HomeMy WebLinkAbout06-11-15 (2) k Au pennsytvania 1505614105
.j T DOWATMWOFF048M EX(03-14)(171)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 11
PO BOX 280601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
09172014 1 08311928
Decedent's Last Name Suffix Decedents First Name MI
Cohick Mildred i L
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
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THIS RE MN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
cXD 1.Original Return r—,% 2.Supplemental Return C=D 3. Remainder Return(date of death
prior to 12-13-82)
C=D 4.Agriculture Exemption(date of r--% 5.Future Interest Compromise(date of C=) 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
CED 7.Decedent Died Testate C:) 8.Decedent Maintained a Living Trust 0 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
C= 10.Litigation Proceeds Received C:n 11.Non-Probate Transferee Return C=) 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
O 13.Business Assets C=D 14.Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT— THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Richard J.Seneca, Esq. 11(717) 932-6000
First Line of Address
P.O. Box 333
Second Line of Address
1680 Yorktown Road
City or Post Office State ZIP Code
1
Lewisberry F7339
Correspondent's email address:,dseneca@senecalaw.com
REGISTER OF WILLS
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PLEASE USE ORIGINAL FORM ONLY
Side I
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1505614105
1505614205
REV-1500 EX(FI) Decedent's Social Security Number
Decedent's Name: Mildred L. Cohick
RECAPITULATION
i -
1. Real Estate(Schedule A). .. .. .............. 0.00
_ 21, 727. 74
2. Stocks and Bonds(Schedule B) .................... ................... 2.
i
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. 0.00
11
4. Mortgages and Notes Receivable(Schedule D) ......................... .. 4. I 0.00
5. Cash,Bank Deposits and Miscellaneous Personal Properly(Schedule E)....... 5. 68, 298. 83
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 0.00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7. 0.00
8. Total Gross Assets(total Lines 1 through 7)............................. 8. 90,026. 57
9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 425122. 72
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. 19009. 00
11. Total Deductions(total Lines 9 and 10).................................. 11. 432131 . 72
12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. 46 , 894. 85
13. Charitable and Governmental Bequests/Sec.9113 Trusts for which
an election to tax has not been made(Schedule J) ........................13. 0.00
14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. 467894. 85
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 -
(a)(1.2)X.0_ -- 15. -
16. Amount of Line 14 taxable
at lineal rate x.045 46 , 894. 85 16• 21110. 27
17. Amount of Line 14 taxable
at sibling rate X.12 __ 17.
18. Amount of Line 14 taxable
at collateral rate X.15 -- 18. -
19. TAX DUE ......................................................... 19. 2 , 110. 27
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Under penalties of perjury,I declare I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the person responsible for filing the return is based on all information of which preparer has
any knowledge.
SIGNATURE OF PERSON RPONSIBLE FOR FILING RETURN A . / DATE
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ADDRESS
ISO 4 wtJ I!1u 16W WS Sq4 S .e.L421 up.. 1
SIGNA EPAR TH N PERSON RESPONSIBLE FOR FILING THE RETURN DTE
10 2 C, S
ADDRESS
Seneca Law, ox , LeWsberry, PA 17339
Side 2
61 1505614205
?ESI--1500 EX (FI) ,Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
Mildred L. Cohick
STREET ADDRESS
824 Lisburn Road
CITY STATE ZIP
Camp Hill PA 17011
Tax Payments and Credits: 2 , 110. 27
I. Tax Due(Page 2,Line 19) (1)
2. Credits/Payments 51900.00
A.Prior Payments
B.Discount 105. 51 62005. 51
(See instructions) Total Credits(A+B) (2)
3. Interest (3) 0.00
4. If line 2 is greater than Line 1+Line.3,enter the difference. This is the OVERPAYMENT. 31895. 24
Fill in oval on Page 2,Line 20 to request a refund. (4)
0.00
5. if Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5)
Make check payable to: REGISTER OF WILLS,AGENT.
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PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN"X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred..........................................................:............................... ❑ M
b. retain the right to designate who shall use the property transferred or its Income............................................ ❑
c. retain a reversionary interest............................................................................................................................. ❑ e
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 0
2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. ❑ N
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ 0
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.
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For dates of death on or after July 1,1994,and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(0)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
e The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent or a step-parent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
e The tax rate imposed on the net value of transfers to or for the use of the decedents lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
o The tax rate imposed on the net value of transfers to or for the use of the decedents siblings is 12 percent V2 P.S.§9116(a)(1.3)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption,
AEV-1503 EX+(02-15)
pennsytvania SCHEDULE t
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mildred L. Cohick 21-14-0949
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1• Comcast Corporation Class A Stock, 10 shares @$57.09 per share(see attached value letter)
570.90
2 Verizon Stock,283.010359 shares @$49.21 per share(see attached value letter) 13,926.94
3 Prudential Financial Stock,74 shares @$90.82 per share(see attached value letter) 6,720.68
4 Frontier Communications Stock,78.100551 shares @$6.52 per share(see attached value letter) 509.22
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TOTAL(Also enter on Line 2, Recapitulation) $ 21,727.74
If more space is needed,insert additional sheets of the same size
?.EV-1508 EX+(02-13)
pennsylvania SCHE®ULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Mildred L. Cohick 21-14-0949
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PNC Bank Checking Account No.*"***3234(see attached value letter) 17,022.90
2 PNC Bank Savings Account No.*"**'2881 (see attached value letter) 1,921.41
3 PNC Bank Investment Account No.*'"""976(see attached value e-mail) 19.44
4. New Cumberland Federal Credit Union("NCFCU")Acct.No.78947,Savings(see attached value letter) 54.95
5. NCFCU Acct.No.78947,Certificate of Deposit("CD")#1 (see attached value letter) 2,580.11
6 NCFCU Acct.No.78947,CD#2(see attached value letter) 25,396.51 ,
7 NCFCU Acct.No.78947,CD#4(see attached value letter) 15,303.15
8. Miscellaneous Personal Property 100.00
9.: Mutual of Omaha.Medicare Supplement Refund 290.26!
10. Cash on Hand 1,000.00.
Prudential Dividends Received 125.06
12.,' ,Refund of The Woods Cash Account Balance 95.00.
13. The Woods Residence Fee Refund 1,633.04,
14.11RiverSource Insurance Refund 1,800.00;
15.- -Comcast Dividends Received V 7.00;
16.E AccelorMital Medicare Benefit Refund 950.00'
TOTAL(Also enter on Line 5, Recapitulation) $ 68,298.83
If more space is needed,use additional sheets of paper of the same size.
REV-1510 EX+ (02-15)
>� �pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mildred L. Cohick 21-14-0949
This schedule must be completed and sled if the answer to any of questions 1 through'4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
INCLUDE THE NAME OF THE TRANSFEREE,THEIR-RELAITONSHIP TO DECEDENT AND
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1. Ameriprise Annuity Account No.**"**'""703004
(See attached value letter and list of transferees) 33,256.34 100 33,256.34 0.00.
Ameriprise Annuity Account No."**'`'"*'538.1004
2. (See attached value letter and list of transferees) 50,444.10 100 50,444.10 0.00
Western&Southern Life Annuity Account No.'20178291
3 (See attached value letter and list of transferees) 16,713.16 140 16,713.16 0.00
New York Life Annuity Account No.'""'*8764
4. (See attached value letter and list of transferees) 247,645.11 100 247,fi45.11 0.04
Prudential Annuity Account No.'1148
i
5• (See attached value letter and list of transferees) 10,008.58 100 10,008.58 0.00
Bankers Life and Casualty Company Annuity Account No.'4206
6. (See attached value letter and list of transferees) 112,229.37 100 112,229.37 0.00
tt (See attached value quiTrust Annuity letter and list
unt No.'6301 F
7. transferees) 183,027.28 100
- 183,027.28 0.00
I Ameriprise Annuity with Death Benefit Account No.*%****"*855304
8- 151,311.52 attached value letter and list of transferees) 151,311.52 100 151,311.52 0.00
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TOTAL(Also enter on Line 7, Recapitulation) $ 0.00
If more space is needed,use additional sheets of paper of the same size.
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SCHEDULE G
(continued)
Non-Probate Property Transferees
All below listed assets were transferred in accordance with the
beneficiary designations attached to the asset after Decedent's death.
1. Ameriprise Annuity Account Ending in 703004
2. Ameriprise Annuity Account Ending in 5384004
3. Ameriprise Annuity with Death Benefit Account Ending in 855304
4. Equitrust Annuity Account Ending in 6301F
Larry H. Cohick Son of Decedent
Steven Cohick Son of Decedent
Cheryl S. Cohick Daughter-in-Law of Decedent
Carol W. Cohick Daughter-in-Law of Decedent
Lauren Steco Granddaughter of Decedent
Brandon Cohick Grandson of Decedent
Jessica Cohick Wife of Grandson of Decedent
Addison Cohick Great-granddaughter of Decedent
5. Western& Souther Life Annuity Account Ending in 20178291
6. Bankers Life and Casualty Company Annuity Account Ending in 4206
7. Prudential Annuity Account Ending in 1148
Larry H. Cohick Son of Decedent
Steven Cohick Son of Decedent
8. New York Life Annuity Account Ending in 8764
Larry H. Cohick Son of Decedent
Steven Cohick Son of Decedent
Cheryl S. Cohick Daughter-in-Law of Decedent
Carol W. Cohick Daughter-in-Law of Decedent
Lauren Steco Granddaughter of Decedent
Brandon Cohick Grandson of Decedent
Addison Cohick Great-granddaughter of Decedent
REV-151: EX- (02-15)
�pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mildred L. Cohick 21-14-0949
Decedent's debts must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
George P.Garman Funeral Homes, Inc. Funeral Expense(see attached invoice) 8,190.11
2. Burial Clothing Items for Decedent 20.35
3. Chaplain Services 250.00
4. Ranch House for Funeral Luncheon 300.00
5. Honorariums Paid 150.00
6. Rice Memorials Marker Engraving Fee 175.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 0.00
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2. Attorney Fees: 32 000.00
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: 720.50
5. Accountant Fees: 0.00
6. Tax Return Preparer Fees: 0.00
7• Central Penn Business Journal Estate Notice Publication Fee — T _-- T^ 150.00
8.' 'Cumberland Law Journal Estate Notice Publication Fee =� 75.00
s. Short Certificate Fee — 60.00
�.10^ Postage 31.76
TOTAL(Also enter on Line 9, Recapitulation) $ 42 122• 72
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+ (02- 5)
-Ta
Pennsylvania SCHEDULEI
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mildred L. Cohick 21-14-0949
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses,
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Social Secuirty Payment Reversal 989.00
2. The Woods Final Bill Payment 20.00
TOTAL(Also enter on Line 10, Recapitulation) $ 1,009.00
If more space is needed,insert additional sheets of the same size,
Ree-1513 EX+(02-15)
>, pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Mildred L. Cohick 21-14-0949
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS(Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1. Larry H.Cohick,685 Sand Spur Drive,Etters, PA 17319 Son One ninth(1/9)
2. Cheryl S.Cohick,685 Sand Spur Drive,Etters,PA 17319 Daughter-in-Law One ninth (1/9)
3. Steven Cohick, 150 Dawn Avenue,Julian, PA 16844 Son One ninth(1/9)
4. Carol W.Cohick, 150 Dawn Avenue,Julian,PA 16844 Daughter-in-Law One ninth (1/9)
5. Rocco Steco,2206 Crestwyck Cir.,Mt.Joy,PA 17552 Husband of Granddaughter One ninth (119)
6. Lauren Steco,2206 Crestwyck Cir.,Mt.Joy,PA 17552 Granddaughter One ninth (1/9)
_ 7., Brandon Cohick, 108 Blue Spruce Ln.,Apt.2,Mifflinburg, PA 17844 Grandson One ninth (1/9)
8. Jessica Cohick, 108 Blue Spruce Ln.,Apt.2,Mifflinburg, PA 17844 Wife of Grandson One ninth(1/9)
,— 9. Addison Cohick, 108 Blue Spruce Ln.,Apt. 2, Mifflinburg, PA 17844 Great-granddaughter I One ninth(1/9)
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II
NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
t
t y
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1
TOTAL OF PART II— ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.
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LAST WILL rn
OF
f
MILDRED L. COHICK
Edmund "Tad" Berger
Berger Law Firm,P.C.
2104 Market Street
Camp Hill,PA 17011
Phone: (717)920-8900
TABLE OF CONTENTS
Introductory Clause 1
ITEM I
Direction to Pay All Taxes from Residuary Estate 1
ITEM II
Outright Gift of Residuary 1
ITEM III
Naming the Executor,Executor Succession,Executor's Fees and Other Matters 1
Naming Individuals as Executor 2
Individual Executors Succession 2
Fee Schedule for Individual Executor 2
Executor Voting Rights 2
Error! Not a valid heading level in TOC entry on page 2
ITEM IV
Definition of Executor 2
ITEM V
Powers for Executor 2
ITEM VI
Provision for Executor to Act as Trustee for Beneficiary Under Age,Twenty-One 3
ITEM VII
Discretion Granted to Executor in Reference to Tax Matters 3
ITEM VIII
Definitions of Family 3
Testimonium Clause 4
Attestation Clause 4
. a
LAST WILL AND TESTAMENT
OF
NIILDRED L. COIHCK
Introductory Clause. I, N LDRED L. COHICK, a resident of and domiciled in the
Township of Lower Allen, County of Cumberland and State of Pennsylvania, do hereby make,
publish and declare this to be my Last Will and Testament, hereby revoking all Wills and
Codicils at any time heretofore made by me.
rw. 4A.
I have two living children: LARRY H. COHICK, born December 14, 1951, and
STEVEN COHICK,born June 25, 1954.
ITEM I
Direction to Pay All Taxes from Residuary Estate. I direct that all estate, inheritance,
succession, death or similar taxes (except generation-skipping transfer taxes) assessed with
respect to my estate herein disposed of, or any part thereof, or on any bequest or devise
contained in this my Last Will (which term wherever used herein shall include any Codicil
hereto), or on any insurance upon my life or on any property held-jointly by me with another or
on any transfer made by me during my lifetime or on any other property or interests in property ,
included in my estate for such tax purposes be paid out of my residuary estate and shall not be
charged to or against any recipient, beneficiary, transferee or owner of any such property or
interests in property included in my estate for such tax purposes.
ITEM II
Outright Gift of All Property, including Residuary. I give, devise and bequeath all of
my property, including the rest, residue and remainder of my property of every kind and
description(including lapsed legacies and devises)wherever situate and whether acquired before
or after the execution of this Will, to my then-living lineal descendants and then-living spouses
of my lineal descendants in equal shares. More specifically,my property shall be divided into as
many shares as there are living lineal descendants and living spouses of lineal descendants
(individuals married to my lineal descendants at the time of my death or widows/widowers of my
lineal descendants and who were married to a lineal descendant at the time of the lineal
descendant's death) at the time of my death, and each of my then-living lineal descendants and
each then-living spouse of my lineal descendants shall take an equal share of the residue of my
estate.
ITEM III
Naming the Executor, Executor Succession, Executor's Fees and Other Matters.
The provisions for naming the Executor, Executor succession, Executor's fees and other matters
are set forth below:
Last Will and Testament of Mildred L.Cohick Page 1
(1) Naming Individuals as Executor. I hereby nominate, constitute and appoint as
Executors of this my Last Will and Testament LARRY H. CO1HCK and STEVEN COHICK
and direct that they shall serve without bond.
(2) "Individual Executors Succession. If any individual Executor should fail to qualify
as Executor hereunder, or for any reason should cease to act in such capacity, the remaining
individual Executors shall continue to serve without a successor or substitute.
(3) Fee Schedule for Individual Executor. For its services as Executor,the individual
Executor shall receive no compensation but shall be entitled to reimbursement for reasonable
expenses.
(4) Executor Voting Rights. If there is more than one Executor serving, then the-vote
of the Executors for any action hereunder must be by unanimous vote of the Executors.
(5) Delegation Among Executors. When there is more than one individual or entity
serving as co-Executors, then any Executor may delegate to any other Executor the power to
exercise any or all of the powers granted to the Executors in this Last Will and Testament,
including those powers, which are discretionary, to the extent allowed by law. Any delegating
Executor may revoke any such delegation with written notice to the other serving co-Executors.
The delegation of any such power, as well as the revocation of any such delegation, shall be
evidenced by an instrument in writing signed by the delegating co-Executor. As long as any
such delegation is in effect, any of the delegated powers may be exercised by the Executor
receiving such delegation with the same force and effect as if the delegating Executor had
personally joined in the exercise of such power. Provided,however,that if such Executor, or co-
Executor, shall also be a current beneficiary and such delegation shall be deemed to create in that
Executor a right that shall be deemed to be a general power of appointment,then such individual
Executor shall not be vested with such right to delegate such power.
ITEM IV
Definition of Executor. Whenever the word "Executor" or any modifying or substituted
pronoun therefor is used in this my Will, such words and respective pronouns shall include both
the singular and the plural, the masculine, feminine and neuter gender thereof, and shall apply
eTaally to the Executor named herein and to any successor or substitute Executor acting
hereunder, and such successor or substitute Executor shall possess all the rights, powers and
duties, authority and responsibility conferred upon the Executor originally named herein.
ITEM
Powers for Executor. By way of illustration and not of limitation and in addition to any
inherent, implied or statutory powers granted to Executors generally,my Executor is specifically
authorized and empowered with respect to any property, real or personal, at any time held under
any provision of this my Will: to allot, allocate between principal and income, assign, borrow,
buy, care for, collect, compromise claims, contract with respect to, continue any business of
mine, convey, convert, deal with, dispose of, enter into, exchange, hold, improve, incorporate
any business of mine, invest, lease, manage, mortgage, grant and exercise options with respect
Last Will and Testament of Mildred L.Cohick Page 2
to, take possession of, pledge, receive, release, repair, sell, sue for, to make distributions or
divisions in cash or in kind or partly in each without regard to the income tax basis of such asset,
and in general, to exercise all the powers in the management of my Estate which any individual
could exercise in the management of similar property owned in his or her own right, upon such
terms and conditions as to my Executor may seem best, and to execute and deliver any and all
instruments and to do all acts which my Executor may deem proper or necessary to carry out the
purposes of this my Will,without being limited in any way by the specific grants of power made,
and without the necessity of a court order.
