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02-1013
Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS No. f ~~~'~ 13 _ Estate of Sara R. Klin let also known as ,Deceased Social Security No. 195 - 07 -1398 Linda Ma Lefko Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the executrix named in the last Will of the Decedent, dated 07~10~1979 and codicil(s) dated None Decedent's s ouse, Paul C. Klin let died Jan. 31, 1992 State relevant circumstances, e.g.. renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: none B. Grant of Letters of Administration (c.t.a.; d.b.n.c.t.a; pendente liter durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and or principal residence at 2174 Yale Ave., Boro of Cam Hill, Cam Hill, PA 17011 (list street, number, and municipality) Decedent, then 91 years of age, died 11~03~2002 at Cam Hill, PA (Location) Decedent at death owned property with estimated values as follows: $ 90 , 000.00 (If domiciled in PA) All personal property $ (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ 110 , 000 .00 Value of real estate in Pennsylvania situated as follows: 2174 Yale Ave., Boro of Cam Hill, PA Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the a ro riate form to the undersi ned: T ed or tinted name and residence Si nature ~ Linda May Lefko 9'S _ 7lI~~, 1427 Aspen Court , West Chester , PA 19380 17 /Do - (o Form fRW-1 (1991) Prepared by the Pennsylvania Bar Association .. _____.. roc..~tomc Inc. (COMPLETE IN ALL County, Pennsylvania with his/her ast amly Decedent was domiciled at death in Cumberland Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ~ ~ ~~ Linda May Le o before me this 13 day of November ,2002 ~~~~ For the Register Donna M. Otto,lst Deputy No. 21 2on2 1(11 R Estate of Sara R Klingler Deceased Social Security No: 195 - 07 -1398 Date of Death: 11/03/2002 AND NOW, November 14th 2002 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary ~ Of Administration (c.t.a.; d.b.n.c.t.a.; pendente life; durante absentia; durante minoritate) are hereby granted to Linda May Lefko in the above estate and that the instrument(s) dated 07/10/1979 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES !~ ~- ~~ ~ ~ ~~~ Letters . $0 ~~5~~ Register of Wills Short Certificate(s). 5... $ 15.00 Donna M. Otto, 1st Deputy Renunciation. $ Attorney: John E. Slike Affidavits ( ) $ I.D. No: 06262 Saidis, Shuff, Flower & Lindsay Extra Pages (2 ) ~ ~ $ 6.00 Address: 2109 Market Street Codicil. .. .. $ Camp Hill, PA 17011 JCP Fee .......... $ 10.00 Telephone: 717/737 - 3405 Inventory. $ Other $ MAILED LE'1"I'ERS TO A'I'I'OI2NEY SLIKE ON 11-14-2002 TOTAL. $ 266.00 Prepared 6v the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-~ (1991) .;I,y 'r, _ . .,.. .3 .' `?}dTl.=.1 iit') .G,tr' (5 C(~.'fl'CCIV C(:1?l..C~ ii'17I71 ill I Cl~'1fl<~~ ~~I£1~F..1,~` - r ._ ,. (1 !; ,-~. 1~' 15 It1~;il _ '! '.]( ~ ;.'i? . '-i'c-lr2 F;-~1 Itl film/d;-C:.GC~ [t~ rl'ie `>17Tt' ti~lC2i ~heCOTI~S {.~C~1C%` itil ...~ `s:2, :»~,' ~-,a: i~~ i~ illegal t~ duplicate ~hi~ cc~~Y b~ photostat or ~~t~feet~rr:ai~`s'~, ,~~~~~(N 6f oE~~'~ _ ,~ ,, ~, ~ ~ - I . d. ~: ~ l ,,~ L.aa ;i d ~. ~ p 6 2p4 P 8 6 4 3 7 4 ~ ```~.~; _ ~~~~~;~~ ~~0 -- _ _ _ - - __ _ _ _ - - hff NT 0 , -.,~~_„r,~,r ~ _ - S~~ULU READ AS F©LL~`/v4; ~~r~:,1 n3 Rev. vB7 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH STATE FILE `LUMBER NAME OF DECEDENT (F~rv. Midtlle. ~~a9) SEX SGCIAL SECURITY NUMBER DATE '.D/EATM,MarN. Day. reay Female e -~~~ ~ ~ ~ h ~ ~; 195 - 07 -1398 ~~ O~KI~, Klin ter :. T ,. ra R . AGE (Last Birtnaay) UNDER 1 YEAR UNDER 1 DAY GATE OF BIRTH BIRTHPLACE ;Cdy artl PLACE OF DEATH iCnecF rxvy nr~e -- ,ee ~nslnx:lKn~v nn an•e~ vdel Momhs , Day Hours , Mvales 1MOnm. Uay. reed Stale or Fcre~yn Counayl HOSPITAL. OTHER: Inpaoenl~ ER/Outpatwm LJ DOA ^ Hom~ ^ Readsnu ^ specMl ^ 8-4-11 Marysville, PA 91 Yn. ~ M . e. S , - COUNTY OF DEQH CITY, BOFiO. TWP OF DEATH FACILITY NAME (II pat mv~lulan. g,ve slreel and numceri WAS~~DF(,GEDENT OF HISPANIC ORIGIN? RACE - AmerKan IrWian. &ack, Whoa. etc. ISpecM) ^ u C ban N Y yaa. speaN u . ea o lJ Clrnbesland E. Pennsboro ~ t~ {-~ 5 f I ~ l 1 ~~ ~S~i i I ~ l-. Mexican. Puerto Rican, ac White • ee. k. ad. 9. 10. DECEDENT'S USUAL OCCUPATION KING OF BUSINESS/INDUSTRY WAS DECEDENT EVER IN DECEDENT'S EDUCATION MARITAL STATUS-Marned SURVIVING SPOUSE (11 e,le. Jive maiden name) Widowed radecmt letea Naver Marnsd ne n est S , , ~ o . (Give kurd olwpk done Owxtg most U. S. ARMED FO..RiiC~~E S? A6 ElamenlarylSecondary Coaega Divacaa ($peaN1 of workirp INe: w n01 use releedJ Y ^ N o ea 12t43~1 "'«5«, Widowed 1 ire, tx. 13. ,.. 3.. __ _ - ,,,, Homemaker , -- - - DECEDENT'S MAILING ADDRESS(Street. Clry/TOwn. State. Ip Cooel DECEDENT'S Pennsylvania 17a^ VM woeeaM kvad in ~' 2174 Yale Avenue . ACTUAL 17e. Stale Did RESIDENCE decsdara liw m a PA 17011 ill ISee mwuctans tdwnahtp? „d~~~m°K, ~M,~„ E. Pennsboro 'Itivp. ~~,~ onanersdel C~unberland , Camp H 1s _ 1Te.coanly - ------ . FATHER'S NAME(First. MiaWe. Lasq Raymond E. Koontz MOTHER'S NAMEtFasl, Middle. MaiwnSurname) Clara M. HuRmel u. 1st. -- -- - INFORMANT'S MAILING ADDRESS (Slreel.CMRown, Stale. Zlp Code) INFORMANT'SNAME(TypatPnnO Westchester, PA 19380 n Ct 1427 As inda Lefko xa. -. ., _ _ Zoe. . ~ DATE OF DISPOSITION N METH000F DISPOSITI O PLACE OF DISPOSITION - Nama al Cemetery. Crematory LOCATION ~ CM/Town, Sula. Zip Caw t p ~ Burial !SJ Cnmalion ^ Removal lrom Slats ^ (MOrxh, Day. Y6ar) ^ 11-9-02 or Other Place John's Cemetery Camp Hill, PA 17011 St DOn.lion^ OlharespapAyt . 21d. 21c 11a. xiD. . DDRESS OF FACILITY ' SIGNATURE OF FU RAL S LI SEE OR PERSON ACTING AS SUCH LICENSE NUMBER NAME AND A PA 17011 C H 012755-L 22 ers-Harper FH 1903 Mitt St - 2xe _ . xxa Complela aem Sat omy when w M^9 To Ina Des1 of my knowlatlge. wam occurred al the nme, dale and place slated. LICENSE NUMBER DATE SIGNED (Monet. DaY. Pearl Ohysiciert is vaitable>t lime al waln to lSgnalW a antl Title) ' candy WIl9e warn. _ 27a. 23e. 27c. -_._. - - ~, ~ Nama 2A48 mual be completed by TIME OF DEATH /~ DATE PRONOUNCED DEAD (Monet, Day. Year) WAS CASE REFERRED TO MEDICAL EXAMINERICORONER? ^ t'tO • person who pronounces warn. ~ ~ y I_ 1 ~~ 2 J ~ ~ V ~'1 p~ n Yea -_ Yh~ ~L / +-I 0 _ - _.