Loading...
HomeMy WebLinkAbout02-0078PETITION FOR PROBATE & GRANT OF LETTERS Estate of HELEN V. GROUP No. 21-02-78 also known as , deceased. Social Security No. 199-07-2017 To: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The Petition of the undersigned respectfully represents that: Your Petitioners, who are 18 years of age or older and the Co-Executrices named in the Last Will of the above decedent dated September 9 ,1997, and codicils dated none ,19 The Executor named none died Renunciations for ~ none attached hereto. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 107 W. Butler Street, Mt. Holly Springs Borou,qh Decedent, then 86 years of age, died Carlisle Reqional Medical Center December 25 ,2001, at Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the Will offered for probate; was not the victim of a killing and was never adjudicated incompetent: 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 PA (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania, situated as follows: 107 W. Butler Street, Mt. Holly Springs Borough, 17065 $30,000.00 $ $70,000.00 yce4_~re(s) and Residence(s) of Petitioner(s): · Lebo ' 442 N. Colleqe St. Carlisle, PA 17013 717-249-6481 WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented herewith and the grant of letters testamentary thereon. Iler 35 E. Gate Dr. #208 Carlisle, PA 17013 717-258-5439 Doris I. Group 127C W. Ridqe St. Carlisle, PA 17013 717-249-2461 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA · COUNTY OF CUMBERLAND . SS The Petitioner(s) above named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that as personal representative of the above decedent, petitioner(s) will well and truly admin~r the estate according to law. Sworn tooraffirmedandsubscribed (. I.,._x~qc'ce- ~ before me this 17th __day of .~ . ~y,c~e F. Lebo January, 2002. ,/~L~,//t~ ( '~.~. ~.e~.,~, ~t'~,,, .,.t/~'. ,~,~,.~z~/z,/,/(27 .; ~,:z',~' ' ,i~ebv'~rly Jane Keller ' /'~ ~ ~ t~egister"--7 --~ Doris I. Group No. 21-02- Estate of HELEN V. GROUP, deceased. DECREE OF PROBATE & GRANT OF LETTERS AND NOW, January 23 , 2002, in consideration of the Petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated September 9, 1997 described therein be admitted to probate and filed of record as the Last Will of Helen V. Group ; and Letters Testamentary are hereby granted to Joyce F. Lebo, Beverly Jane Keller and Doris I. Group FEES Probate, Letters, Etc ........ $ 200.00 Short Certificates(-3- ) .... $ 9.00 Renunciation(s) ........... $. JCP .................... $ 5.00 Other Will Pac~es (-2-) .... $ 6.00 TOTAL: .... $ 220.00 Filed ...... .3'.A_~.....2.3.,..20.0.2 ........ Ja e . Hu hes Es uire. 58884 .~RNEY (Sup. Ct. I.D. No.) 60 West Pomfret St., Carlisle, PA 17013 ADDRESS 717-249-2353 PHONE PETITION FOR PROBATE and GRANT OF LETTERS Estate of HELEN V GROUP also known as Social Security No. · Deceased. No. 21-02-78 To: Register of Wills for the County of CUMBERLAND Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut in the last will of the above decedent, dated and codicil(s) dated in the named ,19 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in County, Pennsylvania, with last family or principal residence at at (list street, number and muncipality) Decendent, then years of age, died , 19. ., Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent 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 $_ situated as follows: WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters. theron. request(s) the probate of the last will and codicil(s) (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF f ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that a.s?ersonal represen- tative(s) of the above decedent petitioner(s)will well an/d/[~v administer. ~tl3e esta~, according to law. bS~f{~;~ mte° th~ a~f~rr~ed and subs~ribed~ rZ ~X'/ff-'~'~°~ ~P' .X~~',. _% . ay ot I' / ~. JANUgR% 1~ 2002 I ' ~ his 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 P 7913304 No. 21-02-78 Local Registrar DEC 2 6 2001 Date HELEN V. GROUP C~UMBERLAND COMMONWEALTH OF PENNSYLVANIA ° OEPARTMENT OF HEALTH ° VITAL RECORDS CERTIFICATE OF DEATH garr&sburg, PA "0 SPIT,~.: CA~LZSLE ,CA~LZSLE ~EGZO~AL ~EPZCAL CENTE~ J;.' .... ~ ..... ' * · ,o. ~HZTE w~do~d 107 W~St But~r St. Ac~ ,?..~.. Po..xt~,m.~ ,,,.0~.~ Mt. Hoary Springs, PA 17065 ,,.~ L. ~oqq~e ~Bcvcr~y J~n~ Kc~r J~ 513 So~t~ West S~. Car~Zsf~. PA 1701~ ~O ~ ..... O ~s,.,.O O[,,~.12/28/2001 J,~s~inst~r M~morra~ Ga~dn~, Car~rs~c, PA 17013 i 21-02-78 LAST WILL AND TESTAMENT I, HELEN V. GROUP, of the Borough of Mount Holly Springs, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my executrices to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I authorize and empower my executrices to sell any realty owned by me at my death and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I give, devise and bequeath all of my estate of every nature and wherever situate in four shares as follows: (a) 1/4th to Joyce F. Lebo, (b) 1/4th to Beverly Jane Keller, (c) 1/4th to Doris I. Group, and (d) 1/4th to the children of Conrad R. Group, share and share alike. 