ITEM VI
Provision for Distribution to Beneficiaries Under Age Eighteen. If any share
hereunder becomes distributable to a beneficiary who has not attained the age of Eighteen (18)
years, then such share shall immediately vest in the beneficiary, but shall be paid as follows: If
the beneficiary is younger than Sixteen (16) years, then the amount shall be paid to a custodian z'
for the beneficiary under the Uniform Gifts or Transfers to Minors Act, such custodian to be the
beneficiary's natural guardian or, if there is no natural guardian, the legal guardian for that
beneficiary. If the beneficiary is Sixteen(16) years or older,then 1/3rd of the beneficiary's share
shall be paid directly to the beneficiary and the balance (2/3rds) shall be paid to a custodian for 9�
the beneficiary under the Uniform Gifts or Transfers to Minors Act, such custodian to be the
beneficiary's natural guardian or, if there is no natural guardian, the legal guardian for that
beneficiary. Custodians entrusted with the beneficiary's share under the Uniform Gift or �.
Transfers to Minors Act shall pay 1/3rd of the share directly to the beneficiary at the time the
beneficiary reaches the age of Sixteen (16) and the balance shall be distributed directly to the
beneficiary at the time the beneficiary reaches Eighteen(18).
ITEM VII
Discretion Granted to Executor in Reference to Tax Matters. My Executor as the
fiduciary of my estate shall have the discretion, but shall not be required when allocating receipts
of my estate between income and principal, to make adjustments in the rights of any
beneficiaries, or among the principal and income accounts to compensate for the consequences
of any tax decision or election, or of any investment or administrative decision,that my Executor
believes has had the effect, directly or indirectly, of preferring one beneficiary or group of
beneficiaries over others; provided, however, my Executor shall not exercise its discretion in a
manner which would cause the loss or reduction of the marital deduction as may be herein
provided. In determining the state or federal estate and income tax liabilities of my estate, my
Executor shall have discretion to select the valuation date and to determine whether any or all of
the allowable administration expenses in my estate shall be used as state or federal estate tax
deductions or as state or federal income tax deductions.
ITEM VIII
Definition of Lineal Descendants. For purposes of this Will, "lineal descendants"
means the lawful blood descendants in any degree of the testatrix. This includes children,
Last Will and Testament of Mildred L.Cohick Page 3
w �
grandchildren, great-grandchildren and great-great-grandchildren but does not include collateral
descendants such as nieces and nephews or their progeny.
Testimonium Clause. IN WITNESS WHEREOF, I have hereunto set my hand and
affixed my seal this July 23, 2007.
)1-�f _(SEAL)
MILDRED L. COHICK
Attestation Clause. The foregoing Will bearing on the margin the signature of the
Testatrix, was this July 23, 2007, signed, sealed, published and declared by the Testatrix as and
for her Last Will and Testament in our presence, and we, at her request and in her presence, and
in the presence of each other, have hereunto subscribed our names as witnesses on the above
date.
of
of
Last Will and Testament of Mildred L.Cohick Page 4
PROOF OF WILL
STATE OF PENNSYLVANIA )
Self-Proving Affidavit
COUNTY OF CUMBERLAND )
We, MILDRED L. COHICK, and I , / and
, the Testatrix and the witnesses, espectively, 4bose names are
signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testatrix signed and executed the instrument as her Last Will and
that she had signed willingly(or willingly directed another to sign for her), and that she executed
it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses,
in the presence and hearing of the Testatrix, and in the presence of each other, signed the Will as
witness and to the best of our knowledge the Testatrix was at that time eighteen years of age or
older,of sound mind, and under no constraint or undue influence..
x
MILDRED L. CK
ess
V966s
Subscribed, sworn to, and acknowledged before me by MILDRED L COHICK, the
Testatrix and s>lbscribed and sworn to before me by 'r�iia tlSh v4:b�Gt/l1 and
A?� .!/70'011 L�/rr ,witnesses,this July 23, 2007.
(Seal)
COMMONWEALTH OF PENNSYLVANIA No Public for Pennsylvania
Notaft!Seal
Jo Ann Salter,Notary Public My Commission Expires: �JU f
City Of Harrisburg,DaupNn Camty
My Commission E)#res June 30.2011
Member,Pennsylvania Association of Notaries
Last Will and Testament of Mildred L.Cohick Page 5
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX0 1-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 020037
COHICK LARRY H
685 SAND SPUR DRIVE
ETTERS, PA 17319-6000
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- told
__________ --------
101 $5,900.00
ESTATE INFORMATION: SSN:
FILE NUMBER: 2114-0949
DECEDENT NAME: COHICK MILDRED L
DATE OF PAYMENT: 12/17/2014
POSTMARK DATE: 12/17/2014
COUNTY: CUMBERLAND
DATE OF DEATH: 09/17/2014
TOTAL AMOUNT PAID: $5,900.00
REMARKS: RECEIPT TO ATTY
CHECK# 005
INITIALS: DMB
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
TAXPAYER
Shareowner Services
Post Office Box 64874
St.Paul,MN 55164-0874
shareowneronline.com/comcast
MILDRED L COHICK April 23,2015
15o DAWN AVE
JULIAN PA 16844-9231
Re: Share Balance Summary
Account number:3500842325
Registration: MILDRED L COHICK
15o DAWN AVE
JULIAN PA 16844-9231
Account creation date: 11/18/2002
Issue name of stock: Comcast Corporation Class A
Total share balance on 09/17/2014: 10.000
Certificate shares: .000
DRS/book-entry shares: 1o.000
Plan shares: .000
Dividend Amount Paid YTD: N/A
Closing price per share on 09/17/2014: $57.0900
Estimated value: $570.90
Ticker symbol for the company: CMCSA
Stock exchange: NASDAQ
Please note that as a transfer agent,we are not directly connected to the stock market.The above price is given as an
estimate and is not a guarantee of a specific price.The estimated value may lose value and is not guaranteed.
