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HomeMy WebLinkAbout03-0901 PETITION FOR PROBATE & GRANT OF LETTERS o, ,',,o. 0 0 / also known as To: Register of Wills for the , deceased. County of Cumber/and Social Security No. 167-14-9493 Commonwealth of Pennsylvania The Petition of the undersigned respectfully represents that: Your Petitioners, who is 18 years of age or older and the Executor named in the Last Will of the above decedent dated August 2, 1995 , and codicils dated none The Executor named none died Renunciations for none attached hereto. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 9 Cedar Cliff Drive, Camp Hill, Lower Allen Township Decedent, then 78 years of age, died Mechanicsburq, Pennsylvania October 20 ,2003, at Messiah Village, 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 not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in PA (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania, situated as follows: 9 Cedar Cliff Drive, Lower Allen Township, Camp Hill, PA 17011 $50,000.00 $ $130,000.00 WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented herewith and the grant of letters testamentary thereon. Sig ,, (s) d Residenc~e(§) o.f Petitig. D. er(s): ~,leh"h H. Klin.qler Jr. // ,7' ~..5~0 Harvest Lane ~// Mechanicsburq, PA 17055 717-697-9510 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA : : COUNTY OF CUMBERLAND : 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 of Petitioner(s) and that as personal representative of the above decedent, petitioner(s) will well and truly administeCfh'~ estate accord~g to law./~ Sworn to or affirmcsd, L,and subscribed% .-~ ler~ ~ before me this k,PLJ day of H. Klinq  October, 2003. , . ~ ~, I Re~ter No. 21-03- ~0/ Estate of JOHN H. KLINGLER SR. , deceased. DECREE OF PROBATE & GRANT OF LETTERS AND NOW, October ~)1 ,2003, in consideration of the Petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated Auqust 2, 1995 described therein be admitted to probate and filed of record as the Last Will of John H. Klinqler Sr. ; and Letters Testamentary are hereby granted to John H. Klinqler Jr. FEES Probate, Letters, Etc ........ $.235.00 Short Certificates(-10- ) .... $.30.00 Renunciation(s) ........... $ JCP .................... $10.00 Other Will Pages (-4-) .... $12.00 TOTAL: .... $ 287.00 Filed .' ........................... I~g~ster of Wills ' _ IRWIN & McKNIGHT RO~, Esquire (06282) ATTORNE-~up. Ct. I.D. No.) 60 West Pomfret St., Carlisle, PA 17013 ADDRESS 717-249-2353 PHONE his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ Local Registrar No. ~~ Date 2./87 COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH ,. John H. Klingler, Sr. Cumberland ,,,.Plumber/Maint. 550 Harvest Lane Mechanicsburg,PA 17055 .Male ,367 -- 14 -- 9493 Dctober '2~, 2003 ,Columbia,PA I,. ~pper Allen Twp~.l ~/~ ~"/[~q~ ,~.--o,-- .... ' ~hite iFenn State Unlv I .~0f~, I ~s~v.~c~ ,, ~2 ( ~') Widowed  CE~NT'S PA ~'~' ,~. ~.~ Cumberland '~ ,,. John H. Klingler [,OT,E,'S,^U~,F.~,~.,.~S~.) ,, Martha E. Bowers INFORMANT'S NAME (Type/Pt mO IiiN~OR~ANT.S MAILIN~ ADDRE~ (SWeM. ~. John H. Klin&ler Jr 550~u Harvest Lane,C~"'~"Mechanicsburg,ZeC°~ PA 17055 |Rolling Green Mem. Parkl Camp Hill. PA 17011 12''0' 12,.. -- - ~ AN AU'I1DPS¥ PERFORMED? DUE TO (O~ AS A CONSEOUE NCE OF): DUE TO (OR AS A CONSEOUE NCE 0~): LAST WILL AND TESTAMENT OF JOHN H. KLINGLER, SR. I, John H. Klingler, Sr., of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and revoke all Wills and Codicils previously made by me. ITEM I: I direct that all my legally enforceable debts and funeral expenses, including all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II: I bequeath any automobiles or motor vehicles I may own at my death, my personal effects, such household goods if any as may be my individual property and not the property of my wife or owned jointly by me with her, and other tangible personal property of like nature (not including cash or securities), together with any existing insurance thereon, to my wife, Winifred A. Klingler, providing she survives me by thirty (30) days. Should my said wife predecease me or die on or before the thirtieth day following my death, I bequeath such tangible personal property and insurance thereon to my son, John H. Klingler, Jr., of Mechanicsburg, Pennsylvania. Should my said son predecease me I direct that the foregoing articles be sold at public or private sale by my personal representative(s), and I further direct that the net proceeds thereof shall be administered and distributed as a part of the residue of my estate. ITEM III: I devise and bequeath the residue of my estate of every nature and wherever situate to my said wife, providing she survives me by thirty (30) days. ITF~ IV: Should my said wife predecease me or die on or before the thirtieth day following my death, I devise and bequeath the residue of my estate of every nature and wherever situate, including any property over which I shall have any power of appointment, to my son, John H. Klingler, Jr., of Mechanicsburg, Pennsylvania. Should my said son predecease me I devise and bequeath the residue of my estate of every nature and wherever situate in equal shares to my daughter-in-law, Doreen M. Klingler, of Mechanicsburg, Pennsylvania, my granddaughter, Andrea M. Klingler, of Mechanicsburg, Pennsylvania, and my grandson, Justin H. Klingler, of Mechanicsburg, Pennsylvania. Should any of the foregoing named persons predecease me, I devise and bequeath his or her share of my estate in equal shares to the remaining persons. ITeM V: Should any person entitled to a share of my estate not have attained the age of twenty-one (21) years at the time of distribution to him or her, I devise and bequeath the share of each such person to my Trustee hereinafter named, IN SEPARATE TRUST, to hold, manage, invest and reinvest the share so received, and the accumulation of income thereon, and to use and apply the income and principal, or so much thereof as, in the sole discretion of my Trustee, may be necessary or appropriate for such beneficiary's support, health and medical care, and education (including college education, both undergraduate and graduate), or to make payment for these purposes, without further obligation or responsibility to see to the proper expenditure thereof, directly to such beneficiary or to any person taking care of such beneficiary. Any principal or income not so applied shall be distributed to such beneficiary absolutely when he or she attains the age of twenty-one (21) years. If he or she dies before attaining age twenty-one (21), such share shall be distributed to his or her personal representative(s), discharged of the trust. ITEM VI: All Federal, State and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether passing under this Will or otherwise, including any interest or penalty imposed in connection with such taxes, shall be considered a part of the expense of the administration of my estate and shall be paid out of the principal of my residuary estate without apportionment or right of reimbursement. ITEM VII: No beneficial interest under any of the trusts held hereunder, whether in income or principal, shall be subject to anticipation, assignment, pledge, sale or transfer in any manner, nor shall any beneficiary have the power to anticipate, encumber or charge such interest, nor shall such interest, while in the possession of the Trustee, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary. ITEM VIII: I appoint my daughter-in-law, Doreen M. Klingler, Trustee of any trust established under this my last Will. Should my said daughter-in-law fail to qualify or cease to act as Trustee, I appoint Farmers Trust Company, of Carlisle, Pennsylvania, Trustee. ITEM IX: I appoint my said son, John H. Klingler, Jr., Executor of this my last Will. Should my said son fail to qualify or cease to act as Executor, I appoint Farmers Trust Company of Carlisle, Pennsylvania, Executor. ITeM X: I direct that all fiduciaries acting under this Will, whether or not named herein, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal, this ~Dday of ~ , 1995. ~[SEAL] The preceding instrument, consisting of this and three (3) other typewritten pages, each identified by the signature of the Testator, was on the date thereof, signed, published and declared by John H. Klingler, Sr., the Testator therein named, as and for his last Will, in the presence of us, who, at his request, in his presence and in the presence of each other, have subscribed our names as witnesses hereto. COMMONWEALTH OF PENNSYLVANIA : : ss. COUNTY OF CUMBERLAND : We, John H. Klingler, Sr., Michael R. Rundle and Mary M. Price, the Testator and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his last Will and that he has signed willingly, and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of his/her knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~ ~Tes/t/a~o/r~ Witness Subscribed, sworn to and acknowledged before me by ~ohn H. Klingler, Sr., the Testator, and subscribed and sworn to before me by Michael R. Rundle and Mary M. Price, the witnesses, Nota~Publ ic JOHN H. KLINGLER, SR. Michael R. Rundle, Esquire FOV~LER, ADDA/~S, SHUOH3~RT & RUNDLE ATTORNEYS AT LAW 28 SOUTH PITT S~TREET CARLISLE, PENNSYLVANIA 17013 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: JOHN H. KLINGLER SR. OCTOBER 20, 2003 21-03-0901 Date of Death: Estate No.: To the Register: I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Febmary 9, 2004 . Name Address John H. Klingler Jr. 550 Harvest Lane, Mechanicsburg, PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except __ Date: 02/09/04 IR N~cKNIGHT Name Roger B. Irwin, Esquire Address 60 West Pomfret Street none . Carlisle, PA 1~013 Telephone (717) 249-2353 Capacity: X __ Personal Representative __ Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT, 280601 HARRISBURG, PA 1712~0601 INHERITANCE TAX RETURN RESIDENT DECEDENT / - 3 ? DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z John H. Klingler, Sr 167-14-9493 ~j · f"t DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPUCATE WiTH THE U.I O October 20, 2003 September 17,1925 REGISTEROFVVILLS LU IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER LU [] 1. Original Rstum [] 4. Limited Estate [] 6. DecedeatDiedTestate(^ttachcopyofW~) [] 9. Litigati~nProosedsRsceived [] 2. ~pplementalRetum ] 4a. Fature Intereat Cc~p¢crnise (date of death ~er 12-12-82) [] 7. DecedentMaintainedaLivingTrust(At~achco~orwm0 [] 10, Spousal Pove~yCredit(dateoldeathbetw~en12o31.91 and1-1-95) [] 5. Feda'al Estate Tax Ratum Required 0 8. Total Numba'd Safe Deposit Boxes [] 11. ElectimtotaxuederSsc. 9113(A)(,~achsc~o) THIS ,SEC fiON MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Roger B. Irwin 60 W. Pomfret St FIRM NAME (ff App~ca~) Irwin & McKnight Carlisle, PA 17013 TELEPHONE NUMBER 717-249-2353 1. Real Estate (Schedule A) (1) 2. Slocks and Bonds (schedule B) (2) l Closely Held Corporation, Par~ship or Sde-Propdstorship (3) 4. Mortgages & Notes Reosivable (Schedule D) (4) 5. Cash, B~nk Deposits & Miscatlanec, Js Persc~al Properly (5) (Schedule E) 6. JointJy Owned Prepe~J (Schedule F) (6) [] Separate Billing Requested 7. bret-Vivos Transfers & Misosllaneous Non-Probate Property (7) (Schedde G or L) 8. Total Gross Aes~s (total Unes 1 - 7) 9. Funera~ E~eeses & Admini~at~ve Costs (Schedule H) (9) 10. Debts d Denedent, Ivl~tgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Unes 9 & 10) 1Z Ne~ ~alue d E..~ate (Line 8 minus Line 11) 13. Charitable end Governmental Bequests/S~c 9113 Trusts fa' which an eleoti~ to tax has not besn mede (Schedule J) 14. Ne~ Vat ue Subject to Tax (Line 12 minus Une 13) 133,000.00 170,962.~4 47,364.91 36,100.73 OFFICIAL USE ONLY (8) 387,428.58 25,239.72 1,651.90 (11) 26,891.62 (12) 360,536.96 (13) (14) 360,536.96 SEE INSTRUCTIONS FOR APPUCABLE RATES 15. Arn~ d Une 14 taxable at the spcusal tax rate, or trashes under Sec. 9116 (a)(12) 16. Amount d Une 14 taxable at lineal rate 17. Amount of Une 14 taxable at sibling rate 18. Amount d Line 14 taxable at collateral rate 19. Tax Due x .o__ (18) 360,536.96 x .o 45 (16) x .12 (17) x .15 (18) 20. [] I CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 16,224.16 (19) 16,224.16 · · BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < $~ PA42021F I Decedent's Complete Address: 151KbblADDRESS c/o John H. Klingler, 550 Harvest Lane crrY Mechanicsburg ISTATE PA IziP Jr. Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty credit B. Pdor Payments C. Discount 16,100.00 811.21 3. Interest/Penalty if applicable D, Interest E. Penalty Total Interest/Penalty (D + E) 4. If Line 2 is greater lhan Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, Check box on Page I 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) A. Enter the interest on the tax due. Total Credits (A + B + C) (2) (3) (4) (5) (5A) (5B) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE, Make Check Payab/e to: REGISTER OF IMLLS, AGENT 17055 16,224.16 16,911.21 687.05 0,00 0.00 PLEASE ANSV1ER THE FOLLO~NG QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. [:)id decedent make a transfor and: Yes No a. mlain the use or income of the property transferred; ........................................ [] [] b. retain the dght to designate who shall use the properly transferred or its income; ................... [] [] c. retain a revisionary interest; or ....................................................... [] [] d. receivethepmmise for life of alther payrnents, benefits orcare? ............................... [] [] 2. If death occurred alter 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 benk acceunt or secudty et his or her death? ..... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiau designetion? ....................................................... [] [] 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 penaitias~e~, r dedere that I have examined lhis tatum, including ~ ,iv,~,ying schedu es and statements, and to the best d my knowledge and bslief, it is true, correct and complete. Dedaredco of ~repa'er~her thai the personal repr~,entatJve is based co aJI infemnafico Of whirl1 preparer has any knov~edge. S,C.*TUR RETF DATE ',~-.. ADDRESS .,/' __ / SI~A~ ~ ~RE~RER ~'~ER T~ R~PRESE~TATIYE DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rote 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 dales of death on or after Januaq/1, 1995, the tax rate imposed on the net value of transfers to or for the use of the su~ving spouse is 0% [72 P S §9116 (a) (1 1) ii ~Tl~..s!~.e~_d_ce~..n~t_~??~ a !,ra?sfor.to' a sur~ving spouse from tax, and the statutory requirements for disclosure of assets and filing a ax retum a~e ~till annlicabl~ ev(~' For dates of death on or after Juty 1 2000: The tax rate reposed 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 stepperent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfars to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for he use of the denedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at east one parent in common with the decedent, whether by blood or adoption. STF PA42021F 2 , REV-1502 EX + (1-97) (r) co~o.~,T, orP~..s~w.~ SCHEDULE A I ,..~,T^.c~ T~x.E~.. REAL ESTATE RESIOENT DECEDENT ESTATE OF FILE NUMBER John H. Klingler, Sr 2103-0901 N I real W,~)' owned solsly or as a tenant in c~,,,,~ must be i~i[~-~ at fair marke~ vet ue. Fair mad<et value is defined as the pdce at which property would be exchanged between a ~ ~tgb~ d~i sc~o~7~n.~le~:l~l ene~h., being compelled to buy or sell, both having reasonable know~edge d the relevant facts. Real prof~y which isj oint/y-own~ vdth .~ght of suwivo~hip ITEM NUMBER 1. DESCRIPTION Personal residence 9 Cedar Cliff Drive Camp Hill, PA 17011 Deed Book 17, Page 302 Assessor's parcel number 13-24-0805-094 TOTAL (Also enter on Fine 1, Recapitulation) STF PA42021F.3 (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 133,000.00 $ 133,000.00 , REV*1503 ,EX + (1~7) (I} COf/~MOh"WF. ALTH OF PENNSYLV/U~L~ INHERITANCE TAX RETURN ESTATE OF John H. Klinqler, Sr SCHEDULE B STOCKS & BONDS FILE NUMBER 2103-0901 All propen'y jothfly..ovmed with the right of suwlveeship must be disclosed on Schedule F. · ITEM NUMBER 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. DESCRIPTION 128.704 Shs Altria Group, Inc. 101.6815 Shs Bank of America 300 Shs WR Berkley Corp 100 Shs Burlington Resources 100 Shs Citigroup, Inc. 102.632 Shs Fannie Mae 1081.756 Shs Fidelity Ginnie Mae 209.5954 Shs G'ener~l Electric Corp 200 Shs Home Depot, Inc. 76.741 Shs IBM Corporation 300 Shs Intel Corp 207.4276 Shs Microsoft Corp 209.04 Shs Pfizer Inc 103.627 Shs PPL Resources 100 Shs NASDAQ-100 Index Shares 200 Shs Vernado Realty Trust 102 Shs Wal-Mart Inc 214.327 Shs Exxon-Mobil Corp 250 Shs Zila, Inc. GMAC, 6.6% Bond, Due 5/15/18 GMAC, 3.4% Bond, Due 5/15/05 GMAC, (46) Fund CBF4F0 CBG3V6 2.6% Bond, Due 11/15/04 CBG3V8 United States Savings Bonds - Series E/EE TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH 5,771.73 8,234.17 10,086.00 4,802.50 4,800.50 7,546.53 12,029.13 6,003.86 7,215.00 6,839.93 9,565.50 6,033.03 6,434.25 4,229.54 3,479.00 10,096.00 6,002.19 8,264.45 875.00 4,777.50 4,940.25 4,954.70 27,982.18 $ 170,962.9~ S~PA42021F.4 (Ifmomspaceisneed~,ins~ ~ditionalsh~tsofthesamesize) REV-1508EX+ 1-97 I SCHEDULE E c~o~.*L~, or PE..s~v~.~ CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RERID~NT DECEDENT PERSONAL PROPERTY ESTATE OF FILE NUMBER John H. Klinqler, Sr 2103-0901 Include the proceeds d litJgatio~ and the date the proceeds v,~re received by the estate. All p~ol:~:y jointly-owned with the ,~ght of survivomhip must be disat osed on Schedule F. ITEM NUMBER DESCRIPTION 1. Pennsylvania State Bank, Checking Account, A/C # 1001007 (Includes accrued interest) 2. M&T Bank, Checking Account, A/C # 51889668 (Includes accrued interest of $.18) 3. Waypoint Bank, Certificate of Deposit, A/C# 1000013008 (Includes accrued interest of $39.96) 4. Pennsylvania State Employees Retirement System October 2003 retirement distribution 5. Personal property and household goods sold at auction 6. Yeager's Personal Care Home - October 2003 refund proration of monthly fee for care 7. Penn State University Insurance reimbursement of prescription costs 8. Coventry Healthcare Management Corp prescription reimbursement 9. Stocks trading ex-dividend at October 20, 2003 TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE OF DEATH 23,394.70 848.83 19,143.17 557.65 1,627.92 1,525.00 51.62 143.01 73.01 $ 47,364.91 (If more space is needed, insert additional sheets of the same size) STF PA42021F 9 REV-1510 EX + 1-97 I SCHEDULE G / COMMONWEALTH OF PENNSYLVANIA INTER-VIVOS TRANSFERS & INHERrrANCE TAX RETURN .ES~C~CECECE~ MISC. NON-PROBATE PROPERTY ESTATE OF FiLE NUMBER John H. Klingler, Sr 2103-0901 This schedule must be completed ond filed if the answer to ony of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PRu~'~K I'( % OF ITEM I NCLL~E ~cE N~%IE OF T~E TRANSFEREE, TrEIR RELATIOFF~FI p TO DECEDENT A~D TrE DA~ DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER OF TRANSFER ATTACH A COPY OF TFE DEED FOR Rfd~ ESTATE VALUE OF ASSET iNTEREST (~F APR. IC,~LE 1. John H. Klingler, Sr. IRA PA State Bank, Custodian 18,221.06 100. 18,221.0~ 2. John H. Klingler, Sr. IRA PA State Bank, Custodian 17,879.67 100. 17,879.65 TOTAL (Also enter on line 7, R~capitulation) $ 3 6 t 10 0 7 3 (If more space is needed, inse~ additional sheets of the same size) s~ .~.4~o~.~ REV-1511 .EX + (1-97) ( ) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John H. Klingler, Sr SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 2103-0901 Del~ts of decedent must be reported on Schedule t. ITEM NUMBER 8. 9. 10. 11. 12. 13. 14. 15. 