HomeMy WebLinkAbout04-11-14 � 1505610140
REV-1500 EX (01-10)
OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisbur4 PA 17128-0601 RESIDENT DECEDENT °��� f� �`��'3
ENTER DECEDENT INFORMATION BELOW
Sociai Security Number Date of Death MMDDYWY Date of Birth MMDDYWY
1 1 1 0 2 0 1 1 1 1 0 4 1 9 3 4
DecedenYs Last Name Su�x Decedent's First Name MI
C E K O V I C E L L E N 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
a 1.Original Return � 2.Supplemental Return � 3.Remainder Return(date of death
prior to 12-13-82)
� 4.Limited Estate � 4a. Future Interest Compromise(date of � 5. Federal Estate Tax Return Required
death after 12-12-82)
Q 6.Decedent Died Testate � 7.Decedent Maintained a Living Trust � 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
� 9.Litigation Proceeds Received � 10.Spousal Poverty Credit(date of death � 11. Election to tax under Sec.9113(A)
between 12-31-91 and 1-1-95) (Attach Sch.O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
C H A R L E S E P E T R I E 7 1 7 5 6 1 1 9 3 9
REGI�,�TER OP WILL�E ONLY�
_G � (T�
...'�"�r � �3 G� �
First line of address � -ti � � C,� �
3 5 2 8 B R I S B A N S T R E E T �' =`" � �' +�`� �
°" - n F—+ -;� c�
Second line of address �- �� "��
::�; <::� Q
C_7 �-j � —q _a't '�R
C`7 �� "Y'1 � � �
City or Post Office State ZIP Code � �ATE FILED --�- f7 �
--� Pr
H A R R I S B U R G P A 1 7 1 1 1 � � � �
Correspondent's e-mail address: Pet�lel8w �40L.com
Under penalties of perjury,I declare that i have examined this retum,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.
SIGN�RE OF P RSONg�SPg�S�IB�L�E FOR FILING RETURN DATE
�, �_C��� �C 8/29/2013
ADDRESS
15 Teaberry Circle Carlisle PA 17015
SIGNATURE O�PR ARER,THER TH�RESENTATIVE �9,T_�C' /�`�
�� � �„ lo�
ADDRESS
3528 Brisban Street Harrisburq PA 17111
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505610140 1505610140 J ��
�
J 150561�240
REV-1500 EX
DecedenYs Social Security Number
�ecedent's Name: ELLEN M. CEKOVIC
RECAPITULATION
1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 1 7 0 7 4 7 . 6 3
2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. •
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. •
4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. •
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 5 5 5 7 2 0 . 3 2
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 9 � 2 6 3 . 5 9
7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property
(Schedule G) � Separate Billing Requested . . . . . . . 7. .
8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 8 1 7 7 3 1 . 5 4
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 3 3 9 8 2 . 0 0
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . 10. •
11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 3 3 9 8 2 . 0 0
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 7 8 3 7 4 9 . 5 4
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . 13. .
14. Net Vatue Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. 7 8 3 7 4 9 . 5 4
TAX CALCULATION-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•0_ 0 . 0 0 15. 0 . 0 0
16. Amount of Line 14 taxable
at�ineal rate x.045 7 8 3 7 4 9 . 5 4 �6. 3 5 2 6 8 . 7 3
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 0 0 17. 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 0 0 �g, 0 . 0 0
19. T�4x DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 3 5 2 6 8 • 7 3
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
� 1505610240 1505610240 J
REV-1500 EX Page 3 Flle Number
Decedent's Complete Address: o 0
DECEDENT'S NAME
ELLEN M. CEKOVIC
STREET ADDRESS
6050 Wertzville Road
CITY STATE ZIP
Eno�a PA 17025
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 35,268.73
2. Credits/Payments 40,000.00
A.Prior Payments
B.Discount 1,763.44
Total Credits(A+B) (2) 41,763.44
3. interest
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT.
Fili in oval on Page 2,Line 20 to request a refund. (4) 6,494.71
5. If Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00
Make check payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred: ...................................................................... ❑ X❑
b, retain the right to designate who shall use the propeRy transferred or its income; ............................... ❑ 0
c, retain a reversionary interest;or ................................................................................................ ❑ 0
d, receive the promise for life of either payments,benefits or care? ....................................................... ❑ 0
2. If death occurred after December 12,1982,did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ❑ �
3, Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ 0
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
containsa beneficiary designation?.................................................................................................. ❑ �
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan, 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse i:
3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 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 chiltl 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)j.