- - Y 1. M. x5. te, 27. PART 1: Enter the diseases, injuries or canplaatans which caused IM warn. Do not emer the mode of dying, such as carduc or respnamry anasl, shock or heart IaAure t Approxrmaro PART 11: Dinar stgnificam corWadns mntribuling to wath but ~ interval belwean na resulting m IM urrderlymg ratxca given In PART I. List only Ona cause on each kne. I Onset drd wem IMMEDIATE CAUSE (Fna1 H~ ,^ tlte0a58 Or COndean ~. ~LrK~LV'~ ~IriuN~.y/~J. ~~ ` / _ ^~~i~ , T1 I I esWkng to walnl-~ a. DUE TO TOR ASACONSEOUENCE F): r ; -J 7 - ~ T G ~t/~- L V`CG'~ A $aglWnllaey ksl condndna b. I OUE TO (OR AS A CONSEQUENCE OF): i1 any, Iaadkp to xnmadrale I Q _ ~ ~ l cause. Enlar UNDERLYIND • CAUSE IDtsease or mNry c. --- - • CON EOUENCE OFT: -_ ' R AS A roar k,aialed events DUE T'OT (O {{S r IS • / ~ JJ ~~ ~~ resuaugawam)LAST U~y'/~/HIX..A1_L' d --- - -. WAS AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF D H GATE OF INJURY TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED. PERFORMED? AVAILABLE PRIOR TO (MOnm. Day. Year) COMPLETION OF CAUSE Naturel .~ Homicda ^ OF DEATHI Yas ^ No ^ Accdant ^ Perdng lnvesligalbn ^ M. 30c. 70d. _ w _-.- 30a. _ ~ _ Yea ^ No ~ Yes ^ No ^ Suiciw ^ Could not w determined ^ PUCE OF INJURY - AI tame tar .weal. factory, otlica LOCATION (Street. GNR vet. Seale) Dwldinq. arc. tSpecdvl 701 . - - 2M. 2aD. 29. 3w. SIGNATURE TIT RTIFIER CERTIFIER IC1`eck only ape) 'CERTIFYING PHYSICIAN (Phys~aan cendymq cause of death caner anolner pnv~~c~an pas pronounced dealn and completed hem 231 / / ~---- /~~- L ~1 .. _- To du Daat of mY knowladga, daslh Occurred due to tM cauaNsl and manner as stated ... ...... ....... .... ... ...... .. ..... 71 e. LICF;NSE NUMBER [J~Q DATE SIGNED Monet Oay. Pearl `~ /~~ ~ ~~ ' O~ 'PRONOUNCING ANO CERTIFYING PHYSICIANIF'tiyvc an ann ,:iw pu~K ng dealhu Alen ly,ny a~au~x of death) --~ MO 7/ a __ 710___ _ __. I 71c. ___ - _ ______ _ To INe beat of my knowledge, Beam xcurrad al IM beta, date, and place. and dud to lM cause(s) and manner as stated .......................... NAME AND ADDRESS OF PERSON WMO COMPLETED CAUSE OF DEATH pleni 11) Type or Pnnl ~. G JV 87.5/! sT~LMbV /C 'MEDICAL EXAMINER/CORONER 747 /O/<ye,L C/7IY/Z(/17 ~. On the basis of examination andlor investigation, in my opinion, deem occurred at the time, date, and place, and due Io the cause(s) app GAN/A//C..C~/A 7/O// ........................................................_..................................<. . manner as atated .. . 7x. 71a. _-- - ~'jIGNATURE ANO~UMBER / _.i REGISTRA R', __ Jl T ~ / / / DATE FILED(MUnln. Oay/Yeah / ~ ~ / ~ :Lcdt.t: ~~~----' ._ C.,C~'h',.~/ j ~ 7A. a~~ C~ .;/{ ~ O 1' - ~7 a~ va-~oi3 LAST WILL AND TESTAMENT OF SARA R. KLIIQGLER ARNOLD, SLIHE Ec BAYLEY ATTORNEYS sTHLAW CwrP H~tc,Pexxsr ~vwxu i~o ~ Cwnr NiiL,Pexxsrc nxu i~oi~ I, SARA R. KLINGLER, of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any will previously made by me. I - I direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II - I devise and bequeath all of my estate of whatever nature and wherever situate unto my husband, Paul C. Klingler, providing he survives me by sixty (60) days. III - Should my said husband fail to be living on the sixty-first (61st) day following my death, then I devise and bequeath all of my estate of whatever nature and wherever situate unto my children,. Linda P~tay Lefko of Exton, Pennsylvania and Wayne C. Klingler of Camp Hill, Pennsylvania, in equal shares per stirpes. IV - In the event my husband is deceased and I still own real estate in Camp Hill, Pennsylvania, my son, Wayne C. Klingler, shall have the right to purchase the real estate at its appraised value. V - I appoint CCNB Bank, N.A, of New Cumberland, Pennsylvania, guardian of any property which passes under this will or otherwise to a minor or an incompetent and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so. Such guardian shall have the power to use principal as well as income from time to time for the minor's education and support or to make payment for those purposes without further responsibility to the minor or to any person taking care of the minor. The said guardianship shall terminate as to each beneficiary when he or she reaches the age of 21 years. r ,T _. .,' ~~,,.. -.-~: rr..... ~ ;i ~ ~ L~ .~`~' ~ Page 1 f}. Page 2 nsr~oi~, a rc2: a< aen.~ ATTl /11N1:Y1 AT LAN 211! YA\tff tfft3r c~uv wa. MItYLtAN111 n0 COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND) I, Sara R. Klingler , the testatrix whose name is signed to the attached or foregoing instrument, having been duly quali- fied according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it will- ingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, b ~ Sara R Klingler the testat rix this _~ day of , 19 79 . L Notary Public KIM E. KEIIK, Notary Public Camp Hill, Cumberland CJ.. Pa. My Commission Expires Gct. 75, 1491 COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND) WE, the undersigned the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose ar,d say that we were present and saw the testat rix sign and execute the instrument as her Last Will; that Sara R. Klingler signed willingly and that Sara R. Klingler executed it as herfree and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to and subscribed before me this ~~ day of , 19 79 ~ ry Public K!M E. KELtY, -Notary Pubtic Camp Hiit, Cumberland Co., P~. My Commission Expires Oct, 25, 1932 VI - I appoint my husband, Paul C. Klingler, Executor of this, my Last TJVill and Testament. Should my said husband fail to qualify or cease to act as such, then I appoint my daughter, Linda l~~ay Lefko, to act in this capacity. Neither of my personal representatives shall be required to post bond in this or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, the 't~~~ day of wl~~~(~ , 19 7 9 . /~,l ~;.~ t~C.~~ ~ ^) ,/`~'f l1/~~7L~'.