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HomeMy WebLinkAbout03-0216PETITION FOR PROBATE and GRANT OF LETTERS also known as To: .%~Deceased, Social Security No. lillY""/~ ~ The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age orpld_er_.~n the execu~ in the last will of the above decedent, dated and codicil(s) dated Register of Wills for the _ ~ County of ~/~/',d~'~'~D/in the Commonwealth of Pennsylvania (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~gt: ,~_ ~'~t~~Z) County, Pennsylvania, with ~ las~Lfamily or~ princi~a,l residence at -- (list street, number and muncipality) Decenfient, then t'~ years of_age, died Except as follows, ~l~cedent di~t no'marry, was ~ot divorce-c~ and did not have a ~ld born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of ~th_e last will and codicil(s) herewith and the grant of letters '.~--'-'-'-'-'-'-'-~'~~~~ presented (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF C%~berland 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 an~Lkruly administer the estate according to law. Sworn to or affirmed and subscribed .~ ~t'*~~~t~*~'~' · /~x before me this 14th day of (, P ~Fe~a~ , ~ 2003 / , , . "' - No. 21-2003-216 Estate Of ~ward j. morn , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW March 10th lrg._2~ in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated October 23rd, 2001 described therein be admitted to probate and filed of record as the last will of Edward J. Thorn ; and Letters Testamentary F_rSward are hereby granted to F.Thorn and Cherry T. Gronski FEES Probate, Letters, Etc .......... $ 18.00 Short Certificates(2) .......... $ 6,00 Renunciation . .1. ............. $ 5.00 - x-Pages ( 1 ) 3.00 JCP $ 5.912 TOTAL __ $ 42.00 Filed Mar. ch. 10.th, 20.0.3 ................. ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE MAILED LETUERS TO EDWARD F. THORN 3/10/03 REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that / present and saw the testat. , sign the same and t /"' signed as a witness at the request of testat.__ in h presence ~d (in the presence of ~fich other) (in the presence of the other subscribing witness(es)). ~ ,/ Sworn to or affirmed and subscribed before me this day of " / '/ (Name) // ""x (Address) Register x % (Name) (~&tress) R~ISTER OF WILLS OF Cllnberland COUNTY OATH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified according to law depose(s) and say(s) that ~(,~t~~' ~....~t~ familiar with the signature of ~~'~ x~t /"~,~ te~tat~ of (one of the subscribing witnesses to) the presented herewith and ~dicil that ~ believe~ the signature on thais in the handwriting of to the best of ~ knowledge and belief.~ Sworn to or affirmed and sabscribed before~~ ' " me this 14th day of _ ~ ~Name)~ ~ Feb~a~ ~.~ ~ ~ 2003 ~/~00~ /~ ~~~ ~nna M Otto, 1st ~puty ~ ~ ' ~ '~ · ' - Register ~ '~f~~~' ~~ ' (Address) March 11, 2003 As per the request of Sue Koser at the Office of the Registrar of Wills in the Cumberland County Courthouse This is to verify that the names listed on the renunciation form are all children of the late Edward J. Thom. Edward F. Thom Judith A. Thom Kenneth L.Thom Cherry T. Gronski Robert M. Thom Joseph A. Thom Edward F. Thom his is to certi~ that the information here given is correctly copied fi'om an original certificate o( death dui', [.Deal Registrar. The original certificate will be forwarded to the 5tare Vital Records Office for pcrm:u',c:,t filin:. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 8913276 No. FEB 0 I)atc ,b 143R~v 2/87 COMMONWEALTH OF PENNSYLVANIA o DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH blAME OECEDENT 1szM°-J~e l'-160 --16 -- 4147 ..Februo.,,t 5:2003 yEd~ard J. Thorn Enola, PA 17025 Howard W. Thorn Ken Thorn ]1.~THEFl'sN'l'iulEtFNsl'M~le'P'lade~namd) Helen C. Carnes ~.1351 Wandering Way, Harris§~r~, PA 17110 ,,, PA Crematory I~,, Harrisbu~9, PA 17109 I~x~F~u~ Cremation 5ocre~j o~ FA ~.4100 Jonestown Road. Harrisb~o. PA 1710~ FUNERAL SERVI~E. LICENSEE I.~t4 ACTING AS SUCH ILICENSE NUMBER V when ce~d~ing I~:) Ihe.bell.p~ ?y knorr, death occ~'r ed &l the time. date ancI piece I,,~ ~ [ DUE ~ ~S A C~E~E ~: 21-2003-216 LAST WILL and TESTAMENT of EDWARD J.THORN 21-2003-216 I,Edward J.Thom,of East Pennsboro Township, Cumberland County, Pennsylvania being of sound mind and understanding, do make publish and declare this My Last Will and Testament in manner as follows. I, Edward J.Thorn at the time of My death leave my house and furnishings to my Son Robert M.Thom and his wife Heather under certain conditions. The above mentioned must live at property until equity loan is paid in full .They then will be sole owners and then the land, home and all furnishings will belong to them. But if they decide to sell said property before the note is paid, they must then settle the note with the proceeds of sale and the balance to be split in equal shares with my then living Children including Himself. They will also will be liable for property taxes and sewerage and trash fees.If at any time he was at default on the payments,the property would then be sold to satisfy the bank judgement and balance would then be divided among the survivors, including hisself. Otherwise they would be the sole owners of said property when they finished paying the note and could do with the property as they wanted. This Will Supersedes any and all former Wills that I formerly made. Edward J.Thom October 23,2001 Signed this day of OUR LORD October 23,2001 NOTARIAL SEAL LLOYO p. SCHROEOER, Notary Public Harrisburg, Dolphin Coun PA BUREAU OF ZNDTVTDUAL TAXES TNHERTTANCE TAX DTVZSTnN DEPT. 280601 HARRISBURG, PA 17128-0601 COHNONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTZCE OF INHERITANCE TAX APPRAZSEHENT. ALLONANCE OR DZSALLONANCE OF DEDUCTIONS, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-16q8 EX AFP C01-0S) ROBERT M THORN'0~ FEB 20 ,~\11:22 1000 VALLEY ST ENO LA Ct~Inbe~iar'~a Co., PA FILE NUHBER COUNTY SSN/DC ACN DATE 02-2q-200q ESTATE OF THORN EDWARD DATE OF DEATH 02-06-2003 21 03-0216 CUHBERLAND 160-16-qlq7 03112503 Amoun~ R.m/~ed I HAKE CHECK PAYABLE AHD REHIT PAYHEHT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 J CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-2~-200~ ESTATE OF THORN EDWARD J DATE OF DEATH 02-06-2003 COUNTY CUHBERLAND FILE NO. 21 03-0216 S.S/D.C. NO. 160-16-~1~7 ACN 03112503 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET ZNFORHATZON FINANCIAL INSTITUTION: ALLFIRST BANK ACCOUNT NO. 0085561037 TYPE 05 ACCOUNT: ( ) SAVINGS C~ CHECKING ( ) TRUST ( ) TIHE CERTIFICATE DATE ESTABLISHED 08-28-196~ Accoun~ Balance 10,008.79 Percen~ Taxable X 0.500 Amoun~ Sub~ec~ ~o Tax 5,00~.~0 Debts and Deductions - .00 TaxabZe Amoun~ 5,00q.~O Tax Ra~e X .~5 Tax Due 225.20 TAX CREDITS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID INTEREST IS CHARGED THROUGH 03-03-200q TOTAL TAX CREDIT AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE REVERSE SIDE OF THIS FORM INTEREST AND PEN. TOTAL DUE ~ ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REi~UZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" ( CR}, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) .00 225.20 3.26 228.q6 COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z&0601 HARRISBURG, PA 17128-0601 REV-154,~ EX &FP (09-00) ROBERT M THORN 1000 VALLEY ST ENOLA PA 17025-1338 ZNFORNATZON NOTZCE AND TAXPAYER RESPONSE ACN 03112503 DATE 03-27-2003 TYPE OF ACCOUNT EST. OF EDWARD J THORN [] SAVINGS S.S. NO. 160-16-qlq7 [] CHECKING DATE OF DEATH 02-06-2003 [] TRUST COUNTY CUMBERLAND [] CERTIF. REHIT PAYMENT AND FORHS TO: REGISTER OF NTLLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ALLFZRST BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance mlth the Inheritance Tax lams of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-85Z7. COMPLETE PART 1 BELON x # ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTZONS Account No. 0085561037 Data 08-28-196q Established Accoun~ Balance 10,008.79 Percent Taxable X 50 · 000 Amount SubSect to Tax 5 · OOq. ~0 Tax Rata X .15 Potential Tax Due 750.66 To insure proper credit to your account, rna (Z) copies of this notice must accompany your payment to the Register of Hills. Hake check payable to: "Register of Mills, Agent". NOTE: If tax payments ara made within three (5) months of the decedant's data of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE ~b~ ~ ........ -="-! ........ ~'~?'~[~"~ ................ A. ~ The above in~ormation and tax due is correct. 1. You may choose to remit payment to the Register o~ ~111s ~1~ t~o cop~es oF this notice to obtain  CHECK ~ Hills and an o,,[c,al asses~ent ,J11 bo [s~ed by ~e PA Depar~ent o~ Revenue. ONE ~LOCK~ B. ~ The above asset has been or ~111 be reported and tax paid ~/th the PennsylvmJa [~eritance Tax return ONLY --/tm be ~11ed by ~e decedent's repre~ntatJve. C. ~ The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ belo~. PART Zf you Andlca~e a d1~feren~m~ ra~e~ please s~a~e your rela~[onshlp TAX RETURN - COHPUTATZON OF TAX ON JO/NT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Accoun~ Balance ~. Percen~ Taxable 6, ABoun* Taxable 6 8. Tax Due 8 DEBTS AND DEDUCTIONS CLAIMED PART DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line .; of Tax Computation) Under penalties of perSury, ! declare that the facts ! have reported above are true· correc~ and ,~_~.~olap[eta ,o *he bast of m~L_.knowladge and b el,el. CFind ~Find C~ (no ~.ege) [] = ww ~ (a~k) ~ ='4ew ~.age (ta~e) List rela~ Posting Date 2003 Mar 12 Research Seq # 1405565894 Account # a5561~ Check/Store # 7505 DB/CR DB Dollar Amount $42,00 Bank # 001 __ Deposit Acct # Posting Date 2003 Mar 17 Research Seq # 2007914160 Account # 65561037 Check/Store # 7504 DB/CE DB Dollar Amount $625.00 Bank # 00t Deposit Acct# O MSN Search Search (o~ oth~ items: Fi~s or Fol~l~)~ PFmte~ UCS 4~gP.2Sm3OOO~.-~g 7.373~1 Pi RI ICl DI D, B~ D' JAMES D. BOGAR JENNIFER B. HIPP* *Also admitted to New Jersey Bar JAMES D. BOGAR A~rORNEY AT LAW ONE WEST MAIN STREET SHIREMANSTOWN. PENNSYLVANIA 17011 e-mail mail@bogarlaw.com April 21, 2004 TELEPHONE (717) 737-8761 FACSIMILE (717) 737-2086 Direct e-mail Jbogar@bogarlaw. com VIA HAND DELIVERY Glenda Farner Strasburgh Register of Wills Cumberland County Courthouse Carlisle, PA 17013 RE: The Estate of Edward J. Thorn No. 21-03-0216 Dear Ms. Strasburgh: Please be advised that we have been retained to represent the Estate of Edward J. Thorn. Please forward all further communications with respect to this matter to our direct attention. Your time and consideration in this matter are greatly appreciated. JDB/blw CC: Very truly yours, Edward F. Thorn, Co-Executor Cherry T. Gronski, Co-Executor CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Edward J. Thorn Date of Death: February 6, 2003 Will No. 21-03-0216 To the Register: Admin. No. 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 May 14, 2004: Name Address Edward F. Thorn 311 Pinewood Drive Shiremanstown, PA 17011 Cherry T. Gronski Judith A. Thorn Kenneth L. Thorn Robert M. Thorn Joseph A. Thorn Heather Thorn 2836 S. Queen Street Dallastown, PA 17313 699 Torway Road Gardners, PA 17324 1351 Wandering Way Harrisburg, PA 17110 1000 Valley Street Enola, PA 17025 125 Second Street Enola, PA 17025 1000 Valley Street Enola, PA 17025 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: e~e~[~r~t~e~ttire Shiremanstown, PA 17011 (717) 737-8761 Capacity: Personal Representative X Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 0041 50 BOGAR JAMES D 1 W MAIN STREET SHIREMANSTOWN, PA 17011 ........ fold ESTATE INFORMATION: SSN: 160-16-4147 FILE NUMBER: 2103-021 6 DECEDENT NAME: THORN EDWARD J DATE OF PAYMENT: 07/12/2004 POSTMARK DATE: 07/1 2/2004 COUNTY: CUMBERLAND DATE OF DEATH: 02/06/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,595.43 REMARKS: TOTAL AMOUNT PAID: $1,595.43 SEAL INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS For ~-'O ~' I' ~' I, 8 ? ~8': 5OO~, 30qO 7 5,' REV- 1500 EX * (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 171Z8-0601 D E C E D E N T HP? CR~ KO~ R E C A P I T U L A T I 0 N REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT C O M T O DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Thorn Edward J. DATE OF DEATH (MM-DO-YEAR) I DATE OF B{RTH (MM-DO-YEAR) 02/06/2003 I 03/03/1920 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USEONLY FILE NUMBER 21-03-0216 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 160-16-4147 THIS RETURN MUST BE RLED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 1. OriginaIReturn ~ 2. Supplemental Return ~ 4. Limited Estate 4a. Future Interest Compromise (date of death after 1;'- 1Z-8Z) 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 (Attach copy of Will) (Attach copy of Trust) F'---]" Litigation Proceeds Received I--'-110. Spousa, Poverty Credit i~1 (date of death between 1Z-31-91 and 1-1-95) (date of death 3. Remainder Return prior to 1Z- 13-8Z) 5. Fed:eral Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME James D. Do,ar Esquire FI RM NAME (If Applicable) TELEPHONE NUMBER 717,/737-8761 COMPLETE MAILING ADDRESS One West Main Shiremanstown, Street PA 17011 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or (3) Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) E~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11 ) 13. 14. None 1,317.95 Non-e None 1,345.90 5,004.40 82,597.50 3,869.19 50,942.61 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) OFFICIAL USE ONLY (8) 90,265.75 (11) 54,811.80 (12) 35,453,95 (13~ (14) 35,453.95 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 35,453.95 X .0 0 (15) 0.00 X .0 45 (16) 1,595.43 X .12 (17) 0.00 X .lS (18) 0.00 19. Tax Due (19) 1,595.43 Copyright (c) 2000 form software only The Lackner Group. Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STR~-~- i ADDRESS 1000 Valley Street CITY Enola Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty I STATE ZIP PA 17025 1,595.43 (1) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line .5 + SA. This is the BALANCE DUE. (SB) 0.00 0.00 0.00 1,595.43 0.00 1,595.43 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; ......................... r"-] 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? ................................ r--] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and compJete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Edward F. Thorn DATE SIGNATURE OF PF~EPARER OTHER THAN REPRESENTATIVE 3ames D Bogar Esquire DATE //~ ~ .~.,.~A One Wes~ Main Street 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 does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2) [72 P.S. 9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Copyright (c) ~'000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) ADDITIONAL Personal Representatives Estate of Edward J. Thorn SS# 160-16-4147 02/06/2003 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. Signature Marne Address Line 1 Address Line 2 City, State, Zip Date Ch erry T. Gronski 2836 S. Queen Street Dallastown, PA 17313 REV-I$03 EX + {1-97) COMMONWEALTH OFPENNSYLVANIA INHERITANCETAXRETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Edward J. Thorn SSf/ 160-16-4147 02/06/2003 21-03-0216 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION U. NIT VALUE OF DEATH 1 43 Prudential Financial, Inc. - 43 shares of Prudential 30.65 1,317.95 Stock ,.~ TOTAL (Also enter on line 2, Recapitulation) 1,317.95 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, inc. Form REV-I$03 EX (Rev. 1-97) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAXRETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER Edward J. Thorn SS# 160-16-4147 02/06/2003 21-03-0216 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION AARP Insurance Refund of Healthcare Insurance Premium United Services Automobile Association - Payment received as a result of Decede~t's car (1985 Buick LeSabre), being considered totaled as a result of damages that were incurred prior ko date of death TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE Of DEATH 115.00 1,230.90 $ 1,345.90 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, [nc. Form REV-I$08 EX (Rev. 1-97) REV- 1509 EX + (1-97) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Edward J. Thorn SS~/ 160-16-4147 02/06/2003 21-03-0216 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Robert M. Thorn Son 1000 Valley Street Enola, PA 17025 JOINTLY-OWNED PROPERTY: LI~fTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financIal institution and bank DATE OF DEATH DECD'S VALUE OF account number or similar identifying number. NUMBER TENANT JOINT Attach deed forjoirttly-held realestate. VALUE OF ASSET INTEREST DECEDENT'S INTERES 1 A 08/28/64 M&T Bank - Checking Account 10,008.79 50.00% 5,004.40 No. 85561037, date of death balance $10,008.79, accrued interest $0.00 2 A M&T Bank - Checking Account 0.00 50.00% 0.00 No. 85564494, date of death balance $0.00, accrued interest $0.00 TOTAL (Also enter on line 6, Recapitulation) $ 5,004.40 (If more space is needed insert additional sheets of the same size) C~3pyrfght (c) 1996 form software only CPSystems, Inc. Form REV-I{~09 lex (Rev. 1-97} MaTBank April21,2004 499 Mitchell Street, Millsboro, DE 19966 James D. Bogar Attorney At Law One West Main Street Shiremanstown, PA 17011 Estate of Edward J. Thorn Date of Death: February 6, 2003 Social Security Number: 160-I6-4147 Dear Mr. Bogar: In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following accounts. Account Type ........................... Checking Account Account Number. ...................... 85561037 Ownership (Names of) ..............Edward J. Thom, Robert M. Thom Opening Date ........................... 08/28/64 (account closed 12 / 09 / 03) Balance on Date of Deatk ......... $10,008.79 Accrued Interest $ 0.00 Total ...................................... $10,008.79 Account Type ........................... Checking Account Account Number. ...................... 85564494 Ownership (Names oJ} ..............Edward J. Thom, Robert M. Thom Opening Date ........................... 06/28/82 (account closed 02/06/03) Balance on Date of Deatk ......... $0. O0 Accrued Interest $0.00 Total ...................................... $0.00 · Page 2 April 21, 2004 Accourrt Type ........................... Installment Loan Account Number. ...................... 10000192598380001 Ownership (.Names oj~ ..............Edward J. Thom Opening Date ........................... 03/15/02 {account closed 07/05/'03) Balance on Date of Death. ......... $43,569.00 Sincerely, Charlene V~ arrington, Recor~/s Management 1-888-502-4349 REV-1510 EX* (1-97) SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC, NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Edward J. Thorn SS~; 160-16-4147 02/06/2003 21-03-0216 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes, DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFERE~THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE, VALUE OF ASSET INTEREST (IF APPLICABLE) 1 Ail that certain piece or 85,597.50 3';000.00 82,597.50 parcel of real estate - having erected thereon a dwelling house being known and numbered as 1000 Valley Street, Enola, , Pennsylvania, being Tax Parcel No. 09-13-0999-020. The property was conveyed to Edward 3. Thorn, widower, Robert Michael Thorn and Heather Marie Thorn, husband and wife, as joint tenants with the right of survivorship, by Deed dated January 15, 2003 and recorded February 6, 2003 in the Cumberland County Recorder of Deeds Office in Deed Book 255, Page 3380. See attached copy of Deed dated 3anuary 15, 2003. It is respectfully suggested that the fair market value of the real estate, as of 2/6/03, the date of death, is as follows: $84,750 (county assessed value) x 1.01 (common level ratio factor in effect on date of death) = $85,597.50. Furnishings in home are of no value. TOTAL (Also enter on line 7, Recap~ulation) $ 82,597.50 (If more space ~s needed, insert additional sheets of the same s~ze) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1510 EX (Rev. 1-97) .p.: Tax 2~cel ID #: .' .: --_ F',T ~:. ZiE',3LEF: . .,.~-.~'~', 0-': DEE''''¢ ~ EP, LAhlD OOUNT'f-" O3 FEB 6 £ 3O General Warranty Deed This Indenture, Made the lSth day of January, 2003, Between Edward J. Thom (widower) and husband of the late Dorothy L. Thorn, grantor of the first part and Edward J. Thorn, widower, Robert Michael Thom and Heather Marie Thorn, husband and wife, as joint tenants with right of survivorship and grantees of the second part. WlTNESSSETH, that said Grantor(s) for and in consideration of the sum of one and 00/100 dollars, paid to the Grantor(s) by the Grantee(s) does grant, bargain, sell, and convey unto the said Grantee(s), their heirs and assigns, ALL that certain portion of farm and tract or piece of land situate in the Township of East Pennsboro, County of Cumberland and State of Permsylvania further bounded and described to wit: BEGINNSN'G at a point in the center line of Valley Road and Sak Road; THENCE along the center line of Salt Road South 41 degrees 45 minutes East 100 feet to a point at line of land now or late of John L. Gutshall, et u.x; THENCE along same South 48 degrees 15 minutes West 150 feet to a point; THENCE further along same North 41 Degrees 45 minutes West 147.6 feet to a point in the center line of Valley Road aforesaid; THENCE along same North 65 degrees 5'2 m/nutes East 157.88 feet to a point the place of BEGINN~'G. BEING premises known as 1000 Valley Road. BEING the same property which Raymond L. Dallmeyer and Mary E. Dallmeyer, his wife conveyed by their deed of November 12, 1958 duly recorded in the Office of the Recorder of Deeds in and for Cumberland County at Deed Book U18 Page 206 unto Edward f. Thorn and the late Dorothy L. Thorn, the grantor(s) herein. THIS CONVEYANCE IS EXEMF'r FROM TRANSFER TAX AS IT IS BETWEEN PzadtENT AND With the appurtenances: To Have and To Hold the same to and for the use of the said GRANTEES, their heirs and assigns forever, And the GRANTOR for their heirs and assigns hereby covenant and agree that they will release their interest and generally warrant the property hereby conveyed. 2,5,5 ',',013380 In V/itness Whereof, The said Grantor(s) has/have hereunto set hand and seal the day and year first above written. Witness (Seal) CO~vLi~[ONW!:_g I_TH OF PENN'SYLVANIA COUNTY OF cLr~mERLAND On this the /5~ay of .J'6~/oC/O/',,v' ,2003, before me, the undersized officer, personally appeared Edward J. Thorn, known to me (or satisfactorily proven) to be the person(s) whose name or names are subscribed to the within instrument and acknowledged that he executed the same for the purpose therein contained and acknowledge the foregoing to be his free act and deed. . ?: :¢~ ,.¢'.i .~.~., / NIx Commission Expires:~~"--~--/' I, hereby certify that the precise residence of the GR.~NTEE herein as follows: 4-5- VALLEY ROAD ENOLA, PA 17025 Witness my hand this/~'r~y of ,,7'~/9~i~~,~ / ,2003 Lee E. 0estert~~re - '~ .... . P~P~D BY ~ ~~ TO: .c [~.~S [0 ~e recor~e~ Lee E. Oe~t~g & ~Sociates, LLC [ Ce~3 :~ ~,,,, ,~[V p :k 42 E~ Ma~ S~eet C,¢Bi oc~ ~ ....... ~,, ' Mec~csb~g, PA 17055 ~B ;, -... · .' ..< .... .'-~' / .,4~ REV- 1511 EX *(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Edward J. Thorn SS~; 160-16-4147 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS 02/06/2003 FILENUMBER 21-03-0216 Debts of decedent must be reported on Schedule I. ITEM NUMBER 1 2 3 4 1 2 3 4 5 DESCRIPTION FUNERAL EXPENSES: American Catholic Church - Honorarium Gingrich Memorials - Monument Engraving J. C. Snyder Florist Funeral Flowers Patriot News Co. Obituary Total of Continuation Schedule(s) ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney's Fees James D. Bogar Esquire 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 Probate Fees Accountant's Fees Register of Wills Tax Return Preparer's Fees Other Administrative Costs Cumberland Law Journal - Estate Notice Paxton Herald - Estate Notice Register of Wills - Three (3) Short Certificates Register of Wills - Copies RESERVES: Costs to conclude administration of Estate including filing fee for PA Inheritance Tax Return, Inventory and First & Final Account; preparation of Personal and Fiduciary Income Tax Returns Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation AMOUNT 50.00 125.00 112.31 278.20 625.00 1,757.50 42.00 75.00 39.44 9.00 5.50 750.00 0.24 $ 3,869.19 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, inc. Form REV-l$11 EX (Rev. 1-97) Estate of: Edward J. Thorn Soc Sec #: 160-16-4147 Date of Death: 02/06/2003 Item Description Continuation of Schedule H-A (Funeral Expenses) Amount 5 Woodlawn Memorial Gardens Burial 625.00 625.00 Estate of: Edward J. Thorn Soc Sec #: 160-16-4147 Date of Death: 02/06/2003 Item Description Continuation of Schedule H-B7 (Other Administrative Costs) Amount U.S. Postal Service -. Postage Due incoming mail from Robert M. Thorn 0.24 0.24 REV-151Z EX + {1-97) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Edward J. Thorn SS~; 160-16-4147 02/06/2003 21-03-0216 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT Citibank Universal Card Services Payoff of Credit Card 1 2 M&T Bank Installment Loan, Account No.10000192598380001, date of death balance $43,569.00. See Page 2 of M&T Bank letter dated April 21, 2004 attached. TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) 7,373.61 43,569.00 $ 50,942.61 Coloyrlght (c)1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) MaTBank April 21, 2004 499 Mitchell Street, Millsboro, DE 19966 James D. Bogar Attorney At Law One West Main Street Shiremanstown, PA 17011 Estate of Edward J. Thom Date of Death: February 6, 2003 Social Security Number: 160-1'/5-4147 Dear Mr. Bogar: In response to your request, please be advised that at the time of death, the above- named decedent had on deposit w/th this bank the following accounts. Account Type ........................... Check/ng Account Account Number. ...................... 85561037 Ownership (Names of) ..............Edward d. Thom, Robert M. Thom Opening Date ........................... 08/28/64 (account closed 12/09/03) Balance on Date of DeatE ......... $10,008.79 Accrued Interest $ 0.00 Total. ...................................... $10,008.79 Account Type ........................... Checking Account Account Number. ...................... 85564494 Ownership (Names of) ..............Edward J. Thom, Robert M. Thom Opening Date ........................... 06 / 28/82 (account closed 02 / 06 / 03) Balance on Date of DeatE ......... $0.00 Accrued Interest $0.00 Total. ...................................... $0.00 · Page 2 April 21, 2004 o Account Type ........................... Installment Loan Account Number ....................... 10000192598380001 Ownership (Names o~ .............. Edward J. Thom Opening Date ........................... 03/15/02 (account closed 07/05/(~3) Balance on Date of Death. ......... $43,569.00 Sincerely, Charlene ~VanSngton, Recor~'s Management 1-888-502-4349 REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Edward J. Thorn SS~/ 160-16-4147 SCHEDULE J BENEFICIARIES 02/06/2003 FILENUMBER 21-03-0216 NUMBER I. 2 II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 91 Cherry T. Gronski 2836 S. Queen St. Dallastown, PA 17313 Edward F. Thorn 311 Pinewood Drive Shiremanstown, PA 17011 Heather M. Thorn 1000 Valley Street Enola, PA 17025 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter S on Daughter-in-Law AMOUNT OR SHARE OF ESTATE One sixth (1/6) of rest, residue and remainder One sixth (1/6) of rest, residue and remainder Specific bequest of real estate being known and numbered as 1000 Valley Street, Enola, PA 17025 and ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18. AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: i A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) $ 0.00 Co!oyrfght (c') ZOO0 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) Estate of: Edward J. Thorn Soc Sec #: 160-16-4147 Date of Death: 02/06/2003 Continuation of Schedule J, Part I (Taxable Bequests) Item Name and Address of Beneficiary Relationship ;dnount or Share of Estate 4 7 Joseph A. Thorn 125 Second Street Enola, PA 17025 Judith A. Thorn 699 Torway Road Gardners, PA 17324 Kenneth L. Thorn 1351 Wandering Way Harrisburg, PA 17110 Robert M. Thorn 1000 Valley Street Enola, PA 17025 Son Daughter Son Son furnishings, jointly with her husband, Robert M. Thorn, son of the Decedent One sixth (1/6) of rest, residue and remainder One sixth (1/6) of rest,. residue and remainder One sixth (1/6) of rest, residue and remainder One sixth (1/6) of rest, residue and remainder, plus specific bequest of real estate being known and numbered as 1000 Valley Street, Enoia, PA 17025 and furnishings. The real estate in this specific bequest was conveyed prior to date of death. LAST WiLL and TESTAMENT of EDWARD J.THORN I,Edward J.Thom, of East Permsboro Township, ctanberland County, Pennsylvania being of so,und m/nd and understanding, do make publish and declare this My Last Will and Testament in mzanner as follows. I, Edward J.Thorn at the ,time of My death leave my house and furnishings to my Son Robert M.Thorn and kis wife Heather under certain conditions. The above mentioned must live at property until equity loan is paid in full .They then will be sole owners and then the land, home and all furnishings will belong to them. But ff they decide to sell said property before the note is paid, they must then settle the note with the proceeds of sale and the balance to be split in equal shares with my then living Children including Himself. They will also will be liable for property taxes and sewerage and trash fees.If at any time he was at default on the payments,the property wo 'uld then be sold to satisfy the bank judgement and balance would then be divided among the survivors, including hisself. Otherwise they would be the sole owners of said property when they finished paying the note and could do with the property as they wanted. This Will Supersedes any and all Signed this day of former Wills that I formerly made. Edward J.Thom October 23,2001 O..UR LORD October 23,2001 ttOTARIAL SF..AL LLOYD p. $CI41~O~DE~, lqo~at$, Pu ~,l~H~arn~s.~urg, Do~ollin County ~au~";J r~y ~;ommL~ion '-. ~;£'",: '_'~_ / -~.~.Exo~,~ ~-y ~, 2005 Register of Wills of CUMBERLAND INVENTORY County, Pennsylvania Estate of Edward J. Thorn also known as , Deceased No. 21- 03- 0216 Date of Death 02/06/2003 Social Security No. 160-16-4147 Edward F. Thorn and Cherry T. Gronski, Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item 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 except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: I.D. No.: James D. Bo~ar Esquire 19475 Address: One West Main Street Shiremanstown, PA 17011 Telephone: 717/737-8761 Personal Representative Signature: ~~~. ~l~/rd F. Thorn Signature: ~i~, ~-~'"~ L Cherry. Gronski Address: 311 Pinewood Drive Shiremanstown, PA 17011 Telephone: 717/737-0672 Dated: Description "~:Value (See continuation page(s) attached) (Attach additional sheets if necessary) Total: 2,663.85 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form #RW-7 (1992) Estate of: Date of Death: County: Edward J. Thorn 02/06/2003 Cumberland INVENTORY CASH: AARP Insurance - Refund of Healthcare Insurance Premium United Services Automobile Association - Payment received as a result of Decedent's car (1985 Buick LeSabre), being considered totaled as a result of damages that were incurred prior to date of death 115.00 1,230.90 STOCKS/LISTED: Prudential Financial, Inc. 43 shares of Prudential Stock 1,317.95 1,345.90 TOTAL RECEIPTS OF PRINCIPAL ............... 1,317.95 2,663.85 -1- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128~0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 004452 B©GAR JAMES D 1 W MAIN STREET SHIREMANSTOWN, PA 17011 ESTATE INFORMATION: SSN: 160-16-4147 FILE NUMBER: 2103-021 6 DECEDENT NAME: THORN EDWARD J DATE OF PAYMENT: 10/01/2004 POSTMARK DATE: 10/01/2004 COUNTY: CUMBERLAND DATE OF DEATH: 02/06/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $46.07 TOTAL AMOUNT PAID: $46.07 REMARKS: CHECK SIGNED BYGRONSKI/THORN\ CHECK NOT NUMBERED SEAL INITIALS: GFS RECEIVED BY' GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDZVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARR[S~URG, PA 171Z6-0601 JAMES D BOGAR I W MAIN ST t SHIREMANSTO~ ESq COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN PA' 17011 09-1q-200q THORN 02-06-2005 21 05-0216 CUMBERLAND 101 Aaoun~ Reai~ed EDWARD J MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS REV-1547 EX AFP [01-03) NOTZCE OF ZNHERZTANCE TAX APPRAISEMENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTZONS AN/) ASSESSMENT OF TAX ESTATE OF THORN EDWARD J FZLE NO. 21 03-0216 ACN 101 DATE 09-1q-ZOOq TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST ' SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~ca~e (Schedule A) (1) . O0 NOTE: To insure proper 2. S~:ocks and Bonds (Schedule B) (2) credi~c ~:o your accoun~¢ :5 Closely Held S~cock/Par~:nership In~:eres~c (Schedule C) ($) subai~c ~che upper por~cion · of ~chis form wi(h your q. Hor(gages/No(es Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Proper~cy (Schedu[e E) [5) ~ex payaen~c. 6. Jointly Owned Proper~cY (Schedule F) (6) 7. Transfers (Schedule G] (7) 8. To,al Asse~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ada. Costs/Misc. Expenses (Schedule H) 10. Deb~cs/Mor~gage Liabilities/Liens (Schedule I) 11. To,al Deductions 12. 15. NOTE: lz$17.95. .00 .00 l~345.90 5/00q.q0 82~597.50 (8) 3,869.19 (9) (~o) 50 ~9q2.61 (11) Ne~ Value of Tax Re~urn (12) Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Ne~ Value of Es~a~e Sub~ec~ ~o Tax If an assessment was issued previously, lines 14, 15 and/or 16, 17, reflect f/Ourse that include the total of ALL. returns assessed to date. 90,265.75 56, .811.80 35,6,53.95 .00 35,653.95 18 and 19 will .00 ASSESSMENT OF TAX: .00 x 00 = 15. Aaoun~ of Line lq a~ Spousal ra~e (15) 16. Aaoun~ of Line lq ~axable a~ Lineal/Class A ra~e (16) 35,q53.95 X 0q5: 1,595.6,3 · O0 x 12 : . OO 17. Aaoun~ of Line lq a~ Sibling ra~ce (17) 00' · O0 x 15 = · 18. Aaoun~ of Line lq ~axable a~ Collateral/Class B ra~e [18) (zg): 1,595. 19. Principal Tax Due DZ$COUN1 INTEREST/PEN PAID (-) .0O AMOUNT PAID 1,595.6,3 TOTAL TAX CREDZT BALANCE OF TAX DUE/ ZNTEREST AND PEN-/ TOTAL DUE RECEZP] NUMBER CD006,150 TAX CREDITS: DATE 07-1Z-2006, BALANCE OF UNPAID INTEREST/PENALTY AS OF 07-13-ZO0q IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 1,595· 6,3 .00 q6.07 q6.07 ( IF TOTAL DUE IS LESS THAN 01, NO PAYMENT tS REOU/RED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTVTS/ON DEPT. Z80601 HARRISBURG, PA 171Z8-0601 ROBERT N THORN 1000 VALLEY ST ENOLA CONNONWEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE Z~ERZ'r'ANCE TAX RECORD ADJUSTNENT JOINTLY HELD OR TRUST ASSETS PA 17025-1558 REV-],60'~ EX AFP CD1-05) DATE 08-Z6-ZO04 ESTATE OF THORN EDWARD J DATE OF DEATH 02-06-Z005 FZLE NUMBER 21,40216 COUNTY CU~ANDc:~ SSN/DC 160~16-414~ Amoun :: :, HAKE CHECK PAYABLE:'AND REld..~.]:T PAyHENT TO: REGISTER OF WILLS CUHBERLAND CO:COURT ~USE CARLISLE, PA 17015 CUT ALONG THIS LINE ~'* RETAIN LOWER PORTION FOR YOUR RECORDS *~ REV-1604 EX AFP (01-03) ~ INHERITANCE TAX RECORD ADJUSTHENT JOINTLY HELD OR TRUST ASSETS DATE 08-26-2004 ESTATE OF THORN EDWARD J DATE OF DEATH 02-06-2005 COUNTY CUHBERLAND FILE NO. 21 05-0216 S.S/D.C. NO. 160-16-4147 ACN 05112505 ADJUSTHENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST BANK ACCOUNT NO. 0085561057 TYPE OF ACCOUNT: ( ) SAVINGS eX) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 08-28-1964 Account Balance Percent Taxable X. Amoun~ Sub~ec~ ~o Tax Debts and Deductions Taxable Amount Tax Ra~e X Tax Due .00 NOTE: 0.500 .00 .00 .00 .45 .O0 TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHZT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYHENT TO THE REGISTER OF NZLLS AT THE ADDRESS SHO#N ABOVE. HAKE CHECK OR HONEY ORDER PAYABLE TO: **REGISTER OF NXLLS, AGENT.ff TAX CREDITS: PAYHENT DATE RECEIPT NUHBER DISCOUNT (+) INTEREST/PEN PAID (- AHOUNT PAID TOTAL TAX CREDIT I I BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ZF PA/D AFTER TH/S DATE, SEE REVERSE FOR CALCULATTON OF ADD/T/ONAL /NTEREST. ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THTS FORH FOR TNSTRUCTZONS.) .00 .00 .00 .00 PAYHENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- Hake check or money order payable to: REGISTER OF HILLS, AGENT. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania /nharitance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills, any of the Z3 Revenue District Offices or from the Depart~ent's Z~-hour answering service for farms ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and / ar speaking needs: 1-SOO-~fiT-3OZO (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601, Phone [7173 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (SZ) discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of tho tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency er nine (9) months and one (1) day free the date of death to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .gOO16q. All taxes which became deZlnquent on and after January [, 198Z ail[ bear interest at a rate ahich Nil! vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for I98Z through 2003 ara: Interest Daily Interest Daily Interest Daily Rate Factor Year Rate Factor Yea.__r Rate Factor 198Z ZOZ .0005~8 1987 9Z .O00Z~7 1999 7Z .O0019Z 1983 16Z .000~38 1988-1991 X1Z .000501 2000 8Z .000219 198~ 112 .000301 1992 92 .O00Z~7 2001 92 .0002~7 1985 13Z .000356 1993-199~ 7Z .O0019Z ZOOZ 6Z .00016~ 1986 IOZ .O00Z7~ 1995-1998 9Z .O00Zfi7 ZOO3 5Z .0D0137 --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 becomes dallnquant will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. REV-1470 EX (6-88) (~ INHEI~i~'AN~E TAX EXPLANATION GOMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG~ PA 17128-0601 DECEDENT'S NAME FILE NUMBER Thorn, Edward J 21 03-0216 REVIEWED BY ACN Steven James 03112503 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The above referenced ACN has been adjusted to $0 as it was reported and paid on the probate return. ROW Pa.qe 1 BUREAU OF INDIVIDUAL TAXES /NHERITANCE TAX D/VTS/ON DEPT. Z80601 HARRTSBURG, PA 171Z8-0601 JAMES D BOGAR ESQ ! W MAIN ST SHIREMANSTOWN COMHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX RE¥-1547 EX AFP DATE 09-14-ZOOq ~*' ESTATE OF THORN ~DATE OF DEATH 02-06-2005 FILE NUMBER 21 05-0216 '04 SEP ] 5 /~ 8 ~NTY CUMBERLAND 101 EDWARD J PA 170111~j. Amoun~ Resin*ed HAKE CHECK PAYABLE AND REM/T PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORT/ON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF ZNHER/TANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF THORN EDWARD J FILE NO. 21 05-0Z16 ACN 101 DATE 09-1q-200~ TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: 0RTGINAL RETURN 1. Real Es/:a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B} (2) 3. Closely Held S/:ock/Par/:nersh/p Zn~eres~ (Schedule C) (3) q. Nor/:gagas/No~es Receivable (Schedule D) (q) 5. Cash/Bank Deposi/:s/Nisc. Personal Proper/:y (Schedule E) (S) 6. Join/:ly Owned Proper/:y (Schedule F) (6) 7. Transfers (Schedule G} (7) 8. To/:al Asse/:s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad.. Cos~s/Nisc. Expenses (Schedule H) (9) 10. Deb/:s/Nor/:gege Liabili/:ies/Liens (Schedule I) (10:) 11. To,al Deduc/:ions 12. Ne~ Value of Tax Re/:urn .O0 lz317.95 .0O .0O lz$~5.90 5~00~.~0 82z597.50 (8) 3,869.19 NOTE: To insure proper credi/: /:o your accoun/:, subei/: ~he upper portion of /:his for. wi~h your ~ax pay.en~. 13. NOTE: 07-1Z-ZOOq 90,265.75 50~9~Z.61 (11) 5~,8]1.80 (12) 35,~53.95 .00 BALANCE OF UNPAID INTEREST/PENALTY AS OF 07-15-Z00~ AHOUNT PAID 1,595.~$ TOTAL TAX CREDIT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE (~5) .00 X O0 = .00 (16) $5,q55.95 X 0q5 = 1,595.q3 (17) .00 X 12 = .00 (lB) .00 x 15 = .00 (19)= 1,595.q$ ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 1,595.q$ .00 q6.07 ~6.07 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE STDE OF TH'rS FORH FOR 'rNSTRUCTIONS.) ASSESSMENT OF TAX: 15. A.oun/: of Line lq a/: Spousal ra/:a 16. Aeoun/: of Line lq ~axabla a~ Lineal/Class A ra/:e 17. Amoun/: of Line lq a~ Sibling ra/:e 18. A.oun/: of Line lq /:axeble a~ Collateral/Class B ra~e 19. Principal Tax Due TAX CREDITS: PAYH~NT . R~EIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) CDO0~150 .00 reflect figures that include the total of ALL returns assessed to date. Cheri/:able/Governmen~al Beques/:s; Non-elec/:ad 9115 Trus*s (Schedule J) (15) Ne/: Value of Es/:a~:a Sub3ec/: /:o Tax (lq) ~5, qS,~. 95 re an assessBent ~as Assued previously, lanes 14, 15 and/or 16, 17, 18 and 19 RESERVATION: PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS= ADHIN- ZSTRATZVE CORRECTIONS: DZSCOUNT: PENALTY= INTEREST: Estates of decedents dying on or before December 12, 1981 -- if any futura interest in the estate is transferred in possession or enjoyment to Class S (collateral) beneficiaries of the decedent after the expiration of any estate for tile or for years) the Coemonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act) Act Z$ of 2000. (71 P.S. Section 9140). Detach the tap portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NZLLS) AGENT A refund of a tax credit) ahich was not requested on the Tax Return) may ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications ere available at the Office of the Register of Nills) any of the 15 Revenue District Offices, or by calling the special Z4-hour mnsaering service for forms ordering: 1-800-361-Z050; services for taxpayers aith special hearing and / or speaking needs= 1-800-447-3010 iTT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions) or assessment of tax (including discount or interest) as shomn on this Notice must object eithin sixty (60) days of receipt of this Notice by: --aritten protest to tho PA Department of Revenue) Board of Appeals, Dept. 181011) Harrisburg, PA 17118-1011) OR --election to have the matter determined at audit of the account of the personal representative) OR --appeal to the Orphans' Court, Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue) Bureau of Individual Taxes, ATTN: Past Assessment Review Unit, Dept. Z80601, Harrisburg, PA 17118-060! Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the dacedent's death, a five percent (SZ) discount of the tax paid is allowed. The 151 tax amnesty non-participation penalty is computed on the tatar of the tax and interest assessed) and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning aith first day of delinquency) or nine (9) months and one (1) day free the date of death) to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest et the rate of six (61) percent per annum calculated at a daily rate of .000164. Al! taxes which became delinquent on and after January 1) 1982 will bear interest at a rate which will vary frae calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through Z004 are: Interest Da i ly Interest Daily Interest Year Rate Factor Year Rate Factor Year Rate 1981 ZOZ .0005~,8 1988-1991 llX .000501 ~ 91 1983 162 . O O 0438 1992 92 . OO 0247 ZOO Z 62 1984 112 .000301 1993-/994 71 .000191 ZOO3 52 1965 132 .000356 1995-1998 92 .000247 2004 42 1986 101 .000274 1999 71 .000192 1987 lOX .000274 ZOO0 72 .000192 --Interest is calculated as follows: ZNTEREST= BALANCE OF TAX UNPATD X NUI~BER OF DAYS DELZNqUENT X DAZLY ZNTEREST FACTOR Daily Factor .000247 .000164 .000137 .000110 --Any Notice issued after the tax becomes delinquent wlll reflect an lnterast calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF 'rND'rVzDUAL TAXES TNHERTTANCE TAX nTVTSIOH PO BOX Z80601 HARRTSBURg, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE ZHHERZTANCE TAX STATEMENT OF ACCOUHT REV-/607 EX AFP (09-0~) JAMES D BOGAR ESQ 1 W MAIN ST '- SHIREMANSTOWN PA 17 01~12,. DATE 11-15-200q ESTATE OF THORN EDWARD DATE OF DEATH 02-06-2005 FILE NUMBER 2! 05-0216 --COUNTY CUMBERLAND ACN 101 Amoun~ Remi~ed MAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA I7015 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his fore wi~h your ~ax payment. CUT ALONG THIS L'rNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -',ql ESTATE OF THORN EDWARD J FILE NO. 21 05-0216 ACN 101 DATE 11-15-200q TH/S STATEMENT 1S PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHO#N BELO# KS A SUMMARY OF THE PRZNC[PAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: O9-1q-Z00q PRINCIPAL TAX DUE: ............................................................................................... PAYMENTS (TAX CREDITS): 1,595.q3 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID .00 07-12-200q 10-01-Z00q CDOOq150 CDOOqqSZ q6.07- 1,595.q3 q6.07 ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), TOTAL TAX CRED'rT 1,595.q$ BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THI'S FORM FOR TNSTRUCTTONS. PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF NILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or monmy order payable to: COHHONNEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, amy be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-X313). Applications are available online at www.revmnua.stata.pa.us, any Register of Nills or Revenue District Office, or from the Department's Z~-hour answering service for forms orders: 1-800-36Z-ZOSO; services for taxpayers with special hearing and/or speaking needs: 1-800-~7-3020 (TT only). REPLY TO: DISCOUNT: PENALTY: questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit) P.O. Dox 280601, Harrisburg, PA 17liD-g601, phone (717) 787-6505. If any tax due is paid within three (3) calendar months after the dacedant's death, a five percent (52) discount of the tax paid is allowed. The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 1982 bear interest at the rate of six (62) percent per annum calculated at a daily rate of .08018~. A11 taxes which became delinquent on and after January 1, 1982 ail1 bear intarmst at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates far 1982 through ZO0~ ara: Interest Daily Interest Daily Interest OaiZy Year Rate Factor Year Rate Factor Year Rate Factor 1982 202 .0005~8 1988-1991 Ill .000301 ZOO1 9X .'0002~7 1983 162 .000~38 1992 92 .0002~7 ZOOZ 62 .00016~ 198~ 11Z .000301 1995-199q 72 .000192 2003 52 .000137 1985 132 .000356 1995-1998 9Z .0002~7 ZO0~ ~Z .000110 1986 XOZ ,00027~ 1999 72 .000192 1987 92 .000247 ZOO0 82 .000219 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must bm calculated. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 1/10/2005 BOGAR JAMES D 1 W MAIN STREET SHIREMANSTOWN, PA 17011 RE: Estate of THORN EDWARD J File Number: 2003-00216 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 2/06/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge STATUS REPORT UNDER RULE 6.12 Name of Decedent: Edward J. Thorn Date of Death: February 6. 2003 will No. 21-03-0216 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes XX No 2. I f the answer is No, s ta te when the personal representative reasonably believes that the administration will be complete: 3. I f the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No XX 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? YesXX No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. ~}~: 8lj./12/05 l..L.J' en C co C"i::- ?!-~; .1 ~~ l_L~ CJ . ffi?:~~' u~}~:', cc~. Os (.,) cry James D. Bog Esquire Name (Please, type or print) One West Ma~n St. Shiremanstown, FA 17011 Address .~ ~; Q' C) U UJ CL: ..-.c:'" ~ -, ,..-:r = ~ "" (717) 737-8761 Te l. No. Capacity: Personal Representative x Counsel for personal representative ~ (MAH: rmf! AM3)