HomeMy WebLinkAbout09-17-13 J 1505610143
REV-1500 EX(02-11) t
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes oslieT.rivro f1E.
PO 80x.280601 INHERITANCE TAX RETURN 21 13 0063
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
01 07 2013 04 12 1922
Decedent's Last Name Suffix Decedent's First Name MI
KINGSBOROUGH EDITH M
(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
O 1. Original Return 2. Supplemental Return 3. 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)
g Decedent Died Testate 7. Decedent Maintained a Living Trust 0 S. Total Number of Safe Deposit Boxes
(Attach Copyof Will)
9. Litigation Proceeds Received 10. Spousal Pover[v 1 and Dete) Death 11.Election to tax under Sec.9113(A)
between 12-3191 and Date (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
GEORGE F DOUGLAS III ESQ 717 249 6,333
C nl n
REGI TS R OF WILLS USE ONLY
Cc;
First Line of Address
354 ALEXANDER SPRING RO z r cy
Second Line of Address .� p O -T7
'a DATE F D Cl
City or Post Office State ZIP Code Cn r
CARLISLE PA 17015
Correspondent's e-mail address: gdouglas @salzmannhughes.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.
GNATURE OF P 0 REBP BLE FOR FILING RE)U Q DATE p
�trnn Jp}Z(Q Pamela M. Hagerich
ADDRESS
432 Limestone Road Carlisle PA 17015
SIGNA UREURE OF PREPARER OTHER THAN REP ESENTATIr DATE
George F Douglas, III Esq. q/ i6 j3
ADDRFfSS
354 Alexander Spring Road, Suite 1, Carlisle, PA 17015
Side 1
L 1505610143 1505610143
PA Inheritance Tax Return
Signature of Additional Fiduciaries
ESTATE OF FILE NUMBER
Kingsborough, Edith M. 21-13-0063
Under penalties of perjury,I declare that I have examined this ret ,including accompanying schedules and statements,and to the best of
my knowledge and belief,it is tru "correct and complete.Dec[ ion of eparer other than the personal representative is based on all
information of which preparer h any oW1l 509e..
Signature#2
Name James D.Ktn sboro
Address' 6 Wellington Court
Address2
City, State, Zip Carlisle A 13213
Date
1505610243
REV-1500 EX Decedent's Social Security Number
De effl'SN.Me: Kingsborough, Edith M.
RECAPITULATION
1. Real Estate(Schedule A)..•................................................................................... 216, 000 . 00
2. Storks and Bonds(Schedule B)............................................................................. 2. 155 , 092 . 87
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. 28 , 770 . 55
61.1 Jointly Owned.Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Tiansiers'&Miscellaneous Probate Property
(Schedule G) It Separate Billing Requested............ 7. 142 , 245 . 14
8. Total Gross Assets (total Lines I through 7)........................................................ 8. 542 , 108 56
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 69 , 183 52
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 3 , 029 . 93
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 72 , 213 . 45
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 469, 895 . 11
13. Charitable and Governmental BeqUesisiSec"9113 Trusts for which
an election to tax'has not been made(S6hedule J)............................................... 13.
14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 469 , 895 . 11
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 15. 0 . 00
(a)(1.2)X.00
16. Amount of Line 14 taxable
at lineal rate X ..045 -469, 895 . �11 16. 21 , 145 . 28
17. Amount of Line 14 taxable
.at sibling rate X.12 0_ 0 0; 1T 0 . 00
18. Amount of Line 14 taxable 0 . 00 18. 0 . 00
at collateral rate X.15
19. TAX DUE..................................... ......................................................................... 19. 21 , 145 . 28
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Fx1
Side 2
1505610243 1505610243
i
1.
j elf Ott I Aaz
`fus' ef-'rmrtt�3�- ...
hosts"
(c, ,SUO XAV em 6 ai. .rrxnJ;eitih.+r?'xe;:s.Stn±l;';s't..sW.;;t a�".ent.i a t sr:#.' ?
- gT M t:A is .JJ1W iO .t^'y.3T.8t'Y/r,'. `r"4s C g NO ' x�f And-) �',7�sgh'i
^.',r'-9,_ oLy9P4i!r�) y 1/.y y �w1 [Y�".C'fz:T'T�1V�,�}RS+iA ^Yl f2 Y�( 'ir�ry2�itr�?SaLtA 'S.r"�e?°
6)1,)OJf`i31AM`li')FVi.,`l4A 38 i'�i 'X" VIA K 01',)ji 4 (-:.> ^C�+�At^iifii.: 41� 2tV,Etttla_F..�x!"1���'ii���i V�[4J'f.^+�1` S,� 'r-¢��!
all any
�$,J t. 3 -. ... .-..._..._. ..-. ..._._...._..__ .. .. . ... ..;E+t';^sl,xr"rrH{hex}Gxg emu smn 's?e3i)am Kom .r,
Y .,_... ...... .......: z rs•a�'K v'„ ,"tx -uuep.s.!Y`--`vrFO3ry srl e ar i"a,rz a"i;p a#gv,��es#x Of xibarr 4dP_ „+u: _n - -
,ta--nelrn tntiav:^sau3:c niui^�
,Xv
',.a-"•px- i:it2o io ...,Y ;>nn nlr.lia gf+c:, � rsrtnS;J °ns4ssan� b��+ SSP ,tiE :;v�3 r„s5 s,^+o:;aa "t➢4ea ;{ ,:
:3_i
.3 b asC�t„ :,!1m vlq d,a_M to f<ruwm And Omb noqu `,rA Tau?t rf ne 7r,O Mf be sG twL f
- _ tiylir`v.^Ylre^Y^�r{!�lwirna-noc 1sK1c w,{;iu^-an.irn.��.:»kngm�tifat Is;r,bin.7t£t sz,�xr:a 1nnl�r.:nt#;i� .+
l �7
.«s,Et',,'JH aHT 90 YMAex an Tr M 10A 0 3JUk'ili:5d�m^T:1.V4A?t, O TPU'AA,'10 Y,Q3+f�Y e^.d 2NEe"31.27,00 .p2HT a..YYSR uY�i”5[�°FVEt;9.Y�3Yi �t
,.�'fi✓.w.wWa�.ia�K^ r<r. :'��o-4� - >�+ z�S.`5� ".x��L3".iA �>�.��§�s�„„b�� �� �a �e�L. �2` < 2. >8 `3P a�'"A."dt"°q
two Ote Wh k -sQ!'tolvJnraiorllu;n to n A I v sn an 1 no Ran lad 01W v i amREQ ,fBbd,totolQ'J J'S' 104t .”YK 351;5 ld so Psttt esxb109
now P
,
d:>nuxraq 0:''°a✓a,,.r'-:VT M vl u,st ,p 1 w sA U&_ai awls=In a 0 av oil 9,°f no : .t<.-hs.;..1,?.12Y r ::,,r,!L-lems 10 on r .,"a to an%b IcA -
A., ,r1.,w;�Pt,v''sra-.sliunc+x i?5fufale G,.0 S.Sf
to 11 ua a 4,...1r-mia 1gWsxar;go&:�b }ixsb !:;1T (F?'Y,Pj{e,; rr i Yy§ ,P,0&Tf
in Obsonsd 1W At%e`nZEtoo9 liM1I4tmltt:aC 7 ev'�el"t, Wv,,W s a Ov:`0 ai q MM was d son;
c1`d0: iO4 qt aT5F Vag x D N1 ,1, cfr� 3t'arn g A loans W:W Ov av israh 0 6WgTto Mk; l -. i1w IN ;' 0_i i, ,;,.,r -, .; ?e s•to,Ynnx , ,tllnfrkx+
-
n�{f,ta: i..�>I� "Y-,.�R!'i•5A51!'�'. u�!'�`.�r.AF'r9sYiSY',a��i:,Wrr..+.esrra2?r-.rcv.t-�:q+war�w.r,_.,,._r�x »,.:,.,,.r,-..,i-Aw..,_....�,::.::, .,a ...',.,. ,. ._.,( ..._.._u .._ _ _.. - .-_" __.