4. I nominate and appoint Joyce F. Lebo, Beverly Jane Keller and Doris I. Group, to be the executrices of this my Last Will and Testament; they are to serve as such without bond. 5. I hereby suggest that my personal representative retain the services of Irwin, McKnight & Hughes, as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 9TH day of September, 1997. HELEN V. GROUP (SEAL) Signed, sealed, published and declared by HELEN V. GROUP, the testatrix above named, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. ACKNOWLEDGMENT AND AFFIDAVIT WE, HELEN V. GROUP, CHERYL L. CLELAND and MARTHA L. NOEL, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will, and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. .~ HELEN V. GROUP _ CER~L L.~cL~L,~r~i~ 'k,, MARTI~IA L. NOeL COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : Subscribed, sworn to and acknowledged before me by HELEN V. GROUP, the testatrix herein and subscribed and swom to before me by CHERYL L. CLELAND and MARTHA L. NOEL, witnesses, this 9TH day of September, 1997. ary Public '""-I~arial Seal Roger B. Irwin, Notary Public Carlisle Bore Cumberland County My Commission Expires, Oct. 3, 2000 ~embe~ Pennsylvania Association of Notaries o~cc CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Estate No.: HELEN V. GROUP December 25, 2001 21-02-0078 To the Register: I certify that notice of the beneficial interest 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 February 6, 2002 . Name Address Joyce F. Lebo Beverly Jane Keller 442 N. College Street, Carlisle, PA 17013 35 East Gate Drive #208, Carlisle, PA 17013 Doris I. Group Brad L. Group Craig L. Group Mindy Jo Group 127C West Ridge Street, Carlilse, PA 17013 P.O. Box 451, Boiling Springs, PA 17007 935 North 2nd Street, Harrisburg, PA 17102 3900 City Avenue, Apt. D530, Philadelphia, PA 19131 Notice has now been given to all persons entitled thereto Date: 02/06/02 except__ :RW~?I~cKNIGHT & HU~e James D. Hughes, ~Yq~ire Address 60 West Pomfret Street none. Carlisle~ PA 17013 Telephone (717) 249-2353 Capacity: X Personal Representative Counsel for Personal Representative REV- 1500 EX + (6-00) D E C E D E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. Z80601 HARRISBURG, PA 171Z8-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT cAPB CR AC KO TK ES T A X DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Croup Helen V. DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 12/25/2001 08/18/1915 (IF APPL CABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)  1. Original Return ~ 247! Supplemental Return 4. Limited Estate · Future lnterest Compromise (date of death after 1Z-12-8Z) 6. Decedent Died Testate Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) ~ 9. Litigation Proceeds Received r-~ 10. Spousal Poverty Credit (date of death between 1;'-31-91 and 1 - 1-95) NAME James D. Hughes Esq. FIRM NAME (If Applicable) IRWIN McKNIGHT & HUGHES TELEPHONE NUMBER 717/249-2353 OFFICIAL USE ONLY /7' FILE NUMBER 21-02-078 COUNTYCODE YEAR NUMBER SOCIAL SECURITY NUMBER 199-07-2017 THIS RETURN MUST BE FILED IN DUPLICATE ~ITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER  (date of death 3. Remainder Return prior to 12-13-82) 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes Election to tax under Sec. 9113(A) (Attach Sch O) R E C A P I T U L A T I 'O N C O M T I 0 COMPLETEMAILINGADDRESS 60 West Pomfret Street West Pomfret Professional Bldg. Carlisle, PA 17013 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or (3) Sole -Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) ~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deducti~)ns (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. 82,00~(~,~0 NOne 184,046;42 None 13,354.44 27,334.92 417.20 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) C~ OFFIC,h~.~ HEONLY (8) 279,400.86 (11) 27,752.12 (12) 251,648.74 (13~ 14. SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) X .0 0 16. Amount of Line 14 taxable at linealrate 251,648.74 X .0 45 17, Amount of Line 14 taxable at sibling rate X .12 18, Amount of Line 14 taxable at collateral rate X .15 19. Tax Due (14) 251,648.74 (15) 0.00 (16) 11,324.19 (17) 0.00 (18) O. O0 (19) 11,324.19 Copyright (c) ;~000 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00/ Decedent's Complete Address: STREET ADDRESS 107 W. Butler Street CITY STATE I ZIP Mount Holly Springs PA I 17065 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) :~. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount :3. Interest/Pena~if applicable D. Interest E. Penalty 0.00 566.21 (1) Total Credits ( A + B + C ) (2) 11,324.19 Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 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 1. Did decedent make a transfer and: Yes No a. retaintheuseorincomeofthepropertytransferred; ......................... ~ ~ b. retain the right to designate who shall use the property transferred or its income; ........... c. retain a reversionary interest; or .................................... d. receive the promise for life of either payments, benefits or care? ................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................ ~ ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............................................. r-'-] ~ 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. 566.21 0.00 0.00 10,757.98 0.00 10,757.98 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 PER.~ON RESPONSIBLE FOR FILJNG RETURN Joyce F. Lebo DATE // . ~' ~~ 442 N. Colleg~e St. ' ........................... SIGNATOREO~~HERT~ANREPRESENTATIVE IRW[N McKNIC~ & ~GHES DATE' ~ .....................................................  :::~ Carlisle, PA 17013 // FO/dates o~ death ~or after July 1, 1994 and before Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the s~i~i~~ ~ 9U6 (~)~.~)(i)]. Fo date ~eath on or after Janua~ 1 1995 the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% ~r J~ua~ 1, 1995, the tax ra [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. 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 The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) ADDITIONAL Personal Representatives Estate of Helen V. Group SS# 199-07-2017 12/25/2001 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. Signature ~~~ Beverly Jane Keller 35 E. Gate Dr. #208 N~2ne Address Line 1 Address Line 2 City, State, Zip Date Signature Name Address Line 1 Address Line 2 City, State, Zip Date Carlisle, PA 17013 / / Doris I. Group 127C W. Ridge St. Carlisle, PA v/ / 17013 REV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen V. Group SS# 199-07-2017 SCHEDULE A REAL ESTATE FILE NUMBER 12/25/2001 21- 02- 078 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 107 W. Butler Street, Mt. Holly Springs, Cumb. Co. settlement 82,000.00 sheet attached TOTAL (Also enter on line 1, Recapitulation) ;$ 82,000.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-150:~ EX (Rev. 1-97) REV- 1508 EX + (1-97) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Helen V. Croup SS# 199-07-2017 12/25/2001 21~02-078 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 2 '3 4 5 6 7 8 9 Cash on hand Allfirst Bank, Allfirst Bank, Allfirst Bank, Waypoint Bank, Waypoint Bank, relationship with interest #00389-0498-5 certificate of deposit #87008140941395 certificate of deposit #87008140941387 checking certificate Personal property kept (including 1992 Buick) Personal property sold U.S. Savings Bonds (list attached) TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additionaJ sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. 187.00 8,503.71 17,415.41 52,387.18 17,951.47 72 733.29 5,200.00 1,096.00 8,572.36 $ 184,046.42 Form REV-1508 EX (Rev. 1-97) REV-1510 EX+ (t-97) SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERT~ RESIDENT DECEDENT ESTATE OF Helen V. Croup SS~/ 199-07-2017 12/25/2001 FILE NUMBER 21-02-078 This schedule must be completed and filed if the answer to any of questions 1 through 4 on pa~. e 2 is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DECEDENT AND TH E DATE OF TRANSFER. NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 1 Prudential Investments, 13,354.44 13,354.44 annuity contract 4/96 097 174 TOTAL (Also enter on line 7, Recapitulation) $ 13,354.44 (If more space is needed, insert additional sheets of the same raze) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1510 EX (Rev. 1-97) REV- 1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA {NHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen V. Group SS¢) 199-07-2017 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 12/25/2001 21- 02 - 078 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. 1 2 3 4 5 6 FUNERAL EXPENSES: Hollinger Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Atlomey's Fees IRWIN McKNIGHT & HUGHES Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees Register of Wills Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Cumberland Law Journal - DeHart's Auction - commission State Zip estate notice publication DeHart's Auction - appraisal fee Register of Wills - filing fee Register of Wills - additional probate fee Settlement charges on sale of real estate 5,816.00 12,000.00 220.00 75.00 383.60 75.00 25.00 70.00 8,573.25 Total of Continuation Schedule(s) 97.07 TOTAL (Also enter on line 9, Recapitulation) 27,334.92 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) Estate of: Helen V. Group Soc Sec #: 199-07-2017 Date of Death: 12/25/2001 Item