HomeMy WebLinkAbout09-02-14 (2) 1505610143
REV-1500 EX(02-11)
PA Department of Revenue OFFICIAL USE ONLY
Pennsylvania County Code Year File Number
Bureau of Individual Taxes W^^n^m
^ *er�aue
PO 60X.280601 INHERITANCE TAX RETURN 21 13 1314
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
12 06 2013 06 26 1929
Decedent's Last Name Suffix Decedent's First Name MI
JOHNSON JACK E
(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. Supplemental Return 3. Remainder Return(Date of Death
Prior to 12-13-82)
❑ 4. Limited Estate 4a. Future Interest Compromise
❑ (date of death after 12-12-82) ❑ 5. Federal Estate Tax Return Required
g Decedent pytl Tesmte 7 pec ger�l Maintained a Living Trust O 8. Total Number of Safe De
Attach CO of N411 Attac o of Trust posit Boxes
❑ 9. Litigation Proceeds Received ❑ 10.bblwean 12-31-�J1 and-11-95)r Death 11.Election to tax under Sec.9113('
(Attach Sched4so) s
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATIO$S LD BE L CTE CP
Name Daytime TelephorS8NOA1b —o rn
CHRISTOPHER E RICE (717) 243a A rn m
M fV „a c3
.� O
REGISTER OF WILILS-USC ONL]�
First Line of Address r— rrt
r
10 EAST HIGH STREET ' Co
Second Line of Address
City or Post Office DATE FILED
State ZIP Code
CARLISLE PA 17013
Correspondent's e-mail address: criceRDmartsonlaw.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
SIGNATU F PERSON RESPONSIBLE FOR FILING RETURN GATE
df_a"1A��..e� Judith J. Fickel as X11
ADDR
10 Bentley Place Carlisle PA 17013
SIGN R OF EPARER OTHERTH EPRESENTATIVE DATE
�• Christopher E. Rice
ADDRESS
10 East High Street, Carlisle, PA 17013
Side 1
1505610143 1505610143
1505610243
REV-1500 EX
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 0 . 00
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 120 , 115 .24
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) a Separate Billing Requested............ 7.
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 120 , 115 . 24
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 26,222 . 12
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 12 , 069 . 87
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 38 ,291 . 99
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12, 81 , 823 . 25
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)............................................... 13.
14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 81, 823 . 25
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.00 15. 0 . 00
16. Amount of Line 14 taxable 81 823 . 25 16. 3 682 . 05
at lineal rate X .045 r r
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00
19. TAX DUE................................................................................................................ 19. 3, 682 . 05
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. El
Side 2
L 1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21-13-1314
Decedent's Complete Address:
DECEDENT'S NAME
Johnson,Jack E.
STREETADDRESS
8 Broad Street
CITY STATE ZIP
Shippensburg PA 17257
Tax Payments and Credits:
1, Tax Due(Page 2,Line 19) (1) 3,682.05
2. Credits/Payments
A. Prior Payments 7,000.00
B. Discount 184.10
Total Credits(A +B) (2) 7,184.10
3. Interest (3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference, This is the OVERPAYMENT. (4) 3,502.05
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)
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 property transferred or its income;.................................. ❑ ❑
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?.........._................_........................................_..........................._.............,. ❑
3. Did decedent own an"in trust for' or payable upon death bank account or security at his or her death?....... ❑ ❑x
4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑ ❑
contains a beneficiary designation?,,......... ............._.....__......__---------...-.............__......................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONSIS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent 172 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 lax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a stepparent of the child is 0 percent(72 P.S.§9116(a)(1.2)1.
• 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 172 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
Rev-1502 EX-(01-10)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Johnson, Jack E. 21-13-1314
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 survivorship 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 Residence-Real Estate located at 8 Broad Street,Southampton Township, Cumberland 0.00
County,PA,known as Tax Parcel No. 39-37-2092-016, being described in that certain Deed
dated 11115/1994 and recorded on 11/17/1994 in Cumberland County,PA Deed Book 114,
Page 1119 and being conveyed to Jack E.Johnson and Betty J.Johnson, his wife. Betty J.
Johnson died on 06105/2007, leaving title solely vested in Jack E.Johnson, Decedent herein.
ASSET SUSPENDED PENDING SALE OF REAL ESTATE.
