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Home My WebLink About02-0393 Register of Wills Cumberland County. Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Ruth Marie Hallett Ruth M. Hallett No. ~/_I) t1. .:J~ also known as. , Deceased Social Security No. 159-24-7524 Deborah A. Sterling and Jay M. Hallett. PWtion..-""I.....al.,_IBv_oj...D..........p1y~1or. (COMPLETE" A ~ OR "B" BELOW:I ~ A. Probate and Grant of letters and aver that Petitioner(s) is/are the executors named in the last Will of the Decedent, dated August 16.1991 and codicillsl dated N/A - A1AM.A&ot'\ t::~~(!O'f'r.JP. ~ ~ICH"'l2i:'J -J.HAuPt""f' O"C'~l1kFO c-Jf, Z-Z ,qq-,. ~. ......~lel_. ..".~. ~...ofnewlo'. Me Except 88 follows, Decedent did not marry, was not divorced, and dkt not have 8 child born or adopted after execution of the documents offered for probate; wee not the victim of a killing end was never adjudioated incompetent: lJ B. Grant of letters of Administration ....t.........".......:....-..""';__._._-......... Petitioner(s} after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any] and heirs: I Name Reletionship Residence' I . I t: IN ALL (,;A~t:o:1 Attaon eaaltlonel . .ets I' necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 4175 Mountain View Road, Apartment #104. Hampden Township. Cumberland County PA 17050-9118 ~IH._.n_""'~WI Decedent, then ~ years of age, died' March 18 , 20QL, at Holv Soirit Hosoital 503 N. 21st SI. Camo Hill, Cumberland eotJT1ly, Pennsylvania Decedent at death owned property with estimated values 8S follows: (If domiciled in PAl All personal property . . . . . . . . . . . . . . . $ 5,000.00 (If not domiciled in PAl Personal property in Pennsylvania. . . . . . . . . . . . . . . . . . . . . . $ (If not domiciled in PAl Personal property in County. . . . . . . . . . . . . . . . . . . . _ $ Value of teal estate in Pennsylvania .................................... . . . . . $ Tot.' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . _ . . . . . . . . . $ 5 nnn 00 Reel Estl'!lte situated as follows: Wherefore, Petitioner(e) respectfully request{s) the probate of the last Will and Codicillsl presented with this Petition and the grant of Istters in the appropriate form to the undersigned: Signature Typed or printed name and residence Deborah A. Sterlin 258 Rid e Hill Road, Mechanlcsbur , PA 17050 Ja M. Hallett 416 Limestone Road Cariisle PA 17013 RW-7 /1~,57~1'I Oath of Personal Representative Commonwealth of Pennsylvania County of The Petitionerls) above-named swearls) and affirm(s) that the statements in the foregoing Petition are true and correct to the best oHhe knowledge and belief of Petitionerls) and that, as personal representativels) of the Decedent, Petitionerls) will well and truly administer the es~cording to law~ ,. . Swom to and affirmed and subscribed ~~_~I~ before me this 15 t h dey of . ./ April 2O:Jl? ~ 7P/- //~ e.~/JIA/ ,// /~ ~. cowi. ,- ~ DECREE OF REGISTER Deceased No. 21-2002-393 Estate of Ruth Marie Hallett. a/k/ a Ruth M. Hallett also known as Social Security No: 159 -24 -7 5 24 Date of Death: MAiTr-h lR,?O()? AND NOW. April 16th, 2OQL, in consideration of the Petition on the reverse side hereon. satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary 0 of Administration are hereby granted to Deborah A. Sterlinq and Jay M. Hallett ~,..._. ~_..".~,I,;...,-. .,"; _.... _'Ill; ..,_. _..lit."" in the above estate and that the instrument(sl, if any, dated October 22. 1 qcn described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES $ 24.00 $ $ $ 39.00 $ $ 5.00 $ $ Letters........................... $ 40.00 Short Certificate(s)...?..... Renunciation................. . Affidavit ( )................. Extra Pages ( 1 )............ Codicil.......................... JCP Fee........................ Inventory &. Tax Forms... Other............................ Mary C.Lewis \ TOTAL...........:... $ 108.00 Lowell R Gates. Esq. 46779 . 1013 Mumma Road. Suite 100 . Lemoyne. PA 17043 Telephone: (717) 731-9600 DATE FILED: March 16, 2002 ftI/-7. Attorney: 1.0. No: Address: MAILED LETTERS TO DEBORAH STERLING, EXECUTRIX ON APRIL 16th, 2002 0(' ~. ('. :::< -n' 1'3 ?O :;0 --> 0\ -'J ~-.,. '-0 ,-- ill 111()'j.HI)'j REV 911((, This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local R~gistrar. The original certificate will be forwarded to the State Vital Records Office tor permanent tiling. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ",\ll.(~rpl,t>.~~ ,i;o,;~ ~4'~"\ ''''~._\<:<o, S5, ",']I'" ,'.-p'i. ic;gt.~ ',' . ,,~~ ~u\, ,,_;l';~', /;:J::,.~ \ * \-:. '.',~..", 'i * ~ 'a~ ~ . ;.<>,,' \.~~ /-$>/' ->>-})rMfN1~{~':""'" ";;;;;"'##11,"1/1111' 1." / r ~ \, 'I1JJr((/Lf) l'Anu. -,()~ Local Regisrrar Fec for this certificate, $2.00 P 8203385 qJLI.-tQv,:ltJ, ~L - Date HlO~ a3Aey val COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH ,YPE/PRINT " PEAMJlNENT E1(JlCI'.INI( STA,~."-~,,,,_R NA~EO':~~NTr::-~:;e~~llett ~'-~~=~=~~~:e~eroale _~;9UA:NU2;R ~ 7524 AGElla..a""'oa\'l UNOfR1YEAA UtlOliRIPIli:Q.- OATE-QFDIRTH -e~~,c.y;on<l Pl.o\CEOI'OEAfHICI>tC.""'~""""_"""""'''''''''''_'''''-I -.. D.~ -I....."'.. ,Mo",,,o..y,_1 S\;lle",'c,o"""COOO"VI HOSPIlAt. - ~ 73 v", ~. 9/9/1928 7 ~l19 COUNTY Of' OE.AfH CfTY.IK)FM). TWPOf DEATH FACilITY NAMf III ""',n.."""oo Q''''' ...-.10<><1 """'-, _"""U :=....,0 ~land I~OfOl:ATH""'o.n.,,lJa,"_1 '2YJ.~ )(",2'0<-' R.<l:E.A'I'I<<ICM_".~.\IIIha.,,,,, ,-. White ,~. ~ - _.. Cumberland --..1 "..0 :::'::=-=:01 WlQTHEII.."'Ml4EIf..._,_s....- II. Edna Clauss 1NF00000T.SMAIUNOAOORESSlSlr....~,sw.,Z4>~ 258 Ridge Hill Road Mechanicsburg, PA 17055 Pl./lCt:OI'OlSf'OSmON.......afea-y.c.-y t. lOH.~.S1.aIe.llpCoGa ._- ". 17c.OJ_.__in IoIAAIlJlLSTRUS.M_ Na_.........-. ......- Widowed SI,IAV1VlNGsPOUSE l._.~'-'_ DECfDENT.SVSV4LOCCUPAJlON (~I'::,,~::"~':::2~ II. Clerical 11 Insurance OECEot:NT.SIAAILIf<<lAOOf\ESS(Su....~._.~C"'"1 OfCEOENT"$ 4175 Mountain View Road .o.C~"'ta Mechanicsburg, PA 17055 :-:~ "e.se.. - . 2 2 c o ~ . ,. FRH~R.SNJlw:(fir.,_,L..1 11. Wilson F. Bland _CIflMANT.S_lT-">inll Deborah A. Sterlin METHOOOFDlSPOSI11ON O ......00 c_O __51_0 ~ ou..,(Spaay< II.. $IGfIJlTUAEOf'F~NEAAL -- ~ , ~ " 2002 ne.Rolli Green Mem. PArk _NCIAOCAESSOf'~'TY nc.Mal zzi 8 Market LICl:MSEMUMDER It4. Hill, PA 17011 fI\ 17055 Plaza Way OFOEAf"l OAfE PAOfoIQUNCEOOEAOI"''"'''', D.a~. 'r1.."1 OAfESlGNtO f\oI<InIh,~~-1 .. 1:1c. \W<SCo\SEf\EfERAE01QME:CIC.at.~P.? _D .'HoJ81 ....1:00 4..- 11. 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LOCAflONlSIr...,CoI\o'lown. _I ."EOliCAL EllAMINERlCOflOHEA On"'.b..I.........mlnallonendlOllnw.ell~IIon.In"'VOj:lln;on.c18elho."::"r".<l.111'r.llme.<le,e..n<lplace..n<l<l".'olhooce"../.jand men......"............... .. .. ................ .. .... ............ .... .. ... ........ ...... ........ ". REGIS AAA'SSIONATUAEJlHONUI,I8E"I . t.i4.tL fUa,A.- ~----- ru,;?,/~ n ~" n. 0311. .~AtroCl."TIf't*OI'M'f&lCl""ll'h__;l"""""""~"""I".''''''''''~"'9roc~"..",,,,,~,") fo...._I..I""_""""......"'OO-<............._.dA'.._olKe.end~...le.....c....M(.I.nJmenn..~.....ed n EOI.........,D.y,_1 t:.relL .;lO. .;l.OO~ 21-2002-393 IqUl;1:J .:~:<-) R[: vd c;t :~d\J ZOo -< \ ;- ..,~ ' ;< /- ;J,(JCJ;) -393 LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT I, RUTH MARIE HALLETT, now of 5231 Terrace Road, Mechanicsburg, Cumberland County, Pennsylvania, do publish and declare this to be my Last will and Testament, hereby revoking all other prior wills and codicils made by me. FIRST: Family Background and Appointment of Executor. (A) Family and Background Information. I am married to RICHARD J. HALLETT. I have not been previously married. The children of our marriage are DEBORAH A. STERLING and JAY M. HALLETT (and any children born or adopted hereafter). Throughout this Will, RICHARD J. HALLETT will be referred to as "my husband" or "my spouse" and DEBORAH A. STERLING and JAY M. HALLETT will be referred to as "my children." The word "issue" will include my children as well as my other descendants. (B) Appointment of Executor. I appoint as my Executor and successor Executor (all hereinafter referred to as Executor or Executor(s)) under this Will, the following named persons or corporations to serve without bond and without being required to account to any Court: Executor: My husband, RICHARD J. HALLETT Successor Executor: My children, DEBORAH A. STERLING and JAY M. HALLETT, to act jointly. SECOND: Funeral and Last Illness Expenses; Taxes. . (A) Expenses of Funeral and Last Illness. Notwithstanding that my spouse survives me, I direct my Executor to pay my funeral expenses (regardless of amount) and the expenses of my last illness from my estate. f~'7-:Y .' LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 2 (B) Taxes. I direct my Executor to pay any and all estate, inheritance, succession, legacy, transfer and other death taxes or duties, by whatever name called, including any and all interest and penalties thereon, imposed under the laws of any jurisdiction by reason of my death, upon or with respect to any and all property included in my gross estate for the purpose of such taxes, whether such property passes under or outside of this Will, out of my residuary estate, without being prorated or apportioned among or charged against the respective devises, legatees, beneficiaries, transferees, or other recipients of any such property or charged against any property passing or which may have passed to any of them. My Executor shall not be entitled to reimbursement for any portion of any such taxes from any such person. THIRD: Tangible Personal property. Except for those items excluded below and those items enumerated in the Letter of Instruction, I bequeath to my spouse, RICHARD J. HALLETT, all tangible personal property, which I own, and the insurance thereon, if my spouse survives me by sixty (60) days. Tangible personal property shall not include: (1) any and all property used by me in any business, (2) cash on hand or on deposit in banks, (3) stock or securities, (4) any type of evidence of indebtedness, and (5) any life, health or accident insurance policies. If my spouse is not living on the sixty-first (61st) day after my death, I bequeath such tangible personal property to my children living at the time of my death to be divided among them as they may select in as nearly equal shares as is practical. If my spouse and my children do not survive me, I leave such tangible personal property to the issue of my children, per stirpes. If there is any disagreement as to distribution, I direct my Executor to make such distribution. The decision of my Executor shall be final and binding. Any items not selected or any items which my Executor considers unsuitable for my children may be distributed or sold in the sole discretion of my Executor and, if sold, the net proceeds therefrom shall be added to the ~~ LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 3 residue of my estate. Any such article allocated to a minor may, as my Executor deems advisable, either be delivered to the minor or to any person to safeguard on behalf of the minor. Notwithstanding any other provisions in this Article THIRD, I may leave a separate, dated and unsigned Letter of Instruction, which I shall place with my Will, containing directions as to the ultimate disposition of certain of the property bequeathed under this Article THIRD, and such Letter of Instruction shall determine the distribution of such items. FOURTH: Residuary Gifts. (A) If my spouse, RICHARD J. HALLETT, survives me, I give, devise and bequeath all the rest, residue and remainder of my estate, of every kind and character, real, personal and mixed, tangible and intangible, and wherever situated, including any lapsed or renounced legacies, devises or residuary bequests (and including any property over which I may have a Power of Appointment), to my spouse, RICHARD J. HALLETT. (B) If my spouse, RICHARD J. HALLETT, does not survive me, and if one or more of my children survive me, I give, devise and bequeath all the rest, residue and remainder of my estate, as follows: (1) I give, devise and bequeath all of the life insurance policies which I own on the lives of my daughter, DEBORAH A. STERLING, my son, JAY M. HALLETT, my son-in-law, CHARLES W. STERLING, and my grandchildren, JAMIE M. STERLING and ERIKA L. STERLING, which life insurance policies are with the Baltimore Life Insurance Company, to the Trustee hereinafter named, in Trust for the following uses and purposes: (a) The Trustee shall receive all payments from the annuity which I own at my death with the Life of Maryland Annuity company and the Trustee shall use said ~ LAST WILL AND TESTAMENT OF RUTH HARIE HALLETT PAGE 4 annuity payments to make the premium payments on the above-referenced life insurance policies with Baltimore Life Insurance company. Trustee shall hold said policies and any proceeds, if any, until the death of one of the insureds or until the termination of this Trust as set forth below. (b) As each of my children, DEBORAH A. STERLING and JAY M. HALLETT, reach the age of forty (40) years, the Trustee shall distribute to said child that child's policy and the life insurance policies on the life of that child's children. In the event that the annuity payments should cease prior to the time that my children reach age forty (40), respectively, then the Trustee shall distribute the life insurance policies, absolutely, to my children, respectively, and to the parent of the grandchildren. (c) In the event that one or both of my children die before attaining age forty (40), then the Trustee shall use the proceeds from that child's life insurance pOlicy, and any income generated thereby, for the health, education, support and maintenance of said child's issue, as the Trustee deems advisable. The Trustee may apply the net income, accumulated income, and principal should said child's issue, by reason of age, illness, or any other cause, in the opinion of my Trustee, be incapable of disbursing it. As each grandchild (of a deceased parent) attains the age of twenty-one (21) years, the Trustee shall distribute, absolutely, to said grandchild, his or her respective equal share of his or her parent's life insurance ~~ LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 5 proceeds and shall distribute to said grandchild his or her respective life insurance policy. (2) I give, devise and bequeath all the rest, residue and remainder of my estate, of every kind and character, real, personal and mixed, tangible and intangible, and wherever situated, including any lapsed or renounced legacies or devises (and including any property over which I may have a power of appointment) in equal shares to my children, DEBORAH A. STERLING and JAY M. HALLETT, per stirpes. (Cl Distributions During Administration. Prior to final distribution of my estate, the Executor, in his discretion, may make partial distributions to one or more beneficiaries or Trusts. As a consequence, the Executorship and any Trusts created under this will may exist contemporaneously. A distribution may be made subject to any indebtedness or liability of my estate. FIFTH: s~endthrift Provision. No beneficiary shall have the power to ant~cipate, encumber or transfer his or her interest in the estate or any trust estate in any manner other than by the valid exercise of a power of appointment. No part of the estate or any trust estate shall be liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. SIXTH: Appointment of Trustee and Successor Trustees. (A) I nominate, constitute and appoint CCNE BANK, N.A., camp Hill, Pennsylvania, to act as Trustee of all Trusts created by my Will. ,? +~ ~ LAST WILL AND TESTAMENT OF RUTH KARIE HALLETT PAGE 6 (B) The Trustees may resign from the Trusts without the necessity of any Court proceeding if at least thirty (30) days' written notice is given to each beneficiary (including a beneficiary's natural or legal guardian or legal representative, in the case of a beneficiary under a legal disability) who might then be entitled to receive a distribution from the Trust Estate. Upon the death, resignation, removal or incapacity of the Trustee, then a Successor Trustee may be appointed by a majority of the beneficiaries who might then be entitled to receive a distribution from the Trust Estate, provided that the Successor Trustee is a financially sound and competent corporate trustee. A Successor Trustee may be any bank or trust company and may be domiciled anywhere. Any Successor Trustee thus appointed, or, if the Trustee shall merge with or be consolidated with another corporate fiduciary, then such corporate fiduciary, shall succeed to all the duties and to all the powers, including discretionary powers, herein granted to the Trustee. SEVENTH: Powers of Trustee and Executor. In addition to the powers and duties as may have been granted elsewhere in this will, but subject to any limitations stated elsewhere in this Will, the Executor and Trustee (when applicable) shall have and exercise exclusive management and control of the Estate or Trusts, respectively, and shall be vested with the following specific powers and discretion, in addition to the powers as may be generally conferred form time to time upon them by law: (A) In the management, care and disposition of the Trusts or Estate, the Trustee and Executor, respectively, shall have the power to do all things and to execute such instruments as may be deemed necessary or proper, including the following powers, all of which may be exercised without order of or report to any Court: (1) To sell, exchange or otherwise dispose of any property at any time held or acquired hereunder, at public or private sale, for cash or on terms, without advertisement, including the right to lease for any term notwithstanding the period of the Trust, and to ~~ 4-fX LAST WILL AND TESTAMENT OF RUTH HARIE HALLETT PAGE 7 grant options, including any option for a period beyond the duration of the Trust; except that, in lieu of any binding shareholder agreement or buy/sell agreement to the contrary, the Executor and Trustee shall not be permitted to sell the stock or any other ownership interest in any business owned by me, or my spouse, or held in trust, at my death, without first offering the same for sale to my children, or without next offering the same to the corporation or business represented by such ownership interest for redemption. (2) To invest all monies in such stocks, bonds, securities, mortgages, notes, choses in action, real estate or improvements thereon, and any other property as the Trustee or Executor may deem best, without regard to any law now or hereafter enforced limiting investments of fiduciaries, except that the Trustee or Executor may not invest in any securities issued by the corporate Trustee or Executor, or issued by a parent or affiliate company of such Trustee or Executor. (3) To retain for investment any property deposited with the Trustee or Executor hereunder; except that the Trustee or Executor may not retain for investment any stock in the corporate Trustee or Executor, or in a parent or affiliate company of such Trustee or Executor. (4) To vote in person or by proxy any corporate stock or other security and to agree to or take any other action in regard to any reorganization, merger, consolidation, liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note or other security. (5) To use attorneys, real estate brokers, accountants and other agents, if such employment is deemed necessary or desirable, and to pay reasonable compensation for their services. ~v AJ/x:- LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 8 (6) To compromise, settle or adjust any claim or demand by or against the Trusts or Estate and to agree to any rescission or modification of any contract or agreement affecting the Trusts or Estate. (7) To renew any indebtedness, as well as to borrow money, and to secure the same by mortgaging, pledging or conveying any property of the Trusts or Estate, including the power to borrow from the Trustee at a reasonable rate of interest. (8) To retain and carryon any business in which the Trusts or Estate may acquire an interest, to acquire additional interest in any such business, to agree to the liquidation in kind of any corporation in which the Trusts or Estate may have an interest and to carryon the business thereof, to join with other owners in adopting any form of management for any business or property in which the Trusts or Estate may have an interest, to become or remain a partner, general or limited, in regard to any such business or property and to hold the stock or other securities as an investment, and to employ agents and confer on them authority to manage and operate the business, property or corporation, without liability for the acts of such agent or for any loss, liability or indebtedness of such business if the management is selected or retained with reasonable care. (9) To register any stock, bond or other security in the name of a nominee, without the addition of words indicating that such security is held in a fiduciary capacity, but accurate records shall be maintained showing that such security is a Trust or Estate asset and the Trustee or Executor shall be responsible for the acts of such nominee. ~o/ AJrr " LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 9 (B) Whenever the Trustee or Executor is directed to distribute any Trust principal or Estate assets in fee simple to a person who is then under twenty-one (21) years of age, the Trustee or Executor shall be authorized to hold such property in Trust for such person until he/she becomes twenty-one (21) years of age, and in the meantime shall use such part of the income and the principal of the Trusts or Estate as the Trustee or Executor, respectively, may deem necessary to provide for the proper support and education of such person. If such person should die before becoming twenty-one (21) years of age, the property then remaining in trust shall be distributed to the personal representative of such person's estate. (C) In making distributions from the Trusts or Estate to or for the benefit of any minor or other person under a legal disability, the Trustee or Executor need not require the appointment of a guardian, but shall be authorized to payor deliver the same to the custodian of such person, to payor deliver the same to such person without the intervention of a guardian, to payor deliver the same to a legal guardian of such person if one has already been appointed, or to use the same for the benefit of such person. (D) In the disbursement of the Trusts or Estate and any division into separate trusts or shares, the Trustee or Executor shall be authorized to make the distribution and division in money or in kind, or both, regardless of the basis for income tax purposes of any property distributed or divided in kind, and the distribution and division made and the values established by the Trustee or Executor shall be binding and conclusive on all persons taking hereunder. The Trustee or Executor may in making such distribution or division allot undivided interests in the same property to several trusts or shares. (E) The Trustee and Executor shall be authorized to lend or borrow, including the right to lend to or borrow from my estate or the estate of my spouse or any trusts which I or my spouse may have established during life or by will at an adequate rate of 7-v LAST WILL AND TESTAMENT OF RUTH HARIE HALLETT PAGE 10 interest and with adequate security, and upon such terms and conditions as the Trustee or Executor shall deem fair and equitable. (Fl The Trustee and Executor shall be authorized to sell or purchase at the fair market value as determined by the Trustee or Executor, any property to or from my estate, the estate of my spouse, or any trust created by me or my spouse during life or by Will, even though the same person or corporation may be acting as Executor of my estate or the estate of my spouse or as Trustee of any of my other trusts. (G) The Trustee and Executor shall have discretion to determine whether items should be charged or credited to income or principal or allocated between income and principal as the Trustee or Executor may deem equitable and fair under all the circumstances, including the power to amortize or fail to amortize any part or all of any premium or discount, to treat any part or all of the profit resulting from the maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal or apportion the same between income and principal, to apportion the sales price of any asset between income and principal, to treat any dividend or other distribution of any investment as income or principal or apportion the same between income and principal, to charge any expense against income or principal or apportion the same, and to provide or fail to provide a reasonable reserve against depreciation or obsolescence on any assets subject to depreciation or obsolescence, all as the Trustee and Executor may reasonably deem equitable and just under all the circumstances. (H) If at any time the total fair market value of the assets of any trust established or to be established hereunder is so small that the corporate Trustee's annual fee for administering the trust would be the minimum annual fee set forth in the Trustee's regularly published fee schedule then, in effect, the Trustee in its discretion shall be authorized to terminate such trust or to decide not to establish such trust, and in such event the property then held in or to be distributed +~ A""~ .' LAST WILL AND TESTAMENT OF RUTH MARiE HALLETT PAGE 11 to such trust shall be distributed to the persons who are then or would be entitled to the income of such trust. If the amount of income to be received by such persons is to be determined in the discretion of the Trustee, then the Trustee shall distribute the property among such of the persons to whom the Trustee is authorized to distribute income, and in such proportions, as the Trustee in its discretion shall determine. (I) When the authority and power under this will is vested in two (2) or more Executors or Trustees, the authority and powers are to be held jointly by the Executors or Trustees, respectively. A majority of the Executors or Trustees may exercise any authority or power granted under this Will or granted by law, and may act under this will. Any attempt by one such Executor or Trustee to act under this will on other than ministerial acts shall be void. The action of one such Executor or Trustee under this will may be validated by a subsequent ratification of the act by a majority of the Executors or Trustees. EIGHTH: Rights and Liabilities of Executor and Trustee. (A) No bond or other security shall be required of any Executor or Trustee. (B) This instrument always shall be construed in favor of the validity of any act or omission by any Executor or Trustee, and any Executor or Trustee shall not be liable for any act or omission except in the case of gross negligence, bad faith or fraud. Specifically, in assessing the propriety of any investment of a Trust, the overall performance of the entire Trust shall be taken into account. (C) Each Executor and Trustee shall be entitled to receive reasonable compensation for services actually rendered to my estate or to my Trusts, in an amount the Trustee or Executor normally and customarily charges for performing similar services during the time which he/she performs the services. Yf~ .' . LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 12 NINTH: Definitions and General Provisions. (AI Survival. Any beneficiary, including my spouse, who dies within sixty (601 days after my death shall be considered not to have survived me. (B) Trust Estate. "Trust Estate" means all assets, however and wherever acquired, including income, which may belong to a Trust at any given time. (C) Children. Except for discretionary distributions which may be made unequally among a group of persons and distributions pursuant to a valid exercise of a Power of Appointment, in making a distribution to the children of any person, the property to be distributed shall be divided into as many shares as there are living children of the person and deceased children of the person who left children who are then-living. Each living child shall take one share and the share of each deceased child shall be divided among his then-living descendants in the same manner. A posthumous child shall be considered as living at the death of his parent. (D) Code. Unless otherwise stated, all references in my Will to section and chapter numbers are to those of the Internal Revenue Code of 1986, as amended, or the corresponding provisions of any subsequent federal tax laws applicable to my estate. (E) genders, includes other terms. The use of any gender includes the other and the use of either the singular or the plural the other. (F) Captions. The captions set forth in this will at the beginning of the various divisions hereof are for convenience of reference only and shall not be deemed to define or limit the provisions hereof or to affect in any way their construction and application. uf-~~ 4hr .1 LAST WILL AND TESTAMENT OF RUTH HARiE HALLETT PAGE 13 (G) exercise death. Powers of Appointment are Exercised. By this Will I any Power of Appointment which I may possess at my IN WITNESS WHEREOF, I, RUTH HARlE HALLETT, the Testatrix, have to this my Last will and Testament, typewritten on fourteen (14) pages, including the Acknowle gment and Affidavit, set my hand and seal this /.0 day of ----; 1991- . Signed, sealed, published and declared by the above-named Testatrix, as and for her Last will and Testament, in the presence of us, who have hereunto subscribed our names at her request, as witnesses hereto, in the presence of the said Testatrix, and in the presence of each other. Each of us further declares that he or she believes the Testatrix to be of sound mind and memory. The preceding instrument consists of this and thirteen (13) other consecutively numbered typewritten pages including the Acknowledgment and Affidavit. ,I'~ .,(d"/.' ./ c')(~/VVl/J./ :; /!