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'-;l.'.f...t '1.'- ':{;J;;' :'-~,:,{{' P .:i"ir ~ifi.~~r:',:};(.:.': Mr&:. ,;~~~i~~;?l: '::A":?' ~c,~-.' N _.... .. C'-! c.. C\ N Q:\ If ".1 (l\ \:) ~c: , .. _J '", t,) -.,.-- ,,~~:~~.r; _ t J. ( ':;,:..E ..~. . . .. _ L' _, ..('1 ,':~~ c::::)(, . ~. ".\~.'.~~ ~ J =: l2: I ~ 0 S ~ J:) E rh = 14 \tot 11< SiS Q . ~ s i! ~ I l2: ,:lCll ':a m al . S j ~ .;~ .',',/ '::-: ',,',.; !':-' ~;-, . . . 't'<;:.;.,.. ,(.' ~. .. ". ~: ,,,,'; .' " .. . ~ . . A..OlD,SU.." UUln 'nm~" uw _ ouHn "H" C....,U........"....._ ., and expenses of the trust including reasonable compensation of the trustee. t1y son shall have the right to withdraw the income from the trust estate at least quarterly, and any income not withdrawn by him within sixty (60) days of the end of any calendar year shall be added to the principal and no longer be subject to withdrawal. The trustee, at its sole and absolute discretion, may expend from time to time sums of principal which may be necessary for his support, health and maintenance, includ- ing but not limited to hospitalization and medical expenses. Upon the death of my said son, the remaining trust estate shall be distributed to his then living issue per stirpes, and if he has no such issue surviving him, including afterborn issue, then it shall be distributed as follows: A. 50% to the daughter of my deceased husband by a former marriage, Christine Shepherd, if living. and if not to her then living issue. B. 50% to the Shriners Hospital for Crippled Children, a corporation. IV - I appoint Dauphin Deposit Bank and Trust Company, Harrisburg, Pennsylvania guardian of any property which passes either under this will or otherwise to a minor or incompetent and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so. Such guardian shall have the p01~er to use principal as well as income from education (including Page 2 A..OLD, Suaa A n,,:na. "~"TU. -......".." c....Il4,,....,,........_ college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payments for these purposes without further responsibility to the minor or to the minor's parent or to any person taking care of the minor. v - The principal and income of the trust hereinabove created shall be free from anticipation, assignment, pledge or obligation of any beneficiary and shall not be subject to any execution or attachment or to voluntary or involuntary aliena- tion. VI - The trustee hereinafter named shall have the following powers and duties in addition to those already vested in it by law and other provisions of this will: A. To retain any or all of the assets of this trust, real or personal, including its own stock, without regard to any principle of diversification or risk. B. To invest in all forms of property, including stock, common trust funds and mortgage investment funds whether operated by it or others, without restricton to investments authorized for Pennsylvania fiduciaries, as it deems proper, without regard to any principle of diversification or risk. C. To sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as it deems proper. D. To allocate receipts and expenses to principal or or partly to each as it from time to time thinks proper sole discretion. income in its JA~IIW'~ Page 3 E. To lend to, or purchase from, my executor even though trustee may also be such executor. F. To hold property in my name or in its name without designation of any fiduciary capacity, or in the name of a nominee or unregistered. VII - I appoint Dauphin Deposit Bank and Trust Com- pany, Harrisburg, Pennsylvania, Trustee of the trust hereinabove created. VIII - I appoint James K. Arnold, Esq. and my son, Lovell L. Peterson, Coexecutors of this, my Last Will and Testament. Should either of my said coexecutors fail to qualify or cease to act as such, then I appoint the said Dauphin Deposit Bank and Trust Company to act in this capacity. None of my personal representatives shall be required to post bond in this or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, the 71'H day of \lAPllill ( , 1981. ~~4~(SEAL) e en~. eterson Page 4 . . ... . . . Signed, published and declared on the date thereof by the above-named . HELEN W. PETERSON, as and for the sole codicil to her Last Will dated January 7, 1981, in the presence of us, who, at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses hereto. ~ Camp Hill, PA . Name Address , ~ t. U. jl Landisburq, PA Name Address Page 2 ARNOLD Ie SLlKE. ATrOkNtn.AT.t..\W, 1109 MAun STRUT. CAM,mLL.'A nOli ',~:fr.~?~~:;~rt~;L:~~~l~~-.,~~:~~,~~~,~,,;, . ",,, .'1 ., . - 1 ] ., . . I .l , i I . J . I ,) .' .' / . . .,' I I . I ) '.-.'"' ';;';;:-~'" .1 ~l~;~'Y-}~(.~~~:~,;_,:~;,' ,'" 'f ..". ......~#l.,... .'. , "~~~:~'Jf:~~~~;:~::h.;_'._<_:. .. ~--'-'~-"'-~"""'-~~--" ---~_.",..".~-- -_.~.- .. I ~ Q Z < o-l 11I < ~ ~!;; ::J J<. ::! ~ J<. !;; .. ::J I- .. :I: .. ~CIl~ :5 0 g Q - .. " ::J " en .. Q .. ~ .. M .. 9 ~ < ~ " :t. ~ ;.! )( ::i 2 ~ O. 7- :t. '"J! ~ :Ii c. :r. ~ , .'.' ""'''''''(>< l.."'.."'i"..t"'.\-...._,_~......,H ...",.' "--"1.-"," ,.,~''-f'''''/-~:'-~-!.t'~'f ~~ r ~ .~~ III en t:l 1<10 U:Z; HE-< f;:~ 00 U . M en >0... jE-<O H~::; ~O f:)~U~ II: 1<1 ~ li1 enl<lH t;~~ [lluu .' :i. ~ ~C~)~Ji fiT) .,.-..... , . . 1 I' f \' . I I I j I .." o ~::l .~ r; l>. eo ,. ,. l 'J """.", I I t H', t " ,"-. I.;\'. .t.~ 1';:-: ,-'.:/ I'" ,-:-"J , '.1 I..~ \) v/;,"; \"} \: r: flt.. . . " ,.' " .' '. M / 'f, ,". .- .... ",' , ..~.- ~ ',', .. :lJ'i{? "'8 {I-" :-,;--.' ... lJ ',:': ~t\ . .1. .:.; ., '1', ,fA'" '. > . 1.' I\.. . .t,. .. \ ! r ....,:..,. i\.., -I. .... ." , I' ~ ' ,~' ..:," f .! ~ .,....:.. 1,/, ....I~... . t.. . . ~ /" ~. I .. . ..;: ~ /. .' III ' .\ . I' (Cl ~..- .... I ' 1.1 .1,' I I. 'i~',.( i" . I' _. . ~ '. ,,' , I J .. .to' 't ;:. ' tOt . - ~ . . ... .! .' t. " . . ~:', ~:? ..- :.' ~ :;; >.~ UJ~ t' oft ")0, ~' .~ " . I .., " \.. :- " '. --......--.,;".....-..- '-- .,.(","-'- - ---- -.--- -- - --- -- --'- - ---- -- -- -- -. - -- ---- --- RECEIVED FROM, ACN ASSESSMENT P:' CONTROL Ii;I NUMBER AMOUNT SLIKE JOHN E 2109 MARKET STREET 101 '6,::166.00 CAMP HILL, PA 17011 fOlD Hfll ESTATE INfORMATION. !II IL N R II 21-1996-0161 !II NAME Of DECEDENT LAST) ~ PETERSON HELEN W II f PAYMENT EI POSTMARK lIME COUNTY SSN 179-36-1672 (FIRST) (Mil < , .j CUMBERLAND DATE Of DEATH , . , .' REMARKS m TOTAL AMOUNT PAID ,~ ,;: JOHN E BLIKE ESQUIRE '6,eoo.oo PB SEAL CHECK. 1004 , J<N4 tv ,I , ,/ MARY C. LEWIS '. '1.tV,), " REGISTER OF WILLS /o.9/Lt-r : REGISTER OF WILLS '!~____________________'__~_____~._~__~ . ./ J I' '. -. ..., \ :- ~, .f " -,~-- , ~ ._-~.JV" ~ - i r .~ \. , I ; I i I ~ 'j i i , ; , ~ C A 8 H P L E PO C R C K 0 K P S . j,':'; /,', c-;.) >~/ .)) , !5.Y6.// FOR OA'U A. OEA'H AFTER 12/11101 CHECK HERE C. A IF A SPOUSAL REV. 1500 EX .0.94) INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS COUNTY CODE C P o 0 NAME R N R D John E. Sl1ko Es uiro E E S N TELEPMONE NUUBER - T 717 737-31,05 1. Rul Estalo(Schodulo A) 2. Slock. and Bond. (Schadulo B) 3. CIoSlIy Hold SlockIPlrtne"hlp Intarl" (Schadull C) 4. Mortglg" Ind Not.. Rocoivlbla (Schodule D) (4) 5. Co.h. Blnk Dopo.its & MisCIU.noou. Parsonal Property (Sch. E) (5) B. Jointly Owned Property (Schadule F) (e) 7. Tronsfo" (Schadule G) (Schadule Ll (7) B. Tolal Gross AssolS Itolal Line. 1-7) 9. Funeral Expenses. Administrative Costs. MlSc.llaneous E,penso.ISchadule H) 10. DobIS. Mortglgo LllbMil" Lien. (Schadulo il 11. Tolal Ooduction.ltolal Lina. 9 & 10) 12. Nol Vlluo 01 E.toll (L1na 8 mnu. Line 11) 13. Char~lble Ind Govornmonlol Boquo.', (Schadulo J) 14. Nol Vlluo Sub' cl to Tn (L1nl 12 mnu. L1no 13) 15. Spousal Trlns!o" (tor dll" 01 doalh Ihar 6-30-94) St. Instructions for Applic.ble Percentage on page 2. lInclude values from Schedule K or Sch.dule M.) '1. Amounl 01 line 14 laKable at 6'1. ,ale (Include values from Schedule K or Schedule M.) 17. Amount 01 Line 14 taxable 1115'/. rat. (Include valuts bom Schedule K or Sch.dule M.) lB. Princip"lt.. duo (Add tl' Irom Line 15, 161nd 17.) 19.Credits/Sp Poverty Prior Payments Discount + 6,500.00 + 342.11 20. II Line 19" groltor lhan L1no lB, onlor Iho ddteronco on Une 20 Thi. i. Iho OVERPAYMENT. ~ 0 ICheck hara II you Ira raquaotlng 0 ralund 01 your overpaymant.1 21. If line 18 rs grlatlr than Line 19, enter the diNer.nce on Line 21. This is the TAX DUE. A. Ent.r 1h. intlr.st on the balance due on line 21A. B. Enlor lha lolal 01 Lino 21 and 21A on Line 21B Thi." tho BALANCE DUE. Moka Chock Po obloto, R lotar 01 WlIIo. A ont . . BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TD RECHECK MATH .. .. Under peNIU.s 01 petllM'Y.1 d.cIl'.lhatl h........m1ntd this "h.l'n.lrcludlng aCCOmpol"yinq schedul.s'nd statemenl.. .nd 10 Ih. bn1 01 """ tnowledg. .nd bellet, IllS I''''', c:on.cl.nd com"lete. I d.c~telh.t.1l 'e.1 nl.t. hll bHn ,epa'lld .111\" mI,tet ....,..... D.c:I.,.Uon ot prepat.' olher Ih.n the pe'SONI ,eptnent.U...els baSed on.n Inlorm.lUon 01 whkh ,,'.pI,e, hll Iny tnowled9. FILE NUMBER CO"MFmH.M:\'If".MIWiI~ANIA HARRISa5~t,'tI.m\z;'0601 D E C E D E N T DECEDENT' NAME (LAST, FIRST .AND UIDDlE INITIAL) PETERSON HELEN W. DECEDENT'S COUPLETE ADDRESS 3453 Greon Stroot Camp Hill, PA 17011 SOCIAL SECURITY HUUBER 179-36-1672 DATE OF OEATH 02/01/96 OATE OF BIRTH 02/13/13 County Cumborland (IF APPLICABLE) SURVlVlNQ SPOUSE'S NAUE ILAST .FIRST AND Ul00LE INITIAL) SOCIAL SECURITy NUUBER 2. Supplemontll Roturn 4.. Future Inl.r.st Compromise lIor dol.. 01 dOlth Ihor 12-12-82) []] 5. O.cedent Died T.st.t. D 7. O.c.d.nt Maintain.d I living Trust (Attach co 01 Will) (Attach 0 co 01 Tru.t) ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE OIRECTED TO: Xl. Original Rolurn 4. Llrnilod E.lall 05. 1 B. COUPLETE UAlLlNQ AODRESS Saidis, Guido, Shuff 2109 Markot Stroot Cam Hill PA 17011 R E C A P I T U L A T I o N , 12 ,110.63 Nono Nono 22,250.23 8,110.12 Nono (9) 18,179.80 (10) 4,171.33 (15) 0.00 X (16) 2196-0161 YUR HUMBER AMOUNT RECEIVED (SEE IHSTRUCrlONSI 0.00 R.maind.r Return (tor dot.. 01 doalh prior to 12-13-82) F.dlr.1 Estat. TII R.turn R.quir.d Tolal Number 01 Solo Dopo.~ Bo... Ex Masland (8) 146,864.98 (11) (12) (13) (14) 22 , 351.13 124,513.85 124 513.85 : 0.00 7,470.83 12/,,513.85 X .06 : 0.00 T A X C o M ~ T A T I o N (17) 0.00 X .15: Lovo11 L. Poterson/John E. Stiko 2109 Markot Stroot tam.' iiiii': .PA. - "i7Ciii........"".. -. - -. -.......... Saldls, Guido, Shuff Ex Mas1and 2109 Market Streot tamp' iiiii': 'PA.. -i 7ciii - -....... -" - -..... -..... -... Inllr.st SIGNATURE OF PRE PARER OTHER THAN REPRESENTATIVE ""f'....I.,..' '.., ,Qq. In'... '''11....'.. ""tv C:PSy.'emt Inc (1B) 7,470.83 (19) (20) 6,81,2.11 0.00 (21) (21A) ( 21B) 628.72 0.00 628.72 otJ"/;.r. /'1 V F.. IR.....7.'.) CODICIL TO THE LAST WILL AND TESTAMENT OF HELEN W: PETERSON I, HELEN W. PETERSON of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be the sole codicil to my Last Will dated January 7, 1981. I - I hereby revoke the appointment of James K. Arnold. Esq. as one of the Coexecutors of my Last Will and Testament in Paragraph VIII thereof, and appoint John E. Slike, Esquire, to act in this capa- city, along with my son, Lovell L. Peterson. Should either of my said coexecutors fail to qualify or cease to act as such, then I appoint Dauphin Deposit Bank and Trust Company to act in this capacity. None of my personal representatives shall be required to post bond in this or any jurisdiction. II - In all other respects I hereby ratify, confirm and republish my Last Will dated January 7, 1981, together with this sole codicil as and for my Last Will. the IN W~ESS WHEREOF~have hereunto set my hand and seal on this, 7 day of ~ ' 1985. 4tk/~'f1~ elen W. Peterson (SEAL) Page 1 ARNOLD &.: SLIKE. ATTOkNln."T.LAW, Ilot MAun STUlT. CAJoCr HilL p" HOIl Signed, published and declared on the date thereof by the above-named HELEN W. PETERSON, as and for the sole codicil to her Last will dated January 7, 1981, in the presence of us, who, at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses hereto. Camp Hill, PA Address i ('. Name jLJ~. .I Landisburg, PA Address ARNOLD k SLIKE, AnoaNlYS.AT.LAW.lIDt MAUlT STun, CAMP HILL. '" nOli Page 2 ....._...._.".- _ ._-_.-t-~-''''~-'''''''' I - LAS't WILL' AND 'tESTAMENT OF HELEN W. PETERSON I, HELEN W. PETERS Oil of the Borough of Camp Hill. Cumberland County, Pennsylvania. declare this to be my Last Will and Testament, hereby revoking any will previously made by me. I _ I direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II _ 1 devise and bequeath all of my automobiles and all other articles of personal or household use. including but not limited to household goods, furniture, personal effects, and other tangible personal property, to my son, Lovell L. Peterson. III _ 1 devise and bequeath all the rest, residue and remainder of my estate of every nature and wheresoever situate unto my trustee hereinafter named, III TRUST, nevertheless for the following uses and purposes and under the following terms and conditions. The trust shall be held for the benefit of my said son, Lovell L. Peterson. for life. Out of the income derived by the trustee, it shall pay all th~ necessary costs ,POLIt. SL'.. &- On"." Anat.Nn" At u.. -......".." c....l"".h..."~.....- J/1J4jb i- ~ I ~.nJ Page 1 ,., .~.... ~._,-.._--.--... ., ; and expenses of the trust including reasonable compensation of the trustee. l~y son shall have the right to withdraw the income from the trust estate at 'least quarterly, and any income not withdrawn by him within sixty (60) days of the end of any calendar year shall be added to the principal and no longer be subject to withdrawal. The trustee. at its sole and absolute discretion, may expend from time to time sums of principal which may be necessary for his support, health and maintenance, includ- ing but not limited to hospitalization and medical expenses. Upon the death of my said son, the remaining trust estate shall be distributed to his then living issue per stirpes, and if he has no such issue surviving him, including afterborn issue, then it shall be distributed as follows: A. 50% to the daughter of my deceased husband by a former marriage. Christine Shepherd. if living. and if not to her then living issue. B. 50% to the Shriners Hospital for Crippled Children, a corporation. \."OLD. Sua. a D...TUT .noaHI'Yt,,'UW _..M"'''''' (....."'.,......,......... IV _ I appoint Dauphin Deposit Bank and Trust Company, Harrisburg. Pennsylvania guardian of any property which passes either under this will or otherwise to a minor or incompetent and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so. Such guardian shall have the power to use principal as well as income from e minor's support and education (including Page 2 ~ ...\ t;. . ~~ v .' ,. I \ t- o' r t ~ \ AlutOLD, !ILl.... II D.t.YLa. 4TTO&N1\'I4TU,W --.......... C....."'-.......-....- I' I ,.-......_-............_-.._~.,..~,'". ,".' ...., . college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payments for these purposes without further responsibility to the minor or to the minor's parent or to any person taking care of the minor. v - The principal and income of the trust hereinabove created shall be free from anticipation, assignment, pledge or obligation of any beneficiary and shall not be subject to any execution or attachment or to voluntary or involuntary aliena- tion. VI - The trustee hereinafter named shall have the following powers and duties in addition to those already vested in it by law and other provisions of this will: A. To retain any or all of the assets of this trust, real or personal, including its own stock, without regard to any principle of diversification or risk. B. To invest in all forms of property, including stock, cornmon trust funds and mortgage investment funds whether operated by it or others, without restricton to investments authorized for Pennsylvania fiduciaries, as it deems proper, without regard to any principle of diversification or risk. C. To sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as it deems proper. D. To allocate receipts and expenses to principal or or partly to each as it from time to time thinks proper sole discretion. income in its ff~IIx1/~ Page 3 Page -1_ of _Z- SAFE DEPOSIT BOX INVENTORY INSTRUCTIONS (1) Caah: Reparllalal only. (2) Slack.: Li.1 in delail every cammon or preferred cerlilicale, warranl or alher righ" found in ba.. Slach are to be designated by nome of company, certificate number, dale of certificate, name in which Slock is regislered, and number of shares and clan of slack. (3) ObI/got/an. of U. S. Governmant: Number of ilems, dale of inue, face value. names in which regislered and Iype of ownership. i.e., joinlly held, payable an dealh. elc. (4) Bond.. Oesignale by name. amaunl. serial number, or alher de.ignalion. (Bearer Bands) (5) Bank and Savlnga and Loan Pa..book.. Slale name ~f deposilor. number of book. lasl dale appearing in book. name of bank and branch, and balance. (6) Jlwalry. Colna, Stampa, Manu.crlpta, ItC: Lisl and demibe as fully as ponible. (7) Dead., Mortgaga.. Currant InaurancI PoI/cia. or other avldlnc.. of Indabtadna..: Lisl and describe as fully as panible. (8) All athar cantanta. ITEM DESCRIPTION Ieee - .fIle) -.. +- IN "'AM L. ,. , l W IN Il NOTE: , ...p .'A II ~ A- ......htc\l,orf',..IOAdmini"'alorlf'i..1 C hlol, R.p'...nloti.... 0 Join' Owner of lof. d'POlil bo. Attach additional 8'h" x II" ahaat (.)If naca..ary or usa dupllcata. of thl. palla of farm. <- 0 .. ~, ~ % ~'l o , - o ~ w .. ~-=. ~ ~ " z u ~ ! ;; - " 0 w U w .. .. w .. 0 ~ "' " " .. w w Z C .. :c w ~ g t; .. w ;;: ~ ~ N '" C1)o Zllli ge -Z "'... :.c> Uz ~- .. i ~ - ::ow 51 ..=> i3 ~! cD z~_~ ;j' ~..~!:: . "OOCD~ - ... .;:':', "'i,," 4l; ~r.uA.Clt ~!~~ ~ac ~ zf :: gw C iD '" o u f . . ! . . l I I I I ! , I I I , i I I I:' T ! , () T ~ I I .. I I I 0 ~ E I "'w ~ I ~~ I ~~ , ~ - - I , , ..- - ~ - , ~I - - .... - lllil ..:: .. '. I , , , - .. I =~ j t; 2 { I - - I I ~ I I i ~ r-I ~ l" ~ ~ .....:' N ~ ;;f a- r/"" o-.;'\.J) cia 00 '-:l \.l) -.0 <oJ) , . . I , I ' \ w w ~ ...;... I . \\I VI '" ..... y, , ~ \II ....." aO;!! ...... - .... '" "":"'"1 . -:-- ..... .... I , ci- , c:.. . 'OQo~ . I C-- cJ.. '" '-Cl ..... VI ~ - <...p ! , , , el ,... ~ .J I ~ .. .>- ':)- l" I ':)0.. ~ ~ \J) tl - r-,' " '> e, 0 r; ~ \.1 '::). '\j) z ~ '-0 - 0- 0 C't\ t'1 ~ ~ N l' ~ N ~ ..... z 0-. ..... ~ 0:> ..... 0 ~ N I' ...... S -:r .... \j ..... - 5 <t ~ ;;: Iii w u .... , '~ ~ 0' - ~ :c ~ w i C' " ~ CI " c ,< <:::a q - U; z - = ': - ~ .. -J -= .. - z ~ . t - - ~ ~ s:: , - ~ 0 ~ u I-J Q.. 'v tl ..-f'~ ~ ~ es ~ ~ ~ < . ;; w ~ :: - - - - .::: - - S l = - .. - - - - :: - . 3 t u ~ z ao -!i N Cz c r- :r ':: ~~ 0 0 ~ - ":)- ~ 0 ~ - IN ~ - ~i!i - 0 ~ '\ ~', . ..~ " \ . - --,~~",-----~-'--"'~"'--"~ '~:.-:~ >,,;,::/,'/:.''''' .-'" -~~~'~~i~r,~~:i.? ,,~- -- ~~-~~ " "~::'1:,;'\i.',,,:~.i',';l":'~;H;:""')~;~;;'i:";;-"~"'.'~~" ~,"- REV, I~ EX + IIZ.85) .-. [1' ,~, ,-:. cO"'~HqlO:tM.lJ,t\!l,.e'il\.ll~:Q,yAHIA SCHEDULE A ''Rl'ilb1llt"b~.l'f" REAL ESTATE ESTATE OF FILE NUMBER HELEN Y. PETERSON SSj 179.36-1672 02 01 96 2196.0161 (Proporty Jointly-OWned with RighI of Survivorship musl be dllclolod on Schodulo FI All r..IOIlllo Ihould be roporlod IIIllr markol vlluo whIch II dollnod litho prlca II which proporty would be o.chlngod betwHn I willing buyor Ind I willing lollor, nollher baing compollod 10 or ..11, both hlvln r...onablo knowlod a 01 tho roloVlnl IleII, ITEM NUMBER VALUE AT DATE OF DEATH DESCRIPTION 1 Residential property located at 3453 Green Street. Csmp Hill Borough assessed at 7,620 per attached copy of tax bill 104,394.00 7.620 x common level ratio of 13.70 S 104 394.00 TOTAL (AI.o onlar on lin. \, R.c. ~ulalion) (II moll'P.C. i> na.dld. in..n .dd~ioftll sha." ol..ma .iz..l CODY'\Qtllltl \". 'DI'm soltwlrt only cpsystems.1nc. F_l!lOO Schod'" A \,..... IZ.85) . RIV. 1103 EX + (4.16) cO"'lI.m~g~"'A ESTATE OF SCHEDULE B STOCKS AND BONDS FILE NUMBER 2196-0161 HELEN Y. PETERSON ssg 179-36-1672 02/01/96 (All ITEM NUMBER ownacl with R ht 01 Survlvorshl mUll be dllcloled on Schedule F.I DESCRIPTION VALUE AT DATE OF DEATH 1 329 sha of PP&L common 25.625 8,430.63 2 115 sha of Orrstown Financial Services common 32 3.680.00 TOTAL (Also enlar on line 2. Raca ~ulatlonl (II mora spica i> needed. Insen Idd~ftllshae" of sama size.) Cooy,lqht'cl 1994 fOtffllCftw.re orly CPSyttems.lnc. S 12 110.63 Fonn 1500 Schld'" B IA.., 4-1,) RIV. 1109 EX + 11Z.1I) SCHEDULE F JOINTLY-OWNED PROPERTY CO"'~Hm~~~~"'A ESTATE OF HELEN Y. PETERSON SS 179-36-1672 FILE NUMBER 2196-0161 02 01 96 JolnllOftlntlll. RELATIONSHIP TO DECEDENT Son A. NAME Lovell L. Peterson ADDRESS 3453 Green Street Camp Hill, PA 17011 B. C. LETTER DATE TOTAL VALUE DECO'S DOLLAR VALUE OF ITEM FOR MADE DESCRIPTION OF PROPERTY NUMBER JOINT OF ASSET % INT. pECEDENTINTEREST TENANT JOINT 1 A 06/01/70 PNC Bank Acct. 2.571.53 50.00'; 1,285.77 5140049503 2 A 09/01/79 PNC Bank Acct. 1,178.39 50.00'; 589.20 5140162071 3 A 09/30/92 Prudential Municipal 12,470.30 50.00'; 6,235.15 Fund, Acct. No. 3900185549 The fo1 lLowing ccount el ists; however, the tax will be paid by the beneficil ry. It is not to be cons id red a part f the state: 4 A Prudential Insurance Co. annuity with date of death balance of $86,542.53 TOTAL (Also enler on lint 6. Reclo~ulationl 8,110.12 Jolnlly-owned prop arty. {II mort SpIC' ts Mlded, InSlrt additlonll sheets of Slme siz..} r."~,h1hlll" '~4 tn'," "nflwI,1t ontyCPSy.lefM.lnc Form 1500 Schedule F (R.... '2-88l RIV.lI1UlC. (1.11) ..._;"'....~""".i;',.. ,', ~;,. ~U.;:::..~.......~.,.t:,...l .,-'---", . _..... .............b....':.. ,...";;,"^,_._.___. . ,.,.",J.. . 4__~__'''';'''-.. CO"'II._4\~~~1hY"'A UTATlOF SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Piau. Print of T a FILE HUMBER 2196.0161 HELEN W. PETERSON ssg 179-36-1672 02/01/96 ITEM HUMBER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 DESCRIPTION Bell At1antic-PA PP&L PAWC The Bon-Ton - debt of decedent Susquehanna Surgeons Conner-Rich, Kearney & Torchia Ann Markley, Tax Collector - county and borough taxes Apria Hea1thcare - balance due Innera-Davis Associates PA Dept. of Revenue. 1995 individual tax due Hartman & Scheuchenzuber, CPA's - tax preparation EKe Asaoc iates Security and Life Syatems - balance due on monitoring contract A. Z. Ritzman Asaocietes Waste Management of Central PA Ann Markley, Tax Collector - school taxes Borough of Camp Hill - aewer rental USAA - insurence AMOUNT 151.41 439.24 101. 87 64.32 35.98 100.00 444.32 2.14 48.15 130.00 245.00 6.65 1,012.00 55.53 71.76 1,168.68 60.00 34.28 TOTAL (Also ani.. on Una 10. R,c. .ulotlon) S (It moll IplCO i> naedod, Insln Idd~ioftllshae" of sima lizl.) Copyrtgh1 fe) '"4 form MI'tw.,. 0f'It CPSyItllfM,lnc. " .--'--"'-'-'- "- r , , . . ~''''::':'''::'''''-~-- --- - - - _.:- ~ - _:.- ~-'- - - - ---'- -'- =, I RECEIVED FROM: 1\'-";"\(.lI'.:~'l!1.~!"'1ll'~'I...>}~~~'fr;:"~':;:iJ"~r;"'\~-~' '';'\''~1:\i:~ ' = fO.;!I"NSYLYANtA'l\~Wil.~~~~f~' ' G. !i'l\"I~ '''If!' . ^.. !+,..~~...!" (i!-,t ,~,,~,.f ~':: e,c..]1':'f..1.'i~~l'k...~.. 811.1 .;Joii3:il fi/1; ":J~~f .:-~~~.t'~~~-:l::'iif>,:.i-./;:"" .~,. ~;!t'""..,." ,1,),'lt!l"",,'l,\ '4~'f;"'l;;il~tj,;j'~;:;i'1:. IN CI D-&ftITAX'J~"',1Iii~1'1 .,,:~ ,,'.. _. _....'-"^ _.. " ___. ..... . .~~,~l._ . _~~ .~..tf 'f!, jl'!'(4!"Ji ACN ~ ASSESSMENT P:' AMOUNT II CONTROL 1;1 NUMBER . SLIKE JOHN E 2109 MARKET STREET 101 t61:9.72 CAMP HILL, PA 17011 SSN 179-36-1672 (FIRST) (MI) W CUMBERLAND E Of DEATH REGISTER OF WILLS fa TOTAL AMOUNT PAID .62e. 72 SK RECEIVED BY 9/k.J ~oHC . .;I4w-< ""1 ~.PV MARY C. LE~{S N~ I'AhJ,,()r.1'c.L REGISTER OF WILLS ~ REMARKS JOHN E SLIKE ESQUIRE SEAL CHECK" 1024 , ~----; _ _ _.-...: -'-- .-'-- _ ~ ~~{-- _.- .-~.- _ - -- -- - - -.- -,- -:------,-_. . \. -, "': '. ~ .r 11- - ,-- r'T.- _21 ~~ .-.~ ~ - . .- -- ,.--" 20. If L1n. 19 i. ,,"aI" than lIn. 18. tnl., the diRt,.nc. on L1n. 20. Thl,1I the OVIRPAYMENT. riD 21. If lIn, 18 It ""01., Ihon Lln. 19, ,nl" th, diH.,,"c. on Lin. 21. Thll i"h. TAX DUE. A. Enl" Ih.lnt"'1I on the balonc. due on Lint 21A. B. Enl., Ih. 10101 0' L1n. 21 ond 21 A on line 218. Thl. it Ih. BALANCE DUE. Moke ChICk Poyable 10' Regl.t.. el Will., Agenl IA'NSWII1~U;QUESTIONs;oN'RMRS.,S1DI:AND,TO_RICHICKiMAUlli(O f$';f"ji. \ Und.r Plnalll.. of perjury. I d.clar.thot I have uomln.d Ihl, ,.'urn. Including accompanying tch.dul.. and "at.mlnU, and fa the blat of my ~nowl.d9' and b,li.f, 1111 truI. corrld and compl'll. I dldor. that 011 r.ol "tal. hal bit" ,.port.a ollru. marlt' yolu.. D,c1aration of pr.po,,, olh., thon IhI plrsonal r.p,,,.nlativl i. balld on 01 Infor 'on of which r. or., hat any knowl.dge. SIGN 1 01 'lUNG .nUIN ADDUU OAf( A 2109 Market St., Camp Hill, PA /1~'/7' ADDlln DAIl ' 2109 Market St., Cam Hill, PA /I/~r;-/tj'r;. ~. IlV.UOO IX. tl,("l ~ ..:5::: IIlfu "'i9 u:r"' ~8 ..., ":0: B~ I 5 - 51& -II *,.9 '(\ ..... 'OR DATIS 0' DIATHAnlR 12/31191 CHICK HIRE If A SPOUSAL POYIRTY CREDIT IS CLAIMED 0 'Ill NUMIIR INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) COMMONW!ALTH 0' 'INNsnVANIA DI,,,,UM(NI Of IlVINUI Df,T 210601 HAUISlU_O.'A 1112..0601 CIO N' NAM IlA . flU. AND MIDOlllNI tA\1 PETERSON, HELEN W. COUNIY CODE 2196 - 0161 YEAR NUMIER DlCEDENT', COM'UU ...DOIIU 3453 Green Street Camp Hill, PA 17011 c.." - Cumberland AMOUNt '(CIIVID 1$(( IN$u.uCY.ON$1 8 a III ., $O(IAl SleUltllY HUMIU 179-36-1672 DATI Of 0lA1H DAn 0' IIIIH 02/13/13 I" ,,'''1(....111 lu''I'vlHO lfOUU" "'AIIIIIl"". 'IU' "NO ""'ODlllHlIIA'1 01. 04. ~ 2. Supplemental Rtlur" o 3. R.maind., Relur" (10' dol.. 01 d.o,h prlo, 00 12.13,821 o 5. F,d,ral ellolt Tall Rtlur" Requir,d Original Rt''''" o 40. Futur. Inl.,tst Compromit. ('0' dolO I 01 d.olh oft.. 12.12.821 06. D.ced.nt Di.d Te"ott 0 7. Olc,d,nl Maintained a living TruI' (Alloch copy 0' Willi (Alloch copy of T,ull) ALL'CORRISPONDINCI;AND'CONflDINTIAL'TAXINFORMATlON SHOULD BE DIRECTED TO. . HAM 'OM,un "'AJ,llHO ADDlUS . John E. Slike, Esq. ~a~a~s, uu~do, Shuff 2109 Market Street Camp Hill, PA 17011 limit.d ellal. _ B. TOlol Numb.r of Sol. O,polil BO.llII & Mas1and 737-3405 :0: ., 3 ! co 111 ( 21 8,430.63 (3) (41 (51 3,227.62 ( 61 9,766.19 (7) ( 91 685.00 (101 685.00 1. R.ol 101010 (Sch.dul. AI 2. S'ocll ond Bondi (Sch.dul. BI 3. ClolOly H.ld Soocl/Palln."hlp Inl...II (Sch.dul. C) .. Mortgogll and Naill R.c.ivobl. (Sch.dul. 01 5. COlh, Bonlc O,polill & Mil"Uon,oul P.nonol Prop.rty (Sch.dul. E) 6. Jointly Own.d Property (Sch.dul. f) 7, fron.I." (Schedul. GI (Sch.dul. L) 8. Tolol Grall Au." (totallinll 1.7) 9. Fun.rol E.IIp.n"l, Adminiltrativ. COlli, MilC.llan,oul Exp..... (Schedul. H) 10. O.bll, Mortgog. liobiliti.., li.nl (Sch.dul. I) 11. T 0101 D.duct;on. (10101 Un.. 9 & 101 12. N., Valu. of Eliot. (lin. B minuI lin. 11) 13. Charitabl. and Gov.rnm.ntal S.quIIII (Sch.dul. J) U. N.t Yolu. Sub .<110 To. (line 12 mlnul L;nl 13) 15. Spoulal Trand,,. (for dot.. of d.ath ah.r 6.30.9.) 5.. Inltrudlonl for Applicabl. P.rcenlag. on R.v.,.. (151 Sid.. (Includ. volu.. from Sch.dul. K or Sch.dul. M.l 16. Amounl 01 lIn. U lo.obl. DO 6% '0" (161 (Includ. ...olu.. from Sch,dul. K or Sch.dul. M.) 17, Amount 01 Un. U la.abll ot 15% '01. (171 Ilnclud. ...olu.. from Sch.dul. K or Sch.dul. M.) 18. P,inclpoloo. du'IAdd 10. ',om lIn.. 15. 16 and 17,1 19. Cr.dill Spoulol Po....rty C,.dit Prior Paym.nll + (81 21,424.44 (111 (121 (13) (141 20,739.44 20,739.44 )(._- 20,739.44 )( .06 - 1,244.37 x ,15 . :0: 2 S iC . B ~ .. (IB) 1,244.37 DilCount In'''''1 (191 (20) + C'lI'(k IH'IU ., you OIf' ft'(tul'\ling n r('fund of your oVl'fpoynwnt 1,244.37 (211 (2IA) 12181 1,244.37 _9.~~~j{'i""\~ {;"~"':';''':'''''' RE'I.lI01EX + IJ.l7) SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Pial.. Prlnl or T . FILE NUMBER 2196-0161 CO"'II.~_,WbY"'A UTATEOF HELEN Y. PETERSON ssg 179-36.1672 02/01/96 -owned with AI ht 01 Survlvorahl must be dllclOled on Schedulo Fl DESCRIPTION VALUE AT DATE OF DEATH 1 2 USAA savings account No. 00006 98 72 827.62 Household goods and personal effects 2,400.00 .... ...L_ -- . .-. I. 3,227.62 ~ I. 0,1,' I: .. f, : \ f I ~ USAA f. USAA 9BOO Fredericksburg ROld Sin Anlonlo. r.... 7B2BB FEBRUARY 01, 1996 USAA NUMBER : 00006 98 72 I / FOR AUTOMATED VOICE RESPONSE INFORMATION ABOUT YOUR SSA. CALL I-BOO-531-6095 AND PRESS I ON YOUR TOUCH-TONE PHONE MRS HELEN W PETERSON 3453 GREEN STREET CAMP HILL PA 17011-4420 **THIS IS NOT A BILL OR A CHECK. THIS IS A STATEMENT OF YOUR ACCOUNT eALANCE.** SUBSCRIBER'S SAVINGS ACCOUNT ACTIVITY 1. 2. PREVIOUS BALANCE IN YOUR ACCOUNT L~SS CASH DISTRIBUTION (12/26/95) NEW SSA BALANCE PLUS NEW ALLOCATION AS OF 12/31/95 CURRENT BALANCE $ 768.50 61. 48 3. 4. $ + 707.02 120.60 5. $ 827.62 As you know, the net worth of the Association constitutes those funds that are held in reserve as invested assets, to assure that we can meet regulatory requirements, sustain a sound financial position in the eyes of the industry's rating agencies (Best's, Standard & Poor's and Moody's) and survive the consequences of catastrophic contingencies. These funds are the principal measure of our financial strength and appear in the consolidated balance sheet of our Annual Report. Part of this net worth resides in the individual Subscriber's Savings Account of each USAA member: collectively, the allocated funds held in these accounts constitute 58% of our aggregate net worth, Each year the Board of Directors may authorize a new allocation of the Association's income from the current year to these accounts in order to sustain an adequate capital position for the purposes stated above and to minimize our tax liability. Cash distributions to members may also be made periodically from these accounts when the net worth held by the Association exceeds the amounts needed for these purposes. (For example, in December 1995, USAA members with a minimum of $350 in their accounts received 8% of their SSA balances, for a total distribution of $178 Million.) As long as you are a member, funds in your SSA remain with the Association, unless the Board of Directors specifically authorizes cash distributions. SSA allocations and distributions are not considered taxable by the Internal Revenue Service. (However, if your insurance premium is a business expense deduction, then the allocation added to your SSA reduces your deduction.) . b . RIV. 11011;; + I'Z.1I1 SCHEDULE F JOINTLY-OWNED PROPERTY co"'r"m~_,WbY"'A .ITATI OF ~EN W. PETERSON SSn 179-36-1672 Joint 101llll1(1). A. HAMI Lovell L. Petsrson B. C. Jolnlly-ownod proporly. 02/01/96 ADDRESS 3453 Groen Stroet Camp Hill, PA 17011 FILE NUMBER 2196.0161 RELATIONSHIP TO DECEDENT Son LETTER DATE DECO'S ITEM FOR MADE DESCRIPTION OF PROPERTY TOTAL VALUE DOLLAR VALUE OF HUMBER JOINT OF ASSET % INT. ECEDENTINTEREST TENANT JOINT 1 A 07/28/94 PNC Brokerage acct 19,532.38 50.00~ 9,766.19 No. 22055358 TOTAL (Also entl! on Tina 6. RlClo~ulatlon) 9 766.19 (II moll spica Is naeded. Insen Idd~ioftll shoo" olsama size.) CGpyrlQhl (e) '994 form toltw.'. rrit CPSy.ternt, Inc. Form 1500 Sch~ua. F CRtv. 12.84) ..."- .--"..~ . PNC lBIRUOKlERA(G lE THROUGH THE COURTESY OF PNC SECURITIES CORP Inveslmcnts olhcr than Certificates of Dcposlt: rmu . ~Ia\' I.me \'"hll' I!MM .:'\Il'(llllk (;\I,Ir.lIIll'e PERIOD 06/28/96-07/31/96 sue SEC/TAX 10 179-36-1672 PAGE ONE PNC PLAZA Twelfth Floor 249 Fifth Ayenue Pittsburgh. PA 15222-2707 liE LEN W PETERSON AN[) LOVElL L PETERSON .ITWROS 3453 GREEN STREEl CAMP IIILL PA 17011 ACCT NG 22055358 OFFICE 3311 A/E 3259 YOUR REPRESENTATIVE: TIlOMAS DILELLO 717-881-4003 ----_..~ .>-,~~. A C C 0 U N T V A L U E DESCRIPTION MARXET VALUE l(, PORTFOLIO MONEY MAPKET rUNDS 5.86CR MUTUAL EUNDS 19.556.9DCR 100.0 VALU. 13.5C:Z.":'Ccr: NET VALUE LAST PERIGO 18.532 .3SCR PERCENT CHANGE 0.2 INCREASE EAR N I N G S SUM MAR Y DESCRIPTION TIllS PERIOD YEAR-TO-DATE TAXABLE INClJoIE DIVIDENDS TOTAL TAXA8LE I~COMF TOTAL 100.45 746.33 100.45 748,33 100.45 74B.33 COM BIN E 0 CAS H SUM MAR Y DESCRIPTION AMOUNTS PAID AMOUNTS RECEIVED BALANCE BALANCE FRlJoI PREV STATEMENT 5 , BBCR AMOUNTS CREDITEO DUE TO: EARNINGS AMOUNTS PAID DUE TO: REINVESTED EARNINGS 100.45 100.45 ENDING BALANCE 100.45 100.45 5,8BCR YOU R P 0 RTF 0 L I 0 SUM MAR Y ACCOUNT TYPE SYMBOL QUANTITY DESCRIPTION CURRENT PRICE MARXET VALUE EST ANNUAL INClJoIE E!iT YLO MUTUAL FUNDS CASIt GNUSX 2347.768 INVESTORS TRUST GOVERNMENT rUND CLASS B 8.330 19.556.90 o AIL Y Ace 0 U N T ACT I V I T Y DATE ACTIVITY QUANTITY DESCRIPTION AMOUNT BALANCE 7/23/96 RECEIVED OPENING ACCOUNT BALANCE ACTIONS AFFECTING YOUR PORTFOLIO 12.059 INVESTORS TRUST GOVERNMENT rUND CLASS B OIl' REINVST @ B.330 07/24/96 0.00 7/23196 DIVIOEND DIVIDENDS AND INTEREST INVESTORS TRUST GOVERNMENT rUNO CLASS B INCOME OIl' 100.45CR CONTINUED ON PAGE 2 ---,...-.--..- 2~ 3:; 0'- m \. r.. ...- " NOTICE. c o' . .- . , (' -0': )>~ To fulfill the ,..,1......,.t. of Section 1140 of the I....rlblnc. ... [Itot. Tax Aot, Aat IZ .f 1"1. lleUon Z141l. lS! ::0::0 ~8 c -'~ If) 0 n '-~ (" ~' ;~, ~ ~~ '1' ...." is ~h) - iiiO (..j - \0 (71 P.I. D1tad1 the top portlon .. tt1h Matl_ ... __It with your ~t to the bllstor ., Mllll printed on the rwer_ .1d1. n _. c:Mdc or ~ order PQIIblo tol REIIllTEJI (II' WUll, ACIOfT. All ~tI rttOIlved ..11 flrot M ...,U" to ~ lnt.r..t ...,lc:I1 .., M .., .SUl ~ ....lndllr ."Ued to the tal NYIlDIT. m1.IID (eI). . rerv.d of 0 tax credit, Mhld1 .... not r....tld on the tax return, .., be ,....t.. bJ ..IoU". In --..ll_tlan for ..fund of Pent.,1wnl. I""rl~ end E.t.te Tu" (REV-IllS). AppU.tlonl.,.. .willll,lo at tN D.ft.. of the _lltor of IUlh, InJ' ., the z:s ~ Dbtr!ot Offlcel or by aUl". U. .......1 Z4.hDUr "'....r1"11 MrVl.. .....,. for 10,.., .nSerll'11l In Pemnlwnlo l-IDD"S6Z-ZD50, autll. PwWInlnnl. end vlthln I_I Harrhbul"'lorM (717) 7.7-10114, ml (717) nl-ItsZ (....,.1"' 1~lr" Onlv). OIJECTllllla lIr'I.-b In 1ntor..t not ..tllft.. ...v. the ..,.ral..."t, all-. or dl..U__ o' ~t1on. or .........t .f taac UnoludS.... cu-...t Dr lnt.,...l] .. ......, on tit" Not1~ -v obJeat .Ithln .lxt>>' (61) _. of r_l,t of thl. MoU. t.v. ..-....ltt.. ,rob.t to the PA Deperu..t of Rev....., IMrd of .,...11, Datlt. 1110U, .....rhbul"ll, P' 17UI-lOU, OR --.Ieatl,.. to ....,. the ..tt.r ...,..Ined .t the MIdSt of the ~t of the ...r..... .....reMnbUve, OR .......... to the 0"""" Court AIIlIIM- lllUTZVE CCIIIECTIONII ,.tuel .rrore dlacovered on ttlh ......wIt thould 1M; Bdd....Md In .rIU", tal P. Depert.Mt of RweruI, Iur-.. gf IncUvlo..l Tue., .fTto': P lit ...........t Rwl... .....St, DEPT. 210601, H1rrhburl, P' 17UI"0601 Phone (717) 717-'505. s.. pega ~ of the booklet -In.tructlon. for Inherlt.noe T.. R.turn for. R..ldent DMedent" (REV..nOI) for ., IJqIl_tlon of ...lnhtraUyeb correat..e error.. DIICCUCT. If ." ta due 11 peld ..Itt'll" tt'lr.. (S) ~."r eonth. .ft.r the cIecIdwIt's _th, . flve percMt (U) dl8OClU"lt of U. tax peld II .11owd. The lU ta __.tv ...,..pertlclP11Uon pw'IOl ty II COIIIPUtN on thI totsl of the to tnd Int.r..t .....Md, tnd not ,.Id balan ......ry II, I"" the Unt dQ' .ft.r the .-.d of the talc __.t>>' ...rlod. Thl. non-participation ,...ltv Ie ....1.1. In the .... ....r ... In the the __ U_ period .. 10U MOUld .....1 the tUl ... Inter..t thet he. been ........ .. IncuC8ted on this noUOI. POIAl. n. Int.rllt II cherged beglml", with first dQ' of d1111~, Dr "1M (t) eonttl. ... OM (I) _ f,. the .t. of ..th, to the .t. of PII,..-at. Tu.. IMfdoh __ dell.,.,.,t before ......ry ., lHI beer Int.r..t .t the rat. of .1. (U) pe,,*,t per .... ~lt:ul.ted .t . .11, Mlt. of .001114. .n taxe. MhIClh __ .1I,....,t on or .fter "...,.ry 1, IHI ..Ill beer Int.".t .t . nt. ....Joh ..Ill V'l1'Y f... _landt, reer to _landtr reer with thet nt. ~ by the PA DIpIIr'-'t of R..,..... The ...11_1. Int....1t r.t.. for lHI through 1"7 ''''1 11llI1lUT. Yoo. Int.relt Rlt. Otll, Int.r..t feator ~ Inter..t bt. Otll' Int.r..t Feator 1HZ ZlI .000141 lH7 n .00OZ47 INS 11% .00001 1911-1"1 111 .00OS01 lH4 111 .00nOl l"Z n .00IZ47 lNS 151 .00OS56 1""1994 n .IU1U 1911 lOl .000174 1"5-1"7 n .100147 ""Intt,..et It _loul.tld .. faU... IIlTDEIIT . IALAllCIl OF TAX UICP&ID X NUIIIER OF DAYI DELIIlQUEIlT X DilLY IIlTEIIElIT FACTOR --Any Motl.. It....... .ft.r the tu ..... .1I,...-,t ..Ill r.fleat In Interllt ~lcul.Uon to flft.... US) _. bQond the dlt. of U. IIMI..,t. If ~t I, .. .ft.r the Int.....t ...-ubtlon dIIt. ~ .. the Mati.., tddltl_l Int.,...t w.t be _loul.ted. I:;:" 16 - 1/ COHHDNWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE 'i~ l___~ BUREAU OF INDIVIDUAL TA~ES INHERITANCE TAX DIVISION D(PT. Zl06Dl HARRJIIURG, PA 171Z.'0601 NOTICE OF INHERITANCE TA~ APPRAISEHENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TA~ 1...It.,,, tI' 111.'.. JOHN E SLIKE ESQ SAlOIS ETAL 2109 MARKET ST CAMP HILL DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN W 12-02-96 PETERSDN 02-01-96 21 96-0161 CUMBERLAND 101 HELEN AMount R..Ut.d PA 17011 HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER DF WILLS CUMBERLAND CO CDURT HDUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ii'iV': i54-j-Ex-"Fji-io''-:9lii-iiij'''-icEnciTYNHEiiifAiicE-YAx-jipjiiijiisEifEiii'-,--,U,i-ciwANCE-iili-n-------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATI! OF PETERSON HELEN W FILE ND.21 96-0161 ACN 101 DATE 12-02-96 TA~ RETURN WAS, I XI ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. RooI Eet.to (Schodul. AI III 2. Stock. _ Bondi IScheduI. BI 121 5. Cla..ly Held Stack/Partner.hip Int.r..t (Schedule C) 131 4. Hortg.gel/Not.. Receivabl. (Schedule OJ (4) 5. Caah/lank D.pollta'Hilo. Parlonal Property (Schedul. EJ (5) 6. Jolntl~ Owned Propart~ ISchadulo FI 161 7. Tranlforl ISchadulo 01 171 I. Total A...t. I CHANGED 104.394.00 12.110.63 .00 .00 22.250.23 8.110,12 .00 IBI NOTE~ To Inlur. proper cradit to your account, lubeit the upper portion of thl1 for. with your talC pay..nt. 146.864.98 APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funeral El(pen.../A~. Co.t.'Hlle. Expen... (Schedul. HI I') 10. Dobtl/Hortgogo LleblIltlol/Llanl ISchadulo II 1101 11. Tot.I Daduotlonl 12. Not Volu. of To. Roturn 15. Chorltablo/GoyorneentoI SOquOltl (Schodulo JI 14. Not Value of Elt.to Subjoot to To. 18,179.80 4.171.33 1111 1121 1151 1141 ".