 Harrisburg, PA 17128-0601 RESIDENT DECEDENT PILL IN APPROPRIATE OVALS BELOW _ X 1. Original Return ! '~ 2. Supplemental Return '~ ~ g Remainder Return (date of death `- - ~- ~ prior to 12-13-82) 4. Limited Estate r l; - ~~ 4a Future Interest Compromise (date of death after 12-12-82) j~- '~, ;_ _ 5. Federal Estate Tax Return Required '`Xf 6 Decedent Died Testate l~, (Attach Copy of Will) ~._J ~ Decedent Maintained a Living Trust (Attach Copy of Trust) g. Total Number of Safe De osit Boxes P --- -- i g, Litigation Proceeds Received ~ ___ ~__~ 1 C Spousal Poverty Credit date of death between 12-3191 and -1-95) i 11 Election to tax under Sec. 9113(A) ; ~ (Attach Sch. O) Suffix Decedent's First Name MI JOSEPH A Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE 1IVITH THE REGISTER OF WILLS CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number MICHAEL L BANGS 717 730 7310___ First line of address 429 SOUTH 18TH STREET Second line of address City or Post Office State ZIP Cade CAMP HILL PA 17011 } ._;=~; REGISTEA~T-;p"ILLS U~ONL~-` ~_~. ,,: _~ -~, rrt ~ ~ .C ~~ ; I -_x 7 .,~. r- i I ~;~ tV fi -„ ~ _ .. -' ~ n ,~.. ~. ~~'~ -~I ~ '~.. :j C.= ~ w'~` .. ~--1 1 ~'^ ...r. DATE FILED ~' Correspondent's a-mail address: . Under penalties of perjury, I declare that I have examined this return, including accompanying schedules anr:? starements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative Is Eased on all irfarmation of which preparer has any knowledge. SIGNATURE OF PERSON ESPONSIBLE FOR FILING RETURN DAT Mark A. Kovalcik _ ~~~` ~ ADDf2ES Post Office Box 39~ Chaptico, MD 20621 SIGNI~,TURE OF PR~PAR~R OT¢I~r"R THAN REPRESENTATIVE DATE ~ tl~ ,:~d~li~''e~_.~~ f,` ~~"~~~ ~~ -~ Michael L. Bangs ~ ~' ~, t ~, .f,~ ~ , ~r ADDRESS 429 South 18th Street, Camp Hill, PA 17011 Side 1 ~~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 209 20 9463 02 16 2010 Decedent's Last Name KOVALCIK (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Date of Birth 1505610143 J 1505610243 REV-1500 EX Decedent's Name: KOVIICIIC, Joseph A. Decedent's Social Security Number 2 0 9 2 0 94 63 RECAPITULATION 0.00 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 1, 679.56 5~ Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 54 ,106.68 6. Jointly Owned Property (Schedule F) I__ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers 8~ Miscellaneous Nnn, Probate Property 3 18 9.93 (Schedule G) ~ Separate Billing Requested............ ~_ _, 7. ~ 8. Total Gross Assets (total Lines 1-7) ..................................................................... g 58 , 97 6.17 14,579.13 9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... 9. 15,911.77 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 8~ 10) ................................................................... 11. 30,490.90 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 28,485.27 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................ 14. 2 8 , 4 8 5. 2 7 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 0 00 (a)(1.2) X .00 . . 16. Amount of Line 14 taxable 2 $ 4 8 5 .2 7 16. 1, 2 81.8 4 , at lineal rate X .045 17. Amount of Line 14 taxable 0 0 0 17 0 0 0 . at sibling rate X .12 . . 18. Amount of Line 14 taxable 0 0 0 18 0 0 0 . at collateral rate X .15 . . 19. Tax Due ................................................................................................................ 19. 1 , 2 81.8 4 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. L 1505610243 Side 2 1505610243 J REV-1500 EX Page 3 File Number 21-10-0573 vvvvwv... v ~~...~'~-- - --'_'- -- DECEDENT'S NAME Kovalcik, Joseph A. STREET ADDRESS 407 Woodland Avenue CITY I STATE ZIP New Cumberland PA ~ 17070 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 0.00 4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) 1,281.84 Total Credits (A + B) (2) 0.00 (3) (4) c5) 1,281.84 Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ...............................:............................................ r c. retain ahrevehsionary irate est! oo shall use the property transferred or its income;.... ;,,";::;:;;; „". ,'::,' ~'. ~ I ~ ~! d. receive the promise for life of either payments, benefits or care? ........................................................... ~~ 'u 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without r-_1 ~, receiving adequate consideration? .................................................................................................................... ~- r~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ~_J ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ~ -, contains a beneficiary designation? .................................................................................................................. '~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.5. §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 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1.2000' • The tax rate imposed on the net value of transfers from a deceased child 21 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 percent [72 P.S. §9116 (a) (1.2)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1 )]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption Rev-1502 EX+ (11-08) ,. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Kovalcik, Joseph A. 21-10-0573 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Real Estate - 407 Woodland Avenue, New Cumberland, PA. 0.00 At this time we are unable to provide a value as the real estate has not been sold yet. We will file a supplemental return for the real estate and any additional assets as soon as possible. Please suspend the assessment of tax on this asset. TOTAL (Also enter on Line 1, Recapitulation) I 0.00 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 11-08) Rev-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Kovalcik, Joseph A. 21-10-0573 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1509 EX+ (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Kovalcik, Joseph A. _ _ 21-10-0573 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Mark A. Kovalcik Post Office Box 396 Son Chaptico, MD 20621 B. C. JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE o ~0 OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A 07/10/2009 Community Bank -Account 932615626 54,106.68 100.000% 54,106.68 TOTAL (Also enter on Line 6, Recapitulation) I 54,106.68 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1510 EX+ (6-98) SCHEDULE G a ~ INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Kovalcik, Joseph A. ~ 21-10-0573 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF TRANSFERSATTACFi A CO Y OF THE DEIED FOOREREAL ESTATDE. DATE OF DEATH VALUE OF ASSET °i° OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Vanguard -Target Retirement Income Fund 3.189.93 3,189.93 TOTAL (Also enter on Line 7, Recapitulation) I 3.189.93 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-15p0 Schedule G (Rev. 6-98) REV-1151 EX+ (10-06) COMMNHERITANCE~FgP RETURNANIA RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Kovalcik, Joseph A. 21-10-0573 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT M R A, FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zia Year(sl Commission paid 2. Attorney's Fees Michael L. Bangs 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 10,543.57 3,500.00 4. Probate Fees 315.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 220.06 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 14,579.13 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Kovalcik, Joseph A. 21-10-0573 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex ep nses 1 Parthemore Funeral Home 8~ Cremation Services, Inc. 10,543.57 H-A 10,543.57 Other Administrative Costs 2 Cumberland Law Journal -estate advertisement 75.00 3 The Sentinel -estate advertising 145.06 H-B7 220.06 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Kovalcik, Jose h A. 21-10-0573 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 AAA Transport 44.72 2 AAA Transport 43.42 3 ABB Benefits Service Center -Repayment of March and April payments 946.26 4 Alliance Anesthesia Associates 28.97 5 American Radiology Associates, P.A. 7.73 6 American Radiology Associates, P.A. 8.63 7 Borough of New Cumberland -sewer and trash 102.43 8 Borough of New Cumberland -sewer and trash 97.55 9 Borough of New Cumberland -sewer and trash 101.55 10 Citicard 233.52 11 Manor Care of Camp Hill 636.00 12 Medical Emergency Prof., LLC 33.75 13 PA American Water 88.48 14 PA American Water 28.48 15 Patriot Medical Transport System, LLC 44.64 16 PP8~L Electric 14.63 17 Remedi Senior Care 108.17 I Total of Continuation Schedules See attached pages TOTAL (Also enter on Line 10, Recapitulation) 15,911.77 