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HomeMy WebLinkAbout03-0947Estate of also known as Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Martha C. Ratcliff No. ,~ i - ~) ~) -- q ~ -7 C. Michael Ratcliff Petitioner, who is18 years o~ age or older, aplY~(ies) for: , Deceased Social Security No. 173-38-5910 (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner is the executor named in the Last Will of the ~ Decedent, dated June 1, 1989 and codicil(s) dated October 1, 1999 Stale relevant cifcumnt~nces, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: NO EXCEPTIONS B. Grant of Letters of Administration (d.b.n.c.t.a.: pendente lite; durante ab~entJa; durante miaont ate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence I (COMPLP_ I P_ IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or 1139 Country Club Road, Camp Hill, East Pennsboro Township, Cumberland County, Pennsylvania (list street, number and municipality) Decedent, then 90 years of age, died October 27, 2003, at Holy Spidt Hospital, Camp Hill, Pennsylvania (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property ........................................................................................... $ (If not domiciled in PA) Personal property in Pennsylvania ..................................................................... $ (If not domiciled in PA) Personal property in County ............................................................................... $ Value of real estate in Pennsylvania ............................................................................................................................ $ Total ................................................................................................................... $ Real Estate situated as follows: principal residence at 500,000.00 Wherefore, Petitioner respectfully requests the probate of the last Will presented with this Petition and the grant of letters in the appropriate form to the undersigned: Typed or pdnted name and residence v/ Signature C. Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Form RW*I Page 1 of 2 (Dauphin County) - Rev. 9/92 494894.1 Oath of Personal Representative Commonwealth of Pennsylvania County of The Petitioner above-named swears and affirms that the statements in the foregoing P~tition are true and correct to the best of the knowledge and belief of Petitioner and that, as personal representative of theJ:~dent Pet tioner will well and truly administer the estate according to law. ,~ / Sworn to and affirmed and subscribed '~//r~'~1~ .~~ before me this !~ ~ day of C. Michael Ratcliff 2003 No. o,~1- 0,,.,~ - Estateof ~'~.(~.~_~_o~ ~_~ [~O~CL~j~ Deceased Social Secudty No: ~,~° '~.- ~jo~ ~O Date of Death: AND NOW, ~ke~- ~,~-,L,-~-. i q ,20 O_0_~, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [] Testamentary [] of Administration d.b.n.c.t.; pendente lite; durante absentia; durante minoritate are hereby granted to ~.. ~"'~.£~~ "~,,c~ c.),j~, in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........................... Short Certificate(s) .......... $ Renunciation .................. $ Affidavit ( ) ................. $ Extra Pages ( ) ............ $ Codicil .......................... $ JCP Fee ........................ $ Inventory ....................... $. Other ............................ $. C~.~ P ~. ~- L~..,,~-~ ~ IS', 00"~-"1 ~z~ .~ TOTAL ................ Form RVV-1 Page 2 of 2 (Dauphin County) - Rev. 9/92 Attomey: Stanley A. Smith I.D. No: 33782 Address: Rhoads & Sinon LLP1 PO Box 1146 1 South Market Square, Hardsbur.q, PA 17108-1146 Tale. phone: 717-233-5731 Register of Wills of Dauphin County, Pennsylvania OATH OF SUBSCRIBING WITNESS Estate of ~Ou"~~ t) U also known as , Deceased (each) a subscribing witness to the '~codicil(s) ~lvvill(s) presented herewith, (each) being duly qualified according to law depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and that she/he/they signed as a witness at the request of Testator(rix) in his/her/their presence and [ I in the presence of each other [] in the presence of the other subscribing witness(es). Sworn to or affirmed and subscribed before me this Io~~J~ day of lic (-J (Signature) F - (Signature) (Address) NOTE: To be taken by officer authorized to administer oaths. Please have present the original or copy of Instrument(s) at time of notarization. RW-11 Register of Wills of'Battl~in County, Pennsylvania OATH OF SUBSCRIBING WITNESS also known as , Deceased (each) a subscribing witness to the [~i codicil(s) ~will(s) presented herewith, (each) being duly qualified according to law depose(s) and say(s) that shffZ~lthe~ere present and saw the above Testator(rix) sign the same and that she~[hey signed as a witness at the request of Testato~.~_~. in hi~)/their presence and ~iJ in the presence of each other Bin the presence of the other subscribing witness(es). Sworn to or affirmed and subscribed before me this /'~/'/2 ~ _ day of (Signature) (Address) To be taken by officer authorized to administer oaths. Please have present the original or copy of Instrument(s) at time of notarization. RW-11 also known as Register of Wills of Dauphin County, Pennsylvania OATH OF NON-SUBSCRIBING WITNESS ., Deceased (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that she/he/they codicil was/were familiar with the signature of I"IC~CL,'dd~::~ ~--_~. ~c3.~._'~)_~13 , testator(rix)of the~ codicil presented herewith, and that such subscriber(s) believes the signature on the ~ is in the handwriting of ~~~. ~. ~ 0 to the best of such subscriber's knowledge and belief. t, ,~,u.ature, ~ ~ ~ , (Signature) ' Sworn to or affirmed and subscribed before me this } ~ ~ day of For~e Register (Address) RW-12 Estate of Martha C. Ratcliff also known as Register of Wills of Cumberland County, Pennsylvania OATH OF NON-SUBSCRIBING WITNESS , Deceased Henry W. Rhoads a subscriber hereto, being duly qualified according to law, depose and say that he was familiar with the signature of Martha C. Ratcliff, testatrix of the codicil presented herewith, and that such subscribers believe the signature on the codicil is in the handwriting of Martha C. Rat~ff, to the best of such subscriber's knowledge and belief. Mechanicsburg, PA 1~Q§5 Sworn to or affirmed and subscribed before me this /c~ dayof Form RW-12 (Dauphin County. Rev. 495051.1 I05112 REV. 8/88 (FEE FOR THIS CERTIFICATE $2.0011 WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH VITAL RECORDS LOCAL REGISTRAR'S CERTIFICATION OF DEATH CERT. NO. T 5512631 October 31, 2003 Date of Issue of This Certification Name of Decedent Martha First Ce Ratcliff Middle Last Sex. Female Social Security No. 173-38-5910 Date of Birth March 19, 1913Birthplace Williamsport, Place of Death Holy Spirit ~-ospital Cumberland Facility Name County PA Date of Death E.Pennsboro City, I~k~rough or Township 10-27-2003 T~. Pennsylvania Race. Marital Status Informant H. White Occupation Homemaker Decedent's Married Mailing Address Chalfant Ratcliff 1139 Country Number Name and Address of Funeral Establishment Funeral Director David Myers Funeral Home, Armed Forces? (YesorNo) Club Rd. Camp Hill Street ~ty or Town Sally A. Myers Newport, PA 17074 No PA 17011 State Part h Part I1: Immediate Cause (a) Pulmonary Edema (b) Congestive Heart Failure (c) (d) Other Significant Conditions Interval Between Onset and Death Manner of Death Natural [~[X Accident [] Suicide [] Homicide [] Pending Investigation [] Could not be Determined [] Describe how injury occurred: Name and Title of Certfier Eric J. Binder M.D. Address Camp Hill, PA 17011 (M.D., D.O., Coroner, M.E.) This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing..,,~ __ _ 1~/ /al ~e~,strar of Vital Records District NO October 31, 2003 01 Barnett St., New Bloomfield, PA Date Received by Local Registrar Street Address City, Borough, Township 17068 CODICIL TO THE WILL OF MARTHA C. RATCLIFF I, MARTHA C. RATCLIFF, of Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be a Codicil to my Last Will and Testament dated June 1, 1989. I hereby delete ITEM X of my Will and replace said ITEM with the following provision: "ITEM X: I appoint my son C. MICHAEL RATCLIFF as Executor of my Estate." IN WITNESS WHEREOF, I have hereunto set my hand and seal to this Codicil to my Last Will and Testament, consisting of this page, this /~ day of ~~j , 1999. Martha C. Ratci'iff~ SEAL ) 313005.1 We, the undersigned, hereby certify that the foregoing Codicil was signed, sealed, published and declared by the above- named Testatrix as and for her Codicil to her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. SEAL) SEAL) ~sLding at: ~./3~- ~/~L~¥~ ~/ Residing at: CODICIL MARTHA C. RATCLIFF ATTORNEYS AT LAW ONE SOUTH MARKET SQUARE P.O. BOX 1146 HARRISBURG, PA 17108-1146 LE~/Will Disk #6/May 24, 1989/bl~/RatcliffM.wil/#1 LAST WILL AND TESTAMENT OF MARTHA C. RATCLIFF I, MARTHA C. RATCLIFF, of Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time previously made. ITEM I: All inheritance, estate and similar taxes becoming due by reason of my death ("Death Taxes"), whether such Death Taxes shall be payable by my estate or by any recipient of any property, shall be paid by my Executor out of the property