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Home My WebLink About04-0863 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Lillian C. Koelsch Date of Death: September 9, 2004 Will No. 21-04-0863 Admin. No. 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 September 24, 2004: Name Address Louis Brodnick 2117 S. 2nd Street Steel ton, PA 17113 Ann D. Koelsch 56 Jane Street New York, NY 10014 The Garden Club of New Jersey, 126 Ryders Lane Inc. East Brunswick, NJ 08816-1331 Lovina O'Connor 57 Riverdale, South P.O. Box 475 South Dennis, MA 02660 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: q/,94/0Lf Jen ifer B. Hipp, Esquire One West Main Street Shiremanstown, PA 17011 '-'c;~~UlJ \~) (717) 737-8761 :c'&pacity: Personal Representative X Counsel for Personal m Zld l- 180 \70. Representative :"<~8 I )~'''d \:r- JAMES D. BOGAR ATTORNEY AT LAW ONE WEST MAIN STREET SHIREMANSTOWN. PENNSYLVANIA 17011 e-mall maU@bogarlaw.com TELEPHONE (717) 737.8761 JAMES D. BOGAR FACSIMILE JENNIFER B. HIPP'" (7 I 7) 737.2086 .Also admltted to New Jersey Bar Direct e-matlJbogarCbogarlaw.com December 6, 2004 VIA HAND DELIVERY Glenda Farner Strasbaugh Register of wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 RE: The Estate of Lillian C. Koelsch No. 21-04-0863 Date of Death: September 9, 2004 Dear Ms. Strasbaugh: I represent the Estate of Lillian C. Koelsch. Enclosed is a check made payable to the Register of wills in the amount of $12,779.26, same constituting a prepayment at discount on account of Pennsylvania inheritance taxes in the above-captioned estate. The prepayment is determined as follows: $64,056.42 multiplied by 15% or $9,608.46, plus $32,028.21 multiplied by 12% or $3,843.39, less discount in the amount of 5% or $672.59, result- ing in payment of $12,779.26. Please provide me with the appropriate receipt in this matter. Your time and consideration in this matter axe. greatly appreciated. ~~ g I .::),,\ -J ':.f: JDB/blw Enclosure cc: Louis Brodnick, Co-Executor (w/o encl.) STATUS REPORT UNDER RULE 6.12 Name of Decedent: Lillian C. Koelsch Date of Death: 9/4/2004 Will No. 21-04-0863 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: l. State whether administration of the estate is complete: Yes XX 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 XX 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 ~n interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: rlLl(?) James D. r, Esquire Name JPlease, ty~e or print) One est Maln t. Shiremanstown, PA 17011 Address (717 ) 737-8761 Tel. No. Capacity: Personal Representative x Counsel for personal representative cfi (MAH: rmf! AM3) COMMONWEALTH OF PENNSYLVANIA REV-l 162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004691 BOGAR JAMES 0 1 W MAIN STREET SHIREMANSTOWN, PA 17011 ACN ASSESSMENT AMOUNT CONTROL NUMBER ____un fold ____n_n_ ____u__ 101 I $12,779.26 ESTATE INFORMATION: SSN: 041-18.6254 I FILE NUMBER: 2104-0863 I DECEDENT NAME: KOELSCH LILLIAN C I DATE OF PAYMENT: 12/06/2004 I POSTMARK DATE: 12/06/2004 I COUNTY: CUMBERLAND I DATE OF DEATH: 09/09/2004 I I TOTAL AMOUNT PAID: $12,779.26 REMARKS: CHECK# 0099 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WillS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004980 BRODNICK LOUIS 2117 S 2ND ST STEELTON, PA 17113 ACN ASSESSM ENT AMOUNT CONTROL NUMBER n______ fold ---------- -------- 101 I $4.20 ESTATE INFORMATION: SSN: 041-18-6254 I FILE NUMBER: 2104-0863 I DECEDENT NAME: KOELSCH LILLIAN C I DATE OF PAYMENT: 02/23/2005 I POSTMARK DATE: 02/23/2005 I . COUNTY: CUMBERLAND I DATE OF DEATH: 09/09/2004 I I TOT AL AMOUNT PAID: $4.20 REMARKS: L BRODNICK CHECK#102 INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of Lillian C. Koelsch No. 21-04-0863 also known as Date of Death 09/09/2004 , Deceased Social Security No. 041-18-6254 Louis Brodnick and James D. Bogar, 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 estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said 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. I /We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative Name of James D. Bogar Esquire ~ Attorney: Signature: J.D, No.: 19475 Signature: Address: One West Main Street Address: Shirernanstown, PA 17011 Steel ton, PA 17113 Telephone: 717/737-8761 Telephone: 717/939- 3688 Dated: dJf)~}0!5 Description Value co..") !"',-) (See continuation page(s) attached) (,,;1) ~~".-. ". -.-'- .. 0) \.0 (Attach additional sheets if necessary) Total: 143,334.97 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Prepared by the Pennsylvania Bar Association Copyright (cl 1996 form software only CPSystems, Inc. Form tlRW-7 (1992) INVENTORY Estate of: Lillian C. Koelsch Date of Death: 09/09/2004 County: Cumberland CASH: ----- Contents of home and personal 200.00 property, sold at private sale Hartford Life - Annuity 134,577 .15 Contract #210180032 (The named beneficiary under this annuity was John G. Koelsch, husband of decedent. Mr. Koelsch predeceased decedent, having died on November 28, 1999. The proceeds of this annuity have been paid to the Estate of Lillian Koelsch). Horizon Blue Cross/Blue Shield 269.10 of New Jersey - Premium Refund MBNA Procurement Services, 0.22 Inc. - Refund of Credit Balance Parthemore Funeral Home - 982.52 Refund Wachovia Securities, LLC - CAP 7,305.98 Account No. 8882892852 -------------- 143,334.97 -1- ---------------- TOTAL RECEIPTS OF PRINCIPAL............... 143,334.97 ---------------- ---------------- -2- ~~, NApo OFFICIAL USE ONLY REV-1500 EX +(6-00) REV-1500 INHERITANCE TAX RETURN FILE NUMBER COMMONWEALTH OF PENNSYLVANIA 21-04-0863 DEPARTMENT OF REVENUE RESIDENT DECEDENT DEPT. 280601 COUNTY CODE YEAR HARRISBURG, PA 17128-0601 NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER D Koelsch Lillian C. 041-18-6254 E c DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE AlED IN DUPUCATEWlTH THE E D REGISTER OF WILLS E soaALSECU~TYNUMBER N T 1. Original Return Z. Supplemental Return 3 R' date of death . emalnder Return prior to 12-13-82) CAP B 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82) 5. Federal Estate Tax Return Required ~ ~ ~ 5 X 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes C R ~ ~ (Attach copy of Will) (Attach copy of Trust) - KO D' . D D 11. Election to tax under Sec. 9113(A) E S 9. litigation Proceeds ReceIved 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) (AttaCh Sch 0) ~!1.!~.I~~iJf.::MP$;I.TI$g~P'MRj1jiijjeg;!I.'IQge~NPeN~,ll~,peNli1!~'f4lj;.t.IF~i.Mii~P'N;$HQ'PCP;iQe;'Q.i.a~~~,II;*!i P NAME COMPLETE MAiliNG ADDRESS C 0 0 uire R N R D One West Main Street E E Shiremanstown, PA 17011 S N T TELEPHONE NUMBER -8 6 1. Real Estate (Schedule A) (1 ) None OFFICIAL USE ONLY Z. Stocks and Bonds (Schedule B) (Z) None 3. Closely Held Corporation, Partnership or (3) None Sole-Proprietorship , ., 4. Mortgages & Notes Receivable (Schedule D) (4) None R 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 143,334.97 1'....,..1 E (Schedule E) CJ C A 6. Jointly Owned Property (Schedule F) (6) None P I D Separate Billing Requested T 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) None U L (Schedule G or L) A I...C T 8. Total Gross Assets (total Lines 1-7) (8) 143,334.97 I 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 12,679.07 0 N 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule J) (10) 2,503.06 11. Total Deductions (total Lines 9 & 10) (11) 15.182.13 1Z. Net Value of Estate (Line 8 minus Line 11) (1Z) 128,152.84 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) 32.038.21 made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 96,114.63 C 0 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES M T P 15. Amount of Line 14 taxable at the spousal tax U A T rate, ortransfers under Sec. 9116(aX1.2) X .0 0 (15) 0.00 X A .0 45 (16) T 16. Amount of Line 14 taxable at lineal rate X 0.00 I 17. Amount of Line 14 taxable at sibling rate 32,038.21 X .12 (17) 3,844.59 0 N 18. Amount of Line 14 taxable at collateral rate 64,076.42 X .15 (18) 9.611.46 19. Tax Due (19) 13,456.05 ZOo :m~fI~qKiBf$~~:.f,1iYQiiI,l~R~lRf$~Q~$1!!~~:~:R~i!iQ~~:~l~f.1!l:p~Rf.r.~~~~rJ.1::il ttli.Jillt.ll[1~1'111ilfu'til%\t~Thllfl'i~;lllsti$ua;el,pllN$'wei.ij~'11l)e~iQN$lgNIe~~$e~gelgQII11im~g~iiM~mITlli~I.I~t%l$mlt~{!"Jk~m!'#~.; Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 824 Lisburn Road, Apt. 213 CITY I STATE I ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1 ) 13,456.05 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments 12,779.26 C. Discount 672.59 Total Credits ( A + B + C) (2) 13,451. 85 3. InteresVPenalty if applicable D. Interest E. Penalty TotallnteresVPenalty ( D + E ) (3) 0.00 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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 4.20 A. Enter the interest on the tax due. (SA) 0.00 B.Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) 4.20 Make Check Payable to: REGISTER OF WillS, AGENT 1I1111I1111I11I1I1111I111I111I1I1111I11I1111I1I1111I1111111I111111111I1111I111111111I1111111I111111III11I111II11111I111I1I11I1111I11III1111I1111I111II1111I111111I1IIIIIIIIIIIIIIIIIIIIIIIIlmllllllllllllllllllllllllllll111111111111111111111111111111111111111111111111111111Illllllillllllllillll:llllllllllllll!llllllllllllllilllll1IIIIIIllllllllllllllllllllllllllllllllllllli PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . ~ ~ b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest; or. . . . . . , . . . . . . . . . . . . . . , . . . . d. receive the promise for life of either payments, benefits or care? . . . . . . , . , 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . , . . . . . . . . . . . . . . . . . . . , . , . . . . . 0 [!I 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......0 [!I 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . 0 [!I IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, 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 Louis Brodnick DATE 2117 S. 2nd Street ~J9B)C6 ----------------------------------------------------- Stee1ton, PA 17113 James D. Bogar Esquire DATE One West Main Street - - -Shirema~;t~mi ~ - PA - - riair - - - -- -- - - - - -- - - - - - -- For dates of death on or a 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)J. 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 P.S. 9116(1.2) [72 P.S. 9116(aX1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(aX1.3)). 