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HomeMy WebLinkAbout01-0970 Estate of Irene C. Krajewski also known as PETITION FOR PROBATE and GRANT OF LETTERS a?/-Ol-q?o No. To: Register of Wills for the Deceased. County of Cumberland in the Social Security No. 204 - 0 9 - 3 8 8 2 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(~, who is~8 years of age or older an the execut rix in the last will of the above decedent, dated June 22 aK~~~~~}(M~g named f9x 2000 , - (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumber land County, Pennsylvania, with }1er last family or principal residence at 211 0 Logan S tree t , Camp Hill (list street, number and muncipality) Decendent then 86 yearsofa~e,died October 17 fCP9 2001, at Carlisle Regional Medlcal Center, Carlisle, PA Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: none Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 1 0 , 0 0 0 . 0 0 (If not domiciled in Pa.) - Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner~) respectfully request(s) the probate of the last will DItXEctiED(~ presented herewith and the grant of letters testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. - '" '-" Q) u s::: Q) '0_ .~~ Q)..... ~Q) s::: '00 S:::'O ~.= 3~ Q) ..... 50 ~ s::: OIl en 'i(~~!lD'~ Kathleen A. O'Connor 23 Conway Drive Mechanlcsburg, PA I IU~~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I ss COUNTY OF CUMBERLAND J The petitioner(sXabove-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner~) and that as personal represen- tative(ij of the above decedent petitioner~) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed { before me this 23rd. day of ~tober ~2001 /"nn Con. - I ~.~ Register }l--J~-- -)6 V:l Kathleen A. o'connor ~ '-1-<}D~ () IJ /J .A J ft:1) I ~ AA .L) ~ ~ ~ Estate of Irene C. Kraj ewski also known as PETITION FOR PROBATE and GRANT OF LETTERS ~J-Ol-q?o No. To: Register of Wills for the Deceased. County of Cumber land in the Social Security No. 204 - 0 9 - 3882 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: y our petitioner(~, who is~ 8 years of age or older an the execut r i x in the last will of the above decedent, dated June 22 aH~~~~~}(Mte8 named , ~x 2000 (state re).evant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumber land County, Pennsylvania, with .,er last family or principal residence at 211 0 Loqan street, Camp Hi 11 (list street, number and muncipality) Decendent then 86 years of age, died October 1 7 {CP9 2001 , m Carlisle Reqional Medlcal Center, Carlisle, PA Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: none Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 10,000.00 $ $ $ WHEREFORE, petitioner~) respectfully request(s) the probate of the last will aJlItx:motiEU(~ presented herewith and the grant of letters testamentary theron. (testamentary; administration c.La.; administration d.b.n.c.La.) - ~ Q) u s::: Q) 't:l_ .V;~ Q) ... ~g 't:lO C.';: cu ".0 3~ Q),- 50 ~ s::: 00 r;) 1~~~2~~ 23 Conway Drive Mechanlcsnurg, PA I IU~~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I ss COUNTY OF CUMBERLAND J The petitioner(sXabove-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner~) and that as personal represen- tative(ij of the above decedent petitioner8) will well and truly administer the estate according to law. Sworn to or affi.rm.ed and subscribed { before me this 23rd. day of crtober ~2001 ~iC.~~ - ~.~ . ". Register }l--J~-- -)3 _n_ _ CIl Ka thleen A. 0 I Connor aQ' '--f<{Dij;nL)/J.A JD_ D' ~ ~ ..c~ ~ ~ 7_T' ('~ r:oAC; ':'''':'T.' '''',''::" This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent flling. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 p 7691537 No. ~~ K~ A.hn1 Local RegIstrar ~ 0Ci-~ 19 drJ/JI { , Date Hl0S :43 Rev 2/87 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECOROS CERTIFICATE OF DEATH STAlE filE NUMBER SOCIAl. SECURITY NUMBER T YPEJPAINT IN PERMANENT BLACK INK NAME Of DECEDENT If... Mocl<IIe. Las, SEX 2. female AGE (La..Bonhaay) 3. 204 - 09 17, 2001 86 YIS BIRTHPlACEI.C.V....a ~OfOERHICI'4!C.llf'ly""" _,ns"UCLOfflonllll1et_1 ,..,.. Of fc,e.gn CounaYI HOSPITAl: Wilkesbarre PA 1""".- W 7. FACILITY NAMe (II noIlfl~ltultOn. give streec and I'ltJI1"lt)efI ::="YIO $. COUNTY Of OE.CI'H .. CUmber land ... 'RHEA'S NAME IF.... MKJaIe. LaSI) Adam Chicknosk ... INFORMANT'S NAME (TypelPllncl J J \.J ....( \ t 24. 2$. 21. PART I: Em., rhe diUa..s, "'jur. or complecal.ona which caused lhe death 00 noI enl., me mode of dying, such as cardiac Of '.st>Katory a"asl. shock or healt la"",. loll only one ca.... on .ac/lline (f;RE~Ro V.rK'OVLA<2... / N~Cf70 N .. OUERMOAASA~.-9\l.!~UJF): A I b J-r1/FR /-z::-7V':>/O/v I. M~Sf.OUENCEOl}:::~ - . c /./ I, /"7C:Z-L /' Fl/;;' _____________ DUE 10 COR AS ACONSEOUENCE Of) cS WERE AU10PSY FINOINGS MANNEA OF DEATH AlAllAIllE PRIOR JO COMPlETION OF CAUSE 01' OE.CI'H7 '-. '..../. \ --: \0 --; ORE OF INJUAY (_ Day. "'at) ~ o o HomOCMlO o o o Hal"''' Accodon( P.nd....... lnveshg.a1l0n V.o 0 NoD 5uM:odo Coukl not be delemuned a... a.... a. COITIFIER tCNlCI< oniy onel .CERTIfYING PH't$1C&AH (Phy!OC...... CelllfyllM] cauM 0' deatrlwh6(l.)nOlhet' Dfl'VSIL,an has Pfonounced dealfl ano cornpl~le<J Ilern 231 Te.... bM. o' "'. knowledge, de.. OCCurred due 10... Caule(st and m~nn., .I. .tated. , . . . . . ~ ~ ~ o ~ '" ~ Z .PRONOUNCING AND CEATlfytHG PHYStC'AH IPtt'r.iQallIX>lt1 t>4onouoclflg oedltl ana ~etlllyWlg 10 cause of lledltll Ta lhe boN' of my knowle4*a_, de.IhOC~Ufr"".' She ,...... d..e, .lAd place. and dIH to Ihei CAUse(l) and manne' n slaled.. 'UEDICAL EXAMINER/CORONER On 'he beai, of ..amin.UOA and/or 'n~.sUg~'ton. in my opinion, d..th ocf;urred at the time, date, ~nd place. and due to the cluleCI) and manner.. ,t.ted.. , . . . . . . . . . . . Jt. "."."~~"-~lWl.dh/ ~_~% 12LL~ RACE - Amencan Indian, aa.c.... White. _ (~I 10. White SUAVlYING SPOUSE IM_.o-lIlMWInomel - CIIy/lJan> 17055 !t. I AopfoxlR1al. :=::-..= ! 