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HomeMy WebLinkAbout03-0869REV ~,500 EX (600) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 / REV-I$00 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Kinsinger, Fredrick L. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 7/31/2003 07/14/1920 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Kinsinger, Anna M FILE NUMBER COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 175-07-3153 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER I 185-18-3158 r~l. Original Return E~4. Limited Estate El6. Decedent Died Testate (Attach copy of Will) []9. Litigation Proceeds Received NAME Fred L. Kinsinger II FIRM NAME (If Applicable) TELEPHONE NUMBER (330) 336-5173 -]2. Supplemental Retum [] 3. Remainder Return (date of death prior to 12-13.-82) [] 4a. Future Interest Compromise (date of death after 12-12-82) [] 5. Federal Estate Tax Retum Required D7. Decedent Maintained a Living Trust (Attach copy of Trust) 8. Total Number of Safe Deposit Boxes [] 10. Spousal Poverty Credit (date of death between 12-31-9~ a,d 1-1-95) BI 11. Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS 531 Charles Court Wadsworth, OH 44281 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages 8, Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses &Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 2,975.00 101,987.99 42,616.62 (8) 9,446.93 (11) (12) (13) (14) 147,579.59 9,446.93 138,132.66 138,132.66 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal 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 at sibling rate 18. Amount of Line 14 taxable at collateral rate 19, Tax Due 20. 79,162.52 x .0 O0 ¢5) 58,970.14 x .0 45 (16) x .12 (17) x .15 (18) (19) 2,653.66 Decedent's Complete Address: STREET ADDRESS 2917 Harvard Avenue CITYcamp Hill I STATEpA Tax Payments and Credits: 1. Tax Due(Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) I z~P17011 132.68 Total Credits ( A + B + C ) (2) 3. InterestJPenalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + 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) 2,653.66 132.68 0.00 2,520.98 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 2,520.98 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS IF THE ANSWER Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT [] AS PARTOF THE RETURN. Under penalties of perjury, { declare that I have examined this retum, including 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 2917 Harvard Avenue, Camp Hill, PA 17011 SIGNA_.~_ R~~HER THAN REPRESENTATIVE 531 Charles Court, Wadsworth, OH 44281 DATE DATE Ocr /~', 2.00,.3' 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 to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 RS. §9116(1.2) [72 RS. §9116(a)(1)]. The tax rate imposed on the net vatue of transfers to or for the use of the decedent's siblings is 12% [72 RS. §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-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Fredrick L. Kinsinger Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 300.OO 1984 Oldsmobile Sedan, 1G3AN69Y9EX357998, mileage = 86,374 (value based on Blue Book value as determined On-Line) 1994 Oldsmobile Sedan, 1G3HN53L5PH310633, mileage = 45,857 (value based on Blue Book value as determined On-Line) 2675.00 TOTAL (Also enter on line 5, Recapitulation) $ 2,975.00 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (6-98~;~.~..~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER FredrickL. Kinsinger If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Anna May Kinsinger Fred L. Kinsinger 2917 Harvard Avenue, Camp Hill, PA 17011 531 Chades Court, Wadsworth, OH 44281 Surviving Spouse Son JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER, ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 11/01/60 PNC Bank, Checking account # 5140034512 2912.62 50 1,456.3' 2. A. 09/21/88 PNC Bank, Checking Account # 5140122889 4,089.39 50 2,044.7( 3. A+B 06/22/01 PNC Bank, CD # 31900212072 66,115.53 33.3 22,038.5' 4. A+B 07/05/01 PNC Bank, CD#31600212735 10,958.77 33.3 3,652.9; 5. A+B 08/03/01 PNCBank, CD#31200216367 2,592.72 33.3 864.2, 6. A+B 10/24/01 PNC Bank, CD#31900220792 7,503.37 33.3 2,501.1; 7. A+B 10/23/01 Pennsylvania State Bank, Savings Account # 21402599 2,639.76 33.3 879.9; 8. A+B 12/30/02 Pennsylvania State Bank, CD#010677 20,000.00 33.3 6,666.6; 9. A+B 12/30/02 Pennsylvania State Bank, CD # 011285 25,500.47 33.3 8,500.1( 10. A+B 12/30/02 Pennsylvania State Bank, CD # 011286 25,500.47 33.3 8,500.1( 11. A+B 12/30/02 Pennsylvania State Bank, CD # 011287 25,500.47 33.3 8,500.1( 12. A+B 12/30/02 Pennsylvania State Bank, CD# 011288 10,200.20 33.3 3,400.0; 13. A+B 12/30/02 Pennsylvania State BAnk, CD # 011289 10,200.20 33.3 3,400.0; 14. A+B 12/30/02: Pennsylvania State Bank, CD # 011290 5,100.10 33.3 1,700.0; 15. A+B 04/09/02 Pennsylvania State Bank, CD # 010526 30,382.83 33.3 10,127.6' 16. A+B 04/09/02 1 Pennsylvania State Bank, CD # 040647 26,498.76 33.3 8,832.9; 17. A+B 03/25/02 Pennsylvania State Bank, CD # 011160 26,767.19 33.3 8,922.4( TOTAL (Also enter on line 6, Recapitulation) $ 101,987.97 (If more space is needed, insert additional sheets of the same size) REV-1510 EX+ (6-98~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Fredrick L. Kinsinger 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 ~es. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OFTHE TF{ANSFEREE, THEIR RELATIONSHIPTO 0ECEDENTAND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATrACHACOPYOFTHEDEEDFORREALESTATE. VALUE OFASSET INTEREST (IFAPPLICABLE) VALUE 1. Pennsylvania State Bank CD# 040654 held as an IRA. 22,661.94 100 3,000.00 19,661 .(, CD Originally purchased in 2001 or before. Beneficiary: Anna May Kinsinger, Surviving Spouse 2. Waypoint Bank, Checking Account # 0100491539 3,855.49 33.3 3,855.z Account Opened 5/9/03 Jointly Owned by Decedent + Anna May Kinsinger, Surviving Spouse + Fred L. Kinsinger II, son 3. Waypoint Bank, CD # 9600010246 2,010.80 33.3 2,010.~ CD Purchased 5/9/03 Jointly Owned by Decedent + Anna May Kinsinger, Surviving Spouse + Fred L. Kinsinger II, son 4. Waypoint Bank, CD # 9600011290 20,088.03 33.3 3,000.00 17,088.( CD Purchased ~/'2.//o,.~ Jointly Owned by Decedent + Anna May Kinsinger, Surviving Spouse + Fred L. Kinsinger II, son TOTAL (Also enter on line 7 Recapitulation) $ 42,616.~ (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99)/~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Fredrick L. Kinsinger Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 5. 6. 7. FUNERAL EXPENSES: Paid to Myers-Hamer Funeral Home, 1903 Market Street, Camp Hill, PA 17011 Casket, mortician, viewing service, transport, etc. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Anna May Kinsinger Street Address 2917 Harvard Avenue City Camp Hill Relationship of Claimant to Decedent Surviving Spouse Probate Fees Accountant's Fees Tax Return Preparer's Fees State PA Zip 17011 5,090.00 856.93 3,500.00 TOTAL (Also enter on line 9, Recapitulation) $ 9,446.93 (If more space is needed, insert additional sheets of the same size) Pennsylvania State Bank September 3, 2003 Fredrick L. Kinsinger, II 531 Charles Court Wadsworth, OH 44281 RE: Estate ofFredrick L. Kinsinger Dear Mr. Kinsinger, Again, let me take a moment to express my condolences to both you and your mother on the passing of your father. I would like to let you know I am thinking of you during this time. I have received your letter regarding the accounts your father had with Pennsylvania State Bank. The following is information I took off the system: (Please note that balances are reflected as of your father's date of death and have continued to earn interest since that date) Premium Savings Account #21402599:$2,639.76 Joint Owners: Anna May Kinsinger or Fredrick L. Kins~nger II* *added 10/23/01 CD #010677:$20,000.00 Joint Owners: Anna May Kinsinger or Fredrick L. Kins~nger II 3. CD #011285:$25,500.47 Joint O,~mers: Anna May Kinsinger or Freddck L. Kins~nger II 4. CD #011286:$25,500.47 Joint Owners: Anna May Kinsinger or Fredrick L. K/ns~nger II 5. CD #011287:$25,500.47 Joint Owners: Anna May Kinsinger or Fredrick L. Kinsinger II 6. CD #011288:$10,200.20 Joint Owners: Anna May Kinsinger or Fredrick L. Kinslnger II 7. CD #011289:$10,200.20 Joint Owners: Anna May Kinsinger or Fredrick L. Kinslnger II 2148 Mariner Street P. 0. Box487 Camp Hill, PA 17001-0487 717.731.7272 fax 717.731.7276 pastatebank.com 8. CD# 012290:$5,100.10 Joint Owners: Anna May Kinsinger or Fredrick L. Kinsinger II CD# 010526:$30,382.83 Joint Owners: Anna May Kinsinger or Fredrick L. Kinsinger II* *Added 4/9/02 10. CD #040647:$26,498.76 Joint Owners: Anna May Kinsinger* or Fredrick L. Kinsinger II* *Added 4/9/02 11. CD#011160:$26,767.19 Joint Owners: Anna May Kinsinger or Fredrick L. Kinsinger II 12. IRACD #040654:$22,661.94 Beneficiary: Anna May Kinsinger This concludes the list of accounts your father has with Pennsylvania State Bank. If you should need any further information, please do not hesitate to call me. You may also reach me via email at smcgovem@pastatebank.com. Si~.