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HomeMy WebLinkAbout96-00141 ,.\'.l..' -'.' >~ ','.., -'---' , ' '~;' .~:;::; .,'~; ';.... -, " ~ -,," -. ~ , .' , f'r /:-.' ,,' , -- .. ,'i. ., ,',:' ~' ' ,;,-.,,', ....' 1II~1lO\ kEV \IN, This is to ccrci(y thac the inform;lIion hcn' Ri\'cn is corrnely writ." from ,Ill origin,II (cuificatc IIf dc.lIh tlllly fiI~d with me 35 Local Registrar. Th~ origin.IIl"l'uif;"llc will be forw;mlc:d 10 lhl' Srilte: Vil,11 Rl'lonls Offill' (or pCrm,H1l'nc filing. WARNING: 1111 Illegal to duplicate this copy by photo stet or photogreph, a ~ ~-:-'v.",..A / . /~-."' -,-<.I' ~..:;;~_.. v-- _ _~ y;;..< P. ~ 22.222 I'K"ll\cgisu"r EG,:2 /"':1(';) Dr. I'bli::",:::, Pa, 17100 Fcc (ur this (cnirk"rc, $2.00 3406816 __A~-z - :; ~ D"te No. MI.ltJIIlItorW COIIMOHWWTH 01' PEHHIYUIlHIA . OUMTMlHT 0' HIAUH' YflAt. RECORDS CERTIFICATE OF DEATH ..- . -, --- ...0 ,... .-- oJ"'"- l4'~ II.....:~~ Cr__.D~' D U:a"~'~1 R1. 1'1/01 ~ -L. , B' ~ - - ...0 tl"" ., ......-.--.-...... 1- -- 1-"- I , . ..-..-........... . 0# ..... ..... - G-" - 0 ...0 ..0 - 0 -- 0 _0 ..0 0 0 . - CNlI...____ .........,.--................ -- .. ~....-..-........~-.....-.............._..... .......................-..... --.......---......"........-_.~. ........ ...., ...,. ...... o .. .J? .12..<'..2l .. )J/:r-- 21-96-141 c)(~ , :-:1 c: , , - ,', -, Pl I":';. ~ '-oJ ; ., " .- " ~ ~. .-; ;--." . , ,'., ~. "';, ~.:' '.' .,',.', ,-,j- " , ~, .' ,'" ","" ;'~~~~..i;"\' :,:;'! -:~'j:': R".." ~...." f',,' oj '_ ,'It. .,,1'.' -95 FEe 13 1'2 :,12 CIL: Cum;,' ,dll ,..:.1, PA ..:I' ..:I 0 ,Cj , ..t iC ... ..t 1Xl' ~ Eo4 H a I'll ,/ '" ;;'-,:. .'. ~ ' '.~ -.; I:;.;. ...." "'''''' .... ~~ ." '.' '..... ,-"'---'--', -::~ ~ , .. '__:..--O'1!"" ~-,... 0" .~ Z ;;,~, .... -.. $ 'b',c', bi 3: W Z' lL'.:S t~ c' ~~ ~'" Z' , 8 Z ~l= f,':~" ."z " " ... 'G:. % ,'-"'- -,.. Z 0 ~ ~:,", ~" xo, ~ 0 :I;: ,....,":;'.:"i~ ,'C ZlD:. -,.... ... :':". VI" ., '_~. 'PI'--':':": '0' ,,11:,. 'II: ,< '.' ,%: ::',,' .,'- ;.: .' .' ..,0,' -: a>-. ~ p . '- , . . ....- ,. , , LAST WILL AND TBSTAMBNT OF BDITH A. GOLL I, EDITH A. GOLL, of 712 Messiah Village, Mechanicsburg, Pennsylvania being of sound mind, memory and understanding do hereby make, publish and declare this as my Last will and Testament, hereby revoking and making void any and all wills and codicils heretofore made by me. ITEM I - I direct my Executor to pay the expenses of my last illness, funeral expenses and estate and inheritance taxes as soon after my death as may be found convenient. ITEM II - I direct that my remains be cremated, the ashes to be interred in the Goll Family Plot in Auchinbach Cemetary, Reading, Pennsylvania. ITEM II I I give all my tangible personal property, including, but not limited to, any and all automobiles, furniture, furnishings, china, silverware, jewelry, ornaments, works of art, books, pictures and wearing apparel, together with all policies of insurance thereon, but excluding cash on hand and tangible evidences of intangible personal property to the Messiah Village Endowment Fund, Mechanicsburg, Pennsylvania. ITEM IV - I give the refund of the purchase price for my apartment at Messiah Village which is due my estate at my death to the Messiah Village Endowment Fund, Mechanicsburg, Pennsylvania. CLICKHrR . 'IAREN A"OIlUTS ., "A. M....I..U... 'IHMnLVAHIA PAGE ONE OF THREE 0J ~J P \ . ' , . ... " .' , . - . : ITEM V I give, devise and bequeath all the residue and remainder of my estate, real and personal as follows: A. One-third (1/3) thereof to the OAKWOOD BAPTIST CHURCH, 4315 Chestnut Street, Camp Hill, Pennsylvania. B. One-third (1/3) thereof to the aforesaid MESSIAH VILLAGE ENDOWMENT FUND. C. One-third (1/3) thereof to MESSIAH COLLEGE, Grantham, Pennsylvania foe the purposes of scholarship encowment. ITEM VI - I hereby nominate, constitute and appoint WILLIAM FEAREN, ESQUIRE, as Executor of this Will. If WILLIAM FEAREN, ESQUIRE, is unable or unwilling to act or continue as Executor, for any reason whatsoever and whether before or after my death, I appoint RICHARD W. CLECKNER, ESQUIRE, successor Executor. My Executor is directed to proceed with the expeditious administration of my estate. If my estate shall not have been fully settled within one year from the date of my death and such delay is not due to an unavoidable delay in securing the necessary approvals of State and Federal taxing agents, then my personal representative shall be removed in favor of the next personal representative named in my Will, and if none of them is available to serve, then such removal shall be effected and the Register of Wills of Cumberland County, Pennsylvania, shall appoint an Administrator, CTA. CLlCKNrR . nAREN InOO;111 A' UW MUIII'UtI. .IM""LYAM.A PAGE TWO OF THREE COUNn O' CUMIIRLAND ~ N' WILLIAM FEAREN sworn .ccordin9 10 I.w, d.po.., end "y' Ih.1 h. is Executor 01 Ih. e...I. 01 Edith A. Goll. a/k/a Edith Ann Goll 1.1. 01 _..YP.E.!!.~ ,!\l~~!I_~~~nship _. - , Cumb.rl.nd County, ,.., d.c....d .nd thtl the wilhln I. .n Inv,nlory m.d. by Wi 11 iam Fearen , Ih. ..Id Executor 01 the ,ntlr, ..1.1, 01 ..Id d.c.d.nt. con,ltlin9 01 .11 the p,non.1 prop'4rty end rill ..I.t" ncept r..1 ..t.l, ouhld. Ih, Commonwullh 01 P,n",ylvlnil, .nd thll the fi9ur.. opposlt, IIch It.m 01 Ih. 'nvenlory r.pr..'nt It'. Illr v.ru, .. 01 Ih, d.l, 01 d.ced.nl', dlllh. end lub,crib.d b.lor. m., -~~ - heeuf., . AJ",t"r."..., 426 Deerfield Road Camp Hill, PA 17011 AJJron 8th of February 1996 D.y M..lh v.., INSTRUCTIONS i I. , An Inventory must b. fiI.d within Ihrll monlhs .ller Ippointm.nl 01 penonel represent.tlve. ~,supplement Invenlory mu~ be filed wilhin Ihirty dlYI ~I dilcovery 01 ,dditionll .1S.h. Addi'lio,;.' Ihllh m.y b. ditch.d II to porson,IIy or rulty Sit Article IV, Fiduci.ries Act 011949. .. I r-- . ., ,gj <Xl III .s:: ..... Ul o-i .