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HomeMy WebLinkAbout04-16-14 (3) � 1505610143 REV-1500 EX`o2_,,, � OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENTOFREVENUE Po Box.2sosoi INHERITANCE TAX RETURN 21 14 0133 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Sociai Security Number Date of Death Date of Birth 01 21 2014 O1 24 1916 DecedenYs Last Name Suffx DecedenYs First Name MI MARTER HELEN G (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 � 1. Original Return � 2. Suppiemental Retum � 3. Remainder Retum(Date of Death Prior to 12-13-82) � 4. Limited Estate � 4g.Future Interest Compromise � 5. Federal Estate Tax Return Required (date of death after 12-12-82) � g Decedent Died Testate � �• AttacheCopy�of Tnest)a Living Trusl � 8. Totai Number of Safe Deposit Boxes (Attach Copy of Will) � 9. Litigation Proceeds Received � 10•between12v31�J1 a^dit�(Da95�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 ��,.�.: JAMES D BOGAR (717) �,7�37 87F� � � rn REGISTER�V/�LLS US�VLY� p tTl � � � V) �b � D r-- --� n First Line of Address � � � ~ rn rn CT7 ONE WEST MAIN STREET � � � �� � c.� a Second Line of Address Q C '�'t � ;� � . � i—+ r= TE FILED r City or Post Office State ZIP Code �,,J SHIREMANSTOWN PA 17011 CorrespondenYs e-mail address: jboaar boqarlaw com Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowiedge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on ali information of which preparer has any knowledge. SIG TURE OF PERSON SPONSIBLE FOR FILING RETUR DATE Victoria Dickey Bekelja / —�� ADDRESS 439 West Sim son Street Mechanicsbur PA 17055 SIGNATU 0 PREPAR HER THAN REPRESENTATIVE DATE James D. Bogar y c.� ADDRESS One West Main St et, Shiremanstown, PA 17011 � Side 1 � 1505610143 1505610143 � � 1505610243 REV-1500 EX DecedenYs Sociai Security Number Decedent's Name: Ma�t@I'� Helen G. RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 2. Stocks and Bonds(Schedule B)............................................................................. 2. 9,5 61 . 82 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C)......... 3. 4. Mortgages&Notes Receivable(Schedule D)........................................................ 4. 5. Cash, Bank Deposits&Miscelianeous Personal Property(Schedule E)............... 5. 2 94 , 10 6. 71 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 392 ,494 . 66 7. inter-Vivos Transfers&Miscellaneous Nnn;Probate Property (Schedule G) L� Separate Billing Requested............ 7. 1 , 0 99,732 . 04 g. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 1 , 7 95,8 95 .23 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 53 , 671 . 8 9 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 11. Total Deductions(total Lines 9 and 10)................................................................ ��. 53 , 671. 89 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 1 , 742 ,223 .34 13. Charitabie and Governmental Bequests/Sec 9113 Trusts forwhich an election to tax has not been made(Schedule J)............................................... 13. 14. Net Value Subjectto Tax(Line 12 minus Line 13)............................................... 14. 1, 742 ,223 . 34 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 . 0 0 16. Amount of Line 14 taxable at lineal rate X .045 0 . 0 0 16. � . 0 0 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0� 17. 0 . 0 0 18. Amount of Line 14 taxable atcollateralrateX.15 1, 742 , 223 . 34 �8. 261 ,333 . 50 19. TAXDUE................................................................................................................ 19. ZFi1 ,333 .50 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � Side 2 L 1505610243 150561�243 J REV-1500 EX Page 3 File Number 21-14-0133 Decedent's Complete Address: DECEDENT'S NAME Marter, Helen G. STREET ADDRESS 325 Wesley Drive,Apt. 3127 CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 261,333.50 2. Credits/Payments A. Prior Payments B. Discount 13,066.68 Total Credits(A +B) (2) 13,066.68 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) 24$,26Cj.$2 Make Check Payable to: REGISTER OF WILLS, AGENT c ^� i�i�i�,,'�' ?���n� `� ,���"�����'"a '�'��``��:� �� .:�� ��°��'s��,� :`s-* s': ��° ���.�r ��- �� g�e��—r��s z.°i�r�'^ , "".��; m,��.���,nfi�e�``��'�, ��c,s`;�`.t�"�-�`��.�`�'.�a� �'0������.��i_..��:����aR � ,:;.�v,..�,...��_...,�..w.... .��. 4.��r;.�'--�,..�.eae.����.,� ,�x��.�v�ur����rw�:� .t�'�i�.�...�..�.��.�e�..����.3 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE B�OCKS 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:.................................. ❑ 0 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?....... 0 ❑ 4. Did decedent own an individual retirement account, annuity,or other non-probate property which � ❑ contains a 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. ,, , � s .s,�. �_E��.a����`i�.���.F,�.���.�,��w���.��.x,.. ._ �z . p��,�" . ,ti��,��x�,.�,��. � �. . . _..,, �._ <,_� r.��.���;�_.�.��. ����. .�">_ For dates of death on or after July 1,1994 and before Jan.1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)). For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent,or a stepparent of the child is D 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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)J. . The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. Rev-1503 EX+(6-98) SCHEDULE B � � STOCKS & BONDS � COMMONWEALTH OF PENNSYLVANIA � � INHERITANCETAXRETURN RESIDENTDECEDENT ESTATE OF FILE NUMBER Marter, Helen G. 21-14-0133 � 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 1 PNC Investments-BlackRock PA Municipal Bond 9,561.82 TOTAL(Also enter on Line 2, Recapitulation) 9,561.82 (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) Fme ail Ne�r ris Fi�iarce �fJeather Games rouos An ers reen Flickr Mo le More nance f-�`�ome �y Por��'oqio Market Data Business&Fin�ance �ersonall-'�inance Yahoo�ngi als CNBC � Enter Symbol i r�oh Uo _�-- � N.