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HomeMy WebLinkAbout03-0747PETITION FOR PROBATE and GRANT OF LETTERS Estate of RICI-LARD B. ZllV~{ERM-AN No. also known as To: Register of Wills for the , Deceased. County of Cumberland in the Social Security No. 167-36-2418 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older ~~Iy beneficiary named in the last wilt of the above decedent, dated September 27 ,19. 72 and codicil(s) dated None ~ and being the nominee of MST Bank~ successor to Dauphin Deposit Trust Co~ per Renunciation filed herewith. It is further ~uEge.qtmd Eth~.] M Zimmmrmmn.. wife of decedent, died on September 21~ 1997. (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with is last family or principal residence at 770 S, Hanover Street, Borough of Carlisle (list street, number and muncipality) Decendent, then__ 91 years of age, died August 26, 200,3312j.__, at Borough of Carlisle, C,mherland County, Pennsylvania 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: None 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: Unestimated None WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters of adminJ serari on c~m to.qr~mento anno_xo. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. Judith ~. Zimmerman March 1223 Pin Oak Drive Mmnhnnic.qburE: PA 17055 OATH OF'PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF 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 affirmed and subscribed Q~Agl¢~C~ ff)~.~4~ before me this //*'// day of ~ g -Judith 1~. Z±nnnerman March- September ' ~ 2003~ Estate Of No. .x9../-~.9~- 7,%/'7 RICHARD B. ZIMMERMAN , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW September // xl~fled!fl0.3_, 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 27, 1972 described therein be admitted to probate and filed of record as the last will of Richard B. Zimmerman . and Letters of Administration Cum Testamento Annexo are hereby granted to Judith M. Zimmerman March FEES Probate, Letters, Etc. ShdrtCertificates( ) .......... Renunciation ................ TOTAL Filed {,~ ~,~.. Ri ak r'~ O ' 44 West Main Street Mechanicsburg, PA 17055-0318 ADDRESS (717) 697-8528 PHONE RENUNCIATION In Re Estate of RICHARD B. ZIMMERMAN deceased. Tothe RegisterofWillsof Cumberland County, Pennsylvania. M & T Bank, successor to Dauphin Deposit Trust The undersigned Company, the executor named in the Last Will and Testament of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters of Administration Cum Testamento Annexo be issued to Judith M. March (nee Judith M. Zimmerman WITNESS our hand this day of September ,1~ 2003 M ~ T ~AN~, ~cces~,~ to ~y'fjr DEPOSIT TRUST/COI~ / r ~/z/ ~/~ ~ '/ (Signat~] fi' (Address) (Signature) (Address) (Signature) (Address) REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that present and saw the testat request of testat__ other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19.__ , sign the same and that signed as a witness at the in h presence and (in the presence of each other) (in the presence of the Register (Name) (Address) (Name) (Address) REGISTER OF WILLS OF Ctr~ERLA~ COUNTY OATH OF NON-SUBSCRIBING WITNESS Judith M. March and Kenneth E. March (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that each is familiar with the signature of Richard B. Zimmerman , testator of ( ffaggi~ to) the will presented herewith and that each believes the signature on the will is in the handwriting of Richard B. Zimmerman to the best of Sworn to or affirmed and subscribed before me this day of September ~9 2003 their knowledge and belief. 6/ Judith..M. Ma~ch t~vame) 1223 Pin Oak Drive, Mechan±csburg, Register Kenneth E~ March (Name) 1233 Big Oak Drive, Mechanicsburg (Address) PA 17055 PA 17055 his is to certify that the information here given is correctly copied from an original certificate of death duly filed ~vith 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/~;. No. ~ Date HmS ~43 Rev 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH STATE FILE NUMBER · NAME OF DECEDENT {First. M~ldle. Last) SEX SOCIAL SECURITY NUMBER I DATE OF DF-ATH {Mo~th. Day Year) · 4. Richard Bowman Zimmerman [= Male 3167 -36 - 2418 14August 26, 2003 ~JAGE{kaslB~-thday) I UNDERIYEAR ~ UNDERI~AY DATE OF BIRTH BIRTHPLACE (City and p'LACE OF DEATH Ch~,cko~'dvone-see nsU1Jcfionso~,;l~r~.]9 ' ~'~ I M~th$ [Days~ Hours ] Minutes I (Month. Day. Year) I Stale (x F~e~gn C,~Jnlly) I HOSPITAJ.; I aT.ER: Y,s I I I I Is. 3/ 0/1012 I,.Penbrook,PA I:"'"'l-I De. U1 ~ COUNTY OF DEATH I CITY. BORO, TWP OF DEATH I FACILITY NAME (if not i~UleUon, give s~eet and number) IWAS~ECEDENT OF HIBI'~ANIC ORIGIN? IR~CE - Am.,~. ~'-., No Yes if yes sPeOfy Cuban (Specify) ~.. Cumberland lB,Carlisle I.Chapel Pointe IM:'~.P"e~R"":o~. ' White '=~ ' ' ' ~ ' I~, I DECEDEN'rS USUAL OCCUPATION ,a. Supervisor I AS DECEDENT EVER IN DECEDENT'S EDUCATION I KIND OF BUSINESS / INDUSTRY IU~wA'S' AR%~ED FORCES? [[ (Se~ty Dray ~,~...t ~ ~)~IT~ STA~S - Mafia, SURV~ ~5E I Postal Se~ce [ ~"~ No~ [ 1~,~, c ..... ' I'~ (S~) · pz I'- . W~dOW~ ~s. DECEDENTS MAILING ADDRESS (Stmel. City/Town, Stale. Zip Code) I DECEDENT*S ACTUAL 770 S. Hanover St. ]RES,DENCE Carlisle, PA 17013 (s,.~,,~,, Dewitt C. Zimmerman p .1 ~.enns~.van~.a o~ ,ye. [] Yes. decedent ,red ~ ~ 1731. Slete decedent bye ~ a 'Tbc~..~rland ,~? 