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HomeMy WebLinkAbout04-0294PETITION FOR PROBATE AND GRANT OF LETTERS Estate of Jean H. Gibbs No atso known ~ Jean ~7~ie Black To · Deceased Soctal Securtty No 201-18-1543 The petmon of the undersigned respectfully represents that Your pennoner(s) is/are 18 years of age or older and execut wall of the above decedent, dated February 18, 1993 Register of Wills for the County of~itf~llrox Cumberland zn the Commonwealth of Pennsylvania named m the last and co&cd(s) dated Cumberland Decedent was dom~cded at death in ~kOIRs County, Pennsylvama, with h er principal residence at 1_42 Old State Road, Gardners, S. Dzck~_nson Twp. Cumberland County PA 17324 last family or Decedent, then 78 years of age, died Ma~_'ch 2, 2004 at S. Florida Baptist Hospital Plant City FL 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 kdhng and was never adjudicated incompetent decedent marrzed Glenn W. Black after execution of the Wzll. Decedent at death owned property with estimat~d values as follows (If domiciled in Pa ) (If not domiciled in Pa ) (If not domicded in Pa ) Value of real estate in Pennsylvania situated as follows All personal property Personal property ~n Pennsylvania Personal property in County WHEREFORE, pentt?.n, er(s) respectfully request(s) the probate of the last will and codlcd(s) presented herewith and the ~rant df l&ters~ ,%~sta~entarv - thereon ~' 6~ 9Z ~ ~0. Ronald J. Cl~ ~qV~ tO , ~,~OH Kay~ Pl~nk J~f~ ~a' Chne I R M Gilbert idl ~;, PC Sharon E..Myers, Attorney smyers@cgalaw.com May 25, 2004 Register of Wi lis Cumberland County Courthouse 1 Courthouse Square Carlisle PA 17013 Re: Estate of Jean H. Gibbs aka Jean Marie Black File No. 20-04-00294 Dear Register of Wills: Enclosed is a check for two thousand dollars ($2,000.00), an advance paymem of the Inheritance Tax for the above referenced estate. Please send a receipt to: Sharon E. Myers, 106 Harrisburg Street, East Berlin PA 17316. If you have an)' questions, please feel free to contact me. Sincerely, Sharon E. Myers SEM/nh C__. Enclosure {00124571/1 ) CGA Law Firm, l0 H Irisbur9 St., P.O. Box 606, East Berlin, PA 17316, 717.259.9592, Fax 717.259.9148, www. cgalaw, com L F I IR. M countess Gilbert AndrewS, PC Register of Wills Cumberland county Courthouse 1 Courthouse Square Carlisle PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 004002 MYERS SHARON E 29 NORTH DUKE ST YORK, PA 17401 fold ESTATE INFORMATION: SSN: 201-18-1543 FILE NUMBER: 2104-0294 DECEDENT NAME: GIBBS JEAN H DATE OF PAYMENT: 06/03/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/02/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2,000.00 REMARKS: CGA TOTAL AMOUNT PAID: $2,000.00 SEAL CHECK# 5 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Doc ID=7467.1 Author=SM User=LS Dg~e=January 26, 1993 qq tllill atti estameat I, Jean H. Gibbs, OF JEAN H. GIBBS of Reading Township, Adams County, Pennsylvania, being of sound and disDosing mind, ~o~y~nd .-~ understanding, do make, publish and declare the f.~llowl~A~~ as:~and for my Last Will and Testament, hereby revoking aha, ma~nq ~oxa any and all Wills and Testaments, or writings in~e,~ n~ure~,~' ;~' thereof by me at any t~me heretofore made~ ~ I. I direct that all expenses of my last ~llness, including hospital expenses, expenses for medical c~re, funeral expenses and the cost of a gravemarker, as weli as all debts or obligations owed by me at the time of my death, which in the opinion of my Executors are not sub]ect to either a legal or equitable defense, shall be paid from my residuary estate, unless cthe~wise provided herein, as soon as practicable after my decease, as a part of the expense of the administration of my e%~tate. ! give and bequeatn al~ ]ac~q~ o,= tanq~Dle personal property ~hlch I may own at thc tl',~e uf ~- ,~eat~ !nc!uAlng any automobiles whlch I may o'~n, forcible% with an} insurance policies thereon in e~al shares to mI sujv}ving children, to be divided among them ~n k~nd as they may agree. In the event that none of Doc ID=7467.1 Author=SM User=LS Date=January 26, 1993 my said children survive me, said tangible personal property shall be divided among their surviving issue equally and distributed to such issue in kind per capita. III. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, of whatever kind or character and wherever situated, which I may own or have the right to dispose of at the time of my death in equal shares to my children, Ronald J. Cline, Kay F. Plank and Jeffrey W. Cline, or to their respective issue, per stirpes. IV. My personal representatives and the Trustees of any trust created hereunder shall have the following powers and authority in addition to, and not in limitation of, any other rights and powers granted by law: To retain any property transferred, devised or bequeathed to them by me, or any undivided interest therein, regardless of the character of said property, or whether it is such as may be authorized by law as a legal investment by a fiduciary; To sell any estate or trust property, for cash or on credit, at public or private sale; to exchange any of said property for other property; to grant options to purchase or acquire any estate or trust property; and to determine the prices and terms of sales, exchanges and options; To execute leases and sub-leases for terms extending beyond the termination of any Trust established herein; to subdivide or improve real estate and tear down or alter improvements; to grant easements, give consents and make contracts relating to real estate or its use; and to release or dedicate any interest in real estate; -2- Doc ID=7467.1 De Author=SM User=~S Date=January 26, 1993 To borrow money and to mortgage or pledge any estate or trust property in connection with the administration of the Trusts created hereunder; to execute promissory notes or other obligations for amounts so borrowed; and to secure the payment of any amounts so borrowed by mortgage or pledge of any real or personal property; provided, however, that said authority may be exercised only to the extent that it is necessary or required in connection with the proper administration of my estate or any of the trusts created hereunder, and shall not be used for the purpose of making speculative investments or for the purchase of securities on margin; To take any action realizing upon the property, and with reorganizations or or trust property; or abandon demands property, wherever with respect to conserving or value of any estate or trust respect to foreclosures, other changes affecting the estate to collect, pay, consent, compromise of or against the estate or trust situated; and to execute contracts, notes, conveyances and other instruments, including instruments containing covenants and warranties binding upon and creating a charge against the estate or trust property, and containing provisIons excluding personal liability; To keep any property in the name of a nominee, with or without disclosure of any fiduciary relationship; To employ agents, attorneys, auditors, depositaries and proxies, w~th or without discretionary powers; To give proxies, to deposit securities with and transfer title to committees representing security holders and to participate in voting trust, reorganizations, and other transactions involving the common interest of security holders; To exercise any option to subscribe for or purchase any stocks, bonds, certificates, or other securities which may be given to it as the holder of other stocks, bonds, certificates, or other securities constituting a part of the estate or trust property; To purchase stocks, bonds or.other property, real or personal, from the executor or legal representative of my spouse's estate, or any trust established by my spouse, even though such executor or legal representative is also a fiduciary hereunder; -3- Doc ID=7467.1 Author=SM User=LS Date=January 26, 1993 In the event that my spouse survives me, to join with my spouse or his personal representative in the filing of any income or gift tax return for any period prior to my death and without requiring indemnification from my spouse or his personal representative for any liability which may arise from joining in such return; To elect to take administration expenses on either the estate's federal income tax return or the estate's federal estate tax return in such manner as to provide the greatest overall tax savings. My Executors are authorized but not required to adjust the interest of any beneficiary detrimentally affected by such election in order to compensate said beneficiary for any loss due to the making of such election; To exercise any election provided in the Internal Revenue Code or under Pennsylvania Inheritance or Estate Tax Laws with respect to the valuation of property for purpose of such taxes, and the time and manner of payment of tax, and