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HomeMy WebLinkAbout03-0453Estate of also known as PETITION FOR PROBATE and GRANT OF LETTERS Irene F. Fulk No. ~a~tt- I~}3 -' t.//..~ To: ,Deceased. Social Security No. 201-18-4434 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older and the executor in the last will of he above decedent, dated June 4 and codicils(s) dated None Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania named 19 97 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at Messiah Village Nursing Home, 100 Mt. Allen Dr., Mechanicsburg, PA 17055 (li.qt street: number and munm?a ~lty) Decedent, then 92 years of age, died May 25 at Messiah Village Nursing Home, 100 Mt. Allen Dr., Mechanicsburg, PA 17055 , 2003 Except as follows, decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: No exceptions Decedent at death owned property with estimated vales as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: None WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Testamentary thereon. (testamentary; administration c.t.a; administration d.b.n.c.t.a.) W LLIAh~. PHILLIPS OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ] 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 representative(s) of the above decedent petitioner(s) will well and truly, administer thcem'a~e accord~j~g ~ law. Sworn to or affirmed an_d, subscribed ,/~.~.~a,t~ / Jz~d~.~/,~<ZD ~' befores!ne this ~,,nac~ day of ' ' /'-'¥' - ~ ~ 27'/¢4-/3 ZO: lcl Z'- Nfl? £0. NO 21-03-453 ESTATE OF IRENE F. FULK, DECEASED DECREE OF PROBATE AND GRANT OF LETTERS AND NOW SUNE 3, 20 03 , in consideration o£ the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated June 4, 1997 described therein be admitted to probate and filed o£ record as the last will of and Letters 'l'estamentary are hereby granted to William J. IJhlllips Reg/s~er of Wills FEE Probate, Letters, E ........... $ 305.00 Short Certificates (10) ......... $ 30.00 Illfox~_~g__~N~.EXTRA. P.G8.4.. $ 12.00 JCP $ 10.00 TOTAL $ 357.00 Filed . .J.U.~E..3.,..2.o9) ..................... Herbert G. Rupp, Jr., Esquire. No. 01597 ATI'ORNEY (Sup. Ct. 1.D. No.) 355 N. 21st St., Ste. 205,Camp Hill,PA 17011 ADDRESS 717-761-3459 PHONE MAILED AND SHORT CERT. LETTERS TO ATTORNEY RUPP, JUNE 3, 2003 21-03-0453 C:\WP60\WlLLS\FULKIREN.WI L LAST WILL AND TESTAMENT OF IRENE F. FULK I, IRENE F. FULK, a resident of Harrisburg, Dauphin County, Pennsylvania, being of sound and disposing mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time made. ITEM I; TAXES. I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my Estate or by any recipient of any property, shall be paid by my Executor out of the property passing under this Will, which is not specifically bequeathed or devised, as an expense and cost of administration of my Estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax paid by my Executor, even though on proceeds of insurance or other property not passing under this Will. ITEM I1: POWERS OF APPOINTMENT. I hereby exercise all powers of appointment which I may have at the time of my death in favor of my Executor, and all property subject to all such powers of appointment shall ITEM III; REAL AND PERSONAL PROPERTY, a. the sum of $30,000 to my daughter, PHYLLIS D. McCANN. be included in my Estate. I give, devise and bequeath RUPP AND MEIKLE, 355 NORTH 21ST STREET, CAMP HILL, PA 17011 Page 1 of 4 b. I give, devise and bequeath 50% of all of the residue of my property, real, personal and mixed, as follows: 1. To my grandson, DEAN J. FALK, per stirpes, the sum of $30,000 and one-half of the remainder of the 50% after subtracting the $30,000. 2. To my granddaughter, TAMI S. WHITE, per stirpes, the other one-half of the remainder of the 50% after subtracting the $30,000. c. To my daughter, PHYLLIS D. McCANN, per stirpes, the other remaining 50% of all of my property, real, personal and mixed. ITEM IV: EXECUTOR'S POWERS, In the settlement of my Estate, my Executor shall possess, among others, the following powers: a. To sell either at public or private sale and upon such terms and conditions as my Executor may deem advantageous to my Estate, any or all real or personal estate or interest therein, whether owned by me severally or in conjunction with other persons or acquired after my death by my Executor and to consummate said sale or sales by sufficient deeds or other instruments to the purchasers, conveying in a fee simple title, free and clear of all trust and without liability of the purchaser or purchasers to see the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon my Executor in this paragraph or elsewhere in my Will. I~e2 of? b. To pay all costs, taxes, expenses and charges in connection with the administration of my Estate. c. To distribute my Estate in kind or money. In the event assets are distributed in kind, such assets shall be distributed at their value(s) on the respective date(s) of their distribution. d. To do all other acts in the judgement of my Executor necessary or desirable for the proper and advantageous management, investment and distribution of my Estate. ITEM V; GUARDIANSHIP. If at any time any minor child shall be entitled to receive any assets hereunder, DAUPHIN DEPOSIT BANK AND TRUST COMPANY, having offices in and around Harrisburg, Pennsylvania, shall act as Guardian of the assets payable to such child. Said Guardian may receive and administer all assets authorized by law and shall have full authority to use such assets, both principal and income, in any manner said Guardian shall deem advisable for the best interests of such child, including college, university, post-graduate or other education, without securing court order. Said Guardian shall have all the rights and privileges as to the Guardianship(s) and the assets thereof as are herein granted to my Executor as to my Estate and the assets therein. ITEM VI: SIMULTANEOUS DEATH. Any person who shall have died at the same time as I or in a common disaster with me or under such circumstances that it is difficult or impossible to determine who died first, shall be deemed to have predeceased me. Page 3 of 4 ITEM Vll; EXECUTOR. I hereby nominate, constitute and appoint WILLIAM J. PHILLIPS of 5949 Longview Road, Harrisburg, Pennsylvania, 17112, to be my Executor. If William J. Phillips predeceases me or declines to serve, I nominate, constitute and appoint my daughter, PHYLLIS D. McCANN, to be my Executrix. In the event my daughter, Phyllis D. McCann, predeceases me or declines to serve, I nominate, constitute and appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY to be my Executor. My Executor and Guardian specifically are relieved from the duty or obligation of filing any bond or other security. IN WITNESS WHEREOF. I have hereunto set~y hand and seal on this my Last Will,and .Testament this ~'"~ day of J/~r.