2. t4;atf !y~...r !V~ ~-----"T'---~ ! ~'Q' PART II: CXher sogr>iftconl_ conuollulino 10 cSeOl/l. but IIOl "sulIIn9 in "'" ~ c:auoe _ in IWn I .51-1/ /f1.-I..-.OW/N V;....- j? 5 e7 h/"e t:35' 6VC~1-/'Z o/J1/7l'/ TIME OF INJUAY INJURY R WOflK7 DESCAI8E HOW INJURY OCCURRED _ 0 NoD /~ o )4 .... .' LAST WILL AND TESTAMENT OF IRENE C. KRAJEWSKI I, IRENE C. KRAJEWSKI, now of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and hereby revoke all prior Wills and Codicils made by me. ITEM I. I direct that all of my just debts and funeral expenses, including the cost of my gravemarker, if any, shall be paid for from my residuary estate as soon as practical after my decease as an administrative expense of my estate. ITEM II. I give and devise all of my estate of every nature and wherever situate to my daughter, KATHLEEN A. O'CONNOR, provided she survives me by thirty (30) days. Should my daughter, KATHLEEN A. O'CONNOR, predecease me or die on or before the thirtieth (30th) day following my death, I give and devise my estate as follows: A. Fifty Thousand ($50,000.00) Dollars to my son-in-law, FRANK O'CONNOR. B. Fifteen (15%) percent of the remainder thereof to JOAN HANNON and WILLIAM HANNON, or the survivor of them. C. Ten (10%) percent of the remainder thereof to each of the following: MARJORIE JOLLIE, JAMES COWELL, KAlHY LAMB, BETTY ANN ADDY, MARGIE ELLEN BROOME and JAMES FIORE, if then living. ~~. Irene C. Krajewski " D. The remainder thereof in equal shares to my other then living nephews and nieces and those of my late husband, Stanley Krajewski. ITEM ITI. If any income or principal shall be payable to any person who shall be under the age of twenty-five (25) or who shall be incapacitated for any reason, my personal representative, as trustee, shall hold such income and principal and shall apply such income and principal to the health, maintenance, support and education of such person until age twenty-five (25) or during incapacity, without the appointment of any guardian or committee or any authority of court, and shall be entitled to make direct application hereunder or to make application by payment thereof to the parent or other person in charge of such person, or to his or her guardian or to a custodian under the Uniform Transfers to Minors Act, or to the person. Any remaining income and principal to which such person shall be entitled shall be paid and distributed to such person upon attaining age twenty-five (25) or termination of incapacity. ITEM IV. I appoint my daughter, KATHLEEN A. O'CONNOR, Executrix of this my Last Will and Testament. Should she fail to qualify or cease to act in such capacity, I then appoint my niece, BEITY ANN ADDY, First Contingent Executrix of this my Last Will and Testament. Should she also fail to qualify or cease to act in such capacity, I then appoint my nephew, JAMES FIORE, Second Contingent Executor of this my Last Will and Testament. No bond shall be required by my personal representative in any jurisdiction. ITEM V. In addition to the powers given by law to my personal representative(s) and trustee( s) [hereinafter fiduciaries] in the administration of my estate and of any trust( s) created herein, they shall have the following discretionary powers applicable to all real and personal property held ~~~ Irene C. Krajewski 2 .. by them, including property held for minors, effective without court order until actual distribution. A. To retain any property owned by me at my death and to invest any funds held by them in any stocks, bonds, notes or other securities or property, real or personal, including common trust funds, mutual funds and money market deposit accounts operated or offered by my corporate trustee, if any, or any affiliate of it. B. To sell or otherwise dispose of any property, real or personal, at any time fonning a part of my estate or the trust estate, for cash or upon credit, in such manner and on such terms as they see fit, and no one dealing with the fiduciaries shall be bound to see to the application of any monies paid. C. To manage, operate, repair, improve, mortgage or lease for any tenn [even ifbeyond the duration of the trust( s)] any real estate at any time held or owned by them as fiduciaries. D. To hold investments in the name of a nominee and exercise and dispose of warrants. E. To engage in litigation and compromise, arbitrate or abandon claims and property. F. To conduct any business in which I am engaged or in which I have an interest at the time of my death for such period as the fiduciaries deem advisable, with the power to borrow money and to pledge the assets of the business and to do all other acts which I, in my lifetime, could have done, or to delegate such powers to a partner, manager or employee without liability for any loss occurring therein. G. To allocate items of receipt or disbursement between principal and income as the fiduciaries deem equitable regardless of the character given such items by law; to distribute in cash or kind or partly in each at valuations fixed by the fid~ t2. . Irene C. Krajewski 3 ~ H. To borrow money, including the right to borrow from any corporate trustee, if any, and to mortgage or pledge as security or to hold its own stock if a corporate trustee. I. To join in any merger, reorganization, voting trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto. J. Should the principal of any trust herein provided for be or become too small in trustee's opinion so as to make establishment or continuance of the trust 'inadvisable, my trustee(s) may make immediate distribution of the then remaining principal and any accumulated or undistributed income outright to the person or persons and in the proportion they are then entitled to income. Upon such termination, the rights of all beneficiary(ies) who might otherwise have an interest as succeeding income beneficiary(ies) or in remainder shall cease. K. In general, to exercise all powers in