-~C'_ti. ~ SEAL) Sara P.. Klingler/ Signed, sealed, published and declared by SARA R. KLINGLER, Testatrix therein named, on this and one (1) other sheets of paper as and for her Last Will and Testament in our presence, who, in her presence, at her request and in the presence of each other, have hereunto subscribed. our names as attesting witnesses. C -~X ~ Name Address ~ ~ ~ ~ Name Address ` ARNOLD, SLIEE Bc BAYLEY ATTORNEYS AT LAW C:wwv Nii~,Pexxsrvnxu i~o~~ Page 2 C P o 0 R N R 0 E E S N T C o M P T U A T X A T I o N 11,,/rJrJ,~ REV-150Q EX + If 00) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COUNTY CODE SOCIAL SECURITY NUMBER 195-07 -1398 THIS RETURN MUST BE FI.ED IN DUPUCA FILE NUMBER o E C E o E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128.Q601 DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) K1in 1er Sara R. DATE OF DEATH (MM-DD-YEAR) /,:\ L~ OFFICIAL USE ONLY 21-02-01013 YEAR NUMBER DATE OF BIRTH (MM-DO-YEAR) 1I~1J1J'li'~02 08/04 1911 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) REGISTER OF WILLS SOCIAL SECURITY NUMBER Supplemental Aetum ~~r~~re!lCOmpromise (date of death after 12-12- 2) Beqet1edt Maintained a Living Trust 0 ~pyofTrust) Spousal Poverty Credit o 11. 3. S. 8. (da p" Federal Estate Tax Return X 1. OnginalRetum 2. CAPB 4. Limited Estate 4a. HpRL X 6. Decedent Died Testate 7. EplO CRAC (Atlach copy 01 Will) KOTK 09. Litigation Proceeds RecelvedD 10. ES Remainder Retum Total Number oi Safe Depo Election to tax under Sec. 9 .. . "ffll$[$Ee'ClQ . .. 'mill_. NAME COMPLETE MAILING ADDRESS John E. Slike FIRM NAME (II Applicable) Saidis, Shuff, Flower & Lindsa TELEPHONE NUMBER 2109 Market Street Camp Hill, PA 17011 () ONLY ::3: ?:;( I (Xl a 0 i.Jl 0 (8) 284,483.01 (11) 42,852.49 (12) 241,630.52 (13) (14) 241,630.52 R E C A P I T U L A T I o N 1 3 -3405 lReal Estate (Schedule A) 2Stocks and Bonds (Schedule B) 3Closely Held Corporation, Partnership or Sole-Proprietorship 4Mortgages & Notes Receivable (Schedule D) 5Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6Jointly Owned Property (Schedule F) Deparate Billing Requested 7Jnter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) BIotal Gross Assets (total Lines 1-7) 9Funeral Expenses & Administrative Costs (Schedule H) 1QJebts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 1 TT otal Deductions (total Lines 9 & 10) 131et Value of Estate (Line 8 minus Line 11) 13:haritable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 1a11et Value Subject to Tax (Line 12 minus Line 13) (15) (16) (17) (18) (19) 0.00 10,873.37 0.00 0.00 10,873.37 (1) (2) (3) (4) (5) ~.. ~)le 2,63fi.,jL6 (6) 65, 999..;jP ::r-",,:::t (7) None (9) (10) 41,627.48 1,225.01 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15C\mount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 160.mount of Line 14 taxable at lineal rate 17Amount of Line 14 taxable at sibling rate 1~mount of Line 14 taxable at collateral rate 19Tax Due 20. .0 0 .0 45 241,630.52 x X X X .12 .15 Copyright (c) 2000 lorm software only The Lackner Group, Inc. Form REV-1500 EX (Rev, 6-00) Decedent's Complete Address: STREET ADDRESS , 2174 Yale Ave. CITY STATE I ZIP I Carno Hill PA 17011 Tax Payments and Credits: 1:rax Due (Page 1 Line 19) 2Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 10,873.37 0.00 Total Craoits (A + B + C) (2) 0.00 31nterestlPenalty \1 applicable D. Interest E. Penalty TotallnteresVPenalty (D + E) (3) 4J1 Line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) Sit Line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line S + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT "'\i::mW!!!!!!:!!i!!!:II:!l!!!:!!Wmii!I!I!!!!!!,'W!!lllliimmmmml!!!!!!:!!iii!!!!!iii!1!!'j::!!','!!!',!!!'!!i!!!:,!!!'!:'!'!Wiil!iiI!!iiiWii!!!:!!!!lmmIW!!!'!!!':!!!!lil!!iil!!!!!!!iii'i!!f...!!-!:!' [-n PLEASE ANSweR THE FOLLOWING QUESTIONS BY PLACING AN 0.00 0.00 10,873.37 0.00 10,873.37 "X" !mmmmmmm:!w::!!m::!wmmm!m!!i::!:i::::!!::wm!::i::!!mm:imm::: IN THE APPI'IOPI'IIATE . Bl.OCKS Yes No ~~ 1Did decedent make a transfer and: a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; e. retain a reversionary interest; or d. receive the promise for life of either payments, benefIts or care? . . . . . . 21f death occurred after December 12. 1982, did decede(lt transfer property within one year of death without receiving adequate consideration? 3Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . . . . . . 4Did 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 QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. o o o []J []J []J Under pena"ies ol pe~ury, I declare that I have examined this retl.lm, including accompanying schedules and statements, and to the best 01 my knowledge and beliel, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all inlormation 01 which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING AETUAN Linda May Lefko _ _ _~4.??_.~~P-''-'' _ ~_,,~,,~_ __ _ __ _ _ _ - -_._ - - - -- - - - - -- - -- - -- West Chester, PA 19380 Saidis, Shuff, Flower & Lindsay 2109 Market Street -- -Cam- - -HiYi -- FA --Yi6iY- - -- - - - -- -- - -- --- - -- - ---- 'I);, Ie ~ D A T 8 A T E For dates of death n r after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is Yo [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% [72 P.S. 9116 (a) (1.1) (H)J. The statute does not exemot 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 twenty-one 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'% [72 P .S. 9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, 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% [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. Copyright (cl 2000 form software only The Lackner Group, Inc_ Form REV-1500 EX (Rev. 6-00\ REV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA \ INHEAITANCE TAX AETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Sara R. Klingler SS# 195-07-1398 11/03/2002 21-02-01013 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 which is jOintly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE DESCRIPTION NUMBER OF DEATH 1 2174 Yale Ave., Camp Hill, PA 17011 119,900.00 (value based on sale price - see copy of settlement sheet attached) SCHEDULE A REAL ESTATE TOTAL (Also enter on line 1, Recapitulation) ([f more space is needed, insert additional sheets of the same size) Copyright (c) 1996 fonn softwam only CPSystems, Inc. $ 119 , 900 . 00 Fonn REV-1502 EX {Rev. 1-97) REV-1503 EX + (1-97) \ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Sara R. Klingler SSlf 195 - 07 -1398 11/03/2002 All property jOintly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21-02-01013 ITEM DESCRIPTION VALUE AT DATE UNIT VALUE NUMBER OF DEATH 1 Prudential Mutual Fund, acct. 07000713276 841.692 15.72 13,231. 40 2 Government Securities Income Fund, GNMA 1, acct. 02388481, 25000 units .01931 482.75 3 1200 shares PPL, common stock 34.58 41,496.00 4 1500 shares DQE, common stock 15.55 23,325.00 5 600 shares Public Service Enterprise, common stock 29.02 17,412.00 TOTAL (Arso enter on line 2, Recapitulation) 95,947.15 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 torm software only CPSystems, Inc. Form REV-1503 EX (Rev. 1-97) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Sara R. Klingler SS# 195-07-1398 11/03/2002 21-02-01013 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 2 3 4 5 6 DESCRIPTION Myers Harner Funeral Home, refund Personal property and household furnishings (based on sale prices) Blue Shield, reimbursement of premium PPL, refund Verizon, refund Personal property, items not sold-distributed in-kind to heirs VALUE AT DATE OF DEATH 21. 00 1,505.25 79.18 29.78 0.95 1,000.00 TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. S 2,636.16 Form REV-15GB EX (Rev. 1-97) REV-1509 EX + (1-97) \ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Sara R. Klingler SCHEDULE F JOINTL V-OWNED PROPERTY SSfI 195-07-1398 11/03/2002 FILE NUMBER 21- 02 - 01013 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G, A. SURVIVING JOINT TENANT(S) NAME Wayne C. Klingler ADDRESS 1305 Conewago Creek Dr. Manchester, PA 17345 RELATIONSHIP TO DECEDENT son B. Linda M. Lefko 1427 Aspen Court West Chester, PA 19380 daughter c. JOINTL V-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOIN MADE Include name ollinanclal institution and ban DATE OF DEATH DECD'S VALUE OF account number or similar identifying numbe . NUMBER TENANT JOINT Attach deed lor jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES 1 A 10/21/96 Waypoint Bank, CD 461300116 20,354.95 50.00% 10,177.48 2 A 01/21/97 Waypoint Bank, CD 461300163 13,332.71 50.00% 6,666.36 3 B 10/21/96 Waypoint Bank, CD 461300115 20,354.95 50.00% 10,177.48 4 A 10/19/93 Waypoint Bank, checking act 405008638 4,209.27 50.00% 2,104.64 5 AB 07/01/48 PNC Bank, checking act. 51-4003-5064 12,755.51 33.33% 4,251.84 6 A 01/08/90 PNC Bank, CD 31000115272 18,965.07 50.00% 9,482.54 7 A 01/10/00 PNC Bank, CD 31000175252 1,124.25 50.00% 562.13 8 B 01/10/00 PNC Bank, CD 31300210846 1,120.92 50.00% 560.46 9 B 11/08/98 PNC Bank, CD 31000115270 27,472.71 50.00% 13 ,736.36 10 AB 11/14/00 PNC Bank, CD 31100203233 16,560.81 50.00% 8,280.41 TOTAL (Also enter on line 6, Recapitulation) $ 65,999.70 T (If more space is needed insert additional sheets of the same size) Form REV-1509 EX (Rev. 1-97) Copyright (c) 1996 form soflware only CPSystems, Inc. REV-1511 EX + (1-97) I COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Sara R. Klingler SSII 195-07-1398 11/03/2002 FILE NUMBER 21- 02 - 01013 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. UNERAL EXPENSES: Myers Harner Funeral Home 6,120.00 St. John's Cemetery 500.00 Funeral dinner 528.75 Minister 75.00 clothing 49.99 B. DMINISTRATIVE COSTS: 1. Personal Representative's Commissions 10,874.00 Name of Personal Representative(s) Linda May Lefko Social Security Number(s) / EIN Number of Personal Representative(s) Street Address 1427 Aspen Court City West Chester State PA Zip 19380 - Year(s) Commission Paid: 2. Attorney's Fees Saidis, Shuff, Flower & Lindsay 11,087.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip - Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 275.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs Cumberland Law Journal, estate notice 75.00 L.G. Connor, real estate appraisal 275.00 The Patriot News, estate notice 125.71 Costs incurred in sale of real estate: points 3,500.00 commission 6,984.00 notary 6.00 trans. fee 125.00 transfer taxes 1,199.00 pro-rated sewer 18.56 (less school tax credit of $245.73) 11,586.83 PNC Bank, check charges 55.20 TOTAL (Also enter on line 9, Recapitulation) $ 41,627.48 (If more space is needed, insert additional sheets of the same size) Copyright {c) 1996 lorm software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) REV.1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Sara R. Klin~ler SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SSfft 195-07-1398 11/03/2002 FILE NUMBER 21-02-01013 Include unreimbursed medical expenses. ITEM NUMBER 1 2 3 4 5 6 7 8 DESCRIPTION AMOUNT 62.49 99.72 551. 47 132.24 72.08 73.86 40.74 192 .41 Verizon, phone bill AT&T, phone bill UGI, utility bill PPL Electric Pa American Water Company Comcast, cable TV Penn Waste UGI TOTAL (Also enter on line 10, Recapitulation) (If mora space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. S 1,225.01 Form REV-1512 EX (Rev. 1-97) REV-1513 EX + (9-00) , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Sara R. Klingler SS# 195-07-1398 11/03/2002 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. AXABLE DISTRIBUTIONS [include outright spousal distributions, and transleTS untler Sec:. 91 16(a)(1 .2)) 1 Linda May Lefko 1427 Aspen Ct. West Chester, PA 19380 FILE NUMBER 21-02-01013 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE daughter 1/2 of res idue 2 Wayne C. Klingler 1305 Conewago Creek Dr. Manchester, PA 17345 son 1/2 of residue ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18 AS APPROPRIATE ON REV 1500 COVER SHEET II. ON-TAXABLE DISTRIBUTIONS: . SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE \I. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. 0.00 Form REV-1513 EX (Rev. 9-00) - ,i' , /' ~- I,' " " . ': ,,"., '-" .... c",/ ,,.e,,,.......,.t'.. ..;- " (.,. ,'" '.,,~;' ".;, HAAR'S TAX ,- 0 Name <. ':l (/, '( AUCTION TAXABLE . ((J1. (it) Street or R.F.D, TOTAL SALE DILLSBURG, PA 50/,7:' . 432.3815 . 432.3011 COMM City AUCTION EVERY TUESDAY Be I r'O<< # J FRIDAY EVE. 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'" Q, a '" ... 0 01/0I/03 00025580 MAH1'lEM AFPIXS JRN-05-2003 23:31 PNCBRNK 412 768 3458 P.01 o PNCBAN< January 6, 2003 Saidis, Shuff, Flower & Lindsay Attn:]ohn E Slike 2109 Market St Camp Hill, PA 1701I /scp RE: Estate of Sara R Klingler (Deceased) SSN: 195-07-1398 000: 11-03-2002 Dear Mr Slike: In response to your request for Date of Death balances for the customer noted above, our records show the following: Certificate of Deposit Account#3 10001 15270 Established 01-08-1998 SARA R KLINGLER OR LINDA M LEFKO DOD balance: $27,424.42 + $48.29 accrued interest Account#31300210846 Established 01-10-2000 SARA R KLINGLER OR LINDA M LEFKO DOD balance: $1,120.19 + $0,73 accrued interest Account#31000115272 Established 01-08-1998 SARA R KLINGLER WAYNE C KLINGLER 000 balance: $18,931.73 + $33.34 accrued interest Account#31 000175252 Established 0 I-I 0-2000 SARA R KLINGLER WAYNE C KLINGLER DOD balance: $1,122.86 + $1.39 accrued interest Account#31100203233 Established 11-14-2000 SARA R KLINGLER LINDA M LEFKO WAYNE C KLINGLER 000 balance: $16,550.92 + $9.89 accrued mterest Page 1 ofl JAN-0S-200~ ?3:32 PNCBANK <\ 12 7(,8 3458 Checking Account Account#5140035064 Established 07-01-1948 SARA R KLINGLER WAYNE C KLINGLER LfNDA M LEFKO DaD balance: $12,750.13 + $5,38 accrued interest The decedent did not maintain any safe deposit box at PNC Bank. Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements, If you need assistance with lInY of these items, please cali 1-888-PNC-BANK (1-888-762-2265) Or slop by your local PNC Bank branch office. Sincerely, ~c1~ Erica L Schlegel PNC Decedent Reporting F irstside Center 500 Fi"'t Ave, 4'" FI CIF Pittsburgh PA 15219-3128 1-800-762-1775 Member FDIC P.02 TnT,,1 0 Q~) Historical Prices Y.li.Hoor.FINANCE ;,tW Historical Prices - DQE (DQE) Page I of I Search -Finance Home - Yahoo' - Help As af Nav-04-02 More Info: Quote I Chart I News I Profile I Re$earch I Si::C I Msgs jlnsiqer Start: INav .:.l~12002 End I Nav ..:1~12oo2 (i Daily (' Weekly (' Monthly (' Dividends Ticker Symbol: !dqe Get Data Date Open High Low Close Volume Adj. Close' Nov-04-02 15.46 15.70 15.30 15.30 338,700 15.30 Nov-Ol-02 15.90 15.90 15.29 15.46 528,700 15.46 Download Spreadsheet Format · adjusted for dividends and splits please see FAQ. ;r, r;," (Ji:'~' ) ~ ADVERTISEMENT ('w 11\) "b, f'),~; ,L~k "lll" E'~ [) IN. ~....., i i t,n :It".", ,. .," ., II;'J'." ,..:,., ." ,,-'1, ;:.,.j , "'\011",' .".. ."..\\1' I,i'. .,' 'k'~';:; , W'~'h " ' .,1,; ~".,.,:~. ..~ 'i""" , . ::':' ~::';: ,. ,c. ",i .~\' .,....... classm Questions or Comments? Copyright@2002 Yahoo) Inc. Ail righlsreservedF'rivacy Policy -Terms of Service Historical chart dala and daily updates provided byCommodity Systems, Inc. (CSI) Data and information is provided for informational purposes only, and is notintended for trading purposes. Neither Yahoo nor a.ny of its data or content providers (suchas CSI) shall be liable for any errors or delays in the content, or for any actions taken in reliance thereon. THE BANK OF NEW YORK NEW VORK'S FIRST BANK - FOUNDED 1784 BY ALEXANDER HAMILTON December 3, 2002 John E. Slike Saidis, Shuff, Flower & Lindsay Law Offices 2109 Market Street Camp Hill P A 17011 RE: GOVERNMENT SECURITIES INCOME FUND GNMA I AlC: 02388481 N/O: SARA R KLINGLER Dear Mr. Slike: Thank you for your recent correspondence concerning the referenced Unit Investment Trust. Please be advised the date of death November 3, 2002 was a non-business day, therefore we used the date of November 1 st, 2002. The per unit value of the referenced fund was as follows: Units Bid Price Fund & Series Trade Date 208/0001 11/01/02 25,000 $.01931 We trust this information proves helpful. If you have questions or require further assistance, please call our Customer Service Department at (800) 221- 7771. We look forward to being of service. Very truly yours, j/;~(I"'fA-.o~V.' 11./ William Carroll Unit Investment Trust Customer Service Department P.O. BOX 974, NEW VORK, NEW YORK 10286 - 0974 2 Dividend Reinvestment Plan Account Statement 1~v:lfIltllJ__f~_""\..~J"I_rl.."tl -, .,. ^. ".; 'A,- Ie . '.i . OM .., ' ',',-, ''',' . ~ ',' '.' fJl~"L. ,,,."', <.c,_. v...... _"qh.,.' "~,-,= "~,,'~ , .',' . ,..... '_..' '.,' " ~.... "~' . '.." . ',".', ..:. '_' :. . . .<c, , Questior,o;:, For online account information, please visit W'N\N,shareowneronline.com Fax numder for transaction requests: 610~774-5106 Or call toll free 1-800-345-3085 Cusip # 69351T106 " , \ ,I, J .. " ... , .- ~., \0.....,.' .. ., +.' pp l=:: . " '.. fill Account Summary PPL Corporation POige 1 of1 SARA R KLINGLER CIO LINDA M LEFKO 2109 MARKET STREET CAMP HILL PA 17011 Balances Shares Held in Plan Shares Held by You Totai Common Shares Year-to-Date Amounts - Common Gross Dividend Reinvested Federal Tax Withheld Nonresident Alien Tax Withheld Cash Investments Total Invested Commissions Paid by Company (Year-to-Date Activity Current Dividend Record Date Payable Date Dividend Rate - Common $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Account# 3097115778 February 20, 2003 Record Date Current 1,200.000 0.000 1,200.000 Account Value Market Value Date Market Value Price - Common Account Market Value - Common Transaction Date Transaction Type Gross Amount of Transaction Taxes Withheld Net Amount of Transaction Price per Share ORWARD Certificate Deposit OU REQUES Detach here. FOfWard bottom portion to the address shown below. Shares Increased or Decreased 02/19/03 $ 33.65 $40,380.00 ) Total Shares Held in Plan 0.000 1,200.000 Transaction Request PPL Corporation Account# 3097115778 Mail to: PPL Corporation I nvestor Services Two North Ninth Street Allentown, PA 18101-1179 OPTIONAL CASH PURCHASE ELECTION o Enclosed is a check made payable ta PPL Agent far $ i I RP Maximum $80,000,00 per year PPL Investor Services must receive your voluntary cash payment by the 25th of each month to ensure it is invested on the first business day of the following month This assumes timely receipt of your check and properly completed purchase instructions including account number. PPL Investor Services will make every effort to process your properly completed purchase instructions, but will not be liable for any failure to purchase shares on a certain date or at a specific price. SARA R KLINGLER C/O LINDA M LEFKO 2109 MARKET STREET CAMP HILL PA 17011 o Please change my address as indicated above. o 3097115778 4 Historical Prices 'YAHOO' FINANCE AvJ .... Historical Prices - PPL (PPL CORP) Page I of I Search -Finance Home - Yahool - Help As of Nov-04-02 More Info: Quote I Chart I New~ I Profile I Re~earch I SEe I Msgs I Insider Start INov .:fr12002 End: INov E1~.12002 Ie Daily (' Weekly (' Monthly (' Dividends Ticker Symbol:lppl Get Data Date Open High Low Close Volume Adj. Close* Nov-04-02 34.55 35.50 34.30 35.50 1,052,800 35.50 Nov-OI-02 34.45 34.60 33.92 34.10 1,051,000 34.10 Download Spreadsheet Fonnat · adjusted for dividends and splits please see FAQ. AOVERTISEMENT , ~:"'.~" :..I....<h~ ~'~', :.t:t.... .:.... ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~ ~~ ~~~ ~ ~ ~ ~~ ~~~~ ~~~~~ I~~l~~~~~~~~~: ~ . , E~~H~~~~H~~HH~H~~~~~~~.i!miHH!ilii~H~~EH~~~~H. i~, 1 ......................u.........i~im.. illilljju. .... ...............1\] 1!!i1111!liiiiliiii~~tli~,~1 ................__..nn............h.______.............h....______.......... ...............__.__................_______..................h................. ----------.....................--......................_---.-.............------ ]~~~J[~~!~~~~~~~~~~~~~~~~~~~~~~~I QJ,IJ~_$!1QnS9(~CClmment$? Copyright@2002Yahoo! Inc. All rights reserved. Privacy Policy ~Terms of Service Historical chart data and daily updates provided byCommodity Systems, Inc. (CSI). Data and information is provided for informational purposes only, and is notintended for trading purposes. 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WEU GET YOU THERE. 11125/2002 SAIDIS SHUFF FLOWER & LINDSAY 2109 MARKET ST CAMP HILL PA 17011 The information which you requested on the account(s) of SARA KLINGLER (Social Security Number 195-07-1398) is/are as follows: Account Number Class of Account Date Opened Principal Balance Accrued Interest 405008638 CHECKING 10119193 4208.92 .35 4209.27 Balance at Date of Death Account Ownership ITO Name ofJoint WAYNE Owner, if any KLINGLER Date Ownership 10119193 Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested 461300115 CERTIFICATE 10121/96 20352.91 2.04 20354.95 461300116 CERTIFICATE 10121196 20352.91 2.04 20354.95 461300163 CERTIFICATE 01121197 13329.39 3.32 13332.71 JTO JTO LINDALEFKO WAYNE KLINGLER 10121196 10121196 ITO WAYNE KLINGLER 01121/97 Si!;gerely, l7at~~' tifJu 1)9~ KATIf'! YOUNG SENIOR SERVICES REP. P.O. 80x 1711. HARRISBURG. PENNSYLVANIA 17105-1711 Toll Free 1-86G-WAYPOINT (1-866-929-7646) .IN YORK AREA 717/815-4500' www.waypointbank.com OMS NO. 2502-0265 q.:: . SEtTLEMENT STATEMENT 1.DFHA 20FmHA 6. FILE NUMBER: ZORKIC.M 8. MORTGAGE INS CASE NUMBER: B. TYPE OF LOAN: 3.oCONV UNINS. 4. OVA 17. LOAN NUMBER: 5. [g]CONV. INS S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT NOTE. This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "{POC]" were paid outside the closing; they are shown here fOf informational purposes and are not included in the tola!s. 1 Q 3/98 (z.ORKle M PFDIZ.ORK1C M}19) NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: ~RIJA ZORKIC and COMMERCE BANKlHARRISBURG, NA ,SNA ZORKIC LINDA MAY LEFKO, Executrix of the Estate of Sara R Kllnger PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-2402316 I. SETTLEMENT DATE: 74 YALE AVENUE PURITY ABSTRACT COMPANY \MP HILL, PA 17011 February 26, 2003 JMBERLAND County, Pennsylvania PLACE OF SETTLEMENT 3329 Market Street Camp Hill. PA 17011 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION ). GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: I. Contract Sales Price I 119,900.00 4Q1. Contract Sales Price , 119,900.00 , Personal Pronertv I 402. Personal Prooerty I l. Settlement Charaes to Borrower (Line 1400) I 4,504.85 403. I I I 2003 CO/BOROUGH TAX to MICHAEL W. HARLING, TA 501.95 404. I ; I 405. I Adjustments For Items Paid 8v Seller in advance Ad'ustments For Items Paid Bv Se11er in advance ; CountvlBoro Taxes to i 406. Countv/Boro Taxes to I 7 City Tax to 407. Gjtv Tax to l. School Tax 02126/03 to 07/01/03 447.74 408. School Tax 02/26/03 to 07101103 447.74 J. 409. ) 410. I. 411. , 412. J. GROSS AMOUNT DUE FROM BORROWER 125,354.54 420. GROSS AMOUNT DUE TO SELLER 120,347.74 J. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: I. Deoosit or earnest monev 1,500.00 501. Excess Deoosit (See Instructions) , Principal Amount of New loan(S\ 113,905.00 502. Settlement CharQes to Seller (Line 1400) 8,332.56 I. Existina loan si taken sUbiect to 503. Existina -loan(5\ taken subiect to I 504. Payoff of first Mortgage L 505. Pavoff of second MortQage i. 508. , 507. (Deoosit disb. as proceedS) I 508. I CLOSING COST CREDIT 3,500.00 509. CLOSING COST CREDIT 3,500.00 Ad;ustments For Items Unnaid 811 Seller Adiustments For !terns UnDaid Bv Seller ) Countv/Boro Taxes 01/01/03 to 02/26/03 i 77.01 510. Count"lBoro Taxes 01/01/03 to 02/26/03 77.01 I Cllv Tax to I 511. Cltv Tax to , School Tax 10 i 512. School Tax to I TREE REMOVAL , 125.00 513. TREE REMOVAL 125.00 I I 514. ; 515. l 516. 517. I. 518. l I 519. I ). TOTAL PA/D BY/FOR BORROWER 119,107.01 520. TOTAL REDUCTiON AMOUNT DUE SELLER I 12,034.57 I. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER: Gross Amount Due From Borrower- (Line 120) 125,354.54 601. Gross Amount Due To Seller (Une 420) 120,347.74 , Less Amount Paid ByJFor Borrower (Line 220) ( 119,107.01) 602. Less Reductions Due Seller (Une 520) ( 12,034.57) I. CASH ( X FROM) ( TO) BORROWER 6,247.53 603. CASH ( X TO) ( FROM) SELLER 108,313.17 1e undersigned hereby acknowledge receipt of a completed copy of pages 1 &2 of this statement & any attachments referred to herein. Borrower Seller , ,&:e{~4 VESNA ZORKIC L.::il:: I:: 700. TOTAL COMMISSION Based on Price $ 116,400.00 @ 6.0000 % 6.984.00 PAID FROM PAID FROM Division of Commission (fine 700) as FoJ}ows: BORROWER'S SELLER'S 701. $ 3,517.00 to PRUDENTIAL THOMPSON WOOD fUNDS AT FUNDS AT 702. $ 3,467.00 to CENTURY 21 PISCIONERI REALTY, INC. SETTLEMENT SETTLEMENT 703. Commi9lsitJn Paid at Settlement 6,984.00 704. TRANSACTION FEE to CENTURY 21 PISCIONERI REALTY. INC. 195.00 BOO. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan OriQinatlon Fee % to 802. Loan Discount % to 803. Appraisal Fee to GARDNER REAL ESTATE APPRAISAL SERVICES 250.00 804. Credit Report to 805. Lender's Inspection Fee to 806. Flood Cert Fee to CREDIT PLUS SOLUTIONS 11.00 807. Tax Service Fee to 808, Document Prep Fee to COMMERCE BANK/HARRISBURG. NA 150.00 809. UNDERWRITING FEE to COMMERCE BANK/HARRISBURG, NA 245.00 810 COURIER FEE to AIRBORNE EXPRESS 25.00 811. PROCESSING FEE to COMMERCE BANK/HARRISBURG, N.A. 75.00 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 02/26/03 to 03/01/03 @ $ 18.190000/day ( 3 days %) 54.58 902. Mort a e Insurance Premium for months to 903. Hazard Insurance Premium for 1.0 vears to POC 904 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 3.000 months @ $ 24.83 per month 74.49 1002. Mortqaqe Insurance months @ $ per month 1003. CountY/Bora Taxes 2.000 months @ $ 41.83 oer month 83.66 1004. CitvTax months @ $ oer month 1005, School Tax 9.000 months @ $ 108.95 per month 980.55 1006. months @ $ oer month 1007. months (Q) $ oer month 1008. AGGREGATE ESCROW ADJ. months @ $ per month -358.12 1100. TITLE CHARGES 1101. Settlement or Closino Fee to 1102. Abstract or Title Search to 1103. Title Examination to 1104. Insured Closino Letter to First American Title Insurance Co. 1105. Document Preparation to ATTORNEY JOHN SLlKE DEED/POC 1106. Notary Fees to CASH 12.00 6.00 1107. Attorney's Fees to (includes above item numbers: ) 1108. Title Insurance to PURITY ABSTRACT COMPANY P.03-094 928.75 (includes above item numbers: ) 1109. Lender's Coverage $ 113,905.00 111 Q. Owner's Coverage $ 119,900.00 1111. PA ENDORSEMENTS:100,300,900 to PURITY ABSTRACT COMPANY 150.00 1112. Overnight Fee/package to PURITY ABSTRACT COMPANY 15.50 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 120'1. Recording Fees: Deed $ 39.50; Mortgage $ 45.50; Releases $ 85.00 1202. City/County Tax/Starn s: Deed 1.199.00' Mort aoe 1,199.00 1203. State TaxJStamps: Revenue Stamos 1,199.00; Mortoaoe 1,199.00 1204. ASSIGNMENT to RECORDER OF DEEDS 27.00 1205. RECORDER OF DEEDS 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to 1302. Pest Inspection to BIECHLER & TILLERY 260.00 1303. TRANSACTION FEE to PRUDENTIAL THOMPSON WOOD 125.00 1304. SEWER (1/1-6130/03) $60 to BOROUGH OF CAMP HILL 41.44 18.56 1305. 1400. TOTAL SETTLEMENT CHARGES IEnter on Lines 103. Section J and 502, Section K\ 4,50~.85 8,332.56 By ,ig"og P'g' 1 0/ ICi, '''''moot. th, ,ig",tori" oo'oow"'g, ""ipt of, "mpl,/" "" of"g' 2 oflhi, Iwo ~ "",m"!. "';j:(,' ) ~ / ~/ . ~{, ./' '- ~>I>A 01 1".1 .r~_ a fRITY.'\~STRACT UlJMPANY tlement Agent Certified to be a true copy. I I L 'MENT CHARGES (ZORKIC.M I ZORKIC.M /20) I~ . . LAST WILL AND TESTAMENT OF SARA R. KLINGLER I, SARA R. KLINGLER, of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any will previOUSly made by me. I - I direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II - I devise and bequeath all of my estate of whatever nature and wherever situate unto my husband, Paul C. Klingler, providing he survives me by sixty (60) days. III - Should my said husband fail to be living on the sixty-first (6lst) day following my death, then I devise and bequeath all of my estate of whatever nature and wherever situate unto my children, Linda Hay Lefko of Exton, Pennsylvania and Wayne C. Klingler of Camp Hill, Pennsylvania, in equal shares per stirpes. IV - In the event my husband is deceased and I still own real estate in Camp Hill, Pennsylvania, my son, Wayne C. Klingler, shall have the right to purchase the real estate at its appraised value. V - I appoint CCNB Bank, N.A. of New Cumberland, Pennsylvania, guardian of any property which passes under this will or otherwise to a minor or an incompetent and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so. Such guardian shall have the power to use principal as well as income from time to time for the minor's education and support or to make payment for those purposes 'wi thout further responsibility to the minor or to any person taking care of the minor. The said guardianShip shall terminate as to each beneficiary when he or she reaches the age of 21 years. AaNOLD, SUIt:e: & B.l.YL~Y "-TNM.l'.'{SI.;rl;\W ~IOQ "^~u.,. n....n \;"",..Hl~".PtlfN.nv"'''''''Oll ., ,\,';;/"". ,<,,,.t,~~.,,.~' T .'1'.,,~/ ,.::'; . - .1.i"'7 ., "1" r' . .-'t".'.'- ~::;i/.,j,.-(,. Page 1 =..,,~-~ _.. !1 VI - I appoint my husband, Paul C. Klingler, Executor of this, my Last Will and Testament. Should my said husband fail to qualify or cease to act as such, then I appoint my daughter, Linda May Lefko, to act in this capacity. Neither of my personal representatives shall be required to post bond in this or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, the / ,? tit day of C)."" {,: ~? ./ ~/ (/ 1979. /,/" i") j'// ,,1 . .~'7 ">fcZ,/L. ..r /f j~11f,t/C(l4- (SEAL) Sara R. Klingler"'/ Signed, sealed, published and declared by SARA R. KLINGLER, Testatrix therein named, on this and one (1) other sheets of paper as and for her Last Will and Testament in our presence, who, in her presence, at her request and in the presence of each other, have hereunto subscribed our names as attesting witnesses. fJ Name ~ddf!s~~ ~. ~' ".~"') ,'! ~"'_/" ' ,/" \ ! 'I.<.L7MJ J :7 ~e~ ( Name /) d C~7'" -e..&.. Address ' (4 hlirNOLD, SLIIut & B.....VLl<Y "TIOIlNEYS A. U'.w "OOMA.U~OT.,,"H C"Kr I\\"l..,f'''''''~~''-''''H,,^ ,m" Page 2 '1 '. 