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HomeMy WebLinkAbout99-0509 Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Robert C. Donson Date of Death: 04/30/1999 File Number: 1999-00509 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: DYes 00 No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 04/30/2008 3. If the answer to NO.1 is YES, state the following: a. Did the personal representative file a final account with the Court? DYes 0 No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? DYes 0 No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date 1..;)))07 / / Capacity: 0 Personal Representative lXl Counsel Edward P. Seeber Name of Person Filing this Form 1205 Manor Drive, Ste 200 IS: I'l ,I'I--,ll.} (' \1 "j '" ,'" . c.,- cd". LUU(~ Address Mechanicsburg, PA 17055 City, State, Zip 717-766-9431 Form RW.fl)~e~~O:I~~' Telephone Copyright (c) 2006 form software only The Lackner Group, Inc, \ ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT TINA L BEAM 1350 WINDSOR ROAD MECHANICSBURG, PA 17050 -------- fold ESTATE INFORMATION: SSN: 175-40-5870 FILE NUMBER: 2199-0509 DECEDENT NAME: DONSON ROBERT C DA TE OF PAYMENT: 07/12/2007 POSTMARK DATE: 07/11/2007 COUNTY: CUMBERLAND DATE OF DEATH: 04/30/1999 NO. CD 008394 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $53.90 I I I I I I I I TOTAL AMOUNT PAID: $53.90 REMARKS: RECEIPT TO ATTORNEY CHECK# 503 INITIALS: AJW RECEIVED BY: SEAL REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS --.J 15[)5b[)41147 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes. ~ PO BOX.280601 ~ Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year INHERITANCE TAX RETURN nn RESIDENT DECEDENT a \ ~\ -\ File Number D5tf\ Date of Birth 175405870 04301999 06291949 Decedent's Last Name Suffix Decedent's First Name MI DONSON ROBERT C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW D 1. Original Return 9. Litigation Proceeds Received [!] D D D 4a. Future Interest Compromise (date of death after 12-12-82) 2. Supplemental Return D D 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4. Limited Estate [K] [K] 6. Decedent Died Testate (Attach Copy of Will) 7 Decedent Maintained a Living Trust . (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes 10 Spousal Poverty Credit (date of death . between 12-31-91 and 1-1-95) D 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) ~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ame Daytime Telephone Number EDWARD P. SEEBER 7177669431 Firm Name (If Applicable) PECHT & ASSOCIATES, PC 1205 MANOR DRIVE, STE 200 REGISTER OF WILLS \.@: ONLY = ,= -...J C- c: r- (J '-::;0 'j;g ;-i'-CJ ;:~;g \.../.... /'. N City or Post Office MECHANICSBURG State PA ZIP Code 17055 00 -0 Q~~ffi.ED :x '\.) --I ).:~ .., l' 1 ) , -) ~:J ) ':1~1 .J .:..-:> .-t _ c, . :J ,'- II ~../) ,-) . ',"t First line of address Second line of address .&:'" 0"' Correspondent's e-mail address:tseeber@pechtlaw.com Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct and com lete. Declaration of preparer other than the ersonal representative is based on all information of which preparer has any knowledge. ' SIGNATURE OF PERSON BIG E TE ADDRESS Edward P. Seeber 05 Manor Drive, Ste 200, Mechanicsburg, PA 17055 Side 1 L 15[)5b[)41147 15[)5b[)41147 --.J ---I 15[]5b[]42148 REV-1500 EX Decedent's Name: Robert C. Danson RECAPITULATION 1. Real Estate (Schedule A~.............................no..................................................... 1. 2. Stocks and Bonds (Schedule B~.......................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D)....................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E~.............. 5. 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested............. 7. 8. Total Gross Assets (total Lines 1-7)................................................................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H)...................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)............................... 10. 11. Total Deductions (total Lines 9 & 10~................................................................. 11. 12. Net Value of Estate (Line 8 minus Line 11)........................................................... 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J).............................................. 13. 14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2) X ~ 16. Amount of Line 14 taxable at lineal rate X .06 17. Amount of Line 1"4"taXable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 0.00 15. 898.33 16. 0.00 17. 0.00 18. 19. Tax Due.............................. n............................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15[]5b[]42148 Decedent's Social Security Number 175405870 1,580.00 1,580.00 ....~~._-----.,- 681.67 681.67 898.33 898.33 0.00 53.90 0.00 0.00 53.90 D 15[]5b[]42148 ---I REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Robert C. Donson STREET ADDRESS File Number f------ CITY I STATE PA [ZIP ----~ Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 53.90 3. InteresUPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) TotallnteresUPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theDVERPA YMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (3) (4) (5) (5A) (5B) 53.90 53.90 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;............................................................................. lJ b. retain the right to designate who shall use the property transferred or its income;................................ [J 0- c. retain a reversionary interest; 0[.........................................................................................__................ d. receive the promise for life of either payments, benefits or care?........................................................... D 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?................................................................................................................. D ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death.?....... [J ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which __ contains a beneficiary designation?................................................................................................................ D ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. No ~ ~ [!J r-' J<.J For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statutedoes not exemota transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. ~9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. ~9116 1.2) [72 P.S. ~9116 (a) (1)]. The tax rate imposed on the net value oftransfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. ~9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1508 EX+ (8-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONIM:ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Donson, Robert C. IFILE NUMBER ESTATE OF Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 H.K. Porter asbestos settlement litigation - a copy of the check dated June 18, 2007 is attached hereto PLEASE ABATE ALL INTEREST VALUE AT DATE OF DEATH 1.580.00 TOTAL (Also enter on Line 5, Recapitulation) 1.580.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1151 EX+ (12-99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONV\lEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Donson, Robert C. Debts of decedent must be reported on Schedule I. I FILE NUMBER ESTATE OF ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees Pecht & Associates, PC 125.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 556.67 TOTAL (Also enter on line 9, Recapitulation) 681.67 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (6-98) *' SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMON~LTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Donson, Robert C. IFILE NUMBER ESTATE OF ITEM NUMBER 1 DESCRIPTION Register of Wills, Cumberland County - filing fee for Inventory & Return AMOUNT 30.00 2 Shein Law Center, Ltd. - attorney fees for civil litigation 526.67 Subtotal 556.67 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) REV-1513 EX+ 19-00) *' SCHEDULE .. BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER 1 Donson, Robert C. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal aistributions, and transfers under Sec. 9116(a)(1.2)] Tina Beam-Klinefelter 1350 Windsor Road Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT Do Not List Trusteels) SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) NUMBER I. Daughter 1/2 of Residue 449.17 2 Alexander Donson 101 Milfording Road Mechanicsburg, PA 17050 Son 1/2 of residue 449.16 Total Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet 898.33 II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) STATEMENT OF SETTLEMENT RE: Estate of Robert Donson v. H.K. Porter GROSS AMOUNT OF SETTLEMENT: $1,580.00 LESS EXPENSES: $ -0- LESS ATTORNEY'S FEE: $ 526.67 NET FUND FOR PLAINTIFF: $1,053.33 Received from SHEIN LAW CENTER, LTD., the sum of$1,053.33 the same being in full settlement, satisfaction and payment of my/our claim against the above-named defendant, arising by reason of the alleged negligence of the defendant. I/W e hereby verify and confirm the above settlement which was made with my/our consent and approval and do hereby acknowledge receipt of a copy ofthis Statement of Settlement. And I/W e do hereby release and forever discharge the said SHEIN LAW CENTER, LTD., their heirs, executors, and administrators of and from all manner of actions, and causes of actions, suits, covenants, contracts, agreements, claims, and demands whatsoever, in law or equity especially arising from the prosecution of and settlement of the above suit of damages, which against the said SHEIN LAW CENTER, LTD., I/We ever had, now have, or which my/our heirs, executors, administrators or assigns hereafter can, shall or may have, for or by reason of any cause, matter or thing whatsoever. Tina Klinefelter, Extrx. Date WITNESS: SHEIN LAW CENTER, LTD. IOLTA ACCOUNT H.K. Porter .1:ffCiIk"'l_tJ.Jfo:ltlr'il:l~IIM:.l;:lh.I.::i'II.}~.~:I~;'ill"""_:.;:f""'l'''::&::l'':J=-.lllll':Ili''llf~:I.l~.'illll.=-'.:I.I:III=: SHEIN LAW CENTER, LTD. IOLTA ACCOUNT 121 S. BROAD STREET - 21ST FLOOR PHILADELPHIA, PA 19107 PNCBANK PNC Sank. Nm-t AsIodatiou Philadelphia, PA 3-5/310 PAY: $1,053.33 DATE 6/18/07 TO THE ORDER (;5~VL- OF Tina Klinefelter, Extrx. Estate of Robert Danson 1:1!......I.IIol.li'll=lI...f\lOUI"'Ii'~:I:::r.'t__'"i::l.'I-"ililrJ::aIN~...r.JII~:..l:C:.l;~~'"i..'"1E:I::l:-I~-I=I.I,T.'.'e1:a.I~.,:.l.:J:1,'.........l;ljlli.:II:OI:;:f', III 0 ~ 5 g 8 7111 I: 0 ~ ~ 0 0 0 0 5 ~ I: 8 b ~ 8 g g b 7 58111 SHEIN LAW CENTER, LTD. IOLTA ACCOUNT ,REORDER FROM YOUR LOCAL SAFEGUARD DISTRIBUTOR, IF UNKNOWN, 800-523-2422 35987 35987 NUMBER AMOUNT $1,053.33 {;:),,<,~J'c.(' ~<<..(j ,'>' J;;1<e: ' ~.fo~""(. a. 35987 HGM4lV0020000 197LCOO3345 . INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland Tina L. Beam Personal Representative(s) of the Estate of } SS } File Number 1999-00509 Robert C. Donson deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the R,ersonal assets wherever situate and all of the real estate in tlie Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears i a m mora m a! the end . inventory I verify that the statements made in this Inven- } tory are true and correct. I understand that false state- ments herein are made subject to the penalties of 18 Pa.C.S. 94904 relating to unsworn falsification to } authorities. Attorney - (Name) (Firm) (Address) (Telephone) Edward P. Seeber Pecht & Associates, PC 1205 Manor Drive, Ste 200, Mechanicsburg, PA 717-766-9431 (Supreme Court 1.0. No.) 76084 17055 PA FIGURES MUST BE TOTALED DECEDENTS SOC. SEC. NO. 175-40-5870 DATE OF DEATH 04/30/1999 LAST RESIDENCE Personal Property Cash............................................................................................... Personal Property......................................................................... Stocks/Listed................................................................................. Stocks/Closely Held...................................................................... Bonds............................................................................................. Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable............................................... All Other Property......................................................................... (") ~~:o <~:o . .;-0 , ~I.: <::2 ~~(:: h, 4:0 (j) 7-: 00 )O-n :,)Sj -'U~ )> "" = = -.J 1 680.00:-;' 'e: ':';. I "', N -0 :x (~:;~ _'.J ;'-) trl ,'- ") +' -.J Total Personal Property......................................... 1,580.00 Total Real Property................................................ Total Personal and Real Property......................... NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may. at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. ~ 3301 (b)) Form RW-09 Rev. 10.13.2006 ~ INVENTORY REGISTER OF WillS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } 55 COUNTY OF Cumberland } File Number 1999-00509 PA DECEDENTS SOC. SEC. NO. 175-40-5870 DATE OF DEATH 04/30/1999 LAST RESIDENCE ~ H.K. Porter asbestos settlement litigation - a copy of the check dated June 18, 2007 is attached hereto PLEASE ABATE ALL INTEREST 1.580.00 Total Cash 1.580.00 (Attach additional sheets if necessary) Total Personal Property and Real Estate 1.580.00 - -= - - - - - - = - - - == == - ..... =- - -- - - - - - ~ ~ L:- tr:ltr:l('" n tv:r ::c: 0 ; >-Of<; Z............. ......tv..... nOlJ r:F.lVllJ t:l::l7'c C~F ~ >-z c- O > 0, ""'d ~ II >- lJ ....... t:l : '. -..J~r o VI VI r- ..::t" cf I- CL(. =:> .' LLC-'( ad- x: 0- N ~(l) CL::'7 ':::::J~f [' OIL D-c CL~< o~-) o --I :::::> -, ,...... c::> c::::> c--.I ('}-('}:;:d ~(')~~ ~ 0 S 1-'- ~=~~ (ll s..... .... -:- 0 Pi 0 .., .... ::l ..., >~p.~ -rnQs -.l.c ~ '" o ~ .... - ~.::;. w....'<; ~(ll(') w 0 00 ~ -.l ::i- ==r o ~ '" (ll ... BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ~r0/Y-1r"T: 0C:-,"[ ('v \:\',.)i1Li=~) '.I; :-\~l '-INHERITANCE TAX SmATEMENT OF ACCOUNT *' 2001 AUG I 0 M~ II: I 9 REV-1607 EX AFP (03-05) EDWARD P SEEBER 134 SIPE AVE HUMMELSTOWN CLERK OF OOPHil\I''' ('(\1 JRT II. "I., 0 VJ'~ E~~~'/':'~~:' ,r-'I' PA DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-06-2007 DONSON 04-30-1999 21 99-0509 CUMBERLAND 101 ROBERT C Amount Remitted PA 17036 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. --. RETAIN LOWER PORTION FOR YOUR RECORDS ..... REV-1607 EX AFP (03-05) --------------------------------------------------------------------------- ... INHERITANCE TAX STATEMENT OF ACCOUNT .** ESTATE OF DONSON ROBERT C FILE NO. 21 99-0509 ACN 101 DATE 08-06-2007 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-27-2000 PRINCIPAL TAX DUE: 15,658.87 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-20-1999 AA378825 782.94 15,000.00 04-04-2000 REFUND .00 124.07- 07-11-2007 CD008394 .00 53.90 TOTAL TAX CREDIT 15,712.77 BALANCE OF TAX DUE 53.90CR INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 53.90CR * SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN *1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) c!o BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE f)r('(lpnprq1J'l\l=E:'(ClJ: (iAAERITANCE TAX ~PPR.u~-ME'Nr~ l'At.L/:lWANCE OR DISALLOWANCE F\\~5,;:~E@lG.!~ON,~~ ~~D ASSESSMENT OF TAX '* REV-1547 EX AFP (06-05) EDWARD P SEEBER ESQ PECHT & ASSOCIATES PC 1205 MANOR DR STE 200 MECHANICSBURG PA 17055 ('I !=R"I( ("oj: \,.}I..,.."- ' " '-, I ORP'.-I " > 1':-;: {~/II JRT 1; ii'\', 'j "-'~ ,~,'-", '.,.j , '-" ClJ-/\ PM 12: 31.pATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-26-2007 DONSON 04-30-1999 21 99-0509 CUMBERLAND 504 APPEAL DATE: 01-25-2008 ( See reverse side under Objections) A.ount Remittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ROBERT C 2001 DEe - 5 TO: CUT ALONG THIS LINE ..... RETAIN LOWER PORTION FOR YOUR RECORDS ~ ------------------------------------------------------------------------------------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DONSON ROBERT C FILE NO. 21 99-0509 ACN 504 DATE 11-26-2007 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) Total Assets .00 .00 .00 .00 1.580.00 .00 .00 (8) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 8. 1,580.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 681. 67 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (9) ClO) .00 Cl1) Cl2) Cl3) Cl4) "81 "7 898.33 .00 898.33 14. Net Value of Estate Subject to Tax If an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of !hh returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: PAYMENT DATE 07-11-2007 NOTE: Cl5) .00 X 00 898.33 X 06 = .00 X 00 = .00 X 15 = Cl9)= .00 53.90 .00 .00 53.90 Cl6) RECEIPT NUMBER CDo08394 DISCOUNT (+) INTEREST/PEN PAID (-) .00 AMOUNT PAID 53.90 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 53.90 .00 .00 .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. q IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE D A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/26/2008 j-,) SEEBER EDWARD PETER ESQUIRE SUITE 204 5020 RITTER ROAD MECHANICSBURG, PA 17055 -..J RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of ~Jills a Status Report of completed or uncompleted administration. This filing lS due by: 4/30/2008 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~. ~..L Ii .' '''Jm ~ i' ~~!~2< .t... .. i' .-"\ ....f:..n~'t7..&'-.~., ~, '''''- '-' . ~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 ,~.... " Date: 3/26/2008 [',,) TINA L BEAM --.J 1350 WINDSOR ROAD MECHANICSBURG, PA 17050 RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing lS due by: 4/30/2008 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~' ~ .c. ..... f} ./ ... ~ ~~.; .. 'It<.jJ:&~e Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WillS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Robert C. Donson Date of Death: 04130/1999 File Number: 1999-00509 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: DYes 00 No ;~. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 4/30/2009 3. If the answer to NO.1 is YES, state the following: a. Did the personal representative file a final account with the Court? DYes 0 No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? DYes 0 No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date 4 ~ Personal Representative 00 Counsel Vd "00 ONV'ilJ3aVif1~ ltlOOO S.NVHdHO :10 )lH31~ Edward P. Seeber #76084 Name of Person Filing this Form Suite 204, 5020 Ritter Road I9t :Zl Wd E... ~dV DUOZ Address c: 1W,,!('; \.Ill ~~iCIJH ...' .1." _.~ __..~~ ,...... ',~_ ..j,.~ .,:;,.\;rtt-1. .F"'~ ;.,J ...",...._1.,,; Form RW-10 Rev. 10-13-2006 Mechanicsburg, PA 17055 City, State. Zip 717/533-3280 Telephone Copyright (c) 2006 form software only The Lackner Group, Inc. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 3/24/2009 SEEBER EDWARD PETER ESQUIRE 555 GETTYSBURG ROAD SUITE C 400 MECHANICSBURG, PA 17055 RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: rv f ~•. _.J ,_ :~ ...~ ..., _ 1 ~_ r_'._ __. _ ~~ ~)a - r~~.~ -'- _, w.. _~ - -- `~ r This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Pegister of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/30/2009 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 3/24/2009 TINA L BEAM 1350 WINDSOR ROAD MECHANICSBURG, PA 17050 RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: r-., c7 w~ __ _; ,-, ~: .~ -,-~ ~' .~\ y- Y - _ ~~ This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/30/2009 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~' ~ . -, 4e/Z~%°L'~~'L~/~ +A/V'd~ ~ti~'J...r/ '~'.b Lw++~'/aa,/,~,.i y~T'/~'.`°' Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND Name of Decedent: Robert C. Donson Date of Death: 04/30/1999 COUNTY, PENNSYLVANIA File Number: 1999_nn~no Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 4/30/2010 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? b. The separate Orphans' Court No. (if any) for the personal representative's account is: of Person Filing this Form y: ^ Personal Representative ~ Counsel c. Did the personal representative state an account informally to the parties in interest? ^ Yes ^ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and maybe attached to this report. Dace 03/26/2D09 M _ ..... L ~ ~~ . - i.:..- nr- c' T- „~= l r_ -. .+ ~ ~-, L~ =: ; _ Edward P. Seeber ^ Yes Q No ^ Yes ^ No #76084 ~~~o ~~ ~e~sun Hong rn~s rorm Suite C-400, 555 Gettysburg Pike Address Mechanicsburg, PA 17055 ....r, .. o ~ uy 717/533-3280 Form RW-10 Rey. ~0-~3-loos Copyright (c) 2006 form software only The Lackner Group, Inc. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 ~ '`~ ~ -t `~',.,~ lJ;. Phone . (717) 240-6345 ~.~,~ U ~ ..i .... ,1,.,: ' 4 .l. ZII 4 ~ APB _ i ~~~ 1~= ~ 7 „,,- G! Frig ~,.;~ v' k'4 Date: 3/29/2010 TINA L BEAM 1350 WINDSOR ROAD MECHANICSBURG, PA 17050 RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the-below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/30/2010 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 " "" ~'' _"'' ~ =~"!i';~ ~~~ "_ ~~~ Phone: (717) 240-6345 ~ ~ ri , ~~ ~ Q APR - I A~~ I~~ 5 7 ~i F~~ ,~- ('1{ n ~1'~ " ~'~ .. fit''. Date: 3/29/2010 SEEBER EDWARD PETER ESQUIRE 555 GETTYSBURG ROAD SUITE C 400 MECHANICSBURG, PA 17055 RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET N0. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration.. This filing is due by: 4/30/2010 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner Strasbah g' Clerk of the Orphans' Court cc: File Personal Representative(s) T 1 Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Robert C. Donson Date of Death: 04/30/1999 File Number: 1999-00509 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: ^ Yes ® No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 4/30/2011 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? ^ Yes ^ No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ^ Yes ^ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. ~~ Dare 04/12/2010 S' n t oI Person Filing this Form Capacity: ^ Personal Representative ® Counsel N Q tQ U~; ~_ ~°~: Edward P. Seeber #76084 (J-J T:::' ~ t ;~`~ Name of Person Filing thk Form V .-_:~- ~ ~~ C c u-. - a- c_~v `-~, Suite C-400, 555 Gettysburg Pike L i..: 4 ..J -~- J .c7- LV _ Address C ~. ~~ Qom„ v~~-j~." Mechanicsburg, PA 17055 c ~ '{._~ ~ O ~ crry, srare, zip '- ~ ~ ~ v 7171533-3280 C_i. ©, N Telephone Form RW 1 U Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. ---~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 ;'~ ~~ -~_ Lii,;1,.._. ~.,~ Phone: (717) 240-6345 ~ ~' Z~ f 0 APB -1 ~~~ 1~= 57 ~.~~,4 ~n~ ~~T Os~~~ 'l."`.f ` 1J L ~ j~ E ~ f, ~ ~ Date: 3/29/2010 TINA L BEAM 1350 WINDSOR ROAD MECHANICSBURG, PA 17050 RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative-under Rule 6.12 is due on the-below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing is due by: 4/30/2010 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc. File Counsel Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 '~'"~~~"' =''' ~.`,__~~,~ ~jj~ Phone: (717) 240-6345 ~ -~ r,, ~~ ~ o ~P~ - ~ ~~~ ~o. ~ ~ G~Ft-=,~.~~~ ~3 ~.,O~R~ Date: 3/29/2010 SEEBER EDWARD PETER ESQUIRE 555 GETTYSBURG ROAD SUITE C 400 MECHANICSBURG, PA 17055 RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration.. This filing is due by: 4/30/2010 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner Strasbau.gh Clerk of the Orphans' Court cc: File Personal Representative(s) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 013275 TINA L BEAM 1350 WINDSOR ROAD MECHANICSBURG, PA 17050 -- fold ESTATE INFORMATION: SSN: 175-40-5870 FILE NUMBER: 2199-0509 DECEDENT NAME: DONSON ROBERT C DATE OF PAYMENT: 08/30/2010 POSTMARK DATE: 08/26/2010 COUNTY: CUMBERLAND DATE OF DEATH: 04/30/ 1 999 REMARKS: ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 5427.23 TOTAL AMOUNT PAID: 5427.23 CHECK#533 INITIALS: DM SEAL RECEIVED BY: GLENDA EARNER STR,ASBAUGH REGISTER OF WILLS REGISTER OF WILLS i ~ ~ INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA ~.~ COMMONWEALTH OF PENNSYLVANIA } r? ~' ~-+ COUNTY OF Cumberland } SS File Number 1999-00509 `._ = ~ y' =~l~. ~ '-.` C J ~.~ ~- ; Tina Beam Klinefelter ~; _ry_ C? c Personal Representative(s) of the Estate of Robert C. DOnSOn ~ "~ `~,~; ~`, ~` .. - deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal ~~sets'where~er situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placid opposite-each ~ - ; ; _~~ item of said inventory represents its fair value as of the date of the d cedent's dea ,and that De a ent overt n eal estate ,.