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Home My WebLink About03-0264PETITION FOR PROBATE and GRANT OF LETTERS Estate of ~ u. Lew~s also known as To: Register of Wills for the ~ Deceased. County of Cumberland in the Social Security No. 578-03-6706 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(%'), who is)~Ye 18 years of age or older an the execut or named in the last will of the above decedent, dated jv3_y 17 ,1998 and codicil(s) dated N/A (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 2804 Market Street, Camp H±ll, PA 17011 at (list street, number and muncipality) Decendent, then 92 years of age, died ~areh 16 Manor Care West, Camp Hill~ PA 2003 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: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $.~oo, ooo.oo (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ 400,000.00 situated as follows: All thoese certain pieces or parcels of land situate in the 'Borough of Camp Hill, County of Cumberland and State of Pennsylvania WHEREFORE, petitioner~) respectfully request(g) the probate of the last will and codicil(s) presented herewith and the grant of letters Testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. Elmer G. Engle 37 Beard Road Mechanicsburg, PA 17055 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF c~~ The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s)will well and truly administe.r t~e estate according to law. bSe~ mte° th~ ~rm~t~tt~nd subs~ar~b~o~3 f X ~?~ '4J/g/~'-~ ~ ~. ~nna M. Otto, 1st ~puty' /- - ~Reg~Z,;o';-'D~b~'~, ~ 9 NO. 21-2003-264 Estate of Mary H. Lewis ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW March 26th _x~9 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 July 17, 1998 described therein be admitted to probate and filed of record as the last will of Mary H. Lewis and Letters Testamentary are hereby granted to Elmer G. Engle FEES Probate, Letters, Etc .......... $ Short Certificates(3) .......... $ 9.00 ~ .x~D~ges.(.5.).. $ 15.00 JCP $ ].0.00 410.00 TOTAL __ $444.00 Filed .l~l~h. 2fitla, 2{103 ................ Re~ster of Wills Donna M. Otto,lst Deputy ATTORNEY (Sup. Ct. I.D. No.) Jane M. Alexander, Esquire #07355 148 S. Baltimore St., Dillsburg, PA 17019 ADDRESS (717) 432-4514 PHONE Mailed Letters to Attorney on 3/26/2003. his is to certi~' that the information here given is correcth, copied fi-om an original certificate of death duly filed with me as Local Rogistrar. The original certificate will be forwarded to the State Vital Records Office fbr permanent hhng. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 8921092 mo~ :4aRe~ ~ez COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH · ' " ..... "'~ I,*. I,, ~/& ' ~" ,,~/~wr~ I 21-2003-264 SAIDIS, SHUFF & MASLAND ATrORNEYS*AT,LAW 2109 Market Street Camp Hill, PA LAST WILL AND TESTAMENT OF MARY H. LEWIS I, MARY H. LEWIS of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testa- ment, hereby revoking any will previously made by me. I - I dJr~c~ ~ ~=~ = ~ ....... ~=n~ of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II - I devise my apartment building, known as the Ben Franklin Apartments and numbered 2804 Market Street, Camp Hill, Pennsylvania, to ELMER G. ENGLE and WINNIE L. EN~LE, now of 37 Beard Road, Mechanicsburg, Pennsylvania. III - I bequeath the contents of said apartment build- ing, other than the contents of my own apartment, to ELMER G. ENGLE and WINNIE L. EN~LE. IV - I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate unto my niece, JUDITH ANN FAIRCHILD, now of Bangor, Pennsylvania, provide that she survives my by sixty (60) days. V - Should the said JUDITH ANN FAIRCHILD fail to be living on the sixty-first (61) day following my death, then I SAIDIS, SHUFF & MASLAND ATrORNEYS.AT*LAW 2109 Market Street Camp Hill, PA devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate as follows: A. I bequeath all of my automobiles and all other articles of personal or household use, including but not limited to household goods, furniture, personal effects, and other tangible personal property to COLBY FAIRCHILD. B. I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate unto Dauphin Deposit Bank and Trust Company, Trustee, IN TRUST, NEVERTHELESS, for the following uses and purposes and under the following terms and conditions: 1. The trust shall be held for the benefit of my grandnephew, COLBY FAIRCHILD. The trustee shall invest and reinvest the principal and out of the income derived by the trustee, trustee shall pay all the necessary costs and expenses of the trust, including its reasonable compensation, and shall pay the net income to or for the benefit of my grandnephew. The trustee, at. its sole and absolute discretion, may make expendi- tures from the principal of the trust as it may deem necessary for the support, maintenance and education of said beneficiary. As he attains the age of 35, he shall have the right to withdraw one-third of the principal balance of the trust; as he attains the age of 40, he shall have the right to withdraw one-half of the then-remaining principal; as he attains the age of 45, he 2 SAIDIS, SHUFF & MASLAND AT~ORh~'~*AT*LAW 2109 Market Street Camp Hill, PA shall have the right to terminate the trust and receive the balance of the funds. Such rights of withdrawal may be exercisec at any time or from time to time after the right accrues. If he shall have attained any such respective ages at the time when such shares are directed to be set apart or at the time when any addition is made thereto, he shall then have the right to with- draw such part or parts or all, as the case my be, of such share as is given to him upon attaining such respective age. 2. Should the said COLBY FAIRCHILD die before distribution of the entire share held for his benefit, the principal and any accumulated and undistributed income of the share shall then be distributed to his issue. Should he die and have no issue surviving, including afterborn issue, then the remaining principal and accumulated and undistributed income of the share shall be distributed to his heirs at law. 3. No interest in income or principal shall be assignable by, or be available to anyone having a claim against, my said beneficiary before actual payment to the benefi- ciary. VI - My trustee herein named shall have the following powers and duties, in addition to those vested in it by law and other provisions of this Will: SAIDIS, SHUFF & MASLAND ATFORI~*AT*LAW 2109 Market Street Camp Hill, PA A. To retain any or all of the assets of this trust, real or personal, including its own stock, without regard to any principal of diversification or risk. B. To invest in all forms of property, including stock, common trust funds and mortgage investment funds whether operated by it or others, without restriction to investments authorized for Pennsylvania fiduciaries, as it deems proper, without regard to any principal of diversification or risk. C. To sell at public or private sale, to ex- change, or to lease for any period of time, any real or personal property and to give options for sales, exchanges or leases, for property for such prices and upon such terms or conditions as it deems proper. D. To allocate receipts and expenses to princi- pal or income or partly to each as it from time to time thinks proper in its sole discretion. E. To make payment to the parents or guardians of any minor or incompetent beneficiary. F. To hold property in my name or in its name, or in the name of a nominee or unregistered. G. To lend to, or purchase from, my executor even though trustee may also be such executor. VII - I appoint ELMER G. ENGLE, Executor of this, my Last Will and Testament. Should he fail to qualify or cease to act as such, then I appoint JUDITH ANN FAIRCHILD to act in this capacity. Neither of my personal representatives shall be required to post bond in this or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set this, the /7 7~ day of ~ my hand and seal on · 1998. (SEAL) 4 SAIDIS, SHUFF & MASLAND A'I'rORNEYS,AT~LAW 2109 Market Street Camp Hill, PA Signed, sealed, published and declared by ~IARY ~. LEWIS, Testa- trix therein named, on this and three (3) other sheets of paper as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Name Address SAIDIS, SHUFF & MASLAND ATrORb~YS.AT*LAW 2109 Market Street Camp Hill, PA COMMONWEALTH OF PENNSYLVANIA) : COUNTY OF CUMBERLAND ) SS. WE, the undersigned, the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instru- ment, being first duly sworn, do hereby declare to the under- signed authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix signed the Will as witnesses and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind, and under no constraint or undue influence. T~s t at ri~x% Wit~e§~3~-~ Witness Subscribed, sworn to and acknowledged before me by the testatrix, and subscribed andz~worn to before me by both wit- nesses, this /¢~ day of ~'?~ , 1998. Notarial Sea! Shelby L. Yingling, Notary Public Camp Hill Bore, Cumber!arid County My Corem s$ion Expircs Ar.~ri 8, Member, Pennsylvania Association of Notaries MARY H. LEWIS Law Offices SAIDIS, SHUFF & MASLAND A PROFESSIONAL CORPORATION 2109 Market Street · Post Office Box 737 Camp Hill, Pennsylvania 17001-0737 (717) 737-3405 Fax (717) 737-3407 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name, of Decedent.. Mary H. Lewis Date of Deaths March 16, 2003 Admin. No. % 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 Name E~er G. ~gl~"' Address 37 Beard R~d, Mechanicsb~g, PA 17055 Winnie L. Engle 37 Beard Road, Mechanicsburg, PA 17055 Judith Ann Fairchild 573 S. 6th Street, Bangor, PA 18013 Colby Fairchild RR6, Box 6228, Stroudsburg, PA 18360 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except /ynature/ _ /~ame Jane M. Alexander, Esquire Address 148 S. Baltimore Street Dillsburg, PA 17019 Telephonef717) 432-4514 Capacity:~ Personal Representative x Counsel for personal representative BUREAU OF ZNDZVTDUAL TAXES I'NHERTTANCE TAX DTVTSTON DEPT. 280601 HARRTSBURG, PA 17116-D601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-1547 EX AFP JANE H ALEXANDER ESQ 1~8 S BALTIHORE ST DILLSBURG DATE 0~-11-200~ ESTATE OF LEWIS MARY H DATE OF DEATH 05-16-Z005 FZLE NUHBER 21 05-026q COUNTY CUHBERLAND ACN 101 '04 P, PR 14 Aaount Rem1 '~ted HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~.