HomeMy WebLinkAbout01-25-1215D561D143
REV-1500 ~`(°'-'°' "
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes of-MfMEM OF REVENIE
Po Box.2sosol INHERITANCE TAX RETURN 21 11 0581
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
202 20 8183 04 28 2011 02 06 1927
Decedent's Last Name
KONSKO
(If Applicable) Enter Surviving Spouse's Information Below
Suffix Decedent's First Name
ROBERTA
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
LJ 1. Original Return
^ 4. limited Estate
X i 6. Decedent Died Testate
(Anach copy of wap
^ 2. Supplemental Return
^ ~ Future Interest Compromise
(pdate of death after 12-12$2)
^ ~• (Al~ader~opyint8ined~aLivingTrust
I~ g. Remainder Return (date of death
pnorto 12-13-82)
^ 5. Federal Estate Tax Return Required
MI
I
MI
B. Total Number of Safe Deposit Boxes
g, Litigation Proceeds Received 1 D Spousal P4vertu Credit (date of death Eledlon to tax under SeC. 9113 A
^ between 12-31- and t-1-95) ^ 11'(Attach Sch. O) ( )
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
MICHAEL L BANGS 717 730 7310
REGISTER. LS US~NLY ~.
First line of address ~ ~'
,
429 SOUTH 18TH STREET N
~~ crr ` 3 ~`
<_ ~,'
~
Second line of address ~~ ~ ~ ~
!
:C
~
D
~
~'"~ rt
City or Post Office A
FILED
State ZIP Code ,
CAMP SILL PA
Correspondent's e-mail address:
Under penalties of pery"ury, I dedare that I have examined this return, induding accompanying schedules and statements, and to the best of my knowledge and belief.
it is true, correct and complete, Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
J e ~ ~~,F~ Robert D. Firkal /~/y~jz
ADDRESS
SIG TURE OF PREPARER OTHER TH RESENTATNE ~~ DATE
I '~ y/"~ Michael L. Bangs ~ ~l//% d
429 South 18th Street, G`amp Hill, PA
Side 1
L 15D5610143 1505610143 J
J
REV-1500 EX
°~"~'s "~ Konsko, Roberta I.
Decedent's Social Security Number
202 20 8183
RECAPITULATION
1. Real Estate (Schedule A) ....................................................................................... 1.
2. Stocks and Bonds (Schedule B) ............................................................................. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3.
4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4
5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ............... 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested...,........ 6.
7. Inter-Vivos Transfers 8 Miscellaneous Inn; Probate Property
(Schedule G)
S
u
eparate Billing Requested............ 7•
8. Total Gross Assets (total Lines 1-7) ..................................................................... g,
9. Funeral Expenses 8 Administrative Costs (Schedule H) ....................................... 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10.
11. Total Deductions (total Lines 9 ~ 10) ................................................................... 11.
12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............................................... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ......................................... ...... 14.
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .00 15.
16. Amount of Line 14 taxable
at lineal rate X .045 16.
17. Amount of Line 14 taxable
at sibling rate X .12 3 0, 8 2 6. 7 5 17.
18. Amount of Line 14 taxable
at collateral rate X .15 2 2 0, 6 8 7. 4 8 18.
19. Tax Due .................................................................................................................. 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
15D561D243
5,098.50
154,756.84
100,389.18
22,719.54
282,964.06
30,774.52
675.31
31,449.83
251,514.23
251,514.23
0.00
0.00
3,699.21
33,103.12
36,802.33
Side 2
15D5610243 15D561D243 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-11-0581
DECEDENT'S NAME
Konsko, Roberta 1.
STREET ADDRESS
824 Lisburn Road
CITY
Camp Hill STATE
PA ZIP
17011
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
3. Interest
33,000.00
1,736.84
4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5, If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(1)
Total Credits (A + B) (2)
(3)
(4)
(5)
36,802.33
34,736.84
2,065.49
Make Check Pa able 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 :............................................................................... ^ ^x
b. retain the right to designate who shall use the property transferred or its income :.................................. ^ ^x
c. retain a reversionary interest; or ............................................................................................................... ^ ^x
d. receive the promise for life of either payments, benefits or care? ............................................................ ^ ^x
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .................................................................................................................... ^
3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death?....... ^ ^x
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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of
assets and filing a tax return are still applicable even 'rf the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)].
. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in
72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)].
. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)]. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rev-1503 IJC+ Is•sel
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Konsko, Roberta I. 21-11-0581
All property jointlyowned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER CUSIP
NUMBER
DESCRIPTION
UNIT VALUE VALUE AT DATE
OF DEATH
1 412 shares of Banco Santander - 412 Shares (mean value) 12.375 5,098.50
TOTAL (Also enter on Line 2, Recapitulation) 5,098.50
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule B (Rev. 6-98)
Rew1S08 FJ(+ Is-~l
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
Konsko, Roberta I. 21-11-0581
Include the proceeds of litigation and the date the proceeds were received by the estate.
All propsRy jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1 Holy Spirit Hospital -refund of overpayment 107.72
2 Integrity Bank -Checking Account 203001811 4,858.12
3 Integrity Bank -Checking Account 203028771 34,575.22
4 Integrity Bank -Savings Account 403001921 2,412.65
5 IRS Tax Refund (2010) 3,031.00
6 M8rT Bank -Checking account 2,905.14
7 Miscellaneous cash 64.12
8 Sale of 1923 Silver Dollar 22.00
9 Sale of five gold bracelets 900.00
10 RiverSource Life Insurance Company -Annuity Contract No. 9920-5946929 (paid to estate) 105,880.87
TOTAL (Also enter on Line 5, Recapitulation) ~ 154,756.84
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98)
Rev-1509 rx+ (8-95)
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERRANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Konsko, Roberta 1. 21-11-0581
Han asset was made joint within one year of the decedents data of death, It must bs reported on schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Martin F. Butler 407 E. Marble Street Friend
Mechanicsburg, PA 17055
B.
C
JOINTLY OWNED PROPERTY:
ITEM
NUMBER
LETTER
FOR JOIN
TENANT
DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT
NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR
JOINTLY-HELD REAL ESTATE.
DATE OF DEATH
ALUE OF ASSE % OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
1 A 03/31/2009 Integrity Bank -Certificate of Deposit 100,239.17 50.000°/a 50,119.59
30139970
2 A 03/31/2009 Integrity Bank -Certificate of Deposit 3013988 100,239.17 50.000°/a 50,119.59
3 A Two ladies bracelets -located in safe deposit 300.00 50.000% 150.00
box held by Decedent and Martin Butler
TOTAL (Also enter on Line 6, Recapitulation) I 100,389.18
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98)
Rev-1510 EX+ (B-95)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
cor~oNwEUTN of PENNSnvANIA
INHERRANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Konsko, Roberta I. 21-11-0581
This schedule must be completed and filed 'If the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
THE DATE OF TROAFNSFRERSATfACNTA COPY of THE DEED FOOREREAL ESTATE. DATE OF DEATH
VALUE OF ASSET % OF DECD'S
INTEREST EXCLUSION
(IF APPLICABLE) TAXABLE
VALUE
1 Martin Butler -cash gift (4/25/11) 7.000.00 3,000.00 4,000.00
2 Prudential Annuity -Annuity Contract 97 620 737; the 18,719.54 18,719.54
beneficiaries of this asset are the decedent's heirs,
Betty R. Renninger and Theodore Bogosh, III.
TOTAL (Also enter on Line 7, Recapitulation) I 22,719.54
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98)
REV-1757 EX+I~O.05)
CONIAAI~~TECEi~~AN IA
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Konsko, Roberta I. 21-11-0581
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
A, FUNERAL EXPENSES:
See continuation schedule(s) attached
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Robert D. Firkal
Street Address 699 Carbon Avenue
City Harrisburg State PA zio 17111
Year(sl Commission paid
2. Attorney's Fees Michael L. Bangs
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zio
Relationship of Claimant to Decedent
9,386.55
10,000.00
10,000.00
4. Probate Fees 366.50
5. Accountant's Fees 750.00
6. Tax Return Preparer's Fees
7. Other Administrative Costs 271.47
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 30,774.52
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF (FILE NUMBER
Konsko, Roberta I. 21-11-0581
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Robert D. Firkal -reimbursement for funeral luncheon 662.55
2 Stone 8 Murray Funeral Home 8,724.00
H-A 9,386.55
Other Administrative Costs
3 Cumberland Law Journal -estate advertisement
4 Register of Wills -short certificates
5 The Sentinel -estate advertisement
H-67
75.00
20.00
176.47
271.47
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
Rev-1512 F,(a (12.08)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Konsko, Roberta I. 21-11-0581
Report debts incurred by the decedent prior to death that romainsd unpaid at the date of death, including unreimburead medical expenses.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1 Center for Kidney Disease and Hypertension 199.72
2 Manor Care 16.00
3 Medco Health Solutions 15.00
4 State Employees Retirement System -refund of overpayment 61.68
5 The Woods At Cedar Run 78.06
6 Verizon 149.66
7 Weis Pharmacy 53.52
8 West Shore EMS -BLS 101.67
TOTAL (Also enter on Line 10, Recapitulation) ( 675.31
(H more space is needed, additional pages of the same size)
Copyright (c) 2009 form software only The Lackner Group, Inc. Forrn PA-1500 Schedule I (Rev. 12-08)
REV-1513 EX+(11.08)
COMIrI~,~~I~~~~~ANIA
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
Konsko, Roberta I. 21-11-05 81
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
~ distnbutions, and transfers
under Sec. 9116 a 1.2
See attached schedule
Total 251,514.23
Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 15 00 cover sheet as a r o riate.
