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HomeMy WebLinkAbout96-00516 PETITION nm PlmnATE 111111 C;HANT OF LETTEI~S ;)./- q ~ . 5"/ (" Nu. I,,: I:"'all' IIj K(\t~dne L. IInrl/ell 01.\0 kilo"''' (1.\ ~. . /)('n'awll. Sucia/ Sl'l'IIri,y Nil, ,_175,.,34..,8392- - - l{e~i\lel "I Wil" I", Ih,' (''''""Y "I Cumbgrland, ill Ihe t'(HI1I1HlIIWI.'allh (If IJ,,'nn,yl\'allia liB,' pClilioll 01 I Ill' lIIHh:I...il!lIl'd Il',p"'l'tfully rCI1II.""'1I1, thai: YOHr !l",tilillIlCr(\), \\llll j.. ale IS y",;U\ of ill!l' (If older an thl'l'\l'l'UI. inlhe la\1 "ill ,.llhe ab",,' d,',:,'denl. daled April 13, , and ""d i.:i 1('1 dilled August ,14,..1991 dx _,.._......_..___ nallled ___..__. IL8~_ ~__'~_'__ . - ___ ~_ .____..___________..__._. __.".____..__. ~~_._ _________u_._ _Co-executrices ,named inthe _ Codicil, Patricia _Harwe1LHamliILann _Barbara Harwell- 'l'aylor..have.renunciated.. - l.t;\I\.',d"'\,1Il1 nh'llI11'lalltl."\. l'.~'. Il'lllln~I"litlll. lk;llh III 1'\l'tUltll,l'IC.) lJe.:cmknl w,,, dlll\li.:ikd ," deillh in __ ._9J~E!i.md_ _' .__,," ('"nnIY, l'enn\ylVill1ia, wilh IL~_I:. ... 1a\1 lamily llf prin.:ipal re\iden.:c al ,,70.5_~Qdd, ~_!.rslE!.,_J3.o..roug~ of Carlisle, _t'ennsylvania-l701.3".--- __._______.___ 111\1 \I".'~'I. IlIl111hCI ;lIld 1I1111l.ql;lhl~1 Ikcelldelll, Ihen ..89-- yc:,t\ of age, dicd _,__,_June_24.__ ,19 q,; 'II _ .-Carlisle-Hospital, .Carlisle,-PA-,----------- . heel'l a, 1'011,,,\\. decedenl did nol marry, "a\ nol dimrced alld did nol have a child born or adopled after 1.'\cculillt1 or 1111.' \\iIIllfh:rcu for prohate: wa... 1I011he vktim or a killing. ami \\'a~ never adjudicated iIH.'0I11PCIClll: ________...__ .---- ----- DCl."l'llllc111 .11 death o\\IIl...d properly with l'\timatcu \'ahll:\ a\ follo\\': (If ,h'mi.:ilcd in I'a,) All pel\l1l1al properlY (I l' nol domiciled in Pa,) l'el\l1l1al properlY in I'enn\yl\'ania (111101 dOJl\icill..'d in Pa.) Pl'r'llJ1at properlY in County \'allll' "I' rcall"lal\.' ill PCI1I1,yhania ,ilual",:d ", flllhm..: ____~___________.____~__ -----. S 100,000.00 S S S -----.--.. --------~_..._---_. ---.-.-.--------- .~. -.--------..---------..----...----... --. ..------.... \\ IIEI{I:H)){E. pelilioner(\l rC\l'eclfully requC\t(\) Ihe plllhme of Ihe lasl will and codicil(s) pre'enled h,'rellilh and Ihe granlof IcIlCC\..__,__. _____Testamentary , Il,"',IIll"1I1ar\; ,hlrn;m'll;llillll':.I.;I.; :ldmini\lr:ninn d.h.n.f,.'.l,a,) tIH,,'IOII, ~ _'_~Lu,~--~udl" /&--C&. ..__Kath1ee~.Harwell-Cotte _ __60 ~e>gilfltol/ Brook Road _,'_ SlJerboJ:'n/J'!!L.9.1770 i:: x~ ~.~ -, '- " 1 --~ .-- --~--_._~_.._._...- - _.._------_.~--~_.~-- OATH OF PEHSONAL H.EPHESENTATIVE (,0:\I:\10~WE"I.TII OF I'E~~SYL\'ANIA ! .. J' >;>i cm ~TY OF __C1JmQet:.l;'!J!'~,__-,_ Th\,.' p\"'lili\lIl\"'l{") ahOH'-I1:.1I11\,.'" "WI.:.IT:") os- anirl11t~) thatlhc 'talCIllt:nh illlht: foregoing pClition arc Inh.' .tlld ~'IU-H.'~'1 III lhc h\""1 \If ,h\'" kno\\h:'dgl' alllt hclid of pClitinner(,) anu lhat as personal represen- taliH'(-.) lI1111I..' ahn\\'" \kl'C\ktll pClitilllll"Z:') \\ill \\1.'11 anu truly :lllmilli'lcr the estate ul.:l.:nrding to la\\'. s\\ III II Itl or anill11l'f.,I, and 'uh",...rH'cd I her",... Ill<' Ihi, ,., ,27Th __ "a, ,,1' (~} Juqpe,' J'I q6 -'(ltCfjil C. :V~,;:<tf;j.ll-: J).U,'k..1 1 IS-III-jt) (J Ma~rC. Leds Nl'gllr<,r -.. %tk.;;I:-;~-~tE(~ej &tti- -Katfileen-Ha['\lel1~COt~e '" ~' " .. :: ~ ~ _. _.. _ _...- .... _ 0-, No. _ 21-96-516 Estutc 01' KlIthlldne I.. lIarwell , Ucccuscd UECREE 01" PRonATE ANU GRANT 01" LETTERS AND NOW June 28th 19....9.6_, in comideration of the petition on Ihe reverse side hereof. satisfactory prool having been presented before me, IT IS DECREED Ihnt the instrument!s) dOled April 13, 1984 and August 14, 1991 described Iherein be admilled 10 probate and filed of record as Ihe laS! will of -' l<athildre L. lIarwell and Letters are hereby granted 10 Telltamentary Kathle"n AaN" 11 Co!:t" ----- -- /, v;I!J;ri!t Mary C. Lew~s '( FEES Probate, Letters. Etc. .".,.,.. S 200.00 Short Certificates! 3) . .,. .' , , .' S 9.00 Renunciation .........,...... S 5.00 Codicil S 10.50 ~c~ages (4) TOTAL_S 12.00 :J.UU Filed ... .June ,2Bth,,1996 ' , . , , , . , . , . , , . $ 241.50 7R Srnl~h p;~~ S~r""~. p n RnY 20B t\DDREs!Carlis1e, PA 17013 (717) 249-8300 PIIONE Dale F. Shughart, Jr. ATTORNEY (Sup. C\. I,D, No,) 19373 00 c- ",l1? !