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HomeMy WebLinkAbout02-1180Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Lester M. Mohler Np, o2/~Jo~ -//~ 0 also known as ,Deceased Social Security No._ 2z7 y-o7-yo-zb Petitioner(s), who islare 18 years of age or older, apply(ies) for (COMPLETE "A" OR "B" E3ELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) islare the execut or named in the Last Will of the Decedent, dated 10/14/1988 and codicil(s) dated and avers that the last Will and Testament of the \*Decedent, dated October 14, 1.9.88, appointed Wayne F. Mohler as Executor. Wa ne F. Mohler is deceased and petitioner is designated as substitute executor. State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: f~ B. Grant of Letters of Administration ~.J (c.t.a., d.b.n.c.t.a.: pendente life, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 86 East Main >treet, Newville, PA 17241 (Newville Borou.Qh, Cumberland County) (list street, number and municipality) Decedent, then 81 years of age, died December 23 , 2002 , at Carlisle Hospital (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA) All personal property ......................................... $ (if not domiciiled in PA) Personal property in Pennsylvania .................... (If not domiciled in PA) Personal property in County .............................. $ value of real estate in Pennsylvania ........................................................................................ $ 60.000.00 lrotal ..................................................................................................................... S 60,000.00 Real Estate situated as follows: \*86 East Main Street, Newville, PA 17241 Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence ~i -~ n T,rl .r i-~~ J Sharon Lightner, 9 Oak Flat Road, Newville, PA 17241 RW-7 (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Oath of Personal Representative Commonwealth of Pennsylvania COUnty Of Cumberland The Petitioner(s) above-named swear(s) and 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(s) of the Decedent, Petitioner(s) will well and 1:ruly administer the estate ac rding to law. Sworn to and affirmed and subscribed Sharon Lightner before me this 31st day of _ December 2002 Donna M. Otto,lst Deiputy Social Selcurity No: 2c~c-l - U ~- OOz-6 Date of Death: 12/23/2002 AND NOW, _ December 31st . 2002 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary ^ of Administration (c.t.a., d.b.n.c.t.; pendente life; durante absentia; durante minoritate) are hereby granted to ~*Sh.aron Lightner in the above estate and that the instrument(s), if any, dated 10/14/1988 described in the Petition bf; admitted to probate and filed of record as the last Will of Decedent. FEES . ~ l'o-~~ Letters ................................ .... $ 115.00 ~ L~ ~~ ~ Register of Wills ~ Short Certificate(s) ......10 $ 30.00 ~ Donna M. Otto,lst Deputy ~~~~ri9`-~•%~~ Renunciation .......................... $ Affidavit ( ) ....................... $ Extra Pages ( 2 ) .............. $ 6.00 Codicil ................................. $ JCP Fee ................................. $ 10.00 Attorney: HAMILTON C. DAMS Inventory & Tax Forms ............. $ No: 10264 I D . . Other ...................................... $ Address: P.O. BOX 40 SHIPPENSBURG PA 17257 TOTAL ............................. $ 161.00 p 532-5713 Tele hone: MAILED LE7:TERS 12-31-2002 `I'O ATI'012NEY ON DE~FI', RW-7A DECREE OF REGISTER Estate of Lester M. Mohler Deceased No._ 21-2002-1180 also known as LAST WILL AND TESTAMENT r I;, LESTER M. MOHLER, of 86 East Main Street, Newville, Pennsyvlania, _ ~ ~~\` , c-" ~,,•,~~ ~_.~, ~N? declare this to be my Last Will and Testament and revoke any will or codicil previously made by me. I'CEM I: I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the administration of my estate. ITEM II: I devise and bequeath the residue of my estate of every nature and wherever situate in equal shares to such of my niece, SHARON LIGHTNER, and my nephews, JERRE MOHLER, WILLIAM SHOEMAKER III, and STEPHAN SHOEMAKER, as shall survive me by thirty (30) days, per capita. ITEM III: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the expenses of the administration of my estate. ITEM IV: I appoint my brother, WAYNE F. MOHLER, executor of this my Mast will. Should he fail to qualify or cease to act as executor, I appoint Ilmy nii>_ce, SHARON LIGHTNER, executrix of this my last will. :ITEM V: I direct that my executor or guardian or their successors shall Ilnot bye required to give bond for the faithful performance of their duties in ~~any jurisdiction. IN WITNESS WHEREOF, I hereunto set my hand and seal to this my Last Will and Testament, written on three (3) sheets of paper, dated this ~u~ day of D~-~ 19ss. --E.