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. Copvrlaht (c) 2000 form software onlv The Lackner Grouc. Inc:. c...._ tU:'U_1cnn -=v In_.. I!' "'^' ADDITIONAL Personal Representatives Estate of Lillian C. Koelsch SS# 041-18-6254 09/09/2004 ******************************************************* Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. Signature Name James D. Address Line 1 One West Address Line 2 City, State, Zip Shiremanstown, PA 17011 Date c9 jf)i). } f6 , REV-1508 EX + (1-97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Lillian C. Koelsch SSfI 041-18-6254 09/09/2004 21-04-0863 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Parthemore Funeral Home - Refund 982.52 2 Contents of home and personal property, sold at private sale 200.00 3 Horizon Blue Cross/Blue Shield of New Jersey - Premium Refund 269.10 4 MBNA Procurement Services, Inc. - Refund of Credit Balance 0.22 5 Wachovia Securities, LLC - CAP Account No. 8882892852 7,305.98 6 Hartford Life .':" Annuity Contract /f210180032 (The named 134,577.15 beneficiary under this annuity was John G. Koelsch, husband of decedent. Mr. Koelsch predeceased decedent, having died on November 28, 1999. The proceeds of this annuity have been paid to the Estate of Lillian Koelsch). TOTAL (Also enter on line 5. Recapitulation) $ 143,334.97 (If more space is needed, insert additional sheets of the same size) CODvriaht (c:) 1996 fnrm snftwarA nnlv ~P~Vc:tAPn4C: Inl" - --... ........-. Wachovia Securities, LLC RetaillnvestmeniGroup NCl164 401 South Tryon Street Charlotte, NC 28288 . October 18, 2004 ~~~- "'- \-\~CHOVIA. SECU""RITIES James D. Bogar Attorney at Law One West Main Street Shiremanstown, P A 17011 RE: CAP Account 8882892852 Investment Account 4854-9421 Dear Mr. Bogar: Thank you for contacting Wachovia Securities, LLC. This letter is in reference to your recent request regarding the date of death valuation for the above accounts. The date of death valuation dated September 27,2004 was $7,305.98; however, the closing balance as of October 1, 2004 for this account was $14,320.70. A September 2004 statement has been sent under separate cover, which will detail the difference in the date of death value and the close out value of the account. The cost basis information for the Delaware De1chester Fund Class B is detailed on the enclosed August 2002 statement. Unfortunately, we do not have the cost basis information for all the securities since this account was acquired as part of a merger. We suggest that you seek competent tax advice regarding this matter. We apologize for any inconvenience this has caused. If you have any questions regarding this matter or if you need further assistance, please contact an Estate Processing Specialist at 866-874-2717, Monday through Friday, 8 a.m. to 6 p.m. We will be pleased to assist you. Sincerely, ~Ad" Ykrt/fiJ Richard Shinn RIG Specialist Wachovia Securities Enclosure Securities and Insurance Products: Not Insured By FDIC Or An)' MAY LOSE VALUE Not A Deposit Of Or Guaranteed By Federal Government Agency A Bank Or Any Bank Affiliate Brokerage services offered through Wachovia Securities, LLC, a registered broker-dealer and a separate, nonbank affiliate ofWachovia Corporation. Member NYSE and SIPC. RGCUS 404532707 8882892852 MelTll>er NYSE/SIPC ~..- z . . ... . .... .... ' , ... . . . . . . '. .. . .... . . . .... . .. .' . '. . .. .. .. ." , ' . .' . , ' ' . .. . . ,. . . . ... . ." . .. .. .. Hartford ,Life .' October 22, 2004 James D Bogar Fax: 717-737-2086 ... .. Re: Hartford Annuity Contract # 210180032 Dear =:~ U1lian KO<l<ch/':':;::,'I';;,"",I,:,,,,,,,,,, .. .................... ....................... ............ . . . . . . . ' '. .. .. . ' . .. .......,.. ..... . . . . . .. .. .. .................... ........................ ...... . ....... ........ .................... ...... . . . ...~ ... . . .... .. . . . ......... ..... .. . .. . ... . ...,........'..... ............. . .... . Thank you for your correspondence regard~g the abOve annuityco~~~t:.::::;t.~~!;:i:~~![:.;..::~~\~~~~t;;:::..:::.;::::. ":, The death benefit payable under this' contract is notcoIisidered "lifeinsUhi#&:"7: ~$qrlii;i~::.:.\:/::~::'::':' on IRS ~OIlIl 712, (life insuranCe statement). Please find thebelowinfo~~lion:uf~~iisf:r. ' to your request ' , '. . ..., .' ' , , , , ,,' " . ..::~:::::~~~~~:~:::{::::::::;.:)~:: ................... ......... . ............. ..... ... ..... . . . , . . . . . . . . . .. .. ..... . .. ... ..............'.. ... ....... ... ........,..... ..... .. .. . . . .... ................ .... ..... . . . . . .. .....' . . . . . . . . ..... ." ... ............. ....... ........ .... . .'"..,.... . . .. Contract Number: 210180032 ' :::.. '.::~(~):\:::::.:::::::: . . . ....... ..........' .. .... ..... ...... '... . . .... Owner: ' LilIiai1:KoelSCh " ' : <:~):~~:~:: :"~::~r:::'::.:;:':~::::;~t:>' , , , ., , . ............ ......... ............. Owner's SSN#:041.;18-6254:,~~I):~~:~::'::: ... ::::::::\~{.:~t( .. ... . .. . ............... ... ............. .. ... . .. .... Deceased: . Lillian Koelsch. ' . .' , ' ,:}}}:~~::~;(;;:~:::. ,,::::~(:;;::;,:~t;:::' , . .. . .............................................. . . . . . . . .. . ." . .. .. ' . . . . . . . . .. . 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" " ....,...... ..: :::::::::}::::::::.:::::::::}::~:::)::::: ::::}: ::}::::: :::::::::H~r~rilijf~:~~~kompaDies Investment Product Services '::::: :::::::::::.::::: :.:: :::::::::::::::: ::: ::::::::::::::::: :::: ::!eoHDpmaQo;r.Stml : :::: ::::::::::::::::::.: :::::::::::::::::: :::::: :::: ::::: ::::::swbliij; CT 0.60.8'-:::' Contract Management ':: ::::::::: ::::::::::: ::::::::::::: ::::: ::::::: ::: ::::::::::. :::!F:iIIlhftlsoo:W:6668,:.', .:., ,:: Hartford Life Insurance Company': <TT::[\[[n[[[nt[::[[T:n[n::::::::" ',:' X1i~~r4~f::'~~::\:nn\:~nn:L::: ,::::[\~ ~::~ :~~ t::t:. :.:n~~:~~~~m:;~~~t~~t~'\j\~:: ::::::}}:::. ..' .:::.',: .:~D~~!~~~::::tt:):}::~~::,)::I?: :':.:::.:.:.:.::.:. .':-::::-:-:, .:':.:.::.:.:.:.:-:.:'::.:-:.:-:.:.:-:.:.:.:':.:.:.:.:.:.:.::.:.:.:::.:::.:'::.:.:.:.:.:.:.:':-:.:.:.:.:.:.::.:':':.:.:.:.:':-: . ... . ,--'..... .... ...................... , .. ................. .. ....,....,.,... ....................................,............................................ . . . ........... .. ....... ,... ...... .."............ .. ......,.... . .............................................-.......... .................... .... ,,,"."'.,,..... ..".....".......,,, .. ...... .... .. .. .............. ..... .............................................................................. .. .".... 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'.' . . . . . . . . ..... ...... . ......... . . .... ..,... .. .. ~.......,""'....,...., . - . . - , , , , , , , . - . . Hartford · Life October 23,2004 John G Koelsch C/o Bonnie ............ ....... ..... ........ ......... .. Contract Owner: Lillian Koelsch ., Decedent: Lillian Koelsch RecipientofProceeds: JohnG Koelschp,p . 'P' P' =: ~:~er. ....~~~0032 . .i}:;i~:i.......}<:.................... . . ................. . . . Dear Mr. Koelsch, ::::;.:.::::::::n::!::::.::::::::,.,:::.:::.:,:' Please accept our sympathy on your loss. We understand tIns is a trying time:f9.r:y~ :~;Your ,.:.: family and will try to make this process easier for you. '::: ' ':.:.:.:.:.::;: ::::: )::: :::.::, . . . . . . . . . . . . . .. -.. - . .. ..... ......... ......-... .. ............. ... . .. ...... As requested we have enclosed a Benefit Option Election Fonnwhich pr{)viti~{~4euffi~:):<.: .::: e>>'l'lanation of the options that are, available to you the beneficiary. , Please r~:~~se fotihs:.: :. .n.nn::: carefully, consult with your investmerit professiona~tax advisor,: orcontactij6J.71lliany'.:.::::: :.::: :::::::::: ~~~::nfu;:~~~ ~a;:~=~~~:;:y:.prepared.to anSwer7q}~W~~~~~i~m The contract owner purchased a 'variable anntiitywitha:4e:ath:b~ni:fit; HartfQt.4.L:ife:(;~~l~lij~::: ://: the guaranteed death benefit upon receipt of 1l:~~fi~4. ~y:qnb#:~~th :~p.~M<<,lftp~.~~~~::.:.::, is not received in good order the day th~:we:clil~lat~.~NA~@{W~~fit..ji~~#m~f%~ajY~mr::r.. .n...n: receive the cash value on the close ofbiisi.riesst~ 4~y:tlle:iiis~c.tiQii~ ~: f~~v.~iri.g~::::::: :{:::.... order. In addition Hartford Life is~q~l#eti:tQ:~aicu:ia.t~:fue(ie~titW~~ij{o~:~if~~#n:n..:r :;::...:.r.' associated with the decedent wheIJ.:~A~f:#f1.e.d. :cqpy: o(1i1~:~~*~~~(i(i~.f#~N~M.JJ.~~$j*-{:.:({.:: :~~~~ti~:re~~~m~JeF:f~~11!!~~~I'IL~~~ ......,..,..,:::::::::::::::::::::.......,.,::.::.~:tt~~c1~:st~~ , ' ::. ."...,...::::::::::'. ':.~=~:1 ~~~J~::..:...::.:::.::::,' InYetitmefttPrOdtJCtS8iViC:iIiS: : . ' : . . . . . . . . . . . . . . . - - . . .... '0-. .................... .. -. .-...... :< ,::::, ::<..~~~~if~~~r~~a~/.::.:. ., .., ...... ,..,... ..."......'.. "';;,;;",,",:o:.~..;';';If"..."."""'" ,.. ......,..".. ,',,:, .: .::::::::':'.:, ,..:. ......:.: .... .:'.'."<..::..:.:!:..;,:..(T!~T7nTIT..:2.:':' ,:. :,,:.~..:.. ............................. --........... .. ........ .............. ..... .... ,. .. .. ...... ........... ......... .......... ........ " .... ........ . -. . ,,-. . .. .... ........... ..... .... ..... ..... ......... ................. ............... . .- . -,.". ...... . .-...... .' .-.... .................................... .... , ..- . . .-,-..." ,. . . . . . . . . . . . - . . - . . . . . . . . . . . . . . . . . . . .. ............ ........... . . . . . . . . . . . . . . . . " ,. , ',.-.-... -- . -"'.-. ...... ............ ............................. ..........................-.. .... ,...,... ......,,_... ,... ".-.... . .. .......... ......... .... - . . . . . .. ............ - . . . . . . . .. ..................... - . - . . . . . . . . . . . . . . . . . . . , --,-".. ...................................................................................................- Under this contract one of your benefit election options is Treat Contract as your Own. If this benefit option is elected a death benefit adjustment will not be applicable. If a death benefit adjustment was applied prior to the election of this option, this amount will be removed. Please review the enclosed benefit option election form for details regarding all options available under the contracts. IMPORTANT INFORMATION ABOrT CUSTOMER IDENTIFICATION. Tohelpthe government fight the funding of terrorism and money launderingictivities, Y911may be asked to provide your name, address, date of birth, social security numbeLand::ofuei ,infonllation that identifies you. The information you provide, may als~ ,be::yalidated)through various pl1[jiic , ., databases. ':, :::::. ' , , .::: ...... .. .... . ... Please rest assured that this process is in compliance with The:H~ord:'~..pntil~ypolicy. FC?i additional inf~rm~~on about our privacy policy please visit our Irit~f~i~e.