~ ~ :lJ :TJm '" ., ((-' , f= z N (> (, -.J -0 ~"':7 ,:-;" W C" 0 8- \0 ,. Mailed Letters and order On 6-28-96. , , )" .. > -, ~ I I II I I I I I I \Iii 1111\ ldld \~llh lilt' ,I' Thi"j'hl\1'IIil)lh.Ilt1II'illllllllI.lIIIJI1It'111..:1\1,IlI'l"lltll:."'I';{' "'lll,IIl'III,I~lIl.llt'IIII.I('" It". , . 1.0l:.11 ({ll~i...tt.lr. Thl'llliglll.llll'llIlIl,IIl' will h(" 11I1\~.lhk\II" IIi( ~I.I'" \'11.11 1\1\111,1.... ()IIII(' 1111 l'l'III1.1IlI"1I1 1IIlllg WARNING: Ills Illegal to dupllcatl! this copy by pholostat or photograph. r\ll ...j'ffffl;;""""~, If~~\.~'" Ote(",~ li.~ ,."~"~,.\ ~I' .,' .~,..~ '-' ;;: . ., . ~"'-:':. ;"'~'" Cf-9IAr--:...-~'!-\.~l ...{Nl a:",.,~~ ~ "I..v.-'-'~,- \VI ~.",J ~~J.'1 ) Illl.1I Ht"gi<,Il.11 ,) Fn' for rhi, U"lilh ,lit.'. S!.OIl ')("1"'1" v) I '1 0 ..~" 1\' ~(;, \'1 I~' 1>.lIl' "'ClI~""':" I~ COMMONWEALTH OF PENNSYlVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH .., or ... ~ n) L. I,/l'oOlIl t lOll - 0." ... . ,,,,,.,._,, k1C'......CUlllf'rt<UWlIfll ., llAl(OfDUJ.._o.. _, ., .. V"Cltll'tl.or -1-" _Thl'UCAlC"_ s....,.,..,.COU'III N.w York City , '~"'Tl'..a"",.",,,,,,,,,,,~,,,,,__, JIVo(;I()llOfaJ..or._.........____"..._.... 89 ooCVOI.O~ -cx ,""-- 0 - ~ ,~#otU -~'" .. lucl..__"-'...... "'C ,- ;1.\ Cumberland .. Carlisle " \/hIt. 1uf"o'lIo-...Q\I'O.lV ~-,........_- 205 Todd Clrcl. "C.rll.l., P. 17013 U'tC"'H."",.U_U1ft I Ed", "'(If\WAIIl,.HAUt(l~ I orne oteIDl"'" ac'U.L IlI$lOlOCI ...- "'"...- '- Ila~"1 ...,.,ULIUJut...._ -"'-.- ---.. Of. 0( U aL UNtOOOol .~-;.O::::::J:~ tl Homemaker 1111 Own DlC.ot"lT....AVtQAOOflI..r"... c....-.- ~'Clc..- .""l)Ol'IV\lHtS~""'. .. I" I&n-l!) .. -- M", Cumberland --.' ,,.~ ::::::-.::::.. "OTIt(I'IIH."I,'..__s..._ 1,.,0'11II._...... ... ,~ C.rli.l. - .." ...............0 . ..,OOl........'..~UlOf\lU.s....~,....IClc- 60 Bo .tow Brook Rd., Sh.rborn. MA 01770 PVt. OI$P0511OOOo1,,,_.c-..,.c.-..., 1.OCAl' ..... r.ea. ..~"'-cl 11 1996 \11:'1"",,",,"'1(1'1 "ArBn ton at n '. .....I&HO.lOOAI..Ol'.ACUl'f H rr 219 N. Il.nov.r gt. maen ~i LCI"KN\JIlON." RI'I - 5Cc"'1So' L . :~:.) ( u L ".H.InI; 1_...._"..I_.........._.._~t._..........c.............._.................._.~.....,......_............,.......1 L....._~_......,._ . Ac...it.. D<tur.ef.;J. ,~r:..n..u-.;,... II r~:.,ro1~~~JV{'"'~I-~ J,u \&~(jO'..lOlJI.IC.I~1 _. DVlT1Jf(Jla.satOtIloLOlJlOlCIOtI . I"""....... ,.......- ,-....- , i ""'''' 011'>oo........_--......... --....."...~-......."""I Co/IJ ...If.( .Ultl",.,,,OOtQ, "."'''IAOIU.I.. -.u..IHlC:ll'll'O xf COt,tI'\.ITIOi\IOICAUU -~ 0 Ol'OUf..t .-.. 'n- O "'-"~- 0 ...0 ~O ...~ 0 C_....MlII<_ 0 OAlI 01 o>&Nft, ,~..n...... T''''QI'~Il. _,.orl\OAltr OlK""'OOWIl'lNll'cc.c..-.:o .-.0...0 .. 'M cun_..Il.tP"""_..... .etll'.,,'-O""'.ICl..IIII....JW_<~._<1___~.._~...."""""'I"!"""..~(_..,_n. "...........,.--......"'--......-......-..".... .. I'VC.OI'~....._.__.'___ -.... I'( &Iooc"o1 * ., C Q 1Ol(:I'IQ..'<<IC'I"".,.,IIOG....,.Cl."',......h.::>"......."Q""...,..OC{__"'<.-~~..1 "..._.................I.._._..II..._,..'-........M......_"''''.~h..'''........_........ .".DIC....U.."IHIIllCOIIO...II ::::::~::::_~~I.~...~'..IoO..'''.II_.I.....' "'_.11'"'' on....." " '~I ,~., "". ''''' lllKI."" 11...1111'1 U,,"!'.''''' 0 '" " ....1['..'0,_',.._. L (~r ,~~ .. t> :J.I"q% , ~ ~\ r \ \ ~ ~ ~ ~\ I A';( \'1 I I I I, KAIII^,lINL I. II A I l\'1 I II , 01 1'1I1'11llll'. ('1111I1"'1'1110<1 ('o'lIlt y, 1'1'1111- nylvllnill, del' I 111'1' Ihin 10 I,,' IIII' IlInl I'/i II lIn<l I'l'vllkl' 1101' IIi 1/11 pl'l'- viollnly IIIl1dl' hI' IIII'. I. I devise (Jnd Ill'qllelllh III I of thl' I'l'!lidlll' of IIII' l'lllllLe 1.0 my Lhree duuqhlel's, l'uLricill 1I111'\~l'11 111111I1 ill, Ilurhllrll 11111'1'/1)11 IlIylol' ond Kalhleeo lIu I'I'/e I I Colle. In L1w I'venl uoy of lilY dllllqhLero Ol'e de- ceased, I devise ood bequealh her ,;nid llhare lo her children Sllr- viving her. II. direct lhul any ohure pllosinq lo u child or children of my deceased dauqhler shull be held in lrusl by lilY Iruolee hereinafler named upon the following tel'lIlo ond condilions: A, My Trustee!l 11101' payor opply 011 of the nel incollle from eoch child's shore of Lhe lruot eoLate to or for Lhe benefit of such ch il d, 0, My TrusLees lilaI' payor opply ouch porlion or all of the principol of lhe lrusl eotote