HomeMy WebLinkAbout07-13-15 J 150561�1�5
REV-1500�'�°�,°"^ �
PF OPpar(rtlPfl[0�RPVP�UP PQ��SyIVdOId OFFICIAL OSE ONLT
BureauoflndivitlualTaxes �` ��•"„� CountyCode Vear FAeNumber
Po sox zeo5oi INHERITANCE TAX RETURN
Harrssb�ra aa v��a-o6oa RESIDENT DECEDENT a � �`� I I �-( s
ENTER DECEDENT INFORMATION BELOW
Sociel Securily Numbar Da�e of Dea[It MMppVYYV Da�e of 8irth MM��VYVY
210-22-4474 10/26/2014 03I01/1930
Last Name SuRix DecetlenPs First Name M�
Veneski Helen
Qf Applicable�Enter Surviving Spouse's Intormation Below
SpousesLaslName SuRix SpousesFirslName MI
Spouse s Social Secunty Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
RLL IN APPROPRIATE OVALS BELOW
� 1. Original Return O 2. Supplemanlal ReWm O 3. Remainder Relum(�els ol0ealn
Prior b 12-13-82�
O u. Limi�ed Estate O 4a. FUWre Imerest Gompmmise(tlate of O 5_ Federel Estala Tax ReWm Requlred
tleam etler 12-12-82)
(p 6. Decedenl Dietl Teslale p 1.pecetlen�Mamlainetl a Gving Trust 8. Tolal Numberol Safe DeUost Boxes
(AitacM1 Copy of Will) (qtlach Gopy of Tms�.) -
O 9. Liligation P�oceetls Recaivetl p 10. Spousal Povatly Cretlil(�a�e of Oeath O 11_ ElecHon lo Tax untla�Sec. 9113(N)
Between 1231-81 entl 1-0-95) (Atlac�Schatlu e O)
CORRESPONOENT- iN15 SECiION MUST BE COMPLETEO.AlL CORRESPONDENCE ANO WNFI�ENiIAL iAX INFORMATION SHOUL�BE DIRECiED TO�.
Name Daylime Telephone Number ,�
Andrew C. Sheely, Esquire 717-697-7067i '� � m �
' � c ^' o
'_ . �
REGISTEROFI{'ILL�SOSEVNLY� � '
_ __ - 1-+ ,-1 O
� i-i W m m
First Llne of Adtlress - -� � v
127 South Market Street � ' ��� �� �� � � '
� 3 t �
Second Line o!Atltlrass - � � n '
PO. Box95 -� � �
_ �-- cn
Gi� O�POS�ORc¢ I DqTE FlLED � '
Y S�at¢ ZIPCotle _
Mechanicsburg PA 17055 � '
co..esNonaene�s e.maii aaaress:antlrewc.sheety@verizonnet
u�oerpo,amesorperu�y,ic iare�na�ine�ee.amineam�sremm.mcwa��gnemmpa„�nnqsmeaumsamsia�eme��s,amm�ne�ee�oimyx�o�ndagea�doerer,
�i���me.cor.om a�a comv� oeaararo�or o�epe.a�orne.�na���ne Personai�p,esenr�n�e.s easoa on au mrom,a��on oi.mcn p.epe�ernas e�y wiowieege.
SIGNATLiRE E SPONSI6LEFORFlLINGRETURN �HTE
John A. Ver�eski, Executor 1317 Cherry Sheet, Scranton. PA 18505 �� �/
SIGN OFPREpAHE T � ryq1 R RESENTATNE /y�.q�TE
0o E s W �J �/�
Andrew C. Sheely, Esquire, 127 South Market Street, PO. Box 95, Mechanicsburg PA 17055
PLEASE USE ORIGINAL FORM ONLV
Side 1
L 1505610105 1505610105 � l ' /
\D
J 1505610205
REV4500 EX(FI) Decedenls Social Securiry Number
oe�eao�r:Name: HelenVeneski 210-22�474
RECAPITULATION
1. Real Eslale(Schetlule AI. . . .. . .. . . .. . . . . . . . . . .. . . . . . . . . .. . ... . . . . .. 1.
z. smoas,�d eo�ds lsonedme e� _ _. . _ . _ . . _. . .. _ __ _ . . _ . . . . . z. $4,368.14
3. Closely Held Goryorenon, Petlnership or Sole-Pmpnemrship(Scnetlule C� _.-- 3.
4_ Mort9agesandNotesReceivable(ScheduleD). ... ... . .. . . ... .. .... .... . 4.
S Gasn, aank Dspos�s and M�isceilaneous Personai Pmperry(scneAole et._. . _ 5. 219,668_14
6- Jointly Owned Property(Schedule F) O Seperate Bllliny Repuesied ._. . . . . 8. 61,715.64
]. Irter-Vivos Transfers&Miscellaneous Non-Prooate FrupenY 6G,641.$4
(Schetlula G) O Sepaate Bllling Hequasted_. . . .-- ]
e. Total Gmss Assets(to�al Lines� thmugh]). . . .. . . . . . . . . . . . . . . . . . . . .. . . e. 346�293.26
9. �uneral Expenses and AdminisUative Costs(Schetlule H1. .__. . . . . . .__ . .- 9. 10,227.35
10. Debls of Decedenl, Mortgege Liabillties and Liens(SCI�eJu;e I)... . . . .. .... . tC. 367-98
it Total Detluctions�mtal Lines 9 an� t0). . . . . .. . . . . . . . . . . . . . . .. . . . . . . . 11. 10,615.33 �
12 Net Value ot Estate(�ine e minue Line�t) . _ . . . . .. . .. . . t2. 335,67Z93
13. Chari�able antl Govammenlal Beques�s/Sec 9�13 Tms�s�or which
anelecGonrotaxhasmtbeenmada(ScheduleJ) _.__ . . . .--. _ . . .__. . 13-
14. Net Value Subject m Tax(Line t2 minus�ine t3� .. . . .. . . .. . . . . .. . . ta. 335,677.93
TAX CALCULATION -SEE INSTRUGTIONS FOR APPLIGABLE RATES .
16_ Amoun[ot Line 14 texa0le
et tM1e spousal tax re[e.or
Uansfors under Sec.9t16
(a1(t21X 0_ 15.
�s- nmo���o�o�eia�a,aeie 335,fi77.93 �s. $15,105.50
a�iineai ra�e x 045
V. Amount of Gne 14�axable
at sibling ate X .12 ��-
18. Amount of Line 14 taxable �
etcollaterslrate X.15 18
is. Tnuoue . . _ _ _ . _. .. . . _ . _. _.. _ . . _. is. E75�105.50
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Q
Side 2
L 1505610205 15�5610205 �
R��,Soo Ex«„ Paoe a F��e��mee,a i— �y — i l �t 5
DecedenPs Complete Address:
CECEDENiSNAME
Helen Veneski
sraeernooaess . ..___... __.. ._.._..
4833 East Trindle Road
arv . ____.... ._.... j srnTe .._.__, ziP
Mechanicsburg �. pq I 17050
Tax Payments and Credits:
7. TaxOue�Page2,Line19� (1) $15,105.50
2. Gredits/Payments -�
q.PnorPaymenis $11,750A0
B.Discount 618 40
3. Inte�est To4ICraDits(A�B) (2�_ $12,368.40
(31
4. If Line 2 is grealer ihan Line 1 a Cine 3,enter Ihe diRerence. Tnis is Ihe OVERPAYMENT. —
Fi�l in oval on Page 2,Line YO to reques�a refund (d)
5. it Line 1 +Line 3 is greater ihan Line 2 enter�he dlflerenca.Ths Is�he TAX DUE. (5) $2,737.10
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did tlecetlent make a transfer and: Ves No
a. !ela�n�heuseorinwmeof�hepmpertytransferred .._._.. ..._._. ....__. ._._.. � �
b. alain�he right�o designate�Mo shall use the pmpetly Iransferzed orits Income ___ ..__.. ❑ �
c. re�ainareversonaryin�eresl ._._.. _._.._ ._. „ � �
...._ ........._ ._..
d. receive ihe pmmise for life ot edner payments,benefl�s or wre� ._._.. .,,,.,_ ❑ �
2. If dea�h oaurred alter�ea 12, 7982,did decedenl Vans(er pmpetlywlthin one year of Dealh
wdhouVeceivingade9ua�econsiaeration2_ ._...... .......... ........... ...._.... ❑ �
3. Did decedenl own an"�n tmst to�"or payable-upon-death bank acrqun�or securily a�hls or her Oee�h?............_ ❑ �
4. �id deceden�own an Individual relirement aecounl,annuityor olher nonymbate property,which
containsabeneficiarydesgna6on� _.._._. ._.._.. ,,,.__, , � �
..._.._ _.......
IF THE ANSWER 70 ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART Of THE RETURN.