~lil 1~ 124.513.85 .00 124.513.85 If an a.sessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will reflect figure. that include the total of ~ returns assessed to date. ASSESSMENT OF TAXI IS. A.aunt of Llno 14 at Spoulol rata 1151 16. Aoount of Llno 14 to.ob10 at Llno.I/Cloll A rata 1161 17. A.aunt of Line 14 t..ablo at Collotorol/Clol1 8 rata 1171 IS. Prlnolp.1 To. Duo NOTE: .00 124.513.85 .00 ~ .00_ ~ .06_ ~ .15. IIBI .00 7.470.83 .00 7.470.83 TAX CREDITS: PAYHENT DATE 04-29-96 08-29-96 RECEIPT NUHBER AA112791 AA146672 DISCOUNT (+ I INTEREST (-I 342.11 .00 AIKlUNT PAID 6.500.00 628.72 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 7.470.83 .00 .00 .00 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN 61. NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU HAV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I \ c) r'; i :.-....:J 1 ,::-~ .~. /j(; RESEAvaTIONa E.tat.. af d.cedent. dvlng on a~ ~far. Dec.~r Il, 191' -- If any future Int.r..t In t~ ..t.t. I. tran.f'rr~ In po.....lon a~ ~Jav..nt ta CI... . Ccall.t.~..) ~flcl'rla' af the d.cadant .ft.~ the .xplr.tlon of any ..t.t. fo~ llf. or for y..r., the Ca-.onwe.lth hereby axpra..ly r...rv.. the right to appr.l.a and ...... tran.f.r Inherltanc. Tax.. .t the lawful CI... . (coll.t.r.l) r.t. on any .uch future Int.r..t. PIJRPOSt llf NOTICE: fo fulfill the ~aqulr'unts of Section llU of the Inherltanc. end E.t.t. Tax Act, Act II of 1991. 7Z P.S. Section lUlO. paYMENfa Detach the top portIon 0' thl. Notlc. and .ubalt wIth your pay.ant to the R.gl.t.~ 0' Will. prlnt.d on the r.v.r.. .Id.. -""ek. ch.ck or .on.y ord.~ payabl. to: REGISTER OF HILLS, AGENT all p.,..nt. r.c.lved shall '.r.t ~ appll.d to any Int.r..t whIch ..y b. duo wIth any ~.a.lnder appllad to the tax. REF\InJ (CRh . nf..nl of . tax cr.cHt, whIch .,u not raqu4l.ted on the Tax R.turn, .av b. r'qI.M.t.d by co.I.Ung an "Appllc.tlon 'Or R.fund 0' Penn'Ylvanla Inherltanca and E.tat. fax" (REV-1313). 'ppllc.tlon. .r. .v.llabl. .t the O'flc. of the Ragl.t.r 0' Will., any 0' the l3 R.v.nu. OI.t~lct Offlc.., or by c.lllng the .pacl.1 ".hou~ an.warlng ..~vlc. nuabar. fo~ fo~" ord.rlng: In Pann.vlvanl. 1"100"]6l.l050, out.ld. Penn.ylvanla and .,Ithln loc.l H.rrlsburg .r.. (717) 717"1094, TOOl (7171 77l"l25% (Ha.~lng lap.lr.d Only). DIJECflDNSa Anv p.rty In Int.r..t not ..tl.fled with the appral..eant, .llowanca or dl..llowanc. of deduction., o~ ......-.nt of tax (Including dl.count a~ Int.r..tl .. shown on thl. Notlca au.t ObJ.ct within .Ixtv (60) d.y. 0' r.c.lpt of thlt Notlc. bva ...,~Ittan prot..t to the pa Departaent of R.venu., loard of App.al., D.pt. lllOll, Hlrrl.burg, Pi .....lectlon to haY' th. ..tt.~ d.t.ralned at audit of the account of the par.onal ~,pr..antatlva, .-appea. to the Orph...." Cou~t. 171za....Z1, OR OR aDMIN ISTRAlIVE CORRfCTlDNS: Factual arrar. dl.cov.rad on this ........nt .hould ~ addr....d In wrIting to: PA Oap.rtaant of A.venue, Bur.au of Indlvldu.1 T.x.., ATTN: Po.t A......-nt R.vlew unit, Dept. 210601, Har~l.burg, Pi 17121-0601 Phone (717) 7.7"6505. Sa. pag. S of the bookl.t "In.tructlon. for Inharltenc. fax R.turn fo~ . R..ldant Dac~t~ (REV-ISOI) for an .xplanatlan of adalnl.tr.tlvalv correctable .rror.. DISctIt*T: If any tax due I. paid within thr.. (3) c.lendar aonth. .ft.r tha decadent"s d..th, . flv. parcent C5%1 dl.count of tM tax p.ld It .Uowed. PENALTY a The 15% tax -.na.ty non"p.~tlclp.tlon pen.lty I. co.put.d on the total of the t.x and Int.r..t ......ed, and not p.id before Janu.ry II, 1996, the 'Ir.t d.v .fta~ the 8nd of the t.x .~.ty p.~lod. Thl. non.p.rtlclp.tlon penalty I. appealabla In the .... .annar Met In the tha .... tI.. p.rlod u you would .....1 the tax and Inh~ut that h.. bean ......ed a. Indlc.t.d on thl. notlc.. INTER[ST~ Int.r..t I. charged beginning with flr.t d.y of dellnquencv, or nlna (91 aonth. and ona CII d.v fro. the d.t. of d.ath, to thl data of payaant. Tax.. which bac... d.llnquent b.for. Januarv 1, 19.2 b..~ Int.ra.t at the r.t. 0' .Ix C6XI p.rcent par ~ c.lculatad at . dally rat. of .00016'. All t.... which b.ca.. d.llnquent on and .ft.r January I, 1911 will b.ar Intara.t .t a rata which .,111 v.ry fro. calandar y.ar to cal.ndar y.ar .,Ith th.t r.ta announcad by the p, Depart..nt of Rav.nua. Th. appllCabla Int.ra.t ret.. for .,.Z through .996 ara: '!!!r Int.rut R.t. Oalh lnt.rut Factor :!!!r Intara.t Aat. Dally Inlar..t Facto,. 1911 lOX .0005"1 1917 'X .0002'7 I9IJ 16X .000'11 1961"1991 llX .000501 191' llX .000501 1991 'X .000"7 1915 ISX .000356 1995.1994 7X .0001" 1916 lOX .00D%7" ."5"1996 'X .000l,,7 --Int.rut II calculat.d .. foU"".: INTEREST a BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notlc. Inuad afta~ the tax b.coae. daUnquent will raflact an lntarut calculation to flftaen (151 dlY' bevond the data of the .......ant. If plVlant I. .ad. aftar the Intar..t coaput.tlon d.ta .hown an the Hotlc., addition.. Intar..t .u.t b. c.lculatad. .",...- --.....~..._... '- , . ~--------------------------------~ I I I I m"~~ ,~,~",..", P' '" '''',' ", ' ~, , , '"" "' - ">^ .,"-- '~-"~!M~~ ( ...r,;.yf..,..;~~ ,.,-~....,..J i>.. 4~';' ' J... ',' " . c . ~ \ " '~..l" '"., .-.p. '!loT .~ .;11,:.0: !'no' \., " .~l", ~ ". -< ,'. ~ ( " ~ j. ... J. t'~'\'~ .,~....,..-.'i~";< ~~~J1' S \;!! 'I~CO~U\IIIALTHOr PENNSYLVANIA' ~! ;~:,' ;' :':iif,~}:';;;~~'"" '\: (' ,.\,~ I 'h'l',l~'}!,..".~ .." ,,- , '\ ~ " t '"" <....~,~!~..,'" '~'"f''' ,. " 1""'~OJIUYINU.' .d_ ..'..',., l'/""'- #0 ,""'. ,,-~;;-..,~: -. ,,' .r} .,. _" ,~, -ot . ~'1"'"t'.~. ~.'.."c' '. -:.~ . ". '" .. ... , . , ~., }(~"M"',,,'I\""~".\,,),,,,,,,,--, ''''''''''.'_ ','., ".','e, -"-'k'" ""~"';~!I; ~:~:O~"SYLYANIA!N,"~NCI~ND~.~~~ll~M;:t. RECEIVED FROM. & ACN ASSESSMENT P:' CONTROL ... NUMBER AMOUNT JOHN E SLIKE 2109 MARKET ST lv1 .1.C:::'t't.t:;IIl CAMP HILL, PA 17011 ESTATE INFORMATION: !II ILE N MIER Ii 21-1996-0161 !II NAME Of DECEDENT (lAST) ~ PET RSON HELEN W II DATE 0 PAYMENT B POSTMARK E COUNTY SSN 179-36-1672 (fiRST) (MI) CUMBERLAND DATE Of DEATH REGISTER OF WillS m TOTAL AMOUNT PAID .1 .244.37. '. VZ ~ RECEIVED BY 9lJ1J.7 Il'~-.J~ ~kV " J MARY C. LEWIS .. 7;1;'..~, REGISTER OF WILLS .-, /'" REMARKS JOHN E SLIKE ESQUIRE SEAL CHECK" 104e :; ~-~.--------------- ---- - .-----------------r-........ t'- . .' ~. \. '. ~, . . . .f '" ......-.. . --- ,'" __'iT -~ ~- . .... ._-" \, , Recm:-" Ro~u\~. \.. ,,;! of ./ills 'CJ7 JAN 13 P 3 :09 Clllfr., Cumbl;',.:.; , ,...rl ,,'.. PA ~Of' NOTICE. To fulfill U. ,..,lr-.b of Section Zl4D of thI ZnrltMCtl .. [It,t. Tax Act, Aot II of 1"1. (12 P.I. IeCltlon 1140), PlYMDfT. Debclh tM tap portion of thl, NoU_ ... .-.It "Jth rour ~t to U. ....,t.r of NIlIl print... an the reverl. ,... ..- ....., CIhMk or -V order ....1. to. I1E11II1DI at WILLI, MlDfT. All ~t. .....lved "11 flrd _ ....11.. to .,y Intlr..t tthlClh ->> bII .., "UIt ." r_I"" ....U'" t. tN 0.. RE11III (till A nf\nl of . tax credlt, ....Ich .... not r..-sted on U. tax r.tum, .., be r.qullted br c-..laU". ~ -Appllatlon for ....... of Penn.,........ tmerlt..... WId E,bt. Tax. (REV-nu), application. ar. "",U_1. at the OffiCII of U. helda,. of NUh, MY of U. Z3 ...... DI.trlot a,llcel Dr br Qll1"11 the ......1 Z4"hour ."...rl... Hrvlce ,...ra for for.. order...... In ......QIYMI. l-laa-36Z-ZGSD, out". ""Qlv.dl Ind ..Ith!" loal ...",.1..,,...... (717) 717....94, TUD' (717) nz-uS! (....'1,.. t..,.lred Onh). OI.J(CTIDNSI ...,. ~rty In Int.r..t nat ..th'.ad .,Ith the 1lPP...I~t, .U0WW'tC8 Dr d!..U0wnc8 of decklctlonl Dr .....~t of tax Clnoludl,.. dJlCOWtt or Interest) I' ....., on this Notice ~ abject ..lthln .beb (60) _. af r.-Ipt af this Matlos hi -......Itten problt to tM Pi a.,.r'-'t af A...., brei af ......h, _to 21UI1, ",rrisbul"I, Pi 17121.1121, DR .....Iectl,... ta IwVII the .ttlr dlhrlllned It the _It af the ICCCUtt af the "rlGnll npr....,tlith,., DR ........1 ta the 0".,...,.' Court AIIIIN- IITlIATM COARECTICIII. F.Ml .rrors dlSCOYllrld an thll .........t lhauld bIi Ilddr...1ld In ..rIU,... tal Pi __rbent af ...,..., IurMU af Indlvl~1 TUII, Arnel Past ........t Aevl... LMIt, DEPT. ZlO'Dl, "rrllburt, Pi 17UI-u01 Phone (717) 7.7-6505. See PIOI 5 af the booklet -In.tructlon. far Inhlrltenc. 'ax Altum far I A..ldent DIoIden~ (A[V.1501J for en axpl~tlDn af edllnl.tr.tlvllw correct...l. .rror.. DISCClUfTI If In>>' tu ~ is ,.ld ..Ithln thr.. UJ CIII"r -.nth. .ft.r the decedent'. dMth, . flw perCltlt (UJ dllCDW\t af the tile plld is IUawed. PO'll TVt Th: 15% ~ ..,...t:o Mn-,.r~hlp.t1on pwl:lI! ty h c~.:t= :n th: tote! ~f tho t::t and Intc;"lU~ Dlsc:Kd. :t'Il! net plld before Jenulry .1, ."', U. flnt _ "t.r the end af U. tax .....b perlad. Thh nan-partlc1P1tlan ,..Ib I. .....1...1. In the ... .......r end In the the ... tI.. plrlad .. !tOY .....ld .....1 U. tu end Inter..t thet ... been ......... .. Indlcetld an thll natlce. 11fTtIlUT. Inter..t II cNrllld ~IMI"I ..IUI flnt dQ af dallnquwcw, Dr nl,. C9J IGnth. end aM (1) dQ fr. the dlt. af dMUt, to the dlt. af p..,..,t. ,.... Wllch bee-. .ll~t blfor. JInuIry I, 1.12 _r Inter..t .t u. nt. af .1. (U) PlrCltlt plr ... celeulltld .t . dIIlb nt. af .000164. 'U tanl ....lc:fI __ .ll~t an Dr .fter ,J.....,.~ I, 1..2 ..UI belr Inhr..t et . nt. ...,Ich ..IU VI~ frOll esl....r yur ta e111"r weIIr ..Ith that rate ..-.ouncld bv the Pi Deperbent af AIIftRM. The ."UCllble Interllt nt.. far 1,1l through ."7 erel Yoo. Inh,..1t Rltl o.lly Int.r..t FlOtar Yoo. Int.r..t Rite o.llv Int.r..t r.tar INZ ZlI .110541 IN7 tI .000247 1M3 161 .0004" 1911-1"1 111 .OOOSGI 19M 111 .110501 I"Z tI .011247 111I5 ISI . oalS56 1"5-1994 71 .Olll'! 1916 101 .DOOl?4 1"5-1"7 tI .011247 --Int.,...t 11 .Icullted .. fall_I' IIlTEIlElIT . UUIlCll DF TAX UItl'AID X NVIIBER OF DAYS DELIHQUEIlT X DAILY IIlTEIlElIT F&croR ..AIty MaUes l..uM .fhr the tax becoeI. .1I~t ..Ill r.fl_t en Int.r..t C8lcul.Uan to flftMn US) _. beyond the dIIt. af 1M .........t. If ~t II .. .fter the Int'r11lt ~t.tlan dilt. .,..., an the Mati., IddIU_I Int.,...t ...t .. aleul.tld. . '. " , i 1 , I I I I I I j I " .'..... ~' f<~:,y{,-,~"">,/j;-'~'~' i' ._~- '.~ <,t.... ",". . '." ""'!f . t:';'~J..;i~i>~i~\'" --- ",', ':>," l . . ) , , I i i ; ! ; , ), ." j , . , .. . i J , ~ '} ',' , / . '\ '. I ! Q Z j III ~ " M " 9 ~ ~l;; :3 ~ ::! " ~ u ... I;; '" .. - 5 ,,:C ~ ~)(::i o Ul " 51 ~ ~ . ~ 0 ~ .J g ~ " 8! s'" ::I (.') :i:: . ll. !!l 7- 8 6 ~ . ----~-..-'-- -'- , " III CIl o III 0 U:I: ....E-t rz.P: rz.o '- 00 U ...::l' l"l \~~~ o-:lzr-- ,,,", ....O.-i ~~O ,"-rz.u I o~~ ,~/.,P: III " III o-:l E-t CIl CIlIll.... ~~~ ~uu . ---,- ..~.-" . fl " t) t) , I~ " o ~ .' ,.' " . - . , " .',. . .. "- .' I . l.t. oJ '-" . ':.;' .~ ,"'.. . I 1. ' : ..~.. ~ . . r .' '."'~' ...\" ~.of. ...... ,I ." ; 'f ~;'.;. t. ... It 4, . t , . t. . ) . ~ .., .'" \ Go ..... .' ~ '1 .r,' I " ~, . i~;:; i" . .... ' , ...-.... ~ .!: ~" . ,.; . .. , L ,'~ " I" , . . q \. .. ~. . ! ,-I -' -~ .... I. I , . i i ! , . , , f' 'I',' . \";, , I' I I ~ ~\ I',;, ):.: I ' ,"' ,"" I' f;~ I':"'.' I..),;~';' """.;, . I. ,,' Vfi, ;:t' . ?{. J'~:-( !c'.'"' ~.-.J.4 ;;..-:~~'" /s--,f6.~ // COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES IHHEAlfAHCE TAil DIVISION MPT. :80601 HARAlSIURC, PA 17111-0601 NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX c... JOHN E SLIKE ESQ SAlOIS ETAL 2109 MARKET ST CAMP HILL DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-20-97 PETERSON 02-01-96 21 96-0161 CUMBERLAND 101 Allount H..Hted PA 17011 - 1I1-I"''''''III.t.. HELEN W MAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER DF WILLS CUMBERLAND CO CDURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~ iiE'y:isW-EX"AFii-n'2:ijiij-iicificE--cin-tiHEiiiTANCE"Ylix-iipjiRiiisEiiEiir;-ALi.