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HomeMy WebLinkAbout04-05-06 \ .~ "f .....I 15056051058 REV-1500 EX (06-05) PADeparlment of Revenue '*' Bureau of Individual Taxes PO BOX 28C601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMAnON BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year 21 05 File Number 0908 Date of Birth 176-22-6026 10/0212005 07/14/1926 Decedent's Last Name Suffix Decedent's First Name Genevieve a/k/a Genevieve A. MI R Morgan (If Applicabte) Enter Surviving Spouse's Infonnation Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ... 1. Original Return ,----.... ~---,' 3. Remainder Return (date of dea1h prior to 12-13-82) C:J 48. Future Interest Compromise (date of C') 5. Federal Estate Tax RellA1l Required death after 12-12-82) c::; 7. Decedent Maintained a living Trust (Attach Copy of Trust) 10. Spousa/ Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - ntls SEcnON MUST BE COMPLETED. All CORRESPONDENCE AND CONfIDENTIAl TAX INfORIIATJON SHOULD BE DIRECTED TO: Name Daytime Telephone Number 2. Supplemental Return 4. Umited Estate 6. Decedent Died Testate (Attach Copy of W1R) 9. Utigation Proceeds Received , 8. Total Number of Safe Deposit Boxes ~.,.-:-... Robert R. Black Firm Name (If Applicable) Landis & Black (717) 243-3727 -"1 REGISTER OF WILLS USE ONLY First line of address 36 South Hanover Street Second line of address Oty or Post Office Carlisle State ZIP Code DATE FILED PA 17013 Correspondent's &-mail address: Under penallles of perJ.try. I dedare that I have examined this retum, including accompaI'I)Vlg schedules and 1Ilatsments. and to the best of my knowledge and belief. it islrue, comlCt and complete. DecIaralion d preparer olher than the personal representative ill based on all infonnalion of which preparar has any knowledge. SI RE OF PE RE~lruR~RN JS/O ~ ADDRESS )C 1706 Ne on Ransom Boulevard, Clarks Summit, PA 18411 SIGNA~F,II ~.,. :!n>IHE~ REPRESENTATIVE lJAT9 ~CJ~<- . ,.}I?II'()(., ADDRESS 36 South Hanover Street, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY '- Side 1 L 15056051058 15056051058 --I C/ , , , -I 15056052059 REV-1500 EX Decedenfs Name: Genevieve Decedenfs Social Security Number R Morgan a/k/a Genevieve A. 176-22-6026 RECAPITULATION 1. Real estate (Schedule A). ............ . .. . . . . . .. .. . . . . . . . . .. . . . . . . . . .. 1. 92,628.64 330,510.02 0.00 0.00 2. Stocks and Bonds (Schedule B) .... . . . . . . . . .. . . . . . .. . . . . . . .. . . .. .. . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . .. . . . . . .. .. . .. . . . . . . . ... 4. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 317,382.70 0.00 119,022.76 859,544.12 57,985.28 1,159.46 59,144.74 800,399.38 0.00 800,399.38 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly OWned Property (Schedule F) c--=> Separate Billing Requested . . . . . .. 6. 7. Inter-VIVos Transfers & Miscellaneous Non-Probate Property (Schedule G) ::::::, Separate Billing Requested... . . ... 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)................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) .. . . . . . . . . . . . . . . . . . . .. . . . . . . . . 12. 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. _____..,._~__,,___~___...__._._..___~_.__.._..,__.~~<_._.'~_'~__'H_'C_~'_,.W"~_."'_'_"'_~_'_'..,.,___..w~._._~_'~".'_ __"~'~._~~'~'.'.__'_ ._"'~;,,__. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 15. 16. Amount of Line 14 taxable at lineal rate X.O _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 800,399.38 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 120,059.91 120,059.91 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 15056052059 ......I REV-1500 lx Page 3 ,File N"mbeI" Decedent's Complete Address: 21 Ii 05 10908 DECEDENT'S NAME a/k/a Genevieve A. OECEOENrS SOCIAl. SECURIlY NUMBER Genevieve R Morgan 176-22-6026 - STREET ADDRESS 555 W. Penn Street CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Une 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 120,059.91 0.00 93,000.00 4,894.59 Total Credits (A + B + C ) (2) 97,894.59 3. InteresWenalty if applicable D. Interest E. Penalty TotaIlnterestJPenalty ( 0 + E ) (3) 4. If Une 2 is greater than Une 1 + Line 3, enter the di1fenlnce. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Una 1 + line 3 is greater than Une 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 22,165.32 B. Enter the total of Une 5 + SA. This is the BAlANCE DUE. (5) (SA) (58) 22,165.32 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "Xn IN THE APPROPRIATE BLOCKS 1. Did decedent make 8 transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... 0 ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 ~ c. retain a reversionary interest; or.......................................................................................................................... 0 Eia d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 ~ 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 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPlETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 three (3) percent [72 P.S. S9116 (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 zero (O) percent [72 P.S. ~9116 (a) (1.1) (ii)}. The statute does not exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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 zero (0) pettent [72 P.S. 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 four and one-half (4.5) percent, except as noted in 72 P.S. S9116(1.2) [72 P.S. S9116(a}(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)). A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. RE~:\1502 EX+ (6-98) SCHEDULE A REAL ESTATE , \ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Genevieve R. Morgan alkJa Genevieve A. FILE NUMBER 21-05-0908 All real property owned solely or.. I '-nant In common must be reported at fair martet value. Fair Itl8l'ket value is defined as the pOOe al which property would be exchanged between a willing buyer and a willing seier. neither being compelled 10 buy or seI, bolh having reasonable ~e of the relevant facts. Rell property which Is JoIntIy-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VAlUE AT DATE OF DEATH 1. Residence & lot of ground at 555 W. Penn Street, Carlisle, PA. See Deed Book L. Volume H., Page 526. Reported at net sales price at public sale. See attached HUD. 92.628.64 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 92,628.64 REV~~503 EX+ (6--98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Genevieve R. Morgan aIkIa Genevieve A. All property Jointly-owned with right of survivorship must be di&dosed on Schedule F. FILE NUMBER 21-05-0908 ITEM NUMBER 1. 2. DESCRIPTION 1880 Shares of the common stock of Carlisle Companies (CSl) at $63.61 (mean value) per share 444 Shares of the common stock of Tyco Intemational (TYC) at $27.80 (mean value) per share 123 Shares of the common stock of Sovereign Bancorp (SOV) at $21.90 (mean value) per share VALUE AT DATE OF DEATH 119,586.80 3. 12,343.20 2.693.70 4. 3917.449 Shares Delaware American Government Bond A Class (DEGGX) at $7.61 (mean value) per share 29,811.79 5. 9610.684 Shares of Van Kamper US Mortgage Fund Class A (VKMGX) at $13.73 (mean value) per share 131.954.69 6. 48 Shares of the common stock of Met Ute at $49.83 per share 2.391.84 7. 3 U.S. Savings Bonds, Series EE, 10,000.00 each, Ser. No. X2233557, X2233558 & X2233559, issue date 10/1992 for all. See attached calculations. 31.728.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 330,510.02 , \ REV.~508 EX+ (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Genevieve R. Morgan alkla Genevieve A. Indude the proceeds of litigation and the date the proceeds were received by the estate. All property Jolntly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21-05-0908 ITEM NUMBER DESCRIPTION 1. M & T Bank - Checking Account #1195956. See attached letter. 2. M & T Bank - Savings Account #015004202072390. See attached letter 3. Sovereign Bank - Checking Account #1671005732. See attached letter. " " II 4. Sovereign Bank - Money Market #1671014804 5. Sovereign Bank - Certificte of Deposit #1675533440. See attached letter. 6. American Home Bank - Certificate of Deposit #290001447. See attached letter. 7. American Home Bank - Certificate of Deposit #290001527. See attached letter. 8. American Home Bank - Certificate ofDeposit#290001645. See attached letter. 9. American Home Bank - Certificate of Deposit #290001789. See attached letter. 10. Wachovia - Certificate of Deposit #247402112136908. See attached letter. 11. Wachovia - Certificate of Deposit #247402112137615. See attached letter. 