55. I I COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND) I, Sara R. Klingler , the testatrix whose name is signed to the attached or foregoing instrument, having been duly quali- fied according to law, do hereby acknowledge that I signed and executed the instrument as my Last Willl that I signed it will- ingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sara of Sworn or affirmed to and hKlingler T~ ' 19..22... acknowledged before me, bfOib the testat rix this _ day ill rl L(, ~jff Notary Public KIM E, KEllY, Notary Puhlic Camp Hill, Cumaerland CJ., Pa. M{ Commission Expires Oct, 25, '982 COMMONWEALTH OF PENNSYLVANIA) : 55. COUNTY OF CUMBERLAND) WE, the undersigned the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her Last Will; that Sara R. Klingler signed willingly and that Sara R. Klingler executed it as her free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. [! "ntlRNliY~ AT L...." Sworn to and subscribed before me this /0 tP day of ~I 1922 1{0A,Y, 1JIJ;?I ~ry Pubhc .aNOLD. SUItE .t: BAYLEY :11I., MAb.aT IftDl' :.u.>HIu., ~"ANIA 11011 KIM f, KElty, Nota.., Public Cimp Hill, Cumberlind Co, h My CommissIon Expires Oct. 25, 19\32 - REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: Sara R. Klingler Date of Death: November 3, 2002 Will No. 21-02-1013 Admin. No. To the Register: I certify that notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiary of the above- captioned estate on November 20, 2002. Name Address Linda May Lefko 1427 Aspen Court, West Chester, PA 19380 Wayne C. Klingler 1305 Conewago Creek Dr., Manchester, PA 17345 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none !~ ,p Date: `~ ~ ~ ~ "~ ~ ~, , ~~ ~ G{ ~~ .~ J n E. Sli e, Esquire 09 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: Personal Representative X Counsel for Perscr.al Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX~11-96) NO. CD 002539 SLIKE JOHN E ESQUIRE 2109 MARKET STREET CAMP HILL, PA 1701 1 fold ESTATE INFORMATION: ssN: ~ 95-o7-i 398 FILE NUMBER: 2102-1013 DECEDENT NAME: KLINGLER SARA R DATE OF PAYMENT: 05/08/2003 POSTMARK DATE: 05/08/2003 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /03/2002 REMARKS: PNC BANK JOHN E SLIKE ESQUIRE CHECK#1024 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 510,873.37 TOTAL AMOUNT PAID: 510,873.37 INITIALS: SK SEAL RECEIVED BY: DONNA M. OTTO REGISTER OF WILLS DEPUTY REGISTER OF WILLS LAW OFFICES SAIDIS, SHUFF, FLOWER. & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 JOHN E. SLIKE TELEPHONE: (717) 737-3405 -FACSIMILE: (717) 737-3407 ROBERT C. SAIDIS EMAIL: attorney@ssfl-law.com GEOFFREY S. SHUFF www.ssfl-law.com JAMES D. FLOWER, JR. CAROL J. LINDSAY KIRK S. SOHONAGE THOMAS E. FLOWER LINDSAY GINGRICH MACLAY JACLYN M. SMITH May 7, 2003 Register of Wills Cumberland County Courthouse Carlisle, PA 17013 Re: The Estate of Sara R. Klingler File No. 21-02-01013 Dear Ladies: CARLISLE OFFICE: 26 W. HIGH STREET CARLISLE, PA 17013 TELEPHONE: (717)243-6222 FACSIMILE: (717)243-6486 REPLY TO CAMP HILL .-. ,. ~~ S -~ i 00 -~ _~ ~`:' :._ ,~, -~:~, ~ Enclosed please find an original and two copies of an Inheritance tax in regard to the above-referenced estate. Also enclosed are checks for the filing fee and the tax due. Please return atime-stamped copy of the return to our office in the envelope provided. Thank you. Very truly yours, SAIDIS, SHUFF, FLOWER & LINDSAY ~C" ,r,f ~,` ~~. ,,~`Shelb~L. Yingling, Estate Paralegal /sly Enclosures IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PE. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Sara R. Klingler Date of Death: November 3, 2002 Will No. 21-02-01013 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes_; No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date ~i~~°" ~ ~ `~. off ~~ ~ -~,i~ {=;,, S ignatu`re ~~ATame: John E. Slike, Esquire I.D. No. 06262 SAIDIS, SNUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: Personal Representative X Counsel for Personal Representative ~~~" ~r"~'~ ~~ COMMONWEALTH OF PENNSYLVANIA ~, BUREAU of INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 NOTICE OF INHERITANCE TAX HARRISBURG, PA 17128-0601 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX RFP col-os> _ DATE 06-23-2003 ESTATE OF KLINGLER SARA R DATE OF DEATH 11-03-2002 E NUMBER 21 02-1013 F ~, ~ 'Qj ._1li;V ~+~ '• C NTY CUMBERLAND JOHN E SLIKE ACN 101 SAIDIS ETAL Amount Remitted 2109 MARKET ST = CAMP HILL PA 17011 ~~'~~' MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ _____________________ --------- ---------------------------------------------------- -------------------------- -- - REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KLINGLER SARA R FILE N0. 21 02-1013 ACN 101 DATE 06-23-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN (1) 119,900.00 NOTE: To insure proper 1. Real Estate (Schedule A) 15 94 7 95 credit to your account, 2 Stocks and Bonds (Schedule B) (2) . , . 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this form with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 2,63 6.16 tax payment. 6. Jointly Owned Property (Schedule F) (6) 65, 999.70 7. Transfers (Schedule G) (7) .00 284,483.01 8. Total Assets ~$) APPROVED DEDUCTIONS AND EXEMPTIONS: 41,627.48 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 1+2 25.01 (11) 4 .852.49_ 11. Total Deductions 241,630.52 12. Net Value of Tax Return c12) .00 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (S chedule J) (13) 241,6 30.52 14. Net Value of Estate Subject to Tax (14) NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 1 7, 18 and 19 will reflect figures that include the total of ALL ret urns assessed to date. ASSESSMENT OF TAX: 00 00 .00 c15) t . X = 15. e Amount of Line 14 at Spousal ra 045 52 630 241 10,873.37 16. Amount of Line 14 taxable at Lineal/Class A rate C16) . , X 12 00 = .00 cln t . X = 17. e Amount of Line 14 at Sibling ra 15 00 teral/Class B rate (18) ll C . = X 18. a o Amount of Line 14 taxable at 10,873.37 19. Principal Tax Due (19 )= PAYMENT RECEIPT ulst,uuni ~T, I AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-08-2003 CD002539 .00 10,873.37 TOTAL TAX CREDIT 10,873.37 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE e«~~.~., ecr DCVFRCF srnF OF THIS FORM FOR INSTRUCTIONS.)