>( C .,; ., ~ ..... :> . ClI w III 0 - o-i ~ a: l- e-. . s.. 0 w ~ -..:I . '... 0 ... u :l Z 0 '^ ..:1..:1 C . . ~ 0 w W ..:10 ClI C '" I a: . Ul .0: l- X ... ...OCl o-i ... fiI E< \0 Z I- oJ OClZ o-i <Ii ofil ... oJ ~ <I ... - =r.. < w 0 -< .z >. Ul-< o.o-i 1 > z a: << ~ - '0 0 .... Z 0 c III Z -r-- 0 " ,; VI Z :c:c 0 0 < Clo-i a: e-.e-. 0 .s:: s.. I Z I w -< ........ ~ ... 0: 0: :l<Xl ... 00 ... c fiI .0.... filli1 ~ . Z UlN I - ~ fiI :.: ...~ I 0 . U s..r-- "" ,! . E ... .>I C fiI s..o-i - ..! 0 C ..:I Illr-- " 0 . 0 it CD < u :c~ " oJ - Invenlory of Ihe ,.al and personalesta'e of EDITH A. GOLL, a/k/a EDITH ANN GOLL deceased '10.. 1. Harrisburg Belco Federal Credit Union Account '032290 2. AARP GNMA and U.S. Treasury Fund Account .531101918 3. 335.112 Shares The American Funds Group Capital Income Builder @ $37.62/share 4. 5,662.479 Shares Delaware Group, Delchester Fund A Class @ $6.30/share 5. PNC Money Market Account .5130104767 6. PNC Interest Checking Account '51-4002-3813 7. Harrisburg Belco Federal Credit Union Life Insurance 8. PA Blue Shield Reimbursements 9. Medicare Reimbursement '10. Prudential Life Insurance Proceeds 11. Messiah College Annuity Payment (replacement of 11/95 check never cashed) 12. Jewelry 13. Miscellaneous Old Coins 14. Bell Atlantic Pension 0, t- rf' .~:.. ~..! 'U: :'1 ,- i N N C) l!:l .....-: 'J . . ~1 .. 41 cr' 'or.} ~ c::' p\ .r' ::l UU TOTAL ;r":" 30,449 88 2,399 21 12,606 91 35,673 62 2,488 35 21, 189 19 500 00 1, 070 07 89 70 8,590 36 786 10 i2,300 00 1, 000 00 308 05 129,451 44 llY,1500 fX + (7.9'1 l!! ..:s'" Illf~ :"9 u~"' .j 15- 85-1 INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) '*' S iii III ,. COMMONWEALTH O' PENNSYLVANIA DE,,,UMfNT O' REVENUE DE". 2.0601 HARRISBURG, 'A 1712'-0601 DECEDINT'S NAMIILA$T. 'IUT. AND ,..IDDtf INltlAll GOLL, EDITH A. SOCIAL SfCUtlfY NU"'IU CAU Of DEAtH 'OR DATlSO'DIATHAnlR 12131191 CHICKHIRl If A SPOUSAL POVIITT CRlDIT IS CLAIMID 0 fill NUMIlR 21 96 0141 COUN1Y CODE YEAR NUMBER DECEDENT'S COMPUU AOOIUS 712 Messiah Village P. O. Box 2015 Mechanicsburg, PA 17055 COlin' Cum 1 AMOUNt ItCll'dO I!lU IN$lIUClION$1 062-07-0212 02/0B/96 07/16/12 II' "PlICAIUIIUlmlHQ 'IOUU" H.....I ",UT. ,..n AND ..IDOIIINITI,I,II SOCIAL UCUI.IY NUMUI None 00 1. Orlginol Relurn 0 2. Supplemenlol Relurn o A. Umit.d Ellat. 0 Aa. fulure Inler"t Compromise (lor dOltS 01 deo,h oher 12,12,82) [X] 6. D.ced.n' Di.d T..loI. 0 7. DIC,d.nl Maintained a living TrUll (A"och copy of Will) (Alloch copy 01 Tru"1 ~RRESPONDENCEAND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO. ", COM'LIH MAILING ..ooun LECKNER AND FEAR EN . O. Box 1l8470~ N. Secont1St. arrisbur . PA ~1'JI08'>': 847 :DCI illS a:,. a:z 3~ Esquire 20, If Un. 1910 greoler Ihon Line 18, .nler the difference on L1n. 20. Thi. i, ,he OVERPAYMENT, aD 21. If lIn. 181, g,.o'er than lIn. 19, .nl., thl diFf".nc. an lIn. 21. Thill. the TAX DUE. A. Ent.r Ih.ln'.'II' on ,h. balonc. due on lIn. 21A. B. Enltr,helolol of Line 21 ond 21A on L1n. 218, Thillo Ihe BALANCE DUE, Mok. Check Poyobl. tOl Regl.t.. 0' Will., Agent ~\iHiiJ:;ijli1nV' ,.BI SURE TO ANSWER ALL QUEmONS ON REVERSE SIDE AND TO RECHECK MATH t~':;"';" en,;' ' f..',; Under Plnchl.. of p.rlury. I declor. thot I hay, ....amin.d ,hi, r.turn, including accompanying sch.dul.. and "olemenlt. and 10 the b", of my knowledge and blll.f, III. lru., corr,d and compl.t.. I declor. IhlJl all r.al .1101. has bit" r.port.er atlru. market value. Declaration of prepare' other than thl penonal r.presentative II balld on alllnformallon of which prepare' has ony knowledge. 1I0HA O"'''OH '0' ""HO "'U'H A.."" WILLIAM FEAREN, 426 Deerfield Road. .A~\c-J ~ 101 Carn Hill, PA 17011 ~ A.."" ANN E. RHOADS, CLECKNER AND FEAREN, ~ z ,. s E III a: I. Reol Ellole (Schedule AI 2, Sloch ond Bond, ISchedule BI 3, Cloltly Held S'ocklPorlnellhlp In'erell (Schedule q ... Mongoo.. and Nol.. Receivabl. (Schedule OJ 5. Ca.h. Bank D'po.it. & MilC.llan.ou. Penanal Property ISchedule E) 6, Join,ly Owned Properly (Schedule F) 7, TronsferslSchedule G)ISchedule l) B. Talal Gra.. An... (10101 Lin.. 1.7) 9. Funeral.f:...p.n.... Admini.ltativ. Ca.", Mbcellaneou. bpenlt' ISchedule HI 10. D.bll. Martgag. llabiliti.., lien. (Schedule I) 11, T 0'01 Deduction. 1'0101 lintS 9 & 10) 12. N.t Valu. of e.lat. (lin. B minu. Line 11) 13. Charitabl. and Governm.ntal Bequ.'" (Sch.dule J) 14, Ne' Volu. Sublect 10 To_lline 12 minulline 131 15. Spou.al Tran.f.n (far do'.. of death aher 6.30.9A) 5.. In.trudlan. for Appllcabl. Percenlage on Rev".. Sid.. (Includ. valu.. from Schedul. K or Schedule M.l 16. Amount of lint 1,C ta...able at 6% rate (Include valu.. from Schedule K or Schedule M.) 17. Amount of lIn. 1.4 ta...abl. at 15% rate (Includ. valu.. from Sch.dule K or Sch.dule M.) lB. Principal to... due (Add to... from Lin.. 15, 16 and 17.) 19. Credill Spau.al Pav.rty Credit Prior Paym.nll + z ,. ~ ~ :II ,. u S o 3. R.mainder R.turn (lor do'tS 01 deo,h prior '0 12,13,82) o 5. F.d"al e.tat. To... R.turn R.quired .1. 8. Total Numb" of Safe C.po.it Bo..... ',"'-... .,.c.i.j';.':::...';r; ,: ....-..... . -'-,", (1) 0.00 121 50,679.74 1;-1 LJ (3) N N (4) IS) 68.521.57 ::-=" (6) 48.727.59 '!. -. l..-; \!J (71139.175.81 (8) 307,104,71 (9) 12,926.00 (10) 7,824.71 (151 0.00 (16) 0.00 (17) 0.00 OilCount Inl"'" + (111 20.750.71 (121 286.354.00 (131 286.354.00 (14) 0.00 X._II 0 00 X .06 II 0,00 )( .15 II 0,00 (18) 0.00 (19) 0.00 (20) 0.00 Chcck hl"eo if you au! rcquC'\ting a refund of your avcrpayn-umt. (21) (21A) (21BI 0.00 0,00 0.00 Ad '48 o' 1994 provld.. 'or the r.dudlon o' the tox rat.. Impo..d on the n.t valu. o' tran.'.r. to or 'or the u.. o' the .pou... Th. rat.. a. pr..crlb.d by the .tatut. will b.: . 3% (.03) will b. appllcabl. 'or ..tat.. o' d.c.d.nll dying on or aft.r 7/1/94 and b.'or. 1/1/96 . 2% (.02) will b. appllcabl. for ..tat.. o' d.c.d.nt. dying on or aft.r 1/1/96 and b.'or. 1/1/97 . 1% (.01) will b. appllcabl. for ..tat.. o' d.c.d.nll dying on or aft.r 1/1/97 and b.'or. 1/1/98 . Spou.al trand.,. occurring on or aft.r 1/1/98 will b. .x.mpt 'rom Inh.rltanc. tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (...) IN THE APPROPRIATE BLOCKS. YES NO 1. Did decedent moke a tronsfer and: X a, retoln the use or income of the property transferred, ....................................................... b, retoin the right to designote who shall use the property tronsferred or Its income, ............... X c, retoln a reversionary interest; or .................................................................................., X d. receive the promise for life of either payments, benefit. or coreV ....................................... 2, If death occurred on or before December 12, 1982, did decedent within two yeors preceding deoth transfer property without receiving odequate conslderotlonV If deoth occurred after December 12, 1982, did decedent tronsfer property within one year of death without receiving adequate conslderation'.................o................................................................................. X X 3, Old decedent own on 'In trust for', bank account at his or her death9..................,................... X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, lIY,l5oi IX. 1""1 *' SCHEDULE B STOCKS AND BONDS COMMONWEALTH 0' PENNSYLVANIA INHEIIUNCE TAX tlnUIN IUIDlNl DECEDENT FILE NUMBER ESTATE OF GOLL, EDITH A. 21 - 96 - 0141 (Ail property lolntly-own.d with Right 0' Survivorship mull b. dl"lo..d on Sch.dul. F.) ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1, AARP GNMA and U.S. Treasury Fund Account No. 531101918 155.894 Shares @ $15.39 $ 2,399.21 2. 335.112 Shares American Funds Group Capital Inc. Builder @ $37.62/share 12,606.91 3. 5,662.479 Shares Delaware Group, De1chester Fund A Class @ $6.30/share 35,673.62 S 50,679.74 TOTAL (AI.o onler on IIno 2, Roca ilulallan (Ir mort spac. ;, n..d.d, ins.rt addi'ionol ,h..,. 01 lam. sill.) .,....., .~.~ IN-UCltU.IIJ.a) ~,,t,~ ~ SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWfAUlt O' PENNSYLVANIA INHUltANCl! TAX UTURN IISIOIHT OlaOINI ESTATE O' GOLL, EDITH A. FILE NUMBER 21 - 96 - 0141 Joint tonanl('I' A, NAME Messiah College ADDRESS Grantham, PA 17027 RELATIONSHIP TO DECEDENT Charitable benef c ary B, Oakwood Baptist Church 4315 Chestnut Street Camp Hill, PA 17011 Charitable beneficiary C, Jolnlly-ownod property. ITEM LmER DATE FOR TOTAL VALUE DECD'S DOLLAR VALUE OF NUMBEI JOINT MADE DESCRIPTION OF PROPERTY TENANT JOINT OF ASSET % INT. DECEDENT'S INTEREST 1. A 11/94 Certificate of Deposit 25,179.76 50% 12,589.88 '000021001021067 PNC Bank 2. B 02/89 Certificate of Deposit 72,275.41 50% 36,137.71 '21001020453 PNC Bank TOTAL (Aba onl., on lin. 6, Rocapilulalion) 548,727.59 (II mar. spac. is n..d.d ins.rt addilional she.ls or sam. sill' II~UIlI" Poll] ~-._..,~.,..-.--_.- . ~i~ COMMONWfAU'H 0' 'INNSytyANIA INHllltAHCI TA. InUIN .ISIDIN! DICIDINT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES .1.. I I Plea.e Print or Tvpe FILE NUMBER . 121 - 96 - 0141 GOLL, EDITH A. ITEM NUMBER A. Funeral Expen.ell 1, B. 4. C. 1, 2, 3, 4, 5, 6, 7. 8, DESCRIPTION 1. Admlnl.tratlve CO.t., William Fearen ""nonal Rep",.enlolive Comml..ion. Social Security Number 01 ""nonal Representative: Year Commi..lon. paid 1996 201 - 18 - 3551 2. Allorney Fee. Cleckner and Fearen 3, Family Exemption None Claimant Add",.. 01 Claimant at decedent's deolh S'",et Add",.. City Slale Zip Code Relollonship Probate Fee. 2/14/96 - Register of Wills, Probate MI..ellaneou. Expen.e'l 4/01/96 - Cumberland Law Journal - Advertising 3/25/96 - Betty Guy Tax Service 3/25/96 - Patriot News Co. - Advertising TOTAL (AI.o enler on line 9, Recopilulation) (II mar. .pace I. needed, In.ert addltlanal.heet. of .ame .I.e.) AMOUNT 6 , 178 .00 6,170.00 159.00 60.00 272.00 79.00 S 12,926.00 . ..-...--.-' . . ITEM V - I give, devise and bequeath all the residue and remainder of my estate, real and personal as follows: A. One-third (1/3) thereof to the OAKWOOD BAPTIST CHURCH, 4315 Chestnut Street, Camp Hill, Pennsylvania. B; One-third (1/3) thereof to the aforesaid MESSIAH VILLAGE ENDOWMENT FUND. C. One-third (1/3) thereof to MESSIAH COLLEGE, Grantham, Pennsylvania for the purposes of scholarship encowment. ITEM VI - I hereby nominate, constitute and appoint WILLIAM FEAREN, ESQUIRE, as Executor of this Will. If WILLIAM FEAREN, ESQUIRE, is unable or unwilling to act or continue as Executor, for any reason whatsoever and whether before or after my death, I r:,. appoint RICHARD W. CLECKNER, ESQUIRE, successor Executor. My r r- (" .'/ ,.: l r r', (' \', 'V 1 r r Executor is directed to proceed with the expeditious administration of my estate. If my estate shall not have been fully settled within one year from the date of my death and such delay is not due to an unavoidable delay in securing the necessary approvals of State and Federal taxing agents, then my personal representati ve shall be removed in favor of the next personal representative named in my Will, and if none of them is available to serve, then such removal shall be effected and the Register of Wills of Cumberland County, Pennsylvania, shall appoint an Administrator, CTA. <<CItHE. . FrAUM "'olllns Af uw IIlU... ,e'UllnYAlrUl PAGE TWO OF THREE Ie " r r) ,;:; - ,1'::> " I COHHONWEALTH OF PENNSVLVANIA DEPARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE 'AX DIVISION DEPT. lIO.o1 ttARRUlUAC. PI 1112'-0.01 NDTIC" OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ANN E RHOADS ESQ CLECKNER 8 FEAREN PO BOX 11847 HBG PA 17108 DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 12-02-96 GOLL 02-08-96 21 96-0141 CUMBERLAND 101 Allount R...Ut.d ~ .1f.1I.,..".l.,.... EDITH A HAKE CHECK PAVABLE AND REHIT PAVHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iiEV:isiij-EX-AFji-ioY:9r.T"iicificE--cii'uiliHEiiifliNCE-i:iiiD-PPR'AisEHEiiT-,uAi.i.