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.
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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) ~
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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.)
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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
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Ka thleen A. 0 I Connor aQ'
'--f<{Dij;nL)/J.A JD_ D' ~ ~ ..c~
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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, $2.00
p
7691537
No.
~~ K~ A.hn1
Local RegIstrar ~
0Ci-~ 19 drJ/JI
{ ,
Date
Hl0S :43 Rev 2/87
COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECOROS
CERTIFICATE OF DEATH
STAlE filE NUMBER
SOCIAl. SECURITY NUMBER
T YPEJPAINT
IN
PERMANENT
BLACK INK
NAME Of DECEDENT If... Mocl<IIe. Las,
SEX
2. female
AGE (La..Bonhaay)
3. 204 - 09
17, 2001
86 YIS
BIRTHPlACEI.C.V....a ~OfOERHICI'4!C.llf'ly""" _,ns"UCLOfflonllll1et_1
,..,.. Of fc,e.gn CounaYI HOSPITAl:
Wilkesbarre PA 1""".- W
7.
FACILITY NAMe (II noIlfl~ltultOn. give streec and I'ltJI1"lt)efI
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COUNTY Of OE.CI'H
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CUmber land
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'RHEA'S NAME IF.... MKJaIe. LaSI)
Adam Chicknosk
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INFORMANT'S NAME (TypelPllncl
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24. 2$.
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
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DUE 10 COR AS ACONSEOUENCE Of)
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WERE AU10PSY FINOINGS MANNEA OF DEATH
AlAllAIllE PRIOR JO
COMPlETION OF CAUSE
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COITIFIER tCNlCI< oniy onel
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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.. , . . . . . . . . . . .
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SUAVlYING SPOUSE
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PART II: CXher sogr>iftconl_ conuollulino 10 cSeOl/l. but
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TIME OF INJUAY
INJURY R WOflK7
DESCAI8E HOW INJURY OCCURRED
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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&
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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 .
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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
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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)
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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
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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)
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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-
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(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.
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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/;/#((/~
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5
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-
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 ~ ~ (,..