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HomeMy WebLinkAbout04-0379 PETITION FOR PROBATE and GRANT OF LETTERS Estate of' ~-~ t'D6~ L., f~ (L{~ No. C~ also known as To: Register of glills for the Deceased. County of ([urr~kz~f{CLw c~ in the Social Security No. i (o ~L ~ ~ ~ - ~ ~ q '7 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut tc I C E $ ~ed in the last will of the above decedent, dated Jg01]~]~l~ / , 19 and codicil(s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in (qA.L~ ~O~f [0~ ~ d Ca. unty, Pennsylvania, with h ~ f last f~mily or principa~residence at (list street, number and muncipality) . ~O Decendent. th~ ~. ye~s,ofag%~died ~Qt~ ~ ~ ,~ O~ , at Ch&Q~ ~m~ , ~rttSl~, ~,~ .... bornor ado te~ Except as }~llows, deC%ent did not marry, was not divorced and did not nave a cnild P after executio~ of the~ offered for probate; was not the victim of a killing and was never adjudicated incompetent~ I ~ ~ ' .. Decendent a~eath owned property with estimated values as follows: (If domicite~n Pa.) All personal property $ ~/ (If not dom~ed in PaO Personal property in Pennsylvania $ (ILnot dom~ed in Pa3 Personal property in County V~u~ of re.state i~ ~nnsylvaoia _ ,, / s~tuated, as follows:~g ~ ( ; I t/i '~ I00 ~ 000 ~ WHEREFORE, petitioner(s) respectfully request(s) the prpbate of the last will and codicil(s) presented herewith and the grant of letters (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF (L~c,-,~ (- ~o.~ c~ The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly ad~in~.ster the estate according to law. Sworn to or affirmed and subscribed c ~~~~~~ be~re me this ~QO~ day of J ,~ ~~ v~ ~ -~r ~. ~C ~ Regist~ [ d LJ ~ I05.805 REV 9/86 This is to certify that the information here given is correctly copied from an original certific.ate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. P 10326559 A~R 11 200 , No. ~ Date mos.:~ R~ ~7 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH --2777 ,. Ap:~Z 7, 2004 ,. 85 ~- ~ I: ~4___1919 ,~rlisle,. PA t~ ~ ~ ~rl~d ~. ~rlisle ~ ~.~1 Po~t 0 ~rlisle I.~'-'~"~' [,~. ~te ,,~ ~ker ,~Her ~ ~ ,,. 8 ~,a ~,~s+, ,~i~ ,~ - ~m.s.~~c~.z.~ ~C~.T'S PA ,,.~ ~.~ West Pe~s~ro 1628 N~ille ~d ,~ ,t~rlisle, PA 17013 ~ ,~.~ ~rl~d ~* Line ~ ~a ~. ~olE~ge~ w 2 Eazel~ 9a~h; ~c~[cs~9, ~A 17050 ~ ~ , D[a~. ~12/2004 a[es~nster ~rial Gard~,. hrlisle, P~ 17013 I I,,. /~ u -. I~.q/z/~~/Y/~7 I~. ~ ~'~'~ ~ ~ ~')'~ ~ ~ ~ ..................................................... ~ I*m ....... ~ ................. . ........ .., ....................................... ~ .... ~ t m~ ,.~~ LAST WILL AND TESTAMENT IMA L. MELL b%~ I, ~MA L. MELL, of Carlisle, Cumberland County, Pennsylvania, being of sound' and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking any and all prior Wills and all Codicils made by me at any time heretofore. ITEM I: I direct that the expenses of my last illness and my death, including all costs and expenses of administration of my estate, my funeral, and all other taxes arising by reason of my death be paid from the residue of my estate as soon as practicable after my death. ITEM II: I give and devise my dishes and the furniture in my home to VIRGINIA HOCKENBERRY, of Shippensburg, Pennsylvania, HARRY LINE, of Carlisle, Pennsylvania, MARTINA MILLER, of Enola, Pennsylvania, and BEVERLY J. GEIGER, of Mechanicsburg, Pennsylvania, such personalty to be divided between them in as nearly equal shares as possible and as they shall determine. In the event of any disputes or disagreements, my Executors hereinafter named shall resolve all such disputes, and, if my Executors are incapable of resolving any such dispute, any such individual item of personalty which is the subject of dispute shall be added to my residuary estate and distributed as hereinafter provided. ITEM III: All the rest, residue and remainder of my estate, whether real, personal or mixed, I give, devise and bequeath as follows: (a) Twenty percent (20%) to VIRGINIA HOCKENBERRY, of Shippensburg, Pennsylvania, or to her heirs if the said VIRGINIA HOCKENBERRY does not survive me; (b) Twenty percent (20%) to MARTINA MILLER, of Enola, Pennsylvania, or to her heirs if the said MARTINA MILLER does not survive me; (c) Twenty percent (20%) to HARRY LINE, of Carlisle, Pennsylvania, or to his heirs if the said HARRY LINE does not survive me; (d) Twenty percent (20%) to BEVERLY J. GEIGER, of Mechanicsburg, Pennsylvania, or to her heirs if the said BEVERLY J. GEIGER does not survive me; (e) Fifteen percent (15%) to the children of any of the four persons named in this Article if such children are living at the time of my death, in equal shares, per capita; and (f) Five percent (5%) to ST. MATTHEW EVANGELICAL LUTHERAN CHURCH, of Plainfield, Pennsylvania, if such church continues to exist and to hold regular services in Plainfield, Pennsylvania; if such church does not exist 2 INITIALS:~ and conduct regular services in Plainfield, Pennsylvania at the time of my death, then such gift to the church shall lapse, and the said five percent (5%) shall be distributed to HOSPICE OF CENTRAL PENNSYLVANIA, of 98 South Enola Drive, Enola, Pennsylvania, to be used in Cumberland County only. ITEM IV: No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction, but if bond is nevertheless required, it shall be without surety. ITEM V: In addition to all powers conferred herein upon my Executrix or personal representative, or vested in them by law, my said Executrix or personal representative shall have the following powers applicable to all property, real, personal and mixed, wheresoever situate, exercisable without Court approval and effective with respect to each item of said property until actual distribution thereof: (a) To pay all taxes, charges and expenses of maintenance, upkeep, improvement, development, protection and preservation of any obtained or acquired real or personal property. Such payments may be made either from principal or income as my said Executrix shall determine; (b) To retain or invest any and all funds, whether principal or income, and any real or personal property without restriction to legal investment; (c) To purchase investments at premium; 3 INITIALS: (d) To exercise all rights of a security holder or shareholder in any corporation; (e) To lease, mortgage, pledge, give options upon or sell at public or private sale and without approval of any court and without any responsibility to the buyer or buyers to see to the application of the purchase price, any real or personal property or portions thereof, irrespective of the manner or means by which the same was acquired by my said Executrix; (f) To make any payment or distribution herein provided for in cash, kind, or partly in cash and partly in kind, except as herein otherwise specifically provided, at valuations fixed by my Executrix at the time of distribution. ITEM VI: I direct that no interest of any beneficiary in any property distributable to a beneficiary hereunder may be anticipated, assigned or encumbered or be subject to any creditor's claims or legal process prior to its actual distribution to the beneficiary. ITEM VII: I hereby nominate, constitute and appoint MARTINA MILLER and VIRGINIA HOCKENBERRY to be the Co-Executrices of this, my Last Will and Testament. In the event either of the said Executrices has predeceased me or cannot qualify or, having qualified, cannot or does not continue to serve as my Executrix, 4 INITIALS :~~ then, in that event, the surviving Executrix herein named shall serve alone. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, this /~ day of ~/~~ , 1996. Ima L. Mell The preceding instrument, consisting of six (6) typewritten pages, initialed at the bottom of each page for security purposes, was on the date thereof signed, published and declared by Ima L. Mell, Testatrix herein named, as and for her Last Will and Testament, in our presence, who, at her request, in her presence and in the presence of each other, have subscribed our names as witnesses whereof. Wit's! 5 INITIALS:~ COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF /~,,,,J : We, the Testatrix and Witnesses, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned that the Testatrix signed and executed the instrument as her Last Will, that she signed willingly, and executed it as her free and voluntary act for the purposes therein contained, and that each of the witnesses, in the presence and hearing of the Testatrix, was at the time eighteen (18) years of age or older, of sound and disposing mind and under no constraint or undue influence. Sworn and subscribed to before me this /Jr- day of ~j~a,~f~ , 1996. My commission expires: //~$~ Not.iai Seal Nancy E. Roach, Notary Put:~ic · _Harri.J3urg, Dauphin County My Commission Expires Jan. 13, 1997 6 INITIALS:~ Will No. ~ / ' 0 q - 5-/q Admin. No. To the Register: I cerffy that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Cou~t Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 0 ~/- ! ~ - ~ O0 ~t : Name Address Notice has now been given to all persons entitled thereto under Rule 5M(a) except Date: Signature ~/~~ 0._._.--~ ~'~~ Name~ ~ ',) Capacity:__ v Personal Representative ~2 ?: 0 ~.~ ~ Counsel for personal representative COMtvIONWEALTH OF PEN~N'SYLV/ PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004585 HOCKENBERRY V RGINIA 2313 LINDSAY LC~T ROAD SHIPPENSBURG, 'A 17257 ACN ASSESSMENT AMOUI~T CONTROL NUMBER 101 ¢24,949. ESTATE INFORMATION: SSN: 162542777 FILE NUMBER: 2104-0379 DECEDENT NAME: MELL IMA L DATE OF PAYMENT: 11/04/2004 POSTMARK DATE: 11/04/2004 COUNTY: CUMBERLAND DATE OF DEATH: 04/07/2004 TOTAL AMOUNT PAID: $24,949.!~8 REMARKS: M K WO.FINGER CHECK# XXX INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAU(iH REGISTER OF WILLS REGfSTER OF WILLS Inventory of the real an personal estate IMA L. MELL , deceased / 1. 1628 Newvil le Road, Ne*mille, PA .......... 110,000 2. Legg Mason Value Trust ............... 30,493 '39 3. Orrstown B~nk - Checking Account - 106211741 . . 41,344 )5 4. Orrstown B. tnk- Checking Account - 106001042 . 12,911 ~6 5. Auction Pr,~ceeds ................. 6,769 200 6. 1983 Cadil.ac ................... TOTAL ............. 201,718 COMMONWEALTH O]~ PENNSYLVANIA : :SS COUNTY OF CUMBER ,AND : Martina Wolfin_~er and Vir inia Hockenberry , being duly sworn according to law, deposes and says they are the Executors of the Estate of [ma L, Moll , late of West Pennsbt*ro Township Cumberland County, Pent 'Ivania, deceased and that the within is an inventory made b3 Martina Wolfinzer and Virgin a Hockenberry , the said Executors of Ihe entire estate of said decedent, consisting of all the person* I property and real estate, except real ~,state outside the Commonwealth of Pennsylvania. and that the figures opposite each item of :he Inventory represent it's fair value as f thc date ofdecedent's death. Martina WoIfinger. Executrix Sworn an~l subscribed belt this-= day 2004. } 2 Hazelwood Path } Mechanicsburg. PA 17055 Vir2i niaqqockenberrv, Executrix 2313 Lindsay Lot Road Shippensburg, PA 17257 Date of Death 04 2004 Day Month Year INSTRUCTIONS I An inventory must be led within three months after appointment of personal representative. 2. A supplement inventoi, must be filed ~ithin thirty days of disco,,ery of additionaI assets. 3. Additional sheets may I e attached as to personalty or realty. 4. See Article IV, Fiducia les Act of- 1!249. STATUS REPORT UNDER RULE 6.12 Name of Decedent: IMA L. MELL Date of Death: APRIL 7, 2004 No. 21-04-0379 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, ! report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: X Yes ~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes X No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? X Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. Date: 01/05/2005 SignatUre Y I IRWIN & McKlqlGHT Roger B. Irwin, Esquire Name (please type or print) 60 West Pomfret Street Address c,,~ Carlisle, PA 17013 ~ ~- City, State, Zip % ~..:, (717) 249-2353 :~;~ ~ C)~' Telephone Number ~ 5qz ~ .... Capacity: Personal Representative :;'~ ~n ~ ~ ¢~::: X Counsel for Person~ Representative BUREAU. OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX Z8D60l HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE RC:C("~0r.:P OFF"CE ChTICE OF INHERITANCE TAX '- ,j,n_' "~~R!\~~MENT, ALLOWANCE OR DISALLOWANCE .. 'OF 'HDUCTIONS AND ASSESSMENT OF TAX 2C05 JAN 10 AI"I 9: III CLER\( OF ORPHAN'S fQ.l[H\" ROGER B IRWIN ES~UMPrpl,..!,. 'j , r", IRWIN & MCKNIGHT 60 W POMFRET ST CARLISLE PA 17013 ESTATE OF MELL TAX RETURN WAS: ( DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-03-2005 MELL 04-07-2004 21 04-0379 CUMBERLAND 101 *' REV-1547 EX ~FP [(1'9-04) IMA L Allount Remitted I ACCEPTED AS FILED I XI CHANGED SEE DATE 01-03-2005 ATTACHED NDTICE 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 ... RifV'=m-j-Eif-AFP--coFoiY-NoT-ieE""liF-i:iiiiEifiTAi.jci-TAx-A-PPRiiisEHiNT~--AmiwANCi-ijR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX IMA L FILE NO. 21 04-0379 ACN 101 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. stocks and Bonds (Schedule 8) 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax III 121 [31 (41 151 161 (7) 110,000.00 30.493.09 .00 .00 61.224.91 .00 .00 181 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 201, 718.00 ?8.084 R? 173,633.18 8,343.18 165,290.00 NOTE: 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~ ~ returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 et 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 B rate (18) 19. Principal Tax Due .00 X 00 = .00 .00 X 045 = .00 .00 X 12 = .00 165,290.00 X 15 = 24,793.50 1191= 24,793.50 191 1101 19,276.47 TAX CREDTTS: ft...." "J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID I-I 11-04-2004 CD004585 .00 24,949.98 TOTAL TAX CREDIT 24,949.98 BALANCE OF TAX DUE 156.48CR INTEREST AND PEN. .00 TOTAL DUE 156.48CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 8.808.35 Ill! 1121 1131 1141 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 :5)( REV-1470 EX (6-88) '* INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME FILE NUMBER Ima L. Mell 2104-0379 REVIEWED BY ACN Destiny S.R.Brown 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The charitable bequest has been increased to reflect 5% of the residue after specific req uest. ROW Page 1 Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: Invoice Date: Estate of: Estate No: 187 2/1/2005 VIOLETMSTARNER 21-2004-0310 Frey & Tiley 5 South Hanover Street " Carlisle, PA 17013 Qty 1 Fee Description Additional Probate Fee 35,00 Total $35.00 Total: $35,00 Checks should be made payable to the Register of Wills, Terms: Net 30, Please return one copy of this invoice with your payment. Thank you. COM O.WE*LT, OFPEN.SYLV*.,* INHERITANCE TAX RETURN FILE NUMBER DEPARTMENT OF REVENUE 21-04-0379 oEPT. 80 0 RESIDENT DECEDENT HARRrSBURG,PA17128 060t COUNTYCODE YEAR NUMBER DECEDENTS NAMEiLAST, FIRST AND MIDDLEINITIAL~ SOC~ALSECURITYNUMBER D E HELL IMA L. 162-54 2777 E ED 04/07/2004 04/02/1919 REGISTER OF WILLS T HpRL ~ . E PAil CO IL~J 6. Decedent DiedTestate Decedent MaintafnedaLivingTrust __ 8. TotalNumberof SafeDeposit B .... KC oR ET sK J ~-~ 9. (Attach copy of Will) [~ (Attach copy of Trust) LitiGation Proceeds Received I 110. Spousal Poverty Credit [] 11. Ejection to tax under Sec 911 THIS SECTION MUST BE COMPLETED; ALL CORRESPONDENCE &CONFIDENTIAL TAX INFORMATION sHOULD BE DIRECTED TO: P C O Roger B. Irwin Esq. 60 West Pomfret Street ~O~ C~ RRMNAME(IfApplicable) West Pomfret Professional Bldg. b ~ IRWIN & McKNIGHT Carlisle, PA 17013 S T TELEPHONE NUMBER 717,/249-2353 1. Real Estate (Schedule A) (1) 110,000 . 00 OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule B) (2) 30,493.09 3. Closely Held Corporation. Partnership or (3) None Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (4) Nolqe R 5. Cash Bank Deposits & Miscellaneous Personal Property (5) 61,224.91 E C (Schedule E) A 6. Jointly Owned Property (Schedule F) (6) None P I [] Separate Billing Requested T U 7. Inter-Vivos Transfers & Miscellaneous Non Probate Proper~y (7) None L (Schedule G or L) A iT 8. Total Gross Assets (total Lines 1 7) (8) -' 201 , 718.00 O 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 19,276.47 N 10. Debts of Decedent. Mortgage Liabilities. & Liens (Schedule I) (10) 8,808.35 11. Total Deductions (total Lines 9 & 10) (11) 28 ~ 084.82_ 12. Net Value of Estate (Line 8 minus Line 11) (12) 173,633.18 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) 7 ~ 300 . 00 made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) ].66,333.1.8 C O SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES M ~ 15. Amount of Line 14 taxable at the tax T A T rate or transfers under Sec 9116(a/(12) 0,00 X 0 0 (15) 0.00 X A ' T 16. Amount of Line 14 taxable at lineal rate 0.00 X 0 45 (16) 0. I 17. Amount of Line 14 taxable at sibling rate 0.00 X 12 (17) 0.00 O N 18. Amount of Line 14 taxable at collateral rate 166,333.18 X 15 (18) 24,949. 98 19. Tax Due (19) 24,949.98 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS 1628 Newville Road CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1, Tax Due (Page 1 Line 19) (1} 24,949.98 ;'. Credits/Payments A. Spousal Poverty Credit 0.00 B. Prior Payments C. Discount TotalCredits(A+B+C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (4) 0.00 5. if Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 24,949.98 A. Enter the interest on the tax due (SA) 0 . 00 B. Enter the total of Line 5 + SA. This is the BALANCE DUE, (SS) 24,949.98 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....... [__J L~ b. retain the right to designate who shall use the property transferred or its income; ..... c. retain a reversionary interest; or ..... d. receive the promise for life of either payments, benefits or care? 2. If death occurred after December 12 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....... [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. SIGNATURE OF PERSON RESPONSIBLE FOR FJLING RETURN MARTINA WOLFINGER DATE SIGNATUREOFPREPAREROTHERTHANR~PRESEh~ TIVE IRWIN ~x McKN~GHT DATE ~ _ / 60 West Pomfret Street i! ~ For dates(kof dea~ 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 spo, u~ Is 3% [72 PS. 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 does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filin9 a tax return are still applicable even if the surviving spouse is the only beneficiary For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 PS. 9116 (a) (1 2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5% except as noted Jn 72 P.S 9116(1 2 [72PS 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 ADDITIONAL Personal Representatives Estate of IMA L. MELL SS~ 162-54-2777 04/07/2004 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. Name VIRGINIA HOCKENBERRY Address Line 1 2313 Lindsay Lot Rd Address Line 2 City, State, Zip Shippensburg, PA 17257 REV 150£EX+¢1 97) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF FILE NUMBER IPLA L. HELL SS~/ 162-54-2777 04/07/2004 21-04-0379 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as [he price at which property would be exchanged between a wiliin9 buyer and a willing seller neither being compelled to buy or sell both having reaso~able knowledge of the relevant facts Real property which is jointly-owned with ri~lht of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 1628 Newville Road, Newville, PA - - SOLD - Settlement Sheet 110,000.00 Attached TOTAL (Also enter on line 1. Recapitulation) ~ 110,000.00 (If more space is needed, insert additional sheets of the same size) SCHEDULE B COMMONWEALTHOFPENNSYLVANIA STOCKS & BONDS ESTATE OF FILE NUMBER IHA L,. HEL£ SSJ~ 162-54-2777 04/07/200/4 21 04-0379 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION UNiT VALUE OF DEATH 1 Legs Mason Value "frust 30,493.(}9 I ! TOTAL (Also enter on line 2. Recapitulation) 30,493.09 (if more space is needed insert additional sheets of the same size) SCHEDULE E COMMO.~LT~O~N~¥LV~NIA CASH, BANK DEPOSITS, & MISC. INHERITANCE FAX RETURN RESrDENT DECEDENT PERSONAL PROPERTY ESTATE OF FILE NUMBER ItvLA L. HELL SS~ 162-~4-2777 04/07/2004 ~1 04 0379 I~clude the proceeds of litigation and the date the proceeds we e ece[ved by the estate. All proper~ jointly-owned with the right of survivorship must be disclosed on Schedule F. iTEM VALUE AT DATE NUMBER DESCRfPTfON OF DEATH i Or=sto~ ~ - Check~ng Accou~% - 1062117~1 41,344.05 2 O:=sto~ ~ank - Check&rig Account - 106001042 12,911.46 3 Auct~o~ P~oceeds 6,769.40 4 1983 Cadillac 200.00 TOTAL (Abo on line 5. Recapitulation) I, 6 L, 224.9i enter more space is needed, inseri additional sheets of the sarr~e size, REV 1~11 E×+it 97~ t SCHEDULE H COMMONWEALTHOFPENNSYLVANIA I FUNERAL EXPENSES & INHERITANCE TAX RETURN RESIDENT DECEDENT I ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER IMA L. MELL SS~ 162-54-2777 04/07/2004 21-{)4-0379 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: i E~ing Brothers Funeral Home, Inc. 6,417.50 2 Pastors 70.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of P ersonal Represen a reis Street Address City State Zip Year(s) Commission Paid: 2. Attorney's Fees IRWIN & McKN'IGHT 8,850. O0 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4, Probate Fees Register o£ Wills 275.00 5. Accountant's Fees 6, Tax Return Preparers Fees 250.00 7, Other Administrative Costs 1 Dennis L. Cotshall, Auctioneer 1,585.85 2 Closing Costs Settlement Sheet Attached. 1,100.00 3 ComforTek, LLC - Service Furnace 380.33 4 Jackson's Auto Service - Service on Vehicle 46.79 5 Kruger's Rental Service Piano/Organ Doily 15.90 6 Register of Wills - Filing Fee 25.00 Total of Continuation Schedule(s) 260.10 TOTAL (Also enter on line 9. Recapitulation) $ 19,276.47 ([f nqore space is needed insert additional sheets of the same srze) Copyright (c) 1996 form software only CPSystems, I nc Form REV- 1511 EX ;Rr, v 1 97 Estate of: IMA L. MELL 5oc Sec ~: 162-54-2777 Date of Death: 04/07/2004 Continuation of Schedule H-B7 {Other Administrative Costs) Item Description Amnunt 7 Sears Auto Center - Removal of Car 34.55 8 State Auto Insurance Company - Auto Policy 54.00 9 UHAUL - Moving Expense 17].55 260.10 SCHEDULE I COMMONW£ALTHOFPENNSYLVANIA DEBTS OF DECEDENT, RESIDENT OECE~ENT MORTGAGE LIABILITIES, AND LIENS ESTATE OF FILE NUMBER IMA L. HELL SS7/ 162-54-2777 04/07/2004 21-04-0379 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 Agway Energy Products - Fuel Oil 154.31 2 Chapel Pointe at Carlisle - Nursing 5,969.55 3 Deborah W. Piper, Tax Collector - Real Estate Taxes 1,317.95 4 Deborah W. Piper, Tax Collector - Personal Taxes 278.00 5 Highmark Blue Shield - Medical Policy 567.42 6 Omnicare Pharmacies Pharmacy 278.72 7 PP&L - Electric 172.33 8 William Phelan, M.D. - Medical 70.07 TOTAL (Also enter on line 10 Recapitulation) ~ 8,808. 35 (If more space is needed, insert additional sheets of the san~e s~ze} i SCHEDULE J CO M MON~VEALT H OF PEN NSYLVANIA BENEFICIARIES INHERITANCE T~X RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER IMA L. MELL SS/~ 162-54-2777 04/07/2004 21-04-0379 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 spousaldistributio~s, and transfers under Sec 9116(a;(1 1 Virginia Coover Grand Niece 1.67% 477 McCulloch Road Shippensburg, PA 17257 2 Beverly J. Oeiger Niece 20% 3502 Ada Drive Mechanicsburg, PA 17050 3 Jacqueline Geiger Grand Niece 1.67% 3502 Ada Drive Mechanicsburg, PA 17050 4 Jennifer Geiger Grand Niece 1.677, 3502 Ada Drive Mechanicsburg, PA 17055 5 Lauren Geiger Grand Niece 1.67% 3502 Ada Drive Mechanicsburg, PA 17055 i ENTER DOLLARAMTS FOR DISTRJBUTIONS SHOWN ABOVE ON LN 15 THRU 18. AS APPROPRIATE. ON REV 1500 COVER SHEET II. NON TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLEAND GOVERNMENTALBISTRIBUTIONS 1 St. Matthew's Luthern Church 7,300.00 2070 Newville Road Plainfield, PA 17081 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET ~$ 7,300. O0 (If more space is needed, inser~ additional sheets of the same size) Estate of: I~{A L. MELL Sec Sec ~: 162-54-2777 Date of Death: 04/07/2004 Continuation of Schedule J, Part I (Taxable Bequests) Item Name and Address of Beneficiary Relationship Amount or ~ Share of Estate 6 F. Virginia Hockenberry Niece 20% 2313 Lindsay Lot Road Shippensburg, PA 17257 7 Ellen Line Grand Niece 1.67% 100 Flintstone Drive Newville, PA 17241 8 Harry E. Line Nephew 20% 100 Flintstone Drive Newville, PA 17241 9 Jertna Line Grand Niece 1.67% 100 Flintstone Drive Newville, PA 17241 10 Kenneth Line Grand Nephew 1.67% 100 Flintstone Drive Shippensburg, PA 17257 11 Marring K. Wolfinger Niece 20% 2 Hazelwoed Path Mechanicsburg, PA 17050 12 Christianna Benner Grand Niece 1.67% 216 Clearfield Road Shippensburg, PA 17257 13 April Line Grand Niece 1.67% 100 Flinstone Drive Ne~ville, PA 17241 LAST WILL AND TESTAMENT · ~- IMA L. HELL I, ~MA L. HELL, of Carlisle, Cumberland County, Pennsylvania, of sou~' and disposing mind, memory and understanding/ do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking any and all prier Wills and all Codicils made by me at any time heretofore. ITEH I: I direct that the expenses of my last illness and my death, including all costs and expenses of administration of my estate, my funeral, and all other taxes arising by reason ef my death be paid from the residue ef my estate as soon as practicable after my death. iTEH II: I give and devise my dishes and the furniture in my home te VIRGINIA HOCKENBERRY, ef Shippensburg, Pennsylvania, HARRY LINE, of Carlisle, Pennsylvania, MARTINA MILLER, ef Enela, Pennsylvania, and BEVERLY J. GE!GER~ cf Hechanicsburg, Pennsylvania, such personalty to be divided between them in as nearly equal shares as possible and as they shall determine. In the event of any disputes er disagreements, my Executors hereinafter named shall resolve all such disputes, and, if my Executors are incapable ef resolving any such dispute, any such individual item of personalty which is the subject of dispute shall INITIALS ..-~6}~d~i be added to my residuary estate and distributed as hereinafter provided. ITEM III: Ail the rest, residue and remainder of my estate, whether real, personal or mixed, I give, devise and bequeath as follows: (a) Twenty percent (20%) to VIRGINIA HOCKENBERRY, of Shippensburg, Pennsylvania, or to her heirs if the said VIRGINIA HOCKENBERRY does not survive me; (b) Twenty percent (20%) to ~RTINA MILLER, of Enola, Pennsylvania, or to her heirs if the said MARTINA MILLER does not survive me; (c) Twenty percent (20%) to HARRY LINE, of Carlisle, Pennsylvania, or to his heirs if the said N~ARRY LENE does not survive me; (d}· Twenty percent {20%) to BEVERLY J. G~IGmR,~ ~ of Hechanicsbu~g,_ Pennsylvania, or to her heirs if ~ ~h~ said BEVERLY J. GEIGER does not survive me; (e) Fifteen percent (15%) to the children of any of the four persons named in this Article if such children are living at the time of my death, in equal shares, per capita; and (f) Five percent (5%) to ST. P~TTHEW EVANGELICAL LUTHERAN CHURCH, of Plainfield, Pennsylvania, if such church continues to exist and to hold regular services in and conduct regular services in Plainfield, Pennsylvania at the time of my death, then such gift to the church shall lapse, and the said five percent (5%) shall be distributed to HOSPICE OF CENTNAL PENNSYLVANIA, of 98 South Enola Drive, Enola, Pennsylvania, to be used in Cumberland County only. ITEM IV: No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction, but if bond is nevertheless required, it shall be without surety. ITEM V: In addition to all powers conferred herein upon my Executrix or personal representative, or vested in them by law, my said Executrix or personal representative shall have the following powers applicable to all property, real, personal and mixed, wheresoever situate, exercisable without Court approval and effective with respect to each item of said property until actual distribution thereof: {a) To pay all taxes, charges and expenses of maintenance, upkeep, improvement, development, protection and preservation of any obtained or acquired real or personal property. Such payments may be made either from principal or income as my said Executrix shall determine; (b) To retain or invest any and all funds, whether principal or income, and any real or personal property without restriction to legal investment; (c) To purchase investments at premium; (d) To exercise all rights of a security holder or shareholder in any corporation; (e) To lease, mortgage, pledge, give options upon or sell at public or private sale and without approval of any court and without any responsibility to the buyer or buyers to see to the application of the purchase price, any real or personal property or portions thereof, irrespective of the manner or means by which the same was acquired by my said Executrix; (f) To make any payment or distribution herein provided for in cash, kind, or partly in cash and partly in kind, except as herein otherwise specifically provided, at valuations fixed by my Executrix at the time of distribution. ITEM VI: I direct that no interest of any beneficiary in any property distributable to a beneficiary hereunder may be anticipated, assigned or encumbered or be subject to any creditor's claims or legal process prior to its actual distribution to the beneficiary. ITEM VII: I hereby nominate, constitute and appoint kARTINA MILLER and ViRGINiA KOCKENBERRY to be the Ce-Executrices of this, my Last Hill and Testament. In the event either of the said Executrices has predeceased me or cannot qualify or, having qualified, cannot or does not continue to serve as my Executrix, 4 INITIALS: then, in that event, the surviving Executrix herein named shall serve alene. IN WITNESS WHEREOF, i have set my hand and sea! to this, my Last Will and Testament, this./ ~[ day of ,{/~Ud.e-z~6-{ 1996. Ima L. Me!l The preceding instrument, consisting of six (6) typewritten pages, initialed at the bottom of each page for security purposes, was on the date thereof signed, published and declared by Ima L. Melt, Testatrix herein named, as and for her Last Will and Testament, in our presence, who, at her request, in her presence and in the presence of each other, have subscribed our names as witnesses whereof. wit~es~ / f / COMHONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF ?~,{~ ~ ~'/,~ : We, the Testatrix and Witnesses, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned that the Testatrix signed and executed the instrument as her Last Will, that she signed willingly, and executed it as her free and voluntary act for the purposes therein contained, and that each of the witnesses, in the presence and hearing of the Testatrix, was at the time eighteen (18) years of age or older, of sound and disposing mind and under no constraint or undue influence. /SEAL/ ima L. Hell Sworn and subscribed to before me this /~ day of ~}~6~ , 1996. Not~ry P~lic . l My commission expires: Nape/E. Run.h, Ndar}, Publ~o Hanisbu'.g, Dauphin County 6 INITIALS LAW OFFICES A. Setdement Statement IR WIN & McKNIGHT .s ..~_ OMB No 2502-0265 REV HUD:I ~/~6) WEST POMFRET PROFESSIONAL BUILDING , 1 LJFHA 2 L'FmHA 3 ~Conv Uefns 60 WESTPOMFRETSTREET ' 4. E~VA 5. [JConv. lns CARLISLE, PENNSYLVANIA 17013-3222 6. RLENUMaER .... ~7~~ (717) 249-2353 YOU~GC9-04 8 MORTGAGEINSURANCECASE NUMB~ - ~ - conviction can include a f ne a ~d i~ment' For de~it~ ~ee: Title ~8 U. S. Code Sectlo~ 1001 and Sect~n 10fO ....................... - -~ D NAME OF BORROWER: CLARENCE E YOUNG and WONNE J. YOUNG - ~ - _ _~D~RESS E NAME OF SELLER: I~A L. ~ELL ESTATE ~DRESS: 2 H~ELWOOD PATH~ MECHANICSBURG~ PA 17050 - ADDRESS: G PROPERTY ADDRESS: 1628 NEWVILLE ROAD, Neville, PA 17241 West Pennsboro Township H SETTLEMENT AGENT: - ' ~ ...... I&M REAL ESTATE SERVICES, LLC, Telephone: 717-249-2353 Fax: 717-249-6354 P~CE O~SE~%EME 4T: West Pomfret Profess onal BId~60 West Pomfret Stre~Oarlisle=PA ~TL~ME~T ~ATE: - ~ 09/29/2004 J. SU~E~OF BO~WEE'S~AdT~-~ -~~R~~,~R~ ~0~ _.Cont~ saes2rice ....... ~ ~00~GROSS A~OUNT ..... SA~Z~0N. !~Per~nal P~edj ~1 _ _ , 90.00~_~!~ Contr~L~81esprice !03. S~tt~mentcha~e~t~;~;roTer~e ~c; -~N .... ~ 4~ 2ersonal Pro ;dy ...... ' _ 110.000 104 .... 2~w~--~2~ 1~969.50 403 - P! ..... ~ ¢ 405 ~ ' · - ....'- - · 109 / ¢ j 409 ~ r~( ~dvance ' 110 CO TAX 09/17/04 TO 12,31/04 ~ LI~ SCH~AX 09/17/04 TO 06/30105 ~ ....... ~0~7~ L ~10 _%O TAX 09/17 04 TO 12/31'*' -~ ' - .L1&~ ~ d~36'3~ L~!~: ~C~L TAX 09,'!Z~ TO 06/30/05 !~¢~UNT D~ FROM BORROWER ~ --,~__~¢12__ ~ ..... ~-- - ~0~6.30~ 200' AMOUNTS PAID BY OR ON BEHALF OF BORROWER .... ~EDUCTIONS IN AMOUNT DUE TO~Lt ~ ......... ,,0¢~ 53¢ 420. GROSS AMOUNT DUE TO~EL 201 De. sit orearnest mon~ I--'-- ........ ' ~ ~ .... ~-~ 5,000.00,1 50 Excess De~osit~see n~tructionsL ~ ~ - 202 PrinciE~f amoum ofnewleans ..... LER 203 Exi~oan~ aken subjeD o_ ] ~ :5¢~ ~t/19me~ha~s~9~el~r(line 14~- ~- - 204 -- - - - ~ .... 1 .... ~03 ~Zisli~oan~s%/aken sub~ec~t~ ..... { ~ - ~,!00.001 .... Adjustments for tems un~a d byseller ~!3 --- ~ ~- - I ~ ~ ~ ..... F .... A~justments for items ...... L · s ams nls aid b ¢ -- - --~ a~ 3J J 6 ~ ~ ~ - ~u~ 5bLL ' P- - ~gE~rrowe ~ne 220 -~ ' = ~J= ~[gE~oun due ; ' ~ - : )3 CASH FROM I t - -vx/~9~09~¢rE~un dues~J~r ' BORROWE ......... 0¢,086'~._6~ CAS~ TO SELLER L) S DEP,:R]I/E. NT OF HOUS0~G At'~D URB,~N DE'/ELOPMENT ~ --SE-T~EMENT STATEMENT RE'/ HUD 1 ,; .... File,Nun,be; YOUNGC9-04 L ~L.~SETTLEMENTC~A~S .... z: _~ Ld,Euj T eEx~ressSetliemerCe ........ ~ PAID FROM m PAI FROM OO TOTAL SALES/BROKER,S COMMISSION based On~rice $110j0¢0.00 = Div sion of commission ~ine 700) as follows: i 70% $ ~o ~ FUNDSAT I ~- to ~ SE~LEMENT ~ FUNOSAT m -: ~ SE~LEMENT ~ r03 Comm~ss)~a~d a[ SO ~0O. JTEMS PAYABLE JN CONNECTION W TH LOAN J 801. Loan O i~nation Fee % I 802. Loan Discount % ...... ~ ,I ' 803 A~isaJFee ........... ~_ ~804 Cred~tR~on ............ ~ ~- _ ' - - I 805 Lender's l~ection Fee ~ 8 ~ 06'~e A~lication Fee ~8~7~ S~on Fee 809 810 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901 interest From 902. Mop--Insurance Pre~ um for ~ 903 Hazardlnsurance Premium for ~ 904~ 905 1000. RESERVES DEPOSITED W TH LENDER FOR ~' .... k ~ ~ ~0~1 Haza~d~n~urance 1002. M~a~e ~nsurance 1003. C~ Pr~ed~ Tax mo~ $ /mo 1004 Cou~ Properly Tax ...... ~ ~ - _ 10~. Sc~o~ Tax - rng=~ S ..... 23,1 ~/m~ ............ ~ 00~ate Analysis ~dju~tment 1100. TITLE CHARGES 1~01. SetUement or closio~ fee ~!~2 Abs~ or ~earch ......... 1104 Titte insurance binder l~05._Docu~n%Preparation ~ ~ i -- I 1~06~ Fees to NOTARY - I ' ~07~t~s fees to iRWIN & MOKNIGHT ~ ~ndudes abovectems o: l~O~itle I~su~ance .__ ~dEs above itAms No: ~10 Ow~r's Cover~E~ 110~000 00 11~1~ ' ~ , 11_!~~ m3. I ___. ~e~ra~Qg bees_Deed $38.50 ' '~ ..... ~ ~202 C~ax/s~~ .... ~a~ .... L~Jea~e ~ ~ State Tax/sta~-- --~uee~]~l~m0~---L~e $ ........... 1300. ADDITIONAL SETTLEMENT CHARGES J302, Pest inspection 304 j 305, 306 307 308. -- ~- ' ! ..... ~-~ OCT 20 2004- 9: 15FIM CRLL CENTER 717 530 2624, p. 1 October 20, 2004 TO: Law Offices Irwin & McKr~ight 60 We~t Pomfret S~'eet Carlisle, PA 17~" 3 FROM: 'rimothea Moose Cust. Serv. Op. P.O. BOX 250 SH,PPENSBURG PA 17257-0250 RE: ESTATE OF ,ma L. Mell DATE OF DEATH: April 7, 2004 It IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD ON THE ABOVE DATE, THE FOLLOWING ACCOUNTS WiTH ORRSTOWN BANK: ' (1) ~CH ECK~ AOCO_UNTNO_. TITLE OFACCQUNT DATE OPENED PRINCIPAL & ~ 106001042 Ima L Mell "11/5/99 12.911 O9 .37 10~211741 Ima L Mell 11/5199 41,336.12 7.93 (2) SAVINGS ACCOUNTS ACCOUNT NO. TITTLE OF ACCOUNT DATE OPENED PRINCIPAL &A~OCRUED INT~RES. TT (3) CERTIFICATES OF DEPOSIT A~CCOUNT NO. _T~TLE OFACCOUNT D_~ATE OPENFI~ PRINCfPAL & ACCRUED INTERES~T P.O, BOX 250 SHIPPENSBURG, PA 17257 TEL. (717) 532-8114 October 22~ 2004 Roger B Irwin West Pomfret Professional Building 60 West Pomfret Street Carlisle, Pa 17013 RE: Estate oflma L. Mell Date of Death: April 7, 2004 De~ Roger, On September 21, 1998 an account was opened at Legg Mason, Wood, Walker, Inc., by Ms. Mell, titled [ma Mell. There had never been any change of ownership or registration of this account. On April 22, 2004 an account titled F Virginia Hockenberry & Marina K Wolfinger, Estate oflma L Mell was opened, at that time $161.61 cash, 2020 shares of Delaware Investments income Fund Inc.,end I00.467 shares of Legg Mason Value Trust were transferred into this account. All holding we)e sold and and the cash balance including .35 cents interest were issued. The Date of Death Value for the Legg Mason Valuc Trust was $58.42/share(x 100.467 shares = $ 5,869.28), and the DDF average price was $12.1 l(x 2020 shares = $ 24,462.20), with the high price of $12.22, and the low price of $12.00. With cash balance included, the total account was valued at: $ 30,493.09 If we can offbr any other assistance, please call. Sincerely, Legg Mason Wood, Walker, Inc. fi'~'[~:'"~: .... ;-~:.:' i. GM/daz ~ : ';4 FINAL SETTLEMENT SELLER NAME DATE OF SALE ADDRESS /~L~' /~'"~'--, ;-'.~Z.A ~ ~x~Z PHONE ~- LOCATION OF SALE ~ ~ ~ ~/f~ ~ ~['~ ~ (" [ AUCTIONEER ~,~Zd //~lt~ ~ ~,~ ~%~' /~ ~-/t ~*z PHONE ~ ~ C SELLER'S EXPENSES ) C RECEIPTS PROFESSIONAL FEES AUCT~ON~E~ ~($ ~;/, ~ CAS~ CLERK $ CHECKS $ CASHIER $ OTHER RECEIPTS OTHER EXPENSES $ $ TOTAL RECEIPTS $ L~SS ~OTAL ~XP~SES $ /~: I (or we). the seller, accept thi~ se~lement and acknowledge receipt of the above specified net proceeds from the auction o~ my goods and proper~ sold on the above date. I accept all respons bili~ for providing merc~?able title to all goods, and prop~r~ sold, and for delive~ of title to the purchaser. J ../A~cti~eer: or Cashier's. Sig nature ~SSeller's Sinn~_ ' ::u /' _ ~/////~' 7 Date Date ' / ' ~ / (Seller's Signature) Ewing Brothers Funeral ttome, inc. 630 South Hanover Street Carlisle, PA 17013- (717)2,13-2421 May 3 I, 2004 Martina K. Wolfinger 2 Hazet~',ood Path Mechanicsburg, PA 17050 The Funeral Service For Ima L. Mell We sinccrel3 appreciate the confidence you have placed in us and ',','ill continae to assist '~ou in every way ,ae can. Please feel tree to contact us if you have any qtlestions in regard to this statement. ' TI iE FOI.LO~,MNG IS AN iTEMIZED STATEMENT OF TI [E SERVICES. FACILITIES, AUT )MOTIVE FQUII ~ ENT AND MERCHANDISE TI I/VI' YOU SELECTED WHEN MAKING 'I HE FbTNrERAL ARRANGEMEN 1. PROFESSIONAL SERVICES Services of' Funeral Director/Staff ................... S3460 00 FUNERAL HOME SERVICE CHARGES ............ $3460.00 SELECTED MERCHANDISE: I SG Biblc Pra~ in~[Iands Casket $275000 THE COST OF OUR SERVICES, EQUIPMENT, A~D MERCH kNDISE THAT YOU II[A¥'E SELECTED ............... S6210.00 (7ash Ad',ances Certified Copies of thc Death Certificate $40.00 Flowers ........................... $13250 Hairdresser .......................... $35.00 TOTAL CASH ADVANCES AND SPECIAL CHARGES ........ $207.50 Total Total Cost .......................... $641750 SUB-TOTAL ( _S6,!17:~57 ~ INITIAL PAYMENT/DISCOUNT/CREDITS 541750 -- TOTAl. ,%'vlOb~T DUE SI000.00 '!he unpaid balance ovcr 45 dL~s is subj¢ctgd to a I 00 % scp,'icc ch ~rge per monlh - 12 0000 9~ per annum.