¢erely, Salli A. M~Gove~ Ba~ing Officer Comm~ity Office Manager Crop Hill Office (717)796-2656 WaU p.o i n LOOK FOR US. WE'LL GET YOU THERE. September 5, 2003 Mr Fred L. Kinsinger II C/O CMA 531 Charles Court Wadsworth, OH 44281 Re: Estate of Fredrick L Kinsinger, deceased Dear Fred, I hope every thing is going well for you and your family after your great loss. I will admit that 1 greatly miss the conversations I had with your father. All of the accounts with your fathers' name also had your name as well as your mothers' name. You were not just signers but joint account holders. The balances on the account as of July 31, 2003 were as follows: 1) checking 0100491539--$ 3,855.49 2) CD# 9600010246-- $2,010.80 3) CD# 9600011290- -$20,088.03 If you or your mother need anything please doWt hesitate to contact me. Sincerely, Heather Williams Branch Sales Manager P.O. Box 1711, HARRISBURG, PENNSYLVANIA 17105-1711 Toll FrE~ 1-866-WAYPOINT (I-866-929-7646) · IN YORK AREA 717/815-4500 · vvvvw, wagpointbank.com PNCBank PNC Bank Phone: 717-761-2372 FAX: em. ail: To: FRED L KINSINGER II From: JIM LOOP, PNC Bank c~"ate: Tuesday, September 9, 20~3 Subject: PNC ACCOUNTS For documentation purposes, I am forwarding the attached papers. Checking acct 5140034512, Fred L Kinsinger II added as co-owner 8/1/03. All CD accounts were opened on or after 8/27/99. At this time the CD Accounts tiffed with 3 owners, and no subsequent title changes. All joint accounts have right of survivorship, unless otherwise titled. All accounts in question are titled with names only, and therefore have Survivorship rights. The balances will be mailed under separate cover. Page 1 Document Name: untitled **** ACCT COMMENT: 040 00000000005140034512 TYPE: DDA ICK BID: 00102 CYL: DATE OPEN: 11/01/1960 CLOSED: PLAINT: 08/01/2003 ADDRESS: 08/01/2003 ID CCT X SOLD BY REST PACKAGE HDM ST A DP-ID CR LEGALI: FREDERICK LEE KINSINGER SSN-TA~X: 175-07-3153 LEGAL2: ANNA MAY KINSINGER LEGAL3: FRED L KINSINGER II LEGAL4: ADDRESSI: USE FROM: ADDRESS2: COUNTRY: CITY : STATE: ZIP: DATE PURGE SEQ TYP COMMENT 04/25/2000 99 01 W-C PC 04/25/2000 --- CERTIFIED TIN 04/25/2000 99 08/01/2003 7Y 02 W-P PC 09/09/1999 CERTIFIED TIN 01 REDERICK LEE KINSINGER k~/ ANNA MAY KINSINGER TO: PAGE: 1 OF DRA568A HIT 'CLEAR KEY' TO QUIT DRA001I TRANSACTION COMPLETE CMT Date: 9/9/2003 Time: 1:06:50 PM Page~ 1 Document Name: untitled **** ACCT COMMENT: 040 00000000003500074910 TYPE: CDA BID: 00000 CYL: DATE OPEN: 12/27/2000 CLOSED: MAINT: 10/26/2001 ADDRESS: ID CCT X SOLD BY REST PACKAGE ST A DP-ID CR LEGALi: FREDRICK LEE KINSINGER SSN-TAX: 175-07-3153 LEGAL2: ANNA M KINSINGER LEGAL3: FREDRICK L KINSINGER II LEGAL4: ADDRESSI: USE FROM: ADDRESS2: COUNTRY: CITY : STATE: ZIP: DATE PURGE SEQ TYP COMMENT 12/28/2000 99 01 W-C PC 04/25/2000 --- CERTIFIED TIN 12/28/2000 99 02 W-P PC 12/27/2000 --- CERTIFIED TIN TO: PAGE: 1 OF 1 CMT DRA568A HIT 'CLEAR KEY' TO QUIT DRA001I TRANSACTION COMPLETE Date: 9/9/2003 Time: 1:16:08 PM Page~ 1 Document Name: untitled · **** PER CUST REL ACCT 000 KINSI4F7L001 SSN: 175073153 PH: 7177373703 NAME : FREDRICK LEE KINSINGER BUS: ADDRESSi: 2917 HARVARD AVE ADDRESS2: CITY : CAMP HILL EMPLOYER: RETIRED OCCUP : RETIRED BID: 00106 OFFICERS: EMP PBK CMB / PRV X CCT X CNO USE FROM: TO: STATE: PA ZIP: 17011-5235 COUNTRY: DOB: 07/14/1920 ON FILE: 11/01/1960 CONTACT: 02/24/1997 ADDRESS: 02/24/1997 PNA C DEL PIN MAINT: 08/01/2003 PAGE: 1 OF 1 TRN BNK TYP ACCOUNT NUMBER BID REL MAIL OPEN CLOSED PRODUCT - 000 ALK 00000000001750731532 00000 F-N A 04/27/1996 TBK 040 CCA 0000XXXXXXXXXXXX8324 00000 F-N A 05/01/1985 CPL 040 CDA 00000000003500074910 00000 F-N A 12/27/2000 040 DCA 00574023002979223664 00000 F-N A 12/15/1999 ATM 040 DDA 00000000005140034512 00102 F-N A 11/01/1960 ICK HDM 040 DDA 00000000005140122889 00102 O-N A 09/21/1988 ICK 040 SDB 0000000000040102955N 00102 O-N A 11/19/1987 040 SVG 00000000005002037539 00102 F-N A 04/24/2000 04/11/2003 MMA DRA064I CUST HAS PRIVACY FLAG DRA568A HIT 'CLEAR KEY' TO QUIT DRA536I KEY X,F,N OR TRAN CODE DRA007I LAST PAGE CMT Date: 9/9/2003 Time: 1:16:28 PM PN CBAlXK September 15, 2003 Dear Mr. Kinsinger II On Friday September 12, I mailed you a letter with the date of death balances for your father. Please disregard it and replace it with the one enclosed. I did not realize at the time on the checking account it should have been in Fredrick and Anna name only. If you have any questions please do not hesitate to call. Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, Erica L Schlegel PNC Decedent Reporting Firstside Center 500 First Ave, 4th F1 CIF Pittsburgh PA 15219-3128 1-800-762-1775 Member FDIC O. PNCBAN< September 12, 2003 Fred L Kinsinger II 531 Charles Ct. Wadsworth, OH 44281 scp RE: Estate of Fredrick Lee Kinsinger (Deceased) SSN: 175-07-3153 DOD: 07-31-2003 Dear Mr. Kinsinger: In response to your request for Date of Death balances for the customer noted above, our records show the following: Certificate of Deposit Account#31900212072 Established 06-22-2001 FREDRICK LEE KINSINGER ANNA M KINSINGER FREDRICK L KINSINGER II DOD balance: $66,087.47 + $28.06 accrued interest Account#31600212735 Established 07-05-2001 FREDRICK LEE KINSINGER ANNA M KINSINGER FREDRICK L KINSINGER II DOD balance: $10,921.43 + $37.34 accrued interest : g / o, ~3-~. 