Loading...
HomeMy WebLinkAbout11-01-121505610143 R~~-1500 EX (01-10) OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 80X.280601 INHERITANCE TAX RETURN 21 12 0832 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 204 03 9961 07 14 2012 12 29 1920 Decedent's Last Name Suffix Decedent's First Name MI TRITT EMMA M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 1. Original Return ~ 2. Supplemental Return 4. Limited Estate ~ ~--I 4a. `uture Interest Compromise ) date of death after 12-12-82 ~ ;, ~ L~ ~ 6 Decedent Died Testate (Attach Copy of Will) Ci 7• AttacdheCopy of Trust)a Living Trust ^ 9. Litigation Proceeds Received ,~~ 10 between12V31 ~~anditl(dat~e5~f death 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number RR_ADLEY L GRIFFIE 717 243 551 ~_ First line of address 200 NORTH HANOVER STREE Second line of address City or Post Office CARLISLE State ZIP Code PA 17013 -r~ r't REGISTER O~~L,S USE QYl15~LY y -, -~~ ~ ...1 ~ ~, ~~:J ~ _ -~ : _ ~ .} --, :. j...,. n a ~ --,n DATE FILED Correspondent's a-mail address: b9riffie@gr'Iffielaw.COm 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 4F PERSON RESPONSIBLE FOILING RETURN DATE ~ / ~ ,~ ~~„`~}~, ~ ~ n~ Richard L. Tritt ~ ~' - ' , ADDRESS 33 Silver Ma a Drive Boilin S rin s PA 17007 SIGNATU ARER ER THAN REPRESENTATIVE DATE Bradley L Griffie (a ~3 ~ (~- 200 Nori~Hanover Street, Carlisle, PA Side 1 1505610143 1505610143 J REV-1500 EX Decedent's Name: TCItt, Emma M. Decedent's Social Security Number 204 03 9961 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous t~nn; Probate Property ^ Separate Billing Requested............ 7, (Schedule G) 8. Total Gross Assets (total Lines 1-7) ...............:...................:................................. 8. 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Scheduled) .............................. 10. 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 12. Net-Value of Estate (Line 8 minus Line 11) .......................................................... 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15. (a)(1.2) X .00 16. Amount of Line 14 taxable 3 $ , 4 6 8 . 4 8 16. at lineal rate X .045 17. Amount of Line 14 taxable 0 , Q Q 17. at sibling rate X .12 18. Amount of Line 14 taxable 0 . 0 0 18. at collateral rate X .15 19. Tax Due .................................................................................................................. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 15D561D243 32,241.31 3,033.56 13,036.58 0.00 48,311.45 3,_953.62 5,889.35 9,842.97 38,468.48 38,468.48 0.00 1,731.08 0.00 0.00 1,731.08 Side 2 L 1505610243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Tritt, Emma M. STREET ADDRESS 9 Alliance Drive CITY Carlisle Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest File Number 21-12-0832 STATE ZIP PA 17013 (1) 2,205.30 110.27 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5, If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Total Credits (A + B) (2) (3) (4) (5) 1,731.08 2,315.57 584.49 Make Check Payable to REGISTER OF WILLS, AGENT ~ ~ ~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes ^ No a. retain the use or income of the. property transferred :............................................................................... i x ncome :.................................. b. retain the right to designate who shall use the property transferred or its ^ ~ . 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? .................................................................................................................. . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ^ ~^ contains a beneficiary designation? ................................................................................................................ . IF THE ANSWER TO-ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE 1T AS PART OF THE RETURN. ..5,. N' _~ .. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets, and filing a tax return are still applicable even 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 21 years of age or younger at death to or for the use of a natural, parent, an adoptive parent, or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1503 EX+ (6-98) S~HEDUl.E B ,~ STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Emma M. All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21-12-0832 (If more space is needed, adaluonal pages yr ine same s~~C~ Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1508 EX+ (6-98) SCHED4lLE E ~~ CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Trit+ Fmma M_ 21-12-0832 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. (If more space is neeaea, aaaluonal pages vi ine sank aicc~ Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1509 EX+ (1i-98) . ;° SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Tritt. Emma M. 21-12-0832 A. Jane Hippensteel g, Richard L. Tcitt C. 52 Ashton Street Daughter Carlisle, PA 17015 33 Silver Maple Drive Son Boiling Springs, PA 17007 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF pECD'S INTEREST DATE OF DEATH DECEDENT'S NTEREST 1 A 05/04/2010 Orrstown Bank -Certificate of Deposit 9,604.44 50.000°!0 4,802.22 No. XXXXXX7550 2 B 05/04/2012 Orrstown Bank -Certificate of Deposit 9,604.44 50.000% 4,802.22 No. XXXXXX7551 3 A 04/14/2008 Citizens Bank -Certificate of Deposit 3,367.75 50.000% 1,683.88 No. XXXXXX3953 4 A 06!2512010 Metro Bank -Checking Account - 3,496.51 50.000% 1,748.26 No. XXXXX7782 TOTAL (Also enter on Line 6, Recapitulation) (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. If an asset was made joint within one year of the decedents date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT 13,036.58 Form PA-1500 Schedule F (Rev. 6-98) Rev-1510 EX+ (6-98) SCF~ED!!LE G _~ INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Tritt. Emma M. FILE NUMBER 21-12-0832 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH °i° OF DECD'S EXCLUSION NUMBER THELDATE OF TRANSFERSATTACIiTA COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 1 Prudential Annuities -Contract No. PIA 000002786 0.00 0.000% 100.00 (See attached letter; this Annuity was payable to the Commonwealth of Pennsylvania Department of Public Welfare) TOTAL (Also enter on Line 7, Recapitulation) (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. TAXABLE VALUE 0.00 0.00 Form PA-1500 Schedule G (Rev. 6-98) REV-1151 EX+ (10-06} COMMNHERITANCE T~ RET~RNANIA RESIDENT DECEDEN FUNERAL EXPENSES: ESTATE OF Tritt_ Emma M. SCHED~lLE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-12-0832 ITEM NUMBE A. Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representatives} Street Address City State Zip Yearlsl Commission paid 2, Attorney's Fees Griffie & Associates, P.C. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zia Relationship of Claimant to Decedent 485.33 2,500.00 4. Probate Fees 192.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 775.79 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 3,953.62 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) S~HEDUl.E H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued FILE NUMBER ESTATE OF 21-12-0832 Tritt, Emma M. ITEM DESCRIPTION AMOUNT NUMBER 1 Funeral Expenses Eby Granite Work (Memorial Stone Inscription) 119.00 125.00 2 Pastor donation 100.00 3 Church donation ~ 86.03 4 Funeral meal expense 55.30 5 Funeral flowers I-I _A 485.33 Qther Administrative Costs 6 The Sentinel (Advertising) 189'54 7 Cumberland Law Journal (Advertising) 75.00 8 Orrstown Bank (estate checking account fees) - 11.25 500.00 9 Reserves H-B7 775.79 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE 1 ,` DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Tritt, Emma M. 21-12-0832 .,___~ ~_~._ :.,,....