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Home My WebLink About03-0548SCHRACK & LINSENBACH 124 W. HARRISBURG ST. P.O. BOX 310 DILLSBURG, PA 17019-0310 PHONE (717) 432-9733 FAX (717) 432-1053 LAW OFFICES Attorneys WM. D. SCHRACK III BRIAN C. LINSENBACH April 2, 2004 Register of Wills of Cumberland County Cumberland County Court House Carlisle, PA 17013 Ladies: Re: Estate of Evelyn F. Saltzer Social Security #~ File #: You will find enclosed herewith the original and one copy of a Resident Decedent Inheritance Tax Return for the above-noted estate. Accompanying that Return is my trust account check #3731, payable to the order of the Register of Wills, for the sum of$15.00, which represents the appropriate filing fee. Please accept the Return as filed, and return to me a time-stamped face page of the Return, accompanied by a receipt for the filing fee tendered. I enclose a self-addressed stamped envelope for that purpose. Thank you for your assistance. Very truly yours, III SCItRACK & LINSENBACH WDS/jsg eric. cc: James E. Saltzer REv-1500 EX + (6-00) CAPB HpRL E=IO chAC KOTK ES R E C A P I T U L A T I O N C O R R E S C 0 M T I O COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT, 280601 HARRISBURG, PA 17128-0601 REV-1500 NHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Seltzer Evelyn F. DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 06~/~1'~/~03 I 07/21/1906 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND M~DDLE INITIAL) OFFICIAL USE ONLY FILE NUMBER 2103-0548 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 190-26-6582 REGISTER OF WILLS SOCIAL SECURITY NUMBER 1. Original Return ~ 2. 4. Limited Estate 6. Decedent Died Testate 7. (Attach copy of Will) I----"] 9. Litigation Proceeds Receivedr--"~ 10. ~,~ufrd~r~h~ tSupplemental Return J~ 5,3' Remainder Return (pdda ur,='~',:',o'8~; Compromise (date of death after 12-12- Federal Estate Tax Return Beqei:~edt Maintained a Living Trust 8, Total Number of Safe Depo 64111~et~opy of Trust) Spousal Poverty Credit I I 11. Election to tax under Sec. 9 0cl~8(~)! death between 12-31-91 and 1-1-95) (Attach Sch O) NAME Wm. D. Schrack III Esq. FIRM NAME (If Applicable) Wm. D. Schrack, III Esquire TELEPHONE NUMBER 717/432- 9733 1Real Estate (Schedule A) (1) 2Stocks and Bonds (Schedule B) (2) 3Closely Held Corporation, Partnership or (3) Sole-Proprietorship 4Mortgages & Notes Receivable (Schedule D) (4) 5Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6Jointly Owned Property (Schedule F) (6) [~Separate Billing Requested 7Jnter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8.Total Gross Assets (total Lines 1-7) 9Funeral Expenses & Administrative Costs (Schedule H) (9) 1CDebts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11Total Deductions (total Lines 9 & 10) 12Net Value of Estate (Line 8 minus Line 11) COMPLETEMAILINGADDRESS 124 W. Harrisburg Street Post Office Box 310 Dillsburg, PA 17019-0310 377,817;00: None None None 6,772.47 259,096.37 None 22,091.11 ~ OFFICIAI~S~?ONLY I 13;heritable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14det Value Subject to Tax (Line 12 minus Line 13) None (8) 643,685.84 (11) (12) (13). 22,091.11 621,594.73 (14) 621,594.73 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15~,mount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 160,mount of Line 14 taxable at lineal rate 17Amount of Line 14 taxable at sibling rate 80,mount of Line 14 taxable at collateral rate 19Tax Due 621,594.73 X .0 0 (15) 0.00 X .0 45 (16) 27,971.76 X .12 (17) 0.00 X .15 (15). O. O0 (19) 27,971.76 Copyright (c) 2000 lorm software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: $'1HEET ADDRESS 100 Mt. Allen Drive Messiah Village C~TY Mechan i c sbur ~; STATE I PA ZIP I 17055 Tax Payments and Credits: 1.Tax Due (Page 1 Line 19) 2Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 33,000.00 1,398.59 (1) Total Credits ( A + B + C ) (2) 27,971.76 3Jnterest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4Jf Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to recluest a refund (4) 5Jf 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. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1Did decedent make a transfer and: Yes Nol- 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? ................... 2If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................ 3Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............................................. [-~ 4Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ ~ r~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 34,398.59 0.00 6,426.83 0.00 0.00 0.00 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 information of which preparer has any knowledge. SIGNA. I~RE OF PERSON RESPONSIBLE FOR FILING RETURN James F. Saltzer /// \-- // ~ -/~-~--,- 26 Sprin8 Lane Road ====================== ......................... SIGNAT~E OF PREPARER OTHER ~AN REPRE~NTATIVE W . ~ ' f t _ m.D. Schrack, III Es=uzre / [ ~ 124 W. Harrisbur~ Street ~/ ~ For dates of death on or after July 1, 1994 and before Januau 1, 1995, the t~ rate im~s~ on the net value of transfers to or for ~e use of the sumiving s~use is 3% [72 P.S. 9116 (a) (1.1) (i)]. For dates of death on or after Janua~ 1, 1995, the ~ rate im~s~ on the net value of transfers to or for the use of the suwiving s~use is 0% [72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a suwiving s~use from mx, and the smtuto~ requirements for disclosure of assets and filing a tax return are still applicable even ~ the su~iving s~use is the only ~neficia~. For dates of death on or after July 1, 20~: The tax rate impos~ on the net value of transfers from a d~eas~ child ~en~-one years of age or younger at dea~ to or for ~e use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. The tax rate im~sed on the net value of transfers to or for the use of ~e d~ent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2) [72 P.S. 9~ ~ 6(a)0 )]. The tax rate im~s~ on the net value of transfers to or for ~e use of ~e d~ent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under S~tion 9102, as an individual who has at least one parent in common with the d~ent, whe~er by bl~ or adoption. Copyright (c) 20~ fo~ so~wa~ only ~e Lackner G~up, Inc. Fo~ R~V-I~00 ~X (Rev. 6~) D A T B A T E REV-I'502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Evelyn F. Saltzer SS# 190-26-6582 SCHEDULE A REAL ESTATE FILE NUMBER 06/15/2003 2103- 0548 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts, Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 2 3 4 Copynght (c) 1996 fo~'n software only CPSysterns, Inc, DESCRIPTION Real estate situate at 212 Wood Street, Harrisburg, PA 17109-3935 Real estate situate at 216 Wood Street, Harrisburg, PA 17109-3935 Real estate situate at 3806 Bollinger Road, Harrisburg, PA Real estate situate at 3808 Bollinger Road, Harrisburg, PA VALUE AT DATE OF DEATH 119,305.00 64,414.00 103,469.00 90,629.00 TOTAL (Aisc enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) Form REV-1502 EX (Rev. 1-97) 377,817.00 2 0-8'3 s u s Q §_~.n.k.