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03-0573
PETITION FOR PROBATE ~nd GRANT OF al&o known ~ To: R~r~ of Wi~ for . Dece~ed. Co~ of Cumber~ana in the Socta/Secunt~ No. 17~-20-5823 Co~onw~ of Pennsylv~ia The Petition of the unde~ign~ r~pecrfully r~r~ents Your peritioneris), who ~/~e 18 years of a~e or older ~ the ~e~r~/ces in the t~t will of the above d~ent, dared October 30 .. 19~reed and codicil(s) dated (state relevant circnmstances, ~.g. renuadafion, Decendent w~ domiciled at death in Cumberland ~unty, ~nsy~ia, with ~J~t/amily or pri~gip~ r~idence at 727 Messiah Village, vpper A~en '~-~., ~umDerzano CounEy, g~ (l~t str~. n~ber ~d m~p~ty) Decendent, th~ 89 y~s ~fage,,~ ~uty 10, 2003 at HoZy Sp~t~r Hosptra~ E. renns~oto T~., Cumberland ~ounry~ ~A ~~' Except ~ follows, decedent did not ma~, wm not ~vorc~d ~d ~d not have a child bom or a~opted after execution of th~ will offer~ for probate; w~ not the ~ of a ~g ~d wm never adjudicated incompetent: ~ - Decendent at denth owned prope~ ~th estimat~ v~u~ m follows: (If domiciled in Pa~) ~I personal prope~y ~ 650~000.00 (If aot domiciled in Pa.} Personal prope~y in Pennsylv~a (If not domiciled in ~=.) Per~on~ propeHy in Co~ty V~ue of real estate in F~nnsyiv~a situated ~ follows: WHEREFORE, petitioner(s) r~pec:fully reclUe~t(s) the probate of the last will and codicil(s) presented hereWhh and the grant of letters testamentary theron. , (t=tamearary; a~minmmtion c-t.a.; administration d.b.n.c.t.a.) '~ ~'EONA . 'FOSTER ~LOIS M.' ~_c __526 Pigeon Hill Road RD1, Box zt43j~' ~'= Galeton, ~A l~zz Liverpoo~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ] COUNTY OF .... . CUMBERLAND Th~ ~etitioner/s) above-named swear(s) or affirm(s) that the sta~emen~ in the foregoing petition are true and correct to the'best of the knowledge and belief of petitioner(s) and that as persona/represen- tativeis) o£ the above ,:ie:edent petitioner(s) will well and truly administer the estate according to law. Sworn · /~ ~-.~' day of ~' Ree:ster '~ Estate of Charlotte W. Buyer , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~'~'.t~../~, /,~ "~~ in consideration of the petition on ' / sati~actory been presented before me, the reverse side hereof, proof having IT IS DECREED that the instrument(s) dated October 30, 1997 described therein be admitted to probate and filed of record as the last will of Charlotte W. Buyer and Letters Testamentary ~ are hereby granted to LEONA FI. FOSTER and LOIS H. KICItYLAN ~ RcMt~r of Wilh Probate, Letters, Etc .......... $~ "l~v~Hl S,one #39785 Short Certificates( ) .......... $.~-~ ATrO~ (~up. Ct. LD. No.) ~t~on ................ ~_ ~,~ 414 Bridge St., .New Cumberland, PA 17070 TOTAL ~e ~ (717) 774-7435 , PHO~ 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. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 ~ /' '(~' ';/¢-¢-~4,,e~ ..- ~ .Local Registrar P 9 2 6 8 314 ~~ 4U.L 1.'L No. '~ Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTI4 · VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT ~F,,sl M,d~e, ka~) ]~EX rsoc,~L s~cu.,~-~ a' female ~ 174 -- 20 -- 5823 Cumberland . P ,.. ~ T ~c~o~.vs usuat ~cu,mm. -- ~ I,. ' ' Ira. white .... Accounting Clerk ,,b. Federal Governmen~,~ ....... ],~ 12 ~0.,a [ o ~ctu.c ...s,.,. Pennsylvania _ ~ ,,..~ ~.~,~. Upper Allen 727 Messiah Village .~s,~.c~ ~., ,.. Mechanicsbur~, PA 17055 o~.,~o~ ,~.,,,,~ ~.~ ,m. c~..~ Cumberland ,,~.~ ,,. Benjamin Franklin Wilt ,~vo...m.s~..~o,~,,,~, ,,. Carrie B. Imhoff ~. Lois M. Kichman ~. RD 1, Box 245F, Liverpool, PA 17045 ~.oo ~ ms~,~ ~.~ ~ o,s,osmo~ ~1~ Cte~t~ Re~v~l,omSla~e~ J(Mo~h Da~) orP~CEOFOIS~SIT[~'Na~°tCeme~e~'C~m~~r a~ ~L~ATION-Ci~,SI~W,~W~ ~ ~NATURE OF FUN "CE LI NSEE OR PER~ AC.,NG AS S~H ILiCENSE~ .ER NA' ,-- ' "D AD E. OF F~IL,. --..~m ............ ~ ..~ o, ~am ,o I(~u~e ~d fi,e) J S UMBER [DATE ~NED .... " .... - ................ F I I ........ ~ .................. oI I j,.o .ooj · f2eb. J~,. /3 · I ~,.~ ....... ~"~ ............................... ' ................... :: 7:: ..... ' .... :~.~'~:~Y.~'2 ~ ..... ~')'~ ~ ~ ~ t~ ~ ~ ~/~ ep\wills\buyer.cw\10-97 ~ LAST WI?.T. AND TESTAMENT OF CHARLOTTE W. BUYER I, CHARLOTTE W. BUYER, of Upper Allen Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I devise and bequeath my household goods and personal effects, not including cash or securities, to my Co-Executrices hereinafter named to be distributed by them in their sole discretion to such persons as they deem fit. ITEM II: I bequeath the sum of One Thousand ($1,000.00) Dollars to ZION LUTHERAN CHURCH, Enola, Pennsylvania. ITEM III: I bequeath the sum of Five Thousand ($5,000.00) Dollars to MESSIAH VILLAGE ENDOWMENT FUND. ITEM IV: I bequeath the sum of Five Thousand ($5,000.00) Dollars to ROBERT L. BUYER. ITEM V: I devise and bequeath the residue of my estate, of every nature and wherever situate, to be divided equally among such of my following named nieces and nephews who survive me: LEONA M. FOSTER, LINDA K. HOOVER, LOIS M. KICHMAN, JEAN L. McBRIDE, LELAND B. WILT, and MARILYN B. BEARDSLEE. ITEM VI: I appoint LEONA M. FOSTER and LOIS M. KICHMAN, Co- Executrices of this my last will. Page 1 of~ ~,~ r ITEM VII: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of her duties in any jurisdiction. IN WITNESS WHEREOF, I, CHARLOTTE W. BUYER, have hereunto set my hand and seal this ~ day of 0~'~o~_~,. , 1997. CHARLOTTE W. SIGNED, SEALED, P~LISHED and DECLARED by CHARLOTTE W. BUYER, the Testatrix above n~ed, as and for her Last Will and Test~ent, and in the presence of us, who at her request, in her presence and in the p~ach other, have subscribed our n~es as witnesses. Address s Address Page 2 of COMMONWEALTH OF PENNSYLVANIA: : SS: COUNTY OF CUMBERLAND : I, CHARLOTTE W. BUYER, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. CHARLOTTE W. Sworn to or affirmed to and acknowledged before me by CHARLOTTE W. BUYER, the Testatrix, this day of ~t/ , 1997. Notary Public NOTARIAL $~AL CONSTA~C,E L. COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that Page 3 of .~&~ we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence to or affirmed to and acknowledged before me by and ./~_/i/~ ~. ~tc'~ ? witnesses, this ~ day of ~c~~% , 1997. ~ .... ~, I ~3, 1999] Page 4 of ~ A~ RECEIPT FOR PAYMENT Cumberland_County - Register Of Wills Receipt Date: 3/31/2004 Hanover and High Street Receipt Time: 16:05:14 Carlisle, PA I7013 Receipt No.: 1036131 BUYER CHARLOTTE W Estate File No.: 2003-00573 Paid By Remarks: JA ........................ Receipt Distribution ........................ Fee/Tax Description Payment Amount Payee Name SPOUSAL TAX RETURN 10.00 CUMBERLAND COUNTY GENERAL FUN INVENTORY 13.00 CUMBERLAND COUNTY GENERAL FUN Check# 1001 ~3.00 Total Received ......... 3 00 STONE LAFAVER & SI-IEKLETSKI ATTORNEYS AT LAW 414 BRIDGE STREET DAVID H. STONE POST OFFICE BOX E OF COUNSEL GERALD J. SHEKLETSKI N~;w CU~]~EI~LAND, PA 17070 CHARLES H. STONE ELIZABETH B. STONE v~w. ston¢law, net JON F. LAFAVER TELEPHONE (7 ! 7) 774-7435 April 2, 2004 F^CSlmLE Register of Wills Office Cumberland County Court House 28 E. Market Street Carlisle, PA 17013 RE: Estate of Charlotte W. Buyer File No. 2003-0573 Greetings: Enclosed please find the "Receipt of Payment" showing a Spousal Inheritance Tax Return was filed for the above mentioned estate on March 31, 2004. The return was not a spousal return and therefore I am enclosing a check in the amount of $5.00 for additional payment on the filing of the return. Please white out the spouses name {Chester Buyer) on the front of the return on both copies and send us the new receipt in the enclosed stamped addressed envelope. Your cooperation in this matter is certainly appreciated. Very truly yours, STONE LaFAVER & SHEKLETSKI DHS/tmb ""' Enclosures : CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Charlotte W. Buyer Date of Death: July 10, 2003 Will No. 2003-00573 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court rules was served on or mailed to the following beneficiaries of the above captioned estate on July 25, 2003. Zion Lutheran Church Messiah Village Endowment Fund 265 N. Enola Drive 100 Mt. Allen Drive Enola, PA 17025 Mechanicsburg, PA 17055 Leona M. Foster Linda K. Hoover 526 Pigeon Hill Road 2448 Moraine Circle Gaieton, PA 16922 Rancho Cordova, CA 95670 Lois M. Kichman Jean L. McBride RD 1, Box 245F 10 Regency North Liverpool, PA 17045 Carlisle, PA 17013 Marilyn B. Beardslee Robert L. Buyer 6160 River Dr. PO Box 191 28 Power Street Wrightsville, PA 17368 Norton, MA 02766 Notice has now been given to all persons entitled thereto under Rule 5.6(a) . ~ Date: ~- 9fi '~ ~ '~" ¥.U,I[) D T6~, Esquire ':~ 414 Bridge Street New Cumberland, PA 17070 ~ 717-774-7435 Capacity: Personal Representative :i'~ X Counsel for Personal ~:~!~ Representative COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003108 STONE DAVID HEAN 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold 101 $85,000.00 ESTATE INFORMATION: SSN: 174-20-5823 FILE NUMBER: 2103-0573 DECEDENT NAME: BUYER CHARLOTTE W DATE OF PAYMENT: 1 O/10/2003 POSTMARK DATE: 10/09/2003 COUNTY: CUMBERLAND DATE OF DEATH: 07/10/2003 TOTAL AMOUNT PAID: $85,000.00 REMARKS' DAVID H STONE ESQUIRE CHECK# 08 INITIALS: AC SEAL RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS ' REGISTER OF WILLS LAW OFFICES OF STONE LAFAVER & SHEKLETSKI 414 BRIDGE STREET POST OFFICE BOX E NEW CUMBERLAND, PA. 17070 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 COM:~ONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 28O601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003744 STONE DAVID HEAN 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 ACN ASSESSMENT AMOUNT CONTROL NUMBER .......... fold ?, ~ 101 $618.00 ESTATE INFORMATION: SSN: 174-20-5823 FILE NUMBER: 2103-0573 DECEDENT NAME: BUYER CHARLOTTE W DATE OF PAYMENT: 03/31/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 07/10/2003 ", TOTAL AMOUNT PAID: $618.00 REMARKS' -: CHECK//10 ...... INITIALS: JA · ',i' SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX (S-O0) OFFICIAL USE ONLY ' ~ COMMONWEALTH OF REV-1500 DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN E, LE NUMBER HARRISBURG,PA 17128-0601 RESIDENT DECEDENT 21 -- 2___00~ __OS:B_ COUNTY CODE YEAR NUIMBER DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER F- Buyer Charlotte W - Z 174 20-5823 ILl DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE UJ 7/10/2003 1/24/1914 REGISTER OF WILLS I.~ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER uul._ I~ 1, Original Return I I 2. Supplemental Return [~] 3. Remainder Return (date of death prior to (D nO::~ [~ 4. Limited Estate r-~ 4a. Future lnterest Compromise (date of doath aftor 12-12-82) ~-I 5. Federal Estate Tax Return Required ~(~D_~O~:;D r~ 6. Oecedent Died Testate (Attach copy of Will) ~'~ 7. Decedent Maintained a Living Trust (Attach copy of Tru~t) -- 8. TotaI Number of Safe Deposit Boxes I I 9. Litigation Proceeds Received II 10. Spousal Poverty Credit (da,, o~d,~th be, .... 123191 and 1-1 95) I I 11. Election to tax under Sec. 9113(A)(AUafh ~- THIS SECTION MUST BE COMPLETED, ALL CORREsPONDENcE AND CONFIDENTIAL TAX INFORI~"T,0N SHOULD BE DIR]3~;TED TO: :~ NAME COMPLETE MAILING ADDRE~; [~"' ~ ,J'-'~ ~O FIRM NAME (If Applicable) (' O TELEPHONE NUMBER 1. Real Estate (Schedule A) (1) 0 .... :. ~r ~ OFFI¢~)~L USE ONLY 2. Stocks and Bonds (Schedule B) (2) 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0 4. Mortgages & Notes Receivable (Schedule D) (4) 0 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5} 345, 070 Z 6. Jointly Owned Property (Schedule F) 0 O (6) ~-- [] separate Billing Requested <~ 318 763 .-I 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) , ~) (Schedule G or L) ~' 8. Total Gross Assets (total Lines 1-7) 663 833 ~ (8) , t't'LLI 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 53 , 183 l O. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 4, 0 3 9 1. Total Deductions (total Lines 9 & 1 O) ( 11 ) 5 '7, 2 22 12_. Net Value of Estate (Line S minus Line 11) (12) 60(~, (~11 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) {13) 6 00 0 14. Net Value Subject to Tax (Line12 minus Line13) (14) 600 611 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax Z rate, or transfers under Sec. 9116 (a)( 1.2) 0 x .0 0 . 0 0 (15) 0 © ~- 0 45 0 16. Amountof Line 14 taxable at lineal rate x.O (16) 0_ 17. Amount of Line 14 taxable at sibling rate 0 0 ~ x .12 (17) (.J 18. Amount of Line 14 taxable at collateral rate. 600~ 611 x.15 (18) 90 092 X ~ 19. TaxDue (19) 90 092 HASPXXNUMBER . Oecedent's Complete Address: STREET ADDRESS '727 M~ssiah Village Cumberland County CITY I STATE ZIP Mechanicsburg PA 17055 - Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 90~ 092 2. Credits/Payments A. Spousal Poverty Credit 0 B. Prior Payments 85, 000 C. Discount 4, A74 Total Credits(A+B+C) (2) 89 3. Interest/Penalty if applicable D. Interest 0 E. Penalty 0 Total Interest/Penalty (D + E) (3) 0 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (4) 0 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 618 A. Enter the interest on the tax due. (SA) 0 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) 6]_8 Make Check Payab/e to: REGISTER OF WILLS. AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: 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; ......... I----1 c. retain a reversionary interest; or ................................ r~ d. receive the promise for Life of either payments, benefits or care? ................. ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................ [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? E~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ [~ [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge, SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE RD #1, BOX 245F Liverpool, PA 17045-9534 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 414 Bridge Street New Cumberland, PA 17070 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 396 [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. § 9116 (a) ( 1.1 ) (ii)] The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. § 9116(a)( 1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. § 9116( 1.2) [72 P.S. § 9110{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. HASPXXNUMBER REV-I~08 EX + (1-~) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANI( DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF FILE NUMBER Charlotte W. Buyer 21 2003 0573 Include the ~roceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship i~ust be disclosed on Schedul~ ITEM VALUE AT DATE NUMBER DESCRIPTION OFDEATH 1. Citizens Bank-Cert of Dep. #6240958684 52 095 Interest accrued to 7/10/2003 141 2 Citizens Bank-Cert. of Deposit #6240959672 49 764 Interest accrued to 7/10/2003 5 3 Citizens Bank-Checking Acct. #6200241604, Princ. $22,644.10, Int. $14.67 22 644 Interest accrued to 7/10/2003 14 4 Messiah Village-Refund on apartment 21 250 5 Personal property appraised by Charles R. Stull 1,200 6 PNC Bank-Cert. of Deposit #31200225959 28,538 Interest accrued to 7/10/2003 53 7 PNC Bank-Cert. of Deposit #31600151614 61,382 Interest accrued to 7/10/2003 50 8 PNC Bank-Checking Acct. #5070101782 23,262 Interest accrued to 7/10/2003 3 9 Wachovia Bank-Cert. of Deposit #247412061061483 25,242 Interest accrued to 7/10/2003 45 10 Waypoint Bank-Cert. of Deposit #7800012874 59,315 Total from continuation pages 67 TOTAL(AIsc enteron line 5, Recapitulation) $ 345, 070 HASPXXNUMBER (If more space is needed, insert additional sheets of the same size) · ' Schedule E (Page 2) Estate of: Charlotte W. Buyer Item Value at Date No. Description of Death Interest accrued to 7/10/2003 67 Total (Carry forward to main schedule) 67 REV-1510 EX + (%97) ' ' SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Charlotte W. Buyer 21 2003 0573 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DATE OF DEATH DECD'S EXCLUSION DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE TAXABLE VALUE NUMBER DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IF APPLICABLE) ~' PNC Advisors-Charlotte Buyer Trust Under Agreement 16-27-027-3104978 318,753 100.000 0 318,753 Interest accrued to 7/10/2003 10 100.000 10 TOTAL (Also enter on line 7, Recapitulation) $ 318,763 (If more space is needed, insert additional sheets of same size.) HASPXXNUMBER REV-~ 511 EX + SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Charlotte W. Buyer ° 21 2003 0573 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Parthemore Funeral Home funeral expenses 7,524 B. ADMINISTRATIVE COSTS:' 1. Personal Representative's Commissions Name of Personal Representative(s) T,OiS Fi. Ki£hman/Leona Fi. Foster Social Security Number(s) /EIN Number of Personal Representative(s) Street Address RD 1, BOX 245F / 526 Pigeon Hill Rd City Liverpool / Galaton State PA Zip 17045 / 16§22 Year(s) Commission Paid: 2 004 2. Attorney Fees David H. Stone, Esquire 22,277 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State __ Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. TaxReturnPrepareYsFees 7. 1 AF&L-insurance premium 127 2 Cumberland Law Journal-adv. grant of letters 75 3 PNC Bank-check printing fee 49 4 PPL-electric service at home 23 Total from continuation pages 372 TOTAL(Also enter on line 9, Recapitulation) $ 53, 183 HASPXXNUMBER (If more space is needed, insert additional sheets of same size) Schedule H part 2 (Page 2) Estate of~ Charlotte W. Buyer Item No. Description Amount 5 Register of Wills-Piling Inheritance Tax Return and Inventory 27 6 Reserve for closing expenses 200 7 The Patriot News Co.-advertising grant of letters 124 8 Vartele Com, Inc.-phone service 4 9 Verizon-telephone services 17 Total (Carry forward to main schedule) 372 REV-l~12 EX ~ (1-9~7) SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Charlotte W. Buyer 21 2003 0573 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. Charles R. Fields, DDS-dental work 5 3 2 Messiah Village 3,986 TOTAL(Also enter on line 10, Recapitulation) $ 4, 039 HASPXXNUMBER (~f more space is needed, insert additional sheets of the same size) REV-] 513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Charlotte W. Bu!/er 21 2003 0573 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a)(1.2)] 1. Jean L. HcBride 10 Regency Nerth CarlisLe, PA 17013 20% Residue: 119,122 Niece 119,122 2 Leona H. Foster 526 Pigeon Hill Rd GaleEon, PA 16922 20% Residue: 119,122 Niece 119,122 Total from continuation pages 362,366 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE. ON REV-1500 COVER SHEE1 II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLEANDGOVERNMENTALDISTRIBUTIONS 1. Zion Lutheran Church 265 N. Enola Dr., Enola, PA 17025 1,000 Total from continuation pages 5,000 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 6, 000 HASPXXNUMBER (If more space is needed, insert additional sheets of the same size) Schedule J part 1 (Page 2) EstaEe of: CharloEte W. Buyer IEem No. Description Relation Amount 3 Linda K. Hoover 2448 Moraine Circle Rancho Cordova, ~ 95670 20% Residue: 119,122 Niece 119,122 4 Lois M. Kichman RD #1, Box 245F Liverpool, PA 17045 20% Residue: 119,122 Niece 119,122 5 Marilyn B. Beardslee 6160 River Drive, P.O. Box 191 Wrightsville, PA 17368 20% Residue: 119,122 Niece 119,122 6 Robert L. Buyer 28 Power Street Norton, MA 02766 General Bequests: 5,000 Nephew 5,000 Total (Carry forward to main schedule) 0 . Schedule J part 2 B (Page 2) EsUate of: Charlotte W. Buyer Item No. Description Amount 2 Messiah Village Endowment Fund 100 M~. Allen Dr., Mechanicsburg, PA 17055 5,000 Total (Carry forward to main schedule) 0 ~--~ STONE, LAFAVER & STONE ATTORNEYS AT LAW 414 BRIDGE STREET NEW GUMBERL~%/~D, PA 17070 LAST WILL AND TESTAMENT OF CHARLOTTE W. BUYER I, CHARLOTTE W. BUYER, of Upper Allen Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I devise and bequeath my household goods and personal effects, not including cash or securities, to my Co-Executrices hereinafter named to be distributed by them in their sole discretion to such persons as they deem fit. ITEM II: I bequeath the sum of One Thousand ($1,000.00) Dollars to ZION LUTHERAN CHURCH, Enola, Pennsylvania. ITEM III: I bequeath the sum of Five Thousand ($5,000.00) Dollars to MESSIAH VILLAGE ENDOWMENT FUND. ITEM IV: I bequeath the sum of Five Thousand ($5,000.00) Dollars to ROBERT L. BUYER. ITEM V: I devise and bequeath the residue of my estate, of every nature and wherever situate, to be divided equally among such of my following named nieces and nephews who survive me: LEONA M. FOSTER, LINDA K. HOOVER, LOIS M. KICHMAN, JEAN L..McBRIDE, LELAND B. WILT, and MARILYN B. BEARDSLEE. ITEM VI: I appoint LEONA M. FOSTER and LOIS M. KICHMAN, Co- Executrices of this my last will. Page 1 of ~ ~.~.~ ITEM VII: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of her duties in any jurisdiction. IN WITNESS WHEREOF, I, CHARLOTTE W. BUYER, have hereunto set my hand and seal this ~? day of <l~e~ , 1997. CHARLOTTE W. BUYER SIGNED, SEALED, PUBLISHED and DECLARED by CHARLOTTE W. BUYER, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the pr~~each other, have subscribed our names as witnesses. - % <.~%]~3-- Address Wlt~ess Address Page 2 of ~ ~>=~'~3 COMMONWEALTH OF PENNSYLVANIA: : SS: COUNTY OF CUMBERLAND : I, CHARLOTTE W. BUYER, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. CHARLOTTE W. Sworn to or affirmed to and acknowledged before me by CHARLOTTE W. BUYER, the Testatrix, this ~0~ day of/77... _~~tt/' , 1997. Notary Public COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that Page 3 of-~-~,~,..~ we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence.,... ......... , Wztnes~ orn to or affixed to and acknowledged before me by witnesses, this ~ day of ~,~,~ , 1997. ~- Notary ' ' Page 4 of REV?85 EX+ (9-00) ,~~ SAFE DEPOSIT BOX COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE I NVE NTO RY iNHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 Please Print or Type MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRES: UCOUNTYCODE ~ FILENUMBER ~.~ SOCIAL SECURITY OR DEATH CERTIFICATE NUMBER ~,1~ DECEDENT'S NAME (LAST, FIRST, MIDDLE) 2003-00573 174-20-5823 M DATE OF DEATH Buyer, Charlotte W. I July 10, 2003 '~1 ADDRESS OF DECEDENT (STREET) (CITY) (STATE) (ZIP CODE) 727 Messiah Village, Mechanicsburg, PA 17055 U NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX (NAME) David H. Stone, Esq., 414 Bridge Street, New Cumberland, PA 17070 (STREET NAME) (CITY) (STATE) (ZIP CODE) ~;~ NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING a. (NAME) (RELATIONSHIP) David H. Stone, Esquire Attorney for Estate (STREET NAME) (CITY) (STATE) (ZiP CODE) 414 Bridge Street, New Cumberland, PA 17070 b. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) (STATE) (ZIP CODE) c. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) (STATE) (ZIP CODE) NA~D ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (NAME) PNC Bank, N.A. (STREb I NAME) (CITY) (STATE) (ZIP CODE) 939 Oak Oval, Mechanicsburg, PA 17055 ~[l~J NAME OF PERSON MAKING LAST ENTRY ~ DATE AND TIME OF LAST ENTRY Marilyn B. Beardslee I July 8, 2003 i~ DATE OF CONTRACT TO RENT BOX Bi~ NUMBER OF BOX W TITLE UNDER WHICH BOX IS REQUESTED J~_q~_~, 1987 I F-7 [Chester A. & Charlotte W. Buyer [] N~,~DDR-~ OF PERSON(S) HAVING ACCESS TO BOX a. (NAME) b. (NAME) Chester A. Buyer (deceased in 1995) Charlotte W. Buyer (STREET ADDRESS) (STREET ADDRESS) 727 Messiah Village (CITY) (STATE) (ZIP CODE) (C~TY) (STATE) (ZIP CODE) Me chanic sburg, PA 17055 ~[.1 NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY WAS AWILL IN THE BOX? [] YES :~NO If yes, a. Date of will: b. Name and address of personal representative, if named in the will (NAME) (STREET NAME) (CITY) (STATE) (ZIP CODE) c. Name and address of attorney, if any (NAME) David H. Stone, Esquire (STREET NAME) (CITY) (STATE) (ZIP CODE) 414 Bridge Street, New Cumberland, PA 17070 'CITIZENS BANK s2s William Penn Place Suite 153-2510 Pittsburgh, PA 15219 September 30, 2003 STONE L,4FLA VER & SHEKLETSKI ATTORNEYS AT LAW 414 BRIDGE STREET, POST OFFICE BOX E NEW CUMBERLAND, PA 17070 Estate of CHARLOTTE W BUYER Date of Death: Jul 10, 2003 SSN: 174-20-5823 Dear Sir/Madam: In accordance with your request, the attached information sheet has been provided in the above decedent's name as of her date of death. For IL or LC accounts, contact our Loan Department at 1-800-708-6680. Sincerely, Carol DeMarco Operations Services CITIZENS BANK Account Number 6240958684 Account Title Charlotte W Buyer Date Opened 07/15/2002 Account Type Time Deposits Principal Balance as of DOD $52095.25 Interest from Last Postin~ to DOD $141.3 i Account Balance as of DOD $52236.56 YTD Interest to DOD $978.44 CITIZENS BANK Account Number 6240959672 Account Title Charlotte W Buyer Date Opened 04/09/2003 Account Type Time Deposits Principal Balance as of DOD $49764.46 Interest from Last Posting to DOD $5.45 Account Balance as of DOD $49769.91 YTD Interest to DOD $247.23 CITIZENS BANK Account Number 6200241604 Account Title Charlotte W Buyer Date Opened 07/30/2002 Account Type Checking Principal Balance as of DOD $22644.10 Interest from Last Posting to DOD $14.27 Account Balance as of DOD $22658.37 YTD Interest to DOD $140.52 August4,2003 Marilyn Beardslee P.O. Box 191 Wrightsville, PA 17368 Dear Ms. Beardslee: I am writing to you concerning the refund due to you for the apartment occu~ Buyer at 727 Allegheny, Messiah Village. The acquisition fee paid £or the unit in August 1987 was $85,000.00. The ag~_ terminated July 29, 2003. Seventy-five percent of the acquisition fee was ar- years leaving a refund in the amount of $21,250.00 (see enclosed amortizatic The payment of the refund will take place after the unit is acquired by anoth~ months after the date the unit was vacated, whichever occurs first. If you have any questions regarding the refund, please call me at (717) 790-8 Sincerely, 1 Senior Accountant 100 Mt. Allen Drive [] Box 2015 [] Mechanicsburg, PA 17055-~:= (717) 697-4666 [] Fax {717) 790-8200 [] www. messiahvillage, c · COPY DEPOS IT AMORTIZATION HOUSE TYPE AND $: AMOUNT AMORTIZED: TF~dVl OF AMORTIZATION: j b~ r~?o,,,'~.,~ 17' M~NTHLY AMORTIZATION: /~K)RTIZATION BEGINNING DATE: ~RTIZATION ~ING DATE: FISCAL YEAR-END'- DATES AMOUNT BALANCE I TO 3o / ~ lo g37,~o FINAL UNAMORTIZED AMOUNT: ~UG-24-2~03 19:38 PNCBANK 412 ?68 3458 P.O1 0 PN CBA K August 25, 2003 David H. Stone 414 Bridge Street P.O. Box E New Cumberland, PA 17070 Estate of Charlotte W. Buyer, deceased SSN: 174-20-5823 DOD: 7/10/2003 Dear Mr. Stone:Name: In response to your request for Date of Dealh balances for the customer noted above, our records show the following: Certificates of Deposit Account #316001516 l 4 Established 03/31 / 1999 CHARLOTTE W BUYER DOD balance: $61,382.14 + $49.78 accrued interest Account #31200225959 Established 04/17/2002 CHARLOTTE W BUYER DOD balance: $28,538.41 + $53.25 accrued interest Checking Account Account #5070101782 Established 11/10/1987 CHARLOTTE W BUYER DOD balance: $23,262.17 + $3.44 accrued interest Safe Deposit Box #7 Established 07/! 5/1987 CHARLOTTE BUYER Located: MESSIAH VILLAGE BRANCH VILLAGE COMMONS - 100 MT. ALLEN DRIVE MECHANICSBURG PA 17055 717-691-4090 Page 1 of 2 AUG-24-2083 19:38 PNCBANK 412 768 3458 P,82 Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process a~ay fiaaneial transactions or provide statements. If you need assistance with any of these items, please call 1-8$8-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, Rachelle Wells 1-800-762-1775 P7-PFSC-O4-F 500 first Ave. Pittsburgh PA 15219 Page 2 of 2 Member FDIC TOTAL Reference ID: 666662 Wachovia Bank N.A. Balance Confirmation Services P O Box 40028 Roanoke, VA 24022-7313 August 1, 2003 STONE LAFAVER & SHEKLETSKI 414 BRIDGE STREET P O BOX E NEW CUMBERLAND, PA 17070 SUBJECT: Verification / Confirmation of Account and Balance Information provided for: Customer: CHARLOTTE W BUYER (SSN# 174-20-5823) Date of Death: July 10, 2003 Deposit Account Information Account Account Date of Death Average Date Maturity Interest Accrued YTD Date Type Number Balance Balance* Opened Date Rate Interest Interest Paid Closed CERTIFICATE OF DEPOSIT 247412061061483 $25,241.64 2/22/2000 $45.24 $429.25 7/22/2003 LEGAL TITLE: CHARLOTTE W BUYER CLOSING BALANCE: $25313.11 * Due to system limitations, we can only provide a twelve month average balance on depository accounts. No Safe Deposit Box found for customer. * Date of death balance does not include accrued interest. * If date of death occurrs on a weekend or a holiday, date of death balance does not include any transactions that were eriod. Servicenter Associate Phone: (540)563-7323 chc; tb 0000 000614 LOOK FOR US. Wi?LL GET YOU THfiRIE. 7/28/2003 STONE LAFAVER & SHEKLETSKI 414 BRIDGE ST PO BOX E NEW CUMBERLAND PA 17070 The information which you requested on the account(s) of CHARLOTTE W BUYER (Social Security Number 174205823 ) is/are as follows: Account Number 7800012874 Class of Account CERTIFICATE Date Opened 071599 Principal Balance 59314.65 Accrued Interest 66.54 Balance at Date of 59381.19 Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership 071599 Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name o£Joint Owner, if any Date Ownership Was Established Additional Si~oe~ely,f?/, Information SENIOR SERVICES REP. P.O. Box 171 I, HARRISBURG. PENNSYLVANIA 17105-1711 Toll Fr~ 1-866-WAYPOINT (I-866-929-7646) · IN YORK AREA 717/815-4500 · www. wagpointbank.com PNCADwsoRs November 13, 2003 David H. Stone, Esquire Stone, LaFaver, and Shekletski 414 Bridge Street Post Office Box E New Cumberland, PA 17070 RE: Charlotte Buyer Trust Under Agreement 16-27-027-3104978 Dear Mr. Stone: Enclosed please find a copy of the Date of Death Values for the above-referenced account. I apologize for the delay. Once I receive the letter from the other co-executrix directing the sale of the assets, as well as the short certificate, I will liquidate the account and forward the proceeds to you. If you should have any questions I may be reached directly at 1-800-762-3439, ext. 8-2147. Sincerely,~' Meg~tn R. Ross Trust Administrator PNC Advisors A member of lhe PNC Financial Services Group [wo PNCPlaza 620 LibertyAven,)c Pit!sburgl~ ?ennsylvania !52'22 PHC~DVI SORS Yssues so,ted, by security. P0~O ~0~ ~UA~O~ ~: ~hu~s~y, ~y ~0 2003 IT~ ~SIP NO/ S~S/ DESk,ION P~ HIGH/~K ~/B~ ~ S~T~ ACC~ C~S TIeR P~ ~ DA~ P~CE P~CE P~CE ~ D~/I~ 1) 091928~64 5,838.2380 ~K ~S 07/10 10.7600 10.76000 62,819.44 2) 091928~64 986.1930 ~K ~) 091928622 17,837.2480 PA T~ INS 4) 99~099100 916.7500 ~ ~y ~T 07/10 1.0000 1.00000 916.7S User/~n P~IP~ D~ $0.0002 ~ 07/10/2003 ~C 07/10/200S PAY 07/31/200S 0.18 5) 999099104 47,303.9400 ~K ~Y ~T 07/10 1.0000 1.00000 47,303.94 User/~n IN~ D~ $0.0002 ~ 07/10/2003 ~C 07/10/2003 P~ 07/31/2003 9.46 ............................ Gr~d ~ls 318,7~. 16 9.64 To~l Principal plus ~c~ed interest and ~vi~n~ ~18,762.80 This report was prepared using APPRAISE.ASP Vet. 1.0.2 software, an EVALUATION SER~/CES, INC. product. visit our w~b site at ~W.APPRAXSENJ.COM. security Tl~e Percentage Security ~ Percentage Value of Value Div/Int of Dlv/Int Total Grand Total Total Grand Total Mutual Fund (s) 318,753.16 100. 000% 9.64 100. 000% GRAND TOT/~LS 318,7S3.16 100 . 000% 9 . 64 100. 000% Inventory'of the real and personal estate of Charlotte W. Buyer deceased Estate o£ Charlotte W. Buyer Estate Inventory Valued as of Date of Death Face Value Cash & Cash Equivalents Citizens Bank-Cert of Dep. %6240958684 $ 52,095.25 Interest at Date of Death 141.31 Citizens Bank-Cert. of Deposit #6240959672 49,764.46 Interest at Date of Death 5.45 Citizens Bank-Checking Acct. %6200241604, Princ. $22, 644.10, Int. $14.67 22,644.10 Interest at Date of Death 14.27 PNC Bank-Cert. of Deposit %31200225959 28,538.41 Interest at Date of Death 53.25 PNC Bank-Cert. of Deposit ~ 31600151614, 61,382.14 ,. ~nterest at Date of Death 49.78 C~NC Ban~'-Checking Acct. JL5070101782 23,262.17 ~_I~terest., ~ at Date of Death 3.44 ' ' ~chovia%Bank-Cert. of Deposit ~ ~-nter~j~at Date of Death 45.24 Waypoint Bank-Cert. of Deposit %7800012874 59,314.65 Interest at Date of Death 66.54 Total Cash & Cash Equivalents $ 322,622. Tangible Personal Prope~y Personal property appraised by Charles R. Stull $ 1,200.00 Total Tangible Personal Prope~y 1,200, )0 Estate Inventory Miscellaneous Messiah Village-Refund on apartment $ 21,250.00 Total Miscellaneous $ 21,250.00 No. of Units Mutual Funds PNC Advisors-Charlotte Buyer Trust Under Agreement 16-27-027-3104978 $ 318,753.16 Dividend at Date of Death 9.64 Total Mutual Funds 318,762.80 Total Inventory $ 663,834.90 RESERYAT[OH: Estates of decedents dying on or be~ore December lZ, 198Z -- if any future interest in the estate is transferred in possession or an~oyeant to Class B [collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Coeeoneealth hereby expressly reserves the right to appraise and assess transfer inheritance Taxes at the 1aclu1 Class B (collateral) rate on any such futura interest. PURPOSE OF NOT[CE: To fulfill the requireeants of Section 21~0 of the inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section 91q0). PAYNENT: Detach the top portion of this Notice and subeit Nith your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGZS?ER OF #XLLS, AGENT REFUND (CR): A refund of a tax credit, which ams not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance end Estate Tax" (REV-1313). Applications are available at the Office of the Register of Nills, any of the Z5 Revenue Bistrict Dffices, or by calling the special Z~-hour ansaering service for forms ordering: 1-800-36Z-ZO50~ services for taxpayers #ith special hearing end / or speaking needs: 1-BOO-~47-30ZO (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disalloNence of deductions, or assessment of tax (including discount or interest) es shoHn on this Notice must object ~ithin sixty (60) days of receipt of this Notice by: --aritten protest to the PA Dapar~nent of Revenue, Board of Appeals, Dept. Z&IOZI, Harrisburg, PA l?lZB-lOZ1, OR --election to have the setter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADNIN- ISTRATIVE CDRRECT[ONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of individual Taxes, ATTN: Post Assessment Ravia# Unit, Dept. ES0601, Harrisburg, PA 171Z&-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for inheritance Tax Return for e Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (5Z) discount of the tax paid is allo~ed. PENALTY: 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, tho first day after the end of tho tax aenesty period. This non-participation penalty is appealable in the saea manner and in the the same time period as you ~ould appeal the tax and interest that has been assessed es indicated on this notice. iNTEREST: interest is charged beginning Nith first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .00016~. A11 taxes #hich became delinquent on and after January l, 198Z ~ill bear interest at a rate ~hich will vary from calendar year to calendar year eith that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are= ~ntarast Daily interest Daily interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198Z ZOZ .0005R8 v~l~rB-1991 1ix .000501 ~ 9x .000z47 1985 16z .000~$8 199z 9z .000z47 zooz 6z .000164 198~ 11z .000301 1993-199~ 7z .000192 2005 sz .00013? 1985 15z .000356 1995-1998 9z .oooz47 zoo4 ~z .000110 1986 IOZ .00027~ 1999 ?Z .000192 1987 IOZ .00027~ ZOO0 7Z .000192 --Interest is calculated as folloes: ZNTEREST = BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELXNQUENT X DA/L¥ ZNTERE~T FACTOR --Any Notice issued mfter the tax bacoees delinquent will reflect an interest calculation to fifteen ~15} days beyond the date of the assessment. If payeant is cede after the interest coeputation date shown on the Notice, additional interest aust be calculated. CONHONHEALTH OF PENNSYLVANIA ~ ~ m BUREAU OF ZNDZV/DUAL TAXES DEPARTHENT OF REVENUE INHERITANCE TAX DZVZS/ON DEPT. 280601 NOTICE OF XNHERZTANCE TAX HARRISBURG, PA 17128-060! APPRAZSENENT, ALLO#ANCE OR DZSALLOHANCE ~F DEDUCTIONS AND ASSESSHENT OF TAX RE¥-I647EXAFP(01-§5) DATE 05-17-2004 ESTATE OF BUYER CHARLOTTE S '~ :~!.,.. ~ ,:: DATE OF DEATH 07-10-2005 ~"~ ~ ' ~ .... FILE NUHBER 21 03-0573 COUNTY CUHBERLAND DAVID STONE ACN 101 414 BRIDGE ST J Amount Remitted NEg CUHBERLAND PA 17070 I HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS L/NE I~~ RETAIN LO#ER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF BUYER CHARLOTTE S FILE NO. 21 03-0573 ACN 101 DATE 05-17-2004 TAX RETURN #AS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Estate (Schedule A) (1) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, $. Closely Held Stock/Partnership Interest (Schedule C) ($) .00 submit the upper portion q. Nortgages/Notes Receivable (Schedule D) (q) .00 of this form ~ith your 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (5) $45;070.00 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) ~18z765.00 8. Total Assets (S) 665,8~$.00 APPROVED DEDUCTIONS AND EXEHPTZONS: 5~,18~.00 9. Funeral Expenses/Adc. Costs/Nisc. Expenses (Schedule H) (9) 10. Debts/Hortgage Liabilities/Liens (Schedule Z) (10) 4;0~9.00 11. Total Deductions (11) ~7.222.00 12. Net Velue of Tax Return (12) 606,611.00 15. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) 6,000.00 lq. Net Value of Estate Subject to Tax (lq) 600,611.00 NOTE: If an assessment gas issued previously, 11nes 1~, 15 and/or 16, 17, 18 and 19 ~ill reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: O0 x O0 .00 15. Amount of Line lq at Spouse1 rate (15) ' = 16. Amount of Line lq taxable at Lineal/Class A rats (16) .00 X 045 = .00 17. Amount of Line lq at Sibling rats (17) .00 X 12 = .00 18. Amount of Line lq taxable st Collateral/Class B rats (18) 600,611.00 X 15 = 90,092.00 (19)= 90,092.00 19. Principal Tax Due rAX CREDITS: PAYMENT RECEZP1 DZSCOUNT (+} ANOUNT PAZD DATE NUNBER INTEREST/PEN PAID (-) 10-09-200~ CD005108 4,475.68 85,000.00 05-~1-2004 CD005744 .00 618.00 TOTAL TAX CREDIT I 90,091.68 BALANCE OF TAX DUEI .$2 INTEREST AND PEN. / .00 TOTAL DUE / .32 ZF PAID AFTER DATE INDICATED, SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT TS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) STATUS REPORT UNDER RULE 6.12 Name of Decedent: Charlotte W. Buyer Date of Death: July 10, 2003 Will No. 21-03-0573 To the Register: 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: (a) Did the personal representative file a final account with the Court? Yes No X {b) The separate Orphans' Court No. (if any) for the personal representative's account is: N/A (c) Did the personal representative state an account informally to the parties in interest? Yes X No (d) Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court ~ be~ttached to this report. D~ ton~, Esquire 414 Brid¢'e Street New Cumberland, PA 17070 717-774-7435 CaPacity: Personal Representative t~: ?~ 0Z ~ )0. X Counsel for Personal Representative ~ :1 -esl' ~ e! ,BNYERHARiLYN !i ~; iN RE: ESTATE OF CHARLOTTE W. : IN THE COURT OF COMMON PLEAS OF BUYER, LATE OF THE TOWNSHIP: CUHBERLAND, PENNSYLVANIA ' OF UPPER ALLEN, CUMBERLAND : ORPHANS COURT DIVISION COUNTY, PENNSYLVANIA : NO. 21-03-0573 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, MARILYN B. BEARDSLEE, being one of the beneficiaries under the will of CHARLOTTE W. BUYER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of CHARLOTTE W. BUYER, in full satisfaction and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, MARILYN B. BEARDSLEE, do by these presents, remise, release, quitclaim and forever discharge the Co-Executrices, their heirs, successors and assigns, from the acts of the Co-Execu- trices as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Co-Executrices. IN WITNESS WHEREOF, I have hereunto set my hand and seal the |~ day of ~/-~t~.(~EAC'o'~ , 2004. MARILYN B. BEARDSLEE COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF : On this, the ~ day of ~'-~~. , 2004, before me a Netary Public, the undersigned officer, personally appeared MARILYN B. BEARDSLEE, known to me (er satisfacterily preven) to be the persen whose name is subscribed to the within instrument and acknewl- edged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunte set my hand and seal the day and year first abeve written. ~ Notary bu~lic COMMONWEALTH OF PENNSYLVANIA Nota~al Seal I Lisa M. Ferree, Notary Public Wrightsville Bom, York County My Commission F_x~res Sept. 4, 2007 Member, Pennsylvania Association Of Notaries I! . est \rel \BUYERLOIS IN RE: ESTATE OF CHARLOTTE W. : IN THE COURT OF COMMON PLEAS OF BUYER, LATE OF THE TOWNSHIP: CUMBERLAND, PENNSYLVANIA OF UPPER ALLEN, CUMBERLAND : ORPHANS COURT DIVISION COUNTY, PENNSYLVANIA : NO. 21-03-0573 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, LOIS M. KICHMAN, being one of the beneficiaries under the will of CHARLOTTE W. BUYER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of CHARLOTTE W. BUYER, in full satisfac- tion and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, LOIS M. KICHMAN, do by these presents, remise, release, quitclaim and forever discharge the Co-Executrices, their heirs, successors and assigns, from the acts of the Co-Executrices as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Co-Executrices. IN WITNESS WHEREOF, I have hereunto set my hand and seal the~!-~ day of ~~ , 2004. Witness LOIS M. KICHMAN COMMONWEALTH OF PENNSYLVANIA: : SS: COUNTY OF CUMBERLAND : On this, the ~ day of ~j&~_l~p~ , 2004, before me a Notary Public, the undersigned officer, personally appeared LOIS M. KICHMAN, known to me (or satisfactorily proven to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. Notary COMMONWEALTH OF PENNSYLVANIA J TINA M. BURKI~Y, Notary Public J J New Cumberland Boro, Cumberland Co. J j My Commission Expires April 15, 2005 J · estkrelIBUYERLEONA IN RE: ESTATE OF CHARLOTTE W. : IN THE COURT OF COMMON PLEAS OF BUYER, LATE OF THE TOWNSHIP: CUMBERLAND, PENNSYLVANIA OF UPPER ALLEN, CUMBERLAND : ORPHANS COURT DIVISION COUNTY, PENNSYLVANIA : NO. 21-03-0573 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, LEONA M. FOSTER, being one of the beneficiaries under the will of CHARLOTTE W. BUYER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of CHARLOTTE W. BUYER, in full satisfac- tion and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, LEONA M. FOSTER, do by these presents, remise, release, quitclaim and forever discharge the Co-Executrices, their heirs, successors and assigns, from the acts of the Co-Executrices as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Co-Executrices. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day of ~,2...~JE , 2004. Witness LEONA M. FOSTER COMMONWEALTH OF PENNSYLVANIA: : ss: COUNTY OFW /~ : On this, the ~/~ day of ~:J~2~~ -- , 2004, before d me a Notary Public, the undersigned officer, personally appeared LEONA M. FOSTER, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREO~, I have hereunto set my hand and seal the day and year first above written. Notary Public .COMMONWEALTH OF PENNSYLVANIA Bonnie L. Denlin~r, ~ ~ ~ B~, Po~r Coun~ ~ Commission E~r~ J~y 28, 2007 ~m~c P~vania Assoda~ ~ No~s 2 - esEkrel\BUYERJEAN IN RE: ESTATE OF CHARLOTTE W. : IN THE COURT OF COMMON PLEAS OF BUYER, LATE OF THE TOWNSHIP: CUMBERLAND, PENNSYLVANIA OF UPPER ALLEN, CUMBERLAND : ORPHANS COURT DIVISION COUNTY, PENNSYLVANIA : NO. 21-03-0573 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, JEAN L. McBRIDE, being one of the beneficiaries under the will of CHARLOTTE W. BUYER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of CHARLOTTE W. BUYER, in full satisfac- tion and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, JEAN L. McBRIDE, do by these presents, remise, release, quitclaim and forever discharge the Co-Executrices, their heirs, successors and assigns, from the acts of the Co-Executrices as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Co-Executrices. IN WITNESS WHEREOF, I have hereunto set my hand and seal the [~ day of ~_~_~+ , 2004. COMMONWEALTH OF PENNSYLVANIA: : SS: COUNTY OFn/,_ ~~L'~ : On this, the ~ day of ~~f~ , 2004, before me a Notary Public, the undersigned officer, personally appeared JEAN L. McBRIDE, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. ~ota~ Public ' 0~ pOMMONW~m ~ ~YLVANIA J :1 ' est\rel~BUYERLINDA IN RE: ESTATE OF CHARLOTTE W. : IN THE COURT OF COMMON PLEAS OF BUYER, LATE OF THE TOWNSHIP: CUMBERLAND, PENNSYLVANIA OF UPPER ALLEN, CUMBERLAND : ORPHANS COURT DIVISION COUNTY, PENNSYLVANIA : NO. 21-03-0573 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, LINDA K. HOOVER, being one of the beneficiaries under the will of CHARLOTTE W. BUYER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of CHARLOTTE W. BUYER, in full satisfac- tion and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, LINDA K. HOOVER, do by these presents, remise, release, quitclaim and forever discharge the Co-Executrices, their heirs, successors and assigns, from the acts of the Co-Executrices as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Co-Executrices. IN WITNESS WHEREOF, I have hereunto set my hand and seal the ~4itness LINDA K. HOOVER STATE OF CALIFORNIA : : SS: COUNTY OF~C~ ~C~ ~0',~ O~ : On this, the iT day of ~%(~.11..~ , 2004, before me a Notary Public, the undersigned officer, personally appeared LINDA K. HOOVER, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged zhat she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. ,.- -- - -- ~ ~-- ~ ~ Notary Public 2 'esEkrel\buyerrobert IN THE MATTER OF THE ESTATE OF : IN THE COURT OF COMMON PLEAS OF CHARLOTTE W. BUYER, LATE OF : CUMBE~ COUNTY, PENNSYLVANIA UPPER ALLEN TOWNSHIP, CUMBERLAND : COUNTY, PENNSYLVANIA : ORPHAN'S COURT DIVISION : NO. 21-03-0573 RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS that the undersigned does hereby acknowledge receipt from LOIS M. KICHMAN AND LEONA M. FOSTER, Co- Executrices of the above named estate, the following: The sum of Five Thousand and no/100---($5,000.00) Dollars. IN CONSIDERATION of said payment and transfer, the undersigned does hereby release, remise, quitclaim and forever discharge the said Co-Executrices of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever relating to the Estate. IN WIT.NESS WHEREOF, the undersigned has caused this instrument to be executed on the /~-~ day of ~_~t~ $ , 2004. W~'tn~~s /~Z~-- ~~L~, ~ Robert L. Buyer · est',rel\buyerzion IN THE MATTER OF THE ESTATE OF : IN THE COURT OF COMMON PLEAS OF CHARLOTTE W. BUYER, LATE OF : CUMBE~ COUNTY, PENNSYLVANIA UPPER ALLEN TOWNSHIP, CUMBERLAND : COUNTY, PENNSYLVANIA : ORPHAN ' S COURT DIVISION : NO. 21-03-0573 RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS that the undersigned does hereby acknowledge receipt from LOIS M. KICHMAN AND LEONA M. FOSTER, Co- Executrices of the above named estate, the following: The sum of One Thousand and no/100---($1,000.00) Dollars. IN CONSIDERATION of said payment and transfer, the undersigned does hereby release, remise, quitclaim and forever discharge the said Co-Executrices of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever relating to the Estate. IN WITNESS WHEREOF, the underszgned has caused this instrument to be executed on the /~~d-~ day of ~'~a~,.~L , 2004. Zion Lutheran Church By ~~ ~ /~~ Witness '-~st'~rel\buyermessiah IN THE MATTER OF THE ESTATE OF : IN THE COURT OF COMMON PLEAS OF CHARLOTTE W. BUYER, LATE OF : CUMBERLAND COUNTY, PENNSYLVANIA UPPER ALLEN TOWNSHIP, CUMBERLAND : COUNTY, PENNSYLVANIA : ORPHAN ' S COURT DIVISION : NO. 21-03-0573 RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS that the undersigned does hereby acknowledge receipt from LOIS M. KICHMAN AND LEONA M. FOSTER, Co- Executrices of the above named estate, the following: The sum of Five Thousand and no/100---($5,000.00) Dollars. IN CONSIDERATION of said payment and transfer, the undersigned does hereby release, remise, quitclaim and forever discharge the said Co-Executrices of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever relating to the Estate. IN WITNESS WHEREOF, the undersigned has caused Ehi$ inst~'ument to be executed on the ~ daYM~sia~ h V~~il~o A nt Fu~ 2004. Witness