77 Account#31200216367 Established 08-03-2001 FREDRICK LEE KINSINGER ANNA M KINSINGER FREDRICK L KINSINGER ti '~ DOD balance: $2,590.24 + $92.48 accrued interest ~-"e ~L.~ $~7 ~. - Account#31900220792 DOD balance: Established 10-24-2001 FREDRICK LEE KINSINGER ANNA M KINSINGER FREDRICK L KINSiNGER II $7,497.72 + $5.65 accrued interest -: gt 7, ~-o~. '2 Page 1 of 2 Checking Account Account#5140034512 Established 11-01 - 1960 FREDERICK LEE KINSINGER ANNA MAY KINSINGER DOD balance: $2,912.30 + $0.32 accrued interest Account#5140122889 Established 09-21 - 1988 ANNA MAY KINSINGER FREDRICK LEE KINSINGER DOD balance: $4,088.83 + $0.56 accrued interest Safe deposit box The decedent maintained safe deposit box #955N. It was in two names. ANNA MAY KINSINGER FREDERICK KINSINGER It is located at: CAMP HILL 2101 MARKET STREET CAMP HILL PA 17011 717-761-2372 Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, Erica L Schlegel PNC Decedent Reporting Firstside Center 500 First Ave, 4th F1 CIF Pittsburgh PA 15219-3128 1-800-762-1775 Member FDIC Page 2 of 2 ,. Kinsinger ~ aries Court ,, OH 44281-2204 LOVE I OVE Register of Wills Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003168 KINSINGER FRED L II 531 CHARLES COURT WADSWORTH, OH 44281 ........ fold ESTATE INFORMATION: SSN: 175-07-3153 FILE NUMBER: 2103-0869 DECEDENT NAME: KINSINGER FREDRICK L DATE OF PAYMENT: 10/23/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 07/31/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 92,520.98 TOTAL AMOUNT PAID: 92,520.98 REMARKS: ANNA MAY KINSINGER C/O FRED L KINSINGER II SEAL CHECK# 9522 INITIALS: SK RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES TNHERXTANCE TAX DXVTSION DEPT. Z80601 HARRISBURG, PA 17128-0601 FRED L KINSINGER II 551 CHARLES CT WADSWORTH CONNONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE OH qq281 NOTZCE OF INHERZTANCE TAX APPRAISEMENT, ALLO#ANCE OR DISALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RE¥-1S¢7 EX ~FP DATE 12-15-2005 ESTATE OF KINSINGER DATE OF DEATH 07-$1-2003 FILE NUMBER 21 03-0869 COUNTY CUHBERLAND ACN 101 I Amount Remitted FREDRICK L HAKE CHECK PAYABLE AND REHIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND C0 COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAZN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP [01-03) NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KINSINGER FREDRICK L FILE NO. 21 03-0869 ACN 101 DATE 12-15-2003 TAX RETURN NAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVATZON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: 1. Real Estate (Schedule A) 2. 3. 5. 6. 7. B. ORIGINAL RETURN (1) Stocks and Bonds (Schedule B) (2) Closely Held Stock/Partnership Znterest (Schedule C) (3) Hortgeges/Notes Receivable (Schedule D) (q) Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) Jointly Owned Property (Schedule F) (6) Transfers (Schedule G) (7) Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Cos~:s/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 15. (9) (10) Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Subjec~ to Tax 2;975.00 101~987.99 q2~616.62 (8) 9,~6.93 .00 NOTE: To insure proper .00 credit to your account, .00 submit the upper port/on .00 of this form wi*h your *ax payment. .00 NOTE: 1~7,579.59 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULAT/ON OF ADDITIONAL INTEREST. ASSESSMENT OF TAX: 15. Amount of Line lq ai Spousal ra~e 16. Amount of Line lq taxable Bi Lineal/Class A rate 17. Amount of Line lq at Sibling ra~e 18. Amoun~ of Line lq taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDZTS: PAYMENT RECETpT DISCOUNT (*) DATE NUMBER INTEREST/PEN PAID (-) 10-23-2003 CD003168 132.68 (15) 79,162.52 x O0 = .00 (16) 58,970.1fi x OqB= 2,653.66 (17) . O0 X 12 = . O0 (la) .00 x 15 = .00 (19)= 2,653.66 AMOUNT PAID 2,520.98 reflect figures that include the total of ALL returns assessed to date. TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE 2,653.66 .00 .00 .00 ( XF 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.) If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 rill (11) 9. q66.93 (12) 138,152.66 (13) . O0 (lq) 138,132.66 RESERVATION: PURPOSE OF NOT/CE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCDUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for 1ifa or for years, the Comaonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side. --Make check or money order payable to: REGISTER OF #ILLS, AGENT A refund of a tax credlt, which was not requested an the Tax Return, amy ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of the Register of Hills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour ansaering service for forms ordering: 1-800-362-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 17128-1021, --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. OR Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 17128-8601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z mill bear interest at a rate ehich will vary fram calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198Z ZOZ . 