For dates otdeath on or after July 1, 1994,antl before Jan.1, 1995,�he�ax rale imposetl on the net value of Iransfers Io or for Ihe use of the surviving spouse
is 3 percent p2 PS. §9116(e)(1 1)(i)].
Por dates of death on or afler Jan. t, 7995. the tax rate imposed on the net value of �ransfers m or for ihe use of ihe surviving spouse Is 0 percent
�72 PS.§9116(a)(1.1)(li)].The s�atute does not exempt a transfer to a suniving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax reWm are still applicable even ii�he surviving spouse is the only bene6ciary.
For dates of death on or aAer July 1,2000�.
. The tax rate Imposed on ihe nat value of iransters Gom a deceased child 21 years o(age or younger at tleath to or tor�he use ot a naNral parent, an
adoptive parent or a stepparent of ihe chiltl is 0 percent[72 P.S.§9116(a)�12)].
. The lax rate Imposed on the net value of hansfers�o or forihe useof the tlecedenfs Ilneal beneficiaries Is 4.5 percent exceptas noted'm�72 P.S.§9116(a)�i)].
• The tax rate imposed on�he net value o(Iransfers lo or for Ihe use of�he tlecedenPs siblings is 12 percent�72 P.S. §9116(a)(1.3)J.A si611ng Is defned,
under Sectlon 9102.as an individual who has at leas�one parent in common with the decedeni,whe�her by 61ood or atloptlon.
COMMONWE4LTY OF PENNSYLVRNIA RFV'182 S%("-961
DEFPiTMENIOFaEVEmUE
9JPEAO OiIN��VIOVPLiPXES
�Eo„}.8�601
MPRFISBUB6,Pn .9R8-0601
PENNSYWANIA
RECENED FROM: INHEIiITANCE AND ESTATE TAX
OFFlCIAI RECEIPT
N0. CD 020136
VENESKI JOHN A �
1317 CHERRY ST
SCRANTON, PA 18505
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
---- --
101 � 511 ,750.00
ESTATE INFORMATION: 55r�: I
FILE NUMBER: 2114-1145 �
oECEOENrrvannE: VENESKI HELEN I
DATEOFPAYMENi: O1/ZO/ZO15 I
POSTMARK DATE: Ol/lf)/2015 I
CouNrv: CUMBERLAND I
iDATE OFDEATH: lO�2G�ZO14 �
TOTAL AMOUNT PAID: 511,750.00
REMARKS: RCPT OT ATTY
CHECK# 112
INITIALS: DB1
sEA� RECENED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
TAXPAVER
PEVa503E%�(p�t) �
�� pennsylvania SCNEDULE B
���FR�*A�=E9�Ax RE*�R� STOCKS & BONDS
aEsmENroECEOENr
i
ESTATE OF FILE NUMeER
Helen Veneski 21-14-1145
All property jointly owneA with righc of survivorship must be disclosed on Schedule F,
ITEM VF W E AT DATE
NUMBE0. �cSCRIPTION OF DEATn
�� US. Saving Bonds-Series EE,issued 10l3111986
' $4.368.14
I
I
(
TOTAL (Also enrer cn Line 2, Recapitulation) ; $4,368.14
I(more space is needeQ inreG aatliGonal shee6 of[he same size
Calculated Value of Your Paper Savings Bond(s)
Calculator Results for Redemption Date 10/2014
. . .. . ... _ i.e_ _. ,r.• � ., r .�.t... ��-.t
$1,025.00 $4,368.14 $3,343.14 � $169.74
Bonds: i-5 of 5
e = r;_:
. _7 .. ,�.... �,_ ��_res . .
,� t
, _ �. . . :� _r?c; r ,_:r ; � �
., e �, _ ' r... . , _. i2atn
D11754376EE EE $500. 10/1986 04/2015 10/2016 $250.00 $815.40 4.00% $1,065.40
D11754375EE EE � $500 10/1986 04/2�15� 10/2016 $250.00 $615.40 4.00% $1,065.40
D11754373EE EE $500 10/1986 04/2015 10/2016 $250.00 $815.40 4.00°/0 $1�065.40
D11754373EE EE $500 10/1986 04/2015 10/2016 $250.00 $815.40 4.00°/ $1,065.40
L274532882EE EE $50 10/1986 04/2015 10/2016 $25.00 $81.54 4.00% $106.54.
Totals for 5 Bonds $1 025.00 $3 343.14 $4 368.14
NI Not Issued �
NE Not eligible for payment
PS Indudes 3 month interest penalty
MA Matured and not eamin interest
9Fv.5o8 EX.(n-ia)
j i. pennsylvania SCFIEDULE E
��� oevAa*MeH*o�ae�=H�E CASH, BANK DEPOSITS & MISC.
in��erurarvcerazuroarv PERSONAIPROPERTY
aesmexi oeceoerv.
ESTATE OF: FILE NUMBER:
Helen Veneski 21-14-1145
Indude the pmceeds of li[igaton anG the date the pmceeGs were receivetl by the esWte.
All proper[y jointly owned with right of survivorohip must be Eisclosep on Schedule F.
IT[h1 VA W E AT DATE
f:UMeER �ESCRIPTION OF D:ATH
� Morgan S�anley InvesMent aaount#620-071107-017,pnncipal$215,72875,accured interest$72.05 gp�5.800.80
z Horizon Healthrare refund $30.00
3 Country MeadowreFund $700.10
4 HighmaMBlueCrossreFund $�Z4�
5 2014 Federal Income Tae refund $2,541 A0
6 Blue Cross refund $483.84
I
TOTAL (Alsa enter on Line S, Recapitulation) $ 219.568.14
If more space Is needed,use additional shee[s of paper of[he same size.
eacn�. ioiacizoia F a P M �� � ascace oa�. v �aski
�i�.,�i�� oa�P� �onsnma xccaunr. cao-0�zo6�
Ceocm+irg 9aR�. OS/?1R415 Pepoi[ 9ppe: W[e of Wa[h
Num1� af Stt�ailler: 30
t'Sle xh, veveski 620-map6�
auJ/o� Dir anE i i�cd�
o�aPao �es<ein[fbn XiaM1/Rsk LwBid Ad]usG�en[s Accivals � Value Y
❑ $$$ FRONTIG0.COION62CA'f[ON9 CORP 13f90M1Utl1
Hca York 5[oek SttFtn9e
1V�26RUt9 6194J0 6.22000 X/u
1aR9q019 fi.lS00d 6.?2000 N/L
6.Ri0000 �,599.85
a) tlfil p X09m19wFI.iNR PIC (]99i]NID51
EPON60PE0 AOP �
1�VYo�k Smck Exc�ange
39/30L9 ES]9000 AS.S6000 H/L
10/]l/101� Ah.]100� 4it9500 N/L
�s.se�vso sa,os�.ss
}) �1631.]] CacM1 1G9N1 4��69i ��
91 dOV MONEYW9uL tNTb INC 14J8ll61061
CON
oek 9 ock LkcM1ange
n�/'[9/Lp19� 91,85000 9).L000 X/4
��/2'1/xntn 9L44500 9d25000 P/L
9I.9IBi50 i8�1B5.]5
51 RI10 OGP.4C0 INC 191t9AB1091
COX
o[k 5 ack GneLa�ge
30/24RO19� 9d.99p0� 9JSSOOJ N/L
10/29/301< 95.21000 9E.31000 N/L
99.9+di00 3E,899.50
61 500 eet CbxP 169151m10O
CM
qev Ypik 5[ock Exctlan9e
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�oizino�a �+.�,oao ><.<0000 v.
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v� irs enooexrxw exn� �nc mn�zomn
cox
oek 5[ock Qxelmutle
�p/29/2015 89.6�000 82.9�400 XG
!0/3l/dOl9 0516000 9168�00 X/L
d5da00�0 16.48J.60
BI 900 WI CVFP NEW (9W68I105)
CON
o:k Scock 0¢Tavgc
10/39/201< �6.9�000 36.62000 M/o
]0/29/2019 36.BJ�00 3h.S60U0 X/L
]6_9]i500 _].�6i.15
91 1J1 VE4120N COqA1M[CAT:ON6 :IiC IS]a9]V1091
C6E
New Yo[k 9cack Bvcl.ange
ioixaiaote ar.iiovo as.ia000 nro
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aa.eva000 c,aci.s�
oi�: o.ss z., mioaiao:a x�� iaierzmn ivvr i�/os/mia �z.os
1ot �l2 voonroue cnoue em x6w t9abs9boe)
rl NO PTP
pYVtlX TJ
NAS�Aq 4mck Narkat
]0/3</8019 ]d-33000 12.0000 H/L
10/3LE014 32.4�000 33.G9000 M/L
)2.0:]5�] B,IDB.]E
'Ib[al Valuc�. � $Z15,ti8.4.