~(:::: :::::,........ \vww.hartfordlnvestor .conl ,.'. ..: :::::::::::::::,: ::. .:::::::::::. . ......... ..-.--.-,-, ... .. ... ---............... .--.... .. . ...,-,.. .... ....- ......... ............. . . . . . . . . . .. ............... , , . . . . . . . . . . . . ." .....- -. .. ....... ...... . ,'._n. .. If you have questions, please contact your investment professional or one: of oUr :~~11y sen~:' specialists at 1-800-862-6668, Monday through Thursday :from. 8 a.m. to 7:p~m~:~:~.#~a)'::fr&Jil::: :,'::' a.m. to 6 p.m Eastern time. ::::::::::::::::, .,...., ..... ........ .... .......... .......... .,... Sincerely, ":::::: ::::::::.:::: ::::: ':::., . . . . . . , . . - .. .. - . . . - . - . . . .. -..- ..... ............ ........... ..".... . . . . . . . . . . . .. .. ... . ..... ... . . . . . . . . - . . .. ... . ..........- - . ............ . . .". ... -". ..... ...- ... ..... ....... ..... - .... . . .... ...... .... . ....... ..... ....... SoDen Tek .:::::::::.... ,..:.<:, ., Ty:r::: Investment Products Services ':::::::::::::: ,:::::: :::::::::" Hartford Life Insurance Company .,,: H::::::::{:: H ::::::::: :::::::{:::::r::: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . ". ....................... ... ..................... ....... ..... ..... . .......... . . . . . . . . . . .. .................... ........ .. . . ............... ......................... Enclosures (2) ::.:::::: :::':::':'.::::.:.:::.:::::.::::::::,." .......... ... .................... F b () HL 17488 ' .........,.' ..,..,' ........ orm num er s : - ':.:::::::::.:.::>:::::>::::::::::::::::::::' ..... ... ......... ............. . . . . . . . . . . . . . . . . . . . . ... ...... .......................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... ..."."".._"--,,..".... . ... .......... .. ......................... ... ... ....".".. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . - .... . ... ......... .... ...... ............ ... ...... ................ ................ ..... ................. . ........... ..................... ...... ................ .......... ........ .... .. ...... , , .. . ........... ........ .... ........ ....................... .. ....... .... ........................... .... .......... ..... .................. .................... ....... .. . . . .. ...... . . . .. ........... . . . . . . . . . . . . . . . . ... .." ",,--- "....-.. ....... ................................................ ... .. "" .... ". . . .. ........................................ . . . . . . . . . . . . . . . . . . . ......... .... ................. .............. ... . .... .................... . ............ ........... .... ............ ....... .................. ....................... ............ .... . "" ........ .-.................... ............. .................................. . . .. ...... ............... . .... .. ..................... ... ........................ ............................. ................... .... ................... . .".._".... ......................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ". ... . . ......... ............ . . . . . . . . . . . . . . . . . . . . . . . . "'..::,::':,:'::::::,':' ,>liaitfoid~IieIP.S~i8i1iie Companies "':::::::::::.,;..;":::::::::'::,~r~:~'f.~~~~~" ,. ':::: :'::: :::::':: ::::::::::::::::::::::::,." "'~IJ::F.~:r800:S~:'li66'-:: .::::::::." ,:::, ,.:::,:::::::::::: ::: :::::::::: :::::::::' 'Inli~rPrQIilUQtS~~: :::::::::::.. ................ . . . . . . . . . . . . . . . . . . .. .... Mailing :Add~~:P'({BriX:508!5::..' .. .....................~mili'.................... .............................. .............. ............................... .. . .... ... ..... ...... . ...................... ....... ................ ................. ........ ... ...... ........ ............. ... .... ........... ......... ... .... ................... ...... ............................ ........... .". . " .... ............. ...............................................................- REV-1511 EX + (1-97) SCHEDULE H COMMONWE:::ALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Lillian C. Koelsch SSf! 041-18-6254 09/09/2004 21-04-0863 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Brachendorf Memorials, Inc. - Monument Inscription 195.00 B. ADMINISTRATIVE COSrS: 1. Personal Representative's Commissions 3,367.50 Name of Personal Representative(s) Louis Brodnick Social Security Number(s) / EIN Number of Personal Representative(s) 192-14-6376 Street Address 2117 S. 2nd Street City Stee1ton State PA Zip 17113 Year(s) Commission Paid: 2. Attorney's Fees James D. Bogar Esquire 6,735.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip - Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 260.00 5. Accountant's Fees 325.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Cumberland Law Journal - Estate Notice 75.00 2 ING - Return of September 2004 annuity payment 633.89 3 RESERVES: Costs to conclude administration of Estate including 950.00 filing fee for PA Inheritance Tax Return, Inventory and First & Final Account; preparation of Personal and Fiduciary Income Tax Returns 4 The Patriot News - Estate Notice 103.15 5 U.S. Postal Service - Certificate Mail-Hartford and Internal 9.53 Total of Continuation Schedule(s) 25.00 TOTAL (Also enter on line 9, Recapitulation) $ 12,679.07 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software onlv CPSlIstems. Inc. -=___ ~e"~...e.... ~v 1_ ~ --, Estate of: Lillian C. Koelsch Soc Sec iJ: 041-18-6254 Date of Death: 09/09/2004 Continuation of Schedule H-B7 (Other Administrative Costs) Item Description Amount If Revenue Service 6 Vital Check - Death Certificates-John Koelsch 25.00 ------..-.....---- 25.00 REV-1S1Z EX +(1-97) SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, AND LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Lillian C. Koelsch SS11 041-18-6254 09/09/2004 21-04-0863 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 Credit Plus Collection Services - Wheel Chair Transport 40.00 2 Holy Spirit Hospital - Final Bill 54.06 3 Manorcare - Nursing Home Bill-Final 2,409.00 TOTAL (Also enter on line 10, Recapitulation) $ 2,503.06 (If more space is needed, insert additional sheets of the same size) Copyright (cl 1996 form software onlY CPSvstems.lnc. ~___ ~~\'_4r..~ PV ~_ - --, REV-1513 EX +(9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Lillian C. Koelsch SSII 041-18-6254 09/09/2004 21-04-0863 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [Include outright spousal distributions, and transfers under Sec. 9116(aX1.2)] 1 Ann D. Koelsch Sister-in-Law Twenty-five 56 Jane Street (25%) percent New York, NY 10014 of rest, residue and remainder 2 Brodnick Louis Cousin Twenty-five 2117 South 2nd Street (25%) percent Steelton, PA 17113 of rest, residue and remainder 3 Lovina O'Connor Friend Twenty-five 57 Riverdale, South (25%) percent P.O. Box 475 of rest, South Dennis, MA 02660 residue and remainder ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET 11. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 The Garden Club of New Jersey, Inc. Twenty-five 126 Ryders Lane (25%) percent East Brunswick, NJ 08816-1331 of rest, residue and remainder TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) ~nnvrll'lht f,..) ,nnn fnr"", ~I"\++\..u~...... .......... T....... I .......t.......... ~.._..... I...... - -...,. .~.... -.., .- . LAST WILL AND TESTAMENT OF LILLIAN C. KOELSCH I, LILLIAN C. KOELSCH, of Camp Hill, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last will and Testament, hereby revoking all other wills and Codicils heretofore made by me. FIRST: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, unto my husband, JOHN G. KOELSCH, provided he survives me by sixty (60) days. SECOND: Should my husband, JOHN G. KOELSCH, predecease me or die on or before the sixty-first (61st) day following my death, I devise and bequeath all the rest, residue and remainder-= of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together.~ with any insurance policies thereon, as follows: (A) Twenty-five (25%) percent thereof to my husband's sister, ANN D. KOELSCH, of 56 Jane Street, New York, NY 10014, provided that should she predecease me, I give and bequeath her share, in equal shares, to the individually named residuary beneficiaries as set forth hereinunder. (B) Twenty-five (25%) percent thereof to my cousin, LOUIS BRODNICK, provided that should he predecease me, I give and bequeath his share, to his wife, PAULINE R. BRODNICK. (C) Twenty-five (25%) percent thereof to THE GARDEN CLUB OF NEW JERSEY, INC., Holly House, 126 Ryders Lane, East Brunswick, New Jersey 08816-1331. (D) Twenty-five (25%) percent thereof to my friend, LOVINA O'CONNOR, of 57 Riverdale, South, P.O. Box 475, South Dennis, MA 02660, provided that should she predecease me, then to her issue per stirpes by representation. THIRD: In addition to all powers granted to them by , law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective' until actual distribution of all property: (A) To sell at public or private sale, 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 (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (e) To compromise any claim or controversy and to - abandon any property which is of little or no value. (D) To invest in all forms of property, including ~ stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) ~o exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under 'my will, and for investment purposes. (I) To select a mode of payment under any qualified 2 retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. FOURTH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of the principal of my residuary estate. FIFTH :", All interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, -- assignment, conveyance or anticipation. SIXTH: I nominate and appoint my LOUIS BRODNICK and " -, JAMES D. BOGAR, Co-Executors of this, my Last will and Testament. I direct that my Executor or Executrix, as the case may be, and their successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last will and Testament, this d....t:J~ day of C\ ~LL;Z- , 1999. ~~r;ar C. ~..cj<v~ ( SEAL) ILLIAN C. KOE CH Signed, sealed, published and declared by the above- named Testatrix as and for her Last will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. f' r,/?c ,~ 'l i, at/f! C~lJ.v Address 1 / J ~ ~", / .. ~ I ,,<tt.. (L ~Y()l';/5/.11.1;" \Address l....... f ) ;;;.......' . COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0863 ESTATE OF LILLIAN C. KOELSCH, DECEASED -------------------------------------- -------------------------------------- FIRST AND FINAL ACCOUNT AND STATEMENT OF PROPOSED DISTRIBUTION OF Louis Brodnick and James D. Bogar, Executors ================================================================================ Date of Death: September 9, 2004 Date of Executor's Appointment: September 22, 2004 Date of First Advertisement of Letters: October 1, 2004 Accounting for the Period: September 9, 2004 to May 19, 2005 -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Purpose of Account: Louis Brodnick and James D. Bogar, Executors, offer this account to acquaint interested parties with the transactions that have occurred during this administration. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: James D. Bogar Esquire Attorney Identification No. 19475 . One West Main Street Shiremanstown, PA 17011 '" 717/737-8761 e:::. c:::'l 0 <on :0 ::J:: =;-JO > "1:::r- -< Z('T\ N ,___0-5~ C) '-:-)("")0 :Duo C) ,."::0,') -rl ',)C :x: -'n . CD CO C) -i fTl C) C:J W "'-'1 ^ ,_..._"_..,,...._.~..-.._. ._...... " -----.------- SUMMARY OF ACCOUNT Estate of Lillian C. Koelsch, Deceased For Period of 09/09/2004 through 05/19/2005 Fiduciary Current Acquisition Page Value Value ------ ------- ----------- PRINCIPAL Receipts: Per Inventory Filed This Account 1 143,334.97 Net Gain (or Loss) on Sales 2 7,014.72 or Other Disposition --------------- 150,349.69 Less Disbursements: Debts of Decedent 2 2,672.06 Funeral Expenses 3 195.00 Administration Expenses 3 2,166.57 Federal and State Taxes 4 13,744.61 Fees and Commissions 4 10,652.50 Family Exemption 0.00 29,430.74 --------------- --------------- Balance before Distributions 120,918.95 Distributions to Beneficiaries 5 80,000.00 --------------- Principal Balance on Hand 40,918.95 INCOME Receipts: This Account 5-6 435.75 Net Gain (or Loss) on Sales 0.00 or Other Disposition ---------------. 435.75 Less Disbursements 0.00 --------------- Balance Before Distribution 435.75 Distributions to Beneficiaries 0.00 --------------- . Income Balance on Hand 435.75 COMBINED BALANCE ON HAND 41,354.70 --------------- --------------- Proposed Distributions 7 0.00 41,354.70 to Beneficiaries --------------- --------------- --------------- --------------- _....,."_._..---~~ ...-..-..,-.. ..'~ '-".-".. ."....-.. --,-,,~~ SCHEDULE A RECEIPTS OF PRINCIPAL Fiduciary Acquisition Value ----------- CASH: ---- 09/16/04 Contents of home and personal 200.00 property and costume jewelry sold at private sale 09/09/04 Hartford Life - Annuity 134,577 .15 Contract #210180032 (The named beneficiary under this annuity was John G. Koelsch, husband of decedent. Mr. Koelsch predeceased decedent, having died on November 28, 1999. The proceeds of this annuity have been paid to the Estate of Lillian Koelsch) . 09/09/04 Horizon Blue Cross/Blue Shield 269.10 of New Jersey - Premium Refund 10/19/04 MBNA Procurement Services, 0.22 Inc. - Refund of Credit Balance 09/09/04 Parthemore Funeral Home - 982.52 Refund 09/09/04 Wachovia Securities, LLC - CAP 7,305.98 Account No. 8882892852 -------------- 143,334.97 -------------- TOTAL RECEIPTS OF PRINCIPAL... ..... ....... 143,334.97 -------------- -------------- . 1 ~__,."_..,,u~ u.. _ ----- ^.,..-....-..,...-. -,--,-,....._...~--...- SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS - PRINCIPAL Gain Loss ---- ---- 05/18/05 Wachovia Securities, LLC-Listed here to account for difference between date of death and close-out value. Transferred from Hartford-+$6,500.00; ING Deposit-+$633,89; Annual Fee--$100.00; DOD Value Fee--$25.00; Interest earned-+$5.83 Net Proceeds 14,320.70 Fid. Acq. Value 7,305.98 7,014.72 ---------------------------- TOTAL GAINS AND LOSSES/PRINCIPAL.... ....... 7,014.72 0.00 LESS LOSS.................. . . . . . . . . . . . 0.00 -------------- NET GAIN OR LOSS............. .. ........ .. .. 7,014.72 -------------- -------------- SCHEDULE C DISBURSEMENTS OF PRINCIPAL SCHEDULE C-l DEBTS OF DECEDENT ----------------- 11/09/04 Manorcare - Nursing Home 2,409.00 Bill-Final 11/17/04 Holy Spirit Hospital - Final 54.06 Bill 12/08/04 Credit Plus Collection 40.00 Services -; Wheel Chair Transport 04/08/05 United States Treasury - 169.00 2004 Personal Income Tax Paid w/Return -------------- TOTAL DEBTS OF DECEDENT........ ........ .......... ... 2,672.06 2 - .,.---.-.--.-.., ....._,.,- ._......n....__.."___ SCHEDULE C-2 FUNERAL EXPENSES ---------------- 11/03/04 Brachendorf Memorials, Inc. - 195.00 Monument Inscription -------------- TOTAL FUNERAL EXPENSES.. ................. ....... .... 195.00 SCHEDULE C-3 ADMINISTRATION EXPENSES ----------------------- 09/22/04 Cumberland Law Journal - 75.00 Estate Notice 09/22/04 Register of Wills - Probate 260.00 Fee 09/24/04 Henderson Jewelers - Jewelry 80.00 Appraisal 10/11/04 ING - Return of September 633.89 2004 annuity payment 10/14/04 The Patriot News - Estate 103.15 Notice 11/12/04 U.S. Postal Service - 9.53 Certificate Mail-Hartford and Internal Revenue Service 11/22/04 Vital Check - Death 25.00 Certificates-John Koelsch TO BE PAID RESERVES: Costs to conclude 950.00 administration of Estate including filing fee for PA Inheritance Tax Return, Inventory and First & Final Account; preparation of Personal and Fiduciary Income Tax Returns 02/22/05 Register of Wills - Filing 30.00 Fee, Pa. ~nheritance Tax Return & Inventory -------------- TOTAL ADMINISTRATION EXPENSES. ......... ......... .... 2,166.57 3 -~ .. ".'--~---'-'-'~-~".'-'.'- '. -,- .. ~--,,---"- SCHEDULE C-4 FEDERAL AND STATE TAXES ----------------------- 12/30/04 Register of wills - Pa. 12,779.26 Inheritance Tax Prepayment 02/22/05 Register of Wills - 4.20 Additional Pennsylvania Inheritance Tax Paid w/Return 05/16/05 Register of Wills - 961.15 Additional Pa. Inheritance Taxes owed per Notice of Appraisement -------------- TOTAL FEDERAL AND STATE TAXES.................. ..... 13,744.61 SCHEDULE C-5 FEES AND COMMISSIONS -------------------- 11/12/04 Greenawalt & Company, P.C. - 325.00 Preparation of 2002 personal income tax returns 02/17/05 James D. Bogar, Esquire - 3,367.50 One-half of Attorney's fee for representation of Estate as per agreement 04/14/05 Greenawalt & Company, P.C. - 225.00 Preparation of 2004 federal and state personal income tax returns TO BE PAID Louis Brodnick - Executor's 3,367.50 Fees TO BE PAID James D. Bogar, Esquire - 3,367.50 One-Half of Attorney's fee for representation of Estate as per agreement -------------- TOTAL FEES AND COMMISSIONS... ................,...... 10,652.50 . -------------- TOTAL DISBURSEMENTS OF PRINCIPAL................ .... 29,430.74 -------------- -------------- 4 . ~,. ..---.--....,.,,",.......---.---. -'---"~'_.._.. SCHEDULE D DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES Ann D. Koelsch -------------- 02/22/05 Ann D. Koelsch - Advancement 20,000.00 Lavina O'Connor --------------- 02/22/05 Lavina O'Connor - Advancement 20,000.00 Louis Brodnick -------------- 02/22/05 Louis Brodnick - Advancement 20,000.00 The Garden Club of New Jersey, Inc. ----------------------------------- 02/22/05 The Garden Club of New Jersey, 20,000.00 Inc. - Advancement -------------- TOTAL DISTRIBUTIONS TO BENEFICIARIES...... 80,000.00 -------------- -------------- SCHEDULE G RECEIPTS OF INCOME . SCHEDULE G- 2 INTEREST ------------ Commerce Bank ------------- 05/18/05 Interest earned in Estate 4.72 Checking Account 05/18/05 Interest earned in Estate 406.48 Savings Account -------------- 411.20 5 - - -"-"-'--'~-~"-"~-'--- - ,- -.---._,.,.,. Hartford Life ------------- 02118/05 Interest Earned on annuity 21.01 from date of death to close-out -------------- TOTAL INTEREST INCOME.... .... ........ ..... 432.21 -------------- -------------- SCHEDULE G-3 OTHER INCOME ------------ Horizon Blue Cross/Blue Shield of New Jersey ------------------------------------- 05/06/05 Reimbursement for claim 3.54 -------------- TOTAL OTHER INCOME........... ........ ..... 3.54 -------------- -------------- TOTAL RECEIPTS OF INCOME..... ........ ..... 435.75 -------------- -------------- 6 ..,._....."._,,_,,_.,,' ,. _._...._~.,,~ ....__.,,_"~.".m.'.^_ PROPOSED DISTRIBUTIONS TO BENEFICIARIES Current Value Fiduciary Acquisition /I Units or as Noted Value Ann D. Koelsch -------------- Ann D. Koelsch - Proposed 10,338.67 Distribution -------------- -------------- 0.00 10,338.67 The Garden Club of New Jersey, Inc. ----------------------------------- The Garden Club of New Jersey, 10,338.68 Inc. - Proposed Distribution -------------- -------------- 0.00 10,338.68 Louis Brodnick -------------- Louis Brodnick - Proposed 10,338.68 Distribution -------------- -------------- 0.00 10,338.68 Lavina O'Connor --------------- Lavina O'Connor - Proposed 10,338.67 Distribution -------------- -------------- 0.00 10,338.67 -------------- -------------- 0.00 41,354.70 -------------- -------------- -------------- -------------- . 7 .....-.." ........-..-.-.... AFFIDAVIT Louis Brodnick and James D. Bogar, Executors under the Last Will and Testament of LILLIAN C. KOELSCH, deceased, hereby declare under oath that he has fully and faithfully discharged the duties of his office; that the foregoing Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that, to his knowledge, there are no claims now outstanding against the Estate; that all taxes presently due from the estate have been paid; and that more than four months have elapsed since the first complete advertisement of the granting of letters in this estate. s Subscribed and sworn to by Louis Brodnick and James D. Bogar, Executors before me this I q+h- day of rvltu..t ' 2005. ~f\ III cf uJ.JJ.ol (JIYlbt) Notary Public , aII5 , , '_L-'" " ~~ -- ...,.. I ~_-m__ I 8 . .......-.-.-.--- ""'-'-,.._.,- ._........_~..,,_..- - ~ - - - ~".._--_.._."'.~---~.- !9~H~ ~ I~ ig~i ~. ~ ~. ? ~ I K~ - I ~ .. ;j mg:o lil . ~i~ ~ ~ 0 ~Il., !"To' N ~ I:~ g ..... I ~ ~:o Slil~ ~ ~o I 0 I~ ~. ~~ ex> ~ 1ll~~~ ~ - ~ ~ '" w s f~~ ~~ ~ ~I] ~~i ~ ~ . ~ ~ ~~Cl~ ~. ~ ~..... CD g 1'0 ::l "ll i ~o ~ .. ~ ~, !I~ ~ld ;~~ ~~ i~ ~. 000 !B 2 ~o ~ O;ij~: ~~ g ~ ~~iil~iilj i i i J I Sf Ii i ~fl5 !l~l i!