-ciwAiicE-ifli-uumu----m DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PETERSON HELEN W FILE NO. 21 96-0161 ACN 101 DATE 01-20-97 TAX RETURN WAS, I X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. R..I Eltoto (Schodulo AI III 2. Stockl end Bondi ISchodulo BJ 121 3. Clo..ly Held stock/Partnership Int.r.lt (Schedul. C) (3) 4. Hortgegel/Not.. Receivabla (Sch.dula DJ (4) 5. CalhJ8ank o.pollta'Hllc. Parlonal Property (Schedule E) (5) 6. Jointly Owned Prop.rty (ScheduI. FI 161 7. f,.anl#.,.. (Schedule OJ (7) a. Total A...t. I CHANGED NO. 01 .00 8.430.63 ,00 .00 3.227,62 9.766.19 .00 IS) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral bpan.../AdII. Cost./Hhc. bpln... (Schedule HJ (9) 10. Dabtl/Hortgoge LlablIltlol/Llonl ISchodul. II lID) 11. Tot.I Oaductlonl 12. Net Value of Ta. Ratur-n 13. Ch.rlt.bl./Gov.r~.nt.l Baqua.t. (Schedule J) I~. Not Vlluo of Elt.t. Subjoct to Tax 685.00 .00 1111 U21 USI U~I HOTEl To in.ur. proper cr.dit to your account, .ub.it the upper portion of thi. for_ with your tax pa~t. 21. 424.44 6A~ no 20,739.44 .00 145.253.29 NOTE: 14. 15 and/or 16. 17 and 18 will returns assessed to date. If an assess.ent was issusd previously. lines reflect figures that include the total of ALL ASSESSMENT OF TAX: 15. A.ount of Line 14 at Spou..l rat. (15) 16. Aaount of Line 14 taxabl. .t Lin..I/CI... A rat. (16) 17. Aaount of line 14 taxabl. .t Coll.t.raI/Cl... Brat. 1171 18. Principal Tax Dua TAX CREDITS: PAYHENT DATE 04-29-96 08-29-96 12- 04-96 .00 X .00. 145.253.29 X .06. .00 X .15. ue) RECEIPT NUHBER AA1l2791 AA146672 AAIB4916 DISCOUNT (+1 INTEREST (-I 342.11 .00 10.14- AHOUNT PAID 6.500.00 628.72 1,244.37 INTEREST IS CHARGED FROM 12-05-96 TD 01-2B-97 AT THE RATES APPLICABLE AS DUTLINED DN THE REVERSE SIDE DF THIS FDRM TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 8,715.20 .00 8,715.20 8.705.06 10.14 .14 10.28 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN '1, NO PAYHENT ZS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. VDU HAV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) Reco", R"f! , or "'1 III!> '97 JAN 17 AII:4 6 Chi!: Comu. JLltl (;(,., PA RESERVATION. E.tat.. of dec~t. dying on or before Dec~r 12. 1'.' -. l' ~v future Int.r..t In thl I...t. I. 'ran,f.tt.d In po.....lon or enJoyunt to tl... . (coUlt.r.U b~flcl.rl'l of the dle"nt after the ..plratlon 0' any ..t.t. for II" or for y..t., the C~.lth her-oy ..pt..tlv rll.ry.. the right to eppr.I.. and ...... tran".r InherltlnCl ,.... It the l.wful Cia.. I (col1.t.ral) r.t. on any ,uch lutur. Int.r..t. PIJlPOS[ 01 NanCE I To 'ulflll the r~lr..-nt. 01 Section 2141 0' the Inherlt~. ~ E,t,t, ,.. Act. Act It of .991. 72 P.S. Section 21U. PAM"T. Detech the top portIon 0' thl. Hatlel and .~It wIth your p.~t to the Rlal.t.r of Will. printed on the r.v.r.. side. u"', check or lIOMy ordtlr pIyeb1, tal REOISTER OF MILLS, AGENT All p.,...,t. rec.h,~ shlill flr.t be eppllMl to ."y lnt.rut which ..y b. dI.Mi with any r...lnd.r .ppllM to thl t... mum ICAlI " r.f1.ftI of . t.x credit, .....Ich .... not r....ltad on tM Tax R.turn, ..y b. r.qu..tlld by coapl.tlnt ." "Appllcltlon for R.fund of Penn,ylvanl. lnh.rltanc. end E,tat. Tax" CREY.I]I]). Appllc.tlon. .r. avall~l. .t the Offlc. of the R.ght.r of Willi, any of the Z] A.vlftUl Dlltrlct Office., or by ceiling tM ,peclal 2".hour .",..rlng ,.rvlc. nueber. for for.. ordering, In Penn,ylv."l, 1.100.]',.:050, out, Ida Penn,ylv."l. end within loul HIIrrhburg .r.. (111) 711.10"', lDD' 1117. 772.ZZ5Z IH..rlng 1..lr.d Onlyl. OBJECTIONS I Any p.rty In Int.r.,t not ,.tl.flld with the appr.l,eeent, .llowene. or dl,.llowenc. of deduction" or a".,.-.nt of tax lInclucUng dbcOl6\t or Int.rut) ., .hown on thl. Matlce MI.t obJ.ct within .bty (6at day, of recalpt of thh Hotlc. byl ..wrlttan prot..t to the PA Pep.rtBlnt of R.vanua, laird of App.al., Dept. 211021, Hlrrl.burg, PA ...Iectlon to have the ..tt.r d.t.ralned at BUdlt of the .ccount of the Plr.on.1 rapr.,."t.tlv., ..lIpSMal to the Drphan,' Court. 11121.1021, OR OR AI>>UN ISTRATtVE CORRfCTIDHSI Factual .rror. dl,cov.rad on thl. ....,.-.nt .hould be addr...ed In ..rltlng tOl Pi Gaplrt.ant of R.VInUl, Bur.au of Individual TaM", ATlHr Po.t A.....eant R.vl... Unit, D.pt. :10601, H.rrl.burg, PA 1712..0601 ~ 11171 711.6505. See Pili 5 of thl bookl.t "In.tructlon. for Inherltanc. "M R.turn for a R..ldent Decadent" CREY.IS01) for an 'Mplan.tlon of ~lnl.tratlv.ly corr.ct~l. .rror.. DIKUll If any t.. dI.Mi I. paid within thr.. I]) clland.r .onth. .ft.r the d.c.dant'. de.th, . flv. parc."t 15%' dl.count af the tlX p.ld II .lIowad. PDlAL TVI The 15X t.x a.na.ty non.p.rtlclp.tlon panalty I. CQlPUtad on thl tot.l of thl t.. end Int.r..t ......ad, end not Plld bafor. January I', 1996, thl flr.t d.y .ft.r thl and of thl t.. .-na.ty p.rlod. 'hi. non.p.rtlclp.tlon PlNlty 11 1IPPI.1MiI. In the .... .annar and In the thl .... till p.rlod II you would IIPPI.I the tlM end Intlrut that ha. bien ......ad .. Indlc.ted on thh notice. INTEREST 1 lnt.r..t II charged M8lmlng with flr.t d.y of d.lInquency, or nlntl f9. .onth. end one ell day fro. the d.t. of death, to the d.t. 01 p.y.ant. r.... which bee... delinquent blfor. Janulry I, 19.2 bI.t Int.r..t .t ~ rlt. of .1. 16XI parcent par ~ c.lcul.tad .t . d.lly r.t. 0' .0001"'. All t.... which bee... delinquent on end .ft.r January I, nil will bI.r Int.r..t .t a rat. which ..III v.ry froe caland.r y..r to calend.r y..r ..lth that r.t. announced by the Pi Dep.rt,,"t of R.venue. lhl appllcabl. Int.r..t r.t.. for 19., through 1"7 .r.1 !!!! lnt.r..t Rat. D.lly lnt.rut factor ~ lnt.r..t R.t. O.lIv Int.n.t factor 1911 lOX .0005"1 1917 .. .OD02~7 19as I.~ .0000' 1911.1991 11:< .ODUOI I'" II~ .0QnOI I"" ,~ .0D02oU 1915 U~ .00nS6 199].1"4 1> .00019: 191. I.~ .00027" 1995.1997 .. .0002'" "Int.rut iI c.leul.tM .. follo..lI INTEREST . SALANCE or TAX UNPAID X NUNBER or DAYS DELINQUENT X DAILY ZNTEREST rACTOR uAny Notice Is.ued aft.r ttM tax bacHl. cMllnquant wll1 nfl.ct an Intlrut calcul.tlon to flft.an liS. d.n beYond the d.t. of the ......eent. If p.y.ant 1_ .Ida aft.r th. Int.r..t coeput.tlan dlt. shown an ttM Notlca, additional lnt.r.,t au.t be calcullt.d. CDHHDNWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES JMtERUAHCE U. DIV!SJOO DlPT. ZlUOl HARRISBURG. PI 11111-0'01 NOTICE OF INNERITANCE TAX APPRAISENENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX JOHN E SLIKE ESQ SAlOIS ETAL 2109 MARKET ST CAMP HILL DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-20-97 PETERSON 02-01-96 21 96-0161 CUMBERLAND 101 Anount R..ltt.d PA 17011 * '.1011.'" '" III.t.. HELEN W MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER DF WILLS CUMBERLAND CO CDURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV:is4TEx-iii:'ji-nF9&rHi.oYicnWYHHEiiifANcE-YAx-A'PPRA'isEiiiHT";"iii.i"ciwAiicE-Ori----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF PETERSON HELEN W FILE NO. 21 96-0161 ACN 101 DATE 01-20-97 APPROVED DEDUCTIONS AND EXEHPTIDNS: 9. Funeral Expen.../A~. Co.t.'Hllc. Expln... (Schedul. HI (,) 10. Dobtl/NortOIOo Llabllltlol/Llonl ISchodul. II 1101 .00 11. Total Daductlonl 1111 12. Not Value of To. Rotum n21 13. CherHable/Go...er,,""t.1 Illqulst. (Scheduh J) (13) 14. Net Value of Eatat. Subjoct to To. n4 I NOTE: If an aSSBs.mBnt was i'SUBd prBviously, linB' 14, 15 and/or 16, 17 and 18 will rBfIBct figurBs that includB thB tDtal of ~ rBturns assesssd to datB. ASSESSHENT OF TAX: 15. AMOUnt of Llno 14 at SpouI.l rata 1151 16. A.aunt of Llno 14 to.ablo .t Llne.l/CloI1 A rata 1161 17. Aeount of Line 14 to.ablo at Collotorol/Cloll B rata 1171 18. PrinciPII Tlx DUI TAX RETURN WAS. I X I ACCEPTED AS FILED I I CHAN;ED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEHENTAL 1. Rool Elt.to ISchodul. Al 2. Stockl and Bondi ISchedule BI S. Cloa.ly Held stock/Partnership Int.r..t (Schedule C) 4. Hertgag../Not.. Receivable (Schedule D) 5. C.ah/lank Plpa,ita'Hila. Perlon.l Property ISchedule E) 6. Jointly Owned Property ISchedul. FI 7. Tr~.f.r. (Schedule OJ I. Tot.l A.let. RETURN III 121 l31 I~I 151 161 171 ND. 01 .00 8.430.63 .00 .00 3.227.62 9.766.19 .00 ISI 685.00 .00 145.253.29 .00 X .00. X .06. X .15. nBI TAX CREDITS: PAYNE NT DATE 04-29-96 08-29-96 12-04-96 DISCOUNT l+ I INTEREST (- I 342.11 .00 10.14- RECEIPT NUNBER AA112791 AA146672 AA184916 AI10UIIT PAID 6,500.00 628.72 1,244.37 INTEREST IS CHARGED FROM 12-05-96 TD 01-28-97 AT THE RATES APPLICABLE AS DUTLINED DN THE REVERSE SIDE OF THIS FORM TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE NOTEt'To in lure proper credit to your eccount, lubtolt the uppor portion of thll for. with your tex PI_t. 21,424.44 ~AIi nn 20.739.44 .00 145.253.29 .00 8.715.20 .00 8.715.20 8,705.06 10.14 .14 10.28 . If PAID AFTER DATE INDICATED. SEE REVERSE FDR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN .1. NO PAYNENT IS P.EQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. VOU NAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I N ~8: 0<1) 1/1 N 3 ",= ., ~ a.. .~ 0 ()~ 'u .-"" .~ : .... co Uo N d "r: 1j '- ~ .!~ m tV '. 073 '(11 .. ... '..0 0'- ...' -=e uco p; cua: ~8 a: . ,-" '.~--~,- ,,- f~-I/ CDHHDNWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE INliERITANCE TAX STATEMENT OF ACCOUNT '- *' BUREAU OF INDIVIDUAL TAXES INHrRI'AHC[ ,ax DIYISION OfP'. l10601 HARAlsIURa, pa 171ll'0601 1I',ItU,.aUIU"" JOHN E SLIKE ESQ SAIDIS ETAL 2109 HARKET ST CAMP HILL DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 02-18-97 PETERSDN 02-01-96 21 96-0161 CUHBERLAND 101 HELEN W A.ount R..lttod PA 17011 HAKE CHECK PAYABLE AND REHIT PAYHENT TOI REGISTER OF WILLS CUHBERLANO CO COURT HOUSE CARLISLE. PA 17013 NOTEI To inlur. prop.r cr.dit to your account, lub.it th. upp.r portion of thil for. with your tax pay..nt. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ..... ifiV':iiiiij-E'ic-AFjo--n Z-:96y----n.iii-iNHERii'Aiic'Eni'AX-STA-iitiE-tii'-ilTAC-CoiJiiiuiili.-----n---u--------- ESTATE OF PETERSDN HELEN W FILE ND.21 96-0161 ACN 101 DATE 02-18-97 TNIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURREHT STATUS OF THE STATED ACN IH THE HAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAY"ENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT, 01-13-97 PRINCIPAL TAX DUE, 8,715.20 PAYMENTS (TAX CREDITS), PAYMENT RECEIPT DISCDUNT C+) AHDUNT PAID DATE NUHBER INTEREST C-) 04-29-96 AA1l2791 342.11 6,500.00 08-29-96 AA146672 .00 62B.72 12-04-96 AA184916 10.14- 1,244.37 01-28-97 AA185119 .14- 10.28 - o (Y) - ~ ..:~ q.; - 5: .:? TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 8,715.20 . It'\ N 1'. CD l.J~, ~ U """l IF PA-iti tMTER TIltS DATE. ~E REVERSE SIDE fGR CALCULATION ~~ITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN II, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. I .00 .00 .00 . ..... ._- --- -....--~--.._-- ~~- PAMHTa Detach the top portion of thl. Notlcl and lubalt with your ply.,nt Ilda Plyable to thl n,.. end addr... printed on the ranr.. .Ide. If RUIMHT DEC[O[", _eke check or MMY order paYable tal REGISTER OF WILLS, ACENT. If NOtHftS1DtHT DECEDENT .... check or 1tOI11ll' order plyable tOI CO""OHWEALTH OF PENNSYLVANIA. All p.,..nt. '.c.ly~ ~11 bl .,pllld flr.t to any 1",.,..t which "Y b. due with eny r...I~r .,,111d to the t... REF1ICD (ath A refund 0' . till cnel11, which .... not requ..tad on thl 'Ill Rlturn, ..y ba r...,..ted by co...l,"", an "application 'or R.fund of Penn'Ylvanl, Inheritance end [,tata Ta." (REV-ISIS). ',pllcatlont .t. IVlllabl. .t the O"lcI 0' the AI.ll',r 0' Willi, ,"y 0' the 2S A.v~ District O"lc.. or fro. the O'P.,t-.nt', "-hOur ..,....rlng ,.rvlcl nu.ber. for for.. ordering, In P~'Ylv..,l. 1-100-362-2050, out.lde Penn.ylvenll ~ within 10cII Hlrrl.burg .r.. 1717) 717~109', TOO. (717) 772.2252 CH..rln, 1.,.lr.d only). REPLY TOr Due.tlon. r',lrdlng Irror. cont.lntd on thl. notlc. lhould b. .ddr....d tOI PA D.p.rtlent of A.VInUl, Bur.1V of IndlvldUll TtxII, AfTN, Po.t A......ent Alvlew Unit, nlpt. 210601, Hlrrllbur" PA 17121.0601, phone C7171 717-6505. DISCOlJlTI If IftY tax due I. paid within thr.. CJ) c'ltnd.r .onth. aftlr the d.cadent', dl.th, I five p.rc.nt C5~1 dllcount of thl t.. p.ld II .Ilowtd. PfNj" TYI The 15~ t.. eenelty non-plrtlelpltlon p.nllty I. c~t.d on thl tot.1 of the tlx ~ Int.ra.t .......d, ~ not plld befora J~.ry II, 1996, thl flr.t d.~ Ift.r thl end of tha tax tana.ty parlod. INTEREST I Int.r.,t I. charted beginning with flr.t dlY of dall~ey, or nlna C.) .onth. ~ one III d.y fro. thl dlt. of dlath, to thl dlt. of PIV-tnt. TIXI' which bICI" d.llnquent bafor. Jenu.ry I, 1..2 be.r Int.r..t .t thl r.ta 0' .1. 