~.~.A .TC~T~ _~T_ ~ c E 12 MONTHS NA/~CY L BLAIR, TREASURER 1900 LINGLESTO;,~J RD HARRISBURG PA 17110 ~F~i~:December 31, 2003 UNPAID REAL ESTATE TAXES WILL BE COLLECTED BY DAUPHIN COUNTY TAX CLAIM BUREAU. -001095- SALTZER ERNEST SALTZER EVELYN 211 WOOD ST HARRISBURG PA 17109-3935 AssessmentappealsmustbefiledwithDauphin August 1 2003 County Board of Assessment Appeals on or before ' JULY ~5-2003 62-034-196 212 WOOD ST PHONE NUI,:B_R 545-0262 HOURS: MONDAY THRU FRIDAY 9: 00~.u TO 4: 30PM 2% DISCOUNT FLAT 10% PENALTY TAXPAYER SCHOOL 1 1. 0 8 0 MILLS PAYMEhJT PERIOD FAYME'~4T Af4OUNT JULY-AUG SEPT-OCT NOV-DEC 1210.71 1235.42 1358.96 IF YOU DESIRE A RECEIPT, ENCLOSE A STAMPED ADDRESSED EN~LOPE WITH THIS NOTICE !2 ~'~O!~TH S v-'-£ :-.~2.. N~Cy L BLAIR, TREASURER 1900 LINGLESTO~,;N RD HARRISBURG PA 17110 ~Dece~er 31, 2003 UNPAID REAL ESTATE TAXES WILL mE BY DAUPHiN COUN~ TAX CLA;M - COLLECTED BUREAU. -007874- SALTZER ERNEST SALTZER EVELYn F 211 WOOD ST HARRISBURG PA 17109-3935 AssessmentappealsmustbefiledwithDauphi~ AUgUSt 1,2003 County Board of AsseSSment Appeals on or before 62-034-198 216 WOOD ST JULY PHO%E %U!4BER 545-0252 HOURS: >:ONDAy THRU FRiDAy 9:00A~ TO 4:30PM 2% DISCOUNT FLAT 10% PE,%'ALTY -__.______ SCHOOL PAYMENTPERt6~ JULY-AUG SEPT-OCT NOV-DEC 11. 080 /PAYMENTAMo~ 653. 6~ 66? · O2 733.?2 TAXPAYER YOU DESIRE A RECEIPT, ENCLOSE A STAM S U S ~.ESTAT'E:)T'A~ N O~ I C E 12 NANCY L BLAIR, TREASURER 1900 LINGLESTO?~ RD HARRISBURG PA 17110 December 31, 2003 AFTER: UNPAID REAL ESTATE TAXES WILL BE COLLECTED BY DAUPHIN COUNTY TAX CLAIM BUREAU. -001191- SALTZER ERNEST SALTZER EVELYN 211 WOOD ST HARRISBURG PA 17109-3935 JULY 62-034-204 3806 BOLINGER PHONE HOURS: NUMBER 545-0262 MONDAY THRU FRIDAY 9:00}2~ TO 4:30PM RD 2% DISCOUNT FLAT 10% PENALTY SCHOOL !i . 080 MILLS PAYMENT PERIOD PAYMENT AMOUNT JULY-AUG SEPT-OCT NOV-DEC 1050.01 1071.44 1178.58 IF YOU DESIRE A RECEIPT. ENCLOSE A STAMPED ADDRESSED ENVELOF'E 'WITH THIS NOTICE Assessment appeals must be filed with Dauphin August 1, 2003 County Board of Assessment Appeals on or before TAXPAYER 1900 LINGLESTCWN RD HARRISBURG PA 17110 Dece~2~er 31, 2003 UNPAID REAL ESTATE TAXES WILL BE COLLECiED BY DAUPHIN COUNTY TAX CLAIM BUREAU. -004343- SALTZER ER-NEST SALTZER EVELYN 211 WOOD ST HARRISBURG PA F 17109-3935 JULY 62-034-210 ~808 BOLLINGER RD PHONE HOURS: NU:':BER 545-0262 !{CNDAY THRU FRIDAY 9: 00A/M TO 4: 30PM 2% D!SCOU,,T FLAT 10% PENALTY SCHOOL 11.080 MILLS ~AYMENT PERIOD PAYM. ENT AMOUNT JULY-AUG SEPT-OCT NOV-DEC 919.71 938.48 1032.33 IF YOU DESIRE A RECEIPT, ENCLOSE A STAMPED ADDRESSED ENVELOPE wrrH THIS NOTICE Assessment appeals must be filed with Dauphin August !, 2003 County Board of Assessment Appeals on or before TAXPAYER REV~1508 EX + (1-97) SCHEDULE E COMMONWE^'~OFPE..SV.V^N,^ CASH. BANK DEPOSITS, & MISC. RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF FILE NUMBER Eve].3m F. Salt:zer SS~/ 3.90-26-6582 06/15/2003 2103-0548 include the proceeds 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 Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 M & T Bank - checking acc~ ~/90016700 6,772.47 TOTAL (Also enter on line 5, Recapitulation) $ 6,772.47 (If more space is needed, insert additional sheets of the same size) Copyright (c) t996 form software only CPSystems. Inc. Fora1 RE[V-1508 EX (Rev. 1-97) FNA Allfirst Bank Manufacturers and Traders Trust Company, 1109 Wehrie Drive. P.O. Bcx 767, Buffalo, NY 14240-0767 July 23, 2003 Schrack & Linsenbach Law Offices 124 W. Harrisburg Street P.O. Box 310 Dil]sburg, PA 17079-0310 Estate of Evelyn F. Saltzer Date of Death: June 15, 2003 Social Security Number: 190-26-6582 Dear Mr. Schrackr: In response to your request, please be adx/sed that at the time of death, the above- named decedent had on deposit with r_h_/s bank the following accounts. Account Type ........................... Checking Account Account -Number. ...................... 90016700 Ownersh/p (.Names of) .............. Evel.~m F. Saltzer Opening Date ........................... 06/28/81 (account closed 07/09/03) Balance on Date of Death. .........$6,772.47 Accrued Interest S 0.00 Total. ...................................... $6,772.47 Sincerely, Charlene Warrington, Associate I (302) 934-2722 REV-1509 EX + (1-97) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Evelyn F. Saltzer SS# 190-26-6582 06/15/2003 2103-0548 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. James E. Saltzer Son B. Janet S. McLane 26 Spring Lane Road Dillsburg, PA 17019 408 Elizabeth St. Harrisburg, PA 17109 Daughter JOINTLY-OWNED PROPERTY: LEI-I'ER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bani DATE OF DEATH DECD'S VALUE OF account number or similar identifying numbe NUMBER TENANT JOINT A~ach deed for jointly-held real estate, VALUE OF ASSET INTEREST 3ECEDENT'S INTEREI 1 B Prudential Mutual Fund 33,796.43 50.00~ 16,898.22 Account #03800194128 2 A Prudential Mutual Fund 32,822.12 50.00% 16,411.06 Account #03800194127 3 A Real estate situate at 211 114,383.00 50.00% 57,191.50 Wood Street, Harrisburg, PA 17109-3935 4 A Real estate known as 156,755.00 50.00% 78,377.50 Greenwood Court Apartments, Harrisburg, PA 5 A Vartan National Bank - 3,100.87 50.00~ 1,550.44 checking acct #1041300 6 A Vartan National Bank - 177,335.30 50.00% 88,667.65 money market acct #1502397 TOTAL(Alsoenteronline6, R~apitulation) $ 259,096.37 .qT (If more space is needed insert additional sheets of the same size) Copynght (c) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97) Prudential Mutual Fund Services LLC P.O. Box 7387 Philadelphia, PA 19101-7387 A Consolidated Overview Of Your Investments This is your Prudential Mutual Fund Statement for the period April 1, 2003 to June 30, 2003 As of July 2003, Prudential renamed its mutual fund product lines. Your funds are now grouped under the JennisonDryden or Strategic Partners name. Please read Making Advised Choices to learn more. Your Account Summary Prudential Financifil Mail to: EVELYN F SALTZER JANET S MCLANE JT TEN 211 WOOD ST HARRISBURG PA 17109-3935 I,,,llh,,h,,lllh,,hh,,,ihhh,,,lh,hh,,,Ih,,lllh,,I Page 1 of 2 ::..Shares Sha~es Ow~d:~:?~ ~H~:: ~p'~}~ [~ A~:6I 6~0a ] EVELYN FSALTZER $707,67 $0.00 $0.00 0.000 6,089.447 6,089.447 $5.55 $33,796.43 JANET S MC~NE JT TEN~ · ..Features & Services: ,Dividends: Cash Capital Gains: Reinvest Telephone Exchange ~~m ::Detailed Transaction Activity as Fra~ Date Description 04/01/03 Opening Share Balance . ~'. 