lo or for the beneifit of ouch child os my Trusleeo mol' deem neceosory or odvisoble for lhe core, mointenonce, support, educotion or generol 111'11'01'1' of ouch child or for any illness or elllergency which mol' befoll ouch child. C, My Trusleen sholl pol' lhe remoining portion of such child'o truoL eotole to such child upon orrivul ot oge twenLy-four (24) 1'1'01'0. Ill. All principnl IInd income nhnl I, unli I oclunl distribution to ony beneficinl'y, Ill' free of Lhe dehl!l, coolrllclo, nlicnolions ond onlicipolion of !llJch heneficilll'y nnd Lhe nllme ohllll nol he lioble lo ony levy, ottnchml'nL, l'XI'Clltilll1 or nl'qlJl'IlLrlllion I'Ihile in the hands ~ ~. ~\ ~\ r"! . tI Iff' , , ~ , ~ " A of my II'1IBll!PB III' t '''ClIt III'n. IV. ^II I'olnll', 111111'I'IIl11l1'I', !IIJl'('I'Bnlllll /lfld 111111'1' tlJXI'~1 illlpo!ll'd 01' pnYlIhln hy J'PUBon of lilY dl'ulh, nlld illl.l'l'pol and pt'llo1t.ipB '-hPI'POU, \~iLh I'l'llpl'el 10 nIl propl'rly l'omprinio(J my (JI'I)!;!l "!llnll' for dl'nlh lnx purpost'H, \'/!lplhel' 01' lloL nuell PJ'upf'l'ty pUBueu undel' lhiB \'Ii J 1 ahuJ J be puid out of my [1ulnlc uo ir Buell Lnxpu "/PJ'I~ adlll.ininlrnlivp ex- penDes, wllhoul npporlionml'nl 01' righl of rl'imhurDl'ml'nl. nulhor- ize my [xecuLors [Ind lr'uuLeen to puy all such lnxcu ol Buell Lime ai' limes os moy be deemed odvlDoble. V, In addllion 10 nil olher powcrD nulhoriled by low, my Execulors ond trosleeD mny reloin ony of the ODDelD of my esloLe which come inlo lhelr hondo. the troslees Dhnll loveDl ond keep Invesled lhe principal of the lruDl eDtole in ouch monner and In such securitieD or olher properly, renl or persooal, ond upon ouch terms and for such length of Lime as lhe trusLees shall deem advisable, iL being intended hereby 10 give unto Lhe truslees full and compleLe authorily 10 hold, posDeDs, manage, conlrol, sell, convey, encumber, leose, give ond exerciDe oplionD, invesl and reinveDL lhe whole and every pari of Lhe lrusl eDlaLe occording 10 lhelr sole judgmenl ond dlscrellon, wllhout any limit upon lhcir power ood oulhority so to do, either by slatule or otherwise. VI. [appoint my dnughtcrs, Polrlcia 1I0rwell 1I0ml in ond Barbora Horwell Taylor ond Formers Trusl Compony 10 be Executors under this my ~I ill, v [I. I oppolnt my doughtcl's, Palricia IIn I'I'/c 1 I 1I0mlln ond Barboro lIaJ'l~ell Taylor nnd FormeI'll trusL Company 10 be Trusleell uodcl' lhis my IH 11. VIII. [ direcl lhol my cxeeulorll and Truslel'D uholl nol be rp- -2- CODICIl" I, Katherine L. Harwell, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this to be the sole Codicil to my Last Will and Testament dated April 13, 1984. ITEM I: I hereby amend Item I of my Last Will and Testament to add as follows: I direct that my three (3) daughters or any of them may accept in kind distribution of any of my tangible personal property which may pass to them under my Last Will and Testament, to be valued in accordance with its appraised value as finally determined for Pennsylvania Inheritance Tax purposes. Should more than one of my said daughters wish to accept personal property in kind but be unable to agree upon the division thereof, such property shall be divided among them on the basis of alternating selections. ITEM II: I hereby revoke Item VI of my Last will and Testament, in its entirety, and in lieu thereof provide as follows: I appoint my daughters, Patricia Harwell Hamlin, Barbara Harwell Taylor, and Kathleen Harwell Cotte, co- Executrices of this my Last Will and Testament. ITEM III: I hereby revoke Item VII of my Last Will and Testament, in its entirety, and in lieu thereof provide as follows: I appoint Farmers Trust company, of Carlisle, Pennsylvania, Trustee under my Last Will and Testament. , /,: /;:j 'r" J > '/ \;,. iu/ t't!/ 21-96-516 ImGISTElt 0... WILLS 0... CUMOERI.AND COUNTY OATil 0... SUIISClmUNG WITNESS "Ii' , Dale F. shug!1!!.Ij:' ilncL!3QnnhLI.. .Coyle____..____._ cllllidl (cach) a subscribing witncss 10 thc \'lill (lIc'cnlcd hcrcwith. (cad.) hcing duly qualificd according to luw, dcposc(s) und suy(s) Ihat .they_w,er.!L- prcscnl :lIId suw Katharine L, Harwell thc Icstat rix, sign thc sUlnc und that _t_h_ev signcd a;, a wilncss ullhc rcqncsl of Icslat-Ci..lL in h_er- prcscncc and (in lhc prc,cncc of cach othcr) (in tl1f prcscncc of Ihc othcr snbscribing wilncss(cs)). . .J' .) (\ ../\ /') 1/ I \~;.)',,1 - / h '. r Sworn to or affirmcd und subscribcd bcforc V ' ,\ , /' ' ! mc Ihis 27th day of ' (amc) Ie --'21. June", 19 9~ .