TOCal P ual: $idAS
POCal�. SdI5,B00.30
rey= i
mmE .w�m wzo e.�.w�aa wl:n s c:vaL a e��a�ce oc evcacc wloaz:on: c e orre �Xcros. �rc. rf w� nzoe ��iesuo�_
olmee conlacM1 EJP Systens a[ (B1B) J1]-000 or wv evpsya.cw. IRevieaon �.).'el
REF N 4003012A001 PAGE 2 OF 2
Counlry Meadows Associates Z26�94
Pay to: ESTATE OF HELEN VENESKI Date: 11202014 Amt $700.10"'
MEMO INV.DATE �NV.NUMBER INV.ANWNT DISCOUNT NETM1011NT
RESIDENT REFUND 10/27/2014 VENESKI, H 700 .10 700 .10
HELEN VENESKI
9045/94909
ESSA?c OF NELF]v VEN85%I
C/0 ELL�T' SMIiH
424 SIDVX. DFIVE
MELtFIANICSHVRG, PA 1'J5f �
PEV-15og Exi(o1-1a7
ji; pennsylvania SCIIEDULE F
r�„ occ+arnc�+.oraE�e.uE
�N�EaRq��E.qxaEnp„ JOINTLY-OWNED PROPERTY
RESIDGNi DECEDENT
ESTATE OF: FILE NUMBER:
Helen Veneski 21-14-1145
If an asset bewme jointly owned within one year of[he tlereOenPs paM of tleathr it must be reportetl on Schedule G.
St1RVIVING]OINT TENANT(5)NAME(5) ADDRE55 RELATIONSHIG TO�KEDE4Ir
q,John A.Veneski 1317 Cherry Stree6 Scran�on, PA 18505 Son
e. Ellen R. Smith 901 Sleepy Hollow Lane, Mechanicsburg, PA 77050 Daughter
�� PaUipa Hartman 1416 East Locust Streel, Scranton, PA 18505 Daughter
JOINTLY OWNED GROPERTV:
�r*Ea or.iE oEStumorvoFPaovEan a,or oniForoFn*n
:ifM FORIOIM MA�E MCLO�EWIMEOFFlNPNCIOLINSfiIlIDCN4N�BPNKLCCOUNiNUM9FRO0.51MIlAA DAiEOFDFAiH OECE�EM'S WWEOF
NOMBER iEN4NT IOIM IOf1(lIfY1NGNUMBEP.RIIACHOEfDFOP10INRYHEI➢0.FALESIAiE. VPWEOfA55Ei IMEPE4 �KE�EM'$ItfIERfSi
�' A' 1212912011 WeIISFargoHighYieldSavingsAcct.lt6964766072,Jtamt.wilhJo�nA. 705,066.14 50 $52,533.07
Veneski
2. BC t013111990 WellsFargoRegularSavingsAcct#3014179329320,Jtxcl.wiOEllen 11,02Z05 33 $3,675.69
R.Smilh and Patncia Hatlman
3. A 72129120fl WeIlsFargoPremierCheckingAaL»6964763657,Jtacct.withJohnA. 5,56177 50 82,780.89
Veneskl
4. BC W/05/1983 WeOs Fargo Cmwn AccL p1000W4A71020,J�acc�.wi�h Ellen R.Smith 8,177.96 33 2,725 99
and Pa�ncia Hatlman
TOTAL(Also enter on Line 6, Recapitulatian) f 61,715.64
If more spare is needed,use additianal sheets of paper of the same size.
w'elis Pargo StoreVision Platform Page 1 of 2
���;1
�
sea�-n I saie., ! aa�ue�romeo. , aemm�s�ano� I Mam � ,a�,oe om�a.orne i c.a�e�r�. io� ;
� Gci�a.u��
Account m w�°"°„°'"°"°'°
wellsFargoHi9hYeldSavings s5sarsso>z
BankPENNSYLVPNIP(3E5� I 0 �e a � � I Sulemmh � 5 nn . OrnE� a � �jgp�eFce�s � =
Perenal e
CMck� I T31£f46 I LLsomerEve orv �f�g
CheekinglSavingsAccountDeGil seienan�o�._ - 0
TaxResponsibleCusromer HELENVENESK.I PnmaryJoin[Owner(or)
Adtlitional Gustomers JOHN A VENESKI Secontlary Joint Owner(or)
PgTRICIAANNHARTMAN Beneficiary
ELLEN R SMITH e¢nefdary
StatemenVMailing Name HELEN VENESKI
Account TIN TIN on fik
Certification W-9 Certification
Basic
OateOpened 12I29201�
Date Cloutl 1 210 4 2 0 14
ReasonforClosing �ea�h
StaNs Clasea
Letlger Balance $0.00
Avdilable Balance $0.00
Average Balance Last 12 Months $11�,346.�]
InsuNcienlPontls/OveMrokTotlay No � pe�P ���
Balance Sweep None . �-- '
Pletlges No
Nolds No
Stop Payments No
Last ACH�irect Deposi[ None
Money Services Business No
Fee Waiver New Account 3 Cycle Waiver 3 cydes remaining-NEVJ ACCOUNT 3 CYCLE WANER
Rela�onship Pricing No ,
AU 68132
Location 9239 EAST MOUNTAIN
EAST MOUNTAIN. PD.BO%6995
PORT�AND.OR 9]228-6995
OfficerlPoMolio A7700 ROSARIO-0EJESUS,JESSICA 5�0-348-829]
Llne of Basiness RETAIL CONSUMER
Overdraft Protection
Proviaes Overtlraft Pmfec[ion No
Overtlraks Lasl12 Months 0
ReWmetl Items Last 12 Mon[hs 0
Pay/ReNrn ReNm aIIMo chargelClosinq
OveMraX Limit 80.00
OvertlraftCharge $000
ReWmed Item Charge $0.00
Debit Card Overdrak Service
p;bit Card Overtlraft Service Accoun[Not Eligible
Statement
Sfa�ement Cyde End of Month
Last Sta�ement Oate 11/302014
Combinetl Statement No
Language Preference English
StatementType CneckSafekeeping
Retum Check Fee �es
Statement Option Paper
InteresU�ividend
https://��site l.salesandservice.wellsfa�go.com/svp/accountSeazchDispatch.do?companyl... 12/27/2014
Wells Fargo° High Yield Savings �
Account number 6964766072 • October�, 2014- October 31, 2014 • Page 1 of 3
Questions?
HELEN VENESKI Available by phone 24 bours a day, ]tlays a week'
4833 E TRINDLE RD APT 506 1•600�742-4932
MECHANICSBURG PA 170503652 m-1-ao0-enre33
En espanol: 1-BP42]-2932
�0 1-800-288-2288 (6 am ro]pm PT, M-FJ
Online: wellstargo.com
WnfE' Wells FarBo�nk.N.A.(345)
P O.Box 6995
Portlan0,Oa 99228-6995
You and Weils Fargo
Don't forget ro nofdy us of yom i2vel plans to�elp avola issues wnen using your Welis Fargo raras wM1ile vaveling.IPs easy to notiry us of
your Irevel plans onllne e[wellsfergo coMtravelDlaq IM1rougM1�he Wells Fa�go mo01e apD.oe Gy ralling tM1e pM1one num0eron Vie Oack of
yourcartl.
Activitysummary nao„�e��mee�: ssfw�sso�z
BeginningbalanceonID/1 $110ASZ01 HELENVENESKI
�eposits/AOOitions 913 PennsyNania accowt krms and wM2ons appry
Wi�M1tl2waI5lSuefraclrons � 5,000.00 ForDireclDeposi�use
EntlingLalanuon10131 f105,066.i� RoutingNum�er(RTN): 031000W3
Interest summary
mterest paitl mis s�atement S9 i3
AreragecolledeE�alanre 810�a]636
Annualperce^lageylelaeametl O.tO%
ImeresteamedtM1lss�e�ement0eriod 8913
Interest paitl mis year Sse.�o
xs�
Accounl number. 6964166072 • October 1, 2014-October 31. 2014 . Page 2 of 3
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Transaction history �
oerosw wmaawaia eoo„q oo;ry
Date �escnption AeONons Su�bacrions balence
10/i6 TrdnslerlNBren[NSbre-FromHelenVene5ki00Axvxra80]266t6Cdtli5le 0,50000
Plke MecM1ani¢Oury PA
10/16 WilhtlrdwalMatl¢InAB�anch/Store 500.00 1050R01
1013� Intaees�Payment 9.13 105.066�E
Entling balance on 10131 tO5,O66d6
Touls 59-03 A,000.00
The Entling Daily Balance tloes nof reflect any pentling wtl�eawals or Irolds on Deposifed/untls tbat may have been ou[stantling on your acmunt wM1en youi
frenSeCGOnspp$VBtl_ Ifypodedln9ul(ekntaVtlllableluntlswhenahensacllOn009etl.1¢BSmayhaVBbBenaSSB95Bd
Monthly service fee summary
Por a complete list ol fees and Ee�aile�accoun�InkrTd6on,please Sf¢I�e Wells Faryo Fee ana In(om�afidt Sc�edule ana Attoun(Agreemen�appllca�le lo
your acmun�or�alk�o a bankec Go to wellsfa�go.roMfeehq to find answers�o wmmon pues�ions abou��M1e monfily servlce tee on ywr account.