the management of the assets of my estate or the trust estate which any individual could exercise in the management of similar property owned in his own right, upon such terms and conditions as the fiduciaries may deem best, and to execute and deliver all instruments and to do all acts which the fiduciaries may deem necessary or proper to carry out the purposes of this will or any trust( s) created herein. L. To apply income or principal to which any beneficiary is entitled, directly for his or her comfort, maintenance and support, should the fiduciaries deem such beneficiary incapable of receiving the same by reason of age, illness, infirmity or incapacity, or to pay the same to such person or persons as the fiduciaries select to disburse it, whose receipt shall be a complete acquittance therefore without the intervention of any guardian. ~. Irene C. Krajewski 4 , M. To assume continuance of the status of any beneficiary with reference to death, marriage, divorce, illness, incapacity or other change in the absence of information deemed reliable without liability for disbursements made on such assumptions. N. All principal and income shall, until actual distribution to any beneficiary, be free of the debts, contracts, alienations and anticipations of any beneficiary, and the same may not be liable for any levy, attachment, execution or sequestration while in the hands of any beneficiary, and the same may not be liable for any levy, attachment, execution or sequestration while in the hands of any fiduciaries. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ of GU ~~ , 2000. ~~. Irene C. Krajewski The preceding instrument, consisting of this and four other typewritten pages, identified by the signature of the testatrix, as on the day and date thereof signed, published and declared by Irene C. Krajewski, the testatrix erein named, as and for her last Will, in the presence of us, who, at her request, in her presence ~ each other, subscribed our names as witnesses hereto. . I"l-~ ;).cfO/V g~AcO ~Y'ffi/lrfcz 4~~~~7 10#3 ~~~ A., ~,u-7& 5 . . ACKNOWLEDGMENT COMMONWEALTH OF PENNSYL VANIA: : S8. COUNTY OF DAUPHIN I, IRENE C. KRAJEWSKI, testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last Will, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. ~<1, Irene C. Krajewski this '7 h oL Sworn or A 1.. day of ed to and acknowledged before me, by Irene C. Krajewski, testatrix, U^-'L ,2000. ~~!/d N tary Public My Commission xpIres: NOTARIAL SEAL HOLLY S, KIRK. Notary Public AFFIDAVIT Harrisburg, Dauphin County My Commi::sion Expires Feb. 15. 2003 COMMONWEALTH OF PENNSYL VANIA: : SS. COUNTY OF DAUPHIN We, - 61 Qf cL L PI and (tt. L - f3 611 CijA/ , the witnesses whose names are signed to the attache or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testatrix sign and execute the instrument as her last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the t~statrix signed the Will as witnesses; an~ that to the best Of...our knOW~dge t..te i as at that tIme 18 or more years of age, of sound mmd and under no CO,D8tnfI 0 u ue n c . ~/" ~ -:d~ty<&~~' Sworn to and subscribed before me this 2 J. h"lday of 9 u"-t.- , 2000. ~ x0. i/d Notary Public NOTARIAL SEAL My Commission Expir ~s: HOLLY S, KIRK. Notary Public Harrisburg, Dauphin County My Commission Expires Feb. 15, 2003 .,....._.......~...... ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Irene C. Krajewski Date of Death: October 17,2001 Administration No.: 21-01-0970 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was given to the following beneficiary on October 26,2001. Kathleen A. O'Connor 23 Conway Drive Mechanicsburg, P A 17055 Notice has now been given to all persons entitled thereto under R . r?;?~ 6 . Placey, Esquire :.,-- ~ Attorney for the Estate 3631 North Front Street Harrisburg, P A 17110 (717)236-9577 Date: October 26, 2001 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 PLACEY RICHARD L ESQ 3631 NORTH FRONT STREET HARRISBURG, PA 17110-1533 -------- fold ESTATE INFORMATION: SSN: 204-09-3882 FILE NUMBER: 21-2001- 0970 DECEDENT NAME: KRAJEWSKI IRENE C DA TE OF PAYMENT: 01/17/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/17/2001 NO. CD 000763 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $8,656.51 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: RICHARD PLACEY ESQUIRE CHECK# 1511 SEAL INITIALS: VZ RECEIVED BY: $8,656.51 MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS RE1I-l500EXll>OO) . ~ :.:~~ UL(,) Woo :l:a:.... ULIlI ~ COMMONWEAlTH OF PENNSYlVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY 17-l5-1&- c/ FILE NUMBER 21_01 o 9 7 0 -- -- ----- COUNTY CODE YEAR NUIIlER I- Z w Q w o W Q DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) KRAJEWSKI, Irene C. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 10-17-2001 07-30-1915 (IF APPlICABLE) SURVMNG SPOUSE'S NAME (lAST, ARST, AND MIDDLE INITIAL) n/a SOCIAL SECURITY NUMBER 204 - 09 3882 IX] 1. Original Return D 4. Limited Estate IX] 6. Decedent Died Testate (AlIach lXJPY d WI) o 9. Utigation Proceeds Received THIS RETURN MUST BE ALED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 2. Supplemental Return o 4a. Future Interest Compromise (d8Io d deoIh Bllor 12-12-ll2) o 7. Decedent Maintained a Living Trust (AlIach lXJPY dTrust) o 10. Spousal Poverty Credit (dale d deoIh ~ 12-31-91 MId 1-1-95) o 3. Remainder Refurn (dalealdOath priorb 12-13,32) o 5. Federal Estate Tax Retum Required 8. ToIal Number of Safe Deposit Boxes o 11. Election to tax under See. 9113{A) (AlIachSchO) z o j j l- ii: c( o w It:: z o ~ ~ j D.. :IE o o g NAME Richard L. Placey, Esquire A~J~") Wright TELEPHONE NUMBER (717)236-9577 16. Amount of Une 14 taxable at lineal rate 17_ Amount of Une 14 taxable at sibling rate 18. Amount of Une 14 taxable at ooIlateral rate 19. Tax Due 3631 North Front Street Harrisburg, P'A 1710-1533 an (1) (2) (3) (4) (5) .00 .00 .00 .00 20,670.21 :::.1 ::::. "'0FFIC fr /'" E ONLY 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or SoIe-Proprietorip 4. Mortgages & NOles Receivable (Schedule D) 5. Cash, Bank Deposits & MISCellaneous Personal Property (Schedule E) 6. Joinlly Owned Property (Schedule F) o Separate BiDing Requested 7. Inter-VMlS Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Unes 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent. Mortgage Uabnities, & Uens (Schedule I) 11. Total Deductions (total Unes 9 & 10) 12. Net Value of Estate (Une 8 minus Una 11) 13. Charitable and Governmental Bequests/See 9113 TrusIs for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Une 12 minus Une 13) SEE INSTRUCTlONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Une 14 taxable at the spousal tax rate, or transfers under See. 9116 (a)(12) Co- ~ z -..J .