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HomeMy WebLinkAbout11-14-11 (2) 1505611185 REV-1500 Ex (°2-"' (Fi, OFFICIAL U3E ONLY PA Department of Revenue County Code Year Fil u e Bureau or Individual Taxes Po Box 2eosof 1 ~ ~ ~ INHERITANCE TAX RETURN 21 11 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 204-26-7949 02122011 01D61934 Decedent's Last Name Suffix Decedent's First Name M I KOCHENOUR COLLEEN M (if Applicable) Enter Surviving Spous e's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRUITE BOXES BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (Date of Death Prior to 12-13-82) ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Return Required death after 12-12-82) ® 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) ^ 9 ^ 11 El S 9113 A ^ 10 f i T d . Litigation Proceeds Received . ax un er ) Death ect on to ec. ( . Spousal Poverty Credit (Date o Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT - THIS SECTION MUST 8E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number CRAIG A. HATCH, ESQ• 717-731-960D r..~ First Line of Address 1013 MUMMA ROAD Second Line of Address SUITE 100 City or Post Office LEMOYNE State ZIP Code PA 17043 Correspondent's e-mail address: C• H A T C H a G A T E S L A W F I R M• C O M REGISTER ~ ~L8 USE ONLY ilia ~ '~ ~ -n;y *~ -...'~ r-- i`-- -~ t~ ~ ~-a ,~ G ~ ~s ~~~ `_` '~ ~ r".~ C1~TE FILED Under penalties of perjury, 1 declare that I have examined this return, inGuding accompanying schedules and statements, and to the best of my knawledge and belief, it is true, correct and complete. Declaration of preparer other than the personal roproaentative is based on ell information of which preparor has any knowledge. SIGNATURE OF PERSON RE NSIBLE FOR FI RETURN DATE SHERRY L • KERSTETTER _sL~~~a~- //'/~-1~ nnnoccc P•0• BOX 133 FRANKLINTO PA 17323 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE CRAIG A • HATCH, ESQ - _...,-~ ~, /,, /~~ 1013 MUMMA ROAD, SUITE 100 1505611185 / LEMOYNE, PA 17043 ~R~I~AL F NLYF NLY Side 1 OM4847 3.°00 15 0 5 61118 5 J ~ .. ,~ 17 -- ~_j r': C-~ C' r-rl 1505611285 REV-1500 EX (FI) l)ecedent'siVame~ KOCHENOLIR COLL EN Decedent's Socia! Security Number 204-26-7949 M RECAPITULATION 1. Real Estate (Schedule A) 1 0 • 0 0 2. Stocks and Bonds (Schedule B) . 2. 0 . Q 0 3. Closely field Corporation, Partnership or Sole-Proprietorship (Schedule C) , 3, 0 . 0 0 4. Mortgages and Notes Receivable {Schedule D) 4, 0 • 00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E} 5. 9 , 0 9 0.0 0 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested g, 4 , 2 0 2.16 7. Inter-Vivos Transfers ~ Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. 2 0 6 , 9 9 0.3 8 8. Total Grosa Aasets (total Lines 1 through 7) g. 2 2 0 , 2 8 2.5 4 9. Funeral Expenses and Administrative Costs (Schedule ti). s. 2 3 ,10 6.2 9 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 1 p, 1 , 0 4 0 • 0 0 11. Total Deductions (total Lines 9 and 10) , . 11. 2 4 ,14 6.2 9 12. Net Value of Estate (Line 8 minus Line 11) 12, 19 6 ,13 6.2 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) , , 13, 0 • 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) . 1a. 196,136.25 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers unfler Sec. 9116 (a)(1.2)x.o_ 0.00 t5. 0.0D 16. Amount of Line 14 xable 4~ at ~inealratex.o 196,136.25 1s. 8,826.13 17. Amount of Line 14 taxable at sibling rate X .12 0, 0 0 17 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0.O D 1 a. 0.0 0 19. TAX DUE 19. 20. FILL IN THE BOX fF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505611285 1505611285 OM4848 3.000 8,826.13 REV-1500 EX (FI) Page 3 tlerer~ent'a [_mm~la4o OrlelrnA4• File Number ~ 1. 1.1. DECEDENTS NAME K H N M STREET ADDRESS CITY OY STATE A ZiP 7 4 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 0 • 0 0 B. Discount 0 •0 0 3. Interest {1) 8,826.13 Total Credits (A + B) (2} 0 • Q Q 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3> 0.00 (a> 0.0 0 (5) 8, 826.13 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 properly transferred or its income .... . c. retain a reversionary interest .... . d. receive the promise for life of either payments, benefits or care? .. .. .. .. .. . . 2. If death occurred after Dec. 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. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S.§9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)j. 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 Juy 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9118{a)(1.2)J. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9118(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. OM4671 2.000 REV-1508 EX+ (11-10) Pennsylvania DEPARTTAENTOF REVENUE INI#RITANCE TAX RETURN RESIDENiDECEDENT SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY ESTATE ~: FILE NUMBER: Colleen M. Kochenour 21 11 OW48AD 2.000 If more space is needed, use addkional sheets d paper of the same size. REV-1509 EX+ (01-10) Pennsylvania SCHEDULE F DEPARTMENT OF REVENUE INHERITANCE TAX RETURN JOINTLY OWNED PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Colleen M. Kochenour 21 11 tf an asset t/ecame joNrtly awned within one year of the decedent's date of death, h must be reported on Schedule G. SLRVNtUG JONf TBJANr(S1 tWNgS) AI~RESS Re:AT10FSFPTO OECEI7BYT A Straub, Melanie A 11108 Oyster Mill Road, Camp Hill, PA 17011 Daughter JOINTLY OWNED PROPERTY: R73~11 -~J~ LETTER FOR JOINT 7QrpHT Dore hA4l~ ,~M Ol'~SCRIF'IION OF FRO~'TY INOLUDE NAME OF FlNANGAL INETITViIDN AND BANK ACCOUNT NULlER OR SNAUR IDEMIFVINDNUGBER.ATTACHDEEDraRJOINTLVHELDREALESTATE. ~~ ~ t~TF'1 VALLEOFASSET % OF S INT@iE;ST DOTE OF OEAT}i VALIr£ D~ SMS~ST 1 A 11/10/201 MST Bank, Savings Account #15004208613784 494.59 50.0000 247.30 2 A 11/10/20 M&T Hank, Checking Account #52188221 7,909.71 50.0000 3,954.86 TOTAL (Also enter on Line e, Recapitulation) S 4 , 202.16 aweeaE z.ooo H more space is needed, use additional sheets of paper of the same size. REV-1510 EX + (08-09) SCHEDULE G Pennsylvania DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ...,-.-...... cu Colleen M. Kochenour 21 11 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUM9E DESCRIPTION F PROPERTY N10.lAETFENM~EOF7}E7RAl~AFEREE,TI#IRREUTION6MP70DECEDENTAND ~++E DA7EOF7RM6FER. ATfAOHA00PV OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OFDECD~S INTEREST EXCLUSION IF APPLICABLE TAXABLE VALUE 1~ Ameriprise Financial, Mutual Fund Account #0215391474-1-002, Transfer on Death to Melanie A. Straub, Sherry L. Kerstetter, Robin E. Johnson, Tracy L. Forrester. 