passing under ITEM V of this Will as an expense and cost of administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any Death Taxes paid by my Executor, even though paid with respect to proceeds of insurance or other property not passing under this Will. ITEM II: I hereby exercise all powers of appointment which I may have at the time of my death in favor of my Executor, and all property subject to all such powers of appointment shall be included in my estate and be governed by the provisions of this Will. Page 1 of 6 pages ITEM III: I give and bequeath all of my jewelry to my issue living at my death, per stirpes, in such shares as they shall select and agree between themselves. I may leave with this Will a separate unsigned list of such jewelry and the issue to which I desire such items to be distributed, which shall not be binding on my Executor. If my issue cannot reach an agreement as to the distribution of such items, I give such items to my husband, H. CHALFANT RATCLIFF ("My Husband"), if he survives me; or, if he does not survive me, such items shall be sold and the proceeds thereof shall be distributed as part of my residuary estate. ITEM IV: I give and bequeath all of my household furniture and furnishings, automobiles, books, pictures, china, crystal, appliances, silverware, wearing apparel and all other like articles of household or personal use or adornment, not disposed of in the preceding portions of this Will, to My Husband, if he survives me. If My Husband does not survive me, I give such articles to my issue living at my death, per stirpes, in as nearly equal shares as they shall select under the supervision of my Executor. If any such articles cannot be fairly divided or distributed in kind in the opinion of my Executor, such articles shall be sold and the proceeds thereof shall pass as a part of my residuary estate. Page 2 of 6 pages ITEM V: I give, devise and bequeath all the rest and residue of my property, real, personal and mixed, not disposed of in the preceding portions of this Will, to My Husband, if he survives me; or, if he does not survive me, to my issue living at my death, per stirpes. ITEM VI: No interest in income or principal of my estate shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary of my estate prior to the beneficiary's actual receipt thereof. My Executor shall pay over the net income and the principal to the beneficiaries herein designated, as their interests may appear, without regard to any attempted anticipation (except as may be specifically provided herein), pledging or assignment by any beneficiary of my estate and without regard to any claim thereto or attempted levy, attachment, seizure or other process against said beneficiary. ITEM VII: Any person, who shall have died at the same time as I or under such circumstances that it is difficult or impossible to determine who shall have died first, shall be deemed to have predeceased me. ITEM VIII: In the settlement of my estate, my Executor shall possess, among others, the following powers to be exercised for the best interests of the beneficiaries: Page 3 of 6 pages (a) To retain any investments I may have at my death so long as my Executor may deem it advisable to my estate so to do. (b) To vary investments, when deemed desirable by my Executor, and to invest in such bonds, stocks, notes, real estate mortgages or other securities or in such other real or personal property as my Executor shall deem wise, without being restricted to so-called "legal investments.,, (c) In order to effect a division of the principal of my estate or for any other purpose, including any final distribution of my estate, my Executor is authorized to make said divisions or distributions of the personalty and realty partly or wholly in kind. If such division or distribution is made in kind, said assets shall be divided or distributed at their respective values on the date or dates of their division or distribution. In making any division or distribution in kind, my Executor shall divide or distribute said assets in a manner which will fairly allocate any unrealized appreciation among the beneficiaries. (d) To sell either at public or private sale and upon such terms and conditions as my Executor may deem advantageous to my estate, any or all real or personal estate or interest therein owned by my estate severally or in conjunction with other persons or acquired after my death by my Executor, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon my Executor in this paragraph or elsewhere in this Will. (e) To mortgage real estate and to make leases of real estate for any term. (f) To borrow money from any party, including my Executor, to pay indebtedness of mine or of my estate, expenses of administration, Death Taxes or other taxes. Page 4 of 6 pages (g) To pay all costs, Death Taxes or other taxes, expenses and charges in connection with the administra- tion of my estate, and my Executor shall pay the expenses of my last illness and funeral expenses. (h) To vote any shares of stock which form a part of my estate and to otherwise exercise all the powers incident to the ownership of such stock and to actively manage and operate any unincorporated business, including any joint ventures and partnerships, with all the rights and powers of any owner thereof. (i) In the discretion of my Executor to unite with any other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of my estate. (j) To assign to and hold in my estate an undivided portion of any asset. (k) To hold investments in the name of a nominee. (1) To compromise controversies. ITEM IX: If at any time any minor shall be entitled to receive any assets free of trust hereunder, I give such minor's share to my surviving son, as Custodian for such minor under the Pennsylvania Uniform Gifts to Minors Act; or, if neither of my sons is then living, to the minor's surviving natural parent, as such Custodian for the minor. ITEM X: I hereby appoint My Husband as Executor of this Will. If for any reason he should fail or cease to act, I appoint my son, C. MICHAEL RATCLIFF, as Executor. If for any reason my son, C. Michael Ratcliff, should fail or cease to act, I appoint my son, H. CHALFANT RATCLIFF, JR., as Executor. Page 5 of 6 pages Ail references in this Will to my "Executor" shall refer to my originally appointed Executor or to my successor Executor, as the case may be. My Executor shall qualify and serve without the duty or obligation of filing any bond or other security. If either of my sons serves as Executor, he shall serve without compensation. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding five (5) pages, this ~'~,~£~--day of ~!~.~-~ ~ .... , 1989. Page 6 of 6 pages Martha C. Ra~-cllff .~.~ We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year ~ove written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and di~p lng mi a ory. ~\~t\l~,~~ ~~h(SEAL) Residing at: (SEAL) Residing at: LAST WILL AND TESTAMENT OF MARTHA C. RATCLIFF ATTO~NIEYS AT LAW 410 NORTH THIRD STREET P. O. BOX 1146 HARRISBURG, PA 17108-1146 I CERTIFICATE OF NOTICE UNDER RULE 5.6(a) Martha C. Ratcliff October 27, 2003 Adm. No. Name of Decedent: Date of Death: Will No. 2003-00947 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on November 24, 2003. Name Mr. H. Chalfant Ratcliff Mr. Hugh Chalfant Ratcliff, Jr. Address 1139 Country Club Road Camp Hill, PA 17011 329 S. Lee Street Alexandria, VA 22314 38 Sunfire Avenue Camp Hill, PA 17011 Mr. C. Michael Ratcliff Date: November~, 2003 Signature: Name: Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NO EXCEPTIONS ....... ~ Telephone: Rhoads & Sinon LLP One South Market Square, 12th Floor P. O. Box 1146 Harrisburg, PA 17108-1146 (717) 233-5731 Capacity: Personal Representative X Counsel for Personal Representative 495875.1 I=V- 15OO EX (0-(30) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER __~- 03-=0947 COUNTY CODE YEAR NUMBER Z 0 A. 0 Z Z 0 DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL) Ratcliff Martha DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DO-YEAR) 10/27/2003 03/19/1913 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL) ~. Chalfant Ratcliff I x I 1. Original Return I I 2, Supplemental Return SOCIAL SECURITY NUMBER C 173-38-5910 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 172-24-8334 ----] 3. Remainder Return (date of death prior to 12-13-8 I-'"-] 4. Limited Estate ~--~0. Decedent Died Testate (Attach copy of Will) [~9. Litigation Proceeds Received ~'] 4a. Future Interest Compromise (date of death after 12-12-82) ~] 5. Federal Estate Tax Return Required --]7. Decedent Maintained a Living Trust (Attach copy of Trust) 0 8. Total Number of Safe Depoelt Boxes ~'-] 10. Spousal Poverty Credit (date of death be~w)e. 12-31-91 and 1-1-95] I--'] 1 1. Election to tax under Sec. 91 13(A)iA.ach Sch :THIS: SECTION MUST: BE COM~D: ~ CORRESPONDENCE AND :CONFiDENTIAE TAX INFORMATION SHOULD SE DtRECTED TO: NAME ~tanley A. Smith, Esquire FIRM NAME (If ApplicaB~) Rhoads & Sinon, LLP TELEPHONE NUMBER 717-233-5731 COMPLETE MAILING ADDRESS P.O. Box 1146 Harrisburg, PA 17108-1146 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 (Schedule E) (5) 0. Jointly Owned Property (Schedule F) (§) [-~ ~parate Billing Requested 7.Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross As~ts (total Lines 1-7) 9. Funeral Expeneas & Administrath/e Costs (schedule H) (9) 10. Debtsof Decedent, Mortgage Liabilities, & Liens (Schedule l) (10) 11. Total Deductione (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11 ) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 0.00 474,293.95 0.00 0.00 151,501.91 0.00 0.00 30,061.30 0.00 (11) (12) (13) OFFICIAL USE ONLY 625,795.86 30,061.30 595,734.56 0.00 14. Net Value Subjeet to Tax (Line 12 minus Line 13) (14) 595,734.56 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9110 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. 580,899.56 x.O 0.00(15) 14,835.00 x.O45 0.00 x.lZ (17) 0. 00 x.15 (18) (19) 0.00 667.58 0.00 0.00 667.58 > > BE SURETO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < HASPXXNUMBER Estate"of Martha C Ratcliff 173-38-5910 Name Address Tax ID Executors (Page 1) C. Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011- 173-38-5972 Decedent's Complete Address: STREET ADDRESS ~139 Country Club Road Cumberland Camp Hill ISTATE IZIP Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty 0.00 634.20 33.38 0.00 0.00 (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) 17011- 667.58 667.58 0.00 0.00 0.00 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) A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) 0.00 Make Check Payable to: REG/STER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................... ~ ~-~ b. retain the right to designate who shall use the 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 death7 ~ ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ E~ ~ 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 return, including accompanying schedules end statements, and to the best of my knowledge and belief, it is true. correct and complete. Declaration of preparer other then the personal representative ~jed on all information of which preparer has any knowledge. 'SIGNATURE OF,~ERSQN, RES,PONSIB{.E FOR FILING~ET~R~ C/O Rhoa= ' /"7 LLP ~ ~ ~B~ ~,~-~_ ~ ~n .... ox 1146 Harrisburg, SIGNATURE OF ~AR~T~ T~AN~R~ENTATIVE Rhoads ~ 8inon, hhp, P.0. Box ~146 PA DATE 17108-1146 DATE Harrisburg, PA 17108-1146 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. § 9916 (a) (1.1) (i)]. For dates of death on or after January 1. 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. § 911§ (a) ( 1.1 ) (ii)] Jrhe 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 surviwng spouse is the only beneficiary. ~=or 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. § 911 §(a)( 1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. § 9116( 1.2) [ 72 P.S. § 9116(a)( 1 )]. n he tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. § 9116(a)( 1.3)]. A sibling is defined, under Section 9102, as an dividual who has at least one parent in common with the decedent, whether by blood or adoption, HASPXXNUMBER REV-1503 EX * (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Martha C. Ratcliff 21-03-0947 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. 4 300 Shares Air Prods & Chems Inc Common New York Stock Exchange CUSIP: 009158106 Dividend accrued on 10/27/2003 300 Shares Allete Inc Common New York Stock Exchange CUSIP: 018522102 528 Shares Bp P L C Adr Sponsored New York Stock Exchange CUSIP: 055622104 7,000 Shares CAT Ser S 0.00 081508 CUSIP: 156884E61 500 Shares Conagra Foods Inc Common New York Stock Exchange CUSIP: 205887102 200 Shares Consolidated Edison Inc Common New York Stock Exchange CUSIP: 209115104 10,000 Shares Cranberry PA 5.00 120125 CUSIP: 224288EF3 Dividend accrued on 10/27/2003 Total from continuation pages TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH 13,944.00 69.00 8,734.50 22,368.72 5,949.06 11,955.00 8,165.00 10,119.80 202.78 392,786.09 $ 474,293.95 HASPXXNUMBER (If more space is needed, insert additional sheets of the same size) Schedule B (Page 2) Estate of: Martha C. Ratcliff Item No. Description 10,000 Shares Cumberland PA 3.75 111514 CUSIP: 230822NA2 Dividend accrued on 10/27/2003 10,000 Shares Delaware River PA 6.00 011510 CUSIP: 246361AX7 10 Dividend accrued on 10/27/2003 200 Shares Dominion Res Inc Va New Common New York Stock Exchange CUSIP: 25746U109 11 10,000 Shares Erie PA 5.00 120120 CUSIP: 295533KM4 12 Dividend accrued on 10/27/2003 30,000 Par FHLMC 14-1079 8.00 020117 CUSIP: 31340B-FU 13 25,000 Par GNMA 02116 7.00 112025 CUSIP: 36202C-K5 14 Interest accrued to 10/27/2003 75,000 Shares GNMA 09110 8.50 011506 15 51,333 Par GNMA 09661 8.00 081506 CUSIP: 362035-WW 16 Interest accrued to 10/27/2003 70,000 Par GNMA 207023 8.50 041517 CUSIP: 36217X-4G Interest accrued to 10/27/2003 Value at Date of Death 9,809.80 168.75 11,373.70 170.00 12,159.00 10,371.00 202.78 6,962.73 3,240.55 15.46 511.72 448.82 2.45 4,057.71 22.58 Total (Carry forward to main schedule) 59,517.05 Schedule B (Page 3) Estate of: Martha C. Ratcliff Item No. Description 17 30,000 Par GNMA 221130 7.00 101517 CUSIP: 36218F-ST 18 Interest accrued to 10/27/2003 25,000 Par GNMA 272072 8.50 111521 CUSIP: 36220A-FM 19 Interest accrued to 10/27/2003 25,000 Shares GNMA 317734 7.50 031522 20 100,000 Shares GNMA 325146 7.50 051522 21 75,000 Shares GNMA 325162 7.50 061522 22 25,000 Shares GNMA 379225 7.00 021524 23 25,000 Par GNMA 391555 8.00 071524 CUSIP: 36205H-5Q 24 Interest accrued to 10/27/2003 45,000 Par GNMA II 1655 7.00 042024 CUSIP: 36202B-ZU 25 Interest accrued to 10/27/2003 10,000 Shares Lackawanna PA 5.10 100119 CUSIP: 505480VR1 26 Dividend accrued on 10/27/2003 15,000 Units Lancaster PA 4.50 050128 CUSIP: 514282-KP Interest accrued to 10/27/2003 Value at Date of Death 7,237.90 34.29 482.69 2.69 1,904.70 4,880.81 3,763.39 6,249.41 3,220.10 17.13 5,463.66 26.03 10,504.00 36.83 14,151.15 330.00 Total (Carry forward to main schedule) 58,304.78 Schedule B (Page 4) Estate of: Martha C. Ratcliff Item No. Description 27 5,000 Units Loyalsock PA 4.30 110117 CUSIP: 549050-DU Interest accrued to 10/27/2003 28 10,000 Units Nanty Glo PA 3.00 090106 CUSIP: 630200-BN Interest accrued to 10/27/2003 29 25,000 Units PA ST 4.75 010122 CUSIP: 709141-ZQ Interest accrued to 10/27/2003 30 10,000 Units PA ST HI ED 5.00 061524 CUSIP: 70917N-GC Interest accrued to 10/27/2003 31 10,000 Units PA ST Turnpike 5.00 120121 CUSIP: 709223-NK Interest accrued to 10/27/2003 32 10,000 Units Phil PA SD 4.50 040123 CUSIP: 717880-Z3 Interest accrued to 10/27/2003 33 10,000 Units Pitts PA NPHA 5.125 120105 CUSIP: 725242-JT Interest accrued to 10/27/2003 34 5,000 Units Pittsbrg PA 5.05 090125 CUSIP: 725304-JW Interest accrued to 10/27/2003 Value at Date of Death 5,034.65 101.11 10,383.60 46.67 25 165.25 382.64 10,203.10 183.33 10,364.30 202.78 9 697.00 32.50 10,699.10 207.85 5 061.35 39.28 Total (Carry forward to main schedule) 87,804.51 Schedule B (Page 5) Estate of: Martha C. Ratcliff Item No. Description 35 5,000 Units Swarthmore PA 5.00-091512 CUSIP: 870000-FA Interest accrued to 10/27/2003 36 1,000 Par United States Svgs Bds Serhh 12/1/87-12/1/97 Us Savings Bonds Hh CUSIP: 912550DZ0 37 10,000 Par United States Svgs Bds Serhh 12/1/87-12/1/97 Us Savings Bonds Hh CUSIP: 912550DZ0 38 500 Par United States Svgs Bds Serhh 12/1/87-12/1/97 Us Savings Bonds Hh CUSIP: 912550DZ0 39 40,000 Par UST Bond 6.00 021526 CUSIP: 912810-EW Interest accrued to 10/27/2003 40 50,000 Par UST Inflt 3.00 071512 CUSIP: 912828-AF Interest accrued to 10/27/2003 41 50,000 Par UST Note 5.50 051509 CUSIP: 912827-5G Interest accrued to 10/27/2003 42 50,000 Par UST Strip 0.00 111526 CUSIP: 912833-PB Value at Date of Death 5,513.30 29.17 1,000.00 10,000.00 500.00 44,012.50 476.09 54,703.13 423.91 55,578.13 1,233.02 13,690.50 Total (Carry forward to main schedule) 187,159.75 REV-~ 508 EX * (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER Martha C. Ratcliff 21-03-0947 Include the )roceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on ~he4~i~ ITEM NUMBEFI 1. Alliance DESCRIPTION Gov't Reserves MMKT Jewelry See attached appraised 7,648.59 Par PNC Bank Certificate of Deposit No.: 31300212927 VALUE AT DATE OF DEATH 128,313.47 14,835.00 8,353.44 $ 151,501.91 TOTAL (Also enter on line 5, Recapitulation) HASPXXNUMBER (If more sPaCe is needed, insert additional shee~ of the same size) V'~'(~'e~) I SCHEDULE H / COMMONVVEALTH OF PENNSYLVANIA FUNERAL . / ~NHER~TANCE TAX RETURN EXPENSES & FILE NUMBER 21-03-0947 1 ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION 'David W. Myers Funeral Home Funeral Rolling Green Cemetary Grave Marker COSTS: Personal Representative's Commissions Nameof Personal Representative(s) C. Michael Ratcliff Social Security Number(s) / EIN Number of Personal Represantative(s StreetAddress 38 Sunfire Avenue Qty Camp ~Iill State PA 7ip 17011 Year(a) Commission Paid: 2004 A.omey F~ Rhoads & Sinon, LLP Family Exemption: (If decedent"a address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decadent Probate Fees Accountant's Fees State _ Zip Tax Return Preparer'a Fees AMOUNT 728.54 2,624.00 12,000.00 12,000.00 396.50 Cumberland Law Journal Legal Advertisement of Letters Testamentary Dauphin County Register of Wills - Oath of Executor 75.00 15.00 Total from continuation pages 1,222.26 IBER TOTAL(Also enter on line 9, Recapitulation (If more space is needed, insert additional sheets of same size) $ 30,061.30 Schedule H part 2 (Page 2) Estate of: Martha C. Ratcliff Item No. Description Amount Joseph A. Rosi Jewelers Jewelery Appraisal RESERVES: Rhoads & Sinon, LLP Out-of-pocket expenses to include: Telephone - $1.27; Postage $8.50; Fax - $4.00; Fee to file inventory - $34.00; RESERVES: Miscellaneous - $100.00. RESERVES: Souder Tax Service Preparation of income tax return The Patriot News Legal Advertisement of Letters Testamentary 795.00 147.77 150.00 129.49 Total (Carry forward to main schedule) 1,222.26 REV-1513 EX+(9-O0) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER Martha C. Ratcliff NUMBER II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLEDiS/HiBUTiONS[includeoutdghtspouseldistdbuflons, andtmnsfers underSac. 