~~h..EitLStreet..." ! ,nfLAj e.);< H.."" ,-'11.)11 ^ itv' .,'/' 1'1 J lA, ddJess) ? Mary d!. Lewis ' I Re~isler' (~/\1._), .~ \..<....~ .~", l'f.' ~ 1:..' r (Name) Bonnie L.Coyle 28 South Pitt Stre~t. r~rli~lp, pa 17013 (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS Icstat_ (cach) a subscn hcrclo. (cach) bcing duly qualificd according to law, dcposc(s) and say(s) thai familiar with Ihc signaturc of codicil will prcscnlcd codi ' IS in thc handwriting of thai to Ihc bcsl of knowlcdgc and bclicf. / Sworn to or affirmcd and subscribcd bcforc ~ / mc Ihis day/of / 19/ /- (Address) Rellisler (Name) (Addre,u) , 21-96-516 RENUNCIATION In Re Estate of Katharine L, Harwell deceased. To the Register of Wills of Cumberland County, Pennsylvania. The undersigned patricia Harwell Hamlin and Barbara Harwell Ta lor of thc above deccdcnt, hcrcby renounce(s) the right to administer the estale and rcspectfully ask(s) that Lctters Testamentarv be issucd to Kathleen Harwell Cotte WITNESS hand this 27th day of June ,19~. witness: \'oJ L"C.;....(_ ~\l',w'rl\ Ib"j:.~ (Signature) Patricia Harwell Hamlin 112 Harvest Road Cherry Hill, NJ 08002 (Addre..) PY//.lAcU ,..~~, ~Z/--/~-' . (Sis.nalure) , BaFbara Harwell Taylor 905 Hillen Drive Millersville, MD 21108 (Address) (Signature) m ':~ -: ~:r .' ;~J l"'l rL " l- N (Address) ~ :-i ...., " ." WU; 0: '0 P' .- t: .~ :J ()() .. NOTICE OF DENE~'ICIAL INTEREST IN ES'rA1'/; DEFORE TilE REGISTER OF WII.LS, COUNTY OF CUMBERLAND , PENNSYLVANIA In re Estate of Katharine L, Harwell , deceased, No. 516 of 1996 TO: Barbara H. Taylor (benefiCiary) 905 Hillen Drive (address) Millersville, MD 21108 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. You may have a beneficial interest in the estate as follows: The will and Codicil of Katharine L. Harwell divides her Estate eauallv amona her three dauQhters, You are a one-third residuarv beneficiarv of the Estate. (if additional space is needed, use back of page) Name of decedent Katharine L. Harwell Last known address 205 Todd Circle, Carlisle, PA 17013 of decedent Date of death June 24, 1996 Place of death Carlisle HosDital, Carlisle, PA County of grant of origin,l letters Cumberland Decedent died x testat."! intestate. A copy of the will ~ is is not attac~ed. Name(s), address(es) and telephone number(s) of all personal representatives appointed Name Address Telephone Kathleen H. Cotte 60 Bogastow Brook Rd, Sterborn, MA 01770 (508) 655-9277 \ - I,' " ' :~ Fon 0""E!i OF OEATU AFTER lZ1ll191 CHECK HERE If A SPOUSAL P R R IT 15 CAlM FILE NUMBER INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS REV. 1500 EX 1(7-94) CAB H P L E P 0 C R C K 0 K P S COM~F~lIMj"~'![ ~lWfIIM'NIA HARRlsR5~tiIM'Z!l.0l>0' D E C E o E N T DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INitiAL) Hllrwoll Klltharlno L. SOCIAL SECURITY NUMDER DATE OF DEATH DATE OF OlAlH 175 - 3/, - 8392 06/2/,/96 0"122/07 21-96-516 COUNTY CODE yEAR OECEOENY'SCOMPlETE ADDRESS 205 Todd Circlo Cllrlislo, P^ 17013 Counl)' Cumber land (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST ,FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER X 1. Original Relurn 4. Limrted Eslale R E C A P I T U L A T I o N T A X C o M P U T A T I o N SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN , ~i.,ttV'L V/ 6etc. S~::l~~~~~ROTHERTH'N~PRES Copyright (e) 199410rm saftw.,. anly NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS) 05. o e. Romaindor Roturn (lor dales 01 dealh p,ior 1012-13-82) Fodoral Estate Tax Return Required Tolal Number of Safe Deposit Boxes 136,780.05 221,685./.8 (8) (9) 16,660.1.1 2. Supplemental Rolurn 41. Future Inlerest ComprorTllso (lor dates 01 death after 12-12-82) [!] 6. Decedent Died Testatlt [Rl7. Oecedent Maintained a Living Trust (Mach co y 01 Will) (Anach a copy 01 T,us\) C P ALL CORRESPONDENCE AND CONFIOENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: 2 ~ NAME COMPLETE MAILING ADDRESS R D Da10 F. Shu hart, Jr. 01110 F. Shughart, Jr. ~ ~ TELEPHONE NUMBER 35 East High Stroot, Suito 203 - T 717 2/.1-4311 Carlislo P^ 17013 1. Real Eslale (Schedule AI 1 2. Slacks and Bonds (Schedule B) (2) 3. Closely Held Slack/Partnership Inle,esl (Schedule C) (3) 4. Mortgages and Noles Receivable (Schedule D) (4) 5. Cash, Bank Oeposi\s & Miscellaneous Personal P'operty (Sch, E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (Schedule L) (7) 8. Tola1 Gross Assets (total lines 1-7) 9. Funeral Expenses. Administrative Costs. Miscellaneous Expenses (Schedule H) 10. Debts. Mortgage liabilities, Liens (Schedule I) 11. Tolal Oeduclions !lotal Lines 9 & 10) 12. Net Value of Estato (Line 8 minus Line 11) 13. Charitable and Governmental Bequosts (Schedule J) 14. Net Valuo Subject to Tax (Line 12 minus Line 13) 15. Spousal Translers (lor dales 01 dealh aile, 6-30-94) See Instructions lor Applicable Percentage on page 2. (Include values from Schedule K or Schedule M,) 16. Amount olUne 141axable at 61'. rale (Include values from Schedule K or Schedule M.) 17. Amount 01 Line 14 taxable at 15'/. rale (Include values from Schedule K or Schedule M.) 18. Principal I.. due (Add lax from Line 15, 16 and 17,) 19.Credits/Sp Poverty Prior Payments Discount 0.00+ 18,500.00 + 973.68 20. If line 19 is greater than line 18, enlor tho difference on line 20. This is the OVERPAYMENT. [!J 0 Check here If au are re uestln a refund 01 your over a ment. 21. If line 18 is greater than Lino 19. enler the difference on line 21. This is the TAX DUE. A. Enler the interest on the balance due on Line 21A B. Enler 'helolal of Line 21 and 21A on Line 21B, This is the BALANCE DUE. Make Check P. .ble to: Re Iste, 01 Wills, A ent ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH .. .. nder pe~lUes 0 perlury,l deel". Ih.11 hive examined thIs feluIn,lnclucllng .ccompanying schedules.OO sl.lements,.nd 10 the b&sl 0 rJrf knowl~g"'OO belill ,It Is true. correct and comptete, I declaf.lh.I..llre.leslate hu ~en reporled.t trlle nur~et value. DeclaraUon of preparer olher than the personal repfesentaflve Is bued on ..lIln'ornuUon of whIch preparer hu any knowledge. Kathloen H. Cotto ?9_ ,~~ll!~~~!'_':, ~F.~'?1.<_ -~'??~-, -" -"., -" -" - -"" -, -, Sherborn, MA 01770 Dalo F. Shughart, Jr. ~?_.~?!'_t., ~_iJ~~ _ ?t.':~!'_t., _ ?~! ~!'_ _~9~,. - - - - - -, - - -" -- ~ Carlislo, P^ 17013 (10) 767.10 (11) (12) (13) (14) (15) 0.00 X , (16) 3/.1,038.02 X ,06' (17) 0.00 X ,15' (18) Interest (19) (20) (21) (21A) (21B) 358,/,65.53 17,/.27.51 341,038_02 341,038.02 0.00 20,/.62.28 0.00 20,462.28 19,/173.68 0.00 988.60 0.00 988.60 DATE 1/10/71 DATE / /2 i'?; Farm 1500 (Aev. 7.94) Act 148 011994 provides lor the reduction 01 the talC rates Imposed on the net value oltranslers to or lor the use 01 the spouse, The rates as prescribed by the statute will be: .3'1. (.03) will be applicable lor estates 01 decedents dying on or alter 7/1/94 and belore 1/1/96 .2'1. (.02) will be applicable lor estates 01 decedents dying on or alter 1/1196 and belore 1/1/97 .1'1. (.01) will be applicable lor estates 01 decedents dying on or alter 1/1/97 and belore 1/1/98 .Spousal translers occurring on or alter 1/1/98 will be elCemptlrom Inherilance talC. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A MARK (X) IN THE APPROPRIATE BLOCKS. YES NO 1. Did decedent make a transfer and: a. retain the use or income of the property transferrod.. . x b. fltaln the right 10 designate who shall use the property transferred or Its income. c. 'etaln a reversionary Interest: or . . . . . d. r.c.iv. the promise lor Iii. of either payments. benellls or caro? . 2. II death occurred on or before December 12. 1982. did dacedenl Within two years preceding death transf.r property without receiving adequate consideration? II dealh occurred aller December 12. 1982. did decedent transf.r property within one year 01 death without receiving adequate consld.ration? . . . . . . . . . . . . . . . . . . . . 3. Okl decedent own an 'in ttust lot' bank account at his or her death? . . . , . . . IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. COpytlghllt} '"4 'Ofm lof1W.,. only CPSYllems,lnc. FOlm 1500 (Rh' 7-941 X X x x X REV. ,... EX + (2,011 SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY cot~rN\l\ltiM~~X1~jhY.NI. ESTATE OF Please Print or T 8 FILE NUMBER 21-96-516 SS(/ 175.3/,-8392 06/21./96 Katharine L, Harwell (All 10. ITEM NUMBER 1 2 mUlt b. dllclol.d on Sch.dul. F) VALUE AT DATE OF OEA TH 0.00 3 OESCRIPTION Clothing and personal offects. 