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Home My WebLink About01-1047 Register of Wills for the County of Cumberland In the Commonwealth of Pennsylvania Estate of Marvin J. Sorensen, Deceased Social Security No. 508-12-2136 Petition for Probate and Grant of Letters N ::1}-01-/0'/7 o. .... .0............... ............... ... To: Suzanne C. Palkovic alkla Suzanne C. Sorensen The petition of the undersigned respectfully represents that: Your petitioner is 18 years of age or older and the executrix named in the last will of the above decedent, dated AUQust 30. 1979. Suzanne C. Sorensen is now married and known as Suzanne C. Palkovic. (State relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in East Pennsboro Townshio. Cumberland County, Pennsylvania, with his last family or principal residence at 5 Charisma Drive Camp Hill, PA 17011 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: None Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 50.000.00 (If not domiciled in Pa.) Personal property in County $ n/a..................... $ nl a... .. . ... .. ... .. .. .. . (If not domiciled in Pa.) Personal property in Pa. Value of real estate in Pennsylvania $ nla Situated as follows: ........... ............................................................................................... WHEREFORE, Petitioner respectfully requests the probate of the last will and codicil(s) presented herewith and the grant of letters Testamentary to aJ2 Suzanne C. Palkovic 5 Charisma Drive Camp Hill, PA 17011 /7- 02/'- .1/ - ---------- OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND The petitioner above-named swears or affirms that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner and that as personal representative of the above decedent petitioner will well and truly administrator the estate according to law. Sworn to or affirmed and subscribed Before me this 13t1:(Jayof November, 2001 a2 ne C. Palkovp _ C~.Ik~"--- 21-7.001-1047 DECREE OF PROBATE AND GRANT OF LETTERS And now, November 15t;lQ001, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument, dated August 30, 1979 described therein be admitted to probate and filed of record as the last will of Marvin J. Sorensen; and LETTERS TESTAMENTARY are hereby granted to Suzanne C. Palkovic. FEES Probate, Letters, Etc. $ RO 00 Short Certificates (4 ) $ 1? .00 x-Pages (1) $ 3.00 ,TCP l:) .00 TOTAL $ 100.00 ~~~~~ Karen M. Balaban, Esquire (28160) P.O. Box 821 Harrisburg, PA 17108-0821 717.232.3708 Filed Novemher 15 th , 2001 MAILED LETTERS 'IO ATI'OFNEv 21-2001-1047 REGISTER OF WILLS OF CUmberland COUNTY OATH OF SUBSCRIBING WITNESS (Yl (1 (' 0 n ( 1-1-CA F fY7 i ) /~ r ~Qdidl (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that ~ LA...J (A..../) present and saw (V\ (1 r u i f'I T", '- <) t\ r P n ~ t3 /\J the testat r ; f ' sign the same and that ,<, h C. signed as a witness at the request of testatUr- in h " S presence and . the presence of each othe .n the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before his day of ~~ ) I-/OOY /;10/ (Name) (Address) 21-7.001-. 1047 REGISTER OF WILLS OF Cumberland COUNTY OATH OF NON-SUBSCRIBING WITNESS Suzanne C. Palkovic, a/k/a Suzanne C. Sorensen (each) a subscriber hereto, (neb) being duly qualified according to law, depose(s) and say(s) that I am familiar with the signature of Marvin J. ;Sorerrsem ~x* testat~ of {anex~x*~~~x~~x~ the will presented herewith and JmdUtitx that T believCjtthe signature on the will is in the handwriting of Marvjn J. S~sensen to the best of my knowledge and belief. ~. day of J (Na~ ~ 5 CI1A-"''-s""",- JJr . A~ (Address) Register ~ 1i7tC?!t7tJ if (Name) (Address) ~ ..-:~: "'~" l'his is to certify that the information here given is correctly copied from an original certificate of death duJy filed with me as Local R,q;istrar. 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. No. ~M~' ~ ~ Local Registrar Fee for this certificate, $2.00 p 7691773 & ~ .]tJ; f}oo I . Date 71.-/.001-1047 "105. :43R"" 2187 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH TYPE/PRINT IN PERIlAHENT BLACK INI( ~ ~ :.l o i:; w ~ Z NAME OE DECEllENT If... _.lOll) J UNDER I YEAR MonIha o.v. SEX STAlE FilE ~R SOCIAl. SECURITY NUMBER BIRTtlPLACE (C.ly and SlaIe 01 fCleogn CwnlrYl - clI'f_ o w III ::> '" . ::; << P'i7/ "",1"'.4"~rc'"r .5/ ORE SIGNED (Monfl. Oey. _, 2:l1t. 23c. ~ CASE REFERRED TO MEDICAL EXAUINER/COROHeR? .....0 "",u:t' )f~i 5~()lk DUE TO (OR A CONSEQUENCE Of): at. I AjlpO&....e . iIlIeIVa betW\Mft :--- I I PART.: Ol'* 1igI\illcaI1I....