�eU.Fzb^��.?(��:����rr(T$'�Geli•P:iar�'rE�,Q+,'�IIrW?�hr a ic�����i;r,ins �v — �- �. _._. Dow$0.06l�Nasdaq 50.09°l0 ...____._. __.�._._--- �j Ameritrade... ,., �� . �tSftOtlY � . .� '. :� A�uhca!Frerrci Fideality ' �� . ,.. _ Center � BlackRock PA Municipal Bond Inv A(MEPYX) fii FonoW add co Porttoiio'� 1 O.�7 1 s 0.01 (0.09%� Feb 25 HIStO�ICdI P�IC@S Get Historical Prices for:�� GO Set Date Range � Q Daily ; �. . . Start Date: J8f1 V 21 2014 Eg.Jan 1,20'10 ��A/eekly � Susie�spasliQ :r�;, End Date: Jan �/ 21 2014 Q Monthly uan u.u?mN�"si E°oor C�Dividends Only �°�.t,r r= Get Prices Flrst�Previous�Next�Last ,�.; � � .._nz;'�i Prices � Date Open High Low Close Volume Adj Close' Jan 21,2014 10.82 10.82 10.82 10.82 0 10.78 � � `Close price adjusted for dividends and splits. r=irst�Previo�,is�Next�last �`'Download to Spreadsheet Currency in USD. $ 10.82 �rice 883.717 Shares Owned $ 9,561.82 Date of Death Value �� ` Van�aa.rfi" �_ � . ���.�.�.���,�.: Ad Topics That Might Interest You... � 1.Best Penny Stocks to Buy 5.Best Retirement Funds ! 2.Stocks to Buy Now 6.Top Mutuai Funds 3. Best income Mutual Funds 7.Best CD Rates _.,.__._ _ _ _. 4.Penny Stocks To Own 8.Fixed Income Funds Feedback -.... .�...... ._...... ......_ �. .._. ads AclfYwsces�.;«� �r�uPCy-�t:o�i o��r„ns-?erm=.sc�d r->ednacK-Yahoo!-ABC News Net�,vork -:.tuoie=_r�2 real-time ior NASC„M.� ;S� ntl^;Y.;E .� _e aisc daiay times fcr c;.he'excha•�yes.=11,^,FCrmaticn provezd`as is or in�ormaUOra;pu�coses cnly.nut�rt2�id�n`cr vadiny purF�s �o�ad:��ce.tdeit7er Yahoel no!any of i�icep2ne_.�,providers is ii2ble ior any ir,FOrma;i�rai crro�s i uemeleteness;or de!ays.�r io!any ac+.ions take�i in�elia,ice or�pPOrmalior cor,tainetl nerclr.Gy�c...essin�thF Yahoo�.s�te you:�grs�nat:u r=_disMbute the irfa.ma,ic;�tou�r,:�=re-n.Rc�ai-Tim2 con5nuous ,reaming quot2s are a�ailad!e;hrough aur prem i:ri sFrdice.Yc.,may tu,n stro�mi^c;G�i;:t�s nn cr cf!. 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ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Belco Community Credit Union -Regular Savings-Date of death balance$5.00;accrued 5.00 interest$0.00 2 Belco Community Credit Union -Money Market Account-Date of death balance$86,798.37; 86,820.85 accrued interest$22.48 3 Belco Community Credit Union -Checking Account-Date of death balance$12,065.63; 12,067.64 accrued interest$2.01 4 Belco Community Credit Union -CD-Date of death balance$50,848.92; accrued interest 50,856.24 $7.32 5 Invesco-Individual Account No.718777. Date of death balance$46,191.62 46,191.62 6 Members 1st Federal Credit Union-Regular Savings Account No.8974-00. Date of death 6.08 balance$5.00;accrued interest$1.08 7 Members 1st Federal Credit Union-Life Savings Account No.8974-04. Date of death 4,000.33 balance$4,000.00;accrued interest$0.33. 8 Members 1st Federal Credit Union-CD No. 8974-04. Date of death balance$53,831.29; 53,834.56 accrued interest$13.27 9 Members 1st Federal Credit Union-CD No. 8974-46. Date of death balance$37,699.14; 37,710.50 accrued interest$11.36 10 Personal Property-per appraisal 2,465.00 11 Asbury-Refund 54.93 12 AT&T-Refund 14.26 13 State Farm -premium refund 79.70 TOTAL(Also enter on Line 5,Recapitulation) 294,106.71 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10) t � o ,� .� .._ , , e ; ���� � `� §;°� �' � s; �, x �� �� i �. ��., � �...�''..�..� .�,.�� ��,,� k f. � � _ . •u . . � � , : . �! . . .. . . . . . . .. . .. „6, "3s `" :�: .,,� - ��" x i' �. - � F > � N � �~��' � �'eE�ruary 18. ?f)14 ,� � . �� � , *'� �;:� �� � �� �: � f ��. ����� James D. Qo�ai-, Attocney at La�n� ���,� �; ��.�-�;;;.<; One West Main St��eet (f Fd� -" ��f� ' Shireusansto���n, PA 17E�11 �a� ..n�� i;1 � �a�k���{`i Dear James, ae� t �� ��� ����,� My uame ?s Kately�� Ti�ompson and I arn the Compliailce Specia�ist here at Lelca Commi�€ilit_y Cred�t ��,�', Union. I have received your 1-equest for information regardin��Helen G. Marter. �,:a. n��; � � ���Ty j �� x�.� Enclosed you will find date af death balances for Ms. R�Iarter's account. �,�� �� Please Iet�ne know if there is anything else that I cau help you wit11. ,�� �. �� � ���� Sincerely, � � �>Y: , � ��`' � , ' _. . , , �-- � �_ ,:,. . � �h�i �::l�.`.-'.__! �.,_�... �! �'�+ + �.:.�,.R �1 � �h, Katelyn Thompson, CUCE � ��� Y�"; Selco Community Credit Union .�� :�, ,�,;�� Compliance Specta ist �tr:��; �u�� 717-720-6270 �*� �^�'„ z , ;�,,�; thompsonk@belco.org u ,.;; � „��`; �:: �„,� ��' � ��„ �..: �� ��;� y,�. a s'��" ��>�s � �,� �nv;-i r. *cy.�.�;; a y�"�"-�i r .� �: -�:�:`� �,.; ����-�-�;; r,��,-;! }..����:� � �;�,� �:�w; r,�� _ r �� �t r�'' � ����� �� a�"�, k'�����" �s ':, e # yk$. ��z�31 � { p,'3j�y�,��• �' ,{� G L i' #�� , �Y �': I� � � ��_ R � � E _ � _i � ,; s � r,�,�� � �t,,:,; r �` �..,:,! _> � ��. -` ' � " ' ' *��`' . � n ,.F""'����.�.._ _ , f / � . �. �;. � .,:.; _ 3 .,1 ` H��� _.... f� � � �y [_f L � ",�'� ' �' � C� t ' v; p.� � �i �.�i�.�w.�Y� � � _ fi�, k , . . r a�„ ��'t�.. .d�.',;.....n� _�s��.r�.,.+� 1 �,' � .�.." .. . . :.' ; . .. � i ' . . . . . . . � A . . . �� � . . . . . k. '�.v -_ S.„,_. y� §' ? ;:L r t t �,. - r'r ��_. Decedent.Account lnformatio�l (On D�te of Death) , ; Belco Conu���inity Credit Uilioil ' - z� � IEq E# ' n ��� ;;�, 1. Naa�e(s) in whicl� the accoti��t was held: Helen G. Marter �x�� , h ����A �`i � ��� t���,� �;; 2. AccountNumber: 2520 � e ���- �€��"': ;. Total Account Balance as of Date of Death: $149,717.92 F,ee�yy��� 'J �5.3�St'y£`i ��Yy E�': 4��L�.��.� Balance Accrued Dividends Date Opened ���'��;�; ��`���� Regular Savinas $5.00 $.00 (O1/O1/14-01/21/14} 07/11/61 �r_:; �a� � Holiday Club $ � ��� p� P ,� Whatever Chtb $ a ,a, `� �� Money Market $$6,79837 $22.48 (O1/O1/14-01/21/14} 03/14/11 r� ��:�, �� Checking $12,065.63 $2.01 (Cl/OU14-Ol/21/14) 07/Il/61 �'� I� � h� � � _ �� �.