HomeMy WebLinkAbout04-04-06
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1500
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FILE NUMBER
2 1 - 0
INHERITANCE TAX RETURN
RESIDENT DECEDENT
6
- 0
043
SOLN'" CDCE
YEAR NUMBER
DECEDENT'S NAME (LAST FIRST AND MIDDLE INITIAL)
Hockenberr Leabelle M.
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
12/15/2005 7/24/1929
i.IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST. AND MIDDLE INITIAL)
SOCiAL SECURITY NUMBER
- 22
- 0575
207
, THIS RETURN MUST BE FILED IN DUPLICATE WITH TH;
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[Xl 1. anginal Return
o 4. Limited Estate
[Xl 6. Decedent Died Testate IAttach CODY of Will)
o 9. litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise Idale of death after '2-' 2-B2
o 7. Decedent Maintained a living Trust IAttacn copy ofTruSll
o 10. Spousal Poverty Credit :date ofdeatn between 12.31-91 ano '.1-95
o 3. Remainder Return ,date of dea\!) pnor:c '2.13-821
[] 5. Federal Estate Tax Return ReqUired
JL 8. Total Number of Safe Deposit Boxes
[] 11. Election to tax under Sec. 9113(A) Attach Son 01
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NAME
FIRM NAME (If Appltcable)
Bradle L. Griffie
TELEPHONE NUMBER
1".../
(1) .00 OFFICIAL USE ONLY
(2) .00
(3) 00
(4) .00
(5) 80,555.56
(6) 23,521.80
(7) 168,282.11
(8) 272,359.47
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (Iotal Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent. Mortgage Liabilities, & liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
fi,417 11
.00
(11) 6,437.33
(12) 2 6 5 , 9 2 2 . 1 4
:13) .00
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)
(14) 265,922. 1 4
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate. or transfers under Sec. 9116 (a)(1.2)
x.O_ (15)
x.o 45 (16) 11,437.26
x 12 (17)
x .15 118) 1,764.14
,19\ 13,201.40
16. Amount of Line 14 taxable at lineal rate
254,161.24
17. ,t.,rnount of line 14 taxable at sibling rate
18. Amount of lme 14 taxable at collateral rate
11,760.90
19. Tax Due
20~
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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ecedent's Complete Address:
,TREET ADDRESS
80 Stone Church R d
JTY
ax Payments and Credits:
Tax Due (Page 1 Line 19)
Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) 13,201.40
.00
17,000.00
660.07
Total Credits ( A + 6 + C ) (2) 1 7 , 6 6 0 . 0 7
i.
InterestlPenalty if applicable
D. Interest
E. Penalty
0%
.00
4.
TotallnterestlPenalty ( D + E )
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
.00
A. Enter the interest on the tax due.
(3)
(4)
(5)
(SA)
(56)
: REGISTER OF WILLS, AGENT
5.
If Line 1 + line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
B. Enter the total of line 5 + SA. This is the BALANCE DUE.
4,458 67
.00
.00
.00
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F 41 ~l b' 0 ~c-v cI
8 ( D I (f1)~
IS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Yes
.....................................................................................0
transferred or its income; ............................................ 0
....................................................................................U
or care? ...................................................................... 0
'ansfer property within one year of death
....................................................................................0
ank account or security at his or her death? .............. 0
y, or other non-probate property which
.................................................,.................................. [J
'J MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN.
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IF THE ANS
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md statements. and to the best of my knowledge and belief. it IS true. correct ar~ complete.
H has any knowledge
Linda Fisher
DATE
3-3/-0&
B
DATE
to
REV-l50B EX + (1-971 ~
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-06-0043
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Leabelle M. Hockenberry
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
NUMBER
1.
DESCRIPTION
2.
M & T
Checking Account # 712671
(statement attached)
M & T Bank
Savings Account # 01500420090335
(statement attached)
MFS Investment Management Account
Account # 0215-00090083526
(Statement attached)
2005 Federal Income Tax Refund
VALUE AT DATE
OF DEATH
5,598.51
30,671.45
43,810.60
475.00
3.
4.
