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HomeMy WebLinkAbout05-11-15 (2) pennsyfvania 1505618288 Ex(03-14)(FI) OFFICIAL USE ONLY REV-1500 County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 21 14 0807 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 08 03 2014 05 09 1929 Decedent's Last Name Suffix Decedent's First Name MI Martin Christine J (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1.Original Return Q 2. Supplemental Return Q 3. Remainder Return(date of death prior to 12-13-82) Q 4.Agriculture Exemption(date of Q 5. Future Interest Compromise(date of Q 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) 7,Decedent Died Testate Q 8. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes (Attach copy of will.) (Attach copy of trust.) Q 10.Litigation Proceeds Received Q 11. Non-Probate Transferee Return Q 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) Q 13.Business Assets Q 14. Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT—THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Elyse E . Rogers 717 612 5801 First Line of Address 635 North 12th Street w ' Second Line of Address C) UO O City or Post Office State ZIP Code O U i Lemoyne PA 17043 t, uuaol O s.comssr-attorneers Correspondent's email address: ero 9 @ Y REGISTER OF WILLS USE ONLY' I REGISTER OF WILLS USE ONLY DATE FILED MMDDYYYY DATE FILED STAMP PLEASE USE ORIGINAL FORM ONLY Side 1 111111 IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII 1505618288 1505618288 J1505618296 z REV-1500 EX(FI) Decedent's Social Security Number Decedents Name: Christine J Martin RECAPITULATION 1. Real Estate(Schedule A) .. . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . ... . . . . . . 1. 0 . 00 2. Stocks and Bonds(Schedule B) . . . . . . . . . .. . .. . . . . . . . . . . . . . .. . . .. . . 2. 1 ,365 - 7 6 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) .. . . 3. 0 - 00 4. Mortgages and Notes Receivable(Schedule D) 0 . 00 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) . . . . . 5. 11 , 418 - 88 6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . . . . 6. 701731 - 22 7. Infer-Vivos Transfers&Miscellaneous Non-Probate Property 1191665 • 8 9 (Schedule G) O Separate Billing Requested . . . . . 7. 8. Total Gross Assets(total Lines 1 through 7) . .. . . . .. . . . . . ... . .... . . . . . 8. 203,181 - 75 9. Funeral Expenses and Administrative Costs(Schedule H) . .. .. . . . . . . . . . .. 9. 12 ,151 - 95 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1) ..... . . . . . . . . 10. 350 - 80 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . .. ..... .. . .. . . . . . 11. 12 -,502 • 75 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . .... ... . ... . . . . . 12. 190 ,679 - 00 13. Charitable and Governmental Bequests/Sec.9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . . .. . ... . . .... . . . 13. 14 • 09 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . .. ..... . . ... . . . 14. 190,664 - 91 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0 0 0 . 00 15. 0 . 00 16. Amount of Line 14 taxable at lineal rate X.045 190 ,664 - 91 16. 81579 - 92 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. 8 ,579 • 92 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Under penalties of perjury,I declare 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 person responsible for filing the return is based on all information of which preparer has any knowledge. )7 SIGNATURE� Ok5IBLE R FILING RETURN �DAy/IS ADDRESS „� (�OI'I�� �InS /007 SIGNA/T/URE OF PREPA HR OTHE, TH6N PERSON RESIQ9SIBIJ'tFOR FIL G THE RETURN DATE L s a3�� ADDRESS 635 North/12th Stp6et -Lemoyne, PA 170P I I��I�I il��l�IIII��I�I�III��II�I ILII�I�I�IIT ILII��II I��i Side 2 1505618296 1505618296 REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: 21 140807 DECEDENT'S NAME Christine J. Martin STREET ADDRESS 112 Fourth Street CITY STATE ZIP Boiling Springs PA 17007 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 8,579.92 2. Credits/Payments A.Prior Payments 8,345.00 B.Discount 429.00 (See instructions.) Total Credits(A+B) (2) 8,774.00 3. Interest (3) 0.00 4, If Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 194.08 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 . ... . ... . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . ❑ El b. retain the right to designate who shall use the property transferred or its income . . . . . . . . . . . . . . . . . . ❑ c. retain a reversionary interest. . . . . . .. . . .... .. ... . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . ❑ d. receive the promise for life of either payments,benefits or care? . .. . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ ZI 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?. . . ... ❑ 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[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent or a step-parent 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(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-1503 EX+ (8-12) i Pennsylvania SCHEDULE B DEPARTMENT OF REVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER Christine J. Martin 21 140807 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTIONVALUE AT DATE NUMBER OF DEATH 1 $100.00 US Savings Bonds- Series EE 300.00 Per Savings Bond Calculator Interest on above bond accrued as of decedent's death 1,065.76 TOTAL (Also enter on Line 2, Recapitulation) 1,365.76 If more space is needed, insert additional sheets of the same size REV-1508 EX+ (08-12) zfpr pennsylvania SCHEDULE E ? DEPARTMENT OFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE EDENAX TURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Christine J. Martin 21 140807 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1 M&T Bank Savings Account 15004201558218 10,768.55 Per 9/17/14 letter 2 Members 1 st Federal Credit Union 351112-00 5.07 Per 10/2/14 letter 3 Highmark Refund 465.26 4 US Treasury, Refund on 2014 Form 1040 180.00 TOTAL (Also enter on Line 5, Recapitulation) 11,418.88 If more space is needed, use additional sheets of paper of the same size. REV-1509 EX+ (01-10) E. Pennsylvania SCHEDULE F DEPARTMENT OF REVENUE INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Christine J. Martin 21 140807 If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. Pamela C. Martin 112 Fourth Street Daughter Boiling Springs, PA 17007 B. C. JOINTLY OWNED PROPERTY: ITEM LETTER DATE DECSRIPTION OF PROPERTY DATE OF DEATH %OF DATE OF DEATH NUMBER FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR VALUE OF ASSET DECEDENT'S VALUE OF TENANT JOINT SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE INTEREST DECEDENT'S INTEREST 1 A 06/1996 M&T Bank Checking Account 1322745 joint 5,456.95 50.00OC 2,728.48 with Decedent's daughter, Pamela C. Martin Per 9/17/14 letter 2 A 03/1996 Fidelity Investments Account 2BZ616567 joint 130,680.60 50.00OC 65,340.30 with Decedent's daughter, Pamela C. Martin Per 9/16/14 letter 3 A 05/2012 Members 1st Federal Credit Union CD 351112- 5,324.88 50.00OC 2,662.44 42 owned jointly with Decedent's daughter, Pamela C. Martin $5,324.49 plus$.39 accrued interest Per 10/2/14 letter TOTAL (Also enter on Line 6, Recapitulation) 70,731.22 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+ (08-09) � Pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX DECEDENT URN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Christine J. Martin 21 140807 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. - ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBER INCLUDETHE NAME OF THE TRANSFEREE,THEIR RELATIONSHIPTO DECEDENT VALUE OF ASSET INTEREST IF APPLICABLE VALUE AND THE DATE OF TRANSFER.ATTACH COPY OF THE DEED FOR REAL ESATE. 1 Fidelity Investments Account Z42286133 84,368.54 100 84,368.54 Transfer on death account to Decedent's daughter, Pamela C. Martin Per 9/16/14 letter 2 Fidelity Investments IRA Account 2BZ616559 35,297.35 100 35,297.35 Beneficiary: Decedent's daughter, Pamela C. Martin Per 9/16/14 letter TOTAL (Also enter on Line 7, Recapitulation) 119,665.89 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (08-13) ' pennsylvanial SCHEDULE H rZ DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENT DECEDENTTURN ADMINSTRATIVE COSTS ESTATE OF FILE NUMBER Christine J. Martin 21 140807 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See schedule attached 3,477.20 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 2. Attorney Fees: 4,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) 3,500.00 Claimant Pamela C. Martin Street Address 112 Fourth Street City Boiling Springs State PA ZIP 17007 Relationship of Claimant to Decedent Daughter 4. Probate Fees: 315.