-no COflIIobuling 10 ..elh.1lul IIQI reNIinll in "'" ~ _ given ill PART I ~ I : DuE TO (OR AS A CONSEOUENCE Of): DuE TOlaR AS A CONSEOUENCE Of): Wl:'RE AUTOPSY FINDINGS AlAl~ PRIOR 10 COWPlETIOH 0# CAUSE OF OERH? MANNER OE DEATH DAlE OF INJURY 1M"""'. Day. '<\la<l TIME 0# INJURY INJURY II WORK? DESCRIBE tK1W INJl,IRY OCCURRED Natural 0" Hom~. _0 No4 .....0 a... .' a... "IITIFIER ICI'eck oiliy """I "CEATtFYtNG PHYSlCSAN ~PhySl:"fl cer\lt'(lng cause ~ death wtlao drlothef phYSM.:>dn has pI()(l()Uoced dealh ana compl91ttd flam 23) TD Ihe... o. ",!_,knowIedge. de.'" OCCUrwH due to". cauN(a).net man".r.' ,"'ed. . N.;";';"t. o Pend.ng lnYeatigiltNJO o o o PlACE OF INJURY. AI home. te''', ..,.... l..:tory. olfice buoldinQ. "c. ISl*:M JOe. _ 0 NoD NoD Suoclde o COutd not De del.rmlfleO 32. DAlE FILED (Month ca.. _, 1 () b(',.e :M. ]() ;LbO f ."ROHOUHCING AND URTI.VING PHYSICIAN (Physc.an txlIh ~Of1OU(lCl(lg lJedlh dnd certlfylOQ 10 cause 01 aealtll To.... bHI oIrny knOwledge, a'-occUlred at ....1Ime. date. and place. and due 10 the cau..(a) and m.nner.. ....ed.. OMt!DICAL EXAMINER/CORONER . On lhe belil ol......lnallon and/or .nvelllealiOn,1n my'opiniOft. ....Ih occurre" allhe lime, dale, and plac.. and du. 10 the ",uu(lllnd "'."Mr .. .,.ted. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ". REGIST 61, ( "~Il ,;ll .- J ~\ \ . \ \\ ~' ';;D~,' \) " , :\ \ ~\ , ~\.~ A. \ ..~",~ \ \\.\\\ '\ -.. . .. , . ~ ,.. . " W ILL I, MARVIN J. SORENSEN, of Hampden Township, Cumber- land County, Pennsylvania, declare this to be my Last Will and revoke any Will previously made by me. ITEM I: I devise and bequeath all my estate of every nature and wherever situate to my wife, Bernita K. Sorensen, providing she shall survive me by sixty days. ITEM II: Should my wife, Bernita K. Sorensen, pre- decease me or die on or before the sixtieth day following my death, I devise and bequeath all of my estate of every nature and wherever situate unto my son, Gregory H. Sorensen, of Lincoln, Nabraska, and my daughter, Suzanne C. Sorensen, of Hampden Township, Cumberland County, Pennsylvania, per capita. ITEM III: I direct and empower my executrix to sell any and all real estate of which I die seized, at such time and upon such terms as she may deem best, and to deliver good and sufficient deeds therefor to the purchaser or purchasers thereof. ITEM IV: All death taxes that may be assessed in con- sequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be considered a part of the expense of the adminis- tration of my estate, and my executrix shall have the absolute power in her discretion to pay the same at once whether or not the law under which they are imposed permits the postponement of payment of all or part of them to a later time. ITEM V: I appoint my wife, Bernita K. Sorensen, executrix of this my last Will. Should my wife, Bernita K. Sorensen, fail to qualify or cease to act as executrix, I appoint my daughter, .., ., . " -.., Suzanne I: Sorensen, executrix of this my last Will. .-" . r .. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 30thday of August , 1979. ~~~~ The preceding instrument, consisting of this and one other typewritten page, identified by the signature of the Teatator, was on the day and date thereof signed, published and declared by Marvin J. Sorensen, the Testator therein named, as and for his Last Will in the presence of us, who at his request. in his presenc nd in the presence of each other have subscribed our ames w t esses hereto: M~l~~ Qfr 7 r!':'c LGy,~[tt6- ' /y( CO~CL '- " ( \../ / " {-) f/ v CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Marvin J. Sorensen Date of Death: October 26, 2001 Estate No. 2001-01047 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on February 21, 2002. Gregory H. Sorensen Address 5 Charisma Drive Camp Hill, PA 17011 1544 S. 11 th Street Lincoln, Nebraska 68502 Name Suzanne C. Palkovic Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A Date: ~. ~ I, () -z..- /~/'7~ Karen M. Balaban Counsel for Executrix Karen M. Balaban LLC P.O. Box 821 Harrisburg, P A 17108-0821 Telephone: 717.232.3708 nc; =~ d ::;$ ::; N rr CT" ...,., rT1 CD f'-) Vl -',:] !'.J d 0'1 ""-.. .J Register of Wills of Cumberland County, Pennsylvania 0(; _ r',_ :<t> ::::S ~'" 0" '~., 0? ." Estate of Marvin J. Sorensen 8:: No. 2001-01047 '- ;::x::. :z: :0 m () '"" ~....,~ ~~:~ INVENTORY Fa - Also known as . Ul . Date of Death Oct91;)er 26. 2001 .