9116(a)(1.2)] C. Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Specific Bequest of Jewelry under Item III of the Will: 7,417.50 H. Chalfant Ratcliff 329 S. Lee Street Alexandria, VA 22314 100% Residue: 580,899.56 Total from continuation pages AMOUNT OR SHARE OF ESTATE 21-03-0947 RELATIONSHIP TO DECEDENT Do Not Ust ;on ;urviving Spouse 7,417.50 580,899.56 7,417.50 =.NTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHFFT NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXAm?_ DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ HASPXXNUMBER (If more space is needed, insert additiOnal sheets of the same size) Schedule J part 1 (Page 2) Estate of: Martha C. Ratcliff Item No. Description Relation A~nount Hugh Chalfant Ratcliff, Jr. 329 S. Lee Street Alexandria, VA 22314 Specific Bequest of Jewelry under Item III of the Will: 7,417.50 Son 7,417.50 Total (Carry forward to main schedule) 0.00 INDEX ESTATE OF MARTHA C. RATCLIFF SSN: 173-38-5910 DOD: 1027/2003 PENNSYLVANIA INHERITANCE TAX RETURN INDEX TO EXHIBITS Document Last Will and Testament and Codicil Jewelry Appraisal Return Reference Page 1, Line 6 Schedule E, Item 2 502704.1 1 LAST WILL AND TESTAMENT 0_EF MARTHA C. RATCLIFF I, MARTMA C. RATCLIFF, of Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind an4 memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time previously made. I__T~: All inheritance, estate and similar taxes becoming due by reason of my death ("Death Taxes"), whether such Death Taxes shall be payable by my estate or by any recipient of any property, shall be paid by my Executor out of the Property passing under ITEM V of this Will as an expense and cost of administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any Death Taxes paid by my Executor, even though paid with respect to proceeds of insurance or other property not passing under this Will. /~: I hereby exercise all powers of appointment which I may have at the time of my death in favor of my Executor, and all property subject to all such powers of appointment shall be included in my estate and be governed by the provisions of this Will. Page 1 of 6 pages E~: I give and bequeath all of my jewelry to my issue living at my death, per stirpes, in such shares as they shall select and agree between themselves. I may leave with this Will a separate unsigned list of such jewelry and the issue to which I desire such items to be distributed, which shall not be binding on my Executor. If my issue cannot reach an agreement as to the distribution of such items, I give such items to my husband, H. CHALFANT RATCLIFF ("My Husband,,), if he survives me; or, if he does not survive me, such items shall be sold and the proceeds thereof shall be distributed as part of my residuary estate. /L~: I give and bequeath all of my household furniture and furnishings, automobiles, books, pictures, china, crystal, appliances, silverware, wearing apparel and all other like articles of household or personal use or adornment, not disposed of in the preceding portions of this Will, to My Husband, if he survives me. If My Husband does not survive me, I give such articles to my issue living at my death, per stirpes, in as nearly equal shares as they shall select under the supervision of my Executor. If any such articles cannot be fairly divided or distributed in kind in the opinion of my Executor, such articles shall be sold and the proceeds thereof shall pass as a part of my residuary estate. Page 2 of 6 pages ~: I give, devise and bequeath all the rest and residue of my property, real, personal and mixed, not disposed of in the preceding portions of this Will, to My Husband, if he survives me; or, if he does not survive me, to my issue living at my death, per stirpes. '- ~: No interest in income or principal.of my estate shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary of my estate prior to the beneficiary,s actual receipt thereof. My Executor shall pay over the net income and the principal to the beneficiaries herein designated, as their interests may appear, without regard to any attempted anticipation (except as may be specifically provided herein), pledging or assignment by any beneficiary of my estate and without regard to any claim thereto or attempted levy, attachment, seizure or other process against said beneficiary. ~: Any person, who shall have died at the same time as I or under such circumstances that it is difficult or impossible to determine who shall have died first, shall be deemed to have predeceased me. ~: In the settlement of my estate, my Executor shall possess, among others, the following powers to be exercised for the best interests of the beneficiaries: Page 3 of 6 pages (a) To retain any investments I may have at my death so long as my Executor may deem it advisable to my estate so to do. (b) To vary investments, when deemed desirable by my Executor, and to invest in such bonds, stocks, notes, real estate mortgages or other securities or in such other real or personal property as m shall deem wise w~ ..... . Y Executor · , ~vu= ~elng restricted to "legal investments., so-called (c) In order to effect a division of the principal of my estate or for any other purpose, including any final distribution of my estate, my Executor is authorized to make said divisions or distributions of the personalty and rea wholly in kind. ~ .... ~ ~_ . . lty partly or ade in kind, o .di t ibution is aistribute . ~ ~,~zz oe azvide~ or d at their respective values on the date or dates of their division or distribution. In making any division or distribution in kind, my Executor shall divide or distribute said assets in a manner which will fairly allocate any unrealized appreciation among the beneficiaries. (d) To sell either at public or private sale and upon such terms and conditions as my Executor may deem advantageous to my estate, any or all real or personal ~, uvn]unc=zon wl~ other persons or acquired after my death by my Executor, sales by su~-= ..... and to consummate said -~]- ~- n,,~k.-i_ _~uP~ aeeas or other in~,---~--~i-~r ~ free and clear of all trus+ --~ -~ f~e slmple tztle, ~ =,,u wz=nou= obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales~ also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon my Executor in this paragraph or elsewhere in this Will. (e) To mortgage real estate and to make leases of real estate for any term. (f) To borrow money from any party, including my Executor, to pay indebtedness of mine or of my estate, expenses of administration, Death Taxes or other taxes. Page 4 of 6 pages (g) To pay all costs, Death Taxes or other taxes, expenses and charges in connection with the administra- tion of my estate, and my Executor shall pay the expenses of my last illness and funeral expenses. (h) To vote any shares of stock which form a part of my estate and to otherwise exercise all the powers incident to the ownership of such stock and to actively manage and operate any unincorporated business, including any joint ventures and partnerships, with all the rights and powers of any owner thereof. (i) In the discretion of my Executor to unite with any other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of my estate. (J) To assign to and hold in my estate an undivided portion of any asset. (k) To hold investments in the name of a nominee. (1) To compromise controversies. " ~: If at any time any minor shall be entitled to receive any assets free of trust hereunder, I ive such minor,s share to my survivi - g ng son, as Cust!dian for such minor under the Pen?sylvania Uniform Gifts to M nors Act; or, if neither of my sons ls then living, to the minor s surviving natural parent, as Such Custodian for the minor. ~: I hereby appoint My Husband as Executor of this Will. If for any reason he should fail or cease to act, I appoint my son, C. MICHAEL RATCLIFF, as Executor. If for any reason my son, C. Michael Ratcliff, should fail or cease to act, I appoint my son, H. CHALFANT RATCLIFF, JR., as Executor. Page 5 of 6 pages Ail referenc~ in this Will to my "Executor,, shall refer to my °riginally~appointed Executor or to my successor Executor, as the case may be. My Executor shall qualify and serve without the duty or obligation of filing any bond or other security. If either of my sons serves as Executor, he shall serve without compensation. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding five (5) pages, this~ =_~~day of .~.I~.~.~ ~ , 1989. Page 6 of 6 pages Martha C. Rat-cliff We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year ~bove written, and we ce ' ?.f the execution ~hereof the .--~ - - r~.lfy that at the time /l~j ~. - _.,~ ,~Q "; ~esiaing at: lit/!t .,. .... :. '- (SEAL) Residing at- CODICIL TO THE WILL OF MARTHA C. RATCLIFF I,'NARTHA C. RATCLIFF, of Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be a Codicil to my Last Will and Testament dated June 1, 1989. I hereby delete ITEM X of my Will and replace said ITEM with the following provision: "ITEM X: I appoint my son C. MICHAEL RATCLIFF as Executor of my Estate." IN W~TNESS WHEREOF, I have hereunto set my hand and seal to this Codicil to my 'Last Will and Testament, consisting of this page, this ~ day of ~, 1999. Martha C. Ratctiff~ (SEAL 313005.1 We, the undersigned, hereby certify that the foregoing Codicil was signed, sealed, published and declared by the above- named Testatrix as and for her Codicil to her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. (SEAL) 2 01/[4/04 Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Dear Mr. Ratcliff: 4636 Jonestown Road Harrisburg, Pennsylvania 17109 Phone (717) 652-8477 · Fax (717) 652-9245 Joseph A. Rosi, Jr., CGA President This appraisal is being issued by a Certified Gemologist Appraiser of the American Gem Society, an elite group of gelologically-trained professional jewelers who subscribe to a strict code of ethics. Great care has been taken to provide you with complete descriptions of your jewelery and accurate estimated ESTATE VALUE. Unless specifically stated, mounting are assumed to be mass produced rather than handmade, and in good repair. Most mountings will not permit us to examine and measure every detail, therefore the appraisal values are based only on estimated quality, weights and measurements of the items, unless otherwise stated. It should be understood by our appraisal clientele that an appraisal is not an all inclusive document, but, rather, that there are many specific types of appraisals suited for specific needs. To avoid misunderstanding, the enclosed appraisal is report number 000877. The total ESTATE VALUE for the jewelry listed is $14,835.00. Sincerely~, ~ Certified Gemologist Appraiser, American Gem Society l-$ FA I-E Ob MAI'~ i' HA RATCLIFF 000~77B 000e77C 8.5 fA I E OF MAP, FHA RATCLIFF 000877G 000877H OOO8771 OOO877,/ ES FA fF__ Ur MAM i MA ~ i'L;LIFF O00~?TO O00~??P t-"'b IA ib UP MAI'Cfi'dA I'-~.~ i'ULit'::'F 00087'/'$ r'o i/A I i- ~Jr iVI/AI~ I rl/A ~ I L.,LII-I- Appraisal Number: 000877 Date: 01/14/04 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items List Coin Necklace Gold Plated Silver Dollar with a Gold Plated Cooin Holder and a 14K Yellow Gold French Rope Chain measuring approximately 22 inches in length and 2.5 am% in width. The Chain weighs approximately 13.0 grams. ESTAT~ VALUE: 160.00 Charm Bracelet w/Crest Disc Gold Filled Single Link Bracelet measuring approximately 7 inches in length with one Diamond Shape Gold Filled Locket with Sardonyx on front and hand-engraved on back with a swivel type hinge securing Locket to Bracelet. ESTAT~VALUE: 100.00 Appraisal continued on next page. Appraisal Number: 000877 Page: 2 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Gold Filled Tube Bracelet Ladies Gold Filled Tube Bracelet with Spring Loaded Top fashioned with Flower and Vase embossed on Top of disc and stamped on back "PAT. DEC.16.1879" ESTATE VALUE: 14K Filli~ree Pin Ladies 14K White Gold Filligree Bar Pin Containing one European Cut Diamond (.05 carat) set in Box Illusion Head with one Square Cut Synthetic Sapphire on either end of pin in set in Box Head. The Pin measures approximately 2.5 inches and weighs approximately 3.9 grams. ESTA~'EVALIIE: Appraisal continued on next page. Appraisal Number: 000877 Page: 3 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Ladies Sapphire Rina Ladies 14K Yellow Gold Sapphire and Diamond Ring containing one Genuine Cabochen Cut Blue Sapphire set in 4-prong Head surrounded by eight (8) Round Single Cut Diamonds set in bead prongs on 14K White Gold plate and three (3) Square Cut Genuine Blue Sapphires on each shoulder at top of shank set in Cheannel. The Ring weighs approximately 2.6 grams. CENTER STONE GRADING: Type ................. Genuine Sapphire Shape ................ Round Cabochen Size ................. 8.0 x 4.60 n~n Weight ............... 3.06 carat Color ................ Med/Med Dark Blue Clarity .............. VS SIDE STONE GRADING: Type ................. Diamonds/Sapphires Shape ................ Round Single Cut/Square Cut Size ................. 8-1.7LtU~L / 6-1.75 X 1.75m~ Weight ................ 30 carat/ .16 carat total Color ................ Near Colorless (G) / Med Dark Blue Clarity .............. VS 1 / VS ESTATE VALUE: 450.00 Appraisal continued on next page. Appraisal Number: 000877 Page: 4 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list ~adies Watch Ladies 14K White Gold "Movado" Diamond Watch containing 2 Round Brilliant Cut Diamonds one on 12 and one on 6 position set in prongs. The Watch measures approximately 15t~L in diameter 14K WHite Gold Case # G47350 with 17 Jewel manual wind movement caliber # 103 and having a Black Rope watchband. GEMSTONE GRADING REPORT: Type ......................... Diamonds (2) Shape ........................ Round Brilliant Cut Size ......................... 2-3.0 mm each Weight ........................ 20 carat total Color ........................ Near Colorless (H) Clarity ...................... VS I 400.00 Appraisal continued on next page. Appraisal Number: 000877 Page: 5 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Ladies Pearl Bracelet Ladies 18K Yellow Gold Cultured Pearl Bracelet containing ten (10) 5mm Cultured Pearls with five (5) 18K Yellow Gold Black Enamel 0val Beads and five (5) 8mm Open Rope Design Round Balls. The Bracelet measures approximately 7 inches in length. ESTATE VALUe: 200.00 14K Yellow Gold Charm Bracelet 14 Yellow Gold Triple Link Charm Bracelet measuring approximately 7 1/2 inches in length with box catch and figure "8" salty. Attached is a 14K Yellow Gold Baseball Diamond Shape Fraturnity type charm measuring approximately 3/4 inch square with an embossed enameled crest on a Black Onyx background and hand engraved on back. The weight of the entire bracelet including charm is approximately 31.7 grams. ESTATE VALU~: 475.00 Appraisal continued on next page. Appraisal Number: 000877 Page: 6 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Round CharmonChain 14K Yellow Gold disc measuring approximately 27 ~uL~ with fancy design embossed on front with 14K Yellow Gold open Link Rope Chain measuring approximately 24 inches in length and 2.25 mm in width. The entire necklace weighs approximately 19.3 grams. ESTATE VALUe; 235.00 14K Yellow Gold Bracelet 14K Yellow Gold Large Link Bracelet containing five full oval hollow links and five half oval hollow links intermingled into Bracelet. The Bracelet measures approximately 8 inches in length and weighs approximately 45.3 grams. ESTATE VALUE: 550.00 Appraisal continued on next page. Appraisal Number: 000877 Page: 7 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Ladies Mesh Bracelet Ladies 14K Yellow Gold Mesh Bracelet with Box catch and figure "8"salty with a weave design measuring approximately 7 inches in length and 12 mm in width and weighing approximately 23.5 grams. ~STATE VALUE: Ladies Mesh and Ro~e Bracelet Ladies 14K Yellow Gold Mesh Bracelet with Rope Borders. The Bracelet measures approximately 9 in width and 7 inches in length and weighs approximately 19.5 grams. ESTA~'E VALUE: 235.00 Ladies Fancy_ Link Bracelet Ladies 14K Yellow gold Fancy Link Bracelet containing hand engraved section links in a Baseball Diamond pattern. The Bracelet measures approximately 10 mm in width and 7 inches in length and weighs 27.8 grams. ESTATE VALUE: 335.00 Appraisal continued on next page. Appraisal Number: 000877 Page: 8 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list ~erringbone Chain 14K Yellow Gold Herringbone Chain measuring approximately 18 inches in length and 6mm in width and weighing approximately 26.8 grams. The Chain has a Box Catch and figure "8" safty. ESTATE 325.00 Pearl Circle Pin 14K Yellow Gold Cultured Pearl Circle Pin containing twenty (20) 3.5 mm Cultured Pearls set in post on a 14K Yellow Gold Circle Pin measuring approximately 1 inch in diameter. The Pin has a 14K hinge and bar with a safty clasp. ESTATE VALUE: 375.00 Appraisal continued on next page. Appraisal Number: 000877 Page: 9 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list L~dies ~m~raldan~DiamondRino Ladies 14K Yellow Gold Diamond and Emerald Round Cluster Ring containing one Center Round Brilliant Cut Diamond surrounded by six Round Brilliant Cut Genuine Emeralds and intermingled with six additional Diamonds and six additional Emeralds. The Ring is a four teir Round Cluster with Center Diamond. The Ring weighs approximately 4.2 grams. GEMSTONE GRADING REPORT: Type ..................... Diamonds/Emeralds Shape .................... Round Brilliant Cut Size ..................... 1-3.Smm, 6-2.5rm~/12-3.0tmL~ Weight .................... 93 carat total Color .................... Near Colorless (G)/ Med./Med, Dark Green Clarity .................. VS 1/VS ESTATE VALUE: 800.00 Appraisal continued on next page. Appraisal Number: 000877 Page: 10 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Ladies Emerald/DiamondRin~ Ladies 14K Yellow Gold Emerlad and Diamond Ring containing one Oval Cut Genuine Emerald surrounded by ten (10) Round Brilliant Cut Diamonds all set in prongs. The Ring is 14K Yellow Gold weighing approximately 3.4 grams. CENTER STONE GRADING: Type ..................... Genuine Emerald Shape .................... 0val Cut Size ..................... 5.00 x 3.60 x 2.90 L~,~ Weight .................... 30 carat Color .................... Med/Med Dark Yellow-Green Clarity .................. Cloudy SIDE STONE GRADING: Type ...................... Diamonds (10) Shape ..................... Round Brilliant Cut Size ...................... 10-2.4 mm each Weight .............. ~ ...... 50 carat total Color ..................... Near Colorless (H) Clarity ................... SI 1 ESTATE VALUE: 500.00 Appraisal continued on next page. Appraisal Number: 000877 Page: 11 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Ladies Enaaaemmmt Rina Ladies 14K White Gold Diamond Engagement Ring containing one Marquise Cut Diamond set in 14K WHite Gold 6-prong Solitare Head on a 14K White Gold Band. The Ring has a spring inside ring ~uard soldered to bottom of shank and measures approximately 1.5 mm and weighs approximately 3.3 grams. GEMSTONE GRADING REPORT: Type ......................... Diamond Shape ........................ Marquise Cut Size ......................... 7.70 x 4.95 x 2.70 Weight ........................ 58 carat Color ........................ Near Colorless (G) Clarity ...................... VVS 2 ESTATE VALUE: 1.650.00 Appraisal continued on next page. Appraisal Number: 000877 Page: 12 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Ladies 14K Yellow Gold Diamond Engagement Ring containing one Round European Cut Diamond set in a 14K Yellow Gold Box Head with two Round Single Cut Diamonds set in "Flush Set" Bezels on either side of Center Diamond on a 14K Yellow Gold Band. The Ring weighs approximately 2.1 grams. CENTER STONE GRADING: Type ....................... Diamond Shape ...................... European Cut Size ....................... 6.45-6.50 x 4.50 mm Weight ..................... 1.16 carat Color ...................... Slightly Yellow (J) Clarity .................... VS 1 SIDE STONE GRADING: Type ....................... Diamonds (4) Shape ...................... Single Cut Size ..................... ..4-1.3 mm each Weight ............... . ....... 04 carat total Color ...................... Near Colorless (H) Clarity .................... VS 1 ESTATE Appraisal continued on next page. Appraisal Number: 000877 Page: 13 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Ladies 14K White Gold Diamond WeddingRing containing ten (10) Round Single Cut Diamonds set in Bead Prongs on a 14K White Gold Band. The Ring has a spring loaded ring guard soldered to the bottom of shank and measures approximately 1.8 mm and weighs approximately 2.4 grams. GEMSTONE GRADING REPORT: Type ....................... Diamonds (10) Shape ...................... Round Single Cut Size ....................... 10-1.3 mm each Weight ...................... 10 carat total Color ...................... Near Colorless (G) Clarity .................... SI 1 ESTATE VALUE: 400.00 Appraisal continued on next page. Appraisal Number: 000877 Page: 14 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Ladies 14K Yellow GOld Sapphire and Diamond Wedding Ring containing six (6) Genuine Blue Emerald Cut Sapphires alternating with five rows of two Round Brilliant Cut Diamonds set in prongs. The Ring measures approximately 3.6 n~n at shoulders and tapers to 2.2 t,u~ at bottom of shank and weighs approximately 2.9 grams. GEMSTONE GRADING REPORT: Type .................. Sapphires(6)/Diamonds (10) Shape ................. Emerald Cut/Brilliant Cut Size .................. 6-3.75 x 2.20 x 1.70 mm 10-1.7 mm each Weight ................. 66carat + .20 carat Color ................. Med/Med Dark Blue Near Colorless (H) Clarity ............... VS/VS I ESTATRVALUR: Appraisal continued on next page. Appraisal Number: 000877 Page: 15 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Ladies Diamond Necklace Ladies 14K Yellow Gold Round Diamond Cluster Pendent containing one Round Brilliant Cut Diamond surrounded by six Round Brilliant Cut Diamonds set in 14K White Gold pronged plate and mounted on a 14K Yellow Gold frame. The Chain is a 14K Yellow Gold "French Rope" style measuring approximately 1.5 tm~ in width and 16 inches in length weighing approximately 5.6 grams. GEMSTONE GRADING REPORT: Type ....................... Diamonds (7) Shape ..................... Round Brilliant Cut Size ...................... 1-2.Sf~f,, 6-2.5 n~n Weight ..................... 44 carat total Color ..................... Near Colorless (I) Clarity ................... SI 2 Appraisal continued on next page. Appraisal Number: 000877 Page: 16 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Baroque Pearl Pendent Ladies 14K Yellow Gold "Biwa" Cultured Pearl and Diamond Pendent containing four (4) Biwa Pearls measuring approximately 6 x 5 mm each and one Round Brilliant Cut Diamond measuring approximately 2.0 ~f~L (.03 carat) set in freeform pattern on a 14K Yellow Gold wire type pendent. The Pearls are 1/2 drilled and mounted on posts. The Diamond is set in a 4-prong Head and soldered to the pendent. ESTATE VALUE: 100.00 Appraisal continued on next page. Appraisal Number: 000877 Page: 17 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list 17 inch Strand Cultured Pearl~ Single Graduated Strand of Cultured Pearls (78) measuring approximately 17 inches in length and 3 1/2 to 7 t~=~t in diameter with a 14K White Gold Filligree Pearl Clasp. Type ................... CUltured Roundness .............. Slightly Out of Round Size ................... 3 1/3- 7 mm Color .................. Cream Overtone ............... Rose Orient ................. Moderate Luster ................. Medium Blemish ................ Light Nacre Thickness ........ Moderate Match .................. Good ESTATE VALUE: Appraisal continued on next page. Appraisal Number: 000877 Page: 18 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list 20 inch Strand Cultured Pearls Single Strand of Graduated Cultured Pearls (89) measuring approximately 20 inches in length and 3 to 7 1/2 ~u~t in diameter with a 14K White Gold Filligree Clasp. Type ................... Cultured Roundness .............. Slightly Out of Round Size ................... 3-7 1/2 ~%~%~ Color .................. Silver Overtone ............... Rose Orient ................. Good Luster ................. Moderate · Blemish ................ Light Nacre Thickness ........ Moderate Match .................. Good ESTATE VALUe: 400.00 Appraisal continued on next page. Appraisal Number: 000877 Page: 19 Property of: MiChael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Single Strand of Uniform Cultured Pearls (44) knotted measuring approximately 16 inches in length and 7au. in Diameter. The Catch is 14K Yellow Gold in the shape of a Flower with a 6 1/4 ah. Cultured Pearl and a Box Catch. Type ................... Cultured Roundness .............. Slightly Out of Round Size ................... 44-7 n~neach Color .................. Cream Overtone ............... Rose Orient ................. Moderate LuSter ................. Good Blemish ................ Light Nacre Thickness ........ Thin Match .................. Good RST~TR VALUR: Appraisal continued on next page. Appraisal Number: 000877 Page: 20 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list Ladies 14K Yellow Gold "Mobe" Cultured Pearl Stud Earrings containing one "Mobe" Pearl measuring approximately 12uaa set in a "Crown Head" pronged setting with twisted wire surrounding the Pearl in 'each of two Earrings. the Earrings have 14K Yellow Gold Friction Back posts. 400.00 14K Pearl Pierced P. arr~nas 14K Yellow Gold Pearl Pierced Stud Earrings containing one 8 1/2 uRu Cultured Pearl set in a 14K Yellow Gold 6-prong Stud setting with 14K Yellow Gold Friction Back post. The Pearls are 3/4 Round. Appraisal continued on next page. Appraisal Number: 000877 Page: 21 Property of: Michael Ratcliff 38 Sunfire Avenue Camp Hill, PA 17011 Items list ~dies ~u~Bracelet 14K Yellow Gold Single Link Charm Bracelet with Spring Ring catch and the following charms attached and soldered: 14K Disc Monogramed CAC 14K Canastas 14K Dipolma 14K Pivoting Fish 14K Money Bag Jade Elephant Gold Filled 1/2 Locket 14K House 14K Disc 'Moonwalk Coin and Coin Holder 14K Fraturnity Pin 14K Pineapple 14K Cow Bell 14K Roller Skate 14K Rooster 14K Disc monogramed LCB This is to certify that we are engaged in the business of buying and selling items made from precious metals and precious and semi-precious stones. We certify that the item(s) on this appraisal were appraised using a 10 power gemscope and other gemological equipment in accordance with industry standard procedures. This is not an offer to buy. It represents our evaluation of the replacement value at the time of inspection. Josep_~'~.. Ro~, Jr., C.G.A. Certffied G~mologist Appraiser, American Gem Society Register of Wills of Cumberland County, Pennsylvania Estate of Martha C. Ratcliff also known as INVENTORY No. 00947 of 2003 Date of Death October 27, 2003 , Deceased Social Security No. 173-38-5910 I, C. Michael Ratcliff, Personal Represer,;.a~e of the above E$ia[~, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the mai estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I verify that the statements made in this Inventory are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. Name of Attomey: Stanley A. Smith, Esquire I.D. No.: 33782 Address: Rhoads & Sinon LLP, P.O. Box 1146 Harrisburg, PA 17108-1146 Telephone: (717) 233-5731 Personal Representative: C.'Mich~el Ratcliff ' See attachment Description (Attach Additional Sheets if necessary) Dated: Value $625,795.86 Total: $625,795.86 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Fora1 RW-7 (Dauphin County - Rev. 9/92) 502041.1 Estate of Martha C. Ratcliff Estate Inventory Valued as of Date of Death 7,648.59 No. of Shares 3OO 300 528 5OO 200 20O Par Value 7,000 1,000 Cash & Cash Equivalents Alliance Gov't Reserves MMKT PNC Bank Certificate of Deposit No.: 31300212927 Total Cash & Cash Equivalents Stocks Air Prods & Chems Inc Common New York Stock Exchange Dividend at Date of Death Allete Inc Common New York Stock Exchange Bp P L C Adr Sponsored New York Stock Exchange Conagra Foods Inc Common New York Stock Exchange Consolidated Edison Inc Common New York Stock Exchange Dominion Res Inc Va New Common New York Stock Exchange Total Stocks Bonds, Debentures & T-Bills CAT Ser S 0.00 081508 United States Svgs Bds Serhh 12/1/87-12/1/97 Us Savings Bonds Hh 128,313.47 8,353.44 13,944.00 69.00 8,734.50 22,368.72 11,955.00 8,165.00 12,159.00 5,949.06 1,000.00 136,666.91 77,395.22 Page 1 (1) Estate Inventory Par Value 10,000 5OO 40,000 50,000 50,000 50,000 Bonds, Debentures & T-Bills United States Svgs Bds Serhh 12/1/87-12/1/97 Us Savings Bonds Hh United States Svgs Bds Serhh 12/1/87-12/1/97 Us Savings Bonds Hh UST Bond 6.00 021526 Interest at Date of Death UST Inflt 3.00 071512 Interest at Date of Death UST Note 5.50 051509 Interest at Date of Death UST Strip 0.00 111526 Total Bonds, Debentures & T-Bills 10,000.00 500.00 44,012.50 476.09 54,703.13 423.91 55,578.13 1,233.02 13,690.50 187,566.34 No. of Units 10,000 10,000 10,000 10,000 Tangible Pemonal Property Jewelry See attached appraised Total Tangible Personal Property Mutual Funds Cranberry PA 5.00 120125 Interest at Date of Death Cumberland PA 3.75 111514 Interest at Date of Death Delaware River PA 6.00 011510 Interest at Date of Death Erie PA 5.00 120120 Interest at Date of Death 14,835.00 10,119.80 202.78 9,809.80 168.75 11,373.70 170.00 10,371.00 202.78 14,835.00 Page 2 (2) Estate Inventory Par Value 30,000 25,000 75,000 51,333 70,000 30,000 25,000 25,000 100,000 75,000 25,000 25,000 45,000 10,000 15,000 5,000 10,000 Mutual Funds FHLMC 14-1079 8.00 020117 GNMA 02116 7.00 112025 Interest at Date of Death GNMA 09110 8.50 011506 GNMA 09661 8.00 081506 Interest at Date of Death GNMA 207023 8.50 041517 Interest at Date of Death GNMA 221130 7.00 101517 Interest at Date of Death GNMA 272072 8.50 111521 Interest at Date of Death GNMA 317734 7.50 031522 GNMA 325146 7.50 051522 GNMA 325162 7.50 061522 GNMA 379225 7.00 021524 GNMA 391555 8.00 071524 Interest at Date of Death GNMA II 1655 7.00 042024 Interest at Date of Death Lackawanna PA 5.10 100119 Interest at Date of Death Lancaster PA 4.50 050128 Interest at Date of Death Loyalsock PA 4.30 110117 Interest at Date of Death Nanty Glo PA 3.00 090106 Interest at Date of Death 6,962.73 3,240.55 15.46 511.72 448.82 2.45 4,057.71 22.58 7,237.90 34.29 482.69 2.69 1,904.70 4,880.81 3,763.39 6,249.41 3,220.10 17.13 5,463.66 26.03 10,504.00 36.83 14,151.15 330.00 5,034.65 101.11 10,383.60 46.67 Page 3 (3) Estate Inventory No. of Units 25,O0O 10,000 10,000 10,000 10,000 5,000 5,000 Mutual Funds PA ST 4.75 010122 Interest at Date of Death PA ST HI ED 5.00 061524 Interest at Date of Death PA ST Turnpike 5.00 120121 Interest at Date of Death Phil PA SD 4.50 040123 Interest at Date of Death Pitts PA NPHA 5.125 120105 Interest at Date of Death ?ittsbrg PA 5.05 090125 Interest at Date of Death Swarthmore PA 5.00-091512 Interest at Date of Death Total Mutual Funds Total Inventory 25,165.25 382.64 10,203.10 183.33 10,364.30 202.78 9,697.00 32.50 10,699.10 207.85 5,061.35 39.28 5,513.30 29.17 209,332.39 625,795.86 Page 4 (4) 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 003481 SMITH STANLEY A P O BOX 1146 HARRISBURG, PA 17108-1146 ........ fold ESTATE INFORMATION: SSN: 173-38-5910 FILE NUMBER: 2103-0947 DECEDENT NAME: RATCLIFF MARTHA C DATE OF PAYMENT: 01/27/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/27/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $634.2O REMARKS: TOTAL AMOUNT PAID: $634.20 SEAL CHECK# 104 INITIALS- JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS & SINON LLP Kimberly A. Meals ph (717) 231-6671 fx (717) 232-1459 kmeals~rhoads-sinon.com FILE NO: 3067/02 March 25, 2004 Re: Estate of Martha Ratcliff Ms. Glenda Famer-Strasbaugh Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Dear Ms. ~: Enclosed for filing please find an Approval of Accoum Release and Indemnification in the above matter. Also enclosed is our Firm's check in the amount of $22.00 representing the fee to file the Approval. Please time stamp the fi:ont cover of the extra Approval of Account Release and Indemnification along with a copy of our letter and return the same to me in the enclosed self-addressed postage prepaid envelope. Thank you for your kind cooperation in this matter Very truly yours, Enclosures RHOADS & SINON LLP Kimberly A. Meals Paralegal 511323.1 Rhoads & Sinon LLP · Attorneys at Law · Twelfth Floor · One South Market Square · EO. Box 1146 Harrisburg, PA 17108-1146 ° ph (717) 233-5731 ° fx (717) 232-1459 ° www. rhoads-sinon.com IN RE: ESTATE OF MARTHA C. RATCLIFF Deceased IN THE ORPHANS' COURT DIVISION OF THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 00947 of 2003 APPROVAL OF ACCOUNT RELEASE AND INDEMNIFICATION WHEREAS, Martha C. Ratcliff (the "Decedent") died testate on October 27, 2003, leaving a Will and Codicil which were duly probated by the Register of Wills of Cumberland County, Pennsylvania on November 14, 2003; and WltEREAS, Decedent was survived by her husband, H. Chalfant Ratcliff and her to sons, C. Michael Ratcliffand Hugh Chalfant Ratcliff, Jr.; and WHEREAS, the Decedent's Will appoints Decedent's son, C. Michael Ratcliff, as Executor of Decedent's estate (the "Executor") and Letters Testamentary were duly granted to C. Michael Ratcliff on November 14, 2003; and WHEREAS, Decedent's Will bequeaths all of Decedent's jewelry to her issue, C. Michael Ratcliff and Hugh Chalfant Ratcliff, Jr., her household and personal property to her husband H. Chalfant Ratcliff and the rest, residue and remainder of Decedent's Estate to her husband, H. Chalfant Ratcliff; and WHEREAS, the Pennsylvania Inheritance Tax and Federal Estate Tax returns have been filed and administration of the estate is nearly cOmplete~%0th the exception of the receipt of approval letter from the Pennsylvania I~lxul~en~)~i~vq~.e and the filing final income tax returns; and 506739.1 WHEREAS, the Beneficiaries desire that the Estate be concluded without the expense and formality of a court accounting; and WHEREAS, the Executor is willing to consent to such a conclusion of the Estate upon receipt of a proper approval of account, release and indemnification, which it is the purpose of this Agreement to provide. NOW, THEREFORE, the undersigned, jointly, separately and severally, for themselves, their heirs, administrators, and assigns: (1) State that they have examined the First and Final Account of the administration of Decedent's Estate, which is attached hereto as Exhibit "A" (the "Account"), and approve the transactions and distributions set forth or proposed therein as though they had been confirmed absolutely by the Court having jurisdiction over the Estate. (2) State that they have examined the Statement of Proposed Distribution attached to the Account and they approve the distributions proposed therein as though they were ordered by the Court having jurisdiction over the Estate. (3) Waive the filing and auditing of the Account by any Court and agree that having jurisdiction over the Estate may confirm the Account and the Proposed any Court Distribution. (4) Acknowledge receipt from the Executor of the assets shown as distributed or distributable to them in the said Account or Statement of Proposed Distribution in absolute payment of full satisfaction of the bequest to them under Decedem's Will. (5) Do hereby absolutely and irrevocably release, remise, quitclaim and forever discharge the said Executor, his heirs and personal representatives, of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever relating to the Estate of the said Decedent. (6) Account, Petition Do hereby absolutely and irrevocably release the Executor from filing any for Distribution or other document with the Court of Common Pleas of Cumberland County, Pennsylvania, or in any other jurisdiction in connection with the Estate of the Decedent. (7) Hereby agree that if, at any time in the future, the said Executor receives any demand or claim for any amount claimed to be due and owing from him, as Executor, and approves said demand or claim, they shall, at the request of the said Executor, pay to the said Executor the amount of any such demand or claim, or if it has been paid by the said Executor, then reimburse him for the amount paid by him, provided that the amount of such requested payment or reimbursement shall not exceed the total of the assets paid or distributed by said Executor to the Beneficiaries as set forth in the attached Account. (8) Hereby agree to indemnify the Executor and hold him harmless, to the extent of the Estate assets received by them, from and against any and all claims, loss, liability or damage (including legal fees and costs) which they may suffer or to which he may be subjected by reason of the administration of the Estate or the distribution of the assets of the estate without having formal approval of the Court of Common Pleas, Orphans' Court Division, of Cumberland County, Pennsylvania, or any other jurisdiction. (9) Do hereby agree that this Agreement may be signed and acknowledged by the parties hereto in counterparts and a complete set of executed counterparts, containing the signatures of all parties, shall constitute an original and complete instrument. This instrument shall be legally binding on each of the undersigned and their personal represematives, heirs and assigns. IN WITNESS WHEREOF, each of the undersigned has executed this Agreement on the ~ day of -~/~4 ,2004. Wi~~~~~_~ r. ~ (SEAL) RHOI A T'\S _->>----..-.-...._ fi.L..J .~~~"'.....<...- -<--..- --",_.v, & SINON LLP Shawn D. Funk Phone (717) 231-6671 Fax (717) 232-1459 sfun k@rhoads-sinon.com FILE NO 3067/03 C3.. 0(--)<+ 7 January 25,2006 Re: Estate of Martha C. Ratcliff Glenda Farner-Strasbaugh Register of Wills of Cumberland County Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Dear Ms. Famer-Strasbaugh: Please prepare a short certificate for the Estate of Martha C. Ratcliff, File No. 2003- 200947. Enclosed is a check in the amount of$4.00 for payment of said certificate. Please return the certificate and the receipt for payment in the enclosed envelope. If you have any questions or require additional information, please do not hesitate to contact our office. Very truly yours, Enclosures il S ::.~ II.l .., ...,J 0".-, 7 '." c,,, "" I' ( ~.J ~. . l .J 594044_1 Rhoads &: Sinon LLP . Attorneys at Law. Twelfth Floor. One South Market Square. P.O. Box 1146 Harrisburg, PA 17108-1146 . ph (717) 233-5731 . fx (717) 232-1459 . www.rhoads-sinon.com COMMONWEALTH OF PENNSYLVANIA: COUNTY OF .3.~.L6fl hr'/3 i SS: On this, the~V~d~y ofCCP, 2004, before me, a Notary Public, in and for the Commonwealth of Pennsylvania, the undersigned officer, personally appeared H. CHALFANT RATCLIFF, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Agreement and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Ngt,~ P~blic ~/ '~~~Y (SEAL) My Commission Expires: (SEAL) Notarial Seal Kimberly A. Meals, Notary Public City of Harrisburg, Dauphin County My Commission Expires Mar. 11, 2007 Member, Pennsylvania Association of Notaries COMMONWEALTH OF PENNSYLVANIA: ~t ' .ss: COUNTY OF 'i,~L '~ ~ · On~i~, ~a~of%~, 200~, ~fo,~m~,~So~b~i~, in ~ fo,~ Commonwealth of Pennsylvania, the undersigned officer, personally appeared C. MICHAEL RATCLIFF, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Agreement and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. NO/tary bt~blic - (SEAL) My Commission Expires: (SEAL) COMMONWEALTH OF PENNSYLVANIA Kimberly A. Meals, Notary Public City of Harrisburg, Dauphin County My Commission Expires Mar. 11, 2007 Member, Pennsylvania Association of Notaries STATE OF COUNTY OF · SS: On this, the ~'day of Commonwealth of Pennsylvania, P/~[(4/~, 2004, before me, a Notary Public, in and for the the undersigned officer, personally appeared HUGH CHALFANT RATCLIFF, JR., known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Agreement and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. My Commission Expires: ~5//~ydSt~ (SEAL) STATUS REPORT UNDER RULE 6.12 Name of Decedent: Martha C. Ratcliff Date of Death: October 27, 2003 Will No. 2003-00947 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: ao Yes No Did the personal representative file a final account with the Court? X b. The separate Orphans' Court No. (if any) for the personal representative's account is: parties in interest? Yes Did the personal representative state an account informally to the X No d. Copies of receipts, releases, j0i~ders and approvals of formal or informal accounts may be filed with the Clerk of t~-Cxourt and may be attached to this report. ~{' St~ley ~h Name (Please type or prim) Rhoads & Sinon LLP One South Market Square, 12th Floor Harrisburg, PA 17101 Address (717) 233-5731 Tel. No. Capacity: Personal Representative X Counsel for personal representative 520803.1 BUREAU OF INDIVIDUAL TAXES ZNHERTTANCE TAX DTVTSTON DEPT. 180601 HARRTSBURG, PA 17118-0601 COHNONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX R[¥-lGd7 EX AFP (01-05) 12 STANLEY A SNITH ESQ' RHOADS &SINON LLP PO BOX 11~6 ~: HARRISBURG ~rT~A~7108 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-15-200q RATCLIFF 10-27-2005 Z1 05-09q7 CUMBERLAND 101 Amoun'l: Ree/'l:~:ed MARTHA C HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF ZNHER]:TANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCT:ZONS AND ASSESSMENT OF TAX ESTATE OF RATCLIFF NARTHA C FILE NO. 21 0:3-09~7 ACH 101 DATE 05-15-200~ TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVAT]:ON CONCERNING FUTURE ]:NTEREST - SEE REVERSE APPRA/SED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. S*ocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership In~eres* (Schedule C) (3) q. Hor~gegos/No~es Receivable (Schedule D) (q) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jo/ntly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Costs/H/sc. Expanses (Schedule H) (9) 10. Debts/Hot,gage L/ab/1/~/as/L/ans (Schedule I) (10) 11. To,al Doduc~/ons Na~ Value of Tax Ra~urn 15. lq. Char/~able/governmon~al Bequests; Non-elected 9115 Trusts (Schedule J) Ne~ Value of Es~a~e Sub~ec~ ~o Tax q7q~295.95 .00 151~501.91 .00 .00 NOTE: To /nsura proper credit ~o your account, sub~/~ ~ha upper port/on .00 of ~his fore w/~h your tax payment. .0O (8) 30,061.30 .00 NOTE: 625,795.86 (11) 30.0~].. 30 (12) 595,75q.58 (1:3) . O0 (1,~) 595,75q. 56 Z~ an assessment Has issued previously, lines 14, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. A.oun~ of L/ne 1~ a~ Spousal ra~e 16. Amoun~ of L/ne lq ~axable a~ Lineal/Class A ra~e 17. Amoun~ of L/ne lq a~c S/bl/ng ra~e 18. Amoun~ of L/ne lq ~axabla a~ Collateral/Class B ra~a 19. Pr/nc/pal Tax Due TAX CREDTTS: PAYMENT RECETP1 DT$COUNT DATE NUMBER INTEREST/PEN PAID (-) 01-27-200q CDOOSq81 33.38 18 and 19 #ill IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (15) 580,899.56 x O0 = .00 (lb) lq,835.00 x Oq5= 667.58 (17) .00 x 12 = .00 (lB) .00 X 15 = .00 (19)= 667.58 AMOUNT PAID 65q.20 TOTAL TAX CREDIT I 667.58 BALANCE OF TAX DUEl .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. 0~/'~\ IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRAT[VE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December ZZ, 1982 -- if any futura interest [n the estate is transferred [n possess[on or enjoyment to Class B (collateral) beneficiaries of the decadent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit mith your payment to the Register of #ills printed on the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Nills, any of the 23 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-562-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-5020 (TT only). 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 must object aithin 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 --election to have the matter datera[nsd at audit of the account of the personal representative, OR --appeaI to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revise Un[t, 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-1501) for an explanation of administratively correctable errors. If any tax due [s paid within three (5) calendar months after the decedent's death, a five percent (52) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning eith first day of delinquency, ar 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 (62) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through Z004 ara: Interest Daily Interest Dally Year Rate Factor Year Rate Factor ~ 2OZ .000548 ~)T~- X991 XXZ .000.~01 1985 162 .000458 X992 92 .000247 1984 117. .000501 1995-1994 72 .0D0192 1985 157. .000556 1995-1998 92 .000247 1986 IOZ .000274 1999 72 .000192 I987 IOZ .000274 2000 77. .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID Interest Dally Year Rate Factor ~'~ 92 .000247 2002 62 .000164 2005 57. .000137 2004 42 .OOOllO X NUllBER 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 data sheen on the Notice, additional interest must be calculated.