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7 Deluxe Check Order 14.95 8 Saidis, Sullivan & Rogers, out of pocket expenses 244.30 9 Saidis, Sullivan & Rogers, out of pocket expenses (reserve) 100.00 TOTAL (Also enter on Line 9, Recapitulation) 12,151.95 If more space is needed, use additional sheets of paper of the same size. Page 2 Estate of: Christine J. Martin 21 140807 Schedule H, Part A - Funeral Expenses Item Number Description Amount 1 Amazon.com, funeral urn 99.99 2 Hoffman - Roth Funeral Home &Crematory, Inc. 2,805.61 3 Adrian Paskey, funeral music 100.00 4 Andrew Vensel, funeral music 100.00 5 Allenberry Resort, Inn, funeral luncheon 287.20 6 Pamela Martin, reimbursement for funeral expense 84.40 TOTAL. (Carry forward to main schedule) . . . . . . 3,477.20 REV-1512 EX+ (12-12) �I)A` pennsylvania SCHEDULE I DEPARTMENT of REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Christine J. Martin 21 140807 Report debts inwrred by the decedent prior to death that remained unpaid at the date of death,indluding unreimbursed medical expenses. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1 Synergy HomeCare of Mid PA 79.40 2 Synergy HomeCare of Mid PA 100.40 3 Saidis, Sullivan & Rogers 171.00 TOTAL (Also enter on Line 10, Recapitulation) 350.80 If more space is needed, insert additional sheets of the same size REV-1513 EX+ (01-10) jp pennsylvaniaDEPARTMENT OF REVENUE SCHEDULE J INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Christine J. Martin 21 140807 NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1 Pamela C. Martin Daughter 190,467.59 112 Fourth Street Boiling Springs, PA 17007 3 James M. Diodato Grandson 28.19 18 Fleischman Cricle Madison, WI 53719 4 Zoe Martin Granddaughter 28.19 c/o Susan Yee Martin 4646 Virginia Drive Bethlehem, PA 18017 5 Walter Paskey Son-in-law 70.47 112 Fourth Street Boiling Springs, PA 17007 6 Adrian Paskey Granddaughter 70.47 112 Fourth Street Boiling Springs, PA 17007 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 Lehigh Valley Community Foundation 14.09 Dr. Richard D. Martin Memorial Fund 968 Postal Road, Suite 100 Allentown, PA 18109 TOTAL OF PART II— ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. 14.09 If more space is needed, use additional sheets of paper of the same size. ' CY) CA o o O O O d ; L O T r C ' It Iq O O co � YLc) r— ti � O N N as 61). 6 . rn rn o ti T r O N Oo Cd U� E O N N V M r 7 � 64 6F? 64 __ V7 T- O N ti o 00 00 O 1-: N N d � O T O N 69 6", 6-- a) �. 00 O O r O to o T p d' M It O M r O O O N 00 O N 00 r-_ r-: O 06 O Iq p o N d' Cfl (D O O V- CO) d' r- 6. 0 a r- co Cfl co N M O O C- O N to N V O 6 606 aO = C CD 00 co V Z 64 b9 64 64 64 69 64 O CD w w O NT 't O O O O O O N O O O 00 V ti 00 qT M qt O M r` O a0 f` O t! O O O O = O M M O N M I- T- S O N O Cr) O OD I' d' m X T N qq O CD O 00 O O O rl- h NT N ti O c6 M IT ti M CD M N r CO O Cfl O M S r` r .y H 1 V- N O N V O M N N O t10 00 00 CD 00 M O V r O = N 64 64 64 K? 64 64 03 69 V., 64 EA 64 69 (;4 69 61% 61) y � 0°o m m0000ti OR O 00 et O tV 'C O v- co O O O 00 = N Mqq f` T M O N N N O a) 69 64 69 64 64 v% 64 5 r X a) N ~ U = d C/5M V � O .CU T N M (V N N cu N Q G � d E E E E E C i 1C U Co m m w ii Z U: C� C7 m = 2 _ = = cn L m c6 'a p _> o 0 a� a� a� a� a� w a� N O w a) ami O m t c °-75 c m _ Q w ccnn'� (r o 0M0) L a " i " iio ° w ° C �w o co iU),W, n U) o cQ o ct: Calculated Value of Your Paper Savings Bond(s) http://www.treasutydirect.gov/BC/SBCPrice Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 07/2014 Total Price Total Value Total Interest YTD Interest $300.00 $1,365.76 $1,065.76 $31.24 Bonds: 1-6 of 6 Issue Next Final Issue Interest Serial # Series Denom Date Accrual Maturity Price Interest Rate Value .-_ __ _.____._.. _.._-_' $100 09/1984:09/2014 09/2014! $50.00 $176.12 4.00% $226.12 c650.----- EE c65086413 EE $100;06/1984; 06/2014 $50.00; $180.64, $230.64 - -- ------------ -:------ --- -------—- _----------- - - ....--- I c65086417 EE $100:08/1984'08/2014; 08/2014; $50.00 $176.12 4.00% $226.12 c65086418: EE $100:08/1984 08/2014' 08/2014- $50.00 $176.12 4.00%� $226.12 c65086414, EE $100107/1984 07/2014, $50.00 $180.64. $230.64 c65086416. EE $100 08/1984 08/2014 08/2014 $50.00; $176.12; 4.00%: $226.12 -.. Totals for 6 Bonds $300.00.$1,065.76, $1,365.76 Notes NI Not Issued - - ------------------------------..