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Home My WebLink About04-0299 Estate of Arlene S Cook No. also known as To: PETITION FOR PROBATE and GRANT OF LETTERS 21-04- ., Deceased. Social Security No. 181-22-4886 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execuPr in the last wilt of the above decedent, dated November 30 and codicil(s) dated Register of Wills for the County of C' b · -and in the Commonwea~ befrl~nnsylvania , 19± (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland Cou ty P s van{ w' , her last family or principal residence at 4 Kitszell Drive, ~3ou~ Ml~on ~oWw~hzp (list street, number and muncipality) 78 February 29, 2004 Decendent, then years of age, died at ' -~-- ~- ~ , ~. na' -'e ' ca CeuLe£ , ~ ~ -' -% - not ~vorcecl and did not have a child born or adopted marry, was . after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent 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 ~:eeq~ntthaerFrobate of the last will and codicil(s) presented herewith and the grant of letters t lherou. {testamentary; administration c.t.a.; administration d.b.n.c.t.a.) Robert J. Cook; .T?. O. H OF PERSONAL REPRESENTATIVE ~ · COMMON~-~'EALTtl OF PENNSYLVANIA The petitioner(si above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(si of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn lo c,,' affirmed and subscribed Robert J. Cook, Jr. No. 21-o4- 9-99 Estate of Arlene S. Cook , Deceased DECREE OF PROBATE AND GRANT OF LETTERS March AND NOW the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated November 30, 1999 described therein be admitted to probate and filed of record as the last will of Arlene S. Cook, deceased and Letters testamentary are hereby granted to Robert J. Cook, Jr. 200/.. , in consideration of the petition on FEES Probate, Letters, Etc .......... Short Certificates( ) .......... $ i'lL, r CID TOTAL __ $ Filed .~..-...2..LO.. 7..2-...cAe?. ~. .............. William ^ .......~ ATTORNEY (Sup. Ct. I.D. No.) 11rvine Row ADDRESS 717-249-7780 PHONE I05 805 REV 9186 Thts Is to certify that the ]nformaUon here g~ven ,s correctly copted from an original certfficate of death duly filed with me as Local Registrar The original certificate will be forwarded to the State Vital Records Office for permanent flhng WARNING: It is illegal to duphcate this copy by photostat or photograph. Fee tor th~s certificate, $2 00 P 10159408 No Local Registrar MAR i 200 Date COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH 4 Kltzell Drxve Carlzsle, PA 17013 Earl Shrawder ,, Jennie Felster ~arch 3, 2004 ,,,Memorial Gardens ,,i Garllsle, PA 17013 LAST WILL AND TESTAMENT o-: , ' OF .~_.~ . RLENE S. COOK 'U]l ou 2qq ~I, A~ENE S. COOK, of C~hsle, Cmberl~d Co~ty, Pe~sylv~a, hereby revoke amy p r ~1}~ ~d decl~e tbs to be my will. SAIDIS, SHUFF & MASLAND Camp Hill, PA I. Personal and Household Effects: I give all my articles of personal or household use, Including automobdes, together with all insurance relating thereto, to my husband, ROBERT J. COOK, SR. If he does not survive me, I give all such property to those persons named on a written hst made by me during my hfetlme, or m absence of a written list or designation on said list, ! give all such property to my son, ROBERT J. COOK, JR. My Executor may make whatever arrangements my Executor deems appropriate for storing and dehvenng articles of personal or household use to the beneficiaries, and may pay the cost thereof and any related expenses including insurance from my residuary estate II. Residue Upon my death, I direct that all the rest, residue and remainder of my estate of whatever nature and wherever situate be dlmded into two (2) parts, each of winch shall be held ~n trust and constitute a separate Trust Fund, to be known as "Trust A" and "Trust B" SAIDIS, SHHFF & MASLAND 2109 Market Street A. Trust "A": My Executor shall pay to the Trustee, hereinafter named, to be placed ~n "Trust A" that fractional amount of the total pnnclpal of which the numerator shall be a sum equal to the largest amount that can pass free of Federal estate tax by reason of the unified credit and the state death tax credit (provided that the use of this credit does not require an increase ~n state death taxes) allowable to my estate but no other credit and after taking account of property passing outside of my estate which does not qualify for the marital or charitable deduction and after taking account of charges to principal that are not allowed as deductions in computing the Federal estate tax, and of which the denominator shall be the value of the total principal For the purposes of establishing such fraction, the value finally fixed in the Federal estate tax proceedings relating to my estate shall be used I recogmze that the numerator of such fraction may be zero (0), in which case no property shall pass under "Trust A" and that said numerator may be affected by the action of the Executor of my estate in exercising elect~ons for tax purposes B. "Trust B" The balance of the pnnclpal not placed ~n "Trust A" shall be placed in "Trust B" IlL Provisions of "Trust A": The following provisions shall apply to "Trust A Trustee shall pay the net income arising from the prlnclpal of tlus Trust in quarterly installments to my husband, ROBERT J. COOK, SR., dunng his lifetime B. Dunng my husband's hfetlme, Trustee shall pay to or for h~s benefit, so much of the pnnclpal of this Trust as may be necessary, in the discretion of the SAIDIS, SHUFF & MASLAND 2109 Market Street Camp Hill, PA Trustee, for the proper support, maintenance and medical care of my husband In addition, ~n each calendar year following the year of my death, the Trustee shall pay to my husband such portions of the principal as he may request ~n writing not to exceed ~n any one calendar year, on a non-cmnulatlve basis, the greater of Five Thousand Dollars ($5,000 00) or up to five percent (5%) of the aggregate value of the principal as of the first request for withdrawal in such year C. Upon my husband's death, Trustee shall convey and pay over all of the remaining assets to my son, ROBERT J. COOK, JR. Should my son not be living, the remaining assets shall be paid to my daughter-in-law, KAREN ENGLANDER COOK IV. Provisions of "Trust B": The following provisions shall apply to "Trust A. Trustee shall have, hold, manage invest and reinvest the assets of this Trust, collect the income and beginning at my death pay over the net income in quarterly installments to my husband, ROBERT J. COOK, SR., dunng his hfet~me Trustee shall also, from time to time, pay to my husband such amounts of pnnclpal of this Trust, as Trustee deems necessary for the proper support, maintenance and medical care of my husband In addition, in each calendar year following the year of my death, the Trustee shall pay to my husband such porhons of the pnncipal as he may request in writing not to exceed in any one calendar year, on a non-cmnulatlve bas~s, the greater of F~ve Thousand Dollars ($5,000 00) or up to five percent (5%) of the aggregate value of the pnnclpal as of the first request for withdrawal in such year B. Upon the death of my husband, Trustee shall pay all accrued income and all income accumulated but undistributed to the estate of my deceased husband and 3 SAIDIS, SHUFF & MASLAND C~mp Hill, PA shall thereafter transfer the then remmmng pnnc~pal of tlus Trust to "Trust A" to be held, adm~mstered and distributed tn accordance with the provisions of ITEM III of this Last Wall and Testament. C. If my husband should not survive me, then the provisions of"Tmst B" shall be void and the assets which would have constituted "Trust B' shall be added to "Trust A" to be d~sposed of ~n accordance w~th ITEM III of th~s Last Wall and Testament D. Trustee shall be authorized ~n Tmstee's sole, exclusive and unrestricted d~screUon to determine whether to elect (under Section 2056(b)(7) of the Internal Revenue Code of 1986 as amended, or any corresponding prowslons of the Federal estate law), to qualify all, none or a fractmn of "Trust B" for the Federal estate tax martial deduction The declsmn of Trustee with respect to the exercise of the elecUon shall be final and conclusive upon all persons whose interests in my estate are d~rectly or indirectly affected by the electron Only property which ~s fully ehg~ble for the marital deducUon under Federal estate tax law shall be assigned to th~s Trust Notwithstanding anything to the contrary contmned in tlus Last Will and Testament, Trustee of this Trust shall not retain beyond a reasonable Ume any property which may at any Ume be or become unproductive, nor shall they invest in unproductive property Notwithstanding the prows~ons of Subparagraph B. of thxs paragraph, Trustee shall pay to the Executor of my husband's estate, out of the pnnmpal of this Trust upon the death of my husband, an amount equal to the estate, inheritance, transfer, succession and other death taxes ("death taxes"), Federal, state and other, payable by reason of the Inclusion of the value of Trust property in my husband's estate Such payment shall be equal to the amount by whmh (1) the total of such SAIDIS, SHUFF & MASLAND 21~9 Market Street Camp Hill, PA death taxes by my husband's estate exceeds (2) the total of such death taxes which would have