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04-0047
PETITION FOR PROBATE and GRANT OF LETTERS Estate of Betty J. Snyder No. also known as To: Deceased. Social Security No. 201-16-4737' The petition of the undersigned respectfully represents that: Your petitioner(x), who is/am 18 years 'of age or older an the execut or in the last wilt of the above decedent, dated June 9 and codicil(s) dated N/A Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the named , ~k 2003 (state relevant circumstances, e.g. renunciation, death Of executor, etc.) · Decendent was domiciled at death in Cumberland . COunty, pennsylvania, with h er last family or principal residence at 98C Herman Av-enue, Lemo3~ne 17043 (list street, number and muncipality) Decendent, then 77 years of age, died January 7 ,~t~t 2004 , at Holy Spirit Hospital~ Camp Hill, Cumberland County~ Pennsylvania Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: N/A Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled i~ Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: OO WHEREFORE, petitioner(a)respectfully presented herewith and the grant of letters theron. request(s) the probate of the last will and codicil(s) testamentary (testamentary; administration c.t.a.; administration d.bJ.n.c.t.a.) lmm PO Box 2387 San Rafael,.CA 94912 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA -lc ss COUNTY OF The petitioner(x)above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of tile knowledge and belief of petitioner(a) and that as personal represen- tative(x) of the above decedent petitioner(a) will well and truly admi/~ter the estate according to law. SwOrn to or affir e~, and subscribed ~'~-~'~ ~re me this J)%~/ day of ~ IJ - ~Y~"~"'~~ { Estate of Betty J. Snyder , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW~~JJ /~ 1~ 200~ in consideration of the petition on the reverse side~ereof, satisf~tory proof having been presented before me, IT IS DECREED that the instrument(~) dated June 9, 2003 described therein be admitted to probate and filed of record as the last will of Betty J. Snyder .; and Letters Testamentary are hereby granted to Eugene F. Grimm FEES Probate, Letters, Etc .......... $~_~_~_ Short_Certificates( ) .......... $ ................ $ .,,,~'-.. o o $ ~ ,TOTAL $ File , .~... '.Z'.~.~, David H. ~ar~au~ E~qu~re A~O~Y (Sup. Ct. I.D. No.) 84127 3211 N. Front St.; P0 Box 5300 ADDRESS Harrisburg, PA 17110-0300 (717) 238-8187 PHO~ ]'his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9813521 No. Local Registrar JAt'J 0 9 2004 Date ~1~ DECEDENT'S USUAL OCCUPATION I [] ~ousewife I-".. own home ~ DECEDENT'S MAILING ADORESS (StreW, City/T(~wn, Slate, Zip Code) I DE(: Il 98(2 Herman Ave. I~'~NCE I-. e,PA 17043 I · FATHER'S NAME (First. Middle. Last) · -. Paul E. ~imm I INFORMANT'S NAME (Type/Pdrd) J 20,. Eugene Gr~ I~lMETHOD OF DISPOSIT~OJ~ l~ 21,. ~) . omer-(a~ce/) L la S'~"~F'jI.~.%U".EDL..N'~.~CE L":ENSEE OR P~RSON ACT~ ^S Compete item~ 23a-c Ord~/whon ceftifyirlg - H10§ 143 Rev. 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH . NAME OF DECEDENT (F.L Middle. Last) .SF~( , SOC~.L SECURITY NUMBER . [X'%TE OF DEATH (Mon.~. Day, Year) · Betty Jane Snyder I~.~e I.~01 --16 --4737 I~Tanun~ 7. Zoo~ · ^GE (Last Bir~y) I UNDER1YEAR I UNDERI~,~y I DATE OF BIRTH l~] I M~r"h, I ~,, I Ho.. I Mtnutes I (Md:~'~h, DaY, YOa0 / State~xFeemlgnCounby) IH°sp'kC: . Iom~.: ,. 77 Yrs'l I I l~... 29,1926 ~ltimore,MD I . Cumberland · · · I~st Pennsboro I.d. NO~ ?::)~I~'I'F ~2).~pl-t'o.~ I~,,Ll~."~OOR.',.c. 1,0. white KIND O~ BUSINESS / INDUSTRY ~VAS DECEDENT EVER IN ID~CE~NT'S EDUCATION I MARITAL STATUS - M~. ~ SURVIVING SPDUSE I U.B. ARMEDFO~CJE$? I / v F1 ~ I m~-~o~ I c~ ~(~) I ~CEDE~S ',. S'~,. P~s¥1v~ia · ACTUAL ~mt t7c. [] Y~. ~ ~ in ~p live th e (s.~.,~s Cumberland t(~.nship? NO, ~i,~ Lemoyne MOTHER'S NAME (Fi~t, MLle. Ma~n Burn,ne) I-Dorothy A. Shur , MA,L, ^ ESS ,S,,.,. S','.. Oo,,*, /~b, . Box 2387,San l~3.:[ael,CA 94912 I DATE OF ENSPOSITION I PLACE OF DISPOSITION- Name d Cemelery, Cremalory I LOCATION - CltyKown, Slate, Zip Code I ~--~ I~*".. · · .~ ^S SUCH I LICENSE NUMEER l NAME ^ND ADDRESS OF FACILITY Ilia-013163-~ [~Ja~tsselman YI-I&C. St 324 llml Ave. ~I.,emoyne~ PA l To the besl ot my know!_ _~'~ _, ~,~.~th occun'ed al the lime, 0ate and place slated, LICENSE NUMBER IDATE SIGNED I (Slgrmt~e anti Title) I TIME ~.~DEATH [ DATE PRONOUNCED DEAD (Monlh. Day. Year) 1 23c. WAS CASE REFERRED TO A MEDICAL EXAMINER/CORONEi~?- I,. O.'O M. I,. '3-cLnu IMMEDIATE CAUSE (Final ~NCE ~ disease o4- COrldibon resultl~ in de•b%) ~ a. DUE TO (0 : 5e~tla4ty #st co~dilions b. ~ha,CAUSE, any. ,adthg to immedia,, klitlaledEfller (DI--..vents UNDERLYING or i.u~ 1~:: ~ DLIE TO (OR ~ A CON~EO~, OF:i:TO (OR AS A CONSEQUENCE OF): re~udting o~ death ) L~ST intMval be~veen onset and death PART I1: no{ re~ulting th the und~ng cause given in PART I. LAST WILL AND TESTAMENT OF BETTY J. SNYDER I, BETTY J. SNYDER, currently of 98-C Herman Avenue, Lemoyne, Cumberland County, Pennsylvania, revoke any prior Wills and Codicils and declare this to be my Will. ITEM 1. I give my furniture, household and personal effects, and other tangible personalty of like nature, other than cash or securities, together with any existing insurance thereon, in as nearly equal shares as practicable, to EUGENE F. GRIMM, LARRY J. PECK, SUSAN J. KRAMER and DAVID J. HOFFERT, subject to the survival clause of Item 3 of this Will. It is my intention that the furniture and other personal possessions that comprise this bequest will be divided by agreement of my beneficiaries under this Item 1. If my beneficiaries under this Item 1 are unable to agree upon the disposition of any particular item of furniture or personal property, then my Personal Representative shall have the power to settle all disputes and my Personal Representative's decision shall be final. ITEM 2. I give the rest, residue and remainder of my estate to the following beneficiaries and in the following proportions: ao EUGENE F. GRIMM 25% LARRY J. PECK 25% SUSAN J. KRAMER 30% DAVID J. HOFFERT 20% The bequests made in this Item 2 are subject to the survival clause of Item 3 of this Will. Page 1 of 6 ITEM 3. Any bequest made subject to this survival clause shall be subject to the condition that my beneficiary survives me by thirty days. If my daughter-in-law, SUSAN J. KRAMER, is not living on the thirty first day following my death, then any bequest made to her shall lapse and I give any bequest that she would have received under this Will to her issue, per stirpes. If any beneficiary of mine, other than SUSAN J. KRAMER is not living on the thirty first day following my death, any gift to that beneficiary shall lapse, and I give whatever portion of each bequest that beneficiary would have received to my other beneficiaries of the bequest in the same proportions that the remaining beneficiaries take with respect to each other. ITEM 4. I direct that all my just debts and the expenses of my last illness and disposition of my remains shall be paid from my residuary estate as soon as practicable after my death and as part of the expense of the administration of my estate. I mention for the convenience of my Personal Representative and family that I have made pre-paid funeral arrangements through Musselman Funeral Home, Inc. in Lemoyne, Pennsylvania. Furthermore, I have made arrangements for my final resting place to be with my late husband, ALBERT SNYDER, at Indiantown Gap National Cemetery. ITEM 5. In addition to the powers conferred by the common law, by statute, or by any other provisions hereby, my Personal Representatives are hereby empowered as follows: (a) Subject to the gifts made in Item 1 of this Will, to sell at public or private sale, to exchange, to lease, to pledge, to mortgage, to transfer, to convert, or otherwise dispose of, or grant options with respect to, any and all property, real, personal, or mixed, at any time forming a part of my probate or trust estates, in such manner, at such time or times, for such Page 2 of 6 ,~...~, ~, purposes, for such price or prices, and upon such terms, credits, and conditions as shall be deemed advisable or necessary under the circumstances. (b) To assent to, join in, and vote in favor of any merger, reorganization, voting trust, plan, lease, mortgage, consolidation, exchange, foreclosure of any corporation or other investment in which the probate estate or trusts may hold stock, bonds, investments, or an interest; (c) To vote in person or by general or limited proxy with respect to any share of stock or other investment held by the probate estate or trusts; (d) To make distribution in division of the probate estate in cash, in kind, or partly in both; (e) To distribute articles to a minor or to her or his guardian or to any person taking care of the minor to hold for the minor within the limits authorized by statute or rule of law; (f) To compromise any claim or controversy; (g) To apportion between principal and income any receipts and disbursements and to ascertain income and principal in accordance with the statutes and roles of law of the Commonwealth of Pennsylvania; (h) To keep property in the name of a nominee with or without disclosure of any fiduciary relationship; (i) To employ attomeys, auditors, depositories and proxies with or without discretionary power. Page 3 of 6 ~o 3o (j) To make, execute, acknowledge, and deliver any and all instruments which may be deemed advisable or necessary to carry out any of the powers herein granted or provided by law; (k) To invest and reinvest the principal of the trusts, together with any accumulated income thereon whenever such accumulation has been permitted by the terms hereof, in all forms of property, real, personal, or mixed, including but not limited to stocks, bonds, common trust funds, mortgage, investment funds, insurance policies, and annuities, without being limited by any statute or rule of law concerning investments by fiduciaries; (1) To carry out the terms of any agreement I may have entered into to sell all or any part of any property or any interest I may own in any business at the time of my death; (m) To exercise any law-given option to treat administrative expenses either as income tax or as estate tax deductions, without regard to whether the expenses were paid from principal or income; (n) To disclaim inheritances and interests in property. (o) To apportion tax basis among bequests in accordance with the Intemal Revenue Code, applicable regulations and other state or federal laws. ITEM 6. No bond shall be required of my Personal Representatives but if bond is nevertheless required, it shall be without surety. ITEM 7. No interest of any beneficiary under this Will or any trust established hereunder or any codicil hereto shall be subjected to anticipation. Page 4 of 6 ~i~, .~, ~,o ITEM 8. I appoint my brother, EUGENE F. GRIMM, Executor. If EUGENE F. GRIMM, fails to qualify or ceases to act, I appoint my brother, LARRY J. PECK, Executor. ITEM 9. For the convenience of my altemate Executor, I note that this Will has been prepared by David H. Martineau, Esquire, and the law firm ofMetzger, Wickersham, Knauss & Erb, P.C. Executed on ...)o~, ~ ~ , 2003. Betty J. Srtyc~ In our presence, BETTY J. SNYDER signed this Will 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 wimesses: Residencd '~ Page5of6 ~.~}. ~'. COMMONWEALTH OF PENNSYLVANIA · COUNTY OF [5~u.P~x:~ · SS ,, We, BETTYJ. SN.~YI~,ER, and ~,;J /4. f¥},,,g-;~.~q ,and ~'~ta-) i~/z /9'~o ^~.~_/,t, , the Testatrix and the wimesses, respectively, whose na~es are signed to tl~e ~ttached o~' f~r-egoing instmment, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the wimesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of our knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Testatrix f Witness Witness SWORN to or affirmed and acknowledged before me by the above named Testatrix and witnesses this q-~ day of ~_-'?,,~. __, 2003. Notary P~blic My Commission Expires: (SEAL) Page 6 of 6 ,~, t~o .~'. Seal Angola M. Miller, Notary Public City of Harrisburg Dauphin Cor ,,ion 15, BETTY J. SNYDER METZgER ~ WiCKERSHAM ~ I~NAUSS ~ ERB, P.C. ~TTORNEYS AT LAW 321l NORTH FRONT STREET P. O. BOX 5300 HARRISBURG, PENNSYLVANIA I 7 110-0300 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent · Betty J. Snyder ~' -- Date of Death · January 7, 2004 Will No. · 2004-00047 Admin. No.: 21-04-0047 To the Register: I hereby certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on January 19, 2004. Name Eugene F. Grimm Lan'y J. Peck Susan J. Kramer David J. Hoffert Address P.O. Box 2387, San Rafael, CA 94912 3512 Walnut Street, Camp Hill, PA 17011 4437 Winfield Street, Harrisburg, PA 17109 303 Niblick Court, Dillsburg, PA 17019 4437 Winfield Street, Harrisburg, PA 17109 4437 Winfield Street, Harrisburg, PA 17109 John P. Kramer Matthew A. Kramer Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: January 19, 2004 Signature Name David H. Martineau, Esquire Address 3211 North Front Street P.O. Box 5300 Harrisburg, PA 17110-0300 (717) 238-8187 __ Personal Representative Counsel for Personal Representative Telephone Capacity: X 296586-1 BUREAU ~F ZNDIV/DUAL TAXES TNHERZTANCE TAX D/V/STON PO oSOX 280601 HARRTSBURG, PA 17128-n601 DAVID H HARTINEAU HETZGER ETAL PO BOX 5500 HBG COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX RE¥-1547 EX &FP PA 17110 DATE 11-29-2004 ESTATE OF SNYDER DATE OF DEATH 01-07-Z004 FILE NUHBER 21 04-0047 9c COUNTy- CUHBERLAND '-~ ACN 101 Amoun~ Reei~ed BETTY J HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DXSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF SNYDER BETTY J FILE NO. 21 04-0047 ACN 101 DATE 11-29-2004 TAX RETURN NAS: ( ) ACCEPTED AS FTLED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Es~e~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par~nership Tn~eres~ (Schedule C) ($) ~. Hor~:gages/No~es Receivable (Schedule D) (Q) 5. Cash/Bank Deposi~s/Hisc. Personal Proper~y (Schedule E) (5) 6. Join*ly Owned Proper*y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To~el Asse~s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Cos~s/Hisc. Expanses (Schedule H) (9) 10. Debts/Hot,gage Liabilities/Liens (Schedule I) (10) 11. To,al Deductions 12. Ne~ Value of Tax Re~urn 76z052.11 .00 .00 NOTE: To insure proper .00 credi~ ~o your account, .00 subei~ ~he upper portion .00 of ~his fore ~i~h your ~ax payment. .00 (8) 15,852.15 76,052.11 13. NOTE: 185.18 16 .n37.33 60,014.78 Chari~able/Ooverneen~al Bequests; Non-elected 9113 Trus*s (Schedule J) (15) Ne~: Value of Es*e~e Sub~ec~ ~o Tax (lQ) 60,014.78 If an assessment ~as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 ~ill .00 .00 805.11 3,600.88 1,817.40 6,223.39 AHOUNT PAID reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 16. Amoun~ of Line lQ a~ Spousal ra~e (15) .00 X O0 = 16. Amount of Line lQ iexable at Lineal/Class A rate (16) 17,891.$8 X 045: 17. A=oun~ of Line lQ a~ Sibling re~e (17) 30,007.39 X 12 = 18. Aaoun~ of Line 1~ *exable a* Collateral/Class B re~e (18) 12,116.00 X 15 [] 19. Principal Tax Due (19)= TAX CREDITS: PAYHENT RECEIPT DISCOUNT (+1 DATE NUHBER INTEREST/PEN PAID (-) 05-29-2004 CD003735 226.$2 09-29-2004 CD004460 .00 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 4,$00.00 1,877.07 TOTAL TAX CREDIT I 6,405.39 BALANCE OF TAX DUEl 180.00CR ZNTEREST AND PEN. .00 TOTAL DUE 180. OOCR 0 ( TF TOTAL DUE KS LESS THAN $1, NO PAYNENT TS REQUTRED. TF TOTAL DUE KS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FOR" FOR TNSTRUCTTONS.) RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1962 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of tho decedent after the expiration of any estate for life or for years, the Comaonesalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such futura interest. To fulfill tho requirements of Section 21q0 of tho Inheritance and Estate Tax Act, Act Z5 of 2000. (72 P.S. Section 91qO). Detach tho top portion of this Notice and submit with your payment to tho Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF NXLLS, 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 Xnharitanca and Estate Tax" (RE¥-1313). Applications ara available online at www.ravanue.state.oa.us, any Register of Nills or Revenue District Office, or from the Department's Zq-hour answering service for forms orders: 1-BOO-36Z-Z050; services for taxpayers with special hearing and/or speaking needs: 1-800-qqT-50ZO (TT only). Any party in interest not satisfied with tho appraisasnt, allowance or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice amy object within 60 days of the date of receipt of this notice by filing one of the following: A) Protest to tho PA Department of Revenue, Board of Appeals. You amy object by filing a protest online at www.boardofappaals.state.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 from the Board of Appeals wsbsite. You may also send a written protest to PA Department of Revenue, Board of Appeals P.O. Box Z81021, Harrisburg, PA 171Z8-1021. Petitions may not bo 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 Review Unit, P.O. Sox Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6503. Sea page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administrativeZy correctable errors. Xf any tax due is paid within three (5) calendar months after tho dacedent's death, a five percent (SZ) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the totat of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (93 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 (6g) percent par annum calculated at a daily rate of .O0016q. 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 zooq are: Interest Daily Interest Daily Interest Daily Year Rata Factor Year Rate Factor Year Rata Factor 198Z ZOZ ,OOOSqB ~q~)'~'8-1991 X1Z .000301 ~ 9Z .OOOZfi7 1983 16Z .000438 1992 92 .000Z47 ZOOZ 6Z .000164 1984 11Z .000301 1993-199q 72 .00019Z 2003 5Z .000137 1985 13Z .0D0556 1995-1998 92 .000247 ZOOq 42 .000110 1986 XOZ .000274 1999 ?Z .O0019Z 1987 lOZ .000274 ZOO0 7Z .00019Z --Interest is calculated as follows: 'rNTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent wi11 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. ~EV-1470 EX (6-88) , ' ~ INHERITANCE TAX EXPLANATION COMMONVVEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG~ PA 17128-0601 DECEDENTS NAME FILE NUMBER SNYDER,BETTY J 2104-0047 REVIEVVED BY ACN Kathryn Harbilas 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The value of the estate has been adjusted as the result of the correction of an error in arithmetic. ROW Page I ~ COMMONWEALTH OF PENNSYLVANIA - ~ DEPARTMENT OF REVENUE . ~.~BUREAU OF INDIVIDUAL TAXES "lc DEPT 280601 '~ HARRISBURG PA 17128~3601 RECEIVED FROM ,. MARTINEAU DAVID H 3211 NORTH FRONT STREET HARRISBURG, PA 17110-0300 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX(11 96) NO. CD 003733 E'STATE INFORMATION SSN 201-16-4737 F'I'LE NUMBER 21 04-0047 D'ECEDENT NAME SNYDER BETTY J DATE OF PAYMENT 03/29/2004 POSTMARK DATE 00/00/0000 COUNTY, CUMBERLAND DATE OF DEATH 01/07/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4,300.00 ;I~EMARKS t SEAL TOTAL AMOUNT PAID $4,300 O0 EUGENE GRIMM CHECK#109 INITIALS: VZ RECEIVED BY GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS McNees Wallace & Nurick attorneys at law LINDA M. ESHELMAN ESTATE pARALEGAL DIRECT DIAL:(717)237-5210 E-MAIL ADDRESS: LESHELMAN~MWN.COM August 24, 2004 VIA CERTIFIED MAIL Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 RE: DONALD U. FRUTIGER ESTATE ~ © Cumberland County File No. 2003-00047 ,, Pennsylvania Department of Revenue No. 21-03-0047 ,' Our File: 21536-0001 Ladies and Gentlemen: Enclosed for filing for the above-referenced estate are two (2) originals of a Pennsylvania supplemental inheritance tax return. The return shows a tax due of $324.33 and a check is attached in payment thereof. Aisc, enclosed is a check for the $15.00 fee to file the return. Please date-stamp the enclosed copy and return to us in the stamped envelope provided. Thank you. rs truly ~./ Estate Paralegal LME/mha Enclosures cc: Johanna C. Frutiger RO. Box 1166 · 100 PINE STREET ° HARRISBURG, PA 17108-1166 · TEL; 717.232.8000 ° FAX: 717.237.5300 · WWW. MWN.COM HAZLETON, PA ° STATE COLLEGE, PA ° COLUMBUS, OH · WASHINGTON, DC COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFINOIVIDUAL TAXES OEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11 96) NO. CD 004303 STEVENSON RICHARD W ESQ 100 PINE STREET P O BOX 1166 HARRISBURG, PA 17108-1166 ESTATE INFORMATION: SSN: 201-16-4475 FILE NUMBER: 2103-0047 DECEDENT NAME: FRUTIGER DONALD U DATE OF PAYMENT: 08/25/2004 POSTMARK DATE: 08/24/2004 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/27/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $324.33 REMARKS: TOTAL AMOUNT PAID: 9324.33 SEAL CHECK# 724114930 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS 7160 ~901 9~44 444~ 4197 RETURN RECEIPT REQUESTED First Class Mail h"llh"ffh,,,,,lf,,H,,,Ih,,lhl,,l,h,,fhh,hJ,rhl,, REGISTER OF WILLS CUMBERLAND COUNTY COURTHOUSE ONE COURTHOUSE SQUARE CARLISLE PA 17013-3387 oo COMt,/~NW EALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT· 280601 HARRISBURG, PA 17128-0601 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE iNITIAL) SOCIAL SECURITY NUUBER Z SNYDER, BETTY J. 201-16-4737 DATE OF O.,EAT~ (~D-YEAR) DATE OF BIRTH (MM-DD-YEAR THIS RE3%IRN MUST BE FILED IN DMPUCATE WITH THE I,LI 01 -,,~H~- 2004 12-29-1926 REGISTER OF VVILLS LM F APPLICASLE) SURVIVING SPOUSS'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL ~ECURITY NUMBER [] 1. OfiginalRetum [] 2, SupplementalRetum [] 3. RemaindsrReturn(daedcie~h~tol2-~3-~) [] 4. limitedEstate [] 4a. FuturelnlerestComprom~se(~.o,'de~h~er~2-~2.~) [] 5, FederalEstateT~ReturnRequired [] 6. DocedentDiedTestate(Atta~copyofW~ll) [] 7. DecebentMaintainedaLivingTrust(^tt~..hoo~yo~T,-~t) 8. TotslNumberofse~sDepositsexes [] 9. UlJgatkmProceedsReosived [] 10. Spo(JsalPovertyCredit(dateddeahbetw~n12.31-9~afl~-l-~5) [] 11. Electi~totaxunderSec. g113(A){Attachs~ho) Z c)~ NAME ~ COMPLETE MAILING ADDRESS n©z FIRMNAME(~fApplicable)DAVID II. MARTIN'RAU ~321]- N'OP,~I-I FRONT STREET pJ~P.O.,~ BOX 5300 ~u METZGER, WICKERHSAM, KNAUSS & ERB, rr mLEP~0NE ~UMSER HARR I SBURG, Pg. 171 ~ 0 - 0300 O ~ (717) 238-8187 1. Real Estate {sehedule A) (1) OFFICIAL USE ONLY 2. Stocks and Sends (Schedule B) (2) 3. Closely Held Corporation. Partnership or Sele-Proprietorship (3) 4. Mortgages & Nc~es Receivable (sehedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 7 6, 05 2 . 11 C~ ~ (Schedde E) ,~ 6. Joinay Owned Proper~ (sehedule F) (6) [] Separate Billing Request~ Cc 7. Intsr-VN~s Transfers & Miscellanocus Non-Prebate Prope~y (7) (Schedule G or L) 8. Total Gm~s Assets (total Unes 1-7) (8) 76, 052.11 O 9. Funera~Expenses&Administrat[veCosts(seheduleH) (9) 15, 852 . 15 UJ 10. Debts of Decedent, Mortgage Liabi~itiss, & Liens (Schedule I) (10) 18 5. 18 11. TotalDeductlens(tota~ Lines 9& 10) (1t) 16, 037.33 12. Ne~ValueofEstate(IJne8minusLine11) (12) 60 014 . 78 13. Charitable and Govornmental Seques~sec 9113 Trusls f~r which an elec~m io tax has not been (13) made (Schedule J) 14. NelValueSubjecttoT~(Lir, e12minusUne13) (14) 60 014.78 SEE INSTRUCTIONS FOR APPUCABLE RATES LU 15. Amcent of Une 14 taxable al t~e spousal tax ~ rate, orfsansfersundorSec. 9116(a)(12) 0. 00 X .0 (15) ,~ 16. AmountofUne14ta.~ebleatlinealrate 18, 151. 05 x .0 45 (16) 816 80 O~ 17. Araount of Une 14 taxable at sibling rate 30,630.98 X.12 (17) 3,675.72 (,,3 18. Am~JntofUne 14 tsxebleatcdlatoralrate 12, 663.64 x .15 (18) 1, 899.55 ~. 19. Tax Due (19) 6,392.O7 ~o. [] {~=~FyOU~ OF"." Decedent's Complete Address: STREETADDRESS 98C HERMAN STREET CrTY LEMOYNE I STATE PA I ZlP 17043 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Povedy Credit B. Prior Payments C. Discount 4,300.00 215.00 (1) Total Credits (A + B + C) (2) 3. Intamst/Penalty if applicable D. interest E. Penalty Total thterest/Penalty (D + E) (3) 4. If Une 2 is greater than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Lir~ 1 + Une 3 is greater tha~ Line 2, enter the difference. This is the TAX DUE (5) 6,392.07 4,515.00 0.00 1,877.07 A. Enter the interest on the tax due. (5Al B. Enter the total of Line 5 + SAm This is tho BN. ANCE DUE. (58) Make Check Payable to: REGISTER OF I/I/ILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ........................................ ~ ~ b. retain the right to designate who shall use the properly 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 cocurred after December 12, 1982, did decedent transfer prope~ within one year of death without receiving adequate consideration? .................................................. [] [] 3. Did decedect own an 'In trust for" or payable upon death bank account cr security at his or her death? ..... [] [] 4. Did decedect own an Individual Retiremect Acoount, annuity, or other non-probate properly which contains a honeficiary designation? ....................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEBIJLE G AND FILE IT AS PART OF THE RETURN, 1,877.07 Under penatties of peduu, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is lrue, c~ect and complete. Dederatke of preparer other than the personal represa~tative is based on all informatiee of which preparer has any knowledge. SIG,bI~.TURE OF PER~J~N R~:~ONSIBLE FOR FILING RETURN ADDRESS~ - '' EUGENE F. GRIMM, EXECUTOR, P.O. BOX 2387, SIGNATURE OF PREPAREROTHF_j~5'EN IAI I~rE' ADDRESS ~-- ..... SAN FAFAEL, CA 94912 DATE / For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of tmnsfers to Or for the u~e~f the surviving spouse is 3% [72 P.S. §9116 {al (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate irs posed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (al {1.1 ) (ii). Tho statute does not exempt a transfer to a sun,,iving spouse from tax, and the statutory requJrereenta for disclosure d assets and filing a tax retam am sa app cab e 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 deceascd child twenty-one years of age or ynenger 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)]. The tax rate imposed on the net value of transfers to or for the use of tho decedecrs lineal beneficiaries is 4.5%, except es noted in 72 RS. §9116(1,2) [72 P.S. §9116(a)(1)]. Tho tax rate im posed o~ the net value of tmnsfere to or for tho use of the decedent's siblings is 12% [72 RS. §9116(aX1.3)]. A sibling is defined, under Section 9102, as an indMdual who has at least one parent in common with tho decedent, whether by blood or adoption. STF PA42021F.2 COMMONWEALTH OF P~NNSYLVANIA · ';'[~EpARTMEN~OF REVENUE ;~ BUREAU OF INDIVIDUAL TAXES . DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 0O3733 MARTINEAU DAVID H 3211 NORTH FRONT STREET HARRISBURG, PA 17110-0300 ESTATE INFORMATION: SSN: 201-16-4737 FILE NUMBER: 2104-0047 DECEDENT NAME: SNYDER BETTY J i~ATE OF PAYMENT: 03/29/2004 ~OSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND 'DATE OF DEATH: 01/07/2004 ACH ASSESSMENT CONTROL NUMBER AMOUNT 101 I $4,300.00 'i REMARKS: [~'~" SEAL EUGENE GRIMM CHECK# 109 TOTAL AMOUNT PAID: $4,300.00 INITIALS: VZ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS TAXPAYER R, EVo1502 EX ~- (1-97) (I) COMMONWEALTH OF PENNSYLVN~IA INHERITANCE TAX EETURN RESI~NT DECEDENT ESTATE OF SNYDER, BETTY J. SCHEDULE A REAL ESTATE FILE NUMBER NI mai pl'opel~y owned solely or as a tenant In common must be rel~orted at fair ma'M value. Fair market velue is deft red as the price at which properly woad be exchanged behesun a willing buyer and a willing seller, neither being competled to buy or se~l, both having reasonable kno~edge of the relevant facts. Real prolx(~ which Is Jat ntly-owasd with/fght of survivorship must be dlsuJesud on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) S3~c PA42021F.3 P~EV-1503 EX + (1-97) (I) SCHEDULE B CO~MON~ALT"OFPENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER SNYDER, BETTY J. All Ixoberty Jolntly.owne~ with the Hitht of suwlvomhlp must be disclosed on Sch~:lule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. TOTN. (Also enter on line 2, Recapitulation) (If more space is needed, insert additional sheets of the same size) SI~F PA42021F 4 R,EV-1504 EX · (1 °97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SNYDER, BETTY J. SCHEDULE C CLOSELY.HELD CORPORATION, PARTNERSHIP or SOLE-PROPRIETORSHIP FILE NUMBER Schedule C-I er C-2 (Including all supp(xting information) must be attached for each closely-held corp~atio~par thership inlerest of the decedent, (Y;her than a sale-proprietorship. See insi~'ucfions for the suppa'tJng information th be submitled fo~ sole- propriethr ships. ITEM VALUE AT CATE NUMBER DESCRIPTION OF DEATH 1. TOTAL (Also enter on line 3, Recapitulation) $ (If more space is nseded, insert additional sheets of the same size) S"i~F PA42021F.5 R~SV-1505 EX * (1-97) (I) COMMONWEALTH OF PENNSYt.VANIA INHERITANCE TAN RETURN RESIDENT DECEDENT ESTATE OF SNYDERt BETTY J. SCHEDULE C-1 CLOSELY-HELD CORPORATE STOCK INFORMATION REPORT FILE NUMBER 1. Name of Corporation Address City State Zip Code 2. Federal Employer I.D. Number 3. Type of Business Product/Service State of Incorporation Date of Incorporation Total Number of Shareholders Business Reporting Year TYPE TOTAL NUMBER OF NUMBER OF SHARES VALUE OF THE STOCK V~Jng / Non-V~ng SHARES OUTSTANDING PAR VALUE OWNED BY THE DECEDENT DECEDENT'S STOCK Common $ Preferred $ Provide all tights and resthctiens pertaining to each class of stock. 5. Was the decedent employed by the Coq3oration? If yes, Position 6. Was the Corporation indebted to the decedent? If yes, provide amount of inde~tedneas $ r-lYes r'-i No Annual Salary $ I~Yes [~No ~me Devoted to Business 7. Was there lifo insurance payable to the corporation upon the death of the decedent? [~]Yes [] No If yes, Cash Surrender Value $ Net proceeds payable $ Owner of the policy 8. Did the decedent seil or transfer stock of this compeny within one year prier to death or within two yearn if the date of death was prior to 12-31-827 []Yes []No Ifyes, []Transfer r--]Sale Number of Shares Transferee or Pumhaser Consideration $ Date Attach a separat~ sheel for additional traesfa's and/or sales. 9. Was there a wtitten sheroholde"s agreement in effect at the time of the decedent's death? [] Yes [] No If yes, provide a copy of the agreement. 10. Wes the decedent's stock sold? [] Yea [] No If yes, provide a copy of the agreemem of sale, etc. 11. Was the corporation dissolved or Ikluidated after the decedeot's death? [] Yea [] No If yes, provide a breakdown of distrtbutions received by the estate, including dates and amounts received. 12. Did the corporation have an interest in other corporations or partnerships? [] Yes [] No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. A. Detailed calculations used in the valuation of the decedent's stock. B. complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years. C. If the corporation owned real estate, submit a list showing the complete eddreas/ea and estimated fair market value/s. If rea] estate appraisals have been secured, attach copies. D. List of principal stockholders at the date of death, number of shares held and their ralationship to the decedent. E, List of olficers, their salaries, bonuses end any other benefits received from the corporatien, E Statement of dividends paid each year. List these declared and unpaid. G. Any other information relating to the valuation of the decedent's stock. STF PA42021 F.6 R~V-1506 EX ,~ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SNYDER, BETTY J. SCHEDULE C-2 PARTNERSHIP INFORMATION REPORT FILE NUMBER Nome of Pa~tnemhip. Address City Fedoral Employer I.D. Number State Zip Code Date Business Commenced Business Reporting Year Type of Business Product/Service Decedent was a [] General [] Limited partner. If decedent was a limited partner, provide initial investment $ PERCENT OF PERCENT OF BALANCE OF PARTNER NAME INCOME OWNERSHIP CAPITAL ACCOUNT A. B, C. D. 6. Value of the decedem's interest $ 7. Was the Partnemhip indebted to the decedent? [] Yes [] No If yes, provide amount of indebtedness $ 8. Was there life insurance payeble to the partnership upon the death of the decedent? ['--[Yes If yes, Cash Surrender Value $. Nat proceeds payable $ Owner of the policy 10. 11. 12. 13. 14. A. B. C. D. [] No Did the decedent sell or transfer an interest in this partnership within one year pdor to death or within two years rf the date of death was pdor to 12-31-827 []Yea [] No If yes, []Transfer [] Sale Percentage transferred/sold Transferee or Pumhasor Consideration $ Date Altach a separate sheet for addilJonal ffansfers and/or sales. Was there a written partnership agreernent in atfent at the t~me of the decedent's death?[] Yes [] No If yes, provide a copy of the agreement. Was the denedent's partnership interest sold? [] Yes [] No If yes, provide a copy of the agreement of sale, eth. Was the partnership dissolved or liquidated alter the decedent's death? [] Yes [] No If yes, provide a breakdown of disb'ibotions received by the estate, including dates and amounts received. Was the decedent related to any of the partners? [] Yes [] No If yes, explain Did the partnemhip have an interest in other corporations or part~rships? [] Yes [] No If yes, report the necessary information on a separate sheet, including a Schedule ~1 or C-2 for each interest. Detailed calculations used in the valuation of the denedent's partnership interest. Complete copies of financial staternects or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding years. If the partnership owned real estate, submit a list showing the complete eddmssJes and estimated fair market veiue/s. If real estate appraisals have been secured, attach copies. Any other information relating to the valuation of the decedenrs partnership interest. STF PA42021F.7 R~V-1507 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAN RETURN RESIDENT DECEDENT ESTATE OF SNYDER, BETTY J. SCHEDULE D MORTGAGES & NOTES RECEIVABLE FILE NUMBER All property Jointly-owned wlth the right of survivorship must be disclosed on Schedule R ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. TOTAL (Also enter on line 4, RecapitulatiON) $ (if more space is needed, insat additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAN RETURN RESIDENT DECEDENT ESTATE OF SNYDER, BETTY J. SCHEDULE E I CASH, BANKDEPOSlTS,&MlSC. PERSONALPROPERTY FILE NUMBER Include the proceeds of litigation and the dale the proceeds wee received by the estate. NI pmpely Jointly-owned with the NgM of suwlv~'ship must be disclosed on Schedule R ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 10,150.51 2 o 6. 7. 8. 9. CERTIFICATE OF DEPOSIT PNC BANK 500 FIRST AVENUE PITTSBURGH, PA 15219 ACCOUNT NO. 31000213236 ACCRUED INTEREST CERTIFICATE OF DEPOSIT WAYPOINT BANK P.O. BOX 1711, HARRISBURG, ACCOUNT NO. 9600010665 ACCRUED INTEREST PA 17105-1711 CHECKING ACCOUNT WAYPOINT BANK P.O. BOX 1711, HARRISBURG, ACCOUNT NO. 500026319 ACCRUED INTEREST PA 17105-1711 SAVINGS ACCOUNT WAYPOINT BANK P.O. BOX 1711, HARRISBURG, ACCOUNT NO. 5500031077 ACCRUED INTEREST PA 17105-1711 DECEDENT'S AUTOMOBILE MISCELLANEOUS PERSONAL PROPERTY OF DECEDENT REFUND OF APARTMENT SECURITY DEPOSIT REFUND OF AUTO INSURANCE PREMIUM RENT REBATE FROM PA DEPARTMENT OF REVENUE 230.61 50,791.41 19.79 2,481.20 0.01 6,016.69 0.23 3,100.00 2,261.00 429.46 140.00 431.20 TOTAL (Alee enter on line 5, Recapitulation) $ 76, 052.1'1 (If mom space is needed, inset additional sheets of the same size) STF PA4202/F.9 LOOK FOR US. WI?LL GI~T YOU THI~RI~. 4/16/2004 METZGER WICKERSHAM 3211 N FRONT ST PO BOX 5300 HARRISBURG PA 17110-0300 The information which you requested on the account(s) of BETTY JANE SNYDER (Social Security Number 201-16-4737) is/are as follows: Account Number 500026319 5500031077 9600010665 Class of Account CHECKING SAVINGS CERTIFICATE Date Opened 062992 100302 052203 Principal Balance 2481.20 6016.69 50791.41 Accrued Interest .01 .23 19.79 Balance atDate of 2481.21 6016.92 50811.19 Death Account Ownership SOLE SOLE SOLE Name of Joint Owner, if any Date Ownership 062992 100302 052203 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. P.O. Box 171 I. HARRISBURG. PENNSYLVANIA 17105-1711 Toll Fr~ 1-866-WAYPOINT (I-866-9;~9-7646) · IN YORK AR~, 717/815-4500 - www. wattpointbank.com R~V-1509 EX ,~ (1-97) (I) COUMONWEN.TH OF PENNSYLVANIA INHERUANCE TAX RETURN RESIDENT DECEDENT ESTA'I~ OF SNYDER, BETTY J. SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER If an asse~ was made Joint within one year of the decedent's da~e of death, It must be reputed on Schedule G. SDRVNING JOINT TENANT(S) NAME ADORESS RELATIONSHIP TO DECEOENT A. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTtCN OF PROPERTY %OF DATE OF DEATH U~ FOR JOINT MADE Include nan~ of finendalinsti~ion a~ bank accost rarnber or mmibr ide~ti~r,g nit, bet. DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT A~ch deed for joiN%9'eld real ~fate VALUE OF ASSET iNTEREST DECEDENTS INTEREST 1. A. TOTAL (Nso enter on Kine 6, Recapitulation) $ (;f more space is needed, insert additional sheets of the same size) s3~: PA4202~ F.I 0 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SNYDER, BETTY J. SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBATE PROPERTY FILE NUMBER This schedule must be completed and filnd if the a nswa' to any of questions 1 through 4 on II~e reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERI~ % OF rTEM iNCLOUE 3HE NAME OF 31~ I~,~S~EREE, 'R~IR RELATION~.I p TO ~C~D(ENT AI~) 3~E DA~ DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER OF ~FER. ATTACH A COPY OF ~ DEED FOR REAL ESTA3E. VALUE OF ASSET INTEREST (IF N=F%ICABLE) 1. TOTAL (Also enter on line 7, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SNYDER, BETTY J. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER D~t~s of decedent must be relx~ted on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 10. 11. 12. 13. 14. FUNERAL EXPENSES: ivFJSSELM3LN FUNER.AL HOME MEMORIAL SERVICES ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representat[ve(s) EUGENE F. GRIMM S~ctal Security Number(s) ! EIN Number of Personal Representotive(s) 195 - 28 - 0364 SffeetAddrees P.O. BOX 2387 City SAN RAFAEL State CA Year(s) Commission Paid: 2 0 0 4 Ntomey Fees Family Exemption: (If decedent's address is ~ot the same as claimant's, attach explanation) Claimant Zip.94912 Sffeet Address City State Zip Reltaionship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees SHORT CERTIFICATES PUBLICATION OF ESTATE NOTICE PATRIOT NEWS CUMBERLAND LAW JOURNAL POSTAL EXPENSES MISC. EXPENSES (PHONE, FA3~,COPIES) TRAVEL FOR EXECUTOR'S APPEAR.AN'CE IN PENNSYLVANIA PRESERVATION OF APARTMENT SECURITY DEPOSIT APPRAISAL COSTS FOR MISC. PERSONAL PROPERTY FILING FEE FOR INHERITA_NCE TAX RETURN TOTAL (Also enter on line 9, Recapitulation) $ 4 737.66 867.68 3,774.30 5,000.00 75.00 15.00 127.75 74.74 40.00 1,000.00 82.63 42.39 15.00 15,852.15 (if more space is needed, insert additional sheets of the same size) STF PA42021F.12 R .EV-1512 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SNYDER, BETTY J. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER In~u~ unr~mbur~d nmdlcal ~ ITEM NUMBER DESCRIPTION AMOUNT 2. 3. 4. COMCAST CABLE PPL ELECTRIC UTILITIES VERIZON PATRIOT NEWS 39.64 83.82 34.32 27.40 TOTAL (Also enter on line 10, Recapitulation) $ 18 5.18 (If more space is nseded, insert additional sheets of the same size) STF PA42021F.13 REVo1513 EX + (9~)0) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SNYDER BETTY J. SCHEDULE J BENEFICIARIES FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1. 2. 3. 4. '1. TAXABLEDl~RIBUTlONS[includeoutdghts~usaldis~butims, and~n¢~ und~S~.9116(a)(1,2~ EUGENE F. GRIMM P.O. BOX 2387 SAN RAFAEL, CA 94912 DAVID J. HOFFERT 303 NIBLICK COURT DILLSBURG, PA 17019 SUSAN J. KRAMER 4437 WINFIELD STREET HARRISBURG, PA 17109 I2tRRY J. PECK 3512 WALNUT STREET CAMP HILL, PA 17011 BROTHER NEPHEW DAUGHTER-IN-LAW BROTHER 25% PERSONALTY 25% RESIDUARY 25% PERSONALTY 20% RESIDUARY 25% PERSOANLTY 30% RESIDUARY 25% PERSONALTY 25% RESIDUARY ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) S~F PA42021F 14 Estate of Betty J. Snyder Breakdown of Gifts Taxable at differing rates for Pennsylvania Inheritance Tax Personalty $5,361.00 Deductions: Gross Residuary $70,691.11 $14,224.16 $56,466.95 Personalty Taxable Residuary TotalTaxable Bequest $5,361.00 $56,466.95 Eugene Grimm $1,340.25 $14,116.74 $15,315.49 Larry Peck $1,340.25 $14,116.74 $15,315.49 David Hoffe~ $1,340.25 $11,293.39 $12,633.64 Susan Kramer $1,340.25 $16,810.80 $18,151.05 Relationship Brother Brother Nephew Daughter-in-law Total Gifts Taxable at Lineal Rate (4.5%): Total Gifts Taxable at Sibling Rate (12%): Total Gifts Taxable at Collateral Rate (15%): $18,151.05 $30,630.98 $12,633.64 Note: Susan Kramer is entitled to lineal rate as surviving spouse of Decedent's pre-deceaed son. COMMOflWEAL~ OF PENNSYLVANIA INHERITANCE TAX RETURN ~SIDENT OECEDENT ESTATE OF SNYDER, BETTY J. SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN (Check Box 4 on Rev-1500 Cover Sheet) FILE NUMBER 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 retum. r--~Will [~lntervivos Deed of Trust [-]Other NAME(S) OF NEAREST AGE AT TERM OF YEARS LIFE ESTATE IS LIFE TENANT(S) DATE OF BIRTH DATE OF DEATH 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 life estate is payable 2. Actuarial factor per appropriate table Interest table rate - [-J3 1/2% []6% 3, Value of life estate (Line 1 multiplied by Line 2) [] 10% []Variable Rate % 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 OF []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) [] Bi-weekly (26) [] Monthly (12) []Quarterly (4) [] Semi-annually (2) []Annually (1) [] 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 []3 1/2% I-']6% [] 10% [-iVariable Rate % 6. Adjustment Factor (see instructions) 7. Value of annuity - If using 3 1/2%, 6%, 10%, or if vadable rate and pehod payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 $ If using vadable rate and pedod payout is at beginning of pedod, calculation is: (Line4 x Line5 x Line 6) + Line3 $ 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 return. 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) S33= PA42021F.15 REW-1647 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SNYDER, BETTY SCHEDULE M FUTURE INTEREST COMPROMISE (Check Box 4a on Rev-1500 Cover Sheet) FILE NUMBER This schedule is appropriate only for estates of decedents dying after December 12, 1982. This schedule is to be used fo¢ all future interests where the rate of tax which will be applicable when the future interest vests in possession and enjoyment cannot be established with certainly. Indicate below the t,jpe of instrumont which created the future interest and attach a copy to the tax return. [] Will [] Trust [] Other ]. Beneficiaries AGE TO NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH NEAREST BIRTHDAY 1. 2. 3. 4. 5. r[ For decedents dying on or after July 1, 1994, if a surviving spo~ee exercised or intends to exercise a dght of withdrawal within 9 months of the decedent's death, check the appropriate block and attach a copy of the document in which the su~ving spouse exercises such withdrawal right. [] Unlimited right of withdrawal [] Limited right of withdrawal uL Explanation of Compromise Offer: Summary of Compromise Offer: 1. Amount of Future Interest .................................................................... $ 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (also include as part of totel shown on Une 13 of Cover Sheet) ........... $ 3. Value of Line t passing to spouse at appropriate tax rate CheckOne [-]6%, []3%, []0% .......................... $ (also include as part of total shown on Line 15 of Cover Sheet) 4. Value of Line 1 taxable at lineal rate Check One []6%, [-]4.5% ................................. $ (also include as part of total shown on Line 16 of Cover Sheet) 5. Value of Line 1 Taxable at sibling rate (12%) (also include as part of total shown on Line 17 of Cover Sheet) ........... $ 6. Value of Line 1 Taxable at collatera~ rate (15%) (also include as part of total shown on Line 18 of Cover Sheet) ........... $ 7. Total value of Future Interest (sum of Unes 2 thru 6 must equal Line 1) ................................ $ (If more space is needed, insert additional sheets of the same size) STF PA42021F.16 REV~1649 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SNYDER, BETTY J. SCHEDULE O ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) FILE NUMBER Do not complete this schedule unless the estate is making the election to tax assets under Section 9113 (A) of the Inheritance & Estate Tax Act. If the election applies to more then one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Trust (maXtal, residual A, B, By-pass, Unitied Credit, etc,). If a trust or similar arrangement meets the requirements of Section 9113 (A), and: a. The trust or similar arrangement is listed on Schedule O, and b. ~ value of the tnJst or similar arrangement is entered in whole or in part as an es,set on Schedule O, then the transforor% personal representative may specifically identify the trust (ell or a fractional portion or percentage) to be included in the election to have such trust or similar properly treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfa' on Schedule O, the personal representative shell he considered to have made the election only es to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement, PART A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's survMng spouse under a Section 9113 (A) trust or similar arrangement. Part A Total $ PART B: Enter the description and value of all interests included in Part A for which the Section 9113 (A) election to tax is being made. Part B Total $ (If more space is needed, insert additional sheets of the same size) S~F PA42021F.17 LAST WILL AND TESTAMENT OF BETTY J. SNYDER I, BETTY J. SNYDER, currently of 98-C Herman Avenue, Lemoyne, Cumberland County, Pennsylvania, revoke any prior Wills and Codicils and declare this to be my Will. ITEM 1. I give my furniture, household and personal effects, and other tangible personalty of like nature, other than cash or securities, together with any existing insurance thereon, in as nearly equal shares as practicable, to EUGENE F. GRIMM, LARRY J. PECK, SUSAN J. KRAMER and DAVID J. HOFFERT, subject to the sUrVival clause of Item 3 of this Will. It is my intention that the furniture and other personal possessions that comprise this bequest will be divided by agreement of my beneficiaries under this Item 1. If my beneficiaries under this Item 1 are unable to agree upon the disposition of any particular item of furniture or personal property, then my Personal Representative shall have the power to settle all disputes and my Personal Representative's decision shall be final. ITEM 2. I give the rest, residue and remainder of my estate to the following beneficiaries and in the following proportions: EUGENE F. GRIMM 25% LARRY J. PECK 25% SUSAN J. KRAMER 30% DAVID J. HOFFERT 20% The bequests made in this Item 2 are subject to the survival clause of Item 3 of this Will. ITEM 3. Any bequest made subject to this survival clause shall be subject to the condition that my beneficiary survives me by thirty days. If my daughter-in-law, SUSAN J. KRAMER, is not living on the thirty first day following my death, then any bequest made to her shall lapse and I give any bequest that she would have received under this Will to her issue, per stirpes. If any beneficiary of mine, other than SUSAN J. KRAMER is not living on the thirty first day following my death, any gift to that beneficiary shall lapse, and I give whatever portion of each bequest that beneficiary would have received to my other beneficiaries of the bequest in the same proportions that the remaining beneficiaries take with respect to each other. ITEM 4. I direct that all my just debts and the expenses of my last illness and disposition of my remains Shall be paid from my residuary estate as soon as practicable after my death and as part of the expense of the administration of my estate. I mention for the convenience of my Personal Representative and family that I have made pre-paid funeral arrangements through Musselman Funeral Home, Inc. in Lemoyne, Pennsylvania. Furthermore, I have made arrangements for my final resting place to be with my late husband, ALBERT SNYDER, at Indiantown Gap National Cemetery. ITEM 5. In addition to the powers conferred by the common law, by statute, or by any other provisions hereby, my Personal Representatives are hereby empowered as follows: (a) Subject to the gifts made in Item 1 of this Will, to sell at public or private sale, to exchange, to lease, to pledge, to mortgage, to transfer, to convert, or otherwise dispose of, or grant options with respect to, any and all property, real, personal, or mixed, at any time forming a part of my probate or trust estates, in such manner, at such time or times, for such purposes, for such price or prices, and upon such terms, credits, and conditions as shall be deemed advisable or necessary under the circmnstances. (b) To assent to, join in, and vote in favor of any merger, reorganization, voting trust, plan, lease, mortgage, consolidation, exchange, foreclosure of any corporation or other investment in which the probate estate or trusts may hold stock, bonds, investments, or an interest; (c) To vote in person or by general or limited proxy with respect to any share of stock or other investment held by the probate estate or trusts; To make distribution in division of the probate estate in cash, in kind, (d) or partly in both; (e) To distribute artiCles to a minor or to her or his guardian or to any person taking care of the minor to hold for the minor within the limits authorized by statute or role of law; (f) To compromise any claim or controversy; (g) To apportion between principal and income any receipts and disbursements and to ascertain income and principal in accordance with the statutes and roles of law of the Commonwealth of Pennsylvania; (h) To keep property in the name of a nominee with or without disclosure of any fiduciary relationship; (i) To employ attorneys, auditors, depositories and proxies with or without discretionary power. Page 3 of 6 ~a/~, ~. (j) To make, execute, acknowledge, and deliver any and all instruments which may be deemed advisable or necessary to carry out any of the powers herein granted or provided by law; (k) To invest and reinvest the principal of the trusts, together with any accumulated income thereon whenever such accumulation has been permitted by the terms hereof, in all forms of property, real, personal, or mixed, including but not limited to stocks, bonds, common trust funds, mortgage, investment funds, insurance policies, and annuities, without being limited by any statute or role of law concerning investments by fiduciaries; (1) To carry out the terms of any agreement I may have entered into to sell all or any part of any property or any interest I may own in any business at the time of my death; (m) To exercise any law-given option to treat adminis~xative expenses either as income tax or as estate tax deductions, without regard to whether the expenses were paid from principal or income; (n) To disclaim inheritances and interests in property. (o) To apportion tax basis among bequests in accordance with the Internal Revenue Code, applicable regulations and other state or federal laws. ITEM 6. No bond shall be required of my Personal Representatives but if bond is nevertheless required, it shall be without surety. ITEM 7. NO interest of any beneficiary under this Will or any trust established hereunder or any codicil hereto shall be subjected to anticipation. ITEM 8. I appoint my brother, EUGENE F. GRIMM, Executor. If EUGENE F. GRIMM, fails to qualify or ceases to act, I appoint my brother, LARRY J. PECK, Executor. ITEM 9. For the convenience of my alternate Executor, I note that this Will has been prepared by David H. Martineau, Esquire, and the law finn of Metzger, Wickersham, Knauss & Erb, P.C. Executedon ~~~- ~ ., 2003. Be~' J. S~[yffe{ (~ In our presence, BETTY J. SNYDER signed this Will 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 wimesses: Reside/Ice H il PA Residenc~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF SS .~Ir~We, BETTYJ. SN~YI~,ER, and ~,.:J /4. ?at']..~;,¢~,~4 ,and ta ~) t'~_J. ~7fi2o ^,~r'~,'~ ~_ / ~ , the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instnanent as her last Will and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her flee and voluntary act for the purposes therein expressed, and that each of the wimesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of our knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Testatrix f cd Witness Witness SWORN to or affirmed and acknowledged before me by the above named Testatrix and wimesses this ~ day of ~7,~,~e_ . 2003. Notary P~blic My Commission Expires: (SEAL) Page 6 of 6 ~al~. ~, Notarial Seal .Ang¢la M. Miller, Notary Public MC~ty of Rarfisburg, Dauphin County y Comnflssion .F. xpir~ Oct. 15, 2006 PNCBAN< March 22, 2004 David H. Martineau 3211NorthFrontS~eet P.O. Box 5300 Harrisburg, PA 17110-0300 Estate of Betty J. Snydcr~ decdeased SSN: 201-16-4737 DOD: 1/7/2004 Dear Mr. Martineau In response to your requot for Date of Death balances for the customer noted above, our records show the following: Certificate of Deposit Account #31000213236 BETFY J SNYDER DOD balance: $10,150.51 +$230.61 accruedinter,st Interest Paid 1 / 1/2004 - 1/7/2004 - $0.00 Established 07/20/2001 Please note that this office only provides date of death balances for deposit accounts 0[RAs, CDs, Checking and Savings as~ouats). We do not process any financial. transactions or provide statements, If you need assistance with any ofthes¢ items, please call 1-888-PNC-BANK (1-$88-762-2265) or stop by your local PNC Bank bnmch office. Sincerely, Rachelle Wells 1-gD0-752-I775 PT-PFSC-O4-F 500 first Ave. P iCrsbur~h PA 15219 Member FDIC TOTAL P,O1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11 96) NO. CD 004460 MARTINEAU DAVID H 3211 NORTH FRONT STREET HARRISBURG, PA 17110-0300 ESTATE INFORMATION: SSN: 201-16-4737 FILE NUMBER: 2104- 0047 DECEDENT NAME: SNYDER BETTY J DATE OF PAYMENT: 10/04/2004 POSTMARK DATE: 09/29/2004 COUNTY: CUMBERLAND DATE OF DEATH: 01/07/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,877.07 TOTAL AMOUNT PAID: $1,877.07 REMARKS: SEAL CHECK//119 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of Betty J. Snyder No. 21 04 0047 also known as Date of Death 01107/2004 Social Security No. 201-16-4737 , Deceased Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the foJlowing inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We vedfy that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. Name of Attorney: David H. Martineau~ Esquire I.D. No.: 84127 Address: 3211 N. Front St., PO Box 5300 Harrisburg PA 171100300 Personal Representative: Eugene F. Grimm PO Box 2387; San Rafael~ CA 94912 Deted Telephone: (717) 238-8187 Description PNC Bank ~ Certificate of Deposit #31000213236 Accrued Interest: $230.61 Waypoint Bank * Certificate of Deposit #9600010665 Accrued Interest: $19.79 Waypoint Bank - Checking Account #500026319 Accrued Interest: $0.01 Waypoint Bank - Savings Account #5500031077 Accrued Interest: $0.23 Automobile of decedent Miscellaneous personal property of decedent (Attach Additional Sheets if necessary) Total Value 10,381.12 50,811.20 2,481.21 6,016.92 3,100.00 2,261.00 76,052.11 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, atthe ejection of the personal representative, include the value of each item, but such figures should not be extended into the total of the inventory. RW-4 REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of Betty J. Snyder No. 21 04 0047 also known as Date of Death 01/07/2004 Social Security No. 201-16-4737 , Deceased Personal Representative(s) of the above Estate, deceased, verif7 that the items appearing in the following inventory include all of the personal assets wherever situate and all of the mai estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. INVe verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. Name of Attorney: David H. Martineau~ Esquire I.D. No.: 84127 Address: 3211 N. Front St.~ PO Box 5300 Harrisburg PA 171100300 Personal Representative: Eugene F. Grimm PO Box 2387; San Rafael~ CA 94912 Dated [~//(~/0~ Telephone: (717) 238-8187 Description PNC Bank - Certificate of Deposit #31000213236 Accrued Interest: $230.61 Waypoint Ban k - Certificate of Deposit #9600010665 Accrued Interest: $19.79 Waypoint Bank - Checking Account #500026319 Accrued Interest: $0.01 Waypoint Bank - Savings Account #5500031077 Accrued Interest: $0.23 Automobile of decedent Miscellaneous personal property of decedent (Attach Additional Sheets if necessary) Total Value 10,381.12 50,811.20 2,~1.21 6,016.92 3,100.00 2,261.00 76,052.11 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 BeVy J. Snyder Description of Inventory Description Refund of apartment security deposit Refund of auto insurance premium Rent rebate from Pa Department of Revenue Continuation of Inventory Pa,qe 1 21 04 Value 0047 429.46 140.00 431.20 Su~oal $ 1,000.66 GrandTotal $ 76,052.11 In the matter of the ESTATE OF BETTY J. SNYDER, Deceased. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PE~~YL V A.fflA ORPHANS' COURT DIVISION NO. 2004-00047 RRf:RTPT, RRT RASR, ANn RRFITNnTNG RONn \.,:"" I hereby agree to accept from Eugene F. Grimm, Executor, the sum of Fourteen Thousand Two Hundred Sixty-Eight Dollars and Five Cents ($14,268.05), representing my total net distributive share of the Estate. I request that the Fiduciary send the check to me in this amount, payable to me, by first-class mail, return receipt requested, addressed as follows: (Releasor to fill in LA~~ J. Pt:C-K 3SIA--A u:nLN0I3\~1 ('AMP HiLL,YA ~. address in Releasor's own handwriting): Upon receipt of the aforesaid check, I do hereby release the said Fiduciary of and from any and all claims I have under the laws of the Commonwealth of Pennsylvania, or of any other jurisdiction and under the Last Will and Testament of the above-captioned decedent with respect to the aforesaid $14,268.05 and with respect to the administration of said estate. I also acknowledge that I am hereby advised that the Estate has not received a final clearance of fiduciary income tax from the Internal Revenue Service or the Pennsylvania Department of Revenue. If there is a further assessment or claim from either of these taxing bodies or any other governmental body or any other party or creditor with a lienable claim or other claim, I hereby agree to pay to the governmental body or other party or creditor my share of any amount which may be necessary to discharge the Estate or Fiduciary, and I agree to refund to the Estate or 320919-1 Fiduciary my share of any amount the Estate or Fiduciary may pay to discharge such debts or claims. IN WITNESS WHEREOF, I have hereunto set my hand and seal this I ,""'" day of ~b ""A~'f , 2005. WITNESS: I?~~ (SEAL) 320919-1 STATE OF PENNSYLVANIA COUNTYOF t.....-.Io..Rf~ SS. On this, the \ Q"'dayof r; b "'" ,.n." , Anno Domini 2005, before me, the undersigned officer, personally appeared LARRY J. PECK, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and seal. ~~~- NOTARIAL SEAL LOUIS J. LORE, Notary Public Camp Hi'! Boro, Cumberland County My CommISSion Exp"6s April 14, 2007 3209/9-/ In the matter of the ESTATE OF BETTY J. SNYDER, Deceased. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DNISION . NO. 2004-00047 RF.C1UPT, RRT.F.ASR, ANn RRFlJNnrNG HONn , I hereby agree to accept from Eugene F. Grimm, Executor, the sum of Seventeen ThOUsand Nine Hundred Twelve Dollars and Seventy-Three Cents ($17,912.73), representing my total net distributive share of the Estate. I request that the Fiduciary send the check to me in this amount, payable to me, by first-class mail, return receipt requested, addressed as follows: (Releasor to fill in address in Releasor's own handwriting): 4 h[ , I f~. tff- ") 7 uJ/~hf;/d J 7/01 Sf. / Upon receipt of the aforesaid check, I do hereby release the said Fiduciary of and from any and all claims I have under the laws of the Commonwealth of Pennsylvania, or of any other jurisdiction and under the Last Will and Testament of the above-captioned decedent with respect to the aforesaid $17,912.73 and with respect to the administration of said estate. I also acknowledge that 1 am hereby advised that the Estate has not received a final clearance of fiduciary income tax from the Internal Revenue Service or the Pennsylvania Department of Revenue. If there is a further assessment or claim from either of these taxing bodies or any other governmental body or any other party or creditor with a lienable claim or other claim, I hereby agree to pay to the governmental body or other party or creditor my share of any amount which may be necessary to discharge the Estate or Fiduciary, and I agree to refund to the Estate or 320919-1 Fiduciary my share of any amount the Estate or Fiduciary may pay to discharge such debts or claims. IN WITNESS WHEREOF, I have hereunto set my hand and seal this z .,d day of t11~,~" ,2005. WITNESS: ~ ~~ ~ ~ ~AL) Susan J. Krame~ . 3209/9.1 STATE OF PENNSYLVANIA COUNTY OF ~: r'\ On this, the~ day of {\J\arL-V\ . .;;;;x:::c,S , Anno Domini 2005, before me, the undersigned officer, personally appeared SUSAN J. KRAMER, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. SS. IN WITNESS WHEREOF, I hereunto set my hand L' ^- Notari;S;;.::-/ -'--'- <"\IIIVE . ___c. City Of Ham""bng, .'Votary Public ! s urg 0 . M~~~e~o~~::~~J -'e..,J, 01 Notaries 3209/9./ In the matter of the ESTATE OF BETTY J. SNYDER, Deceased. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DNISION NO. 2004-00047 RFCFTPT, RFT RASF, ANn RFFTJNnTNG RONn I hereby agree to accept from Eugene F. Grirnm, Executor, the sum of Eight TIiousand, Eighty-Six Dollars and Ninety-Four Cents ($8,086.94), representing my total net distributive share , of the Estate. I request that the Fiduciary send the check to me in this amount, payable to me, by Upon receipt of the aforesaid check, I do hereby release the said Fiduciary of and from any and all claims I have under the laws of the Commonwealth of Pennsylvania, or of any other jurisdiction and under the Last Will and Testament of the above-captioned decedent with respect to the aforesaid $8,086.94 and with respect to the administration of said estate. I also acknowledge that I am hereby advised that the Estate has not received a final clearance of fiduciary income tax from the Internal Revenue Service or the Pennsylvania Department of Revenue. If there is a further assessment or claim from either of these taxing bodies or any other governmental body or any other party or creditor with a lienable claim or other claim, I hereby agree to pay to the governmental body or other party or creditor my share of any amount which may be necessary to discharge the Estate or Fiduciary, and I agree to refund to the Estate or 320919-1 Fiduciary my share of any amount the Estate or Fiduciary may pay to discharge such debts or claims. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of rebr";;('~:J , 2005. WITNESS: !7 J ;'/$:J(~/..~ ~1 ~ ' Y' Da IdJ.HO~ (SEAL) 320919.1 STATE OF PENNSYLVANIA SS. COUNTY OF On this, the ~ day of 01'7f W (;jj; , Anno Domini 2005, before me, the undersigned officer, personally appeared DA V J. HOFFERT, known to me (or salisfactonly proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and seal. Not , J Not::'llal Seal Amy Ewing. Notary Public City Of Hanisbu'lJ. Dauphin County My Commission Expires May 11,2006 Member. Pennsy:vani;':\ Ll,::sCiciiJTIan Of Notaries 3209/9-1 STATUS REPORT UNDER RULE 6.12 Name of Decedent Date of Death Will No. 2004-00047 Bettv J. Snyder J anuarv 7, 2004 Admin No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No. 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. Ifthe answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk ofthe Orphans' Court and may be attached to this report. Date: :3/J.J I () "; D.-/ // ,52 ~ Signature Name David H. Martineau, Esquire Ci''''\ .. ",..,.~ Address 3211 North Front Street P.O. Box 5300 Harrisburg, P A 17110-0300 Telephone (717) 238-8187 Capacity: Personal Representative X Counsel for Personal Representative uN 301064-1