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Home My WebLink About03-27-06 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 GLESNER SAMUEL J 11 5 HOPE DRIVE BOILING SPRINGS, PA 17007 u______ fold EST ATE INFORMATION: SSN: 209-28-8241 FILE NUMBER: 2105-0595 DECEDENT NAME: COHICK SAMUEL H DATE OF PAYMENT: 03/27/2006 POSTMARK DATE: 03/27/2006 COUNTY: CUMBERLAND DATE OF DEATH: 06/26/2005 NO. CD 006478 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $211.49 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK#124 SEAL INITIALS: MG RECEIVED BY: REGISTER OF WILLS $211.49 GLENDA FARNER STRASBAUGH REGISTER OF WILLS f~ REV-1500 EX + (6-00) . w ~ ~~cn ua:~ wo.u ::t:OO ua:..J Q.ID 0.. 01( OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER II 05 COUNTY CODE YEAR SOCIAL SECURITY NUMBER t- Z W Q W (.) W Q DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Cohick, Samuel H. DATE OF DEATH (MM-DD-YEAR) 209-28-8241 00595 NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a living Trust (Attach copy of Trust) 10 Spousal PovertY Credit (date of death between . 12-31-91 and 1-1-t15) D 3. Remainoor Retum(date of death prior to 12-1382) D 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) ~ 1. Original Return o 4. Limited Estate ~ 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o o o o 2. Supplemental Return DATE OF BIRTH (MM-DD-YEAR) 06-26-2005 05-25-1914 COMPLETE MAILING ADDRESS 126 East King Street Shippensburg, PA 17257 (1 ) (2) (3) (4) (5) (6) (7) None 264,944.00 /- ) None None 195,128.64 14,567.95 None (8) 40,476.38 745.01 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) ~ z W Q Z o 0.. cn w a: a: o u (9) (11 ) (12) (13) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 20. D (14) SEE INSTRUCTIONS ~ REVERSE SIDE FOR APPLCABLE RATES Copyright 2002 form software only 11e Lackner Group, Inc. NAME Richard L Webber, Jr., Esquire FIRM NAME (If applicable) Weigle & Associates, P.C. TELEPHONE NUMBER 717 -532-7388 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o ~ <r: -J :::>> t- o: <r: (.) w a= 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) D Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 15. Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15) z or transfers under Sec. 9116(a)(1.2) 0 ~ 16. Amount of Line 14 taxable at lineal rate 422,419.20 x .045 (16) <r: r- :::>> 0.. 17. Amount of Line 14 taxable at sibling rate 0.00 .12 (17) ::i x 0 u 18. Amount of Line 14 taxable at collateral rate 1,000.00 .15 (18) X x <r: r- 19. Tax Due (19) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. OFFICIAL USE ONLY .- \ I .~ 474,640.59 41,221.39 433,419.20 10,000.00 423,419.20 0.00 19,008.86 0.00 150.00 19,158.86 Form REV-1500 EX (Re~ ~ \ , t Decedent's Complete Address: STREET ADDRESS 210 Big Spring Road CITY Newville ISTATE PA I ZIP 17241 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 19,158.86 18,000.00 947.37 Total Credits (A + B + C) (2) 18,947.37 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theT AX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE. (3) (4) (5) 211.49 (5A) (58) 211 .49 Make Check Payab/3 to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FQ.LOVVlNG QUESTIONS BY PLACING AN "X" IN lHE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;................................................................................. D ~ b. retain the right to designate who shall use the property transferred or its income~................................... D [!] c. retain a reversionary interest; or............................. .......... ....... ....................... ........... .......... ........................ 0 [!] d. receive the promise for life of either payments, benefits or care?............................................................. 0 [!J 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?. ..................... .................... .......................... .............. .......... .......................... 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ 0 [!J 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?............................ ...... ................. ....................................... ............................ 0 [!J IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparelOther than the personal repesentative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS - DATE Hope E.Glesner 311 Bullshead Roid ...., Newville, PA 17241 ADDRESS 115 Hope Drive Boiling Springs, PA 17007 3)?':l1 ~ DATE )!2Lj/~( ADDRESS 126 East King Street Shippensburg, PA 17257 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P .5.99116 (a) (1.1) (ii)]. The statutedoes not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P .5. 