-ciwliNCE-iilimum-umm DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF GDLL EDITH A FILE NO. 21 96-0141 ACN 101 DATE 12-02-96 APPROVED DEDUCTIONS AND EXEHPTIONS: 12,926,00 9. Funeral Expen.../Ad.. Co.ta/Hise. Expens.. (Schedule HJ I') 10. Debh/Horloaoa LlabUIU../Uan. ISchadule II 1101 7.824,71 11, Total Deduction. 1111 12. Net Valua of Ta. Raturn 1121 13. Ch8rltabl./Cov.r~.nt.l alqua.t, (Schedul. J) (13) 14, Nat Valu. of E.tata Subjaot to Ta. (141 NOTE: If an assessment was issued previOUSly, lines 14, 15 and/or 16, 17 and 18 reflect figures that include the total of 6hh returns assessed to date. ASSESSHENT OF TAX: 15, Aoount of Lln. 14 at Spou.al rata 1151 16, Aoount of Line 14 ta.abla at LlnaaI/Cla.. A rata 1161 17. Aoount of Line 14 ta.abla at Collataral/Cla.. B rata 1171 lB. Principal Ta. Due TAX CREDITS: PAYMENT DATE TAX RFTURt: WAF I (X, ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Raal E.tata ISchedula AI 2, Stock. and Bond. (Schadula BI 5. CIoa.ly Held stock/Partnership Int.r..t (Schedule CJ 4. Kortg.gal/Hot.. Receivabl. (Schedule OJ 5. C..h/Bank Oapollta'Hllc. Parlonal Property (Schedule EJ 6, Jointly Owned Proparty ISchodula FI 7. T~an.f.r' ISchedule GJ 8. Total A...t. I CHANGED III (21 (31 (4) (51 (6) (71 ,00 50,679,74 ,00 .00 68.521. 57 48.727,59 139.175,81 leI ,00 ,00 ,00 x,OO. X ,06. x ,15. Ilel RECEIPT NUMBER DISCOUNT 1+' INTEREST 1-) AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE NOTEI To jnlura proper credit to your account, sub.it the upper portion of this for_ with your taM payaent. 307,104,71 '0.71;0 71 286,354,00 286,354.00 .00 will ,00 ,00 .00 ,00 ,00 ,00 ,00 ,00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, I IF TOTAL DUE IS LESS TNAN tl, NO PAYMENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE A REFUND, SEE REVERSE SIDE OF TNIS FORM FOR INSTRUCTIONS,I c' !!::-; P\ I r__1 C:.J . , -h ._ :J IJO RESERVATION. r.ta'.. of decedent' dying on or before Dec.-ber 12, 19'! .. I' ~y future In'ar..' In the I.'at. I, tr~".rred In po.....lon or InJo~t to Cl... . (col1,',r,1) bene'lcl"... of the decedent I,t,r the ..p.rtllon 01 InV ..'at. 'or 11'. or for y..r., the Co..onwellth h.rabv ..pr..'lv t...rva. the right to .",.... end ...... ttln,f., Jnh.rlt~. ,.... at the l.wful C1I.. . (co11,',r.l) r.t. on 8nV luch lutur. Int.r..t. PUIlPOSf: OF HOIJtE, To fulfill the requlr.-.ntt of Section Zl~a of the Jnherltencl ~ Elt.t. ,.. Act, Act II of 1991. 72 P,S. Section 2141. PAMNTI o.tach the tap portion of thh NotlcI Met luI*lt .,lth you,. PIVMI'l' to the _..ht.r 0' WUlI prln'''' on the revl'" ,... ..M.... check or -., order pI,.tII_ tOI REGISTER OF MILLS I AGEHT All P.~t. r.cllv.d ~11 flr.t be ~11'" to 1n1 In'.r..t which "V be ~ with 8nV ,...Inder ~11ed to the t... RU\JrCD caul A nfund of a ta. cnellt, ..,Sch .... not r..,..ted on the T.. Raturn, ..y be reque.ted by cDllPlaUno an "Appllc.Uon for _.fund of Pennlylvanl. I~rltanc. and E.t.t. T.... (REV-1313). Appllc.tlon. ara avallabl. .t the afflc. 0' the R..I.t.r of Will., any of the ZS Rayenue DI.trlct a'flc.., or by c.lllne the .peelal 24-hour antwerlng ..rvlc. nuaber. 'or for.. orderlngl In Penn.ylvanl. 1-.00.S6Z.2050, out.lde PennlYlvanla and within lOCal Harrhbur. .r.. (717) "'-'OM, TOO' (111) 712-2152 (He.rlng I.alred Onlyl. alJECTIDHSI Any p.rt, In Int.r..t not ..tl.fled with the apprall..-nt, .llowanca or dl.all~anc. of deduction., or .......-nt of tax (Including discount or Int.r.,t) .. shown on thl. Hotle. .u.t ObJact ..Ithln .I.ty (60) d.y. of rac.lpt of thh MoUe. brl ....rlttan protatt to the PA Dapartaant of AlylnUe, loard of App.a", o.,t. 211021, Harrhbur., PA 11121-1021, OR ....INUon to have the ..tt.r clat.ralned at audit of thl account of thl p.r'ONI r.,r..ant.Uv., OR -......1 to the Orphans' Court. AlliUM IITIlATlYE CQRRfCTIDHSI 'aotual .rror. dl,cOY.red on thl. ......eant should be addr...ed In ..rltlng to. PA O.,arteent of R.yenue, lur.au of Individual Ta..., ATTNI Po.t i.....aant R.yl... unit, D.pt. 210'01, Harrisburg, Pi 11121-0'01 Phone (717) ,.7.6505. S.. page 5 of thl booklat "In.tructlon. for Inherltanc. T.. R.turn for I R..ldant Decadent" (REV-1S01) for an ..planatlon of ~lnl.tratIYaly correctable .rror.. DISCOUNT, If any tlx due I. paid ..Ithln thr.. (SJ c.landar eonth. aft.r thl dIe.dant'. death, . fly. parcant (IX) dl.count of thl t.. paid I. .llowed. The IIX tl. .-na.ty non-p.rtlclpltlon panalty I. c~tld on the tot.l of thl t.. and Intar..t ......Id, and not p.ld bafor. Janu.ry II, 1996, the flr.t d.y .ft.r the and of the t.. aana.ty p.rlod. Thl. non-p.rtlclpatlon penalty I, .....Iab.. In thl ... unnar and In the the .... tI.. par lod II YOU would appa,.l the tl. and Int.nlt that haa baan ......1Id a. Indlc.tad on thl. noUc.. PfHALTVI INTEREST. Intarllt h charted baglnnlng with first day of d.lInquency, or nine (tJ eonth. and ana (II day froe the data of death, to the d.t. of p.,.ant. T.... which bac... d.llnquent bafor. January 1, l'IZ b..r Intar..t .t thl rat. of .he (IX) p.rcant par ........ calculatlld .t . d.lh rata of .000164. All t.... which bec... delinquent on and .ft.,. Janua,.y 1, .'12 will ba.r Intar..t at . r.t. which will v.ry fro. c.land.r y..,. to c.landar y..r ..Ith th.t r.ta announced by thl Pi Dap.rt-.nt of R.vanua. Th. appllCabla Int.,...t ,..ta. fo,. 1982 through 1996 a,..1 !!!! In'',nt "t. Dally Jnt.r.at Factor !!!r Jnt.r..t R." Dally tnt.,...t Facto,. 1912 lOX .000548 1911 'X .00DZ47 1915 lOX .00001 1911-199. IIX ,000501 1'.4 IIX .000301 1992 'X .OODZU I.n UX ,OOnS6 1993-1994 1X .0001'2 .'