HomeMy WebLinkAbout04-15-15 /1
1505610143
REV-1500 Ex(°'-'°'
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO 60x.280601 INHERITANCE TAX RETURN 21 14 676
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
06 22 2014 12 21 1926
Decedent's Last Name Suffix Decedent's First Name MI
MENTZER THOMAS 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
x] 1. Original Return ❑ 2. Supplemental Return ❑ 3. Remainder Return(date of death
prior to 12-13-82)
❑ 4. Limited Estate El 4a Future Interest Compromise —15. Federal Estate Tax Return Required
(date of death after 12-12-82)
8 Decedent Died Testate Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
X❑ (Attach Copy of Will) ❑ (Attach Copy of Trust)
F-19. Litigation Proceeds Received 10.Spousal Poverty Credit(dateof death 11.Election to tax under Sec.9113(A)
❑ between 12-31-91 and -1-95) (Attach Soh.O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
BRADLEY L GRIFFIE 717 243 5551
REGISTER OF WILLS USI�)ONLY
C-) <n
First line of address —0
200 N HANOVER S TREE T 1'7
.1 F--+
Second line of address
DA+TE'":FILED Z]3
City or Post Office State ZIP Code fV r
CARLISLE PA 17013 --1
Correspondent's a-mai ddres : bgriffie@griffielaw.com
Under penalties of perjury,1 eclar hat I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is t nd comple claratioN of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF RSON SP NSIB G RETURN DATE
Roger W. Thomas /
ADDRESS
121 Sas_aafras Lane Elizabethtown PA 17022
SI R a
HER THAN REPRESENTATIVE DATE
Bradley L. Griffie j
ADDR
200 N. anover Street, Carlisle, PA
Side 1
1505610143 1505610143 J
P`
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Mentzer, Thomas E.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1.
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. 6,395 . 92
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 250 . 20
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) U Separate Billing Requested............ 7,
8. Total Gross Assets(total Lines 1-7)..................................................................... 8. 6, 646. 12
9. Funeral Expenses&Administrative Costs(Schedule H)....................................... 9. 7 , 650 . 80
10. Debts of Decedent,Mortgage Liabilities,&Liens(Schedule 1).............................. 10. 52 ,192 .26
11. Total Deductions(total Lines 9&10)................................................................... 11. 59, 843 . 06
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. -531196. 94
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. -53, 196. 94
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.00 500 . 39 15. 0 . 00
16. Amount of Line 14 taxable
at lineal rate X .045 0 . 00 16. 0 . 00
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. 0 . 00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
1505610243 1505610243 ,J
REV-1500 EX Page 3 File Number 21-14-676
Decedent's Complete Address:
DECEDENT'S NAME
Mentzer,Thomas E.
STREET ADDRESS
Green Ridge Village
210 Big Spring Road
CITY NeSTATE ZIP
wville PA 17241
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +B) (2) 0.00
3. Interest (3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2 Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 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;............................................................................... ❑ Q
b. retain the right to designate who shall use the property transferred or its income;.................................. ❑ ❑x
c. retain a reversionary interest;or............................................................................................................... ❑ n
d. receive the promise for life of either payments,benefits or care?............................................................ ❑ ❑x
2. If death occurred after December 12, 1982,did decedent transfer property within one year of death without
receiving adequate consideration?.................................................................................................................... ❑ 0
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 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 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 tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the 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 under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
Rev-1508 EX+(6-98)
SCHEDULE E
I
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mentzer,Thomas E. 21-14-676
Include the proceeds of litigation and the date the proceeds were received by the estate.
All properly jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Members 1st Federal Credit Union- 3,374.83
Savings Account No.XXX307-00
(See attached statement)
2 Members 1st Federal Credit Union- 2,400.09
Checking Account No.XXX307-11
(See attached statement)
3 ACNB Bank- 100.00
Checking Account No.XXXX385
(See attached statement)
4 2014 Personal Income Tax Refund 521.00
TOTAL(Also enter on Line 5, Recapitulation) 6,395.92
(If more space is needed,additional pages of the same size)
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.6-98)
Rev-1509 EX+(6-98) LIN
*' SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mentzer, Thomas E. 21-14-676
If an asset was made joint within one year of the decedent's date of death,it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Janet H. Mentzer Green Ridge Village, Manor Building, Spouse
Room 109
Newville, PA 17241
B.
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 DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR VALUE OF ASSET
JOINTLY-HELD REAL ESTATE. INTEREST DECEDENT'S INTEREST
1 A 2/7/1985 ACNB Bank- 500.39 50.000% 250.20
Checking Account No.XXX265
(See attached statement)
TOTAL(Also enter on Line 6, Recapitulation) 250.20
(If more space is needed,additional pages of the same size)
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule F(Rev.6-98)
REV-1151 EX+(10.06)
;• SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN
RESIDENT DECEDENT ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Mentzer,Thomas E. 21-14-676
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s)attached 3,499.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Roger W.Thomas
Street Address 121 Sassafras Lane
city Elizabethtown State PA zio 17022
Year(s)Commission Daid 2015 1,000.00
2. Attornev's Fees Griffie&Associates, P.C. 2,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State ZiD
Relationship of Claimant to Decedent
4. Probate Fees 148.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 1,003.30
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 7,650.80
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Mentzer, Thomas E. 21-14-676
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Eby Granite Works - 3,499.00
(Memorial stone and engraving)
H-A 3,499.00
Other Administrative Costs
2 The Sentinel(Advertising) 169.30
3 Cumberland Law Journal (Advertising) 75.00
4 Eby Granite Works(Memorial Stone) 299.00
5 Accountant Fees- 210.00
2014 Personal Tax Preparation
6 Reserves 250.00
H-B7 1,003.30
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1512 EX+(12-08)
SCHEDULE
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF [FILE NUMBER
Mentzer,Thomas E. 21-14-676
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
I Department of Public Welfare Estate Recovery Claim 51,338.26
2 Reimbursement of overpayment from Social Security Administration 729.00
3 Medical Bill 125.00
TOTAL(Also enter on Line 10, Recapitulation) 52,192.26
(if more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev. 12-08)
REV-1513 EX+(11.08) W
SCHEDULE J
COMMONWEALTH OFpp,PP�ENNbYLVANIA
INREIITANCETA RENTRN BENEFICIARIES
,DENTESTATE OF FILE NUMBER
Mentzer,Thomas E. 21-14-676
NAME AND ADDRESS OF RELATIONSHIP TOSHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$)
Do Not List Trustee s
I� TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
Janet H. Mentzer Wife One hundred
Green Ridge Village percent of net
Manor Building, Room 109 distributable
Newville, PA 17241 estate
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 15 10 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 ONLINE 13 OF REV-1500 COVER SHEET
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev. 11-08)
'SILL A ND TESTAMENT
OF
THOMAS K MEENTZER
I, THOMAS E. MENTZER, of Swaim Health Center, Green Ridge Village,
Room 109, Newville, Cumberland County, Pennsylvania, being of sound and disposing
mind, memory and understanding, do make, publish and declare this to be my Last Will
and Testament, hereby revoking and making void all previous Wills and Codicils
heretofore made by me.
FIRST
I order and direct my Executor/Executrix hereinafter named to pay all of my just
debts, funeral expenses and expenses involved or connected with the administration of
my estate as soon after my death as is reasonably possible.I direct my Executor/Executrix
to pay all inheritance, estate, succession and legacy taxes, to which my estate or the
transfer of any property hereunder may be subject, and to charge such taxes as part of the
expenses of the administration of my estate, being deducted and paid from the residue of
my estate and not to be deducted in any manner from any specific bequests made herein.
However, my Executor/Executrix need not accelerate and pay those unmatured
obligations which, in his,her or its opinion, it might be proper and more advantageous to
retain or renew and pay as they become due and payable. If I do not own a burial plot or a
GRIFFIE&ASSOCIATES
Attorneys At Law
200 N. Hanover Street 100 Lincoln NVay East,Suite D
Carlisle,PA 17013 Page 1 of 7 Chambersburg,PA 17201
1
grave marker at the time of my death,I authorize my Executor/Executrix,in his,her or its
sole discretion, to purchase a burial,plot and to erect a suitable grave marker at my grave,
and to expend sums from my estate for this purpose.
SECOND
I give, devise and bequeath the rest, residue and remainder of my estate of
whatever nature and wheresoever situate,together with all insurance proceeds thereon,to
my wife,JANET R.MENTZER,providing that she survives me by sixty(60) days.
THIRD
Should my wife, Janet H. Mentzer,predecease me or die on or before the sixtieth
(60th) day following my death, then I give, devise and bequeath my entire estate of
S- whatsoever nature and wheresoever situate, together with all insurance proceeds thereon,
to my dear and close friends, ROGER W. THOMAS and -SUZANNE D. THOMAS,
who survive me by sixty(60) days,per stirpes.
FOURTH
I grant my Executor/Executrix the following powers in addition to and not in
limitation of such powers as my Executor/Executrix shall hold by law:
(a) To retain all property received including the stock of any corporate fiduciary
acting hereunder,provided such property remains productive.
(b) To join in any corporation, partnership, recapitalization, merger,
reorganization or voting trust plan; to delegate authority with respect thereto;
to deposit investments under agreements and pay assessments; and generally
GRIFFIE&ASSOCIATES
Attorneys At Law
200 N. Hanover Street 100 Lincoln Way East,Suite D
Carlisle,PA 17013 Page 2 of 7 Chambersburg,PA 17201
to exercise all rights of investors, including but not limited to, the voting of
shares.