99116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P .S. 99116 1.2) [72 P.S. ~9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116 (a) (1.3)J. A sibling;s defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. , '1 , Rev-1503 EX+ (6-98) . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Cohick, Samuel H. FILE NUMBER 21-05-00595 ESTATE OF All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 11,420 shares of ACNB Corporation Common Stock 23.20 264,944.00 TOTAL (Also enter on Line 2, Recapitulation) 264,944.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) ~ \1. , Rev-1508 EX+ (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Cohick, Samuel H. FILE NUMBER 21-05-00595 Include the proceeds of litigation 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 DEA 1H 1 Farmers National Bank #220132 - Checking Account 15,220.45 2 Farmers National Bank #220132 - Accrued Interest 5.68 3 Farmers National Bank #3990608 - Certificate of Deposit 50,000.00 4 Farmers National Bank #3990608 - Accrued Interest 383.20 5 Farmers National Bank #3990609 - Certificate of Deposit 50,000.00 6 Farmers National Bank #3990609 - Accrued Interest 383.20 7 Farmers National Bank #3990616 - Certificate of Deposit 7,000.00 8 Farmers National Bank #3990616 - Accrued Interest 10.07 9 Farmers National Bank #3990849 - Certificate of Deposit 7,056.45 10 Farmers National Bank #3990849 - Accrued Interest 18.08 11 Farmers National Bank #3990965 - Certificate of Deposit 10,000.00 12 Farmers National Bank #3990965 - Accrued Interest 43.27 13 Farmers National Bank #4990181 - Certificate of Deposit 16,000.00 14 Farmers National Bank #4990181 - Accrued Interest 28.39 15 Farmers National Bank #4990470 - Certificate of Deposit 3,500.00 16 Farmers National Bank #4990470 - Accrued Interest 32.78 Total of Continuation Schedule(s) See attached page TOTAL (Also enter on Line 5, Recapitulation) 195,128.64 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) '\ '\ , Rev-1508 EX+ (6-98) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Cohick, Samuel H. FILE NUMBER 21-05-00595 ESTATE OF ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATIi 17 Farmers National Bank #4990679 - Certificate of Deposit 21,000.00 18 Farmers National Bank #4990679 - Accrued Interest 12.48 19 Farmers National Bank #4990835 - Certificate of Deposit 3,000.00 20 Farmers National Bank #4990835 - Accrued Interest 9.05 21 Farmers National Bank #5990143 - Certificate of Deposit 3,000.00 22 Farmers National Bank #5990143 - Accrued Interest 13.64 23 Farmers National Bank #5990502 - Certificate of Deposit 4,000.00 24 Farmers National Bank #5990502 - Accrued Interest 31.40 25 Farmers National Bank #5990527 - Certificate of Deposit 2,000.00 26 Farmers National Bank #5990527 - Accrued Interest 11.36 27 Farmers National Bank #9643222 - Savings Account 990.78 28 Farmers National Bank #9643222 - Accrued Interest 1.43 29 PFB Health Insurance Refund 322.69 30 Presbyterian Homes, Inc. - Refund 1,054.24 TOTAL (Also enter on Line 5, Recapitulation) 195,128.64 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule E (Rev. 6-98) '\ , , \ Rev-1509 EX+ (6-98) . SCHEDULE F JOINTL V-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Cohick, Samuel H. FILE NUMBER 21-05-00595 ESTATE OF If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. B. Hope E Glesner Co-Executor ADDRESS c/o Samuel J. Glesner, his agent 210 Big Spring Road Boiling Springs, PA 17007 311 Bullshead Road Newville, PA 17241 RELATIONSHIP TODECEDENT Son SURVIVING JONT TENANT(S) NAME A. Robert H Cohick Daughter C. Samuel J. Glesner Co-Executor 115 Hope Drive Boiling Springs, PA 17007 Grandson JOINTLY OWNED PRlPERTY: DESCRIPTION OF PROPERTY %OF DATE OF DEATH LETTER DATE ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF NUMBER NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSEl DECEDENT'S INTEREST TENANT JOINT JOINTLY-HELD REAL ESTATE. INTEREST 1 A,B,C 1/4/1999 Farmers National Bank #185868- 18,770.12 0.2500/0 4,692.53 Checking Account 2 A,B,C 1/4/1999 Farmers National Bank #185868- 5.50 0.2500/0 1.38 Accrued Interest 3 A 9/6/1999 Farmers National Bank #3990676 - 7,000.00 0.5000/0 3,500.00 Certificate of Deposit 4 A 9/6/1999 Farmers National Bank #3990676- 99.19 0.5000/0 49.60 Accrued Interest 5 A 5/3/2000 Farmers National Bank #4990833- 4,800.00 0.5000/0 2,400.00 Certificate of Deposit 6 A 5/3/2000 Farmers National Bank #4990833- 14.48 0.5000/0 7.24 Accrued Interest 7 A 5/3/2000 Farmers National Bank #4990834- 3,800.00 0.5000/0 1,900.00 Certificate of Deposit 8 A 5/3/2000 Farmers