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HomeMy WebLinkAbout05-16-13 J 1505610143 REV-1500 Ex(D2-"' . PA Department of Revenue OFFICIAL USE ONLY P Pennsylvania County Code Year File Number Bureau of Individual Taxes EX^^^*•EAReF aErEaaE PO 60x.280601 INHERITANCE TAX RETURN 21 13 0295 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 02 16 2013 11 14 1911 Decedent's Last Name Suffix Decedent's First Name MI O' TOOLE GERTRUDE R (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X❑ 1. Original Return 2, Supplemental Return g. Remainder Return(Date of Death Prior to 12-13-82) 4. Limited Estate 4a Future Interest Compromise 5. Federal Estate Tax Return Required (date of death after 12-12-82) 6 Dece part Died Testate 7. Decedent Maintained fined a Living Trust g, Total Number of Safe Deposit Boxes (Attach Copy of Will) Copy ) 9, Litigation Proceeds Received 10.be&ieen 12,3rtSi aoaitt(Dat95j f Death 11 Election to tax under Sec.9113(A) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number MICHAEL L BANGS 717 730 7310 REGISTER OF WILLS-USE ONL C p l M C) First Line of Address 429 SOUTH 18TH STREET r < ` c Second Line of Address 3„ r i ' is c: o 'fT �> DATE;FILEB3 :2- City or Post Office State ZIP Code cr ,� CAMP HILL PA 17011 _,J —I Cf) Correspondent's e-mail address: mlkebangs @veriZOn.net 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.De laration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIG �RE�SPO NSIB I WVU DATE Melissa M. McCord ADDRESS 2727 South Rosegarden Blvd., Mechanicsburg, PA 17055 SIGNATURE OF PREPARER THER THAN RESENTATIVE DAT ! 'l L Michael L. Bangs �s �� ADDRESS 429 South 18th Street, Camp Hill, PA Side 1 L 1505610143 1505610143 J , r� 1505610243 REV-1500 EX 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. 249, 563 . 38 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 8 , 496 . 97 7. Inter-Vivos Transfers&Miscellaneous h{oq-Probate Property (Schedule G) u Separate Billing Requested............ 7, 480,505 .25 B. Total Gross Assets(total Lines 1 through 7)........................................................ 8, 738 ,565 . 60 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 22 , 886. 87 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 6,576 . 77 11, Total Deductions(total Lines 9 and 10)................................................................ 11. 29, 463 . 64 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 709, 101 . 9 6 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. 709, 101 . 96 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.00 15. 0 . 00 16. Amount of Line 14 taxable 0 • 00 16. 0 . 00 at lineal rate X .045 17. Amount of Line 14 taxable at sibling rate X.12 0 . 00 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 709, 101 . 96 18. 106,365 . 29 19. TAX DUE................................................................................................................. 19. 106, 365 . 29 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. El Side 2 L 1505610243 1505610243 J REV-1500 EX Page 3 File Number 21-13-0295 Decedent's Complete Address: DECEDENT'S NAME O'Toole, Gertrude R. STREETADDRESS 20 North 12th Street CITY STATE ZIP Lemoyne PA 17043 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 106,365.29 2. Credits/Payments A. Prior Payments 101,047.03 B. Discount 5,318.26 Total Credits(A +B) (2) 106,365.29 3. Interest (3) 4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 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. (5) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT. __ 777 - PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;...................................... ........................................ ❑ ❑x b. retain the right to designate who shall use the property transferred or its income;..................... ............ ❑ ❑x c. retain a reversionary interest;or............................................................................................................... ❑ ❑x d. receive the promise for life of either payments,benefits or care?.......................................__....... ❑ ❑x 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................................................... ❑ ❑x 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ ❑x 4. Did decedent own an individual retirement account, annuity,or other non-probate property which ❑ ❑ containsa beneficiary designation?.................................................................................................................. x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after January 1, 1995,the lax 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(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-1508 EX-(11.10) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE T"RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER O'Toole, Gertrude R. 21-13-0295 Include the proceeds of litigation and the dale 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 Members 1st Federal Credit Union -Savings Account 110.03 2 PA Department of Revenue-2012 income tax due 78.00 3 Refund from Boscov's 24.99 4 Refund from Manor Care 357.00 5 Tri-Ag Federal Credit Union-Regular share account 197.83 6 Tri-Ag Federal Credit Union -Super share account 13,913.07 7 Wells Fargo Bank, N.A.-Checking Account#7173 25,607.86 8 Wells Fargo Bank, N.A. -Savings#7647 10,722.98 9 Wells Fargo Bank, N.A. -Savings account#7186 0.44 10 Wells Fargo Bank, N.A.-Certificate of Deposit#1019 29,702.01 11 Wells Fargo Bank, N.A.-Certificate of deposit#1025 59,399.65 12 Wells Fargo Bank, N.A.-Certificate of deposit#3047 50,913.39 13 Wells Fargo Bank, N.A. -Certificate of Deposit#0144 29,678.46 14 Members 1st Federal Credit Union-Certificate of Deposit 280603-49 11,606.88 15 Members 1st Federal Credit Union-Certificate of Deposit 280603-50 17,250.79 TOTAL(Also enter on Line 5, Recapitulation) 249,563.38 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10) Rev-1509 EX+(01-10) SCHEDULE COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER O'Toole, Gertrude R. 21-13-0295 If an asset was made joint within one year of the decedent's date of death,it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Melissa M. McCord 2727 S. Rosegarden Blvd Niece Mechanicsburg, PA 17055 B. C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY %OF DATE OF DEATH VALUE OF ITEM FORTJOIN MADE INCLUDE NUMBEER OR SIMILAR IDENTIFYING INSTITUTION NUMBER.ATTACH DEED FOR DATE OF DEATH DECD$ DECEDENT'S INTEREST NUMBER TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST 1 A 10/15/2010 Members 1st Federal Credit Union- 16,993.93 50.000% 8,496.97 Certificate of Deposit 208063-43 TOTAL(Also enter on Line 6, Recapitulation) 8,496.97 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule F(Rev. 01-10) Rev-1510 EX.(08-09) SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER O'Toole, Gertrude R. 21-13-0295 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %of DECD s EXCLUSION TAXABLE NUMBER THE DATENOF TERANSFERSATfAC THEIR COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1 American General Life Company-Annuity Contract 28.763.40 28.763.40 #FJ245773;the four beneficiaries on Schedule J are the four beneficiaries of this annuity. 2 American General Life Companies-Annuity Contract 22,383.63 22,383.63 #FJ237761; this annuity is paid to the estate. 3 Ameriprise-This annuity was paid to Joel McCord, 429,358.22 429,358.22 Kathleen Tyler and Donna Freas. TOTAL(Also enter on Line 7, Recapitulation) 480,505.25 (If more space is needed,additional pages of the same size) Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09) REV-1151 EX.