(c) To manage, operate, repair, improve, mortgage or lease on any terms any real
estate held or owned by my estate.
(d) To operate any business that I may own at my death.
(e) To invest any funds of my estate in any stocks,bonds,notes or other securities
or property,real or personal, without regard to the principle of diversification
or any other statute or general rule of law in his, her or its absolute discretion,
it being my intention to give my Executor/Executrix the broadest investment
powers possible, providing such investments do not unnecessarily prevent the
prompt settlement of my estate.
(f) To sell or otherwise dispose of any property, real or personal, tangible or
intangible, at any time forming a part of m} estate in any manner and on such
terms and conditions as my Executor/Executrix shall see fit in his, her or its
absolute discretion.
(g) To borrow money for the payment of taxes or for any other proper purposes in
the administration of my estate, and to mortgage or pledge estate assets as
security.
(h) To compromise claims without court approval including, but not limited to,
any controversies with the United States of America or the Commonwealth of
Pennsylvania concerning estate and inheritance taxes on any interests that may
pass under this my Last Will and Testament.
GRIFFIE&ASSOCIATES
Attorneys At Law
200 N. Hanover Street 100 Lincoln Way East,Suite D
Carlisle,PA 17013 Page 3 of 7 Chambersburg,PA 17201
(i) To distribute in cash or in kind upon any division or distribution of my estate.
(j) To access,use and control any digital device that I may own or have license to
use (such as computers, cell phones, etc.) for purposes of accessing,
controlling, deleting, transferring and distributing any digital asset and digital
account that I may own or have license to use,to the extent then authorized by
law. My Executor/Executrix has authority to obtain any username, login,
password or other electronic credential associated with any of my digital
devices, digital assets and digital accounts.
(k) To undertake any and all acts deemed necessary and proper by my
1�. Executor/Executrix for the proper, advantageous and prompt management of
the settlement of my estate.
(1) To disclaim any benefits-to which I may have been entitled posthumously,
whether said benefits result from distribution from an estate,trust or any other
J
such account.
(m)In general, to exercise all powers in the management of my estate which any
individual could exercise in the management of similar properly owned in his
own right, upon such terms and conditions as to him, her or it may seem best
and to execute and deliver all instruments and to do all acts which he, she or it
deems necessary or proper to carry out the purposes of this, my Last Will and
Testament.
GRIFFIE&ASSOCIATES
Attorneys At Law
200 X Hanover Street 100 Lincoln Way East,Suite D
Carlisle,PA 17013 Page 4 of 7 Chambersburg,PA 17201
FIFTH
No interest of any beneficiary of my estate, either in income or in principal, shall
be subject to anticipation or pledge, assignment, sale or transfer in any manner, nor shall
any beneficiary have the power in any manner to charge or encumber his interest either in
income or principal, nor shall the interest of any beneficiary be liable or subject in any
manner while in the possession of my Executor/Executrix for the liability of such
beneficiary.
SIXTH
I nominate, constitute and appoint my dear and close friend, ROGER W.
THOMAS, as Executor of this my Last Will and Testament. In the event Roger W.
Thomas is deceased, unable or unwilling to serve or shall cease to serve for any reason
whatsoever,then I nominate, constitute and appoint my wife,JANET H. MENTZER,as
Executrix of this my Last Will and Testament. In the event my wife, Janet H. Mentzer,is
k
filikewise deceased, unable or unwilling to serve or shall cease to serve for any reason
whatsoever,then I nominate, constitute and appoint my dear and close friend,-SUZANNE
D. THOMAS, as Executrix of this my Last Will and Testament. I direct that my
Executor/Executrix shall not be required to give or post bond for the faithful performance
of his,her or its duties in this or any other jurisdiction.
SEVENTH
I hereby declare it to be my expressed desire that my Executor/Executrix employ
the law firm of Griffie & Associates, of Carlisle, Pennsylvania, for legal advice and
assistance regarding this my last Will and Testament, they having considerable
GRIFFIE&ASSOCIATES
Attorneys At Law
200 N. Hanover Street 100 Lincoln Way East, Suite D
Carlisle,PA 17013 Page 5 of 7 Cliambersburg,PA 17201
knowledge of my affairs, views and wishes respecting any matters that may arise at the
probate of this instrument, the administration of my estate, and the execution. of the
powers herein mentioned.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last
Will and Testament, consisting of seven (7) typewritten pages, the first five (5) of which
bear my signature on the side margin, for purpose of identification, this
day of �ZV-rt '2013.
