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HomeMy WebLinkAbout02-0068Estate of also known as Anna Jane Spotts ' Pennsyl! Register of Wills .ofCU~.~'~DCounty; ania PETIT'ION FOR GRANT OF LETTEI S · . . (COMPLr-'TE "A' OR 'B" 3ELOV~:) ,, Deceased No. i'68-24-9892 A. Probate and Grant of LettErs and-Aver that Petitioner(s) is/are the ex. ec"j{ors~- Decedent, dated 'Nov~n,}~r 21: 2001 and codicil(s) dated no~o. I named in the Last Will oi the after exe UtlOn of the documents c~fered Except,as follow_% Decec~nt did nb~' marry, was not divorcca, and did not have a child born or adop'.-~-d c ' fo,' .probate; was not the ~ictim of a killing and was r, ev.;r adjudicated incompetent: B. Gra~t of Letters of Administration Petitions, .a: after a preper search has/have ascertained that Deceden~ ieft no \^.dill! ~nc was s~,,-vived by the ~nhr'' ';"'~ s:c, use (if any) and heirs: Name ':' Relationship t Residence (COMPLETE IN ALLCASOS:) Attach additional sheets if necessary. Dece.dent was'demici~d at:death"in , C'umb~rl~nd ' Decedent, then 71 years.of aaei~died': December 18. 20Q1, 19 , at St.~queJlap~ Decedent at death o~,.'n*3~ properPi..with ~sti,~ated values as (if domiciled in ;?A) All personal progerty ......................... '- . (if not der~ci!e_": in PA) ' Personal property in Pennsylvania ................ .. (if not' dom2cil.e-' in PA) ' . Personal propemt in County ..................... Value cf real e-:zate in Pennsylvania Total ............... Real Estate situated as i:ilows: Center, Harrisburq~_PA ·.. s 1-2Q~ 000. ¢0 --- .... s__ 50~000_00 -- · .. $ 17(I ~OO ~ Wherefore, Petitioner(s) respectfully request(s) the o'robate of the last Will and Codicil(s) presented ~*-~(h this Petition and the grant of ;suers .n th,'.' appropriate form to the ,~ndersigned: , I Signature Typed°rp'tinted name-~nd residence ] William J. Woll Barbara Woll 201 Sunset Dr., R.D!I New Cumberalnd¢ PA_17070 .Oath of Personal Representative Commonwealth of Pennsylvania ~ County .of~ [~]~fl~l, i4~ CUMBERLAND' ' ~he Petitioner(s) above-named swear(s) andaffirrn'(s) that the statements in the foregoing Petition are .true and correct to the best (~f the knowledge and belief o¢ Peti-tioner(s) arid that, as personal representative(s) of the DecedentF Sworn to and affirmed and subscribed .. ~ 'Winiam j. Wo~¢/' '.'.' ~: " .~ EEW!S ' '--.", -. : · _ DECREE OF REGISTER . Deceased l','o. 71 - 0_2 - 0006_.~_ ........ Estate of also known as . : Social Sec:urity No: 168-24-9892 [)ate of Death: r~-~mbe, r---l~r 200! AND NOW, january 22 X~2001 in consideration Of the Peti~0n on the reverse side hereon, satisfactory p~oof hating been presented before .me, .~... IT. IS DECREED that Letters J~] Testamentary- L-3 of Administration are hereby granted to._ William J. Woll and Barbar~_Woll ~n the above .estate a~d that ~,f~e instrument(s), if any, dated November' .:.... -. described"in the--:~Petition be admitted ,to. probate and-fi.led o.f,. reoer.d as..the .las'...,: W.ill..of ''~ ......... '~'~ F Es _ . . . ~' ~ S 270 00 - · W(/~~,~~ $ 19 O0 s 5.00 Letters ........................... Short Cert ficate(s) .... (.4.).. Renunciation .................. Affidavit ( ') ................. Extra Pages ( ?-'~ ............ Codicil .......................... JCP Fee .................... :-.- Inventory & Tax Forms... Other ....... TOTAL ................ gW-7a Attoroe¥' John A. 5,00 $__ I.D. N0:__07109 Address: 2520___DQehne:_R.Qad-- Harrisburg, 'PA 121 i,0 '.' ?.93.00 Telephone:_ 7i'~/67i-9870, ,."':-"¢. ' DATE FILED' January . 2Q_~. Mailed le~te~ssto &ttor~ey on 1-??-07 ',. .... 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'~..5~ ' ,~.~,~ ~ ':~ , ..'~,,. ,,. .'~ LAST WILL AND TESTAMENT ANNA JANE SPOTTS I, ANNA JANE SPOTTS of Enola, East Pennsboro Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understandi do make; utter, and publish this, my Last Will and Testament, hereby revoking all former Wills made. i y me heretofore I order and direct that my Executor, hereinafter named, shall pay in full as soon as may be conveniently possible after my decease my just debts and funeral expenses, including all inheritance, estate, succession and legacy taxes of whatsoever nature and kin~, both State and Federal, to which my estate or the transfer of any property passing hereunder or otherwise passing by reason of my death, may be subject, and to charge such taxes against the residue of my estate, 1 it being my intention that none of the aforesaid taxes or any of the property requir;d to be included · · in the gross estate under the provisions of any State or Federal Law now in fo ce and effect or hereafter enacted, shall be pro-rated among the persons interested in my estate at property is or may be transferred or to whom any benefit accrues.- 1. I give, devise and bequeath the sum of One Thousand Dollars Market Square Presbyterian Church of Harrisburg, Pennsylvania. 2. I give, devise and bequeath the sum of Five Thousand Dollars Lakeside Lutheran Church of Harrisburg, Pennsylvania. d to whom such ($1,000.00) to ($5,000.00) to 3. I give, devise and bequeath the sum of Five Thousand Dollars ($5,000.00) to my Niece, Lynn Marco, of Lebanon, PennsYlvania. l 4. I give, devise and bequeath all the rest, residue and remainder of my property, real, 1' persona and mixed, of whatsoever nature and wheresoever situate, of which I shall die seized and possessed, or to which I shall be entitled at the time of my decease, to my br ther, William J. Woll and his wife, Barbara Woll, or the survivor of them, per stirpes. 5. I nominate, constitute and appoint my brother, William J. W[oll and his wife, Barbara Woll, or the survivor of them, co-Executors of this, my Last Will and Te without bond of any type whatsoever. 6. I direct that my Executor shall serve as Guardian of the estat~ beneficiaries, to serve without bond of any type whatsoever. IN WITNESS WHEREOF, I have to this, my Last Will and Testament, seal at the end hereof, this 21st day of ;tament, to serve :s of any minor ;et my hand and November, 2001. The Preceding instrument, consisting of this and one (1) page, was on hhe date thereof- signed, published, and declared by ANNA JANE SPOTTS, the Testatrix thereiln named, as and for her Last Will and Testament, in the presence of us, who at her request, in h~r presence, and in the presence of each other, have subscribed our names as witnesses hereto. -'1 ~' wITNESS ~ ' ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF DAUPHIN ) SS On this 21st day of November, 2001, ANNA JANE SPOTTS, Johr A. Roe and Ann M. Robinson, the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being fa'st duly sworn, do hereby declare to the undersig ed authority that the Testatrix signed and executed the instrument as her Last Will and Testam:nt, and that she signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Tes~ atrix; signed the Will as witnesses and that to the best of his/her knowledge, the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or Undue influence. Subscribed, sworn to, and acknowledged before me by ANNA JANE SPOTTS, Testatrix, I John A. Roe and Ann M. Robinson, witnesses, this 21st day of November, 9~001. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will No. To the Register: ANNA JANE SPOTTS December 18, 2002 2002-00068 Admin. No. I certify that Notice. of estate administration required, by R le 5.6(a) of the · .I Orphans' Court Rules was served on/or mailed to the following beneficmnes of the above- captioned Estate on January 31, 2002. NAME ADDRESS 20 SourlY'2nd 'Stre[t, Harfi§bi~rg, P 17101 Market Square Presbyterian Chu'~[ii" Lakeside Lutheran Church Lynn Marco Mr. and Mrs. William J. Woll [none]. ~45 "Divi~siSon' St. reet, ~a. rrisburg, P~ 311 North l0th Street, Lebanon, PA 210 Sunset Drive, New Cumberlan Notice has now been given to all persons entitled thereto under R Date: January. 31, 2002 John .~Roe, E's/s~q.~ & Attorney I.D.//07109 2520 Doelme Road .Harrisb~urg;. ~A 1711.0_,.-9622 7'1-)/671:98~]0.;.' -.:~' .5!" :.. :' ..... ' '~ei:'sonalRepresentative'' '..::.:>',: X Counsel for Personal Repre 17110 17046 1, PA 17070 fie 5.6(a) except entative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 28O601 HARRISBURG, PA 17128-0601 RECEIVED FROM: WILLIAM J WOLL RD1 201 SUNSET DRIVE NEW CUMBERLAND, PA 17070 ........ fold ESTATE INFORMATION: SSN: 168-24-9892 FILE NUMBER: 2102-0068 DECEDENT NAME: SPOTTS ANNA JANE DATE OF PAYMENT: 03/15/2002 POSTMARK DATE: 00/00/0000 COUNTY: C U M BERLAN D DATE OF DEATH: 12/18/2001 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) WILLIAM J WOLL REMARKS: SEAL CHECK# 306 NO CD O00963 TOTAL AMOUNT PAID' AMOUNT INITIALS: JA RECEIVED BY: REGISTER OF WILLS ACN ASSESSMENT CONTROL NUMBER 101 MARY C. LEWIS REGISTER OF WILLS $20,488.40 $20,488.40 Register of Wills of ' County, Pennsylvania INVENTORY Estate of ANNA JANE S1:C/1~S also known as Deceased No. 21-02-00066 Date of Death 112/1B/01 Social Security IX ~. 168-24-9892 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the foil of the personal assets wherever situate and all of the real estate in the Commonwealth of Perinsylv the valuation placed opposite each item of said Inventory represents its fair value as of the date of owing_i.ny.e_n,t,q[y i.nclude all mia of said Decedbnt, that the Decedent's death, and that Decedent Owned no real estate outside of the Commonwealth of Pennsylvania except that whicF appears in a memorandum at the end of this inventory. I/We verify that the statements made in this Inventory are true and correct I/We understand that false statements herein are made subjec? to the penalties of 18 Pa. C.S. Section 4904 relating 1~o unsworn falsification ko authorities. Personal Representatile: Name of Attorney: John A, Roe, Esq. Willi_~_m ,J_ WOll I~D. No'.: Address: Telephone: 07109 2520' Doo~hn~_ Rc~d Harrisburg; PA 1 711 0 71 7/671~9870 Barbara Woll Dated RW-8 Description 810 Wertzville Road, Enola, Pennsylvania All that certain tract or parcel of land situate in East Pennsboro Township, Cumberland County, Pennsylvania more particularly bounded and described according to a survey of D. P. Raffensperger, Registered Surveyor, dated December 8, 1955 and recorded in the Register of Deeds Office, Cumberland County, PA Book Z18, Pagp~ Property sold July 3, 2002 (see attached settlement sheet) The Dreyfus Fund Account #026-0251053526 Jefferson Pilot Annuity Contract #388004708 Prudential Financial, Inc. Demutualization Proceeds CUSIP 744320 102 25.000 shs. @ $28.44 (Attach Additional Sheets if necessary) NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of thepers~ the value of each item, but such figures should not be extended into the total of the InveF~tory. Value O 97,713.07 19.,396.05 711.00 $206,820.77 mai representative, include ANNA JANE SPOTTS No. 21-02-00068 Page Two INVENTORY U. S. Government Savings Bonds 18 EE ~ $100 136 EE @ $50 U. S. Government Savings Bonds 6 E @ $25.00 Citizens Bank Checking Account 111-861-2629 Allstate Insurance Refund Comcast Cable Refund East Shore Oncology Refund Sale of Furniture Sale of Coins Sale of 1993 Chevrolet Lumina Susquehanna Center partial reimbursement of monthly charge 2001 Federal Income Tax refund Refund for dumpster deposit 9,313.24 1,210.93 11,553.76 39.20 11.23 12.00 935.00 1,500.00 1,000.00 1,575.00 564.09 162.25 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: ........ fold REV-1162 EX(11-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT JOHN A ROE ESQUIRE 2520 DOEHNE ROAD HARRISBURG,' PA 17110 ESTATE INFORMATION: SSN: 168-24-9892 FILE NUMBER: 2102-0068 DECEDENT NAME: SPOTTS ANNA JANE DATE OF PAYMENT: 08/12/2002 POSTMARK DATE: 08/1 0/2002 COUNTY: CUMBERLAND DATE OF DEATH: 12/18/2001 NO. CD 001510 TOTAL AMOUNT PAID' REMARKS: WILLIAM J W. OLL & BARBARA W~LL C/O JOHN.A: ROE ESQUIRE SEAL CHECK# 334 INITIALS: CW RECEIVED BY: ACN ASSESSMENT CONTROL NUMBER MARY C. LEWIS AMOUNT 101 9976.93 9976.93 REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 Z ILl ILl O U.I I-. Z LU C~ Z D. UJ n~ 0 REV-1500 INHERITANCE TAX RETURN · RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SPOITS, ANNA JANE DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 12/18/01 4/17/30 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY NUMBER - 02 -00068' 'CODE YEAR NUMBER SOCIJ~L SECURITY NUMBER ~---~1. Original Return E~]4. Limited Estate r--] 6. Decedent Died Testate (Attacl~ copy of W,i~) E~9. Litigation Proceeds Receiv. ed NAME John A. Roe, Esq. FIRM 'NAME (If Applicable) 1'6~8-24---9892 - / THIS I~ETURN MUST BE FILED IN DUPLICATE WITH TH TELEPHONE NUMBER 717/671_qR7n REGISTER OF WILLS SOCITL SECURITY NUMBER E~2. Supplemental Return r--] 4a. Fuiure Interest C(~mpromise (date of death after 12-12-82) 'r--~ 7. Decedent Maintained a Living Trust (Attach copyof T~ust) ~'-] 10. Spousal Poverty ~redit {date of death between 12-31-91 and 1-1-95) COMPLETE MAILING ADDRESS 2520 Doeh~e Road Harrisburg, PA 1; 3. Remainder Return (date of death pdor Io 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A)(Attach Sch O) '110 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole,Proprietorship . (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) '(6) k'"-~ Separate Billing Requested ' 7. Inter-Vivos Transfers & Miscellaneous Non-probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Sohedule I) (10) 11. Total DeduCtions (total Lines 9 & 10) 12. Net Value of Estate. (Line 8 minus Line 11) 61,123.95 ~ ~¥'_ 128,344.29 ~ >' 17,352.53 .?~F~51CIAL USE ONLY 13. 14. . 8,790.00 ' 4¢166.82 Char. itable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (8) ' (11) (12) (13) (14) 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(12) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 187:863.95 x .12 x .15 (15) (16) (17) (18) (19) 206,820.77 12,956..82 196,863.95 6,000.00 87¢863.95 22¢ ~4R: 67 Decedent's Complete Address: STREET ADDRESS 8!0 Wertzvi!l-e Road CITY Enola~ , STATE PA IZIP 17025 Tax Payments and Credits: 1. Tax Due (Page 1 Lirie 19) 2. Credits/Payments A. Spousal Poverty credit B. Prior Payments C. Discount Interes?enalty if applicabl_e D. Interest E. Penalty (1) 22,543.67 20¢488.40 1,078-34 ~talCredits(A+B+C) (2) 21,~66.74 (3) Total InterestJPenalty ( D + E ) 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 If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. ' ' A. Enter the interest on the tax due.. · , · . . (4) (5) (5A) 5. " 976:93 0 976.93 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. ' (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS i. Did'decedent make a transfer and: Yes .No a. retain the use or income of the prolserty transferred; .......................................................................................... [] [] · b. retain the right to designate who shall use the property transferred or its income; ..... : ...................................... [] [] c. retain a reversionary interest; or ............................................................. ' ' [] ·" [] d. receive the promise for life of either.payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................ : ............................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. E~' ' [] 4. Bid decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ' ' ' ' [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE 6 AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all inform~ior)lof wh~¥prep~[er I~as an~c=k,gowl,,cdge.· · SIGNATURE OF PERSON.. RESPON~IB~-E. ~~~ ~f'J~/'/~//'~"FO"~"~IN~ETURI~ ~//V'~,I~ k YVF- t"-~'--~ .~../~2//~.DATE ADDRESS W±ll±am J. Woll and ~3a~ba~a Wo11, co-Executors v/ ,/ 210 Sunset Drive~ New Cumber]and, PA 17870 DATE SIGNATURE/~~SENTATIVE..,,L,;,;,,,,. '"-- / ADDRESS~A. Roe, Esq.. - ... 2520 Doehne Road. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate' imposed on the net value of transfers to Or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. ... For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 RS. §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 applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 RS. §9116(a)(1.2)]. The tax rate impose~ on the net value of transfers to or for the use of the decedenrs lineal beneficiaries is 4.5%, except as noted in 72 RS. §9116(1.2) [72 RS. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use'of the decedent's siblings is 12% [72 RS. §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. COM,V~q!,',¥EALTH OF PENNSYLVANIA INH.=.-qJTANCE TAX RETURN FcSIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUM'3ER ANNA JANE SPOri~S 21-02-00068 All real property owned solely or as a tenant in common must be reported at fair market value. ,--air -:arkervalue is defined as th~ price at which property would be exchanged between a willing ~uyer and a willing seller, neither being compelled to buy'6?'sell, both having reasonable knowle:,;e of the relevant facts. Re~il property which is jointly-owned with right of su~ivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH !. 810 Wertzville Road, Enola, Pennsylvania All that certain tract or parcel of land situate in East Pennsboro Township, Cumberland County, Pennsylvania more particularly bounded and described according to a survey of D. P. Raffensperger, Registered Surveyor, dated December 8, 1955 and recorded in the Register of Deeds Office, Cumberland County, PA Book Z18, Page 409. Property sold July 3, 2002 (see attached settlement sheet) $61,123.95 TOTAL (.-'Jso enter on line 1, Recalitulation) I $ 61,123.95 (If more space is needed, insert additional sheets of the same size) · . R~V, 15~3 EX i.