12. Wachovia - Checking Account #1010083586909. See attached letter. 13. Proceeds - sale of 1997 Pontiac automobile - VIN 1GZWP12K8VF21063 14. Rowe's Auction Service - Net proceeds 15. Penn National Ins. Co. - Insurance refund 16. Sprint - Refund VALUE AT DATE OF DEATH 2.316,93 18.701,93 123.106.00 45,845.84 30.618.13 5.119.78 5,099.49 10.162.97 10.115,63 10,181.26 10,161.95 33,905.43 5.100.00 6.787.00 158.00 2.36 TOTAL (Also enter on line 5. Recapitulation) $ (If more space is needed. Insert additional sheets of the same size) 317,382.70 REV1l510 EX+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY , , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ALE NUMBER Genevieve R. Morgan aJkJa Genevieve A. 21-05-0908 This schedule must be completed and filed if the answer to any of questions 1 through" on the rewrse side of the REV-1500 COVER SHEET is yes. =J DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECO'S EXClUSION TAXABlE tIClUllE ll1E !WE Of ll1E 'IRANSFEREf. no AEl.A1IONSHI' TO IESlENT 1M) ll1E DIiIE Of 1RIlNSFER. illTACIl A fXX'Y Of TtE DEED ~ RfAI. ESTATE. VALUE Of ASSET INTEREST nF N'I'l..lCAIU) VALUE 1. Annuity - AIG Annuity Insurance Company - Poficy No. FJ243145. See attached Transaction Statement 107.644.54 2. IRA - Wachovia Bank - Account No. 257400090712318. See attached statement at Schedule E. 11.378.22 TOTAl (Also enter on line 7 Recapitulation) $ 119,022.76 (If more space is needed, insert additional sheets of the same size) .. REV-1S11 EX+ (12-99>. COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Genevieve R. Morgan alkIa Genevieve A. Debts of decedent must be reported on Schedule I. ALE NUUBER 21..Q5-0908 ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Hoffman-Roth Funeral Home - Services Carlisle Memorial SeMce - Marker 8,852.50 970.00 1.010.14 111.05 2. 3. Carlisle County Club - Funeral Luncheon 4. Hoffman-Roth Funeral Home - Additional Services B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representalive(s) Holly E. Hans Social Security Number(s)/EIN Number of Personal Representative(s) 200-50-2041 StreetAddress 1706 Newton Ransom Boulevard city Clarks Summit . Stale PA Zip 18411 Year(s) Commission Paid: 2006 23,190.00 2. AIIomey Fees 17,392.00 3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation) Claimant None 0.00 Street Address City Slale . Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Wolfe & Shearer - Real Estate Appraisal 8. UGI - Invoice for utilities 9. UGI - Invoice for utilities 10. UGI - Invoice for utilities 11. PPL - Invoice for utilities 12. PPL - Invoice for utilities 412.51 800.00 250.00 96.77 49.17 52.30 15.88 6.72 SUB- TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 53,209.04 (,continued) , , SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS (Continued) ESTATE OF FILE NUMBER Genevieve R. Morgan a/kJa Genevieve A. 21-05-0908 Sub-Total (Page 1) $53,209.04 13. Sprint - Invoice for services 27.11 14. Federal income tax estate paid on Final 1040 for 2005 4,182.00 on Series EE savings bond income which had accrued prior to the death of the decedent. Executrix elected to include such accrued income on decedent's final life- time return under IRS Section 454. See Estate of Stewart and Kramer (O.C.Div., Phila.) 21 Fiduc. Rep. 2nd 199. Interest as per bond inventory attached at Schedule B, $16,728.00 x 2005 tax bracket rate .25 = 4,182.00 15. Holly E. Hans - Executrix expenses for gas & hotel 444.13 16. Holly E. Hans - Executrix expenses for mileage 123.00 TOTAL $57,985.28 " REy..1~12 EX+ (12.03) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RE8IDEHT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABIUnES, & UENS ESTATE OF ALE NUMBER Genevieve R. Morgan aIkIa Genevieve A. 21-05-0908 Report cIebts IIICUmId by the cIec:edent prior to death which remained unpaid as of the date of death. including unreimbursed medical expenses. ITEM VAlUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Penn National Insurance Co. - Invoice for insurance 70.00 2. Green's Painting - Invoice for painting house 771.35 3. Borough of Carlisle - Invoice for water/sewer 55.71 4. Baltlett Tree Experts - Invoice for tree service 243.60 5. Geisinger - Invoice - Services 18.80 TOTAl (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1.159.46 . , REV.1~13 EX+ (9-00) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Genevieve R. Morgan alkla Genevieve A. FILE NUMBER 21-05-0908 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee(s) OF ESTATE I TAXABlE DISTRIBUTIONS pndude outright spousal distributions. and transfers under See. 9116 (a) (1.2)] 1. Florence Keys - See attached Niece 5% 2. James H. Rydzewski - See attached Nephew 5% 3. Lorraine Buono - See attached Niece 5% 4. Dr. Dean OePerro -See attached Nephew 5% 5. Edward Wesolowski - See attached Nephew 5:t 6. Holly E. Hans - See attached Niece 75% ENTER OOLLARAMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE, ON REV-1500 COVER SHEET n NON- TAXABlE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAl DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 (If more space is needed. insert additional sheets of the same size) . , GENEVlVE MORGAN'S LIST OF HEIR'S 1) Florence Keyes RR#1 Box 384 Falls, PA 18615 SS# 168-30-8268 Phone # 570-388-2564 2) James H. Rydzewski P.O. Box 411 42 State Street Oxford, N.Y. 13830 SS# 083-36-7524 Phone# 607-843-9332 3) Lorraine Buono 40 Rochelle Road Binghamton, NY 13901 SS# 074-24-1106 4) Dr. Dean DePerro 503 Overlook Drive Kent, OR 44240 SS# 277-56-4064 Phone# 330-346-0700 5) Edward Wesolowski 681 Charles Street Torrington, CT 06790 SS# 049-36-7936 Phone# 860-489-0892 6) Holly Hans 1706 Newton Ransom Blvd Clarks Summit, P A 18411 SS# 200-50-2041 Phone# 570-586-3708 . . LAST WILL AND TESTAMENT OF GENEVIEVE R. MORGAN I, GENEVIEVE R MORGAN> of the Borough of Carlisle> Cumberland County, Pennsylvania, declare this to be my Last Will> hereby revoking all prior wills and codicils. FUNERAL EXPENSES FIRST: I direct the payment of my funeral expenses> including my gravemarker, as soon as may be convenient after my death. PAYMENT OF DEATH TAXES SECOND: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of administration of my estate. DISTRIBUTION OF PERSONAL PROPERTY THIRD: I bequeath those articles of my household furnishings> personal effects and personal property as set forth in a separate memorandum which I intend to sign and keep with my copy of this Will, to the persons named in that memorandum. DISTRIBUTION OF RESIDUE FOURTH: I give the rest of my estate to the hereinafter named persons who survive me for a period of thirty (30) days, as follows: A To Holly Hans> my niece, Seventy-five (75%) percent. B. To James H. Rydzewski, my nephew> Five (5%) percent. C. To Florence R. Keyes, my niece> Five (5%) percent. D. To Lorraine E. Buono> my niece, Five (5%) percent. r-. AN) . OuOa! ' 1D1 s . . E. To Edward A. Wesolowski, my nephew, Five (5%) percent. F. To Dean J. DePerro, Sr., my nephew, Five (5%) percent. If any beneficiary shall not survive me, their share shall be added to the residue and distnouted in accordance with this paragraph. POWERS OF EXECUTOR J4'DPl'H: I confer upon my executor the right to sell or otherwise convert any real or personal property at public or private sale, at such time or times, in such manner, and for such price or prices, and on such terms and conditions as my executor shall determine, and to execute and deliver good and sufficient conveyances, assignments and transfers of the property, without liability of any purchaser for the application of any consideration; to borrow money and to secure its payment by mortgage of real or personal property, pledge of investments, or otherwise, without liability on the part of the lenders to see to the application thereof; to retain any investments at discretion; to invest and reinvest at discretion, without restriction to so-called "legal investments"; to make distribution in cash or in kind; to allocate and distribute different kinds or disproportionate shares of property or undivided interests in property among beneficiaries, in cash or in kind, or partly in each; and to do all other acts and things necessary or appropriate in the management, administration and distribution of my estate. APPOINTMENT OF EXECUTOR SIXTH: I appoint Holly E. Hans, Executrix of my Will. WAIVER OF BOND SEVENTH: I direct that no fiduciary hereunder shall be required to furnish bond in any jurisdiction, and ifany bond is necessary, no surety shall be required. INTERCHANGEABILITY OF LANGUAGE EIGHTH: Words used in the singular may be read to