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Home My WebLink About96-00769 .;:;:.~, ' -,":;,-:r.:':,}~;: ><.'.:. .i.~ :>t , i:.'..,~ , , - L;L:/~~ ~~t~tfL '~' '_ ~~~2t)!/\ "":" ',-J;"-- ~, ... '. ..~ /.-~,",I .. .'~', >, .,<}~j':'~ .<A ' L' ".'{,~,i;~~" '~l-.!,. C\ ~" ':, :'r'({i~~ '. ~ '. ':("~ -1!f1j~ '~;'t'~ 'f~ ~ "...."t...'-J.~~. ~:~tef'\ '~"-:'::L'.>:;'AA<<;'!i;'~ .'~;~;<:zt~rtf~i: .'. ". .'j"'f~1-< n, l:':'l~'?:~f~;::" . '~">"O }!~~ '.;:: '0 cu a 1;; ~ .." .. ,:'<',;.,,1"; :;':..:, t~~;l"."" ;:~';%y.:," ZH....,..,';.,:_". ._ ",",:;:':~: ;: )",,;, ~.!. -,', 'c. ,.,.j C\J (', Ll , , , " lU ri' ~- a: .... '::\ _: -. ,..,.. d '-' ~ ~ ~ ... U - ~ <C ~ :! I- en W tn ~ <: tn :c ...I <C W :I: I- ... E-~ 0 Z>- tIle! I- ::; tn ~ a:: ~ tIl - 0 IL E- CIl ::> ~ E- / / / o ;~l\t -~ ?*~11 If) ~i\~~ ~ "'JJr, a~;g~~ ~fkY 0 u"""' uo... ij:~ 7-rJ0l M ~11 ~ l~Jlt';' OJ W ~i~ *~ ,~~~~~, f' ~ LL 0'" r-.I- e! r-.'W 'u 0' 'I- <(I'a: '0 O':I: ~Ien pO, h' . _" I .,i ICE: -Qon 0 1BI,,'-'" t'l I LL ;~I!I' pOI ,,,is'.:! rl,W ",..l1, pO W ~~~" 11. oaaae 'ON illOIl ~_"':3..sz I~ll 'l;)nno.....~ )llIV,1 ,UJ1vnl> ~ ~ ..- ~ l'0 -n 1'- 00 - I l'0 :z:J ~ l'0 (/I , ~ -I W 0 en ::I .... 0 :I: :.:- I- a: 5 en " U en t'l en>- pO ...II- 0 !: ..J;Z r-. "'::1 pO 30 UI- :.:- LL en<: OQ 0- za: - et:<:WW pO .... W..J:>..J t'l I-o:oen r-. enW;ZH OJ ...iX'<<l:..J ~i ::J:C:I:a: W::I <: 0- a:uenu O~ I ~ 1 " " 1'1 , ...I - <C :E o o <C ...I o I- o a: - LL . u ~ ~ ~ ~ ~ - ~ :z: ~ ~ ( rJl ~ L z ~~E~q ~ZI:;>X> ~<~=n o ::1 " ~ . ~ ~ ~ ~ n ': ~ ~ q ~ ~ ~ . .11 (',,,~ . :1' ::..,..,.... '1 \'., ..j -:-;7,---"" /\), '\ ~.~.;... ,,' J':' -/ , . - ,; .. 'J. ..r.' ". '/'}.i .../ .~_.- '. .'--..-- ~ III III Q ..l o o .!O~ == ::I ~,.g ...t: o = "0 r-- .. " co ..."'" M 'i~~~ ..... = =... ... c:r'= .0Cl)r-- .:au..... it"",-, "==;;- " 01 0... ... -.CI _. ....... u.. .._ >,..CI = ~ ..- So.. 01 = U r~ =Su..."", .. g - - - - - - - - - , - -. .,. "''' '. '.' .{/- 1?!G / PNC18ANK December 13, 1996 Please send 5 short Thelma K. Ryan to: certificates for S. Coleman PNC Bank, N.A. P.O. Box 308 Camp Hill, PA 17001-0308 " Thank you. '4 ..~' "';-. ..I- , . l. r, -. '., .." " ~ F ,. w .. . r. . ,;, '", i.' f ... ..) ,. "-:', f ORMI0601fi'H. 'j~l j \. ". :', 03, , I ! , . ~ , , , )0 . . , " . I ~. . , ..... ,1 y ... .-- --:'~ ---..,..".,,- -F:. - - - " .__.1 --.-" :-..- \ , ~^ : ': ~ .' .: ' ; ; ; ~ ' I '. ,'.J : , t.. , i IJ r) ,. ~ ' . , ,~, 4.' - 4 I......,. .' . . . , , , , - , ' # ' " ::4f ,. " . !~ !'~. , ~ I ;~ !~ I ' , ,~ I ", .;:r,- I ) , I . \ , ~ , ~ " . i ,~ Id 91'~ :' '. .' ~lIIIIlI!IIIII ~~~. \ I I , ,\ " 'l . :' ~ ~ c , ' . ~ ?J' ,. ~ , _ ~\ ..d : c~-' ~ " .._ IC4 , .;.:;.;,'- U , G- '-'l"- I o~ Z ,....v ~ - - ..: - .; .; .; .; - - - - - .; ~ .; - ~ - ~~ " '\ ' " I'; , " _ ..... ~i.. . . . f' , . ,.',; ~ . .' ' , ", ~\ ,I ' ' . I.' ' , ' I' .,." . , . n . ~ ~"; ,j . ~ \ ' , ' . ;,.; ...l, ~ , I ,. , " , t'~~' ," I ~. --', ~~ \ t. . :" ...... .' . ---I ,-~'--' -.- '. -..........-.. .M1J _ _..._..... _ __ . ""1'-:_- __ i' . ,. I . . - -. .... .....- ... ,~ . " .. III = Q ..c: 1: = r-. a ~- l:of:'? c = :=: ~ :: 6 g~ _ ~ u .._ ..". ~ - ,. '" "C w:l ..... c = <: ..J Q <1 Q C. . s. 1:.c .. U .. .. 1: .. = .. -.c ~-= c. III C = .- oS .~ = a '5 ~lXU_U i " .---' ---..,.."...- . --._--;--~~ --- :-'~~ . \ 0, ~ I . . . 1':..., . .--."--""'-" Register of Wills of Cumberland County, Pennsylvania ) PETITION FOR GRANT OF LETTERS Estato 01 THELMA K. RYAN ,;}./- 9(,- 76 9 No. _ also known as , 'I , Docoasod Social Sacurity No. 056.09-3830 CATHERINE MANN and HARRY B, GOLDBERG rw_t.I,""""..'...ll'.........GtOIf..ppl,t...,.Df. (COMPLETE "A" OR "B' BElOW:1 1;1 A. Probata and Grant of lattnrs and ovar that Potitionor is tho executor nomad in the last Will of tho Decedent, dot ad June 10, 1993 and codicil(s) deled NONE $1'" 'Mwllll erreum.ltnc... '1 .'_.-IIDfI, ..thDf'"ICII1Df. .Ie Except as follows, Decedent did not marry, was not divorced. and did not haVD a child born or adopted alter oxecution of the documents oltered for probata; was not tho victim of a killing and was novor adjudicatod Incompotont: NO EXCEPTIONS 1;1 B. Grant 01 letters 01 Administration Idbnel.: pendMl"""; UIIII..b...nt\f; u,"II~I.1 Petitionor(s) after a proper search has/hove ascertained that Decedent left no Will end wes survived by tho lollowlng spouse (if on I and heirs: Nama Aolationshi Residonce (COMPLETE IN All CASES:I Attach additional shoats if n.c.ssary. Decedent was domiciled at death In residence at County, Pennsylvania, with his/her lastlamily or principal (Ito1."....numbefllld_IClP1,1 Decedent, then '.is....- years of aga. died SeD'ember 14 , 19J1.L, at Holv Soirit Hosoital . Como Hill. PA 17011 lloClllOll1 Decedent at death owned property wilh estimatod values as follows: lif domicil.d In PAl All p.rson.1 prop.rty ."...,...,.................. $ (If not domiciled in PA) Personal property in Pennsylvania .................... $ (If not domiciled in PAl Personal proporty in County ........................ $ Value of roal ostate In Ponnsylvanla .............................................. $ Totar ..".........,.....,............,...,....,....,.......,.,.." $ Real Estate situatod as follows: 760000,00 760.000.00 Wherafore. Potitioner(s) respoctfully roquost(s) tho probato or tho last Will and Codicillsl presentod with this Petition and tho grant or lottors in tho approprlato form to tho underslgnod: T od or rinted name and residence 0'111. ',t .)'(' I."'l",j,",,',! I:' lit Catherine Mann. R.~. Oillsbur . PA 17019 Harr B. Goldber .3334 North Third Slreot. Harrisbur . PA 17110 21-96-769 '1'1",,,.,, llllll~ 1i',lI II" "11,,'"1.'""" 11"11 '~""" "~I ,,,,,,..,, "'1''''\ 1,,,," ,'" "",""'.1 "."11"",, "1,1.,,,11 d,,\v I.k,\ ,,"11 lI1e.I\ \.".,11 Hq;i",," 'I'll., ""~.,,.d """1,..,,. ".III" I"", ,,,,II ,I,.. II" ,,,", VlI,d H..., ",\,1111'<1' I.., \""11,"" II' Id'"g, WARNING: Ills IIlegnlto duplicate this copy by photostat or photogrnph, ru. IHI Ihi~ ~('IIIIIl,III'. $.' IlO ~/ ,<....,~\fii.~:P,il(:...~ ,~. '''''ar.'''''. ! ~~, ~~' \~~ ~~( -.. , \~~ ,'" * ~ _I, ,. . . '/ \~, ",~'-' " /;:,'" ..~'.9I1i- d,....'i',1 IF1EHl\)'...ot!!!' "",,,,,,,,,,'.1Y 1-/7 11,11" 1{- lot.1I Hq.;I~f1.1T 3806735 Nil. J1;~(; t.- yL/.UI.I4' /LL~j1- I~ -II''! 1 "'011&)"""' CCMUOHWlALTH Of PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH 1"'''''''-'' l,QC.W.IlC\,tllllO'"""",iIII OIiICIICJIA'M.......-~ . .., I. - 1'VICa0l,..-...,....----,.....,......-- ... _!lI ::"0 --..co""'" ,...,....,.c.u... ORIOl.nll ,......0.,-1 . New York, NY ~1II..._......IlI'IIlI_' ;lvl S/hrtl 1Ir;~fJdA'- , ~.wus.__ --- -- White -- .-...--- J.I cumber land East Pennsbor .. .. ..., ...:.:.:.-===r Housewife I ~YM.NIACltN.,....~"'l.-tedII lUJ Hay Drive Camp Hl11,PA 17011 ,. ...,.....~f'..._UIID PA . 1,..,0............. ....... """" ...... - ....- ....- .. - ~.. cumberland"""'"'t tu.D=-= ..m.lII'.fWIII'....YCIdiI _w- ,.. - - ............-- of PA b .-. ._- Cremation Society ........__...0 ..-n>o "'- 9-16-96 . """",NQAOClflUS~ ..-. - I=- :-..... I .... NllI'fII\ID Il~' ...8" 0Mf..-..-............... ................,.._..........nL - (p:~ -. . 11'.",,",11 s-..-...,....,....--........... o..._..__....._.W'lIM._--.....--.-- lA.....__......- ~o m1t" OUI1DpIl....WCOJlN:lOf'l' L t~ ~1DpI'l...CCNlOJlN:lOf'l' 0UI1D1O'I .CCNlWl Otl tc.U'lT_wQMl 0l~~M.Un'0C:0,.lJlN0. -........ """'...... ...-, T"'~1lUUl'n' -"""",,- -,,,,,,,,,.. ..........."'...... "'...... o o o .va 01 ANII""- ___.... WI ....-- - ... 0 ,.G- 9- o o - -- ...............--. - - - _0 ..9- .. - ClIIITlPIIIIo-__ .~""'O"'"IICIoUII........-~--....-_........-~..._~-'" "........................---"""-. ...........-...-.. ........ -............... __AHOCIII1'rrM~"...,..,.....~....,._t..-..-.c.aM-~ ".........,...-.,......-........-.-.........--...-.....-....... ........... '1II.DlCAl,.._.~. :.::::.--=~~~~~~.~:~~~.~~.~.~..~:~.~~:~.~~~~~~I.~ 0 ... ..." L2'::!I:2.~ .. (')Q :;J c: ( " ., , lq .W N {)', . .' -' , - N Au r: '9: ';EP 20 i' ? : 1 2 C!l; Cur ;t .','\ ,n \ . \ . . .... -+-- t ..., u Po; :i ~ ~ ~ Ilt 8 ... E := t w 4 VI .. ~ ~ :tlSEg~~ ~zt=!l~ ~~==2! ~N~~cl2 .. ~~ ~.:, .. ~ 0 g" S . " III Cl " P: iil III III 9 ~ o Cl ~ III , to: ; .' ,,' .,' .- ~.../-9t.~ 7'- 9 ..-~ .. .' .. . J, appropriate services shall be conducted and arrangcmcnts made in keeping with my station in life. ITEM Ill. I give and bequeath those items of tangible personal property that are identified in any separate writing, which is dated, makes specific refcrcnce to this Will, and is signed by me at the end thereof, to those persons designated in such separate writing who survive me. If any item of tangible personal property is identified in more than one separate writing, I direetthat only thc separate writing bearing the last date shall govern the disposition of such item. ITEM IV. I give and bequeath all my household and personal effects, jewelry, automobiles, and other tangible personalty of like nature, not effectively disposed of by any separate writing referred to above, to CATHERINE MANN, now of DiIlsburg, Pennsylvania, if she survives me by thirty (30) days. If she does not so survive me, then such personal property shall be distributed as a part of the residue of my estate. ITEM V. I make the following pecuniary bequests: I. I give and bequeath the sum of One Hundred Thousand Dollars ($100,000.00) to CATHERINE MANN, now ofDillsburg, Pennsylvania, 2 .. if she survives me by thirty (30) days; but, if she should not so survive me, such bequest shall lapse, 2. I give and bequeath the sum of One Hundred Thousand Dollars ($100,000.00) to ROBERT A. ROSENER, now of Morris Township, New Jersey, if he survives me by thirty (30) days; but, if he should not so survive me, such bequest shall lapsc. ITEM VI. I give, devise and bequeath all of the rcsidue of my estate, whether real, personal, or mixed, and wherever situate, including any property subject to any power of appointment which I may now have or hereafter acquire, outright to such charitable groups or organizations and as selected by my Executor and in such amounts or shares as determined by my Executor, in the sole and absolute discretion of my Executor. In making such selection, my Executor shall consider those charitable groups or organizations that are dedicated to researching, assisting, or alleviating the diseases or disabilities of young children, particularly of pre-school age or infancy, including mental or physical handicaps or ailments, abandonment, poverty, disadvantaged educational, social, or home life, or other afflictions or impediments limiting their potential. It is my intention that any such charitable beneficiaries, as selected by my Executor, shall distribute or use such funds without regard to race or religion, My Executor shall not be required to make a selection of any particular interested, qualified organization. My Executor shall consider, in making designations as to charitable beneficiaries, the amount that 3 ITEM X, Any person who shall have died at the same time as me, or in a common disaster with me, or under such circumstances that it is difficult or impossible to determine who died first, shall be deemed to have predeceased me. ITEM XI. My Executor shall have the following powers in addition to those invested by law and by other provisions of my Will applicable to all property, whether principal or income, exercisable without Court approval, and effective until distribution of all property: I. To retain any investments I may have at my death so long as my Executor may deem it advisable to my Estate so to do. 2. To vary investments, when deemed desirable by my Executor, and to invest in such bonds, common trust funds, stocks, notes, real estate mortgages, or other securities or in such other property, real or personal, as my Execulor deems wise, without being restricted to so-called "legal investments" , 3. In order to effect a division of the principal of my Estate or for any other purpose, including any final distribution, my Executor is authorized to make said divisions or distributions of the personalty and realty partly or wholly in kind, If such division or distribution is made in kind, said 5 assets are required to be divided or distributed at their respective values on the date or dates of their division or distribution. 4. To sell either at public or private sale and upon such terms and conditions as my Executor may deem advantageous to my Estate, any or all real or personal estate or interests therein owned by my Estate severally or in conjunction with other persons or acquired after my death by my Exeeutor, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge, and deliver any and all deeds, assignments, options, or other writings which may be necessary or desirable, in carrying out any of the powers conferred upon my Executor in this paragraph or elsewhere in my Will. 5. To mortgage real estate, and to make leases of real estate for any period of time as my Executor may deem reasonable. 6 We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testatrix, THELMA K. RYAN, as and for her Last Will and Testament, in the presence of us, who at hcr request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year above wrillen, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. "r:{._,......,l", , I ,. ~ \,-) t' , , ; I residing at - \ Hc:I.Jf ) I':l i'I("U 12'.llcClI '- r -, . . ( . I.' " ~! J ( , , (f I & ,IM- P. fJ ~1 residing at IN S. wd St {~Altd., .' f t:1 I '/0/3 COMMONWEALTH OF PENN5YLV ANIA : 55.: COUNTY OF DAUPHIN We, THELMA K. RYAN, the Testatrix, and4."~,,., I.. b N, I le......-, and n~.Ew P. (,"'''''.x.rJ ,the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Y~/;C: THELMA K. RYAN , 'J." " I deLL; k'\~"'n. l' ILL , Witness \ -ltIlU'- f f!a4VMlt Witness 8 C\ci Cun 3' r ...i.\ ,., Rf:} , p ,\:.' I' ., J '96 :;tP 20 r2 :\2 " . . .' IN RE: ESTATE OF THELMA K. RYAN, Deceased IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION No. 1996-00769 f;ERTIFICA TION OF NOTICES UNDER RULE 5.6(0) TO THE REGISTER OF WILLS: I certify that notices of beneficial interest required by Rule 5.6 (a) of the Orphans' Court Rules were served on or mailed to the following beneficiaries of the above captioned estate on or before October 4. 1996 . I l i . ';1 Nome Catherine Mann Robert A. Rosener Address 643 West Siddonsburll Road 8 Sherwood Road DilIsburll. PA 17019 Morristown. NJ 07960 Office of the Attorney General of Pennsylvania Attn: Lawrence Barth, Esquire, Senior Deputy Attorney General-in-Charge Charitable Trusts & Orl:anizations Section. 21 S. 12tb St.-3rd FI..Philadelphia. PA 19107 -\ I i Notice has now been given to all persons entitled thereto under Rule 5.6(a). Date: ()cr ~ 17:;;; . /1 /. By: !cd!. / IL....do!. v ,J.. ..- Iileil Hendershot, Esquire Supreme Court Id. #23316 Goldberg, Katzman & Shipman, P.C. 320 Market Street Post Office Box 1268 Harrisburg, PA 17108-1268 Telephone: (717) 234-4161 " ':), ~C.l L:':,' .): ,,~) I f- r,1 f:1 '. ...1 , WLL a: ''-' p; .,-.,..__..._....v_ 1'- .'- :> ()() disadvantaged educational, social, or home life, or other amictions or impcdiments limiting their potential. It is my intention thut uny such charitable beneficiaries, as selected by my Exccutor, shall distribute or use such funds without regard to race or rcligion. My Executor shall consider, in making dcsignations as to charitable beneficiaries, the amount that such groups or organizations actually dcvote to programs to benefit young children, as opposed to "overhead", "self- promotion", or "administrative costs". It is my intention that this bequest and the resulting donations to charitable organizations should qualify for state inheritance tax and federal estate tax purposes, Accordingly, my Executor shall not make any distribution to any group or organization that would not qualify for such a charitable deduction. F. The Executors have considered certain factors, including: the Decedent's intentions and distribution parameters set forth in the Residuary Bequest; the medical history, personal experiences, values, character, and interests of the Decedent during her lifetime and those of her late son and husband who predeceased her; the amount available in the Estate for distribution; the advisability of making distributions to charitable organizations with both a local and a statewide or national impact; the desire to address research, capital, and operational needs of appropriate charitable organizations; the expectations to maximize the impact of distributions in advancing those causes selected and to achieve efficiencies in distributions from the Estate; and the desire to benefit a reasonable number of charitable organizations, but not dissipate funds among too many charitable organizations. G. The Executors have obtained infonnation regarding the mission, organization, and programs of certain qualified charities that maintain some significant relationship or involvement in causes or clientele consistent with these factors. H. The Executors now desire to designate, pursuant to the authorizations and powers set forth in the Will, certain qualified charitable organizations that shall receive benefit under the Residuary Bequest, and also to quantify the interest that each such qualified charitable organization shall receive thereunder, subject to the provisions regarding effectiveness and irrevocability of this Designation Document. P .. rOVISlons 1. The Recitals sct forth above are made part of this document for all purposes, 2 .,_....._.