NON-TAXABLE DISTRIBUTIONS:
II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 of REV-1500 CovER StiEETI
Copyright (c) 2009 form software only The Lackner Group, Inc. Forth PA-1500 Schedule J (Rev. 11-08)
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Roberta 1. Konsko 04/28/2011 202-20-8183
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) (~~~)
1 Marion Bogosh Sister 25% of residue
10 Bogosh Lane
Tamaqua, PA 18252
2 Theodore Bogosh III Nephew 1/2 Schedule B; 1/2
10 Bogosh Lane Schedule G, Item 2; 9%
Tamaqua, PA 18252 residue
3 Martin F. Butler Friend Schedule F; Schedule
407 E. Marble Street G, Item 1; 23% of
Mechanicsburg, PA 17055 residue
4 Robert Frank Nephew 10% of residue
5209 Shore View Drive
Lake Shore Estates
Concord, NC 28025
5 Joan Haldeman Niece 6% of residue
337 Penn Street
Tamaqua, PA 18252
6 Betty Bogosh Renninger Niece 1/2 Schedule B; 1/2
Post Office Box 492 Schedule G, Item 2; 9%
139 Market Street of residue
Aubum, PA 17922-0492
7 Barry Stahler, Jr. Grand Nephew 1/3 of 5% residue
25 North Railroad Street
Apt. 2
Tamaqua, PA 18252-1340
8 Dale Stahler Nephew 6% of residue
217 Penn Street
Tamaqua, PA 18252
1
SCHEDULE J
BENEFICIARIES
(Part 1, Taxable Distributions)
ESTATE OF:
Roberta I. Konsko 04/28/2011 202-20-8183
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) (aas)
9 Matthew Stahler Grand Nephew 113 of 5% residue 2,055.12
121 Ben Tidus Road
Stillcreek, PA 18252
10 Ronald Stahler Nephew 7% of residue 8,631.49
317 Penn Street
Tamaqua, PA 18252
11 Scott Stahler Grand Nephew 113 of 5% residue 2,055.11
34 W. Phillips Street
Coaldale, PA 18218
Total 251.514.23
2
SCHEDULE J - BENEFICIARIES
Estate of Roberta I. Konsko File No. 21-11-0581
CALCULATION OF RESERVE
Martin Butler Schedule F $100,389.18
Schedule G, Item 1 $4,000.00
Betty Renninger % Schedule B $2,549.25
%z Schedule G $9,359.77
Theodore Bogosh '/Z Schedule B $2,549.25
'/Z Schedule G $9,359.77
$128,207.22
So Net Value of Estate $251,514.23
6128,207.22
$123,307.01
Residue Calculation:
Marion Bogosh 25% ~ $123,307.01 = $30,826.75
Martin Butler 23% x $123,307.01 = $28,360.61
Robert Frank 10% x $123,307.01 = $12,330.70
Betty Renninger 9% x $:123,307.01 = $11,097.63
Theodore Bogosh 9% x $123,307.01 = $11,097.63
Ronald Stabler 7% x $123,307.01 = $8,631.49
Dale Stabler 6% x $123,307.01 = $7,398.42
Joan Haldeman 6% x $123,307.01 = $7,398.43
Barry Stabler
Matthew Stabler 5% x $123,307.01 = $6,165.35
Scott Stabler (divided such that two receive $2,055.12 and one receives $2,055.11)
Total: $123,307.01
Integrity
B A N K
Michael L. Bangs
429 South 18`h Street
Camp Hill, Pa 17011
RE: Estate of I•'.oberta I. Konsko
To whom it may concern:
Here is the information your office has requested regarding the accounts held by
Roberta Konsko.