�; Certificates: �������] Certifcate Number Balance Accrued Dividends Date Opeued ��`���' $7.32 (Ol/01/14-01!21/14) 04/Il/ll � ����y 51004 $50, 848.92 �����= � ',� $ u �� , '�� ��, �Ik��� $ �.d'�,`k. �j ..'Y �'ci � 1 - b ��j Q 4 a r�i �P � }t�"': ���Slv�is � ����. y.c��y� ��.. . � T� ��;. ��� 1 C �,�3�i' � � �:; � 4. Na���e{s} in whici� Safe� Deposit Boa was held: �� � � r� i-�'»Yp...: �`�� `�� 5. Date the box was initially rented:�� �� .�-. ��� : :': ��,�'� _-, ����=; 6. Eranch address at whicl� the box is located: _` ` � � � h; - �•� f �f ` �.�? f ? � ' T �� Invesco �nvesco InvestmentServices,Inc. PO Box 219078 Kansas City,Missouri 64121-9078 www.invesco.com March 18, 2014 VICTORIA D BEKELJA ESTATE OF HELEN G MARTER 439 W SIMPSON ST MECHANICSBURG PA 17055-3763 Correspondence ID: 00878615 Dear Victoria D. Bekelja: Thank you for doing business with Invescos"'., We recently received the enclosed request regarding Helen G. Marter's individual account number 718777. As requested, ali shares in this account were redeemed under the estate of Helen G. Marter's tax identification number as of March 17, 2014. A check for the proceeds has been sent under separate cover to your address. As of January 21, 2014, this account had a market value of $46,191.62. Please reference the Correspondence ID listed above on any future inquiries regarding this request. If you have any questions regarding the above information, please call one of our Client Services Representatives foll free at 1-800-959-4246 from 7:00 A.M. t0 6:00 P.M. Central Time, Monday through Friday. We will be glad to answer any questions you may have. Sincerely, �� � Fred Jahnson Correspondence Representative _ _ ,_, , , .. ,. ,. , � ,�.,, �� �,.�....���t ��,:.,�,.�.�� $t � MEMBERS 1St PEDERALCREDITiJNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 8974-00 Date Account Established 11/30/1966 Principal Balance at Date of Death $5.00 Accrued Interest to Date of Death $1.08 Total Principal and Accrued Interest $6.08 Name of Joint Owner None LIFE SAVINGS ACCOUNT: Account Number/Su�fix 8574-04* Date Account Established 11/30/1966 Principal Balance at Date of Death $4,000.00 Accrued Interest to Date of Death $0.33 Totai Principal and Accrued Interest $4,000.33 Name of Joint Owner None *Rollover from 8974-00 on 02/01/2001. CERTIFICATE OF DEPOSIT: Account Number/Suffix 8974-42* Date Account Estabiished 05/14/2012 Principal Balance at Date of Death $53,82129 Accrued interest to Date of Death $13.27 Total Principal and Accrued Interest $53,834.56 Name of Joint Owner None *Rollover from CD 8974-48 opened 10/19/2010 CERTIFICATE OF DEPOSIT: Account Number/Suffix 8974-46** Date Account Established 09/20/2011 Principal Balance at Date of Death $37,699.14 Accrued Interest to Date of Death $11:36 Total Principal and Accrued Interest $37,710.50 Name of Joint Owner None **P.cl!over Frcm C�J R974-47 opened ?0/19!2010. MEMBERS 1ST FEDERAL CREDIT UNION � ���� Tessa L Klugh Lending Insurance Support Specialist February 20, 2014 Estate of: HELEN G MARTER Date of Death: 01/21/2014 Social Security Number: 172-01-8918 5000 Louise Drive • P.O. Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • wwwmemberslst.org LINDEN HALL ANTIQUES 211 N.OLD STONEHOUSE ROAD CARLISLE, PA 17015 717-249-1978 To: James Bogar, Esquire Bogar& Hipps One West Main Street Shiremanstown, PA 17011 From: William G. Rowe,Appraiser 211 N. Old Stonehouse Road Cariisle, PA 17015 Re: Personal Property Appraisaf Estate of Helen Marter Date: February 18,2014 BEDROOM Bed $50.00 Dresser $85.00 Lamps $10.00 Chair $15.00 Prints $15.00 Dresser items $25.00 Miscellaneous household $10.00 BEDROOM CLOSET Dressers(2) $50.00 Dresser items $25.00 Dresser set-porcelain-4 pc. $25.00 Costume jewelry $50.00 DEN Love seat $85.00 T.V./stand/electronics $80.00 Stand $25.00 Lamps/prints $15.00 Bookcases $25.00 Books $15.00 Knick knacks $30.00 Wall hangings $15.00 Pitcher $20.00 LIVtNG ROOM-DINING ROOM Sofa $55.00 Upholstered chairs(2) $30.00 T.V.-no value $0.00 Stereo consofe-no value $0.00 Stand $15.00 Sterling flatware $500.00 Miscellaneous flatware $15.00 Rugs $85.00 Wall hangings $50.00 Marter Appraisal 1 02/18/2014 End tables-lamps $75.00 Glassware-Fostoria $85.00 Bedding $20.00 Cedar chest $90.00 Mirror $25.00 Dining room set $110.00 Jewelry $125.00 Desk $25.00 Clock $10.00 Collectibles $25.00 KITCHEN Kitchen wares $10.00 Pots/pans $15.00 Set dishes $20.00 Flatware/utensils $15.00 Fosforia glassware $25.00 Collectibles $35.00 HALLWAY Desk $20.00 Washstand $115.00 Chair $10.00 Household $5.00 PICTURED ITEMS Dresser $45.00 High chest $50.00 China closet $60.00 Oval mirror $30.00 TOTAL $2,465.00 �-` � William G. Rowe Marter Appraisal 2 02/18/2014 Rev-1509 EX+(p�-10) pennsylvania SCHEDULE F DEPARTMENTOFREVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Marter, Helen G. 21-14-0133 If an asset was made joint within one year of the decedenYs date of death,it must be reported on schedule G. � SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Victoria Dickey Bekelja 439 West Simpson Street Niece Mechanicsburg, PA 17055 B. C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY o�a pF DATE OF DEATH ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD�S DECED NT'S NTEREST NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATfACH DEED FOR VALUE OF ASSE INTEREST TENANT JOINT JOINTLY-HELD REAL ESTATE. 1 A Members 1 st Federal Credit Union-Regular 5.00 50.000% 2.50 Savings Account No.276740-00. Date of death balance$5.00 2 A Members 1st Federal Credit Union-CD No. 124,095.39 50.000% 62,047.70 276740. Date of death balance$124,061.40; accrued interest$33.99 3 A PNC -CD No. 31700241025. Date of death 10,034.94 50.000% 5,017.47 balance$10,033.66;accrued interest$1.28 4 A PNC -CD No. 31800236106. Date of death 27,720.21 50.000% 13,860.11 balance$27,719.47;accrued interest$0.74 5 A PNC -CD No.31500262085. Date of death 32,855.56 50.000% 16,427.78 balance$32,854.13;accrued interest$1.43 6 A PNC -CD No. 5140041827. Date of death 39,797.94 50.000% 19,898.97 balance$39,797.83;accrued interest$0.11 7 A PSECU -Savings (S1)-Date of death balance 11,695.36 50.000% 5,847.68 $11,694.35; accrued interest$1.01 8 A PSECU -CD(S53)-Date of death balance 50,693.16 50.000% 25,346.58 $50,680.04; accrued interest$13.12 Total of Continuation Schedule ee attached page TOTAL(Also enter on Line 6, Recapitulation) 356,473.53 (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-1509 EX+(01-10� pennsylvania SCHEDULE F DEPARTMENTOFREVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Marter, Helen G. 21-14-0133 If an asset was made joint within one year of the decedenYs date of death,it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Victoria Dickey Bekefja 439 West Simpson Street Niece Mechanicsburg, PA 17055 B. C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY o�o OF DATE OF DEATH ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S DECED NT'S NTEREST NUMBER FOR JOIN MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR VALUE OF ASSE INTEREST TENANT JOINT JOINTLY-HELD REAL ESTATE. 1 A Members 1st Federal Credit Union-Regular 5.00 50.000% 2.50 Savings Account No.276740-00. Date of death balance$5.00 2 A Members 1st Federal Credit Union-CD No. 124,095.39 50.000% 62,047.70 276740. Date of death balance$124,061.40; accrued interest$33.99 3 A PNC -CD No.31700241025. Date of death 10,034.94 50.000% 5,017.47 balance$10,033.66;accrued interest$1.28 4 A PNC -CD No. 31800236106. Date of death 27,720.21 50.000% 13,860.11 balance$27,719.47;accrued interest$0.74 5 A PNC -CD No.31500262085. Date of death 32,855.56 50.000% 16,427.78 balance$32,854.13;accrued interest$1.43 6 A PNC -CD No. 5140041827. Date of death 39,797.94 50.000% 19,898.97 balance$39,797.83;accrued interest$0.11 7 A PSECU-Savings(S1)-Date of death balance 11,695.36 50.000% 5,847.68 $11,694.35; accrued interest$1.01 8 A PSECU-CD(S53)-Date of death balance 50,693.16 50.000% 25,346.58 $50,680.04; accrued interest$13.12 Total of Continuation Schedule ee attached page TOTAL(Also enter on Line 6, Recapitulation) 392,494.66 (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-1509 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENTOFREVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Marter, Helen G. 21-14-0133 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY DESCRIPTION OF PROPERTY %OF DATE OF DEATH LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DECD'S ITEM FOR JOIN MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR DATE OF DEATH VALUE OF NUMBER TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUE OF ASSE INTEREST DECEDENT'S INTEREST 9 A PSECU -CD(S54)-Date of death balance 30,410.29 50.000% 15,205.15 $30,402.42; accrued interest$7.87 10 A PSECU -CD(S55)-Date of death balance 41,631.96 50.000% 20,815.98 $41,621.18; accrued interest$10.78 11 A PSECU -CD(S56)-Date of death balance 60,619.25 50.000% 30,309.63 $60,603.56; accrued interest$15.69 12 A PSECU -Savings (S1)-Date of death balance 87,889.18 50.000% 43,944.59 $87,881.60; accrued interest$7.58 13 A PSECU -CD(S55). Date of death balance 41,153.94 50.000% 20,576.97 $41,136.19; accrued interest$17.75 14 A PSECU -CD(S57). Date of death balance 43,238.75 50.000% 21,619.38 $43,227.56; accrued interest$11.19 15 A PSECU -CD(S58). Date of death balance 50,692.51 50.000% 25,346.26 $50,679.39;accrued interest$13.12 16 A PSECU -CD(S62). Date of death balance 20,440.65 50.000% 10,220.33 $20,435.36;accrued interest$5.29 17 A PSECU -CD(S63). Date of death balance 25,523.91 50.000% 12,761.96 $25,517.30;accrued interest$6.61 18 A PSECU -CD (S64). Date of death balance 30,628.73 50.000% 15,314.37 $30,620.80;accrued interest$7.93 19 A PSECU -CD (S65). Date of death balance 55,862.49 50.000% 27,931.25 $55,838.40;accrued interest$24.09 TOTAL(Also enter on Line 6, Recapitulation) 392,494.66 Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule F(Rev. 01-10) .._ .� ,�.�, �,.:� .,�,a.;�--..�,� �,�.�.,�����,�..���. , , _ . _ S � MEMBERS lst FEDERAL CREDIT[JNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 276740-00 Date Account Established 12/17/2005 Principal Balance at Date of Death $5.00 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $5.00 Name of Joint Owner Victoria Bekefja Date Joint Added 12/17/2005 CERTIFICATE OF DEPOSIT: Account Number/Suffix 276740-42* Date Account Established 5/16/2012 Principal Balance at Date of Death $124,061.40 Accrued Interest to Date of Death $33.99 Total Principal and Accrued Interest $124,095.39 Name of Joint Owner Victoria Bekefja Date Joint Added 06/17/2011 '`Rollover from CD 276740-41 opened 06/17/2011. MEMBERS 1ST FEDERAL CREDIT UNION �.,P.daD—�-fi:.� Tessa L Klugh Lending Insur�nce Support Specialist February 20, 2014 Estate of: HELEN G MARTER Date of Death: 01/21/2014 Social Security Number: 172-01-8918 5000 Louise Drive • P.O.Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • wwwmemberslst.org . : � -�.. �:� � .� �� ����.��.�-,� m.�.� _ _ r . ��_h:��;� February 25, 2014 � lames D Bvgar Esq One W Main St Shiremanstown, PA 17011 RE: Name: Helen G Marter 55N: 172-01-8918 DOD: 01-21-2014 Dear Mr_ Bogar: In response to your request for Date vf Death (DOD) balances fvr the custvmer nvted above, vur records show the following: Certificate of Deposit Account#31700241�Z5 Established: �6-26-2004 ' . HELEN G MARTER VICTORIA D BEKEUA DOD balance: �10,D33.66+1.28 accrued interest Interest paid 01-01-Z014thru 01-Z1-2014$0.00 YTD Account#31800236106 Established: l0-14-Z�03 HEIEN G MARTER VICTORIA D BEKEUA DOD balanCe: $z7,719.47+p.74 accrued interest Interest paid 01-01-2014 thru 01-Z1-2014$3.3Z YTD Accvunt#31500z620S5 Established: 05-13-2005 HELEN G MARTER VICTORIA D BEKEUA DOD balance; $32,854.�.3+�..43 accrued interest Interest paid 01-01-2014thru 01-21-Z014$5.53 YTD Pag2 1 of 2 �Checking Accvunt Accaunt#5140�418z7 Established: 07-01-7.968 HELEN G MARTER VlCTORIA D BEKEUA DOD balance:.