include the plural or the plural may be read as the singular. Similarly, the masculine form may be read to include the feminine and neuter; the feminine may be read to include the masculine and neuter; and the neuter may be read to include the masculine and feminine. ~~ HEADINGS NINTH: The headings used on the various paragraphs of this will are included for convenience only and shall have no legal significance. I bave signed this will tbis ZCo"fit day of XPrEJHM-R .2005. i~.. ~~4-- / Genevieve R. Morg ~~ Witness JJ~-&. ACKNOWLEDGMENT and AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) We, Genevieve R. Morgan, the Testatrix in and the undersigned witnesses to the will, tbe attached or foregoing instrument, who have signed the instrument, having been qualified according to law do depose and say: (a) that I, the Testatrix, do hereby acknowledge that I signed the instrument as my will, that I signed it willingly and as my free and voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the Testatrix sign and execute the instrument as her will, that she signed it willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as a witness and that to the best of our knowledge the .. , Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. ~~:... !('&? tA~ t G' R.M v eneVleve organ ~ Witness ~.. ~fLl~ 1 ess , d~F d~--- Notary Public COMMONWEALTH 01' PENNSYLVANIA Notarial Seal Angela F. Unger. Notary Public OrrstoWf! J;loro. Franklin County My CommISSIon Expires Oct. 7. 2008 Member. Pennsylvania Association of Notalie!; \.-1 REV-485 EX (05-04) ~- SAFE DEPOSIT ~ BOX INVENTORY PA DepaItment ci Revenue Social 8ecUrIty or Death Certificate Number Date of Death . 48S00041046 ( '1 fp 1,1, ~ 0 -z.. '" Decedent's Last Name tN\O(<~PrrJ {Ooz-z,oo~ Suffix pLEASE USE ORIGINAL FORM ONLY County Code Year File Number -z. f 6 !.-; Fltst Name Ml G-tENf2Vl ~Ve R STATE: ZIP CoDE: -; STATE: ZIP CODE: r~WJ b. NAME: RElATIONSHIP: CITY: STATE: ZIP CODE: STREET ADDRESS: RElAllONSHIP: Co NAME; STATE: ZIP CODE: ZIP CODE: b. NAME; STREET ADDRESS: ZIP CODE: CITY: STATE: ZIP CODE: WAS A WILL IN THE BOX? IifI.. YES 0 NO yes. a. Dale of wID. b. Name and address of personal representative, if named In tile wHI NAME; STREET ADDRESS: CITY: STATE: ZIP CODE: c. Name and ~ of attorney. if any NAME: f<{jfJJ€f<1 f<. t?utLf< STREET . ~. kf1hJo\JC,e.. S1" c41t'<Ll 5 Le I ZIP CODE: L 4aS0004104b 48S00041046 ---1 341.0 ~~ ~1-lt:4" ~ It" ~ -+ ~ l-l \' "" -... co ~ 0' ~ '> ~ ~ s: '::' ~ ....... s: -\ ~-~ g ~ 'S:~ ~ ~ ~ ~ ~ ~ \.f' i:~ \:t ~ -& \s::>: VlU\ ~ ~ ~ ~ -s ~ Q ~ ~ ~ s:~ l'\. ~ ~~~t:::-~~ ~~rS?-~F=:.-:::: ~.~~ ~ ~~ ~~f.IS~ ~l~ 'S; So r s:- \j) "$ ~ :s; r::: V\ '" ~\ , ~ ~ :l ~ ~ <. ~ \1\ M ~"2 \\ ~ z:.. fA 0: ~ ~ ~ \.A ~r~~ ,.l~ ~I~~ r.. ~ t::: ~- ~~ ~ ~-~ ~r~ s: s: '> '!.: s ~ - - ~ s- so ,~ eel) ~~ ~~ it! 'i'. \ ~ ~ ~ g (\\ ~ '^ ~ ~~\ "'f--..r ~ ~;~ --N~ ~~ '-.i\ \J\ ~~ t'\ {\\ ~ l\\ ~ ~ ~ s:; ~ ~ \ ~ m 8 :l: 01. ~ roo :n ~i iQ ~m ~o;'~ J~~~ "tI"'i 00 )> -non __ ;:JJ"tI ::l.....m~ ~ ~z c2 z~ 3 ~~ -- ,.. ~ )> -J-.. ~ ~ 1 \J'l ~ ~ l!!. ~ OJ \1\ % ~ ~ ~ i III ~ C> :::::::-- :s ~ ...t.'\ ~ ~ ~ ~ <:: S W\ ~ ~j::) ~l "'Q"> l: = ~ :n ~ ~ ~ 'Oi .0 S t !l 10 ;cR I'" ...' 01 ~z G . W -n m -t 00- rm ",0 ~ 9 ~GJ m ~ f:.e~C -n CDiOCD lP moc m -n ~ i :n:n z ~ ~ ~~ ~ - ~~ ~ ' ~~ :JI ~ ~ ~I S ~ ..- hl'\ ~ ~~ ~ :J: i~ ~ ~i \ ~. ~ ~ "> ~ ~ ~ ;;::; ~ ~ ;.;: RE'NasEX SAFE DEPOSIT BOX INVENTORY Page INSTRUCTIONS of (1) (2) (3) (4) (5) (6) (7) (8) (9) ITEM NO. I" Cash: Report total only. Stocks: List in detail every common or preferred certificate. warrant or other rights found in box. Stocks are to be designated by name of company. certificate number. date of certificate. name in which stock is registered. and number of shares and class of stock. Obligations of U.S. Government: Number of items. date of issue, face value, names in which registered and type of ownership. i.e., joinUy held. payable on death. etc. Bonds: Designate by name. amount, serial number. or other designation. (Bearer Bonds) Bank and Savings and Loan Passbooks: State name of depositor. number of book. last date appearing in book. name of bank and branch, and balance. Jewelry, Coins, stamPS. Manuscripts. ate: Ust and desaibe as fully as possible. Deeds. Mortgages. Current Insurance Policies Of" other evidences of indebtedness: Ust and desaibe as fuRy as possible. All other contents. Return completed fonn to: DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 ITEM DESCRIPTION , ~(liG~ 'It". ,..,{)~lilJJ{ ;)z. DATE I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS CORRECT AND TO THE BEST OF MY KNOWLEDGE AND BELIEF. SlGNATlJRE i1 ExecuIor(1rix) 0 AdmInislraIor(t) o Estate R__dllIi... 0 JolnIOMllll'ofsafe deposit box NOTE: Attach additional 81/,. x 11. sheet(s) if necessary or use duplicates of this page of tonn. The. Deparlment is ~ by law. 42 U.S.C. S405 (c)(2)(C)(I), 10 require dlscIosure of Soda! SecurIy I1UIl'lbefs in 00.,,-..... wiIh adI.iuiste.ing ~ lax IBws. The Department uses !he Social SeaJrily number to idenlIy the decedent and personaIIIlpMS8ntalives of the eslate. The Q"...IUi1lIJeaIIh may also use the i............ in ~ of laX Llb..laIio.. agreements wiIh Federal and local . authories. The sIaIe law prohtils the COl\1I'lIDoMeaIh'S personnel from cIsdosing conIidentiaIlaX ilol...a&.n, except... olIiciaI \ A. Settlement Statement U.s. Department of Housing and Urban Development * ,r OMS No. 2502-0265 (Page II B. Ty\"! of Loan I. FHA 2. FmHA 4. V A 5. Cony. Ins. e. Note: 'RlI_ .._...,.._._.r~_ ___ "- ,........,....__-- _....."fp&o.J'.........._......... __.........for ---........-..... , I). NilmcandAddressof8om>wer E. Address. and Taxpeyer idenlifJCalion flofSeller ' F. Name and Address of Lender Lmry D. and Sandra L. Lebo oily E. Hans. Executrix of the Eslale N1A 1106 Newville Road enevieve R. Morgan, alkJa Genevieve A. Carlisle. PA 17013 organ , J. Conv. Unins. 6. FileNumb<r 7. Lo.n Number 8. Mortgage IJlSlQlInCe Case Number G. Pmpcny U>cation 555 West Penn Street Carlisle. PA 170B 120. Gross Amount Due From Borrower H. Settlenalt Agent Name. Address and Taxpayer klcntilication Number Dale F. Shughart. Jr.. Esq.- 35 East High Street, Suite 203 Carlisle, PA 17013 25-180-2515 PIlIcc ofSealemenl I. Sel1loInent Dale 35 East High SIJ'ed. Carlisle, PA 1211912005 K. Summary of Seller's Transaction 400. GrOSl Amount Due To SeDer 98.000.00 401. Contract sales price 98.000.00 402. Personal Property 1.674.00 403. 404. 405. . . Adjustments for items paid by seDer in adYaDce 12.84 406. CityttDwntaxes .. iVI9iOs tol2n1105 12.84 407. County taxes to 408. Assessments to 528.16 409. School Tax 12119/05 to 06130106 528.16 410. Garbage Fee 411. 412. 100,215.00 410. Gross Amouat Due To Seller 98,541.00 J. Summa". or Borrower's Transactions 100. Gross Amount Due From Borrower 1111. C l"llltrnct sales price 1ll2. Personal Property I (I.~. Settlement charges to borrower (line 1400) 104. 105. AdJustmeuts for Items paid by seDer in ad ee 106. Cityitown taxes 12119105 to 1213 105 lln. Cl\Unty taxes to I OS. Assessments 109. School Tal. II O. Garbage Fee III. 112. lOCI. Amonnts Paid By Or in Behalf or Bo 20 I. Deposits or earnest money 202. Principal arnoum of new Ioan(s) 203. Existing 100n(5) lllken subject to 204. 205. 2tlb. 207. 21111. 2n<l. Adjustments for items unpaid by seUer 210. City/town lB.'tes to 211. County taxes to 212. Assessments to 21J. SchoolTax to 214. 215. 216. 217. 218. 219. 9.800.00 5,912..36 110. Total Paid BylFor Borrower 9,800.00 510. Total Redactioll Amount Due Seller 15,712.36 300. Casb At Settlemeut FromITo Borrow~r 600. CIISh At Settlemeat TalFrom SeDer 301. Gross Amount due from borrower (line 12 ) 100,215.00 6O\. GToss Ainount due to seller (line 420) 98.541.00 302. Less amounts paid by/foe- borrower (line 0) 9,800.00 602- Less reductions in am!. due Seller (line 520) 15.712.36) 303. Casb X From ToBo S 90,415.00 6l.8. Cub X To From Seller S 82.828.64 I h:n. ,_rul~' ""......"" '...IfUD-1 s.u_ ~ 10"'''''' 0I'ff1'/ Imowlodp..... belief. iI is a '""'..... __ _ 01'011 m:eipos_.!>4- ......,..m ,.. ~ '"" in Ibis _1iOD. I funherconify 1haI1.... 1<I:<i..... campleled _ 01'_ I and 2 oI'dlis 1f\.ID-1 _ S_ Borrower Larry D. Lebo ~ I,. ~ ~ Borrower Sandra L Lebo_~ SElTLEMENT AGENT CERn AnON ~~ID- /-;;;~; [~I~~~=:'~ rmead .........I(IF~tJ . -A:.. ... 011 my Seller Holly E. Hans, ExecUlrix of Eslate of Genevieve R. Morgan Seller lit 'p. 1 )-91 Seller's T."Pll~ IdeulIIleat\Ga Namber Solldlatloa aad CertilkatJoa =m:=.....,~..- ._~--->!'W=~--;: ~..J:1....:c~_~_~<OI\"l'I7~.1 . _...-=.