~.~__ , 1997, at C'~,~ .~.~/ , Pennsylvania. ~/ IRENE F. FULK (SEAL) We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testatrix, 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 set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. Page 4 of 4 COMMONWEALTH OF PENNSYLVANIA : COUNTY OF ~c:~{~f4~t~ : SS. WE, IRENE F. FULK, and i_~ ~ ~. ,_-T. I~I~P~. , ~~ ~ ~ ~ , and ~ ~_~ , the Testatrix and the Witnesses, respectively, whose names are-s~ed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary a~ for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and to the best of his or her knowledge the Testatrix was at that time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. IRENE F. FULK, Testatrix ~itness ~ ~ ~ Witness Subscribed, sworn to, and acknowledged before me by IRENE F. FULK, the Testatrix, and subscribed and sworn to before .~e by L~it~t:pt ~. (~4~t_~l~ , , and V~c~<~ ~.~¢~.r~/ ~ , w. it~esses, this ~ day Notary Public :.". CERTIFICATION OF NOTICE UNDEK RULE 5.6 (a) Name of Decedent: Irene F. Fulk Date of Death: May 25, 2003 Will No. To the Register: Admin. No. 2003-00453 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 June 9, 2003: Name Address Mr. Dean J. Faulk, 974 Eppley Road, Mechanicsburq, PA 17055 Mrs. Tami S. White, 21 Hemlock Drive, Mechanicsburg, PA 17055 Mrs. Phyllis McCann, 440 S. Fremont Road, Coldwater, MI 49036-9434 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Date: June 9, 2003 Capacity: Signature Name~b~rt G'~ R~p~% Jr., Esquire Address 355 N. 21 '= St., Suite 205 Camp Hill, PA 17011 Telephone (717) 761-3459 X Personal Representative Counsel for Personal Representative HERBERT G. RUPP, .IR. RICHARD C. RUPP ANN MEIKLE ERIKSSON (1954-82) LAW OFFICES RUPP AND MEIKLE A PROFESSIONAL CORPORATION 355 NORTH 21ST STREET, SUITE 205 CAMP HILL, PA 17011 (717) 761-3459 E-MAIL: RUPPLAW I~AOL.COM August 19, 2003 MAILING ADDRESS P.O. BOX 395 CAMP HILL, PA 17001-0395 TELEFAX: (717) 730-0214 Cumberland County Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Estate of Irene F. Fulk, deceased No. 21-03-0453 Our File No.: F-3046.02 Dear Madam: ~T~. o. ~ ~ ~_~ _ 03 Enclosed is check in the amount of $14,000 as payment on account of the Pennsylvania Inheritance Taxes for the above Estate. Please send the receipt to me. Thank you. Very truly yours, HGR/lin Enclosure L.~W OFFICES RUPP AND MEIKLE A PROFESSIONAL CORPORATION P. O. BOX 395 · CAMP HILL; PA 17001-0395 Cumberland County Register o4 Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 COMMONWEALTH OF PENNSYLVANIA DF?^~TMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 002922 RUPP HERBERT G JR ESQ 355 NORTH 21 ST ST SUITE 205 CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 201-18-4434 :ILE NUMBER: 2103-0453 DECEDENT NAME: FULK IRENE F ;)ATE OF PAYMENT: 08/20/2003 POSTMARK DATE: 08/19/2003 COUNTY: CUMBERLAND DATE OF DEATH: 05/25/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $14,000.00 TOTAL AMOUNT PAID: 4,000.00 REMARKS: WILLIAM J PHILLIPS EXECUTOR C/O HERBERT G RUPP JR ESQUIRE SEAL CHECK# 1016 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 00358O RUPP HERBERT G JR ESQ 355 NORTH 21 ST ST SUITE 205 CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 201-18-4434 FILE NUMBER: 21 03-0453 DECEDENT NAME: FULK IRENE F DATE OF PAYMENT: 02/19/2004 POSTMARK DATE: 02/1 8/2004 COUNTY: CUMBERLAND DATE OF DEATH: 05/25/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $130.04 REMARKS: SEAL CHECK//1028 TOTAL AMOUNT PAID' $130.04 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REV~,~UF DEPT. 280601 HARRISBURG, PA 17128..u~, Rev-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER County Code Year Number 1. Original Return 4. Limited Estate 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received 2. Supplemental Return 3. Remainder Return(d~d.~ 48. Future Interest Comprise (date of death after 12-12-82) 5. Federal Estate Tax Return Required t 8 Total Number of Safe Depos t Boxes ~7. Decedent Malntelned a Living Trust (Attach. copy of Truat) ' ' 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1- ~ 1 1. Election to tax under Sec. 9113(A) U( ..... ) Z z o 0 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 & Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) ~ Separate Billing Requested 7. Inter-Vivos Transfers & Misc. Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities & Liens (Schedule I) (10) 1t. Total Deductions (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) 14. Net Value Subject to Tax (Line t2 minus Line 13) $7~52;45 $0.00 $28~}85.72 $0.00 i OFFICIAL ~USE ONLY (8) $25,563.10 $2,500.06 (11) (12) (13) $358,438.17 $28.063.1§ $330,375.0t $0.00 (14) $330,375.01 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of fine 14 taxable at lineal rate 17. Amount of line 14 taxable at sibling rate (18) .12 (17) .15 (18) (19) $0.00 $14,866.88 $0.00 $0.00 $14,866.88 D~cedent's Complete .~.ddress: Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments AC Spousal Poverty Credit B. Prior Payments C. Discount InterestJPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) (1) $14,866.88 Total Interest/Penalty (D + E) (3) If line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (4) If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) Ac Enter the interest on the tax due. B. Enter the total of Line 5 + 5AC This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT $14.736,84 $0.00 $130.04 $130.04 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN X IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; c. retain a revisionary interest; or d. receive the promise for life of either payments, benefits or care? If death occurred after December 12, 1982, did decedent transfer property within on year of death without receiving adequate consideration? Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? 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 then the personal representative is based on all the information of which preparer has any knowledge. DATE OT.E.T.A..E..ESE.TAT,VE DATE ADDRE~ ' For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. C:\WP60\WILLS\FULKIREN.WIL LAST WILL AND TESTAMENT OF IRENE F. FULK I, IRENE F. FULK, a resident of Harrisburg, Dauphin County, Pennsylvania, being of sound and disposing mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time made. ITEM I; TAXES. I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my Estate or by any recipient of any property, shall be paid by my Executor out of the property passing under this Will, which is not specifically bequeathed or devised, as an expense and cost of administration of my Estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax paid by my Executor, even though on proceeds of insurance or other property not passing under this Will. ITEM Ih POWERS OF APPOINTMENT. I hereby exercise all powers of appointment which I may have at the time of my death in favor of my Executor, and all property subject to all such powers of appointment shall ITEM III; REAL AND PERSONAL PROPERTy. a. the sum of $30,000 to my daughter, PHYLLIS D. McCANN. be included in my Estate. I give, devise and bequeath Page 1 of 4 RUPP AND MEIKLE, 355 NORTH 21ST STREET, CAMP HILL, PA 17011 b. I give, devise and bequeath 50% of all of the residue of my property, real, personal and mixed, as follows: 1. To my grandson, DEAN J. FALK, per stirpes, the sum of $30,000 and one-half of the remainder of the 50% after subtracting the $30,000. 2. To .my granddaughter, TAMI S. WHITE, per stirpes, the other one-half of the remainder of the 50% after subtracting the $30,000. c. To my daughter, PHYLLIS D. McCANN, per stirpes, the other remaining 50% of all of my property, real, personal and mixed. ITEM IV; EXECUTOR'S POWERS. In the settlement of my Estate, my Executor shall possess, among others, the following powers: a. To sell either at public or private sale and upon such terms and conditions as my Executor may deem advantageous to my Estate, any or all real or personal estate or interest therein, whether owned by me severally or in conjunction with other persons or acquired after my death by my Executor and to consummate said sale or sales by sufficient deeds or other instruments to the purchasers, conveying in a fee simple title, free and clear of all trust and without liability of the purchaser or purchasers to see the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon my Executor in this paragraph or elsewhere in my Will. 2of 4 b. To pay all costs, taxes, expenses and charges in connection with the administration of my Estate. c. To distribute my Estate in kind or money. In the event assets are distributed in kind, such assets shall be distributed at their value(s) on the respective date(s) of their distribution. d. To do all other acts in the judgement of my Executor necessary or desirable for the proper and advantageous management, investment and distribution of my Estate. ITEM V; GUARDIANSHIP. If at any time any minor child shall be entitled to receive any assets hereunder, DAUPHIN DEPOSIT BANK AND TRUST COMPANY, having offices in and around Harrisburg, Pennsylvania, shall act as Guardian of the assets payable to such child. Said Guardian may receive and administer all assets authorized by law and shall have full authority to use such assets, both principal and income, in any manner said Guardian shall deem advisable for the best interests of such child, including college, university, post-graduate or other education, without securing court order. Said Guardian shall have all the rights and privileges as to the Guardianship(s) and the assets thereof as are herein granted to my Executor as to my Estate and the assets therein. ITEM VI; SIMULTANEOUS DEATH. Any person who shall have died at the same time as I or in a common disaster with me or under such circumstances that it is difficult or impossible to determine who died first, shall be deemed to have predeceased me. Page 3 of 4 ITEM VII: EXECUTOR. I hereby nominate, constitute and appoint WILLIAM J. PHILLIPS of 5949 Longview Road, Harrisburg, Pennsylvania, 17112, to be my Executor. If William J. Phillips predeceases me or declines to.serve, I nominate, constitute and appoint my daughter, PHYLLIS D. McCANN, to be my Executrix. In the event my daughter, Phyllis D. McCann, predeceases me or declines to serve, I nominate, constitute and appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY to be my Executor. My Executor and Guardian specifically are relieved from the duty or obligation of filing any bond or other security. IN WITNESS WHEREOF. I have hereunto set~y hand and seal on this my Last 1997, Will,and .Testament this ~/CL~A day of j/,_.~..~. , at ~"2a~/,~//' , Pennsylvania. :~//4/~ ~"~- ,~~ (SEAL) IRENE F. FULK We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testatrix, 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 set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. Page 4 of 4 COMMONWEALTH OF PENNSYLVANIA : COUNTY OF d. u'I'~B'F-.~~ : SS. WE, IRENE F. FULK, and I_~ I~.~.~ ,'T, g~l~P~. , 1~-~T /_L-t~.~;~.- ,and L/Ic~V.~_ ~P~r~_~ -,theTest~trixand the ~A)itr~esses, respectively, whose names are' s'ig-~ed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and to the best of his or her knowledge the Testatrix was at that time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. IRENE F. FULK, Testatrix ~tness Witness Subscribed, sworn to, and acknowledged before me by IRENE F. FULK, the Testatrix, and subscribed and sworn to before .~e by t~.~m ~. ~-~/_~.