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Home My WebLink About01-0165 PETInON IfORP-ROBATE anOGRANT OF ~l.l.liliS Estare of MARY L. KLINGLER also known as No. To: Register of Wills for the Deceased. County of Cumber land in the Social Security No. 180-26-55/4 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/aR 18 years of age or older an the execut rix in the last will of the above decedent, dated March 11 and codicil(s) dated 21-01-165 named , 1997 (srare relevant circnmstances. e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumber land J19.untt' ~enll~Jv~~~tB her last f.a.miIv. or principal residence at 1 30 7 Scenery vri~ 1 ve prlrrg s p, Cumberland county, PA (list street. number and muncipality) Decendent, .th~n 70 years of age, died Januarv ~2001 ~ at Holy Splrlt HOSplta:l, East ~nnsooro Twp., C r.ldIU1LowILy, 1:'1\' . Except ~.~ f <,Haws, decedem did not marry. was not divorced and did not have a child born or adopted after execution of rhe will offered for probate; was not the victim of a killing and was never adjudicated incompetent: __ Decendenr ai. dea(h Gwned property with estimated values as follows: (If domiciled in .P.~.} All personal property (If not domidled i:l Fa) Personal property in Pennsylvania (If not domic:~~d in Pr~.) Personal property in County Value cf ren: esrat~ 1~. Pennsylvania situated as foBows: 110.7 Sr.enerv Drive. Cumberland.~ounty, PA S 160,000.00 S S S 100.000 _ 00 Silvpr ~prina Township, WHEREFORE, petitioner(s} respectfully request(s) the probate of the last will and codiciI(s} presented herewith and the grant of letters testamentary theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) '" lj' --'-( -,., - - !~ fr~~ ~C1~ :x~ ~c -.- ;.= E~ u~ = O' :; C OIl CiS 313 Glenn Road Camp H1Ll, PA I fUn OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF' GJr.1BERLAND The peti[icner(~) abo\- ~-m~med swear(s} or affirm(s) that the statements in the foregoing petition are true and correct to th~ b~st o{ the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decccem perlrloner(s) will ~niSter the estate according to law. sw....o,.. .rn. to .o,r, .a. .f, fi.rme, d. "'" and, subscribed { C , ~ ~ before me this ~tb , da1' of Trema C. Bender ~ 52{p;;~~Y)~.__..-.- ~ 001 ~ , I ( .' ~J..~~-~ f);;/,./ . ~ . ./ / R~grsrer ~ ~ / b '. r.2C? 9'.'=______ ~o. 21-01-165 Estate of Mary L. Klingler , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW FEBRUARY 12 ~,200 1 . in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated March 11, 1997 described therein be admitted to probate and filed of record as the last will of Mary L. Klingler and Letters Testamentary are hereby granted to Trema C. Bender FEES Probate, Letters, Etc. ......... $ 270.00 Shorr Certific3tes( ).......... S l~. gg x-pag~s. . RenUnCIatIOn ................ $ JCP $ 5.00 TOTAL _ $ 30 /., 00 Filed .. .EF;~~YA~X . ~ l . .2.o.Q ~ . . . . . . . . . . . . . . )7'--' /.:' \. /. - . .:'. I /7w~,::,,~//,,"f.hn~ tf.(t / A <',d'( ( , ( -, ~giS[er uf .wills ! W~ David H. stops #39785 AlTORt1F.Y (Sup. Ct. 1.0. No.) 414 Bridge st., New Cumberland, PA 17070 ADDRESS (717) 774-7435 PHONE t~)n\ ,1 i((''11 P llri:-:.IILll u:nific;ltL' D: dc:;!:!1 d 11\' llled with me as 'Ju L Vi 111 Rt, ods (Hfi ,~c k!r 1'"1'111 a 11L'1! t ti [111 g, I)... IS [,J Rl':..:i"tLlI, t h, \t I L c' 1:1 r, ) n ],,1{1 (I n h l'i'l' ',i'\1', ,. II) "L'.rtI/t,1ft' WIll - UllFll1, ~ . \VARNING: It is illegal to duplicate this copy by photostat or photograph. t'l't' it); rhi., ,'null, lie 1011 /"lil(~:~jfgtpi2:;, ll~~~lJ .t ,\ ,.~. *.J.: \~-?rMi~'. ,,< 'FA'Jt ~<''-.~~~~.;' .,'~" ~,;~;'~~ \_',,', p 7175760 ---~-- ,.--,-----.-- -_.._---~---.-.._'- ~- , '.. : ~ 21-01-165 . /7 . ~~, ,r;;5't.::-...-I" ~ /'.... ,/ ~.;;..'t.....l-~..,...;~.~--- -..--.-'--..---------d.. ,..' IIJ(.-,d ",1 , ').~ '/0111 t.) J, L_UL t I \t!, 143 Rev 2187 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH STATE FILE NUMBER SOCIAL SECURITY NUMBER Did decedenl live In a Cumber land townshIp? 17d.D :~I=ot MOTHER'S NAME (F"s(, Ml(ldle. MaiOen Surname) 19. Mar Weistlin INFORMANT'S MAILING ADDRESS (Street, CltyfTown, Slate, Zip Code) 2~313 Glenn Road Cam Hill PA 17011 PLACE OF DISPOSITION. Name of Cematery. Crematory LOCATION. Cil\llTown, Stale, Zip Code or Othar PIKe Paddletown Cemetery Newberrytown,PA 17314 21c. 21d, NAME AND AOOAESS OF FACILITY 1 7 7' 0 ~.one&Murra FH408 3rd St New Cumberlang PA LICENSE NUMBER DATE SIGNED (Month. Day, Year) NAME Of DECEDENT (F"SI. Moddle. lasl) SEX 1,Mar Female UNDER I DAY Hour1I '! Mlnut.. 70 5. COUNTY OF OEJIO'H Cumberland ~~st Pennsboro T Q, KINO OF BUSINESs/INDUSTRY Mfgr. Products 13. DECEDENT'S USUAl OCCUPATION (~~~~::;zr,:'f . 11a.Production Set--up ~?pi tol DECEDENT'S MAILING ADDRESS (Slrll8l. CitylTown. State. Zop Code) 1307 Scenery Drive Mechanicsburg,PA 17055 I'. fATHER'S NAME IF,,51. M,Odle LaSl) ".Frank Wri ht INFORMANT'S NAME (Typelpnnn ~.Trema C. Bender UETHOO OF DISPOSITION BunaI 89 CrematIOn 0 Removal I,om Sial. 0 Ot'- (Speedy! DECEDENT'S ACTUAL RESIDENCE (See lnstrucuons on Oltler Slde) 17a. SIal. PA 17b. Coun DonatIOn 0 . 21.. SIGN U OF fUNERAL SERVICE LICENSEE OR PER _ 22a. 'I1'V~ ~~~~, :=- ~-- te rtema 23a-<: only when cently.ng _~ wan IS not: available al time o' death to =' CA'*' 0/ death. 2001 L IMMEDIATE CAUSE (F,nal aosease 01 COOlllttOn resunu"J In Cl6aIh)- DUE Sequenually II. c:ondtIlOna n any, leading 10 _.. .,.... Enter UNOERLYING CAUSE (0.- OII"""y . . Ihat ,",,&a\ee e_ r8SUIIInQ In 0e8lh) LAST DUE TO (OR AS A CONSEQUENCE OF): WAS AN AUTOPSY PERFORMED? d WERE AU10PSY FINDINGS AI.ltJLA81E PRIOR TO COMPLETION OF CAUSE OF DEATH7 HomICide MANNER OF DEATH DATE Of INJURY (Monlll. Day. Year) Natural ~ Accident 0 Swcide 0 3.180 - 26 5574 g'=,ty) 0 RACE. AmencAn Indien, Black, Wh_e. ale (Specity) 10, Whi te SURVIVING SPOUSE I" WIle, grve maiden name) MARITAL STATUS. Mamed Never Marriecl, W~. DivOrced (Specdy) 1.. Widowed 17c.~ v..,~llvedln Silver Spring t.. crtylboo 23b. 23c. WAS CASE REFERRED TO MEDICAL EXAMINERlCORONER? Yes 0 ~ 21, I Approxunata : intllfVaI belween I onset and death I I I PART II: Other stgf1incant condiliona oontllbuting to death, but not resuning in tha undeflying cause _ in PART I TIME OF INJURY INJURY IU' WORK? DESCRIBE HOW INJURY OCCURRED. Pending Invesligallon o o o ~CE OF INJURY, At home. fa";, st;H\, factory, otllce M. building, etc. (Spec,ly) 308, 3OC. ......0 No0 v..s0 NoD Could nol be determined I '!~ 2... 21b, CERTifIER ,Check only one) .CERTIFYING PHYSJCIAN (phYSlC..an certltylng cause of death wtl6fl another phYSICian has pronounced dealh anO ccrnpleled Item 231 To the _ of my knowledge, death occurred due to the CM>M(aland manner.. ...1.... , , . . . , , . . , , . , , . . . . , , , . . . , , , . , . , , . , , , . , . , , . . , . . , 29, . PRONOUNCING AND CEflTIFYING PHYSICIAN (Phy"",'an tJolh ~lonouroC.ng oealh anO cer1ltylng 10 cause 01 oeath) To the _ of my knowledve, d.ath occurr... at the t....., dale. and place, and duato the cau..,a) and manner 00 alat... 'MEDICAL EXAMINERlCORONER On the baala ole.aminellon and/or Invesllgation, in mv opinion, dealh occurred al the lime, date, and place, and due to the cauae(a) and menner.. alated.. , . . . , . . , . .. .....,',..,',.,",.,.,....,',.,..."....,.,....,.".""."..,..,.,.,.,.".,."".., 31a REGISTRAR'S SIGNATURE AND NUMBER I Jr /I~ / I II 33 Yes 0 NoD SIGNIU'URE AND TIT ~ 31b. LICENSE NUMBER o 31c. 31d. NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH (lIem 271 Type or Print Dr. Francis S. Perna, MD C~~ 1 ~icr~r 11Ai~ ve o 32. DATE FILED (Month 34. ep\wills\klingler.ml\3-97 21-01-165 LAST WILL AND TESTAMENT OF MARY L. KLINGLER I, MARY L. KLINGLER, of Silver Spring Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I bequeath all of my household goods and personal effects in equal shares to such of my children, BENJAMIN F. GILBERT and TREMA C. BENDER, as survive me. ITEM II: I devise and bequeath all the rest, residue and remain- der of my estate, of every nature and wherever situate, in equal shares to my children, BENJAMIN F. GILBERT and TREMA C. BENDER, provided they survive me. Should either of my children, BENJAMIN F. GILBERT or TREMA C. BENDER, fail to survive me, all the rest, residue and remainder of my estate, of every nature and wherever situate, shall be divided one-eighth to the issue of such deceased child and the remaining seven-eighths to my living child. Should both BENJAMIN F. GILBERT and TREMA C. BENDER fail to survive me, all the rest, residue and remainder of my estate, of every nature and wherever situate, shall be distributed to my issue, per stirpes. ITEM III: I appoint my Executrix and her successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this ap- Page 1 of 4 pointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM IV: I appoint my daughter, TREMA C. BENDER, Executrix of this my last will. Should my daughter, TREMA C. BENDER, fail to qualify or cease to act as Executrix, I appoint my son, BENJAMIN F. GILBERT, Executor of this my last will. No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his/her duties ITEM V: in any jurisdiction. IN WITNESS WHEREOF, I, MARY L. KLINGLER, have hereunto set my hand and seal this l ( day of ~~ , 1997. .... \. ). .~ '~~' ",' '. r- :, -', "'-- ". "\ ,. , ,~ "Il. \J..j. ......J '. . '" \ \~ )..x A MAI{Y"'~. KLINGLER G - SIGNED, SEALED, PUBLISHED and DECLARED by MARY L. KLINGLER, the Testatrix above named, as and for her Last will and Testament, and in Page 2 of 4 the presence of us, who at her request, in her presence and in the presence of each other, ~'l"((r~ ltness have subscribed our names as witnesses. Ll-v(~~ 4 Address / , ,t(_~ ,;:#?i 'I Dt'l ), )) Wltness ;;t,.. ./ i 'J . '<.._..ifJ--rt,cL / / I /), .J \.."). r. IL-t t(j (~L'J?LIC(~ / ~ -H' .if.. Address p:"/y" COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF CUMBERLAND I, MARY L. KLINGLER, the 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 this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. r--. f' ''-'\\~() ~ ~ ~L~~U Sworn to or affirmed to and acknowledged before me by MARY L. KLINGLER, the Testatrix, this (( day of ~~"- , 1997. /) ~'.':_) (I ._._/ . './ (J.. ~1A...<L~~{,//'" "'~ Q,,\.x--t Notary Public Page 3 of 4 r'--'=-~""'~'~~-.~"--"~'''~'-~~ I., . ~ ~j ---......-. -..' "....-..-.......-......... ._..._,..~.' ..~..---..1 COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND We, DA$AA J4--- /' and yll-1L ''1La 7<;--) 0 l'j~,';"tt~lt/)-0~} the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she 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; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. tr " / ... - .r'''-'.j )(; ,~N/ 7L~ ))-1, /L,ltJ-h"L.L en YJ witness Sworn to or affirmed to and acknowledged before me by ~'^ l-f ~ ( ( day of and flm~l [L)/} /7{).. /vl 1*1 to.._ I /I't '7r witnesses, this , 1997. a -/;. v I~~ ,J ,-IL/}ul /0-14 /~. ~, ~/0~L Notary Public Page 4 of 4 '''''-'-'--'~' '1 i ..-...--......-..---.-.--....-_1 STO~E. LAFAVER & SIIEKLETSrZI A. PROfTSSIONA_L CORPORATION ATTORNEYS AT LAW 414 BRIDGE STREET lS'EW C!"HlJEHL\..:Yn, P.\ 17070 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) .\L;'" :Jec:eie:lt: t1A:::r'! L. K="L=N:::;~ER (!ctt =,f :Jec;.:h: Ja::l.uary 3et 2]01 \';~ _ ~o. 20J1-00165 T(J tl:e Register: I certify that notice of beneficial interest requlred by Rule 5.6~a) of the Orphans' Cou~t rules was served on or mailed t8 t~e f81lowi::l.g beneficiaries of the above captioned estate on Februal'Y 14, 2001. Trerr,a C:. Bender 313 Glenn Road Camp Hill, PA 17011 Benjamin F. Gilbert 319 Mt. Allen Drive Mechanicsburg, PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) Date: f) " "" "I ,(. (J t r ")" ,( DAVID H. STONE, Esquire 414 Bridge Street New Cumberland, PA 17070 717-774-7435 Capacity': Personal Representative x Counsel for Personal Representative cst\mis\KLINGLERrealestate IN RE: ESTATE OF MARY L. KLINGLER,: LATE OF SILVER SPRING TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA,: DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-01-0165 JAN 1 3 2004 . L.. DECREE AWARDING REAL ESTATE NOW, this 11: ~y of , 200t at I ~ S!