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HomeMy WebLinkAbout03-0351 PETITION FOR PROBATE and aBo known as To: GRANT OF LETTERS , Deceased. Social Security No. _ [q~. 't~,e5'' -- ~,~3 7 The petition of the undersigned respectfully represents that: Your petitioner{~O, who is/,m'e 18 years of age or older an the executor in the last will of the above decedent, dated Register of Wills for the County of Commonwealth of Pennsylvania in the named //' _/~ ,19 ~}.~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cl~ot~er/a~oI County, Penns¥lya~nia, with h e. ar last family or principal residence at ~r /aaa ~v,~ ~,re, ~Z'~& (~,~/~~) (list street, number and muncipality) Decendent, then ~7 years of ~e. died. , ~m~er .~, ~00~ , ExCept as follows, dece~t did ~ot g~rr~, was not divo}ced aadMid ~ot have a child born or adopted after execution of~e will offered, fohprobate; was not the victim of a killing and was never adjudicated incompetent: ( ~rgr Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: WHEREFORE, petitioner(s) respectfully' request(~s) the probate of the last will and codicil(s) presented herewith and the grant of letters theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) Sworn to or affirmed and. subscribed ~~ before m~o~,~~ -'O' O.~'~ ~10~3f ['/,..%,/'0.. _.Ye 0 c.~/"5~"'~ t/le-/'/'t/ao~ Register / OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ] COUNTY OF ('-,Lt/11 t~6'-~/_~./3 ~ ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. No. 21-03-0351 Estate Of T~m3~A a. SLONAKER , Deceased DECREE OF PROBATE AND GRANT-OF LETTERS AND NOW AUGUST 13, ~ 2003, in consideration of the petition on the reverse side hereof, satisfactory proof ha~vi~gc~ IT IS DECREED that the instrument(s a)~ed' JANUARY 1!. 1993 HERETO OF described therein be admitted to probate and filed of record as the last will of THELMA J. SLONAKER ; and Letters TESTAMENTARY are hereby granted to STEVEN ZIMMERMAN FEES Probate, Letters, Etc .......... $. 25.00 Short Certificates(3) .......... $ 9.00 ~ EXTRA. PAGES..2 $ 6.00 ' JCP $ 10.00 TOTAL . $. 50.00 Filed . .A.U..G.U.S.T.. ,1.3:..2.0.9.3 ................ ~ Register of Wills ATTORNEY (Sup. Ct. I.D. No.) ADD.SS PHONE MAILED LETTERS TO ATTORNEY AUGUST 13, 2003 21-03-351 REGISTER OF WILLS OF O~'/~z:~L~#D COUNTY OATH OF SUBSCRIBING WITNESS {-~¢0a) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that .,.~J'6' ~,f present and saw the testatr~tx , sign the same and that ~ signed as a witness at the request of testatt4~ in l~t- presence anda(.~n the ~rezence of e~ch other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this 4ff//~.~ day of NOTARIAL SEAL ~ ~P. C~ c~ i ~~ E~r~ du~ 20, (Address) (Name) (Address) REGISTER OF WILLS OF COUNTY T F_ NON-SUBSCRIBING WITNESS , (each) a subscriber hereto, (eacl~eing duly qualified according to law, depose(s) and say(s) that ..... Pa~iliar with the signature of ...... ........... .,NX codicil testat of (one of the subscribi~x witnesses to) the will presented herewith and ,xX.' codicil that be/i{ves the signature on the will is in the handwriting of to the best of knowledge and belief. Sworn to or affirmed and subscribed before me this day of 19 Register (Name) (Address) (Name) (Address) 21-03-351 REGISTER OF WILLS OF C U N4~-~db COUNTY OATH OF SUBSCRIBING WITNESS ~(cac,~) a subscribing witness to the will presented herewith, (.eaeh-) being duly qualified according to law, depose(s) and say(s) that ]~ /~/,~ present and saw the testat ~'~y , sign the same and that ~ signed as a witness at the request of testatr'~ in h~r presence [,_m~u,,!n the~rese.nce of .~z....~ 7thzr) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this g/t"~rd~ day of Register ' ~,6,~-/e-s ,e'. ~ ame) (Address) (Name) (Address) REOI~ER OF WILLS OF COUNTY (each) a subscriber hereto(each) bein~uly qualified according to law, depose(s) and say(s) that ----~ famih'ar"~h the signature of _~--, .... ~ codicil testat_ ___ of (one of the subscribing witne%to) the will presented herewith and . __ ~ codicil that ..... believes the sig/~on the will is in the handwriting of to the best of__ ___ knowledge and belief. Sworn to or affirmed and subscribed before me this _ day of (Name) 19 (Address) Register (Name) (Address) his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Psegistrar. The original certificate will be forwarded to the State Vital Records Office forpermanent"fihng." WARNING: It is illegal to duplicate this copy by photostat or photograph. Local Registrar P 8607403 ~~~ ¢¢~/~R ~ ~oo2 No. ~ Date ii COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH o~=~'~.~,T,.;,:,:;,;=;;- ......................................... ~T ...... .~ ......... ,~-~S~C~"''~ ~.~-~-~,~;.~ ~: ,=;, . ..... ~.___ Thelma J. Slonaker 'J~ Femur:. 19~ 05-- 933}: November 3 2002 I' L_~" ~ i Jan 1 Cumberland Court ..... LJ .......... L~ Cumberland L Middlesex Twp. J C aremont Nursinn & Rehabilitation ~c.o.. ~" I-. _~ _"-"~ ' J~ ' '"' ,. White 's ...... ~ss~ .... c~-~.l~ z~c~, I - lu. ~ I"- Never Marrled[~,. 1000 Claremont Drive .~s,o~.c~ .............. ~ '*~'~ Carlisle, Pa. 17013 ~,,o,,,~,.d~ ~'"" ~ Co... Cumber and '~'"~ ,z..~ ' Cleve Slonaker II.-'"a' Blanche Shank - ~ ........ I.. NOV 6, 2002 ~ Longsdorf Cemete~ L. New Kingstown, Pennsylvania I t "COPY FAIR" 21-03-351 LAST WILL AND TESTAMENT OF TI~J MA J. SLONAKER I, THELMA J. SLONAKER, of Silver Spring Township, State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon as conveniently may be after my decease. , .v . . g~ e and bequea~oo ~e ~rsons, tlie following items and/or sums of money: A. Steven Zimmerman, of 705 S. Market Street, Mechanicsburg, a sum of ~!~I~, my "player piano", and the "cabinet and roils"; C. To Doris and Harold Zimmerman, of 702 S. York St., Mechanicsburg, a sum of $1,000.00 ~ my "bamboo stand", and my "milking stool". 4. To each of the following persons I give and bequeath the sum of $1,000.00: I. Paul Melton, J. Lucille Melton, K. Anna E. Yohe, L. Genevieve Yohn, M. Virginia Raudabaugh, all of New Kingston, O. I-larry A. Y6hn, 252 Locust Point Road, Me, chanicsburg, ~~,-~7 $ P. Clyde Swartz, of gle~'~ingston. ~ Should my estate, after debts, taxes and the like, not be sufficient to support all of the above-listed specific bequests in paragraphs 2, 3, and 4 then each shall be reduced a proportionate pro-rata amount. Should any of the above named parties predecease me, their share shall be proportionately divided between those listed who do survive me. ? 1 gige and deVise property situate at 70 . a~mn St., New · Diablo, Green Valley, Arizona 85614. A. Should my house have been sold during my lifetime, then this gift shall lapse. B. Should my house not have been sold and should there not be sufficiem funds available to pay the specific bequests listed in paragraphs 2, 3, and 4, above, then the specific devise to my said sister shall take priority over the specific bequests in paragraphs 2, 3, and 4, above. ~" shall be sold and that amount of the proceeds therefrom which remain after the payment of debts and specific bequests shall be placed in the residue of my estate. Each person named as a specific beneficiary or specific devisee herein shall pay their fair share of the inheritance tax on the face value of their devise or bequest. 8. All the reit, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to be divided equally between my said the said Steven Zimmerman. Should my said sister predecease me, then her share shall go to me said Steven Zimmerman. Should the said Steven Zimmerman predecease me, then his share shall be given in equal shares to his mother, Doris Zimmerman, ~ 9. I nominate, constitute and appoint Steven Zimmerman to be the Executor of this, my Last Will and Testament. If he should predecease me, or for .any other reason be unable to act, or to continue to act as such Executor, I appoint the Farmer's Trust Company of Carlisle, as Executor in his place and stead- IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ [ ~ day of January, A.D. 1993. Signed, sealed, published and declared by the above-named THELMA J. SLONAKER, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. COPY FAIR LETTERS TESTAMENTARY ESTATE OF, THELMA J. SLONAKER. LATE OF, MIDDLESEX TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED. ISSUED ON: AUGUST 13, 2003 ESTATE NO: 21-03-351 REGISTER OF WILLS & CLERK OF THE ORPHANS' COURT Cumberland County Courthouse Carlisle, Pennsylvania 17013 LAST WILL AND TESTAMENT OF TI-IFil JMA J. SLONAKER 21-03-351 I, THELMA J. SLONAKER, of Silver Spring Township, State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon as conveniently may be after my decease. ' gl oeq e following persons, me following items and/or sums of money: A. Steven Zimmerman, of 705 S. Market Street, Mechanicsburg, a sum of my "player piano", and the "cabinet and rolls"; C. To Doris and Harold Zimmerman, of 702 S. York St., Mechanicsburg, a sum of $1,000.00 ~l~ my "bamboo stand", and my "milking stool". 4. To each of the following persons I give and bequeath the sum of $1,000.00: I. Paul Melton, J. Lucille Melton, K. Anna E. Yohe, L. Genevieve Yohn, M. Virginia Raudabaugh, all of New Kingston, Oo Clyde o Should my estate, after debts, taxes and the like, not be sufficient to support ail of the above-listed specific bequests in paragraphs 2, 3, and 4 then each shail be reduced a proportionate pro-rata amount. Should any of the above named parties predecease me, their share shall be proportionately divided between those listed who do survive me. property situate at 70 w. ~nmn ~t., New Diablo, Green Vailey, Arizona 85614. A. Should my house have been sold during my lifetime, then this gift shail lapse. B. Should my house not have been sold and should there not be sufficient funds available to pay the specific bequests listed in paragraphs 2, 3, and 4, above, then the specific devise to my said sister shall take priority over the specific bequests in paragraphs 2, 3, and 4, above. C° shall be sold and that amount of the proceeds therefrom which remain after the payment of debts and specific bequests shall be placed in the residue of my estate. 7. Each person named as a specific beneficiary or specific devisee herein shail pay their fair share of the inheritance tax on the face vaiue of their devise or bequest. 8. All the reit, residue and remainder of my Estate, reai, personai and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to be divided equaily between my said ~?_ ~ the said Steven Zimmerman. Should my said sister predecease me, then her share shall go said Steven Zimmerman. Should the said Steven Zimmerman predecease me, then his share shall be given in equai shares to his mother, Doris Zimmerman, ~ 9. I nominate, constitute and appoint Steven Zimmerman to be the Executor of this, my Last Will and Testament. If he should predecease me, or for .any other reason be unable to act, or to continue to act as such Executor, I appoint the Farmer's Trust Company of Carlisle, as Executor in his place and stead. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ] I ~ day of January, A.D. 1993. Signed, sealed, published and declared by the above-named THELMA J. SLONAKER, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as wimesses. LAST WILL AND TESTAMENT OF TNk~MA J. SLONAKER CHARLES E. SHIELDS III ATTOR N EY-AT-LAW COMMONWEALTH NATIONAL BANK BUILDING 2 W. MAIN STREET MECHANICSBURG, PA 17055 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will No. Thelma J. Slonaker November 3, 2002 Admin. No. 21-03-0351 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 August 19, 2003: Name Address. Salesian Missions Steven Zimmerman Doffs & Harold Zimmerman Anna E. Yohe Genevieve Yohn Virginia Raudabaugh Harry A .Yohn Clyde Swartz 2 Lefenre Lane, P. O. Box 30, New Rochelle, New York 10802-0030 22 Wineberry Drive, Mechanicsburg, PA 1.7055 702 S. York Street, Mechanicsburg, PA 17055 69 W. Main Street, New Kingston, PA 17072 252 Locust Point Road, Mechanicsburg, PA 17055 28 Nottingham Drive, Mechanicsburg, PA 17055 252 Loucst Point Road, Mechanicsburg, PA 17055 8 Cottage Court, Mechanicsburg, PA 17055 Paul & Lucille Melton Both believed to be deceased Charles E. Donohue, Deputy Attorney General Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: August t9, 2003 6 Clouser Road Mechanicsburg, PA 17055 Telephone: (717) 766-0209 Counsel for Personal Representative REV-1500 EX (64)0) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN Z UJ Z 0 0 ~J UJ RESIDENT DECEDENT DATE OF DEATH (MM-DD-YEAR) (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) I DATE OF B~RT. (MM-DD-YEAR) //-03- [~2. Supplemental Return r-"-~ 4a. Future t~terest Compromise (dale of death after 12-12-82) ~---~ 7. Decedent Maintained a Living Trust (A~ch copy of Tr,st) r---] 10. Spousal Povedy Credit (date of death between 12-31-91 and 1-1-95) [~1. Original Return J--~ 4. Limited Estate [~6. Decedent Died Testate (Altech copy of Will) ~--] 9. Litigation Proceeds Received OFFICIAL USE ONLY' FILE NUMBER (8) (11) (12) (13) (14) 15. 16. 17. 18. 19. 20. SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) Amount of Line 14 taxable at lineal rate Amount of Line 14 taxable at sibling rate Amount of Line 14 taxable at collateral rate x .0 o (15) x .0 ~' (16) x .12 (17) x .15 (18) (19) Tax Due 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) ,~ 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) ~ 2/ ~ 7 (Schedule E) 6. Jointly Owned Property (Schedule F) (6) r--] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8, Total Gross Assets (total Lines 1-7) ,~ 9. Funeral Expenses & Administrative Costs (Schedule H) (9) /~ ~Oj~5'" 10. Debts of Decedent, Mortgage Liabilities, & Liens (Sch~edule l) (10) ,,~'~ 7'7 ~'o 11. Total Deduction· (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) [~3. Remainder Return (date of death prlor to 12-13-82) [~5. Federal Estate Tax Return Required O 8. Total Number of Safe Deposit Boxes [~11. Election to tax under Sec. 9113(A)(Aftach Sch O) COMPLETE MAILING ADDRESS THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 14. Net Value Subject to Tax (Line 12 minus Line 13) OFFICIAL USE ONLY b5 5 %l .'75 FIRM NAME (IfApplicable) ~//~ m TELEPHONE NUMBER SOCIAL SECURITY NUMBER lq?- ~.5" - 73.~7 ,2,/ - o3 ~ o ~.~'/ COUNTY CODE YEAR NUMBER Decedent's Complete Address: STREET ADDRESS /~0 C ~'~,~/~"'//~ ~/I/' '7- ~Z~ ~'. CITY STATE IZIP /?~13 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty (1) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) 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. (3) (4) (5) (5A) (5B) A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT n~:~=.._-.-_ ..... =~ r PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE 1. Did decedent make a transfer and: Yes 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? ........................................................................................................................ [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT '111 BLOCKS No 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN X ~"~-~-- ADDRESS ~INE~R~Y ~R. ~ / 7o5'5' DATE .~./~oo~' SIGNATURE .~ P,,~,EPARF~R OTHF._R THAN.Rj~R.E.~E~TA~T. IVE ADDRESS ~'/,~',4~'/.E~ ,~'. /~ ~ DATE ~',/~, o~ 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 exemot 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 ESTATE OF SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY FILE NUMBER -2/-o.3 --.35-/ Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshi ITEM NUMBER DESCRIPTION must be disclosed on Sch~,,;i_~le F. VALUE AT DATE OF DEATH TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) q72670 { CLASSIC CHECKING O0 0 Oq~2N NH 017 :STATEHENT PERIOD ' : : PAGE FEB. 08-NAR. 07, 2005 1 OF THELMA J SLONAKER REGULAR ACCT C/O STEVEN B ZIMMERMAN 22 WINEBERRY DR MECHANICSBURG PA 17055 q9918 CARLISLE PIKE ACCOUNT SUMMARY BEGINNING i: DEPOSITS &:: : : : : :: : : OTHER CURRENT : : : :ENDING : ~- ~- 1-~ ~.o-'~~ ACC ~UU~l ~ 1V1 IY i POSTING i iiiiiii!iiiiiiiiiiiiii ii ! i!i!:;!'i: !i! iii!i i! DEPOSZTS~ZNTEREST; iiCHECKS:& OTHERi : i i iDAZLY DATE .... TRANSACTION DESCRIPTION .... ' ...... &OTHERi!ADDITIONS i: SUBTRACTIONS ....... iii:BALANCEi · 02-08-05 BEGINNING BALANCE $1,567.$7 ENDING BALANCE $1,567.57 REFER A FRIEND TO N&T BANK AND GET A FREE GIFT! NOW, HHEN YOU ASK A FRIEND TO OPEN A CHECKING ACCOUNT WITH N&T, NOT ONLY HILL YOU GET A FREE GIFT - SO WILL YOUR FRIEND. STOP BY ANY N&T BRANCH OR CALL NgT'S TELEPHONE BANKING CENTER AT 1-800-72q-2qqO TO GET A REFER-A-FRIEND COUPON. HURRY, GIFT QUANTITIES ARE LINITED. FREE GIFT PROVIDED AT TIME OF ACCOUNT OPENING. Fac: 1 CLAREMONT NURSING & REHAB CTR Run Date: 04/01/03 Time: 3:58 PM Resident Funds History Report Period/Year From: 11/2002 Period/Year Thru: 03/2003 [PA673] Page 1 Reference Type Tran Year Per Run-Date Journ Date Number Fund Code Description G/L Acct Deposits Disbursements Balance Slonaker, Thelma j. Res ID: 3918 Medicaid ID: 91685 PA80 Admission Date: 11/04/1999 Balance B/F 618.97 618.97 2002 11 12/03/2002 RFINT 11/30/2002 G INTER INTEREST INC TO RES .20 619.17 2002 12 12/17/2002 RFJ 12/06/2002 NOV02 G PCA RESIDENT CARE ALLOW -30.00 649.17 2002 12 12/17/2002 RFJ 12/06/2002 NOV02 G INTOUT INTEREST DUE TO CNRC .04 649.13 2002 12 12/24/2002 RFJ 12/24/2002 NOV02 G INCOME INCOME ADJUSTMENT -261.05 910.18 2002 12 01/03/2003 RFINT 12/31/2002 G INTER INTEREST INC TO RES .29 910.47 2003 01 02/04/2003 RFINT 01/31/2003 G INTER INTERES'T INC TO RES .30 910.77 2003 02 03/05/2003 RFINT 02/28/2003 G INTER INTEREST INC TO RES .22 910.99 2003 03 04/01/2003 RFINT 03/31/2003 G INTER INTEREST INC TO RES .26 911.25 * Resident Totals 618.97 1.27 -291.01 911.25 * Facility Totals 618.97 1.27 -291.01 Wag P.O. Box 17IL Harrisburg, Pennsglvania 17105-1711 Member FDIC STATEMENT DATE 1-19-04 THELMA j SLONAKER ESTATE C/O STEVEN B ZIMMERMAN 22 WINEBERRY DR MECHANICSBURG PA 17055 22 WINEBERRY DR MECHANCISBURG PA 17055 011-237 LOOKING TO EARN MORE? OUR CERTIFICATE OF DEPOSIT SPECIALS ARE HARD TO BEAT! VISIT YOUR LOCAL BRANCH OR CALL US AT 1-866-WAYPOINT FOR DETAILS. ACCOUNT TYPE OF ACCOUNT 100670330 TOTALLY FREE AVERAGE BALANCE 2.476.86 PREVIOUS BALANCE 2.476 86 DEPOSITS WITHDRAWALS O0 CHARGES O0 INTEREST O0 O0 ENDING BALANCE 2,476 86 * ............ INTEREST SUMMARY .............. INTEREST PAID THIS YEAR .00 INTEREST WITHHELD THIS YEAR .00 THANK YOU FOR BANKING AT WAYPOINT BANK POD-502 (8/02) Customer Service Toll-t:ree 1-866-WAYPOINT (I-B66-91~9-7646) · In York Area 717/815-4500 www. wagpointbank.com Manufacturers and Traders Trust Company 'No.356240 BUFFALO, N.Y. 14240 60-295 313 .EMPirE. DATE PAY TO THE ORDER OF 'J~e l~et:al:e of ~L'be].am I~].oaal[er~eeaaaee C U ST..~vljclE R ~R EC E..~~ R. 7U R RECORDS NoT, I~1~~. BLE Way BEttEr Banking only from Waypoint Bank Receipt - ~cct. #: 0100670330 TLR ~:0731 DD~ Deposit TR ~: 178 TR RHT: i567.57 Date: 08/18/2003 TiMe: 11:36 Checks and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain deposits are subject to delays in availability according to Bank policy. TEL-O~0(0~02) Thank You F:or Banking At Wagpoint Member FDIC Way BEttEr Banking only from Waypoint Bank Receipt - Acct. ~: 0100670330 TLR ~:02!2 DDA Deposit TR #: 140 TR AMT: 912.29 Date: 08/25/2003 linde: 11:12 Checks and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain deposits are subject to delays in availability according to Bank policy. TEL-O~O(O~O~) Thank You For Banking At Wa~lpoint UembermC EV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF . ___ _G SCHEDULE H FUNERAL EXPENSES & E COSTS FILE NUMBER 2/--o5-- ~5"! ITEM NUMBER A. 5. 6. 7. Debts of decedent must be reported on Schedule L DESCRIPTION FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address c:~ /../,///J 2~", ~ ', ~ "~, ~, ~ City /~"--~"~////~ ,/Y'/C,~' State/,3,,~ Zip Year(s) Commission Paid: O~¢:~-2z Attorney Fees ~J-t//~/~L~-..~ ,~...,,~"/C//,~..Z~),~. ~ ;~ Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant /~/0~'" Street Address City Relationship of Claimant to Decedent Probate Fees ~,Kd' Accountant's Fees Tax Return PreparePs Fee State Zip AMOUNT .5"00, / 7.5'. ao TOTAL (Also enter on line 9, Recapitulation) $ i, j~/~o q/ (If more space is needed, insert additional sheets of the same size) REV-1512 EX * {1-97)~ I SCHEDULE I COMMONWEALTH OF PENNSYLVANIA I DEBTS OF DECEDENT, MOR IENSEsTATE OF ,.~. ~/I/~"~'"~,, ~"',,~L~-g~#,Af ~.. FlEE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION TOTAL (Also enter on line I0, Recapitulation) AMOUNT s ,,¢'$ ,1 77 more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF -~ Z. ~/!/'/~./~'~"/~, '"~"Z~'/i~ ~ FlEE NUMBER :;~-/- ~ ~- ~'/ NUMBER II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE 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 B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ,,.I' ~z: &~-~i/~N /n/$$/~/v'.~' TOTAL OF PART II - ENTER TOTAL NON-TA~BLE DISTRIBUTIONS ON LINE 13 OF REV 1600 OOVER SHEET $ (If mom spa~ is n~, insert additional sh~ts of the same size) Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters No. 2003-00351 PA No. 21-03-0351 ESTATE OF SLONAKER THELMA J Late of MIDDLESEX TOWNSHIP ~UM~L~qZ~ ~UU~'I'~, ' Deceased Social Security No. 199-05-9337 WHEREAS, on the 13th day of Auqust dated January llth 1993 was admitted to probate as the last will of SLONAKER THELMA J (LA~'i', ~'l~S'i', ~luu~) late of MIDDLESEX TONNSHIP , CUMBERLAND County, who died on the 3rd day of November 2002 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, DONNA M. OTTO , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to ZIMMERMAN STEVEN 2003 an instrument who has duly qualified as Executor(rix) and has agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the 13th day of August 2003. ~ ~egisner of wills **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) I! COPY FAIR LAST WILL AND TESTAMENT OF TI-1EIAMA J, SLONAKER 21-03-351 I, THELMA J. SLONAKER, of Silver Spring Township, State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon as conveniently may be after my decease. 2. ~o.~ I give and bequea~ ~o the~rsons, ttie following items and/or sums of money: A. Steven Zimmerman, of 705 S. Market Street, Mechanicsburg, a sum of l~m~l~, m,, "player piano", and the "cabinet and rolls"; C. To Doris and Harold Zimmerman, of 702 S. York St., Mechanicsburg, a sum of $1,000.00 ~ my "bamboo stand", and my "milking stool". 4. To each of the following persons I give and bequeath the sum of $1,000.00: I. Paul Melton, J. Lucille Melton, K. Anna E. Yohe, L. Genevieve Yohn, M. Virginia Raudabaugh, all of New Kingston, .t O. Harry A. YOhn, z52 Locust Point Road, Mechanicsburg, P. Clyde Swartz, of New Kingston. Should my estate, after debts, taxes and the like, not be sufficient to support all of the above-listed specific bequests in paragraphs 2, 3, and 4 then each shall be reduced a proportionate pro-rata amount. Should any of the above named parties predecease me, their share shall be proportionately divided between those listed who do survive me. '~ ~g~~;wse property situate at 70 w. lv~mn ~t.; New' Diablo, Green Valley, Arizona 85614. A. Should my house have been sold during my lifetime, then this gift shall lapse. B. Should my house not have been sold and should there not be su, fficient funds available to pay the specific bequests listed in paragraphs 2, 3, and 4, above, then the specific devise to my said sister shah take priority over the specific bequests in paragraphs 2, 3, and 4, above. Co shall be sold and that amount of the proceeds therefrom which remain after the payment of debts and specific bequests shall be placed in the residue of my estate. 7. Each person named as a specific beneficiary or specific devisee herein shall pay their fair share of the inheritance tax on the face value of their devise or bequest. 8. AH the reit, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to be divided equally between my said ~llll~._ nd the said Steven Zimmerman. Should my said sister predecease me, then her share shall go to the said Steven Zimmerman. Should the said Steven Zimmerman predecease me, then his share shall be given in equal shares to his mother, Doris Zimmerman, ~ I nominate, constitute and appoint Steven Zimmerman to be the Executor of this, my Last Will and Testament. If he should predecease me, or for.any othor mason be unable to act, or to continue to act as such Executor, I appoint the Farmer's Trust Company of Carlisle, as Executor in his place and stead. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ [ ~ day of January, A.D. 1993. Signed, sealed, published and declared by the above-named TI-IELMA J. SLONAKER, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. 21-03-351 LAST WILL AND TESTAMENT OF THEI JMA J. SLONAKER I, THELMA J. SLONAKER, of Silver Spring Township, State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon as conveniently may be after my decease. I give and beque- ' ' ath ~o the following persons, tti¢'~' t~Uowing items and/or sums of money: A. Steven Zimmerman, of 705 S. Market Street, Mechanicsburg, a sum of my "pl$yer piano", and the "cabinet and rolls"; C. To Doris and Harold Zimmerman, of 702 S. York St., Mechanicsburg, a sum of $1,000.00 ~ my "bamboo stand", and my "milking stool". 4. To each of the following persons I give and bequeath the sum of $1,000.00: I. Paul Melton, J. Lucille Melton, K. Anna E. Yohe, L. Genevieve Yohn, M. Virginia Raudabaugh, all of New Kingston, .i Oo ~o~n, 252 Locust Point Clyde Swartz, of New Kingston~ 5. ~ Should my estate, after debts, taxes and the like, not be sufficient to support ail of the above-listed specific bequests in paragraphs 2, 3, and 4 then each shail be reduced a proportionate pro-rata amount. Should any of the above named parties predecease me, their share shall be proportionately divided between those listed who do survive me. situate at 70 W. mmn ~t.; NeW Diablo, Green Vailey, Arizona 85614. A. Should my house have been sold during my lifetime, then this gift shall lapse. B. Should my house not have been sold and should there not be sufficient funds available to pay the specific bequests listed in paragraphs 2, 3, and 4, above, then the specific devise to my said sister shall take priority over the specific bequests in paragraphs 2, 3, and 4, above. shall be sold and that amount of the proceeds therefrom which remain after the payment of debts and specific bequests shail be placed in the residue of my estate. 7. Each person named as a specific beneficiary or specific devisee herein shail pay their fair share of the inheritance tax on the face vaiue of their devise or bequest. 8. All the regt, residue and remainder of my Estate, reai, personai and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to be divided equally between my said~ the said Steven Zimmerman. Should my said sister predecease me, then her share shall go to me said Steven Zimmerman. Should the said Steven Zimmerman predecease me, then his share shall be given in equai shares to his mother, Doris Zimmerman, ~ 9. I nominate, constitute and appoint Steven Zimmerman to be the Executor of this, my Last Will and Testament. If he should predecease me, or for.any othor reason be unable to act, or to continue to act as such Executor, I appoint the Farmer's Trust Company of Carlisle, as Executor in his place and stead. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ [ ~ day of January, A.D. 1993. Signed, sealed, published and declared by the above-named THELMA J. SLONAKER, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. MILFORD L. M~cBRIDE, JR. BRENDA K. McBRIDE MILFORD L. M~CBRIDE, Tr~ MCBRIDE AND MCBRIDE, p. C. ATTORNEYS AT LAW ::~11 SOUTH CENTER STREET GROVE CITY, PA. 161:~7 TELEPHONE {7;~4) 458-6640 MILFORD L. McBRIDE FA X 458-5401 March 11, 2003 Cumberland County Courthouse Clerk of Courts - Register of Wills ~ One Courthouse Square ~ = ~' Carlisle, PA 17013 ~i~, Re: Supplemental Inheritance Tax Re%urn Gary E. Filer Estate 21-2002-0351 To Whom It May Concern: Enclosed herein, please find two (2) copies of the Supplemental Inheritance Tax Return for the Estate of Gary E. Filer, along with a check in the amount of $3,801.41 payable to the Register of Wills, Agent to complete the Inheritance Tax payment. Please file this return at your earliest convenience and send a receipt to our office. If you have any questions, please feel free to contact our office. Thanking you, I am, MLM,JR./pas cc enclosures Very truly yours, McBRIDE and McBRIDE, P.C. M. L. McBride, Jr. MILFORD L. McBRIDE, ~IR. BRENDA K. M~BRIDE MILFORD L. M~CBRIDE, 133 MCBRIDE AND MCBRIDE, p. C. ATTORNEYS AT LAW :~11 SOUTH CENTER STREET GROVE CITY, PA. 161~.7 TELEPHONE (7:~4) 458-6640 fA X (7:~4} 458-5401 March 16, 2004 Cumberland County Courthouse Clerk of Courts - Register of Wills One Courthouse Square Carlisle, PA 17013 Re: Supplemental Inheritance Tax Return Gary E. Filer Estate 21-2002-0351 Dear Jackie: Enclosed herein, please find our check in the amount of $15.00 for the filing of the Supplemental Inheritance Tax Return for the Estate of Gary E. Filer. Please file this return at your earliest convenience and send a receipt to our office. If you have any questions, please feel free to contact our office. Thanking you, I am, , ; {"'-.I i /pas CC enclosures Very truly yours, McBRIDE and McBRIDE, P.C. M. L. McBride, Jr. MCBRIDE AND ~V~CBRIDE~ ATTORNEYS AT LAW 211 SOUTH CENTER STREET GROVE CITY~ PA I 6127 MCBRIDE AND MCBRIDE, P.C. ATTORNEYS AT LAW 21 ! SOUTH CENTER STREET GROV£ CITY, PA 1 6 ! 27 '04 l'ifiii t~ ? 7 :! ? BUREAU OF ZNDZVZDUAL TAXES INH£RTTANC£ TAX DIVISION DEPT. 280601 HARRZSBURr-, PA 17118-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLOHANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CHARLES E SHIELDS II! 6 CLOUSER RD HECHANICSBURG PA REV-2611? EX AFP DATE Oq-12-Z00q ESTATE OF SLONAKER THELNA J DATE OF DEATH 11-03-2002 FILE NUMBER 21 03-0351 COUNTY CUMBERLAND ACN 101 I Amoun~ Rem/~ed HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTZCE OF INHERITANCE TAX APPRAZSEHENT~ ALLOWANCE OR ESTATE OF SLONAKER DISALLOWANCE OF DEDUCTZONS AND ASSESSMENT OF TAX THELHA JFZLE NO. 21 03-0351 ACN 101 DATE Oq-IZ-ZO0~ TAX RETURN HAS: (X) ACCEPTED AS FZLED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE ( ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) $. Closely HeLd S~ock/Par~nership Zn~eres~ (Schedule C) ($) q. Not,gages/No,es Receivable (Schedule D) (q) $. Cash/Dank Deposits/Misc. Personal Proper~y (SchoduZe E) (E). 6. Joln~ly O~ned Proper~y (ScheduZe F) (6} 7. Transfers (Schedule G) (7) D. To~e/ Asse~s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Costs~Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (ScheduZe Z) (10) 11. To,al Deductions 2/q79.86 .00 .00 NOTE: To insure proper .00 credi~ ~o your account, .00 submi~ ~he upper portion .00 of ~his form wi~h your ~ax payment. .00 (8) 1,815.~1 12. 15. 1~. NOTE: 58~777.32 (11) Ne* Value of Tmx Re*urn (12) Char/~ablo/Governmen~ml Bequest:s; Non-elected 9115 Trusts (Schedule J) (15) No~: Value of Es~:a~:e Subject: ~:o Tax (1~) Zf a~ assess;ent ~as issued previously, lines 14, 15 and/or 16, 17, 2,~79.86 reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amoun~ of L/ne 1~ a* Spousal re~e 16. Amoun~ of L/ne l~ *axable a~ Lineal/CZess A re~e 17. Aeoun* of L/ne lq a~ Sibling re~e 18. Amoun~ of L/ne lq ~:axablo e~: ColZa*eraZ/Class B ra~e 19. Princlpal Tax Due TAX CREDITS: PAYMENT RECEZPT D~SCOUNT t+J DATE NUHBER ZNTEREST/PEN PAZD &O.592.73 58,112.87- .00 58,112.87- ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDZT BALANCE OF TAX DUEI .00 ZNTEREST ANB PEN. / .00 TOTAL DUE / .00 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTZONS. AMOUNT PAID (15) .00 X O0 = .00 (16) .00 X Oq5= .00 (17) . O0 X 12 = . O0 (18) . O0 x 15 = .00 (19)= .00 18 and 19 w111 RESERVATION: Estates of decedents dying on or before December ZZ, 1982 -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decadent after the expiration of any estate for life or for years, the Coaaoneealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class S (collateral) rate on any such futura interest. PURPOSE OF NOTICE: To fulfill the requirements of Section Zl~O of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (TZ P.S. Section 91¢0). PAYHEHT: Detach the top portion of this Notice and submit aith your payment to the Register of dills printed on the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT REFUND (CR): A refund of a tax credit) which ems not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-iS15). Applications are available at the Office of the Register of Hills, any of the Z3 Revenue District Offices) or by calling the special Z~-hour answering service for fores ordering: 1-800-562-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-~7-50Z0 (TT only). OBJECTIONS: Any party in interest not satisfied aith the appraiseaent~ allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice .ust object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 17IlS-lOll) OR --election to have the .attar determined at audit of the account of the personal representative, ON --appeal to the Orphans' Court. ADHIN- ISTRATIVE CORRECT[OHS: Factual errors discovered on this assessment should be addressed Jn writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg) PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet -Instructions for inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. DISCOUNT: [f any tax due is paid within three (5) calendar months after the decedent's death, a five percent [SI} discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty non-p=,rticipation penalty is computed on the total of the tax and interest assessed) and not paid before January 16) 1996) the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same ti.e period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency) or nine (9) months and one il} day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (BI) percent per annum calculated at a daily rate of .00016~. All taxes which beca.e delinquent on and after January 1) 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19aZ through ZO0~ are: Interest Daily Interest Daily interest Daily Year Rate Factor Year Rata Factor Year Rate Factor ~ ZOZ .0005~ff 1988-1991 11Z .000501 200[ 9X .000Z~7' 1985 1BI .ooo~SB 1992 9Z .O00Zfi7 ZOOZ 6Z .00016~ 198~ 111 .000301 1995-199~ 72 .000192 2003 52 .000157 1985 152 ,000356 1995-1998 92 .o00Z~7 ZO0~ ~Z .000110 1986 lOZ .O0027~ 1999 7Z .O0019Z 1967 IOZ .00027~ ZOO0 7Z .O0019Z --Interest ls calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (1S) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest eust be calculated. FIRST AND FINAL ACCOUNT INCLUDING PROPOSED DISTRIBUTION OF STEVEN ZIMMERMAN, EXECUTOR OF THE ESTATE OF THELMA J. SLONAKER LATE OF SILVER SPRING TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED 21-03-00351 Date of Death: Letters Granted: Dates of Publishing Notices: Cumberland Law Journal Dates of Publishing Notices: Patriot Metro-West Covering the Period: November 3, 2002 August 13, 2003 Aug. 29, Sept. 5, Sept. 12, 2003 Aug. 26, Sept. 2, Sept. 9, 2003 Nov. 4, 2002 - April 12, 2004 Purpose of the Account: Steven B. Zimmerman, Executor offers this account to acquaint interested parties with the transactions that have occurred during his administration. The account also indicates the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with Steven B. Zimmerman, Executor, c/o Charles E. Shields, III, Esq., 6 Clouser Road; Mechanicsburg, Pennsylvania 17055. SUMMARY OF ACCOUNT TABLE OF CONTENTS Proposed Schedule of Distribution Page # PRINCIPAL Receipts Real Estate Cash and miscellaneous TOTAL RECEIPTS OF PRINCIPAL 4 Amount $2,479.86 $2,479.86 DISBURSEMENTS Funeral Expenses Fees and Commissions Miscellaneous Probate & Administrative Expenses Inheritance Taxes Debts of Decedent TOTAL DISBURSEMENT OF PRINCIPAL Receipts of Income 3 3 3 3 3 3 3 4 $ 1,250.00 $ 545.41 $-0- $58,777.32 $ 1,815.41 RECEIPTS OF PRINCIPAL Real Estate Stocks and Bonds Cash and Miscellaneous 1. M&T Bank 2. Personal Account at Claremont Nursing Home TOTAL RECEIPTS OF PRINCIPAL $1,567.57 $ 912.29 -$0- -$0- $2,479.86 $2,479.86 DISBURSEMENT OF PRINCIPAL Funeral Expense: 1. Funeral Home Fees 1. Reimbursement to Executor 2. Attorney Fees: Charles E. Shields, III Administrative Expenses $ 500.00 $ 750.00 1. Probate and short certificates $ 50.00 2. Tax Return - Janet Brackbill, H&R Block $175.00 3. Advertising - Cumberland Law Journal $ 75.00 4. Advertising - Metro West Patriot News $ 87.91 5. Filing an Insolvent Inheritance Tax Return $ 10.00 6. Reimbursement to Charles E. Shields, III for Long distance calls, photocopies, certified and regular Postage mailing, etc. $ 31.50 9. Filing an Account with Orphans' Court (estimated) $127.00 10. Service fee on opening estate checking account $ 3.00 11. Additional short certificates $ 6.00 -$0- $1,250.00 $565.41 Inheritance Taxes: Paid on Account Debts of Decedent: 1. Department of Public Welfare, Class 3 Claim 2. Department of Public Welfare, Class 6 Claim TOTAL DISBURSEMENTS OF PRINCIPAL (** Subject to approval before payment of Fees) Receipts of Incc, m e: $26,836.24 $31,941.08 $58,777.32 $1,815.41'* Disbursements of Income: Income Balance on Hand: RECAPITULATION Total Principal Receipts Total Principal Disbursements Total Income Receipts Total Income Disbursements Balance on Hand for Payment of Debts owed to Department of Public Welfare $ 2,479.86 $ 1,815.41 $-0- $-0- $664.45* (* subject to reimbursement for costs of copying and certified mailings of accountings) PROPOSED SCHEDULE OF PAYMENT AND DISTR/BUTION Department of Public Welfare Salesian Missions Steven B. Zimmerman Paul Melton Lucille Melton Anna E. Yohe Genevieve Yohn Virginia Raudabaugh Harry A. Yohn Clyde Swartz $664.45 $-0- $-0- $-0- $-0- $-0- $-0- $-0- $-0- TOTAL .................................................... $664.45 Steven B. Zimmerman, Executor of the Estate of THELMA J. SLONAKER, deceased, hereby declares under oath that he has fully and faithfully discharged the duties of his office, that the foregoing First and Final Account is true and correct and fully discloses all the significant transactions occurring during the accounting period; that all claims now outstanding against the Estate; and that all taxes presently due from the Estate have been paid. en B. Zi~li~e/~man, l~xecutor I / da ~ me this ~ y of f~ A.D. 2004. Sworn to and subscribed to before Notary Public Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters No. 2003-00351 PA No. 21-03-0351 ESTATE OF SLONAKER THELMA J (~A$'i', ~'i~S'i', WHEREAS, on the 13th ated January llth 1993 Late of MIDDLESEX TOWNSHIP Deceased Social Security No. 199-05-9337 day of Auqust as admitted to probate as the last will of SLONAKER THELMA J (nAS'i', ~'i~S'i', miu~n~) 2003 an instrument ate of MIDDLESEX TOWNSHIP , CUMBERLAND County, who died on the 3rd day of November 2002 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, DONNA M. OTTO , Register of Wills in and for he County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify hat I have this day granted Letters TESTAMENTARY o ZIMMERMAN STEVEN ho has duly qualified as Executor(rix) nd has agreed to administer the estate according to law, all of which fully ppears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, ARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal f my Office the 13th day of August 2003. ~ '~egiscer of wills ~--' **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) COPY FAIR LAST WILL AND TESTAMENT OF THELMA J, SLONAKER 21-03-351 I, THELMA J. SLONAKER, of Silver Spring Township, State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon as conveniently may be after my decease. 2. ~ .Z%~'~- . ta~_'-~'-.~. . . /.9 fmon give and bequeath L the~rsons, the follovang ,terns and/or sums o ey: A. Steven Zimmerman, of 705 S. Market Street, Mechanicsburg, a sum of ~ ,~,, "player piano", and the "cabinet and rolls"; C. To Doris and Harold Zinwnerman, of 702 S. York St., Mechanicsburg, a sum of $1,000.00 ~ my "bamboo stand", and my "milking stool". 4. To each of the following persons I give and bequeath the sum of $1,000.00: I. Paul Melton, J. Lucille Melton, K. Anna E. Yohe, L. Genevieve Yohn, M. Virginia Raudabaugh, all of New Kingston, O. Harry A. Y°hn, z52 Locust Point Road, Me, chanicsburg, -4~-,,o~,~~, ' P. Clyde Sw~z, of New Kingston. 5. Should my estate, after debts, rexes and the tike, not be sufficient to support all of the above-listed specific bequests in p~a~aphs 2, 3, and 4 then each shM1 be reduced a propoffionate pro-rata amount. Should ~y of the above n~ed p~ies pred<ease me, thek shoe shah ~ proportionately divided between ~ose listed who do su~ive me. 6. ~ "I ~e ~d demse prope~y situate at 70 W. Mmn St.,' ew Diablo, Green Valley, Arizona 85614. A. Should my house have been sold during my lifetime, then this gift shall lapse. B. Should my house not have been sold and should there not be sufficient funds available to pay the specific bequests listed in paragraphs 2, 3, and 4, above, then the specific devise to my said sister shall take priority over the specific bequests in paragraphs 2, 3, and 4, above. C. shall be sold and that amount of the proceeds therefrom which remain after the payment of debts and specific bequests shall be placed in the residue of my estate. 7. Each person named as a specific beneficiary or specific devisee herein shall pay their fair share of the inheritance tax on the face value of their devise or bequest. 8. All the re§t, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to be divided equally between my said dgll~._ nd .~d~ the said Steven Zimmerman. Should my said sister predecease me, then her share shall go to the said Steven Zimmerman. Should the said Steven Zimmerman predecease me, then his share shall be given in equal shares to his mother, Doris Zimmennan, ~ 1~, I . ~ _L ' 9. I nominate, constitute and appoint Steven Zirnmerman to be the Executor of this, my Last Will and Testament. If he should predecease me, or for.any othor reason be unable to act, or to continue to act as such Executor, I appoint the Farmer's Trust Company of Carlisle, as Executor in his place and stead. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ I ]'~ day of January, A.D. 1993. Signed, sealed, published and declared by the above-named THELMA I. SLONAKER, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. ~LAST WH~L A.ND TESTAMENT OF .T[-1ELMA J. SLONAKER 21-03-351 I, THELMA J. SLONAKER, of Silver Spring Township, State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon as conveniently may be after my decease. 2. tv "'~ I ~'an~~ea~o ~e ~~°~nn~} th~e f~ll°wing items'~n~/or sums of money: A. Steven Zimmerman, of 705 S. Market Street, Mechanicsburg, a sum of my "player piano", and the "cabinet and rolls"; C. To Doris and Harold Zimmerman, of 702 S. York St., Mechanicsburg, a sum of $1,000.00 ~ my "bamboo stand", and my "milking stool". 4. To each of the following persons I give and bequ.eath the sum of $1,000.00: I. Paul Melton, J. Lucille Melton, K. Anna E. Yohe, L. Genevieve Yohn, M. Virginia Raudabaugh, all of New Kingston, Oo gfohn, 252 Locust Point Clyde Swartz, of New Kingston~l! 5. Should my estate, after debts, taxes and the like, not be sufficient to support all of the above-listed specific bequests in paragraphs 2, 3, and 4 then each shall be reduced a proportionate pro-rata amount. Should any of the above named parties predecease me, their share shall be proportionately divided between those listed who do survive me. 6. .: ~I giree and demse >ropertY situate at 70 W. Main St.; New Diablo, Green Valley, Arizona 85614. A. Should my house have been sold during my lifetime, then this gift shall lapse. B. Should my house not have been sold and should there not be sufficient funds available to pay the specific bequests listed in paragraphs 2, 3, and 4, above, then the specific devise to my said sister shall take priority over the specific bequests in paragraphs 2, 3, and 4, above. C° shall be sold and that amount of the proceeds therefrom which remain after the payment of debts and specific bequests shall be placed in the residue of my estate. 7. Each person named as a specific beneficiary or specific devisee herein shall pay their fair share of the inheritance tax on the face value of their devise or bequest. 8. All the re~t, residue and remainder of my Estate, real, personal and mixed, whatgoever and wheresoever situate, I give, devise and bequeath to be divided equally between my said ~d~a~~ ~ the said Steven Zimmerman. Should my said sister predecease me, then her share shall go to me said Steven Zimmerman. Should the said Steven Zimmerman predecease me, then his share shall be given in equal shares to his mother, Doris Zimmerman, ~ I nominate, constitute and appoint Steven Zimmerman to be the Executor of this, my Last Will and Testament. If he should predecease me, or for ~any othor reason be unable to act, or to continue to act as such Executor, I appoint the Farmer's Trust Company of Carlisle, as Executor in his place and stead. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ I~ day of January, A.D. 1993. (SEAL) Signed, sealed, published and declared by the above-named THELMA J. SLONAKER, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. ~uu~y megzsEer O~ W±lls Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/24/2004 SHIELDS CHARLES E III 6 CLOUSER ROAD MECHANICSBURG, PA 17055 RE: Estate of SLONAKER THELMA J File Number: 2003-00351 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6 12) in the above captioned estate. ' As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent,s death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 11/03/2004 Your prompt attention to this matter will be appreciated. Thank You. cc: File Personal Representative(s) Judge S ' ncere~y, ~ ~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS STATUS REPORT UNDER RULE 6.12 Name of Decedent: '7-,,~/,~, ~ ,_5-',,¢,~,,~,,~ r- Date of Death: ,/P',~.. Will No.: Admin. No.: :2,/- ,~.~_ Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 1~ No [-'] 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes ,X No [~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes ~-1 No ]--] Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Signature Name Address 7/ 7 - - ? Telephone No. Capacity: ['-] Personal Representative ~ Counsel for personal representative BUREAU OF INDIVIDUAL TAXES INHERTTANCE TAX DTVTSIDN DEPT. 280601 HARRISBURG, PA 17128-0601 CONMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TNHERZTANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP C01-03) M L MCBRIDE JR MCBRIDE & MCBRIDE 211 S CENTER ST GROVE CITY PA 16127 DATE 05-24-200~ ESTATE OF FILER DATE OF DEATH 02-27-2002 FILE NUMBER 21 02-0551 COUNTY CUMBERLAND ACN 101 Amount Rem'; tted GARY E MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:5 NOTE: To insure proper credi~ to your account, submit the upper portion of this for. with your tax payment. CUT ALONG THIS LINE ~ RETATN LONER PORTION FOR YOUR RECORDS -~ REV'1607 EX AFP (01'03) --- INHERITANCE TAX STATEMENT OF ACCOUNT --~ ESTATE OF FILER GARY E FILE NO. 21 02-0551 ACN 101 DATE 05-2~-Z00~ THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHO#N BELOW/ IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FTGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 0~-19-2004 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 86,997.08 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) ANOUNT ~ SUMHARY OF 05-10-200~ 05-10-200~ ILL 008 PAYMENTS ~ 5,000.00 468.65- IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), .00 8~,~65.71 TOTAL TAX CRED'rT 86,997.08 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF NILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications ara available at the Office of the Register of gills, any of the 22 Revenue District Offices or from the Department's Iq-hour answering service for forms ordering: 1-BOO-56Z-ZOSO; services for taxpayers with special hearing and / or speaking needs: 1-800-~q7-5OZO (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit~ Dept. 2B0601, Harrisburg~ PA 17liB-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (BI) discount af the tax paid is allowed. PENALTY: The ZBZ tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January I, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daiIy rate of .O0016q. AIl taxes which became delinquent on and after January 1, 19BI wi[1 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 ZOOq are: Interest Daily Interest Daily Interest Year Rate Factor Year Rate Factor Year Rate 1982 ZOZ .OOOSq8 1988-199! llZ .000501 ZOO1 9Z 1982 16Z .000q58 199Z 9Z .O00Zq7 ZOOZ 6Z 198q llZ .000301 1993-199~ 72 .O0019Z 2003 5Z 1985 13Z .000356 1995-1998 9Z .O00Z~7 200q qZ 1986 lOX .00027q 1999 72 .O0019g 1987 9Z .0002q7 2000 8Z .O00Z19 Daily Factor .O00Z~7 .00016q .000157 .o00110 --Interest is calculated as follows: INTEREST TM BALANCE OF TAX UNPAID X NUNBER 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.