~ , , and V~<~ ~.r~¥ . , w. it~esses, this ~ day ,1997. V i/.' , J Notary Public NOT/,~AL ,~,AL I(.ATi'tLE~ A. A'~i~,~, N~'~'y Pubk Camp kii~l Bc~,o, C~m~nd Co., PA ~y CGm.,w~an F..,q~n~ hpt. 21, 199~ REV-IS03EX = (~1.97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FULK, IRENE F. SCHEDULE B STOCKS & BONDS FILE NUMBER 21-03-0453 All property jointly.owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. $30,168.32 2. $7,706.03 3. 368 shams- Morgan Stanley ~ 43.065 $15,847.92 4. $16;384.56 5. $1,263.83 6. $4,881.79 TOTAL (Also enter on line 2, Recapitulation) (If more space is needed, insert additional sheets of the same size) $76,252.45 RE¥o1508 EX + (~-97)(1) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FULK, IRENE F. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-03-0453 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION Waypoint Bank Certificates of Deposit Valu~ Lette~ ~ VALUE AT DATE OF DEATH $83,711.98 5. 6. 7. 8; g, 10~ 11. 12. 1,3, Allfl~ ~k - ~ Fund Aitemative Account. NO. 0098221973. Valuation Letter ~ched AIIfist Bank~:.Checklng Account No, 00127893712 24 month (S6t). $36,066.05 PSECU - Regular Shares (S1)- n Letter Attached iPSECU - Checking Shar--rs (S4) - Valuation Letter ~d BB & T Bank- Certificate of Deposit - No, 2 Fumlture in Room at Nursing Home nt of Revenue-Refund of PA 40 Tax Payment LOt. Rolling Green Cemetery-sold to William Phillips ~ ~P®nsi0n Paint for May, 2003 ' ord Abbott.~ Dividend TOTAL (Also enter on line 5, Recapitulation) $65,701.73 $9,729.40 $6,656.55 $108,957.74 $205.68 $104.99 $6,780.19 $25.00 $100.00 $100.00 SOl .70 $20.76 $282,185.72 06/25/2003 LOOK FOR US. WE'LL GET YOU THERE. RUPP & MEIKLE 355 N 21ST ST SUITE 205 CAMP HILL PA 17011 The information which you requested on the account(s) of IRENE F FULK (Social Security Number 201-18-4434) is/are as follows: Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership Was Established 2100012356 2100012444 CERTIFICATE CERTIFICATE 12/03/99 08/13/99 48390.36 35124.21 103.41 94.00 48493.77 35218.21 SOLE Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested rely,. / SENIOR SERVICES REP. P.O, Box 171 I, HARRISBURG, PENNSYLVANIA 17105-1711 Toll Free 1-866-WAYPOINT (I-866-9;=9-7646) · IN YORK AREA 717/815-4500 · vvvwv, wa~lpointbank, com allfirst Allfirst Financial Center, N.A. Baac 501-120 P.O. Box 900 Millsboro, DE 19966 A Division of M& T Bank June 17, 2003 Ruppand Meikle Attn:Herbe~ G. Rupp, Jr. 355 North21a S~eet, Suite205 Camp Hffi, Pennsylvania 17011 Dear Mr. Rupp: Estate of Irene F. FUlk Date of Deatb~' May 25, 2003 Social Security Number: 201-18~434 In response to your request, please be advised that at the time of death the above named decedent had on deposit with this bank the following accounts. 1. Type of Account ....................... Relationship w/Int. Checking Account Account Number. ..................... 0017893 712 Ownership .............................. Irene F. Fulk or Owen R. Ftdk; William Phillips, POA Opening Date .......................... 04/28/89 Balance on Date of Deatk ........ $ 6, 656. 02 Accrued Interest $ .5,ct Total ..................................... $ 6, 656. 55 Type of Account ....................... Money Fund Alt. Account Account Number. ..................... 0098221973 Ownership .............................. Irene F. Fulk; William Phillips, POA Opening Date .......................... 02/17/98 Balance on Date of Deatlt ........ $ 9, 725. 68 Accrued Interest $ 3. 7~, Total ..................................... $ 9,729.40 Tjjpe of Account. ......................Certificate of Deposit~30 MOS~3. 940000 Account Number. ..................... 80000002150693 Ownership ..............................Irene F. Fulk or Owen R. Fulk; William Phillips, POA Opening Date .......................... 03/31/00 Balance on Date of Deattt ........ $ 22,473.83 Accrued Interest $ 65.50 Total ...................................... $ 22,539.33 T~jpe of Account .......................Certificate of Deposit~30 MOS~3. 700000 Account Number. ..................... 80000002150818 Ownership ..............................Irene F. Fulk Opening Date .......................... 05/31/00 Balance on Date of Deatk ........ $ 31,020.45 Accrued Interest $ 179.24 Total. ..................................... $ 31,1'99. 69 Type of Account ....................... Certificate of Deposit~30 MOS~3. 940000 Account Number. ..................... 8 700814097878 7 Ownership .............................. Irene F. Fulk Opening Date .......................... 11/03/97 Balance on Date of Deattt ........ $ 11,853.95 Accrued Interest $ 108. 76 Total ...................................... $ 11,962.71 Type of Account ....................... Safe Deposit Box Account Number ...................... 00001000499100025136 Ou~nership .............................. Irene F. Fulk or Otoen R. Fulk Opening Date .......................... 11/13/98 (from Dauphin Deposit Bank) This letter does not include any accounts in which the deceased may have been listed as Power of Attorney, Custodian of Uniform Transfers, Representative Payee, or Trustee under a Written Agreement For any additional information on these accounts please contact our branch at: Allfirst Bank 4950 Jonestown Road Harrisburg, PA 17109 Phone-717-255-2233 Sincerely, Mary Anne Macielag Associate 1 (302) 934-2240 PSEC the financial linkTM June 12, 2003 Account # 0201184434 HERBERT G RUPP JR PO BOX 395 CAMP HILL, PA 17001-0395 Dear MR RUPP: The following is the status of IRENE F FULK's account with PSECU as of the date of death. Joint Owner's Name NONE Date Established 01.25.1996 Date of Death 05.25.2003 Date of Birth 09.21.1910 Share(s) Regular Shares (S 1) Checking Shares (S4) 36 Month Certificate (S50) 18 Month Certificate (S51) 24 Month Certificate (S60) 24 Month Certificate (S61) 24 Month Certificate (S64) 24 Month Certificate (S65) Balance Accrued Dividend $ 205.55 $ 0.13 104.96 0.03 14,662.54 35.57 8,801.07 15.97 24,466.08 57.75 35,991.50 74.55 12,937.72 35.52 11,850.72 28.75 The dividend earned from January 1, 2003 through the date of death was $1,720.19. The decedent had no loans with us. We do not have safe deposit boxes for our members. If you have any questions, please call 234-8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Sincerely, Meacie Fairfax/' Member Service Representative Finance Support Unit PENNSYLVANIA STATE EMPLOYEES CREDIT UNION Main Address: I Credit Union Place, Harrisburg, PA 17110-2990 · (717)234-8484 · (800)237-7328 Mailing Address: P.O. Box 67013, Harrisburg, PA 17106-7013 · (717)777-2100 (TDD) · (800)472-1967 (TDD) Web Address: www. psecu.com Savings federally insured up to $100,000 by the National Credit Union Administration. ~EV-1 $tt EX + (1-97X1} SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONW'r-ALTH OF PENNSYLVANIA INHERITANCE TA~( RETURN P__;$!