> ~.M.' prevailing time, it appearing that the First and Final Account and Statement of Proposed Distribution of Trema C. Bender, AND o'clock Executrix of the Last Will and Testament of MARY L. KLINGLER, De- ceased, have been duly filed and advertised according to law and Rules of Court, and said First and Final Account and Statement of Proposed Distribution have been confirmed and approved by the above Court in and for Cumberland County, Pennsylvania, on October 25, 2002; and it further appearing that the said Executrix has in her Statement of Proposed Distribution proposed to distribute certain Real Estate in kind to TREMA C. BENDER, in accordance with the provisions of the Last Will and Testament of Mary L. Klingler, Deceased, and the Court aforesaid having decreed distribution in accordance with said State- ment of Proposed Distribution. IT IS ORDERED, ADJUDGED AND DECREED that all right, title and interest of the said Mary L. Klingler, Deceased, in and to -1- ALL THAT CERTAIN lot of ground situate in the Township of Silver Spring, County of Cumberland and Commonwealth of Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point in the western line of Scenery Drive (50 feet wide), which said point is in the division line between Lots Nos. 58 and 59 on the hereinafter mentioned Plan of Lots; thence extending along the western line of Scenery Drive, South 05 degrees 00 minutes East, one hundred five (105) feet to a point in the division line between Lots Nos. 59 and 60 on said Plan; thence extending along the division line between Lots Nos. 59 and 60, South 85 degrees 00 minutes West, one hundred sixty (160) feet to a point; thence North 05 degrees 00 minutes West, one hundred five (105) feet to a point in the divi- sion line between Lots Nos. 58 and 59 on said Plan aforementioned; thence extending along the division line between Lots Nos. 58 and 59 on said Plan aforementioned; thence extending along the division line between Lots Nos. 58 and 59, North 85 degrees 00 minutes East, one hundred sixty (160) feet to a point in the western line of Scenery Drive, aforementioned, at the point and place of BEGINNING. BEING Lot No. 59 on Plan No. 2 of Bunker Hills, which said Plan is recorded in the Cumberland County Recorder's Office in Plan Book No. 22, Page 65. HAVING thereon erected a brick and aluminum type dwelling. SUBJECT to restrictions and conditions as contained in prior deeds. BEING the same premises which Cleason C. Cromer and Florence A. Cromer, husband and wife, by their deed dated January 6, 1972, and recorded January 7, 1972, in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Deed Book "L", Volume 24, Page 145, granted and conveyed unto Fred D. Klingler, Jr., and Mary L. Klingler, husband and wife. The said Fred D. Klingler, Jr., died January 3, 1997, thus vesting title in Mary L. Klingler, the decedent, is hereby awarded unto TREMA C. BENDER in fee simple. IT IS FURTHER ORDERED AND DIRECTED that a certified copy of the Decree be recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, among the deeds recorded in said -2- Office, said Decree to be indexed in the Grantor Index against the Estate of Mary L. Klingler, Deceased, and in the Grantee Index to Trema C. Bender, pursuant to the Probate, Estates and Fiduciaries Code, Act of 1972, P.L. 164, Section 3536 (20 PA. C.S.A. 3536). BY THE COURT, J. -3- 2s:\ffa\Kling:ernot I IN RE: ESTATE OF MARY L. KLINGLER LATE OF THE TOWNSHIP OF SILVER SPRING, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPH,A:NS' COURT" DIVI ION NO. "21-01-0165 NOTICE OF FILING ACCOUNT AND STATEMENT OF PROPOSED DISTRIBUTION NOTICE IS HEREBY GIVEN THAT Trema C. Bender, Executrix of the Last Will and Testament of Mary L. Klingler, deceased, has this date filed his First and Final Account and Statement of Proposed Distribution in the above captioned Estate in the Office of the Register of Wills in and for Cumberland County, Pennsylvania, at Carlisle, PA 17013, where the same are filed as public records and may be inspected. Enclosed herewith are copies of the Inventory, First and Final Account and Statement of Proposed Distribution as filed, together with copies of the will. YOU are further notified that any exceptions or objections to said account or statement must be filed in writing at the Office of the Register of Wills aforesaid prior to the confirmation of said account scheduled as set forth below. UNLESS written exceptions or objections are filed prior thereto, said account and statement will be presented to the above captioned Court in Court Room No. 1 of the Cumberland County Courthouse, Carlisle, Pennsylvania, at 9:30 A.M., prevailing time on Tuesday, June 18, 2002, at which time said account will be con- firmed and distribution ordered in accordance with the Statement of Proposed Distribution. DATE OF NOTICE: ~ \( -i ~i \~~ NOTICE TO: 1. Trema C. Bender, 313 Glenn Road, Camp Hill, PA 17011 ~ I I: I, I e5t\mis\K~=GGLt~disclaime~ IN RE: ESTATE OF MARY L. KLINGLER,: IN THE COURT OF COMMON PLEAS OF LATE OF SILVER SPRING TOWN-: CUMBERLAND COUNTY, PENNSYLVANIA SHIP, CUMBERLAND COUNTY, ORPHANS' COURT DIVISION PENNSYLVANIA, DECEASED NO. 2001-00165 DISCLAIMER UNDER 20 PA C.S.A. ~6201 The ESTATE OF BENJAMIN F. GILBERT, JR., DECEASED, late of Cumber- land County, Pennsylvania, by his Executrix, Trema C. Bender, hereby exercise the rights granted to Benjamin F. Gilbert, Jr., in Chapter 62 of the Probate, Estates and Fiduciaries Code, 20 PA C.S.A. ~6201-6107, and hereby disclaims and renounces any and all of his right, title and interest which he may have in the said estate of Mary L. Klingler as a beneficiary under the Last Will and Testament of Mary L. Klingler. IN WITNESS WHEREOF and intending to be legally bound hereby, and intending that this disclaimer and renunciation shall be filed of record in the Office of the Clerk of the Orphans' Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania, as provided in 20 PA C.S.A. ~6204(a), I have hereunto set my hand and seal this 10 M day of Gfb'u.l , 2002. ~rrloL 8Zr(~cie/ '1 c ( SEAL) TREMA C. BENDER, Executrix of the Estate of Benjamin F. Gilbert, Jr. "",. COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF Cu.{Y\f)e~LA^Na On this, the Ig~ day of Q . /j -1tOA1- (! , 2002, before me the undersigned officer, a Notary Public, personally appeared TREMA C. BENDER, EXECUTRIX OF THE ESTATE OF BENJAMIN F. GILBERT, JR., known to me (or satisfactorily proven) to be the person whose name is sub- scribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official se2l the day and year first above written. V~"-/I1 ~ Notary PU~ll ."'O"'\"':u.'l.~':~~~ ," _fijl.:J.qr .,...... "'.'.'_, ~ -; NC')TARil\L ~Jt:J'\L " ,i i T]NA M. BURKEY. Netmy l~e~nl!~. j .- . "'] ~ -'t :"1." - ......., ~t""\ ~ Ii ''-li-N; Cumberl3Pt,JbChU, \AJmhe,H~~:~~O. '., Commission ExplrQs Apr1l1~J, d~15 : ~___.-__....., __".__......'"'.~...:;.:,......,.>oil>':".., ::!'~'lIf'_:~~:.M~.t.z..;4>:.::!<.~,"-. '--","""",,"- t:;J () "r ,; ~ ')Ofj" ..)' (.,/ (! {" i I IN RE: : IN THE COURT OF COMMON PLEAS OF FIRST AND FINAL ACCOUNT : CUMBERLAND COUNTY, PENNSYLVANIA AND PROPOSED : ORPHANS' COURT DIVISION DISTRIBUTION : ESTATE NUMBER 21-0141 \lo5 OF MARY L KLINGER, DECEASED ORDER OF COURT AND NOW, October z(io02, the within account is confirmed and distribution directed in accordance with the schedule. By the Court, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 21-01-0165 FIRST AND FINAL ACCOUNT AND PROPOSED DISTRIBUTION OF MARY L. KLINGLER, DECEASED TREMA C. BENDER, EXECUTRIX LATE OF THE TOWNSHIP OF SILVER SPRING Social Security No.: 180-26-5574 Date of Death: January 30, 2001 Date of Executrix's Appointment: February 12, 2001 Date of Advertising Letters Testamentary: Cumberland Law Journal - March 2, 9 & 16, 2001 The Patriot News Co. - February 20, 27 & March 6, 2001 Accounting for the Period: January 30, 2001 to March 27, 2002. Purpose of Account: Trema C. Bender, Executrix, offers this account to acquaint interested parties with the transactions which have occurred during her administration. The account also indicates the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Trema C. Bender 313 Glenn Road Camp Hill, PA 17011 David H. Stone, Esquire Stone LaFaver & Shekletski 414 Bridge Street New Cumberland, PA 17070 SUMlVlARY OF ACCOUNT Estate of Mary L. Klingler For Period 12/30/00 Through 03/27/02 Page Proposed Distribution to Beneficiaries 11 Principal Receipts Net Gain (or lDss) on Sales or Other Dispositions Other Receipts 1-3 Less Disburserrents: Administration Expenses (prin) Fees and Commissions (Prin) Funeral Expenses (prin) 4-6 6 7 $13,563.66 13/065.00 6/314.00 Balance before Distributions Distributions to Beneficiaries Principal Balance on Hand 8 IncaTe Receipts Less Disburserrents 9-10 Balance before Distributions Distributions to Beneficiaries Incare Balance on Hand Combined Balance on Hand Fiduciary Acquisition Value $162,080.11 ----------- ----------- $192/803.87 0.00 0.00 $192,803.87 32/942.66 $159,861.21 0.00 $159,861.21 $ 2,218.90 0.00 $ 2,218.90 0.00 $ 2,218.90 $162/080.11 RECEIPTS OF PRINCIPAL Estate of Mary L. Klingler As of 03/27/02 Assets Listed in Inventory (Valued as of date of death) Cash on Hand Cigna Pension checks for Feb. & March 2001 Checking Accounts Allfirst-Checking Acct. #0042688019 $5.44 Accrued Interest Money Market Accounts Allfirst-Money Fund Alternative Acct. #0098126989 $14 . 38 Accrued Interest Connon Stocks 90 $100 US Savings Bonds with various dates from 1983 to 1991 issued to Mary L. Klinger "pXi" and "or" Fred D. Klinger who has predeceased the decedent Certificates of Deposit Allfirst-Cert. of Deposit #80000002186825 $160.03 Accrued Interest Allfirst-Cert. of Deposit #87008140731463 $57.01 Accrued Interest Residences Property located at 1307 Scenery Dr. , Mechanicsburg , Silver Spring Twp., Cumberland County, PA, by deed dated January 6, 1972 and recorded in CUmber land County Deed Book L 24, Page 145, granted and conveyed unto Fred D. Klinger and Mary L. Klinger, his wife. The said Fred D. Klinger died January 3, 1997 vesting title in Mary L. Klinger, the decedent. Assessed value tirres CIR $ 10,160.03 23,462.49 Page 1 Fiduciary Acquisition Value $ 624.72 10,187.25 20,885.40 10,070.96 33,622.52 105,780.00 RECEIPTS OF PRINCIPAL Estate of Mary L. Klingler As of 03/27/02 Assets Listed in Inventory (Valued as of date of death) Household Gc:xx:ls & Furnishings Net proceeds of personal property sold at Potteiger Auction Misc. Personal Property 1996 Chev. Sedan Title No. 49974957002KL sold to Sutliff Autoplex Refunds Verizon-refund Ibnegal Insurance-refund on car insurance premium IRS - refund on decedent I S 1040 incorre tax return for 2000 Refund from doctor's office TOTAL INVENIDRY $ 6.25 159.50 480.00 10.85 Page 2 Fiduciary Acquisition Value $ 276.15 10,700.00 656.60 $192/803.60 ----------- ----------- RECEIPTS OF PRINCIPAL Estate of Mary L. Klingler As of 03/27/02 Receipts Subsequent to Inventory (Valued when received) Miscellaneous credit received on Allfirst Checking Acct. to close out account 'TOTAL RECEIPTS SUBSEQUENT 10 INVEN'IDRY SlJlVJMARY Total Inventory Total Receipts Subsequent To Inventory TOTAL RECEIPTS OF PRINCIPAL $ 0.27 Page 3 $ 0.27 $192,803.60 0.27 $192,803.87 ----------- ----------- DISBURSEMENTS OF PRINCIPAL Estate of Mary L. Klingler For Period 12/30/00 Through 03/27/02 Page 4 Administration Expenses (Prin) 02/12/01 Bankers Fidelity Bankdrafts $ 51.16 302.00 6.40 22.17 84.98 28.89 1.60 22.42 624.72 64.33 17.38 29.34 69.00 4.44 22.13 6.30 03/06/01 Stone LaFaver & Shekletski-Reimb. on probate Check number 1 03/06/01 Patriot News-paper service Check number 3 03/06/01 Verizon-telephone service at property Check number 4 03/26/01 PPL Utilities-electric service at property Check number 5 03/26/01 Comcast-cable service at property Check number 6 03/26/01 Patriot News-paper service Check number 7 03/26/01 Verizon-telephone service at property Check number 8 03/26/01 Connecticut Life-pension repayment Check number 9 04/03/01 Comcast-cable service at property Check number 10 04/15/01 AT&T-telephone service at property Check number 11 04/15/01 York Waste-trash service at property Check number 12 04/15/01 PPL Utilities-electric service at property Check number 14 04/15/01 Segelbaum Gastro-medical expense Check number 15 04/16/01 Verizon-telephone service at property Check number 16 04/16/01 Jackson Gastro-medical expense Check number 17 DISBURSElVlENTS OF PRINCIPAL Estate of Mary L. Klingler For Period 12/30/00 Through 03/27/02 04/17/01 Debra Basehore Wiest-taxes on property Check n1J1T1Cer 18 04/27/01 Register of Wills, Agent-payment on Inheritance Tax w/5% discount Check n1J1T1Cer 19 05/02/01 Harrp::ien Township-sewer services at property Check n1J1T1Cer 20 05/03/01 Ibnegal Insurance-insurance on property Check number 21 05/15/01 Comcast-cable service at property Check n1J1T1Cer 22 OS/22/01 PPL Utilities-electric service at property Check n1J1T1Cer 23 06/14/01 Estate Checkbook printing fee 06/20/01 Stone & Murray Funeral Home-lettering on stone Check n1J1T1Cer 24 06/20/01 PPL Utilities-electric service at property Check n1J1T1Cer 1001 06/22/01 Francis Perna-hospital visits Check n1J1T1Cer 1002 07/25/01 PPL Utilities-electric service at property Check n1J1T1Cer 1003 07/25/01 York Waste-trash service at property Check n1J1T1Cer 1004 08/04/01 HarrpJ.en Township-sewer services at property Check n1J1T1Cer 1005 08/17/01 Holy Spirit Hospital-hospital expense Check number 1006 08/23/01 Susqueharma Surgeons-services rendered Check number 1007 09/06/01 Howard Cohen, lV[)-services rendered Check n1J1T1Cer 1008 Page 5 $ 263.11 9,000.00 147.70 126.50 6.26 62.91 27.70 75.00 110.78 54.12 44.23 29.34 84.35 284.28 7.11 11.96 DISBURSEMENTS OF PRINCIPAL Estate of Mary L. Klingler For Period 12/30/00 Through 03/27/02 09/07/01 Quantum Imaging-services rendered Check number 1009 09/08/01 PPL Utilities-electric service at property Check number 1010 09/14/01 Holy Spirit Hospital-services rendered Check number 1011 09/19/01 Moffett, Pease & Lim-services rendered Check number 1012 10/30/01 Register of Wills, Agent-payment of Inheri tance tax Check number 1013 10/30/01 Register of Wills-filing Inheritance Tax Return and Inventory Check number 1014 11/26/01 PNC Bank-service charge 12/11/01 Holy Spirit Hospital-debt of last illness Check number 1016 12/11/01 Holy Spirit Hospital-debt of last illness Check number 1017 12/24/01 PNC Bank-service charge 01/25/02 PNC Bank-service charge 02/22/02 PNC Bank-service charge 02/28/02 Holy Spirit Hospital-debt of last illness Check number 1018 03/27/02 Reserve for filing First and Final Account and closing expenses Fees and Commissions (Prin) 10/30/01 David H. Stone-partial Attorney's fee Check number 1015 03/27/02 Reserve for David H. Stone-balance due on Attorney's fee $ 47.96 99.19 35.58 17.59 1,266.55 25.00 9.00 25.79 3.84 9.00 9.00 9.00 113.55 200.00 $ 7,000.00 6,065.00 Page 6 $ 13,563.66 13,065.00 DISBURSEMENTS OF PRINCIPAL Estate of Mary L. Klingler For Period 12/30/00 Through 03/27/02 Page 7 Funeral Expenses (Prin) 03/06/01 Stone & Murray Funeral Harre-funeral expenses Check number 2 $ 6,314.00 1DTAL DISBURSElVlENTS OF PRINCIPAL $ 32,942.66 PRINCIPAL BALANCE ON HAND Estate of Mary L. Klingler As of 03/27/02 Checking AccOlll1ts PNC Bank-Estate Checking Acct. #50-0213-7855 Residences Property located at 1307 Scenery Dr. , Mechanicsburg , Silver Spring Twp. , CUmberland COlll1ty, PA, by deed dated January 6, 1972 and recorded in Curriber land COlll1ty Deed Bc:ok L 24, Page 145, granted and conveyed lll1to Fred D. Klinger and Mary L. Klinger, his wife. The said Fred D. Klinger died January 3, 1997 vesting title in Mary L. Klinger, the decedent. Assessed value times CIR Less: Incorre balance on hand PRINCIPAL BALANCE ON HAND CUrrent Value $ 56,300.11 105,780.00 $162,080.11 2,218.90 $159,861.21 ----------- ----------- Page 8 Carrying Value $ 56,300.11 105,780.00 $162,080.11 2,218.90 $159,861.21 RECEIPT'S OF INcavIE Estate of Mary L. Klingler For Period 12/30/00 Through 03/27/02 Page 9 Interest Allfirst-Checking Acct. 02/08/01 Allfirst-Interest on Checking Acct. $ 2.46 03/06/01 Allfirst-Interest on Checking Acct. 6.48 8.94 PNC Bank-Estate Checking Acct. 09/24/01 Estate Checking Acct.-Interest from 3-23 to 9-24-01 $ 10.32 10/25/01 PNC Bank-Interest on Estate Checking Acct. 0.45 11/26/01 PNC Bank-Interest on Estate Checking Acct. 0.41 12/24/01 PNC Bank-Interest on Estate Checking 0.33 01/25/02 PNC Bank-Interest on Estate Checking 0.42 02/22/02 PNC Bank-Interest on Estate Checking 0.37 03/25/02 PNC Bank-Interest on Estate Checking Acct. 0.42 12.72 PNC Bank-Estate lYloney Market Acct. 03/23/01 PNC Bank-Interest on Estate MVl Acct. $ 145.10 04/24/01 PNC Bank-Interest on Estate MVl Acct. 255.71 04/27/01 PNC Bank-Interest on Estate MVl Acct. 6.05 OS/24/01 PNC Bank-Interest on Estate MM Acct. 209.34 06/25/01 PNC Bank-Interest on Estate MM Acct. 228.79 07/25/01 PNC Bank-Interest on Estate MM Acct. 208.53 08/24/01 PNC Bank-Interest on Estate MM Acct. 193.81 09/24/01 PNC Bank-Interest on Estate MM Acct. 189.44 10/25/01 PNC Bank-Interest on Estate MM Acct. 106.30 11/26/01 PNe Bank-Interest on Estate MM Acct. 69.21 RECEIPTS OF INCOVIE Estate of Mary L. Klingler For Period 12/30/00 Through 03/27/02 12/24/01 PNC Bank-Interest on Estate MM Acct. 01/25/02 PNC Bank-Interest on Estate MM Acct. 02/22/02 PNC Bank-Interest on Estate MM Acct. 03/25/02 PNC Bank-Interest on Estate MM Acct. 90 $100 US Savings Bonds 03/06/01 90 $100 US Savings Bonds Miscellaneous 03/06/01 Allfirst-Cert. of Deposit 03/06/01 Allfirst-Cert. of Deposit 03/06/01 Allfirst-Money Fund Alternative Total Interest TOTAL RECEIPTS OF INCOVIE $ 51.11 53.00 46.41 51.35 1,814.15 $ 84.00 61.38 138.44 99.27 299.09 Page 10 $ 2,218.90 $ 2,218.90 PROroSED DISTRIBUTIONS W BENEFICIARIES Estate of Mary L. Klingler For Period 12/30/00 Through 03/27/02 Page 11 To: Trerra C. Bender Residue of estate Cash $ 56/300.11 Total $ 56/300.11 To: Trerra C. Bender Property located at 1307 Scenery Dr. / Mechanicsburg, PA 03/27/02 Property located at 1307 Scenery Dr CUrrent balance $105/780.00 105/780.00 Total $105/780.00 TOTAL PROroSED DISTRIBUTIONS 'ill BENEFICIARIES $162/080.11 NOTE: Benjamin F. Gilbert, Jr., through his Executor, disclaimed his interest in the estate. COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Trema C. Bender, Executrix under the Last Will and Testament of Mary L. Klingler, deceased, hereby declares under oath (penalties of perjury) that she has fully and faithfully discharged the duties of her office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that, to her knowledge, there are no claims now outstanding against the estate; and that all taxes pres- ently due from the estate have been paid. ~LLYi~X C) - &>1-"ct../1 Trema C. Bender, Executrix Sworn to and subscribed befc~e me this ~~day /"\ of ___(~ f ' 2002. NOTARIAL SEAL TINA M. BURKEY, Notary Public New Cumberland Bora, Cumberland Co. t. "} Commission Expires April 15. 2005 STONE. LAF A VER &, STONE ' .ti.~:~i:ii~f/.:=~~i~~~..~~i~_~~_...,.. ... - -.:_.. ..L_~':":'~ ~ ,ii, LAST WILL AND TESTAMENT OF MARY L. KLINGLER I, MARY L. KLINGLER, of Silver Spring Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I bequeath all of my household goods and personal effects in equal shares to such of my children, BENJAMIN F. GILBERT and TREMA C. BENDER, as survive me. ITEM II: I devise and bequeath all the rest, residue and rema::_n-. der of my estate, of every nature and wherever situate, in equal shares to my children, BENJAMIN F. GILBERT and TREMA C. BENDER, provided they survive me. Should either of my children, BENJAMIN F. GILBERT or TREMA C. BENDER, fail to survive me, all the rest, residu\:! and remainder of my estate, of every nature and wherever situate, shall be divided one-eighth to the issue of such deceased child and the remaining seven-eighths to my living child. Should both BENJAMIN F. GILBERT and TREMA C. BENDER fail to survive me, all the rest, residue and remainder of my estate, of every nature and wherever situate, shall be distributed to my ~ssue, per stirpes. ITEM III: I appoint my Executrix and her successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this ap- Page 1 of 4 - pointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM IV: I appoint my daughter, TREMA C. BENDER, Executrix of this my last will. Should my daughter, TREMA C. BENDER, fail to qualify or cease to act as Executrix, I appoint my son, BENJAMIN F. GILBERT, Executor of this my last will. ITEM V: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his/her duties in any jurisdiction. IN WITNESS WHEREOF, I, MARY L. KLINGLER, have hereunto set my hand and seal this l( day of ~~ , 1997. r- -">,~ r", \) , "~<, "':' ~'", ; MAl{Y L. KLINGLER '- ~ SIGNED, SEALED, PUBLISHED and DECLARED by MARY L. KLINGLER, the Testatrix above named, as and for her Last will and Testament, and in Page 2 of 4 the presence of us, who at her request, in her presence and in the presence of each other, ~,,--((J~ ~tness have subscribed our names as witnesses. IJ,'-V(~~ 4 Address r ./ ,<( ( ./hf '/ [At.. ) }") Witness C/ . '.' / ;; , rf'-rt'<.-',:", / /'; /, v ~7 - /; /., / . j.:.J Ii.J /LnL~Lr,(, -I .N ,,{ Address f--' >r COMMONWEALTH OF PENNSYLVANIA: S5: COUNTY OF CUMBERLAND I, MARY L. KLINGLER, the 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 this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. ',\,\,,~ ~ ~~,~tu _ L. KLINGLER j Sworn to or affirmed to and acknowledged before me by ~~RY L. KLINGLER; the Testatrix, this (( day of ~.-h. , 1997. //;' \. " / I Z ! / . --I ~ ~~-,,\.. <i'. v<: /](.: (" v " G: Notary Public I . "'..... - ~ . , I I ~r..'r:.,.' . f '.i!:l- ,., - . ~...'r.. ,,_... : Page 3 of 4 , . :." : -.. li:y Cc,e.c. 2;, .,'.,;, ,2" i 219J l~ ,.... - - . -::: ~. .~ ,~ "'__'~ ~ 11 ..-. --------- -~~, .~, COMMONWEALTH OF PENNSYLVANIA . . . 55: . COUNTY OF CUMBERLAND . . We, ~^ ;..f~ .. /~ and,;(Lf--n.-?f I.t '7:h. ):,J~..LzL1 [/)U:'/1 v the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she 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; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. /. /1. / ' xJ..;.A''lL., 7U..-. )1-7. . u{~ -h:J ~ . -n ~ WJ..tness Sworn to or affirmed to and acknowledged before me by ~'A l-f ~ and 7 I' /) I 1[. I:' I / ..,.~ ~ (I o', , witnesses, this fI day of /1m<l , 1997. a ~ :.e.--tu 1 t-.~ / ~ 1< Q .1.)2 L Notary Public Page 4 of 4 "~l :rl'"',' ~:'f ^; C'C: ,', I ~~\.,... . J t~ t tt~_ '-.;'....,'.._~t- ~;~~8~':.:'..' .:'.~ '-, \.~,.:~b.~:;,::~;..cr.y2~_; i My GC1!:rj3StC;;18:i}!~sS r:~:;112. 1999 'p . .,.r ."'''.,~''~.~~ ,. PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 STATEOFPENNSYLVANIA : SSe COUNTY OF CUMBERLAND : Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical l-iub li shed in the Borough of Carlisle in th~ County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, V1Z: MARCH 2,9, 16, 2001 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject n1atter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. 1dnA;t---- Roge{. M. Morgenthal, Editor Klingler, Mary L., dec'd. Late of Silver Spring Township. Executrix: Trema C. Bender. 313 Glenn Road. Camp Hill. PA 17011. Attorneys: David H. Stone. Es- quire, Stone LaFaver & Sheklet- ski. P.O. Box E. New Cumber- land, PA 17070. SWORN TO AND SUBSCRIBED before me this 16 day of MARCH. 2001 Nor ARiAt.: SEAl LOIS E. SNYDER, Notary PubIc ('..arli!l.le Eoro. Cumberiand eoum,r, PJ" L~!"'Y CCi'TH'iHuion h~nK NIorcn 5, 2001 ~ , THE THE PATRIOT NEWS SUNDA Y PATRIOT NEWS Proof of Publication Under Act No. 587, Approved May 16, 1929 Commonwealth of Pennsylvania, County of Dauphin} ss Michael Morrow being duly sworn according to law, deposes and says: That he is the Asst. Controller of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or Sunday/ Metro editions which appeared on the 20th and 27th day(s) of February and the 6th day(s) of March 2001. That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M", V;I~:L11::~~~~7 ~qqqqqqqqqqq COpy of/~rch 2001 A.D. EXECUTOR'S NOTICE Letters Testamentary all the Estate of Mary L. Klinger, late of Sliver Spring Town- ShiP, County of Cumber land and Common- wealth at PennsYlvania, deceased, have been granted to the underSigned. All persons indebted to the said Estate are reCluested to make immediate payment and those having claims will presentthem without delay to: Trena C. Bender 313 Glenn Rood Camp HIli, PA 17011 David H. Stone, Esquire STONE LaFAVER & SHEKLETSKI P.O. Box E "TTl -'" 17070 _ ::lTTlPC;: .... Member, PennsYlVania Association ot Notaries My commission expires June 6, 2002 STONE, LAFAVER & SHEKLETSKI ATTN: DAVID H. STONE 414 BRIDGE STREET NEW CUMBERLAND, PA. 17070 Statement of Advertising Costs To THE PATRIOT-NEWS CO., Dr. For publishing the notice or publication attached hereto on the above stated dates $ Probating same Notary Fee(s) $ Total $ 92.31 1.50 93.81 Publisher's Receipt for Advertising Cost The Patriot News Co., publisher of The Patriot-News and The Sunday Patriot-News, newspapers of general circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have been duly paid. By.................................................................... Inventory of the real and personal estate of Mary L. KlinJer deceased Inventory Estate of Mary L. Klingbr From 12/30/00 To 10/26/01 Description Accrued Interest Cash on Hand Cigna Pension checks Checking Accounts Allfirst-Checking Acct. 5.44 fvbney Market Accounts Allfirst-Money Fund Alternative 14.38 Canmn Stocks 90 $100 US Savings Bonds Certificates of Deposit Allfirst-Cert. of Deposit 160.03 Allfirst-Cert. of Deposit 57.01 Residences Property located at 1307 Scenery Dr Household Gcx::xis & Furnishings Net proceeds of personal property Misc. Personal Property 1996 Chev. Sedan Refunds Verizon-refund wnegal Insurance-refund IRS-refund on decedent's return Value 10,160.03 23,462.49 6.25 159.50 480.00 II 11 Total 62 .72 I: I Ii Ii Ii 1: II il L 11 I I I i ! I I i 10,18 .25 20,88 .40 10,07 .96 33,62 .52 192,7 ------ ------ I I I I I I I I ~ Inventory of the real and personal estate of Mary L. Klin~r deceased Inventory Estate of Mary L. K1in~r From 12/30/00 To 10/26/01 Description Accrued Interest Cash on Hand Cigna Pension checks Checking Acconnts Allfirst-Checking Acct. 5.44 r-bney Market Acconnts Allfirst-Money Fund Alternative 14.38 Carrmn Stocks 90 $100 US Savings Bonds Certificates of Deposit Allfirst-Cert. of Deposit 160.03 Allfirst-Cert. of Deposit 57.01 Residences Property located at 1307 Scenery Dr Household Gccds & Furnishings Net proceeds of personal property Misc. Personal Property 1996 Chev. Sedan RefW1ds Verizon-refW1d Cbnegal Insurance-refnnd IRS - refnnd on decedent I s return -r --- - .