17,557.58 100.0000 0.00 17,557.58 2 Ameriprise Financial Annuity Account #93006613461-8-004, Beneficiaries: Melanie A. Straub, Sherry L. Kerstetter, Robin E. Johnson, Tracy L. Forrester 22,010.51 100.0000 0.00 22,010.51 3 Ameriprise Financial Annuity Account #93006613474-1-004, Beneficiaries: Melanie A. Straub, Sherry L. Kerstetter, Robin E. Johnson, Tracy L. Forrester 46,457.19 100.0000 0.00 46,457.19 4 Ameriprise Financial Annuity Account #93008099998-8-004, Beneficiaries: Melanie A. Straub, Sherry L. Kerstetter, Robin E. Johnson, Tracy L. Forrester 65,389.77 100.0000 0.00 65,389.77 5 Ameriprise Financial Annuity Account #93008102539-5-004, Beneficiaries: Melanie S. Straub, Sherry L. Kerstetter, Robin E. Johnson, Tracy L. Forrester 55,575.33 100.0000 0.00 55,575.33 TOTAL {Also enter on line 7, Recapitulation) $ 206,990.38 If more space is needed, use additional sheets ai paper of the same size. 9W48AF 2.000 REV-1511 EX+(10-09) Pennsylvania DEPARTNENTOF REVENUE INHERITANCE TAX RETURN RES~ENrDECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Co]:le~n M Kochenour 21 11 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~, Parthemore Funeral Home ~ Cremation Services, Znc. 12,431.87 Total from continuation schedules . B. ADMINISTRATNE COSTS: t. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP _ Year(s) Commission Paid: 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. 1 PP&L, electric TOTAL (Also enter on Line 9, Recapkulation) ~ 3 2 9Wd6AG 2.000 If more space is needed, use addkional sheets of paper of the same size. 4,523.29 6,000.00 151.13 2 Estate of: Colleen M. Kochenour Schedule H Part 1 (Page 2) Item No. Description 2 Gingrich Memorials, headstone 3 Harrisburg Cemetery Association, care charge 4 Harrisburg Cemetery Association, interment cost 5 Harrisburg Cemetery Association, grave opening and arrears 6 Trinity Lutheran, luncheon following funeral service Total (Carry forward to main schedule) 21 11 Amount 1,064.00 110.94 850.00 2,260.94 237.41 4,523.29 REV-1512EXt(12-OB) SCHEDULE Pennsylvania oEPPRTMENrOF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES 8~ LIENS RESIOENroECEOENT ESTATE OF FILE NUMBER Colleen M. Kochenour 21 11 Report debts Incurred by the decedent prior to death that remained unpaid at the date of death, including unreimburaed medical expenses. 8W48AH 2.000 If more space is needed, insert additional sheets of the same size. REV-1513 EX+(01-10) SCHEDULE J Pennsylvania DEPaRTMENTOF REVENUE BENEFICIARIES INFERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Colleen M. Kochenour 21 11 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECENING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Indude outNght spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Sherry L. Kerstetter P.O. Box 133 Franklintown, PA 17323 Daughter 47,983.52 2 Robin B. Johnson 13 Stephen Road Camp Hill, PA 17011 Daughter 47,983.52 3 Tracy L. Townsend 146 Regency Woods North Carlisle, PA 17015 Daughter 47,983.52 4 Melanie A. Straub 1108 Oyster Mill Road Camp Hill, PA 17011 Daughter 52,185.69 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 8 OF REV-1500 COVER SHEET, AS APP ROPRIATE. [) NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARRABLEANDGOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART U -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET, S 0.00 awaeal z.ooo Ir more space Is neeaea, use aaarclonal sneers or paper oT the same size. Estate of: Colleen M. Kochenour Schedule J Part 1 (Page 2) Item No. Description 5 Debra K. Fasnacht 4816 Orchard Street Harrisburg, PA 17109 6 Denise L. Heil P.O. Box 109 Highspire, PA 17034 Relation Step daughter Step daughter 21 11 Amount 0.00 0.00 SCHEDULE E EXHIBITS .,-2011 TUE 08;26 RM RE 2005 Pontiac Trade In Values, ews -Kelley Biue Book ~ I 7NE7Ar~E05EfO11t~E~ ,i 2005 POn~IdC Vibe Sport Wagon 4D t~+~eege:~tl,ce00 Kelley Blue Book' Private Party Values ~a L . .. .__ . .. - .._.. ~ Vehicle Highlw~ghts ~ MPG: City25MMy31 Max Seating: 5 l)aors: 4 Engine' 4-CyL f-B t.iter ~ priveeratn: FWD •7ransmisslon: Autontat3c ' 1 EPA Class: Cdnpaet bars ~ 9odY Style: Sport Wagon ~ Country of Origln: UiMted Slues I Country of Assemby: uMtad States I Your Configured Options ' our pre~arAeam aoaon<, bated m avK,l etpttwwe~ to nue ~. / oq~nt detyou added wApe ~>m thit cal: ' ~~ i ~ ~-gd,1.8 weer 7Yaaeadatlera i I Auaxwrtie r ptirbaM i FY4D i CONfriIK ind f~elMdNigeOe ~ ~ Ar C~IIRk} ~ ~ / POIM1r We1dDM6 J Pbiner D0a' I.adS ' / (k~iat tbftpd . 9tettde- I Pa~er~eaeg Ttit tYNeat ~ ~aeei~ I i ~ ~~ ~ Lb G+In01C WtC) ,~Irtgand+nan~Al I pint Air mps FRX N0. 7120 3880 P, 02 Page 1 of 2 httv:l/www.kl>b.com/Pontiac/~ribe/2005~antiac-vibeJsport ws~gon-4dP??categaryr-~tvntent=t... SCHEDULE F EXHIBITS Page 1 of 1 Stacey Nace From: "Cavanaugh, Torrin" <tavanaugh@mtb.com> To: <s.nace@gateslawfirm.com> Sent: Thursday, November 10, 2011 2:04 PM Subject: Colleen M Kochenour Hey Stacey, Here is your info. 1. The checking was opened 9-28-1968. 2. Robin and Sherry were both added in Feb of 2011. 3. Melaine has been on both accounts for at least four years. 4. Interest earned is 0.00. 5. The date of death balance was $7,909.71. 6. The savings was opened on 2-18-1993 7. Robin and Sherry were both added in Feb of 2011. 8. Interest earned was 2 cents. 9. The date of death balance was $494.59. 10. Account was closed on 8/15/2011. This email may contain privileged and/or confidential information that is intended solely for the use of the addressee. If you are not the intended recipient or entity, you are strictly prohibited from disclosing, copying, distributing or using any of the information contained in the transmission. If you received this communication in error, please contact the sender immediately and destroy the material in its entirety, whether electronic or hard copy. This communication may contain nonpublic personal information about consumers subject to the restrictions of the Gramm-Leach-Bliley Act and the Sarbanes-Oxley Act. You may not directly or indirectly reuse or disclose such information for any purpose other than to provide the services for which you are receiving the information. There are risks associated with the use of electronic transmission. The sender of this information does not control the method of transmittal or service providers and assumes no duty or obligation for the security, receipt, or third party interception of this transmission. ************************************ 11/10/2011 SCHEDU TSG EXHIBI APR/Ol/2011/FRI 11:36 AM Doris E. Brytz FAX No, 717 432 2424 P, 003 To Doris E Bryt7JFeIdIAMPF~AMPF bcc Sutgea 13788318 COLLEEN M KOCHENQUR DATE OF DEATH VALUES PLEASE DQ NOT DELETE Rivw~3aurce Life dtsurance Company Amorfprlss Financial Comparry 7010p MleiipMo Financhl Gnbr IIAInneUpolis, MN 3+S4T4 Match 28, 2011 bORTS E BRYTZ .J STE 101 11 T RIPIJET'T C'1' D~BURG, ~A 17019-9490 Dear D(?