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Home My WebLink About05-25-05 ," , REV 1500 EX + (6-00) CAPB HpRL EplO CRAC KOTK ES C P o 0 R N R D E E S N T C o M P T U A T XA T I o N \}' REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER D E C E D E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DE PI. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) CQUNTYCODE SOCIAL SECURITY NUMBER HONTZ CLEO L. DATE OF DEATH (MM~DD~YEAR) 03/12/2005 08 06 1907 (IF APPLICABLE) SURVIVING SPOUSE'S NAME(lAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY 21-05-0319 YEAR NUMBER 188-22-8164 THIS RETURN MUST BE FILEDIN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER X 1. Original Return 4. Limited Estate X 6. Decedent Died Testate 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Will) D 9. Litigation Proceeds Received 3. (date of death . Remainder Return prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes (Attach copy of Trust) D 10. Spousal Poverty Credit D 11. Election to tax under Sec. 9113(A) (date of death between 12-31-91 and 1-1-95) (Attach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE& CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Marcus A. McKni ht FIRM NAME (If AppHcable) IRWIN & McKNIGHT TELEPHONE NUMBER 60 West Pomfret Street West Pomfret Professional Bldg. Carlisle, PA 17013 R E C A P I T U L A T I o N 717 249-2353 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Une 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Une 13) (1) (2) (3) None 9,222.00 None (4) (5) None None (6) 160,217.50 None 9,373.00 7,402.70 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES r< OFFICIAL:tJSE ONLY (:,.,1 r" (=, ;'""1) i il cr... (8) 169,439.50 (11) 16 ,775.70 (12) 152,663.80 (13) (14) 152,663.80 15. Amount of Une 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)( 1,2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH .( < 0.00 X .0 0 (15) 0.00 152,663.80 X o 45 (16) 6,869.87 0.00 X .12 (17) 0.00 0.00 X .15 (18) 0.00 (19) 6,869.87 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev_ 6-00) Decedent's Complete Address: STREET ADDRESS 442 Walnut Bottom Road CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 6,869.87 343.49 Total Credits ( A + B + C) (2) 343.49 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) Make Check Payable 10: REGISTER OF WillS, AGENT 0.00 0.00 6,526.38 0.00 6,526.38 :m~:t!~~~~::~~~!~~!;~:~~:~;gttg!\~~!::~U~!~~~g'~:~;!i~;~;!;~L~S!I;~~;~~; "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; . e. retain a reversionary interest; or . d. receive the promise for life of either payments, benefits or care? 2. If death occurred after December 12. 1982, did decedent transfer property within one year of death without receiving adequate consideration? . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? No ~~ Yes 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. D D D [!] [!] [!] Under penalties of perjury, I declare that I have examined this return. including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Jack R. Hontz __ _~5 _ "_t.,,,,ye, _ P_r:~ ~."_ _ _ _ ___ _ ___ __ _ ___ __ _ __ _ ___ _ _ _ __ Carlisle, PA 17013 IRWIN & McKNIGHT 60 West Pomfret Street ---carYisie-,--P"-- i i6i3-- DATE ~iJ / 17 ).00) , , 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the u 6 (a) (11) (;)]. For dates of death on or a er January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent. or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116( 1 ,2) [72P.S 9116(a)(11]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent whether by blood or adoption. Copyright (c) 2000 form software only The Lackner C?