Rev-1502 EX.(01-10)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Kingsborough, Edith M. 21-13-0063
All real property owned solely or as a tenant In common must be reported at fair market value.Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survlvorahlp must be disclosed on schedule F.
Attach a copy of the settlement sheet If the property has been sold
Include a copy of the deed showing decedent's Interest if owned as tenant In common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real estate situate at 120 Parker Street,Carlisle, Cumberland Co., PA 216,000.00
TOTAL(Also enter on Line 1, Recapitulation) 216,000.00
(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 A(Rev.01-10)
Rev-1503 EX•(6-98)
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENTOECEDENT
ESTATE OF FILE NUMBER
Kingsborough Edith M 21-13-0063
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
",:organStanlev SmithBarney Account No. 912-105384-308-
Stock
1 760 shares of Aegon N Vp, pfd 6.5% 25.1442 19,109.59
2 400 shares of Barclays Bank, PLC; pfd 7.75% 25.374 10,148.00
3 972.046 shares of Federated Invt.Series Funds Inc.;Class B 9.66 9,389,96
4 1,920 shares of TORO Co. 43.6925 83,689.60
Morcian Stanley Smith Barney Account No 912-105384-308 -
Corporate Bond
5 $400 Citigroup Cap XVI, pfd gtd 6.45%; matures 12/2112066; 2512 10,048.00
interest payable quarterly
MornanStanlev SmithBarnev Account No.912-105384-308=
Mutual Funds
6 994.854 shares of Alliancebernstein Growth &Income; Class 4.12 4,098.80
A
7 91.751 shares of Blackrock International Fund A 12.78 1,172.58
8 393.496 shares of DWS Core Plus Income A 11.26 4,430.76
9 2,840.909 shares of Sunamerica Stategic Bond B 3.62 10,284.09
Accrued dividend on Item 9 through date of death 5.99
10 45 shares of Prudential Financial, Inc. 55.9 2,515.50
TOTAL(Also enter on Line 2, Recapitulation) 155,092.87
(if more space is needed,additional pages of the same size)
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev.6-98)
Rev-1508 EX-(11.10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT REVENUE INHERITANCE TAX RET URN
PERSONAL PROPERTY
RESIDNT DECEDENT
ESTATE OF FILE NUMBER
Kingsborough, Edith M. 21-13-0063
Include he proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-bwned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 M&T Bank, IRA No. 35004200224555 1,191.40
2 Sunamerica Stategic Bond B 48.47
Accrued income on Item 2 through date of death 3.18
3 Ameriprise Financial Company, Annuity Account No. 93002970658 5 004-payout dated 261.56
1118/13
4 Members 1st Federal Credit Union,Checking Account#179763-11 3,382.00
Accrued interest on Item 4 through date of death 0.01
5 Members 1st Federal Credit Union, Holiday Club Account#179763-02 100.07
6 Members 1st Federal Credit Union,Investment Savings Account#179763-05 812.36
Accrued interest on Item 6 through date of death 0.01
7 Members 1st Federal Credit Union,Regular Savings Account#179763-00 2,467.34
Accrued interest on Item 7 through date of death 0.08
8 MorganStanley, Money Market Account 912-105384-308 2,482.07
9 Household goods at appraisal and taken in kind 3,579.00
10 Household goods at proceeds of public sale 12,879.25
11 Comcast Financial Agency Corporation-refund 235.51
12 Commonwealth of PA'-2012, PA40 income tax refund 120.00
Total of Continuation Schedule See attached page
TOTAL(Also enter on Line 5, Recapitulation) 28,770.55
(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-1508 EX-(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
continued
ESTATE OF FILE NUMBER
Kingsborough, Edith M. 21-13-0063
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
13 Commonwealth of PA-2012 tax rebate 250.00
14 Erie Insurance Group-refund from cancellation of homeowners insurance 308.00
15 IDT Energy, Inc. -refund 47.24
16 United States Treasury-2012, 1040 income tax refund 603.00
TOTAL (Also enter on Line 5, Recapitulation) 28,770.55
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10)
Rev 4510 EX.(09-99)
SCHEDULE G
pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Kingsborough, Edith M. 21-13-0063
This schedule must be completed and filed lithe answer to any of Questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % DECVS EXCLUSION TAXABLE
NUMBER THE DATE OF TRAANSFERSATTACFI A COPRELATIONSHIP F TE EED FFOREREAL ESTATE. VALUE OF ASSET INTEREST )IF APPLICABLE) VALUE
1 Ameriprise Financial Company,Annuity Account No. 102,245.14 100.000% 102,245.14
93002970658 5 004-beneficiaries are the decedents
four children; Bonnie R. Murray,Steven
Kingsborough, Pamela M.Hagerich and James D.