16. DESCRIPTION FUNERAL 5XPENSES: Stone & Murry Funeral Home - Balance due after application of prepaid funeral trust ADMINISTRATIVE COSTS: Personal Representaifve's Commissions Nome of Personal Representative(s) Sodal ,Security Number(s) / EIN Number of Personal Reprasentat~ve(s) Streof Address City State Year(s) Commission Paid: Family Exemption: (if decedents address is not the some as ciaiment's, atfac~ explanation) Claimaof~ Zip Street Address City State Zip Relationship of Claimant to Decedent Tax Ratum Preparer's Fees Carlisle Glass - window repair, prop maint Enviroquest Radon testing to prepare for sale Lower Allen Township - Sewer/Trash billing Verizon telephone- net of $11.72 refund US Postal Service - Mail stock certificates US Postal Service - Mail stock certificates PA ~unerican Water Co - water service PA State Employees' Retirement refund overpayment CW Fritz - furnace maintenance Lorant's Electric Service - electrical repairs Additional expense listing attached TOTAL (Also enter on line 9, Recapitulation) AMOUNT 218.00 17,000.00 287.00 31.16 120.00 73.35 2.74 3.69 15.23 11.23 185.88 222.95 2,282.78 4,785.71 $ 25r239.72 ST/: PA42021F.12 (If more space is needed, inset additional sheets of the same size) , REV-1512 EX + (-97) ( ) SCHEDULE I COMMON~F-ALTH OFPENNSYLVANLA DEBTS OF DECEDENT, RESIDENTDECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER John H. Klingler, Sr 2103-0901 Include unreimbursed medical expenses. ITEM NUMBER 2. 3. 4. 5. 7. 8. 9. DESCRIPTION PA American Water Company - water service 9/5-10/6 PPL Resources electric service - 9/9-10/9 Harrisburg Gastroentology - 8/27/03 office visit Metro Med Services - Medical Transport 10/17/03 Bonnie K. Miller Tax Collector - real estate taxes net of reimbursement from house sale of $590.06 Members First FCU, Visa Account - Sep 03 charges Robert P. Lonergan, MD - ofice visit 9/23/03 The Medicine Shop -'Medications - Thru 10/13/03 Kathryn D. Wilson, DPM - Nursing home visit - 8/11 West Shore EMS - Medical transport - 9/24/03 Neurology Center, PC office visit - 8/15 & 10/9 West Shore EMS - medical transport - 10/14/03 Carlos DeFuentes, MD - office visit 9/10 Silver Spring Ambulance - Medical transport TOTAL (Also ent~ on line 10, Recapitulation) AMOUNT 14.99 21.26 9.76 88.75 684.56 51.47 20.62 95.87 7.16 55.77 41.58 497.64 9.76 52.71 $ 1,651.90 S~PA42021F.13 (Ifmo~spa~isneed~,ins~ ~diti~sheetsof~es~esize) SCHEDULE J INHERITANCE TAX RETURN BENEFICIARIES ESTATE OF FILE NUMBER John H. Klingler, Sr 2103-0901 NUMBER II. 1. RELATIONSHIP TO DECEDENT D9 Not List Trustee(s) 100% .AMOUNTORSHARE OF ESTATE NAME AND ADDRESS Of PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] John H. Klingler, Jr. 550 Harvest Lane Mechanicsburg, PA 17055 Son ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE , ON REV-1500 COVER SHEET NONLTAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PAET II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LiNE 13 OF REV. 1500 COVER SHEET $ (If more space is needed, inserl additional sheets of the same size) STF PA42021F 14 LAST WILL AND TESTAMENT OF JOHN H. KLINGLER, SR. I, John H. Klingler, Sr., of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and revoke all Wills and Codicils previously made by me. ITEM I: I direct that all my legally enforceable debts and funeral expenses, including all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II: I bequeath any automobiles or motor vehicles I may own at my death, my personal effects, such household goods if any as may be my individual property and not the property of my wife or owned jointly by me with her, and other tangible personal property of like nature (not including cash or securities), together with any existing insurance thereon, to my wife, Winifred A. Klingler, providing she survives me by thirty (30) days. Should my said wife predecease me or die on or before the thirtieth day following my death, I bequeath such tangible personal property and insurance thereon to my son, John H. Klingler, Jr., of Mechanicsburg, Pennsylvania. Should my said son predecease me I direct that the foregoing articles be sold at public or private sale by my personal representative(s), and i further direct that the net proceeds thereof shall be administered and distributed as a part of the residue of my estate. ITEM III: I devise and bequeath the residue of my estate of every nature and wherever situate to my said wife, providing she survives me by thirty (30) days. ITEM IV: Should my said wife predecease me or die on or before the thirtieth day following my death, I devise and bequeath the residue of my estate of every nature and wherever situate, including any property over which I shall have any power of appointment, to my son, John H. ~lingler, Jr., of Mechanicsburg, Pennsylvania. Should my said son predecease me I devise and bequeath the residue of my estate of every nature and wherever situate in equal shares to my daughter-in-law, Doreen M. Klingler, of Mechanicsburg, Pennsylvania, my granddaughter, Andrea M. Klingler, of Mechanicsburg, Pennsylvania, and my grandson, Justin H. ~lingler, of Mechanicsburg, Pennsylvania. Should any of the foregoing named persons predecease me, I devise and bequeath his or her share of my estate in equal shares to the remaining persons. ITEM V: Should any person entitled to a share of my estate not have attained the age of twenty-one (21) years at the time of distribution to him or her, I devise and bequeath the share of each such person to my Trustee hereinafter named, IN SEPARATE TRUST, to hold, manage, invest and reinvest the share so ~received,'and the accumulation of income thereon, and to use and apply the income and principal, or so much thereof as, in the sole discretion of my Trustee, may be necessary or appropriate for such beneficiary,s support, health and medical care, and education (including college education, both undergraduate and graduate), or to make payment for these purposes, without further obligation or responsibility to see to the proper expenditure thereof, directly to such beneficiary or to any person taking care of such beneficiary. Any principal or income not so applied shall be distributed to such beneficiary absolutely when he or she attains the age of twenty-one (21) years. If he or she dies before attaining age twenty-one (21), such share shall be distributed to his or her personal representative(s), discharged of the trust. ITEM VI: All Federal, State and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether passing under this Will or otherwise, including any interest or penalty imposed in connection with such taxes, shall be considered a part of the expense of the administration of my estate and shall be paid out of the principal of my residuary estate without apportionment or right'of reimbursement. ITEM VII: No beneficial interest under any of the trusts held hereunder, whether in income or principal, shall be subject to anticipation, assignment, pledge, sale or transfer in any