1984 8ulck Contury automobile, valued In accordance with attached appraisal of Graham Motor Company. Household goods and furniture valued In accordance with attached appraisal of James Bistline, licensed auctioneer. Jewelry, valued In accordance with attached appraisal of Anne Arundel County Coin Shop Coins and currency valued In accordance with attached appraisal of Anne Arundel County Coin Shop. Fur coat valued In accordance with attached appraisal of Muscalus Furs. Checking account (/633275 Farmers Trust Company Principal Accrued Interest Sarah A. Todd Memorial Home occupancy Agreement. Refund, Visa account Refund, Lifetime Systems Subscriber Savings Account, USAA Refund, USAA. auto Insurance Refund, Klrke-VanOrsdel (Health Insurance) Refund, U,S. Treasury, Decedent'S 1996 Federal Income Tax 3,495.00 1.700.00 4,360.00 4 1,072,80 5 773.35 1,000,00 6 7 64.843,64 53.25 8 58,382.00 52.22 25.00 525.44 129,03 368,32 9 10 11 12 13 14 S 136 780.05 TOTAL (Also enler on line 5, Reca ~ulalion) (Anach addilionalS 112- x 11" sheels ~ more space is needed,) Copyrl9hl (c) 199~ form softw.r. only CPSys'ems, Int. Form 1500 Schedule E (RrI. 2-87) REV. 1$\0 EX + (2.17) COMrNm~~{\,g~}hY'N" ESTATE OF SCHEDULE G TRANSFERS Please Print Of T . FILE NUMBER 21-96-516 Katharine L, Harwell SSO 175.34-8392 06/24/96 THIS SCHEOULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANV OF THE QUESTIONS ON PAGE 21S YES ITEM OESCRIPTlON OF PROPERTY EXCLUSION TOTAL VALUE DECO'S OOLLAR VALUE OF NUMBER 1",ludtNnw 01 'h.I"nll".., th.lr OF ASSET 'I. INT. DECEDENT INTEREST '....lIon.hlo to dlced.nl, dill. 01 h'MI,r. 1 Revocable Trust Agreement 221,685,1,8 100.007. 221,685.48 between Decedent and Farmers Trust Company, now Financial Trust Services Company, dated August 1991, the assets of which Trust are itemized and valued as per attached statement of Trustee (Copy of Trust Agreement also attached. TOTAL (Also enter on line 7. Recapitulation) 221,685./18 (If mort space is needed. insert additional sheets 01 same size.) Copyright It) 1994 form softwar. onlt CPSyslerm, Inc. FOlm 1500 Schlrdule G tRe~.2.a71 REV.. 1&12 EX. (t.gl) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Pl.... Prln! 01 T . FILE NUMBER 21-96-516 cOMrH~lrr:~~%O{~\V~r1Y'H" ESTATE OF Katharine L. Harwell SS(! 175-3/1-8392 06/21,/96 ITEM NUMBER 1 2 3 DESCRIPTION AMOUNT 284 .65 86.17 355.42 4 United of PA, phone bills BMe Pharmacy, final pharmacy bill Sarah A. Todd Memorial Home, final monthly residential charges Vital ink Pharmacy Services, final pharmacy bill PA Department of Revenue, 1996 income taxes 28.00 12.86 5 TOTAL (Also .nter on line 10. Reca ~ulation) (II more space Is needed. Insert add~ional sheels of same size,) Copyright (c) 1194 farm soUw.r. 0"'1 CPSys1Ims, Inc. S 767,10 Form 1500Schedul,I(RIV. 1..9l) " REV. 1m EX' (1.111 ESTATE OF CO"I1.'ll\l~~~~~p>>"N" SCHEDULE J BENEFICIARIES 5511 175-3'..8392 06 2'. 96 Katharino L. Harwoll ITEM NUMBER ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP 1 A. Taxablo Boquo.I': Patricia H. Hamlin 112 Harvest Road Cherry Hill, NJ 08002 Daughter 2 Kathloen H. Cotto 60 Bogastow Brook Road Sherborn, MA 01770 Daughter 3 Barbara H. Taylor 905 HIllen Drivo Millersville, MD 21108 Daughter NAME AND ADDRESS OF BENEFICIARY 8. Charitable and Governmental Bequests: TOTAL CHARITABLE AND GOVERNMENTAL BEOUESTS (AI.o onlo' on I,no 13. Rocapitulation) (If mere space is needed, Insert additional sheels of same size.) Copyrlght(c} '994 form .anwar. onl')' CPSy.tems, Inc:. FILE NUMBER 21-96-516 AMOUNT OR SHARE OF ESTATE ono-third one-third ono-third AMOUNT OR SHARE OF ESTATE s Fo,m 1500 Schedule J IR..... 2.871 0.00 ~ - COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND l J 55: ~~!:!.1}~~~_J!~_ c::~t te _ ______._ bolng duly aWOrl!___ according to law, doposos a"d says thaI aha ____,J:,l_________ Executrix _._ ____ 01 tho Eslato 01 KlIthllrine L. 1I11rwell 1010 01 ~o;:9..!!9l:L_oJ_~'!.r_IJa}e_ .--.___ " Cumborland County, P." d.c....d and thaI tho , ." d b KlIthleen II Cotte h 'd Executrix Within II .n ,nvontory m.. y .