16XI p.rcant Plr annul e.lcullt.d at a dall~ rat. of .000164. All t.x., which blc", d'llnqu.nt on ~ .ft.r Jenu.ry 1, 1..2 will b.lr Int.r..t .t . rlt. which will vary frOI e.lend.r y..r to clllnd.r y.lr with th.t rlt. announced by thl PA D.p.rtltnt 0' A.v.nu.. Thl ."llc.bla Int.ra.t rlt., for 1911 through 1991 Iral Yilt Int.rllt Aatl Dilly Int.ra.t Fector Yllr Inter..t A.ta DIII~ Int.r..t Factor 1.1l zn .oon.. .91' 'X .00GlU 191' .6X .000411 ltal-I991 IIX .000301 1914 .U .001301 ."z 'X .0oolU 1915 ISX .000556 1995-.'" IX .000192 1"6 .'X .000214 1995-1991 'X .Oool., ."Int.rllt I. cllcul.ted .. follow'l INTEREST . BALANCE DF TAX UNPAID X NUHBER DF DAYS DELINQUENT X DAILY INTEREST FACTOR ....Any Notice luued .ft.r thl t.x b.COM. dellnqu.nt will raflact 11\ Intlrt" calculltlon to flft"" In) dly. beyond thl dltl of thl ......-.nt. If plyaent I. ltd. Ift.r thl Int.r..t coeput.tlon d.tl .hown on thl Notlcl, addltlon.1 Int.r..t ~.t b. c'lcul.t.d. ,.----,,--., /5,r~ - II COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT c: .. Ilfo1..,.."'IU.NI HELEN ) LOVELL L PETERSON 3453 GREEN ST CAMP HILL PA l70l1 t MAKE CHECK PAYABLE AND REMIT PAYMENT TOI W REGISTER OF WILLS CUM8ERLAND CO COURT HOUSE CARLISLE, PA l7013 HOTE. To lnlur. proper crodlt to your ..count, IUD. It tho uppor portion of thl. fore with your to. poyoent. DATE OF LAST ASSESSMENT OR RECDRD ADJUSTMENT. 12-16-96 PRINCIPAL TAX DUE, PAYMENTS (TAX CREDITS). DISCOUNT (+) AMOUNT PAID INTEREST (-) 89.78- 5,282.33 BUREAU OF IIIDIVIOUAL TAXES INHERITANCE TAX DIVISIoN D€PT. ZI"Dl HARRlllURQ, PA 17121."01 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-10-97 PETERSON 02-01-96 21 96-0l61 CUMBERLAND 96003380 AllOUI\t RHI Hod CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -4 ii'i'j:i6cij.iX.AFp.liZ:96Y-....-.iii.iiiiiERiTAHC'!.i'AinTATEilEHi'-OF-Acciiiliiy-.iiJi..._...._........_.... ESTATE OF PETERSON HELEN W FILE NO. 21 96-0161 ACN 96003380 DATE 02-l0-97 THIS STATE"ENT IS pROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACH IH THE NAKED ESTATE. sHOWN BELOW IS A SUttlARY OF THE PRINCIPAL TAX OUE, APPLICATION OF ALL PAYIIENTS, THE CURRENT BALANCE, AIID, IF APPLICABLE, pROJECTED INTEREST FlGllRE. ,I II 'I i\ , ' : \' ! " , , ,: "1 ! \ I I , I PAYMENT DATE 01-10-97 RECEIPT NUMBER AA185062 O.:fl 0'::':';' ., ~~ .-.,;... - c;') r:<c .1U.. " - d: .... ,j '. .J ~ '-' '-' ~ 0....'; l '\ f~' Cl[I; a: co W L1- , .. ~ ci'- _:J ~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE, SEE REUERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL OUE IS LESS THAN .1, HO PAYIIENT IS REQUIRED. IF TOTAL OUE IS REFLECTED AS A "CREDIT" ICRI, YOU !lAY BE OUE A REFUllD. SEE REVERSE SIDE OF THIS FORtI FOR IHSTRlJCTIONS. I 5,192.55 5,192.55 .00 .00 .00 PAYIDT, Detech the t. portion of thb Notle. Met ___It "lth your Plyaent aede p.pbl. to the nMe Ind ldett... prlntlld on the r.ver.. I1c1t. If IInlllOlT Il(CEIlOIT -. ....... or ___. ordor P..obl. to, REGISTER OF WILLS, AGENT. If HOIH'.SIIlOIT Il(CEIlOIT _. _k or ___. ordor p..obl. to' CIlIlItONIIEALTH OF PENNSYLVANIA. AU PQMints ,...Ived ....11 1M ..UecI first to eny lnt.r..t which ..y be due .,lth My ''''.ncM,. 1PP1I1Id to the tax. REFUND (CAlI' r.f\n:t of . tax crldlt, lilhlch .... not r..,..ted on the Tax Rlturn, ..y be r.qullted by eMIIl,tlnt IIr'I "'AppllClltlon for Refund of PennlYlnnl. ZriMrltwcl Ind Eat,t, To" (REV-UlS). Appllcltlon. .r. awUlbll It the Office 0' the R..llt,r of Willa, My of the tJ Revenue DI.trlct Offlc.. or fr~ the o.p.rt-.nt". Z'-hour Wl~rlng Hrvlcl nu.blr. for for.. orderlngl In Penn'Y1Y".' 1-'DO-S6Z-Z0S0, out,lde Pennlvl.,.,., Ind within lOCI! HarriSburg .r.. (717) 7'7-'094, TOO. (717) 77Z-ZZSZ CHeering 1.,.lrlld only). REPLY Ta, b,Uon. r....rdlng .rrar. contained on thh notte. thould be edd,...ed tal P' Oeptirbwlt of AIV.,.., au,..... of Indlvldull T...., ATTNa Po,t ......-ent Rlvl.. unit, Dept. Z10601, HarrJabur., PA 171".0601, phone 17171 117-15'5. DISCO'''''' If My tax ~ h 'lid .,Ithln thrH CS) cII"'ar Nnth. aft.r the dac:edent'. death, I fJVII ,.rc....t (5%) dl.count of the tax ,aid I. Illowed, PENAL TV! n. 15% tax ~,ty nan.,.rtlcl,IUan ..-nIl ty h caput. an ttMI tot.l of ttMI tu end Jnt.r..t ......., WId not 'lid bafara J.nuary 18, 1996, the fJr.t day aft.r the and a' ttMI tu .-na.ty ,.rlod, INTEREST I Intera" h charged ballmlnt vlth fJrlt day a' dellnqtMnCy, or nine (9) Mnth. and OM (1) day 'r. the dIIta a' death, to the data a' 'IYNnt. Talll' which bee_ delinquent be'ar. J....ry 1, 1912 bear Intar..t at the rat. of ... (0) ,.rCMt ,.r ...... calculltMl It I daUy rata of .000164. All tax.. Wllch bee.. delinquent an end aft.r Jlnuary 1, 1'82 viiI bear Int.r..t .t I r.t. Wllch NIll v.ry 'ro. cll~r y..r to cal~r ya.r with that r.t. announced by the 'A o.,.rtaent 0' R.venue. The appllcabl. Int.r..t rat.. for 1"2 through 1997 Ir'l V..r Int.r..t Rat. Dally Intar..t Factor Vaar Intaraat R.t. DailY Int.r..t Factor I9IZ ZIX .00054' 1"7 OX .00n47 I9IS 10 .00"31 1911-1991 11% .00OS01 1914 IIX . "OSIl I99Z OX .000147 1"5 IU .00OS56 1995'1994 n ....In I'll IIX .000114 1995.1991 OX .00n47 ."Int.r..t I. calculated .. fol1o..11 IHTERElT . BALANCE OF TAX UNPAID X NUKsER OF DAYS DELINQUENT X DAILY IHTERElT FACTOR ".Any Notlca luuad .ftar the tu beeGle, dellnquent Nlll r,UKt ., Int.r..t c.lculatlon to 'lit.., US) dQ, beYOnd the data of the ...........t. If ,IYNnt I. .... aft.r the Inter..t CMpUt.UCIrI data IhoMn CIrI ttMI Notlca, additional Inter..t au,t be c.lculated. ~d Recore ;'0:: ,..ic;' of R('~.;,:..~r (,;; \,\,:Hs '97 nPR 28 P2 :I)~ 'eOpOU lII/lllJlM pepnPu,II'" IUBWlIllllS PllIllO Ado~ 'tCler". ',' 'UI~ 10 IXI'1 j/'CufTlb,. " .I JIBI/'AJetouIuIq '.1011 1M." III BllIlIB BI/I UIISBJBIUI UlI WIl!IO OIl 8^1I1/ 011U1lU1lOOCIt 8\11 01 UMOUll U08Jed J8410 .\1_ 01 ~IJ": IUSWllll' PlIIdun A.IIM 01 UlMllI ualq 11II/'UOjlnCllJIIIO PBSO<lO'J 10 IUlIWBllIlS PIli 01 IUOp:l8/qo UBIlIJM Bill 01 Aep 18111 941 10 pUll UOllllWJUlIlI3 lOJ unO:) 8\11 01 pBIU98SJd Iq III'" 8WIl1l oql UBI/'" &:IlIld PUlIBWII'8111P Bill 10 pUll 'uollnq,Jl810 p1I8odOJd 10 IUeWlIllllS 814110 IIuUY 81ll jO &:IIIOU U9U1J'" \lI4IAJIUlI:J Aq9J94/ :'" PA , I ~ ::l ::l ~i~ ~ .!! a~ ~U 'ra:lZ r..0-1~0 ii~sEII o gj POPO~ Eo<~ll:~ '!iliS ... 2'lIljSl If~ II) ~~~fol =E1il Its ... 00 Po t;: lllS GI ; 80~ tjo-1gJ '0 1!5C III UO II) ;ij~~a ]i'!i!~i r.. u ClI il~ ClI all! &~ ... ~tl~~Li . r..Hra:l 0 iil~r. 0 0-1 Z ~tIl ~r.. l ~ J fl u~~ :2:0 '0 ~ 0 folgJfol ! ~ ft c Eo< ~ ~!ISE~ ~~ gj~~Eo< i 9]'-'0 HOra:llll r....Pofol C lOll _ OC~ ; ~ ~ I! ~ .~ =;s"8-uS.c lltl ::uu)oo 8~.m 'C. -c..c 8~ gi U::J 0 Ci '= ~.o..:; \: Q..c: ;,;., .- _ c: O.i .~ '" :; ""<> CIIgE >~.! 'CD..."O _0 , .:! go o. j . . .~.!:'ii -' . , .r ~ :_~I: 1 ~ ~ ol:I ~~ Om "'- ~O ~~un fa = F: F: 8,1iEE < ~~~~ m ~ I~n I~~!:! :li~E'E CC ~!~ ~ . .J J"'" ~ (> SAlDIS, GUIDO, SHUFF '" MASLAND 2109 Mubl SIRcl Camp HIll PA DISBURSEMENTS Debts of Decedent: Bell Atlantic PAWC PP&L Bon-Ton Susquehanna Surgeons Conner-Rich-Kearney & Torchia Bell Atlantic PAWC Ann Markley, Tax Collector - county & boro taxes Apria Healthcare Inners-Davis Associates Hartman & Scheu chen zuber - tax preparation PP&L EKG Associates Conner-Rich-Kearney & Torchia Bell Atlantic A. Z. Ritzman & Associates Borough of Camp Hill - sewer PP&L PAWC Waste Management A. Z. Ritzman & Associates USAA - car insurance Westinghouse Security Systems Bell Atlantic PAWC Westinghouse Security Systems Bell Atlantic A. Z. Ritzman & Associdtes Westinghouse Security SYBtems PP&L Ann Markley, Tax Collector - school taxes PAWC PAWC Bell Atlantic Westinghouse Security SYBtems PP&L Waste Management PAWC Westinghouse Security Systems PP&L Bell Atlantic PAWC 4 $ 26,94 12.46 108.22 64.32 35.98 32.27 33.31 17.59 444.32 2.14 48.15 245.00 97.10 6.65 67.73 18.30 39.77 60.00 74.27 18.58 35.88 53.75 34.28 98.00 23.55 17.02 22.00 34.58 1. 78 22.00 70.34 1,168.68 21. 25 14.97 19.98 22.00 89.31 35.88 16.71 22.00 78.25 26.96 18.98 Westinghouse Security Systems PP&L Bell Atlantic Westinghouse Security Systems PP&L PAWC USAA - home owners insurance premium Bell Atlantic Waste Management PAWC Borough of Camp Hill - sewer Westinghouss Security Systems PP&L PAWC Bell Atlantic Westinghouse Security Systems PP&L Bell Atlantic Bell Atlantic Westinghouse Security Systems PP&L PAWC Westinghouse Security Systems Waste Management Bell Atlantic PAWC Westinghouse Security SYBtems PP&L 22.00 86.56 25.50 22.00 56.16 20.16 206.07 27.05 35.88 17.02 60.00 22.00 60.31 20,55 33,30 22.00 99.07 33.30 35.93 22.00 132.23 20.20 22.00 35.70 43.53 17.06 22.00 98.12 Total Debts of Decedent $ 4,663.65 Funeral EXDen.e.1 SAlOIS, GUIDO, SHtlFF &: MASLAND 2109 MarbI_ Camp HIII.PA Musselman Funeral Home Reimbursement to L. L. Peterson for: Grave opening Marker down payment Rolling Green Cemetery - balance due Total Funeral ExpenBes $ 5,641.00 605.00 326,00 931.00 on marker 326,00 $ 6,898.00 5 SAlOIS, GUIDO, SHUFF '" MASLAND 2109 M..uc St...c CIlop HIl~ PA INCOMB ACCOUICT RECEIPTS Prudential Securities - February annuity $ 450.00 Prudential Securities - March annuity 450.00 Pru-Mutual Fund - dividend 46.42 PP&L - dividend 274.72 Prudential Securities - April annuity 450.00 Orrstown Financial Services - dividend 19.55 PP&L - dividend 274.72 Pru-Mutual Fund - dividend 46.56 Orrstown Financial Services - dividend 19.55 Pru-Mutual Fund - dividend 44.57 Pru-Mutual Fund - dividend 49.49 PP&L - dividend 274.72 Orrstown Financial Services - dividend 274.72 PNC Bank - interest on estate checking account from 2/22/96 to 1/29/97 173.75 TOTAL INCOMB RECEIPTS $ 2,BU.34 7 SAlOIS, GUIDO, SHUFF " MASLAND 2109 Market sum Camp Hili. PA COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND) JOHN E. SLIKE and LOVELL L. PE~ERSOH, Executors under the LaBt Will and Testament of Helen W. Peterson, deceased, hereby declare under oath that they have fully and faithfully discharged the duties of their office; that the foregoing First and Final Account is true and correct and fully discloBeB all significant transactionB occurring during the accounting period; that all known claimB againBt the estate have been paid in full; that, to their knowledge, there are no claims now outstanding againBt the estate; and that all taxes preBently due from the estate have been paid. Sworn to ~d sUbscribed. before me thiB t7f.5 day of ~ ~ , 1997 ~J.0n~ /Notary public NOTARIAL SEAL . THELMA S. McCAUSUN. Nolary Public I Camp Hili. Cumberland COUnty My Commlsslon Expires July 3, 2000 ---- -....- . ..t!u;:....i,.;:..h.:.:t->=>"-;.::~ ~-- ,..--',.-.-" INVEN'rORY OF 'rHE REAL AND PERSONAL ES'rA'lE OF HELEN W. PE'rERSON, DECEASED Real Estate: ReBidential dwelling located at 3453 Green Street, Camp Hill, PA $l04,394.00 Personal ProDertv: 8,430.63 3,680.00 20,540.23 1,600.00 110.00 329 BhareB of PP&L common @ 25.625 l19 BhareB of OrrBtown Financial Services common @ 32 PNC Bank account No. 5140049482 1986 Dodge Aries Bedan - actual sale price $2.50 gold piece $l38,754.86 TOTAL . . . ~..-~..~--_... .....- Signed, published and declared on the date thereof by the above-named HELEN W. PETERSON, as and for the sole codicil to her Last Will dated January 7, 19B1, in the presence of us, who, at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses hereto. Camp Hi 11 , PA Address , ('. ~. F Landisburq, PA Name Address Page 2 ARNOLD Ie SLIKE. AnOlN1VS."T.U,W, 1109 "'Aun STUlT. CAM'IIIL1.,'A nOli ... ""~""~,_~,,,,,'Jll' ~... .:1 ....,.,WI.~W- "" ". - . .. . . .. . LAST WILL AND TESTAMENT OF HELEN W. PETERSON I, HELEN W. PETERSON of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any will previously made by me. I _ I direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II _ I devise, and bequeath all of my automobiles and all other articles of personal or household use, including but not limited to household goods, furniture, personal effects, and other tangible personal property, to my son, Lovell L. Peterson. III _ I devise and bequeath all the rest, residue and remainder of my estate of every nature and wheresoever situate unto my trustee hereinafter named, IN TRUST, nevertheless for the following uses and purposes and under the following terms and conditions. The trust shall be held for the benefit of my said son, Lovell L. Peterson, for life. Out of the income derived by the trustee, it shall pay all the necessary costs ,.-OLD, !IURa 1tI DIoTUT Ano&NIT1 AT ""w _............, c:..........................- JJk ?J.lJl~ Page 1 '. .........--..-.. <00 '. - '.....'.-.-........-..-.------.:..O""'-';'.i.oI.-._...., . '.....'....._..'.: 0,- and expenses of the trust including reaBonable compensation of the trustee. 