~L L~-"L d~/ /. ~~ ~~ ~ i (SEAL) Lester M. Mohler Tlie preceding instrument, consisting of this and two (2) other typewritten pages, each identified by the signature of the testator, was on the da:y and date thereof signed, published and declared by the testator therein named, as and for his Last Will, in the presence of us, who, at his request, in his presence, and in the presence of each other have subscribed our names as witnesses h reto. ,~~ ~ /~,1~•"' residing at ~~t • //ie Y "` ~~~_~~ ~. ( t,,~Y' residing at ~ ~ ~~ 2 COMMON4dEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. I, LESTER M. MOHLER, the testator 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 the instrument as my Last Will; and th;~t I signed it willingly and as my free and voluntary act for the purposes therein expressed. ~ ~` ~~br ` .!'.-C~ ~ ~G"~-'(.C_~f~L( ( SEAL ) Lester M. Mohler Sworn to or affirmed and ackn/o~'ledged before me by LL.S~-z° ~ /~- ~d/4~°-r' the testator, this / y`~~ day of D ~ ,~ ~- 1988 . .....~- Pu ~ l,~c SA J. G!! '{~L~~-" tic*ary fuuiiV TiR` ~ Pa. `L, :.,.. n.. :~l'.If C1 ~"J C(1~ ~~,i fl~~l,'.~ ~-fl C:l ~i:._ _ _ COUNTY OF CUMBERLAND • SS. ~, We (or I) , ~ r)!~ /z~bA ~ ~G~ L'i i and /'n /2/ ,4c ~. L,C,% /~' , the witness(es) whose name(s) are (is) signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we .were (I was) present and saw the testator sign and execute the instrument as his Last Will; that the testator signed willingly and executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witne~>s in the hearing and sight of the testator signed the Will as a witne:~s; and that to the best of our (my) knowledge the testator was at that time eighteen (18) or more years of age and of sound mind and under no constl-aint or undue influence. G c'C~- m~~~ ~ ~~ Sworn to or affirmed and sub cribed to before me by ,LlGtvn> !fit>i[ ~- ~Q i~ i 5 and ry(~~~~~yz-- witness(es), this _~ day of ~ y~U~j.u-' 1988. II -=~. Nota Public i _. ~ ~. ~_~ ~.,..= FUpii„ ' _, ;,rrb gin: C~., Pa 3 i ~,/ G,,~~~rni~_.:~r. i:; ;irc~ ~_pt. ° ;y9' ~.'~__~ __ _ _ ___ _ __ _ ___ U~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Lester M. Mohler Date of Death: December 23, 2002 Will No.: 21-02-1180 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above- captioned estate on January 17, 2002 Name Address Sharon Mohler Lightner 9 Oak Flat Road, Newville, PA 17241 Jerre Wayne Mohler 206 Rock Road, Trout Run, PA 17771 William Guy `shoemaker, III 365 Blacksmith Shop Road, Gettysburg, PA 17325 Stephan Todd Shoemaker 34 1/2 Locust Street, Gett sag, PA 17325 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Date. 01/17, 03 Signature Name: Hamilton C. Davis, Esq. Address: P.O. Box 40 Shippensburg, PA 17257 Telephone: 717-532-5713 Capacity: personal representative X counsel for personal representative .- i'AME COMPLETE MAILING ADDRESS 'r Hamilton C. Davis ~% J:!~ IRM NAME (If applicable) 20 East Burd Street, Suite 6 ~% 00 Zullinger - Davis, PC P.O. Box 40 u~ ELEPHONE NUMBER Shippensburg, P A 17257 717/532-5713 1. Real Estate (Schedule A) (1) 58,500.00 DFFiCiAL USE: ONl'( - 2. Stocks and Bonds (Schedule B) (2) None - cO ,,". [ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None 4. Mortgages & Notes Receivable (Schedule D) (4) None ~ 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 6,164.59 . (Schedule E) -..-. 6. Jointly Owned Property (Scheduie F) u (6) None ) % o Separate Billing Requested '< 0 ~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) None - ~ii'f.1501lEhlll-Olll '" r ':ll:$<n u~~ ","u %00 U~~ .~ ~ < '* /1-- //:J.~I REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT C;j, _.. 'oNLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF FlEVENUE DEPT280601 HARR1SaURG. PA 17128-06/:P 02 1180 NUMBER r z '" " '" U '" " DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) I Mohler, Lester M. DATE OF DEATH (MM.OD-YEAR) I DATE OF BIRTH (MM.DD-YEARI 12/23/2002 11012811921 I (If' APPt.\CABlE) SURVl'J1NG SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) 1181 1. 