TOTAL (Also enter on line 5, Recapitulation) $ 80, 555 . 56
(If more space is needed, insert additional sheets of the same size)
RE'it-15D9 f.X + (1-97)
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSl LVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
Leabelle M. Hockenberry
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
21-06-0043
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Linda F. Fisher
80 stone Church Road
Carlisle, PA 17013
Daughter
B.
Marlin R. Fisher
80 stone Church Road
Carlisle, PA 17013
Son-in-law
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY 0/0 OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A.B 5/03/ 02 M&T Bank
Savings Account #01500419831433~ 70,565.41 33.3_ 23,521.80
(letter attached)
TOTAL (Also enter on line 6, Recapitulation) $ 23,521.80
lit __...... ____..... :.... ___..I........ :_...._..... ......J....:..:...._....I _1.................. _, ..\....... ____ .....:_....,
,REY.1S10EX+ (2.871
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COMMONWEALTH OF PENNSYLYANIA
INHERITANCE TAX RETURN
RfSIDENT DECEDENT
SCHEDULE G
TRANSFERS
PLEASE PRINT OR TYPE
Leabelle M. Hockenberry
FILE NUMBER
21-06-0043
ESTATE OF
THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES.
1. Western-Southern Life
Assurance Company
Annuity Policy #W0020569851
(letter attached)
I TOTAL VALUE 'I
EXCLUSION OF ASSET
66'0aa.at
DECD.
%
INT.
100% I
DOllAR VALUE
OF DECEDENT'S
INTEREST
ITEM I DESCRIPTION OF PROPERTY
NUMBER! Include nome of the transferee, their relationship to decedent, dale of transfer.
66,088.82
2.
Allstate Life Insurance Company
Annuity Policy #GA18439871
(letter attached)
55,051.54
100~ 55,051.54
10J 47,141.75
3.
Allstate Life Insurance Company
Annuity Policy #GA16147668
(letter attached)
47,141.7:
TOT AllAlso enter on line 7, Recapitulation) 51 68 282. 1 1
(If more space is needed, insert additional sheets of same size.)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAY. RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
21-06-0043
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
1.
B.
1.
2.
3.
4.
5.
6.
7.
Leabelle M. Hockenberry
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
Hoffman Roth Funeral Horne
270.30
ADMINISTRA T1VE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Numbe~s) I EIN Number of Personal Representative(s)
Street Address
City
Zip
Slate
Year(s) CommISSion Paid:
A~m~F~ Griffie & Associates
Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant Linda F. Fisher
StreetAddress 80 stone Church Road
City Carlisle
Relationship of Claimant to Decedent D a u q h t e r
2,000.00
3,500.00
Zip 17013
State P A
Probate F~
390.00
Accountanfs Fees
Wagner's Accounting Service
65.00
~ax Retum Preparers Fees
Advertising Costs:
Cumberland Law Journal
The Sentinel
75.00
137.03
TOTAL (Also enter on line 9, Recapitulation) $ 6, 437 . 33
(If more space is needed, insert additional sheets of the same size)
REV-151 ~ EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
Leabelle M. Hockenberry
21-06-0043
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not ListTrustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Linda F. Fisher Daughter 252,751.34
80 stone Church Road
Carlisle, PA 17013
2 Marlin R. Fisher
80 stone Church Road
Carlisle, PA 17013
Son-in-law
11,760.90
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(if more space is needed, insert additional sheets of the same size)
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l1Tctitt Mill &110 Wt,tctttttltt
OF
LEABELLE M. Hocr~NBERRY
I, LEABELLE M. HOCKENBEP~Y, of 952 cavalry street, Carlisle,
Cumberland County, Pennsylvania, being-of sound and disposing
mind, memory and understanding, do make, 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.
FIRST
I order and direct my personal representative hereinafter
named to pay all of my just debts, funeral expenses and expenses
involved or connected with the administration of my estate as
soon after my death as is reasonably possible.