no adjustment in any beneficiary's interest in my estate shall be made by reason of the making of such election; To deduct, retain, expend and pay out of any money belonging to the estate or any trust established herein any and all necessary and proper expenses in connection with the operation and conduct of the same, and to pay all taxes, insurance premiums on any policy constituting part of the trust property, and any other legal assessments, debts, claims or charges which at any time may be due and owing by, or which may exist against my estate or any trust established herein; Oe To charge commissions or compensation for their services hereunder, which commissions or compensation in the case of a corporate fiduciary may be charged against or payable from both principal and income received on an annual basis at such rates as may be provided in its publ!shed fee schedule in effect at the time said services are performed; To make any distributions or division of estate or trust property in cash or in kind, or both. I direct that all state and federal estate, succession, legacy, inheritance or other transfer taxes, however designated, -4- D~c ID=7467.1 Author=SM User=LS Date=January 26, 1993 together with any interest thereon, that shall become payable by reason of my death with respect to any property which is included in my estate for purposes of computing such taxes and subject to administration by my personal representatives, shall be paid from my residuary estate, as an expense of administration and without apportionment. My Executors shall have no duty or obligation to obtain reimbursement for any such tax paid by them even though on proceeds of insurance or other property not passing under this Will. I appoint my children, Ronald J. Cline, Kay F. Plank and Jeffrey W. Cline, or the survivor of them, Co-Executors of this my Last Will and Testament. All shall serve without bond. Any fiduciary who is an individual shall be entitled to receive reasonable compensation for his or her services hereunder and shall be reimbursed for all expenses incurred in connection with the administration of my estate or any trusts established herein. Compensation for any corporate fiduciary for its services hereunder shall be in accordance with its published fee schedule in effect at the time said services are performed. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Will this /~- day of ~~ , 1993. Je~ H. Gibbs'- Doc ID=7467.1 Author=SM U~er=~S Date=January 26, 1993 Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request, in her presence and in the presence of each other, all being p~esent at the same time, have hereunto subscribed our names as witnesses. -6- D6c ID=7467.1 Author=SM User=~S Date=January 26, 1993 COMMONWEALTH OF PENNSYLVANIA ) ( ss. COUNTY OF'-~OR'K~ ) I, Jean H. Gibbs, the Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed said instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein contained. Jean;: Gibbs, Testatrix Sworn or s%lbscribed to and ackDg~ledged he. fore me this .:~f ~/~.~ , 1993. Not~ry Public I N~m~S~_ . . c.- I COMMONWEALTH OF PENNS¥~~ma~m~mdN~m~~ .,' . /p. . --( ss. COUNTY OF~ ~ ) We, the undersigned witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix, Jean H. Gibbs, sign and execute the instrument as her Last Will; that the said Jean H. Gibbs signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix, Jean H. Gibbs, signed the Will as witnesses; and that to the best of our knowledge, the Testatrix, Jean H. Gibbs, was at the time 18 or more years of age, of sound mild and under no constraint or undue Witness Sworn or subscribed to and agxkp, owledged be$ore me this Not~y Publ lc I ~st l~lin Bo~, ,t~:Jams ex:~nt'ff I Memtmr, Pennsylvania ;s. ss~x~:~n of Not~,es CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Jean H. Gibbs Date of Death: March 2, 2004 Admin. No.: 20-04-00294 To the Register: I certify that notice of estate administration 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 April 12, 2004. Name Ronald J. Cline Ms. Kay F. Plank Mr. Jeffrey W. Cline Mr. Glenn W. Black Address 935 Mt. Tabor Road Gardners, PA 17324 2127 Cranberry Road York Springs, PA 17372 294 Creek Road Aspers, PA 17304 142 Old State Road Gardners, PA 17324 Notice has now been given to all persons entitled thereto~/_A' Date: April 12, 2004 Signature: '---/DJ ~ ~--~ Name:Sharo~.~:ers/ Q J Address: 29 North Duke Street Telephone: Capacity: Counsel for Personal Representative York, PA 17401 (717) 848-4900 IN RE: ESTATE OF JEAN H. GIBBS a/k/a JEAN H. BLACK, deceased 1N THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS COURT DIVISION No. 21-04-0294 ELECTION TO TAKE UNDER WILL TO WHOM IT MAY CONCERN: I, Glenn W. Black, widower of Jean H. Gibbs a/k/a Jean H. Black, deceased, who died on March 2, 2004, leaving a Last Will and Testament dated February 18, 1993, probated in the Office of the Register of Wills of Cumberland County, Pennsylvania on March 26, 2004, hereby elect to take my spousal election under the terms of the Will pursuant to 20 Pa. Cons. Stat. ,q 2510. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /~o day of September, 2004. L~ENN W. BLACK (SE4L) COMMONWEALTH OF PENNSYLVANIA · COUNTY OF CUMBERLAND · SS Onthis, the [!¢ dayof September, 2004, beforeme, the undersigned officer, personally appeared GLENN W. BLACK, known to me (or satisfactorily proven) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged that he executed the same for the purpose herein contained. y handffm ~~ C~OMMONWEALTH OF PENNSYLVANIA Notarial Seal Jaclluclinc L. Drawbaugh, Notary Public South Middlcton Twp., Cumberland County My Commission Expires Aug. 14, 2007 Member, Pennsylvania Association of Notades IN WITNESS WHEREOF, I hereunto~ IN RE:ESTAI'E OF JEAN H. GIBBS a/k/a JEAN H. BLACK. deceased : IN file COURT OF COMMON PLEAS OF : CUMBERI.AND COUNTY. PENNSYI,VANIA : : ORPHANS COURT DIVISION : No. 21-04-0294 PETITION FOR FAMILY EXEMPTION IN CASH PURSUANT TO 20 PA. CONS. STAT. '3121 TO TtfE HONORABI,E. THE JUDGES OF SAID COURT: The petition of Glenn W. Black, respectfully represents that: I. Petitioner is the widower of Jean I1. Gibbs-Black ("Decedent") x~lo, o died March 2. 2004. a resident of Cumberland County. Pennsylvania. Decedent and Petitioner were married August 10, 1997. and the Petitioner was a member of the Decedent's household at thc time of her death. Decedent left a Last Will and Testament dated February 18. 1993. duly probated in the office of the Register of Wills of Cumberland Count>. Pennsslvania. a cop? of x~hich is attached hereto as Exhibit Letters Testamentar? were granted to Ronald J. Cline. Kay F. Plank and Jeffrey W. Citric, b? the Register of Wills of Cumberland County, Pennsylxania. Notice of this petition has been given to the Executor. Petitioner claims $3.500.00 cash, now in the hands of the Executor. as the t:amily exemption under 20 Pa. Cons. State .~ 3121. 'lMent> days' prior notice of the presentation of this petition has been given to the personal representative, above named, by and through their counsel, a copy of which notice is attached hereto as Exhibit "B". WI IEREI:ORE. pctitior, er requests that the sam of $3,500.00 cash be paid to him as the l:amily exemption under 20 la. Cons. Stat. § _>I_1. GEENN W. BLA-£:K, Petitioner Doc iD=7467 Author-= i, Jean H. Gibbs, ,lEAN Of Read Lng Date=Oan!!arv 26, 1993 Gi~DS I'ownsh [p, ~d ....... COLlnLy, Pennsylvania, being of sound and disposing mind, memory understanding, do make, publish and decla~-e the following as for my Last Will and Testament, hereby raw,king and making void any and all Wills and Testaments, or writh~gs in the nature thereof by me at any time he~etofere maple. I direct that all expenses of my last [~Iness, including hospital expenses, expenses loc medical cafe, [uneFa] expenses and the cast o[ a gFavemarkeF, as well as al! deb[s ebligations owed by me at the time of my death, which in the opinion ef my Executors afc net subject to either a legal or equitable defense, shall be paid from my t-esiduary estate, unless ctherwise provided hecein, as soon as pFacticable afteF my decease, as a pert e%tate. give adm~r~_~tr-t .].o,, of my tang~nle personal propers;, ~,zhich I may own at autonobiles thereon in among ~he~ in kind l:~c !lrling any any insuFance policies chlidren, to be divided h ~' ~'~'~ that none of my said children survive me, said tangible personal property shall be divided among their surviving issue equally and distributed to such~'='~ ..... ~ [:: k~n~: [ per capLta. r .... dh .. and I give, devzse and ~,~qu_ath all the rest., ~--i ,e remainder of my estate, real, ~""'~ ~n~ p~ .... r,_~ and mLxed, of whatever kJ. nd or character an~f whezever situated, which i may own or bare the right to dispose of at the t~me of my ~v ~n equal star-es to my children, Rona]d J. Clime, Kay F. Plank and Jeffrey W. Clime, or