1. Checking account number 203001811, opened 8/4/2005 titled Roberta I. Konsko
POA Martin Butler. At th~ time of death the account balance was $4,858.12. The year to
date interest on the account is $5.80. The account was closed by Mr. Robert Firkal on
May 17`h, 2011 in the amount of $2396.79.
2. Checking account number 203028771, opened 4/25/2011 titled Roberta I. Konsko
POA Martin Butler. At tre time of death the account balance was $34,575.22. The year to
date interest on the account is $15.63. The account was closed by Mr. Robert Firkal on
May 17`h, 2011 in the amount of $34.590.85.
3. Savings account number 403001921, opened 8/4/2005 titled Roberta I. Konsko. At the
time of death the account balance was $2412.65. The yeaz to date interest on the account
is $2.31. The account was closed by Mr. Robert Firkal on May 17`h, 2011 in the amount
of $2413.41.
4. Safe Deposit Box number 90, opened 9/16/2010 titled Roberta I. Konsko and Martin
Butler. The safe deposit box is still open.
5. Certificate of Deposit number 3014468, opened 7/20/2009 titled Roberta I. Konsko.
The account was closed on April 25`~ 2011 in the amount of $44,575.22. The funds were
distributed as follows: $34,575.22 into checking account # 203028771, $3000.00 into
checking account #2030!.1811, and the remaining $7000.00 was taken in cash.
3345 Ma~krt Stnrt, Camp HzU, PA 17011 • Pbonc: 717-920-4900.877- l-HAV~'IT • lar 717-920-49114 • wruw. r~urgrit~am(ronline.com
Integrity
B A N K
6. Certificate of Deposit number 3013970, opened 3/31/2009 titled Roberta I. Konsko
and Martin Butler. At the time of death the account balance was $100,239.17. The year to
date interest on the account is $1,149.55. The account is still active.
7. Certificate of Deposit number 3013988, opened 3/31/2009 titled Roberta I. Konsko
and Martin Butler. At the time of death the account balance was $100,239.17. The year to
date interest on the account is $1,149.55. The account is still active.
If you have any question: or concerns please feel free to contact me at 717-901-5500.
Joe Ritter
~5_
Joe Ritter
Customer Service Rep.
Integrity Bank
440 Bridge St.
New Cumberland, Pa 17070
717-901-5500
3345 Mwrker Srnct, Camp Hill. PA 17011 • Pbo»e: 717-920- 4900.877- I-HAVEIT • Firms 717-9Z0-9909 • www. rnrcgit~an~+v-din<.cam
RiverSource
Life Insurance Company
829 Aa~eriprise Financial Center
Mimeapolis, NN 55474
July 12, 2011
Estate Of Roberta I Konsko
Robert D Firkal Adminstrative
699 Carbon Avenue
Harrisburg, PA 17111
Contract Owner: Roberta I Konsko
Contract Number: 9920-5946929
Dear Estate Of Roberta I Konsko:
Please accept our condolences on your loss.
Enclosed is a check in the amount of $105,880.87. This check represents the
death benefit due on the above annuity contract.
The following is provided for your records:
STANDARD DEATH BENEFIT: $ 105,880.87
FEDERAL TAX WITHHELD: 0.00
STATE TAX WITHHELD: 0.00
CHECK AMOUNT;
TAXABLE AMOUNT
105,880.87
5,880.87
If you have any questions, please contact our Customer Service Team at
1-800-333-3437.
Sincerely,
RiverSource Life Insurance Company
C46i35LG4.C01 -Alp
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PAY One Hundred Five Thousand Eight Hundred Fi~~fi~ and 87/100 Do ars****
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Estate Of Roberta I ,
Konsko ~w.
Pay to BigRobert D Firkal Admirxstrai:ive
order of 699 Carbon Avenue
Harrisburg, PA- 17111 .