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) Rev-1512 EX+ (6-98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER Kovalcik, Joseph A 21-10-0573 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 18 Remedi Senior Care -prescriptions at nursing home 243.00 19 Robin Gasperetti, Tax Collector -school real estate tax 1,198.27 20 Robin Gasperetti, Tax Collector -per capita tax 9.80 21 Robin Gasperetti, Tax Collector -county/borough real estate tax 729.44 22 Shah and Associates 34.62 23 Shah and Associates 133.00 24 So. Maryland Orthopaedic and Sports Medicine 256.75 25 St. Mary's Hospital 144.84 26 St. Mary's Hospital 1,068.00 27 St. Mary's Medical Associates 155.34 28 St. Mary's Medical Associates 26.01 29 St. Mary's Medical Associates 155.34 30 St. Mary's Medical Associates 18.28 31 St. Mary's Medical Associates 32.76 32 St. Mary's Nursing Center 8,484.40 33 Terminix -annual service contract 183.90 34 The Hartford -homeowners' insurance 404.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) Rev-1512 EX+ (6-98) SCHEDULE 1 a ~ DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER Kovalcik, Joseph A. 21-10-0573 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1513 EX+ (11-08) SCHEDULE J COMMNHERITANCE~Fa,Px RET~RNANIA BENEFICIARIES RESIDENT DECEDEN ESTATE OF FILE NUMBER Kovalcik. Joseph A. 21-10-0573 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal • distributions, and transfers under Sec. 9116 a 1.2 Mark A. Kovalcik Son Post Office Box 396 Chaptico, MD 20621 Jill A. Weaver Daughter 1332 Sugar Maple Court New Cumberland, PA 17070 Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 150 0 cover sheet as a r o riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) TOGETHER, WE GROW COMMl1NIT1ES • mmunl an OFTRI-COUNTY October 15, 2010 Michael L. Bangs, Attorney at Law 429 South 18t~' Street Camp Hill, PA 17011 i2e: Estate of Joseph A. I~ovaicik To Whom it Mav Concern: Our records indicate that Mr. Kovalcik did have an account with our institution prior to his passing. The following information may be used for the purposes of settling his estate. Account type: Checking Account number: 932615626 Names on die account: Joseph A. hovalcik and/or Mark Kovalcik QT'WROS) Account opened: July 10, 2009 ~~ Value as of 2/15/10: $54106.68 plus $.05 unpaid accrued interest Paid interest as of 2/15/10: $0.12 I have also ::nelosed the copy of the original signatur:. card sl-.ow-ing the account ownership and date of establishment. If you have any other questions, please feel free to contact: me at 301-884-5724. Thank you, ~~ -~ C ~~ I~arrie Wood Branch Sales Manager ilssitant Vice President CHARLOTTE HALL Community Bank of Tri-County, 30165 Three Notch Road, P.O. Box 472, Charlotte Hall, MD 20622 Te1:301.884.5872 1.888.745.BANK Fax: 301.884.3047 www.cbtc.ccnn Vanguarcl~ October 4, 2010 P.O. Box 2600 Valley Forge, PA 19482-2600 www.vanguarcl.com ATTN: MICHAEL BANGS. BANGS LAW OFFICE 429 S 18TH ST CAMP HILL, PA 17011 Estate of Joseph A. Kovalcik Dear Mr. Bangs: We are responding to your letter requesting a valuation of Joseph A. Kovalcik's accounts as of February 16, 2010. The number of shares, the price per share, and the value of Mr. Kovalcik's individual retirement account (IRA) were as follows; Fund Shares Price Value Tar et Retirement Income 300.370 $10.62 $3,189.93 Please be aware that the account currently has a zero balance. Additionally, Mr. Kovalcik also held a Vanguard non-retirement account jointly with Janet Kovalcik. That account was closed prior to Mr. Kovalcik's death. If you have any questions, please call me at 800-379-1727, extension 46616. You can reach me on business days from 8:30 a.m. to 5 p.m. Eastern time. Sincerely, GG,: ~ Chris Milano Beneficiary Administrator CM 51588579 ,;F , , p M~~ 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Phone 888-502-4349 F ax (302) 934-2955 August 3, 2010 Bangs Law Office 429 South 18th Street Camp Hill, PA 17011 Re: Estate of Joseph A Kovalcik Social Security: 209-20-9463 Date of Death: February 16,2010 Dear Sir or Madam: Per your inquiry on July 21, 2010, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Account Number Ownership (Names o~ Opening Date Balance on Date of Death Accrued Interest Total Checking Account 52568407 Joseph A Kovalcik Or Janet Kovalcik Est of Joseph a Kovalcik 0828/1964 $129.56 $ .00 $129.56 For further account information, closures andlor reimbursement of funds please call the Highland Park Office at #717-737-3322. We were unable to locate any safe deposit box for the above-mentioned decedent. 