Description Continuation of Schedule H-B7 (Other Administrative Costs) Amount 7 The Sentinel ~ Legal - estate notice publication 97.07 97.07 REV- 1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen V. Croup SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS FILE NUMBER SS# 199-07-2017 12/25/2001 21-02-078 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT Aero Oil Company Borough of Check #104 GPU Energy Sprint Telephone Mt. Holly Springs water/sewer written 12/12/01; cleared 01/04/02 157.82 83.12 100.00 49.84 26.42 TOTAL (Also enter on line 10, Recapitulation) $ 417.20 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software on{y CPSystems, Inc, Form REV-1512 EX (Rev. 1-97) REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen V. Group SS# 199-07-2017 NUMBER SCHEDULE J BENEFICIARIES 4 II. 12/25/2001 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.Z)] Brad L. Group P.O. Box 451 Boiling Springs, PA 17007 Craig L. Group 935 North 2nd Street Harrisburg, PA 17102 Doris I. Group 127C West Ridge Street Carlisle, PA 17013 Mindy Jo Group 3900 City Avenue Apt. D530 Philadelphia, PA 19131 Beverly Jane Kelle~ 35 East Gate Drive #208 Carlisle, PA 17013 Joyce F. Lebo 442 North College Street Carlisle, PA 17013 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Grandson Grandson Daughter Granddaughter Daughter Daughter FILE NUMBER 21-02-078 AMOUNT OR SHARE OF ESTATE 1/12 remainder 1/12 remainder 1/4 remainder 1/12 remainder 1/4 remainder 1/4 remainder ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ O. O0 (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) LAST WILL AND TESTAMENT I, HELEN V. GROUP, of the Borough of Mount Holly Springs, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my executrices to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I authorize and empower my executrices to sell any realty owned by me at my death and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I give, devise and bequeath all of my estate of.every nature and wherever situate in four shares as follows: (a) 1/4th to Joyce F. Lebo, (b) 1/4th to Beverly Jane Keller, (c) 1/4th to Doris I. Group, and (d) 1/4th to the children of Conrad R. Group, share and share alike. 4. I nominate and appoint Joyce F. Lebo, Beverly Jane Keller and Doris I. Group, to be the executrices of this my Last Will and Testament; they are to serve as such without bond. 5. I hereby suggest that my personal representative retain the services of Irwin, McKnight & Hughes, as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 9TH day of September, 1997. HELEN V. GROUP (SEAL) Signed, sealed, published and declared by HELEN V. GROUP, the testatrix above named, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. ACKNOWLEDGMENT AND AFFIDAVIT WE, HELEN V. GROUP, CHERYL L. CLELAND and MARTHA L. NOEL, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will, and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. COMNIONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : Subscribed, sworn to and acknowledged before me by HELEN V. GROUP, the testatrix herein and subscribed and sworn to before me by CHERYL L. CLELAND and MARTHA L. NOEL, witnesses, this 9TH day of September, 1997. / No~tary Public ...... fq'btarial Seal Roger B. Irwin. Notary Public Carlisle Boro, Cumberland County My Commission Expires Oct. 3, 2000 Membe~ pennsylvania Association of Notaries A U.5 DEl 'AIII'MEH [ OF I tOUL;INLi and UliBAI i [~LVELOI'MEi'I1 Ulvl[J IJ~, ,:502 02L, 5 SETTLEMENT STATEMENT mLEPRO SECURED LAND ---- ------TRANSFERS, INC. 8. I-YPE OFLOAN 5006 East Trindle Road t, I I FHA 2. I ]FMHA 3. I I CONV, UNINS. Suite 203 4. I I VA 5. I I CONV INS, Mechanicsburg,PA 17055 6. FILE NUMBER: I 7. LOAN NUMBER: 503575I 0018123182 Phone: (717) 591-8500 FAX: (717) 591-8506 8. MORT. INS. CASENO.: C. NOTE: This form is furnished to give you a slatement of actual seltlement costs. AmoLmls paid to and by Ihe settlement agenl are shown. Items marked '(p,o.c,)' were paid oulside the closing; Ihey are shown here for inlormational purposes and are not included in Ihe tolals. D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: E NAME AND ADDRESS OF LENDER: Kreg A. Kimmel Estate of Helen V. Group ERA Mortgage Jennifer D. Kimmel 3000 Leadenball Road Mount Laurel NJ 08054 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: I, SETTLEMENT DATE: 107 West Butler Street Secured Land Transfers, Inc. 02/28/02 Mt. Holly Springs BOROUG5 PLACE OF SE~LEMENT: CUMBERLAND County 101 Old Schoolhouse Ln., Mech. PA 17055 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: too. GROSS AMOUNT DUE FROM BORROWER 40o GROSS AMOUNT DUE TO SELLER IO! Contracl sales price 82000 . O0 4et.Contract sales price 82000 . O0 lO2. Personal property 4o2,Personal property IO3 Selllement charges to borrower (line 1400) '3973 . 2 '7 403 I0,1. ,IO,L 105. 405 Adjuslmenls for items paid by seller in advance Adjustments for items paid by seller in advance 106. Cily/rown tax Io 406.Cily/Town lax to lO7. Coun,y ~ax 02/28/02~o 12/31/02 232.38 4.7. County tax 02/28/02to 12/31/02 232.38 ioa Assessments Io 4o~. Assessmenls to 109 sc~ooZ 02/28/02~o 06/30/02 231.84 40.~..~ohoo~. 02/28/02to 06/30/02 231.84 ,10 S/W/R:$83.12/q tend 03~31 28.24 410. S/W/R:$83.12/q end 03/31 28.24 411. 412, U.S. DEPARTMENT OF HOUSING AHD URBAN DEVELOPMENT OMB No. 2502-0265 SETTLEMENf STATEMENT Page 2' L. SETTLEMENT CHARGES 503575 PAID FROM PAID FROM BORROWER'S SELLER'S 700. TOTAL SALES/BROKER'S COMMISSION based on prices 8~-000. O0 6.0 FUNDS AT FUNDS AT Division of Commission (line 700) as follows'. Tot al: $ 4 ~, 9 2 0 . 0 0 SETTLEMENT SETTLEMENT 702. $ 2485 .00 to Wolfe & Shearer Realtors ................................. "':::::::::::::~ ................. '"*:"" ................. 703. Commission paid at Settlement 4 9 2 0 . 0 0 m4. Trans Fee ERA/NRT, Inc 100.00 800. ITEMS PAYAELE IN CONNECTION WITH LOAN e0t. Loan Origination Fee 1.000 % ERA Mortgage 820.00 8o2. Loan Discount .500 % ERA Mortgage 410.00 803. Appraisal Fee to 804. Credit Report to 805. Lenders Inspection Fee 806. Mortgage Insurance Application Fee to 807. Assumption Fee 808. 809. 810. 900. ITEMS REOUIRED BY LENDER TO BE PAID IN ADVANCE 9ct. lnteresttrom 02/28/02 to02/28/02 es 15 .66/day 15 .66 902. Mortgage Insurance Premium for mo. to 903. Hazard Insurance Premium lot yrs. to 904. yrs, to 905. I000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance mo. @ $ /mo. 1002. Mortgage Insurance mo. @ $ 65 · 60 /mo. lO03. City/Town tax mo. @ $ /mo. 1004. Countytax 2 mo.@$ 15.47 /mo. 30.94 1005. Assessmer, ts mo. @ $ /mo. mos. School Tax 9 mo.@$ 59.53 /mo. 535.?7 1007. mo. @ $ /mo. Ioo8. Aggregate mo. @ $ /,'no. - 7 7 . 3 5 1100. TITLE CHARGES I101. Settlement or closing lee to 1102, Abstract or ~itle search to 1103. Title examination to 1104. Title insurance binder to 1105. Document preparalion to ( I rwinMcKnight &Hughes POC) 1106. Notary tees to Cash 10.00 10 . 00 107. Attorney's fees to 108. Title Insu,ance to Secured Land Transfers ..9.00.75 J 109. Lender's coverage $ 82,000 ~110. Owner's coverages 82, 000 ~tml. Wire Fee Secured Land Transfers 20.00 ll2. Tax Cert Secured Land Transfers 3.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees: Deeds 26 . 00 Mortgages 51 . 50 Misc. $ 77 . 50 1202. City/courtly tax/stamps: Deed $ 8 2 0 . 0 0 Mortgage $ 8 2 0 . 0 0 12o3. State tax/stamps: Deed $ 8 2 0 . 0 0 Mortgage $ 8 2 0 . 0 0 1204. 1205. 300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to 1302. Pest Inspection to Biechler & Tillery 35.00 ,so4.13°3' Home02, CO/TwDInsp Biechler & Tillery ~ t305. -- -- ' Form 712 i,.ev. Ma¢oo0) Life Insurance Statement OMB,o.0022 Department of the Treasury Internal Revenue Service Decedent--Insured (To be filed by the executor with Form 706, United State Estate (and Generation-Skipping Transfer) Tax Return, or Form 706-NA, United States Estate (and Generation-Skipping Transfer) Tax Return, Estate of nonresident not a citizen of the United States.) 1 Decedent's first name and middle initial -r ~ ~ ~' Decedent's social security number (if T 4 Date of death HELEN V ! GROUP ~ known) 199-07-2017 ! 12/25/2001 5 Name and address of insurance company The Prudential Insurance Company of America, 751 Broad Street, Newark, New Jersey 07102-3777 6 Type of policy ANNUITY 7 Policy number 96097174 Owner's name. If decedent is not owner, attach copy of application. 12 Value of the policy atthe time of assignment 9 Date issued 03/14/1996 15 16 17 18 19 20 21 22 23 24 25 26 10 Assignor's name. Attach copy of assignment. 13 Amount of premium (see instructions) 14 Name of beneficiaries JOYCE LEBO; DORIS GROUP BEVERLY KELLER Face amount of policy .............................................. I ndem nity benefits ................................................. Additional insurance ................................................ Other benefits ................................................... Principal of any indebtedness to the company that is deductible in determining net proceeds ............. Interest on indebtedness (line 19) accrued to date of death .............................. Amount of accumulated dividends .......................................... Amount of post-mortem dividends .......................................... Amount of returned premium ............................................ Amount of proceeds if payable in one sum ...................................... Value of proceeds as of date of death (if not payable in one sum) ........................... Policy provisions concerning deferred payments or installments. Note: If other than lump-sum settlement is authorized for a surviving spouse, attach a copy of the insurance policy. 27 Amount of installments 28 Date of birth, sex, and name of any person the duration of whose life may measure the number of payments. Date of birth: Sex: Name: 29 Amount applied by the insurance company as a single premium representing the purchase of installment benefits 30 Basis (mortality table and rate of interest) used by insurer in valuing installment benefits Date assigned 31 Were there any transfers of the policy within the three years prior to the death of the decedent? ............. [] Yes [] No 32 Date of assignment or transfer. 33 Was the insured the annuitant or beneficiary of any annuity contract issued by the company? ............... [] Yes [] No 34 Did the decedent have any incidents of ownership on any policies on his/her life, but not owned by him/her at the date of death? ........................................................ [] Yes [] No 35 Names of companies with which decedent carried other policies and amount of such policies if this information is disclosed by your records. The undersigned officer of the above-named insurance company (or appropriate Federal agency or retirement system official) hereby certifies that this statement sets forth true and correct information. Signature ~ %o'~L.~ Title Secretary Date of Certification 02/08/2002 Document2 Form 712 (Rev. 5-2000) ITEM SERVICE FOR 12 (MISSING A FEW PIECES) ROSE PATTERN 8 PIECE MAPLE DINING ROOM SUITE 4 GOBLETS 2 TABLECLOTHES 12 NAPKINS 1 MAHOGANY DESK AND CHAIR 1 MAHOGANY DRUM TOP TABLE 2 BRASS LAMPS 1 GOOSENECK ROCKER 2 PIECE LIVING ROOM SUITE I 7 PIECE KITCHEN SET TAPPAN WASHER GE DRYER 1 SUMMER CHERRY 5 PIECE BEDROOM SUITE COMPLETE PANASONIC 21 INCH TV 1920'S STEAMER TRUNK 1992 BUICK CENTURY ALL ITEMS WERE APPRAISED AT FAIT TO GOOD CONDITION. VALUE $140.00 $475.00 $7. OO $10.00 $8.OO $110.00 $145.00 $65.00 $35.00 $350.00 $35.00 $175.00 $125.00 $675.00 $85.00 $60.00 $2,700.00 $5,200.00 DeHart's Auction Service 1554 Holly Pike Carlisle, PA 17013 258-5858 Bill to: Doris Group Estate Jim Hughes 60 W. Pomfret St. Carlisle, PA 17013 Attn: Jim Hughes Service: Appraisal of household contents and automobile. Date: 01/09/2002 Fee: $75 03/20/02 11:17 81 302 934 2955 CIS ~001/002 allfirst March 20, 2002 Irwin, McKnight & Hughes Att: James D. Hughes West Pomfret Professional Bldg. 60 West Pomfret Street Carlisle, PA 17013-3222 Allfirst Financial Center N.A. P.O, Box 900 Iv[illsboro, DE 19966 Dear Mr. Hughes: Estate of Helen V. Group Date of Death: Decemlt,~r 95, o-001 Social Security Number: 199-07-2017 In response to your request, please be advised that at ~:he time of death, the above- named decedent had on deposit with this bank the follc,wing accounts. Account Type ........................... Relationship w/Int. C. hecking Account Account Number. ...................... 0038904985 Oumership (Names oj~ ............... Helen V. Group (Rich,:rd removed 5/7/99) Opening Date ........................... 04/28/75 Balance on Date of Death. .......... $ 8,503.65 Accrued Interest. ...................... O.Ofi Total ...................................... $ 8,503.71 Account Type ........................... Certificate ~f Deposit/2 ! Account Number. ...................... 87008140941387 Ownership (Names o~ ...............Helen V. GT ~up Opening Date ........................... 09/18/97 Balance on Date of Death. .......... $ 52,333.6 Accrued Interest. ...................... 53.5' Total ...................................... $ 52,387.11 MOS/4.670C 00 03/20/02 11:17 81 302 934 2955 CIS ~002/002 Page 2 March 20, 2002 Account Type ........................... Certificate of Deposit./13 MOS/5. 100000 Account Number. ...................... 87008140941395 Ownership (Names oj') ............... Helen V. Group Opening Date ........................... 09 / 18 / 97 Balance on Date of Death. .......... $17,395.96 Accrued Interest ....................... 19.45 Total ...................................... $ 17,415.41 This letler does not include any accounts in which the deceased may have been liste~ ,as Power of Attomey, Custodian of Uniform Transfers, Representative Payee, or Trustee under a Written Agreement If you have any further questions on these accounts, ';>lease contact the branch of record: 812 % West High Street, Carlisle, PA 17013, telli.~phone 717- 240-6717. Sincerely, Mary Anne Macielag Associate I/CI8 (302) 934-2240 LOOK FOR US. WE'LL GET YOU THERE. 01/09/2002 IRWIN MCKNIGHT & HUGHES 60 W POMFRET ST CARLISLE PA 17013 The information which you requested on the account(s) of HELEN GROUP DECEASED (Social Security Number 199-07-2017) is/are as follows: Account Number 4100043430 8000036086 Class of Account CHECKING CERTIFICATE Date Opened 12/19/01 09/18/97 Principal Balance 17950.60 72500.18 Accrued Interest .87 233.11 Balance at Date of 17951.47 72733.29 Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established SOLE IRWI% McKNiGHT & HUGH[$ Additional PLEASE COMPLETE W-9 Sincer.~., ) / Information / ~t~,,~.~ ~$ ~/T~O .- N~z~' ~R~,c,P a~ ~EU~ay K~ SENIOR SE~VIC~ ~P. Helen V. Group Estate Accrual Bonds Redemption Date: 12/2001 Issue Serial Number Denom. Series Date Value Interest Ct033950674E $100 E 3/1974 $465.48 $390.48 C203847834E $100 E 3/1978 $348.00 S273.00 C2038478342E $100 E 3/1978 $348.00 $273.00 C1033950675E $100 E 3/1974 $465.48 $390.48 D102710442E $500 E 7/1974 $2,309.00 $1,934.00 D102710441E $500 E 3/1974 $2,327.40 $1,952.40 D102710440E $500 E 7/1974 $2,309.00 $1,934.00 Yield Next Final To Date Accrual Maturity 6.75% 3/2002 3/2004 6.64% 3/2002 3/2008 6.64% 3/2002 3/2008 6.75% 3/2002 3/2004 6.85% 1/2002 7/2004 6.75% 3/2002 3/2004 6.85% 1/2002 7/2004 1 = Not eligible for payment (purchase price) 2 = Matured (exchangeable for HH) * = Possibly eligible for U.S. Savings Bond Education Benefit Program. See footnotes on Inventory Summary page. 3 = Matured (not exchangeable) Redemption Date: 12/2001 Accrual Bonds Pre-January 1990 Issue Dates: January 1990 and Later Issue Dates: Current Income Bonds Inventory Totals Helen V. Group Estate Inventory Summary Number Inventory Redemption of Bonds Value Value Interest 7 $8,572.36 $8,572.36 $7,147.36 0 $0.00 $0.00 $0.00 * 7 $8,572.36 $8,572.36 $7,147.36 0 $0.00 $0.00 $0.00 7 $8,572.36 $8,572.36 $7,147.36 Footnotes * Proceeds from Series EE & I Savings Bonds with issue dates beginning January 1990 may be eligible for special tax exemption when used for post-secondary education. For further information concerning the benefits and restrictions that apply, please contact the Internal Revenue Service. I These bonds are not eligible for payment within 6 months of their issue date. 2 These bonds have reached final maturity and will earn no additional interest. They can be exchanged for HH Bonds within a year of their final maturity date. 3 These bonds have reached final maturity and will earn no additional interest. They are not eligible for exchange for Series HH Bonds since they have been held over a year past their final maturity date. 2 Inventory of the real and personal estate of HELEN V. GROUP deceased 1. 107 West Butler Street, Mt. Holly Springs, Cumberland County, PA ....... 2. Cash on Hand ................................. 3. Allfirst Bank - Relationship with interest #00389-0498-5 ........... 4. Allfirst Bank - Certificate of Deposit #87008140941395 ............ 5. Allfirst Bank - Certificate of Deposit #87008140941387 ............ 6. Waypoint Bank - Checking ........................... 7. Waypoint Bank - Certificate ......................... 8. Personal Property kept (including 1992 Buick) ................ 9. Personal Property sold ............................ 10. U.S. Savings Bonds .............................. TOTAL .................. 82,00C 187 8,503 17,395 52,333 17,951 72,733 5,200 1,096 8,572 265,973 00 00 65 96 61 47 29 00 00 36 34 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Joyce F. Lebo, Beverly Jane Keller and Doris I. Group being duly sworn according fo law, deposes and says that they. are the Executrices of the Estate of Helen V. Group late of the Boroug~__~f_~Mt. Ho_~lly ._S_~r_iqgp_ ., Cumberland County, Pa., deceased and fhaf fha wlfhin is an inventory made by the above-names persons , the said Executrices of the enflre estate of said decedent, conslsflng of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and fhaf the figures opposlfe each item of the Inventory represent it's fair value as of the date of decedenf's death. Sworn and subscribed before me, t ' 02 Member, Pennsylvania Association ot Notaries Date of Death 25 ~yce~ F. Lebb, Executrice 4~4~ N. Col~lege St.,, Carlisle, PA 17013 35 E. a~ Dr. #2 , Carlisle, PA 17013 Doris I. Group 127-12 W. Ridge St., Carlisle, PA 17013 12 ~ 2001 2. 3. 4. Day Month Year INSTRUCTIONS An inventory must be filed wlthJn three months after appointment of personal represenfaflve. A supplement inventory must be filed withln thirty days of discovery of additional asset's. Additional sheets may be attached as to personalty or realty .~. See Article IV, Fiduciaries Ac+ of 1949. , 9'-' 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. CD REV-1162 EX(11-96) 000980 HUGHES JAMES D 60 WEST POMFRET STREET CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 1 99-07-201 7 FILE NUMBER: 2102-0078 DECEDENT NAME: GROUP HELEN V DATE OF PAYMENT: 03/20/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 12/25/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 910,757.98 REMARKS: TOTAL AMOUNT PAID: JAMES D HUGHES ESQUIRE 910,757.98 SEAL CHECK//18354 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS BUREAU TAXES TNHERTTANCE TAX D/V/S/ON DEPT. 280601 HARRISBURG, PA 17118-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTXONS AND ASSESSHENT OF TAX R£V-I{;4? EX &FP C01-D2) ,JAMES D HUGHES 'ESQC3? IRWIN ETAL 60 W POMFRET ~: CARLISLE DATE 05-06-Z002 ESTATE OF GROUP DATE OF DEATH 12-25-2001 FILE NUMBER 21 02-0078 COUNTY CUMBERLAND ACH 101 I Amount Remitted HELEN V MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLTSLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR BZSALLOWANCE OF BEDUCTZONS AND ASSESSMENT OF TAX ESTATE OF GROUP HELEN V FILE NO. 21 02-0078 ACN 101 BATE 05-06-2001 TAX RETURN WAS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATION CONCERNING FUTURE XNTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN I Real Estate (Schedule A) 2 Stocks and Bonds (Schedule B} $ Closely Held Stock/Partnership Interest (Schedule C) Mortgages/Notes ReceAvable (Schedule D) 5 Cash/Bank DeposAts/HAsc. Personal Property (Schedule E) 6 JoAntly Owned Property (Schedule F) 7 Transfers (Schedule G) 8 Total Assets APPROVED DEDUCTZONS ANB EXEMPTZONS: 9 Funeral Expansos/Adm. Costs/MAsc. Expenses (Schedule H) 10 Debts/Hortgago LAabA1AtAas/LAens (Schedule Z) 11 Total Deduct/ohs 12 Nat VaLue of Tax Return (1) 82~000.00 (2) .00 ($) .00 .00 (5) 18~/046.~2 (6) .00 NOTE: To Ansura proper credAt to your account, submAt the upper portion of thAs form with your tax payment. (9) Z7,$$~.9Z (10) ~17 .ZO (11) 27.7~2. ']2 (12) Z51,6~8.7~ NOTE: ASSESSMENT OF TAX: 15. Amount of L/ne 14 at Spousal rate 16. Amount of LAne 14 taxable at Lineal/Class A rate 17. Amount of LAne 14 at Sibling rata 18. Amount of LAne 14 taxable at Collateral/Class B rata 19. PrAncApal Tax Due TAX CREDZTS: PAYMENT RECETpT DTSCOUNT DATE NUHBER INTEREST/PEN pAXD (-) 0:3-20-2002 CD000980 566.21 (1.6) .00 X O0 = .00 (16) 251,6~8.7~ X 045 = 11,:32~.19 (17) .00 x 12 = .00 (18) .00 x 15 = .00 (].9)= 11,:32~.19 AMOUNT PAID CherAteble/Govern.en~al Bequests; Non-elected 911:5 Trusts (Schedule J) (1:5) . O0 Net Valu~ of Estate Sub~ect to Tax (14) Z51,6~8.74 Zf an assessment ~as lssued previously, lines 1~, 15 and/or 16, 17, 18 and 19 reflect figures that include the total of ALL returns assessed to date. 10,757.98 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATZON OF ADDITIONAL INTEREST. TOTAL TAX CREBZT DALANCE OF TAX BUE INTEREST AND PEN. TOTAL BUE 11,:31fi.19 .00 .00 .00 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTZONS.) (7) 1:3/:35R.Rq (8) Z79,~00.86 RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIYE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of tho decedent after the expiration of any estate for 1ifa or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 21qO of the Inheritance and Estate Tax Act, Act 23 of 2000. C7Z P.S. Section 91q0). Detach the top portion of this Notice and submit eith your payment to the Register of gills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, say be requested by completing an "Application for Refund of PennsyLvania Inheritance end Estate Tax" (REV-1313). Applications ara available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Iq-hour answering service for fores ordering: 1-800-562-2050; services for taxpayers eith spaclal hearing and / or speaking needs: 1-800-4~7-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount qr interest) es shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assess, ant should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for e Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (52) discount of the tax paid is allowed. The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you mould appeal the tax and interest that has been assessed es indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one C1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (62) percent per annum calculated at e daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which mill vary from calendar year to calendar year eith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Daily Tnterast Factor Year Interest Rate Daily Interest Factor 1982 207. .00050,8 199Z 9Z .000247 1983 167. .000438 1993-1996, 77. .000192 1984 llZ .000301 1995-1998 9Z .000247 1985 13Z .000356 1999 72 .000192 1986 IOZ .000274 2000 8Z .000219 1987 92 .000247 2001 92 .000247 1988-1991 112 .OOO3Ol 2002 67. .000164 --Interest is calculatad as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, addltional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: HELEN V. GROUP Date of Death: December 25, 2001 No. 21-02-0078 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: x Yes ~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes x No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? x Yes ~ No Date: do attached to this 8/20/02 Copies of receipts, releases, joinders anfiL~aplgrovals of formal or informal accounts may be filed with the Court and may be & HUGHES [ IR~i'N, McKNIGHT Hughes, Esquire k~/~J'am es D. Name (please type or print) 60 West Pomfret Street Address Carlisle, PA 17013 city, State, Zip (717) 249-2353 Telephone Number Capacity: X Personal Representative Counsel for Personal Representative