17d~ NO'~""'~" ~rlisle MOTHER'S NAME First, Middle Maiden Surname) ~s. Anna H. Bowman INFORI~i%.N]~S MAILJ _NG ADDRESS LStreet. City/Town. State. ~.o Code) 2Ob. /40-J Walnut Fores[ Rd., Winston-Salem~ NC 27103 I PLACE OF DISPOSITION- Name of Dee~elerf, Crematc~* I LOCATION - CRy/Town Stele. F-ko Code ,~:%'h~gl'a. ntown Gap Nat'l Cern ,,,.Annville, PA 17003 INFORMAN'PS NAME (Type/Print) 20,. Richard W. Zimmerman . METHOD OF DISPOSl DATE OF DISPOSITION Donation [] Burial ~-~emalJon E]Removal from S~ ~ (~. Y ~ SIG~TUR RVI E OR PERSON ACTING ~ SUCH LICEN E NUM R N~E ~O ~DRESS OF F~tLI~ ~_ ~ ~ta *~ 23a~ ~ ~ ceding [ To ~e ~st ol my ~e. dee~ ~ at~e fi~e. ~le a~ ~ce s~led. LICENSE NUMBER DATE SIGNED 1 ~mnis~tavailab~att~eo~dea~to I (~nature~d~e) I/ . ./I ~' t n - I ~ / ~ ~ Ot ~i ~ (~ Oly YIU) CAUSE WAS AN AUTOPSY I WERE AUTOPSY FINDINGS I MANNER OF DEATH P~RFORMED? I AVAILABLE PRIOR TO I OF DEATH? Accident[] Pendt~g thveaflGa~,k~ NmE ~D ~"ESS OF PER~. WHO COMPLETED ~USE OF O~m DATE FILED (Month. Day. Year) ,,, ~ -~ I, RICHARD B. ZIMMERMAN~ of Susquehanna Township, Dauphin County, Pennsylvania, being of sound mind, memory and understand- ing, do make and publish this my Last Will and Testament hereby revoking and making void all former wills by me at any time here- tofore made. ITEM 1. I order and direct that all my just debts and funeral expenses be fully paid and satisfied by my Executrix hereinafter named as soon as conveniently may be after my de- cease. ITEM 2. I give, devise and bequeath all the rest, residue and remainder of my estate~ real, personal and mixed, whatso- ever and wheresoever~ to my wife, ETHEL M. ZIMMERMAN, absolutely. ITEM 3. In the event that my said wife, ETHEL M. ZIMMER- MAN, predeceases me then I give, devise and bequeath the said rest, residue and remainder of my estate~ real, personal and mixed, whatsoever and wheresoever to my children~ RICHARD W. ZIMMERMAN, THOMAS E. ZIMMERMAN, and JUDITH M. ZIMMERMAN~ equally, share and share alike. ITEM 4. My Executrix hereinafter named shall have the full power and authority to sell any and all personal property and real estate belonging to my estate at the time of my death, including the power to lease the real estate for such length of time as shy may deem wise and beneficial for the best interests of my estate. ITEM 5. I hereby nominate, constitute and appoint my wife, ETHEL M. ZIMMERMAN, as Executrix, and in the event she prede- ceases me, then I nominate, constitute and appoint the DAUPHIN DEPOSIT TRUST COMPANY, of Harrisburg, Pennsylvania, as Executor - 1 - of this my Last Will and Testament. IN WITNESS WHEREOF, I, RICHARD B. ZIMMERMAN, have to this my Last Will and Testament set my hand and seal this ~~ day Signed, sealed, published and declared by RICHARD B. ZIMMERMAN, the Testator above named, as and for his Last Will and Testament, in the presence of us who, in his presence, at his request, and in the presence of each other, have here- unto set our names as witnesses. ) ) ) ) ......... ~ ) ) ) ) ) ) ) ) ) ) ) (SEAL) - 2 - 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 003241 SNELBAKER BRENNEMAN & SPARE PC 44 WEST MAIN STREET MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 167-36-2418 FILE NUMBER: 21 03-0747 DECEDENT NAME: ZIMMERMAN RICHARD B DATE OF PAYMENT: 11/17/2003 POSTMARK DATE: 11/17/2003 COUNTY: CUMBERLAND DATE OF DEATH: 08/26/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,800.00 TOTAL AMOUNT PAID: $1,800.00 REMARKS: JUDITH MZIMMERMAN MARCH C/O SNELBAKER BRENNEMAN SPARE SEAL CHECK//102 INITIALS: SK RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: No. 2003-00747 Richard B. Zimmerman, Deceased August 26, 2003 PA No. 2103-0747 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 or about September 15, 2003: Nanle Judith M. Zimmerman March Address 1223 Pin Oak Drive Mechanicsburg, PA 17055 Richard W. Zimmerman 740-J Walnut Forest Road Winston-Salem, NC 27103 Thomas E. Zimmerman 2404 Burcham Drive East Lansing, MI 48823 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE. Date: September15, 2003 ~~ ~ ~ ,/~; aker, Esquire 44 West Main Street Mechanicsburg, PA 17055-0318 (717) 697-8528 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BLiREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-11 62 EX(11-96) CD 003657 ........ fold MARCH JUDITH M ZIMMERMAN 1223 PIN OAK DRIVE MECHANICSBURG, PA 17055 ESTATE INFORMATION: SSN: 167-36-2418 FILE NUMBER: 2103-0747 DECEDENT NAME: ZIMMERMAN RICHARD B DATE OF PAYMENT: 03/10/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUM BERLAN D DATE OF DEATH: 08/26/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $536.22 ~REMARKS: TOTAL AMOUNT PAID' JUDITH M ZIMMERMN MARCH HAND DELIVERED TAX PAYMENT INITIALS: SK CHECK# 107 $536.22 SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-tEO0 Ex (~oo) COMMONWEALTH OF REV-I$O0 DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN HARRISBURG, PA 17128-0601 RESIDENT DECEDENT DECECENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL) Zin~nerman, Richard B UJ DATE OF DEATH (M M-OD-YEAR) J ~ DATE OF BIRTH (MM-DD-YEAR) uJ 08/26/2003 03/30/1912 l. LI (IFAPPLICABLE) SURVIVING SPOUSE'S NAME (LAST FIRST, AND MIDDLE INITIAL) ~ , ~ Ir'X! I Original Return I ~ 2. Supplemental Return O~,~,, I Limited Estate ['---] 4a Futurelnterest Compromise (date of death a~er12.12.~2) [~ 6. Decedent Died Testate (Attach copy of Will) r-~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) OFFICe. USE ONLY 0747 NUMBER TI'~S RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER FILE NUMBER 21 -- 2003 COUNTY CODE YEAR ISOCIAL SECURITY NUMBER ! 167-36-2418 L ] 3. Remainder Return (date of death pdor to 12-13-82) r'~5. Federal Estate Tax Return Required Z Z z o i 8. Total Number of Safe Deposit Boxes ~ 9. Litigation Proceeds Received ~-~ 10. Spousal Poverty Credit (date of death between 12-31.91 and 1-1-,5) E~ 11. Election to tax under Sec. 9113(A)(A~,a~ Sc~ O) NAME COMPLETE MAILING ADDRESS Richard C. Snelbaker FIRM NAME (If Applicable) 44 West Main Street Snelbaker, Brenneman & Spare, P.C. P.O. Box 318 TELEPHONE NUMBER Mechanicsburg, PA 17055 717-697-8528 1. Real Estate (Schedu~ A) (1) 0,00 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4 Mortgages & Notes Receivable (Schedule D) (4) 0.001 5. Cash, Bank Deposits & Miscellaneous Personal Property ;':: (Schedule E) (5) 55,315.4i' 6. Jointly Owned Property (Schedule F) [] Separate Billing Requested (6) 0.00 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 0.01~ii' (Schedule G or L) 8 Total 6ross Assets (total Lines 1-7) (8) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 2,833.75 10. Debts of Decedent, Mortgage Liabilities, & Liens(Schedule I) (10) 725. 5? 11. Total Deductions (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Beq uests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUC~ONS ON REVF,.~,.~E SIDE FOR APPLICABLE RATES O( 0. OFFKT, IAL USE ONLY 57,475.33 3,559.32 53,916.01 0.00 53,916.01 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16 Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 0.00 x.00 (15) 0.00 53,916.01 x.045 (18) 2,426.22 0.00 x.12 (17) 0.00 0,00 x .15 (18) 0.00 20 ~] (19) 2,426.22 2W4645 1.000 · Decedent's Complete Address: k Ha__._~_~ve._~ Stree_______~ Boro, Cumberland LCarlisle Cry Tax Payments and Credits: I ~7013 Tax Due (Page 1 Line 19) Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 1,800.00 90.00 0.00 0.00 Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (1) 2,426.22 lr890.00 (3) 0.00 (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 536.22 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 536.22 ~ ................ .,.. ............................................... ~,a..,.k.....e....,.C,...h..e..c..~ ~f~y~le to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................... ['~ b. retain the right to designate who shall use the property transferred or its income; ......... E~ ~_ c. retain a reversionary interest; or ................................ [----] d. receive the promise for life of either payments, benefits or care7 2. if death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................ r~l [] 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 des gnation? . . IF THE ANSWER TO ANY OF THE ABOVE QUEStIOnS I~ ~Si fOb b~T'Cb~L~fE'S~Eb0L'E'G'A~ ;ll'E'lf A~-PART ~;HE RETURN Under penalties of perjury, I declare that I have exam ned 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 th an the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN % ' ' DATE ____~anicsburg, PA 17055 ADDRES~44~st Main Street P.O. Box 318 Mechanicsburg, PA 17055 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 PS. § 9916 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfem to or for the use of the surviving spouse is 0% [72 P.S. § 9116 (a) (1.1) (ii)] The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate im posed 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. 2W4646 1000 , REV-1503 BX + (1-97) COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS Zimmerman, Richard B FILE NUMBER 21-2003-0747 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBEF DESCRIPTION MetLife, Inc., 76 shares of c~.._.~_:on stock, valued at share VALUE AT DATE OF DEATH 2,159.92 TOTAL (Also enter on line 2, Recapitulation) $ 2,159.92 2W4696 3000 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENTDECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Zimtaerman, R.i-chard B FILE NUMBER 21-2003-0747 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. ITE~ VALUEATDA~ DESCRIPTION OFDEATH Chapel Pointe, refund on resident care 5,151.07 M&T Bank, checking account # 950227153 50,164.34 2W46AD 2.000 TOTAL(Also enter on line (If more space is needed, insert additional sheets of the same size) 55,315.41 , REV-1511 E~+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Zim~erman, Richard B FILENUMBER 21-2003-0747 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. 1. 5. 6. 7. 10 FUNERAL EXPENSES: Hetrick Funeral Home, DESCRIPTION Inc., funeral services 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: Attorney Fees Name: Snelbaker, Brenneman & Spare Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address State ~ Zip City Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Cumberland Law Journal, advertising Administratrix notice Patriot-News, advertising Administratrix notice Cumberland County Register of Wills, filing fee for Inheritance Tax Return AMOUNT 160.20 Reserve for filing fees, accounting costs and other miscellaneous costs associated with the administration of Decedent,s estate TOTAL (Aisc enter on line 9, Reca 2W46AG 2000 (if more space is needed, insert additional sheets of same size) 0.00 1,850.00 0.00 110.00 0.00 0.00 75.00 123.55 15.00 500.00 $ 2,833.75 REV-1512 EX + (1~97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN F~SIDENTDECEDENT ESTATE OF SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES,& LIENS Zim~erman, Richard B FILENUMBER 21-2003-0747 Include unreimbursed medical expenses. ITEM NUMBEF DESCRIPTION 1. Central Penn Medical Center, medical expense 20mnicare Pharmacies of Pennsylvania East, LLC, medical expense 3 Belvedere Medical Corp., medical expense 4 Andorra Radiology Assoc, PC, medical expense 5 Mobile X-Ray Imaging, Inc., medical expense 6 Quantum Imaging & Therapeutic, medical expenses 7 Cumberland Goodwill Fire Rescue, ambulance service 8 West Shore EMS, ambulance service 9 PhilHaven, medical expense 10 Carlisle Regional Medical Center, medical expense 11 Pinker & Associates, m~dical expense AMOUNT 28.40 266.75 9.77 8.39 86.82 2.26 72.94 72.71 24.57 138.64 14.32 TOTAL (Also enter on line 10,___.~ 2W46AH 2.000 (If more space is needed, insert additional sheets of the same size) 725.57 ' REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Z inm~.~ NUMBER I. 3 man, Richard B NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLEDISTRIBUTIONS[includeoutrights~usaldistributions, andtran~ers underSec. 9116(a)(l.2)] Zim~erman, Richard W 740-J Walnut Forest Road Winston-Salem, NC 27103 Zim~erman, Thomas E 2404 BurchamDrive East Lansing, MI 48823 FILE NUMBER 21-2003-0747 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Son Son Zin~nerman March, Judith M 1223 Pin Oak Drive Mechanicsburg, PA 17055 Daughter AMOUNT OR SHARE OFESTATE 17,972.00 17,972.00 17,972.01 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 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 $ 0.00 2W46A11000 (If more space is needed, insert additional sheets of the same size) I, RICHARD B. ZIMMERMAN, of Susquehanna Township, Dauphin County, Pennsylvania, being of sound mind, memory and understand- ing, do make and publish this my Last Will and Testament hereby revoking and making void all former wills by me at any time here- tofore made. ITEM 1. I order and direct that all my just debts and funeral expenses be fully paid and satisfied by my Executrix hereinafter named as soon as conveniently may be after my de- cease. ITEM 2. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatso- ever and wheresoever~ to my wife~ ETHEL M. ZIMMERMAN, absolutely. ITEM 3. In the event that my said wife, ETHEL M. ZIMMER- MAN, predeceases me then I give, devise and bequeath the said rest, residue and remainder of my estate~ real, personal and mixed, whatsoever and wheresoever to my children~ RICHARD W. ZIMMERMAN~ THOMAS E. ZIMMERMAN, and JUDITH M. ZIMMERMAN, equally, share and share alike. ITEM 4. My Executrix hereinafter named shall have the full power and authority to sell any and all personal property and real estate belonging to my estate at the time of my death, including the power to lease the real estate for such length of time as shy may deem wise and beneficial for the best interests of my estate. ITEM 5. I hereby nominate, constitute and appoint my wife, ETHEL M. ZIMMERMAN, as Executrix, and in the event she prede- ceases me, then I nominate~ constitute and appoint the DAUPHIN DEPOSIT TRUST COMPANY, of Harrisburg, Pennsylvania~ as Executor - 1 - of this my Last Will and Testament. IN WITNESS WHEREOF, I, RICHARD B. ZIMMERMAN, have to this my Last Will and Testament set my hand and seal this ~~ day ? Signed, sealed, published and declared by RICHARD B. ZIMMERMAN, the Testator above named, as and for his Last Will and Testament, in the presence of us who, in his presence, at his request, and in the presence of each other, have here- unto set our names as witnesses. ( SEAL ) BUREAU OF TNDZVIDUAL TAXES TNHERTTANCE TAX DTV/STON DEPT. ZBO60l HARRISBURg, PA 17128-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-l;47 EX AFP (01-OS) ~*. DATE Oq-26-200q :?~ ESTATE OF ZIHMERHAN RICHARD B DATE OF DEATH 08-26-2005 FILE NUHBER 21 05-07q7 ~ 2~ 13t :35 COUNTY CUNaERLAND ACN 10! Amoun~ Remi~ad I HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 RICHARD C SNELBAKER '0~ SNELBAKER ETAL PO BOX 518 HECHANICSBURG CUT ALONG TH'rS L'rNE ~.~ RETA'rN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF TNHERITANCE TAX APPRAISEHENT, ALLOWANCE OR D'rSALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF ZINHERHAN RICHARD B FILE NO. 21 05-07~7 ACN 101 DATE OR-26-ZO0~ TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~a (Schedule A) (1) 2. S~ocks end Bonds (Schedule B) (2) $. Closely Held S~ock/Par~nership Zn~eres~ (Schedule C) ($) q. Mortgages/No,es Receivable (Schedule D) (~) 5. Cash/Bank Deposits/Misc. Personal Proper~y (Schadule E) (5) 6. Jointly O~ned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To~al Asse~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad~. Cos~s/M~sc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10). 11. To~al Deductions 12. Ne~ Value of Tax Re~urn Zz159.9Z .00 55~515.ql .00 .00 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion .00 of ~his fora wi~h your ~ax payment. .O0 (8) 2,855.75 725.57 13. 1~. NOTE: 57,q75.55 (11) ~ .S59. ~2 (12) 55,916.01 Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) Na~ Value of Es~a~e Subjac~ ~o Tax (1~) If an assess;ant ~as issued previously, lines 14, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amoun~ of Line 1~ a~ Spousal ra~a 16. Amoun~ of L/ne lq ~axable a~ Lineal/Class A ra~e 17. Amoun~ of L/ne lq a~ Sibling ra~e 18. Amoun~ of Line lq ~axable a~ Collateral/Class B ra~e 19. Principal Tax Due TAX CREDITS PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) 11-17-2005 CDOOSZ~I 9~.7q 05-Z0-200~ CD005657 .00 .00 55,916.01 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 18 and 19 ~ill (15) .00 X O0 = .00 (~6). 55,916.01 X Oq5= 2,~,Z6.22 (17) .00 X 1Z = .00 (18) .00 x 15 = .00 (19)= Z,qZ6.ZZ AMOUNT PAID 1,800.00 556.22 TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE 2,q50.96 q.7qCR .00 q.7qCR ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT' (CR)~ YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYNERT: REFUND (CR): OBJECTIONS: ADH/N- ISTRATIVE 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 the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appralsa and assess transfer Inheritance Taxes at the lawful Class S (collateral) rate on any such future interest. To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S. Section 91~0). Detach the top portion of this Notice and submit with your payment to tho Register of Rills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NILLS, 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-1315). Applications ara available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling tho special Zq-hour answering service for forms ordering: 1-800-~62-Z050; services for taxpayers with special hearing and / or speaking needs: 1-B00-~7-5020 (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, 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 assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Pest Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-lDO1) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the decadent's death, a five percent (52) discount of the tax paid is allowed. The 152 tax amnesty non-parti;ipation 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 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, 1982 bear interest at the rate of six (62) percent per annum calculated at a daily rate of .00016~. 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 ZO0~ are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor ~ ZOZ .0005~8 ~7'~'8 - / 991 llZ .000301 1983 16X .000q. S8 1992 92 . O00Z~,7 198~ 112 .000301 1995-199~ 7Z .000192 1985 13X .000556 1995-1998 9Z .0002~7 1986 107. .00027~ 1999 7Z .000192 1987 lex .00027~ ZOOO 7Z .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID Interest Dally Year Rate Factor ~ 9Z .O00Zfi7 2002 62 .O0016q 2005 52 .000137 ZOO~ ~Z .000110 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 tho date of the assessment. Xf payment is made after the interest computation date shown on the Notice, additional interest must be calculatmd. COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREV£NUE BUREAU OFINDIVlDUAL TAXES DEPT, 280601 HARRISBURG, PA 17128-0001 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004297 SNELBAKER RICHARD C 44 W MAIN STREET MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 167-36-2418 FILE NUMBER: 2103 - 0747 DECEDENT NAME: ZIMMERMAN RICHARD B DATE OF PAYMENT: 08/23/2004 POSTMARK DATE: 08/23/2004 COUNTY: CUMBERLAND DATE OF DEATH: 08/26/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $106.65 TOTAL AMOUNT PAID: 9106.65 REMARKS: SEAL CHECK//111 INITIALS: JA 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 O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004297 SNELBAKER RICHARD C 44 W MAIN STREET MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 167-36-2418 FILE NUM DER: 2103- 0747 DECEDENT NAME: ZIMMERMAN RICHARD B DATE OF PAYMENT: 08/23/2004 POSTMARK DATE: 08/23/2004 COUNTY: CUMBERLAND DATE OF DEATH: 08/26/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $106.65 TOTAL AMOUNT PAID: 8106.65 REMARKS: SEAL CHECK# 111 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Inventory of the real and personal estate of RICHARD B. ZIMMERMAN, Deceased PERSONALTY: 1. Metlife, Inc., 76 shares of common stock, valued at $28.42 per share 2. Chapel Pointe, refund on resident care 3. M&T Bank, checking account # 950227153 4. U.S. Treasury, refund due on 2003 Individual Income Taxes TOTAL PERSONALTY: REAL ESTATE: 1. Decedent owned no Real Estate at the time of his death TOTAL PERSONALTY AND REAL ESTATE: 2,159.92 5,151.07 50,164.34 2,347.00 59,822.33 0.00 59,822.33 Page 1 LAW OFFICES SNELI3AKER, BRENNEMAN & SPARE RECEIPT AND RELEASE WHEREAS, Richard B. Zimmerman, late of Carlisle Borough, County of Cumberland and Commonwealth of Pennsylvania, died on August 26, 2003, having first made his Last Will and Testament which was duly probated before the Register of Wills in and for said Cumberland County on September 11, 2003, and Letters of Administration were issued on the same date to, Judith M. Zimmerman March, the Administratrix C.T.A. named in the Last Will and Testament of said Decedent; and WHEREAS, said Administratrix C.T.A. has entered upon and completed her administration of said Decedent's Estate as set forth in her First and Final Account attached hereto, ancO_intends to distribute the net balance of the assets of sai'~~' Esta~ to the persons named in the Statement of Proposed Distribetion'~'ellso attached thereto, both of said documents being incorporai~~ herein by reference thereto; NOW, KNOW ALL MEN BY THESE PRESENTS, that we, Judith M. Zimmerman March, Richard W. Zimmerman and Thomas E. Zimmerman, being the principal legatees, beneficiaries and distributees named in the Will of said Decedent and the persons entitled to share in the residuary distribution of the Estate of said Decedent, do hereby declare and say that we, and each of us, have examined the attached Account and Statement of Proposed LAW OFFICES SNELI3AKER. BRENINEMAN & SPARE Distribution, and find the same to be true and correct, and in strict accordance with the terms and provisions of said Will, and we do hereby acknowledge that we, and each of us, this day have, had and received of and from Judith M. Zimmerman March, the Administratrix C.T.A. of the Estate of Richard B. Zimmerman, the cash, personalty and/or real estate set opposite our names in the above Statement of Proposed Distribution, in full satisfaction, payment and discharge of all such sum or sums of money, legacies and bequests, share or shares, purparts and dividends which were due, owing and payable and belonging to us, and each of us, by any means whatsoever, for or on account of our full share, part or dividend of the Estate of Richard B. Zimmerman, Deceased. NOW, THEREFORE, we, and each of us, the said Judith M. Zimmerman March, Richard W. Zimmerman and Thomas E. Zimmerman, do by these presents, remise, release, quit-claim and forever discharge the said Judith M. Zimmerman March, her heirs, executors and administrators, of and from our said shares or dividends of the Estate aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason thereof, or of any act, matter, cause or thing whatsoever, from the beginning of the world to the day and date of these presents. AND, desiring to avoid the delay and expense of the settlement of said Estate by filing the foregoing Account of said administration in the Office of the Register of Wills of said LAW CIFFICES SNELBaKEr, BREN NEMAN & SPAre Cumberland County and by having the balance in the hands of the Administratrix C.T.A., as shown by said Account, distributed by the Court of Common Pleas of Cumberland County - Orphans' Court Division, we, and each of us, do hereby agree that the foregoing Account and Statement concerning the matter of settlement may be recorded with the same effect upon us, and each of us, as if the same had been reported upon by said Court, in a decree of distribution made on such proposed Statement of Distribution by the said Court of Common Pleas - Orphans' Court Division. A_ND in consideration of the aforesaid settlement being made without the aid of such Court of Common Pleas - Orphans' Court Division, that we, and each of us, the said Judith M. Zimmerman March, Richard W. Zimmerman and Thomas E. Zimmerman, do hereby agree that if any debts or demands other than those included in the above referenced First and Final Account, as hereinbefore set forth, shall be hereafter recovered lawfully against the Estate of said Decedent and be legally payable out of the same, that we, and each of us, will return to the said Administratrix C.T.A. such amounts thereof as may be necessary to pay such debts or demands. We and each of us, do hereby acknowledge our understanding that the reserve amount claimed on the Final Accounting is estimated on the assumption that the Administrative Correction showing the voluntary increase of Pennsylvania Inheritance caused by the unanticipated refund paid for the 2003 Individual Income LAW OFFICES SNELBAKER, BRENNEMAN & SPARE Taxes will be accepted as presented to the Pennsylvania Department of Revenue. If that assumption proves to be incorrect, the Administratrix C.T.A. reserves the right to withdraw the accounting or amend it to reflect the then-current circumstances and has the right to request return of any said sums necessary to pay any further taxes due on said administrative correction and for all costs and expenses occasioned thereby. IN WITNESS WHEREOF, we have hereunto set our hands and seals this ~O4~ day of ~k~ 2004 WITNESSED BY: O~ 2~2/~~Z~ 2Y]~SEAL) ~ Judith'. Zimmerman~ March (SEAL) Richard W. Zimmerman (SEAL) Thomas E. Zimmerman LAW OFFICES SN eliBakEr. BRENNEMaN & Spare Taxes will be accepted as presented to the Pennsylvania Department of Revenue. If that assumption proves to be incorrect, the Administratrix C.T.A. reserves the right to withdraw the accounting or amend it to reflect the then-current circumstances and has the right to request return of any said sums necessary to pay any further taxes due on said administrative correction and for all costs and expenses occasioned thereby. IN WITNESS WHEREOF, we have hereunto set our hands and seals 2004 this day of WITNESSED BY: ( SEAL ) Judith M. Zimmerman March ~Ri ch~rd~WL2Z imme rman ( SEAL ) Thomas E. Zimmerman LAW OFFICES SNELI3AKER. BRENNEMAN & SPARE Taxes will be accepted as presented to the Pennsylvania Department of Revenue. If that assumption proves to be incorrect, the Administratrix C.T.A. reserves the right to withdraw the accounting or amend it to reflect the then-current circumstances and has the right to request return of any said sums necessary to pay any further taxes due on said administrative correction and for all costs and expenses occasioned thereby. IN WITNESS WHEREOF, we have hereunto set our hands and seals 2004 this day of WITNESSED BY: ( SEAL ) Judith M. Zimmerman March /~c~/d W. Zimmerman · ~ - (SEAL) (SEAL) ROBIN RAYCHELL SORRELLS Notary Public, Ingham Co., M! My Comm. Expires April 17, 2007 LAW OFFICES SNEIBaKER. BRENNEMaN & Spare COMMONWEALTH OF PENNSYLVANIA) : SS. COUNTY OF CUMBERLAND) On this th~~ day of 0~~ 2004, before me, a Notary Public in and for said State and County, the undersigned officer, personally appeared Judith M. Zimmerman March, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official Notary Public COMMONWEALTH OF PENNSYLVANIA Notadal Seal Sandra K. Showem, Notary Public Mechanicsburg Boro, Cumberland County My Commission Expires Nov. 22, 2007 Member, Pennsylvania Association Of Notaries LAW OFFICES SNELBAKER. BRENNEmAN & SPARE STATE OF NORTH CAROLINA ) : SS. COUNTY OF ~O{~\~ ) On this the ~O day of kA~d~.~A~2~ 2004, before me, a Notary Public in and for said State and County, the undersigned officer, personally appeared Richard W. Zimmerman, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notary Public LAW OFFICES SNELIgAKEr, BRENNEMAN & SPARE STATE OF MICHIGAN ) : SS. COUNTY OF ~~ ) On this the ~9qa~ day of ~~ 2004, before me, a Notary Public in and for said State and County, the undersigned officer, personally appeared Thomas E. Zimmerman, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notary Public IROBIN RAYCHELLSORRELLS ~ Notary Public, Ingham Co., MI J My ,Comm. Expires April 17, 20071 LAW OFFICES SNEIBaKEr. BRENNEMAN & SPARE ESTATE NO. 21-03-0747 FIRST AND FINAL ACCOUNT AND STATEMENT OF PROPOSED DISTRIBUTION OF AND BY JUDITH M. ZlMMERMAN MARCH, ADMINISTRATRIX C.T.A. OF THE ESTATE AND UNDER THE LAST WILL AND TESTAMENT OF RICHARD B. ZIMMERMAN, DECEASED, LATE OF CARLISLE BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA Judith M. Zimmerman March, Administratrix C.T.A. as aforesaid and Accountant herein, avers as follows: DATE OF DECEDENTS DEATH: DATE LETTERS TESTAMENTARY ISSUED: August 26, 2003 September 11, 2003 DATES AMINISTRATRIX C.T.A. NOTICE ADVERTISED: Cumberland Law Journal September 26, October 3, 10, 2003 Patriot-News September 30, October 7, 14, 2003 FIRST AND FINAL ACCOUNT PERSONALTY - PRINCIPAL ACCOUNT DEBITS The Accountant charges herself with the receipt of the following items of Decedent's Personalty valued as of the date of Decedent's death: 1. Metlife, Inc., 76 shares of common stock, valued at $28.42 per share 2. Chapel Pointe, refund on resident care 3. M&T Bank, checking account # 950227153 4. U.S. Treasury, refund on 2003 Final Individual Return 5. M&T Bank, cash from postmark credit union 6. Metlife, Inc., gain on sale of 76 shares of common stock TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, DEBITS: PERSONALTY - PRINCIPAL ACCOUNT CREDITS The Accountant claims credit for the payment of the following items from Decedent's Personalty Account: 1. Carlisle Regional Medical Center, medical expenses 2. Cumberland Goodwill Fire Rescue, ambulance services 3. West Shore Ambulance Service, ambulance services 4. Quantum Imaging & Therapeutic, medical expenses 5. Mobil X-Ray Imaging, Inc., medical expenses 6. Andorra Radiology Assoc., P.C., medical expenses 7. BMC, medical expenses 8. Omnicare Pharmacies of Pennsylvania East LLC, medical expenses 9. Hetrick Funeral Home, Inc., funeral services 10. Pinker & Associates, medical expenses 11. Philhaven, medical expenses 12. Register of Wills, Agent, estimated tax payment 13. Central Penn Medical Group Emergency, medical expenses 14. Judy March, reimbursement for preparation of Final Individual Income Taxes Page 1 2,159.92 5,151.07 50,164.34 2,347.00 50.40 557.03 60,429.76 225.66 72.94 72.71 2.26 86.82 20.91 5.91 266.75 160.2O 14.32 24.57 ,800.00 28.40 122.00 LAW OFFICES SNELBAKER, BRENNEMAN & SPARE 15. Register of Wills, filing fee for Inheritance Tax Return 15.00 16. Register of Wills, Agent, Inheritance Tax Return 536.22 17. Register of Wills, additional probate fee 35.00 18. M&T Bank, check number 3966 paid on account # 950227153 51.24 19. Snelbaker, Brenneman & Spare, P.C., attorney services 1,850.00 20. Snelbaker, Brenneman & Spare, P.C., costs advanced: 308.55 a. Cumberland Law Journal, advertising Administratrix notice 75.00 b. Patriot-News, advertising Administratrix notice 123.55 c. Register of Wills, probate fees 110.00 21. Reserve for filing fees, accounting fees and other costs associated with the administration of Decedent's Estate The foregoing reserve and tax amounts are estimated on the assumption that the Administrative Correction showing the voluntary increase for the refund paid for the 2003 Individual Income Taxes will be accepted as presented to the Pennsylvania Department of Revenue. If that assumption proves to be incorrect, the Administratrix C.T.A. reserves the right to withdraw the accounting or amend it to reflect the then-current circumstances. TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, CREDITS: $ 7,199.46 1,500.00 PERSONALTY - INCOME ACCOUNT DEBITS The Accountant charges herself with the receipt of the following income from the investment of Personalty Principal: 1. Orrstown Bank, interest on estate checking account 2. Metlife, Inc., stock dividend TOTAL, PERSONALTY, INCOME ACCOUNT, DEBITS: 83.60 17.48 101.08 PERSONALTY - INCOME ACCOUNT CREDITS The Accountant claims credit for the payment of the following items from the Personalty Principal Account: TOTAL, PERSONALTY, INCOME ACCOUNT, CREDITS: NONE NONE REAL ESTATE - PRINCIPAL ACCOUNT DEBITS The Accountant charges herself with the receipt of Decedent's Real Estate as follows: TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, DEBITS: NONE NONE REAL ESTATE - PRINCIPAL ACCOUNT CREDITS The Accountant claims credit for the payment of the following items from Real Estate Principal Account: TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, CREDITS: NONE NONE Page 2 LAW OFFICES SNELBAKER. BRENNEMAN & SpAre REAL ESTATE - INCOME ACCOUNT DEBITS The Accountant charges herself with the receipt of the income from the investment of Real Estate Principal Account: TOTAL, REAL ESTATE, INCOME ACCOUNT, DEBITS: REAL ESTATE - INCOME ACCOUNT CREDITS The Accountant claims credit for the payment of the following items from the Real Estate Income Account: TOTAL, REAL ESTATE, INCOME ACCOUNT, CREDITS: Page 3 NONE $ NONE NONE $ NONE LAW O~FICES SNELBakEr, BRENNEMaN & ~;PARE PRINCIPAL ACCOUNT: Debits Credits Balance INCOME ACCOUNT: Debits Credits Balance TOTAL PERSONALTY PRINCIPAL ACCOUNT: Debits Credits Balance INCOME ACCOUNT: Debits Credits Balance TOTAL REAL ESTATE: TOTAL FOR DISTRIBUTION: RECAPITULATION Page 4 $ 60,429.76 7,199.46 101.08 NONE NONE NONE NONE NONE 53,230.30 101.08 NONE NONE 53,331.38 NONE 53,331.38 LAW OFFICES SNELBAKER, BrENNEMaN & ~;PARE STATEMENT OF PROPOSED DISTRIBUTION Judith M. Zimmerman March, Administratrix C.T.A. and Accountant herein, proposes to distribute the balance of the Estate of Richard B. Zimmerman, Deceased, to wit: $ 53,331.38 in accordance with the Last Will and Testament of said Decedent as follows: 1. Judith M. Zimmerman March 1/3 of residue as per Item 3 of Will 2. Richard W. Zimmerman 1/3 of residue as per Item 3 of Will 3. Thomas E. Zimmerman 1/3 of residue as per Item 3 of Will TOTAL FOR DISTRIBUTION: Page 5 17,777.13 17,777.13 17,777.12 53,331.38 LAW OFFICES SNELbAkER. BrENNEMAN & ~;pare COMMONWEALTH OF PENNSYLVANIA SS: COUNTY Of CUMBERLAND Judith M. Zimmerman March, being duly sworn according to law deposes and says: that she is the Administratrix of the Estate and under the Last Will and Testament of Richard B. Zimmerman, Deceased, and the Accountant herein; that there are no unpaid creditors or claimants of said Estate; that there are no persons interested in the distribution of said Estate other than as stated in the foregoing Statement of Proposed Distribution; and that the facts set forth in the foreqoing First and Final Account and Statement of Proposed Distribution are true and correct to the best of her knowledge, information and belief. Judith/--~l. Zimmerman March ~ Administratrix C.T.A. and Accountant Sworn to and subscribed before me 2004 Page 6 STATUS REPORT UNDER RULE 6.12 Name of Decedent: Richard- B. Zimmerman Date of Death: August 26, 2003 Will No.: 21-03-0747 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: 1. 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: 3. If the answer to No. 1 is Yes, state the following: Did the personal representative file a final account with the Court? Yes _ 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? Yesx[~ No [--1 Date: Co 9/3/Q4 Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed/w~ the Cl~.~-~the Orphans' Court and may be attached to thi~_. -- ~i~gnatur~'-'" XRR Richard C. Snelbaker Capacity: Sallie Snelbaker, Brenneman & Spare, 44 West Main Street Mechanicsburg, PA 17055 Address 717-697-8528 Telephone No. Personal Representative Counsel for personal representative PoC. BUREAU OF INDIVIDUAL TAXES TNHERITANCE TAX DTVTSTON DEPT. Z80601 HARRTSBURG, PA 17128-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE Z~HERZ~ANCE TAX RECORD ADJUSTHENT RE¥-1693 EX AFP [01-03,1 RICHARD C SNELBAKER SNELBAKER ETAL PO BOX 318 HECHANICSBURG '04 SEP 15 DATE 08-31-ZOOq ESTATE OF ZIHNERHAN DATE OF DEATH 08-Z6-ZO03 FZLE NUHBER 21 03-07q7 :25 COUNTY CUHBERLAND ACN 101 Amoun~ Remi~ed RICHARD HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA I7013 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper por{ion of ~his fore wi~h your ~ax payment:. CUT ALONG THIS LINE ~.- RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1593 EX AFP (01-03) ~x INHERITANCE TAX RECORD ADJUSTHENT x~ ESTATE OF ZIHNERHAN RICHARD B FILE NO. 21 03-07~7 ACN 101 DATE 08-31-200~ ADJUSTMENT BASED ON: ADHINISTRATIVE CORRECTION VALUE 1 2 5 6 7 OF ESTATE: Real Es~a~e (Schedule A) (1) S~ocks and Bonds (Schedule B) (2) Closely Held S~ock/Par~nership In~eres~ (Schedule C) ($) Mot*gages/No*es Receivable (Schedule D) (q) Cash/Bank Deposi*s/Misc. Personal Proper*y (Schedule E) ($) Jointly Owned Proper~y (Schedule F) (6) Transfers (Schedule G) (7) To*al Asse*s DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses~Administrative Costs/ Miscellaneous Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. To~el Deductions 12. Ne~ Value of Tax Re~urn .O0 2~159.92 .00 .00 57~66Z.ql .00 .O0 (8) 59,822.33 (9) (10) 2,833.75 725.57 (11) 3;559.3Z (12) 56~Z63.01 15. lq. Ne~ Value of Es~e~e Subjec* ~o Tax TAX: 15. Amoun~ of Line lq a~ Spouse1 ra~e 16. Amoun~ of Line 1~ ~axable a~ Lineal/Class A ra~e 17. Amoun~ of Line Zq a~ Sibling ra~e 18. Amoun~ of Line 1~ ~axable a~ Collateral/Class B ra~e 19. Princi=al Tax Due TAX CREDITS DATE NUMBER 11-17-2003 05-10-200~ 08-Z3-200~ 08-Z3-ZOOq Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) UI~CUUNI (~7 INTEREST/PEN PAID (-) COOO32q1 CD003657 REFUND CDOOqZ97 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (15) (16) (17) (18) 9q.7q .00 .00 .99- (15) .00 (1~) 56;263.01 .OOX O0 = .00 56;263.01x 0~5= 2z531.8q .OOx 12 = .00 .OOX 15 = .00 (19) 2~531.8q. AMOUNT PAID 65 1,800.00 536.22 q.7q- 106. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 2,531.88 .OqCR .00 .OqCR ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) PAYHENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- Hake check or money order payable to: REGISTER OF NILLS, AGENT. REFUND £CR): A refund of a tax credit, which ems not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices or from the Department's 2q-hour answering service for fores ordering: 1-800-362-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-qq7-3020 (TT only). REPLY TO: guestions regarding errors contained on this notice should ba addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, Phone ¢717) 787-6505. DISCOUNT: PENALTY: INTEREST: If any tax due is paid aithin three (3) calendar months after the decedent's death, a five percent (52) discount a; the tax paid is allaaad. The 151 tax amnesty non-participation penalty is computed on the total of tho tax and interest assessed, and not paid before January 18, 1996, tho first day after tho end of the tax amnesty period. 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 l, 1982 bear interest at the rate of six (623 percent per annum calculated at a daily rate of .O0016~. All taxes which became delinquent on and after January I, 1982 wiIL bear interest at a rate ehich ail! vary from caIendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through ZOOq are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20Z .0005q8 1988-1991 Ill .000301 2001 92 .0002q7 1983 162 .000q38 1992 92 .0002~7 ZOOZ 6Z .00016q 198~ 112 .000301 1993-199~ 72 .000192 2003 52 .000137 1985 132 .000356 1995-1998 9Z .O00Zq7 200~ ~Z .000110 1986 102 .O0027q 1999 72 .000192 1987 92 .O00Zq7 ZOO0 8Z .000219 --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 shoan on the Notice, additional interest must be calculated. :~EV-1470 EX (6-88)  INHEI~ITAN~E TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURGt PA 17128-0601 DECEDENT'S NAME FILE NUMBER RICHARD B ZlMMERMAN 2103-0747 REVIEWED BY ACN Dianne McClain 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The Notice of Inheritance Tax Appraisement, Allowance or Disallowance of Deductions and Assessment of Tax has been adjusted to accept an additional asset reported by the Estate and apply the August 23, 2004 payment made to the Register of Wills. ROW Pa.qe 1 BUREAU OF TNDZVZDUAL TAXES ZNHERTTANCE TAX DTV'rSTON DEPT. Z80601 HARRZSBURG, PA 171Z8-0601 COHHONNEALTH OF PENNSYLVANZA BEPARTNENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT REV-1607 EX &FP (01-03) RZCHARD C SNELBAKER SNELBAKER ETAL PO BOX $18 HECHANZCSBURG PA 17055 DATE 09-07-ZOOq ESTATE OF ZTHHERHAN RI'CHARD DATE OF DEATH 08-,?,.,6,=.2.005 FZLE NUNBER Z1 _ 7q7c~ COUNTY CUMbErLAND ACN 10 HAKE CHECK PAYABLE AND RE~I~T PAYHENT TO: REGTSTER OF WZ:LLS CUNBERLAND CO COURT HOUSE CARLTSLE, PA 1701:5 NOTE: To insure proper credi~ ~o your account, submi* ~he upper por~cion of *his form frith your ~ax payment. CUT ALONG THZS L'rNE ~-* RETAZN LONER PORT'rON FOR YOUR RECORDS REV-1607 EX AFP (01-03) x~ 'rNHERZTANCE TAX STATEHENT OF ACCOUNT ESTATE OF ZTHHERMAN RTCHARD B FZLE Ne. Z1 0:5-07~7 ACN 101 DATE 09-07-ZOOq THZS STATEMENT ZS PROVZDED TO ADVZSE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHOI./N BELOti ZS A SUMMARY OF THE PRZNCZPAL TAX DUE, APPLZCATZON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLZCABLE, A PROJECTED ZNTEREST F*rOURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 08-:50-200~ PRINCZPAL TAX DUE= ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDZTS): Z,5:51.8~ PAYMENT RECEZPT DZSCOUNT (+) I DATE NUMBER ZNTEREST/PEN PAZD (-)! AMOUNT PAZD 9q.Tq 11-17-200:5 0:5-10-ZOOq 08-2:5-200q 08-2:5-200q COOO:sZql CD00:5657 REFUND CDOOqZ97 .00 .00 .99- 1,800.00 5:56.22 q.7q- 106.65 ZF PAZD AFTER THZS DATE, SEE REVERSE SZDE FOR CALCULAT/ON OF ADDITIONAL /NTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUZRED. ZF TOTAL DUE ~S REFLECTED AS A 'CREDIT' (CR}, TOTAL TAX CREDZT 2,5:51.88 BALANCE OF TAX DUE .OqCR ZNTEREST AND PEN. .00 TOTAL DUE .OqCR YOU MAY BE DUE A REFUND. SEE REVERSE S'rDE OF THZS FORM FOR TNSTRUCTTONS.