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HomeMy WebLinkAbout02-0112PETITION FOR PROBATE and GRANT OF LETTERS Estate of also known as ~caa ecunty o. Edith M. Roush Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are I8 years of age or older and the executors named in the last will of the above decedent, dated October 17, 1995 and codicil(s) dated N/A (state relevenat circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland County, Pennsylvania, with the Decedent's last family or principal residence at 1437 Trindle Road (Middlesex Township) Carlisle, Pennsylvania 17013 (list street, number and municipality) Decedent, then 80 years of age, died Januar 26, 2002 at Carlisle Regional Medical Center, Carlisle, Penns lvania Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Robert E. Roush, Sr. died Februa 10, 2000 Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) thereon. ~~ ,~j />. Kenneth R. Roush 14 Paradise Drive Carlisle, PA 17013 OATH OF PERSONAL REPRSENTATIVE COMMONWEATLH OF PENNSYLVANIA COUNTY OF CUMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statement in the foregoing peition are true and correct to the bes*. of the k.r~owledge and belief of petitioner(s) and that as personal represen- tative(s) of the above d~,cedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ~~~-~~~ ~ ~,~ before me this3 I day of JANUARY ?002 M RY - LE R ister No. 21-02- ~ / pC 'I'o: PETITION FOR PROBATE and GRANT OF LETTERS Estate of also known as Edith M. Roush ~c~a ecuraty o. Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older and the executors named in the last will of the above decedent, dated October 17, 1995 and codicil(s) dated N/A (state relevenat circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland County, Pennsylvania, with the Decedent's last family or principal residence at 1437 Trindle Road _^, at Decedent, then 80 st street, years of age, died Carlisle Regions Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Robert E. Roush, Sr. died February 10, 2000 Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) thereon. Fay . Sheaffer ~" Patricia .Smith 6601 Carlisle Pike 4 Pleasant View Drive Mechanicsburg, PA 17050 Mechanicsburg, PA 17050 No. 21-02-~ 102 'I'o: 2002 OATH OF PERSONAL REPRSENTATIVE COMMONWEATLH OF PENNSYLVANIA COUNTY OF CUMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statement in the foregoing peition are true and correct io tl~.e best of tht knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this3l day of JANUARY 2002 RY , L S egister ~~z~~'~ PETITION FOR PROBATE and GRANT OF LETTERS Estate of Edith M. Roush No. 21-02- ' also known as 't'o: Register of Wills for the ~cca ecunty o. - County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older and the executors named in the last will of the above decedent, dated October 17, 1995 and codicil(s) dated N/A (state relevenat circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland County, Pennsylvania, with the Decedent's last family or principal residence at 1437 Trindle Road (Middlesex Township) Carlisle, Pennsylvania 17013 (list street, number and municipality) Decedent, then 80 years of age, died January 26, 2002 at Carlisle Regional Medical Center, Carlisle, Pennsylvania Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Robert E Roush, Sr. died February 10, 2000 Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) thereon. n ,/ obert E. Roush, Jr. BarrLr~`y' L~ oush 447 Oak Flat Road 842 Ridge Road Newville, PA 17241 Carlisle, PA 17013 OATH OF PERSONAL REPRSENTATIVE COMMONWEATLH OF PENNSYLVANIA COUNTY OF CUMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statement in the foregoing peition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above deceden± petiti;~ner(s) will well and truly administer the estate acc rd' g to law. Sworn to or affirmed and s~~bscribed before me this31 ~cl~ay of ~_ JANUARY 200?. Register No. ~ i - r~.2-1 ~ 2 Estate of EDITH M ROUSH ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOR+ ~p,N~.Rv _~ 7 cm _~____ ~ ._ _~~~g.q~, !n consideration c: ,~e ~~eraior; on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated OCTOBER 1 7TH 1 995 described therein be admitted to probate and filed of record as the last will of EDITH M ROUSH and Letters TFSTAMF1~iTARV are hereby granted to ROBERT E ROUSH JR, BARRY L ROUSH . FAME A SHEAFFER, PATRICIA J SMITH AND KENNETH R ROUSH ister of Wi FEES Probate, Letters, Etc. ......... S ~ z.~., n n~ Short Certificates( .......... S 9 . 0 0 Renunciation ................ ~ JCP ~ 5.00 TOTAL ~~a9_nn Filed 1 -,31.:9 2 ......................... . ATTGR.vEY Sup. Ct. LD. No.j ADDRESS PHONE ~~ ~',C! ~ ~~~o,~ sc_~_l_ _ ARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. ,~.:~_~ ti ;~; ... >~acr ~ .. - =a . 1{ ,`jy.f, ~{ ;~ '~ .. 5 0 3 7 4 7 4 A~ ~~~r~~~ ~ ~-~~- ~:~ ~-fi,~/~r/%,~'~f~,~,s/~~'c~-.~c~/~,e:',/t,G.,~C~~.c:..~%-!c~ ~,i~.c,%:r/ /~~~~~/ w~.~r 1y3 7 /.~/ ,~~.(, C,q,'z/mss/ ., ,.~ i ~a~~ ~? ~. .?it ~~' ~,v ,~, ~~ ~!; i ~~~ 7 y ..~ - y 21-02-112 LAST WILL AND TESTAMENT OF EDITH M. ROUSH I, EDITH M. ROUSH, married woman, of 1437 Trindle Road, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make, publish, and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executor to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. 2 . I declare that I am currently married to Robert E. Roush, Sr., and that we have five (5) children who are: Robert E. Roush, Jr., Barry E. Roush, Kenneth R. Roush, Patricia J. Smith and Faye A. Sheaffer. 3. All the rest, residue, and remainder of my estate, real, personal, or mixed, and wheresoever the same may be situate, I give, devise, and bequeath to my said children, to the exclusion of my said husband, Robert E. Roush, Sr., in equal shares, the share any deceased child would have received to pass to his or her issue per stirpes, and if there be no issue, such share shall lapse and be added to the remaining share or shares per stirpes. I have five (5) children as aforesaid. 4. Should any person less than 18 years of age be entitled to distribution from my estate, in such event the share that person would otherwise have received shall be paid to my hereinafter named Executors, in trust, to receive and invest the same, and to pay the income arising therefrom, together with so much of the principal thereof as in her opinion is necessary or desirable to be expended for the proper maintenance, support, and education of such person, to or for the benefit of such person, and upon such person attaining 18 years of age to pay to him or her the then remaining principal together with any undistributed income. 5 . I hereby nominate, constitute, and appoint my five (5) children, Robert E. Roush, Jr. , Barry E. Roush, Kenneth R. Roush, Patricia J. Smith and Faye A. Sheaffer, or any of them, as Co-Executors of this my Last Will and Testament, and I further direct that none of them shall be required to post any bond to secure the faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on one (1) page this 17th day of October, 1995. ~o~t, ~'+'1 ~ /\ ~~~-- (SEAL) Edith M. Roush Signed, sealed, published and declared, by Edith M. Roush, the Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ~r~-a'~.~1 ~ 1,-a i , (_' ~l ~~ -i i~ REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS codicil- (each) asubscribing witness the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that ~ present and saw the testat ,sign request of testat other subscribing wit`ne Sworn to or me this ie same and tha)' h`_ presence aid (in the presence of es)). and subscribed before day of l9 /`, signed as a witness at the other) (in the presence of the ,~' (Name) ~r (Address) Register (Name) ~.~ (Address) r~ c.. ~ ~~ ,; ~ o ~; a `~ R~GIS~~R OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS ~`~~'N (each) a subscriber hereto, (each) being duly qualified according to law, depose(s),/and say(s) that 1'~'Y~"\ _ familiar with the signature of ~)S% r? ~ ~~~" , ee~iei~l- ~F (one of the subscribing witnesses to) the will presented herewith and eadiei~l-. that ~ believes the signature on the will is in the handwriting of to the best of ~ -knowledge and belief. Sworn to or affirmed and subscribed before me~tE?is ___ day of ~ANUARY 2002 ___~ x M1~€~~ C L WIS Register ~ i i ww ~ . (N ,me) ~ ~ - , ~~ ~, ddress) ~ ~ ~ ~ ~- (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS Robert G. Frey a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that they were present and saw Edith M. Roush the testator, sign the same and that they signed as a witness at the request of testator in his presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this 31st day of January, 2002 i a Register Robert G. Frey - S South Hanover Street Carlisle, PA 70 M ~ ~ ~, ~ t.- 7_ ~. i d l ~ Nd(' 70. .- ~. CERTIFICATION OF NOTICE UNDER RULE 5.6 fal Name of Decedent: Edith M. Roush Date of Death: Will No. To the Register: January 26, 2002 21-02-112 Admin. No. I Certify that notice of beneficial interest required by Rule 5.6 (a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Name Address See Attached List of Beneficiaries. Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except No Exceptions. Date: February 25, 2002 ~'~--~.~ / i nature Name Robert G. Frey Address 5 outh anover treet Carlisle, Pennsylvania 17013 t • • w e ep one .-- ,~. Capacity: _ Personal Representative `'v X Counsel for personal representative ..1 ~ ~..: v y T Robert E. Roush, Jr. 447 Oak Flat Road Newville, PA 17241 717-776-4632 175-40-7016 Barry L. Roush 842 Ridge Road Carlisle, PA 17013 717-243-9723 175-40-7015 Faye A. Sheaffer 6601 Carlisle Pike Mechanicsburg, PA 17050 717-795-7023 202-46-5816 Patricia J. Smith 4 Pleasant View Drive Mechanicsburg, PA 17050 717-697-1434 Kenneth R. Roush 14 Paradise Drive Carlisle, PA 17013 717-249-8368 184-50-9812 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280607 HARAISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT DUPLICATE FREY ROBERT G 5 S HANOVER STREET CARLISLE, PA 17013 ACN ASSESSMENT CONTROL NUMBER fold ESTATE INFORMATION: SsN: is4-2s-42s5 FILE NUMBER: 2102-01 12 DECEDENT NAME: ROUSH EDITH M DATE OF PAYMENT: 04/26/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01 /26/2002 AMOUNT 101 ~ $8,275.00 TOTAL AMOUNT PAID: REMARKS: ROBERT G FREY ESQUIRE FREY & TILEY SEAL CHECK# 3465 INITIALS: CW RECEIVED BY: MARY C. LEWIS $8,275.00 REGISTER OF WILLS REV-1162 EX111-96) N0. CD 001 1 17 REGISTER OF WILLS REV-lsoo Ex (s-oo) L , REV 1500 OFFICIAL USE ONLY COMMONlyEALTH OF. - ~ ~, ~~~ ~ ~. PENNSYLVANIA DEPARTMENTOFREVENUE INHERITANCE TAX RETURN :, ~ DEPT. 280601 FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 2 ' - ° 2 D 1 1 2 COUMY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ Roush, Edith M 184-26-4265 Z t1.1 DATE OF DEATH n~ApA DD-YEAR ~~•~•~- ) DATE OF BIRTH SAM-DD-YEAR \~•~ ) THIS RETURN MUST BE FILED W DUPLICATE N77N THE 0 u' U 1/16/2002 8/11/1931 REGISTER OF WILLS W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER O ^ ^ w 3. Remainder Return (date of death pna to 12-13-82) 2. Supplemental Return ~ 1. Original Return r rn ~ ~ 4. Limited Estate ~4a. Future Interest Compromise (date of death after 12-12-52) 5. Federal Estate Tax Return Required 0 U f Trust) 8 osit Boxes ~ 7 i Livi Tru t (Att ch Total Number of Safe De h f Will D d t M i t d ~ 6 d t Di d T t t Att D ~ . . p ac ) ece en a n a ne a ng s a copy o . ece en e es a e ( copy o 1 ^ ^ 1 O. Spousal Poverty Credit (date of deaM between 12-31-91 and 1-1-95) 1 . Election to tax under Sec. 9113(A) (Attach Sch O) 9. Litigation Proceeds Received F. "THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: w NAME COMPLETE MAILING ADDRESS °z Robert G. Fre 5 South Hanover Street FIRM NAME (If Applicable) Carlisle PA 17013 rn ~ Fre 8 Tile lY TELEPHONE NUMBER O v 717 243-5838 OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) 194,267 2. Stocks and Bonds (Schedule B) (2) 1,228 3. Closely Hetd Corporation, Partnership or Sole-Proprietorship (3) NONE 4. Mortgages 8 Notes Receivable (Schedule D) (4) NONE 5. Cash, Bank Deposits 8 Miscellaneous Personal Property , (Schedule E) (5) 17,928 6. Jointly Owned Property (Schedule F) (s) NONE Z ~ Separate Billing Requested O Q ~ Inter-Vivos Transfer 8 Miscellaneous Non-Probate Property ~ (Schedule G or L) (7) NONE .- a Q U w 8. TOTAL GROSS ASSETS (total Lines 1-~ 9. Funeral Expenses 8 Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) 10) 11. TOTAL DEDUCTIONS (total Lines 9 8 10) 12. NET VALUE OF ESTATE (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (8) 213.423 Z O a a O U X Q t- 10,771 9,178 (11) _ 19,949 (12) _ 193,474 (13) _ 0 (14) _ 193, 474 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate ,or transfers under Sec.9116 (a)(1.2) x .0 (15) 16. Amount of Line 14 taxable at lineal rate 193,474 x .0 45 (16) 706 0 0 706 0 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATN < < Decedent's Complete Address: STREET ADDRESS 1437 ~~indle Road C1~, STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit (1) 8, 706 B. Prior Payments 8,275 c. Discount 436 Total Credits (A+ B + G) (2) 8,711 3. InteresUPenalty if applicable D. Interest E. Penalty 4. 5. 4. Did decedent own an {ndividtsal Retirenlgrtt , t~h>jlibr'pr other non-probate property which contains a beneficiary designation? .. IF THE ANSWER TO ANY OF THE ABOVE QU ESTIQIIS'IS ~ ,.Tpt1 NtlST CDMPLLTE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, inofridirig . yingsotiedules and statements, and to the best of my knowledge and belief, it is true, Total InteresUPenalty (D + I_) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (q) This is the TAX DUE (5) the difference t li 2 h . . er ne , en an K line 1 + tine 3 is greater t {5A) t d th ue. ax e A. Enter the interest on (SB) the BALANCE DUE Thi i 5 + SA . s s . 8. Enter the total of Line 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 x retain the use or income of the property transferred; a . co e it i d f ; s n m erre or b. retain the right to designate who shall use the property trans ~ - i X nterest; or - - - - ~ c. retain a reversionary ? ~ { L^ 1 d. receive the promise for lrfe of eithe care .. 2. If death occurred after December 12,1! ~ E er property within one year of death i ^ ~ - - - - - ~ - without receiving adequate considerat d th? " eaa or payable upon death bank account or security at his or her 3. Did decedent own an "in trust for DRESS(1 447 Oak Flat Rd, Carlisle PA (2) 842 Ridge Rt:~, Carlis e PA (3)6601 Carlisle Pike, Mechanicsburg PA (4)ll4 Paradise Dr, Carlisle PA SIGNATURE OFPREPAREROTi1ERTHANREPRESENTATN~S) 4 Pleasant View DR, Mechani~~burg PA ADDRESS 5 South Hanover Street, Carlisle PA 17013 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 3% [72 P.S. Section 9116 (a)(1.1)(i)j. 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 (Nti f72 P.S. Section 9116 (a)(1.1)(i)]. The statute does not exempt a transfer to a surviving spouse from tax, and [he 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 0%[72 P.S. Section 9116(a)(1.2)]. () 5 0 0 The tax rate imposed on the net value of transfers to or for the use of the decedents lineal beneficiaries is 4.5%, except as noted in 72 P, S. Section 9116(1.2) [72 P.S. Section 9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedents siblings is 12% [72 P.S. Section 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. AT REV-150;? EX + (1-9~ (I) , i ~.., , COMMONWEALTH OF PENNSYLVANIA INHERrrANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE A REAL ESTATE FILIE NUMBER Edith M. Roush 21-02-0112 ALL RF1>,L PROPERTY OWNED SOLELY OR AS A TENANT IN COMMON MUST BE REPORTED AT FAIR MARKET VALUE. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. REAL PROPERTY WHICH IS JOINTLY-OWNED WITH RIGHT OF SURVIVORSHIP MUST BE DISCLOSED ON SCHEDULE F. ITEM j VALUE AT DATE NUMBER DESCRIPTION ~ OF DEATH 1. House& Lot 10 Paradise Drive, Middlesex Township, Cumberland County, see HUD-1 attached 50 000 Assessed Value $51,740 x Common level ratio factor 1.01 = $52,257.40 2. House & Lot 1437 Trindle Road, Middlesex Township, Cumberland County, see HUD-1 attached ', Assessed Value $67,590 x Common level ratio factor 1.01 = $68,265.90 3. 6 Building Lots, Fetrow Acres, Middlesex Township, Cumberland '.Assessed Value $40,660 x Common level ratio factor 1.01 = $41,066.60 4. 'Building lot, Fetrow Acres, Middlesex Township, Cumberland County Assessed Value $20,000 x Common level ratio factor 1.01 = $20,200 -- _ --- TOT~AIso enter on line 1, Recapitulation)~$ _ (If more space is needed, insert additional sheets of the same size) 83, 000 41,067 20,200 194.267 L A. US Department Of Housing & Urban Development SETTLEMENT STATEMENT THE INFORMATION CONTAINED IN BLOCKS E,G,H,I AND LINE 401 IS IMPORTANT TAX INFORMATION ANC) IS BEING FURNISHED TO THE IRS. IF YOU ARE REQUIRED TO FILE A RETURN, A NEGLIGENCE PENALTY OR OTHER SANCTION WILL BE IMPOSED ON YOU IF THIS ITEM IS REOUIRED TO BE REPORTED AND THE IRS DETERMINES THAT IT HAS NOT BEEN REPORTED. B.Type of Loan 1. FHA 2. FmHA 3. Conv. Unins. 6. File No: 7. Loan No: 8. Nlortgage Ins Case No: 4. VA 5. Conv. Ins. 1870106921 C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "POC" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. Name and Address of Buyer: KENNETH R. ROUSH E. Name and Address of Seller: KENNETH R. ROUSH ROBERT E. ROUSH, JR. BARRY L. ROUSH FAYE A. SHEAFFER PATRICIA J. SMITH F. Name aind Address of Lender: CHASE MANHATTAN MORTGAGE CORPORATION G. Property Location: 1437 TRINDLE RD CARLISLE, PA 17013 H. Settlement Agent: HAROLD S. IRWIN, III Place of Settlement: 35 EAST HIGH STREET CARLISLE PA 17013 I. Settlement Date: Septemlber 6, 2002 J. SUMMARY OF BUYER'S TRANSACTION: K. SUMMARY O F SELLER'~5 TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price 83,000.00 401. Contract Sales Price 83,000.OD 102. Personal Property 402. Personal Property 103. Settlement Charges to Borrower (line 1400) 2,299.16 403. 104. 404. 105. 405. Adjustments for items paid by Seller in advance 106. Cily/Town Taxes 09106/03 TO 12!31/03 56.84 Adjustments for items paid by Seller in advance 406. CitylTown Taxes 09106!03 TO 12/31/03 56.84 107. County Taxes 407. County Taxes 108. School Taxes 09/06!03 TO 06/30!03 478.17 408. School Taxes 09/06!03 TO 06130/03 478.17 109. Water/Sewer 409. Water/Sewer 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 85,834.19 420. GROSS AMOUNT DUE TO SELLER 83,535.01 200. AMOUNTS PAID BY OR FOR BORROWER: 500. REDUCTIONS IN AMOUNT DUE: SELLER: 201. Deposit or Earnest Money 8,660.00 501. Excess Deposit 8,660.00 202. Principal amount of new loan(s) 53,950.00 502. Settlement charges to Seller (line 1400) 588.86 203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to 204. 504. Payoff first mortgage loan 205. 505. 206. 506. 207. 507. 208. 508. 209. 509. Adjustments for Items unpaid by Seller Adjustments for Items unpaid by Seller 210. Cilyfrown Taxes 510. City/Town Taxes 211. County Taxes 511. County taxes 212. School Taxes 512. School Taxes 213. Water/Sewer 513. WaterlSewer 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 82,610.00 520. TOTAL REDUCTIONS FROM SELLER 9,248.86 300. CASH AT SETTLEMENT TOIFM BORROWER 600. CASH AT SETTLEMENT TO/Fh1 SELLER 301. Gross amount due from Borrower (line 120) 85,834.19 601. Gross amount due to Seller 83,535.01 302. Less amounts paid bylfor Borrower (line 220) 62,610.00 602. Less reductions from Seller (line 520) 9,248.86 303. CASH X FROM TO BORROWER 23,224,19 603. CASH FROM _X_ TO SELLER 74,286.15 I have carefully reviewed this Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of this HUD-1 Settlement Statement. I direct and authorize the Settlement Agent to make the distributions indicated far my ayyyy ount, recognizing that the Settlement Agent is not responsible for the accuracy or validity of the disbursement amounts or the completeness of c arg~s de by of ~ s. Any i st earned on fu s deposited with Settlement Agen,~er u r may t)p ref Aned by eltiement Agent. ,, l1TT /~ f BUYER KENNETH R. ROUS S LLE KENNETH R. ~ OU H ~, ~ ,r2 ~ BUYER SELLER`' R R E~.S USH, JR. BUYER SELLER BARRY L. ROUSH BUYER SELLER FAYE A. SHEAFFER BUYER SELLER PATRICIA J. SMITH To the best of my knowledge, he HUD1 Settlement Statement which 1 have prepared is a true & accurate account of the funds which were received and have/will be disbursed by th ndersigned as part of the settlement of this transaction. ~/~ /~`Z- SETTLEME AG T HAROLD S. WIN, III DATE L. SETTLEMENT CHARGES Page 2 FTPA3-HUD-1 REV. (4/90) 700. TOTAL SALES/BROKER'S COMMISSION: BASED ON PRICE $ @ % _ $ Division of Commission (line 700) as follows: 701. $ f0 PAID FROM BUYER'S FUNDS AT SETTLEMENT PAID FROM SELLER'S FUNDS AT SETTLEMENT 702. $ to 703. Commission paid at settlement 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee % to 802. Loan Discount % to CHASE MANHATTAN MTG CORP 539.50 803. Appraisal Fee to B-H AGENCY APPRAISALS ($275.00) POC 804. Appraisal Review to 805. Lender's Inspection Fee to 806. Mortgage Ins. App. Fee to 807. Document Preparation to CHASE MANHATTAN MTG CORP 325.00 808. Tax Service fee to TRANSAMERICA RE TAX SERV 55.00 809. Underwriting Fee to 810. Processing Fee to CHASE MANHATTAN MTG CORP 375.00 811. Flood Determination to FIRST AMERICAN FLOOD DATA 11.00 812. Flood Certification -Life to FIRST AMERICAN FLOOD DATA 7.00 913. Overnight Mail Fee to FEDERAL EXPRESS 20.00 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from 09/06!02 to 09/11/02 @ $16.81 / day X 05 days (84.07) 902. Mortgage Insurance Premium for 12 months to 903. Hazard Insurance Premium far 01 year to 904. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance months @ $ per month 1002. Mortgage Insurance months @ per month 1003. City/Town Taxes months @ $ per month 1004. County Taxes months @ per month 1005. School Taxes months @ _ $ per month 1006. months @ per month 1007. Aggregate Adjustment 1100. TITLE CHARGES 1101. Settlement or Closing Fee to 1102. Abstract or Title Search to 1103. Title Examination to _ 1104. Title Insurance Binder to 1105. Document Preparation to 1106. Notary Fees to HAROLD S. IRW_IN, III 10.00 1107. Attorney Fees to FREY & TILEY POC (includes item numbers: 1108. Title Insurance to PENN ATTORNEYS TITLE INS. CO. 941.75 (includes item numbers: 1109. Lender's Coverage $ 39,000.00 1110. Owner's Coverage $ 83,000.00 1111. Endorsement Fees 1112. Overnight Mails Expenses to 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording: Deed $28.50 Mortgage $70.50 Other $ 99.00 1202. Local Transfer Tax Deed $ 1203. State Transfer Tax Deed $ 1204. _ 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Pest Inspection to 1302. Water Certification to 1303. Septic Inspection to 1304 2002 School Taxes to NANCY SHEIBLEY 588.86 1305. 1306. 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103, Sec. J and 502, Sec. K) 2,299.18 588.86 ---- --- - -----.._........._...__......_~.._...._...__....._.._..,.,...,..,,,._.,..,~......,,...,....~,,.~~",~~m~,.,,,.,~,.,..,,,,.,,~,.,~n~~RR~,.~~,,,,~,,.~R IDENTIFICATION NUMBER. IF THE CORRECT TAXPAVER IDENTIFICATION NUMBER IS NOT PROVIDED. SELLER MAV BE SUBJECT TO CIVIL OR CRIMINAL PENALTIES IMPOSED BV LAW. ITEM E.. WHICH CONTAINS THIS INFORMATION SHOULD BE CHECKED FOR ACCURACY. UNDER PENALTIES OF PERJURY, I CERTIFY THAT THE T.I.N. SHOWN IN THIS STATEMENT IS h7V CORRECT TAXPAVER IOENTIF ICA7ION NUMBER. WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENT TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION CAN INCLUDE A FINE ANO IMPRISONMENT. FOR DETAILS SEE TITLE 18 US CODE SECTIONS 7001 AND 1070. Any interest earned on funds deposited with Settlement Agenl hereunder may be retained by Settlement Aaent. ( ' a; FHA , Settlement Statement - U. S. De artment of Housin and Urban Develo ment Form US HUD - 1 Pa e No. 1 ( ) 2. Fm HA 6. File Number 7. Loan Number 8. Mortgage Insurance ( ) 3. Conv. Unins. Case Number ( ) 4. VA 5. Conv. Ins. C. This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the setiement agent are snown. items marxea -tp.o.c.l- were paw outsiae o. the closin ;the are shown here for informational purposes and are not included in the totals. D. Name and Address of Borrower: E. Name and Address of Seller: Kenneth R. Roush Robert E. Roush, Barry L. Roush, Faye A. Sheaf£er Partricia J. Smith and Kenneth R. Roush Carlisle, Pennsylvania 17013 F Name antl Address of Lentler G. Property Location 10 Paradise Drive Carlisle, Pennsylvania 17013 Middlesflx Township 21-22-0119-072 H. Seller's Settlement Agent: Frfly & Tiley Law Office I. Settlement Data: Place of Settlement: 5 South Hanover St. May 22, 2002 5 South Hanover Street TIN 25-1730538 Carlisle, PA 17013 Carlisle, PA 17013 J SUMMARY OF BO RROWER'S TRANSACTION K. SUMMARY OF SELLER':> TRANSACTION 100 GrossAmount Due From Borrower 400 Gross Amount Due To Seller 101 Contract sates price 50, 000.00 401 Contract Sales price 50, 000.00 102 Personal property 402 Personal property 103 Settlement charges from (line 1400) 52.00 403 104 404 105 405 Adjustments for items paid by seller in advance: Adjustments for items paid by seller in advance: 106 Cityttown taxes 5/22/02 to 12/31/02 84.85 406 City/town taxes 5!22/02 to 12/31/02 84.85 107 County taxes 407 County taxes 108 Assessments 408 Assessments 109 409 110 School taxes 5/22/02 to 6/30/02 48.12 410 School taxes 5/22/02 to 6/30/02 48.12 111 411 l12 412 120 Gross Amount Due From Borrower 50, 184.97 420 Gross Amount Due to Seller 50,132 .97 200 AmountsrPBid By pr In 88half Di Borrower 201 Deposit or earnest money 202 Principal amount of new loan(s)"' 203 Existing loan(s) taken subject to 204 205 206 207 208 209 Adjustments for items upaid by seller 210 City/town taxes 1/1/02 211 County taxes 212 Assessments 213 214 School taxes 7/1/01 215 216 217 218 219 220 Total Paid BylFOr Borrower to 5/22/02 to 5/22/02 500 Reductions In Amount Due To Seller 5, 000.00 501 Excess deposit (see instructions) 502 Settlement charges to seller (line 1400) 503 Existing loan(s) taken subject to 504 Payoff of first mortgage loan 505 Payott of second mortgage loan 506 507 508 509 Adjustments for items upaid by seller 510 City/town taxes 1/1/02 511 County taxes 512 Assessments 513 514 School taxes 7/1/01 515 516 517 518 519 5 , 0 00 .00 520 Total Reductions to Amt Due Seller 5,000.00 -------------- -------------- 300 Cash At 58tUement FronJTo Borrower. 600 Cash At Settlement To/From Seller: 301 Gross amount due from borrower (line 120) 50, 184 .97 601 Gross amount to seller from (line 420) 50 132.97 302 Less amounts paid by/for borrower (from line 220) (5, 000.00) 602 Less reductions in amount due seller (from line 520): (5, 000.00 ) 303 Cash (X) From () To Borrower 45, 184 .97 603 Cash ()From (X) To Seller 45, 132 .97 5,000.00 0.00 to 5/22/02 to 5/22/02 HUD-t L. SETTLEMENT CHARGES Page No. 2 700 Total Sales/Broker's Comm, based on price: so,ooo.oo a +c = o.oo Pald From Pald From 700f Division o/ Commission (line 700J as lollows: N/A Borrower's Seller's 701 to ~ Funds at Funds at 701 702 to Settlement Settlement 702 703 703 704 Commission paid al Settlement 704 705 705 eoo items Payable in Gonnectlon With Loan: 600 (Mortgage Amt: 0.00) Total charges, Lines 801 through 8' o. o0 801 Loan Origination Fee .000 % to 0.00 801 802 Loan Discount .000 % t0 0.00 802 803 Appraisal Fee to 803 804 Credit Report to 804 805 Lender's Inspection Fee to 805 806 Mortgage Insurance Application Fee to 806 807 Assumption Fee to 807 808 Tax Service Contract to 808 809 Flood Certification fee to 809 810 DOClltaeAt Preparation fee t0 810 811 t0 811 soo Items.: Required By Lender To Be Patd In Advance:' soo 901 Interest From 22-May-02 to @ 0.00000 per day = 901 902 Mortgage Insurance Premium for months to 902 903 Hazard Insurance Premium for 1 years to P.O.C. 903 904 years l0 904 905 905 looo'Reserves;Deposited With:Lender. coal Reserves, Llnesi001 thorugh 100&. 0.00 1000 1001 Hazard insurance mos. ~ per month 1001 1002 Mortgage insurance mos. ~ per month 1002 1003 City property taxes mos. ® $11.81 per month 0.00 1003 1004 Couniy property taxes mos. ~ per month 1004 1005 Annual assessments mos. ~ per month 1005 1006 mos. ~ per month 1006 1007 School taxes mos. ® $38.29 per month 0.00 1007 1008 Aggregate Battlement Adjustment mos. ~ per month 1008 1100 Title Charges: ' _1100 1101 Settlement or closing fee to 1101 1102 Abstract or title search to 1102 1103 Title examination to 1103 1104 Title insurance binder to 1104 1105 Document preparation to 1105 1106 Notary fees to 1106 1107 Attorney's tees to Frey & Tiley P.O.C. 1107 (includes above items numbers: 1 1108 Title Insurance to 1108 (includes above items numbers: ) 1109 Lender's Coverage $ Endorsements: 1109 1110 Owners Coverage $ 1110 1111 Closing Service Letter to Commonwealth Land Title Insurance Co. N.A. 1111 1112 1112 1113 OvBrnlght delivery fees 1113 1200 Government Recording and Transfer Charge need Pages: 3 Mtg pages.: 1200 1201 Recording fees: Deed $52.00 Mortgage: $ Releases 52.00 1201 1202 City/county/stamps: Deed $ Mortgage: $ Tax Exempt 1202 1203 State tax/stamps: Deed $ Mortgage: $ Tax Exempt 1203 1204 1204 1205 1205 13oti Adtlitional'Settlement Charges: 1300 1301 Survey to 1301 1302 Pest inspection to 1302 1303 Current Taxes due from Borrower/Seller P .O. C . 1303 1304 1304 1305 1305 1306 1306 7307 1307 1400 Total Settlement Charges (enter oniines 103, Section J and 502, Section K) 52.00 0 . oo taoo CERTIFICATION I direct and authorize Frey & Tiley to make distributions indicated for my account on the attached HUD-1 Settlement ;statement, approving the tax prorations indicated therein, and understand that prorations were based on figures for the preceding year, or estimates for the current year, and in the event of any change for the current year, all necessary adjustments must be made between Seller and Borrower direct; likewise any DEFICIT in delinquent taxes will be reimbursed to Frey & Tiley by Seller. t have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a ttve and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that [have received a copy of the HUD-1 SS/,,ettlement Statement. ~ ~ ,~ ~~ , Kenneth R. Roush Robert E. Roush, arry L. R~o ,Faye A. SheafferP` To the best of my knowledge, the HUD-1 Settlement Statement which I have prepared is a true and accurate account of-the funds which were received and have been or will be disbursed by the undersigned as part of the settlement of this transaction. `~ May 22, 2002 Frey & Tiley, Settlement Agent Date WARNING: [t is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include fine and itnprisonrnent. For details see: Title I8 U.S. Code Section 1001 and Section 1010. INFORMATION REPORTING ON REAL ESTATE TRANSACTIONS THIS HUD SETTLEMENT STATEMENT CONTAINS IMPORTANT TAX INFORMATION (BOXES E, G, H, I, M AND LINE 401) AND [S BEING FURNISHED TO THE INTERNAL REVENUE SERVICE. IF YOU ARE REQUIRED TO FILE A RETURN, A NEGLIGENCE PENALTY OR OTHER SANCTION WILL BE IMPOSED UN YOU !F THIS ITEM IS REQUIRED TO BE REPORTED AND THE INTERNAL REVENUE SERVICE DETERMINES THAT IT HAS NGT BEEN REPORTED. FREY & TILEY PRIVACY POLICY As attorneys, we have a duty of confidentiality to our clients. As a part of representing our clients in a real estate transaction, we collect information concerning the Buyers and Sellers. This information can include names, addresses, telephone numbers, social security numbers, account balances and account numbers with financial institutions, credit reports, appraisals, contracts, and details concerning the real estate transaction and financing; for the transaction. Some or all of this information may be nonpublic personal information. We also obtain information from public records. We restrict access to nonpublic personal information to those employees who need the information to provide necessary services in connection with the transaction. We also share this information to the extent necessary to complete the transaction with others involved in the transaction. These persons may include lenders, real estate agents, and inspectors. We may also share this information with government agencies as required by law. We do not share this information with marketers or persons not connected with the transaction. TAX PRO-RATION ADDENDUM Date of Pro-Ratlon: Borrower Seller SCHOOL REAL ESTATE TAX Owes: May 22, 2002 from July 1, 2001 to June 30, 2002 8.88 mills School ReaY Estate Tax- Face $459.50 P.O.C. School Real Estate Tax- Per Day $1.25890 ASSESSMENT: $51,740.00 COUNTY & MUNICIPAL TAX owes from January 1, 2002 to December 31, 2002 Co. &Munic. Real Estate Tax• Face $1 a1.72 P.O.C. Parcel No.: Co. &Munic. Real Estate Tax- Per Day 50.38827 21 -22-0119-072 See Settlement Sheet Lines Yes tOfi & 406,110 & 410, School taxes P.O.C. or charged to Seller: x 210 & 510, 214 & 514, School taxes P.O.C. or charged to Borrower and 1303 for Co. &Munic. P.O.C. or charged to Seller : x Results of this Addendum. Co. &Munic. P.O.C. or charged to Borrower V v~ ~ ~ ~V~ ~ ~ y~ ~~ vv V~ ~ • Control No: 021 -002588 2002 Statement of Real Estate Taxes Bill Date: 3/01/2002 PAYABLE TO'. NANCY R. SHEIBLEY ~ 3235 SPRING ROAD ~ CARLISLE PA 17013-8741 DESC: MAP NO: 21-22-0119-068 1437 TRINDLE ROAD ACRES .350 DEED 00134/ 00263 FETROW ACRES Residential With Buildings RESIDENTIAL Assessed Land Improvement Mineral Total Values 21,560 96,030 0 67,590 COUNTY OF CUMBERLAND Dlscounl Face Penalt Rates .00204600 .00204600 2'k 10 6 COUNTY R/E 44.11 94.18 135.52 138.29 152.12 Rates .00030300 .00010300 2'k 10 S CODNTY LIB 2.22 4.74 6.82 6.96 7.66 TO NSHtP MID ESF~( Rates .00059000 .00059000 2 $ 10 'k MUNIC. R/E 12.721 27.16 39.08 39.88 43.87 TAX AMOUNT DUE -> $181.42 $185.13 $203.65 If Paid On or After 3/01/2002 5(01/2002 7(01!2002 If Paid On or Before 4/30/2002 6/30/2002 IF NOT PAID BY 12/16/2002 THIS BILL WILL BE RETURN® TO TAX TAx ROUSH, EDITH M CLAIM BUREAU FOR COLLECTION AND PILING OF A LIEN AGAINST PAVER 1437 TRINDLE ROAD YOUR PROPERTY. CARLISLE PA 17013 oPFlCE MON &TUE NOON-7PM WED 9AM-7PM RouRS: SPEC HRS:APR 30 & JUN 28 9AM-7PM CLOSED: SEPT 14-28 JAN&FEB 2003 PHONE: (717) 243-6328 IF TAXES ARE IN ESCROW. PLEASE FORWARD THIS BILL TO YOUR MORTGAGE COMPANY. - PAYABLE TO: NANCY R. SHEIBLEY 3235 SPRING ROAD CARLISLE PA 17013.8741 DEBC: MAP NO: 21-22-0119-066 PROSPECT DRIVE ACRES 1.020 DEED 00134!00267 FETROW ACRES Residential -Out-Buildings RESIDENTIAL OUT-BUILDING Tax ROUSH, EDITH M PAYER 1437 TRINDLE ROAD CARLISLE PA 17013 OFFCE MON & 7UE NOON-7PM WED 9AM-7PM NouRS: SPEC HRS:APR 30 & JUN 28 9AM-7PM CLOSED: SEPT 14-26 JAN&FEB 2003 PHONE: (717) 243-6328 IF TAXES ARE IN ESCROW, PLEASE FORWARD THIS BILL TO YOUR MORTGAGE COMPANY. PAYABLE To: NANCY R. SHEIBLEY 3235 SPRING ROAD CARLISLE PA 17013-8741 DESC. MAP NO: 21-22-0119-072 10 PARADISE DRIVE ' ACRES .170 DEED 00134/00269 FETROW ACRES Residential With Buildings RESIDENTIAL TAX ROUSH, EDITH M PAYER 1437 TRINDLE ROAD CARLISLE PA 17013 Return Bill with Payment. For a Receipt ,Enclose Self /\ddressed Stamped Envelope. TAXPAYER COPY Bill No: 2007 l.Onlr01 NO: U'Ll -UUYOtlO "LVU"L 5[a[e menl Ot t4ea 1 talal8 IaX05 [5111 uate: J/U u[V V[ Assessed Land Improvement Mineral Total Values 40,160 500 0 40,660 . OUN Y F CUMBE LAND Dlscounl Face Penal Aates .00204600 .00204600 2 4 10 t COUNTY R E 82.17 1.02 81.53 83.19 91.51 Rates .00010300 .00010300 2 4 10 i COUNTY LIB 4.19 .OS 4.11 9.19 9.61 1 Rates .00059000 .00059000 2 t 10 ~ MUNIC. R(E 23.69 .30 23.51 23.99 26.39 TAX AMOUNT DUE -> $109.15 5111.37 $122.51 If Paid Oa or After :I Ol 2002 5(01(2002 7/01/2002 If Paid Oo or Before sl/30 2002 fi 30/2002 iAr ao~cuu~ -inia n CLAIM BUREAU FOR COLLECTION AND PIL]:NG OF A LIEN AGAINST YOUR PROPERTY. Retum Bill with Payment. For a Receipt ,Enclose Self Addressed Stamped Envelope. TAXPAYER COPY Bill No: 2009 L,onn01 rv0: u[I -uuzanz zuuz alate menr or Hea l tsta[e lazes nw Dale: ~iuuzuuz Assessed Land Improvement Mineral Total values 20,000 31,740 0 51,740 CO NTY OF CUMB R AND Discount Face Penal Rates ,00204600 .00204600 2 t 30 R COUNTY R/E 40.92 64.99 103.74 105.86 116.95 Rates .00010300 .00010300 2 i 10 i COUNTY LIB 2.06 3.27 5.22 5.33 5.86 T S I MI Rates .00059000 .00059000 2 t 10 4 MUNIC. R/E 11.60 18.73 29.42 30.53 33.58 TAX AMOUNT DUE --> $73B.ee $741.72 $155.89 If Paid On or After :)/01/2002 5/01/2002 7/01/2002 If Paid On or Before !1/30/2002 6/30/2002 ~~i ~~~~ CLAIM BUREAU FOR COLLECTION AND FILING OF A LIEN AGAINST YOUR PROPERTY. OFFICE MON &TUE NOON-7PM WED 9AM-7PM RouRS: SPEC NRS:APR 30 & JUN 28 9AM-7PM CLOSED: SEPT 14-28 JAN8FE8 2003 PHONE: (717) 243-6328 Return Bill with Payment. For a Receipt ,Enclose Self Addressed Stamped Envelope. IF TAXES AAE IN ESCAOW, PLEASE FORWARD THIS BILL TO YOUR MORTGAGE COMPANY. PAYABLE TOr NANCY R. SHEIBLEY 3235 SPRING ROAD CARLISLE PA 17013-8741 ossc: MAP NO: 21-22-0119.073 PARADISE DRIVE ACRES .170 DEED 00134/00265 FETROW ACRES Vacant Land VACANT LOT -LESS THAN 1 ACRE TAx ROUSH, EDITH M PAYER 1437 TRINDLE ROAD CARLISLE PA 17013 TAXPAYER COPY Bill No: 2070 r....