11y son shall have the right to withdraw the income from the trust estate at least quarterly, and any income not withdrawn by him within sixty (60) day~ f the 0nd of any calendar year shall be added to the principal and no longer be subj ect to withdr8\~al. The trus tee, at its sole and ab:,ol lite discretion, may expend from time to time sums of principal which may be necessary for his support, health and maintenance, includ- ing but not limited to hospitalization and medical expenses. Upon the death of my said son, the remaining trust estate shall be distributed to his then living issue per stirpes, and if he has no such issue surviving him, including afterborn issue, then it shall be distributed as follows: A. 50% to the daughter of my deceased imsband by a former marriage, Christine Shepherd, if ljving, and if not to her then living issue. B. 50% to the Shriners Hospital for Crippled Children, a corporation. \II1fOLD,SU....O.t.l'La" ATft&HIYI " LA. __n...... c.....Il,...r-,,~..""- IV - I appoint Dauphin Deposit Bank and Trust Company, Harrisburg, Pennsylvania guardian of any property which passes either under this will or otherwise to a minor or incompetent and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so. Such guardian shall have the power to use principal as well as income from e minor's support and education (including Page 2 :; I'. ! . VI _ The trustee hereinafter named shall have the following powers and duties in addition to those already vested in it by law and other provisions of this will: A. To retain any or all of the assets of this trust, real or personal, including its own stock, without regard to any principle of diversification or risk. B. To invest in all forms of property, including stock, common trust funds and mortgage investment funds whether operated by it or others, without restricton to investments authorized for Pennsylvania fiduciaries, as it deems proper, without regard to any principle of diversification or risk. c. To sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such termS or conditions as it deems proper. D. To allocate receipts and expenses to principal or income or partly to each as it from time to time thinks proper in its sole discretion. .-----.,.. ;, /I .. I . ._. - --_...~._---...-..- ___.,.,._t.:.,,r.......-l'.,'.........., college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payments for these purposeB without further responsibility to the minor or to the minor'S parent or to any person taking care of the minor. V _ The principal and income of the trust hereinabove created shall be free from anticipation, assignment, pledge or obligation of any beneficiary and shall not be subject to any execution or attachment or to voluntary or involuntary aliena- tion. j , '~ I \ \ I , 1 A."OLD,SU'" A 0.,....., \ =~~~.~~ , (.,0,...1""....."""..""'- ~~i4A~ Page 3 .. _,.,~~\ti;t~:- ;>j.~~f,..:.",,: ~Wt~~:~::?", -. ti:~~:t;f:~ ", ~: N"':':~' , I ~~"',i t .- I"'i:::;:;~~':-' :.':M.oI;l.rI."~ ' ~;ff.~~',' ',~:l!. . ~'".". {i..;\';:::"", '-t!.~<r;~:, ~'-- ,: ~~V'()>"1~"< '" ~ .::!:....\.~' '") - ~t'~I.;, g:....l ~. ~ ~~~1}-/[~ ';,' - .- :',- 'i." """".' ~~~w;y, ~'t'-",- ' ;\.i{:,"'" ," ~1,~~;;:.-~/r/; \ t~V',"""~'" .~ ~~.~:~~.;~:~~~'\. I,";{., " W",":'"'' :<;:~~~;;~~::.- . Jt~~l':j,;.j."', ..h;;,_.:,,'_~ ~;:~\i::' B" ' !{;'".fi;!;~ ;C-,.:. > . ~'~\~:h m ... ~r;'>;';;j' ft. S, },"<:"'" ?IllUl -~tf,,~.f~,~., lZ:ii':"~~ J1.~~3-'..!:.-; . H tD ~'NJI" 8 :,Q~I" ~::}ii~ r;.8~1i) ""~, il~ ~ 'ma~.. ~B C!..,.. .0 ~'r.; ~.; "';}J;;... ::o~... ~ ~;:-~\ ":J:i::~: .' -:..~<: , . ~~';'.:. " ", ~i~~ . ~~""'_'J""'" "''':j~~''~,;,':~'>_ ):x~.: ~>~.~." '-..", ~{~:;f'};' ~'-'''I'''' :f"1i~":""_' - .". ,!It~~ ...', " to;",:;:-~'t:,;" ' ~~'l." ,~ . 'I ..,;,~~'5'-~",' '{~1\1~ ."'",' :';:. ~:~?(/, ~!d::'/' 20 ~ :rI':O :'i~ ;~g - . e' c' j f: "Oo. .',j ~; Q. - ,) m .,. . : I'! " ..:... -"\ -:l :~~~ -' ~.} :r~ .. !J -' -.. .' ,". 0 ~ l~U . lif~~ ~ ~ ~EE s:: IS f~e Gl ;:; ~.! .-4 ~ 81 ;~ lH fil 0 ~ Gl O{/J ~ 'tl l:} ~ ~ :l Gl ~ In al III U~I fil 'Gl s::u OGl ~ ;if;$ .... uu::a ~ ~~~ ~.:~ r cc .,~ :if.! ~:'Gl :!l F :~ {/J ... .. .~ : ,6-. F ~ i:':" ~UL 1 0 1997 -. ." SAlDIS, GUIDO, SHUFF '" MASLAND 2109 Mutd SIRet Camp Hill. PA ~~f~'~~"~!r:ll~\~W~~t:t~<'\Y"" ~'>': ,.\.,' . , .. ". J IN RE: ESTATE OF IN THE COURT OF COMMON PLEAS HELEN W. PETERSON, OF CUMBERLAND COUNTY, PENNA. ORPHANS' COURT DIVISION NO. 1996 - 161 DECEASED DECREE r-f{ ARD NOW, this / b - day of at <<' ? J o'clock, ~.m., upon motion ~Jl-j/, 1997, /' of John E. Slike, Esquire, it is hereby decreed that in accordance with the First and Final Account confirmed by this court on June 17, 1997, the following described real estate be awarded to Dauphin Deposit Bank and Trust Company, IN TRUST, nevertheless under the provisions of the LaBt Will and Testament of Helen W. Peterson dated May 7, 1985: ALL that certain unit in the property known, named and identified in the Declaration referred to below as Green Oaks Condominium, located in the Borough of Camp Hill, Cumberland County, Pennsylvania, which has heretofore been subjected to the proviBions of the Pennsylvania Uniform Condominium Act, 68 Pa.C.S.A. 53101 et Beq., by the recording in the Office of the Recorder of Deeds in and for Cumberland County, a Declaration dated April II, 1989 and recorded May 19, 1989, in Misc. Book 364, Page 405, and Plan Book 58, Page 27, being and designated in such Declaration as Unit 18, also known as 3453 Green Street; as more fully described in such Declaration, together with a proportionate undivided intereBt in the Common Elements (as defined in such Declaration) of 12.58. BEING the same premises which Blue Star Properties, a PennBylvania General PartnerBhip, by its deed dated June 7, 1989, and recorded in Deed Book~, Vol "2;", Page ~1? ,Cumberland County recordB, granted and conveyed unto Helen W. Peterson, the within-named decedent. - I IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY. PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: Helen W. Peterson Date of Death: February 1, 1996 Will No. 00161 of 1996 Admin. No. pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X i No 2. representative complete: If the answer is No, state when the personal reasonably believes that the administration will be 3 . If the answer to No. 1 is Yes, state the following: a. Did the pe~onal representative file a final account with the Court? Yes)<i No b. The separate Orphans' Court No. (if any) for the personal representative's account is: /1/~ c. Did the personal representative state an account informally to the parties in interest? Yes Xi No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: I )../?--7.. / f" I I + John E. Slike, Esquire .D. No. 06262 SAIDIS, GUIDO, SHUFF & MASLAND 2109 Market Street Camp Hill, PA 17011 (7171 737-3405 " . ~" Capacity: Personal Representative X counsel for personal Representative . ., T<;;'~,~'f:~I~.' "-~,',:'''-r.t:~ ;gf'~~k:,'::::.;,;".:"-~;r~ :, ;;.,:;:<~I;:~'!~~~~%e~f;;;~:1:~;J~!f~ ,,0,.., . . RECEIPTS OF PRINCIPAL k " I' Fiduciary I" Acquisition I' Value t. ----------- , I CASH: I 08/20/97 Estate of Helen W. Peterson 1,784.19 04/08/98 Estate of llelen W. Peterson - 255.00 Proceeds on sale of 5 shares of Orrstown Financial Services Conunon Stock 07/08/99 Lovell Peterson Trust 7.49 07/26/99 Lovell Peterson Trust 2,750.00 07/27/99 Lovell Peterson Trust 335.00 01/05/00 Transfer From Income 9.06 02/08/00 Transfer From Income 78.12 03/07/00 Transfer From Income 78.11 04/05/0D Transfer From Income 78.12 07/18/00 Transfer From Income 678.Dl 08/11/00 Transfer From Income 275.00 -------------- 6,328.10 STOCKS/LISTED: ------------- 06/30/97 115.000 shares Orrstown Financial 3,68D.00 Services Conunon - Received from the Estate of Helen W. Peterson 06/30/97 658.000 shares PPL Resources Inc Hldg 16,861.26 Co - Received from the Estate of Helen W. Peterson -------------- 20,541.26 3 . . GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS - PRINCIPAL Gain Loss 08/11/97 658.000 shares PPL Resources Inc Hldg Co. Net Proceeds 12,976.26 Fid. Acq. Value 16,861.26 3,885.DO 09/03/97 115.000 shares Orrstown Financial Services Common Net Proceeds 3,759.52 Fid. Acq. Value 3,68D.DO 89.52 09/11/97 1. 000 share Marketvest Funds Inc Intermediate US Govt Bond Fund .593 Net Proceeds 9.74 Fid. Acq. Value 9.76 0.02 09/18/97 351. 453 shares Marketvest Funds Inc. Equity Fund .590 Net Proceeds 4,92D.34 Fid. Acq. Value 4,830.00 90.34 02/20/98 1. 039 shares Marketvest Funds Inc Intermediate US Govt Bond Fund .593 Net Proceeds 10.29 Fid. Acq. Value 10.16 0.13 02/25/98 50.865 shares Marketvest Funds Inc Intermediate US Govt Bond Fund .593 Net Proceeds 500.00 rid. Acq. Value 497. 51 2.49 05/06/99 25.562 units ARK Funds US Government Bond Portfolio Net Proceeds 250.DO Fid. Acq. Value 250.D2 0.02 08/06/99 8.412 units ARK Funds US Government Bond Portfolio Net Proceeds 80.00 rid. Acq. Value 82.28 2.28 09/08/99 8.430 units ARK Funds US Government Bond Portfolio Net Proceeds 80.0D Fid. Acq. Value 82.45 2.45 5 10/06/99 04/06/0D 07/17/0D 07131/00 08/16/DO 12/01/0D 31. 64 6 units ARK Funds US Government Bond Port folio Net Proceeds 300.00 Fid. Acq. Value 309.53 105.708 units ARK Funds US Government Bond Port! olio Net Proceeds 1,000.00 Fid. Acq. Value 1,033.93 75.269 units ARK Funds US Government Bond Portfolio Net Proceeds 7CO.OD Fid. Acq. Value 736.21 32.154 units ARK Funds US Government Bond Portfolio Net Proceeds 3DO.00 rid. Acq. Value 314.5D 42 . 644 units ARK Funds US Government Bond Portfolio Net Proceeds 40D.OD Fid. Acq. Value 417.10 9.53 33.93 36.21 14.50 17.1D 1,520.994 units ARK Funds US Government Bond Portfolio Net Proceeds Fid. Acq. Value 14,525.49 14,876.89 351. 4 D ---------------------------- TOTAL GAINS AND LOSSES/PRINCIPAL........... 182.48 4,352.44 4,352.44 LESS LOSS............................. NET GAIN OR LOSS........................... (4,169.96) -.------------ 6 08/10/00 Mark E. Hilbert Associates - 275.DO Appraisal Expense 08/16/00 Transfer to Income 241. 8D 09/05/DO A11first Trust Company of PA, NA - 8D.OD Trustee Fee 10/D5/DD A11first Trust Company of PA, NA - 79.97 Trustee Fee 11/06/00 A11first Trust Company of PA, NA - 80.DO Trustee Fee 12/05/00 A11first Trust Company of PA, NA - 85.51 Trustee Fee DI/05/01 A11first Trust Company of PA, NA - 85.48 Trustee Fee 02/02/01 A11first Trust Company of PA, NA - 85.45 Trustee Fee 03/05/01 A11first Trust Company of PA, NA - 85.41 Trustee Fee 04/05/01 A11first Trust Company of PA, NA - 85.37 Trustee Fee 04/17/01 Transfer to Income 394.90 D5/07/01 Allfirst Trust Company of PA, NA - 85.12 Trustee Fee 06/05/01 Allfirst Trust Company of PA, NA - 85.03 Trustee Fee D7/05/01 A11first Trust Company of PA, NA - 84.98 Trustee Fee -------------- TOTAL GENERAL DISBURSEMENTS......................... 9,172.15 RESERVES -------- Cumberland County Register of Wills - 17 4.00 Account Filing Fee Saidis, Shuff, Flower & Lindsay PC - 65D.OD Attorney's Fee -------------- TOTAL RESERVES...................................... 824.00 -------------- TOTAL DISBURSEMENTS OF PRINCIPAL.................... 9,996.15 ..-----------. 9 INVESTMENTS MADE - PRINCIPAL 1 Units Cost ------- 08/25/97 342.D67 shares Marketvest Funds Inc. 4,700.00 Equity Fund 1590 08/25/97 1,024.590 shares Marketvest Funds Ine 10,00D.DO Intermediate US Govt Bond Fund 1593 09/D5/97 9.386 shares Marketvest Funds Inc. l3D.00 Equity Fund 1590 09/05/97 379.098 shares Marketvest Funds Ine 3,700.0D Intermediate US Govt Bond Fund 1593 09/22/97 500.035 shares Marketvest Funds Ine 4,920.34 Intermediate US Govt Bond Fund 1593 11 RECEIPTS OF INCOME DIVIDENDS Marketvest Funds Inc. Equity Fund *590 -------------------------------------- 09/02/97 . 5.06 Orrstown Financial Services Common ---------------------------------- 08/20/97 01/07/98 02/06/98 22.80 D.50 1.05 24.35 TOTAL DIVIDEND INCOME.... ... ...... .... .... 29.41 ....-.-------- INTEREST ARK Funds US Government Bond Portfolio -------------------------------------- D4/06/98 05/04/98 06/01/98 07/01/98 08/D3/98 09/01/98 10/01/98 11/02/98 12/Dl/98 01/D4/99 02/Dl/99 03/01/99 04/01/99 05/03/99 06/01/99 07/01/99 08/02/99 09/01/99 lD/Ol/99 11/01/99 12/01/99 01/D3/00 D2/Dl/00 03/01/DD 04/D3/00 05/01/00 06/01/00 07/03/DD 08/01/00 09/01/0D 26.90 89.76 92.21 89.44 91.72 82.28 79.24 81. 61 80.24 82.94 81.41 74.63 83.37 79.26 75.60 74.66 78.86 77 .58 74.56 76.66 75.36 75.79 76.72 74.48 78.83 75.4D 75.75 71. 79 73.48 69.66 14 . 10/02/00 67.83 11/01/00 68.54 12/01/DO 67.08 -------------- 2,523.64 ARK Money Market Portfolio -------------------------- 07/D1/98 0.16 08/03/98 2.27 09/01/98 2.18 10/01/98 2.16 11/D2/98 2.04 12/D1/98 1.52 01/04/99 1. 