- NENot eligible for payment P5 Includes 3 month interest penalty ---__:_------------------__..-------- MA : .__-_-_MA :Matured and not earning interest I of 1 7/12/14 11:41 AM . ,MM&TBank 499 Mitchell Road,Millsboro,DE 19966 Records Management Phone 888-502-4349 F ax (302)934-2955 September 17,2014 Law Offices Of Saidis,:SuHivan& Rogers 635 North 12th Street, Suite 400 Lemoyne,PA 17043 Re: Estate of Christine J.Martin Social Security: Date of Death: August 3, 2014 . Dear Sir or Madam: Per your inquiry on September 10,2014,please be advised that at the time of death,the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 1322745 Ownership(Names of Christine J.Martin Pamela.C.Martin Opening Date 0611111996 Balance on Date of Death $ 5,45690 Accrued Interest $ .05 Total $5,456.95 2. Type of Account Sm,ings Account Account Number 15004201558218 Ownership(Names ofJ Christine J.Martin Opening Date 1111211999 Balance on Date of Death $ 10,768.41 Accrued Interest $ .14 _...._.._._.._......._....__....... ........_...... ..............._.._....__.... Total $10,768.55 For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds, please call the Boiling Springs at 717-241-7790. We were unable to locate any safe deposit boa for the above-mentioned decedent. This letter does not include any accounts in which the deceased may have been listed as Power of Attorney,Custodian of Uniform Transfers, Representative Payee,or Trustee under a Written Agreement Sincerely, Valarie Mercer Records Management A ]IV 1. MEMBERS 1t FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: AccountNumber/Guffix 351112-00 Date Account Established 03/08/2009 Principal Balance atDate VfDeath $5.07 Accrued Interest toDate ofDeath $0.00 Total Principal and Accrued Interest $5.07 Name ofJoint Owner None CERTIFICATE OF DEPOSIT: - AccountNumber/Suffix 351112-42* Date Account Established 12/84/2013 Principal Balance atDate ofDeath $5.324.49 Accrued Interest to Date ofDeath $0.39 Total Principal and Accrued Interest $5.324.88 Name ofJoint Owner Pamela CMartin Date Joint Added 05/06/2012 *Rollover from CID 351112-4Dopened O5/U6/2D12. MEMBERS 1 IT FEDERAL CREDIT UNION Lending Insurance Support Specialist October 2. 2D14 Estate of: CHRISTINE MARTIN Date of Death: 08/0312014 Social Security Number: 157-20*-2064 ' 5000,LouiscDrive " �O. Box 40 ^ ".Nfechanksburg, 17055 ° (800) 283-2328 ~ www.members1ot. © MsTBank 499 Mitchell Road,Millsboro,DE 19966 Records Management Phone 888-502-4349 F ax (302)934-2955 September l7,2014 Law Offices Of Saidis, Sullivan & Rogers 635 North 12th Street, Suite 400 Lemoyne, PA 17043 Re: Estate of Christine J.Martin Social Security: Date of Death: August 3, 2014 Dear Sir or Madam: Per your inquiry on September 10,2014,please be advised that at the time of death,the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 1322745 Ownership(Names oj) Christine J.Martin Pamela C.Martin Opening Date 0611111996 Balance on Date of Death $ 5,45690 Accrued Interest $ .05 ------------------------------------------------ -- .. Total $5,45695 2. Type of Account Savings Account Account Number 15004201558218 Ownership(Names ofJ Christine J.Martin Opening Date 1111211999 Balance on Date of Death $ 10,768.41 Accrued Interest $ .14 __............._......_......._...............-.....--.............__.._..._....._._............ _._........_ Total $10,768.55 gvilR e � I m v e s r M E N T September 16,2014 ELYSE E ROGERS C/O LAW OFFICES OF SAIDIS SULLIVAN&ROGERS PC 635 N 12TH ST STE 400 LEMOYNE,PA 17043 Dear Elyse E Rogers: As requested,please find the Date of Death Account Valuation for the Estate of Christine J Martin. Estate Valuation Account Number: Z42286133 Individual TOD Value Date: 08/03/2014 Share Symbol Security Description Qty Value Price AGRFX ALLIANCEBER GROWTH CLASS A 614.22 $35,182.51 $57.28 ABQUX ALLIANCEBER INTERMEDBOND CL A 2361.154 $26,468.60 $11.21 T AT&T INC COM 23 $815.52 $35.46 CMCSA COMCAST CORP NEW CL A 72 $3,861.18 $53.63 DTE DTE ENERGY HOLDING CO 42 $3,096.08 $73.72 FBALX FIDELITY BALANCED 202.316 $4,772.63 $23.59 CRYSTAL PPTYS HLDGS INC CL A 100 $0.00 $0.00 Total Securities: $74,196.52 Cash/Money Markets: $10,172.02 $1.00 Total Value: $84,368.54 Estate Valuation Account Number: 2BZ616567 (Joint) established 03/28/1996 Value Date: 08/03/2014 Share Symbol Security Description Qty Value Price FASGX FIDELITY ASSET MANAGER 70% 6152.569 $130,680.60 $21.24 Total Securities: $130,680.60 D? )!) 1:V,'Brokeraee Services provided by Fidelity Brokerage Services LLC Member NYSE,SIPC Clearing,custody and settlement services by National Financial Services LLC Member NYSE,SIPC P..O.Box 770001,Cincinnati,01-145277-0034 ` ` ~. ' . - =11111111111k AIF IV0N� MEMBERS 11t FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 351112-00 Date Account Established 03/08/2000 Principal Balance atDate ofDeath $5.07 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $5.07 Name ofJoint Owner Nona CERTIFICATE OF DEPOSIT: - A000untNumher/SuOix 351112-42° Date Account Established 12/04/2013 Principal Balance at Date of Death $5.32449 Accrued \Oten}St to [}ate of Death $0.39 Total Principal dAccru d Interest @n � n reot $5.324.88 Name 0fJoint Owner Pamela C Martin Date Joint Added 05/08/2012 *Rollover from CD351112-4Oopened O5/06/2O12. yNEM8ERG 1 ST FEDERAL CREDIT UNION -- Teasa�K]�gh - L�ndinQ \nour�ncaSu , 8pedaUst October 2. 2O14 Estate of: CHRISTINE J MARTIN Date ofDeath: 08/03/2014 ' Social Security Number: 157-20-2064 ' 5000 Louise Drive " �O. Box 40 " Mechanicsburg,Pennsylvania 17055 ° (800) 20-2328 ~ www.members1st.org Fidelft�. "m"".S r""e ivy SAW September}6,2Ol4 ELYSBE ROGBDS C/O LAW OFFICES OF SADDI8SULLIVAN&DDGERSPC 635N12z11STSIB400 LEM0YBE`PAl7043 Dear Elyse BRogers: As requested,please find the Date of Death Account Valuation for the Estate ofChristine JMartin. Estate Valuation Account Number: Z42286133 |ndividua|TOD Value Date: 08/02C2014 8hona Symbol Security Description Oty Value Price AGRFX ALL|ANCEBERGROWTH CLASS A 614.22 $35,182.51 $5728 AB(2UX ALL|ANCEBER |NTERMEDBDNDCLA 2361.154 $26.468.60 $11.21 T AT&T INC COM 23 $815.52 s35.46 CK4CSA COK8CASTCORP NEW CLA 72 G3.86118 *53.03 DTE DTE ENERGY HOLDING CO 42 $3'096.08 $73.72 FBALX FIDELITY BALANCED 202.316 $4.772.63 $23.59 CRYSTAL PPTYSHLOGSINC CLA 100 $0.00 G0.00 Total Securities: $74.196-52 Cash/Money Markets: $10.172.02 $1.00 Total Value: $84.368.54 Estate Valuation Account Number: 2BZ616567 Uoint\ established O2&2B/19S6 Value Date: 08K03C2014 Shan* Symbol Security Description Oty Value Price FASGX FIDELITY ASSET MANAGER 70% 6152.569 $130.680.60 $21.24 Total Securities: $130.680.60 �xBrokerage Services provided uvFidelity Brokerage Services LLC Member NYSE,SnC Clearing,CUstody aiTd settlement services o'National Financial Services LLC Member NYSE,opc Ro,Box 77oom.Cincinnati,on45zn-0o34 Fidelftv. t N Y E S T M E N T Estate Valuation Account Number: 2BZ616559 IRA Value Date: 08/03/2014 Share Symbol Security Description Qty Value Price FASMX FIDELITY ASSET MANAGER 50% 1959.875 $35,297.35 $18.01 Total Securities: $35,297.35 The beneficiary of account number Z42-286133 is Pamela C.Martin— 100%. The beneficiaries of account number 2BZ-616559 are Pamela C.Martin—70%and Richard D.Martin—30%.C��C� S��\J All values included represent the Fair Market Value(FMV)of assets held in the account as of the owner's date of death. The report does not include Limited Partnerships, Options,Precious Metals or Worthless Security positions held in the account as of the date of death nor any accrued dividends not distributed prior to the date of death. Values for any accounts that only hold those asset types are therefore,not included. Fidelity does not warranty the accuracy of this information for any particular purpose nor does Fidelity provide legal or tax advice. Consult with an attorney or tax professional regarding any specific legal or tax situation. FOR TRUST ACCOUNTS: Please note that if the account on the valuation is a trust registration reporting under a social security number(SSN),then the cost basis of 100%of the account will automatically be stepped up. If the trust has an employer identification number(EIN), a separate request must be submitted. The letter must include the following three items: 1. A statement that the trust qualifies under the IRS regulation to receive a step up 2. The percentage of the trust that should be stepped ups 3. The signature of a currently acting trustee The request to update cost basis should be sent directly to: Fidelity Investments ATTN: Cost Basis 100 Crosby Pkwy,Mailzone KCIK-PR Covington,KY 41015 We hope this information is helpful. If you have any questions regarding this matter or need instructions on how to transfer the ownership of the accounts not yet transferred,please call us at 800-544-0003. Fidelity Inheritor Services Representatives are available Monday through Friday, from 8:00 A.M. to 6:30 P.M.Eastern time,or you may visit our website at www.fideliiy.com and search under"change account registration"for additional information. Sincerely, Fidelity Investments Operations and Services Group Our file number: W940047-14SEP14 Dffl)M V,Brokerage Services provided by Fidelity Brokerage Services LLC Member NYSE,S1PC Clearing,custody and settlement services by National Financial Services LLC Member NYSE,SIPC P.O.Box 770001,Cincinnati,OH 45277-0034 i D Last Will and Testament OF CHRISTINE J. MARTIN I, CHRISTINE J. MARTIN, of South Middleton Township, Cumberland County, Pennsylvania, do make, publish and declare this to be my Last "7111 and Testament, hereby revoking all Wills and Codicils by me heretofore made. ITEM I: Family Information. I am a widow. I have one living child: PAMELA C. MARTIN. My son, RICHARD D. MARTIN, has predeceased me. Any person born to or adopted by issue of mine is to be included as issue of mine. Provided, however, no adopted person shall benefit under this NA7111 unless the order or decree of adoption is entered before the adopted person attains the age of twenty-one (21) years. ITEM II: Death Taxes. I direct that all inheritance and estate taxes becoming due by reason of my death, whether payable by my estate or by any recipient of any property, shall be paid by the Executor out of the residue of my estate, as an expense and cost of administration of my estate. The Executor 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. Law Offices of Saidis Sullivan ITEM III: Debts and Final Expenses. I direct the & Rogers Executor to pay the expenses of my last illness, my legally enforceable debts, 635 North 12th Street and my funeral expenses from the residue of my estate as an expense and cost Suite 400 Lemoyne,PA 17043 of administration of my estate. Page 1 ITEM IV: Tangible Personal Property. (a) Written List. I may leave a written list in my safe deposit box or elsewhere disposing of certain items of my tangible personal property. The Executor shall dispose of items of my personal property as specified in the written list. If no written list is found in my safe deposit box or elsewhere and properly identified by the Executor within thirty (30) days after the probate of my Will, it shall be presumed that there is no other statement or list. Any subsequently discovered list shall be ignored. (b) Other Property to Daughter. I give all of my household furniture and furnishings, books, pictures, jewelry, silverware, wearing apparel and all other articles of household or personal use or adornment and all policies of insurance thereon which are not set forth in a written list to my daughter, PAMELA C. MARTIN, if she survives me. If she does not survive me, I make this gift to my son-in-law, WALTER J. PASKEY. ITEM V: Residue. I give the residue of my estate, not disposed of in the preceding portions of this Will, as follows: (a) To Zoe Martin. TEN (10%) PERCENT to my Law Offices of granddaughter, ZOE MAARTIN, to be added to her existing 529 Saidis Account, of which her mother, SUSAN YEE MARTIN, is Sullivan custodian/owner. If my granddaughter, ZOE MARTIN, does not & Rogers survive me, this share shall lapse. 635 North 12th Street Suite 400 Lemoyne,PA 17043 (b) To/For James Al. Martin. The Executor shall expend TEN (10%) PERCENT of the residue to discharge any student loans owed by my grandson, JAMES M. MARTIN, at the time of Page 2 n my death. If these student loans are fully discharged, the Executor shall distribute this share to him. If my grandson, JAMES M. MARTIN, does not survive me, this share shall lapse. (c) To Adrian Paskev. TWENTY-FIVE (25%) PERCENT to my granddaughter, ADRIAN C. PASKEY. If she has not attained the age of thirty (30) years at the time of my death, the Executor is authorized to add this to any existing 529 account for her benefit or otherwise to use this for her education. If she has attained the age of thirty (30) years, this share shall be distributed to her. If my granddaughter,ADRIAN C. PASKEY, does not survive me, this share shall be added to the share