Kingsborough
2 Ann Marie Murray-Cash gift- 1/1/2013 50.00 100.000% 50.00 0.00
3 Bonnie R.Murray-Cash gift-1111312012 13,000.00 100.000% 3,000.00 10,000.00
4 Bonnie R. Murray-Cash gift-1/1/2013 100.00 100.000% 100.00 0.00
5 C.Stephen Kingsborough-Cash gift-11/13/2012 13,000.00 100.000% 3,000.00 10,000.00
6 James D. Kingsborough -Cash gift-1111312012 13,000.00 100.000% 3,000.00 10,000.00
7 Pamela M. Hagerich-Cash gift-11/1312012 13,000.00 100.000% 3,000.00 10,000.00
TOTAL(Also enter on Line 7, Recapitulation) 142,245.14
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group, Inc. Form PAA500 Schedule G(Rev.08-09)
REV-1511 EX-(1049)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Kingsborough, Edith M. 21-13-0063
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 11,089.18
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Pamela M. Hagerich James D.
Street Address 432 Limestone Road
City Carlisle State PA zio 17015
Year(s) Commission Paid 14,996.00
See continuation schedule(s) attached
2. Attornev's Fees Salzmann Hughes, P.C. 17,165.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State ZiD
Relationshio of Claimant to Decedent
4. Probate Fees 463.50
5. Accountant's Fees
6, Tax Return Preparer's Fees
7. Other Administrative Costs 25,469.84
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 69,183.52
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
Kingsborough, Edith M. 21-13-0063
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Ewing Brothers Funeral Home, Inc.-funeral services 7,959.50
2 James D. Kingsborough -reimbursement for funeral expenses 66.99
3 James D. Kingsborough-reimbursement for funeral expenses 9.39
4 Pamela M. Hagerich -reimbursement for payment to Osiris Holding of Pennsylvania, Inc.for 2,068.00
fee of Interment
5 Pamela M. Hagerich -reimbursement for payment to Osiris Holding of Pennsylvania, Inc.for 210.00
inscription
6 Pamela M. Hagerich -reimbursement for payment to Carlisle First Church of God, luncheon 400.00
7 Pamela M. Hagerich -reimbursement for payment to Rev.Alan Mathna for funeral services 100.00
8 Pamela M. Hagerich-reimbursement for funeral food 54.18
9 Pamela M. Hagerich-reimbursement for funeral expenses 221.12
H-A 11,089.18
Personal Representative Commissions
10 James D. Kingsborough -Co-Executor's commission 7,498.00
11 Pamela M. Hagerich -Co-Executor's commission 7,498.00
H-61 14,996.00
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Kingsborough, Edith M. 21-13-0063
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative Costs
12 Bass Air Quality Services-radon mitigation paid to sell real estate in order to administer the 375.00
estate
13 Bonnie R. Murray-payment for preparation of the household goods sale in order to 1,837.00
administer the estate
14 C.Stephen Kingsborough-payment for preparation of the household goods sale in order to 143.00
administer the estate
15 Dana J.and Jeffrey L.Wohlbach-seller assistance paid to sell real estate in order to 2,160.00
administer the estate
16 Fehl Awning Company, Inc. -final storage bill 151.79
17 George W. Fitzpatrick Plumbing& Heating -plumbing work completed and paid to sell real 611.50
estate in order to administer the estate
18 Howard Hanna-commission paid to sell real estate in order to administer the estate 6,415.20
19 HSA Home Warranty -home warranty paid to sell real estate in order to administer the estate 419.00
20 Ibis Appraisal Services, LLC -appraisal of personal property 525.00
21 James D. Kingsborough -payment for preparation of the household goods sale in order to 1,749.00
administer the estate
22 Linda McBeth -notary fees paid to sell real estate in order to administer the estate 12.00
23 Martin's Auction Service-advertising, labor and miscellaneous expenses to sell household 1,436.25
goods in order to administer the estate
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Kingsborough, Edith M. 21-13-0063
ITEM
NUMBER DESCRIPTION AMOUNT
24 Martin's Auction Service-commission paid to sell household goods in order to administer 1,287.00
the estate
25 MorganStanleySmithBarney-expenses paid to sell securities in order to administer the 834.02
estate
26 MorganStanleySmithBarney-service fee paid to sell securities in order to administer the 5.00
estate
27 MorganStanleySmithBarney-service fee paid for duplicate statement copy in order to 15.00
administer the estate
28 MorganStanleySmithBarney-service fee paid for duplicate statement copy in order to 10.00
administer the estate
29 Pamela M. Hagerich-reimbursement cleaning services to ready the real estate for the 278.69
household goods sale in order to administer the estate
30 Pamela M. Hagerich-payment for preparation of the household goods sale in order to 1,947.00
administer the estate
31 Prudential Financial, Inc. -fees to sell stock in order to administer the estate 14.60
32 Recorder of Deeds -1%realty transfer tax paid to sell real estate in order to administer the 2,160.00
estate
33 Register of Wills -six short certificates 30.00
34 Salzmann Hughes, P.C. -reimbursement for probate expenses reimbursement for payment 75.00
to Cumberland Law Journal for legal advertising
35 Salzmann Hughes, P.C. -closing costs and final fees for income tax preparation, postage 1,000.00
and miscellaneous contingencies in order to administer the estate
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Kingsborough, Edith M. 21-13-0063
ITEM
NUMBER DESCRIPTION AMOUNT
36 Stephen Brink Construction-electrical work completed and paid to sell real estate in order 1,365.00
to administer the estate
37 The Sentinel -Legal advertising 210.78
38 UGI Utilities, Inc.-gas service from 1/21113 third 2/19113 145.88
39 UGI Utilities, Inc. -gas service from 2/19/13 to 3120113 106.16
40 UGI Utilities, Inc.-gas service from 3/20113 to 4119113 62.07
41 UGI Utilities, Inc.-gas service from 4119113 to 5120113 29.38
42 UGI Utilities, Inc.-gas service -final 39.52
H-B7 25,469.84
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1512 Exa(12-08)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Kingsborough Edith M. 21-13-0063
Report debts Incurred by the decedent prior to death that remained unpaid at the date of death,Including unreimbumed medical expanses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Ann Marie Murray-birthday gift, check written prior to death cleared after death 50.00
2 Bonnie R. Murray-birthday gift,check written prior to death cleared after death 100.00
3 Borough of Carlisle-water and sewer service from 10/3/12 thru 114/13 78.36
4 Borough of Carlisle-water and sewer service from 114113 to 4/2/13 72.90
5 Borough of Carlisle-final water and sewer service 69.66
6 Carlisle Borough Tax Collector-2013 County real estate tax 959.27
7 Carlisle Borough Tax Collector-2013 School real estate tax 12.18
8 Comcast-cable,internet and phone service 258.50
9 Cumberland Goodwill Fire Rescue EMS-medical transportation on 117113 83.25
10 Giant-food,check written prior to death cleared after death 43.13
11 Giant-food, check written prior to death cleared after death 40.91
12 Groups Tax and Payroll Service -preparation of 2012 income tax returns 150.00
13 Pamela M. Hagerich -reimbursement for payment to Carlisle MPO for lifeline service 8.90
14 PPL Electric Utilities-electric service from 12/27/12 thru 1125/13 60.61
15 PPL Electric Utilities-electric service from 1125/13 thru 2126113 27.99
16 PPL Electric Utilities-electric service, check written prior to death cleared after death 85.97
17 PPL Electric Utilities -electric service 20.59
Total of Continuation Schedule See attached page
TOTAL(Also enter on Line 10, Recapitulation) 3,029.93
(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-1512 E%+112-081
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
continued
ESTATE OF FILE NUMBER
Kingsborough, Edith M. 21-13-0063
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
18 PPL Electric Utilities -electric service 19.25
19 PPL Electric Utilities-electric service 23.01
20 PPL Electric Utilities-electric service-final 64.85
21 Stephen Kingsborough-care taking serivices 600.00
22 UGI Utilities, Inc.-gas service from 12118112 thru 1/21113 200.60
TOTAL(Also enter on Line 10, Recapitulation) 3,029.93
Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev, 12-08)
REVAS10 EX.(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Kingsborough, Edith M. 21-13-0063
RELATIONSHIP TO
NUMBER NAME AND ADDRESS OF DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE
PERSON(S)RECEIVING PROPERTY (Words) ($$$)
Do Not Ust T�V..fsl I• TAXABLE DISTRIBUTIONS (include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2))
1 Ann Marie Murray Granddaughter Sch. G Item 2
1416 Bradley Drive H312
Carlisle, PA 17013
2 Bonnie R. Murray Daughter Sch. G 114th Item 117,473.78
10 Mountain View Drive 1 &all Item 3, 4
Carlisle, PA 17013 114th Residue
3 C.Stephen Kingsborough Son Sch.G 114th Item 117,473.78
928 Alexander Spring Road 1 &all Item 5
17015 1/4th Residue
4 Pamela M. Hagerich Daughter Sch. G 1/4th Item 117,473.78
432 Limestone Road 1 &all Item 7
Carlisle, PA 17015 1/4th Residue
5 James D. Kingsborough Son Sch. G 1/4th Item 117,473.77
6 Wellington Court 1 &all Item 6
Carlisle, PA 17013 114th Residue
Total 469,895.11
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as approp 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)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10)
LAST WILL AND TESTAMENT
OF n
o rn
EDITH M. KINGSBOROUGH m = f N
n r- F-- y c7
m of rR
CO � C' 3 t_y
'c - c c>
n,V In
I, EDITH M. KINGSBOROUGH, of Carlisle, Cumbertard County;-
__ m
Pennsylvania, being of sound and disposing mind, memory and understAding, do;c�iak6'
publish and declare this as and for my Last Will and Testament, hereby revoking and
making void any and all former Wills, Codicils, or writings in the nature thereof, by me at
any time heretofore made.
FIRST: I hereby order and direct my Executrix or Executor, hereinafter
named, to pay all my just debts, funeral expenses, testamentary expenses and all
Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently
done after my death, out of my residuary estate. Further, to the extent that sufficient
assets exist in my estate, any and all inheritance or other estate taxes, whether to non-
charitable or charitable beneficiaries, shall be paid by my Executor or Executrix from the
residuary of my estate prior to distribution and no part of the taxes paid shall be prorated
or apportioned among the persons or beneficiaries receiving the taxable property
regardless of tax rate applicable by law to each such persons or beneficiaries.
SECOND: I give devise and bequeath my entire estate to my four
children, BONNIE R. MURRAY, C. STEPHEN KINGSBOROUGH, PAMELA M.
HAGERICH and JAMES D. KINGSBOROUGH in equal shares per stirpes, provided they
survive me by sixty (60) days.
LASTLY: I nominate, constitute and appoint my daughter and son,
PAMELA M. HAGERICH and JAMES D. KINGSBOROUGH to serve as Co-Executors of
this my Last Will and Testament. No Executor or Executrix shall be required to file bond in
this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
TN
1 S day of 1,1 12010.
EDITH M., INGSBOROITGH
SIGNED, SEALED, PUBLISHED and
DECLARED in the presence of:
T
COMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF CUMBERLAND
I, EDITH M. KINGSBOROUGH, Testatrix, whose name is signed to the
attached or foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will; that I signed it
willingly; and that I signed it as my free and voluntary act for the purposes therein
expressed.
Sworn or affirmed to and acknowledged before me, by EDITH M.
r:`T N
KINGSBOROUGH, the Testatrix, this ( 3 day of 1 >> Win* r' 12010.
EDITH M. KINGSBOROUG Testatrix
—�
Notary
NOTAAIALSEAL
GEORGE F.DOUOlAS,III,NOTARY FJni C
(CARLISLE BORO,CUMBERLAND COUN Y
M(COMMISSION EXPIRES JUNE 26,2011
3
COMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF CUMBERLAND
We, George F. Douglas, III and Karen Riccardo, 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 Testatrix sign and execute the instrument
as her Last Will; that she signed 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
influence.
Sworn or affirmed to and subscribed to before me by George F. Douglas, 111 and
Karen Riccardo this 18th day of November, 2010.
n
George F. Douglas, III, Witness
Karen Riccardo, Witness
Notary Public
COMMONWEALTH OF PENNSY VANIA
Nomrtal Seal
LSII'TharM""'ton era S.51egr�yY,Seal
PubAc
Twp.,CGxnbeMnG .MEM[A,p6N�SYL�A fRf Dec 3 20h
A DN
OMB Approval No.2502-0265
A. Settlement Statement (HUD-1)
FINAL
1.❑FHA 2.❑RHS 3.❑Conv.Unins. 6.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number:
13-01.29087 5701662580
4.❑VA 5. X❑Conv.Ins.
C.Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown Items marked
"(p.o c)"were paid outside the closing;they are shown here for informational purposes and are not included in the totals.
D.Name&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender:
Dana J.Wohlbach,Jeffrey L.Wohlbach Kingsborough aide Edith Made KingsboroughlEslate of Fulton Bank,NA.
503 East Main Street,Sun Prairie,WI 53590 Edith M. One Penn Square,Suite 304,Lancaster,PA
120 Parker Street,Carlisle,PA 17013 17602
G.Property Location: H.Settlement Agent: I.Settlement Date:0710312013
120 Parker Street Barristers Land Abstract Company Disbursement Date:07/03/2013
Carlisle,PA 17013 3310 Markel Street,Camp Hill,PA 17011
Carlisle Borough
717-7615190
Place of Settlement: TitleExpress
163 N.Hanover Street,Carlisle,PA 17013 Printed 0 770 312 01 3 at 8:12 am
by KL
100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller
101. Contract sales price 216,000.00 401. Contract sales price 215,000.00
102. Personal property 402. Personal property
103. Selllement charges to borrower(line 1400) 12,096.31 403,
104. 404.