to their ~.oect~v._ 1ssue, per ~ ' es My personal, reD~-esentat[ves and the Trustees of any trust created hereunder shall hnve the following powers and authority in addition to, and not Jn limitation of, any other rights and powers granted bi' law: Ao To retain any property transferred, devised becueathed to them by me, er any undivided interest therein, regard]ess of the character of said property, or whether it is such as may be authorized by law as a legal investment by a fiduciary; Co To sell any estate or trust property, for cash or on credit, at public or private sale; to exchange any of said property for ouher property; to grant options to purchase or acquire any estate or trust property; and to determine the prices and terms of sales, exchanges and options; To execute leases and sub-leases for terms extending beyond the termination of any Trust established herein; to subdivide or improve real estate and tear down or alter improvements; to grant easements, give consents and make contracts relating to real estate or its use; and to release or dedicate any interest in real estate; -2- Do Zo G. H. To borrow honey and to morhgage or pledge an}' estate or trust property in connection with tho administration the TrusEs created hereuNler; to execute pTomisso~y notes or otheF obliga~2ior;s lot amounts so ho~;nowet; and mo~%gage or plerige of any real or personnel property; provided, however, that said anthor[ty may be exercismd only to the exkent that it is necessary o~ required connection with the p~eper administration of my estate er any e[ the trusts creaNed heFeNFldel , and shall not be used for the purpose of making speculative inveshments or for the puTchase Of securities o~ marg in; To take any act Lon realizing upon the property, and with reorganizations or or trust property; or abandon demands property, wherever with respect to conseFving or other c:hanges affecting the estate to collect, pal,, consent, compromise of or against the estate or trust and other instruments, including instrumemts containing covenants and warranties binding upon and creating a charge against the estate or trust property, and containing provJ, sious excluding personal liability; To keep any property in the name of a nominee, with or without disclosure of any fiduciary relationship; To employ agents, attorneys, auditors, depositaries and proxies, with or without discretionary powers; To give proxies, to deposit securities with and transfer title te cemu~ittees zepresentLng security holders and to participate in voting trust, reorganizations, and other transactions involving the common interest of security he!dots; To exercise any option to subscribe for or purchase any stocks, bends, certificates, or ether securities which may be given to it as the holder ef other stocks, bonds, certificates, or other securities constituting a part of the estate or trust property; To purchase stocks, bonds or other property, real or personal, from the executor or legal representative of my spouse's estate, or any trust established by my spouse, even though such executor or legal. representative is also a fiduciary hereunder; -3- in the even~ that my spouse survives me, to join leith my s?ouse or his personal representative Jn the f[]ing of any income or cliff tax return for any NerJod pr{er to my d~dth ami without requi}-ing indemnification from my spouse or his personal representative fo~; any liability which may arise from jeinLng in such return; To elect tn take ad~inistration expenses on either the estate's federal income tax return or the estate's federal estate tax return in such manner as te provide the greatest overall tax savings. My Executors are authorizer] but not required to adjust the interest of any beneficiary detrimentally affected b!, such electio:l in order to comper~sate said bel~eficiary for any loss due to the making of such election; To exercis~ any election provided in the inter-nal revenue Code or un,'ter Pennsylvania Inheritance or Estate Tax Laws with respect te the valuation ef property for purpose of such taxes, and the time and manner of payment ef tax, and no adjustment in any benofic[ary's .interest in my estate shall be made by reason of the mating of such election; To deduct, retain, expend and pr~y out of any honey belonging te the estate er any trust esteh'lished herein ally a~ld ali necessary arid proper expenses in connection with the operdtion and conduct of the same, and to pay all taxes, insurance premiums on any policy constituting part ef the trust property, and any other legal assessments, debts, claims or charges which at any time ma}, he due and owing by, or which may exist egainst my estate er any trust established herein; To charge col~tmissiens or' compensatio.~ fo~- their services hereunder, which commissions or compensation in the ease efa corporate fiduciary may be charged against or payable from both principal and income received on an annual basis at such rates as may be provided in its published fee schedu}e ii~ effect at the time said services are performed; To make any distributions or division of estate or trust property in cash or in kind, or both. I direct that all ~ ~ .~=a~_e and federal estate, succession, legacy, inheritance or other' transfer taxes, however designated, together with any interest thereon, that si~eil become payable bi~ reason of my death with respect to any prepertl' which is included it/., my estahe for p~:-poses of computing s~cb taxes and subject to administration by my pe~sena] representatives, shall, be paid from ml; residuary estate, as an expense of admin[straEien and withok~t apportionment. ply Executors shall have no duty or ob![gat[eh to obtain reimbursement fou an~' such tax paid by them even tNough cn proceeds Wil 1. of insurance or other property Vi. I appoint my childz-cn, Nonald J. Ciine, Ray F. Plank and Jeffrey W. Ciine, or ti~e survivor of them, Co-Executors of this my I,-lst Will and l'est-h~[~eF'~- All shall serve without be~:d. AP.y fiduciary who is an individual shall be entitled to receive reasonable compensation for his or her services hereunder and shall be reimburset for all expenses incurred in connection with the administration of my estate er any trusts established herein. Compensation for any corporate fiduciary for its services hereunder shall be in accordance with its published fee schedule in effect at the time said services are performed. IN WITPIESS WHEREOF, I have hereunto set my hand and seal to this my Will th~s /'~p ~{ day of .i/ . . . . ~k ~_,~ ' ' , 1993 Jep H. Gibh- -5- Doc ID=7467'1 ~uthor=SM User=LS Da te=Januar i/ Signed, sealed, pub* ~ ~ ~ '-- as and for her Last ~it! and Testamenh, tn hhe ~esence of each other, all being pr~_~n~ at the same time, h~ve -6- TR ~'=LS Date=January " Doc ID=7467-1 Author=SM ~' ~ · COMMONWEALTh{ OF pENNSYLVANiA ' '} ....... '~' '~-i' whose nu~e i~< signed to the I, jean H. Glb~s, the ~ ..... ~ ..... , '- attached or foregoing instFument, having been duly qualified according to law, do be~reby acknowledge that I siqned and executed said instrument as my Last Will; that I signed it ~'-:m~ it as my free and voluntaFy act for willingly; and that I .~ .... the purposes therein contained. Jean ..H. Gibbs, Testatrix Sworn o~ subscribed to and ackno~vtedged befere me this /~/~ der ov .,~.~.~2~{~z~%f~ , 1993. ( ss. We, the undersigned witnesses whose names are signed to the attached or foregoing instrument-, beAng duly qualified according to law, do depose and say that we were puesent and saw the Testatrix, Jean H. Gibbs, sign and execute the instrument as her Last will; that the said Jean H- Gibbs signed wAlling!F and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix, Jean H. Gibbs, signed the Will as witnesses; and t b~st of our knowledge, the Testatrix, Jean H. Gibbs, that _o the .... _ ..... ~ ~und mind and under ,</ Witness Sworn or subscribed to and acknowledged beSore me this ~ Nota!r~, Ptlbl lc SALZMANN, HUGHES & FISHMAN, P.C. J.'3,1E< D. HUGHES, ESQ. S FEVEN J. F[SHMAN, E>Q. September 20. 2004 Sharon E. Myers. Esquire COLNTESS GILBERT & ANDREWS 106 Harrisburg Street East Berlin. PA 17316 RE: ESTATE OF JEAN FI. GIBBS-BLACK Dear Sharon: I am enclosing for your file a copy of the Election to Take Under Will on behalf of Glenn W. Plack and his petition. In addition, this letter shall serve as written notice/hr a claim of the family ,:xemption as required by statute. However. based upon our most recent conversation, it is my understanding that the parties have agreed to the terms and conditions set forth in my letter to you dated July 13. 