~S E BRYTZ: Tbaz~k you for your recent inquiry regarding COZ,I.EEN M KOCBENOUR's accounts. Thesc are the values of the accoimta as of 02/1,?J2011. Acco>a~nt In#olrmat~on Mntuul Farads Q l AfCCAllnt 1 llm mr 02153951474 1002 IQdivic3wl- x'O]7 Anusaltia -post 1985 N b A " ccount um cr 93006613461 8004 w s Individual 930066134741004 Individual 93008099998 8004 Individual 93008102539 5004 lndividual Muta~uX Funds Ac~ountNumber ~'otal Value ~ Asset Valve Per Share 021539514741002 $17,557.58 4,372.083 $ 4,01 Awtnitfes ~ Post 1<985 Account Number ~'otal'Valuc 9300b6134618 004 52,2,010.51 930066134741004 $46,457.19 93008099998 8004 $65,389.77 AFR/01/2011/FRI 11:37 AM Doris E. Brytz FAX No, 717 432 2424 P. 004 93608102539 5 004 $55,575.33 The date of death values pxovided are for estate tax purposes sad are not a value m be paid. Accoatrts. tray be subject to ~aaarbet flactuation as governed by each product Please note that the values indicated for any Life Iasura>1ce pmduct(s) wi#It We inszued deceased xeflect the gross death benefit at date of death and aot the cash value, Values indicated for Life Insazance Products wxtlx oWdy the owner daxasod reflect the cash value as of the date of death. Values for any proprietary mutual funds include accrued dividends as applicable. 'V'alues pmavided for brokerage products are maa~ually calculated, and should be used as esGimuttea only. 'I'ha prices used to provide values are eatlnnaoes obtained from outside sources believed to be reliable. A~iprise 1~iz~avcial pt,vvidea these vsalues as a service to its clients. Actual va1-tea used in preparation of tai[ returns or for pL'mniuatg purposes should be verified by your leYal aad accoutuirlg adviseas. '~'e appreeiau the oppordmiry to be of service to you. Please contact us if you have any questions. Sincemly, Kat+Gn Fabros Heath Settte~nts Pmcessiteg ream Ameriprise Finaacia}. Center MianeapoIis, MN 554'14 1-800-862-7919, Option 2, ask for Estate Settlements Please do not reply to this email. This database does not support incoming mail. Please Call the phone # witttirt the letter it you require assistance. Thank you. Life Evenis Team Cliegt ~~vr~r gd~isorCompasse • Account Protiie -FIXED RETIREIAEN f ANNUITY - VP ~ ~~~ Aocaunt ProAb J ~Gd>,e ~ ~ ( Amoam~ o add and ttainaa~orn es. Pnvioua Account ~ nershi ~formatlan *: 0930 0681 3461 8 004 nt Status: ~ bato; M 1/2000 OLLEEN M KOCHENOUR T • ON-QUALIFIED T1N: 28-7949 s Current c: ~ss+ocfetad Grow IDs - SMlict Grow Account List iD 393 1474 0 001 USEHOLD PRIMARY BENEFICIARY MELANIE A 3TRAUB DAUGHTER SHERRY L KERSTET'C'ER DAUGHTER ROBIN E JOHNSON DAUGHTER ~ TRACY L FORRES'('ER DAUGHTER EQUALLY, THE SURVIVORS EQUALLY, OR THE s6m se of Aai/AQMA91 Dint Casa Value: 1~- Be~~; NOT APPLIC oR81 PtXChasra Pa ~ ~• rnhase Pa within Last 10 Da • nterest Rage: 3• un+endar value: ~zz 184. Available w/o Surrender ~• 1 ~• rr fwRw~w~~itia~ x Af AUf19/9A41 n~rNum Tax Raluna: o• ail End Tax: axable Inoome YTD~ •31 axatrle Income TTD: 11858. TeFi a Contrtbudons: r~Tefra Eaml SO.0 eira ConMbutlons: 013_ aka Eam s: 148.5 3A 12/31/88 Amount: NOT APPLIGAB Amount YTD: ~. Tax Nes: Client Viewer Cliorit Viewer AdvtsorCon~sse Acaaurrt Profrb - REf ADY V ANN NQ mount profse ~ ectiadbc I ~ Am~ariprisc i~weaTnt ~>a~]EGn~a~ o add .nd , use the es. Previous Ae~nnt i~A~. ntrshi Inforn~atlon #. 0830 0861 3474 1 004 t Status: ~ Date: 7p72000 i : U.EEN M KOCHENOUR T N-GtUAL1FIED TIN: 04-26-7849 . s CunBttt e: sad associated Grow tds Select Grou Accaurtt fiat T 396 1474 0 001 OUSEHOLD RY BENEFIGIARY R~L1°Q' Seel~~g "^`°ti°" IIE A STRAUB DAUGHTER ;Y L KERSTE~ITER DAUGHTER E JOHNSON DAUGHTER L FORRESTER DAUGHTER LY, THE SURVIVORS EQUALLY, OR THE aiue as of x5/4813011 - otai Cash Value; 71 p~ gam; NOT APPLICAB otal Pine Pa manta: 102 537. with(n Last 1 A ~• landed Intenast Rate: vne Fund Blended Interest Rate: 0° utrender Vdue: 7164 urrender Charge: Includes a of S3o.oo> 530. AvaNetb wio Sun~ender Ch 7184 umpnder3ohedub: 10 Y siimated Death 8ar>eflt: 1'~- ax lnfarmaSon as of 05J09/2411 axaWe income YTD: 633. ~~ Inoome -Rp; 15930.8 efra CortiMbutions: re-Tsfra mi efia Contri ons' $48 358. efra Eami s: ~' `Client Viewer Client Viewer ~~~ AdvisorCompass~ Account Profile - RVS RAVA 4 ADYANT N4 Clraa]etmdo~c aocau~ Pro61e I Ar.~d4e ( I o add and rseu use the nb s. Previous A~runt ~.A •rslei Information (/: 0930 OB09 9998 8 004 siaa~: Tlv~ oar: moos erah' : EEN M KOCHENOUR ~ T N-QUALIFlED TIN: 26-7949 s Current e: MELAINE A STRAUB ELQEST DAUGHTER SHERRY L KERSTEfTER MIDDLE CHELD R0131N E JOHNSON MIDDLE DAUGHTER TRACY L FOfZRt:STER YOUNGEST DAUGHTER EQUALLY, THE SURVIVORS EGIUALLY, OR THE SURVIVOR slue as of as/o8n011 ofal Cash Value: 0~.7 ~n g~~; NOT APPLI a4el F'a meats: 1 ~• r+chsae Pa wffttin Last 10 D s: A: ~- lended t Rabe: 0 one Fund Blended Interest Rete: 0 der Value: 491. urrender Charge: I~edudaa cha o1 30.00 x,807. Available w/o Surrender Cha e: 489. Schedule: 7 Y stimated Death BeneRt: ,690.31 ax information as of 05/09 12011 axable tr-corne YTD: .0 e In~me TTD: ~• re~T Contr~t~iursa: Tatra F_amin efra 'butiaris: ~4 efra s: 812 Ciierrt Vlewer AdvlsorCompass~ Aooamt Profits - RY8 RAVA 4 ADVANT NQ Accourrt Profile ~ ,AGtiYlilt ~ ~ A-r~ o add and mod tran Cho s. ~ylous Account Last Accquftt neraftt in#armatian t #: 0830 0810 2539 5 004 nt Status: CTIVE ed Date: 8 i : LLEEN M KOCHENOUR T e: N-GIUALIFIED tad TIN: 26-7949 sC t PR{MARY BENEFIGARY Renuest~rwginc Corm O MELANtE STRAUB ELDEST DAUGHTER SHERRY l KERS'i'l=LTER MIDDLE CHILD ROBIN E JOHNSON MIDDLE CHILD 7RAGY FORRES7Eit YOUNGEST DAUGHTER EQUALLY, THE SURVIVORS EQUALLY, OR THE SURVIVOR ~tuo es of 03JQ9/201 f oRal Cash Vahte: 3'~6 799.01 oan Belence: NOT AP'PLICABL crtal Purchase ts: $66800. P menu within Last 10 Da MVA: ~. lntenest Rate: Fund Blended tnteest Rate: OY txren ale: $63 691.8 un+endor Charge: tndtld+~ Contract cha of .00 $3,107.1 unt Awallabie w/o Surrender Cha e: 51 9 ~ gee; 7 Y ay p~ Ber>efit: $b7 089.2 ax lstformaHan as of Q5l09 01 f e income YTD: $4 553.01 inc~orne TTD: 563. 1 T t;,Orllfibutions: ~• re-Tetra Eami s: g~ COntrtbudon3: 354 7 .1 efra Earni `~•8 Client 'Viewer Client Viewer ~sorcompass® ,4ccourrt PrvFb -TAX-EXEMPT NI IN - A Account PeoNk ( (chedrs Isswd Aroearipxis+e t o fieelrfi tritnackions. ua the Y6. hi Infonnalion nt #: 0021 a39S 1474 9002 Status: NACTIVE cd Date: 8!2000 naCtivo bate: 1!2011 LLEEN M KOCHENOUR TOD T ; ON-QUALtFiED TIN: 6-7!949 s Cum3nt ~aaociated (iron iDSt - SQiwt Grou Account List ~+ou 1D 1385 1474 0 009 USE t-D :Y BENEFIGIARY LAWFUL CHILDREN IN EQUAL BRAKES etas as of 11/OSPZ011 Date n$rloov Furl Amount .00 Rlek Amount .00 nt ava~bls for ~ Idatlon Inlormatlon as of 11l09/2~11 herea: .000 NAV: 0 Value: 00 Plus Accrued Dividends: .00 rose Value: .00 i_ess CDSC Amount: .DO datlon value; .00 vestment information idcor S NHYX IJSfP Number. 88919807 Vahw: ml~ed ROA Value: .00 seer Of Intent mitment Amount: of Available rohases widfin 90 NOt Av~lable rchaee Cnsdib: Nat AvaUable OI Eacrow Shares: •~ SCHEDULE H EXHIBITS Parthemore Funeral Home & Cremation Services, Inc. P.O. Box 431 1303 Bridge Street New Cumberland, PA 17070-0431 (717) 774-7721. Mrs. Sherry L. Kerstetter P.O. Box 133 Franklintown, PA 17323 Statement For the Service of Colleen M. Kochenour DATE 3/31!2011 AMOUNT DUE AMOUNT ENC. $0.00 DATE TRANSACTION AMOUNT BALANCE 01/31/2011 Balance forward 0.00 02!14/2011 INV #2310. 12,43].87 12,431.87 02/1b12011 PMT #8439, tec from Colleen M. Kochenonr -1,000.00 11,431.87 03/28!2011 PMT #9002. nec from Sherry Kerstetter -1 l ,431, 87 0.00 ~,,~ C ~ 1 CURRENT 1-30 DAYS PAST 31-60 DAYS PAST 81-80 DAYS PAST OVER 90 DAYS AMOUNT DUE DUE DUE DUE PAST DUE 0.00 0.00 0,00 0.00 0,00 $0.00 Please don't hesitate to call our office if we may be of assistance. Thank you. ~ • zn rzc _ 2- ~v3 f ~ _~ ~. lyj~yjf~~(S $>tnCe I921 Drawing -' Drawing Sent to Cust. Approved .5243 Simpson Fe»y Road, Mechanicsburg, PA 17tJ50 Found: By -Found: Ordered (717) 766-5b22 • Fax (717) 766-8007: Vendor At;k. # www.gingrichmetnorials.com _ • _ ?Grave Position Verffied `' ' Cremation ~ "' ... ~: . ~. . SOLD TO: ~ ~ F;, ~ ~~ ~ ~ ~ - _ Date of Order. )`~~ ~~* ,:: i `~ , ^~: ~~ ! t - _ ~. - , , r ~' '~~ t-. . ~ , ~~' .Cemetery. ~ ,~~t~ ~~ , ti~~ ~ ~ ; Cemetery Location "< ~' ~ -Phone , ~-~ ~ , '.; 7 ~ `. ~ a ~ Ce0 - • ~ Center Over ~ Graves .Sec. !Lot # Email - : _ ,; • Approx. Date of, Completion ;~. .~ ~~~ Lettering - - g ,~, x~i _ t tag - ~ ~...: ,.:., ~ ! ,--> ;p.__ •. i f1 E. ' ~. ,: erairas>ws...r.araw.rs>+urasvv.ywr..nan.wn^.~~+~+.~.•-••mnwwarw.+ax~w..+.4.w+• .e...iv~wwe,vrs ~.. ~ . Type ~ ~r~~ ~~ ~s~:i"~#~ Mat®rlal r~>f~;~~~t'~ ~~:zrr~,~~ ` '~~`~t.=~,~ ~(~~ ±'t?~z i e.. Additional Lettering Size .~ X ,': ` i _ X Finish _ ^ Back ^ Base n _,; ,~ ~ _. , .. ~F~ i _ . ,. , ~tze X ~ X =~ Finish p {,~.,~• .n ~ . ~: ~. ~ ~,,,; ,.: ... . - a Description - _ Location on Cemetery ;~,:; ~" :~ ,~ :,, ,° i. ,~ f~;s , ~~, ~ r. (: d .Vase ^ Photo ^ Other _ Agreemer>t: A SO% deposit Is requlredto commencement of work.- ~ - COSTSZ Agree to pay stated balance upon ereotlon regardless of labor troubles or shipments or any. other good reasons. Thin orcJer or Memorial . $ ~ ` ~. ~ `~"' ooMreot oanrwt be cancelled by ouetomer unless agreed by both parties. The article herein mentionedshall remain the property of ` - s ~.: Jantee R. Q1ngNOh Memartals until paid In full end tfiey reserve the-right to remove the same is no# paid ea stated. FOUndation ~ $ ~ ~ ~ .. " spree to carefully proofread all names and dates for accuracy end accept toll resportsibiiityfcr any errore or omissions: THERE .Cemetery F8@8 $ Wq.L dE AN ADD1770NAL CHARQE FOR ANY LETTERlNQ ADDED TO THIS MEMORIAL AFTER ERECTED ON THE _ - _. - {R'Y - $ ~ further agree to pay the batar>ce stated-for the work perfom-ed under this contract within thirty (30) days of receipt of the tlnal nvoce and further agree that interest shah accrue at the rate of one-and one-half percent (116%) per month on the unpaid balance $ ~rYad to James R. OingrichMemodals not paid within thirty (30) days of the invoice data. In addition thereto, (agree H h becomes , _ $ teWeaery for James R. Oingrtch to lnetitute legal proceeding to collect any funds due from me for my account being past due thirty 90) days, to pay as court caste and atlomeya fees Mcurred by James R. dingrich Memortel8 to collect the same. TOTAL - , •: $ F ~•' :. ~ _ - =- sealer DEPOSIT $ .. ' ;uatomer ~. Balance Due $ . ~ •=_~ ( - . ,, - (l further agree that the above names, spelling, and dates are correct) Upon Completion . HARRISBURG CEMETERY ASSOCIATION 110 Bergner Street Harrisburg, PA 171 10 June 30, 2011 Ms. Sherry Kerstetter PO Box 133 Franlclirrtown, PA 17323 Please return this invoice or indicate lot number when sending payment. Make checks payable to Harrisburg Cemetery Association. Lot number: SZ 22 & 3l EXPENSES: Mairrtenarrce ~ 110.94, Trees, Slu-ubbery, Ivy, etc. Clearurrg Markers, Monuments, etc. Flowers for Special Occasions Miscellaneous TOTAL EXPENSES ~; 110.94 LESS CREDITS: Income li-om Trusts, Endowments, etc. $ 0.00 BALANCE $ 11().94 PAST DL1E Accumulated past due amount $ ~~a( c~ ~~_ BALANCE DI1E :6 110.94. ~/aa/~f Gt* 900 9 We hope you would consider providing for these expenses by adding to dre funds already set aside for dus purpose. While we ar-e unable to predict the extent of future irrflalion, we believe dle endowment should be large enough so drat die income (at 4. percent) will cover current TOTAL EXPENSES (see above.} From dris recommended endowment figure, you would, of course, subtract arry endowment we already established (see amount under LESS CREDITS above.) This does not have to be paid at one tune. You may make payments over future years but we urge you to make a start. ~ N ~~. w s ~ i~ .~ ~ ~. n t w . ~ ,- N jA~G,'i w ~! k ~. .^.~~ g ,~ ~ ~ ~• s y .k ID ~ Q ~ ~ ~ ~~ ~i ., r. o~r'w. ~ ~- . ~~tJ r~ ~ '~ .~ ...~.+..or~+°w~es+~''~ TELEPHONE (717 737-7231 HARRISBURG CEMETERY ASSOCIATION 13T"AND LIBERTY STREETS HARRISBURG, PENNSYLVANIA 17103 REPLY MAIL: 110 BERGNER STREET, HARRISBURG, PA 17110 February 18, 2011 Ms. Melanie A. Straub 1100 Columbia Ave.; Apt. 3 Lemoyne, PA 17043 Re: Colleen M. Kochenour Lot SZ 22 & 32 Dear Ms. Straub: Please accept our sympathy in the loss of Colleen Kochenour. We have been advised by the Cemetery Manager that payment was received for the prior annual care charges due, but not the actual interment costs. Therefore, we must contact you concerning payment of the outstanding interment cost of $ 850.00. Please make the payment payable to Harrisburg Cemetery Association, and mail to: Harrisburg Cemetery Association 110 Bergner Street Harrisburg, PA 17110 If you have any questions at all, please contact our office. Very truly yours, For Harrisburg Cemetery Association /s ~ .r+ r~ypp~~,~ ~4 C'a ..r+ •r ~A ~ w.~+M' ~ a .. Vag,,,, .... ~ ... ~""~ : , y, ~ M n ~ ~~ i ` ~ *r ~ 3 ~.~ N /` ~ ~2 i ~s ^ J ~ ~ "II ~~~ ~i ^ ~ ; ~M ~ 6"• ~ I .~ r --~-z---- - -.a..d..:r.. - - 3z aar s~ COLLEEN w1 KOCHENOUR ~'u 8438 ~ MELANIE A STRAUB 110D COLUAABIA AVE APT 7 - LFMCYNE, PA 170iJ OMIN i ~~;;a ~ ~~l~tr' ob $ da Lo:q~ ii ~~`~.ou+v..Aw~ -iwo ~~ s~Z'4'r g..~ ~"~ i, w~+«Axs 8 ~' ~~ /c~a1MdTBank , ~ wow~~!tA1y Sd ~ Irl~Q, l..('~ cl~ i~ x:03 i 30 295 5~: 5 2 i88 2 21M84 38 RlVTERSlAE~031 11 » `- -O1L5g0120t . ` 1 1 of 1 n ,_„_.-- •c; W r jj! 0 ~~ 1P N r M a 3 t O _ ~T ;, ~~~ • '` ~t~ ~'G. M J i ~ _ !~ ~ O ,~~~ x r.. ,;: v~ 4: '.~ :F r fL w v~ ~ r va o °uN r ~f; 0 r • y~ `~~ d ~~ i.l":t t~W ~ dM _ ~ r;~ . WM %- ~ ~ Q O ~ "..L~ ti ::~ ~ R ~ ~ ':.. ~ OC o~n ~ I"1'y laW ~~~ ,..- .. ~+ -- ~' 1 r ~ ~_ ~' ~ o ~ ~ v u r- •- o oc ~ u W O ~ ~ W O M J .+ d p,tnr•1 r-•- 00 [ICJ t. trG GG- u+ln NN- TIT • . tl.l MA....'.. w.. •.U1.::..• .. 4• • ~ 11: ~i 1'R p ~ M®~ f1f ~ O W ~; r-~ : `t `' 8 ~, ~ °a >= y~~ ~ ~~~ a ~~ '~ . ~`' ~~ ~~ ~- _ , ~~~ c. _ j ~ ~j~ myr j 1~l •• ~ w ~~ ~ ~ ~~ ~~ ~ ~~ ~~ ~~ _~ =~ ~i ~ ° ~ I~ :a~~~~~ - SCHEDULEI EXHIBITS ° ~ ~ ~a a ' ~ ° r t ~ O w~ ~ ~ .a ~ , ;~ r ~ i f ~ • ~ ti A ti O ~ ',e ~ ~ ~ o ~ 1 o ~ Q 4 i so r ® ~. o O ~ o ~, ., t o, , .. ~ 1 y n •w n+/r.~• mn.x .•. •s •e~r.w~l• ./.~.~ , . .. _. . ~~ f of ,.+...~..v. ~!' n7 wer..r....~+ wi..+~./• +..+w.+. q r ~ i ~ X J ~ • • J • ANN i ~ V "~ ~ {~ J •Ji ~rN ~ • ~ t t N • P V V i ~ -+ r iWt•.nLL IM)t .d MrlalW duVii Luw1~w1170 ~, •~,~ .a90£OLfLttR Ol£tZZZSC£ 1 SY1 xll W L,p~ ~V p ~8 ENO M.~Q pd. _.._.._.._~_ n DEATH CERTIFICATE __ 15.805 REV !01107} LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. e for this certificate, $6.00 t ms is to certtry mat me tntormatton Here given is correctly copied from an original Certificate of Death l duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. P 17047723 ~~~-~~ FE~.1e~o11 Certification Number Local Registrar `'` Date Issued REV w2oad COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAI. RECORDS wAN~arr" CERTIFICATE OF DEATH use PR (Sos InsVUCtlons end sXNnpIM on TWM!!t) STATE FILE NUMBER 1.IMmddoederl(Fiel nadd,, Wleuahd 2.8r 3.8afel S•ca0! Nnba t. Wb a Dsdr IAfaeh~ mY~ yal Colleen M. Kochenour Female 204 - 26, - 7949 February 12, 2011 S AaY ~ BMideJj IAtaa f UM~r t 8. Ode d Bkm Manor 7. feldeYee a as Prp d Orai ar Yarw 0•M Nan Alper FbepNd: Qarr: 77 y,~ January 6, 1434 Harrisburg, PA „~,„ ^~/ ^~„ ^rr~,,,,,,,e ^Rearnr ^omaso.dy ae. Oaehh d Deem Bc tae( Ba0. Twp. d OWh B6 Fl~ly flan! (M Hal IiMWlaaq aNe •eel epanNrtal 1. Wr Deoedere d 1flePerdE ArlynT Nb ^ Yr 10: Ras: Amaken bWr, BNCk, Wllb, see: Cumberland. E. Pennsboro Twp. Holy Spirit Hospital (i FrroPo~an,.b.) ( White 11. oera.ly urw d.ra-m. dead ra Oo Haar iz wr Deedww ewr h ar 1s DeaerlY EMr6ae 1~+N ~d aus• ~Naal u. Mad ~ Mama, u. samhe saarr m wN.. aw awaa, ar,,.1 Klda Wak rands BuWrp/IndtaYy U.s. Annr FoRr? ply 1 Y lo-1?? CaMpe (1~t a Sr) -Sales Assistant Retail Cameras ^rr ®Na 12 1 Widowed +aB.a.aar.MrroAeew(sa.a.anrfrrl,ar,~aaaal °r°al'irs Pennsylvania u01d„m°e0led"" na®va;oe,aaaliweah Lower Allen T,~ ~ s°"'M1Ct7L~1e 1100 Columbus Avenue, Apt. 3 " Naawahln ~ f Cumberland. Ttl'"""D? na ^ Lemo a PA 17043 ~ d cylearo 'Tb~~ 16 Fearte lrnr(FM, mPode, rel euNlr) 19, lAOarce rlar (Fbd, mbde, nWOen eurrrr) James P. Cowan Mar aret Pierce Dorwart 2!Oa NraprlY Ntpne RyP• 1 plel - 20b. haanma'e Mena Aadlr (9tlee1, lly I mrm, ~, eepcode) Sherr L. Kerstetter P.O. Box 133, Franklintown, PA 17323 2taAINbOdOrpaMon a ^(y,restbn ^Darbn 210.0erdDYprabr(Maah,ay~yrr) 21t:RaaaDtepaltlat(NardrmeMy~arrayai~arrPros) 2ldlatetlon(Caylban,dM,tJpaoae) - mss'"" ~ Ra"°~110ma" ~ Y February 16, 2011 Harrisburg Cemetery Harrisburg, PA 17103 r ca ^ Yr^ No ^ rls Brl P7a 9prnr d tloares D•r•a^ eodg r IaAI 220. Lkwre hMAnba 22a Nrr rd Addnr d Fedey ~ FS 012 849 L Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070 Cunprleaar.29ec aaM/Iq 29s.7o4r.. nryrnwrdpe, deem ached star drm,da uidWr•erYd.l~••raPlMl. 28b. tkenr Neulrr 25c Dees Sgrad (Afardh; dell, Y'M p1yM^rrernal ereae6rd ddeemb ortly ewer d aeeae. d~bP~n~r aueh'D~ 24. Trr d Deetlf /~ ~,. M. 2a. Dre Prarrornoed Ertl (Morph, dry, yeea a~ I o~ c~~ I 2d Wr fir ReMM Mescal EeemA'rr / Carorier Mx a Reeean Otlrr tlrn Crenran a Oanron? ^Yr G No CRIME OF DEATH(Dr Irettre,Gloru raAOalmPMa) r APPntlrtd• laerval: Mra 2T. PeA l: EMa ar dIW.dNOd-4es•ee~ inM•MA a aanpM'Wau- melal•eaP oared ar rWr. 00 NOT enea tenn4ri evsi# each r rrdeo anal i Qrt b [rem 1: aarr bd nd rrddrp h the uMalylrp rrr a~ h Paa 1. 26. Dk Torso tre Cmtrlbur b Oeely/ ^ Yr ^ FnwbM - taepYebry emd a wuakder wlaprA ar •aabOY• LM ar our on eeah M. r ^ No ^ Unbawn ~A ~,~y~9E ~y a r i 29. N Femde: mdlr reaAhO la aerq _ j- e rt ^ Nd rd wNNh /er . - Dwb(are r r y p pg ^ Frpmd name d seam BgriM/ Y1 wN1ar. a aM, b ~ ^ . ~ bIMEIFJILTfp CAl11E a. Drr b (a r e oarwpwb aQ: I Nd pr,p~enl 6ul pspint wgNia d2 hye d deem (deer~a arlYMerdar r y~y a r ea wM twl ^Nd ebt M^f 13 da r• . eWa naA IAi it deeM! IAST. dr b (a r e oareVaar al~ i y preg , P Y 9 atlas deMh i ^ Unaioam Y Pr•aa•m wahh dr Wa 4w d 3fh Wr r Nappy 30D. Was AtAopey Fhdnae 31. Maur d Deetlr 71e. Da d MiN7lAfareh. sly. yeea 32b. 0eedme Haw NaP (kand 32c. Race d Injry: ebme, Fam, Slresl Faddy, OMr Srdldrq, ek. fsh•a'Yl RaAarmd7 AvrehY Pria b CangelM m7 d t1 d C ^ Nr+al ^ llomkld, . Breeyy ^ Yr Ill Nb r rr ^ Yr ^ Wo ^ AcdtlNd ^ PerrdYp tnretlpetlolr ~' Time d Iryrey 92e. Iryary tl WaM 32f. N TraYpoNYOn ~ (SpeaPy) •r ^ t4aeeeAr b ^ perar /(I ^ Da 32¢ laaeaon d u(ay IStnel oy / torn, ~•) ^ Sdtlm ^ Coral Not M Dernmred M ^ Yr ^ No pere r a eer ~' ~•~' ]8s Calms (dredt ony ar) 33E.91pnere ahTllr d 0 PM•ler• (g7err• oeNyYpaeur d deem rMOn arisarr PI~Y•b•• hr Praisers dedh ercl mrtplerd Irtn 23) deetlr oeeulM drbiM nryl)eM starrrded_________________________________ ^ • Toth 4ddny WgaMdOe . • pn••a•ra•YeMaatlryYr pM•bb•(~Y~~P~tl^a deem and aullyhpbaarddeeM) 39G 33d. Deb ~ •+~ fy ~ ~. ~ TetlrhMdgrreea0p,tlrmaaurreddlM ifrel,der, sad prep,aM drlolM rwe(grM ernnerrerrd._^________^_____. ^ • ` L . • Yeded Fi•earr/Calar OnIMlrrdeeentYrrr erd/a Nweealdlon,hnry opMan, hlM asrrtl dMetlr,aa,ea6 Prr.eM arblM e•rNd eeA aerrrerrd. ^ Orm(Irm 2>f Typel m Who Can a d Aldred Mre ed Caw 14. Name a d N + ~ ` , 7, ~ L , R n~ ( ` ~ RepYf'eh -ae'd'w~i ~~ ~~ ~ ~ ~ ~. Id I ~ ~ ~ 9&De1eFYd(~q•~ dy, r••n '/ ' m.MG l'o'r ~ t nre'}7 •f^ PA 1 ~ o ~3 ~ G~'7wo ~ v S L . ~ P , w DhPaeabnr«mlNo. ~4~.~~ LAST WILL AND TESTAMENT LAST WILL AND TESTAMENT C E O I, COLLEEN M. KOCHENOUR, now of 425 Hummel Avenue, Lemoyne, Cumberland County, Pennsylvania, 17043, do publish and declare this to be my Last Will and Testament, hereby revoking all other prior wills and codicils made by me. FIRST: Fa i y Baclground and ARpointment of Executor. (A) Fami y and Background Information. I am not currently married. My children are MELANIE A. STRAUB, SHERRY L. KERSTETTER, ROBIN B. JOHNSON and TRACY L. FORRESTER. My stepchildren are DEBRA K. FASNACHT, DENISE L. HEIL, DIANE KOCHENOUR and ROBERT H. KOCHENOUR. Throughout this Will, MELANIE A. STRAUB, SHERRY L. KERSTETTER, ROBIN B. JOHNSON and TRACY L. FORRESTER will be referred to as "my children" or "my daughters"and DEBRA K. FASNACHT and DENISE L. HEIL will be referred to as "my stepchildren" or "my stepdaughters." I decline to make distribution to DIANNE KOCHENOUR and ROBERT H. KOCHENOUR. (B) ARgointment of Executor. I appoint as my Executrix and Successor Executors (all hereinafter referred to as Executor) under this Will, the following named persons to serve without bond and without being required to account to any Court: Executrix: My daughter, SHERRY L. KERSTETTER. Successor Executors: My daughters, MELANIE A. STRAUB or ROBIN B. JOHNSON, to act jointly or individually. SECOND: Funeral and Last Illness Exggnses: Taxes. (A) Exeenses of Funeral and Last Illness. I direct my Executor to pay my funeral expenses and the expenses of my last illness from my estate. (B) Taxes. I direct my Executor to pay any and all estate, inheritance, succession, legacy, transfer and other death taxes or duties, by whatever name called, including any and all interest and penalties thereon, imposed under the laws of any jurisdiction by reason of my death, upon or with respect to any and all property included in my gross estate for the purpose of such taxes, whether such property passes under or outside of this Will, out of my residuary estate, without being prorated or apportioned among or charged against the respective devises, legatees, beneficiaries, transferees, or other recipients of any such property or charged against any property passing or which may have passed to any of them. The Executor shall not be entitled to reimbursement for any portion of any such taxes from any such person. c ~* K -.~~ LAST WILL AND TESTAMENT COLLEEN M. KOCHENOUR PAGE 2 THIRD: Tangible Personal Pro,,~t~v. Except for those items enumerated in the Letter of Instruction, I direct that all tangible personal property, including but not .limited to clothing, jewelry, heirlooms, furniture, personal effects, motor vehicles, and all other similar articles, which I own, and the insurance thereon, be sold in the sole discretion of my executor and, when sold, the net proceeds therefrom shall be added to the residue of my estate. Tangible personal property shall not include: (1) any and all property used by me in any business, (2} cash on hand or on deposit in banks, (3) stock or securities, (4) any type of evidence of indebtedness, and (5} any life, health or accident insurance policies. Notwithstanding any other provisions in this Article THIRD, I may leave a separate, dated and unsigned Letter of Instruction, which I shall place with my Will, containing directions as to the ultimate disposition of certain of the property bequeathed under this Article THIRD, and such Letter of Instruction shall determine the distribution of such items. FOURTH: esiduarv Gifts. (A) I give, devise and bequeath all the rest, residue and remainder of my estate, of every kind and chazacter, real, personal and mixed, tangible and intangible, and wherever situated, including any lapsed or renounced legacies or devises (and including any property over which I may have a power of appointment), in the following amounts to.the respective named and designated beneficiary: (1) EIGHTY PERCENT (80%) of the residue of my estate shall be distributed in equal shares to my daughters, MELANIE A. STRAUB, SHERRY L. KERSTETTER, ROBIN B. JOHNSON and TRACY L. FORRESTER, per stirpes. (2) TEN PERCENT (10%} of the residue of my estate shall be distributed to my stepdaughter, DEBRA K. FASNACHT, per stirpes. (3) TEN PERCENT (10%) of the residue of my estate shall be distributed to my stepdaughter, DENISE L. NEIL, per stirpes. (B) Distributions During Administration. Prior to final distribution of my estate, the Executor, in his discretion, may make partial distributions to one or more beneficiaries or Trusts. As a wnsequence, the Executorship and any Trusts created under this Will may exist contemporaneously. A distribution may be made subject to any indebtedness or liability of my estate. FIFTH: Powers of Executor. In addition to the powers and duties as may have been granted elsewhere in this Will, but subject to any limitations stated elsewhere in this Will, the Executor shall have and exercise exclusive management and control of the Estate and shall be vested with the following specific powers and discretion, in addition to the powers as maybe generally conferred from time to time upon the Executor bylaw: `Lm K LAST WILL AND TESTAMENT COLLEEN M. KOCHENOUR PA 3 (A) In the management, care and disposition of the Estate, the Executor shall have the power to do all things and to execute such instruments, deeds, or other documents as maybe deemed necessary or proper, including the following powers, all of which maybe exercised without order of or report to any Court: (1) To sell, exchange or otherwise dispose of any property at any time held or acquired hereunder, at public or private sale, for cash or on terms, without advertisement, including the right to lease for any term notwithstanding the period of the Estate, and to grant options, including any option for a period beyond the duration of the Estate. (2) To invest all monies in such stocks, bonds, securities, mortgages, notes, choses in action, real estate or improvements thereon, and any other property as the Executor may deem best, without regard to any law now or hereafter enforced limiting investments of fiduciaries. (3) To retain for investment any property deposited with the Executor hereunder. (4) To vote in person or by proxy any corporate stock or other security and to agree to or take any other action in regard to any reorganization, merger, consolidation, liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note or other security. (5) To use attorneys, real estate brokers, accountants and other agents, if such employment is deemed necessary or desirable, and to pay reasonable compensation for their services. (6) To compromise, settle or adjust any claim or demand by or against the Estate and to agree to any rescission or modification of any contract or agreement affecting the Estate. (7) To renew any indebtedness, as