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Home My WebLink About01-04-08 .:.J 15056051047 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 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAl USE ONLY County Code Year File Number Date of Birth Decedent's Last Name Suffix Decedent's First Name MI (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 c::;:) 2. Supplemental Return C) ~ 4. Limited Estate c:> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required C) c::3 4a. Future Interest Compromise (date of death after 12-12-82) C:) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) C) 10. Spousal Poverty Credit (date of death C) 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Da time Telephone Number 6. Decedent Diec Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes c::>> Firm Name (If Applicable) REGISTER OF WILLS US6..6lNLY C-"") c:.' .. . f~:;:.J '"r:-, "'-J L_ ~-~._'b -.". *,,'1_ I J:;'- )C) ;:' ) --, 'j \j 3.: 1'0 .. o Correspondent's e-mail address: I:> b v ~-e,.. t:. Q.. r' 0{ . /"l e f 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 complete. Declaration of preparer other than the pers al representative is based on all information of which preparer has any knowledge. DATE / 2. -2()~20d7 ~/J- 1'/ () ~s. 9..r J/ ADDRESS /<./2. J gox 1~ /..../vep;ooo~ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 --.Jon r --l 15056052048 REV-1500 EX Decedent's Name: l: 0 N It RECAPITULATION f-.. Fo'>TEre... 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. 6. Jointly Owned Property (Schedule F) c::::> Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c::::> Separate Billing Requested. . . . . . .. 7. Lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. Decedent's Social Security Number "'ll ,0 .<!' '-t 0, \ 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 12 minus Line TAX COMPUTATION. SEE 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O '-l S- 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 " . 'Z.- '2. t J 19. TAX DUE.. . . . .. . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT .~'v~'L ~Crt Side 2 15056052048 15. 16. 17. 18. '1 '1 c::> 15056052048 --l REV-150? EX Pag~ 3 Decedeht's Complete Address: DECEDENT'S NAME ___ er {)~_f2____u~__fy_~1 E K______________ STREET ADDRESS / 0 U 0 c- ~1l4t ~ ^" 6 N T K () I} () File Number CITY C-11-fJ.. ~ I$. l... E STATE fIT ZIP IID/"] Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) /4.<-/'( Total Credits ( A + B + C ) (2) 3. InteresUPenally if applicable D. Interest E. Penalty _______________0. '2 '-1.._ TotallnteresUPenally ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0, LIY 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) /'-1.'3 A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SA) (5B) 1'-1.9] 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;.......................................................................................... D EtJ b. retain the right to designate who shall use the property transferred or its income; ............................................ D EtJ c. retain a reversionary interest; or........................................"A.............................................................................. D Q d. receive the promise for life of either payments, benefits or care? ...................................................................... D 5l 2. If death occurred after December 12, 1982, didaecedent 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? .............. D Ii] 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. 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. 99116 (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. 99116 (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 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. 99116(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. 99116(1.2) [72 P.S. 99116(a)(1)). The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(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 + (1-97) ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT EDNA- i<- 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 disclosed on Schedule F. F~SjER ITEM NUMBER 1. DESCRIPTION P /V c- gq-/V K. j}-cc-vv....., -# .s- / 'f 02. 2...- 8""//'-1 :2/ B/'rfVl.{ I}-c::C(/~"t- #- 05">112-/ Lfq~ VALUE AT DATE OF DEATH I 0 '-I .8~ Ile/.7,/ 6 '-Is ./t. I L 2. J. i-S s 0 v E"R G , CrN 6, - C LbR. E ^1 O,v r IV () (<.S IIt9/ c- trol'-( IE (J 127<( S tJN j} It- c Cd lJ 11 t-t. f< EJVtI}-I ~D tEl?. Pt<OM pet/I}/D rtJ/V';/?jJ.L A--CCfJVI1 T TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3/s-1,'i:1 REV-1511 EX+ (12-99) ~"J~_~_ . . ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF EDN.4- /<- SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER POS' r~ lC- Debts of decedent must be reported on Schedule 1. ITEM NUMBER A. 1. FUNERAL EXPENSES: I< ec.e-P71()N DESCRIPTION ~ ~S T 11 V t2-tJ-IV T alL'- B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address Social Security Number(s)/EIN Number of Personal Representative(s) City State _ Zip 2. Attorney Fees Year(s) Commission Paid: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 4. Claimant Street Address City State _ Zip Relationship of Claimant to Decedent 5. Accountant's Fees Probate Fees Cov Ii!- 1170 \J s 17 ;::= t: ~ s 6. Tax Return Preparer's Fees 7. AMOUNT 168',/6 ~ 5'. 0 0 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) A5( 7t '\506EX>ll,97l ESTATE OF COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT E()/VI} SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER ~ ?t/S .r~-R 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 NUMBER 1. ;2. 2, ~, F,) C [~ . . ,. ~.... S.O"fr~'e""" (~:f"(~"~,,,-i DESCRIPTION ItCO?V"t 17 :: /LfD,c '2 f {''1 Ie. ..' ;, < .J~'" -. o!:> 7 II Z- 1 4 C( r , <>\ c ~ "oJ- .\- ()A., ,- c ,~... r t. 1'\'\, ~_:-f ~ "I (" }'" \ )i-t/ "" ~ ,0 .....J 'F,.J~ ff~...tt:.J t\J~-Q.~\ Il--C.CI'^-''\'''' ,......... ~ ....,.. (>.._ \ ..... ,~r f VALUE AT DATE OF DEATH f D,-/. gLj f/~1.7'7 G ~1, I '2... 1:2.'-1.7'1 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 315'J.tfJ REV-1512 EX+ (12-03) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER eOIl//)- /< r-o <;; je R ITEM NUMBER 1. Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. VALUE AT DATE OF DEATH Fit- DESCRIPTION D ,z-PT or wel-FI!tR.1ff' ~ST14 T~ R. ~c..o v z: ~ "( :;'5 C;L .si / TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, Insert additional sheets of the same size) 2,5 <12 .S-'1 / ~EV-1513 ~X+ (9-00) ~ - ,~ ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER I SCHEDULE J BENEFICIARIES EONf) ,:- 0) n- re FILE NUMBER RELATIONSHIP TO DECEDENT Do Not List Trustee(s) G- (( rHV oS 0 IV C- {2. fJ tv (),C I) ...... - ----- - - - --.-- ------.-- ---- -. -. G- rQ~! (J "- .' ---.- ---. AMOUNT OR SHARE OF ESTATE ~ .? ~ J Yl ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE r< 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Iv I <: It( I'r I Fo f" rlf' f?.. 6 1 s () ~'"1 'f'c..$ L~ t\ ~ H Ii Q ~ I':; ,,,i'!- G-- P ft I~ II I TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ --- '2 5Tt:~/}€W J. 77 3 IJ:I""~ l C eOIlDce, 12 on 0 fv1 T, P L.C~S~Jl/T M'Ll5 fA f) eS] 3r TO P.> ":' (< 8' (J J P ~ ~ p ~ \ .g 0-<- qg LIVcR PObt- Pt:t ('704r 1_ B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. (If more space is needed, insert additional sheets of the same size) . . LAST WILL AND TESTAMENT OF ,:;C) EDNA R. FOSTER , '....) .