2004. Accordingly. please prepare the appropriate agreement tbr all of the executors and Mr. Black to execute together with preparation of a check in the amount of $4,975.00 payable to the undersigned as attorney l%r Mr. Glenn W. Black. Once you have the agreement prepared, kindly send a copy of the same to me tbr review so that we may finalize this matter as soon as possible. Thank 3ou for your cooperation with respect to the above. JDl[,~jld Enclosures cc: Glenn BLack EXHIBIT Very' truly' yours. /./~ES &, FISHMAN PC . ughes CERTIFICATE OF SERVICE i, James D. Hughes. do hereby certit~' that i have this day served a true and correct copy of the tbregoing document upon the person indicated below by first class United States mail postage paid in Carlisle. Pennsylvania. on the date set forth below: SI1ARON E. MYERS, ESQUIRE COUNTESS, GILBERT & ANDREWS 106 ilARRISBURG STREEI' EASTBERI,IN PA 17316 Date: October 13,2004 Respcctftdly submitted. SALZMANN. tT~ES & FISHMAN. P.C. Ja~c~,~ mzhcs. Esquire Suf, j/or Co& No. 58884 . 95flexandcr Spring Road, Ste ~ ~rlisl=~ Pennsylvania 17013 (717) 249-6333 ~(717) 249-6 aJk/a JEAN H. BLACK, deceased OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : : ORPHANS COURT DIVISION : No. 21-04-0294 DECREE-AWARD MADE UNDER FAMILY EXEMPTION AND NOW, on October / f) , 2004, on consideration of the annexed Petition of Glenn W. Black and the presentation of proof of notice, $3,500.00 cash is awarded to Glenn W. Black as his family exemption under 20 Pa. Cons. Stat.§ 3121. By the Court: I IR M Gilbert ,dr PC Sharon E. Myers, Attorney smyers@cgalaw, com December l, 2004 Register of Wills of Cumberland County One Courthous,.- Square Carlisle PA 1701%3387 Re; Estate of Jean H. Gibbs Black File No. 21-04-00294 Date o! Death: 3/2/2004 Dear Register of Wills: Enclosed are m o copies of a Pennsylvania Inheritance Tax Return for the Estate of Jean H. Gibbs aka Jeau Marie Black and one copy of the estate Inventory. Enclosed is a clerk in the amount of $28.00 to cover the cost of filing the Inheritance Tax Returns and the h~ventory and a check for $3,337.16 to pay the balance of the inheritance tax due. Sharon E. Myer~l SEM'nh Eric] o s ures N.~ CG.~ Firm, 10d da ri~burg St., RO. Box 606, East Berlin, PA 17316, 717.2599592, Fax 717.259.9748, www. cgalaw, com REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 04 00294 COUNTY CODE YEAR NUMaER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INI'RAL) SCCIAL SECUREY NUMBER Gibbs, J'ean H. aka Black, Jean Marie, 20 ] - 18-1543 2: DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) tu THIS RETURN MUST BE FILED IN DUPLICATE W1TH THE au 03/02/2004 12/29/1925 REGISTER OF WILLS ¢3 SOCIAL SECURr~' NUMBER [IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) Black, Glenn W. [] 1. Original Return [] 2. Supplemental Return [] 4, Limited Estate [] 4a. Future Interest Compromise (date of death after 12-12~2) [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach [] 9. Litigation Proceeds Received [] 10. SpousalPoveayCredit(dateofdeathbetween ] 8. Total Number of Safe Deposit Boxes [] 11.Election to tax under Sec. 9113(A) (Attach S~h O) Z Z 4AME Sharon E Myers :IRM NAME (If applicable) CGA Law Fh-m ~_t_EPHONE NUMBER 717/259~9592 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellanesus Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1~7) 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) 12. Net Value of Estate (Line 8 minus Line 11 ) COMPLE-i~ MAILING ADDRESS 106 Harrisburg Sh-eet P.O. Box 606 East Berlin, PA 17316 None 32,819.17 None None 87,587.22 37,393.15 9,729.86 21,520.46 912.23 (a) 167,529.40 (11) 22,432.69 (12) 145,096.71 (13) (14) 145,096.7 1 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spouesl tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) 16. Amount of Line t 4 taxable at lineal rate x .045 (16) 17.Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 20. [] ["~=#:~l=~t~wa~]""-`~If~;a~4~[~]~J=``~[~`-~l~i~-.If~=~[~`-~`~`~;I 24,154.04 0.00 120,942.67 5,442.42 5,442.42 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1600 EX (Rev. $-00) · Decedent's Complete Address: STREET ADDRESS CITY 142 Old State Road Gardners I STATE PA IztP 17324 Tax Payments and Credits: I. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount 2,000.00 105.26 (1) 5,442.42 Total Cradits (A +B+C) (2) 2,105.26 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interast/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page I Line 20 to request a refund 5. If Line1 + Line 3 is greeter than Line 2, enter the differsnce. This is the TAX DUE. (5) 3,337.16 A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE, (5B) 3,337.16 Make Check Payable to: REGISTER OFWILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. ratain the usa or income of the property transferrad; ..................................................................................... [--~ ~ b. retain the right to designate who shall usa the property transterred or ita income; ......................................... R ~[~ C. ratain a reversionary interest; or ..................................................................................................................... d. receive the promise for life of either payments, benefits or care? .................................................................. [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .......................................................................................................................... [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? ............... [] 4. Did decedent own an Individual Retirament Account, annuity, or other non-probate proberty which contains a beneficiary designation? ........................................................................................................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Aspers, PA 17304 SIGNATURE OF PREPARER OTHER ~IAN REPRESENTATIVE ADDRESS DATE SImronZ M ey31a_._.~ ~_. ~ 106 Han'isburg Street P.O Box 606 ~'~ r..~ ~- ....... Eas/~Berlin, mA 17316 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate impc~ed on the net value of transfers to or for the usa of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does net exemnt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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 steppersnt of the child is 0% [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the usa of the desedent's siblings is 12% [72 P.S. §9116 (a) (1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. SCHEDULE B STOCKS & BONDS ESTATE OF Gibbs, Jean H. aka Black, Jean Marie, FILE NUMBER 21 - 04 - 00294 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 Legg Mason Act. No. 363 -03173 - Mutual Funds 32,819.17 Cash Balance ($844.52) 1,100.636 Dryden Muai Set FD Ser CL B $11,32~.70 1,380.692 Delaware Group TF PA FD CL B $t 1,224.51 1,083.536 Eaton Vance PA Mtmi FD CL B $ ! 1,117.08 TOTAL (Also enter on line 2, Recapitulation) 32,819.17 SCHEDULEE CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Gibbs, Jean H. aka Black, Jean Mar~e, 21 - 04 - 00294 Include the proceeds of litigation and the date the.proceeds were received by the estate. All property jo nt y-owned w th the right of survivorship must be d sclosed on schedu e I-. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Sterling Financial CD # 153363 $10,000.00 + DOD int. $13.29 Waypoim Bank CD #1000160434 $10,000.00 + DOD int. $.55 Waypoint Bank CD #1000160435 $10,000.00 + DOD int $.55 Cornmunity Banks ~5130025861 $10,000.00 + DOD int. $7.62 Community Banks CD #6130033982 $ 5,000.00 + DOD int. $ 4.87 Community Banks CD #6130033983 $ 5,000.00 +DOD int. $ 4.87 Community Banks CD #6130044888 $20,000.00 + DOD int. $ 4.47 Community Banks CD # 6130046198 $ 5,000.00 + DOD int. $ .65 Coins in Lock Box - Jim Lenigs Jewelry & Coins - appraisal attached Remaining Coins in Lock Box - face value Personal propeO, y - Laity J. Peters appraisal attached Refund - Gevalia Coffee De Hart's Auction - Proceeds of sale of personal property Refund - Combined Insurance Co of America 2002 Oldsmobile VIN IG3WS52H32F230684 10,013.29 10,000.55 10,000.55 10,007.62 5,004.87 5,004.87 20,004.47 5,000.65 206.00 38.64 1,130.00 10.00 129.68 36.03 11,000.00 TOTAL (Also enter on Line 5, Recapitulation) 87,587.22 SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEAL'~f OF PENNSYLVANIA INHERITANCE T,~( RETURN RESIDENT DECEDENT ESTATE OF ~ikb, JcarJ H. aka lql !~ FILE NUMBER ~.~vs, ~ac.., Jean ~o,4...~.e, 21 - 04 - 00294 If an asset was made joint within one year of the decedent's date of death, it must be repo~ted on schedule G. SURVIVING JOINT TENANT(S) NAME A Glenn W. Black B Jeffrey W. Cline ADDRESS 142 Old State Road Gardners PA 17324 294 Creek Road Aspers PA 17301 RELATIONSHIP TO DECEDENT Husband Son JOINTLY OWNED PROPERTY DESCRIPTION OF PROPER'FY LETTER DATE % OF DATE OF DEATH ITEM FOR JOIN7 MADE Include name of financial }nstitution and bank account number or DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT similar identifying number. Attach deed for jointly-held real estate. VALUE OF ASSET ~ NTEREST DECEDENT'S INTERES 1 A 09/28/1998 Orcstown Bank Checking Act. 106000523 $23,296.20 23,297.1( 50% 11,648.51 + DOD int. $.96 2 A 12/21/1999 Orrstown Bank CD 5060064733 $25,000.00 + DOD 25,010.9,~ 50°g 12,505.41 int. $10.92 3 B 09/30/1992 Gartmore Funds Non ~ Fund act. no. 26,478.21 50~ 13,239.11 20/9030004348 TOTAL (Also enter on line 6, Recapitulation) 37~93.15 SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Gibbs, Jean H. aka Black, Jean Marie, 21 - 04 - 00294 This schedule must be completed and filed if the answer to any of questions I throu, ~ 4 on page; is yes. ITEM DESCRIPTION OF PROPERTY nc~udethenameofthetransferee the reationshiptodecedentandthedateofbansfer. DATE OF DEATH % OF EXCLUSION TAXABLE VALUE NUMBER Attach a copy of the deed for real estate VALUE OF ASSET DECD'S (IF APPLICABLE) INTEREST 1 PNC Bank - IRA Act. No. 65001015590 $9,729.68 9,729.86 9,729.86 plus DOD mt. $.18 TOTAL (Also enter on line 7, Recapitulation) 9,729.86 SI~'IB~ULE H FUNE~AL~& ADMINISTRATNE COS'1S ESTATE OF FILE NUMBER Gibbs, Jean H. aka Black, Jean Made, 21 - 04 - 00294 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. 1 2 3 FUNERAL EXPENSES: Dugan Funeral Home - Funeral Glen Black - Reimburse for Ben W. Stayers Excavation - open & close grave Dugan Funeral Home - Lettehng Tombstone ADMINISTRATIVE COSTS: Personal Representative's Commisslons Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State __ Zip Year(s) Commission paid Attorney's Fesa CGA Law Firm Family Exemption: (If decedenrs addresa is not the same as claimant's, attach explanation) Claimant Glenn W. Black Street Address 142 Old State Road City Gardners State PA Relationship of Claimant to Decedent Spouse Probate Fees Register of Wills - Cumberland Co. __ Z~p 17324 Accountant's Fess Tax Return Preparer's Fees Other Administrative Costs Cumberland Law Journal - Legal Ad The Senfmel - Legal Ad Total of Continuation Schedule(s) TOTAL (Also enter on line g, Recapitulation) 8,513.31 475.00 84.00 7,150.00 3,500.00 55.00 75.00 80.15 1,588.00 21,520.46 COMMONWEALTH OF PENNSYLVANIA INHERITANCE T,~( RETURN RESIDENT DECEDENT Schedule H ESTATE OF FILE NUMBER Gibbs, Jean H. aka Black, Jean Marie, 21 - 04 - 00294 3 4 5 6 7 Register of Wills of Cumberland Co. - Filing Fees Reserve for Expenses Glen W. Black - Reimburse for Attorney Fees to Salzmann, Hughes & Fishman, PC Lenigs Jewelry - Appraisal of coins Lan'y Peters - Appraisal of personal property 28.00 500.00 1,000.00 10.00 50.00 Page 2 of Schedule H SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Gibbs, Jean H. aka Black, Jea~ Ma~e, FILE NUMBER 21 - 04 - 00294 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT Midway Self Storage - rent of storage unit Ron Cline - reimburse for estate expenses American Progressive - Insurance bill South Florida Baptist Hospital - Last Illness Bon Ton - Credit card bill Reader Service - Book bill Rodale Inc. - Book bill Adams Comb. Med Center - Last Illness 74.20 143.50 131.00 387.44 35.53 16.96 44.63 78.97 TOTAL (Also enter on Line 10, Recapitulation) 912.23 SCHEDULE J BENEFICIARIES FILE NUMBER ESTATE OF Gibbs, Jean H. aka Black, Jean Marie, 21 - 04 - 00294 RELATIONSHIP TO NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT AMOUNT OR SHARE ~ .~' ~ ~,~' T.~I~ OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Ronald J. Cline Son 33 1/3 % Residue 935 Mt Tabor Roa, Gardners PA 17324d 2 Kay F. Plank Daughter 33 1/3 % Residue 2127 Cranberry Road, York Springs PA 17372 3 Jeffrey W. Clme Son 33 1/3 % Residue 294 Creek Road, Aspers PA 17304 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II, NON-TAXABLE DISTRIBUTIONS: ~. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DiSTRiBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Legg Mason Wood Walker, Incorporated 214 Senate Avenue, 7th Floor, F O. Box 8853, Camp Hill, PA 17001 · 8853 717 · 737 · 6500 800 · 433 · 8186 Fax: 717. 737 · 0800 Member New York Stock Exchange, Inc./Member SIPC Jean H. Black (Account #363-03173) (a/k/a Jean Gibbs) Date of Death of Jean Black (March 2, 2004) Qum~tity Symbol Security Cash Balance 1,100.636 Dryden Muni Ser FD Ser CL B PBPAX 1,380.692 Delaware Group TF PA FD CL B DPTBX 1,083.536 Eaton Vance PA Muni FD CL B EVPAX TOTAL *** This account was established as m~ individual account in April of 2003 Respectfully, Price 10.29 8.13 10.26 Total Value $ (844.52) 11,322.70 11,224.51 11,117.08 $32,819.17 STERLING FINANCIAL CORPORATION® April 19, 2004 CGA Law Finn 29 N Duke St York PA 17401-1282 Re~ Estate of Jean H Gibbs a/k/a Jean Marie Black SSN 201-18-1543 Dear Madam or Sir: As of the date of death, our bank had one account for the above-named decedent. The Certificate of Deposit Account #153363 was opened July 25, 1995 in the name of Jean H Black. The balance as of the date of death is $10,000.00. The accrued interest as of the date of death is $13.29. The interest paid from January 1, 2004 to the date of death is $103.19. IfI cma be of any further assistance, please contact me at 717-735-5913. Sincerely, Ronda Trimble Compliance/Reconcilement Specialist LOOK FOR US. WE'LL GET YOU THERE. 4/22/2004 CGA LAW FIRM 29 N DUKE ST YORK PA 17401-1282 The information which you requested on the account(s) of JEAN H BLACK (Social Security Number 201-18-1543) is/are as follows: Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownemhip OWN/BNF Name of Joint SEE NOTES Owner, if any BELOW Date Ownership 072188 Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established 1000160434 1000160435 CERTIFICATE CERTIFICATE 072188 072188 10000.00 10000.00 .55 .55 10000.55 10000.55 OWN/BNF SEE BELOW 072188 Additional Information Requested KAY PLAN RONALD CLINE JEFFREY CLINE BENEFICIARIES SENIOR SERVICES REP. P.O. Box 171 I, HARRISBURG, PENNSYLVANIA 17105-1711 Toll FrEE 1-866-WAYPOINT (I-866-9;=9-7646) · IN YORK AREA 717/815~4500 . vvvvw, wahlpointbank.com CommunityBanks ACCOUNT NUMBER{S) TYPE OF ACCOUNT DATE OPENED PRINCIPAL BALANCE ACCRUED INTEREST TILL DATE OF DEATH BALANCE AT DATE OF DEATH MATURITY DATE ACCOUNT OWNERSHIP NAMES OF JOINT OWNER- SHIP,IF ANY DATE JOINT OWNER- SHIP WAS ESTABLISHED ADDITIONAL INFORMATION INTEREST RATE SIGNATURE DATE OL~ - 2_0 -OCq P.O. Box 350 · Millersburg, PA 17061 . Phone 1-800-331-8362 Banks ACCOUNT NUMBER(S) TYPE OF ACCOUNT DATE OPENED PRINCIPAL BALANCE ACCRUED INTEREST TILL DATE OF DEJkTH BALANCE AT DATE OF DEATH MATURITY DATE ACCOUNT OWNERSHIP NANES OF JOINT OWNER- SHIP, IF ANY DATE JOINT OWNER- SHIP WAS ESTABLISHED ADDITIONAL INFORMATION INTEREST RATE SIGNATURE DATE P,O. Box 350 · Millersburg, PA 17061 · Phone 1-800-331-8362 499 Mill:~ Rind, Mfl!slx~ DE 19966 Mail Code D~MB-I2 C G A Law Finn Attorneys At Law 106 Harrisburg Street P. O. Box 606 East Berlin, PA 17316 Fax: (302) 934-2955 Phone (888) 502.-4349 November 1, 2004 RE: Estate of: Jean Marie Black $ocialSecurity Number: 201-18-1543 Date of Death: March 02, 2004 Dear Sir or Madam: Thank you for your inquiry dated October 25, 2004, addressed to M & T Bank; however, we are unable to locate any files for the above-mentioned decedent. If you feel that any should exist, please provide us with an account number and/or the name of any possible joint account holder. Sincerely, Nancy Clagett Records Management JIM LENIGS JEWELRY & COINS 104 Lincoln Way East Route 30 NEW OXFORD, PENNSYLVANIA 17350 (717) 624-7367 2096 All el.ires afld retur.e~ ~ood, ~AgSTbe[~compsniedbytJ~isbi]l Thank You! 123677 xls. Estate of Jean H. Gibbs aka Jean Marie Black Cumberland Co. File No. 20-04-00294 04/27104 Safe Deposit Box Inventory Item No. Item Description Face Value I Continental Casualty Company Cert. #0710010554 (accidental death) 2 CCNB (Now PNC) IRA (TDOA) #717084-8 3 ITT Hartford Accidental Life Ins. Policy #ADD-5265-1 4 2002 Oldsmobile Car Title VIN # IG3WS52H32F230684 5 PET, Inc. Savings & Investment Plan and Life Ins. Benefit Summary 6 CCNB IRA Acct. # 300007170848071 3/31/1993 7 PNC IRA Beneficial/Designation #6001008227 8 Bank of Hanover CD #153363 7/25/1995 9 Peoples State Bank CD #25861 1/16/1991 10 Peoples State Bank CD ~33982 11/14/1990 11 Peoples State Bank CD #33983 11/14/1990 12 Peoples State Bank CD #44888 7/27/1994 13 Peoples State Bank CD #30046198 11/25/1994 14 Waypoint CD#10-160435 7/21/1988 15 Waypoint CD ~K)11000160434 7/21/1988 16 Musselman Retirement Plan Statement of Benefits 17 Union Mutual Ins. Cert. #2733 1/1/1970 18 Fireman's Fund Ins. Co. Cert. #~733 7/1/1971 19 The Equitable Life Assurance #1685 W 20 Fifty-five (55) nickels (Buffalo) 21 1972 One dollar piece 22 Ten (10) 1936 nickels 23 $3.50 in coins 24 Ten (10) Eisenhower Dollars 25 Two (2) 1924 Silver Dollars 26 Three (3) pennies - 1988 penny, 1859 penny, 1887 penny 27 One (1) Five cent piece, One (1) 1850 penny, Three (3) one cent pieces, One(l) one-half cent piece, One (1) 1818 - 50 cent piece, Nine (9) Silver Dollars - 1924, 1923, 1922, 1890, 1922, 1922, 1923, 1922, 1889, 2 tokens, Ten (10) 1935-1937 Buffalo nickels, $19.05 in coins, $2.51 in coins, $ 4.75 in silver quarters, $ 2.00 in silver dimes, Eight (8) $2.00 bills $1,000.00 $13,000.00 $22,788.48 $10,000.00 $10,000.00 $5,000.00 $5,000.00 $20,000.00 $5,0OO.00 $10,000.00 $10,000.00 00123677.xis APPRAISAL Personal Property of: ESTATE OF JEAN H BLACK Adams County, Huntingdon Township Kay Plank, Executrix 2127 Cranberry Rd York Springs, PA 17372 Phone 717-528-8558 Jeffrey W. Cline, Executor 294 Creek Rd Aspers, PA 17304 Phone 717-677-9781 Ronald Cline, Executor 935 Mt. Tabor Rd Gardners, PA 17324 Phone 717-677-8405 Flat top trunk w/till ................................ $ 40.00 Square oak stand ..................................... 55.00 4 pc. modern bedroom suit ............................ 75.00 Jewelry Arimore w/costume jewelry .................... 50.00 Round oak table w/4 leaves ........................... 65.00 Softwood dry sink .................................... 175.00 6 plank bottom chairs 6 @ $40.00 ea .................. 240.00 Kenmore apt. size upright freezer .................... 55.00 Art Deco cedar chest ................................. 80.00 Modern oak Boston rocker ............................. 35.00 Modern Pine corner cupboard-(1 pc) ................... 150.00 2 drawer metal file cabinet .......................... 10.00 TOTAL $1130.00 APPRAISED BY: L~/ry ~et e rT~s ,v ~uct~' onee r 247 Clear Spring Road Biglerville, PA 17307 Phone (717) 677-8086 (PA AU-709L) Date TO: CGA Law Firm 106 Harrisburg St PO Box 606 East Berlin, PA 17316 FROM: ORRSTOWN BANK P.O. BOX 250 SHIPPENSBURG PA 17257-0250 RE: ESTATE OF Jean H Black DECEASED DATE OF DEATH: March 2, 2004 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK: (1) CHECKING ACCOUNTS ACCOUNTNO. TITLE OF ACCOUNT DATE OPENED 106000523 Jean H Black 9~28~98 Glenn W Black DATE OF DEATH PRINCIPLE & ACCRUEDINTEREST 23,296.20 .96 SAVlNGSACCOUNT ACCOUNTNO. TITLE OFACCOUNT DATE OPENED DATE OF DEATH PRINCIPLE & ACCRUEDINTEREST (3) CERTIFICATES OF DEPOSIT ACCOUNTNO. TITLE OF ACCOUNT DATE OPENED 5060064733 Glenn W Black 12/21/99 Jean H Black DATE OF DEATH PRINCIPLE & ACCRUED INTEREST 25,000.00 10.92 8/4/04 By Timothea Customer Service Operator P.O. BOX 250 SHIPPENSBURG, PA 17257 TEL. (717) 532-6114 Cjartmore Funds 7/28/2004 AUG - CGA LAW FIRM ATTN: SHARON E MYERS 106 HARRISBURG ST PO BOX 606 EAST BERLIN PA 17316 RE: Non-IRA Fund/Accotmt Number: 20/9030004348 Account Registration: JEAN H BLACK & JEFFREY W CLINE ~ JTWROS Reference Number: E7S016 Dear Sharon Myers: Thank you for contacting Gartmore Funds. We are writing to confirm the following information: Date of Death Value ccount ] FUnd t ccount Iopened ,I I 9/30/1992 020 9030004348 2,460.800 $10.76 $26,478.21 In order to re-register the account to the surviving shareholder, Jeffrey W Cline, we will require the following: [] A Certified copy of the Death Certificate. If you send a certified copy, the stamp or raised seal of certification must be embossed on the copy we receive. A photocopy of the certification stamp cannot be accepted. [] A *Medallion Signature Guarantee letter of instruction signed by the surviving shareholder. [] A completed Application from the surviving shareholder, if transferring. vi A completed W-9 Form for the surviving shareholder, if liquidating. [] An Inheritance Tax Waiver, if applicable. *To obtain a medallion signature guarantee, please sign your letter of instruction in the presence of an authorized officer of an eligible guarantor institution. Notaries Public are not acceptable providers of signature guarantees. PNCBAN< August 16, 2004 Sharon E Myers Attorney at Law 29 N Duke St. York, PA 17401-1282 /scp Estate of Jean H Black (Deceased) SSN: 201-18-1543 DOD: 03-02-2004 Dear Ms. Myers: In response to your request for Date of Death balances for the customer noted above, our records show the following: IRA Account Account #65001015590 Established 08-19-1993 JEAN H BLACK DOD balance $9,729.68 + $0.18 accrued interest For IRA or Beneficiary information, please call 1-888-PNC-IRAS. Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accoums). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, Erica L Schlegel 1-800-762-1775 P7-PFSC-04-F 500 First Ave. Pittsburgh PA 15219 Member FDIC I, Jean H. Gibbs, OF JEAN H. GIBBS of Reading Township, Adams County, Pennsylvania, being of sound and disposing mind~ memory and understanding, do make, publish and declare the following as and for my Last Will and Testament, hereby revoki]]g and making void any and all Wills and Testaments, or writings in the nature thereof by me at any time heretofore made~ I. I direct that all expenses of my last illness, including hospital expenses, expenses for medical care, funeral expenses and the cost of a gravemarker, as well as all debts or obligations owed by me at the time of my death, which in the opinion of my Executors are not subject to either a legal or equitable defense, shall be paid from my residuary estate, unless cthe~wise provided herein, as soon as practicable after my decease, as a part of the e×pense of the administration of my e~tate. ! give and bequeath ali! Jta,~c~ of tang~it, le personal property which I may own at the t. ime of !~y death~ ]nc!uding any automobiles wh_[ch I m~f owu~ %'ogcthe~ ~,'ith aay insurance policies thereon in equal shares to my surviving children, to be divided among them in kind as they may agree. In the event that none of my said children survive me, said tangible personal property shall be divided among their surviving issue equally and distributed to such issue in kind per capita. III. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, of whatever kind or character and wherever situated, which I may own or have the right to dispose of at the time of my death in equal shares to my children, Ronald J. Cline, Kay F. Plank and Jeffrey W. Cline, or to their respective issue, per stirpes. IV. My personal representatives and the Trustees of any trust created hereunder shall have the following powers and authority in addition to, and not in limitation of, any other rights and powers granted by law: no To retain any property transferred, devised or bequeathed to them by me, or any undivided interest therein, regardless of the character of said property, or whether it is such as may be authorized by law as a legal investment by a fiduciary; To sell any estate or trust property, for cash or on credit, at public or private sale; to exchange any of said property for other property; to grant options to purchase or acquire any estate or trust property; and to determine the prices and terms of sales, exchanges and options; To execute leases and sub-leases for terms extending beyond the termination of any Trust established herein; to subdivide or improve real estate and tear down or alter improvements; to grant easements, give consents and make contracts relating to real estate or its use; and to release or dedicate any interest in real estate; -2- Fo Jo To borrow money and to mortgage or pledge any estate or trust property in connection with the administration of the Trusts created hereunder; to execute promissory notes or other obligations for amounts so borrowed; and to secure the payment of any amounts so borrowed by mortgage or pledge of any real or personal property; provided, however, that said authority may be exercised only to the extent that it is necessary or required in connection with the proper administration of my estate or any of the trusts created hereunder, and shall not be used for the purpose of making speculative investments or for the purchase of securities on margin; To take any action realizing upon the property, and with reorganizations or or trust property; or abandon demands property, wherever with respect to conserving or value of any estate or trust respect to foreclosures, other changes affecting the estate to collect, pay, consent, compromise of or against the estate or trust situated; and to execute contracts, notes, conveyances and other instruments, including instruments containing covenants and warranties binding upon and creating a charge against the estate or trust property, and containing provisions excluding personal liability; To keep any property in the name of a nominee, with or without disclosure of any fiduciary relationship; To employ agents, attorneys, auditors, depositaries and proxies, with or without discretionary powers; To give proxies, to deposit securities with and transfer title to committees representing security holders and to participate in voting trust, reorganizations, and other transactions involving the common interest of security holders; To exercise any option to subscribe for or purchase any stocks, bonds, certificates, or other securities which may be given to it as the holder of other stocks, bonds, certificates, or other securities constituting