~ENT DECE-nENT ESTATE OF FULK, IRENE F. FILE NUMBER 21-03-0453 Debts of decedent must be reported on Schedule I. ITEM I NUM_nER DESCRIPTION AMOUNT FUNERAL EXPENSES: NISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Reprseentative(s) Street Address City Year(s) Commission Paid: Attorney Fees - Rupp and Meikle Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address State ~i;~,~'~!~i Zip city Relationship of Claimant to Decedent Probate Fees - Accountant's Fees Tax Return Preparer's Fees TOTAL (Also enter on line 9, Recapitulation) $25,563.10 (If more space is needed, insert additional sheets of the same size) · REV.1512 EX. + (1-97X1 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF FULK, IRENE F. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-03-0453 Include unreimbursed medical expenses. ITEM NUMBER 2. 3. 4. 6. 7. 8. 9. 10. 11. DESCRIPTION Alert Phari~acy- Medicines PharAmerica - Medicines MessiahVillage - Ambulance Services from 'Hospital: Nephrology'ASsocJate~:~ Medical Services. Pennsylvania NeurologicalAssociation-~MediCal Services Internists of Central Pennsylvania -Medical Services /erizon- TelephOne Services William J. Phillips- Power ~.AttOr~eyServices Quantum. Imaging Mobile X-ray Imaging, TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT $13.35 $13.t4 $1,896.82 $76.90 $62.41 $1~!.30 $119.99 $5.45 ~ $150:64 $103.tl $2,500.06 R~V-'I513 EX + (9-00)) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULEJ BENEFICIARIES ESTATE OF FULK, IRENE F. NUMBER I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] i FILE NUMBER RELATIONSHIP TO DECEDENT Do Not List Trustee(s) 21-03-0453 AMOUNT OR SHARE OF ESTATE II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $0.00 (If more space is needed, insert additional sheets of the same size) Register of Wills Cumberland County, Pennsylvania INVENTORY Estate of IRENE F. FULK No. 21-03-0453 Social Security No. Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal wherever situate end all of the real estate in the Commonwealth of Pennsylvania of said, Decedent that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedenrs death, and th Decedent owned no real estate outside of the of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Attorney I.D. No.: Address Dated Telephone: 832 shares Exxon ~MobilQ 26:26 2. 261 shamsSesrs Q 26.526 368 shares Morgan Stanley~43~065 466 shares Allstate (~ 35.16 Description 9. 10. ~dlflretBank No, 800000821~3 1t~. ~AIIfirst Bank Certificate of DePosit No. 87068140978787 12. ~ Allfirst. BankMoney Fund Alternative Account No. 0098221973 S64:- $12,973.24, $65- $11,879,47 18~ Furniture:in Room 19, PA Department of Revenue. Refundof PA4OTax Payment Total from Continuation Page(s) (Attach additional sheets if necessary) Value $30,168.32 $7,706.03 $15,847.92 $16,384.56 $1,263.83 $48,493.77 $35,218~21 ~1,199,69 $22,539.33 $11,962.71 $9,729.40 $6,656.55 $108,957.74 $205.68 $104.99 $8,780.19 $25.0O $100;00 $212.46 Total: $358,438.17 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of personal representative, include the each item, but such figures should not he extended into the total of the Inventory. Register of Wills Cumberland County, Pennsylvania INVENTORY CONTINUATION PAGE Estate of IRENE F. FULK No. 21-03-0453 Description 20~ ~Lot- Rolling Green Cemetery.sold toWllllam Phillips ZI.. Metlife:-.~ion:P~ntforMay, 2003 22. ' Lord AbbOtt'~ Dividend Value Total: $100.00 $91.70 $20.76 $212.46 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of personal representative, include the each item, but such figures should not be extended into the total of the Inventory. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 180601 HARRISBURG, PA 17128-0601 CONNONNEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX REV-15q7 EX AFP COl-OS) HERBERT G RUPP JR"ESQ RUPP & HEIKLE $55 N 21ST ST STF~ CANP HILL CUT ALONG THIS LINE ~ 9:50 BATE 0~-12-2004 ESTATE OF FULK BATE OF DEATH 05-15-Z005 FILE NUHBER 11 05-0455 COUNTY CUHBERLAND ACH 101 kmoun~ RemL~ed IRENE HAKE CHECK PAYABLE ANB REHZT PAYHENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 RETAIN LONER PORTION FOR YOUR RECORDS ~-~ REV-1547 EX AFP [01-03} NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR BZSALLONANCE OF BEBUCTZONS AND ASSESSHENT OF TAX ESTATE OF FULK IRENE F FILE NO. 21 05-0~55 ACN 101 DATE 04-12-2004 TAX RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATION CONCERNZNG FUTURE INTEREST - SEE REVERSE APPRAZSEB VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~a (Schedule A) {1) 2. S~ocks and Bonds (Schodulo B) (2} $. Closely Held S~ock/Par~nership In~aras~ (Schedule C) [3} ~. Nor~gagas/No~es Receivable (Schedule D) (~) 5. Cash/Bank Deposi~s/Nisc. Personal Proper~y (Schedule E) (5) 6. Jointly O~nad Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED BEBUCTZONS AND EXEHPT[ONS: 9. Funeral Expansas/Adm. Cos~s/Hisc. Expanses (Schedule H) (9) 10. Dab~s/Nor~gaga Liabilities/Liens (Schedule I) (10) 11. To,al Deductions 12. Ne~ Value of Tax Re~urn 76z252.45 .00 282z185.72 .00 .00 NOTE: To insure proper cradi~ ~o your account, subei~ ~he upper portion .00 of ~his fore ~i~h your ~IX pIyman~. .0O (8) 25,565.10 15. 