--, I, EDNA R. FOSTER, now domiciled in Cumberland County, Pennsylvania, declare thitji to be my Last Will and Testament. I revoke all other Wills and Codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. Article III I give, devise and bequeath in accordance with any memorandum which I have either handwritten or signed, located with my will or with my valuable papers and found within 30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. Article N I give, devise and bequeath all the remainder of my estate, of whatsoever nature and wheresoever situate, to my daughter, ZELDA F. BOUDER, of Cumberland County, Pennsylvania, should she survive me by thirty (30) days. In the event that ZELDA F. BOUDER predeceases me or does not survive me by thirty (30) days, I give, devise, and bequeath the remainder of my estate, of whatsoever nature and wheresoever situtate IN EQUAL SHARES to my grandchildren, NICK A. FOSTER of Dauphin County, Pennsylvania, provided he survives me by thirty (30) days, STEPHEN J. BOUDER, of Snyder County, Pennsylvania, provided he survives me by thirty (30) days, and TOBY R. BOUDER, of Juniata County, Pennsylvania, provided he survives me by thirty (30) days. However, if a beneficiary does not survive me by thirty (30) days, but leaves descendants who survive me by thirty (30) days, those descendants shall receive, per stirpes, the share the beneficiary would have received had he survived me by thirty (30) days. Article V Ifa beneficiary under this Will has not attained the age of twenty-five (25) years, the share of the beneficiary shall be placed in a separate trust, for the benefit of that beneficiary according to the terms in Article VI. 2 Article VI In the event that a Trust is created by or as a result of any part of this Will, the terms and conditions of the Trust shall be as follows: A. To expend and apply so much of the net income and so much of the principal of the Trust as the Trustee shall consider advisable for the support, care, health and education of the child until the child attains the age of twenty-two (22). B. Upon attaining the age of twenty-five (25), the remaining principal and accumulated income of the child's share shall be distributed outright to the child. C. No beneficiary or remainderman of this Trust shall have any right to alienate, encumber, or hypothecate his or her interest in the principal or income of the Trust in any manner, nor shall any interest be subject to claims of his or her creditors or liable to attachment, execution, or other processes oflaw. Article VII In order to carry out the purposes of the Trust established by this Will, the Trustee, in addition to all other powers granted by this will or by law, shall have the following powers over the Trust estate, subject to any limitations specified elsewhere in this Will. (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal 3 investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, and (i) to conduct along with or with others, any business in which I am engaged in or have an interest in at the time of my death. Article vrn I hereby appoint my grandson, TOBY R. BOUDER, as Trustee for any Trust(s) created in this Will. In the event of the renunciation, death, resignation, or inability to act for any reason whatsoever of TOBY R. BOUDER, I nominate and appoint NICK A. FOSTER, as the Trustee of any Trust(s) created in this Will. In the event of the renunciation, death, resignation, or inability to act for any reason whatsoever of NICK A. FOSTER, I nominate and appoint STEPHEN J. BOVDER, as Trustee of any Trust(s) created in this Will. 4 Article IX I nominate, constitute, and appoint my daughter, ZELDA F. BOUDER as Executrix of my Last Will and Testament. In the event of the renunciation, death, or inability to act, for any reason whatsoever of ZELDA F. BOUDER, I nominate, constitute and appoint my grandson, TOBY R. BOUDER as Executor of my Last Will and Testament. In the event ofthe renunciation, death, or inability to act, for any reason whatsoever of TOBY R. BOUDER, I nominate, constitute and appoint my grandson, NICKA. FOSTER as Executor of my Last Will and Testament. I direct that my Executors be permitted to serve without bond. My Executors shall receive reasonable compensation for services rendered to my estate. Article X In addition to the powers conferred by law, I authorize my Executor, in their absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath he/she herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such 5 return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the vclue of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, and (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death. IN WITNESS WHEREOF, I, EDNA R. FOSTER, hereby set my hand to this my Last Will and Testament, on this /J day of /Jz,ci'4r'~ , /99 % , at Harrisburg, Pennsylvania. t:'fE1'-- P~4U-~ EDNA FOSTER . ~ In our presence, the above-named EDNA R. FOSTER signed this and declared this to be her Last Will and Testament and now at her request, in her presence, and in the presence of each other, we sign as witnesses. Address ,&''Ir;- ~t $Y'-v:1 {j, fIIo J ;:J /7/ Of ~ ~ n\U,^~S' (~/ t~1 ~ ~. c-l t \)\' 6 ... '" I, EDNA R. FOSTER, Testatrix, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Last Will and Testament, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by EDN~ R. FOST~e Testatrix, . G. ~ this _.\Oday of -e..u..l.>--. ~ '\ <1 (J ~. J' / ( ~~/17~ Nota.)' Public Notarial Seal ~on Messerschmidt, Notary PUblic My C ntcsf?u'll Boro, Cumberland Count ommlSSlOn Expires June 19, 2000Y c g ~ fP ~t;;;;_. EDNA R. FOSTER We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by Rr~HIJI!.IJ f). khfl/lJ-5KIE and'"TllvI L ~'\ witnesses... this \ 0 day of.J::)2C.:<2 ~ , V1<?\ ~. A~ 7Jk1-,J~ Notary Public tfZLJd~ ~~ Wi ess Notarial Seal Sharon Messerschmidt. Notary Public Mechanicsburg Boro, Cumberland County My Commission Expires June 19, 2000 7 . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DNlSION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 17105-8486 September 11, 2007 TOBY R BOUDER RR 1 BOX 98 LIVERPOOL PA 17045 BReOD lUlOU.ST ltBfltOlflR DCB8$.1JlY Re: EDNA FOSTER CIS#:..14oT69826 SSN: 177-10-3401 Date of Death: 12/31/2006 Dear Mr. Bouder: This letter is to advise you that according to the information you provided to our office regarding the assets of the above-referenced estate, the Department of Public Welfare will accept the balance, namely $2,592.54 remaining in the estate for payment of our existing claim. Please have the check made payable to the Department of Public Welfare and forwarded to my attention in the self-addressed, stamped envelope provided. Your cooperation in resolving this matter is appreciated. SIZ~ i~c~ Nicole L. Lipscomb TPL Program Investigator 717-772-6606 717-772-6553 FAX Enclosure RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17G13 Receipt Date: Recetpt Time: Recel.pt No.: 3/09/2007 12:56:16 1047608 FOSTER EDNA R Estate File No. : Paid By Remarks: 2007-00224 TOBY R BOUDER CJ ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST WILL SHORT CERTIFICATE JCP FEE AUTOMATION FEE Check# 7080 Total Received......... 30.00 15.00 4.00 10.00 5.00 ---------------- $64.00 $64.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D CUMBERLAND COUNTY GENERAL FUN RECEIPT FOR PAYMENT =================== GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17G13 FOSTER EDNA R Estate File No. : Paid By Remarks: Receipt Date: Receipt Time: Receipt No.: 3/09/2007 13:08:25 1047609 2007-00224 ROBERT BOUDER CJ Fee/Tax Description SHORT CERTIFICATE Check# 7081 Total Received......... Receipt Distribution -----------_____________ Payment Amount Payee Name __________~~~~__ CUMBERLAND COUNTY GENERAL FUN $4.00 $4.00 ~ ~ ~ ffi ~ ~ :gp Iii f a ~ o 00 . Ck i . E -a 8 .:i. . c: = ! o .~ U Q.l ~ 2 ~ o I :i) '-D ':-1-"'. ~j w (0 r-....... a.'G ~ .- ... Qg~ _U;;> u_ 0 at a ~ as ~ f;~ ;:: ;:: ~5 g . . .. u o;o:i~~ -.-l. ",,--I ~ - "t-f ...~-t ..... ..... r<) Ct (:;) , ';l.! ~,' ...-l <i...l j-..-. C/'. (>.. ...... c;, .---i c'.t :2. ;:".j .,'0 "':::r r ;~', ~ll .;.J ::..-. ".. \) ~-1 ~~:~ i: . ~ ;~~: ~ r'''o._ ':t"'....-;r .:;:. C ....... ~ ~:r-<rarG o,,:"-f~ .::;U~;A ~' ro * .;:... :;.....i-Cl '11 ~~;~?,'~n:: r..... I. ," "* :,) ~~. +~, ..0 <:> ~fs :: ];. " :; ((l ~lJ,,:; ~SL~:::: ~ -I. ~... 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