~,...... . 2, This Designlllion Docull1cnt is cxcCUlcd in c.~crcisc o/' lhosc lIulhori1~llions IInd powers specifically vesled in the Excculors, or inlhcir succcssor, undcr lhc Will liS fiducillries, and not as individuals. 3. This Designulion Docull1CUl is cxcculcd in rccognition o/' ccrtuin case law of the Commonwealth of Pennsylvuniu, which rClJuircs lhul un UJlJloinlcd Ikluciury vested with such authorilJltions and powcrs undcr U willll1usl clllnJllclc lhul dUly und dcsignutc, without any further or external conditions ofllny kind, lhosc "churitics"10 Icccivc hcncfits o/'lhc staled bequest. 4. Any informul or fill/nul, Wlillcn or 011I1, iudiculions, i/'uny, hcretofore made by the Execulors or any o/' lhcm rcfcrcncin!! this fhluciury dUly 10 dcsignulc the charitable residuary beuefieiaries, arc hereby sUJlerscdcd und rcvokcd, sOlhullhis Dcsignlltion Document shall control the disposition of such inlcrcsts uudcr Ihc I(csiduury 11c11ucst. 5. In making lhis desillnulion, lhe Exccutor hus considered and relied upon a "Calculation of Estilllutcd Gross J(csidue Inlcrcsts" (Ihe "Culcululion"), which is attached hereto and made a part hereof as Exhibll "" ". This clllculution is slulcd liS of the date of death, comports with the proposed death tax relurns to be /ilcd by lhc ESlute by the Executors, omits the Estate's obligation for Pennsylvania Inheritunce TlIx in order 10 culculule a Pennsylvania Inherilanee Tax charitable deduClion caleulution,lInd sllltes nooblillulion!ilr Fedcml Estate Tax due to the charitable deductions available to the Estale by virtuc of the bequcsl to ehurilies under the Residuary Bequest. The Calculation docs not include any post,deulh earnings or gains on the residue of the Estate, or any expenses and taxes related therelo, which will bceome dislribulable hereunder as a part of the remainder of the residue to those ehariluble organi1~ltions designaled to receive such interests. 6. The Executors acknowledge und decJlIre thUl the Calculation is only an estimate as to proceeds available in the Estale, stilted liS o/'lhe dale of dCllth, for proposed distribution under the Residuary Bequest assuming acceplllnce o/'lhe dClllh tllX relurns by the Pennsylvania Department of Revenue and Ihe Internal Revenue Scrvice; lind, if IIdjustmcnls lire Illade by such authorities or if the assumptions thereof arc inllccurulc, lhc Exccutors rcscrve lhc righI, limited as set forth hereinafter, to amend or adjust lhc dcsignlllions scl fimh hercin. 7. In making thcse dcsillnulions, the Excculors rely uJlon the qualified nature of the charitable organilJltions, lhut is, lhut cllch rccipicnt churilllble orllllni1~llion qualifies as a purely public charily under Scclion 501 ec) (3) o/'lhc Inlcnlul J(el'Cnue Codc 0/'1986, as amended, and the regulations Ihereunder; IInd this rcliuncc is csscntiullo cuch dcsignutionmllde. 8. In considcrulion o/' the Illullcrs sellimh ubove, the Executors deternline, and hereby declare, thUl the residue ofthc ESlule 5111111 be dislribUlcd Jlursuuntlo the Residuary Bequest to those chllritable beneficiuries in thc Ulllounls or inlcrcsls set forth below: .... 3 1":'-1 ~}~. f>i '.~.- j W;:.':.- ~,:.-., ~l ~:,:,.i ~;g'::! ~i\:;,l q-",:I Fl :"'1 ':f,:_~l to"! r,...." ~" ,"" ~:I' ",.:J'" ~).,i; -. a. The swn of nvo HUNDRED mOUSAND DOllARS ($200,000.00) in cash to THE DA VID S. & AMY S. GOLDBERG MEMORIAL RESEARCH FUND at THE MILTON S. HERSHEY MEDICAL CENTER OF THE PENNSYLVANIA STATE UNIVERSITY, c/o Office of University Development, The Milton S. Hershey Medical Center, P.O. Box 850, Hershey, PA 17033-0850, for purposes of research and education in human genetics, as presently conducted by the Division of Genetics within the Department of Pediatrics at the Medical Center. b. The sum of ONE HUNDRED TWENTY-FIVE mOUSAND DOllARS ($125,000.00) to the AMERICAN HEART ASSOCIATION, c/o Office of Planned Giving, American Heart Association, Pennsylvania Affiliate, Inc., P.O. Box 8835, Camp Hill, PA 17001-8835, specifically to be allocated and used as follows: i. The sum of SIXTY mOUSAND DOlLARS ($60,000.00) to HEART POWER, a schoolsite program to help students understand how to keep their hearts healthy, for application in the Central Pennsylvania region; and ~d :";.'1 :~;;-f ,";i ,,,( f;J' Jt ..1 ~~~:.; ,-(, '"'"j' ~,. ;;:'!' -;.~ :""\ " ,,~, ~:: ,j .:,'1 'i': ti ,,1 ::1 I ":'1' '.i'; ,. ? ~ ~1 -:;;" ~ ii. The sum of SIXTY-FIVE THOUSAND DOlLARS ($65,000.00), for purposes of researching treatments or cures for cardiovascular disease among children and infants. c. The sum of ONE HUNDRED TWENTY-FIVE THOUSAND DOlLARS ($125,000.00) to the AMERICAN CANCER SOCIETY, c/o Commonwealth Division, P.O. Box 897, Rt. 422 & Sipe Avenue, Hershey, PA 17033-0897, specifically to be allocated and used as follows: i. The sum of SIXTY THOUSAND DOlLARS ($60,000,00) to CAMP CAN-DO, a camp for children with cancer, for application in the Central Pennsylvania region; and ii. The sum of SIXTY-FIVE THOUSAND DOlLARS ($65,000.00), for purposes of researching into treatments or cures for cancer among children and infants. d. The sum of ONE HUNDRED mOUSAND DOllARS ($100,000.00) to THE MILTON S. HERSHEY MEDICAL CENTER OF THE PENNSYLVANIA STATE UNIVERSITY, c/o Office of University Development, The Milton S. Hershey Medical Center, P.O. Box 850, Hershey, PA 17033-0850, 4 . for purposes of pedilllrlc hellrl resellrch IInd educlllion, liS preselllly conducted by Ihe Division of I'edhllric ClInllolol.lY lit lhe Millon S. Hershey Medical Center of the Pennsylvllnlll SllIte Ilniversily, in lIershey, Pennsylvllnla. '<I " 'I I e, The S11111 of fo'/V/'Y 11/OIlSAND DOLLARS ($50,000,00) to the 11B7'/IIl'S/JA MISSWN, 6111{ellly Slreel,P,O. Box 3041, Harrisburg, PA 17105, for progrllllls to henenl (loor, hlllneless lind/or disadvantaged children at the Mission's Youlh Cenler IInd the WOlllen & Childrcn's Shellcr. 1', The sum of fo'/V/'Y 7'/IOUSAND DOlLARS ($50,000.00) to the ARTIIRITIS I,'OUNI>A7'/ON, c/o the Arthritis Foundation - Central Pennsylvania chapler, 17 Soulh 191h Slrecl,l'.O, Box 668, Camp Hill, PA 17011, for purposes of researching, IIssisting or 1I11evillling juvenile arthritis. g. The sum of 7WENIY-FIVE THOUSAND DOlLARS ($25.000.00) 10 lIOSI'/C/~ OF CliNTRAL PENNSYL VANIA, 98 South Enola Drive, P.O. Box 266, Enola, PA 17025-0266, to meet the needs of the terminally ill and their families, for IIppllcatlon inlhe Central Pennsylvania region. h. The sum of 7WENIY-FIVE THOUSAND DOlLARS ($25,000.00) to the COMMUNITY ACTION COMMISSION OF THE CAPITAL REGION, 1514 Derry Street, Harrisburg, PA 17104, for the use and benefit of the DAUPHIN COUNIY COMMUNITY FAMILY CENTER, for applicalion to services offered at its HIIII Manor site, to meet the needs of families and children at risk for child abuse in Dauphin County, Pennsylvania. i. The sum of 7WENIY-FIVE THOUSAND DOlLARS ($25.000.00) to ESCAPE CENTER, INC., 331 Bridge Street, New Cumberland, PA 17070, 10 meet Ihe needs of families and children at risk for child abuse in Cumberland and York Counlies, Pennsylvania. j. The sum of 7WENIY-FIVE THOUSAND DOlLARS ($25,000.00) to lhe CUMBERLAND-PERRY ASSOCIATION FOR RETARDED CITIZENS, 117 North Hanover Slreel, P.O. Box 386, Carlisle, PA 17013, 10 meet the needs of children with or wilhout disability and/or their families in Cumberland and Perry Counties, Pennsylvania. k. The sum of 7WENIY-FIVE THOUSAND DOlLARS ($25,000.00) to TilE ARC OF DAUPI1IN COUNTY, 4309 Linglestown Road, Suite 114E, Harrisburg, PA 17112,10 meet the needs of children who are mentally retarded and/or physically challenged and their families in Dauphin County, Pennsylvania. 5 '. r' \ I. ALL REMAINING SUMS, not disposed of above and constituting the REMAINDER OF TilE RESIDUE of the Estate, shall be distributcd in cqual shares to the following two charitable organizations: i. One-half (V,) thereof to the ARTIlRITIS FOUNDA TION, c/o the Arthritis Foundation - Central Pennsylvania Chapter, 17 South 19th Street, P.O. Box 668, Camp Hill, PA 17011, for purposes of researching, assisting or alleviating juvenile arthritis; and ii. One-Iwlf (V,) tl/Creof to the DA VID S. & AMY S. GOLDBERG MEMORIAL RESEARCH FUND at TilE MILTON S. HERSHEY MEDICAL CENTER OF THE PENNSYLVANIA STATE UNIVERSITY, c/o Office of University Development, The Milton S, Hershey Medical Center, P.O, Box 850, Hershey, PA 17033-0850, for purposes of research and education in human genetics, as presently conducted by the Division of Genetics within the Department of Pediatrics at the Medical Center. 9. In carrying out the fiduciary powers vested in them, the Executors have projected and anticipated the effects of death taxes upon the Estate, and hereby designate the cash bequests to selected charitable beneficiaries considering those net funds expected to be available as calculated above. Those charities designated to receive a stated pecuniary amount shall not receive any other interest under the Residuary Bequest, including but not limited to income earnings or capital gains of the Estate, except as provided by the law of Pennsylvania regarding the payment of interest on a pecuniary charitable bequest after a period of time. All income eamed or capital gains realized by the Estate and available for distribution under the Residuary Bequest shall inure to the remainder residuary beneficiaries identified in Subparagraph I. of the Paragraph above. 10. Such designations and payments arc conditioned upon sufficient proof to the Executors as to the qualified charitable nature of each organization, and the approval or clearance thereofby both the Internal Revenue Service and the Pennsylvania Department of Revenue. II. Such designations and payments are further conditioned upon the approval or clearance of this Designation Document by the Pennsylvania Office of the Attorney General, Charitable Organizations Section, which will be sought by the Executors, 12. This Designation Document may be amended by the Executors at any time up to the filing of a Federal Estate Tax Return with the Internal Revenue Service and the filing of an Inheritance Tax Return with the Pennsylvania Department of Revenue, at which time it shall become amendable only with notice to the Internal Revenue Service and the Pennsylvania Department of Revenue, and with consent or approval by the Pennsylvania Office of the Attorney General, 6 ESTATE OF THELMA K, RYAN EXHIBIT "A" PA Inheritance Tax CALCULATION OF ESTIMATED GROSS RESIDUE INTERESTS CATEGORY ASSETS: Real Estate Stecks & Bonds Exxon ConEd Cash DO ckg. Ace. In\. DO sav. Ace. In\. PNC ckg. Ace. Int. PNC-CD Ace. In\. Dreyfus Ace. In\. Dreyfus Ace. In\. T,bllls Personal property {ap\.} Perstmal property {summer house} Automobile Reimbursements & refunds TOTAL GROSS ASSETS Debts Funeral Expenses Miscellaneous Expenses Admlnlstrallve Costs Executor Allomey TOTAL DEDUCTIONS NET VALUE OF ESTATE SPECIFIC BEQUESTS Catherine Mann {cash & pers,prop.} Robert A. Rosener {cash} GROSS RESIDUE ITEMS 107,000.00 16,943,75 2,606,25 41,385.49 80.85 1,464.27 4.56 59,242.93 15,37 50,000,00 60.79 29,122.40 53.05 112,503.98 233,66 654,900.00 2,064,00 145,00 1,200,00 1,011.60 1,080,237.95 3,565.93 1,190.00 1,666.90 35,000.00 35,000.00 76,422,83 1,003,615.12 103,209,00 100,000.00 203,209.00 800,606,12 ESTATE OF THELMA K. RYAN . , . CATEGORIES ITEMS TOTALS GROSS RESIDUE BEFORE DEATH TAXES 800,606.12 DEATH TAXES PA Inheritance tax (esllmeted) NY death tax (esllmated) Federal estate tex (esllmated) TOTAL ESTIMATED DEATH TAXES PAYABLE Omllled for PIT calculallon Omllled for PIT calculallon 0.00 NET RESIDUE 800,606,12 RESIDUE GIFTS FOR CHARITY David S. & Amy S. Goldberg Memorial Research Fund (genellc research) Milton S. Hershey Medical Center 200,000.00 American Heart Assoclallon 125,000.00 American Cancer Society 125,000,00 Millon S, Hershey Medical Center (pediatric heart research) Pennsylvania State University 100,000.00 Bethesda Mission 50,000.00 Arthrllls Foundallon 50,000.00 Hospice of Central Pennsylvania 25,000.00 Community Action Commission Hall Manor 25,000.00 Escape Center 25,000.00 Cumberland-Perry Assoclallon for Retarded Clllzens 25,000,00 ARC of Dauphin County 25,000.00 775,000.00 Remainder of Residue as Calculated 25,606.12 Dlstrlbullon of Remainder of Residue: Arthrllls Foundallon (50% share) David S. & Amy S. Goldberg Memorial Research Fund (50% share) 12,803,06 12,803.06 - ... c. ,J/ J/(; ,1r:. 9 1. Charity: Address: Phone: Fax: Interest: 2, Charity: Address: Phone: Fax: Interest: Milton S. Hershey Medical Center of the Pennsylvania State University Office of University Development The Milton S, Hershey Medical Center University Communications Center Attention: James H. Brucker, Ph.D., Director of Development 140 Sipe Avenue, P,O. Box 852 Hershey, PA 17033 531-8497 531-7259 (a) $200,000,00, plus 1/2 of remaining sums- The David S. and Amy S. Goldberg Memorial Research Fund (b) $100,000.00 - Department of Pediatrics American Heart Association American Heart Association, Pennsylvania Affiliate, Inc. Office of Planned Giving Attention: Wendy Warner P. O. Box 8835 Camp Hill, PA 17011-8835 730-0480 975-5597 (a) $60,000,00 - Heart power (b) $65,000.00 - Researching treatments/cures for cardiovascular disease among childrenlinfants ""J -.. " (;, :, C N CJ 1..',1 ~lJ~ l"- i)', . ~ .-: :; L.)U LAW OFFICES GOLDIIERG, KATZMAN & SUU'MAN, P.C. RONALD M. KATZMAN ItARRY .. OOLDBERG f, UE SUIPMAN PAUL J. [SPOSITO NtllllENOERSIlOT J. JAY COQI"f.R TUOMAS E. BRlNNER JOUN A.ITATun APRlll. 'TRANG.JoUT"Y GUY U. BROOKS JUfERSON .I. SUII'MAN KAntN I. nUCtlllNBf.RotR JERRY J. RullO MICltAEL J. CoRCENZI ARNOLD B. KOO"" THOMAS J. WEBER [VAN J. IItUNE. III JOHN D.lORENZO SUVEN E. GRUBB DIANA WOODSIDE JOHN R. NIMOSKV 310 MARKET STREET STRAWOERRY SQUARE P.o. BOX 1168 IIARRISIlURO. PENNSYLVANIA 17I0R.llbR TnLI!PIIONE: (111) 114.41b1 FAX: 11111114.bROR FIRM E.MAIL: OKS4IOKSLAW.COM ARmUR L. QOlDBERG OF COUNSEL YOnK OHlC!: 2 W. MARKET ItRUT YORK, rA ,UOl 11171143.7912 CARLISLE orne[: U W. POMFRU StAUT CARLISLE. PI. 11013 11171241.0197 HERSHEY QfFICE: &23 w. CIlOCOLAn AVENUE IlERSltEY. PA 11033 11111 &]].4049 ICORRESPDND to UARRtSDURO OfFICE} January 23. 1998 Mary C. Lewis, Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle. PA 17013-3387 Re: Estate of Thelma K. Ryan, Deceased Estate No. 1996-769 Dear Ms. Lewis: Enclosed are two copies of the "Notice of Inheritance Tax Appraisement. Allowance or Disallowance of Deduction and Assessment of Tax". dated January 15. 1998, indicating additional Pennsylvania inheritance taxes of $4,195.56 and interest owed of $251.82 due on the above Estate. Accordingly. I am tendering to you Estate Check No. 001047 in the amount of $4.447.38 representing payment in full of these taxes. Please apply the time-stamp of your Office to the additional copy of the Notice. and return it to me in the envelope which I have provided. Thank you for your: assistance in this matter. Very truly yours. / ' , '/ 1--- ",;2 . y-t,.,...t-L.J'" Neil Hender(hot NH/rkr Enclosures: As stated cc: Catherine Mann, Co-Executor cc: Harry B. Goldberg, Co-Executor E:IDOCS.NEIIIRY AN.TlRY AN 127 .WPD I.AW OI'l'ICI!S GOI.IJII1HtO, KATZMAN & SHIPMAN, P .C. RONALD M. KATZMAN HARRY e. OOLOB[RO '0 UE 'HlrMAN PAUL J. ESPOSITO N[ll HENDERSHOT J. JAY COOPER THOMAS E. BRENNER JOHN A. STAnER APAIl L. STRANO.KUlAY GUY H. BROOKS JEfFERSON J. SHIPMAN KAREN S. f(UCUltNBERGER JERRY J. RUSSO MICHAEl J. CORCENZI ARNOLD B. KOOAN THOMAS J. wrOER EVAN J. KLINE. III JOHN DILORENZO STEVEN E. GRUBB DIANA WOODSIDE JOHN R. NINOSKY llO MARKI!T STRI!H STRAWIII!RRY SlJUARU r.o. 1I0X \lbR IIARRISBURO. PI;NNSVLVANIA 1110..