.6 In .00027_ 1995-199' 'X .OODZU --Int.r..t It c.lculat.d n follow.. INTEREST . BALANCE OF TAX UNPAID X NunBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Motlca I..ued .ft.,. thl t.. b.c... dallnquent wIll rafl.ct an Intarllt calcul.tion to flft.an 1151 d.y. bayond thl d.t. of the .....a.ant. If payeant I. .ada .ft.r the Int.,...t co~t.tlon data .hown on thl Notlca, addltlONl Int.rllt "".t be c.lculat.d. .~ , ,. " .' . ,', " ':c; , ~l ' ". - .. , ,I . ..t....', -I" . ,~... . . ..f\' .(, 4", -~ ,1 " . '. ff,'..;! .. '. ".. I~.', '. . /,.,. .. ....... V ' ,\ '0. r . II . '.1 '~,r.;, i~'.f:"\- . . - . '. " . . t .. '. 1 ." ..~ ", '. ,~. tlJ I:. I } .~ \ I I r. f." r >'.- -,~. .. - -- ~ .;... -~..~.. ..-.-- .----. . .i J 1" , .. ~. , \- ., ,,' \, t' -~ !'. : ; .f -~ ~ "" . IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA IN RE: ORPHANS' COURT DIVISION ESTATE OF EDITH A, GOLL, a/k/a EDITH ANN GOLL, Deceased NO. 00141 - 1996 AGREEMENT REGARDING DISPOSITION OF CERTAIN ASSETS AND RELEASE FILED ON BEHALF OF: WILLIAM FEAREN, EXECUTOR Ann E. Rhoads, Esquire Attorney I,D. No, 49631 CLECKNER AND FEAREN 31 North Second Street P. O. Box 11847 Harrisburg, PA 17108-1847 (717)238-1731 -_:_- - , .. .~. ~. '" 1'""\ --I -~L<;'.;'.z:;"'_"" ~ AGREEMENT REGARDING DISPOSITION OF CERTAIN ASSBTS AND RELEASB '" THIS AGREEMENT, entered into this L day of 1996, by and between WILLIAM FEAREN, individually and of the Estate of Edith A. Goll, also known as Edith Ann Goll, deceased; Messiah Village on behalf of its Endowment Fund; Oakwood Baptist Church; and Messiah College, WHEREAS, Edith A. Goll, also known as Edith Ann Goll (herein- after referred to as "Decedent"), late of Upper Allen Township, Cumberland County, Pennsylvania, died February 8, 1996, having left her Last Will and Testament dated March 5, 1990, which was duly admitted to probate by the Register of Wills of Dauphin County on February 15, 1996, File No. 1996-00141; and WHEREAS, WILLIAM FEAREN was duly appointed as Executor of Decedent's Estate on February 16, 1996; and WHEREAS, the parties in interest under the Last Will and Testament of the Decedent are: (1) Messiah Village Endowment Fund 100 Mt. Allen Drive Mechanicsburg, PA 17055 (2) Oakwood Baptist Church 4315 Chestnut Street Camp Hill, PA 17011 (3) Messiah College Grantham, PA 17027 ; and WHEREAS, the bequests to the above-named beneficiaries by the Decedent in her Last Will and Testament were as follows: - 1 - '~_"'_'''''''_''~.'':;W'-'''_''''_''''''.''__ "\ ,"'-'" . ITEM III - I give all my tangible personal property, including, but not limited to, any and all automobiles, furniture, furnishings, china, silverware, jewelry, ornaments, works of art, books, pictures and wearing apparel, together with all policies of insurance thereon, but excluding cash on hand and tangible evidences of intangible personal property to the Messiah Village Endowment Fund, Mechanicsburg, Pennsylvania. ITEM IV - I give the refund of the purchase price for my apartment at Messiah Village which is due my estate at my death to the Messiah Village Endowment Fund, Mechanicsburg, Pennsylvania, ITEM V - I give, devise and bequeath all the residue and remainder of my estate, real and personal as follows: A. One-third (1/3) CHURCH, 4315 Pennsylvania. B. One-third (1/3) thereof to the aforesaid MESSIAH VILLAGE ENDOWMENT FUND. thereof to the OAKWOOD BAPTIST Chestnut Street, Camp Hill, C, One-third (1/3) thereof to Grantham, Pennsylvania for scholarship endowment MESSIAH COLLEGE, the purposes of ; and WHEREAS, in addition to her testamentary bequests, Decedent made lifetime transfers to each of the above-named beneficiaries through various mechanisms, such as but not limited to, outright gifts, annuities, beneficiary designations and the creation of joint or payable on death accounts; and WHEREAS, the Decedent also held the following assets at the time of her death which she had titled "EDITH ANN GOLL TRUST, Edith Ann Goll, Trustee, FBO OAKWOOD BAPTIST CHURCH UtA DTD 10-30-91": - 2 - r ~ 1""\ ,......, ~ ASSET DATE OF DEATH VALUE (1) 100 shares common stock, DSC Communications Corporation $ 3,337.50 (2) $25,000.00 Dauphin County General Authority Senior Mortgage Revenue Bond, Series of 1991 (3) Wheat, First, Butcher, Singer Account #3595-5011 25,000.00 (est,) 11,375.59 and WHEREAS, after diligent search, the Executor of Decedent's estate has been unable to locate a Trust instrument as referenced in the title to the assets listed above or any evidence other than said titles that such an instrument ever existed; and WHEREAS, as a result of the above, the parties have come to believe that the Decedent was attempting to create an informal trust for the benefit of Oakwood Baptist Church by titling the above assets as described; and WHEREAS, while each of the parties hereto understands the existence of a potential challenge to the title to the above- mentioned assets which if successful would bring said assets into the probate estate, each is nevertheless willing to forego such a challenge to allow the Decedent's apparent intention with respect to said assets to be fulfilled; and WHEREAS, it is the desire of the parties to this Agreement that disposition of the above identified assets be agreed upon without the expense, delay and publicity of litigation. - 3 - ." r", < NOW, THEREFORE, in consideration of the mutual promises, covenants and agreements recited herein and with the intention to be legally bound, the parties agree as follows: 1. Messiah College, Messiah Village on behalf of its Endowment Fund and the Estate of Edith A, Goll, also known as Edith Ann Goll, do hereby waive, disclaim and release any and all interest any of them may have of any nature whatsoever in the following assets, in favor of Oakwood Baptist Church: 100 shares of common stock in DSC Communications Corporation, represented by stock certificate No. DS 79730, CUSIP 233311-10-9; Wheat, First, Butcher, Singer Account No. 3595-5011; and a $25,000.00 Dauphin County General Authority Senior Mortgage Revenue Bond, Series of 1991 (Messiah Village Project), represented by certificate No, R0872, CUSIP: 238259 SV 8. 