•...I nl..• n~• nnocDa enno c•~•e...e..•,.• nes~ e~•~~•eT~.e~ sal n~•o~ vnv~nm Assessed Land Improvement Mineral Total Values 20,000 0 0 20,000 CO NTY F UMBER D Olacount Face Penal Rates .00204600 2 ! 10 ~ COUNTY R/E 40.92 40.10 40.92 95.01 Rates .00010300 2 ~ 10 ~ COUNTY LIB 2.06 2.02 2.06 2.27 O 1 OF DL Rates .00059000 2 ~ 10 $ MUNIC. R/E 11.80 11.56 11.80 12.48 TAX AMOUNT DUE -,> $53.68 $54.78 $60.26 If Paid On or After 3/01/2002 5/01/2002 7/01/2002 If paid On or Before 4j30/2002 6 30/2002 CLAIM BUREAU FOR COLLECTION AND FILING OF A LIEN AGAINST YOUR PROPERTY. AT REV-1503 EX+ (1-97~ (I) SCHEDULE B ~ ~ ' STOCKS 8~ BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~~. ESTATE OF -~ FILE NUMBER Roush, Edith M 21-G2-0112 All property jointly-owned with right of survivorship must be disclosed on Schedule F. -_- - - - - ITEM -- -- -- - - -- - -- _-- VALUE AT DATE - __ _ _ -- -__ OF DEATH rt - NUMBER Nlcor Inc, (30 shares @40.930) DESCRIPTION ~ 1,228 I -- TOTAL (Also enter on line 2, Recapitulation) $ 1,228 _- -__ ---- __ . - - - -- (If more space is needed, insert additional sheets of the same size) n' r; T~ p C - - '~ y O D Z ~ n ~ L m J7 a m c N T ~ ~~~~n m - ~ c, C._ n _ ~ D ?' C \ z ... m ~ O J p N~ D_ ~ y, ~ C :; ~o D Z z U? m l~ ~-' ~, ^ ~~:; ~ ~_~ n m ~ n D D D z o r Z ~ ~, \_ /z~ i~ ~ \`\ l J ~:~.~v ~~ \. ~ ~:: ~ ~ n 1 ~ ~ ~- \~ ~~~~\ ~. ,` \ \ ~ :.~~ 1 ~ \. \~ ~ ~ ~ \.' 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[Ind ut tno uallum a.tan~ ~Cayt yanoyt s~ pan.ttsuoo aq [[>;ys `att'ot3ttaao stye .~o aoi-1 ~~y1 uo uonduasui ayt ^[ pasn uayn~ 'suonetnatgge ouin~o[io~ ay,L SNOIlINI~~a 'sauas luanbasgns ;o saouaaa;aad pue s;y6ia ant;e~aa ay1 auiwaa;ap pue xi; 01 saolaaaip ;o paeo8 ay1 ;o ~tluoylne ay1 (£) pue 'pauiw~a;ap pue paxi; uaaq aney awes se ae; os ~{oo;s aoua~a;aid pue ~{ools pa~aa;aid ;o sauas yoea ;o sa~eys ay; uaaMlaq saouaaa;aad pue sly6ia ant;p~a~ au1 ui suoi;euen ay1 (Z) `~(uedwo~ ay[ ~(q panssi aq o} pazi~oy~ne ~{oo;s ;o sse~o yaea ;o sateys ay[ ;o s;y6u ant;e~aa .co ~eioads pue 'suoi;oia~saa 'suoi;e[iwi~ `suoileoi;i~enb 'saouaaa;aad 'suoi;eu6isap au;;o ~~e (G) ;o luawa~els e a6~eyo 1noylinn pue ~sanbaa uodn aap~oyaaet.~s ~(ue o1 ysiuan; ~~iM 1ua6y ~a;sueal s1i ao ~(uedwo~ ayl ~NI »OOIN "' Stock Chartina for GAS Date Price High Low Volume 1!28/02 40.5 41.36 40.48 318,900 No Splits Get another quote any day after 1/2/1970 1 /2/1970 Symbol: ~ Date: 1/28/2002 ~0 ., .. ~.__e.~~~va..._ _ ..~_.,ne. Copyright ©1998-2002 BigCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. 10/15/02 12:26 PM 2 bi~ni:h Daily) C~i3igChart~.c:~~m 4~.IJ r"~•~rti~ f~~ ~ ~~ 41 . 41 . ~ Y '~'4 `# ~ . J ! Ij'~ I" a~ 11~ 2mo 3mo 6mo ~ ~ 5~ http://www.bigcharts.com/custom/wsjie/wsjbb-historical.asp?symb=gas&close_tlate=l%2F28%2F2002&x=17&y=11 Page 1 Of 1 Copyright ©2002 Dow Jones & Company, Inc. All Rights Reserved Stock Charting for GAS (NYSE) U.S. Dollar Date Price High Low Volume 1/25/02 41.36 41.49 40.7 157,200 No Splits _ _. _. Get another quote any day after 1/2/1970 1 /2/1970 Symbol: ~ Date: 1/25/2002 G0 Copyright ©1998-2002 BigCharts.com Inc. Historical and current ~~~ end-of-day data provided by FT Interactive Data. ~~~~ C~BigCl-larts.co m t41. J '~1,~ ~u. 5 ~}Ij, D J,~ _ _ Fek} 1 mo, 2mo ~ mo ~ ~ 5~r tT~~# ~E'f Its '~~ ~ Copyright ©2002 Dow Jones & Company, Inc. All Rights Reserved 10/15/02 12:25 PM http://www.bigcharts.com/custom/wsjielwsjbb-historical.asp?symb=gas&close_date=1%2F25%2F2002&x=13&y=7 Page 1 Of 1 2 rvkrr)th Daily) AT REV-1508 EX+ (1-9~ (I) SCHEDULE E ~' ~ CASH BANK DEPOSITS ~ MISC. COMMONWEALTH OF PENNSYLVANIA ~ f INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ~~_ ESTATE OF FILE IJUMBER Edith M. Roush 21-02.-0112 IricWde [he proceeds of Riga[ion aM the date the proceeds were receNed try the estate. ALL PROPERTY JOINTLY-OWNED WITH THE RIGHT OF SURVIVOF;SHIP MUST BE DISCLOSED ON SCHEDULE F. ITEM ~LUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. ~Allfirst Bank, Golden Age Checking Account #0042152364 Allfirst Bank, Passbook Savings Account #87004600051017 !Accrued Interest to January 26, 2002 M&T Bank, Checking Account #725552 Proceeds from auction of household goods, see Auctioneer's statements attached ',Refund, The Sentinel 'Refund, The Patriot News I Refund, Conseco II Real estate tax proration for 1437 Trindle Road, Carlisle 'i Real estate tax proration for 10 Paradise Drive Cumberlnad County Veterans, Burial Allowance Refund, U.S. Treasury ~~ Refund, Allstate Automobile Policy TOTA (If more space is needed, insert L (Also enter on line 5, Recai not sheets of the same s'e) 1, 789 2,036 2 136 12, 804 38 11 42 535 133 100 118 184 17, 928 ~~ '' ' ° ailfirst Allfirst Financial Center N.A. BO. I3ox 9r)0 Millsboro, DE 1966 March 13, 2002 Frey & Tiley Attorneys-at-Law Attn: Robert G. Frey 5 South Hanover Street Carlisle, PA 17013 RE: Estate of Edith M. Roush Date of Death: January 26, 2002 Social Security Number: 18~~-26-4265 Dear Mr. Frey: In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following accounts. 1. Account Type ........................... Golden Age Checking Account Account Number ....................... 0042152364 Ownership (Names off .............. Edith M. Roush Opening Date ............................10/06/95 Balance on Date of Death ........ $1,788.54 Accrued Interest $ 0 00 Total ................:........................$1,788.54 2. Account Type ........................... Passuook Sav~Zgs Account Account Number ....................... 87004600051017 Ownership (Names off .............. Edith M. Roush Opening Date ............................10/23/95 Balance on Date of Death ........ $2,036.49 Accrued Interest $ 2 39 Total ......................................... $2, 038.88 This letter does not include any accounts in which the deceased may have been listed as power of attorney, custodian of uniform transfers, representative payee, or trustee under a written trust agreement. i ~M~~~ March 22, 2002 RE: Estate Search The Estate of: EDITH M ROUSH Date of Death (D.O.D.) 1/26/2002 To Whom It May Concern: Identified below is the account information requested. 1. M&T Bank accounts in which the decedent's name appears: Account Type Account Number Account Title Opening Branch D.O.D. Balances (Includes Accr. Int. ) 5136.03 Accrued Interest CHK 725552 EDITH ROUSH 4319 2. Loans, Mortgages, or other obligations titled in the decedent's name Account Number Amount Owed Ac;count Description 5.00 No Safe Deposit Box titled in the Decedent's name existed at our office. If you have any questions about the information provided, please contact our Records Department at (716) 635-4010 or 1-800-724- 2440 outside of the Buffalo, NY calling area. Thank you. Sincerely, M&T BANK CORPORATION Authorized Signature DATE: ~ - Z ~- ~~ 2 Manufacturers and Traders Trust Company • 1100 Wehrle Drive, I?O. Box 767, Buffalo, NY 14240-0767 . '~'"' FINAL SETTLEMENT ~ _ ~--ate z ` ` Data ~ ~ s OWNER •ESkk~t t'9rc ~ ~~ h M . -CZ.ti v5 1'~ S{ 11 cQ PR 1 Address (~3-1 T~`^[IIC Rd ~arlt5 -- Date of Sale ~ - ~D ~~ °1OpZ Sele LocaUan • Clerk Ceshler Auctioneer Other ~ loZ .25 pads ~~ ~..dar~r. PROCEEDS OF SALE: Cash .___.._....--^___.__..____ .............. S I '4,,.,,. Poy \.2~~ 1 Checks___..___._~..-._.W_.._.•._...... J ~ ;. ~! Miscetlaneous (see attached Ilsl) __.___~._._._~_.__._.__.~.._.. i TOTAL PROCEEDS OF SALE __._f__P..~_.~/_.~'_f./S~ ~~5 ~ ' LE~ELLER'S SALE EXPENSE: sy • ~d~'f-[~1 v ~s c /l ~~< Auctlonaer's Fea_~~0C5_,go~ t+cl~~_Sa~t-rrG T??~~.li_~3{g~~ / -1J .OU Other SeUer's Expenses AdvancedbYAUCIIo(neer.11 ,~, \\ .Q ~~//~~ ~ n~~ Q7Tf7 e rrC \ Ot7YS\ ~tRJ ~ ' CN'r d~ `t(~ O a p ~~ ASV + Qo~la4r~o To:~e-~~~y~ Oo.oo v~ ~~ Sate NQID ~~ls~f.~.~ h'i6/v ~S.oo 'l~ ~; Mlscalleneous (see attached tlsl) .._.__.._ ...............__.___~..._. DEDUCT 70TAL SELLER'S SALE £XPENSE..____..__.__..___r_ S- ~ r 4 3 ~' ~~ • . TOTAL NET PROCEEDS TO SELLER .._ ..............._.._..._.. 1 ~p ~ o a a. `7.5 I, (ar we), the seller of goods, merchandise, and(or property sold al pubtlc auclbn on above dale and lacafbn, acknowledge and accept lhls settlement of proceeds of sale. I (ar we) agree fo accept aU responelblllly for provlding merchantable tllle to alt goods, merchandise, and)or property sold, end for detlvery of UUe fo the purchaser. (Data) (Sellar'a Slgnalura) Auclloneer ar Casttlet'a Slgnalure (Seper's Signature) Fmm Nu. FS namdm Imm: A11aalXarl Al1CilON SCHOOL PM,w IAa0~67fr15S5 V ~~ ~~ ~ O $ ~K ~ ~ ~ ~• as ~. .~ ~\ 1 e V' i t ' (! V ~~ 1 ~ o,~Y, ~,,, . ~. ~ ~ ~ ,\ ` ~ Q ,. ~~~ . ' FINAL SETTLEMENT ~• sic 942.750 + .cQO ~tr°~ 1.2._5.003 ~d. ul~ ~L~ 81 7 •7 5 t~ ~~ ~(,~. , y42•`750 -~ (~!; Y~-~ 60.4 • "I U U =~ ~s 604 • 1 00 N~~ Sale Location Cierk Cashier ;h ._ $.~ ~y~.5~ 21 3. 6 5 0 ~'-~s'u`~,cks 5 9 7. 7 5 0(~ -------------------------------------------- Miscellaneous (see attached list) TOTAL PROCEEDS OF SALE ___.________________. LESS SELLER'S SALE EXPENSE: (,~~ Auctioneer's Fee---~f-~? ~---~~~---------------------------------------- $ ~ • t/7C~ CCC~.~j 4 ~ ~~~ :~ ' S, G' 0 /~ ~~'~ _~"___ ) -~~~. - -- Oct ~ ~ ~~~~~'~`~ Miscellaneous (see attached list} ____________________________________________ . ( n,l/~ ~ f~ Cash ~a : ~ ', ~ ~, ~,.- (~ ~~( ~ J ~` ~~~~T'•~nr~-. ~ ~ 0 )DEDUCT TOTAL SELLER'S SALE EXPENSE ____ 1 ____."__________________ $ - ~. ~ Irr-ks $ 5 4 ~' R2 i ~(ell~" ~ ~5 TOTAL NET PROCEEDS TO SELLER ____ g ~_~.._'__ ~_~~________ $ ' I, {or we), the seller of goods, merchandise, and(or property sold at public auction on above date and location, acknowledge and accept this settlement of proceeds of sale. t (or we) agree to accept all responsibility for providing merchantable title to all goods, merchandise, and(or property sold, and for delivery of title to the purchaser. (Date) Auctioneer or Cashier's Signature (Seller's Signature) (Seller's Signature) Form No. FS Reorder from: MISSOURI AUCTION SCHOOL Phone 1.800-835-1955 Other Seller's Expenses Advanced by Auctioneer: AT REV-1511 EX + (1-97) (p ', SCHEDULE H ~ ~ ~'~jMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES $ rnrkERrrANCETaxRr=ruRN ' ADMINISTRATIVE COSTS RESIDENT DECEDENT _~~~ ESTATE OF FILIE NUMBER Edity M. Roush 21-02-0112 Debts of decedent must 6e reported on Schedule 1. _ _- --.. ITEM _ -- _- - - NUMBER DESCRIPTION _ - A. FUNERAL EXPENSES: 1. '.Ronald C.L.Smith Funeral Home B. 1 2. 3. 4. 5. 6. 7. 8. 10. 11. 12,. 'ADMINISTRATIVE COSTS: I Personal Representative's Commissions Name of Personal Representative (s) N/A Social Security Number(s) ! EIN Number of Personal Representative(s) Street Address ---- City _ State Zip _ i Year(s) Commission Paid: i Attorney Fees I, 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 I Probate Fees ~ Accountant's Fees Tax Return Preparer's Fees Checks cleared after date of death .Bank Charges for estate checks The Sentinel, Advertising i, Cumberland Law Journal, Advertising Register of Wills, Filing Fee Register of Wills, Fee to file Final Accounting I i r-__ ___ _ ___.__ _ _ _'_ _ -TOTAL (Also enter on line 9_F2ec~itulatlon) ~__ __ _ _ _ __ (If more space is needed, insert additional sheets of the same size) AMOUNT 3,654 0 6,500 0 252 0 0 48 17 91 75 15 119 10,771 nr NEV-1512 EX+ (1-97} (I) ..~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTA NUMBER SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS Include unre ITEM NUMBER imbursed medical ex nses. DESCRIPTION AMOUNT 1. Allstate Insurance Company, Homeowners & Landlord Insurance 230 2. Nancy Sheibley, Tax Collector, 2002 Real Estate and School Taxes, 1427 Trindle Road, Carli 879 3. Nancy Sheibley, Tax Collector, 2002 Real Estate Taxes, 10 Paradise Road, Carlisle 193 4. Roy Gutshall, Auctioneer fees and expenses 3,177 5. Helen & Martin Shughart, Parking for Auction 100 6. Bank Fee 7 7. Robert E. Roush, Advertisement for auction 5 8. Exxon 31 9. Carter Lumber, Supplies to replace well pump 333 11. B & S Hauling, Labor to replace well pump 300 12. York Waste Hauling, Trash removal 47 13. West Shore Oil Company, Heating oil 268 14. Patricia Smith, Reimburse postage 79 15. Comcast, Cable 7 16. PP&L, Electricity 393 17. UGI, Gas 69 18. Sprint, Telephone 96 19. Carlisle Pathology 14 20. United Church of Christ, Nusing Home bill 1,110 21. Belvedere Medical Center 24 22. Pinker & Associates 8 23. Moffitt Heart & Vascular Group 3 24. Carlisle Imaging 18 25. Central Penn Medical Group 6 26. Sara Todd Memorial Home, Final Nursing Home bill 61 27. Barry Roush, Mowing 1,700 28. Wal-Mart, final bill 20 TOTAL (Also enter on line 10, Reca (If more space is needed, insert additional sheets of the same size 178 zip REV-1513~EX + (9-00) {~ ~' ~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN ATE FILE Edith M. Roush """`-" "` RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSONS RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Robert E. Roush 447 Oak Flat Road Newville PA 17241 Son 20% 2. Barry L. Roush 842 Ridge Road Carlisle PA 17013 Son 20% 3. Faye A. Sheaffer 6601 Carlisle Pike Mechanicsburg PA 17050 Daughter 20% 4. Patricia J. Smith 4 Pleasant View Drive Mechanicsburg PA 17050 Daughter 20% 5. Kenneth R. Roush 14 Paradise Drive Carlisle PA 17013 Son 20% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 1 5 THROUGH 18 AS APPROPRIATE O N REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING NAADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0 (if more space is needed, insert additional sheets of the same size) :, ~~ ~ it. ~t~ LAST WILL AND TESTAMENT _ P.~ or '`" EDITH M. ROUSH - ~~• I, EDITH M. ROUSH, married woman, of 1437 TrindleRoad, Carlisle, Cumberland !; i County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do { ,~~ hereby make, publish, and declare this as and for my Last Will and Testament, hereby revoking j and making void any and all Wills by me at any time heretofore made. ~'~~ + ;. 1. I direct my hereinafternamedExecutor to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. „ ' 2. I declare that I am currently married to Robert E. Roush, Sr., and that we have five (5) ~: ~,,.j children who are: Robert E. Roush, Jr., Barry E. Roush, Kenneth R. Roush, Patricia J. Smith _ ~'" ~~ and Faye A. Sheaffer. ~l ~L.:t 3. All the rest, residue, and remainder of my estate, real, personal, or mixed, and :~,: wheresoever the same may be situate, I give, devise, and bequeath to my said children, to the i - ~ exclusion of my said husband, Robert E. Roush, Sr., in equal shares, the share any deceased child ; ~ would have received to pass to his or her issue per stirpes, and if there be no issue, such share "~ shall lapse and be added to the remaining share or shares per stirpes. I have five (5) children as j aforesaid. z'' ;; ~: 4. Should any person less than 18 years of age be entitled to distribution from my estate, ; j `' , ~. in such event the share that erson would otherwise have received shall be a~ d to m hereinafter p P ~ Y . . ~' named Executors, in trust, to receive and invest the same, and to pay the income arising therefrom, ~; ~, together with so much of the principal thereof as in her opinion is necessar}+ or desirable to be . l ~ ~: expended for the proper maintenance, support, and education of such person, to or for the benefit '~' ' ; and upon such person attaining 18 years of age to pay to him or her the then of such person =: ~:,~: !'< <+ , remaining principal together with any undistributed income. - , 5. I hereby nominate, constitute, and appoint my five (5) children, Robert E. Roush, Jr. , Barry E. Roush, Kenneth R. Roush, Patricia J. Smith and Faye A. Sheaffer, or any of them, as i ~.~: Co-Executors of this my Last Will and Testament, and I further duect that none of them shall be ~~' required to post any bond to secure the faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. 1:. ,;~ IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on one (1) page this 17th day of October, 1995. ,:r r _ .I p ~C~-G~. yi?~ /1 ~-`~- (SEAL) l Edith M. Roush Signed, sealed, published and declared, by Edith M. Roush, theTestatrix above named, as and for `=` her Last Will and Testament, in our presence, who, in her presence, at her request, and in the , ,.~ presence of each other, have hereunto subscribed our names as attesting witnessa:s. ; , ~~~ f ,:,: - ~` ~~ k d`~ ~, ~~"3~" ~~~ COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE +iNF~RITARICE TAX DIVISION DEpriz8obol NOTICE OF INHERITANCE TAX HARRISBURG, PA 17128-060I APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 E% -FP (01-02) DATE 1a-25-2002 ESTATE OF ROUSH EDITH M DATE OF DEATH O:l-2b-2002 FILE NUMBER 21 02-0112 -- COUNTY CUMBERLAND ROBERT G FREY ACN 101 5 S HANOVER ST Amount Remitted CARLISLE PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND C:0 COURT H DUSE CARLISLE, PA 17013 CUT AL ONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS. ~ - - --------------------- - - -------------------- -- -- -- -- ----------------------------------------------------------- REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ,ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF ROUSH EDITH M FILE N0. 21 02-0112 ACN 101 DATE 11-25-2002 TAX i2ETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estata (Schedule A) (1) 194,267.00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) 1,228.00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable [Schedule D) (4) .00 of this form with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 17,,9 28.00 tax payment. 6. Jointly Owned Property [Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets ($) 213,423.00 APPROV ED DEDUCTIONS AND EXEMPTIONS: 10,771.00 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule Hl (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) [10) 9,178.00 11. Total Deductions (11) 19.949.00 12. Net Value of Tax Return (1P) 193,474.00 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 143,474.00 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 ofi Line 14 at Spousal rate (15) •00 X 00 = .00 16. Amount of Line 14 taxable at LineallClass A rate (16) 193,474.00 X 045 = 8,706.00 17. Amount of Line 14 at Sibling rate (17) ,.00 X 12 = .00 18. Amount of Line 14 taxable at Collateral/Glass B rate (18) ~00 X 1 5 = .00 19. Principal Tax Due (19)= 8,706.00 TAY f`DCTTTC• DATE NUMBER + INTEREST/PEN PAID (-) AMOUNT PAID 04-26-2002 CD001117 435.30 8,275.00 11-18-2002 REFUND .00 4.30- TOTAL TAX CREDIT 8,70b.00 BALANCE OF TA:X DUE .00 INTEREST AND PEN. .00 TOTAL DUE: .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN 51,, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE 01' THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or anjcynent to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: Tc fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. C72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and subnit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF [tILLS, AGENT REFUND CCRI: A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" CREV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: I-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty C60) days of receipt of this Notice by: --written protest tc the PA Department of Revenue, Beard of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Oept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance lax Return for a Resident Decedent^ (REV-15017 far an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1] day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .080164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 7% .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 7% .000192 1986 10% .000274 2000 8% ,000219 1987 9% .000247 2001 9% .000247 1988-1991 11% .000301 2002 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. ~~ _~ First and Final Account of Robert E. Roush, Jr., Barry L. Roush, Faye A. Sheaffer, Kenneth R. Roush and Patricia J. Smith, Executors of the Last Will and Testament of Edith M. Roush Late of Middlesex Township, Cumberland County, Pennsylvania DATE OF DEATH: LETTERS TESTAMENTARY ADVERTISED: January 26, 2002 CUMBERLAND LAW JOURNAL February 15, 22, and March 1, 2002 ESTATE FILE NO.: THE SENTINEL 21-02-0112 February 12, 19, and 26, 2002 ACCOUNTANTS CHARGE THEMSELVES WITH THE AMOUNT> OF PRINCIPAL AND INTEREST RECEIVED AND CLAIM CREDIT FOR THE DISBURSEMENTS MADE AS STATED BELOW: PRINCIPAL RECEIVED January 26, 2002 House & Lot of ground, 10 Paradise Dr., Middlesex Township 50,000.00 January 26, 2002 House & Lot of ground, 1437 Trindle Rd., Middlesex Township 83,000.00 January 26, 2002 Lot 141, Fetrow Acres, Middlesex Township 13,720.00 January 26, 2002 Lot 107 Fetrow Acres, Middlesex Township 7,500.00 January 26, 2002 Lot 108 Fetrow Acres, Middlesex Township 8,400.00 January 26, 2002 Lots 109 and 110 Fetrow Acres, Middlesex Township 8,750.00 January 26, 2002 Lot 111 Fetrow Acres, Middlesex Township 5,868.00 January 26, 2002 Lot 112 Fetrow Acres, Middlesex Township 7,000.00 January 26, 2002 30 Shares, Nicor, Inc. (per share value: $40.93} 1,228.00 January 26, 2002 Allfirst Bank, Account no. 0042152364 1,788.54 January 26, 2002 Allfirst Bank, Account no. 87004600051017 2,036.49 January 26, 2002 Accrued interest on above account to date of death 2.00 January 26, 2002 M&T Bank, Account no. 725552 136.03 February 26, 2002 Refund, The Sentinel 37.80 March 6, 2002 Refund, The Patriot News 10.85 March 26, 2002 Pension receivable from Bethlehem Steel at date of death 168.68 March 26, 2002 Refund, Funeral Expenses paid 44.92 April 8, 2002 Proceeds from public sale of tangible personal property 11,860.75 April 23, 2002 Medical insurance refund from Conseco 42.02 April 30, 2002 Proceeds from public sale of tangible personal property 942.75 May 22, 2002 Reimbursement for real estate taxes paid 132.97 July 6, 2002 Refund from Exxon Mobil 3.00 July 6, 2002 Refund of automobile insurance from Allstate 184.10 July 6, 2002 Refund from York Waste Disposal 25.94 September 5, 2002 Refund from U.S. Dept. of Treasury for income taxes paid 118.00 September 6, 2002 Reimbursement for real estate taxes paid 535.01 September 22, 2002 Refund, Belvedere Medical Corp. 1.39 Pennsylvania Inheritance Tax Refund 4.30 TOTAL PRINCIPAL RECEIVED 203,541.54 INCOME RECEIVED February 26, 2002 Dividend, N1cor 13.20 February 26, 2002 Rent received, Paul and Janet Roush 350.00 March 26, 2002 Interest earned on Account no. 87004600051017 after date of death 0.39 Tuly 6, 2002 Dividend, Nicor ~ 3.80 September 22, 2002 Dividend, Nicor 13.80 December l0, 2002 Dividend, Nicor ] 3.80 TOTAL INCOME RECEIVED 404.99 DISBURSEMENTS March l , 2002 Returned check, Paul & Janet Roush Rent 350.00 March 1, 2002 Bank fee for returned check 6.50 March 26, 2002 Heating Expenses to West Shore Oil Co. 267.93 March 26, 2002 Checks clearing after date of death 48.09 March 30, 2002 Insurance on Real Estate held to Allstate Insurance 108.12 March 30, 2002 Electric Expense to PPL 129.74 March 30, 2002 Heating Expenses to UGI 17.24 March 30, 2002 Final Bill owed to Wal-Mart 19.71 March 30, 2002 Repairs to Well, reimbursement to Faye Sheaffer 332.82 March 30, 2002 Labor to repair well to B & S Hauling 300.00 March 30. 2002 Advertising Expense to The Sentinel 90.59 March 30, 2002 Final Bill owed to Exxon Mobil 33.86 March 30, 2002 Telephone bill to Sprint 95.85 April 8, 2002 Auctioneer's fees and expenses ] ,838.00 April 14, 2002 Income taxes to Pa. Department of Revenue 44.00 April 21, 2002 Heating Expenses to UGI 8.51 April 21, 2002 Electric Expense to PPL 92.05 April 21, 2002 Electric Expense to PPL (rental property) 50.18 April 21, 2002 Trash Removal to York Waste Disposal 36.39 April 21, 2002 Trash Removal to York Waste Disposal 36.39 April 21, 2002 Final bill to Comcast Cable 6.93 April 21, 2002 Final Nursing home bill to United Church of Christ Home 1,110.00 April 21, 2002 .Advertising and postage, reimbursement to Patricia Smith 78.56 April 29, 2002 ,Auctioneer's fees and expenses 213.b5 April 29, 2002 Compensation to Auction assistants ] 25.00 April 29, 2002 Pa. Inheritance Taxes to Register of Wills, Agent 8,275.00 April 29, 2002 Real estate taxes to Nancy 5heibley, Tax Collector 483.13 April 29, 2002 Advertising for auction, reimbursement to Robert Roush 5.00 April 29, 2002 Parking expenses for auction to Helen & Marlin Shughart 100.00 April 30, 2002 Bank fee for checks 8.50 May 19, 2002 Medical Bill to Carlisle Pathology 13.50 May 19, 2002 Medical Bill to Belvedere Medical Corp. 25.24 May 19, 2002 Medical Bill to Pinker & Associates 7.70 May 19, 2002 Medical Bill to Moffitt Heart & Vascular 3.33 May t 9, 2002 Auctioneer's fees for sale of real estate 1,000.00 May 19, 2002 Landlord Insurance Policy to Allstate 23.17 May 19, 2002 Homeowners Insurance to Allstate 51.34 May 19, 2002 Medical Bill to Carlisle Imaging 17.74 May 19, 2002 Electric Expense to PPL 28.84 May 19, 2002 Electric Expense to PPL 55.16 July 6, 2002 Mowing expenses to Barry Roush 1,200.00 Ju-y 6, 2002 Medical Bill to Central Penn Medical Group 6.06 July 6, 2002 Heating Expenses to UGI 25.85 July 6, 2002 Electric Expense to PPL 20.30 July 6, 2002 Homeowners Insurance to Allstate 23.92 Ju-y 21, 2002 Electric Expense to PPL 17.22 July 21, 2002 Final Nursing home bill to Sarah Todd Home 60.90 July 21, 2002 Homeowners Insurance to Allstate 23.92 July 21, 2002 Bank fee for checks 8.50 September 6, 2002 Real estate taxes to Nancy Sheibley, Tax Collector 588.86 September 22, 2002 Mowing expenses to Barry Roush 500.00 September 22, 2002 Heating Expenses to UGI 1736 October 20, 2002 Probate fees, Cumberland Law Journal advertising, reimbursement to Frey and Tiley 330.00 11/22102 Additional Probate fees to Register of Wills 35.00 December 10, 2002 Real estate taxes to Nancy Sheibley, Tax Collector 593.19 January 8, 2002 Recording fees advanced, reimbursement to Frey & Tiley 289.00 January 8, 2002 Filing fees advanced, reimbursement to Frey & Tiley ~ 5.00 January 8, 2002 Attorney's fees to Frey & Tiley 6,500.00 January 8, 2002 Reserve for Final Income Taxes 500.00 TOTAL DISBURSEMENTS 26,292.84 RECAPITULATION 'TOTAL PRINCIPAL RECEIVED 203,541.54 TOTAL INCOME RECEIVED 404.99 TOTAL DISBURSEMENTS 26,292.84 BALANCE FOR DISTRIBUTION 177,653.69 PROPOSED SCHEDULE OF DISTRIBUTION Robert E. Roush, Jr., 447 Oak flat Rd., Newville, PA 17241 35,530.74 Less, 1/5 interest in Nicor Stock received in kind (245.60) July 6, 2002 Less, partial distribution made (6,000.00) September 5, 2002 Less, Lot 111 received in kind (5,868.00) September 5, 2002 Less, Lot 112 received in kind (7,000.00) September 5, 2002 Less, recording costs for recording deeds of distribution (119.00) September 5, 2002 Less, real estate tax proration on lots received (] 19.28) September 22, 2002 Less, partial distribution made (6,000.00) Net to be distributed 10,178.86 Barry L. Roush, 842 Ridge Road, Carlisle, PA 17013 35,530.74 Less, lI5 interest in Nicor Stock received in kind (245.60) July 6, 2002 Less, partial distribution made (6,000.00) September 22, 2002 Less, partial distribution made (6,000.00) November 3, 2002 Less, partial distribution made (12,000.00) Net to be distributed 11,285.14 Faye A. Sheaffer, 6601 Carlisle Pike, Mechanicsburg, PA 17050 35,530.74 Less, 1/5 interest in Nicor Stock received in kind (245.60) July 6, 2002 Less, partial distribution made (6,000.00) September 22, 2002 Less, partial distribution made (8,000.00) November 3, 2002 Less, partial distribution made (10,000.00) Net to be distributed 11,285.14 Kenneth R. Roush, 14 Paradise Drive, Carlisle, PA 1701.3 35,530.74 Less, ll5 interest in Nicor Stock received in kind (245.60} September 5, 2002 Less, Lot 141 received in kind (13,720.00) September 5, 2002 Less, Lot 107 received in kind (7,500.00} September 5, 2002 Less, Lot 108 received in kind (8,400.00) September 5, 2002 Less, Lots 109 and 110 received in kind (8,750.00) September 5, 2002 Plus, refund to Estate for excess distribution 3,529.47 September 5, 2002 Less, real estate tax proration on lots received (325.61) September 5, 2002 Less, recording costs for recording deeds of distribution (119.00} Net to be distributed 0.00 Patricia J. Smith, 4 Pleasant View Dr. Mechanicsburg, PA 17050 35,530.74 Less, 1/5 interest in Nicor Stock received in kind (245.60) July 6, 2002 Less, partial distribution made (6,000.00) September 22, 2002 Less, partial distribution made (6,004.00) November 3, 2002 Less, partial distribution made (11,000.00) Net to be distributed 12,285.14 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS.: Before me, the undersigned officer, personally appeared Robert E. Roush, Jr. Barry L. Roush, Faye A. Sheaffer, Kenneth R. Roush, and Patricia J. Smith, Executors of the Last Will and Testament of Edith M. Roush who, being duly sworn according to law, depose and say that the foregoing First and Final Account and Proposed Schedule are true and correct to the best of their knowledge, information and belief. Robert E. Roush, Jr. Barry L. Roush Faye A. Sheaffer 9,~ ~ ~~ Kenneth R. Roush ~~ Patricia J. Smith Sworn to and subscribed before me this l~tay of Dece ber, 2002 NOTARIAL SEAL TRISt1A A. LIES, NOTARY PU81.MC BOROUGH OF CARUSI.E, CUMBERLAND CO.. PA MY COMAMSSpN EXPIRES MAY 20 2001! t (.. ~_.y____.__._.____ _,._ - i d ~ to - ~'.+4 a'' ~Fjv. .-,:~...f,v .Vts r,t ,.;",. ice, t~:>rr f. i('.~ ~~ ~? LAST WILL AND TESTAMENT P ~; OIt' '~`' EDITH M. ROUSH _- _ r !' I, EDITH M. ROUSH, married woman, of 1437 Trindle Road, Carlisle, Cumberland '.~ ` k-: County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do ~ =~ hereby make, publish, and declare this as and for my Last Will and Testament, hereby revoking ~~ and makin void an and all Wills b me at an time heretofore made. t; g Y Y Y ~ ~' ~ 1. I direct my hereinafter named Executor to pay all of my just debts and funeral expenses ! as soon after my death as may be found convenient to do so. ,: 2. I declare that I am currently matTied to Robert E. Roush, Sr., and that we have five (5) children who are: Robert E. Roush, Jr., Barry E. Roush, Kenneth R. Roush, Patricia J. Smith ~~~ and Faye A. Sheaffer. ~, . 3. All the rest, residue, and remainder of my estate, real, personal, or mixed, and == wheresoever the same may be situate, I give, devise, and bequeath to my said children, to the !. ~,: exclusion of my said husband, Robert E. Roush, Sr., in equal shares, the share: any deceased child `° ~ would have received to pass to his or her issue per stirpes, and if there be no issue, such share ' ~'! shall lapse and be added to the remaining share or shares per stirpes. I have five (5) children as i ~ aforesaid. ~ `: f ~;; :.; 4. Should any person less than 18 years of age be entitled to distribution from my estate, ~`' ~ in such event the share that person would otherwise have received shall be paid to my hereinafter named Executors, in trust, to receive and invest the same, and to pay the income arising therefrom, ~~ ` together with so much of the principal thereof as in her opinion is necessary or desirable to be ~: ~ expended for the groper maintenance, support, and education of such person, to or for the benefit !' of such person, and upon such Berson attaining 1S years of age to pay to him or her the then ,., "' remaining principal together with any undistributed income. "~ 5. I hereby nominate, constitute, and appointmy five (5) children, Robert E. Roush, Jr. , Barry E. Roush, Kenneth R. Roush, Patricia J. Smith and Faye A. Sheaffer, or any of them, as Co-Executors of this my Last Will and Testament, and I further direct that none of them shall be `~" required to post any bond to secure the faithful performance of his or hear duties in the Commonwealth of Pennsylvania or in any other jurisdiction. d _~~ IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on one (1) page this 17th day of October, 1995. F ~ ~? t /1 ~-- (SEAL) 1 Edith M. Roush 1 j Signed, sealed, published and declared, by Edith M. Roush, the Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ~~~ -~t E j F y '; ~~::~ ~: ; ti°:` ~~ `~~~ /~ COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL raxES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 INHERITANCE TAX HARRISBURG, PA 17128-0601 STATEMENT OF ACCOUNT REV-1607 E% ~FV [01-02) DATE 12-03-2002 ESTATE OF ROUSH EDITH M DATE OF DEATH 01-26-2002 FILE NUMBER 21 02-0112 COUNTY CUMBERLAND ROBERT G FREY ACN 101 5 S HANOVER ST CARLISLE PA 17013 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PEA 17013 NOTE: To insure 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 -~ ---------------------------------------------------------------------------------------------------------------- REV-1607 EX AFP (01-02) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ~~~ ESTATE OF ROUSH EDITH M FILE N0. 21 02-0112 ACN 101 DATE 12-03-2002 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: 11-25-2002 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 8,706.00 PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 04-26-2002 CD001117 435.30 8,2'75.00 11-18-2002 REFUND .00 4.30- TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. * IF PAID AFTER THI5 DATE, SEE REVERSE I TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, 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. ) 8,706.00 .00 .00 .00 PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested an the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Department's 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). REPLY T0: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Oept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three C3) calendar months after the decedent's death, a five percent (5%l discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 hear interest at the rate of six C6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 7% .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 7% .000192 1986 10% .000274 2000 8% .000219 1987 9% .000247 2001 9% .000247 1988-1991 11% .000301 2002 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the ;~, Notice, additional interest must be calculated. Cumberland County - Register Of Wills ' One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 12/01/2004 FREY ROBERT G 5 S HANOVER STREET CARLISLE, PA 17013 RE: Estate of ROUSH EDITH M File Number: 2002-00112 Dear Sir/Madam: It ha.s come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. 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 will become delinquent on: 1/26/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FAR:~TER STRASBAUGH REGISTER O:F WILLS cc: File Personal Representative(s) Judge STATUS REPORT UNDER RULE 6.12 Name of Decedent: Edith M. Roush Date of Death: January 26, 2002 Will No. Admin. No. 21-02.-0112 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes (X) No ( ) 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: _ 3. If the answer to No. l is Yes, state the following: (a) Did the personal representative file a final account with the Court? Yes ( ) No (X ) (b) The separate Orphans' Court no. (if any) for the personal representative's account is: (c) Did the personal representative state an account informally to the parties in interest? Yes (X) No ( ) (d) Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: December 9.2004 'nature Robert G. Frey South Hanover Street_ Carlisle, Pa 17013 (717) 243-5838 Capacity: ( )Personal Representative (X) Counsel for personal representative 4,