1~. NOTE: Z.500.06 (11) (12) Chari~Ibla/Govarnmen~el Bequests; Non-elected 9115 Trusts (Schidula J) (15) Ne~ Value of Es~e~e Sub~ac~ ~o Tax (lq) Zf an assessment Has issued previously, lines 14, 15 and/or 16, 17, reflect figures that lnclude the total of ALL returns assessed to date. (15) .00 x O0 = (16) 530,575.01 x 0~5= (17) .00 x 12 = (18) .00 x 15 = (19)= AHOUNT PAID 14,000.00 150.0~ ASSESSHENT OF TAX: 15. Amoun~ of Line lQ e~ Spousal ra~e 16. AIoun~ of Line 1~ ~axabla a~ Lineal/Class A re~e 17. AIoun~ of L/ne 18. A.oun~ of Line 1~ ~axeble a~ Collateral/Class B ra~e 19. Principal Tax Due TAX CREBZTS: PAYH~NT DATE NUNBER INTEREST/PEN PAID (- 08-19-Z005 CDOOZgZZ 756.84 02-~8-2004 CD005580 . O0 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATZON OF ADDITIONAL INTEREST. 558,438.17 2B.063.16 550,$75.01 .00 530,375.01 18 and 19 .00 14,866.88 .00 .00 14,866.88 TOTAL TAX CREBZT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 1~,866.88 .00 .00 .00 ( IF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SZDE OF THIS FORH FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decadents dying on or before December 1Z, 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 Coemonaealth hereby expressZy reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (collateral) rate on any such futura interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act ZS of ZOO0. (71 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: REG/STER OF NILES, AGENT A refund of a tax credit, ahich ams not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications ara available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Z4-hour answering service for fores ordering: 1-800-361-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-5010 (TT only). Any party in interest not satisfied eith the appraisement, allowance, or disalloaance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object aithin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1011, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in eriting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg, PA 17118-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedant's death, e five percent (SX) discount of the tax paid is allowed. The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and net paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the sase manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (61) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will boar interest at a rate which will vary from calendar year to calendar year eith that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through Z004 are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year 1982 201 .000548 ~'~'~& - 1991 111 .000301 ~ 1983 162 .000438 1992 91 .000247 ZOOZ 1984 llZ .000501 1993-1994 72 .000192 ZOOS 1985 132 .000356 1995-1998 9Z .000247 2004 1986 lOZ .000274 1999 7Z .000192 1987 102 .000274 ZOO0 71 .000191 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DA/LY INTEREST FACTOR Interest Daily Rate Factor 91 .000147 61 .000164 5X .000157 4Z .000110 --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. BUREAU OF INDIVIDUAL TAXES INHERTTANCE TAX DT¥ISION DEPT. 280601 HARRISBURG, PA 17128-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX HERBERT G RUPP JR'I~(II'IA APF 14 RUPP & HEIKLE $55 N 21ST ST STF~)5 CAHP HI L L (~AT~L7_~ll DATE 04-12-200~ ESTATE OF FULK DATE OF DEATH 05-25-2003 FILE NUHDER 21 05-0455 COUNTY CUHBERLAND ACN 101 I Aeoun~ Ree/~ed REV-lSd7 EX &FP (01-05) IRENE F HAKE CHECK PAYABLE AND REHZT PAYNENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THTS LTNE I~- RETAIN LOWER PORTTON FOR YOUR RECORDS -~1 REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF FULK IRENE F FILE NO. 21 05-0~55 ACN 101 DATE 0q-12-2004 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERS; APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) 3. Closely Hold S~ock/Par~nership In~ores~ (Schedule C) ($) ~. Not,gages/No,es Receivable (Schedule D) (~) $. Cash/Bank DeposL~s/Misc. Personal Proper~y (Schedule E) (5) 6. Jointly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule g) (7) 8. To,al Asse~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ado. Costs/Misc. Expenses (Schedule H) (9) 10. Dob~s/Nor~gage Limb/lilies/L/ohs (Schedule Z) (10) To,al Deductions 12. Ne~ Value of Tex Re~urn 76z252.45 .00 282~185.72 .00 .00 NOTE: To /nsure proper crodi~ ~o your account, subei~ ~he upper por~/on .00 of ~his fore wL~h your ~ax payment. .O0 (8) 25,565.10 13. lq. NOTE: $58,~38.17 2,500.06 (11) 28.0~3.16 (12) 330,375.01 Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 No~ Value of Es~e~e Sub5oc~ ~o Tax (1~) ~0,~75.01 Zf an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~ill reflect figures that lnclude the total of ALL returns assessed to date. (15) .00 x O0 = .00 (16) 330,$75.0! x 0~5= 1~,866.88 (17) .00 x 12 = .00 (18,) .00 x 15 = .00 (19,)= 1~,866.88 ANOUNT PAID ASSESSHENT OF TAX: 15. Aeoun~ of L/ne 1~ e~ Spousal ra~e 16. Aeoun'l; of L/no 1~ ~axable a~ L/noel/Class A ra~e 17. Aeoun~ of Line 1~ a~ Sibling ra~e 18. Aeoun~ of Line lq ~axable a~ Colla:~ora1/Class B ra~e 19. Pr/nc/pal Tax Duo TAX CREDITS: PAYNENT RECEIPT DZSCOUNT (+) DATE NUNBER INTEREST/PEN PAID (-) 08-19 - 2003 CDO 02922 736.84 02-18-200~ CD005580 . O0 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULAT/ON OF ADDITIONAL INTEREST. 14,000.00 130.0~ TOTAL TAX CREDIT ] 1~,866.88 BALANCE OF TAX DUE J .00 INTEREST AND PEN. I .00 TOTAL DUE I . 00 ( 1F TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUIRED. ZF TOTAL DUE 1S REFLECTED AS A "CREDIT- (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SZDE OF THIS FORN FOR INSTRUCTIONS. } RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraiso and assess transfer Inheritanco Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYNENT: --Hake chock or money order payable to: REGISTER OF HILLS, AGENT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may bo requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-I3i$). Applications ara available at tho Office of tho Register of Hills, any of tho 23 Revenue District Offices, or by calling the special 24-hour ansaaring service for forms ordering: 1-800-362-2080; services for taxpayers aith special hearing and / or speaking needs: 1-800-447-3020 (TT only). OBJECTIONS: Any party in interest not satisfied aith the appraisaoont, alloNancm, or disallowance of deductions, or assessment of tax (including discount or interest) as