2. Each of the parties to this Agreement does hereby release and forever discharge William Fearen, individually and as Executor from any and all liability in connection with his actions as Executor of the Estate of Edith A, Goll, a/k/a Edith Ann Goll regarding the assets which are the subject of this Agreement. The parties further agree to indemnify and hold harmless the said William Fearen from any and all liability which may arise against the estate or him by third persons relating to the assets which are the subject of this Agreement. 3. The parties each acknowledge and agree that this Agreement is an amicable resolution of an unclear legal situation and - 4 - 1""\ r'\ agreement hereto and shall not constitute an admission as to the merits or lack thereof of any party's possible position with respect to the legal effect of the way in which the Decedent titled the assets which are the subject of this Agreement. The parties each further acknowledge and agree that each has consulted its own legal counsel regarding this Agreement or hereby waives its right to do so, 4. Each party to this Agreement acknowledges that this Agree- ment shall be indexed and recorded in the estate proceedings and that the terms hereof shall be binding upon their respective successors and assigns, WITNESSES: ~..-(~ WI LIAM F N, Indi viduall~ as Executor of the Estate of Edith A. Goll, a/k/a Edith Ann GOll, Deceased W~~~ MESSIAH VILLAGE, ON BEHALF OF ITS ENDOWMENT FUND .;;( BYrJd ),'1: /' OAKWOOD BAPTIST CHURCH //~.ff./~/;;f: -?:t~4tP,//~4~.(/ By ~~ (f.?~,,-) (J L~~~;~ MESSIAH COLLEGE . '-jl(& :> BY~ roo ~ C - 5 - '1()il:'f.1,";;\,: ';, P,fH'0i;\;', m'i'J;<",:)j .;, 8~~ii~;'I,~i~.::;:~, ,.," ;~iJ' .~: '. ~ilf,~W?j~ ~I"~'l;,,",' .c'lll,IIl.';" 1Il:~E:!:'\'; M,=:~'o), i~,o~~;:,.( .i,41/~'Q.~G":~ Eola','~,' u3,':,,\ ':~'~":" H~"',' IIlHJ:'~. ")'j,,~,.. ::,'i\ I;' , ';,!"'.""~' " Q(!'> '.: ':~-~~'.~_.,:~:, '''. . . ~,-; -"-;..ul'I,...o f,b:~,,';',..r; J .",~" 0""1 ti'/ , _ ,1"n~lI'!"II""" UOnnq"II,P'O I'" ,,~;;,~~:jitijoi::ilt,'OdO,l!l III1M ,'~UlP/OllOI UI ('~(;~"/lI'~';'Uonnq"",p PUI A,I,nlolql ,!~n~l( pMWf,uOo' . . , . '~~~t~;:I~;~~.:!",~( .\;,.., . " lili?< ;JL~~i~,")," '.' :!,,' ','" "/ .~. ,'. N' '':'f ~ a.:. 0' -c-'.... c3 o .~ ...... ~ ~ 0" . ". ,~~.~ .. 3;i":+:~g", ,c, "lIIZ" J>.':., E-I:Z: .~~~t'~~-?g: ~ ' "'., ~,lZI :i ;,'H ,AiM' ,0 Q,'O ',JlI3,$ , '" IIIl 'II, "EoloC III ,.c..... $ ';;EolIll:'U (/).....41 ,IIIl,oCC t',,' .n_'" .,' ,:'f'.:'J ,. . -;.:~ "'D- " (- d ',I '8:IflOU ,..,.lPJM plIpnlClUllIM 1UIUI"''Il8 pt.. jO ~ It , ~jO~~ JII" 'AJIJoueueq '.IOIIpuln emte ..,.11I.....,., III WIII:I 10 lAllj lit IUIWIIOCIOt 11I1 lit UMIlUlt UOlUId alfIO A-. 01 pul IUIIWIIp ptldun AIeIlI CII UMfD UHq I8If 'UlIfI/lCIJIII( ptIOdoJd ,0 IUIIWIIIIl1S pt.. C111UOpl1l1fqo u~ ItY ell Alp III' eIl1 '0 PUlIlIOJl8IUJIlUOO MIl IUlO:) IllIIIt PlIIIIlIftJd eq IIJM ew.. II'll UllljNIlI:lllld PU8ewp '8UIP IMp jO PUI 'UOJlllCll4lKl peIOdoJd jO IUIIWIIIl1S 11'11 jO lIuJllIlIl/IjOlI:lpou UIIIIfJM I8IlIAMueo Aq8.l." I J .'\ ( ..~ :~, -;.,.'._~ - ,'.. E !2::l ()() .' ~i Ii ~ . Jl ~Js It 0 'B;,fSs z E ~I j IlJ ti :S ell at) I ~a:~ .. ~el~5 II: z ...t ~ t ;jHil WI '<l' pI&." ';J ...t rgOi( 0 ).' z VI till I ,1IIl ~ VI 0 Z U Z \D W-a:~ w Ill, .. O'l (/) IlJ Z II. h111j ~I[ '" 0 I Z 0 ~ II: I[ ...t O~\: 0 :l N II ,Iiii lIIUi( z III ll:1lJ - VI -' " - , , U ',I[' 0 f'!sll'15 IIIl ~ :z: Z :t I~ ~I ~ 1lo - ,l: 7Js.! _II.. ~' 0. 'PI .c II !i o Eol C 41 ~ ...t :..' ...t.lJ , oC C =', 1.'0 GI U III 0. 'PI 0.'0' C PC lII. , III > Ol-I...t...t 0"':" GIll 41 .0 s:: .lJElS:: 1\I='Q1 ~UP, . t . . ,~ 'I" ., .'1.:_ .",- "';',"';< -'1"',""'; SUMMARY OF ACCOUNT proposed Distribution to Beneficiaries: $ 34,169.54 princioal Receipts $129,411,44 Less Disbursements: Debts of Decedent Funeral Expenses Administration Expenses Federal and State Taxes Fees and Commissions $11,245.69 0,00 718,12 256,00 12,900,00 Balance Before Distributions Distributions to Beneficiaries Principal Balance on Hand - 25,119,81 $104,291.63 73,300.00 $ 30,991.63 Income Receipts Less Disbursements Income Balance on Hand $ 967,44 0,00 Combined Balance on Hand Adjustment Adjusted Combined Balance on Hand $ 967,44 $ 31,959.07 2,210,47 $ 34,169.54 RECEIPTS OF PRINCIPAL Assets Listed in Inventory (Valued as of Date of Death) Fiduciary Acquisition Value ~ Harrisburg Belco Federal Credit Union Account #032290 AARP-GNMA and U.S. Treasury Fund Account #531101918 $30,449.88 2,359.21 PNC Money Market Account #5130104767 2,488,35 PNC Interest Checking Account #51-4002-3813 21,189,19 Pa. Blue Shield Reimbursement 1,070.07 Medicare Reimbursement 89.70 - 2 - DISBURSEMENTS OP PRINCIPAL Debts of Decedent 03/29/96 - Messiah Village $ 4,515.49 07/08/96 - Bankers Trust (repayment of Bell retirement) 2,233.38 07/08/96 - Medical & Surgical Centers, Inc. 1,236.82 RESERVE - Robert Conrad - services performed as Power of Attorney 3/93 - 2/96 3.260.00 $ 11,245.69 Funeral ElCtlenses None Administration Exoenses 02/14/96 - Register of Wills $ 159.00 03/21/96 - Ann E. Rhoads (travel) 3,41 03/25/96 - Patriot News Co. (advertising) 79.00 03/25/96 - Ann E. Rhoads (travel) 3.41 04/01/96 Cumberland Law Journal (advertising) 60.00 08/20/96 - Postmaster 18.30 08/21/96 - Register of Wills 25.00 09/12/96 - Register of Wills 120.00 RESERVE - Register of Wills, Account Filing Fee 250.00 $ 718,12 Federal and State Taxes j 03/29/96 - Pa. Dept. of Revenue :; (1995 income taxes) $ 56.00 RESERVE - 1996 income taxes 200.00 t , $ 256.00 ~ - 4 - ~~ ~; RECEIPTS OF INCOME Dividends Wheat First Butcher Singer Account: 04/29/96 05/14/96 $ 79.71 68.41 $ 148.12 Interest Dauphin Deposit Bank & Trust Company Checking Account: 04/96 05/96 06/96 07/96 08/96 09/96 10/96 $ 13,97 90,65 157.06 172,01 160.85 110.69 114,09 $ 819.32 TOTAL RECEIPTS OF INCOME $ 967,44 DISBURSEMENTS OP INCOME None Income Balance on Hand Principal Balance on Hand Combined Balance on Hand Adjustment Adjusted Combined Balance on Hand $ 967.44 30,991.63 $ 31,959.07 2.210.47 $ 34,169.54 PROPOSED DISTRIBUTIONS TO BENEPICIARIES TO: MESSIAH VILLAGE, in satisfaction of gift in ITEM III of Will 02/21/96 - Furniture, Household Goods, miscellaneous old coins, jewelry $13,300,00 $ 13,300.00 ! - 6 - . IN WITNESS WHEREOF, I have hereunto set my hand and seal to o f)-I ~<A. e-I?.. , 1990. this my Last Will and Testament this _ day \" --: ISI (r, .:.t..,t(A..o EDITH Signed, sealed, published and declared by the above Testatrix as and for her Last Will. in our presence, who, at her request, in her presence and in the presence of each other, we believing she is of sound mind and memory, have hereunto subscribed our names as witnesses. ,~ i:,~)d of ~U'" M(l \l. int..h\. ~ . 1 I:..... .It.. ct...~..-0_ <. J of C-rJ. I . '~~'''-r'<~'''< <-c .fJA.<'j- f4, I I t , i CUCKHU . 'UIU A"oun. " u. MU'IIIU.'. ,Ullln.....A PAGE THREE OF THREE . Proof of Publication of Notite in The' Patriot and The Evening News and The Sunday Patriot-News Uade. Act No, AT, "rpro.rd May 18, Isr-o, Commonwtalth 01 Ptnn8"lvonia, } County 01 Dauphin RR: """"""'......,,,.....f.,!:~,n,Js,..;r,',,"~p.l!!.J;:,..,,...,,",,..,,,,,,,,,,,,belnlf duly sworn according to law. deposes and says: Controller That he Is the "",.."""",,,,,....,,,,of THE PATRIOT -l\EWS CO" a corporation organized and existing under the laws of the Commonwealth of Penns)'lvanla, with Its principal office and place of business at 812 to 818 Market Street, in the City of Harrioburg, County of Dauphin, State of Pennsylvania, owner and publisher of THE PATRIOT and THE EVENING NEWS and the SUNDAY PATRIOT-NEWS newspapers of general circulation, printed and published at 812 to 818 Market Street. In the City, County and State aforesaid; that THE PATRIOT and THE EVENING NEWS and the SUNDAY PATRIOT. NEWS were established March 4th, 1854, and February 15th, 1917 and September 18th. 1949. respectively, and all have been continuously published ever since; That the printed notice or publication which Is securely attached hereto Is exactly as printed and M~tro l~c~t 5th, 12th, and 19th published In their regularA!dttlons ana Issues which appeared on the ,...""""....,.....".."..",,,,,,,,,,,,,,,,,.,,,,,,,, days of March 1996. ........................................................................................................................................................................................ That neither he nor said Company Is Interested In the subject matter of said printed notice or adver- tlsln8'. and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and Is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolu- tion unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly re.:orded In the office for the Recordin of Deeds in and for said Count)' of Dauphin In Mise.llen,oul Book "M", Volumr l-l. Pe~r 317, ~ P. C; -- Copy of Notice or Publication '''''''''..,..~~'''''''''' ,;~..jU:.,.._""""""'..""......... S~nio and subscdt('od1iefore me ~~" ,.t."",day of M~,!:,S~ ...", A, D, I I':' ' I'} {(j "/A~-f/ / T~ty Isi.':'~~d~' ,,{.! ".."f.. ,/t;:;,:i;""..,,-;l.=, My Co:'mlMi:l1i e;piros Jun~~lC Notary Public "'-es""""""" """,..."" Statement of Advertising Costs IITA'. NOTICI NOTIC. II HIR.IV alVI!N fha' Lt".... ,..MmtntcrY In 1M I...... Ifldlth A Gon. alto kMwn OIlIdlth AM 0.011. loft ef U..... AIIfl'l ,..".,.llIf Cumbtrklnd Ctunty. Itenn.ylvanlo. dIctOMd. haYt IMtn tronttcl to !hi uncI<<1llMd. .. 011 ........ I~ .. IOid ftIatt en r.. ...,.. .. matt IrnmedkttI NYfMftt oncI thoM _..ctoI....."..-,_...._,.., WI.....'.... .. at DIIrfItM.... OIfftJH....'..'ml .- .. AM.................... --- ...O....,IN7 JI N.",. ....., Itnet . H__.....'A tn.'M7 AfttnttYI c l,'i:j;.kn~l:',..,(i....F.li\ilX;~')..,......................"'......"",,....,.., lIa r r t!!,l?,!:1,r..g,I......r,~"..,.."f.1.LQ.~................,..............., To THE PATRIOT-NEWS CO,. Dr. For publishing the notice or publication attached hereto on the above stated dates . $..........?~,:..9,R...." Probating same $....."...,,~,:..~,~,..," 79.00 Total $...........,..........,...., Publisher's Receipt for Advertising Costs THE PATRIOT-NEWS CO" IJublisher of TilE PATRIOT and THE EVENING NEWS and the SUNDAY PATRIOT-NEWS, newspapers of general circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have been duly paid. TilE PATRIOT-NEWS CO. By....,....,..,......,....,....,...........,..................,......,.....,..,......., EXUIBLT "A~I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU Of INOIVIOUAL TAXES IHHUITAHCE ."Ax DIVISl.ON DEP'. 210601 HlRRlSaUAG, PA 1712"0601 NOTICE' OF INNtRITANCE TAX APPRAISEHENT. ALLOWANCE OR DISALLOWANCE Of OEDUCTIONS AND ASSESSHENT OF TAX ANN E RHOADS ESQ CLECKNER & FEAREN PU nnx 11847 HBG PA 17108 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-02-96 GOll 02-08-96 21 96-0141 CUMBERLAND 101 Allount R..Ht.d .. tl,o\It' ....'.U..II EDITH A MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ Rt~~ LOWER PORTION FOR YOUR RECORDS ~ 'ff:.y: is-;'''j''E3f-^!=p--f~;-''-96-f-~~~ff!3i- . ..~~..~~ ~f~^~-~~"~~~~"! ~"?P'!-;':r~~f');'-:-.~~l"o~~.