~ '-' x~ (6) 138,467.79 d 1..)1 (7) 51,726.30 (8) 210,864.30 (9) (10) 8,372.71 .00 (11) 8,372.71 (12) 202,491.59 (13) .00 (14) 202,491.59 202,491.59 x.O_ (15) x .0 45 (16) x .12 (17) x .15 (18) (19) 9,112.12 9,112.12 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT , . REV.15Oll EX. (1-97) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEA1. TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF IRENE C. KRAJEWSKI FILE NUMBER 21-01-0970 Include the proceeds of rltigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Allfirst Certificate of Deposit 87008140436240 Principal - $1,453.63 Interest - $ 1.03 1,454.66 2. Waypoint Certificate of Deposit 400002312 Principal - $4,648.73 Interest - $ 20.49 12,065.86 3. Waypoint Checking 4100000257 Principal - $4,648.73 Interest - $ .96 4,649.69 4. 1988 Ford Taurus Sedan (valued at price sold) . 1,000.00 5. Household Goods 1,500.00 6. Miscellaneous Personal Effects NO VALUE TOT At (Also enter on line 5, Recapitulation) $ 2 0 , 6 7 0 . 21 (If more space is needed, insert additional sheets of the same size) Nov 14 01 03:24p ALLFIRST CIS 3029342855 p.2 !l allfirst AlIl1rsl f'il1llilcial CenterN.A. PO Box 9{lI) Millboro, OE 19'J66 November 14,2001 Place)' & Wright Attorneys At Law 3631 North Front Street Harrisburg. P A 17110-1533 Re: Estate o/1rene C Kraiewski Social Securj(v: 204-09-3882 Date otDealh: October 17, 2001 Dear Sir or Madam: Per your inquiry dated October 26, 2001 please be advi3ed that at the time ofdealh, the above-naml.'<l decedent had on depru.it with this bank the following: I. 7)pe o{Accol/nl Golden Age Chr:;c:king Account Number 0052593746 OW'1ership (.^It.ullc.r oj) Irene C. Krajewski, Owner Karhleen A. Oconnor. Owner Stanley F. Krajewski, DECD Opening Dale 0>1/18177 Balance 011 Dale of Death S6.949.65 Accrued Interest s 0.00 TtJ! ;:1/ $6.949.65 2. '(vpe of Account Cerrijicate of Oepmit ACt."OI.II1t Number 87008140436240 Ownership (Names of) Irene C. Kf'ajewski, Owner Op./ll/l1g Dalc 0....:;/12/96 BuJance on Date ofDeaih S1.453.63 Accrued Imerest .') /.03 Total $1.454.66 -.- .----- ! 11/01/2001 PLACEY & WRIGHT 3631 NORm FRONT ST HARRISBURG PA 17110 Y'IWay~qi!,~ LOOK FOR us. WE'LL GET YOU THERE. The information which you requested on the account(s) ofIRENE KRAJEWSKI DECEASED (Social Security Number 204-09-3882) is/are as follows: 4100000257 CHECKING 06/06/00 4648.73 .96 4649.69 400002312 CERTIFICATE 01/28/00 12045.37 20.49 12065.86 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership SOLE Name of Joint Owner, ifany Date Ownership Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested SOLE .terelYjI ~ KA~Y~GP' SENIOR SERVICES REP. PLEASE COMPLETE W-9 P.O. Box 171 I. HARRISBURG. PENNSYlVANIA 17105-1711 Toll Free 1-866-WAYPOINT (1-866-929-7646) . www.waypointbank.com . . REV.tS19 EX + ('~ ESTATE OF *' SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT IRENE C. KRAJEWSKI If an asset was made joint within one year of the ~. dale of death, . must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS A. Kathleen A. O'Connor B. c. 23 Conway Drive Mechanicsburg, PA 17055 JOINTLY -OWNED PROPERTY: ITEM 'lUMBER 1. 2 3. 4. lETTER FOR JOINT TENANT DATE DESCRJPTION OF PROPERTY MADE Include rane offinancialinsfitulion lIId bank lIXXlUIlI number or sinila- identifying number. AIIa:h JOINT deed for joinlIy.J1eld real estae. A. 04/7 Allfirst Checking 0052593746 04/9" PSECU Account 0204093882 Principal - $125,222.10 Interest - $ 307.82 A FILE NUMBER 21-01-0970 DATE OF DEATH VAlUE OF ASSET 6,949.65 125,529.92 03/0l Edward Jones Account 896-07474 49,046.00 07/0' Real estate situate in the Borough of Camp Hill, Cumberland County, PI, more particularly described in Record Book 227, Page 421, known as 2110 Logan Street, Camp Hill. 95,410.00 (Assessed value. See tax bill attached. ) A A RElATIONSHIP TO DECEDENT Daughter %OF DECD'S INTEREST 50% 50% DATE OF DEATH VAlUE OF DECEOENT'S INTEREST 3,474.83 50% 24,523.00 62,764.96 50% . 47,705.00 TOT~(AIso enter on nne 6, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 138,467.79 Nov 14 01 03:24p ALLFIRST CIS 3029342955 p.2 !) atlfirst Allfirst Finllllc.a1 Center N.A. 1'0 Box 9('.() MillhOf'Cl. OE 19;166 November 14.2001 Plnel.")' & Wright Attorneys At Law 3631 North Front Street Harrisburg~ P A 17110-1533 Re: Estate of Irene C Kra;ewski Social Securirv: 204-09-3882 Dale ofDealh: October /7. 2001 Dear Sir or Madam: Per your inquiry dated October 26,200 I plcase be advised that at the time of death, the above-named decedent had on deposit widl this bank the following: I. 7)'Pe {lfAcc(JIJf1l Golden Age Checking Account Number 0052593746 O""'1crship (Nlulle.r oj) Irene C. Krajewski, Owner Kalhleen A. Oconnor. Owner Stcmley F. Klryewski DEeD Openil?g Date rU/18177 Balance 011 Dale of Death S6. 949. 65 Accrued Intl!resl S 0.00 Towl S6. 949. 