HomeMy WebLinkAbout06-27-06
REV- '"Go EX ',5-00)
OFFICIAl USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBEI=l
~L
COUNTY CODE
~L 0588 ___
YEAR NUMBER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
~ Turnbaugh M. Luther
W DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
C
~ 3/10/2005 4/17/1913
W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
C
SOCIAL SECURITY NUMBER
171-2:8-6108
THIS RETURII MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
W
I-
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Ol1.al
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<t
[i] 1, Original Return
D 4_ Limited Estate
[i] 6, Decedent Died Testate (Attach copy of Will)
D 9, Litigation Proceeds Received
D 2_ Supplemental Return D 3, Riemainder Return (date of death prior to 12-13-82)
D 4a, Future Interest Compromise (date of death alter 12-12-82) D 5, Federal Estate Tax Return Required
D 7, Decedent Maintained a Living Trust (Attach copy of Trust) _ 8_ Total Number of Safe Deposit Boxes
D 10, Spousal Poverty Credit (date of death between 12,31-91 and 1-1-95) D 11, Election to tax under See, 9113(A) (AtlachSch0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
I-
Z
W
C
Z
o
D..
1Il
W
II:
II:
o
U
Craig A. Hatch, Esquire
FIRM NAME (If Applicable)
Gates, Halbruner & Hatch, P.C.
TELEPHONE NUMBER
1013 Mumma Road, Suit:e 100
Lemoyne, PA 17043
717-731-9600
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a:
6, J~ Owned Property (Schedule F)
LJ Separate Billing Requested
7, Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
(6)
$0.00
$0.00
$0.00
$0.00
$0.00
$107,645.50
OFFICIAL USE ONLY
1, Real Estate (Schedule A)
(1)
2, Stocks and Bonds (Schedule B)
(2)
3, Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4_ Mortgages & Notes Receivable (Schedule D)
5, Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
(4)
(5)
$31,304.49
8, Total Gross Assets (total Lines 1-7)
(8)
$11,874.58
$3,196.50
$138,949.99
9, Funeral Expenses & Administrative Costs (Schedule H) (9)
1 0, Debts of Decedent, Mortgage liabilities, & Liens (Schedule I) (1 0)
(13)
$15,071.08
$123,878.91
$0.00
11, Total Deductions (total Lines 9 & 10)
(11)
12, Net Value of Estate (Line 8 minus Line 11)
13, Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
(12)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
$123,878.91
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax $85,942.35 L.. (15)
z rate, or transfers under Sec. 9116 (a)(1.2) x .0
0
~ 16. Amount of Line 14 taxable at lineal rate $37,936.56 x .0 45 (16)
<t
I-
~ $0.00
l1. 17. Amount of Line 14 taxable at sibling rate x.12 (17)
::!:
0 $0.00
0 18. Amount of Line 14 taxable at collateral rate x .15 (18)
X
<t Tax Due (19)
I- 19.
$0.00
$1,707.15
$0.00
$0.00
$1,707.15
20. ~
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
3W4645 1,000
Decedent'!:; Complete Address:
STREET ADDRESS
2717 Harvard Avenue
CWDberland
CI1Y
CamD Hill
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
I STATE
P1...
1~01l-
(1)
$1,707.15
$0.00
$3,060.00
$85.36
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C) (2)
$3,145.36
$0.00
$0.00
Total Interest/Penalty (0 + E) (3)
$0.00
4. 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
(4)
$1,438.21
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
$0.00
A. Enter the interest on the tax due.
(SA)
$0.00
B. Enter the total of Line 5 + SA.
(5B)
$0.00
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPFIOPRJATE BLOCKS
No
Qg
Qg
Qg
[ij
o
[]j
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D [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 preparer other than the personal representative is based on all intolTl1ation of whK:h preparer has any knowledge.
SIGNAiURE OF PERSON RESPONSIBLE FOR FlUNG REiURN
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;. . . . . . . . . . . . . . .
b. retain the right to designate who shall use the property transferred or its income; .
c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . .
d. receive the promise for life of either payments, benefits or care? . . . . . . . . .