National Bank #4990834- 11.46 0.5000/0 5.73 Accrued Interest Total of Continuation Schedule(s) )ee attached page TOTAL (Also enter on Line 6, Recapitulation) 14,567.95 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) " , . \ Rev-1509 EX+ (6-98) *' SCHEDULE F JOINTL V-OWNED PROPERTY continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Cohick, Samuel H. FILE NUMBER 21-05-00595 ESTATE OF If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY DESCRIPTION OF PROPERTY %OF ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DATE OF DEATH NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSEl DECO'S VALUE OF TENANT JOINT INTEREST DECEDENT'S INTEREST JOINTL V-HELD REAL ESTATE. 9 A 10/12/1999 Farmers National Bank #5990703 - 4,000.00 0.5000/0 2,000.00 Certificate of Deposit 10 A 10/12/1999 Farmers National Bank #5990703- 22.94 0.500% 11.47 Accrued Interest TOTAL (Also enter on Line 6, Recapitulation) 14,567.95 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) " . . \ REV-1151 EX+ (12.99) *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Cohick, Samuel H. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-05-00595 ESTATE OF ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT See continuation schedule(s) attached 7,074.53 1. ADMINISTRATIVE COS1S: Personal Representative's Commissions B. Hope E. Glesner Samuel J. Glesner Social Security Number(s) I EIN Number of Personal Representative(s): Street Address 311 Bullshead Road City Newville State Y ear( s) Commission paid 2005-2006 See continuation schedule(s) attached PA Zip 17241 18,492.84 2. Attorney's Fees See continuation schedule(s) attached 14,239.26 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees 460.00 See continuation schedule(s) attached 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs See continuation schedule(s) attached 209.75 TOTAL (Also enter on line 9, Recapitulation) 40,476.38 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) 1\ I. \ Rev-1502 EX+ (6-98) . SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Cohick, Samuel H. FILE NUMBER 21-05-00595 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Egger Funeral Home 7,074.53 Subtotal 7,074.53 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) !l , . , Rev-1502 EX+ (6-98) . SCHEDULE H-B1 PERSONAL REPRESENT A liVE'S COMMISSIONS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Cohick, Samuel H. FILE NUMBER 21-05-00595 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Hope E. Glesner, Co-Executor 311 Bullshead Road, Newville, PA 17241 - Personal Representatives Commission 18,492.84 Subtotal 18,492.84 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-81 (Rev. 6-98) , ~ . , Rev-1502 EX+ (6-98) . SCHEDULE H-82 ATTORNEY'S FEES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Cohick, Samuel H. FILE NUMBER 21-05-00595 ITEM NUMBER DESCRIPTION AMOUNT 1 Weigle & Associates, P.C. 14,239.26 Subtotal 14,239.26 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B2 (Rev. 6-98) "' \ Rev-1502 EX+ (6-98) . SCHEDULE H-B4 PROBATE FEES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Cohick, Samuel H. FILE NUMBER 21-05..00595 ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland County Register of Wills 460.00 Subtotal 460.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B4 (Rev. 6-98) I. , Rev-1502 EX+ (6-98) *' SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAXRETURN RESIDENT DECEDENT Cohick, Samuel H. FILE NUMBER 21-05-00595 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland County Recorder of Deeds - Filing fee for mortgage satisfaction 30.00 2 Cumberland County Register of Wills - Filing fee for inheritance tax return 15.00 3 Cumberland Law Journal - Legal advertisement 75.00 4 Valley Times-Star - Legal advertisement 89.75 Subtotal 209.75 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Ii . Rev-1512 EX+ (6-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABiliTIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Cohick, Samuel H. FILE NUMBER 21-05-00595 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Central Penn Medical Group VALUE AT DATE OF DEA TI-i 12.1 0 2 Continuing Care - RX 533.89 3 Pennsylvania Department of Revenue - 2005 - Personal Income Tqax 199.02 TOTAL (Also enter on Line 10, Recapitulation) 745.01 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA~1500 Schedule I (Rev. 6-98) .It REV-1513 EX+ (9-00) . SCHEDULE wi BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT NUMBER Cohick, Samuel H. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTONS [include outright spousal aistributions, and transfers under Sec. 9116(a)(1.2)] RELATIONSHIP TO DECEDENT Do Not List Trusteeto) I FILE NUMBER 21-05-00595 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) ESTATE OF I. See attached schedule Total 423,419.20 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIO.JS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION U TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUT1GJS See continuation schedule(s) attached 10,000.00 TOTAL OF PART 11- ENTER TOTf:.L NON-TAXABLE DISTRIBUTICNS ON LINE 13 OFREV-1500 COVER SHEET 10,000.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) \ . , . . SCHEDULE .J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Samuel H. Cohick 209-28-8241 06/26/2005 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 1 Joann H. Clugston Granddaughter 500.00 11415 Archer Circle Monrovia, MD 21770 2 Joanna Martin Other 100.00 clo Mr. and Mrs. Lester M. Martin 395 Bullshead Road Newville, PA 17241 3 Robert H. Cohick Son 420,419.20 clo Samuel J. Glesner, his agent 115 Hope Drive Boiling Springs, PA 17007 4 Janice Glesner Granddaughter 500.00 311 Bullshead Road Newville, PA 17241 5 Ronald Glesner Grandson 500.00 323 Bullshead Road Newville, PA 17241 6 Samuel J. Glesner Grandson 500.00 115 Hope Drive Boiling Springs, PA 17007 7 Arlene Martin Other 100.00 clo Mr. and Mrs. Lester M. Martin 395 Bullshead Road Newville, P A 17241 8 Daniel Martin Other 100.00 clo Mr. and Mrs. Lester M. Martin 395 Bullshead Road Newville, PA 17241 9 Jonathan Martin Other 100.00 clo Mr. and Mrs. Lester M. Martin 395 Bullshead Road Newville, PA 17241 1 I' I · . SCHEDULE -I BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Samuel H. Cohick 209-28-8241 06/26/2005 I Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 10 Lester Martin, Jr. Other 100.00 cIa Mr. and Mrs. Lester M. Martin 395 Bullshead Road Newville, PA 127241 11 Matthew Martin Other 100.00 clo Mr. and Mrs. Lester M. Martin 395 Bullshead Road Newville, PA 17241 12 Noah Martin Other 100.00 clo Mr. and Mrs. Lester M. Martin 395 Bullshead Road Newville, P A 17241 13 Philip Martin Other 100.00 clo Mr. and Mrs. Lester M. Martin 395 Bullshead Road Newville, P A 17241 14 Rachel Martin Other 100.00 clo Mr. and Mrs. Lester M. Martin 395 Bullshead Road Newville, P A 17241 15 Stephen Martin Other 100.00 clo Mr. and Mrs. Lester M. Martin 395 Bullshead Road Newville, PA 17241 Total 423,419.20 2 , l . . . Rev-1502 EX+ (6-98) *' SCHEDULE .I-liB CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Cohick, Samuel H. IFILE NUMBER 21-05-00595 ESTATE OF ITEM NUMBER 1 DESCRIPTION Ridge Church of the Brethren - 1095 Ridge Road Shippensburg, PA 17257 AMOUNT 10,000.00 Subtotal 10,000.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J-IIB (Rev. 6-98) . .. , ~-:.:--: .~.:-~"':'"'. ~--"""":"--.-"' LAST WILL AND TESTAMENT OF SAMUEL H. COHICK I, SAMUEL H. COHICK, of the 396 Bulls Head Road, North Newton Township, Cumberland County , Pennsylvania, being of sound and disposing mind, memory a~d understanding, "do make; publish and declare this to beumyu Last-Will and Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me. 1 I direct that the expenses of my last illness and funeral be paid fr~m my estate as soon as may conveniently be done. 2 I give and bequeath sum ofTen Thousand ($10,000.00) Dollars to RIDGE CHURCH OF THE BRETHREN, Hopewell Township, Cumberland County, Pennsylvania. 3 I give and bequeath my entire re~iduary estate as follows: (A) I give to each of my grandchildren, namely, RONALD GLESNER, SAMUEL J. GLESNER, JOANN GLESNER and JANICE CLUGSTON, the sum of FIVE HUNDRED ($500.00) DOLLARS each, on a per capita distribution basis. (B) My son, ROBERT H. COHICK, may choose any of my furniture from my house that he desires. 1 ':'-,;:-'::-:::'.-:-."';.=-::-::;''::;:::=-:'':'::::'''-~'"::..-:':;:;::~.::':'':::;':::'..:,.o;i~-.~;:':'''A.-;-:;':'~:;;~~,.;..--..-...,.......... .... ,". ~_.. ......."..........----- .-. "..- - - . , ~l:'.~ :.r':!lY; ;:~o"~"'.:;::::r..'.t~-: :',4'.,." ~~~\&,~ ~)~~~,~I':"'4\':'.;' '.' ". -. I~, :,., -:; i .