-=- ..n-iWs-___IS..,.CCII'I'Ut.....,u~ ......,.. ~~-fk' /1 ~ i 2-~7 /os- RESPA. HB 4305_2 . . ~ .ement Chllrges TotRl SaleslBrokrr's Commission based S Di,i~i(ln ofCommissiOll (line 700) as fal Jill. $ 7112. S 703. Commission paid at Settlement 704. 800. Items hyable in COIll\cdIon Wkb '--0 IlOI. loon Origination Fee 0/0 lUll. lllan Discount % 1I113. Appraisal Fee to ll(M. Credit Report to 805. lender's Inspection Fee 10 806. Mortgage Insurance Application fee to 807. As..<umption Fee 80S. Flood Certification Fee to: 809. 810. 811. 900. Items Required By Leader To Be Paid 1 Advance 901. Interest from to @S 902. Mortgage Insurance Premium for 'X13. Hazard Insurance Premium for lJO.1. 9\15. @ .""= Paid Fmm _'s FlUlds II SettJemmt Page 1 Paid From SeUer's Funds at Settlement 4,900.00 lday months to years to 1000. Reserves Deposited With Leader \01\1. HllZO.ud Insurance sO $ per 11102. Mortgage Insurance s 0 $ per 1003. City property taxes s @ S per I 004. County property Illxes s 0 $ per 1U05. Annual assessments S @ S per 100b. School T8lIes 80 $ per 1007. sO S per lOOS. A te Reserve A . 1100. Tide Charges II 0 I . Settlement or dosing fee to 1101. Abstroct or title sean:h to 1103. Title examination to 1104. Title insunmce binder 10 1105. Documenl preparation 10 1106. NOOIty's fees 10 . 1107. AltOmey's fee,; to Dale F. Shughart/lr. (includes above items numbers: II OS. Tith: insurance to (includes above items numbers: 11119 . lenders coverage S 1I11l. (h'-nef' s coverage S I1II . Recorder of Deeds. photocopies II t2. 1113. 1200. Government Recording and Transfer baraes 120 I. Recording fees: Deed S 3 50; Mortgage S ; Releases S 1202. City/county I8XIStlImps: Deed S 980.00 ; Mortgage S 1203. State taxlsttlmps: Deed S ; Mortgage S 120-1. 12\15. 1.300. Additional Settlement Cba I 311 I. Surv<:y I,,: BII!. Pest Insp.'''Rln w: B1I3. IWrough of Carlisle. sewer llIllI wale.- Acct 1# 2 8O-A 1J(\4. 1305. 1306. 1307. 130&. 130'1. 1400. Total Settleatellt C 650.00 ) 5.50 38.50 980.00 0.00 0.00 980.00 3236 5,CH2.36 PaY'" Yoar esct1IW DttIIIIDt paymetll wlII be S . per I'llrpose AmidpaUd Dae Date EstI_ed Amoaat BegloRiRll Dal": 1U11)- 1391 RESPA. HB 430$.2 .;aviags Bond Calculator ~ "\ . Page 1 of 1 Value As Of IUpdatel I: "HeIp',:'l CALCU Savinc 110/2005 Bond Info Series I EE Bonds .dO Denomination $110,000 .=1 Serial Number Issue Date Results # Bonds Total Price Total Interest Total Value YTD In' 3 $15,000.00 $16,728.00 $31,728.00 $I,23f Serial Issue Issue Interest Next Final Number Date Series Denom Price Interest Value Rate Accrual Maturit: X2233559 10/1992 EE $10,000 $5,000.00 $5,576.00 $10,576.00 4.00% 04/2006 10/202: X2233558 10/1992 EE 10,000 5,000.00 5,576.00 10,576.00 4.00% 04/2006 10/202: X2233557 10/1992 EE 10,000 5,000.00 5,576.00 10,576.00 4.00% 04/2006 10/202: le end Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty MA Matured and Not Earning Interest Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator r r r r Submit Survey Reset' , omM&fBank 499 Mitchell Road. Millsboro, DE 19966 Mail Code DE-MB--12 Phone (888) 502-4349 Fax. (302) 934-2955 December 30, 2005 Law Offices Landis & Black 36 South Hanover Street Carlisle, Pennsylvania 17013 Re: Estate ot Genevieve R Morflan Social Securitv: 176-22.,;6026 Date of Death: October 02. 2005 Dear Sir or Madam: Per your inquiry dated December 22, 2005, please be advised that at the time of death, the above-named decedent bad on deposit with this bank the following: 1. Type of Account Checking Account Account Number 1195956 Ownership (Names oj) Genevieve R Morgan * Opening Date 1///8193 Balance on Date of Death $2,316.93 Total $ 0.00 --ii,3I6~3------------------------------------ --j--769(AccnieJT;t;mi is n;;iinduJ;d)------- Accrued Interest Interest Paid YTD 2. Type of Account Savings Account Account Number 0/5004202072390 Ownership (Names oj) Opening Date Genevieve R Morgan * 11/06/01 Closed 10//4/05 Balance on Date o/Death $18,70/.93 Accrued Interest $ 0.00 Total $/8,70/.93 Interest Paid YTD $ 213.34 (Accrued interest is not included) 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 caD the High Street Carlisle Oft"tee # 717- 240-4536. Sincerely, .....-..:;? ~-;7"_.,;/t:/c,;~., ~C- / t--) Nancy Clagett Records Management . ... ' Sovereign Bank ESTATE OF SOCIAL SECURITY #: DATE OF DEAm: Genevieve R Morgan 176-22-6026 October 2, 2005 Account #: 1671005732 Type: In the name of: Genevieve R Morgan Date of Death Balance: Int.(YTD) from 1/112005 to Accrued interest to date of death: Other Info: Checking Open date: 7/21/2004 $123,106.00 9/3012005 $0.00 $1,843.87 Account#: 1671014804 Type: In the name of: Genevieve R Morgan Date of Death Balance: Int.(YTD) from 1/112005 to Accrued interest to date of death: Other Info: Money Market Open date: 10/22/1999 $45,845.84 9/3012005 $0.00 $453.01 Account #: 1675533440 Type: In the name of: Genevieve R Morgan Date of Death Balance: Int.(YTD) from 1/112005 to Accrued interest to date of death: Other Info: CD Open date: 12/30/2004 $30,618.13 9/3012005 $6.84 $618.13 Page 1 of 1 ~ AMERICAN /c. '. '> HOME BANKNA. We help build your future. 51\1 January 12,2006 Robert R. Black Landis & Black 36 South Hanover Street Carlisle, PA 17013 Dear Mr. Black: As per your request of January 11, 2006, please find below the information required for Federal Estate and/or Inheritance Tax pmposes regarding the account.~ of Genevieve R. Morgan. Type of account: All accounts are Certificates of Deposit, which list the account holder as Genevieve R. Morgan (only). Account Numbers & Balances as of date of death: #290001447 $5119.78 #290001527 $5099.49 #290001645 $10,162.97 #290001789 $10,115.63 If we can be of further assistance to you, please feel free to contact our office. Sincerely, ~@t#~ Michele N. Wojtas ;/ Financial Services Representative American Home Bank, NA. ----.-_.,~,~-~. -,~_.. .._--~ ~._-_.-._---"_..__.- -----.- _._-~.~_._-._.._. --~-~~ -.----., .----.... 417 Stonehedge DrillCI Carfisle, PA 17013-6929 ., Phone 717/J1IU.f>ln . ,,,,,^,,h~.."',hh m~. .. -~~ ~OHOVIA Reference ID: 1467045 Wachovia Bank N.A. Balance Confirmation Services POBox 40028 Roanoke, VA 24022-7313 January 13, 2006 LANDIS & BLACK 36 SOUTH HANOVER STREET CARLISLE. P A 17013 SUBJECf: Verification / Confirmation of Account and Balance Information provided for: Customer: GENEVIEVE R MORGAN (SSN# 176-21-(026) Date of Death: October 2, 2005 Deuosit Account Information Account Type Account Number Date of Death Balance Average Ba1ance* Date Opened 1113012004 Maturity Interest Accrued Y1D Date Date Rate Interest Interest Paid Closed CERTIFICATE OF DEPOSIT 247402112136908 LEGAL TITLE: GENEVIEVE R MORGAN CLOSING BALANCE: $10181.26 $161.82 9nJ2005 CERTIFICATE OF DEPOSIT 247402112137615 LEGAL TITLE: GENEVIEVE R MORGAN CLOSING BALANCE: $10161.95 1211/2004 $161.95 9/2/2005 CHECKING 1010083586909 LEGAL TITLE: GENEVIEVE R MORGAN CLOSING BALANCE: $33905.43 $33.837.50 1115/2003 $39.04 $137.90 111812005 IRA 257400090712318 LEGAL TITLE: GENEVIEVE R MORGAN $11,378.22 5/28/2004 $3.67 $335.53 10/21/2005 ""or Beneficiary Claim Fonn information, please calJ 1 (800)669-2136. · Due to system limitations, we can only provide a twelve month average balance on depository accounts. Other Aeeount Information Account Type Account Number Date ofBaJance Date Opened Date Closed 11/23/2005 Ledger CoDected lNNUITY WNFCAFJ24314S .BGAL TITLE: GENEVIEVE R MORGAN \MERlCAN GENERAL - For information regarding annuities, please calJ 800-424-4990 }PEN DATENlA lO on061'; . ",'" AIG Annuity Insurance .Company P.O. Box 871. Amarillo. TX 79105-0871 A Member of American Intemational Group, Inc. NAME: POLICY: TRANSACTION: OWNER: TRANSACTION STATEMENT GENEVIEVE MORGAN November 23, 2005 FJ243145 FULL AND FINAL SETTLEMENT ole GENEVIEVE MORGAN DEATH CLAIM PAYMENT AMOUNT OF CHECK $ $ 107,644.54 107,644.54 TAXABLE INCOME $ 7,644.54 PLEASE DETACH AND KEEP THIS' STUB FOR YOUR RECORDS ~~ .; IJ.:'I Ii: l:(eI ~'t f.;.....:I :II~ .1:11 I.J~I:f'JJ.:i ~ ~~ l-'*i fiI.~ ]'J ~ :l~~ I'~ Ic{.)~ I :f.~':i::t: 1'1'1 :nli;l; ,.l-....1l.;! Ila'l'/.. :11=-:l~i"':1 ~-~'J ~n:l.__.~~}iiJl~\.'tj}.:u:ta =1:&1 :J:a :~':~_ \IG AnnuitY .Insurance Company. '.0. Box 871; Amarillo. TX 79105-0871 \ Member of American International GrouP. Inc. VENDOR NO. OAS POUCY NO. OFJ243145 CHECK NO 11990012 62-35 u;HiU . '.. THE BANK OF NEW YOfl!CIDELAWAREl NEWARK,DElAWARf . PAY THIS AMOUNT ** ONE HUNDRED SEVEN' THOUSAND SIX HUNDRED FORTY-FOUR. and 54/100 DOLLARS *** $*.**..*107.644.54* "*****MOT VALID BEFORE CHECK DATE CHECK DATE 11/23105 VOID AFTER 180 DAYS Two signatures required if over $2~;OOO.OO PAY TO THE ORDER OF ESTATE OF GENEVIEVE R MOR~AN HOLLY E HANS, ADMINISTRATOR OF THE ESTATE 1706 NEWTON RANSOM BlVD ~~