well as to borrow money, and to secure the same by mortgaging, pledging or conveying any property of the Estate. (8) To retain and carryon any business in which the Estate may acquire an interest, to acquire additional interest in any such business, to agree to the liquidation in kind of any corporation in which the Estate may have an interest and to carry on the business thereof, to join with other owners in adopting any form of management for any business or property in which the Estate may have an interest, to become or remain a partner, general or limited, in regazd to any such business or property and to hold the stock or other securities as an investment, and to employ agents and confer on them authority to manage and operate the business, property or corporation, without liability for the acts of such agent or for any loss, liability or indebtedness of such business if the management is selected or retained with reasonable care. C,"-'l 1~ LAST WILL AND TESTAMENT COLLEEN M. KOCHENOUR PAGE 4 (9) To register any stock, bond or other security in the name of a nominee, without the addition of words indicating that such security is held in a fiduciary capacity, but accurate records shall be maintained showing that.such security is a Estate asset and the Executor shall be responsible for the acts of such nominee. (B) Whenever the Executor is directed to distribute any Estate assets in fee simple to a person who is then under twenty-one (21) years of age, the Executor shall be authorized to hold such property in Trust for such person until he/she becomes twenty-one (21) years of age, and in the meantime shall use such part of the income and the principal of the Estate as the Executor may deem necessary to provide for the proper support and education of such person. If such person should die before becomingtwenty-one (21) years of age, the property then remaining in trust shall be distributed to the personal representative of such person's estate. (C) In making distributions from the Estate to or for the benefit of any minor or other person under a legal disability, the Executor need not require the appointment of a guardian, but shall be authorized to pay or deliver the same to the custodian of such person, to pay ar deliver the same to such person without the intervention of a guardian, to pay or deliver the same to a legal guardian of such person if one has already been appointed, or to use the same for the benefit of such person. (D) In the disbursement of the Estate and any division into separate trusts or shares, the Executor shall be authorized to make the distribution and division in money or in kind, or bath, regardless of the basis for income tax purposes of any property distributed or divided in kind, and the distribution and division made and the values established by the Executor shall be binding and conclusive on all persons taking hereunder. The Executor may in making such distribution or division allot undivided interests in the same property to several trusts or shares. (E) The Executor shall be authorized to lend or borrow, including the right to lend to or borrow from any trusts which I or my husband may have established during life or by will at an adequate rate of interest and with adequate security, and upon such teens and conditions as the Executor shall deem fair and equitable. ()~ The Executor shall be authorized to sell or purchase at the fair market value as determined by the Executor, any property to or from any trust created by me or my husband during life or by Will, even though the same person or corporation maybe acting as Executor of my estate or as Trustee of any of my other trusts. (G) The Executor shall have discretion to determine whether items should be charged or credited to income or principal or allocated between income and principal as the Executor may deem equitable and fair under all the circumstances, including the power to amortize or fail to amortize any part or all of any premium or discount, to treat any part or all of the profit resulting from the maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal or apportion the same between income and principal, to apportion the sales price of any asset between income and principal, to treat any dividend or other distribution of an ~~ rt ~- ~A~T WILL AND TESTAMENT COLLEEN M KOCHENOUR PAGE 5 investment as income or principal, or apportion the same between income and principal, to charge any expense against income or principal or apportion the same, and to provide or fail to provide a reasonable reserve against depreciation or obsolescence on any assets subject to depreciation or obsolescence, all as the Executor may reasonably deem equitable and just under all the circumstances. If the Executor does not exercise the above discretionary power, the cash or accrual allocation shall be in accordance with Chapter 81 of Title 20 of the Pennsylvania Consolidated Statutes, or the corresponding provisions of subsequent state law. (H) If at any time the total fair mazket value of the assets of any trust established or to be established hereunder is so small that the corporate Trustee's annual fee for administering the trust would be the minimum annual fee set forth in the Trustee's regularly published fee schedule then, in effect, the Trustee in its discretion shall be authorized to terminate such trust or to decide not to establish such trust, and in such event the property then held in or to be distributed to such trust shall be distributed to the persons who are then or would be entitled to the income of such trust. If the amount of income to be received by such persons is to be determined in the discretion of the Trustee, then the Trustee shall distribute the property among such of the persons to whom the Trustee is authorized to distribute income, and in such proportions, as the Trustee in its discretion shall determine. (I) Except as otherwise provided in this Will, when the authority and power under this Will is vested in two (2} or more Executors or Trustees, the authority and powers are to be held jointly by the Executors or Trustees, respectively. A majority of the Executors or Trustees may exercise any authority or power granted under this Will or granted by law, and may act under this Will. Any attempt by one such Executor or Trustee to act under this Will on other than ministerial acts shall be void. The action of one such Executor or Trustee under this Will maybe validated by a subsequent ratification of the act by a majority of the Executors or Trustees. SIXTH: Rig#}ts and Liabilities of