been payable if the value of the Trust property had not been included in my husband's estate The determination by the Executor of my husband's estate of the amount payable hereunder shall be final I further direct the Trustee to pay such amount promptly upon written request of the Executor of my husband's estate The final determination of the amount due hereunder shall be based upon the value as finally determined for Federal estate tax purposes in my husband's estate. After payment of the amount finally determined to be due hereunder, Trustee shall be discharged from any further liability with respect to such payment My husband may wmve his estate's right to payment under this subparagraph by Will, executed after my death, in which he specifically refers to the right to payment hereunder given to his estate V. Disclaimer: My husband (or his personal representative, guardian or agent acting under a power of attorney) may disclaim any part or all of the gifts to him hereunder, including the provisions for him in the trusts set forth in ITEMS III and IV In such event, the disclaimed amounts which would be payable to him or to the trusts created herein shall be dis- trlbuted to my son, ROBERT J. COOK, JR. VI. Survivorship: Any person, other than my husband, who shall have died at the same time as myself, or under such circumstances that the order of deaths cannot be established by proof, or within thirty (30) days of my death, shall be deemed to have predeceased him If my husband dies at the stone time as myself, or under such circumstances that the order of deaths cannot be established by proof, my husband shall be deemed to have SAIDIS, SHUFF & MASLAND Camp Hill, PA survived me Any person (other than myself) who shall have died at the same time as any then recipient of income under such circumstances that the order of deaths cannot be established by proof, shall be deemed to have predeceased such beneficiary VII. Power of Appointment: No provtslon of this will shall exercise any power of appointment I may have VIII. Protective Provisions: No part of the income of the property held under the Trusts shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt thereof Trustee shall pay over the net income and the principal to the parties herein designated, as their interest may appear, without regard to any attempted anticipation, pledging or assignment by any beneficiary under a Trust and without regard to any claim thereto or attempted levy, attachment, seizure or other process against stud beneficiary IX. Powers of Personal Representative and Trustee: My personal representative and Trustee shall posses, among others, the followang powers exercisable without court approval A. To vary or to retmn investments, including the stock of any corporate Trustee named herein, when deemed desirable by them, and to invest in such bonds, stocks, notes, real estate mortgages or securities or in such other property, real or personal as they 6 SAIDIS, SHUFF & MASLAND 2109 Market Street Camp Hill, PA shall deem w~se B. In order to effect a d~ws~on of the pnnc~pal of a Trust or for any other purpose, including any final d~stnbut~on of a Trust, they are authorized to make smd d~ws~ons or &str~but~ons of the personalty and realty, partly or wholly ~n k~nd, and to allocate specffic assets among beneficiaries and Trusts created hereunder so long as the total market value of any share ~s not affected by such allocations Should ~t appear desirable to partition any real estate, they are authorized to make, jmn ~n and consurmnate partitions of lands, voluntarily or involuntarily, ~nclud~ng g~wng of mutual deeds, recognizances, or other obhgat~ons w~th as w~de powers as can be exercised by an tnd~wdual owner ~n fee s~mple C. To sell e~ther at pubhc or private sale and upon such terms and conditions as they may deem advantageous to a Trust, any or all real or personal estate or ~nterest there~n owned by a Trust severally or ~n conjunction w~th other persons, and to consummate sm sale or sales by sufficmnt deeds or other ~nstruments to the purchasers or purchasers, conveying fee s~mple t~tle, free and clear of all trust and w~thout obhgat~on or liabthty of the purchaser or purchasers to see to the apphcat~on of the purchase money, or to make ~nqmry ~nto the vahd~ty of smd sale or sales, also, to make, execute, acknowledge and dehver any and all deeds assignments, options or other writings wtuch may be necessary or desirable ~n carrying out any o the powers conferred upon them ~n th~s paragraph or elsewhere ~n the ~nstrument D. To mortgage real estate, and to make leases of real estate extending beyond the term of the Trusts hereunder E. To borrow money from any party, xnclud~ng my persona representative and trustee, to pay ~ndebtedness of a Trust and taxes, and to assign and pledge 7 SAIDIS, SHUFF & MASLAND assets of a Trust therefor from "Trust B" F. Provided, however, that this paragraph shall not authorize borrowin To pay all costs, taxes, expenses and charges in connectton ,ant the adm~mstratton of a Trust, including a reasonable compensatton to agents If any estate or tnherltance taxes are payable from assets received by Trustee, such taxes shall be paid from the assets of"Trust A" G. In the dlscreUon of my personal representative or trustee, to unite with other owners of stmtlar property tn carrytng out any plans for the reorgantzatton of any corporation or company whose secunUes form a part of a Trust H. To vote any shares of stock whtch form a part of a Trust. I. To asstgn to and hold in trust an undivided portton of any asset J. To dtvtde any Trust created in this Agreement into two or more separate Trusts (1) to segregate property not subject to Pennsylvania inheritance tax, or (2) so that the inclusion ratio for purposes of the generation-skipping transfer tax shall be etther zero or one, in order that an elecUon under 2652(SecUon a)(3) of the Internal Revenue Code may be made wtth respect to one of the separate Trusts, or (3) for any other reason K. To do all other acts tn ~ts judgment deemed necessary or desirable for the proper and advantageous management, investment and distribution of the Trusts L. Any corporate fiduciary acttng as a personal representative or trustee hereunder shall be entitled to compensaUon based on its regular schedule of fees for such services in effect at the time of the service rendered M. Should the prtnmpal of any Trust herein provtded for become toe SAIDIS, SHUFF & MASLAND 2109 Market Streel Camp Hill, PA small, in ihelr discretion, so as to make continuance of the Trust inadvisable, they may make immediate distribution of the then remalmng principal and any accumulated or undistributed ~ncome outright to the person or persons and in the proportions they are then entitled to income Upon such terminat~on the rights of all persons who might otherwise have any interest as succeeding income benefictary or in remmnder shall cease If any person to receive dlstrtbutlon is a minor or disabled in any way, they may pay the fund to the parent, guardian, or person or organization taking care of that person, or, with respect to a minor, Trustee may deposit the fund in a savings fund account in the minor's name payable to the minor at majority These authorities shall extend to all property at any time held by my Executor or my Trustee and shall continue in full force until the actual distribution of all such property, except as otherwise specifically stated All powers, authorities, and discretion granted by this w~ll shall be in addition to those granted by law and shall be exercisable without court authoriza- tion X. Disability: Whenever and as often as any beneficiary hereunder, to whom payments of income or principal are here~n directed to be made, shall be under legal disability, or m the sole judgment of Trustee, shall otherwise be unable to apply such payments to his own or her own best interests and advantages, Trustee may make all or any portion of such payments in any one or more of the following ways A. Directly to such beneficiary, B. To the Legal Guardian or Conservator of such beneficiary, SAIDIS, SHUFF & MASLAND 2109 Market Street Camp Hill, PA C. To a relative of such beneficiary, to be expended by such relative for the benefit or such beneficiary, or D. By itself expending same for the benefit of smd beneficiary These prows~ons shall not apply to "Trust B" XI. Personal Representatives and Trustees: I appoint my son, ROBERT J. COOK, JR., Executor of this, my Last Will and Testament Should my said son fall to qualify or cease to act as such, then I appoint my daughterqn-law, KAREN ENGLANDER COOK, to act in this capacity I appoint my son, ROBERT J. COOK, JR. as Trustee of any trusts created hereto Should my smd son fall to qualify or cease to act as such, I appoint my daughter-in-law, KAREN ENGLANDER COOK, to act m this capamty None of my personal representatives shall be reqmred to post bond in th~s or any junsdmtlon IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, the ~ ~3 day of /k,~,o~/B c~t% , 1999 ARLENE S. COOK .