(10-09) SCHEDULE H COMr(I WID OTFONN RWANIA FUNERAL EXPENSES AND RESIDENT DECEDENTRN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER O'Toole, Gertrude R. 21-13-0295 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 6,283.37 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Melissa M. McCord Street Address 2727 South Rosegarden Blvd. City Mechanicsburg State PA zio 17055 Year(s)Commission Paid 7,500.00 2. Attornev's Fees Michael L. Bangs 7,500.00 3, Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State Zio Relationshio of Claimant to Decedent 4. Probate Fees 408.50 5. Accountant's Fees 1,000.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 195.00 See continuation schedule(s) attached TOTAL(Also enter on line 9, Recapitulation) 22,886.87 Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER O'Toole, Gertrude R. 21-13-0295 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Donna Fleming-funeral services 50.00 2 ELCW of St. Peter Lutheran Church -funeral luncheon 400.00 3 Parthemore Funeral Home 5,808.37 4 Susan Houndshell-funeral services 25.00 H-A 6,283.37 Other Administrative Costs 5 Cumberland Law Journal -estate advertisement 75.00 6 The Patriot News Co.-estate advertisement 120.00 H-B7 195.00 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98) ReY-1512 EX.p2-08t SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER O'Toole, Gertrude R. 21-13-0295 Report debts incurred by the decedent prior to death that remained unpaid at the dale of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 American Home Medical 125.00 2 Essex House 441.61 3 Home Instead Care 1,201.90 4 Manor Care Health Services 357.54 5 U.S.Treasury-2012 income tax due 4,251.00 6 Verizon 24.75 7 West Shore EMS 174.97 TOTAL(Also enter on Line 10, Recapitulation) 6,576.77 (If more space is needed,additional pages of the same size) Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08) REV-1510 E%+(01-10) SCHEDULE J COMMONV�N4, _PEEN YRANIA BENEFICIARIES ESTATEOFJ E��TTAAJJCCEE PG�XRREETTUT4RJ FILE NUMBER O'Toole, Gertrude R. 21-13-0295 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$) I. TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] Donna Lynn Freas Niece 220,421.23 4056 Oak Road Buena, NJ 08310 Catherine Leggett Grand Niece 77,301.83 2727 S. Rosegarden Blvd. Mechanicsburg, PA 17055 Joel S.McCord Nephew 220,421.23 1920 Severn Grove Road Annapolis,MD 21401 Kathleen A.Tyler Niece 220,421.23 30850 Cole Grade Road Valley Center, CA 92082 Total 738,565.52 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. 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 11 -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10) Lyon, David R I I III 1111 IlealYgWYrI Ilrlll�l From: Kharatmal,Anilkumar I on behaatf of SDLifeEventsCommunicationCenter Sent Wednesday, March 27,2013 539 PM To: Lyon, David R - Subject 15668827 7 001 GERTRUDE R O'TOOLE -DEATH SETTLEMENT REQUIREMENTS PLS DO NOT DELETE. Rhlarsauao We Insurance Company Amadlube Rnmeld Cempsay MOD Amarlpeleo Ftnaaetat CMW liv 6 pour,NN 66474 March 27,2013 KATHLEEN TYLER 30850 COLE GRADE ROAD VALLEY CENTER,CA 92082 1566882'17 001 Dear KATHLEEN TYLER. We have received notification of GERTRUDE R O'TODLE's death. Please accept our condolmocs on your loss, The deceased's name is associated with the following accounts. Account values as of 02!16!2013 are listed below. At the end of this letter,you will find a list of beneficiaries shown in our initial review of the accounts, Account Information Annuities-Post 1985 Accoupt Numb er Owrxxship 93004229062 5 004 Individual Annuities-Post 1985 Account Number Total Value 93004229062 5 004 $430,374.42 The date of death values provided arc for estate tax purposes and are not a value to be paid_ Accounts may he subject to market fluchwhon as governed by each product. Please note that the values indicated for any Life Im naace products with the insured deemed reflect the gross death benefit at date of death and not the cash value. Values indicated for Life Insurance products with only the owner deceased reflect the lash value as of the date of death. Values for any Proprietary mutual funds inchrde accrued dividends as applicable.Values provided for brokerage products are manuatly calculated,and should be used as estimates only. The prices used to provide values are estimates obtained from outside sources believed to be reliable. Ameriprise Financial provides time values as a service to its clients. Actual values used in preparation of tax returns or fir planning purposes should be verified by your legal and accounting advisors. AttromM Disposition 1 ® WESTERN NATIONAL April 15, 2013 MICHAEL L BANGS, ESQ BANGS LAW OFFICE LLC 429 SOUTH 18TH STREET CAMP HILL PA 17011 Re: Annuity Contract#: FJ237761 Deceased: Gertrude R O'Toole Dear Mr Bangs: Thank you for your letter for the referenced contract. We would like to take this opportunity to provide you with the information requested. The date of death value of the contract as of February 16, 2013 was 522,383.63 We appreciate your prompt attention to this matter. Should you have any questions or require further assistance, please feel free to contact our Client Care Center by using our toll free number of 1-800-424-4990. Sincerely, Patrick Bailey Claims Department American General Life Insurance Company Annuity Service Center•P.O. Box 871 •Amarillo, TX 79105-0871 The Western National series of annuities is issued and underwritten in New York by The United States Life Insurance Company in the City of New York and in all other states by American General Life Insurance Company. LH-WNAGL WESTERN tJ NAT O\NAL L i f e I n s u r a n c e C o p 1 n y QUARTERLY GROWTH REPORT OF YOUR POLICY FOR THE QUARTER ENDING 12/31/2012 1-800-424-4990 #BWBCGWV •Contract Number FJ245773 >01511 3039941 001 008129 •Policy Date 11/05/2002 GERTRUDE R OTOOLE •Annuitant Gertrude R Otoole 20 N 12TH ST •Policy Type Non-Qualified LEMOYNE, PA 17043-1448 •Agent Wells Fargo Wealth Brokerage Ins Ag •Composite Annual Yield 3.00% Important Messages We are going green! Go on-line today at www.ammuityaccess.com to find out how to sign up for electronic delivery of your quarterly statement Account Information Current Quarter Year-To - Date 10/01/2012 - 12/31/2012 01/01/2012 - 12/31/2012 Beginning Value 28,549.89 27,925.63 Interest 213.51 837.77 Accumulated Value 28,763.40 28,763.40 Surrender Value 28,763.40 28,763.40 Your surrender value as of 12/31/2011 was$27,925.63. VL 14939-AGL VER112013 - 01511 3039941 001512 001512 00001100001 2L7 �- m m ro 3 � 0 0 N g 3O w Bag ag Nag Nab Nag Nagr C, w tz w s f A f f s F CD to- CD m � °a W (*D N �O 'G ��•ff {1 M N O Ell N p yy O ! M $ A O p.yQ• Ypp N V m 8 gs O W pO, v W O O O O 5 Y O O G7 O b F 14 W Or tJ� m G W O F V b S no O o N O $ ON W U Abl i9 K K}I p C� rJ r •O N W r. � R m0 ! \ { ( j ] ! ( } / [ } ( � \ ) § ( / J 2 } / . ( } 0 k w ! { } � { { ! It MEMBERS r REGULAR SAVINGS ACCOUNT: FEDERAL CREW U ON Account Number/Suffix 208063-00 D-ate Account Established 08/04/2001 Principal Balance at Date of Death $110.02 Accrued Interest to Date of Death $0.01 Total Principal and Accrued Interest $110.03 Total Accrued Interest 01/01/2013-02/16/2013 $0.03 Name of Joint Owner None CERTIFICATE OF DEPOST: Account Number/Suffix 208063-43* D-ate Account Established 01/17/2012 Principal Balance at Date of Death $16,986.25 Accrued Interest to Date of Death $7.68 Total Principal and Accrued Interest $16,993.93 Total Accrued Interest 01/01/2013-02/16/2013 $23.53 Name of Joint Owner Melissa Leggett Date Joint Added 10/15/2010 *Rollover from certificate 208063-47 opened 10/15/2010. CERTIFICATE OF DEPOST: Account Number/Suffix 208063-49* D-ate Account Established 01/30/2012 Principal Balance at Date of Death $11,601.64 Accrued Interest to Date of Death $5.24 Total Principal and Accrued Interest $11,606.88 Total Accrued Interest 01/01/2013-02/16/2013 $16.07 Name of Joint Owner None *Rollover from certificate 208063-48 opened 10/29/2010. CERTIFICATE OF DEPOST: Account Number/Suffix 208063-50* D-ate Account Established 07/19/2012 Principal Balance at Date of Death $17,239.88 Accrued Interest to Date of Death $10,91 Total Principal and Accrued Interest $17,250.79 Total Accrued Interest 01/01/2013-02/16/2013 $33.43 Name of Joint Owner None *Rollover from certificate 208063-42 opened 04/18/2011. MEMBERS IT FEDERAL CREDIT UNION Tessa L Klugh Lending Insurance Support Specialist March 26, 2013 Estate of: GERTRUDE R. O'TOOLE Date of Death: 02/1612013 Social Security Number: 197-24-0667 5000 Louise Drive P.O. Box 40 • Mechanicsburg, Pennsylvania 17055 • (800) 283-2328 • www.memberslst.org BANGS LAW OFFICE, LLC 429 SOUTH 18TH STREET PHONE: 117-730-7310 CAMP HILL, PA 17011 FAX: 717-730-7374 E-mail: mikebanes(a),verizon.net MICHAEL L. BANGS,Attorney-at-Law WILLIAM E. MILLER,JR. WENDY K. STRAUB, Paralegal Of Counsel March 25, 2013 Tri Ag Federal Credit Union I 1--pus Bot&vnd Suit 200 Newtown Square;PA 19073 RE: Estate of Gertrude R. O'Toole Date of Death: February 16, 2013 Social Security #197-24-0667 Gentlemen: Our office is assisting in the administration of the above-referenced estate. At the_time of death, the decedent held several accounts and/or certificates of deposit with your bank, We need to,know; fo'r purposes of administering the estate, the following information about each of the accounts and certificafes of deposit: L The type of account. — (S'a u n3 s 2. Account number. 3 78- t 3 78-io 3. Name or names in which the account was maintained. 4. The date the account was opened. /I " 7 - 18 5. The value, including any accrued and unpaid interest as of the date Of death. 378-t — iF-7. F3 373'- 0 39/3 .07 If the decedent owned any other accounts or assets with your bank, either jointly or solely in her name, we will need information about those accounts as well. For any account that may have been held jointly, we need to know the names in which it was maintained and the date it was created. Also, if you could send us a copy of the signature card or document used to create or designate the joint account. that would be most helpful. If the account was created within one year of the date of death, we need to know whether it represented a rollover or extension of a pre-existing account. If so, then we need the date that account was opened. 231539072 03/27/13 TRI AG FEDERAL CREDIT UNION 11 CAMPUS BOULEVARD - STE. 200 NEWTOWN SQUARE PA 19073 TEL: 610-355-7610 STATEMENT PERIOD 01/01/13 03/15/13 CN/ACCOUNT# 1/ 278.0 GERTRUDE R. O'TOOLE ESSEX HOUSE SOC-SEC-NUM 20 N. 12TH STREET #303 197-24-0667 LEMOYNE PA 17043 TRAN TRAN TRANSACTION CHK # TRAN INT/INS ACCOUNT NUM DATE TYPE AMOUNT AMOUNT BALANCE - --- - --- ------------------------ Share # 1 REGULAR S Beg Bal : 197.78 278 01/01/13 DIVIDEND 0.05 Cj97.83) 2161 03/15/13 TRANSFER TO 13, 913.07 14, 110.90 FROM: 1/ 278.0 SH 10 2162 03/15/13 TRANSFER FROM 0:00 14, 110. 90 2163 03/15/13 TRANSFER FROM 14, 110. 90 0.00 Div Paid YTD 05 Last Div Rate 008 3 7 Jf Tot Div Paid YTD 17.56 Finance Charge YTD 0.00 PG 1 231539072 03/27/13 TRI AG FEDERAL CREDIT UNION 11 CAMPUS BOULEVARD - STE. 200 NEWTOWN SQUARE PA 19073 TEL: 610-355-7610 STATEMENT PERIOD 01/01/13 03/15/13 CN/ACCOUNT# 1/ 278.0 GERTRUDE R. O'TOOLE ESSEX HOUSE SOC-SEC-NUM 20 N. 12TH STREET #303 197-24-0667 LEMOYNE PA 17043 TRAN TRAN TRANSACTION CHK # TRAN INT/INS ACCOUNT NUM DATE TYPE AMOUNT AMOUNT BALANCE -------------------------------------- Share # 10 SUPER SHARE Beg Bal: 13, 895.56 471 01/01/13 DIVIDEND �17.51 13, 913.07 2160 03/15/13 TRANSFER FROM 13, 913.07 TO: 1/ 278.0 SH 1 Div Paid YTD 17.51 Last Div .Rate 000$ 3 . 0 7 3 Tot Div Paid YTD 17.56 Finance Charge YTD 0.00 PG 1 y 1. GERTRUDE R. WTOOLE. of the Borough of Lemoyne. Cumberland County, Pennsylvania. declare this to be my last will and revoke any will previously made by me. ITEM I. 1 direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness. shall be paid from my residuary estate as soon as practicable after my death as pan of the expense of the administration of my estate. ITEM II. All death taxes (and interest and penalties thereon) imposed as a result of my death shall he paid by the person receiving the property to which such taxes are attributable. For outnoses of this paragraph. the term `death takes" sWl rncan fc deal estate tax and any inheritance or estate tax imposed at death by any state of the United States. ITEM III. In the event that I have any personal property of any nature. I direct my Executrix. Melissa M. Leggett. to divide those among those individuals that she deems appropriate. She has the sole and absolute discretion to divide those items. ITEM IV. I give, devise, and bequeath all the rest. residue, and remainder of my possessions and estate of every nature and wherever situate in equal shares to CATHERINE E. LEGGETT, JOEL MCCORD, DONNA LYNN FREAS, KATHLEEN ANN TYLER, or the survivor of them who shall survive my death by thirty (30) days. I have already provided Catherine E. Leggett an advancement in the amount of$33,250.00. Therefore, Joel McCord, Donna Lynn Freas and Kathleen Ann Tyler. or the survivor of them who survive my death by 1 thirty (30) days. should each receive $33,250.00 to equalize the advancement that I made to IJ Catherine E. Leggett and then the remainder, if any of the estate, would be divided evenly among CATHERINE E. LEGGETT, JOEL McCORD, DONNA LYNN FREAS, KATHLEEN ANN TYLER, or the survivor of them who shall survive my death by thirty (30) days as set forth under this Item IV. ITEM V. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM VI. I appoint MELISSA M. LEGGETT executrix of this my last will. Should Melissa M. Leggett predecease me or otherwise fail to qualify or cease to serve as executrix of this my last will, I appoint DONNA LYNN FREAS executrix of this my last will. ITEM VII. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at valuations finally to be fixed by them; to invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representatives deem proper, without regard to any principle of risk or diversification; to retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices 2 and upon such terms or conditions as my personal-representatives deem proper, and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VIII. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this 3 day of 2010. GERTRUDE R. O'TOOLE 3 The preceding instrument.consisting of this and THREE other type"tten des,each identified by the signature of the testatrix was on the date thereof signed, published and declared by GERTRUDE R. O'TOOLE, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. j 4 t - COMMONWEALTH OF PENNSYLVANIA _ ) ( SS: COUNTY OF CUMBERLAND ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will,that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. �) / GERTRUDE R. O'TOOLE or affirmed to and acknowledged bef-c re mesb y the t statrix named above '-'' this _day of�1A Co,%W 'WEALTH OF PENNSYLVANIA Nbtariai Seal 1� / � �' 6Vcarciy K.E°�ub,Notary Public �' l.l��' 1-0,0 ^r Xeii Tv p.,Ck nbxosnd County Notaq Public j ty COMM-sdon E' +ras May 16,2011 Pennsylvania Association of Notaries COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) WE, �,c:hne. � ��,�., andSS�-/t /. /EGG ,the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed;that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue influences El � �, Sworn or affirmed-t and acknowledged beto j#1is h day of C , 2010. 1 Notaty Public OMi pNWE OF PENNSYLVAN A •NOrT a Seal Wendy K 5da;i�,?•:nom ^,;L'ii;. Lower Aia_n Tw;,�.,G My Commssion cX;irE,c Fenruylvania ASSOciatlon of Now," ' {ry 5 L� {+ 7 = W RECORDED OFFICE OF REGISTER OF PILLS o' 1 3 f IRY 16 Pig 1 t t 23 w a w J�Q CLERK G : OC,P40S' COURT r CUMBERLAND CO FA w I 3z a qpm OOJ->V» C�o do-icy M C O y Cl xU � - y O ¢ O U O U ° ° .G �8 w 1 i 4 I U a � Oro¢ cds j 0 oA + N U) Q. d C` CGG q U �_:__