0'19'nal Return 0 2. Supplemental Relurn ; 0 4. Limited Estate 0 4a. Future Interest Compromise (date of death after I 12-12..a2) I 0 6. Decedent Died Testate (Attach copy 0 7. Decedent Maintained a U.....ing Trust (Attach of 'Will) copy of Trust) I 0 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between 0 11.Election to tax under Sec. 9113(A) (Attach Sch O} 12.31.91 ar.d 1-1-%\ I THIS SECTION MUST BE COMPLETED ALl. CORRESPoNDENCE AND CONFIDENTIAl. TAx INFOIlMATtoN SHOULl} BE DIRECTED Tei: THIS RETURN MUST BE FILED IN OUPlICA Tf! WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER I I o 3. Remainder Return (date of death prior to 12-13-S2) o o 5. Federal Estate Tax Relurn Required 8. Total Number of Safe Deposit Boxes :l ~ ~ Ii: < U '" ~ (Schedule G 0' L) 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent. Mortgage Liabilities. & liens (Schedule I) (8) 64,664.59 (9) (10) 17,05 1.83 1,978.79 11. Total Deductions (total Lines g & 10) (11) 19,030.62 45,633.97 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 45,633.97 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate. x ,00 (15) or Iransfe" under Sec. 9116(a)(1.2) z ,045 (16) 2 16.Amount of Line 14 taxable at lineal rate x r ;0 ~ (17) . 17.Amount of Line 14 taxable at sibling rate x ,12 ~ 0 U ~ 18. Amount of Line 14 taxable at collateral rate 45,633.97 x .15 (18) 6,845.10 19. Tax Due (19) 6,845.10 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT >> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SlOE AND RECffECK MATH << Copyright 2000 form softwate only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 86 East Main Street CITY Newville [STATE PA IZIP 17241 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 6,845.10 Total Credits (A + 8 + C) (2) 0.00 3. Interest/Penalty if applicable O. Interest E. Penalty A Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the 8AlANCE DUE. (3) 0.00 (4) (5) 6,845.10 (SA) (58) 6,845.10 Total inleresYPenalty (D + E) 4. If Line 2 is greater than Une 1 + Line 3. enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than line 2. enter the difference. This is the TAX DUE. Make Check to: REGISTER OF WILLS, AGENT 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;.................................................................................. b. retain the right to designate who shall use the property transferred or its income;................................:... c. retain a reversionary interest; or...... ..................... .....:. ... ...................,................. ......................................... d. receive the promise for life of either payments, benefits or care?............................................................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ..................... ............................. ..... .,........,................ .... ...... ............. .............. 3. Did decedent own an ~in trust for" or payable upon death bank account or security at his or her death?........ 4. Did decedent own an Individual Retirement Account, annuity, or other non.probate property which contains a benefiCiary designation? .............. ..,......... ....................... ..... ....................... ................. ........................ PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS '~ I o o o ~ ~ ~ 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 thai I have examined this retu.m. ioc1lJdtng accomparl'jil1g '5cl'1&du\" and statements, ana 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 infonnalion of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Sharon Li htner D''''' SIGNATU 9 Oak Flat Road Newville, P A 17241 3 ADDRESS SIGNATURE OF PREPAAEROrER THAN REPRESENTATIVE Hamilton C. Davis /' / ADDRESS 20 East Burd Street, Suite 6 P.O. Box 40 Shippensburg, P A 17257 OATE --' '1/ I}( J:J For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% (72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% (72 P.S. ~9116 (a) (1.1) (U)J. The statute does not exemct 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 nOled in 72 P .5. 99116 1.2) (72 P.S. ~9116 (a)(1)]. The tax rate imposed on the net value of transfe(s to or for the use of the decedent's siblings is 12% [72 P.S, 99116 (a) (1.3)J. 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. *' SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX ~ETURN RE310ENT OECeDENT ESTATE OF Mohler, Lester M. I FILE NUMBER ! 21-02-1180 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F, ITEM NUMBER I DESCRIPTION VALUE AT DATE OF DEATH 58,500.00 86 East Main Street, Newville, PA 17241 (See attached settlement sheet). Sold to an unrelated third party at arm's length price and terms. Sale necessary to settle estate. See Schedule Jjfor necessary and. ordinary expenses of sale. TOTAL (Also enter on Line 1, Recapitulation) 58,500,00 *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAL rH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT ESTATE OF Mohler, Lester M. I FILE NUMBER , 21-02-1180 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 NUMBER 1 DESCRiPTiON VALUE AT DATE OF DEATH 1,004.85 Farmers National Bank Checking Account No. 166111 2 VFW Death Benefit 300.00 3 1985 Chevrolet Sedan 2,500.00 4 United American Insurance Company Refund 208.12 5 Miscellaneous Household Goods and Furnishings and Personal Effects - Public Sale 1,382.00 6 Pro-Rated Real Estate Taxes from Sale of House 620.62 7 Cash from Wallet 49.00 8 Failor-Wagner Post421 Death Benefit 100.00 TOTAL (Also enter on Line 5, Recapitulation) 6,164.59 . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF" PENNSYLVANIA INHERITANCE TAX RETl.JRN RESIOENT DECEDENT ESTATE OF Mohler, Lester M. I FILE NUMBER I 21-02-1180 Debts of decedent must be reported on Schedule I. ITEM I NUMBER i A. \ FUNERAL EXPENSES: I Egger Funeral Home , I \ I I B. DESCRIPTION AMOUNT 4,465.60 I 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Sharon Lightner Social Security Number{s) I EIN Number of Personal Representative{s): Street Address 9 Oak Flat Road City . Newville Year(s) Commission paid 2003 3,000.00 I I State PA Zip 17241 2. Attorney's Fees Hamilton C. Davis, Esquire 3,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees Cumberland County Register of Wills 161.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Legal Advertising - Cumberland County Legal Journal 75.00 2 Legal Advertising - The Valley Times Star 69.20 Total of Continuation Schedule(s) 5,781.03 TOTAL (Also enter on line 9, Recapitulation) 17,051.83 '*' Schedule H Funeral Expenses & Administr3iw Costs conlinued COMMONWEALTH OF PENNSYLVANIA INHERITANCE Tf\X RETURN RESIDENT DECEDENT ESTATE OF Mohler, Lester M. I FILE NUMBER I 21-02-1180 3 3,385.13 Real Estate Settlement Expenses. It was necessary to liquidate this asset for the benetit of settling the estate (not for the benetit of the beneticiaries). 4 Nationwide Insurance Company - Homeowner's Insurance 5 David Fromb.ugh - Snow Removal 6 Groff s Septic System 7 Interstate Pest Control Tennite Treatment 8 Sharon Lightner - reimburse for Interstate Pest Control Inspection 9 2003 County and Township Real Estate Taxes to Betty Hockensmith 10 Reserve for contingencies 172.90 75.00 125.00 663.20 125.00 234.80 1,000.00 Page 2 of Schedule H '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYt.VANIA INHERITANCE TAX RETlJRN RESIDENT oeCEDENT ESTATE OF Mohler, Lester M. i FILE NUMBER I 21-02-1180 Include unreimbursed medical expenses. ITEM NUMBER I Sprint DESCRIPTION AMOUNT 272.94 2 Carlisle Hospital 3 Commonwealth of Pennsylvania 4 PPL Utility Company 5 Cumberland County Landfill 6 Kough's Oil Service 7 Newville Water and Sewyer Authority 8 PCS Medical Co. 9 Help for Public Sale of personal properly 23.50 36.00 196.67 390.07 519.14 313.83 26.64 200.00 TOTAL (Also enter on Line 10, Recapitulation) 1,978.79 ( ) ~.FHA Settlemenl Sl3tement - U. S. De artmenl o( Housin and Urban Develo men! Form Us HUD _ I Pa eNo. J ( ) z.FmHA. 5. File Number 7. Loan Number a.Mortgagelnsurance ( ) J. COli\", Vni!'!s. REULE C;ueNumber I; ; 4. VA . Con\!, Ins. C, This (orm IS furnished 10 give you II slatemem ot actual sertJement costs. Amounu paid 10 and by the settiemen\ agent afe shown. Hems marked "(p.o.c.)" "'ere paid outside of the dosin : the\' an~ skown here for informational Ournosts and afe not included in the tOtals. D. Name .:ind Mdress o(BoTTOwer: ~ Name and..o.ddress of Seller; HAZEL L. SMrTIl SHARON UGHTIffiR, EXECUTRIX 3 WEST BIG SPRlNG AVENUE LESTER M. MOHLER ESTATE APT. #6 N'E\\;"VlLLE, PA 17Z41 TIN F. Name and Address of Lender G. ?ropertl' UlcaDlIn WAYPOINT BANK 86 E. MAIN STREET, NEWVILLE, PA ISAOAATIMA BOROUGH OF NEWVILLE 101 S. GEORGE STREET CUMBEIU.AND COUNTY YORK. PA 17401 PARCEL NO. 27-20-17 6-101 H Seller'sSettlemelltA~ellt FREY &0 TILEY L SenJementDate; Placea{Sett!en\enl: 5 South Hanover St. SEPTEMBER la, 2003 5 SOUTH HANOVER STREET TIN 2<-17305'S Carlisle. PA 17013 CARUSLE, PENNsYLVANIA J. SUMMA RV OF RORROWER'S TRANSACTION Ie. SUMMARY OF SF.LLER'S TRANSACTION 100 Cross Arno\Utt Due from Bon-ower 101 Canll'3ctsl.luprietl 102 P~n;r.lp~rty 103 Settlt.me.1\t thaqD from (line 1400' '04 AdjuJrmenufor ilems paid by seller in adIHm~: 106 CitY/IDWlllU"U to: 107 Co\lnlytaxes to: IOI! Assessmenl$ 10: 109 Tax Pro-Ration tQ . SEPTEMBER lO, 2003 400 Cro.. Amount Due To Seller 58,500.00 401 COlllnlct Sales. price 402 Personalpz:operty 2,474.18 403 404 40' A<#lLEtmenl$for ilmu poid by u/ler in adl1tl"':e: 406 City/tcWl'\\axu ta; 407 Cauntyaxes to: 408 Mstmmelllf to: 620.62 409 Tax Pro~Ration to SePTEMBER 10, '200 58,500.00 '0, 620.62 "0 '" 4'. '" ", 120 Cross Amount Due From Borrower ." 61.594.80 420 Gross Amount Du.eto SeUer 59,12.0.62 "'-"'",==",-",-..",.== 200 -'mounts Paid By Or In Beha1fOf Borrower 201 DepasitQreame.stmQiley 202 Prindpal'llmouill ornew 1lla.II(s) 20;3 Existinl:loal1(S)fakensllbjeelto '04 500 ReductiON In Amount Due To Seller 100.00 501 EKc~s.s deposit (s~e inslnJdiol15) 55,700.00 502 Settlemenl ehargeslO seller (fine 1400) 503 tllistingIQan{s)lIkmrobjectlo 504 P.yoffoftirstmQrtpgeloan 505 Payoffof,eermdmortglgeloan 3,000.00 506 '07 2,000.00 508 SELLERS ASSISTANCE 1,385.13 ,os ". REDEVELOPMENT GRANT "7 ". SELLERS ASSISTANCE - 2,000.00 "0 City{IOW"llIa.xes '" Col.\ntytaXes '" A.uessments "3 '''' "5 ". "7 ,,' ". Atijustmrntsjor ileTOl$ lipaid by stller "" to: to: '09 Adjusf111fmlJ!or items upoid by seller ,,0 City/IOWl1Ia.tes 10: ,a CQunt}'taxes to: '" J\ssessm~nts (\I', '" '" ", ,,' '" 5" '" 2.20 Total Paid By/For BorroweT '" 60.800.00 520 Total Reductions to Amt DueSeUeT 3,385.1.3 "'-Z"'-"'-"'-====",,,,,=, .300 Ca.shAtSettlement From/To Bort'ower: 301 Gross amount dl.\! from borrQwer (liD! 120) 302 Las amOUnts paid byJfor bOrtO",...r (from line ::?2ol 30] Cash (X) From ( ) To Borrower 600 CAsh At Se.ttlement To/From Sellel': 61,594.80 601 Gross amollnt 10 s.ellet fum 0i1le420) (60,800.00) 602 I.e5.s reductiollS in amoUnt dUl!selJer (from Jin!5:!0): 794.80 60,3 C#sh( ) from (X)ToSeUer 59,120.62 (3,385.13) 55.735.49 -~..==",==""",,,,,,,=,,,- ====="'''''''='''=='''-'''= ["lID.' 100 Total Sales/Broker's Carom. based on price: Diuision ofCommissiall (line 700) Cl5jollollJs: 701 to 102 to 70) 704 CommissiollpairlalSertlement 1.. SEITLEMENT CHARGES 58,500.00 @%= ".= '" Boo Items Payable In Connection With Loan: (MottgageAmt: 55,700.(0) ." LJanOriginatioll fee .00% ." Loan Discollnt .00% "3 APprai.sa.JFee " '0< CteditReport to '" Lender's Ins~clion ree to .00 Mortgage IMurlnee Appltcarion Fu to eo, FLOOD CERTIFICATION FEE TO WAYPOINT BANK ". UNDERWRITlNGFEETOWAYFONTBANK .", DOCUMENT PREPARATION FEE TO WAYFOINT BANK ." TAXSERVlCEFEETOWAYPOlNTBANK .n APPliCATION FEE TO WAYFOINT BANK - $350 ~a Items Required By Lender To Be Paid In Advance: 9(l1 lnttre5t FrOIll lo-Sep.o3 to I-Oct-o3 @ 10.06000 perdJ:;~ 902 MortslCell1$urancePrerniumfor '103 HlltilnllnsUMlllCe P~mium for 00' montll$1O yens to ~allilo $241 1 00' 1000 Reserves Deposited With Lender: 1001 HUlIrdlnsuunce 1002 MortgageinslJrance 1003 CitypropenytuelI IDO.ol QI'lnlypropertytJXI:S 100' Asll1llalas~e$.Smenls $2.0.08 per month per month per month . permonth perrnonth permonlh permont:h .000 3 mat.@ <no.@ mOl..@ 6 mos.@ mM.,@ mD$,@ $19.18 1007 Sehoollaxes 4 11\O\S. @ 1008 AGGREGATE ACCOUNTING ADJUSI'MENT lJOO Title Charges: $56.80 IIClI SettJemenlorelo~inr:fee '" ""' A/:lstcaCl or title SeJ.tcli t" ""3 TItleenmination t" 1104 Title insuMln~e binder '" "o, Document preparation '" .... Nolaryfees '0 1I0? ArtOl'l'Iey'sfe<!ll '0 nncludC!$aboYeilellt$num~t$: "08 TItlelruuu,nc:e '0 (includes ~baYe items numbers: ) lAW OFFICE OF ZULLINGER - DAVIS FREY & TILEY Oosing Service Letter (Frey & riley for Comwlt:h. Land Title) 1I0li Lend<<'sCOvt.t'i;t. $ 55,700 1110 Ownett Coven;! $ 58.500 .... COURIER/OVERNIGHT FEE TO FRliY & TILEY IU2 1\13 1:l0Il GovernmentRecording and Transfer Charges: 1:101 Recording {<<s: Deed $38,50 ; Mongilge: $66.50 : Mise. 1202 City/counly/stamps; Oeed $585.00 MOr'lgage: $ 1203 State tax/namps: Oeed $585.00 ; Mortgage; $ "0, SATISFACTION FEE TO RECORDER OF DEEDS FOR SATISFYING MTG $17.00 120S 1.100 Additional Settlement Charges; 1301 Survey '0 1302 Pe.flinspecrion 10 IJOJ CUlTenl TUell due from BOlTowerf5e.llec to 6etty L HDd,tn~mith, Tax COllector "0, FINAl WATER^"""D SE\VER TO NEWVILLE BOROUGH -ACCT. NO. 179 lJOS '306 .3D' 1.400 Total Settlement Charges (enter onlines 103. Section J and 502. Section K) Paidfrorn Borrower's Funds at Settlement 0.00 0.00 14.()O 115.00 290.00 9:1.00 P.O.C. 211.26 P.D.C. 60.24 153.44 227.20 (15-".71) _712_.75 35.00 10.00 122.00 58$.00 0.00 2.,474.18 Page No. ~ Paid From ,= SeUer's FUJ1dsat 701 Settlement '" '03 "" 'OS ",,0 '0' !O2 '03 '0' .OS '0' '07 '08 3 "0 .u "'0 '0' "', ,OJ - "" ,- ,"', ,"', ''''3 '00< ''''' 10010 1007 ,"'. 1100 1101 1102 1103 lIll4 1105 1106 P.D.C. 1107 u0.8 1109 1110 Ill' lll~ lllj ,,~ 1201 "" 585.00 \~n3 "'" l:O:D~ "~ IJDI IJ02 695.52 IJ03 104.61 ,,0< '305 ,,00 1307 1,385.13 1"00 .". """.-""-=-"""'-=== -==-"''''--='''-== !HUD.\ PJ\!,eNo, 31 CERTIFICATION I direct and authorize the Cornpnayto make distributions indicated fOT my account On the attached HUD-l Settlement Stat~ment, approving the lax prorations indicated therein, and understand that prorations wefe based on figu;ts for the preceding year, or estimates for tlle cllrrent year, and in the event of any change for the current year, 311 necessary adjustments must he made between Seller and Borrower direct; likewise any DEFICIT in delinquent taxes wiU he reimbuTsed to Attorney/Title by Seller. ~ I have carefully reviewed the HUD-l Settlement Statemellt Hnd to the best or my knowli':dge and belief, it is a true and accurate statement of all receipts and disbursements marle on my account or by me in this tramactiot'l. t further certify that 1 have received II copy of the HUO-1 Settlement Statement. xJAiLUJl~-~~J~. . / ~-, //~. C7 . ~.i:9-.Y ,X ~~. ~ BoM'"oWCI'S Sellers To the best of my knowledge, the HUD-1 Settlement Statement which J have prepared is a true and accurate account of the funds which were recehled and b,wei been or wiU be rlisbursed by the undersigned as part of the settlement or this ttaJ1.11~tjon. ~/ -',7/>1<1 s,~ nt Ag'n '--4 ,7' -L; ~ C /i>,-j / Date- WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form, Penalties upon conviction can include fine and imprisonment. For details see: Title 18 U.s. Code Section 1001 and Section 1010. INFORMATION REPORTING ON REAL ESfATE TRANSACTIONS THIS HUD SETTLEMENT STATEMENTCONTAlNS IMPORTANT TAX INFORMATION (BOXES E, G, H, I, M AND UNE401) AND IS BEING FURNl8HEDTO THE INTERNAL REVENUE8ERVICE. IFYOU ARE REQUIRED TO FILE A RETURN, A NEGUGENCE PENAL1YOR OTHER SANctION WILL BE IMPOSED ON YOU IF THIS ITEM 18 REQUIRED TO BE REPORTED AND THE INTERNAL REVENUE SERVICE DETERMINES THAT IT HAS NOT BEEN REPORTED. Solicitation aCTIN Seller is required by law to ptovirlethe Attorney/Company with his/herJ;orrect taxpayer identification number. If correct taxpayer identification number is not provided, be/she may be subject fO civil or criminal penalties imposed by law. Certification of TIM Under penalties of perjury, I cerUfy that the taxpayer identification number shown in this statement is my correct taxpayer identification number. SeHer Seller TAX PRO-RATION ADDENDUM Dale ofPrp-Ration: Borrower "u~ ASS~MENi: $61,550.00 '61,550.00 2003'2004 School Real Estate Tax 2003-20[14 School Real Eslate Tax. Face 2003'2004 Scllool Real Estate Tax. Pe.r Day 295DaysP~patd.. 11.3mUls $695.52 $1.90033 $560.60 695.52 September 10. 2003 See Sto."t""n\~l\t Sheet tines NllnlbeN ltO, 4\() and 1303 for Resuluofl:hls Addendum. 2003 Co. & Twp./Bor. Real Ettate Tax 2003 CO. & Twp.fBor. Real Euate Tax.- Fa~ 2003 Co. I: Twp./Bor. Real Ettate Tax- Pe.T Day 113 DaYIIPrt.paid.. 3,8l47mi1ls $'23<1.7'1 $0.643'26 $7'2.69 P.O.C. Purchaser owes: Les32%disCOUlll ""'" 72.69 633.'::!q. 1'2.67 6::10.6'2 295 DaY5 pre-pai.d School PI~ 113 Dilly.; Pre-paid Co. &Twp./Bor. August 29, 2003 Hamilton c. Davis, Esquire 20 East Burd Street, Suite 6 P. O. Box 40 Shippensburg, PA 17257 RE: Estate of Lester M. Mohler Dear Hamilton: Lester had a checking account in this bank in his name alone which was opened November 19, 1993. The balance as of December 23, 2002 was $1,004.85. Sincerely yours, A:~1r:!:f~ Executive Vice President F'P f;,,:.); "! ':;,'\ '\',,--'">,>,',';Ht:',I"\ ;-'211 .,,~Tc" -,.....,;."'5; 2. SEP 0 3 2003 Foreman Auctioneering Richard Foreman AU 1163L 12 Oakville Road Shippensburg, PA 17257 717-776-4602 Sale For: ,L) -+- "1- c. ~'f~' I ; ~. , ",- .,< .'.... y. " __ . I:: ,,";' '/" ._1 ?/J CL.re tf""'f_) / ...:'"7'if&, Sale Date: J?/CZL( / 7 J .:?({)C7_ j Sale Total (sheets): . . . . . . . . . . . . . . . . . . . . . . . . , . . . , , . . . . . $ ~, J. ~[ 50 , Less: Outstandings (Refunds): "}L<!YI..(j $ $ $ $ $ Total Outstandings: $ $ $ $ $ $ Add: Sales Tax Charged: $ Sub-Total: , . , , ' . . ' , . , . , ' . . , . , . . . . , . . , , . , . . . . ' , , , . . . . $ :so d, J. (/;{J - Less: Adv(tSing ILtdp, lJT.$, '>'- neGVs fi D e c: po At!. , n r S j" I . 10 -e ~i; I <. Total Advertising: $ ,,/; roi tel e.- $ $ $ $ 3/&,- ..7'7,). J q,o "-10 -- j FI .' ~;;.- 6d? /};I.. Less: Auctioneer's Percentage OJ, ,;1.6t?S-Oat -'? % = $ lio ~ at %= $ at % = $ Total Auctioneer's Percentage:$ ., Less/Add: Miscellaneous Adjustments/f'l<!,UJ ~a.& t'lfli!J<iU $ $ $ Total Misc. Adjustments: $ Net Sale: , . . , . . , . , , . . , . ' , ' . , ' . . . . . . . . , ' , . . . ' . . ' . . , ,,$ I. ,/.3:J. 'f!. Cash: ~ ~!JtJ ::;? Checks: ~ 11. {:... ,'YJC.. ~4'.d<J 15;(3,[)0 ~ , . <Iii Afb ;;;/;t;t - /i 3cf if - \ ..J .>,,-':' .<:...:s '-d ,"<> ," .... r"::::" ,-.,' ,.r ., \ j 'kS ..,,\.) x.'\.) ".- r,,- .... '" LAST WILL AND TESTAMENT I~ LESTER M. MOHLER, of 86 Edst Main Street, Ne~~ille, Pennsyvlania, ,'eclare this to be my Last Will and Testament and revoke any will or codicil previously made by me. ITEM I: I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the administration of my estate. ITEM II: I devise and bequeath the residue of my estate of every nature and wherever situate in equal shares to such of my niece, SHARON LIGHTNER, and my nephews, JERRE MOHLER, WILLIA-~ SHOEMAKER III, and STEPHAN SHOE~~KER, as shall survive me by thirty (30) days, per capita. ITEM III: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the expenses of the administration of my estate. ITEM IV: I appoint my brother, WAYNE F. MOHLER, executor of this my last will. Should he fail to qualify or cease to act as executor, I appoint my niece, SHARON LIGHTNER, executrix of this my last will. ITEM V: I direct that my executor or guardian or their successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS ~~EREOF, I hereunto set my hand and seal to this my Last Will and Testament, written on three (3) sheets of paper, dated this 14~ day of DJvk'\. , 1988. .'" " /~_,/~ f :/(-i-!-. I .I " /'-::' . f7 7 "'J.'! ,/ I ~ ;. ;.. .. ~'I .... '.. d..L ,..//. ./;"",;[C\ Lester M. Mohler (SEAL) The preceding instrument, consisting of this and two (2) other typewritt~n pages, each identified by the signature of the testator, was on the day and date thereof signed, published and declared by the testator therein named, as and for his Last Will, in the presence of us, who, at his request, in his presence, and in the presence of each other have subscribed our names as witnesses h reto. I. residing at lJ1..!UJ.Jj)J,a.....J !J.. ( JjJ residing at 2 /w/,)/~ ~. .. / ~,.1UU1bJ- ,. 1& . COffi10NWEALTH OF PENNSYLVANIA 55. COUNTY OF CUMEERLfu,D I, LESTER M. MOHLER, the testator whose name is signed to the attached or foregoing fnstrume.nt, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. / .. . ..iV.......-- ~-'J -1 _ I' /,- ,;',"" " / ,Y1 ,/"~\ _" " (A..-'"::'L"~~ -n, //'.hL-U( . Lester M. Mohler (SEAL) Sworn to or affirmed and ack~ledged before me by L'C.s.f.Lr- (i1.;7)0 o!:-r-' , the testator, this /1./ '/-L day of ()I' W!}e.r" , 1988. l--- -NoPtiolJ,c f ;. .;,y-::'._t ;:'.'-:.. 1 T=?~:''', J. G-~I:~::'.:;L~~Ci~-:'I. t:,:_,;:c:"!!->~![~ co11~t1X~aC:i1'i~~~NSY~~X:tA- COUNTY OF CUMBERLAND S5. "- He (or I), HCulI;/f/"lf C.t-aft!"'; and !11!1/l/().,a N./0//1- ,the witness(es) whose name(s) are (is) signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were (I was) present and saw the testator sign and execute the instrument as his Last Will; that the testator signed willingly and executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the Will as a witness; and that to the best of our (my) knowledge the testator was at that time eighteen (18) or more years of age and of sound mind. and ~ni7no constraint or undue influence. -;;;f~-1.#- C ~. I'll t1u!~u k aJ (j. tJ.JJ. Sworn to or affirmed and sub~cribed to before me by U(}nJi I'C/I. (7, t,a /lis and t'ila ,^ .. lJ..)r + . witness(es), this ,"1(1,. day of flklo,r ,1988. ~ UI(J. IIL.vJJr~~ . '0.9 t i?:fj .p..u)?J_,~c;____~_~'__"~1 3 LAW OFFICES OF ZULLINGER -DAVIS PROFESSIONAL CORPORATION JOEL R. ZULLINGER 14 North Main Street Suite 200 Chambersburg„ PA 17201 717-264-6029 Fax: 717-264-1.884 zuln rg_ law(cr~su~pernet.com Dale F. Shughart, Jr of counsel September 16, 2003 Register of Wills Cumberland County One Courthouse Square Carlisle, PA 1'7013 RE: Estate of Lester M. Mohler Est. No. 21-02-1180 HAMILTON C. DAVIS 20 East Burd Street, Suite 6 P.O. Box 40 Shippensburg, PA 17257 717-532-5713 Fax: 717-530-5222 davislaw(cr~,supernet. com Dear Sir or Madam: Enclosed herewith please find an inheritance tax return, filed in duplicate, and payment in the amount of Six Thousand Eight Hundred Forty-Five and 10/100 ($6,845.10), as payment for the above estate. A check for filing fee in the amount of $15.00 is also enclosed If there are any questions or concerns, please contact me at the Shippensburg office. Thank you. Sincerely, ~~ Hamilton C. Davis for Zullinger -Davis _- Professional Corporation HCD/njk _-~ Enclosure C~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: ACN ASSESSMENT AMOUNT CONTROL NUMBER ZULLINGER-DAVIS C/O DAVIS HAMIILTON C 20 EAST BURD STREET SUITE 6 SHIPPENSBURG, PA 17257-0040 fold ESTATE INFORMATION.. ssN: 204-07-0026 FILE NUMBER: 2102-1 180 DECEDENT NAME: MOHLER LESTER M DATE OF PAYMENT: 09/18/2003 POSTMARK DATE: 09/17/2003 couNTY: CUMBERLAND DATE OF DEATH: 12/23/2002 101 ~ 56,845.10 TOTAL AMOUNT PAID: REMARKS: SHARON LIGHTNER EXECUTRIX C/O ZULLINGER -DAVIS CHECK#138 INITIALS: SK SEAL RECEIVED BY: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NQ. CD 003029 DONNA M. OTTO REV-1162 EX(11-961 56,845.10 DEPUTY REGISTER OF WILLS REGISTER OF WILLS /~ _ ~i~ - i V BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 HAMILTON C I)AVIS ZULLINGER DAVIS PO BOX 40 SHIPPENSBURG PA 17257 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 E% AFP (Y1-OS) DATE 10-27-2003 ESTATE OF MOHLER LESTER M DATE OF DEATH 12-23-2002 FILE NUMBER 21 02-1180 COUNTY CUMBERLAND _ ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ _____________________ ------------------------------ -------------------------- ---------------------------------- REV-1547 EX AFP (01-031 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE of MOHLER LESTER M FILE N0. 21 02-1180 ACN 101 DATE 10-27-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (.schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held :stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Sclhedule G) 8. Total Assets (1) 58,500.00 (2) .00 (3) .00 (4) .00 [5) 6,164.59 (6) .00 (7) .00 (8) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 64,664.59 APPROVED DEDUCTIONS AND EXEMPTIONS: 17,051.83 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule Il (10) 1.978.79 11. Total Deductions (11) 19.030.62 45,633.97 12. Net Value of Tax Return (12) .00 13 Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) . 14. Net Value of Estate Subject to Tax (14) 45,633.97 NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 00 00 .00 15. Amount of Line 14 at Spousal rate (15) . = X 045 00 . 00 16 Amount ofi Line 14 taxable at Lineal/Class A rate (16) . • X . 17 Amount of Line 14 at Sibling rate (17) .00 X 12 .00 . 18 Amount of Line 14 taxable at Collateral/Class B rate (18) 45,633.97 X 15 6,845.10 . (19)= 6,845.10 19. Principal Tax Due IA1C GKCL11.7- DATE NUMBER + INTEREST/PEN PAID (-) AMOUNT PAID 09-17-2003 CD003029 .00 6,845.10 TOTAL TAX CREDIT 6,845.10 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ^ IF PAID AFTER DATE: INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF' ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: 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 the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: Ta fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed an the reverse side. --Make check or money order payable to: REGISTER OF MILLS, AGENT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an ^Application far Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount ar interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: --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 an this assessment should he 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. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has bean assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one C1l 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 [6%l percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Y~ar Rate Factor Year Rate Factor 1982 20% .000548 1987 9% .000247 1999 7% .000192 1983 16% .000438 1988-1991 11% .000301 2000 8% .000219 1984 11% .000301 1992 9% .000247 2001 9% .000247 1985 13% .000356 1993-1994 7% .000192 2002 6% .000164 1986 10% .000274 1995-1998 9% .000247 2003 5% .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER 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, additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Lester M. Mohler Name of Decedem: Date of Death: Estate No. 12/23/2002 2002-01180 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 If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Date: If the answer to No. 1 is Yes, state the following: Did the personal representative file a final account with the Court? Yes No X The separate Orphans' Court No. (if any) for the personal representative's account is: Did the personal representative state an account informally to the parties in interest? Yes X No Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' court and may be attached to this report. r c.'Davis, e P.O. Box 40 Shippensburg, PA 17257 (717) 532-5713 Capacity: __ Personal RePresentat',.~~ XX Counsel for ~rsonal Representati{,e