However, my
personal representative need not accelerate and pay
those
unmatured obligations which, in his, her or its' opinion, it might
be proper and more advantageous to retain or renew and pay as
they become due and payable. If I do not own a burial plot or a
grave marker at the time of my death, I authorize my personal
representative, in'his, her or its sole discretion, to purchase a
burial plot and to erect a suitable grave m.arker a~__~y _-~~;f1:X\r'" and
, I , . -,,' , \; )'_f kJ;Jd\ - \J
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to expend sums from my estate for this purpose. -'i'..!\...e'f(; S,\',htt\ CJ
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GRIFFIE & ASSOCIATES '
}J'3ij\~~~s ~j~6~g~~\1
ATTORNEYS-AT-LAW,
200 NORTH HANOVER STREET
- lI,.....,l ,_t r-- 1"""lr:-~n.....IC:Vl ,,^ y..,,:U"f\ 1'""7(")1"':l'
NORTH MAIN STREET
r~""Ml::n=.RC;R' lRr:; PFNNSYLVANIA 17201
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SECOND
I give, devise and bequeath the rest, residue and remainder
of my estate, together with all insurance proceeds thereon of
whatever nature and wheresoever situate to my beloved spouse,
CLYDE D. HOCKENBERRY, providing that she survives me by sixty
(60) days.
THIRD
Should my spouse CLYDE D. HOCKENBERRY predecease me or die
on or before the sixtieth (60) day following my death, then I
give, devise and bequeath the rest, residue and remainder of my
estate together with all insurance proceeds thereon of whatsoever
nature and wheresoever situate to my daughter, LINDA F.
FIS:f,:ER,
provided that she survives me by sixty (60)
days.
Should my
daughter predecease me or die on or before the sixtieth (60th)
day following my death, then I give, devise and bequeath the
rest, residue and remainder of my estate together with all
insurance proceeds thereon of whatsoever nature and wheresoever
situate to my son-in-law, Y~RLIN R. FISHER, provided that he was
married to my daughter, LINDA F. FISHER, at the time of her
death, and also provided he survives me by sixty (60)
days.
FOURTH
I gra~t my personal representative the following powers in
addition to and not in limitation of such powers as my personal
representative shall hold by law:
GRIFFIE & ASSOCIATES
ATtORNEYS AT LAW
200 NOR~H HANOVE:R STRE:E:T
14 NORTH MAIN STREET
SU ITE 307 .
_0....' .r-,.r-r-.rr:JI tnr-:'" D^ "I;?rl1
(a) To retain all property received including the stocJc of
any corporate fiduciary acting hereunder, provided such
property remains productive.
(b)
join
corporation,
partnership,
in
To
any
recapitalization, merger, reorganization or
voting
trust plan; to delegate authority with respect thereto;
to
deposit investments under agreements and
pay
assessments; and generally to exercise all rights of
investors, including but not limited to., the voting of
shares.
(c) To manage, operate, repair, improve, mortgage or lease
on any terms any real estate held or owned by my estate.
(d) To operate any business that I may Dvm at my death.
(e) To invest any funds of my estate in any stocks, bonds,
.notes
or other securities or property, real
or
personal,
without
regard to
the
principle
of
diversification or any other statute or general rule of
law in his, her or its absolute discretion, it being my
intention to give my personal representative the
broadest investment powers possible, providing such
investments do not unnecessarily prevent the prompt
settlement of my estate.
(f) To sell or otherwise dispose of any property, real or
personal, tangible or intangible, at any time forming a
GRIFFIE & ASSOCIA'TE:S
ATTORNEYS AT LAW
200 i~ORTH HANOVER STREET
V. NORTH MAIN STREET
SUITE 307
_.....1I"..........-.:......--r-"lI1T1F"'" O^ 1"'"'1?n1
part of my estate in any manner and on such terms and
conditions as my personal representative shall see fit
in his, her or its absolute discretion.
(g) To borrow money for the payment of taxes or for any
other proper purposes in the administration of my
estate, and to mortgage or pledge estate assets as
security.
(h) To compromise claims without court approval including,
but not limited to, any controversies with the United
states of America or the Commonwealth of Pennsylvania
concerning
estate and inheritance taxes
on
any
interests that may pass under this my Last Will and
Testament.
(i) To distribute in cash or in kind upon any division or
distribution of my estate.
(j) To undertake any and all acts deeThed necessary and
proper by my personal representative for the properr
advantageous and prompt management of the settlement of
my est a te .
(k) In general, to exercise all powers in the management of
my estate which any individual could exercise in the
management of similar property owned in his own right,
upon such terms and conditions as to himr her or it may
seem best and to execute and deliver all instruments
and to do all acts which he, she or it deems necessary
-
or proper to carry out tlie purposes of. .this, my Last
Will and Testament.