~ REV-1547 EX AFP (01-03) NOTZCE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF LEWIS MARY H FILE NO. 21 05-026~ ACN 101 DATE 0~-12-200~ TAX RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATION CONCERNING FUTURE ZNTEREST- SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A} (1) 2. Stocks end Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Zntares~ (Schedule C) (3) ~. Hor~cgagas/Notas Receivable (Schedule D) (~). $. Cash/Bank Daposits/Nisc. Personal Propar~y (Schedule E) (S) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schadula G) (7) B. Total Assats APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funeral Expanses/Ada. Costs/Hisc. Expanses (Schedule H) (9) 10. Dabts/Nor~gaga Liabilltlas/Lians (Schedule Z) (10) 11. Total Deduct ions 12. Net Value 04: Tax Return ~25/000.00 257~701.29 .00 .00 7Z~7~1.72 .00 NOTE: To insure proper credit to your account, submit ~he upper port/on of this fora with your tax payment. 209/773.05 (8) 9R5,216.06 R5,658.~9 Z,511.9~ {11} ~8.]70.~ (1~) 897,0~5.65 15. 14. NOTE CharitIbla/Govarnmantal Bequests; Non-alec*ad 9115 Trusts (Schedule J) (15) . O0 Net Valua of Estate Sub,act to Tax (lq) 897,0q5.65 If an assesseent was issued previously, lines la, 15 and/or 16, 17, 18 and 19 reflect figures that include the total of ALL returns assessed to date. 06-13-2003 01-ZS-ZO0~ OZ-15-ZO0~ 19. Principal Tax Dua TAX CREDITS: PAY~-'-;;T RECETpT DATE NUNBER 06-13-2003 CD00268~ CD002685 CD005~75 CD005565 DISCOUNT (+) ZNTEREST/PEN PAZD (-) Z,100.00 1,573.30 .00 5.01- BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-1~-200~ ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · O0 X O0 = . O0 · 00 X 0~5= .00 · O0 X 12 = . O0 897,0R5.65 X 15 = 15~,556.8~ (19)= 13~,556.8~ ANOUNT PAID 39,900.00 19,892.66 60,500.00 595.89 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 15~,556.8~ .00 276.~5 276.~5 ( IF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SZDE OF THIS FORN FOR INSTRUCTIONS.) ASSESSHENT OF TAX-' 15. Amount of Line 1~ et Spousal rata (15) 16. AIount of LJ. ne 1~ taxable et Lineal/Class A rata (16) 17. Amount of Line 1~ at Sibling ra~a (17) 18. Amount of Line 1~ taxable et Collateral/Class B rata (18). RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 198Z -- [f any future interest in the estate is transferred [n possession or enjoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class B (collataral) rate an any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to thm Register of gills printed on the reverse side. --Hake check or money order payable to: REGISTER OF #ZLLS~ AGENT A refund of a tax credit, which ams not requested on the Tax Return, amy ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" [REV-IS13). Applications are available at the Office of the Register of gills, any of the Z3 Revenue District Offices, ar by calling the special Z4-hour anseering service for forms ordering: 1-aOO-56Z-ZOSG; services for taxpayers with special hearing and / or speaking needs: 1-800-447-50Z0 (TT only). Any party in interest not satisfied a[th the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Not[ce must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writ[no to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Znstructions for Inheritance Tax Return for a Resident Decedent" (REV-IDOl) for an explanation of administratively correctable errors. Zf any tax due is paid within three (5) calendar months after the decedent's death, a five percent [SI) discount of the tax paid [s allowed. The iSZ 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. This non-participation penalty is appealable [n the same manner and [n the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. interest is charged beginning aith 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 et the rate of six (SI) percent par annum calculated at a dally rate of .000164. Al1 taxes ahich became delinquent on and after January 1, 198Z will bear interest at · rata which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are: Interest DaiZy Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20Z .000548 ~'~-1991 1XZ .000501 ~ 9Z .OOOZq? 1985 16Z .000458 1992 9Z .000247 ZOOZ 6Z .000164 1984 I1Z .000501 1995-1994 7Z .O00igz 2005 5Z .000157 1985 13Z .000556 1995-1998 9X .000247 2004 4X .O0011O 1986 lOX .000Z74 1999 7Z .00019Z 1987 XOZ .000Z74 ZOO0 7Z .OOOIgZ --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUIfBER OF DAYS DELINQUENT X DAILY TNTEREST FACTOR --Any Notice issued after the tax becomes delinquent wilt reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after tho interest computation date shown on the Notice, additional interest must be calculated. REV-1500 EX COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 INHERITANCE TAX RETURN RESIDENT DECEDENT COUN CODE OFFICIAL USE ONLY FILE NUMBER 21-0 3 O0 2 6 4 YEAR NUMBER Z UJ UJ Z Z O O UJ DECEDENT'S NAME (LASI FIRST, AND MIDDLE INITIAL) Lewls, Hary H, D~E OF DE~H (MM-DD-YEAR) D~E OF BIRTH (MM-DD-YEAR 03/16/2003 8/23/1910 SOCIAL SECURI~ NUMBER 578-- 03 -- 6706 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ---1 Original Return [~]4. Limited Estate ~]6. Decedent Died Testate (Attach copy of Will) r~9. Litigation Proceeds Received ~-~2. Supplemental Return r~4a. Future Interest Compromise (date of death after 12-12-82) [~7. Decedent Maintained a Living Trust (Attach copy of Trust) [10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ~13. Remainder Return (date of death prior to 12-13-82) [~5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes J~11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME Jane M. Alexander, Esquire FIRM NAME (IfApplicable) TELEPHONE NUMBER (717) 432-4514 COMPLETE MAILING ADDRESS 148 S. Baltimore Street Dillsburg, PA 17~1.,~. 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Padnership or Sole-Proprietorship (3) 4. Modgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 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) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. (9) (10) (8) 2490.00 (11) (12) (13) Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) ~OFFICIAL USE ONLY 2490.00 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) x .0 __ (15) 16. Amount of Line 14 taxable at lineal rate x .0 __ (16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) Decedent's Complete Address: STREETADDRESS 2804 Market Street IzIP CITY Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount STATE Total Credits (A + B + C ) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. IF THE ANSWER (1) PA (2) (3) (4) (5) (SA) (5B) 17011 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 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; ................... -::J ..................... [] [] c. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ..............[] [] Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [~ [] 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 complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. ..~,,SIGNATUI~ OF PERSON RESPO~I,~IBLE FOR FILING RETURN ADDRESS Kimer G. ERgie~ ~,~ecutor 37 Beard Road, Mechanicsburg, PA 17055 DATE SIGNATURE ADDRESS Ot[ 141 eet, Dillsburg, PA 17019 -~ /QATE 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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTA~'E,,ewmsOF., Mary H. FILE NUMBER 21-03-00264 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 2. 3. 4. Tenant's security deposits paid to Lisa M. Golden Tenant's security deposits paid to Erin G. Soden Tenant's security deposits paid to Marie E. Park Tenant's security deposits for Karl M. Heckert paid to the new owner, Elmer G. Engle Tenant's security deposits for Patricia M. Barbaro paid to the new owner, Elmer G. Engle TOTAL (Also enter on line 10, Recapitulation) $ 2490. O0 (If more space is needed, insert additional sheets of the same size) 500.00 435.00 435.00 580.00 540.00 COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF MARY H. LEWIS LATE OF CAMP HILL BOROUGH FIRST AND FINAL ACCOUNT OF ELMER G. ENGLE EXECUTOR Date of Death: Marcy 16, 2003 Social Security No. 578-03-6706 Letters Granted: March 26, 2003 Date of Advertising Grant of Letters: Account stated to · May 13, 2004 File No. 2103-00264 Cumberland Law Journal: 4/11, 4/18, and 4/25/2003 The Sentinel: 4/1,4/8 and 4/15/2003 SUMMARY AND INDEX PRINCIPAL Receipts Disbursements Balance before distribution Distribution to beneficiaries Total available after distribution INCOME Receipts Disbursements Balance before distribution Distribution to beneficiaries Income balance remaining Combined balance remaining $1,039,024.25 $181,528.63 $857,495.62 $309,969.05 $547,526.57 $48,727.10 $18,041.00 $30,686.10 $0.00 $30,686.10 $578,212.67 PRINCIPAL RECEIPTS The Accountant charges themselves with the following: Personal property as set forth in the Inventory filed in the Register of Wills Office of Cumberland County, Pennsylvania on February 25, 2004 confirmed by Pennsylvania Department of Revenue April , 2004 Funds received from Judith Ann Fairchild for Inheritance tax due on Annuity Funds received from Elmer G. Engle and Winnie L. Engle for Inheritance tax due on specific bequest TOTAL PRINCIPAL RECEIPTS $945,216.06 $29,892.66 $63,915.53 $1,039,024.25 PRINCIPAL DISBURSEMENTS And ask credit for the following disbursements: Neilt Funeral Home - funeral expense Reverend Carl Heckert. - Minister Gingrich Memorials - lettering tombstone (paid by Bud) Michael W. Harling - 2003 per capita tax Michael W. Harling - Pro-rate share of 2003 County and Municipal Tax Verizon - phone services ~ debt of decedent Ralph A. Greiman, Jr. - real estate appraisal fee Vascular Associates - expense of last illness PP&L - electric services - debt of decedent Pennsylvania American Water - debt of decedent $7,986.38 $150.00 $205.00 $4.90 $233.11 $52.97 $500.00 $50.40 $78.55 $104.09 PRINCIPAL DISBURSEMENTS (CONT'D) AT&T - phone services - debt of decedent Penn Waste Trash removal - debt of decedent Home Depot - debt of decedent Bob Warner - lawn care - debt of decedent Keystone Oil - heating oil - debt of decedent Borough of Camp Hill - sewer services - debt of decedent Todd Engle - baby gift - debt of decedent Faith Church - donation made by decedent Elmer G. Engle - security deposit for apartment nos. 2 and 5 Lisa M. Golden - refund on security deposit for apartment no. 3 Erin G. Soden - refund on security deposit for apartment no. 6 Marie E. Park - refund on security deposit for apartment no. 7 Register of Wills, Agent - Inheritance tax due on Annuity Register of Wills, Agent - Inheritance tax due on specific bequest Register of Wills - probate fee Register of Wills - short certificates Cumberland Law Journal - advertising Grant of Letters The Sentinel - advertising Grant of Letters Samuel D. Thuma - 2003 individual tax preparation $8.52 $40.74 $25.06 $58.25 $200.00 $577.34 $378.00 $150.00 $50.00 $1,120.00 $5O0.00 $435.00 $435.00 $29,892.66 $63,915.53 $540.00 $9.00 $75.00 $102.11 $500.00 PRINCIPAL DISBURSEMENTS (CONT'D) Halvard E. Alexander - notary fees Elmer G. Engle - Executor's commission Register of Wills - filing Inventory and Inheritance tax Register of Wills - filing Supplemental Return Jane M. Alexander - Attorney fee Register of Wills, Agent - Inheritance tax Clerk of Orphans' Court - reserved for filing First and Final Account Register of Wills - reserved for filing Release TOTAL DISBURSEMENTS TOTAL PRINCIPAL AVAILABLE $20.00 $16,530.00 $31.00 $10.00 $19,386.00 $37,019.02 $140.00 $15.00 $181,528.63 $857,495.62 INCOME RECEIPTS Vartan National - estate checking account no. 1096213 - interest received 2003 Vartan National - estate checking account no. 1096213 - interest received 2004 All first - checking account no. 55458009 - interest received after date of death Att first - checking account no. 950947644 - interest received after date of death Prudential Securities - account no. 044-227193-018 - interest or iost received after date of death TOTAL INCOME RECEIPTS $34.58 $12.61 $22.42 $10.29 $48,647.20 $48,727.10 INCOME DISBURSEMENTS Vartan National - estate checks Internal Revenue - 2003 income tax return Pennsylvania Department of Revenue - 2003 income tax return Reserved for 2004 income tax return TOTAL iNCOME DISBURSEMENTS TOTAL iNCOME AVAILABLE FOR DISTRIBUTION $10.00 $15,684.00 $1,347.00 $1,000.00 $18,041.00 $30,686.10 RECAPITULATION Total Principal Receipts Total Principal Disbursements Total Principal Available for Distribution Total Income Receipts Total Income Disbursements Total Income Available for Distribution COMBiNED BALANCE AVAILABLE FOR DISTRIBUTION $1,039,024.25 $181,528.63 $857,495.62 $48,647.20 $18,041.00 $30,686.10 $888,181.72 DISTRIBUTION PRIOR TO FINAL ACCOUNTING 3/16/2003 to Judith Ann Fairchild - Prudential Financial Annuity Contract #CSC000000104-A 1/27/2004 to Judith Ann Fairchild - cash from Prudential Securities account no. 044-227193-018 4/16/2003 to Elmer G. Engle and Winnie L. Engle Personal property in the building sold at public sale TOTAL DISTRIBUTION TO DATE OF ACCOUNTiNG $209,773.05 $100,000.00 $196.00 $309,969.05 BALANCE AVAILABLE FOR DISTRIBUTION Held as follows: Vartan National - estate checking account no. 1096213 Prudential Securities account no. 044-227193-018 Equity Mutual Funds Property located at 2804 Market Street, Camp Hill, PA Borough of Camp Hill, Cumberland County PROPOSED DISTRIBUTION Judith Ann Fairchild - 100% of residue Elmer G. Engte and Winnie Engle - Property locates at 2804 Market Street, Camp Hill, PA Total Proposed Distribution $578,2t2.67 63,281.18 $89,931.49 $425,000.00 $153,212.67 $425,000.00 $578,212.67 COMMONWEALTH OF PENNSYLVANIA · COUNTY OF YORK - I, Elmer G. Engle, accountant in the foregoing Account, being duly sworn according to law, depose and say that the above Account is just and true, both as to items of charge and discharge, and that the grant of letters and the first complete advertisement thereof occurred more than six months prior to the filing of this Account. Elmei' Sworn to and subscribed before me this/3~r'r~day of ~_.4~ ,2004. ' Notary Public / Notarial Seal Halyard E. Alexander, Notary Public Dillsburg Bom, York County My Commission Expires Apr. 23, 2005 Member, Pennsylvania Association of Notaries STATEMENT OF SERVICE OF NOTICE AS REQUIRED UNDER RULE 63.1 I, Jane M. Alexander, Attorney for the Mary H. Lewis Estate, late of the Borough of Camp Hill, County o t' Cumberland and Commonwealth of Pennsylvania hereby certify that I have given notice of the filing of the First and Final Account accompanied by a Petition for Adjudication for Audit on June 22, 2004 with the office of the Clerk of Orphans' Court Division of the Court of Common Pleas of Cumberland County. There are no creditors to be notified. Notice has been sent to the persons and charity who claim an interest in the estate as a beneficiary: Elmer G. Engle and Winnie L. Engle 37 Beard Road Mechanicsburg, PA 17055 Judith Ann Fairchild 573 South 6th Street Bangor, PA 18013 BUREAU OF ZNDTVTDUAL TAXES TNHERZTANCE TAX DIVISION DEPT. 180601 HARRISBURG, PA 17128-0601 COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX JANE M ALEXANDER ESQ Iq8 S BALTIMORE ST DZLLSBURG CUT ALONG THIS LINE REV-1547 EX AFP (01-03) 'O4 PA 1701~ DATE 05-31-200q ESTATE OF LENIS DATE OF DEATH 03-16-2003 FILE NUMBER 21 03-026q ~COUNTY CUMBERLAND ACM 101 RE¥-lSq7 EX AFP MARY H MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 RETAIN LONER PORTION FOR YOUR RECORDS ~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR ESTATE OF LEWIS DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MARY H FILE NO. 21 03-0264 ACN 101 DATE 05-31-2004 TAX RETURN )/AS: (X) ACCEPTED AS FTLED RESERVATZON CONCERNING FUTURE INTEREST - SEE REVERSe. ( ) CHANGED APPRAZSE~ VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. ReeZ Es4:a4:a (Schedule A) (1) 2. S4:ocks and Bonds (Schedule B) (2) $. Closely Held S4:ock/Par4:narship Zn4:eras4: (Schedule C) ($) q. Mor4:gages/No4:as RecaAvable (Schedule D) (q) 5. Cash/Bank DeposA4:s/Misc. Personal Proper4:y (Schedule E) (B) 6. Join4:ly Owned Proper4:y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To4:al Assa4:s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Cos4:s/MAsc. Expanses (Schedule H) (9) 10. Dab4:s/Mor4:gage LiabilA4:Aas/LAens (Schedule Z) (10) 11. To4:al Deduc4:ions NO. 01 O§ NOTE: To /nsure proper O0 cred14: 4:o your account, O0 submi4: 4:he upper por4:Aon O0 of 4:his form with your 00 4:ax paymen4:. O0 .00 (8) .00 12. 15. NOTE: ASSESSMENT OF TAX: 15. Amoun4: of L/ne Zq a4: Spousal ra4:e (15) 16. Amoun4: of LAne, lq 4:axeble a4: Lineal~Class A ra4:a (16). 17. Amoun4: of LAne lq a4: S/bling rata (17) 18. Amoun4: of L/ne lq 4:axabla a4: Colla4:aral/Class B re4:a (18) 2a490.00 (11) .0o 2.~90.00 2,490.00- 05 PAYMENTS 3,673.30 278.89- IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 19. Principal Tax Due TAX CREDZTS: DATE NUMBER ~ SUMMARY 05-Z4-200q · O0 X O0 = . O0 · 00 X 045= .00 · 00 x 12 = .00 89q,555.63 X 15 = 134,183.3q AMOUNT PAID .00 130,788.93 TOTAL TAX CREDIT I 134,183.34 BALANCE OF TAX DUEI .00 INTEREST AND PEN. J .00 TOTAL DUE / .00 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS RE~UZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT' (CR), YOU MAY BE DUE A REFUND· SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) (19)-- 134,183.34 ALL DISCOUNT INTEREST/PEN PAID (-) Ne4: Value of Tax Re4:urn Chari4:able/Governmen4:al Beques4:s; Non-elec4:ed 9115 Trus4:s (Schedule J) (13) . O0 Ne4: Value of Es4:a4:e Sub.iec4: to Tax (1(+) 894,555.63 If an assesseent ~as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 ~ill reflect figures that include the total of ALL returns assessed to date. RESERVATION: Estates of decedents dying on or before December iZ, 1982 -- if any futura interest in the estate [s transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years) the Coamonaaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S. Section 9140). PAYMENT: Detach tho top portion of this Notice and submit with your payment to the Rag[star of Nills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NXLLS, AGENT REFUND (CR): A refund of a tax credit, ahich Nas net requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-15153. Applications ara available at the Office of the Register of Nills, any of the Z$ Revenue District Offices, or by calling the special Z4-hour answering service far forms ordering: 1-800-~62-Z0501 services for taxpayers aith special hearing and / or speaking needs: 1-B00-447-5020 iTT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax Eincluding discount or interest) as sheen on this Notice must object within sixty (60} days of receipt of this Notice by: --written protest to the PA Department of Revenue) Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. PURPOSE OF NOTICE: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601) Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after tho decedent's death, a five percent (SI) discount of the tax paid is allowed. The 15X 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 tho tax amnesty period. This non-participation penalty is appealable in the same manner and [n the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one il) day from the data of death, to the date of payment. Taxes which became delinquent before January l, 1982 bear interest at the rata of six [SX) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through Z004 ara: Interest Daily Interest Daily Interest 1983 1984 1985 1986 1987 --Interest Rate Factor Year Rate Factor 202 .OOOS4~ ~-1991 11X ,000501 16Z .O0043B 1992 92 .000247 IIZ .000301 1995-1994 7Z .OOOl9Z 132 .000~56 1995-1998 92 .000247 10Z .000274 1999 7X .000192 102 .00027~ ZOO0 7Z .000192 is calculated as follows: Daily Year Rate Factor ~ 92 .000247 ZOOZ 62 .000164 Z003 5X .000157 2004 4Z .000110 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 be calculated. J hereby certify that wr~en no{ice o~ lhe fdi~,~ o( ti'~ Statame~ of Proposed Di~t~x~tion. and of the d~e, A copy of eaid Slatement was ~ with the notice ~noo eql o~ pe#me~d eq BW~ eu,q~ $ql ueq~ )o §u!tu a411o eop, ou u~!J~ mq! ,~Lq. mo ~.qeJaq I IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF MARY H. LEWIS Deceased Late of Camp Hill Borough, Cumberland County, Pennsylvania File No. '2103-00264 ORDER AND DECREE AWARDING REAL ESTATE AND NOW, TO WIT, this _ day of ,.[ ~ ,2004, upon motion of Jane M. Alexander, Esquire, Attorney for Elmer G. Engle, Executor of the Estate of Mary H. Lewis, in consideration of the Adjudication in the foregoing Estate entered nisi on June 22, 2004 and recorded in Orphans' Court Docket File No. 2103-00264 and in accordance with Sections 3534-36 of the P-E-F Code, it is hereby ORDERED AND DECREED that there be awarded and there is hereby awarded unto the said Elmer G. Engle and Winnie L. Engle, husband and wife, the following tract of real estate owned by the deceased at the time of her death: ALL THOSE CERTAIN pieces or parcels of land situate in the Borough of Camp Hill, County of Cumberland and Commonwealth of Pennsylvania, bounded and described as follows, to wit: TRACT NO. 1: BEGINNING at a point on Market Street, Camp Hill, Pennsylvania, at the western line of land of Sugrue; thence along lands of Sugrue North 2 degrees 7 minutes East, 115.28 feet to a stake; thence South 84 degrees 20 minutes East along lands of Sugrue at distance of 28 feet to a stake; thence North 2 degrees 7 minutes East along lands of Sugrue, 46.97 feet to a stake; thence North 86 degrees 38 minutes West, 88.37 feet along line of other lands of Emma D. Hofl'man Estate to a stake; thence South 5 degrees 30 minutes West, 158.70 feet along North Twenty- ninth Street to a post; thence South 84 degrees 30 minutes East and along Market Street, a distance of 69.94 feet to a point, the place of BEGINNING. HAVING thereon erected a two story brick apartment house known as Ben Franklin Apartments, No. 2804 Market Street, Camp Hill, Pennsylvania. AND also the right to use the driveway along the eastern boundary of said Sugrue lot, running from Market Street to the property formerly of Emma D. Hoffman, situate north of the premises of said Sugrue. TRACT NO. 2: BEGINNING at a point on the eastern line of North 29th Street (45 feet wide) said point being referenced North 5 O degrees 30 minutes East, a distance of 14.35 feet from the northeastern intersection of Market Street and North 29th Street (before widening); thence along the eastern line of North 29th Street (45 feet wide) North 0 degrees 31 minutes West, a distance of 144.82 feet to a point on the southern line of land to be transferred from the Borough of Camp Hill to George L. Gleeson and Helen G. Gleeson, his wife; thence along same South 85 degrees 46 minutes East, a distance of 15.18 feet to a point on the western line of land of the Ben Franklin Apartments (also known as the original right-of-way line of North 29th Street); thence along same South 5 degrees 30 minutes West, a distance of 144.35 feet to a point, the place of BEGINNING. BEING Parcel No. 2of the Plan of North 29th Street, showing the proposed location of the street and sidewalk area, which said Plan was drawn for the Borough of Camp Hill, Cumberland County, Pennsylvania, by William B. Whittock, Registered Professional Engineer, and dated August 3, 1959. IT BEING the same premises which BEN FRANKLIN, INC., a Pennsylvania Corporation, by deed dated March 1, 1968 and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania in Dsed Book R 22, page 446 granted and conveyed unto John L. Lewis and Mary H. Lewis, his wife. The said J6tan L. Lewis having died January 25, 1979 title therein vested by right of survivorship in Mary H. Lewis, his wife. The said Mary H. Lewis having died March 16, 2003, Testate, Letters Testamentary granted March 26, 2Oi)3 to Elmer G. Engle, Executor, Grantor herein. BY THE C'(31 II~T I HEREBY CERTIFY that the address of the within Grantee is: 37 Beard Road, Mechanicsburg, PA 17055 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND : SS. Recorded in the Office for Recording Deeds in the County of Cumberland, Commonwealth of Pennsylvania, on the __ of ,2004, in Deed Book __, Page __ WITNESS my hand and seal of Office. Recorder MAIL TO: .lANE M. ALEXANDER, ESQUIRE 148 S. BALTIMORE STREET D1LLSBURG. PA 17019 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 002684 ENGLE ELMER G 37 BEARD ROAD MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 578-03-6706 FILE NUMBER: 2103-0264 DECEDENT NAME: LEWIS MARY H DATE OF PAYMENT: 06/16/2003 POSTMARK DATE: 06/1 3/2003 COUNTY: CUMBERLAND DATE OF DEATH: 03/16/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $39,900.00 REMARKS: TOTAL AMOUNT PAID: JANE M ALEXANDER, ESQ. $39,900.00 SEAL CHECK//120 INITIALS: CW RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF ~NDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 002685 ALEXANDER JANE M 148 S BALTIMORE ST DILLSBURG, PA 17019 fold ESTATE INFORMATION: SSN: 578-03-6706 FILE NUMBER: 2103-0264 DECEDENT NAME: LEWIS MARY H DATE OF PAYMENT: 06/1 6/2003 POSTMARK DATE: 06/1 3/2003 COUNTY: CUMBERLAND DATE OF DEATH: 03/1 6/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 929,892.66 TOTAL AMOUNT PAID: 929,892.66 REMARKS: SEAL CHECK//1 271 8 INITIALS: CW RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS 148 SOUTH BALTIMORE STREET P. O, Box 421 DILLSBURG, PENNSYLVANIA 17OI9-O4;~1 (717) 432-4514 Fax (717) 502-1087 E- Mail:j malexander148L~earthlink, net June 13, 2003 Register of Wills Cumberland County Court House One Courthouse Square Carlisle, PA 17013 Re: Estate of Mary H. Lewis Dear Folks: Enclosed herewith are two (2) checks representing payment on account of inheritance tax due on the above-captioned estate. Check no. 12718 in the amount of $29,892.66 is payment on account of tax due on $209,773.05 at 15% less the 5% discount for payment within ninety (90) days of date of death. Estate check no. 120 in the amount of $39,900.00 is payment of account of tax due at the rate of 15% on $280,000.00 less 5% for payment within ninety (90) days of dated of death. Please forward a separate receipt for each check to my office in the stamped, addressed envelope enclosed. Thank you for your attention to this matter. JMA/na Enclosures CC: Elmer G. Engle tORnEY AT LAW 148 SOUTH BALTIMORE STREET P. O. BOX 421 DILLSBURG, PENNSYLVANIA 1'7019-0421 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HAR~SBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-11 62 EX(11-96) CD 003473 ALEXANDER JANE M 148 S BALTIMORE ST DILLSBURG, PA 17019 fold ESTATE INFORMATION: SSN: 578-03-6706 FILE NUMBER: 2103-0264 DECEDENT NAME: LEWIS MARY H DATE OF PAYMENT: 01/23/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUM BERLAN D DATE OF DEATH: 03/16/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $60,500.00 TOTAL AMOUNT PAID' $60,500.00 REMARKS: ELMERG ENGLE C/O JANE ALEXANDER ESQUIRE SEAL CHECK# 220 INITIALS: SK RECEIVED BY: GLENDA FARNER STRASBAUGH DEPUTY REGISTER OF WILLS REGISTER OF WILLS ~OMMONWEALTH 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. CD REV-1162 EX(11-96) 003565 ALEXANDER JANE M 148 S BALTIMORE ST DILLSBURG, PA 17019 fold ESTATE INFORMATION: SSN: 578-03-6706 FILE NUMBER: 2103-0264 DECEDENT NAME: LEWIS MARY H DATE OF PAYMENT: 02/17/2004 POSTMARK DATE: 02/1 3/2004 COUNTY: CUMBERLAND DATE OF DEATH: 03/16/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $595.89 REMARKS: TOTAL AMOUNT PAID: RECEIVED OF ELMER G ENGLE IN C/O JANE M ALEXANDER, ESQ. $595.89 SEAL CHECK# 213 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX 'o-00) · , ' ~ COMMONWEALTH Of ~ PENNSYLVANIA j~~~, DEPARTMENT OF REVENUE ,~",~:~i~,~-"'~ '~ DEPT. 280601 · '~¢~,~~' HARRISB U RG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2 1 -0 3 UJ [-'~ 1. Original Return r-j4. Limited Estate [~]6. Decedent Died Testate (Attach copy of Will) [~9. Litigation Proceeds Received r--i 2. Supplemental Return ---I 4a. Future Interest Compromise (date of death after 12-12.-82) [~]7. Decedent Maintained a Living Trust (Attach copy of Trust) ~110. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ] 3. Remainder Return (date of death p~or to 12-13-82) [~5. Federal Estate Tax Return Required _.0_ 8. Total Number of Safe Deposit Boxes -'-]11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME Jane M. Alexander, Esquire FIRM NAME Of,Applicable) TELEPHONE N~J~y) 432-4514 COMPLETE MAILING ADDRESS 148 S. Baltimore Street Dillsburg, pA 17019 1. Real Estate (Schedule A) (1) 425, OO0. O0 2. Stocks and Bonds (Schedule B) (2) 2 37,701. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) ~ .... 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 72,741. (Schedule E) 6. Jointly Owned Property (Schedule F) (6) O [] Separate Billing Requested 2o9,773.o h. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (8) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 45,658.49 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 2,511.94 11. Total Deductions (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) OFFICIAL USE ONLY 945,216.06 48,170.43 897,045.63 0.00 897,045.63 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) x .0 __ (15) 16. Amount of Line 14 taxable at lineal rate x .0 __ (16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate 897,045.63 x .15 (18) 19. Tax Due (19) 134,556.84 Z LU Z 0 UJ 0 ~o~ fl. 0 0 2 6 4 COUNTY CODE YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z Lewis, Mary H. 578 - 03 - 6706 ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR THIS RETURN MUST BE FILED IN DUPLICATE WITH THE UJ O3/16/2OO3 O8/23/1910 REGISTER OF WILLS III (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Decedent's Complete Address: STREET ADDRESS 2804 Market Street CITY Camp Hill STATE PA zip 17011 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 130,292.66 3,673.30 (1) 134,556.84 Total Credits (A + B + C ) (2) 133,965.96 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) 5. 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. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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; .......................................................................................... [] [] 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? ........................................................................................................................ [] [] 590.88 5.01 595.89 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 the 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. SIGNATURE ~F P~RSON RES~JONSIBLE FOR FILING RETURN ADDRESS Elmer G. Engl~ 37 Beard Road, Mechanicsburg, PA 17055 DATE SIGNATURE OF OTHER 1 ADDRESS 1 S. Baltimc _~ Street, Dillsburg,PA 17019 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. REV-1502EX * (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT · SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Lewis, Mary H. 21 03 00264 All real propeN~ owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the pdce at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Ail those two dertain pieces or parcels of land situate in the Borough of Camp Hill, County of Cumberland, Pennsylvania, acquired by deed from .Ben Franklin, Inc. dated March 1,1968 to John Lewis and Mary H. Lewis his Wife. Recorded in the Office of the Recorder of Deeds in and for 'Cumberland County in Deed Book R 22 page 446. The said John L.~ .Lewis havinf died January 25,1979 title therein vested in Mary H. Lewis his Wife. There are no liens against the l/roperty TOTAL (Also enter on line 1, Recapitulation) $425,000.00 $ 425,000.00 (If more space is needed, insert additional sheets of the same size) DILLSBURG OFFICE I 9 North Baltimore Street Dillsbur,g, PA 17019 717 432-0029 717 766-0055 7 ] 7 432-.0042 FAX Jane M. Alexander, 148 South Baltimore Street ~01 0 l)i!lsbur.~, PA 1~..,,> RE: 2~01, Market Street~ Camp Hill~ PA Dear Jane ~ .~t your request on N~arch 29 I have contacted Pit, Elmer arrange a tour of the aboYe men%ioned property. I R~et with Mr. Fngle on Thersd.~y, A. eril } a.t which ti~e he ga~e me a thorough to~. This 7 uni~ apa. rtment building is ].ocated on the northeast corner of the intersection of }la. rke~ and 29th Streets in Camp Hill. This .tin eztremelO/ attractive all brick, 2 story bui].din~ constructed with a light brown brick. The kuildin~ is set-Lack a substantial distance from Market Street which enhances the curb appe,~l of the ~ro~erty. ~e roef is flat with a slope to the east and a mansard-type .].edge ~f Spanish tile surrounds the to9 of the 2~d level of the building. The b.~lding contains a (~ene'rous supply ,3f win~tows all of which ha?~e storm windows added. Sidewal~s alons 29th Street ~nd ~d~rk:et Street arm in e~cel!ent conditien~ and ample par}~in~ is availah, le~ especi'.i, ll? on beth sides of 29th Street. The exterior of this building seems to be saying, "i~m in ~A~eat conditien~", and a view of %he interior confirms it. Throughout.. the interior the;ne is e~'idence ef the obvious care with 'which t, bis building has been upda. Zed and main'b,zined. 5 of the :}.par{,l~enhs each contain 2 bedPoonls~ ba. th~ living roo!71~ ,iii!lacE" 'room, !n.-I ]x'.tcheo. q. c,.[' these ap'' .... *'-':"~",b .......... L,:,' ~' are on ~ S~l"e OR t4;.e Is[, fl. ooP. Independentp Owned And Operated % NRT Inc. 2 o;f the. a:,ar'i:,menLz e;zch co~¥LaS.n t 'L:.ed'r'o...',m, ba.'bh~ ].ivin;:; room kitchen., 'bo'th of' these sX~or'tmeuts r~.:ce oo. the Jst ?'hez'e are en'[.r.~.ucos to '~,he 'h~Ai].d:La.~:~ a]_on~ '~!a?[hel Stz'~ee'l:, as '~s].,]. The bui]..d~.r::g wss consvr'ucbed fi_n the 19/..0's and the oil---ffi, red steam heatin,~: u, lsn[; ~_s or:~Z~..na], to 'the bui!din,~T. Te~perat~re ir: the bu.i].din~ · s r~R;u]q'hed bx ~ '~'h,-~r. rn,qsta'[ The baseme:~% exists ~mder ,-,l. ouu 1.;0/o the bui.]_ding, sn~ the rest. is cranial s.:,ace. Har. ctvrood floors exist throughout -bhe anar"tmen, ts e:xcept[ng k.[tchens and baths. A. :col..led rubber ~'oof has beeT~ ~:~laced on the bui. ldinE and the e]_ec%xJ.cs], system has been uods. t. ed. The kitchens are equioped ~rith a. oo!iances. Hot ~,'ter, hea't, and r~ublic v~a~et' and se~,~er f~e~: are oaid 1.~y- -the o~ner. Term.¥tt.s si.~n s ~ year' lesse~ snd there is a.n e:xces'bior:ta]_ly ~o~ ra~,e of tenant turnove?. There are no ~.~ndr~ facil ~ ~.a.~.~e~. Total_ monthly inco~e from these apartments, includiaffj the one formerly occuo~_ed by the owner, is about ~t3,500, or ~/~.~,200 annua!.ly. A "rule of thumb" for es'bablishin~ a price for' multi-family real estate sugf~:ests that the price off the bui!.ding should ~:e ~0 ~:.:imes the total annual, rental, income. I;~ this instsnce the total rental ~.ncome ~ou!d sugfest a res! estate ~rice of ~.ttached ~.s a print-out of the Cumbe.t~].and County assessment J_ndi. cating t?m'h the assessed value of 'this property ~_s ~270,920. Cumber].and County sssessm~nt 2':[gures are considered %o be ~OO~ c,f msrPet va~.ue, however, n~y rese~-rch i. ndicstes that in this ins'[;ance the actual market value much h:i..~her than 'the a:~se~:se~ vs]_ue of this iii have r,?sea~-ched mul%i.-.-~:nit oz'o~e~"~tie~z :Ln the boros of,~,an.'~°~' ,,~a~u.]~ 7~remo?n.e, end }:.~echanJ. csbur~. .~t ~:.he oresent 'Lime tbei~e J.s s lack o:(; unJ. t',s on the marke~, la fscJs I ca.r~ loc. ate onl.y one a:~:o~:,ert:ff in the abo'~e commun)_h'~_es ~r]:~ich can bc used ~.s a coJ~:usa:~ab]_e [,o ~,he s~bjec't ~,z'ooer~,y- I% is as.~ 8 unit apartment, house in d.swnto,,m ',%~:c:h_?,nicsburg with a total al"irluql, i_llcoP,!e .,bP d., ~. ,'-,/,~ · ...... · ;'.,.~,-,~oL5, ~ and. zh is: on the market for. ,~:_,~d~.~.q. ~ 9()0~ op. a unit · ,~;h.~73(, A des,-","~,-~-~v .... ~'e,:,'- is attached oroe~ t.o assist in estabtishi.a.e a ............ Yalue, the following sanoling: . , of sales in_ recent_ ,~-~=-~-s.~-~.z._ in the three boros mentioned above. It is essential t,o keeo in roi;ad that ths~re is a wide variety of architecture reoresented as ,,,=1.,. as wi. ry'ing amenities provided in each of the ten pro0erties~ Descriptive sheets are attached for each of 'the properties. In the boro o£ CAHP HILL there are three sales of mul.ti-units summarized follows: Selling Price # of Units Unit Price 2225,000 7 $32,142 129,900 2 64,950 97,900 2 48,950 (a.) $60,000 (a.) I have been in this property; and Z would consider its condition to be an excellent comparison to the larger apartments in the subject pwoperty. Dednc~ing an estimate for the value of the garsge building mentioned in the descriotion, I would revise the value per apartment unit ±,o he $60,00©. !n the boro of ~MOYNE, which is general!5~ a lower oriced real estate market in ±he mul_ti-umit section, I am using two 3-unit orooerties for cc. mearative ourposes: Selling Price # of Units Unit Price ~1 ;2; 900 3 $31~1"633 i 02,000 3 34, O00 The boro of HI~CHANICSEURG is tine largest market on the West Shore for multi-unit residential orooerties, .:'~nd it generally c o. .'ma nd sm higher_ orices for them. I have found~.oev~.zal.~'~' dozen sales, of .oropert'ies. which I have narrowed. down 'to 5 for use in this comparative st, udy: Selling Price ~-~- of Units Unit Price $x9, ,~oo 5 ~9, 9so 208, CO0 L 52,000 130, COO 3 43,333 1 1 0, OOC 2 55, OeO 1 09,000 2 54,500 (a.) ~50,000 .., , l.Mduct_,,,4:, an est, 5. ma'te eot the value 0£ the r:entioned in the descriotion, I would Fe'vise k,.t~:: value '-=r ao~rt, ment unit to be PSO,O00. W~v'e factors we;c'? t~.l.~en J. nto consider~i~!T, ion in a.?ri~ing n% th? of v:~].u~ for [,he ~rope?.v lock, ted ~'t 280~ Yar!<et S'bPee%~ C~Eio NJ.II. The}~ were: I. The excell.{~n% interior and ei~{,eric'F condi%io:n o~ %,he 2. The desi.r'~h]e n, nd cenvenien% location. 3~ The cuFren'h ],~ci~ of mul. l.i--unit pronert~ies oD. the 'marl{et. ~i The se!i'i}:¥[ ',m?ice~: cf otk,~r n'ul. ti~unit buil.din{s. 5. The Cu,~lberland Cot.tnty assessment. lin view of t~]..i %htz facts~ observations, and information contained this ]e'tter and enclosures, it i_s reason~bl.e to calculate a~,.~,~c~-- cf $65,000 Der uni't on each of' the 5 ln. rge .{~pnrtmen-bs, and a price of $~5,000 pep unit on each of the 2 smaller ap~rtme~%s. 865,000 x 5 = aS~ooo x 2 = 9o~o0o If this buildEns were to be ~}]_aced on the nmr~et tod~{~ I would ~ecommend to the o~er that he establish a !istiug price ~etween $~.29,000 and ® ' · ,~l. 9~O00, and to expect a sale between ~25,000 ~nd {}~J~O~O00. CC: Elmer Engle Very truly yours, N.al,gh A. Greiman, Jr. Associate Brcker 10f C-DEEI)---Corp. lo Ind. or Cm'p. Executive Sale, Co., 1211 Arch SI., Phila. 7, Pa. Jffade the 2~7/~ 7- day of ~arch , ir~ the year ~Vineteen hundred and Sixty-Eight (1968) ~h~g~I~EN!'FRANKLIN, INC., a Pennsylvania Corporation having its principal place of business in R. D. I~2, Gardners, Pennsylvania. (hereinafter called the Grantor ), of the one part, and JOHN L. LEWIS and MARY H. LEWIS, his wife, of New Cumberland, Pennsylvania (hereinafter called the Grantees ),of the other part: ~Mi~[~, That the said Grantor for and in consideration of the su,r~ of Seventy Eight Thousand Five Hundred ($78,500.00) .lawful t~oney of the United States of ~merica, unto it well and truly paid by the said Grantee s at and before the sealin~ and delivery of these presents, the receipt whereof is hereby acknowledged, has . ~ranted, bargained, sold, aliened, enfeoffed, released and confirmed, and by these presents do ~ra~t, bargain, sell, alien, enfeoff , release and confirm unto the said Grante~ their heirs and Jssi~ns, ALL those certain pieces or parcels of land situate in the Borough of Camp Hill, ~ount of Ctmberland and Stat~ of Pennsylvania, bounded and d~zcr~bed aa follows, to.w~t: T~CT NO. 1. ~EGI~ING at a point on ~vk~t $t~t, C~p H~I~ P~nnsy~van~a, at the western line of land of Sugrue; thence along land~ of Sugrue North 2 degrees 7 minutes east 115.28 feet to a s~ake; =hence sou~h 84 ~egrees 20 minutes east along lands of Surgrue at distance of 28 feet =o a s~ake;~:=hence north 2 degrees 7 minutes east along lands of Sugrue 46.97 fee~ ~o a stake; ~hence north 86 degrees 38 minutes west 88.37 feet along line of other lands of ~ D.'~offman Eas=a~e to a stake; =hence south 5 degrees 30 minu~es wes~ 158.70 feet.along Notch Twenty-ninth Street to a post; thence south 84 degrees 30 minu~ea eas~ and along Market S~reet, a distance of 69.94 feet to a point, the place of BEGI~ING .... ~ ~VING thereon erected a two s~ory brick apar~men~.ho~e known as B~ Franklin Apart- ments, No. 2804 ~rket Stmeet, Camp Hill, Penna~vaqi~. ~ also the right to use ~he driv~ay.along~=he,~=ern boundary of said Sugrue lot, ruling from~rket Street ~o the property fo~e~i~0f~a D. Hoffman, situate north Of the praises of said Sugrue. · BEING ~he same praises which John W. Frame and~E~neatine H. Frame, his wife, by their deed dated Dec~ber 1, 1954 and recorded~in.~=he C~berland County Recorder's Office in Deed ~ook 16, Vol. D, page 10, $ra~c'ed~d~convey~d unto Ben Franklin, Inc. a Pennsylvania Co~poration, Grantor herein.~ ': ..... ~:/ T~CT NO. ~, BEGINNING at a point on the eastern line of North 29th Street (45 feet wide) said point being referen=e~ Mor=h~,~egre~s zo mxnu=*~ m=.=, ~ ~- Lance of 14.35 feet from the northeastern in~eraa~ian of ~rket Street and North 446 29TH Street (before widening); thence along theeastern line of.~or~h'29th~treet (45 feet wide) North 0 degrees 31 minuteS'~st, a distance of ~4~.82 feet to a point on the southern line of land to be transferred from the BoroUgh'of 0amp Hiii to George L. Gleeson and Helen G. Gleeson, his wife; ~thence along'isame. South 85 d~grees 46 minutes East, a distance of 15.18 feet toa'potnt on the Wes%~rn..iine~of, l~nd of the Ben Franklin Apartment~ (also known as the original righ~o~-W~Y'line2of. North 29th Street); thence along same South 5 degrees 30 minutes West,_i~a~distan~e of 144.35 feet to a point, the Place of BEGINNING. '~ ...... BEING Parcel No. 2 of the Plan of North 29th Street, showing the proposed loca- tion of the street and sidewalk area, which said Plan was drawn for the Borough of Camp Hill, Cumberland County, Pennsylvania, by William B. Whittock, Registered Professional Engineer, and dated August 3, 1959. BEING. the same premises which the Borough of. Camp Hill, a municipal corporation, by its deed dated August 11, 1959 and recorded in the Cumberland County Recorder's Office in Deed Book I, Vol. 19, page 466, granted and conveyed unto Ben Franklin~ Incorporated, a Pennsylvania Corporation, Grantor herein. O~e~ er wi~[~ all and singular tae '. improvements, walls, street s, allells, passages, waters, water-courses, ~i~s, liberties, privileges, heredi~a- ment~ and apP~rte~ees whatsoever thereunto b~lo~gi~g, or i~ an, y wis~ apper;~alnin~, and tke reversions and remainders/rents, issues and profits thereof, and all the estate, right, title, interest, prope.rty, claim and demand whatsoever of the s~ Grantor , in law, equity, or otherwise howsoaw~, of, in, and to the ~ame 447 ~ ,: ~ hereditaments and premises hereby ~ranted, or mentioned 'and intended so to be, with the appurtenances, unto the said Grantee $ their heiv$ and Jssi~ns, to and for the only proper use and behoof of the said Granteez a~d Jssi~s forever. ~ the said Grantor, for itself and its.s~ceessors does by these presents covenant, ~rant and a~ree, to and wit~ the said Grantees their he~ and Jssi~ns, that $~ .the said Gra~tor, and its.~ccessors, all and singular the hereditaments and premises herei~ described and ~ran~ed, or mentioned and intended so to be, with the appurtenances, ~to the said Grantee z their he,rs and Jssi~s, a~ainst } ~t the said Grantor and its S~ccessors, and a~ai~st all and every other Person a~d Persons whomsoever, lawfully claimin~ or to claim the same, or a~y part thereof,~ ' ' ~ · Cumb. Co., P~. S=hool Dist. Cumb. Co., Pa.. ~ Re~l Es~fe Tr~n*fer Tex ~ Re~l Est*re Transfer Tax Cumb. C~. Dist. ~1. Agt. .....~ .~..~:t ~, %,. the sa~ Gran~or, has caused ~his I~ent~re tobeexeoeted by its President, attested by its the day and year first above written. U' ' · uF'X~,' ,, corporate seal to be affixed ~ Presiden~ ~ -....' '......~ me, rn¢ st&oserioe~, a '-" ~ol:ary ~-ub~.t~' ' ' ii~ 'and 'fo~ sdid CO~5~w~l~'h and 'c~nt%'" a Corporation, and that he as suvh Pres~d~n~ . being authorized to do exec~ed t~ fore,oi~ instr~ment.fo~th~ p~rpos~s therein oontained b~ si, nin, ~h~,~a~,: ~:~ .... corporation b~ himself a~ 'Pr~g~a~ : .' ......................... .... ,~:,, ,t~l.~.~ ., , : . ~ - ~.~'~,' ........................ . ...?- -%~-~..,.~:...~'~ ~IT~E~5 my hand a~not~r~al Zea~ the day and ~ear aforesaid f ~ :" '~ ..)':' ~i~te~ my hand and JVotarial seal the day and year aforesaid. J~ly eom mission expires ~ X~'~k~' ~e precise address of t~ a~tee ~ .erei~ is ~e~z~e~ in tKe Office ]'or Recordin~ of Deeds in and for ~[ne~g my hand and seal of Office this ay Jnno Domini 19 449 %: REV.]503 EX+ COMMONWEALTH OF PENNSYLVANIA INHERITAINICE TAX RETURN RESIDENT DECEDENT SCHEDULE "B" STOCKS AND BONDS ESTATE OF Lewi s, Mary H. (All property jointly-owr~ed with Right of Survivorship.must be disclosed on Schedule "F") FiLE NUMBER 21-03-00264 ITEM NUMBER 10 11 12 DESCRIPTION Prudential Securities Account No. 044-227193-018 Eqities and Options 201 AOL Time WarnerInc. Equity Mutual Funds 425. 918 Calamos Investment Trust Growth Fund Class C 1206.569 Cohen & Steers Equity Income Fund CLC 1521.581 Davis N Y VentureFund Class C 1145.214 First Eagle Sogen Overseas Fund CL C 881.333 Lord Abbett Mid Capital Value Fund Inc. ClassC 2841.800 Prudential Jennison Growth Fund Inc. Class A 973.288 Putman InternationalGrowth Fund Class C 1403.571 Washington Mutual Fixed Income Mutual Funds 3187.677 @ 11.13 @ 30.04 @ 10.85 @ 18.97 @ 12.80 @ 13.26 @ 9.71 @ 14.56 Investors Fund @ 21.81 Eaton Vance Floating Fund Class C Balanced Mutual Funds 1909.097 870.981 Amarican Balanced Fund Class A @ 9.62 @ 13.76 @ 17.04 Calamos Investment Trust Convertable Fund Class C Total from Continuation scheQu±es TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH 2, 237. 13 12,794.58 13,'091.27 28,864.52 14,658.74 11,686.48 27,593.88 14,171.07 30,611.88 30, 665.45 26, 269. 17 14,841.52 t0,215.60 $ 237,701.29 (if more space is needed insert additional ~Deets of same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS Continued ESTATE OF Lewis, Mary H. FiLE NUMBER 21-03-0026~ Ali property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 13 14 DESCRIPTION Close End Mutual Fund 380 Pimco Commercial Mortgage Securitie~ Money Market Fbnd 4736 Command Money Fund Class A @ 14.42 @ 1.00 TOTAL (Also enter on tine 2, Recapitulation) $ 1:0,215.60 VALUE AT DATE OF DEATH 5,479.60 4,736.00 (if mnm sn.qn~ is n~d~d instal ~dditinn~l shp.~.t,~ nf th~ g;~m~ gi7¢~ Prudential Financial The Prudential Insurance Company of America Annuity Services PO Box13379 Philadelphia, PA 19101 (888) 778-2888 JANE M ALEXANDER 148 SOUTH BALTIMORE ST PO BOX 421 DILLSBURG PA 17019-0421 Contract Number: CSC000000104 Payee: Mary Lewis April25, 20O3 Dear Ms. Alexander: You recently called concerning the above referenced contract. The value of this contract is $211,558.84. If you have any questions, please call the Prudential Annuity Service Center at (888) 778-2888. The Service Center is open Monday through Friday between 8:00 a.m. and 8:00 p.m. Eastern time. If you are using a telecommunications device for the hearing impaired, you may call (800) 654-7637, Monday through Friday between 8:00 a.m. and 8:00 p.m. Eastern time. Sincerely, Sherry L. Gehring Post Issue Approver A Prudential business Corporate Office: 751 Broad Street, Newark NJ 07102-3777 Realtime Positions Name: As of: 03/24/03 12:32 PM Contact: ~ ~? t, ~ New RT Positions Details Start of Day TOTALS: Market Value: $243,649.41 Net Worth: $248t385.83 Gain/(Loss): ($31,047.97) NOTE: Quotes for Equities, Options and Closed End Mutual Funds are delayed by at least 20 minutes. Type //~/ ,~ ~ Total Cost :[nfo Qb/ Symbol / Description -~ OC) Price Average Cost Equities and Options 201 AOL ~ j' j~ AOL TIME WARNER TNC Equity MUtual FUndS ..... 425.918 CVGCX A CALAMOS INVESTMENT TRUST GROWTH FUND -. CLASS C 2 -1.2__De.icg csc x .... A CO.E,, STEERS E U,T I,CO,E FU,D CLC 2 1~521.588 A _1,145.214 A 2 881.333 A 2-' 2~841.800 A 11.030 $7,458.33 37.10 31.820 $13,000.00 30.52 11.230 $13,000.00 10.77 NYVCX 20.210 $31,000.00 DAVIS N Y VENTURE FUND CLASS C / 8' ? '7 20.37 FESOx 12.850 $15,500.00 FIRST EAGLE SOGEN OVERSEAS FUND CL C / ~ ,/~0 1:3.53 LMccx 14.240' $13,0i3~38 -- LORD ABBETT MI'D CAPITAL VALUE FUND INC '-~'/~'~ ~_~ 14.76 CLASS C p3FAX 9 '7 / 10.470 $49,580.04 PRUDENTIAL 3ENNZSON GROWTH FUND INC , 17.44 ...... CLASS A 2 g,3.2... cx u CLA .15;2 o $1s 5oo,oo A PUTNAM INTERNATIONAL GROWTH F ND S ' 15.92 23.320 $33,236.57 23.68 9.620 $31,211.64 9.79 Market Gain/ Value (Loss~) Rating $2,217.03 ($5,241.30) HOLD (70.27o/0) $13,552.71 $552.71 $13,549.77 $549.77 $30,751.2g ($248.71) $14,7i6~00 (~784.00) $12,Ss0.18 ($~63~20) $29~7S3.65($19,826.3g) $14,842.64 *' ($657.36) $32,732.28 ($S05.29) 14.3g0 $31,758.44 16.63 17.640 $15'500'0017.79 14.430 $4,938.98 12.99 $30,665.45 ($546.19) $27,471.91 ($4,286.53) $15,364~10 ($135.90) :1, ,_4.0-_3 ._S.7__[_ AWSHX WASHINGTON MUTUAL INVESTORS FUND Fixed Tncome Mutual Funds 3~187.677 ECBLX EATON VANCE FLOATING RATE FUND CLASS C Balanced Mutual Funds [~909.097 ABALX AMERICAN BALANCED FUND CLASS A 870.981. CCVCX CALAMOS INVESTMENT TRUST CONVERTIBLE FUND CLASS C CJosed End Mutual FUnds 380 PCM PIMCO COMMERCTAL MORTGAGE SECURTTIES TRUST rNC ~4oney Market Funds 4,736 CDMXX COMMAND MONEY FUND CLASS A $5,483.40 $544.42 S_P_A~R 1.000 $4,736.00 # - The price and certain values shown for this security are derived from the prior business day's closing price (or, if unavailable, the last Bid price). * - Summary totals may not reflect a comprehensive view of your complete portfolio. Summaries where this may apply are marked with an (*). N/A - For securities where no cost basis and/or proceeds are available, a 'N/A' will be shown. N/C - For securities where the cost basis is not calculated, a 'N/C' will be shown. [] - All or part of the information may have been provided by the client or the Financial Advisor. Records 1-14 of 14 Page: I of ! This representation of your account history is not the official record of your account. Et is for informational purposes only and has been prepared to assist you with your investment planning. Your Prudential Securities Client Statement is the official record of your account. Therefore, if there are any discrepancies between this information and your Client Statement, you should rely on the Client Statement and call your local Branch Manager with any questions. http://branchserver.prusec.com/fi~ncRTIME/apsnlist.asp 3/24/2003 REV-1508 EX + 1-97 ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Lewis, Mary H. 21-03-00264 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2. 3. 4. De 6. 7. 8. Allfirst checking account no. 55458009 Allfirst Money Market account no. 950947644 Cash found around the house Commonwealth of Pennsylvania State Treasury Department - PA Tax refund for 2002 Comcast - refund Net Proceeds from sales of personalty at auction 4/16/2003 Proceeds of private sale of personal property Refund of personal property insurance premium -J Gordon Gains Inc. Internal Revenue Service - 2003 Tax Refund PA Dept of Rev. - 2003 Tax Refund TOTAL (Also enter on line 5, Recapitulation) $ 72,741.72 (If more space is needed, insert additional sheets of the same size) 38331.10 32835.92 80.15 98.00 27.72 363.83 196.00 6.00 437.00 366.00 allfirst' A Division of M&,T Bank ..Xlll'irst Fimmcial {it'nh'r N.A. "l,ll,l.,,.,, I)1 lu,,,., April 7, 2003 Jane M. Alexander Attorney At Law 148 South Baltimore Street P.O. Box 421 Dillsburg, PA 17019-0421 RE: Estate of Mary H. Lewis Date of Death: March 16, 2003 Social Security Number: 578-03-6706 Dear Ms. Alexander: 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. 1. Account Type ........................... Checking Account Account Number. ...................... 0055458009 Ownership (Names of) .............. Mary H. Lewis Opening Date ........................... 08/28/64 {account closed 03/28/03) Balance on Date of Deatb~ ......... $38,328.60 Accrued Interest $ 2.50 Total ....................................... $38,331.10 Account Type ........................... Money Market Account Account Number. ...................... 0950947644 Ownership (Names of) .............. Mary H. Lewis Opemng Date ........................... 09/13/02 (account closed 03/28/03) Balance on Date of Death. ......... $32,814.42 Accrued Interest $ 21.50 Total ....................................... $32,835.92 Page 2 April 7, 2003 'l'hi:~ h,ltrl- d~le,~ Iml inrhlde ,'1ny fwf'Ollrllfi in which the deceased may have been lisled as pnwer d' allorlley, custochan of unitbm~ transfers, representative payee, or trustee under a written trust agreement. For any additional information on these accounts, please contact our branch at: 3045 Market Street Camp Hill, PA 17011 Phone: (717) 255-2279 Sincerely, Charlene Warrington, Assdciate I (302) 934-2722 Appraisal done April 3rd, 2003 for the Estate of Mary H. Lewis 2804 Market St. Camp Hill, PA. 17011 4pc. Blond bedroom suite $60.00 Maytag washer $35.00 Everyday dishes (lot) $35.00 Frigidaire dryer $25.00 Frigidaire refrigerator $25.00 3 pcs. Sofa-chair & ottoman $25.00 Drop leaf table & 4 chairs (lot) $20.00 Server $20.00 2 pcs. Bed & dresser $20.00 Pots-pans & cooker (lot) $18.00 Breakfast table $15.00 Window air condition $15.00 3 stand lamps (lot) $15.00 1 drawer black 4 legs stand $15.00 3 pc. Wall mirror & 2 plaques $10.00 Pr. Colonial scene wall pictures $10.00 Orange love seat $10.00 End table $10.00 2 round stands pr. $10.00 Sofa $10.00 Pull out end table $10.00 Coffee table $10.00 Gold trim wall mirror $10.00 Jewelry & costume jewelry $10.00 Wall picture "Lovers" $10.00 Magic Chief Micro Wave oven $10.00 Server stand $10.00 3 Lg. round stand $10.00 2 plank bottom chairs pr. $10.00 2 tier stand w/light $10.00 2 plastic plants pr. $10.00 Lg. wall picture "Church Scene" $10.00 Brass box for phone stand $10.00 Green Chinese plate decanter $10.00 3 European Country scene pictures $10.00 Lamp stand $8.00 Dehumidifier $6.00 6 long handle tools lot $6.00 Zenith floor model TV, $15.00 5 wall pictures lot $5.00 TV stand $5.00 Elect. Heater $5.00 Fan $5.00 Hand tools hammers-screw driver etc. $5.00 Little IKE Eichelberger Auctioneer,;'~ ~/~.~ ~-~,~' ~' '/' P":9' prop. TV, tuner $5.00 Wall Clock $5.00 Lg. wall picture $5.00 2 stuff chairs pr. $5.00 2 drawer file cabinet $5.00 Zenith radio $5.00 $633.00 Total t ,- ;. L RECEIVED ~, DATE, ~':/," ,/~- CONSIGNOR'S NAME ' ADDRESS SHEET # / OF ? TOTAL SHEETS I (consignor) hereby commission you to sell the items listed above & on the attached sheets to the highest bidder by public auction. I certify that I am the owner of the above listed items and have good t t e and the right to sell them. I certify that the items listed are free from all incumbrances. I agree to accept all responsibility for providing good title and for delivery of title to the purchaser. It is agreed that the consignee is not respons ble for the loss of any item due to fire, theft, damage etc. t understand that a % corem ssion will be deducted from the gross sales of my items. "No Bid" items will be disposed of at the discretion of the Auctioneer/Auction House. Payment will be made to the consignor within __ days from date of sale. Consignor Signature Auctioneer/Auction Staff Signature REV-1510 EX * 0-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER 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 yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT ANO THE DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATrACN A COPY OF THE DEED FOR REAL ESTATE. , VALUE OF ASSET INTEREST {IFAPPLICABLE) !. Prudential Financial Annuity contract 209,773.05 100% no. CSCO00000104-A Named beneficiary: Judith A. Fairchilde, niece TOTAL (Also enter on line 7, Recapitulation) $ 209773.05 (If more space is needed, insert additional sheets of the same size) Prudential Financial Prudential Investments Annuity Services P.O. Box 13379 Philadelphia, PA 19101 (888) 778-2888 ESTATE OF MARY H LEWIS c/o June M Alexander 148 S Baltimore St P O BOX 421 Dillsburg PA 17019-0421 Owner: MARY H LEWIS Annuitant: MARY H LEWIS Contract Number: CSC000000104-A APRIL 16, 2OO3 Dear ESTATE OF MARY H LEWIS, Thank you for notifying us of MARY H LEWIS's death. Please accept our sincere condolences for your loss. Our goal is to make the processing of your request for benefits as prompt and convenient for you as possible. According to the terms of t~the remaining benefits are payable as a lump sum payment in the amount o~'$209773.0_~, Our records indicate that the beneficiary(ies) for any benefits payable under this contract are as follows: JUDITH A FAIRCHILD, NIECE We would appreciate your help in obtaining the following information: · Claiming Insurance Benefits form · A photocopy of the death certificate · The Contract or Claim Settlement Certificate (if it is available) We have enclosed a reply envelope for your convenience in returning these forms. Once we receive them, we can start the claim process. If you have any questions, please call the Prudential Annuity Service Center at (888) 778-2888. We are available Monday through Friday between 8:00 a.m. and 8:00 p.m. Eastern Time. If you are using a telecommunications device for the hearing impaired (TDD), please call (800) 654-7637, Monday through Friday between 8:00 a.m. and 8:00 p.m. Eastern Time. One of our Customer Service Representatives will be glad to help you. Sincerely, Leonard Hayes Director, Mutual Funds and Annuities Enclosures: Claiming Insurance Benefits form Business Reply Envelope A Prudential business Corporate Office: 751 Broad Street, Newark, NJ 0710~'-3777 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Lewis, Mary H. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-03-00264 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 8. 9. 10. 12. 13. FUNERAL EXPENSES: Neill Funeral Home - Funeral expense Reverend Carl Hechert - Minister Gingrich Memorials - lettering tombstone ADMINISTRATIVE COSTS: Pemonal Representative's Commissions Elmer G. Engle Name of Personal Representa§ve (s) Social Security Number(s) / EIN Number of Personal RepresentaUve(s) Street Address 37 Beard Road 176-34-8406 city Mechanicsburg State PA Year(s) Commission Paid: 2004 AttemeyFees Jane M. Alexander, Esquire Family Exemption: (if decedent's address is not the same as claimant's, attach explanation) Claimant None claimed 17055 Zip Street Address City State Zip Relationship of Claimant to Decedent ProbateFees Register of Wills - probate Accountant's Fees Samuel D. Thuma, CPA - Tax preparation Ta~RemmPrepa~fsPees' Register of Wills - short certificate The Cumberland County Law Journal - advertise Executor's notice The Sentinel Legal - advertising Executor's notice Register of Wills - filing Inheritance Tax Return & Inventory Notary fees Clerk of Orphans' Court - filing First and Final Account Clerk of OrPhans' Court - filing Release TOTAL (Also enter on line 9, Recapitulation) $ 45658.49 (If more space is needed, insert additional sheets of the same size) 7986.38 150.00 205.00 16530.00 19386.00 515.00 500.00 9.00 75.00 102.11 25.00 20.00 140.00 15.00 Funeral Home Inc. April 7, 2003 Mr. Elmer Engle 37 Beard Road Mechanicsburg, PA 17055 This is an itemized bill for the funeral of: Mary H. Lewis PROFESSIONAL SERVICES AND MERCHANDISE SELECTED 18 ga. Casket wi Crepe Interior (Roman ............... Sentinel Protective Burial Vault ....................... Additional Transportation @ $1.90/Mile ................ Visitation Concluding at Graveside .................... Flowers ......................................... Sub - Total CASH ADVANCES Death Certificates ................................. Newspaper Notice, Patriot-News ..................... Cemetery Equipment .............................. Harmony Cemetery ................................ Sub - Total Total Funeral Charges Payment Received 2,695.00 995.00 104.50 2,995.00 439.88 7,229.38 20.00 37.00 100.00 600.00 757.00 $ $ 7,986.38 (7,986.38) Ref No.: 1002008 / 2742 Balance Due on Account $0.00 3401 Market Street Camp Hill, PA - 17011-4428 tel 717 737-8726 fax 717 737-1859 Robert J. Pramih, Supervisor 3501 Derry Street Harrisburg, PA - 17111-1.817 tel 717 564-2633 [ax 717 561-9918 5tephen J. Wilsbclch, Supervisor Members *% ri - ~ ,'~ r~.~ GROUP 01/23/2004 FRI 10:40 FAX 9443636 IRC3200 [~001/001 :lames R. Gingrich Memorials 568 N. Union Street Middletown, PA 17057 ('7171 944-3441 Xnvoice Mary Lewis Estate 1/23/2004 c/o bud Engle 37 Beard Road Mechanicsburg, PA 17055 117281 9/5/2003 Maw Lewis James Gingrich Order Total: $205.00 1 Cemetery Inscription Payments: $0.00 Balance Due: $205.00 A .finance ch~,'ge u.f 1 ~.% per mm,d, (I,f% ~mn,m#y) ,,#! be atMed q fret 30 days PLEASE TEAR THIS PORTION OFF AND RETURN WITH PAYMENT .lames R. Ginarich Memorials 568 N. Union Street Middletown, PA 17057 Balance Due: $205.00 Family: Lewis Contract#: 117281 Amount Paid: ~EV-1512 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Lewis, Mary H. 21-03-00264 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 2. 3. 4. 5. 6. 7. 8. 9. 10 11. 12. 13. 14. 15. 16. Michael W. Harling,Tax collector - 2003 personal tax Pro-rate share of 2003 County and Township tax Verizon - phone services - debt of decedent Ralph A. Greiman, Jr. - appraisal of real estate Vascular Associates - expense of last illness PP&L - electric services - debt of decedent Pennsylvania American Water - debt of decedent AT&T - phone services - debt of decedent Penn Waste Trash removal - debt of decedent Checks writen by decedent prior to death honored by bank: Home Depot - debt of decedent Ollie's - debt of decedent Bob Warner - debt of decedent - lawn care Keystone Oil - heating oil - debt of decedent Borough of Camp Hill - sewer service - debt of decedent Todd Engle - baby gift - debt of decedent Faith Church - donation TOTAL (Also enter on line 10, Recapitulation) $ 2511.94 (If more space is needed, insert additional sheets of the same size) 4.90 233.11 52.97 5O0.OO 50.40 78.55 104.09 8.52 40.75 25.06 58.25 200.00 577.34 378.00 150.00 50.00 REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Lewis, Mary H. 21-03-00264 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE II. TAXABLE DISTRIBUTIONS (include outright spousal distributions) Elmer G. gngle and Winnie L. Engle 37 Beard Road, Mechanicsburg, PA 17055 Judith Ann Fairchild 573 South 6th Street Bangor, PA 18013 None Niece $425,000.00 196.00 $425,196.00 Residue of Estate ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None TOTAL OF PART Il . 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) 'COMI~ONWEALTH OF PENNSYLVANIA COUNTY OF ~:O]~aBCDE]K[ ¥0RE SS: Elmer G. Engle being duly sworn according to law, deposes and says that he is the Executor of the Estate of Mary H. Lewis late of Boro_u_g_h_p__f___Camp Hill__ , Cumberland County, Pa., deceased and that the within is an inventory made by Elmer G. Engle . , the said Executor of the entire estate of said decedent, consisting of all the personal proparfy and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedenf's death. S~o~ and subscribed before me, Date of Death Notarial Seal I Halyard E. Alexander, Notary Public I DiUsburg Boro, York County . / My Commission Expires Apr. 23, 2005 16 t~[ember' Pennsylvania Association ot Nolaries Executor 37 Beard Road, Mechanicsburg, PA 17055 Address March 2003 2. 3. 4. Day Month Yeer INSTRUCTIONS An inventory must be filed wifhin three months after appoinfmenf of personal re~esenfaflv~ L A supplement inventory must be filed within thirty days of discovery of addlhongl..~assets. Additional sheets may be attached as fo personalty or realty ';~'. r,~ See Article IV, Fiduciaries Act of 1949. 0 0 Inventory of the real and personal estate of , Mary H. Lewis deceased 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Allfirst checking account no. 55458009 Allfirst Money Market account no. 950947644 Cash found around the house Commonwealth of Pennsylvania State Treasury Department - PA Tax refund Comcast - refund Net Proceeds from sales of personalty at auction 4/16/2003 Proceeds of private sale of personal property Refund of personal property insurance premium - J Gordon Gains, Inc. Internal Revenue Service - 2003 tax refund PA Dept of Rev. - 2003 tax refund Prudential Securities Account No. 044-227193-018 (See list attached) All those two certain pieces or parcels of land situate in the Borough of Camp Hill, County of Cumberland, Pennsylvania, acquired by deed from Ben Franklin, Inc. dated March 1, 1968 to John Lewis and Mary H. Lewis, his wife Recorded in th&: Office of the Recorder of Deeds in and for Cumberland County in Deed Book R 22, page 446. The said John L. Lewis having died January 25, 1979 title therein vested in Mary H. Lewis, his wife 38331 32835 ~80 98 27 363 196 6 437 366 237701 425000 10 92 15 O0 72 83 O0 O0 O0 00 29 00 REV: 150'~ EX+ COMMONWEALTH OF PENNSYLVANIA INHEFIITANCE TAX RETURN RESIDEI~IT DECEDENT SCHEDULE "B" STOCKS AND BONDS ESTATE OF Lewis, Mary H. (All property jointl¥-owr~ed with Right of Survivorship.must be disclosed on Schedule "F") FILE NUMBER 21-03-00264 ITEM NUMBER 3 o 5 o 10 11 12 DESCRIPTION Prudential Securities Account No. 044-227193-018 Eqities and Options 201 AOL Time WarnerInc. Equity Mutual Funds 425.918 Calamos Investment Trust Growth Fund Class C 1206.569 Cohen & Steers Equity Income Fund CLC 1521.581 Davis N Y VentureFund Class C 1145.214 First Eagle Sogen Overseas Fund CL C 881.333 Lord Abbett Mid Capital Value Fund Inc. ClassC 2841.800 Prudential Jennison Growth Fund Inc. Class A 973.288 Putman InternationalGrowth Fund Class C 1403.571 Washington Mutual Investors Fund Fixed Income Mutual Funds 3187.677 Eaton Vance Floating Fund Class C Balanced Mutual Funds 1909.097 Amarican Balanced Fund Class A 870.981 Calamos Investment Trust Convertable Fund Class C Total from Continuation scheau±es @ 11.13 @ 30.04 @ 10.85 @ 18.97 @ 12.80 @ 13.26 @ 9.71 @ 14.56 @ 21.81 @ 9.62 @ 13.76 @ 17.04 TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH 2, 237. 13 12,794.58 13,091.27 28,864.52 14,658.74 11,686.48 27,593.88 14, 171.07 30,611. 88 30, 645. 45 26, 269. 17 14,841. 52 5!0,215.60 $ 237,701.29 (if more space is needed insert additional sheets of same size) COMMONWEALTH OF PENNSYLVANIA INFIERFrANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS Continued ESTATE OF Lewis, Mary H. FiLE NUMBER 21-03-0026~ All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 13 14 DESCRIPTION Close End Mutual Fund 380 Pimco Commercial Mortgage Securitie~ Money Market FQnd 4736 Command Money Fund Class A @ 14.42 @ 1.00 TOTAL (Also enter on line 2, Recapitulation) $ 1,0,215.60 VALUE AT DATE OF DEATH 5, 479. 60 4, 736. O0 more space is needed, insert additional sheets of the same sizel IN THE COURT OF COM3MON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF MARY H. LEWIS Late of Camp Hill Borough File No. 2103-00264 RELEASE KNOWALL MEN BY THESE PRESENTS, that Elmer G. Engle~ Winnie L. Engle, and Judith Ann Fairchild, being the beneficiary of Mary H. Lewis~ acknowledge that we have had and received of and from Elmer G. Engle, Executor of the Estate of the said Mary H. Lewis, deceased, funds due from the said estate as set forth in the First and Final Account. WHEREFORE, we do, by these presents, remise, release, quit-claim and forever discharge the said Elmer G. Engle, his assigns, heirs, Executors, of the duties of the trust imposed and from all actions, suits, payments, accounts~ reckonings~ claims and demands whatsoever for or by reaso~n thereof. IN WITHNESS WHEREOF~ we have hereunto set our hands and seals this ._~ c~?, day of '//~/~/~ O~:"} '7- .2004. WITNESS: Judi~ Ann Fairchild Elmer G. Engle , Winnie L. Engle ~..~ COMMONWEALTH OF PENNSYLVANIA : :SS. COUNTY oF ...A' e~.~.~,,, ~ : On this, the ~ ~. e~_day of__ ~ ,2004, before me, the undersigned officer, a Notary Public, personally appeared Judith Ann Fairchild sxvom to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal. My Commission Expires: COMMONWEALTH OF PENNSYLVANIA COUNTY OF ycR~< tary Public K, Murray, Notm'v SS. My Commission Expires: On this, the day of L. ~ ~ _ __, 2004, before me, the undersigned officer, a Notary Public, personally appeared Elmer G. Engle and Winnie L. Engle sworn to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument and acknowledged that they executed the same for the purpose therein contained. IN WITNESS WHEREOF. I have hereunto set my hand and notarial seal. //,/'~Otary Public '// ~ - Notarial Sea Halyard E. Alexander Notary Public s ~Dillsburg Boro, York County M, ,~ormmssion Expires Apr. 23, 2005 ~ ssoc at onofNotanes STATUS REPORT UNDER RULE 6.12 Name of Decedent: Mary H. Lewis Date of Death: March 16, 2003 Will No. 2103-00264 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the ~ ~ =o~=cwina with respect to completion of the administration of the above-captioned estate: State whether admini -=~ of st .... on the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 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 X No d. Copies of receipts, r~ieases, 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. /~jiag~nea 7 r e / - J ~/NOame (.~leAal~a~ 'oErS~i~) 148 S. Baltimore Street Address Dillsburg, PA 17019 I 7171 432-4514 Tel. No. Capacity: __Personal°Representative ( MAH ~ rmf/AM3 ) X Counsel for personal representative BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DTVZSZON DEPT. 280601 HARRTSBURG, PA 171Z8-060! COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-I~D? EX AFP ¢01-05) JANE M ALEXANDER ESQ 1fi8 S BALTIMORE ST DILLSBURG PA 17019 DATE ESTATE OF MARY DATE OF DEATH FILE NUMBER CounTY ACH Amoun~ Remi~ed HAKE CHECK PAYABLE AND REHZT PAYMENT TO: 06-07-ZOOq LEWIS 03-16-2005 210$-OZ6q CUMBERLAND 101 REGTSTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subm/t the upper port/on of :this form wJ~h your ~ax payment. CUT ALONG THxS LXNE ~ RETA/N LOWER PORTXON FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03} aaa XNHERZTANCE TAX STATEMENT OF ACCOUNT aaa ESTATE OF LEWIS MARY H F/LE NO. Z10$-OZ6q ACN 101 DATE 06-07-ZOOq TH/S STATEMENT TS PROV/DED TO ADV/SE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAMED ESTATE. SHOWN BELOW TS A SUMMARY OF THE PR/NC/PAL TAX DUE, APpLTCATTON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, TF APPL/CABLE, A PROJECTED /NTEREST FTGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-$1-ZOOq PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 15q,183.3q PAYMENT RECEIPT DISCOUNT ¢+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID ~ SUMMARY OF 05-2q-200q 05-2q-200q IF 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), ~LL 005 PAYMENTS ~ 3,673.30 278.89- .00 130,788.93 TOTAL TAX CREDIT lSq,185.3q BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THIS 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 HILLS, AGENT. -- Tf NON-RESIDENT DECEDENT make check or money order payable to: COHHONNEALTN OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which Has not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-Z313). Applications are available at the Office of the Register of Nills, any of the Z3 Revenue District Offices or from the DepartJ~ent's Z4-hour answering service for forms ordering: 1-800-36Z-ZO50; services for taxpayers mith special hearing and / or speaking needs: 1-DOO-447-30ZO (TT only). REPLY TO: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 171Z8-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid ~ithin three (3) calendar months after the decedent'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 the tax amnesty period. INTEREST: Interest is charged beginning ~ith first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes ehich became delinquent before January 1, 198Z bear interest at the rate of six (BZ) percent par annum calculated at a daily rate of .000164. Ail taxes which became delinquent on and after January 1, 198Z mill bear interest at a rate which will vary from calendar year to calendar year ~ith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOO4 are: Interest Daily Interest DaiLy Interest Year Rate Factor Year Rate Factor Year~ Rate 1982 ZOZ .000548 1988-1991 llZ .000301 2001 9X 1983 16Z .D00438 1992 92 .000247 ZOO2 6X 1984 11Z .000301 1993-1994 7Z .000192 2003 5Z 1985 132 .000356 1995-1998 9X .000247 2004 42 1986 IOZ .000274 1999 7Z .00019Z 1987 9Z .000Z47 ZOO0 8Z .000Z19 Daily Factor .000247 .000164 .000137 .000110 --Interest is calculated as folloes: INTEREST = BALANCE OF TAX UNPAID X NURBER OF DAYS DELINQUENT X DA]:LY /NTEREST 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 sho~n on the Notice, additional interest must be calculated.