000548 1987 9Z . 000Z47 1999 7Z . OO019Z 1983 16Z .000438 1988-1991 11Z .000301 ZOO0 8Z .OOOZ19 1984 11X . 000301 199Z 9Z . 000247 ZOOl 9Z . 000Z47 1985 15Z .000356 1993-1994 7Z .O0019Z ZOOZ 67. .000164 1986 lOZ . OOOZT~ 1995-1998 9Z .000247 2003 5Z .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (153 days beyond the date of the assessment. If payment is made after the interest computation date sheen on the Notice, additional interest must bo calculated. REV-1470 EX (6-88)  INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG~ PA 17128-0601 DECEDENT'S NAME FILE NUMBER FREDRICK L KINISlNGER 2103-0869 REVIEVVED BY ACN John Kealy 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES An exclusion cannot be claimed against an IRA because the transfer was not made within G a year of death but upon the death of the decedent. An exclusion has been applied to item 2 of schedule G. Row Page 1 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYL VANIA Estate of Fredrick Lee Kinsinger also known as File Number ~\ 0'3 e><6I.D/ , Deceased Social Security Number 175-07-3153 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE ~' or 'B' BELOW:) o A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is I are the Executrix last Will of the Decedent dated October 18,1979 and codicil(s) dated None named in the (State relevant circumstances, e.g., renunciation, death of executor, etc.) Except as follows, Decedent did not many, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: o B. Grant of Letters of Administration (lfapplicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has I have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Administration, c.t.a. or db.n.c.t.a., enter date o/Will in Section A above and complete list o/heirs.) Name Relationship Residra.,,_., , e" ~,r:-,"" ~o ~ l~ c , U) ;:'Z CO J '__ ~ Decedent was domiciled at death in Cumberland 2917 Harvard Avenue, Camn Hill. Pennsvlvania 17011 (List street address, town/city, township, county, state, zip code) -. ~~)C) j "") -'{'j ') C' -- County, Pennsylvania with his I her last principaliestbnce at TJ --{ ,~ 3.'..:~ -- ....... -=-! (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. "!? c.n N . -........:. Decedent, then 83 years of age, died on July 31, 2003 at Holy Spirit Hospital Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (lfnot domiciled in PA) Personal property in Pennsylvania (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania 22,000.00 $ $ $ $ situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: T ed or rinted name and residence Anna May Kinsinger, 325 Wesley Drive, Apt. 3332, Mechanicsburg, PA 17055 FormRW-02 rev.10.J3.06 Page 1 of2 Oath of Personal Representative COMMONWEALTH OF PENNSYL VANIA SS COUNTY OF CUMBERLAND The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief ofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me the ~ ~ day of ~v..:::,. ~ . clD.)) C\;~~}:;:, @; ~"'A' Jz7.p.~' ature of Personal Represen e Signature of Personal Representative Signature of Personal Representative AND NOW, having been presented before me, IT IS DECREED that Letters are hereby granted to Anna May Kinsinger Q ~;;: 0 ::~=O ....u '-;-- ,.-, , DeceaS~ ~ :;>~ rT1 "..'-:,; ~~:! Date of Death: July 31, 2003 . ),=; /'. ~,:",j C-=:) ~~ ~ , in consideration of the foregoing Pet~i6ij, satisfa~ proof 1 --I ~, Testamentaryj2 .. Ul 1'.) in the above estate I'-..;; '= ,= --.J ::J:;b File Number: d. \ (:)3 0%\0, Estate of Fredrick Lee Kinsinger ,- 6::; N CO Social Security Number: 175-07-3153 and that the instrument( s) dated October 18, 1979 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters ............... $ Short Certificate(s) . . . . . . . . $ Renunciation(s) .......... $ Will . . . $ J.C.P. Fee . . . $ Automation Fee . . . $ .. . $ .. . $ .. . $ .. . $ .. . $ .. . $ TOTAL .............. $ 60.00 12.00 Register of Wills Attorney Signature: ~~~.../ 15.00 10.00 5.00 Attorney Name: Thomas S. Beckley, Esquire Supreme Court LD. No.: 77040 Address: 212 North Third Street Harrisburg, Pennsylvania 17101 Telephone: (717) 233-7691 102.00 Form RW-02 rev. 10.13.06 Page 2 of2 HIO').l:SU') Kt. v ~fl'Sb This is to certify that the information here given is correctly copied from an original certificare of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ~ ~~~7" Local Registrar .-. Fee for this certificate, $2.00 p 9505127 AUG 0 1 2003 Date ClInberland ,....." = = --J > c:: (i') f"...') CD J Rev 2187 ~ ,- D3- (:)'8b~ COMMONWEALTH OF PENNSVLVANIA . DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH NAME Of OECEDENT th$f. MIddle. lasH I. AGE (loti 1lw1I>Oay) UNDER 1 YEAR ......... Day" SEX STAtE FILE NUMBER SOCIAL SECURITY NUMBER a. Male 3. 175 - 07 3153 83 Y... .. CO\INTYOF llEAI'H UNDER I DI<II Houts ! ~ BlRTHPl..ACe !C,ty ~ 3la1e 01' fCffillgn Counuvl PLACE: OF O€ATH 'CNc" QIlfy I)r'e -- ... <f11lrucbOn$on aIt!et M>>J HOSPITAL: ,_,_ 5a E~.." 0 0ClA 0 ~,D Erie, PA 17b. Cou Q;d -- lIveina CUmberland -.ohip1 17dl9 :...-=='" MOTHER'S NA~ (f.s.. M.dOle. Malden Suname) MARITAL STATUS. w.rn.cI Ne~ Married. Widowed. ~tsPec:'Yl 1.. Married 17.f] ....__in RACE . Amencan nun, Black, White. eIc. 1---'1 White _SPOUSE IW........ gtVlt rnaKJen namel Ie. E. DECEDENT'S USUAL 0CC\IPRf0H (~.:=:...:to~~~:r . ".. Asst. D:lputy Ill. State Govt. DECEllEHT'S IIAl\.IHG AOORESS(S/t.... C~. _. Z"CaMI DECEDENT'S ACTUAL RESIDENCE (Sea'-- on_soda) Wocd 2917 Harvard Ave. ... Canp Hill, PA 17011 FRHER'S NAME IF.... .....,....l...) Dennis 17..SIaIo Pennsylvania ...... lL INFORMAHT'S_ IT-'''iflIl Kinsinger Camp Hill Margaret Eckendorf ~. Fred L. Kinsin _....._0 II OATE OF DISPOSITION .Ooy.-I 8-5-03 Annville, PA .. N H. f ApptoM:Imate , inIervaI brIhtrMn : onMl and... , I , PART .: I: WERE AUTOPSY FINDINGS ~E PAIORlO COMPI.ETION 01' CAUSE OF DeATH? _ROf DEATH OATE Of INJURY (Monlh. Day. .....t T..... Of INJURY INJURY AT WORk? DESCRIBE HOW INJURY OCCURRED. _of Homicide o o o PlACE Of INJURY. AI hOme. tarm~..I.ladOfy. office u. buiadinQ. eu:. cSpecllv) .... Yoo D NoD - D D ..._~ -.. TRAft.S SlG~,,!" ~R .,,*~." ,r~/ o/.-:.'.",A.~~./Z._ ~/qot""" I YooD NoD Couki noI be detenrurww:l -. _. c:aJrJ_,Chocl<...... onol -CERTIfYING PHYSICIAN (Ph~ Cet"Wyw1g cause d cWMh wh., ~er ph'fSlC.... ha pr()('lOUrnC8d deam ano canpteled Item 23) To...bMtot...v~..adloecumtdclUl"o""c.uM(s.andmanne'..state4........................... ..-.............. 29. .:::o'~c:,':r~=:O':~~~:~-=.=~~=~:lDc;::o~c;)~otm~::ta.".led................... 0 "MEDICAL EXAMlNERlCORONER ::'.::, ~~:::::~~1.1~ ...~~ ~~~~~I~~'.~~: ~ ".'.y. ~~j.n.~~: ~~~~~ ~~~~~..~ ~~ ~~ ~I~~,.~~I~: ~~.~'~~~: ~~.~~~ ~~ ~~ ~~~~~~).~~ 0 )1.. ,.. On ~.~<! /,) ~~O ..!>> A' -' .' ". '. LAST HILL AND TESTAMENl' OF FREDRICK L. KTI\JSINGER I, FREDRICK L,. KINSlliGER, of Curriberland County, Pennsylvania, being K) of sotmd and disposing mind and memory. do make. pUblish and dec~ this~o b~ '. :n :r.-- ,1-0 . ,', my Last Will and Testament, hereby revoking all Wills and Codicils .~~ ~ any , . .~;3 3-? co ( " -'c'J 'O-n ~ ~._=:~ ~ --I \.0' ITEM t. I direct that all inheritance and esiate t~ be';'~, ,", coming due by reason of my death, whether such taxes may be payable by my Estate time made. or by any recipient of any property, shall be paid by my Executor out of the property passing tmder this Will which is not specifically bequeathed or devised. as an expense and cost of administration of my Estate. My Executor shall have no duty or obligation to obtain reimbursement for any such t;ax paid by my Executor, even though on proceeds of insurance or other property not passing tmder this Will. In the absolute discretion of my Executor, my Executor may pay such taxes inmediately or may postpone the payment of taxes on future or remainder interests tnltil the time possession thereof accrues to the beneficiaries. ITEM' II. I hereby exercise all p0\vers of appointment which T may have at the time of my death in favor of my Executor, and all property subject to all such powers of appointment shall be included in my Estate. ITEM III. I hereby give and bequeath all of my household fur- niture and furnishings, autorrobiles, books, pictures, jewelry. china, linen, silver- ware, wearing apparel and all other articles of hoUsehold or personal use and adorn- ment to my spouse, ANNA MAY KINSINGER, if she survives me, or, if she does not, in equal shares to such of my children as survive me. Page 1 of 4 pages. Y;7( ITEM IV: I give, devise and bequeath all of the rest, residue and ranainder of my property, real, personal and mixed. to my spouse, ANNA MAY KINSINGER. if she survives me. or, if she does not. per stirpes to such of my issue as survive me. ITEM V: In the settlement of my Estate, my Executor shall possess. anong others, the following powers: (a) To sell either at public or private sale and upon such tenns and conditions as my Executor may dean advantageous to my Estate, any or all real or personal estate or interest therein) whether owned by me severally or in conjunction with other persons or acquired after my death by my Executor and to consmmate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple. title. free and clear of all trust and without liability of the purchaser or pur- chase~s to see to the application of the purchase mmey or to make inquiry into the validity of said sale or sales; also, to make. execute, acknowledge and deliver any and all deeds. assigrnnents. options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon my Executor in this