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. [i]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or hl~r death? D
4. Did decedent own an Individual Retirement Account. annuity, or other non-probate property which
Yes
D
D
D
D
Violet M. Turnbaugh, Executrix
ADDRESS
2717 Harvard Avenue
SIGNAiURE OF PRE PARER O"THER "THAN REPRESENTAnVE
Craig A. Hatch, Esquire
ADDRESS
y'~6~
7
7:lJ J ~/.lrt:<..~
Camp Hill, PA
" DATE
ell" / (it-
I /
17011
DATE
1013
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. 9 9916 (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.S. 99116 (a) (1.1) (ii)]
The statute does 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.S. 99116(a)(1.2)].
The tax rate imposed on the net value of transfers to orlor the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9 9116(1.2) [72 P.S. 99116(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. 9 9116(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.
3W4646 1.000
REV-1509 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
EST ATE OF
M. Luther Turnbauah
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
211:>5 0588
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A_
Diener, Mary E
clo 1287 Woodruff Place,
Morgantown, WV 26505
Granddaughter
B.
Diener, Nancy L
1287 Woodruff Place, Morgantown,
WV 26505
Daughter
c.
Turnbaugh, Violet M
JOINTL V-OWNED PROPERTY:
ITEM
NUMBER
lETTER
FOR JOINT
TENANT
DATE
MADE
JOINT
DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION At-V BANK ACCOUNT
N...M8ER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR
JOINTLy-t-ElD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET
%OF
DECD'S
INTEREST
DATE OF DEATH
VALUE OF
DECEDENTS INTEREST
1. A.
1
C
4/11/2003 Community Banks
Certificate of Deposit
Account No. 4800746731
$10,022.71 50.0000
$5,011.36
2
C
10/3/2003 Community Banks
Certificate of Deposit
Account No. 4800746732
$10,004.29 50.0000
$5,002.15
3
C
12/16/2002 Community Banks
Certificate of Deposit
Account No. 4800746730
$10,017.72 50.0000
$5,008.86
4
C
1/4/2005 Fulton Bank
Certificate of Deposit
Account No. 022-0220907
(Exclusion for transfer
made less than year from
date of death is fully
allocated to joint owner on
Schedule G; therefore, the
full value of this asset is
being reported.)
$15,000.00 100.0000
$15,000.00
5
C
4/11/1990 M&T Bank
Certificate of Deposit
Acct. No. 31003914224678
$34,198.19 50.0000
$17,099.10
To al from co]tinuation schedules. . .
$60,524.03
3W46AE 1.000
TOTAL (Also enter on line 6 RecaDitulation) $
(If more space is needed, insert additional sheets of the same size)
$107,645.50
Estate of: M. Luther Turnbaugh
Name
C Turnbaugh, Violet M
Schedule F Part 1 (Page 2)
Address
2717 Harvard Avenue, Camp Hill, PA
17011
171-28-6108
Relation
Surviving Spouse
Estate of: M. Luther Turnbaugh
Item
No. Cot.
6
7
8
9
10
11
12
Joint
Date
Schedule F Part 2 (Page 2)
Description
A
5/11/2000 M&T Bank
Certificate of Deposit
Acct. No. 31003913916185
C
12/30/1899
MainStay Investments
Account No. 79578486
Mainstay Tax-Free Bond
B
DOD Value of
Asset
Perc
Int.
$17,068.64 50.0000
Fund, Class
$19,697.27
PNC Bank
Certificate of Deposit
Acct. No. 31400197843
Interest accrued to 3/10/2005
PNC Bank
Certificate of Deposit
Acct. No. 31700215084
Interest accrued to 3/10/2005
PNC Bank
Certificate of Deposit
Acct. No. 31300243774
Interest accrued to 3/10/2005
Wachovia Bank, N.A.
Certificate of Deposit
Account No. 247022051227923
Wachovia Bank, N.A.
Checking Account
Acct. No. 1010058127746
Total (Carry forward to main schedule)
C
8/11/2000
C
7/30/2001
C
7/9/2001
C
6/20/2000
C
9/3/2002
$35,004.88
$71. 70
$14,500.17
$16.01
$6,000.00
$78.82
$25,004.24
$3,606.29
5el.0000
50.0000
50.0000
50.0000
51).0000
50.0000
50.0000
50.0000
50.0000
171-28-6108
DOD Value of
Interest
$8,534.32
$9,848.64
$17,502.44
$35.85
$7,250.09
$8.01
$3,000.00
$39.41
$12,502.12
$1,803.15
$60,524.03
REV-1510 EX + (6-98)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
M. Luther Turnbaugh
FILE NUMBER
21 05 0588
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of thl~ REV-1500 COVER SHEET is yes.
ITEM
NUMBER
1.
DESCRIPTION OF PROPERlY
ItC..LDE TI-E NAIvE OF Tl-E TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT MD
Tl-E DATE OFTRAfISFER. ATT.6.()-1ACOPV OF THE DEED FOR REAL ESTATE
PNC Bank
Checking Account
Acct. No. 5070086236
Interest accrued to 3/10/2005
Funds transferred to joint
checking account established in
names of M. Luther Turnbaugh
(decedent), Violet M. Turnbaugh
(spouse) and Nancy L. Diener
(daughter) by M. Luther
Turnbaugh on March 7, 2005. An
exclusion equal to one-third of
the date of death value of the
account, or $1,582.58, is being
claimed for each transferree.
The total exclusion claimed on
this transfer is $3,165.16,
which is two-thirds the value
of the account.
2
PNC Bank
Savings Account
Acct. No. 5000735093
Interest accrued to 3/10/2005
Funds transferred to joint
checking account established in
names of M. Luther Turnbaugh
(decedent), Violet M. Turnbaugh
(spouse) and Nancy L. Diener
(daughter) by M. Luther
Turnbaugh on March 7, 2005. The
balance of the $3,000.00
exclusion available to each
transferree after the transfer
of the checking account is
$1,417.42; therefore, the total
remaining exclusion amount of
$2,834.84 is being claimed.
DATE OF DEATH
VALUE OF ASSET
% OF DECD'S
INTEREST
$4,747.75 100.0000
$0.15 100.0000
$5,053.65 100.0000
$2.94 100.0000
Total from continuation sched~les . . . . . . . . .
TOTAL (Also enter on line 7, Recapitulation) $
3W46AF 1.000
(If more space is needed, insert additional sheets of the same size)
EXCLUSION
!IF APF'UCABLE\
$3,165.16
$.!,834.84
TAXABLE
VALUE
$1,582.59
$0.15
$2,218.81
$2.94
$27,500.00
$31,304.49
Estate of: M. Luther Turnbaugh
Schedule G (Page 2)
Item
No. Description
3 Sovereign Bank
Certificate of Deposit
Acct. No. 2335293110
Owner: M. Luther Turnbaugh
Transfer on Death Beneficiary:
daughter, Nancy L. Diener
4 Sovereign Bank
Certificate of Deposit
Acct. No. 2335251407
Owner: M. Luther Turnbaugh
Transfer on Death Beneficiary:
daughter, Nancy L. Diener
Total (Carry forward to main schedule)
DOD Value
of Asset % Interest
$9,000.00 100.0000
$18,500.00 100.0000
Exclusion
$0.00
$0.00
171-28-6108
Taxable
Value
$9,000.00
$18,500.00
$27,500.00
REV-j,,'1 EX + (12-Q9)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
M. Luther Turnbauah
ITEM
NUMBER
A.
B.
1.
1.
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
Faith United Church of Christ
service at funeral luncheon
Total from continuation schedules . . . . . . . . .
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City
State
Zip
2. Attorney Fees
Year(s) Commission Paid:
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
4.
Claimant
Street Address
City
State
Zip
Relationship of Claimant to Decedent
Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
3W46AG 1.000
7.
1
parthemore Funeral Home
additional death certificates
FILE NUMBER
21 105 0588
TOT AL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
AMOUNT
$500.00
$11,255.58
$58.00
$61.00
$11,874.58
Estate of: M. Luther Turnbaugh
Item
No.
2
3
4
171-28-6108
Schedule H Part 1 (Page 2)
Description
Amount
parthemore Funeral Home
funeral goods & services
$10,923.00
Rice Memorial Works
gravestone engraving
$100.00
Shirley Horting
food for funeral luncheon
$232.58
Total (Carry forward to main schedule)
$11,255.58
REV-1512 EX + (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
M. Luther Turnbauah
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21 OS 0588
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
Ann Callahan
home nursing care
$50.00
2
Links & Care
home nursing care
$3,146.50
3W46AH 2.000
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
$3,196.50
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
M. Luther Turnbauah
NUMBER
I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
Mary E. Diener
c/o 1287 Woodruff Place
Morgantown, WV 26505
Schedule F, Item 6
1
2
Nancy L. Diener
1287 Woodruff Place
Morgantown, WV 26505
50% of Schedule G, Items 1 & 2
100% of Schedule G, Items 3 & 4
3
Violet M. Turnbaugh
2717 Harvard Avenue
Camp Hill, PA 17011
Schedule F, Items 1 - 5, 7 - 12
50% of Schedule G, Items 1 & 2
(100% of expenses allocated to
surviving spouse's share of
distribution.)
FILE NUMBER
21 05 0588
RELATlONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustl~e(s) OF ESTATE
Granddaughter
Daughter
Survi ving SpO\lSe
$8,534.32
$29,402.24
$85,942.35
ENTlER 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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
3W46AI1.000
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SI-IEET
$
(If more space IS needed, Insert additional sheets of the same size)
$0.00
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records III accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
/!.~ ~d
C4(j~ G~ II~
No.
Charles Hardester
S tate Registrar
Calvin B. Johnson, M.D., M.P.H.
Secretary of Health
FES 1 4 2006
Date
CERTIFICATE OF DEATH
027447
H105.143 Rev. VB7
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
TYPE/PRINT
IN
PERMANENT
BLACK INK
NAME OF DECEDENT (First, Middle, last)
SEX
STATE FilE NUMBER
SOCIAL SECURITY NUMBER
~)/
"/~.
1. M.
AGE (Last Birthday)
5. 91
COUNTY OF DEATH
Yrs.
2. male 3. 171 - 28
BIRTHPLACE (City and PLACE OF DEATH Check on one
State or FOI"eign Country) HOSPITAL:
Inpa~enl [k3' OOA 0
8..
FACILITY NAME (If nol institution, give street and number)
8b.
Cumberland
8e.
2717 Harvard Avenue
"Camp Hill, PA 17011
Supplies
DECEDENT'S
ACTUAL
HESIOENCE
(See instructions
on other side)
MA.RITAL STATUS - Married,
Never Married, Widowed,
Divorced (Specify)
,.. Married
DECEDENT'S USUAL OCCUPATION
(~~v=o~i~1Iia~~od~~lllu~rir~~:gtt
Cumberland
Did
decedent
~ve in a
township?
He. 0 Yes, de'~ent lived in
twp.
17a. State
17b. County
17d. ~ ~~h~e~~~t~~~~i~i~~ of
Camp Hill
city/bora
FATHER'S NAME (First, Middle. Last)
18. Shuman Jacob Turnbaugh
INFORMANTS NAME (Type/Print)
20.. Violet M. Turnbau h
ME THOO OF DISPOSITION
. Donation n Burial ~ Cremation ~emoval from State 0 .., "1 I ., n n r
. 21a. Umer\:::ipeClry, 21b.1.1id.ll:U .1.'-+, LVVJ
. SIGNATURE OF F ICE LICE SEE OR PERSON ACTING AS SUCH LICENSE NUMBER
22b. FD 012 848 L
MOTHER'S NAME (First, Middle, Maiden Surname)
19. Bessie M. Burd
INFORMANTS MAILING ADDRESS (Street, CilyfTown. Slate, lip Code)
2Ob. 2717 Harvard Avenue, Cam Hill, PA 17011
PLACE OF DISPOSITION- Name of Cemetery, Crematory
or Other Place
LOCATION CitylTown. Slate, lip Code
n-!__ __~__J --_ ,,-__...._____
21c.1'\.J..vt::1.vJ..t::W ......tWtLC.L.y
21d. Hil12rG tC;.iTq P..^... 17062
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To the best of my knowledge. death occurred at the time, date and place stated
(Signature and Title)
23a.
TIME OF DEATH
__~ 2':~.._...._~ Ie
27. PART I: Enl.r lh. dl..a..., InJuri.. or compllcallon. which cau..d lh<I d.alh. Do not enter the mode ofdylna, .uch... cardiac 0; r..pirtltory ../T..t, .hock or h.a" f.lIure.
Uatonlyonecau..on.achlln..
NAMEANDADDRESSOFFACIUTYParthemore FH & CS, Inc.
22e. P.O. Box 431 New Cumberland PA 17070
LICENSE NUMBER DATE SlGNED
(Month. Day, Year)
0431
23b. 23c.
WAS CASE FtEFERRED TO A MEDICAL EXAMINER ICORONER?
26. Yes 0 No IXJ
: Approximate PART II: Uther significant conditions contributing to death, but
. interval between not resulting in the underlying cause gi....en in PART I
: onset and doath
...."
Sequentially list conditions 1 eb..
if any. leading to immediate
cause. Enter UNDERLYING
CAUSE (Disease or injury
that initialed events
resulting on death) LAST d.
WERE AUTOPSY FINDI
AVAIlABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED
.,
..
Ye, 0 No [0'
NoD
Natural 123
ACGidelll 0
Suicide 0
Homicide
o
o
o ~~CE OF INJURY _ AI home, :aO:, street, factory, o:ce
building...tc_ (Specify)
30e.
Ye, 0 No [J
30e. 30d.
LOCATION (Street, CitylTown, Slale)
-31
PtmJing lllve::.tigdtion
y"O
Could nol be determined
~MEOICAl EXAMINER/CORONER
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31a.
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CERTIFIER (Check only one)
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29.
'PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both pronouncing death and certifying to cause of death)
To the best of my knowledge. death occurred at the time, date, and place, and due to the eausfts(s) and manner as stated...
LAST WILL AND TESTAMENT
OF
M.LUTHERTURNBAU(;H
REGISTER OF WILLS
CUMBERLAND County, Pennsylvania
CERTIFICATE OIF GRANT OF LETTERS
No. 2005- 00588 PA No. 21- 05- 0588
Estate Of: M LUTHER TURNBAUGH
(First, Middle, Last)
Late Of:
CAMP HILL BOROUGH
CUMBERLAND COUNTY
Deceased
Social Security No: 171-28-6108
WHEREAS, on the 29th day of June 2005 an instrument dated
April 29th 1996 was admitted to probate as the last wi.Il of
M LUTHER TURNBAUGH
(First, Middle, Last!
la te of CAMP HILL BOROUGH, CUMBERLAND County,
who died on the lOth day of March 2005 and,
WHEREAS, a true copy of the will as probated 1.S annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH Register of wills 1.n and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMEN7ARY to:
VIOLET M TURNBAUGH
who has duly qualified as EXECUTOR(RIX)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 29th day of June 2005.
,..1 '1 \ f (0
\_ll~ Vil(if\':'~rC\_,~_V'\,,^ \ J.}..-\n ,\,1..>(\ , {'\.j
Register of Wills \
,~
"'-~ (~ (.
" . \ \ " l. \
-' ~ '~- ~ _ zIT::
\' Deputy
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
ep\wills\trnbaugh.ml\4-96
LAST WILL AND TESTAMENT
OF
MARTIN L. TURNBAUGH
I, MARTIN L. TURNBAUGH, of the Borough of C~mp Hill, Cumberland
County, Pennsylvania, declare this to be my last 'will and revoke any
will previously made by me.