If you have any questions,you can send us an email by selecting"Contact Us"at any time while online at
shareowneronline.com.You can also call 888-883-8903 to talk to a shareowner relations specialist Monday through
Friday from 7:oo a.m.to 7:00 p.m.Central Time.
Sincerely,
Wells Fargo Shareowner Services
CMC3 1
eid you knovu? Miost shareholders can manage their holdings online witch free � (,omputershare
access to Computershare's Investor CenFrJm website. Use this simple tool to
quickly and easily update account information, sign up For electronic delivery of
documents and more. Enroll FREE today at wwvv.cornputershare.com/investor. � computershare Investor Services
L 250 Royall Street
Canton Massachusetts 02021
www.computershare.com
RICHARD] SENECA
PO BOX 333
LEWISBERRY PA 17339
March 4, 2015
Company: FRONTIER COMMUNICATIONS CORPORATION
Registration: MILDRED L COHICK
Holder Account Number: C0004488873
Document I.D.: 15057WF00490376
Our Reference: FRON/0002884968/11/
Dear Sir/Madam:
Thank you for contacting Computershare, the transfer agent for FRONTIER COMMUNICATIONS
CORPORATION. We appreciate the opportunity to be of service to you.
Our records indicate the following (values as of September 17, 2014):
Company Name-,Frontier Communications _u
Account Number: C00_04488873
78 0
Total Shares:j0551 '_�
Closing Price Per Share:t$6.52
Dividends: This security historically has paid dividends quarterly, most recently at $0.10 per share.
Date account was established: 7/1/10
Company Name:,Prudential Financial
Account Number:,00017546732
Total Shares: 74
Closing Price Per Share:'$90.82_
Dividends: This security historically has paid dividends quarterly, most recently at $0. per share.
Date account was established: 12/18/01
Company Name:LVerizon
Account Number: C0007395965
Total Shares:'2-83.010359,
Closing Price Per Shared 49.21
Dividends: This security historically has paid dividends quarterly, most recently at$0.58 per share.
Date account was established: 12/31/90
All shares are currently registered in the deceased shareholder's name. In order to sell shares of Common
Stock registered in the name of a deceased party, a transfer of ownership must first be completed.
For your convenience, we have enclosed the forms and instructions needed to transfer the shares to a new
account. the forms may be photocopied as needed. Alternatively, you may access the Computershare
Stock Transfer Wizard on our website at www.transfermystock.com. The Stock Transfer Wizard is an online
tool that will walk you through the completion of the transfer form and advise you of any additional steps
or documentation that you may need to complete the transfer.
If it is desired that the shares are sold after completion of the transfer, please include a letter of instruction
signed by the new holder(s) requesting that the shares be sold once the transfer is complete.
If applicable, please include the original unsigned stock certificates. If sending certificates through the mail,
we recommend the use of registered or certified mail, with return receipt requested. We also recommend
you insure your package at 3% of the current market value of your certificates (or$20.00, whichever is
greater). This represents an approximation of the cost of an indemnity bond to replace your certificates
should they be lost or stolen.To calculate the value, take the number of shares represented by the
certificate, multiplied by the previous day's closing price, multiplied by .03.
Under Internal Revenue Service (IRS) regulations, we are required to withhold the applicable tax rate from
all payments made to an account without a certified Taxpayer Identification Number(TIN). If the new
account is uncertified at the time of a payment (i.e. sale check, dividend, etc.), the backup withholding tax
applied cannot be refunded. Please be sure to complete the tax certification instructions included with the
transfer package.
Should you have other account related questions, please call us at 877-770-0496 during regular business
hours. Please note that any available representative can assist you.
Sincerely,
Service Representative
Enclosure: US Holder-Deceased Transfer Package
H o}
G' PNC
October 21, 2014
Richard J Seneca
Seneca Law
P O Box 333
680 Yorktown Rd
Lewisberry, PA 17339
RE: Mildred L Cohick
SSN:
DOD: 09-14-2014
Dear Mr. Seneca:
In response to your request for Date of Death (DOD) balances for the customer noted above, our
records show the following:
Checking Account
Account# 5140323234 Established: 12-21-1989
MILDRED L COHICK
DOD balance: .$ 17,022.90+ 0.15 accrued interest
Savings Account
Account# 5130232881 Established: 06-03-1983
MILDRED L COHICK
DOD balance:, 1,921.41 + 0.03 accrued interest
Investment Account
The decedent maintained Investment Account# 1332976 . For further information, you may call the
Brokerage Department at 1-800-762-6111.
Please note that this office provides date of death balances for deposit accounts (IRAs, CDs, Checking and
Savings). We do not process any financial transactions or provide statements. If you need assistance with
any of these items,please call 1-888-PNC-BANK(1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
National Financial Services Center
PNC Bank,N.A.
Member FDIC
Page 1 of 2
d �
This message is intended for the use of the individual or entity to which it is addressed and may
contain information that is privileged, confidential and exempt from disclosure under applicable law.
If the reader of this message is not the intended recipient or the employee or agent responsible for
delivering this message to the intended recipient,you are hereby notified that any dissemination,
distribution or copying of this communications is strictly prohibited. If you have received this
communication in error,please notify me immediately by reply or by telephone at 800-762-1775 and
immediately destroy this faxed document.
Page 2 of 2
•
New Cumberland Federal Credit Union
Your Community Credit Union
P.O.Box 658,New Cumberland,PA 17070-0658
Phone: (717)774-7706 1-800-716-2328 •Fax: (717)774-7996•Web: www.ncfcuonline.org
January 14, 2015
Seneca Law
P.O. Box 333
680 Yorktown Road
Lewisberry, PA 17339
RE: Estate of Mildred L. Co-hick
Dear Mr. Seneca,
Pursuant to your letter dated January 14, 2015, pertaining to the above referenced
member the information is as follows:
Account Number: 78947
Owner(s) on Account: Mildred L. Cohick
Date acct opened: 4/23/2001
Date of Death Balances: S1 (Savings) E $ 54.95
CD1 (Certificate) -
(Grandchildren were Beneficiaries)
CD2 (Certificate) s' $25,396.51]
(Larry and Steven were Beneficiaries)
CD4 (Certificate) `_$15,30__3.15_
DOD Dividends: $ 212.14
YTD Dividends: $ 309.74
If you need anything additional pertaining to this matter, piease do.n A-hcsitate tr, ;,orltact
me directly.
SAraJ.
,
Bar Wright
Branch Manager
3i
Enclosures
Richard J. Seneca
From: john.mcgowan@pnc.com
Sent: June 09, 2015 10:11 AM
To: Richard J. Seneca
Subject: Re: Estaet of Mildred L. Cohick
Rich:
The account held an annuity and $19.44 in cash at the time of her death. I know that the beneficiaries have already
cashed the annuity . What else do you need?
Jahn
John C.McGowan
Financial Advisor
PNC Investments
110 South 32nd Street
Camp Hill,PA 17011
717-761-1931 (Office)
717-761-2149(Fax)
Caution:Electronic Mail(e-mail)sent through the Internet may not be secure and could be intercepted by a third party For your protection avoid sending confidential or
proprietary information,or identifying information such as account or social security numbers to others or us.Further,do not send time sensitive,action oriented messages such as
orders to buy or sell securities,fund transfer instructions,check stop payments,ets, as it is our policy not to accept such items via e-mail.All security prices,yields and availability.
are subject to change.PNCI reserves and intends to exercise the right to review e-mail communications.
Not FDIC Insured-Not Bank Guaranteed-Not a Deposit-Not Insured By Any Federal Government Agency-May lose Value
From: "Richard J.Seneca"<RJSeneca(cDsenecalaw.com>
To: "iohn.mcoowan(&i)nc.com"<john.mcctowan(o)pnc.com>,
Date: 06/09/2015 10:00 AM
Subject: Estaet of Mildred L.Cohick
John:
I'm working on preparing an inheritance tax return for the Estate of Mildred L.Cohick and had previously requested from PNC a date
of death value for a small investment account Mrs. Cohick held with PNC Bank. The Account No.is 1332976. PNC should have on
file materials authorizing the bank to deal with me directly on this matter.
The date of death value letter I received from PNC contained the value of all of Mrs.Cohick's accounts except for the investment
account. Can you send me today the date of death value for this account? I need it by close-of-business. Mrs.Cohick's date of
death was 09/17/2014 and her SSN is 207-22-1681.
Thanks,
i
Richard J. Seneca, Esq.
dseneca@senecalaw.com
?!�SeneCa LCtW
46
P.O. Box 333
680 Yorktown Road
Lewisberry, PA 17339
Phone: (717) 932-6000
Fax: (717) 932-1319
www.senecalaw.com
This message is confidential,intended only for the named recipient(s)and may contain information that is privileged,attorney work product,or exempt from
disclosure under applicable law. If you are not the intended recipient(s),you are notified that the dissemination,distribution,or copying of this message is strictly
prohibited. If you received this message in error or are not the named recipient(s),please notify the sender at either the e-mail address or telephone number
above and delete this e-mail from your computer. Receipt by anyone other than the named recipient(s)is not a waiver of any attomey-client,work product,or
other applicable privilege. Thank you.
The contents of this email are the property of PNC. If it was not addressed to you, you have no legal right to
read it. If you think you received it in error, please notify the sender. Do not forward or copy without
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law or this message may contain an advertisement of a product or service and thus may constitute a commercial
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PNC, 249 Fifth Avenue, Pittsburgh, PA 15222; pnc.com
2
7& " °
, . ����r�U�D~D s��
— Financial
Account Summary for the Estate Settlement of Mildred L Cmhick Client ;D 11021769
1>Type ofinvestment: Life Insurance
Product Name: Life Insurance
Total Account Value(as ofDate ofDeath):$200.000.00
Account Number:9O9O33728550O4
Account Registration: Mildred LCnhiok
8enafniaryDeoignedon:
PRIMARY BENEFICIARY
LARRY HCDH|CKSON
STEVEN LCOH|CK SDN
EQUALLY,ORTHE SURVIVOR
How the accoumt(s)proceeds will besettled:
Wewill distribute proceeds 0mthe beneficiary.
inportmnt Details about this account:
WA
2)Type of investment: Deferred Annuity'Beneficiary
Product Name: Deferred Annuity- Beneficiary
Total Account Value(as cf Dote of Death):$33.258.34
Account Number:8DO0S1217O3OO4
Account Registration:Mildred LCnhink
0enmficimry Designation:
PR|K8ARYBENEF/O|ARY
LARRY HCOH|CKSON
STEVEN LOOH|CKSON
CHERYLACOH\CKDAUGHTER'|N'LAW
CARDLVVOOH|CKDAU8HTER.|N'LAVV
BRANDON MCOH|CKGRANDSON
JESSICA COH|0KGRANDD&U8HTER'\N'LAW
LAUREN ACOH|CKGRANDDAUGHTER
ADD|SONC{}H|CKGREAT GRANDDAUGHTER
EQUALLY,THE SURVIVORS EOUALLY,DRTHE SURVIVOR
How the mcoouut(o)proceeds will bmsettled:
YVowill distribute proceeds tothe beneficiary.
important Details about this account:
~ +
3)Type ofinvestment: Deferred Annuity-Beneficiary
Product Name: Deferred Annuity' Beneficiary
Total Account Value(as ofDate ofDeath):$50.444.81
Account Number: S3OO7O57538OO4
Account Registration: Mildred LCohimk
Beneficiary Designation:
PRIMARY BENEFICIARY
LARRY HCOH}CKSON
STEVEN LCDH|CKSON
CHERYL ACOH\CK0AUGHTER'|N'LAW
CAROL VVCOH|CKDAUGHTER'|N'LAVV
BRANDON K8COH|OKGRANDSON
JESSICA COH/CKGRANDDAUGHTER'|N-LAW
LAUREN ACOH|CKGRANDDAUGHTER
ADD|S(JNCOH|CKGREAT GRANDDAUGHTER
EQUALLY,THE SURVIVORS EQUALLY,ORTHE SURVIVOR
How the eomownt(m)proceeds will be settled:
VVowill distribute proceeds Vmthe beneficiary.
Important Details about this account:
N/A
Annuity Operations
PO Box 2918
Western & Southern Life
Cincinnati,OH 45201-2918
A member of Western&Southern Financial Group toll free 800.926.1702
fax 513.362.2353
Date: 03/13/2015
SENECA LAW
RICHARD SENECA
PO BOX 333
680 YORKTOWN RD
LEWISBERRY PA 17339
Re: Contract Number W0020178291
Dear Mr. Seneca:
Please accept our condolences on the death of Mildred Cohick. We are here to serve
you during this difficult time.
As a designated beneficiary, Larry Cohick and Steven Cohick are entitled to receive
payment on the Western-Southern Life annuity referenced above. Payment of benefits
under the contract is the obligation of, and is guaranteed by, Western-Southern Life
Assurance Company, Cincinnati, Ohio. The following settlement options are available to
you:
• Lump sum. You can receive your settlement in one installment. Any earnings on this
contract may be subject to tax. Western-Southern Life encourages you to seek tax or
legal advice before selecting this option.
If you choose this option, a check for the entire amount, including any interest, will be
mailed directly to you.
• Income payments. • Income payments. You can receive a stream of guaranteed
income payments. If you choose this option, a variety of options are available. Some
guarantee you an income for as long as you live, others spread your distribution out
over the number of years that you choose. You must select this option within 1 year
of the annuitant's death. Payments from qualified annuity contracts will be taxable
when you begin receiving payments. If you select this option, please complete the
enclosed Election of Annuity Income Form in addition to the claim form to specify the
terms of your payments.
• Defer five years. Payout on the contract will be deferred for five years. Partial
withdrawals or a full withdrawal will be allowed anytime during the five-year period.
The entire remaining balance will be distributed on the fifth anniversary of the date of
death. Not available on Qualified Annuities where owner was over age 70 '/2.
• Non Qualified Required Minimum Distribution (Stretch). This election is available
only to non spouse beneficiaries and allows you to "stretch" payments over your
lifetime based on your life expectancy. You can elect to receive annual IRS
Western-Southern Life Assurance Company
mandated distributions beginning the year following the death. The contract will
continue to grow tax-deferred as long as the distribution method allows.
• The date of death value is $16,713.16.
• The client put$12,011.47 into the contract when first opened.
The enclosed claim form is for your use in selecting a settlement option. Please return
your completed form, along with a certified death certificate listing the cause of.
death, using the postage-paid envelope provided. Our goal is to serve your needs and
we will implement your selection as quickly as possible.
Please note if this contract is a Qualified Annuity, a Required Minimum Distribution may be due
by 12/31 of this year. Please contact your tax advisor with additional questions.
We understand that decision-making may be difficult right now. If you have questions or wish to
discuss your options, a representative is ready to help you. Call toll-free at(800) 926-1702
Monday through Thursday, 8:00 a.m. to 6:00 p.m. Eastern time and Friday, 8:00 a.m. to
5:00 p.m. Eastern time.
Sincerely,
Teresa Fleisch
Annuity Administrator
Annuity Operations Department
F021/Fl-42-015-1312
Winner of the Datbar
Service Award from V.
2000-2013
March 9,2015
Seneca Law
Attn: Richard J.Seneca
P.O.Box 333
680 Yorktown Road
Lewisberry,PA 17339
Re: Policy 52178764
Decedent: Mildred Cohick
Dear Mr.Seneca:
We have received your request for information on the above-named policy.The information you
requested is shown below.
The date of death value is:$247,645.11 as of 9/17/2014
The initial deposit into this account was:$193,435.27
The increase in value was$54,209.84
The value of the contract does not change once the policy owner passes. The beneficiaries on the
contract have been earning miscellaneous interest from September 17,2014 until their claim is
paid.
Ms.Cohick listed 7 beneficiaries on her contract. In order to process their claim,we will require the
following:
• One original Death certificate for Ms.Cohick
• A New York Life claim form completed by each of the names beneficiaries.
• The named beneficiaries are: Larry H.Cohick;Steven L.Cohick;Cheryl A.Cohick;Carol
Cohick;Brandon M.Cohick;Lauren A.Cohick;and Addison K.Cohick.
Please note that if any of the beneficiaries is a minor,we will require guardianship paperwork,
signed by the courts,for that minor beneficiary.
If you should have any questions or need assistance,please feel free to contact the New York Life
Annuity Service Center and speak with one of our customer service representatives Monday
through Friday from 8:30 a.m.to 5:30 p.m. Eastern Standard Time at 800-762-6212.
On behalf of New York Life,
Jim Roth
New York Life Annuity Service Center
New York Life Annuity Service Center•P.O. Box 9859*Providence, RI 02940-r 1-800-762-6212
Annuities are issued by New York.Life Insurance and Annuity Corporation (NYLIAC) (A Delaware Corporation)
variable annuities are distributed,by-. NYLIFE Distributors LLC, Member FINRAISIPC
NYUAC and NYLIFE Distributors LLC are wholly owned subsidiaries of New York Life Insurance Company
51 Madison Ave, New York,NY 100101
Fax Server 3/4/2015 10 : 54 : 38 PM PAGE 2/002 Fax Server
Prudential Annuities
A Business of Prudential Financial,Inc.
P.O.Box 7960
-n It ?biladclpbia,PA 19176
(888)778-2888
March 4, 2015
SENECA LAW Contract Owner: Mildred L. Cohick
ATTN: RICHARD J SENECA ESQ Contract Number: 96081148
VIA FACSIMILE: (717)932-1319
Dear Mr. Seneca:
I am writing in response to your letter of February 18, 2015,in which you requested information on the
above referenced contract. I regret the delay in my response.
The requested information is provided below:
1. The contract value as of Ms. Cohick's date of death, September 17,2014,was$10,008.58.
2. The initial premium payment amount on October 13, 1995 was $4,815.29.
3. The contract value as of the surrender date of December 16,2014 was$10,081.79. The contract
value increased by$5,266.51 since the initial premium payment. There were no additional
contributions or withdrawals taken from the contract.
4. The contract value increased by$73.21 between Ms. Cohick's date of death and the termination
date of December 16, 2014. There is no current value.
The death claim payments were processed on December 16,2014. Please find this letter as confirmation
that there are no other annuity contracts held by Ms, Cohick. Information on other accounts held by Ms.