\l6R TnLl!PIIONE: (111) 134.4161 FAX: (111) 134.bRO. FIRM E.MAIL: GKS4IOKSLAW.COM "nTltUR L. GOLDBERQ OF tOUMln VORK omcE.: 2 W, MARKET STRtET VORK, p" 17401 111711.,.7912 CARLISLE OFfICE: n W. POMFRET STREET CARLISlE. PA ,,01:1 11\1124&.0&97 UERSUEY OFFICE: 123 w. CHOCOLAtE AVENUE HERSHEY. PA '7033 t117In3.4049 ICORRESPOND TO HARRISBURG OFflCEI August 27,1997 Mary C. Lewis, Register of Wills Cumberland County Courthouse I Courthouse Square Carlisle, PA 17013-3387 Re: Estate of Thelma K. Ryan, Deceased Estate No. 1996-769 Dear Ms. Lewis: Enclosed for your infonnation are the following items regarding the referenced Estate: I. A copy of my Memorandum Letter dated August 15, 1997, to all Charities on the Distribution List mentioned below. 2. Distribution List of Designated Charitable Residuary Benelieinries. 3. Original of the Distribution Document entitled "Executor's Agreement and Designation for Distribution of Residue of Estate". dated June \3, 1997, executed by the Co- Executors of the Estate ofThelma K. Ryan, Deceased, which is detailed and self-explanatory. 4. A copy of the letter dated June 27.1997, from Lawrence Barth, Deputy Attorney General of the Pennsylvania Attorney General's Office, indicating no objection by that Office to the proposed distributions as set forth in the Distribution Document. Please time-stamp the extra copy of this leller, and return it to me in the envelope which 1 have provided. and advise ifthere is an additionalliling fee for the liIing of any of the above. GOLDDERO, KATZMAN & SHII'MAN. P.C. Mary C. Lewis, Register of Wills Page Two August 27.1997 If you hove any questions on this maller. please contaet us, as Counsel for the Estate. Very truly yours, /_. ./ ~ # / . / . I .,.(...~ / ~"",,,l:.rJ~ Ji;ieil Hendershot NI-I1rkr Enclosures: As Stated cc: Catherine Mann. Co-Executor cc: Harry B. Goldberg, Co-Executor or; c:- . ,-,:, , , : 1"''-' . > /S .1:.J(/...3 .......... /1 - \ f 0 J[~O" [HAIH Arf[ n n/lUg! CIl[CK tunE If.. JU!iAl 1'0 y, Ill"( AI FILE NUMOER COMMONW~".T" or PfN"YlVANIA O[PA" M[NT or I [VlNut [PI. 20,"0\ IlARRlS una,l'A 11121-01101 INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS couNIVCOIU VIAH RtVa HlOO U . 1'.114' C A 0 H P L E P 0 CRC KOK P S 21.9(,.0769 D E C E D E N T DECEDENT'S NAME lLAST. FIRST, AND MIDDLE tNlTIAL) R an Thelma K. O[crOrNT'5 COMPlllf AOlJIlU.S 103 Hay Ilr 1 VI! Gllmp lilli, I'A 17011 NuMlll1t AMOUNT n[Cel"rOIS[[ INSTnueTION51 0.00 X 1. Original Rolurn 4. Umltod Eslato ITI 5. 1 8. Romalndor Rolurn (lor datos 01 doalh prior to 12-1~-02) Fodoral Estalo Tax ROIUfIl Roqulrod Total Number 01 Salo Doposit Boxos r.c. 973,237.95 79,918.35 893,319.60 800,606.12 92,713.48 0.00 0.00 13,907.02 13 ,907.02 25,695.35 11,788.33 0.00 0.00 0.00 SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Catherine Mann erg DATE I ___[ 643 West Siddonsburu Road 33 :-l th Third Street . II / -7 _ e",,, to / Jl-J!.>Jo ii{iEb-ur-mpi-:.-i7oig---m- ariIsb-urg-;I'A"" 17110 ((Ilt (I EPAREROTHERT AN REPRESENTATIVE Goldberg, Katzman & Shipman, P. C. . ~o~ ~ r-- ~~-~r~~~~~~--~k-~~7"~6~-:H~~--..-----..--.--..m .., pyrighl c) 111II4 form 'O!tW,If' only CPSyl'lrnl,lnc. SOCIAL SECURITY NUMUER 056.09.3830 OAT[ OF DEAltl 09/11,/1996 OAT[ or IIlA1I1 12/11/1917 C P o 0 NAME R N R D Neil Hendershot Es . E E S N TELEPHONE NUMBER - T 717 234-4161 1. Roal EslalO (SChodulo A) (1) 2. Stocks and Bond. (SChodula B) (2) 3. Clo.oly Hold Stock/Parlnorahlp Inlorosl (Schodulo C) (~) 4. Mortgago. and Notos Roeolvablo (SChodulo 0) (4) S. Cash, Bank Ooposit. & MI!lCoUanoou. Porsonal Propor1y (Sch. E) (5) 8. Jointly Ownod Propor1y (SChodulo F) (6) 7. Tronslors (SChodulo G) (SChodulo L) (7) 8. Total Gross Assots (Iotal Unosl-7) 9. Funoral Expansos, Admlnlstrativo Costs, Mlscollanoous Expon.os (SChodulo H) 10. Dobis, Mortgago UablllUos. Uons (SChodulo I) 11. Tolal Ooducllons (Iotal Unos 9 & 10) 12. Nol Valuo of Estalo (Uno 9 minus Uno 11) 1~. Charilablo and Govornroonlal Boquosls (SChodulo J) 14. Not Valuo Sub oet to Tax Uno 12 minus Uno 1~) 15. Spou.aI Tronsfors (for dalO' of doath altor 0-~0-94) $00 Instructions lor Applicablo Porconlago on pago 2. (Includo valuo. from Schodulo K or Schodulo M.) 18. Amounl of Uno 14 taxablo al6% ralo (Includo valuos from SChodulo K or SChodulo M.) 17. Amount of Uno 14 taxablo al15% rato (Includo valuos from SChodulo K or SChodulo M.) 18. Prlnclpal tax duo (Add tax from Uno IS. 16 and 17.) 19.Crodlls/Sp povor1y Prlor Payroonls DI!lCounl 0.00+ 25,000.00 + 695.35 20. II Uno 191s groalor than Uno 10, ontor Iho dilloronco on Uno 20. Thl.ls tho OVERPAYMENT. ~ ~ Check here If au are ra uesUng a refund of our ove a moot 21. II Uno 10 Is groalor than Uno 19, ontor Iho dilloronco on Uno 21. Thl.l. tho TAX DUE. A. Entor tho Intofost on tho balanco duo on Uno 21A. O. Entor Iho total of Uno 21 ond 21A on Uno 21 O. Thl.Is Iho OALANCE OUE. Make Check pa able to: Re Ister 01 Wills, A ent ~ ~ OE SURE TO ANSWER ALL OUESTIONS ON PAGE 2 ANO TO Und.r pln.ltl" 01 p.rJury,1 dul,,,. 1h&11 hay, ...mln.d thl' nturn, Including .ccompanYlng .ch.dulu and .trol.m'l)r.. n eorr.et and compl.t... d.clAr. that all ,..llItatl hu bun rlportld.t truI mark It value. Olclar.tlon 01 preparer othh t whlchprlpa'lrhuanyknowl.dgl. Counly Cumberland (IF APPLICAOLEISURVIVINO SPOUSE'SNAME (LAST.FIRST ANO MIDDLE INITIALI SOCIAL S[CUntTY NUMU[H 2. Supploroonlal Rolurn 4a. Fuluro Inlorosl ComprOrT\l50 (for dalo' of doalh altor 12-12-02) ~ 8. Ooeodont Dlod Tootato 0 7. Doeodont Malntalnod a Uvlng Trust (Anach co of Will) (Anach e co of Trust) ALL CORRESPONOENCE AND CONFIOENTIAL TAX INFORMATION SHOULD OE DIRECTED TO: R E C A P I T U L A T I o N COMPLETE MAILING ADDRESS Goldberg, Katzman & Shipman, 320 Market St, PO 80x 1268 Ilarrisbur PA 1710B -1268 None 816,563.09 None None 156,674.86 None None (0) t9) 76,122.40 (10) 3,795.95 (11) (12) (1~) 14 (15) 0.00 X = (15) 0.00 X .00 = T A X C o M P U T A T I o N (17) 92,713.48 X .15 = (10) Intorost (19) (20) (21) (21A) (210) (\ " " - .- . 1:-.) " - ~. :-": .c. r-,~ ('. c= - :1 "., , ''':'LL I- e u: ?' ~::J Uu ^""" Act 1148 of 1994 provldel for the r80...:t1on of the tax ratel Impoled on the n... "alue of tranlferl to or for the UI8 of the lpoule. The ratel II prelcrlbed by tho Itatule will be: 13% (.03) will be appllcablo for oltatel of decedentl dying on or alter 7/1/114 and belore 1/1/116 12% (.02) will be applicable for IItatel of decedentl dying on or alter 1/1/116 and before 1/1/117 11% (.01) will be applicable for eatatel of decedentl dying on or alter 1/1/117 and before 1/1/116 ISpouaal tranlferl occurring on or after 1/1/118 will be exempt from Inheritance tax. PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING A MARK (Xl IN THE APPROPRIATE BLOCKS. YES NO 1. Old decedont moko a tronslor and: a. rotolnthouseorlncomoolthoproportytronslonod,. . . ..... .. . . .. .. .. . . . . . . . ... . . . . . . . . X b. rololn tho right to doslgnalo who sholl uselho proporty translonod or Its Incomo, . . . . . . . . . . . . . . . . . . . . . X c. rotolnarevOl8lonorylntores1;or.. .. . ... . . . .. .. . . . . . .. . . . . .. ..... .. . . . . .. . . .. . X d. recelvothoprorriselorllfoolol1horpaymonll,bonenllorcllo?.......................... ... X 2. II doath occunod on or boloro Docembof 12.1982, did decedont wllhln two YOIII preceding doath translor proplll1y without rocolvlng adoquato consldoranon? II doath occunod anor Decembor 12, 1982, did decedont transfer proplll1y within one YOII 01 doath without recolvlng adoqualo consldoranon? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 3. Old decedont own on 1n trustfo( bank account at his or hor doalh? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Coprrlght Ie) tll14 fo,m .oU...a,. only CPSyst.ml, Inc. Fa"" 1500 (Rtv. '.04) ..,. -. ".. .~.' ."" AtV" 160S EX . 14.111 CO"r.\l\gftfE~~~~~~I,.y'NI' ESTATE OF SCHEDULE B STOCKS AND BONDS Thelma K. Ryan ssn 056-09-3830 09/14/1996 mUll be dllcloled on Schedule F. OESCRIPTION 100 Consolidated Edison of New York, Inc. - shares of common stock, valued per custodian letter (copy attached). 2 Dreyfus Money Market Government Series - Investment Account #008-0000434217, with date of death balance valued per investment fund letter (copy attached). 3 Dreyfus Money Market Government Series - Investment Account #008-0000434217, accrued dividends. 4 Dreyfus Municipal Bond Fund - Account #054-0005505151, with a date of death balance valued per investment fund letter (copy attached). 5 Dreyfus Municipal Bond Fund - Accrued dividends on Account #054-0005505151. 6 200 Exxon Corporation - shares of common stock, valued per custodian letter (copy attached). 7 U.S. Treasury Bill, CUSIP #9l2794Z98 - U.S. Treasury obligation, $100,000.00 face amount, with l3-week maturity, valued per public pricings. 8 U.S. Treasury Bill, CUSIP #9l27943N2 - U.S. Treasury obligation, $160,000.00 face amount, with l3-week maturity, valued per public pricings. 9 U.S. Treasury Bill, CUSIP #9l27942Al - U.S. Treasury obligation, $100,000.00 face amount, with 13-week maturity, valued per public pricings. 10 U.S. Treasury Bill, CUSIP #9l27943P7 - U.S. Treasury obligation, $100,000.00 face amount, with l3-week maturity, valued per public pricings. 11 U.S. Treasury Bill, CUSIP #9127942B9 - U.S. Treasury obligation, $100,000.00 face amount, with 13-week maturity, valued per public pricings. 12 U.S. Treasury Bill, CUSIP #9l27942K8 - U.S. Treasury obligation, $100,000.00 face amount, with l3-week maturity, valued per public pricings. TOTAL Also onlor on IIno 2. ROCD ltulatlon (II moro spa.. Is noodod. Insort DddltlonlllshoolS olslU1lO slzo.) Cop)'fi;hl(t) 10;4 form ,ollwar. only CPSy'1,ml, Inc. FILE NUMBER 21-96-0769 VALUE AT DATE OF OEATH 2,806.25 29,122.40 53.05 112,503.98 233.66 16,943.75 99,550.00 158,800.00 99,150.00 99,000.00 98,750.00 99,650.00 S 816 563.09 Form 1500 Sth,dul. 8 IRa.." 4-11) REV. '101 U + 11-.71 ""'" -- SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY cO"~~A~rt~~~\''V&!KI~ih\''NI' ESTATE OF PI0090 Prlnl or T 0 FILE NUMBER 21-96-0769 SS" 056-09-3830 09/11./1996 Thelma K. Ryan All . . ITEM NUMBER 1 olnll -owned with RI hI 01 Survlvollhl mu,' b. dllclol.d on Sch.dul. F OESCRIPTION Aetna Casualty & Insurance Company - Reimbursement for medical expenses 2 Aetna Casualty & Insurance Company - Reimbursement for medical expenses 3 Camp Hill Plaza Apartments - Refund of security deposit 4 Dauphin Deposit Bank and Trust Company - Insured money market account #0028861787, titled in Decedent's name alone, principal balance valued per bank letter (copy attached). 5 Dauphin Deposit Bank and Trust Company - Insured money market account #0028861787, accrued interest valued per bank letter (copy attached). 6 Dauphin Deposit Bank and Trust Company - Savings account #5700404001, titled in Decedent's name alone, principal balance valued per bank letter (copy attached). 7 Dauphin Deposit Bank and Trust Company - Savings account #5700404001, accrued interest valued per bank letter (copy attached). 8 Diocese of Rockville Centre - Refund of health insurance premium 9 Diocese of Rockville Centre Reimbursement of medical expenses 10 PNC Bank, N.A. - Certificate of Deposit #21001019869, titled in decedent's name alone, principal balance valued per bank letter (copy attached). 11 PNC Bank, N.A. - Certificate of Deposit #21001019869, accrued interest, valued per bank letter (copy attached). 12 PNC Bank, N.A. - Checking account #5140168828, titled in Decedent's name alone, principal balance valued per bank letter (copy attached). 13 PNC Bank, N.A. - Checking account #5140168828, accrued interest, valued per bank letter (copy attached). 14 Decedent's vehicle - 1984 Oldsmobile Cutlass Supreme, in poor condition, valued per America Online's Autovantage Services. Total of Continuation Schedule s TOTAL Also onlo. on IIno 5. Roca Ilulallon (Anach additional s 11;1!' . 11" shoolsll moro aplco Is noodod.) COPY'lghl(e) 111II4 form loftwlr. only CPSvlt.ml,lne. VALUE AT DATE OF DEATH 16.00 17 .00 100.00 41,385.49 80.85 1,464.27 4.56 110.40 768.20 50,000.00 60.79 59,242.93 15.37 1,200.00 2 209.00 S 156 674.86 Form 1500 5eh.dull E (R.v, 2-171 REV- '"1 EX' (7-111 E'lTATE OF Thelma ITEM NUMBER A. B. 1. 2. 3. C. 1"'0. cOM~N'<<\lfC'l~{~%~~r~'NI' SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Pl.... Print or . FILE NUMBER 21-96-0769 K. R an SSu 056-09-3830 09 II, 1996 DESCRIPTION 1 Fun.ral Exp.n...: Cremation Society of Pennsylvania - Cremation services, container, packing and transport of remains to New York cemetery. 2 Yardley & Pino Funeral Home - Grave opening, burial of cremated remains & monument lettering in New York. Admlnl.lrInv. Colla: POl1lOnal Roprosont.Uve Convrlsslon. SocIal Security Number 01 PllfllOnal Ropre.ontsUvo: Yell Commissions paid 171-30-5529 (HBG) 15.000.00 056-32-3863 (eM) 20.000.00 Attorney F.... Goldberg, Katzman & Shipman, P.C. Famlty ExompUon Clalmlnt Addr.... 01 Claimant at decodent'o desth Stroot Addro.. CIty Ro'oUonshlp Stale Zip Code 4. Probsle F.... Register of Wills 1 Mlscelllneoul Expenl..: Camp Hill Plaza Apartments - Additional month's rent 2 Charles K. Mann - Labor charges for removing furniture and carpe from decedent's apartment. Cumberland County Law Journal - Estate notice publication 4 Cumberland County Register of Wills - Exemplified copy of will required for ancillary administration in New York. 3 5 Esseks, Hefter & Angel - Reimbursement for filing fee, New York ancillary probate petition. 6 Esseks, Hefter & Angel - New York counsel fees 7 Frances Redell-White appraisal of furnishings located in decedent's apartment Total of Continuation Schedule s TOTAL Also entor on Ilno 9. Roc I1ulsUon (II mora apac. II n.oded, Ins.rt Iddlnonll Ih..la ot lam. II.e.) Copyrlghl(C) '8M totm lotl.at. onl,;, CPS,;,lteml,I"c. AMOUNT 900.00 290.00 35,000.00 35,000.00 504.00 565.00 250.00 60.00 51. 50 335.00 1,500.00 264.50 1 402.40 s 76 122.40 Fotm 1600 Schedul. HIRev, 7-11) .' " '\! r , 1 j' j " ',' I I j :-j, :-1 '..1 h .1 ,. 1: 'I 11' Ii ~ J: .~ ' ;:' ; ,-., ~ Estate of: Thelma K. Ryan Soc Sec #: 056-09-3830 Date of Death: 09/14/1996 Continuation of Schedule H-C (Miscellaneous Expenses) Amount Item Description # 8 John Blaney Appraisals - Appraisal of decedent's rental residential property in Noyack, New York. 300.00 9 New York Commissioner of Taxation - Release of lien for transfer of New York house 25.00 10 New York State Transfer Tax - Real estate transfer tax payable through title company 428.00 11 PNC Bank, N.A. - Estate checking account, check printing fee 20.00 12 Richard Henn _ Reimbursement for removing personal property from New York house. 175.00 13 Richard Henn _ Repairs to water heater in Noyack, NY property in anticipation of sale. 100.00 14 Royal Insurance - Fire insurance for rental property in New York 117.75 15 Royal Insurance - Fire insurance on rental property 117.75 16 Suffolk County Surrogate Court Clerk - Ancillary letters testamentary 17 Suffolk County Surrogate Court Clerk - Filing fee for release of Uen 31. 00 18 The Patriot-News Company - Estate notice publication 82.90 ..................................... 1,402.40 5.00 REV-UUU. (t-l1) ESTATE OF " f""\ CO.....ONwE.LTH OF PENNSYlV.NI. INH RITANCE TAX RETURN R alDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS PI.... Print olT . FILE NUMBER 21-96-0769 Thelma K. Ryan SS# 056-09-3830 09/14/1996 ITEM NUMBER 1 I DESCRIPTION Anesthasia Associates of PA - medical bill not covered by insurance AMOUNT 29.02 2 Camp Hill Plaza Apartments - Final monthly rental of Decedent's apartment 565.00 3 Cumberland Ambulance Service - Transport bill not covered by insurance 74.00 4 Cumberland Ambulance Service - Transport bill not covered by insurance 117.75 5 Diocese of Rockville Centre - final health insurance premium 125.02 6 East Pennsboro Ambulance Service - Transport bill not covered by insurance 61. 20 7 Family Physician Associates - medical bill not covered by insurance 20.89 8 Family Physician Associates - medical bill not covered by insurance 27.00 9 Internal Revenue Service - Last lifetime income tax return, Form 1040 tax due 528.00 10 Martin M. Sacks & Associates - Accounting services for Decedent, including bank reconciliations, reconciliations of medical expenses and anaylsis of investment income. 