ITEM I: I devise and bequeath all of my estate of every nature
and wherever situate to my wife, VIOLET M. TURNBAUGH, if she survives
me.
ITEM II: Should my wife, VIOLET M. TURNBAUGH, fail to survive
me, I devise and bequeath all of my estate, of every nature and
wherever situate, as follows: two-thirds to my daughter, NANCY L.
DIENER, and one-third to my granddaughter, MARY ELLEN DIENER.
ITEM III: I appoint my wife, VIOLET M. TURNBAUGH, Executrix of
this my last will. Should my wife, VIOLET M. TURNBAUGH, fail to
qualify or cease to act as Executrix, I appoint ~~ daughter, NANCY L.
DIENER, Executrix of this my last will.
ITEM IV: No fiduciary acting hereunder shall be required to post
bond or enter security for the faithful performan.ce of her duties in
any jurisdiction.
IN WITNESS WHEREOF, I, MARTIN L. TURNBAUGH, have hereunto set my
hand and seal this 2'1\.l day of ACr-:\ ' 1996.
(11.1 ,?:l.J, L -.{) --.(, _ jl' )j
If!i I {v /"?yV 4'<-- ,r ,,1 (Vu<:... 'it;'-' -<c...z.(l /
{~ ' '--. "~-
M..ll.RTIN L. TURNElmGH ':./
Page 1 of 3
PA REV-1500
SCHEDULE F
JOINTL Y OWNED PROPE:RTY
Communit'(Banks
January 26, 2006
Violet M. Trunbaugh
2717 Harvard Avenue
Camp Hill, P A 17011
RE: Estate ofM. Lulher Turnbaugh, deceased
Enclosed you will find the information requested on the above referenced individual's
accounts. Unless otherwise noted, the infonnation furnished is as of date of death.
Please feel free to contact me at 717-354-3590 in can be of further assistance.
Sincerely,
Deborah K Lorah
Deposit Services/Research Manager
P.O. Box 350 . Millersburg, PA 17061 . Phone 1-866-255-2580
Communi~Banks
Decedent's Name M. Luther Turnbaugh
Social Security Number 185-01-1563
Date of Death 03/1 0/05
Account Number
4800746730
4800746731
Account Type
Time deposit
Time deposit
Date Opened
12/16/02
04/11/03
Principal Balance
$10,000.00
$10,000.00
Accrued Interest at Date of Death
$17.72
$22.71
Balance at Date of Death
$10,017.72
$10,022.71
Maturity Date
06/16/05
04/11/06
Account Ownership
Joint
Joint
Names of .Joint Owners, if any
Violet M. Turnbaugh
Violet M. Turnbaugh
Date Joint Ownership was
Established
12/16/02
04/11/03
Interest Rate
'"' (")"1 ""'11'\1\/
L.(') L)V~/o
2.9600S/o
Additional Information
I
"j.,
.
II
\.........._\<\.-
\ ;~~-" I '~ f\;
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,....., .... i '- ',-
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.\\---.\\\".
~ i, ~- ~ '. '_ \tJ
Authorized Signature
Date
i i
CFDCUSACCT
CRF Display Customer Accounts
1057
09/14/05
TIN 171-28-6108 A-K TURNBML.01 Appl cd ___ Acct
Total accts 0002
Name M LUTHER TURNBAUGH
PREVAKEY
NEXTAKEY
-----Customer Accounts--- AT -Status- Acct ReI Addr TRI
TD 022-0164870 MATURED PRIMARY 001 *
-
TD 022-0220907 OPEN PRIMARY 001 *
DECEASED
Open Date Next Hldr
12/29/2001 TURNBVM.01
01/04/2005 TURNBVM.01
CFDCUSCMNT CFDBPTOTREL
Only one page of information.
COMMAND ===>
CFDACCTINFO
CFDACCTHLDR CFDSVCLST
GN20000I04
F2=Retrieve F3=Exit
F6=Toggle
1V-(tcfyL/
~----
01109/06 10: 58 FAX 302 ~4--=-9_~___.__~~~_T~ANK_~CORDS
--~_._-'~ -~._--- -------
[4J 001
499 Mitchell Road
Millsboro, Delaware 19966
1-888-502-4349
(302) 934-2955 fax
r! M&I'Bank
Fax
To: Ramona Bianchi
From: Charlene Warrington
Fax: (717) 238-6580
Pages; 1
Phone: (717) 230-0615
Date: 1/9/2006
Re: M. Luther Turnbaugh-Date of Death
03/10/05
o urgent
o For Review
o Please Comment
o Pkase Reply
o Please Recycle
. Comments;
Please fmd below the date of death balances you had requested for the above na.lned
decedent.
1. Account Type. . .<<... .... ............ '" Certificate of Deposit
Account Number...... ................. 31003913916185
Ownership (Names ofJ..... ......... Mary E. Diener, M. Luther Tumbaugh
Opening Date. ......... """'" ........05/ 11/00 (account closed OS/23/051
Balance on Date ojDeath.........$17,OOO.00
Accrued Interest
$
68.64
Total................. ... ............... ....$17,068.64
2. Account Type......... ... ,.... .......... Certificate of Deposit
Account Number....... ...... .... ......31003914224678
Ownership (Names oJ).............. M. Luther Turnbaugh, Violet M. Turnbaugh
Opening Date.... .... ... ..... .... ..... ..04/ 11/90
Balance on Date ojDeath..........$34,067.07
Accrued Interest
$ 131.12
Total........... ...................... ......$34, 198.19
~NJ U{;IJU/r~
{/
MAINSTAY
iilINVEST~lENTS ill
MainStay Shareholder Services
May 18, 2006
P.O. Box 8401
Boston, MA 02266-8401
1-800-MAINSTAY (1-800-624-6782)
WNW. ma i nstayfu n ds.com
VIOLET M TURNBAUGH
2717 HARVARD AVE
CAMP HILL PA 17011-5336
REFERENCE: 02876886
MAINSTAY TAX FREE BOND FUND B
ACCOUNT NUMBER 79578486 (CLOSED)
MARTIN LUTHER TURNBAUGH
VIOLET M TURNBAUGH JT TEN
Dear Ms. Turnbaugh:
I am contacting you concerning your recent request for
information pertaining to the above referenced MainStay joint
tenant account.
The requested balance information for this account, as of March
10, 2005, is provided in the following table:
IIr I""'l'f'""'Ir-I""')'("\Jtr""'l.....
"":!:;.;-/:;:J::J/O<:l:OO
Share Balance
2,018.163
Net A:~e~ value~1 Account Balance I
I :;;~./b I ~1'::1,6'::17.27 I
Account Number
Ms. Turnbaugh, I hope this information is helpful. If you have
any questions concerning this letter, please contact MainStay
Shareholder Services by calling 1-800-MAINSTAY. A
representative will be happy to assist you.
Sincerely,
D- p~
c::r-u- I' f -.;
Steven Reilly
Correspondent
MainStay Shareholder Services is a division af NYLlM Service Company LLC, a Registered
Transfer Agent and affiliate of New York Life Investment Management LLC. Securities distributed
Savings Account
Account #5000735093 Established 03-07-2005
M LUTHER TURNBAUGH
VIOLET M TURNBAUGH
NANCY L DIENER
DOD balance: $5,053.65 + $2.94 accrued interest
Please note that this office only provides date of death balances for deposit accounts
(IRAs, CDs, Checking and Savings accounts). We do not process any financial
transactions or provide statements. If you need assistance with any of these items,
please call1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
'i,,-~<-~ ~. ,4.<~~
Erica L Schlegel
1-800-762-1775
P / -PFSC-04-F
500 First Ave.
Pittsburgh PA 15219
Member FDIC
Page 2 of2
II!
-~
~.....:..'-
"VACHOVIA
Reference ill: 1465526
Wachovia Bank N.A.
Balance Confirmation Services
POBox 40028
Roanoke, VA 24022-7313
January 11, 2006
VIOLET TURNBAUGH
2717 HARVARD AVE
CAMP HILL, PA 17011
SUBJECT: Verification / Confirmation of Account and Balance Information provided for:
Customer: M LUTHER TURNBAUGH (SSN# 171-28-6108)
Date of Death: March 10,2005
Deposit Account Information
Account
Type
Account
Number
Date of Death
Balance
Average
Balance*
Date
Opened
Maturity Interest Accrued YTD Date
Date Rate Interest Interest Paid Closed
CERTIFICATE OF DEPOSIT 247022051227923
LEGAL TITLE: VIOLET M TURNBAUGH
M LUTHER TU&"fBAUGH
CLOSING BALANCE: $25012.35
$25,004.24
6/20/2000
$40.59
$125.80
3/23/2005
CHECKING 1010058127746
LEGAL TITLE: M LUTHER TURNBAUGH
VIOLET M TURNBAUGH
CLOSING BALA..NCE: $3606.93
$3,606.29
9/3/2002
$0.35
$2.16
3/23/2005
* Due to system limitations, we can only provide a twelve month average balance on depository accounts.
* Date of death balance does not include accrued interest.
* If date of death occurrs on a weekend or a holiday, date of death balance does not include any transactions that were
made during that time period.
/ IJ:lUttJ-LL S-htLiLb
(.JJcnnifer ~traub
Servicenter Associate
Phone: (540)563-7323
abs; js
PA REV-1500
SCHEDULE G
INTER-VIVOS TRANSFERS and
MISCELLANEOUS NON-PR()BATE
PROPERTY
o PNCBAN<
January 04, 2006
Ms. Violet M Turnbaugh
2717 Harvard Ave.
Camp Hill, P A 17011
/scp
RE: Estate ofM Luther Turnbaugh (Deceased)
SSN: 171-28-6108
DOD: 03-10-2005
Dear Ms. Turnbaugh:
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Certificate of Deposit
Account #31400197843 Established 08-11-2000
M LUTHER TURNBAUGH
VIOLET M TURNBAUGH
DOD balance: $35,004.88 + $71.70 accrued interest
Account #31700215084 Established 07-30-2001
M LUTHER TURNBAUGH
VIOLET M TURNBAUGH
DOD balance: $14,500.17 + $16.01 accrued interest
Account #31300243774 Established 07-09-2001
.M LUTHER TURNBAUGH
VIOLET M TURNBAUGH
DOD balance: $6,000.00 + $78.82 accrued interest
Checking Account
Account #5070086236 Established 03-07 -2005
M LUTHER TURNBAUGH
VIOLET M TURNBAUGH
NANCY L DIENER
DOD balance: $4,747.75 + $0.15 accnled interest
Page 1 of2
Savings Account
Account #5000735093 Established 03-07-2005
M LUTHER TURNBAUGH
VIOLET M TURNBAUGH
NANCY L DIENER
DOD balance: $5,053.65 + $2.94 accrued interest
Please note that this office only provides date of death balances for deposit accounts
(IRAs, CDs, Checking and Savings accounts). We do not process any financial
transactions or provide statements. If you need assistance with any of these items,
please call l-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
'iu~4'- ~. ~~
Erica L Schlegel
1-800-762-1775
P7 -PFSC-04-F
500 First Ave.
Pittsburgh P A 15219
Member FDIC
Page 2 of2
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PA REV-1500
SCHEDULE H
FUNERAL EXPENSES and
ADMINISTRATIVE COSTS
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VIOLET M. TURNBAUGH 'I
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VIOLET M. TURNBAUGH
2717 HARVARD AVENUE
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9228
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VIOLET M. TURNBAUGH
2717 HARVARD AVENUE
CAMP HILL, PA 17011-5336
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VIOLET M. TURNBAUGH
2717 HARVARD AVENUE
CAMP HILL, PA 17011-5336
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VIOLET M. TURNBAUGH
2717 HARVARD AVENUE
CAMP HILL, PA 17011-5336
9197
Date (~? I'} (';> ;,(., Ij - D:r 60-1273/313
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, VIOLET M. TURNBAUGH
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CAMP HILL, PA 17011-5336
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