~. :; .::g -,.,~ :.;.' N 1...1' :"'" , . . ,Deceased. Social Security Ncr.t:50a-12-m6 Personal Representative(s) of the above Estate, deceased, verify that the Items appearing In the following Inventory Include all of the personal assets wherever situate and all of the real setae In the Commonwealth of Pennsylvania of said Decedent, that the valuation place opposite eac.'1 item of sa:d Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears In a memorandum at the end of this inventory. If\Ne verify that the statements made in this Inventory are true and correct. If\Ne understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attomey: Karen M. Balaban 1.0. No.: 28160 Address: P.O. Box 821. Harrisbura. PA 17108-0821 Telephone: 717.232.3708 Dated Description Value 1. Fulton Bank Checking Acct. #2219-62985 P.O. Box 4887 Savings Acct. #9904-46617 Lancaster, PA 17604 809.22 9,376.92 2. McDonald's Corporation 1 share common stock (MCD) @ $28.95 28.95 3. 1979 Lincoln Continental automobile 1,000.00 1 ,205.00 500.00 4. Clothing 5. Furnishings and Personal Effects 6. Meals on Wheels refund 10.95 7. Medicare prescription reimbursement 426.50 8. Blue Cross/Blue Shield health ins refund 316.90 9. Investors Life Insurance life ins. premium refund 18.01 TOTAL J13.692.45 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT KAREN M BALABAN LLC POBOX821 HARRISBURG, PA 17108-0821 -------- fold ESTATE INFORMATION: SSN: 508-12-2136 FILE NUMBER: 21-2001- 1047 DECEDENT NAME: SORENSEN MARVIN J DA TE OF PAYMENT: 01/15/2002 POSTMARK DATE: 01/14/2002 COUNTY: CUMBERLAND DATE OF DEATH: 10/26/2001 NO. CD 000753 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,870.21 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: SUZANNE C PALKOVIC C/O KAREN M BALABAN LLC CHECK# 1002 SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS $2,870.21 MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SUZANNE C PALKOVIC 5 CHARISMA DRIVE CAMP HILL, PA 17011 -------- lold ESTATE INFORMATION: SSN: 508-12-2136 FILE NUMBER: 2101-1047 DECEDENT NAME: SORENSEN MARVIN J DA TE OF PAYMENT: 07/18/2002 POSTMARK DATE: 07/17/2002 COUNTY: CUMBERLAND DATE OF DEATH: 10/26/2001 NO. CD 001420 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $550.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: SUZANNE C PALKOVIC CHECK#1012 SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS $550.00 MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SUZANNE PALKOVIC 5 CHARISMA DRIVE CAMP HILL, PA 17011 -------- fold ESTATE INFORMATION: SSN: 508-12-2136 FILE NUMBER: 2101-1047 DECEDENT NAME: SORENSEN MARVIN J DA TE OF PAYMENT: 07/18/2002 POSTMARK DATE: 07/17/2002 COUNTY: CUMBERLAND DATE OF DEATH: 10/26/2001 NO. CD 001421 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,323.23 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: SUZANNE PALKOVIC CHECK# 1018 SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS $1,323.23 MARY C. LEWIS REGISTER OF WILLS /7-c:2/-,y , BUREAU OF INDIVIDUAL TAXES 'v INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG1 PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-1U7 EX AFP <01-05> KAREN M BALABAN PO BOX 821 HBG DATE ESTATE OF DATE OF DEATH FILE NUMBER : COUNTY ACN 03-24-2003 SORENSEN 10-26-2001 21 01-1047 CUMBERLAND 101 MARVIN J Allount Rellitted PA 17108 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV =i6"ifj-ix--AFP--((ff.:o31-------...--iNifERI;--ANCE_-yiX--SyjrfEME-Ny-oF'-ic-couiff--.-..--------------- - -- - -- ESTATE OF SORENSEN MARVIN J FILE NO. 21 01-1047 ACN 101 DATE 03-24-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-03-2003 P R I NC I PAL TAX DU E : ........................................................................................................................................................................................................................... 4,678.15 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-14-2002 CDOO0753 151.06 2,870.21 07-17-2002 CDOO1420 .00 550.00 07-17-2002 CDOO1421 .00 1,323.23 03-05-2003 REFUND .00 216.35- TOTAL TAX CREDIT 4,678.15 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l /?-.:J 1- Y \- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG I PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * REV-IU7 EX AFP (01-03) KAREN M BALABAN PO BOX 821 HBG DATE ESTATE OF DATE OF DEATH FILE NUMBER ,A;OUNTY ACN 02-10-2003 SORENSEN 10-26-2001 21 01-1047 CUMBERLAND 101 MARVIN J Allount Rellitted PA 17108 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V =i6cfj-i:x--AFP--((ff.:o3i-------...--iNifERITANCi--YAX-STAfEMENY-OF-ACfcouiff--...