for my daughter, PAMELA C. MARTIN and my son-in-law, WALTER J. PASKEY. (d) To Pamela C. Martin and Walter J. Paskev. FIFTY (50%) PERCENT to my daughter, PAMELA C. MARTIN and my son-in-law, WALTER J. PASKEY, or all to the survivor of them. If neither of them survive me, this share shall be added to the share for my granddaughter, ADRIAN C. PASKEY. (e) To the Dr. Richard D Martin Memorial Fund. FIVE (5%) PERCENT to the LEHIGH VALLEY COMMUNITY FOUNDATION, 968 Postal Road, Suite 100, Allentown, Pennsylvania 18109-9301, to be added to the Dr. Richard D. Law Offices of Martin Memorial Fund, provided that it is still in existence and Saidis qualifies as an organization under Section 501 (c)(3) of the Sullivan Internal Revenue Code, as amended. & Rogers 635 North 12th Street ITEM VI: Administrative Powers. In addition to Suite 400 Lemoyne,PA 17043 the powers granted at law, the Executor shall possess the following powers, each of which shall be construed broadly and may be exercised without court approval, but in a fiduciary capacity only: Page 3 (a) Retain Investments. To retain any investments I have at my death, including specifically those consisting of stock of any bank even if I have named that bank as the Executor. (b) Vary Investments. To vary investments and to invest in bonds, stocks, notes, real estate mortgages or other securities or in other property, real or personal, without being restricted to so-called "legal investments", and without being limited by any statute or rule of law regarding investments by fiduciaries. (c) Division of Assets. In order to divide the principal of my estate or make distributions, the Executor is authorized to distribute personal property and real property partly or wholly in kind, and to allocate specific assets among beneficiaries so long as the total market value of each share is not affected by the division, distribution or allocation in kind. The Executor is authorized to make, join in and consummate partitions of lands, voluntarily or involuntarily, including giving of mutual deeds, or other obligations, with as wide powers as an individual owner in fee simple. (d) Sell Assets. To sell either at public or private sale any or all real or personal property severally or in conjunction with other persons, and to consummate sale(s) by deed(s) or other Law Offices of instrument(s) to the purchaser(s), conveying a fee simple title. Saidis No purchaser shall be obligated to see to the application of the Sullivan purchase money or to make inquiry into the validity of any sale. & Rogers The Executor is authorized to make, execute, acknowledge and 635 North 12th Street Suite 400 deliver deeds, assignments, options or other writings as Lemoyne,PA 17043 necessary or convenient to carry out the powers conferred upon the Executor. Page 4 V (e) Encumber Real Estate. To mortgage real estate, and to make leases of real estate. (f) Borrow Money. To borrow money from any person, including the Executor, to pay indebtedness of mine or of my estate, expenses of administration or inheritance, legacy, estate and other taxes, and to assign and pledge assets of my estate. (g) Pay Costs. To pay all costs, taxes, expenses and charges in connection with the administration of my estate. (h) Distributions without Court Order. To make distributions of income and of principal to the proper beneficiaries, during the administration of my estate, with or without court order, in such manner and in such amounts as my Executor deems prudent and appropriate. (i) Rights as Stockholder. To exercise voting rights with respect to securities which form a part of my estate, and to exercise all the powers incident to the ownership of securities. (j) Reorganize. To unite with other owners of property similar to property in my estate to carry out any plans for the reorganization of any company whose securities form a part of my estate. Law Offices of Sa.idis (k) Disclaim. To disclaim any interest in property Sullivan which would devolve to me or my estate by whatever means, & Rogers including but not limited to the following means: as beneficiary 635 North 12th Street under a will, as an appointee under the exercise of a power of Suite 400 Lemoyne,PA 17043 appointment, as a person entitled to take by intestacy, as a donee of an inter vivos transfer, and as a donee under a third-party beneficiary contract. Page 5 (1) Tax Returns. To prepare, execute and file tax returns of any type required by applicable law, and to make all tax elections authorized by law. (m) Allocate Expenses. To allocate administrative expenses to income or to principal, as the Executor deems appropriate. However, no allocation to income shall be made if the effect of the allocation is to cause a reduction in the amount of any estate tax marital deduction or estate tax charitable deduction. (n) Employ Advisors. To employ custodians of property, investment or business advisors, accountants and attorneys as the Executor deems appropriate, and to compensate these persons from assets of my estate, without affecting the compensation to which the Executor is entitled. (o) Compromise Claims. To compromise claims. (p) Other Acts. To do all other acts in the Executor's judgment deemed necessary or desirable for the proper and advantageous management, investment and distribution of the estate. ITEM VII: Survival. Any person who has died Law Offices of within thirty (30) days of my death, or under such circumstances that the Saidis order of our deaths cannot be established by proof, shall be deemed to have Sullivan predeceased me. & Rogers 635 North 12th Street ITEM VIII: Executors. I make the following Suite 400 Lemoyne,PA 17043 provisions with respect to Executors: Page 6 (a) Primary Executor. I appoint my daughter, PAMELA C. MARTIN, to serve as Executor. (b) Contingent Executors. In the event that PAMELA C. MARTIN is unable or refuses to serve as Executor, I appoint my son-in-law, WALTER J. PASKEY, to serve as the Executor. If both my daughter and my son-in-law are unable or refuse to serve as Executor, I appoint my fiend, THOMAS A. ROR.EX, to serve as Executor. (c) Compensation. The Executor shall have the right to receive reasonable compensation for services rendered and reimbursement for reasonable expenses. (d) Standard of Care. No Executor shall be liable or accountable for any loss that may result from the good faith exercise of the authority granted in this Will. (e) Security. The Executor is specifically relieved from the duty of filing bond or entering security. IN NATITNESS `THEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding six (6) pages, at the end of each page of which I have also set my initials for greater security and better identification this )_9 day of , 2A . Law Offices of Saidis — - 2 (SEAL) Sullivan CHRISTINE J ZARTIN & Rogers 635 North 12th Street Suite 400 Lemoyne,PA 17043 We, the undersigned, hereby certify that the foregoing «Till was signed, sealed, published and declared by the above-named Testatrix as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. KA &'�i (SEAL) Residing at A � 4 r (SEAL) Residing at f Alo"4�c5L'a Law Offices of Saidis Sullivan & Rogers 635 North 12th Street Suite 400 Lemoyne,PA 17043 ACKNMA LEDGMENT COMMONWEALTH OF PENNSYLVANIA ) } SS: COUNTY OFA -v�- ) I, CHRISTINE J. MARTIN, Testatrix, 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 fee and voluntary act for the purposes therein expressed. -�-� (SEAL) CHRISTINE YMARTIN Sworn to and subscribed before me thisc--�-q4�- day of 201 Notary Public My Commission Expires: (SEAL) Law Offices of Saidis Sullivan & Rogers 635 North 12th Street Suite 400 C0tRA0N%ArEALTH OF PENNSYLVANIA Lemoyne,PA 17043 NCTA.Ri;`,L SEAL CYI-ITHIA J RUL",N'0" r7 Public E Boro;uh of L eroyne Clunteriend COurity My Commission Expires Fsbru,:ry 3,2016 i AFFIDAVIT COMMONAVEALTH OF PENNSYLVANIA ) (� ) SS: COUNTY OF We, &I i, and L.C S e 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 Testatrix, CHRISTINE J. MARTIN sign and execute the instrument as her Last Will and Testament; that Testatrix signed willingly and that she executed said Will 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 '"Till as Witnesses; and that to the best of our knowledge the Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no constraint of undue influence. r 1 a ITitness «Tit ess Sworn to and subscrib d before me this aq 4-&-day of 201 Law Offices of Sa,idis Sullivan Notary Pu lic & Rogers Aly Commission Expires: 635 North 12th Street (SEAL) Suite 400 Lemoyne,PA 170435l'' 'Jf iq€Fa tt„,,L NCY wAL S Pur,I C 1 C'NiHA iRLU: i.0�-ry ('�ntnr!_�nd Count Boroge i of �Y i6 tlV(,omrnnis--loll Enol C-s