---, outside of the Commonwealth of Pennsylvania except that which ap, e r i e , d f thi ~irw ' ry. ~ - (~`, I verify that the statements made in this Inven- ~' ~ i `+ ~ u~~~ . ` tory are true and correct. I understand that false state- Tina Beam Klinef er ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorney -- (Name) (Firm) {Address) (Telephone) Edward P. Seeber (Supreme Court I.C). No.) 76084 James, Smith, Dietterick 8~ Connell , LLP ___ 555 Gettysburg Pk, Mechanicsburg, PA 17055 _ 717/533-3280 DATE OF DEATH LAST RESIDENCE 12 Clover Lane DECEDENT'S SOC. SEC. NO. 04/30/1999 Mechanicsbur_ , PA 17055 175-40-5870 FIGURES MUST BE TOTALED Personal Pro,~ertv Cash ............................................................................................... Personal Property ........................................................................ Stocks/Listed ................................................................................ Stocks/Closely Held ..................................................................... Bonds ............................................................................................ Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ........................................................................ Total Personal Property ........................................ Total Real Property ................................................ Total Personal and Real Property ........................ ~- '10,725.fi8 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. § 3301(b)) Form RW-09 Rev. 1o-~3-20os 10,725.68 10,725.68 '~'ir`~ REGISTER OF WILLS OF INVENTORY CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS couNTY of Cumberland } DATE OF DEATH LAST RESIDENCE 04/30/1999 Cash File Number 1999-00509 12 Clover Lane DECEDENT'S liOC. SEC. NO. Mechanicsburg, PA 17055 175-40-5870 Babcock 8~ Wilcox asbestos settlement litigation • a copy of the settlement agreement is attached hereto; as in all prior filings 10% is allocated to survival action (PLEASE ABATE ALL PENALTIES 8< INTEREST) Babcock 8~ Wi{cox asbestos settlement litigation - a copy of the settlement agreement is attached hereto; as in all prior filings 10% is allocated to survival action (PLEASE ABATE ALL PENALTIES 8 INTEREST) Total Cash 5,162.60 5,563.08 10,725.68 (Attach additional sheets if necessary) Total Personal Property and Real Estate 10,725.68 f / 1505610143 REV-1500 Ex (°'-'°' OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO BOX.280601 INHERITANCE TAX RETURN ' ~ r ~ -~`~ - Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~:Y ~ `~~ ~ ' `>~~~~ ~.. ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 175 40 5870 04 30 1999 06 29 1949 Decedent's Last Name Suffix Decedent's First Name MI DONSON ROBERT C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WIITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ^ 1. Original Return ~ 2. Supplemental Return ^ 4. Limited Estate ^ 4a. Future Interest Compromise /rl~fn ni rlno~h .Her ~ 7 ~ 7 471 g Decedent Died Testate 7 Decedent Maintained a Living Trust (Attach Copy of Will) ^ (Attach Copy of Trust) 9. Litigation Proceeds Received ^ 10. Spousal Povertyy Credit (date of death between 12-31 ~J1 and 1-1-95) ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required MI 8. Total Number of Safe Deposit Boxes ^ 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION ;iHOULD BE DIRECTED TO: Name Daytime Telephone Number EDWARD P SEEBER 717 533 3280 First line of address 555 GETTYSBURG PK Second line of address SUITE C400 City or Post Office MECHANICSBURG Correspondent's a-mail address: eps~jsdc.com State ZIP Code PA 17055 REGISTER OF•~~L.17S USE Qt~Y `_ . -:~ -~u, ~7 i, =j _ '~ --1 -. - - _,ry . , ._~ .,,.' DAT~~ILED ,~~, _ . I'~.r _ _.T . -, Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, orrect and comp) te. Declaratio of preparer ther t a the personal representative Is based on all information of which preparer has any knowledge. SIGNAT E P S F I E N TE e ~'~~' ,~ ~'''~ r'. ~ ~ ~ Tina Beam Klinefelter ~ ~ ADDRESS 26211 Camden Woods Dr Ft Mill SC 29707 SIGNATURE OF PR OTHER THAN REPRESENTATIVE DATE ~ Edward P. Seeber ~ '~ ~~,~ A SS 555 Gettysburg Pk, Mechanicsburg, PA 17055 Side 1 1505610143 1505610141 J .~s.~~ '~ J 1505610243 REV-1500 EX Decedent's Social Security Number Decedents Name: DO~'IS011, Robert C. 17 5 4 0 5 8 7 0 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ............... 5. :LO , 725.68 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous fyQn-Probate Property (Schedule G arate Billi ~^ Se R t d p ng ) eques ............ e 7, 8. Total Gross Assets (total Lines 1-7) ..................................................................... g. :LO , 725.68 9. Funeral Expenses 8 Administrative Costs (Schedule H) ....................................... 9. 3,605.23 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 8 10) ................................................................... 11 3 , 605 .23 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 7,120.45 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14. 7 , 12 0.45 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15. 0 . 0 0 16. Amount of Line 14 taxable '7 12 0 . 4 5 at lineal rate X .06 ~ 16. 4 2 7 . 2 3 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18. 0. 0 0 19. Tax Due ............................................................... .. -_ 19. 427.23 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME Donson, Robert C. STREET ADDRESS 12 Clover Lane CITY Mechanicsburg STATE PA ZIF' 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments B. Discount 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Total Credits (A + B) (1) 427.23 (2) (3) (4) (5) 427.23 Make Check Pa able to: REGISTER OF WILLS, ,AGENT. b. .. .... ... . i ... ~: ....... ...~ .. i ...... ... :. .. ...... .. .. .... :. .. .: ..~.... e .. .. ~~ .....~ t~'' .! PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :............................................................................... ^ ]x b. retain the right to designate who shall use the property transferred or its income :.................................. ^ 0 c. retain a reversionary interest; or ............................................................................................................... d. receive the promise for life of either payments, benefits or care? ............................................................ ^ 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without [] ] receiving adequate consideration? .................................................................................................................... x 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ^ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ] ] contains a beneficiary designation? .................................................................................................................. x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS FART OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survivi , ng spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the suroivinc~ spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use' of a natural parent, an adoptive parent, or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1608 EX+ (6-88) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Donson, Robert C. FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survlvorahip must bs disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Babcock 8< Wilcox asbestos settlement litigation - a copy of the settlement agreement is 5,162.60 attached hereto; as in all prior filings 10% is allocated to survival action (PLEASE ABATE ALL PENALTIES ~ INTEREST) 2 Babcock Sz Wilcox asbestos settlement litigation - a copy of the settlement agreement is attached hereto; as in all prior filings 10% is allocated to survival action (PLEASE ABATE ALL PENALTIES St INTEREST) 5,563.08 TOTAL (Also enter on Line 5, Recapitulation) I 10,725.68 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1161 EX+ X10-06) COM I~NHERITANCE~TAX RETURN AN{A RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Donson, Robert C. Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N M R A, FUNERAL EXPENSES: B. ADMIN{STRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zia Year(sl Commission Wald 2, ~ Attorney's Fees 3. I Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zia Relationship of Claimant to Decedent 4. I Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 3,605.23 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 3,605.23 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Donson, Robert C. ITEM NUMBER DESCRIPTION AMOUNT Other Administrative Costs 1 Register of Wills -filing fee for Supplemental Return 8~ Inventory 30.00 2 Shein Law Center, LTD. -attorney fees for civil litigation; 10% allocated to survival action 1,720.87 3 Shein Law Center, LTD. -attorney fees for civil litigation; 10% allocated to survival action 1,854.36 H-B7 3,605.23 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE J COMMNHERITANCE TAX RETURNANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Donson, Robert C. NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUN T OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal • distributions, and transfers under Sec. 9116 a 1.2 1 Alexander D. Donson Son 1/2 of residue 3,560.22 213 N. Locust Point Road Mechanicsburg, PA 17055 2 Tina Beam Klinefelter Daughter 1/2 of residue 3,560.23 26211 Camden Woods Dr Ft Mill, SC 29707 Total 7,120.45 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 15 00 cover sheet, as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) r _. ~,,n .,~~-rw _~,~'~11•~E~h,I TANCE TAX BUREAU OF INDIVIDUAL TAXES ~ -! i .t°~ ~.,, INHERITANCE TAX DIVISION .~T~'T~~F''~~T' OF ACCOUNT PO BOX 280601 i..;' _.. ~, ,,.. .. _ HARRISBURG PA 17128-0601 ~ `~- ~"" "`` ' ~ ZQ6~ aCT - I P 12~ 41 l~~Ct~i\ ~i~ EDWARD P SEEBER ES6~~~~~gG~~'~i ~~,,~[~ ~,'~~ „ p~,. PECHT 8~ ASSOCIATES PC 1205 MANOR DR STE 200 MECHANICSBURG PA 17055 Pennsylvania ~ R DEPARTMENT OF REVENUE REV-1607 EX AFP (12-09) !` DATE 09-27-2010 ESTATE OF DONSON ROBERT C DATE OF DEATH 04-30-1999 FILE NUMBER 21 99-0509 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -~+~ rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr~rrrrrrrrrrrrrrrrrrrr~rrrr~rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr^ REV-1607 EX AFP C12-09) *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF:DONSON ROBERT C FILE NO.: 21 99-0509 ACN: 101 DATE: 09-27-2010 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-27-2000 PRINCIPAL TAX DUE: 15,658.87 PAYMENTS CTAX CREDITS): PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 07-20-1999 AA378825 782.94 15,000.00 04-04-2000 REFUND .00 124.07- 08-26-2010 CD013275 .00 427.23 TOTAL TAX PAYMENT ~ 16,086.10 BALANCE OF TAX DUES 427.23CR INTEREST AND PEN. L .00 TOTAL DUE * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. 427.23CR . ~~ r ~..~ ~, ; ~ ,_ r, ~i„QT,,~CE~,OF INHERITANCE TAX BUREAU OF INDIVIDUAL TAxES AF~PRd:ISEMEr~~', f,~I~tLLOWANCE OR DISALLOWANCE INHERITANCE TAX DIVISION ~ ;:.4,(3F,~'D~~}UC,TIQ'NS AND ASSESSMENT OF TAX PO BOX 2B0601 - - HARRISBURG PA 17128-0601 ~I~ ~~ -3 P{~~ 1~~ C'0 ~; C~r~~-~~; ~ J~ ~ r, T EDWARD P SEEBER - SUITE (400 555 GETTYSBURG PK MECHANICSBURG PA 17055 pennsylvania:~~ ~ DEPARTMENT OF REVENUE REV-1547 EX AFP C12-09) DATE 11-29-2010 ESTATE OF DONSON ROBERT C DATE OF DEATH 04-30-1999 FILE NUMBER 21 99-0509 COUNTY CUMBERLAND ACN 505 APPEAL DATE: 01-28-2011 (See reverse side under Objections ) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS- L INE- - - - _ -~ R_ ETA_ IN LOWER POR_ TION_ FOR YOUR RECO_ RDS F'-- _ REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: DONSON ROBERT (FILE N0.:21 99-0509 ACN: 505 _ _ _ _ _ _ _ _ _ OR DATE: 11-29-2010 TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN 1. Real Estate (Schedule A) ~1) .0 0 NOTE: To ensure proper 2. Stocks and Bonds (Schedule B) ~2) .0 0 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) L3) .0 0 submit the upper portion of this form with your 4. Mortgages/Notes Receivable (Schedule D) (4) .0 0 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 10,725.68 6. Jointly Owned Property (Schedule F) (6) .0 0 7. Transfers (Schedule G) (7) .0 0 8. Total Assets (8) _ 10 , 725.68 APPROV ED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 3.6 0 5, 10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .0 0 11. Total Deductions C11) 3,605.23 12. Net Value of Tax Return (12) 7, 120 .45 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0 14. Net Value of Estate Subject to Tax (14) 7, 120 .45 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate C15) .0 0 X 0 0 = .0 0 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 7.170.4 X 06 = 427.23 17. Amount of Line 14 at Sibling rate (17) _ 00 X 00 = . 