a part of the estate or trust property; To purchase stocks, bonds or other property, real or personal, from the executor or legal representative of my spouse's estate, or any trust established by my spouse, even though such executor or legal representative is also a fiduciary hereunder; In the event that my spouse survives me, to join with my spouse or his personal representative in the filing of any income or gift tax return for any period prior to my death and without requiring indemnification from my spouse or his personal representative for any liability which may arise from joining in such return; ne To elect to take administration expenses on either the estate's federal income tax return or the estate's federal estate tax return in such manner as to provide the greatest overall tax savings. My Executors are authorized but not required to adjust the interest of any beneficiary detrimentally affected by such election in order to compensate said beneficiary for any loss due to the making of such election; To exercise any election provided in the Internal Revenue Code or under Pennsylvania Inheritance or Estate Tax Laws with respect to the valuation of property for purpose of such taxes, and the time and manner of payment of tax, and no adjustment in any beneficiary's interest in my estate shall be made by reason of the making of such election; Ne To deduct, retain, expend and pay out of any money belonging to the estate or any trust established herein any and all necessary and proper expenses in connection with the operation and conduct of the same, and to pay all taxes, ~nsurance premiums on any policy constituting part of the trust property, and any other legal assessments, debts, claims or charges which at any time may be due and owing by, or which may exist against my estate or any trust established herein; Oo To charge commissions or compensation for their services hereunder, which commissions or compensation in the case of a corporate fiduciary may be charged against or payable from both principal and income received on an annual basis at such rates as may be provided in its published fee schedule in effect at the time said services are performed; To make any d~stributions or division of estate or trust property in cash or in kind, or both. I direct that all state and federal estate, succession, legacy, inheritance or other transfer taxes, however designated, -4- together with any interest thereon, that shall become payable by reason of my death with respect to any property which is included in my estate for purposes of computing such taxes and subject to administration by my personal representatives, shall be paid from my residuary estate, as an expense of administration and without apportionment. My Executors shall have no duty or obligation to obtain reimbursement for any such tax paid by them even though on proceeds of insurance or other property not passing under this Will. VI. I appoint my children, Ronald J. Cline, Kay F. Plank and Jeffrey W. Cline, or the survivor of them, Co-Executors of this my Last Will and Testament. All shall serve without bond. Any fiduciary who is an individual shall be entitled to receive reasonable compensation for his or her services hereunder and shall be reimbursed for all e×penses incurred in connection with the administration of my estate or any trusts established herein. Compensation for any corporate fiduciary for its services hereunder shall be in accordance with its published fee schedule in effect at the time said services are performed. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Will this ,/~ day of ~,~.~ ~.~ ~ , 1993. H. Gibbs -5- presence presence hereunto Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the of us, who, at her request, in her presence and in the of each other, all being present at the same time, have subscribed our names as witnesses. CO~ONWEALTM g~' F~mm~xbV/{~lA ( ss. COUNTY OF -Yf~RK ~ ) I, Jean H. Gibbs, the Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed said instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein contained. Jean~. Gibbs, TeStatrix Sworn or subscribed to and ackkn.owledged he, fore me this Not~f~y Public J' J Eas~ Be~n Bo~o, Adwr, s Courtly J J ~n~.~,~ I CO~O_~;EALTH OF PENNS~LV~NI~ ' . ( ss. COUNTY OF ~ ~ ) We, the undersigned witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix, Jean H. Gibbs, sign and execute the instrument as her Last Will; that the said Jean H. Gibbs signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix, Jean H. Gibbs, signed the Will as witnesses; and that to the best of our knowledge, the Testatrix, Jean H. Gibbs, was at the time 18 or more years of age, of sound mi~d and under no constraint or undue influence.~/~q~ ~~/~ Witness Sworn or subscribed to and ackg~wledged before me this /~z~/ ~ay of~~ 1993. · ot~y Public ,J ~ ~miss~ ~r~ J~. ~, 1~4 J Mem~ Pannsy~anJa~n of Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Gibbs, Jean H. aka Black, Jean Marie, also known as , Deceased JeffiW W Cline No. 21-04-00294 Date of De~h 3/2/2004 SocialSecurityNo. 201-18-1543 The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: Sharon E Myers I.D. No.: 32111 Personal Representati/~el fi/// Signature: ~/qJ/.//t~ Signature: Signature: Address: 106 Harrisburg Street Address: P.O. Box 606 East Berlin, PA 17316 Telephone: 717/259-9592 Telephone: Dated: 294 Creek Rd Aspers, PA 17304 Personal Property Legg Mason Act. No. 363-03173 - Mutual Funds Cash Balance ($844.52) 1,100.636 Dryden Muni Ser FD Ser CL B $11,322.70 1,380.692 Delaware Group TF PA FD CL B $11,224.51 1,083.536 Eaton Vance PA Muni FD CL B $11,117.08 Sterling Financial CD #153363 $10,000.00 +DOD mt. $13.29 WaypomtBankCD#1000160434 $10,000.00 +DOD mt. $.55 32,819.17 10,013.29 10,000.55 Waypoint Bank CD #1000160435 $10,000.00 + DOD iht $55 Community Banks #6130025861 $10,000.00 + DOD int. $7.62 10,000.55 10,007.62 Community Banks CD #6130033982 $ 5,000.00 + DOD int. $ 4.87 5,004.87 Community Banks CD g6130033983 $ 5,000.00 + DOD int. $ 4.87 5,004.87 Commumty Banks CD g6130044888 $20,000.00 + DOD int. $ 4.47 20,004.47 (Attach additional sheets if necessary) Total Personal Property and Real Estate $120,406.39 Register of Wills of Cumberland County, Pennsylvania INVENTORY continued Estate of Gibbs, Jean H. aka Black, Jean Made, also known as , Deceased CommUmty Banks CD # 6130046198 $ 5,000.00 + DOD mt. $ .65 Coins in Lock Box - Jim Lenigs Jewelry & Coins - appraisal attached Remdming Coins in Lock Box - face value Personal property - Larry J. Peters appraisal attached Refund - Gevalia Coffee De HaWs Auction - Proceeds sale of Lot 5871 Refund - Combined Insurance Co of America 2002 Oldsmobile VIN IG3WS52H32F230684 No, 21 -04-00294 Date of Death 3/2/2004 SociaI Security No. 201-18-1543 5,000.65 206.00 38.64 1,130.00 10.00 129.68 36.03 11,000.00 Total Personal Property $120,406.39 2 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-060t RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX(11 96) NO. CD 004696 PLANK KAY F 2127 CRANBERRY ROAD YORK SPRINGS, PA 17372 ESTATE INFORMATION: SSN: 201-18 1543 FILE NUMBER: 2104-0294 DECEDENT NAME: GIBBS JEAN H DATE OF PAYMENT: 12/06/2004 POSTMARK DATE: 12/02/2004 COUNTY: CUMBERLAND )ATE OF DEATH: 03/02/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3,337.16 TOTAL AMOUNT PAID: $3,337.16 REMARKS: K PLANK SEAL CHECK# 107 INITIALS: VZ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER ©FWlLLS C 0 NDV-16-2004 11:29 CGA LAW FIRM 717 259 9148 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE; Estate of Jean H. Gibbs aka Jean Marie Black; Deceased, Late of Dickinson Township Cumberland County, P A No. 20-04-00294 SPOUSAL ELECTION AGREEMENT THIS AGREEMENT, made as of this 1 day of (? "-00 :; ::;/J - u : c~~c C) '-',. "',-. "'" ~-') ~ ~': "-"",," ....- Q) 2004, by and among Ronald J. Cline, Kay F, Plank, and Jeffrey W. Cline, as Co- W -if'U-zZ Executors, and Glenn ..'Black, as Elector. ~. 0-. WHEREAS, Jean H. Gibbs aka Jean Marie Black late of Dickinson Township, Cumberland County, Pennsylvania, died March 2, ,2004, testate, leaving a Last Will and Testament dated February 18, 1993, which was duly probated in the Office of the Register of Wills in and for Cumberland County, Pennsylvania, on March 26,2004, and appears of record to File No. 20-04-00294 and WHEREAS, Letters Testamentary were issued thereon on March 26, 2004, to Ronald J. Cline, Kay F, Plank, and Jeffrey W. Cline; and WHEREAS, Glenn W. Black, widower oHean H. Gibbs aka Jean Marie Black, filed an election to take under the Will, dated September 16,2004, and WHEREAS, tbe panies hereto wish to settle the election to take under the Will without the necessity of fUlther proceedings by the Orphans' Court; NOW, THEREFORE, the parties hereto agree as follows: 1. The Estate of Jean H. Gibbs aka Jean Marie Black shall pay to Glenn Black four thousand nine hundred seventy-five ($4,975,00) dollars, said /UIlI:}1'l:;!7Il) .:::r P.02/04 ~1:~J /'q ;'0 ::::;,.J . r:.