- ~ l.',;_ LAST WILL AND TESTAMENT OF SAMUEL H. COHICK (C) The tractor, recliner and golf buggy belong to my son, ROBERT I-I. COHICK. These assets are not part of my estate. (D) Each of my grandchildren listed in Paragraph A as well as my daughter, HOPE E. -- nGLESNERabove-shalleachhave-therighttochoose one (1) remaining piece of furniture from my house, as can be agreed among them. (E) Any remaining household goods and furnishings not distributed in subparagraphs Band D above shall be sold at public sale and the proceeds therefrom added to the Trust in favor of my son, ROBERT H. COHICK, as set forth in subparagraph J below. (F) I give to each of the following children of LESTER M. MARTIN and ARLENE S. MARTIN the sum of ONE HUNDRED ($100.00) DOLLARS each: JOANNA MARTIN, MATTHEW MARTIN, RACHEL MARTIN, STEPHEN MARTIN, LESTER MARTIN, JR., ARLENE MARTIN, DANIEL MARTIN, JONATHAN MARTIN, NOAH MARTIN and PHILIP MARTIN, and any other child of LESTER M. MARTIN and ARLENE S . MARTIN born after the date of this Will. (G) My shares of Farmers National Bank stock shall be sold at public auction, in quantities no greater than ten (10) to twenty (20) shares at a time until the first five hundred shares are sold. The stock may be sold in any quantity thereafter. The proceeds therefrom shall be added to the Trust established for my son pursuant to subparagraph J below. (H) I give my family pictures to my family as they can agree. 2 . , LAST WILL AND TESTAMENT OF SAMUEL H. COHICK (1) I direct that my picture of the Newville Fountain and the Laughlin Mill be sold at public sale. (J) The remainder of my estate, including the proceeds from the sale of any assets of my estate, shall be placed IN TRUST with SAMUEL GLESNER of Boiling Springs, -- -- .,--~-----_.--- Pennsylvania, for my son, ROBERT H. COHICK, for and during his natural life, to supply income and so much or all of the principal thereof as the Trustee may deem proper for his support, maintenance, welfare, medical and funeral expenses. At his death, any portion thereafter remaining I give and bequeath to the issue of my daughter, HOPE E. GLESNER, on a per stirpes distribution basis. 4 It is my desire that my son, ROBERT H. COHICK, reside with whom he desires. It is my preference that he lives with my daughter, HOPE E. GLESNER, one of my grandchildren, or at GREEN RIDGE VILLAGE, Newville, Pennsylvania. I further request that any such guardian for my son should make extra effort to see that my son is capable ?f attending the church of his choice and participating in decisions concerning his ability to perform useful work. 5 I direct that all estate and similar taxes which may become due upon my death shall be paid from my residuary estate in expense of administration. 3 . , LAsT WILL AND TESTAMENT OF SAMUEL H. COHICK '6 If any beneficiary of distributee under this Will in any manner, directly or indirectly, contests or attacks this Will or any of its provisions, any share or interest in my estate given or passing to the contesting beneficiary under this Will is revoked and shall be disposed of in the same manner provided herein, as if that consenting beneficiary or distributee had pre-deceased me, without issue. 7 I nominate, constitute and appoint my daughter, HOPE E. GLESNER and my grandson SAMUEL J. GLESNER , or the survivor thereof, as Co-Executors of this my Last Will and Testament, without the necessity of filing bond or surety in this or any other jurisdiction. 8 I recommend that my personal representatives retain Richard L. Webber, Jr., Esquire, as the attorney to represent them in administering my estate. 9 I direct that my personal representatives:l by and through the attorney, notify, in writing, each beneficiary listed in my Will or otherwise. 10 If any beneficiary or distributee under this Will in any manner, directly or indirectly contests or attacks this Will or any of its provisions, any share or interest in my estate given or passing to that contesting beneficiary under this Will is revoked and shall be disposed of in the same manner provided herein, as if that contesting beneficiary or distributee had pre-deceased me, without issue. 4 ~'~:::~-:--:~:::-:~'~-~~:;:7:r ~;-:r ~ ~';r .-';. ~-c- "- '-":' -, - . - -----,------_."---- --".-...---., ... , .". -', "1." - -~ -. i -- ~ - -----..... - ,- ~ . '.,~ :;'; '; :.~:l.. :'; ~~.:,_::~';. ,-. ,:...,~ ./..~y, -":"--'-;-r;, _ .~_.:~_~...-~-:<:-~...__ -. ._~. ::C!. _ .." _ ~-: :~.-.~~: ~.,!.~."~: ':""'.,:"~~----,,..~:.. .~.- ,- ~~",,--"._;"f ::,- .~:: ::':;j7.~.;;;;-.-:-:::-:7;";-;-;r."',::,~,-j'~:-::;'.~t,," /~~rf ~~~~!(.~~. ~:-!i:;::~:f.~:~:~~0.~lr} :..;!~ LAST WILL AND TESTAMENT OF SAMUEL H. COHICK 11 I direct that Executors make prompt sales of any of my assets that they are authorized to sell. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament "2 ' S" ~ 1 0 this ...:;> l--:day of-7r-~~ 'p___u' ,2001. WITNESS: Vfu.(/ 4--&~~ ( F / ~ ef!f/ t1IJd: Sa ~. Cohick t{(j2 'It, 62ucV 5 "',;:]:</" ';',,,.-' e,',.. . "'.'" ~ .. .' \. \ \ " ~. . __ ~.. _,~~ .~. ..~: _. " "__' ......-..,- .~_ ,:-~'T~_~'.4~,~~-~..:~,";".::.:~_,.:-,--;-.::-"-~.:c:_ -';~:~ :C~'7.::':'~)-r:"""':~',~_,:~,"'~r:;"~':"l""!,,,-~,~~~~':;f~~-O:--;~:,c:~~1:'!~'~::T~i: '-r~';~'~. ~~~t:'f:;'?f-;'.f.~\!~~~J~~~~ ~~~t1~,. ",,_ 1, .'1!~':"~~1~1;-~,'~'M'"=:_.~'.._ _..~ -.:"""'r.~:.,,:,,~,~!:-~:-::-,::lT~--'-';':-::-~7'~'-'-'~~.~-- ~---:--:-'_..-;-'~. .- . LAST WILL AND TESTAMENT OF SAMUEL H. COHICK ACKNOWLEDGMENT COMMONWEAL TH OF PENNSYL VANIA COUNTY OF CUMBERLAND SS. I, SAMUEL H. COHICK, the testator 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 and Testament; that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. ~~jj~ Samuel .~ 0 icl{ Sworn or affirmed and acknowledged before me by SAMUEL H. COHICK, the testator ':2 sl~ Tf0 ,this ,-:) I day of TJ - 0 ' 200~, Ci::+r C~ ~~ Notarial Seal Terry E. Walker. Notary Public MSo~th Middleton TWp.. Cumberland County .'" COMmIssIon Expires Mar. 31. 2003 . eM.' r, P~mlsVlwmlf} .l\s~ociati()n of Notaries I I' 6 , " , ~.l. ~~':;."~"':1!:;;;J.~~~~~~-'i"fIJ.. ....~~;pT:;;':.!~7.:,.-:.~.,..,:~~r,::: LAST WILL AND TESTAMENT OF SAMUEL H. COHICK AFFIDA VIT COMMONWEAL TH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS. WE, ;/~/ICI~' 0Llct'..r and rlary rl. PrliCfj , the ;r I / witnesses_~?~s~.~_~me~_are_~t!':l~~~d to the fore~oing document, being duly qualified according to law, do depose and say that we were present and saw SAMUEL H. COHICK sign and execute the instrument as his Last Will and Testament; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; thai each subscribing witness in the hearing and sight of the SAMUEL H. COHICK signed the Last Will and Testament as witnesses and that to the best of our knowledge the SAMUEL H. COHICK was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Y;:dI1O,r ~~A.) / r / tzJ1tl Q~~ Sworn or affirmed and subscribed before me by ~ ~ '3s:t Y---:1t' .(.r /' 1>L/f-,^" / this .) day of / IJ / and , 2001. ~ Cl )/ L ~~C. UJrLU,AA_ Notarial Seal Terry E. Walker, Notary Public South Middleton Twp., Cumberland County My CommissIon Expires Mar. 31, 2003 Member. PennsVlvBnia ~ssbciation of Notaries F:\User Folder\Firm Docs\WiIls\1634-1shc.2will.wpd 7 I I LAST WILL AND TESTAMENT OF l... SAMUEL H. COHICK I, SAMUEL H. COHICK, of the 396 Bulls Head Road, North Newton Township, Cumberland County , Pennsylvania, being of sound and disposing mind, memory a~d understanding, dOlllake; publish and declare this to be "my" Last-Will and Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me. 1 I direct that the expenses of my last illness and funeral be paid from my estate as soon as may conveniently be done. 2 I give and bequeath sum ofTen Thousand ($10,000.00) Dollars to RIDGE CHURCH OF THE BRETHREN, Hopewell Township, Cumberland County, Pennsylvania. 3 I give and bequeath my entire re~iduary estate as follows: (A) I give to each of my grandchildren, namely, RONALD GLESNER, SAMUEL 1. GLESNER, JOANN GLESNER and JANICE CLUGSTON, the sum of FIVE HUNDRED ($500.00) DOLLARS each, on a per capita distribution basis. (B) My son, ROBERT H. COHICK, may choose any of my furniture from my house that he desires. 1 ::. '_'-"~::!~~ :. ~ -.~"::; :.;, .1~:-.:,,':;7';:'.-:;.::~:;;:-:::::-_:,::-....;-.:..;.:::..-;~=.:.=.:::::;::.::....:",;,;,:,~~;:;:~:.t.::-;'..:..~::~-;,.;.:;'"':7:-',"" ,..'.- ....,._~_""...,........J.. ".... --............_-~~._--.:': .~.~~"""--:_~.,=., -,- - .~ , ' I' , ' l' \ ~~~~ .,.~:':t1:~;;:1;:t:..'.:;(J~1..r",-::,- ... ~~:'i' ~)f!i:~,~i~-f;':".;' LAST WILL AND TESTAMENT OF SAMUEL H. COHICK (C) The tractor, recliner and golf buggy belong to my son, ROBERT 11. COHICK. These assets are not part of my estate. (D) Each of my grandchildren listed in Paragraph A as well as my daughter, HOPE E. - _.. G LESNER. above - shall each. have the right to . choose one (1 ) remaining piece of furniture from my house, as can be agreed among them. (E) Any remaining household goods and furnishings not distributed in subparagraphs Band D above shall be sold at public sale and the proceeds therefrom added to the Trust in favor of my son, ROBERT H. COHICK, as set forth in subparagraph J below. (F) I give to each of the following children of LESTER M. MARTIN and ARLENE S. MARTIN the sum of ONE HUNDRED ($100.00) DOLLARS each: JOANNA MARTIN, MA TTHEWMARTIN, RACHEL MARTIN, STEPHEN MARTIN, LESTER MARTIN, JR., ARLENE MARTIN, DANIEL MARTIN, JONATHAN MARTIN, NOAH MARTIN and PHILIP MARTIN, and any other child of LESTER M. MARTIN and ARLENE S . MARTIN born after the date of this Will. (G) My shares of Farmers National Bank stock shall be sold at public auction, in quantities no greater than ten (10) to twenty (20) shares at a time until the first five hundred shares are sold. The stock may be sold in any quantity thereafter. The proceeds therefrom shall be added to the Trust established for my son pursuant to subparagraph J below. (H) I give my family pictures to my family as they can agree. 2 . ' I 4 . ' ,f \ LAST WILL AND TESTAMENT OF SAMUEL H. COHICK (I) I direct that my picture of the Newville Fountain and the Laughlin Mill be sold at public sale. (J) The remainder of my estate, including the proceeds from the sale of any assets of my estate, shall be placed IN TRUST with SAMUEL GLESNER of Boiling Springs, Penn~ylvania, for my son, ROBERT H. COHICK, for and during his natural life, to supply income and so much or all of the principal thereof as the Trustee may deem proper for his support, maintenance, welfare, medical and funeral expenses. At his death, any portion thereafter remaining I give and bequeath to the issue of my daughter, HOPE E. GLESNER, on a per stirpes distribution basis. 4 It is my desire that my son, ROBERT H. COHICK, reside with whom he desires. It is my preference that he lives with my daughter, HOPE E. GLESNER, one of my grandchildren, or at GREEN RIDGE VILLAGE, Newville, Pennsylvania. I further request that any such guardian for my son should make extra effort to see that my son is capable ?f attending the church of his choice and participating in decisions concerning his ability to perform useful work. 5 I direct that all estate and similar taxes which may become due upon my death shall be paid from my residuary estate in expense of administration. 3 P "'''''~'',''''.'' T:'",,"," l' I \ i~ . -",t'.., T~"'''' LAsT WILL AND TESTAMENT OF SAMUEL H. COHICK '6 If any beneficiary of distributee under this Will in any manner, directly or indirectly, contests or attacks this Will or any of its provisions, any share or interest in my estate given or passing to the contesting beneficiary under this Will is revoked and shall be disposed of in the same manner provided herein, as if that consenting beneficiary or distributee had pre-deceased me, without issue. 7 I nominate, constitute and appoint my daughter, HOPE E. GLESNER and my grandson SAMUEL J. GLESNER , or the survivor thereof, as Co-Executors of this my Last Will and Testament, without the necessity of filing bond or surety in this or any other jurisdiction. 8 I recommend that my personal representatives retain Richard L. Webber, Jr., Esquire, as the attorney to represent them in administering my estate. 9 I direct that my personal representatives=, by and through the attorney, notify, in writing, each beneficiary listed in my Will or otherwise. 10 Ifany beneficiary or distributee under this Will in any manner, directly or indirectly contests or attacks this Will or any of its provisions, any share or interest in my estate given or passing to that contesting beneficiary under this Will is revoked and shall be disposed of in the same manner provided herein, as if that contesting beneficiary or distributee had pre-deceased me, without issue. 4 ~.~:;:~,:~~;.::,~ .,;: :-;T ~r~~'.r~~?"; ::~~~... -, "-:-:-;' --:- -~'7~: ~., -. C~.~-:-. ',::-7,': ";,--:-,--'-,:-:,:-','-:- .... F" . . ", .' ". .... , ...: . -. . -, . I "..." t :'~ _:--"::,:.;:,-~'_~,-"-'-;::'~:'>;:-"_.;;-;:~'" d _ .' ,I . \ ,\ . ~flj{!J,::~?~,~\~:,!:,~,"~;'t!-?\h~ ~~~-;:~~~?t~';::i':;::':~~"T0' .::r:;~~:-"~::,-fr.::;i:'::-;-'-~ ~..:'::'.~"i~~ 0:~>' ';, ~ :.:;~..: '~.':'r.~';-;.~.~. c';"~",:;'-::-~T:::". ~,;:;'~:-r'~~(;rr' .," 'f?-~,~~r.-:': ; '~.-'~;-"'-r,'.'=: .,. ..~ -"~:'- , LAST WILL AND TESTAMENT OF SAMUEL H. COHICK '-:::-~.:''C ~~ :~':.'-~::--,':'7':' ,",:C ~; ~~;;.:; :;>'T~" ,-:,: ;;:,;-:; -:r;r;-.-::-.~.;7~'; ,:,::,~j'~'::::-:-~r:""'.,t :1("~t1' ~~::~~'~r .....?-i""!~\~t.:: 11 I direct that Executors make prompt sales of any of my assets that they are authorized to sell. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament ~ S" ~ "' () this 3 1- day ofu[r~-<O .._--,--.-- - ,.2001. WITNESS: vtJ:!.d ~ft-.e>>tJ ( / ~ t/:tl {Uij Sa ~. Co ick t(ti ~l. 6d{~ 5 " i "f.,' _~'-" :;-~:;:l:"'::'::'-": ',.' ;,'-~-. ~~.- ;~~. '.- -.....~-.:::-_:- .---. .~ I t . ' ~. .\ 1, ,'i11!~~~--tF~~.~~.~r,-.p:.":,~~~:-:'";.~~::t~~--:-.~.~.:",!:,,,,;~~,-~.,-~--:--:-....: _~._ '_ ....- _. .' ...... _....-:_., ".,,"' ',"".~ .....~~..'-: r~~T~"'t7'":""""""~"";~"":":'~'7;'-. '''':-:'-_7"';~-~';" .-~ p- ='~~"""-"_-::":,,",~.1~"""";~."(:'~"~t~.~..:J;\~':~;":"7~~..~~~~:~:;r:~r:;.":7ifr~.::~:r.r;~T'Yi1"~ ~~~~~kf.~t~?~~H~,,? LAST WILL AND TESTAMENT OF SAMUEL H. COHICK ACKNOWLEDGMENT COMMONWEAL TH OF PENNSYL VANIA COUNTY OF CUMBERLAND SS. I, SAMUEL H. COHICK, the testator 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 and Testament; that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. ~~J/~ Samuel . ~o ick Sworn or affirmed and acknowledged before me by SAMUEL H. COHICK, the testator '") sl U, (/ rEV ,-:21 day of ~ ' 200~. CJ;;;(f r=~ ~ , this NotarIal Seal . Terry E. Walker, Notary Publio MSo~th Middleton T~p., Cumberland County y Oommlsslon Expires Mar. 31 2003 -" . , eM "~r, P'Anrlsvlvanfa l\s~()Cjati(lnot Notaries I I 6 ~\ t t ,\ - .. \ ~":;1'~~~~~~;r~~~.ry:~~., :_ft _ ."..., ,_i;"~:;;0".~'-::';'''';-:~..~,~-:,-''~" LAST WILL AND TESTAMENT OF SAMUEL H. COHICK AFFIDA VIT COMMONWEAL TH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS. WE, y(~IID/~' &L/~e.r and rlary r1. PV'\iC'ej , the ;r I / witnesses _.~_h~~~u~~mes are atta~~~d to the fore~oing document, being duly qualified according to law, do depose and say that we were present and saw SAMUEL H. COHICK sign and execute the instrument as his Last Will and Testament; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the SAMUEL H. COHICK signed the Last Will and Testament as witnesses and that to the best of our knowledge the SAMUEL H. COHICK was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. ':z4.-IhfC ~--eA) / (/ tz~ it, Q~~ Sworn or affirmed and subscribed before me by ~ fJd '3s:[ 7ft.V' /7'J't.,r R.-^</ this .) day of and , 2001. ~~s. ~AA_ Notarial Seal Terry E. Walker, Notary Public South Middleton Twp., Cumberland County My Commission Expires Mar. 31, 2003 Member. Pennsvlv:,ni8 j~ssbciation of Notaries F:\User Folder\Firm Docs\Wi/ls\1634-lshc.2will.wpd 7 I I - --. - ~:- :". -..:'..... :.~..- ..~. .,", -;"-r, 7_""; .-..:-.. - -41 ~.. \ ~ . ~ FARMERS NATIONAL BANK OF NEWVILLE A Dil'isio1/ o/Ad!';ii; Co Ifil zy Nat!oi!l?l Baili: JUL 1 8 2005 July 14, 2005 Richard L. Webber Jr., Esquire 126 East King Street Shippensburgi FA 17257 RE: Estate of Samuel H. Cohick Date of death June 26, 2005 Dear Mr. Webber: Mr. Cohick owned 11,420 shares of ACN~ Corporation stock in his name alone. The market price as of June 26 was $23.20. Sincerely yours, ~~ Executive Vice President l~ c), ~2.o~.c I FA 17241: (717) 776.5312 .~ ~, \ "\ 11 ~ FARMERS NATIONAL BANK OF NEWVILLE /1 DiuiJioii ofActrn?il C~'iit;'f)' Nf1.flO';!lil3(!;,!? July 14, 2005 Richard L. Webber Jr., Esquire 126 East King Street Shippensburg, PA 17257 RE: Estate of Samuel H. Cohick Date of death June 26, 2005 Dear Mr., Webber: Mr. Cohick had the following accounts with this bank, all of which were in his name alone: Checking account #220132 opeh~d::12/28/83 with a balance of $15,220.45 and accrued interest of $5.68. Savings account 11964"3222opened 11/29/83 with a balance of $990.78 and accrued interest of $1.43. Certificates of deposit: 113990608 dated 7/9/99 for $50,000.00 with accrued interest of $383.20 113990609 dated 7/9/99 for $50,000.00 with accrued interest of #383.20 #3990916 dated 8/29/00 for $7,.000.00 with accrued interest of $10.07 #3990965 dated 10/5/00 for $10,000.00 with accrued interest of $43.27 #4990181 dated 5/21/98 for $16,000.00 with accrued interest of $28.39 114990470 dated 2/',8/99 for $3,500.00 with accrued interest of $32.78" #4990679 dated 9/13/99 for $21,000.00 with accrued interest of $12.48 #4990835 dated 5/3/00 for $3,000.00 with accrued interest of $9.05 #5990143 dated 4/23/98 for $3,000.00 with accrued interest of $13.64 #5990502 dated 2/20/99 for $4,000.00 with accrued interest of $31.40 #5990527 dated 3/27/99 for $2~000.00 with accrued interest of $11.36 #3990849 dated 5/24/00 for $7,056.45 with accrued interest of $18.08 - this is a burial fund. Mr. Cohick's name was also on the following accounts of Robert H. Cohick: Certificates - #4990833 dated 5/3/00 for $4,800.00 lrith accrued interest of $14.48 $4990834 dated 5/3/00 for $3,800~00 with accrued interest of $11.46 #5990703 dated 10/12/99 for $4,000.00 with accrued interest of $22.94 #3990676 dated 9/6/99 for $7,000.00 with accrued interest of $99.19; and checking account #185868 in the names of Robert H. Cohick, Samuel H. Cohick; Hope E. Glesner or Samuel J. Glesner opened 1/4/99 with a balance of $18,770.12 and accrued interest of $5.50. ~:~;~~/ ~fL, / Executive Vice President PO. Box 156, Pi-\. 17241 () cn.7) 776-5312 1 , -\ . ~ FARMERS NATIONAL BANK OF NEWVILLE A Dit'isioi! oIid1iiil5 G!!!iit]' !\'1!iui/a! B,mJ< August 8, 2005 Richard L. Webber Jr.~ Esquire 126 East King Street Shippensburg, PA 17257 ~UG 9 10nS RE: Estate of Samuel H. Cohick Dear Mr. Webber: The four certificates of deposit of Robert H. Cohick in this bank are registered Robert H. COhick or Samuel H. Cohick and the checking account is Robert H. Cohick or Samuel H. Cohick or Hope E. Glesner or Samuel J. Glesner. Sincerely yours, /~~lAAf~k .:;;IH Carolyn H. Kough Executive Vice President t~ t-:}. Ec>'.5( ~/'(~4 I ':) -1') 7)