&ai ~~Ij iUtlliw ~:s , ,,2 ~ g,~~ ~il~~ . JIWI1h l-Ibrt IJtli1lt ~ilSil!i : Jl, (;S,I.' i g, rJ (t._-. it'llll} It'i;r1r f I i ~ ,~ - ~i! ~,~IJ ;!l :> ..:1 ~ ," fi- ~ {.. c :;I'" ~ 2 - r . . COMMONWEALTH OF PENNSYLVANIA '* ~ DEPARTMENT OF REVENUE B~F INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX A~PRAISEHENT, A~LOVANCE OR DISALLOWANCE INHERITANCE TAX DIVISION ' OF DEDUCTIONS,', Aill) ASSESSMENT OF TAX PO BOX Z506a1 HARRISBURG PA 17128-0601 REV-1S47 EX AFP (03-05) DATE 05-16-2005 " "J "1 ;." ~: ~.$TATE OF KOELSCH LILLIAN C ii, j , , DATE OF DEATH 09-09-2004 FILE NUMBER 21 04-0863 COUNTY CUMBERLAND JAMES D BOGAR ESQ "IICN 101 1 W MAIN ST I Amount Rellitted I SHIREMANSTOWN PA 17011 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 .... IWr-"1"!;l:""fi.m.m~"d'S'.'N'/I~.b'I!'.I\'.lmA'r1'~M.Pt.'!'X':r.llWAllW~M.'ltT~."IfCr.W~M.Pt.IlTr...."''''''..... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KOELSCH LILLIAN C FILE NO. 21 04-0863 ACN 101 DATE 05-16-2005 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 Es~ate {Schedule AJ (1) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account~ subnit the upper portion 3. Closely Held stock/Partnership Interest (Schedule C) (3) .00 of this form with your 4. Mortgages/Notes Receivable (Schedule OJ (4) .00 tax payment. S. Cash/Bank Deposits/Misc. Personal Property {Schedule EJ (5) 143,334.97 6. Jointly Owned Property {Schedule FJ (0) .00 7. TransTers (Schedule GJ (7) .00 8. Total Assets (8) 143,334.97 APPROVED DEDUCTIONS AND EXEMPTIONS: 12,679.07 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule HJ (9) 10. Debts/Mortgage Liabilities/Liens (Schedule Il (10) 2,503.06 11. Total Deductions Ill) 1~.182 13 12. Net Value aT Tax Return (12) 128,152.84 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 32,038.21 14, Net Value oT Estate Subject to Tax (14) 96,114.63 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal'rate (15) .00 X 00 = .00 16. Amount of Line 14 taxable at Lineal/Class A rate (10) .00 X 045 = ,00 17. Amount of Line 14 at Sibling rate (17) .00 X 12 = ,00 18. Amount aT Line 14 taxable at Collateral/Class B rate (18) 96,114.63 X 15 = 14,417.20 19. Principal Tax Due (19)= 14,417.20 TAX CREDITS: DATE NUMBER ,+, AMOUNT PAID INTEREST/PEN PAID (-) 12-06-2004 CD004691 672.59 12,779.26 02-23-2005 CD004980 .00 4,20 PAYMENT MUST BE MADE BY 06-09-2005*. TOTAL TAX CREDIT 13,456,05 BALANCE OF TAX DUE 961.15 INTEREST AND PEN. .00 TOTAL DUE 961.15 . IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED, ~R CALCULAT~ OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE . . '*' INHERITANCE TAX EXPLANA TION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG. PA 17128M0601 IECEDENTS NAME FILE NUMBER Lillian C Koelsch 2104-0863 iEVIEWED BY Sandra J Eslinger ACN 101 ITEM lCHEDULE NO. EXPLANATION OF CHANGES J 1 Changed tax rate from 12 percent to 15 percent since a sister-in-law is a collateral beneficiary. :!; f"lC!'~IN41 n . COMMONWEALTH OF PENNSYLVANIA REV.1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO, CD 005328 BOGAR JAMES D 1 W MAIN STREET SHIREMANSTOWN, PA 17011 ACN ASSESSMENT AMOUNT CONTROL NUMBER nnnn rDld n_+n_ nnnn 101 I $961.15 EST A TE INFORMATION: SSN: 041 ~ 18~6254 I FILE NUMBER: 2104-0863 I DECEDENT NAME: KOELSCH LILLIAN C I OATE OF PAYMENT: 05/17/2005 I POSTMARK DATE: 05/17/2005 I COUNTY: CUMBERLAND I DATE OF DEATH: 09/09/2004 I I TOTAL AMOUNT PAID: $961.15 REMARKS: CHECK# 110 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WillS REGISTER OF WILLS IN RE: ESTATE OF : IN THE COURT OF COMMON PLEAS OF LILLIAN C. KOELSCH, : CUMBERLAND COUNTY, PENNSYLVANIA LATE OF LOWER ALLEN TWP., : CUMBERLAND COUNTY, : ORPHANS' COURT DIVISION PENNSYLVANIA, : DECEASED : NO. 21-04-0863 NOTXCE TO THE ATTORNEY GENERAL, COMMONWEALTH OF PENNSYLVANXA, OF PROCEEDXNGS AFFECTXNG CHARXTABLE XNTERESTS NOTICE IS HEREBY GIVEN, that the First and Final Account and Statement of Proposed Distribution of Louis Brodnick and James D. Bogar, Co-Executors of the Estate of Lillian C. Koelsch, was filed in the Cumberland County Register of Wills Office on May 20, 2005. In the absence of exceptions to the Account, it will be called for audit by the Court at 9:30 A.M. on Tuesday, June 21, 2005. A copy of the First and Final Account and Statement of Proposed Distribution is attached hereto. A copy of the Will of the decedent is also enclosed herewith. The names and addresses of the specific charities affected byrbhis c..:::.' c,::) 0 "". proceeding are: ::0 :::2: '~o -" . -< The Garden Club of New Jersey, Inc. ["",) U"1 126 Ryders Lane -r:J East Brunswick, NJ 08816-1331 -,,'" r"J p.,) The names and addresses of the Co-Executors are as follows: Cl Louis Brodnick James D. Bogar 2117 South 2nd Street One West Main Street Steelton, PA 17113 Shiremanstown, PA 17011 The name and address of Counsel for the fiduciary is James D. Bogar, Esquire, One West Main Street, Shiremanstown, PA 17011. {f:; All charities referred to herein were given a written Notice of Filing Account, which Notice included a full and complete copy of the First and Final Account and Statement of Proposed Distribution, said Notice being sent on or about May 20, 2005, a copy of which is enclosed herein. ESTATE OF LILLIAN C. KOELSCH Date: ..( \).0 U9S" By: gar, Esquire r the Estate Certified Mail - No. 7003 2260 0002 1615 2647 Return Receipt Requested Addressee: Commonwealth of Pennsylvania Office of the Attorney General Charitable Trust & Organization Section Strawberry Square - 14th Floor Harrisburg, PA 17120 cc: Louis Brodnick, Co-Executor James D. Bogar, Esquire, Co-Executor IN RE: ESTATE OF : IN THE COURT OF COMMON PLEAS OF LILLIAN C. KOELSCH, : CUMBERLAND COUNTY, PENNSYLVANIA LATE OF LOWER ALLEN TWP., : CUMBERLAND COUNTY, : ORPHANS' COURT DIVISION r-..J CC", PENNSYLVANIA, 0 r.~::~' : ;;0 c.n DECEASED NO. 21-04-0863 ~;':::~ :J: : ;:r:'. ::\~i~~ -~'- i"',) :-,~~ ---;"'J (.J: NOTICE OF FILING ACCOUNT -r' , -' NOTICE IS HEREBY GIVEN that Louis Brodnick and James D.adgar,~to-' ,.- 1'0 C) Executors of the Estate of Lillian C. Koelsch, deceased, have this date filed their First and Final Account and Statement of Proposed Distribution in the above-captioned Estate in the Cumberland County Register of Wills Office where the same is filed as public record and may be inspected. Enclosed herewith is a copy of the First and Final Account as filed. YOU ARE FURTHER notified that any exceptions or objections to said Account must be filed in writing at the Cumberland County Clerk of the Orphans' Court Office not later than the audit day of said Account sched- uled as set forth below. UNLESS written exceptions or objections are filed thereto, said Account will be presented to the above-captioned Court at 9:30 A.M. on Tuesday, June 21, 2005, ~t which time said Account will be audited. Date: 5\Ul~ Esquire for e Estate One West Main Street Shiremanstown, PA 17011 (717) 737-8761 cc: The Garden Club of New Jersey, Inc. Ann D. Koelsch Lovina O'Connor Louis Brodnick, Co-Executor James D. Bogar, Esquire, Co-Executor vI: IN RE: ESTATE OF : IN THE COURT OF COMMON PLEAS OF LILLIAN C. KOELSCH, : CUMBERLAND COUNTY, PENNSYLVANIA LATE OF LOWER ALLEN TWP., : CUMBERLAND COUNTY, : ORPHANS' COURT DIVISION PENNSYLVANIA, : DECEASED : NO. 21-04-0863 AFFIDAVIT OF SERVICE "" ~ COMMONWEALTH OF PENNSYLVANIA 0 C:~l Co <:.J" : SS. <:1;:9, COUNTY OF CUMBERLAND . -.... : r,.') c..Y", .....-/ (") 0 -0 ~Tl JAMES D. BOGAR, being duly sworn according to law, def:!'l@s' aneF say:sFl -:::15 N ~rTl --I .. ~. .', that in accordance with Cumberland County Orphans' Court R~f~ No. ~5, h~h caused the Notice to the Attorney General, Commonwealth of Pennsylvania, of Proceedings Affecting Charitable Interests, in the above-captioned matter to be served by Certified Mail, Return Receipt Requested, as indicated by the attached receipt cards. ~o~ Sworn to and subscribed before me this .;iJ..jR day of fYl Cl '1 , 2005. =Bon . oe W~~~V) ,-- - ilu Notary Public My Commission Expires: _LMUJMIS,_PUIIIC ~1IIIlIO.,~Cll IlY COIIIII EllPIIlES WRllll 2001 V~ 7003 2260 0002 1615 2647 (It ... ... ... ... .... ., - '" ~ g ~ ig COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX BUREAU OF INDIVIDU"L"T~~:;' APPRAISEHENT, ALLOWANCE OR DISALLOWANCE INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSHENT OF TAX PO BOX 280601 HARRISBURG PA 17128-0601 REV-1541 EX AFP (03-05) O',C" If'" ,- Pi 2:4& DATE 05-16-2005 bjJ:J b'\( I b ESTATE OF KOELSCH LILLIAN C DATE OF DEATH 09-09-2004 C' EO!! nc FILE NUMBER 21 04-0863 L ! ,,\ VI ~~T""(' ('0 'AT COUNTY CUMBERLAND JAMES D ~,KR1ts4 ";('; pr, ACN 101 1 W MAIN f ,- " ", I AlIOUllt R..i He<! I SHIREMANSTOWN PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS .... 1f~V--.M~,."tf.m.m'!!'1I!'. ft'l!J!.!II!'.!Ml!It'l"l'lFlW.m.1WlUMMMf~.'lrC[WlFlW.lIr.............. ... DI ALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KOelSCH LILLIAN C FILE NO. 21 04- 0863 ACN 101 DATE 05-16-2005 TAX RETURN WAS: I ) ACCEPTED AS FILED I X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FU URE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Est.t. (Schedule A ll) .00 NOTE: To insure prOHI" 2. Stocks and Bonds (Sche 1. B) (2) .00 credit to your account... ~it the upper portion 3. Closely Held Stock/Part ership Interest (Schedule C) (3) .00 of this for. with your 4. Hortg.ges/Notes Recelv. 1. (Schedule DJ I~) .00 tax P8~nt. S. Cash/Bank DeposHs/Hisc 'ersonal Property (Schedule E) (5) 143.334,97 6. Jointly Owned Property Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Tot.l Assets (8) 143,334.97 APPROVED DEDUCTIONS AND E EMPTIONS: 12,679.07 9. FU1eral ExP8I\ses/AdII. C sts/Hisc. Expenses (Schedule H) (9) 10. Debts/Mortgage Llabilit es/LIens (Schedule I) IlO) 2.503,06 11, Total Deductions Ill) lli.1R? 13 12. Net Value of Tax Ret rn (12) 128,152.84 13, CharIt~Ie/Govern.. al Bequests; Non-elected 9113 Trusts (Schedule J) (13) 32,038.21 1~. Net Value of Estat. ubiect to Tax ll~) 96,114.63 NOTE: If an assessment as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures t at include the total of ALL returns assessed to date. ASSESSMENT OF TAX: . DO X 00 .00 15. Anount of Line 14 .t S IlS) = 16. Aoount of Line 1~ t. 1. at Lineal/Cl8sS A rat. (16) .00 X 045= .00 17. Amount of Line 14 .t S lIng rate (17) .00 X 12 = .00 18. A-ount of LIne 14 t.xa Ie at Collateral/Class Brat. (18) 96,114.63 X 15 = 14,417.20 19. Principal Tax Due (19)= 14,417.20 A R . DATE IIUIUIER INTEREST/PEH PAID 1-) AMOUNT PAID 12-06-2004 CD00469 672.59 12,779.26 02-23-2005 CD00498 .00 4.20 PAYMENT MUST BE MADE BY 6-09-2005lE. TOTAL TAX CREDIT 13,456.05 .~ BALANCE OF TAX DUE 961.15 INTEREST AND PEN. .00 TOTAL DUE 961.15 . IF PAID AFTER DATE INDICATE , SEE REVERSE I IF TOTAL DUE IS LESS THAN 01, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITION L INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YDU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR IHSTRUl:TIONS.) REV_'.(70EX(6-88) '*' INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME ,"ch FILE NUMBER Lillian C Koe 2104-0863 REVIEWED BY ACN Sandra J Esli ger 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES J 1 Changed tax lite from 12 percent to 15 percent since a sister-in-law is a collateral beneficiary. " , ROW Page 1 . , COURT OF COMMON PLEAS OF CUMBERLAND COUN , PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0863 ESTATE OF LILLIAN C. KOELSCH, D EASED ------------------------------- ------ ------------------------------- ------ REVISED FIRST AND FINAL ACCOUNT AND STATEMENT OF ROPOSED DISTRIBUTION OF Louis Brodnick and James D. Bogar, Executors ----------------------------------------------------- -------------------------- ----------------------------------------------------- -------------------------- Date of Death: Septe er 9, 2004 Date of Executor's Appointment: Septe er 22, 2004 Date of First Advertisement of Letters: Octob Accounting for the period: Septe er 9, 2004 to May 1 , 2005 ----------------------------------------------------- -------------------------- ----------------------------------------------------- -------------------------- Purpose of Account: Louis Brodnick and James D. Boga , Executors, offer this account to acquaint interested parties with the trans ctions that have occurred during this administration. It is important that the account be carefully examine Requests for additional information or questions or objections can be discuss d with: James D. Bogar Esquire Attorney Identification No. 1 475 One West Main Street Shiremanstown, PA 17011 , 717/737-8761 \, ',! ,- f'",;, I > I . SUMMARY OF ACCOUNT Estate of Lillian C. Koelsch, Deceased For Period of 09/09/2004 through 05/19/2005 I Current Fiduciary Acquisition Page . Value Value ------ ------- ----------- PRINCIPAL Receipts: Per Inventory Filed This Account 1 143,334.97 Net Gain (or Loss) on Sales 2 7,014.72 or Other Disposition --------------- 150,349.69 Less Disbursements: Debts of Decedent 2 2,672.06 Funeral Expenses 3 195.00 Administration Expenses 3 2,166.57 Federal and State Taxes 4 13,744.61 Fees and Commissions 4 10,652.50 Family Exemption 0.00 29,430.74 ----- --------- --------------- Balance before Distributions 120,918.95 Distributions to Beneficiaries 5 80,000.00 --------------- Principal Balance on Hand 40,918.95 INCOME Receipts: This Account 5-6 435.75 Net Gain (or Loss) on Sales 0.00 or Other Disposition --------------- 435.75 Less Disbursements 0.00 --------------- Balance Before Distribution 435.75 Distributions to Beneficiaries 0.00 --------------- Income Balance on Hand 435.75 COMBINED BALANCE ON HAND 41,354.70 --------------- --------------- Proposed Distributions 7 0.00 41,354.70 to Beneficiaries ----- --------- --------------- --------- --------------- **Total Residuary Estate Without Including deduction for Pennsylvania Inheritance Taxes(to be used to compute charity portion of residuary estate) 135,099.31 SCHEDULE A RECEIPTS OF PRINCIPAL Fiduciary Acquisition Value ----------- CASH: ---- 09/16/04 Contents of home and personal 200.00 property and costume jewelry sold at private sale 09/09/04 Hartford Life - Annuity 34,577.15 Contract #210180032 (The named beneficiary under this annuity was John G. Koelsch, husband of decedent. Mr. Koelsch predeceased decedent, having died on November 28, 1999. The proceeds of this annuity have been paid to the Estate of Lillian Koelsch) . 09/09/04 Horizon Blue Cross/Blue Shield 269.10 of New Jersey - Premium Refund 10/19/04 MBNA Procurement Services, 0.22 Inc. - Refund of Credit Balance 09/09/04 parthemore Funeral Horne - 982.52 Refund 09/09/04 Wachovia Securities, LLC - CAP 7,305.98 Account No. 8882892852 --- ---------- 143,334.97 -------------- TOTAL RECEIPTS OF PRINCIPAL...... . . . . . . . . 143,334.97 -------------- -------------- 1 SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOS TIONS - PRINCIPAL Gain Loss ---- ---- 05/18/05 Wachovia Securities, LLC-Listed here to account for difference between date of death and close-out value. Transferred from Hartford-+$6,500.00; ING Deposit-+$633.89; Annual Fee--$100.00; DaD Value Fee--$25. 00; Interest earned-+$5.83 Net Proceeds 14,320.70 Fid. Acq. Value 7,305.98 7,014.72 -- ------------------------- TOTAL GAINS AND LOSSES/PRINCIPAL........... 7,014.72 0.00 LESS LaSS.... . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 -- ----------- NET GAIN OR LOSS. . . . . . . . . . . . . . . . . . . . . . . . . . . 7,014.72 -- ----------- ----------- SCHEDULE C I DISBURSEMENTS OF PRINCIPAL SCHEDULE C-1 DEBTS OF DECEDENT ----------------- 11/09/04 Manorcare - Nursing Home 2,409.00 Bill-Final 11/17/04 Holy Spirit Hospital - Final 54.06 Bill 12/08/04 Credit Plus Collection 40.00 Services - Wheel Chair Transport 04/08/05 United States Treasury - 169.00 2004 Personal Income Tax Paid w/Return - ------------ TOTAL DEBTS OF DECEDENT. . . . . . . . . . . . . . . . .. . . . . . . . . . . 2,672.06 2 . SCHEDULE C-2 FUNERAL EXPENSES ---------------- 11/03/04 Brachendorf Memorials, Inc. - 195.00 Monument Inscription - ------------ TOTAL FUNERAL EXPENSES...... . . . . . . . . . . . . . . . . . . . . . . . 195.00 SCHEDULE C-3 ADMINISTRATION EXPENSES ----------------------- 09/22/04 Cumberland Law Journal - 75.00 Estate Notice 09/22/04 Register of Wills - Probate 260.00 Fee 09/24/04 Henderson Jewelers - Jewelry 80.00 Appraisal 10/11/04 ING - Return of September 633.89 2004 annuity payment 10/14/04 The Patriot News - Estate 103.15 Notice 11/12/04 U.S. Postal Service - 9.53 Certificate Mail-Hartford and Internal Revenue Service 11/22/04 Vital Check - Death 25.00 Certificates-John Koelsch TO BE PAID RESERVES: Costs to conclude 950.00 administration of Estate including filing fee for PA Inheritance Tax Return, Inventory and First & Final Account; preparation of Personal and Fiduciary Income Tax Returns 02/22/05 Register of Wills - Filing 30.00 Fee, Pa. Inheritance Tax Return & Inventory - ------------ TOTAL ADMINISTRATION EXPENSES....... ... . . . . ... . . . . . 2,166.57 3 I I I I SCHEDULE C-4 FEDERAL AND STATE TAXES ----------------------- 12/30/04 Register of Wills - Pa. 12,779.26 Inheritance Tax Prepayment 02/22/05 Register of Wills - 4.20 Additional Pennsylvania Inheritance Tax Paid w/Return 05/16/05 Register of Wills - 961.15 Additional Pa. Inheritance Taxes owed per Notice of Appraisement - ------------ TOTAL FEDERAL AND STATE TAXES... ....... . . . . . . . . . . . . 13,744.61 SCHEDULE C-5 FEES AND COMMISSIONS -------------------- 11/12/04 Greenawalt & Company, P.C. - 325.00 Preparation of 2002 personal income tax returns 02/17/05 James D. Bogar, Esquire - 3,367.50 One-half of Attorney's fee for representation of Estate as per agreement 04/14/05 Greenawalt & Company, P.C. - 225.00 Preparation of 2004 federal and state personal income tax returns TO BE PAID Louis Brodnick - Executor's 3,367.50 Fees TO BE PAID James D. Bogar, Esquire - 3,367.50 One-Half of Attorney's fee for representation of Estate as per agreement - ------------ TOTAL FEES AND COMMISSIONS............. . . . . . . . . . . . . 10,652.50 -------------- TOTAL DISBURSEMENTS OF PRINCIPAL....... . ... . . . . . ... 29,430.74 -------------- -------------- 4 I I SCHEDULE D DISTRIBUTIONS OF PRINCIPAL TO BE EFICIARIES Ann D. Koelsch -------------- 02/22/05 Ann D. Koelsch - Advancement 20,000.00 Lavina O'Connor --------------- 02/22/05 Lavina O'Connor - Advancement 20,000.00 Louis Brodnick -------------- 02/22/05 Louis Brodnick - Advancement 20,000.00 The Garden Club of New Jersey, Inc. ----------------------------------- 02/22/05 The Garden Club of New Jersey, 20,000.00 Inc. - Advancement -------------- TOTAL DISTRIBUTIONS TO BENEFICI RIES..... . 80,000.00 -------------- -------------- SCHEDULE G RECEIPTS OF INCOME SCHEDULE G-2 INTEREST ------------ Commerce Bank ------------- 05/18/05 Interest earned in Estate 4.72 Checking Account 05/18/05 Interest earned in Estate 406.48 Savings Account - ------------ 411.20 5 I I I . Hartford Life ------------- 02/18/05 Interest Earned on annuity 21. 01 from date of death to close-out -------------- TOTAL INTEREST INCOME.... ... ... . . . . .. . . . . 432.21 -------------- -------------- SCHEDULE G-3 OTHER INCOME ------------ Horizon Blue Cross/Blue Shield of New Jersey ------------------------------------- 05/06/05 Reimbursement for claim 3.54 -------------- TOTAL OTHER INCOME............. .. . . . . . ... 3.54 -------------- -------------- TOTAL RECEIPTS OF INCOME....... . .. . . . . . . . 435.75 -------------- -------------- 6 i I I I . . PROPOSED DISTRIBUTIONS TO BENEF CIARIES Curr nt Value Fiduciary Acquisition # Units or s Noted Value Ann D. Koelsch -------------- Ann D. Koelsch - Proposed 9,193.29 Distribution --- ---------- -------------- 0.00 9,193.29 The Garden Club of New Jersey, Inc. ----------------------------------- The Garden Club of New Jersey, 13,774.83 Inc. - Proposed Distribution --- ---------- -------------- 0.00 13,774.83 Louis Brodnick -------------- Louis Brodnick - Proposed 9,193.29 Distribution --- ---------- -------------- 0.00 9,193.29 Lavina O'Connor --------------- Lavina O'Connor - Proposed 9,193.29 Distribution --- ---------- -------------- 0.00 9,193.29 --- ---------- -------------- 0.00 41,354.70 --- ---------- -------------- ---------- -------------- 7 . . AFFIDAVIT Louis Brodnick and James D. Bogar, Executors under the Last Will and Testament of LILLIAN C. KOELSCH, deceased, hereby decl re under oath that he has fully and faithfully discharged the duties of his offi e; that the foregoing Account is true and correct and fully discloses all si nificant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that, to his knowledge, there re no claims now outstanding against the Estate; that all taxes present y due from the estate have been paid; and that more than four months have el psed since the first complete advertisement of the granting of letters in t is estate. ,,/) ~~dJ' Louis Brodnick and James Subscribed and sworn to by Louis Brodnick and James D. Bogar, Executors 3fL- before me this I . day of ,~LV~L , 2005. -713 en f) I..Q if LJ.J2Ql Ct/(J\./) Notary Public AIlIM. SEAL "l. W1WM1S, .MrPOlUC IItIREMAlS1OWIIIORO.. CUlBlMD co. MY COMMISSIOII EJPIIQ APRIL 18 2009 , 8 I IN RE: ESTATE OF : RT OF COMMON PLEAS OF LILLIAN C. KOELSCH, : COUNTY, PENNSYLVANIA LATE OF LOWER ALLEN TWP., : CUMBERLAND COUNTY, : ORPHANS' OURT DIVISION PENNSYLVANIA, : DECEASED : 0863 NOTICE OF NOTICE IS HEREBY GIVEN that Louis Brodnick a d James D. Bogar, Co- Executors of the Estate of Lillian C. Koelsch, de eased, have this date filed their Revised First and Final Account and S atement of Proposed Distribution in the above-captioned Estate in the Cumberland County Register of Wills Office where the same is filed s public record and may be inspected. Enclosed herewith is a copy of the Revised First and Final Account as filed. YOU ARE FURTHER notified that any exceptions or objections to said Account must be filed in writing at the Cumberlan County Clerk of the Orphans' Court Office not of said Account sched- uled as set forth below. UNLESS written exceptions or objections are iled thereto, said Account will be presented to the above-captioned ourt at 9:30 A.M. on Tuesday, June 21, 2005, at which will be audited. Date: L. J 13/05 J es D. Esquire Attorney e Estate One West Maln treet Shiremanstown, PA 17011 (717) 737-8761 cc: The Garden Club of New Jersey, Inc. Ann D. Koelsch Lovina O'Connor Louis Brodnick, Co-Executor James D. Bogar, Esquire, Co-Executor I I I 01 .. IN RE: ESTATE OF : RT OF COMMON PLEAS OF LILLIAN C. KOELSCH, : COUNTY, PENNSYLVANIA LATE OF LOWER ALLEN TWP., : CUMBERLAND COUNTY, : ORPHANS' DIVISION PENNSYLVANIA, : DECEASED : NO. 21-04-0863 AFFIDAVIT OF SERVICE COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : JAMES D. BOGAR, being duly sworn according t law, deposes and says that in accordance with Cumberland County Orphans' Court Rule No. 5.5, he caused the Notice to the Attorney General, Common ealth of Pennsylvania, of Proceedings Affecting Charitable Interests, in th above-captioned matter to be served by facsimile transmission at 717-787 1190, as indicated by the attached facsimile confirmation receipt. Sworn to and subscribed before me this /3+J..-.. day of ('~"I'U , 2005. ---:'"8 VII n l~ - L\.)~Q{ a_ r/l~) ,-j Notary Public My Commission Expires: OF _L IIWMIS....PIIUC tII1REMMSIOWIIBCIIO.. QlBMMD co. MY COMMISSlOfI OPIIIES APRIl 1. 200t I I I **#****~~******************************************************** ********************************** * P,01 :+: * TRANSACTION REPORT * * JUN-13-05 MON 01:23 PM * * * * DATE START RECEIVER TX TI ME PAGES TYPE NOTE M# DP * * * * JUN-13 01:19 PM 7871190 3' 13" 14 SEND OK 077 * * * * * * TOTAL : 3M 13S PAGES: 14 * * * ***************************************************************** ********************************** JAMl~S D. BOGAR Ntorncy at Law One West Main Street Shircmanstown, P^ 17011 ,',II n,:':,i (l. ~10(}1( (~"mt:\il m<lil@bognrl,')w.porn T91ephono (717) 7~17..B7G 1 J::i'I:\i[ L r t~. ~ lipp' FclcsimllH (117) '7:3" .2<lfJ(5 '^I,~') .l/II: 1,1I.,)(i tiJ N\I)V Jl'h:,'y tl,-,r DirOL! u-m,lII jllO(I(,1 ~.lll,\(lM"w,CDm g,AC's,lMJJJJt CQ~gfLJmEE'I' TlNr'F~ : lJune 13, ;lOO5 '1'0 ; O~fice of Attorney Gene al JVn:'N: 'rhOffii:lS H. Devlin, r~~~qui c Senior Deputy Attorney ~moral FACSHLtl,B NO: 7 1 7 -, 7 8 7 .. 11. 9 0 FHOM: ,Tar1l8~:; D. Bogar, Esqui.re }'tl~ : Estate of Lt.illian C. Ko lsch Cmnbe-clfmd County Orpha Sl Court No. 21-0.1-0863 PAG};~ 1 01<' lt1 ---.- )S"..- HARn COpy WI J.L FOr.LOW _,,~,~__,_ ORI INAL WILL BE Rl~rI'l\INgD r.1lM~f S !'.G J!: ; . r IN RE: ESTATE OF : RT OF COMMON PLEAS OF LILLIAN C. KOELSCH, : COUNTY, PENNSYLVANIA LATE OF LOWER ALLEN TWP., : CUMBERLAND COUNTY, : ORPHANS' OURT DIVISION PENNSYLVANIA, : DECEASED : 0863 NOTICE TO THE ATTORNEY GENERAL, COMMONWEAL H OF PENNSYLVANIA, OF PROCEEDINGS AFFECTING CHARITABLE NTERESTS NOTICE IS HEREBY GIVEN, that the Revised Fir t and Final Account and Statement of Proposed Distribution of Louis Brodn'ck and James D. Bogar, Co-Executors of the Estate of Lillian C. Koelsch, was filed in the Cumber- land County Register of Wills Office on June 13, 005. In the absence of exceptions to the Account, it will be called for udit by the Court at 9:30 A.M. on Tuesday, June 21, 2005. A copy of the Revised First and Final and Statement of Proposed Distribution is attached hereto. A copy of the Will of the decedent is also enclosed herewith. The names and addresses of the specific char'ties affected by this proceeding are: The Garden Club of New Jersey, Inc. 126 Ryders Lane East Brunswick, NJ 08816-1331 The names and addresses of the Co-Executors re as follows: Louis Brodnick D. Bogar 2117 South 2nd Street est Main Street Steelton, PA 17113 mans town, PA 17011 The name and address of Counsel for the iary is James D. Bogar, Esquire, One West Main Street, Shiremanstown, PA 17011. I I . , All charities referred to herein were written Notice of Filing Account, which Notice included a full copy of the Revised First and Final Account and Statement Distribution, said Notice being sent on or about June 13, 2005, a copy of ich is enclosed herein. ESTATE OF Date: (p J 13JO'5 Bogar, Esquire for the Estate Certified Mail - No. 7003 2260 0002 1615 facsimile transmission-717-787-1190 Return Receipt Requested Addressee: Commonwealth of Pennsylvania Office of the Attorney General Charitable Trust & Organization Secti n Strawberry Square - 14th Floor Harrisburg, PA 17120 cc: Louis Brodnick, Co-Executor James D. Bogar, Esquire, Co-Executor I I I I - IN RE: : IN THE COURT OF COMMON PLEAS OF ESTATE OF SUSAN M. RITTER : CUMBERLAND COUNTY, PENNSYLVANIA : MICHAEL E. ALLEMAN, : Petitioner : ORPHANS' COURT DIVISION : CECELIA J. STONER, : Respondent : No. 21-03-0486 ORDER AND NOW, this day of , 2005, upon consideration of the attached Motion to Quash Subpoena to Attend and Testify, oral argument is scheduled on James D. Bogar's Motion for Courtroom No. 1 on the day of , 2005, at .m. By the Court: J. Wesley Oler, Jr. , J. - . , IN RE: : IN THE COURT OF COMMON PLEAS OF ESTATE OF SUSAN M. RITTER : CUMBERLAND COUNTY, PENNSYLVANIA : MICHAEL E. ALLEMAN, : Petitioner : ORPHANS' COURT DIVISION : CECELIA J. STONER, : Respondent : No. 21-03-0486 MOTION TO QUASH SUBPOENA TO ATTEND AND TESTIFY AND NOW, comes Jennifer B. Hipp, Esquire and James D. Bogar, Esquire, attorneys for the Estate of Susan M. Ritter, by and through Cecelia J. Stoner, Executrix, and respectfully objects to the Subpoena to Attend and Testify, same being served upon James D. Bogar, Esquire, said Subpoena being attached to this Motion, for the following reasons: 1. James D. Bogar, Esquire, is the attorney for the Estate of Susan M. Ritter, by and through Cecelia J. Stoner, Executrix, which is one of the parties to the Objections to Proposed Distribution and Petition for Accounting for the Estate of Susan M. Ritter, as filed by Michael E. Alleman, Petitioner. Thus, the Subpoena to Attend and Testify is objected to and should be dismissed on the basis of attorney-client privilege. j - 2. Requiring the attendance of James D. Bogar, Esquire, as a witness to provide testimony and documents would cause James D. Bogar, Esquire, unreasonable annoyance, embarrassment, oppression, burden and/or expense, all pursuant to Pa. R.C.P. 2004.4(b) . 3 . The Subpoena to Attend and Testify is designed to cause the unreasonable annoyance, embarrassment, oppression, burden and/or expense of James D. Bogar, Esquire, in that it is overly vague in the documents requested to be brought to the Hearing scheduled for June 29, 2005, at 1:30 p.m. 4. The Subpoena to Attend and Testify should be quashed on the basis that any and all of the information and documentation pertaining to the administration of the Estate of Susan M. Ritter and the Power of Attorney of Susan M. Ritter at issue are protected by the attorney-client privilege. 5 . The Subpoena should be quashed and is objected to on the ground that it seeks disclosure of mental impressions, conclusions and opinions and/or memorandum, notes, summaries, legal research of James D. Bogar, Esquire, attorney for the Estate of Susan M. Ritter, by and through Cecelia J. Stoner, Executrix. 2 - . 6 . The Subpoena should be quashed and is objected to on the ground that it seeks disclosure of mental impressions, conclusions or opinions of James D. Bogar, Esquire, attorney for the Estate of Susan M. Ritter, by and through Cecelia J. Stoner, Executrix, regarding the value and merit of Petitioner's claim, and/or respecting strategy or tactics to be employed in the defense of this action. WHEREFORE, it is respectfully requested that this Honorable Court grant the Motion to Quash Subpoena to Attend and Testify and, further, grant and render such other relief as is appropriate under the circumstances. Respectfully submitted, Date: <pII1-\Oc; J~~rLl~rPHiPp, Esquire Pa. I.D. No. 86556 One West Main Street Shiremanstown, PA 17011 (717)737-8761 Date: I.Q l~ 'Wr /;}tWBq~a::quire Pa. I.D. No. ~75 One West Main Street Shiremanstown, PA 17011 (717)737-8761 3 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN RE: SUSAN M. RITTER, : Docket No 21-03-486 MICHAEL E. ALLEMAN, Petitioner . Orphans' Court Division CECELIA J. STONER, Respondent SUBPOENA TO ATTEND AND TESTIFY To: James D. Bogar, Esquire One West Main Street Sh~remanstown, PA l/ull . Courtroom No. 1 1. You are ordered by the court to come to (Specify Courtroom or other place) , at Carlisle, Cumberland County, Pennsylvania, on June 29, 2005 at 1:30 o'clock,~M, to testify on behalf of Petitioner in the above case, and to remain until excused. 2. And bring with you the following: Any and all information pertaining to the estate administration of Susan M. Ritter and the related Power of Attorney at issue. If you fail to attend or to produce the documents or things required by this subpoena, you may be subject to the sanctions authorized by Rule 234.5 of the Pennsylvania Rules of Civil Procedure, including but not limited to costs, attorney fees and imprisonment. Requested by: Name: Neil W. Yahn, Esquire Address: P.O. Box 650 Hershey, PA 17033 Telephone: (717) 533-3280 Supreme Court ID: 82278 Date:.5~ 7/a.~ Note: This form of subpoena shall be used whenever a subpoena is issuable, including hearings in connection with depositions and before arbitrators, masters, commissioners, etc. in compliance with Pa R.C.P.No.234.1. If a subpoena for a production of documents, records or things is desired, complete paragraph 2. CERTIFICATE OF SERVICE Jennifer B. Hipp, Esquire and James D. Bogar, Esquire hereby certify that on this l-:ro\-~ day of June, 2005, we placed in the united States Mail a true and correct copy of the foregoing, to the following: Neil W. Yahn, Esquire James, Smith Dietterick & Connelly, LLP P. O. Box 650 Hershey, PA 17033-0650 Jeffrey A. Ernico, Esquire Ronald L. Finck, Esquire Mette, Evans & Woodside 3401 North Front Street P. O. Box 5950 Harrisburg, PA 17110-0950 By' ~l~'?Y Esquire Jenni er B. Hipp, Pa. I.D. No. 86556 One West Main Street Shiremanstown, PA 17011 (717) 737-8761 By: Ja es D. Pa. I.D. One West Main Street Shiremanstown, PA 17011 (717) 737-8761 , IN RE: : IN THE COURT OF COMMON PLEAS OF ESTATE OF SUSAN M. RITTER : CUMBERLAND COUNTY, PENNSYLVANIA : MICHAEL E. ALLEMAN, : Petitioner : ORPHANS' COURT DIVISION : CECELIA J. STONER, : Respondent : No. 21-03-0486 OBJECTIONS TO SUBPOENA PURSUANT TO RULE 4009.21 TO PRODUCE DOCUMENTS AND THINGS PURSUANT TO RULE 4009.21 The Estate of Susan M. Ritter, by and through its attorney, James D. Bogar, Esquire, objects to the proposed subpoena that is attached to these objections for the following reasons: 1. The Estate of Susan M. Ritter, by and through its Executrix, Cecelia J. Stoner, is represented by James D. Bogar, Esquire, and, thus, is a party to the Objections to Proposed Distribution and Petition for Accounting for the Estate of Susan M. Ritter as filed by Michael E. Alleman, Petitioner. Acco~dingly, service of the subpoena upon James D. Bogar, Esquire, is inappropriate given that he is an attorney representing a party to the pending Objections. 2. ,The subpoena is objected to on the grounds that it seeks disclosure of the mental impressions, conclusions and opinions and/or memoranda, notes, summaries, legal research of James D. Bogar, Esquire, in violation of Pa. R.C.P. 4003.3. vA 3. This subpoena is objected to on the ground that it seeks disclosure of the mental impressions, conclusions or opinions of the Estate of Susan M. Ritter's legal representative regarding the value and merit of Alleman's claim or respecting strategy or tactics to be employed in the defense of this action, all in violation of Pa. R.C.P. 4003.3. 4. On or about May 31, 2005, Alleman served a Notice of Intent to Serve a Subpoena to Produce Documents and Things seeking information and certain documents regarding the administration of the Estate of Susan M. Ritter and the Power of Attorney of Susan M. Ritter. The voluminous quantity of documentation requested demonstrates that the subpoena was served on James D. Bogar, Esquire, for the purpose of imposing unreasonable annoyance, embarrassment, oppression, burden and expense on James D. Bogar, Esquire and Cecelia J. Stoner, Executrix, in violation of Pa. R.C.P. 4011. 5. The subpoena for the production of documents is objected to on the ground that it fails to describe each item to be inspected with reasonable particularity in violation of Pa. R.C.P. 4009.11 (b) . 2 . 6. The Subpoena to Produce Documents or Things is objected to under Pa. R.C.P. 4003.1 and 4011(c) in that it seeks information, material and documentation which is privileged in violation of Pa. R.C.P. 4003.1 and 4011(c) in that that information, documentation and material is protected by the attorney-client privilege. 7. The Subpoena to Produce Documents or Things is objected to on the basis that James D. Bogar, Esquire, in his capacity as attorney for Cecelia J. Stoner, Executrix of the Estate of Susan M. Ritter, is not in possession of any checking account statements and duplicative checks relating to PNC Bank Account No. 5070085663 from 1999 through 2003, and, thus, was served for the purpose of imposing unreasonable annoyance, embarrassment, oppression, burden and expense in violation of Pa. R.C.P. 4011(a) and 4011 (b) . WHEREFORE, it is respectfully requested that this Honorable Court sustain the Objections as set forth herein and disallow 3 , . service of the Subpoena to Produce Documents and Things and, further, to grant and render such other relief as is appropriate under the circumstances. Respectfully submitted, Date: ~/I~/O~ ~tf-'~ Esquire Jenn'fer B. H1pp, Pa. I.D. No. 86556 One West Main Street Shiremanstown, PA 17011 (717)737-8761 Date: (,,\ nlo) , Esquire 475 One West Main Street Shiremanstown, PA 17011 (717)737-8761 Attorneys for the Estate of Susan M. Ritter 4 , . . . COMMONWEALTH OF PENNSYL VANIA COUNTY OF CUMBERLAND IN RE: : SUSAN M. RITTER, : 21-03-486 : FileNo. MICHAEL E. ALLEMAN, Petitioner : : Orphans' Court Division CECELIA J. STONER, Respondent : SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: James D. Bogar, Esquire (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: Any and all information pertaining to the estate administration of Susan M. Ritter and the related Power of Attorney at issue including but nuL limited to the following. MUD 1 otatelllents fur real eotate transactions sold by Cecelia J. Stoner as agent for Susan M. Ritter 0 PNC Bank Account #5070085663 from 1999 through 2003. at 134 Sipe Avenue, Hummelstown, PA 17036 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: Neil W. Yahn, Esquire ADDRESS: P.O. Box 650 Hp-rsh~ ' PA 17033 TELEPHONE: (/1./) 533-3280 SUPREME COURT ID # 1:122/1:1 A TIORNEY FOR: Petitioner Court Date: 5/27/05 Seal of the Court D8~1it). . , . CERTIFICATE OF SERVICE Jennifer B. Hipp, Esquire and James D. Bogar, Esquire, hereby certify that on this J:}~~ day of June, 2005, we placed in the United States Mail a true and correct copy of the foregoing, to the following: Neil W. Yahn, Esquire James, Smith Dietterick & Connelly, LLP P. O. Box 650 Hershey, PA 17033-0650 Jeffrey A. Ernico, Esquire Ronald L. Finck, Esquire Mette, Evans & Woodside 3401 North Front Street P. O. Box 5950 Harrisburg, PA 17110-0950 By: ~lt~~ Jenn' e B. Hlpp, Esqulre Pa. I.D. No. 86556 One West Main Street Shiremanstown, PA 17011 (717) 737-8761 By: James D. r, Esquire Pa. I.D. 19475 One West Main Street Shiremanstown, PA 17011 (717) 737-8761 - " IN RE: ESTATE OF : IN THE COURT OF COMMON PLEAS OF LILLIAN C. KOELSCH, . CUMBERLAND COUNTY, PENNSYLVANIA LATE OF LOWER ALLEN TWP., : CUMBERLAND COUNTY, : ORPHANS' COURT DIVISION PENNSYLVANIA, : DECEASED : NO. 21-04-0863 AFFIDAVIT OF SERVICE COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : JAMES D. BOGAR, being duly sworn according to law, deposes and says that in accordance with Cumberland County Orphans' Court Rule No. 5.5, he caused the Notice to the Attorney General, Commonwealth of Pennsylvania, of Proceedings Affecting Charitable Interests, in the above-captioned matter to be served by Certified Mail, Return Receipt Requested, as indicated by the attached receipt cards. Sworn to9nd subscribed before me this J to+L day of ,-J u. ru- , 2005. , b~nnu .T LLl~Qu:tr--_'} Notary Public My Commission E~pires: OF IOTARIAL DIllE l. WIWAIIS, lorARY PU8UC IHIREMAHSTOWN IIORO.. aJllBERlAHD ce. MY COMMISSION fJPIRD APRll18 2009 vel ~ r-------~-- --- I j ~ SENDER: COMPLETE THIS SECTION . Compieteltetns 1, 2. and 3. Also complete item 4 If RestrlctQd Delivery Is desired. . Print your name and address on the reverse so that we can return the card to you. . Attach this card ~ the back of the mallpiece. or on the front if space pennits. 1. ArtIcle Addressed to: Ccmoonweal th of Pennsylvania Office of the Attorney General Charitable Trust & Organization Strawberry Square - 14th Floor Harrisburg, PA 17120 ~ype ad MaR o Express Mail o Registered o Return Receipt for Merchandise (J{otbc^-) o Insured Mall o C.O.D. 4. Restricted Delivery? (Extra Fee) Dyes 2. Article Number' 7003 2260 0002 1615 2937 ((Trans. from ServIce label) , PS Form 3811, February 2004 Dor1'Ieettc Return ReceIpt 102595-02-M-154jl J I"- IT) CT' rtJ LI'J . r-'l H,Qs6d'~ '7G I ...J] r-'l Postage $ $1. 06 rtJ CJ Certified Fee $ . 0 CJ CJ (E Return Reclept Fee $1.75 nclorsement Required) CJ Restrlcled Delivery Fee $0.00 re (Endorsement Required) rtJ Total Postage & Fees $ $5.11 IT) CJ CJ l"- I I COMMONWEALTH OF PENNSYLVANIA OFFICE OF ATTORNEY GENERAL TOM CORBETT ATTORNEY GENERAL June 14, 2005 Charitable Trusts and Organizations Section 14th Floor, Strawberry Square Harrisburg, PA 17120 (717) 783-2853 (717) 787-1190 (Fax No.) VIA FAX (717) 737-2086 & MAIL James D. Bogar Attorney At Law One West Main Street Shiremanstown, PA. 17011 RE: ESTATE OF LILLIAN C. KOELSCH, CUMBERLAND COUNTY ORPHANS' COURT, NO. 21-04-0863 (Clearance) Dear Jim: I have received your revised accounting and revised proposed distribution. I am pleased to be able to indicate to you that the Attorney General's Office has no-objection to your revised accounting and revised proposed distribution. You may present this letter of no-objection as clearance for your revised accounting and proposed distribution to the Orphans' Court. Please be advised that this no-objection letter relates only to the Attorney General's parens patriae power with respect to charitable interests and relates to no other function of this office. Very truly yours, ~ Thomas M. Devlin Senior Deputy Attorney General TMD/Iss vf - 'ff!II""'" ~.. '. - ~"_H'm.. ,-.....,,~,~ lIlC; cB Q) - e e :., :s~.gl 10- f o 0) 0 ~iIRll~ . CHi) 1:: E 0 ~ c~:J...-O)e . 11> ld:l~t i = o~ea.tl;l~ -= a. 0 0) ~ ... E .~ CD '0 1! is 'C1~ '(ij .g /' lIB)'! ,. !'ie_OeQUO) "6l'lS - e in;Jijll CD .9~:E~o~ t)~-o-o.o 0) ". 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BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REY-1607 EX AFP (05-05) '''0 " , DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-13-2005 KOELSCH 09-09-2004 21 04-0863 CUMBERLAND 101 LILLIAN C JAMES D BOGAR 1 W MAIN ST SHIREMANSTOWN ESQ AlIOunt Remi tt.d PA 17011 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, submit the upper portion of this for. with your tax pay~nt. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ................................................................................................................ REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF KOELSCH LILLIAN C FILE NO.21 04-0863 ACN 101 DATE 06-13-2005 THIS STATENENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NANED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYNENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 05-16-2005 PRINCIPAL TAX DUE, 14,417.20 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-06-2004 CD004691 672.59 12,779.26 02-23-2005 COO04980 .00 4.20 05-17-2005 CD005328 .00 961.15 TOTAL TAX CREDIT 14,417 .20 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 . ~ SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOHN FOR INSTRUCTIONS. I