1,080.00 11 Moffitt, Pease & Lim Associates - Medical bill not covered by insurance 2.22 28.00 36.37 17.77 223.48 8.22 715.20 136.81 S 3 795.95 12 Pennsylvania Department of Revenue - Last lifetime income tax return, Form PA-41 tax due 13 PP&L Electric bill 14 PP&L Electric bill 15 Special Care, Inc. - nursing services not covered by insurance 16 suburban Cable TV - Final cable television bill 17 Suffolk County Treasurer - real estate taxes on New York rental Total of Continuation Schedule s TOTAL Also on'or on IIno 10. Roc. l1u101l0n (II mora spoco Is noodod. Insort oddillonol shoo's 01 sarno slzo.) Capyt'llIhI (e) 1194 fo,m .olt.ar. only CPsy.t.m"lne. Form 1S00Seh.dul.llR.v,1-131 ,..,~ .'"t ~~!! ;. , . . ..1 - - -- . .. .------..... -'"" .,...." . Estate of: Thelma K. Ryan Soc Sec #: 056-09-3830 Date of Death: 09/14/1996 Continuation of Schedule J-B (Charitable and Governmental BequestS) 1\I1l0unt or Share of Estate Item Description # arthritis, per Executors' Agreement and Designation for Distribution of Residue of Estate (copy attached). 50,000.00 5 BETHESDA MISSION _ Bequest for programs to benefit poor, homeless and/or disadvantaged children at the Mission's Youth Center and the Women & Children's Shelter, per Executors' Agreement and Designation for Distribution of Residue of Estate (copy attached). 25.000.00 6 coMMUNITY ACTION COMMISSION OF THE CAPITAL REGION for the use and benefit of the DAUPHIN COUNTY coMMUNITY FAMILY CENTER for application to services offered at its HALL MANOR site - Bequest to meet the needs of families and children at risk for child abuse in Dauphin County, Pennsylvania, per Executors' Agreement and Designation for Distribution of Residue of Estate (copy attached). 25,000.00 7 CUMBERLAND-PERRY ASSOCIATION FOR RETARDED CITIZENS - Bequest to meet the needs of children with or without disability and/or their families in cumberland and Perry Counties, Pennsylvania, per Executors' Agreement and Designation for Distribution of Residue of Estate (copy attached). 25,000.00 8 ESCAPE CENTER, INC. _ Bequest to meet the needs of families and children at risk for child abuse in cumberland and York Counties, Pennsylvania, per Executors' Agreement and Designation for Distribution of Residue of Estate (copy attached). 25,000.00 9 HOSPICE OF CENTRAL PENNSYLVANIA - Bequest to meet the needs of the terminally ill and their families, for application in the Central pennsylvania region, per Executors' Agreement and Designation for Distribution of Residue of Estate (copy attached). 200,000.00 10 MILTON S. HERSHEY MEDICAL CENTER of THE PENNSYLVANIA STATE UNIVERSITY for the DAVID S. & AMY S. GOLDBERG MEMORIAL RESEARCH FUND _ Bequest for purposes of research and education in human geneticS, as presently conducted by the Division of Genetics within the Department of Pediatrics at the Medical Center, per Executors' Agreement and Designation for Distribution of Residue of Estate (copy attached). 100,000.00 11 MILTON S. HERSHEY MEDICAL CENTER of THE PENNSYLVANIA STATE UNIVERSITY _ Bequest for purposes of pediatric heart research and .-. ~ Estate of: Thelma K. Ryan Soc See #: 056.09-3830 Date of Death: 09/14/1996 Continuation of Schedule J.B (Charitable and Governmental Bequests) Item Description # education, as presently conducted by the Division of Pediatric Cardiology at the Milton S. Hershey Medical Center of the Pennsy1venia State University, per Executors' Agreement and Designation for Distribution of Residue of Estate (copy attached) . 12 REMAINDER RESIDUARY INTEREST. to MILTON S. HERSHEY MEDICAL CENTER of THE PENNSYLVANIA STATE UNIVERSITY for the DAVID S. & AMY S. GOLDBERG MEMORIAL RESEARCH FUND. 50% of remainder of residue for purposes of reseerch and education in humen genetics, as presently conducted by the Division of Genetics within the Department of Pediatrics at the Medical Center, per ExecutorS' Agreement and Designation for Distribution of Residue of Estate (copy attached). 13 REMAINDER RESIDUARY INTEREST . to ARTHRITIS FOUNDATION. CENTRAL PENNSYLVANIA CHAPTER . 50% of remainder of residue for purposes of researching, assisting and alleviating juvenile arthritis, per Executors' Agreement and Designation for Distribution of Residue of Estate (copy attached). ..,.-... 1"'- j. . .. Amount or Share of Estate 12,803.06 12,803.06 ............................. 475,606.12 -- . ;i ~~ ::l~ ~o !-<u r , l !1 ~.. n .-.., ('\. .unlltlG) I .:JliJI1/.. " ~"" 'II. ~ ,., ~~ ~I.' t:7. ~ !ft.'" t2 ~ ......n..n__.. #4 ~ (l)~ ..,. tll". ".4 ~ .... ",~~.., /,"1" ~'l'<@ ~ .. l..,,) ~rt" . ~") :: "r., ~ . . .~,. ..,_ - ..,. r...... _ ;:":;: . . = ". ':; "W. ~' ~ <1 "-i ;:: .; ~ ~\" .,. .e,:~ - (\ -; '" #'~'.f4,:- : ,'\ - -: , ,f' ._ .' ~ /I.. '" .. 0 '" .. .., '. .....,..~ ~ ~I,' ....- i!) ~~ I"~, 111Ft 'r'~ .~ "I, . .\ 1., ,\\~ ""1IUIUUll\ ,......, "......,. Register of Wills of CUMBERLAND County, pennsylvania certificate of Grant of Letters Testamentary No. 1996-00769 PA No. 2196-0769 ESTATE OF RYAN THELMA K ILAb'~, riKb'~, MiUUL~) Late of CAMP HILL BOROUGH ~UM~~KLANU ~UUN'~l, Deceased social security No. 056-09-3830 day of september 192i an instrument WHEREAS, on the 27th dated June lOth 1993 was admitted to probate as the last will of RYAN THELMA K (LAb'l', r iK:i'l', MiuuLt;) CUMBERLAND County, who died on the late of CAMP HILL BOROUGH 14th day of september ~ and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS ' Register of Wills in and for the county of CUMBERLAND in the commonwealth of pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to CATHERINE MANN and HARRY B GOLDBERG who ~ duly qualified as Executor(rix) and have agreed to administer the estate according to law, all of which fully \1 appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, \ CARLISLE, PENNSYLVANIA. \ IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the ~ day of September 1996. I I I , i LfYlI1'( r1~'J.'li€ '~J' (;.a. ~ .0u,,,f eg ter or 1 ' I **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) ~ if she survives me by thirty (30) days; but, if she should not so survive me, such bequest shall lapse. 2. I give and bUjLIr:<lti '.hr ,am. of Cor Hll~dwj Thousand Dollars ($100,000.00) to ROBERT A. ROSENER, now of Morris Township, New Jersey, if he survives me by thirty (30) days; but, if he should not so survive me, such bequest shall lapse. ITEM VI. I give, devise and bequeath all of the residue of my estate, whether real, personal, or mixed, and wherever situate, including any property subject to any power of appointment which I may now have or hereafter acquire, outright to such charitable groups or organizations and as selected by my Executor and in such amounts or shares as determined by my Executor, in the sole and absolute discretion of my Executor. In making such selection, my Executor shall consider those charitable groups or organizations that are dedicated to researching, assisting, or alleviating the diseases or disabilities of young children, particularly of pre-school age or infancy, including mental or physical handicaps or ailments, abandonment, poverty, disadvantaged educational, social, or home life, or other afflictions or impediments limiting their potential. It is my intention that any such charitable beneficiaries, as selected by my Executor, shall distribute or use such funds without regard to race or religion. My Executor shall not be required to make a selection of any particular interested, qualified organization. My Executor shall consider, in making designations as to charitable beneficiaries, the amount that 3 such groups or organizations actually devote to programs for the benefit of such young children, as opposed to "overhead", "self-promotion", or "administrative costs". It is my intention that this bequest and the resulting donations to charitable organizations should qualify for a "charitable deduction" for both state inheritance tax and federal estate tax purposes. Accordingly, my Executor shall not make any distribution to any group or organization that would not qualify for such a charitable deduction. ITEM VII. The interest of beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation. ITEM VIII. I hereby appoint CATHERINE MANN, now of Dillsburg, Pennsylvania, and HARRY B. GOLDBERG, now of Harrisburg, Pennsylvania, to serve together as the executors (collectively, my "Executor"), of this, my Last Will and Testament. In the event that either of such named persons shall refuse or be unable to so serve, I then nominate and appoint NEIL HENDERSHOT, now of Harrisburg, Pennsylvania, to replace such person. ITEM IX. I direct that my Executor shall not be required to give bond or post hany other security for the faithful performance of duties in any jurisdiction. 4 .-.. ITEM X. Any pcrson who shall have died at the same time as me, or in a common disaster with me, or under such circumstances that it is difficult or impossible to determine who died first, shall be deemed to have predeceased me. ITEM XI. My Executor shall have the following powers in addition to those invested by law and by other provisions of my Will applicable to all propcrty, whether principal or income, exercisable without Court approval, and effective until distribution of all propcrty: I. To retain any investments I may have at my death so long as my Executor may deem it advisable to my Estate so to do. 2. To vary investments, when deemed desirable by my Executor, and to invest in sueh bonds, common trust funds, stocks, notes, real estate mortgages, or other securities or in such other propcrty, real or pcrsonal, as my Executor deems wise, without being restricted to so-called "legal investments" . 3. In order to effect a division of the principal of my Estate or for any other purpose, including any final distribution, my Executor is authorized to make said divisions or distributions of the pcrsonalty and realty partly or wholly in kind. If such division or distribution is made in kind, said 5 .-. Subscribed, sworn to and oeknowledged before me by the Testatrix, THELMA K. RYAN, and subscribed and sworn to before me by Kim/'...rJ'f D Mli/~". and Dn:1V r. G"nnM , witnesses, this /O~ day of June, 1993. .xiu<24--1'- /r;. f.k.:. d.A-rr- Notary Public (SEAL) . ." NOTARiAl SEAL SUSAN U. IlUOSON, Notary Public Harrisburg. DauphIn County PA lly eomlNsslon ExpIres Oct 10. 11114 " (NI!Il:IWIU011:lwUlllry...hr ...121 9 exhibit B . - . o.-~ ...-.., D AA >I 8 ^ 956 COMMONWEALTH OF PENNSYLVANIA NO. ,I 't DEPARTMENT OF REVENUE OFFICIAL RECEtPT . PENNSYLVANIA INHERITANCE AND ESTATE TAX IPUt' PI'.'" RECEIVED FROM: NEIL HENDERSHOT ESQUIRE POBOX 1268 HARRISBURG. PA 17108-1268 EST..TE INFOR".,..TION: !:I FILE NUMBER U 21-1996-0769 !:I N.o.ME Of DECEDENT ('-'ST] ~ RVAN THELMA K ... D"TE Of P"VMENT Iii I 3/96 m POST".,..RK o.o.TE COUNTY SSN 056-09-3830 (fiRST] (MI) CUMElERLAND D..TE Of DE..TH 09/14/96 REMARKS PNC BANK CIO NEIL HENDERSHOT ESQUIRE SEAL CHECKII 347083 TAXPAYER fl ACN ASSESSMENT r:'I CONTROL ~ NUMBER '* AMOUNT lC:".o0a.JO fOlD"" $25.000.00 CW MARY C. LE IS REGISTER OF WILLS 101 DEe 1 S 1996 fa TOTAL AMOUNT PAID RECEIVED BY ~, ,..,,..,.,,,0' """""0 ,.." ,.,,,.,.. (.\ '. ,...... Exhibit C J:'~:~t\ ....~~ COM/IIOUW'AlIH 01 "NNlnv,A'l'" OI...."..INfOI.lvINUI INHllnA..elloU OIV'"ON 01" 110601 ",U'lnUIO, u. 11'" 0001 Plla'l Print or Type MUST I COMPLETED IV REPRESENTATIVE OF FINANCIAllNSlITUTlON WHERE SAFE DEPOSIT lOX IS lOCATED AND RETURNED TO ABOVE ADDRESS COUNTY CODE filE NUMBER SOCIAL SECURITY OR DEATH6CERTlF~ATE NUMBER 05 - O'].,g~30 DATE Of DEATH .1'/-'6 f' ISTATEI ,.:~.....,,~}., ..~. "SS' '('HU'., 11"1 1""'\ SAFE DEPOSIT BOX INVENTORY (CITY) I~TIIEET ADo~s'l {jo r 1 NAME. ADDRESS AND R a. INAMEy, . l- trine.. {STRE ADDRfSSI 3W II. INAMEIO ~1-(". ~ ~ c. (NAMEI /VI.a,,(I. S, b~.. fck. .:#=7 I I .s LA. 1b1~:~ONl~ ICIlY) (StATE I (ZIPCODEI IRELAtIONSHIP) (STREET ADORUS) ICITY) ISTATEI IIIP coon NAME AND ADDRESS Of FINANCIAL INSTITUTION WHERE THE SAfE DEPOSIT BOX IS LOCATED I&JJ IIIPCOD'1 }7011 "'Z. : CJ V NAME AND ADDRESS Of PERSONISI HAVINO ACCESS TO BOX Do IN.....'I (2-\-1\ e.... /'" e.. (STREET ADDRESS} .s ~e b,(H.....'1 !Y\An 1\ ~o-. (STREET ADDRESSI lSTATEj II,peCOEI ICITY) ISlA"1 (lIP COO'I ICITY) NAME AVTLE Of EMPLOYE TAKING THE INVENTORY D ('~ Ci't1 U &0. 11\ WAS A WILL IN THE BOXl OYES _ 0 II V". D. .,..f will: b. Nam. and add,... of p.rsonal ,.pfll.nlatln, I' nam.d In the will (HAM'I (StRffT ADDRESS) (CITY) ISlATEI (liP CODEI c. Nam. and add,... 0' attorn.y, If any IHAM'I {StREET ADDRESSI ICilYI (SlA'" IIIPCOD'I z o Ei ~ z ., 'l~ ~ ~1 ~ i '" .. u '" "'" II) Uol '" 0 ~ "" ::J \AI i ~ ~ :( '" 0 o tit :# 0 .... '" - "" t:l '\- <:> ~ III C)o ZD: 00 11I1'0 -Z III... ~> Uz e- III .. z ~w ,.:> ..z zw z~_ o.f! ~ac2 .":{ "",1.1.0 ~OO~ d:c; 5z~ ..Ww w~o ~.. zOl: ow ~'" o u . ~ J 0 ~I ;;; ..... ~' "':I U ~ .... "" - , ~e ~ ... .... ... ... ... "' ... ... '.... - - t;~ ... ... - t; ... i) - ~ w ~ . ~ r-- - ~ 'U ~ C/"" ~ tr- ,j ~ \-, Co ~ l' r-- '"' 110 ~ I' l' ~ l' , . . ..:. .. .. Ii, , - a... I , , , ..~:> ..".. ..0 ..... ..... .... ":1- N N 1"'\ '-\) go;; ..... ...... .... tV , . , . , ~ , . , l' <Xl , M ~ 'll \.p Vl '-D r-- ~ ~ ~ w \)0 - ., :I ~ "> ll' ~ .,... Co :> l' Iv, z :~ II' ~ ~ - - '" M (roo ('.... 'vi ~ - - M z 0<> 0 - VI N l"l ...0 M Vl .. () ~~ (X, IV) l'1 () ('J 0.... Oil ~ l"'I .... 0..... ('f) 3 N'O ....... ...... , . I' ~ ~ - Ii: (;) VJ V) -1 -.1 V, ~ ~ \J~ Q.. ~ .. ~ ~ ~ ':::t V) ~ "'l u .~ .. <: ~ :I .. ~ - < z '" ~ e )- a z ~ . - -~ f ~ - ~~ - :I , ::: - - 0 - - ~ - u \.) " l\ ~ ~ ~ ( ~ '1 .. N 5 .. " .. ~ Ol: .. .. .. ~ - - .:: !li - - - 'ci <: '- ... - ... - - - \) ... ... .. .. :> S \J .. u .. .. .. .. :I: Z ill 0 0 ..- e. ..:;; "z ~ \r "" ~\ c;:; :1:- C B G"- ..... \; ":I /l <:> dO t-..I - ~ Cl, zi!i 52 N c-J ~ '" ~\ ""11100 Exhibit 0 r-.. liNe: llian". S..\. ~ ,.~ ,:.! 1 ,uh..k 111\' Ill) nll\.'II~ 1..111I1111111. 11.\ l';lllllll\iI~ PNC PllUVATlE lBANK Dccember 3 \, 1996 Ms. Betsy Eck Goldberg. Katzman & Shipman P.O. Box 1268 Harrisburg, P A 17108-1268 Re: Estat~ of Thelma K. Ryan, Deceased Custody Agreemcnt Dear Betsy: We have now received the transferred stocks into the custody account. Fortunately. the stocks have appreciated since the Thelma's date of death. The information on the stocks is as follows: Date of 12/30/96 ~ Death Value Value. Consolidated Edison $ 2.806.00 Exxon $16,943.00 $ 2,925.00 $19,875.00 Would you like these stocks sold at this time? Also, would you please provide a current statement from the U.S. Treasury on the Treasury Bills? We have been in touch with them and they told us that some of the maturing issues rolled over. We will need this information in order to set thcm up properly on our books. 1fyou have any questions regarding this maller, please call me at 730-2256. Thank you for your assistance in this matter. Best Wishes for a very Happy New Year!!! Very truly yours, ~i1eY Vice President JASI Investments . Trusts . Ban/ling Services ,-...." 1'"', exhibit E "'.r-- ~ D Dauphin Deposit Bank and Trust comPOrt{ MAIN OFFICE 2'3 MARKET STREET, HARRISBURG. PENNSYLVANI^ 11'01 111255.2'21 Oecaoenl conflrmntlon Name: Tnelmn R,ar. Soclal Securlty No.: 05e-O~-3eJO Date of Death (000): :.J'J/1~/'Jb Account No. OC23861787 ------------------------ ------------------------ ------------------------ 570C~Q~001 Type ------------------------ -------~---------------- ------------------------ Su\i,ng3 lr,surec ~'oney ~'arl-et Date Opened or Issued 08/06/31 ------------------------ ------------------------ ------------------------ OS/C2/'J:' Date Closeo or Matured ------------------------ ----------------.-------- ------------------------ Date of Death Balance $~i ,:85.~~ --------------------.---- -- ---- -------,--- ------.-- ------------------------ $~,~e..t..~7 PLUS Date of Death Accrued Int. $20.85 ------------------------ ------------------------ ------------------------ $~.56 Joint o,.;ners (if any) Ncne ------------------------ ------------------------ ------------------------ r:one Date of Joint Offllership ------------------------ ------------------------ ------------------------ ------------- ------------- ------------------------ ------------------------ ------------------------ special eomments: N/A Addition.' information iI,'\lailable at S20.00 per hour. One hour minimum. Date Prepared: October 7, 1996 Prepared by: Cheryl A. Bowers Telephone No. (717) 255-2054 customer Management lnformatlon Dept. tCM1) Page 1 of 1 reI () 8 'i~("" Form 00-0%0-21& (REV 7/93) ,...