manner, nor shall any beneficiary have the power to anticipate, encumber or charge such interest, nor shall such interest, while in the possession of the Trustee, be liable for or subject to the debts, contracts~ obligations, liabilities or torts of any beneficiary. ITEM VIII: I appoint my daughter-in-law, Doreen M. Klingler, Trustee of any trust established under this my last Will. Should my said daughter-in-law fail to qualify or cease to act as Trustee, I appoint Farmers Trust Company, of Carlisle, Pennsylvania, Trustee. ITEM IX: I appoint my said son, John H. Klingler, Jr., Executor of this my last Will. Should my said son fail to qualify or cease to act as Executor, I appoint Farmers Trust Company of Carlisle, Pennsylvania, Executor. ITEM X: I direct that all fiduciaries acting under this Will, whether or not named herein, shall not be required to give bond for the faithful performance of jurisdiction. IN WITNESS WHEREOF, I have hereunto this ~'~day of ~- , 1995. their duties in any set my hand and seal, The preceding instrument, consisting of this and three (3) other typewritten pages, each identified by the signature of the Testator, was on the date thereof, signed, published and declared by John H. Klingler, sr., the Testator therein named, as and for his last Will, in the ~resence of us, who, at his request, in his presence and in the presence of each other, have subscribed our names as witnesses hereto. COMMONWEALTH OF PENNSYLVANIA COUNTY OF. CUMBERLAND We, John H. Klingler, Sr., Michael R. Rundle and Mary M. Price, the Testator and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his last Will and that he has signed willingly, and that he executed it as his free and voluntary act for'the'~urposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of his/her knowledge the Testator was at that time eighteen years of age or older~ of sound mind and under no constraint or undue influence. Witness Witness Subscribed, sworn to and acknowledged before me by John H. Klingler, Sr., the Testator, and subscribed and sworn to before me by Michael R. Rundle and Mary M. Price, the witnesses, this ~ day of ~u~ , 1995. Notar~JPublic COMMONWEALTH OF ~ENNSYLVANIA DEPART~MENT OF REVENUE BUREAU OF ~NDIV[OUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003435 KLINGLER JR JOHN H 550 HARVEST LANE MECHANICSBURG, PA 17055 fold ESTATE INFORMATION: SSN: 167-14-9493 FILE NUMBER: 2103-0901 DECEDENT NAME: KLINGLER SR JOHN H DATE OF PAYMENT: 01 / 14/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/20/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $16,100.00 REMARKS: TOTAL AMOUNT PAID: $16,100.00 CHECK# 195 INITIALS: AC SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH DEPUTY REGISTER OF WILLS TAXPAYER A.. B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT I.F]FHA 2.[~FmHA 3. ~]CONV. UNINS. 4.~--~VA 5.1'~CONV. INS. 6. FILE NUMBER: I 7. LOAN NUMBER: 1008-1278a-BOYD-PINC SETTLEMENT STATEMENT 5. MORTGAGE INS CASE NUMBER: C. NOTE: T,.his form i.s fu. ,rn/~he,,d,,to give you a sta. !ement of actual settlement costs. Amounts paid to and by the settlement agent are shown. ~tems marKe(] ~1~0~'.1 were p?d outs/oe the dosing; they are shown here for informational purposes and are not included in the to a s. 1.0 3~8 ( lC/38-12788-eOYDoPINCIN.PFD/1008~ 12788-BOYD.PiN C44 D. NAME AND ADDRESS OF BORROWER: E, NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: Karl Ann Boyd and Estate of John H. Klingler Washington Mutual Bank, FA Steven K. Pincin aJka John H. Klingler, Sr. 227 Granite Run Drive Lancaster, PA 17604 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1756308 I. SETTLEMENT DATE: 9 Cedar Cliff Ddve American Heritage Abstract Camp Hill, PA 17011 April 29, 2004 Cumberland County, Pennsylvania PLACE OF SETTLEMENT 508 North Second Street : Harrisburg, PA 17101 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER; 400. GROSS AMOUNT DUE TO ~ELLFR; 101. Contract Sales Price 133,000.00 401. Contract Sales Price 133,000.00 102. Personal Property 402. Personal Property 103. Settlement Char~es to Borrower (Line 1400) 6,270.27 403. 104. 404. 105. 405. Adiustrnents For Items Paid Bv Seller in advance Adiustments For Items Paid Bv Seller in advance 106. City/Town Taxes to 406. City/Town Taxes to 107. County Taxes 04/29/04 to 01/01/05 370.66 407. County Taxes 04/29/04 to 01/01/05 370.66 108. Assessment~ 04/29/04 to 07/01/04 219,40 408. Assessments 04/29/04 to 07/01/04 219.40 109. Sewer 04/29/04 to 07/O1/04 50.78 409. Sewer 04/29/04 to 07/01/04 50.78 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER I 139,911.11 420. GROSS AMOUNT DUE TO SELLER 133,640.84 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 1,500.00 501. Excess Deposit (See Instructions} 202. Principal Amount of New Loan(s) 131,950.00 502. Settlement Char~es to Seller (line 1400) 1,883.23 ~03. Existing loan(s) taken subiect to 503. Existing loan(s} taken subject to 1204. 504. Payoff of first Mortgage 205. 505. Pa~/off of second Mort~la~e 206. Prepaid Fees 300.00 506. Deposit retsined by seller 1,500.00 207. 507. 208. 508. 209. 509. Adjustments For items Unpaid By Seller Adiustments For Items Unpaid By Seller 210. C~ty/Town Taxes to 510. City/Town Taxes to 211. County Taxes to 511. County Taxes to 212. Assessments to 512. Assessments to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 219. 519. 220. TOTAL PAID BY/FOR BORROWER I 133,750.00 520. TOTAL REDUCTION AMOUNT DUE SELLER I 3,383.23 300, CASH AT SETTLEMENT FROM/TO BORROWER: 600, CASH AT SETFLEMENT TO/FROM SELLER: 301. Gross Amount Due From Borrower (Line 1201 J 139,911,11 601. Gross Amount Due To Seller (Line 420) I 133,640.84 302. Less Amount Paid B~//For Borrower (Line 220) ( 133,750.0( 602. Less Reductions Due Seller (Line 520) I( 3,383 ?Ri ~03. CASH( X FROM)( TO)BORROWER I 6r161.11 603. CASH( X TO)( FROM)SELLER I 130,257.61 gned hereb~ ~Knowleage recalpt.of a completed copy of pages 1&2 of this statement & any attachments referred to herein. Seller Estate of John H. Klingler aJka John H. Klingler, Sr. I L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price $ @ o~ PAiD FROM PAID FROM Division of Commission (line 700) as Follows: BORROWER'S SELLSR'S 701. $ to FUNDS AT FUNDS AT 702. $ to 703. Commission Paid at Settlement S~-~TLEMENT SETTLSMENr 704. to 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee % to 802. Loan Discount % to 803. Appraisal Fee to Washington Mutual Bank, FA 325.0( 804. Rate Protection Fee to Washington Mutual Bank, FA ' 325.0¢ !805. Lender's Inspection Fee to Washington Mutual Bank, FA 75.0( 806. Flood Certification to Washington Mutual Bank, FA 13.0C 807. Assumption Fee to 808. 809. 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 04/29/04 to 05/01/04 @ $ 20.330000/day ( 2 days %) 40.66 902. Mortgage Insurance Premium for months to Washington Mutual Bank, FA 1,950.00 903. Hazard Insurance Premium for years to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 3.000 months @ $ 29.17 per month 87.51 1002. Mortgacjelnsurance months @ $ per month 1003. City/TownTaxes months @ $ per month 1004. Count~Taxes 4.000 months @ $ 44.85 per month 179.40 1005. Assessments 10.000 months @ $ 104.09 per month 1,040.90 1006. months @ $ per month 1007. months @ $ per month 1008, Ag~3reclateAnalys~s months @ $ per month -414.95 1100. TITLE CHARGES 1101. Sefflement or Closing Fee to 1102. Abstract or T/fie Search to 1103. Title Examination to 1104. Title Insurance Binder to 1105. Document Preparation to 1106. Notary Fees to Cash 6.0(; 4.0C 1107. Affomey's Fees to (includes above item numbers: 1108. Title Insurance to American Herita,qe Abs tact Tiff e Inseranc 1~173.7~ (includes above item numbers.l 101-1104, End. 100, 300~ 900 1109. Lender's Coverage $ 131,950,00 1110. Owner's Coverage $ 133,000.00 1,173.75 1111. Insured Closing Letter to American Heritage Abstract 35.00 1112. 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGI~ 1201. Recording Fees: Deed $ 38.50; Mortgage $ 50.50; Releases $ 89.00 1202. City/Count~ TaxJStamps: Deed 1,330.00; Mortgage 1,330.00 1203. State Tax/Stamps: Revenue Stamps 1,330.00; Mortgage 1,330.00 1204. 1205. 1300. ADDITIONAL SETrLEMENT CHARGE{~ 1301. Survey to 1302. Pest Inspection to 1303. UPS Overnight Mai[ Fee to Wix, Wenger & Weidner 15.00 1304. 2004 Count~/TownshipTax to Bonnie Miller/Tax Collector 549.23 1305. 1400, TOTAL SETTLEMENT CHARGES {Enter on Lines 103, Section J and 502, Section KI 6,270.27i 1,883.23 Certified to be a true copy. 3ge receipt of a completed c/q~ of page 2 of this~vo p~ge statement. American Heritage Abstract J Settlement Agent (1008-1278S.SOYD.PINC / l OOS- ~ 2788-~OYD.PINC / 5 ) Borrower: Seller: Lender: Settlement Agent: Place of Settlement: Settlement Date: Property Location: DISBURSEMENTS SUMMARY / BALANCE SHEET Karl Ann Boyd and Steven K. Pincin Estate of John H. Klingler aJka John H. Klingler, Sr. Washington Mutual Bank, FA American Heritage Abstract (717)234-4182 508 North Second Street Harrisburg, PA 17101 April 29, 2004 9 Cedar Cliff Drive Camp Hill, PA 17011 Cumberland County, Pennsylvania INCOMING FUNDS Washington Mutual Bank, FA Karl Ann Boyd and Steven K. Pincin Loan Funding Amount Total Incoming Funds DISBURSEMENTS 128,628.48 6,161.11 134,789.59 Cash American Heritage Abstract Recorder of Deeds Recorder of Deeds Recorder of Deeds Bonnie Miller/Tax Collector Estate of John H. Klingler a/ka John H. Klingler Closing Proceeds Washington Mutual Bank, FA Loan Closing Appraisal Fee 325.00 Rate Protection Fee 325.00 Lender's Inspection Fee 75,00 Flood Certification 13.00 Interim Interest 40.66 Mortgage Insurance Premium 1,950.00 Escrow: Hazard Insurance 87.51 Escrow: County Taxes 179.40 Escrow: Assessments 1,040.90 A~:l.clre~ate Analysis -414.95 American Heritage Abstract 1111, 1303 Insured Closing Letter 35.00 UPS Overnight Mail Fee 15.00 Notary Fees Title Insurance Recording Fees City/County Tax/Stamps State Tax/Stamps 2004 County/Township Tax Number of checks - 8 Deducted Deducted Deducted Deducted Deducted Deducted Deducted Deducted Deducted Deducted 10,00 1,173.75 89.00 1,330.00 1,330.00 549.23 130,257,61 0,00 50.00 Total Disbursements 134,789.59 (1008-12788-BOYD-PINClN.PFD/1008-12788.BOYD.PINC/3 John H. Klingler, Sr. Summary of FMV of Stocks and Bonds October 20, 2003 STOCKS Number of Shares Descdption Symbol Hi Lo 128.704 101.6815 3OO 100 100 102.632 1081.756 209.5954 200 76.741 300 207.4276 209.04 103.627 100 200 102 214.327 250 October 20, 2003 ,BONDS 5OOO 5000 5000 Daily Average Altria Group, Inc. MO 45.500 44.190 44.845 Bank of America BAC 81.660 80.300 80.980 WR Berkley Corp BER 33.890 33.350 33.620 Burlington Resources, Inc. BR 48.400 47.650 48.025 Citigroup, Inc. C 48.610 47.400 48.005 Fannie Mae FNM 73.970 73.090 73.530 Fidelity Ginnie Mae Fund FGMNX 11.120 11.120 11.120 General Electric GE 28.780 28.510 28.645 Home Depot, Inc. HD 36.350 35.800 36.075 IBM Corporation IBM 89.400 88.860 89.130 Intel Corporation INTC 32.210 31.560 31.885 Microsoft Corporation MSFT 29.370 28.800 29.085 Pfizer, Inc. PFE 31.000 30.560 30.780 PPL Corporation PPL 41.010 40.620 40.815 Nasdaq-100 Index Shares QQQ 35.080 34.500 34.790 Vornado Realty Trust VNO 50.600 50.360 50.480 Wal-Mart Corporation WMT 59.140 58.550 58.845 Exxon-Mobil Corporation XOM 38.790 38.330 38.560 Zila Pharmaceuticals, Inc. ZILA 3.550 3.450 3.500 GMAC, 6.60%, Due 5/15/18 CBF4F0 GMAC, 3.4%, Due 05/15/05 CBG3V6 GMAC, 2.6%, Due 11/15/04 CBG3U8 Value 5,771.73 8,234.17 10,086.00 4,802.50 4,800.50 7,546.53 12,029.13 6,003.86 7,215.00 6,839.93 9,565.50 6,033.03 6,434.25 4,229.54 3,479.00 10,096.00 6,002.19 8,264.45 875.00 $ 128,308.30 $ 4,777.50 4,940.25 4,954.70 $ 14,672.45 Last Dividend Payment Date 10/09/03 09/26/03 10/01/03 10/10/03 08/22/03 08/25/03 09/30/03 07/25/03 ·. 09/18/03 09/10~03 09~02~03 N/A 09~04~03 10/01/03 N/A 08/12/03 N/A 09/10/03 N/A 08/15~03 10/15~03 10/15~03 Redemption Date: U.S. Savings Bond Transaction Paying Agent Copy 1/2/2004 Series i EE 2 EE 3 EE 4 EE 5 EE 6 EE 7 EE 8 EE 9 EE 10 EE 11 EE 12 E 13 E 14 E 15 E 16 E 17 E 18 8 lg E 20 E 21 8 22 E 23 8 24 E 25 E 26 E 27 E 28 E 29 E 30 E 31 E ~2 E 33 E 34 E 35 E 36 E 37 E 38 E 3g E 40 E Denomination $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $50.00 $500.00 $500.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $50.00 $100.00 $100.00 Issue Date Se/ 1992 Se/ 1992 Se/ 1992 Se / 1992 Se / 1992 Se/ 1992 Se/ 1992 Se/ 1992 Se / 1992 Se/ 1992 Oct/ 1991 Mar/ 1978 Mar/ 1978 Mar/ 1978 Mar/ 1978 Mar/ 1978 lan / 1978 lan / 1978 .]an / 1978 lan / 1978 ~pr / 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Apr/ 1976 Mar/ 1976 Mar/ 1976 Redemption Value $958.40 $958.40 $958.4o $958.4o $958.40 $958.40 $958.40 $958.40 $958.40 $958.40 $50.82 $1,875.20 $1,875.20 $375.04 $375.04 $375.04 $438.52 $438.52 $438.52 $438.52 $488.24 $488.24 $488.24 $488.24 $488.24 $488.24 $488.24 $488.24 $488.24 $488.24 $488.24 $488.24 $488.24 .