/y M!A t:. I Ld'AJS (print name) residing at vJ~ f'ff residing at ~h' ,110'/', /fI res1.ding at ~;r~/ p+ / , ." AClQfOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF~~ . . ss: The Testatrix and the witnesses whose names are subscribed to the foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge and declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will in the presence of the witnesses, that she signed willingly or willingly directed another to sign for her, that she executed it as her free and voluntary act for the purposes therein expressed, that each of the witnesses, in the presence and hearing of the Testatrix, signed the will as witnesses, and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. if. -z;e.~:";,. S/,t ,", ,. T tatrix (,,~/)kL?j;;./ (' ~.-/.~.....-z':...--. . witness ~sworn to, subscribed and acknowledged befo~e. m.e ab e-name~* Testatrix and witnesses this ~ "~J I 1991. . by day the of T"l Notary or ~Attorney-at~Law .. .... SUSM L .. IlDTAIIY PUtllIC CAMI' 1IIlJ.,. . CUMBER\.AND COUNtY "., COMMISSION EXPIRES NOV. 12, 1994 ,..,,~ u :::::---.~, ~~ ~........ d "" .." ~ ~ V1 --J ',~ n OJ - 0 Eo< Q.: (" Z r: 10-< g z ..; Eo< Of Eo< r-'i >- UJ r-'i ..; '" >-'i :>: a: H ..:t~ a: << :3: ~ ~-'i ~ (1J 0 D- -- - ~ ~ (j" CERTIFICATION OF NOTICE UNDER RULE 5.6(al Name of Decedent: Ruth Marie Hallett a/k/a Ruth M. Hallett Date of Death: March 18, 2002 File No.: 21-02-0393 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 1"'\6.'( If, , 2002. Name Address Deborah A. Sterling 258 Ridge Hill Road Mechanisburg, PA 17055 Jamie M. Sterling c/o Deborah A. Sterling 258 Ridge Hill Road Mechanicsburg, PA 17055 Erika L. Sterling c/o Deborah A. Sterling 258 Ridge Hill Road Mechanicsburg, PA 17055 Jay M. Hallett 416 Limestone Road Carlisle, PA 17013 Elisha Hallett c/o Jay M. Hallett 416 Limestone Road Carlisle, PA 17013 Shane Hallett c/o Jay M. '~i'-rallett 416 Limestone Road Carlisle, PA 17013 Notice- has now been given to all persons entitled thereto under Rule~5.6(a). ~- 11~4<<~) - Mar E. a bruner, Esquire, Esquire GATES, HALBRUNER & HATCH, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 (717) 731-9600 ~ Dated: M~rlh , 2002 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX{1 1-96} RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT GATES LOWELL R ESQ 1013 MUMMA RD SUITE 100 LEMOYNE, PA 17043-1144 ----.--~ fold ESTATE INFORMATION: SSN, 159-24-7524 FILE NUMBER: 2102-0393 DECEDENT NAME: HALLETT RUTH MARIE DATE OF PAYMENT: 06/18/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/18/2002 NO. CD 001306 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $4,500.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: DEBORAH A STERLING CHECK# 114 SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS $4,500.00 MARY C. LEWIS REGISTER OF WILLS LAW OFFICES OF GATES, HALBRUNER IStHATCH, P.C. 1013 MUMMA ROAD, SUITE 100 LEMOYNE, PENNSYLVANIA 17043 11: CUMBERLAND COUNTY COURTHOUSE OFFICE OF THE REGISTER OF WILLS ONE COURTHOUSE SQUARE CARLISLE, PA 17013 LAW OFFICES OF GATES, HALBRUNER &-HATCH, P.C. 1013 MUMMA ROAD. SUITE 100. LEMOYNE, PENNSYLVANIA 17043 (717) 731-9600. FAX: (717) 731-9627 LOWELL R. GATES Also Admitted to Massachusetts Bar MARK E. HALBRUNER Also Admitted 10 New Jersey Bar CRAIG A. HATCH CORY J. SNOOK ALBERT N, PETERLlN Also AdmiUed to Maryland Bar BRANCH OFFICE: 3 WEST MONUMENT SQUARE, SUITE 304 LEWISTOWN, PA 17044 (717)248-6909 WEB SITE: www.GatesLawFirm.com STAGEY L NAGE Paralegal/OfficeManager TRAGI L SEPKOVIC Paralegal December 16,2002 CORRESPONDENCE ADDRESS: Lemoyne Office Cumberland County Courthouse Office of the Register of Wills One Courthouse Square Carlisle, P A 17013 RE: Estate of Ruth M. Hallett Estate No. 21-02-0393 Dear Sir or Madam: Enclosed for filing are the Pennsylvania Inheritance Tax Return (in duplicate), Inventory and Status Report for the Estate of Ruth M. Hallett. A check in the amount of$28.00 is enclosed as the filing fees for the return and Inventory, and a second check in the amount of$89.89 as the balance of inheritance tax due. Please notifY our office of any probate fees that are due and we will forward the balance to you. Please time-stamp the additional photocopy of the return and Inventory and return them to our office in the enclosed envelope. Please contact our office if you have any questions or need additional information. Thank you for your assistance in this matter. Sincerely, it flu j ~bvt 'c Traci 1. Sepkovic Paralegal Enclosures cc: Deborah A. Sterling, Co-Executor Jay M. Hallett, Co-Executor COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-' 162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT HALBRUNER MARK E ESQUIRE GATES HALBRUNER & HATCH PC 1013 MUMMA RD SUITE 100 LEMOYNE, PA 17043 -- fold ESTATE INFORMATION: SSN: , 59-24-7524 FILE NUMBER: 2102-0393 DECEDENT NAME: HALLETT RUTH MARIE DATE OF PAYMENT: 12/17/2002 POSTMARK DATE: 12/16/2002 COUNTY: CUMBERLAND DATE OF DEATH: 03/18/2002 NO. CD 001960 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $89,89 I I I I I I I I TOTAL AMOUNT PAID: $89,89 REMARKS: DEBORAH A STERLING C/O MARK E HALBRUNER ESQUIRE CHECK#120 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS DONNA M. OTTO DEPUTY REGISTER OF WILLS REV.l500E)((e-OOl OFFiCIAL USE ONLY ~/ '* COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF REVENUE DEP1280601 HARRISBURG. PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COUNTY CODE w .., ","''' uii:'" w"g ::c~... U..1Il ~ - 51- /'1 FILE NUMBER 21 02 I- Z W C W U W C DECEDENT'S NAME (lAST, FIRST. AND MIDDLE INITIAL) Hallett, Ruth M. SOCIAL SECURITY NUMBER 159-24-7572 0393 YEAR NUMBER DATE OF DEATH (MM.DD-YEAR) 03/18/02 DATE OF BIRTH (MM-DD-YEAR) 09/09/28 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) [!] 1. Original Return D 4. Limited Estate [!] 6. Decedent Died Testate (AI\aCh copy of W~I) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (dale cfdeaih alter 12-12-82) D 7. Decedent Maintained a Living Trust (Al\achcopycfTrust) D 10. Spousal Poverty Credit {dale afdeath be\weeIl12.31-91 and 1-1-95} D 3. Remainder Return (dale cf death prier to 12-13-82) D 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) {Attach Sch 0) I- Z W Q Z o .. .. II! '" 8 NAME Mark E. Halbruner, Esquire FIRM NAME (''''_1 Gates, Halbruner & Hatch, P.C. TELEPHONE NUMBER (717) 731-9600 COMPLETE MAILING ADDRESS Gates, Halbruner & Hatch, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA t 7043 132,213.44 25,215.84 106,997.60 0.00 106,997.60 0.00 4,8 t 4,89 0.00 0.00 4,814.89 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) 0.00 957.96 0.00 0.00 126,714.12 z o ~ ::) l- ii: <( u w 0:: 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule 0) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Joinlly Owned Property (Schedule F) o Separate Billing Requested 7. InterNivos Transfers & Miscellaneous Non-Probate Property (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, Totsl Deductions (total Lines 9 & 10) 12. Net Value of Estate (line 8 minus line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to lax has not been made (Schedule J) (8) 17,533.81 7,682,03 (11) (12) (13) (6) 4,541.36 (7) 0.00 (9) (10) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !< ~ ::) a.. ::E o U ~ 15. Amount of Line 14 taxable at the spousal tax 0.00 x ,0 Q!L rate, or transfers under Sec. 9116 (a)(1.2) (15) 16. Amount of Line 14 taxable at lineal rate 106,997.60 x,O~ (16) 17. Amount of Line 14 taxable al sibling rate 0.00 x .12 (17) 18. Amount of line 14 taxable at collateral rate 0,00 x .15 (18) 19. Tax Due (19) 200 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADORESS 4175 Mountain View Road Cumberland Counlv CITY Mechanicsburg T STATEpA I ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2, CreditS/Payments A, Spousal Poverty Credit B, Prior Payments C, Discount (1) 4,814.89 0.00 4,500.00 225,00 Total Credits (A + B + C) (2) 4,725.00 3. InteresUPenalty if applicable D, Interest E, Penalty 0.00 0,00 4, TotallnteresUPenalty ( D + E ) If Une 2 is greater than Une1 + Une 3, enter the difference, This is the OVERPAYMENT. Check box on Page 1 Une 20 to request a refund (3) (4) (5) (5A) (5B) 0.00 0,00 89,89 0,00 89,89 5, If Une 1 + Une 3 is greater than Une 2, enter the difference, This is the TAX DUE, A, Enter the interest on the tax due, B, Enter the total of Une 5 + 5A, This is the BALANCE DUE, Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes D b, retain the right to designate who shall use the property transferred or its income; """,,,,,,,,.,,,,,,,,,,,,,,.,,,,,.,,,,,,,. D c, retain a reversionary interest; 0[,,,,...,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,""""""""'" D d. receive the promise for life of either payments, benefits or care? ...................................................................... D 2, If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? """"""",,,,,,,,,,,,,,,,,,,,.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"""'" D 3, Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? """"""" D 4. Did decedent own an Individual Retirement Account, annuity, or other non.probate property which contains a beneficiary designation? """"""""""""""""""""..""""""". ,."""""""""""""""""""", D ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 1, Did decedent make a transfer and: a, retain the use or income of the property transferred;""""""""""""""""""""""""""""""" No ~ ~ [iJ iii [iJ ~ oz ADDRESS Deborah A. S Ridge HiI ., Mechanicsburg, PA 17055 ~~R~E_S~~:A:I~E . ______.. .___~_ ADDRESS Mark E, Halbruner, Esquire c/o Gates, Halbruner & Hatch, P,C., 1013 Mumma Road, Suite 100, Lemoyne, PA 17043 Y M, Hallett, 416 Limestone Rd" Carlisle, PA 17013 DATE l':) II"'(Q~ For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P,S, ~9116 (a) (1.1) (i)], For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P,S, ~9116 (a) (1.1) (ii)] The statute dOAS not Axernot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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 stepperent of the child is 0% [72 P,S, ~9116(a)(1.2)], The tax rate imposed on the net value of transfers to orlor the use of the decedent's lineal beneficiaries is 4,5%, except as noted in 72 PS, ~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-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Hallett, Ruth II All property loIntly-owned wRh right of survivorship must be disclosed on Schedule F. SCHEDULE B STOCKS & BONDS FILE NUMBER 21-2002-0393 ITEM NO, DESCRIPTION 1. Edward Jonea Lord Abbett Bond Debenture; Class A; Acct. No. 270-0939B (lIee attached) VALUE AT DATE OF DEATH 957.96 o PAl5031 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) Copyright 2000 Greatland/Nelco lP - Forms Software Only NTF33300 957.96 PA REV-1500 SCHEDULE B STOCKS and BONDS Edward Jones 4829 East Trindle Road Mechanicsburg, PA 17050 (717) 763-7669 Mark R. Snyder Investment Representative EdwardJones May 30, 2002 Gates, Halbruner & Hatch, P.C. Attn: Traci L. Sepkovic 1013 Mumma Road, Suite 100 Lemoyne, Pa. 17043 Re: Estate of Ruth Marie Hallett Date of Death: March 18, 2002 Social Security Number: 159-24-7524 Dear Traci: This letter is in response to Ruth Marie Hallett, deceased. order that they are asked: your request for account information for I will respond to the questions in the 1. Ruth M. Hallett - single account - number 270-09398 2. There are no joint owners 3. The account was opened July 2, 2001 4. There was no change of ownership 5. The date of death balance was $957.96 6. Dividends earned from January 1, 2002 to date of death was $13.65 7. Not applicable If you have any questions, please call me 717-763-7669. "000'0", ( :m~f:sf:"~,". PA REV-1500 SCHEDULE E CASH, BANK DEPOSITS & MISCELLANEOUS PERSONAL PROPERTY REV-I50B EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Hallett, Ruth M 21-2002-0393 Include proceeds of litigation 6. date proceeds were received by the estate. All prop. Jointly-owned with rtght of survivorship must be disclosed on 8ch. F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 201. 64 1. Baltimore Life Life Xnsurance Policy A0969455 OWner: Ruth M. Hallett Xnllured: Elisha N. Hallett Value reported is surrender value. See attached XRS Form 712 2 Baltimore Life Life Xnllurance Policy 01152010776 OWner: Ruth M. Hallett Xnsured: Brenda S. Hallett Value reported is surrender value. See attached XRS Form 712. 3 Baltimore Life Life Xnsurance Policy 01152002989 OWner: Ruth M. Hallett Xnllured: Charles W. Sterling Value reported is surrender value. See attached XRS Form 712. 4 Baltimore Life Life Xnsurance Policy A0902794 OWner: Ruth M. Hallett Xnsured: Deborah A. Sterling Value reported is surrender value. See attached XRS Form 712. 5 Baltimore Life Life Xnsurance Policy A0902792 OWner: Ruth M. Hallett Xnsured: Erika L. Sterling Value report.d is surr.nder value. See attached XRS Form 712. 6 Baltimore Life Life XnBurance Policy A0902791 OWner: Ruth M. Hallett Xnsured: Jamie M. Sterling Value reported is surrender value. See attached XRS Form 712. 7 Baltimore Life Life Xnsurance Policy 01152010775 OWner: Ruth M. Hallett Xnsured: Jay M. Hallett Value reported is surrender value. See attached XRS Form 712. 8 Baltimore Life 1,272.88 11,434.73 3,700.41 399.07 367.44 2,177.27 2,504.75 Total from continuation pag.s.... o PAl5081 NTF 33305 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) Copyright2000 Greatland/Nelco LP- Forms Software Only 104,655.93 126,714.12 Bstate of: Hallett, Ruth M Schedule B -- Cash, Bank Deposits & Misc. Personal Property Page 2 21-2002-0393 It..... No. Description Value at Date of Death 8 Life Insurance Policy A0902790 OWner: Ruth M. Hallett Insured: Jay M. Hallett Value reported is surrender value. See attached IRS Form 712. BaltilllOre Life Life Insurance Policy A0957012 OWner: Ruth M. Hallett Insured: Shane B. Hallett Value reported is surrender value. See attached IRS Form 712. 167.57 9 10 Internal Revenue Service 345.00 Refund on 2001 income tax return 11 American Express Traveleres Check 100.00 Check No. RA290-283-420 12 BaltilllOre Life 102,993.36 Annuity No. A-468 Annuitant: Ruth M. Hallett Beneficiary: Bstate of Ruth M. Hallett (no beneficiary designated) 13 American Express Travelers Check Check No. HA429-474-419 14 Miscellaneous Personal Property 50.00 1,000.00 TOTAL. (Carry forward to main schedule) 104,655.93 REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Hallett, Ruth M SCHEDULE F JOINTL V-OWNED PROPERTY FILE NUMBER 21-2002-0393 11 an asset was made joint within one year 01 the decedent's date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME A.Sterling, Deborah A. ADDRESS 258 Ridge Hill Road Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT Daughter B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOA MADE Include name of financial Institution and bank DATE OF DEATH DECO'S VALUE OF JOINT account number or similar identifying number. NO. TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A 08/07/1993 rs 1st rederal Cred:Lt t 4,143.28 50.00 2,071.64 lliOD; Savings Account No. 13 4515-00 (Xncludes $3.35 interest acc jrued to date of death.) 2 A 06/23/2000 ~embers 1st rederal Credit t 2,918.41 50.00 1,459.20 Inion; Xnvestment Savings Ace ount No. 134515-05 (Xncludes $2.43 interest ace rued to date of death.) 3 A 02/18/1994 jMembers 1st rederal Credit t 2,021.04 50.00 1,010.52 nion; Checking Account No. 1 34515-11 TOTAL (Also enter on line 6, Recapitulation) $ 4,541.36 (If more space is needed, insert additional sheets of the same size) Copyright2000 Greatland/Nelco loP - Forms Software Only o PA15091 NTF33306 REY-1511EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Hallett, Ruth II SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-2002-0393 Debts of decedent must be reported on Schedule I. ITEM NO. DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ,. Malpezzi l'uneral Heale 4,220.00 l'uneral Good" and Service" 2 Wayne Nos" Plowers 159.00 Plowers for l'uneral Service B. ADMINISTRATIVE COSTS: ,. Personal Representative's Commissions *SEE ATTACHED FOR CO-EXECUTORS 6,300.00 Name of Personal Representative(s) Jay II. Hallett Social Security Number(s)/EIN No. of Personal Representative(s) Street Address 416 Lime"tone Road City Carlisle StatePA Zip 17014 Year(s) Commission Paid: 2002 2. Attomey Fees N......: Gates, Halbruner & Hatch, P.C. 6,300.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Ctaimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 218.00 5. Accountant's Fees 0.00 6. Tax RebJrn Preparer's Fees 0.00 7. COJIlClallt Cable 36.93 cable service 9 Patriot-News Co. 125.71 publication of estate notice 10 CUmberland Law Journal 75.00 publication of eBtate notice 11 UGI 34.99 gas service 12 Water Bill 14.37 13 PPL Utilities 12.19 electric service Totar from conUnuat:l.on page".... 37.62 TOTAL (Also enter on line 9, Recapitulation) $ 17,533.81 o PA16111 NTF 33308 (If more space is needed, insert additional sheets of the same size) Copyright 2000 Greatland/Nelco LP- Forms Software Only Estate of. Hallett, Ruth It Schedule H, Part B -- Administrative Costs xtem No. Description 14 Verizon phone service TOTAL. (Carry forward to main schedule) . . . . . . Page 2 21-2002-0393 Amount 37.62 37.62 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Hallett, Ruth M Include unrelmbursed medical expenses. ITEM NO. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER 21-2002-0393 DESCRIPTION 1. HealthSouth Rehabilitation Hospital medical service. rendered 4 Bxxon Credit Card Acct. No. 332 742 461 4 3 Brie J:nsurance Group automobile insurance premium on leased vehicle 4 Comc:ast Cable cable service 5 National Health I< Wellness Club III8IIlbership fee 6 PA Department of Revenue 2001 PA income tax liability 7 PPI<L Utilities electric .ervice 8 Water Bill 9 UGI gas service 10 CapitalOne KHart Credit Card Acct. No. 5570-0918-0699-3828 11 ATI<T Wireless cellular phone service 12 Baltimore Life Premium on life insurance policy owed at da te of death 13 ATI<T phone service 14 _ llDIerica Credit Card Acct. No. 5329 0900 1116 9756 15 Quantum J:maging I< Therapeutic Associates, J: AMOUNT 44.38 4.25 229.00 1.22 50.00 23.00 20.56 14.57 48.79 40.30 33.08 424.55 47.45 4,044.93 54.37 nc. medical bill 16 Verizon phone service 17 West Shore Bmergency Medical Services emergency medical transport 18 HealthSouth Rehabilitation Hospital medical services rendered 19 GllAC SmartLease FreYBinger Pontiac, Xnc. 2.12 39.60 23.00 4,578.86 o PA15121 NTF333Qij TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) CGpyright 2000 GreatlandJNelco LP - Forms Software Only 7,682.03 E.t.t. of: H.ll.tt, Ruth III Sch.dul. I -- Debt. of Dec.d.nt, Mortgag. Liabiliti.. & Li.n. I?g. 2 21-2002-0393 It..... No. Description V.lu. .t Dat. of De.th 19 Balanc. of 1.... owed on 2000 I?onti.c Grand Am '1'O'1'AL. (C.rry forward to ...in .ch.dul.) . . . . . . 0.00 REV.1513 EX'" (9-Dlf) . SCHEDULE J BENEFICIARIES COMMONWEAlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF Ruth M. Hallett FILE NUMBER 21-02-0393 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Tru.tse(sj OF ESTATE I TAXABLE OISTRIBUTIONS Fnr:lude outrighl spousal distributions. and transfers under sec. 9116 (a) (1.2}) 1. Jay M. Hallett Son $46,439.35 416 Limestone Road Carlisle, PA 17013 a. Schedule E: Life insurance policies on Jay M. Hallett, Brenda S. Hallett, Elisha N. Hallett and Shane E. Hallett b. One-Half of remainder 2. Deborah A. Sterling Daughter $60,558.25 258 Ridge Hill Road Mechanicsburg, PA 17055 a. Schedule E: Life insurance policies on Deborah A. Sterling, Charles W. Sterling, Erika L. Sterling and Jamie M. Sterling b. Schedule F: One-Half of accounts co-owned with decedent c. One-Half of remainder ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH lB, AS APPROPRIATE, ON REV-15110 COVER SHEET II 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 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed. insert addjtional sheals of the same size) ~ FIFTY US DOLLARS ~ ONE HUNDRI;D US DOLLARS., ~ U"I U !Xl ':.: ~ LIFE OF MARYLAND 10075 RED RUN BLVD OWINGS MlLLS. MD 21117-6050 0000024290 CHECK DATE 04/19/02 INVOICE DATE 04/19/02 ESTATE OF RUTH MARIE HALLETT C/O JAY M. HALLETT 416 LIMESTONE RD CARLISLE, PA 17013 000001 192486 REF/INV. if. DESCRIPTION DISCOUNT AMOUNT A-468 CLA1" ON RUTH HALLETT 102,993.36 . I 102,993.36 '.:I:ll:"l~<C!.I:5I'ti:I~";C;1'l..'"t'1'1"';":"I;lI~","III'.ti.::r:1lIjr.1:1;_;:(.lIl1ll."~.'1"1!','1..re1.:III..m.'JI::I.ril '1.M.\\\'i~Telii.'IIll.r:"L"\ i'/'#".r:!t.\\\"\,~ 'f.' ~'II!I.i:J1.\\ LIFE OF MARYLAND 10075 RED RUN BLVD OWINGS MlLLS. MD 21117-6050 7-11 S20 0000024290 PADne Hundred Two Thousand Nine Hundred Ninety-Three and 361100 Dollars TO THE ESTATE OF RUTH MARIE HALLETT ORDER OF DATE 04/19/02 NOH-NEGOnABLE AFTER. MONTHS I S .........102,993.36 AllFlRST BANK BALTIMORE, MARYLAND ESTATE OF RUTH MARIE HALLETT C/O JAY M. HALLETT 416 LIMESTONE RD CARLISLE, PA 17013 ~}~ AUTHORCZED SIGHA TURE . ~000002~2~O~ ~052000~~~~ ~70 2~ ~~~ 711" Fom; Tl2 (Rev. May 2000) Oepartmefltof Il'Ie lleasury Imemal Revenue Service Life Insurance Statement OMS No_ 1545.0022 5 Decedent-Insured (To be filed by the executor with Form 708, United States Estate (and Gencfation-Skipping Transfer) Tax Return, or Form 706.NA, United States Estate (and Generation-Skippin Transfer) Tax Return, Estate of nonresident not a citizen of the United States,) Decedent's first name and middle initial 2 Decedent's last name 3 Decedent's social security number 4 Date of death Ruth M. Hallett (if known) 159-24-7524 3-18-02 Name and address of insurance company The Baltimore Life Companies 10075 Red Run Blvd. Type of policy OWings Mills, Md. 21117 1 Policy number 6 8 Owner's name, If decedent is not owner, attach copy of application. 9 Date issued 10 Assignor's name. Attach copy of assignment. 11 Date assigned 12 Value of the policy at the 13 Amount of premium (see instructions) 14 Name of beneficiaries time of assignment 15 Face amount of policy 16 Indemnity benefits 17 Additional insurance 18 Other benefits . 19 Principal of any indebtedness to the company that is deductible in determining net proceeds 20 Interest on indebtedness (line 19) accrued to date of death. 21 Amount of accumulated dividends 22 Amount of post-mortem dividends 23 Amount of returned premium 24 Amount of proceeds if payable in one sum 25 Value of proceeds as of date of death (if not payable in one sum) 26 Policy provisions concerning deferred payments or installments. Note: If other than lump-sum settlement is authorized for a surviving spouse, attach a copy of the insurance policy. 15 $ 16 $ 17 $ 18 $ 19 5 20 $ 21 $ 22 $ 23 $ 24 $ 25 $ -'--.-.--.-"-.-'-.-"-__'__._.'_"'._.__._.._"_..n_n.h.__.._......__._._.._._.._._.._._.._.__.__._...._._.._ II . -.-..-.-..-....-.-.-....-.-..-.......-.-..-..-.......-....-..---...----.---.-..---.--.--.--.-.-----.-.-..-.-..--- 27 Amount of installments 28 Date of birth, sex, and name of any person the duration of whose life may measure the number of payments. ..-.-.--...--.-.------.-.-...--..-------.-.--.-..-..----------..--.--..-.-.----..-----------..-.--.-..-.--.----.. ----.-.-..-. -.--.-.-.-. -- .-..-.--.-.--.-_"_ ..-.. -._n_u_u____._._.._.__.____..._____._._.._h_h..___n_u._-.- 29 Amount applied by the insurance company as a single premium representing the purchase of installment benefits 30 Basis (mortality table and rate of interest) used by insurer in valuing installment benefits. ..-.--.-.--.-.--.-.-._.._._.._....__._.__.____..__..._n-....-_n________...._n___..___.._._..___.h...._..n_.._.__.__........._......_....... 31 Were there any transfers of the policy within the three years prior to the death of the decedent? 32 Date of assignment or transfer: I / Month Day Year 33 Was the insured the annuitant or beneficiary of any annuity contract issued by the company? 0 Yes 0 No 34 Did the decedent have any incidents of ownership on any policies on hislher life. but not owned by him/her at the date of dealh? 0 Yes 0 No 35 Names of companies with which decedent carried other policies and amount of such poficies if this information is disclosed by your records. . OVes ONo ...-.-.-.--.-.-..-....-.----.-.--.-..-.-.---.-.--.--.-..-..-.-----......-.---.-.-.-.--.-..--...-.----..-....-.--.-.--.-...------.-.-.----.-..-.- .----...--.-...-..-.-. _.._--_.-..__.....__.__.__.-..-.._._.__.-.._..._~.__.-.-..-.-.--....-..-..-.-..-..-.-....-.--..-.--.-..---.-..-...-.--.-.- The undersigned officer ot the above-named insurance company lor appropriate federal agency or retirement system official) hereby certifies that this statement sets forth true and correct information. . "9"''"'. ~ Il"-./-tuhtc;tq /'( A"J\.t-w-1n Title ~ Cat. No. 10170V ate of Certification'" I Form 712 (Rev. ~ ) fOfm 112 tReY. 5-20(0) Page 2 IillIIIII living Insured (File with Form 109. United States Gift (and Generation-Skipping Transfer) Tax Return. May also be filed with Form 706, United State'5 (state {and Generation-Skipping Trallsfer) Ta:A Return, or Form 106~NA. Ullitecl State'5 Estate land Generation-Skipping Transfer) Tax Return, Estate of nomesident I'1ot a citizen of the United States, where decedent owned insurance on fife of another.) SECTION A-General Information 36 First name and middle initial of donor (or decedent) 17 Last name Ruth M. Hallett 39 Date of gift for which valuation data submitted. 