~-~f-~~D-----------""" --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GOLL EDITH A FILE NO. 21 96-0141 ACN 101 DATE 12-02-96 TAX RETURN WAS I (X I ACCEPTED AS fILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1, Reel Estete (Schedule Al (11 2, Stocke end Bonds (Schedule BI (21 3, Closel~ Held Stock/Pertnership Interest (Schedule CI (31 4. Hortg.gal/Hot.. Receivabl. (Schedule OJ (4) 5. Ca.h/Bank Dapollt.'Hlac. Parlonal Property (Schedule E) 15) 6, Jointl~ Owned Propert~ (Schedule fl (61 7. Tranafara (Schedul. GJ (7) e, Totel Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expens../Ad.. Coat./Htle. Expans.. (Sch.dul. H) I') la, Oebt./Hortgege Liabilities/Liens (Schedule II (101 11, Tote1 Deduction. 12. N.t Value of Tax R.turn 13. Charitable/Covern..nt.l aequa.t. (Schedul. J) 1~, Net Velue of Estete Subject to Tex I CHANGED ,00 50.679,74 ,00 .00 68 ,521. 57 48,727,59 139.175.81 (el 12.926,00 7.824.71 (111 ll21 (131 ll~1 HOTEl To Insure proper cradlt to your account, sub.lt the upp.r portion of this for. with your tax pay..nt. 307.104.71 ?n.7~n 71 286.354,00 286.354,00 ,00 NOT~: 14, l~ and/or Ib, 11 ana IH Wl~~ returns assessed to date. l' an assessmen~ was Issued preVIOUSly, lInes reflect figures that include the total of ALL ASSESSMENT OF TAX: 15. A.ount of Llna 14 at Spousal rata 115) 16, A..unt of Line 14 t..ebl. .t Lin.el/Cle.s A r.te (161 17. A.ount of Llna 14 taxabl. at Collataral/Class 8 rata 117) 11. Principal Tax Du. TAX CREDITS: PAYHEHT DATE RECEIPT HUHBER DISCOUNT (t I INTEREST (-I ,00 X ,00. ,00 X .06. ,00 X .15. nel A/tOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE EXHIBIT "B" . If PAID AfTER DATE INDICATED. SEE REVERSE fOR CALCULATION Of AOOITIONAL INTEREST. ,00 .00 .00 ,00 ,00 ,00 ,00 ,00 I If TOTAL DUE IS LESS THAN ll. ND PAYHENT IS REQUIRED. If TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. YOU HAY BE DUE A REFUND. SEE REVERSE SIDE Of THIS fORH fOR INSTRUCTIONS,' --..-- -.-.' .~._'~"'-.. ~~ RllllVAflONI (,..... I' decedent. d'lnt on I' blfo,. Dtcllblr 12, "" .~ I' InV 'utur. Int.r..t In thl ..t.t. I. trln.ferrad I" ,......Ien .r '"J.,-.nt tl CI... I Ic.ll.t.r'll ~flol.rl.. 0' \~ dIc~t ,'t.r the .xplr.tlon of eny ..t.t. for II'e or 'or v..r., the C..-onw...th he'''' ..,r.,.I, r...rv.. th. rl~l \D ~,.I.. and ...... tren.,.r I~rltanc. T.... .t the ...'ul CI... I Ic.II.,.,.11 ,.t. on en, .uch 'utu,. I",.,..t. ~1lI' NOTltr:1 ,. fulfill 'he r...ItMlfth If SIIUon 'UO o' the IMirltanc:. Md ht.,. 'lie Act, Act ZZ of 1"1. 72 P.S. SIIUon "". "'MHh DetlCh 'hi to, ,.rtlon of thlt NotlCI Met ......11 ..lth vour ,.'tHnt to thl ...lIt.r 0' Wllh prlntld on thl rIVer.. .ldI. ""-l. chick or MM' or'" ,.veb.. t" Rtell.fEII OF MILLS, AGENT all ,'yMn" r"'lv'" wll first bI -..1I1d to anv Int.r..t which Ill' be ..... ..Ith ....V r...lndar appllld to the tax. ltl'UND CClII a ,,'\nII .f I t'll ItHII, w.lch .... not r.....tld on the hll Return, ... bI r..,.".d by cOIIPhtlng .... "Appllc.tion 'Ir ."und I' '~.vlvenll IMir1t1nC1 Met [.t.,. t.... CAtY-ISISI. Appllc.tlon. .r. IVllllbl. It the Offlc. .f thl _..I.,., .. Will., InV of thl II _.venue DI.trlct Of'lc.., or bv c.lllng thl .peclll 24-hour en...,I", ,.,vl.. nueblr, '.r for.. .r"rlntl In Penn.vlvenl. 1-1.0-S'Z-Z050, out.lde Penn'rlvenl. end within 1...1 tta"ltbu" .n. "111 """M, '001 11111 711~ZZSZ IHI"lng 1....lnd Onhl. OIJlCTIONII AnV ,I,t, In Int.r..t not ,..llflad with thl ep".II.-.nt, Illow.nc1 or dl..llowlnC, of deduction., or .....~t .f t.. (1",ludl", dl.count or lnt.,..'1 .. shOwn on thl. Hotlc. ~.t object within .llItv e601 day. of ,acelpt of thlt "'U.. "VI ....'IU.. ,r.tnt t. thl PA Dep.rt-.nt of .'VII'IUI, laird of Appea", Dept. lllDZ1, ",rrhburl, pa IlUI-IDZI, OR --.1....... t. hew. thl ..tt., .....relned .t IUdIt of tM HCount 0' thl P."onal repr..."tetlv., OR .......1 t. the 0'''''''' Court. ADIIIM IIIUIII/( C_CIIIlNI, ,..tuII .rr.r. ~1'clV.r" on thl. ......eent .hoUld bI Iddr...1d In Nrltlne tal PA o.,.rt-.nt of A.venue, aur.., .. .ncllvldllll h..., afl"1 POIt A......ant a.vl... Unit, Dept. lID601, H."laburl, PA 17UI-D601 PhenI 17111 ,.,-".,. S.. ,... . of the bookl.t "In.t,uctlon. '0' Inherltanc. T.. R.turn 'or I A..ldent ~,.. IRlY-I'.11 'e, en ..,Ianatlon a' IdIlnl.tr.tlv.lv corrlCtabl. .,rorl. DIICllUIIt .f ...v ,.. due I' ,eld within th,.. ISI c.llndar .onth. aft.r thl decedent'. d..th, I 'Iv. Plrcent 15~1 dl.count .f the ,.. ,.I~ I. .11...... 'he lit t.. IInt.,v non-p.rtlal,atlon ,~Ity I. COlPUttd on thl tot.1 0' thl t.. and Int.,..t ......Id, ~ not ,.Id bI..,e Januar, '1, 1..6. thl fl,.t d., .,t.r the and of thl t.. -.na.tv period. Thl. non-p.rtlcl,.tlon "",It, II ..,..111I1. In thl .... lomer and In thl the .... tI.. ,.,locI n ,ou would ""11 thl t.x Met Int"..t thlt hi' bean ......... n Indlc.tld on thll notlct. 'lOLlY. INI[IIlIl, In'.'.., I. ch.rted bltlnnl", with flr.t d., 0' d.llnquency, or nine e'l -.nth. and one ell d.v frol thl d.t. 0' ""h, to thl d.t. .f p.yeant. '.X.. which bee... d'llnquent bI'o,. Janu.ry I, I'll blar Int.r..t .t thl r.t. 0' .1. ('XI parc...t par ~ c.lcul.tld .t . dlllv r.t. of .000164. all t.... which bee... delinquent on end .ft.r Janu.r, I, 1'1' will ba.r In'.r..' .t . r.l. which will v.r, frol c.landlr ,..r to c'land.r y..r with that r.t. ~.. by thl pa DeI.rtlln' of A.vlnUl. ThI appllcabll Inter..t rat.. for I'IZ through 1996 .r'l US! Int.,.., _et. O.lly Int.,..t 'acto, !!!! Int.,..t .lte Dally Inte,..t Factor "., IU .OIUU ...7 n .OOOlit7 ...S I.X .OIOU' 1....1"1 IIX .OODSOI I". m .00DSI1 199Z n .000lU U.. III ,DOOU. 1995-I.M 7X .OD01'Z I'" IU .OODZ" 1"5.1'" n .ODOlU -'In,,,..t I. c.lcul.tld " 'ollowll INTEaElT . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ..an, Notice l..uId .ft., thl t.. bec.... delinquent ..Ill "fI.ct .,. Inhr..t celcul.tlon to flft.1ft 1151 d.v. be,and thl da'. of thl .......ant. I' P'~""t I. .ldl ,'I.r IhI Inl.,..t cQlPUtltlon dlt. shawn on thl NotlCl, IMSdIt lon'l Intlrllt IUlt be calcullted.