-e., ti.. •-.e ~o,.o~o.,r .,~~r to death that remained unsaid at the date of death, including unreimbursed medical expenses. (If more space is needed, aaoluonai pages of u-e san~C ~:~~~ Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule 1 (Rev. 12-08) REV-1513 EX+ (11-OS) ., COMMNHERITAN~EOT~ RETURLN ANIA RESIDEN DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Tritt, Emma M. 21-12-0832 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NAME AND ADDRESS OF DECEDENT NUMBER PERSON(S) RECEIVING PROPERTY (Words) ($$$) TAXABLE DISTRIBUTIONS [include outright spousal I. distributions, and transfers under Sec. 9116(a)(1.2)] __ Jane Hippensteel 52 Ashton Street Carlisle, PA 17015 Richard L. Tritt 33 Siiver Maple Drive Boiling Springs, PA 17007 Daughter Fifty percent of 19,234.24 net estate Son Fifty percent of 19,234.24 net estate Total ~ 38,468.48 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet, as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II ENTER TOTAL NON TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) LAST WILL AND TESTAMENT OF EMMA M. TRITT I, EMMA M. TRITT of Cumberland County, Pennsylvania, do make, publish and declare this as and for my Last Will and Testament, hereby expressly revoking all wills and codicils made by me heretofore, and dispose of my estate as follows: ITEM 1: I direct the payment of my just debts and funeral expenses, including a suitable and proper grave marker, as soon as conveniently can be done following my decease. ITEM 2: I direct that all State and Federal Transfer Inheritance Tax, Estate Tax, Succession Tax or any other tax, including any interest, assessments or penalties thereon, that may become due and payable by virtue of my death, or by virtue of the assing of any property either under my Last Will and Testament, or in .any :other ,manner, P shall be paid from my residuary estate, just as if such taxes were my debts, and no beneficiary shall be required to pay or refund any part thereof. ITEM 3: I give and bequeath my grandfather's clock to my daughter, .JANE HIPPENSTEEL. ITEM 4: I give, devise, and bequeath all the rest, residue and remainder of my estate tom children RICHARD TRITT and JANE HIPPENSTEEL, equally. If either child Y of mine is not living at the time of my death, but has issue who are then living, then that deceased child's share of my estate shall be distributed to the issue of that deceased child, per stirpes. If a child is not then living and does not leave issue who are then (iving, then such deceased child's share of my estate shall lapse. If I have no living children or other issue, my residuary estate shall be distributed to my heirs at law as determined at the time of my death under the laws of the Commonwealth of Pennsylvania in effect at my death. ITEM 5: in the administration of my estate my Executor shall have the following powers without leave of court in addition to, but not in limitation. of, the powers granted by law to the Executors of estates, which powers shall continue after the termination of my estate until actual distribution of the assets: A. To receive in the estate and to retain any assets, real or personal, to which I. may be entitled at the time of my death, which my Executor may deem for the best interest of the estate without being required to convert-said assets into so-called "legal investments". B. To invest and reinvest in such securities as a prudent investor of intelligence and discretion would buy for himself for investment, and not for speculation, giving .due regard to the safety of the principal and the adequacy of the income, and