- AJ. ~RAISAL & CONSULTANT t.~RVICES FRANCES REDELL-WHITE, APPRAISER 564 WELLINGTON ROAD, HARRISBURG, PA 17109 717-671-8116 E5TATEOI'TIIEl.MA IlYAN 103 MAY DIUVI';. PAT,/I r; CAMP HIl.L. PA 170 II COUNTY OF CUMBERl.AND DATE OF DEATII: SEP1'I';MBEIl 13. \DOG 5EIYrEMm:R2.1.I!JDO II'rances Redell.White deposes and states that 1011I a qualified appraiser Including the kind and character set forth upon the annexed schedule of six (6) pages. 10111 current sole proprietor of Appraisal and Consuitant Services located at 564 Wellington Rood. Harrisburg, PA. 17109. and 0 fonner director ofTepper Galleries, New York. NY frolll 1986-1993. I mn on active member of the Appraisers Association of America since 1988 and hove been engaged In the business of buying, selling and appraising fumlshlngs, works of art and personal property for the post seventeen years. On September 23. 1996. I personally eXnlnlned and Inventoried certain tangible PersolUlI Property said to belong to the ESTATE OF THELMA RYAN I 03 MAY STREET. APT. # 6. CAMP HILL. PA.. CUMBERLAND COUNTY. and mode on appraisal thereof for Fair Market Valuations for the purpose of ESTATE VALUATION. which Is attached hereto and made a part of this affidavit of six (6) pages: that the annexed schedule Is a true copy. and that appraised fair market value for each article or group of articles Is set opposite the descrlptlon and Is the same as the date of death In the amount of 1W0 THOUSAND AND SIXTY FOUR DOLLARS ($2,064.00J In my opinion and experience. Fair Market Value as defined by the department of Treasury. lntemal Revenue Service publication 561 Is as follows: -Fair Market Value generally Is the price that property would sell for on the open market. It Is the price that would be agreed on between an willing buyer and a willing seller. with neither being required to act.. and both having reasonable knowledge of the facts. It takes Into account many factors that affect the value ofproperty: The fee for this appraisal Is not contingent upon the stated grand total. I have no present or future contemplated Interest In any of the appraised articles or group of articles nor do I have any relationship to any Interest party except as an obJectlve appraiser. All articles are In good condItion unless otheJWIse Indicated. The stated fair market valuations are for like kind In like condition of like quality and character. Should this appraiser be required to testify In a court oflaw or any other legal assembly, a fee of $ 150.00 per hour plus the same rate for standby time. travel time and all other related expenses will be charged. This appraisal Is only valid for tlle purpose Intended. Please refer to -Assumptions and Limiting Conditions- attached for further conditions. Sworn to before me this 24 day of eptenWer 1~lA..,U ~l'.J 1.\~l;iL SE,\t I: I',',;wn I. '.\'!'lCIf, t'::;:~,,. P .L, So"" ":";''', 11>'.', r.'.,..:: Co, ''''.' I ..~.',... ",' '. .tl.. "-- ,,' .,..'." t,'~'r:~::.r-;,~.;.,;,,~,.~ .:'~ .._iy:,. E.r" : ESTA PRAlSAL'FORf'THELMA RYAN 103 MAY DRIVE, APT. # 6 CAMP HILL, PA 10711 CUMBERLAND COUNTY DATE OF DEATH: 9/13/96 ~4;j1/~ .Frances Redell-White. ApI' r APPRAISAL & CONSULTANT SERVICES 073.46-2253 PAGE 1 of 6. "'"' A.. ~RAISAL & CONSULTANT ...~RVICES FRANCES REDELL-WHITE, APPRAISER 564 WELLINGTON ROAD, HARRISBURG, PA 17109 717-671-8116 DESCRIPTION LMNG ROOM I DINING ROOM FAIR MARKET VALUE I. COLONIAL STYLE PAINTED DROP LEAF LAMP TABLE Commercial quality, worn. S 15.00 2. WOOD KNEEHOLE DESK Commercial quality, worn. 60.00 3. ENAMEL METAL FILE CABINET 6.00 4. BOOK CASE WITH GLASS SLIDING DOORS, H - 3S" Commercial quality, worn. 15.00 5. CLUB STYLE UPHOLSTERED SOFA, BEIGE (worn, stained) 25.00 6. MAHOGANY TWO TIER LAMP TABLE Sheraton style. tool leather top 40.00 7. PINE FOUR DRAWER DRESSER, TURNED HANDLES Commercial quality. 15.00 S. PINE NINE DRAWER DOUBLE DRESSER Commercial quality. 20.00 9. FIVE PIECE FORMICA D1NETIE SET Table and 4 side chairs, worn. IS.00 10. WOOD AND METAL BARSTOOL Commercial quality. 9.00 11. "SONY" 19" COLOR T.V. AND STAND 15.00 12. MAHOGANY DROP LEAF OCCASIONAL TABLE Sheraton style. brass paw feet on casters. 150.00 13. PAIR MAPLE ROCKERS. SPINDLE Ui\CKS Commercial quality. 30.00 14. STAINED KNOTTY PINE CAPTAINS CHAIR Commercial quality. 15.00 ESTATE APPRAISAL FOR: THELMA RYAN 103 MAY DRIVE, APT. /I 6 CAMP HILL, PA 10711 CUMBERLAND COUNTY DATE OF DEATH: 9/13/96 PAGE 2 or 6. ."""\ A... PRAISAL & CONSULTANT ....ERVICES FRANCES REDELL-WHITE, APPRAISER 664 WELLINGTON ROAD, HARRISBURG, PA 17109 717-671-8116 DESCRIPTION FAIR MARKET VALUE 15. PAIR BRASS COLUMN LAMPS WITH SHADES Commercia) quality. 14.00 16. BRASS TONE SWING ARM DESK LAMP Commercial quality. 6.00 17. BRASS TONE STICK FLOOR LAMP WITH SHADE Commercial quality. 7.00 18. PORCELAIN COLUMN TABLE LAMP WITH SHADE Commercial quality. 7.00 19. STAINED PINE MAGAZINE RACK 3.00 20. WALL CLOCK & BAROMETER 8.00 21. "KENMORE" MICROWAVE OVEN 22.00 22. "PANASONIC" CASSETTE RECORDER AM/FM RADIO 35.00 BEDROOM 23. TWIN MATTRESS. BOX SPRINGS, (worn) 24. MAPLE FOUR DRAWER DRESSER. H - 34" Commercial quality. 25. FRUITWOOD TALL DRESSER Commercial quality. 10.00 25.00 45.00 26. FRUITWOOD TRIPLE DRESSER, FORMICA TOP Commercial quality. 30.00 15.00 27. STAINED WALNUT SEWING STAND 28. FAN BACK CARVED & UPHOLSTERED ARMCHAIR Worn. 45.00 7.00 29. PORCELAIN COLUMN LAMP WITH SHADE ESTATE APPRAISAL FOR: THELMA RYAN 103 MAY DRIVE, APT. # 6 CAMP lULL, PA 10711 CUMBERLAND COUNTY DATE OF DEATH: 9/13/96 PAGE 30r6. . I '"' A1.!RAISAL & CONSULTANT .....::RVlCES FRANCES REDELL-WHITE. APPRAISER 564 WELLINGTON ROAD, HARRISBURG. PA 17109 717-671-8116 DESCRIPTION FAIR MARKET VALUE 30. PORCELAIN COLUMN LAMP WITH SHADE 7.00 Floral decor. 31. PORCELAIN COLUMN LAMP WITH SHADE 7.00 Ivy decor. 32. TWO (2) ALARM CLOCKS. WIND AND BATTERY OPERATED 8.00 33. TWO (2) WOODEN JEWELRY BOXES 4.00 KITCHEN 34. ASSORTED DISHES, GLASSES. POTS, PANS. UTENSILS, ELECTRIC FOOD CHOPPER. ALL IN USED CONDITION. 10.00 35. 35 PIECE SILVER PLATED FLATWARE SERVICE 20.00 36. EIGHT (8) SILVER PLATED TEASPOONS 4.00 37. SET OF SIX (6) CONTINENTAL SILVER (850) DEMITASSE SPOONS 20.00 38. STERLING SILVER SOUP SPOON 5.00 39. CUT CRYSTAL FRUIT BOWL, DlA. 8" 25.00 40. CUT CRYSTAL DECANTER WITH STOPPER (CHIPPED) 15.00 41. 28 PC. BROWN GLAZED DINNER SERVICE FOR EIGHT 56.00 42. ELECTRIC TABLE FAN 3.00 43. ASSORTED SERVING TRAYS. DISHES. ETC. 12.00 44. TWO LAWN CHAIRS 4.00 45. ASSORTED WOMEN'S CLOTHING (WORN) 10.00 46. ASSORTED BED LINENS (WORN) 30.00 47. STANDING WALKER AND CANE. METAL 15.00 ESTATE APPRAISAL FOR: THELMA RYAN 103 MAY DRIVE, APT. # 6 CAMP HILL, PA 10711 CUMBERLAND COUNTY DATE OF DEATH: 9/13/96 PAGE 4 of 6. Ar-PRAISAL & CONSULTANT oERVICES FRANCES REDELL.WHITE, APPRAISER 564 WELLINGTON ROAD. HARRISBURG, PA 17109 717-671-8116 DESCRIPTION FAIR MARKET VALUE 48. SET fOUR (4) WATERfORD CRYSTAL LIQUORS (CHIPPED) 44.00 49. "KUTANI" STYLE PORCELAIN VASE LAMP. H - 16" (DRILLED) Brass Base with custom shade. 175.00 50. CARVED STAINED PINE CHEST, BAROQUE MANNER (poor condition) 65.00 FURNITURE AND FURNISHINGS TOTAL $ 1,251.00 JEWELRY 51. 18 KT YELLOW GOLD LINK BRACELET 225.00 52. 14 KT. YELLOW GOLD fRAMED CAMEO PIN 175.00 53. 14 KT WHIT GOLD CHAIN WITH CLEAR STONE PENDANT 70.00 54. 14 KT YELLOW GOLD WEDDING BAND 45.00 55. 14 KT YELLOW GOLD WEDDING BAND 30.00 56. PAIR 14 KT YELLOW GOLD HOOP EARRINGS, RED STONE & WATER PEARL ATIACHMENTS 75.00 57. YELLOW GOLD BROOCH WITH 12 BLUE STONES 125.00 58. ASSORTED COSTUME JEWELRY INCLUDING: yellow metal cuffilnks & tie pin sterling pin with mounted cameo sterling chain with pearl mounted pendant pair sterling earrings. pearls pair yellow metal eagle pins. (military) cameo, no fitting double strand faux pearls with white metal clasp woman's "Selko" wrist watch. leather band 68.00 JEWELRY FAIR MARKET TOTAL $ 813.00 ESTATE APPRAISAL FOR: TImLMA RYAN 103 MAY DRIVE, APT. # 6 CAMP HILL, PA 10711 CUMBERLAND COUNTY DATE OF DEATH: 9/13/96 PAGE 6 of 6. /,-..~ '-, At-PRAISAL & CONSULTANT i::JERVICES FRANCES REDELL.WHITE, APPRAISER 564 WELLINGTON ROAD, HARRISBURG, PA 17109 717.671.8116 SUMMARY FURNITURE AND FURNISHINGS JEWELRY $ 1.251.00 813.00 FAIR MARKET GRAND TOTAL $ 2,064.00 .................................................................. ............................... . ESTATE APPRAISAL FOR: THELMA RYAN 103 MAY DRIVE. APT. # 6 CAMP HILL, PA 10711 CUMBERLAND COUNTY DATE OF DEATH: 9/13/96 PAGE 60r6. r""J ."""1",.0.".""(" '.""'''''. ",,, r-.. ~",'.""~__~~_~<...~,,,,,,,~~'W_--.__,#,,, exhibit F oJ '""" >--- disadvantllgcd cducationlll, socilll, or homc Iifc, or other lIf1lictions or impcdiments limiting their potcntilll. It is my intcntion thllt any such charitable bcncficillrics, liS sclcctcd by my Exccutor, shall distribute or use such funds without rcgllrd to racc or rcligion. My Exccutor shall considcr, in making dcsignlltions as to charitllblc bcncficiarics, the amount thllt such groups or organizations actually dcvotc to programs to bcncfit young childrcn, liS opposed to "overhcad", "self. promotion", or "administrativc costs". It is my intention tllllt this bequest and the resulting donations to charitable organizations should qualify for state inheritance tax and fcdernl estatc tax purposcs. Accordingly, my Exccutor shall not make any distribution to any group or organization that would not qualify for such a charitable deduction. F. The Exccutors havc considered certain factors, ineluding: the Decedent's intentions and distribution parameters set forth in the Rcsiduary Bequest; the mcdical history, pcrsonal expericnces, values, character, and interests of the Decedent during her lifetime and thosc ofhcr late son and husband who predeceascd her; the amount available in the Estate for distribution; the advisability of making distributions to charitable organizations with both a local and a statewide or national impact; the desire to address research, capital, and operntional needs of appropriate charitable organizations; the expectations to maximize the impact of distributions in advancing those causes selccted and to achieve efficiencies in distributions from the Estate; and the desirc to benefit a reasonable number of charitable organizations, but not dissipate funds among too many charitablc organizations. G. The Executors havc obtained information regarding the mission, organi7.ation, and programs of ccrtain qualified charities that maintain some significant relationship or involvement in causes or clientele consistent with these factors. H. The Executors now desire to designate, pursuant to the authori7.ations and powers set forth in the Will, certain qualificd charitable organizations that shall receive benefit undcr the Residuary Bequest, and also to quantify the intcrcst that each such qualificd charitable organization shall rcceive thereunder, subject to the provisions rcgarding effectivcness and irrevocability of this Designation Document. Provisions I. The Rccitals sct forth above are made part of this documcnt for all purposes. 2 ,-..., "' 2. This Dcsignation Documcnt is cxccutcd in excrcisc of thosc authorizations and powers spccifically vcstcd in thc Executors. or in thcir succcssor. undcr thc Will as fiduciarics, and not as individuals. 3. This Dcsignation Documcnt is cxccutcd in rccognition of ccrtain casc law of thc Commonwealth of Pennsylvania. which rcquircs that an appointcd liduciury vested with such authorizations and powcrs undcr a will must complctc that duty und dcsignutc, without any furthcr or extcrnal conditions of any kind. thosc "churitics" to rcccivc bcncfits of thc stutcd bcqucst. 4. Any infonnal or fonnal. wrillcn or oral, indicutions. if any. hcretofore made by thc Executors or any of them referencing this fiduciary duty to dcsignate the charitable residuary beneficiaries, are hercby supersedcd and revokcd, so that this Designation Documcnt shall control the disposition of such interests under the Residuary Bcqucst. 5. In making this designation. the Executor has considcrcd and relied upon a "Calculation of Estimated Gross Residuc Interests" (thc "Calculation"), which is allached hcreto and made a part hereof as Exhibit "A ". This calculation is stated as of the date of death, comports with the proposed death tax returns to be filed by the Estate by the Executors, omits the Estate' s obligation for Pennsylvania Inheritance Tax in order to calculate a Pennsylvania Inheritance Tax charitable deduction calculation, and states no obligation for Federal Estate Tax due to the charitable deductions available to the Estate by virtue of the bequest to charities under the Residuary Bequest. The Calculation does not include any post-death earnings or gains on the residue of the Estate, or any expenses and ta.xes related thereto, which will become distributable hereunder as a part of the remainder of the residue to those charitable organizations designated to receive such interests. 6. The Executors acknowledge and declare that the Calculation is only an estimate as to proceeds available in the Estate, stated as of the date of death, for proposed distribution under the Residuary Bequest assuming acceptance of the death tax returns by the Pennsylvania Department of Revenue and the Internal Revenue Service; and, if adjustments are made by such authorities or if the assumptions thereof are inaccurate, the Executors reserve the right, limited as set forth hereinafter, to amend or adjust the designations set forth herein. 7. In making these designations, the Executors rely upon the qualified nature of the charitable organizations, that is, that each recipient charitable organization qualifies as a purely public charity under Section 501 (c) (3) of the Internal Revenue Code of 1986, as amended, and the regulations thereunder; and this reliance is essential to each designation made. 8. In consideration of the mailers set forth above, the Executors detennine. and hereby declare, that the residue of the Estate shall be distributed pursuant to the Residuary Bequest to thosc charitable beneficiaries in the amounts or interests set forth below: 3 ""'\ """' a. The sum of nvo HUNDRED mOUSAND DOUARS ($200,000.00) in cash to THE DA VID S. & AMY S. GOLDBERG l'.IE,'.IORlAL RESEARCH FUND at THE MILTON S. HERSHEY MEDICAL CENTER OF THE PENNSYL V,\NIA STATE UNIVERSITY, c/o Office of University Development, The Milton S. Hershey Medical Center, P.O. Box 850, Hershey, PA 17033-0850, for purposes of research and education in human genetics, as presently conducted by the Division of Genetics within the Department of Pediatrics at the Medical Center. b. The sum of ONE HUNDRED TWENTY-FIVE THOUSAND DOUARS ($125,000.00) to the AMERICAN HEART ASSOCIATION, c/o Office of Planned Giving, American Heart Association, Pennsylvania Affiliate, Inc., P.O. Box 8835, Camp Hill, PA 17001-8835, specifically to be allocated and used as follows: i. The sum of SIXTY THOUSAND DOUARS ($60,000.00) to HEART POWER, a schoolsite program to help students understand how to keep their hearts healthy, for application in the Central Pennsylvania region; and ii. The sum of SIXTY-FIVE mOUSAND DOUARS ($65,000.00), for purposes of researching treatments or cures for cardiovascular disease among children and infants. c. The sum of ONE HUNDRED TWENTY-FIVE THOUSAND DOLLARS ($125.000.00) to the M..IERICAN CANCER SOCIETY, c/o .. Commonwealth Division, P.O. Box 897, Rt. 422 & Sipe Avenue, Hershey, PA 17033-0897, specifically to be allocated and used as follows: i. The sum of SIXTY THOUSAND DOLLARS ($60.000.00) to CAMP CAN-DO, a camp for children with cancer, for application in the Central Pennsylvania region; and ii. The sum of SIXTY-FIVE THOUSA!v7J DOLLARS ($65,000.00), for purposes of researching into treatments or cures for cancer among children and infants. d. The sum of ONE HUNDRED mOUSAND DOllARS ($100.000.00) to THE MILTON S. HERSHEY MEDICAL CENTER OF THE PENNSYLVANIA STATE UNIVERSITY, c/o Office of University Development, The Milton S. Hershey Medical Center, P.O. Box 850, Hershey, PA 17033-0850, 4 ,'"' .