00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .0 0 X 15 = .0 0 19. Principal Tax Due (19)= 427.23 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 08-26-2010 CD013275 .00 427.23 TOTAL TAX PAYMENT 427.23 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~''~ ~~.,: "y Cumberland County - Register Of Wi11s One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 3/15/2011 SEEBER EDV~)ARD PETER ESQUIRE C7 ~- ~" ~ 555 GETTYSBURG ROAD ~~~ - SUITE C 400 "n _~_ MECHANICSBURG, PA 17055 '-z~ ~- ~5 ~_~ - : c. ~ .. ,t:. ~.~J _ - RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/30/2011 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report., please disregard this notice. S~.incerely, ~~~~ Y ~~~ Glenda Farner Strasbau Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County- - xegister v= wa~r~.s One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 3/15/2011 ~~ -~_ ._r_;~? . . TINA L BEAM ~ +~~ , -~ t7 >~ c. ;. 1350 WINDSOR ROAD ~., MECHANICSBURG, PA 17050 ~~ ,, , ,, -:. , .- .. . __ ,_, , r . --; ~ RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/30/2011 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~ / Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Robert C. Donson Date of Death: 04/30/1999 File Number: 1999-00509 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: ^ Yes ® No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 4/3012012 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? ^ Yes ^ No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ^ Yes ^ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. ~--''' Date 03/2112011 'S' ature of Person Filing this Form Capacity: ^ Personal Representative ~ Counsel -'', ~ ~ ~~ ~- Edward P. Seeber : - ,, ,1 #76084 __ _ - ~ -. .. ~~ _ <, ~ ~ <_ ~~ Name of Person Filing this Form -~ r - 555 Gettysburg Pike _ t. ~. ~ Suite C400 I -; - L J _ _ ~ ;- Address " `~' -= PA 17055 - ~ = Mechanicsburg, v -. - U City, State, Zip ~ 7171533-3280 `Y Telephone Form RW ~O Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. o `- "' ~ •, tt'~~ • lf) ~ ~~ ~ ~N ~ i ¢ ~ _ ~ B N _ i~~a~~_~ rn O ~~ O~ i \1 `~' ~ 1 ~ ~ / ~. r~• O -~ ~I V J ~b( ~ N ~, Q ~OJtiNC~ ° ° ~ T .,~ "~ 4 .~-- '~ ~ ~_ ~ ~ G~~ cam., t ;// t~ ,c~~,. !'Y~ _ f ~ ? t_a~.l ~~ ~ -~ c ~.~ i3 - °~,~ Z3 Y ~~ ~ ~~ ~~ ~ YF ~1^i~~ ~. ~7~iG~ o~ '' .pf 7i~t ~tA ~~~~ ~. ~i~ ~~ ^" ~~~~ ~~ ~~ u~ ~~ `~ xk1G~ ~" ---. YP!-tfie d ~~~~ ~ a~~z m~ ~~tt': « ~ N~ ~ -'- ,per rs kft© . ~~ i'•l~i€~ ~~ ~ ~ ~ ~ r~ Ai ~ ~ x ~ r~ ~t s ,~ d ~ 4 ~a ~ t flQ3 ~ L9lC~ ~ omo U r~F x~.w ~a~ m ~w¢t `' ~~~ w n w t~ z x rt s a U CR ~.~ i,{~ i3t'! iii ::~ lit o i"i ~ ~•. O •r•! C" ~'-~ w ~ o -~ ~ ~ ~ ~ ~ ~ r ~ W ~ Q r~l M M ^ H H yo a 0 ~, v L.^ F-i ~ H cY1 W ~ ~ ~~ V u ..~..~ 1505610143 REV-1500 Ex(o,_,°) PA Department of Revenue Pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes DEPARTMENT OF REVENUE County Code Year PO 80X.280601 File Number Harrisburg, PA 17128-0601 INHERITANCE TAX RETURN ENTER DECEDENT INFORMATION BELOW RESIDENT DECEDENT ~t') Social Security Number Date of Death ~ 17 5 4 0 5 8 7 0 Date of Birth 04 30 1999 06 29 1949 Decedent's Last Name DONSON Suffix Decedent's First Name MI ROBERT C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE F REGISTER OF WILLS ILL IN APPROPRIATE OVALS BELOW 1. Original Return a 2. Supplemental Return 3 Remainder R 4. Limited Estate . eturn (date of death prior to 12-13-82) Future Interest C 4a . ompromise ^ (date of death after 12-12-82) 5. Federal Estate Tax Retum Required g. Decedent Died Testate (Attach Copy of Will) ^ 7, Decader~ t Maint fined a Living Trust 0 (Attach Gopy of~Trust) 9 Liti ati P 8. Total Number of Safe Deposit Boxes . g on roceeds Received ~ 1 p. Spousal PovertY Credit (date of death between 12-31 91 and T-1-95) ~ 11, Election to tax under Sec. 9113(A) CORRESPONDENT -THIS SECTION MUST BE N COMP (Attach Sch. O) LETED. ALL CORRESPONDENCE AND ame CONFIDENTIAL TAX INFORMATION SHOULD BE DI RECTED TO: EDWARD P SEEBER Daytime TelepF>~e~e Number ':~:; 717 533 80 ==- ~~ First line of address 555 GETTYSBURG PIKE Second line of address SUITE C400 City or Post Office MECHANICSBURG ~ REGISTER O r--- 4 USE ~ r- ~J p~..,y . '~ - r '~ ~ DILY r;-~ :.:~ C ~-:~~. ~ ---; ~ '" Z~ ~: ni -n c a.~ State ZIP Code DATE FILED pA 17055 " Correspondent's a-mail address: eps~Q J~sdc.COm Under penalties of pery'ury, I declare that I have exarbined~is~eturn, including accompanying schedules and stateme t it is true, Forrest a~td c9rt]plete. [~Ircl~ation of oreo r nt ~ ~~ th ADDRESS 26211 C en Woods Dr Ft Mill SC 51GNATUR EPARER OTHER THAN REPRESENTATIVE e personal representative is based on all informatlon~of which preparerfhas any knowledge belief, DATE ~T na Beam Klinefelter ~ / / ~ 07 Edward P. Seeber 555 Gettysburg Pk, Mechanicsburg, PA 17055 L Side 1 1505610143 DATE 8~ ~ /~ 1505610143 J ~-~Gr 1505610243 REV-1500 EX Decedents Name: ponson, Robert C. Decedent's Social Security Number RECAPITULATION 175 40 5870 1. Real Estate (Schedule A) .................. .................................................................... . 1. 2. Stocks and Bonds (Schedule B) ............. ....................................... ........................ . 2. 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C)......... 3, 4. Mortgages 8~ Notes Receivable (Schedule D).....,..,. ,•,••,•._.•.•„ 4 5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) 5 ............... . 2,464.75 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..........,. 7. Inter-Vivos Transfers & Miscellaneous I~n~ Probate Property (Schedule G) U Se a t Bi 6. p ra e lling Requested............ 7. 8. Total Gross Assets (total Lines 1-7) ........ ............................................................. 8. 2,464.75 9. Funeral Expenses ~ Administrative Costs (Schedule H) ....................................... g. 1 101 58 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) , . .............................. 10. 11. Total Deductions (total Lines 9 8~ 10) .................... ............................................... 11. 1,101.58 12. Net Value of Estate (Line 8 minus Line 11)........ .. .... ................................. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 12. 1, 3 63.17 an election to tax has not been made (Schedule J) ... ............................................ 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ......... ...................................... 14. 1,363.17 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 0 15. O O 0 16. Amount of Line 14 taxable . at lineal rate x .06 1, 3 63.17 1s. 81 7 9 17. Amount of Line 14 ble . at sibling rate X .12 0. 0 0 17. 0 0 0 18. Amount of Line 14 taxable . at collateral rate X .15 O. 0 0 18. 0. 0 0 19. Tax Due .................................................................................................................. 19. 81.7 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME Donson, Robert C. STREET ADDRESS 12 Clover Lane CITY Mechanicsburg STATE iZlp PA I 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments (1) 81.79 A. Prior Payments B. Discount Total Credits (A + g) (2) 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Llne 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. l5) - 81.79 Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN " " X IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;....... Yes No b. retain the right to designate who shall use the property transferred or its income :.................................. c. retain a reversionary interest; or ................. x ...... .......................................... x d. receive the promise for life of either ~~~~~~~~~~~~~~~~~~~~~ payments, benefits or care? ...................... . . ............. 2. If death occurred after December 12 1982, did decedent transfer property within one year of death without x receiving adequate consideration .............................................................................. 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ^ a contains a beneficiary designation? ............... ................................. ~ 0 F ............................ THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PAR T OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)J, transfers to or for the use of the surviving For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survivin s o [72 P.S. §9116 (a) (1.1) (ii)J. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements f r assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. g p use is 0 percent o disclosure of For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a adoptive parent, or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)J. . The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 er natural parent, an 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)], p cent, except as noted in . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 a 1.3 sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether b )blood] A y or adoption. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Rev-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~.~ ~ r+ ~ ~ yr Donson, Robert C. FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jointly-owned with the right of survivorship must be dtscloaed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE 1 Fibreboard asbestos settlement litigation - a co OF DEATH hereto; as in all prior filings 10% is allocated to survival actiton (PLEASE ABA t is attached PENALTIES ~ INTEREST) TE ALL 2,464.75 TOTAL (Also enter on Line 5, Recapitulation) 2,464.75 Copyright (c) 2002 form software only The (Lackne rGroup, Inced, additional pages of the same size) Form PA-1500 Schedule E (Rev. 6-98) REV-1151 EX+ (10-06) ,. COM IN R~~IIDE~NT DECEDEN~RN ANIA SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Donson, Robert C. Debts of decedent must be reported on Schedule I. ITEM M DESCRIPTION A. FUNERAL EXPENSES: FILE NUMBER AMOUNT B• ADMINISTRATIVE COSTS: 1• Personal Representative's Commissions Name of Personal Representative(s) Street Address City State ZiD Year(sl Commission paid 2. Attorney's Fees James, Smith, Dietterick ~ Connelly, LLP 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zio RelationshiQ of Claimant to Decedent 4• Probate Fees 5• ~ Accountant's Fees 6• I Tax Return Preparer's Fees 250.00 ~• Other Administrative Costs See continuation schedule(s) attached 851.58 TOTAL (Also enter on line 9, Recapitulation) 1,101.58 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ~-~+ ~ n 1 G V 1- Donson, Robert C. FILE NUMBER ITEM NUMBER DESCRIPTION AMOUNT Qther Adminis native Coctc 1 Register of Wills -filing fee for Supplemental Return & Inventory 30.00 2 Shein Law Center, LTD. -attorney fees for civil litigation; 10% allocated to survival actin n 821.58 H-67 851.58 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV-1513 EX+ (11-08) COMINHN~„IDE~N~E ECEpEN~R~VANIA SCHEDULE J BENEFICIARIES Donson, Robert C. NUMBER PERSON(S) RECEIDV NG PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 a 1.2 1 Alexander D. Donson 213 N. Locust Point Road Mechanicsburg, Pq 17055 2 Tina Beam Klinefelter 26211 Camden Woods Dr Ft Mill, SC 29707 FILE NUMBER RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) Son 1/2 of residue Daughter 11/2 of residue Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 15 IO o~eal I II. NON-TAXABLE DISTRIBUTIONS: sheet, as a ro A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX I S NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 681.58 681.58 1,363.16 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 C Copyright (c) 2009 form software only The Lackner Group, Inc. OVER SHEET Fom~ PA.1500 Schedule J (Rev. 11-08) Pennsylvania Office: L 121 South Broad Street ~ C Twenty First Floor ~ ' Philadelphia, PA 19107 (215) 735-6677 SHEIN LAW Fax (215) 732-3630 CENTER LTD A~-rox~Y,~ Az Law ~ • July 1 1, 2011 Tina Klinefelter, Extrx. Estate of Robert Donson 26211 Camden Woods Drive North Mill, SC 29707 Re: Asbestos Liti ation Dear Ms. Klinefelter: New Jersey Office 5434 King Avenue Suite 202 Pennsauken, NJ 08109 (856) 427-9527 Fax (856) 427-9585 Enclosed please find a check in the amount of $16,431.69 which r settlement a epresents the p yment from Fibreboard. As you are aware, expenses (if applicable will be deducted from future settlements. ~ Since this case involved a decedent, you as personal re resentativ have certain legal responsibilities. An estate bank account must a of the estate check made payable to the estate is for deposit into the estate accoe opened. The outstanding debts of the estate must be paid, State Inheritance Tax Ret All possibly Federal Estate Tax Returns must be filed with the Court and rns and paid. Finally, all distributions must be paid to the persons desi ate all taxes beneficiaries: All of this is your responsibility. ~ d as If you have any questions or wish to consult an estate attorne le and we will recommend someone. Y~ p ase contact us We thank you for your reliance upon our experience and 'ud en display of confidence in permitting us to negotiate your ase~tow t and for your ards settlement. Kindly sign one copy of the Statement of Settlement and envelope. The second copy is for your personal records, return It in the enclosed Very truly yours, SHEIN LA W CE TER, LTD. By: Benjamin Peter ein, Enclosures www.sheinlaw.com .