$39,797.83+ 0.11 accrued interest . Interest paid 01-01-Z014 thru Ol-Z1-2014$0.19 Y7D . I�vestment Account The decedent maintained Investment Account#5296805. For further information,you may call t[,e Brvkerage Department at 1-500-762-6111. Please note that this ofFice provides date of death balance5 for deposit accounts (IRAs,CDs, Che�king and Savings). We dn not pro�ess any financiaf transactions or prnvide statements. If you need assistance with any of these items, please call 1-S8S-PNC-BANK(1-888-762-2265) or stop by your lacal PNC gank branch office, � 5incerely, National Financial Services Center PNC Bank, N.A. Member FDIC . . This messoge is intended far the use of the individudl or entity tv which it is addressed 4nd mvy contain inforrn�tron Yhat is privileged, confidenriol and ex�mpt from disdosure under opplicoble law. !f the reader Qf this messoge is nof the intended recipient or the employe�ar ogenf responsible fo� delivering this message to rhe intended recipient, you are hereby notified that any dissemination, distribution ar copying of this communicprions is strictly prohibited. If you have received this communicatian rn error,please norify me immediately byreply orby telephvne dr800-762-1775 and immediotely destroy this faxed dacument_ Page 2 af Z 0 02/18/2014 James D. Bogar Attorney at Law � 1 W. Main St. Shiremanstown, PA 17011 Re: IiELEN G MARTLR, Deceased. PSECU Reference# 3157576267538 Dear Attorney Bogar: The above referenced person has an account with PSECU which was opened on . October 29, 1999. The Share accounts were jointly held by HELEN G MARTER and VICTORIA D BEKELJA. VICTORIA D BEKELJA was added as a joint owner on December 18, 2007. The following are the Date of Death Balances for HELEN G MARTER's account with PSECU: Account Date of Death Balances Interest—January 1-21 Shares: (S1) Savings $11,694.35 $1.01 (S53) Certificate $50,680.04 $1312—opened 11/22/OS (S54) Certificate $30,402.42 $7.87—opened 12/7/09 "(S55) Certificate $41,621.18 $10.78—opened 10/13/10 (S56) Certificate $60,603.56 $15.69—opened 2/11/11 If you have any questions, please contact our department toll-free at (800)237-7328,press 6, ��tension 3120 or email accountservices(�a,psecu.com. Sincerely, , �tt.�� Sandy Fab ey j�� Member Service Representative PSECU P. O. B O X 6 7 0 1 3 N A R R I S B U R G, P A 1 7 1 0 6-7 0 1 3 800.Z37J328 »psecu.com THIS CREDIT UNION IS FEDERALLY INSURED BY THE NATIONAL CREDIT UNION ADMINISTRATION.EQUAL OPPORTUNITY LENDER. 0 02/18/2014 James D. Bogar Attorney at Law 1 W. Main St. Shiremanstown, PA 17011 Re: riELEN(�MARTER, Deceased. PSECU Reference#3792128930643 Dear Attorney Bogar: The above referenced person has an account with PSECU which was opened on July 11, 1985. The Share accounts were jointly held by HELEN G MARTER and VICTORIA D BEKELJA. VICTORIA D BEKELJA was added as a j oint owner on December 18, 2007. The following are the Date of Deatli Balances for HELEN G MARTER's account with PSECU: Account Date of Death Balances Interest—January 1-21 Shares: (S1) Savings $87,881.60 $7.58 (S55)Certificate $41,13619 $17.75—opened 6/14/OS (S57)Certificate $43,227.56 $11.19—opened 9/15/10 (S58)Certificate $50,679.39 $13.12—opened ll/23/09 (S62) Certificate $20,435.36 $5.29—opened 6/10/11 (S63) Certificate $25,517.30 $6.61 —opened 7/25/11 (S64) Certificate $30,620.80 $7.93—opened 7/25/11 (S65) Certificate $55,838.40 $24.09—o�ened 11/9/11 If you have any questions,please contact our department toll-free at (800)237-7328,press 6, extension 3120 or email accountservices@,psecu.com. Sincerely, %? , c� ;�2;a t�'� �``r,�� �' .� , � Sandy Fagley r� � Member Service Representative PSECU P. O. BOX 6701 3 HARRISBURG, PA 1 71 Ob-701 3 800.237.73Z8 »psecu.com THIS CREDIT UNION IS FEDERALLY INSURED BYTHE NATIONAL CREDIT UNION ADMINISTRATION.EQUAL OPPORTUNITY LENDER. Rev-1510 EX+(OS-09) SCHEDULE G pennsylvania lNTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Marter, Helen G. 21-14-0133 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 DATE OF TRANSFERSATTACH A COPY O TI�E DEIED�OREREAL ESTATE. VALUE OF ASSET �NTEREST ��F APPLICABLE) VALUE 1 ING-Annuity No.2A022358940. David Dickey, 242,382.35 242,382.35 Michael Dickey,Jacqueline Moore and Kathleen Moore are the named beneficiaries of this account. 2 Lincoln Benefit Life-Annuity No. LBF1092709. 436,155.70 436,155.70 Victoria Bekelja,Melissa Wanzer, Kevin Bekelja, M. Brett Bekelja, Rachel Bekelja, Katherine Eisenhower, Michael Dickey and Carol Bender are the named beneficiaries of this account. 3 Merrill Lynch Wealth Management-Account No.872 108,721.32 108,721.32 -14265. Victoria Dickey Bekelja is the named beneficiary of this account. 4 Protective Life Insurance Company-Annuity No. 312,472.67 312,472.67 FK4039934. Katherine M. Bekelja, Brett Bekelja, Kevin Bekelja, Melissa Bekelja and Rachel Bekelja are the named beneficiaries of this account. TOTAL(Also enter on Line 7, Recapitulation) 1,099,732.04 (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) March Z0, 2014 Victoria Bekelja, Executor . 439 Vd Simpson St � M�: Mechanicsburg, PA 17055 'x���; ING USA Annuity and Life Insurance Company Decedent: Helen G Marter _ Contract Number: 2A0235 8940 Claim Code: 03010 Dear Executor, We do not issue IRS Form 712 for this product type;however we are happy to provide the following information in Iieu of IRS Form 712: Owner/Annuitant AccumulationValue, Line of Business: as of the date death O1/21/2014 Helen G Marter $242,382.35 �Tori-Quaiified If you r.a�e questions regarding this information,please contact our Custorner Contact Center, available Monday—Thursday, 8:30 a.m. to 6:30 p.m., Eastern Time, and Friday, 8:30 a.m.to 5:30 . . p.m., Eastern Time. Call 800-369-5303 and press 3 to identify yourself as a beneficiary. When prompted,enter the five digit Claim Code above and press#. Your call will be addressed by a claims specialist. � Sincerely, Customer Service ' INC _ - . . Annuities issued by!NG USA A�muity and Life Luurance Company 1001 Ui Pabe 1 of 1 � I � ^ } , . %. u ReliaStar Life Insurance Company r eUruaiy 24,2014 David Dickey, Michael Dickey, Jacqueline Moore,Katllleen Moore ictoria Bekelj� 439 W Simpson St Mechanicsburg PA 17055 ReliaStar Life Insurance Company Contract Number: 2A02358940 Tax Status: Non-Quali.fied �en::act O:k.