without being limited to the so-called "legal investments" of the Commonwealth of Pennsylvania, said investment authority to include the right to invest in any Discretionary or Legal Common Trust Fund that may be administered and managed by a Corporate Executor or Corporate Trustee. C. To sell or buy real estate without Court order at public or private sale; to make, execute and deliver or receive good and sufficient deeds of conveyance and give or receive good title therefor; to reinvest the proceeds as. if they had originated in personal 2 property; to mortgage or encumber any real estate comprising part of my estate, borrowing the necessary funds from himself or from any other source; to improve any property or otherwise expend principal funds for the upkeep and welfare of ..any properties; to release, vacate and abandon the same; to grant and acquire licenses and easements with respect thereto; to make improvements to or upon the same; and in general to do all things necessary in the management of the properties as if he is the owner thereof, including the right to let property and to make leases for any term. The purchaser shall not be required to see to the proper application of proceeds but may pay the same over`to the Executor selling the same. D. To make distribution hereunder in cash or of property and securities in kind at fair market value at the time of such distribution and in such a manner as to be fair, equitable and just to all concerned. Distributions of property and securities are not required to be identical among the beneficiaries, and some may receive one type of property or security while another may receive an-other type of property or security. ~. E. To exercise any election or privilege given by the federal and other tax laws., including but not (invited to, the election of the alternate valuation date for federal estate tax purposes, the election to claim deductions for federal estate tax or for federal.. income tax purposes, and the election of the method of payment of pension, profit- sharing, HR-10, individual retirement account, and any other similar benefits.. In addition, my Executor, in his sole discretion, may make or not make equitable adjustment among -the beneficiaries, without the consent of the beneficiaries, ,for the exercise or non-exercise of any election or privileges. 3 ITEM 6: I nominate, constitute and appoint my son, RICHARD TRITT, to be Executor of this, my Last Will and Testament. If RICHARD is unable or unwilling to serve or continue to serve as Executor, I appoint my daughter, JANE HIPPENSTEEL to be Executrix of this; 'my Last Will and Testament. No Executor or Executrix shall be required to give bond. ITEM 7: Wherever the context requires, the masculine gender shall include -the feminine .gender- and neuter gender, and vice versa, and the singular shall include the plural, and vice .versa. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~'day of OC_~"0b~'~ , 2007. r U ` / '~-~ ~ EMMA M. TRITT Signed., sealed, published, acknowledged and declared by the above-Warned. Testatrix, EMMA M. TRITT, as and for her Last Will and Testament, in the presence of us, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto. of (~o ~on b.