---- 1 Value Total I 62 .72 I I II 10,18 .25 I: fi Ii 20,88 .40 Ii ,: 10,07 .96 II 10,160.03 iI I) 23,462.49 II ----------- I I I i 6.25 159.50 480.00 ""- / 0- r::2o q - b BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * REV-1607 EX AFP (01-02> DAVID H STONE ESQ STONE ETAL 414 BRIDGE ST NEW CUMBERLAND PA 17070 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 10-15-2002 KLINGLER 01-30-2001 21 01-0165 CUMBERLAND 101 MARY L Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE~ PA 17013 NOTE: To insure proper credit to your account~ subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V =i 6o-j-E:3f-AFP--f 01-:0 2Y------...--i NifERI"-ANCE--iAx--s TA-fEME-tii-cfF-ACfcouiff-- .-..--------------- - - - - -- ESTATE OF KLINGLER MARY L FILE NO.21 01-0165 ACN 101 DATE 10-15-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE~ APPLICATION OF ALL PAYMENTS~ THE CURRENT BALANCE~ AND~ IF APPLICABLE~ A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-16-2002 P R I NC I PAL TAX DUE: ......................................................................................................................................................................................... 10~892.65 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-30-2001 AA496534 473.68 9~000.00 10-30-2001 CDOO0458 .00 1~266.55 08-21-2002 CDOO1549 .00 152.42 09-26-2002 CD001654 8.16- 8.16 TOTAL TAX CREDIT 10~892.65 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 :IE IF PAID AFTER THIS DATE~ SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $l~ NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) /6-D7cr-- b ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DAVID H STONE ESQ STONE ETAL 414 BRIDGE ST NEW CUMBERLAND PA 17070 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-16-2002 KLINGLER 01-30-2001 21 01-0165 CUMBERLAND 101 REV-1547 EX AFP (01-02) MARY L Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iff,,: iSt'-j-Ex-AFP--foY':02-r-NoYicE--oF-YNHEifiTAi.fci-YAjC-JrPPRAisEiwfENT:--ALi-oWAifci-ifri----------- - -- - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KLINGLER MARY L FILE NO. 21 01-0165 ACN 101 DATE 09-16-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 242,058.86 X 045 = 10,892.65 .00 X 12 = .00 .00 X 15 = .00 (9)= 10,892.65 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets NO. 01 .00 .00 .00 .00 .00 3.747.07 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 360.00 (9) UO) .00 (11) (2) (3) (4) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 3,747.07 360 00 3,387.07 .00 242,058.86 .-".n~n. "........... . I l + J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-30-2001 AA496534 473.68 9,000.00 10-30-2001 CDOO0458 .00 1,266.55 08-21-2002 CDOO1549 .00 152.42 BALANCE OF UNPAID INTEREST/PENALTY AS OF 08-22-2002 TOTAL TAX CREDIT 10,892.65 BALANCE OF TAX DUE .00 INTEREST AND PEN. 8.16 TOTAL DUE 8.16 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) /~-dCJ9- ~ ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 ~ REY-1604 EX AFP 112-00> BENJAMIN GILBERT 319 MT ALLEN DR MECHANICSBURG PA 17055-0000 09-17-2002 KLINGLER 01-30-2001 21 01-0165 CUMBERLAND 180-26-5574 01129423 MARY L Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE~ PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (12-00) __ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS -- DATE 09-17-2002 ESTATE OF KLINGLER MARY L DATE OF DEATH 01-30-2001 COUNTY CUMBERLAND FILE NO. 21 01-0165 ADJUSTMENT BASED ON: S.S/D.C. NO. 180-26-5574 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 01129423 FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. 3060000436 TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 05-10-1999 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .00 .00 .00 .15 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1~ NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV-1470 EX (&-88) INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEA~TH OF F~i"\jNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME MARY L KLINGER FILE NUMBER ROBERT D WILKERSON ACN 2101-0165 01129423 REVIEWED BY ITEM SCHEDULE NO. EXPLANATION OF CHANGES PER ESTATE EXAMINATION THE ABOVE MENTIONED JOINT BANK ACCOUNT HAS BEEN ADJUSTED TO ZERO DUE TO BEING REPORTED PREVIOUSLY ON THE PROBATE RETURN ROW Paqe 1 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 DAVID H STONE ESQ STONE ETAL 414 BRIDGE ST NEW CUMBERLAND LINE ~/~.. NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX .1 09-1 -2002 KLINGLER 01-30-2001 21 01-0165 CUMBERLAND 101 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN REY-15~7 EX AFP (01-02l MARY L Amount Remitted PA 17070 (f 'if.(f.c MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ \; /6 -~cJ9-6 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLOMANCE OR DISALLOMANCE OF DEDUCTION~, AND ASSESS KENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP (01-02> 1 j DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 05-20-2002 KLINGLER 01-30-2001 21 01-0165 CUMBERLAND 180-26-5574 01129423 MARY L BENJAMIN GILBERT 319 MT ALLEN DR MECHANICSBURG PA 17,055 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1548 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-20-2002 ESTATE OF KLINGLER MARY L DATE OF DEATH 01-30-2001 COUNTY CUMBERLAND FILE NO. 21 01-0165 TAX RETURN WAS: S.S/D.C. NO. 180-26-5574 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01129423 FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. 3060000436 TYPE OF ACCOUNT: DATE ESTABLISHED ()() SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE 05-10-1999 X 7,494.13 0.500 3,747.07 .00 3,747.07 .15 562.06 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID 5\7. 0i4 DATE NUMBER INTEREST/PEN PAID (-) -.r_____ ~ (I en;! (fIL\ .' .p.' ii\ Jl~L'1 \,,) .. INTEREST IS CHARGED THROUGH 05-28-2002 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 562.06 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 22.25 TOTAL DUE 584.31 .~. ~ * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) '~/6 -0209- b COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG. PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ReeL>: Rs:): DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN .01 ole 27 AlO :11 DAVID H STONE ESQ STONE ET AL .',. 414 BRIDGE ST L;len., NEW CUMBERLAND Cl~'Rbj):070 12-17-2001 KLINGLER 01-30-2001 21 01-0165 CUMBERLAND 101 REV-1547 EX AFP (12-00) MARY L Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ rifv = iStrj-EX-AFP--[i"2-:ooj--NOT-icE--OF--fNHEifiTANci-TAjrA-PPRAisEHENT-,--AL1-oWANci-ifR------------ - - --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KLINGLER MARY L FILE NO. 21 01-0165 ACN 101 DATE 12-17-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 105.780.00 10.070.96 .00 .00 76.941.79 8.188.54 60.331.24 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 22.163.40 477.34 (11) (12) (13) (14) NOTE: To insure proper credit to your account. submit the upper portion of this form with your tax payment. 261.312.53 ')").640 74 238.671.79 .00 238.671.79 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (15) .00 X 00 = .00 (16) 238.671.79 X 045 = 10.740.23 (17) .00 X 12 = .00 (18) .00 X 15 = .00 (19)= 10.740.23 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-30-2001 AA496534 473.68 9.000.00 10-30-2001 CDOO0458 .00 1.266.55 TOTAL TAX CREDIT 10.740.23 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" lCR). YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 11 , :n Z (f) -.:j 0 :r: m ." :D :J: ." =1-0 - IT' 0 )>m G Zz - Oz u; )> - mC/) IT r- )>-< JJ ~ :xJ zr- 0 0< -n m m> :f 0 ~~ r m )>)> r -l \ - -I CJ) JJ 0 -0 m m 0 -l :P- -t -I m > zO~ )> <: I :P- cOm >< m ~ ~Z(fJb 0 0 CO-lCDZ co c m:n~ -< Z \ :nOm -l 'Z Z -l -0 P > 6 )> \ )> ~ to :P- Ol ~ c..n 0 w c Z ..s::- -l JJ m :E c;, ~ m x 'T1 ~ cO CJ ~ ~ :D [T1 - CD m :P- I ~r ~ ~ SJ ~ \ ~ ~ ~\' ~ Ie IJ o (f) -1 S );> JJ ?' o ~ )> ~ -1 "; m II I i2 CJ o );> -I m o II IJ )> -< S m 2 -I 1T1 ::Q m ~ r(j) m-l E~ ~m gjz -n o :D ~ ):> --I o Z IOWOO )>mc:mO 55~~~~ (j)f\.)>~o OJ~C:S:z ~s~~~ o %-1)> IJ oOCi )> <"I 5JJo c:~" >mIJ '2m -4CZ ~m~ rn -< (/) ~ )> Z J> 1J3 m o m <: m o " J3 o ~ -J j\) 0) b 0) S / rb - C:::;o 9'- b ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT~ ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX TL: -, .., ".:...:; DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-16-2002 KLINGLER 01-30-2001 21 01-0165 CUMBERLAND 101 . I, i DAVID H STONE ESQ STONE ETAL 414 BRIDGE ST NEW CUMBERLAND *' REV-1547 EX AFP UI-OZ) MARY L Allount Rellitted t -'I Pf\ 17070 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=isi,-j-i3f-AFP--foi-:o21--Ncjfici-oF-'rNHERiTANci-YAi-APPRA-isEifENT~--ALloWANCE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KLINGLER MARY L FILE NO. 21 01-0165 ACN 101 DATE 09-16-2002 TAX RETURN WAS: (X) ACCEPTED AS fILED ) CHANGED If an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: IS. Allount of Line 14 at Spousal rate (IS) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. AIIount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Hortgages/Notes Receivable (Schedule D) (4) S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets NO. 01 .00 .00 .00 .00 .00 3.747.07 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllenta1 Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) UO) 360.00 .00 (11) (2) (13) (4) NOTE: NOTE: To insure proper credit to your account subllit the upper partir of this forll with your tax paYlJent. 3,747.07 360 00 3,387.07 .00 242,058.86 .00 242,058.86 .00 .00 X 00 = .00 X 045 = 10,892.65 X 12 = .00 X 15 = .00 (19)= 10,892.65 r"'n~nl K~\';~U.I r+r AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-30-2001 AA496534 473.68 9~000.00 10-3D-2001 CDOO0458 .00 1~266.55 08-21-2002 CDOO1549 .00 152.42 BALANCE OF UNPAID INTEREST/PENALTY AS OF 08-22-2002 TOTAL TAX CREDIT 10,892.65 BALANCE OF TAX DUE .00 INTEREST AND PEN. 8.16 TOTAL DUE 8.16 . IF PAID AfTER DATE INDICATED~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( If TOTAL DUE IS LESS THAN $l~ NO PAYMENT IS REQUIRED. If TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU MAY BE DUE A REfUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) /l1-oZ.CJ9- ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE * ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER , COUNTY l) SSN/DC ACN REY-IU~ EX AFP (12-10> ,- , 09-17-2002 KLINGLER 01-30-2001 21 01-0165 CUMBERLAND 180-26-5574 01129423 Allount Rellitted MARV L BENJAMIN GILBERT 319 MT ALLEN DR MECHANICSBURG PA 17055-0000 t 0,,\ MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (12-00) __ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS -- DATE 09-17-2002 ESTATE OF KLINGLER MARY L DATE OF DEATH 01-30-2001 COUNTY CUMBERLAND FILE NO. 21 01-0165 ADJUSTMENT BASED ON: S.S/D.C. NO. 180-26-5574 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 01129423 FINANCIAL INSTITUTION: WAVPOINT BANK ACCOUNT NO. 3060000436 TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 05-10-1999 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .00 .00 .00 .15 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTTnN~ 1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT DAVID HEAN STONE ESQUIRE 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 nnnn fold ESTATE INFORMATION: SSN: 180-26-5574 FILE NUMBER: 2101-0165 DECEDENT NAME: KLINGLER MARY L DA TE OF PAYMENT: 08/21/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/30/2001 NO. CD 001549 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $152.42 I I I I I I I I TOTAL AMOUNT PAID: $152.42 REMARKS: TREMA BENDER C/O DAVID H STONE ESQUIRE CHECK# 1024 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT TREMA C BENDER 313 GLENN ROAD CAMP HILL, PA 17011 ______n fold ESTATE INFORMATION: SSN: 180-26-5574 FILE NUMBER: 21 - 2001 - 01 65 DECEDENT NAME: KLINGLER MARY L DA TE OF PAYMENT: 10/30/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/30/2001 NO. CD 000458 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,266.55 I I I I I I I I TOTAL AMOUNT PAID: $1,266.55 REMARKS: TREMA C BENDER CHECK# 1013 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVI DUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT STONE DAVID HEAN 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 ____uu fold EST A TE INFORMATION: SSN: 180-26-5574 FILE NUMBER: 2101-0165 DECEDENT NAME: KLINGLER MARY L DATE OF PAYMENT: 09/26/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/30/2001 NO. CD 001654 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $8.16 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: DAVID H STONE ESQUIRE CHECK# 1 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $8.16 MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT STONE DAVID HEAN 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 n_n___ fold ESTATE INFORMATION: SSN: 180-26-5574 FILE NUMBER: 2101-0165 DECEDENT NAME: KLINGLER MARY L DA TE OF PAYMENT: 09/26/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/30/2001 NO. CD 001654 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $8.16 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: DAVID H STONE ESQUIRE CHECK# 1 INITIALS: JA SEAL RECEIVED BY: REGISTER OF WILLS $8.16 MARY C. LEWIS REGISTER OF WILLS \. II II I' I: ,~ I' I '"'' vI"" '....../' STATUS REPORT UNDER RULE 6.12 ./ ";,, Name of Decedent: Mary L. Klingler Date of Death: January 30, 2001 Will No. 21-01-0165 To the Register: 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 lS 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 X No (b) The separate Orphans' Court No. the personal representative's account is: (if any) for N/A (c) Did the personal representative state an account informally to the parties in interest? Yes 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: i2 ,\ '':'v ... Capacity: Personal Representative X Counsel for Personal Representative . Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (71 7) 240 - 6345 Date: 12/06/2002 TREMA C BENDER 313 GLENN ROAD CAMP HILL, PA 17011 RE: Estate of KLINGLER MARY L File Number: 2001-00165 Dear Sir/Madam: It has corne to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 1/30/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, MARY C. LEWIS REGISTER OF WILLS cc: JFile Counsel Judge REV-1500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 1& -'),60 Lo DEPARTMENT OF REVENUE - DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 0165 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER kOUilflt 180 26 5574 , Mary L. DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 01/30/01 01/17/1931 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 3. Remainder Return CHECK ~ 1. Original Return ~ 2. Supplemental Return 8 (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required (date ot dealh atter 12-12-B2) PRIATE 6. Decedent Died Testate 7. Decedent Maintained a Living Trusl 0 8. Total Number ot Safe Deposit Boxes (Attacn copy u,Will) (Altach acopy 01 Trust) BLOCKS 9. Litigation Proceeds Received to. Spousal Poverty Credit (dale 01 death between D 11. Eleclion 10 tax under Sec. 9113(A) 12-31-91 and 1-1-95) (Anach Seh 0) THIS',S!OCTION MusTe!O'COMpLEtEici.j\lL..cO~REi$PQNcP"N!:iW~cPNcFlp"Nct'#.J;.i4lill~qRMAtjqM$l!9!liltj'~..jj,i'i~$t"i:ltO: NAME COMPLETE MAILING AOORESS COR- David H. Stone, Esquire 414 Bridge Street RE- FIRM NA~~r;: flf An'llicable) New Currt:Jer land. PA 17070 SPON DENT Stone Laraver & Shekletski TELEPHONE NUMBER (717) 774-7435 lO'C..}80.00 OFFICIAL USE ONLY t. Real Estare (Schedule A) (t) 2. Slocks and Bonds (Schedule B) (2) j,0.!_(~70. 96 3. Closely Held Cor~oralion, Partnership or Sole-Proprietorship (3) None -..--- 4. Mortgage:; & Notes Receivable (Schedule 0) (4) None 5. Cash, 8ank Deposits & Miscellaneous Personal Property (Schedule E) (5) 76,941. 79 6. Jointly Owned Property (Schedule F) D Separate Billing Requested (6) , 188.54 ~, RECA- PlTULA- 7. Inter-Vivos Transfers & Miscellaneous nON Non-Probate Property (Schedule G or L) (7) 60,331.24 8. Total Gross Assets (total lines 1-7) (8) 261,312.53 9. Funeral Expenses & Administrative Costs (ScheduleH) (9) 22,163.40 to. Debts of Decedent, Mortgage Liabilities. & liens (Schedule l) (to) 477.34 11. Total Deductions (Iotal Lines 9 & 10) (11) 22,640.74 12. Net Value of Estate (Line 8 minus Line 11) (12) 238,671.79 t3. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) None has not been made (Schedule J) t4. Net Value Subject to Tax (Line 12 minus Line 13) (14) 238,671.79 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES t5. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a}(1.2} X.O (15) TAX 16. Amount of Line 14 taxable at lineal rale 238,671.79 x.o 45 (16) 10,740.23 - COMPU- 17. Amount of Line 14taxablealsiblingrale 0.00 X .12 (17) 0,00 TATION 18. Amounlof Line 14 taxable at collateral rale 0.00 X .15 (18) 0.00 t9. Tax Due (19) 10,740.23 20. D IC@CKijEiflSlfYWAAEIlEQ\.ifi.5nN<lA,i!i;B)illpPFANOVEJJl1j\YMlijIft! >> BE SURE TO ANSWEl'l ALL QUSS1"IONSON PAGE 2I\NDRECH~KMATH<< o PA15001 NTF 29755 Copyrignt 2000 GreatlandlNelco LP . Forms Software Only , PA REV.1500 EX (6.00) Decedent's Complete Address: Page 2 STREET ADDRESS 1307 Scenery Drive CITY I STATE I ZIP Mechanicsburg PA 17055 1. Did 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; . . . . . . . . . . . c. retain a reversionary interest; or. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise tor life of either payments, benefits or care? .............. .. . . . . . . . If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............ . . . . . . . . . . . . . . . . . . . Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............ 0 0 0 . . . . IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that r have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on information of which preparer has any knowledqe. SIG A RE OF PERSON RESPONSI E FOR FlljN,G RETURN DATE ~ C - v:/'1U1l') .30 ," I ADDRESS See Schedule attached SIGNATURE PA T Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousai Poverty Credit B. Prior Payments C. Discount (1) 9,000.00 473 . 68 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnteresVPenalty (D + E) 4. If Line 2 is greater than line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If line 1 + line 3 is greater than Une 2, enter the difference. This is the TAX DUE. A. Enter the interest on the t;:>)( d1lfl. B. Enter the total of Line S + SA. This is the (3) (4) (5) (SA) (b~) 2. 3. 4. THAN REPRESENTATIVE 10,740.23 9,473.68 0.00 1,266.55 0.00 1,266.55 Yes No ~ I a ~ o o DATE ()..3-)-0 \ " [72P,S l1i 9116(a)(1.1)(i)) For dates ot death on or after January 1, 1995. the lax rate is imposed on the net value of transfers to or for the use of the sUNiving spouse is 0% [72 P,S. ij 9116 (a) (1,1) (ii)j. The statute rln~" nnt l'!XAmnl a transfer to a surviving spouse from tax, and the statutory requirements lor disclosure of assets and liling a tax return are still appiicable even it thesuNivingspouseistheonlybeneticiary For dates oj death on or after July 1. 2000: The tax rate imposed on the net vaiue of transfers from a deceased Child twenty-one years of age or younger at death to or lor the use 01 a natural parent, an adoptive parent, Of a stepparent of the child is 0% (72 P.S. fj9116(a}(1.2)j. The tax rate imposed on the net value of transJers to or for the use of the decedent's lineal beneficiaries is 4,5%, except as noted in 72oP.S. fj 9116(1,2) [72 P,S. %9116(a)(1)J The tax rale imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. l1i 9116(8)(1.3)J. A sibling Is defined, under Section 9102, as an individuai who has at least one parent in common with the decedent. whether by biood or adoption o PA15002 NTF 29756 Copyright 2000 GreallanaiNelco LP. Forms Software Only Estate of: Mary L. Kling,r 21-2001-0165 The following person(s) are signing the return as representative(s) of the estate: Trerra C. Bender 313 Glenn Road Camp Hill, PA 17011 ReV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mary L. Klinc/er SCHEDULE A REAL ESTATE FILE NUMBER 21-2001-0165 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 NO. DESCRIPTION VALUE AT DATE OF DEATH 1 Property l=ated at 1307 Scenery Dr., Mechanicsburg, Silver Spring Twp., CurrJ::Jerland County, PA, by deed dated January 6, 1972 and recorded in CurrJ::Jerland County Deed Book L 24, Page 145, granted and conveyed unto Fred D. Klinger and Mary L. Klinger, his wife. The said Fred D. Klinger died January 3, 1997 vesting title ir1 Mary L. Klinger, the decedent. Assessed value tirres erR 105,780.00 1 CPA21 NTF 10904 Copyright Forms Software Only. 1997 Nelco. Inc. TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 105,780.00 R~V-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF !'my L. Klir19l=r SCHEDULE B STOCKS & BONDS FILE NUMBER 21-2001-0165 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 90 $100 US Savings Bonds with various dates frem 1983 to 1991 issued to Mary L. Klinger "pod" and "or" Fred D. Klinger who has predeceased the decedent 10,070.96 TOTAL (Also enter on line 2, Recapitulation) $ (\1 more space is needed, insert additional sheets of the same size) 10,070.96 7 CPA31 NTF 10905 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF , ___L Mary L. Kl~r SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-2001-0165 Include proceeds 01 litigation & date proceeds were received by the estate. All prop. Jointly-owned with rlaht of survivorship must be disclosed on 5ch. F. ITEM VALUE AT NO. DESCRIPTION DATE OF DEATH 1 Cigna Pension checks for Feb. & March 2001 624 . 72 2 Allfirst-Checking Acct. #0042688019 10,181. 81 Interest on ab:Jve item accrued as of decedent's death 5.44 3 Allfirst-Money Fund Alternative Acct. #0098126989 20,871. 02 Interest on ab:Jve item accrued as of decedent's death 14.38 4 Allfirst-Cert. of Deposit #80000002186825 10,000.00 Interest on above item accrued as of decedent's death 16U.U3 5 Allfirst-Cert. of Deposit #87008140731463 23,405.48 Interest on ab:Jve item accrued as of decedent's death 57.01 6 Net proceeds of personal property sold at Potteiger Auction 276.15 7 1996 Chev. Sedan Title No. 49974957002KL sold to Sutliff Autoplex 10,700.00 8 Verizon-refund 6.25 9 r:onegal Insurance-refund on car insurance premium 159.50 10 IRS-refund on decedent's 1040 incorre tax return for 2000 480.00 7 CPA81 NTF 10908 Copyright FOmlS Software Only, 1997 Nelco. Inc. TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 76,941. 79 .; REV-1S09 EX + (1.97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mary L. Klinc/er SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21-2001-0165 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 A Trerra C. Bender ADDRESS 313 Glerm Road Camp Hill, PA 17011 RELATIONSHIP TO DECEDENT daughter JOINTL Y.OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR MADE Include name of financial institution and bank DATE OF DEATH DECD'S VALUE OF JOINT account number or similar identifying number. NO. TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENTSINTERES 1 A 01/30/98 PSECU-Regular Shares (Sl) , 116.23 50% 58.11 Prine. 116.11, Int. $.12 joint with Trerra Bender on 1-30-98 2 A 01/30/98 PSECU-Share 51 24 ~nth 5,914.45 50% 2,957.22 Certifieate-2, Prine. $5,887.13, Int. $27.32, joint with Trerra C. Bender on 1-30-98 3 A 01/30/98 PSECU-Share 52 24 ~nth 10,197.57 50% 5,098.78 Certificate, Prine. $10,141. 01, Int. $56.56 joint wi th Trerra C. Bender on 1-30-98 4 A various 3 US EE $100.00 Savings Bonds 148.86 50% 74.43 joint with Trerra Bender (see attached) TOTAL (Also enter on line 6, Recapitulation) $ 8,188.54 T 7 CPA91 NTF 10909 (If more space is needed, insert additional sheets of the same size) Copyright Forms Software Only, 1997 Neice, Inc REV-1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mary L_ Klinckr SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-2001-0165 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NO. DESCRIPTION OF PROPERTY INCLUDE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECD & DATE OF TRANSFER. ATTACH COPY OF THE DEED FOR REAL ESTATE. %QF EXCLUSION DATE OF DEATH DECD'S (IF TAXABLE VALUE VALUE OF ASSET INTEREST APPLICABLE) 0.00 32,543.21 100% 32,543.21 27,788.03 100% 27,788.03 1 Gift taxes on gifts within 3 years of death 2 Allfirst-IRA Acct. #87000096387001, Prine. $31,999.12, Int. $544.09 3 PSECU-Share 50 60 Month IRA Certificate-I, Prine. $27,645.26, Int. $142.77, Trema C. Bender as beneficiary 7 CPA01 NTF 10910 TOTAL (Also enter on line 7, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 60,331. 24 Copyright Forms Software Only, 1997 Nelco. Ine REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF , I Mary L. Klm~r SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-2001-0165 Debts of decedent must be reported on Schedule I. ITEM NO. DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Stone & Murray Funeral Harre- funeral expenses 6,314.00 2 Stone & Murray Funeral Harre-lettering on stone 75.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 0.00 Name of Personal Representative(s) Social Security Number(s)/EIN No. of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Narre: David H. Stone 13,065.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 302.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 See Schedule attached Total from continuation page(s) 2,407.40 TOTAL (Also enter on fine 9, Recapitulation) $ 22,163.40 7 CPA11 NTF10911 Copyright Forms Software Only, 1997 Nelco, Inc (If more space is needed, insert additional sheets of the same size) Estate of: Mary L. KlinJ,r SaJEDULE H, PART B -- Administrative Costs Item No. Description 7 Cumberland Law Journal-advertising grant of letters 8 The Patriot News Co. -advertising grant of letters 9 Verizon-telephone service at property 10 PPL Utilities-electric service ~t prcperty 11 Comcast-cable service at property 12 Verizon-telephone service at property 13 Connecticut Life-pension repayrrent 14 Comcast-cable service at property 15 AT&T-telephone service at property 16 York Waste-trash service at prcperty 17 PPL Utilities-electric service at property 18 Verizon-telephone service at property 19 Debra Basehore Wiest-taxes on property 20 Harrp::ien Township-sewer services at prcperty 21 D:::>negal Insurance-insurance on property 22 Comcast-cable service at prcperty 23 PPL Utilities-electric service at property 24 PPL Utilities-electric service at property 25 PPL Utilities-electric service at prcperty 26 York Waste-trash service at property 27 Harrpden Township-sewer services at property 28 PPL Utilities-electric service at property 29 Estate Checkbook printing fee TOTAL. (Carry forward to main schedule) . . . . . . Page 2 21-2001-0165 Arrount 75.00 93.81 22.17 84.98 28.89 22.42 624 . 72 64.33 17.38 29.34 69.00 22.13 263.11 147.70 126.50 6.26 62.91 110.78 44.23 29.34 84.35 99.19 27.70 2,156.24 Estate of: Mary L. Klinder SCHEDULE H, PART B -- Administrative Costs Item No. Description 30 Bankers Fidelity Bankdrafts 31 Reserve for closing expenses TOTAL. (Carry forward to main schedule) . . . . . . Page 3 21-2001-0165 Arrount 51.16 200.00 251.16 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF . I M3.:ry L. Kl~~r Include unreimbursed medical expenses. ITEM NO. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-2001-0165 DESCRIPTION AMOUNT 1 Patriot News-paper service 6.40 2 Patriot News-paper service 1.60 3 Segelbaum Gastro-rredical expense 4.44 4 Jackson Gastro-rredical expense 6.30 5 Francis Perna-hospital visits 54.12 6 Holy Spirit Hospital-hospital expense 284.28 7 SUsquehanna Surgeons-services rendered 7.11 8 Howard Cohen, MD-services rendered 11.96 9 Quantum Imaging-services rendered 47.96 10 Holy Spirit Hospital-services rendered 35.58 11 Moffett, Pease & Lim-services rendered 17.59 7 CPA12 NTF 10912 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 477. 34 Copyright FOllTls Software Only. 1997 Nelco. Inc. REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mar' L. Klinclor SCHEDULE J BENEFICIARIES FILE NUMBER No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY l. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 21-2001-0165 RELATIONSHIP TO DECEDENT AMOUNT OR Do Not Ust Trustee(s} SHARE OF ESTATE 1 Trerra C. Bender 313 Glenn Road Carrp Hill, PA 17011 daughter 119,335.90 2 Benjamin F. Gilbert 319 Mt. Allen Drive Mechanicsburg, PA 17055 son 119,335.89 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPRIATE ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUT[ONS UNDER SECTION 9113 FOR WHICH AN ELECT[ON TO TAX [S NOT BEING MADE None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None TOTAL OF PART" -- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 7 CPA13 NTF 10913 (If more space is needed, insert additional sheets of the same size) Copyright Forms Software Only, 1997 NelcQ, Inc. ep\w~115\klingler.ml\3_97 LAST WILL AND TESTAMENT OF MARY L. KLINGLER I, MARY L. KLINGLER, of Silver Spring Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I bequeath all of my household goods and personal effects in equal shares to such of my children, BENJAMIN F. GILBERT a"'.l~'REMA C. BENDER, as survive me. ITEM II: I devise and bequeath all the rest, residue and remain- der of my estate, of every nature and wherever situate, in equal shares to my children, BENJAMIN F. GILBERT and TREMA C. BENDER, provided they survive me. Should either of my children, BENJAMIN F. GILBERT or TREMA C. BENDER, fail to survive me, all the rest, residue and remainder of my estate, of every nature and wherever situate, shall be divided one-eighth to the issue of such deceased child and the remaining seven-eighths to my living child. Should both BENJAMIN F. GILBERT and TREMA C. BENDER fail to survive me, all the rest, residue and remainder of my estate, of every nature and wherever situate, shall be distributed to my issue, per stirpes. ITEM III: I appoint my Executrix and her successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this ap- Page I of 4 pointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM IV: I appoint my daughter, TREMA C. BENDER, Executrix of this my last will. Should my daughter, TREMA C. BENDER, fail to qualify or cease to act as Executrix, I appoint my son, BENJAMIN F. GILBERT, Executor of this my last will. ITEM V: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his/her duties in any jurisdiction. IN WITNESS WHEREOF, I, MARY L. KLINGLER, have hereunto set my hand and seal this I( day of ~~ , 1997. [' ) ~.....;; -. . ("- 1:'1'\ '':1 \A ~~ -.< f\ "f"'.\",.....t \ ~ ~. KLINGLER ~ - SIGNED, SEALED, PUBLISHED and DECLARED by MARY L. KLINGLER, the Testatrix above named, as and for her Last Will and Testament, and in Page 2 of 4 the presence of us, who at her request, in her presence and in the presence of each other, Ji5>.,..(t\~ ~ ~tness have subscribed our names as witnesses. Il.t.i~....t....-4.~ 4. Address ,l ht"Ut )}J witness "'/ _/_ 'i . A..-;'.(J7'Z<-L / /f ./J J 721 ILl Address /) a.., / I //-.nt '"" [' A ,-14' / i">r COMMONWEALTH OF PENNSYLVANIA: : 55: COUNTY "F ~T".ffiERLAND I, MARY L. KLINGLER, the 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 tc,xecuted this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. s:; ~ 'li ~'\(\~ 2>~~~U _ L. KLINGLER Sworn to or affirmed to and acknowledged before me by MARY L. KLINGLER, the Testatrix, this (( day of ~k , 1997. /) . .) ~'K<L-t<~.(.r? ~ ,k( 0..,.21 Notary Public I .,- I'~"o-" . I ;~': l,:.y:; h -'.7"/<. 0I'.:':,': '....,.:::.... """", ,,:J i , Page 3 of 4 COMMONWEALTH OF PENNSYLVANIA : : 55: COUNTY OF CUMBERLAND . . We, DA<A^ J~. and ,r vl'h-'L'11 11 :;-),. l....j~ ~/~. ')L.'..} v , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of. .~'Z ,~. t-he hearing and sight of the Te..t."t-r; x signed the will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. x:l",1i.- -'LA... >1-7 Witness --/ / "Ur)'-I;:Lt... '- n <rl " Sworn to or affirmed to and acknowledged before me by ~It. I~ ~ and T ('/1/1(< /J../ /-Ir'-<-{1I/",-, witnesses, this I( day of ~,l , 1997. /1 ' <--/' J ([..c".,t;l.,' ~ l<o.1.--(Cc. Notary Public i'/y'-,-'.r:::;:.~. 'II. '- Page 4 of 4 (>:~'!S"';".' ;'..'!!;". ;'.~~: ,~~' ;", ';:.1..:.,:::". ,"' .. , ; .'.' . :'~r i . I, ,._~ I Form View - public tax file 3-1-01.fp5 Page 1 of 1 Form View public tax file 3-1-0l.fpS Home tt<tl~ S_e~--.rc::h I..able View Viewing: 1 of 1 District_Number 38 ParceUdentifier 38-17-1029-004 Map_Suffix_Number 002056 House_Number 1307 St'eet SCENERY DRIVE Owne'_Name_' KLINGLER, FRED D & MARY L Owner_Name_2 Land_Us8_Code R Property_Description living_Area 1176 Current_land_ Value 15000 CurrenUmprovement_Value 90780 Current_TotaLVaJue 105780 Current_Preferred _Value Acreage .39 Clean Green_Status Taxable_or_Exempt Sale_Amount Sale_Month Sale_Day Sale_Century Sale_Year http://205.247 .227 .57:591/FMRes/FMPro?-db=public%20tax%20file%203-1-0 1.fp5&-op=b\\.. 9/27/01 UCQRQ~~',O!~\C~NJIE ~6~~E!\L;.tIU "(,Uhl1 PUill$~\.'4lll\A NO. !l36 IN' 1 '3 53 f\\ 'll. PEE-SlMPLE DEED- Typo"ri,.. ~btg 3Jubruturr1 & 77f- d.y of J;:r)J U-mvf Thou,.nd Nin, Hu.."d .nd S 6JC:?v7( -llVd. !lube IDbr ,,. tin "'11" of O1Ir LorJ o.u 1BrtUtPP" CLEASON C. CROMER and FLORENCE A; CROMER, his wife, of the Township of Carroll, County of York and State of pennsylvania, Grantors and Parties of the First Part, - AND - FRED D. KLINGLER, JR. and MARY L. KLINGLER, his wife, of 501 Bridge Street, New Cumberland, Pennsylvania, Grantees and Parties .f lb. st.".. P'TI, ill!lit"PBBtth Thol Ih< ,pid p'Tties .11h< fi'" P'TI, fm ond ;n .on,;d"."o" .f Ih, ,um of TWENTY-SIX THOUSAND FIVE HUNDRED----------n----------($26,500.00) Dollars, Idwfnl mont, of tht United Stales of Amn"ica, u,'tll 1m" truJ)' pilla by the sllia pMtiesal the 1unnd part to the said PliTt iesal the first p.rt, at .nd befort the ud/ing and delivery of theu prtsf'ntsJ the rtcrtM whereof is hereby acknowledged, have granted, htlrf,tJin,d, fold, ISlienea, ,nfeoffed, released, convey,d ."d conprnJtd and b, these presenh 40 gr",.t, btlT,'(tJi". I,ll, ,jlitn, ,nfeog. ",ttau. ro"vt'y, 4n4 confirm unto th, JtliJ bdrties of fIN uconJ ".rf the i r ~irt .nJ ..ssigns. J\ll THAT CERTAIN lot of ground situate in the Township of Silver Spring, County of Cumberland and State of Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point in the Western line of Scenery Drive (50 feet wide), which said point is in the division line between Lots Nos. 5~ and 59 on the hereinafter mentioned Plan of Lots; thence extending along the Western line of Scenery Drive, South 05 degrees 00 minutes East, one hundrea five (105) feet to a point in the division line between Lots Nos. 59 and 60 on said Plan; thence extending along the division line between Lots Nos. 59 and 60, South 85 degrees 00 minutes West, one hundred sixty (160) feet to a point; thence North 05 degrees 00 minutes West, one hundred five (105) feet to a point in the division line between Lots Nos. 58 and 59 on said Plan, aforementioned; thence extending along the division line between Lots Nos. 58 and 59 on said Plan, afnrementioned: thence extending along t~e dlvi6ion L1ne between Lots Nos. 58 and 59, North 85 degrees 00 minutes East, one hundred sixty (160) f,eet to a point in the Western line of Scenery Drive, aforementioned, at tmpoint and pla,e of BEGINNING. BEING Lot No. 59 on Plan No.2 of BUNKER HILLS, which said Plan is recorded in the Cumberland County Recorder's Office in PIa" Book No. 22, Page 65. BEING the same premiees which Paul T. Shearer, Forrest S. Brenneman, Jack E. Bertolette, and Cleason C. Cromer, Co-partners, trading and doing business as Bunker Hills, by Deed dated June 9, 1971 and recorded in the Cumberland County Recorder's Office'in Deed Book "E", Volume 24, Page 168, granted and conveyed unto CI.e ason C. Cromer, one of the Grantors herein. SUBJECT to restrictions and conditions as contained in prior Deeds. HAVING thereon erected a brick and alum',nuTd type dwelling. eoOK ~24NGE 145 J . _.~._----------~t )chool Dist. Cumb Co. P. . . IOWluhip of ...;,....'.:...f:t.~.':l.:;/ Cumbo CO., Pi!. A 1. . Real hhts T rl!lMsf.r T iur .- ! . 7 7 .: ) ') '::.~ ~ I, ',",... '. . -.s ^'J*.l!:.... (>AW k:/~yv--1../' Cumbo C". OJ..+. ~L A.,+, _,~r. ROlli &taie Tr.nsfl!r Te. f 7 '7.J1) '0:-. ,Ito ...... .$.~ Ami i,i' -~ ~ ;<3 ~ ...... .