-. for purposes of pediatric heart rescarch and cducation, as prcscntly conductcd by the Division of Pediatric Cardiology at the Milton S. Hershey Medical Centcr of the Pennsylvania State University, in Hcrshcy, Pennsylvania. e. The sum of FIFTY THOUSAND DOllARS ($50.000.00) to the BETHESDA MISSION, 611 Rcilly Street, P.O. Box 3041, Harrisburg, PA 17\05, for programs to benefit poor, homelcss and/or disadvantaged childrcn at the Mission's Youth Center and the Women & Children's Shelter. f. The sum of FIFTY THOUSAND DOllARS ($50.000.00) to the ARTHRITIS FOUNDATION, c/o the Arthritis Foundation - Central Pennsylvania chapter, 17 South 19th Street, P.O. Box 668, Camp Hill, PA 17011, for purposes of researching, assisting or alleviating juvenile anhritis. g. The sum of TWENTY-FIVE THOUSAND DOllARS ($25.000.00) to HOSPICE OF CENTRAL PENNSYLVANIA, 98 South Enola Drive, P.O. Box 266, Enola, PA 17025-0266, to meet the needs of the tenninally ill and their families, for application in the Central Pennsylvania region. h. The sum of TWENTY-FIVE THOUSAND DOllARS ($25,000.00) to the COMlrlUNITY ACTION CO....U,lISSION OF THE CAPITAL REGION, 1514 Derry Street, Harrisburg, PA 17104, for the use and benefit of the DAUPHIN COUNTY COMMUNITY FAMILY CENTER, for application to services offered at its Hall Manor site, to meet the needs of families and children at risk for child abuse in Dauphin County, Pennsylvania. i. The sum of TWENTY-FIVE THOUSAND DOllARS ($25.000.00) to ESCAPE CENTER, INC., 331 Bridge Street, New Cumberland, PA 17070, to meet the needs of families and children at risk for child abuse in Cumberland and York Counties, Pennsylvania. j. The sum of TWENTY-FIVE THOUSAND DOllARS ($25.000.00) to the CUMBERLAND-PERRY ASSOCIATION FOR RETARDED CITIZENS, 117 North Hanover Street, P.O. Box 386, Carlisle, PA 17013, to meet the needs of children with or without disability and/or their families in Cumberland and Perry Counties, Pennsylvania. k. The sum of TWENTY-FIVE THOUSAND DOllARS ($25,000.00) to THE ARC OF DAUPHIN COUNTY, 4309 Linglestown Road, Suite 114E, Harrisburg, PA 17112, to meet the needs of children who are mentally retarded and/or physically challenged and their families in Dauphin County, Pennsylvania. 5 I. ALL REMAINING SUMS, not disposed of above and constituting the REMAINDER OF THE RESIDUE of the Estate, shall be distributed in cqual shares to the following two charitable organizlltions: i. Ollc-half (V,) thercof to the ARTHRITIS FOUNDA TION, c/o the Arthritis Foundation - Ccntral Pcnnsylvania Chapter, 17 South 19th Strcet, P.O. Box 668, Camp I-Iill, PA 17011, for purposes of researching, assisting or alleviating juvenile arthritis; and ii. Ollc-half (V,) thercof to the DA VID S. & AMY S. GOLDBERG MEMORIAL RESEARCH FUND at THE MILTON S. HERSHEY MEDICAL CENTER OF THE PENNSYLVANIA STATE UNIVERSITY, c/o Office of University Development, The Milton S. Hershey Medical Center, P.O. Box 850, Hershey, PA 17033-0850, for purposes of research and educlltion in human genetics, as presently conducted by the Division ofGcnetics within the Department of Pediatrics at the Medical Center. 9. In currying out the fiducilll)' powers vested in them, the Executors have projected and anticipated the effects of death taxes upon the Estate, and hereby designate the cash bcquests to selected charitable beneficiaries considering those net funds expected to be available as calculated above. Those charities designated to receive a stated pecuniary 1lI1l0unt shall not receive any other interest under the Residuary Bequest, including but not limited to income earnings or capital gains of the Estate, except as provided by the law of Pennsylvania regarding the payment of interest on a pecunilll)' charitable bequest after a period of time. All income earned or capital gains realized by the Estate and available for distribution under the Residuary Bequest shall inure to the remainder residuary beneficiaries identified in Subparagraph I. of the Paragraph above. 10. Such designations and payments are conditioned upon sufficient proof to the Executors as to the qualified charitable nature of cach organization, and the approval or clearance thereof by both the Internal Revenuc Service and the Pennsylvania Department of Revenuc. II. Such designations and payments are further conditioned upon the approval or clearance of this Designation Document by the Pennsylvania Office of the Attorney General, Charitable Organizations Section, which will be sought by the Executors. 12. This Designation Document may be amended by the Executors at any time up to the filing of a Federal Estate Tax Rctum with the Internal Revenue Service and the filing of an Inheritance Tax Return with the Pcnnsylvania Dcpartment ofRevcnue, at which time it shall bccome amendable only with noticc to the Internal Revenue Service and the Pcnnsylvania Dcpartmcnt of Revenue, and with consent or approval by the Pennsylvania Officc of the Attorney General, 6 /"'" """ Charitable OrganiZlltions Section: Provided, howcvcr, that the Executors rcscrve the right to supplement this Designation Document, substantively consistcnt with the designations set forth above, for purposes of clarilieation or correction in carrying out such designations. 13. The Exeeutors further express their desire and cxpectation to each of the selccted charitable organizations that a suitable foml of acknowledgment or memorialization of these bequests designated by the Executors on behalf of and in the memory of the Decedent should be made by each selected charitable organization, and notice thereof provided to the Executors. 14. This Designation Document may be recorded with the Register, and it shall be binding upon the Executors and their successors in office, subject to the provisions regarding amendment or supplementation. Execution IN WITNESS WHEREOF, intending to bind the Estate, the Executors, acting together in their liduciary capacities as aforesaid, hereby execute this Designation Document for the purposes herein set forth on this 13th day of June, 1997. WITNESSES: EXECUTORS: J~/L~4~r t/ . n/L~4~ P' ' rta~< ~ Catheril/e MallII, as a Co-Executor of the Estate of Thelma K. Ryan, deccased ..... 7 --- ,..., COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND . . On this, the 13111 day of June, 1997, before me, a Notary Public in and for said County and State, the undersigned officer, personally appeared CATHERINE MANN, whose name is subscribed to the foregoing "Executors' Agreemellt and Designation of Beneficiaries for Distribution of Residue of Estate., who acknowledged executing the same in the capacities referenced therein, for the purposes set forth therein. WITNESS my hand and seal the day and year aforesaid tkl.lfl,.l~ .11 I Eli!nbrJI1 S lrk. ~J,11Jry Puhllc DI~ ! \' i\' J . [),lllf'\'l, If: )'1 "V , IV Cornll'l'.::,on E.r. us r.1':Ht..: 0, 1r,:"", I , ' I III J,/.I.u Jj, .j (1-,,--.. : ) Notary Public (SEAL) COMMONWEALTH OF PENNSYLVANIA . . : SS: COUNTY OF DAUPHIN On this, the 13111 day of June, 1997, before me, a Notary Public in and for said County and State, the undersigned officer, personally appeared HARRY B. GOLDBERG, whose name is subscribed to the foregoing "Execlltors' Agreement and Designation of Beneficiaries for Distribution of Residue of Estate-, who acknowledged executing the same in the capacities referenced therein, for the purposes set forth therein. WITNESS my hand and seal the day and year aforesaid , ' I ~:o:,";,,' S -.11 I Eli:!ab0th S. L:i'., r~c':;'y .n. tjl~l:c OWl,' 'h"p. L',uptHl ('''':':!)' . i ~ 1~'Conrl'l!,s.:ufl LJf.,er, '.~;:'t.~'. 0.1';,0 j .-. (! / '/ , ... (j) j Notary Public .J s~ .', i I: .t._ (SEAL) 8 ,-., ESTATE OF THELMA K. RYAN EXHIBIT "A" PA Inherllance Tax CALCULATION OF ESTIMATED GROSS RESIDUE INTERESTS CATEGORY ITEMS ASSETS: Real Estate Stocks & Bonds 107,000.00 Exxon ConEd 16,943.75 2,806.25 Cash DO ckg. Ace. In!. DO sav. Ace. In!. PNC ckg. Ace. In!. PNC.CD Ace. In!. Dreyfus Ace. in!. Dreyfus Ace. in!. T.bllls Personal property (ap!.) Personal property (summer house) Automobile Reimbursements & refunds 41,385.49 80.85 1,464.27 4.56 59,242.93 15.37 50,000.00 60.79 29,122.40 53.05 112,503.98 233.66 654,900.00 2,064.00 145.00 1,200.00 1,011.60 TOTAL GROSS ASSETS 1,080,237.95 Debts Funeral Expenses Miscellaneous Expenses Administrative Costs 3,565.93 1,190.00 1,666.90 Executor Allomey 35,000.00 35.000.00 TOTAL DEDUCTIONS 76,422.63 NET VALUE OF ESTATE 1,003,815.12 SPECIFIC BEQUESTS Catherine Mann (cash & pers.prop.) Robert A. Rosener (cash) 103,209.00 100.000.00 203,209.00 GROSS RESIDUE 800,606.12 t"'. ESTATE OF THELMA K. RYAN CATEGORIES ITEMS TOTALS GROSS RESIDUE BEFORE DEATH TAXES 800,606.12 DEATH TAXES PA Inheritance tax (estimated) NY death tax (estimated) Federal estate tax (estimated) TOTAL ESTIMATED DEATH TAXES PAYABLE Omitted for PIT calculation Omitted for PIT calculation 0.00 NET RESIDUE 800,606.12 RESIDUE GIFTS FOR CHARITY David S. & Amy S. Goldberg Memorial Research Fund (genetic research) Millon S. Hershey Medical Center 200,000.00 American Heart Association 125,000.00 American Cancer Society 125,000.00 Milton S. Hershey Medical Center (pediatric heart research) Pennsylvania State University 100,000.00 Bethesda Mission 50,000.00 Arthritis Foundation 50,000.00 Hospice of Central Pennsylvania 25,000.00 Community Action Commission Hall Manor 25,000.00 Escape Center 25,000.00 Cumberland-Perry Association for Retarded CItizens 25,000.00 ARC of Dauphin County 25,000.00 775,000.00 Remainder of Residue as Calculated 25,606.12 Distribution of Remainder of Residue: Arthritis Foundation (50% share) David S. & Amy S. GOldberg Memorial Research Fund (50% share) 12,803.06 12,803.06 COMMONWEAlTIl or PENNSYlVANIA DEPARtMEtlT or r'EVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 ttARRISOURG, PA 17128.0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ,. NO. AA 242688 REV,"" EX (11"'1 RECEIVED FROM: r ACN ASSESSMENT CONTROL NUMBER AMOUNT NEIL HENDERSHOT ESQUIRE 101 t.4.447.::IA POBOX 1268 HARRISBURG, PA 17108-1268 < " 1"- UXOII[RE FOlD HERE - ,< ESTATE INFORMATION: FilE NUMBER 21-1996-0769 NAME OF OECEDENT ILAST! RYAN THELMA K OATE or PAVMENT 1/26/1998 POSTMARK DATE 1/23/1998 COUNTY _.cUMBERl.,"AND OA1E or DEATH SSN 056-09-3030 tFIRST) IMI) TOTAL AMOUNT PAlO "4,447.38 REMARKSCATHER I NE MANN 8. HARRY D GOLDBERG C/O NEIl, HENDERfiHCll'. SEAf=HECKII 001047 CW RECEIVEO BY 'J., (. '" u (.'-<-:Y' ~V MARY C. U; IS U"/)l PI2-T.). REGISTER OF WILLS ~ '1'''" , ~. \..Ii J: ! ~, ()f '..... ,; f, :-, ..-------..--.----.- j --' ..'-'--." - --- ---. 1< ,< .._, -r~ _ ..4"'T~~ -,:... . --'---'" . ~.-:'~ -. ~.. ~ . ~-- -.- I I I I '"1162111'''41 184956 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OP REVENUE OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX '*' II NO. AA RECEIVED FROM: & ACN ASSESSMENT flI CONTROL ... NUMBER AMOUNT I I I 'I I I I I I I !_IOtD HUE , . . NEIL HENDERSHOT ESQUIRE 101 ~E!:),OOv.OO POBOX 126B HARRISBURG, PA 17108-1268 ESTATE INfORMATION: f:II fiLE NUMBER li1 21-1996-0769 I!:I NAME Of DECEDENT (LAST) I;tI RYAN THELMA K II DATE Of PAYMENT m POSTMARK DATE COUNTY SSN 056-09-8830 (FIRST) (Mil CUMBERLAND DATE OF DEATH 09/14/96 REMARKS m TOTAL AMOUNT PAID S25,000.00 CW PNC 8ANK C/O NEIL HENDERSHOT CHECKlI 347083 REGISTER OF WILLS " .. \ I" RECEIVED BY '/ ;";;,i, , .b f I 7:t MARY c. LEwis 11'/,h'..l .".'jLr:Lj; REGISTER OF WILLS ~ ESOUIriE SEAL - _.~_ ..___ _+_0 ____._ _.+ t'. " i J . ,- --, -~ . -"-:",JII" _ ~-. ---,:,. ----- PURPOSE OF HOUCE: PAY"EHh REFUND (CR), To 'ulflll the r.qulr...nt. 0' S.etlon ZI~S (b) 0' the Inh.rltane. and [.tat. ta. Act, Act Zl of 1995. (7Z P.S. S.etlon 91~S). D.tach the tap portion of 'thl. Hotlc. and .ub.lt with your pay..nt to thl Rlgl.t.r of Will. prlnt.d an the revu.. sid.. n "ake ch.ck or .on.y ard.r payabl. tal REGISTER OF MILLS, AGENT. A r.fund of a tax cr.dlt .ay b. r.qu.st.d by ca~l.tlng an ~Appllcatlon 'or R,'und a' P.nn.vlvanla Inh.rltanc. and E.tat. Ta.~ (REY-l]l]). Applications sr. avallabl. at the Dfflc. of the R.gl.t.r of Wills, any of the Z] R.v.nu. Ol.trlct Df,lc.. or fro. the D.part..nt's Z4-hour an'wlrlng s.rvlcl nu.b.r, 'or 'or.. ard.rlng: In P.nnsylv.nla 1~8oa-]6Z-ZaSa, autsld. P.nn.ylvanla and within local Harrl.burg ar.a (717) 787~8a94, TOO' (717) 77Z-Z15Z (Hlarlng I.p.lr.d Only). OBJECTIONS: Any party In Int.rl.t not ..tl.flld with the ........nt of ta. as .hawn on thl. not lei .ay obJlct within .I.ty (60) day. of rlc.lpt of thl. Notlc. bYI ..wrJtt.n prat..t to the PA O'Plrt..nt of Rlv.nu., Board a' App.al., O.pt. 181021, Harrl.burg, PA 17128-1021, OR ...I.ctlng to have thl .att.r dltlr.ln.d at .udlt a' thl plr.anal r.pr"lntatlv., OR --app.al to the Orphan.' Court. ADHIN- ISTRATlYE CORRECTIONS I PENalTY: INTEREST: Factual .rror. dl.cav.rld on thl. ........nt .hould b. .ddr.s..d In writing tal PA O.part..nt of Alv.nu., Bur.au 0' Indlvldu.1 T...., ATTNI Po.t A.......nt R.vl.w unit, O.pt. 280601, Harrl.burg, PA 17128-0601, Phon. (717) 787-6505. S.. pagl 5 a' the baakl.t ~In.tructlon. 'or Inh.rltanc. Ta. R.turn 'or. R..ldlnt Olc.d.nt~ (REY-1501) far an ..planatlon 0' .d.lnlstratlv.ly corr.ctabl. .rrar.. Th. ISX ta. ..n..ty non-participation p.nalty I' co.put.d on the total 0' the ta. and Int.r..t .......d, and not paid bl'ar. January 18, 1996, the 'Ir.t day a't.r the .nd a' the t.. .an.,ty p.rlod. Thl. non-p.rtlclpatlon p.nalty I. app.al.bl. In the .... ..nn.r .nd In the the .... tl.. p.rlod a. you would app.al the tax and Int.r..t that ha. b..n .......d .. Indlc.t.d on thl. not Ie.. For dat.. 0' d.ath on or .'tar 10-]-91, Penn.ylv.nla E.tata T.. ba..d on thl F.d.ral E.t.t. Ta. r.turn b.ca... d.llnquent .t the ..plr.tlon 0' nlnl, (09) .onth' 'roe the date 0' death. For dat.s 0' d.ath prior to 10-]-91, P.nn.ylvanla E.t.t. Te. b..ed on the F.d.rel E.t.t. Ta. r.turn baco... d.llnquent at the ..plratlon of ,Ight,an (18) .onth. fro. the date 0' d..th. T.... which blc.', d.llnqu.nt b.for. January 1, 198Z b..r Int.r..t .t the r.t. of .1. (6~) p.rcent p.r annul calcul.t.d .t a dally rate 0' .000164. All t.... which b.ca.. d.llnquent on or a't.r January I, 1982 will b.ar Int.r..t at a r.t. which will vary 'roe cal.ndar yaar to c.l.ndar y.ar with that rat. announc.d by the PA OIPart..nt 0' Rlv.nul. Th. appllcabl' Int.ra.t r.tl. for 1982 through 1997 ar.: Y.ar Intuest Rat. O.lly Int.r..t Factor Ynr Inter..t Rlt. O.lly Inter..t Factor 1982 ,,~ .000S48 1987 .~ .000241 198J 16~ .000~18 1988-1991 1I~ .000301 1984 II~ .000301 1992 .. .000247 1985 U~ .000356 1991-1994 '" .000192 1986 IO:C .000Z7~ 1995.1991 .. .000241 ulnt.,a.t I. e.lculat.d a. 'allow.: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Hatlc. I"uld .,t.r the ta. b.co.e. d.llnquent will r,'llct an Int.re,t c.lcul.tlon to flft.an (IS) days b.yond the date of the ........nt. I' pay..nt I. .ad. a,t.r the Int.r..t co.putatlon date .hown on the Notlc., additional Int.r..t lU.t b. calcul.t.d. 6-/;<9.,3 COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSVLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN ,* c,; BUREAU OF INDIVIDUAL TAXES IHtlEAI1ANC[ lAIC DiViSION DEP," U0601 IIARHlsaURO, Pi 11118-0601 11,.,11 I. l".II."1 NEll HENDERSHOT GOLDBERG ETAL PO BOX 1268 HBG Esa 10-13-97 RVAN 09-1(,-96 21 96-0769 CUMBERLAND 201 TltELMA Allount Rant tt.d PA 17108 MAKE CHECK PAVABLE AND REMIT PAVMENT TOl REGISTER OF WILLS CUMBERLAND CO CDURT HOUSE CARLISLE, PA 17013 NOTE: To Insure prop.r credit to your account, subn1t the upper portion of thil farn with your t.K pay.ent. CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR FILES ~ R-iv:48]i-EX--AFP--ioj:-97j-----iii-Niiiic:i-OF--PETifRHiiiAfiiiN-Aiip-A!iSESS-HENif---------------------------- OF PENNSVLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN .. ESTATE OF RVAN THELMA K FILE NO.21 96-0769 ACN 201 DATE 10-13-97 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 13.211.67 3. Inheritance Tax Assessed by Other States or Territorias of tha United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 13,211.67 5. Pennsylvania Estate Tax' Due TAX CREDITS: PAVMENT DATE DI SCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID RECEIPT NUMBER "'.' TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 _IF PAID AFTER THIS DATE. SEE REVERSE SIDE elF TOTAL DUE IS LESS THAN fl, NO PAYNENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YDU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIDNS.l K .00 .00 pURPOSE Of HaUCEI To fulfill thl r.qulr...nt. of Slctlon 21~~ lb) of thl Inh.rltent. and [It,t. Ta_ Act, Act 21 of 19'~. (72 P.5. Slctlon 9"51. PA'mEHT. Detach thl top portion of thl, Hotlcl and lubllt with your ply..nt to thl RIgII'ar of will. prlntld on the rl..,lr.' ,Idl. .... "_I chIck or 10nlV ord.r payable tal REGISTER OF MILLS, AOEHT. REFUND (eA) I A r.fund of . tlM cradlt ..y bl r.qu..t~ by coapl.t1nt an -Application for R,fund of Plnnlvlv.nla Inhlrltancl end EI'I'I '1M" (REV-ISIS'. Applications .r. Ivallabl' at thl O,.lcI of t~. Rlgl.tar of willi, ony .f .h. ,) R.y.nu. DI..rlc' Dfflc., .r fr.' .h. B.p.r...n". ,'-hour .n...rln. ..rylc. nuab.r. f.r I.r.. .rd.rln.. In p.nnlylvenl1 1-800-S6Z-io50, outllda pennsvlvenla and within 10cIl Harrl,burg .r.. (717) 781.a09', 1001 (717) 77'''US2 (H..rlnG l~.lrad Only). DlJECTIONS. Any p.rty In Int.r..t n.t ..tl.fl.d .I.h tho ........nt .f t., .. .h... .n .hl. n.'lc, ..y .."c' wllhln .Ixty l6D) dlY' of r,cIlpt of thl. Hatlc. by1 .