40 Date of decedent's death for which valuation data submitted SECTION 8-Policy Intormation 38 Social security number 159! 24 ! 7524 .~ . ~ 03-18-02 41 Name of insured Elisha N. Hallett 44 Name and address of insurance company The Baltimore Life Companies 10015 Red Run Blvd. Owings Mills, Md. 21117 42 Sex F 43 Date of birth 09-17-96 45 Type of policy [46 Policy number 47 Face amount 48 Issue date Flextra (Life) A 0969455 $25,000 10-14-96 49 Gross premium 50 Frequency of payment 516.00 Monthly 51 Assignee '5 name 52 Date assigned 53 If irrevocable designation of benefICiary made. name of 54 Sex 55 Date 01 birth. 56 Date beneficiary if known designated 57 If other than simple designation, quote in full. (Attach additional sheets jf necessary.) 58b 5Se $52.75 4.12 59c 59d 5Se $201.64 58 If policy is not paid up: a Interpolated terminal reserve on date of death, assignment, or irrevocable designation of beneficiary . . . . b Add proportion of gross premium paid beyond date of death, assignment, or irrevocable designation of beneficiary c Add adjustment on account of dividends to credit of policy d Total (add lines 58a. b. and c) . . . . . e Outstanding indebtedness against policy . f Net total value of the policy (for gift or estate tax purposes) (subtract line 5Se rfom line 5Bd) S9 If policy is either paid up or a single premium: a Total cost, on date of death, assignment or irrevocable designation of beneficiary, of a single-premium policy on life of insured at attained age. for original face amount plus any additional paid-up insurance (additional face amount $ ) .......... (If a single-premium policy for the total face amount would not have been issued on the life of the insured as of the date specified, nevertheless, assume that such a policy could then have been purchased by the insured and state the cost thereof. using for such purpose the same formula and basis employed, on the date specified, by the company in calculating single premiums.) b Adjustment on account of dividends to credit of policy c Total (add lines 59a and 59b) . . . . d Outstanding indebtedness against policy e Net total value of otic (for jft or estate tax ur oses) (subtract line 59d from line 59c) 58a $144.71 59a 59b $201.64 Tht! under<;igned officer of the above-named insuram:e compimy (or appropriate Federal agency or retirement 5y~tem official) hereby certitie", that thIS statement sets forth true and correct information. Sig"at~'" C\.vj;:Hh.Q...~ R )JJ,j V-t..:>.-'--:t/\ Title" J- Date of Certification .. I 1<;/0. Form 712 (Rev_ 5~2000) Fo'm 712 {Rev. May 2000) Depan(nel\lnl the. fre;'l5\JT)' Internal Rellenue service Life Insurance Statement OMB No. 15<15-0022 Decedent-Insured lTo be filed by the executor with form 706. United States Estate (and Generation-Skipping Transfer) Tax Return, or Form 706-NA, Unrred States Estate land Generation-Skippin Transferl Tax Return, Estate of nonresident not a citizen of the United States.) Decedent's first name and middle initial 2 Decedent's last name 3 Decedent's social security number 4 Date of death Rulh M. Hallett or known) 159-24--7524 3-18-02 5 Name and address of insurance company The Baltimore Life Companies 10075 Red Run Blvd. Type of policy OWings Mills, Md. 21117 1 Policy number 6 8 Owner's name. If decedent is not owner, attach copy of application. 9 Date issued 10 Assignor's name. Attach copy of assignment. 11 Date assigned 12 Value of the policy at the 13 Amount of premium (see instructions) 14 Name of beneficiaries time of assignment '5 Face amount of policy 16 Indemnity benefits 17 Additional insurance 18 Other benefits . 19 Princlpal of any indebtedness to the company that is deductible in determining net proceeds 20 Interest on indebtedness (line 19) accrued to date of death. 21 Amount of accumulated dividends 22 Amount of post-mortem dividends 23 Amount of returned premium 24 Amount of proceeds if payable in one sum 25 Value of proceeds as of date of death (if not payable in one sum) 26 Policy provisions concerning deferred payments Dr installments. Note: If other than lump-sum settlement is authorized for a surviving spouse, attach a copy of the insurance policy. 15 $ 16 $ 11 $ 18 $ 19 $ 20 $ 21 $ 22 $ 23 $ 24 $ 25 $ .-..-.--.---------.__._.._.____..._________..__._..__._..__.__.____________.._.__.__h_._______.._.._...._.._._~. II . 27 Amount of installments 28 Date of birth. sex, and name of any person the duration ot whose life may measure the number of payments. -.-----.-.__.____._._.._.__.~..__.__.__.__.__.__.__.___________._____n__._.___.__._____.__.__.~.._.___.___.._.._ - -. - - - -. - - - -. - - _ -. _. _ _ _ _ _. _ _. _. _ _. _ _.._. _ _..~ _. _ __ _. _ _ h _ h_ ._. .____ ._._.._ _ _ ._._ _. ._. __ .._. ~_. _ _. _.. _ u _ u ___ _._ 29 Amount applied by the insurance company as a single premium representing the purchase of Jnstallment benefits . 30 Basis (mortality table and rate of interest) used by insurer in valuing installment benefits. .-.----------.--.-.-..-.----..-..-.._____._.._.._.._.._..________._.._...___.__._U_h_._.__.._..__.___.._..~..~.._...u_.__.__.____.___......._ 31 Were there any transfers of the policy within the three years prior to the death of the decedent? 32 Date of assignment or transfer: I / Month Day Year 33 Was the insured the annuitant or beneficiary of any annuity contract issued by the company? 0 Yes 0 No 34 Did the decedent have any inddents of ownership on any poliCieS on hislher life, but not owned by him/her at lhe dale of dealh? DYes D No as Names of companies with which decedent carried other policies and amount of such pOlicies if this information is disclosed by your records. . DYes DNo -._---_.-.-..-._-----.~-.~.._._-_._.._..-..-.--..-.---.-_.-..-._--_.._....--..-.--..__.-.~..__...._.__.-..-..-....-..-..-.--.---.--.---...--.-.. --..----.---..-.-.-.--.-..-.--..-.--.--.--.--.-----..-.-..._-----.._._~..~.._--..-..__...~.._..__._..._-_.-.-------..-..-.--....--.-.--.-...-.-. The ufld~j9ned officer ot the above-named insurance company lor appropnate federal agency OJ retirement system officjal) hereby certifIeS that this statement sets ::,::,: ': e~J;:;::m R A~1.0A]1 T~e" A V P, ~ . Q.A Date or Cernfic,tio" .. 7 1$ d.. Cat. No. lD17DV Form 712 (Rev. 5-2000) Fam 712 (Rev. 5-2000) Page 2 ImII Uving Insured (File with Form 709. United States Gift (and Generation-Skipping Transfer} Tax Return. May also be filed with form 706. United States Estate (and GeT'\eTation-Skipping TraT'\sfer) Tax Retum, or Form 706-NA, United States Estate "md Generation-Skipping Transfer) Tax Retum, Estate of nonresident not a citizen of the United States, where decedent owned insurance on life of anothe,') SECTION A-General Information 36 First name and middle initial of donor (or decedent) 31 Last name Ruth M. Hallett 39 Date of gift for which valuation data submitted. 40 Date of decedent's death for which valuation data submitted 38 Social security number 159! 24 ! 7524 ... ... 03-18-02 SECTION B-Policy Information 41 Name of insured Brenda S. Hallett 44 Name and address of insurance company The Baltimore Life Companies 10075 Red Run Blvd. Owings Mills, Md. 21117 42 Sex F 43 Date of birth 04-30-85 45 Type of policy 146 Policy number 47 Face amount 48 Issue date Universal life 01152010776 $204,600 08/01/95 49 Gross premium 50 Frequency of payment $92.00 Monthly 51 Assignee's name 52 Date assIgned 53 If irrevocable designation of beneficiary made, name of 54 Sex 55 Date of birth. 56 Date beneficiary if known designated 57 If other than simple designation, quote in full. (Attach additional sheets if necessary.) 58 If policy is not paid up: a Interpolated terminal reserve on date of death, assignment, or irrevocable designation of beneficiary .,.......... b Add proportion of gross premium paid beyond date of death, assignment, or irrevocable designation of beneficiary c Add adjustment on account of d,vidends to credit of policy d Total (add iines 58a, b, and c) . . .. .... e Outstanding indebtedness against policy. f Net total value of the policy (for gilt or estate tax purposes) (subtract line 5Se from line 58d) 59 If policy is either paid up or a single premium: a Total cost, on date of death, assignment, or irrevocable designation of beneficiary, of a single-premium policy on lifa of insured at attained age, for original face amount plus any additional paid-up insurance (additional face amount $ )..__...... (If a single-premium policy for the total face amount would not have been issued on the life of the insured as af the date specified, nevertheless, assume that such a policy could then have been purchased by the insured and state the cost thereof, using for such purpose the same formula and basis employed, on the date specified, by the company in calculating single premjums.) b Adjustment on account of dividends to credit of policy c Total (add lines 59a and 59b) . . . . d Outstanding indebtedness against policy. e Net total value of olie (for ift. or estate tax ur ses) (subtrac~ line 59d from line 59c) 58a $1,272.88 59c 59<1 5ge $1,272.88 58b 58c 598 59b $1,272.88 The underSigned olficer of the above-named insurance company (Of appmpnate Federal agency or retirement system afficiell hereby certifres that thiS statement sets fanh true and correct information Signature ... 1vt{)~*tr- R. ~J\.<-,->{~ Title'" -.4 Date of SCt.....;. l.; ~ G-4 Certification ... F~m Decedent-Insured (To be filed by the executor with Form 106, United States Estate land Generation-Skipping TTansfe'~ Tax Return. or Form 706-NA, United States Estate (and Genefation-Skippin Transfer) Tax Return, Estate of nonresident not a citizen of the United StatesJ Decedent's first name and middle initial 2 Decedent's last name 3 Decedent's social security number 4 Date of death Ruth M. Hallell [of known) 159-24-7524 3-18-02 Name and address of .Insurance company The Baltimore Life Companies 10075 Red Run Blvd. Type of policy Fcrm 712 (Rev, May 2000) Oepilrtl11!:'.ntol Ine lreasury Internal Rel/illllle S"'1Vlce life Insurance Statement 5 6 Owings Mills. Md. 21117 7 Policy number 8 Owner's name. Jf decedent is not owner, attach copy of application, 9 Date issued 10 Assignor's name. Attach copy of assignment. 12. Value of the policy at the 13 Amount of premium (see instructions) 14 Name of benefICiaries time of assignment 15 Face amount of policy 16 Indemnity benefits 17 Additional insurance 18 Other benefits . 19 Principal of any indebtedness to the company that is deductible in determining net proceeds 20 Interest on indebtedness (line 19) accrued to date of death. 21 Amount of accumulated dividends 22 Amount of post-mortem dividends . 23 Amount of returned premium 24 Amount of proceeds if payable in one sum 25 Value of proceeds as of date of death (if not payable in one sum) 26 Policy provisions concerning deferred payments or installments. Note: If other than lump-sum settlement is authorized for a surviving spouse, attach a copy of the insurance policy. - ~_~ - _. - - - ~ - - - - - _.. - - - _. - - _. - - - - - - _. - - - - - - _. - - - - - - _._ _u ___ _ __ _ _ _ _ __ _ __ _ __. __. _ _ _ __ _ - _ - _ - - - -... - - - - - ~ -- - - - - - -. - -. _ _ __ _ _ _ _ _. _ _ _ ~ ~. _ _ _ _ h __ _ _ _ _. _. _ _. _ _. _.. _ _. _ _ __ _ h _ _ _ _ __ _ _~_ _ - _ ~_ - __ - - _____ _~ - u _ __ ___ - -. --. - -. -- - - - - - -. - - - - -. - -- 27 Amount of installments 28 Date of birth, sex, and name of any person the duration of whose life may measure the number of payments. -----~-_._---------.-----_..._--.----------~-.-------.----.-._--------~-_._..~-.------------~-----~---.----~-.--- ---~---------------------------------------------.---------..------------------.-.-----------------------------.- 29 Amount applied by the insurance company as a single premium representing the purchase of installment benefits , 30 BaSIS (mortality table and rate of interest) used by insurer in valuing installment benefits. OMS No. 1545-0022 11 Date assigned 1S $ 16 $ 17 $ 18 $ 19 $ 20 $ 21 $ 22 $ 23 $ 24 $ 2S $ _ _ _ _... _ _ _ _ _ _ _ _ _ _ _~ _ _ _ _ ~ _ _ _ _~__ _. _ _ _. _ _ __ _ _ _' __ _ __ _ __ _ u _ _ _ _ n _ ___ _ _. __ .__ _ __ ~_~_______ _' __ _ ~ _ __.. _ _. _._ _ u _ _. _ _ __ u - _ - - u_ _ -_ _ -~ -___.. - - - - -~ - -- . DVes DNa 31 Were there any transfers of the policy within the three years prior to the death of the decedent? 32 Date of assignment or transfer: I I Month Day Year 33 Was the insured the annuitant or benefrdary of any annuity contract issueD by the company? 0 Yes 0 No 34 Did the decedent have any incidents of ownership on any policies on hislher life, but not owned by him/her al the date of dealh? D Yes D No 3S Names of companies with which decedent carried other policies and amount of such policies if this information is disclosed by your records. - - --." - -. - ~. ~ - - - -. - -- - -.- - - - - - -,- - - - - - -~- - - - - -. -~. ----- - -- - ~---~. -- --. ---- -- ----.---- --- --. ----~- -.-. -- - -. - - - -~~. - -. - - - -. - - -- - -.- -.- -- - -----~-- _ _ _ _ _ __ __. _ _~ _ _. _ _ _ __. _ _. _ _ _ _ _. __. _ _ _ __ _ _ _ _ _ _ __.__ _ __. h_~.___. _ _ ___.___ __ __.~ _~~ __ _ u_ _ __ _ _~ _ __ _ h. _~_. .____ __~~ __. _ _ - __ ______.. _._ - ____n -- --- Signature ... ..JX\L~ Title ~ A ,SJ...1...-v1-U "t The undersigned officer of the above-named insurance company lor appropriate Federal agency or retirement s~tem offIcial) hereby certifies that this statement sets forth true and ect inf rmation. Date of Certiflcatioo .. Fcrm 712 (Rev.5-2000l I( Cat, No. 10170V lsl~ Form 712 (Rev, 5-2000) Page 2 ImII Living Insured (File with Form 109, United States Gift (and Generation-Skipping Transferl Tax Return. May also be fried with form 106, United States Estate (and Ger'ieration~S'Kippjng Transfer) Tax Return, or Form 106-NA, United State~ Estate (and Generation-Skipping Transfer) Tax Return, Estate of nonresider'it not a citizen of the United States. where decedent owned insurance Ol1l\fe of anottler,) SECTION A-Generallnfonnation 36 First name and middle initial of donor (or decedent) 37 Last name Ru1h M. Hallett 39 Date of gift for which valuation data submitted . 40 Date of decedent's death for which valuation data submitted SECTION B-Policy Information 38 Social security number 159; 24 ! 7524 .~ . ~ 03-18-02 41 Name or insured Charles W. Sterling 44 Name and address of insurance company The Baltimore Life Companies 10075 Red Run Blvd. Owings Mills, Md. 21117 42 Sex M 43 Date of birth 02.26-56 45 Type of policy 146 Policy number 47 Face amount 48 Issue date Universal Ufe 01152002989 nll.700 7/31/90 49 Gross premium 50 Frequency of payment $125.00 Monthly 51 Assignee's name 52 Date assigned 53 If irrevocable designation of beneficiary made, name of 54 Sex 55 Date of birth, 56 Date benefidary if known designated 57 If other than Simple designation, quote In full. (Attach additional sheets If necessary.) 58 If policy is not paid up: a Interpolated terminal reserve on date of death, assignment, or irrevocable designation of beneficiary ..... 58a 511,434.73 b Add proportion or gross premium paid beyond date of death, assignment or irrevocable designation of beneficiary 58b c Add adjustment on account of di..ndends to credit of policy sSe d Total (add lines 58a, b, and c) . . . . e Outstanding indebtedness against policy. f Net total value of the policy (fOf gift or estate tax purposes) (subtract line 5Se from line 58d) 59 If polic)' is either paid up or a single premium: a Total cost, on date of death, assignment, or irrevocable designation of beneficiary, of a single-premium policy on life of insured at attained age, for original face amount plus any additional paid-up insurance {additional face amountS ).......... 59a (If a single-premium policy for the total face amount would not have been Issued on the life of the insured as of the date specified, nevertheless, assume that such a policy could then have been purchased by the insured and state the cost thereof, using for such purpose the same formula and basis employed, on the date specified, by the company in calculating single premiums.) b Adjustment on account of dividends to credit of policy 59b c Total (add lines 59a and 59b) 59c d Outstanding indebtedness against policy 59d e Net total value of olic (for ift or estate tax u oses) (subtract line 59d from line 5ge) 5ge $11,434.73 The undersigned {)fficer {)f the above-named Insurance company (or appropriate Federal agency or retirement system offlcialj hereby certifies that this statement sets forth true and correct information. Signature ~ Title ~ t\ .; jJ '\ f~c\)._ j i"~ C .\ g:r~ation ... cl.. Form 712 (Rev. 5-20001 Fo,m712 (Rev_ May 20001 Depanment of tile lrea",1lf)' Internal Revenue Service Life Insurance Statement OMS No. 1545-0022 Decedent-Insured [To be filed by the executOf with Form 106. United States Estate (and Generatton-Skipping Tfansfer) Tax Return. or Form 706-NA, United States Estate (and Generation-Skippin Transfer) Tax Return. Estate of nonresident not a citizen of the United States.l Decedent's first name and middle inITial 2 Decedent's last name 3 Decedent's social security number 4 Dale of death Ruth M. Hallell Of known) 159-24-7524 3.18-02 5 Name and address of insurance company The Baltimore Life Companies 10075 Red Run Blvd. Type of poltcy OWings Mills, Md. 21117 1 Policy number 6 8 Owner's name. If decedent is not owner, attach copy of application. 9 Date issued 10 Assignor's name. Attach copy of assignment. 11 Date assigned 12 Value of the policy at the 13 Amount of premium (see instructions) 14 Name of benefICiaries time of assignment '5 Face amount of policy 16 Indemnity benefits 17 Additional insurance 18 Other benefits. 19 Principal of any indebtedness to the company that is deductible in determining net proceeds 20 Interest on indebtedness (line 19) accrued to date of death. 21 Amount of accumulated dividends 22 Amount of post-mortem dividends . 23 Amount of returned premium 24 Amount of proceeds if payable in one sum 25 Value of proceeds as of date of death (if not payable in one sum) 26 Policy provisions concerning deferred payments or installments. Note: If other than lump-sum settlement is authorized for iJ surviving spouse, attach a copy of the insurance policy. 15 $ 16 $ 17 $ 18 $ 19 $ 20 $ 21 $ 22 $ 23 $ 24 $ 25 $ 27 Amount of installments 28 Date of birth, sex, and name of any person the duration of whose Me may measure the number of payments. 29 Amount applied by the insurance company as a single premium representing the purchase of installment benefits 30 Basis (mortality table and rate of interest) used by insurer in valuing installment benefits. _ _ _ _ _ _ _ _ _. _.. _ h._ h. d. _.. h.... __ _ _. _. _ # _..__ _ __... _ __ _ __.._ __. ..___. _... .._.. _ __. _.... _ # _ #...._ _ h.... _.......... _.. ._.. _.. _ .~. _.. n. .~_.. -.. . DYes DNo 31 Were there any transfers of the policy within the three years prior to the death of the decedent? 32 Date of assignment or transfer: I I Month Day Year 33 Was the insured the annuitant or beneficiary of any annuity contract issued by the company? 0 Yes 0 No 34 Did the decedent have any incidents of ownership on any policies on his/her life. but not owned by him/her allhe date of death? DYes 0 No 3S Names of companies with which decedent carried other policies and amount of such potides if this information is disclosed by your records. The undersigned offrcer of the above-named insurance c.ompany tor appropriate federal agency or retiremeilt system official) hereby certifies that this statement sets forth true an~ect inf rmat~on. Signature .. "-.t L- Title ... Date 01" Catifir;ation'" J Cat. No. 10170V Form 712 (Rev. 5-2000) i~ '<. Form 712 (Rev. 5-2000) ImII Living Insured {File w;th Form 709, United States Gift (and Generation-Skipping Transfer) Tax Return. May also be filed with Form 106, United States Estate (and Generation-SKipping Transfer) Tax Return, or Form 106-NiII., Urnted States Estate (and Generation-Skipping Transfer) Tax Return, Estate of nonresident not a citizen of the United States, where decedent owned insurance on life of another,) Page 2 SECTION A-General Information 36 First name and middle initial of donor (or decedent) 31 last name Ruth M. Hallett 39 Date of gift for which valuation data submitted , 40 Date of decedent's death for which valuation data submitted 38 Social security number 159: 24 ! 7524 .~ . ~ 03-18-02 SECTION 8-Policy Information 42 Sex F 43 Date of birth 05-25-56 41 Name of insured Deborah Ann Sterling 44 Name and address of insurance company The Baltimore Life Companies 10075 Red Run Blvd. Owings Mitis, Md. 21117 45 Type of policy 146 Policy number 47 Face amount 48 Issue date Flextra {Life} A 0902794 550,000 07-01-90 49 Gross premium 50 Frequency of payment $60.26 Monthly 51 Assignee's name 52 Date assigned 53 If irrevocable designation of beneficiary made, name of 54 Sex 55 Date of birth. 56 Date benefidary jf known designated 57 If other than simple designation, quote in full. (Attach additional sheets if necessary.) 58b 5tIc 5206.89 5794.20 $3.700.41 58 If policy is not paid up: a Interpolated terminal reserve on date of death, assignment, or irrevocable designation of beneficiary ..... . . . . , b Add proportion of gross premium paid beyond date of death, assignment, or irrevocable designation of beneficiary c Add adjustment on account of d\\lidends to credit of policy d Total (add lines 58a. b, and c) . . . . e Outstanding indebtedness against policy. f Net total value of the policy (for gift Of eslale tax PUfPOses) (subtract line 58e from line 58d) 59 If policy is either paid up or a single premium: a Total cost, on date of death, assignment, or irrevocable designation of beneficiary, of a single-premium policy on life of insured at attained age, for original face amount plus any additional paid-up insurance {additional face amount 5 ).... ........ (If a single-premium policy for the total face amount would not have been issued on the life of the insured as of the date specified, nevertheless, assume that such a policy could then have been purchased by the insured and state the cost thereof, using far such purpose the same formula and basis employed, on the date specified, by the company in calculating single premiums.) b Adjustment on account of dividends to credit of policy 59b c Total (add lines 59a and 59b) 59c d Outstanding indebtedness against policy. 59d e Net total value of pofic (for ift or estate tax u oses)(subtract line 59d from fine 59cl 5ge S3.700.41 The undersigned officer of the above-named insurance company (or appcopriate Federal agency or retirement system official) hereby certifies tl1at this statement setS forth true and ~ooect information. S'gn""," .. Q~6~m K i~~\.-\-~~-\;c-'1 T~"" 58a $2,699.32 59a / Date of CertificatiOn __ Fmn 712 (Rev, 5.2000\ "liS 1;;;;_ Decedent-Insured (To be filed by the executor with Form 106, United States Estate (and Generation-Skipping Tfansfer) Tax Retum or form J06-NA, United States Estate (and Generation-Skipping Transfer) Tax Return. Estate of nOnfesident not a cftizen of the United States.} Decedent's first name and middle initial 2 Decedent's last name 3 Decedent's social security number 4 Date of death Ruth M. Hallett lif known) 159-24-7524 3-18-02 Name and address of insurance company The Baltimore Life Companies 10015 Red Run Blvd. Type of policy Form 712 (Rev. May 2000l Deparlmenl of tile rr(>.3sIJI'f Internal Revenue Service Life Insurance Statement 5 6 OWings Mills, Md. 21117 1 Policy number 8 Owner's name. If decedent is not owner, attach copy of application. 9 Date issued 10 Assignor's name. Attach copy of assignment. 12 Value of the policy at the 13 Amount of premium (see instructions) 14 Name of benefICiaries time of assignment 15 Face amount of policy 16 Indemnity benefits 17 Additional insurance 18 Other benefits. 19 Principal of any indebtedness to the company that is deductible in determining net proceeds 20 Interest on indebtedness (line 19) accrued to date of death. 21 Amount of accumulated dividends 22 Amoum of post-mortem dividends 23 Amount of returned premjum 24 Amount of proceeds if payable in one sum 25 Value of proceeds as or date of death ~f not payable in one sum) 26 Policy provisions concerning deferred payments or installments, Note: If other than lump-sum settlement is authorized for a surviving spouse. attach a copy of the insurance policy 27 Amount of installments 28 Date of birth, sex, and name ot any person the duration of whose life may measure the number of payments. 29 Amount applied by the insurance company as a single premium representing the purchase of installment benefits . 30 Basis (mortality table and rate of interest) used by insurer in valuing installment benefits. OMS No. 1545-0022 11 Date assigned 15 $ 16 $ 17 $ 18 $ 19 $ 20 $ 21 $ 22 $ 23 $ 24 $ 25 $ II . ._h'_'_.._._...___'___~._'___'._._'_'.___'.'_________".___._..___._..__________._~._._...._._._...._____.__._.___..-.---.....---.---.----..... . DYes DNa 31 Were there any transfers of the policy within the three years prior to the death of the decedent? 32 Date of assignment or transfer: I I Month Day Year 33 Was the insured the annuitant or beneficiary of any annuity contract issued by me company? 0 Yes 0 No 34 Did the decedent have any inddents of ownership on any policies on his/her life, but not owned by him/her at the date of death? DYes D No 35 Names of companies with which decedent carried other policies and amount of such policies if this information is disclosed by your records. ._-_.-.-._...._._-_._._---_.._._._..---.-.-~.-.-~.~._--_.._-.._-~.-.-.-_.__._._._-"-_.._._----.-.-.._--.-.-.~_._._._~._._......--_._-------_.__. Th. e und€!S19n~fflcer of the above-named insuran. ce company. (or appropriate Federal agency or retin!ment system offICial) hereby certifies that this statement sets forth true. and ect Inf~rmatIQn. I S.gn'M'" 1",(j\:;L R M01'u.~ itle" Dot' a. Certi"e,bon" 1 I 5 J ~ Cat. No. 10170V Form 712 (Re.v. 5-2000) , , Form 712 (Rev. 5-2000\ ... Page 2 living Insured {File with Form 709, United States Gift (and Generation-Skipping Transfer) Tax Return. May also be filed with Form 706, United States Estate (and Generation-SKipping Transfer) Ta)( Return. or Form 706A'IA, Ut'iited States Estate land Generation~Sklpping Transferl Tax Return, Estate of nonresident not a citizen of the United States, where decedent owned insurance on life of another.) SECTION A-General Information 36 First name and middle initial of donor (or decedent) 37 Last name Ruth M. Hallett 39 Date of gift for which valuation data submitted. 40 Date of decedent's death for which valuation data submitted 38 Social security number 159 ~ 24 : 7524 .~ . ~ 03-18-02 SECTION B-Policy Information 42 Sex F 43 Date of birth 09-28-84 41 Name of insured Erika L. Sterling 44 Name and address of insurance company The Baltimore Life Companies 10075 Red Run Blvd. Owings Mills, Md. 21117 45 Type of policy 146 Policy number 47 Face amount 48 Issue date Ftextra (life) A 0902792 515,000 07-01-90 49 Gross premium 50 Frequency of payment $15.19 Monthly 51 Assignee's name 52 Date assigned 53 If irrevocable designation of beneficiary made, name of 54 Sex 55 Date of birth, 56 Date beneficiary if known designated 57 If other than simple designation, quote in full. (Attach additional sheets if necessary,) 58 If policy is not paid up: a Interpolated terminal reserve on date of death, assignment. or irrevocable designation of beneficiary . _ . _ . - . - . b Add proportion of gross premium paid beyond date of death, assignment, or irrevocable designation of beneficiary c Add adjustment on account of di\lidends to credit of policy d Total (add lines 58a, b, and c) . . . . e Outstanding indebtedness against policy. .... I Net total value of the policy (for gift or estate tax purposes) (subtract line sSe Irom line 58d) 59 If policy is either paid up or a single premium: a Total cost, on date of death, assignment, or irrevocable designation of beneficiary, of a single-premium policy on life of insured at attained age, for original face amount plus any additional paid-up insurance (additional face amount $ ).. ....,. (If a single~premium policy for the total face amount would not have been issued on the life of the insured as of the date specified, nevertheless, assume that such a policy could then have been purchased by the insured and state the cost thereof, using for such purpose the same formula and basis employed, on the date specified, by the company in calculating single premiums.) b Adjustment on account of d,vidends to credit of policy c Totalladd lines 59a and 59b) d Outstanding indebtedness against policy. e Net total value of oUe (for ift. or estate tax or ases) {subtract line 59d from line 59cl 588 $235.62 59c 59<1 sSe 5399.07 SUb sUe $52.t5 $111.30 59a 59b 5399.07 The undersigned officer of the above-named Insurance company (or appropriate Fedcf:11 agency or retirement system offiCial) hereby certifies that tl1is statement SetS fonh twe "d Ii'ct 'n'I"~_ ^ ~ S'gnatu," ~ Ij;.vUmXj\A..\. R ./oJd",vtdt/\ r,tl' ~ n / e g:::;f~"'on ~ ') 0 Form 712 (Rev, 5-2000\ Fo<m 712 (Rev. May 2000) IJepanmenl althe lreasury Internal Rev!Omle$efVi{:e Life Insurance Statement OM8 No. 1545-0022 Decedent-Insured [To be filed by the executor with Form 10&, United States Estate land Generation.Skipping Transfer) Tax Return. or Form 706.NA, United States Estate (and Generation-Skippin Transferl Tax Return. Estate of nonresident not a citizen of the United States,) Decedent's first name and middle initial 2 Decedent's last name 3 Decedent's social security number 4 Date of death Ruth M. Hallett (if known) 159-24-7524 3-18-02 5 Name and address of insurance company The Baltimore life Companies 10075 Red Run Blvd. Type of policy OWings Mills, Md. 21117 7 Policy number 6 8 Owner's name. If decedent is not owner, aUach copy of application. 9 Date issued 10 Assignor's name. Attach copy of assignment. 12 Value of the policy at the 13 Amount of premium (see instructions) 14 Name 0( benefICiaries time of assignment 15 F ace amount of policy 16 Indemnity benefits 17 Additional insurance 18 Other benefits. 19 Principal of any indebtedness to the company that is deductible in determining net proceeds 20 Interest on indebtedness (line 19) accrued to date of death. 21 Amount of accumulated dividends 22 Amount of post-mortem dividends 23 Amount of returned premium 24 Amount of proceeds if payable in one sum 2S Value of proceeds as of date of death (if not payable in one sum) 26 Policy provisions concerning deferred payments or installments. Note; If other than lump-sum settlement is authorized for a surviving spouse, attach a copy of the insurance policy .'-'-'--'-""-'--'_'_'~_'__'_"_'____'_"____._n'h.h_____..__..__..__..__...._.._.__._._.__._.._.~...._._.._. ..-.-..---....-_._._...._.._._.._._.__...___._..n.n.__..___........._____..._._h_____.__..._...._.._.__..___.. 27 Amount of installments 28 Date of birth, sex, and name of any person the duration of whose lire may measure the number of payments, -.---.- -.,- ----._.._._.__._.___~.._h_h.__.__~.h.h___._..n_..__.____u__.._.~.__u..______.._.___________nn -----------.------.------.--.--.--.-.--.-.-------.--.---..-.--.-----.-.---------.-..-.--...-.--.--.----...--'-... 29 Amount applied by the insurance company as a single premium representing the purchase of installment benefits . 30 Basis (mortality table and rate of interest) used by insurer in valuing installment benefits. 11 Date assigned 15 $ 16 $ 17 $ 18 $ 19 $ 20 $ 21 $ 22 $ 23 $ 24 $ 25 $ II . ----.-.--.------.-.--.-.-.--.-.--.--.-..-.-----..--.---.--.--..---.-------.---.--------....--..------.--..---.__.._-_._.__.__._-~_._._--._--_._.- 31 Were there any transfers of the policy within the three years prior to the death of the decedent? 32 Date Of assignment or transfer: / / Month Day Year 33 Was the insured the annuitant or beneficiary of any annuity contract issued by the company? 0 Yes 0 No 34 Did the decedent have any incidents of ownership on any policies on hislher life, but not owned by him/her at the date of death? D Ves D No 35 Names of companies with which decedent carried other pO~Cie5 and amount of such policies if this information is disclosed by 'Jour records. _ DVes DNo . - -- -. --. -- -..-..- -.'. - -- -- - -.- -- -..- --. --.-. -- ---- --- ._-~. --- ---. _._~---- --- ---. -.. --.- -- - - - ---. - --- -. ~-~- -.' - -' - ---- --- ._~ ---.-. -".. - -. - -. --- .-..--.--.-.-.-....----.------.----..---..-------..--..-._.-.--_.-_._--._-_.__._---~--_.-.----_._-_..-.._.---.-----.-----...-.----..--.----.--.. The undersigned officer of the above-named insurance company (or appropriate federal agency or retiremem system official) hereby certifies. that this statement sets forth true and wect inFoFation_, ,0 ~ . . 5'90""" ~ t"",,---V\)Y\.Q.W K ~.t.V-'-;b rm. ~ ( 0". of Cen>f",aUon ~) ( S ~ Cat. No. 10170V Form 712 (Rev. 5-2000) FOfm 712 (Rev. 5-20001 Page 2 ImII living Insured (File with Form 709, United States Gift (and Generation-Skipping Transfer) Tax Return. May also be filed with Form 106, United States Estate \and Generation-Skipping Transfer) Tax Return. or Form 706-NA, Unitoo State5 Estate tanG Generation-Skipping Transfer) Tax Return, Estate of nonresident not a citizen of the United States, where decedent owned insurance on life of another.) SECTION A-Generallnfonnation 36 First name and middle initial of donor (or decedent) 37 Last name Ruth M. Hallell 39 Date of gift for which valuation data submitted, 40 Date of decedent's death for which valuation data submitted 38 Social security number 159~ 24: 7524 .~ . ~ 03-18-02 SECTION B-Policy Information 41 Name of insured Jamie M. Sterling 44 Name and address of insurance company The Baltimore Life Companies 10075 Red Run Blvd. Owings Milts, Md. 21117 42 Sex F 43 Date of birth 07-12-83 45 Type of policy 146 Policy number 47 Face amount 48 Issue date Flextra (Life) A 0902791 $15,000 08-01.90 49 Gross premium 50 Frequency of payment $15.71 Monthly 51 Assignee's name 52 Date assigned 53 If irrevocable designation of benefICiary made, name of 54 Sex 55 Date of birth, 56 Date benefidary if known designated 57 If other than simple designation, quote In full. (Attach additional sheets if necessary.) 58 II policy is not paid up: a Interpolated terminal reserve on date of death, assignment or irrevocable designation of beneficiary . . . . b Add proportion of gross premium paid beyond date of death, assignment, or irrevocable designation of beneficiary c Add adjustment on account of dividends to credit of policy d Total (add lines 58a. b, and cj . . . . e Outstanding indebtedness against policy. .... f Net total value of the policy (for gift or estate tax purposes) (subtract line 5Se from line Sad) 59 If policy is either paid up or a single premium: a Total cost on date of death, assignment, or irrevocable designation of beneficiary. of a single-premium policy on life of insured at anained age, for original face amount plus any additional paid-up insurance (additional face amount $ )... ...... (If a single-premium policy far the total face amount would not have been issued on the life of the insured as of the date specified, nevenheless, assume that such a policy could then have been purchased by the insured and state the cost thereof, using for such purpose the same formula and baSIS employed, on the date specified, by the company in calculating single premiums.) b Adjustment on account of dividends to credit of policy 5gb c Total (add lines 59a and 59b) 59c d Outstanding indebtedness against policy> 59d e Net total value of olic (for ift or estate tax ur ses) (subtract line 59d from line 59cl 5ge $421.38 The undersigned officer of the above-named insurance company (or appropriate Federal agency or retirement system o!tici"l) hereby cenlties that this statement sets 'on' tree eo" rr '"':4'''0:" ^7+" s'go",",. ~ l", tvU-" ''-''-'\;\.\ R J>h.1,v\..,-> ~ T'tle ~-:> ~:::;f::'a"oo. -7 i i :; I 0.. Form 712 (Rev. 5-2000] 5Ba $256.37 58b 5ac $111.07 59a F~m 712 (Rev. May 2000) Depanmel1l of the Treasury Internal RevenueServtce Life Insurance Statement OMB No. 1545-0022 Decedent Insured (To be filed by the executor with form 706, United States Estate (and Generation-Skipping Transfer) Tax Return. or form J06-NA, United States Estate (and Generation-Skipping Transfer) Tax Return. Estate of nonresident not: a citizen of the United States.) Decedel1t's first name and middle initial 2 Decedent's last name 3 Decedent's social security number 4 Date of death Ruth M. Hallett Of known) 159-24-7524 3-18-ll2 s Name and address of insurance company The Baltimore Life Companies 10075 Red Run Blvd. Type of policy Owings Mills, Md. 21117 1 Policy number 6 8 Owner's name. IF decedent is not owner. attach copy of application. 9 Date issued 10 Assignor's name. Attach copy of assignment. 12 Value of the policy at the 13 Amount of premium (see instructions) 14 Name of beneficiaries time of assignment 15 Face amount of policy 16 Indemnity benefits 17 Additional insurance 18 Other benefits . 19 Principal of any indebtedness to the company that is deductible in determining net proceeds 20 Interest on indebtedness (line 19) accrued to date of death. 21 Amount of accumulated dividends 22 Amount of post-mortem dividends . 23 Amount of returned premium 24 Amount of proceeds if payable in one sum 25 Value of proceeds as of date of death (if not payable in one sum) 26 Policy provisions concerning deferred payments or installments. Note; if other than lump~sum settlement is authorized for a surviving spouse, attach a copy of the insurance policy. -.... -. - -. -.... -. -. ~ -. - -. -.. -. _.. _. _ _. _.. _.. _ h _ h,h.. _. __ ._. _.. _ .__ 0.__' _._.... _.. _. _ _. _. _ _. _ _. _. _ _.... _.. u _.. ..-.--.--.---..-.-.._._.._.._._.._._.._.._.._...._..__..._.....u_.._.__.__._._.._.._.._._.._.____.._._.._......_ 27 Amount of installments 28 Dare of birth, sex, and name of any person the duration of whose life may measure the number of payments. ---.-.--...-..-.______.._.__._.._._.._.__..____._.._._U_'__'__'___.__'._'__'__'_.'_'_'_'__'__"_".'_'__'_____.. .--.-.--...-..-.----.--.-.--.----.--.--.----.--.--.-.--.--.-.__._.__________._.._.__h______.____.__._U_h____._ 29 Amount applied by the insurance company as a single premium representing the purchase of installment benefits 30 Basis (mortality table and rate of interest) used by insurer in valuing installment benefits. 11 Date assigned 15 $ 16 $ 17 $ 18 $ 19 $ 20 $ 21 $ 22 $ 23 $ 24 $ 25 $ II . ----....-..-.--.-.--.--.-.-..-....-.--.-.--..-.--.--.-..-.--.-..---..-..-..-.-----.---.-..-..-..-.--.-..-.--.----.-.--.-..-..--.-.--.-.-.--..... 31 Were there any transfers of the policy within the three years prior to the death of the decedent? 32 Date of assignment or transfer: / / Month Day Year 33 Was the insured the annuitant or beneficiary of any annuity contract Issued by the company? 0 Yes 0 No 34 Did the decedent have any inCidents of ownership on any poliCies on hislher life, but not owned by him/her at the date of death? DYes D No 3S Names of companies with which decedent carried other policies and amount of such poficies if this information is disclosed by your records. . DYes DNa _._._-.-_._-_._---...-.-----.-..---~._~--.--.--.----.-..-.--.--.-....-.---.----..---.-.--.-------.--.-..-.--.---..-.--.-..-..----.-.-..-...----. ._.._____._h.____.._...._.______..__~.._.._._____.._.___.._..__.__._u_.______.___._.._..._.h_h___...._....___.~___.__._________.._._U____h Signature ... ;Jcl~~ T<Je".AV Cat. No. 10170V The undersigned officer ot the above-named insurance company (or appropriate FeDeral agency or retirement system official) hereby certifies that this statement sets forth true and Qrfect information. ~-tb Date of CenjflCation'" ,II ~ -=<- FCfm 712 (Rev. 5-2000) Form 712 (Rev. 5-2000) Page 2 ImII Living Insured (File with Form 709, United States Gift (and Generation-Skipping Transferl Tax Return. May also be filed with Form 706, United States Estate ~ar.d Generation-Skipping Transfer) Tax Return, or Form 706-NA, United States Estate tand Generation-Skipping Transfer) Tax Return, Estate of nonresident not a citizen of the United States, where decedent owned insurance on life of another.) SECTION A-General Information 36 First name and middle initial of donor (or decedent) 37 Last name Ruth M. Hallett 39 Date of gift for which valuation data submitted, 40 Date of decedent's death for which valuation data submitted 38 Social securtty number 159i 24 : 7524 .~ . ~ 03-18-02 SECTION B-policy Information 41 Name of insured Jay M, Hallett 44 Name and address of insurance company The Baltimore Life Companies 10075 Red Run Blvd. Owings Mills, Md. 21117 42 Sex M 43 Date of birth 09-04-66 45 Type of pohcy 146 Policy number 47 Face a~unt 48 Issue date Universal Life 01152010775 s2h, 00 7/25/95 49 Gross premium 50 Frequency of payment S106.08 Monthly 51 Assignee's name 52 Date assigned 53 If irrevocable designation of benefICiary made. name of 54 Sex 55 Date of birth, 56 Date beneficiary if known designated 57 If other than simple designation. quote in full. (Attach additional sheets if necessary.) 58 If policy is not paid up: a Interpolated terminal reserve on date of death. assignment, or irrevocable designation of beneficiary . . . . b Add proportion of gross premium paid beyond date of death. assignment, or irrevocable designation of beneficiary c Add adjustment On account of divloends to credit of policy d Total (add lines 58a, b, and c) e Outstanding indebtedness against policy f Net total value of the policy (for gift or estate tax purposes) (subtract line 5ee from line 58d) 59 If policy is either paid up or a single premium: a Total cost, on date of death. assignment. or irrevocable designation of beneficiary, of a single-premium policy on life of insured at attained age, for original face amount plus any additional paid-up insurance (additional face amount $ ).. ....... (If a single-premium policy for the total face amount would not have been issued on the life of the insured as of the date specified, nevertheless. assume that such a policy could then have been purchased by the insured and state the cost thereof, using for such purpose the same formula and basis employed, on the date specified, by the company in calculating single premiums.) b Adjustment on account of dividends to credit of policy 59b c Total (add lines 59a and 59b) 5Se d Outstanding indebtedness against policy. 5911 e Net total value of olic (for ift or estate tax pu ses) (subtract line 59d from line 59c) 5ge $2,177.27 The umjerSlgned officer of the above-named insurance company (or appropriate federal agency or retirement system official) hereby cenities that this statement sets forth true and correct information S'gn,,",e" (1.d.u~ R A-(L~-tA. 588 $2,177.27 58b 5Se S9a MP~ U 'r"e " :j;'\J: 'L'f i~ Date of Certification ... Form 712 (Rev. 5-2000) 7/t<;/2_ '<Ym 712 (Rev. May 2000J Depanment at the lreasury Imernal Revenue Service Lite Insurance Statement OMS No. 1545-0022 Decedent-Insured !To be filed by the executor with form 706. United States Estate (and Generation-Skipping Transfer) Tax Return. or Form 706-NA, United States Estate land Generation-Skippin Transfer) Tax Return, Estate of nonresident not a citizen of the United States.) Decedent's first name and middle initial 2 Decedent's last name 3 Decedent's social security number 4 Date of death Ruth M. Hallett (if known) 159-24-7524 3-18-02 5 Name and address of insurance company The Baltimore Life Companies 10075 Red Run Blvd. Type of policy Owings Mills, Md. 21117 7 Policy number 6 8 Owner's name. If decedent is not owner, attach copy of application. 9 Date Issued 10 Assignor's name. Attach copy of assignment. 12 Value of the policy at the 13 Amount of premium (see instructions) 14 Name of beneficiaries time of assignment 15 Face amount of policy 16 Indemnity benefits 17 Additional insurance 18 Other benefits . 19 Principal of any indebtedness to the company that is deductible in determining net proceeds 20 Interest on indebtedness (line 19) accrued to date of death. 21 Amount of accumulated dividends 22 Amount of post-mortem dividends 23 Amount of returned premium 24 Amount of proceeds if payable in one sum 25 Value of proceeds as of date of death (if not payable in one sum) 26 Policy provisions concerning deferred payments or installments. Note; If other than fump~sum settlement is authorized for a surviving spouse, attach a copy of the insurance policy. 27 Amount of installments 28 Date of birth, sex, and name of any person the duration at whose life may measure the number of payments. 29 Amount applied by the insurance company as a single premium representing the purchase of installment benefits . 30 Basis (mortality table and rate of interest) used by insurer in valuing installment benefits. 11 Date assigned 15 $ 16 $ 11 $ 18 $ 19 $ 20 $ 21 $ 22 $ 23 $ 24 $ 25 $ II . . DYes DNa 31 Were there any transfers of the policy within the three years prior to the death of the decedent? 32 Date of assignment or transfer: I I Month Day Year 33 Was the insured the annuitant or beneficiary of any annuity contract issued by the company'? 0 Yes 0 No 34 Did the decedent have any incidents of ownership on any policies on hislher life, but not owned by him/her at the date of death? DYes D No 3S Names of companies with which decedent carried other poliCieS and amount of such po6cies if this information is disclosed by your records. __..________..._.._._.__.~_.__.~_.__.__.~_._~.~_____.__._n___~~.__.__._~._d_.~__._____._..._.._.~._..__..__._~..~.._.__._..__~__~._________... -. ..- -.. -. - -. -.. - - -.- --. -. - - ~ - -.. - - - -. - -.. -.. -..--- --- --. ----. -~..... --..- --~- -. -~.- --. -. --.- -.~ -.. -.. -.... - -.... -~. - -' -------- .-_.- -.--.. -..... Th€ undersIgned officer ot the above-named insurance company (or appropriate federal agency or retirement system official) hereby cenifies that this statement sets forth true andf\er:.t il1f,mation. Signa,",e ~ \_l,~(i~W (C OateofCe"fication ~ If {~/'::1. Cat, No. 10170V form 712 (Rev, 5.2000) FOfm 712 (Rev_ 5-20(0) IDIII Page 2 Living Insured \File with Form 709, United States Gift (and Generation-Skipping Transfer} Tax Return. May also be filed with Form 706, United States Estate \and Generation-Skipping Transfer) Tax Return. or Form 706-NA. United States Estate {and Generation-Skipping Transfer) Tax Return, Estate of nonresident not a citizen of the United States. where decedent owned insurance on life of another.\ SECT10N A-General Information 36 First name and middle initial of donor (or decedent) 37 Last name Ruth M. Hallell 39 Date of gift for which valuation data submitted. 40 Date of decedent's death for which valuation data submitted 38 Social security number 159! 24 : 7524 .~ ~ 03-18-02 SECTION B-Policy Information 41 Name of insured Jay M. Hallett 44 Name and address of insurance company The Baltimore Life Companies 10075 Red Run Blvd. Owings Mills, Md. 21117 42 Sex M 43 Date of birth 09-04-66 45 Type of policy 146 Policy number 47 Face amount 48 Issue date Flextra (Life) A 0902790 $50,000 07-01.90 49 Gross premium 50 Frequency of payment $54.41 Monthly 51 Assignee's name 52 Date assigned 53 If irrevocable designation of beneficiary made. name of 54 Sex 55 Date of birth, 56 Date beneficiary jf known designated 57 If other than sImple deSignation, quote In full. (Attach additional sheets If necessary.) 58b sSe $241.22 $335.45 590 59d 5ge $2,504.75 58 If policy is not paid up: a Interpolated terminal reserve on date of death, assignment, or irrevocable designation of beneficiary b Add proportion of gross premium paid beyond date of death, assignment. or irrevocable designation of beneficiary c Add adjustment on account of d\o.Jidends to credit of policy d Total (add lines 58a. b, and c) . . . . e Outstanding indebtedness against policy. f Net total value of the policy (for gift or estate tax purposes) (subtract line 58e from line 58d) S9 If policy is either paid up or a single premium: a Total cost, on date of death, assignment, or irrevocable designation of beneficiary, of a single-premium policy on life of insured at attained age. for original face amount plus any additional paid-up insurance (additional face amountS ).. .._... M a single-premium policy for the total face amount would not have been issued on the life of the insured as of the date specified, nevertheless, assume that such a policy could then have been purchased by the insured and state the cost thereof, using for such purpose the same formula and basis employed, on the date specified, by the company in calculating single premiums.) b Adjustment on account of dividends to credit of policy c Total (add lines 59a and 59b) . . _ . d Outstanding indebtedness against policy. e Net total value of otic (for ift or estate tax 58a $1,928.08 598 59b ses) (subtract line 59d from line 59c) $2,504.75 The underSigned officer of the above-named insurance company (or appropriate Federal agency or retirement system official) hereby certifie'5. that ttll'2. '2.tatement setS lortn trwe 8nd correct information Sign"",e ~ l~~~\-~ R xklWV~1 Title ... Date of -7 Certification ,. Fexm 112 (Rev_ 5-2000) IS J -~ Forn, .. 4L (Rev. May 2000) Deparunem allhe rrl!aSUry lntefrlal RellernJe Service life Insurance Statement OMS No. 1545-0022 Decedent-Insured (To be filed by the executor with Form 706, United States Es.tate (and Generation-Sk.ipping Transfer) Tax Return. or Form 706-NA. United States Estate (and Generation-Skippin Transfer) Tax Return, Estate of I100resldent not a citizen of the United States.) 1 Decedent's first name and middle initial 2 Decedent's last name 3 Decedent's social security number 4 Date of death Ruth M. Hallett Of known) 159-24-7524 3-18-02 5 Name and address of insurance company The Baltimore Life Companies 10075 Red Run Blvd. Type of policy OWings Mills, Md. 21117 7 Policy number . 8 Owner's name. If decedent is not owner, attach copy of application. 9 Date issued 10 Assignor's name. Attach copy of assignment. 12 Value of the policy at the 13 Amount of premium (see instructions) 14 Name of beneficiaries time of assignment 15 Face amount of policy 16 Indemnity benefits 17 Additional insurance 18 Other benefits . 19 Principal of any indebtedness to the company that is deductible in determining net proceeds 20 Interest on indebtedness (line 19) accrued to date of death, 21 Amount of accumulated dividends 22 Amount of post~mortem dividends 23 Amount of returned premium 24 Amount of proceeds if payable in one sum 25 Value of proceeds as of date of death (if not payable in one sum) 26 Policy provisions concerning deferred payments or installments. Note; If other than lump-sum settlement is authorized for a surviving spouse, attach a copy of the insurance poJicy. 27 Amount of installments 28 Date of birth, sex, and name of any person the duration of whose life may measure the number of payments. 29 Amount applied by the insurance company as a single premium representing the purchase of installment benefits . 30 Basis (mortality table and rate of interest) used by insurer in valuing installment benefits. 11 Date assigned 15 $ 16 17 $ 18 $ 19 $ 20 $ 21 $ 22 $ 23 $ 24 $ 25 $ II . . DVes DNa 31 Were there any transfers of the policy within the three years prior to the death of the decedent? 32 Date of assignment or transfer: I I Month Day Year 33 Was the insured the annuitant or beneficiary of any annuity contract issued by the company? 0 Yes 0 No 34 Old the decedent have any inddents of ownership on any policies on hisJher life, but not owned by him/he, at the date of death? D Ves D No 35 Names of companies with which decedent carried other policies and amount of such policies if this information is disclosed by your records, Signature .. F .j (1."",~ The undersigned officer of the above-named insurance company (Of appropnate Federal agency Of retirement system official) hereby certifies that this statement sets forth true and CfTeet in ormation. Title .. Cat. No. 1D17DV Date of Certification .... 7 I s:. :d- Form 712 (Rev.5-2OQO) FOI"m 712 (Rev. '1-2000) ImII Page 2 Living Insured (File with Form 709. United States Gift (and Generation-Skipping Transfer) Ta)( Return. May also be filed with Form 706. United States Estate land Generation-Skipping Transfer) 1a"1.. Return, Of form l{W)-NA., \Jolted States Estate land Generation-Skipping Transfer! Tax Retum, Estate of nonresident not a citizen of the United States, where decedent owned insurance on life of another) SECTION A-Generallnfonnation 36 First name and middle initial of donor (or decedent) 37 Last name Ruth M. Hallett 39 Date of gift for which valuation data submitted. 40 Date of decedent's death for which valuation data submitted 38 Social security number 159! 24 : 7524 .~ _ ~ 03-18-0Z SECTION B-Policy Information 41 Name of insured Shane E. Hallett 44 Name and address of insurance company The Baltimore life Companies 10015 Red Run Blvd. Owings Muts, Md. 21117 42 Sex M 43 Date of birth 02-24-95 45 Type of policy 146 Policy number 47 Face amount 48 Issue date Flextr. (Life) A 0957012 $25,000 06-06-95 49 Gross premium 50 Frequency of payment $15.99 Monthly 51 Assignee's name 52 Date assigned 53 If irrevocable designation of beneficiary made, name of 54 Sex 55 Date of bifth, 56 Date beneficiary if known designated 57 If other than Simple deSignatIon, quote In fulL (Attach additional sheets if necessary.) 58 If policy is not paid up: a Interpolated terminal reserve on date of death, assignment, or irrevocable designation of beneficiary 58a b Add proportion of gross premium paid beyond date of death, assignment, or irrevocable designation of beneficiary 58b c Add adjustment on account of di"jdends to credit of policy 58c d Total (add lines 58a, b, and c) e Outstanding indebtedness against policy. f Net total value of the policy (for gift or estate tax purposes) (subtract line sSe from line Sad) S9 If policy is either paid up or a single premium: a Total cost, on date of death, assignment, or irrevocable designation of beneficiary, of a single-premium policy on life of insured at attained age, for original face amount plus any additional paid-up insurance (additional face amount $ ) . 590 (If a single-premium policy for the total face amount would not have been issued on the liFe of the insured as of the date specified, nevertheless, assume that such a policy could then have been purchased by the insured and state the cost thereof, using for such purpose the same formula and basis employed, on the date specified, by the company in calculating single premiums.) b Adjustment on account of dividends to credit of policy 59b c Total (add lines 59. and 59b) d Outstanding indebtedness against policy. e Net total value of olie (for ift or estate tax U oses) (subtract line S9d from line 59c) $99,67 59c 59d 5ge $167.57 $67.90 The undersigned officer 01 the above-named insurance company (or appropriate Federal agency or retirement system official) hereby certifies that this statement sets :~~:a:~:::d rC~t~ R. J,~ l~~~"\ Titl. ~ A V P g~f~"on .1/1 ~ I ~ Form 712 (Rev_ 5-20(0) Bedroom Suite (bedframe, dresser, chest drawer, night stand) 6 Lamps Metal Futon Computer Stand Computer Cherry Desk VCR Rack Apartment Size Washer/Dryer Kitchen table and chairs (4) Wall Clock Sofa Coffee Table End Table TV VCR TV stand Curio Arm Chair Buffet Rocking Chair (outside plastic) Microwave Coffee Maker Toaster Picture 3D General Kitchenware (dishes, glasses, Tupperware, utensils, etc.) Boom Box Clock Misc Family Pictures Magazine Rack Clothes Jewelry (costume, Indianjewelry, wedding, earrings etc.) Odds/ends knick knacks DEATH CERTIFICATE LAST WILL AND TESTAMENT OF RUTH M. HALLETT ~_:\/-:.----:-' ~'-" ~-. .1 \ '-" \, w LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT I, RUTH MARIE HALLETT, now of 5231 Terrace Road, Mechanicsburg, Cumberland County, Pennsylvania, do publish and declare this to be my Last Will and Testament, hereby revoking all other prior wills and codicils made by me. FIRST: Family Background and Appointment of Executor. (A) Family and Background Information. I am married to RICHARD J. HALLETT. I have not been previously married. The children of our marriage are DEBORAH A. STERLING and JAY M. HALLETT (and any children born or adopted hereafter). Throughout this Will, RICHARD J. HALLETT will be referred to as "my husband" or "my spouse" and DEBORAH A. STERLING and JAY M. HALLETT will be referred to as "my children." The word "issue" will include my children as well as my other descendants. (B) Appointment of Executor. I appoint as my Executor and successor Executor (all hereinafter referred to as Executor or Executor(s)) under this Will, the following named persons or corporations to serve without bond and without being required to account to any Court: Executor: My husband, RICHARD J. HALLETT Successor Executor: My children, DEBORAH A. STERLING and JAY M. HALLETT, to act jointly. SECOND: Funeral and Last Illness Expenses; Taxes. (A) Expenses of Funeral and Last Illness. Notwithstanding that my spouse survives me, I direct my Executor to pay my funeral expenses (regardless of amount) and the expenses of my last illness from my estate. ~/ ~,?' I /J' 7'- J LAST WILL AND TESTAMENT OF RUTH MARiE HALLETT PAGE 2 (Bl Taxes. I direct my Executor to pay any and all estate, inheritance, succession, legacy, transfer and other death taxes or duties, by whatever name called, including any and all interest and penalties thereon, imposed under the laws of any jurisdiction by reason of my death, upon or with respect to any and all property included in my gross estate for the purpose of such taxes, whether such property passes under or outside of this Will, out of my residuary estate, without being prorated or apportioned among or charged against the respective devises, legatees, beneficiaries, transferees, or other recipients of any such property or charged against any property passing or which may have passed to any of them. My Executor shall not be entitled to reimbursement for any portion of any such taxes from any such person. THIRD: Tangible Personal Property. Except for those items excluded below and those items enumerated in the Letter of Instruction, I bequeath to my spouse, RICHARD J. HALLETT, all tangible personal property, which I own, and the ~nsurance thereon, if my spouse survives me by sixty (60) days. Tangible personal property shall not include: (1) any and all property used by me in any business, (2) cash on hand or on deposit in banks, (3) stock or securities, (4) any type of evidence of indebtedness, and (5) any life, health or accident insurance policies. If my spouse is not living on the sixty-first (6Ist) day after my death, I bequeath such tangible personal property to my children living at the time of my death to be divided among them as they may select in as nearly equal shares as is practical. If my spouse and my children do not survive me, I leave such tangible personal property to the issue of my children, per stirpes. If there is any disagreement as to distribution, I direct my Executor to make such distribution. The decision of my Executor shall be final and binding. Any items not selected or any items which my Executor considers unsuitable for my children may be distributed or sold in the sole discretion of my Executor and, if sold, 'the net proceeds therefrom shall be added to the // -::;:s-.~~ '-- LAST WILL AND TESTAMENT OF RUTH MARrE HALLETT PAGE 3 residue of my estate. Any such article allocated to a minor may, as my Executor deems advisable, either be delivered to the minor or to any person to safeguard on behalf of the minor. Notwithstanding any other provisions in this Article THIRD, I may leave a separate, dated and unsigned Letter of Instruction, which I shall place with my Will, containing directions as to the ultimate disposition of certain of the property bequeathed under this Article THIRD, and such Letter of Instruction shall determine the distribution of such items. . FOURTH: Residuary Gifts. (A) If my spouse, RICHARD J. HALLETT, survives me, I give, devise and bequeath all the rest, residue and remainder of my estate, of every kind and character, real, personal and mixed, tangible and intangible, and wherever situated, including any lapsed or renounced legacies, devises or residuary bequests (and inCluding any property over which I may have a Power of Appointment), to my spouse, RICHARD J. HALLETT. (B) If my spouse, RICHARD J. HALLETT, does not survive me, and if one or more of my children survive me, I give, devise and bequeath all the rest, residue and remainder of my estate, as follows: (1) I give, devise and bequeath all of the life insurance policies which I own on the lives of my daughter, DEBORAH A. STERLING, my son, JAY M. HALLETT, my son-in-law, CHARLES W. STERLING, and my grandchildren, JAMIE H. STERLING and ERIKA L. STERLING, which life insurance policies are with the Baltimore Life Insurance Company, to the Trustee hereinafter named, in Trust for the following uses and purposes: (a) The Trustee shall receive all pa~ents from the annuity which I own at death with the Life of Maryland Annuity Company and the Trustee shall use said my ~rY / . ~.!c .x:::'~ L r /I ~-~ / LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 4 annuity payments to make the premium payments on the above-referenced life insurance policies with Baltimore Life Insurance Company. Trustee shall hold said pOlicies and any proceeds, if any, until the death of one of the insureds or until the termination of this Trust as set forth below. (b) AS each of my children, DEBORAH A. STERLING and JAY M. HALLETT, reach the age of forty (40) years, the Trustee shall distribute to said child that child's policy and the life insurance pOlicies on the life of that child's children. In the event that the annuity payments should cease prior to the time that my children reach age forty (40), respectively, then the Trustee shall distribute the life insurance policies, absolutely, to my children, respectively, and to the parent of the grandchildren. (c) In the event that one or both of my children die before attaining age forty (40), then the Trustee shall use the proceeds from that child's life insurance policy, and any income generated thereby, for the health, education, support and maintenance of said child's issue, as the Trustee deems advisable. The Trustee may apply the net income, accumulated income, and principal should said child's issue, by reason of age, illness, or any other cause, in the opinion of my Trustee, be incapable of disbursing it. As each grandchild (of a deceased parent) attains the age of twenty-one (21) years, the Trustee shall distribute, absolutely, to said grandchild, his or her respective equal share of his or her parent's life insurance .<2<.- t- d...''- LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 5 proceeds and shall distribute to said grandchild his or her respective life insurance policy. (2) I give, devise and bequeath all the rest, residue and remainder of my estate, of every kind and character, real, personal and mixed, tangible and intangible, and wherever situated, including any lapsed or renounced legacies or devises (and including any property over which I may have a power of appointment) in equal shares to my children, DEBORAH A. STERLING and JAY M. HALLETT, per stirpes. (C) Distributions During Administration. Prior to final distribution of my estate, the Executor, in his discretion, may make partial distributions to one or more beneficiaries or Trusts. As a consequence, the Executorship and any Trusts created under this will may exist contemporaneously. A distribution may be made subject to any indebtedness or liability of my estate. FIFTH: Spendthrift Provision. No beneficiary shall have the power to anticipate, encumber or transfer his or her interest in the estate or any trust estate in any manner other than by the valid exercise of a power of appointment. No part of the estate or any trust estate shall be liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. SIXTH: Appointment of Trustee and Successor Trustees. (A) I nominate, constitute and appoint CCNB BANK, N.A., Camp Hill, Pennsylvania, to act as Trustee of all Trusts created by my Will. " -A~/~/C.LC x:.' f., L /J LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 6 (B) The Trustees may resign from the Trusts without the necessity of any Court proceeding if at least thirty (30) days' written notice is given to each beneficiary (including a beneficiary's natural or legal guardian or legal representative, in the case of a beneficiary under a legal disability) who might then be entitled to receive a distribution from the Trust Estate. Upon the death, resignation, removal or incapacity of the Trustee, then a Successor Trustee may be appointed by a majority of the beneficiaries who might then be entitled to receive a distribution from the Trust Estate, provided that the Successor Trustee is a financially sound and competent corporate trustee. A Successor Trustee may be any bank or trust company and may be domiciled anywhere. Any Successor Trustee thus appointed, or, if the Trustee shall merge with or be consolidated with another corporate fiduciary, then such corporate fiduciary, shall succeed to all the duties and to all the powers, including discretionary powers, herein granted to the Trustee. SEVENTH: Powers of Trustee and Executor. In addition to the powers and duties as may have been granted elsewhere in this Will, but subject to any limitations stated elsewhere in this Will, the Executor and Trustee (when applicable) shall have and exercise exclusive management and control of the Estate or Trusts, respectively, and shall be vested with the following specific powers and discretion, in addition to the powers as may be generally conferred form time to time upon them by law: (A) In the management, care and disposition of the Trusts or Estate, the Trustee and Executor, respectively, shall have the power to do all things and to execute such instruments as may be deemed necessary or proper, including the following powers, all of which may be exercised without order of or report to any Court: (1) To sell, exchange or otherwise dispose of any property at any time held or acquired hereunder, at public or private sale, for cash or on terms, without advertisement, including the right to lease for any term notwithstanding the period of the Trust, and to /) :::6:.:_.5-..// 4-LC LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 7 grant options, including any option for a period beyond the duration of the Trust; except that, in lieu of any binding shareholder agreement or buy/sell agreement to the contrary, the Executor and Trustee shall not be permitted to sell the stock or any other ownership interest in any business owned by me, or my spouse, or held in trust, at my death, without first offering the same for sale to my children, or without next offering the same to the corporation or business represented by such ownership interest for redemption. (2) To invest all monies in such stocks, bonds, securities, mortgages, notes, choses in action, real estate or improvements thereon, and any other property as the Trustee or Executor may deem best, without regard to any law now or hereafter enforced limiting investments of fiduciaries, except that the Trustee or Executor may not invest in any securities issued by the corporate Trustee or Executor, or issued by a parent or affiliate company of such Trustee or Executor. (3) To retain for investment any property deposited with the Trustee or Executor hereunder; except that the Trustee or Executor may not retain for investment any stock in the corporate Trustee or Executor, or in a parent or affiliate company of such Trustee or Executor. (4) To vote in person or by proxy any corporate stock or other security and to agree to or take any other action in regard to any reorganization, merger, consolidation, liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note or other security. (5) To use attorneys, real estate brokers, accountants and other agents, if such employment is deemed necessary or desirable, and to pay reasonable compensation for their services. ~"-L/ } Je"r z::. <::::L/ LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 8 (6) To compromise, settle or adjust any claim or demand by or against the Trusts or Estate and to agree to any rescission or modification of any contract or agreement affecting the Trusts or Estate. (7) To renew any indebtedness, as well as to borrow money, and to secure the same by mortgaging, pledging or conveying any property of the Trusts or Estate, including the power to borrow from the Trustee at a reasonable rate of interest. (8) To retain and carryon any business in which the Trusts or Estate may acquire an interest, to acquire additional interest in any such business, to agree to the liquidation in kind of any corporation in which the Trusts or Estate may have an interest and to carryon the business thereof, to join with other owners in adopting any form of management for any business or property in which the Trusts or Estate may have an interest, to become or remain a partner, general or limited, in regard to any such business or property and to hold the stock or other securities as an investment, and to employ agents and confer on them authority to manage and operate the business, property or corporation, without liability for the acts of such agent or for any loss, liability or indebtedness of such business if the management is selected or retained with reasonable care. (9) To register any stock, bond or other security in the name of a nominee, without the addition of words indicating that such security is held in a fiduciary capacity, but accurate records shall be maintained showing that such security is a Trust or Estate asset and the Trustee or Executor shall be responsible for the acts of such nominee. _(! /' r- LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 9 (B) Whenever the Trustee or Executor is directed to distribute any Trust principal or Estate assets in fee simple to a person who is then under twenty-one (21) years of age, the Trustee or Executor shall be authorized to hold such property in Trust for such person until he/she becomes twenty-one (21) years of age, and in the meantime shall use such part of the income and the principal of the Trusts or Estate as the Trustee or Executor, respectively, may deem necessary to provide for the proper support and education of such person. If such person should die before becoming twenty-one (21) years of age, the property then remaining in trust shall be distributed to the personal representative of such person's estate. (e) In making distributions from the Trusts or Estate to or for the benefit of any minor or other person under a legal disability, the Trustee or Executor need not require the appointment of a guardian, but shall be authorized to payor deliver the same to the custodian of such person, to payor deliver the same to such person without the intervention of a guardian, to payor deliver the same to a legal guardian of such person if one has already been appointed, or to use the same for the benefit of such person. (D) In the disbursement of the Trusts or Estate and any division into separate trusts or shares, the Trustee or Executor shall be authorized to make the distribution and division in money or in kind, or both, regardless of the basis for income tax purposes of any property distributed or divided in kind, and the distribution and division made and the values established by the Trustee or Executor shall be binding and conclusive on all persons taking hereunder. The Trustee or Executor may in making such distribution or division allot undivided interests in the same property to several trusts or shares. (E) The Trustee and Executor shall be authorized to lend or borrow, including the right to lend to or borrow from my estate or the estate of my spouse or any trusts which I or my spouse may have established during life or by will at an adequate rate of 7~ LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 10 interest and with adequate security, and upon such terms and conditions as the Trustee or Executor shall deem fair and equitable. (F) The Trustee and Executor shall be authorized to sell or purchase at the fair market value as determined by the Trustee or Executor, any property to or from my estate, the estate of my spouse, or any trust created by me or my spouse during life or by Will, even though the same person or corporation may be acting as Executor of my estate or the estate of my spouse or as Trustee of any of my other trusts. (G) The Trustee and Executor shall have discretion to determine whether items should be charged or credited to income or principal or allocated between income and principal as the Trustee or Executor may deem equitable and fair under all the circumstances, including the power to amortize or fail to amortize any part or all of any premium or discount, to treat any part or all of the profit resulting from the maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal or apportion the same between income and principal, to apportion the sales price of any asset between income and principal, to treat any dividend or other distribution of any investment as income or principal or apportion the same between income and principal, to charge any expense against income or principal or apportion the same, and to provide or fail to provide a reasonable reserve against depreciation or obsolescence on any assets subject to depreciation or obsolescence, all as the Trustee and Executor may reasonably deem equitable and just under all the circumstances. (H) If at any time the total fair market value of the assets of any trust established or to be established hereunder is so small that the corporate Trustee's annual fee for administering the trust would be the minimum annual fee set forth in the Trustee's regularly published fee schedule then, in effect, the Trustee in its discretion shall be authorized to terminate such trust or to decide not to establish such trust, and in such event the property then held in or to be distributed ~~ ,,) ,-c- y--- V LAST WILL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 11 to such trust shall be distributed to the persons who are then or would be entitled to the income of such trust. If the amount of income to be received by such persons is to be determined in the discretion of the Trustee, then the Trustee shall distribute the property among such of the persons to whom the Trustee is authorized to distribute income, and in such proportions, as the Trustee in its discretion shall determine. (I) When the authority and power under this Will is vested in two (2) or more Executors or Trustees, the authority and powers are to be held jointly by the Executors or Trustees, respectively. A majority of the Executors or Trustees may exercise any authority or power granted under this Will or granted by law, and may act under this Will. Any attempt by one such Executor or Trustee to act under this will on other than ministerial acts shall be void. The action of one such Executor or Trustee under this Will may be validated by a subsequent ratification of the act by a majority of the Executors or Trustees. EIGHTH: Rights and Liabilities of Executor and Trustee. (A) No bond or other security shall be required of any Executor or Trustee. (Bl This instrument always shall be construed in favor of the validity of any act or omission by any Executor or Trustee, and any Executor or Trustee shall not be liable for any act or omission except in the case of gross negligence, bad faith or fraud. Specifically, in assessing the propriety of any investment of a Trust, the overall performance of the entire Trust shall be taken into account. (e) Each Executor and Trustee shall be entitled to receive reasonable compensation for services actually rendered to my estate or to my Trusts, in an amount the Trustee or Executor normally and customarily charges for performing similar services during the time which he/she performs the services. ~c.;L J ,Ji L LAST WILL AND TESTAMENT OF RUTH MARrE HALLETT PAGE 12 NINTH: Definitions and General Provisions. (A) Survival. Any beneficiary, including my spouse, who dies within sixty (60) days after my death shall be considered not to have survived me. (D) Trust Estate. "Trust Estate" means all assets, however and wherever acquired, including income, which may belong to a Trust at any given time. (C) Children. Except for discretionary distributions which may be made unequally among a group of persons and distributions pursuant to a valid exercise of a Power of Appointment, in making a distribution to the children of any person, the property to be distributed shall be divided into as many shares as there are living children of the person and deceased children of the person who left children who are then-living. Each living child shall take one share and the share of each deceased child shall be divided among his then-living descendants in the same manner. A posthumous child shall be considered as living at the death of his parent. (D) Code. Unless otherwise stated, all references in my Will to section and chapter numbers are to those of the Internal Revenue Code of 1986, as amended, or the corresponding provisions of any subsequent federal tax laws applicable to my estate. (E) genders, includes Other terms. The use of any gender includes the other and the use of either the singular or the plural the other. (F) captions. The captions set forth in this Will at the beginning of the various divisions hereof are for convenience of reference only and shall not be deemed to define or limit the provisions hereof or to affect in any way their construction and application. c-Yf-~ ~r- ~r- LAST WXLL AND TESTAMENT OF RUTH MARIE HALLETT PAGE 13 (G) exercise death. Powers of Appointment are Exercised. By this Will I any Power of Appointment which I may possess at my XN WXTNESS WHEREOF, I, RUTH MARIE HALLETT, the Testatrix, to this my Last will and Testament, typewritten on fourteen pages, incl~ding ~he Acknowl~_gment ~nd Affidavit, set my and seal thJ.s /,(, day o~,;~- ~:)jj-:Z;; 1991- (G,~ d7""./>~,", L. r/L/p, '-t RlP1'H MARXE lIALLETT ~ . [ Signed, sealed, published and declared by the above-named Testatrix, as and for her Last will and Testament, in the presence of us, who have hereunto subscribed our names at her request, as witnesses hereto, in the presence of the said Testatrix, and in the presence of each other. Each of us further declares that he or she believes the Testatrix to be of sound mind and memory. The preceding instrument consists of this and thirteen (13) other consecutively numbered typewritten pages including the Acknowledgment and Affidavit. have (14) hand / (" --' . . . .~..., ,...... . -I +_. ~ ,v.,_ _ ~ "/{'o' ...../ residing at \j,jJ;:~- 1?4 ,J .r;-Ity'p,;;~ t::- IUK.US (print name) ,- '~-_-l 7 . . ,I ~)J/It/1 ;?Jll/ 1/ ,4 residin"'l ....., , "- -'='j~ ~--I~ding I Uev.-nL !2-. 6~7 (print name) at Mi/M'/'~I'M, P4-- I ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF~~ : : ss: : The Testatrix and the witnesses whose names are subscribed to the foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge and declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will in the presence of the witnesses, that she signed willingly or willingly directed another to sign for her, that she executed it as her free and voluntary act for the purposes therein expressed, that each of the witnesses, in the presence and hearing of the Testatrix, signed the will as witnesses, and that to the be~~~~~air knowledge the Testatrix was at that time eighte~ars ~~age or older, of sound mind and under no constraint br /indue ,inflt1ence. \... '---'/ --- - if, -;&.~:..;,. so.: "H '. T tatrix (/~/)d":7_ (' r:-::frA'A~_ , witness ~61'1!/,/ it /kef ~ J1 witness n..'-V~ ___ <,::-/<-=;-;:-,,7 Witness (, -~, . ;;J \.1 , 11 -/'....... Sworn to, subscribed-..::::an~acknowledged bef?l~L_ me by abdve-named i Testatrix and witnesses this ~ day ~"-e. J.t~ I 1991. ~ . the of L) Notary or ~Attorney~at~LaW lIlIfAlllM. SOL SUWI L IIIISIiMAN. 1lOlAR't I'IlSUC CAMP HJU.. PA CUMBERLAND COUNtY MY COMMISSION EXPIRES NOV. 12. 1994 PA REV-1500 SCHEDULE F JOINTLY OWNED PROPERTY MemberslST FEDERAL CREDIT UNION INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1161 ---.., r:: ," ~ 0!\" ..-" ; ~,.i...-----' : ...; ~ ... " -"~'~~I"''''''''?~'_. -."--" W' ~ '" / \.-..--,:.~ ..~, ' . ... ,.,~._". June 7, 2002 Traci L. Sepkovic Gates, Halbruner & Hatch, PC 1013 Mumma Road Suite 100 Lemoyne, PA 17043 RE: Estate of Ruth M. Hallett SSIN 159.24-7524 Dear Ms. Sepkovic, Enclosed is the information requested in your letter of May 23, 2002 regarding the accounts held with Members 1 sl by Ruth Hallett. Please do not hesitate to contact me at 795-5131 should you have any questions or require additional information. Vijtr~IYY~ ~lj:",rZ-t' , -- Denise A. Anders Insurance Products Supervisor Enclosure rm -; ..... :;.... ~ . ...r--- _11 ._\~\. ..~ \"".('-0. n ~ .i.....'t~. y/y )UC. ..~.~~-:'~..-..... .-~~~~~ ~ e Malpezzi FUNERAL HOME Micho,l J. Molpeui Owner 8 Mork't Plo%o Woy. Mechonicsburg, PA 17055 Phone: 697.4696 April 17, 2002 Deborah A. Sterling 258 Ridge Hill Road Mechanicsburg, PA 17055 The Funeral Service for Ruth Marie Hallett We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff Embalming Other Preparation of Body 2. FAClLITlESANDSERVICES Viewing (VisitationIWake) Funeral Ceremony 3. AUTOMOTIVE EQUIPMENT V chicle to transfer remains to Funeral Home Hearse (Casket Coach) Limousine Lead car/Clergy FUNERAL HOME SERVICE CHARGES SELECTED MERCHANDISE, Register, Memorial Cards, Ackn. THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN ACCOMMODATION. THE FOLWWING IS AN ACCOUNTlNG FOR THOSE CHARGES. CASH ADVANCES ClergylMass Offering Certified Copies of the Death Certificate TOTAL CASH ADVANCES AND SPECIAL CHARGES SUB-TOTAL INmAL PAYMENT / DISCOUNT I CREDITS TOTAL AMOUNT DUE Please $1565.00 $585.00 $85.00 $365.00 $425.00 $235.00 $285.00 $235.00 $115.00 $3895.00 $45.00 $3940.00 $200.00 $80.00 $280.00 $4220.00 --------------- $4220,00 \j J MembersIST FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/02 to Date of Death Name of Joint Owner Date Joint Ownership Created CHECKING ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/02 to Date of Death Name of Joint Owner Date Joint Ownership Created INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/02 to Date of Death Name of Joint Owner Date Joint Ownership Created Estate of: RUTH M. HALLETT Date of Death: 03/18/2002 Social Security Number: 159-24-7524 INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, P A 17055 1-800-283-2328 or (717) 697-1161 134515 -00 08/07/1993 $4,136.58 $3.35 $4,139.93 $9.88 Deborah A. Sterling 10/29/1994 134515 -11 02/18/1994 $2,021.04 $.00 $2,021.04 $.00 Deborah A. Sterling 10/29/1994 134515 -05 06/23/2000 $2,913.55 $2.43 $2,9t 5.98 $12.90 Deborah A. Sterling 06/23/2000 ~~B~RS 1ST Al)j"(; Denise A. An e s Insurance Products Supervisor CREDIT UNION June 7,2002 PA REV-1500 SCHEDULE H FUNERAL EXPENSES and ADMINISTRATIVE COSTS Schedule H, Item B-1 Personal Representative's Commissions Co-Executors claiming Personal Representative's Commissions are as follows: Jay M. Hallett 416 Limestone Road Carlisle, P A 17013 SSN: 177-42-4720 and Deborah A. Sterling 258 Ridge Hill Road Mechanicsburg, P A 17055 SSN: 160-38-9948 - -= i8! ~ ...e~ '" < '" ~ ~ ~ ~ -=t .. n ~ <2: ~ o 'ai \ p 8 & 1 IS " ~ i a Ii ~ ~ ,l5 g a~~~ -526~ :Ia~~ ..u,.-..8 o::sc-~ _o-~ 'S:>"c~ ~t1 "" !l 'l!~ .,$ ,.- .. Ci...... !.~ e '5''; & ~~:r. ~ ..~ ~ '5 ~ r">U · e i 0 00 " \ ! I .. , ! ! \ ~ i '3 \ " ~ \ I I I \~ I , , \. +-' (J) 00 s 8 r- ~ ~ ~ s:; .~ t ~ E ?> i ';j" i .~ c os @) i::g~'~ I ~gil " \fI"" ,'.,'" \\ ~ - 1 ... 5 ~ ~ .. o 1 .. "" . .H~ ~ <) 1\= a i ~~ ~ S's Po -. ",~,g ~~ ...l!U ::l'" ~~~ ~? ~ ~1 ~~ '~&.44 gu %. . lS @. ,,~A .:;: .~O~ ~~ .8 g ~ a~ ;;! c.:l$ '" ~c fI) Po< a""" l(\' ~e1:l ~~ ~~~ ?;"" lS.gi ~e . ~ ~~ ~~~ ;.-~,., :x:S~ I'i"a w 0 ~ il 8 .~ z~~ re~~ ~.~ b o1l!=:x: ::l~:a ~~e ~.~'8 e<'" ~ a = :x:8s 0" OI\~-' ;.- ~.g ot;~ o as ~ ~ ~"g If\~~ ~5~ o::;l t3 ",,'i'9 2 0 ! ~,.,la o~'" ; g1~ ~~t; .... ::liS 'If "'.;0< O;.:o~ ';>,""u ~ ;.- 8:'6.. i<~ J:l :>:l" 8 ~u ; z~'" 08 .. ~s ~ <';roo z ::: ~" ~N":' I I , . ~" ~.s:. ~ ""t' ~ ";\It;:; ~~ ~~ ~~ ;;~ $~ <i'i<i\ %~ 0. "'''' ,,~ 'g~ %~ ~~ ~ ~ Q ~ \fJ 9, "- ~ , ;. ('.~ uJ ':;( o (!) ~ ::1 Cii fu m >-1;: tt; ~~ ~ 'rXz o "-0 'c: ~~ ~ \..-"~Ul Q eel;: U- fl,.:!. ';;: ~ 1 ~ \ i ~ ~~ ~~~ ~\ .,<\~::~\ ~ ~ 'iJ I' '" '5 <' % ~~~~ u:--_~ m~O~ ~~~\ ..1 Q ~ 0.1{ g .~ . 6 o ~ :; c ID o ~ ::; c 8 IS ">:'< '.,- <1l ,... 5 ~ <5 'Z ~ ~ Q. 't3 ~ ::> ~ uJ 5 ':l ,... '6 5 ~ a 'J, ~ ;-'---:"'->-'._-.'.._".~-"-' 'j I ~ i, i,;:'.) J~:' ,.,"".. UL;:._-~'~\ ~. , ;.i .--,....., "'I' -'- CUMBERLAND LAW JOURNAL 2 LIBERTY AVENUE CARLISLE, PA 17013 . .~,.,.....",~... . ~.," ,~"'_~ '" _..... or JUNE 21, 2002 Cumberland Law Journal is published every Friday by the Cumband County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication oflegal notices, TO: Lowell R Gates, ESQUIRE RE: Ruth Marie Hallett aka Ruth M. Hallett, ESTATE Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. -------------------------------------- --- ----- ------------------ Advertisement inserted on following dates: JUNE 7,14,21,2002 Advertising Cost $ 75.00 $ 0.00 $ 0.00 $ 75.00 ------------- $ 0.00 ---- Proof of Publication Second Proof Request Payment received Total Amount Due Payment received JUNE 4. 2002 by Beckv H. Morgenthal/Executive Director ftp~"" 0..k \05 6()D Past Bllllnfurmatlaa - UGI Th. account balance.n your last bill was ....._...... Payments ..........____............................_................ Your balance as of 05/02/2002 (due n.w) ...m....... $ 30.89 0.00 30.89 If you have any questiDns. I please call us at 717-232-1811. .rwrits to POBX 13009. Reading. PA 19612-3009. Pleas. contact us by May 24. Billing Summ.ry lor Servlcollr. RUTH M HAllm 4175 MOUNTAINVIEW RO Al04 MECHANICSBURG PA 17050 Rata CI....lficatl.n: Residential H..ting BIlling Period: 04/25/2002 to 04/30/2002 (5 days I Final Read Current Bill In_ .. UGl Custom.r Charg. __........_.....__....._............. Commodity Charg. ( 3 CCF at $0.55667) .....__ Ilislribution Charg.s ....._........................................... PA Stal. Tax Surcharge .._.................................... Total Current Charg.s (due by OS/24/2002) .......... Total Charges Due .. UGl ...._..........._...................... laIal Amount Due _............_....._.._.... 1.43 1.67 1.02 -0.02 4.10 $4.10 $ 34.99 CPT 220 479 1420 83 1 . Your current UGI charg.s includ. State taxes totaling $ 0.13. 2.10 1.89 1.68 1.47 1.26 1.05 0.84 0.63 0.42 0.21 0.00 Avarage CCF Per Day ater Reading Information ater Number Pravious Reading 1173615 4539 (estimated) Present Reading 4542 (final) CCF U.ed 3 ......g.. tram UGI .leur current price to compare is $ 0.55698 /CCF. .....r total annual usage is 279 CCF. Your average monthly usage is 23 CCF. .lEnk you for your busin.... Vou have maintained an exc.ll.nt paym.nt history with UGI. "Dis bill may be used as a credit ref.rence for obtaining future utility s.rvice. .1fIIp prevent pipeline damag.. accid.nts and service disruptions. If you s.. someone .ing near your ham. please call UGI. . . . . . . AMJJASONOJFMA 2001 Month. 2002 ~ . = Estimated Usage Last V..r 1.03 SO'F This V..r 0.80 54'F Averag. CCF /day Daily tempomlure If,.. pay at a paym.nt ag.nt pi.... take your .ntire bill. Mak. check payable to UGI. KIop this part for your records. Important information is on the b.ck of this bill. Q For Service To: Ruth Hallell 4175 Mountain Vi_ Rd A104 Account Numb..r: 24-1179578-0 Premise Number: 24-0394058 -Prior Balance Balance from last bilt Payments prior 10 May 03. 2002. Thanks! Total prior balance; May 03, 2002 -Currenl Walar Charge.- Service Charge . T olal walar charges, May 03, 2002 $11.57 .00 11. 57 Billing Period & Meter Information ~patf!' lAJlIyn!:l,7nn~ illin Period: IIpr 2210 30 (8 daysG Nexl reading ontabout: May 22, 2002 Rate Type: Residential 2.80 2.80 -AMOUNT DUE $14.37 MeIer readings in currenl billing period: MeIer Number NOOOOl3420 is a 5/8-ioOO meter. Present.actual 361400 Lasl-actual 361400 Gallons used 0 ~ ) ~O 0> Water Usage Comparison Monthly usage in hundred gallons, ,/ PPL Electric Utilities Electric Service For: RlITH MARIE HALLETI' 4175 MOUNTAIN VW RD 104 MECHANICSBURG PA 17055 Adjusled Final Bill PPL Electric Ulilities Customer Service 827 Hausman Rd. Allentown, PA 18104-9392 1.800-342-5775 www.pplweb.com General Information ppl Page 3 /2J /. ~~ () 'U ~ w our BiIlA<:ooun' Nwnbe< 33440-80023 Total fro", Last Bill Pav",ent Received Apr 29. Thank You! $ 20.56 $ 20_;6 Billing Details Balance as of May 1, 2002 $ 0.00 Current C arge Charges for. PPL LECfRIC UTILIT Residential Rate: RS for Apr 5 - Apr 30 . ibution Charge: Cus ar e 69 KWH at . ~per . Transmission Char..E,.e: 69 KWH at O.37700000~ per KWH Transition Charge: 69 KWH at 1.58800000(1 per KWH Generation Charge: Cal"acily and Energy. 09 KWH al 4.92000000(1 per KWH PA Tax Ag;uslmenl Surcharge al 1.08000000% PA Sales Tax Total PPL ELECTRlC UTILITIES Charges 5.39 1.24 0.26 1.10 3.39 0.12 0.69 $ 12.19 Account Balance $ 12.19 Generation prices and charges are set by Ihe electric generation supplier you have cliosen. The Pubflc Utilily Commission re~lates dislrioution prices '!fIq selVi.ces. The Feqeral Energy Regulatory 'Commission regulates transmISSIon pnces and services. PPL Eleclric Utilities uses about $1.13 of this billto..pay stale taxes. In addition, about $0.50 of this bill pays the PA Gross Keceipts Tax. The Transition Charge includes an Intangible Transition Charge (ITq and the applicable gross receipts tax which together amount to $0.90. The ITC is a per usage Charge approved by the Pu5Jic Utility Commission which PPL Electnc Utililtes collects as agent for PPL Electric Utilities Transition Bond Company LLC and which tliat company uses to selVice debt incurred to recover a portion of PPL Electric Utililtes' stranded costs. The gross . . '. i lIecte for the Commonwealth of Pennsvlvania. is :!+ 1'#.' PA REV-1500 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES and LIENS 13 ." 0 'tl '" ~ 0 ~ ~ ~ 0 :<I e; )< )< e; l'il , l'il ~ l'il ltl :<I .... to' , ltl , < l'il ~ '" ~ l'il ~ n .... .. l'il .. 0 , lOl .. 0 g lOl l<l l<l Z .... .... c: ..... l'il to< ltl 'tl ltl l'il n ltl ~ .... ~ ~ 0 ltl l'il g .... 'tl i i ~ l'il to' 0 t"' : .... .... .... '" '" ... .... ... I . . . ... ... 0 '" CO 0 '" 'tl 'tl -n: .... )< )< Om to' .., .., to' .... .... ~:l> l'il l'il ~ ~ ~ "'r- 0 m-f i ~ Q: 3: ...:<1 j!::cn l'il eno l'il ~~ l'il .. ~ l<l ~c UlII: .. l<l ~3: ... ~ $-f .... ... II: 0: n ~~ 0 m CI:l 0 3: en;;o '" co ;a l'ilto' \0 ~ m :e:l'il :r: Q .., to' ~ ~ .., to' to 'tl l'il ;:= )< .., ::j .... ~ ....0 :=; ...... 0 0 Ul Ul z :r: 0 en ." ~ r Gf~ .... '" . '" .... to' to' .... ~ o e; l'il .. ~ Q '" o o '" , , 031 06 03/05 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , f~ iCREDIT LIMIT 'ZOOO CREDIT AVAILABLE :PAYHEIlT - THANK YOU 06 : EXXOH TRAVEL CLUB I HONTJa. Y DUES ~'INQUIRIES CALL 1-800-833-"66, ~ : SUBTOTAL OTHER CHARllES 4.25 ft: THE PERIODIC RATE S_ ON THIS STATEHEHT HAY VA Y 9, IP1_.. not.: A copy of the privacy policy thai: 11.s to your :ecoount i. enclos.d for your infor..tion and rev eN. If you Iprevlausly exerci.ed your choice under t~ polic J you need not ! do so _in. , , , , , , , , , , , n,SQCR 4.25 ~ LOu..t ~ eo ~o...\.ct JlPl-W. (!'hcv.~ co ~-t Sav."or 0011_' _..:In.r YOU" c:r8dlt card with up,..l...eOllend then u.. 1t to buy... at Exxon or ~11 at.tlona. Itl. . ...rt _y to f....l. You like -..t. How do we know? We' r. drive.... too. t Purcl1aS"s I + Debits I ;;; New Balance I Minimum Payment .00 4.25 .00 4.25 l\.25 .00 l\.25 .01 l\.25 l\.25 rhll financa ct.,._ WtJtllI'1II TOllllll~"'''b$flOI _.~ To l/lal pMOIIIW "platIimpoMs11InInct """'- I_ ...rmIMl1 Wy --- ~~clwge AM. -.oJ. ~..._oI ==~.: ~(. ,......... periDlllIc. "'"liT''' _00 ."lyl",. ... =reJ~ "". _.f "". REO . 057547, DAILY Z1.00 EHTIRE IlALANC .00 ~,"'lItnS,.ndpaymtnllmlldeiustprlol'lobl,"ng_maynot.ppearunlllneJtalllh'IItI!Inltnl lInlIIsllfO'llOtion.CIlIIor.peclalltmll,.ddlliOBalfillanutllalgestlm'Dt.vQicledlfwe....th./llWbllanctbyttle.dulcII&t. INQUIRIES: Send Inquirlet (not payment) and your acccunt number ta: PO BOX 103031 ROSWELL, GA 30076 NOTICE: See IVVtrse side tor important BIlling Rights and other in/ormation. ~ CC:<r 800-344-4355 't ~ T.I.ph""'" ,b,,,,, bjWng """. wfII..t """n.. you, ~ rights underfedfral/lw. To preserve your rights, plelSe "::,, write to theil/ling Rights 5um~ry Add,," on reverse U( sfde. CUSTOMER SERVICE: For aCCOll'lt Informstion call toll frH: PO BOX 4556 CRLSTRK IL 60197-4556 Q11 :'::<'~lr~\~~;~:",*:?r~T11~~;~1$~~?}W~{K~J~J:,j'fft!':,. EIG~4041 DP-41 R(7i92 II ~ ERIE, NOTICE OF PAYMENT DUE BILLING DATE J %. 02-18-02 ~ ERIE INSURANCE GROUP 100 Erie Ins. PI. . Erie, PA 16530 FAMILY AUTO POLICY NUMBER 002 1502360 AGENT NUMBER AA7605 FARNHAM INSURANCE AGY 717-766-8678 1",111",111",.1.1,11",1".1,11""1,11,,1,,,1,11.1".,11,1 RUTH M HALLETT 4175 MOUNTAIN VIEW RD APT 104 MECHANICSBURG PA 17050-7628 P()LICYTJU\NSAC'f!ONS 02-'5-02 PREMIUM 01-31-02 PAYMENT $ $ 687.00 229.00CR OUR LIBERAL PAYMENT PLANS DO NOT ALLOW FOR A GRACE PERIOD CURRENT BALANCE $ 458.00 FUTUREINSTAJ,;LMENTS DUE 04-15-02 $ 229.00 TRANSACTIONS OCCURRING IN THE LAST 10 DAYS MAY NOT APPEAR ON THIS STATEMENT. IF THERE IS AN ERROR, PLEASE CONTACT YOUR AGENT OR THE HOME OFFICE. RETURNED CHECK FEES WILL BE ADDEO TO YOUR ACCOUNT. ~ . . . . . . I . I . I . I . I I I I . I . I . I I . I . I . . . . . . . . . . I . 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(I) (t) ~<<lg"i3::l ",,,, ::> "," 0 ~ < .ll' '3 "?" u; _.cog co ~~ -oO'<(\)-=' ~ "O(1):1~O ~ ~~~ '0 ~ YJ ", ~l 'ii' ~, -' ", ~\ r 10-'"0::3-" :;oX 10-' =" , ..,p~f"llo-' c> lJ1 , 0 .....-..1 -lr ..ll lJ1 XlJ1 Xr I , 0 > f"l ru , Z::3 -l -" , H-l -l I , ..... -..I , Vl< lJ1 , CJH ru , Cf"l -" N' :;oE: '" 0' :;0 X 0' 0 ::3 > ~\ > -0' "" :1;>\ .. <:, 10-' , 8\ 0 , -" , '0 's "'0'1' >'% 8~ "'0' DI'~ '<:' 3'0 CD'r 8~ ::S'~ ...., <:, 0' c:\ C"l' "" -03 if' .... ",. ...' ".. , :s." , ,,'" 0 .... 10-' , a.~ 0 I ..0 0 I O~ ~% ..ll I .." ... "0 10-' , ~~ 01 lJ1 I "" 0 , ~o a 10-' , L _a. ro II'" , 0" -~ :> , ",'" r1" , .... ,,'" I ..!} ru ... ,,- w a , "" "0 . 0 , S' 0 c: , .. 0 :> I r1" J I I , , PPL Electric Utilities " , , l't ' "':~~I::'~<:- pp '\..':::~ "'''-'-. ",""" - ~ 'e._, _no Page 1 .bQt'.i' >A~rWiibet:'<:'::::':--';': 33440-80023 Ouestions about tliis bill? Please contact us by Apr 29 at 1-8D0-342-S77S Summary Page Balance as of Apr 5, 2002 $ 0.00 CharMS: TolafPPL ELECIRIC Ul1Ul1ES Charges $ 20.56 Total Charges $ 20.56 -'.....,.......,.."."....,.,....'.',......."',......'.... .~..~.- Account Balance $ 20.56 ?) ~CJ -PV- -6 :/" Electric Service For: RUTH MARtE IIALLEIT 4175 MOUNTAIN YW RD 104 MECHANICSBURG PA 17055 or write to: Customer Service 827 Hausman Rd. Allentown, PA 18104-9392 www.pplweb.com Electric Use 18 KVfH-AverogePerDay Meter Reading Information eter 9 15 ~r 5 Actual ar 6 Actual 12 30 a s 11 e 9 Average -Apr 2001 2002 TernlIerature 40F 44F KW Per Day 7 5 6 Yearly Use: Total A ve'dSe 3 Use Mon ~ May 2000 - Apr 2001 3125 26 0 May 2001 - Apr 2002 3198 267 AMJ JASONDJ FMA 2001 Months 2002 This groph shows your electric use over the last 13 months. Types of Meter Readings: Actual _ Estimated _ Customer D For Service To: Ruth Hallett 4175 Mountain View Rd A104 Account Number: 24-1179578-0 Premise Number: 24-0394058 Billing Period & Meter Information Billing Date: Feb 27, 2002 Billing Period: Jan 23 to Feb 22 (30 days) Next reading on/about: Mar 22, 2002 Rate Type: Residential Meter readings in current billing period: Meter Number N000013420 is a 5/8-inch meter. Present-actual 360400 Last-actuai 360000 Gallons used 400 Water Usage Comparison Monthly usage in hundred gallons. 21 -Prior Balance Balance from last bill Payments prior to Feb 27. 2002. Thanks! Total prior balance, Feb 27, 2002 -Current Water Charges- Service Charge Water Volume ($.000150 x Water Volume ($.005100 x Total Usage Billed $18.96 -18.96 .00 10.47 .06 2.04 12.57 400) 400) 800 -AMOUNT DUE $12.571 ftu:t!"" <t~ Past Bllllnfarmation .. UGI ;> The aCl:Ollnt balance on your last bill was ............. $ 43.43 Thank you for your payment of .................................. -43.43 Your balance as of 03/28/2002 ................................ 0.00 BIlling Summary lor Service to: RUTH M HAum 4175 MOUNTAINVIEW RD Al04 MECHANtCSBURG PA 17050 CumtnlBiIIlnformation - UGI Cuslllmer Charge ........................................................... Commodity Charge, 45 CCF at $0.55689) ............ Distribution Charges (First 45 CCF at $0.34200) . PI. Slate Tax Surcharge ..._..m_.................................... Tolal Cu/lllntCharges (due by 04/22/2002) ......... Talal Cbarg.. Due.. UGI ..._................................. Talal AlDaunt Due ................_................................... 8.55 25.06 15.39 -0.21 48.79 $48.79 $ 48.79 Rata Clas.lfication: Residential Heating Billing Peri4d: 02/25/2002lD 03/26/2002 (29 days) Company !lead . Your current UGI charges include Slatelaxesllllaling $ 1.57. 2.70 Aversge CCF Per Day 2.43 2.16 1.89 1.62 1.35 1.08 0.81 0.54 0.27 0.00 Malar Resding Information Metar Number Previu.. Reading 1173615 4469 (estlmatad) Present Reading 4514 (company) M....g..lrom UGI .Yourcu"""t price to compare is $ 0.55698 fCCF. ~ If you have any questions, please call us at 717-232-1811. or write III POBl< 13009, Reading, PA 19612-3009. PI..se conlact us by April 22. May 24, 2002 CPT 220479 1420831 CCF Used 45 . Yourtolal annual usage is 295 CCF. Your average monthly usage is 24 CCF. . We can make your energy costs easier on your budget with our 12 month EMP plan. Your monthly payment would be apprnximately $ 37.00. For more information about this plan ..11001. . Help prevent pipeline damage, accidents and service disruptions. If you see someone digging near your home please call UGI. . . . III . . MAMJJASONDJFM 2001 Month. 2002 . = Estimated Usage Average Last 'fear This Year CCF /day 2.10 Ooily temperature 380F 1.55 410F , ,~ ~, ~ .. ! ,.. . ~ ~u N _ g ~ N 0 - ~ e3 Ii: '"' ::! Z .-,: -. ~ :::> 8 u :::: -< ~ Ii! i: -< ;g ~ ~ ~ g) < R ;:g :::: w o ~ ~ ~ ~ ~ .~ f-o ~ @ -g ~ ; ~ '6 ~ c; i Z c: $, ~ ~ ~ "0 o " . s~ ~ ='" t.li ~d~.2~ ~ ,:1.3U] gf~e~ e 's E c ~ ~ < d:~~~z e- " E E <ii g ,.: ~ - :::> p .... '" Z ..: :r f-< ~ .g ~ ~ ~ = N e r,... N gg~Jg r'r'd ' -o.o:<r ~ ........- - . . ~ s ~ " =-ii' .-,: " -. ci ~ - ~ ~ :::> ... on U Z .-,: :r u '" ;g ~ "- N V .. !;; .-,: ~ gN .8 SN -... - '" ~ ;g ~g vi,,; -- ~g ~g """ vi.,) -- ; " .. " "- a~ ~~ ;6- u~ ='" ~g ..( t1: u u 'E ~ " ~ ~ " ..E ~ ~ ~ ~ .;, . ~ ,~ ~ b~~ ~a> o~1 zcil S '3,. '-fj u~t2 . . 'i . ~ 1. ~, g; ZO< .-,:... z.;: 4:U gC" C" .......... ~ = 'c u "- ;@ ~ c: " ~ ~ '" '.' c ;<: ~ u '" ..' 0: <: ::; z z: -< ~ ~ =:. ~ ~ggg ~?...... -- " c. " .g ,:t ... . U ." ~ a j~ :::: C:: 1l 0 'Z u_ 0; ~ .". o .g o V ~ . . .e~~ ::.....:: ei::g~ t:::;~ $ ~ 1; ~ 0 s ...o~ .s '2 = (100 ;so..z ~- ~ j s . :E .. .S ~ 5 ~ t ': ,. i ~ 2 it!!.,; ~~~ :::;:;=:: ~ ~ ;:: ~ in g N '" ./' - " " - " . 00 e " -<" sO E f .::; z i:~ ..". " u o . _"0 ~~"S ~!!:; =c:;"'R 1>_~c=l ~~c~ _ dO^"" ~.::.dZU 1:0_-- ;; ~ c ~ s , u .: ~ . .. 2: n ~ 0. 0 N S ~"e ~ "'Co:Xl:< ~.E ~ $ ~ ';"50 ",,1 e.A:::-;;~ ! .., i:!'a . :: j~u~~ , ,... ~. - E ~ ~ - ; a: 1. ~ i! itiiiiJ; ~~!;! ~~~ o.~Q; ~ ~~ ggg ~"'i ........ i'J. ..~ . ao ~ Ci u u = " c <i: ::J ~ < ~'" "lU ~" <- ",0: u,.. e:" -< ~j "'x <z~ :;:0< xzu 16WNGFYV 100159200063019561 w AV 01 025841 554636139 A**5DGT 1...111...111....1.1.11...1.1.....11...111..1.1.1..1,1..11...1 RUTH M. HALLETT APT 104 4175 MOUNTAIN VIEW RD MECHAHICS6URG PA 17050-9118 SIJIlARY OF IIIImtlY CHAASES FOR ACCWIfT 2000830195 Wireless NtoIber 717-877-1226 66.16 66.16CR .00 Your billing cycle began on 03/02 and ended on 04/01. J Current Monthly Charges Monthly Service Charges Home Airtime Charges Home Lon9 Distance Charges Text Messaging Charges Roami n9 Charges Other Charges and Credits Taxes, Surcharges & Regulatory Fees Total Current Monthly Charges OlJE UPON RECEIPT TOTAL NIlIIlHT IllIE You can now pay your invoice online' _.attwireless.c.. AT&T WIRELESS APPRECIATES YOUR BUSI_.s;:L ~ AM Wireless Questions? . www.attwireless.com . 1-800-888-7600 . 611 from your wireless phone . TTY users - 1-866-4~AWS~TrY Date of Invoice: 04/03/02 .00 .00 33.08 29.99 .00 .00 .00 .00 .00 ~ 33.08 33.08 (!S NOTICE OF PREMIUM DUE fhe Baltimore Life Billing Number: Date of Notice: 01152010775 03/31/2002 The Baltimore Life Insurance Comp-3.: Life of Maryland, Inc. 10075 Red Run Boulevard Owings Mills. Maryland 21117-487; Tel: (800) 628-5433. www.baltlife.co- COMPA.NIES SALES REPRESENTATIVE: RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 CARLISLE AGENCY 401 EAST LOUTHER STREET CARLISLE PA 17013 (800) 324-5796 SEE REVERSE SIDE FOR ADDITIONAL INFORMATION . TOTAL . AMOUNT ..' .DUE 106.: AMOUNT DUE BY 04/25/2002 106.0: Descriptions of "Other Amounts Due" F =:; Optional Additional Insurance Rider p:: Amount Past Due Descriptions of ~l.ess These Amounts" R=Dividend Reduction (Credited) 0= Previous OverPayment Thank you for your confidence in Baltimore Life and Life of Maryland. We appreciate your business. ~~ ne Baltimore Ufe The Baltimore Life Insurance Company. Ufe of Maryland, Inc. 10075 Red Run Boulevard' Owings Mills' Maryland 21117-4871 Tel: (800) 628-5433 . www.baltllfe.com 01152010775100000106085000021216000003182427 RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 BILLING NUMBER: AMOUNT DUE: AMOUNT DUE BY: AMOUNT PAID: $ 01152010775 106.08 04/25/2002 If you have changed your name, address, or telephone number, please check this box and complete the back of this formD PLEASE DETACH AND REMIT WITH YOUR PAYMENT MAKE CHECKS PAYABLE TO BALTIMORE LIFE ~ NOTICE OF PREMIUM DUE The Baltimore Life Billing Number: Date of Notice: A 0969455 03/28/2002 The Baltimore Ufe Insurance Comp; Life of Maryland, Inc. 10075 Red Run Boulevard Owings MilJs. MJryl:md 21117-487: rei: (800) 628-5433' www.baltllfe.cc... C:OMFp~JlFS SALES REPRESENTATIVE: RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RO MECHANICSBURG PA 17050-9118 CARLISLE AGENCY 401 EAST LOUTHER STREET CARLISLE PA 17013 (800) 324-5796 SEE REVERSE SIDE FOR ADDITIONAL INFORMATION BLI Life A 0969455 ELISHA NICOLE HALLETT 04/02 M 13.64 F 2.56 16. Descriptions of "Less These Amounts" R= Dividend Reduction (Credited) 0= Previous OverPayment AMOUNT DUE BY 04/14/2002 Descriptions of "Other Amounts Due" F = Optional Additional Insurance Rider P=Amount Past Due 16.2: Thank you for your confidence in Baltimore Life and Life of Maryland. We appreciate your business. ~. he Baltimore life The BaJtimore Ufe Insurance Company. Ufe of Maryland, Inc. 10075 Red Run Boulevard' Owings Mills' Maryland 21117-4871 Tel: (800) 628-5433 . www.baltlife.com 99096945500130000016201000003240500000486067 RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RO MECHANICSBURG PA 17050-9118 BILLING NUMBER: AMOUNT DUE: A 0969455 16.20 AMOUNT DUE BY: 04/14/2002 AMOUNT PAID: $ =nrm ",Q7P. If you have changed your name, address, or telephone number, please check this box and complete the back of this formD PLEASE DETACH AND REMIT WITH YOUR PAYMENT MAKE CHECKS PAYABLE TO BALTIMORE LIFE ~- NOTICE OF PREMIUM DUE fhe Baltimore Life Billing Number: Date of Notice: A 0957012 03/28/2002 The Baltimore Life Insurance Camp; Life of Maryland, Inc. /0075 Red Run Boulevard Owings Mills. Maryland 21117-48~1 Tel: (8aO) 628-5433' www.baltlife.ccc' cor/,~l.'.r'J!FS SALES REPRESENTATIVE: RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 CARLISLE AGENCY 401 EAST LOUTHER STREET CARLISLE PA 17013 (800) 324-5796 SEE REVERSE SIDE FOR ADDITIONAL INFORMATION BLI Life A 0957012 SHANE E HALLETT 04/02 M 14.76 F 1.23 15.~ Descriptions of nOther Amounts Due" F = Optional Additional Insurance Rider P=Amount Past Due AMOUNT DUE BY 04/06/2002 15.9~ Descriptions of -Less These Amounts" R= Dividend Reduction (Credited) 0= Previous OverPayment Thank you for your confidence in Baltimore Life and Life of Maryland. We appreciate your business. ~. ~'C, ~,-'~-- The Baltimore Life Insurance Company' Life of Maryland, Inc. 10075 Red Run Boulevard' Owings Mills' Maryland 21117-4871 Tel: (800) 628-5433' www.baltlife.com 1e Baltimore Life 99095701200170000015998000003198500000479797 RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 BilLING NUMBER: AMOUNT DUE: AMOUNT DUE BY: AMOUNT PAID: $ A 0957012 15.99 04/06/2002 -arm 5978 If you have changed your name, address, or telephone number, please cheek this box and complete the back of this formD PLEASE DETACH AND REMIT WITH YOUR PAYMENT MAKE CHECKS PAYABLE TO BALTIMORE LIFE ~~ fhe Baltimore Life NOTICE OF PREMIUM DUE Billing Number: A 0902794 Date of Notice: 03/31/2002 The Baltimore Life Insurance Comp~ Life of Maryland, rnc. 10075 Red Run Boulevard Owings Mills. Maryland 21117-487: Tel; (800) 628-5433. www.baltlife.cc... COt"!FJ..hlIFS SALES REPRESENTATIVE: RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 CARLISLE AGENCY 401 EAST LOUTHER STREET CARLISLE PA 17013 (800) 324-5796 SEE REVERSE SIDE FOR ADDITIONAL INFORMATION eLl Life A 0902794 DEBORAH ANN STERLING 04/02 M 60.26 60 : Descriptions of "Other Amounts Due" F", Optional Additional Insurance Rider P=Amount Past Due AMOUNT DUE BY 04/01/2002 60.20 Descriptions of "Less These Amounts" R = Dividend Reduction (Credited) 0= Previous OverPayment Thank you for your confidence in Baltimore Life and Life of Maryland. We appreciate your business. ~. The Baltimore life Insurance Company. Ufe of Maryland, 'nc. r0075 Red Run Boulevard' Owings Mills' Maryland 211/7-'1871 Tel; (800) 628-5433 . www.baltlife.com he Baltimore Life 99090279400120000060260000012052400001807846 RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 BILLING NUMBER: AMOUNT DUE: AMOUNT DUE BY: AMOUNT PAID: $ A 0902794 60.26 04/01/2002 =f"lrrn "'Q7~ If you have changed your name, address, or telephone number, please check this box and complete the back of this formD PLEASE DETACH AND REMIT WITH YOUR PAVMENT MAKE CHECKS PAYABLE TO BALTIMORE LIFE ~. NOTICE OF PREMIUM DUE Billing Number: Date of Notice: OJ 152002989 03/31/2002 The Baltimore Life Insurance Camp.; Life of Maryland, Inc. 10075 Red Run Boulevard Owings Mills. Maryland 21117-4871 Tel; (800) 628-5433 . www.baldlfe.coc. fhe Baltimore Life corv:D,L,i'JIFS SALES REPRESENTATIVE: RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 CARLISLE AGENCY 401 EAST LOUTHER STREET CARLISLE PA 17013 (800) 324-5796 SEE REVERSE SIDE FOR ADDITIONAL INFORMATION BLI Life 0115200298 CHARLES W STERLING M 125.00 125.C Descriptions of "Less These Amounts" A"" Dividend Reduction (Credited) 0:: Previous OverPayment AMOUNT DUE BY 04/02/2002 Descriptions of "Other Amounts Due" F::- Optional Additional Insurance Rider P=Amount Past Due 125.0C Thank you for your confidence in Baltimore Life and Life of Maryland. We appreciate your business. ~~. 1e BaltImore Life The Baltimore Ufe Insurance Company. Life of Maryland, Inc. 10075 Red Run Boulevard' Owings Mills' Maryland211 17-4871 Tel; (800) 628-5433 . www.baltlife.com 01152002989180000125008000025000900003750075 RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 BILLING NUMBER: AMOUNT DUE: AMOUNT DUE BY: AMOUNT PAID: $ 01152002989 125.00 04/02/2002 =orm 5978 If you have changed your name, address. or telephone number, please check this box and complete the back of this formD PLEASE DETACH AND REMIT WITH YOUR PAYMENT MAKE CHECKS PAYABLE TO BALTIMORE LIFE €~ fhe Baltimore Life NOTICE OF PREMIUM DUE Billing Number: Date of Notice: A 0902791 04/01/2002 The Baltimore Life Insurance Comp Ufe of Maryland, Inc. 10075 Red Run Boulevard Owings Mills. Maryland 21117-4871 Tel: (800) 628-5433. www.baltlife.co~' COM PAr.,.) i r S SALES REPRESENTATIVE, RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 CARLISLE AGENCY 401 EAST LOUTHER STREET CARLISLE PA 17013 (800) 324-5796 SEE REVERSE SIDE FOR ADDITIONAL INFORMATION TOTAL AMOUNT DUE BLI Life A 0902791 JAMIE M STERLING 04/02 M 15.71 P 15.71 3< . . .- AMOUNT DUE BY 05/01/2002 31.4. Descriptions of MOther Amounts Due" F = Optional Additional Insurance Rider P=Amount Past Due Descriptions of NLeas These Amounts" R= Dividend Reduction (Credited) 0= Previous OverPayment Thank you for your confidence in Baltimore Life and Life of Maryland. We appreciate your business. ~, he Ba~Jmore Life The Baltimore Life Insurance Company. life of Maryland, Inc. 10075 Red Run Boulevard. Owings Mills. Maryland 21117-4871 Tel: (800) 628-5433 . www.baltlife.com 99090279100130000015710000003142200000471312 RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 BILLING NUMBER: AMOUNT DUE: AMOUNT DUE BY: AMOUNT PAID: $ A 0902791 31.42 05/01/2002 :orm !,Q7R If you have changed your name, address, or telephone number, please check this box and complete the back of this formD PLEASE DETACH AND REMIT WITH YOUR PAYMENT MAKE CHECKS PAYABLE TO BALTIMORE LIFE (!Ii. -- - NOTICE OF PREMIUM DUE Billing Number: Date of Notice: A 0902792 03/31/2002 The Baltimore Life Insurance Com~.:l. Ufe of Maryland. Inc. 10075 Red Run Boulevard Owings Mills. Maryland 211\7 -48i , Tel: (800) 628-5433' www.baltlife.co- fhe Baltimore Life CC)~~ ?J.,~'I i;: S SALES REPRESENTATIVE: RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 CARLISLE AGENCY 401 EAST LDUTHER STREET CARLISLE PA 17013 (800) 324-5796 SEE REVERSE SIDE FOR ADDITIONAL INFORMATION 8U Life A 0902792 ERIKA L STERLING 'rOTAL . . AMD~~NT 04/02 M 15.19 '" . AMOUNT DUE BY 04/01/2002 15. 1 ~ Descriptions of "Other Amounts Due" F'" Optional Additional Insurance Rider P",Amount Past Due Descriptions of "Less These Amounts" R=Oividend Reduction (Credited) 0'= Previous OverPayment Thank you for your confidence In Baltimore Life and Life of Maryland. We appreciate your business. A~."'";4; ~~- The Baltimore Ufe Insurance Company. Life of Maryland, Inc. 10075 Red Run Boulevard' Owings Mills' Maryland 21117-4871 Tel: (800) 628-5433 . www.baitlife.com le Baltimore Life 99090279200160000015192000003038400000455732 RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 BILLING NUMBER: AMOUNT DUE: AMOUNT DUE BY: AMOUNT PAID: $ A 0902792 15.19 04/01/2002 :orm 5978 If you have changed your name, address, or telephone number, please check this box and complete the back of this formD PLEASE DETACH AND REMIT WITH YOUR PAYMENT MAKE CHECKS PAYABLE TO BALTIMORE LIFE ~o ~-- NOTICE OF PREMIUM DUE fhe Baltimore Life Billing Number: Date of Notice: A 0902790 03/31/2002 The BaJtimore Life Insurance Campa Life of Maryland, Inc. 10075 Red Run Boulevard Owings Mills. Maryland 21 \ \ 7 -48i i Tel: (800) 628-5433. www.baltlife.cc" COMPA,I'~IES SALES REPRESENTATIVE: RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 CARLISLE AGENCY 401 EAST LOUTHER STREET CARLISLE PA 17013 (800) 324-5796 SEE REVERSE SIDE FOR ADDITIONAL INFORMATION Bll Life A 0902790 JAY M HALLETT 04/02 M TOTAL AMOUNT DUE 54.41 54,": AMOUNT DUE BY 04/01/2002 54.4 Descriptions of "Other Amounts Due" F -= Optional Additional Insurance Rider P =: Amount Past Due Descriptions of "Less These Amounts" R= Dividend Reduction (Credited) 0-= Previous OverPayment Thank you for your confidence in Baltimore life and life of Maryland. We appreciate your business. ~, ..~._~ The Baltimore Ufe Insurance Company. Ufe of Maryland, Inc. 10075 Red Run Boulevard' Owings Mills' Maryland 21117-4871 Tel: (800) 628-5433 . www.baltlife.com he Baltimore Life 99090279000100000054412000010882100001632353 RUTH MARIE HALLETT 4175 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-9118 BILliNG NUMBER: AMOUNT DUE: AMOUNT DUE BY: AMOUNT PAID: $ A 0902790 54.41 04/01/2002 ::....,...-, r:07Q If you have changed your name, address, or telephone number, please check this box and complete the back of this tormD PLEASE DETACH AND REMIT WITH YOUR PAYMENT MAKE CHECKS PAYABLE TO BALTIMORE LIFE Your AT&T Statement January 26-April 25, 2002 \5;ft ,BWNCJFM ~ #09161357164012' 0 53806AV10.255B303A43579uSDGT 1...111,.,111.,..1.1.11",1".1.11....1,11..1...1.11.1....11.1 :;;j RUTH M HALLETT /' APT 104 ,) 4175 MOUNT AIN VIEW RD '-(") MECHANICSBURG PA 17050-7628 /' Customer 10: 717 728-8854 Page 1 01 4 Customer Service: 1 800 222-0300 Text Phone (TTY): 1 800833-3232 Internet Address: www.att.com Summary of <.:hat'~es 41- Extra! Extra! Imagine being able to___Make as many calls as you want. Talk as long as you want. Whenever you want. With AT&T Unlimited you can! Continued_ Previous balance __' __..... .__. __...__ .'__'__ .__._.____..__. __.__.... ..... .... ... ....34.93 Payment received Feb 10 . Thank you ............................. -34_93 AT&T direct dialed caUs..............................._........p 3 ..........23.64 Other charges and credits ..._..._.._.........................p 3 ............0.64 Taxes and surcharges .........._..__.._____.....__..._..___..._p 3 ____.__.____ 3.17 Total amount due Date due $27.45 May 20, 2002 99 L# Jed.d """~<i If) \ ." '" ~ PNCBAN< INDIVIDUALIZED BANK0JID SEM::ES www.pncnetaccess.com M... check I., .111.1.,1..1,1..1" II., .1.1, II ,..,..III, I,." II, I ~Y8b1f!1to: CARDHOLDER SINCE 1983 MBNA AMERICA P.O. BOX 15019 WILMINGTON, DE 19886-5019 I ACCOUNT NU:;~9 0900 1116 9756 PAYMENT DUE DATE NEW BJ!LfJNCE TOT IJl. I 04/04/02 I I $4.044 931 TOTAL MINIMUM PAYMENT DUE AMOUNT ENCLOSED I $5900 I I - - DETACH TOP PORTION fWD RETURN WITH PAYMENT - For account Information caU 1-600-626-2556 Print change of address 01 new telephone number belClW - - RUTH M HALLETT 4175 MOUNTAIN VIEW RD #104 MECHANICSBURG ~ Address City I ) Home phone Stat. I ) Work phone Zlp PA 17050-762800 07 00404493000059000005329090011169756 Qua DaM C.sh Of Crrt1dit AvtiJabJe $10,300.00 $6,255.07 Postlng Dote Transectlons MARCH 2002 STATEMENT PAYMENTS AND CREDITS 03/04 8936 MC PAYMENT - THANK YOU PURCHASES AND ADuUSTMENTS 02/09 02/08 4439 MC C #AOL ONLINE SERVICE 02 800-827-6364 VA TOTAL FOR BILLING CYCLE FROM 02/07/2002 THROUGH 03/06/2002 C/Osin Date Total Minimum Pa Ow fa 03/06/02 $59.00 04/04/02 Charges Credits (CR) 100.00 C 23.90 $23.90 $100.00 C IMPORTANT NEWS ENuOY THE CONVENIENCE ANO FLEXIBILITY THE ENCLOSEO CHECKS HAVE TO OFFER-- OR CONTACT US AT WWW.IBSCASH.COM OR 1-888-515-3309. CONGRATULATIONS! YOUR CREDIT LINE IS INCREASED TO THE AMOUNT SHOWN ABOVE! USE IT TO TRANSFER OTHER ACCOUNT BALANCES TO THIS ACCOUNT. CALL 800-615-3277. FOR UP-TO-THE-MINUTE ACCOUNT INFORMATION, VISIT WWW.PNCNETACCESS.COM. SUMMARY OF TRANSACTIONS TOTAL MINIMUM PAYMENT DUE Previous ealam:e (-)Payments (+) Cash- (+) Purchases and (+) Periodic Rate ~) Transaction Fee (-) New Balance andCrlld/bl AdVances Adjustments fiNANCE CHARGES NANCE CHARGES Total $4,076.92 $100.00 $0.00 $23.90 $44.11 $0.00 $4,044.93 FOR YOUR SATISFACTION. EVERY HOUR. EVERY DAY For CUS\OITI8f Salis1action and up to Ihe .ooute automaled informaliOll indudirlr balance, avaiable aedil, payments recenred. payments due, due date, paymen address inlormalion, or 10 request duplicate statements, caJl1-AOO-626.?!i:: For TOO IT e1ecommunicaliorl Davicg for the Deaf) assisl8nce. call1-BOO-346-317B. Maiipaymer.\$lo: MBNA AMERICA, P.O. BOX 15019, WllMINGlON, DE 19886-5019. Biling rights are preserved only by wriUen inquiry. Mail biDing inqlJiries:.l.lSing lormon lheback. and olher inQlliries 10: MANA AMFRICA P () AOX 15MB WII MINGTON DF 1 QAS0-5026. 1465 5329 0900 1116 9756 FINANCE CHARGE SCHEDUL.E Category Periodic Rate- Cash Advances A. BALANCE TRANSFERS, CHECKS.0.038328% OLY B. ATM. BANK................ .0.038328% DLY C. PURCHASES.................. .0.038328% OLY Corresponding Annual Percentage Rata Balllnce Subject to Finance Charge 13.99% 13.99% 13.99% $0.00 $0.00 $4,110.52 FOR THIS BILLING PERfOD: ANNUAL PERCENTAGE RATE................... 13.99% (IncfutiN PeriodJc Rae MId Ttamaction Fee RrIIIF1O$ Chvgea.) Past Cue Amount ................. $0.00 Current Payment ................" $S9. 00 Total Minimum Paymant Due ...................................... $59.(}O 080 Y 1LT 0502 0000 00 PAGE t OF 1 !- Z .. W f- :::; <[ '" w 0 '-'" l- t;'" c( :J.J...J ~ ~'" I- a::<[ .... 0 ",::;; CJl WI- .... 0) ~~ 0....1-0 ru Zll.Wr-. 0- :=!~ WO)W.... r-. 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" " " "l 'tl ~ 'tl tJj g: ~ ~ ~ "l tl 0 ~ ~ ~ t:l ~ 0 I:" .. l>:l " ~ l<l .. 0 tl lo l<l ~ I-< I-< c:: 1iJ '- t<I '" 'tl '" 0 '" ~ "l I-< "l ~ I '" t: '- '" I>l "l <J> I-' w . "l I-< '" <J> I-' 0 . <J> <J> <J> .., '" W W ~ . 0 0 0 0 ~ tJl 'tl '" "Tl% 1Ii'- H ~ ~ Om I:" I:" H H ~3> ~ t:l ... n<illO 0 m "'t<l1:" 0 :J: 00;;0 tJl H '" m ~~5 \D ~ :I: <ill:" ~ ",I:" I:" CD I>l ;= :.- ~ "l :::j "l I-' ~ .., 0 0 Ul Ul Z :I: 0 00 "U j;! r- e lo 01 tl I:" 01 I:" I-< ~ a3 0< e t<I ~ ! Q I-' .., , .., 0 ~I~~ 0 .., JUL-Uj-cUUc nON 10:21 An PATIENT ADMIN SVC FAX NO. 7178513478 p, 02 -- - --- --.-"-.--'--........-- - ._,--- - ----.-._- ---- ~.-, -- .~. --_. ,_. - -- --. ..-, GMAC PAYMENT PROCESSING CENTER PO. BOX 660314 DALLAS TX 75265-0314 SmartLease by~ ~ I :>1M FOR ASSISTANCE CALL: (600) SS1-53n TDDfTTY 1l1EARING IMPAIRED) : 600-<333-462:; Est Of RlIlh M Hallett 4175 Ml View Rd Apl104 Mechanicsburg PA 17055 1",111...11/,..,1,'.11..,',.,'.11....1,11,,1,..1.11.1...,11,1 June 3. 2002 Acca~nl N~mber: 020-03161-31326 Dear Est Of Ruth M Hallett, We recently informed you lhat before your accoun1 could be settled. we would sell the leased vehicle. The vehicle has been solO and we are providing you with your final account settlement. Account Settlement Now lhat the vehicle has been sold. to settle your accounl and satisfy your obligations, a balance of $2,578.86 is due .-4rom"f6tl..'Fhisin"ludcott.efoltowiTTq:------ - --.... -". ---,. . .---.... Remaining Base Monthly Payments (22@$259.08) is 5.699.76 Less - Unearned Rent Charge - is 767.95 Less - Surplus from Vehicle Sale - is 2.352.95 Net Remaining Base Monthly Payments (zero if negative) is 2,578.86 Net Remaining Base Monthly Payments (zero if negative) Less. Security Deposit Less - Other Refunos' Balance Due $ -$ -$ $ 2.576.86 0.00 0.00 2,578.86 Please send payment of the balance due and the attached payment coupon in the envelope we have enclosed for your convenience. . Other refunds can inciude an aodilional security deposft VQu paid during the lease, payments already made for excess mileage or excess wear charges, or refunds we received from cancellee optional insurance, service, or maintenance agreements. Thank You ThankS again for using GMAC 5mBrtLease. Your business is very important to us and we hope tllat we exceeded your expectafions. We in.,;te you to visit www.gmacfs.comto leam more abOut GMAC's fuilline of consumer products and services. If you have any questions, comments, or 1'e41J1re acldijional information about the vehicle sale information or your account settlement, please contact a rearesentati"" at thA tAlP,flhMp n..mh.... prmAdea. abO''li Sincerely. SMARTLEASE Department .......... ~ ~ = ~ ......... ~ -- - iiiiiS - ==0 38964\-01651 T~f\OiOl:I 411570~11'3.09 P.O. BOX 7041 TROY, MI 48007-7041 1-800-551~5377 July 27, 2002 \ C\OZ--. . ""' ~~ CW ::\\\,,,,,\ .~A \l- eve r~ (;V...,.....- w<.'-" S':>\O-~~~'-~ Dear RUTH M HALLET!: GMA~, RUTH M )-IALLETT 4175 MOUNTAIN VIEW RD APT 104 ESTATE MECHANICSBURG PA 17050-7628 1...1111..1111,,11,1.11...1...1,11....1.11..1...1.11.1...,11.1 Account No .020-03161-31326 Account Bal. $.00 /" --' ,,---------- c -~- In checking our records, we find that we do not have your current telephone number. To bettcr servc you. it is important that a line of communication remain available. Accordingly, please help us update our records by completing the information below and returning this letter. Ifvou have am questions regarding your account, pleasc contact us at (248)813-3500 or toll frec 1-800-551-5377. Residence Telephone. Very truly yours. M. GAINES (area code) Business Telephone. (area code) Other Telephone. (area code) We are attempting to collect the amount our rccords say you owe us now. Any information we obtain will be used for that purpose. Reference #. 281 N44 .......... .......... .......... = - - - - ~ = - - ~ === /?-0-7-/y' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-06Dl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REY-IU7 EX AfP [Ol~O5> MARK E HAL BRUNER ESQ GATES HAL 1013 MUMMA RD STE 100 LEMOYNE PA 17043 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-17-2003 HALLETT 03-18-2002 21 02-0393 CUMBERLAND 101 Allouni: R..itted RUTH M MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account} submit the upper portion of this for. with your tax pay..nt. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ R'E-y=ic,iWEif-iFii-roFo3Y------..ii-iNifER'iTANC'E--iilif-STiifEMENi-ijF-ilifcoiJiff--ii..--------------- - - - --- ESTATE OF HALLETT RUTH M FILE NO.21 02-0393 ACN 101 DATE 03-17-2003 THIS STATEHENT IS PROVIOED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-03-2003 PRINCIPAL TAX DUE:... 4,814.89 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-18-2002 CDOO1306 236.84 4,500.00 12-16-2002 CDOO1960 .00 89.89 03-03-2003 REFUND .00 11.84- TOTAL TAX CREDIT 4,814.89 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 . SIDE FDR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO' PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I \. /"/-67-/-';/ BUREAU OF INOIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRIS8URG~ PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NDTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MARK E HALBRUNER ESQ GATES ETAL 1013 MUMMA RD STE 100 LEMOYNE PA 17043-4802' DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-10-2003 HALLEn 03-18-2002 21 02-0393 CUMBERLAND 101 '* IEY~1541 EX AFP ell-05> RUTH M Amount R...itted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ 'REV':iS4-j-iif-AFi'--fiIFo3Y-NOi'"ici--oF-i:NHi'R-iTAi"-CE-TAX-XpjiRXisiiiENT~--AL:rOWANCE-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HALLEn RUTH M FILE NO. 21 02-0393 ACN 101 DATE 02-10-2003 TAX RETURN WAS: (X I ACCEPTED AS FILED I CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule AJ 2. Stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule fJ 7. Transfers (Schedule G) 8. Total Assets III 121 (31 (41 (51 (61 171 .00 957.96 .00 .00 126.714.12 4.541.36 .00 (BI APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad... Costs/Misc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule Il 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 191 1101 17,533.81 7.682.03 1111 1121 [131 1141 NOTE: If an assessment was issued previously, lines reflect figures that include the total of ~ ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class Brat. (18) 19. Principal Tax Due T R IT: NOTE: To insure proper credit to your account 1 submit tha upper portion of this form with your tax payatent. 132,213.44 21;.211; 84 106,997.60 .00 106,997.60 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = 106,997.60 X 045= .00 X 12 = .00X15= 1191= . INTEREST/PEN PAID (-I 236.84 .00 AMOUNT PAID 4,500.00 89.89 DATE 06-18-2002 12-16-2002 NUMBER CD001306 CD001960 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 4,814.89 .00 .00 4,814.89 4,826.73 11 .84CR .00 11 .84CR IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)1 YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.I /?-~~7-/.y BUREAU Of INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REY.16D7EX.FP<Ol_05l MARK E HAL BRUNER ESQ GATES ETAL 1013 MUMMA RD STE 100 LEMOYNE PA 17043 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-17-2003 HALLETT 03-18-2002 21 02-0393 CUMBERLAND 101 RUTH M A.lloun't R_ii:i.ed MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this for.. with your tax pay..nt. CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ___ REV=i6iWE"x-AFP--fiiFo3y------ii..-iNifERITANC'E-iA'if-sTAfEHENi-OF-ACfcouiff--iEifii--------------- - - - --- ESTATE OF HALLETT RUTH M FILE NO. 21 02-0393 ACN 101 DATE 03-17-2003 THIS STATEMENT IS PRDVIDED TO ADVISE Of THE CURRENT STATUS Of THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY Of THE PRINCIPAL TAX DUE, APPLICATION Of ALL PAYMENTS, THE CURRENT BALANCE, AND, If APPLICABLE, A PROJECTED INTEREST fIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-03-2003 PRINCIPAL TAX DUE:... 4,814.89 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-18-2002 CDOO1306 236.84 4,500.00 12-16-2002 CDOO1960 .00 89.89 03-03-2003 REFUND .00 11 .84- TOTAL TAX CREDIT 4,814.89 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 If PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 . SIDE fOR CALCULATION Of ADDITIONAL INTEREST. ( If TOTAL DUE IS LESS THAN $1, NO'PAYMENT IS REQUIRED. If TOTAL DUE IS REflECTED AS A "CREDIT" (CRI, YOU MAY BE DUE A REfUND. SEE REVERSE SIDE Of THIS fORM fOR INSTRUCTIONS. I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1712.8-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT HALBRUNER MARK E ESQUIRE 1013 MUMMA ROAD LEMOYNE, PA 17043 n_n_U fOld ESTATE INFORMATION: SSN: 159-24-7524 FILE NUMBER: 2102-0393 DECEDENT NAME: HALLETT RUTH MARIE DATE OF PAYMENT: 10/10/2003 POSTMARK DATE: 1010912003 COUNTY: CUMBERLAND DATE OF DEATH: 03/18/2002 NO. CD 003105 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,971.96 I I I I I I I I TOTAL AMOUNT PAID: $1,971.96 REMARKS: DEBORAH A STERLING CIO MARK E HALBRUNER ESQUIRE CHECK# 132 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS DONNA M. OTTO DEPUTY REGISTER OF WILLS , . .' COMMONWEALTH OF '.' PENNSYLVANIA . ilIii.. . DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0001 REV. j~,oo EX ~ll-OOI ~ :.:;:$(1) ,,0:'" w~g %0:-' "..., ~ , L.~ /7 .<./ -c:> / - / / " . v REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 02 0393 COUNTY COOf: YEAR ----- NUMaER t- Z W o W (,J W o DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) Hallett, Ruth M. SOCIAL SECURITY NUMBER 159-24-7572 DATE OF BIRTH (MM.OD. YEAR) 09/09/28 DATE OF DEATH IMM.DD.YEARI 03/18/02 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME !LAST. FIRST, AND MIDDLE INITIAL) o 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (Attach cop~ 01 Will) o 9. Uligation Proceeds Received o 3. Remainder Return (daleoftieatl1 priOr!o 12-13-B2) D 5. Federal Estate Tax Return Required a. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (AttacnScnOJ [!] 2. Supplemental Return o 4a. Future Interest Compromise !date 01 death afler 12.12-82, D 7. Decedent Maintained a livjng Trust (Attach CIlpyolTl'ttsl) o 1 D. Spousal Poverty Credit (dale ()\ Math between t2-31-!,lland '.1-95) ... Z :g Z l( Ul il1 0: o " NAME Mark E. Halbruner, Esquire FIRM NAME (lIAppllcable\ Gates, Halbruner & Hatch, P.C. TELEPHONE NUMBER (717) 731-9600 COMPLETE MAILING ADDRESS 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 (1) (2) (3) (4) 15) 0.00 0.00 0.00 0.00 43,368.28 z o ~ ::l l- ii: <( (,J W ~ 1. Real Estate (ScheduteA) 2. StQCks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4_ Mortgages & Notes Receivable (Schedule OJ 5. Cash, Bank Deposits & Miscellaneous Persaoa! Property (SchOO"I. E) 6. Jointly Owned Property {Schedule F} o Separate Billing Requested 7. lnler-Vivos Transfers & Miscellaneous Non.Probate Property (Schedule G or l) 8. Total Gross A$sets (tolal Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debls of Decedent, Mortgage Liabilities, & Liens (Schedule J) 11. Total Deductions (total Lines 9 & 10) 12. Net Valu& of Estate (Line 8 minus Line 11) 13. Charitable and GovemmentalBequestsfSec 9113 Trusts for which an election to tax has not been made (Schedule J) (11) (12) (13) 1,015.00 42,353.28 0.00 (6) 0.00 (7) 0.00 19) 181 1,015.00 0.00 43,368.28 110) 14. Net Value Subject to Tax (line 12 minus Line 13) (14) 42,353.28 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !;( ... ::l a. :E o (,J ~ 15. Amount of line 14 taxable at the spousal lax rate, or transfers under Sec. 9116 (a}(1.2) .~~____ _~._w~__~___J2,()JL x .0 ()_ (15) 42.3~,;!l.i x ,0 45 (16) _'~M__~_M__________o.Q~ x .12 (17) 0.00 1,905.90 0.00 0.00 1 ,905.90 16. Amount of Line 14 taxable at lineal rate 17. Amount of line 14 taxable at sibling rate 0,00 x .15 (18) (19) 18, Amount of Line 14 taxable at collateral rate 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Dec&dept's Complete Address: S"REET ADDRESS . 417 Mountain View Road Cumberland Coun CITYM h . b ec amcs urg STATEpA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditS/Payments A. Spousal Poverty Credil B. Plior Payments C. Discount (1) 1,905.90 0.00 0.00 0.00 3. InteresUPenally if applicable D. Interest E. Penally Tolal Credits ( A + B + C ) (2) 0.00 4. TotallnleresUPenally ( D + E ) If Une 2 is greater than Line 1 + Line 3. enter the difference. This is Ihe OVERPAYMENT. Check box on Page 1 line 20 to request a refund 66.06 0.00 -~~-~-~- 5. If Line t + Line 3 is grealer than Une 2. enter the difference. This is Ihe TAX DUE. (3) (4) (5) (SA) (5B) 66.06 0.00 1,971.96 A Enler Ihe interest on the tax dUe. B. Enter the Iotal of Line 5 + SA. This is Ihe BALANCE DUE. 1,971.96 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedant maka a transfer and: Yas No a. retain Ihe use or income of the property Iransferred;...... ............... 0 [iJ b. retain the righl 10 designate who shail use Ihe property lransferred or ils income;. .................. 0 [iJ c. retain a reversionary interest; or. hh'...."..,.... ",." . ......."......................................... ....,.. .."......... 0 [i] d. receive Ihe promise for life oteilher payments. benefits or care? .................. ...................... . . 0 [iJ 2. If death occurred after December 12. 1982. did decedent transfer property within one year ofdealh without receiving adequate consideration? ................... .................... ....... ..................................... ... 0 [iJ 3. Did decedent own an "in trust for" or payable upon death bank aceounl or security at his or har daath?.... ..... .. 0 [iJ 4. Did decedent own an Individual Retiremenl Accounl, annuily, or other non-probata proparty which conlains a baneficiary designation? ............... .......................... .......................... ... ........... 0 [iJ 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 pefjul)', I declare that i have exammoo this return, including accompanying SChedules and statements, ami m the best of my knowledga and belief, ills bue, correct and complete. DeclafllOOn of preparer ether lhan the personal representative is based on aU mformaliOll of which preparer has any knowledge. SI ATURE P SO SPONSIBLE FOR FIL.:G RETUR~_~___~~.A _t_~q,za~__~~~~_..___~_~___ Deborah A. Sterling, 253 Ridg Rd.. Mechat1icsCbllffi.~Z;5~....J.aY M. Hallett, 41~ Limestone Rd.,_Carlisle, P~.1.7013_~_ S~~,ER~~ESENTATIVE DAT~ ~"\~2,_ ADDRESS GatEl~' Halbruner & Hatch, P.C., 1013 Mllmma R<1:,SuitEl-"Q()'-L,e'!'.o}'fl.ElcI"!\_1'704:3.._~______~____~_____~_____ For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. S9116 (a) (1.1) (i}J. For dales at daath on or after January 1. 1995. tha lax rata imposed on the nel value of transfers 10 or for Iha use at the surviving spouse is 0% [72 P.S. !l9116 (a) (1.1) (ii)). The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements fur disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of daath 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 parenJ or a slepparenlof Ihe chikJ is 0% [72 P.S. ~9116(a)(1.2)1. The lax rale imposed on the net valua of ~an.fars 10 or for the use of!ha decedent's lineal baneficiarias i. 4.5%, except as noled in 72 P.S. S9116(1.2) [72 P.S. ~9116(a)(I)J. The tax rate Imposed on tha nel valua of transters to or for Ihe use of Iha decedant'. siblings is 12% [72 P.S. 99116(a)(1.3)]. A sjbling is dafined, under Seclion 9102. as : individual who has at least one parent in common with the decedent, whether by blood or adoption. REV.1508 E".... (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN AESJDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Ruth M. Hallett FILE NUMBER 21-02-0393 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned _ right 0' survlllOlshlp must be disclosed on Schedule F. 2 Distribution from Zelda A. Bland Trust VALUE AT DATE OF DEATH $33,450.43 9,917.85 ITEM NUMBER DESCRIPTION Distribution from Bland Irrevocable Trust Agreement TOTAL (Also enler on line 5, Recapitulalion) $ (If more space is needed, insert additional sheets of the same size) 43,368.28 . _ REV.''''' EX' 1'2'99. COMMONWEALTH Of PENNSYLVANJA JNHERtTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Rutl1 M, HaHett FILE NUMBER 21-02-0393 Debl$ of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1, Personal Representative's Commissions Name of Personal Representative(s) Social Security Number{s)JEIN Number of Personal Representative{s) Street Address City State_Zip Year(s) Commission Paid: 2. Attorney Fees 1,000,00 3, Family Exemption: (If decedent's address is nof the same as claimant's, attach explanation) Claimant Street Address City State~Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Register of Wills. filing fee 15,00 TOTAL (Also enler on line 9, Recapitulation) $ 1,015,00 (If more space is needed, insert additional sheets of the same size) REV-15f3.t9<+(!j-OO) '* SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruth M. Hallett FILE NUMBER 21-02-0393 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s} Of ESTATE I TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under Sec. 9116 (a) (1.211 1 Deborah A. Sterling Daughter 21,176.64 253 Ridge Hill Road Mechanicsburg, PA 17055 2 Jay M. Hallett Son 21,176.64 416 Limestone Road Carlisle, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV.1500 COVER SHEET II 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 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 42,353.28 (If more space is needed, insert additional sheets of the same size) _._,-1' BLAND IRREVOCABLE TRUST AGREEMENT 3 4 6 2401 MCCLINTOCK AD. . A WHITE OAK, PA 15131 ~(nU.SI If) '*"'~~ 8-12/430 bARY6,3~'1oE 8rto-7l! Or PUT7I (fJto-i2.lI: HML~f-1 $ 33,'f1;;0.'i3: . . -" ..,.- '-/31 TfliR-7y 7]J12L"l.~ 7HoU$.&ND 1o~R- HV'-'lJiLt'-7J ri Fly 'I )Icb DOL L A R 5 InlellroBllnk ~~ 'i1"NllCRA B4NIC/PITT5BURCH CHOICE M'MO o~Y%'-7;;;:;1S132 . v?~ I:OI,::lDOO~221: O:l:lbOOSI,B?IIB O:ll,b,.'ii,' i " Y'k;,~.~@'L j~:~r:4~1;,1('j2.( , ;'~>i/,~,;:;;:~~~\:,.;, :); , ZELDA A. BLAND TRUST ANN E. KEMP 11102 2401 MCCLINTOCK AD MCKEESPORT, PA 15131 114 A .121430 033 1<H!.6t/lsT/J;,:Z",,3 DATE I ;~\HE~ t!Jp 'K:.--m ,41;Ul.ttr ;!P-titPT"' I $ '1917.36 ORDER. eS: I WINe- ""}7J."uSiWD ,J<I/-"c' diJlJlZ6-"1> 'E;J;~ , ~to DOLLAR' {[j mie,~~ p. "\xlalCIlx / _..I Clty_ol P....,..,.,III a P...bUJglI, _yIvonIo FOR 80% Ots175 ~c:~ .. I:OI,:I000U21: B?2BO:lI,BI,IIB OUI, ? .. 00 O~>>I~ 'e.t'l';'!.~ 00Q~ ..... 0'" ~~~ . t:!l,., .,;~~g ll>", ~ '-~m~ -;3..g~(') ~'etf)o '""t<l~~ :>',., 0\5 >>Ic; ~'A ';:\ t-' '" ~ i\ ~s $~ Q~ ~ <" fu~ ';ll ~ -.,,~ ~ ~ ~ -- z~ ~ ~ ~; 0 ~-(J) ~\'Tl ~~ % ;~ ~~ %8 ~ l'\l b . / .. ! I -:~ , - : T) \ '",- /"2-6'7- / Y \, 1\JREAU OF INDIVIDUAL TAXES ~~\:r~A"CE TAX DIVISION ~ J1EPT. -"80601 . MARRtv~JRGI PA 11128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MARK E HAL BRUNER ESQ GATES ETAL 1013 MUMMA RD STE 100 LEMOYNE PA 17043 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-17-2003 HALLETT 03-18-2002 21 02-0393 CUMBERLAND 501 Allaunt R...ittad '* IEV~1'50 EX AFP (91-0) RUTH M MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RW=iSW-Eif-AFii-coFciiY-Nii'ficnirlNHERifANcrT"AYiiPPRiiisEMENT~--AL'i.-OWANCE-oii----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RUTH M FILE NO. 21 02-0393 ACN 501 ESTATE OF HALLETT TAX RETURN WAS: I ( XI CHANGED SEE DATE 11-17-2003 ATTACHED NOTICE I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ 6bb returns assessed to date. ASSESSMENT OF TAX: 15. Aaount of Line 14 at Spousal rate (IS) 16. Anount of line 14 taxable at Lin..l/Class A rate (16J 17. A.aunt of Line 14 .t Sibling rate (17) 18. ~ount of Line 14 taxable at Collateral/Class Brat. (18) 19. Principel Tax Due ) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN 1. R..I Estate (Schedule A) (1) 2. stocks end Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Hortgages/Notes Receivable (Schedule DJ (4J S. Cash/Bank Deposits/Misc. Personal Property (Schedule E> (S) 6. ~ointly Owned Property (Schedule f) (6) 7. Transfers (Schedule G) (7J 8. Total Assets .00 .00 .00 .00 43.368.28 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H> 10. Debts/Mortgage Liabilities/Liens (Schedule IJ 11. Total Deductions 12. Net Value of TaK Return 13. Charitable/Govern.ental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Ve1uB of Estate Subject to Tax (9) (10) 1,015.00 .00 Ill) 112J 1131 (14) NOTE: .00 42,353.28 .00 .00 X 00 = X 045 = X 12 = X 15 = : INTEREST/PEN PAID (-) 14.36- AHOUNT PAID 1,971.96 DATE 10-09-2003 NUMBER CD003105 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. NOTE: To insure proper credit to your eccount~ sub.it the upper portion of this fo", loll th your tax pay..nt. 43,368.28 1.011; 00 42,353.28 .00 42,353.28 (19)= .00 1,905.90 .00 .00 1,905.90 1,957.60 51.70CR .00 51. 70CR IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE I A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.: RESERVATION: Estates of decedents dying on or befOre o.G~er lZ~ 1982 -- if an~ future interest in the estate is transferred in possession or enjoyment to Class B (co11eteral) bena~ici8ries of the decedent after the 8~piration of any estate for life or for Y8ars~ the Ca-.onwealth hereby e~pressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate an any such future interest. PURPOSE OF HOll CE: To fulfill the require.ents of Section 2148 of the Inheritance and Estate Tax Act~ Act 23 of 200n. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and subwit with your paywent to the Register of Wills printed on the reverse side. --Make check or IlDOey order payable to: REGISTER OF MILLS, AGENT REfUND (CR): A refund of a tax credit? which was not requested on the Ta~ Return. aay be requested by COMpleting an ~Application for Refund of Penns~lvania Inheritance and Estate Taxft (REV-1313). Applications are available at the Office of the Register of WillS, any of the Z3 Revenue District Dffices? or by ceIling the special 24-hour answering service for forMS ordering: 1-8DD-36Z-ZG50} services for taxpayers with special hearing and I or speaking needs: l-BOO-447-302D (TT only). OBJECTIONS: An~ 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 Hotice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Departllent of Revenue, 80ard of Appeals. Dept. 261021. Harrisburg, PA 1712&-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Drphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue. Bureau of Individual Taxes, AlTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (117) 787-6505. See page 5 of the booklet "Instr-uctitms for Inheritance Tax Return for a Resident Decedent" (REV-150l) for an explanation of adllinistratively c:orr-ectable IIIrror-s. DISCOUNT: If any tax dulil is paid within three (3) calendar lIonths after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15~ tax ennesty non-participation penalty is computed on the total of the tax and interest assessed. and not paid before January 18. 1996, the first day after the end of the tax allnesty period. This non-participation penalty is appealable in the ~ manner and in the the same t1.e period as you would appeal the tax and in~rest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency. or nine (9) ~nths and one (1) day frOM the dat. of death. to the date of paYlleot. Taxes which bec~e delinquent before January I, 1962 bear interest at the rate of six (6iO percent per annua calGu1ated at a dally rate of .000164. All taxlils which became delinquent on and after January 1. 1982 will bear interlilst at a rate which will vary fro. calendar year to calendar year with that rate Bnnounced by the PA Depart.ent of Revenue. The applicable intlilrest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest ~~ ~ ~~ Vear~ Year Daily ~ 1982 204 .000548 1987 '" .000247 1999 7. .OOlJ192 1983 164 .000438 1988.1991 117- .000301 2000 ". .000219 1984 117. .000301 1992 .. .000247 ZOO1 .. .044247 1985 13X .000356 1993-1994 7% .000192 2002 6. .001ll64 19&6 lOX ,000274- 1995-1998 ,. .OOOZ47 2OD3 5X .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR .-Any Notice issued after the tax b~es delinquent will reflect 8n interest calculation to ~ift88n (15) days beyond the date of the assessment. If pa~ent is .ade after the interest co.potation date shown on the NoticB, additional interest dUst be calculated. . INHERITANCE TAX EXPLANATION JNWEAL TH OF PENNSYLVANIA ,PARTMENT OF REVENUE OF CHANGES IEAU OF INDIVIDUAL TAXES DEPT. 280601 .RRISBURG PA 17128.0601 NAME FILE NUMBER Ruth M Hallett 2102-0393 ( ACN Sandra J Eslinger 501 ITEM EXPLANATION OF CHANGES NO. 1 In terest is effective 08-16-2003. \ ROW Page 1 LAW OFFICES OF GATES, HALBRVNER &-HATCH, P.C. 1013 MUMMA ROAD. SUITE 100. LEMOYNE, PENNSYLVANIA 17043 (717) 731-9600. FAX: (717) 731-9627 BRANCH OFFICES: 3 WEST MONUMENT SQUARE, SUITE 304 lEWISTOWN, PA 17044 (717)248-6909 2917 NORTH FRONT STREET, SUITE 302 HARRISBURG, PA 17110 (717)731-9600 LOWELL R. GATEOS Also Admitted to Massachusetts Bar MARK E. HALBRUNER Also Admitted to New Jersey BOll CRAIG A. HATCH CORY J. SNOOK ALBERT N. PETERUN Also Admitted 10 Maryland Bar STACEY L. NACE Paralega.I/Ol1iceManager TRACI L SEPKOVIC Pala1ega\ VALERIE lONG Paralegal WEB SITE' www.GaleslawFirm.com April 14, 2004 CORRESPONDENCE ADDRESS' Lemoyne Office Cumberland County Courthouse Office of the Register ofWiJls One Courthouse Square Carlisle, P A 17013 ~,...... :-.J'. . ;;;;; (," .:~; g .1.1 ~ --0 ;:::r ~ Lfl RE: Estate of Ruth M. Hallett Estate No. 21-02-0393 Cri ~~, Dear Sir or Madam: Enclosed for filing, in duplicate, is the second supplemental Pennsylvania inheritance tax return for the Estate of Ruth M. Hallett. A check in the amount of$15.00 as the filing fee is enclosed. A second check in the amount of$507.97 is enclosed as payment ofthe inheritance tax. Please time-stamp the additional photocopy of the inheritance tax return and return it to our office in the enclosed envelope. Thank you for your assistance in this matter. Sincerely, tlr-@;{hl4uIC Traci L. Sepkovic Paralegal Enclosures cc: Deborah A. Sterling, Co-Executor Jay M. Hallett, Co-Executor >- REV.1';'1OE~(IHlOI REV-1500 *' COMMONWEALTH OF . PENNSYLVANIA . .... DEPARTMENT OF REVENUE OEPl 280601 HARRISBURG, PA 17128-0601 w .. ::t'~U) "II:'" w"" :too "II:'" .... .. " INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 02 0393 - mER- - - COUNTY CODE YEAR I- Z W o W o W o DECEDENTS NAME (LAST. FIRST. AND MIDDLE INITIAL) Hallett, Ruth M. SOCIAL SECURITY NUMBER 159-24-7572 DATE OF DEATH (MM-DD-YEAR) 03/18/2002 DATE OF BIRTH (MM-DD-YEAR) 09/09/1928 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WillS SOCIAL SECURITY NUMBER IIF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) o 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (Milch copy of W~I) o 9. Litigation Proceeds Received ~ 2. Supplemental Return o 4a. Future Interest Compromise (date of dealt1 alter 12.1H12j o 7. Decedent Maintained a living Trust {Anach copy of T1\I51) o 10. Spousal Poverty Credit (date of death between 12.31-91 and 1+95) o 3. Remainder Retum (dale of death prior to 12-1-3-8.2) o 5. Federal Estate Ta)( Return Required 8. Tol8l Number of Safe Deposit Boxes o 11. Electkm to tax under Sec. 9113(A) (AttachSch 0) .. z w Q Z o .. III W II: '" o " COMPLETE MAILING ADDRESS 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 NAME Mark E. Halbruner, Esquire FIRM NAME (I/Applicable) Gates, Halbruner & Hatch, P.C. TELEPHONE NUMBER (717) 731-9600 1. Real Estate (Schedule A) 2. Stock.s and Bonds (Schedule B) (1) (2) 13) (4) (5) 0.00 . 0.00 0.00 0.00 10,842.08 ~ I"J) d .b ~ ...".' z o ~ :::l I- Q: <( o W 0:: 3. Closely Held Corporation, Partnership or Sole-PropMtorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Scheduie 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) 1t Total Deductions {total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Une 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (11) (12) (13) 265.00 10,577.08 0.00 (6) 0.00 j",. (7) 0.00 (9) (8) 265.00 000 10,842.08 (10) 14. Net Value Subject to Tax (line 12 minus line 13) (14) 10,577.08 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !;( I-' :::l l1. :2 o o ~ 15. Amount of Line 14 taxable at the spousal ta)l. rate, or transfers under Sec. 9116 (a}(1.21 0.00 x.O 0 (15) 10,577.08 xO ~ (16) 0.00 475.97 0.00 0.00 475.97 16. Amount of Line 14 taxable at lineal rate 17. Amount of Une 14 taxable at sibling rate x .12 (17) 18. Amount of Une 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT '^ DeC:;edent's Complete Address: STREET ADDRESS 4175 Mountain View Road Cumberland County CITIM h . sb ec amc urg Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. Cred~sJPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty it applicable D. Interesl E. Penaity TolallnteresUPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. IfUne 1 t Line 31s greater than Line 2, enterthe difference. This is the TAX DUE. (5) 32.00 0.00 507.97 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SA) (58) A. Enter the interest on Ihe tax due. 507.97 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"'N THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;..... . 0 ~ b. retain the right to designate who shall use the property ~ansterred or ils income; ..... . 0 ~ c. retain a reversionary interest; or............... ... .... ........... . 0 ~ d. receive the promise for life ot eilher payments, benefits or care? ....... 0 ~ 2. If dealh occurred affer December 12, 1982, did decedent transfer property within one year of death without receivif19 adequate consideration?.. ... ............ . 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her dealh? 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non~probate property which contains a beneficiary designation? ..... . 0 ~ 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 pe~ury, I declare thai I have examined this retllm, Including accompanying scheduJas and statements, and \0 \he best of my knol'lledge and bellef, it is true, correct and complete. De . n of Pfeparer ~ than \he p8lSonal reprosentative is based on all infonnadon of which preparer has any knowledge. IGN URE OF PERSO ESP LE FOR FILING RET~1 __ _' DATE ADDRESS . . -. ~_m~~_ <:?;;"__~_.3/z.3/<;i!"t:___m_ r{ " .> ..--.-.../ //'" [)~boratlJ>.:mSlerlir1\l'--253~ic!flel1i11 Rd,,-M_e~I1~J1iCll~lIr\l,l>J>.1.70?0_ . _~axM. Hallett, 416 J-irne.!lt()n~R(j: ,-C...rl~I~f>AYO 13 SI~<~ER~~PR~:AT1VE __~_______________ '1L~c'l-_______ ADDRESS Gal,*, Halbrllner &Halch'.F'C,.1013 MumrnaRd, Suile100,Lernoyne,PA17043 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)J. For dates of death on Of affer January 1,1995, Ihe tax rale imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)). The statute daes not exemot a transfer to a surviving spouse from tax, and the statutory requirements far disclosure of assets and filing a tax return are still applicable even if the surviving spause is the anly benefICiary. For dates 01 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 Of younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the chad is 0% [72 P.S. ~9116(a)(1.2)]. The tax rale imposed on the nel value of Iransfers to orlor the use of the decedent's lineai beneficiaries is 4.5%, excepl as noted in 72 P.S. ~9116(1.21 [72 P.S. s9116(a)(I)). The tax rate imposed on the net value of transfers to or for Ihe use of the decedent's siblings is 12% [72 P.S. s9116(e}(1.3)]. A sibiing is defined, under Section 9102, as an individual wha has at least one parent \n common with the decedent, whether by blood or adoption. OEV-15oo EX+ 16-98) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Ruth M. Hallett FILE NUMBER 21-02-0393 Include the proceeds of litigation and the date the proceeds were received by the estate. An property Jolntly.owned with right of survivorship must be disclosed on Schedule F. 2 Distribution from Zelda A. Bland Trust VAWE AT DATE OF DEATH 8,362.61 2,479.47 ITEM NUMBER DESCRIPTION Distribution from Bland Irrevocable Trust Agreement TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 10,842.08 W;V.1511 EX+ 112.99). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Ruth M. Hallett FILE NUMBER 21-02-0393 Debts of decedent must be reported on SChedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ,. B. ADMINISTRATIVE COSTS: ,. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Represenlallve(s) Street Address City Slale_Zip Year(s) Commission Paid: 2. Attorney Fees 250.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Slreel Address City Slate _Zip Relationship of Claimant 10 Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Register of Wills - filing fee 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 265.00 (If more space is needed, insert addltionalshe€lts of the same size) Il,EV.1513 EX. 19.00) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RE5\DEN1 DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Ruth M. Hallett FILE NUMBER 21-02-0393 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trustee{s) OF ESTATE I TAXABLE DISTRIBUTIONS linclude outright spousal distributions, and transfers under Sec. 9116 ta) (1.2)) 1 Deborah A Sterling Daughter 5,288.54 253 Ridge Hill Road Mechanicsburg, PA 17050 2 Jay M. Hallett Son 5,288.54 416 Limestone Road Carlisle, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II 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 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space (s neeOOd. insert additional sheets of the same size) ANN E. KEMP 2401 McClintock Road White Oak, PA 15131 412-678-5326 ' November 5, 2003 Re: Zelda A. Bland Irrevocable Trust .-"'" .~ Dear t;;;7c,/U: ;- We're closing in on the end. We hope to have all estate accounts closed before the end of the year. By now you should have received from Attorney Jones any information or explanations which you may have requested. I hope you now understand from Mr Jones' letter of October 8, which I had asked him to prepare, the complexity of the esiate and best of all the resulting benefits. I had asked him to keep it simple and'in laymen's language. We did not receive any follow-up inquiries or comments as a result of the letter.. Therefore, enclosed is a check for the remaining 20% of your principal share which you can invest or put to good use. As the end of-the year approaches, we will be preparing the final consolidated accounting which may reflect _some additional, but small, interest earnings from the trust which I will eventually pass on to you. Some of these accrued earnings may have to be used to satisfY any last minute expenses and legal fees. For the most part, this 100% distribution constitutes the bulk of your inheritance. As stated in previous correspondence, be prepared to receive K -1 income tax reporting for the earnings on the trust and limited partnership. No taxes to be paid on the principal. If questions, as always to not hesitate to contact me. Love to all, ,.-..-) / / l 1'77 r& ," / C' 4/HY~ , BLAND IRREVOCABLE TRUST AGREEMENT 2401 MCCLINTOCK RD, WHITE .oAK, PA 15131 362 ~IL3 ..-+_~Q'3 8-121430 ,'/ 2 ~ ' ,.l:u77l..."!.'I':,J2/.'!:.L~'::L::{,!)T~=-=.=:---'-- ':$[//~~,2. (,1 9.G JJT T!iptJ.,S:':,~pl/lI!",7? ;/o'!..()_.e~_.20T'i.!..u:'[)f- ,6.'!){!!t'.r)(, ! !H,' Inle roBtlnk "?~ 'INTK.RA BANK/PITTSBUR(>H , ..::':/: OlympIa - McKeesport, PA 15132 __--~") .e ~ :2t If ''/ / / f y:';1 ",'/t.. J::C~./f].IJIIVLJq_. L,.L.:;:!~0 ~,.fZ?~ ~O~~ODO~22~ O~~&005~87. O~~2 . " ANN E. KEMP 2401 McClintock Road White Oak, PA 15131 412-678-5326 ' November 5, 2003 Re: Zelda A. Bland Trust [Revocable Living] Dear C'~~-'--I We're closing in on the end. We hope to have all estate accounts closed before the end of the year. By now you should have received from Attorney Jones any information or explanations which you may have requested. I hope you now understahd from Mr lones' letter of October 8, which I had asked him to prepare, the complexity' of the estate and best of all the resulting benefits. I had asked him to keep it simple and in laymen's language. We did not receive any follow-up inquiries or comments as a result of the letter.. Therefore, enclosed is a check for the remaining 20% of your principal share which you can invest or put to good use. As the end oftht; year approaches, we will be preparing the final consolidated accounting which may reflect some additional, but small, interest earnings from the trust which I will eventually pass on to you. Some of these accrued earnings may have to be used to satisfy any last minute expenses and legal fees. For the most part, this 100% distribution constitutes the bulk of your inheritance. As stated in previous correspondence, be prepared to receive K-I income tax reporting for the earnings on the trust and limited partnership. No taxes to be paid on the principal. If questions, as always to not hesitate to contact me. Love to all%!"} ," C' 'I ~~0J'j/?./ C. /~r./ ZELDA A. BLAND TRUST ANN E. KEMP 11/02 24()1 MCCUNTOCK RD MCKEESPORT, PI. 15131 No 1H2J430033 iJ ~ ZtlLo3 DATE ~~\HEET7! nD./2I/J ;.),uL/;' IT L~,crt'G I $ '7 '-'79 '"'7 ORDER , ^II ,I 01'--- '-;7i .- II ~. , ) 'f7:a I i).5() If"OdS:,,y /)70,1/2... HlJJJIJu'q) Jcv~<.f7y N/tJD 1 DDLlA.S fIJ ~li;,~:. ,. ~Ioi -II~ ;' _ICIly_of~ Pltlllburgh. PwmIprama fl CJ-I '--;:7 fOR ;</)/;, !-L>,l1p/I.)Dt:f!- 126 /) fJ d: ~~c:' ~~.~ ~ "Ir'.."~' ".. .1 r COM,..'v10NWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU Of INDIVIDUAL TAXES DEp"T. 280601 HARRISBURG, PA 17128.0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT GATES LOWELL R ESQ 1013 MUMMA RD SUITE 100 LEMOYNE, PA 17043-1144 ---~---- lold -~ ,. . . , ESTATE INFORMATION: SSN: 159-24-7524 FILE NUMBER: 2102-0393 DECEDENT NAME: HALLETT RUTH MARIE DATE OF PAYMENT: 04/15/2004 POSTMARK DATE: 04/15/2004 COUNTY: CUMBERLAND DATE OF DEATH: 03/18/2002 NO. CD 003825 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $507.97 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 139 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WillS v-r- $507.97 GLENDA FARNER STRASBAUGH REGISTER OF WILLS , """"II ~ c;') .. noon ~ f;;;',i~~ f.!;l t"' H r HC1('1t%j m- =: <n0t"l1S ;::':1 t"'c 0'" ~ "':<'o~ -<;:: . >-'l "'l Zc r 0:: !'1;:: ""OM ~ ~ il>cp::n ""0;:: m;,. <nt"l0 Z:n Z 0 '" c :;j H :<'~ Zo l'l '"'<nt"l ~;,. \>:l (i 0.0 '" ~p '" HCH ~ '" VJ~Cl:ln ,><" 0 HO zc ." ~HJ };=i =: ~m >-'l ,,~ ~ 00:: 00 >,j0 tio n c ,,"<n i-::t H'" t"' :-0 t"' <n r ... ...,j / (: ,"--_........~ , , , , "", \,0. \ " " .;)' '~/ '" C) --> c.:l 0) c, 0' J;: c> ,,'. ,Of, :"J " w ~~_':!:.--1:..!....'*.J': ./ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEKENT, ALLOWANCE OR DISALLOWANCE DF DEDUCTIONS AND ASSESSKENT OF TAX ~-J DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-08-2004 HALLETT 03-18-2002 21 02-0393 CUMBERLAND 502 AlROUnt R...itt.d MARK E HAL BRUNER ESQ GATES ETAL 1013 MUMMA RD STE 100 LEMOYNE PA 11043 *' REV-l!i47EXAFP{0l_D31 RUTH M MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=is4j-Eif-"Fiq.iiFii3Y-NiirYci--oF-i:-NiiiififANCE-YAX-XPPRAYsiiifNT:--"i:roWAN-CE-cfri----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RUTH M FILE NO. 21 02-0393 ACN 502 ESTATE OF HALLETT TAX RETURN WAS: I I XI CHANGED SEE DATE 06-08-2004 ATTACHED NOTICE I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN 1. Real Estate (Schedule AJ (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held stock/Partnership Interest (Schedule CJ (3) 4. Mortgages/Notes Receivable (Schedule DJ (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets .00 .00 .00 .00 10.842.08 .00 .00 181 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Hort~age Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax R.turn 13. Charitable/Govern..ntal Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 191 1101 265.00 .00 1111 1121 1131 1141 NOTE: I~ an assessment was issued previously, lines re~lect figures that include the total o~ ALL ASSESSKENT OF TAX: IS. A.aunt of Line 14 at Spousal rate (IS) 16. Amount of Line 14 taxable at lineal/Class A rat. (16) 17. Amount of Line 1~ at Siblin~ rat. (17) 18. Amount of Line 14 taxable at Collateral/Class Brat. (18) 19. Principal Tax Due T CDS: NOTE: To insure proper credit to your account 1 submit the upper portion of this form with your tax payment. 10,842.08 ?61i on 10,577.08 .00 10,577.08 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00Xoo= 10,577 .08 X 045 = .00 X 12 = .00 X 15 = 1191= AKOUNT PAID 507.97 DATE 04-15-2004 INTEREST/PEN PAID I-I 9.33- NUKBER CD003825 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 475.97 .00 .00 475.97 498.64 22.67CR .00 Z2.67CR 6~ I IF TOTAL DUE IS LESS THAN $1, NO PAYKENT IS REQUIRED. IF TDTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU KAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS. I PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE ISNOT COMPLETED, FILE FORM 6.12 YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Rutb M. Hallett alkla Rutb Marie Hallett Marcb 18,2002 21-02-0393 Will 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: I. State whether administration of the estate is complete: Yes 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. I is yes, state the following: A. Did the personal representative file a final account with the court? No 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 D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Ie t Tn I.ft .nz. /"~. , --c::> I c' ~-L.t:c ",:. C~- Mark E. Halbruner, Esquire PA!.D. # 66737 GATES, HALBRlJNER & HATCH, P.c. 1013 Mumma Road, Suite 100 Lemoyne, P A 17043 (717) 731-9600 Capacity: Counsel for Personal Representative Date: June 14,2004 /'7-6'7- / Y ~ BUREAU OF INDIVIDUAL TAXES ~_~NHE~}~ANCE T~X DIVISION IlEPT. LlJ0601 HARRr~BURG~ PA 17128~0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MARK E HAL BRUNER ESQ GATES ETAL 1013 MUMMA RD STE 100 LEMOVNE PA 17043 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-17-2003 HAllETT 03-18-2002 21 02-0393 CUMBERLAND 501 *' RfY~1S47 Ell' AFP IDI-OJ) RUTH M Allaunt Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLANO CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-Y':is'4-j-iif-AFii-iiiFo3-r-NOT'ici--OF-iiiHiififANCE-TAX-jipiiRAisiHENT~--ALi.-owANCE-(iC--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RUTH M FILE NO. 21 02-0393 ACN 501 ESTATE OF HALLETT TAX RETURN WAS, ( I ACCEPTED AS FILED I XI CHANGED SEE DATE 11-17-2003 ATTACHED NOTICE NOTE: I~ an assessmen~ was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will re~lec~ ~igures ~ha~ include ~he ~o~al o~ ~ re~urns assessed ~o da~e. ASSESSMENT OF TAX: 15. Allaunt of Line 14 at Spousal rate (15) 16. AMOUnt of Line 14 taxable at Lin..l/Class A rat. (16) 17. Allount of Line 14 at Sibling rate (17) 18. A.aunt of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Du. .00 X 00 = .00 42,353.28 X 045 = 1,905.90 .00 X 12 = .00 .00 X 15 = .00 1191= 1,905.90 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Rec.i vable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (6) 6. Jointly Owned Property [S~hedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets .00 .00 .00 .00 43.368.28 .00 .00 IBI APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens [Schedule Il 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Govern.ental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 191 llPI 1,015.00 .00 (111 ll21 ll31 ll41 NOTE: To insure proper credit to your account, sub.it the upper portion of this for. with your tax: pay..ent. 43,368.28 l.nll; 00 42,353.28 .00 42,353.28 TAY "D"nIT": I+J AI10UtlT PAID DATE NUMBER INTEREST/PEN PAID I-I 10-09-2003 CDo03105 14.36- 1,971.96 TOTAL TAX CREDIT 1,957.60 BALANCE OF TAX DUE 51.70CR INTEREST AND PEN. .00 TOTAL DUE 51. 70CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I . INHERITANCE TAX . . EXPLANATION OMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG PA 17128-0601 NTS NAME FILE NUMBER Ruth M Hallett 2102-0393 ED BY ACN Sandra J Eslinger 501 ITEM EXPLANATION OF CHANGES ULE NO. 1 Interest is effective 08-16-2003. ROW Page 1 .. '+ .. - .-~. ~ __ _ _ __ _ ~ Register of Wills Cumberland County, Pennsylvania INVENTORY Estate of Ruth M. Hallett also known as NO, 21-02-0393 Date of Death March 18, 2002 ,Deceased Social Security No. 159-24-7572 Deborah A. Sterling and JaY M. Hallett,.. Pereonaf Rsprasentativefa) of the above Estate, deceased, verify that the items sppesrinq in the following inventory include ail of the personal assets wherever situate and ell of the reel estate in the Commonwealth of Pennsylvania of ssid Qecedent, that the valuation p{scsd opposite ssch ttem of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania exospt that which appears in a memorandum at the end of this inveMOry. {/we verify that the statements made in this Inventory are true and correct. IlVYe understand that false statements herein are made subjeot to the penalties of 18 Pe. C.S. Section 4904 relating to unsworn faleifioetion to authorities. ereonal Representa~ ve: Name of Attorney: Mark E. Halbruner, Esquire i.D. No.: 66, 737 Address: Gates, Halbruner & Hatch, P.C. D tad .- 1013 Mumma Road, Suite 100, Lemoyne, PA 17043 Telephone: (717} 731-9600 Osacription Edward Jones; Lord Abbett Bond Debenture, Class A Baltimore Life Insurance Policy A0969455 Owner: Ruth M. Hallett; Insured: Elisha N. Hallett Baltimore Life Insurance Policy 01152010776 Owner: Ruth M. Hallett; Insured: Brenda S. Hallett Baltimore Life Insurance Policy 01152002989 Owner: Ruth M. Hallett; Insured: Charles W. Sterling Baltimore Life Insurance Policy A0902794 Owner: Ruth M. Hallett; Insured: Deborah A. Sterling Baltimore Life Insurance Policy A0902792 Owner: Ruth M. Hallett; Insured: Erika L. Sterling Baltimore Life Insurance Policy A0902791 Owner: Ruth M. Hallett; Insured: Jamie M. Sterling (Attach Additional Sheets if necessary! Value $ 957.96 201.64 1,272.88 11,434.73 3,700.41 399.07 367.44 Total: 127, 672.08 NOTE: Ths Nkmorandum of real estate outside the Commonwealth of f'ennsylvanla may, at the election of the personal repnesentetive, include the vahie of each item, twt such fpuros should not be extended into the total of the InvsMOry. Rk-8 _ ._ . ~ - .~.~- •"- Register of Wills, Cumberland County, Pennsylvania INVENTORY (Pass 2) Estate of Ruth M. Hallett, No. 21-02-0393 Deceased Date of Death: March 18, 2002 Social Security No. 159-24-7572 Description Value Baltimore Life Insurance Policy 01152010775 Owner: Ruth M. Hallett; Insured: Jay M. Hallett $ 2,177.27 Baltimore Life Insurance Policy A0902790 Owner: Ruth M. Hallett; Insured: Jay M. Hallett 2,504.75 Baltimore Life Insurance Policy A0957012 Owner: Ruth M. Hallett; Insured: Shane E. Hallett 167.57 Baltimore Life Annuity No. A-468 Annuitant: Ruth M. Hallett; Beneficiary: Estate 102,993.36 American Express Travelers Check No. HA429-474-419 50.00 American Express Travelers Check No. RA290-283-420 100.00 Miscellaneous Personal Property 1,000.00 Internal Revenue Service -refund on 2001 tax return 345.00 ~~_ $1Z7,67a.08 (carried Forward to Page 1) c~ ~r` PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE FORM 6.12 YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Ruth M. Hallett a/k/a Ruth Marie Hallett Date of Death: March 18, 2002 Will No.: 21-02-0393 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: No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Jnne 2003 3. If the answer to No. 1 is yes, state the following: A. Did the personal representative file a final account with the court? N/A 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? N/A D. Copies of receipts, releases, joinders and approvals of formal or informal accounts maybe filed with the Clerk of Orphans' Court and maybe attached to this report. ., .~i~.> Date: December 16, 2002 i~2~~ Mark E. Halbruner, Esquire PA LD. #66737 GATES, HALBRUNER & HATCH, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 (717)731-9600 Capacity: Counsel for Personal Representative G oK PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE FORM 6.12 YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Ruth M. Hallett a/k/a Ruth Marie Hallett Date of Death: Will No.: March 18, 2002 21-02-0393 Pursuant to Rule 6.1 Z 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: No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: August 2003 3. If the answer to No. 1 is yes, state the following: A. B. C. ~• :" Date: April 1, 2Q03 ,~ Did the personal representative file a final account with the court? N/A The separate Orphans' Court No. (if any) for the personal representative's account is: N/A Did the personal representative state an account informally to the parties in interest? N/A Copies of receipts, releases, joinders and approvals of formal or informal mounts maybe filed with the Clerk of Orphans' Court and maybe attached to this report. 7 Mark E. Halbruner, Esquire `~ PA LD. # 66737 GATES, HALBRUNER & HATCH, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA 1'7043 (717)731-9600 Capacity: Counsel for Personal Representative