-, C.d::f: v0-V . /( , ...,,-u.'l/ ;~I "V. Old. Col. Agt. IDog,rt1lrr wi'b all ana sing,udr, tht ttMffU1Its, htrtditamtnts and tI;purttnllnu$ to tht scr.mt' brJongi1lg or in ."ywise "pperl,,;,,;ng, tlnd the reversion tlnd revtTsiom, rtmflinJer find rnnainJns. rmts, issues, tlJUl profitJ ther.of; AOOllhIII ,,1.1 th. ..tat., righi, titl., inter"I, properly, claim an. .rman. whatso.ver, both In law .nd .quity, of th. ,aid part ies of tM lint pari. of. in. 10 .. out of Ihr ,aid "".mim, and .very p4f'1 .nd parcn t","o( IDa ~au~ anll to ~011l ,aid pari ies of Ih. ..cond part, "'hoof of Ih< ,aid parI ies of Ih. the stlid premises, with till tlnd singul", the ir ht;rf tlnJ assigns. to anJ ..cond pa", their tht app"rltntlnces, "nto tb, for th. only prop" ".. .nd brirs find 'ss;~ns fort II" , Anb THIl SAID Parties of the First Part, their bdrs, txet:1lturs ,aJd ;..rt i es fln4 Mltni1l;strtltors, do of th< ,<<and pari, Ibt..iIl Parties fry these presents, cot'tn.tnt, grant .nJ tI~rtt to and with thi thei,r lNirs flnJ tluig'", thllt First Part, their of the briT, ,ll .nd singul"" tIN h"~Jit"m~1fts ImJ prrm;,((J b~"inabol'r dfscrib~d and granted qf' mentioned, and intended so to btJ with tlpp"'rtenanCts, untn tbe said parties of the ste-and part, their hein .nd ''';gm, agaiml Ih. said parlies of Ih, Ii..; pari and the ir b,i.. and against all and tVtry otbt, ~"..on or ptTlons whomsoetler, t.wfuUy dtlimhJg or to claim thr Mmt or any part thereof, ,hall and will, by 11m, pmrnl., WARRANT AND FOREVER DEFEND 1J n 1I1\l itnl'B B 1I1\l11 ~rr of her",nlo..1 the ir hand s Ih. .aid pari ies of Ih, fml pari .md stal s tbe ally.""J yttl' fi,st above UlTitttn. ~~r(;o~{4~~.~............,. ..~.6.,'!,:0d'..(.../(...{!.Cc.C:?!d..\:.. 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W A.LNnO:J I 'SS VINVA1ASNN:ild "0 H.L1V:il41NOIYWO:J Savings Bond Calculator Page 1 of 3 10 1/.?~0~~_ ~ [!!pdatel [J!eIP:::J Savinc ~ Value As Of Bond Info Series Denomination Serial Number Issue Date lE~ ~~~ds.. .II $1100__.If I.~____-_.._----~.. Results # Bonds 90 Total Price $4,500.00 Total Interest $5,570.96 Total Value $10,070.96 YTDln $29. Issue Interest Next Final Serial Number Issue Date Series Denom Price Interest Value Rate Accrual Maturit C115697230EE 08/1986 EE $100 $50.00 $72.40 $122.40 4.00% 02/2001 08/201 C96161270EE 12/1985 EE 100 50.00 77.32 127.32 4.00% 06/2001 12/201 C280082582EE 01/1991 EE 100 50.00 40.32 90.32 6.00% 07/2001 01/202 C279988654EE 12/1990 EE 100 50.00 40.32 90.32 6.00% 06/2001 12/202 C26531625'lliE 17/1990 EE 100 50.00 40.32 90.32 6.00% 06/2001 12/202 C258676695EE 11/1990 EE 100 50.00 40.32 90.32 6.00% OS/200 I 11/202 C258475886EE 10/1990 EE 100 50.00 40.32 90.32 6.00% 04/200 I 10/202 C255416375EE 09/1990 EE 100 50.00 40.32 90.32 6.00% 03/2001 09/202 C241272799EE 08/1990 EE 100 50.00 40.32 90.32 6.00% 02/200 I 08/202 C241191607EE 07/1990 EE 100 50.00 43.04 93.04 6.00% 07/2001 07/202 C241104125EE 06/1990 EE 100 50.00 43.04 93.04 6.00% 06/2001 06/202 C241 00 1515EE 05/1990 EE 100 50.00 43.04 93.04 6.00% OS/2001 OS/202 C240909135EE 04/1990 EE 100 50.00 43.04 93.04 6.00% 04/2001 04/202 C240827178EE 03/1990 EE 100 50.00 43.04 93.04 6.00% 03/2001 03/202 C240804498EE 03/1990 EE 100 50.00 43.04 93.04 6.00% 03/200 I 03/202 C240722087EE 02/1990 EE 100 50.00 43.04 93.04 6.00% 02/2001 02/202 C231893722EE 12/1989 EE 100 50.00 45.84 95.84 6.00% 06/2001 12/201 C231874682EE 12/1989 EE 100 50.00 45.84 95.84 6.00% 06/2001 12/201 C229540527EE 11/1989 EE 100 50.00 45.84 95.84 6.00% OS/2001 11/201 C225353614EE 10/1989 EE 100 50.00 45.84 95.84 6.00% 04/2001 10/201 C222674048EE 09/1989 EE 100 50.00 45.84 95.84 6.00% 03/2001 09/201 C222628425EE 08/1989 EE 100 50.00 45.84 95.84 6.00% 02/2001 08/201 C212113298E 07/1989 EE 100 50.00 48.68 98.68 6.00% 07/2001 07/201 C212046090EE 06/1989 EE 100 50.00 48.68 98.68 6.00% 06/2001 06:201 C211493903EE 05/1989 EE 100 50.00 48.68 98.68 6.00% OS/2001 OS/201 C2 10261 967EE 04/1989 EE 100 50.00 48.68 98.68 6.00% 04/2001 04/201 C208071080EE 03/1989 EE 100 50.00 48.68 98.68 6.00% 03/2001 03/201 C208053091EE 03/1989 EE 100 50.00 48.68 98.68 6.00% 03/2001 03/201 http://www . pub licdebt. treas. gov / serv let/SB CPrice 10/19/01 Savings Bond Calculator Page 2 of 3 CI96754756EE 01/1989 EE 100 50.00 51.64 101.64 4.00% 07/2001 01/201 CI96686894EE 12/1988 EE 100 50.00 51.64 101.64 4.00% 06/2001 12/201 C 196648979EE 12/1988 EE 100 50.00 51.64 10 1. 64 4.00% 06/2001 12/201 C194416048EE 11/1988 EE 100 50.00 51.64 101.64 4.00% OS/2001 11/201 C183917750EE 10/1988 EE 100 50.00 51.64 101.64 4.00% 04/2001 10/201 CI78851510EE 08/1988 EE 100 50.00 51.64 101.64 4.00% 02/2001 08/201 CI78828765EE 08/1988 EE 100 50.00 51.64 101.64 4.00% 02/200 I 08/201 C178565506EE 07/1988 EE 100 50.00 53.68 103.68 4.00% 07/2001 07/201 CI77017008EE 06/1988 EE 100 50.00 53.68 103.68 4.00% 06/2001 06/201 C176997996EE 05/1988 EE 100 50.00 53.68 103.68 4.00% OS/2001 OS/201 C 165639985EE 04/1988 EE 100 50.00 53.68 103.68 4.00% 04/2001 04/201 C165596367EE 03/1988 EE 100 50.00 53.68 103.68 4.00% 03/2001 03/201 C159993559EE 02/1988 EE 100 50.00 53.68 103.68 4.00% 02/2001 02/201 CI59916253EE 01/1988 EE 100 50.00 55.76 105.76 4.00% 07/2001 01/201 C152538904EE 12/198'/ EE 100 50.00 55.76 105.76 4.0(;% 06/2001 12/201 C152537824EE 12/1987 EE 100 50.00 55.76 105.76 4.00% 06/2001 12/201 C152535286EE 10/1987 EE 100 50.00 55.76 105.76 4.00% 04/2001 10/201 C 152535020EE 10/1987 EE 100 50.00 55.76 105.76 4.00% 04/2001 10/201 C 151696092EE 09/1987 EE 100 50.00 55.76 105.76 4.00% 03/2001 09/201 C151698737EE 08/1987 EE 100 50.00 55.76 105.76 4.00% 02/2001 08/201 C140552953EE 07/1987 EE 100 50.00 57.88 107.88 5.20% 07/2001 07/201 C140551965EE 06/1987 EE 100 50.00 57.88 107.88 5.20% 06/2001 06/201 C140549380EE 05/1987 EE 100 50.00 57.88 107.88 5.20% OS/2001 OS/201 C140547909EE 04/1987 EE 100 50.00 57.92 107.92 5.50% 04/200 1 04/20 1 C140547154EE 03/1987 EE 100 50.00 57.92 107.92 5.50% 03/2001 03/201 C124335220EE 02/1987 EE 100 50.00 57.92 107.92 5.50% 02/2001 02/201 C124337870EE 01/1987 EE 100 50.00 60.88 11 0.88 5.19% 07/2001 01/201 C 124339773EE 12/1986 EE 100 50.00 60.88 11 0.88 5.]9% 06/2001 ]2/201 C 124338828EE 11/] 986 EE 100 50.00 60.88 110.88 5.19% OS/200 I ] 1/20 I C115890884EE 10/1986 EE 100 50.00 72.40 122.40 4.00% 04/2001 10/201 C115890218EE 10/1986 EE 100 50.00 72.40 122.40 4.00% 04/2001 10/201 C115889178EE 09/1986 EE 100 50.00 72.40 122.40 4.00% 03/2001 09/201 C] 15696874EE 08/1986 EE 100 50.00 72.40 122.40 4.00% 02/200] 08/201 C115888682EE 06/1986 EE 100 50.00 74.84 124.84 4.00% 06/2001 06/20] C115888138EE 05/1986 EE 100 50.00 74.84 124.84 4.00% OS/2001 OS/20] C115886956EE 04/1986 EE 100 50.00 74.84 124.84 4.00% 04/2001 04/201 C116675063EE 03/1986 EE 100 50.00 74.84 124.84 4.00% 03/2001 03/201 CI07240233EE 02/1986 EE 100 50.00 74.84 124.84 4.00% 02/2001 02/201 http://www.publicdebt.treas.gov/servlet/SBCPrice 10/19/01 " Savings Bond Calculator Page 3 of3 CI07218190EE 01/1986 EE 100 50.00 77.32 127.32 4.00% 07/2001 01/201 C93391344EE 11/1985 EE 100 50.00 77.32 127.32 4.00% OS/2001 11/201 C85107889EE 10/1985 EE 100 50.00 77.32 127.32 4.00% 04/2001 10/201 C85112277EE 0911985 EE 100 50.00 77.32 127.32 4.00% 03/200 I 09/20 I C85031136EE 08/1985 EE 100 50.00 77.32 127.32 4.00% 02/200 I 08/20 I C85110831EE 08/1985 EE 100 50.00 77.32 127.32 4.00% 02/200 I 08/20 I C85085804EE 06/1985 EE 100 50.00 79.88 129.88 4.00% 06/200 I 06/20 I C81239924EE 05/1985 EE 100 50.00 79.88 129.88 4.00% OS/200 I OS/20 I C81238495EE 04/1985 EE 100 50.00 79.88 129.88 4.00% 04/2001 04/201 C85081337EE 06/1985 EE 100 50.00 79.88 129.88 4.00% 06/200 I 06/20 I C81229079EE 03/1985 EE 100 50.00 79.88 129.88 4.00% 03/200 I 03/20 I C78183076EE 02/1985 EE 100 50.00 79.88 129.88 4.00% 02/200 I 02/20 I C78177241 EE 01/1985 EE 100 50.00 82.48 132.48 5.18% 07/2001 01/201 C75741482EE 12/1984 EE 100 50.00 82.48 132.48 5.18% 06/2001 12/201 C77877499EE 11/1984 EE 100 50.00 82.48 132.48 5.18% 05/LOO j /1/201 C75728579EE 10/1984 EE 100 50.00 85.12 135.12 5.32% 04/2001 10/201 C68122179EE 09/1984 EE 100 50.00 85.12 135.12 5.32% 03/200 I 09/20 I C68121669EE 08/1984 EE 100 50.00 85.12 135.12 5.32% 02/2001 08/201 C68106925EE 06/1984 EE 100 50.00 88.72 138.72 5.26% 06/200 I 06/20 I C61934742EE 05/1984 EE 100 50.00 88.72 138.72 5.26% OS/200 I OS/20 I C12527319EE 03/1984 EE 100 50.00 91.40 141.40 5.38% 03/2001 03/201 CI2527272EE 01/1984 EE 100 50.00 95.20 145.20 5.32% 07/2001 01/201 C12527259EE /1/1983 EE 100 50.00 95.20 145.20 5.32% OS/2001 11/201 C12527243EE 09/1983 EE 100 50.00 97.64 147.64 5.42% 03/200 I 09/201 'Vi."w 10 'I Viewing Bonds 1-90 Note Description N1 Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty ME Matured (Exchangeable for HH) MN Matured (Not Exchangeable for HH) ALL OF THE ABOVE MENTIONED SAVINGS BONDS WERE ISSUED IN THE NAME OF MARY KLINGER OR FRED D. KLINGER. THE SAID FRED D. KLINGER HAS PREDECEASED THE DECEDENT. le end http://www.publicdebt.treas.gov/servlet/SBCPrice 10/19/01 ." !l allflrst Allfirst Financial Center :\i,A. P.O. Box 900 MilIsboro, DE 19%6 March 1, 2001 Stone LaFaver & Shekletski Attorneys At Law 414 Bridge Street P.O. Box E New Cumberland, PA 17070 RE: Estate of Mary L. Klingler Date of Death: January 30,2001 /Social Security Number: 180-26-5574 Dear Mr. Stone: In response to your request, please be advised that at the time of death, the aoove- named decedent had on deposit with this bank the foIIowing accounts. 1. Account Type........................... Checking Account Account Number........... ............ 0042688019 Ownership (Names of). .... ... ...... Mary Klingler Opening Date.............. ........... ..11/28/84 Balance on Date of Death.........$10, 181.81 Accrued Interest $ 5.44 Total................. .................. ....$1 0,187.25 2. Account Type........................... Money Fund Alternative Account Number....................... 0098126989 Ownership (Names of).............. Mary L. Klingler Opening Date............. .... ...... ....05/06/97 Balance on Date of Death....... ..$20,871.02 Accrued Interest $ 14.38 Total................................... '" .$20,885.40 . Page 2 3. Account Type........................... Home Equity Line of Credit Account Number....................... 115969850001 Ownership (Names oJ).............. Mary L. Klingler Opening Date.......................... .08/06/92 Balance on Date of Death...... ...$0.00 4. Account Type........................... Individual Retirement Account Account Number....................... 87000096387001 Ownership (Names oj).. ............ Mary L. Klingler Opening Date...........................02/ 15/83 Balance on Date ofDeath.........$3 1,999.12 Accrned Interest $ 544.09 Total. .... ..................... ......... ....$32,543.21 5. Account Type........................... Certificate of Deposit Account Number....................... 80000002186825 Ownership (NamesoJ).............. Mary L. Klingler Opening Date...........................ll/02/00 Balance on Date of Death...... ...$10,000.00 Accrned Interest $ 160.03 Total........ ... ........................ ....$10, 160.03 March 1, 2001 . Page 3 March 1, 2001 6. Account Type........................... Certificate of Deposit Account Number....................... 87008140731463 Ownership (Names of}.............. Mary L. Klingler Opening Date...........................03/ 17/97 Balance on Date of Death....... ..$23,405.48 Accrued Interest $ 57.01 Total...................................... .$23,462.69 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 trust agreement. For any additional information on these accounts, please contact our branch at: 5528 Carlisle Pike Mechanicsburg, PA 17055 Phone: (717) 255-2293 Sincerely, () JJ J;17L UtCU?jU L Charlene Warrington, Assistant III (302) 934-2722 . o o o The unde~ried IWlf8l)y ~ IIpp/il::11lion tor CatliIQhI ~ T1:\let\)~....wc. dlHICl'IbIKl W ~."uil;.ctIOI""lInevmlll1l_atlllOlhil'flI9'l~",lorth~, tJ1 <::) SlGN...ruREOF....~ IlloitOR...l/Ti'iORIZE SIGNEA 0">1 (X) I " I "'.. SlGNA.TUAEOFCO-APl""LICAHTIfITtEQF.&Ai'11'IORlZEOSIGNE1'I ~ Cf~rI."'~l1.:"ftlII'lfl[ ... -- DEPARTMENT OF TRANSPORTATION CERTIFICATE OF TITLE F'OR A VEHICLE I } '7D22D020DO.50b-DO~ .,!" ~~~'~O!~A!~~:?~~,*'~it~~~~~i'~~~~~iF.' 000''''' -~.];'drF';-.mf~~~-;;~~~~~:.il~~~~~~AlVS ~u37';F'n~', ~~~~--~ ==-~;;~;-=r~TEoilsSuE:---=~r -~LADENwE~J=~~R -=r-=:::- GCWR ===r- TN1.ESAAHOS I " , ~ REGIS~O OWNERI$) . MARY L KLINGl.ER 1301 SCENERY DR I1ECHANICSBURG PA -"- --l -1 i J 'I- t J }!,"' " 17055 t1 ii. " FIRST UEM FAVOR OF; ~ ~l ~j \;1 n FIRST LIEN RELEASEO " SECOHC~fAVOFlOF; . ! \ -~ . SECONIl U.t"aEASED -- DAn -- os'" LBY MAILING ADDRESS At17HOAIZED REPRESENTATIVE BY AUTHORIZED REPRESENTATIVE 05'1580 MARY l. KUNGLER 1307 SCENERY OR I'lECHANICS6URG PA 17055 , ; 8RADLEY l \ee"ily..ofth.~of......ll'JeOfflclal'e<lOfd.oftlwlPwmsytlotmill~ 01 T,anspoIt.,\1on rlllhK1lhallt>e pel'fOn{.j or eooTIpaI1Y namlMl he~ klM Illwlul owner otthenld~\thICle. "" '" "'" 'M'1en~Ior~wICI'I._r.otIwflt\al\yQIlfSOOU",checIl:oneol ~~,lInoblPck"~,IItleWjllbelt&Ull(l.."T~ inComrnon", A 0 J"ln'"T.....,..wiVtftlglll'oISl/fYMlrlhlFl((l(Icte.ltloIOI1lI_r,~9l* lq"INl~~. sO T~inComrnoll(andulho!one_r.i~otdlce..~ gOMtDI'Worher""'or_llt!. SlGWITUFlE OF PERSON "'QMIH/STE'RI O"'TH "EN DATE; FIRST LIENHOLDER' NAME ~ If't.JOLIE'N CHECKBOJl o STREET em< STm "EN O"'TE; seCON LIENHOlDER; NAM' STl'lEET "' If' NO UEN CHecK BOX o em< STm '" PSE(~ the financial link February 27,200 \ Account # 0180265574 DA VID H. STONE 414 BRIDGE ST PO BOX E NEW CUMBERLAND, PA 17070 Dear MR. STONE: The following is the status of MARY L. KLINGER's account with PSECU as of the date of death. Joint Owner's Name Date Estab I ished Date of Death Date of Birth TREMA C. BENDER, JOINT TENANT W/ROS 0\301998 01302001 0\17193\ Share(s) Regular Shares (S \) Share 50 60 Month IRA Certificate-I Share 51 24 Month Certificate-2 Share 52 24 Month Certificate Balance $ 116.11 27,645.26 5,887.13 10,141.01 Accrued Dividcnd $ 0.12 142.77 27.32 56.56 The dividend earned from January I, 2001 through the date of death was $226.77. The decedent had no loans with us. We do not have safe deposit boxes for our members. If you have any questions, please call 234-8484 in Harrisburg or our toll-free number, (800) 237-7318. At the menu prompt, enter 6 and then extension 2227. Sincerely, . " . i" . - i lf3cC'4'f Meacie Fair(,ax Member Service Representative Finance Support Unit PENNSYLVANIA STATE EMPLOYEES CREDIT UNION Main Address' 1 Credit Union Place. Harrisburg, PA 17110-2990' (717) 234-8484. (BOO) 237-732B Mailing Address: P.O. Box 67013, Harrisburg, PA 17106-7013. (717) 777-2100 (TOO)' (BOO) 472-1967 (TOO) Web Address: www.psecu.com Savings federally insured up to $100,000 by the National Credit Union Administration. Savings Bond Calculator Page I of I l_Jielp I Savinc ~ Value As Of LO].j200 1____ , '_!I.P_<<!.a.tllj Bond Info Series Denomination Serial Number $I~O___ L_______-' ~ Bon~~___1!I Results Total Price $75.00 Total Interest $73.86 Total Value $148.86 # Bonds 3 Serial Number Issue Interest Issue Date Series Denom Price Interest Value Rate 1111990 EE $50 $25.00 $20.16 $45.16 6.00% 12/1988 EE 50 25.00 25.82 50.82 4.00% 12/1987 EE 50 25.00 27.88 52.88 4.00% L556498137EE L556498136EE L556498135EE Le end Note Deseription NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty ME Matured (Exchangeable for HH) MN Matured (Not Exchangeable for HH) http://www . pub licdebt. treas. gov / serv let/SB CPrice Issue Date Next Accrual OS/200 I 06/200 I 06/2001 YTDIll SO. Fillal Maturi! 111202 12/201 12/201 10119101 )- A' f i SERIES EI1~; INn.EST cu... so YLf,q_ ;~". I'ROM ...,.. QATI: . ",- _~:_'~ ! 121 Id 19B~'~ , , r. , J..;J ..~-._"._..__._-! I" ", 180 26 5574 . .. -~oc~'i:(: [......;,;';,.0 --::0;:;;:;-;-:;- To MARY L KL 1NGLER ?:';~ . !5S"":E DA"E ~~~-,--~..~~" !,oRB PITT, (' 0 li'~1.!i.-=r~7_.\ . . - -, -; , OATINClIITAfIe" '" .J...III...III....I.I..I.I..../IJ.I;..li.r.I,i/ll...Ji;;;n...1I " \, i' ~"~t~~..J~~1~~0~i~~~.~~ :tBr ~ ~ I ~~.L:-.n:,~,~l.7tf.. ~::'O~i&~9~ig~. .,; ).,L: ~ : LJ J J }lt~ )~. 1~~jyDl.HIL 55b Lf9 813 sEE' . .:~ooo Cjooo'?;':'o'~ IICj~'s ~;:-:ui 103 511" ...it ..' , }rr~:_t C~1307 SCENERY RD .' MECHAN1CSBURG vlJ.iIT I":,,:~'~~--~~ P A 1'7055-1944 .. III" tot I _- "t _ _. ' . INT.II'ST CIA... :10 VIEA". u::', ':,::::,. l':, i:!;~:;!~~!' I ~#-:1307 SCENERY RD . L Xu " . :-' O,,~.7.{'~;T?'\ ~ ,," MECHAN1CSBURG ."~~,, PA 17055-1944 : ' . Ii .-', C...TIN..T....." .' ~ .~;~,;:,.~~"~~~.~~~.,~~~~,~;~I.~..I~;~..I~r~"..." .~~~:,::,::i \"... .// , \ R1 970660033 .001 DOllE!,!. ,.;;;;;;;;,;;r.c~._,:':;~,' 055649<1136 " . .,. ,I.. If" ~ ... Ii ..,. iI I i L) );l!!'. II, . ';'f" ", .' . .----''-:..:.....;..:.:-~;~~. ii.1'~' L55b lf9813bEE ':OOOOqOOO"?;':'O'~ .~OSm% UJ;II"' ..' .' r > ;) It t" \iI:"_ ,,: - _. . ~U!ltl~~81f!D'4t1~ ~!!!!.H.l~ SERIES EE lNTI:Itl[.T CIE....... ao VIE""" ".- "1II0N ..au. DATI: . ( hll.i0 180 26 5574 ,-!J" ~ J~.c.. F''''"~T- 1-----, L_.!~"90, 11 ~ . c: _ . r .;;> ',,,, IS S'l.j E o'ArE ToMARY L KLINGLER ~~...~ ,F"RB PITT. . 03-14-97' : 1..UINfAGllllr.' '; , ',1. : . DATl"'''.TA'''' ~_~Ol f01Si-n'1" ~'Sl30 7 SCENERY RD, ~'. ' .. MECHAN1CSBURG~"'c- PA 17055-1944 ',';:'I...I/I,..III...,I,I"I,I"',.m;J;..I..llIii 1/1....1....1".," . . OR ;TREMA BENDER:. , .J.l J. .!. .' R1 970660033 .001 001 li1IQ ;~~."../.,. .. liS5~498137 '" L~l j J..~".~. ~,,;_.r..cl~~eJ1i:_' . L55blf98131EE .:OOOOCj0007':03 IIOOSSJ;l,qB 103711" . . , ;' c, ~ i <:.. REV-1500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 I G -;{09-LP DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 0165 COUNTYCODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Klinaler, Marv L 180-26-5574 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 01/30/2001 10/17/1931 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 3. Remainder Return CHECK ~ ' ""..-. ~" '"'""-~- .0 (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required i.8ate of death after12-12-82) ,j PRIATE 6. Decedent Died Testate 7. ecedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach acopyofTrust) BLOCKS 9. Litigation Proceeds Received 10. Spousal PovertyCredit(date of death between 011. Election to tax under Sec. 9113(A) 12-31-91 and 1-1-95) (AttachSchQ) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE & CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS COR- David H. Stone, Esquire 414 Bridge Street RE- SPON FIRM NAME (If Applicable) New Cumberland, PA 17055 DENT Stone LaFaver & Shekletski TELEPHONE NUMBER 717-774-7435 OFFICIAL USE ONLY ,. Real Estate (Schedule A) (1) 0.00 2. Stocks and Bonds (Schedule B) (2) 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0.00 4. Mortgages & Notes Receivable (Schedule D) (4) 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 0.00 6. Jointly Owned Property (Schedule F) o Separate Billing Requested (6) 3,747.07 RECA- PITULA- 7. Inter-Vivos Transfers & Miscellaneous TION Non-Probate Property (Schedule G or L) (7) 0.00 8. Total Gross Assets (total Lines 1-7) (8) 3,747.07 9. Funeral Expenses & Administrative Costs (Schedule H)(9) 360.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I} (1 0) 0.00 11. Total Deductions (total Lines 9 & 10) (11) 360.00 12. Net Value of Estate (Line 8 minus Line 11) (12) 3,387.07 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) 0.00 has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 3,387.07 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amountof Line 14 taxable at the spousal tax rate, ortransfBrsunderSec. 9116(a)(1.2) 0.00 X .00 (15) 0.00 - TAX 16. Amountof Line 14 taxable at lineal rate 3,387.07 X .045 (16) 152.42 - COMPU- 17. Amount of Line 14 taxable at sibling rate 0.00 X .12 (17) 0.00 TATlON 18. AmountofLine 14 taxable at collateral rate 0.00 X .15 (18) 0.00 19. Tax Due (19) 152.42 20. o I CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT I >> BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND RECHECK MATH<< o PA'500' NTF 29755 Copyright 2000 Greatland/Nelco LP- Forms Software Only PA REV-1500 EX (6-00) Decedent's Complete Address: Page 2 STREET ADDRESS 1307 Scenerv Dr CITY I STATE I ZIP MechanicsburtT PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 152.42 0.00 0.00 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 Totallnterest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 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. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WillS, AGENT (3) 0.00 (4) (5) 152.42 (5A) 0.00 (5B) 152.42 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did 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; c. retain a reversionary interest; or. . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? ........ . . . . . . . . . . . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 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. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on information of which preparer has any knowledge. SIGNAT~F PERSON RESPONSIB FOR FILlN ~ c. ADDRESS 313 Glenn Rd. Yes No ~ I B ~ D RETURN 1 DATE ? / 1./ -u z.. ADDRESS 4 New AN REPRESENTATIVE For date.s of death on or after July 1,1994 and before January 1, 1995, the tax rate impo.sed on the net value of tran.sfer.s to or for the use of the .surviving spouse is 3% [72 P.S.' 9116(a)(1.1)(i)]. For date.s of death on or after January 1, 1995, the tax rate is imposed on the net value of tran.sfers to or for the use of the .surviving spouse is 0% [72 P.S. Ii 9116 (a) (1.1}(ii)]. The .statute dJHIS not exemnt a transfer to a .surviving spouse from tax. and the statutory requirements for di.sclo.sure of asset.s and filing a tax return are still applicable even if the.surviving.spou.sei.stheonJybeneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a decea.sed child twenty-one years of age or younger at death to orfor the use of a natural parent, an adoptive parent, ora stepparent of the child i.sO% [72 P.S.99116(aX1.2)J. The tax rate imposed on the net value of transfers to or for the \l.se of the decedent's lineal beneficiaries is 4.5%, except as noted in 72.P.S. Ii 9116(1.2) [72 P.S. 99116(aX1)]. The tax rate imposed on the net value of transfer.s to Dr for the u.se of the decedent's siblings is 12% [72 P.S. Ii 9116(aX1.3}]. A sibling is defined, under Section 9102, a.s an individual who hasat least one parent in common with the decedent, whether by blood oradoption. o PA15002 NTF 29756 Copyright 2000 Greatland/NeJco LP - Form.s Software Only REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Klingler, Mary L SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21-2001-0165 If an asset was made joint within one year 01 the decedent's date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME A.Gilbert, Benjamin F ADDRESS 319 Mt. Allen Drive Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT son B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH FOR Include name of financial institution and bank ITEM JOINT MADE account number or similar identifying number. DATE OF DEATH DECD'S VALUE OF NO. TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 05/10/1999 ~aypoint Bank-Savings Acct. 7,494.14 50.00 3,747.07 #3060000436, Principal $7,482.36, Int. $11.77 joint w/Benjamin Gilbert on 5-10-99 TOTAL (Also enter on line 6, Recapitulation) $ 3,747.07 o PA15091 NTF33306 (If more space is needed, insert additional sheets of the same size) Copyright 2000 Greatland/Nelco LP - Forms Software Only REV-1511EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Klingler, Mary L SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-2D01-0165 Debts of decedent must be reported on Schedule I. ITEM NO. DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ,. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions D.OO Name of Personal Representative(s) Social Security Number(s)/EIN No. of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Name: David H. Stone 250.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 0.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7. Register of Wills-filing Amended Inheritance Tax Retur 10.00 n 9 Reserve for closing expenses 100.00 TOTAL (Also enter on line 9, Recapitulation) $ 360.00 o PA15111 NTF33308 (11 more space is needed, insert additional sheets of the same size) Copyright 2000 Greatland/Nelco LP - Forms Software Only REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Klingler 1 Mary L NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Bender, Trema C 313 Glenn Rd. Camp Hill, PA 17D11 2 Gilbert, Benjamin F 319 Mt. Allen Drive ~echanicsburg, PA 17055 FILE NUMBER 21-2001-0165 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) daughter son AMOUNT OR SHARE OF ESTATE 1,693.54 1,693.53 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 18 AS APPROPRIATE ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE ,. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ,. o PA1S131 TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBS. ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) NTF33293 Copyright 2000 Greatland/Nelco LP- Forms Software Only 0.00 \ .~ 7 ~ ;// j WaYRql!lt - :., ':,~ J=o.'NE'LL GET YOU THERE 07/10/2002 STONE LAFA VER & SHEKLETSKl 414 BRIDGE ST NEW CUMBERLAND P A 17070 The information which you requested on the account(s) of MARY KLINGLER (Social Security Number 180-26-5574) is/are as follows: Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownetship JTO Name of Joint BENJAMIN Owner, if any GILBERT Dcte Ownetship 05/1 0/99 Was Established 3060000436 SA VINaS 0511 0/99 748236 11.77 7494.13 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of JC1;nt Owne:- ; - any Date Ownership Was Established Additional fi{'(rJ(;../" I i.cifJ.5 (I.IE-IV;::;/) Sl.t/iff;' O{IUflii:/!.jl{l!' Sincer~~ InformatIOn.__ 1 ........ '.. I L 11 . Requested J rz. Bt::::rv::JIWI/IV (</Ll3w:..T (l~ 11'}/.)l.!.y KI.IN(,UI:, KATHY Y U , v:1JJ- tlL/!3t'/t I - m H;'~ If I<.LIr1c-taZ- I)j 11m!: J.?Em /vEl) SENIOR SERVICEiR'EP. f.fi})E..J) Tl2Em/~ &:NilEL~ BEfv.JL'iffll/v &/LBL7!.J Df11EUo( uf::fJ:'THi/jiili!.80'/< 6If.-k~B~~~~ANIA 17105-1711 (! ~~~~We~~~~~~~~'7,,~~IN A~~t,F3ft 717/815-4500 . www.waypointbank.com