sheen on this Notice must object within sixty (60) days of receipt of this Notice by: --Nrittan protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, --election to have the matter determined at audit of the account of tho personal representative, OR --appeal to the Orphans' Court. ADHIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section ZI40 of the Inheritance and Estate Tax Act, Act Z$ of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit ~ith your payment to the Register of Rills printed on the reverse side. Factual errors discovered on this assessment should ba addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively corroctablo errors. If any tax due is paid ~ithin three (3) calendar months after the decedent's death, a five percent (52) discount of the tax paid is allowed. The 1SI tax amnesty non-participation penalty is computed on the total of tho tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you Nould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from tho date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (62) percent per annum calculated at a daily rate of .000164. All taxes ahich became delinquent on and after January 1, 1982 will bear interest at a rate .hich Nil1 vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicabZa interest rates for 1982 through 2004 ars: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ ZOZ ;000548 '~1~"~a-1991 112 .000301 ~ 92 .000247 1983 162 .000438 1992 92 .000247 ZOOZ 62 .000164 1984 112 .000301 1993-1994 72 .000192 2003 32 .000137 1985 132 .000356 1995-1998 92 .000247 2004 42 .000110 1986 102 .000274 1999 72 .000192 1987 XOZ .000274 ZOO0 7Z .000192 --Interest ls calculated as folloNs: INTEREST = BALANCE OF TAX UNPAID X NUIIBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent Hill reflect an interest calculation to fifteen (13) days beyond the date of the assessment. Xf payment is made after the interest computation date shone on the Notice, additional interest must be calculated. OR I. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: IRENE F. FULK . . : NO. 2003-00453 : Deceased. . . RECEIPT, RELEASE AND REFUNDING AGREEMENT A. BACKGROUND. The circumstances leading to the signing of this Receipt, Release and Refunding Agreement ("Receipt and Release") are as follows: 1. Irene F. Fulk died on May 25, 2003, leaving a Will dated June 4, 1987 ("the Will") in which William J. Phillips was named Executor. The Will was probated and Letters Testamentary were granted to William J. Phillips on June 3, 2003. (The Estate of Irene F. Fulk is herein referred to as "the Estate."). 2. Item III a.l of the Will gives $30,000 to daughter, PHYLLIS D. McCANN. 3. Item III b.1 of the Will gives $30,000 and one-haH of remainder of 50% after subtracting the $30,000, to grandson, DEAN J. FAULK. 4. Item III b.2 of the Will gives the other one-half of the remainder of 50% after subtracting $30,000, to granddaughter, TAMI S. WHITE. 5. Item III c. of the Will gives the other remaining 50% to daughter, PHYLLIS D. McCANN. 6. The undersigned wishes to effect a final distribution of his or her share under the Will without an accounting by the Executor and consents to this final distribution upon the terms and conditions stated in Section B below. B. TERMS. In consideration of the foregoing and this final distribution being made pursuant to this Receipt and Release, without a filing of the First and Final Account. 1. The undersigned represents and warrants that the undersigned has read and understands the foregoing Background, 2. The undersigned (a) agrees to refund to the Estate of Irene F. Fulk any amount which may be at any time be determined to have been erroneously distributed to the undersigned regardless of the cause of such erroneous distribution, (b) agrees that any period for the limitation of actions on collection of an erroneous distribution to the undersigned shall not commence as to him or her until the undersigned Executor shall have obtained actual knowledge of such erroneous distribution, 3. The undersigned releases and forever discharges William J. Phillips as Executor of the Estate from all actions, payments, accounts, liabilities and claims relating In any way to the advance distribution effected pursuant to this Receipt and Release. . 4. The undersigned agrees to Indemnify and hold harmless to the extent of the funds received by the undersigned hereunder, William J. Phillips in his capacity as Executor of the Estate, from and against any and all claims, losses, liability or damage (Including legal fees and costs in connection therewith) which she may suffer or which she may be subJected to by reason of carrying out the advance distribution being effected pursuant to this Receipt and Release, 5. The undersigned declares It to be the undersigned's intention that this Instrument shall be legally binding as an agreement of the undersigned and be binding upon the undersigned's heirs, executors, administrators and assigns. 6. The undersigned acknowledges that the total amount distributed to the undersigned pursuant to this Receipt and Release is $180,695.19. Dated: .J. / J. t / ~ 5', 2005 , I ~~.; P. {!Jt ~ PHY LIS D. McCAN I, COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ' .-, IN RE: IRENE F. FULK . . r".:::.-i : NO. 2003-00453 Deceased. . . (j: RECEIPT. RELEASE AND REFUNDING AGREEMENT A. BACKGROUND. The circumstances leading to the signing of this Receipt, Release and Refunding Agreement ("Receipt and Release") are as follows: 1. Irene F. Fulk died on May 25, 2003, leaving a Will dated June 4, 1987 (lithe Will") in which William J. Phillips was named Executor. The Will was probated and Letters Testamentary were granted to William J. Phillips on June 3, 2003. (The Estate of Irene F. Fulk is herein referred to as lithe Estate."). 2. Item III a.1 of the Will gives $30,000 to daughter, PHYLLIS D. McCANN. 3. Item III b.l of the Will gives $30,000 and one-half of remainder of 50% after subtracting the $30,000, to grandson, DEAN J. FAULK. 4. Item III b.2 of the Will gives the other one-half of the remainder of 50% after subtracting $30,000, to granddaughter, TAMI S. WHITE. 