65 2. Typ'..! Q.f Accnunt (.'ert!flCate 0/ Deposit Aa:ount Nll111/x.,. S7008140436240 O....nership (Names of) {,en€! C. Krajewski. Owr.er Opening Dale OS!! 2'96 i1u/ance on Date if Death S1.451.63 Accrued Imerest S 1.03 T<xal SI.B:t.66 ----I PSEC. the financiallinkTM November 2,2001 Account # 0204093882 RICHARD L PLACEY 3631 NORTH FRONT STREET HARRISBURG, PA 17110-1533 Dear MR PLACEY: The following is the status of IRENE C KRAJEWSKI's account with PSECU as of the date of death. Joint Owner's Name Date Established Date of Death Date of Birth KATHLEEN A O'CONNOR, ADDED 04.29.1997, JOINT TENANT WIROS 03.09.1965 10.17.2001 07.30.1915 Sbare(s) Regular Shares (S 1) Money Handler(S4) Share 52 24 Month Certificate Share 54 24 Month Certificate Share 55 24 Month Certificate Share 56 24 Month Certificate Share 57 36 Month Certificate Share 58 36 Month Certificate Balance $11,188.85 0.00 24,849.38 5,357.88 2,137.23 37,846.86 22,428.75 21,413.15 Accrued Dividend $13.34 0.00 56.86 16.48 6.57 98.54 50.14 65.89 The dividend earned from January 1,2001 through the date of death was $5,605.86. The decedent had no loans with us. We do not have safe deposit boxes for our members. To close the decedent's account, we need the joint owner to sign, date and return the enclosed Authorization to Close Account form along with a death certificate. If you have any questions, please call 234-8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Sincerely, 7:f::fr Member Service Representative Finance Support Unit enc. PENNSYLVANIA STATE EMPLOYEES CREDIT UNION Main Address: 1 Credit Union Place, Harrisburg, PA 17110-2990 . (717) 234-8484 . (800) 237-7328 Mailing Address: P.O. Box 67013, Harrisburg, PA 17106-7013 . (717) 777-2100 (TOO) . (800) 472-1967 (TOO) Web Address: www.psecu.com Savings federally Insured up to $100,000 by the National Credit Union Administration. fI) .., = o -.. ] ~ ~ 8 111111111 g; 1!1:11!111!1! 3 ~ 811111!1:;:::1 rz:I~rz:I:::::i::::.:::: ~ ~ ~ili ~ i o u ~ o ;I;::til :6/~: ::::::W=::::Ul';:: n~ul ::::::I:::::~:::: ~ rz:I ~ E-4 ~ .::$18. ?tt:~t ;;;I:::;~. ~ H ~ ~ ~ ~;:! ~-l:t " rz:IO ~ J:, :::::::::.:::::::::::::::::: ii:l 0\ :.:.:';;:::::::lOA:V: HeX)'" ~~:~:~~=r ~ II:III!!!I ;a ::::1:.:1.: ~ ~ :::(:~(:;t: Po. :i:;;:~ ~ ~n::nnn.n Po. S :tt:1 ~ ~ ~lllllli ~ ;:tic::::::: ~ .qMmi1i ...: qr::s:: Oi(t(~{ :{::::ta;: tl:t:; n:il:n !SIn :::::~::JZi:::: rJl E-4 rz:I rJl rJl ...: :::mr:( :::il..:~ :::::i!l::::::::::::::::: :::::=2:::::::::::=::::: :::::g:j#:::: fi;tt~f -::::5::::::-:::::::.- &} rJl o Po. ~ Po. :~: 11:1 ~~ 1.0:. tI:2~. ... tI) N ... t3 ~..... =0 =.0 = = + + ~ L1) ~ = + ~ .... ~ L1) ~ ~ ~ N 00 ,,; 1.0 <.0 N .... L1) ~ ~ .... = .... N .... o--co C> CO C> .......... 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(;'>'-5 . 6.~ t eou i >-c.'9...='" ~.g g~=~ "'U>:Jl-O .5 E . 11 0 c "2.a~.w g.R ;!.5 ~ ~ l;. ~ ti.s....fI).!!!,: "2 - C.c~ ::; :::I g e u . 3.= 1ll 5 8'3 O:O~rl~C~ -5'ic> U "i ='::.5 0'= - 0 C'f: fI) ~ c !l .. 8,.- c~~~ a -E -i ~.;, ~ ~ ~a~CQJo ".-3" e.. c.C"-RCl. .-"'--<15- "B ~'O co;;; ~ :;u~~';;;3 ~:: .3 ii ~ ~ Q.oCca~ .. 1l8~-5-5g .&:J~~~.58vi ~E~C::~W~ ~Ja:~:ai:': "2 8."B!E ~ ~ .5 (lSu2"O~U'2 rl-5lll"'.;~~ >_c~tlOO~ .flo8cc-o il 8..-.... :E'.~ ~ c -5 ~:; olii.",:lI~iI" t;5cE-...c .u C r!.a .. -5 .j !l;.::;8.B:;~ c ~ C c; E uoi'- 'Oc;igaa~ J!fl~<!il:8 '=~-uiO~~ e..!1-g!ll;.~ ;l3s'BC2~:!! ;:s"Bce .-or! 'E "2.!!! :5 ~ 5! 'S! .g.~~j.5-g l! ;!ot::oE"o8 c~g,1;~~:2 o:;~c~~6 j"2~~~oii .2:.....~co8"2 ~g~:08~eO ::c~eiJ:5e 5!8,-oe>,.,.... ~>("...C!!l'S! .:;> <>-5 "B.- c:; ~ ~ :5.:: ~ g rl u.!! Gf) t:~ lU co g :.~"C ~ ~ :; <.> o."'~- il-5 Ci1-g~...~bO - ~ 0._ c 1l...8e",,,:o ~ ..... CI) I..::; E =' <~~:g~og j.2 ~.~.. ~.-: .~ _ c ~ c 8.e 9 fl._.C.2 ee<>E~~"'-~ ~ 8;' -.= .- rl- ~5~i:~~~ ....1,.;;; '"'_.... cu._ <1> > +-> <U +-> e: <1> V> <1> <- <- <1> 0- N ..a Z<1> ME 00::: ;1;~ (/) ~~ ..... <1> C%:<1> Me: LL1E .....0 I.L. +-> .r= V> ~ 0- ~~ 1"-<1> .....~ ..... <1> Vl_ ~I-- TAX YEAR 2001-02 REAL ESTATE TAX NOTICE CAMP HILL SCHOOL DISTRICT MAKE CHECKS PAYABLE TO: 95,410 BILL Ho.Cl 1523 "** DATE SCHOOL ** JULY 1 2001 I PHO~E 717-737-26.81 . OFFICE HOURS TUESDAYS 9-2 & 4-6 ASSESSMENT ANNE M RAMSEY TAX COLLECTOR 358 BEVERLY ROAD CAMP HILL PA 17011 2110 CAMP /1 - 8/31 /1 -10/31 FTER 10/31 %P II %P II DURING THIS PERIOD DISCQUNT hND PENAL n HAVE BEEN COMPUTED FOA YOUR CQNVOIIfHCI:: 965.88 985.59 1,084.15 ACCT NO 01-21-0271-119 1 OF 82-83-84-85 IF , THIS BILL TO YOUR MORTGAGE COMPANY _~.n.".. _ COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY IRENE C. KRAJEWSKI FILE NUMBER 21-01-0970 ESTATEOF This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reveJSe side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM INClUDE 1ltE NAME OF 1ME TRAIlSfERfE. TIfEJR RElATIOHSHIPTO IlECEDENT /IlK) 1ltE DATE OF TRANSFER DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE NUMBER ATTACIl A COPY Of 1ME OEED FOR REH. ESTATE. VALUE OF ASSET INTEREST (If AI'I'I..ICAIU) 1. Jackson National Life Annuity 0059069730. Beneficiary Kathleen A. Connor, Daughter. Transferred on October 17, 2001. 51,726.30 100% n/a 51,726.3 TOT AI. (Also enter on line 7, Recapitulation) $ 51,726.30 o (If more space is needed, insert additional sheets of the same size) '{OV ? j ? 001 j . ~J. _, . I: 39PM DPW/OIM SDHQ Hbg, Pa. 17105 NO. 3066 P. 3 ackson National Life A Woolly Oamed Subsidiary of Pru~ntiQI Corporntion pic London. England October 29,2001 Kathleen 0 Conner 23 Conway Dr Mechanicsburg, PA 17055 Insured: Policy No. Irene C Krajewski 0059069730 Dear Mrs. 0 Conner: Please accept our condolences on the death of Irene C Krajewski. We understand that this must be a difficult time and we wo,uld Ijl<~. . to know that we are available for any Questions you may have. The value of the poIiq. :ll.Jll~. j nis value is with date of passing as October 1tl'i. 2001. Once we receive the original death certificate. we can determine the worth of the policy with better accuracy. In order to a5liUre your privacy we can only release this information to you (the beneficiary) and the servicing agent. If you wish to have an advisor help with this information, please include a signed release to offer the information. In order to process your claim prompUy, please