~':T' Inc. Form REV-1500 EX (Rev. 6-00) ,. REV-1503 EX + {1-97} , , SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CLEO L. HONTZ SSII 188-22-8164 03/12/2005 All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21-05-0319 ITEM VALUE AT DATE NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 200 shares Exe10n Corporation - 200 Shares @ $46.11 per 46.11 9,222.00 share TOTAL (Also enter on line 2, Recapitulation) 9,222.00 (If more space is needed, insert additional sheets of the same size) Copyright (e) 1996 form software only CPSystems.lnc. Form REV-1503 EX (Rev. 1-97) . REV-1509 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CLEO L. HONTZ SCHEDULE F JOINTLY-OWNED PROPERTY SSlft 188-22-8164 03/12/2005 FILE NUMBER 21-05-0319 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. A. SURVIVING JOINT TENANT(S) NAME Jack R. Hontz ADDRESS RELATIONSHIP TO DECEDENT 15 Strayer Drive Carlisle, PA 17013 Son B. c. JOINTLY-OWNED PROPERTY, LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank: DATE OF DEATH DECD'S VALUE OF account number or similar identifying number. NUMBER TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES 1 Citizens Bank - Time 17,190.14 50.00% 8,595.07 Deposit - 6140844851 2 M&T Bank - Certificate of 25,020.18 50.00% 12,510.09 Deposit - 031003913903760 3 M&T Bank - Certificate of 12,012.41 50.00% 6,006.21 Depos it - 031003913903992 4 M&T Bank - Certificate of 14,01l.53 50.00% 7,005.77 Deposit - 031003913904156 5 M&T Bank - Certificate of 19,038.34 50.00% 9,519.17 Deposit - 031003914204935 6 Orrstown Bank - Certificate 14,013.50 50.00% 7,006.75 of Deposit - 66551 7 Orrstown Bank - Certificate 15,039.94 50.00% 7,519.97 of Deposit - 334 8 Pennsylvania State Bank - 12,128.88 50.00% 6,064.44 Certificate of Deposit - 20001 9 Pennsylvania State Bank - 16,160.93 50.00% 8,080.47 Certificate of Deposit - 30409 10 Pennsylvania State Bank - 9,092.06 50.00% 4,546.03 Tot 1 of Cont im ation Schedu1e(s) 83,363.53 TOTAL (Also enter on line 6, Recapitulation) $ 160,217.50 T (If more space is needed insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, tne. Form REV-1509 EX (Rev. 1-91', . Estate of: CLEO L. HONTZ Sac Sec #: 188-22-8164 Date of Death: 03/12/2005 Item Ltr for # Jt Ten 11 12 13 14 15 16 17 18 19 20 21 Date Joint Continuation of Schedule F (Jointly Owned Property) Description of property Certificate of Deposit - 30468 Pennsylvania State Bank - Certificate of Deposit - 30476 Sovereign Bank - Checking Account - 2891032802 Sovereign Bank Certificate of Deposit 1675202970 Sovereign Bank Certificate of Deposit 3385039486 Sovereign Bank Certificate of Deposit 3385122100 Sovereign Bank Certificate of Deposit 3385043611 Wachovia Bank Certificate of Deposit - 247412061041297 Wachovia Bank - Certificate of Deposit - 247412061107400 Wachovia Bank - Certificate of Deposit - 247412081554911 Wachovia Bank - Certificate of Deposit - 247412091814711 Wachovia Bank Certificate of Deposit - Total Val of Asset 15,143.74 10,124.34 18,148.66 15,153.89 5,034.50 15,146.69 16,216.28 10,091. 52 11,167.00 10,113.55 10,094.82 50.00% 50.00% 50.00% 50.00% 50.00% 50.00% 50.00% 50.00% 50.00% 50.00% 50.00% Dollar Val of Deeds Interest 7,571.87 5,062.17 9,074.33 7,576.95 2,517.25 7,573.35 8,108.14 5,045.76 5,583.50 5,056.77 5,047.41 . , . Estate of: CLEO L. HONTZ Soc Sec #: 188-22-8164 Date of Death: 03/12/2005 Item Ltr for II Jt Ten Date Joint Continuation of Schedule F (Jointly Owned Property) Description of property Total Val of Asset Dollar Val of Deeds Interest 22 23 247412091843195 Wachovia Bank - Certificate of Deposit - 247412091981644 Wachovia Bank - Checking Account - 1010008385211 30,287.05 5.00 50.00% 50.00% 15,143.53 2.50 83,363.53 . ~REV 1511EX+(1 97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CLEO L. HONTZ SSfj 188-22-8164 03/12/2005 Debts of decedent must be reported on Schedule I. FILE NUMBER 21-05-0319 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES, 1 Church Luncheon - Funeral 140.00 2 First United Church of Christ - Funeral 500.00 3 Heller Funeral Home - Funeral 3,500.00 4 Mt. Zion UCC - Funeral 500.00 Total of Continuation Schedu1e(s) 400.00 B. ADMINISTRATIVE COSTS, 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address CIty State Zip - Year(s) Commission Paid: 2. Attorney's Fees IRWIN & McKNIGHT 4,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Cirl State Zip - Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 79.00 5. Accountant's Fees 6. Tax Return Pre parer's Fees 250.00 7. Other Administrative Costs 1 Short - Certificate 4.00 TOTAL (Also enter on line 9, Recapitulation) $ 9,373.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev_ 1-97) . Estate of: CLEO L. HONTZ Soc Sec #: 188-22-8164 Date of Death: 03/12/2005 Continuation of Schedule H-A (Funeral Expenses) Item il Description Amount 5 Rev. Lynn Schultz - Funeral 400.00 400.00 . , '.REV-1512 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CLEO L. HONTZ SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SSlf 188-22-8164 03/12/2005 FILE NUMBER 21-05-0319 Include unreimbursed medical expenses. ITEM NUMBER 1 PA Department of Revenue DESCRIPTION Taxes AMOUNT 350.00 2 Pharmerica - Medical 829.04 3 Thornwa1d Home - Nursing 6,223.66 TOTAL (Also enter on line 10, Recapitulation) $ 7,402.70 (If more space is needed, insert additional sheets of the same size) Copyright (el 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev_ 1-97) '. REv-1513 EX + (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA I NHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CLEO L. HONTZ 5511 188-22-8164 03/12/2005 NUMBER I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 Jack R. Hontz 15 Strayer Drive Carlisle, PA 17013 2 Ruth H. Brubaker 247 Park Avenue, Apt. 5 Ephrata, PA 17522 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Son Daughter FILE NUMBER 21-05-0319 AMOUNT OR SHARE OF ESTATE 75% of Remainder 25% of ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18. AS APPROPRIATE, ON REV 1500 COVER SHEET II, NON- TAXABLE DISTRIBUTIONS, A. SPOUSAL DISTRIBUTIONS UNDER SEC, 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 0.00 TOTAL OF PART 11- ENTER TOTAL NON- TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX [Rev 9-001 . LAST WILL AND TESTAMENT I, CLEO L. HONTZ, of South Middleton Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. ONE: I direct my Executor to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. TWO: I give, devise and bequeath all of my property of every nature and wherever situate as follows: a. To my son, JACK R. HONTZ.........................................................75%; b. To my daughter, RUTH H. BRUBAKER........................................25% The above shares shall be on a per stirpes basis. If either of my aforementioned children has predeceased me, then their share must be distributed equally, to the issue of my child who has predeceased me. If either of my children has died without living issue, the said share must be distributed to my child who survives me or the issue of my other child if that child has also predeceased me. THREE: I nominate and appoint my son, JACK R. HONTZ, to be the Executor of this - my Last Will. FOUR: My Executor may, at his discretion, compromise claims, borrow money, retain property for such length of time as he may deem proper, lease and sell property for such prices, on such terms, at public or private sales, as he may deem proper; and invest estate property and income without restriction to legal investments. FIVE: I direct that my Executor shall not be required to post bond or enter security in this or any jurisdiction. i-rr, IN WITNESS WHEREOF, I have hereunto set my hand and seal thi~1 ~ day of February, 1996. ~~;f~ CLEO L. HONTZ (SEAL) Signed, sealed, published and declared by CLEO L. HONTZ, the above named Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other have subscribed our names as witnesses hereto. - 2 ACKNOWLEDGMENT AND AFFIDA VIT WE, CLEO L. HONTZ, TERESA M. HENRY and CHERYL L. CLELAND, the testatrix and witnesses respectively, whose names are signed to the 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 wilJingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by CLEO L. HONTZ, the testatrix herein and subscribed and s~'to before me by TERESA M. HENRY and CHERYL L. CLELAND, witnesses, this'o}'I~) day ofFebruary, 1996. u ~--~,"",""",,-- - I f'-~;tQf.al 2~~11 J::~i::,\.A;-., fA?~::'C\1,..!"VJt[;i.Y ~Jb!ic . (.(""~""'~ ,::~.iM.l.LUTICi;.JtlIXJ ',-,clniy L "..'....~"'f...."'.......:.,' .-......' '" "1 '^^ i,,/ -,'-"'''_''~'"''''';, I t:..\..~n:;s' . .,r_ ..., ;"bO r'Jleil:&;I;~Pffil~4~~~;S~7t:r~tir.eG (V) 'I- LD 0 0 "- ~. ..-< (\) ~ "- en LD Cl CL ~ .9 ~! ~, (\) Ei u 0, I' e l ~! Cl u e c u: m' "I u.. 0 0 -<: Cl >- ~~ .;j.v .t';:.;" Z it'!-! 0 ~ Di <( =>: c' CY. 01 0 Oil CL c ,. . ~ CY. t-lifr: 0 Ci=> '-.l C1" '-'l1.l Z U'lz 0 W --J l1J U X Z l1J <( '- 0 Z 4- - '" u.. (\) u -.. 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" U 0 s:: Cl '" s:: <;> 'l- III <IJ m "- w 1il "- u 0 :;;; 0- ~ lX ~ +- 0. ~ +- -<: ~i ~j gl -5;1 :i 31' ~[ 0 ...:; ~! 1"* ~ .E on " u '~ 0. jij u '~ o ~ on :f W '" >- c o "' >- >- -g 32 :c (I) ~Q.l'E"C 'Cij ~ .g " o > '" i5 (! l. l. l. ~ .(4,......" QI. , "C .,~. ~I :" . I....,.:"....,'ii,' '-'P'fi1T".. '-I 1-, "F ~! fA'~'" .; ~: o """ l:: r:;;:-)" li~l~ ~' ,lei,:: -., c '" ~I ~'" II,::I~ "' ,0 <Il IfQ,~ U.I OlO CD ] WN () 1:~'c5 ~.~ 'i:: ,~ a.. Ir--: v, +- ~! Ql i. i CJ _ lwo+ I 01 b..b. u~ z, >< W ~ ~'~ - '0 III C. E . Cl> t j (.) w ... .;: 0 . C> U ~ ~ a.. z ~ ~I ;:! !: \'l C1l .. a; [;J (.) w - - 0 ~ m .;: I- '" '" ~ .=i 0 < c c CIl " <U! Q t:: >< ~ ~' - "tl "' .!!l I- '" C W u.' w - w J: III en O/l tIl CIl ..- o ::l o 3,nl/0 CLEO ! He TZ .s,A.CKj HCNTZ 15 S'/RAY: R DRIVE CARU SLE PA 17013 I j I , Curl,ar,~ balance: Accrued interest: Penalty amount: Current cash value: Issue date: Original balance: Last payment date: Last renewal date: Last renewal balance: Date redeemed: Interest pmt freq: Interest disposition: F1=Addl functions F5=History Time Deposit Inquiry Page l of 5 11:58:15 CIF number: H024153 Phone: (H) (000) 000-0000 Birth date: (B) (000) 000-0000 Tax 10 number: 188-22-8164 C/O type: 72 60-119 MONTH INCOME Account number: 4000000334 15,000.00 39.94 303.75 14,736.19 10/07/02 15,000.00 3/07/05 10/07/02 15,000.00 0/00/00 1 M Issue check F2=Image F6=Messages Certificate no: Interest rate: APY: C/O term: Maturity date: Hold amount: Y-T-O interest: Per diem: Next payment date: Next pay amount: Value after next pmt: Renewable: Deposit Acct/Type: 4.0500% 4.13% 60 M 10/07/07 .00 149.68 1. 66438 4/07/05 .00 .00 Yes F3=Exit F8=Maintenance More.. . F4=Sweep Inquiry F24=More Keys , i 3h31/0~ I CLEO L Hol'ilTZ I JACK R HOITzl 15 STRAYEj DB IVE CARLISLE ~A 17013 I ! I j Current l:J\ 1 - nce: Accrued interest: Penalty amount: Current cash value: Issue date: Original balance: Last payment date: Last renewal date: Last renewal balance: Date redeemed: Interest pmt freq: Interest disposition: Fl=Addl functions E'5=History Time Deposit Inquiry Page 1 of 5 11:59:59 CIF number: H024153 Phone: (H) (000) 000-0000 Birth date: (8) (000) 000-0000 Tax 10 number: 188-22-8164 C/O type: 72 60-119 MONTH INCOME Account number: 5080066551 14,000.00 13.50 154.00 13,859.50 11/23/01 14,000.00 3/23/05 11/23/01 14,000.00 0/00/00 1 M Issue check F2=Image F6=Messages Certificate no: Interest rate: APY: C/O term: Maturity date: Hold amount: Y-T-O interest: Per diem: Next payment date: Next pay amount: Value after next pmt: Renewable: Deposit Acct/Type: 4.4000% 4.49% 60 M 11/23/06 .00 151. 85 1. 68767 4/23/05 .00 .00 Yes F3=Exit F8=Maintenance More.. . F4=Sweep Inquiry F24=More Keys .. \-\'ACHOVIA \\.'achovia Bank N.A. Balance Confirmation Services POBox 40028 Roanoke, VA 24022-7313 April 4, 2005 IRWIN & MCKNIGHT 60 WEST POMFRET STREET CARLISLE, PA 17013-3222 Reference lD: 1189348 fD>[~BUWR. ff:1 ~Sl# ~"0 'H j, )(!(Ii; .J _"""-',-, ; \, ,"'I. .P i\,'! ,-, IF ~,~rr ," i..A.;. ., ~ _l Iv':'\.J '>!1. C; SUBJECT: Verification / Confirmation of Account and Balance Information provided for: Customer: CLEO L HONTZ (SSN# 188-22-8164) Date of Death: March 12,2005 Account Type CERTIFICATE OF DEPOSIT Account Number 247412061041297 LEGAL TITLE: CLEO L HONTZ JACK R HONTZ Deoosit Account Information Date of Death Balance Average Balance* Dale Opened Maturity Interest Accrued YTD Date Date Rate Interest hlterest Paid Closed 8/3/2008 4,88 $16,000,00 2/3/2000 CERTIFICATE OF DEPOSIT 247412061107400 LEGAL TITLE: CLEO L HONTZ JACK R HONTZ $10,000,00 3/2l/2000 12/21/2008 4,02 CERTIFICATE OF DEPOSIT 247412081554911 71;/2001 LEGAL TITLE: CLEO L HONTZ JACK R HONTZ CERTIFICATE OF DEPOSIT 247412091814711 LEGAL TITLE: CLEO L HONTZ JACK R HONTZ CERTIFICATE OF DEPOSIT 247412091843195 LEGAL TITLE: CLEO L HONTZ JACK R HONTZ CERTIFICATE OF DEPOSIT 247412091981644 LEGAL TITLE: CLEO L HONTZ JACK R HONTZ .:\}r:,n OLOG1.:.i $11,000,00 7/5/2005 5,59 $10,00000 4.5 $11 L09 8112/2002 8/12/2008 $10,000,00 10/18/2002 10/18/2008 4,02 $68.36 $30,000,00 12/15/2003 12/1912009 3,92 $23.55 $23.15 $15,17 $2.46 $26.46 $87,12 $192,73 $68.37 $15L83 $199,93 . . . Reference ID: 1]89348 ~~rrJG ;#< . -O;\L llTLE: CLEO L HONl Z V;~K R tlONTZ l;\' 1010008385211 $5.00 12/13/2000 ,., Due to system limitations, we can only provide a twelve month average balance on depository accounts, * Date of death balance does not include accrued interest .. If date of death occurrs on a weekend or a holiday, date of death balance does 110t include any transactions that were made during that time period. ~(It i [, U( 1Sh a ((/) :Jennifer Sttaub ''-./' Servicenter Associates Phone: (540)563-7323 abs;js 5"~ "'_i\;i~' , ~ . ~ M&rBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Law Offices Irwin & McKnight West Pomfret Professional Building 60 West Pomfret Street Carlisle, Pennsylvania 17013-3222 Re' Estate of' Cleo L Hontz Social Security' 188-22-8164 Date of Death: March 12, 2005 Dear Sir or Madam: Phone (888) 502-4349 Fax (302) 934-2955 March 3],2005 ,.rf(;,.~f?. '. (C f~ ~'W7 i? 1n1'1 iI~~"'" ~,,, ,.~ Il ~~ ~& !'-"f,. k' '.t<.,: .' . : !~_ ~4 . ~ J.~ . Per your inquiry dated March 21, 2005, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: I. Type of Account Account Number Ownership (Names oj) Opening Date Batance on Date of Death Accrued interest Total 2, Type of Account Account Number Ownership (Names oj) Opening Date Balance on Date of Death Accrued Interest Total Certificate of Deposit 031003913903760 Cleo L Hontz, Joint oYvners '" Jack R Hontz, Joint Owners '" 518100 $25,000,00 $ 20,18 $25,020,18 Certificate of Deposit 031003913903992 Cleo L Hontz, Joint Owners If< Jack R Hontz, Joint Owners ... 91610 I $12,000,00 $ 1241 3. Type of Account Certificate of Deposit Account Number 031003913904156 Ownership (Names oj) Cleo L Hontz, Joint Owners * Jack R Hontz, Joint Owners * Opening Date 3/8/02 Balance an Date of Death $14,000.00 Accrued Interest $ 11.53 Total $14,011.53 4. Type of Account Certificate of Deposit Account Number 031003914204935 Ownership (Names oj) Cleo L Hontz, Joint Owners * Jack R Hantz, Joint Owners' Opening Date 6/27/02 Balance on Date of Death $19,000.00 Accrued Interest $ 38.34 Total $19,038.34 Please be advised, there was no safe deposit box found for the above decedent. * For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the High Street Carlisle Office # 7]7-240-4536. Sincerely, ~ftf~r:;~f~<J Nancy Clagett Records Management " - . {] 3 "- iii" " " CD ;0 CD " o " SJ" co 3 CD ~ (f) u '" " ~ ~ " " n n ~ . . . " " ~ " '" '" '" ~~ n" n" n" n" ~ ~ 2i. ~ n" .. .. . .. Om Co ~.., z>> c" ;:" '" '" '" ",0 N mC '" '" '" '" "z .... .... .... '" .... .... Cl '" '" Cl GO CD ~ 0 >> .... '" '" '" '" m ~ ~ ~ '" 0 - - - ~ '" ~ '" " .... 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N -0 " .. !Xl c 9; " (Q ;0 !1:1 Oln(") Oln" O~o w-a.r- _ GO - ...."":z: ~NO ~':'Ja ""N ~ a> ... :I> " == ~ GO '" '" '" <./I en -l m ;;0 C z (i) :!! z > z n > r n o ;;0 "tI o ~ -l o '2 ~ ,. ~ -- Sovereign Bank ESTATE OF SOCIAL SECURITY #: DATE OF DEATH: Cleo Hontz 188-22-8164 March 12, 2005 Account #: 2891032802 Type: Checking In the name of: Cleo L. Hontz or Jack R. Hontz Date of Death Balance: $10,121.41 Int.(YTD) from 1/1/2005 to 2/27/2005 Accrued interest to date of death: $0.17 Other Info: Open date: 8/3/1990 $2.76 Account #: 1675202970 Type: CD In the name of: Cleo L. Hontz or Jack R. Hontz Date of Death Balance: $18,000.00 Int.(YTD) from 1/1/2005 to 2/28/2005 Accrued interest to date of death: $28.51 Other Info: Open date: 12/21/1998 $120.15 Account #: 3385039486 Type: In the name of: Cleo L. Hontz or Jack R. Hontz Date of Death Balance: Int.(YTD) from 1/1/2005 to Accrued interest to date of death: Other Info: CD Open date: 1/4/2002 $15,000.00 2/28/2005 $29.51 $124.38 Account #: 3385043611 Type: CD In the name of: Cleo L. Hontz or Jack R. Hontz Date of Death Balance: $15,000.00 Int.(YTD) from 1/1/2005 to 2/28/2005 Accrued interest to date of death: $28.13 Other Info: Open date: 1/16/2002 $118.56 Account #: 3385122100 Type: In the name of: Cleo L. Hontz or Jack R. Hontz Date of Death Balance: Int.(YTD) from 1/1/2005 to Accrued interest to date of death: Other Info: CD Open date: 10/22/2003 $5,000.00 2/28/2005 $6.61 $27.89 Page 1 of 1 . . . I '+.': CITIZENS BANK Account Number 6140844851 Account Title CLEO L HONTZ OR JACK R HONTZ Date Opened 11/6/01 Account Type Time Deposits Principal Balance as ofDOD $17000.00 Interest from Last Posting to DOD $15.51 Account Balance as ofDOD $17015.51 YTD Interest to DOD $174.63 Ma~ 19 05 08:30a . Thornwald Home . jLD 7172498906 p. 1 -; L{ Cj - &"7 st( ~~ )6~ A4- ~. tt /l) ) j' //)/ ~,.- #j lY~' IV. v'" ,/" U--'" 'li I/~ "' /"1 .../ -- . j -- rC:':> ....---- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MCKNIGHT MARCUS A III 60 W POMFRET STREET CARLISLE, PA 17013 u__u__ fold ESTATE INFORMATION: SSNo 188-22-8164 FILE NUMBER: 2105-0319 DECEDENT NAME: HONTZ CLEO l DATE OF PAYMENT: OS/20/2005 POSTMARK DATE: OS/20/2005 COUNTY: CUMBERLAND DATE OF DEATH: 03/12/2005 NO. CD 005354 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $6,526.38 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 021983 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $6,526.38 GLENDA FARNER STRASBAUGH REGISTER OF WillS