105. 405.
Adjustments for items paid by seller in advance Adjustments for items paid h seller In advance
106. Cilyllmvn lazes to 406. City/town lazes to
107. County taxes 07/0312013 to 12/31/2013 488.00 407. County taxes 07/0312013 to 1213112013 488.08
108. School Taxes to 408. School Tares to
109. 409,
110, 410.
111. 411.
112. 412.
120. Gross Amount Due from Borrower 1 218,584.39 420. Gross Amount Due to Seller 216,488.08
200. Amounts Paid by or In Behalf of Borrower 500. Reductions In Amount Due to Seller
201. Deposit or earnest money 2,000.00 501. Excess deposit(see ins0uclions)
202. Principal amount of new loan(s) 205,200.00 502. Settlement charges to seller(line 1400) 12,334.16
203. Existing loo 5 to an subject to 503. Existing loos taken subject to
204. 504. Payoff of first mortgage loan
205. 505. Payoff of second mortgage loan
206. Seller Assist 2,160.00 506. Seller Assist 2,160.00
207. 507.
208. 508.
209. 509.
Adjustments for items unpaid b seller Adjustments foritems unpaid h seller
210. Cilyllown tares to P209,372.18 510. Cilyltown taxes to
211. County lazes to 511. Countylaxes to
212. School Taxes 07/0112013 to 07103/2013 512. School Taxes 0710112013 to 0710312013 12.18
213. 513,
214, 514.
215. 515.
216. 516.
217. 517,
218. 518.
219. 519.
220. Total Paid by/for Borrower 520. Total Reduction Amount Due Seller 14,506.34
300. Cash at Settlement fronthe Borrower 600. Cash at Settlement lolfrom Seller
301. Grass amount due from borrower(line 120) 228,584.39 601, Gross amount due to seller(line 420) 216,488.08
302. Less amounts paid by/for borrower(line 220) 209,372.18 602. Less reductions in amount due seller(line 520) 14,506.34
303, Cash ❑% From ❑ To Borrower 19,212.21 1603, Cash FX To ❑ From Seller 201,981.74
+mM1mmp,ou++fe�,yen+m nn,lY rnb ouemmu.umx.Ne,nnleen iryh eueurt?IU+nlnmeelemege ory9inl+Irenb wte pevtle,npenle+meiaESD�mr+.ee 1,nreawn wn Mlom,nleneunrq,ne ee
Previous editions are obsolete Page 1 of 4 HUD-I
L.Settlement Chamers
700. Total Real Estate Broker Fees $6,640.20 - Paid From Paid From
Division of commission line 700 as follows: Borrower's Seller's
701. $0.00 to Funds at Funds at
702. $6,640.20 10 Howard Hanna Carlisle office Settlement Settlement
703. Commission paid at seHlemenl 4,640.20
704. Earnest Money Deposit to $2,000.00 P.O.C.B' 225.00 1,775.00
F ms Pa able In Connection with Loan ronginationcharge (Includes Origination Point 0,000 cr$0.00) $695.00 (from GFE#1)
ur credit or charge(points)for the specific interest rate chosen $ (from GFE#2)
ur adjusted origination charges (from GFE A) 69500
praisal fee toAppraisal Solutions (from GFE#31 375.00
1 805, Credit report to CREDSTAR (from GFE#3) 24.82
806. Tax service to from GFE#3
807. Flood certification to Corelogic Flood Services (from GFE#3) 11.50
808. o
900.
he Re wired b Lender to be Paid in Advance
901. Daily interest charges from from 0770312013 to 08 10112013 @$21.0822/day (from GFE#10) 611.38
902. Mortgage Ins.Premium for months to (from GFE 0)
903. Homeowners insurance for 12 months t0 Erie Insurance $569.00 P.O.C.B'(from GFE#11)
904. months to from GFE#11
WM Reserves Deposited with Lender
1001. Initial deposit for your escrow account (from GFE 99) 702.85
1002.Homeowners insurance 3 months 0$ 47.42/menth $142.26
1003.Mortgage Insurance months 0,$ 114.571month $
1004.City Property Tax months $ 0.001monlh $
1005.County Property Tax 6 months $ 81.57/month $489.42
1006.School Taxes 2 months $ 222.33/month $444.66
1007.Aggregate Adjustment $-373.69
1100.Title Charges
1101. Title services and lenders title insurance from GFE#4 1,943.46
1102. Sefllemenl or closing fee to $
1103. Owners title insurance-First American Title Insurance Co-Hbg from GFE#5) 5500
1104. Lenders title insurance-First Amercan Title Insurance Cc-Hbg $1,848.00
1105. Lenders title policy limit$205,200.00 Lenders Policy
1106. Owners title policy limit$216,000.00 Owners Policy
1107.Agent's portion of the total title insurance premium $1,645.20
1108. Underwriters portion of the total title insurance premium $257.80
1109.
1200.Government Recording and Transfer Charges
1201. Government recording charges $ (from GFE V) 168.00
1202. Deed$67.00 Mortgage$101.00 Release$
1203. Transferlaxes $ (from GFE#8) 2,16000
1204.City/County lax/stamps Deed$2,160.00 Mortgage$
1205.Stale Taxlslamps Deed$2,160.00 Mortgage$ 2,16000
1206. Deed$ Mortgage$
1207. $
1300. Additional Settlement Charges
1301.Required services that you can shop for (from GFE#6)
1302. Notary Fee to Linda Mc8elh 12.06
1303, Pest Inspection to Gilberts Pest Control 85.D0
1304. Payment of Inheritance Tax to Register of WIIIS,Agent 1186.60
1305. Home Warranty to HSA Home Warranty 419.06
1306. Radon Mitigation to Bass Air Quality Services 375.00 375.00
1307. Ellectrical Work to Stephen Brink Construction 1,385.00 1,385.011
1308. Plumbing Work to George W.Fitzpatrick Plumbing&Healing 611.50 6FI 50
1309. 2013-14 School Tax to Carlisle Borough Tax Account 2,668.00
1310.Final Waler/Sewer acct#010298 to Borough of Carlisle Authority 69.66
'ROME= - 1209631 1233416
Paid outside of closing by(B)orrower,(S)eller,(L)ender,(I)nvestor,Sro(K)er."Credit by lender shown on page 1.-Credit by seller shown on page 1.
