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Home My WebLink About04-0310 PETITION FOR PROBATE and GRANT OF LETTERS Estate of Violet M. Starner N021-04 310 also known as To: Register of Wills for the County of Cumberland in the Social Security No. 181-03-9719 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older and the elCutrix named in the last will of the above decedent, dated Feb. 19, 1976 and codicil(s) dated N/A NOTED: RICHARD S. STARNER DIED NOVEMBE 15, 2002 (state relevenat circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 329 Stamer Station Road, Dickinson Township (list street, number and municipality) Decedent, then 89 years of age, died Feb. 29,2004 at Dickinson Township, Cumberland County 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: No Exceptions Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ unestimated (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: Total: unestimated WHEREFOR~, petitioner(s) respectfully request(s) the probate of the last wi~d CO~il(s) ::;:1 t' presented herewIth and the grant of letters testamentary ... 5 -; . . (::.: (testamentary; adrrumstratlOn(~.t.a.; admInIstratIon d.b.n.c.t.a.) thereon. f ~ ~~ w --' Beverly Starn~ -- 350 Georgetown Road = ,.,...... Gardners P A 17324 ..... W 00 UATH UJf PERSUNAL KEPRSENTATI V E COMMONWEA TLH OF PENNSYLVANIA COUNTY OF CUMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statement in the foregoing peition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmJrd and subscribed .6~ 5i~ before me this 31 day of March, 2004 ~~~~ '~Aa~~l~(1~ Reglster No. 21-04 310 Estate of Violet M. Starner , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW -,Yn Y"'(Iln 61 20 Ol-f , in consideration of the petition on \ the reverse side hereof, satisfactory proof having been presented before me, IT I~ DECREED that the instrument(s) dated_ Feb. 19, 1976 described therein be admitted to probate and filed of record as the last will of Violet M. Starner and Letters Testamentary are hereby granted to Beverly Starner FEES Probate, Letters, Etc. $ 200 . 00 Robert M. Frey #06274 Short Certificates(l ) $ 0.00 ATTORNEY (Sup. Ct. I.D. No.) R8RwMsiaoon ~ _ $ '3.00 5 South Hanover Street ~p $ io.oo Carlisle, Pennsylvania 17013 Total_ $ ~Jq. 00 ADDRESS Filed..:??.: .-;?.1. ::.. ?:-.?~':t.......... (717) 243-5838 PHONE 00 ~ :::r, ,.. _.... -- (f) ..,..'::. :3 -'. C' <'. ,. ::;:: = :::t"J .. W -- ."... ~ --' W CXl ~- Register of Wills of Cumberland County, Pennsylvania OATH OF NON-SUBSCRIBING WITNESS Eslateof ,I,ok-\- m SIf\~NF-Q Number 21-04-3\0 also known as , Deceased (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that~we are) familiar with the signature of , testat_ of (one of the subscribing witnesses to) the will/codiCil presented herewith and that believes the signature on the will/codiCil IS In the handwriting of to the best of knowledge and belief Sworn to or affirmed and subscribed )( tJJ~ ~ ~ #,_,/_:, -:~, *=-"-- (Signature) before,me tflis l 0 day of l'f'ia..x-<:.oyY - , ~ '- ~ :;-'.1 (Signature) ~. d ."'~~O~ . For the, R:9Iste101.... ~ - ~i Sworn to or affirmed and subscribed (Signature) before me this day of \ld' 0:) put'pequlIl:) lln:)~ ::: I t"' '. :;~>iJa,~ (Signature) ,20--90. Olll 9ll:!\lW t>O. For the Register S!llr~ 10 JdlS!5al::l )0 3CII.j~J :JaDJOoal::l I I REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS 21-04-':~IO J WARD COOPER , ~ (each) a subscrIbmg wItness to the wIll presented herewith, (each) bemg duly qualJfled accordmg to law, depose(s) and say(s) that he was present and saw VIOLET M. STARNER , the testat ri x , sIgn the same and that he signed as a wItness at the reqUest of testat nx In h er presence and (m the presence of each other) (m the presence of the other sUbscrIbmg wltness(es)). , / Sworn t~ 0; affirmed al)d subscnbed before 9- ,~~/ ~ ;~.--'Z -- t' J!-/_~ ~t.t"t. d f / J. Ward Cooper (N ) me ms ~ - ay 0 ame - '. . Marc\~~~ J..- J&:~ 4401 Carl1s1e Rd.Gardners PA 17324 ~ ~ ~~: -, ~n: ~ ~eglster 1-: (Address) -, ' I """rf (Name) .-,r ;0 (Address~ ~ g ffi'~ 0-:::' ~ 0 <P/) 3 U;Q~ ~ "" ~ [;'" ,t~i ;0 (p <n =' ~- -'"'I: 1..1., u.. L.. N (' ~J, \D ~...... (;(.."'- . ;:1 "'1 "',,;--0 REGISTER OF WILLS OF GOl1N1i! ;:: ~' OATH OF NON-SUBSC NG WITNESS~ ff, en s- , (each) a subscnber Ii (each) bemg duly qual! I accordmg to law, depo famll!ar With the sIgna re of , " eodled teslat of (one of the witnesses to) will presented herew codIcIl that II IS m the handwrItmg to the best of Sworn to or affIrmed and subsc me thIS Register (Name) (Address) ---- - m05805 REV 9186 ThIS IS 10 certify that lhe mformalIon here given IS correctly copied from an ongmal cemficale of death duly filed wIlh me as Local Reglslrar The ongmal certlflcale Will be forwarded 10 lhe Slale V 1Ial Records Office for permanenl filmg WARNING: It is Illegal to duplicate thiS copy by photostat or photograph. Fee for lhlS certIficate, $2 00 ~~-~.~~~~ Local Registrar p 10159391 MAR 1 200~ No Dale nc:. :DiSl 5(0 g ::I~ 0'':'" <t>o <00 m () ~ (ftO - ' p.;."d ;:0 ft)(\) :J - ." Q- o.f W 1"') 1-" " ~ -=~ (){fJ .0 ("> ;;: ~b '':::'" (U COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. IIITAL RECORDS ~ ~ ~ iif I::; Iil0$lo&:)A..ZII7 CERTIFICATE OF DEATH :l>;:i (.j - - "- ~'NT 00 - swr'U"U,,"HR ..., N.O..IolEOFOECEOENT(F..M_LMI '" SOC'ALSECUA'l'Y"U~9EA OATEOFOEATH,,,,_o."_1 '" , V<o~et M, Stal/.nelt , Fema.ee , 181 - 03 -9719 . Feb. 29,2004 .lOE1L"S.,.",..,., UNOEA1YE,.tJl UNOEA1CQ O'IITt<'l.AC(lC....1II<I 1'I...ACE000DE.o1t<<O,<<........".. _....,\OC.......""__, 89 -!Oayo -l~" we:k;~~71r:YlpA HOSPffAL ,. 111plI.....O ~,O , ~ COUNTVOl'CE1JH FACIUT'l'NAME(ll""'.........",_...~III<I......,O', 0,1 Adam,o ~ ,. OECEDENTSUSUAl.CX:CUNllQl\l MAAIT...LSTA1'US 1.1.".... SUPYlYINGSPOUSl! (~-~~"=.:::~~ N...'Mlft....W~ ,......_----, -- ".Head Cook. H' Ca6et,^<a It w-<.dowed OECEOE.NTSo.u.lUNG.o.OOAESScs-...Ct,~_(VCo<ooI DECEDENTS 17. $I... Vq""~ ~ye'!a'<l 't:( 17CJXl...__.. P lek lfll !G'11 329 Sta'ne, Stat<on Rd, ACTUAl. '" - Flf:SlDENCE - <S""'.'''''I>OI\I -.. 1" Galtdne.Jt-6, PA 17324 ""-_I Cumbe.lt-iand -' 17~ 0 :'=-:::<>1 ,~ - "'OTHERSNALtE,F.. 1.1""'" M_Suo...".. " " n ~ S tw.l (I..-PMI ,NFOAM...NTSMAll.IHQ"'OCRESSISl,...CotyrfowtlSlaleZillC"""1 - Be.v IIi M, Staltnel/. - 350 Geo' etown Rd, Galtdnelt-6 PA 17324 METHOO OF OOSPQSITION Pl"CEOI'OISPOSlTION_C1C1.........,c.....aIOry LOCATlCIN C<lyiToom.St-. Z'c>Co<oo ......Orl c._O ___SleI.O 0<0"""'- _0 --- Wenk-6v-<.ffe. c.e.m z,~e.nk.-6v-<.lfe , PA 17325 '" '" ~, NA"'E ANOAOOA.fSSOl' F'AClI.lTY zJi.o.f..f.-<.Yl 17065 t:"/#- . EOOEAO(MOnt>o.,'I'uIl Wl.SCASEREFEAAEDlOMEOICAt.EXAtolI l-2!}-,? _0 ~SZ- " " " " 27""'"1 E.....""__"'~,.....""""'''''__O..l!>CO..........,,,._OlilyonO"''''''..g''a'"'''''.._.,'''Y.''...IIoC.CI....f\!.~ur. ''''wo..m.,. I'AIITII OI1'1'''"9'''IIcanl_eonII'OuIlnglO_lM.oI ~.ontJ_c:e...Otl.1CI>1Ine '1nI__ nQII.-....,..lN--......_~..l'IlSlTl 6> ",,{toe L,~...A- -G.\,,--( l-ena- A4_,,,r (.1.. c(.(,.",,- . i OUElO(ORASA OLIENCEOFl i~",-( .a..(".~ : I: DUE TO(Ofl AS ACOt<SEOUENCEQFt , C. LI- ~....JI.l-",,~ ~"'c i DUETOIORASACONSEOUENCEOFl : WEREAUTOPsYF1NOIHGS M"'NNEAOF OEATH QATEOF tNJURV TIMEOFINJUAV tNJURV/lr'NQll1\7 DESCRlOE tCl'o'IINJUA'f OCCUAN:O .........""""'" l3' (loOOo'<l\ea.,......1 COlolI'UTlONOFe.o.USE "'~. - 0 "'''''~ _0 ~O ~.- 0 _o>;ln_..-".." 0 ~d _0 ~O 0 OPu.cEOFIt<JURY.\l_'.""..,_,KIOt'/.O~ " .... CI>""''''''boI~I'''''1I'4<l Loc.crlOt4lS1r...~s..t - ~""'Sl>ec.rwt - " - CUlTIl'llRIC/'><<Io_..... CPlTIIP"'t'...a""'SlClAM~_~calMoI___P"vK....N.Ilr~"".,n.""ccrn"'....,"...2], ,...._..,"',..............t"OCC1Irr.clO...talhece<tHfll.fId..........'...u..., 'IM)NOUNClNGANDeVlTII'YING~YSICIAN1""'SC_tIaI'I:>o..--.:... "..",.nacf<bfyoIl<)lO_cl_1 0 To~_OI"..,~",,~. .,.."'''"_.._11.... <MI. .....pl... .....cI~.Io_U~H(.J........ftI..'...,.'" MEDICAL EXAMINER/COAONER Mi?~H On '1l.1M.IIll,......'".'llI" andJOtl"v..'IIlOUlIn In my lIpln...., d"'" lICcv".d "'110 U..... dll. InCI pl.c. .nddv,," II1.u~'.I.).nd 0 '" _""11'" REGISTR.o.ASSIG........URE...NON .~~~ ~ " .;. '. I ! l' . . ~ " " " , , . LAST WILL AND TZSTAME:NT OF VIOLET M. STARNER ,- , \~ , \.~,I-O/.f -310 , l' " ~ ~ ~ I '... I, Violet M. Starner, of R.D~','2'Gardners,'Cumberland County, , 4' . ~ . ~ ~ Pennsylvania, declare this t.~ be, my:,last . -iiLl1,' and, 'revoke any will ( ,. -1 '.. (' . . .... --,~ V" .. " ,<' . . ' ~ previously made by me. . ' ,,~ ...~ ~ ; ~ \.- L" '"', It'_, ITEM I: J".)' "'",~' I' ,,'\ . I direct that all, my ::just 'debts and fune'ral expenses, including my gravemarker and all expenses of my last illness, shall , be paid from my residuary estate as soon as practicable after my decease 'as'a_part of the administrat~on qf my e~ta~e. - r ~ .'" ITEM II: I devise and bequeath all of my estate of every nature and wherever. situate to my husband, Richar~~. 'S1arner:;!,iijl , . ::.ix ~ mn providing he shall survive me by thirty days. ~ ,~, ~ '!~ g -- ;:I::> " co ~, :::0 :'~ ~ 1 'ITEM III: Should my husband, Richard S. Sta:rner, \Jlrede;e~se . -- ."+t me or die on or before the thirtl.eth d'ity followi~~?~Y ds::::th, fi~ 'j"( " l" r;n 0 devise and bequeath all of my estate of every natut'~,>~nd~herever , situate to my issue per stirpes living on the thirty~first day , ' following my death. It is my desire that the shop ana the tools and equipment therein shall be held by my issue as tenants in t common. , ITEM~IV: All federal, state and other death taxes payable , . because of my death, with respect. to -the property 'forming ~y"gross estate ,for tax purposes, whether or not passi~ under. this 'will, , ' i~cluding any interest or penalty imposed in connection with su~h tax, ~hall be considered a part of the expenses of the administrat- ion of my ~state,and shall be paid out of the principal of my estate without anportionment or right of reimbursement. , ' , ITEM V: I appoint my husband, Richard S. Starner, executor of this my last will. Should, my husband, Richard S. Starner, fail to " ~,PoJ- )n~~ -- .: ;. , ~, , " ,- Page -2- oualify or cease to ac: as ex~cutor, I appoint my son, Dwight ,Starner, and mY daughter, Beverly Starner, executo!~ of 'this my last will. ITEM VI: I 'direct that my executor or his successors shall not be reouired to give bond for the faithful performance of their duties in any jurisdiction. . IN W,ITNE~S WHER,EOY.,. I hav,e .~ereunto set my, hand, this /';7',2"-L;. ~ <" '. day of h6~:" .~.; ,19'76;' '. , , I. .. ~ ".J . .\)~ ~~ 1 ' .' , , 'vYl ~ ~ . ' \' , , . .. , , ...... ,-~ ~ " .,. '- The 'p'rec~dliIlg~ln'strumei1t,. .'consisting of t'his .-and one other' ~ ~ I ,.. 't _ ,,~ ~. '", '. . typewritten page, each identified by the signaiure:of the testatrix, was on the day and date thereof signed, published ,and declared by . " Violet M. Starner, the testatrix therein named, as and for her last will, in the presence,of us, who. at her request, in her presence, and in the presence of each other have subscribed our .names as, o . witnesses hereto. " . , , UJ7J ~~..~Jl~ residing at d N, / 4--I'.fi--Q-t:? /7.'l/1;' . ;t,?~~(J-~~ residing atf & 2- ~ ~/73<./ '~~h, arw residing at ;R fl ; ~71~~' . -~ --"1": _'~":.:..,_'"' . ' '0-'" <D r /? :J;)-fL > " . . 0 -.. ' (,Q ) -, ~ ;-' :3. ~ (Ii....\ - ::;t::o ....~. P- m - ::0 n. IT 3 ~~ -.,) 0_' v..> Q.", .' i~t'l ~ Y , y' .. o' ;B :? ~) - ,~ t:. ('.) 0 .~ ~~ w (j)~. " 0 co . > , COMMONWEALTH OF PENNSYLVANIA *' BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. Z80601 NOTICE OF INHERITANCE TAX HARRISBURG, PA 171Z8-0601 APPRAISEltENT ALLOlfANCE OR DISALLOlfANCE OF DEDUCTION~, AND ASSESSltENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REv-me EX AFP (01-03) DATE 08-30-2004 ESTATE OF DUM JR JOSIAH F DATE OF DEATH 02-04-2003 FILE NUMBER 21 03-0310 COUNTY CUJDOLAND. SSN/DC 20~28-91~ SARENA M SMITH ACN 0354988 ,': 427 DOGWOOD cr I .....;......'.i..'.... RI!ll."'~ '....1 CARLISLE PA 17013 ~ .,. ,'.'. N MAKE CHECK PAYABUE' AND REMIT PAYMENT TO: REGISTER OF WIlLS ~ CUMBERLAND Ca;.:C9URT c!!PUSE CARLISLE, PA- f7013:::" CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V=is4-i-EX--AFii-foi-:03i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 08-30-2004 ESTATE OF DUM JR JOSIAH F DATE OF DEATH 02-04-2003 COUNTY CUMBERLAND FILE NO. 21 03-0310 S.S/D.C. NO. 209-28-9107 ACN 03134988 TAX RETURN WAS: (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5000971301 TYPE OF ACCOUNT: () SAVINGS ()() CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 01-21-1997 Account Balance 467.36 NOTE: TO INSURE PROPER CREDIT TO Percent Taxable X 0.166 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 77.89 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 77.89 REGISTER OF WILLS AT THE Tax Rate X .45 ABOVE ADDRESS. MAKE CHECK Tax Due 3.51 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID INTEREST IS CHARGED THROUGH 09-07-2004 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 3.51 REVERSE SIDE OF THIS FORM INTEREST AND PEN. .12 TOTAL DUE 3.63 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · )f ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. " IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl, YOU MAY BE DUE A REFUND. ~ SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. -- Make check or money order payable to: REGISTER OF WILLS, AGENT. 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-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and or speaking needs: 1-800-447-3020 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-150!) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (57-) discount of the tax paid is allowed. PENALTY: The 157- tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (67-) percent per annum calculated at a dailY rate of .000164. All taxes which became delinquent on or 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 2004 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ffi2 ~ ~ rn8-1991 ---m- :Do"03iii' Ziiiii --w- .iiiiD247 1983 167- .000438 1992 97- .000247 2002 67- .000219 1984 117- .000301 1993-1994 n .000192 2003 57- .000137 1985 137- .000356 1995-1998 97- .000247 2004 47- .000110 1986 107- .000274 1999 n .000192 1987 97- .000247 2000 87- .000219 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER 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. COMMONWEALTH OF PENNSYLVANIA REV-1162EX{ll-96J DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004521 STARNER BEVERLY 350 GEORGETOWN RD GARDNERS, PA 17324 ACN ASSESSMENT AMOUNT CONTROL NUMBER --- fold _n____u_ ___u___ 101 I $4,190.00 ESTATE INFORMATION: SSN, 181-03-9719 I FILE NUMBER: 2104-0310 I DECEDENT NAME: STARNER VIOLET M I DA TE OF PAYMENT: 10/21/2004 , POSTMARK DATE: 10/21/2001 I COUNTY: CUMBERLAND I DATE OF DEATH: 02/29/2004 , I TOTAL AMOUNT PAID: $4,190,00 REMARKS: B STARNER CHECK# 18 INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS 217 , REV-1500 EX (6-00) COMMONWEALTH OF REV-1500 OFFICIAL USE ONLY PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RETURN 21-04-0310 DEPT. 280601 FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT - COUNTY CODE "AR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER .... Violet M Starner 181-03-9719 z DATE OF DEATH (MM-DD-YEAR) JDATE OF BIRTH (MM-DD-YEAR) -.-- w THIS RETURN MU$TBE FilED IN DUPLlCATEWrTli THE C W 2/29/2004 2/7/1915 REGISTER OF WILLS u w (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER -- C w 0, Original Retum D 2 Supplemental Return 03 Remainder Relufn {date 01 death prior lO 12-13-82) ~ ~- 04 LimitedEstate D4a Future Interest Compromise (date of death af1er 12-12.82) 05 Federal Estate Tax Return Required ~~~ u.u wOO o 6 Decedent Died Testate (Attach copy of Will) o 7 Oecedent Maintained a Living Trust (Altach copy of Trust) ,~" u.m 8 Total Number of Safe Deposit Boxes . - < 09. Litigation Proceeds Received 010. SlKlusal Poverty Credit (dateofdealh between 12.31.91 and 1-1-95) 011. Election to lax under Sec_ 9113(A) (Attach Sch 0) - tll!~~~t:tIi)Ni.ili$tij~!iqi.iffl#T~i:!,Ni@t:Q~ilPl:!l'iti~liq~4NP9qNf!pgfftV\iiTMilif9!'ll\lAtl<w$I!Qii4DllgDl~~CTl:DTO' .... - Z w NAME COMPLETE MAILING ADDRESS C 5 South Hanover Street z Robert M. Frey c c. FIRM NAME (If Applicable) Carlisle, Pennsylvania 17013 en w 0: Frey and Tiley 0: c TELEPHONE NUMBER U 717)243-5838 I I ~ OFFICIAL USE ONLY - i 1 Real Estate (Schedule A) (1) 120,000 I 2 Stocks and Bonds (Schedule B) (2) NONE I i , 3 Closely Held Corporation, Partnership or Sole-Proprietorship (3) NONE 4 Mortgages & Notes Receivable (Schedule D) (4) NONE ,--< 5 Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 15,656, 6_ Jointly Owned Property (Schedule F) (6) NONE -I z Dseparate Billing Requested C ~ 7 Inter-Vivos Transfer & Miscellaneous Non.Probate Property L -' (7) NONE ::> (Schedule G or L) ._____.J .... ii: .. 8 TOTAL GROSS ASSETS (total Lines 1-7) (8) 135,656 U w 0: 9 Funeral Expenses & Administrative Costs (Schedule H) (9) 21,515 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) :10) 21,023 I 11 TOTAL DEDUCTIONS (total Lines 9 & 10) (11) 42,538 12 NET VALUE OF ESTATE (Line 8 minus Line 11) (12)~_ - 9:l,,11Jl 13 Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not , been made (Schedule J) (13) I 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) '- 93,11_8. SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate ,or transfers under Sec9116 (a)(1.2) x ,0 -- (15) Z -- "--._--- 0 i= 16. Amount of Line 14 taxable at lineal rate 93,118 x .045 _~,190 .. (16) .... -- ------- ::> c. :. 17, Amount of Line 14 taxable at sibling rale x ,12 (17) c -- -. U X x .15 .. 18. Amount of Line 14 taxable al collateral rate (18) .... ~. 19, Tax Due (19) 4,190 ~i20,Q q~~(\ilJ;il~~ijl~OC(!il!r,m~!~ij~~~ri~~!~~ijiiil~p;Qii~!.iJ!v~~!.f~~M~fiji . "'.."'.I!$.$Q!'{$.TqANllW!$~A4".QQg$TjQN$ql'J!'{$Y!$~$~$j!:!l;Al'JP;Rl;PHECK.."'AtHk.~.. .-~~- -~~-- - 217 Violel M Starner 181-03-9719 Decedent's Comolete Address: STREET ADDRESS 329 Starner Station Road CITY I~TATE IZIP Gardners PA 17324 Tax Payments and Credits: ,. Tax Due (Page 1 Line 19) (1) 4,190 2 Credits/Payments A Spousal Poverty Credit B. Prior Payments C. Discount Total Credits ( A + B + C ) (2) 3 InleresUPenalty if applicable o Interest E Penally TolallnteresUPenalty ( 0 + E ) (3) 4 If Line 2 is greater than Line 1 + line 3, enter the difference This is the OVERPAYMENT Check box on Page 1 Line 20 to request a refund (4) 5 If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE (5) 4,190 A Enter the interest on the tax due (5A) B Enter the total of Line 5 + SA This is the BALANCE DUE. (58) 4,190 Make Check to: REGISTER OF 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; 0 II] b retain the right to designate who shall use the property transferred or its income; 0 II] c retain a reversionary interest; or 0 II] d receive the promise for life of either payments, benefits or care? 0 II] 2 If death occurred after December 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration? 0 II] 3 Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 0 II] 4 Did decedent own an Individual Retirement Account, annuity or other non-probate property which contains a beneficiary designation? 0 II] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, Under penalties of perjury, I declare that I have examined this relurn, including accompanying schedules and statements, and to the best of my knowledge and belief, il is true, and com lete. Declaration of re arer other than the ersonal re resentative is based on all information of which re arer has an knowled e SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE &""'--<'-''L.L 0 l'Yl. ~d'-"'-L-Ifj.,:>._ 1 0/20/2004 ADDRESS ' / 350 Georgelown Road, Gardners PA 17324 SIGNATURE OF PRE PARER OTHER THAN REPRESENTATIVE DATE <It...,-A -7-> c, J..:.-c 1-1 . 10/20/2004 ADDRESS FordalesofdeathonorafterJuly1,1994andbeforeJanuary1,1995,thetaxrale imposed on the net value of transfers to or for the us e Of the surviving spouse is 3% [72 PS. Section 9116 (a){1.1 )(i)) For dates 01 death on or after January 1, 1995, the tax rate imposed on the net value 01 transfers to or for the use of the surviving spouse is 0% [72 P.S, Section 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 still appticable even if the surviving spouse is the only beneficl8ry For dates of death on or after July 1,2000: The tax rate imposed on the net value of transfers from a deceased Child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0%[72 P.S. Section 9116(a)(1 ,2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4,5%, except as noted in 72 P.S Section 9116(12) 172 P.S, Section 9116{a)(1)1 The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. Section 9116(a)(1 ,3)] .A sibling is defined, under Section 9102. as an individual who has at least one parent in common with the decedent, whether by blood or adoption. AT REV-1502 EX + (1-97) (I) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL EST ATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Violet M. Starner 21-04-0310 ALL REAL PROPERTY OWNED SOLELY OR AS A TENANT IN COMMON MUST BE REPORTED AT FAIR MARKET VALUE, Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts REAL PROPERTY WHICH IS JQINTL V-OWNED WITH RIGHT OF SURVIVORSHIP MUST BE DISCLOSED ON SCHEDULE F ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 329 Starner Slation Road.Dickinson Township, Cumberland County 120.000 SEE ATTACHED TOTAL tAlso enter on line 1 Recanitulation $ 120.000 (If more space is needed. insert additional sheets of the same size) LEGAL DESCRIPTION FOR HOUSE AND LOT OF GROUND OF VIOLET M. STARNER ESTATE DICKINSON TOWNSHIP MAILING ADDRESS: 329 STARNERS STATION ROAD. GARDNERS. PA 17324 ALL THAT CERTAIN tract of land with the improvements thereon erected situate in Dickinson Township, Cumberland County, Pennsylvania, bounded and described in part in accordance with a survey made by Thomas A. Neff, Regislered Surveyor, dated March 19, 1968, as follows: BEGINNING at a spike in the centerline of the public highway being Township Road No. T-528, known as Starners Station Road at the dividing line between land of Violet M, Starner Estate, known as 329 Starners Station Road, which point at the place of beginning is South 30 degrees 22 minutes East a distance of 113 feet measured along the centerline of said road from land formerly of Jane M. Thomas and now or formerly of Richard Sweilzer and land now or formerly of Barbara L. Starner, described in Cumberland County Deed Book "S," Volume 22, Page 514; thence along line of said land now or formerly of Barbara L. Starner described in Cumberland County Deed Book "S," Volume 22, Page 514, North 59 degrees 15 minutes East a distance of 469,60 feet to a stake in line of land now or formerly of said Richard Sweitzer; lhence along line of said land now or formerly of Richard Sweitzer, South 36 degrees 58 minutes East a distance of 253.08 feet to an iron pin; thence running by land now or formerly of Charles C. Starner, South 57 degrees West a distance of 485 feet to station, said station being 15 feet from an iron pin set back along the line, and the said iron pin being seven and five tenths (7.5) feet from a corner of a shop on the within described tract of land; thence from said station and along the road, North 31 degrees 30 minutes West a distance of 269 feet to a point in said road at the Place of BEGINNING. THE ABOVE described tract of land contains an area of 2,865 acres, more or less, and has thereon erected a 2-story dwelling house and other improvements and has lhe mailing address of 329 Starners Station Road, Gardners, P A 17324, THE ABOVE described tract of land is a portion of a larger tract of land which Charles C, Starner and Rose E, Starner, husband and wife, by deed dated October 27, 1947 and recorded November 7, 1947 in lhe Office of the Recorder of Deeds in and for Cumberland County, at Carlisle, Pennsylvania, in Deed Book "Q," Volume 13, Page 510, granted and conveyed to Richard S. Starner and Violet M. Starner, husband and wife. THE SAID Richard S, Starner having died on November 15,2002, title to the same remained vested by operation of law solely in his surviving spouse Violet M. Starner. . ( ) 1. FHA 5ettlementStatl . U. S. Denartment of Housinn and Urban Develo ment Form US HUO PaaeNo. 1 ( ) 2. FmHA 6. File Number 7. Loan Number tl. Mortgage Insurance ( )3.Conv. Unins. RE2294 569936008 Case Number ( ) 4. VA ABST#6056 Second Mortgage Acct No. 9227380 S.Conv.lns. Fundinn No. 6008 C. This form is furnished to give YOll a statement 01 actual senlemenl costs. Amounts paid 10 and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside of theclosino:lheyan~shownherelorinformatlonalpurposesandarenol included In lhelolals. D. Name and Address olSorrower: E. Name and Address of 5eller: RANDY L. WEISS BEVERLY H. STARNER, EXECUTRIX VICKY A. WEISS ESTATE OF VIOLET H. STARNER, DECEASED 845 TORWAY ROAD 5 SOUTH HANOVER STREET GARDNERS, PA 17324 CARLISLE, PA 17013 nN F. Name and Address 01 Lender G. PropertyLocalion GMAC MORTGAGE CORP 329 STARNERS STATION ROAD, GARDNERS, PA ISAOA ATIMA DICKINSON TOWNSHIP 100 WITMER ROAD CUMBERLAND COUNTY HORSHAM, PA 19044 PARCEL NO. 08-16 0212-028 H. Sellel'sSeltlemllnlAgenl: Frey & Tiley Law Office I SememenlDale: PlaceolSeltlement: 5 Soutb Hanover St. September 15, 2004 5 South Hanover Street TIN 25-1730538 Carlisle PA 17013 11:00 AM carlisle, PA 17013 J, SUMMARY OF BORROWER'S TRANSACTION K SUMMARY OF SELLER'S TRANSACTION 100 Gross Amount Due From Borrower 400 Gras. Amount Due To Seller 101 Conlracl sales price 120,000.00 401 Conlr3l::1Selesprice 120,000.00 102Personalproperty 402 Personal properly 103 SeWemenl charges from (line 1400) 3,926.71 '" 10' <1" 105 '05 Adjustments fo, items paid by s8ller in advance: Adjustments fo, items paid by sella, In advance: 106 Cilyllownlaxes9/15/04 1012131/04 103.4B 406 Cllyllown laxes 9/15104 1012131/04 103.48 107 Coun1ylaxes 407 Countylaxes 108 Assessmenls 408 Assessments 109 409 110 5Chool laxes 9/15104 106130105 1,485.04 410Schoollaxes9f15104 106fJOlO5 1,485.04 "' '" 112 "2 120 Gross Amount Due From Borrower 125,515.23 420 Gross Amow,t Due to Seller 121,58B.52 ------------- -------------- - --- - - 200 Amounts PaId By Or In Behalf 01 Borrower 500 Reductlons In Amount Due To Seller 201 Deposil orearnesl money 40,000.00 501 Excessdeposil(seeinstruclions) 202 Principalamounlolnewloan(s)'" Ck $43,524.54 45,000.00 502 Senlemenl charges 10 seller (line 1400) 1,200.00 203 Exisling loan(s) leken subject 10 503 ElIisllngloan(sltakensublectto 204 SECOND HORT~Gl'l (LIKE OF CREDIT) 42,000.00 504 Payollolllrslmortgagaloarl 205 505 Payoll 01 secol1d mortgage loan 206 506 2" 507 208 508 209 509 Adjustments fe' items upaid by seile, Adjustments fe' items upaid by seller 210 CilyllownlaJCes1l1/04 109115104 510 Cilyltownlaxes 1/1/04 109115104 211 CoUlllylall8s 511 CounlylaJC8s 212 Assessmenls 512 Assessments 213 5}J 2145choo!lalles7t1/04 109/15104 514 Schoollaxes7/tl04 109/15104 2)5 5}5 2)6 5}6 . 217 5}7 2)8 5}8 2)9 5}9 220 Tolal Paid BylFor Borrower 127,000.00 520 Tolal Reductions to Ami Due Seller 1,200.00 -------------- -------------- -- --- --- ---- 300 C,sh At Settlement FromfTo Borrower: 600 Cash At Settlement ToIFrom Seller: I 301 I:ioross amount due lromborrower [Ilne 120) I 125,515.23 601 Gross emounllo seller !rom (Iinll 420) 121,588,52 302 Lessamounls paid by/lol borrowel (rrom line 220) (127 ,000,00 602 Less reductions In amounl due seller (Irom line 520): (1,200.001 303 Cash ( ) From (Xl To Borrower (1,484.77) 603 Cash ( I From (X) To Seller 120,368.52 -------------- -------------- IHUD'1 L. SETTLEMENT CHARGES Page No. 2 700 Total SalesIBroker's Comm. based on prIce: 120,1l00.OO " - 0.00 Paid From Paid From 700 Division of Commission (line 700) as foliows: NfA Borrower's Seller's 701 to Funds at Funds at 701 70Z to Settlement Settlement 702 703 703 704 CommissionpaidatSettJement 70' 705 705 BOO Items Payable In Connection With Loan: S59.76 800 (Mortgage Amt: 45",000.(0) 801 Loan Origination Fee 1.000 % to GMAC MORTGAGE CORP. - $450 PAID BY LENDER P.D.C. 801 802 Loan Discount .000 % to 0.00 802 803 Appraisal Fee to 803 804 Credit Report to 80< 605 Lender's Inspection Fee to 805 806 Application Fee to GMAC MORTGAGE CORP. - $325 P.O.C. 806 807 LIFE OF LOAN FLOOD CERT to GMAC MORTGAGE CORP. 2.00 807 80a Tax Service Contract to GMAC MORTGAGE CORP. 85.00 808 809 Flood Certification fee to GMAC MORTGAGE CORP. 17.00 809 810 Document Preparation fee to GMAC MORTGAGE CORP. 295.00 810 811 EXPRESS MAIL to GMAC MORTGAGE CORP. 35.00 811 900 Items Required By lender To Be Paid In Advance: 900 901 Interest From 15-Sep-04 to 1-0ct-04 @ 7.86000 per day.. 125.76 901 902 Mortgage Insurance Premium for months to 902 903 Hazard Insurance Premium for 1 years co STATE FARM 903 90' years to "" 905 905 1000 Reserves Deposited With Lender: ToaJReserveS,Llnesl001 thorughl008: 915.10 1000 1001 Hazard insurance 4 mos. @ $42.67 per month 170.68 1001 1002 Mortgage insurance mos. @ permonch 1002 1003 City property taxes mos. @ permonch 1003 1004 County property taxes 6 mos. @ $29.42 per month 235.36 1004 1005 Annual assessments mos. @ per month 1005 1006 mos. @ per month 1006 1007SchooJtaxes 4 mos. @ $156.84 per month 627.36 100' 1008 Aggregate Settlement Adjustment (117.70) 1008 1100 Title Charges: 1100 1101 Settlement or closing fee to 1101 1102 Abstract or title search to 1102 1103 Title examination to 1103 1104 Title insurance binder to 110< 1105 Oocument preparation to 1105 1106 Notary fees to 1106 1107 Attorney's fees to FREY & TILEY P.O.C. 1107 {includes above items numbers: I t10aTitJelnsurance to FREY & TILEY 1,058.75 1108 {includes above items numbers: I 1109 Lender's Coverage $67,000 45,000 Endorsements: 300, 8,1 1109 1110 Owners Coverage $120,000 120,000 1110 1111 Closing Service Letter to Commonwealth Land Title Insurance Co. 35.00 1111 1112 1112 1113 Overnight delivery fees 0.00 1113 1200 Government Recording and Transfer Chargel DeedPeges: 0 MlgpDgItS.: 1200 1201 Recording fees: Deed $38.50 Mortgage: $66.50 Releases $ 105.00 1201 1202 City/county/stamp: Deed $1,200.00 Mortgage: $ 1,200.00 1202 1203 State tax/stamps: Deed $1,200.00 ; Mortgage: $ 1,200.00 1203 1204 RECORDING FEE FOR SECOND MORTGAGE '1'0 RECORDER OF DEEDS 52.50 1204 1205 1205 1300 Additional Settlement Charges: 1300 1301 Survey to 1301 1302 Pest inspection to 1302 1303 Current Taxes due from Borrower/Seller to Carolyn R. Mcquillen, Tax Collector 1303 1304 TERMITE REPORT FEE 0.00 1304 1305' 1305 1306 1306 1307 1307 1400 Total Settlement Charges (enter onllnes 103, Section J and 502, Section K) 3,926.71 1,200.00 1400 --......--......-.....- ..------....--..-- AT REV-1508 EX + (1-97) (I) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FilE NUMBER Violet M. Starner 21-04-0310 Include the proceeds ollitlgat'on and the date the proceeds were received by the estate. ALL PROPERTY JOINTLY.OWNED WITH THE RIGHT OF SURVIVORSHIP MUST BE DISCLOSED ON SCHEDULE F ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, ACNB, Checking Acct #61 0976 1,680 2. Refund, Nationwide Insurance Company 38 3. Proceeds from Auction of Household Contents(Automobile included for $250) 13,438 4. Refund, 2003 PA Departmenl of Revenue 500 TOTAL (Also enter on line 5 Recapitulation $ 15656 (If more space IS needed, Insert additional sheets of the same size) ',.."_n.~_.,~, ~ ADAMS COUN1Y NATIONAL BANK May 19,2004 Frey & Tiley Attorneys at Law 5 Soulh Hanover Street Carlisle, PA 17013 Re: Estate of Violet M. Starner Dear Mr. Frey: The following information is being provided as per your request: Acc!. Type Account Account Accrued Ownership Date No. Principal on Interest to Account D,O.D, D,O.D. Opened Checking 610976 $1,679.19 $.58 Individual 4-1-87 Inquiries concerning ACNB Corporation stock information should he directed to the Registrar and Transfer Company at 1-800-368-5948. If you need any additional information, please contacl me at (717)338-2171. Sincerely, Y7~ n L/1rT"\..L. Lois Killle Deposit Services . ODOMETER STATUS C ~ ACTUAL MILEAGE 1 = MILEAGE EXCEEDS THE MECHANICAL LIMITS 2=NOTTHEACTUALMILEAGE 3 _ NOT THE ACTUAL MILEAGE-ODOMETER TAMPERING VERIFIED 4 ~ EXEMPT FROM ODOMETER DISCLOSURE T1TLE BRANDS A ~ ANTIQUE vEHICLE VIOLET M STARNER c ~ CLASSIC VEHICLE D ~ COLLECTIBLE VEHICLE 329 F ~ OUT OF COUNTRY STARNER G ~ ORIGINAli.Y MFGD_ FOR NON.US DISTRIBUTION GARONERS PA H ~ AGRICULTURAL VEHICLE L ~ LOGGING VEHICLE P ~ ISNIAS A POLICE VEHICLE R _ RECONSTRUCTED S "STREET ROO T ~ RECOVERED THEFT VEHICLE V" VEHICLE CONTAINS AEISSUEOVIN w~ FLOOD VEHICLE SECOND LIEN FAVOR OF" X..ISlWASATAXI If a second lienholder Is Ilsled upon satislaclion of lhe first lien ,thelirst lienholder musl lorward lhls Tille to lhe Bureau 01 Motor Vehicles wilh the FIRST LIEN RELEASEO ~ epproprLale form and Ille. DATE " SECOND LIEN RELEASED AUTHORIZED REPAESENTATIVE DATE MAILING ADDAESS " 039036 AUTHORIZED REPRESENTATIVE VIOLET M STARNER 329 STARNER STATION RO GARONERS PA 17324 I cer1lfy as of lhe date 01 issue. Ihe official ,ecords 01 Ihe Pennsylvania Deper/menl BRADLEY L ot Transpor/aljon rellect thai the pe,son(s) Of COmpany named herein is Ihe lawful owne, of lhe said vehicte If a co-purchaser other than your spouse is listed and you want the tiUe to be listed as "Joint Tenants With Right of Survivorship' (On death of one '" '" YEAR owner, title goes 10 surviving owner.) CHECK HERE O. Otherwistl, the title will be issued as "Tenants in Common" (On death of one owner, interest 01 deceased owner goes to hislher heirs or estate) SIGNATUflEOFPERSONA[)MINISTER'NGO.o,TH .... tF NO LIEN. CHECK [ZJ 1ST LIEN DATE: 1ST LIENHOLDER STREET my STATE m FINANCIAL INSTITUTION NUM8ER I-' D 00 2ND LIEN DATE -+- tF NO LIEN. CHECK Th& ""d."'go.d tl.mby m,_., 'po""""on lor C.~Iho". 01 Td'. 10 Ih. "h,ol. d.,,,;b'd ~ obo.., ,ubj.cl to 'h..",:<,mb..""...nd o'h., log.1 Claim. "I ronh h .r. 2ND LIENHOLDER W STREET I-' SI('mATUREOFAPPLlCANr[)RALJTf-l[)AIZEOSIGNEil 0 my STATE '" OJ U1 Little lKE Eichelberger, Auctioneer Dillsburg, PAl 70 1 9 Phone Number (717) 432-0006 PA License # AU. -001954-L Statement of PublW Sale Held For E.S//tTFcJf V,'o/.."TST~fi GTL JU}\j ;)..Lj, .)coy EXPENSES / 1 Advertising..,...... ...."..,...,......, ...".....,.,',..,......,..,..,...,..."....,...,... J 49 . I ~ Insurance... .,. .,.. ,. ,.. ,.. ,.. ,., .., .., ... .,. ,.. ,.. ,., .., ............ ,.. Auctioneer's Commission,..... ,., '" .., .., '" .,. ,..... ,.,." ...... 139f'.33 Real Estate Commission,.. ,., ... ... .., ..,...... ',. ,..... ,.. ,....,... - . Clerk's Commission,..... .f}.u.~:,T'.0.'rJ.:c~,fl,...... ,Pfl:.'/.L..... - Runners Pay.. ,.. ... .., .Lf.,. ~.,S'O':...e.~If..,.........,.......... 0200,0G Miscellaneous Expenses.., J-j. e.. ~.O:.().o.. ..0(.;,7. (J.p. d- '-10 . 0 0 Total Expense. '" ............... ...... ...... ......... ... ................. /9'?8',O7 RECEIPTS Gross Sale.,.... ',. '., ,.. ,.. ,.. ,.. ,.. .., .., '" ..,.... '.... ,.. '.. ,.. ,.. I I G6 J.. . 7 S- , Less Expenses...... .,.... .,. '.. '.,... '..... ,.. '.. ,........ .,..., ',. ) CJ 8'?'. 07 Less Uncollected Amount... .Uo.': J~. ,. C Jqc:-K..,.. 105.00 Total Net of Sale......... ................................ .......... 9 SS9.bf' . 1 received $ 9559, 15 from proceeds of the listed sale on ?/ ,). Lt/O '-) Signature&.A-f~ s:rt-;-;;/1/VV)A Date '/_;;:J,'I-oY- Little IKE Eichelberger, Auctioneer Dillsburg, P A 17019 Phone Number (717) 432-0006 P A License # AU. -001954-L ~ 15 ;)" . ~Stajhnt of Public Sale eld For /b ( o.l!d .1./Yl.RA on EXPENSES Advertising..,..,... ,.......,..,...,...,...........,..... .,..,..,.........,.... .....,.,..". jeJ/S', Oc1 Insurance.., ,., ... ,., .., ,., .., ... .,. ... ... ,.. '" ... '" ... ... ... .., ... ... Auctioneer's cornmission..j~......... ,........ ,....,...... c<!'f.~3 Real Estate Commission..............,......... ,.. ,.. ,.. ,.. ,....,.., - - Clerk's Commission... ,....,..,..,..,.................. ................. Runners Pay,.. j., &2... .$O'.OQ, .:eR-. .,. ........................ cQO(), DO Miscellaneous Expenses............................................. Total Expense.... ....... .............. ...... ......... .... ................ jYCltf, as RECEIPTS Gross Sale......... ,..... ,..... ,...................,.....,............ /7?b'.,JS Less Expenses..,......... ,.............,.....,..................... / ,/;)9- a c . Less Uncollected Amount....................,.....,.............. Total Net of Sale..... ......... ...... ............................... ,3 5'(0, ()Q . 1 received $ 2s-(p,C>o from proceeds of the listed sale on 7 -/S--Q /tJ Signature ~ S;t'~ Date 7 -{ !>-o'f- 217 REV-1511 EX+ (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Violet M Starner 21-04-0310 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1, Hollinger Funeral Home & Crematory 7,739 2. Codori Memorials, Inscription on Foot Slone 125 B, ADMINISTRATIVE COSTS: 1, Personal Representative's Commissions Name of Personal Representative (5) Beverly Starner Social Security Number(s) I EIN Number of Personal Representative(s) 207-30-5874 Street Address 350 GeorQetown Road City Gardners State P A Zip 17324 Year(s) Commission Paid: 2004 6,426 2, Attorney Fees 6,426 3. Family Exemption: (If decedent's address is not the same as claimant's. attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 219 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Check cleared after date of dealh 246 8. Cumberland Law Journal, Advertising 75 9. The Senlinel, Advertising 102 10. Regisler of Wills, Additional Probate Fee 35 11. Register of Wills, Filing Fee for PA Inheritance Tax Return 15 12. Register of Wills, Filing Fee for First and Final Report 107 TOTAL (Also enter on line g Recaoitulalion $ 21515 (If more space Is needed, insert additional sheets of the same size) REV,1512 EX+ (12,03) 217 SCHEDULE I COMMONWI;ALTH 01= PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Violet M Starner 21-04-0310 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, MetEd, Eleclricity 114 2, Carolyn R. McQuillen, Tax Collector(2004 County and Township Taxes) 259 3. Carolyn R. McQuillen, Tax Collector(2004 School Taxes) 397 4, Larry Foote, Appraiser 275 5, The Shelby Insurance Company, Policy #HMOOOO03930 80 6, Associates Products, Auction Expense 148 7. lke Eichelberger, Auctioneer, Advertising and Expenses 3,522 8, Recorder of Deeds, Slate Tax/Stamps 1,200 9. Green Acres Nursing Home, Medical 600 10, Commonweallh of Pennsylvania, PA Department of Welfare, Medical 14,428 TOTAL (Also enler on line 10, Recapitulation) $ 21,023 (If more space IS needed, Insert additional sheets of the same size) 217 REV-1513 EX + (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Violet M Starner 21-04-0310 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(SI RECEIV,NG PROPERTY Do Not List Trust..ls) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Beverly Starner 350 Georgelown Road Gardners PA 17324 Daughter 50% residue of estate 2, Dwight Starner DIED DECEMBER 12, 2001 (2) Surviving Children of Dwight Slarner Son 3. Kellie Campbell 39 Locust Slreel Mt. Holly Springs PA 17065 Granddaughter 25% residue of estate 4. Eddie Starner 335 Starner Stalion Road Gardners PA 17324 Grandson 25% residue of estate ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-15QO COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAAIS NOT BEING MADE 1, S, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART 11- 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) LAST WILL AND T~STAMENT OF VIOLET M. STARNER I, Violet M. Starner, of R.D: 2 Gardners, Cumberland County, Pennsylvania, declare this to be my last will arid revoke any will previously made by me. ITEM I: I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a .part of' the administration of' my, es'tate.. , ".. '..- - ~""""""''''~ '...... ;.",........:.r .;...~~.-..i. ;_;._~_._-" ;..~:..,...<.O:. ITEM II: I devise and bequeath all of my estate of every nature and wherever situate to my ,husband, Richard S.. Starner, providing he shall survive me by thirty days. ITEM III: Should my husband, Richard S. Starner, predecease me or die on or before the thirtieth day following my death, I devise and beoueath all of my estate of every nature and wherever situate to my issue oer stirpes living on the thirty-first day following my death. It is my desire that the shop and the tools and equipment therein shall be held by my issue as tenants in common. J;TEM, IV: All federal, state and other death taxes payable . . - , "! ' 'f, . _,,' .,~. _ -.... ....:. ~ ...::'" . because of' my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this will, including any interest or penalty imposed in connection with such tax, shall be considered a part of the expenses of the administrat- ion of my -estate and shall be paid out of the principal of my estate . without anportionment or right of reimbursement. ITEM V: I appoint my husband, Richard S. Starner, executor of this my last will. Should my husband, Richard S. Starner, fail to \J~~f in /\EI~70Q~ Qualify or cease to act as executor, I appoint my son, Dwight Starner, and my daughter, Beverly Starner, executors of this my last will. ITEM VI: I direct that my executor or his Successors shall not be renuired to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WH8REOF, I have hereunto set my hand this /? zL4 day of h~:-~~r-v , 1976. / \J/~f ~) YY\ The preceding instrument, consisting of this and one other typewritten page, each identified by the signature of the testatrix, was on the day and date thereof signed, published and declared by Violet M. Starner, the testatrix therein named, as and for her last will, in the presence of us, who. at her request, in her presence, and in the presence of each other have subscribed our names as witnesses hereto. ~::J-1 !j2A> P~Jl~ residing at k);), / 4 -&t--Q t:;J /7."1 A Y I ~7~ A::/ cP ~~ ~/75~ -...... ..,' ~/ t/ ~ (/ ~. ~ --L~ residing at _ . 2--_/ - ~ cY;~IJ, ~ residing at If fl;? ~ (;r~ /?3~fL . COMMONWEALTH OF PENNSYLVANIA '* DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISION PO BOX 280601 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE HARRISBURG, PA 17128-0601 OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1m EX AFP [09-04) DATE 12-20-2004 ESTATE OF STARNER VIOLET M DATE OF DEATH 02-29-2004 FILE NUMBER 21 04-0310 COUNTY CUMBERLAND ROBERT M FREY ACN 101 FREV . TILEV I "ount __itt.. I LL 5 SURANOVER ST C)~ARdsLE 1--& PA 17013 U_J' J - 0::' Q :::'::: - ::::>C:: MAKE CHECK PAYABLE AND REMIT PAYMENT TO: 1--1- ---;:ac .-' LI..- !' OC%: u-O"--> ISTER F C) c5 ODe REG 0 WILLS 9 q:: r- ~~:_;~ CUMBERLAND CO COURT HOUSE ~H:J - ::J:ti:;;~ CARLISLE, PA 17013 a.:: ~'.:? u u:r: t, ~i.-~~I~~p-~.iY-~-fCE!l_~~~{~H~~~~~N~~~~i~~A~~~AY~~~-E~f:~~~l-OWA~-(fR----------------- ~ U DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF <STARNER VIOLET M FILE NO. 21 04-0310 ACN 101 DATE 12-20-2004 TAX RETURN WAS: (X) ACCEPTED AS FILED () CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 120 . 000 . 00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2).00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 subllit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this forll with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 15.656.00 tax paYllent. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets (8) 135,656.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 21.515.00 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule IJ (10) 21.023.00 11. Total Deductions (11) 42.53800 12. Net Value of Tax Return (12) 93,118.00 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 93,118.00 NOTE: I~ an assessment was issued previoUSly, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) .00 X 00 = .00 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 93,118.00 X 045 = 4.190.00 17. Allount of Line 14 at Sibling rate (17) .00 X 12 = .00 18. Allount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00 19. Principal Tax Due (19)= 4.190.00 TAX CREDITS: DATE 'NUMS6ER INTEREST/PEN P~~D (_) AMOUNT PAID 10-21-2004 CDo04521 .00 4,190.00 TOTAL TAX CREDIT 4,190.00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 · IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.~~~ REV-l500 EX (6-00) COMMONWEAlTH OF REV-1500 OFFICIAL USE ONLY PENNSYLVANIA . DEPARTMENT OF REVENUE INHERITANCE TAX RETURN DEPT. 280601 FILE NUMBER 21-03-00310 HARRISBURG, PA 17128-0001 RESIDENT DECEDENT - CODE ...... .....ER DECEDENTS NAME (lAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY N~ER .... Dum Josiah F 209-28-9107 z DATE OF DEATH (M\I-llD-YEAR) DATE OF BIRTH (M\I-llD-YEAR) l!I TMI RETUM..,. BE PLIO If DUPUCAn:wmt THI W 2/4/2003 11/27/1927 REGISTER OF WILLS u l!I ~F APPlICABLE) SURVMNQ SPOUSE'S NAME (lAST. FIRST. AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Clara S Dum 195-28-0123 = 0 1. Original Reb.lm o 2. &Jpplemental Retum 03. R........RIIIm(dlhgf....plforlo12-13-82) hD D4a. Future Interest: Compmmise (date of death after 12-12-82) 05. Federal Estate To Reb.lm Required ~ S ~ 4. Umit8d Estate ~D:9 ~ o 7. DececIent MaIntained 8 living Trust (Attach copy of Trust) CJ 8: III X 6. Decedent Died TestaIIl (AtIach copy of Will) 8. Total Number of Safe DeposIt Boxes 0( D 9. LftigaUon PRXleeds Rec:el\ted 010. SlloUIIlIPowltyCnd(dDof.....~ 12-3141 MIl 1-1-11I) o 1. ElectIon to tax under Sec. 9113(A) (Attach Sch 0) .... z NAME w COMPlETE MAlUNG ADDRESS Q 5 South Hanover street z Robert M Fre 0 FIRM NAME (If Applloablo) iii Carlisle, Pennsylvania 17013 w Fre and Tile i 0 TElEPHONE NUMBER u 717243-5838 OFFICIAL USE ONLY 1. Roo! ~ (SchOllule A) (1) 0 ....~ 0 <.'" II 2. S10cIcs and _ (Schedule B) (2) 377,706 c,~, Co 4..- R2~ ;?,~j~ 0 3, CIoooIy Held Corporation, Po_lp or SoJe.Proprietonp (3) NONE r"l c-:' 0 r I-~-C) ,-) >:;1f,~ 4. Mortgageo & _ R__ (SchOllule 0) (4) NONE ~~; ~~ ~ c..-> 0 -::,-~) C:A7 S. Ceoh. Bank Oopoolts & _le...us _I Property C"") ("-) (Schedule E) (S) 0 (:;0 -':1 ""1', 4~1 (")C)~n ::.", _ --'~'l 8. ~ Owned Pmpeny (_ulo F) (8) 57,627 C)j~; ;'~,~~ ('c') -',,--' (-:? F~ rn z D~ BllUng Requeoted ~J~-i ~ c/) (."'.:) )> Ul -Ai, j 7. Inter-Vivos Transfer & Mlscellaneou& NonaProbate Property .- F! (ScheduIeGorL) (7) 242,141 Ii: ~ 8. TOTAL GROSS ASSETS (1oIaI U.... 1-7) (8) 677,474 II: 9. Fun8l'lll1 Expenses & Administrative Costs (Schedule H) (9) 21,462 10. DebIo of Decedent, Mol1gege Lieblllties, & LJeno (Schedule ~ :10) 0 11. TOTALDEOUCTIONS(kh1 U....9& 10) (11) 21,462 12. NeT VALUE OF ESTATE (Uoe 8 minus Un. 11) (12) 656.012 13. CharttabIe and Governmental BeqU8ll8lSec 9113 Trusts for which an efection to tax has not '-" mode (Schedule J) (13) 0 14. Net V.lue Subfect to Tax (Une 12 minus Line 13) (14) 656,012 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUcABLE RATES lS. Amount of Uno 14 _bIe at the spousal lax Z .... ,orll8ll8fenl ulld...See.9118 (0)(1.2) 656,012 x .O~ (15) 0 a 18. Amount of Une 14 taxatM at lineal rate x .0 (18) 0 :!: - i 17. Amount of line 14 taxable at sibling rate X ,12 (17) 0 8 ~ 18. Amount of Une 14 taxable at collateraJ rate X ,15 (18) 0 19. Tu Due (19) 0 217 Dum, Josiah F 209-28-9107 CITY STATE IP Carlisle PA 17013 Tax Payments and Credits: 1. TOll Due (Pogo 1 Line 19) (1) 0 2. Cledil8/Paylnenhl A. Spouoal P<Moty CledM B. Prior Payments c. Olocount Total Credits (A+ B+ C) (2) 0 3, 1_ItyWappl_ D._ E, Panalty Tolall_Ity(D+E) (3) 0 4, tf Une 2 is gre&ter than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Une 20 to req..... refund (4) 0 5, !fline 1 + line 3 is greater than line 2, enlerthe difrerenoe. This is the TAX DUE. (5) 0 A. Enter the inter8st on the tax due. (SA) B. Enter the tolel 01 Line 5 + SA. Thi& is the BALANCE DUE. (5B) 0 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: V.. No a. retain the use or income of the propertytranaferred; . . . . . . . . . . . . . . . . . . . . . .. 0 [RJ b. retain the right to designate who shall UII8 the propeI1y transferred or its Income; . . . . . . . . . . . 0 [RJ c. retain a reversionary interest: or . . . . . . . . . . . . . . . . . . . . . . . . . 0 [RJ d. receive the promise for life of either payments, benefits or care? . . . . . . . . .. . . .. 0 [RJ 2, If death occurred after December 12,19B2,did decedent tranefer property within one year of death __ngadequate...-.uon? . , . . . . . , . . . , . . . , , . . . . . , . . . " 0 [RJ 3. Did decedent own an -in trust for" or payable upon death bank account or secwity at his or her death? . . . . 0 [RJ 4. Did decedent own an Individual Retirement Account, annuity or other non-prob&te property which oontainsabenef"tcililIryde8lgnation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. [RJ 0 IF THE ANSWER TO AHY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLm SCHEDULE G AND FILE IT AS PARr OF THE RETURN. Under perIIIIties cA perjury, I cIec:IaM that I Mve examined this l1IIum, indudlng IlCCOmpllnylng schedules and statementa, and to the beet d my knowtecIge and belief, it Is true, and ~. ~ dDr'ePlnrOCherthanthe PMlklnIIII__.w:i...1s baud on all inforrnlItion dwhlch DND8rerhMllnYknowIedae. ETURE OF PERSON RESPONSIBLE FOR FILING REllJRN DATE r~~ )0'/ a.i<.L- 4J '1'0 ~ - ~.11. c SS , , 3437 Pleasant Valley Road. Elliottburg PA 17024 SIGNATURE OF PREPARER OTHeR 1l-tAN REPRESENTAT1VE DATE lJ-j3d / Of ~ ~_ "'4>-, ADDRESS 5 South Hanover street, Carlisle PA 17013 Ford8lllBoIcIe8th on or""" July 1, 1994 and befonlJ8nUllfY1, 1995, thetof8leknposed on the net value dnnsferl to or for the usedthe survilling spoou is 3'J. [72P.5.Section9116(a)(1.1)(I)). For dal8s of deIth on or lIbr JanU8IY 1, 1995, the _ late irnpoMd on the net wlue of tIanlill'ers to or for the use of the surviving spouse Is ~ [72 P.5. Section 91 16 (8)(1. 1)fll)]. The statuI8 doee not 8IlIllmpt a transfer to a SUl'VMng spouM fn:m bIx, and the stlItutoly Jequil1lll1'lel'lls for dlscloeure of .... and fMIng a to retum are still applieable even If the IIl.IIYMng 8pOUM Is the only benefioiary. For dal8s of cIeaItI on or lIbr July 1, 2000: The tax ,.. impoeed on the net value of Ifan8I8ns from . deceued child twenty.one )'811" of age or younger at death to or for the use of a natural parent. an adoptive plIrent, ora st8pparentdthe child 1s~[72 P.S. Section 9116(a)(1.2)}. Tlle1ax ratB irnpoud on the netvalue oftransfefs to or for the usa of the decedent's lineal beneficiaries is 4.5'1., except.. r'IOCed in 72 P.S. Section 9116(1.2) [72 P.S. Section 9116(8)(1)). ThetaxralltimpoMd on the netva_dnnsreratoorforthe usedthe decedent's siblings Is 12'10 [72 P.S. SectIon 9116(8)(1.3)].A sibling Is defined, under SectIon 9102. as an IndMduaI who has at least one plIrent In common with the decedent, whIIti'Mtr by blood or adoption. 2'17 . REV-1503 EX+ (6.98) SCHEDULE B COMMONWEAlTH OF PENNSYlVANIA STOCKS & BONDS INHERITANCE TAX REnJRN RESIlENT DECEDENT ESTATE OF FIlE NUMBER Josiah F Dum 21..Q3-00310 AH property joInlIy-owned wIIIl right of survivorship must be dl_ on _uIe F, ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, Series EE Bonds 6,383 2. Janney Montgomery Scott LLC, Fund 29123479 AT&T(40sh@18.57) 743 AIM Premiere Equity CI B(2,606@6.80) 17,718 AOL TimeWarner(100sh@11,07) 1,107 CH Energy Group( 12sh@43. 17) 518 Charter Municipal Mortgage(1,416@17.55) 24,851 Delaware PA Tax Free Fund Class A(7,221@8.05) 58,128 Dana Corp(100sh@10.68) 1,068 EV Insured Muni ond Fund(667sh@14.05) 9.371 Evergreen Fixed High Yield Fund Class C(3,340sh@3.13) 10,453 GE(200@23.05) 4,610 Glaxo Smith Kline(100@37.46) 3,746 Hancock Regional Bank Fund Class B(225@32.06) 7,223 Intel(100@15,64) 1,564 International Paper Cap 7.875%(200@25.44) 5,088 Lucent Technologies(64@1,65) 106 MFS Mass Inv Trust Class B(1,956@12.08) 23,627 PLM Equipment Growth Fund(500@1,01 505 PPG Industries( 1, 375@48.77) 67,059 Putnam Fund SBI Class (3,670@14.52) 53,289 UPS Class B(100@59,95) 5,995 Un~ed Technologies Corp(100sh@64.42) 6,442 CommonweaRh Growth LP 1(500@8,OO) 4,000 Berkshire Income Realty Inc(114 @14,09) 1,606 PLM Equipment Growth Fund VI LP(1,000@1.50) 1,500 Harrisburg PA 5,OO%Due 8-1-2010(10,OOO@101.96) 10,196 North Wales PA 5.00%Due 2015(10,000@107.82) 10,782 Phila PA 5.625%Due 11-15-2018(15,OOO@103.27) 15,490 PhillDR 6,00 Due 7-1-2006(10,OOO@96.66) 9,666 West Shore Pa 5,75%Due 1-1-2015(5,OO0@105.12) 5,256 Comeast, AcctfIOO028365496(97sh@24.99) 2,424 NCR, AcctfIOOOO044578(12.5sh@18,67) 233 PPG(145sh@48,77) 6,637 Lucent Technologies(195sh@1,65) 322 TOTAL (Also enter on line 2 RecaD~ulation' $ 377 706 (If more space is needed, insert add~ional sheets of the same size) Savings Bond Calculator Page] of4 . Value As Of Savinc 108/2004 f Up-dat~ ~':"-~-~.l L Help- J Bond Info Series Denomination Serial Number Issue Date I EE Bonds ~ $175 ~. I 1 ~ ! ~- Results # Bonds Total Price Total Interest Total Value YTDln' 114 $5,125,00 $7,640.72 $12,765.72 $331. Issue Interest Next Filial Serial Number Issue Date Series Denom Price Interest Value Rate Accrual Maturity k51836198 07/1985 EE $75 $37,50 $74.40 $111.90 4.00% 01/2005 07/2015 k51836209 0811985 EE 75 37.50 74.40 111.90 4.00% 02/2005 08/2015 i k5]230616 09/1985 EE 75 37,50 72,21 ]09.71 4,00% 09/2004 09/2015 ! k5]230692 10/1985 EE 75 37.50 72.2] 109,7] 4,00% 10/2004 10/20] 5 k5]247292 ll!] 985 EE 75 37.50 72,2] ]09,71 4.00% ] 1/2004 11/2015 k5124738] ]2/] 985 EE 75 37.50 72.2] 109,71 4.00% ]2/2004 ]2/2015 k51247448 01/] 986 EE 75 37,50 72.2] 109,7] 4,00% 01/2005 01/20]6 k5]247536 02/] 986 EE 75 37.50 72.2] 109,7] 4,00% 02/2005 02/20]6 k51247607 03/1986 EE 75 37.50 70,05 107.55 4,00% 09/2004 03/20]6 k60827600 04/1986 EE 75 37,50 70,05 ] 07.55 4,00% 10/2004 04/20]6 k60827627 0511986 EE 75 37,50 70,05 107.55 4.00% 1 ]/2004 OS/20]6 k60827717 06/1986 EE 75 37,50 70,05 107.55 4.00% 12/2004 06/2016 k60827771 07/1986 EE 75 37,50 70.05 107.55 4.00% 01/2005 07/2016 k60827840 08/1986 EE 75 37.50 70,05 107,55 4,00% 02/2005 08/2016 k64765782 09/1986 EE 75 37,50 67,95 105.45 4,00% 09/2004 09/20 16 k64765855 1011986 EE 75 37,50 67,95 105.45 4,00% 10/2004 ]0/2016 k64765949 11/1986 EE 75 37.50 57.30 94,80 4,00% ll!2004 11/2016 k64766063 12/1986 EE 75 37,50 57.30 94,80 4.00% ]2/2004 12/2016 k647661]6 01/1987 EE 75 37,50 57,30 94,80 4,00% 01/2005 01/2017 ~. k70995023 02/1987 EE 75 37.50 57,30 94,80 4.00% 02/2005 02/2017 k70995103 03/] 987 EE 75 37,50 55,59 93,09 4,00% 09/2004 03/2017 k70995190 04/1987 EE 75 37,50 55,59 93,09 4,00% 10/2004 04/20]7 ~ ~ k70995282 05/1987 EE 75 37.50 55.44 92,94 4.00% 11/2004 OS/2017 ~ c136813371 06/1987 EE 100 50,00 73.92 123,92 4,00% 12/2004 06/2017 G cl46133547 07/1987 EE 100 50,00 73.92 123,92 4,00% 01/2005 07/2017 c146133719 08/1987 EE 100 50,00 73,92 123.92 4,00% 02/2005 08/20 17 cI46133902 09/1987 EE 100 50,00 71.48 121.48 4,00% 09/2004 09/20 I 7 c146337704 10/1987 EE 100 50,00 71.48 121.48 4,00% 10/2004 10/20 I 7 http://wwws,publicdebt.treas,gov/BC/SBCPrice 8112/2004 Savings Bond Calculator Page 2 of 4 c46337973 11/1987 EE 100 50,00 71.48 121.48 4,00% 11/2004 11/2017 c146307210 12/1987 EE 100 50.00 71.48 121.48 4,00% 12/2004 1212017 cl 4630742 I . 01/1988 EE 100 50,00 71.48 121.48 4.00% 0112005 01/2018 c146307612 02/1988 EE 100 50,00 71.48 121.48 4.00% 02/2005 02/2018 c146829938 03/1988 EE 100 50,00 69.12 119.12 4,00% 09/2004 03/20 18 c146830173 04/1988 EE 100 50,00 69.12 119.12 4,00% 10/2004 04/2018 cl72341294 05/1988 EE 100 50,00 69.12 119.12 4,00% 11/2004 OS/2018 c172341496 06/1988 EE 100 50,00 69.12 119,12 4,00% 12/2004 06/2018 c172341706 07/1988 EE 100 50,00 69.12 119.12 4,00% 0112005 07/2018 c187481355 08/1988 EE 100 50,00 69,12 119.12 4.00% 02/2005 08/2018 c187481577 09/1988 EE 100 50,00 66,76 116,76 4,00% 09/2004 09/20 18 c188318566 10/1988 EE 100 50,00 66,76 116,76 4.00% 10/2004 10/2018 c188318794 11/1988 EE 100 50.00 66,76 116,76 4,00% 11/2004 11/2018 cl88562859 12/1988 EE 100 50,00 66,76 116,76 4.00% 12/2004 12/2018 , c188563087 01/1989 EE 100 50,00 66,76 116,76 4,00% 01/2005 01/2019 c203869469 02/1989 EE 100 50,00 66,76 116,76 4,00% 02/2005 02/2019 ~ c203869715 03/1989 EE 100 50,00 64.48 114.48 4,00% 09/2004 03/2019 ~ c216906158 04/1989 EE 100 50,00 64.48 114.48 4,00% 10/2004 04/2019 J c244727074 03/1990 EE 100 50,00 60,04 110,04 4,00% 09/2004 03/2020 c216906394 05/1989 EE 100 50,00 64.48 114.48 4,00% 11/2004 OS/2019 Y c216906645 06/1989 EE 100 50,00 64.48 114.48 4,00% 12/2004 06/2019 c21693520 I 07/1989 EE 100 50.00 64.48 114.48 4,00% 01/2005 07/2019 c226158414 08/1989 EE 100 50,00 64.48 114.48 4,00% 02/2005 08/2019 c226285257 09/1989 EE 100 50,00 62,24 112,24 4,00% 09/2004 09/2019 c228411200 10/1989 EE 100 50.00 62,24 112,24 4,00% 10/2004 10/2019 f:J c230573270 11/1989 EE 100 50,00 62,24 112,24 4,00% 11/2004 11/2019 {f'? c238522788 12/1989 EE 100 50,00 62,24 112.24 4,00% 12/2004 12/2019 o-? c239845720 01/1990 EE 100 50,00 62,24 112,24 4,00% 01/2005 01/2020 c243 I 06809 02/1990 EE 100 50,00 62,24 112,24 4,00% 02/2005 02/2020 _.....-.. k51836199 07/1985 EE 75 37,50 74.40 111.90 4,00% 01/2005 07/2015 k51836210 08/1985 EE 75 37,50 74.40 111.90 4,00% 02/2005 08/2015 k51230632 09/1985 EE 75 37.50 72.21 109,71 4,00% 09/2004 09/2015 i k51230706 10/1985 EE 75 37,50 72.21 lO9,71 4.00% 10/2004 10/2015 k51247307 11/1985 EE 75 37,50 72.21 109.71 4,00% 11/2004 11/2015 N ~ k51247393 12/1985 EE 75 37,50 72.21 lO9,71 4.00% 12/2004 12/2015 ~ k51247462 01/1986 EE 75 37.50 72.21 lO9,71 4,00% 01/2005 01/2016 ! 161247547 02/1986 EE 75 37,50 72,21 109,71 4,00% 02/2005 02/2016 --: k51247621 03/1986 EE 75 37,50 70,05 107.55 4,00% 09/2004 03/2016 -0_- http://wwws,publicdebt.treas,gov/BC/SBCPrice 8/12/2004 Savings Bond Calculator Page 3 of 4 . k60827,pll 04/1986 EE 75 37.50 70.05 107,55 4,00% 10/2004 04/2016 k60827640 05/1986 EE 75 37,50 70,05 107.55 4,00% 11/2004 05,12016 k60827726 06/1986 EE 75 37,50 70,05 107,55 4,00% 12/2004 06/2016 k60827785. 07/1986 EE 75 37,50 70,05 107.55 4.00% 0112005 07/2016 k60827851 08/.1986 EE 75 37,50 70.05 107.55 4,00% 02/2005 08/2016 k64765795 09/1986 EE 75 37,50 67,95 105.45 4,00% 09/2004 09/2016 k64765865 10/1986 EE 75 37,50 67,95 105.45 4,00% 10/2004 10/2016 k64765962 I1/1986 EE 75 37,50 57,30 94.80 4,00% I1/2004 I1/2016 k64766073 12/1986 EE 75 37,50 57.30 94,80 4,00% 12/2004 12/2016 k64766130 01/1987 EE 75 37,50 57,30 94,80 4,00% 0112005 01/2017 k70995033 02/1987 EE 75 37,50 57,30 94,80 4,00% 02/2005 02/2017 , k70995115 03/1987 EE 75 37,50 55,59 93,09 4,00% 09/2004 03/2017 : k70995201 04/1987 EE 75 37,50 55.59 93,09 4,00% 10/2004 04/2017 k70995296 05/1987 EE 75 37,50 55.44 92,94 4.00% 11/2004 OS/2017 c136813393 06/1987 EE 100 50,00 73,92 123.92 4,00% 12/2004 06/2017 cI46133572 07/1987 EE 100 50,00 73,92 123,92 4.00% 01/2005 07/2017 c146133742 08/1987 EE 100 50,00 73,92 123,92 4,00% 02/2005 08/2017 c146133924 09/1987 EE 100 50,00 71.48 121.48 4,00% 09/2004 09/2017 c146337727 10/1987 EE 100 50,00 71.48 121.48 4,00% 10/2004 10/2017 c146337994 11/1987 EE 100 50,00 71.48 121.48 4,00% 11/2004 I1/20 17 ~ c146307235 12/1987 EE 100 50,00 71.48 121.48 4,00% 12/2004 12/2017 c 146307443 01/1988 EE 100 50,00 71.48 121.48 4,00% 01/2005 01/2018 ~ cl46307635 02/1988 EE 100 50,00 71.48 121.48 4.00% 02/2005 02/2018 ~ cl46829963 03/1988 EE 100 50,00 69,12 119.12 4.00% 09/2004 03/2018 c146830197 04/1988 EE 100 50,00 69,12 119.12 4,00% 1O/200~ 04/2018 cl72341318 05/1988 EE 100 50,00 69.12 119.12 4,00% 11/2004 OS/2018 _cl72341520 06/1988 EE 100 50,00 69.12 119.12 4,00% 12/2004 06/2018 I c226158441 08/1989 EE 100 50,00 64.48 114.48 4.00% 02/2005 08/2019 c226285368 09/1989 EE 100 50,00 62,24 112,24 4.00% 09/2004 09/2019 c228411321 10/1989 EE 100 50,00 62,24 112,24 4,00% 10/2004 10/2019 c230573397 11/1989 EE 100 50,00 62,24 112.24 4,00% 11/2004 11/2019 c238522892 12/1989 EE 100 50,00 62.24 112,24 4,00% 12/2004 12/20] 9 c239845838 01/1990 EE 100 50,00 62,24 112,24 4,00% 01/2005 01/2020 c243 106905 02/1990 EE 100 50.00 62,24 112,24 4,00% 02/2005 02/2020 c216935224 07/1989 EE 100 50,00 64.48 114,48 4,00% 01/2005 07/2019 c216906666 06/1989 EE 100 50,00 64.48 114.48 4,00% 12/2004 06/2019 c216906420 05/1989 EE 100 50,00 64.48 114.48 4.00% 11/2004 OS/2019 c216906182 04/1989 EE 100 50,00 64.48 114.48 4,00% 10/2004 04/2019 http://wwws,publicdebt.treas,gov/BC/SBCPrice 8/12/2004 Savings Bond Calculator Page 4 of 4 . c203869744 03/] 989 EE _ 100 50.00 64.48 ] ]4.48 4,00% 09/2004 03/20]9 c20386949] 02/] 989 EE 100 50,00 66.76 1]6,76 4,00% 02/2005 0~20]9' c]88563114 01/] 989 EE 100 50,00 66,76 116,76 4,00% 01/2005 01/20]9 c]88562882 ]2/]988 EE 100 50,00 66,76 ]]6,76 4,00% ]2/2004 ]2/20]8 cl883] 8822 ] 1/] 988 EE 100 50.00 66,76 116,76 4,00% ] 1/2004 ll/20] 8 c]883]8592 ]0/]988 EE 100 50,00 66.76 116.76 4,00% 10/2004 ] 0/20] 8 c]8748]606 09/] 988 EE ]00 50,00 66,76 11 6,76 4,00% 09/2004 09/20]8 c]8748]385 08/] 988 EE ]00 50,00 69.12 11 9.12 4,00% 02/2005 08/20] 8 cl87481190 07/]988 EE ]00 50.00 69.12 11 9.12 4,00% 01/2005 07/20]8 /U')...~ c244727170 03/1990 EE ]00 50,00 60,04 110,04 4,00% 09/2004 03/2020 ~?/ [View ((fjlViewingBonds 1-114 JI le end Note Description N! Not Issued ~ NE Not E]igib]e for Payment i P5 Includes 3-month interest penalty ~, ME Matured (Exchangeable for HH) :::Jf' MN Matured (Not Exchangeab]e for HH) ) Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator r r r r Submit SUlvey I Reset I http://wwws.publicdebt.treas,gov/BC/SBCPrice 8/12/2004 , - g 0;' ::- :n tJ t: '" 5" S: I :s Ol ~ Ol w~ ~ W~ ~~ N ~~~mw~~ ~N~NWO~~~ ~m - l>o oaa~~o~m~ONoa~OON~~OO~ C'l oooo~om~oo~aoooo~mNama C'l 0 t: '" 0CC~~~~~~~IQQmmOO00>>> - o~~s~r~~ss~~m~<~~iIO~~ 3moo~Q~oom~-nx ~~ww~mr ~ 3~0~~m~~ffi000 ~00~ro~~~~ o~- ~ ~onOO me ~m~'m ~m~~~~~~~'~~3 ~~~~~~m3~ mnoocoo~ooom ~ ~~~c~ ~~ ~ro~~3-~- m~ ~ >~QZ~~ m~ ~ffi'm~~ ID _.~ -. weD ~~ OOOO~<~~ 5'~ ~c ~ga~m < o ro ~~o~ ~~ ~~. wmc~~ ~~ - Q2~m ~m IO x_~~c Q) o CD . 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"" 0)010010000) , WSJ.com Stock Charting for T 10/20/03 ]2:55 PM (NYSE) U,S, Dollar Date Price High Low Volume 2 M,nth (Daily) (:E:'SigCharts.Qc,rn 2/4/03 18.57 19.02 18.1 5,854,700 .......--........-.\ '''6 1 - l ,~~ "L No Splits \ 20 ..y......'\~....------- 1::; . Get another quote any day after 1/2/1970 Feb 1/2/1970 1mo 2mo 3mo 8mo 1Y!: ~ ~ I 12/4/03 [B - - - Symbol: Date: Copyright @ 1998-2003 BjqCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. Copyright@ 2003 Dow Jones & Company, Inc. AU Rights Reserved hltp://www .bigcharts.com/cuslom/wsj ie/wsj bb-historical.asp?symb=T &sid=8630&close _ date=2/4/03 Page 1 of I W~J.com Stoc~ Charting for A VLBX ]0/20/03 12:56 PM (FUND) U,S, Dollar Date Price High Low Volume 2 t,bnt" (Daily) (518igChart::.e,:, rn 214103 6.8 nla nla nla \['\, \ "'5 ,...:.... "\ 1 7.00 No Splits (1"'\, (/\\/, ~ "5 · ' J -.. \ Get another quote any day after 1/2/1970 Feb 11211970 1mo 2mo 3mo 6mo lE 91! 2l'! I 12/4/03 CB - - - Symbol: Date: Copyright @ 1998-2003 BioCharts.com Inc. Historical and current end-of.day data provided by FT Interactive Data. I I Search! I r ~Picture this~ l Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www .bigcharts,com/custom/wsjie/wsjbb_hislorical.asp?symb=A VLBX&c]ose _ date=2%2F4%2F03&x=] 3&y= 12 Page 1 of 1 WiJ.com Slock Charting for AOL ]0120/03 ]2:56 PM (NYSE) U,S. Dollar Date Price High Low Volume 2 Month (Daily) (}8igCharts.(:(,rn 2/4/03 11,07 11.35 10,85 27,149,900 ('\ t5 ~' \1\1 :: No Splits \ 12 \ r-, 11 ;l'\~,f'''''vj Get another quote any day after 1/2/1970 Feb 1/2/1970 1ma 2mo 3ma 6ma 11!: ~ ~ I /2/4/03 CEJ - - - Symbol: Date: Copyright @ 1998-2003 BiaCharts.com Inc. Historical and current end.of-day data provided by FT Interactive Data. You own a serious ~'!'J:J;I,\!~lb' business. 'fI!IilIt"""," ',,' Ylluttoqlany, @I Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www .bigcharts.com/custom/wsj ie/wsjbb-historical.asp?symb=='AOL&close _ da!e=='2%2F4%2F03&x= 14&y= 16 Page] of I W$J.com SloQk Charting for CHG 10120/03 12:56 PM (NYSE) U,S. Dollar Date Price High Low Volume 2 M'nth (O.ily) @BigCharts,.",rn 2/4/03 43.17 43.48 43.01 39,900 '" 48 , \ 46 \ \ 44 No Splits '-.-__", . \.,~',-c..--'-' 42 Get another quote any day after 1/2/1970 Feb 1/2/1970 1mo 2mo 3mo 6ma .:!.y.!: ~ ~ Symbol: I Date: 12/4/03 lE Copyright @ 1998-2003 BiaCharts,com Inc. Historical and current end-at-day data provided by FT Interactive Data. I .- . :JJ~~~~,'-~~' . 1~;lIfr'!l'fJ~pIII.~/ ';, ,'ot~e,2,",(,.-.A.'. l "" _1 '''i.- :w.~;,~ " _,':'.,."''''.,..... " , .,. "'<"v:"'J&, ",'\1-"'" .,~.I ' ~ ,- .... -- i"'""~.r:{ ~.~. ~j~ . A j;f,i:..i;..,.,....., Copyright @ 2003 Dow Jones & Company, rnc. All Rights Reserved http://www.bigcharts.com/custom!wsj ie/wsjbb-historical,asp?symb=oCHG&close _ date=2%2F4%2F03&x=20&y= 13 Page J of I / W!J.eom Stoel Charting for CHC 1012010312:57 PM Charter Mun Mtg Accep Co (CHC) (AMEX) U,S. Dollar Date Price High Low Volume 2 M>nth (Daily) @8igCharts.cc1rn 2/4/03 17.55 17.64 17.41 123,800 \ ^ 17.75 /If' / ,/\ A "j 17.50 No Splits t' ~ /\ IV/IJ 17.25 \ I 17.00 ~ Get another quote any day after 1/2/1970 Fob 1/2/1970 1mo 2mo 3mo 6mo 1Y': .:ll!: ~ Symbol: I Date: 12/4/03 rE Copyright @ 1998-2003 BiaCharts.com Inc. Historical and current end-of.day data provided by FT Interactive Data. You own a serious GEtltiR.".i))'" .... ,.'" ... . .. .... . . .'''''.'. . ," " .', .....,'.. /,." business. _r::...~;::: :-::~.,,:":)tOtita~'iUIY,:;::'" '".,'/>:;;>.0 .@I . ,COM I GO!j Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www .bigeharts.eom/custom/wsjie/wsjbb_historical.asp?symb=CHC&cJose _ date=2%2F4%2F03&x'=' [2&y=4 Page I of r W,sJ.com Sto~ Charting for DEUX ]0/20103 ]2:57 PM Delaware Tx-Fr PA;A (DEUX) (FUND) U,S, Dollar Date Price High Low Volume 2 Month (Daily) @BigCharts.cl)rT1 2/4/03 8.05 n/a n/a n/a 8.15 I ! 8.10 No Splits r' ,'"\, r',L_.l.....-J :3.05 ~I~,^rj . Get another quote any day after 1/2/1970 Feb 1/2/1970 1mo 2mo 3mo 6mo .!.Y! .:1l!: ~ I 1.2/4/03 @B - - - Symbol: Date: Copyright @ 1998-2003 BiaCharts.com Jnc. Historical and current end-of-day data provided by FT Interactive Data. Copyright@ 2003 Dow Jones & Company, Inc. All Rights Reserved hnp:l/www .bigcharts.com/cuslom/wsj ie/wsjbb-historical.asp?symb=DELIX&close _ date=2%2F4%2F03&x= 17&y=] I Page r of I W'sJ.com St~ Charting for DCN 10/20/03 12:57 PM (NYSE) U.S. Dollar Date Price High Low Volume 2 Month (Daily) @8hJUlar't:.'~om 2/4/03 10.68 10,74 10.47 424,200 '"\^''' 12 ~ V\f\h. 11 No Splits ..........\ 10 V\~9 Get another quote any day after 1/2/1970 Feb 1/2/1970 1ma 2ma 3ma 6ma 1t!: ~ m I 12/4/03 [B - - Symbol: Date: Copyright @ 1998~2003 BiaCharts.com Inc. Historical and current end-af-day data provided by FT Interactive Data. I , Search! I r ~Picture this ~ ~ Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www .bigcharts.com/custom/wsjie/wsjbb_historicaJ.asp?symb:::DCN&c[ose _ date:::2%2F4%2F03&x"'24&y'" J 2 Page I of I WsJ.com StocJ. Charting for ElM 10/20/03 [:07 PM Eaton Vance Ins Mun Bd Fund (ElM) (AMEX) U.S, Dollar Date Price High Low Volume 2 M>nth (D.lly) (:;:'8igCh.3rts.cc,rrr 2/4/03 14.05 14.1 13,92 93,900 14.25 J-I..' / 14,00 ~ '\ I No Splits ~\ ,/",-,,1'. t'v.-^' 1:3, 75 'J 1:3.50 Get another quote any day after 1/2/1970 Feb 1/2/1970 1mo 2mo 3mo Sma 1l': ;!)'r 2Y': I 12/4/03 ~ - - - Symbol: Date: Copyright@ 1998-2003 BiaCharts.com Inc. Historical and current end.of-day data provided by FT Interactive Data. 18 N"::>: WII'.'" !ii;;'.'''''',_~''' U~ ~,' ,,'~1.t'^'"-'" r' ,i~_'_.~"~'>':Jl,<:;,; ..~~~~:\~J:;,;lli~~~_~, ;,;";;,"'"';'"',,'.'.)I'{;;.,.>;.;,,', '._1 I.com ...IIGo'l -;C:>::;;:;i;:r>:';,>.;}:>>",.,; ';.',.':'.";\t/,:;t.t;i;,;~'-:"'--'.,,':__ ',,"' -_ _~ . Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www .bigcharts.com/custom!wsj ie/wsjbb.historical.asp?symb=EIM&close _ date=2%2F4%2F03&x=6&y=8 Page] of 1 W~J.com Stook Charting for EKHCX 10/20103 ]2:58 PM Evergreen High Yld;C (EKHCX) (FUND) U.S. Dollar Date Price High Low Volume 2 Month (Daily) (~"'8igCh.3rts.co m 2/4/03 3.13 nla nla nla ''I ;3.16 1-1 ~ ! ~,15 , ::;.14 No Splits r '01'0 ...... ..... .. I I :3.12 d Get another quote any day after 1/2/1970 Fob 1/2/1970 1mo 2mo 3mo Bmo 1l'! m ~ I 12/4/03 [B - - - Symbol: Date: Copyright @ 1998-2003 BiaCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. r. .'~V"u"lie Jit:i..,,;~,.,~$ ";.... ,::",' c' ".'~Y "';">,":" 'Ir:t'.......i..+,..,.~. ..>'.....', ..,....."......,,-...,.,.~.,,' " -:,::: -'~<;;^'-:, - -- -,~:,1J>=--,?i_::,J: ',~/~;'",~_.,;.:;_~,;;:.;:>:;..', Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www .bigcharts.com/custom/wsjie/wsjbb.h istorica].asp?symb=EKHCX&cJose _ date:2%2F4%2F03&x:26&y=8 Page r of 1 W;;J.com Sto~ Charting for GE 10/20/03 ]2:58 PM General Electric Company (GE) (NYSE) U,S. Dollar Date Price High low Volume 2 Month (Daily) O:?!8igCharts.>::o rn 2/4/03 23,05 23,23 22.87 24,473,400 \\ 26 25 \, ,,~24 No Splits \ (\.... /I~) \, ')":- I f'~ -~ / Get another quote any day after 1/2/1970 Feb 1/2/1970 1mo 2mo 3mo 8mo .11!: .:!l! ~ I 1214/03 rB - Symbol: Date: Copyright@ 1998-2003 BiaCharts.com Inc. Historical and current end-at-day data provided by FT Interactive Data. I I Search! I r ~Picture this ~ ~ Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www .bigcharts.com/custom/wsj ie/wsjbb-historical.asp?symb=GE&close _ date=2%2F4%2F03&x=22&y= 15 Page] of J W;;J.com Sto~ Charting for aSK 10/20/03 [2;58 PM (NYSE) U,S. Dollar Date Price High Low Volume 2 M'nth (Daily) Q'BigCharts.com 37,46 I'~ 2/4103 37,89 37,24 824,700 ,j \ 39 \ ~ IV :: No Splits I "'1\ \ '6 " \ - / \/0- 35 Get another quote any day after 1/2/1970 FEb 1/2/1970 1mo 2mo 3mo 6mo 1l'! ~ ~ I 12/4/03 @.9J - - - Symbol: Date: Copyright @ 1998-2003 BiaCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. . 1i'IT: ., ,..... . .,.,....w, ,... .,. 'iiE" . . NOW! . .' . . '>',^",,< "', , "~~{;:.. .:>.: . ,'~:,;a;,;.~ti~;~f';~~t:;~~i;w::._,';iE~~Y:,:"";- @ I . ,COM I GO!j Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved hnp:llwww .bigcharts.com/custom/wsjie/wsjbb_historicaJ.asp?symb=GSK&close _date=2%2F4%2 F03&x=21 &y=6 Page J of 1 \\SJ.com St~k Charting for FRSFX 10/20/03 12:59 PM Hancock Reg Bnk;B (FRBFX) (FUND) U.s. Dollar Date Price High Low Volume 2 M'nth (Daily) (s>8igCharts.o,) IT! ~- 2/4/03 34,11 nla nla nla \0,\_ 36 \\ 35 No Splits \'\I:\VN1I'l' 34 Get another Quote any day after 1/2/1970 Fee 1/211970 1mo 2mo 3mo 6mo 11r: 2l'! ~ 1 12/4/03 ~ - - - Symbol: Date: Copyright e 1998-2003 BiaCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. I I Search! J r ~Picture this ~ ~ Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www .bigcharts.com/custom/wsjie/wsjbb_historical.asp?symb=FRS FX&close _ date=2%2F4%2F'03&x"" J 2&y=8 Page J of J WiiJ.com Stook Charting for INTC 10120/03 12:59 PM Intel Corporation (INTC) (NASDAQ NM) U,S, Dollar Date Price High Low Volume 1: M:Jnth (Daily) @Bignlarts.C('m 2/4/03 15.64 15.78 15.33 41,210,100 )'\ 17,5 ,1' , ^ V~ \ /\ /\ 17.0 l}, A / \,,~ 16.5 No Splits \/1"" I 16,0 ~\r~1 15,5 Get another quote any day after 1/2/1970 Fi:?b 1/2/1970 1 mo 2mo 3mo 6mo .!l!: ~ 2l': Symbol: I Date: 12/4/03 IB - - - Copyright@ 1998-2003 BiQCharts.com Inc. Historical and current end~of-day data provided by FT Interactive Data. I,' D..II~ " ..... '..i~"AI..a..:0~. ..!!.~_.,.; ,.~!1:!:"':~~I'~.':(. ::Ig;";:~.,'<~~,,,/~~,!_,,::::c'_,'", -:~:,_":..._.~,~};, ," "~~'--:~Kt.:f~:YW<.": >e'.' ...."""", ":?,,,,~,,,.,,..lf., ..:' " ,,-- --;<\~ '--'~--'~:'-:?>}"~~:-<s__,:!-{.;-:;,+::_;< - ,,", :':,":: Copyright@ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www.bigcharts.com/custom/wsj ie/wsjbb~h istoricaJ.asp?symb==INTC&c lose _ date=2%2F4%2F03&x=25&y= [3 Page I of I \l4SJ.com StQ6:k Charting for IPP ]0/20103 ]2:59 PM International Paper Cap Tr Iii (IPP) (NYSE) U,S, Dollar Date Price High Low Volume 2 robrrth (Daily) ':98ign":lf'ts.c:orn 2/4/03 25.44 25.44 25,28 13,900 "\ 25.4 tv \ If\I't- 25.3 25.2 No Splits \V .. ./'{\J"'.- 25.1 Get another quote any day after 1/2/1970 F,::-h 1/2/1970 1mo 2mo 3mo 6mo !..\'!: .:w: ~ I /2/4/03 @D - - - Symbol: Date: Copyright @ 1998-2003 BiaCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www,bigcharts.com/custom/wsj ie/wsjbb-historical.asp?symb=IPP&close _ date=2%2F4%2F03&x=0&y=o Page I of J W~J.com StOQk Charting for LU ]0/20/03 12:59 PM Lucent Technologies Inc. (LUj (NYSE) U.S, Dollar Date Price High Low Volume 2 M>r<h (Daily) @SIgCharts.cQm 2/4/03 1,65 1.79 1,65 63,966,200 . ,tG'~ 1. '3 II I 1 r 1. 8 ) " I / t - I' \) (\,\" ,,,' .. No Splits IV I \ / Lb.: Y ,1 1. 5 " Get another quote any day after 1/2/1970 Feb 1/2/1970 1mo 2mo 3mo 6mo 1.l'! ~ ~ Symbol: I Date: 12/4/03 [B - - - Copyright @ 1998-2003 BioCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. ~~""'" '" I . il!.'. "~""~'''.''>~:;;;'>'':''''<',/'',:::",'''':',/''';,)'<:;:, . ":r....;....yilwi..~...,~':~',:'_.,.,>~..~,VJ;;i '....'~. '.W'~." :<'<!',J1t.." ..... '. . ... .. t . ,"".. .;T"..... '. "'~o~i'I~~!J' . Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www.bigcharlS.com/custom/wsjie/wsjbb_historical.asp?symb=LU&close _ date=2%2F 4%2 F03&x=O&y=O Page I of I WSJ .com Stoci;. Charting for MITBX ] 0/20/03 1 :00 PM (FUND) U,S, Dollar Date Price High Low Volume 2 Month (Daily) '$'8igCharts.com 2/4/03 12.08 nla nla nla , r^ \ \ 13.0 "'\ 12.5 No Splits \/~'(\.\,\/\!\v~ 12.0 Get another quote any day after 1/2/1970 Feb 1/2/1970 lmo 2mo 3mo 6mo 1Y!: ~ ~ I 12/4/03 [EJ - - Symbol: Date: Copyright @ 1998.2003 BiaCharts.com Inc. Historical and current end-of.day data provided by FT Interactive Data. Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www .bigcharts.com/custom/wsj ie/wsjbb.historical.asp?symb=MITBX&close _date=2%2F4%2F03&x=O&y=O Page I of J WSJ.com Stoak Charting for PPO 10120103 ]:01 PM (NYSE) U.S. DoUar Date Price High Low Volume 2 Month (Daily) ,g'8igUlarts.c')m 2/4/03 48.77 48,87 48,2 492,500 \ ("v\ 52 V \ ,1\ ' 50 No Splits I('V"", . "\/\0 48 Iv\... Get another quote any day after 1/2/1970 Feb 112/1970 1mo 2mo 3mo 8mo 1:ir :lYr: W I 12/4/03 ~ - - - Symbol: Date: Copyright @ 1998-2003 BioCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. I I Search! I r 6Picture this~ ~ Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www .bigcharrs.com/custom/wsjie/wsjbb_historical.asp?sym b==PPG&close _ date==2%2F4%2F03&x=0&y=0 Page I of I W~J.com StocJt Charting for PGEOX 10/20/03 [:0] PM George Putnam Boston;A (PGEOX) (FUND) U.S. Dollar Date Price High low Volume 2 Month (Daily) ':9BigChart::.c,om 2/4/03 14.52 nla nla nla \~~. 15.25 " \ l~.OO \. .~ ~.". \ 14, '.,' No Splits I/'\/~ ._. 14.50 ."\j\;o",.,.... 14.25 Get another quote any day after 1/2/1970 Feb 1/2/1970 1mo 2mo 3mo 6mo 11': ~ ~ I 12/4~O3 (B - - - Symbol: Date: Copyright @ 1998-2003 BiaCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. I I Search!:I r ~Picture this ~ ~ Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www.bigcharts.com/custom/wsjie/wsjbh_h istorical .asp?symh==PGEOX&close _ date=2%2F4%2F03&x=0&y=0 Page [ of] WJ)J.com Star;!< Charting for UPS 10120/03 1:01 PM United Parcel Service Inc (UPS) (NYSE) U.S, Dollar Date Price High Low Volume 2 M'nth (Daily) (~)8jgCh.ilrts.c(lm 2/4/03 59.95 60,1 59.62 2,191,700 ,............... 64 ~ -'\ \,' E,2 No Splits .~ V....\ 60 "\ /\ · V 1-,~ 58 Get another quote any day after 1/2/1970 Feb 1/2/1970 1mo 2mo 3mo 8mo 11': ~ ~ Symbol: I Date: 12/4/03. fB Copyright @ 1998-2003 BiaCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. 1-"4'a. ' ~r. .'" ..,' .-'.,; ....." ".. .. ,,: .., ,'irir;',':' ....,J=.t~"';}f~~F,!~,' . .--."..,tlii",. " ,.., <-">,,~~,: .._~ r '.: S;;;\0t;;::::;;;:;:,._':"'*ti!~;-:)j~;;;::,;i:':'-", Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved hup://www .bigcharts.com/cuslOm/wsjie/wsjbb-historical.asp?symb=UPS&close _ date=2%2F4%2F03&x:O&y:o Page J of I w.sJ .com St~k Charting for UTX 10/20/03 1 :02 PM United Technologies Corporation (UTX) (NYSE) U,S, Dollar Date Price High Low Volume 2 Month (O,;ly) (s.8h~Chart::.C'.l)m 2/4/03 64.42 64,84 63,64 1,746,800 l\, 66 \t~1 \,\,,;,,--, E.4 . \ ~'\ 62 j .) No Splits I , 60 \, 58 Get another quote any day after 1/2/1970 Feb 1/2/1970 1mo 2mo 3mo 6mo 11': :li:r ~ I 12/4/03 ~ - - - Symbol: Date: Copyright @ 1998-2003 BiaCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. You own a serious , .fl~#..~~&i~J'i~i~~f~;;ji~;2,; business. @ I . ,COM I Go! I Copyright@ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www .bigcharts.com/custom/wsjie/wsjbb-historical.asp?symb=UTX&close _ date""2%2F 4%2F03&x=0&y=0 Page 1 of J 217 . REV-1509 EX+ (8-Q8) SCHEDULE F COMMONWEAllH OF PENNSYLVANIA JOINTL V-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT 0ECellENT ESTATE OF FILE NUMBER Josiah F Dum 21-03-00310 If an a_ was _joint within one year oflhe _'s data of _.It _ be raportad on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Clara S. Dum 426 Dogwood Court Spouse Carlisla, Pannsylvania B. DarTY1 Cody Smith 540 Gablars Road step Grandson Gardners PA 17324 C. Sarena M. Smith 540 Gablars Road Step Granddaughter Gardners PA 17324 JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY "'OF DATE OF DEATH ITEM FOR JOINT MADE INCl.WE NIWE OF FVW<<:W..1NS1TM'JON AND BAN( ACOOlNI' NMBER OR SMlAR DATE OF DEATH DECO'S VALUE OF ~ TENANT JOINT lDENTlFYIG t.l.UBER. ATTACH DEED FOR JOHn Y-HELD REAL ESl'ATe. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A, 426 Dogwood Court, S, Middleton Twp, Cumberland County 100,000 50.00% 50,000 2, A. 2.28.84 PNC Bank #5140399634 13,638 50.00% 6,819 3. AANDB 2.28.84 PNC Bank #5000971299 282 33,00% 93 4, AANDC 1.21.97 PNC Bank #5000971301 467 33.00% 154 5. A, 3.18.97 PNC Bank #5080579755 1,122 50.00% 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL (Also enter on line 6 RecaDltulation $ 57 627 (If more space is needed, insert additional sheets of the same size) DCT-13-2003 23:32 PNCBAi'I< 412 768 3458 P.01 . . o PNCBAN< October 14, 2003 Ms. Carol Wert scp 427 Dogwood Ct. Carlisle, PA 17013 RE: Estate of Josiah F Dum (Deceased) SSN: 209-28-9107 DOD: 02-04-2003 Dear Ms. Wert; In response to your request for Date of Death balances for the customer noted above, our records show the fOllowing; Cbeddng Aeeount Account#S 1 40399634 Established 02-28-1984 JOSIAH F DUM CLARA SMITH DUM DOD balance: $13,636,96 + $1.34 accrued interest Savings Account Account#5000971299 Established 02-28-1984 DARRYL CODY SMITH OR JOSIAH F DUM JR OR CLARA S DUM DOD balance: $282.21 + $0.01 accrued interest Account#S00097130I Established 01-21-1997 SARENA M SMITH OR JOSIAH F DUM JR CLARA S DUM DOD balance: $467,34 + $0.02 accrued interest Account#S0805797SS ElItablished 03-18-1997 JOSIAH F DUM JR CLARA S DUM DOD balance: $1,122.04 + $0,00 accrued interest Page I of2 217 "'REV.1510 I!K+ (6-S8) SCHEDULE G COMMONWEALTH OF PENNSYlVANIA INTER-VIVOS TRANSFERS & INHERITANCE TAX RETURN Mise, NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Josiah F Dum 21-03-00310 Thta schedule must be completed and flied If the answer to any or questions 1 through. on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM lNCU.EIE TlE NAMEOFlHETRN<<lFEREE, lHElR RElATIONSHPTO 0ECaIENf 1HllHE Do\TE OF DATE OF DEATH 'l6 OF DECO'S EXCLUSION TAXABLE NUMBER TRIoNSt"ER. ATT",llCHA COPY OF 1lE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (F.........1C'a.E1 VALUE 1, Aim High Yield Fund Class B(3,311.359sh@3,77 12,484 100.00% 12,484 2. Mass Inv Growth Stock Fund Class 8(1,924.664sh@8.26) 15,898 100.00% 15,898 3. MFS Mass Inv Trust Class B(l,861.761sh@12.08) 22,490 100,00% 22,490 4. PPG Industries(3,022 shares@48,77) 147,383 100.00% 147,383 5. CNL American Properties Inc(1,500sh@17,13) 25,695 100.00% 25,695 6. Money Market Fund(18,191.48@1.oo) 18,191 100,00% 18,191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL (Also enter on line 7 Recaottulalionl $ 242141 (If more space is needed, insert addttional sheets of the same size) \~[SJ.com StQCk Charting tor PPO ]0/20/0J 1:01 Plyl (NYSE) V,S, Dollar Date Price High Low Volume 2 M'nth (Daily) IgI8igCh.3rt:::.I~I) rn 2/4/03 48,77 48,87 48,2 492,500 \/'.....i\ 52 Y " \/1) 1\ 50 No Splits V..... ('-\ V+\.... '\ 4:3 ',/ ,\ V',~ Get another quote any day after 1/2/1970 F:e[:. 1/2/1970 1mo 2mo 3mo 6mo .!E 2l': ~ I 12/4/03 0 - - - Symbol: Date: Copyright@ 1998-2003 BioCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. I I Search !/ r &Picture this~ l Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved hnp:/lwww .bigcharts,com/custom/wsjie/wsjbb_hisrorical.asp?sym b=PPG&cJose _ date=2%2F4%2F03&x=O&y=O Page 1 of I \\lSJ.com Sto,s:k Chaning for AHYBX 10/20103 ]:02 PM 1M Inv:High Yield;B (AHYBX) (FUND) U,S, Dollar Date Price High Low Volume 2 Month (D.lly) @BigCh.3r"t:.c(lm 2/4/03 3.77 n/. n/a nla ,'--'. 3.80 l~ \" / ". l i ---y.--.., r No Splits I .......... 3.75 " / Get another quote any day after 1/2/1970 Feb 1/2/1970 1mo 2mo 3mo 6mo 11': 1l'! 2lr I 12/4/03 [B - - - Symbol: Date: Copyright @ 1998-2003 BloCharts,com Inc. Historical and current end-of-day data provided by FT Interactive Data. You own a serious ~.~~~t'~~'0~;f0:;'i':~0f;k, .. business. ." @ i '.~;;~"I Go! j Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved hllp:/Iwww .bigcharts.com/custom/wsj ie/wsjbb-historical.asp'?symb=AHYBX&cJose _ date=2%2F4%2F03&x=O&y=o Page J of I W~J.com Storo.!< Charting for MrGBX ]0120/03 1:03 PM MFS Mass Inv Gro;B (MIGBX) (FUND) U.S, Dollar Date Price High Low Volume 2 I'vbrrth (Daily) @BigCh.3rts.'~om 214103 8.26 nla nla nla \(\ 9.00 VI 8.75 No Splits \ _ :3.50 1/ VI ...; " J \"./, 8,25 .'", Get another quote any day after 1/2/1970 Feb 112/1970 1mo 2mo 3mo 8mo .11!: m ~ I 1?/4/03 [B - - - Symbol: Date: Copyright @ 1998-2003 BiaCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www .bigcharts.com/cuslom/wsj ie/wsjbb-historica].asp?symb=MIGBX&cJose _ date=2%2F4%2F03&x=O&y=O Page I of r W$J.com St~ Charting for MITBX 10/20/03 I :03 PM (FUND) U.S. Dollar Date Price High Low Volume 2 h..t.nth (Dail~() ($:'8i!JCh.3rts.c,j m 2/4/03 12,08 nla nla nla '. ,,0 \i \ 13.0 , V\ 12.5 No Splits VV.\~jV\^1' 12.0 Get another quote any day after 1/2/1970 Feb 1/2/1970 1 mo 2mo 3mo 6ma ill ~ ~ Symbol: I Date: 12/4/03 ~ - - - Copyright @ 1998.2003 BioCharts.com Inc. Historical and current end-of-day data provided by FT Interactive Data. I uilCf WI" Ii ' ", ".......... .....'.........................';;;..~:_f:\":."iP"~!i1_''''''. "~'"f1!il''fi:.''' :i""'-~" B IQU""'" site '., '. ',;;'liIl.,;N.' .ill"I,." '- , ",*, ~ Ii", - "">~J2z'i! "" , ';.i:i;;"",,~ ' '. '~t -;;',.11::1 ,., C'';:;'-!! -' ill " .' ..~: - SI....1ii ...." . '('::''''''"': 11!"'~~.tJ!J!DII.r' ',!~ .', ,;,: ,,,,,"'.,,-, ~, ... . """"'. , ~::,. ~'~ ;rt~~ '*" ~," ^'*t',~ I)< f e" '<.\ "Www:J I .com ... f I Go! I ~ ,,~ ~"""'"'' -,,'.. - -','...... Copyright @ 2003 Dow Jones & Company, Inc. All Rights Reserved http://www.bigcharts.com/custom/wsjie/wsjbb_hisloricat.asp?symb=MITBX&c[ose_dale:2%2F4%2F03&x:O&y:O Page J of J 217 ~-1511 EX + (12-99) SCHEDULE H COMMONWEALTH OF PENNSYlVANIA FUNERAL EXPENSES & INHERfTANCE TAX RETURN ADMINISTRATIVE COSTS RESIOEHT DECEDENT ESTATE OF FILE NUMBER Josiah F Dum 21-03-00310 Ilebls of __d must be repoI1ed on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Dugan Funeral Home, Funeral Services 4,540 2. Funeral Luncheon 210 3, Musselman Florist, Flowers for Casket 156 B, ADMINISTRATIVE COSTS: 1. Personat Repl_ntative's Commisaions Namoar_I~(.) N1A - Security Nurnber(s) I EIN Number arPe....... Rep.....1IoIMl(.) Street Address City 5mM Zip Yeor(.) eom_ Paid: 2- -...ey F... 16,060 3. Family Exemption: (If decedent'8 address Is not the same 88 claimant's, attach explanation) Clsimont Stroel Addreeo CIty 5mM ZIp ReIationstNp d ctaimant to Decedent 4, _ F... 318 5. Aooountant's Fees 6, Tu Return Preperer's Fees 7. Cumberland Law Journal, Advertising 75 8, The Sentinel 88 10. Register of Wills, Filing Fee for Pennsylvania Inheritance Tax Return 15 TOTAL (Also enter on Iina 9 RecaD~ulation $ 21462 (If more space is needed, insert add~ional sheets of the same size) 217 .. REV-1'S13EX+(9-OO) SCHEDULE J COMMONWEALlH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FU..E NUMBER Josiah F Dum 21-03-00310 R8.ATlONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSONrSl RECEIVING PROPERTY Do Not Usl TrusleeIsl OF ESTATE I. TAXABLE DISTRIBUTIONS ronclude outr1ght _1_., and transfers under Sec. 9116 (a) (1,2)] 1. Clara S. Dum 426 Dogwood Court Carlisle, Pennsylvania 17013 Spouse 100% residue of estate ENTER DOlLAR AMOUNTS FOR DIS1RIBUTIONS SHOWN _ ON LINES 15 THROUGH 18 AS APPROPRIATE ON REV-I500 COVER SHEET II. NON- TAXABLE llISTRIBUT1ONS: A. SPOUSAl. DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH I'H ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE I'HD GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-I500 COVER SHEET Is 0 (If more space is needed, insert Bddttional sheets of the same size) - . .. LAST WILL AND TESTAMENT OF CLARA S. DUM I, CLARA S. DUM, of South Middleton Township, (mailing address: 427 Dogwood Court, Carlisle, P A 17013), Cumberland County, Pennsylvania. being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament hereby revoking and making void any and all Wills by me at any time heretofore made and which Will is being made in accordance with the agreement for reciprocal wills executed contemporaneously herewith by me with my husband, Josiah F, Dum; 1 . I direct my hereinafter named personal representative or representatives to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. I direct that my funeral services be conducted by Lee Dugan Funeral Home at Bendersville, Pennsylvania. and that my body be inlerred on my burial 101 located in Oakiawn Cemetery located near Gettysburg. Pennsylvania, I bring to the attention of my personal representative that my caskel and vault have been paid for by me to Oaklawn Cemetery. 2. All of the rest, residue and remainder of my eslate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath to my husband, JOSIAH F. DUM, his heirs and Msigns, to the exclusion afmy children, born and unborn, provided my said husband, JOSIAHF.DUM. shall survive me by a period of ninety (90) days. , 3, Should my said husband, JOSIAH F, DUM predecease me or fail to survive me by the aforesaid period of ninety (90) days, then in such event all of the rest, residue and remainder of my estate,real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal shares to such of my two children and such of my husband's four children as shall survive me by a period of ninety (90) days, their heirs and assigns, but should any of the hereinafter named six children fail to so survive me, then the share such deceased person would have received shall pass 10 such of his or her issue as shall survive me by a period of ninety (90) days, per stirpes, and if there be no such issue the same shall lapse and be divided equally among the shares of the remaining children, per stirpes, My two children are DEBRA K, COPENHAVER and JANE L. SMITH, The four children of my husband, Josiah F, Dum are GERALD A, DUM, JOHN LANNY DUKE, who was previously known as LANNY J, DUM, KENNETH L. DUM, and JACIE G, MILLER. 4. 1 hereby nominate, constitute and appoint my said husband, JOSIAH F. DUM as Executor of this my Last Will and Testament, but should he predecease me or fail to qualify or cease serving as such, then in such event I nominate, constitute and appoint my daughter, DEBRA K, COPENHAVER and my husband's daughter JACIE G, MILLER as alternate or successor Co- Executors, and I further direct that none of them shall be required to post any bond to secure the faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction, I further direcl that the compensation as Co-Execulors of my daughter, DEBRA K. COPENHAVER and of my husband's daughter, JACIE G, MILLER shall be $10.000.00 each, IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on one (I) page, this 14th day of May, 2002, ~ 'SDl4" (SEAL) CLARA S, DUM Signed, sealed, published, and declared by CLARA S. DUM. the Testatrix above named, as and for her Last Will and Testament. in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ~ k. "', ~~ /f..Is/IIX-A (~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: JOSIAH F. DUM Date of Death: February 4, 2004 Will No. Admin. No. 21-04-00310 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 () No (X ) 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: December 2005 3. If the answer to No.1 is Yes, state the following: (a) Did the personal representative file a final account with the Court? Yes ( ) No ( ). (b) The separate Orphans' Court no. (if any) for the personal representative's account is: (c) Did the personal representative state an account informally to the parties in interest? Yes () No ( ) (d) Copies of receipts, releases, joinders and approvals offormal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: January 21, 2005 AJ:f' 0-1, ~. Signature Robert M. Frey Name (Please type or print) 5 South Hanover Street Carlisle. Pa 17013 Address (717) 243-5838 , " _ _. :r 1~1'elephone No. L I,,,) ),I"lld:JO Capacity: W >H!~onaI Representative ( X ) ounsel for personal representative 9 j :IIIIV I Z l\jvr gaOZ 1',---1 J '- I. , \,...lli!,l< , .jor'-)r~' -' . }I-i'!! ! I (i,!:J,r>(i:]U \... -',,0,-, I..!...i.-I \...V_jU FIRST AND FINAL ACCOUNT OF BEVERLY STARNER. EXECUTRIX OF THE LAST WILL AND TESTAMENT OF VIOLET M. STARNER, LATE OF DICKINSON TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED. DATE OF DEATH: February 29, 2004 LETTERS TESTAMENTARY ADVERTISED: Sentinel:April14th, 21st & 28th, 2004 CLJ: April 9th, 16th, & 23rd, 2004 ESTATE FILE NO.: 21-04-0310 PRINCIPAL RECEIVED Accountant charges herself with the following principal amounts received: 2004 Feb. 29 Real Estate, 320 Starner Station Road Dickinson Township, Cumberland County $120,000.00 Feb. 29 ACNB Checking Account #610976 $1,679.19 Accrued interest to Date of Death $.58 April 22 Refund, Nationwide Insurance Co, $37.60 Automobile Insurance July 14 Auction of Household Contents by Ike Eichelberger $1,785,25 July 22 Refund, 2003 Pennsylvania Department of Revenue $500,00 July 24 Auction of Household Contents by Ike Eichelberger $11,5-47,75 "'d' (1987 Ford Automobile was auctioned off for $250.00) "'-~I ' . r',',' OJ TOTAL PRINCIPAL $135,550.~ _.,'-. - - C~I INCOME RECEIVED r-,) w 2004 April 5 Interest, ACNB Estate Checking #2165902 $,57 April 15 Interest, ACNB Estate Checking #2165902 $.14 1 in April 30 Interest, ACNB Estate Checking #2165902 $.24 May 31 Interest, ACNB Estate Checking #2165902 $.37 June 30 Interest, ACNB Estate Checking #2165902 $.23 July 31 Interest, ACNB Estate Checking #2165902 $.18 Aug. 31 Interest, ACNB Estate Checking #2165902 $3.52 Sept. 7 Baltimore Life Insurance (No Beneficaries) $502.00 Sept. 30 Interest, ACNB Estate Checking #2165902 $19.22 Oct. 31 Interest, ACNB Estate Checking #2165902 $40,98 Nov. 30 Interest, ACNB Estate Checking #2165902 $34.23 Dec. 31 Interest, ACNB Estate Checking #2165902 $34.73 TOTAL INCOME $636.41 DISBURSEMENTS 2003 Feb. 29 Checks cleared after date of death $246.40 March 25 Register of Wills, Probate Will $219.00 March 25 Cumberland Law Journal, Advertising $75,00 April 23 MetEd, Electricity $21.50 April 27 Carolyn R. McQuillen T/C,2004 County & Twp Taxes $362.90 May 21 Larry Foote, Real Estate Appraiser $275.00 May 22 MetEd, Electricity $20.25 May 26 The Sentinel, Advertising $102.11 2 June 9 The Shelby Insurance Co. ,Homeowners Policy $189.80 June 21 MetEd, Electricity $20.07 July 1 Codori Memorials, Inscription $125.00 July 14 Associates Products, Auction Expenses $147.76 July 15 Ike Eichelberger, Auctioneer's Expenses $1,429.25 July 23 MetEd, Electricity $22.10 July 24 Ike Eichelberger, Auctioneer's Expenses $1,988.00 Aug. 19 MetEd, Electricity $22.59 Aug. 25 Carolyn R. McQuillen TIC, 2004 School Taxes $1,882.08 Sept. 3 The Shelby Insurance Co., Homeowners Policy $189.80 Sept. 13 MetEd, Electricity $7.84 Sept. 16 Hollinger Funeral Home, Funeral Service $7,739,00 Sept. 16 Sale of Real Estate, credit 2004 County & Twp Taxes -$103.48 Sept. 16 Sale of Real Estate, credit 2004 School Taxes -$1,485.04 Sept. 16 Recorder of Deeds, State tax/stamps $1,200.00 Oct. 6 Refund, Shelby Insurance Co"Homeowners Policy -$300,00 Oct. 20 PA Department of Welfare, Reimbursed $14,428.13 Medical Assistance Oct. 20 Green Acres Nursing Home, Room Charge $599,66 Oct. 20 Register of Wills, Filing Fee for $15.00 PA Inheritance Tax Return Oct. 20 Register of Wills, Agent, $4,190.00 PA Inheritance Tax Return 3 2005 Jan, 28 Register of Wills, Filing Fee Final Account $180.00 Jan. 28 Beverly Starner, Executrix Fee $6,426.00 Jan. 28 Robert M. Frey, Attorney Fee $6,426,00 Oct. 4 Robert M, Frey, Prepare and File 2003 Taxes $25,00 TOTAL DISBURSEMENTS $46,686.72 RECAPITULA TION TOTAL PRINCIPAL $135,550.37 TOTAL INCOME RECEIVED $636.41 TOTAL RECEIPTS $136,186.78 LESS TOTAL DISBURSEMENTS $46.686.72 BALANCE FOR DISTRIBUTIONS $89,500.06 4 PROPOSED SCHEDULE OF DISTRIBUTION BALANCE FOR DISTRIBUTION $89,500.06 TO: Beverly Starner $44,750.03 350 Georgetown Road Gardners PA 17324 1/2 resid ue of estate TO: Kellie Campbell $22,375.01 39 Locust Street Mt. Holly Springs PA 17065 1/4 residue of estate TO: Eddie Starner $22,375.02 335 Starner Station Road Gardners PA 17324 1/4 residue of estate TOTAL DISTRIBUTION 189,500.06 5 COMMONWEALTH OF PENN8YL VANIA ) ):88.: COUNTY OF CUMBERLAND ) Before me, the undersigned officer, personally appeared Beverly Starner, Executrix of the Last Will and Testament of Violet M. Starner, deceased, who, being duly sworn according to law, deposes and says that the foregoing First and Final Account is true and correct to the best of her knowledge, information and belief. 13~~ BEVERLY ST A ER Sworn to allvubscribed before ~e this:>PS =-" of January 200} d~ ~C''- I~c:t; ~~ "'X'_' . TR1SI1AA (.tES~;, ).~t;Y/>,ii ':jU;,,': 8OROUGH Of' CARLISLE:. CUMBt,F~i_':'Ni) (r_, l. MY COMMISSION i::XPIR[-'S M<\'" ,'C'. 2"-,,~'( -_."""""",~...,,,_.,:' 6 iml'\t \ ~ta.I,&\~1 l '\~;f' \ i \1 i1lii b\\h1m 1 "61~ \1.' i .!.~ tl\hl\\U lla t .~ ~ r t~ ~ Q. ~ i"" .,a'!:' t ~oo i ~ f <0 ....,.;l. i "iii '" ~ e~ <:> .. .~ ., <0 ~ ~~~~~ ~ ~r-~od 'OS " w'S(/)O~ "'o~ ~ ~ ....l"'_........ 8O'''O.t'~ , _ ct. CD"'" l-w~4:t:: ~.~t ~ ~.. \ ell?i> ~l>-.S o' o~ 1 ~~.;tU ! ~d" · ~ u.l 0 s::. .f!}. c: ~~ ~e1 00 a:}-"5~~ \ u..~ooo.. 'd ~ 0_ (/) ., ~ \ ~~! It) - ~ ~ r-,.;l ~ ~ 001 u p.. "0 ,~ I\~ 9\i' ~ iil\\\ "Ol~ili~ \1ltl.n \~8;\"i' ~~,ll\\\~ \\\tv~~ ".. ~ \:> S 'i ~ .D c: l5 i, i~~~ ._~\~ ii,.:.-'" . . . . CERTIFICATION OF NOTICE UNDER.RULE 5.6(a) Name of Decedent: VIOLET M. &1''-.ME8 Date of Death: FEBRUARY 29, 2004 Will No. Admin.No. 21-04-0310 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-ca~aoned estate on: May 19, 2004 Name Address Beverly ~ Kellle Campbell Eddie _~ri. 350 Georgetown Road, Gardners PA 17324 39 Locust Street, Mt. Holly Springs PA 17065 335 Starner Station .11!t~ Gardners PA 17324 Notice has now been given to all persons entitled thereto under Rule 5.6)a) except NO EXCEPTIONS Date: May 19, 2004 Capacity:_Personal Representative r- -1lCounsel for Personal Representative '? c.") .....-:~~ 0'\ ..- ~ ::;;:: p '.) U l~ ~ :~c \. ""', Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage. Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: Frey & Tiley 5 South Hanover Street InvoiceNo: Invoice Date: Estate of: Estate No: 187 2/1/2005 VIOLETM STARNER 21-2004-0310 vz Carlisle, P A 17013 Qty 1 Fee Description Additional Probate Fee Total 35.00 $35.00 Total: $35.00 Checks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. "'..... c'-" --....... f.-.... :~'~5'~ ~~Q.~ =f:;~ _. ,.... .'" _ _~_ :s 11::: .,. ~,=,':;l:~(,z~<:c..."~,,' ,o~~....:;~o:;l~.1! -. >!;;, '" ;fa..!? t,- ~--'o~:s:r;:;e"< '~~ ~ -1. ro:=; - 1:.: r,' 5,. :f;:r .;::' i" 81 :. %. ';'')Qt':l_ ....=-.:;:-~ .... 1:.> n '(0 0 -' "''' -> ~ c>> ;;.r;.l>>::J 0 !-\-. 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"'ll.1l 'i!: ~ - ~.' ii-.5' ~ !51li! 111 l;1,,'" ",,9-55 !5.iP'il .~ Q '" J ,.. !! '" ':'$:S "'~iP' ;: -0 :;.-,,;, c'" l* - ,,,:,..- " \2 .....:rc:c-OGi~ ill '" '" :'"g~ '" J' ~ Q~~_"$9.i~-~ ~ ~o;;"'X~~c:',;i:: " ~. c: "!l.- -. J" w ~ '!l:t Ii> '''. ~. ~g.,,;z,,; . . 3. 5 ;~ ~~ s- - - " -'"' .~ Cumberland County - Register Ot Wl~~S One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/14/2007 FREY ROBERT M 5 S HANOVER STREET CARLISLE, PA 17013 RE: Estate of STARNER VIOLET M File Number: 2004-00310 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 3/29/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal I Z :2 ~ld 9 I LDDZ cumberland County - Register or Wl~~S One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/14/2007 STARNER BEVERLY 350 GEORGETOWN RD GARDNERS, PA 17324 RE: Estate of STARNER VIOLET M File Number: 2004-00310 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 3/29/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel I Z:Z Lr ".., .0UG Pa. O. C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Violet M. Starner Date of Death: February 29. 2004 File Number: 21-04-0310 Pursuant to Pa. o.c. Rule 6.12, 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 _ No 2. If the answer is NO, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No., 1 is YES, state the following: a. Did the personal representative file a final account with the Court?.................................................................... Yes -1L No b. The separate Orphan's Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest........................................... ~ Yes _ No d. Copies of receipts, releases, joinders and approvals of formal accounts may be filed with the Clerk of the Orphan's Court and may be attached to this report. Date: March 22,2007 ~A/~ '.cD N Signature of Person Filing this Form Capacity: _Personal Representative .. CJl !-- i;I; Robert M. Frey. Esquire Name of Person Filing this Form C"') N c:; 5 South Hanover Street Address Carlisle. Pennsylvania 17013 (717) 243-5838 Telephone ~'~ Form RW-1O rev. 10.13.06 c)