~} ,'1/ :'_J , -) c:) -;'--1 ~IOl)-16-2004 11: 29 CGR LRW FIRM 717 259 9148 P.03/04 figure being comprised of the three thousand five hundred ($3,500.00) dollar family exemption, one thousand ($1,000.00) dollars for Mr. Black's attorney fees, and four hundred seventy-five ($475.00) dollars for reimbursement for the grave opening fee. 2. The Executors shall hereby acknowledge that all furniture and household goods still at the residence owned by Glenn Black are the property of Glenn Black and they waive any interest in any personal property located in Mr. BI1J. ~dence, W. 3. Glenn~. Black hereby acknowledges that he has received of and from Ronald 1. Cline, Kay F. Plank, and Jeffrey W. Cline, Co-Executors of the Estate Jean H. Gibbs aka Jean Marie Black, deceased, his elective share of the Estate. He hereby remises, releases, quit claims and forever discharges the said Ronald J. Cline, Kay F. Plank, and Jeffrey W. Cline, Co- Executors, their heirs and assigns, of and from the payment of any other or further sum in satisfaction and payment of his elective share or family exemption of the estate or any other share of the estate to which he may be entitled, and of and from all actions, suits, claims, duties, and demands whatsoever arising therefrom. (OOl32nilll ~uv-t6-2004 11:29 CGA LAW FIRM 717 259 9148 IN WITNESS WHEREOF, and intending to be legally bound hereby, each of the undersigned have executed this Agreement as of the date set forth above. Witness: t (OOl:n't!1/1} f~/~~ Ronald J. Cline, eo-Executor K'YF~:E~ ~~~ ~~.' P.04/04 ~ IN THE COURT OF COMMON PLEAS OF CMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: Estate of Jean H. Gibbs aka Jean Marie Black : Deceased, Late of Dickinson Township Cumberland County, P A om4 No. 21-04-~ ".<J j",) -~ FAMILY SETTLEMENT AND INDEMNIFICATION AGREEMENT r-~) c: THIS AGREEMENT, made as of this } ~ D:. day of ~~ 2005, by and among Ronald J. Cline, Kay F. Plank, and Jeffrey W. Cline, Co- Executors, and Ronald J. Cline, Kay F. Plank, and Jeffrey W. Cline, beneficiaries, WHEREAS, Jean H. Gibbs aka Jean Marie Black, late of Dickinson Township, Cumberland County, Pennsylvania, died March 2, 2004, testate, leaving a Last Will and Testament dated February 18, 1993, which was duly probated in the Office of the Register of Wills in and for Cumberland County, Pennsylvania, on March 26, 2004, and appears of record to File No. 21-04-0291 and WHEREAS, Letters Testamentary were issued thereon on March 26, 2004, to Ronald 1. Cline, Kay F. Plank, and Jeffrey W. Cline; and WHEREAS, a Pennsylvania Inheritance Tax Return was filed with the Register of Wills Office, as Agent for the Commonwealth of Pennsylvania, on behalf of the Estate of Jean H. Gibbs aka Jean Marie Black, and the inheritance and estate tax due in said Estate has been paid in fuJl; and WHEREAS, all known outstanding debts and obligations of the Decedent have been paid in full; and (OOI3793011) WHEREAS, the parties hereto, being all of the parties interested in the Estate of Jean H. Gibbs aka Jean Marie Black, desire that distribution of the balance of the assets of the Decedent be made without the necessity of further proceedings by the Orphans' Court or a formal accounting. NOW, THEREFORE, in consideration of the payment and distribution of each of their respective shares of the residue and net balance of the Estate available for distribution, the undersigned beneficiaries under the Last Will and Testament of Jean H. Gibbs aka Jean Marie Black, late of Dickinson Township, Cumberland County, Pennsylvania, deceased, do hereby acknowledge that they have received of and from Ronald J. Cline, Kay F. Plank, and Jeffrey W. Cline, Co- Executors of the Estate of Jean H. Gibbs aka Jean Marie Black, deceased, each of their respective shares of the residue and net balance of the Estate available for distribution. The same being in full satisfaction of each of their respective shares of the Estate as provided in the Last Will and Testament of said Decedent. The undersigned do hereby by these presents, remise, release, quit-claim and forever discharge the said Ronald J. Cline, Kay F. Plank, and Jeffrey W. Cline, Co- Executors, their heirs and assigns, of and from the payment of any other or further sum in satisfaction and payment of each of their respective shares ofthe Estate of the said Decedent, and of and from all actions, suits, claims, duties and demands whatsoever arising therefrom. The undersigned further agree to indemnify the said Ronald J. Cline, Kay F. Plank, and Jeffrey W. Cline, Co- Executors, and to hold them harmless from any claims or demands presented against the Estate of the said Decedent subsequent to the execution of this Release, including, but not limited to, any federal, state or local income {OO13793011} taxes, transfer inheritance, estate or death taxes, together with any interest or penalties thereon and together with any costs, expenses and counsel fees associated therewith, if any. In consideration of the distribution of their respective shares of the residue and net balance of the Estate to them, each of the undersigned agrees that he or she shall be firmly bound unto Ronald 1. Cline, Kay F. Plank, and Jeffrey W. Cline, Co- Executors of the Estate of Jean H. Gibbs aka Jean Marie Black and/or to CGA Law Firm (Countess Gilbert Andrews), Attorneys for the Estate of Jean H. Gibbs aka Jean Marie Black, in his or her equal proportionate share of the amount of any claims or demands presented against the Estate as set forth above, up to but not exceeding the amount of his or her distributive share of said Estate, which agreement shall be deemed to be in the nature of a refunding agreement or bond. (OOI37930/1} IN WITNESS WHEREOF, and intending to be legally bound hereby, each of the undersigned have executed this Release as of the date set forth above. Witness: LeL-P Ronald J. Cline, /~ / L-d t~cP~ ~ ~ JxL{j L, / dij- CA ,~ :f,)<J (00137930/1) ,t...-' STATUS REPORT UNDER RULE 6.12 Name of Decedent: \J~)--\. G\'b 60S CA k T-eW\ !t\.W1-c... J?J lc.-...-C/L Date of Death: ~ ) )- \ Cl '4 Will No. Admin. No. ;).1- O~ - OD)-1~ 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 w~ther administration of the estate is complete: Yes No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. C,,! ~;y (~O> ~ Na~e~~ t;e o~~t~ 'D \0 \'-0n:?1, ~ )1- Address ~;-.f:J er I 'n. PA 1") ~ J b ( 7 n) ~ ~0 - Cf S- '1 L- Tel. No. Date: l- f-,tHsloS- C'd {-'...,!, r.".-" '/ Personal Representative Counsel for personal c.JJf representative Capacity: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INQ~IQUALTAX~S INHERITANCE TAKOtVlS-lOM PO BOX 280601 HARRISBURG PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX . ?? DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN (',' ,.., SHAR1)N E MYERS CGA LAW FIRM PO BOX 606 EAST BERLIN 02-14-2005 GIBBS 03-02-2004 21 04-0294 CUMBERLAND 101 AInOUni. Remitted *' REY_l!i47EX4FPI12_Uti) JEAN H PA 17316 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ftlv:r~4"-iic--AFP--Cft1":6'J'--NiiT-iel-iiF-i:'NHiitifl\ilcE-i"AiI-A-pjlRAYsiH''€Nt~--ALtiiQl\NcE-01r------------- - --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GIBBS JEAN H FILE NO. 21 04-0294 ACN 101 DATE 02-14-2005 TAX RETURN WAS: I X I ACCEPTED AS FILED I CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule AJ 2. Stocks and Bonds (Schedule 8) 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Hotes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets III 121 131 I~I 151 161 171 .00 32,819.17 .00 .00 87.587.22 37. 393 .15 9.729.86 IBI APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses {Schedule HJ 10. Debts/Mortgage Liabilities/Liens (Schedule 1) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Govern.ental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 191 [101 21,520.46 912.23 1111 1121 1131 1l~1 NOTE: To insure proper credit to your account~ sub.it the upper portion of this form with your tax payment. 167,529.40 77.437 69 145,096.71 .00 145,096.71 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 Abh returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. A.ount of Line 14 taxable at Lineal/Class A rat. (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due 24,154.04 X 00 = .00 120,942.67 X 045 = 5,442.42 .00 X 12 = .00 .00 X 15 = .00 1191= 5,442.42 TAY CRE:DITS: 1+) AHOUHT PAID QATE NUHBER INTEREST/PEN PAID I-I 06-03-2004 CD004002 .00 2,000.00 12-02-2004 CD004696 .00 3,337.16 INTEREST IS CHARGED THROUGH 03-01-2005 TOTAL TAX CREDIT 5,337.16 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 105.26 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 1.20 TOTAL DUE 106.46 ~ . IF PAID AFTER DATE INDICATED, SEE REVERSE FDR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I