complete the endosed claim fonn and return to us along with the following: . M original or certified copy of the Death certifICate . The above referenced policy or the enclosed Lost Policy Affidavit Once we receive this Information, we will process the daim as quickly as possible. We have also enclosed a Beneficiary Checklist, which you may find helpful. If the face amount is $5,000.00 or greater, we will establish an account in your name in a guaranteed Beneficiary Access Account. You can use this money immediately simply by writing one of the checks we provide for any amount up to the total in the BenefICiary Access Account. Funds in the account currently eam interest at 3% (rate based on JNL Annual Renewable Annuity/CD), compounded daily. Please note that Jackson National guarantees both principle and earned interest. There are no fees or charges to keep thiS account or write checks. If you have any questions or need additional infocmation, please contact our Service Center toll free at 888/5654995. Sincerely, ~ Max Miller, Claim Analyst Claims Administration Enclosure: Claimant's Statement; Lost Policy Affidavit; Beneficiary Checklist D94 PO Box 24008 Lansing fAl 489<l9-4068 8B8/565-4995 'REV-1511'EX+ (12-99>. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF IRENE C. KRAJEWSKI FILE NUMBER 21-01-0970 ITEM NUMBER A. Debts of decedent must be reported on Schedule I. DESCRIPTION 1. 2. 3. 4. FUNERAL EXPENSES: Malpezzi Funeral Home - balance funeral expense Rothermel's Florist Shop - casket spray Rental of limousine for funeral st. Elizabeth Ann Seton Parish - funeral luncheon B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 2. Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s} Street Address City State _ Zip Year(s) Commission Paid: Attorney Fees Placey & Wright 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant 4. Street Address City State _ Zip Relationship of Claimant to Decedent P~mFees Cumberland County Register of Wills 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 8. 9. 10. Cumberland Law Journal - estate advertising Patriot-News Company - estate advertising Messiah Village - debt of decedent Reserve for future costs, income taxes and expenses TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) AMOUNT 163.76 159.00 160.00 200.00 n/a 5,500.00 n/a 69.00 75.00 85.95 960.00 1,000.00 8,372.71 . . REV- 1513 EX + (1-97) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF IRENE C. KRAJEWSKI FILE "UMBER 21-01-0970 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not UstTrustee(s) OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. Kathleen A. O'Connor 23 Conway Drive Mechanicsburg, PA 17055 Daughter Entire Estate ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. 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, insert additional sheets of the same size) -0- ), ,.. , , 1 LAST WILL AND TESTAMENT OF IRENE C. KRAJEWSKI I, IRENE C. KRAJEWSKI, now of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and hereby revoke all prior Wills and Codicils made by me. ITEM I. I direct that all of my just debts and funeral expenses, including the cost of my gravemarker, if any, shall be paid for finm my residuary estate as soon as practical after my decease as an administrative expense of my estate. ITEM ll. I give and devise all of my estate of every nature and wherever situate to my daughter, KA TIILEEN A. O'CONNO~ provided she survives me by thirty (30) days. Should my daughter, KA TIILEEN A. O'CONNO~ predecease me or die on or before the thirtieth (30th) day following my death, I give and devise my estate as follows: A. Fifty Thousand ($50,000.00) Dollars to my son-in-law, FRANK O'CONNOR. B. Fifteen (15%) percent of the remainderthereofto JOAN HANNON and WILLIAM HANNON, or the survivor of them. C. Ten (10%) percent of the remainder thereof to each of the following: MARJORIE JOllIE, JAMES COWEll, KATIIY LAMB, BErrY ANN ADDY, MARGIE ELLEN BROOME and JAMES FIORE, if then living. ~t!, Irene C. Krajewski D. The remainder thereofin equal shares to my other then living nephews and nieces and those of my late husban~ Stanley Krajewski. ITEM ID. If any income or principal shall be payable to any person who shall be under the age of twenty-five (25) or who shall be incapacitated for any reason, my personal representative, as trustee, sba1l hold such income and principal and sba1l apply such income and principal to the health, maintenance, support and education of such person until age twenty-five (25) or during incapacity, without the appointment of any guardian or committee or any authority of court, and shall be entitled to make direct application hereunder or to make application by payment thereof to the parent or other person in charge of such person, or to his or her guardian or to a custodian under the Uniform Transfers to Minors Act, or to the person. Any remaining income and principal to which such person shall be entitled shall be paid and distributed to such person upon attaining age twenty-five (25) or termination of incapacity. ITEM IV. I appoint my daughter, KATHLEEN A. O'CONNOR, Executrix of this my Last Will and Testament Should she fail to qualify or cease to act in such capacity, I then appoint my niece, BETIY ANN ADDY, First Contingent Executrix of this my Last Will and Testament. Should she also fail to qualifY or cease to act in such capacity, I then appoint my nephew, JAMES FIORE, Second Contingent Executor of this my Last Will and Testament. No bond shall be required by my personal representative in any jurisdiction. ITEM V. In addition to the powers given by law to my personal representative(s) and trustee(s) [hereinafter fiduciaries] in the administration of my estate and of any trust( s) created herein, they shall have the following discretionary powers applicable to all real and personal property ileld ~C!