®~.,, STATEMENT OF SETTLEMENT ~~ Estate of Robert Donson v. Fibreboard GROSS AMOUNT OF SETTLEMENT: $24 64 7.53 ($24, 3 81.3 8 payment + $266.15 sequencing adjustment) LESS EXPENSES: ~ -0- LESS ATTORNEY'S FEE: $ 8,215.84 NET FUND FOR PLAINTIFF: $16,431.69 Received from SHEIN LAW CENTER, LTD., the s settlement, satisfaction and a um of $16,431.69 the same being in full p yment of my/o~ claim against the above-named defendant by reason of the alleged negligence of the defendan t, ,arising UWe hereby verify and confirm the above settlemen approval, and do hereby acknowledge receipt of a co ~ which was made with my/o~. consent and hereby release and forever discharge the said SHE Py of this Statement of Settlement. UWe do executors, and administrators of and from all m ~ LAW CENTER, LTD., their heirs, covenants, contracts, agreements, claims, and demnaridsf actions, and causes of actions, suits, arising from the prosecution of and settlement of the whatsoever, in law or equity especially said SHEIK LAW CENTER, LTD., UWe ever had above suit of damages, which against the administrators or assigns hereafter can, shall or rna~ now have, or which my/o~ heirs, executors, or thing whatsoever. y have, for or by reason of any cause, matter Tina Klinefelter, Extrx. WITNESS: Date ,,t INVENTORY REGISTER OF WILLS OF COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS Tina Beam Klinefelter Personal Representative(s) of the Fc+~+e ,.: ~. CUMBERLAND File Number ~~ ~~ ry COUNTY, PE .? VAr CIA l~~ ~~ ~ ~rfa~ ~ : - - r -- ~0~- - _,, ~ ~ C 1999-00509 ~~ ~ ~ - 'O _ " ~ '~ ::.~7 C"~ ~ ~ ~ 7 deceased, depose(s) and say(s) that the items appearing in the followin ' situate and all of the real estate in the Commonwealth of Pennsylvania of `' item of saki inventory represents its fair value as of the date of th g Inventory include all of the personal assets wherever outside of the Commonwealth of Pennsylvania except that whi said Decedent, that the valuation placed o osite each e ecedent's death, and that I verify that the statements made in this Inven- ch ar a edent ow d n r I estate r n u e oft in tory are true and correct. I understand that false state- } ry ments herein are made subject to the penalties of L 18 Pa.C.S. § 4904 relating to unsworn f Tina eam Klinefelter authorities. alslficatlon to } _ Attorney -- (Name) (Firm) (Address) (Telephone) DATE rlr nCwr~. Edward P. Seeber James, Smith, Dietterick ~ Connell , LLP 555 Gett sbur Pike, Mechanicsbur , Pq 17055 717/533-3280 04/30/1999 LAST RESIDENCE 12 Clover Lane Mechanicsbur PA 17055 FIGURES MUST BE TOTALED Personal Pronert~~ Cash ............................ .............................. .............. Personal Prope ....................... y ......................... Stocks/Listed...... ~~'~~~~~'~"~~""~'~""" ........................... ......................... Stocks/Close) '~'~~'~'~~~'"~~~~"" y Held ........................... .................. onds....... ........................ .................................. ............. Partnershi sand ................... P Sole Pro """ prietorships ................. Mortgages and Notes "~""""""""' Receivable....... All Other Prope '~~~~"~~~~~~""""""" rty ........................................................................ Total Personal Property ........................................ Total Real Property ........................... ..................... Total Personal and Real Propert y ........................ (Supreme Court 1. D. No.) 76084 DECEDENTS SOC. SEC. N0. 175-40-5870 2,464.75 2,464.75 2,464.75 ---_ OTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may at the election of item, but such figures should not be extended into the total of the Inventory. (See ~0 Pa. C.S. § 3301 b ~~personal representative include the value of each Form RW-09 Rev. ~o-~s-loos INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, pEN NSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 1999-00509 DATE OF DEATH LAST RESIDENCE 12 Clover Lane 04/30/1999 Mechanicsbur PA 17055 DECEDENTS SOC. SEC. NO. ~~V 175-40-5870 Fibreboard asbestos settlement litigation - a copy of the sett) attached hereto; as in all prior filings 10% is allocated to survey ent agreement is ABATE ALL PENALTIES ~ INTEREST) al action (PLEASE 2,464.75 Total Cash (Attach aririi+~.,.,..~ _~_ _ 2,464.75 -•-• •~• ~, ~~~~~ .r necessa Total Personal Property and Reai Estate 2,464.75 BUREAU OF INDIVIDUAL TAXES ~^~ INHERITANCE TAX DIVISION F?F~~ )~F PO BOX 280601 _ 1Ji I TA N C E TAX HARRISBURG PA 17128-0601 ,, $~i~~NT OF ~'^~' ACCOUNT ~-'J a ~ t r-b ~t..., Ild~` 4~ ~! C~ER~ ~~ EDWARD P SEEBER OR~M~ ~ COURT SUITE C 4 0 0 Ct~~~~, ~: ~, tu~ (~; ) F~ 555 GETTYSBURG PK MECHANICSBURG PA 17055 Pe~#n~ylvania ~ DEP/~RTMIENT OF REVENUE REV-160T EX AFP C12-10) DATE 09-12- 201 ESTATE OF DONSON DATE OF DEATH 04-30-1959 FILE NUMBER 21 99-05 9 COUNTY . ACN CUMBERLAND 101 Amount Remitted ROBERT C MAKE CHECK PAYABLE AND R .MIT PAYMENT T0: REGISTER OF WILLS I' NOTE: 1 COURTHOUSE SQUARE I' To ensure proper credit to CARL ISL E your account, submit the PA 17013 '', CUT ALONG THIS LINE uPPer portion of ~E1~=1607 EX AFI~~~ ..........~:....R...:.i:. this form x~th ~12-1p~ LOWER PORTION FO your tax payment. ~ * ~ INHER~~'~N~E 'fA~~~~ .. R YOUR RECORDS * * *~ S~AfEMENT~OF~ ACC$UN}•...:~ ..~ .................. ESTATE OF:DONSON THIS STATEMENT PROVIDES CURRENT SRTADB SRoF THE C FILE TAX DUE, APPLICATION OF ND• ~ 21 99-0509 ALL PAYMENTS,- STATED ACN IN THE NAMED ESTATE.C BELOWO S A SUM AR TE: O9- THE CURRENT BALANCE, AND, IF APPLICABLE, q PROJECTED I TE~tEST FIGUR 2-2011 ~' OF THE PRINCIPAL DATE OF E' LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-27-2000 PRINCIPAL TAX DUE: ~ PAYMENTS CTAX CREDITS): PAYMENT DATE RECEIPT NUMBER 07-20-1999 04-04_ 2000 AA378825 08-19-2011 REFUND CD014889 15,658.87 TOTAL TAX PAYMENT 15,740.66 BALANCE OF TAX DUE 81.79CR INTEREST AND PEN. .00 ~ IF PAID AFTER THIS DATE, rOTAL DUE ', SEE REVERSE SIDE FOR CALCULATION OF IF TOTAL DUE IS REFLECTED AS ~~ 81 • 79CR A CREDIT'S (CR), ADDITIONAL INTEREST. FOR INSTRUCTIONS. YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS~'FORM INTEREST/PENT ppID (_~ AMOUNT PAID 782.94 .00 15,000.00 .00 124.07- 81.79 bH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 4/02/2012 SEEBER EDWARD PETER ESQUIRE 555 GETTYSBURG ROAD SUITE C 400 MECHANICSBURG, PA 17055 RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: ~~-a .. t., i ~ r^ ~ 4.; _ i~ }_} ...J T7 ~ _. ` ' r'-r ~;-, This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/30/2012 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ... L/ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 4/02/2012 TINA L BEAM 1350 WINDSOR ROAD MECHANICSBURG, PA 17050 RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: ,...~ ~ ~ ~.., ~~ -T, gy ~ ~ ~ r JJ - p ' T,) -'-; ~' ~ I ~ r~-; -- , ,-, ...~ - ~. r, This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/30/2012 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Robert C. Donson Date of Death: 04/30/1999 File Number: 1999-00509 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: ^ Yes ® No 2, If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 4/30/2013 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? ^ Yes ^ No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ^ Yes ^ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date 04/19/2012 ~_~ Li CD G' s C'"7 Q a . _ , . - F _ _ .~~1? ~. L-l_~. - ~ `'r' o V cr -~ 1 ~J ~ .c.., _ , Lt_ .. ~ = r.;r C> 11,1_ - ~ ~-~_ ~- c:= L-- t'Z- L'~a t_T_ _- U Form RtH 'l~ Rev. 10-13-2006 atu of Person Filing this Form Capacity: ^ Personal Representative ® Counsel Edward P Seeber #76084 Name of Person Filing this Form Suite C-400 _555 Gettysburg Pike Address Mechanicsburg, PA 17055 City, State, Zip 717-533-3280 Telephone Copyright (c) 2006 form software only The Lackner Group, Inc ~~ NOTICE OF INHERITANCE TAX Pennsylvania ~ ~. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DI APPR~~'~~1~1~!'~,, ~~ ~,,QW[~A~j CE OR DISALLOWANCE DEPARTMENT OF REVENUE 1~~ ` '~ ~ ~ VISION OF II D~'Dl T_I01VS -I ND' A$SES$MENT OF TAX ` ' PO BOX 280601 ( ~ n~~j ~ t.1 REV-1547 IX AFP (12-11) 5i HARRISBURG PA 17128-0601 - ~- .,,.~ DATE 04-09-2012 ~'~~ nr~~ ~3 ,~ a A_, ~r +~ ~ ' ~% ESTATE OF DONSON ROBERT C DATE OF DEATH 04-30-1999 C~~~ ^ k~ ~`'r' FILE NUMBER 21 99-0509 j~ EDWARD P SEEBER , CUnRPH~~ ~~''~~'Rt COUNTY CUMBERLAND ~. ( <:r.,fj'1 ^~^ P ,. A ACN 506 STE (400 APPEAL DATE: 06-08-2012 555 GETTYSBURG P IKE (See reverse side under Objections) MECHANICSBURG PA 17055-5207 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE --- -------------------- - ~ --RETAIN LOWER PORTION FOR YOUR RECORDS E~ --------- REV-1547 EX AFP (12-11) _ ___ ------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: DONSON ROBERT (FILE N0.:21 99-0509 ACN: 506 DATE: 04-09-2012 TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 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 F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) cl) .00 c2) .00 t3) .00 c4) .00 c5) 2, 464.75 c6) .00 v) .00 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your taX payment. c8) 2 , 464.75 c9)- 1 0 8 clo) .00 11. Total Deductions C11) 1,101.58 12. Net Value of Tax Return X12) 1,363.17 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax C14) 1 , 363.17 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 a nd 19 will reflect figures that include the total of ALL returns assessed to date ASSESSMENT OF TAX: . 15. Amount of Line 14 at Spousal rate C15) .00 X 00 - .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 1 ,363 17 X 06 = 17 . 81.79 . Amount of Line 14 at Sibling rate (17) DO X 00 = _ .00 18. Amount of Line 14 taxable at Collateral/Class B ra te (18) .00 X 15 - .00 19. Principal Tax Due TAX CREDITS: C19)= 81.79 rATmtni RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 08-19-2011 CD014889 .00 81.79 04-02-2012 SBADJUST .00 .99 TOTAL TAX PAYMENT 81.79 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ^~ 15D561D143 REV-1500 Ex(°'-'°' PA Department of Revenue OFFICIAL USE ONLY pennsylvania County Code Year File Number Bureau of Individual Taxes OEVARTMENT OF REVENUE Po Box.2soso~ INHERITANCE TAX RETURN 21 99 0509 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 175 40 5870 04 30 1999 Decedent's Last Name Suffix DONSON (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number Date of Birth 06 29 1949 Decedent's First Name MI ROBERT C Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ^ 1. Original Return O 2. Supplemental Return ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of death after 12-12-82) g Decedent Died Testate (Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) 9. Litigation Proceeds Received ^ 10. Spousal PovertyY Credil (date of death between 12-31-J1 and T-1-95) prlorto 12-13-82) ^ 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes ^ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number EDWARD P SEEBER 717 533 3280 ev ~`-' - , "T7 First line of address 555 GETTYSBURG PIKE Second Tine of address SUITE C400 City or Post Office MECHANICSBURG Correspondent's a-mail address: _epS@JSdC.COnI ~ Cr r... t ~= 7 REGISTER ~$ USE~JLY ~ .. ?'-7 t: . ': , U; ,-. C~ ~ - ~ -'i . -- r r r c~ DATE FILED State ZIP Code PA 17055 Under penalties of perjury, I declare that I have exam'ned t ' return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, rrect and com lete. Declaration of preps r oth r th the personal representative is based on all information of which preparer has any knowledge. SIGNATU E P PON E 0 FILING R U `L X ~• ~ / DA E ;~ ill ~i~ Tina Beam Klinefelter `-'~ l ~ ~'"~ ADDRESS 26211 Ca den Woods Dr Ft Mid' SC 29707 SIGNATURE PREPARER OTHER THAN REPRE VE DATE Edward P. Seeber '~ ~ `E~ ~ j ~ AD SS5 Gettysburg Pk, Mechanicsburg, PA 17055 Side 1 15D561D143 15D561D143 J ^ 3. Remainder Return (date of death ~~ ,~ q ~-- 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: iJO17SOn, Robert C. 17 5 4 0 5 8 7 0 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 60 • 81 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous ion; Probate Property (Schedule G) u Separate Billing Requested............ 7, g. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 60.81 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 280.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 2 8 0 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. -219.19 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14. -219.19 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 0 . 0 0 (a)(1.2) X .00 . 16. Amount of Line 14 taxable 0.00 16. 0.00 at lineal rate X .06 17. Amount of Line 14 taxable 0 0 0 17. 0. 0 0 . at sibling rate X .12 18. Amount of Line 14 taxable 00 0 18. 0 . 0 0 . at collateral rate X .15 19. Tax Due ................................................................................................................. . 19. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME Donson, Robert C. STREET ADDRESS 12 Clover Lane CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments B. Discount Total Credits (A + B) (2) 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0,~~ Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :............................................................................... ^ b. retain the right to designate who shall use the property transferred or its income :.................................. ^ . x c. retain a reversionary interest; or .............................................................................................................. d. receive the promise for life of either payments, benefits or care? ............................................................ ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................................................... ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ^ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................................. ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1508 EX+~6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Donson, Robert C. Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 AC&S Inc. asbestos settlement litigation - as in all prior filings 10% is allocated to survival 21.89 action (PLEASE ABATE ALL PENALTIES 8r INTEREST) 2 H.K. Porter asbestos settlement litigation - as in all prior filings 10% is allocated to survival 38.92 action (PLEASE ABATE ALL PENALTIES & INTEREST) TOTAL (Also enter on Line 5, Recapitulation) I 60.81 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1151 EX+(10-06) gCHEDULE H COMMONWR~EALTCHOFq~PENNgUYLVANIA FUNERAL EXPENSES ~ IN RESIDENTEDECEDENTRN ADMINISTRATIVE COSTS ESTATE OF I FILE NUMBER Donson, Robert C. Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N MBER A. FUNERAL EXPENSES: B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(sl Commission paid 2, Attorney's Fees James, Smith, Dietterick 8~ Connelly, LLP 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zio Relationship of Claimant to Decedent 4. I Probate Fees 5. I Accountant's Fees 6. I Tax Return Preparer's Fees 250.00 7. Other Administrative Costs 30.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 280.00 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF Donson. Robert C. FILE NUMBER ITEM NUMBER DESCRIPTION AMOUNT Register of Wills -filing fee for Supplemental Return & Inventory 30.00 H-B7 30.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV-1573 EX+ (~~.08) ~~ CryH ,,qq~~ SCHEDULE J COMMN RESIDE JTEDECEDEN~RNANIA BENEFICIARIES ESTATE OF ~ FILE NUMBER Donson. Robert C. NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Not t Tru ee s I TAXABLE DISTRIBUTIONS [include outright spousal . distributions, and transfers under Sec. 9116 a 1.2 1 Alexander D. Donson Son 1/2 of residue 213 N. Locust Point Road Mechanicsburg, PA 17055 2 Tina Beam Klinefelter Daughter 1/2 of residue 26211 Camden Woods Dr Ft Mill, SC 29707 Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 15 00 cover sheet, as a r o riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 c;OVtrc 5htt i I Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) -~ ° o ~ m j..,~'i f-+ ~ ~ ~ N ~ ~~~ ~,.' ~ L ~ - r j ~ ~ _ ~ ~ ,!7 r ~~ oC~ ~ ~ ';-' ~ o Q, ' v ~ ~ ,~ i. ~ ._, e. / °~ W ~-' / i `,.,~ ~.. r ' ~tiJ ~,: Ill 'i W {umY u - ~.. r .a i-^~. dTTJ Y ' ~' I..II D ;C b9 N ~ ~ ~ _ ~p -A ~ ^~ S ~ door' oo n ~ ~ND~ ~~om C ~ D ~~ ~ ~ o~ ~ J T r r o ...f v l ~cr i`~4 ~« zs ~~{ ~k ~S [b ~n~ ~i x ~ W ~ Y Y?a 00 ~ `~ a m O a M i--~ /4 ~' 1 '. H~ b9 D ~ O c ` `o z .A .~ ~ W m z {-~' ., cD '. ~' O ~ ~~ ~ _ ~-~ _~_ _ a _ _ -~ ° ° o ~ ~ ~ o --i m = ~ m . '~ ~ ~ ` ~ ~ ~ ~ ~ A ~ o ~~ rh ~ o _ ~ Cr ~--' ~ ~- O r ~ ~ ~ r i, ~ ~ ~. ~ m O : ~ d ~ ~~~~ . o ~~ w r ,'~ ~~ Lfl LI-r .^ r . ~ m 1.1 - i Lfl @~ I ~~ y,~ D ;< 69 W N i--~ D O m W ~~ W D ~ O N z ~ -~ ~ m _~ Z door Oo~cD v ~ D C x m ~ ~ ~~oz D ~~,~m o~ ~ ~ T r r o ,,,~ ° v ~~r~,J .~ ~', w 0 ~°z~ o ~ ``//z~~,, yL~ G !L. R. pay z c m ~ i' N ~` . ~ ;, ~ '! REGISTER OF WILLS OF COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland Tina Beam Klinefelter rv COUNTY, PE YLVA~IA ~ ~ ~ ,;~ ~-~ ; r t.,,~ t.~:~ File Number 1999-00509 .,,,, ~ _,,, c..:'- _-' Personal Representative(s) of the Estate of Robert c. Donson ~: `~,;. "" s deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation place opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent o ed n real estate outside offit/he Commonwealth of Pennsylvania except that which ~ p •in a Fa,nd ~m ~CFye ~nc~,of is:in egtory. I veri that the statements made in this Inven- ~ \ ~: (l. IUI~ f„ tory are true and correct. I understand that false state- Tina Beam. KI efelter ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorney -- (Name) (Firm) (Address) (Telephone) Edward P. Seeber (Supreme Court I.D. No.) 76084 James, Smith, Dietterick 8~ Connelly, LLP 555 Gettysburg Pike, Mechanicsburg, PA 17055 717/533-3280 DATE OF DEATH LAST RESIDENCE 12 Clover Lane DECEDENTS SOC. SEC. NO. 04/30/1999 Mechanicsburg, PA 17055 175-40-5870 FIGURES MUST BE TOTALED Personal Proms Cash ............................................................................................... Personal Property ........................................................................ Stocks/Listed ................................................................................ Stocks/Closely Held ..................................................................... Bonds ............................................................................................ Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ........................................................................ Total Personal Property ........................................ Total Real Property ................................................ 60.81 60.81 Total Personal and Real Property .................... ~- 60.81 INVENTORY (Supplemental) CUMBERLAND NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. § 3301(b)) i €~ ~ J Form RW-09 Rev. 10-13-2006 ~r I INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 1999-00509 DATE OF DEATH LAST RESIDENCE 12 Clover Lane DECEDENTS SOC. SEC. N0. 04/30/1999 Mechanicsburg, PA 17055 175-40-5870 Cash AC&S Inc. asbestos settlement litigation - as in all prior filings 10% is allocated to survival action (PLEASE ABATE ALL PENALTIES & INTEREST) H.K. Porter asbestos settlement litigation - as in all prior filings 10% is allocated to survival action (PLEASE ABATE ALL PENALTIES & INTEREST) Total Cash 21.89 38.92 60.81 (Attach additional sheets if necessary) Total Personal Property and Real Estate 60.81 JAMES SMITE i DIEF,TI'IIZICK & CONNELLY LLP Cheryl L. Baker, CP Certified Paralegal clb c~jsdc.com June 4, 2012 P~o. f3ox ~~so HERSHEY. PII~C'~ ,,,,~,~IJi,,, Glenda Farner Strasbaugh, Register of Wills ~ ~ I . Cumberland County Courthouse „ , ~ ~ ,~,,, 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Robert C. Donson, deceased File No. 1999-00509 Dear Ms. Farner Strasbaugh: Enclosed are the following documents to be filed in the above-referenced Estate: GARY L. JAMES MAX J. SMITH, JR. 1. An original and two (2) copies of the Pennsylvania Inheritance Tax Return. JOHN J. CoNNEUV, JR. 2. An original and one (1) copy of the Inventory. SCOTT A. DIETTERICK JAMES E. SPADE A check in the amount of $30 00 made payable to the "Register of Wills 3 F~ABAL, "' E~w YC M . , . ~ n i Cumberland County" for the filing fee of the Return and Inventory. EDWARD P. SEEBER RONALD T. TOMASKO SUSAN M. KADEL Please time-stamp the extra copies and return them to me in the enclosed self-addressed, COURTNEY K. POWELL K,MBERLY A. BoNNER stamped envelope. KAREN N. CoNNELLY CHRISTINE T. BRANN JESSICA E. LowE If you have any questions, please feel free to contact me. GREGORY A. KOGUT, JR. THOMAS J. cAR RALPH M. SALVIA TERESA M. REIFSNYDER Sincerely, JAMES D. YOUNG OF COUNSEL: GREGORY K. RICHARDS .TAMEST SMITH, DIETTERICK & CONNELLY, LLP BERNARD A. RYAN, JR. ,~., ~ ~~ ~ C1~er I~ L. Baker CP Y Cer~ied Paralegal Enclosures cc: Tina B Klinefelter Executrix ''y ~ ~' . , ~ C r-:, c~ G a < ^ ~w '.. V I V ` ~...... ~ ~.. .. C- ~. 1'~.J ~.:4 ~j Reply to: Suite C-400 555 Gettysburg Pike Mechanicsburg, PA 17055 Direct Dial: 717-298-2094 Direct Fax: 717-298-2095 ,_ ~~ ~' _.. ~ ':9 i=~^ L1 :~_! 1._x.1 ~ ~._., .Y~l :.i_ 0 ~a a, ~ ~~ m P? W O x H 0 U H ~~ o a"' ~ _ ~~~ a ~ v, ~ ~ ~8 ~- - x ~ x w tJ'~ :~;~a ,^~ w H W C/~ Ha ~ C/~ H ' ~) ~ 0 W ~4U ~U NOTICE OF INHERITANCE TAX ~ pennsyLvania APP S~F~IENT, ALLOWANCE OR DISALLOWANCE BUREAU OF INDIVIDUAL TA~.~`(l~}''S(~I"l t`~f1G~CTIONS AND ASSESSMENT OF TAX DEPARTMENT OF REVENUE INHERITANCE TAX DIYISION vti1 f -J`~-LLa JL, t!f" REV-1547 EX AFP (09-12) PO BOX 280601 ~!~';~i 'r ~~,~ { HARRISBURG PA 17128-0601 ' '~'.?~ ._. ~ ~ ~ _.i. -:s,~ ~~~ 13 PM I ~ 10 ~,g ~i It-iV v v~lVfj~ EDWARD P SEt~IFRj AND ~,~ PA STE (400 555 GETTYSBURG PIKE MECHANICSBURG PA 17055-5207 DATE 11-05-2012 ESTATE OF DONSON ROBERT C DATE OF DEATH 04-30-1999 FILE NUMBER 21 99-0509 COUNTY CUMBERLAND ACN 507 APPEAL DATE: 01-04-2013 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ---- ~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS ~ _ REV-1547 EX AFP C12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: DONSON ROBERT (FILE N0.:21 99-0509 ACN: 507 DATE: 11-n~-~n» TAX RETURN WAS: C X] ACCEPTED AS FILED C ) CHANGED APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 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 F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) C1) .00 c2) .00 c3) .00 C4) .00 c5) 60.81 c6) .00 C7) .00 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. cs) 60.81 C9) 280.00 ClD) .00 11. Total Deductions C11) 280.00 12. Net Value of Tax Return 219 19- 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C12) . 0 0 14. Net Value of Estate Subject to Tax C13) . C14) 219.19- NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 19 will reflect figures that include the total of all returns assessed to date ASSESSMENT OF TAX: . 