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in
72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is defined,undei
Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1502 EX+(01-10)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ELLEN M. CEKOVIC 0 0
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 prope�ty
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 survivorship must be disciosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedenYs interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1. REAL ESTATE AT 6050 WERTZVILLE ROAD 170,747.63
ENOLA, PA 17025
SEE ATTACHED SETTLEMENT SHEET
TOTAL(Also enter on Line 1,Recapitulation,) S 170 747.63
If more space is needed,use additional sheets of paper of the same size.
�w`'�� {��`I N�s� OMB Approval No. 2502-0265
��(* ����`� *L a. Settlement Statement (HUD-1)
Q
98�,;.�r•;��°
B.Type of Loan
1.❑ FHA 2.❑ RHS 3.QX Conv. Unins. 6. File Number: 7. Loan Number: 8.Mortgage Insurance Case Number:
1307160005 101181013071600050
4,� VA 5.❑ Conv.Ins.
C.Note:This form is furnished to give you a statement of actual settiement costs.Amounts paid to and by the settlement agent are shown.Items
marked"(p.o.c.)"were paid outside the closing;the are shown here for informational purposes aFdN me&Addr�e slof Lendeais.
D. Name&Address of Borrower E. Name&Address of Selier MTEGRITY BANK
MALINDA E.ROSS MICHAEL JAY CEKOVIC 3345 MARKET STREET
6250 SOUVENIR DRIVE FRANK J.CEKOVIC
ELIAS J.CEKOVIC CAMP HILL,PA 17011
ENOLA,PA 17025 15 TEABERRY DRIVE
CARLISLE,PA 17015
G. Property Location H.Settlement Agent
6050 WERTZVILLE ROAD CHARLES E.PETRIE
ENOLA,PA 17025 Place of Settlement I.Settlement Date
3528 BRISBAN STREET 08/29/13
HARRISBURG,PA 17111 Disburse Date:S/29/2013
K. Summary of Seller's Transaction
J. Summary of Borrowe�'s Transaction 400. Gross Amount Due To Seller
100. Gross Amount Due From Borrower 175,000.00
101. Contract Sales Price 175,000.00 401. Contract Sales Price
102. Personal Property 402. Personal Property
103. Settlement charges to borrower(line 1400) 5,705.78 403.
404.
104. 405.
105.
Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance
106. Cityltown taxes 8/29/2013 to 12/31/2013 153.88 �06: C u/nty taxes s 8/29/2013 to 12/31/2013 153.88
107. County taxes
108. Assessments 408. Assessments
109. 2013-14 School tax 8/29/2013 to 6/30/2014 1,468.75 409. 2013-14 School tax 8/29/2013 to 6/30/2014 1,468.75
410.
110.
411.
111.
412.
112.
120.Gross Amount Due From Borrower
182 328.41 420.Gross Amount Due To Seller 176 622.63
500.Reduction In Amount Due To Seller
200.Amounts Paid By Or In Behalf Of Borrower 2�000.00 501. Excess deposit(see instructions)
201. Deposit or earnest money 2,875.00
202. Principal amount of new loan(s) t t 5,000.00 502. Settlement charges to seller(line 1400)
203. Existing loan(s)taken subject to 503. Existing loan(s)taken subject to
504. Payoff of first mortgage loan
204.
205. 505. Payoff of second mortgage loan
206. Seller hel with closin costs
3,000.00 506. Seller hel with closin costs 3,000.00
507.
207. 508.
208. 509.
209.
Adjustments for items unpaid by Seller Adjustments for items unpaid by Seller
210. City/town taxes 510. City/town taxes
211. County taxes
511. County taxes
212. Assessments
512. Assessments
513.
2�3' 514.
214. 515.
215. 516.
216. 517.
217. 518.
218. 519.
219.
120 000.00 520.Total Reduction Amount Due Seller 5 875.00
220.Total Paid B IFor Borrower __„ „__� �a e..au........++►n/f►nm SaIIP_f
L.Settlement Charges poc(B/S/L)=Paid outside of closing by:Borrower(B)/Seller(S)/Lender(L)
Paid From Paid From
700. Total Real Estate Broker Fees $
Borrower's Selier's
Division of Commission(line 700)as fo�lows: Funds at Funds at
701. $ t0 Settlement Settlement
702. $ to
703. Commission paid at Settlement
7� to
800. Items Payable In Connection With Loan $ 982.50 (from GFE#1)
801. Our origination charge from GFE#2)
802. Your credit or charge(points)for the specific interest rate chosen � 982.50
(from GFE A)
803. Your adjusted origination charges from GFE#3) 375.00
804. Appraisal fee to KOPPENHAVER APPRAISALS � 40.00
to FIRST AMERICAN CREDCO (from GFE#3)
805. Credit report from GFE#3) 89.00
806. Tax service to COLONIAL SAVINGS � 12.00
807. Flood certification to iTNITED ONE RESOURCES (from GFE#3)
808. to
809. to
810. to
811. to
900. Items Required By Lender To Be Paid In Advance 39.53
901. Daily interest charges from 08/29/13 to 09/01/13 $ 13.1771/da from GFE#10
902. Mortgage insurance premium for months to (from GFE#3)
903. Homeowner's insurance for 1 Y
ears to ERIE INSURANCE (from GFE#11) 569.00
904. to
905. to
1000.Reserves Deposited With Lender (from GFE#9)
1001.Initial deposit for your escrow account
1002.Homeowners insurance months @ $ per month $
1003.Mortgage insurance months @ $ per month $
1004.Property taxes months @ $ per month $
$
1005. $
1006. $
1007.Aggregate Adjustment
1100.Title Charges (from GFE#4) 1,633.75
1101.Title services and lenders title insurance $ �25.00
1102.Settlement or closing fee to CHARLES E.PETRIE (from GFE#5) 50.00
1103.Owners title insurance to CHARLES E.PETRIE $ 908.75
1104.Lenders title insurance to CHARLES E.PETRIE
1105.Lenders title policy limit $ 115,000.00
1106.Owners title policy limit $ 175,000.00
1107.AgenYs portion of total title insurance premium $
1108.Undervvriters portion of total title insurance premium $
1109.Additional title services 125.00
1110.DEED PREP t0 1,000.00
1111.ATTORNEY FEES to
1112. to
1200.Govemment Recording and Transfer Charges (from GFE 7) 165.00
1201.Government recording charges:
1202.Deed$69.00 Mortgage$96.00 Releases$
(from GFE 8) 1,750.00
1203.Transfer taxes 1,750.00
1204.City/County taxlstamps Deed $ 1,750.00 Mortgage $
1205.State taxlstamps Deed $ 1,750.00 Mortgage $
1206. to
1207. to
1300.Additional Settlement Charges (from GFE#6)
1301.Required services that you can shop for
1302. to
1303. to
1304. to
Comparison of Good Faith Estimate(GFE) and HUD-1 Charges
Char,' es that Cannot Increase HUD-1 Line No. Good Faith Esfimate Hl1D-1
Our origination charges
# 801 982.50 982.50
Your credit or charge(points)for the specific interest rate chosen # $�2 982.50
Your adjusted origination charges # 803 982.50
Transfer taxes
#1203 1,750.00 1 750.00
Char. es tha�t in Tota�C�nnat Increase More Than 10%o Good Faith Estimate HUb-i
#1201 165.00 165.00
Government recording charges 375.00
# 804 375.00
A raisal fee # 805 40.00 40.00
Credit re ort 89.00 89.00
Tax service # 806
Flood certification
# 807 12.00 12.00
• . $ 681 00 I� 681.00
�. • � , .
$ or °/
Char es that Can Chan e HUD-1 Line No. Good Faith Estimate HUa-1'
Initial deposit for your escrow account #1001
Daily Interest Charges
# 901 39.53 _ 39.53
# 903 569.00 569.00
Homeowner's insurance 1,633.75
# 1101 1,633.75
Title services and lender's title insurance 50.00 50.00
Owner's title insurance # 1103
Loan Terms
Your initiaLloan amount is $ 115,000.00
Your laan term is 20 years
Yaur initial inferest rate is 4.125 %
Your intial monthly amount owed for $704.48 includes
pnncipal,interest � Principal
and any mortgage insuranee is � Interest
❑ Mortgage Insurance
Gan your interest rate rise? J� No. ❑ Yes,it can rise to a maximum of %.The first change
will be on and can change again every after
.Every change date,your interest rate can increase or
decrease by %.Over the life of the loan,your interest rate is
guaranteed to never be lower than %or higher than °/a•
Even ff you make payments on time,
can your loan balance rise? � No. ❑ Yes,it can rise to a maximum of$
Even if yau make payments=on time, � No. ❑ Yes,the first increase can be on
can yourmonthly amount owed for principal, and the amount owed can rise to$
interestand mortgage insurance rise? The maximum it can ever rise to is$
Does yodr loan have a prep�yment penalty? J� No. ❑ Yes,your maximum prepayment penatly is$
Does yourloan have a balfoon payment? J� No. ❑ Yes,you have a balloon payment of$
due in years on
. 1�f v„��,��n�t havP a monthlv escrow account for items,such as property
REV-1508 EX+(6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS� a MISC.
INHERITANCETAXRETURN pERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELLEN M. CEKOVIC 0 0
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. ACCOUNTS AT FIRST BANK OF MARYSVILLE 274,049.67
2. ACCOUNTS AT INTEGRITY BANK 105,404.65
3 ACCOUNTS AT MEMBERS FIRST CREDIT UNION 50,430.41
4. FRANKLIN TEMPLETON FUND 72,683.65
5. MISCELANEOUS PERSONAL PROPERTY 6,000.00
6. MI�CELLANEOUS REFUNDS 380.36
7. NET PROCEEDS FROM WRONGFUL DEATH SUIT 46,771.58
FILED ON BEHALF OF ELI CEKOVIC
TOTAL(Also enter on line 5,Recapitulation) $ 555 720.32
(If more space is needed,insert additional sheets of the same size)
REV-1509 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENTOFREVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ELLEN M. CEKOVIC 0 0
if an asset was made jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
,4. MICHAEL CEKOVIC 15 TEABERRY DRIVE SON
CARLISLE, PA 17015
B. FRANK CEKOVIC WERTZVILLE ROAD SON
ENOLA, PA 17025
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 2/26/02 DREYFUS INT BOND FUND 31,027.25 50. 15,513.63
2. B 7/31/09 ACCOUNT AT SOVEREIGN BANK 50,000.00 50. 25,000.00
3. B 7/31/09 ACCOUNT A SOVEREIGN BANK 100,000.00 50. 50,000.00
4. B 7/31/09 SOVEREIGN BANK CHECKING ACCOUNT 1,305.53 50. 652.77
5 B 5/18/06 MEMBERS FIRST CREDIT UNION SAVINGS ACCOUNT 194.37 50. 97.19
TOTAL(Also enter on Line 6,Recapitulation) $ g1 263.59
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELLEN M. CEKOVIC 0 0
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
�. 11,838.50
B, ADMINISTRATIVE COSTS:
1, Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2. AttomeyFees: CHARLES E. PETRIE 21,500.00
3, Family ExempGon:(If decedenYs address is not the same as claimanYs,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 643.50
5 Accountant Fees:
6. Tax Return Preparer Fees:
7.
TOTAL(Also enter on Line 9,Recapitulation) 3 33 982.00
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-08)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT�
INHERITANCETAXRETURN MORTGAGE LIABILITIES, & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELLEN M. CEKOVIC 0 0
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
TOTAL(Also enter on Line 10,Recapitulation) $
If more space is needed,inseR additional sheets of the same size.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ELLEN M. CEKOVIC 0 0
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1. MICHAEL CEKOVIC Lineai 246,342.29
2 FRANK CEKOVIC Lineal 306,578.60
3. ELIAS CEKOVIC Lineal 230,828.65
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
A,SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size,
I
LAST WILL AND TESTAMENT i
I �F
�
ELLEN MARY MESSINGER CEKOVIC '
�j I , Ellen Mary Messinger Cekovic, presently of 6050 Wertzville I
,
! Road, Enola, Cumberland County, Pennsylvania, declare this to be my
�I
I.
Last Will and Testament hereby revoking all wills and codicils ;
lpreviously made by me. ,
�
I I declare that I am married to Eli Cekovic and that all
� references in this Will to my Husband are references to him.
„
il I have three ( 3 ) children, now living, whose names and dates
;i
�
II of birth are as follows:
I
;i
; Michael Jay Cekovic October 12 , 1962 '
li Elias Junior Cekovic September 7 , 1965
ii Frank James Cekovic November 13 , 1967
,;
ji All references in this Will to my children include only the '
;;
i children named above. '
I! '
��
'� ARTICLE I
;�
I I direct the payment from my estate of the expenses of my
I I
I; last illness and funeral as soon after my death as conveniently may be '
�� done.
�
,j ARTICLE II
'! '
" I give all of my household furnishings and tangible personal
�j
i; property to my Husband provided he survives me by thirty ( 30 ) days . If ,
;;
'�� my Husband fails to survive me by thirty ( 30 ) days, then I give all of
I
�ii my household furnishings and tangible personal property to my children
;
i
il
, ` i
i
II
to be divided among them as they are able to agree; if they are unable ',
to agree, then said property and furnishings shall pass with the '
residue of my estate. !,
ARTICLE III j
� I give the rest, residue and remainder of my estate to my
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�� Husband provided he survives me by thirty ( 30 ) days . Should my Husband '
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�' fail to survive me by thirty ( 30 ) days then I give the rest, residue ',
and remainder of my estate in equal shares to my children who survive �
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i me by thirty ( 30 ) days . If my Husband and all of my children fail to ,
(� survive me b thirt ( 30 ) da s then I
Y y y , give the rest, residue and
� remainder of my estate in equal shares to my grandchildren who survive
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i me by thirty ( 30 ) days. ,
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�i ARTICLE IV
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�� A. I appoint my Husband as the Executor of this Will . In
;', the event of his death, resignation, renunciation or inability to act
'' in that ca acit then I a
I p y, ppoint my son Michael Jay Cekovic as the '
;i Executor of this Will in his place and stead. '
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!' B. No bond or other security shall be required of any
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Executor appointed in this Will . '
C. The Exe
I cut�r shall receive reasonable compensation for
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j his services performed as determined by the Court in which this Will is
� admitted to probate.
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D. I give my Husband in addition to and not in limitation of '
the powers given by law or by other provisions of this Will , the ;I�
following powers with respect to settlement of my estate, to be '
exercised from time to time in the discretion of my Executor without I'�
i further order or license of the Register of Wills or of any court: '
�� '
�i 1 . To borrow money from any person including any
'� fiduciary acting hereunder, and to mortgage or pledge
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(I any real or personal property;
�� 2 . To hold shares of stock or other securities in
�' nominee registration form, including that of a clearing
� corporation or depository, or in book entry form or
� unregistered or in such other form as will pass by
delivery;
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�j 3 . To engage in litigation and compromise,
iarbitrate or abandon claims ;
'� 4 . To make distributions in cash, or in kind at
� current values, or partly in each, allocating specific
assets to particular distributees on a non-prorata
!� basis , and for such purposes to make reasonable
�' determinations of current values ;
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�� 5 . To make elections , decisions , concessions and
� settlements in connection with all income, estate,
inheritance, gift or other tax returns and the payment
I� of such taxes , without obligation to adjust the
;; distributive share of income or principal of any person
il affected thereby;
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6 . To retain any property, pending distribution '
hereunder, to invest in or purchase any property without '
'j restriction to legal investments for fiduciaries , to
i� distribute property in kind, to compromise claims , and
�I to sell any property at public or private sale; ',
7 . To manage, control , repair and improve all '
;; estate property; ,
il 8• To procure and carry at the expense of the '
estate, insurance of the kinds , forms and amounts deemed
�� advisable by the Executor to protect the estate and the ,
; Executor against any hazard;
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9 . To employ any attorney, investment adviser, �
accountant, broker, tax specialist or any other agent
deemed necessary in the discretion of the Trustee; and '
to pay from the Trust estate reasonable compensation for '�
all services performed by any of them;
10 . To conduct alone or with others any business
i' in which I am engaged or in which I have an interest at
I my death, with all the powers of any owner with respect
,� thereto, including the power to delegate discretionary ,
;� duties to others , to invest other property held '
'i hereunder in such business and to organize a partnership
ior corporation to carry on such business; ',
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j ARTICLE V
,! My Husband and I are executing Wills at approximately the
II
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�i same time in which each of us is the primary beneficiary of the Will of
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�� the other. These Wills are not executed because of any agreement
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�I between my Husband and myself. Either Will may be revoked at any time
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at the sole discretion of the maker thereof.
I�I� ARTICLE VI
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'y If any beneficiary or remainderman under this Will in any �
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manner, directly or indirectly, contests or attacks this Will or any of
�
� its provisions , any share or interest in my estate given to that
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�' contesting beneficiary or remainderman under this Will is revoked and
II shall be disposed of in the same manner provided herein as if that
contesting beneficiary or remainderman had predeceased me without I
issue.
ARTICLE VII
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�; If any provision of this Will or of any codicil thereto is '
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'I held to be inoperative, invalid or illegal , it is my intention that all
� of the remaining provisions thereof shall continue to be fully
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operative and effective so far as it is possible and reasonable. '
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Page 4 of 7 �'
ARTICLE VIII '
All estate , inheritance and succession taxes , together with '
any interest and penalties thereon, payable as a result of my death and
imposed with respect to any property, whether or not disposed of by !,
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this Will , shall be paid out of the residue of my estate. '�
j IN WITNESS WHEREOF, I have hereunto set my hand and seal and
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'� caused this my Last Will and Testament, consisting of �� typewritten
'I pages, including this attestation clause, to be executed, declared and
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�� published this �� day of ���,���,�� , , 1989, at �
II ='�l f j /�� �.,-� � ��,i� i l.,?� _� �-��..� , Pennsylvania. }.
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�; G���.:c�- '? ,�t" -; ' �; � =�.
il ELLEN MARY ESSENGER CEKOVIC
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��' �'1 Residing at �� l/h1�G'C �'�
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Page 5 of 7
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ACKNOWLEDGMENT ',
COMMONWEALTH OF PENNSYLVAPZIA: '
. SS. �'
COUNTY OF DAUPHIN .
I, Ellen Mary Messenger Cekovic, Testatrix, whose name is '
� signed to the attached or foregoing instrument, having been duly
i�
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 ,
���
I therein expressed. ° ,_
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II ELLEN MARY MESSENGER CE OVIC
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� Sworn or affirmed to and acknowledged before me, by Ellen
I Mary Messenger Cekovic, Testatrix, this �� day of
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i '�-yt � , 1 9 8 9. ,
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II Notary u lic
'i My Commission Expires :
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I ��iyT�w�lr'3.:Y€�Fw
I biG?CY L.Ff�,*«''�T/:.^�'PtlEA�
AFFIDAVIT N�Rt;���r(;,C,�l,;�}.?�iv';!,;1i��py
I AAi' "�'r�i!"��d�fi!"r�.K�h �'�tGl� 5 1�
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COMMONWEALTH OF PENNSYLVANIA: t��� , •�, � . , . , ,�..�,; , ,. ,;.;.�
. SS.
�,
COUNTY OF DAUPHIN .
I� we , I�e�2� �.`�w.�ae.,1 , �4 ob�-R.-`4-A �• uJ�w.�1e.� , ,
I and �A.�,� �,ee�t f�R�vJr�l , the witnesses whose names are signed to ,
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the attached or foregoing instrument, being duly qualified according to ',
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law, do depose and say that we were present and saw Ellen Mary '
�
Messenger Cekovic sign and execute the instrument as her Last Will and
Testament, that she signed willingly and that she executed it as her !
;
free and voluntary act for the purposes therein expressed, that each of I,
I us in hearing and sight of the Testatrix signed the Will as witnesses I!
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and that to the best of our knowledge, the Testatrix was at the time '
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�i eighteen or more years of age, of sound mind and under no constraint or
!i
�j undue influence.
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'� Sworn or affirmed to and acknowledged before me, by
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�� �-��•� , ��be.Q.�-�+ �. uJ�Ql ►
�; e� and ,
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I N•!4� 4�e e- �le-w i rJ , t h i s `'�`�` d a y o f �`�L.��9.-rv.�.sL.�, ,
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' 1989.
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� Notary u ic
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i My Commission Expires:
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