paragraph or elsewhere in ~ Will. (b) To pay all costs, taxes, expenses and charges in comection with the administration of my: Estate. (c) To distribute my Estate in kind or in mmey. In the event assets are distributed in kind, such assets shall be dis- tributed at their value(s) on the respective date(s) of their distribution. (d) To do all other acts in the judgment of my Executor necessary or desirable for the proper and advantageous manage- ment. investment and distribution of my ".Estate. Page 2 of 4 pages 7/?l" ITEM VI: If at any time any minor child shall be entitled to receive any assets hereunder, CCNB BANK, N .A., having offices in and arotmd Harrisburg, permsylvania, shall act as Guardian of the assets payable to such child. Said Guardian may receive and administer all assets authorized by law and shall have full authority to use such assets, both principal and incane, in any marmer said Guardian shall deem advisable for the best interests of such child, including college, university, post-graduate or other education, with- out securing court order. Said Guardian shall have all the rights and privileges as to the Guardianship(s) and the assets thereof as are herein granted to my Executor as to my Estate and the assets therein. ITEM VII: Any person who shall have died at the same time as me or in a camon disaster with me or under such cirCtiIlStances that it is diffi- cult or impossible to determine who died first, shall be deaned to have pre- deceased me. IIEM VIII: If my estate is the recipient of any life insurance proceeds or funds my Executor shall receive the same as a Trustee (my said Trustee being authorized to collect such proceeds or funds) and shall distribute the same in the same manner as is provided herein for distribution of the rest, residue and rerrainder of my estate. ITEM IX. I hereby nominate, cOnstitute and appoint my spouse, ANNA MAY KINSINGER, to be my Executrix, herein called "Executor." In the event of the death, disqualification, resignation, refusal or inability of my spouse to act as my Executor, my children, FREDRICK. L. KINSINGER, II, CAROL ANN FAN'IZ, and DEBORAH J. KINSINGER, shall act as my Executor. In the event of the death, dis- qualification, resigpation, refusal or inability of any of my children to act as my Executor, the survivor or survivors thereof shall serve. In the event of the death, disqualification resignation, refusal or inability of all of the foregoing persons to act as my Executor, CCNB BANK, N .A. shall act as my Executor. My Execu- tor and Guardian specifically are relieved fran the duty or obligation of filing any bond or other security. Page 3 of 4 pages. ~7( rn WITNESS WHEREOF, I have hereunto set my hand and seal to this.my Last Will and Testament, consisting of this and the preceding three (3) pages, at the end of each page of which I have also set my initials for greater security and better identification this/$ TH- day of 0 c rCJ g~ /L. , 1979. Page 4 of 4 pages. ~77~ Fredrick L. Kinsinger (SEAL) AFFIDAVIT m1Y'lONWEALTH OF PENNSYLVANIA COUNIY OF DAUPHlli . . we'~(}AJ~, .. . ~ ~&.~, the witnesses whose names are signed to the attached or foregoing in trument, being duly qualified according to law, do depose and say that we were present and saw tes:". . .. FredriCk L. tator sign and execute the instrunent as his Last Will; that Kinsinger signed willingly and tha,t he executed it as a free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testator signed the will as 'tntnesses; and that to the best of our knOtvledge the testator was at that time 18 or lIOre years of age, of sound mind and tmder no constraint or undue influence. (}d;;;M Sworn or affirmed to and subscribed to before me by ~ It, ~ and ~ 3. ~. J witnesses, this /f-ti. ~ o~ ,1979. /~~ J{;~ Wi~:::r . Witness SEAL ~7/~ NotaryE ~ESS, ~!OTt\~Y ~UBlIC 1J.y Commission EXllirss kn. 6, 1983. lIanullllllll PjOaujlhirt County My Corrmission Expires ACKNOWI.EIXl1ENl' Corrmmwea1th of Pennsylvania County of Dauphin I, Fredrick L. Kinsinger, testator, whose name is signed to the attached or foregoing instn:ment, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voltmtary act for the purposes therein expressed. &IDm or affinned to and acknowledged before me, by Fredrick. L. Kinsinger, the testator, this If tJ, day of a~ ,1979.' ~~;L/~ ~ick . L. Kinsinger (SEAL) ~L N Public My Coomission Expires: 3-7 - t '2.. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 Date: 11/28/2007 BECKLEY THOMAS SANFORD 212 NORTH THIRD ST (") (- --:::;::0 ?- :0 -n :J~o .....,..,r- <"_> rrl (:~:.; 5~ HARRISBURG, PA 17108 :3 ~-~~ c= :0 :,::-:J --I --> RE: Estate of KINSINGER FREDRICK L File Number: 2003-00869 Dear Sir/Madam: This notice is to serve as a reminder that the Certificate of Notice under Rule 5.6(a) is due on the below listed date. 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 I, 1992, the personal representative or his councel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing lS due by: 12/08/2007 Please feel free to contact this office with any questions you may have. If you have already filed your certificate, please disregard this notice. Sincerely, L~ . c,#" , ^ '~-d'~_ L~,u' ~M';'-:" > .,?l Glenda Farner Strasbaugh ~.. Clerk of the Orphans' Court cc: File Personal Representative(s) ""'-:t c::::> e.,:, -.J :::0 r"'i-l C"J c-, "f") :~,.~.~7 -... ~."..-..- c> -< N co :::- ::1: \.0 W +" Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 phone: (717) 240-6345 KINSINGER ANNA MAY 325 WESLEY DRIVE APT 3332 MECHANICSBURG, PA 17055 (*) c;O <<. ::D ; -0 :TC") )"T~. r-- ,~~ ..... ",~ -"'-, =~ l'.,) = <=> -4 ~ C) ::-'J 1-'1 ("') c:> ~o !"T ~ C:J Date: 11/28/2007 4lIt.c':::: N co ::t:>o CJ -II '-'1 ':"") ("It ~ W .&'" () ; , RE: Estate of KINSINGER FREDRICK L File Number: 2003-00869 Dear Sir/Madam: This notice is to serve as a reminder that the Certificate of Notice under Rule 5.6(a) is due on the below listed date. 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 councel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing is due by: 12/08/2007 Please feel free to contact this office with any questions you may have. If you have already filed your certificate, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh' Clerk of the Orphans' Court cc: File Counsel CERTIFICATION OF NOTICE UNDER Pa. O.C. Rule 5.6(a) REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Frederick L. Kinsinger Date of Death: July 31, 2003 Date Letters Granted: August , 2007 File Number: 21-2003-00869 To the Register: I certify that Notice of Estate Administration required by Pa. O.C. Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on November 30 2007 Name: Anna May Kinsinger Frederick Kinsinger, II Carol Johnstun Deborah Kinsinger Address: 325 Wesley Drive, Apt. 332, Mechanicsburg, PA 17055 531 Charles Court, Wadsworth, OH 44281 72495 Beaver Springs Road, Rainier, OR 97048 162 Crossland Gate, Newmarket, ON L3X lA5 Canada (If more space is needed, attach separate sheet.) Notice has now been given to all persons entitled thereto under Pa. O.C. Rule 5.6(a) except: None. Date November 30, 2007 ~~ ~.-/ Signature of Person Filing this Form Capacity: D Personal Representative III Counsel Thomas S. Beckley, Esquire Name of Person Filing this Form Va I l~-, ~l i'(18 1'-1(',." r', r. i'~': 'd\..lO 1.0; 1\)\..../ 0n\VTlw j(' \j:-1::;'l" --,.J /i'__u J 212 North Third Street Address Sf;:1 Wd 8... J30LOOZ Harrisburg, P A 17101 (717) 233-7691 Telephone ''''-''"1")''''("\ I ':i : ,_,'.~.r~'.-l.~ For";??h100 re.i. J~,l',Hi6.'J. It\', ' iI'\ "--'--1''' 'U"""""tJ'.' J,,)ljjv \JJUij...)J ,---\ fA) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 6/30/2008 -_ -~ BECKLEY THOMAS SANFORD c~-> =--~ 212 NORTH THIRD ST =' ._~ c, T HARRISBURG, PA 17108 c~_., ~`, - ~:~ - c~~ R:E: Estate of KINSINGER FREDRICK L File Number: 2003-00869 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. A;~ per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SL7PREME 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 is due by: 7/31/2008 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, J ~,`f , n ~fil/f.~. tili~(1t~ ~Z~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 ~.? c -_5 Date: 6/30/2008 K:INSINGER ANNA MAY 325 WESLEY DRIVE APT 3332 MECHANICSBURG, PA 17055 RE: Estate of KINSINGER FREDRICK L File Number: 2003-00869 Dear Sir/Madam: _... < , . _ 1 _ _Ty ~, i _ - -~, - ;"~~ -,_. _ _- '=i .-. - , .~ This notice is to serve as a reminder that the Status Report by Pf~rsonal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SIJPREME 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 W~_lls a Status Report of completed or uncompleted administration. This filing is due by: 7/31/2008 Please feel free to contact this office with any questions you may have.. If you have already filed your Status Report, please disregard this notice. Sincerely, ~ ~~ ~~°~" 7 Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Frederick L. Kinsinger Date of Death: July 31, 2003 File Number: 2003-00869 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete :.................... ~ Yes Q No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? ....... Yes ~/ No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ............................... ^Yes ©/ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date July 9, 2008 ~~~~~_ ~ ~~~~ ~.~ Signature of Person Filing this Form Capacity; QPersonal Representative Counsel Thomas S. Beckley Name of Person Filing this Form 212 North Third Street Address Harrisburg, PA 17101 (717) 233-7691 ZZ = ( idd Q 1 ~fil~ ~Q~Z Telephone - ,~~, .~ ~' i' ~,' . ., .. Form RW-10 rev s101~' .9Qi ~wji E ~ '~i_