49 02/01/99 1.25 03/01/99 1.15 04/01/99 D.99 05/03/99 D.16 06/01/99 0.53 07/01199 D.4l 08/02/99 0.09 09/01/99 0.D3 10/01/99 D.05 11/01/99 1.07 12/01/99 1.11 Dl/03/00 1.02 02/01/00 D.68 03/01/00 D.70 04/03/00 0.42 05/01/00 4.32 06/01/0D 5.D5 07/03/00 3.60 08/01/0D 2.80 09/01/00 1.54 10/02/00 1.28 11/01/00 1.42 12/01/00 1.34 01/02/01 79.73 02/01/01 75.70 03/01/01 62.06 04/02/01 64.96 05/01/01 57.35 06/01/01 52.26 07/02/01 45.86 -------------- 48D.75 Capital Reserve Account ----------------------- 09/03/97 26.32 10/02/97 4.89 11/03/97 0.04 12/02/97 0.05 12/31/97 0.64 D2/02/98 0.21 03/02198 0.22 IS . . 09/21/98 D9/23/98 10/05/98 10/22/98 1D/23/98 11105198 12/07/98 12/17/98 12/21/98 01/05/99 01/D6/99 01/13/99 01/22/99 01/26/99 02/05199 D2/17/99 03/02/99 D3/05/99 03/29/99 . . . . Pennsylvania American Water Company - Utility Expense 31. 74 Pennsylvania Power & Light Co - Utility Expense 90.08 Allfirst Trust Company of PA, NA - Trustee Fee 99.40 Pennsylvania American Water Company - Utility Expense 31. 91 Pennsylvania Power & Light Co - Utility Expense 68.89 Allfirst Trust Company of PA, NA - Trustee Fee 99.20 Al1first Trust Company of PA, NA - Trustee Fee 99.23 Pennsylvania American Water Company - Utility Expense 21.31 York Waste Disposal Inc. - Utili ty Expense 25.92 Allfirst Trust Company of PA, NA - Trustee Fee 99.17 Pennsylvania Power & Li9ht Co - Utility Expense 60.49 Ann M. Markley - Real Estate Tax - 1998 School Taxes Camp Hill District 1,349.50 Pennsylvania American Water Company - Utility Expense 25.34 Pennsylvania Power & Light Co - Utility Expense 104.65 A11first Trust Company of PA, NA - Trustee Fee 99.15 Pennsylvania American Water Company - Utility Expense 43.47 Pennsylvania Power & Light Co - Utility Expense 14 .49 Allfirst Trust Company of PA, NA - Trustee Fee 99.00 Pennsylvania Power & Light Co - Utility Expense 83.92 20 ~ . . . . . . 08/11/00 Transfer To Principal 275.00 09/05/0D A11first Trust Company of PA, NA - 43.D8 Trustee Fee 10/05/00 Allfirst Trust Company of PA, NA - 43.06 Trustee Fee 11/06/00 Allfirst Trust Company of PA, NA - 43.08 Trustee Fee 12/05/00 Allfirst Trust Company of PA, NA - 46.04 Trustee Fee 01/05/01 A11first Trust Company of PA, NA - 46.D2 Trustee Fee 02/02/01 Allfirst Trust Company of PA, NA - 46.01 Trustee Fee D3/05/01 Allfirst Trust Company of PA, NA - 45.99 Trustee Fee 04/05/01 Allfirst Trust Company of PA, NA - 45.97 Trustee Fee 04/18/01 Ann M. Ramsey - 394.9D Real Estate Tax - 2000 School R/P Tax for 3454 Green St. 05/07/01 A11first Trust Company of PA, NA - 45.83 Trustee Fee OS/23/01 Seabury & Smith, Inc. - 88.89 Insurance Premium 06/05/01 A11first Trust Company of PA, NA - 45.78 Trustee Fee D7/D5/01 A11first Trust Company of PA, NA - 45.76 Trustee Fee -------------- TOTAL DISBURSEMENTS OF INCOME................. . 9,628.31 ----------.-.- 23 ,... . . ... ...... .. : t.. ! I .,:::';~';::::,,"'::.., I I I I I .. - - .. .. -.- -.... ... ..... r"." ,j / ... ..published and declared on the date thereof by the above-named A. PETERSON, as and for the sole codicil to her Last Will dated if 7, 1981, in the presence of us, who, at her request, in her ~nce, and in the presence of each other, have hereunto subscribed names as witnesses hereto. Camp Hill, PA Address , t. jJ~. jl Landisburq, PA Name Address Page 2 ARNOLD" SLlKE, ATTOINUS.AT.I,AW. 110. ~Aun STlln. CANP HILl. PA nOli ---..~" . '."OLD. Sua. . IIATL8T ATnlUIITt AT "'.. --.."'""" c.... .I.....h_"_~_ - .-- ..__._lUO...:... ...~.:~~~.: -.-.';:- ..-:;.:....:.;;~. - ..:.... ..._~.._.'"':':.~. ......-:-.-.':'f'~-=.,. LAST WILL AND TESTAMENT OF HELEN W. PETERSON I, HELEN W. PETERSOll of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any will previously made by me. I - I direct the pa~ent of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II - I devise and bequeath all of my automobiles and all other articles of personal or household use, including but not limited to household goods, furniture, personal effects, and other tangible personal property, to my son, Lovell L. Peterson. III - I devise and bequeath all the rest, residue and remainder of my estate of every nature and wheresoever situate unto my trustee hereinafter named, III TRUST, nevertheless for the following uses and purposes and under the following terms and conditions. The trust shall be held for the benefit of my said son, Lovell L. Peterson, for life. Out of the income derived by the trustee, it shall pay all the necessary costs JU~ 1- tall.l-nJ Page 1 I. ..,..,Wt. ", ..f .'. .... '. '..~~ t'''!:,:, ':, r -=.' . ,~ ".- .:~ '; . . . . . ,::~':'\J?.. ',...::~:~ ~ . ~) ....... ", , .........~..,.~.....'p,f.........,........., ........~~....." and expenses of the trust including reasonable cocp~nsation of ,'.' ".'';':::'.~ ." . ')o..n :'.,~ -' '.' the trustee. My son ~hal~"hav~ the right to withdraw t~~ I ". ..... ~ . income from the trust estate at least quarterly, and any income . " . . . . ~ Ii . '. '~ '.' :'. . not withdrawn by him within sixty (60) days of the end of any :. ,./ . . calendar year shall ?~ a~?~~ to the principal and no longer be subject to withdrawal. The trustee, at its sole and absolute discretion, may expend from time to time sums of principal which may be necessary for his support, health and maintenance, includ- ing but not limited to hospitalization and medical expenses. Upon the death of my said son, the remaining trust estate shall be distributed to his then living issue per stir?es, and if he has no such issue surviving him, including afterborn issue, then it shall be distributed as follows: A. .50'7. to the daughter of my deceased husband by a former marriage; Christine Shepherd, if living, and if not to her then living issue. B. 50'7. to the Shriners Hospital for Crippled Children, a corporation. \.IifOLD, Sua. 6 II."L." A~'ATU." --.......... c..,......'...n.........- IV _ I appoint Dauphin Deposit Bank and Trust Company, Harrisburg, Pennsylvania guardian of any property which passes either under this will or otherwise to a minor or incompetent and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so. Such guardian shall have the power to use principal as well as income from e minor's support and education (including Page 2 , .. . .",' ., . .......;.....-.--""'"-. . college educa~ion, both graduate and undergraduate) without regard to his or her parent's ability to provide for such Bupport and education, or to make payments for these purposes without further responsibility to the minor or to the minor's parent or to any person taking care of the minor. v _ The principal and income of the trust hereinabove created shall be free from anticipation, assignment, pledge or obligation of any beneficiary and shall not be subject to any execution or attachment or to voluntary or involuntary aliena- tion. VI _ The trustee hereinafter named shall have the following powers and duties in addition to those already vested in it by law and other provisions of this will: A. To retain any or all of the assets of this trust, real or personal, including its own stock, without regard to any principle of diversification or risk. B. To invest in all forms of property, including stock, common trust funds and mortgage investment funds whether operated by it or others, without restricton to investments authorized for Pennsylvania fiduciaries, as it deems proper, without regard to any principle of diversification or risk. C. To sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as it deems proper. D. To allocate receipts and expenses to principal or or partly to each as it from time to time thinks proper sole discretion. AIUIOLD. Sua. . II.YUT AT1'ClIHI11"'''''''. --........., c.....u..h-.......-.- income in its ~~II4)~ Page J ...,--'--------."-- - -- .' 'Ut..... ~-- 1/ . ;.............,. : S~gned, sealed, pubf~B~~~ and declared by HELEN W. PETERSON, Testatrix therein named, on this and four (4) other sheets of paper as and fot:,her Last Will and Testament in our presence, who, in her presence,' at her request and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ' .... . ' . . - . ....,. ,.' ~ ~ "': . Cf.-:j ~,"~ , , & 1~ ;,J~~ ,Pit. Address ~,-If~i.. ) 'ffi, tfA.~~ , l Name (k~l~ A~{~ ~. oD,Suaa. a...yUY ."..,....A"U.. ---., -'''''''-"'-- - Page 5 f I IN RE: ESTATE OF HELEN W. PETERSON, DECEASED : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY PENNSYLVANIA : ORPHANS' COURT DIVISION : NO. 0161 OF 1996 PETITION FOR APPROVAL OF THE RESIGNATION OF ALLFIRST TRUST COMPANY AS TRUSTEE AND THE APPOINTMENT OF COMMUNITY TRUST COMPANY AS SUCCESSOR TRUSTEE OF THE TESTAMENTARY TRUST OF HELEN W. PETERSON AND NOW COMES Allfirst Trust Company of Pennsylvania, N.A., successor by merger to Dauphin Deposit Bank and Trust Company, by and through its allomeys, Saidis, Shuff, Flower & Lindsay, and states the following in support of this Petition: I. The Decedent, Helen W. Peterson, died February I, 1996, having made a Will and one Codicil, duly probated on February 20, 1996, on which lellers Testamentary were granted on February 22, 1996, to Lovell L. Peterson and John E. Slike, Esquire, as Co-Executors. 2. In her Will, the Decedent devised and bequeathed the residue of her estate in trust, for the lifetime benefit of her son, Lovell L. Peterson, appointing Dauphin Deposit Bank and Trust Company as Trustee, without naming a successor Trustee. 3. Decedent's Will gave her son, Lovell, the right to withdraw income from the Trust at least quarterly, and authorized the Trustee, in its discretion, to expend principal for Lovell's support, health and maintenance. 4. Decedent's Will instructs the Trustee, upon her son's death, to distribute the remainder of the Trust to Lovell's issue; or, should there be none, to Christine Shepard and to the Shriners' Hospital for Crippled Children, in equal one-half shares. 5. Petitioner Allfirst Trust Company of Pennsylvania, N.A., successor by merger to Dauphin Deposit Bank and Trust Company, desires to resign as Trustee of the Trust; and Community Trust Company has agreed to act as Successor Trustee of the Trust. (Community Trust Company's consent to this Petition is allaehed hereto.) 6. The sole lifetime beneficiary and both named contingent remaindermen of the Trust have given their consents (which arc allached hereto) to the resignation of Petitioner as Trustee and to the appointment of Community Trust Company as Successor Trustee of the Trust. 7. Afier notice duly given to all parties with an interest in the Trust, Petitioner has filed with the Clerk of the Orphans' Court a First and Final Account, including a proposed schedule of distribution in conformity with the relief requested by this Petition, and scheduled to come up for confirmation on August 28, 200 I. ~ ____.....~i~~.-_d.l~~. ,_.'" ..' JUL. 25. 2001 8:56A1.t73734SHC LEGAL DEPARTMENTLAN!) vm f~~ 2 O~~tL ~:. J~1 16116 CONSENT OF BENEIIICIARY The Shriners' Hospital for Crippled Children C"Shimers' HospllB~') hereby consents to the resignation of Allfim Trust Company as Trostee of the Trost created under the Lasl Will and Testament of Helen W. Peterson (the "Trost") and the appointment ofConununily Trost Company aa Suc:celSorTlU!tee oflhe Trust. I,JlIY Fleisher ;, hereby certilY that I am employed In the Legal Dcpanmenl of the Shrincrs' Hospital and am authori7.od to execute Ihls Consent on behalf or Shrincrs' Hospital.t- WItnesS: J~~ 1r.,6e Cattl!U (SEAl.) leinher, Managing AttOrney Shriners' Hospital-\- *n/k/a Shrinnrs lIosp1tllls for Children . , . . IN RE: ESTATE OF HELEN W. PETERSON, DECEASED : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY PENNSYL VANIA : ORPHANS' COURT DIVISION : NO. 0161 OF 1996 CERTIFICATE OF SERVICE AND NOW, this 251h day of July, 2001, I, Thomas E. Flower, Esquire, of the firm of Saidis, ShutT, Flower and Lindsay, hereby certify that I this day served n true and eorrect copy of the foregoing Petition upon the parties listed below via United States Mail, postage prepaid, addressed as follows: Office of the Attorney General Of the Commonwealth of Pennsylvania 16th Floor, Executive Office Strawberry Square Harrisburg, PA 17120 Mr. Thomas Vrecenak Legal Department Shriners Hospitals for Children P.O. Box 31356 Tampa, FL 33631.3356 Mr. Lovell L. Peterson 3543 Green Street Camp Hili, PA 17011 Ms Christine Shepard 368 Blueberry Pond Drive Brewster, MA 02631 Respectfully submilled, SAlOIS, SHUFF, FLOWER & LINDSAY By: Thomas E. Flower, Esquire Supreme Court ID 1183993 2109 Market Street CampHiII,PA 17011 (717) 737-3405