-~ I~ i2~ , C~ vl ~~ ~~- ~7a~3 4 COMMONWEALTH OF PENNSYLVANIA ) SS: COUNTY OF CUMBERLAND ) 1, EMMA M. TRITT, Testatrix, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed .the instrument as my free and voluntary act for the purposes therein contained. EMMA M. TRITT Sworn to or affirmed and acknowledged before me by EMMA M. TRITT~the Testatrix, this 2~ day of C~ C~0 ~~-~ , 2007. Notary Public Commonwealth of Penns, Ivania NOTARIAL SEAL KIMBERLY R. LEQ, Notary Public Carlisle Borough, Co~mty of Cumberland My Commission Ex{~ires Uct. 10, 2009 COMMONWEALTH OF PENNSYLVANIA ~ ) SS: COUNTY OF CUMBERLAND ) We, the undersigned witnesses who signed the foregoing instrument, being duty qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will and :Testament; that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her -sight and hearing signed the Will as witnesses; that Testatrix is known to each of us; and that to the best of our knowledge and observation the Testatrix -was at the time eighteen (18) years of age or older, of sound mind .n'c!'L~~ der no constraint or undue ~~ Influ~nc~. Sworn to or affirmed and subscribed . to before me b ~ 0~ `~o UVI G2 ~. .d ~ witnesses, and~~ ~~ i 'c. ~ r- this.? ay of C~C~i 001~~~- , 2007. Notary Public 5 'ommonwQalth of Penns rivania NOTARIAL SEAL LIMBERLY F!. LC:O, Notary Public Carlisle E3orougt;. Courtt~~ of Cumberland My Commission E>;Pires C1ct, 10, 2009 ~...,.~...~-„ate.,.,<.~m O 0 m -~ ~ ~ ~ L ~ ~ ~ W ~ ~~ ~ ~_ ~ ~~ ?~ ?3 c fD? ~ m (~ m ~ w a w c cn m~ ~, o~ ~~IIlilll ~~Iillll~uiil~ .,i ~ ~ ~ ~ ~ ~° ~ ~ o ~. ~ ~ w i~ ~ ~ JIlillllll,~ o. ~ ~_ :~ ~ N n. ~ Iillll~lllllllll ;~IIIII~ullilll "~",~ ? r o.: ~ ~ c_ a m ~I cn ~ c '~ ~z ~h III~~IIIIIIIII oz ~:~ . g a ~: ~IIIIIi~lllll o :mac.,. ~ Z ~ ~-~, Y~ `~ ~ ~ ~ a ~ ~ ~ ~o ,.~ ~ ~ o .y I IIY~IUIIiI! '~IIIII~II~I ~ . ~ :.~ ~C ~, . ' ..~ , ~~ m ~m '~fD :m ~~ ~ m ~ ~~'glll~~lllill~ pllli~ll o ~ (-~ N ~ ~ O -m -v, o c~ :o ~, a ~ o. o ~ x " Igllllll ulll~llli ~j ~~' N .a ~ :~ n: m w :~ ~ :c.., m m w ~. o ~ Illnil~gil ~. `` o .:~ ~ .~ o r0 ~ ~~ o D o - ~ ~ ,-1 n c - v, `° s `~ alllinl II~IIIIIII ~ ~ ~' ~: ° .O awi 0. D. ,.I I .,,` i •C ~, ~1 , ~~ y ~; ~ N ~ 'illll~llll~ (IIUl~lll) ~ ~ ~ o f;~ . -• a~ ~~•~ D y : ~ o `"IUI~{III811 Illllip~!IIII ~'~ `~ [.~7 ~ . ~_ ~ I ~ ~ ~ ~ ~ ~ ~' ~ ~~..w.r pal II! Q. ~ ~ : `° _ • VIII „Iilllll~lllllllillllllllll ~ C~ Q' ~ p _ 'i ~ ~ ~ ' • ~ O O ~D ~ N ~ ~D ~ Illlililll~lli~lillilil ~,~' ~ ....~ ~, : ; .~ ~ ~ D~ O 4~ W~ T .+ 1v N K ~ O O ~ O ~ 0 .-~ . ~~ 3 ~ fr ~~ i'~ ~; .; r ~ R~ ~: _ ir_ r: ,:= • k i•' .~ 1 ~.. ;~ ~,;.-~~ ~~~:-~~~~~~ 012 8.3 5 € ~i_~ ~.~~~ ~~~ -~~d 01.2 8 3 5 1Jl~y.~~~.i 1 / f~~'+a ~' ~~~ N~~ k/ ~ i.. b;}F.i ~1 b.o ti.~' f.~P°i.~L+ °J ~'i L.rr.. i ve~LJ.`~at.: .`~`~l~ - ~ rl"'~v~~+. i. ~•~ ~:f~ ~~?. i"l4/'_1 L~. ~ii:~{~[. I-!U•:141:: :.: V7 L•i!c. ')ifUi, Ut1t):. I:./-. ;• „_ ~ ga "YC~ ~ ~ - `Ir- - " 012835 QB,~~ ;~ rt ~ ~~~~T~^ 9C~ : QQ~ i~~nety and N0~~100 .oAv J ~~ j - c7r~~ El'rfMA ~(~ T.R1TT ESTATE (~- .. _. ~_= ~~o~~ coo 6r~a>~ley ~riffiie, % Esquire CI F 2Q0 ~ . Hanauer Street _.. G~ar1151e S RR 17~1~ -- - -, } ~~ • August 13 2012 ''~`'~~' ' `~ ~ ~'ii t ' GRIFFIE & ASSOCIATES PC ATTN BRADLEY L GRIFFIE 200 N HANOVER ST CARLISLE PA 17013 . ~; Prudential Reference Number: 9593979959/2844234 Account(s): 0087-~S:XX~:XX1309 Registration: EMMA M TRITT Dear Attorney Griffie: This letter is in regard to a recent inquiry. As of the close of business on July 14, 2012, the above referenced account was valued at $32,151.31. This value is based on a balance of 5,813.981 shares at the Net Asset Value (NAV) price of $5.53 per share. As changing market conditions .may cause the NAV price to fluctuate on a daily basis, the account value is subject to change. To redeem the above referenced account, we require the following: • The enclosed Non-Retirement Redemption Form must be completed and signed by the Executor in Section 5. The capacity in which the Executor acting box must also be checked in that section. In addition, your signature must be in original form, as photocopies are not accepted. • The signature on the document must bear a Medallion Signature Guarantee. The purpose of the Medallion Signature Guarantee is to protect the shareholder against the possibilities of fraud. Please see the enclosed for instructions regarding the Medallion Signature