--------------- - -- --- ESTATE OF SORENSEN MARVIN J FILE NO.21 01-1047 ACN 101 DATE 02-10-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-03-2003 P R I NC I PAL TAX DU E : ........................................................................................................................................................................................................................... 4,678.15 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-14-2002 CDOO0753 151.06 2,870.21 07-17-2002 CDOO1420 .00 550.00 07-17-2002 CDOO1421 .00 1,323.23 TOTAL TAX CREDIT 4,894.50 BALANCE OF TAX DUE 216.35CR INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 216.35CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) /?-~/- r ~. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT · 9 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-04-2003 SORENSEN 10-26-2001 21 01-1047 CUMBERLAND 101 KAREN M BALABAN PO BOX 821 HBG PA 17108 Allount Rellitted *' REV-l595 EX AFP UI-D3) MARVIN J MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV :is9-i-Ex-AFP--fo1-.:o3i------..-iNHERITANc-i-y;fi-RE-cORD--AUJUsyifiNy--..------------------------ --- -- ESTATE OF SORENSEN MARVIN J F I L E NO. 21 01-1047 ACN 101 DATE 02-04-2003 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adllinistrative Costs/ Miscellaneous Expenses (Schedule H) Debts/Mortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax Return Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate Subject to Tax ADJUSTMENT BASED ON: VALUE OF ESTATE: PROTEST BOARD DECISION 10. 11. 12. 13. 14. TAX: 15. Allount of Line 14 at Spousal rate 16. Allount of Line 14 taxable at Lineal/Class A rate 17. Allount of Line 14 at Sibling rate 18. Allount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (I) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 13,692.45 .00 114,360.27 (8) 128,052.72 24,093.88 103,958.84 .00 103,958.84 .00 4,678.15 .00 .00 4.678.15 "AY"I:N' KI:l;I:J.,.. l1'J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-14-2002 CDOO0753 151.06 2,870.21 07-17-2002 CDOO1420 .00 550.00 07-17-2002 CDOO1421 .00 1,323.23 TOTAL TAX CREDIT 4,894.50 BALANCE OF TAX DUE 216.35CR INTEREST AND PEN. .00 TOTAL DUE 216.35CR (9) (10) 14,944.52 9,149.36 (11) (12) (13) (14) · IF PAID AFTER DATE INDICATED, SEE REVERSE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) (15) (16) (In (18) .00 X 00 103.958.84X 045= .00 X 12 = .00 X 15 = (19) BOARD OF APPEALS DEPT. 281021 HARRISBURG, PA 1~~8=10~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE KAREN M BALABAN ESQ PO BOX 821 HARRISBURG PA 17108-0821 IN RE ESTATE OF: MARVIN J SORENSEN DOCKET NO.: 0216525 TAX TYPE: INHERITANCE APPEAL TYPE PROTEST FILE NUMBER: 2101-1047 ACN: 101 APPRAISEMENT: 06-04-02 PETITION FILED: 07-18-02 EXAMINER: LISA GARLAND DIAZ Direct Dial: (717) 772-3736 Fax: (717) 787-7270 Email: Idiaz@state.pa.us MAILING DATE: l~J It N 2 7 ?,I''tO', " . if t...V J DECISION AND ORDER On June 4, 2002, the Department issued an appraisement and assessment which valued Jackson National Life Annuity #0059547300 for Pennsylvania inheritance tax purposes at $64,067.62. Petitioner has now submitted documentation that establishes the taxable date of death value of that annuity should be reduced to $41,627.40 Accordingly, it is hereby, Ordered that the protest is sustained. The Department is directed to reduce the taxable value of Jackson National Life Annuity #0059547300, appraised and assessed as item 3 of Schedule G on the original inheritance tax return, to $41,627.40. It is further Ordered that a refund be issued for the resulting overpayment, plus interest if appropriate. FOR THE BOARD OF APPEALS ~~ 12 A.Jc Jo~eph R. Sleek, Board Member Page 1 of 2 \1?-e2/- Y ~ BUR~4U OF INDIVIDUAL TAXES , INHER\TANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT~ ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-04-2002 SORENSEN 10-26-2001 21 01-1047 CUMBERLAND 101 '02 Jui~ 1 0 I r"t 'd) 7 KAREN M BALABAN PO BOX 821 HBG PA1ltl08 ( ;t. 1'.; ,,-. * REV-1547 EX iFP U1-02) MARVIN J Allount Rellitted (I) (2) (3) (4) (S) (6) (7) .00 .00 .00 .00 13.692.45 .00 136.800.49 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE~ PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV =is'4j-E3f-AFP--rol-:021--NcfficE--oF-.rtiHEifiTAifci-,.