Executor. (A) No bond or other security shall be required of any Executor. (B) This instrument always shall be construed in favor of the validity of any act or omission by any Executor, and any Executor shall not be liable for any act or omission except in the case of gross negligence, bad faith or fraud. Specifically, in assessing the propriety of any investment, the overall performance of the entire Estate shall be taken into account. (C) Each Executor shall be entitled to receive reasonable compensation for services actually rendered to my estate, in an amount the Executor normally and customarily charges for performing similaz services during the time which he/she performs the services. SEVENTH: SQQndthrift Provision. No beneficiary shall have the power to anticipate, encumber or transfer his or her interest in the estate in any manner other than by the valid exercise of a power of appointment. No part of the estate shall be liable for or charged with any ~.,rn k i.AST WILL AND TESTAMENT COLLEEN M. KOCHENOUR PAGE 6 debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. EIGHTH: Tax Elections. (A) In determining the estate, inheritance and income tax liability relating to my Estate, the Executor's decision as to all available tax elections shall be conclusive on all concerned. In accordance with IRC Section 2632(a) and without regard to whether a Federal estate tax return is actually filed, my Executor shall allocate so much of the Federal Generation Skipping Transfer (GST) exemption amount as will fully exempt any generation skipping transfer which may occur under this Will. (B) The Executor may, in its discretion, determine the date as of which my gross estate shall be valued for the purpose of determining the applicable tax payable by reason of my death. (C) The Executor may, in its discretion, decide whether all or any part of certain deductions shall be taken as income tax deductions (even though they may equal or exceed the taxable income of my estate and whether or not claimed or of benefit on my estate's income tax return) or as estate tax deductions when a choice is available; and in the event that all or any part of such deductions are taken as income tax deductions, no adjustment of income and principal accounts in my estate shall be made as a result of such decisions. NINTH: Definitions and General Provisions. (A) Survival. Any beneficiary who dies within sixty (b0) days after my death shall be considered not to have survived me. (B) Captions. The captions set forth in this Will at the beginning of the various articles hereof are for convenience of reference only and shall not be deemed to define or limit the provisions hereof or to affect in any way their construction and application. (C) Cltild~~gg. As used in this Will, the words "child" and "children" shall include persons who are legally adopted and the issue of said persons, whether born in or out of wedlock, so long as any person born out of wedlock is acknowledged in a written instrument executed by the one of their natural parents who is a descendant of mine to be the child of said descendant. The word "issue" shall include descendants of all generations including adopted persons. A posthumous child shall be considered as living at the death of his parent. The birth to me or the adoption by me of a child or children subsequent to the execution of this Will shall not operate to revoke this Will. Except for discretionary distributions which may be made unequally among a group of persons and distributions pursuant to a valid exercise of a power of appointment, in making a distribution to the children of any person, the property to be distributed shall be divided into as many shares as there are living children of the person and deceased children of the person who left children who are then living. Each living child shall take one share and the share of ~' ~m~ It ` LA4T WiI.i. AND TESTAMENT ['(~i ~ F.FN M KOCHENOUR PAG 7 each deceased child shall be divided among his then-living descendants in the same manner. (D) Code. Unless otherwise stated, all references in my Will to section and chapter numbers are to those of the Internal Revenue Code of 1986, as amended, or the corresponding provisions of any subsequent federal tax laws applicable to my estate. (E) Other terms. The use of any gender includes the other genders, and the use of either the singular or the plural includes the other. (F) Powers of Appointment are Exercised. By this Will I exercise any and all Powers of Appointment which I possess at the time of my death. IN WITNESS WHEREOF, I, COLLEEN M. KOCHENOUR, the Testatrix, have to this my Last Will and Testament, typewritten on eight (8) pages, including the Acknowledgment and Affidavit, set my hand and seal this~~ day of March, 2007. COLLEEN M. KOCHENOUR Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who have hereunto subscribed our names at her request, as witnesses hereto, in the presence of the said Testatrix, and in the presence of each other. Each of us further declares that he or she believes the Testatrix to be of sound mind and memory. The preceding instrument consists of this and seven (7) other consecutively numbered typewritten pages including the Acknowledgment and Affidavit. (print name) residing at C =~~.° ~~.~~ ~,~ !'~'~ residing at d~ ~ ~-~ ~ ~ rZ t r~ ~ S . ~A (print name) ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS: The Testatrix and the witnesses whose names are signed and subscribed to the attached or foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge, depose and say to the undersigned authority, that the Testatrix signed and executed the instrument as her Last Will in the presence of the witnesses; that she signed it willingly or willingly directed another to sign it for her; that she executed it as her free and voluntary act for the purposes therein expressed; that each of the witnesses were present and saw the Testatrix sign and execute the instrument as her Last Will; that each subscribing witness in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Testatrix Witness Witness Sworn to or affirmed, subscribed to, and acknowledged, before me by the above-named y __ .... . Testatrix and witnesses, this ~y'`'~ da of March, 2007. - COMM ~NWEALTH OF PENNSYLVANIA Nofaflel Seal Ted L Waloer, Notary PubYc Lemoyne Boro, Dunberland OantY AAyCorrrr~ieeion ~ Jan. 20; X011 MerrrbK, Permtylvanie Msor:lation o/ Notarise _ ~; ,/~ -- r ~. ' r 'r No~ar'y Public ~...- --.-- -1VCy Commission Expires: 1~, ti ' .,~~. r r ~' . t41~,~ ~.~ r , ' ~ ~,, , J J ,~ `' ~ F. J . r ~ .