$488.24 $488.24 $488.24 $488.24 $244.12 $488.24 $488.24 Interest $458.40 $458.40 $458.40 $458.40 $458.40 $458.40 $458.40 $458.40 $458.40 $458.40 $25.82 $1,500.20 $1,500.20 $300.04 $300.04 $300.04 $363.52 $363.52 $363.52 $363.52 $413.24 $413.24 $413.24 $413.24 $413.24 $413.24 $413.24 $413.24 $413.24 $413.24 $413.24 $413.24 $413.24 $413.24 $413.24 $413.24 $413.24 $206.62 $413.24 $413.24 Backup Withhblding $0.oo $o.00 $o.oo $0.00 $o.oo $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $o.oo $o.oo $o.oo $o.oo $o.oo $o.oo $o.oo $o.oo $o.oo, $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $o.oo $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $o.oo $o.oo $0.00 41 E $100.00 Mar/ 1976 $488.24 $413.24 $0.00 42 E $100.00 Mar/ 1976 $488.24 $413.24 $0.00 43 E $100,00 Mar/ 1976 $488.24 $413,24 $0.00 44 E $100,00 Mar/ 1976 $488.24 $413,24 $0.00 45 E $50.00 Mar/ 1976 $244.12 $206.62 $0,00 Total: 45 Bond(s) $27,982.18 $19,882.18 $0.00 The interest earned on Series EE bonds issued on or after 3anuary 1990 may be wholly or partially exempt from Federal income tax under the provisions of the U.S. Savings Bond Education Benefit Program. For further information concerning the benefits and restrictions that apply, please contact the Internal Revenue Service. MaTBank November 13, 2003 Law Offices' Irwin & Mci(night West Pomfret Profess/onE Building 60 West Pomfret Street Carlisle, PA 17013-3222 499 Mitchell Street, Millsbero, DE 19966 IRWIN & McKNIGHT Dear Mr. Klinger: RE: Estate of John H. Klinger Sr. Date of Death: October 20, 2003 Social Security Number: 167-14-9493 In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with th/s bank the following accounts. Account Type..., ....................... Checking Account Account Number. ...................... 51889668 Ownership {Names of) ..............John H. Klinger Jr., John H. K/inger Sr. Opening Date.... ....................... 11/28/79 Year to Date Interest ................. $14.91 Balance on Date of Deat& ..... $848 65 Accrued Interest $ O. 18 Total ...................................... $848.83 Sincerely, ,7, ,.,,1, ~/0 Charlene Warrington, Associa~ I (302) 934-2722 WagR i n LOOK FOR US. WE'LL GET YOU THERE. ! 1/6/2003 IRWIN & MCKNIGHT 60 W POMFRET ST CARLISLE PA 17013-3222 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death The information which you requested on the account(s) of JOHN H KLINGER (Social Security Number 167-14-9493) is/are as follows: 1000013008 CERTIFICATE 021500 19103.21 39.96 19143.17 Account Ownership JTO Name of Joint WINIFRED A Owner, if any KLINGLER Date Ownership 021500 Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established qOV 12 200) IRWIN & McKNIGHT Additional Information Requested Sincer ! , ERIN WATTS SENIOR SERVICES REP. RO, Box 171 I, HARRISBURG. PENNSYLVANIA 17105-1711 Toll FrEE 1-866-WAYPOINT (I-866-9B9-7646) · IN YORK AREA 717/BI5-4500 · www, wa~pointbank, com ESTATE OF JOHN H KLINGLER ACCOUNT NO .. TYPE OF ACCOUNT OR C/D DATE OF DEATH 10/20/2003 BALANCE ON DATE OFDEATH PRINCIPAL ACCUREDINTEREST 10010007 3984 11339 CHECKING CoPo ], Do $23394.70 Interest include $18221.06 Interest Include~ $17879.67 Interest Include( SAFEDEPOSITBOX AND LOCATION OFBOX DEBITS:TYpE& BALANCEDUE SOCIAL SECURITY NUMBER 167-14-9493 NAMES ON ACCOUNT DATE OPENED JOHN KLINGLER JR JOHN KLINGLER IRA PA STATE BANK CUSTODIAN 'OHN KLINGLER IRA PA STATE BANK ]USTODIAN O2/lO/94 1/17/95 4/18/03 SAVINGS&LOAN OR BANKSTOCK JOINT OWNER(S) TERRY GILL PENNSYLVANIA STATE BANK Estate of John H. Klingler, Sr. Summary of Stocks Held at Date of Death Ex-dividend October 20, 2003 Ex-dividend Date 12/18/03 12/03/03 04/01/03 12/08/03 10/30/03 10/29/03 10/31/03 09/25/03 12/04/03 11/10/03 11/07/03 10/17/03 11/14/03 12/08/03 N/A 11/10/03 12/18/03 10/06/03 11/07/03 N/A Shares Security Description Held at DOD Amount of Dividend per Share Altria Group, Inc. 128.7040 N/A $ Bank of America 101.6815 N/A WR Berkley 300.0000 N/A Burlington Resources, Inc. 100.0000 N/A Citigroup 100.0000 N/A Fannie Mae 102.6320 N/A Fidelity Ginnie Mae Fund 1,081.7560 N/A General Electric 209.5954 0.19 Home Depot, Inc. 200.0000 N/A IBM Corporation 76.7410 N/A Intel Corporation 300.0000 N/A Microsoft Corporation 207.4276 0.16 Pfizer, Inc. 209.0400 N/A PPL Corporation 103.6270 N/A NASDAQ-100 Index Shares 100.0000 N/A Vornado Realty Trust 200.0000 N/A Vornado Realty Trust (Spcl) 200.0000 N/A Wal-Mart Corp 102.0000 N/A Exxon-Mobil Corp 214.3270 N/A Zila Pharmaceuticals, Inc. 250.0000 N/A Ex-dividend Adiustment 39.82 33.19 Total Ex-dividend Additions $ 73.01 Estate of John H. Kllngler, Sr. Form REV-1500, Schedule H, Supplementary Information Date of Death: October 20, 2003 File Number: 2103-0901 Item Number Description 17. PPL Resources - electdc service 10/9-11/7 18. Enviroquest- Radon Mediation, 19. PA American Water Co - water service 11/4 - 12/4 20. CW Fritz - furnace service contract 21. PPL Resources ~ electric service 11/7 - 12/9 22. Sico Oil Company - heating fuel oil 23. Discover card - Home Depot - Home sale sign lettering 24. PA American Water Company 25. Lower Allen Township Sewer/Trash - net of $50.78 refund 26. PPL Resources - electric service 27. Patriot News - house sale advertising 28. PPL Resources - electric service 29. PA American Water Company - water service 30. Sico Oil Company - heating fuel oil 31. CW Fritz - auto feed unit for furnace 32. Safeco Insu'rance Co - homeowners ins net of $107.16 refund 33. CW Fritz - furnace service call 34. PA American Water Company - water service 35. PPL Resources - electric service 36. PA American Water Company - water service 37. PPL Resources - electric service 38. R&R Roofing - roof certification for house sale 39. PA American Water Company - water service 40. PPL Resources - electric service 41. PA American Water Company - water service 42. Home Depot - handrails for house sale 43. PA American Water Company - water service 44. House settlement costs per settlement sheet Amount 14.10 900.00 11.23 179.00 20.12 200.73 8.41 11.33 22.57 21.48 141.60 21.10 10.60 339.80 520.12 72.51 30.00 12.33 25.14 11.53 20.66 100.00 24.07 20.57 15.56 127.76 20.16 1,883.23 Sheet Total ., $ 4,785.71 STATUS REPORT UNDER RULE 6.12 Name of Decedent: JOHN H. KLINGLER, SR. Date of Death: OCTOBER 20, 2003 No. 21-03-0901 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: X Yes ~ 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 X 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? X Yes No do Date: 10/11/2004 Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. Roger B. Irwin, Esquire Name (please type or print) 60 West Pomfret Street Address Carlisle, PA 17013 City, State, Zip (717) 249-2353 Telephone Number Capacity: X Personal Representative Counsel for Personal Representative BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 ROGER B IRWIN IRWIN & HCKNIGHT 60 W POHFRET ST CARLISLE CONNONWEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX '04 SE? 15 DATE 09-14-Z00~ ESTATE OF KLINGLER SR DATE OF DEATH 10-20-2005 FILE NUHBER 21 05-0901 ._~COUNTY CUHBERLAND ACN 101 Amount Remitted JOHN H HAKE CHECK PAYABLE AND REHZT PAYNENT TO= REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-l$47 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF KLINGLER SR JOHN H FILE NO. 21 05-0901 ACN 101 DATE 09-14-Z004 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNTNG FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) (5) q. Nortgages/Notes Receivable (Schedule D) (4) $. Cash/Bank Doposits/Nisc. Personal Property (Schedule E) (S) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. TotaZ Assets APPROVED DEDUCTIONS AND EXENPTZONS: 9. Funeral Expenses/Adm. Costs/Nisc. Expenses (Schedule N) (9) 10. Dabts/Nortgage Liabilities/Liens (Schedule Z) (10) 11. Total Deductions Net Value of Tax Return 155/000.00 170~962.94 .00 .00 471564.91 .00 NOTE: To insure proper credit to your account, submit the upper portion of this form ~ith your tax payment. 