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 S' cerely, . ~~ ~~~ 1' ~~~ Tammy R Spencer Adjustment Services 1995 Oldsmobile 88 -Private Party Pricing Report -Kelley Blue Book Page 1 of 3 Kege B~Ite ~~~ ~~ ~~,-~ 5fEARCH T4IETRII4TED Ri:SOURCE -.___ -..„....--.,,..-.._.M....~..._.~_... Home New Cars Certified Pre-Owned Used Cars Research Reviews & News Dealers & Inventory Useq Cars For sale Loans ak Insurance Used Car Values ~ Search Used Car ClassiReds ~ CerURed Pre-Owned ~ Compare Vehicles ~ Perfect Car Finder ~ Mast Researched Vehicles ~ CARFAX Vehicle History Welcome Back ~ Sign In I Create Account ~ My KB8 ZIP Code: 17070 Recently Viewed You Might Atso Like free Dealer Price Quote _-- ~_ _ - m NeyyS More Car News _r_--- -- - ---- ~ ___ ~ __ 2 ~--_ _ _ _. 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Select Make.`. Blue Baak Private Party Value Kelley Blue Book Private Party Value is the amount a buyer can expect to Select Modei . ' pay when buying a used car from a private party. The Private Party Value , , --- i assumes the vehicle is sold "AS Is" and carries no warranty (other than any remaining factory warranty). The Rnal sale price may vary depending on the http ://www.kbb.com/used-cars/odsmobile/8 8/ 1995/private-party-value/pricing-report?con... 11 /2/2010 LAST WILL AND TESTAMENT OF JOSEPH A. KOVALCIK I, Joseph A. Kovalcik, a resident of New Cumberland, Pennsylvania declare this to be my Last Will and revoke all former Wills and Codicils. ARTICLE I Identification of Family At the present time I am unmarried. In making this Will I have in mind my children, Mark A Kovalcik, born 1957, and Jill K. Weaver, born 1961, but does not include any children hereafter born to or adopted by me. Any reference to a "child of mine" or "my children" shall include the persons named or referred to in this Article. ARTICLE II Disposition of Remains I direct that my remains be buried with my wife. I authorize my Executor to carry out these directions and wishes, particularly those for the disposition of my remains. ARTICLE III Appointment of Fiduciaries A. Appointment of Personal Representative. I appoint my son, Mark A Kovalcik, as Executor of my estate. B. Bond; Court Supervision. My Executor shall have the right to serve without bond and to administer and settle my estate without the intervention or supervision of any court, except to the extent required by law. Nothing herein shall prevent my Executor from seeking the assistance of the court ire any situation where my Executor deems it appropriate. ARTICLE IV Specific Gifts A. Gifts of Specified Items of Property. I give all my interest in certain items of tangible personal. property to the beneficiaries designated in this section as follows: -~ Will of Joseph A. Kovalcik Page 1 of 6 Initials: Date: b 1. Specific Gift One. I give my 1996 Oldsmobile to my son, Mark A Kovalcik if he survives me. If Mark A Kovalcik does not survive me no property shall pass under this Article. 2. Specific Gift Two. I give my home 407 Woodland Ave New Cumberland Pa and all of its contents to be divided equally between to Mark A Kovalcik +)~~~~ 1~ • ~ 1~~[~,-~ A Tln~r~l~,,,~~no~ ,,,,.± ~„ =,;..4 ,moo ~-`*; 1rT ~--~ ~ c~o~rc~~~urv'TS~-r P'" ` ~h C~ ~t,~e Jill K. Weaver. B. Insurance. I give to each recipient of an item of tangible personal property my interest in any insurance covering the item. My purpose in making this gift is to give each recipient the benefit of insurance coverage for which I have already paid. It is not my intention to give any recipient the proceeds of an insurance claim that exists but is unpaid at my death. ARTICLE V Disposition of Residue A. Provision for Descendants. I give all of the rest. and residue of my estate, wherever located (hereafter referred to in this Article as "residue"), to my descendants if they survive me per stirpes. 1. Provision for Others. If I am not survived by any of• my descendants, I give the entire residue to my heirs. ARTICLE VI Alternative Methods of Distribution. A. Purpose of Article. Recognizing that under certain circumstances the terms of this Will may direct that property be distributed outright to a person who is under age twenty-one (21) or under a legal disability; I make the following provisions to facilitate the distribution of property to such persons. B. Alternative Methods. Whenever the terms of this Will direct my personal representative (referred to in this Article as the "fiduciary") to distribute property outright to a person who is then under age twenty-one (21) or under a aegal disability, the fiduciary may retain pursuant to Paragraph C. of this Article or distribute all or any portion of that property in any one or more of the following ways: 1. Delivery directly to the beneficiary; 2. Delivery to the parent or stepparent of the beneficiary; 3. Delivery to the guardian of the beneficiary's person or property; i ,. Will of Joseph A. Kovalcik Page 2 of 6 Initials:'~.~ Date: ~ ~ 4. Delivery to any Custodian for the beneficiary under the Uniform Gifts to Minors Act; 5. Delivery to any then existing trust created for the beneficiary; 6. Deposit in a financial institution in an account established in the name of the beneficiary alone pursuant to the laws of the State of Pennsylvania; 7. Storage of any tangible personal property in safekeeping wit11 the costs of storage to be borne by the beneficiary; or 8. Sale of any tangible personal property and delivery of the proceeds in any manner permitted by this Article. Provided the fiduciary acts in good faith, upon delivery of any property in accordance with the provisions of this Article, the fiduciary shall be discharged from all responsibilities in connection with the prcperty. C. Discretionary Trust. Any property not distributed as provided in Paragraph B. of this Article shall be retained by the fiduciary in trust for the beneficiary on the following terms and conditions: During any period in which the beneficiary is under a legal disability or under twenty-one (21) years of age, the fiduciary shall pay to or apply for the benefit of the beneficiary so much of the income and principal of the trust as the fiduciary, in its sole and absolute discretion, determines is advisable for t11e beneficiary's health, support, education and general welfare. At such time as the beneficiary is neither under a legal disability nor under age twenty-one (21), the fiduciary shall distribute any remaining trust assets to the beneficiary. If the beneficiary dies before all of the trust assets have been distributed, the fiduciary shall distribute any remaining trust assets to the beneficiary's estate. ARTICLE VII Administrative Provisions A. Powers and Duties of Personal Representative. My personal representative shall have all of the powers and duties granted to or imposed upon personal representatives serving with non-intervention powers pursuant to the laws of the State of Pennsylvania. B. Debts and Expenses. All. expenses of administration chat-geable to principal, the expenses of the disposition of my remains, and ~~l my legitimate debts, if and when paid, shall be paid from the principal of my residuar~i estate. No debt need be paid prior to its maturity in due course and except as otherwise provided in this Will no interest in any property passing under this Will need be exonera~~ ed. Will of Joseph A. Kovalcik Page 3 of 6 Initials~1 Date: _ _l L~ f~ ;~ ~.. l ~"~ C. Taxes. All estate, inheritance or other similar d~;a.th taxes, together with any interest or penalties thereon, arising by reason of my de~~th with respect to any property includable in my taxable estate, and any adjusted taxabl:, gifts, whether passing under or outside of this Will, shall be paid from the principal. of my residuary estate without reimbursement from the recipients or beneficiaries of = uch property, provided, however, that in the event any proceeds of insurance upon my life or any property over which I held a power of appointment are included in my estate for purposes of determining the federal estate tax liability of my estate, then the residue of my estate shall be entitled to receive from the recipients of any such proceeds a~ property the portion of such federal estate tax liability attributable to such proceeds or property deternlined in accordance with IRC §§ 2206 and 2207. ARTICLE VIII Miscellaneous A. Number and Gender. Unless the context indicates a contrary intent, the plural and singular forms of words shall each include the other, and every noun and pronoun. shall have a meaning that includes the masculine, feminine and neuter genders. B. Survival. To "survive" me, as that term is used in this Will, a person must continue to live for thirty (30) days after lny death. C. Descendants. The "descendants" of an individual include only the following: 1. All such individual's biological descendants, except any person not born in lawful wedlock and his descendants, unless the biological parent who would otherwise cause him or her to be a descendal~t has acknowledged paternity or maternity in legitimation proceedings, or in an unambiguous signed writing identifying such person by name, or by raising such perso~~~ in the same household; and 2. Persons adopted by such individual or one of his or her descendants, and their descendants. If the parent, who would cause a person to be a descendant as defined above, is replaced in an adoption proceeding, such person shall remain a descendant unless such parent voluntarily consents to the relinquishment of his or her status as parent in connection with such adoption proceedings. D. Heirs. The term "heirs" shall mean those persons entitled to inherit under the then-applicable laws of the State of Pennsylvania governing the descent of an intestate's separate estate. They shall inherit in their statutory proportions. Will of Joseph A. Kovalcik Page 4 of 6 Initials: ~" ~ ._ Date: ~ ~ _.; E. Exclusion of Pretermitted Heirs. Other than as set forth in this Will, I make no provision for any child of mine or descendant of a deceased child of mine. I specifically make no provision for any person (whether now living or hereafter born), other than a child named or referred to in Article I or a descends nt of mine as defined in this Will, who maybe entitled to claim an interest in my estate under the laws of the State of Pennsylvania. F. Legal Disability. A person is under a legal disability if my personal representative determines, in good faith, that the person is incapable of managing his property or of caring for himself, or both, or is in need of protection or assistance by reason of physical injury or illness, mental illness, developm:ntal disability, senility, alcoholism, excessive use of drugs, or other physical or mental incapacity. G. Title to Real Property. Upon my death, title to ~:iny real property passing under this Will shall vest in my personal representative in his fid ~ iciary capacity and shall remain so vested until my personal representative distributes ~.~r sells that property, at which time title shall vest in the distributee or purchaser. H. Disclaimer. Except as may be otherwise specifically provided in this Will, in the event that any beneficiary disclaims an interest arising out of this V~~ill or any trust created herein it is my intention that the interest disclaim~;d shall be distributed in the same manner and at the same time as if the disclaimi-~~g beneficiary had died immediately preceding the event pursuant to the laws of the Stag of Pennsylvania. I. Governing Law. The provisions of this Will. shall be interpreted in accordance with and in light of the laws of the State of Pennsylvania. J. Corporate Successors. Whenever a corporation or other business entity is referred to herein, the reference shall include any successor organization. K. References to Statutes. In this Will, the abbreviation "IRC" shall refer to the Internal Revenue Code of 1986 as amended. Will of Joseph A. Kovalcik Page 5 of 6 . _ f. Initial: Date: V { ~ I have initialed and dated for identification purposes all t~:ages of this, my Last Will, and have executed tiie entire instrument by signing this }age on the ~~..? day of 200_, at ri~a. .. ~~ _ J seph `.~~. Kovalcik Attestation and Statement of Witnesse:.~ Each of us declares under penalty of perjury under the lr, ,vs of Pennsylv~~nia that Joseph A. Kovalcik, the Testator, signed this instrument as his L,:s~ Will in our ~~resence, all of us being present at the same time, and we now, at the r; ~e stator's request, in the Testator's presence, and in the presence of each other, sign ' elow as the ~ -itnesses, declaring that the Testator appears to be of sound mind and ui lcr no duress, fraud, or undue influence. ~ ~-~ ~~~~ [Witness Sign~iture] [Print Namc] Residing at _~~~ -'~1~1~ [Witnc..~ Signature] [Pr1-rt Name] esiding at ~1 c ` ~ ~" °~'~ ~~ R %~ ~ Will of Joseph A. Kovalcik Page 6 of 6 Initials: _ Date: __