(SEAL) l0 SAIDIS, SHUFF & MASLAND 2109 Market $ffeet Camp Hill, PA In our presence the above-named testatrix signed th~s and declared it to be her will, and now at her request, ~n her presence, and ~n the presence of each other, we s~gn as w~tnesses Name ~ddress Address COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND) SS WE, the undersigned, the testatrix and the w~tnesses, respectively, whose names are si the foregoing ~nstmment, being first duly sworn, do hereby declare to the underslgned authority testatrix s~gned and executed the ~nstrument as her Last Will and Testament and that she s~gned (or wflhngly d~rected another to s~gn for her), and that she executed ~t as her free will and for the purposes there~n expressed, and that each of the w~tnesses, ~n the presence and heannl testamx s~gned the wall as w~messes and that to the best of their knowledge the testatrix was at t] e~ghteen years of age or older, of sound m~nd, and under no constrmnt or undue ~nfluence Testatrix SAIDIS, SHUFF & MASLAND Camp Hill, PA Subscribed, sworn to and acknowledged before me by the testatrix, and subscribed ant to before me by both w~messes, th~s ~ day of '~Oyeqo~ae'"t~ ,1999 21_2 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEF~. 28O601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003944 DUNCAN WILLIAM A 1 IRVINE ROW CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 181-22-4886 FILE NUMBER: 2104-0299 DECEDENT NAME: COOK ARLENE S DATE OF PAYMENT: 05/18/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 02/29/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $15,000.00 TOTAL AMOUNT PAID: 5,000.00 REMARKS: ROBERT J COOK JR C/O WILLIAM DUNCAN ESQUIRE SEAL CHECK# 108 INITIALS: SK RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 07/01/2004 DUNCAN WILLIAM A 1 IRVINE ROW CARLISLE, PA 17013 RE: Estate of COOK ARLENE S File Number: 2004-00299 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) 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 ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 07/06/2004 Your prompt attention to this matter will be appreciated. Thank You. cc: File Personal Representative(s) Judge Sincerely, Clerk of the Orphans' Court Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 07/01/2004 COOK ROBERT J, JR. 889 ALEXANDER SPRING ROAD CARLISLE, PA 17013 RE: Estate of COOK ARLENE S File Number: 2004-00299 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) 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 ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 07/06/2004 Your prompt attention to this matter will be appreciated. Thank You. CC: File Counsel Judge Sincerely, GLENDA FARNER STRASB'AUGF~ Clerk of the Orphans' Court Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Arlene $. Cook Date of Death: February 29, 2004 Will No. 21-04-0299 Admin. No. To the Register: I certify that notice of (beneficial interest) 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 March 26, 2004 : Name Address Robert J. Cook,' Sr. Four Kitszell Drive, Carlisle, PA 17013 Robert J. Cook, Jr. 889 Alexander Spring Road, Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE Date: July 8, 2004 Name Wi l~fi a~/A. ~~/~°s q~ 1~ e~ ~-- ~~ Address One Irvine Row Carlisle, PA 17013 Telephone(71~ 249-7780 Capacity:~PersonalRepresentative XX.Counsel ~rpersonalrepresentative 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 004451 COOK ROBERT J, JR. 889 ALEXANDER SPRING ROAD CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 181-22-4886 FILE NUMBER: 2104-0299 DECEDENT NAME: COOK ARLENE S DATE OF PAYMENT: 1 0/01/2004 POSTMARK DATE: 10/01/2004 COUNTY: CUMBERLAND DATE OF DEATH: 02/29/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $5,626.17 REMARKS: COOK ESTATE CHECK//112 SEAL TOTAL AMOUNT PAID' $5,626.17 INITIALS: CCP RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS EV-15~Q,F-~( + (8-00) , COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 Z I-- Z Z o UJ O DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAl Cook, Arlene S. DATE OF DEATH (MM-DD-Yea-) 02/29/2004 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT IDATE OF BIRTH (MM-DD-Year) 08/27/1925 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Cook, Robert J. OFFICIAL USE ONLY FILE NUMBER 2 1 -0 4 0 2 9 9 COUNTY CODE YEAR NUMBER-- SOCIAL SECURITY NUMBER I 8 1-2 ~.-4 8 8 6 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 1 7 2-2 4-7 5 3 9 ~] 1. Original Return O4. Limited Estate [~]6. Decedent Died Testate (At.ch copyofWal [--] 9. Litigation Proceeds Received r"-] 2, Supplemental Return ~] 4a. Future Interest Compromise (dee o1~ a~r 12-12-82) D7. Decedent Maintained a Living Trust (At~ach cWy of Trust) J'--] 10. Spousal Poverty Credit (dee ofdeah be~een 12-31-91 and 1-1-95) r'-j 3. Remainder Return (dee of deat~ pdo~to 12-13-82) 5. Federal Estate Tax Return Required 0__ 8. Total Number of Safe Deposit Boxes J--] 11. Election to tax under Sec. 9113(A) (Atach Sc~ O) THIS SECTION MUST BE COMPL,- it:U. ALL CO~o~aPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS William A. Duncan, Esquire FIRM NAME (~fApp~k-,a~e) Duncan, Hartman & Douglas, P.C. TELEPHONE NUMBER (717) 249-7780 Duncan, Hartman & Douglas, P.C. One Irvine Row Carlisle PA 17013 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietership (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6, Joinity Owned Property (Schedule F) (6) O Separate Billing Requested 7. Intar-Vivos Transfers & Miscellaneous Non-Probate Properly (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) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to lax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 177,000.00 197~386.66 276~913.05 0.00 53~787.69 OFFICIAI~ ~ ONLY (8) 705,087.40 37~417.58 (11) 37,417.58 (12) (13) 667,669.82 (14) 667~669.82 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) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 191,767.26 x 0.00 (15) 475~902.56 x .045 (16) X .12 (17) x .15 (18) (19~ 21,415.62 21,415.62 Dec~dent'~ Complete Address: STREET ADDRESS Four Kitszell Drive CITY Carlisle Tax Payments and Credits: 1. Tax Due (Page l Line19) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount InterestJPenalty if applicable D. Interest E. Penalty ISTATE PA zip 17013 (1) 15,000.00 7~9.45 21,415.62 Total Credits ( A + B + C ) (2) 15,789.45 Total Interest/Penalty ( D + E ) (3) If Une 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 If Line 1 + Line 3 is greater than Une 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Une 5 + SA. This is the BALANCE DUE. (4) (5) (5A) (5B) Ma/(e Chec/( Payab/e to: REGISTER OF WILLS, AGENT 0.00 5,626.17 5,626.17 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ........................................................................... [] [] b. retain the dght to designate who shall use the property transferred or its income; ........................................ [] [] c. retain a reversionary interest; or ...................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ............................................................. [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?. .............................................................................................. [] [] 3. Did decedent own an "in trust for' or payable upon death bank account or secudty at his or her death? ................. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. [~;~Pen. on oa~f ~.~l:~'.u~.~l. ~d~cl~are~ ~.at_/h~ _ay~ e_x_a~n_ ! _n~l_. ~is ~m, i~i~ ~,~,y[~.~u~ ~ s~, ~ ~ ~ ~t of ~ ~ ~ ~, it is ~, ~ and mm~. ~, ~,~,~. ~.~..,=..~ ~.~ r~n~ve Is ~ ~ ar inm~n ~n ~ ~ ~y k~. ADDRESS Robert J. Coc~, Jr.', Execu~r~;- DATE 889 Alexander Spring Ro~ad, Carlisle SIGNATURE OF PRE~RER~R~ ADDRESS ' VV~ ' '- '"' ' lam A. Duncan, Esquire One Irvine Row, 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. §9116 (a) (1.1) (i)]. For dates of death on or affer 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 not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are slill applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rote 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. §9116(a)(1.2)]. REV-1502EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEID~NT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Cook. Arlene S. 21 04 0299 All real property o~med solely or as a tenant in common must be reported st fair mmkst 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 wilh right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION Residence located at Four Kitszell Drive, South Middleton Township, Carlisle, Cumberland County, Pennsylvania `170'13. See attached appraisal TOTAL (Also enter on line 1. RecaDitulationl VALUE AT DATE OF DEATH 177,000.00 REV-15~3 ~X* (1~97) ~ COMIdONWEALTH OF PENNSYLVANIA INHEPJTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS&BONDS ESTATE OF Cook. Arlene S. All property jointly-owned with rigM of suwivorship must be disclosed on Scbedule F. FILE NUMBER 0299 ITEM NUMBER 1. ' VALUE AT DATE DESCRIPTION OF DEATH 2121.611 shares of American Funds, Capital World Growth and Income Fund A. 66,363.99 See attached valuation. 2054.719 shares of American Funds, Washington Mutual A. See attached valuation. 3987.222 shares of American Funds, The Income Fund of Amedca A. See attached valuation. TOTAL (Also enter on line 2, Recapitulation) 61,086.80 69,935.87 197,386.66 REV-1508 EX.~ (t-97} ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Cook. Arlene ~, 21 04 029!~ Include the proceeds of litigation and the date the proceeds were received by the estate. All property joinlly-owned MIh lhe right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 10. 11. 12. 13. DESCRIPTION Waypoint Bank, CD #7100014465. See attached letter. Principal: $50,000.00 Interest: $187.56 E'Trade Financial, CD #2002621767. See attached letter. Principal: $100,000.00 Capital Blue Cross, 3/18/04 refund Citizens Bank, 4/17/04 interest earned. M&T Bank, CD #031003910982733. See attached letter. Principal: $100,000.00 Interest: $111.01 Waypoint Bank 3/31/03 account no 7100014465 interest. E'Trade Bank, 3/31/04 interest eamed on account no. 2002621767 Citizens Bank IRA account # 6140696402. See attached letter. Principal: $3,263.50 Interest: $3.48 Citizens Bank IRA account # 6140703464. See attached letter. Principal: $2,943.73 Interest: $7.06 Citizens Bank IRA account # 6140886409. See attached letter. Principal: $10,749.94 Interest: $30.14 Citizens Bank IRA account # 6140888654. See attached letter. Principal: $384.96 Interest: $1.66 M&T Bank, checking account # 9834621238. See attached letter. Principal: $8,115.64 Interest: $1.42 Citizens Bank, account # 6140888697. See attached letter. Principal: $ 0.00 Interest: $18.26 TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE OF DEATH 50,187.56 100,000.00 193.29 270.00 100,111.01 207.09 431.17 3,266.98 2,943.73 10,780.08 386.62 8,117.26 18.26 276,913.05 I~'V'1510 EX + (1'g7) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TR/~SFEREE, THEIR R~I. ATIONSHIP TO ~CEI~NT AND T~E DATE OF TRANSFER.DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATrACHACOPYOFTHE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST 1. Aurora National Life Assurance Company 53,787.69 100. 53,787.6c. Beneficiary - Robert J. Cook, Sr., spouse TOTAL (Also enter on line 7. Recaoitulation~ ESTATE OF FILE NUMBER Cook. Arl~n~ $. 21 04 02~)~) This schedule must be completed and filed if the answer to any of queslJons 1 through 4 on the reverse side of the REV-1500 COVER SHEET is ~es. REV-1511EX* (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Cook. Arlene S. Debts of decedent must be reported on Schedule I. FILE NUMBER 21 04 02~ ITEM NUMBER DESCRIPTION 2. 3. 8. 9. 10. 11. FUNERAL EXPENSES: Hoffman-Roth Funeral Home Robert J. Cook, Jr., reimbursement of Sunnyside luncheon Grave opening ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address c~ State Year(s) Commission Paid: AttomeyFees Duncan, Hartman & Douglas, P.C. Family Exemption: (If decedent's address is not the same as daimant's, attach explanation) Claimant Robert J. Cook, Sr. Street Address Four Kitszell Drive Zip City Carlisle Relationship of Claimant to Decedent Spouse state PA Zip 17013 Probate Fees costs-to-date $314.00 In Reserve: $500 Accountant's Fees Tax Retum PrepareCs Fees Sarah Todd Home Central PA Hematology The Sentinel, advertise Letters Testamentary Cumberland Law Journal, advertise Letters Testamentary Diversified Appraisal Services, residence appraisal fee TOTAL (Also enter on line 9, Recapitulation) AMOUNT 8,049.92 625.05 995.00 22,655.00 3,500.00 814.00 226.50 100.00 102.11 75.00 275.00 37~417.58 REV-1513 EX + (.~.nm COIVlMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Cook. Ar ~ne ~. NUMBER I. 1. U. 1. 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include oulzight spousal distdbulions, and lmnsfers under Robert J. Cook, Sr. Four Kitszell Drive Carlisle, PA 17013 Sec. 9116 (a) (1.2)] FILE NUMBER 21 O4 RELATIONSHIP TO DECEDENT Do Not List TmOn(s) Spouse 0299 AMOUNT OR SHARE OF ESTATE TOTAL OF PART I| - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If mnm ~n~.r~ i~ n~'l~l in~p. rf ~lditinnnl ~h~t~ nf the ~nmR B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET REV-1514 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN (Check Box 4 on Rev-1500 Cover Sheet) ESTATE OF FILE NUMBER Cook. Arlene ~;, 21 04 0299 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. [] Will [-'l Intervivos Deed of Trust [--I Other LIFE ESTATE INTEREST CALCULATION NAME(S) OF NEAREST AGE AT TERM OF YEARS LIFE ESTATE IS LIFE TENANT(S) DATE OF BIRTH DATE OF DEATH PAYABLE Robert J. Cook, Sr. 10/15/1924 79 [] Life or [--ITerm of Years ~ [] Life or [] Term of Years [] Life or [] Term of Years ~ [] Life or [] Term of Years ~ 1. Value of fund from which life estate is payable $ 667,666.82 2. Actuarial factor per appropriate table .28722 Interest table rate- r'"l 31/2% [-'-] 6% [--! 10% [~] Vadable Rate % 3. Value of life estate (Line 1 multiplied by Line 2) $ 191,767.26 ANNUITY INI'EREST CALCULATION NAME(S) OF NEAREST AGE AT TERM OF YEARS ANNUITANT(S) DATE OF BIRTH DATE OF DEATH ANNUITY IS PAYABLE [] Life or [] Term of Years ~ [] Life or [] Term of Years [] Life or [] Term of Years [] Life or [] Term of Years 1. Value of fund from which annuity is payable $ 2. Check appropriate block below and enter corresponding (number) Frequency of payout- [-"] Weekly (52) r"-I Bi-weekly (26) r-1 Monthly (12) r-1 Quarterly (4) [] Semi-annually (2) r-] Annually (1) r'-I Other ( ). 3. Amount of payout per period $ 4. Aggregate annual payment, Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate E]31/2% E]6% [-]10% ~]VadableRate % 6. Adjustment Factor (see instructions) 7. Value of annuity - If using 31/2%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 $ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3 NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax retum. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15, 16 and 17. (If more space is needed, insert additional sheets of the same size) SAIDIS, SHUFF & MASLAND ATI'ORNI~YS.AT.LAW 2109 Market Street Camp Hill, PA LAST WILL AND TESTAMENT OF ARLENE S. COOK I, ARLENE S. COOK, of Carlisle, Cumberland County, Pennsylvania, hereby revoke my prior wills and declare this to be my will: household husband, I. Personal and Household Effects: I give all my articles of personal or use, including automobiles, together with all insurance relating thereto, to my ROBERT J. COOK, SR. If he does not survive me, I give all such property to those persons named on a written list made by me during my lifetime, or in absence of a written list or designation on said list, I give all such property to my son, ROBERT J. COOK, JR. My Executor may make whatever arrangements my Executor deems appropriate for storing and delivering articles of personal or household use to the beneficiaries, and may pay the cost thereof and any related expenses including insurance from my residuary estate. II. Residue: Upon my death, I direct that all the rest, residue and remainder of my estate of whatever nature and wherever situate be divided into two (2) parts, each of which i shall be held in trust and constitute a separate Trust Fund, to be known as "Trust A" and "Trust B". ! SAIDIS, SHUFF & MASLAND ATrORNEYS,AT,LAW 2109 Market Street Camp Hill, PA A. Trust "A": My Executor shall pay to the Trustee, hereinafter named, to be placed in "Trust A" that fractional amount of the total principal of which the numerator shall be a sum equal to the largest amount that can pass free of Federal estate tax by reason of the unified credit and the state death tax credit (provided that the use of this credit does not require an increase in state death taxes) allowable to my estate but no other credit and after taking account of property passing outside of my estate which does not qualify for the marital or charitable deduction and after taking account of charges to principal that are not allowed as deductions in computing the Federal estate tax, and of which the denominator shall be the value of the total principal. For the purposes of establishing such fraction, the value finally fixed in the Federal estate tax proceedings relating to my estate shall be used. I recognize that the numerator of such fraction may be zero (0), in which case no property shall pass under "Trust A" and that said numerator may be affected by the action of the Executor of my estate in exercising elections for tax purposes. B. "Trust B": The balance of the principal not placed in "Trust A" shall be placed in "Trust B". III. Provisions of "Trust A": The following provisions shall apply to "Trust A. Trustee shall pay the net income arising from the principal of this Trust in quarterly installments to my husband, ROBERT J. COOK, SR., during his lifetime. B. During my husband's lifetime, Trustee shall pay to or for his benefit, so much of the principal of this Trust as may be necessary, in the discretion of the 2 SAIDIS, SHUFF & MASLAND ATTORNEYS,AT*LAW 2109 Market Street Camp Hill, PA Trustee, for the proper support, maintenance and medical care of my husband. In addition, in each calendar year following the year of my death, the Trustee shall pay to my husband such portions of the principal as he may request in writing not to exceed in any one calendar year, on a non-cumulative basis, the greater of Five Thousand Dollars ($5,000.00) or up to five percent (5%) of the aggregate value of the principal as of the first request for withdrawal in such year. C. Upon my husband's death, Trustee shall convey and pay over all of the remaining assets to my son, ROBERT J. COOK, JR. Should my son not be living, the remaining assets shall be paid to my daughter-in-law, KAREN ENGLANDER COOK. IV. Provisions of "Trust B": The following provisions shall apply to "Trust A. Trustee shall have, hold, manage invest and reinvest the assets of this Trust, collect the income and beginning at my death pay over the net income in quarterly installments to my husband, ROBERT J. COOK, SR., during his lifetime. Trustee shall also, from time to time, pay to my husband such amounts of principal of this Trust, as Trustee deems necessary for the proper support, maintenance and medical care of my husband. In addition, in each calendar year following the year of my death, the Trustee shall pay to my husband such portions of the principal as he may request in writing not to exceed in any one calendar year, on a non-cumulative basis, the greater of Five Thousand Dollars ($5,000.00) or up to five percent (5%) of the aggregate value of the principal as of the first request for withdrawal in such year. B. Upon the death of my husband, Trustee shall pay all accrued income and all income accumulated but undistributed to the estate of my deceased husband and 3 SAIDIS, SHUFF & MASLAND ATTORNEYS,AToLAW 2109 Market Street Camp Hill, PA shall thereafter transfer the then remaining principal of this Trust to "Trust A" to be held, administered and distributed in accordance with the provisions of ITEM III. of this Last Will and Testament. C. If my husband should not survive me, then the provisions of"Trust B" shall be void and the assets which would have constituted "Trust B" shall be added to "Trust A" to be disposed of in accordance with ITEM III of this Last Will and Testament. D. Trustee shall be authorized in Trustee's sole, exclusive and unrestricted discretion to determine whether to elect (under Section 2056(b)(7) of the Internal Revenue Code of 1986 as amended, or any corresponding provisions of the Federal estate law), to qualify all, none or a fraction of "Trust B" for the Federal estate tax martial deduction. The decision of Trustee with respect to the exercise of the election shall be final and conclusive upon all persons whose interests in my estate are directly or indirectly affected by the election. Only property which is fully eligible for the marital deduction under Federal estate tax law shall be assigned to this Trust. Notwithstanding anything to the contrary contained in this Last Will and Testament, Trustee of this Trust shall not retain beyond a reasonable time any property which may at any time be or become unproductive, nor shall they invest in unproductive property. Notwithstanding the provisions of Subparagraph B. of this paragraph, Trustee shall pay to the Executor of my husband's estate, out of the principal of this Trust upon the death of my husband, an amount equal to the estate, inheritance, transfer, succession and other death taxes ("death taxes"), Federal, state and other, payable by reason of the inclusion of the value of Trust property in my husband's estate. Such payment shall be equal to the amount by which (1) the total of such SAIDIS, SHUFF & MASLAND ATTORNEYS*AT*LAW 2109 Market Street Camp Hill, PA death taxes by my husband's estate exceeds (2) the total of such death taxes which would have been payable if the value of the Trust property had not been included in my husband's estate. The determination by the Executor of my husband's estate of the amount payable hereunder shall be final. I further direct the Trustee to pay such amount promptly upon written request of the Executor of my husband's estate. The final determination of the amount due hereunder shall be based upon the value as finally determined for Federal estate tax purposes in my husband's estate. After payment of the amount finally determined to be due hereunder, Trustee shall be discharged from any further liability with respect to such payment. My husband may waive his estate's right to payment under this subparagraph by Will, executed after my death, in which he specifically refers to the right to payment hereunder given to his estate. V. Disclaimer: My husband (or his personal representative, guardian or agent acting under a power of attorney) may disclaim any part or all of the gifts to him hereunder, including the provisions for him in the trusts set forth in ITEMS III and IV. In such event, the disclaimed amounts which would be payable to him or to the trusts created herein shall be dis- tributed to my son, ROBERT J. COOK, JR. VI. Survivorship: Any person, other than my husband, who shall have died at the same time as myself, or under such circumstances that the order of deaths cannot be established by proof, or within thirty (30) days of my death, shall be deemed to have predeceased him. If my husband dies at the same time as myself, or under such circumstances that the order of deaths cannot be established by proof, my husband shall be deemed to have survived me. Any person (other than myself) who shall have died at the same time as any then recipient of income under such circumstances that the order of deaths cannot be established by proof, shall be deemed to have predeceased such beneficiary. SAIDIS, SHUFF & MASLAND AITORNEYS*ATeLA.~_...~.~W 2109 Market Street Camp Hill, PA VII. Power of Appointment: No provision of this will shall exercise any power of appointment I may have. VIII. Protective Provisions: No part of the income of the property held under the Trusts shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt thereof. Trustee shall pay over the net income and the principal to the parties herein designated, as their interest may appear, without regard to any attempted anticipation, pledging or assignment by any beneficiary under a Trust and without regard to any claim thereto or attempted levy, attachment, seizure or other process against said beneficiary. IX. representative and Trustee without court approval: Powers of shall Personal Representative and Trustee: My personal posses, among others, the following powers exercisable A. To vary or to retain investments, including the stock of any corporate Trustee named herein, when deemed desirable by them, and to invest in such bonds, stocks, notes, real estate mortgages or securities or in such other property, real or personal as they 6 SAIDIS, SHUFF & MASLAND ATtORNEYS.AT*LAW 2109 Market Street Camp Hill, PA shall deem wise. B. In order to effect a division of the principal of a Trust or for any other purpose, including any final distribution of a Trust, they are authorized to make said divisions or distributions of the personalty and realty, partly or wholly in kind, and to allocate specific assets among beneficiaries and Trusts created hereunder so long as the total market value of any share is not affected by such allocations. Should it appear desirable to partition any real estate, they are authorized to make, join in and consummate partitions of lands, voluntarily or involuntarily, including giving of mutual deeds, recognizances, or other obligations with as wide powers as can be exercised by an individual owner in fee simple. C. To sell either at public or private sale and upon such terms and conditions as they may deem advantageous to a Trust, any or all real or personal estate or interest therein owned by a Trust severally or in conjunction with other persons, and to consummate said sale or sales by sufficient deeds or other instruments to the purchasers or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money, or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon them in this paragraph or elsewhere in the instrument. D. To mortgage real estate, and to make leases of real estate extending beyond the term of the Trusts hereunder. E. To borrow money from any party, including my persona representative and trustee, to pay indebtedness of a Trust and taxes, and to assign and pledge 7 SAIDIS, SHUFF & MASLAND ATtORNEYS,AT*lAW 2109 Market Street Camp Hill, PA assets of a Trust therefor. Provided, however, that this paragraph shall not authorize borrowing from "Trust B". F. To pay all costs, taxes, expenses and charges in connection with the administration of a Trust, including a reasonable compensation to agents. If any estate or inheritance taxes are payable from assets received by Trustee, such taxes shall be paid from the assets of"Trust A". G. In the discretion of my personal representative or trustee, to unite with other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of a Trust. H. To vote any shares of stock which form a part of a Trust. I. To assign to and hold in trust an undivided portion of any asset. J. To divide any Trust created in this Agreement into two or more separate Trusts (1) to segregate property not subject to Pennsylvania inheritance tax, or (2) so that the inclusion ratio for purposes of the generation-skipping transfer tax shall be either zero or one, in order that an election under 2652(Section a)(3) of the Intemal Revenue Code may be made with respect to one of the separate Trusts, or (3) for any other reason. K. To do all other acts in its judgment deemed necessary or desirable for the proper and advantageous management, investment and distribution of the Trusts. L. Any corporate fiduciary acting as a personal representative o~ trustee hereunder shall be entitled to compensation based on its regular schedule of fees for such services in effect at the time of the service rendered. M. Should the principal of any Trust herein provided for become toe SAIDIS, SHUFF & MASLAND ATrORNEYS:AT,LAW 2109 Market Street Camp Hill, PA small, in their discretion, so as to make continuance of the Trust inadvisable, they may make l immediate distribution of the then remaining principal and any accumulated or undistributed income outright to the person or persons and in the proportions they are then entitled to income. Upon such termination the rights of all persons who might otherwise have any interest as succeeding income beneficiary or in remainder shall cease. If any person to receive distribution is a minor or disabled in any way, they may pay the fund to the parent, guardian, or person or organization taking care of that person, or, with respect to a minor, Trustee may deposit the fund in a savings fund account in the minor's name payable to the minor at majority. These authorities shall extend to all property at any time held by my Executor or my Trustee and shall continue in full force until the actual distribution of all such property, except as otherwise specifically stated. All powers, authorities, and discretion granted by this will shall be in addition to those granted by law and shall be exercisable without court authoriza- tion. X. DisabiliW: Whenever and as often as any beneficiary hereunder, to whom payments of income or principal are herein directed to be made, shall be under legal disability, or in the sole judgment of Trustee, shall otherwise be unable to apply such payments to his own or her own best interests and advantages, Trustee may make all or any portion of such payments in any one or more of the following ways: A. Directly to such beneficiary; B. To the Legal Guardian or Conservator of such beneficiary; SAIDIS, SHUFF & MASLAND ATTORNI~YSlATeLAW 2109 Market Street Camp Hill, PA C. To a relative of such beneficiary, to be expended by such relative for the benefit or such beneficiary; or D. By itself expending same for the benefit of said beneficiary. These provisions shall not apply to "Trust B". XI. Personal Representatives and Trustees: I appoint my son, ROBERT J. COOK, JR., Executor of this, my Last Will and Testament. Should my said son fail to qualify or cease to act as such, then I appoint my daughter-in-law, KAREN ENGLANDER COOK, to act in this capacity. ! appoint my son, ROBERT J. COOK, JR. as Trustee of any trusts created herein. Should my said son fail to qualify or cease to act as such, I appoint my daughter-in-law, KAREN ENGLANDER COOK, to act in this capacity. None of my personal representatives shall be required to post bond in this or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, the ,.5~ day of t~.),.:~t~' kg ~:~t'~ , 1999. ARLENE S. COOK (SEAL) lo SAIDIS, SHUFF & MASLAND A'ITORNBYS:AT.LA~W 2109 Market Street Camp Hill, PA In our presence the above-named testatrix signed this and declared it to be her will, and now at her request, in her presence, and in the presence of each other, we sign as witnesses: ~ddress "'" Address COMMONWEALTH OF PENNSYLVANIA) · SS. COUNTY OF CUMBERLAND) WE, the undersigned, the testatrix and the witnesses, respectively, whose names are si~ne the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that testatrix signed and executed the instrument as her Last Will and Testament and that she signed ~illi (or willingly directed another to sign for her), and that she executed it as her free will and volun Iar for the purposes therein expressed, and that each of the witnesses, in the presence and hearint: of testatrix signed the will as witnesses and that to the best of their knowledge the testatrix was at ti ~at t eighteen years of age or older, of sound mind, and under no constraint or undue influence. Testatrix Witness .... (iii SAIDIS, SHUFF & MASLAND ATI'ORNEYS. AT"LA~ 2109 Market Street Camp Hill, PA Subscribed, sworn to and acknowledged before me by the testatrix, and subscribed and to before me by both witnesses, this ,5 day of ~.-.'."f~,-- ,1999. . ~ ~ot~ic' 12 APPRAISAL CERTIFICATION I hereby certify that upon application for valuation by: THE ESTATE OF ARLENE S. COOK the undersigned personally inspected the following described property: All that certain piece or parcel of land, with the improvements thereon erected, situate in South Middleton Township, Cumberland County, Pennsylvania, bounded and described as follows: Beginning at a point on the easterly line of Kitszell Drive, which said point is more particularly located at the intersection of the easterly line of Kitszell Drive and the dividing line between Lots Nos. 24 and 25 on the "Final Land Development Plan for the Mayapple Village Wexford Patio Unit Lots"; thence from said point and place of beginning along the dividing line between Lots Nos. 24 and 25 along a curve to the left having a radius of 233.53 feet, an arc distance of 18.15 feet along a chord bearing of North 01 degrees, 27 minutes 39 seconds East, a chord length of 18.15 feet to an iron pin on the easterly line of Kitszell Drive; thence from said iron pin North 03 degrees, 41 minutes, 16 seconds East, a distance of 79.50 feet to an iron pin along the easterly line of Kitszell Drive; thence from said iron pin along a curve to the right having a radius of 42.00 feet, an arc distance of 110.32 feet along a chord bearing of North 78 degrees 56 minutes 04 seconds East, a chord length of 81.23 feet to an iron pin on the westerly line of Kitszell Drive; thence from said iron pin South 25 degrees, 49 minutes, 07' seconds East, a distance of 65.00 feet to a point on the westerly line of Kitszell Drive and along the dividing line of Lots Nos. 24 and 25; thence from said point South 64 degrees, l0 minutes, 53 seconds West, a distance of 126.20 feet to the point and place of beginning. Containing 0.2266 acre. To the best of my knowledge and belief the statements contained in this report are true and correct, and that neither the employment to make this appraisal nor the compensation is contingent upon the value reported, and that in my opinion the Market Value as of February 29, 2004 is: ONE HUNDRED SEVENTY-SEVEN THOUSAND DOLLARS $177,000 The property was appraised as a whole, subject to the contingent and limiting conditions outlined herein. Larry E. Foote Certified General Appraiser GA-000014-L 3 SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS LOCATION: TAX PARCEL NUMBER: IMPROVEMENTS: PROPERTY RIGHTS: OWNERSHIP HISTORY: SCOPE OF THE ASSIGNMENT: OBJECTIVE: EFFECTIVE DATE: HIGHEST AND BEST USE: COST APPROACH: SALES APPROACH: INCOME APPROACH: FINAL VALUE CONCLUSION: 4 Kitszell Drive Carlisle, Pennsylvania 40-09-0533-119 Two-story detached single-family dwelling. Fee simple interest. The subject property is owned by Arlene S. Cook. The property was purchased on December 30, 1999 for a reported consideration of $1.00 and ownership transferred on Deed Book 214, Page 765. The scope of the assignment included an analysis of the subject's area, an inspection of the subject property, an estimation of the property's highest and best use, consideration of all three approaches to value, and the application of those relevant to the valuation of the subject. To estimate the market value of the subject property as unencumbered. Febmary29,2004. Continued use as a single-family residence. N.A. $177,000 N.A. $177,000 2 and omp , 0. certified Public Accountants Frederick W. Pfister, C.RA. Richard F. Rornpalo, C.P.A. John R. Steffee, C.P.A. 342 North Front Street Wormleysburg, PA 17043 (717) 975-8500 FAX: (717) 975-9952 www. pfiste rand rornpalo, com Willliam A. Duncan, Esquire Duncan, Hartman & Douglas One Irvine Row Carlisle, PA 17013 August25,2004 Re: Estate of Arlene S. Cook Dear Bill: Arlene S. Cook owned three investments in American Funds at the time of her death. I have contacted American Funds and they have given me the following share totals and fair market values of the investments in Mrs. Cook's account number 64365075 as of February 29, 2004. Capital World Growth and Income Fund A Washington Mutual A The Income Fund of America A TOTAL 2121.611sh 2054.719sh 3987.222sh 8163.552sh $ 66,363.99 $ 61,086.80 $ 69,935.87 $197,386.66 There were no income or dividend distributions to this account in 2004 prior to Mrs. Cook's death. According to our records, Mrs. Cook made the initial investment of $150,000 into these funds on November 22, 1999. We have contacted American Funds by phone and letter and requested they transfer the ownership and income reporting on these funds to the Estate of Arlene S. Cook in care of your address as of February 29, 2004. Please contact me with any questions. LOOK FOR US. WE'LL GET YOU THERE. 7/1/2004 DUNCAN HARTMAN & DOUGLAS ONE IRVINE ROW CARLISLE PA 17013 The information which you requested on the account(s) of ARLENE S COOK (Social Security Number 181-32-4886) is/are as follows: Account Number 7100014465 Class of Account CERTIFICATE Date Opened 121001 Principal Balance 50000.00 Accrued Interest 187.56 Balance at Date of 50187.56 Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership 121001 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 Additional Information Requested SENIOR SERVICES REP. RO. Box 171 I, HARRISBURG, PENNSYLVANIA 17105-1711 Toll Free 1-866-WAYPOINT (I-866-E)29-764E;) · IN YORK AREA 717/815-4S00 · vv~vw, wagpointbank.com E TRADE FINANCIAL' July 30, 2004 William A Duncan Duncan Hartman & Douglas PC One Orvine Row Carlisle PA 17013 RE: Arlene S. Cook, Deceased Social Security No: 181-32-4886 Dear Mr. Duncan, In response to your inquiry concerning Arlene S. Cook (SSN 181-32-4886), the value of the accounts as of the date of death, February 29, 2004, was as follows: Account No: Account Type Opening Date DOD Balance Interest Accrued 2002621767 5 Year CD 7/18/00 $100,000.00 $0.00 Titled: Arlene S. Cook, Sole Owner Arlene S. Cook held no other accounts or safe deposit boxes. If you have any further questions, please correspond directly to the Deposit Operations Accounts Servicing team at the address listed below, or via fax at (800) 664 - 4641. Sincerely, Nichelle LucasTM Deposit Operations Accounts Servicing E'TRADE Bank E'TRADE Bank P.O. Box 1542 Merrifleld, VA 22116 tel: 1.800. ETBANK. 1 fax: 1.800.664.4641 etradebank, corn PLEASE READ THE IMPORTANT DISCLOSURES ON THE BACK OF THIS LE'I-rER. 40(~ Mitchell Road, Mil sboro, DE 19966 Mai[ Code DE-MB-12 Duncan, llartman & Douglas, P.C. Attorneys At Law One Irvine Row Carlisle, Pennsylvania 17013 Phone (888) 502-4349 Fax (302) 934-2955 Aagust 18, 2004 Revised Re: Estate of' Arlene S. Cook Social Securitv.~: 181-22-4886 Date of Death: February 29, 2004 Dear Mr. Duncan: Per yoar inquiry dated June 29, 21304, please be advised thai at the time of death, the abow-named decedent had on deposit with ti:is bank the following: 1. Type qAccount dcco~mt Number Chvnership bVames (~ O[~ening Dote Balance on Date qf Dc, ath Accrued Interest To,iai Cert(ficate of Deposit 03 J 003910982733 Arlene S. Cook O&_, l,.'O0 $ t 00, 000. Od $ (l,'pe of ,4ccour~t Box Number/Location Ownership (Nomes Opening Date Safe Deposit Bar O000 l 47 / Spring Garden Robert d Cook Arlene S Cook 04/ 30,/0 t Type of Account Account Number Ownership (Names o]) Opening Date Bakmce on Date of Death ,4 ccrtted D~terest Totot Checking ,4 ccount 9834621238 Arlene S. Cook I0/01,'03 closed 3/30/0,t $8.1 I5.84 S 1.42 $8,117.26 CITIZENS BANK Account Number 6140696402 Account Title ARLENE COOK Date Opened 3/24/95 Account Type Principal Balance as of DOD Interest from Last Posting to DOD Account Balance as of DOD YTD Interest to DOD Time Deposits (IRA) $3263.50 $3.48 $3266.98 $78.66 CITIZENS BANK Account Number 6140703484 Account Title ARLENE COOK 3/14/96 Date Opened Account Type Principal Balance as of DOD Interest from Last Posting to DOD Account Balance as of DOD Time Deposits (IRA) $2936.67 $7.06 $2943.73 YTD Interest to DOD $70.79 CITIZENS BANK Account Number Account Title Date Opened Account Type Principal Balance as of DOD Interest from Last Posting to DOD Account Balance as of DOD 6140888409 ARLENE COOK 4/11/90 Time Deposits (IRA) $10749.94 $30.14 $10780.08 YTD Interestto DOD $259.15 CITIZENS BANK Account Number 6140888654 Account Title ARLENE COOK Date Opened 4/5/91 Account Type Principal Balance as of DOD Interest from Last Posting to DOD Account Balance as of DOD Time Deposits (IRA) $384.96 $1.66 $386.62 YTD Interest to DOD $14.02 CITIZENS BANK Account Number 6140888697 Account Title ARLENE COOK Date Opened 12/16/90 Account Type Principal Balance as of DOD Interest from Last Posting to DOD Time Deposits (IRA) $ .oo $ .00 Account Balance as of DOD $ .00 YTD Interest to DOD $18.26 OP, RSTOWN BANK TO: Duncan, Hartman & Douglas, P.C. Attorneys at Law One Irvine Row Carlisle, PA 17013 FROM: ORRSTOWN BANK P.O. BOX 250 SHIPPENSBURG PA 17257-0250 RE: ESTATE OF Arlene S Cook DECEASED DATE OF DEATH: February 29,2004 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK: (1) CHECKING ACCOUNTS ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED DATE OF DEATH PRINCIPLE & ACCRUEDINTEREST ACCOUNT NO. SAVINGS ACCOUNT TITLE OF ACCOUNT DATE OPENED DATE OF DEATH PRINCIPLE & ACCRUED INTEREST (3) CERTIFICATES OF DEPOSIT ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED 5080066578 Robert J Cook Sr 3/14/02 Arlene S Cook DATE OF DEATH PRINCIPLE & ACCRUED INTEREST 100,000.00 197.26 9/23/04 By Timothea Customer Service Operator P.O. BOX 250 · SHIPPENSBURG, PA 17257 · TEL. (717) 532-6114 BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTVTSZON PO BOX 180601 HARRTSBURG, PA 1711B-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX WILLIAM A DUNCAN ESQ DUNCAN ETAL I 1RVINE ROW CARLISLE PA 17015 DATE 11-ZZ-ZOOq ESTATE OF COOK ARLENE DATE OF DEATH 02-29-200q FILE NUMBER 21 0~-0299 COUNTY CUMB~L AND ACN 101 ~ ' Amoun'V RaeA:k:kad..~. HAKE CHECK PAYABLE AND REfiT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 S CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF COOK ARLENE S FILE NO. 21 0~-0299 ACN 101 DATE 11-22-200~ TAX RETURN NAS: (X) ACCEPTED AS FTLED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRATSED VALUE OF RETURN BASEl) ON: 1. Real Es~a*e (Schedule A) 2. $. q. $. 6. 7. 8. ORIGINAL RETURN S:kocks and Bonds (Schedule B) (2) Closely Held S:kock/Par:knarshAp Zn:kares:k (Schedule C) ($) Hor:kgagas/No:kas RecaAvabla (Schedule D) iq) Cash/Bank DaposA:ks/MAsc. Personal Proper:ky (Schedule E) (5) JoAn:kly Owned Proper:ky (Schedule F) (6) Transfers (Schedule G) (7) To,al Assa:ks APPROVED DEDUCTTONS AND EXEMPTIONS.' 9. Funeral Expansas/Adm. Cos:ks/MAsc. Expanses (Schedule H) 10. Dab:ks/Mor:kgage LAabili:kies/LAans (Schedule 1) 11. To:kal Daduc:kAons 12. Ne:k Value of Tax Re:kurn 1:5. (9) (10) CharA:kable/Governeen:kal Baques:ks; Non-alac:kad 9115 Trusts (Schedule J) Na:k Value of Es:ka~e Subjac:k :ko Tax 177~000.00 197~$86.66 .00 .00 276~915.05 .00 55~787.69 (8) ~7,q17.58 .00 NOTE: To Ansure proper cradA:k :ko your account, subeA:k :kha upper por:kion of :khAs fore wA:kb your NOTE: 705,087.q0 (11) :37.~17.~8 (12) 667,669.82 (1:5) . O0 (lq) 667,669.82 Z~ an assessment ~as lssued previously, 11neb 14, 15 and/er 16, 17, reflect ~igures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Aeoun:k of LAne lq a:k Spousal ra:ke 16. Amoun:k of LAne lq :kaxable a:k LAneal/Class A ra:ke 17. Aeoun:k of LAne lq a:k SAblAng re:kB 18. A.oun:k of LAne lq :kaxabla a:k Colla:karal/Class B ra~a 19. Princi)al Tax Due TAX CREDITS PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) 05-18-Z00~ CD00;59~ 789. q7 10-01-200~ CDOOqq51 . O0 18 and 19 will IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (15) 191,767.26 x O0 = .00 (16), q75,902.56 x Oq5 = 21,q15.62 (17), . O0 x 12 = . O0 (lB), .00 x 15 = .00 (19)= 21,q15.62 AMOUNT PAZD 15,000.00 5,626.17 TOTAL TAX CREDIT 21,q15.6q BALANCE OF TAX DUEI . OZCR INTEREST AND PEN. .00 TOTAL DUE . OZCR ( TF TOTAL DUE TS LESS THAN $1, NO PAYMENT IS REI~UTRED. TF TOTAL DUE TS REFLECTED AS A "CREDTT" (CR}, YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR TNSTRUCTTONS.)~L~ RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any futura interest in the estate is transferred in possession or enjoyment 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 DF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Il40 of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (TZ P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT 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" (REV-1313). Applications are available online at www.ravenue.state.ca.us, any Register of Hills or Revenue District Office, or from the Department's Z4-hour answering service for forms orders: 1-800-56Z-Z050; services for taxpayers aith special hearing and/or speaking needs: 1-800-447-30Z0 (TT only). Any party in interest not satisfied with the appraismant, allowance or disalloaance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object aithin 60 days of the date of receipt of this notice by filing one of the following: A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at www.boardofeppeals.stata.pa.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to be valid, you must receive a confirmation number and processed date frae the Board of Appeals website. You may also send a written protest to PA Department of Revenue, Board of Appeals P.O. Box ZBlOZl, Harrisburg, PA 171ZB-IOZ1. Petitions amy not be foxed. B) Election to have the matter determined at the audit of the account of the personal representative. C) Appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, P.D. Box lB0601, Harrisburg, PA 171ZB-0601 Phone (?17) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decadent's death, a five percent (BX) discount of the tax paid is allowed. The 15Z 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 es indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the data of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January l, 198Z will bear interest et a rate which will vary free calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19BI through ZOO4 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ ZOZ .000548 ~'~-1991 llZ .000301 ~ 9Z .000Z47 1983 16Z .000438 1992 91 .000247 ZOO2 6Z .00016~ 1984 llZ .000301 1993-1994 7Z .O0019Z 2003 5Z .000137 1985 13X .000356 1995-1998 9Z .000247 2004 4Z .000110 1986 IOZ .000Z74 1999 7X .00019Z 1987 IOZ .DOOZ?4 ZOO0 7Z .O0019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINI~UENT X DALLY 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 an the Notice, additional interest must be calculated. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT BUREAU OF INDIVIIl!W:>(nDIn"l ('[qr,: (,C INtERITANCE TAX DIVISfuNi~.)l"'iTX.T...1 \11 I ,0L '._: PD BDX 280601 .-.'-r'i r,- ",' HARRISBURG PA 17128-0601. _, t_,; DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 2,.: f',!: L~ r : i' ...., f'- r..~',' liJu }'i\..': J U I i-I 20'- Ii: C~J::~'<:~:~ WILLIA",9[<riU~~~N DUNCAN"ETAL 1 IRVINE ROW CARLISLE I:~':- ESQ, PA 17013 08-09-2005 COOK 02-29-2004 21 04-0299 CUMBERLAND 101 Allount R8..i tied *' REV-1593 EX AFP (03-05) ARLENE S MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE NOTE: To insure proper credit to your account 1 sub.it the upper portion of this for. with your t.x paYllent. -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- ------------------------------------------~------------------------------------------------------------------------------------------ REV-1593 EX AFP (03-05) ESTATE OF COOK ARLENE .. INHERITANCE TAX RECORD ADJUSTMENT .. ACN 101 S FILE NO. 21 04- 0299 AD.JUSTI1ENT BASED ON: VALUE OF ESTATE: BOARD OF APPEALS REFUND 1. R..1 Est.t. (Schedule A) 2. Stocks .-uI Bonds (Schedul. B) 3. Closely Held Stock/Partnership Interest (Schedule C) 11\. tIortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposlts/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Totel Assets DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Administrative Costs/ Miscellaneous Expenses (Schedule H) Debts/Mortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax Return Charitabl./Gov.r~.ntal Bequests; Non-elected 9113 Trusts Net Value of Estate Subject to Tax 10. 11. 12. 13. 1.... TAX: 15. Anount of Line 14 at Spousal rate 16. Anount of Line 14 taxable at Lineal/Class A rate 17. ADOUnt of Line 14 at Sibling rate 18. Anount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (9) (10) (15) 116l (17) (18) (1) (2) (3) I...) (5) (6) (7) 177.000.00 197.386,66 .00 .00 276.913,05 .00 53.787.69 (8) 37.417.58 .00 Ill) (12) (13) 11...) (Schedule J) 230.106.91X 00 = 437.562,91X 045= .OOX 12 = .OOX 15 = (19) DATE 08-09-2005 705,087.40 37.417 .58 667.669.82 .00 667. 669.82 .00 19.690.33 .00 .00 19.690.33 K~..<.r' .. ,., AI10UNT PAID DATE NUIIBER INTEREST/PEN PAID (-) 05-18-2004 ...... CD003944 789,47 15,000.00 10-01-2004 " CD004451 .00 5,626.17 TOTAL TAX CREDIT 21 415,64 BALANCE OF TAX DUE 1,725.31CR INTEREST AND PEN. .00 TOTAL DUE I 1,725,31CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FDR CALCULATION DF ADDITIONAL INTEREST. IF TDTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. ~ IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FDR INSTRUCTIONS.) BOARD C : APPE o\LS DEPT. 281021 HARRISBURG. PA 17128-1021 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE WILLIAM A DUNCAN ESQ DUNCAN ET AL 1 IRVINE ROW CARLISLE PA 17013 IN RE ESTATE OF: COOK ARLENE S DOCKET NO.: TAX TYPE: APPEAL TYPE FILE NUMBER: ACN: APPRAISEMENT: PETITION FILED: EXAMINER: MAILING DATE: DECISION AND ORDER 0508506 Inheritance Refund 2104-0299 101 11/22/2004 5/16/2005 DONNA E AUMENT Direct Dial: (717) 783-7894 Fax: (717) 787-7270 Email: daument@state.pa.us August 4, 2005 Petitioner has submitted a letter from Aurora National Life Assurance Company which indicates that the decedent's annuity reported on Schedule G passed to her surviving spouse as surviving owner/annuitant/beneficiary. Accordingly, the full value of the annuity is taxable at the 0% rate rather than being included in the trust which has been taxed to the extent of a life estate to the spouse and a remainder interest to the decedent's son. Accordingly, it is hereby Ordered that the petition for refund is granted. The Department is directed to issue an amended appraisement and assessment reflecting the increase in the estate taxable at the 0% spousal rate to $230,106.91 ($53,787.69 annuity + $176,319.22 life estate in $613,882.13 net probate estate) and the reduction in the estate taxable at the 4.5% rate to $437,562.91 (remainder interest in $613,882.13 net probate COOK ARi..ENE S BOARD DOCKET NO. 0508506 Page 2 of 2 estate). It is further Ordered that the estate be issued a cash refund, plus appropriate interest, of the resulting $1,725.31 overpayment ($19,690.33 tax on $437,562.91 remainder at 4.5% less $15,789.47 payment on 5-18-04 and discount thereon, les5$5,626.17 payment 10-01-04). FOR THE BOARD OF APPEALS JOSEPH R. SLEEK, MEMBER ANY APPEAL FROM THIS DECISION MUST BE FILED WITH THE BOARD OF FINANCE AND REVENUE, 1101 SOUTH FRONT ST., SUITE 400, HARRISBURG, PA 17104, WITHIN NINETY (90) DAYS OF THE MAILING DATE OF THIS DECISION. TELEPHONE (717) 787-2974. A CASH REFUND WILL BE MAILED TO YOU BY THE BUREAU OF INDIVIDUAL TAXES. IF YOU REQUIRE THIS INFORMATION IN AN ALTERNATE FORMAT UNDER THE PROVISIONS OF AMERICANS WITH DISABILITIES ACT OF 1990, PLEASE CALL (717) 783-3664, OR FOR SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND SPEAKING NEEDS: 1-800-447-3020 (TT ONLY). BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE r',r~a,~1r~~~i~TAX S:TA.. TEMEN....:10'F ACCOUNT -. . .. ~.. " REV-1607 EX AFP (03-05) r\1 I D.P~-':~n I 'ES'tAlf! OF DATE OF DEATH FILE NUMBER . COUNTY ACN 09-12-2005 COOK 02-29-2004 21 04-0299 CUMBERLAND 101 ARLENE S ,......,.,r- (""..,- ....., iti '.':] :~: .,' - l WILLIAM A DUNCAN DUNCAN ETAL 1 IRVINE ROW CARLISLE ESQ ('\1 Allount Remitted PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ..... RETAIN LOWER PORTION FOR YOUR RECORDS +- --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF COOK ARLENE S FILE NO.21 04-0299 ACN 101 DATE 09-12-2005 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: 08-08-2005 PRINCIPAL TAX DUE: 19,690.33 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-18-2004 CDo03944 789.47 15,000.00 10-01-2004 CDo04451 .00 5,626.17 08-24-2005 REFUND .00 1,725.31- TOTAL TAX CREDIT 19,690.33 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 III IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J Q~ 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 payment if for a RESIDENT DECEDENT, make check or money order payable to: Register ocwms, Agent If payment if for a NON-RESIDENT DECEDENT, make check or money order payable to: Commonwealth oCPennsylvania Failure to pay the tax, interest, and penalty due may result in the filing of a lien of record in the appropriate county, or the issuance of an Orphan's Court citation. REFUND (CR): 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" (REV-13l3). Applications are available online at www.revenue.state.oa.us. any Register of Wills or Revenue District Office, or from the Department's 24-hour answering service for forms orders: 1-800-362-2050; services for taxpayers with special hearing and/or speaking needs: 1-800-447-3020 (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. 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. 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 .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 2005 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20% .000548 1988-1991 11% .000301 2001 9% .000247 1983 16% .000438 1992 9% .000247 2002 6% .000164 1984 11% .000301 1993-1994 n .00019Z 2003 5% .000137 1985 13% .000356 1995-1998 9% .000247 2004 4% .000110 1986 10% .000274 1999 n .000192 2005 5% .000137 1987 9% .000247 2000 8% .000219 --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. ~, /,:".~,r \~~ -Xo'" lif" ~ <~ f.of' ~=! \v\ /gJ \\0 :II ~ ":""":\ _ ~ __"_ _,_. ~,..:L"",,:,;,I\..,..!llil _ _.l: .1l....,____:1_ __.-Ii ___..3 :('"'i__-I--'~- If"~I:'CZ5:Jl:S;!J,,.\Cl1.~ \U1li. rt~ J!..ll..!La tUiJL ~1UiJ!..ld1.lUt;::::.!L' E..G::iLli.!!.\UL \0QJiU!ll1LLy STATUS REPORT LJ~uER RULE 6.12 Name of Decedent: A y ) e Y1 8 Date of Death: 0 ~ I ~ q J () 11 Estate No.: :2/- 04- C) ~ 9 <J 7, Coo )c:- . Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rilles, I report the following with respect to completion of the administration of the above-captioned estate: 1. State yvhyther administration of the estate is complete: Yes B No 0 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 0 No 0 b. The separate Orphans' Comi: No. (if any) for the personal representative's account is: c. Did the personal r~sentative state fu"1 account informally to the pa.."'iies in interest? Yes JB" No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to tbis report. \lA~.M^-(~ Signature flill/d/J1 A, fJw IIp4!? Name dfl / r J/ ;/I~ ~Vf/ ~4,,/i~Je; fJA 170/p Address "'7/'7-- ;7--'1 f-- 77 8~ Date: ~/11 tJ'" ~:" C.T) Lt:; ('"J '. - I 7'p.1~;,,;h^;....p i\..10 .. -'--.t'......---.- ." '.- ~~ '? C2:p~citi: ~ Pe~sQiJ.al P~eprese71:2.::ive !y(',.,..-,,-l .c__ '-e--.I'-.~ 1 ,--~---~~t. ~.;.:.v~ l,T-' ,-..';C"-l~'=_ lUl 1-' ""'-'ll"-_ lCl-'CC"'''"" a-Cl." '~t. Cumberland County - Register Of T'....~. , '1 _ lllJJ.J.J.::J r'\......._ (""'l_..~...-+-'....._.~,.....,,"", ~'--~"-""__ VllC '--VU.LLllVUbC u'-::!.UQ..LC 0-....,...1";.-.1_ 1)7\ '"!'1/\1") ~~~~~O~C, =~ ~,v~~ Phone: (717) 240-6345 Date: 2/02/2006 DUNCAN WILLIAM A 1 IRVINE ROW CARLISLE, PA 17013 RE: Estate of COOK ARLENE S File Number: 2004-00299 Dear Sir/Madam: It has 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. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 3/29/2006 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ),",~~~!}~J~ (' -1'/ GLENDA FARNER STP~SBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge