HomeMy WebLinkAbout07-16-13 1 1505610143
' � REV-'150Q �"Q2-4}�
OFFICtA�USE OFEGY
PA 6epartment of Revenue pennsyivania ca,�y coaa v�r Fne N�mn�
Bureau of Individual Taxes °p""'"E1TtlF"°THOE
ao aox2eosoi INHERITANCE TAX RETURN 21 13 0204
Harr�sbur�,�a n�2s-oso� RE8IDENT[►ECEQENT
ENTER DEQEDEtiT INFORMATION BEIOW
Social Security Number Date of Deakh Date of Birth
02 42 2023 QS Q9 191T
DecedenYs Last Name Suffx DecedenPS�'irst Name MI
ANDERSON LORENZO W
(It Appiicabie}EMer SurviWng Spouse's information Below
Spouse's Last Name Suffiz Spouse's First Name MI
Spouse's Sociai SecuNty Number
THIS RETURN MUST BE FII.ED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILI FN APPROPRIATE OVALS BEIOW
O 7. Oripinal Relum � 2. Supplemenlal Retum � 3. Remainder Retum(Date IN DeaM
PriorM 12-13-92)
�_� 4. limitetl Estate � 4a.Ft9in imereat Cam isa � 5. Federai EWate T�Retum Ra}uir�
si
��e a a�,an�r z-�zal>
I� g necndeni orea rea�ma C� 7. �eua�a�nta� �nad e�roine 7rus� _ g, 7otal Number of Safe Oeposit Boxes
�nttecncomav�niq nna oar���+sq
�j a �lt;gat�onProc�asReceived j� �o. i -�'Ji`���`�(-o���o�am ❑ �t.�at�fa��chns°cr,e�d�o sec.stt3{A)
CORRESPONDENT-TH19 SECTON MUST BE CpMPLETED.ALL CORRE$PONDENCE AND CONFIDENTIAL TA]LNFORMATIO OULD BG�IREC7Ep TO:
Name Day�e Felephana.lium!'� �
�'n�T• RICHARD E2'ZWEILER 71� �34 �QO�? o
m cs � �' '[r�7
R�i1��F V4�S U�.@plY
� � 7c O z�
Flrst Line of Address � c c'> -"'� � '�
� -�s
145 N E'RONfi S'I`REET •�, c �_. �';: r>
+. � N_y � i`�
Second Line of Address .� � t—� u'� ,`� .
� �
- DATE FI�ED .--
City or Ppat tNflce State ZtP Code
HARRISBURG PA 17101
correspenaenes e-mafl address: reiZW@iIC��COrtiCa6t.1ICt
Under penaltles of pe7ury,I declare Ma(I have euamined Mis retum,induding accompanyinp mchedules antl statementa,antl W Me best of my knp�Wedge antl heliet,
It Is true,cortect antl wmplete.DeciaNdan o(preparer ot�r tha�tha Pe��ai roPrercsentative 1a based on aH infoimeBon of whict�Preparer has:�ny krwwiadge.
SK'�KA RESP S f6RFIliNGRETURN v/AiE
Fred E.Anderson 7/ �!5`�/3
A�RESS
1887 NaRh River Road Halifax PR 17032
� 51G TURE pf PR ER OTHER iH REPRESENTATNE q4TE
�J���f�� � ,3� Earl Richard Etzweiler 7%,J-r,t3
��
105 N. Front Street, Harrisburg, PA
Side 9
� 15056101N3 1SU5610143 � �
� �
PA inheritance Tax Return
Signature af Additional Fiduciaries
ESTATE QF FI�E NUMBER
Anderson, Lorenzo W. 27-13-0204
Under penalties of peryury,1 deGare lhat I have examined tbis return,inciuding accompanying scbedules arM statements,and to the hest of
my krtorAedge a�6eiief,it is true,carrect and campiete.Dedaration of preparer other than the personai represenistive is bas�i on a9i
infortnation of which preparer has any knowiedge.
s�gnature#z ��,,, ��y�P��/
Name Bonnie Anderson
Addressl 7067 North River Road
Address2
Ci{yl, St8t8,ZiP Haiifax PA t7032
Date ___J�L?i_._
J 1505610Z43
REV-1500 EX �
� DecedenYs Social Securiiy Number
o�^rsNema qnderson, Lorenzo W.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................. 2. 58 � 45 9. 7 9
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C)......... 3. �
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4. �
5. Cash, Bank Deposits&Miscellaneous Pereonal Property(Schedule E)............... 5. � 3 9� 58 0 . 85
6. Jointly Owned Property(Schedule F) ❑ Separete 8illing Requested............ 6. 19, 647 . 98
7. Inter-Vivos Trensfers&Miscellaneous P{aq Probate Property �
(Schedule G) LJ Separate Billing Requested....._�..... 7,
8. Tota�Gross Assets(total Lines 1 through 7)........................................................ 8. 11') , 688 . 62
9. Funeral Expenses and Administretive Costs(Schedule H).................................... 9. 11 , 2 63 . 70
10. Debts of Decedent,Mortgage LiabilRies and Liens(Schedule I)............................ 10. 1, 7 68 . 02
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 13 � 0 31 . 7 2
t2. Net Value of Estate(Line 8 minus Line 11).......................................................... �y, 104 � 656 . 90
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)............................................... 13. 8 � 50 0 . 8 9
14. Net Value SubJect to Tax(Line 12 minus Line 13)............................................... �4. 9 6� 15 6 . O 1
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE R4TES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec. 9116 'S. O . O O
(a)(12)X.00 �
16. Amount of Line 14 taxable
at�inea� rate x .oas 96, 156 . O1 �s. 4� 327 . 02
17. Amount of Line 14 taxable
at sibling rete X.12 0 . 0 0 17. 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate X.15 � . �0 18. � . 00
19. TAX DUE................................................................................................................ 19. 4�.327 . �2
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
� 1505610243 1505610243 �
REV-1500 Ex Page 3 File Number 21-'13-020d
DeeedenYs Complete Add{gss;
DECEDENT'S NAME .
Ar�derson, Lorenzo W.
STREETADDRESS i � ��� � u�
825 North Hanover Street
CRY�� �� i STATE �ZiP
Carlisle PA I 17013
Fax Payments and Credits:
1. TaxDUe{Page2,tirFe'19} (�) 4,327.02
2 CreditstPaymerrts �_��
A. ariorPayments 4,170.67
B. Discount � 21$.3$
� Totai Credits{a +g} {2} 4,327.02
3. iMerest (37
q, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Chack Dax on Page 2,Une 20 ta tequest a refund� i---`---"—'
5. If Line 1 +�ine 3 is greater than Line 2,enter tbe difference. This is the TAX DUE. (5} (�,QQ
Make Check Pa able to: REGISTER OF WILLS AGENT.
PIEASE AMSWER TffE FOIIdWING QUESTiONS BY PIACING AN "X"IN THE APPROPRIATE BLOCKS
1. Did decetlent make a transfer and: . Yes No
a. retain the use ar income of the ro �
P Perry transferred:....................................................................-.....---- x
b, retain the right to deeignate who shali uee the properry transferred or its income:.................................. � x
c. retain a reversionary intereat;or_.....__..........._._......_.._........_....._......_................................................. x
d. receive the promise tor�ife of eithsr paymenGS,benefits pr care7................................................._..,...... x
2. !f death occurred after Dec. 12, 1982, did decedertt transfer property vriNin one year of death without
receiving adequate consideretion?.................................................................................................................._ ❑ ❑X
� 3. Did dacedent own an"in trusf fo� ar payabte upo�deafh ba�k acmunt or securiry at his or her death?....... �J 0
4, Did tlecedent own an indivitlual retirement account,aanuity,or pther non-probat�property which �_
contains a beneftciary desiqnation?.................................................................................._.............................. � �
IF 7HE ANSWER TO ANY 4F THE ABqVE QUESTIONS IS YE3,YOU MUST COMPLETE SCHEDULE G ANQ FILE IT AS PART 4P TNE RETURN.
For dates of death on or aRer July t, 1994 a�be#ore Jan. t, 1995,itie tax rate imposed on the net vaiue a#trarfsfers to ar far the use ot the surviving
apouse is 3 percdnt p2 P.S. §9718(a)(1.1)(i)]. �
Far dates of death an or after January t,1995,the tax rate imposed on the net vaiue of trensters to or for The use af the survivirtg spouse is 0 perceM
[72 P.S.§9116(a)(1.1}(ii)]. The statute does not exempt a transfer to a surviving spouse from ta�c,and the statutory requirements for disclosure of
asseta and filing a taac return are stiii appiicabis even if the survivirrg spouse is the oniy be�fiaary.
For dates of death on or after July 1,200p:
• The tax rate imposed on the net vaiue of transfers from�daceased child 2� years af age or younger at death to ar for the use of a natural pardnt,an
adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(12)].
+ The t�rate impnsed on the net vaiue of transters to or for the use of the decedenfs lineai beneficiades is 4.5 percent,except as noted in
[72 P.S. §9118(a)(1)1.
. Tha tax rate imposed on the rret vaiue of hansfers ta or for#he use af the decedenYS siblings is 12 percent[72 P.S.§9116(a)(1.3)j, A
sibling is defined under Section 9102,as an individual who has at least one parent in common with the decetlent,whether by 61ood br adnption.
. .. .. ._ . ... _. ..._. .. . _.. ._T_
Rev-7603 EX�(6-88)
SCHEDULE B
STOCKS & BONDS
coMn�w�wfw�m oF a�NSnvnHu
INHERITANCETAXFETURN
RES��EM OECEOENT
ESTATE OF FILE NUMBER
Andereo�, Lorenzo W. 21-13-0204
All propMy jolntly-wmetlwHh rlgM of survivonhip murt bedi�GOSad on Sehedule F.
ITEM CUSIP VALUEATDATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
7 EdwardJoneslnvesfinentAccount#270-04244- 7,792.967 79,223.81
shares of Lord Abbett Total Retum A�70.72 per share
2 Edward Jones Investrnent Account#270-04244-1,715.266 19.056.68
shares of Lord Abbett Core Pixed Inc A@ 11.7 7 per share
3 Edward Jones Investment Account#270-04244-4,733.570 19,224.92
shares of Lord Abbett Short Duration A�$4.65 per share
4 Edward Jones Investment Account#270-04244-44.999 952.18
shares of American Balanced Fd CI C�$21.16 per share
TOTAL(Also enter on Line 2, Recapitulation) 58,459.79
(1t more space is needetl,ad0itlonal pages of the same size)
Copyright(c)2002 fortn software only The Lackner Group,Inc. Fortn PA-7500 Schedule 8(Rev.6-98)
Rev-0508 EX�(H40)
SCHEDl1LE E
pennsylvania CASH, BANK DEPOSITS, 8� MISC.
DEPARTMENT OF REVENUE
INHERITANCETA%RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Anderson, Lorenzo W. 21-13-0204
Inclutle ihe roeeetls of IitiQation antl ihe tlate Iha proceetls ware receivatl by Ihe astale.
All property joPntlyownadvnlh ihe�ight oteurvWOrs�ip must be tllxloud an achetlule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH �.
1 Church of God Home Care Facility, refund of portion of investment for room in nursing care 31.000.00
facility
2 Church of God Home, refund of portion of assisted care 707.26
3 Fulton Bank,refund 706.52
4 Omnicare,insurance refund 30.00
5 OrrstownBankSavingsAccount#708007754 7,143.07
6 3 diamond 14K rings 244.00
7 Grendfathers clock 350.00
TOTAL(Also enter on Line 5, Recapitulation) 39,580.85�
(It more space is needed,additional pages ot the same size)
Copyright(c)2010 fortn soflware only The Lackner Group, Inc. Fortn PA-1500 Schedule E(Rev. 11-10)
_ __
_�
ne.-�ws ex+�ot-io�
pennsylvania SCHEDULE F
DEPARTMENTOFREVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT UECEDENT
ESTATE OF FILE NUMBER
Anderson, Lorenzo W. 21-13-0204
If en uast waa mMa JWnf wlNin one yeerM tl�e dacedanYa Me o(tleM�,It murt be reportad on achWUls G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Fred E.Anderson 1087 N. River Road Son
Halifax, PA 17032
B.
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY /a OF
LETTER DATE INCLUDE NMAE OF FINANCIAI INSTRUTION AND BANKACCOUNT
ITEM FOR JOIN MADE NUMBER OR SIMIIAR IDENTIFI'ING NUMBER.ATfACH DEED FOR DATE OF DEATH DECD'S DECE NT'S INTETREST
NUMBER TENANT JOINT VALUE OFASSE INTEREST
JOINTLV-HELO REFLL ESTATE.
1 A 12/73/2072 1/2 interest in Orrstown Bank Checking 19,647.98 100.000°� 19,647.98
Account#410659
TOTAL(Also enter on Line 6, Recapitulation) 19,647.98
(If more space is neetle0,additional pagas of the same size)
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule F(Rev.01-10)
. ._. . _._ _. ...__ _. .... . .__. . __ .___ . .
REV-0577 E7(+(70-09) .
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
� RESIDENT�EC EN�"R" ADMINISTRATIVE COSTS �
ESTATE OF PILE NUMBER
Anderson, Lorenzo W. 21-13-0204
DecedenYs debts must be reported on Schedule 1.
ITEM DESCRIPTION AMOUNT
N
q, FUNERAL EXPENSES:
See continuation schedule(s) attached 373.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Fred E.Anderson Bonnie Anderson
streetAddress 1087 North River Road
city Halifax state PA zio 17032
Year(s)Commission Paid 5,098.52
z, Attornev's Fees Etzweiler&Associates 5,098.52
3. Family Exemption: (If decedenPs address is not the same as claimant's,attach explanation)
Ciaimant
Street Address
City State• Zio
Relationshio of Claimant to Decedent
4. Probate Fees 298.50
5. AccountanYsFees �
� 6. Tax Return Preparers Fees
7. - OtherAdministretiveCosts �395.16
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 11,263.70
Copynght(c)2009 form software only The Lackner Group,Inc. � Fortn PA-1500 Schedule H(Rev. 10-09)
I
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
And�rson, Lorenzo W. 21-13-0204
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Ex eo nses
1 Myers 8 Buhring Funerel Home, additional funeral charges 373.00
� H-A 373.00
Other Administrative Costs
2 Cumberland Legal Journal,advertise estate 75.00
3 Dauphin County RegisterofWills,take Executoroath 20.00
4 Etzweiler&Associates, photocopies, postage, notary fees,etc. 100.00
5 The Sentinel, advertise estate 200.16
� H-87 395.16
Copyright(c)2002 form soflware only The Lackner Group, Ina Form PA-1500 Schedule H(Rev.6-98)
. . __.__ . _ .._ . �
Rsv-7613 EXi�1P-O8)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENTOFREVENUE
INHERITANCETAXRETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Anderson, Lorenzo W. 27-73-0204
Raport tlebb incurted by Me tlxsAent pNm b tlxtb tlut remsined unpald et ihe tlete o1 tlsath,Nclutling unreimbunad metlVul axpanees.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
7 Church of God Home, Inc.,final assisted care bill 314.20
2 Church of God Home,flnal balance due 70.57
3 PA Department of Revenue,20721ncome tax 39.00
4 U.S.Treasury, 2012 income Wx due 1,156.00
5 United Health Care, February premium automatic deduction 188.25
TOTAL(Also enter on Line 10,Recapitulation) 7,768.02
(If rtwre space is neetle4 atltlkional pages of the same size)
Copyright(c)2008 form soflware only The Lackner Group, Inc. Fortn PA-1500 Schedule I(Rev. 12-08J�
_
REV-0511 EX��0'1-00) .
pennsylvania SCHEDULE J
DEPARiMENT OF REVENUE
INHERRANCE TAX REfURN BEN EFIC IARI ES
RESIDENT DECEDEM �
ESTATE OF FILE NUMBER
Anderson, Lorenzo W. 21-13-0204 .
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER � PERSON(S)RECEIVING PROPERTY �DECEDENT ords
, (VV ) (SSS)
; TAXABLE DISTRIBUTIONS [include outright spousal .
distributions,and trensfer�
under Sec.9116 a 1.2
1 Fred E.Anderson Son 50%of residue of 62,492.45
1087 North River Road esWte and items
Halifax, PA 17032 in Codicil
2 Bonnie Kuduk Daughter 30%of residue of , 25,247.65
2559 Audlyn Drive estate and items
York, PA 17408 in Codicil
3 Christine Shettel Grenddaughter 10%of residue of 8,415.88
659 Elliott Drive estate and items �
Lewisberry, PA 17339 in Codicil
� Total 96,756.01
� Enter dollar amounts for distnbutions 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 -
1 The First Church of God 8,500.89
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHE 8,500.69
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10)
/ __ _- - _-_ _
f,
�� , - LAST WILL AND TESTAMENT
� ., OF
LORENZO W. ANDERSON
I, LORENZO W. ANDERSON, of the Borough of Carlisle, County of
Cumberland and State of Pennsylvania, being of sound and disposing mind,
memory and understanding, do make, publish and declare this my Last Will and
Testament, hereby revoking and making void any and a11 former Wills by me at any
time heretofore made. ,
1.
I direct the payment of all my just debts and funeral e�cpenses as soon after
my decease as the same can be conveniently done.
2. ,
I give, devise and bequeath all the rest, residue and remainder of my estate,
real, personal and mixed, whatsoever and wheresoever tlie same may be situate, to
my wife, HELEN M. ANDERSON, absolutely and unconditionally.
3.
In the event that my wife, HELEN M. ANDERSON, should predecease
me, or should she die within thirty (30) days from the date of my death, then in
- 1 -
-__._ _ _ _ '
.. . .. _._.. __.. .. I
1__
7;
either of such events, I direct the settlement and distribution of my estate to be
made in the following manner, to wit:
( a ) I give and bequeath fifty (50%) per cent of my estate to
my son, FRED E. ANDERSON.
( b ) I give and bequeath thirty (30%) per cent of my estate to
my daughter, BON1vIE KUDiTK.
( c ) I give and bequeath ten (10%) per cent of my estate to my
granddaughter, CHRISTINE SHETTEL.
( d ) I give and bequeath ten (10%) per cent of my estate to
«
THE FIRST CHURCH OF GOD, 28 East Main Street,
Mechanicsburg, PA 17055, to be used where needed.
( e ) For the purpose of facilitating the settiement and
distribution of my estate, I authorize and empower my Executor,
hereinafter named, to sell any and all real estate which I may own at
the time of my decease, as well as my personal property, at either
public or private sale or sales.
4.
LASTLY, I nominate, constitute and appoint my wife, HELEN M.
ANDERSON, Executrix of this my Last Will and Testament and in the event that
_ 2 _
r,
my said wife should predecease me, or should she be unable or unwilling to serve in
such c�pacity for any reason, then in such event, I nominate, constitute and appoint
my son, FRED E. ANDERSON, and his wife, BONNIE ANDERSON, Co-
Executors of this my Last Will and Testament, in her place and stead, and in all
instances, I direct that my said personal representatives be excused from posting
bond or other security for the faithful performance of their duties in any
jurisdiction.
IN WIT'NESS WHEREOF, I have hereunto set my hand and seal this 2�
.
day of November, A. D. 2000.
�y�u (c�, (,�v:���aw (SEAL)
Lorenzo W. Anderson
Signed, sealed, published and declared by the above-named, LORENZO W.
�
ANDERSON, as and for his Last Will and Testament, in the presence of us, who,
at his request and in his presence, and in the presence of each other, have hereunto
subscribed our names as witn es.
�
- 3 -
_ . _ __ . _ _ � _
COMMO�TWEALTH OF PENNSYLVANtA ) ,
: SS
COiJNTY ' OF CiTMBERLAND )
,,
I, LORENZO W. ANDERSON, the testator, whose name is signed to the
attached or foregoing instrument, having been duly qualified according to law, do hereby
aclrnowledge that I signed and executed the same instrument as my Last VJill and
Testament; that I signed it willingly, and that I signed it as my free and voluntary act and
deed, for the purposes therein expressed,
���ea�� (SEAL)
L enzo W. Anderson
Swom and subs ribed to before
me this �N�y of November, ZOOO. Notarial Seal
�,/�Jf//�� tAaMyn E.Wilfiama,Notary Public
� c- . ���/Y'V ` Motrienic5burg 9oro,Cumbedand Coumy
r,�� � �My Commission Expires Nov.6;2001
NOt Public MemDer.Pei�nsyNartia 0.isociation of Notaries
COMMONWEALTH OF PENNSYLVArTIA ) �
: SS
COUNTY OF CUMBERLAND )
VJe, the undersigned, J. ROBERT 5TALTFFER and SUSAN A. McCOY, the
witnesses whose names are signed to the attached or foregoing instrument, being duly
qualified according to law, depose and say that we were present and saw the testator,
LORENZO W. ANDER50N, sign and execute the instrument as his Last Will and
Testament; that the said testator executed it as his free and voluntary act for the purposes
therein expressed; that each of us, in the hearing and sight of the testator, signed the Will
as witnesses; and that, to the best of our knowledge, the testator was, at the time, eighteen
(18) or more years of age, of sound mind, and under no constraint, duress or undue
influence.
Sworn and s �nbed.to before
me this �� iday of November, 2000.
�����i, ����/�' -
Notary Public
�$eal
MerM� No�C�n wC°u�l - 4 -
�ro�i���6•200t
��pusswn �tion of Notariss
�mOe� Petx�sylvanlsWS�
. . _ . _ ._._.. _ _... . . _ _ . -T_
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Rece�ived Time-Feb. �B. -2013-11 : S1A�No. 0884 1°
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Rece�iy�d Tlme Feb. 28, 2013 11 S1AM No. 0884 a m U ° w �
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RPR—ZS-?0' 3!FR?? ^9: d8 nRRSTO�AN BRNK OPERRTI9N5 (FAX!7� 77p93na3 P. 002/00'
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C7RRSTOWN
B�vx
�rt��►�of��ru�B
March 8, 2013
Baweila and As�ociutes AtWrucys aL Iaw
Earl Richnrd Etzweiler,Esquire
1:05 North Front Street
Harrisbtrcg,PA 17101-1436 �
Email:retzweiler@comcastntt
Rc: Earate of Lorenzo W. Anderson
Social Security Numbcr ]84D3-9105
Date of beatlt 2/212Q13
]T lS EL.EREBY.CERTiF(Ep TIIAT T1iE ABOVE NAMED DECEDElVT FiAD TH6
FOLIAWING ACCOLINTS W1TH ORRSTOWI�f BANK:
CHEC NC ACCO(INT
Account No: 410659
Accouaf Z'ype- 50+interes[Checking
Date Opcned- 6/5!]996
Joint Account(namddate)- Fred E.And�7son, 12/13/2072(Helm lvL Anderson-
deceosed wea.prior joint nccount ownc.)
Balancc- $19,647.25
Accrued Interest- $0.�3
Accrued intacst I/1/?013—I]OD- $0.33
2G95.PhilaJelphia Aveaue�•Clwmbersbur�', PA 17201
Received ime Apr. 6. 201 11 :4 A No. 104
. ____. .__. ._ . .
qDD-CS-2f11�(rR' ) 7a: P.d QRRSTQWN 9PNK OPERQTIQNS (fRX)7� 77ng,no3 P. pp'/pp'
S�IVINGSACC()C/NT
Account No: 706001154
Account Type- 3tatcment Savings
Dnte Opened_ 5/13/20t 1
7oint Accpvat(namddale} No
Baliwce- 57,142.IO
Accrueii interest- $0.97
Accrued tntcr�qc i/1/2013—DOD- $0.00
Best Rcsards,
7�..�LLt��'�(.C�i�ruino�,,/o�
R. Worthington
Deposit Pcocessing ClCrk
Received Time Apr. 26. 2013 11 :45AM No. 1045
f
AGREEMENT AND RELEASE
THIS AGREEMENT AND RELEASE made this oZL day of February, 2013,by and
between FRED E. ANDERSON, SR., of 1087 North River Road, Halifax, PA 17032,
AND
BONNIE ANDERSON KUDiTK, of 2559 Audlyn Drive, York, PA 17408
AND
CHRISTINE SHETTEL, of 659 Elliott Drive, I,ewisbury, PA 17339
WHEREAS,onNovember 20,200Q Lorenzo W.Anderson and Helen M.Anderson,
his wife, executed a Codicil in which they bequeathed certain items of personal property to the
parties herein; and
WHEREAS, Helen M. Anderson died on September 10, 2012, and Lorenzo W.
Anderson died on February 2, 2013; and
WHEREAS, the items listed in the Codicil aze of very little value, if any, since the
items aze very old, worn and well used; and
WHEREAS, all the parties to the Codicil aze agreeable to divide the personal
property in accordance with the Codicil; and
WHEREAS,the parties agree that the items bequeathed to Fred E.Anderson,Sr.aze
worth approxnnately $400.00, the items bequeathed to Bonnie Anderson Kuduk aze worth
approximately $300.00 and the items bequeathed to Christine Shettel are worth approxnnately
$45.00.
NO W THEREFORE,in consideration ofthe items ofpersonal property given to me
in accordance with the aforesaid Codicil,the receipt whereof is hereby acknowledged, it is hereby
agreed as follows:
1. The items listed in the Codicil bequeathed to Fred E. Anderson, Sr. shall pass to
Fred E. Anderson, Sr. at a value of$400.00.
2. The items listed in the Codicil bequeathed to Bonnie Anderson Kuduk shall pass
to Bonnie Anderson Kuduk at a value of$300.00.
3. The items listed in the Codicil bequeathed to Christine Shettel shall pass to
Christine Shettel at a value of$45.00.
4. Due to the minimal value, if any, of the items of personal properry and since the
items aze very old, worn and well used, these items shall in no way affect the value of the shazes
given to the heirs under the Last Will and Testament of Lorenzo W. Anderson:
5. The parties hereto, for themselves, their heirs, executors and administrators, do
by these presents remise,release,quitclaim and forever dischazge Fred E.Anderson, Sr.and Bonnie
Anderson, Co-Executors of the Estate of Lorenzo W. Anderson, their heirs, executors,
administrators, successors and assigns, of and from all actions, suits, payments, accounts,
reckonings, claims and demands whatsoever as a result of the distribufion of the items of personal
property listed in the Codicil of Lorenzo W.Anderson and Helen M.Anderson dated November 20,
2000, from the beginning of the world to the day of these presents.
I have hereunto set my hand and seal this -Z� day of February, 2013.
��C C���"�'.•-�' �' (SEAL)
Fred E. Anderson, Sr.
_� __
I have hereunto set my hand and seal this'�- 1 day of February, 2013.
�r-,,s,.�..— C�,�•�,-� � �-�E.�->
Bonnie Anderson Kuduk
�. T_. _ ___ _ _
. . �
I have hereunto set my hand and seal thiso} 7 day of Febniary, 2013.
��/li�(�� ��� (SEAL)
Christine Shettel