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499 Mitchell Road, Millsboro, DE 19966 Adjustment Services
Phone 888-502-4349
F ax (302)934-2955
lone 2, 2011
Bangs Law Office
428 South 18n' Street
Camp Hill, PA 17011
Re: Estate of Roberta I Konsko
Social Security: 202-20-8183
Date of Death: Apri128.2011
Dear Sir or Madam:
Per your inquiry on May 24, 2011, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
1. Type of Account Checking Account
Accoura Number 52334791
Ownership (Names ofl Roberta 1 Konsko
Opening Date D£i/lR/64
Balance on Date of Death $2,905.14
Accrued Interest $ .00
Total $2,905.14 -- -_--_
For any additlonal information on the above aaoanb, indnding ownership and any dumges, dosares and/or reimbursement of foods,
please eaD the Hi~and Park Oilioe at iR117•T37-3322
We were unable to locate any safe deposit box for the above-mentioned decedent.
Ibis lelier does not u>dude any aocamts in which the deceased may have bceu listed as Power of Attorney, C~sMdian of [hifaen Traosfeis,
Represe~athe Payee; or 1~nta under a Writbea Agreeatmt
Sincerely,
Tammy Spencer
Adjustment Services
r
!~. ,~~ Pren~~
Bangs Law Office
429 South 18'h Street 7
Camp Hill, PA 1701 I
Dear Sir or Madam:
Thank you for your inquiry on the above contract.
The contract value as of 4/28/2011 was $18,719.54.
Prudential Annuities
A Business of Prudential Financial, Inc.
P.O. Box 7960
Philadelphia, PA 19176
(888) 778-2888 TTY: (800) 654-7637
www.prudential.com
Re: ROBERTA 1 KONSKO
Contract Number: 97620737
June 30, 2011
if you have any questions, please call the Prudential Annuity Service Center at (888) 778-2888. The
Service Center is open Monday through Thursday between 8:00 a.m. and 7:00 p.m. and Friday between
8:00 a.m. and 6:00 a.m. Eastern time. If you are using a telecommunications device for the hearing
impaired, you may call (800) 654-7637, Monday through Friday between 8:00 a.m. and 8:00 p.m. Eastern
time.
Sincerely,
Annuity Service Center
Prudential Financial
Variable annuities are issued by Pruco Lite Insurance Company (in New York, by Pruco Life Insurance Company of New Jersey). Both companies
are located in Newark, NJ. Variable annuities are distributed by Prudential Annuities Distributors, Inc., Shelton, CT. Fixed annuities are issued by
The Prudential Insurance Company of America. All are Prudential Financial companies and each is solely responsible for its own financial
condition and contractual obligations.
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.~
I, ROBERTA I. KONSKO, of Lower Allen Township, Cumberland Cowrty,
Pennsylvania, declare this to be my last will and revoke any will prP'. iously made by me.
~ ITEM i. I direct that all my just debts and funeral expenses, including my graL-emarker.
~` and all expenses of my last illness, and any and all taxes and assessn ~•ents imposed by any
~ governmental body as a result of my death, whether on property passing under this will or
otherwise, shall be paid from my residuary estate as soon as practica~~le after my death as a part
of the expense of the administration of my estate.
ITEM II. I make the following specific bequests:
A. I give all my shares in Sovereign Bankcorp, in eq~:•al shares, to
THEODORE BOCrUSH, III and BETTY BOGOSH RENNIi `GER, or the
survivor of them that survive my death by thirty (30) days.
ITEM III. I give, devise, and bequeath all the rest, residue, ~ ad remainder of my
passessi~ns and estate in accordance with the following:
A. Seven (7%) percent to RONALD STAHLER;
'~~
B. Six (6%) percent to DALE STAHLER;
' C. Six (6%) percent to JOAN HALDEMAN;
D. Twenty-three (23%) percent to MARTIN F. BLTT',ER;
E. Nine (9%) percent to BETTY BOGOSH RENNITIGER;
F. Nine (9%) percent to THEODORE BOGOSH, III,
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G. Five (5%) percent, divided equally, among the sons of Bany Stahler,
deceased, being BARRY STAHLER, JR.,; MATTHEW STAHLER and SCOTT
STAHLER, or the survivor of them;
H. Ten (10%) percent to ROBERT FRANK. Should~Robert Frank fail to
survive my death by thirty (30) days, then his share shall go ±o CHRISTINA
FRANK MOOSE; and
b.
~~ I. Twenty-five (25%) percent to MARION BOGOSH. Should Marion
a„ ~ Bogosh fail to survive my death by thirty (30) days, then her shaze shall go evenly
~ to THEOGORE BOGOSH, III and BETTY BOGOSH RENNINGER.
~ ITEM IV. If an art of m estate shall vest in a
y p y person who shall not have attained the
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age of majority in the jurisdiction of the person's domicile, my personal representative may, with
absolute discretion, deliver such part of any portion thereof, without 'pond, to the parent or
appointed or legal guardian of such person to be held for such person until he or she reaches his
or her ma~onty. The receipt of any such shaze by the guazdian shall be a complete discharge and
Y acquitance of my personal representative as to that shaze and shall b~~. final and bindin on all
g
persons in interest.
ITEM V. All of the interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation nor shall they to subject to any execution or
attachment.
ITEM VI. I appoint my friend ROBERT D. FIRKAL executor of this my Iast will.
Should Robert D. Firkal predecease me or otherwise fail to qualify c~ cease to serve as executor
of this my last will, I appoint my friend THOMAS R. JOHNSON executor of this my last will.
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The executor is to be paid for his service as executor a fee that is equal to five (5%) percent of
the first $100,000.00 of my gross estate; three (3 %) percent of any amount over $100,000.00 of
my gross estate, but in any event a fee not to exceed $10,000.00.
~ ITEM VII. In addition to the other powers and authorities granted to my personal
b representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby
give to my personal representatives the following powers and authorities effective without court
~~\ approval and until actual distribution of all property: to compromise any claim or controversy;
O to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as
my personal representatives may determine and at valuations finally to be fixed by them; to
invest in all forms of property, including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorized for Pen~isylvania fiduciaries, as my
personal representatives deem proper, without regard to any principle of risk or diversification;
to retain any or all assets of my estate, real or personal, without regard to any principle of risk or
diversification; to sell at public or private sale, to exchange, or to lease for any period of time,
any real or personal property and to give options for sales, exchanges, or leases, for such prices
and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses tc principal or income or partly to each as my personal representatives
deem proper in their sole discretion.
ITEM VIII. I direct that my personal representatives and fiduciaries shall not be
required to give bond for the faithful performance of their duties in any jurisdiction.'
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IN WITNESS WHEREOF, I have hereunto set my hand r~ ~s ~ o? 8' day of
_, 2009.
~~ ~ ~.
ROBERTA I. KONSkJ
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The preceding instrument, consisting of this and FOUR other typewritten pages, each
identified by the signature of the testatrix was on the date thereof signed, published, and declared
by ROBERTA I. KONSKO, the testatrix therein named, as and for her last will, in the presence
of us, who at her request, in her presence, and in the presence of each other, have subscribed our
names as witnesses hereto.
~~ Q
s
COMMONWEALTH OF PENNSYLVANIA ~
COUNTY OF CUMBERLAND (SS:
The undersigned, being the testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, does hereby acknowledge that I signed and
executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free
and voluntary act for the purposes therein expressed.
ROBERTA I. KONSKO
Sworn or affirmed to and acknowledged
before me by the t ~~t~~ri~~n~amed above
this ~C~ ~ day o~~~~.1.~ , 2009.
otary~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Wbndy KK Stiaub, ~Y Public
lroNar Mien Twee., ~ ~a.J
MY Corrxnsssi~~ Wires May 10, 2041
P~ylvania Association of Notaries
( SS:
~,~'~~`L/~ ~N~ and 1yNN E RENFeGD
witnesses whose names are signed to the attached or foregoing instrument, bein dul the
to law, do depose and say that we were present and saw the testatrix sign and execute thealnstrument as ng
her last will; that she signed it willingly and that she executed it as her free and voluntary act for the
purposes therein expressed; that each of us in the hearing and sight of the westatrix signed the wilt as
witnesses; and that to the best of our knowledge, the testatrix was at that tune 18 or more years of age, of
sound mind, and under no constraint or undue infl ce. l
1,
Sworn r affirmed to and acknowledged
before n thi Z day of
--=-- , 2009.
1a~ P 'd A
Lam,,, ~,-~i~c~.-~.~/.0
r`
~~
-~~~.
~oNer~ T~^Ost#'. ~y Pubk
~'rP., Ctrnbe~~
i!'il! CormUeebn E~in~ May 10
of
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