THOMAS E.ME TZ R
GRIFFIE&ASSOCIATES
Attorneys At Law
200 N. Hanover Street 100 Lincoln Way East,Suite D
Carlisle,PA 17013 Page 6 of 7 Chambersburg,PA 17201
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA.:
. SS.
COUNTY OF CUMBERLAND
I, THOMAS E. MENTZER, the Testator whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will and Testament;
that I signed it willingly, and that I signed it as my free and volu tary act for the purposes
therein expressed.
C
THOMAS E. MENT
Swo or affirmed and acknowledged before me by the Testator thisD
day of ,2013.
NOTARIAL SEAL
ROBIN g}ASSETT,Notary Public
CARLISLE f�OROUGll CUMBERLAND CO.
Commission Expires Apr.17,2015
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA:
SS.
COUNTY-OF CUMBERLAND
WE, IJ G, L c-.? c and
the witnesses whose names are attached to the foregoing documenting duly qualified
according to law, do depose and say that we were present and saw the Testator sign and
execute the instrument as his Last Will and Testament; that he signed willingly and that
he executed it as his free and voluntary act for the purposes therein expressed; that each
subscribing witness in the hearing and sight of the Testator signed the.Last Will and
Testament as witnesses and that to the best of our knowledge the Testator was at the time
18 or more years of age, of sound mind and under no c traint or undue influence.
Sworn or affirmed and subscribed before me by
and ��el>," L. e�e z this day of MZ4& 2013.
NOTARIAL SEAL —
ROBIN j.BASSET,Notary Public Notary Publi
CARLISLE BOROUGH,CUMBERLAND CO.
Commission Expires Apr,17,2015 GRIFFIE&ASSOCL4TES
--- Attorneys At Law
20011'.Hanover Street 100 Lincoln Nay East,Suite D
Carlisle,PA 17013 Page 7 of 7 Chambersburg,PA 17201
Mist
male
MEMBERS 111
FEDERAL CREDIT UNION
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 533307-00
Date Account Established 11/18/2013
Principal Balance at Date of Death $3,374.63
Accrued Interest to Date of Death $0.20
Total Principal and Accrued Interest $3,374.83
Name of Joint Owner None
CHECKING ACCOUNT:
Account Number/Suffix 533307-11
Date Account Established 11/18/2013
Principal Balance at Date of Death $2,400.00
Accrued Interest to Date of Death $0.09
Total Principal and Accrued Interest $2,400.09
Name of Joint Owner None
ME�MBERS IST FEDERAL CREDIT UNION
`i bW— —--
Tessa L-Klugh 61
Lending Insurance Support Specialist
August 1, 2014
Estate of: THOMAS E MENTZER
Date of Death: 06/22/2014
Social Security Number:
5000 Louise Drive - P.O.Box 40 - Mechanicsburg,Pennsylvania 17055 - (800) 283-2328 - www.memberslst.org
ACNB
BANK
February 11,2015
Griffie&Associates PC
Attn: Bradley L Griffie
200 N Hanover St
Carlisle PA 17013
RE: Estate of Thomas E Mentzer
Dear Mr. Griffie:
The following information is being provided as per your request:
Acct.Type Account No. Balance at Accrued Ownership Date
D.O.D. Interest to Opened/Joint
D.O.D.
Esteem 124265 $500.32 $0.07 ft w/Janet H Mentzer 2/7/85
Checking
Account
Esteem 2515385 $100.00 $0.00 Individual 8/15/13
Checking
Account
Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer
Company at 1-800-368-5948. If you need any additional information,please contact me at(717)339-5122.
Sincerely,
Barbara J Warne
ACNB Bank
Deposit Services Representative 11
acnb.com • P.O. Box 3129, Gettysburg, PA 17325 • 717.334.3161 - Toll Free 1.888.334.ACNB (2262)
ACNB
BANK
February 11,2015
Griffie&Associates PC
Attn: Bradley L Griffie
200 N Hanover St
Carlisle PA 17013
RE: Estate of Thomas E Mentzer
Dear Mr. Griffie:
The following information is being provided as per your request:
Acct.Type Account No. Balance at Accrued Ownership Date
D.O.D. Interestto Opened/Joint
D.O.D.
Esteem 124265 $500.32 $0.07 Jt w/Janet H Mentzer 2/7/85
Checking
Account
Esteem 2515385 $100.00 $0.00 Individual 8/15/13
Checking
Account
Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer
Company at 1-800-368-5948. If you need any additional information, please contact me at(717)339-5122.
Sincerely,
1
Barbara J Warne
ACN13 Bank
Deposit Services Representative 11
acnb.com • P.O. Box 3129, Gettysburg, PA 17325 • 717.334.3161 • Toll Free 1.888.334.ACNB (2262)
i
i,
��(�'^/e
V
�� � � f
\ � ��
,� `� �
� �- �'
��