Guarantee. • Section 6 of the form must be completed with the Tax Identification Number under which the redemption should be reported. That section must also be signed. • An original Affidavit of Domicile be completed and signed in ink. The form must indicate the state of domicile or permanent residence for the decedent, capacity of affiant (individual supplying the affidavit), decedent's -name as it appears in the account registration, and identification of the fund and account. The form must be notarized with an original signature of the notary, and bear the notary stamp or seal. Prudential Investments Prudential Mutual Fund Services LLC P O Box 9655 Providence, RI 02940 (800) 225-1852 www.prudentialfunds.com • An original Inheritance Tax Waiver for the decedent, if required by the decedent's state of residence. The Inheritance Tax Waiver must be prepared by the county clerk or appropriate state office and display the official state letterhead. Also, the waiver must refer to the specific number of shares when the shareholder died. Please note that no proceeds from the above referenced account have been withdrawn in the past year. Upon receipt of the required documentation in good order, we.will promptly comply with the request. To expedite the request, please indicate the above reference number in your future related correspondence. Enclosed is a reply envelope for your convenience. If you have questions or need further assistance, please contact the Prudential Mutual Fund Service Center at (800) 225 1 °52 Monday through Friday between 8:00 a.m. and 6:00 p.m. Eastern time. For account information that is available 24 hours a day, 7 days a week, you may access your account online at www.prudentialfunds.com. Sincerely, Joseph Gauvin Customer Service Representative Enc. Prudential Investments Prudential Mutual Fund Services LLC P O Box 9655 Providence, RI 02940 (800) 225-1852 www.prudentialfunds.com . , L ~' ~` >~ ~ One Citizens Drive ROP 112 Riverside, RI 02915 _ P C~ ~, . ~ .~53~~ `:. ~ ~a~}i~r ( ~ August 9, 2012 _... _ _ _ . Gi-iffie & Associates, P.C. 200 North Hanover Street Carlisle, PA 17013 :~ Estate of Emma M: Tritt Date of Death: Jul 14, 2012 SSN: 204-03-9961 Dear Sir/Madam: In accordance with your request, the attached information sheet has .been provided in the above decedent's name as of his/her date of death. There were no withdrawals in excess of $3,000.00 from either of the decedent's accounts within one year prior to the date of death. Also enclosed, please find the section of our Personal Deposit Account Agreement that explains joint ownership. Should you have any questions, please call our customer service department at 1-877-579-2667, option 2. Sincerely, Heather Medeiros Decedent Account Processing REF#: 556314 ~~ Citizens ~ar€k Account Number 6240410387 Accol111t Tltle Emma M. Tritt Ttee For Scott P. Hippensteel Date Opened 8/11/2003 Account Type Time Deposits Principal Balance as of DAD $2,499.53 Interest from Last Posting to DOD $1.34 Account Balance as of DOD $2,500.87 YTD Interest to DOD $56.45 August 9, 2012 Gr•iffie & Associates, P.C. 200 North Hanover Street Carlisle, PA 17013 Estate of Emma M. Tritt Date of Death: 7u1 14, 2012 SSN: 204-03-9961 Dear Sir/Madam: ( - ,., . ~ _ .; ~T~~: ~ ~ ~~~~~;y One Citizens Drive ROP112 Riverside, RI 02915 In accordance with your request, the attached information sheet has .been provided in the above decedent's name as of his/her date of death. There were no withdrawals in excess of $3,000.00 from either of the decedent's accounts within one year prior to the date of death. Also enclosed, please find the section of our Personal Deposit Account Agreement that explains j oint ownership. Should you have any questions, please call our customer service department at 