-Ax-jrpPRA-isEifENT~--Ar.i-owANci-cfR------------ ----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SORENSEN MARVIN J FILE NO. 21 01-1047 ACN 101 DATE 06-04-2002 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Est.te (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net V.lue of Estate Subject to Tax I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ~ returns assessed to date. ASSESSMENT OF TAX: IS. Amount of Line 14 at Spousal rate (IS) 16. A.ount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due NOTE: 14~944.52 9.149.36 (II) (12) (13) (14) (9) (10) .00 X 00 = 126 ~ 399.06 X 045 = .00 X 12 = .00 X 15 = NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. (8) 150,492.94 24.093 88 126,399.06 .00 126,399.06 (19)= .00 5~687.96 .00 .00 5~687.96 TAX CREDITS: . ~ ,. ...n . n.._..... . II (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-14-2002 CDOO0753 151.06 2~870.21 PAYMENT MUST BE MADE BY 07-26-2002*. TOTAL TAX CREDIT 3,021.27 BALANCE OF TAX DUE 2~666.69 INTEREST AND PEN. .00 TOTAL DUE 2~666.69 . IF PAID AFTER DATE INDICATED~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $l~ NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ..CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV-1470 EX (".S) ~ . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME Marvin J Sorensen REVIEWED BY Sandra J Eslinger ITEM SCHEDULE NO. G INHERITANCE TAX EXPLANATION OF CHANGES FilE NUMBER ACN EXPLANA liON OF CHANGES Annuities were added to schedule G per correspondence dated May 22,2002. ROW 2101-1047 101 Page 1 REV-'!IIlO EX_I '* COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 w "" :.:~~ lil~g :l:ac..l uA,1D ~ II REV.1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY ~ 1. Original Return o 4. Limited Estate GrS. Decedent Died Testate (AIIoch copy 01 'MIl o 9. I.itIgetton Proceeds ReceiYed 17-c;2/-Y_ FILE NUMBER -4. .L - .J2. -'- -L .Q. ~ .L _ COUNTY CODE YEAR tutIIER SOCIAL SECURITY NUMBER SO 8 - /~ ~ Z W C W o W C DECEDENrs NAME (LAST, FIRST, AND MIDOlE IN mAL) 50ftEf\Ue/ll Htf~VII"..:r DATE OF DEATH (MM-Oo..YEAR) DATE OF BIRTH (MM-OO-YEAR) lO-;l.i..-OI as-II-2"3 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDlE INmAL) z o 5 ;:) ~ a: <( o w a:: z o ~ r; ;:) a. :E o o ~ NAME Ko...e,.. M FIRM NAME (f AppIcsIR) I<(~~""",- M TaEPHONE NUMBER :2/31. THIS RETURN MUST BE FILED IN DUPUCATE ~ THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 2. Supplemental ReIum o 4e. Futurelnler8sl CompromIse (dIlIl01 dIIll8"12-12-&) o 7. Decedent Maintained B LIving TIUSt (AIIoch copy 01 Trull) o 10. Spousal Poverty Credit (dIto 01 dlllII lIIMM 12-31-8111ld 1.1-85j o 3. Remainder RebJm (dIlIloldllllprfcrto 12-1~1 o 5. Federal Estate Tax RebJm Required .!- 8. Tolal Number of Safe Deposit Boxes o 11. EIectlon to tax under Sec. 9113(A) (AIIIi:h Sell 0) I COMPLETE MAILING ADDRESS P, 0 d~)C ~ ~J ,NAr; to!. b u (' J fit 17ft) f- 0 S.11 Jda.f...L<C..~ d..../eo. j, <t.r\ LL.~ .....-,..... ;;..../1... " 11. .732. 3tO~ 1. Reel Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held CorporalIon, PartnershIp or SoIe-ProprIetorshIp 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & M1sceRaneous Personal Property (Schedule E) 6. JolnUy Owned Property (Schedule F) o Separate BIIIng Requested 7. Inler. Vivos Transfers & M1sce1aneous Non-Probate Property (Sched," G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expensetl & Adminislrellve Costs (Schedule H) 10. Debls of Decedenl, Mortgage UabiIIIIes, & liens (Schedule I) 11. lolal Deducllon. (total Lines 9 & 10) 12. Net Value of Estate (Une 8 minus Line 11) 13. Charitable and GcMlmmental BequestsISec 9113 Trusts forwlich en eIecIIon to lax has not been made (Schedule J) 14. Net Value Subject to Till (Une 12 minus Lila 13) -0 r--'""i'3'FFICi'A.L'USE ONi).y I " ., \ ! i ! (1) (2) (3) (4) (5) o o I:::) J"!l.l.c:r:z.~S ., i I ~7 i I .! ~_____-....--J (6) ~ - (7) ~), 7-3:l. 'ir (8) ~". 4;l S.'3:L. (9) (10) '~l' "1<1. S:1.. ~J JL.,q. '31. (11) J L/1 0'3. eo 8 (12) (, :1J 3 :3 /. "1'-1 (13) 0- (14) ~ :2, 33/. '/&./ x.O_ (15) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES o (. :l, 3~ I. ~:L~ x .0 ~ (16) :lJ ~OL.l.ql 15. Amount of Line 14laxable at the spousaf tax rate, or transfers under Sec. 9116 (a){1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of line 14 taxable al sibling rate 18. Amount of Line 14 taxable at coIateraJ rate 19. Till Due 20.01 ___________.__.0.__. ____ x .12 (17) o x .15 (18) (19) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~...~r.'~-'" > ~'" ,', . . "' .... ..... . W;,~~I;J,:-" '.i' ~l i ~r' , , '1'";' ,....,..,,", 'r ''- '"' ~,rp, t~ .'~ ~1'" ~~.., ':r:"'~ 'f11~:;t~"~ff\:~~:l~1':b:"''''.:ii .~". ~ -L~..:f:'~::l-":":"~~I~~^ ,,,,.?'.. ,~(1, :, , _,: ,1~'\_I__L-"< "':...."~.:~i..~n.",{~"" Decedent's Complete Address: STREET ADDRESS 5" tit 4 ~ I ~ WI. A Ca...... P . J-.!.' II Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (JI'IVC- CITY I STATE p,4 I ZIP /10 II (1) J. 1 0'-4. q I -0 - Jli,O.~\ IS/.ot- Total Credits ( A + B + C ) (2) 3,0 "2./. 1~ 3. InterestlPenalty if applicable D. Interest E. Penalty TotallnterestlPenalty ( 0 + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This Is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If line 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the lax due. (SA) - 0 - ;J I/". 3t. ~ (:) B. Enter the tolal of Line 5 + SA. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT - 0- '!~i'~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Old decedent make a transfer and: Yes No a. retain the use or Income of the property transferred;.......................................................................................... 0 ~ b. retain the right to designate who shan use the property transferred or Its income; ............................................ 0 g.. c. retain a reversionary Interest; or.......................................................................................................................... D go d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 W 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 8'" 0 3. Did decedent own an 'n trust for" or payable upon death bank account or security at his or her death? .............. D Gr-'" 4. Old decedent own an Individual Retirement Account, annuity, or other non-probate property which conlains a beneflciarydeslgnallon? ........................................................................................................................ D [3"'" IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND ALE IT AS PART OF THE REtURN. Under 01 peIjury. I decI8re Ihall have -*'ed tIiI return. i1cIudIng a..co.lll*lYlnD ICheduIeIIIId IbIIImenIa. and lIlllle bell 01 my knowledge and belief. ills ...... CIlmICt and campIeiI. DectaralIon 01 oil<< Ih8n IIle Is belled on allnIonn8tIon 01 wIiclI pqpIIW 11M II1y IlNMIedge. S JU OF PERSO~ OR FILlNG)iElURN . -L~ ,Z Y't!cu:fr, AD ESS 5' CJt4r'~ Vt'.'.J'<. l--( 1t.,1 ?.A- I/Olf SIGNAlURE OF PR~PARER OTHER~~ ____.____.s~__~ ______ ADDRESS ~::....;.~_~~ Irf J1uw",,,-/ ~ For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate Imposed on the net value of transfers to or for the use of the surviving spouse Is 3% . (72 P.S. ~9116 (a) (1.1) (I)]. . For dates of death on or after January 1,1995, the tax rate Imposed on the net value of transfers 10 or for the use of the surviving spouse is 0% (72 P.S. ~9116 (a) 1 (1.1) (iI)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and fiUng a tax return are sbll appllcaille even if the surviving spouse Is the only beneficiary. 1 For dates of death on or after July 1. 2000: , The lax rate Imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for. the use of a natural paren~ an adoptiVe parent, or a stepparent of the child is 0% (72 P.S. S9116(aX1.2)]. : The lax rate Imposed on the net value of transfers to or for the use of the decadenfs Uneal beneficiaries is 4.5%, except as noted In 72 P.S. 59116(1.2) [72 P.S. S9116(a)(1)). I The lax rate Imposed on the net value of transfers to or for the use of the decadenfs siblings is 12% (72 P.S. 59116(a)(1.3)). A sibling Is defined. under Section 91102, as an individual who has at least one parent in cornmon with the decadent, whether by blood or adoption. . ~-.'" ".J.~~;,~c~.1)..: ;..~: ":'J~, ~'" ~ " ':: }_'<;<< ...'; ".'f~.... Jt' :: ~ ~(: ...."..." ,." ~' " ~ c '> _,.,1" '....' .. . ;'f<l-:' ,,','. DATE ~.9.(J?- ftd,-.. 1'1 d,,) d.-.- DATE -SI. /d ,CJ 4- 'W ILL " .1, MARVIN J.. SORENSBN, of Hampden Township, CUmber- land,'County. Pennsylvania, declare this to be my Last Will and revoke, ,any Will previousl, made by me. 'ITEM t': I devise and. bequeath all my estate of eye~y nature 'and wherever :situate 'to my wi e, Bernita K. Sorens~, providi~g she 'shall survive me by sixty da s. ITEM 1'1: Should my wife, Bern ta K. Sorensen, 'pre- decease 'me 'or die 'OI'i or before 'the 'sixtiet day following my death,' I devise 'and'bequeath 'all of my est of every nature and wherever. situate 'unto' my, son;'. Gregory H. Sorensen, of' Lincoln. ITEM III: .1 direct and of Hampden Townshi." , , Nabraska" and my da~ghter, Suzanne~. Sore Cumberland County. ,Petins}dvania, per capit, . executrix to sell any, and all real es'tate 'of which 'I ed, at such time and upon, such 'terms ,as she 'may deem best" and 0 deliver good and sufficient 'deeds' 'therefor to the 'purch~ser or purchase~s th~reof. ITEM iv: All, death 'taxes that may be assessed in con- s~qu~rice' 'of my, death,' of, whatever nature a d by whatever jurisdiction tmp~s~d, shall be 'cons~dered a part of the expense of the adminis- 'tration of my estate, and my executrix sha 1 have the absolute power in her di'sc:r'etion to pay the same at once whether or not the law Under which 'they are 'imposed ,permits t e postponement of payment 'af' all, or p~t 'of them to a later ime. , , .. executrix o,f, this my 1.stWill. Should mY-wife, Bernita K. Sorensen, I ITEM V: I appoint my wife,' B rnita K. Sorensen, , fail to qualify or ce'ase 'to act' as "executr x, I appoint my daughte*, ',Suzanne C' Sorensen. executrix of this my lalt Will. IN WITNESS WHE~OF, I have hereunto set my hand and seal this 30thday of August , 1979. .~~_., . .. ;',' .....;. < '..:~:<f~:~~ The preceding instrument, consisting of this and one other typewritteri ,page,' ideritified by the signature of the Teatator, :was 'on the, ~day and date thereof signed, published and declared by Ma;vin J. Sorerisen, the 'Testator therein named" as and for his Last Will in the 'presence 'of us, who at his request. in his preseric d in the 'presence 'of each other have subscrib~d our ames w 't esses hereto: ' .Jf.~l~r Qfr .QY~.d ,{),9 . . . .", . . . . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Marvin J. Sorensen FILE NUMBER 21-01-1047 ITEM DATE NUMBER DESCRIPTION VALUE AT OF DEATH 1. Fulton Bank P.O. Box 4887 Lancaster, PA 17604 Checking Acct. #2219-62985 Savings Acct. #9904-46617 809.22 9,376.92 2. McDonald's Corporation 1 share common stock (MCD) @ $28.95 28.95 3. 1979 Lincoln Continental automobile 1,000.00 1,205.00 500.00 4. Clothing 5. 6. Furnishings and Personal Effects Meals on Wheels refund 10.95 7. Medicare prescription reimbursement 426.50 8. Blue Cross I Blue Shield health ins. premium refund 316.90 9. Investors Life Insurance life ins. premium refund 18.01 TOTAL $13,692.45 FUlton Bank CAPITAL DMSION · LANCASTER/CHESTER DMSION DROVERS BANK DMSION · GREAT VALLEY DMsION (717)291-2437 November 21,2001 Karen M. Balaban LLC P.O. Box 821 Harrisburg, Pennsylvania 17108 Dear Ms. Balaban: RE: Marvin J. Sorensen, deceased October 26,2001. In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: Checking # 2219-62985, open 4/6/2001, balance $809.22, in his name only. Savings # 9904-46617, open 4/6/2001, balance $9,376.92 and accrued interest $.31., in his name only. If you should have any further questions, please do not hesitate to contact me. Very truly yours, . ~~~ Credit Inquiry Processor \,;ONFl DENTl1':;~~ ~ J??:! \:'~i' < 'r'S ",formation 15 fur~sheQ ,a~. ~. ~~'~~.<;-f' '>:!". .,," . answer to Vour inqulfY, M:{;~-' ~;'" ,. ... ;,,{,' ,:;i',," tj?<~ 'hl\ihi ir. 'AssumeG 01) ","" - 0' _.' ',: i'. "ri' ....,'C: ~o respanshJ1 I"~ to> III essed is sutJtect'i'J cMJt~~.:.::.",,,..-. <" '0. n opinion hefeft expf POBox 4887 . Lancaster, PA 17604 www.fultonbank.com 1-800-FULTON-4 REV-1737-6 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN NONRESIDENT DECEDENT ESTATE OF Marvin J. Sorensen SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY Use Schedule G, Part 2, ONLY for proportionate method of tax compupltion. FILE NUMBER 21-01-1047 Part 1 must include all transfers of real estate and intangible personal property located in Pennsylvania. Complete Part 2 ONLY WHEN THE PROPORTIONATE METHOD OF TAX COMPUTATION IS ELECTED. Include in the description of property the date the transfer was made and the name and relationship of the transferee. This schedule must be completed and filed if the answer to questions 1 through 4 on the reverse side of the REV-1737 cover sheet is yes. PART 1 - PROPERTY OR TANGIBLE PERSONAL PROPERTY LOCATED IN PENNSYLVANIA THAT WAS TRANSFERRED ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF EXCLUSION NUMBER Include the name of the transferee, their relationship to Decedent and VALUE OF ASSET DECO'S (IF APPLICABLE) TAXABII.E VALUE the date of transfer. Attach a copy of the deed for real estate. INTEREST 1. Fulton Financial Advisors NA 599 North 1 ih Street Acct. #74362008 Lemoyne, PA 17043 Money Market Joint account with Suzanne C. Palkovic (daughter) Date of Transfer: April 6, 2001 31,543.87 50% $3,000.00 $2~,543.87 2. Suzanne C. (daughter) & Jeffrey Palkovic (son-in-law) 5 Charisma Drive Camp Hill, PA 17011 2001 addition to house (in-kind construction costs) Date of Transfer: March 1, 2001 47,189.00 0% $3,000.00 $41,189.00 PART 1 TOTAL $78,732.87 $ $72,732.87 LAW OFFICE OF KAREN M. BALABAN LLC location Charlevoix Place Suite 200 115 Pine Street Harrisburg, PA 17101 DIRECT