15. Amount of Line 14 at spousal rate C15) .00 X 0 0 - .0 0 16. Amount of Line 14 taxable at lineal rate (16) nn X 0 6 = .0 0 17. Amount of Line 14 at sibling rate C17) nn X 0 0 = .0 0 18. Amount of Line 14 taxable at collateral rate C18) .0 0 X 15 = .00 19. Principal Tax Due TAX CREDITS: (19)= .0 0 PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT CCR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone : (717) 240-6345 1 E. Date : 4/01/2013 CUM8Ef,;_ ': SEEBER EDWARD PETER 555 GETTYSBURG ROAD SUITE C 400 MECHANICSBURG, PA 17055 RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6 . 12 is due on the below listed date . As per the AMENDMENTS TO SUPREME COURT ORPHANS ' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1 , 1992 , the personal representative or his counsel, within two (2) years of the decedent ' s death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/30/2013 Please feel free to contact this office with any questions you may have . If you have already filed your Status Report, please disregard this notice . Sincerely, Glenda Farner Strasbaugh Clerk of the Orphans ' Court CC : File Personal Representative (s) ♦ 0. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone : (717) 240-6345 I !JZ: OF 1 El ? 0 5 JJ (,ii -. :J !tl i� I ii J Date : 4/01/2013 ; I TINA L BEAM 1350 WINDSOR ROAD MECHANICSBURG, PA 17050 RE: Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6 . 12 is due on the below listed date . As per the AMENDMENTS TO SUPREME COURT ORPHANS ' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992 , the personal representative or his counsel, within two (2) years of the decedent ' s death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/30/2013 Please feel free to contact this office with any questions you may have . If you have already filed your Status Report, please disregard this notice . Sincerely, Glenda Farner Strasbaugh Clerk of the Orphans ' Court CC : File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Robert C. Donson Date of Death: 04/30/1999 File Number: 21-99-0509 Pursuant to Pa. O.C. Rule 6.12, 1 report the following with respect to completion of the administration of the above-captioned estate.: 1. State whether administration of the estate is complete: ❑ Yes ® No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 4/30/2013 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? ❑ Yes ❑ No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ❑ Yes ❑ No d. Copies of receipts, releases,joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date 04/12/2013 Sig of Person Filing this Form Capacity: ❑ Personal Representative ® Counsel U_ r Edward P. Seeber #76084 Name of Person Filing this Form -t :.o - 555 Gettysburg Pike - Suite C400 V7 Q Address LI-) _ Mechanicsburg, PA 17055 f.' C.Q U City,State,Zip L3 C-D w f___= p 7171533-3280 LU r = Telephone Form RW 10 Ret'�f�-13-2006 f--- Copyright(c)2006 form software only The Lackner Group.Inc. i� Cumberland County - Register Of Wills One Courthouse Square -° Carlisle, PA 17013 Phone : (717) 240-6345 RECORDED OFFICE OF REGISTER OF WILLS 2014 AN 3 AID 10 04 CLERK OF ORPHANS' COURT CUMBERLAND CO., PA Date : 4/02/2014 SEEBER EDWARD PETER 555 GETTYSBURG ROAD SUITE C 400 MECHANICSBURG, PA 17055 RE : Estate of DONSON ROBERT C File Number: 1999-00509 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6 . 12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS ' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1 , 1992 , the personal representative or his counsel , within two (2) years of the decedent ' s death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/30/2014 Please feel free to contact this office with any questions you may have . If you have already filed your Status Report, please disregard this notice . Sincerely, Lisa M. Grayson, Esq. Clerk of the Orphans ' Court +m Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Robert C. Donson Date of Death: 04/3011999 File Number: 21-99-0509 Pursuant to Pa. O.C. Rule 6.12, 1 report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: ❑ Yes ® No 2_ If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 4130/2014 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? ❑ Yes ❑ No b. The separate Orphans'Court No. (if any)for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ❑ Yes ❑ No d. Copies of receipts, releases,joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. vale"- 1/04/&014 5 J H Sgnafum of Flfrrp to U.I J .N-1 cif U E tL Capacity: ❑ Personal Representative ® Counsel O U p - � Q W W J a Edward P. Seeber #76084 ~ U = LL] Name of Person Rleg this Form p' — C- a c.D � 555 Gettysburg Pike w � Suite C-400 o address N Mechanicsburg, PA 17055 City,state,Lp 7171533-3280 Telephone Form RW-10 Re,to f3-2008 Copyright(c)2006 form somvare arty The Latlmer Group.tric. . _ -�� ..��„�, � .,� " �..r� -.,� �_ . . _. _ � r � INVENTORY (Supplemental) REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 1999-00509 Tina Beam Klinefelter Personal Representative(s)of the Estate of Robert C. Donson deceased,depose(s)and say(s)that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent,that the valuation placed opposite each item of said inventory represents its fair value as of the date of the d cedenYs d ath,and that cedent wne no real estate outside of the Commonwealth of Pennsylvania except that w ich a i r du t end i ' ventory. I verify that the statements made in this Inven- � tory are true and correct. I understand that false state- � Tina Beam Klinefelter ments herein are made subject to the penalties of � 18 Pa.C.S.§4904 relating to unsworn falsification to authorities. Attorney-- (Name) Edward P. Seeber (supreme court i.o. No.) 76084 (Firm) .1SDC Law OffiCes (Address) 555 Gettysburg Pike, Mechanicsburg, PA 17055 (Telephone) 717/533-3280 DATE OF DEATH LAST RESIDENCE 12 Clover Lane DECEDENT'S SOC.SEC.NO. 04130/1999 Mechanicsburg, PA 17055 175- FIGURES MUST BE TOTALED Personal Pro�ertv Cash............................................................................................... 4,172.31 t`.,� PersonalProperty........................................................................ ,.—� , -a_, -� , ;-�-� _ , _ ___ Stocks/Listed................................................................................ ; -',, � � , Stocks/Closely Held..................................................................... , z:, Bonds............................................................................................ :�; -_, , _ Mutual Funds................................................ �' � � ................................ �� � ,,. _ , _,_, --- Partnerships and Sole Proprietorships ..................................... ,_. . ,. ;:�:t -,, _ , - Mortgages and Notes Receivable............................................... �` � � `•'�� ' � '7? AllOther Property........................................................................ .. Total Personal Property........................................ 4,172.31 TotalReal Property................................................ Total Personal and Real Property........................ 4,172.31 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may,at the election of the personal representative include the value of each item,but such figures should not be extended into the total of the Inventory.(See 20 Pa.C.S.§3301(b)) Form RW-09 Re�.io-�s-zoos . ��/t/ �,����������������� _ .__ � ��� .�� INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } ss File Number 1999-00509 DATE OF DEATH LAST RESIDENCE 12 Clover Lane DECEDENT'S SOC.SEC.N0. 04/3011999 Mechanicsburq, PA 17055 S�aS.I] Armstrong asbestos litigation-as in all prior filings 10%is allocated to survival action 4,172.31 (PLEASE ABATE ALL PENALTIES 8�INTEREST) Total Cash 4,172.31 (Attach additional sheets if necessary) Total Personal Property and Real Estate 4,172.31 . . . .A,.. �.,. ..� ,��-�� �_4 ,y„�. � ��:��..� g. �� _.. � 1505610143 REV-1500 Ex`°2_,,, ��_ PA De artment of Revenue y OFFICIAL USE ONLY p penns Ivania County Code Year File Number Bureau of Individual Taxes DEPARTMENTOFREVENUE Po Box.2soso� INHERITANCE TAX RETURN 21 99 0509 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 04 30 1999 06 29 1949 DecedenYs Last Name Suffix DecedenYs First Name MI DONSON ROBERT C (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Original Return � 2. Supplemental Return � 3. Remainder Return(Date of Death Prior to 12-13-82) � 4. Limited Estate � 4a.Future Interest Compromise � 5. Federal Estate Tax Return Required (dale of death after 12-12-82) � g Decedent Died Testate � �� (qttacheCo a�of Trust a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) PY ) � 9. Litigation Proceeds Received � 10.Spousal Povert Credit�(Date of Death � ��.Election to tax under Sec.9113(A) belween 1231�J1 and -1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number EDWARD P SEEBER 717 533 3280. .. r� _ , � :_ ::: z� -�, , REGISTE�;'OF.WILLS USE ONLY' — �..- � First Line of Address �`' � 555 GETTYSBURG PIKE - ,. Second Line of Address �\-� � SUITE C400 'c� _ �A '�-_ � � ,m, c.•� DATE FILED�'' City or Post Office State ZIP Code MECHANICSBURG PA 17055 CorrespondenYs e-mail address: eps(a�isdc.cotl� Under penalties of perjury,I declare that I have examined this retu including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct nd complete. eclaration of prepa er othe ha e personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF P FILI RN DATE Tina Beam Klinefelter � ADDRESS 26211 C den Woods Dr�t Mill❑SC 29707 SIGNATURE PREP OTHER THAN REPRESENTATIVE DATE Edward P. Seeber � �� ADD S 55 Gettysburg Pike�6uite C-400dVlechanicsburgCPA 17055 Side 1 � 1505610143 1505610143 J � _ _ _ . _ _ :: ,. : _ F �� �� ���;� �.�_ ,.� �� ,� .��� ...�;. , , � 150561D243 REV-1500 EX DecedenYs Social Security Number Decedent�sName: DOIlS011� RObe�t C. RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 2. Stocks and Bonds(Schedule B)............................................................................. 2. 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3. 4. Mortgages&Notes Receivable(Schedule D)........................................................ 4. 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 4 , 172 . 31 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous�nn�Probate Property (Schedule G) U Separate Billing Requested............ 7. g. Totai Gross Assets(total Lines 1 through 7)........................................................ g. 4 , 172 . 31 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 4 , 00 6 . 92 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 4 , 00 6. 92 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 165 . 3 9 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)............................................... 13. 14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 165 . 3 9 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.00 15. 0 . 0 0 16. Amount of Line 14 taxable 165 . 3 9 16. 9 • 92 at lineal rate X .06 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 0 18. � . �0 19. TAX DUE................................................................................................................ 19. 9 . 92 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � Side 2 � 1505610243 1505610243 � .. > ._. __., � �-3 � _ �, ,� � $._�:.�. �,.�.�.��_.,���� : ��- REV-1500 EX Page 3 File Number 21-99-0509 Decedent's Complete Address: DECEDENT'S NAME Donson, Robert C. STREET ADDRESS 12 Clover Lane CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 9.92 2. Credits/Payments A. Prior Payments B. Discount Total Credits(A +B) (2) 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2[line 20 to request a refund 5, If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 9.92 Make Check Payable to REGISTER OF WILLS❑AGENT ...;. ..�...� � - .��: -�\ � V f� ��/A �e`ca�,v/i r•�.. -� i/%i� � ;' � ��� .:\a '; �`�S. yy�; � � 1 F � �� \ / ���Mx%�/'ii/ � i„rg � ,.E� o •���� ^; ��� .. .. ,/.v�. .:.... >e�� ....°�!,,. //.,�. ...,,...�.s . ' :i;���..'.i�.�..a... .,,. :-�.� .a, ,�..�.�.��..�.�. .����.�'/y/'✓„G�����i�i/✓.ti ..,i..,.: S.. ..a....'�.� • .... ..,. . ...._ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred:...................................................:........................... ❑ ❑x b. retain the right to designate who shall use the property transferred or its income:.................................. ❑ ❑x c. retain a reversionary interest;or............................................................................................................... ❑ � d. receive the promise for life of either payments,benefits or care?............................................................ ❑ 0 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receivingadequate consideration?.................................................................................................................... ❑ ❑x 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ 0 4. Did decedent own an individual retirement account,annuity,or other non-probate property which containsa beneficiary designation?.................................................................................................................. ❑ ❑X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES�71(OU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ��,......_ �' r � .' � ,: ��-.w,�,.. .��....� � �� .<. ...... ..�:` �,,,,��,,.�`. < ..���:e �1:�!�.�'.,��,ra �..a...,...:;�ea��?Y.`�,•. ,,,.-i'�i� ��::.�..,T�,.�.� For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)J. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: . The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent,or a stepparent of the child is 0 percent(72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedenYs lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. . The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. .;. . - - .�,W -� �.�.�,tt.�.�� . ��� w �..,�. Rev-1508 EX+(�1-10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCETAXRETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Donson, Robert C. 21-99-0509 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Armstrong asbestos litigation-as in all prior filings 10%is allocated to survival action 4,172.31 (PLEASE ABATE ALL PENALTIES&INTEREST) TOTAL(Also enter on Line 5, Recapitulation) 4,172.31 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10) �.� � ��,.,�. � � �_ . .���,.� �;z� .��..�-..._ REV-1511 EX+(�0-09) pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Donsond2obert C. 21-99-0509 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N q, FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Tina Beam Klinefelter StreetAddress 26211 Camden Woods Drive City Ft Mill State SC zio 29707 Year(s)Commission Paid 2014 21086.15 2, Attorney's Fees JSDC Law Offices 500.00 3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address City State Zip Relationshio of Claimant to Decedent 4. Probate Fees 5. AccountanYs Fees 6. Tax Retum Preparer's Fees 7. Other Administrative Costs �f�12�•�7 See continuation schedule(s)attached TOTAL(Also enter on line 9�ecapitulation) 4[D06.92 Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09) �;,� , ,._ � �_>.�,�.� �.���� ��;,�.�.� , �F � , Y�..,�,�. SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Donson, Robert C. 21-99-0509 ITEM NUMBER DESCRIPTION AMOUNT Other Administrative Costs 1 Register of Wills-filing fee for Supplemental Return&Inventory 30.00 2 Shein Law Center, LTD. -attorney fees for civil litigation; 10°/a allocated to survival action 1,390.77 H-B7 1,420.77 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) .�._�.. ����4�.���� �x , . . - _ _ ��-:� . ��.: �„�.. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Donson, Robert C. 21-99-0509 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$) I� TAXABLE DISTRIBUTIONS [include outright spousal distribuUons;and transfers under Sec.9116 a 1.2 1 Alexander D. Donson Son 1/2 of residue 82.69 23 Nottingham Road Camp Hill, PA 17011 2 Tina Beam Klinefelter Daughter 1/2 of residue 82.70 26211 Camden Woods Dr Ft Mill,SC 29707 Tota I 165.39 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTR�BUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10) ,. , ��- � �;� ..�.� �- �.�.��.���„��- �� �- �_ _ - �,_ � - � � — ;� .� . ___ _ _. _ , � h�,%'%' o ° o D I ��lilr � m d � ��� � � � � � � � , � ° � °O � _ _-> �. � � � �, m F � � -� � Z -..`' p� c�'o -P = � J� � � t� Doar � O : �.) � � � �nD � r . ` t� t-ri = � v � C) � f"� � ��-+ D mnIT1 � l, ) p ?� y � CZ � ��.i � � � Pi1 k� p� fO � 70 � � T • � J r� r a■ °� � � O �I 't. ,°. � � ❑ � C� � � � ���, �1,:�; LIl W , ��,"��� . s■ � �N�: Y1 � � A � ��.Y m-' W � I (\P � W � O � � � I-�-+ � LI1 � m � � ��� � G� m � =i� =� s� :�v � D N � J O pp C Z � Z C � � � W � � N � ;: .L`� ' f,0 i,lj' � i,l;;' � u'� , � � �_ _,. =- , , -� _ ___ _. I , _._. � �.4 ��,�,�h �:,�..�m,..�,#.���;r .�m �,�� �__.� �..� � �.� ,�. . Pennsylvania Office: L, � � C New Jersey Office 121 South Broad Street 5434 King Avenue 1i�venty First Floor Suite 202 Philadelphia,PA 19107 Pennsauken,NJ 08109 (215) 735-6677 SHEIN LAW CENTER, LTD. (856)427-9527 Fa.�c (215) 732-3630 ATrox�YS AT Law FaY (856)427-9585 January 14, 2�)14 Tina Klinefelier,Extr x. Estate of Robert Donson 26211 Camden Woods Dr. Fort Mill, �C 29707 Re: Asbes�os Liti ag tion D:,u:T�s. k !�n�felter: Enclosed please find a check in the amount of$27,815.42 which represents an additional payment from Armstrong. Armstrong recently increased their payment percentage. As you are aware, expenses (if applicable) witl be deducted from future settlements. Since ti:is case involved a decedent,you as personal representative of the estate have certain legal responsibilities. An estate bank account must be opened. The check made payable to the estate is for deposit into the estate account. All outstanding debts of the estate must be paid, State Inheritance Tax Returns and possibly Federal Estate Tax Returns must be filed with the Court and all taxes paid. Finally, all distributions must be paid to the persons designated as beneficiaries. All of this is your responsibility. If you have any questions or wish to consult an estate attorney, please contact us and we will recommend someone. We thank you for your reliance upon our experience and judgment and for your display of confidence in permitting us to negotiate your case towards settlernent. Kindly sign one copy of the Statement of Settlement and return it in the enclosed envelope. The second cony is for your personal records. Very truly yours, SHE C , LTD. � By: Benjamin Peter Shein, Esquire Enclosures www.sheinlaw.com ���� COMMONWEALTH OF PENNSYLVANIA REV-1162 EX�11-J6) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 1 7 1 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 018800 JAMES SMITH DIETTERICK ET AL PO BOX 650 HERSHEY, PA 17033 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold '_"_""' '___"_' 101 � S9.92 ESTATE INFORMATION: ssrv: �� I FILE NUMBER: 2199-0509 I DECEDENT NAME: DONSON ROBERT C I DATE OF PAYMENT: 02/24/2014 I POSTMARK DATE: 02/19/2014 I CoUrvTY: CUMBERLAND � DATE OF DEATH: 04/30/1 999 I � TOTAL AMOUNT PAID: 59.92 REMARKS: RECEIPT TO ATTY CHECK# 10411 INITIALS: HMW SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS JsDC Law O�� JAMFS•SMITH�DIETTIIZIQC�CONNELLY�SPADE�CHABAL�YAHN�SEEBER�TOMASKO Cheryl L.Baker,CP Certified Paralegal clb@jsdacom February 19, 2014 P.O.Box 650 HERSHEY,PA 17033 .MNN OFFICE: Register of Wills 1sa s�PE a�EN�E HuMME�STOwN,Pq 17036 Cumberland County Courthouse 1 Courthouse Square WEST SHORE LOCATION: Carlisle, PA 17013 555 G�„''SB�RG P'KE SUITE C400 MECHaNicseuRG,PA 17055 Re: Estate of Robert C. Donson, deceased File No. 1999-OOSO9 TEL.717.533.3280 WWW.JSDC.COM Dear Register: GARY L JAMES Enclosed are the followin documents to be filed in the above-referenced Estate: "'�� sM�T",�R. g JoHN J.CoNNE��v,JR. Scorr A.DiErrEaicK 1. An original and two (2) copies of the Pennsylvania lnheritance Tax Return. �A"'ES F.sPA°E 2. An ori nal and one /1 co of the Inventor . MAnH�cHABA�,��� � l � pY Y NEi�W.YaHrv 3. A check in the amount of $30.00 made payable to the "Register of Wills, E°�^'�°P.sEEeER Cumberland County" for the filing fee of the Return and Inventory. R°"�°T.T°MASK° SUSAN M.KADEL 4. A check in the amount of $9.92 made payable to the "Register of Wills, co�RTN�K.PoWE�� Agent" for the inheritance tax due. 't^RE"".c°""E��Y CHRISTINE T.BRANN JESSica E LowE Please time-stamp the extra copies and return them to me in the enclosed self-addressed, GREGORY A.KoG�T,�R. y� }� THOMAS J.CAR $tamred enVel�Ye. TERESA M.RBFSNYDER JaMES D.YouNG If you have any questions,please feel free to contact me. cAY�B."E"" A��iS M.Mi�OSZEwSKi Sincerely, oF c��NSE�: GREGORY K.RICHARDS � KIMBERLY A.BONNER JSDC LAW OFFICES Rn�PH M.sn�vin f �� � ANDREW H.BRIGGS Ch . aker, CP rtifie Paralegal =- _ : ^�� _ ,� - � sures - ;. , ;,: cc: Tina B. Klinefelter, Executrix � , -,; __:: _ � _, - . -; ,I.J .; :�. ` i�, t��r _ -, Reply to: Suite C-400 555 Gettysburg Pike Mechanicsburg,PA 17055 Direct Dial: 717-298-2094 Direct Fax: 717-298-2095 . ,. °... .�.� . �.� �x�.. , �z � r � .p t� s �i � o�;-C y � tC � t'" ,� � � � � �� � y � � 0 � �, a � o � � ._ � � � � � � roo � o y � z � d o � or W'� � � � y � 0 � � r_�- x = -1-� o , ,, � . � � .� ,,, r� : ._> _ - ,--. - , , -���; � � .� _ . -� „ . --��-: _�, �, . �: ,�� . , . � .r i .�.�� +,_ ..W� �p� a°: _� L� 4, MKY�.4!•4i�' .., . . � ��S�.ER ��;. i m �.j � I �__ ; i „ '- o � � y`. � ;Q - i n,a � ' � v j r" j - ��, -� � ;<;, �:7 � ��'9 Pn��rl'��F-,`. NOTICE OF INHERITANCE TAX %7pennsytvania BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX DEPARTMENT OF REVENUE PO BOX 280601 REV-1547 a AFP (08-13) HARRISBURG PA 17128-0601 DATE 07-28-2014 ESTATE OF DONSON ROBERT C DATE OF DEATH 04-30-1999 FILE NUMBER 21 99-0509 SEEBER EDWARD P COUNTY CUMBERLAND STE C400 ACN 508 APPEAL DATE: 09-26-2014 555 GETTVSBURG PIKE (See reverse side under Objections) MECHANICSBURG PA 17055-5207 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE y RETAIN LOWER PORTION FOR YOUR RECORDS 4-REV-1547 EX AFP (08-133 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE --OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: DONSON ROBERT CFILE NO. :21 99-0509 ACN: 508 DATE: 07-28-2014 TAX RETURN WAS: ( X) ACCEPTED AS FILED ( ) CHANGED APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN 1. Real Estate (Schedule A) (1) . 00 2. Stocks and Bonds (Schedule B) NOTE: To ensure proper (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) of this form with your (4) .00 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 4,172.31 6. Jointly Owned Property (Schedule F) (6) . 00 7. Transfers (Schedule G) .00 8. Total Assets 7) APPROVED DEDUCTIONS AND EXEMPTIONS: (B) 44. 72�� 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 4.006 92 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 00 11. Total Deductions 12. Net Value of Tax Return (11) 4,006.92 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (12) 165.39 14. Net Value of Estate Subject to Tax (13) 00 (14) 165.39 NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 19 will reflect figures that include the total of all returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at spousal rate (15) .00 X 00 = . 00 16. Amount of Line 14 taxable at lineal rate (16) 1F3,i9 x 06 - 9,92 17. Amount of Line 14 at sibling rate (17)� On = 18. Amount of Line 14 taxable at collateral rate X 00 - .00 (is) . 00 X 15 = . 00 19. Principal Tax Due TAX CREDITS: (16= 9.92 PAYMENT RECEIPT DISCOUNT (+) C n r =_1 Ti DATE NUMBER AMOUNT PAID rt -7) C_ 171 r' INTEREST/PEN PAID (-] C f_ . ' 02-19-2014 CDO18800 r- .00 9.92 co C`: C CJ C: =' n TOTAL TAX PAYMEN Cn 9 C BALANCE OF TAX DUE . 00 INTEREST AND PEN. . 00 TOTAL DUE .00 IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS. ,t,� Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Robert C. Donson Date of Death: 04/30/1999 File Number: 1999-00509 Pursuant to Pa. O.C. Rule 6.12, 1 report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: ❑ Yes ® No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 4/30/16 3, If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? ❑ Yes ❑ No b. The separate Orphans' Court No. (if any)for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ❑ Yes ❑ No d. Copies of receipts, releases,joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date 0-L) &-7�— Signatu Person Filing this Form L._ Capacity: ❑ Personal Representative ® Counsel t.._I .»_a r-1 Edward P Seeber #76084 " Name of Person Filing this Form Suite C-400 '`) 555 Gettysburg Pike rf- CJ C M_ Cl_ f D Address Cz= s_ o `j Mechanicsburg, PA 17055 �i C') City,State,Zip 717-533-3280 Telephone Form RW-10 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc.