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Home My WebLink About03-0427Estate of ROBERT M. KNISELY also known as PETITION FOR PROBATE and GRANT OF LETTERS No. To: , Deceased. Social Security No. 164 - 30-4487 Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older ~Xthe execut°rs in the last will of the above decedent, dated June 6 ~ and codicil(s) dated None in the named 2002 ,~.__ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h is last family or principal residence at Messiah Village, 100 Mt. Allen Drive, Upper Allen Township(PostOffice: Mechanicsburg, PA 17055). (list street, number and muncipality) Decendent, then 90 years of age, died January 28, 2003 ,1[9[ at Holy Spirit Hospital, East Pennsboro Township, Cumberland County, PA ' Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: None Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ Unestimmted $ $ None WHEREFORE, petitioner(s) respectfully request(s) the probate of the last.~wjll aad codiCILs) presented herewith and the grant of letters ¢~ee-~at~rr~-~ ........ .-- ~ ....... t,, t ..... l, (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) thef~ ~~ ~ ~ Sandra Ann Knisely Robert L.~Knisel¥ o 6395 South Glencoe Court 5750 South'?~teele Street ~=.= ~'= Littleton. G0-80121 Greenwood Vi~e, CO 80121 OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA q COUNTY OF Cumberland y SS The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed beforfe me this ..__10+..~ _ day of [ .. ,., gOx2003 ~-0,(,~~ ~]I~egister Robert [. Kn~selX Sandra Ann Knisely ~ No. ~q~ - t~$ - q~q-/ Estate Of Robert M. Knisely , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW _ .~c~o_ ~-~ XI~2_%.0_0.3_, in consideration of the petition on the reverse side hereof, ~'atisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated June 6~ 2002 described therein be admitted to probate and filed of record as the last will of Robert M. Knisely ; and Letters T~.mtnmantmry ] are hereby granted to Robert L. Knisel¥ and Sandra Ann Knisel¥ Probate, Letters, Etc .......... Short Certificates( ) .......... Renunciation ................ ~p TOTAL m~ea . .~. r~.~.9.~. ..................... /~ k Regist¢: of WiL~ 0 Mechan±¢sburg, Pg- 17055-0318 ADDRESS (717) 697-8528' PHONE SUPPLEMENT/AMENDMENT TO PREVIOUSLY FILED PETITION PETITION FOR PROBATE and GRANT OF LETTERS Estate of Robert M. Knisely also known as Register of Wills for the Deceased. County of Cumberland in the Social Security No. 164-30-4487' Commonwealth of Pennsylvania No. To: named ,19.__ The petition of the undersigned respectfully represents that: tne nommnee of an Your petitioner(s), who is/are 18 years of age or older/an the execut°r in the last will of the above decedent, dated June 6, 2002 and codicil(s) dated None This petition amends and supplements a Petition submitted heretofore, and ms the result of renuncmation of Robert L. Knisely previously tiled. (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h is last family or principal residence at 100 Mt. Allen Drive, Upper Allen Township, (Mechanicsburg, PA 17055) (list street, number and muncipality) Decendent, then 90 years of age, died January 28, 2003 , ~). ., at Holy Spirit Hospital, East Pennsboro Township, Cumberland County, PA Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: None Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: None Unestimated WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the granlof letters of administ:rati.o.n d.e bo. nis_.ngn cum testamento annexo, in addition to letters to be .~_ssuea to.~anara Ann ttestamentary; aam~mstrat~on c.t.a.; aamm~stration d.b.n.c.t.a.) theron. Virginia L. Knisely (J' 100 Mt. Allen Drive Mechanicsburg, PA 17055 OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA -] COUNTY OF CUMBERLAND ; 88 The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affir and subscribed ~ before me this day of Vi~ginma L. --__ May - ~ 2003 ~ ~ ~' ~ ~ORegister ~ No. Estate Of ROBER~ M. ~SEL~ , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~ ,~,~.~ o _ t-Q., t9:2003 , 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 June 6, 2002 described therein be admitted to probate and filed of record as the last will of Robert M. Knisely ; and Letters Testamentary are herebygrantedto Sandra Ann Knisely and Letters of Administration D. B. N. C. T. A. are hereby granted to Virginia L. Knisely 5~krt~ (DA FEES Probate, Lette~s,~tc .......... Short Certificates( ) .......... Renunciation ................ TOTAL Filed .. ~. :.~ 7. Q~ .................... SNEL~~~ & SPARE, P. C. BYR~6355 44 West Main Street M~chmni~gh~,r~: PA 1.7055-0318 ADDRESS 717-697-8528 PHONE ~- cl- o3 RENUNCIATION 3/- os- qgt--/ In Re Estate of ROBERT M. KNISELY deceased. To the Register of Wills of Cumberland County, Pennsylvania. The undersigned : Robert L. Knisely. son and co-executor named in the will of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters Testamentary be issued to Sandra Ann' Knisely (daughter and co-executrix) and Virginia L. Knisely (widow of Decedent and one of the residuary beReficia_ries)..~ WITNESS my hand this ~_~ day of/~~/ ,~ 2002 / R°be~re~nise 5750 South Steele Stre~z Greenwood Village, CO 80121 (Address) (Signature) (Address) (Signature) (Address) his is to certify that the information here given is correctly copied fi'om ai~ original certificate of tieath Local Rqgistrar. The original certificate will be forwarded to the Stare Vital Records ()fi'ice WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 8920457 No. COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH 100 Mt. Allen Drive Mechanicsburg, PA 17055 Leonard .8/23/1912 ,.Male ,.164 --30 -- 4487 Mt. Pleasant, PA ,,.. ~. Pennsylvania Cumberland White Married ,,.Virginia Law 31, 2003 FD-014889-L 100 Mt. PA 17055 ,,~ollingGreenCemetery Hill, PA 17011 ~ Plaza M~, ~ 17055 10; )0 LAST WILL AND TESTAMENT OF R OBER T M. KNISEL Y ~- o~, - ,.4 ~."t I, ROBERT M. KNISELY, of the Township of Upper Allen, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done. 2. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever situate, to my wife and two (2) children, to wit, my wife, VIRGINIA L. KNISELY, my son, ROBERT L. KNISELY, and my daughter, SANDRA ANN KNISELY, share and share alike, per stirpes. -1- LASTLY, I nominate, constitute and appoint my two (2) children, the aforesaid, ROBERT L. KNISELY and SANDRA ANN KNISELY, Co-Executors of this my Last Will and Testament and direct that they be excused from posting bond or other security for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this of June, A. D., 2002. -2- COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS I, ROBERT M. KNISELY, the testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly, and that I signed it as my free and voluntary act and deed, for the purposes therein expressed. Sworn and subscribed to before me Robert M. Knisely this b~ day of June, 2002. -3- COMMONWEALTH OF PENNSYLVANIA ) : SS COUNTY OF CUMBERLAND ) We, the undersigned, J. ROBERT STAUFFER and JOHN M. EAKIN, the wimcsscs whose names arc signed to the attached or foregoing instnnnent, being duly qualified according to law, depose and say that wc were present and saw the within testator, ROBERT M. KNISELY, sign and execute the instrument as his Last Will and Testament; that the said testator, ROBERT M. KNISELY, executed it as his voluntary act for thc purposes therein expressed; that each of us, in the hearing and sight of thc testatrix, signed thc Will as witnesses; and that, to thc best of our knowledge, the testator was, at thc time, eighteen (18) or more years of age, of sound mind, and under no constraint, duress or undue influence. Sworr~_a}n~l subscribed to before me this I/?~//I day of June, 2002. -4- LAST WILL AND TESTAi?[ENT OF ROBERT M. KA~I SELY J. ROBERT STAUFFER ATTOHN~Y AT LAW MECHANICSBURG, PA. 1705~ Name of Decedent: Date of Death: No. 2003-00427 '03 JUN -6 [I0:53 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Robert M. Knisely, Deceased January 28, 2003 PA No. 2103-0427 Name Sandra Ann Knisely To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on or about June 4, 2003: Address 6395 South Glencoe Court Littleton, CO 80121 Robert L. Knisely 5750 South Steele Street Greenwood Village, CO 80121 Virginia L. Knisely Messiah Village, 100 Mt. Allen Drive Mechanicsburg, PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE. Date: June 4, 2003 ~uire 44 West Main Street Mechanicsburg, PA 17055-0318 (717) 697-8528 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 003534 SNELBAKER RICHARD C 44 W MAIN STREET MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 164-30-4487 FILE NUMBER: 21 03-0427 DECEDENT NAME: KNISELY ROBERT M DATE OF PAYMENT: 02/05/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/28/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3,691.60 TOTAL AMOUNT PAID: $3,691.60 REMARKS: RICHARDCSNELBAKER SEAL CHECK//104 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280&01 HARRISBURG, PA 17128-0601 SANDRA A KNISELY 899 MESSIAH VILLAGE 899 PO BOX 2015 MECHANICSBURG PA 17055 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF XNHERZTANCE TAX APPRAXSEHENT. ALLOWANCE OR DXSALLORANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DA~ 0S-01-200~ ?~F,.~TATE~m~ OF KNISELY : ;' ' D~TE OF DEATH 01-28-2005 21 05-0427 CUHBERLAND 164-50-4487 05114061 Amount Remitted ROBERT M FILE NUMBER COUNTY '04 FEB 27 Pds c ACN Ct,m ........ Co., PA HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701~ CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-01-2004 ESTATE OF KNISELY ROBERT N DATE OF DEATH 01-28-2005 COUNTY CUMBERLAND FILE NO. 21 05-0427 S.S/D.C. NO. 164-50-4487 ACN TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED 05114061 JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PHC BANK ACCOUNT NO. $1600228695 TYPE OF ACCOUNT: ( ) SAVINGS C ) CHECKING C ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 05-15-1996 Account Balance 24,292.40 Percent Taxable X 0.500 Amount Subject to Tax 12,146.20 Debts and Deductions .00 Taxable Amount 12,146.20 Tax Rate ~ .45 Tax Due 546.58 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 C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) NTEREST IS CHARGED THROUGH 05 09-2004 C T THE RATES APPLICABLE AS OUTLINED ON THE EVERSE SIDE OF THIS FORM TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ IF TOTAL DUE IS LESS THAN ~1~ NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CH}, YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THIS FORM FOR INSTRUCTIONS. ) .00 546.58 8.94 555.52 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 SANDRA A KNISELY 899 MESSIAH VILLAGE PO BOX 2015 MECHANICSBURG COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF XNHERITANCE TAX APPRAXSBHENT. ALLONANCE OR DISALLONANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REI/-I5~8 EX AFP (01-05) ~f DATE 05-01-2004 ~ ~mt-- ESTATE OF KNISELY ROBERT '~ , ~ ~'~m~ DATE OF DEATH 01-28-2005 FILE NUMBER 21 05-0427 COUNTY CUMBERLAND '04 FEB 27 P1:0 SN/DC 164-50-4487 ACN 05114062 Coa t PA I Amount Rem,tted r HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 M CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS '~ REV-15~8 EX AFP COl-OS) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-01-2004 ESTATE OF KNISELY ROBERT M DATE OF DEATH 01-28-2005 COUNTY CUMBERLAND FILE NO. 21 05-0427 S.S/D.C. NO. 164-50-4487 ACN 05114062 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5140055152 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 12-01-1961 Account Balance 15,459.81 Percent Taxable X O.l&6 Amount Subject to Tax 2,245.55 Debts and Deductlons .00 Taxable Amount 2,245.55 Tax Rate Tax Due 100.95 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 DATE RECEIPT NUMBER I DISCOUNT C+) INTEREST/PEN PAID (-) !NTEREST IS CHARGED THROUGH 05-09-2004 T THE RATES APPLICABLE AS OUTLINED ON THE EVERSE SIDE OF THIS FORM AMOUNT PAID TOTAL TAX CREDIT I I BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ C IF TOTAL DUE IS LESS THAN ~1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CA), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~ .00 100.95 1.65 102.60 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTXCE OF INHERITANCE TAX APPRAXSEHENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV~15G6 EX AFP (01-03) VIRGINIA R KNISELY 899 HESS[AH VILLAGE 899 PO BOX 2015 MECHAN[CSBURG ~ ,:/D~[E 05-01-2004 i,,ii~STATE OF KN[SELY ROBERT ~:' " '~! ~ ~ATE OF DEATH 01-28-2005 FILE NUMBER 21 05-0427 COUNTY CUHBERLAND '04 FEB 27 ACN 051[~06~ [~[?;: ' ~0~[, F Am°unt Rem'tted I PA 17055-1,0~l),~D~and CO.. PA MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE REV-Z548 EX AFP C01-03) RETAIN LOWER PORT[ON FOR YOUR RECORDS NOT[CE OF XNHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 0)-01-2004 ESTATE OF KNISELY ROBERT H DATE OF DEATH 01-28-200~ COUNTY CUMBERLAND FILE NO. 21 05-0~27 S.S/D.C. NO. 16~-50-~87 ACN 0511~065 TAX RETURN NAS: (X> ACCEPTED AS FILED C ~ CHANGED JOINT OR TRUST ASSET XNFORMATXON FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 51~0035152 TYPE OF ACCOUNT: C ) SAVINGS C ~ CHECKING C ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 12-01-1961 Account Balance 13,459.81 Percent Taxable X 0.166 Amount Subject to Tax 2,2~5.55 Debts and Deductions .00 Taxable Amount 2,2~3.~5 Tax Rate ~ .00 Tax Due .go 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 C-) AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ IF TOTAL DUE IS LESS THAN ~1~ NO PAYMENT IS REQUIRED. IF TOTAL DUE [S REFLECTED AS A "CREDIT" C CA}, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR [NSTRUCTIONS. } .00 .00 .00 .00 REV-I~ EX (~-00) COMMONWEALTH OF REV-1500 DEPARTMENT OF REVENUE DEPT, 280601 INHERITANCE TAX RETURN HARRISBURG, PA 17128-0601 RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) FILE NUMBER 21 COUNTY CODE OFFIC!AL USE ONLY -- 2003 0427 YEAR NUMBER SOCIAL SECURITY NUMBER ~ Knisely, Robert M 2 164-30-4487 UJ DATE OF DEATH (M M-DE,YEAR) I DATE OF BIRTH (M M-DO-YEAR) ~ ThIS RETURN MUST BE FILED IN DUPLICATE WITH THE "~ 01/28/2003 J 08/23/1912 0 REGISTER OF WILLS LLI (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) C) SOCIAL SECURITY NUMBER Knisely, Virginia L 185-18-3518 '" I×11. Original Return I I 2. Supplemental Return I 3 Remai ~ ~ , rider Return (date of death pdor to 12-13-82) II 4. Limited Estate I I 4a. Future Interest Compromise (date of death after 12-12-82) ~--] 5. Federal Estate Tax Return Required ~lC~ 6. DecedentDiedTestate,AttechcopyofWill)~ 7. Decedent Maintained a Living Truat ,Attach copy of Trust) i e Tota, Number~a~'l~si~e~h Spouse f~L~ ~J~:i::~:~ ~: ~Z;~:::::.:.:.:.:~. ~:~::~.~::::> :.::.:.:::::~::.:.::::::::::.:.............~.-................ · ~-......-........_......... lr-] 9' LitigatiOn Proceeds Received [---] 10' Sp°usal P°verty Credit (dar' °f d'ath be~"n 12-:H'~1 and'~'l'~S) [--1 1 i' Electi°n t° tax under Sec~ 9113(A) Att'ch Sch O) /NAME ....................................................................... 'iiii'ii'i'i'i ....................................................... COMPLETE MAILING ADDRESS Richard C S~elbaAe~ 44 ~est Ha±~ Street FIRM NAME (If Applicable) S~elba~e~, B~e~ema~ & Spa~e, ~.C. Hecha~icsbu~9, ~A 17055 TELEPHONE NUMBER (717( 697-8528 Z O O X 1 Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages 8, Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) [~ 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. 8, Liens(S~hedule I) (10) 11~ Total Deductions (total Lines 9 8, 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an eleotion totax has not been made (Schedule J) 0.00 0.00 0.00 0.00 64,020.16 4,486.56 47,184.05 (8) OFFICIAL USE ONLY 115,690.77 14,995.26 112.41 (11) (12) (13) 15,107.67 100,583.10 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 100,583.10 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)(12) 16. Amount of Line 14 taxable at lineal rate 7. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate. 19. Tax Due 20. 18,547.45 x .00 (15) 82,035.65 x.045 (16) 0.00 x .12 (17) 0.00 x.15 (18) (19) 0.00 3,691.60 0.00 0.00 3,691.60 2W4645 1.000 Dededent's Complete Address: S~E~ ADDRESS 100 Mt. Allen Dr., Messiah village Upper Allen Township Mechanicsburg STATE ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D, Interest E. Penalty 0.00 0.00 0.00 0.00 0.00 (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) 3,691.60 0.00 0.00 3,691.60 4. 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) 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 3 ¢ 691.60 Make Check Paj(able to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................... ~-] ['~ b. retain the right to designate who shall use the property transferred or its income; ......... [~ c. retain a reversionary interest; or ................................ r~ d. receive the promise for life of either payments, benefits or care? ................. r-~ 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? J-~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ [--'-] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to We best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNA~?,E OF PERSO R~ON, SI~B_L~ FOR FILING RETURN DDRESS 6395 South Glenc~ Court Li~ to,~_~O_~80 [~ 1 Mechanic sburg, SIGN A tU R E/(~. P~;~E~-'E"'r~,IT, F~I~ TH A N REPRESENTATIVE ADDRES . Box 318 ~'~ ~ _~_~ DATE PA 17055 DATE Mechanicsburg, PA 17055 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfera to or for the use of the surviving spouse is 3% [72 PS § 9916 (a) (1.1)(i)] For dates of death on or after January 1, 1995, the tax rate imposed on the net value of 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 stiJl applicable even if the surviving spouse ~s the only beneficiary For dates of death on or after July 1, 2000: The tax rate im posed on the net vatue 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 orfor 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 im posed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. § 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption, 2w4646 lOOO Estate of: Robert M Knisely Virginia L Knisely 892 Oak Oval, Messiah Village Mechanicsburg, PA 17055 Executrix 164-30-4487 Sandra A. Knisely, Executrix 6395 South Glencoe Court Littleton, CO 80121 REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Knisely, Robert M FILENUMBER 21-2003-0427 Include the ~roceeds 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 2W46AD 2.000 DESCRIPTION PNC Bank, N.A., Certificate of Deposit #31000225540 1951 proof set which includes penny, nickel, dime, quarter and half-dollar 1950 proof set which includes penny, nickel, dime, quarter and half-dollar 1964 year set which includes penny, nickel, dime, quarter and half-dollar Note Receivable from Sandra A. Knisely with an outstanding principal balance of $7,500.00 (non-interest loan) Two cemetery plots located in Rolling Green Cemetery TOTAL(Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 51,411.66 282.00 322.00 4.50 7,500.00 4,500.00 $ 64,020.16 REV-1509 EX + (1-97) OOMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER Knisely, Robert M 21-2003-0427 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 ADORESS RELATIONSHIP TO DECEDENT A. Knisely, Virginia L Spouse B. Knisely, Sandra A. 892 Oak Oval, Messiah Village Mechanicsburg, PA 17055 6395 South Glencoe Court Littleton, CO 80121 Daughter JOINTLY-OWNED PROPERTY: ~,,~ DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or DATE OF DEATH DEC;US VALUE OF NUMBER TE~IANT JOINT similar identif¥in~l number. Attach deed for jointly-held real ~,ta~, VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. ~A. 06/14/2001 PNC Bank, N.A., checking 13,459.81 33.33 4,486.56 & B account #5140035152, jointly owned with Decedent' s spouse and daughter. TOTAL (Also enter on line 6, Recapitulation) $ 4,486.56 2W46AE 2.000 (If more space is needed, insert additional sheets of same size) REV-1510 EX + (1-97) COMMONV~_ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY Knisely, Robert M FILENUMBER 21-2003-0427 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is ~ DESCRIPTION OF PROPERTY %OF ITEM I~LU~ ME NAME OF ME T~NSFEREE, THEIR RE~TIONSHIP TO ~CEDENT~D THE ~ OF T~NSFER. ATTACH A COPY OF THE DATE OF DEATH DECUS EXCLUSION NUMBER TAXABLE VALUE ~EDFORREALESTATE. VALUEOF/~SSET INTEREST (IF~PU~BLE) 1. PNC Bank, N.A., Certificate of 24,292.40 100.00 3,000.00 21,292.40 Deposit #31600228695, established 5/28/02 jointly with Sandra A. Knisely 2 BB&T, investors deposit 25,891.65 100.00 0.00 25,891.65 account #0140139025 individually owned with payable on death designation to Sandra A. Knisely TOTAL(AlsoenteronlineT, Re~pitulation) $ 47,184.05 (If more space is needed, insert additional sheets of same size.) 2W46AF 2.000 REV-,1511 EX+ (1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIBENT DECEDENT ESTATE OF FILE NUMBER Knisely, Robert M 21-2003-0427 Debt~ of decedent must be reported on Schedule I. ITEM NUMBER 5. 6. 7. 8 9 10 Tot( DESCRIPTION FUNERAL EXPENSES: Robert Knisely, expenses reimbursement for funeral luncheon Sandra A. Knisely, reimbursement for following expenses: a. Rolling Green Cemetary, opening of grave $870.00 b. Travel Expenses to administrator estate: 1. Radison Penn Harris Hotel $347.35 2. Thrifty Car Rental $167.72 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address Ci~ State__Zip Year(s) Commission Rid: AttorneyFees Na_~: Snelbaker, Brenneman & Spare FamilyExemption:(Ifdecedent'saddressisnotthesameasclaimant,s,a~chexplanation) Claimant Knisely, Virginia L StreetAddress 892 Oak Oval, Messiah Villaqe Ci~ Mechanicsburg State PA Zip 17055 Relationship of Claimant to Decedent Spouse ~obate Fees Accountant's Fees ~x Return Pre~rer's Fees Register of Wills, filing fee for Inheritance Tax Return Cumberland Law Journal, advertising Executrix notices Patriot-News, advertising Executrix notices Reserve for filing fees, accounting services and other costs associated with the administration of Decedent's estate L from continuation pages .... TOTAL (Also enter on line 9, Recapitulation) $ AMOUNT 155.10 1,862.07 0.00 3,000.00 3,500.00 54.00 0.00 0.00 15.00 75.00 159.19 500.00 5,674.90 14,995.26 2W46AG 2.000 (If more space is needed, insert additional sheets of same size) Estate of: Knisely, Robert M Schedule H, Part A -- Funeral Expenses Item Description 3. United Airlines $477.00 Malpezzi Funeral Hom~, Inc., funeral services Page 2 21-2003-0427 Amount 5,674.90 TOTAL. (Carry forward to main schedule) ...... 5,674.90 REV-1'512 EX + (1-97) SCHEDULEI DEBTS OF DECEDENT, MORTGAGELIABILITIES,& LIENS COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Knisely, Robert M FILE NUMBER 21-2003-0427 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION West Short Pathology, medical services Internists of Central PA, medical services Messiah Village, ambulance service for West Shore EMS TOTAL (Also enter on line 10, Recapitulation) $ AMOUNT 13.71 9.25 89.45 112.41 2W46AH 2.000 (If more space is needed, insert additional sheets of the same size) REV:1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANC~ TAX RETURN RESIDENT DEC~DENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Knisel¥, Robert M 21-2003-0427 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLEDISTRIBUTIONS[includeoutrights~usaldistrib~ions, andtran~en underSec. 9116(a)(1.2)] Knisely, Virginia L 892 Oak Oval, Messiah Village Mechanicsburg, PA 17055 Knisely, Sandra A 6395 South Glencoe Court Littleton, CO 80121 Knisely, Robert L 5750 South Steele Street Greenwood Village, CO 80121 Spouse Daughter Son 18,547.45 65,731.49 16,304.16 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 2W46AI 1.000 (If more space is needed, insert additional sheets of the same size) L.4 ,¢;T WILL AND TESTAMENT OF R OBER T M. KNISEL Y I, ROBERT M. KNISELY, of the Township of Upper Allen, County of Cumberland and State of Penn~qylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease ..as the same can be conveniently done. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever situate, to my wife and two (2) children, to wit, my wife, VIRGINIA L. KNISELY, my son, ROBERT L. KNISELY, and my daughter, SANDRA ANN KNISELY, share and share alike, per stirpes. -1- LASTLY, I nominate, constitute and appoint my two (2) children, the aforesaid, ROBERT L. KNISELY and SANDRA ANN KNISELY, Co-Executors of this my Last Will and Testament and direct that they be excused from posting bond or other security for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this of June, A. D., 2002. 'Robert ~I ~''-~' ~SEAL) M. E/tis y -2- COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS I, ROBERT M. KNISELY, the testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly, and that I signed it as my fi'ee and voluntary act and deed, for the purposes therein expressed. Sworn and subscribed to before me Robert M. Knisely -3- COMMONWEALTH OF PENNSYLVANIA ) · SS COUNTY OF CUMBERLAND ) We, the undersigned, J. ROBERT STAUFFER and JOlt31 M. EAKIN, the witnesses whose names are signed to the attached or foregoing instmment~ being duly qualified according to law, depose and say that we were present and saw the within testator, ROBERT M. K1N-ISELY, sign and execute the instrument as his Last Will and Testament; that the said testator, ROBERT M. KNISELY, executed it as his voluntary act for the Purposes therein expressed; that each of us, in the hearing and sight of the testatrix, signed the Will as wimesses; and that, to the best of our knowledge, the testator was, at the time, eighteen (18) or more years of age, of Sound mind, and under no constraint, duress or undue influence. Swon3 ap~l subscribed to before me _ this ~ day of Jun~e, ,2002. t ~~ ' i~ Not~'ylPublic - -4- '%/BUREAU-- OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RICHARD C SNELBAKER SNELBAKER ETAL 44 W MAIN ST MECHANICSBURG :DATE 05-22-2004 ESTATE OF KNISELY DATE OF DEATH 01-28-2005 FILE NUMBER 21 0~-0~27 ~tlr~PNTY CUMBERLAND ACN 101 PA 17055 Amount Remitted ROBERT M MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONg THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-lB47 EX AFP C01-05) NOT[CE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR D[SALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KNISELY ROBERT M FILE NO. 21 05-0427 ACN 101 DATE 05-22-2004 TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN I Real Estate (Schedule A} 2 Stocks and Bonds (Schedule ~} $ Closely Held Stock/Partnership Interest (Schedule C) ~ Mortgages/Notes Receivable (Schedule D) 5 Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6 Jolntly O~ned 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 LtabtZlttes/Llens (Schedule I) 11 Total Deductions 12 Net Value of Tax Return c1) c2) cs) cB) c7) 64r020.16 47r184.05 .00 NOTE: To Insure proper .00 credit to your account, · 00 submit the upper port/on .00 of this form ~tth your tax payment. 115,690.77 14,995.26 c~0) 112.41 C11) ]~.]07.~7 (12) 100,585.10 15 NOTE: ASSESSMENT OF TAX: 15. Amount of Line 1~ at Spousal rate 16. Amount of Line 1~ taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Princl=al Tax Due TAX CREDITS PAYMENT RECEIPT DISCOUNT DATE NUHBER INTEREST/PEN PAID (-~ 02-05-2004 CD005554 .00 Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule Net Value of Estate Subject to Tax C14) If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 w111 reflect figures that include the total of ALL returns assessed to date. ets) 18,5~7.45 x O0 = c[~) 82,055.65 x 045 = (17) . O0 x 12 = c~8) .00 x 15 = C19)= AHOUNT PAID 5,691.60 .00 100,585.10 .00 BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-06-2004 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 .00 5,691.60 5,691.60 .00 46.99 46.99 C IF TOTAL DUE TS LESS THAN 91, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~'OMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF iNDiVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003746 KNISELY SANDRA ANN 6395 SOUTH GLENCOE COURT LITTLETON, CO 80121 ........ fold ESTATE INFORMATION: SSN: 164-30-4487 FILE NUMBER: 2103-0427 'DECEDENT NAME: KNISELY ROBERT M :)ATE OF PAYMENT: 04/01/2004 POSTMARK DATE: 03/29/2004 COUNTY: CUMBERLAND DATE OF DEATH: 01/28/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 03114062 $102.60 REMARKS: TOTAL AMOUNT PAID: 02.60 SEAL CHECK# 6043 INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003747 KNISELY SANDRA ANN 6395 SOUTH GLENCOE COURT LITTLETON, CO 80121 fold ESTATE INFORMATION: SSN: 164-30-4487 FILE NUMBER: 21 03-0427 DECEDENT NAME: KNISELY ROBERT M DATE OF PAYMENT: 04/01/2004 POSTMARK DATE: 03/29/2004 COUNTY: CUMBERLAND DATE OF DEATH: 01/28/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 03114061 $555.52 REMARKS: CHECK# 6042 SEAL TOTAL AMOUNT PAID: $555.52 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF ZND:LVZDUAL TAXES TNHERTTANCE TAX DZV/S[nN DEPT. 280601 HARRTSBURG, PA 1712D-0601 SANDRA A KNISELY 899 HESSIAH VILLAGE 899 PO BOX 2015 HECHANICSBURG COHHONNEALTH OF PENNSYLVANIA BEPARTHENT OF REVENUE ZNHERZTANCE TAX RECORD ADdUSTHENT dOZNTLY HELD OR TRUST ASSETS DATE 04-02-2004 ESTATE OF KNISELY DATE OF DEATH 01-28-2005 FILE NUHBER 21 05-0427 COUNTY CUHBERLAND SSN/DC ACH 03114061 Amoun~ Remi~ed REV-Ii04 El( &FP COl-OS) ROBERT H HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG TH/S LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS -~ REV-1604 EX AFP (01-03) ## INHERITANCE TAX RECORD ADdUSTNENT dOZNTLY HELD OR TRUST ASSETS DATE 04-0Z-2004 ESTATE OF KNISELY ROBERT H DATE OF DEATH 01-Z8-ZO0$ COUNTY CUHBERLAND FILE NO. 21 05-0427 S.S/D.C. NO. 164-$0-R487 ACN 05114061 ADJUSTHENT BASED ON: ADHINISTRATZVE CORRECTION dOZNT OR TRUST ASSET ZNFORNATZON FTNANCIAL TNSTITUTTON: PNC BANK ACCOUNT NO. 31600228695 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (X) TINE CERTIFICATE DATE ESTABLISHED 05-15-1996 Accoun~ Balance Percen~ Taxable X, Amoun~ Subjec~ ~o Tax Debts and Deduc~/ons - Taxable Amoun~ Tax Ra*e X Tax Due TAX CREDZTS: .00 NOTE: 0.500 .00 .00 .00 .45 .00 TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHZT THE UPPER PORTION OF THIS NOTICE NZTH YOUR TAX PAYHENT TO THE REGISTER OF HILLS AT THE ADDRESS SHONN ABOVE. HAKE CHECK OR HONEY ORDER PAYABLE TO: "REGZSTER OF NZLLS, AGENT." PAYHENT RECEIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUEI ];NTEREST AND PEN. TOTAL DUE ZF PA/D AFTER TH]:S DATE, SEE REVERSE FOR CALCULATION OF ADDZT/ONAL TNTEREST. TF TOTAL DUE TS LESS THAN $1, NO PAYNENT TS REI~UZRED. TF TOTAL DUE TS REFLECTED AS A "CRED/T" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE S/DE OF THTS FORH FOR INSTRUCTIONS.) .00 .00 .00 PAYHENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- Hake check or money order payabla to: REGTSTER OF N/LLS, AGENT. REFUND (CR): A refund of a tax credit, uhich was not requested on tha Tax Return, may ba requested by completing an "Application for Rafund of Pennsylvania Inheritance and Estate Tax" (REV-iS15). Applications ara available at the Office of the Register of Nills, any of the Z5 Revenue District Offices or from the Department's Z~-hour ansaering service for forms ordering: Z-DOO-56Z-ZO50~ services for taxpayers mith special hearing and / or speaking needs: 1-800-~7-30Z0 (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dapt. Z&060Z, Harrisburg, PA lT1ZD-060l, Phone (717) 787-6505. DISCOUNT: If any tax due is paid within three ($) calendar months after the dacedent's death, a five percent (SI) 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 befora January 18, 1996, the first day after the end of fha 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 ta the data of payment. Taxes which became delinquent before January 1, 198Z bear interast at the rate of six (6Z) percent per annum calculated at a daily rate of .00016~. All taxes which became dalinquant an and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Dapartaent of Revenue. The applicable interest rates for 198Z through ZOO3 are: Interest Daily Interest Daily Interast Daily Year Rate Factor Yea.~.r Rate Factor Yea~ Rate Factor 198Z ZOZ .000548 1967 9Z .O00Z~7 1999 7Z .BO019Z 1983 162 .000~38 1988-1991 11X .000501 ZOO0 82 .000219 198~ 1XZ .000301 199Z 92 .O00Z~7 ZOO1 92 .O00Z~7 1985 15Z .000356 1993-199~ 7Z .000192 ZOOZ 62 .00016~ 1986 lOX .O0027~ 1995-1998 92 .O00Zq7 2003 5Z .000157 --Interest is calculated as follows: ZNTEREST= BALANCE OF TAX UNPAZD X NURBER OF DAYS DELZNQUENT X DAZLY ZNTEREST FACTOR --Any Notice issuad after tha tax becomes delinquent will reflect an interest calculation to fifteen (la) days beyond the data of the assessment. If paymant is made after the intarest computation date shown on the Notice, additlonal interest must be calculated. BUREAU OF TNDZVZDUAL TAXES TNHER/TANCE TAX D/VZS/DN BEPT. 280601 HARRZSBURG, PA 171Z8-0601 899 HESSIAH VILLAGE P~}~OX 2015 H~CSiiUR6 PA 17055 COHHONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE ZNHERZTANCE TAX RECORD ADJUSTNENT dOZNTLY HELD OR TRUST ASSETS DATE 0~-0Z-2004 ESTATE OF KNISELY DATE OF DEATH 01-28-2005 FZLE NUHBER Z1 05-0427 COUNTY CUHBERLAND SSN/DC 164-$0-4487 ACN 05114062 Amoun~ Remi~ed REV-iI04 EX AFP C01-05) ROBERT H HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THZS L/NE ~ RETAZN LONER PORTZON FOR YOUR RECORDS REV-160& EX AFP (01-03) ~ ZNHERZTANCE TAX RECORD ADJUSTNENT JOZNTLY HELD OR TRUST ASSETS DATE 04-02-2004 ESTATE OF KNISELY ROBERT H DATE OF DEATH 01-28-2003 COUNTY CUHBERLAND FILE NO. 21 03-0427 S.S/D.C. NO. 164-30-4487 ACN 03114062 ADJUSTHENT BASED ON: ADHINISTRATIVE CORRECTION JOZNT OR TRUST ASSET TNFORHATTON FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 514003515Z TYPE OF ACCOUNT: ( ) SAVINGS eX) CHECKING ( ) TRUST ( ) TINE CERTIFICATE DATE ESTABLISHED 1Z-01-1961 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deduct/ons - Taxable Amount Tax Rate X, Tax Due TAX CREDTTS: .00 NOTE: 0.166 .00 .00 .00 .00 TO /NSURE PROPER CREDZT TO YOUR ACCOUNT~ SUBHZT THE UPPER PORTZON OF THZS NOTZCE NZTH YOUR TAX PAYHENT TO THE REGZSTER OF NZLLS AT THE ADDRESS SHO#N ABOVE. HAKE CHECK OR HONEY ORDER PAYABLE TO: "REGZSTER OF NZLLS~ AGENT." PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID DATE NUNBER INTEREST/PEN PAID (-) TOTAL TAX CREDZT I I BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE TF pATD AFTER THTS DATE~ SEE REVERSE FOR CALCULATTON OF ADDTTTONAL TNTEREST. ZF TOTAL DUE TS LESS THAN $1~ NO PAYNENT ZS REQUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" {CR)~ YOU NAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORH FOR TNSTRUCTZONS.) .00 .00 .00 PAYMENT: Detach the top portion of this Notice and submit Nith your payment made payable to the name and address printed on fha reverse side. -- Make check or money order payable to: REGISTER OF N/LLS, AGENT. REFUND (CR): A refund of a tax credit, Nhich Nas not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications arm available at the Office of the Register of Nills, any of the Z3 Revenue District Offices or from the Department's 2q-hour answering service for forms ordering: 1-B00-362-2050~ services for taxpayers Nith special hearing and / or speaking needs: 1-800-qq7-3020 (TT only). REPLY TO: Questions regarding errors contained on this notica should bm addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment RevieN Unit, Dept. Z80601, Harrisburg, PA 171Z&-0601, Phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the dacedent's death, a five percent (SI) 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 aftar the end of tho tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency or nine (9) months and one (I) day from the data of death to the date of payment. Taxes Nhich became delinquent before January l, 198Z bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .00016q. All taxes which became delinquent an and after January 1, 198Z Nill bear interest at a rate Nhich will vary from calendar year to calendar year Nith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 lOX .000548 1987 9Z .000247 1999 7Z .O00lgZ 1983 162 .000q38 1988-1991 Ill .000301 ZOO0 BZ .000Z19 198q 112 .000301 1992 92 .0002q7 ZOOl 92 .0002q7 1985 13Z .000356 1993-199q 72 .OOOX9Z 2002 6X .00016~ 1986 10Z .O00g7q 1995-1998 9~ .000Z~7 2003 51 .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent Nill raflect an interest calculation to fifteen (la) days beyond the date of the assessment. If payment is made after the interest computation date shoNn on fha Notica, additional interest must ba calculated. REV-1470 EX (6-88) INHI=RITA~CF EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG~ PA 17128-0601 DECEDENT'S NAME FILE NUMBER Knisely Robert 2103-0427 REVIEWED BY ACN Emerson Luciano 03114061-03114062 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The above referenced ACN has been reduced to zero, as this account was reported on the probate return. Paqe 1 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. ::'80601 HARRISBURG, PA 17128-0601 VIRGINIA R S 899 MESSIAH VILLAGE 899 PO BOX ME CHAN I CS B L~l~-i~: ._.~PA 17055-t000 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ZNHERZTANCE TAX RECORD ADJUSTMENT JOZNTLY HELD OR TRUST ASSETS REV-160~i EX &FP (01-OS) DATE 0~-02-2004 ESTATE OF KNISELY ROBERT M DATE OF DEATH 01-28-2005 FILE NUMDER 21 03-0427 COUNTY CUMBERLAND SSN/DC 16~-30-~87 ACN 0311q063 Amoun~ Remi~ed HAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAZN LOWER PORTION FOR YOUR RECORDS '~ REV-1604 EX AFP (01-03) N~ ZNHERZTANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE 0q-02-2004 ESTATE OF KNISELY ROBERT M DATE OF DEATH 01-28-2003 COUNTY CUMBERLAND FILE NO. 21 03-0~27 S.S/D.C. NO. 164-30-~87 ACN 03114063 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JO'rNT OR TRUST ASSET ZNFORNATZON FINANCIAL INSTITUTION: PHC BANK ACCOUNT NO. 51q0035152 TYPE OF ACCOUNT: ( ) SAVINGS (X) CHECKING ( ) TRUST ( ) TINE CERTIFICATE DATE ESTABLISHED 12-01-1961 Account Balance Percent Taxable X, Amount Subject to Tax Debts and Deduct/ons - Taxable Amount Tax Rate X, Tax Due TAX CREDITS: .00 0.166 .00 .00 .00 .00 .00 NOTE: TO ZNSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMZT THE UPPER PORTION OF THZS NOTZCE WZTH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. HAKE CHECK OR MONEY ORDER PAYABLE TO: 'REGISTER OF WZLLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDZT BALANCE OF TAX DUEI ZNTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDTTZONAL /NTEREST. ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) .00 .00 .00 ,00 PAYMENT: Detach the top portion of this Notice and submit aith your payment made payable to the name and address printed on the reverse side. -- Make check or money order payable to: REGISTER OF #TLLS, AGENT. REFUND (CR): A refund of a tax credit, ehich ems not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of #ills, any of the g3 Revenue District Offices or from the Department's gq-hour answering service for forms ordering: 1-800-362-g030~ services for taxpayers with special hearing and / or speaking needs: l-DOO-qq7-3OZO (TT REPLY TO: guastions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviem Unit, Dept. Z80601, Harrisburg, PA ITlZO-0601, Phone (7173 787-6505. DISCOUNT: iF any tax due is paid within three (3) calendar months after the decadent's death, a five percent (SI) discount of the tax paid is allowed. PENALTY: The 1SI 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 1, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which wilt vary from calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable interest rates for 19SI through ZOO3 are: Interest Dally Interest Dally Interest Daily Year Rate Factor Yea.~r Rate Factor Yea.~r Rate Factor 198Z lOX .0005q8 1987 9Z .0002q7 1999 7Z .O0019Z 1983 16Z .000q38 1988-1991 llZ .000301 ZOO0 8Z .O00Z19 198q llZ .000301 1992 9Z .O00Zq7 ZOOZ 9Z .000Z47 1985 132 .000356 1993-199q 7Z .O0019Z ZOO2 6Z .O0016q 1986 lOX .00027q 1995-1998 9Z .O00Zq7 2003 52 .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELIN{IUENT X DATLY 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. Tf payment is made after the interest computation date shown on the Notice, addJtionaZ interest must bm calcuZatmd. REV-1470 EX (6-88) INHERITANCE TAX COMMONWEALTH OF PENNSYLVANIA EXPLANATION DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG~ PA 17128-0601 ~ECEDENT'S NAME FlEE NUMBER Knisely Robert 2103-0427 ~VIEWED BY ACN Emerson Luciano 03114063 SCHEDULE ITEM NO. EXPLANATION OF CHANGES The above referenced ACN has been reduced to zero, as this account was reported on the probate return. Paqe 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 003850 SNELBAKER RICHARD C 44 W MAIN STREET MECHANICSBURG, PA 17055 fold ESTATE INFORMATION: SSN: 164-30-4487 FILE NUMBER: 21 03-0427 DECEDENT NAME: KNISELY ROBERT M DATE OF PAYMENT: 04/21/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/28/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $46.99 REMARKS: TOTAL AMOUNT PAID: KNISELY SANDRA ANN AND VIRGINIA L KNISELY $46.99 SEAL CHECK# 106 INITIALS: SK RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS STATUS REPORT UNDER RULE 6.12 Name of Decedent: Robert Knisely Date of Death: 1/28/03 Will No.: 21-0 3-0 427 Admin. No.: 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: l. State whether administration of the estate is complete: Yes [--] No [] 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Approximately 6 months 3. If the answer to No. 1 is Yes, state the following: Did the personal representative file a final account with the Court? Yes _ No [--] b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes ['-] No Date: Co 4/21/O4 Copies of receipts, releases, joinders and approval of formal or Clerk of the Orphans' Court informal accounts may be filed/w/~ the and may be attached to th~ Richard C. Snelbaker ~a~%kbaKer, Brenneman & Spare, 44 West Main Street -- Mechanicsburg, PA 17055 Address Capacity: (717) 697-8528 Telephone No. Personal Representative Counsel for personal representative PoC. BUREAU OF ZNDZVTDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG., PA 17128-0601 SANDRA A KNISELY 899 MESSIAH VILLAGE PO BOX 2015 MECHANICSBURG PA 17055 CONNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT DATE 04-26-2004 ESTATE OF KNISELY DATE OF DEATH 01-28-2003 FILE NUMBER 21 03-0427 COUNTY CUMBERLAND ACN 03114062 Amoun~ Rem L'l:'l:ed RE¥-1607 EX AFP ROBERT M HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF gILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper por~/on of ~his form wi~h your ~ax payment. CUT ALONG THIS L'rNE ~ RETA'rN LONER PORT'rON FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) ### INHERITANCE TAX STATEMENT OF ACCOUNT ~K ESTATE OF KNISELY ROBERT M F'rLE NO. 21 03-0427 ACN 03114062 DATE 04-26-2004 THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHOHN BELO# ZSA SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADdUSTMENT: 04-01-2004 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): .00 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 03-29-2004 CD003746 .00 102.60 ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), TOTAL TAX CREDIT YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. ) 102.60 BALANCE OF TAX DUE 102.60CR INTEREST AND PEN. .00 TOTAL DUE 102.60CR 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 RES[DENT DECEDENT make check or money order payable to: REGTSTER OF W/LLS, AGENT. -- [f NON-RES/DENT DECEDENT make check er money order payable to: COMMONWEALTH OF PENNSYLVANTA. 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 Inheritance and Estate Tax" (REV-1313). Applications are available at tho Office of the Register of Hills, any of the 23 Revenue District Offices or from the Department's Z4-hour answering service for forms ordering: 1-800-36Z-Z050~ services for taxpayers with special hearing and / or speaking needs: 1-800-447-~0Z0 (TT only). REPLY TO: guestions regarding errors contained on this notice should ba addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Oapt. Z80601, Harrisburg, PA 171ZS-O601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (BZ) 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 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 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes ~hich became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. Interest Daily Interest Oaily Year Rate Factor Year Rate Factor Year 1982 20Z .000S48 1988-1991 llg .000301 2001 1983 162 .000438 1992 92 .000247 ZOO2 198q llX .000301 1993-1994 7X .000192 2003 1985 132 .000356 1995-1998 92 .O00Zq7 2004 1986 102 .000274 1999 72 .O00XeZ 1987 92 .000247 2000 82 .O00Z19 The applicable interest rates for 1982 through 2004 ars: Interest Daily Rate Factor 92 .000Z47 61 .000164 5Z .000137 qZ .000110 --Interest is calculated as follows: TNTEREST = BALANCE OF TAX UNPAXD X NUNBER OF DAYS DELXNQUENT X DATLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest caIculation 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 TNDZVZDUAL TAXES INHERTTANCE TAX DZVTSZON DEPT. 280601 HARRTSRURG, PA 17128-060! COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP COl-OS) SANDRA A KNISELY 899 HESSIAH VILLAGE 899 PO BOX 2015 MECHANICSBURG PA 17055 DATE 04-26-2004 ESTATE OF KNISELY DATE OF DEATH 01-28-2005 FILE NUMBER 21 05-0427 COUNTY CUHBERLAND ACN 05114061 Amount Remi~ed ROBERT N HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ to your account, sub.lt ~che upper portion of ~his for. w~.'~h your tax pay.en~. CUT ALONG THIS L'rNE ~'* RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) ### INHERITANCE TAX STATEMENT OF ACCOUNT ESTATE OF KNISELY ROBERT M FILE NO. 21 03-0427 ACN 03114061 DATE 04-26-2004 THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHONN BELON ZSA SUHHARY OF THE PRINCIPAL TAX DUE.. APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: 04-01-2004 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... .00 PAYHENTS PAYNENT DATE 03-29-2004 (TAX CREDITS): RECEIPT NUMBER DISCOUNT ¢+) INTEREST/PEN PAID CD003747 .00 ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), AHOUNT P~D: ~ 555.52 TOTAL TAX CREDIT YOU HAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORH FOR INSTRUCTIONS. ) 555.52 BALANCE OF TAX DUE 555.52CR INTEREST AND PEN. .00 TOTAL DUE 555.52CR PAYMENT: Detach the top port[on 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: REGTSTER OF NILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: CONNONNEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, ahich mas not requested on the Tax Return) may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of the Register of Hills) any of the Z3 Revenue District Offices or from the gepart.ant's Iq-hour answering service for forms ordering: 1-BOO-36Z-ZOSO; services for taxpayers with special hearing and / or speaking needs: 1-800-q47-30ZO (TT only). REPLY TO: questions regarding errors contained on this notice should be addressed to: PA Depart.ant of Revenue) Bureau of Individual Taxes, ATTN: Post Assessment Review Unit) Dept. ZEOBO[) Harrisburg, PA lTlZE-0601, phone (717) 787-650S. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death) a five percent (SI) discount of the tax paid is al[awed. 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 and of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency) or nine (9) months and one (l) day from the date of death) to tho date of payment. Taxes ~hich became delinquent before January l) 1eSI bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .O0016q. All taxes which became delinquent on and after January 1) 198Z witl bear interest at a rate ~hich ~ill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. Tho applicable interest rates for 198Z through ZOOq are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year gate Factor ZeBZ ZOZ .O005qB 1988-1991 llZ ,000301 2001 9Z .OOOZq7 1983 162 .000438 1992 9Z .0002q7 2002 62 .000164 2003 SZ .000137 198q X1Z .000301 1993-1994 7Z .OOOXeZ 1985 132 .000~56 1995-1998 92 .000Z47 ZOOq 42 .000110 1986 lOX .000274 1999 72 .000192 1987 9Z .000Z47 ZOO0 8Z .000219 --Interest is calculated as follows: /NTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY TNTEREST 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 data shown on the Notice) additional interest must be calculated. BRENNEMAN & SPARE ESTATE NO.21-03-0427 FIRST AND FINAL ACCOUNT AND STATEMENT OF PROPOSED DISTRIBUTION OF AND BY SANDRA ANN KNISELY, EXECUTRIX AND VIRGINIA L. KNISELY, ADMINISTRATRIX D.B.N.C.T.A. OF THE ESTATE AND UNDER THE LAST WILL AND TESTAMENT OF ROBERT M. KNISELY, DECEASED, LATE OF UPER ALLEN TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA Sandra Ann Knisely, Executrix and Virginia L. Knisely, Administratrix D.B.N.C.T.A., as aforesaid and the Accountants herein, avers as follows: DATE OF DECEDENT'S DEATH: DATE LETTERS TESTAMENTARY ISSUED: DATES EXECUTOR'S NOTICE ADVERTISED: Cumberland Law Journal Patriot-News Co. January 28, 2003 June 2, 2003 June 13, 20, 27, 2003 June 17, 24, July 1, 2003 FIRST AND FINAL ACCOUNT PERSONALTY - PRINCIPAL ACCOUNT DEBITS the Accountants charge themselves with the receipt of the Decedent's personalty, goods and chattels as set forth in their inventory heretofore filed in the amount of: The Accountants charge themselves with the following additional receipts: 1. Malpezzi Funeral Home, Cumberland County VA allowance for funeral expenses TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, DEBITS: PERSONALTY - PRINCIPAL ACCOUNT CREDITS The Accountants claim credit for the payment of the following items from Decedent's Personalty Account: 1. Robert L. Knisely, reimbursement for funeral luncheon 2. Sandra Ann Knisely, reimbursement for following expenses: a. Rolling Green Cemetery, grave opening b. Radison Penn Harris Hotel, hotel expense c. Thirfty Car Rental, car rental expense d. United Airlines, airplane flight 3. Internists of Central PA, medical expenses 4. Malpezzi Funeral Home, funeral services 5. Messiah Village, reimburse for amublance service paid to West Shore EMS 6. Register of Wills, filing fee for Inheritance Ta~,Jq~tvr}3,~ pue!~gC~lll0 7. Register of Wills, Agent, Inheritance Tax due ~/c~ 8. Register of Wills, additional probate fee '"~ 9. Register of Wills, Agent, additional Inheritance Tax due Items to be paid subsequent to confirmation of F~e~l. Ai~c~oun~)g:-tl- 10. Virginia L. Kniseiy, family exemption a. Register of Wills, probate fee b. Cumberland Law Journal, advertisir~)nc~; Page 1 of 9 870.00 347.35 167.72 477.00 54.00 75.00 159.19 64,020.16 100.00 $ 64,120.16 $ 155.10 1,862,07 9.25 5,674.9O 89.45 15.00 3,691.60 97.00 46.99 3,500.00 3,000.00 288.19 SNELBAKER, BRENNEMAN SPARE 13. Reserve for filing fees, accounting and other costs associated with the administration of Decedent's Estate ¥OTAL, PERSONALTY, PRINCIPAL ACCOUNT, CREDITS: PERSONALTY- INCOME ACCOUNT DEBITS ~'he Accountants charge themselves with the receipt of the following Income from the investment of Personalty Principal: 1. PNC Bank, Certificate of Deposit # 31000225540, interest 2. Orrstown Bank, estate checking account, interest TOTAL, PERSONALTY, INCOME ACCOUNT, DEBITS: PERSONALTY - INCOME ACCOUNT CREDITS The Accountants claim credit for the payment of the following items from the Personalty Principal Account: TOTAL, PERSONALTY, INCOME ACCOUNT, CREDITS: REAL ESTATE - PRINCIPAL ACCOUNT DEBITS The Accountants charge themselves with the receipt of Decedent's Real Estate as set forth in their Inventory heretofore filed in the amount of: TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, DEBITS: REAL ESTATE - PRINCIPAL ACCOUNT CREDITS The Accountants claim credit for the payment of the following items from Real Estate Principal Account: TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, CREDITS: REAL ESTATE - INCOME ACCOUNT DEBITS The Accountants charge themselves with the receipt of the income from the investment of Real Estate Principal Account: TOTAL, REAL ESTATE, INCOME ACCOUNT, DEBITS: REAL ESTATE - INCOME ACCOUNT CREDITS The Accountants claim credit for the payment of the fo,owing items From the Real Estate Income Account: TOTAL, REAL ESTATE, INCOME ACCOUNT, CREDITS: Page 2 of 9 1,000,00 $ 19,429.55 389.94 11.71 401.65 ' NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE LAW OFFICES SNELBAKER BReNNEMAN & SPARE PEBSONALTY: PRINCIPAL ACCOUNT: Debits Credits Balance INCOME ACCOUNT: Debits Credits Balance TOTAL PERSONALTY REAL ESTATE: PRINCIPAL ACCOUNT: Debits Credits Balance INCOME ACCOUNT: Debits Credits Balance TOTAL REAL ESTATE: TOTAL FOR DISTRIBUTION: RECAPITULATION Page 3 of 9 64,120,16 19,429.55 401.65 NONE NONE NONE NONE NONE 844,690.61 $ 401.65 $ NONE $ NONE $ 45,092.26 NONE 45,092.26 LAW OFFICES SNELBAKER BRENnEMAN & SPARE STATE Of COLORADO ) SS. COUNTY OF ) Sandra Ann Knisely, Executrix, being duly sworn according to law deposes and says: that she is the Executrix of the Estate and under the Last Will and Testament of Robert M. Knisely, Deceased; that she is the Accountant herein; that the foregoing is a true and complete accounting of her administration of said Estate; that the attached list or schedule [*] contains the names, addresses and amounts due unpaid creditors who have given proper notice of their claims; that the attached list or schedule [**] contains the names and addresses of all persons interested in the distribution of said Estate; and that the facts set forth herein are true and correct to the best of her knowledge, information and belief. Sworn to and subscribed before me this /~'~ay of ~ Page 4 of 9 LAW OFFICES SNELBAKER BRENnEMAn & SPARE COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) Virginia L. Knisel¥, Adminstratrix D,B.N.C,T.A., being duly sworn according to law deposes and says: that she is the Administratrix of the Estate and under the Last Will and Testament of Robert M. Knisel¥, Deceased; that she is the Accountant herein; that the foregoing is a true and complete accounting of her administration of said Estate; that the attached list or schedule [*] contains the names, addresses and amounts due unpaid creditors who have given proper notice of their claims; that the attached list or schedule [**] contains the names and addresses of all persons interested in the distribution of said Estate; and that the facts set forth herein are true and correct to the best of her knowledge, information and belief, Sworn to and subscribed before me this [q3~kday of 2004 ~'~?lly Admin~str ~xDBNCTA COMIV~)NWEALTH OF PENNSYLVANIA MY Cemmts&bn E,~ms Nov. 22. 2007 Member, Pen.ayivanla Association Of Notates Page 5 of 9 * UNPAID CREDITORS: NONE LAW OFFICES SNELBAKER BRENNEMAN & SPARE ** PERSONS INTERESTED IN DISTRIBUTION OF ESTATE: Virginia L. Knisely 892 Oak Oval, Messiah Village Mechanicsburg, PA 17055 Sandra Ann Knisely 6395 South Glencee Court Littleten, CO 80121 Robert L. Knisely 5750 South Steele Street Greenwood Village, CO 80121 Page 6 of 9 LAW OFFICES SNELBAKeR BRENNEMAN & SPARE STATEMENT OF PROPOSED DISTRIBUTION Sandra Ann Knisely, Executrix and Virginia L. Knisely, Administratrix D.B.N.C.T.A., and the Accountants herein, proposes to distribute the balance of the Estate of Robert M. Knisely, Deceased, to wit: $45,092,26 in accordance with the Last Will and Testament of said Decedent as follows: Virginia L. Knisely 1/3 of residue as per Item Second of Will Sandra Ann Knisely 1/3 of residue as per Item Second of Will Cancellation of Note Payable Two Cemetery plots located in Rolling Green Cemetery, in kind Cash Robert I. Knisely 1/3 of residue as per Item Second of Will 1951 proof set which includes penny, nickel, dime, quarter & half-dollar, in kind 1964 year set which includes penny, nickel, dime, quarter & half-dollar, in kind 1953 proof set which includes penny, nickel, dime, quarter & half-dollar, in kind Cash TOTAL DISTRIBUTION: Page 7 of 9 15,030.75 7,500.00 4,500.00 3,030.75 282.00 322.00 4.50 14,422.26 $ 45,092.26 LAW OFFICES SNELBAkER BRENNEMAN & SPARE STATE OF COLORADO ) : SS. COUNTY OF ) Sandra Ann Knisely, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Statement of Proposed Distribution are true and correct to the best of her knowledge, information ~/~,'ef ~7=~;~..~,,~ ~ ~/ "'-S~r~dra Ann Knisely, ExecutrJx~ Sworn to and subscribed before me / _~day of 2004 ~ ........ this - u M~ ~'~mm'ssl0n Page 8 of 9 SnElBakEr. BrENNEMaN & SPARE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ) ) SS. Virginia L. Knisely, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Statement of Proposed Distribution are true and correct to the best of her knowledge, information and belief. Virginia L~ Knisely, Administratrix(~.B.N.C.T.A. Sworn to and subscribed before me this [~day of ~-U-[~" :)004 COMMONWEALTH OF PENNSYLVANIA NO.Iai Se~ Sandra I(. Showe~, Notary Public Ma:llanlcsburg Bom, Cumberland County My Commisslo. Expires Nov. 22, 2007 Page 9 of 9 IN2THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE NO: 21-03-0427 RE: Estate of ROBERT M. KNISELY, Late of Upper Allen Township, Cumberland County, Pennsylvania FIRST AND FINAL ACCOUNT AND STATEMENT OF PROPOSED DISTRIBUTION $ i'.YE L B'A'I~ P._, BRENNEM^ SPARE ATI-ORNEY5 AT LAW MECHANICSBUKG, PENNSYLVANIA 17055 COMMONWEALTH OF pENNSYLVANIA '~ ss: COUNTY OF CUMBERLAND Sandra Ann Knisely and Virginia L. Knisely being duly sworn according to law. deposes and says that they are the Executrix and Administratrix of the Estate of Robert M. Knisely [ate of U_p~er Allen Township , ~x~c, . . ....... S&-~iC~ra A'~n ~nisely and Cumberland County, Pa.. de=ease~ha~ the w~thln is an inventory ma~e by V~ rg~ n~ ~ T, ~n ~ ~e] y ' , the sa~Admlnls~ratrix of the e.f~re estate o{ sa~ decedent, cons;sting of a~] %he ~ersonaJ prop.try an~ real estate, except real estate outside the Commonwealth of Pennsy[vanla, an~ that the figures opposite each item of the Inventory represent ~f's ~elr value as of the ~ate o{ ~ece~ent's ~eafh. and subscribed before me, 2004 6395 S. Glencoe Court Littletun, CO 80121 Virginia L. Kni~ ~ 892 Oak Oval Messiah village, Mechanicsburg. PA 17055 January ' ' 2003 2. 3. 4. Day Month Year Sworn and subscribed before me. INSTRUCTIONS July 19 2004 q~ ~ //~l'x~., An inventory must be filed within three months after appointment of persona represen aflve. A supplement inventory must be filed within thirty days of discovery of additional assets. Addlfionel sheets may be effeched .s fo person.lfy or realty COM~NW~LTHOF PENNSYLVANIA See A~icle IV, FiducleHes Act of 1949. ~ I ~ S~,~P~ Mem~r, Penns~venia Association Of Notaries .t Z Om Inventory of the real and personal estate of ROBERT M. KNISELY, Deceased PERSONALTY: 1. PNC Bank, N.A., Certificate of Deposit # 31000225540 2. 1951 proof set which includes penny, nickel, dime, quarter and half-dollar 3. 1950 proof set which includes penny, nickel, dime, quarter and half-dollar 4. 1964 year set which includes penny, nickel, dime, quarter and half-dollar 5. Note Receivable from Sandra A. Knisely, with outstanding principal balance of $7,500.00 (non-interest loan) 6. Two cemetery plots located in Rolling Green Cemetery 51,411.66 282.00 322.00 4.50 7,500.00 4,500.00 TOTAL PERSONALTY: REAL ESTATE: 1 Decedent did not own any property individually at the time of his death TOTAL PERSONALTY AND REAL ESTATE: 64,020.16 0,00 64,020.16 Page 1 BUREAU OF ZNDTVZDUAL TAXES INHERITANCE TAX DTVIS/OH DEPT. 280601 HARRISBURG, PA 17128-06nl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT REV-1607 EX AFP (01-03) SANDRA A KNISELY 899 MESSIAH VILLAGE PO BOX 2015 MECHANICSBURG PA 17055 DATE 07-19-2004 ESTATE OF KNISELY DATE OF DEATH 01-28-2003 F/LE NUMBER 21 03-0427 COUNTY CUMBERLAND ACN 03114062 I Amoun~ Remi'l:'l:ed ROBERT M MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ ~o your acooun~c, submi~ ~che upper por~ion of ~:his form wi~h your ~cax payment. CUT ALONG TH'rS L*rNE ~ RETA'rN LONER PORT'rON FOR YOUR RECORDS *~ REV-1607 EX AFP (01-03) ~## INHERITANCE TAX STATEHENT OF ACCOUNT ~ ESTATE OF KNISELY ROBERT M F'rLE N0.2! 05-0427 ACN 05114062 DATE 07-19-2004 THIS STATEMENT ZS PROVIDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHO#N BELO# ZSA SUHNARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-01-2004 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... .00 PAYMENTS PAYMENT DATE (TAX CREDITS): RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID ¢-) AMOUNT TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF PA/D AFTER THIS DATE, SEE REVERSE S/DE FOR CALCULAT/ON OF ADDZT/ONAL /NTEREST. /F TOTAL DUE 1S LESS THAN $1, NO PAYMENT IS REQU/RED. ZF TOTAL DUE /S REFLECTED AS A "CRED/T" YOU NAY BE DUE A REFUND. SEE REVERSE S/DE OF TH/S FORH FOR /NSTRUCT/ONS. } BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG,, PA 171IS-g601 COMMONNEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEMENT OF ACCOUNT REV-1607 EX &FP C01-03) SANDRA A KNISELY 899 MESSIAH VILLAGE 899 PO BOX 2015 MECHANICSBURG PA 17055 DATE 07-19-ZOOq ESTATE OF KNISELY DATE OF DEATH 01-ZS-Z00~ FILE NUMBER 21 O$-OqZ7 COUNTY CUMBERLAND ACN 0511q061 Amoun~ Rem i'l:'l'ed ROBERT M MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGTSTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his form wi~h your ~ax payment. CUT ALONG TH'rS L*rNE ~ RETA'rN LONER PORTION FOR YOUR RECORDS ESTATE OF KNISELY ROBERT M FZLE ND. Z1 03-0q27 ACM 0511q061 DATE 07-19-200q TH'rS STATEMENT TS PROV*rDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACM 'rN THE NAMED ESTATE. SHO#N BELO# TS A SUMMARY OF THE PR/NC/PAL TAX DUE., APPLTCAT*rON OF ALL PAYMENTS., THE CURRENT BALANCE,, AND, TF APPLICABLE, A PROJECTED TNTEREST F'rGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: Oq-Ol-ZOOq PR[NCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): .O0 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID O$-Zg-zooq O$-Zg-ZOOq 07-1$-ZOOq CDOO~7q7 CDOO$7q6 REFUND .00 .00 .00 TOTAL TAX CREDIT 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" YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 STATUS REPORT UNDER RULE 6.12 Name of Decedent: Robert M. Knisely Date of Death: 1/28/2003 Will No.: 21-03-0427 Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ['~ No [-~ 2. If the answer is No, state when the personal representative reasonably beheves 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_xx No [-"1 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? Yes ['--] No ['~ Date: 8/30/04 Copies of receipts, releases, joinders and approval of formal or anilff~mrmaa~;;c~ttaUncl~en~taYotb~i.~f, the OrphanS'. si~laulFe '~.~-~----- Court Richard C. Snelbaker Snelbaker, Brenneman & Spare~ P.C. Name 44 West Main Street Mechanicsburg, PA 17055 Address (717) 697-8528 Telephone No. Capacity: [[2] Personal Representative [] Counsel for personal representative BUREAU OF ZNDZVTDUAL TAXES TNHERZTAHCE TAX DZVTSTON DEPT. Z80601 HARRXSBURG, PA 171Z8-0601 COHMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TNHERZTANCE TAX STATEHENT OF ACCOUNT RE¥-1~07 EX AFP (D1-03) RICHARD C SNELBAKER SNELBAKER ETAL qq W MAIN ST MECHANICSBURG PA 17055 DATE 06-01-ZOOq ESTATE OF KNISELY DATE OF DEATH 01-28-2005 F/LE NUH~ER 21 05-0~27 COUNTY CUMBERLAND ACM 101 Amoun~ Rem i~*l:ed ROBERT M HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o your account, submit: ~he upper por~:ion of ~:his form wi~ch your ~ax payment:. CUT ALONG THIS L*rNE ~ RETAIN LOWER PORT'rON FOR YOUR RECORDS *~ REV-1607 EX AFP (01-03) .aa 'rNHERZTANCE TAX STATEMENT OF ACCOUNT ~ ESTATE OF KNISELY ROBERT M FILE NO. 21 O$-OqZ7 ACN 101 DATE 06-01-200q THIS STATEMENT TS PROV'rDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAMED ESTATE. SHO#N BELOW TS A SUMMARY OF THE pR'rNCTPAL TAX DUE, APPLZCATTON OF ALL PAYMENTS, THE CURRENT BALANCE.. AND, TF APpLTCABLE, A PROJECTED TNTEREST F'rgURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-ZZ-200~ PRINCIPAL TAX DUE= ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 3,691.60 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) .00 02-05-200R Oq-Zl-ZOOq CDOO$53q CD005850 q6.99- $,691.60 q6.99 3,691.60 .00 TOTAL TAX CREDIT ~ALANCE OF TAX DUE INTEREST AND PEN. .00 TOTAL DUE .00 ZF PAID AFTER THIS DATE, SEE REVERSE S/DE FOR CALCULATION OF ADDITIONAL XNTEREST. XF TOTAL DUE 1S LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" {CR}, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF NTLLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMON#EALTH OF PENNSYLVANIA. REFUND (CA): A refund of a tax credit, ahich was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of the Register of Nills, any of the Z3 Revenue District Offices or from the Department's Z4-hour answering service for fores ordering: 1-800-36Z-ZOSO; services for taxpayers with special hearing and / or speaking needs: l-BOO-447-$OZO (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. gB06Ol, Harrisburg, PA 171Z8-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three ($) calendar months after the decedent's death, a five percent (SI) 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 16, 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 1, 19Bg bear interest at the rate of six (6Z) percent par annum caIcuIated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOO4 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 2OZ .000548 1988-1991 llZ .OOO~O1 ZOO1 9Z .OOOZ47 1983 16Z .000438 1992 9Z .000247 200Z 6Z .000164 1984 1XZ .000301 1993-1994 72 .O0019Z ZOO3 5Z .000157 1985 132 .000356 1995-1998 92 .000Z47 ZOO4 4Z .000110 1986 lOZ .000274 1999 72 .O0019Z 1987 92 .000247 ZOO0 8Z ,000219 --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 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.