Cohick will be sent under separate cover.
If you have questions,please contact our Annuity Service Center at(888)778-2888. Representatives=
available to assist you Monday through Thursday between 8:00 a.m. and 7:00 p.m.,and Friday between
8:00 a.m. and 6:00 p.m. Eastern Time.
Sincerely,
Stefanie Surikowski
Stefanie Sulikowski
Senior Customer Service Representative
Annuities are issued by Tbc Prudential Insurance Company of America,Pruco Life Insurance Company(in Nm,York,by Pruco Life Insurance
Company of New Jersey)or by Prudential Annuities Life Assurance Corporation. Variable annuities are distributed by Prudential Annuities
Distributors,Inc. All are Prudential Financial,Inc.companies,and each is solely responsible for its financial condition and contractual obligations.
BANKERS
LIFE AND CASUALTY COMPANY
P"O.Box 1938
Carmel,IN 46082-1938
(800)621-3724
April 10, 2015
Richard J Seneca Esq
O1 Seneca Law
PO Box 333
0 680 Yorktown Road
Lewisberry, PA 17339
For local service, contact:
Insured: Mildred Cohick Branch Sales Office 1051
Policy Number: 7904206 1215 MANOR DR STE 300
- - MECHANICSBURG, PA 17055
Dear Sir/Madam: Phone: (717) 791-2100
Agent : JEROME WILLIAMS
Thank you for choosing Bankers. We are proud to help our customers
protect their financial security and prepare for retirement. In response
to your request, we would like to provide you with the following
information:
As per our records, the above referenced policy was issued on September
4, 2008, in the amount of $228 ,873. 39.
The withdrawal details are as follows:
EFF DATE GROSS AMT PENALTY AMT TAXES CHECK AMT
03/19/2009 $146,739.13 $11 , 739.13 $0,00 $135,000. 00
Cash Value as of :
September 17, 2014 $112, 229.37
As per our records, the above referenced policy was canceled on April 2 ,
2015, due to insured' s death.
We want to assure you of our continued commitment to provide you with the
best possible insurance service.
We appreciate your business.
Thank you for choosing Bankers for your insurance needs. If you have any
questions, please contact us at (800) 621-3724 Monday through Friday
between the hours of 8 a.m, and 8 p.m. Eastern Time. One of our customer
service representatives would be pleased to assist you.
Sincerely,
Customer Service
BLCO220
7BR
BLC2PB (06/13)
Fill Euff rust.
Life Insurance Company
March 2, 2015
Seneca Law
Attn: Richard J Seneca, Esq.
PO Box 333
680 Yorktown Road
Lewisberry PA 17339
Owner: Mildred L Cohick, DCueased
Contract Number: EQ0001116301F
Mr Seneca,
This letter is being sent to you per the request of Larry H Cohick and Steven Cohick, Co-
Executors for the Estate of Mildred L Cohick. They have requested we forward the value of
Mrs Cohick's EquiTrust Life Insurance Annuity contract as of September 17, 2014, which was
her date of death.
The value of contract EQ0001116301F as of September 17, 2014 was $183,027.28.
The annuity was established at EquiTrust on March 27, 2009 with a premium of$135,000.00.
The contract has accrued earnings and interest of$48,027.28 from the contract effective date
until Mrs Cohick's date of death. The contract ceases to accrue earnings and interest upon the
death of the contract owner.
This is the only contract owned at EquiTrust by Mildred L Cohick, Deceased.
Contract EQ0001116301F does have named beneficiaries. The required claim paperwork has
been previously forwarded to each beneficiary to review and complete. If a beneficiary has
any questions in completing the forms, they may contact us directly at 866-598-3692.
Sincerely,
John Cavins
Sr Customer Service Representative
Annuity Services
EquiTrust Life Insurance Company•PO Box 14500•Des Moines, Iowa 50306-3500•866/598-3692
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" George P. Garman Funeral Homes, Inc.
9366 Route 35 PO. Box 65 606 North Front Street
Mount Pleasant Mills, PA 17853 Liverpool, PA 17045
570-539-2471 717-444-3313
Kenneth Ronald Ebling, Supervisor Charles W. Reigle, Jr., Supervisor
Thursday,October 2,2014
Mr. Steven L.Cohick
150 Dawn Ave.
Julian,PA 16844
Dear Mr. Cohick,
Thank you for selecting our funeral home to provide services for your family during your,time of bereavement. I hope that you found
our services,so far,to be of the highest standards that we always try to achieve. The following is a summary of the service charges as
previously explained and provided in written form on the services for:
MILDRED L. COHICK
PROFESSIONAL SERVICES
Basic service of funeral director and staff $ 1900.00
Embalming $700.00
Other Preparation of Body $275.00
Total Funeral Service Selected
TOTAL PROFESSIONAL SERVICES $2,875.00
FACILITIES,STAFF AND EQUIPMENT
Use of Facilities&Staff for Visitation $750.00
FACILITIES,STAFF AND EQUIPMENT $750.00
AUTOMOTIVE EQUIPMENT
Transfer of Remains to Funeral Home $325.00
Hearse/Funeral Coach $300.00
Service/Utility Vehicle $225.00
TOTAL AUTOMOTIVE EQUIPMENT $850.00
OTHER MERCHANDISE SELECTED
Casket: 20g Steel Bronzetone $1,025.00
Outer Burial Container Monticello Concrete Vault $1,345.00
Yellow Rose Box Set $ 125.00
TOTAL OTHER MERCHANDISE SELECTED $2,495.00
CASH ADVANCES
Grave Opening/Closing Charge $400.00
Certified Copies of Death Certificate $ 120.00
Newspaper Notice Harrisburg Pat.News $ 178.41
Cemetery Assoc.Fee $50.00
Tent&Lowering Device w/Tax Wkdy $ 196.10
Casket Spray and 3 Yellow Roses w Tax $275.60
CASH ADVANCE TOTAL $1,220.11
TOTAL OF SERVICES $8,190.11
BALANCE DUE $8,190.11
If there are any questions or concerns that remain unanswered,please call me.
Sincerely,
Kenneth R.Ebling
Funeral Director