36z100.75 (8) $87,428.58 15. 14. NOTE: 25,259.72 1,651.90 (11) 26.8~1.62 (~2) 560,556.96 Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Net Value of Estate Subject to Tax (14) :~f an assessment ~as lssued previously, llnes 1~, 15 and/or 16, 17, reflect figures that lnclude the total of ALL returns assessed to date. .00 560,556.96 ASSESSNENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rata 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CRED:KTS: PAYHFNT RFCEIPT DTSCOUNT (+J DATE NUHBER TNTEREST/PEN PAID (-) 01-14-2004 CD005455 811.21 18 and 19 will IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (~5) .00 x O0 = .00 (16) 360,536.96 x 045= 16,224.16 (~7) .00 x 12 : .00 (is) .00 x 15 = .00 (~9)= 16,224.16 ANOUNT PAID 16,100.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 16,911.21 687.05CR .00 687.05CR ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE~_o A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) ~{.~ RESERVATION: PURPOSE OF HOT[CE: PAYNENT: REFUND [CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Coaeonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Sect[on 2140 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S. Section 9140). Detach the top port[on of this Notice and submit aith your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: RBGXSTER OF HILLS, AGENT A refund of a tax credit, ah[ch ams not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills, any of the Z$ Revenue District Offices, or by ceiling the special 24-hour ansaer[ng service for fores ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). Any party in interest nat satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Not[ce must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZelOZ1, Harrisburg, PA 17128-1021, OR --elect[on 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. Z80601, Harrisburg, PA 171ZB-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SZ) discount of the tax paid is allowed. The 15Z 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 time period as you would appeal the tax and interest that has been assessed es indicated on this notice. Interest [s charged beginning aith 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, 19aZ bear interest at the rate of six (BZ) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 19aZ mill bear interest at a rate ah[ch mill vary from calendar year to calendar year a[th that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year 1982 20Z .0005~8 ~)'~-1991 llZ .000501 ~ 1983 16X .000438 199Z 9Z .000Z47 ZOOZ 198~ 117. .000301 1993-199~ 7Z . O0019Z 2003 1985 137. .000356 1995-1998 9Z . O00Z~7 2004 1986 107. .000Z74 1999 7Z .000192 1987 107. .000274 ZOOO 7Z .O0019Z --Interest is calculated as fallows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR Interest Daily Rate Factor 9Z .O00Z~7 6Z .00016~ 5Z ,000137 4Z .00Oll0 --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. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COHHONWEALTH OF PENNSYLVAN'rA DEPARTHENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP CD1-03) ROGER B IRWIN IRWIN ~ HCKNIGHT 60 W POHFRET ST CARLISLE :.~ DATE 10-1Z-2004 ESTATE OF KLINGLER SR JOHN H DATE OF DEATH 10-Z0-2005 FILE NUHBER 21 03-0901 ~ .... .... ~* COUNTY CUHBERLAND *0~ ~ -~ ,~..:3 - ACN 101 Amoun'l: Rem i'l:'l:ed HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit: ~:o your account, submi~ ~:he upper potation of ~his form wi~h your ~ax payment. CUT ALONG TH'rS LINE ~-- RETAIN LOWER PORTZON FOR YOUR RECORDS *-~ REV-1607 EX AFP (01-03) ~ ZNHERZTANCE TAX STATENENT OF ACCOUNT ~ ESTATE OF KLINGLER SR JOHN H F'rLE NO. 21 03-0901 ACN 101 DATE 10-12-2004 THIS STATEMENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHOWN BELO# ZSA SUHNARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: 09-07-Z004 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 16,224.16 PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUHBER INTEREST/PEN PAID ¢-) 811.21 01-14-2004 09-24-2004 CD003435 REFUND .00 16,100.00 687.05- TOTAL TAX CRED/T 16,224.16 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ZF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR}, YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. PAYMENT: Detach the top portion of this Notice and submit with your payment mede payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF #ILLS, AGENT. -- If NON-RESIDENT DECEDENT make check er money order payable to: COMMON#EALTH OF PENNSYLVANIA. REFUND [CR): A refund of a tax credit, ehich Nas not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" [REV-1513). Applications are available at the Office of the Register of Hills, any of the Z3 Revenue District Offices or from the Department's gq-hour answering service for forms ordering: 1-800-36Z-ZO50; services for taxpayers mith special hearing and / ar speaking needs: 1-BOO-447-30ZO (TT only). REPLY TO: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individua! Taxes, ATTN: Post Assessment Review Unit, Dept. gE0601, Harrisburg, PA 17liB-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. PENALTY: The 15Z 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. INTEREST: Interest is charged beginning with first day of delinquency, ar nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent an and after January l, 19BI will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198g through gO04 are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year 19BZ ZOZ .000548 1988-1991 llZ .000301 ZOO1 1983 16Z .00043B 1992 9Z .000Z47 ZOOZ 1984 llZ .000301 1993-1994 7Z .00019Z ZOO3 1985 13X .000356 1995-1998 9Z .O00947 gO04 1986 lOg .OOOZ74 1999 7Z .OO019Z 1987 92 .000Z47 ZOO0 82 .O00Z19 Interest Daily Rate Factor .000Z47 .000164 .000137 .000110 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUIIBER OF DAYS DF'--LTNQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (1S) days beyond the date of tho assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated.