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03-0421
PETITION EJ:ate of' Lester E. Slothower ~$o ~nown ~& Soctat Securtty No. Deceased. 192-14-6651' FOR PROBATE :ma GRANT OF No._ To: Register of WiEs for the CoRtlty of Cumberland Con~nonw~th of Pennsylvania The petition of the undersigned respectfully represents theu Your petitioner(s), who is/~ 18 years of age or older an the exert_rix in the test will of the above decedent, dated December l / and codicil(s) dated in the ~med 19. (state r=i~am circumstance, c.g. r~mm~'i~on, death of ex~mtor, ~:.) Decendent was domiciled at death in Cumberland h~ is .... -- C Y, enns vania, C '--l.ast f~rridy o.r pnn_c~paJ residence at 1 ]00 Market St. ;-~ ~ ~o~rou~, w/th umoer±anaoouncy, l~ennsyAvania ~ (list street, number and munc~palhy} Decendent, £hcn 91 years of age, died May 14, 2003 at Manor Care, South Middleton 'I~., Cumberland County, PA ' E.xcept 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 ora killing and was never adjudicated incompetent: _ Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (if not domiciled in Pa.) Personal property in Pennsylvan/a (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: 600,000.00 WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. r~-c~u.~t(s) .the probate of the last will and codicil(s) stamencary (tmtam~ntary;, administration c.t.a.; administration d.b.n.c.t.a.} ~Betse'y S. Bernhardt __32 Brookf±eld Ave. __Nutley, NJ 07110 OATH OF PERSONAL REPRESENTAT/VE COMMONWEALTi-! OF PENNSYLVANIA COUNTY OI~CUHBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the axaternents in the foregoing petition are true and correct to the best of :he knowledge and befief of petitioner(s) and that as personal represen- t,~n e(s) of the above decedent petmoner(s) will well and. truly~adnlir~ter.rhe estate according to law. /oem~e me this 20t day of [ Betge)r S. Bernharat ~ /y?/~//...~ LnDnna ~. otto, ±~t L~eputF--~.;;3-/c ~'~t" ~_~o,<~-~- ~, No. 21-2003-421 Estate of LESTER E. SLLYL'HOWER ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW May 20th ~ in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) datcel r~m~e17-1992 described therein be admitted to probate and flied of record ~ the ta~t will of LESTER E. SLOTHOWER and Letters TESTAMENTARY arc hereby granted to BETSEY S. BERNHARDT FEES Probate, Letters, Etc .......... $ 375.00 Short Certificates(5) .......... $ 15.00 Renunciation ................ x-Pages ( 2 ) $ 6.00 ADDRESS JCP 10.00 TOTAL 6. F/ied . .M.ay. 20th, 2003 $ 406.00 .............................. PHONE A'I'I'ORNEY (Sup. Ct. I.D. No.) 6§: I.d 0E A~ ~0. CALLED Aq?IIDRNEY DAVID STONE 5-20-03 REGISTER OF WILLS'OF COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the w/ii presented herewith, (each) being duly'clualifled according law, depose(s) and say(s) that the testat , sign the same and that -. signed as a witn~,~ at the request of testat, in h i~resence and (in the presence of each other) (in the presence of the other subscribing wimess(es)). Sworn to or afHrmed and subscribed before me this day of 19 Register 21-2003-421 (Name) (Address) (Nam~ (Addrex$~ · ~E~ER OF WILLS OF ¢~SER~.ASD OATH OF NON-SUBSCRIBING WITNESS COUNTY (each) a subsc~ber hereto, (each) being duly qu~fi~ ~cor~ng to law, deposes) ~d say(s) that t~tat~ of (one of the /ubsc~bing ~tn~s~ to) the that ~ ~. beiiev~ the signature on the ~ is in the h~dwfiting of to the best of ~ knowi~ge and beiief. ~nna M. Otto, ~st ~pu~ / 21-2003-421 6g:[d Og ),~t4 ~0. LA'X/- OFFICES 317 THIRD STREET NEW CUMBERLAND, PENNSYLVANIA 17070 LAST WILL AND TESTAMENT OF LESTER E. SLOTHOWER [.AW OFFICES JON F. LAFAVER 317 THIRD STREET NEW CUMBERLAND, PA I, LESTER E. SLOTHOWER, of New Cumberland, Cumberland County, Pennsylvania being of sound mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament hereby revoking and making void any and all other wills by me at any time heretofore made. I. I direct that my Executrix hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease. II. I hereby give and bequeath the sum of Thirty Thousand Dollars ($30,000.0£ unto my daughter, BETSEY S. BERNHARDT. III. Ail the rest, residue and remainder of my estate, whether real, personal or mixed, and wheresoever situate, I hereby give, devise and bequeath as follows: A. Two percent (2%) unto CONTACT, Harrisburg, Inc. (or unto the same organization which may at the time of my decease be Contact Help Line). This bequest to be used for the Information and Referral Department, for such purposes in that department as maybe approved by the Board of Directors of CONTACT, Harrisburg, Inc. B. Eight percent (8%) unto the ENDOWMENT FUND OF GRACE UNITED METHODIS~ CHURCH, Lemoyne, Pennsylvania, with the stipulation that the income from this bequest shall be used in accordance with the rules applying to the income from said Endowment Fund. Page one of three Pages LAW OFFICES JON F. LAFAVER 317 THIRD STREET NEW CUMBERLAND* PA C. Forty-five percent (45%) unto my daughter, BETSEY S. BERNHARDT, or if she is not living, then unto her issue in equal shares, per stirpes. D. Forty-five percent (45%) unto my son, TIMOTHY F. SLOTHOWER, but if he does not survive me this share shall be divided one-quarter (2) to my grandson, DREW SLOTHOWER and one-quarter (2) to my grandson, JEFFREY SLOTHOWER and one-half (~) to my daughter-in-law, BETH SLOTHOWER. If Beth Slothower has also failed to survive me then this portion for her shall be shared equally by SCOTT FENTON and ALYSSA BETH SLOTHOWER. IV. I hereby nominate, constitute and appoint my daughter, BETSEY S. BERNHARDT, as Guardian for the estate of any minor child of my son, TIMOTHY F. SLOTHOWER, who may take a share under this Will. V. I hereby authorize my Executrix hereinafter named to sell and dispose of any of my real or personal property, at public or private sale, as, in the sol discretion of my said Executrix, may be necessary. VI. I hereby nominate, constitute and appoint my daughter, BETSEY S. BERNHARDT, as Executrix of this, my Last Will and Testament. If the said Betsey S. Bernhardt should predecease me, fail to qualify or cease to act as such, then I nominate, constitute and appoint my son, TIMOTHY F. SLOTHOWER, as Executor. VII. No fiduciary action under this Will shall be required to post bond in this jurisdiction or in any jurisdiction in which he may act. Page two of three Pages IN WITNESS WHEREOF, I, LESTER E. SLOTHOWER, the Testator, have unto thi~ my Last Will and Testament, set my hand and seal this i~i~,! day of~g£.~ A.D., 1992. gAL) SIGNED, SEALED, PUBLISHED and DECLARED by LESTER E. SLOTHOWER, the abov named Testator, as and for his Last Will and Testament, in the presence of us who have hereunto subscribed our names as witnesses at his request, in the presence of the said Testator and in the presence of each other. LAW OFFIC:ES JON F. LAFAVER :317 THIRD STREET NEW CUMBERLAND, PA Page three of three Pages LESTER E. SLOTHOWER '03 t~/Iy 20 P~ :59 LAW OFFICES 317 THIRD STREET NEW CUMBERLAND, PENNSYLVANIA 17070 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Lester E. Slothower Date of Death: May 14, 2003 Will No. 21-03-0421 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 May 28, 2003. Betsey S. Bernhardt 32 Brookfield Avenue Nutley, NJ 07110 Timothy F. Slothower 1250 E. Skyview Drive Prescott, AZ 86303 Contact Helpline Post Office Box 90035 Harrisburg, PA 17109-0035 Endowment Fund Grace United Methodist Church 313 Herman Avenue Lemoyne, PA 17043 Notice has now been given to all persons entitlgd~thereto under Rule 5.6(a). ~/Jt' ! Date: ~- ~'O~ Dav~--d~R~.St~ne, Esquire 414 Bridge Street New Cumberland, PA 17070 717-774-7435 Capacity: Personal Representative X Counsel for Personal Representative DAVID H. STONE GERALD J. BHEKLETSKI ELIZABETH B. STONE STONE LAFAVER & SItEKLETSKI ATTORNEYS AT LAW 414 BRIDGE STREET POST OFFICE BOX E NEW CUNIBERLAND. PA 17070 www. stonelaw, net August 13, 2003 OF COUNSEL CHARLES H, STONE JON F. LAFAVER TELEPHONE (717) 774-7435 FACSIMILE (717) 774-3S69 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA ].7013 RE: Estate of Lester E. Slothhower No. 21-03-0421 Greetings: Enclosed please find estate check in the amount of $20,000.00 on account of inheritance taxes in the above captioned estate. Please note the timely postmark of this correspondence. Very truly yours, STyE LaFAVER. & SHEKLETSKI ;~vid H. Stone ~ DHS/tmb Enclosure LAW OFFICES OF STONE LAFAVER & SHEKLETSKI 414 BRIDGE STREET POST OFFICE BOX E NEW CUMBERLAND, PA. 17070 NEt4 CU Register of Wills "<~.':>" Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 002899 STONE LAFAVER & SHEKLETSKI 414 BRIDGE STREET P O BOX E NEW CUMBERLAND, PA 17070 ........ fold ESTATE INFORMATION: SSN: 192-14-6651 FILE NUMBER: 2103-0421 DECEDENT NAME: SLOTHOWER LESTER E DATE OF PAYMENT: 08/1 4/2003 POSTMARK DATE: 08/1 3/2003 COUNTY: CUMBERLAND DATE OF DEATH: 05/1 4/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $20,000.00 TOTAL AMOUNT PAID: $20,000.00 REMARKS: BETSY S BERNHARDT STONE LAFAVER & SHEKLETSKI SEAL CHECK# 109 INITIALS: SK RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS CO~MMONWEALTH 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) 003568 STONE DAVID HEAN 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 ........ fold ESTATE INFORMATION: SSN: 192-14-6651 FILE NUMBER: 2103-0421 DECEDENT NAME: SLOTHOWER LESTER E DATE OF PAYMENT: 02/17/2004 POSTMARK DATE: 02/1 3/2004 COUNTY: CUM BERLAN D DATE OF DEATH: 05/14/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3,629.02 TOTAL AMOUNT PAID: $3,629.02 REMARKS: RECIEVEOF BETSY BERNHARDT IN C/O DAVID H STONE ESQ ...... SEAL CHECK#1002 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS · REV-1500 EX (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I-- 1 Original Return O r,-,,~ ~ 4. Limited Estate LLI zOO O r~._l Lz%J 6. Decedent Died Testate (Attach copy of Will) ~.m Q. b~ 9 Litigation Proceeds Received <~ REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 -- 2003 0421 COUNTY CODE YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Slothower, Lester E 192-14-6651 DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 05/14/2003 05/01/1912 REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I I 2. Supplemental Return r~ 3 Remainder Return (date of death prior to 12-13 82) [~4a. Future Interest Compromise (date of death after 12-12-82) F~ 5. Federal Estate Tax Return Required I~] 7. Decedent Maintained a Living Trust (Attach copy of Trust) i 8 Total Number of Safe Deposit Boxes E~ 1 0. Spousal Povedy Credit (date of death between 12-3t 91 and 1-1-95) E~ 1 1 Election to tax under Sec 911 3(A) (Attach S~I, O) O O z z X I- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS David H. Stone FIRM NAME (If Applicable) Stone LaFaver A Shekletski TELEPHONE NUMBER 717-774-7435 414 Bridge Street New Cumberland, PA 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 (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) ~1 Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (7) (Schedule G or L) 8 Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 1 0. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1 1. Total Deductions (total Lines 9 & 10) 12 Net Value of Estate (Line 8 minus Line 11) 1 3 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 17070 0.0 570,673.4 !.!. 0.0 O. 0 60,327.87 O. O0~ 0.00 (8) OFFICIAL US~ .... ~LY 631,001.34 24,407.22 504.01 (11) 24,911.23 606,090.11 57,609.01 (12) (13) 14 Net Value Subject to Tax (Line 12 minus Line 13) (14) 548,481.10 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 5. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 1 6. Amount of Line 14 taxable at lineal rate 1 7. Amount of Line 14 taxable at sibling rate 1 8. Amount of Line 14 taxable at collateral rate 19. Tax Due 0.00 x.00 (15) 548,481.10 x.o45 (16) 0.00 x .12 (17) 0.00 x .15 (18) (19) > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE .&ND RECHECK MATH < < 0.00 24,681.65 0.00 0.00 24,681.65 2W4645 1000 ecedent's Complete Address: STREET ADDRESS 1700 Market Street ci/Y Camp Hill STATE 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 0.00 20,000.00 1,052.63 0.00 0.00 (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) 24,681.65 21,052.63 0.00 3,629.02 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 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) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (5B) 3~629.02 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; ......... [~ E~] c. retain a reversionary interest; or ................................ E~ d. receive the promise for life of either payments, benefits or care? ................. [~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................ [~] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? [~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ ~] r~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE/// /~'- V .,¢')' OF..I~ERS.ON _RESPQ~SIBL~ FOR FILlinG RETURN ADDRESS 32 Bro6kfield Ave. Nutlel~, NJ 071.1~ SIGNATURE P~ ROTHE REPRESENTAllVE DATE ADDRESS ~ St,~ree~. ~' /~,~' New Cumberland, PA 17070 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed an the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S, § 9916 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. § 9116 (a) (1.1) (ii)] The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are 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. ' 2W4646 1000 REV-1503 EX + (1-97) COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Slothower, Lester E FILE NUMBER 21-2003-0421 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. Met-Life stock 320 shs. @ $26.89 per share 2 Wachovia Sec Municipal Invt Tr 24 M-10 3 Wachovia Sec. Nuveen PA Insd 236M-99 4 Wachovia Sec. Nuveen PA Insd 242S 99 5 Wachovia Sec. Nuveen PA Insd 248S-200 6 Wachovia Sec. Nuveen PA Insd 250S-201 7 Wachovia Sec. Nuveen PA Insd 262S-175 8 Wachovia Sec. Nuveen TE Insd PA 276S-50 9 Wachovia Sec. Nuveen TE Insd PA 281S-101 10 Wachovia Sec. Nuveen Tax Free Insd PA 268S-202 11 Wachovia Sec. PA IMIT 236 M-49 12 Wachovia Sec. PA IMIT 240S-19 13 Wachovia Sec. PA IMIT 242S-20 14 Wachovia Sec. PA IMIT 244S-31 15 Wachovia Sec. PA Tax Ex Ins 283 S/A-51 16 Wachovia Sec. Penn Insd Muns Ser 252S-5 17 Wachovia Securities-Aim Hi Yld Fd C1 B-11,607.131 shs. @ per sh. 18 Wachovia Securities-Bethlehem $10,000 Bond w/5.3% due 11-15-2017 19 20 $4.08 Wachovia Securities-Blackrock Muni Inc Tr 2-700 shs. @ $14.05 per sh. Wachovia Securities-Evergreen Fxd Hi Yld C1 C-8,895.532 shs. @ $3.30 per sh. Total from continuation pages .... TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE Of DEATH 8.604.80 4r785.90 10,117.80 9 852.48 20,134.00 20,467.83 18,823.00 5,116.00 10,324.22 21.102.94 48.939.73 19156.94 20 604.40 32,338.27 5,128.05 5,130.65 47,357.09 10,720.70 9,835.00 29,355.26 212,778.41 570,673.47 2W46963.000 (If more space is needed, insert additional sheets of the same size) Estate of: Slothower, Lester E Schedule B -- Stocks & Bonds Item No. Description Page 2 21-2003-0421 Value at Date of Death 21 21 Wachovia Securities-Firstenergy Corp-1984.581 shs. @ $32.97 per sh. 22 Wachovia Securities-Franklin Penn T/E Inc A-2,261.656 shs. @ $10.68 per sh. 23 Wachovia Securities-Highland PA $10,000 Bond w/ 5.3% due 9-1-2010 24 Wachovia Securities-Intl Paper Cap 7.875%-800 shs. @ $25.06 per sh. 25 Wachovia Securities-John Hancock Pfd Inc Fd-800 shs. @ $25.08 per sh. 26 Wachovia Securities-Penn HFA SFM-$5,000 Bond w/ 6.75% due 2014 27 Wachovia Securities-Penn St Hgh-$15,000 Bond w/5.876% due 2021 28 Wachovia Securities-Pepco Holdings Inc.-1,993 shs. @ $17.66 per sh. 29 Wachovia Securities-Phila Wtr-$5,000 Bond w/5.6% due 8-1-2018 30 Wachovia Securities-Venango-$10,000 Bond w/5.25% due 7-15-2015 65,431.64 24.154.49 10 125.30 20,048.00 20,064.00 5.186.60 17,022.30 35,196.38 5,489.20 10,060.50 TOTAL. (Carry forward to main schedule) ...... 212,778.41 REV-15'08 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Slothower, Lester E 21-2003-0421 include the ITEM NUMBER 3 4 5 6 7 8 2W46AD 2.000 ~roceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. DESCRIPTION Manor Care Resident Trust-balance PNC Bank-Checking Acct. #5140058979, Princ. $33,633.64, $1.46 PSERS-prorated payment plus premium assistance Wachovia Bank-MMAcct. Hartford Insurance-refund on homeowners insurance Manor Care of Camp Hill-refund on care for month of May Mutual of Omaha Insurance-refund Net proceeds of household goods at auction by Smart Move Makers United HealthCare Ins.-Refund on AARP medical services Iht. TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insed additional sheets of the same size) VALUE AT DATE OF DEATH 763.75 33,635.10 1,046.09 21,074.21 13.00 1,840.20 22.62 1,212.90 720.00 $ 60,327.87 REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Slothower, Lester E 21-2003-0421 Debts of decedent must be reported on Schedule I. ITEM NUMBER 5. 6. 7. 8 9 10 Tota DESCRIPTION FUNERAL EXPENSES: Musselman Funeral Home-funeral expenses Sandzimier Memorials-lettering on stone ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: Attorney Fees Name: David H. Stone Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State __ Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Cumberland Law Journal-advertising grant of letters The Patriot News Co.-advertising grant of letters Verizon-telephone service PNC Bank-check printing fee Register of Wills-filing Inheritance Tax Return and Inventory from continuation pages .... TOTAL (Also enter on line 9, Recapitulation) $ AMOUNT 7,392.58 95. O0 0.00 15,775.00 0.00 406.00 0.00 0.00 75.00 105.73 5.31 27.60 25.00 500.00 24,407.22 2W46AG 2000 (If more space is needed, insert additional sheets of same size) Estate of: Slothower, Lester E Schedule H, Part B -- Administrative Costs Page 2 21-2003-0421 Item 12 Description Reserve for closing expenses Amount 500.00 TOTAL. (Carry forward to main schedule) ...... 500.00 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGELIABILITIES,& LIENS ESTATEOF FILENUMBER Slothower, Lester E 21-2003-0421 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION West Shore EMS-services rendered Bankcard Services-credit card balance due Manor Care-haircut Family Physicians Assoc.-doctors visits prior to death TOTAL (Also enter on line 10, Recapitulation) $ AMOUNT 89.25 306.26 8.50 100.00 504.01 2W46AH 2000 (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Slothower, Lester E 21-2003-0421 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLEDISTRIBUTIONS[includeoutrightspousaldistributions, andtransfers underSec. 9116(a)(1.2)] Bernhardt, Betsey S 32 Brookfield Ave. Nutley, NJ 07110 Slothhower, Timothy F 1250 E. Skyline Drive Prescott, AZ 86303 Daughter Son 289,240.55 259,240.55 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE ANDGOVERNMENTALDISTRIBUTIONS Contact Helpline P.O. Box 90035 Harrisburg, PA 17109-0035 Endowment Fund Grace United Methodist Church 313 Herman Avenue Lemoyne, PA 17043 TOTAL OF PART Il ~ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 11,521.80 46,087.21 $ 57,609.01 2W46A11000 (If more space is needed, inse~ additional sheets of the same size) 317 THIRD STREET 'NEW CUMBERLAND, PENNSYLVANIA 17070 LAST WILL AND TESTAMENT OF LESTER E. SLOTHOWER LAW OFFICES JON F. LAFAVER 317 THIRD STREET NEW CUMBERLAND. PA I, LESTER E. SLOTHOWER, of New Cumberland, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament hereby revoking and making void any and all other wills by me at any time heretofore made. I. I direct that my Executrix hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease. II. I hereby give and bequeath the sum of Thirty Thousand Dollars ($30,000.00) unto my daughter, BETSEY S. BERNHARDT. III. Ail the rest, residue and remainder of my estate, whether real, personal or mixed, and wheresoever situate, I hereby give, devise and bequeath as follows: A. Two percent (2%) unto CONTACT, Harrisburg, Inc. (or unto the same organization which may at the time of my decease be Contact Help Line). This bequest to be used for the Information and Referral Department, for such purposes in that department as _m=Tybe approved by the Board of Directors of CONTACT, Harrisburg, Inc. B. Eight percent (8%) unto the ENDOWMENT FUND OF GRACE UNITED METHODIST CHURCH, Lemoyne, Pennsylvania, with the stipulation that the income from this bequest shall be used in accordance with the rules applying to the income from said Endowment Fund. Page one of three Pages C. Forty-five percent (45%) unto my daughter, BETSEY S. BERNHARDT, or if she is not living, then unto her issue in equal shares, per stirpes. D. Forty-five percent (45%) unto my son, TIMOTHY F. SLOTHOWER, but if he does not survive me this share shall be divided one-quarter (¼) to my grandson, DREW SLOTHOWER and one-quarter (¼) to my grandson, JEFFREY SLOTHOWER and one-half (½) to my daughter-in-law, BETH SLOTHOWER. If Beth Slothower has also failed to survive me then this portion for her shall be shared equally by SCOTT FENTON and ALYSSA BETH SLOTHOWER. IV. I hereby nominate, constitute and appoint my daughter, BETSEY S. BERNHARDT, as Guardian for the estate of any minor child of my son, TIMOTHY F. SLOTHOWER, who may take a share under this Will. V. I hereby authorize my Executrix hereinafter named to sell and dispose of any of my real or personal property, at public or private sale, as, in the sole discretion of my said Executrix, may be necessary. VI. I hereby nominate, constitute and appoint my daughter, BETSEY S. BERNHARDT, as Executrix of this, my Last Will and Testament. If the said Betsey S. Bernhardt should predecease me, fail to qualify or cease to act as such, then I nominate, constitute and appoint my son, TIMOTHY F. SLOTHOWER, as Executor. JON F. LAFAVER VII. No fiduciary action under this Will shall be required to post bond in this jurisdiction or in any jurisdiction in which he may act. IN WITNESS WHEREOF, I, LESTER E. SLOTHOWER, the Testator, have unto this, my Last Will and Testament, set my hand and seal this A.D., 1992. SIGNED, SEALED, PUBLISHED and DECLARED by LESTER E. SLOTHOWER, the above- named Testator, as and for his Last Will and Testament, in the presence of us who have hereunto subscribed our names as witnesses at his request, in the presence of the said Testator and in the presence of each other. ~. ~ .~ . --p ~ .) JON F. LAFAVER Page three of three Pages i ' ~. ','-' ~-: ~'~,~ RE:.-485 EX+ (9-00) ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT 280601 HARRISBURG, PA 17128-0601 SAFE DEPOSIT BOX INVENTORY Please Print or Type IS LOCATED AND RETURNED TO ABOVE ADDRES~ SOCIAL SECURITY OR DEATH CERTIFICATE NUMBER MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX COUNTY CODE -~¢.~ FiLENUMBER 21 ~21-03-0421 " ~ Slothower, Lester E. ~;~ADDRESS OF DECEDENT (STREET) 1700 Market Street, Camp Hill, NAMEANDADDRESSOFPERSONREQUESTINGTHEOPENiNGOFTHESAFEDEPOSiTBOX 192-14-6651 (CITY) (STATE) (ZIP CODE) ?A 17O11 (NAME) David H. Stone (STREET NAME) (CITY) 414 Bridge Street, New Cumberland, PA NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING (STATE) 17070 (ZIP CODE) (NAME) David H. Stone, Esquire (STREET NAME) (RELATIONSHIP) Attorney for (CITY) (STATE) (ZIP CODE) 414 Bridge Street, New Cumberland PA b. (NAME) ' 17070 (RELATIONSHIP) (STREET NAME) (CITY) (STATE) (ZIP CODE) c. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) (STATE) (ZIP CODE) NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (NAME) PNC Bank, N.A. (STREET NAME) (CITY) (STATE) (ZiP CODE) 331 Bridge Street, New Cumberland, PA 17070 NAME OF PERSON MAKING LAST ENTRY W DATE AND TIME OF LAST ENTRY Betsey S. Bernhardt J May 17, 2003 DATE OF CONTRACT TO RENT BOX '~;,~ NUMBER OF BOX ~e TITLE UNDER WHICH BOX IS REQUESTED February 2, 1995 149-B ster E. Slothower NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX Estate a.(NAME) Betsey S. Bernhardt (STREETADDRESS) 32 Brookfield Avenue (CITY) (STATE) Nutley, NJ 07110 NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY (ZiP CODE) (NAME) Timothy F. Slothower (STREET ADDRESS) 1250 E. Skyview Drive (CITY) Prescott, AZ 86303 (STATE) (ZiP CODE) N THE BOX? [] YES ~[ NO If yes, a. Date of will: Name and address of personal representative, if named in the will (NAME) (STREET NAME) (CITY) (STATE) (ZIP CODE) c. Name and address of attorney, if any (NAME) David H. Stone, Esquire (STREET NAME) (CITY) (STATE) (ZIP CODE) 414 Bridge Street, New Cumberland, PA 17070 SAFE DEPOSIT BOX INVENTORY Page 1 of 1 INSTRUCTIONS - (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible~ (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. ITEM ITEM DESCRIPTION NO. 1 1 pair of child's scissors -- no value I CERTIFY UJ~I~-R'-PENCM~TY OF PERJI~RY THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF COR~I~-~M-PLET~O TILE. ~[t/~ OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY: PRINT NAME ~ ~" PRINT NAME AND CHECK APPROPRIATE BOX BELOW; David H. Stone PRINT TITLE DATE CHECK APPROPRIATE BOX: Attorney for Estate 2/11 / 2004 [] Executor(trix) [] Administrator(trix) [] Estate Representative [] Joint owner of safe deposit box NOTE: Attach additional 8V/' x 11" sheet(s) if necessary or use duplicates of this page of form. MSN Money - MET Chart: Investor Page 1 of 2 (~uote, Chartt News Snapshot Quotes Charts Historical Real-Time Intraday Key Developments Recent News Research Company Report SEC Filings Advisor FY! Stock Rating Earnings Estimates Analyst Ratings Financial Results !nsider Trading Ownership Community Guided Research Research Wizard Find Stocks Stock Screener Power Searches Top Rated Stocks E-mail & Alerts IpO Center Message Boards Capital Gains Anal_ sysis Name or Sy_mboh MET Metlife Inc -i :: ....':; ~ Prin_tReport I II I 5/30/2003 27.98000 27.00000 27.97000 2,768,500 5/29/2003 27.40000 26.85000 26.87000 2,759,300 5/28/2003 27.53000 27.14000 27.30000 2,578,500 5/27/2003 27.25000 26.53000 26.96000 2,296,900 5/23/2003 26.99000 26.65000 26.78000 1,381,900 5/22/2003 27.20000 26.59000 26.87000 2,961,600 5/21/2003 26.70000 26.30000 26.64000 2,774,500 5/20/2003 27.20000 26.25000 26.61000 4,790,100 5/19/2003 27.29000 26.55000 27.00000 9,062,000 5/16/2003 27.40000 26.80000 27.24000 1,826,300 5/15/2003 27.14000 26.70000 27.00000 2,393,800 5/14/2003 27.25000 26.75000 ~26.89000 ~ 1,639,800 5/13/2003 27.40000 26.87000 27.00000 2,462,200 5/12/2003 27.90000 26.55000 27.57000 2,078,900 5/9/2003 26.99000 26.60000 26.77000 3,308,500 5/8/2003 27.53000 26.75000 26.89000 2,402,400 5/7/2003 27.94000 27.17000 27.56000 2,657,600 5/6/2003 28.26000 27.50000 28.09000 3,752,200 5/5/2003 29.08000 28.16000 28.16000 2,781,700 5/2/2003 28.97000 28.00000 28.79000 2,247,200 5/1/2003 28.90000 28.05000 28.68000 1,272,500 Click Here http://m~neycentra~.msn.c~m/invest~r/charts/chartd~~asp?Symb~~=MET&DateRangeF~rm=... 2/5/2004 MSN Money - MET Chart: Investor Page 2 of 2 I Data Source: CSI http://www.csidata.com http://m~neycentra~.msn.c~m/invest~r/charts/chartd~.asp?Symb~~=MET&DateRangeF~rm=... 2/5/2004 May 27, 2003 Stone Lafaver & Shekletski David H. Stone 414 Bridge Street New Cumberland PA 17070 RE: Estate of Lester E. Slothower Account number 7276-0914 Dear Mr. Stone: Per your request, I am providing you with the date of death values for the assets in above referenced account. Description High Low Close 700 Blackrock Muni Inc TR 2 1984.581 Firstenergy Corp 800 John Hancock Pfd Inc Fd 800 Intl Paper Cap 7.875% 1993 Pepco Holdings Inc 11607.131 Aim Hi Yld Fd C1 B 8895:532 Evrgrn Fxd Hi Yld C1 C 2261.656 Franklin Penn T/E Inc A Description 10000 10000 5000 15000 5000 10000 10 202 50 101 99 99 200 201 175 51 5 49 19 Bethlehem 5.3% 11/15/2017 Highland PA 5.3% 9/1/2010 Pcrm HFA SFM6.75% 20!4 Penn St Hgh 5.875% 2021 Phila Wtr 5.6% 8/1/2018 Venango 5.25% 7/15/2015 Municipal Invt Tr 24 M Nuveen Tax Free Insd PA 268S Nuveen T/E Insd PA 276S Nuveen T/E Insd PA 281S Nuveen PA Insd 236M Nuveen PA Insd 242S Nuveen PA Insd 248S Nuveen PA Insd 250S Nuveen PA Insd 262S Pa Tax Ex Ins 283 S/A Penn Insd Muns Ser 252S PA IMIT 236 M PA IMIT 240 S $14.22 $14.05 $33.39 $32.80 $25.30 $25.06 $25.37 $25.05 $17.66 $17.45 Total Value $10720.70 $10125.30 $5!86.60 $17022.30 $5489.2O $10060.50 $4785.90 $21102.94 $5116.00 $10324.22 $10117.80 $9852.48 $20134.00 $20467.83 $18823.00 $5128.05 $5130.65 $48939.73 $19156.94 $14.05 $32.97 $25.O8 $25.06 $17.66 $4.08 $3.30 $10.68 20 PA IMIT 242 S $20604.40 31 PA IMIT 244 S $32338.27 Cash in Money Market $21074.21 Should you require additional information, please give me a call. CharlegtA. Pas~, CFP AAMS Senior Vice President Invest~.~cer "The above summary of prices/quotes/statistics contained herein has been obtained from sources believed to be reliable but is not necessarily complete and cannot be guaranteed. In some instances the prices may not reflect the value at which securities could be sold. This summary is for is for informational purposes only. This is not a substitute for a Verification of Deposit (or similar form) or the official statement of account holdings at the firm. Past results are not indicative of future performance." O"UL-38-2803 1;2:58 Ph!C]~AhlK CIF DEPARTMENT 412 '785 8857 P.01/02 PNCBANK July 30,2003 David H. Stone 414 Bridge Street P.O. Box E New Cumberland, PA 17070 Estate of Lester E. Slothower, deceased SSN: 192-14-6651 DOD: 5/14/2003 Dear Mr. Stone: In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account #5140058979 LESTER E SLOTHOWER DOD balance: $33,633.64 + $1.46 accrued interest Established 01/01/1978 Safe Deposit Box #149B Established 02/02/1995 LESTER E SLOTHOWER Located: NEW CUMBERLAND BRANCH 331 BRIDGE STREET NEW CUMBERLAND PA 17070 717-774-8743 Page 1 of 2 JUL-30-2003 i2:58 PNCBAHK CIF DEPARTMENT 412 ?05 085? P,02×0~ Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch ofCcP. Sincerely, 1-800-762-1775 P7-PFSC-04-F 500 first Av~. Pittsburgh PA 15219 Page 2 of 2 M~nber FDIC TOTAL P.02 COMMONWEALTH OF ?ENNSYLVANIA ~ COUNTY OF ~'"'-',~ , ~ SS: Betsey S. Bernhardt being du]y swor!l according fo law, deposes and says fha~ he -is the of +he Es+a+e o¢ Lester E. Slothower l~+e o~ Camp Hill. Borough ....... , Cum6er~an~ County, Pa., ~ecease~ an~ o~ fhe ertl[re esfafe o~ sa[~ ~ecegenf, consisf[ng o{ aJJ f~e personaJ properly an~ reaJ esfafe, excepf real e~+afe fNe Commonwee[fN, o+' PennsyJvania,, ~, an~ fNaf fNe ~[gures opposite eac~ ~em o~ fNe Jnvenfory represenf if's {a[r vaJue as o~ +Ne ~afe o~ ~:eceden, s and ¢.ubscribed before me, 19 B e t~s~~~~'~-~ Bernhardt rzx 32 Brookfield Ave. Nutley, NJ 07110 Addras~ Dale of Deafh 14 05 2003 Day Month Year INSTRUCTIONS ~ C' An ;nvenfor,/ mu-:f ber~"lea wlfh[n fhree monfhs affer appolnfmenf of personal rep~nfafive.. A :uppJemenf ~nvenfory musf be filed wifhin fhirfy days of discovery of add[fionaJ ~fs. ~ Aaa,tlcna~ :nec. ts ma,/ beaftacned' ' ' as fo ,°ers°naJfY or really See ArficJe iV, Fiduciaries Acf cf I 949. d Inventory of the real and personal estate of Lester E. Slothower deceased Inventory Estate of Lester E Slethower From 05/14/2003 Te 02/06/2004 Description Accrued Income Form 706 Schedule B Common Stocks Wachovia Securities-Blackrock Muni Wachovia Securities-Firstenergy Wachovia Securities-Intl Paper Cap Wachovia Securities-Pepco Holdings Wachovia Securities-Aim Hi Yld Fd Wachovia Securities-Evergreen Fxd Wachovia Securities-Franklin Penn Wachovia Sec Municipal Invt Tr 24 M Wachovia Sec. Nuveen Tax Free Insd Wachovia Sec Wachovia Sec Wachovia Sec Wachovia Sec Wachovia Sec Wachovia Sec Wachovia Sec Wachovia Sec Wachovia Sec Wachovia Sec Nuveen TE Insd PA 276 Nuveen TE Insd PA 281 Nuveen PA Insd 236M Nuveen PA Insd 242S Nuveen PA Insd 248S Nuveen PA Insd 250S Nuveen PA Insd 262S PA Tax Ex Ins 283 S/A Penn Insd Muns Set PA IMIT 236 M Wachovia Sec. PA IMIT 240S Wachovia Sec. PA IMIT 242S Wachovia Sec. PA IMIT 244S Met-Life stock Preferred Stocks Wachovia Securities-John Hancock Municipal Bonds Wachovia Securities-Bethlehem Wachovia Securities-Highland PA Wachovia Securities-Penn HFA SFM Wachovia Securities-Penn St Hgh Wachovia Securities-Phila Wtr Wachovia Securities-Venango-$10,000 Form 706 Schedule C Cash on Hand Manor Care Resident Trust-balance PSERS-prorated payment plus prem Value 9,835 00 65,431 64 20,048 00 35,196 38 47,357 09 29, 355 26 24, 154 49 4, 785. 9O 21, 102.94 5,116.00 10,324.22 10,117.80 9,852.48 20,134.00 20,467.83 18,823.00 5,128.05 5,130.65 48,939.73 19,156.94 20,604.40 32,338.27 8,604.80 10,720.70 10,125.30 5,186.60 17,022.30 5,489.20 10,060.50 763.75 1,046.09 Total 492,004.87 20,064.00 58,604.60 570, 673.47 - 1 - Inventory Estate of Lester E Slothower From 05/14/2003 To 02/06/2004 Description Accrued Income Value Total Checking Accounts PNC Bank-Checking Acct. Money Market Accounts Wachovia Bank-MM Acct. Form 706 Schedule F Household Goods & Furnishings Net proceeds of household goods Refunds United HealthCare Ins.-Refund Hartford Insurance-refund on home Mutual of Omaha Insurance-refund Manor Care of Camp Hill-refund 1.46 720.00 13.00 22.62 1,840.20 1,809.84 33,635.10 21,074.21 56,519.15 1,212.90 2,595.82 3,808.72 631,001.34 - 2 - BUREAU OF ZNDZVTDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRTSBURG, PA 171Z8-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE '04 f~PR 14 ;~ ~ '" © NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ~:~r: DATE i~:: ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN I DAVID H STONE STONE ETAL qlq BRIDGE ST ~I'~ NEW CUHBERLAND PA ~y~7.0: 0q-12-200~ SLOTHOWER 05-1~-200S 21 05-0~21 CUMBERLAND 101 Amount: REV-l;4? EX AFP (01-05) LESTER E HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE I~ RETA/N LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF SLOTHOWER LESTER E FILE NO. 21 03-0~21 ACN 101 DATE 0q-12-200~ TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Rea/ Estate (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par~nership In~eres~ (Schedule C) ($) ~. Hor~gages/No*es Receivable (Schedule D) (q) 5. Cash/Bank Deposi~s/Hisc. Personal Propar~y (Schedule E) (S) 6. Jointly O~nad Propar~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Assa~s APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funeral Expenses/Ada. Cos~s/Hisc. Expenses (Schedule H) (9). 10. Deb~s/Nor~gaga Liabilities/Liens (Schedule I) (10) 11. To,al Deductions 12. Ne~ Value of Tax Ra~urn O0 570z673.~7 O0 O0 601327.87 O0 O0 (8) 2~,q07.22 50~.01 NOTE: To insure proper credit ~o your accoun*, subai* the upper portion of ~his fora with your ~ax payment. 15. NOTE: 631,001.3q (11} 2~.911.23 (12) 606,090.11 Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Ne~: Value of Es~a~a Sub,ac* ~o Tax (lq) If an assessment was ~ssued previously, lanes 14, 15 andzor 16, 17, refZect f~gures that ~nclude the total of ALL returns assessed to date. ASSESSMENT OF TAX= 15. Aaoun~ of Line lq a~ Spousal ra~e 16. Amoun~ of Line Zq ~axabla a~ Lineal/Class A ra~e 17. Aaoun~ of Line lq a~ Sibling ra~a 18. Aaoun~ of Line lq ~axable a~ Collateral/Class B ra~a 19. Princi}al Tax Due TAX CREDITS PAYHENT RECEZPT DXSCOUNT DATE NUHBER /NTEREST/PEN PAID (-) 08-13-2003 CDOOZ899 1,052.63 02-1~-Z00~ CD003568 .00 57,609.01 5q8,q81.10 18 and 19 Mill (15) .00 x O0 = .00 (16). 5q8,q81.10 x Oq5= 2q,681.65 (17). .00 X 1Z = .00 (18), .00 x 15 = .00 (19)= 2q,681.65 Zq,681.65 .00 .00 .00 AHOUNT PAID 20,000.00 5,629.02 TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE IF PAID AFTER DATE INDICATED, SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECT/ONS: DZSCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 11, 1981 -- if any future interest in the estate is 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 Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawfuZ Crass B (collateral) rate an any such future interest. To fulfill the requirements of Sect[on ZXqO of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (71 P.S. Sect[on Detach the top portion of this Notice and submit with your payment to the Rag[star of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NILLS, AGENT A refund of a tax credit, which was net requested on the Tax Return, may be requested by completing an NAppl[cetion for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications ere available at the Office of the Register of Hills, any of the 13 Revenue District Offices, or by calling the special Zq-hour answering service for forms ordering: 1-800-361-Z050; services for taxpayers with special hearing and / or speaking needs: 1-&OO-q~7-30ZO (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown 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. ZB1021, Harrisburg, PA 171Z&-lOZ1, 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 writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Un[t, Dept. 280601, Harrisburg, PA 17128-0601 Phone [7171 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanatlon of administratively correctable errors. If any tax due is paid within three IS) calendar months after the decsdsnt's death, a five percent [513 discount of the tax paid is allowed. The 151 tax amnesty non-participation penalty is computed on the tuts1 of the tax and [ntsrestassessed, m.d not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning e[th first day of delinquency, or nine (91 months and one [11 day free the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after January 1, 1981 will bear interest at a rate which will vary from calendar year to calender year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 200q are: Interest Daily Interest Dally Year Rate Factor Year Rate Factor ~ 207. . OO05q8 ~%- 1991 117. .000301 1983 167. .000q38 1992 97. .0002q7 198q 117. .000301 1993-199~, 77. .000191 1985 137. .000356 1995-1998 97. .0002q7 1986 107. .00027o, 1999 77. . O00XgZ 1987 107. .000170, ZODO 77. .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID Interest Daily Year Rate Factor ~ 99 .O00Zq7 2002 67. .000160, 2003 57. .000137 2000, qT. .000110 X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (151 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. ~ills an~ C~k o! ~e ®~ol~ns' Court One Couflhouse Square Carlisle. PA 17013-3387 lVLA. YBER. R.y R-'I-CF,_AR.D ,.7 181 R]'DG~, _,TI'L]', P,-OAD IVl'E C-HA-N' I C S B U'R.G ~2A 17050 MAYBI~ 1705030 RETURN TO MAYBERRY'R[CHARD MOVED LEFT UNABLE TO RETURN TO STATUS REPORT UNDER RULE 6.12 Name of Decedent: Lester E. Slothower Date of Death: May 14, 2003 Will No. 21-03-0421 To the Register: 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: Yes X State whether administration of the estate is complete: 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 X (b) The separate Orphans' Court No. (if any) for personal representative's account is: N/A the (c) Did the personal representative state an account informally to the parties in interest? Yes X No Date: (d) Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' report. Capacity: Court and may be attached to this 414 Bridge Street New Cumberland, PA 17070 717-774-7435 Personal Representative X Counsel for Personal Representative est\rel\slothowerbetsey IN RE: ESTATE OF LESTER E. : SLOTHOWER : LATE OF THE BOROUGH OF : CAMP HILL, CUMBERLAND :' COUNTY, PENNSYLVANIA : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-03-0421 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, BETSEY S. BERNHARDT, being one of the beneficiaries under the will of LESTER E. SLOTHOWER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of LESTER E. SLOTHOWER, in full satisfaction and settlement of all of my rights and claims under his estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having. jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, BETSEY S. BERNHARDT, do by these presents, remise, release, quitclaim and forever discharge the Executrix, her heirs, successors and assigns, from the acts of the Executrix as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executrix. wiJ &s IN WITNESS WHEREOF, I have hereunto set my hand and seal the day of ~'~./}"~ ~ ,,, , 2004. BETS~Y S. BERNHARDT STATE OF NEW JERSEY : : SS: COUNTY OF : On this, the 6~' day of , 2004, before me a Notary Public, the undersigned officer, personally appeared BETSEY S. BERNHARDT, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowl- edged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. /~x,~ Notary Public / / ~ NU'ITII~f-PUBUC OF NE~Nf ~ est\rel\slothowertim IN RE: ESTATE OF LESTER E. : SLOTHOWER : LATE OF THE BOROUGH OF : CAMP HILL, CUMBERLAND : COUNTY, PENNSYLVANIA : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-03-0421 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, TIMOTHY F. SLOTHOWER, being one of the beneficiaries under the will of LESTER E. SLOTHOWER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of LESTER E. SLOTHOWER, in full satisfaction and settlement of all of my rights and claims under his estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, TIMOTHY F. SLOTHOWER, do by these presents, remise, release, quitclaim and forever discharge the Executrix, her heirs, successors and assigns, from the acts of the Executrix as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executrix. IN WITNESS WHEREOF, I have hereunto set my hand and seal the ~'~ day of ~t~'~_~ , 2004. Witness TIMO~F. ~5~LOTHOWER STATE OF ARIZONA COUNTY OF SS: me a Notary Public, the undersigned officer, personally appeared TIMOTHY F. SLOTHOWER, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowl- edged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. est\rel\slothowergrace IN RE: ESTATE OF LESTER E. : SLOTHOWER : LATE OF THE BOROUGH OF : CAMP HILL, CUMBERLAND : COUNTY, PENNSYLVANIA : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-03-0421 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that GRACE UNITED METHODIST CHURCH, ENDOWMENT FUND, being one of the beneficiaries under the will of LESTER E. SLOTHOWER, does hereby acknowledge that I have received all sums of money and property due me by virtue of the death of LESTER E. SLOTHOWER, in full satisfaction and settlement of all of my rights and claims under his estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, aod I agree to the final dis~~n ~ the ~+~+~ · ~+ .... further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, GRACE UNITED METHODIST CHURCH, ENDOWMENT FUND, does by these presents, remise, release, quitclaim and forever dis- charge the Executrix, her heirs, successors and assigns, from the acts 7 of the Executrix as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoev- er, and I do hereby consent to the discharge of the said Executrix. IN WITNESS WHEREOF, I have hereunto set my hand and seal the 7 Witness COMMONWEALTH OF PENNSYLVANIA: COUNTY OF : SS: On this, the GRACE UNITED METHODIST CHURCH, ENDOWMENT FUND BY: day of ~/ , 2004, before me a Notary Public, the undersigned officer, personally appeared ~i~,~ [~./ K,~O~L.O , ~,,~ of GRACE UNITED METHODIST CHURCH, ENDOWMENT FUND, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowl- edged that ~ executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. 2 est\rel\slothowercontact IN RE: ESTATE OF LESTER E. : SLOTHOWER : LATE OF THE BOROUGH OF : CAMP HILL, CUMBERLAND : COUNTY, PENNSYLVANIA : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-03-0421 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that CONTACT HELPLINE, being one of the beneficiaries under the will of LESTER E. SLOTHOWER, does hereby acknowledge that I have received all sums of money and property due me by virtue of the death of LESTER E. SLOTHOWER, in full satisfaction and settlement of all of my rights and claims under his estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, CONTACT HELPLINE, does by these presents, remise, release, quitclaim and forever discharge the Executrix, her heirs, successors and assigns, from the acts of the Executrix as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executrix. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day of Witness , 2004. COMMONWEALTH OF PENNSYLVANIA: COUNTY OF ~Pd~?~qzd : SS: On this, the ~f2] day of ~7~ff , 2004, before me a Notary Public, the undersigned officer, personally appeared .~ ~ , ~. ~m~ of CONTACT HELPLINE, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that 5~4~ executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. N0~~ Public COMMONWEALTH OF PENNSYLVANIA Notarial Seal J Jm]et A. Gulick. Notary Public [ 2 Lower Paxton Twp., Dauphin County I My Commission Expires Dec. 20, 2007 ~ Member, Pennsylvania Association of Notaries