TOTAL(Also enter on Line 1, Recapitulation) 0.00
(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-0508 EX.(1140)
SCHEDULE E
Pennsylvania CASH, BANK DEPOSITS, Sr MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Johnson,Jack E. 21-13-1314
Inciude Me proceeds of litigation and the date the proceeds were received by the estate,
All property Is n0ya nedw litigation
the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE j
NUMBER DESCRIPTION OF DEATH
1 Cash found in home 380.00
2 Jones&Martin Auctions, LLC-Proceeds from the sale of vehicles,household Items and 10,316.39
miscellaneous personal property
3 Members First Savings Account 28174-00-Date of death value 205.13
4 Members First Savings Account 281744.05-Date of death value 207.22
6 Miscellaneous Cash Deposit-Patriot FCU Prime Share 350140-00 10.31
6 Orrstown Bank Checking Account 513458-Date of death value 57,200.86
Accrued interest on item 6 through date of death 1.96
7 Patriot FCU Money Market 350140-20-Date of death value 51,178.75
Accrued interest on Item 7 through date of death 1.47
8 Patriot FCU Prime Share 350140-00-Date of death value 187.00
Accrued interest on Item 8 through date of death 0.05
9 Social Security Check-Check for November 2013,deposited after date of death 212.00
10 Adams Electric-Patronage refund 40.68
11 Nationwide Insurance-Auto Insurance, refund of overpayment 117.60
12 Sears-Money refunded to the decedent as a result of a corrected billing error on the credit 55.82
card account
TOTAL(Also enter on Line 5. Recapitulation) 120,115.24
(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)
REVA611 EX.(1049)
pennsylvania SCHEDULE H
j
DEPARWENT OF REVENUE FUNERAL EXPENSES AND
RESIDENT OEC ENTTURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Johnson,Jack E. 21-13-1314
Decedent's debts must be reported on Schedule 1.
NUMBER ITEM DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
See continuation schedule(s)attached 12,726.62
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Judith J. Fickel
Street Address 10 Bentley Place
city Carlisle State PA zio 17013
Year(s)Commission Paid 5.804.61
2, Attorney's Fees Martson Law Offices 6,554.61
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zio
Relationship of Claimant to Decedent
4, Probate Fees 413.50
5, Accountant's Fees
6. Tax Return Preparer's Fees 60.00
7, Other Administrative Costs 662.76
See continuation schedule(s) attached
TOTAL(Also enter on line 9,Recapitulation) 26,222.12
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
Johnson,Jack E. 21-13-1314
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Eby Granite Works -Grave marker 424.00
2 Fogeisanger-Bricker Funeral Home,Inc.-Funeral expenses 11,664.02
3 Penny Howland -Reimbursement for Community Center rental 290.00
4 South Mountain Chapel-Meal following funeral service 348.60
H-A 12,726.62
Other Administrative Costs
5 Legal Advertising-The Sentinel 201.16
6 Legal Advertising-Cumberland Law Journal 75.00
7 Nationwide Insurance-Automobile Insurance,pending sale of vehicles 321.26
8 Orrstown Bank,Deluxe Checks-Order of checks for the Estate checking account(qty=25) 16.25
9 Orrstown Bank, Deluxe Checks-Order of checks for the Estate checking account(qty=25) 16.25
10 Penny Howland-Reimbursement for paying D&L Gulf to service,maintain and prepare 32.86
decedent's vehicle for sate
H-B7 66178
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-0512 EX.(12 48)
SCHEDULE i
Pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Johnson,Jack E. 21-13-1314
Report debts Incurred by the decedent prior to death that remained unpaid at the data of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Adams Electric-Electricity,account payable 33.67
2 Borough of Shippensburg-Water,account payable(for service from 10/l/13 to 12/31/13) 38.20
3 Chapel Pointe of Carlisle-Account payable 9,753.67
4 Chapel Pointe of Carlisle-Account payable 20.23
5 Cumberland Franklin Joint Municipal Authority-Sewer,account payable 36.75
6 Cumberland Goodwill Fire Rescue EMS-Account payable(date of service 10/27113) 52.03
7 Cumberland Goodwill Fire Rescue EMS-Account payable(date of service 12103113) 731.46
8 Cumberland Goodwill Fire Rescue EMS-Account payable(date of service 10127113) 727.44
9 Millenium Pharmacy-Account payable 36.38
10 Millenium Pharmacy-Account payable 21.04
11 United States Treasury-1040A for 2013 619.00
TOTAL(Also enter on Line 10, Recapitulation) 12,069.87
(If more space Is needed,additional pages of the same size)
Copyright(c)2008 form software only The Lackner Group,Inc. Form PA-1600 Schedule 1(Rev. 12-08)
REV-1510 EX.(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Johnson,Jack E. 21-13-1314
RELATIONSHIP TO
NUMBER NAME AND ADDRESS OF DECEDENT SHARE OF ESTATE MOUNT O ESTATE
PERSONS}RECEIVING PROPERTY (Words) ($$$$)
Do Not Ustlrnarf�.l I. TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
Judith J.Fickel Daughter One-quarter 20,455.81
10 Bentley Place share of residue
Carlisle, PA 17013
Penny Howland Daughter One-quarter 20,455.81
101 Rustic Drive share of residue
Shippensburg, PA 17257
Scott Moose Grandson One-eighth share 10,227.91
11098 Hurley Drive of residue
Shippensburg, PA 17257
Todd Moose Grandson One-eighth share 10,227.91
3537 Couchtown Road of residue
Loysville,PA 17047
Darlene Stevenson Daughter One-quarter 20,455.81
1466 Woods Road, Lot 27 share of residue
Shippensburg,PA 17257
Total 81,823.25
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate,
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B,CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
f TILE$$t.1,1126511 luh.,.n 12651 1 wi11 wpd
LAST WILL AND TESTAMENT
I, JACK E. JOHNSON, of Southampton Township, Cumberland County, Pennsylvania,
being of sound and disposing mind and memory,do hereby make,publish and declare this to be my
Last Will and Testament, hereby revoking any and all former Wills or Codicils made by me.
1.
I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and
all death taxes(whether such taxes may be payable by my estate or by any recipient of any property)
shall be paid from my residuary estate as soon as practicable after my decease and as part of the
administration of my estate. My Executrix shall have no duty or obligation to obtain reimbursement
for any such tax so paid,even though on proceeds of insurance or other property not passing under
this Will.
2.
I give, devise and bequeath all the rest, residue and remainder of my estate, both real and
personal property, in the following manner:
a. One share unto my daughter, JUDITH J. FICKEL;
b. One share unto my daughter, DARLENE STEVENSON;
C. One share unto my daughter, PENNY HOWLAND; and
d. One share equally unto my two grandsons, SCOTT" MOOSE and TODD MOOSE.
In the event any beneficiary named in Items 2(a),(b),or(c)shall predecease or fail to survive
me by more than thirty(30)days,then her share shall be distributed to her issue, per stirpes,and in
default of any such living issue, such share shall be distributed to the surviving beneficiaries named
in this Item 2.
In the event any beneficiary named in Item 2(d) shall predecease or fail to survive me by
more than thirty(34)days,then his share shall be distributed to his issue,per stirpes,and in default
of any such living issue, such share shall be distributed to the surviving beneficiary named in Item
2(d). If there is no living beneficiaries under Item 2(d),then the share allocated to Item 2(d) shall
be distributed to the surviving beneficiaries in Items 2(a), (b), and (c).
7niti " ]
Page 1 of 3
i
3.
I nominate, constitute and appoint my daughter, JUDITH J. FICKEL, as Executrix of my
estate. In the event she shall be unable or unwilling to so serve, then I appoint my daughters,
DARLENE STEVENSON and PENNY HOWLAND, as co-Executors of my estate.
4.
I direct that all fiduciaries acting under this Will, whether or not named herein, shall not be
required to give bond for the faithful performance of their duties in any jurisdiction.
5.
I authorize and empower my Executrix,or her successor,in her sole and absolute discretion,
to purchase or otherwise acquire and retain any investments of which I die seized or any real or
personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or
grant options in regard to any or all property of any kind forming a part of my estate for such terms
and such prices as they may deem advisable;to borrow money for any purposes connected with the
protection and preservation of my estate;to mortgage or pledge any real or personal property forming
a part of my estate or to join in or secure the partition of same; to compromise any claims or
demands of my estate against others or of others against my estate;to make distribution in kind and
to cause any share to be composed of cash, property or undivided fractional shares in property
different in kind from any other share; to employ agents, attorneys and proxies and to delegate to
them such powers as my Executrix, or her successor, considers desirable and to pay reasonable
compensation for such services as may be rendered by such agents, attorneys and proxies; and to
execute and deliver such instruments as may be necessary to carry out any of these powers. In
addition, I direct that my Executrix, or her successor,shall have the power to conduct an inventory
of any safe deposit box necessary to the administration of my estate.
IN WITNESS WHEREOF I have hereunto set my hand and seal this 24`h day of
September, 2013.
-.` {SEAL}
ack E. Johnson
SIGNED,SEALED,PUBLISHED AND DECLARED by the above-named Testator,as and
for his Last Will and Testament,in the presence of us,who at his request,have hereunto subscribed
our names as witnesses thereto, in the presence of the said Testator and of each other.
Page 2 of 3
COMMONWEALTH OF PENNSYLVANIA }
SS.
COUNTY OF CUMBERLAND )
We,Jack E. Johnson,Christopher E. Rice and the
Testator and the witnesses,respectively,whose names are signed to the foregoing instrument,being
first duly sworn,do hereby declare to the undersigned authority that the Testator signed and executed
the instrument as his last Will and that the Testator has signed willingly, and that the Testator
executed it as his free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the Testator, signed the Will as a witness and that to the
best of his/her knowledge the Testator was at that time eighteen years of age or older,of sound mind
and under no constraint or undue influence.
Jkk E. Johnson, estta�tor
Witness
�
Witness �`���
Subscribed, sworn to and acknowledged before me by Jack`E. Johnson, the Testator, and
subscribed and sworn to bef re me by Christopher E.Rice and
the witnesses, this day of September, 2013.
= �f/ .tad
Notary Public
COhtMiONWEA LTH OF PENNSYLVANIA
N<YrARlf;L SEAL
Victoria L.C!to,Notary Public
Carlisle Boro,Cumberland County
My commission expires December 20,2014
Page 3 of 3
fV1t
MEMBERS Vt
FEDERAL CREDrr UNION
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 281744-00
Date Account Established 03/17/2006
Principal Balance at Date of Death $205.13 SEC— SG'7&0 u Ce7
Accrued Interest to Date of Death $0.00
Total Principal and Accrued Interest $205.13 = #3
Name of Joint Owner None
INVESTMENT SAVINGS ACCOUNT:
Account Number/Suffix 281744-05
Date Account Established 03/17/2006
Principal Balance at Date of Death $207.22 l E
Accrued Interest to Date of Death $0.00 sC��z,cF)
Total Principal and Accrued Interest $207.22 -:r1-J�m # Ll
Name of Joint Owner None
SAFE DEPOSIT BOX: NONE
MEMBERS 1ST FEDERAL CREDIT UNION
Tessa L Klugh
Lending Insurance Support Specialist
January 9, 2014
Estate of: JACK E JOHNSON
Date of Death: 12/06/2013
Social Security Number: 202-20-4688
5000 Louise Drive • P.O. Box 40 • Mechanicsburg, Pennsylvania 17055 • (800) 283-2328 • www.memberslst.org
ORRSTOWN
BANK
A Tradition of Excellence
December 30, 2013
Martson Law Offices
10 E High St
Carlisle, Pa 17013
Fax: 243-1850
Re: Estate of Jack E Johnson
Social Security Number 202-20-4688
Date of death 12/6/I3
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD THE
FOLLOWING ACCOUNT WITH ORRSTOWNBANK:
CHECKING ACCDUNT
Account No.- 513458
Account Type- 50+Interest Checking SGr SC h&V Ln(E
Account Title-
Jack E, Johnson
Date Opened- 10/1/82 S'I El Y1 6
Joint Account(name/date)- No
Balance- $57,200.86
Account Interest- $1.96
Beards,
Kim over
Deposit Processing Clerk
2695 Philadelphia Avenue •Chambersburg, PA 17201
atriot
FEDERAL CREDIT UNION_
Catch rite Spirit of Financial Freedom - - - - — -- — - .-- --- - -- -- - -- - -
January 10, 2014
Martson Law Offices
Attn: Dena S Brumbaugh
10 East High Street
Carlisle, PA 17013
RE: Jack E Johnson Estate
To Whom It May Concern:
I am writing in regards to your request for date of death values on the above referenced
member. This account was in the sole name of the deceased.
Account Date of Interest Accrued Open Date
XXXXXXO140 Death Principal Rate Interest to DOD
Prime Share (00) $187.00 0.150% $0.05 02/01/1971
Money Market (20) $51,178.75 0.349% $1.47 07/05/1990
If you have any questions with regard to the above balances, or need additional information,
please contact a Membership Officer at 717-263-4444.
Sincerely,
Patriot Federal Credit Union rnohe� M; iU;F-'7- _ SIFG SCIIEI?it IE
rz,mF s+i6-fE — sE�E sc. IE rPV L = �,