5. Item III c. of the Will gives the other remaining 50% to daughter, PHYLLIS D. McCANN. 6. The undersigned wishes to effect a final distribution of his or her share under the Will without an accounting by the Executor and consents to this final distribution upon the terms and conditions stated in Section B below. B. TERMS. In consideration of the foregoing and this final distribution being made pursuant to this Receipt and Release, without a filing of the First and Final Account. 1 . The undersigned represents and warrants that the undersigned has read and understands the foregoing Background, 2. The undersigned (a) agrees to refund to the Estate of Irene F. Fulk any amount which may be at any time be determined to have been erroneously distributed to the undersigned regardless of the cause of such erroneous distribution, (b) agrees that any period for the limitation of actions on collection of an erroneous distribution to the undersigned shall not commence as to him or her until the undersigned Executor shall have obtained actual knowledge of such erroneous distribution, 3. The undersigned releases and forever discharges William J. Phillips as Executor of the Estate from all actions, payments, accounts, liabilities and claims relating in any way to the advance distribution effected pursuant to this Receipt and Release. 4. The undersigned agrees to indemnify and hold harmless to the extent of the funds received by the undersigned hereunder, William J. Phillips in his capacity as Executor of the Estate, from and against any and all claims, losses, liability or damage (including legal fees and costs in connection therewith) which he may suffer or which he may be subjected to by reason of carrying out the advance distribution being effected pursuant to this Receipt and Release, 5. The undersigned declares it to be the undersigned's intention that this instrument shall be legally binding as an agreement of the undersigned and be binding upon the undersigned's heirs, executors, administrators and assigns. 6. The undersigned acknowledges that the total amount distributed to the undersigned pursuant to this Receipt and Release is $90,347.60. Dated: If!IJuJ :L , 2005 ~ J h;t1 DEAN r. FAULK I I. COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: IRENE F. FULK . . : NO. 2003-00453 <....::::. : Deceased' . . RECEIPT. RELEASE AND REFUNDING AGREEMENT c. A. BACKGROUND. The circumstances leading to the signing of this Receipt, Release and Refunding Agreement ("Receipt and Release") are as follows: 1. Irene F. Fulk died on May 25, 2003, leaving a Will dated June 4, 1987 (lithe Will") in which William J. Phillips was named Executor. The Will was probated and Letters Testamentary were granted to William J. Phillips on June 3, 2003. (The Estate of Irene F. Fulk is herein referred to as lithe Estate."). 2. Item III a.1 of the Will gives $30,000 to daughter, PHYLLIS D. McCANN. 3. Item III b.1 of the Will gives $30,000 and one-half of remainder of 50% after subtracting the $30,000, to grandson, DEAN J. FAULK. 4. Item III b.2 of the Will gives the other one-half of the remainder of 50% after subtracting $30,000, to granddaughter, TAMI S. WHITE. 5. Item III c. of the Will gives the other remaining 50% to daughter, PHYLLIS D. McCANN. 6. The undersigned wishes to effect a final distribution of his or her share under the Will without an accounting by the Executor and consents to this final distribution upon the terms and conditions stated in Section B below. B. TERMS. In consideration of the foregoing and this final distribution being made pursuant to this Receipt and Release, without a filing of the First and Final Account. 1. The undersigned represents and warrants that the undersigned has read and understands the foregoing Background, 2. The undersigned (a) agrees to refund to the Estate of Irene F. Fulk any amount which may be at any time be determined to have been erroneously distributed to the undersigned regardless of the cause of such erroneous distribution, (b) agrees that any period for the limitation of actions on collection of an erroneous distribution to the undersigned shall not commence as to him or her until the undersigned Executor shall have obtained actual knowledge of such erroneous distribution, 3. The undersigned releases and forever discharges William J. Phillips as Executor of the Estate from all actions, payments, accounts, liabilities and claims relating in any way to the advance distribution effected pursuant to this Receipt and Release. 4. The undersigned agrees to Indemnify and hold harmless to the extent of the funds received by the undersigned hereunder, William J. Phillips in his capacity as Executor of the Estate, from and against any and all claims, losses, liability or damage (including legal fees and costs in connection therewith) which she may suffer or which she may be subjected to by reason of carrying out the advance distribution being effected pursuant to this Receipt and Release, 5. The undersigned declares it to be the undersigned's intention that this instrument shall be legally binding as an agreement of the undersigned and be binding upon the undersigned's heirs, executors, administrators and assigns. 6. The undersigned acknowledges that the total amount distributed to the undersigned pursuant to this Receipt and Release is $ 60,347.60. Dated: r~. -2.s- ,2005 '7;A4UJ :vhi TAMI S. WHITE STATUS REPORT UNDER RULE 6.12 Name of Decedent: 1: RE: wE 'F. 'F UL..l<' Date of Death: fY\~ 2.5, '2003 Will No.: ..;t I - ;tOQ3 -06 ~ S-.3 Admin. No.: 2003- ocY53 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ~ No 0 2. Tfthe 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 .Kl b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes ~ No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts maybe filed with the Clerk of the Orphans' Court and may be attached to this report. ~y;LiJ(;JL~ Si~ W/~t4NA1 / ,PAI"t:'ft~ . Name ~ S-9~f ~()N6U~ w /Cd"'lO ~~/c!AP~'~' /7//Zo Date: ~-OS- 1_..!') <"i) C'-J Address 7/7-~S~.2-~ 7t 'Z- Telephone No. Capacity: jg! Personal Representative o Counsel for personal representative (