�r.e.: H°?�r.P;�urter Claim Code: 03010 Annuitant: Helen Ma�•ter Dear David Dickey,Michael Dickey,Jacqueline Moore, and Kathleen Moore, We extend sincere sympathy in the passing of Helen Marter. The enclosed packet contains documents tailored specifically for this contract and will help you in your decision making process. The enclosed packet contains the following that will help you make decisions regarding the contract shown above: • Claimant Statem�ent Instructions, including general information and directions for completing the Claimant Statement section by section • Claimant Statement to be completed and returned to our Customer Contact Center. • The ING Personal Transition Supplemental Contract that outlines your rights under the ING Personal Transition Account should you elect to receive a lump sum payment. Please refer to the Claimant Statement for additional settlement options available to you. Please keep this letter for your records, as it contains important information for completing the � Claimant Statement. If you have not already sent us a death certificate and IRS fonn W-9,completed on behalf of the beneficiary, please�o so.\%Ve cannot release specific contract information until we receive these documents. If you would like assistance from a financial advisor, you can call our Customer Contact Center for the agent of record on this contract, or you may contact a financial advisor of your choice. If you have questions regarding this information, please contact our Customer Contact Center, available Monday—Thursday, 8:30 a.m.to 6:30 p.m., Eastern Time, and Friday, 8:30 a.m.to 5:30 p.m., Eastern Time. Call 800-369-5303 and press 3 to identify yourself as a beneficiary. When prompted, enter the five digit Claim Code above and press#. Your call will be addressed by a claims specialist. Sincerely, Annuiiy Clai.ms Aimuities issued by ReliaStar Life[nsurance Company �� � � �� � �.� � , _ , .._ � _ _ . _ I LiNCOLN BENEFlT LIFE . AN ALl.sTa7 [ C4M PANY March 13, 2014 , Stephanfe Roelker 3500 Tfindle Road Camp Hill, PA 17011 Re: Helen Marter Contract No: LBF1092709 � Dear Mrs. Roelker, � We rece(vad a reque�t to complete IRS Form 712 for the above referenced cvntract, The purpose of Form 71Z Is to provide an estate vr danor wlth the value of a fiFe insurance ccntract or Its proceeds as of a certain date (usually the owner's date of death or date cf 4ransfer of the contract), � Because thls contract Is an annuity contract, It Is nat reportable on IRS Form 712. i �an, however, provide the fvllowing informatfon for estate purposes: Da#e af Death: January 21, 2014 � Annuity Value as vf Date of Death: $436,155.70• , Named Benef(c(arfes: Vctorie Bekelja, Meilssa Wanzer, Kevin BekelJa, M. BretE 8ekelje, Ra�hel BakelJa, Kafherine �isenhower, Michael D(ckey, and � Caroi Bender � "Thls value fs �n illustration fvr eatate purpcses only, It doe5 not represe�t a cash value or a lump sum with�rawal vffar. If you have any questions, please ccntact rrte at 1-677�499-6418 E�. 24677. , 5incerely, Nicvle D. Lavas Sr. Clafms �xaminer I.Incoln Benefit LiFe Gompany Llfe and Annuity Ctafms P,O,Box 94Z12,Palstine, IL 60094-4Z12 Phone 877-488-8418 Fex 886-635- �35Z3 �'ixr e5 r ���t..1�si�:�7 _`�_ b � . t „ ��:..,.�.,�.,Y. .. �,�.M � �� _ . . i �tr r u �wr «",.^s^ ..::�. . ��� Merrill Lync� Weatth Management�' Hank af America Corporation FACSIMILE COVER SHEET TO: Jamas Bogar PH�NE: FAX: 17177372086 FR�M: Morrill Lynch SENDER: DENISE DOUBLES DATE: Fri Mar 7 10:02:26 EST 2014 PHO N E: 717-975�612 FAX: 1717TT34439 No.of Pago(s)(including this pagoj: 6 Subjact: FW: Martor DOD Evaluation CONFIDENTIALITY NOTE: The informa6on contained in this FAX message is intended only for the aonfidential use of the designated recipient named above.This message may contain contractual and proprietary information and as such is privileged and confidential.If the reader of this message is not the intended redpient or an agent responsible for delivering it to the intended recipient,you are hereby notified that you have received this do�um�t in error,and that any review,dissemination,distribution or copying vf this message is stri�tly prohibited.If you have received this communication in error, please notify us immediately by telephone and refurn the message to us by maiL Mercill L ch Pierce' Fenner�Smith Inco orated Investment roducts Are Not FDIC Insured Are Not Bank Guaranteed May Lose Value 0 2013 Bank of America Corporation.Ali nghts reserved. 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Protective Life Insurance Company ��/��^�/at'�/e�/-k uL V V 1707 North Randall Road,Suite 310 Life Insurance Company Elgin,IL 60123-9409 James Bogar Attorney at Law One West Main Street Shiremanstown, PA 17011 Helen G Marter, Deceased March 10, 2014 Contract No. FK4039934 Claim No. CL 071567 Dear Mr. Bogar: Please accept our sincere sympathies on the death of Helen G Marter. We realize this is a difficult time and are committed to making the claim processing as simple as possible. According to our records, the beneficiary(ies) is/are: Katherine M Bekelja, Brett Bekelja, Kevin Bekelja, Melissa Bekelja and Rachel Bekelja. To process the claim, we will need the following documents: • A claim form completed by each beneficiary. (Copies enclosed. ) Please remind each beneficiary that their signature must be witnessed by a notary public or an active agent with our company. • A certified death certificate (which must include cause of death)- We cannot accept the submitted faxed copy. As requested please find the contract value information: Ol/21/2014 Date of Death: $312, 472.67 3/10/2014 Value: $314,286. 67 Cost Basis: $100, 000.00 We will handle your claim promptly once the above documents are received and in good order. If you have any questions, please feel free to contact the Claims Department at 1-888-397-8485. We will be glad to assist you in any way possible. Since e Chri to her McMahan Claims Examiner REV-1511 EX+�10-09) pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND RESIDENTDECEDENT URN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Marter, Helen G. 21-14-0133 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER q, FUNERAL EXPENSES: See continuation schedule(s) attached 11,506.47 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid 2, Attorney's Fees Bogar 8�Hipp Law Offices 32,550.00 3, Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address City State Ziq Relationshio of Claimant to Decedent 4. Probate Fees 288.50 5. AccountanYs Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 9,326.92 See continuation schedule(s) attached TOTAL(Also enter on line 9, Recapitulation) 53,671.89 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 Marter, Helen G. 21-14-0133 ITEM NUMBER DESCRIPTION AMOUNT Funeral Exnenses 1 Juice&Java-food for the wake 463.15 2 Malpeui Funeral Home -funeral bill 10,593.32 3 St.Joseph's-hall rental for wake 100.00 4 St Pius X Seminary-fee for Gregorian Masses as per Clause FIRST of the Last Will and 350.00 Testament H-A 11.506.47 Other Administrative Costs 5 AT&T,Comcast and Verizon -final bills 170.77 6 Bethany Village-January Rent 1,538.00 7 Bethany Village-February rent 1,538.00 8 Coble's Transfer-fee to move personal property 450.00 9 Commonwealth of Pennsylvania -reclamation of state retirement payment 433.47 10 Cumberland Law Journal-Executrix's Notice 75.00 11 Linden Hall Antiques -personal property appraisal fee 85.00 12 PA Department of Revenue-2013 Personal Income Tax payment 33.00 13 Register of Wills-fee for four(4) Short Certificates 20.00 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 Marter, Helen G. 21-14-0133 ITEM NUMBER DESCRIPTION AMOUNT 14 RESERVES: -Costs to conclude administration of estate, including preparation and filing of 4,500.00 final 2014 Personal Income Tax Returns and Fiduciary Income Tax Returns 15 The Sentinel-Executrix's Notice 158.68 16 Timothy A. Kline,CPA-fee to prepare 2013 Personal Income Tax Returns 275.00 17 U.S. Postal Service-stamps and postage 50.00 H-B7 9,326.92 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Marter, Helen G. 21-14-0133 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT �Words) ($$$) ot List Trustee s I. TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116 a 1.2 See attached schedule Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group, inc. Form PA-1500 Schedule J(Rev.01-10) SCHEDULE J BENEFICIARIES (Part I,Taxable Distributions) ESTATE OF: Helen G. Marter 01/21/2014 172-01-8918 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 1 Victoria Dickey Bekelja Niece One-third of twenty-five 439 West Simpson Street percent of rest,residue Mechanicsburg, PA 17055 and remainder,plus fifty-thousand dollar specific bequest,plus personal property 2 Carol Bender Niece One-sixth of twenty-five 629 N. Market Street,Apt.210 percent of rest,residue Duncannon, PA 17020 and remainder 3 Deborah Jeanne Bennett Niece One thousand dollar 1763 N.900 E. specific bequest Ogden,UT 84414 4 David Dickey Nephew One-third of 25%of 708 Hill Top Drive rest, residue and New Cumberland, PA 17070 remainder 5 Michael Dickey Nephew One-third of 25%of 4810 Arney Road rest, residue and remainder Harrisburg, PA 17171 6 Anthony Gabner Nephew One-fourth of twenty- 708 Falls Creek Drive five percent of rest, W. Melbourne, FL 32904 residue and remainder 7 David Gabner Nephew One-third of one-sixth 164 Eby Lane of twenty-five percent Middletown, PA 17057 of rest, residue and remainder 8 Donald Gabner Nephew One-sixth of twenty-five Box 2859,Foxiana Road percent of rest,residue Middletown, PA 17057 and remainder 1 SCHEDULE J BENEFICIARIES (Part I,Taxable Distributions) ESTATE OF: Helen G. Marter 01/21/2014 172-01-8918 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 9 James Gabner,Sr. Nephew One-sixth of twenty-five 10447 Mountain Road percent of rest,residue Grantville, PA 17028 and remainder 10 Kenneth Gabner,Sr. Nephew One-half of one-sixth of 400 N.3rd Street twenty-five percent of Newport, PA 17074 rest, residue and remainder 11 Lawrence Gabner Nephew One-fourth of twenty- 15 Signal Hill Road five percent of rest, Pine Hill, NJ 08021 residue and remainder 12 Walter Gabner,Jr. Nephew One-half of one-sixth of 1105 State Road twenty-five percent of New Cumberland, PA 17070 rest, residue and remainder 13 William Gabner Nephew One-fourth of twenty- 673 Siegfried Street five percent of rest, Steelton, PA 17113 residue and remainder 14 William Gabner,Jr. Nephew One-third of one-sixth 115 S. Franklin Street of twenty-five percent Harrisburg, PA 17109 of rest, residue and remainder 15 Joanne Marter Khan Sister-in-Law Five thousand dollar 1003 N.W.Shattuck Way,Apt.237 specific bequest Gresham,OR 97030 16 Elizabeth Lentr Niece One thousand dollar 100 Cottage Drive,Apt. 108 specific bequest Palmyra, PA 17078 2 SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Helen G. Marter 01/21/2014 172-01-8918 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 17 Gregory Lewis Marter Nephew One thousand dollar 12/6 Moo 5,T. Don Sai,A.Maung specific bequest Prachaup Kiri Kahn Thailand 77000 18 Lawrence James Marter Nephew One thousand dollar 4814 Brookhurst Road specific bequest Sylvania, OH 43560 19 Robert Alan Marter Nephew One thousand dollar 2860 W.Angela Drive specific bequest Phoenix,AZ 85053 20 Stephen Curtis Marter Nephew One thousand dollar 11238 N. 109th Avenue specific bequest Sun City,AZ 85351 21 Rebecca McClain Niece