(1-97) ,:, ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBEI; ANNA JANE SPCYITS 121~02-00068 All property jointly.owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. The Dreyfus Fund Account #026-0251053526 9820.409 Shs. @ 9.95/sh. 97,713.07 2 Jefferson Pilot Annuity Contract #388004708 19,396.05 3 Prudential Financial, Inc. Demumalization Proceeds CUSIP 744320 102 24.000 shs. @ $28.44 711.00 4 U.S. Govt. Savings Bonds 18 EE @ $100 Bonds 136 EE @ $50 Bonds 9,313.24 5 U.S. Govt. Savings Bonds 6 E @ $25.00 1,210.93 I TOTAL (Also enter on line 2, Recapitulation) $ 128,344.29 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RE1URN RESIDENT DECEOENI SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER ANNA JANE SPO%TS 21-02-00068 Include the. )roceeds of litigation and the date the proceed:s we:-: 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. 2 3 4 5 6 7 8 9 10 Citizens Bank Checking Acct 111-861-2629 11,551.78 Interest 1.98 Allstate Ins. Refund Comcast Cable Refund East Shore Oncology Refund Furniture sold Coins sold Susquehanna Center partial reimbursement of monthly charge Sale of 1993 Chevrolet Lumina 2001 Federal Income Tax Refund Refund of dumpster deposit TOTAL (Also enter on line 5, Recapil (I'r more space is needed, insert additional sheets o[ the same size) Jlation) 11,553.76 39.20 11.23 12.00 935.00 1,500.00 1,575.00 1,000.00 564.09 162.25 17,3_52.53 .... REV-1511EX + (h97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER ANNA JA_.'~ S~D~S '~ 21-02-00068 Debts of decedent must be reported on Schedule i. - - ITEM NUMBER DESCRIPTION AN~OUNT A. FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representa!ive (S) Social Security Number(s) / EIN Nurr, ber :,' Personal Representative(s) Street Address [ Cib, State Zip I Year(s) Commission Paid: 2. Attorney Fees at ,~97. oo 3. Family Exemption: (It decedent's address is not tJ',e .:ale as claimant's, attach e~planation) Claimant Street Address m City State Zip Relationship of Claimant to Decedent 4. Probate Fees 293. O0 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Aisc enter on line 9, Recapi?ation) $ 8t 790. O0 (If more space is .needed, insert additional sheets of the same size) V, MONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGELIABILITIES,& LIENS ESTATE OF AIXT~A &ZLN-E SPO'I'I'S FILE NUMBER 21-02-00068 Include unreimbursed medicz! expenses. ITEM NUMBER DESCRIPTION AMOUI'-iT 1. 1/02/02 1/17/02 2/1/02 2/1/02 2/1/02 2/1/02 ' 2/1/02 2/4/02 2/4/02 2/15/02 2/18/02 2/19/02 3/11/02 3/11/02 3/11/02 4/18/02 5/7/02 5/8/02 5/9/02 5/13/02 5/20/02 5/28/02 5/28/02 6/10/02 6/18/02 6/24/02 Citizens Bank (check supply, joint checking ) PP&L East Pennsboro Township (sewer) Verizon (cell phone) Youngs MediCal Equipment Verizon Travelers Insurance (homeowners) PA American Water Pinacle Health (hospital bill) Gene Sawyer GM Card PP&L PA American Water PP&L Travelers PP&L PA American Water Alicia Stine, Treasurer (real estate tax) PP&L CVLC (land clearing) Daniel Bome (grass cutting) Travelers Insurance PA American Water PP&L Backyard Woodshop Travelers Insurance TOTAL (Also enter on line 10, Re( (If more space is needed, insert additiona! .:.'~eets of the same size) apitulation)I $ 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 70.00 204.80 87.75 169.74 18.20 8.59 53.83 20.61 983.99' " 125.00 129.31 205.67 10.34 205.93 117.66 136.00 10.51 339.72 136.00 630.00 90.00 53.83 10.51 136.00 159.00 53.83 4,166.82 EE~-1513 EX * (1-97)° ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF NUMBER II. FILE NUMBER RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) TAXABLE DISTRIBUTIONS (include outright spousal distributions) Lynn Marco 311 North l0th Street, Lebanon, PA 17046 William and Barbara Woll 210 Sunset Dr., New Cumberland, PA 17070 niece brother/ sister-in-law ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE AMOUNT OR SHARE OF ESTATE $5,000.00 residue ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Market Square Presbyterian Church 20 South 2nd Street, Harrisburg, PA 17101 Lakeside Lutheran Church 245 Division Street, Harrisburg, PA 17110 TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEtT (If more space is needed, insert additionali'sheets of the same size) $1,000.00 5,000.00 $ 6,000.00 CITIZENS BANK P.O. Box 78 Philadelphia February 12, 2002 JOHN ALEXANDER ROE Attorney at Law 2520 Doehne Road Harrisburg, PA 17110 Estate Of Anna J Spotts Date of Death: 12/18/2001 SSN 168-24-9892 Dear Sir/Madam: In accordance with your request, the attached information sheet has been provid, above decedent's name as of his/her date of death. For IL or LC accounts, contact our Loan Department at 1-800-537-5591. For all other please call (215) 553-1585. Sincerely, Emelyr~ A/gulto Deposit Support Service~ 199-5355 ~9 PA 19101-7899 d in the nquiries, Page 1 of 2 Account Number 111-861-2629 CITIZENS BANK Tuesday, Account Title Allen A Spotts Decd Anna Jane Spotts Date opened: Principal Bal as of DOD $11,551.78 01/01/1962 Int from Last Posting to DOD $1.98 ~bmary 12, 2002 A( count Type: DD AccOunt Bal YTD Int to as cf DOD DOD $11,553.76 $27.69 A~count Type: SD Acco'unt Bal YTD Iht to as off DOD DOD 125-416 Anna Jane Spotts Date Opened: Principal Bal as of DOD 06/30/2000 Int from Last Posting to DOD Page 2 of 2 / S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1,[JFHA 2.L_JFmHA 3. L~CONV. UNINS. 4:LJVA 5. LJCONV. 6. FILE NUMBER: 7. LOAN NUMBER: . SETTLEMENT STATEMENT ETTINGER-MP-2002 8. MORTGAGE INS CASE NUMBER: ' · NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "[POC]" were paid outside the closing; they are shown here for informational purposes and are not/nclude',d in the totals. 10 3!98 =_%FINGER:MP.2OO;'PFDIETTI~GER-MP-200217) NAME AND ADDRESS OF BORROWER: '~arles E. Ettinger, III ~2 Lewisberry Road ,_.w Cumberland, PA 17070 · PROPERTY LOCATION: 0 Wertzville Road ~ola, PA 17025 Jmberland County, Pennsylvania E. NAME AND ADDRESS OF SELLER: William J. Woll and Barbara Woll H. SETTLEMENT AGENT: Mid-Penn Abstract Co. PLACE OF SETTLEMENT 125 Locust Street Harrisburg, Pennsylvania 17101 J. SUMMARY OF BORROWER'S TRANSACTI(~N · ' i. GROSS AMOUNT DUE FROM BORROWER: I. Contract Sales Price .~. Personal Property F...NAME AND ADDiESS OF LENDER: .F I. sETTLEMENT DATE: July 3, 2002 K. SUMMARY OF SELLER'S TI 400· GROSS AMOUNT DUE TO SELLER: 65,000.00 401. Contract Sales Price 402· Personal Property tA~SACTION 65,000.00 Settlement Charges to Borrower (Line '1400) 4,726.47 403. Adjustments For Items Paid By Seller in advance L School Taxes to *. County Taxes 07/04/02 to 01/01/03 168.46 L Ci!y Taxes to ). ). I. !. ). GROSS AMOUNT DUE FROM BORROWER 69,894.93 I. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 2,000.00 63,050.oo 404. 405. Adjustments For Items Paid By Seller in 406. School Taxes to 407.' County Taxes 07/04/02 ~dvance to 01101/03 408. City Taxes to 409. 410. · Deposit or earnest money L Principal Amopnt of New Loan(s) ',., Existing loan(s) taken subject to .. Soft. Second Mortgage ;. 2,100.00 Adjustments For Items Unpaid By Seller i. School Taxes 07/01/02 to 07/04/02 10.6! ., Count), Taxes to !. City Taxes to TO TAL PAID B Y/FOR BORROWER 67,1 CASH AT SETTLEMENT FROM/TO BORROWER: 411. 412. 420. GROSS AMOUNT DUE TO SELLER 168.46 65.168.46 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 501. Excess Deposit (See Instructions) 502. 4,033.86 Settlement Charges to Seller (Line 1400) 503. Existing loan(s) taken subject to 504. Payoff of first Mortgage second Mortgage 506. disb. as Proceeds) 508. 509. Adjustments For Items Unpaid By Sell'er 510. School Taxes 07101102 to 071q4102 10.65 511. County Taxes to I 12. City Taxes to 513. 514. 515. 516· 517, I 518· 519. I 520. TOTAL REDUCTION AMOUNT DUE SELLER 4.044,51 600. CASH AT SETTLEMENT TO/FRoM SELLER: Gross Amount Due From Borrower (Line 120) Less Amount Paid By/For Borrower (Line 220) 69,894.93 601· Gross Amount Due To Seller (Line 420) 67,160.65) 602. Less Reductions Due Seller (Line 520) '..CASH ( X FROM) ( TO) BORROWER ~e undersigned hereby acknowledge receipt of a completed copy of pages 1 &2 of this Borrower Charles E. Ettinger, III 2,734.28 603. CASH( X:TO)( FROM) SELLER statementseller & any attachments referred, to herein 65,168.46 4,044.51', 61.123.95 William J. Woll, Co-Executor of ihe Estate of Anna Jane 1. $ 3,250.00 to Re/Max Realty Associates, Inc. mJNDS AT SETTLEMENT 2. $ . , to 3. Commission Paid at Settlement ,~Ur,,ID S ~T TTLEMENT 4. to I 0. ITEMS PAYABLE IN CONNECTION WITH LOAN I 1. Loan Origination Fee 0.1250 % to Citizens Mortgage Corp. dfa/a CMC Funding Company I 78.81 2. Loan Discount % to r 3. Appraisal Fee to William Derrick I 250.00 4. Credit Report to The Credit Network I 16.00 3,250.00 5. Lenderlnspection Fee to William Derrick ' 6. ,Underwriting Fee 7. Tax Service Fee to Citizens Mortgage Corp. d/b/a CMC Funding Company to Citizens Mortgage Corp. d/b/a CMC Funding Company 8. Flood Certification Fee to First American Flood Data Service 9. Courier Fee 0. ITEMS REQUIRED By LENDER TO BE PAID IN ADVANCE 50.00 300.00 72.00 16.00 1. Interest From 07~03~02 to 08/01/02 @ $ 10.148460/day ( 29 days 5.8750%) 9679338940 POC $2!0.00b] '1 294.31J 50'441 Mortgage Insurance Premium for months to General Electric 3. Hazard Insurance Premium for 1.0 years to 5. )0. RESERVES DEPOSITEB WITH LENDER )1. Hazard Insurance 2.000 months )2. Mortgage Insurance months )3. School Taxes 2.000 months )4. County Taxes 7.000 months )5. City Taxe~ months 17.50 per month per month 107,95 per month 28.31 per month per month )6. months ~ $ per month )7. mon!hs )8.' Aggregate Adjustment months )0. TITLE CHARGES 35.00 215.90 198.17 )1. Settlement or Closing Fee to )2. Abstract or Title Search to )3. Title Certificate to Adler & Claraval )4. Title Insurance Binder to 15. Deed Preparation to Adler & Claraval )6. Notary Fees to Jody Goldring to )7. Attorney's Fees (includes above item numbers: 18. Title Insurance to Mid-Penn Abstract Co. (includes 'above item numbers: 19. Lender's Coverage $ 63,050.00 O. Owner's Coverage $ 65,000.00 1. End. 100,300 & 8.1 2'. Closing Protection Letter to Mid-Penn Abstract Co. to Fidelity National Title Insurance Company 7. Transaction Fee to Re/Max Realty Associates, Inc. 8. Federal Express Charges to Adler & Adler 0. GOVERNMENT RECORDING AND TRANSFER CHARGES per month per month -40.73 18.00 4.00 648.75 150.00 35.00 200.00 15.50 125.00 1. Recording Fees: Deed $ 28.50; Modgage $ 60.50; .2. City/County Tax/Stamps: Deed 3. State Tax/Stamps: Revenue Stamps Releases $ .Mortgage 'Modgage 0. ADDITIONAL SETTLEMENT CHARGES 1. Survey to 2. Pest Inspection to Home Paramount Pest Control to Alicia D. Stine 3. 2002-2003 School Taxes I 89.00J '1 650.00[ I 650.00 30.00 1,269.43[ 84'89I 4,726.471 to East Pennsb~ro Township 4. Quarterly Sewer/Trash 5. Tax Certification to Alicia D. stine 0. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) ~igning Page 1 of this statemenl, tile signatories acknowledge receipt of a completed copy of page 2 of Ibis t¢¢0 page ~ a emen. 2.86 2.00 4.033.86 Mid-Penn Abstract Co. Settlement Agent ,rtified to be a'true copy. JEFFERSON PILOT FI NANC IAL February 7, 2002 JOHN ALEXANDER ROE ATTORNEY AT LAW 2520 DOEHNE ROAD HARRISBURG PA 17i 10-9622 Jeffer Indiv PO B~ Conc (800) In Ne (8oo~, ESTATE OF ANNA JANE SPOTTS Contract #: 388004708 Claim #: 396225 Dear Mr. Roe: As you requested in your letter of January 31, 2002, the value of the abOve annuity as of the date of death of Anna Jane Spotts, December 18, 2001 is The account was opened with an initial premium of $14,481.10. The accou held jointly. There are no other accounts appearing under the name of Ann If you have any other questions, please contact me at 1-800-258-3648, ext. Sincerely yours, Ga'il ~. Jones, ACS, I~A, ALHC Seni0i- Claims Examiner Jefferson Pilot Financial Insurance Company ;O1'1 Pilot Financial dual Claims )x 2052 >rd, NH 03302-2052 258-3648 ~v Hampshire, 422 4481. eferenced ~19,396.05. was not Jane Spotts. 291. ] reyfus Family of Fund February 15, 2002 JOHN A ROE ESQ 2520 DOEHNE RD HARRISBURG PA P. O. Box 9268 Boston, MA 02205-8502 1711o REFERENCE: 01247474 - 2.0020215141715 THE DREYFUS FUND FUND:0000026-ACCOUNT:00251053526 (CLOSED) Dear Mr. Roe: We received recent correspondence regarding the ab©ye referenced account, a copy of which is enclosed..ts of December 18, 2001, the account had 9,820.409 shared with a net asset value of $9.95 per share. The total dol.ar balance on that date was $97,713.07. The balance Was calculated by multiplying the total number of shar.~s by the price (net asset value) per share. If you have any questions, please call a Dreyfus St~rvice Representative toll-free at 1-800-645-6561. Sincerely, Lindsay A. Giammarino BUREAU OF TNDZVZDUAL TAXES INHERITANCE TAX DIVISION EPT. 280601 ARRZSBURG, PA 17128-0601 JOHN A ROE ESQ 2520 DOEHNE RD HBG COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOHANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ~.*%~., ,:~; ' ~' ?:' ::::~ ESTATE OF DATE OF DEATH FILE NUMBER OCT 11 ACN 10-07-2C02 SPOTTS 12-18-2C31 21 OZ-O~S8 CUHBERLAND 101 Amoun~ Remi~ MAKE CHECK PAYADLE AND REGISTER OF HILLS CUMBERLAND CO COURF HOUSE / ANNA J ~ed REMIT PAYMENT TO: CARLISLE, PA 1701 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS REV-15~7 EX AFP (01-02} NOTZCE OF INHERITANCE TAX APPRAZSEMENT~ ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SPOTTS ANNA J FILE NO. 21 02-0068 ACN 10~ DATE i0-07-2002 TAX RETURN NAS: ( ) ACCEPTED AS F[LED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) ~. S~ocks and Bends (Schedule B) $. Closely Held S~ock/Par~narship Tn~eres* (Schedule C) ~. Hor~gages/No~as Receivable (Schedule D) 5. Cash/Bank Deposi~s/Nisc. Personal Eroper~y (Schedule E) 6. Jointly O~ned Proper~:y (Schedule F) . . 7. Transfers (Schedule G) 8. To,al Assa~s APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funeral Expenses/AdB. Costs/His(. Expenses (Schedule H) 10. Debts/Hot,gage Liabilities/Liens (Schedule Z) 11. To':al Deductions 12. Ne~ Value of Tax Re~urn (1) 61z12:5.95 (;) 128~$~.2~ cs) .od (,,) .o~ (s) 17~352.5~ (6) .OIJ (7) .O(J (~) (9) 8'790'001 (lO) ~,166.?~) (12) 15. 1~. NOTE: ASSESSMENT OF TAX: 15. Amoun~ of Line lq a~ Spousal ra~e 16. Amoun~ of Line lq ~axable a~ Lineal/Class A ra~e 17. Amoun~ Of Line 1~ a~ Sibling ra~e 18. Amoun~ of Line 1~ *axable a~ Collateral/Class B ra*e 19. Principal Tax Due TAX CREDXTS: Charitable/Governmental Bequests; Non-Bloc*ed 9115 Trusts (Schedule J) (15) Ne~ Value of Es~a*a Sub,ac* ~o Tax (li) xf an assessment ~as lssued prevlously, lines 1~, 15 and/or 16, reflect figures that lnclude the total of ALL returns assessed (15) . O0 x (16) . O0 X (17) 182,865.95 x (16) 5,000.00 x NOTE: To insure proper credit ~o your accoun*, submi~ ~he uppeH por~ion of ~his for. ~i~h your ~ax payment. 206,820.77 ]2.9;6.82 193,863.95 6,000.00 187,865.95 17, 18 and 19 will to date. I0 = .00 1~5 = . O0 ~2 = 21,9~$.68  5 = 750.00 (19)= 22,695.68 XF PAXD AFTER DATE INDICATED, SEE REVERSE ( ZF TOTAL DUE IS LESS THAN $1, NO PA~NENT 1S REDUZRED. FOR CALCULAT/ON OF ADD/T/ONAL INTEREST. ZF TOTAL DUE IS REFLECTED AS A "CRED/T" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) / PAYHENT RECEIPT DISCOUNT (+) ANOUNT PAID ' J DATE NUHBER ZNTEREST/PEN PA/D (-) I 0:5-15-Z00Z CD000965 1,078. Sq. ZO, ~88. r+O 08-12-2002 CD001510 . O0 976.9:5 INTEREST IS CHARGED THROUGH 10-22-2002 TOTAL TAX CREDIT 22,5q:5.67 AT THE RATES APPLICABLE AS OUTL]:NED ON'THE BALANCE OF TAX DUE 150.01 REVERSE SIDE OF THTS FORM INTEREST AND PEN. .8~ TOTAL DUE 150.85 RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (ER): OBJECTIONS: ADNZN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on br before December IZ, 198Z ~- if any future interest in the estate i~ transferred in possession or'enjoyment to Class B {collateral) beneficiaries of the decedent after the expiration af any estate .for' life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 {collateral) rate on any such future interest. To fulfill, the requirements of Section 21~a of the Inheritance and Estate Tax Act, Act Z5 of 2000. (7Z P.S. Section 91~0). Detach the top portion of this Notice and submit aith your payment tm the Register of Hills printed an the reverse side.. --Hake check or money order payable to: REGISTER OF HZ'ELS, AGENT A refund of a tax credit, ehich ams not requested on the Tax Return, may be requested by completing an "APplica[ion for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register of Nills, any of the Z5 Revenue District Offices, or by calling the special 24-hour ansaaring service for forms ordering: 1-800-36Z-ZO50; services for taxpayers with special hearing and / o~ speaking needs: 1-8OO-4qT-5OZO (TT only). Any party in interest n~t satisfied with the appraisement, 'allaeance, ar disalloaance of deductions, or assessment: of tax (including discount or interest) as shown on this Notlce must 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-lOZ1j --election to have the matter determined at audit of the account of the parsunal representativej OR --appeal to the Orphans' Court. OR Factua! errors discovered on this assessment should be addressed in writing to: .PA Department of Revenue, Bureau of Individua! Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for aResident Decedent" (REV-1SOI) for an explanation of administratively correctable errors. I~ any tax due is paid within thre~ (3) calender'months after the decedent's death, a five percent (SI) discount of the tax paid is allemed. The 15Z tax amnesty 'non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This nan-participation penalty is appealable in the same manner and in the the same time period as you mould appeal the tax and interact that has been assessed as indicated on this notice. Interact is'charged beginning with first day of dalinquancy~ or nine (9) months and Dna (1) day from the date of daath~ to the'date of payment. Taxes mhich became delinquent before January 1~ 198Z bear interest at the rate of six (6Z} percent par annum calculated at a daily rate of .00016~. All taxes which becamedalinqpent an and after January 1, 198Z mill bear interest at a rate.which mill vary from calendar year to calendar.year with that rate announced by the PA Department of Revenue. The applibabla interest rates for 19aZ through ZOOZ are: Daily Interest Factor .000Z47 .O0019Z .OOOZq7 .00019Z .OOOZ19 .O00Z~7 .000164 X DAILY INTEREST FACTOR Year Interest Rate Daily Interest Factor Year Interest Rate 198Z 20Z .0005~8 1992 9Z 1985 16Z - .000~38 1995-1994 7Z 1984 llZ .000301 1995-1998 9Z 1985 13Z .000356 1999 7Z 1986 lOX .00027¢ ZOO0 8Z 1987 9Z .OOOZ~7 ZOO1 9Z 1988-1991 l~Z .000301 ZOOZ 6Z --Interest is calculated as follams: /'NTBREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT --Any Notice issued afterthe 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 caZcuZeted.  TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENTS NAME Spotts, Anna J. FILE NUMBER 21 02-0068 REVIEVVED BY Daniel Heck ACN 101 ITEM r SCHEDULE NO. EXPLANATION OF CHANGES J la Changed tax rate from 12 percent to 15 percent since a nephew i a collateral beneficial. Row Page 1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001764. ROE JOHN A ESQ 2520 DOEHNE ROAD HARRISBURG, PA 17110 ........ fold ESTATE INFORMATION: SSN: 168-24-9892 FILE NUMBER: 2102-0068 DECEDENT NAME: SPOTTS ANNA JANE DATE OF PAYMENT: 10/23/2002 POSTMARK DATE: 1 0/22/2002 COUNTY: CUMBERLAND DATE OF DEATH: 12/18/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $150.85 TOTAL AMOUNT PAID: $150.85 REMARKS: SEAL CHECK# 335 INITIALS: AC RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 02-00068 FIRST AND FINAL ACCOUNT OF William J. Woll and Barbara Woll, co-Executors for the ESTATE OF ANNA JANE SPOTTS, Deceased Date of Death: Date of Executor Appointment: Accounting for the Period: December 18, 2001 January 22, 2002 1/22/02 to 10/31/02 PURPOSE OF ACCOUNT: William J. Woll and Barbara Woll, co-Executors for the ESTATE OF ANNA JANE SPOTTS, offers this Account to acquaint interested parties with the transactions that have occurred during this administration. This Account also indicates the distribution of the Estate. It is important that the Account be carefully examined. Requests for additional information or questions or objections can be discussed with: John A. Roe, Esquire Attorney for the Estate of ANNA JANE SPOTTS 2520 Doehne Road Harrisburg, PA 17110-9622 717/671-9870 ESTATE OF ANNA JANE SPOTTS SUMMARY 810 Wertzville Road Enola, Pennsylvania Sold July 3, 2002 61,123.95 Receipts & Income 120,980.00 TOTAL RECEIPTS $182,103.95 Debts of Decedem Attorney's fee (balance due) 41,633.22 4,248.50 TOTAL DEBTS 45.881.72 BALANCE ON HAND (Estate Checking Accoum) $136,222.23 Balance for Distribution to William J. Woll and Barbara Woll $136,222.23 ESTATE OF ANNA JANE SPOTTS REAL ESTATE 810 Wertzville Road, Enola, Pennsylvania All that certain tract or parcel of land situate in East Pennsboro Township, Cumberland County, Pennsylvania more particularly bounded and described according to a survey of D. P. Raffensperger, Registered Surveyor, dated December 8, 1955 and recorded in the Register of Deeds Office, Cumberland County, PA Book Z 18, Page 409. Property sold July 3, 2002 (see attached settlement sheet) $61,123.95 ESTATE OF ANNA JANE SPOTTS RECEIPTS CASH/STOCKS/BONDS 7,000.00 610.50 94,951.15 1,832.87 Beginning Balance (Transfer from Decedents checking account) Balance to close Decedents checking account The Dreyfus Fund Jefferson Pilot Annuity U. S. Govt. Savings Bonds 18 EE $100 136 EE @ $50 Furniture sold Coins sold Susquehanna Center partial reimbursement of monthly charge Sale of 1993 Chevrolet Lumina 2001 Federal Income Tax Refund Refund of dumpster deposit U. S. Govt. Savings Bonds 6 @ $25.00 1,210.93 Traveler's Insurance (refund) 40.98 Citizens Bank interest 2/28 14.43 Citizens Bank interest 3/29 34.17 Citizens Bank interest 4/30 33.41 Citizens Bank interest 5/31 31.17. Citizens Bank interest 6/20 18.76 Citizens Bank interest 6/28 9.39 Citizens Bank interest 7/31 45.61 Citizens Bank interest 8/31 49.37 Citizens Bank interest 9/30 47.33 9,313.24 935.35 1,500.00 1,575.00 1,000.00 564.09 162.25 TOTAL 120,980.00 ESTATE OF ANNA JANE SPOTTS DEBTS OF DECEDENT William J. Woll (Reimburse probate fee) East Pennsboro Township (sewer) Verizon (cell phone) Youngs Medical Equipment Verizon Travelers Insurance (homeowners) PA American Water Pinacle Health (hospital bill) Gene Sawyer GM Card PP&L PA American Water PP&L PA American Water Travelers Register of Wills, Agent (inheritance tax) PP&L PA American Water East Pennsboro Township (sewer) Travelers Insurance Homeland Center (physical therapy) Lynn Marco (bequest) Lakeside Lutheran Church (bequest) Market Square Presbyterian Church (bequest) PP&L PA American Water Travelers Insurance Alicia Stine, Treasurer (real estate tax) PP&L CVLC (land clearing) Daniel Boone (grass cutting) Travelers Insurance Backyard Woodshop PP&L East Pennsboro Ambulance James Gingrich Memorials (marker inscription) Daniel Boone (grass cutting) PA American Water John A. Roe, Esq. (Partial attorney's fee) Register of Wills (filing fee) Register of Wills, Agent (balance due inheritance tax) 293.00 87.75 169.74 18.20 8.59 53.83 20.61 983.99 125.00 129.31 205.67 10.34 205.93 10.50 117.66 20,488.40 136.00 10.51 87.75 53.83 98.47 5,000.00 5,000.00 1,000.00 136.00 10.51 53.83 339.72 136.00 630.00 90.00 53.83 159.00 258.31 25.00 80.00 45.00 10.51 4,248.50 65.00 976.93 TOTAL $41,633.22 RELEASE KNOW ALL MEN BY THESE PRESENTS, that Lakeside Lutheran Church, Harrisburg, Dauphin County,' Pennsylvania, one of the beneficiaries of Anna Jane Spotts, deceased, late of the Enola, 'Cumberland County, Pennsylvania, who died testate on December 18, 2001 and whose Last Will and Testament dated November 21, 2001 was duly probated in the Office of the Register of Wills of Cumberland County, Pennsylvania on January 22, 2002 and recorded to No. 2002-00068, DO HEREBY: , 1. Acknowledge the receipt of the sum of Five Thousand Dollars ($5,00.00) which represents payment in full of the bequest in paragraph No..2~ of gaid Will which provides as follows: "2. I give, devise and bequeath the sum of Five Thousand Dollars ($5,000.00) to Lakeside Lutheran Church of Harrisburg, Pennsylvania." 2. Release and forever discharge William J. Woll and Barbara Woll, co- Executors of the ESTATE OF ANNA JANE sPoITS, her heirs and assigns, and the Estate of Anna Jane Spotts, deceased, of the aforesaid payment and of and from all actions, suits, payments, accounts, reckonings, claims and 'demands whatsoever. This instrument shall be legally binding upon the successors and assigns of Lakeside Lutheran Church. ~': IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of ,2002. WITNESS: 6L~,~ ~LO By: RELEASE KNOW ALL MEN BY THESE PRESENTS, that Market Square Presbyterian Church, Harrisburg, Dauphin County, Pennsylvania, one of the beneficiaries of Anna Jane Spotts, deceased, late of the Enola, Cumberland County, Pennsylvania, who died testate on December 18, 2001 and whose Last Will and Testament dated November 21, 2001 was duly probated in the Office of the Register of Wills of Cumberland County, Pennsylvania on January 22, 2002 and recorded to No. 2002-00068, DO HEREBY: 1. Acknowledge the receipt of the sum of One Thousand Dollars ($1,00.00) 1. of said Will which provides which represents payment in full of the bequest in paragraph No. as follows: I give, devise and bequeath the sum of One Thousand Dollars ($1,000.00)to Market Square Presbyterian Church of Harrisburg, Pennsylvania." 2. Release~ and forever discharge William J. Woll and Barbara Woll, co- Executors oft. he'ESTATE OF A~n~IA' JANE SPOITS, hel- heirs and assigns, and the Estate °f Anna Jane Spotts, deceased, of the aforesaid payment and of and from all actions, suits, payments, accounts, .reckonings, claims and demands whatsoever. This instrument shall be legally binding upon the successors and assigns of Market Square Presbyterian Church. day of IN WITNESS WHEREOF, I have hereunto set my hand and seal this APf~ 0:'8.,2@@! ,2002. WITNESS: IM' .- NOTARIAL SEAL I TRUONG N. PHUONG, Notary Public ~ City'of Harrisburg, Dauphin County I y Commission Expires Nov. 14, 2oo2J Member, Pennsylvania Association of Notaries By: For Market S~yte~rian Church KNOW ALL MEN BY THESE PRESENTS, that I, Lynn Marco, by her parents and natural guardians, Jean and William Marco, of Lebanon, Lebanon County, Pennsylvania, one of the beneficiaries of Anna Jane Spotts, deceased, late of the Enola, Cumberland County, Pennsylvania, who died testate on December 18, 2001 and whose Last Will and Testament dated November 21, 2001 was duly probated in the Office of the Register of Wills of Cumberland County, Pennsylvania on January 22, 2002 and recorded to No. 2002-00068, DO HEREBY: 1. Acknowledge the receipt of the sum of Five Thousand Dollars ($5,00.00) which represents payment in full of the bequest in paragraph No. 3. of said Will which provides as follows: "3. I give, de,v.i?~e:~-.~..nd~-!'ibequeath the sum of Five Thousand Dollars ($5,000.00) to my Niece, Lynn Marco, of Lebanon, Pennsylvania." 2. Release and forever discharge William J. Woll and Barbara Woll, co- Executors of the ESTATE OF ANNA JANE SPOITS? her heirs and assigns, and the Estate of Anna Jane Spotts, deceased, of the aforesaid payment and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever. This instrument shall be legally binding upon the ~successors and assigns of Lynn Marco. day of IN WITNESS WHEREOF, I have hereumo set my~ hand and seal this ~~ ,2002. ? WITNESS: ~n Marcel Mother and Natural Guardian Of Lynn Marco William Marco, Father and Natural Guardian Of Lynn Marco RELEASE KNOW ALL MEN BY THESE PRESENTS, that we, William J. Woll and Barbara Woll of New Cumberland, Cumberland County, Pennsylvania, two of the beneficiaries of Anna Jane Spotts, deceased, late of the East Pennsboro Township, Cumberland County, Pennsylvania, who died testate on December 18, 2001 and whose Last Will and Testament dated November 21, 2001 was duly probated in the Office of the Register of Wills of Cumberland County, Pennsylvania on January 22, 2002 and recorded to No. 2002-00068, DO HEREBY: 1. Acknowledge the receipt of the sum of One Hundred Thirty-six Thousand Two Hundred Twenty-Two and 23/100 ($136,222.23) which represents the balance for distribution as s~["~orth in the Informal Accounting attached hereto, and which represents full payment of thei'b~luest in paragraph No.4. of said Will which provides as foilows: ~'- ' :" ~"~.:'~',- '. I give, devise and bequeath all the rest, residue and remainder Cff my property, real, personal and mixed, of whatsoever nature and wheresoever situate, of which I shall die seized and possessed, or to which I shall be entitled at the time of my decease, to my brother, William J. Woll and his wife, Barbara Woll, or the survivor of them, per stirpes." 2. Release and forever discharge William J. Woll and Barbara Woll, co- Executors of the ESTATE OF ANNA JANE SPOITS, her heirs and assigns, and the Estate of Anna Jane Spotts, deceased, of the aforesaid payment and of and from all actions, suits, payments, accounts, 'reckoni~gs, claims and demands whatsoever. ":'" ......... ' '~. '~' -T}fi~"'instmment shall be legally binding upon the successors and assigns of William J'.i,Woll:' and Barbai:a Woll. day of IN WITNESS WHEREOF, I have hereunto set my hand and seal this 1 /~ ~/~ ~k~ ,2002. WITNESS: Wllham Y. Wgt~ 'Barbara Woli O_q:tE\/ LZ ADN ZO. PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE A 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Anna Jane Spotts Date of Death: December 18, 2001 Will No. 21-02-00068 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: State whether administration of the estate is complete: Yes x No If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 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 X b. The separate Orphans' Court No. (if any) for the personal representative's account is: Did the personal representative state an account informally to the parties of interest? Yes x No D ate: Novem~ber 26? 2002 Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Sign~~~' John A. Roe, Esq. 2520 Doehne Road Harrisburg, PA 17110 717/671-9870 Capacity: __ X Personal Representative Counsel for personal representative