FeeperiotlID/pt20tC-10/3V20t4 Standardmont�lyserncefae810.00 Voupal�50.D0
TM1¢f¢EiSwdiv¢Ow�¢nNisa oun�ISlinketltOyowPMH°rela6ons�lp.
HowtoavoitlthemwMM1lyserviwfee Mlnimumrequiretl T�isfeepenotl
Have any DNE of Ne�ollowinq accowt repuiremen�s
� Mlnimum�eilybalance 53.500.00 $105.05]01 �
cuv �
Vou coultl go�o Super 8owl XLIX in Arizona courtesy of Visa!
Visit wellsfargo.coMvisafootball fortletails and�ciai Rules.
NO PURGHASE OR 09LIGNTION NECESSARY TO EMER OR WIN.
weus razgo StoreV�sion Ylatfoan Page 1 of 2
Seamn I SaIFs I Benkeriooieoz I �minisiretion I inain � slon Ofi oulckFraie I cusnmerGs� �o� I
Q clea�pst
Account "�"°°°'"""°' -
WeIlsFargoReguFarSavings 301A1]9329320
BankPENNSYLVGNIi(]C5�f1� I AEOress I � I �_ I SooGavmenls I w' tlnNNSFFees � Sm�i g_F_ I Fee
Rereisa
cn, xorm.s I �sLR I c�s �.e.e s�en i ooc�menn
Checking/SavingsAceountDeWil sei�c,a;o�... - 0
Tax Responsible Cusromer HE�N VE KI Primary Joint Owner(or)
AddAionalCustome�s PATRICIAANNHARTMAN SecondaryJoin[Owner(op
ELLEN R SMITH Sewndary Joint Owner(oQ
SlatemenUMailing Name HELEN VENESKI
PATRICIA ANN HARTMAN
EILEN R SMITH
AccounlTW � TlNonfile
Certifiration W-9 Certification
Basic
DateOpened t0131/1990
pate Closea 12IOQ2014
ReawnforQosing Nolongerneetlsaccoun[
S[aNs Closetl
Aa�uiretl From Wachovia 04/16I2011
LetlgerBalance 50.00
AvailableBalance 50.00 '��H�P
Average Balance Last 12 Monihs 513229.53 _. _.._..
InsutficienlfuntlslOvertlraftTotlay No
Balance Swaep None
Pledges No
Holds No
Stop Payments No
LasIACHDirec[Deposi[ 11I03201A
Money Services Business No
FeeWaiver MSF, FirstCycle-FIRSTCYCLEWANE
Rela�ionship Pricing No
AU 68132
Lccation 9234 EASTMOUNTAIN
EAST MOIINTAIN, P.O.BOX 6995
PORTLAND,OR 9]228-6995
Otficer/PorHolio L9234 DPLTOFFICEREASTMOUNTAIN S1034&829]
Line of Business RETAIL CONSUMER
Overdraft Protection
Provitles overarafl PmtecOon No
OverdraRs Lasf 12 MOMhs 0
ReWmed Items Last 12 Months 0
PAyIReWm ReNmalllNochargelClosing
OvertlrakLimu 8400
OvertlraflCnarge 5000
Retumetl Item Charge $0.00
D�bit Lard Overtlraft Service
Debit Card Overtlraft Service Account Not Eliqible
Statement
Statement Cyde Entl of Month
Last Statement Da�e 11I30I2014
Combinetl Sta�ement Related Hctount
Language Preference English
StatementType ChedSafekeeping
fteNrn Check Fee Yes
S[atementOption Paper
https://no-site l.salesa�dservice,wellsfazgo.com/svp/accountSeazchDispatch.do?companyl... 12/27/2014
Primary acmun�number' 1000074477020 • October 1,2014-October 31,20�4 • Page 3 of 4 �
i
- Vou could go to Super Bowl%LI%In Arizona courtesy of Visal
Visit wellafa�go cam/visafootball fortle�aiis and ORcial Rules.
NO PURCHASE OR OBLIGATION NECESSARV TO EMER OR WIN.
Wells Fargo Regular Savings
Activitysummary n«o�m��moe.: soianeassazo
Begionin56alanceonl0/1 g9,952.91 HELENVENESKI
JepositUAadl[ions +,0]4.14 PATw��AANNHARTMAN
WitM1d�awalLSublacGons - 0.00 ELLENRSMRH
PennsyNania accowt terms ane contldio�s apply
Entling balance en t0131 SH,ODDS
Por Diretl Oepasit use
Rauting Number(RTN): 031000503
Interest summary � �
mterest peie mis stetement Eo as
Averagecollecletl�alance 510,822]4
Mnual percentage yield eamed 4 01 b
In�eres�eameE�M1is s�alemen�perial 50 09
imeres�pa�tl onis year 5t o�
Transaction history
Oeposns� WifhtlraweW ErMingtlatly
Oare DemnpNon /Wrtio�s Su�treclrons belance
1011 CnVIPenManPFCkst00114uuxxi4]4HelenAVeneskl 652.00 � 10,60491
t0116 TeamPenJc53Pensiont010t6mu46]4Veneski,Hekn 42205 11026.9fi
t0131 Interest Payment 0 09 11 p2]OS
EntlinB balanca on t0131 H,03].OS
Tolals 51,019d4 50.00
The Enaing Daily falance tice rof reflecf anypentlin9"'��drawals oi holds on daposifedlunCslbal may have Eeen ouhtantling on yow accourrl when yom
bansaclrons postetl. IIYo����nsu/ficienl available NnOs wlien a f2nsacfirn posfe0!res may bare bem assasreE.
N'ells Yargo SmreVision Platform .yq�2�l\ Page l of 2
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sea,rn I saies I ea�korroomo.l aam�i�i:o-am� I me�� I sw�orc ow�.rorie i c�n�.,�..us io� i
Ociea.us�
Account �""'°°°„°°°"°x°`°
Pma Premier Checkin8 Auount 6%ms365� I,7 q 1I` �(/�. _
BankPENN5YLV4NIP�]65�Oe�all � AELLess � �' I �iHhfleP$ I SfmPovm¢nb 'i Ore�dafl/NSFFttS I 3£D1« I fx � � "L��l
Re�ersal � �v
��� I ��3 I CuSbme�EmlH'Sbrv I� Q
CheckinglSavingsAccountDetail sai�a�vo�_. •
TaxResponsibleCustomer HELENVENESKI PrimaryJointOwner(or) �� �
AdditionalCusromers JOHNAVENESKI SecontlaryhintOwner(or)
StatementlMailing Name HELEN VENESKI �A�ti �I� ��
JOHN A VENESKI k7��
Accoun�TlN TlNanfile
CertRwtion W-9 Certifiration
Basic
Da[e0penetl 12I29201t
Oate qosetl 12I042014
ReasonforClosing Noreasongiven
Status Closetl
LetlgerBalance $000
AvailableBalance $000
Average Balance Last 12 MonMs 55,56049
InsuRcientPontls/0vertlrakTOCay No
BalanceSweep None '.., HE{p��.-,.