-wrIU.n pr."" .. .h. PA B.Por"on' .f R.y.nu.. ....d .f Appul.. D.P'. ZlI02I. 1I...llbur.. PA l11Z1-IDZI. OR --.I.ctln. to have the ..tt.r deterelned .t audit of the p.rson.l r.presentatlv., OR --appe.1 to the Orphan.- Court. ADMIN- ISTRATIVE CORRECTIONS. F...u.1 .rr.r. dl.c.y.r.d .n .hl. ........nt .hoUld .. .ddr....d In writing ... PA D.p.r...n' .f R.y,"" Bur'eo of Indlvldu.1 T._", ATTNI po.t A.......nt Revl.w unit, D.pt. 280601. Harrl'bur.. PA 11128-0601, Phon. el11) 787-6505. S.. page 5 of the bookl.t ~In.tructlonl for Inh.rltane. TlX R.turn for' R..ld.nt nee.dant~ CREY-ISOI) for an .xplen.tlon of edelnl.tr.tlvlly corr.ctlbl. .rror.. PEHAL TV I Th. ISX t., ......y non-p.rtlclp..lon p...lty I. c......d on .h. ....1 .f .h. .., ond Int.r..' .......d. ond n.' p.ld ..f.r. Jonu.ry ". \..6. .h. fir" d.y .f..r tho .nd .f .h. ... ......y p.rl.d. Thl. n.n-p.r.lclp."on p.n.lty I. .pp..I..l. In .h. .... .....r ond In tho tho .... .1.. p.rl.d .. you would .pp..1 tho ... ond In..r..' th.t h" b..n .......d a. Indlc.t.d on thl, natlel. For d.t.. af d..th an or .ft.r 10-5-91, Plnn.ylvanla E.t.t. Tax ba..d on the F.der.1 Elt.t. T.x r.turn b.ea... d.llnqu.nt at the .xplratlon of nln. (09) eon'hl fro' thl d.t. of dl.th. IHTERESH For d.t.. of d..th prior ta 10-]-91. pennlylvanl. Eltat. Tax ba.ed on the Fldlr.l E,t.ta Tlx r.turn bleo'" dallnquent at thl Ixplratlan of Ilght,ln (18) lonth' frol the data of death. T.xa. which ble..a dallnquent blforl January 1, 1982 bl.r Int.ra,t at thl r.t. of .Ix (6Xl percent p.r annul calculated at . dailY rat. af .00016'. All tax" which blea.. dlllnqu.nt on ar .ft.r Janu.ry 1, 198t will bier lnt.ra.t at a r.t. which will vary 'roe c.land.r y.ar to cII.ndar y..r with that r.t. 8nMOUMC.d by the PA nlp.rt,,"t of R.vlnu', Thl appllceble Int.rl.t r.t.. for 1912 through 1991 erl' Vllr Intarl.t Ratl Dilly Int.r.st Factor Vier lnterllt R.tl D.lly lntarllt Flctar "12 laX .000S4a ""7 'X .oaoZ'-7 19as 16X .ooaua 198a-1991 \IX .00asOl 198" \IX .000301 199' .X .nozn 1915 UX .000556 1995-1994 1X .000191 1966 lOX .000114 1995-1997 'X .ooozn --Int.rllt I. calcul.t.d .. fallowlI INTEREST s BALANCE OF TAX UNPAID X NU"BER DF DAYB DELINQUENT X DAILY INTEREST FACTOR --Any HatlCI IlIuad .ftar thl tax beco... dlllnquent wlll rafllct w\ Intarllt ulcul.tlon to flft.an US) day. blyond the detl of the ........nt. If p.y.ent I. ,Ida .ft.r the Int.r..t coaputltlon dete .hown on thl Hotlc., additional Intlr..t .u.t bI cllculatad. Ij - 1;/9 - 3 BUREAU OF INDIVIDUAL TAXES INIlERITANCC TAX DIVISION DEPT 2.0001 ItARlllSBURO, PA 1112.,0601 , COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE I.: t' t<_) NOTICE OF INHERITANCE TAX APPRAISEMENT. AllOWANCE OR OISAllOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NO. COUNTY ACN 1/15!98 Thelma K. Ryan 101 2196.0769 Cumberland 101 Nell Hendershot Esq. GOldberg, Katzman & Shipman, P. C. 320 Market 51., PO Box 1268 Harrisburg PA 17108.1268 Amount Remllled c '* 1U\t.l""UI" "111'C1 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: Rogl.tor or Will. Cumborland County Courthou.o Carll.'o, PA 17013 CUT ALONG THIS LINE Q RETAIN LOWER PORTION FOR YOUR RECORDS ~ -~V~~fE~Oe~7)WC)-----NOT~EOFmHEmTANCETAXA~RAffiEMENT~AUOWANCEOR----------------. DISAllOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF Thelma K. Ryan FilE NO. 2196'()769 ACN 101 DATE 1116198 TAll RETURN liAS: (D) ACCEPTED AS FllEO ( B ) CHANGED RESERVA TION CONCERNING FUTURE INTEREST. SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel E.tate (Schedule A) 2. Stocks and 80nds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/80nk Deposits/ Misc. Personal Property (Schedule El 6. Jointly Owned Property (Schedule Fl 7. Tronsfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funerol ExpenseS/Adm. Costs/Misc. Expenses (Schedulo H) (9) 76,122.40 10. Debts/Mortg0ge Llobllltles/Liens (Schedule 11 (10) 3,795.95 11. Totol Deductions (11) 79,918.35 12. Net Value of Tax Return (12) 893,319.60 13. Charltable/Gover"""ntal 8equests (Schedule J) (131 689.910.60 14. Net Value of Estote Subject to Tox (141 203,409.00 NOTE: II an ass.ssm.nt was Issuod pr.vlously, lines 14. 15 and/or 18. 17 and 18 will r.fI.ct figures Ihallnclude Ih. lotal of All r.lurns as.....d to dat.. TOTAL TAX CREDIT 26,315.79 BALANCE OF TAX DUE 4,195.56 INTEREST 251.82 TOTAL DUE 4,447.38 (IF TOTAL DUE IS LESS THAN Sl, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A CREDIT (CR1, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) (1) (2) I3l (4) (51 (61 (7) 0.00 816,563.09 0.00 0.00 156,674.86 0.00 0.00 (81 ASSESSMENT OF TAX: 15. Amount of line 14 at Spousal rate 16. Amount on Line 14 tOMoble at Lineal/Closs A rote 17. Amount of line 14 taxoble at Collateral/Closs 8 rote 18. Principal Tax Due TAX CREOITS: PAYMENT DATE 12/1/96 (151 (16) (17) 0.00 0.00 203,409.00 X .00= X .06 = X .15 = (18) RECEIPT NUN ER AA18 956 DISCOUNT (+1 INTEREST/PEN PAID (.) 1,315.79 AHOlRIT PAID 25,000.00 Interest has been ch8rg~ at the applicable rotes os shown on the reverse side of this form from June 15, 1997 to February 13, 1998. . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. NOTE: To Inlure proper credit to your Iccount. lubmlt the upper portion of this form with your tail payment. 973,237.95 0.00 0.00 30,511.35 30,511.35 i . RESERVATION: Estates of decedents dying on or before December 12, 1982 _ if any future inlerest in the estate is transferred in possession or onjoyment to Clall B (collateral) benefICiaries of the decedenlaner the expiration 01 any estate for life or for yearJ. the Commonwealth hereby 811Pf8SSly relervn the nghllo appraise and aSless transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future Interest. PURPOSE OF NOnCE: To tulflll the requirements of Section 2'.0 oltha Inheritance and Estate Tax Act. Act 22 of 1991. 72 P.S. Section 2'.0. PAYMENT: Detach the top portiOn of this Notice and submit with your payment 10 the Register of Wills pnnted on the reverse side. Make check or money order payable to: REOISTER OF WillS, AGENT, REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return. may be requesled by completing an -Application for Refund of Penn.yl....nia Inheritance and Estate Tox (RCV.1313). Appllcauons are available at the OfFIce of the Register of 'Mils or any of the 23 Revenue District OrrlCel, or by calling the spedal24.hOur answering service numbers for forms ordering: In PennsylvanIa 1.800.362.20SO. outside Pennsylvania and within local Harriaburg area (717) 707.0094, TOO. (717) 772.2252 (Hearing Impaired On~), OBJECTIONS: Any party In Interest not satisfied with the appraisement. allowance or disallowance of deducoons. or assessment 01 tax (Induding discount OlintereSl) 81 shown on this Notice must object within sixty (60) days of receipt of this Notice by: -wrinen protest to the PA Department of Revenue Board 01 Appeals, Dept. 281021, Harrisburg. PA 17128.1021, OR -election to have the matter determined at audit of the account or the perlOn8l representative OR -appeal to the Orphans' Court. ADMINISTRATJVn CORRECTIONS: Factual errors discovered on this assessment should be addressed In writing to: PA Department 01 Revenue. Bureau of Individual Tales, AnN: Post A....sment Re~ew Uni\ Depl 200601 Harri.burg, PA 17120.(l601 Phone (717) 101-6505, See page 3 of the booklet "In.tJUcbOn. for Inhenlance Ta' Return for a Resident Decedenr (REV. 1501) tor an elplanation of administratively correctable errors. INTEREST: If any tax duel. paid within three (3) calendar month. aner the decedent. death a flVO percent (5\\) dIscount 01 the la, paid i. allowed, The 15% tax amnesty non-participation penalty Is computed on the total of the tax and Interest assessed. and not paid before January 18,1996, the first day after the end 01 the tax amnesty period. This non.partiCipation penalty Is appealable in the same manner and In the lime time period as you would appeal the I3x and Interest that has been assessed as Indated on this notice. Interest Is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment T.lel which became delinquent bef04'8 January 1. 1982 bear Interest at the rate of six (6%) percent per annum calculated at a dally rate or .000164. Ah talel which became delinquent on and after January 1. 1982 will bearlnlerest at 8 rate which will vary from calendar year to calendar yearwilh that rale announced by the PA Department of Revenue. The applicable Interest rates for 1982 through 1997 are: DISCQUNT: PENAL TV: YEAR INTEREST RATE DAtl Y INTEREST FACTOR YEAR INTEREST RATE OAllY INTERESTFACTOR 1902 20\\ ,000540 1907 9\\ ,000247 1993 19\\ ,000430 1908-1991 11\\ ,000301 1984 11\\ ,000301 1992 9\\ 000247 1905 13\\ ,000350 1993.199' 1\\ ,000192 1900 10\\ ,000214 1995.1997 9\\ 000241 -Interest is calculated as fOllows: INTEREST' BAlANCE OFTAX UNPAID X NUMBER OF DAYS OHlNQUENT X DAtlY tNTERESTFACTOR -Any Notice issued after the tax becomes delinquent will renect Dn Interest calculatiOn to fifteen (15) days beyond the date of the 8ntnment If Plymtnt Is made after the Interest computation date shown on the Notice. additionallnlerest must be calculated. .....,..,,,..'"~.........,.._., '"' :.'-.- ~ -.. PROBATE tlI JBA 0 OATE'1'15198 RI'IUIOU""1 . INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES OEPT 280001 ttARRISBURO PA 17128,0001 OECEOENrS NAME FILE NUMBER Thelma K. Ryan 2196-0769 ACN 101 SCHEDULE ITEM EXPLANATION OF CHANGES NO. Tax has been calculated as follows: Tax Net Estate $893,319.60 Specific Bequests at 15% 203.409,00 $30,511.35 Residue to Charity $689,910.60 .00 Total Tax Due $30,511.35 TAX EXAMINER: Shawn E. Young PAGE 1 ~~ 1fJjf)~ IlfV.l""u tM..rl II"(I . , . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF OEOUCTIONS ANO ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NO. COUNTY ACN 'i -J '7 . '.2, MAKE CHECK PAYABLE AND REMIT PAYMENT TO: R.glst.r of Wills Cumb.rland County Courthous. Carlisi.. PA 17013 CUT ALONG THIS LINE Q RETAIN LOWER PORTION FOR YOUR RECORDS (:I _~v~~fEXl06~n~CI-----NOT~EOF~HE~TANCETAXAPPRA~EMENT~A~OWANCEOR----------------. OISALLOWANCE OF DEDUCTIONS ANO ASSESSMENT OF TAX FILE NO. 2196-0769 ACN 101 TAX RETURN WAS: ((]) ACCEPTED AS FILEO ( ~ ) CHANGED RESERVATION CONCERNING FUTURE INTEREST. SEE REVERSE APPRAISEO VALUE OF RETURN BAS EO ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule Bl 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (scheduLe D) 5. Cash/Bank Deposits/ Misc. Personal Property (schedule E) 6. Jointly Owned Property (Schedule Fl 7. Transfers (Schedule G) 8. Toul Assets APPROVED DEDUCTIONS ANO EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (91 76,122.40 10. Debts/Hort9age Liabilities/Liens (Schedule I) (10) 3,795.95 11. Total Deductions (11) 79,918.35 12. Net V.lue of Tax Return <121 893,319.60 13. Charitable/Governmental Bequests (Schedule J) (13) 689,910.60 14. Net V.lue of Estate Subject to Tax (141 203,409.00 NOTE: If an a.....m.nt w.. Is.u.d pr.vlou.ly, lines 14, 15 and/or 16, 17 and 18 will r.fI.ct flgur.. that Includ. th. total of ALL r.turn. .......d to dat.. TOTAL TAX CREOIT 26,315.79 BALANCE OF TAX DUE 4,195.56 INTEREST 251.82 TOTAL DUE 4,447.38 (IF 10TAL DUE IS LES5 THAN Sl, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU KAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) BUREAU OF INDIVIOUAL TAXES INHERITANCE TAX DIVISION OEPT 280601 HARRISDURG. PA 17128.0601 Nell Hendershot Esq. Goldberg, Katzman & Shipman, P. c. 320 Market St., PO Box 1268 Harrisburg PA 17108.1268 ESTATE OF Th.lma K. Ryan ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount on Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 taxable at Collateral/Class 8 rate 18. Principal TaX Due TAX CREDITS: PAYMENT DATE 1211/96 RECEIPT NlJ48ER AA185956 DISCOUNT (+1 INTEREST/PEN PAID ('1 1,315.79 Interest has been charged at the applicable rates as shown on the reverse side of this form from June 15, 1997 to February 13, 1998. . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 1/15/98 Tholma K. Ryan 101 2196-0769 Cumborland 101 Amount R,mltt,d DATE 1/15/9B (1) (2) (3) (4) (5) (61 (7) 0.00 816,563.09 0.00 0.00 156,674.86 0.00 0.00 (8) NOTE: To Inlure proper credit to your account. submit thl upper portJon 01 this form with your tax payment. 973.237.95 (15) (16) (17) 0.00 0.00 201,409.00 X .00= X .06 = X .15 = (18) 0.00 0.00 10,511.35 10,511.35 ~OUNT PAID 25,000.00 JAN 1 9 1998 /:;,-/;N '-:~ COHHONW!ALTH OF P!NNSVLVANIA DEPARTH!NT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' BUREAU OF INOIVIOUAL TAXES INlIUUUNC[ IU DIVISION DlPl. :10.01 ItARAISlUMG, ,., 1111.-0.01 "1,1'" II "' III-tll NEIL HENDERSHOT GOLDBERG ETAL PO BOX 1268 HBG ESQ OAT! ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 03-16-98 RYAN 09-14-96 21 96-0769 CUHBERLAND 101 THELHA K Anaunt Rell1 U.d PA 17108 HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 HOTE: To insure proper credit to your .ccount, subllit the upper portion of this forn with your tex pay.ant. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ Rifv:i6Cij-Eif-AFfi-foi-:97i-------...--iNttERiifANcif-rA"i-sTiifEHifNr-CiF-Ac:Couiif--.-..--------------------- ESTATE OF RYAN THELMA K FILE NO. 21 96-0769 ACN 101 DATE 03-16-98 THIS STATEHENT IS PROVIOED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS. THE CURRENT BALANCE. ANO. IF APPLICABLE. A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-15-98 PRINCIPAL TAX DUE. 30.511.35 PAYMENTS (TAX CREDITS): PAYMENT DATE 12-01-96 01-23-98 RECEIPT NUMBER AA1849"56 ,-- AA242688 DISCOUNT (+) INTEREST/PEN PAID (-) 1,315.79 231.10- 25.000.00 4.447.38 AMOUNT PAID ,'" -. -, '-,,-.., TOTAL TAX CREDIT 30.532.07 20.72CR BALANCE OF TAX DUE INTEREST AND PEN. .00 20.72CR TOTAL DUE . IF PAID AFTER THIS DATE. SEE REVERSE SIDE FOR CALCULATION OF ADOITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1. NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REflECTED AS A "CREDIT" (CRI. YOU HAY BE DUE A REFUNO. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I PAY"EHT I Detach the top portion of thh Notlu and sub.U with your pay..nt .adl payabh to the na.. and address printed on the rlverse sid.. If RESIDENT DECEDENT ..ke check or .on.., order Plyabll tal REGISTER OF WILLS, AGENT. If NON-RESIDENT DECEDENT IlIke check or laney order payabll tal COHHONWEALTH OF PENNSYLVANIA. REFUND CCR)I A refund of a tax credit, which will not nquuted on thl Tax Rlturn. ..ay b. nquuted by co.pletlng en "j,ppl1caUon for R.fund of PeMsylvanl. Inhlrltence end Estat. lex" (REV~UI3). APplications are av.lhble at the Office of thl Register of Wills, any of the 23 Revlnue Dhtrlct Offtcu or frol tM OIPlrt.lnt's Zit-hour an,werlng 'ervlce nuaber. for for.. ordering I In Plnnsylvanla 1~8D0-36Z~2050, outsidl PIMlYlvanla and within 10cel Harrisburg ar.a (711) 737-8094, TDD' (717) 772~2252 CHearlng I.palr.d only)_ REPLY Tal Qul,tlon. rlgllrdlng .rrors contaln.d on this notice should bl .ddr....d tal PA DIPllrt.ent of Rlvlnul, Burlau of Indlvhtual Tanl, ATTHl Post A.......nt RIVII" Unit, aept. 280601. Harrisburg, PA 111l8-0601, phonl (717) 187~6505. DISCOUNT I If any till( due Is p.ld within three U) calonder .onths after thl dlc.dent's dlath, II flvl perunt C5:0 discount of the talC paid Is allowld. PENal TY I Thl ISX talC a.n..ty non-participation pinal tv Is co.putld on thl total of the talC IInd Inter..t .u....d. and not p.ld be fan Januar., 18, 1996, thl first d.y aft.r thl end of the t.1C aanllty p.rlod. INTEREST I Intere.t Is chargld blglnnlng with first day of dlllnqulncy, or nlnl (9) eonth. and on. (I) day fro. the date of dlath, to the dati of pay..nt. T.MIS which blca.. d.llnqu.nt b.fore January I, 1982 b..r Int.rest .t the rate of sIM (6X) parclnt par annul calculat.d at a d.lly rat. of .000164. All ta..s which beclI.e dlllnqu.nt on and .fte" Janu."y I, 1932 will bea" Inte"..t at a "ata which will vary f"o. calond." "'1'" to callndiu" year with that rate announced by the PA aepa"taent of Rev.nul. The appl1cabll Intarut r:,tos for 1932 through 1998 at.: V.ar Intlrnt Ratl Dally Intlrnt Facto" Vear Int.".lt Rat. DailY Int.r.lt Factor 1982 20:C .000548 1937 9> ..:00:,.1 1933 16:C .000et38 1983.1991 11;( .000101 1984 In .000301 1992 .