GRIFFIS & ASSOCIATES
ATTUnNEYS AT J:.AW
200 NORTH HANDVER STREET
ro1\r">f teT C' 04 "'7n1~
14 NORTH MAIN STREET
SUITE 307
rl-TAMR1=RSBURG. PA 17201
FIFTH
either .1.n
No interest of any beneficiary of my estate,
~nCDme or in principal, shall be subject to anticipation or
pledge/ assignment, sale or transfer in any manner, nor shall any
beneficiary have the power in any manner to charge or encumber
his interest either in income or principal/ nor shall the
interest of any beneficiary be liable or subject in any manner
while in the possession of my personal representative' for the
liability of such beneficiary.
SIXTH
I nominate, constitute and appoint my spouse, CLYDE D.
HOCKENBERRY, as Executrix of this my Last will and Testament. In
the event my spouse is deceased, unable or unwilling to serve or
shall cease to serve for any reason whatsoever, then.I nominate,
constitute and appoint my daughter LINDA F. FISRERas personal
representative of this my Last will and Testament. In the event
that neither my spouse nor my daughter is able to serve, then I
nominate, constitute and appoint .FARMERS TRUST CONPE~Y as
personal
direct
personal
that
representative.
I
my
representative sha.ll not be reguiredto give or post bond for the
faithful performance of his, her or its duties in this or any
other jurisdiction.
SEVENTH
I hereby declare it to be my expressed desire that my
personal representative employ the law firm of Griffie &
Associates, of Carlisle, Pennsylvania, for legal. advice' and'
assistance regarding this rnyLast Will and Testament., they having
GRIFFIE 8: ASSOCIATES
ATTORNEYS AT LAW
200 NORTH HANOVER STREET
14 t-lC>HTH MAIN STREET
SUITE 307
,...., l' 1\ "xlJt::'DcaT lOr:: 'PA '17?01
considerable J~owledge of my affairs, views and wishes respecting
any matters that may arise at the probate of this instrument, the
administration of my estate, and the execution of the powers
herein mentioned.
IN WITNESS WHEREOF, I have hereunto set my hand to this my
Last Will and Testament this (..9 -If; day of ~/)/!tn7/;Gr
19 t]5 .
WITNESS:
tJI ! /J
/;),P d-A) LA.
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III i cJ~~~llL K 0 WV)-b..r
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r;r/~,/- 1$ /~,1 ./kb .PLA'#-CpY~,P'
LEA-BELLE oM. 'Hocl~NBERRyr
GRIFFIE 8~ ASSOCIA'fE:S
ATTORNEYS AT LAW
;>'00 NORTH HANOVER STREET
14 NORTI-l MAIN STREET
SU ITE 307
r--Y_T ^ "'>1qt::'oc:.~11R~ PA 17?n1
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AFFIDAVIT
COMMOID\7EALTH OF PENNSYLVANIA
55
COUNTY OF CUMBERLAND
We f J~I2A j) (! rlLi (
and
01 (C ~eJ! e R. Ca/ I!f~F +;
the witnesses whose names are attached to the foregoing document,
being duly qualified according to law, do depose and say that we
were present and saw LEABELLE M. HOCY~NBEP~Y sign and execute the
instrument as her Last will and Testament; that she signed
willingly and that she executed it as she free and voluntary act
for the purposes therein expressed; that each subscribing witness
in the hearing and sight of LEABELLE M. HOCKENBERRY signed the
Last Will and Testament as witnesses and that to the best of our
]mowledge the LEABELLE M. HOCKENBERRY was at the time 18 or more
years of age, of sound mind and under no constraint or undue
influence.
!I?.z/U a f;a acL/
1M I cJI'L-Jit If, Wtr'~-f-
Sworn or
affirmed
and
subscribed
before
1(~
me.
by
L pn1 rJ.. fA u) I
of /lrJ7l-l>n1IL/;,r
and
fiu; Jf\ ~l\'oc=. (' Jll'H?r1--this
19 S:l5
day
Notarial Seal
Robin J. Goshorn, Notary Public
Carlisle BorD, Cumberlalld County
My Commission Expires April 17, 1999
AT-rORNEYS AT LAW
ZOO NORTH HANOVER STREEY.
14 NORTH MA1N STREET
SU JTE 307
_1-..1 ^J.A'Clt="DCCll1Dr:: PA 1"7?n1
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVAliIA
55
COUNTY OF CUMBERLAND
II LEABELLE M. Hocr~NBERRY, the 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 and Testament; that I
signed it willinglYr and that I signed it as my free and
voluntary act for the purposes therein expressed.
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!Y- +.... . J~/..:.e. ~:/..-7 e! t1E-~~ ~"'....P'~ ~ A... A~
LeabelleM: Hockenberrq
Sworn or affirmed and ac}~owledged before me by Leabelle M.
'Hockenberry the thisX:!:fL day of ,7?rrClr /; ~/
19~.
1I;l /
.L::J...ft-:i,-A--r~
Notarial Seal .
Robin J. Goshorn, Notary Public
Carlisle BOrD, cu~berlan~ County
My Commission Expires Apn117, 1999
GRIFFIE i:'~ ASSOCIATES
ATTORNEYS AT LAW
...,.....,.., l\.lnOTI-4' l-fANOVER STREET
14 NORTH MAIN STREET
SUITE 307
----- -------
-~
m M&rBank
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
January 27, 2006
Griffie & Associates
Attorneys and Counselors at Law
200 North Hanover Street
Carlisle, Pennsylvania 17013
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Dear SIT or Madam. -,...._.~. ::..:.;: -,,1:.""1."; J
Per your inquiry dated January 12,2006, please be advised that at the time of death, the above-named deceoent:.hi:J.('Lpn:.J' l
deposit with this bank the followmg: --.1
Re: Estate of: LeabelZe M Hockenberrv
Social Securitv: 207-22-0575
-Date of Death: December 15. 2005
1.
Type of AccoWlt
Checl.:ing Account
AccoWlt Number
712671
Ownership (Names oj)
LeabelleMHockenberlJ! *
Lindci F Fisher, POA *
(
Opening Date
09/01/67 Closed 01/25/06
Balance on Date of Death
$5,598.13
Accrued Interest
$ 0.38
Total
$5,598.51
Interest Paid YTD
$ 4.52 (Accrued interest is not included)
2.
Type ojAccount
Savings Account
Account Number
015004198314335
Ownership (Names oj)
Linda F Fisher *
Marlin R Fisher *
LeabelZe M Hockenberry *
Opening Date
05/03/02 Closed 01/25/06
Balance on Date a/Death
$70,507.'13
Accrued Interest
. $ 58.28
Total
$70,565.41
Jmcrest Paid YTD
$. 1,182.52 (Accrued interest is not included)
'"
3.
Type of Account
Savings Account
Account Number
015004200903357
Ownership (Names of)
Leabelle M Hockenberry *
Linda F Fishel~ PDA *
Opening Date
08/0]/75 Closed 0]/25/06
Balance on Date of Death
$30,648.17
Accrued Interest
$ 23.28
Total
$30,671.45
Interest Paid 1TD
T--~l45.09 (i~~edi~ter;;tis notincludedJ----
Please be advised, there was no safe deposit box found for the above decedent.
-;, For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call
the High Street Carlisle Office # 717-240-4536.
Sincerel)',
,.1t0//~~
Nancy Clagett
Records Management
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.
~ M&flnvestment Group
March 16, 2006
Griffie & Associates
Attn: Bradley L. Griffie, Esquire
200 North Hanover Street
Carlisle, PA 17013
RE: Leabelle M. Hockenberry
lvlFS Investment Management
Fund/Account Number: ; 0215-00090083526
Dear Mr. Griffie,
I have received your request for information pertaining to this account. Leabelle M.
Hockenberry was the sole owner of this account at the time of her death. As of
December 15, 2005, the account had 2,830.142 shares with a value of$15.48 per share.
The total value oftms account as of December IS', ,2005 was $43,810.60. At the time of
her death, the entire proceeds of this account was available for withdrawal.
If you should have any questions concerning this memorandum, please contact me at
(717) 218-5426.
IL
rly 1. Heavner, CFP
North Middleton Office
1958 Spring Road
Carlisle, P A 17013
M&f Secmities, Inc. · One M&T Plaza · Buffalo, New York 14203-2399
-~ - ---------- --
~~- -~--
'. .