DiAl 717.232.3708 FACSIMILE 717.232.2748 Malllna Address P.O. Box 821 Harrisburg, PA 17108-0821 ! KMBalaban@BalabanLLC.com November 14, 2001 Christine Shurr Fulton Financial Advisors NA 599 North 12th Street Lemoyne, P A 17043 RE: Estate of Marvin J. Sorensen, deceased Money Market Fund ACCL No. 74362008 Dear Ms. Shurr: Please be advised that I represent the above estate. Mr. Sorensen died on October 26, 2001. Please provide me with a verification of all account information, including balances and account ownership, as of his date of death, as well as the date that joint ownership was estab.lished. Thank you for your attention to this matter. If you have any questions, please don't hesitate to. call. Respectfully yours, ~---- ~~ Karen M. Balaban Cc: Suzanne Palkovic, Executrix ~~~(h clJiJ 1ct~ t 21) [;Lj3,27 , ~ LJCo~6'r\ v-t-o/ h Cn~ JiI . ..... . .. ...... ...... . .' :. . .... () , , /I_/~-(f/ . 4~' . ~ C",. . -,:.--. .:. -.. . .. -. '. ".,' .:--' ,. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Marvin J. Sorensen FILE NUMBER 21-2001-1047 ITEM NUMBER A. B. TOTAL DESCRIPTION 1. 2. 3. 4. 5. 6. 7. FUNERAL EXPENSES Neill Funeral Home, Inc. Resurrection Cemetery Rev. Paul Helwig Royer's Flowers Inc. Suzanne C. Palkovic News Center West Suzanne C. Palkovic funeral services burial expense Stipend to Priest Flowers Memorial photo display for viewing "Thank you" cards post-funeral reception ADMINISTRATIVE EXPENSES 1. Personal Representative Commissions 2. Attorney Fees: Karen M. Balaban LLC (estimated) P.O. Box 821, Harrisburg, PA 17108-0821 3. Probate Fees: Register of Wills (Cumberland County) Hanover and High Streets Carlisle, PA 17013 Probate Short Certificates 4. Cumberland Law Journal - Advertise Letters Testamentary The Sentine/- Advertise Letters Testamentary 5. 6. Family Exemption - Suzanne C. Palkovic, daughter of decedent 5 Charisma Drive, Camp Hill, PA 17011 7. Register of Wills - inheritance tax and inventory filing fee AMOUNT $7,054.50 625.00 100.00 169.60 44.44 50.39 113.24 (waived) 3,000.00 88.00 12.00 75.00 87.35 3,500.00 25.00 $14.944.52 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Marvin J. Sorensen FILE NUMBER ~ 1-2001-1047 ITEM NUMBER DESCRIPTION exoense reimbursements 1. Sue Palkovic pet dog grooming and care 2. Sue Palkovic PP&L electric bill portion 3/1/01 - 10/26/01 3. Sue Palkovic UGI gas heat bill portion 3/1/01 - 10/26/01 4. Sue Palkovic PAWC water bill portion 3/1/01 - 10/26/01 5. Sue Palkovic Homeowners' ins. bill portion 3/1/01 - 10/26/01 6. Sue Palkovic Storage unit ($124/ mo Apr - Aug; $35/mo Sep-Nov) 7. Sue Palkovic Ad to sell car 8. Sue Palkovic real estate bill portion 3/1/01 - 10/26/01 9. Sue Palkovic food bill portion 3/1/01 -10/26/01 10. Salvation Army donation of certain household fumishings 11. Salvation Army donation of clothing 12. Discover Card various charged expenses 13. John Hassler, P.A. 2001 income tax preparation 14. Internal Revenue Service 2001 income tax 15. Pa. Dept. of Revenue 2001 income tax TOTAL 1 AMOUNT 95.33 325.00 200.00 65.00 110.00 725.00 22.00 469.54 800.00 260.00 1,205.00 64.49 475.00 3,451.00 882.00 $9.149.36 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Marvin J. Sorensen FILE NUMBER .11-2001-1047 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE OF ESTATE TAXABLE DISTRIBUTIONS: Suzanne C. Palkovic 5 Charisma Drive Camp Hill, PA 17011 Daughter 50% Gregory H. Sorensen 1544 S. 11th Street Lincoln, Nebraska 68502 Son 50% Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/03/2004 BALABAN KAREN M P 0 BOX 821 HARRISBURG, PA 17108-0821 RE: Estate of SORENSEN MARVIN J File Number: 2001-01047 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 10/26/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLEN-DA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge STATUS REPORT UNDER RULE 6.12 Name of Decedent: ._~__~' u, ,~' ~-' 5, ~' e ~ Date of Death:_ / ~//'~ ~//~ ! Will No.: .~ o ~ 1 - t~ ~ o ,4 · Admin. No.: 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 wh~ther administration of the estate is complete: 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 Co m~t? Yes No [~ : b. The separate Orphans' Court No. (if any) for the personal repre~ntative's account is: ~'~" '~ · · ~ '.~ c. Did the personal representati~tate an account informally to the parties in interest? Yes ~ No 1_2.1 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: ?. ! ~,.?f Signature Name R0. Box 821 tard q, PA 17108-0821 Telephone No. Capacity: [-~ Personal Representative ~Counsel for personal representative