____u___________~______ '_ , I . SOl 01 thn ontiro ost.to 01 s.id doc.denl, consisting 01 .11 the p.rsonal proporty and r..,1 OIt.t., exc.pl real osl.lo outsido tho Commonwealth 01 Pennsylvania, .nd that the ligures opposlto ..ch Itom 01 Iho Invonlory r.prosonl It'. I.ir valuo as 01 tho data 01 doc.d.nt'. d.ath, Sworn and subscribed beloro mo, A yl-(ti6.,~'-2:t_a~r(~( _______ E..cufor . Ao'minislufor Kathleen H. Cotte ___60 B0.92atow ~.E<?<?..k Ro~cl._ Sherborn, MA 01770 1 /:::~"5- January /'f . 1....,,;0 Ir 11.-1<..':'(., A ll"L' ~ 19 /2~ '------.. :] . M\T.~'~'.\L t~l.~ e. .J: L C~',':lr. ~:::'..~.I;i' :'!/ v: 8O~O ()f '.f,T !t'~ll.\' !;;l;r':,~:;, r.iJ'.I~ ;;~..\~o (P. '," C ""If"'" ~~. r(c,"'r-.- ,''''.'''' ,.. . "'Jj '" T 'I .,., ...:. J,' f. .,r...' ....H.....' ". t,"," ......._v..........._ ...'O:..,-.Jl.......-.; Add,... D.le 01 Doath June 1996 '4 D.y Month Yu, INSTRUCTIONS I. An invenlory mud bo rilod within throe monlh. altar 'ppoinlm.nt of pOrlonal roprQ,fifativo.o 2. A .upplomont invontory mu.1 b. lilod within thirty d.y. 01 di.covory of .dditiona,j},iis, -J 3. Additional .hoots m.y bo .ttached .. to pOllon.Jty or roalty '~ 4. 500 Articlo IV, Fiduciario. Acl 011949, ~ .:n D:h \ .~. . ,) -- U1 , ''0 -' N ;'l; S- -:) i~ )~~, 0-. C1J ... Ul ... '" -ti \0 >- ... ... .. ... w C1J \.< ~ ... ~ '" ... ;J III .. 1tI w <( co n. ... \.J U u .. 0 VI III " I 0 w C en "" '" w :c .... .. .. \0 l- I n. 0 n. c 01 Z ... ..J u.. .. ~ I <( 0 Q. 0 u.. ..J :l: ... W 0 <( w ..J .c N > '" 0'> ,:. <( Z C1J :J - Z 0 c c r:: 0 " VI Z '" \.< 0 0 '" U Z w <( \.< 0 ... n. III m "0 .c c .. Ll - -;: ~I 0 " .D "0 '" co E 0 I - " ..!! 0 .. ..J U u: '" . . ... ... ~ . /5'"- /11- /() BUREAU OF INDIVIDUAL TAXES umr.RltANCI: TAM DIVISION DEPT. leabOl IIA11RISBUNG. PA 111;'11-01,01 COMMONWEALTM OF PENNSYLVANIA DEPARTMENT OF REVENUE 04-14-97 HARWEl L 06-24-96 21 96-0516 CUMBERLAND 101 AlIlount R..,Uted <2- ~*' MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 CUT ALONG TMIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECDRDS ~ ifEV: is'47 - Eif -jiFii - [03":97 "i-NoT i CE-- OF-Y NHERi;: ANCE -TAX - APPRA iSEH€Ni'-;- jiLi.-ow ANCE-iili---- _m___ - - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HARWElL KATHARINE L FILE NO. 21 96-0516 ACN 101 DATE 04-14-97 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DALE F SHUGHART JR STE 203 35 E HIGH ST CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN r TAX RETURN WAS, (X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Re.l Estate (Schedule A) 11) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedul. C) (3) 4. Hortgagel/Hotes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (5) 6. Jointly Owned Property ISchedule FJ (6) 7. Transfer. ISchedule G) (7) 8. Tot.l Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad.,. Costs/Hisc. Expenses (Schedule H) (9) 10. Debts/Hortgaga Liabilities/Liens (Schedule I) 110J 11. Total Deductions 12. Het Value of Tex Return 13. Charitable/Govern.,ental Bequests (Schedule JJ 14. Het Value of Est.t. Subject to Tax NOTE: RECEIPT NUMBER AA146758 AA185073 DISCOUNT 1+1 INTEREST/PEN PAID (-I 973.68 .00 I CNANGED 11,.1\.'1111' III-III KATHARINE L NOTE: To insure proper credit to your account, sub.,it the upper portion of this forn wIth your tax paynent. ,00 ,00 ,00 ,00 136.780.05 ,00 221,685.48 CBI 16,660,41 767,10 1111 112) 113) 114) ,00 X ,00= 341.038.02 X ,06= .00 X ,15= I1BI AMOUNT PAID 1B,500.00 988.60 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE If an assessment was issued previously, lines 14. 15 and/or 1&, 17 and 18 will reflect figures that include the total of ahh returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15J 16. Allount of Line 14 taxable at Lineal/Class A rete (16J 17. Allount of Line 14 taxable at Collateral/Class 8 rate (17J 18. PrIncipel Tax Due TAX CREDITS: PAYMENT DATE 09-19-96 01-15-97 358,465,53 17.4?7 ~1 341,038,02 ,00 341.038.02 .00 20,462.28 .00 20,462.28 20,462.28 ,00 .00 .00 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS TNAN $1, NO PAYMENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU MAY BE DUE A REFUND, SEE REVERSE SIDE OF TNIS FORM FOR INSTRUCTIONS. I t;("'J ~~ \:~ -n?J t',' :u ~ 1:.. -.) ~,) ',' U. RESERVATION I E.tate. of d.c.dents dying an or b.rar. D.ce~er Il, 1982 .- If any future Intere.t In the e.t.t. I. tr.n.ferr.d In pa.....lan or .nJay.ent to Cl... B (collateral) ben,'lclarle. of the d.c.d.nt after the e.plretlan a' any ..tat. rar ll'e or 'or yaar., the Ca..anwaalth hereby e.pr...ly r..erve. the right to .ppr.I.. and a..... tr.n,'er Inh.rltanc. fa... .t the lawful CI... B (callat.r.l) rat. on any .uch future Inter..t. i i I , ! I ., PURPOSE OF NOTlCE, PAyttENTz REFUND (CRlI To fulfill the r.qulr..ents a' S.ctlon 21~0 of the Inheritance and E.t.t. Ta. Act, Act 21 of 1995. (72 P.5. Saction 91~0)' Detach the top portion of thl. Natlc. and .ubalt with your p.y.ent to the R.gl.ter of Will. prlnt'd an the r.v.r.. sid.. "'Hake check or .oney order paY.ble tOt REGISTER OF MILLS, AGENT A r.'und a' a t.M cr.dlt, which wa. not r.qul.tad an the Tax R.turn, .ay b. requelted by ca~l.tlng an "Application 'or R.fund of Penn'Ylvanla Inh.rltanc. and E.tat. T.x" (REV.1313). Application. ar. avallabl. at the Offlc. of the Regllt.r of Will., any a' the 23 Revanu. DI.trlct O,flce., or by calling the special 2~-hour anlwerlng ..rvlc. ~er' 'or 'or.. arderlngl In P.nnlylvanl. 1.800.562.2050, aut.lde P.nn.ylvanla end within local Harrl'burg .re. (717) 787.809~, TOO' (717) 172.2252 IHaarlng lapalrad Only). OBJECTIONSZ Any party In Int.r..t not .atl,'I.d with the appral...ent, allowance or dl.allowanc. of d.ductlan., or a..a....nt 0' ta. (Including dl.count or Inter..t) .. .hawn on thl. Hotlc. .u.t obJ.ct within .Ixty (60) day. of rac.lpt of thlt Notice bYI ADHIN ISfRATlVE CDRRfCTIOH5z DISCOUHTI PEHAllYI INTERE5h ..wrltt.n prat..t to the PA Dapart..nt of R.v.nue, Board of App.al., napt. 281021, Harrl.burg, PA 17128.1021, OR ...I.ctlon to h.v. the aattar d.teralnad at audit of the account 0' tha p.r.on.l r.pta..ntatlv., OR ...pp.al to the Orphan.' Court. F.ctu.l arrar. dl.covered an thl. ........nt .hould b. .ddr....d In writing tOt PA aapart.ant a' R.venu., Bur.au 0' Individual Ta.I', ATfNt Po.t A..a...ant Ravlaw unit, O.pt. 280601, Harrl.burg, PA 17128-0601 Phon. (717) 787-6505. 5.. paga 5 0' the bookl.t "In.tructlon. for Inherlt.nca Tax Raturn for a Ra.ld.nt Dac.d.nt" (REV.1501) for an a.planatlon 0' ad.lnl.tratlvaly correctabl. .rror.. I' any tax due I. paid within thraa IS) cal.ndar eonth. a,tar tha dacad.nt'. da.th, a ,Iva p.rcant (5~) dl.count of tha tax paid Is allowad. Th. 15% t.x aan..ty non-partlclp.tlon p.nalty I. coaputad on the tat.1 of tha tax .nd Intar..t .......d, and not p.ld bafor. January 18, 1996, the 'Ir.t d.y a,ter the and of the t.. .ana.ty parlod. Thl. non-p.rtlclpatlon p.n.lty It appaal.bla In the .... aannar and In the the .... tI.. parlod a. you would .pp.al the tax end Int.r..t that h.. ba.n .......d 8. Indicated on thl. notlca. Int.r..t I. ch.rgad bag Inning with 'Ir.t d.y 0' d.llnquancy, or nln. (9) .anth. and one (I) day 'roe the data 0' da.th, to tha data 0' payeant. Taxa. which b.ca.a dallnqu.nt b.'or. Janu.ry I, 1982 ba.r Int.r..t at the r.t. of .1. (6%) p.rc.nt per annua calculatad at a d.lly rat. of .00016~. All taxa. which bac... dallnquent on end a,t.r January I, 1982 will balr Int.r..t at a rata which will vary fro. cal.ndar yaar to c.lend.r yaar with that rata announcad by th_ PA Dapart..nt 0' R.vanua. The appllcabl. Int.ra.t rat.. 'or 1982 through 1997 ar.1 ~ Inter..t Rata 0.11'1 Inter..t Factor !!!! Intarut R.t. D.lly Interltt Factor 1982 lOX .0005"8 1987 .X .0002"7 1985 16;( .ooo~sa 1988-1991 11% .000501 1984 \IX .00OSOI 199Z 'X .000247 1985 15% .00OS56 1995.199" IX .000192 1986 lOX .0002H 1995.1997 'X .aoaz47 uInt"ltt It celculated ., foUow.t INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ..Any Notlc. Is.u.d aft.r tha tax baco.a. dellnquant will r.fl.ct an Intar..t calculation to flftaen (IS) day. bayond tha data of tha a.'I....nt. If pay.ant I. .ad. Ift.r tha Intara.t co.put.tlon d.ta .hown on thl Notlc., additional Internt au.t ba calculated. STATUS REPORT UNDER RULE 6,12 Name of Decedent: Klllhllrlllt' I.. IIl1r",,11 Date of Death: .IUIlt' 2'.. 1996 Eslate ~ No. 21-96-~16 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 No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No y b, The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes x No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this repo t. Date: September 29 , 1997 ,- Dale F. Shughart. ,Jr,. ESQuire Name (Please type or print) 35 East lIigh Street, Suite 203 Address Carlisle, PA 17013 ( 7 I 71 24 I - 4 3 1 1 Tel, No, (..,. _."_J Capacity: Personal Representative y Counsel for personal representative (MAH: rmf/ AM3)