1-877-579-2667, option 2. Sincerely, Heather Medeiros ~De~cedent Accounf Processing REF#: 556314 ~~ C°st'rzens Bank Account Number 6252143953 Account Title *Emma M. Tritt, Jane Hippensteel Date Opened 4/14/2008 Account Type Time Deposits Principal Balance as of 1~~D $3,367.25 Interest from Last Posting to DOD $ .50 Account Balance as of DOD $3,367.75 YTD Interest to DOD $52.83 *Jane Hippensteel added as joint owner on b/~,4/~u 1 u ~~~~~~ A Trnditian of Excellence September 21, 2012 Grif6e & .Associates, P.C. Bradlev L ~riffie, Esquire 200 North Hanover Street Carlisle, PA 17013 .Fax: 243-5063 . Re: Estate of Emma M. Trio Social Security Number.204-03-9961 Date of Death 7/14/2012 IT IS HEREBY CERTIFIED THAT THE ABODE NAMED DECEDENT HAD THE FOLLO~WIN G ACCaUNTS WITH ORRST0~1 BANK: . - : - ..... CER7ZFIC~iTE OF DEPQ:SIT Account No.- Account Type- Date Opened- Joint Account {name/date Balance- Accrued Interest Account No.- Account Type- Date Opened- 3oint Account (name/date)- Balance- Accrued Interest- 4000037550 60-119 Month Income CD .5/4/2010 Jane Hippensteel, 5/4/2010 $9,59.88 ~ :..... . $ 8.56 4000037551 60-119 Month Income CD sl~l2o10 Richard L, Tritt, 5/4/2010 $9,555.88 $8:56 - ..... _ . _. . Best Regards, ~~ J 1 R, Worthington . Depasit~Processing Clerk ~ ~~~ 2695 Philadelphia Avenue • Chambersbutg, PA 17201 METRO BANK Griffie & Associates PC Bradley L Griffie 200 N Hanover St Carlisle PA 17013 RE: Estate of: Emma J. Tritt Tax Identification Number: 204-03-9961 Date of Death: July 14, 2012 To Whom It May Concern: August 16, 2012 This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: Joint Checking Account Number: 538347782 Date Opened: December 18, 2009 Primary Owner: Emma J Tritt Secondary Owner: Jane T Hippensteel (added 6/25/10) Date of Death Balance: $3,496.51 Please feel free to contact me at (717) 412-6105 if I may be of further assistance. Sincerely, L Cindy Stanbery Support Associate/Deposit Services Metro Bank 3801 Paxton Street 888.937.0004 Harrisburg, PA 17111 mymetrobank.com ,~~ Prudential ~~ The Family of Emma Tritt Apt 205 9 Alliance Dr Carlisle PA 17013 Dear Sir or Madam: Prudential Annuities Annuity Service Center P.O. Box 7960 Philadelphia, PA 19176 (888) 778-2888 TTY: (800) 654-7637 www.prudentiai.com August 14, 2012 Contract #: PIA000002786 We are attempting to obtain additional information required to process the death benefit of Emma Tritt's, contract to Dept of Public Welfare Commonwealth of PA. Unfortunately, we cannot proceed until we~ receive this information. We would appreciate your assistance in obtaining the following information: -• A Non Custodial Amluit~~ Death Benefits Claim Form completed by Dept of Public Welfare Commonwealth of PA An Original Certified Death Certificate If we do not hear from the beneficiary, we are required to transfer the records to the Prudential Unclaimed Equities Division, which is responsible for paying unclaimed funds to the state. Please note that once we transfer these fluids to the state, the beneficiary must contact the state to request this money. Enclosed is a reply envelope foi• your convenience. Pleasesend this information as soon as possible so that we can complete the claim process. If you have any questions, please contact Prudential Annuity Service Center at (888) 778-2888. You can obtain contract values,. request forms and duplicate statements, and conduct certain financial transactions 24 hours a day 7 days a week with our automated phone system. The Service Center is open Monday through Thursday between 8:00 a.m. to 7:00 p.m. and Friday 8:00 a.m. through 6:00 p.m., Eastern time. One of our Customer Service Associates will be glad to help you. Sincerely, Annuity Claims A Prudential Business Corporate Office 751 Broad Street Newarl: NJ 07102-3777