previous editions are obsolete Page 2 of 4 HUD-1
03/08/2013 15:14 FAX 7172646483 Morgan Stanley Smith Bar ]002
Estate Valuation
Date of Death: 01/0712013 Estate of: Edith M. Xingsbcrough
valuation Date: 01/07/2013 Account: 9'_2-105384
Processing Date: 03/0312013 Report Type: Date of Death
NU.mber of Securities: 9
Pile ID: kirgshcrough
shares Security Mean and/or Div and Iot Security
or Par Description High/Ask Low/Bid Adjustments Accruals Value
1) 760 AECCN N V 1007924400; AEC)
PERP 6.56 CAP
New York Stock Exchange
01/07/2013 25.19840 25.10.000 H/L
25.144200 19,109:59
ZI 400 BARCLAYS BANK PLC 106739H511)
ADS7.75BPFD S4
New York Stack Exchange
01/0712013 25.42000 25.72000 H/L
25.770000 10,148.00
3) 1920 TORO CO (991092108; 7,C) -
COM
New York Stock Exchange
0110712013 43.96500 43.4200D H/L
43.692500 83,889.60
41 400 CITIGROL'P CA? XVI (17310L201)
PFD GTD 6.458
New York Stock Exchange
01/07/2013 25.16000 25.0E000 H/L
-25.120000. 30,048.00
5) 994.854 ALLIAIICEBERNSTEIN GR'W & INCH (018597104; CABOX)
CL A
mutual Fund (as quoted by NASDAQ)
01/07/2013 4.12000 Mkt
4.120000 4,038,80
6) 91.751 BLACX.RCCX INTL FD (M,OILX)
CL .A
Mutual Fund (as quoted by NASDAQ)
01/D7/2C13 12.78000 Mkt
12.7e0e00 1,172.5e
7) 393.496 DWS PORTFOLIO TR (SZIAX)
CORE PLUSINC A
Mutual Fund (a5 quoted by NASDAQ)
01/0712013 11.26000 Mk[
11.260000 4,410.76
8) 972.046 FEDERATED INVT SER FDS INC (461444606; FDBBX)
BD FD CL B SY.S
mutual Fund (as quoted by NASDAQ)
01/07/2013 9.6601)0 Mkt
9.6 60000 9,385.96
9) 2840.909 SUYAMERICA INCOME FDS (8669189OB; SDIBX)
STRATEGIC BD B
Mutual Fund (as quoted by NASDAQ)
01/07/2013 3.62000 Mkt
3.620.000 10,284.09
Daily Div. Accrual as of 01/07/2013 5.99
Total Value: $152,571.39
Total Accrual: $5.99
Total: S152,571.37
Page 1
This report was produced with EstateVal, a product of Estate Valuations & P:riciog Systems, Inc. If you have questions,
please contact EvP Systeru at (818) 313-6300 or w.w.evpsys.con. (Revision 7.3.11
Prudential Financial Inc.. PRU Historical Quote - (NYSE) PRU. Prudential Financial Inc. ... Page I of I
i I I I En If, ce Y.e.:eollS iSEFBLII
'Q 4 Ways to Avoid Running Out of Money During Retirement
B you have a SSCD 000 poidi io,download die guide by Forbes columnist Ken Fisher's firm,Even it you have something
MChar g C e eke In place.this mmt+e20 guide includes research and analysis you an use right na«.Don I miss
a.7 Click Here to Download Your Guide! 1
11I __..._..__..._-__.__.........
.__..______ FI511l4 IHVI:S'f 41'NTS'�
' f Mdf�cf ryatCh
pru Basic Chart Advanced Chad Interactive Cbrt
__.....__........._............
Haute T Oun:em Wen-s IfAuShieV r.bee1a. ..N6 9O'¢Ies B'ylw..r_6.n a.•:.a_.r,.. vro...ra.a...�ra a. rv♦ .." ._ .n-.a..xasewc.+•n....
T'i,Hnmk I dollar owl aem.a Yoo to bat w a sMoM,'a tract Malt,,take.
Sop,ryXM of sYm[d aw a"atoa of dale to we*a yaeo aM rrim pan to Mal seam. (�
J
Enter Symbol; pru EMn Dale: 7/07113
Prudential Financial Int. 56.32 +
I..,.ne].2013 55.48 +
55.79
Co., 55.15
.y, 55.33
Le. I 55 4A 2-
i.944,]1V
55.9 #
55.9 x
S,MMved Lie1r
Naturally Treat Gout
45 =
Pain Gone in 2 Days!Free Shipping!100Ye Gauranteetl!Try It Today! 2,--,l!;•5 t
Today's Top Stock Pick
Hot Company Set to Capitalize on S60 Billion Industry-Learn More!
.a,w TL..raLFlptdn
Uric Acid Diet
15]Foods Full of Uric Acid,Learn What to Avoid
:me?,R'nnara uarr
gout treatment
You May Have Gout B Not Know It Learn About Common Symptoms.
rMrr,[V m.nrn n+,pN
getaIe ju,_1 av
�i wmMarnde �i_ /g,;^iir—;! rY'�FIdO�I�C t`wy:. tl.awno.Garr C.,.
5 VMSuuA (--•
rode rte,or 60 dap• RM Own or Me,an
W Or.moo'.Open an IM.Get Vp Ill moo
a.CeuK IOdaY
-...+.r.awa..rp a•.,....�rr., ,.. ar...-.�[.\.«a• ,wnrlamalxe oaoor:wveq can..Uyn.[:atr lil.o nrn_m �rtr..r.vre.. a-...me.nr...a.,nsrrn•a,z+rmaa
coo'.' 701,v2r"M.lrc at�SY..aaeneO
8Y wrp mia racy pa•TN[a Ina imm et V.r aK Mna[I Ra[l1V%a:ed I'Jtylol II
--a way a..TmCeo ei 611[naMVl NlamV:<n a+e rubes b lemn al u[e
nnamnV NeNeMa,agaa.m<e:ry6U[mrqul ml>rv:ne tr:.:aY e.a eebYn oe e•wMtttiw - L6WNa.he.bkseal6uinonpV.JO^nACamLry.NC 4Cadn.re it b[»ern.pe 4„e.PeJUrcbn ub
:a prance. w6PO
Cr•,bt. ,5 r..rtleea.,. no me,n:nem.Vr.,:,.,
M.a.r[. oe..rsrmaln......e.v.Mr"+w.co-a-, reannyaf
6l..eon des ,V[ I6Inlinn haw Jonr6[oMan'Irc
6EXr.nl e.IL:.nprorS!fel6lFaWn:u'I,:arrypnaM na"e..l e9•ran� fea arLraa
Y oPorra.Vek:.'..v�,q.tr'e
MM&TBank
499 Mitchell Road.Millsboro.DE 19966 Adjustment Services
Phone 888-5024349
Fax (302)934-2955
February 22,2013
Salzman Hughes, P.C.
Attorney at Law
354 Alexander Spring Road, Suite 1
Carlisle, PA 17015
Re: Estate of Edith M. Kinasboroueh
Social Security: 195-16-4054
Date of'Death: January 7, 2013
Dear Sir or Madam:
Per your inquiry on February 12, 2013, please be advised that at the time of death, the above-named decedent
had on deposit with this bank the followin.g:
I. Type ofAccount Individual Retirement Account
Account Number 35004200224555
Ownership(Names on Edith M Kingsborough
Opening Date 0311111999
Balance on Date ofDeath S1,191,40
Accrued Interest S 3.18
Total 8 1,194.58
For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds,
please call the High street Carlisle at 717-2404536.
We were unable to locate any safe deposit box for the above-mentioned decedent.
This letter dues not include any accounts in which the deceased may have been listed as Power of Attorney,Custodian of Uniform Transfers,
Representative Payer,or Trustee under a Written Agreement.
Sincerely,
Valarie Mercer
Adjustment Services
MAR-13-2013 07:33 From:MENBERS 1ST FCU 7177955176 To:817172497334 P.2/2
f t
b
MEMBERS I't
eeosant.nVinrrUNION
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 179763-00
D-ale Account Established 11103/1998
Principal Balance at Date of Death $2,467.34
Accrued Interest to Date of Death $0.08
Total Principal and Accrued Interest $2,467.42
Interest Earned from 01/01/2013-01107/2013 $0.08
Name of Joint Owner None
HOLIDAY CLUB ACCOUNT:
Account Number/Suffix 179763-02
D-ate Account Established 11113/1998
Principal Balance at Date of Death $100.07
Accrued Interest to Date of Death $0.00
Total Principal and Accrued Interest $100.07
Interest Earned from 01101/2013-01/07/2013 $0.00
Name of Joint Owner None
INVESTMENT SAVINGS ACCOUNT:
Account Number/Suffix 179763.05
D-ate Account Established 11/1311908
Principal Balance at Date of Death 5812.36
Accrued Interest to Date of Death- $0.01
Total Principal and Accrued Interest $812.36
Interest Earned from 01/01/2013-01/07/2013 $0.01
Name of Joint Owner None
CHECKING ACCOUNT:
Account Number/Suffix 179763-11
Date Account Established 11/03/1990
Principal Balance at Date of Death S3,382.00
Accrued Interest to Date of Death. $0.01
Total Principal and Accrued Interest $3,382.01
Interest Earned from 01/01/2013-01107/2013 50.01
Name of Joint Owner None
VISA CREDIT CARD ACCOUNT
Account Number 4672090000296046
Date Account Established 11118/1998
Balance at Date of Death $0.00
Joint Cardholder - None
MEMBERS 1'T FEDERAL lCREDIT-UNION
Tess L K� lugh O
Lending Insurance Support Specialist
February 11, 2013
Estate of: EDITH KINGSBOROUGH
Date of Death: 01/0 712 01 3
Social Security Number: 1 95-1 64 054
5000 Louise Drive • P.O. Laos 40 • Mechanicsburg,Yeruisylvania 17055 • (800)283-232$ w-wwmemberslstotg
03/08/2013 15:13 FAX 7172646483 Horgan Stanley Smith Bar 001
(Morgan Stanley Facsimile
FM'exlth M.nngement
346 Smuffer Avenue
Cha ntersburg.PA 17201
MI 212761 4000
Not for Redistribution by Recipient fax 117.264-6483
To: \ : rn �n x
Company: Telephone: 717-264-5901
Fax: �\'�q- 13 �til Fax: 717-264-6483
Subject:
❑ Urgent ❑ Confirm Receipt Total pages including cover sheet:
J�-
Morgan Stanley Smith Barney LLC.Member SIPC.
James Daihl Kingsborough, Items taken from Edith Kingsborough Estate:
Item No. Appraisal Report Item Amount
# 5 Masonic Ring $550.00
#13 Television 200.00
#79 Blanket Chest 40.00
#90 Small Table 35.00
Misc. Household Items 70.00
Total James Daihl Kingsborough 895.00
C. Stephen Kingsborough, Items taken from Edith Kingsborough Estate:
Item No. Appraisal Report Item Amount
# 1 Lift Chair $ 300.00
# 9 Ring 45.00
#11 Chain Necklaces 366.00
453 15 Inch Television 45.00
Misc. Household Items 140.00
Total C. Stephen Kingsborough $896.00
Pamela M. Hagerich, Items taken from Edith Kingsborough Estate:
Item No. Appraisal Report Item Amount
#2 Necklace & Earrings $ 40.00
# 6 Rings 235.00
#10 Pendant 20.00
#18 Coat Rack 35.00
#19 Chest 25.00
#20 Coffee Table 30.00
#23 Delfware 20.00
#25 Secretary Desk 85.00
#51 Cabinet 125.00
#54 Framed Picture 6.00
#58 Cherry Chest 65.00
#77 Childs Rocker 40.00
#83 Sewing Box 20.00
#88 Bookcase 10.00
#91 Rocking Chairs 45.00
#94 Crock 2.00
#96 Large Crock 35.00
Misc. Household Items 55.00
Total Pamela M. Hagerich 893.00
Bonnie Rae Murray, Items taken from Edith Kingsborough Estate:
Item No. Appraisal Report Item Amount
# 3 Ring, Pendant and Chain $ 475.00
# 8 Ring 250.00
#33 Cabinet 125.00
#61 Coat Rack 10.00
Misc. Household Items 35.00
Total Bonnie Rae Murray 895.00
C-N--XARTIMS 6-21-13
AUCTION SERVICE
Andrew 717.532.5382-Victor 717.658.9930
9015 Molly Pitcher Hwy, Shfppmsbutg, PA 17257
SETTLEMENT SHEET
Auction held 6-18-13 for the Edith Kingsbourgh Estate.
Auction total... .... ..$121879.25
Less expenses........- 2,723.25
Payment...$101156.00
EXPENSES BREAKDOWN.•
TheGuide.........................................................480.00
Carlisle & Shippensburg Sentinel.............................417.00
Newville Star......................................................82.00
Handflyers.........................................................77.00
Port-a-pot...........................................................85.25
Tentrental..........................................................50.00
10% commission...............................................1,287.00
Additional labor...................................................245.00
2,723.00
We enjoyed working with you!
Thanks, Andy
RiverSource Life Insurance
Company
Ameriprise Financial Company
70100 Ameriprise Financial Center
Minneapolis,MN 55474
February 19, 2013
RICHARD MALCOLM MORRIS 1R
37 SOUTH HANOVER ST
CARLISLE,PA 17013-3307
15563163 3 001
Dear RICHARD MALCOLM MORRIS]R:
We have received notification of EDITH M KINGSBOROUGH's death. The deceased's name appears on the
following accounts. Account values as of 01/07/2013 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
Account Number Ownership
93002970658 5 004 Individual
Annuities - Post 1985
Account Number Total Value
93002970658 5 004 $102,245.14
The date of death values provided are for estate tax purposes and are not a value to be paid. Accounts may be
subject to market fluctuation as governed by each product. Please note that the values indicated for any Life
Insurance products with the insured deceased 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 cash value as of the
date of death. Values for any proprietary mutual funds include accrued dividends as applicable.Values provided for
brokerage products are manually 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 these
values as a service to its clients. Actual values used in preparation of tax returns or for planning purposes should be
verified by your legal and accounting advisors.
Account Disposition
Account disposition is based on how an account is owned (the ownership type). The following information will
help you understand the process that will be used to settle the accounts. Accounts may be subject to market
Fluctuation as governed by each product.
Disposition for Individual ownership
Upon the death of the owner and annuitant,account proceeds typically pass to the named beneficiaries. If no
beneficiary is named and the contract includes a default beneficiary provision the proceeds will be paid according to
the beneficiary default language. In all other cases where no beneficiary was designated, the proceeds become part
of the owner's estate for distribution. DEFERRED ANNUITY NOTICE: If the beneficiary(s)wishes to elect an
annuity payment plan, we must receive written notice of this election within 60 days of our receipt of complete
requirements from any individual beneficiary. The contract value will remain invested in the separate account until
we receive a completed claim. If there are multiple beneficiaries,each claim will be processed separately and each
beneficiary's share will remain invested in the separate account until it is claimed. The beneficiaries bear the market
risk during this time.
Required Documents
In order to take appropriate steps to settle the accounts we will need these documents:
Certified Death Certificate
(For account:93002970658 5 004)
The death certificate must be an original document that bears certification from the health department or local
registrar and includes the cause of death.
Death Claim Statement Form (33047)
(For account:93002970658 5 004)
To process a death claim on an annuity account, we must receive a completed Insurance and Annuity Death Claim
Statement form 33047 from each claimant. A completed death claim statement must contain the deceased's client
information and account number, a completed claimant information section,and an acceptable mode of
settlement. The form must also contain a Taxpayer Identification Number and withholding election. Failure to
select a withholding election on an annuity requires mandatory 10% withholding which is forwarded to the IRS that
we cannot refund. In addition,the claimant(s) must sign the form and their signature(s) must be witnessed by an
Ameriprise Financial Services advisor or a notary. If any of this information is incomplete,the form will be
returned. This form is available through an Ameriprise Financial Advisor or online at
huo://www.:unerinri.w com/von/global/cualomer-servicektccount-service.asn, under the list heading"Estate
Settlement".
An Obituary or Statement listing all children of the decedent
(For account: 93002970658 5 004)
Because the beneficiary designation is living lawful children or children per stirpes, we require either an obituary or
a statement signed by either the advisor 6r an adult child,listing all children of the decedent(both living and
deceased). If a child is deceased, we require a certified copy of his or her death certificate. In addition to this,other
requirements may be needed.
In order to be compliant with fair claims practices of many states we will be immediately corresponding with the
beneficiaries listed for any Life and Annuity accounts held by the deceased client. Similarly we will be
corresponding with the beneficiaries or claimants of all accounts held by the decedent within a minimum of six
months of the date of this letter. Please contact us if you wish to see a copy of these correspondences.
We also request any information you may have that may facilitate our efforts to contact other beneficiaries on the
accounts involving the deceased.
In an effort to improve our process, we invite you to share your feedback with us by sending a Lotus Note to: Life
Events Mailbox.
If you wish to complete settlement prior to the end of the 2012 tax year,all requirements must be received by
December 14, 2012. We will put forth our best efforts to handle all requests before year-end even if received after
that date;however, we cannot guarantee that processing will be completed for the 2012 tax year. If there are IRA
assets involved with this claim and the decedent's Required Minimum Distribution for 2012 has not yet been
fulfilled,please contact our office for additional instructions.
If you have questions about this letter or need assistance determining next steps, please call
1-(800)-297-6663 and say Death Settlements to be connected with an operator. Ask to be connected to the Estate
Settlements Team. You will be connected to one of the knowledgeable Life Events Customer Service Professionals
who will be ready to assist you through this process.
More information regarding the Estate Settlement process is available on the Ameriprise.com website. To view the
"Estate Settlement Frequently Asked Questions" page on the website,type"Estate Settlement FAQs"in the search
field on the website homepage,press the "Enter" key and select the first item on the"GLOBAL" list.
Sincerely,
Death Settlements Processing Team
70100 Ameriprise Financial Center
Minneapolis,MN 55474
Death Settlements Processing Team: 800-297-6663, PIN,say Death Settlements
Life Insurance Claims: 800-297-6663,PIN,say Life Claims
Attachment:Beneficiary Information
Beneficiary Information
We have the following beneficiaries on record for the deceased's accounts.
Account Number: 93002970658 5 004
Designation:
PRIMARY BENEFICIARY
LIVING, LAWFUL CHILDREN IN EQUAL SHARES 100.00%
BONNIE R MURRAY CHILD
STEVEN KINGSBOROUGH CHILD
PAMELA M HAGERICH CHILD
JAMES D KINGSBOROUGH CHILD
When submitting the required documents please attach this cover sheet to the
documents. Please include all documents related to the claim or estate settlement
including new account applications, claim forms, etc. Please do not include any
documents not related to the death claim or estate settlement. This will allow for
quicker processing of your claim or estate settlement. Please note that as of August
14, 2007 original documents (i.e. Certified Death Certificates, Letters of
Administration/Testamentary, court orders, etc.) will no longer be returned to the
client or advisor. Power of Attorney documents, however, will continue to be
returned.
15563163
EDITH M KINGSBOROUGH
TO: Ameriprise Financial
70100 Ameriprise Financial Center
Minneapolis, MN 55474
ATTN: DOCUMENT OPERATIONS
DO NOT SEPARATE ANY OF THIS MAIL.
Form #3693
Please do not reply to this email. This database does not support incoming mail. Please call the phone#
within the letter if you require assistance. Thank you.
Life Events Team