~ .0002et7 1985 U:C .000356 1993.1994 7X .000192 1936 lOX .000274 1995.1998 .~ .OQI;I;'" ulnt.,...t Is calculat.d .. folloWl1 INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Hotlc. Issu.d aft.r the tllll blcou. d.llnquent wUI rafl.ct an Int.,...t calculation to flfto.n Cl5) days blyond th. dat. of the a......."t. If pay..nt II ..de aftu the Internt co.putatlon dati lhown on thl Hotlc., additional Inte"..t .u.t b. c.lculat.d. 6/11q~3 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIYISION PEP,. za0601 HARRISBURC, PA 17128.0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT c..- * 1I,.unn ,,, 111."1 NEIL HENDERSHOT GOLDBERG ETAL PO BOX 1268 HBG ESQ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-27-1998 RYAN 09-14-1996 21 96-0769 CUMBERLAND 101 THELMA K A.aunt R..ltt.d PA 17108 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE. PA 17013 HOTE: To Insure proper credit to your account, sub.it the upper portion of this fo~ with your tax pay..nt. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REv=i6o.rEif-AFP-iji3':97y------...--iHH€RITANc'E-iiix-sTATEiiEHi-oF'-Acciiiiiir--ii..--------------------- ESTATE OF RYAN THELMA K FILE NO.21 96-0769 ACN 101 DATE 07-27-1998 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHEO ESTATE. SHOWN BELOM IS A SUKHARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE. AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT: 01-15-1998 PRINCIPAL TAX DUE:, 30 .511.35 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-01-1996 AA184956 1,315.79 25.000.00 01-23-1998 AA242688 231.10- 4.447.38 07-13-1998 REFUND .00 20.72- (V) :---; .- :~.. " -~ ,.., ~:-:2 '. ct -- ,- ':.. ~ , -' '..>C TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 30,511.35 on .00 .00 .00 . IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1. NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREon" (CRI. YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I PAYltEHTI o.tech the top porUon of this Hotle. and .ub.lt ..lth your pay.ant ..da paylJblo to the nua and addre.. printed on the rever.. ald.. If RESIDENT DECEDENT uk. chock or ltOMy order paYable to: REGISTER OF WILLS, AGENT. If HOH~RESIDENT DECEDENT .... ch.ck or aonay ordar paYable to: COHHONWEAlTH OF PENNSVLVANIA. REFUND (CR)s A r.fund of a ta. cr.dlt, ..hlch .... not r.qua.ted on the T.. Return, .ay be roqua.tad by coopl.tlng an -Application for R.fund of P.nn'Ylvanla Inheritance end E.tat. t..- (REY~1313). Appllc.tlon. .re .vallable at the Office of the Ragl,t.r of Will., any of the 23 Rav.nu8 DI.trlct Dfflca. or fro. the Dap.rtaent', 2~.hour an....rlng .arvlc. nuaber. for for.. ordarlng: In Pennsylvanl. l.eOO.36Z-Z050, out.lde P.nn.ylvanla and ..Ithln loc.l Harrl.burg .r.. (717) 787~e09~, TOOl (717) 712.225Z (H.arlng lapalr.d only). REPLV TO: Qu..tlons r.gardlng .rror. contain.d on thl. notlc. .hould ba .ddr....d to: PA Departeant of Ravenue, Bur.au of Individual T...., ATTH: po.t A.......nt R.vlaw unit, Dept. Z8060l, Harrl.burg, PA l71ze.0601, phona (717) 787.6505. DISCOllCT: If any t.. due I. paid ..Ithln thr.. (]) cal.ndar aonth. .ft.r tho d.c.dant'. ~.th, a flv. parcant (SX) dl.count of the t.. paid I. .llow.d. PEHAlTY: The 15X ta. aana.ty non.partlclpatlon panalty I. cooput.d on the total of the t.. and Intere.t ....'..d, and not paid before January 18, 1996, the flr.t day .ft.r tho and of the t.. aan..ty parlod. INTEREST: Jntar..t I. charg.d beginning ..Ith flrat day of dallnquancy, or nlna (9) eonths and ana (1) day fro. the d.t. of death, to the date of paye.nt. t.... which b.ca.a d.llnqu.nt b.fora January I, 198Z b.ar Int.r..t .t tha rat. of sl. (6XI percent par annua c.lcul.ted .t . dally rat. of .0001~. All t.... ..hlch becue dallnquent on and .fter January 1, 198Z ..Ill bear Int.r..t at a r.t. which ..Ill vary fro. c.l.ndar y.ar to c.l.ndar y..r ..Ith that rat. announc.d by the PA Dep.rt..nt of R.v.nue. Th. .pplicable Interest rat.. for 193Z through 1998 .ra: V..r Int.r.st Rat. Dally Intera.t Factor V.ar Inbr..t Rate D.lly Intarest Factor 198Z Z.~ .0005~8 1937 9~ .000Z~7 1983 I'~ .000~]8 19a8~1991 llZ .000301 1964 IU ~OOO301 1992 .. .000247 1935 U~ .00D3S6 1993.199~ 1> .000192 1936 IOZ .OOD27~ 1995~1998 9~ .0002...7 nJntara.t Is celeulated ft. follows: INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ~~Any Hotlca I..ued aft.r the ta. baco.., d.llnqu.nt will r.fl.ct an Intar..t calculation to flft..n (IS) day. beyond the data of the as.....ant. If pay..nt I. .ad. .ft.r the Int.r..t coaputatlon data shown on the HoUc., eddltlonel Inter..t w.t b. calculat.d. ;5 - / ,J. () ~ 3 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF DETERHINATION AND ASSESSHENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN ('-" * BUREAU OF INDIVIDUAL TAXES lteERlTAHCt TAX DIVISION DOT. 2'10601 twtRlSlURC, PA l1ltl"OUt NEIL HENDERSHOT ESQ GOLDBERG ETAL PO BOX 1268 HBG PA 17108 1".'"11'''111.''' 04-27-98 RYAN 09-14-96 21 96-0769 CUHBERLAND 202 THELMA K A.aunt R..ltt.d HAKE CHECK PAYABLE AND REHIT PAYHENT TO: ESTATE OF RYAN THELMA K FILE NO.21 96-0769 REGISTER OF WILLS CUM8ERLAND CO COURT HOUSE CARLISLE, PA 17013 HOTEt To inaure proper credit to your account, sub_it the upper portion of this for_ with your tax pay..nt. CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR FILES ..... R-EV:7jj;-EX--AFP--foj-:97j-----~-.-Niiiicif-OF--UETE-RHiiiATiiiN-Aiiu-AllSESllHENif---------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER .. ESTATE TAX DETERMINATION 1. Credit For Stete Death Taxes as Verified ACN 202 DATE 04-27-98 .00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 29,195.56 3. Inheritance Tax Assessad by Other States or Territories of the United States (Excluding Discount and/or Interest) 4. Total Inheritance Tax Assessed 5. Pennsylvania Estate Tax Due 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return 7. Additional Pennsylvania Estate Tax Due TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) .00 29,195.56 .00 .00 .00 AMOUNT "'2, :D~ ctJ n ~'-: r.. . ~ ~ (-: ( ~-' \; oJ l :uc.. )., ;~ TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE. SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN fl. NO PAYMENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TNIS FORM FOR INSTRUCTIONS.) ~.. '" P\lRPOSf; OF NOTlCEI la fulfill the requlrll~tl of Slctlon 2145 (b) of the Inherltencl end Elt.tl 'ax Act, Act 11 of 1995. (11 P.S. SecUon 91<<15). PAvt€H'T1 Oetech the top parUon of this NoUce end lutMllt ..Ith your p.'fII~t to the Reolstlr of willi printed on the rlvlrSI "de. "akl chKk or .oneY order p.yeb11 tal REGISTER OF MILLS, AGENT. OIA.CTlOHSI Any p.rty In Intlr..t not ..U.fled ..Ith the ...I..Mnt of tax a. shOWn on this noUce .ay object ..Ithln .l.ty (60) day. of recalpt of thl. Hatlca byl --wdtten prat..t to tha PA Depart.~t of Revenutl, Board of Appdh, DePt. 281021, Harrisburll, PA l1U8-1U1, OR .-alectlnt to havI the .athr dltlralned .t eudlt of \hi ~r'anll nprl.entIU"I, OR --appall to tM Orphens. Court A rlflnl of I \I. creell t a.y bI rlquasted by ca.,IIUng en "ApplicaUon far R.flnl of pennsylvanl. Inhlrltenca end E,tlta ,.... (REV-1Sl]). Appllcl~lon. ar. Ivallabll at the OffiCI of thl Rlgl.tar of Wills, eny of thl IS Alvenue Dlltrlct OffiCI' or fr~ thl D~.rt.."t.. 1<<1-hour an.w.rlnll s.rvlcl ~rl far far.' ard.rlngl In pennsy1venla 1_800_161_1050, out. Ida penn.ylvanla and ..Ithln local Harrisburg ar.a (117) 117-8094, TDDI (117) 771-2152 (Hearing I~alr.d Only). REfU(D (tA) I AIlIlIN- ISTAATlVE CORRECTIONS I Factual Irrar. dlscavlred on thl. .......ant shollld be Bddru.eeI In ..rlUng tal PA DePart.ant of R.vllnUl, Bur.au of IndividUal '..IS, ATTNI pa.t A...s...nt A.vl... unit, a.pt. 110601, Harrisburg, PA 1711a-0601, Phone (717) 187-6505. 5.. page 5 of the boOkl.t "Instruction I far Inh.rltanc. la. R.turn far I R.sldant o.cedant- (REV-1S01) far an ..planatlon of adalnl.tr.tlv.lY correctabl. .rrort. PEMAL TVI The 1S% tax aana'lY non-partIclpaUon f*\81lY Is clHIIIUteel on thI total of the tax end Int.r.st ......eet, WMI not paid before January la, 1996, the flrst day aftlr thl end of the talC ...,a.lY period. Thlt non-parUclpatlon panaltY II app.alabll In the .... .annar and In the thl ._ tI.. period .1 you would epplal thl tax and Intarut that hal b.en ......ad IS Indlcat.d on thla notlc.. Addltlonel pennsylvania E.t.t. ,.. .,SISSad .. . ra.ult of a chang. on thl Fad.ral Eat.tl la. closing I.tt.r beCDIHI' dllinquent ..t the l.plrat1on of ana (1) aonth frOll thl date the fln.1 notlCI of the lner..sl In Fld.ral Estltl T.lC I. rae.heel. T.... which bee'" delinquent befarl Jenuary I, 1982 blar Interest .t thl rata of .IM (6X) percent par annua c.lculatld at a d.lly rlta of ,00016<<1. All talCIS which bee_ delinquent on or .ft.r January I, 1982 will blar Inter..t .t . rata which will vary fro. calendar Ylar to calendar Ylar ..Ith that r.t. announced by the PA Dapartaant of Alvenue. 'hi appliCable Intlrlst ratls far 1982 through 1998 aral ~ Intlrl.t Aata Deily tnt.rlst facto~ ~ Intlrut Rat. Dally Intlralt factor 1912 'OX .ooo~a 1'117 9X ,OOOZIt7 19as lOX .oousa 19aa-I991 \IX ,OOOSOI 1914 IIX .ooasOI I'" 9X .OOOZU 1985 UX .000156 1991-1994 7X .000191 19" I'X .000274 1995-1'"8 9X .OOOZU --Intlrllt II celculatld .. fallow" INTEREST . BALANCE OF TAX UNPAID K HUftBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice l..uacI aftlr the taM bKOMI delinquent ..111 rlflect an Intln.t calculltlon to flft..., US) da.,1 be.,ond thl data of the a"IISHRt. If pay.ant II lade Iftlr the Intlrnt c.,.putatlon d.t. IhotIn on tM Notice, additional lntlr..t wst be calcullt~. INTEREST I Register of Wills of CUMIIER1.ANIl County, Pennsylvania INVENTORY Estal. 01 Tholma K. Ryan No, 1996-00769 also known as Oal. 01 O.ath 09/11,/1996 .O.c.asod Social SeculIly No, 056.09.3830 Cathorine Mann and Harry B. Goldborg Esq. , Personal Represlntativ.(s) 01 the aboye Estate, deceased. verify that the items appearing in tho following Inventory include all 01 the personal assets wherever situate and all 01 the real estate In the Commonwealth 01 Pennsylvania 01 said Decedent. thallhe valuation placed opposite each item of said Inventory represents its 'air valult as 01 the date of tho Decedent's death, and that Decedent owned no real.state outside of the Commonweatth 01 Pennsylvania except that which appears in a memorandum at the end of this Inventory. I m. verify that Ihe statoments made In thIs Inventory are truB and correct. INle understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to author~ies. Name 01 Noll Hendershot Esq. Signature: Attorney: 1,0, No,: 23316 Signature: sq. Address: 320 Market St, PO Box 1268 Address: Harrisburg, PA 17108-1268 T.lephone: 717 /23/,-4161 Telephone: Oaled: 06/13/1997 Description Value (Soe continuation page(s) attached) (Attach addttional sheels K necessary) Tolal, 971,173.95 NOTE: The Memorandum or real estate outside the Commonwealth 01 Pennsylvania may. at the election of the personal representative, include the value 01 each item. but such ligures should not be eKtended inlo the lotal 01 the Invenlory. Ptepirtd by Ihe Pennsylv.nl. Bit Aslocl.tlon Copyrlghl Ie) 1996 form softw.re onty CPSyslems,lnc. Form tlRW-7 (1992) 0 i~' ~ . ~I: U (.."; 1'1 n.. CO .- - ~:; '~, ~c.; ,- n)::; a: !J' uO Dauphin Depoalt Bank and Truot Company' Savlngo account 05700404001, Bccruod Interest valued per bank let ter 4.56 Diocese of Rockvllle Centro Refund of health Insurance premium 110.40 Diocese of Rockvllle Centre Reimbursement of medical expenses 768.20 PNC Bank, N.A. - Certificate of Deposit 021001019869, titled in decedent's name alone, principal balance valued per bank letter 50,000.00 PNC Bank, N.A. - Certificate of Deposit 021001019869, accrued interest, valued per bank letter 60.79 PNC Bank, N.A. - Checking account 05140168828, titled in Decedent's name alone, principal balance valued per bank letter 59,242.93 PNC Bank, N.A. . Checking account 05140168828, accrued interest, valued per bank letter 15.37 ........................ 153,265.86 -2- PERSONAL PROPERTY: ................... Decedent'e vehicle. 1984 Oldsmobile Cutlass Supremo, in poor condition, valued per Amorica Online's Autovantage Services. 1,200.00 Personal Property . Miscellaneous furnishings in Decedent's rentBl residential property located in Noyack, New York, valued per appraisal 145.00 ................... 1,345.00 STOCKS/LISTED: ...................... 100 Consolidated Edison of New York, Inc. - shares of common stock, valued per custodian letter 2,806.25 Dreyfus Money Market Covernment Series - Investment Account 0008-0000434217, with date of death balance valued per investment fund letter 29,122.40 Dreyfus Money Market Covernment Series . Investment Account 0008-0000434217, accrued dividends. 53.05 -3 - .' ~ U.S. Treasury Bill - U.S. Treasury obligation, $100,000.00 face amount, with 13-week maturity, valued per public pricings. 9B,750.00 U.S. Treasury Bill - U.S. Treasury obligation, $100,000.00 face amount, with 13-week maturity, valued per public prictngs. 99,650.00 .................. 654,900.00 ..................... TOTAL RECEIPTS OF PRINCIPAL............... 971,173.95 ---------------- MEMORA.'lDUM OF REAL ESTATE OUTSIDE THE COMMO~EALTH OF PEmlSYLVA.'lIA Rental residential property located at 4406 Anchor Road, ~oyack, Suffolk County, ~ew York. valued per actual sale to Richard M. Henn and Margaret Wils-Henn, as closed May 23, 1997, consistent with real estate appraisal 107,000.00 -5- STATUS l~m>>Olrr UNl>lm l(UtE 6,11 Name of Decedent: TIIEJ.MA K. IWAN Date of Death: Scptcmhcr 14. 1996 Will No. Admin. 1996-00769 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following wilh respect to completion of the administration of the above-captioned estate: 1. State Whether adminislration of the estllle is complete: Yes No X 2. If the answer is No, stale when the personal representative reasonably believes that the :Idministnltion will be complete: March 14. 2000 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account wilh the Court'! Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative Slale an account informally to the parties in interest'! Yes No d. Copies of receipts, releases, joinders and approvals of formal or information accounts may be filed wilh the Clerk of the Orphans' Courl and may be attached to eporl. Date: ~~, /'1'i ( / Neil Hendershot. Eso. Goldher!!. Katzman & Shinman. P.C. 320 Market Street. P.O. Box 1268 Harrishurl!. PA 17108-1268 (7 J7) 234-4161 Capacily: Personal Representative X Counsel for personal rcprescntative " STATUS HEI'OJrJ' (INnEI~ IUlI.E (',12 Namc of Dcccdcnt: TIIEI.J\lA K. RYAN Datc of Dcath: SClltcmhcr 14. IlJCJ6 Will No, Admin, IlJ96-0076lJ Pursuant to Rulc 6.12 ofthc Suprcme Court Orphans' Court Rules, I rcport the following with rcspect to complction ofthc administration of the above-captioned estatc: I, State whcthcr administration of the cstatc is complcte: Ycs X No 2. Ifthc anslI'cr is No, sl<ltc whcnlhc pcrsonal rcprcscntative reasonably bclicvcs that the administration will be complete: 3, If the answcr to No.1 is Yes, state the following: a, Did the personal representative tile a final account with the Court? Ycs No X b, The separate Orphans' Court No. (if any) for the personal representative's account is: c, Did the personal rcpresentative state an account informally to the parties in intcrcst? Yes X No Datc: d, Copics of receipts, releascs, joinders and approvals of formal or inlormation accounts may be filed with the Clerk of the Orphans' Court and may be attached to this rejlort{ ( / /)/ . G J. 7/ C I -/. -....17 /) Signature . j John DeLorenzo. Es()uirc Goldberu. Katzman 8:. Shillman. P,c. 320 Market Street. 1',0, Box 1268 Ilarrishuru. I' A 17108.1268 (717) 234.4161 Capacity: Pcrsonal Reprcsentativc X Counscl for Jlcrsonal rcprescntative