~ Irene C. Krajewski 2 by them, including property held for minors, effective without court order until actual distribution. A. To retain any property owned by me at my death and to invest any funds held by them in any stoc~ bonds, notes or other securities or property, real or personal, including common trust funds, mutual funds and money market deposit accounts operated or offered by my corporate trustee, if any, or any affiliate of it. B. To sell or otherwise dispose of any property, real or personal, at any time forming a part of my estate or the trust estate, for cash or upon credit, in such manner and on such terms as they see fit, and no one dealing with the fiduciaries shall be bound to see to the application of any monies paid. c. To manage, operate, repair, improve, mortgage or lease for any term [even if beyond the duration of the trust(s)] any real estate at any time held or owned by them as fiduciaries. D. To hold investments in the name of a nominee and exercise and dispose of warrants. E. To engage in litigation and compromise, arbitrate or abandon claims and property. F. To conduct any business in which I am engaged or in which I have an interest at the time of my death for such period as the fiduciaries deem advisable, with the power to borrow money and to pledge the assets of the business and to do all other acts which I, in my lifetime, could have done, or to delegate such powers to a partner, manager or employee without liability for any loss occurring therein. G. To allocate items of receipt or disbursement between principal and income as the fiduciaries deem equitable regardless of the character given such items by law; to distribute in cash or kind or partly in each at valuations fixed by the fid~ {i! Irene C. Krajewski 3 H. To borrow money, including the right to borrow from any corporate trustee, if any, and to mortgage or pledge as security or to hold its own stock if a corpOrate trustee. I. To join in any merger, reorganization, voting trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto. J. Should the principal of anytnJst herein provided for be or become too small in trustee's opinion so as to make establishment or continuance of the trust -inadvisable, my trustee( s) may make immediate distribution of the then remaining principal and any accumulated or undistributed income outright to the person or persons and in the proportion they are then entitled to income. Upon such termination, the rights of all beneficiary(ies) who might otherwise have an interest as succeeding income beneficiary(ies) or in remainder shall cease. K. In general, to exercise all powers in the management of the assets of my estate or the trust estate which any individual could exercise in the management of similar property owned in his own right, upon such terms and conditions as the fiduciaries may deem best, and to execute and deliver all instruments and to do all acts which the fiduciaries may deem necessary or proper to carry out the purposes of this will or any trust(s) created herein. L. To apply income or principal to which any beneficiary is entitled, directly for his or her comfort, maintenance and support, should the fiduciaries deem such beneficiary incapable of receiving the same by reason of age, illness, infirmity or incapacity, or to pay the same to such person or persons as the fiduciaries select to disburse it, whose receipt shall be a complete acquittance therefore without the intervention of any guardian. ~. Irene C. Krajewski 4 - M. To assume continuance of the status of any beneficiary with reference to death, marriage, divorce, illness, incapacity or other change in the absence of information deemed reliable without liability for disbursements made on such assumptions. N. All principal and income shall, mtil actual distribution to any beneficiary, be free of the debts, contracts, alienations and anticipations of any beneficiary, and the same may not be liable for any levy, attachment, execution or sequestration while in the hands of any beneficiary, and the same may not be liable for any levy, attachment, execution or sequestration while in the hands of any fiduciaries. IN WfINESS WHEREOF, I have hereunto set my hand and seal this ~ of GU ~€ ,2000. · ~~- Irene C. Krajewski The preceding instrument, consisting of this and four other typewritten pages, identified by the signature of the testatrix, as on the day and date thereof signed, published and declared by Irene C. Krajewski, the testatriJ{ erein named, as and for her last Will, in the presence of us, who, at her request, in her pre~ce in se each other, subscribed our names as witnesses hereto. ;)cro/V .2,~Ad) ~V/;/#((/~ /0#3 ~~A..~/?9' /-/ 5 " - ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA: : SS. COUNTY OF DAUPHIN I, IRENE C. KRAJEWSKI, testatrix WhDse name is signed to' the attached Dr fDregDing instrument, having been duly qualified accDrding to' law, dO' hereby acknDwledge that I signed and executed the instrument as my last Will, that I signed it willingly, and that I signed it as my free and vDluntary act fDr the purposes therein expressed. ~ ~~, IrMe C. Krajewski /} h rJ..- SWDrn Dr e"\:ed to' and acknDwledged befDre me, by Irene C. Krajewski, testatrix, this ^ Z day of T I\..L , 2000. ~A.J/u.l N ry Public My CDmmissiO'n I xplres: N(HARIAL SEAL HOLLY S. KIRK. Notary P\lblic AFFIDAVIT Harrisburg, Dauphin County . My Commission Expires Feb. 15. 2003 COMMONWEAL TH OF PENNSYL VANIA: : SS. COUNTY OF DAUPHIN We, a.rcL L PIa witnesses whO'se names are signed to' the attache O'r fDregO'ing instrument, being duly qualified according to' law, dO' depose and say that we were present and saw testatrix sign and execute the instrument as her last Will; that she signed willingly and that she executed it as her free and vO'luntary act for the purposes therein expressed; that each Dfus in the hearing and sight O'fthe testatrix signed the Will as witnesses; and that to' the best Df O'ur know dge t . as at that time 18 O'r mO're years O'f age, O'f sO'und mind and under nO' c' I 0' U e n n d (it- L . f3 6'(1 (v..IS, , the 4~~~ Sworn to aod subscribed before me this "2"2 n'\my of 9 u"t.. , 2000. ~ >lJKd NO'tary Pubhc NOTARIAL SEAL My CDmmissiDn Expi es: HOllY S. KIRK. Notary Public Harrisburg, Dauphin County My Commission Expires Feb. 15, 2003 /' /- /s-: /_3 \r. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, AllOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-04-2002 KRAJEWSKI 10-17-2001 21 01-0970 CUMBERLAND 101 .02 MAR -8 P 1 :22 RICHARD L PLACEV ESQ PLACEV & WRIGHT 3631 N FRONT ST C:sn HBG PA 1 'fil1Q1b,.,,. * REV-l!i47 EX AFP Ul-D2) IRENE C Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-Y-=is4-j-Ex-AFP--foi-:021--NcfficE--oF-'rNHEiiiTANci-TAi-jrppiAIsEMENT~--Ar.i-owANci-oR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KRAJEWSKI IRENE C FILE NO. 21 01-0970 ACN 101 DATE 03-04-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED I~ an assessment was issued previously, lines 14, lS and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ Abb returns assessed to date. ASSESSMENT OF TAX: 15. Allount of line 14 at Spousal rate (15) 16. Allount of line 14 taxable at lineal/Class A rate (16) 17. Allount of line 14 at Sibling rete (17) 18. Allount of line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (l) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 20,670.21 138,467.79 51,726.30 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage liabilities/liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (l0> 8,372.71 .00 (11) (12) (13) (14) NOTE: .00 X 00 = 202,491.59 X 045 = .00 X 12 = .00 X 15 = NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 210,864.30 8.372 71 202,491.59 .00 202,491.59 (19)= .00 9,112.12 .00 .00 9,112.12 TAX CREDITS: . "' I ....." . IU;"'II;.l.r I I+J AMOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 01-17-2002 CDOO0763 455.61 8,,656.51 TOTAL TAX CREDIT 9,,112.12 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 · IF PAID AFTER DATE INDICATED" SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS lESS THAN $1" NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)" YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) CJ/ PLEASE FILE TmS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 Name of Decedent: Irene c. Kraj ewski Date of Death: October 17, 2001 Estate No.: 21:-01-0970 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No .2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: (date) 3. If the answer to No. 1 is yes, state the following: A. Did the personal representative file a final account with the court? ~s ~ x B. The separate Orphans' Court No. (if any) for the personal representative's account is: (Not Applicable in Dauphin County) C. Did the personal representative state an account informally to the parties in interest? Yes X No D. Copies of receipts, releases, joinders and approvals of fOrmal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ..!:= ..-- 17110-1533 Date: 5/15/02 (, (MAH:nntl AM3) ('.~ p (717)236-9577 Telephone No. ~(~ Capacity: Personal Representative X Counsel for Personal Representative RoW. - 6& t~~lf INRE: ESTATEOp. IRENE C. KRAJEWSKI, DECEASED IN TIIE COURT OF C0Ml\10N PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DMSION APPROVAL OF ACCOUNT. RELEASE AND INDEMNIFICATION ESTATE OF IRENE C. KRAJEWSKI. DECEASED The undersigned is one of the residuary beneficiaries of the &tate of Irene C. Krajewski, Deceased. KathleenA. O'Connor, Executrix of the Estate ofIrene C. Krajewski (hereinafter "Personal Representative"), is willing to make distribution of the assets of the estate without the formality of a court accounting upon the receipt of a proPer release, receipt and indemnification, which it is the purpose of this docwnent to provide. In consideration of the willingness of the Personal Representative to make distribution without the formality of a court accounting and agreeing to be legally bound hereby, the undersigned does hereby: 1. Waive the filing of an account of the administration of the estate in any court; 2. Declare that the undersigned has examined the attached informal Statement of Account of the Personal Representative; accepts and approves it with the same force and effect as if it had been prepared and filed with, audited, adjudicated and confirmed absolutely by a court of competent jurisdiction; and as if the balance of principal and income had been awarded by the court in accordance with the Statement; 3. Warrant that the undersigned is the residuary beneficiary named in the informal Statement of Account and is entitled to receive the distribution therein set forth; . 4. Absolutely and irrevocably releases and discharges the estate, the Personal Representative and Placey & Wright, attorneys for the estate, their respective heirs, personal representatives, successors and assigns, of and from any and all actions, liabilities, claims and demands relating in any way to the administration of the estate and distribution in accordance with the informal Statement of Account 5. Agree to indemnify and hold harmless the Personal Representative and her personal representatives, successors and assigns, from and against any claims, liabilities, loss or expenses (including costs and counsel fees) arising from any cause whatsoever which the Personal Representative may incur as a result of the administration of the estate and distribution in accordance with this document and to refund to the Personal Representative any portion of the distribution of the undersigned which exceeds the amount of the undersigned's share as the Personal Representative finally determine. this document this IN WI1NES WHEREOF, intending to be legally bound, the beneficiary has executed day of iP1A y "' J J (!::/ ~2 Jt ' ~/// ~ A:J::A {) Ll^ ~.O ~EAL) ~ athleen A. O'Connor .../ , 2002. Social Security No. J ~:J. -- :3 L -1 ~ ~ (,..