04/21/03 .Dividend-Cash 05/21/03 Dividend-Cash "~": 06/20/03 Dividend-Cash 06/30/03 · .Closing Share Balance Gross Share Number o! Shares Sales Charges and/or Net Amount Total Shams Amount Price Purchased or Sold Taxes Wilhheld 'Owrled $224.50 $224.50 $231.75 $231.75 $251.42 $251.42 i While we make every attempt to ensure that your slatement is accurate, errors may inadvertently occur. Please review your slalemonl thoroughly and contact us if you find any information you believe ::'~ ~ to be inaccurate. If we do not hear from you in 30 days, wo will assume that all information is correct. Prudential Financial is a service mark of Prudential, Newark NJ, and its affiliates. If required by your slate, Prudential Mulual Fund Services LLC will be supplying this information to the appropriate state agency. 6,089.447 6,089.447 6,089.447 6,089.447 :~6~089.447 EVELYN F SALTZER JAMES E SAL'~ER JT TEN 211 WOOD ST HARRISBURG PA 17109-3935 Prudential ;'Fin i:ial CLIENT 'CONFIRMATION F::': Your Account Number Is: 03800194127 I,,,llh,,h,,lllh,,hh,,,Ihhl,,,,ll,,hl,,,,ll,,,lllh,,I Dryden High Yield Fd CIA Fund Ct: 0087/NASDAQ: PBHAX Redemption-Check (532,822.12) $5.39 (6,089.447) 0.000 Dividend Close Out-Cash $153.65 $0.00 0.000 0.000 While we make every attempt to ensure that )'our confirmation b accuate, errors ma)' Inadvertent¥ occur. Please re~qew )'our confirmation thoroughly and contact us Il'you find any information you believe to be inaccurate, ffwe do not hear from you in 30 days, we will assume that all information Is correct. Registered Representative(s): For Do'den High Yield Fd C1 A Fund #: 0087 / NASDAQ: PBHAX THOILAS FRANK (813)287-1726 ?RUCO Securities Corporation, member NASD, SIPC, acted as agent in this transaction. Pruden~al Mutual Fund Sen'ices LLC strives for qualit)' processing. Was this transaction executed to )'our satisfaction? Please call our toll-free Customer Sec'ice number - (800) 22.~-1852 Please refer to the reverse side for addi~onai information. Retain this cop)' for )'our record& Additional Investment Form Please use this ren'n to r:',.ake an addit/onat investment ~.'~ ,,'our mutual fund account(s). Please indicate the dollar amount vou wish to invest on the line below, next to your fund~clxss. ACCOUNT O;;.~ER.(S) List the ~o~l amount of)'eur invc's:.ment and make )'our check payable t~ PMFS. EV'ELS,~ F SALT'ZER J.(MES E SAL'I-ZER JT TEN Your Account Number is:- 038001941'i7 Your SSNfrax ID is: On File Your Personal Account Holdings DR'rD KIGE yl~.13 led CL A Fund Number [ 0087 [S Total Invcs~ent 0380019'412790087000000000000000000003701 s u s Qq~-A~-~ S~AT~CrA~ N C~T I C E 12 !.~ONTHS !'L~-NC¥ L BL,%IR, T.REASUR--?, 1900 LZIqGLESTO?~'~ RD HARRISBURG PA 17110 December 31, 2003 AFT, FR: UNPAID REAL ESTATE TAXES WILL EE COLLECTED BY DAUPHIN COUNTY TAX CLAIM BUREAU, -000735- SALTZER ERI~EST 211 WOOD ST HARRISBURG PA 17109-3935 62-034-186 211 WOOD ST PHONE :fLL?.'.'BER 545-0262 HOUP, S: I':O.NDAY THRU FRIDAY 9: 00.~2'[ TO 4: 2% DISCOUNT FLAT 10% PENALTY SCHOOL 11.080 MILLS PAYMENT PERIOD PAYMENT AMOUNT JULY-AUG SEPT-OCT NOV-DEC 1160.76 1184.45 1302.90 ' IF YOU DESIRE A RECEIPT, ENCLOSE A STAMPED ADDRESSED EkWELOPE WFFH THIS NOTICE Assessment appeals must be filed with Dauphin August I, 2 0 0 3 County Board of Assessment Appeals on or before TAXPAYER 2 · .t~o £ C-_~ 3- S U S QB E/M~ES ~T~ j~ :D~" I C E !2 MOP, TH S I'~NCY L BLAIR, TREASURER 1900 LINGLESTOI?N RD HARRISBURG PA 17110 Decem2~er 31, 2003 AFTER: UNPAID REAL ESTATE TAXES WILL BE COLLECTED BY DAUPHIN COUNTY TAX CLAIM BUREAU. -004340- SALTZER JAMES E TRUSTEE 26 SPRING LANE RD DILLSBURG PA 17019-9474 JULY 62-034-199 211 WOOD ST PHONE NUMBER 545-0262 HOURS: !'[ONDAY THRU FRIDAY 9:00AM TO 4:30PM 2% D~SCOUNT FLAT 10% PENALTY SCHOOL 11.080 MILLS PAYMENT P-'__.RIC12, P,&YME.,"{T AMOU+',~T JULY-AUG SEPT-OCT NOV-DEC 3181.51 3246.44 3571.08 IF YOU DESIRE A RECEIFT, ENCLOSE A STAMPED ADDRESSED ENVELOPE WITH THIS NOTICE Assessment appeals must be filed with Dauphin A~c~'~ S t i , 2 0 0 3 County Board of Assessment Appeals on or before TAXPAYER vartan vartan national bank your local community bank July 28, 2003 Mr. William D. Schrack, III Scnrack & Linsenbach 124 W. Harrisburg Street P.O. Box 310 Dillsburg, PA. 17019-0310 Re: The Estate of Evelyn F. Saltzer Greenwood Apartments c/o James E. Saltzer S.S. #190-26o6582 Date of Death: 06/15/03 Dear Mr. Schrack: Greenwood Court Apartments maintains two accounts at Vartan National Bank. Ms. Evelyn F. Saltzer was a co-owner on both. Checking Acct. No. 1041300 Established 06/01/88 Date of Death Balance $3,100.87 VNB Fund M.M. No. 1502397 Established 06/01/88 Date of Death Balance $177,335.30 There are no safe deposit boxes in the name of Greenwood Court Apartments or Evelyn F. Saltzer. 0683. ~ ....... -" Very truly yours, ./Sharon L. Forry Vice President and Banch Manager PROGRESS OFFICE (717) 657-7727 FAX (717) 657-7748 R O. Box 500, Dauphin, PA SUSQUEHANNA OFFICE (717) 540-0683 FAX (717) 540-0689 17018 · www. vartanbank.com DAUPHIN OFFICE (717) 921-2371 FAX (717) 921-2373 SILVER SPRING OFFICE (717) 591-1360 FAX (717) 591-1363 REV-l~11 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Evelyn F. Saltzer SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS 190-26-6582 06/15/2003 Debts of decedent must be reported on Schedule I. FILE NUMBER 2103-0548 ITEM NUMBER Bo 1 2 3 4 5 DESCRIPTION :UNERALEXPENSES: Cremation Society of Pennsylvania ~DMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Zip Attorney's Fees Wm. D. Schrack, III Esquire Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State~ Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Register of Wills Tax Return Preparer's Fees OtherAdministrativeCosts Ben Kuntz - 212 Wood St. electrical repairs Charles Misceli 3806 Bollinger Rd. toilet repair Charles Miceli 212 Wood Charles Miceli - 212 Wood Charles Miceli - plumbing Rd. St. disconnect and cap stove gas line St. repair lavatory faucets repairs 212 Wood St. & 3806 Bollinger City Treasurer - 212 Wood St. water rent Total of Continuation Schedule(s) Copyright (c) 1996 form software only CPSystems, Inc. AMOUNT 1,050.00 10,000.00 545.00 100.00 0.00 35.00 54.50 165.25 26.06 10,115.30 TOTAL (Also enter on line 9, Recapitulation) $ 22,091.11 (If more space is needed, insert additional sheets of the same size) Form REV-1511 EX (Rev. 1-97) Estate of: Evelyn F. Saltzer Soc Sec #: 190-26-6582 Date of Death: 06/15/2003 Continuation of Schedule H-B7 (Other Administrative Costs) Item Description Am oun t 7 City Trearurer 212 Wood St. water rent 8 City Treasurer 212 Wood St. water rent 9 Clerk of Orphans Court Release fee 10 Cumberland Law Journal - estate advertisement 11 Durofit 212 Wood St. repair tenant's breakfast nook seat 12 Eshenaur Fuel - 3806 Bollinger Rd. augered drain 13 Good Will Insurance Co. - premiums on five properties 14 Harry Mullen - 212 Wood St. cleaning 15 Herr Electric oven repair 3806 Bollinger Road 16 Keystone Oil Service 3806 Bollinger Rd. 17 Keystone Oil - 212 Wood St. 18 Keystone Oil - 212 Wood St. service and oil 19 Keystone Oil - 216 Wood St. clean & service furnace 20 Knaub's 212 Wood St. window sill repair 21 Miscellaneous expense (postage, copies, Notary, etc.) 22 Nancy Blair, Tax Collector - real estate taxes 211, 212, 216 Wood St., 3806, 3808 Bollinger Rd. 23 Patriot News - estate advertisement 24 Register of Wills - filing fee 25 Reserve for future administrative expense 26 Susquehanna Township - 212 Wood St. sewer rent 27 Susquehanna Township Authority - 212 Wood St. sewer 17.24 8.41 16.00 75.00 551.21 215.40 1,523.00 450.00 129.27 81.50 55.00 256.54 90.10 52.25 25.OO 4,994.87 93.85 15.00 500.00 72.00 72.00 Estate of: Evelyn F. Saltzer Soc Sec #: 190-26-6582 Date of Death: 06/15/2003 Item Description Continuation of Schedule H-B7 (Other Administrative Costs) Amount 28 UGI 212 Wood Street gas service 29 Young's Septic Service - 3806 Bollinger Rd. pump septic tank 30 Young's Septic Service - 3806 Bollinger Rd. pump septic tank 31 Young's Septic Service - 3806 Bollinger Rd. pump septic tank 32 Young's Septic Service - 3806 Bollinger Rd. pump septic tank 33 Young's Septic Service - 3806 Bollinger Rd. 21.66 180.00 170.00 150.00 150.00 150.00 10,115.30 REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Evel'm F. Seltzer SS~/ NUMBER I. 2 II. SCHEDULE J BENEFICIARIES 190-26-6582 06/15/2003 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY FAXABLE DISTRIBUTIONS [include outdght spousal distributions, and tmnsfem under Sec. 9116(a)(1,2)] Janet S. McLane 308 Elizabeth Street Harrisburg, PA 17109 James E. Saltzer 26 Spring Lane Road Dillsburg, PA 17019 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter Son FILE NUMBER 2103-0548 AMOUNT OR SHARE OF ESTATE 1/2 of residue 1/2 of residue ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 181 AS APPROPRIATEI ON REV 1500 COVER SHEET ~ON-TAXABLE DISTRIBUTIONS: ~,, SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) $ 0.00 Copydght (c) 2000 form software only The Lackner Group, Inc. Form REV- 1513 EX (Rev. 9-00) REV-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN CAPB HpRL EpIO CRAC voTK " ES C O R R E S R E C A P I T U L A T I O N C 0 M xl T I O RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Saltzer Evelyn F. DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 0 ~/~33B~/~)03 I 07/21/1906 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY FILE NUMBER 2103-0548 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 190-26-6582 REGISTER OF WILLS SOCIAL SECURITY NUMBER 1. Odginal Return ~ 2. 4. Limited Estate 4a. 6. Decedent Died Testate 7. (Attach copy of Will) ~ 9. Litigation Proceeds Receivedr~ 10. Retum ~ 3. Supplemental ~r~j[,~; Compromise (date of death after 12-12- 2)~ 5. Beqed~edt Maintained a Living Trust 8. ~'tl~eJ~3py of Trust) Spousal Pove~y Credit ~ ~ 11. ~f death between 12-31-91 and 1-1-95) (da Remainder Return pn Federal Estate Tax Return Total Number of Safe Depo Election to tax under Sec. 9 (Attach ScL O) NAME Wm. D. Schrack III Esq. FIRM NAME (If Applicable) Wm. D. Schrack, III Esquire TELEPHONE NUMBER 717,/'432 - 9733 COMPLETE MA!L!NC~DRESS 124 W. Harrisb~rg Strut Post Office Box 310 Dillsburg, PA 17019-0c~10 ! 1Real Estate (Schedule A) (1) 2Stocks and Bonds (Schedule B) (2) 3Closely Held Corporation, Partnership or (3) Sole-Proprietorship 4Mortgages & Notes Receivable (Schedule D) (4) 5Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6Jointly Owned Properly (Schedule F) (6) E~eparate Billing Requested 7Jnter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8.Total Gross Assets (total Lines 1-7) 9Funeral Expenses & Administrative Costs (Schedule H) (9) 10;)ebts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11Total Deductions (total Lines 9 & 10) 1;~let Value of Estate (Line 8 minus Line 11) 492,200.00 None None None 6,772.47 201,904.87 None 22,091.11 None 13Charitable and Govemmental Dequests/Sec 9! 13 Trusts for which an election to tax has not been made (Schedule J) 14~let Value Subject to Tax (Line 12 minus Line 13) OFFICIAL USE ONLY (8) 700,877.34 {11) 22,091.11 (12) 678,786.23 (13). (14) 678,786.23 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 50~mount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 160aT~ount of Line 14 taxable at lineal rate 7Amount of Line 14 taxable at sibling rate 8~mount of Line 14 taxable at collateral rate 191'ax Due X .0 0 678,786.23 X .0 45 X .12 X .15 (15) 0.00 (16) 30,545.38 (17) 0.00 (18), O. 00 (19) 30,545.38 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: ;TREETADDRESS 100 Mt. Allen Drive Messiah Village C~TY Mechanic sbur8 Tax Payments and Credits: 1.Tax Due (Page I Line 19) 2Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3interest/Penalty if applicable D. Interest E. Penalty STATE IPA ZIP 0.00 33,000.00 1,527.27 17055 Total Credits ( A + B + C ) (2) (1) 30,545.38 34,527.27 0.00 3,981.89 0.00 0.00 0.00 Total Interest/Penalty ( D + E ) (3) 4Jf 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) 5Jf 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. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1Did 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? ................... 2If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................ [--] [~] 3Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............................................. ~ ~'] 4Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ II L.~ 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 retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is tree, correct and complete. Declaration of preparer ether ~an the personal representative is based on all information of which preparer has any knowledge. ..URE OF PERSON RESPONSIBLE F~"IL~.ING RETURN James E. Saltzer ./' ~/ /~,/CJ/"~' 26 Spring Lane Road ~IGI~TURE OF PREPARER,OTHER THAR'I'I~'PRESENTA'~J.~E Wm. D. Schrack, I I I Esquire ~J / ~/~C~ ~ _ 124 W. Harrisbur~ Street _ /~ -- -~ { il-s-gA~[~ [- ~-- iV 6 i~-f6 §~-d ................... 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 (al (1.1) (il]. 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. 9116 (al (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 P.S. 9116 (al (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)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 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. Copyright (c) 2000 form software only Ti3e Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) REV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Evelyn F. Saltzer SS~ 190-26-6582 SCHEDULE A REAL ESTATE FILE NUMBER 06/15/2003 2103- 0548 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with ri~]ht of survivorship must be disclosed on Schedule F, ITEM NUMBER 1 2 3 4 5 DESCRIPTION Real estate situate at 211 Wood Street, Harrisburg, PA 17109-3935 Real estate situate at 212 Wood Street, Harrisburg, PA 17109-3935 Real estate situate at 216 Wood Street, Harrisburg, PA 17109-3931 Real estate situate at 3806 Bollinger Road, Harrisburg, PA Real estate situate at 3808 Bollinger Road, Harrisburg, PA TOTAL (Also enter on line 1, Recapitulation) VALUE AT DATE OF DEATH 114,383.00 119,305.00 64,414.00 103,469.00 90,629.00 $ 492,200.00 (If more space is needed, inser~ additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-I$02 EX (Rev. 1-97) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER Evelyn F. Saltzer SS# 190-26-6582 06/15/2003 2103-0548 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorsh:p must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OFDEATH 1 M & T Bank - checking acct #90016700 6,772.47 TOTAL (Also enter on line 5, Recapitulation) $ 6,772.47 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Evelyn F. Saltzer SS# SCHEDULE F JOINTLY-OWNED PROPERTY 190-26-6582 06/15/2003 FILENUMBER 2103-0548 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. James E. Saltzer Son B. Janet S. McLane Co 26 Spring Lane Road Dillsburg, PA 17019 408 Elizabeth St. Harrisburg, PA 17109 Daughter JOINTLY-OWNED PROPERTY: LE'I-rER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name ~ financial institution and ban DATE OF DEATH DECD'S VALUE OF account number or similar identifying numbE NUMBEF TENANT JOINT A~ach deed for jointly-held malestate. VALUE OF ASSET INTEREST DECEDENT'S INTERE~ 1 B Prudential Mutual Fund 33,796.43 50.00% 16,898.22 Account #03800194128 2 A Prudential Mutual Fund 32,822.12 50.00% 16,411.06 Account #03800194127 3 A Real estate known as 156,755.00 50.00% 78,377.50 Greenwood Court Apartments, Harrisburg, PA (held jointly by decedent and Executor since Deed of 6/21/1950, recorded in Deed Book U, Volume 33, page 423 -- see attached) 4 A Vartan National Bank - 3,100.87 50.00% 1,550.44 checking acct #1041300 5 A Vartan National Bank - 177,335.30 50.00% 88,667.65 money market acct #1502397 TOTAL(Alsoenteronline6, R~apitul~ion} $ 201,904.87 (If more space is needed insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97) k DEED THIS DEED is made this '2'-{~' day of ~) ~' , 1998, between JAMES E. SALTZER ] hereinafter called 'Grantor' and JAMES E. SALTZER,-~frustee under Trust Agreement dated 1998 with JAMES E. SALTZER as Settlor and Trustee, hereinafter called *Grantee". (Both Gran~'o~' and -- ' Grantee, whether one or more, referred to as though singular in number). WITNESSETH, that the Grantor for and in consideration of' the sum of One Dollar ($I.00) and other good and valuable consideration, paid by the Grantee to the Grantor, at and before the signing and delivery of these presents, the receipt whereof is hereby acknowledged, has granted, bargained, sold. and conveyed, and by these presents does grant, bargain, sell, and convey unto the Granlee and Grantee's heirs, successors and assigns the premises described on Exhibit "A" attached hereto and incorporated herein by reference. TOGETHER with all buildings, improvements, woods, ways, rights, liberties, privileges, hereditaments and appurtenances, to the same belonging, or in any wise appertaining, and any reversions, remainders, rents, issues and profits thereof, and of every part and parcel thereof, including any interests specifically set forth on Exhibit "A", if any. And also, all the estate, right, title, interest, property, possession, claim and demand whatsoever, both in law and equity, of the Grantor of, in and to the same. TO HAVE AND TO HOLD the same premises, and the appurtenances, hereby granted to Grantee and Grantee's heirs, successors and assigns, to and for the only proper use, benefit and behoof of the Grantee and Grantee's heirs, successors and assigns forever, under and subject to the conditions set forth on Exhibit 'A", if any. UNDER AND SUBJECT to all Acts of Assembly, County and Township Ordinances, ~tights of Public Utility and Public Service Companies, existing restrictions and easements, visible or of record, to the extent that any persons or entities have acquired legal rights thereto, plans, rights of way, liens of record. This transfer is exempt from Pennsylvania transfer taxes because to a Trustee of an ordinary trust where the transfer would be exempt if directly to the beneficial. DORIS S, SALTZER joins in execution of this Deed for the purpose of releasing any interest of any kind or nature whatsoever in or to the premises herein conveyed. AND the Grantor hereby covenants and agrees that Grantor will warrant specially the property hereby conveyed, IN WITNESS WHEREOF, the Grantor has hereunto set Grantor's hand and seal the day and year first above written.' ~' ...._.. ~AMES E. SALTZER ~/ DORIS S. S~ALYzEP~ 8 3100P 650 COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF DAUPHIN: On the"~--~'c,/' ~/"~ day of ,~J~ , 1998, before me, the subscriber, a Notary Public in and for said Commonwealth and County, came the above-named JAMES E. SALTZER and DORIS S. SALTZER. his wife, satisfactorily proven to me to be the persons whose names are subscribed Io the within instrument and acknowledged the above instrument to be their act and deed, and desired the same might be recorded as such. WITNESS my hand and Notarial seal. My Commission Expires: Notarial Seal Rhonda E. Eberly. Nolary Publio Harrisburg. Dauphin Counly My Con'~mission Expire.~ Ma7 2, 1998 COMMONWEALTH OF PENNSYLVANIA: ss: .I hereb,. '~'~n C- the ~ mat ~0~ ~COrCe. t~ ~0¢. Recorded on ~e day of v~tllHIIIIIIll/~ ' ~er)~ ~,.. of the Recorder of Deeds of County. e6X!n~a~~ Voium~ ~ ~$~. ...... ~.~, %' .~. - c'Ord., aeff ", of Doe-- 8 3100P 651 EXHIBIT 'A' All that certain undivided one half(~) interest in and 'to that certain piece, parcel or land, situate in the Township of Susquehanna. County of Dauphin, and Commonewealth of Pennsylvania, more particularly bounded and described in the manner following: BEOIRNII{O ·% · point: on %he north a~de of ~¢he pro'l~rgy o£ Jo~ J~oob3~ ~htoh po[n~ ia om h~dred e~y (180) fee~ ea~ of ~he o~er of ~ood 5~ree~ ~ the e~s~e~ line or pro~y of E~os~ 8~l~zer ~ ~el~ ~. 8~l~zer~ ~hem~e nar~h- wardly ·long ~he eastern 1t~ of s~e, one h~re~ and ro~ (104) fee~ ~o · poim~l ~henoe ~ = wea~e~ly direo~iom ·long'line of a~e, one h~dred eighty (1BO) fee~ ~o ~he ~e~er or Wood S~ree~; ~henoe in a northwardly ~re~lom ~hrou~ ~e ~en~er of Woo~ 8~ree% tern (10) fee~ ~o = potn~ on,he a~u~herm line of pro~y of Jo~ ~off~ e'~ uxl ~henoe In ~ easterly direo~lom ~omg line of eme, o~ h~dre~ . eighty (180) fee~ to. a'poin~} ~enoe nor~w~rdly ·long ~ e~a~e~ line of proper~y of Jo~ E~ln HSff, e~ ux, o~ h~dred (100) fee~ ~o ~he =~he~ lib'of prope~y of J~ea Shield, s ~enoe waa~ardly ·long ~he aou~he~m line of a~e, ~wo h~dre~ thlr~ (230) fee~ ~o a poi~ on the western.line of pro~y of Clarenoe R. Roover, e~ ux~ ~henoe In a a~herly ~lreo~lon ~l~g line of ~e, ~o h~dred fo~eem (21~) fee~ ~o ~e nor~he~ line of proper~y of 4o~ Jt~ba tf~reatid$ ~d ~heaoe in = wee~erly direo~ion ~o~ li~ of.a~e, ~ h~dre~ thir~ (2~0) fee~ ~o the po~t ~ plaoe of be~ng. ~.. .. . . .~L. ' BEING the same undivided one half('/:) interest in and to that certain piece, parcel or tract of land, which, Ernest Saltzer and Evefyn F.Saltzer, his wife, by their de.ed dated June 21, 1950 a~d recorded in the Office of the Recorder of Deeds of ~ ~/ $'a , in Deed'Book ol 33, at Page 423, granted //: and conveyed to Grantor herein. ' k BK31OOP§ 652 E EXEMPTION DATA REALTY TRANSFER TAX l~'~ ,_-.,,,,-, o,., ,...., ,:., .., ,,.,,,,,, ,.x,, ........ o, v.,., .*-,.u,~ ..... ~,e~ ..... See Reverse for Instructions C~mplete each ~cHen nnd ~;le in duplicate wit~ Race der of Deeds when ()) tho lull valu~lconsiderollon is not set iorlh in the deed. (2) when the deed without C~n~ide~OliOn. e~ by gilt. ~t (3) a la~ exemplion is cloJmed. A S~alem~nl el Volue ~s nol required if the transfer is wholl~ exempt ~om tax o.: ~)~a?.?~o, ........................... (~LEub"c u~ilh~ ea~em.L , mo~e ~ce is .ceded a ach addltlo.ol CORRESPONDENT - All inquiries may be directed to the following person: Telephone Nvmbe¢: ROD~RT C. S~TZ~R, P.C. ~,..coe,~ 717 )231-7600 Add.e. City Slale Zip Code 407 NORTli FROHT STREET IIARRISBURG PA 17101 ~.. ,~.~.s,,.~,~ :~...,~:. ...... ,. ....... ~/~ ~1~ o~t.,,o I,) ~ ~ . -- Jo,a.,..l,llLe,,..(,) ~ / + ~ = ......... /~v 1~ CheCk Appropfiale ~o~ ~eJow lot ~xlmpfJon Clo~med Tronsfer lo Industrial Of-elopmenl Agency. Tronder beeween pr, nc,pal and agenl. (A.ach complele copy of agency/straw parly og~eemenl.) ~rander~ ~o ~he Commonwealfh. lhe Unhed S~a~*s and Instrumentalities by gift. dedication, condemnofion or (If condemnation or in lieu of condemnation, a.ach copy of resolution.) ~ Trande~ from mo.gagor Io a holder of a mo.gage In de'aah. Modgoge Bao~ Number ~ Corrective or confirmatory deed. {Alloch compl~le copy of the prior deed being correcled or confirmed.) ~ 5ta~uf~r~ co~porafe consolidation, merger or division. (A.ach copy of Under penohlel at taw, I declare Ihol I~ ------ha v~.an~'~ed this Statement. Including oc¢ompanyk~g info.nat on, and to INa best of my knowledge and belief, Il Is true, correcl and compile. )// ,..,..,-,.,,.,~b~// _ z . o.,.. / / , RECORD THE DEED. REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Evelyn F. Saltzer SS# SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS 190-26-6582 06/15/2003 FILE NUMBER 2103-0548 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 1 2 3 4 5 :UNERAL EXPENSES: Cremation Society of Pennsylvania ~,DMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Zip Attorney's Fees Wm. D. Schrack, III Esquire Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State__ Zip Relationship of Claimant to Decedent Probate Fees Register of Wills Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Ben Kuntz 212 Wood Charles Misceli Charles Miceli Charles Miceli Charles Miceli Rd. St. electrical repairs 3806 Bollinger Rd. toilet repair 212 Wood St. disconnect and cap stove gas line 212 Wood St. repair lavatory faucets plumbing repairs 212 Wood St. & 3806 Bollinger City Treasurer 212 Wood St. water rent Total of Continuation Schedule(s) Copyright (c) 1996 form software only CPSystems, Inc. 1,050.00 10,000.00 545.00 100.00 0.00 35.00 54.50 165.25 26.06 10,115.30 TOTAL (Aisc enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) For~ REV-1511 EX (Rev. 1-97) 22,091.11 REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Evel~ F. Saltzer SS~ 190-26-6582 SCHEDULE J BENEFICIARIES 06/15/2003 RELATIONSHIP TO DECEDENT FILE NUMBER 2103- 0548 AMOUNT ORSHARE NUMBER II, NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY tAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] Janet S. McLane 308 Elizabeth Street Harrisburg, PA 17109 James E. Saltzer 26 Spring Lane Road Dillsburg, PA 17019 Do Not List Trustee(s) Daughter Son OF ESTATE 1/2 of residue 1/2 of residue ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 181 AS APPROPRIATE1 ON REV 1500 COVER SHEET qON-TAXABLE DISTRIBUTIONS: ~., SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) Copy~ght (c) 2000 form software only The Lackner Group, Inc. Fonm REV- 1513 EX (Rev. 9-00) Register of Wills County, PETITION FOR GRANT OF Estate of also known as Pennsylvania LETTERS , Deceased Social Security No. 190-26-6582 Petitioner(s) who~/are 18 years of age or older, apply(les) for: (COMPLETE "A" OR "B" BELQW:) [~ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execute decedent, dated and codicil(s) dated ___named in the last Will of the ( State relevant circumstances, e.g. renunciation, death of executor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: [] B. Grant of Letters of Administration (d.b.n.c.ta.; pendente lite; durante absentia; durante minoritate) 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 JAMES E. SALTZER JANET S. McLANE (COMPLi- I i- IN ALL CASES:) Attach additional sheets if necessary son daughter 26 Spring Lane Road Di ] l ,~hm'o'. PA 1 701 9 308 ElizKbeth Street Harrisburg. PA 17109 Decedent was domiciled at death in or principal residence at 47 5/la-nchester, ~r l and County, Pennsylvania, with his/her last family Messiah Villacre. Mechanie~bm-g: PA 17055 ([~.nm, Allen Twp.) (list street, number, and municipality) , at Decedent, then 96 years of age, died June 15 ,20 03 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 $ (Location) 65,000.00 900,000.00 situated as follows: various VVherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: ~ '~.~[ ~1.,,~,~_.~~ Sign~e..__,, ~~"r~ r~(~' . J J..NV~S,~R $~r!_~_~E' S.A~'.I."/.I~:H.i.o.eTyped or printed name and residence -~..~. , ......... T~i 1 '1 ~l~...g,_ OA. ..... 1 "in1G I snace/VVills PetGrantLt/2001 Oath of Personal Representative Commonwealth of Pennsylvania County of York The Petitioner(s) above-named swear(x) or affirrr~,~) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief or Petitioner(s) and that, as personal representative(s) of the Decedent, Petition(s) witl well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this J ST day of ,~TvLLH ~005 ~-~ V¢¥) the Register JAMES E. rSALTZER 0 No. Estate of ~'~--~ F. SALTZER Deceased Social Security No.: 190 26 6582 Date of Death: June 15, 2003 AND NOW, ,20 03 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters I~ Testamentary ~ Of Administration d.b.n.c.t.a.; @endente I~e~rante absentia; durante minoritate are hereby granted to JAMES E. SALT .ZE~ and j~_'~':T R_~__¢_-:~'.~ ~L,~-~- 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 ....... $ Affidavits ( ) ....... $ Extra Pages ( ) ..... $ Codicil ............ $ JCP Fee ........... $ Inventory ........... $ Automation Fee ..... $ Other .............. $ TOTAL ........ snace/WillsPetGrantLt/2001 Register of Wit~L~ ' ' t,J P",, , I.D. No: 15893 124 W. Harrisburg Street Address: Post Office Box 310 Dillsburg, PA 17019-0310 Telephone:717-432-9733 Register of Wills of o.~a]mt~a:) County, Pennsylvania RENUNCIATION Eslate of also kncwn u Deceased The undersigned. JANET S. McLAN~. da _u~ter (Relationship) (Capacity) the above Decedent. hereby renounce(s) tho right to administer tho estate and respectfully request(s) tha! Ler~e,,~ be issued to JA~E{S E. SALTZER WITNESS MY handthis FIRST dayof ,~LTLY ,1~c 2003 Prepared by (Signature) 308 Elizabeth St.~ Harrisburg, PA 17109 (Address) (Signature) (Address) (Signature) (Address) NOTE: RenunciatioM executed outside the Offic~ of Register cd Wills in some counties are required to be notarized. CERTIFICATION OF NOTICE UNDER i~LE 5.6 (a} Name of Decedent: Date of Death: Estate No. ~ =~' :57 '03 JUL 23 ~ EVELYN F. SALTZER JUNE 15, 2003 t.~ ~ 21-03-0548 [i',~. ! ~L , To the Register: I certify that Notice of Estate Administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on JULY 21, 2003. Name JAMES E. SALTZER Address 26 Spring Lane Road Dillsburg, PA 17019 JANET S. McLANE 308 Elizabeth Street Harrisburg, PA 17109 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none. WM. D. SCHRACK, III, ESQUIRE 124 West Harrisburg Street P.O. Box 310 Dillsburg, PA 17019 (717) 432-9733 Counsel for Personal Representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIV~ ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be determined wholly or partly by the decedent's Will. If the decedent died without a Will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA In re: THE ESTATE OF: EVELYN F. SALTZER ESTATE NO. 2103-0548 To: JAMES E. SALTZER JANET S. McLANE Please take note: The Decedent, EVELYN F. SALTZER, died on the 15th day of June, 2003, at Messiah Village, Upper Allen Township, Cumberland County, Pennsylvania. The personal representative of the Decedent is: James E. Saltzer 26 Spring Lane Road Dillsburg, PA 17019 (717) 432-3588 The Decedent died Intestate (without a Will). A Petition for the Grant of Letters of Administration was filed with the office of the Register of Wills of Cumberland County. Register of Wills of Cumberland County 1 Courthouse Square Carlisle, Pennsylvania 17013 (717) 697-0371 A copy of the Petition may be obtained by contacting the Register of Wills and paying the charges for duplication. WM. D. SCHRACK, III, ESQUIRE 124 West Harrisburg Street P.O. Box 310 Dillsburg, PA 17019 (717) 432-9733 Counsel for Personal Representative · ' LOSED FOB YOUR ACTION Date Sept 8, 2003 File No. 2~-03-0548 Re: The Estate of Evelyn F. Saltzer Enclosedyouwillfind adminsitrator's ck # 1015 remitted to prepay estimated Pa Inheritance Tax liability. Please accept check, and return receipt to my office. [] Please review and call with any questions or changes [] Please call to make an appointment [] Please sign and return [] Please sign, have your signature notarized and return. REGISTER OF WILLS Cm~erland County Court House TO CARLISI~, PA 17013 !_ SCHRACK & LINSENBACH LAW OFFICES 124 WEST HARRISBURG STREET POST OFFICE BOX 310 DILLSBURG, PA 17019-0310 (717) 432-9733 · FAX (717) 432-1053 SCBP, ACK& L~NS~J~BACB LAW OFFICE5 124 WEST HAR~ISBLIRO STREET Post OF~CE BOX 310 DILLSBURG, PA 17019-0310 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 002996 SCHRACK WM D III ESQ 124 W HARRISBURG ST P O BOX 310 DILLSBURG, PA 17019 ........ fold ESTATE INFORMATION: SSN: 190-26-6582 FILE NUMBER: 2103-0548 DECEDENT NAME: SALTZER EVELYN F DATE OF PAYMENT: 09/1 0/2003 POSTMARK DATE: 09/09/2003 COUNTY: CUMBERLAND DATE OF DEATH: 06/15/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $33,000.00 TOTAL AMOUNT PAID: $33,000.00 REMARKS: WILLIAM D SCHRACK ESQUIRE SEAL CHECK# 1015 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS ENCLOSED FOR YOUR ACTION Date 7.1.2003 File No. Re:Estate of EvelynF. Saltzer Enclosed you will find administratrix. Please add to file [-I Please review and call with any questions or changes ~1 Please call to make an appointment [-I Please sign and return ~1 Please sign, have your signature notarized and return. i- REGISTER OF WILLS OF CI1V~EIILAND ~ Cuuberland County Court House TO CARLISLE, PA 17013 Renunciation of da~ughter of decedent who elected to not serve as an SCHRACK & LINSENBACH LAW OFFICES 124 WEST HARRISBURG STREET POST OFFICE Box 310 D]LLSBURG, PA 17019-0310 (717) 432-9733 ° FAX (717) 432-1053 SCHRACK & LINSENBACH LAW OFFICES 124 WEST HARRISBURG STREET Post OFFICE BOX 310 DILLSBVRO, PA 17019-0310 ~?0~-~-+.'.-'..~-0~ J~dJJ~ldJJ,.~.JJtlJJ.lJJlldJflJll,,flJlhJldlJ~llllhJ BUREAU OF INOtVIP~ALTAXES INHERITANCE TAX DIVrSION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-1U7 EX AFP (12-0~l ')0 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-24-2005 SALTZER 06-15-2003 21 03-0548 CUMBERLAND 101 EVEL YN F , ;. WM D SCHRACK III ESQ 124 W HARRISBURG ST PO BOX 310 DILLSBURG PA 17019 Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account.. submit the upper portion of this for.. with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ~~:r&~,r.~5r.A~~..rGl~.6!1........;.."fA~!fA~e1r",A5r.!tl"f!~.b".Aei:60~...j(...................... ESTATE OF SAL TZER EVELYN F FILE No.21 03-0548 ACN 101 DATE 01-24-2005 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATIDN DF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-13-2004 PRINCIPAL TAX DUE:. 30,545.38 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-09-2003 \ CD002996 1,527.27 33,000.00 01-03-2005 V REFUND .00 3,981.89- TOTAL TAX CREDIT 30,545.38 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. \ IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ.. YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) Cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 5/03/2005 SCHRACK WM D III ESQ 124 W HARRISBURG ST POBOX 310 DILLSBURG, PA 17019 RE: Estate of SALTZER EVELYN F File Number: 2003-00548 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/15/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~~~~ GLENDA FARNER STRAs4..U~H REGISTER OF WILLS cc: File Personal Representative(s) Judge J Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: EVELYN F. SALTZER Date of Death: JUNE 15, 2003 Estate No.: 21-03-0548 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 JXl No 0 2. lfthe answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No !Xl b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes IX!. No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: 5/06/2005 {~ Signature WVI. D. srnRACX I I I srnRACX & LINSENBAClI LAW OFFICES Name :rosT OFFICE :oox 310 DILLSBURG, PA 17019-0310 --.,'-) Address 717-432-9733 Telephone No. Capacity: 0 Personal Representative ~ Counsel for personal representative " Register of Wills of Cumberland CQ\U1ty - Name of Decedent: STATUS REPORT UNDER RULE 6.12 5alt~e~ cve1qn r Date of Death: June /5,2003 2003-eJ0548 Estate 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 0 No ~ -----" . ~ ---- ~._-_._-- .~-_..--_~"""~---'" ---,-.-~~~-- 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: llvtee tv f-ou~ mvntM - --- - --- - 3. lfthe answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, releases, joinders and approval of fonnal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ~ Date: ,t1Qlj 6,2(,/Yi ~~ (- --- ;'J yame-1 C 5alI3€/l Name 26 5p/linf? Lane 7<d. Address /Jil!/JIJU/lo, 7h. /70/9 Capacity: Telephone No. /, '00 717-'T ]2-3500 J2g. Personal Representative o Counsel for personal representative J INRE: ESTATE OF EVELYN F. SAL TZER, DECEASED : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : NO. 21-03-0548 RECEIPT, RELEASE, REFUNDING AND INDEMNITY AGREEMENT CONCERNING DISTRIBUTION FROM ESTATE THIS AGREEMENT, based upon the family circumstances outlined, is entered into with the Administrator by each beneficiary, from the date of formalization of his or her separate Consent: 1. EVELYN F. SAL TZER died intestate on June 15, 2003, and James E. Saltzer was appointed as Administrator of his affairs on July 7, 2003, which appointment is documented in the Office of the Register of Wills of Cumberland County, Pennsylvania to File Number 21-03-0548. 2. The Beneficiaries have received an acceptable accounting of the disposition of the assets of the Estate, and they desire that the distribution of the assets of the Estate be made without the formality of an accounting in the Orphans I Court Division of the Cumberland County Court of Common Pleas, and the Administrator is willing to make this distribution upon the execution of this Agreement. . " . '~ RK 3. The Beneficiaries desire to forever settle and compromise any and all claims and rights which they may possess, now or hereafter, in the Estate. The Beneficiaries desire that the distribution to shall be in full satisfaction of their rights in the Estate. 4. The Beneficiaries wish to release the Administrator and to indemnify him against any and all claims that may be asserted against the Estate with the Administrator after the date hereof. 5. The Administrator is willing to settle the Estate informally in consideration of the indemnification and agreements hereinafter provided by the Beneficiaries. NOW, THEREFORE, in consideration of the foregoing and intending to be legally bound hereby, jointly and severally, the Beneficiaries do, for themselves, their heirs, personal representatives, successors and assigns, agree as follows: A. Represent and warrant that they have read and understand this Agreement and confirm that the facts set forth above are true and correct, to the best of their knowledge, information and belief. B. Declare that they have sufficient information to make an informed waiver of their rights to a formal accounting with the Court, and do hereby waive the filing and auditing of said formal accounting. C. Acknowledge that the distributive share shall be in full satisfaction of their respective entitlements as beneficiaries of the Decedent. D. Release, remise, quitclaim and forever discharge the Administrator, his heirs, personal representatives, successors and assigns, from and against all claims that they, as residuary Beneficiaries of the Estate, had, now have or may in the future have in connection with the Estate. E. Agree to refund, on demand, all or any part of their proportionate share of any aforesaid distribution, which has been determined by the Administrator of the Court, or by any court of competent jurisdiction, to have been improperly made. F. Agree to indemnify and hold harmless the Administrator, his heirs, personal representatives, successors and assigns, from and against any and all claims, loss, liability or damage (whether or not related to the negligence of the Administrator) that may hereafter be asserted against the Estate or against the Administrator. G. Agree to execute such additional documents as may be necessary to effectuate the agreements set forth herein. H. Acknowledge that this Agreement shall be governed by and construed in accordance with the laws of the Commonwealth of Pennsylvania. I. Consent to the Court exercising personal jurisdiction over their in any suit or action arising out of the enforcement of this Agreement. IN WITNESS WHEREOF, the beneficiaries have set their hands and seals to the Consents attached hereto, to be effective as of the date first above written. ~ ~ I I I I CONSENT TO RECEIPT, RELEASE REFUNDING AND INDEMNITY AGREEMENT CONCERNING DISTRIBUTION FROM ESTATE The undersigned, JANET S. McLANE, a beneficiary of EVELYN F. SALTZER, Deceased, hereby consents to the Receipt, Release, Refunding and Indemnity Agreement Concerning Distribution From Estate, a copy of which has been provided to her. The undersigned also acknowledges receipt of her share of the Estate, as more particularly described in the aforesaid Agreement, subject to all the terms and conditions specified therein. ~--rxfm~ ANET S. McLANE COMMONWEALTH OF PENNSYLVANIA COUNTY OF -DQ u ~\ h \ f\ f, tit \", , On this, the I I day of -J Q~' \ LJ Q v L-{ , 2006, before me, a Notary Public, the undersigned officer, personally appeared JANET S. McLANE, known to me to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and Notarial Seal. ~ ,~ '~~~ NOTARY PUBLIC COMMONWEAlTH OF PENNSVLVANIA NOlt,RJtIi. SEAl P/\.UlA K, SMIT'rL Ncm~ ~,.lbIIc Sus:quOOanna Tvf.p". ~l!) ,,/.)\.lAty 1 My Commission E.xp..:r..!'".~~~~..~-.J .,_.....".....,-,--_........_""...."',................-....- SS. CONSENT TO RECEIPT, RELEASE REFUNDING AND INDEMNITY AGREEMENT CONCERNING DISTRIBUTION FROM ESTATE The undersigned, JAMES E. SAL TZER, a beneficiary of the Estate of EVEL YN F. SAL TZER, Deceased, hereby consents to the Receipt, Release, Refunding and Indemnity Agreement Concerning Distribution From Estate, a copy of which has been provided to him. The undersigned also acknowledges receipt of his share of the Estate, as more particularly described in the aforesaid Agreement, subject to all the terms and conditions specified therein. '\/t.,.02-)- (. S E. SAL TZER COMMONWEALTH OF PENNSYL VANIA ',,- SS. COUNTY OF I \( U /.';)1/1 I -~ On this, the J '/ day of J ,,'!l) , 2006, before me, a Notary Public, the undersigned officer, personally appeared JAMES E. SAL TZER, known to me to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and Notarial Seal. ..~(;- I) ,k 1'-. \. /) f..-,.... ){ i (, l U \ NOTARY PUBLIC COMMONWEALTH Of PENNSYLVANIA NOTARIAL SEAL EBONE'M. TURNER, Nota.ry Public City of Harrisburg, Dauph!n County My Commission Explre~_~!~~,_~~09 .,_....._.,~..-_".'__<<,. i" .....__,~.. ..'"..0, _- - , I I I