~
Western-Southern Ufe@
01/28/2006
BRADLEY L GRIFFIE
ATTORNEY AT LAW
FBO: LEABELLE HOCKENBERRY
200 NORTH HANOVER 3T
CARLISLE PA 17013
Subject: Annuity Contract W0020569851 Leabelle M. Hockenberry
Western-Southern Life Assurance Company
Dear Mr. Griffie:
Thank you for contacting the Western-Southern Life Assurance Company concerning
the above annuity. I hope the information I provide is helpful.
On the date of death, thi~~~9ntr~~t was valued ;at $69,202.95.
According to contract provisions she was entitled to 10% of the contract value without
penalty. A distribution of!t~ls.contract entire value would have been subject to 5%
penalty. ..~.-.
Mrs. Hockenberry did name a beneficiary on this contract. Her daughter, Linda Fisher
is the named beneficiary. If you could please have her contact our office at the number
listed below so that we may send correspondences to her.
If you have questions, please call our Annuity Operations Department at
1-800-926-1702. A representative will be happy to assist you.
Sincerely,
/" /~ 'l
/Y:j,~\,' /
l/ 1., -\ 'l" >:L.\' /1
: 1\ ! J', \ \
-.' u "~ ""
Cissy L. Smith .
Annuity Administrator
Annuity Operations Department
Member. Western & Southern Financial Group@
Annuity Operations Group. PO Box 2918 . Cincinnati, Ohio · 45201-2918
Phnni> {Rnm fl?fl-17n? . F::lV f.J:,i ~\ h?Q_1700
'. .
Allstate Life Insurance Company
544 Lakeview Parkway
Vemon Hills, IL 60061
Telephone: (877) 499-6418
Facsimile: (866) 635-4523
~ Allstate.
FINANCIAL
January 20, 2006
Bradley 1. Griffie
Griffie & Associates
200 North Hanover Street
Carlisle,PA 17013
Re:
Contract No:
Leabelle Hockenberry
GA16147668
,_. """ -. ~,~, '.
..............,r.......A-'...-~..--~..
Dear Mr. Griffie:
We have been requested to complete IRS Form 712 with regard to the above referenced contract. The
purpose of Form 712 is to provide an estate or donor with the value of a life insurance contract or its
proceeds as of a certain date (usually the owner's date of death or date of transfer ofthe contract).
Tbis contract is an annuity contract, which is not reportable on IRS Form 712. The following information is
provided for estate purposes only as of the date specified:
Date of Death:
Annuity Value* as of Date of Death:
Cost Basis:
Named Beneficiary:
December 15,2005
$ 47,141.75
$ 43,000.00
Linda Fisher
*The actual amount paid may differ due to Market Value Adjustments and/or any applicable Surrender
Charges.
If you have any questions, please contact our Customer Care Unit at 1-877-499-6418.
S:incerely,
~~""-/-CJo-J
Margaret Dow
Sf. Claim Representative
. .
Allstate Life Insurance Company
544 Lakeview Parkway
VemonHills, 11 60061
Telephone: (877) 499~6418
Facsimile: (866) 635-4523
~AlIstate.
FINANCIAL
January 20, 2006
Bradley 1. Griffie
Griffie & Associates
200 North Hanover Street
Carlisle, P A 17013
Re:
Contract No:
Leabelle Hockenberry
GA18439871
Dear Mr. Griffie:
We have been requested to complete IRS Form 712 with regard to the above referenced contract. The
purpose of Form 712 is to provide an estate or donor with the value of a life insurance contract or its
proceeds as of a certain date (usually the owner's date of death or date of transfer ofthe contract).
This contract is an annuity contract, which is not reportable on IRS Form 712. The following information is
provided for estate purposes only as of the date specified:
Date of Death:
Annuity Value* as of Date of Death:
Cost Basis:
Named Beneficiary:
December 15, 2005
$ 55,051.54
$ 0.00
Linda Fisher
*The actual amount paid may differ due to Market Value Adjustments and/or any applicable Surrender
Charges.
If you have any questions, please contact OUT Customer Care Unit at 1-877-499-6418.
Sincerely,
H.~Cv
Margaref Dow
Sr. Claim Representative