One-sixth of twenty-five 49 Manny Drive percent of rest, residue Middletown, PA 17057 and remainder 22 Jacqueline Moore Niece One-half of twenty-five 9414 Merry Rest Road percent of rest,residue Columbia,MD 21045 and remainder 23 Kathleen Moore Niece One-half of twenty-five 4100 Third Avenue So. percent of rest, residue Minneapolis,MN 55409 and remainder 24 Frances Gabner Nickoli Niece One-fourth of twenty- 1600 Bear Paw Lane five percent of rest, Hanover, MD 21076 residue and remainder 25 Patricia Peters Niece Qne thousand dollar 9151 Poinsietta Drive specific bequest Scottsdale,AZ 85260 3 SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Helen G. Marter 01/21/2014 172-01-8918 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 26 Raymond Peters Nephew One thousand dollar 3527 Primrose Road specific bequest Philadelphia, PA 19114 27 Bonita Wilsbach Niece One-third of one-sixth 164 Eby Lane of twenty-five percent Middletown, PA 17057 of rest, residue and remainder 4 LAST WILL AND TESTAMENT OF HELEN G. MARTER I, HELEN G. MARTER, of Mechanicsburg, Cumberland County, P.ennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I would like arrangements to be made for the set of 30 Gregorian Masses to be said for me as soon as possible after my death. These can be arranged through St. Alphonsus Church, located at 114 West Saratoga Street, Baltimore, Maryland, 21201. SECOND: I give and bequeath to my niece, VICTORIA DICKEY BEKELJA, of 429 West Simpson Street, Mechanicsburg, . Pennsylvania, all residence and personal effects and other tangible personal property of like nature (not including and excepting, however, all cash, securities, bank accounts, certifi- cates of deposit and like intangible personal property) , pro- vided, however, that should she predecease me, then to her issue � per stirpes by representation. � THIRD: I give and bequeath the sum of Five Thousand and � �._ * No/100 ($5, 000. 00) Dollars to my brother-in-law, GEORGE C. MARTER, of 10113 Desert Hills Drive, Sun City, Arizona, provided, � ��' '�, however, that should he predecease me, then to his issue per � stirpes by representation. ,..-,.s , ``' FOURTH: I give and bequeath the sum of Five Thousand � �"'- and No/100 ($5, 000. 00) Dollars to my sister-in-law, JOANNE MARTER KHAN, of 21 Hazel Circle, Mechanicsburg, Pennsylvania, provided, however, that should she predecease me, then to her issue per stirpes by representation. FIFTH: I give and bequeath the sum of Three Thousand and No/100 ($3 , 000. 00) Dollars to my sister-in-law, ROSALIE MARTER PETERS, of Ecumenical Communities, Inc. , 601 Wilhelm Road, Building No. 2, Room 107 , Harrisburg, Pennsylvania, provided, however, that should she predecease me, then to her issue per stirpes by representation. SIXTH: I give and bequeath the sum of Fifty Thousand and No/100 ($50, 000. 00) Dollars to my niece, VICTORIA DICKEY BEKELJA, of 439 W. Simpson Street, Mechanicsburg, Pennsylvania, provided, however, that should she predecease me, then to her issue per stirpes by representation. SEVENTH: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, as follows: (A) Twenty-five (25%) percent thereof, in equal shares, to the children of my deceased brother, JOSEPH GABNER, said children being WILLIAM GABNER, JAMES GABNER, EILEEN BENDER, ALICE McCLAIN, WALTER GABNER and DONALD GABNER, provided, however, should any of these named individuals predecease me, then their share shall pass to their issue per stirpes by representation. (B) Twenty-five (25%) percent thereof, in equal shares, to the children of my deceased brother, WILLIAM GABNER, said children being LAWRENCE GABNER, FRANCES NIKOLI, ANTHONY GABNER � N and WILLIAM GABNER, JR. , provided, however, should any of these t named individuals predecease me, then their share shall pass to �. their issue per stirpes by representation. t - (C) Twenty-five (25%) percent thereof to my sister, �:. JULIA GABNER MOORE, provided, however, that should she predecease � me, then to her issue per stirpes by representation. . '� `°� (D) Twenty-five (25%) percent thereof to my sister, ,� EDITH GABNER DICKEY, provided, however, that should she prede- cease me, then to her issue per stirpes by representation. EIGHTH: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all proper- 2 ty, exercisable without court approval and effective until actual distribution of all property: (A} To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. � (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F} To exercise any election or privilege given by the � Federal and other tax laws, including, but not necessarily being -�.,_� limited to, personal income, gift and estate or inheritance tax . � laws. � , (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. �� (H) To borrow money from themselves or others in order ��� to pay debts, taxes, or estate or trust administration expenses, �' to protect or improve any property held under my will, and for �,^R investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee 3 stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. NINTH: I direct that all inheritance, estate, trans- fer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of the principal of my residuary estate. TENTH: Al1 interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. ELEVENTH: I nominate and appoint my niece, VICTORIA DICKEY BEKELJA, Executrix of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said VICTORIA DICKEY BEKELJA, I nominate and appoint my nephew, MICHAEL A. DICKEY, Executor of this, my Last Will and Testament. I direct that my Executrix or Executor, as the case may be, and their successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this� � � day of ,�...,�,�-�,.,Cr. , 19 9 7 . i) ,�/ ��., � ,���z�,��� i'��tz..h.1`'..:?,9rJ' (SEAL) HELEN G. MARTER 4 Signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. �r.- Addre s s �--�-��t.r�'4�V� c. r Address � � 5