Pletlges No , -- �
Holtls No
Stop Payments No
Last ACH Direcl Deposd None
Money Senices Business No
FeeWaiver MSF,Firs[Cycle-FIRSTCYCLEWAIVE
Relationship Priung No
AU 68132
Check Routing Transd Number 031000503
Lora[ion 9234 EAST MOUNTAIN
EASTMOUNTAIN, P.O.60%6995
PORTIAND,OR 9]228$995
OfficedPortfollo A]]00 ROSARIO-OEJESUS,JESSICA 5�0348-829]
Line o{gusiness RETNIL WNSUMER
Wertlrak Protec[ion
Pnmary Pm[edion None
OverErafts Last 12 Monihs 0
Retumetl Items Last 12 Months 0
Pay/ReNm ReWrnallMocharye/Closinq
OverdraflLimit $�00
OvertlraRCharge 8Q�0
ReWmetl Item Gharge 80.00
Debit Card Overdraft Service
�ebltCartlOveN2ftService No
Effective Date 01/032�12
Statement
S�atement Cycle Entl of Mon��
Last Statement Date 11I302014
Gambined S�atement No
Langua9e Preference English
StatementType C�eckSafekeeping
ReNm Check Fee Yes
Sta[ementOption Paper
https:�/nc-site l.salesandservice.wellsfargo.com/svp/aceountSeazchDispatch.do?companyI... 12/27/2014
wells tareo StorcVisioo Plafform Page 1 of 1
Seamh I Sales I BaokerToolboxl AtlminStrafion � Main I SIqnOH �uickPmfile I GustomerLis[ (0) �
0 Clear Llst
Account "�`�'�„�`�_�°258.e
Pr11a Pfemlef ChECking AGcoun[ 6964763657
Bank PENNSYLVANIA�365�� I 994�%3 I His� I S�atemenfs � Sfao Pavments � OverE2ft/NSF Fees �
Service Fees � Fee Reversal
CM1eck O�tlers I T�� i Custamer Event HStorv I ��
Checking/Savings Account History
Tax Responsible Customer HELEN VENESKI Primary Joint Owner(or)
Additional Customers JOHN A VENESKI Secondary Joint Owner(or)
Ledger Balance $0.00
Avaflable Balance $0.00
Check
Date Description Number Amount Balance
12/04/14 Wthdrawal Made In A Branch/smre 5562.03 0.00
12l04/14 Outsianding Items Close, Int Wlo Fee 5562.03
12/04114 InierestPayment +0-03 5562.W
12/03/14 Pma Monthly Service Fee Reveraal +30.00 5562.00
12/03/14 Pma Monthty Service Fee 30.00 5532.00
11/28/14 InterestPayment +023 5562.00
11/04/14 Pma Mon[hly Service Fee Reversal +30.00 5561.77
11/04/�4 Pma Monthly Service Fee 30.00 5531.77
10/31/14 Interest Payment +023 5561 77
10/03l14 Pma Monthly Service Fee Reversal +30.00 5561.54
10/03114 Pma Monthly Senice Fee 30.00 5531.54
09/30/14 Interest Paymen[ +023 5561.54
Search I Sales � BenkerToolbox I AtlmimsVafion I Mein I Sion OH am�ro°�Hig��o—�se+_e
https://no-sirel.salesandservice.wellsfargo.com/svp/accountHistoryInit.do 12/27/2014
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QuICM V�oflle ; CuatommLlA �0� I
SearM1 Sa'�u I BankerToolbos I /�tlmm�tretion �� Men � 9anJH
� Otleartizt
=�r�wWr�Pw.w_zse�e
Account
CrownAccountRegular �0000iaa�m¢o
gankVENNSYWfiNIA�]05)Qglpll I �4231 I H�§24h I �H45.1C I �y-m� I � a SFFees � $g�qF_ i Fge
�
CheakO�EM � innsf� '� Cu ome�Nen Xs ',Q�n6
Checking/Savings Account Detall ��'a�'o".. - 0
Tax Responsible Custome� HELEN VENESKI Primary Joint Owner(or)
Adtli[ional Customers PATRICIAANN HARTMAN Sewndary Joint Owner(or)
ELLEN R SMITH Secondary Joint Owner(or�
StatemenVMailing Name HELEN VENESKI
PATRICIA ANN HARTPdAN
ELLEN R SMITH
Accoun�TIN TIN an file
Ce�rfiration W-9 Certifica�ion
BasiC
�ate Opened 0]105I1983
Date Qosed 12I04I2014
Reason for Qosing No longer neetls account
StaWs Closed
Arqulretl Fmm Wachovia 04/16I2011
Letlger Bulance 50.00
AvailableBalance $000 ' N�P���
AvarageBalanceLastl2Monihs S9,6I3.69 ��� � �"�
InsuifcienlWnds/OveMraRToday No
ealance SveeP None
Pletlges No
Holds No
Stop Payments No
LasIACH Direct Deposit 10/032�14
Money Services Business No
PeeWaiver MSF. FirstCycle-RRSTCYCLEWAIVE
RelabonshipPncing No
AU 68132
CM1eck Rmting TransH Number 031000503
Location 9234 EAST MOJNTAIN
EASTMOUNTAIN, P.O.BOX6995
PORTlANO.OR 97228-G995
O(ficetlPortfolio L9234 DFLTOFFICEREASTMOIINTAIN 5]4348-82W
Line o5 Business RETAIL CONSUMER
Overdrak Protection
P�imaryProtec[ion No�e
Overdrafts Last 12 Monlhs 0
Returned Items Last 12 Months 0
PaylReWm ReWmalllNochargelClosing
OvertlrakLimit $000
OvertlraRCharge $0.00
ReNrned Item Charqe 5�.�
Debi[Card Overdraft Service
Debi�Card OverdraR Seriice No-Preterence not indicated by cus�amer
Statemen[
S[atementCyGe Endo(Month
Las[Sta[emen[Date �V3orzo�4
CombinedStatemenl MasterAccount
Language Preference English
Statementrype CherkSafekeeping
Retum Check Fee Yes
httpsJ/no-sitc 1.salesandservicx.wellsfargo.com/svp/accountSearchDispatch.do?companyI... 12/2'7/2014
� Primary account number. 70000744770Y0 • Or,tober 1,2014-October 31,2014 • Page 2 of 4 �
•
Crown Account Regular
Activirysummary nuo�m��me�.: i000maa�iozo
Beginning balanw on 10/1 $6.188 fi4 HELEN VENE9K1
5,960�0 PATRICIAANNHARTMAN
DepositslAddltions ELLEN R SMRH
WiNtlrzwalslSu�Vatiions - 3,851.38
PennryNd�ls accwnf temrs entl contllNoris apply
Entlin9Ealanwon10131 �•���'96 Po�OirectDeposituse
RONing Number(RTN): 03t 000503
Werdreft Profection
Your accoun�is linketl to Me following kr Gverdrafi Protecbo¢
• Savings � 0030�6P9329320
Transaction history �
Check DepoSfN wthtlrawals/ Endingdaity
Oafe NumUer DesrnpHon Atltldrons SuDtra[fion5 balance
t�2 - 7/54 Cneck �2050 6,ta8t4
10/3 SSA Treas 310 Xxsoc Sec 10�3t4 wxxx03]BO SSN Helen A 1 J60 90
Veneski
1013 "]�Sfi CvsCaremerk800]J6]28]10ID03R56201410020101911�2 t&t3 �,590.91
10l] "]155 Capi�al One Arc C�eck Pym�1410051]55 ���3
8100516AOP55t2�000380
101i "7�58 CvsCarama�kB00]66]28>t4100]]]582D14ID060101599W S.ID Z558.38
10/8 �]S) CM1xk 119.99 �.43839
1019 ^9]62 CvsCaremark800]06R8I1Ct00911622016100801011195t 3fi.W
1019 T159 GM1edt 3.tB050
105 9]fit GM1eck 22680 3.995.00
10H0 ]]fi0 CM1eck 3M1.50 9.990 W
+.0�16 Trans�erlNBrancNSbre-IONelenVenesklDOAnN.vx1020 M1.500.00
6C16CatlislePlkeMec�anirsbur PA
10116 ^��63 LYSCaremark8009G6]28116ID161]632014101Wt015�3E1 t1408 8.34642
ID/2t "Pfi4 CvsCaremarkBOOl46]28]14102tT/642010ID200100950t6 635 8,340.W
10122 "]]65 CvsCaremaM800946]28]10ID22I96520141021010IDP68 925 8,330.82
102] ]]fi6 CM1eck 15285 8.1]9.96
B,P].9fi
Entling balance on 10/N
7a��g 55,9fi0.]0 53,951.]8
The Endin9 Daily Balance tices not refled any pentllrg wRhO2wals orholtls on Oeposifed iuntls lba!maY hare been outatan0ing on you�acmunt wM1en yom
lransacliont Oosled. Il you M1ad insuKtienf available Nntls when alransattion posted(ees maV have Ceen assesseC.
" GonvertHcheck:G�eckconvertetlloerielecbonlc(o�melbyMurpayeaordeslgneretlrep�emntaWe Cdecksconvetlearoelecfroniciormamanrrotbe
remmed,mpletl oi imaged.
Summary oi checks written ;cbecks Ifsted ere also Olsplaye4 in the prereding T2nsacfion hisrory)
Num�ei Dafe Amount Numbe� Dale Amowt Number Da(e Amomt
p5q 102 20.50 T�59 10�9 3,t80.W ]]63 10I16 114.08
]]55 1011 2]23 ]]6� t0/1� 34.W T1Gd 102t 6.95
P56 �O13 18.14 ��61 1019 228&1 ]985 ID122 925
]]5; Witl t1999 ]�62 t019 36.09 ]�68 10l2] 152.86
p�sg �on 5.1a
REVQS�9't iC469;
�' pennsylvania SCHEDULE G
oE Aw*neN*orae�exuE INTER-VIVOS TRANSFERS AND
����Ea�*^��E*�*aE"�a^' MISC. NON-PROBATE PROPERTY
NESIDEX�ECUEN'
ESTATE OF FILE NUMBER
Helen Veneski 21-14-1145
TOis scnetlule must be com0le[ed antl fJetl I(tM1e answer ro any of ques[ons 1 t�mugh a an page Nree of tne AEVd500 is yu.
' OESCk1PTtON OF PROPERTV DALE OF DEBiH %OF DECDS E%CLUSfOV TN%A81E
ITEM ueoe e a we+sFE ee .� eunoxnno- .�oeermn
NUNBEA � meo e� . s�.nnc cr.ar eofforoxr,c�a�an. VALUEOFASSET 1NiN1E5T r.rvuc.e�ci VHWE
� Cl6zensSavingsBanklRAAcct!l0189004002,valueatdateotdeath yq,�b6-33 100 24.145.33
$24,146.33.Beneficianes�.son,John A.Veneskl, 1317 Cherry St,Scanton, PA
tlaughter, PaVicia Hartman, 1416 East Locust Street,Scrantoq PA 10505, �
daugh�er,Ellen R. Smilh,901 Sleepy Hollow Lane,Mechanicsburg, PA 17050
PNC Bank IRAAat#75700032894,$34,759.52 principal,accmed interest 3q qy3.17 100 34,843.'�
z- $83.65 Benefcianes:John A.Veneski,1317 Cherry St,Scanton,PA 18505 �
daughfer, Pahicia Hartman, 1416 Eas�Locust Street,Scranton, PA 18505,
daughter,Ellen R.Smith,901 Sleepy Hollow Lane,Mechanicsburg,PA 17050
PNC Bank IRAAcct#550019306W,$1,650-37 principal,accmed in�erest �,651.84 100 1,65i ea
3� $1 47.Beneficianes�.John A.Veneski, 1317 Cherty SL Swntoq PA 18505
tlaughter,Patncia Hariman, 1416 East Locust S�reet, Scranton,PA 18505,
daughter, Ellen R.Smlih,901 Sleepy Hollow Lane,Mechanicsburg,PA 17050
I
TOTAL(Also enter on Llne 7, RecapiNlation) S 60,641 34
If more SDace is neeCea,use adtll[ianal sPee[s of paper of[he same size.
aa.o.iw�� �a.cauuacuaaavni9a�eHwLLOVe�. VMA�UiGIVO[0 Y.WL1Wi
Citizens Savings Bank
P. O. Box 567
Clarks Summit, PA 18411
HELEN VENESKI Account Number 01-89-OD4002
901 SLEEPY HOLLOW LANE Statement Date: 6/4(2015
MECHANIC5BURG, PA 77060-2184 qcrquni Type: 72 Monih IRA CD
Date Descnption Amount Entling Balance
I �9S X Z� -�,`
1028Y1014 INTEREST DEP INTEREST PAIO 10/01 THROUGH 10131 ��5-. 76 $24,155.37
11l14f2014 DISTRIB 07 $7,27920 $22,631.31
�olL����, �4, �4L33
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�, SavinBs Profile I /� Q�-c 4 I � �/� . / . (� , �!�S0 Page 1 of 1
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�nBf,044 BranUr Oi� Wobow MacM1ina:005 Telkc 44 Time�Thu Dec 1814:51:402014
YENESIfIHELEN AttounlNumb�� 018900/002 Of11c�rLetla 0000
6dldnus InfBroallnfOrmitl0n C¢RHICNBIOfO�mahOn
CumontBalanea 22.68338 IMereetPete 2tt� pehmtlnatlon0ab OBl25l�B
Availabbealence 22.883,38 �PY 1.95 MamtlryDate o926ft5
PaasboekBalanCB 2?68338 PplprtodRehOption 00 GRceDays 8
Minimum 9alann �S,BB3 Accruea Inrorost 28]3 Trm �2
OAglnalOpenAmt 9,t29 PaY^�iMediatl 0 MaMrdRenew 1
AccounlTypa 80 IMenatCalcMNhetl i Ra�wwTypsi 0
�P�anNbY 0 InterenlFraqugnry 01 RenawTyppf 0
DabOpenetl ��ZS�B GalvntlaMmount 00 cnangpRate 1
ClnaeElOOen CDtlO 1 Anniveisary Amt .00 R¢�levnl Rdl Opt 0
IMelestYTO 59249 NexlTerm 4
Flags
LeckoutF4g 00 PrevlousYTD 885.58 qolas
Ta11BY0VeRm¢ 00 uro-To-oareim 52.0] 1L19 0
Wam�ngFlag 00 LestlnromlYal! 11/3011a iL20 0
MeilFla9 � NaalnePostingDt 1Y/31114 1]!E1 0
R�1lnmontFbp 1 Yur6e�e 8 �� �
PasebookFlag 0 TnnaReclpAcc110 1212J 0
9tafemeM Flag p Tnu Raelp ACM Nbr 1934 0
Plasticp�d 0 Poztinglntliceter 3 tYl6 �
CqmbimE FIaB � Penilty Inbrmatlon ��26 0
SICWeWeFlop 0 Type W18 12IYf 0
FeC Yfrt��clU Flog 0 Yvar-To-0ab 00 EIM �-�
Non�iPzanOepo�lt D P�ovlousVTD 00
Oab Informrtion Serviu Gherge Infortna4on
Daro46tActive 11I14Ad HpularSlCPkg 00
pa@ Lesl Mene4ry 11(38116 OamuM$IC Ykg 00
One Las1 Malm 09/181o9 Card S/C Pkg �0
https�U10.46.240.108/clear[ouch/savings/profilel.aspx?accmbr-0189004002 12/18/2014 .
' " . �_. to �� t..r �� N9. up�n Y, '!(
� ��
Iune 3Q 20U
,Audrew C Sheely
Attomep At Law
127 S Mazket St
PO Box 95
bfechar�icsburgPA 17055
RE: Helen A Veneski
SSN:210-22-4474
DOD: 10-26-2014
Dear Mr. Sheely:
Tn cesponse to yout zequest foc Date of Death(DOD)balances for the cuammer nouA above, ouc
cecords shaw the following-
ll2A Account
Accoimt#75700032894 Established:Ol•18-2013
7-IELEN VENESKI
DODbalance� $34,95952+8365accruedinterest
IRA Acco�nt
Account# 55001930607 EsrablisheA:03-18-1992
HE'.LEN VENESKT
DOD balaoce: S1,650.37+ 1.0.7 acaued iateies[
Por beneficiary info:mafion,pleese call 1-888•762-4727.
Pleasa note thzt this offiw pmvides data of death balences fn�deposit accom�s(1RAs,CDs,C6ecldng end
SaWings). W a do no[process any SvanciW transactions or provide s(ntementa. Hyou need assisfance with
any of tLese[tems,please cell 1-fl86-PNG9A'dTC(L-888-762-2265)or slnp by your loeal PNC BavV:bcmc6
office.
Sincerely,
National Fioanciel Services Center
PNC Bank,N.A
MemberFDIC
Page I of 2
ae;-is» ex—�o-oyi
' � pennsylvania SCHEDULE H
� oEPaa*nE�*oFAE�E��r FUNERAL EXPENSES AND
�:�rvEF�*+hcE-Axarva�+ ADMINISTRATIVECOSTS
acs�otn-oe¢oer
ESTATE Oi FiLE NUMBER
Helen Veneski 21-14-1145
DecedenPs deb[s must be reported on Schedule I.
iTEM DESCRIPTION BMOUNT
"!0�-0BEk
a. FUNERAL EXPENSES'.
�� Miller Bean Funeral Home, Inc. $6,055.00
z. Funeral Flowers $371.00
3. FuneralWncheon $1,021A5
q. A�MINISTRATNECO5T5�.
1. Personai Aepresen[a[ive Commissons $0.0�
Name(5)of Gersonal Represen[ative(s) �OhO A. V2f125k1 . _
5treetnearess 1317CherryStreet . _ . ._. _ .._...____.
_ _ _
C�ry Scranton _ _ _5tam_PA i�p 18505
Year(s)Comm�ssion Paid ._. ___ _ _.. ... ----- ------
2- Ntromey Fees'.
/an�lre w C. 5kee� � Afko�.�-� si.aoo.00
3. FaaityExemption'. (I(aecedenPsatldresslsno[[hesameasdainznPs, attachezplanation.J
Clalmant _ _ — . ______—. . . _ -
Sheer Adtlress .._. . .. .. -- - .. -. -...--
___
CitY .. .. ... ___ ..._.Stnte___ZIP . . _._ _.
Rela::onsh.pe'ClaimanlroDeceden[ ._._ .__.. .. ._.—_ .____. .--.
$420.50
4_ Proba[e Feer.
$250.00
5- Accountant Fees:
6. Tax ReNm Preparer Yees'.
�. Postqqe 59.80
a. Reserves to wncWde estate adminisiration 5600.00
TOTAL(Also enter on L'me 9, RecaDitula6on) S �0,227.35
I(more space Is needee,use admHcnal shee[s of Oaper of[ne same srze.
MILLER BEAN FUNERAL HOME, INC
PAUL C BUTTNER, SUPERVISOR
A36 CEDAR AVENUE
SCRANTON, PA. 18505
Valerie M. Miller eean, President/PD
TO: JOHN VENESKI
13ll CHERRY STREE7
SCRANTON, PA18505
FORTHEFUNERALEXPENSESOF
HELEN VENESKI
OCTOBER 26, 2014
ITIMIZATION OF GUNERAL E%PENSES
SERNES OF RJNERAL DIRECTOR AN�STAFF 5 1985.00
EMBALMING $J85.00
ORESSING CASKETING AND COSMETICS S 195 00
HAIRDRESSING 5 50.00
VEHIQE TO TRANSFER TO FUNERAL HOME $265.00
Hearse Uay of Funerai 5 295.00
USE OP FAO�ITIES FOR VIEWINGJSERYICE S 345.00
CASKET AS SELEQEO $1280.00
VMULT AS SELEQED $"_200.DD
TRANSPORTATIONWMDIANTOWNGAPOVER30MILES � 5289.00
CFRTIRED COPIES DEATH CERTIFlCATE S 90A0
R[V.FUiNAM QERGY OFFERING S 20D.00
OfiITUARY IN SCRANTON TIMES $366.00
TOTAL 5 W55.00
l •� —�
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1 ' j<�
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¢ .`.;';�
RECEIPT FOR PAYMENT
___________________
�ISA M. GRAYSON, ESq. Receipt Date: 12/04/2014
Cumberland County - Register Of Wiils Receipt Time: 12 : 19 :27
One Courthouse S4uare Receipt No. : 1079842
�arlisle, nA 17013
VENESKI HnLEN
Estate Fi1e No. : 2014-01145
Faid By Remzrks : SOHN A VENESKS
HMW
- - - ------ - - -------- Receipt Distribution
�ee/Tax Description Payment Amount Payee Name
PET_ITION LTRS TEST 310 . 00 CUMBERLAND COUNTY GENERP.L FUN
WILi 15 . 00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 25 . 00 CUMBERLAND COUNPY GENERAL PUN
.7CS rEE 35 . 50 BUREAU OF RECEIPTS & CNTR M.D
AUTOMATION FEE 5 . 00 CUMBERL�AND COUNTY GENERAL FUN
INVENTOR� 15 . 00 CUMBERLAND COUNTY GENERAL FUN
INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN
Casn 5420 .50
Tota1 Received. . . . . . . . . $420 .50
FE�-!S--Ext fl2-OH1
�. ' pennsylvania SCHEDULE I
oEo�w.MEr*a�AE�E��E DEBTSOFDECEDENT,
��„=a�����E*^^aF'�a� MORTGAGE LIABILITIES & LIENS
aes�oEvr oec[oEnr
ESTA7E OF FILE NUMBER
Helen Veneski 21-14-1145
Report debGs incurred by t�e Eecedent priar[o Eeath that remaineA unpaid at the da[e of death,including unreimbursed medical expenses.
VALUE AT�ATE
!TEM
NUM1IBER �FSCRIPTION OF�EATH
1� EstateChecksfee $2200
2. 2014 PA income taxes tlue $26200
3. Plnnacle Health Emergency $34.43
q. 'Pinnacle Health Medical Group F40.07
5. �uanNmlmaging $17A5
6. Es�atechecks-shippingfee 512.03
TOTAL(Also en[eron Line 10, Recapitula6on) 5
387.98
ff more space Is neetled, Insert addl5onal sheefs o.`Che samesize.
FEV-!513 EX+ [�1-Iq
�� - pennsylvania SCHEDULE J
°""aT"`"�°"`�`"°` BENEFICIARIES
INYF0.ITPNCt iP%RRURN
aesioervi oEceoeNr
FILE NUMBER:
ESTATE OF:
Helen Veneski z�-�4-��45
REUIlONSHIP i0�KEDENT AMOUNT OR SHNRE
NUM1I9EA NPMF AND AD�RESS Oi PERSON(S)RECENING�ROPERTY Do Not List Tmstee(s) OF ESTATE
� TnSABLE DI4R[BUTIONS pntlude ouhightspousal dis[ributions anG traosfers under
Sec 9ll6(a)Q.2�.)
L John A.Veneskl, 1317 Cherry SVeet,Scranton,PA 18505 Son 3333%
2. Patricia Hartman, 1416 East Loast SVeet,Scrantoq PA 18505 �augh�er 33.33%
3. Ellen R.Smi�h,901 Sleepy Hollow Lane,Mechanicsburq,PA 17050 Daughter 33.33%
ENTER�OLLAR AMOUNTS FOR OISTRIdI1TI0N5 SHOWN A60VE ON LINES IS THROUGM 18 OF REW1500 COVER SHEET,0.5 FPPROPRIATE.
iI NON-TN%ABLE�ISTRIBUTIONS
A. SPOUSAL DISTRI6UTIONS UNDER SECTION 9113 FON WHICH AN ELECTION TOIA%IS NOT TPKEN'.
1.
B. CHARITAtlLEAND GOVERNMENTAL DISTRIBUTIONS'.
1.
TOTAL OF PART ll- ENTER TOTAL NON-TAXABLE�ISTRIBUTIONS ON IINE 13 OF REV4500 COVER SHEET $
If more spa[e is needed,use addiNonal shee6 of paper of[he same sixe.
� '
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,
�
Nr.asT vrtzL atm Tssxra�x•r i
�� I, ffi,SR Vffi28SXI, pr�szntly o! thz City of Scranten, Covr.t:
of ba�kawar,aa and Commonweaith c� ?ernsy:van`_a, being of scur,d '�,
���'. m�_nc, memcry ar.d understar.dir.g, do he:2by maKe, pebli=_n ar.d I
� decl - e :.Fis to ce my �as�� v7� 11 and ^_escamFr.t, neraby revoiing ��.
ard maK�ng void any aad ll Saills c�v me at ar.y t�'ne haretofore �
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sade.
I
ANO FIRST, I direcr *-;at my Punerai be cor,ducted ir a mar.ne� �.
�� corr2sponding to my e-atate and sit�aticn in iife, and chat al; rv �
legalLy =_nforceable deCts, �xnees=s of ry last illr.es=_, fcneral I.
�� an� curizl expenses, incled_nc tY.e ccst of a s�i�able monument =t �'�
II' my arzve, ano the cos_s of adtranistration of my es�ate be ea_d
ard satisfiec as soon as ccnvenieniiy may Ce a`res my decease; �'��
� crevided, hcwever, any anc a--1 m- rtaaaes or dccunents of .
indebtedeess. ' any, o, rea'_ ss�a�e owned or possess_=d ry ;ne or
c,� wiich ` may hava an ir.tesest at thF time oz my daath, neec not
r
� be oaid excep� in accorQanee wich [he rer.ns orovided in sech �
umor.gages or instruments o£ iedeCtedr,=ss '
�: AND to sucn estate as I nave acquired cu�ir.g my lite:imz, I .
Id� spose o� the same as fo'_lows:
ITSM OAB; S �ereby oive, devise and teqneaT_h a1= or rr:y
� estate, rea'_, personal or r��.ixec, wt�atsa�ve: ard wnzzesoev=r
I
D.. .._.._ . .. . ._. ._. .. _ . . .. ._.._. ___.. ._ ... . . .
8
��
i
s`_tnaSe, includi�g aL' property ov=_r wF.icF. I F.a�� any cor`_rol o-r
j� ncwaz of aocoinsment, to�ether with acp ir.euxance theceon to my �
��
"�'. husband, JOHN 5. VENSSK?, should n� servive me by thirty ;30) �
,;
days. Ir. tF.e ev=nt my hus�and, 'OHN S. VENcS{I, should £cii co
su�vive me by chircy (30) day�, cnen, in tnat even+", I aiaa,
� �ecie ar.d bequeatn r._:� ertire escaca, ir. equel snares, to m_ �'
il _h-lcr�n JOHP1 A �E�IE�K." P�^R�C`_p HaRT_MP.N 3^,c EL�cN R S^1=TN.
Ir the 2v2�t that any c£ m� chil�ren pre3ecease me, then, ie t�at .
e�ent, th= �=a�est to auch dacease: c�iid shall ao _e the ther. ��,
�i
lia-.ng issue o_ said deceased child.
'li ITEM 2W0: A1: 2sta�te, ir.h2ritance, succession oi ather �
''�. dez_h taxes �Toosed or peyable Gy reason oE my dea�h, ir.ciudi�g
r
i` any ieierest oi oe*�alties cherecn but not including any �
C'I qe�s�ation-ski.pping tax, ::it�:� reseec.t te all propzrty aompri�ing ��,
i
�� r yress estat= foc Ceatn cax pnrposes, wheth=r or rot snc�
i _
orops*'ty passes nnder this [dil� ..r any Codicil trtere:o, b��
�'_ OjJ2T2ti011 Gf _e , C�JF,tTd �. G� -_nS�2¢"LGE� OT Oti1PTw132� Sh3�1 P_eT
'
�� be acnortionad but shall b_ paid ou of tne ps�ncipal o� T.y �
I residuarv estate as if t`+e,� c.ere adr'� ni.strat�.en exnenses ard no
on=_ �.ahc sha'-1 F.ave a beneficial ir.terest '_n svch pmpertp' sha11
�i�, be _=qeired tc p=y cnes.. A1� sucr taxes on present or fu-_ur=
I, interests may be paitl at such time or �`_ires as �ny Persona �_
` 3eoreszn_aLia= deems best. �
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��� ITBtd THREE; If mv h�sear.d and I shall die ur,der
i
�I circamstance= �rnicC re�der the order of our daaths urcertaz�, ; t '�,
. sha11 be conc:usively p-esumed that ;ny ��asbaad surviced ±ne. '
4
IT� �'C�II�: My ?='sonai Repre=ent>t�.ve here�r.der shail, ir.
�; -��_�_,,._ to tte ooiaers given by law�, have t*=_ fcllosuing pcseers
� applica +e to all propert� w��thec .srir.c-nae or in_o*.ie, ��,
ex.ercisa �= wi-=hout order of oor�_
�. to retzin an�+ :r,nestm=nC owned by me at the cimz of T
� deaL'n. - �
B. to s:ake s�ch investreats a.^.d reir,ves�*�ents anc i,. s.;c?: �..
li P=opertioas without limitaTicn to what are knoxn as 1egz1 � �
ilinstrunenis, as stall bz considered ban�£icial tc my estate. :
C. �o ii) participa��e in any merger or reorgasization �.
affecting _=ecurities held 'nereunder at zny t-=a:e; (ii) 3e�cs:t
scocks under ��ctir.a agre?ments; ' ii7 exerc'�_se ae: opt':or t..
�E subsCrib= for stocics, ���nds or decer.turEs; and ;i��l grar.t �.
oToxies, discretionary or otherwise, to vote sh_ares oP stock. �
ID. te nanage, ooerat=, rep>iz, alter or impmvz _e-1
i ect=�e cr cthec prwerty ar,d to lease real escate or other ��
''��, propertv upen ��nch terms ar.c f�r s��c; perieds zs Pe-scnaL ��
�-pcesentative deems advisabi�.
[
''��.. E. te sPll and _o grant opt_ons for Ltie sale of any seal �.
N os personal p-ogercy at public cr ncicate sa_e Por sach nric2s �.
��
ana upon such terms as my Pecsonsl kzpreser�tatiaz cons�ders
oroper, witho�t liability on _h� ecrcnasere to see to the �.
apFlication of che purehase ;noney.
��j P. to oorrow mcr,ey withoat liability on che na_* of tne i
leadess to see to the applicatio2 Lh2reoP, and Co mertg3ge or �.
�� PZEQq2 �py _231 OS FlEL50t;0i JTO�ELYV. ��
.,. to .�,ake distribution ir, kiad anc in sha�es �i`feren�- ir, �.
` k-_�d �.r m othez shares, tae alcaeio,s established by m�- �=_rsonai '
��� Representative to be co�c � � i-ve. �,
�_ tc compror;:se c1_a:ms. `
j',
i;'
oy��_j_
1
1. co make oaxtial distr��_tr�tion of =n= assets of nv escaSe
�to �y named beneficiar�cs in th�s Will o:ior to the �inal
settl=mect ar.d distribution of my estat= by my Fersor.sl
Reoresentative.
FTEH FIVB: _ ❑om��nate, consii`ut=_ and anpoint my husbend,
209N S. VENESKI, as tne Personal Reoresentative of this, my Zas���=
, Will and Testament, and he is to ser��e in that capac' tp �ithouc
the necessity of oosting ary bond o- �ther secccity npcn
teceiving Letteis Testaman'_ary unCn ny estate. Shoolo �y
Sesband, JCHN 5. 9EN€Sxi, be um.n� L' inq andJot un3ble co saz-ve or �
� conCinu= to serve in that canacity, I �omirace, conscitute and _
� acpoiat my soa, JOH& �. `�E6ESKI, tc s2rve ie rhGt caoacity anc �e
�hal.t do so sithoat tha necasai�y of posting any bond �i otner �
�acnritp. .
IN WZTNESS WBEREOF, I, AELEIP VENg5R2, ha:re to th'is, rt�, Lasc �
, 49ill antl 'Pestamer.t, �..r_tter on �tis aed Che precad3ng Chree [3! �,
. snsets cf caoer, sat my 4znd ar,G 5ea�. tM_s� day of ��
.___��_ , 2010. .
I�,,., Y ✓�L3.c ��iS_A��; .
�� HELSN VENESKi '.,
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��� NED S,ALE�, pUBLI Y�'U s^d DErl,pRED, by the a��ae r.amed �
'c_-�at ix �EL� N ti`6NESKI as -nd `ct he: Las` Will a�d Tes'a�
� �1' p es r,ce cf us, whc have �ereunto subscribed oui nacnse�a
� he_ tequeet as witness ffi=reto, in tihe pxesence of s=_ad Testa�rix
AI
;� and cf sa�h o:he�.
i� �/
;i .�fi'11.�11/�E �7��.0 _residing at /y� l A.t°P t/ s�1`�.�
il fJ
/�/f 5 L[J r. � t��d�i�
�
�II � ioHoB r���of�. e�idir9 a�_ fL,.d.�LtGl Je._hl�„'� . �- .
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�I AC%NOWZyQf�l�'p
�� COMMON:v'EHLTH CP PENtiSYLVkNIu .
, gc,
'� COJNTY OF L?,CKAWANNA
i
II, HELrN ` ENESKI, '-. c_t=L_ix whos� aame is sianec tc the
' trzccad or £o� eqoing ins ..ment, hav:rig beer. daly cua .i_ed
� a _or� ng �.c 13�a, a< ner2bt, acKne�-�� eage thyt I eignad and
�cu � � 'ae ins- -ume;t as .v Las- n �. . and es`�me�t; and +h�r =
� gned �rilli�gty =_nc a m, ire an volun,.a_ � act for Thz
�. �urp,ses 'ie_^.�i� exps2ss=d. ' �.
s��/�,.� !/-�,��;
F:ELeN 4ENESKI ',
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jl Page 5
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j Sworc co and sabscribed beTore me this
1 � day of �
I __ (�(�(Znn}"1 _ 20i0. '
i i
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�I Ld A � - BLIC
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ii uc a�,.._,-;.. ,ns._;c:,::, .
�� �C1 hl C§- .
Ke�L tilT�Ert koiarvavry� .
' CryaSTren�oFl.iackavmmaCa��py .
) FIY';uT,micua+E¢vE5t4TC:'.3.?',�'': �
AFFIDAVIT �
:.��:�;'NONW�BLTN OF �ENNSYLVAYrF ,
Sq
^CUtJTY OP LACKASrAND;A �.
v�e� /}'!� T/.�Gzr.d � �Gl.w.� � �-� l�e!} the
� wit�esszs ,„h e names are sigr,ed to th=_ =+��ached or fosegoing �
ins�uumert, beinq du'.!y qcalifi=d according to laa, do �ieocse �nc '
say that we weze pre=_ent and saw [he Pestat_ix sign a�d execu�z I
'� he instrumer.i as her Last Will ard ��es'am -�� , that the T=stzcrix ��
II si.cr.ec a. ,.lingly and executed it s her 'ree .d voluntazy ac� ��.
-or the purocses Th.erei, exnre�sed, tta- ea h _¢bscri5ing witr.=_ss �'
ir. the heazir,g ard signt cz the Testatiis signed ��e aili as a �
�+_tness; ard t�at to the best o= our kr.owledge the Tes^atrix �
�� thac ime 18 � � mote y��rs ci age, o` sou�d arind an� under �no �
� CI;St:d ��� 1t OL lln��e lIlLillB'tCB.
II '� //�� �, / �
^'T_TNFc �5!L/�.
I � W_ThES� �.
, swo�z to and s4bscribed before �e c^_s �_ oa� oF
m�Ch , 2Q1G. I
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ii f KE� M1 �� 1�2fyFx�' , -Z-t}g-1--*— .
C C{'70�$Cf2lliPl �ZW Pl2 1 �� � . t<aAJW .
M o n; � �a c r-�_ � NOT' � P;T �IC
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