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Home My WebLink About04-0227COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD O03839 WEBBER RICHARD L JR 126 EAST KING STREET SHIPPENSBURG, PA 17257 ........ fold ESTATE INFORMATION: SSN: 190-16-9389 FILE NUMBER: 2104-0227 DECEDENT NAME: RAND GORDON D DATE OF PAYMENT: 04/19/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/17/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,500.00 REMARKS: SEAL NORMAN S RAND CHECK//13 TOTAL AMOUNT PAID: $1,500.00 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~ R~v-1500 EX+ ($-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 04 COUNTY CODE YEAR HARRISBURG, PA 17128-0601 0 2 2 7 NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY' NUMBER z~ Rand, Gordon D 190-16-9389 ¢ ILl DATE OF DEATH (MM-DD-YEAR) IDATE OF BIRTH (MM-DD-YEAR) t'l THIS RETURN MUST BE FILED IN DUPLICATE WITH THE o 0'1-17-2004 07-27-'1915 DJ REGISTER OF WILLS I't IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER [~1. Original Return [] 2. Supplemental Return ~, [] 4. L,mited Estate o ~ [] 6. Decedent Died Testate (Attach copy of Will) [] 9. Litigation Proceeds Received ] 3. Remainder Return (dale of death prior to 12-13-82) Richard L Webber, Jr., Esq. :IRM NAME (If applicable) Weigle & Associates, P.C. JMBER 7'17-532-7388 ] 4a. Future Inlerest Compromise (date of death after 12-12-82) [] 5. Federal Estate Tax Return Required [] 7. Decedent Maintained a Living Trust (Attach I 8. Total Number of Safe Deposit Boxes copy of Trust) ] 10. Spousal Poverty Credit (date of death behveen 12~31-91 and 1-1-95) [] 11. Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS '126 East King Street Shippensburg, PA 17257 z 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (Schedule G or 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) 11. Total Deductions (total Lines 9 & 10) (1) (2) (3) (4) (5) (6) (7) (9) (lO) None None" None None 46,857.87 352.6'1 None 3,594.00 879.88 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) OFFICIAL USE ONLY (8) 47,210.48 (11) 4,473.88 (12) 42,736.60 (13) 0.00 (14) 42,736.60 z SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, '0.0 0 x .00 (15) or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 42,736.60 x .045 (16) 17. Amount of Line 14 taxable at sibling rate 0.00 x .'12 (17) 18. Amount of Line 14 taxable at collateral rate 0.0 0 x .1 5 (18) 19. Tax Due ~ (19) 20. 0.00 '1,923.'15 0.00 0.00 '1,923.15 Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-001 Decedent's Complete Address: STREET ADDRESS 10 McFarland Street IC'TY Newville S~ATE PA -Z~P 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) 1,923.15 1,500.00 78.95 Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) Total Interest/Penalty (D + E) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 1 Line 20 to request a refund If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (2) 1,578.95 344.20 344.2O (5B) 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. retain the use or income of the properly transferred; .................................................................................. ~ [xJ b. retain the right to designate who shall use the properly 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? ....................................................................................................................... ~ [x~ 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? ...................................................................................................................... ~ [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is ~rue, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Norman S Rand SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS ADDRESS 2837 Keller Road St. Thomas, PA 17252 DATE DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS DATE Richard L Webber, Jr. Esq, 126 East King Street Shippensburg, PA 17257 For dates of death on or after July 1, 1994 and before January 1, i~95, 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 Js 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116 1.2) [72 P.S. §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. Rev-IS08 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rand, Gordon D SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-04-0227 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 2 3 4 6 7 8 9 10 DESCRIPTION Gross proceeds from sale of personalty at public sale TETCO Employees Federal Credit Union Savings Acct. #99 including accrued intreest to date of death PNC - Bank certificate of deposit 21001053225, including accrued interest to date of death. PNC Bank certificate of deposit # 31600070995, including - accrued interest to date of death. F&M Trust Company certificate of deposit #015-2955873 - including accrued interest to date of death F&M Trust Company checking account #33-07190 Cash - in safe deposit box 1984 Ford Tempo #36185071101RA Household - furnishings Insurance - refund TOTAL (Also enter on Line 5, Recapitulation) VALUE AT DATE Of DEATH 3,547.50 1,376.60 10,677.07 6,166.71 2,464.26 21,540.73 15.00 350.00 660.00 60.00 46,857.87 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1609 EX+ (6-98) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Rand, Gordon D 21-04-0227 If an aasst was made joint within one year of the decedent~s date of death, It must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A.Wayne S Rand Mr. Son 10 McFarland Street Newville, PA 17241 JOINTLY OWNED PROPERTY: ITEM LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER. A'FI'ACH DEED FOR VALUE OF ASSET INTEREST DECEDENT'S INTERES'I' TENANT JOINT JOINTLY-HELD REAL ESTATE. I A 10/31/96 F&M Trust account #33-06194 705.21 50% 352.61 TOTAL (Also enter on Line 6, Recapitulation) 352.61 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) REV-1151 EX+ (12-99) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Rand, Gordon D 21-04-0227 Deba of decedent must be reported on Schedule I. ITEM NUMBEr; DESCRIPTION AMOUNT FUNERAL EXPENSES: None ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid Attorney's Fees See continuation schedule(s) attached Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address C~ty State Zip Relationship of Claimant to Decedent Probate Fees See continuation schedule(s) attached Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 2,500.00 99.00 995.00 3,594.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1602 EX+ (6-98) COMMONt/~_ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rand, Gordon D SCHEDULE H-B2 ATTORNEY'S FEES continued FILE NUMBER 21-04-0227 I'~ ~-M NUMBER 1 DESCRIPTION Weigle & Associates - P.C. Subtotal AMOUNT 2,500.00 2,500.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B2 (Rev. 6-98) Rev-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rand, Gordon D SCHEDULE H-B4 PROBATE FEES continued FILE NUMBER 21-04-0227 ITEM NUMBER DESCRIPTION Cumberland - County, Register of Wills Subtotal AMOUNT 99.00 99.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B4 (Rev. 6-98) Rev-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rand, Gordon D SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued FILE NUMBER 21-04-0227 ITEM NUMBER 1 2 3 4 5 6 7 8 9 10 DESCRIPTION F&M Trust Company - -Information Fee Cumberland County Register of Wills - - Short Certificates Cumberland Law Journal - - legal advertisement Valley Times-Star - - legal advertisement Hornbaker & Associates Fry Communications - Advertising for public sale Valley Times-Star, News Chronicle - Advertising for public sale Gary L. Mentzer Auctioneering Service - -Appraisal Fee Groff's Septic - Rental fee for toilet facilities for public sale Wayne Rand - Reimbursement for individual items owned by Wayne Rand sold at public sale that were included in gross proceeds. Subtotal Copyright (c) 2002 form software only The Lackner Group, Inc. AMOUNT 15.00 9.00 75.00 69.50 43.00 128.50 120.00 65.00 65.00 405.00 995.00 Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Rand, Gordon D Include unrelmbumed medical expenses. r FILE NUMBER 21-04-0227 ITEM NUMBER 1 2 3 4 5 6 7 8 9 DESCRIPTION Family Home Health Care Products, Inc. Verizon Wireless Andorra Radiology Associates, P.C. Sprint Graham Medical Clinic Newville Water and Sewer Authority Drew Wellmon, MD Central Penn Medical PP&L TOTAL (Also enter on Line 10, Recapitulation) (If more space is needed, additional pages of the same size) VALUE AT DATE OF DEATH 195.94 69.77 85.00 77.46 124.47 200.56 53.59 28.40 44.69 879.88 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6~98) REV-1513 EX+ (9-00) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Rand, Gordon D NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. U. TAXABLE I')IRTI~IRI ITI(31M~ [include outright spousal distributions, and ............... transfers under Sec. 9116(a)(1.2)] NORMAN STUART RAND 2837 KELLER ROAD ST. THOMAS, PA 17252 WAYNE STEVEN RAND 10 MCFARLAND STREET NEWVILLE, PA 17241-1510 WILLIAM JAMES RAND, SR. 838 SHED ROAD NEWVILLE, PA 17241 DAVID FOSTER RAND 38 PARSONAGE STREET NEWVlLLE, PA 17241 :nter dollar amounts for distributions shown above on lines 15 through 18, as appro rFILE NUMBER 21-04-0227 RELATIONSHIP TO DECEDENT DO Not Mst Tr~:=~i~~ SON SON SON SON 3riate, on Rev 1500 cover sheet NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE AMOUNTORSHARE OF ESTATE $10,684.15 $10,684.15 $10,684.15 $10,684.15 E~. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) FINAL SETTLEMEI Other_ PROCEEDS OF SALE: Cash .............................................. $ Checks .......................................... Other ............................................................................................... Miscellaneous (see attached list) .................................... TOTAL PROCEEDS OF SALE .............................. $ LESS SELLER'S SALE EXPENSE: Auctioneer's Fee ..................................................... Other Seller's Expenses Advanced by Auctioneer: V, T:;3- (.?/w-on,~ L-~¥7. So Miscellaneous (see attached list) ........................ DEDUCT TOTAL SELLER'S SALE EXPENSE ........ TOTAL NET PROCEEDS TO SELLER ........ I, (or we), the seller of goods, merchandise, and/or property sold at public auction on above date and location, acknowledge and accept this settlement of proceeds o[ sale. I (or we) agree to accept all re- sponsibility for providing merchantable title to all goods, merchandise, and/or property sold, and for delivery of title to the purchaser. ,. Auct~t~er or Cast~ie~ s~signa~f~ (Seller's Signature) "< /'~ " (Seller's Signature) MAY-10-2004 23:27 PMCBAMK 412 768 ~458 P.01×01 PNCBAN( May I1, 2004 RiehardL. Webbe~ k.,Esqu~e 126Ea~King S~e~ Shippensburg, PA 1725%1397 Estate of Gordon D. Rand, deceased $SN: 190-16-9389 DOD: 1/17/2004 Dear Mr. Webber:. In response to your request for Date of Death balances for the customer noted above, our records show the following: Certificates of Deposit Account #21001053225 GORDON D KAlqD DOD balance: $10,670.95 + $6,12 accrued interest E~tablished 03/13/1995 Account #31600070995 GORDON D RAND DOD balance: $6,165,51 + $1.20 accrued interest Established 01/07/1997 Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bantr branch office. $mcerely, Rachelle Wells 1-800-762-1775 PT-PFSC-04-F 500 first Ave. Pittsburgh PA 15219 Member FDIC TOTAL P.O1 AMERICA'S CREDIT UNIONS' TETCO EMPLOYEES FEDERAL CREDIT UNION P.O. BOX 534 · WEST CHESTER, PA 19381-0534 Phone (610) 430-0866 Fax (610) 431-2165 April 6, 2004 APR. 8 200Ji Richard L. Webber, Jr., Esquire Weigle & Associates, P.C. 126 East King Street Shippensburg, PA 17257-1397 Re: Estate of Gordon D. Rand, Deceased Dear Mr. Webber: The following is the information you requested regarding the savings account with us of the deceased, Gordon D. Rand. This was a savings account in the name of Gordon D. Rand only. It was not a joint account. The account Number 99 was opened on August 5th, 1955. 2. There is no safe deposit box. The balance in the account as of the date of death, January 17th, 2004 was $1,375.97. The accrued interest as of that date was .63. There will be a quarterly dividend posted to this account as of March 31st, 2004. We do provide our members with a Life Savings Insurance and we will file a claim for this now that we have finally received the requested death certificate. The maximum amount is $3,000.00 but that will be determined by the insurance company and is based on the balance in the account on certain age dates. We will send out a check for the balance to close the account as requested by Norman Rand after the dividend posting. Sincerely, Robert A. Shoff~) Treasurer Where people are worth more than monej~. - March 18, 2003 Weigle & Associates Law Offices 126 East King Street Shippensburg, PA 17257-1397 TRUST RE: GORDON D. RAND Gentlemen: In reference to the above customer, our records show the enclosed information to be accurate. Our researching fee for the information we have provided is $ 15.00. Please send your remittance to the following address: Farmers and Merchants Trust Company ATTN Stacey Stenger 20 South Main Street Chambersburg, PA 17201-0819 =ur~h=~ assistance ease ~ ~ ~ m~ If I may be of any ~' ~ ~ '' pl , c~n~a~,_ Sincerely, Stace!k/A. Stenger ~' Data Operations Supervisor P.O. Box 6010, CHAMBERSBURG, PA 17201-6010 Phone 717-264-6116 · Toll-Free 888-264-6116 · Fax 717-264-3415 RE: GORDON D. RAND DATE OF DEATH 1-17-04 ACCOUNT INFORMATION X CHECKING SAFE DEPOSIT __SAVINGS __CERTIFICATE OF DEPOSIT __SHARES OF STOCK DATE OPENED 10-31-1996 DATE CLOSED ACCOUNT NUMBER 33-06194 ACCOUNT BALANCE AT DATE OF DEATH $705.21 ACCRUED INTEREST TOTAL ACCOUNT BALANCE NAME(S) ON ACCOUNT REGISTRATION OF ACCOUNT STILL ACTIVE NON-INTEREST BEARING ACCOUNT $705.21 GORDON D. RAND , WAYNE S. RAND JOINT WITH SURVIVORSHIP ACCOUNT INFORMATION X CHECKING __SAFE DEPOSIT __SAVINGS CERTIFICATE OF DEPOSIT __SHARES OF STOCK DATE OPENED 11-1-1996 ACCOUNT NUMBER 33-07190 ACCOUNT BALANCE AT DATE OF DEATH ACCRUED INTEREST $.74 TOTAL ACCOUNT BALANCE $21,540.73 NAME(S) ON ACCOUNT GORDON D. RAND REGISTRATION OF ACCOUNT DATE CLOSED STILL ACTIVE $21,539.99 INDIVIDUAL ACCOUNT ACCOUNT INFORMATION RE: GORDON D. RAND DATE OF DEATH 1-17-04 CHECKING X SAFE DEPOSIT __SAVINGS CERTIFICATE OF DEPOSIT SHARES OF STOCK DATE OPENED 6-28-1987 DATE CLOSED ACCOUNT NUMBER 15-617 ACCOUNT BALANCE AT DATE OF DEATH -0- ACCRUED INTEREST TOTAL ACCOUNT BALANCE -0- NAME(S) ON ACCOUNT REGISTRATION OF ACCOUNT STILL ACTIVE NON-INTEREST BEARING ACCOUNT GORDON D. RAND , CORA W. RAND JOINT WITH SURVIVORSHIP ACCOUNT INFORMATION CHECKING SAFE DEPOSIT SAVINGS X CERTIFICATE OF DEPOSIT SHARES OF STOCK DATE OPENED 9-4-1997 ACCOUNT NUMBER 015-2955873 ACCOUNT BALANCE AT DATE OF DEATH ACCRUED INTEREST $2.55 TOTAL ACCOUNT BALANCE $2,466.81 NAME(S) ON ACCOUNT GORDON D. R3kND REGISTRATION OF ACCOUNT DATE CLOSED STILL ACTIVE $2,464.26 INDIVIDUAL ACCOUNT SAFE DEPOSIT BOX INVENTORY INstRUCTIONS (I) Cash: Report total only. (2) Stocks: Ust in detail every common or preferred certificate, warrant or other fights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and dass of stock. (;3) Obligations af U. S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) ' (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, otc: Ust and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. ITEM DESCRIPTION IV~ne i'Vonc, )ne_. ~Jon ~- I~,lon ~. CID 5'oc~b. / I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. PRINT NAME CHd cr PRINT TITLE PERSON RECEIVING COPY OF SAFE DEPOSIT BOX INVENTORY: SIGNATURE CHECK APPROPRIATE BOX: ~Executor (trixJ. [~] Aclmirlislrator (t rix) E]Eslate Represenlative [] Joint owner of safe d~po$i! box / GARY 'L. MENTZER Audioneefing Service AU-1628-L Complete Sale Services Tent Rentals 505 Shippensburg Road Newville, PA 17241 (717) 776-7447 .Pmrmonal Property Appraisal Date ~-- o~O~,'~ Thi.s appraisal is made for the oWner, or agent of owner, of the item(s) listed herein for'the purpose of:... Owner/Agent. '~'~,~,~'-~-~.~-n~. Address: ~ City: ~ ~~ .... Zip ...... Phone (~/~,, ,, As appraiser(s), I/We assume the item(s) listed herein to be authentic, and based upon that assumption, I/We am/are of the opinion that curr. ent fair market value is: Lot No. Quantity Description of Item(s) Value '-- Date On this date I/We have personally inspected and appraised the Item(s) listed herein and the price(s) given represent my/our opinion of current fair market value. The undersigned appraiser(s) make(s) no warranty as to the authenticity, origin, condition, provenance or quality of any item listed and evaluated herein. This estimate of value must not be considered an offer to buy or sell any Item(s) listed. Further, ap- pral.se_r(?).do(es) not have present or contemplated Interest In any Items herein listed. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX{11-96) CD 004097 WEBBER RICHARD L JR 126 EAST KING STREET SHIPPENSBURG, PA 17257 ........ fold ESTATE INFORMATION: SSN.' 190-16-9389 FILE NUMBER: 2104-0227 DECEDENT NAME: RAND GORDON D DATE OF PAYMENT: 06/29/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01 / 1 7/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $344.20 TOTAL AMOUNT PAID: $344.20 REMARKS: NORMAN S RAND, EXECT. SEAL CHECK# 16 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 004097 WEBBER RICHARD L JR 126 EAST KING STREET SHIPPENSBURG, PA 17257 ........ fold ESTATE INFORMATION: SSN.' 190-16-9389 FILE NUMBER: 2104-0227 DECEDENT NAME: RAND GORDON D DATE OF PAYMENT: 06/29/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/17/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $344.20 TOTAL AMOUNT PAID: $344.2O REMARKS' NORMAN S RAND, EXECT. SEAL CHECK# 16 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PETITION FOR PROBATE and GRANT OF LETTERS Estate of Gordon D. Rand No. also known as To: · Deceased. Social Security No. 190-16-9389 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 or in the last wilt of the above decedent, dated May 16 and codicil(s) dated in the named ,1975 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in. Cumberland County, Pennsylvania, with last'family or principal residence at 10 McF. a~rland Street, Newv±lle ~B6rough (list street, number and muncipality) Decendent, then 88 years of age, died January 17 ,12~[ 200/-+, at Green Ridge Village. Newv~lle, PA (Cumberland County) 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 ~S married to Cora W. Rand, 3She dies on July 20, 1994 Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 45 ~ 000.00 (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 request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters. theron. (testamentary; administration c.t.a.~_~li~inistration d.b.n.c.t.a.) Norman S. Rand 2837 Keller Road St. Thommm, PA 17757 OATH OF PERSONAL REPRESENTATIVE COMMONWEALT~I OF PENNSYLVANIA COUNTY OF I~o,x,~a ~ co._~,~ f 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 represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirn~and subscribedf before me this ~rY~ r~ ~C~ c:,~OOI4~ 1~day°f Estate Of Gordan D. Rand , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated May 16, 1975 described therein be admitted to probate and filed of record as the last will of and Letters Testamentary , in consideration of the petition on Gordon D, Rand are hereby granted to Norman S. Rand FEES Probate, Letters, Etc .......... StO~. CY, D Short CertifiCates( ) .......... $ q.~ Renunciation ................ $ TOTAL __ $ qq .cx-~ Filed . .3 -. ¢2 .-.~.q: ................ R±chard L. Webber, Jr., ID//49634 ATTORNEY (Sup. Ct. I.D. No.) 126 East' K-lng Street Sh±ppensburg. PA 17257 ADDRESS (717) 532-7388 PHONE I05.805 REV 9/86 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. 88 Cumberland Fee for this certificate, $2.00 P 9990553 No. Gordon D. Rand 1915 West Pennsboro PetroliumPi Local Registrar k.~ JAN 2 0 2004 Date COMMONWEALTH OF PENNSYLVANIA · OEPARTMENT OF HEALTH · VITAL RECORDS ~ ~i: O? ~:~ CERTIFICATE OF DEATH ~3 ::7. ~ -" 10 McFarland St Newville PA 17241 )land G. Rand ~'""' ~'~"~* .... ' ,W..hi te ,7.. s~,. PA Cumberland ~? lsohlm le PA 17241 '~/'inger Crematory gs PA 17065 D 13895 L ............................................................. · .~.?e, aM place, ~ due to the c.u~e($) ar~ ,..[3,.[3 REGISTER OF WILLS OF Xx COUNTY OATH O~~BING WITN~xx "~~' codicil ~N_ x~ , (each) a subscrib'mg~ness to the win presented_here*4~, (each) being duly qualified a~rding to law, depose(s) and say(s hat \ present d saw ;) and say(~q~N N, presentXsaw, the testat , sign the san~and that N.. signed a as witness at tNMi reqtl~ of testat in h "'i~resence and (in the presence of ~aX'eh~in the presence of the\ other su~,~ng witness(es)). '~'". ~ Sworn to or a~"~tmed and subscribed befor~'.,~ x,,\, me this '~. day of ~'~.,~ (Name) N~ '~'~, 19 ,,~ ,~ N~ Register ~"~"~N (Add ress) ~ (Name) (Address) OF WILLS OF OATH OF NON-SUBSCRIBING WITNESS COUNTY (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that he is ' familiar with th~ signature of Gordon D. Rand , testator of (¢lI~x~ll ~ ' _11OI the will presented herewith and codicil that he believes the signature on the will is in the handwriting of Gordon'D. Rand to the best of hi.q Sworn to or affirmed and subscribed before me this ~fc¥,, day of ~q~c,~- c~, Zo-~q . ~ · knowledge and belieL (Address) I, GORDON D. RAND, of the Borough of Newville, Cumberland County, Pennsylvania, declare this to be my last will and testament and revoke all wills which I have previously made. I - I give, devise and bequeath my entire estate, real and personal, unto my wife, Cora W. Rand, absolutely and in fee simple if she shall survive me. II If my wife, Cora W. Rand, fails to survive me, I give, devise and bequeath my entire estate, real and personal, unto my issue per stirpes, absolutely and in fee simple. III - Any share of my estate which shall become distri- butable to a minor shall be held by The First National Bank of Newville, Pennsylvania, in a savings or other account in the name of the minor, as may be convenient, until the minor attains the age of 18 years. IV - I appoint my wife, Cora W. Rand, as executrix of this will. If for any reason she shall fail to qualify or cease to act as such during the administration of my estate I appoint my son, Norman S. Rand as substituted executor; if for any reason he shall fail to qualify or cease to act as such during the administratim of my estate I appoint my son, David F. Rand as alternate executor. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /~,/~'. day of ,/'/'///t ,~/' , 1975. Signed, sealed, published and declared by Gordon D. Rand, testator above named, as and for his last will and testament, written on one sheet of paper, in our presence, who, in his presence, at his (~ EAL) GORDON D. RAND, LATE OF TOWNSHIP OF NEWVILLE BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : ESTATE NUMBER 2004-00227 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedem: Gordon D. Rand Date of Death: January 17, 2004 Will No. 2004-00227 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on March 18, 2004: Norman Stuart Rand 2837 Keller Road St. Thomas, PA 17252 David Foster Rand 38 Parsonage Street Newville, PA 17241 Wayne Steven Rand 10 McFarland Street Newville, PA 17241 William James Rand, Sr. 838 Shed Road Newville, PA 17241 ~.Date: Notice has now been given to all persons entitled thereto under Rule 5.6(a). Signature Name: Address: Richard L. Webber, Jr., Esquire Weigle & Associates, P.C. 126 East King Street Shippensburg, PA 17257 Telephone: (717) 532-7388 Capacity: Personal Representative X Counsel for Personal Representative BUREAU OF INDIVIDUAL TAXES TNHERZTANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF /NHER1.TANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCT1.0NS AND ASSESSHENT OF TAX REV-1547 EX 4FP (01-05) RICHARD L WEBBER JR ESQ WEIGLE 8 ASSOCS 126 E KING ST SHIPPENSBURG PA 17257 DATE 08-25-200~ ESTATE OF RAND DATE OF DEATH 01-17-200~ FZLE NUMBER 21 O~-OZZ7 COUNTY CUMBERLAND ACN 101 Amount GORDON MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIs LCl'~IE ia RETAIN LOWER PORTION FOR YOUR RECORDS *~ ~-E-V'-'~-7-~-~'~-I--'~'~-~)~r-ZCE OF "rNHERZTANCE TAX APPRATSEMENT, ALLOWANCE OR :, ~c ~SALLOWANCE OF DEDUCT/ONS AND ASSESSMENT OF TAX ESTATE 0~: ~_RAND ~;T ::::- ~ GORDON D FILE NO. 21 0~-0227 ACN 101 DATE :.)~x RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED 08-2~-200~ RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON.' ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2} $. CloseZy Held S~ock/Partnership Tntares~ (Schedule C) ($) ~. Hortgagos/Notos Recoivablo (Schedule D) (q) E. Cash/Bank Daposits/Hisc. Personal Proper~y (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schodule G) (7) B. Total Assets APPROVED DEDUCTTONS AND EXEMPTIONS: 9. Funeral Expensos/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Deb~cs/Hortgage Liabilities/Liens (ScheduZe 1) (10) 11. Total Deductions 12. Nat Value of Tax Return ~6~857.87 $52.61 .00 NOTE: To insure proper .00 credit ~o your account, .00 submit the upper portion .00 of this form with your tax payment. .O0 (8) $,59~.00 ~7,210.~,8 1~. NOTE: 879.88 (11) ~ .~73.88 (~2) q2,756.60 .00 ~2,756.60 18 and 19 will Charitable/Governmental Bequests; Non-alectod 9115 Trusts (Schedule J) (15) Ne~ Value of Estate Subject to Tax (lq) Tf an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, reflect ~:igures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 1~ at Spousal rate 16. Amount of Line 1~ taxable at Lineal/Class A rate 17. Amount of Line 1~ at Slbling rate 18. Amount of Llno 1~ ~axabla at Collateral/Class B rata 19. Principal Tax Duo TAX CREDITS: PAYHENT RECEIPT DISCOUNT DATE NUHBER /NTEREST/PEN PA/D (-) 0~-19-200~ CD00~859 .00 06-29-200~ CD00~097 .00 PAYMENT MUST BE MADE BY 10-17-200q~. (x$). .00 x O0 = .00 (~6). ~2,756.60 x 0~5= 1,925.15 (17). . O0 x 12 = . O0 (z8) .00 x 15 = .00 (19)= 1,92:~. 15 AHOUNT PAID ZF PA1.D AFTER DATE 1.ND1.CATED, SEE REVERSE FOR CALCULATZON OF ADD1.T1.0NAL 1.NTEREST. 1,500.00 $~.20 TOTAL TAX CREDIT BALANCE OF TAX DUEJ INTEREST AND PEN. TOTAL DUE 78.95 .00 78.95 ( ZF TOTAL DUE TS LESS THAN $1., NO PAYHENT 1.S REI;)UI'RED. 'rF TOTAL DUE 'rs REFLECTED AS A -CREDTT" {CR), YOU HAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORH FOR TNSTRUCT'rONS.) RESERVATION: Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class D (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Coeeenamalth 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: PAYHENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Zl~O of the Inheritance and Estate Tax Act, Act Z~ of ZOO0. (72 P.S. Section 91~0). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-lB13). Applications are available et the Office of the Register of Hills, any of the Z3 Revenue District Offices, or by calling the special Z~-hour answering service for forms ordering: 1-800-362-ZOS0; services for taxpayers with special hearing and / or speaking needs: 1-800-~qT-5OZO (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Doard of Appeals, Dept. 2810Z1, 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 assessment 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) 767-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) 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 (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 1D, 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 would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 19D2 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .00016~. All taxes which became delinquent on and after January 1, 19BI 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 198Z through 200~ ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ lOX .0005~8 ~'~'~-6-1991 11Z °000301 ~ 92 .0002~7 1983 Z6Z .000~38 1992 9Z .0002~7 ZOOZ 62 ,OOOl6~ 196~ llZ .000301 1993-199~ 7Z .00019Z 2003 5Z .000137 1985 132 .000556 1995-1996 9Z ,O00Z~7 ZO0~ ~Z .O00110 1986 /OZ .O00Z7~ 1999 72 .OOOlgZ 1987 1Gl .O00Z7~ ZOO0 7Z .OOOIgZ --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY 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. BUREAU OF INDIVIDUAL TAXES ZNHERI'TANCE TAX DI'V'rSTON DEPT. Z80601 HARRTSBURG, PA 171Z8-0601 COHMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT RICHARD L WEBBER JR ESQ WEIGLE & ASSOCS 126 E KING ST SHIPPENSBURG PA 17257 DATE 08-$O-ZOOq ~STATE OF RAND DATE OF DEATH 01-17-ZOOq FILE NUMBER Z1 0~-0227 ~g~CI~NTY CUMBERLAND101 Amoun'~ Remi'l:'~ed REV-I$07 EX AFP (01-0~;) GORDON D MAKE CHECK PAYABLE AND REMXT PAYMENT TO: REGISTER OF NTLLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credl~ ~o your account, subm/~ ~ho upper portion of ~his form wJ~h your ~ax payment. CUT ALONG THZS LINE ~ RETA'rN LONER PORTZON FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) #~ ZNHER'rTANCE TAX STATEMENT OF ACCOUNT ~ ESTATE OF RAND GORDON D FZLE NO. 21 0~-0227 ACN 101 DATE 08-30-200q THZS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHO#N BELO# ZSA SUHNARY OF THE PRZNC*rpAL TAX DUE, APPL'rCATZON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FZGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTMENT: 08-Z3-200~ PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 1,923.15 PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 78.95 Oq-17-ZOOq 06-29-200q CD003839 CDOOq097 .00 1,500.00 3qq.20 IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL ZNTEREST. ( ZF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A 'CRED/T' TOTAL TAX CRED'rT 1,923.15 BALANCE OF TAX DUE .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR TNSTRUCTTONS. ) REGISTER OF WILLS, CUMBERLAND CO~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: GORDON D. RAND Date of Death: JANUARY 17, 2004 Will No. 2004-00227 .% '04 SEP 21 P2._.1 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: State whether administration of the estate is complete: Yes ~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: N/A 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative,s account is: N/A c. Did the personal representative state an account informally to' the parties in interest? Yes x No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk'of the Orphans' Court and may be attached to this report. Date: 9/20/ 04 .. LJ~. ~-- y Signabure Richard L. Webber, Jr., Esquire Name (Please type or print) WEIGLE . & ASSOCIA_TES, _ p. C · '12-6' East King Street Address Shippensburg, PA .(717 ) 532-7388 Tel. No. 17257 (MAH: rmf/AM3) Capacity: X Personal Representative __Counsel for personal representative