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HomeMy WebLinkAbout03-0075PETITION FOR PROBATE and GRANT OF LETTERS also known as ~ To: Deceased. Social Security No. t~ ~ ~4t - ~,~z~' '-' ] ~s' 3 '~ 1-03-7 6 Register of VJl'ills fpr thl: / County of t.'om ~zt,-/~zt; Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age_or qlder an the execut in the last will of the above decedent, dated and codicil(s) dated in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~ t.~ ~O a.,., [o..~5/' County, Pennsylva. nia, with last family or principal residence at /:,_-'~ at Decendent, then ~ (list streeq number and muncipality) years of age, died ~.)t2.~.n Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was noi the victim of a killing and was never adjudicated incompetent: 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 si~ated ~a,.s follows:~ ~ '~ ~ I~, l%~ ~ ~ $ WHEREFORE, petitioner(s) respectfully request(s) the prpbate of the last will codicil(s) presented herewith and the grant of letters ,?'$A.~t ~ ~t.., and theron. (testamentary; admini~t~on c.t.a.; administration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF Cunber!and j~ ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief~C-p'~ioner(s) and t.l:mt as personal represen- tative(s) of the above decedent petitioner(s) will well...arid tru~dminister tl'~estat,~ccording to law Sworn to or affirmed and subscribed ,.- 1 th bef re me this~3 da' of '~9~ January ,.~__ I~r2~03 _J. /?.///.or_Donna M. Otto,lst 13~qty g~-'~,_ No. 21-2003-75 Estate of f ~n $~ ~ ~ /t?7q./~-- ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW January 27th the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated ,2~ -~ -_.~_ ~ tgi- described therein be admitted to probate and filed of record as the last will of and Letters ~ ~~~ ~ ~e hereby granted~o ~ ~ 2003, in consideration of the petition on FEES Probate, Letters, Etc .......... $. 235 o00 Short Certificates(5 ) .......... $ Renunciation-, ' $ x-wages t ~; JCP $ 15.00 .00 TOTAL __ $ 275.00 Filed . i..3..~'].u...c9~..~. 7.~.n.;~.99.~. ........... t Register of Wills ~--~)- Donna M. Otfo, 1st Deputy .~'~~/-~/ ATTORNEY (Sup. Ct. I.D. No.) .t~RESS PHONE Call Attorney Ja~es D. Flower Jr. on 1-27-03 21-2003-75 SAIDIS SHUFF. FLOWER & LINDSEY ATTORNEYS.AT*LAW 26 W. High Street Carlisle, PA LAST WILL AND TESTAMENT OF CONSTANCE I. KUGLER I, CONSTANCE I. KUGLER, of 633 North Hanover Street, Carlisle, Cumberland County, Pennsylvania 17013, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix or Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. I wish to be laid to rest beside my beloved husband, CHARLES E. KUGLER, JR., in the lot reserved in my name at Rolling Green Cemetery. SECOND: I give one-tenth (1/10) of my estate to the SALEM UNITED CHURCH OF CHRIST, located at 231 Chestnut Street, Harrisburg, Pennsylvania, and direct that the church divide the proceeds into three equal parts, the first to be added to the Salem Trust Fund, the second to be added to the Operations Fund, and the third to be for the support of the Salem Guild. THIRD: I give the sum of One Thousand ($1,000.00) Dollars to the SALEM UNITED CHURCH OF CHRIST, located at 231 Chestnut Street, Harrisburg, Pennsylvania, for support of the Religious Services Committee. SAIDIS SHUFF, FLOWER & LINDSEY ATFORN£YSeATeLAW 26 W. High Street Carlisle, PA FOURTH: I give the sum of Ten Thousand ($10,000.00) Dollars to the ORGANIZATION INDUSTRIALIZATION CENTER (OIC), located at 29 South Hanover Street, Carlisle, Pennsylvania, to maintain an achievement and scholarship fund in the name of CHARLES E. KUGLER, JR. Said fund shall pay One Hundred ($100.00) Dollars per year to recognize high subject achievement in class and One Hundred ($100.00) Dollars per year to award the most improved student. FIFTH: I give the sum of Ten Thousand ($10,000.00) Dollars to the CARLISLE ASSOCIATION OF REALTORS, to establish the CONSTANCE I. KUGLER AND CHARLES E. KUGLER, JR. SCHOLARSHIP FUND, One Hundred Fifty ($150.00) Dollars per year from which may be awarded as a scholarship to either a new realtor or a veteran realtor in accordance with the decision of the scholarship committee and the Board of Directors of the Cadisle Association of Realtors. In an exceptional year, if the Board chooses to recognize two equally deserving realtors, the Board shall have the authority to award One Hundred Fifty ($150.00) Dollars to each said realtor. SIXTH: I give my platinum single diamond ring to BARBARA HEFFLEFINGER, of Back Street, Plainfield, Pennsylvania. SEVENTH: I give the sum of Three Thousand ($3,000.00) Dollars to my cousin, WILLIAM BOWEN, of R. R. #2, Milmont, Pennsylvania. EIGHTH: REVEREND MARY Pennsylvania. I give the sum of One Thousand ($1,000.00) Dollars to the ALICE BUTOFSKY, at Brethren Village of Lancaster, SAIDIS SHIJFF, FLOWER & LINDSEY A'ITORNEYS*AT* LAW 26 W. High Street Carlisle, PA NINTH: I give to GEORGE VORCHSEK, of 546 North Bedford Street, Carlisle, Pennsylvania, the sum of Five Thousand ($5,000.00) Dollars, for the sole purpose of supporting his educational expenses, which may include tuition, room and board or books. My Executor shall pay said sum directly to the educational institution for the aforesaid purposes. This gift is not to be used in any way for non- educational purposes, and is not to be used to support any training for professional athletic performance, such as professional wrestling. Education shall be defined to include a vocational or trade school, which may be reasonably expected, in the sole judgment of my Executor, to promote his skills and employability. Any portion of this bequest, which is unused for the aforesaid purpose shall revert to the residuary of my estate five (5) years after the date of my death. TENTH: I give to JESSICA ZEIGLER, of Spring Road, Carlisle, Pennsylvania, the sum of Five Hundred ($500.00) Dollars. ELEVENTH: All the rest, residue and remainder of my estate I give to my brother, JOHN C. WHISLER, of 5711 Wood Mouse Court, Burke, Virginia. LASTLY: I nominate, constitute and appoint my brother, JOHN C. WHISLER, to be the Executor of this my Last Will and Testament. In the event that the said JOHN C. WHISLER, shall be unable to serve as Executor for any reason, I appoint my cousin, WILLIAM BOWEN, as Executor. No Executor shall be required to file bond in this or any other jurisdiction. SAIDIS SHUFF, FLOWER & LINDSEY ATI'ORNEYS*AT*LAW 26 W. High Street Carlisle, PA If my Executor decides to sell my residence Street, I direct that he list the property with Century-~! IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~ day of SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: at 633 North Hanover Associates Coon and .~'~ ,2001. ~,._~: ' Consta-'~'~e I,~.,~,'~ 4 SAIDIS SHUFF, FLOWER & LINDSEY ATrORNEY$*AT*LAW 26 W. High Street Carlisle, PA COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS I, CONSTANCE I. KUGLER, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by CONSTANCE I. KUGLER, the Testatrix, this c:~~ day of '~b~ OC.~ , 2001. LJ ~stance I. KU,~~t~.~ NOTARIAL BF..AL MERLENE J. ~ NOTARY PUBLIC cA,quSI.F. ~ ~, PA SAIDIS SHUFF, FLOWER & LINDSEY ATI'ORNEYS*AT*LAW 26 W. High Street Carlisle, PA COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS We, Gladys M. Lehman and James D. Flower, Jr, , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. and 2001. Sworn or affirmed to and subscribed to before me by Gladys M. Leb_man James D. Flower, Jr. this ~~ day of SaiDiS, ShUff, FLOWER & LlnDSaY 26 WEST HIGH STREET CARLILSE, Pa 17Oi3 Date of Death: Will No. 21-03-0075 To the Register: REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Constance I. Kugler January 10, 2003 Admin. No. 2003-00075 I certify that notice of (beneficial interest) 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 April c~..~'" ,2003. Name Address John C. Whisler Salem United Church of Christ Organization Industrialization Center Carlisle Association of Realtors Barbara Heffiefinger William Bowen Reverend Mary Alice Butofsky George Vorchsek Jessica Zeigler 5711 Wood Mouse Court, Burke, VA 22015 231 Chestnut Street, Harrisburg, PA 17101-2639 29 South Hanover Street, Carlisle, PA 17013 P.O. Box 473, Carlisle, PA 17013 Back Street, Plainfield, PA 17081 R.R. # 2, Millmont, PA 17845 3001 Lititz Pike, Lancaster, PA 17601 546 North Bedford Street, Carlisle, PA 17013 Spring Road, Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none Date: Capacity: THomas E. Flower, Esquire SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Personal Representative X Counsel for Personal Representative , // ESTATE OF CONSTANCE I. KUGLER CLAIM FORM Notice of claim by THE BON TQN ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY 21-03-0075 NO. in the amount of $1722.20 filed pursuant to section 3384, Probate, Estates and Fiduciaries Code Laws of 1972, Act No. 104 effective July 1, 1972 as amended. TO TH~ CLERK OF THE ORP3EANS' COURT DIVISION: THE BON TON Enter the claim of (Claiman: and Address) Date 19 9441LBJ FREEWAY Lock Box 30 ~il~ ~ in the amount of $ 1722.20 against the above entitled Estate. The decedent who resided at633 HANOVER ST. , CARLISLE, PA 17013 1/10/03 (Address) died on (DaCe) Written notice of said claim was given to JOHN C. WHISLER c/o JAMES D. FLOWER, JR., (Personal Represents:ire or Counsel) ESQ. at 26 W. HIGH ST., CARLISLE, PA 17013 (Address } on (Da:e) The basis of aforesaid claim is as follows: (Itemize fully to enable personal representative to make proper investigation). Acct. #035-348-648 Claimant' s Counsel Name ) ! , 9441 LBJ FREEWA'/ Dallas, TX 75243 PROBATE COURT Cumberland County, State of Pennsylvania Constance I. Kugler, Deceased Case #21-03-0075 Proof of Mailing I mailed the creditors claim to the fiduciary (and attorney, follows: if applicable) as I deposited a copy/copies of the claim with the United States Postal Service in a sealed envelope with the postage fully pre-paid. I used first-class mail. I am en/01oyed in the county where the mailing occurred. The envelope (s) was/were addressed and mailed as follows: Mr. John Whisler c/o James D. Flower, 26 W. High St. Carlisle, PA 17013 Jr., Esq. Date of Mailing: County of Mailing: Dallas, Texas I declare un~r~lty of pezjury that the foregoing is true and correct. Date: 4/3/~_~ P.O. Box 741026 Dallas, TX 75374 Page: ! Document Name: untitled CMD=> PH 717 243 6292 NAME *CONSTA/WCE I*KUGLER ADDR 633 N HANOVER ST CITY CARLISLE 4TH SPSE EMPL EADD ECTY EPHN RPHN LST PAY 20030226 LST LET CCYYMMDD LOCAL TIME: 09:09 ** COLLECTIONS ** 35348648 F O-AC BTS QUEUE 12 TEAM 0 CP .00 LIM 0 RP .00 CYC 24 14TH MP .00 PA 17013 STAT DLT MPI AGE TU 1 0815 A 03/03 SCR 000 WAC 1 EMP ADJ DSP N SSN 204 28 1836 NM 1722.20 OPEN 19870511 000 20030403 PDUE ADUE PUR PAY CRED FCHG NBAL CUR .00 00 00 00 00 00 00 MAR 00 00 00 1722 20 00 00 00 29 1722 FEB 00 00 00 00 00 43 2O REV-1500 EX (6~0) COMMONWEALIH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT 21 _ O3 OO75 COUNTY CODE YEAR NUMBER ~oo fl. I- Z uJ Z 0 0 DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Kugler, Constance I. DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 01/10/2003 1 07/18/1935 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) n/a SOCIAL SECURITY NUMBER 204-28-1836 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER r~l. Odginal Return --]4. Limited Estate ['~-J 6. Decedent Died Testate (^r~ch copy ofwm) ['~9. Liligation Proceeds Received r~2. Supplemental Return L--14a. Future Interest Compromise (data of death after 12-12.-82) ~--17. Decedent Maintained a Living Trust (Attach capy of Trust) '-'-]10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ---] 3, Remainder Return (date of death prior to 12-13.-82) [~5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes ~---1 11. Election to tax under Sec. 9113(A)(A~tach Sch O) NAME Thomas E. Flower FIRM NAME (If Applicable) Saidis, Shuff, Flower & Lindsay TELEPHONE NUMBER (717) 737-3405 COMPLETE MAILING ADDRESS 2109 Market Street Camp Hil, PA 17011 1. Real Estate (Schedule A) (1) 2. Stocks and 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. Jointly Owned Property (Schedule F) (6) r"-] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. 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 (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 126,500.00 26,685.48 (8) 63,033.54 19,083.78 153,185.48 (11) 82,117.32 (12) 71,068.16 (13) 18~ 106.82 (14) 52,961.34 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rata, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due x.O 33,461.34 x .12 19,500.00 x .15 20. [] (15) (16) (17) 4,015.36 (18) 2,925.00 (19) 6,940.36 Decedent's Complete Address: ; °?REETADDRESS ' 633 N. Hanover Street C~TYCarlisle I STATEpA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 6,940.36 3. Interest/Penalty if applicable Total Credits (A + B + C ) D. Interest E. Penalty Total Interest/Penalty ( D * E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. if Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (2) 0.00 (3) 0.00 (4) (5) 6,940.36 (SA) (5B) 6,940.36 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; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 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. Under penalties of perjury, I declare th~J.~ave examined this return, including accompanying schedules and s~te.~ents, and to the best of my knowledge and is true, correct and complete. Declaration of preparer other tha?ffi-e pe~,onal representative is,~ased on all information of which preparer has any knowledge, belief, it SIGNATURE OF PER~N RE~ONSlBLE FOR, F~i:G I~F~T,I~xR'N ADDRESS '/" ......./" - DATE John C. Whisler, 5711 Wood Mouse Court, Burke, VA 22015 SIGfbL.~T~, .J{RE OF PREPARER OTH~FF~ THA,~RESENTATIVE DATE A D~D~/E S S~'~'~'~z..a ~ ~'~-----~_~~2~ 10/07/03 Saidis, Shuff, Flower & Lindsay, 2109 Market Street, Camp Hill, PA 17011 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. {}9116 (a) (1.1) (i)]. For dates of death on or alter January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. {}9116 (a) (1.1) (ii)]. The statute does 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 twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. {}9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenrs lineal beneficiaries is 4.5%, except as noted in 72 RS. {}9116(1.2) [72 P.S. {}9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ,REV-1502 EX+ (6-9~;~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Kugler, Constance I. 21-03:0075 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 compe led 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 ITEM NUMBER DESCRIPTION lot and dwelling house at 633 N. Hanover Street, Carlisle, PA gross proceeds of sale (see attached settlement sheet) TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH $126,500 126,500.00 REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kugler, Constance I. SCHEDULE 'E ' CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-03-0075 ITEM NUMBER 2. 3. 4. 5. 6. 7. 8. 9, 10. 11. Include the proceeds of litigation and the date the proceeds were received by the estate'. All property jointly-owned with right of survivorship must be disclosed on Schedule F. DESCRIPTION Orrstown Bank checking #108002666, principal - 586.92; accrued interest - 0.03 M&T Bank checking #472506, principal - 2,572.74; non interest bearing Proceeds of sale 1995 Buick Park Avenue automobile Partial refund of homeowner's insurance premium Partial refund of auto insurance premium Sprint - partial refund of phone bill Refund - Thos. Jefferson University Hospital Union Fidelity Life Insurance Co., refund of unearned premium Proceeds, sale of household goods and personal effects Refund, Carlisle Regional Medical Center Thompson Wood Real Estate, commissions earned by decedent TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH $ 586.95 2,572.74 4,000.00 125.00 80.07 16.28 30.00 78.85 15,506.77 134,87 2,553.95 26,685.48 REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER Kugler, Constance I. 21-O3-0075 ITEM NUMBER 8. 9. 10. 12. 13. 15. Debts of decedent must be reported on Schedule ]. DESCRIPTION FUNERAL EXPENSES: Rolling Green Cemetery - grave opening $870.00 Hoffman - Roth Funeral Home - professional services $3,490.00 steel casket $2,655.00 steel intedor receptacle $2,190.00 budal clothing $123.00 obituary notice $248.24 clergy honorarium $300.00 death certificates $30.00 funeral flowers $159.00 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Pemonal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address city Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Retum Preparer's Fees cost to sell car ($240 sales tax & $10 transfer agent's fee) duplicate automobile title Cumberland Law Joumal- advertising of estate notice The Patriot-News - advertising of estate notice death certificate for Chades Kugler Lois Green - cleaning services in home Lesman Knight - yard services Sprint - telephone service Penrose Cleaners - dry cleaning bill SEE ATTACHED CONTINUATION State __ Zip TOTAL (Also enter on line 9, Recapitulatio~ (If more space is needed, insert additional sheets of the same size) AMOUNT $10,065.24 $9,195.24 0.00 7,070.00 0.00 275.00 0.00 0.00 250.00 22.50 75.00 123.55 6.00 1,200.00 910.00 326.68 52.56 33,461.77 $ 63,033.54 SCHEDULE H CONTINUATION PAGE FUNERAL EXPENSES AND ADMINISTRATIVE COSTS Estate of Kugler, Constance File No. 21-03-0075 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. George Boychock - trash removal service George Boychock - ceiling repair at residence George Boychock - miscellaneous home repairs PPL Electric Services - electric bill Borough of Carlisle - water & sewer bill Lesman Knight - snow removal UGI - heating fuel Graham Motors -repair of decedent's automobile Coles Bicycles, Inc. - new locks on doors at residence Calaman's Lawn Service - rent for trailer to remove trash Penn National Insurance - homeowner's insurance Morrison's Auto Sales - automobile appraisal fee Settlement costs on sale of 633 West Hanover Street: A. Prudential Thompson Wood & Central State Realty- realtor's commission 7,590.00 B. Central State Realty- realtor's transaction fee 125.00 C. Notary fees 10.00 D. Realty transfer tax 1,265.00 E. Recorder of Deeds 17.00 F. Perry Pest Control - termite treatment 852.24 G. Borough of Carlisle - final water & sewer bill 15.08 Grave marker and engraving Eugene Chestnut - automobile repairs Fluss Fooring, Inc. - removal and replacement of carpet Tanger's Appliances - refrigerator repair K-mart - paint supplies Darlene K. Moyer - taxes on residence Foremost Insurance - homeowner's insurance Progressive Insurance - automobile insurance Advance Auto Parts - battery for Buick Shevlin's Maintenance Service- cleaning service 3,590.00 240.00 6,658.00 390.01 114.70 140.00 1,115.88 940.65 53.00 159.00 320.00 20.00 $9,874.32 $1,560.00 $1,219.65 $4,586.40 $213.01 $28.55 $1,061.72 $300.55 $310.07 $92.07 $474.19 Subtotal this page $33,461.77 REV-1512 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF KUGLER, CONSTANCE I. SCHEDULEI · DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-03-0075 ITEM NUMBER Include unrelmbursed medical expenses. DESCRIPTION M & T Bank, line of credit #4258074503214930, pay off balance Heritage Medical Center Robert Candor, MD Susquehanna Surgeons Bon Ton, credit card debt balance VISA, credit card debt balance AT&T Wireless, cell phone bill Patriot News, subscription fee Sprint, phone bill Comcast, TV Cable UGI, 12/02 heating system service call UGI, heating fuel Tanger's Appliances, 12/02 refrigerator service call Boscov's, credit card balance PPL Electric George Boychock, administrative services to decedent°s real estate business Lesman Knight, yard maintenance services Lois Green, cleaning services Graham Motor Company, auto maintenance & repairs Benzon Tax Service, bookkeeping and tax return preparation Penn National Insurance, real estate casualty insurance Strokoff & Cowden, PC, legal services Progressive, overdue auto insurance premium Borough of Carlisle, water & sewer West Shore EMS, ambulance service Darlene L. Moyer, Tax Collector, per capita & occupational privilege taxes TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH $ 4,093.41 16.56 51.90 16.56 1,751.63 6,718.98 168.05 26.95 161.87 160.25 58.30 300.20 51.98 681.71 49.85 574.00 95.00 120.00 946.06 160.00 49.00 566.81 1,214.00 13.53 574.25 462.93 19,083.78 ~EV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Kugler, Constance I. 21-03-0075 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee{s) OF ESTATE ! TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] John C. Whisler 5711 Wood Mouse Court Burke, VA 22015 Reverend Mary Alice Butofsky, Brethen Villiage 3001 Lititz Pike Lancaster, PA 17601 George Boychock 546 North Bedford Street Carlisle, PA 17013 William Bowen R.R. #2 Millmont, PA 17845 Jessica Zeigler Carlisle, PA 17013 Carlisle Association of Realtors P.O. Box 473 Carlisle, PA 17013 brother no relation 100% of residue ($33,461.34) $1,000.00 no relation cousin no relation ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Salem United Church of Christ 231 Chestnut Street Harrisburg, PA 17101-2639 Organization Industrialization Center 29 South Hanover Street Carlisle, PA 17013 $5,000.00 $3,000.00 $500.00 $10,000.00 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 71,068.16 (If more space is needed, insert additional sheets of the same size) $10,000.00 1/10 distributable estate + $1,000.00 ($8,106.82) LAST WILL AND TESTAMENT OF CONSTANCE !. KUGLER SAIDIS ;HUFF, FLOWER & LINDSEY ATTORNEYS*AT*LAW 26 W. High Street Carlisle, PA I, CONSTANCE I. KUGLER, of 633 North Hanover Street, Carlisle, Cumberland County, Pennsylvania 17013, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix or Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. I wish to be laid to rest beside my beloved husband, CHARLES E. KUGLER, JR., in the lot reserved in my name at Rolling Green Cemetery. SECOND: I give one-tenth (1/10) of my estate to the SALEM UNITED CHURCH OF CHRIST, located at 231 Chestnut Street, Harrisburg, Pennsylvania, and direct that the church divide the proceeds into three equal parts, the first to be added to the Salem Trust Fund, the second to be added to the Operations Fund, and the third to be for the support of the Salem Guild. THIRD: I give the sum of One Thousand ($1,000.00) Dollars to the SALEM UNITED CHURCH OF CHRIST, located at 231 Chestnut Street, Harrisburg, Pennsylvania, for support of the Religious Services Committee. SAIDIS 5HUFF, FLOWER & LINDSEY ATtORNEYS*AT*LAW 26 W. High Street Carlisle, PA FOURTH: I give the sum of Ten Thousand ($10,000.00) Dollars to the ORGANIZATION INDUSTRIALIZATION CENTER (OIC), located at 29 South Hanover Street, Carlisle, Pennsylvania, to maintain an achievement and scholarship Cund in the name of CHARLES E. KUGLER, JR. Said fund shall pay One Hundred ($100.00) Dollars per year to recognize high subject achievement in class and One Hundred ($100.00) Dollars per year to award the most improved student. FIFTH: I give the sum of Ten Thousand ($10,000.00) Dollars to the CARLISLE ASSOCIATION OF REALTORS, to establish the CONSTANCE I. KUGLER AND CHARLES E. KUGLER, JR. SCHOLARSHIP FUND, One Hundred Fifty ($150.00) Dollars per year from which may be awarded as a scholarship to either a new realtor or a veteran realtor in accordance with the decision of the scholarship committee and the Board of Directors of the Carlisle Association of Realtors. In an exceptional year, if the Board chooses to recognize two equally deserving realtors, the Board shall have the authority to award One Hundred Fifty ($150.00) Dollars to each said realtor. SIXTH: I give my platinum single diamond ring to BARBARA HEFFLEFINGER, of Back Street, Plainfield, Pennsylvania. SEVENTH: I give the sum of Three Thousand ($3,000.00) Dollars to my cousin, WILLIAM BOWEN, of R. R. #2, Milmont, Pennsylvania. EIGHTH: REVEREND MARY Pennsylvania. I give the sum of One Thousand ($1,000.00) Dollars to the ALICE BUTOFSKY, at Brethren Village of Lancaster, 2 SAIDIS :;HUFF, FLOWER & LINDSEY A'FI'ORNEYS.AToLAW 26 W. High Street Carlisle, PA NINTH: I give to GEORGE VORCHSEK, of 546 North Bedford Street, Carlisle, Pennsylvania, the sum of Five Thousand ($5,000.00) Dollars, for the sole purpose of supporting his educational expenses, which may include tuition, room and board or books. My Executor shall pay said sum directly to the educational institution for the aforesaid purposes. This gift is not to be used in any way for non- educational purposes, and is not to be used to support any training for professional athletic performance, such as professional wrestling. Education shall be defined to include a vocational or trade school, which may be reasonably expected, in the sole judgment of my Executor, to promote his skills and employability. Any portion of this bequest, which is unused for the aforesaid purpose shall revert to the residuary of my estate five (5) years after the date of my death. TENTH: I give to JES01CA ZEIGLER, of Spring Road, Carlisle, Pennsylvania, the sum of Five Hundred ($500.00) Dollars. ELEVENTH: All the rest, residue and remainder of my estate I give to my brother, JOHN C. WHISLER, of 5711 Wood Mouse Court, Burke, Virginia. LASTLY: I nominate, constitute and appoint my brother, JOHN C. WHISLER, to be the Executor of this my Last Will and Testament. In the event that the said JOHN C. WHISLER, shall be unable to serve as Executor for any reason, I appoint my cousin, WILLIAM BOWEN, as Executor. No Executor shall be required to file bond in this or any other jurisdiction. If my Executor decides to sell my Street, I direct that he list the property with Century-21 Company~ ~'~ze;t ¢,~J~ c,.~'~k '~,c.~.. ~ ~o~t .1~(' IN WITNESS WHEREOF, I have hereunto set my hand and seal this residence at 633 North Hanover Associates Coon and SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: ,2001. SAIDIS ,HUFF, FLOWER & LINDSEY ATI'ORNEYS.AT. LAW 26 W. High Street Carlisle, PA 4 SAIDIS ;HUFF, FLOWER & LINDSEY A'ITORNEYS,, AT* LAW 26 W. High Street Carlisle, PA COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss I, CONSTANCE I. KUGLER, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law~ do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by CONSTANCE I. KUGLER, the Testatrix, this ~../~ dayof ~.~--/D~L.c.,. Ct_ ~. ! _ , 2001. '~-J ' [ Notar~ubhc k. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS We, Gladys M. Lehman and James D. Flower, Jr. the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. and 2001. Sworn or affirmed to and subscribed to before me by Gladys M. Lehman James D. Flower, Jr. this ,~/%,~ day of ~~L_~,~ Witness '~/' SAIDIS HUFF, FLOWER & LINDSEY ATTORNEYS*AT, LAW 26 W. High Street Carlisle, PA tlUD - I L;NIFORM SETTLEMENT STATEMENT U.S. ~ING AND URBAN DEVELOPMENT T---~E OF LOAN - ----~u,,.,] 6. File Number: I. FHA 2. FmHA ~ 3. Cony. Unins. 4. VA 5. Cony. Ins. ..~ & Mortgage I~surance Case Number OMB Approval No. 2502-0265 Carlisle, PA 17013 G. PROPERTY LOCATION: 633 N. Hanover Street Carlisle, PA 17013 Parcel # 02-20-1800-063 SETTLEMENTSTATEMENT 7. Loan Number: 03-6120-065934628-2 C. NOTE: This ~rm is ~mished to give you a statement of actual seUlement costs. Amounts paid to and by the se~lement agent are shown, ltems marked "(p.o.c.)" were paid outside the closing; the}, are shown here ~r in~rmational purposes and are not included in the totals. NO.~TE: TIN = Tax aer's I&ntification Number D. NAME AND ADDRESS OF BORROWER: E NAME, ADDRESS AND TIN OF SELLER: I F. NAME AND ADDRESS OF LENDER: Stephen L. Marks Estate of Constance I. Kugler Washington Mutual Bank, FA by John C. Whisler, Exe. 2000 Oxford Drive 14 Hosfeld Road 633 N. Hanover Street Bethel Park, PA 15102 Carlisle, PA 17013 H. SETTLEMENT AGENT NAME, ADDRESS AND TIN PA RealEstate Settlement Service 10 Wes~{~et Carlisle PA 17013 .... PLACE O~EMENT DATE 10 West Pomfret Street 09/30/2003 _~ Carlisle PA 17013 100. GROSS AMOUNT DUE FROM BORROWER: 10 I. Cont~ce 102. Per~ 103~s to borrower Line 1400 104. J.___a_. SUMMARY OF BORROWER'S TRANSACTION 4 005. 63 AdVents lbr items aid b seller in advance ~own taxes 107. Count taxes 09/30/2003-12/31/2003 108. Assessments 109School Taxes 9 30 to 6 30/04 II0. 20. GROSS AMOUNT.___~DUE FROM BORROWER :00. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: .01. De ositorearnestmone 5 000.00 02. Princi al amount ofnew loan s 113 850.00 03. Existi~ to K. SUMMARY OF SELLER'S TRANSACTION 400. GROSS AMOUNT DUE TO SELLER: 401. Contract sales rice 402. Personal roe 403. 404. 405. Ad'ustments for items aid b seller in advance ~xeg. 407~es 09/30/2003-12/31/2003 408. Ass ess.__________~me n ts 409. School Taxes 9 30 to 6 30 04 410. 411. 412. 420. GROSS AMOUNT DUE TO SELLER ~CTIONS IN AMOUNT DUE TO SELLER: 04. 05. 06. 07. 08. 09. Ad'ut~.tments for ite~ seller ~n taxes I 1. Coun~ taxes 12.~Assessments 501. Excess de oBit 502~r es to seller Line 1400 503. Existin loan s takensub'ect to 504. Pa offoffirst mort a e loan 505. Pa offofsecond monna e loan 506. 507. 508. 509. Ad~stments for items un aid b seller ~wn taxes 51 I. Coun________~ taxes 512. Asses._~_~...___~sments -- 513. 514. 515. 516. 517. 518. 519. · 0. TOTAL PAID BY/FOR BORROWER 118 850 . 00 520. TOTAL REDUCTION AMOUNT DUE SELLER 9 874 · 32 0. CASH AT SETTLEMENT FROM/TO BORROWER ~ETTLEMENT FROM/TO SELLER 1. Gross amount due from borro~ ~n~,~ u ~eLLI::t ~ 2. Less amount aid b /for borrower Line 220 3. CASH FROM BORROWER ue seller Line 520 SELLER'S STATEMENT e inl'brmation contained in Blocks E, G, H, and I and on line 401 (or, if line 401 is asterisked, line 403 and 404) is important tax information and is being fi~rnished to the ernal Revenue Service (see Seller Certification). If you are required to file a return, a negligence penalty or other sanction will be imposed on you if this item is required be reported and the IRS determines that it has not been reported. You are required to provide the Settlement Agent with your correct taxpayer identification number. If you not provide the Settlement Agent with your correct taxpayer identification number, you may be subject to civil or criminal penalties imposed by law. Under penalties of jury, I certi~a' that the number shown on this statement is my correct taxpayer identification number. eller'sSignature) Estate of Constance I. Kugler ~ASY SOFT, Inc. 2001 Previous editions are obsolete (Seller's Signature) Page l by John C. Whisler, Exe. form HUD-I (3/86) ref Handbook 4305.2 L. SETTLEMENT CHARGES 700. TOTAL SALES/BROKER% COMMISSION based o~500.00 @ Division of Commission (line 700) as follows: 701.$ 3,820.00 to Prudential Thompson Wood 702.$ 3 770.00 to Central State RealtZ 703. Commission paid at Settlement 704. Transaction Fee to Prudential ThomlDson Wood 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Q.~gination Fee $ 802. Loan Discount 803. Appraisal Fee to Washinqton MutUal Bank, FA 804. Credit report to 805. Lender's Inspection Fee 806. Deposit from Borrower 807. Oriqination Fee to WMB 808. Payment Processinq Fee to WMB 809. Fundinq and Review Fee to WMB 810. Tax Procurement/Trackinq Fee to WMB i 811. Tax Research/Payment Service Fee to WMB 812. Wire Transfer Fee to PA Real Est. ($5) and WMB ($35) 813. Overniqht Fee to PA Real Estate Settlement Services 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from 09/30/2003-09/30/2003 @ $22. 610 per day 902. Mortgage Insurance Premium for 903. Hazard insurance Premium tbr 6.000% PAID FROM BORROWER'S FUNDS AT SETTLEMENT -295.00 142.31 200.00 330.00 50.00 31.00 40.00 15.50 22.61 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard insurance 3 month(s) 13 $53.83 per month 161.49 PAID FROM SELLER'S FUNDS AT I 125.00 1002. Mortgage insurance 1003. City Property Taxes 1004. County Property Taxes 8 month ( s 1005. Annual assessments 1006. School Taxes 4 month(s) 1007. 1008. Aggregate Accounting; Adiustment 1100. TITLE CHARGES $37.75 per month 302.00 0 $88.48 per month 353.92 -277.20 I I 0 I. Settlement or closing fee to I 102. Abstract or title search to 1103. Title Examination to 1104. Title insurance binder to 1105. Document preparation to 1106. Nota~ fees to Ann B. Sensenich 1107. Attorney's fees to Thomas Flower (POC) (includes line numbers: 1101 - 11 05 1108. Title lnsurance to CTIC/PA Real Estate Settlement Services (includes line numbers: 1101 - 1105 l109. Lender's coverage $ 113850.00 I 110. Owner's coverage $ 126500.00 II11. Endorsements: 100t 300t 8.1 1112. Conestoqa Title Insurance Company for CPI 1113. 1200. GOVERNMENT RECORDING AND TIL~NSFER CHARGES 10.00 894.00 150 O0 35.00 10.00 1201. Recording tees: Deed $ 38.50 Morteage $ 68.50 Release $ 107.00 1202. City/cnW tax]stamps: Deed $ 1,265.00 Mortgage $ 1,265.00 1203. State tax]stamps: Deed $ 1,2 6 5.0 0 Mortgage $ 1204. Recorder of Deeds for Power of Attorney 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1,265.00 17.00 1301. Survev to I 1302. Pest inspection to 1303. Transaction Fee to Central State Realty 125.00 1304. Flood Determination Fee to Lereta CorD 13.00 1305. PerrV Pest Control I 45.00 852.24 1306. Carlisle Borouqh for Acct. 01230A for Final Water I 15.08 1400~ TOTAL SETTLEMENT CHARGES (enter on lines 103, Section J and 502, Section K) "/? 4,0 0 5.6 3 9, 8 7 4 . 3 2 CERTIFICATION: I have carefully reviewed the HUD-I Settlement Statement and to the best of my knowJg~ge and belief, it is a true and accurate statement &all receipts and disbursements made on my account or by me in this transaction. [ further certifiy that [ received a copy o~e HUD}-I Settle~ S Ir . ,, _,. Estate of ~ ' (~ 5~'lltlr , ,~ ,,., Est, ate ~f ,C~ e I. ,l~g±er Borro.v~ Stephen L. Marks } ' / ~$~'ller by John~. ~hisler - - K ~ ......... The HUD-I Settlement Statement which'l bare prepared is a true and accurate account of the fimds disbursed or to be disbursed by the undersigned as part o£the settlement of this transaction. 09/30/2003 Settlement Agent PA Realgstate Settlement Services Date WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. © EASY SOFT, Inc. 2001 Previous editions are obsolete Page 2 form HUD-I (3/86) ref Handbook 4305.2 MRY 05 2003 3:O?PM CRLL CENTER 917 530 2624 p. 1 Orrstown Bank 22 South Hanover Street Carlisle, PA 17013 Estate of Constance I. Kugler Date of Death: January 10, 2003 Social Security No. 204-28-1836 Dear Sir/Madam: The following is a complete record of the above decedent's accounts as of January 10, 2003, decedent's date of death. If the decedent had a safe deposit box, indicate number __. Balance on Date )fDeath Account No. Type of Principal Accrued Names on Date Account Interest Account (All Opened Owners) Date: .. Signature of Official M&T Bank 1 West High Street carlisle, PA 17013 Re: Estate of Constance I. Kugler Date of Death: January 10, 2003 Social Security No. 204-28-1836 Dear Sir/Madam: The following is a complete record of the above decedent's accounts as of January 10, 2003, decedent's date of death. If the decedent had a safe deposit box, indicate numberf'l i/2 Balance on Date of Death Account No. Type of Principal Accrued Names on Date Account Interest Account (All Opened Owners) Title: Thie Check is void for all purposes after 12/04/2003 4975 2145 60-244/313 CORDIER ANTIQUES & FINE ART 15109622 2201 MARKET STREET PH. 717-731-8662 ~/,/,,~//~ CAMP HILL, PA 17011 DATE ~' ~ PENNSYLVANIA ,~",~,~STATE BANK ,,p.'O ~ [ 30 2 h h ?l-' ;,S~ Oq&8 PAY TO THE , ORDER I;OSSOOOt?2~: 000r.[?055.2"' ©IMAGE CHECKS, 1999 ON THE WATER DATE 0857 65-371550 O857 'Un~on F~del~ty L~£e Insurance Co. 200 Nor~h]~r2~ngale Road 8chau~burg, IL 60173-2096 ' 3 150821 1 1 I,,I,1,,I,III ...... I1,1,1,,,I,I1,,,I,,11,,11 ..... I1,,,1111,,,I ESTATE OF CONSTANCE I KUGLER 5711 WOOD MOUSE CT BURKE, VA 22015-2736 DESCRIPTION WE REGRET THE DEATH OF INSURED ,REFUNDING UNEARNED PREMIUM 78.85 CHECK NUMBER __._._.__0000150821 PAYEE ESTATE OF CONSTANCE Pleasedetachbe~renegotiatingcheck I KUGLER CHECKS AND OTHER ITEMS ARE RECEIVED FOR DEPOSIT SUBJECT TO THE TERMS AND CONDITIONS OF THIS INSTI'rLfflON'S COLLECTION AGREEMENT Vendor # U000333926 Vendor Name: CONSTANCE KUGLER ODAP11PQ 002315 I Voucher ID Invoice Number PO Number Invoice Date Gross Amount Discount Paid Amount U0333926 717-249-0042-756 01/14/2003 16.28 0.00 FINAL CREDIT 16., Customer Refunds Total Gross AmountI Total Discounts Total Paid Arnounl __________ $16.28 $0. O0 $16.28 $print® Company O00' Paying Agent on Behalf of Itself and Sprint Corporation's Affiliates · ':?' '!':":~' ' P. 0. Box 7977 Shawnee Mission Kansas 66207 ..~:? ? '::'i :'::::;!ii ~; .:: :' 1 - 877- 604- 84154 PAY ~*,**a***~:w,***a16 ~L~S ~ 28 C~S .... ~,~ .......... ~"~""16.28 OR9RR , .:~:~: :::~ .~.:(5 o. .... . ~ ********************** ~.c eeo v°,o ,~ ~o~ :AS.~O w.~% ~0...~A~ CONST~CE KUGLER Authorized S ~ CARLISLE PA 17013-1934 h,,llh,,ll!,,,,,,Ih,ll,,,,llhh,,,Ih,I,J,,ll,,,ll,,hl,I 55-382/412 "'00 ~, 8hL, O"' ~:Or:, ~, &O ? S ~, ~,~-' 80 q O 00 8 r:,O ;I, & r:, L,,' HEALTH MANAGEMENT ASSOCIATES, INC. CARLISLE REG MED CTR 1700 0032440 03/05/2003 7104747 C KLT~ 134.87 ~AY ............. ~.O. ~x ~1 · H~u~, PA 171~ IN~U~N~.~ =~;;).~ ~ 09/05/2003 ONE HUNDRED TWENTY FIVE AND 00/100 DOLLARS TO THE ORDER OF KUGLER CONSTANCE ESTATE OF C/O JOHN C WHISLER / EXECUTOR 5711 WOOD MOUSE CT BURKE VA 22015 Ol .... tint&oh before depositing 62-22 311 CHECK NUMBER .~ k- *:.~:i~, ~, 12 5. O0 oo214e o....... . :ii: RETURN THIS.CHECK IF IJ~"~ORRECT Ty~ls ~JI"IECK y,~lD IF NOT/P~ESENTED /IF(~ PAYM']J~ WlTI4,NI~6 DAYS First Union Bank of Del ..... I I // AUTHORIZED SIGNATURE Il"DO 8 i, I,,o. i, Oll" I:O % ~. &DO ~ 8 51: 8D ?qq SOD 2q ? ~, ~.11" ~nsylvsnis Nationsl Mutual Ccnuel~y Insurance Company payee scknowcldges the usa of thc attached check to be settlement in full of account ns herein Bested Please detach before depositing 3755980300 002 ! 4810 INVOICE NUMBER PURCHASE ORDER DATE INVOICE AMOUNT DISCOUNT NET AMOUNT ~022003 09-02-2003 125.00 .00 125.00 ~EFUND ON ACCOUNT 3755960300 125.00 .00 125.00 REMOVE DOCUMENT ALONG THIS PERFORATION ':'":": "'~' VOID IF NOT PRESENTED WITHIN 90 DAYS AFTER DATE OF IssUE :DELFT NUMI~-I-~ 538§.90~8! 412 ,'53~R5ciOt'R&"' ,:0hl, i]0:~EiciS,: ??O&R?O"' ACCOUNT NO. ~ 60-1503/313 ;HECKING DEPOSIT TICKET PLEASE ITEM ZE ADDITIONAL CHECKS ON REVERSE SIDE CHECKS AND OTHER ITEMS ARE RECEIVED FOR DEPOSIT SUB?ECT TO'/'HE TERMs AND CONDITIONS OF THIS INSTITUTION,S COLLECTION AGREEMENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVtDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003107 FLOWER JAMES D JR 26 WEST HIGH STREET CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 204-28-1836 FILE NUMBER: 2103-0075 DECEDENT NAME: KUGLER CONSTANCE I DATE OF PAYMENT: 10/10/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/10/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $6,940.36 TOTAL AMOUNT PAID: $6,940.36 REMARKS: JAMES FLOWER ESQUIRE SEAL CHECK//1 1 1 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES /NHERTTANCE TAX DIV/SION DEPT. 280601 HARR'rSBURG, PA 17128-060! COHHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-lSd7 EX AFP (01-05) THOMAS E FLOWER SAIDZS ETAL 2109 MARKET ST : CAMP HILL PA 17011 DATE 12-01-2005 ESTATE OF KUGLER DATE OF DEATH 01-10-2003 F/LE NUMBER 21 03-0075 COUNTY CUMBERLAND ACN 101 Amoun"lc Rami'~'l*ad CONSTANCE I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LZNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ~-: ]~-~- g~- ~--[~:~- -~b~-~ -~ - ¥~ i~'f R~g - ~i - ~-~ R~-g ~g~ ¥~- ~EL~[-~ ................. DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KUGLER CONSTANCE I FILE NO. 21 03-0075 ACN I01 DATE 12-01-2003 TAX RETURN HAS: { X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. ReaZ Es~a~a (Schedule A) {1) 2. S~ocks and Bonds (Schedule B} (2) $. Closely Held Stock/Partnership Zntaras~ (Schedule C) ($) q. Nor~gages/No~as Receivable (Schedule D) (q) 5. Cash/Bank Deposits~Misc. Personal Propar~y (Schedule E) 6. Jointly Owned Propar~y (Schedule F] {6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9 Funeral Expenses/Adm. Cos~s/M~sc. Expenses (Schedule H) (9) 10 Debts/Mortgage Liabilities~Liens (Schedule 11 To,al Deductions 12 Na~ Value of Tax Ra~urn 126~500.00 .00 .00 .00 26~685.q8 .00 .00 (8) 63,053.5q (10) NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his fora wi~h your ~ax payment. lq NOTE: ASSESSMENT OF TAX: 15. Amoun~ of Line 16. Amoun'~ of L/ne lq ~axabla a~ Lineal~Class A ra~a 17. Amoun~ of L/ne lq a~ Sibling ra~e 18. Amoun~ of L/nm lq ~axable a~ Collateral/Class B ra~e 19. Principal Tax Due TAX CREDITS PAYMENT RECEIPT DISCOUNT DATE NUMBER INTEREST/PEN PAID (- 10-10-200~ CD00~107 .00 153,185.q8 19~083.78 (11) 82.117.~Z (12) 71,068.16 18,106.82 AMOUNT PAID 6,9q0.36 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE 6,9q0.36 .00 .00 .00 IF TOTAL DUE TS LESS THAN $1, NO PAYMENT TS RE(IU/RED. ~F TOTAL DUE TS REFLECTED AS A "CREDIT" (CR}, YOU MAY BE DUE REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. } (151 .00 X O0 = .00 (~6). .00 X Oq5= .00 (~7). 33,q61.3q X 12 = q,015.36 (181 19,500.00 x 15 = 2,925.00 (19)= 6,9q0.36 reflect figures that include the total o~ ALL returns assessed to date. Chari~abla/Governean~al Bequests; Non-elected 9115 Trusts (Schedule J) (15) Na~: Value of Es~:a~e Sub.~ac~: ~:o Tax (lq) 52,961.3q Zf an assessnent was issued previously, lines lq, 15 and/or 16, 17, 18 and 19 RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December ZZ, 1981 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rata on any such future interest. To fulfill the requirements of Section 21qO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (72 P.S. Section 91q0). Detach the tap portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF N/LLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (RE¥-13Z3). Applications are available at the Office of the Register of Nills, any of the 23 Revenue District Offices, or by calling the special lq-hour answering service for fores ordering: 1-800-S61-2050~ services for taxpayers with special hearing and / or speaking needs: 1-800-qqT-$OZO (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty [60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZSIOZ1, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three ($) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiao period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .00016q. All taxes ahich became delinquent on and after January 1, 1981 will bear interest at a rate which will vary from calendar year to calendar year with that rate X NUNBER OF DAYS DELTNQUENT announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZO0~ are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 202 .OOOSq8 1987 9X .000247 1999 7g .000192 1983 16X .0004~8 1988-1991 IIX .000301 ZOO0 8X .000Z19 1984 IIX .000501 1992 9X .000247 2001 92 .000247 1985 152 .000356 1995-1994 72 .O00lgZ ZOOZ 62 .000164 1986 10X .000274 1995-1996 9X .000147 Z003 52 .000137 --Interest is calculated as ~ollows: ZNTEREST= BALANCE OF TAX UNPA/D X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen [15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Will No. 21-03-0075 Constance I. Kugler January 10, 2003 Admin. No. 2003-00075 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: 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 Clerk of the Orphans' Court and may be attached to this report. Date: Signature Name: Thomas E. Flower, Esquire I.D. No. 83993 SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: Personal Representative X Counsel for Personal Representative Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: :s TA N /.... EY M. ~ I t Tf' L ER Date of Death: F & B. / 6~, d. tJ D 3 Estate No.: ~/-D3- DO'7!) 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 ~ No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a fmal account with the Court? Yes 0 No ~ 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 0 No ~ c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: 0<- /6- oS f.") -? U~ ; , -jfJ J . V J,< -f-.J Signature R () TH Name S TIT l~ L L::: R.. E- , /9, :5:J... !? 1/) & E V / E"W D Je Address ~ Po 12 LIS L c/ P J!J / '70/ .3 /-1., I .. j 7/7- ..;)..<.t<3-/b3'1 Telephone No. Capacity: 00 Personal Representative o Counsel for personal representative ,~ ;