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03-0297
PETITION FOR PROBATE anti GRANT OF LEI-i'v:RS fczate o.f Ethel M. Roche also known as Ethel Mae Roche Deceased. Soctat Securtty No. 195-26-1860' To: Register of Wills for the Cotulty of Cumberland Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/~ 18 years of age or older an the execut_rix in the last will of the above decedent, dated December 13, 2001 and in codicil(s) dated named x~ (state r:ievant circumstance, ~.g. rentm~a~on, death of executor, etc.} Decendent was domiciled at death in Cumberland er .... New Cdmberlana h~ = la~ faj'ni[z orphic:pal res~c~ence at 1714 Sherwood ~,oa-~, County, Pennsylv.ania, with ~orougn, uumoer±ano uounty, ~ennsy±vanla Decendent, then 68 at 1714 Sherwood Road, (list street, number and muncipality} ~eears of age, died March 27, 2003 w Cumberland, PA Except a~ follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of thc will offered for probate; w~ not thc victim of a killing and wa~ never adjudicated incompetent: -- Decendent at death owned property with eatimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.~ Personal property in Pennsylva~a (If not domiciled in Pa.) Personal property in County Value of real estate in ~ennsyivan~a situated a~ follows: 35 Oreenspr'ing Dr-ire, Mechan-icsburg, PA $ 40,000.00 $ $ 98,000.00 WHEREFORE, petitionerts) respectfully presenteci herewith and the grant of letters theron. request(s) the probate of the l~t will and codicil(s) testamentary (t~tamemary; admmiatration c.t.a.; administration d.b.n.c.t.a.) 1714 Sherwood Road New Cumberland, PA 17070 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND The petitioner(r) a~ove-named swear(s) or affirm(s) that the statemenu in the foregoing petition are tr~e and correct :o the bes: of the knowledge and belief of petitioner(s) and that as personal represen- tat/vets) of the above decedent Deiitioner(s) will we. ll and truly adnlin~ter the eatate according to/aw. Sworn t2, ~r affirmed and subscribed [ before ~ ,.his ~-~,q~ ~ ~ day of Patsy J. Dunlap No. ~1-c~-..v92' . Estmle of Ethel M. Roche, a/k/a Ethel Mae Roche ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW j~.t'3v~/ 5g 7-~, 21~Cz~.5, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me. IT IS DECREED that the instrument(s) dated December 13, 2001 described therein be admitted to probate and filed of r~ord as the l~t will of Ethel M. Roche and Letters Testamentary are hereby granted to Patsy J. Dunlap FEES Pro,are, Letters, Etc .......... $~ Short Certificates( ) .......... $_~. ~ nuncmnon ................ $ ~,2. ~ TOTAL ~ ~, ~o Fiie~ .~, I..~,.. ~ ................. David H. Stone #39785 ATTORNEYfSup. CL'I.D. No.) 414 Bridge St., New Cumberland, PA 17070 ADDRF-~S (717) 774-7435 PHONE his is to certify, that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Ofrice for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH .. c~o~na I~. N~ C~b~and 1~. 1714 Sh~ood Rd I I "~ 7 4 Sh~ood Rd I~ ~ N~ C~b~and~ PA 17070 I~' ,~ e~m~o~a,d ~? ,,~~ i ...... Guy R. Kinn~man, Sr ~. P~q J. Du~ap ~ c,~O ~,~.,.0 ,~,.~, ~~.~c~.c,~ t~.c~.~..z,~ ~0 ,~ ~,~. A~ I. 2005 ~,.. M~. O~Jv~_ C~o*~ I~,~Ahho~z~num. PA 17~qfl - ]~,. 011305-L ~.F~ Fun~ Homz. Inc N~ 0x~ord. PA 17350 ' Iaa~' I~. ep\wills\ROCHEethel\12-01 LAST WILL AND TESTAMENT OF ETHEL M. ROCHE I, ETHEL M. ROCHE, of the Borough of New Cumberland, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I devise and bequeath all of my estate of every nature and wherever situate to my daughter, PATSY J. DUNLAP, if she survives me. Should my daughter, PATSY J. DUNLAP, fail to survive me, I devise and bequeath all of my estate of every nature and wherever situate to her issue, per stirpes. Should neither my daughter, PATSY J. DUNLAP, nor any of her issue survive me, I devise and bequeath all of my estate of every nature and wherever situate to my son-in-law, DARREN WAYNE DUNLAP. ITEM Iii: Should neither my daughter, PATSY J. Db%~LAP, nor any of her issue not my son-in-law, DARREN WAYNE DUNLAP, survive me, I devise and bequeathiall of my estate, of every nature and wherever situate, to the FIRSTiCHURCH OF GOD OF NEW CUMBERLAND. Page 1 of 5 ITEM III: I appoint my Executrix and her successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this ap- pointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM IV: I appoint my daughter, PATSY J. DUNLAP, Executrix of this my last will. Should my daughter, PATSY J. DUNLAP, fail to qualify or cease to act as Executrix, I appoint my son-in-law, DARREN WAYNE DUNLAP, Executor of this my last will. Should my son-in-law, DARREN WAYNE DUNLAP, fail to qualify or cease to act as Executor, I appoint DAVID H. STONE, Executor of this my last will. Page 2 of 5 ITEM V: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his/her duties in any jurisdiction. IN WITNESS W~EREOF, I, ETHEL M. ROCHE, have hereunto set my hand and seal this day of ~~ , 2001. ETHEL M. ROCHE SIGNED, SEALED, PUBLISHED and DECLARED by ETHEL M. ROCHE, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses. Wi t~~-~ ~-~ ' Address Witness J Address COMMONWEALTH OF PENNSYLVANIA: : SS: COUNTY OF CUMBERLAND : I, ETHEL M. ROCHE, the Testatrix whose name is signed to the at- tached or foregoing instrument, having been duly qualified according Page 3 of 5 to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. ETHEL M. ROCHE Sworn to or affirmed to and acknowledged before me by ETHEL M. ROCHE, the Testatrix, this /.~ day of .~ , 2001. ~otary Public COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : We, ~/'~"t3, ,-., f-.~ .] ~ and ~,__ ..~/._. the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she executed Page 4 of 5 it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed to and acknowledged before me by ~.~k~_),~ [4, J-o~%--~ and [~,~_~ .~~ , witnesses, this /~ day of ~~~_~" , 2001. /~Notary Public Page 5 of 5 LAST WYI,L AND TESTAMENT OF ETHEL M. ROCHE STONE, LAFAVER & SHEKLETSKI A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 414 BRIDGE STREET NEW GU!~4BERLAND, PA 17070 STONE, LAFAVER & SHEKLETSKI A PROFESSIONAL CORPORATION AT--AT LAW 414 BRIDGE STREET NEW GUMBERI.~24I), PA 17070 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name ef Decedent: Ethel M. Roche, a/k/a Ethel Mae Roche Date ef Death: Hatch 27, 2003 Will Ne. 2003-00297 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 te the following beneficiaries ef the above captioned estate en April 7, 2003. Patsy J. Dunlap 1714 Sherwood Road New Cumberland, PA 17070 Notice has now been given te all persons entitled thereto under Rule 5.6 (a ....................... il'.::::~ ...... /' Date: 't''. ~ , ;' ~ Dag~'~l~i...8..~ ..."St$ e, Esquire 414 Bridge Street New Cumberland, PA 17070 717-774-7435 Capacity: Personal Representative X Counsel for Personal Representative STATE OF PENNSYLVANIA IN RE: ESTATE OF ETHEL M ROCHE IN THE PROBATE COUR~ CUMBERLAND COUNTY? ESTATE NO. 21-03-0297 : STATEMENT OF CLAIM ! MBNA America hereby presents for filing against the above estate this statemen~.~f claiTM the amount of $ 359.77. 2. The basis for the claim is MBNA account number 4264298468409019 which was opened on 3-1-77. 3. The tax identification number of the claimant is 510331454. 4. The name and address of the claimant is MBNA America, P. O. BOX 15409 Wilmington, DE 19885-5409. 5. This claim IS NOT contingent. 6. This claim IS NOT secured. 7. The last payment made on the account was $150.00 on 3-6-03. Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief. Executed this ~7~ day of~/~/~)~( ,2003 NICOLE FRESE MBNA America Claimant State Of Delaware, County of New Castle IN WITNESS WHEREOF, I have set my hand and notarial seal this ~__.~-~day of [~/(/~ ,2003 My Commission Expires: 0 (~/~~O~~ Notary Public X165-1 CUSTOMER INFORMATION SYSTEM MD 05/14/03 * 4264298468409019 * USA 11:14:07 ETHEL M'ROCHE CURBAL: 359.77 CYCLE: 23 N CR LIN: 16500.00 STATUS: 5 CHANGED: 04/02/03 ***************************** APRIL STATEMENT ***************************** POST REFERENCE TRAN ......... DESCRIPTION BC ---AMOUNT--- NO ACTIVITY FOUND **** ***************************** APRIL STATEMENT ***************************** PREV BAL - PAY + SALE + CASH + F/C = NEW BAL 354.79 0.00 0.00 0.00 4.98 359.77 PF10=PAGE FORWARD PFll=TRANSACTION SUMMARY PF06=MARCH STMT PF09=FEBRUARY STMT PAl=BEGIN AGAIN 1 PA2=SYSTEM MENU IAC© 4-© 1 MBNAIS 192.168.16.20 0013CI05 2/31 IN RE: ESTATE OF ETHEL M ROCHE STATE OF PENNSYLVANIA IN THE PROBATE COURT: CUMBERLAND COUNTY ESTATE NO. 21-03-0297 STATEMENT OF CLAIM 1. MBNA America hereby presents for filing against the above estate this statement of claim in the amount of $ 359.77. 2. The basis for the claim is MBNA account number 4264298468409019 which was opened on 3-1-77. 3. The tax identification number of the claimant is 510331454. 4. The name and address of the claimant is MBNA America, P. O. BOX 15409 Wilmington, DE 19885-5409. 5. This claim IS NOT contingem. 6. This claim IS NOT secured. 7. The last payment made on the account was $150.00 on 3-6-03. Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief. Executed this ~ day of~'/~'/~~ ,2003 NICOLE FRESE MBNA America Claimant State Of Delaware, County of New Castle IN WITNESS WHEREOF, I have set my hand and notarial seal this '~__~ day of (~ ~ ,2003 X165-1 CUSTOMER INFORMATION SYSTEM MD 05/14/03 * 4264298468409019 * USA 11:14:07 ETHEL M'ROCHE CURBAL: 359.77 CYCLE: 23 N CR LIN: 16500.00 STATUS: 5 CHANGED: 04/02/03 ***************************** APRIL STATEMENT ***************************** POST ....... REFERENCE ....... TRAN - DESCRIPTION ....... BC ---AMOUNT--- NO ACTIVITY FOUND ***************************** APRIL STATEMENT ***************************** PREV BAL - PAY + SALE + CASH + F/C = NEW BAL 354.79 0.00 0.00 0.00 4.98 359.77 PF10=PAGE FORWARD PFll=TRANSACTION SUMMARY PF06=MARCH STMT PF09=FEBRUARY STMT PAl=BEGIN AGAIN 1 PA2=SYSTEM MENU IACO 0013CI05 2/31 4-© 1 MBNAIS 192.168.16.20 STATE OF PENNSYLVANIA IN RE: ESTATE OF ETHEL M ROCHE IN THE PROBATE COURT: CUMBERLAND COUN~i: ESTATE NO. 21-03-0297~i~I- STATEMENT OF CLAIM MBNA America hereby presents for filing against the above estate this stateme~ of cla(~nS~'~n the amount of $ 224.66. 2. The basis for the claim is MBNA account number 4264296024110006 which was opened on 3-7-85. 3. The tax identification number of the claimant is 510331454. 4. The name and address of the claimant is MBNA America, P. O. BOX 15409 Wilmington, DE 19885-5409. 5. This claim IS NOT contingent. 6. This claim IS NOT secured. 7. The last payment made on the account was $127.48 on 3-3-03. Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are tree, to the best of my knowledge and belief. Executed this '::~.--' day of NICOLE FRESE ,2003 MBNA America Claimant State Of Delaware, County of New Castle IN WITNESS WHEREOF, I have set my hand and notarial seal this ~---~ day of ~{ ~ ,2003 Notary Public My Commission Expires: X165-1 CUSTOMER INFORMATION SYSTEM MD 05/14/03 * 4264296024110006 * USA 11:16:50 ETHEL*ROCHE CURBAL: 224.66 CYCLE: 17 N 0000000000000000 CR LIN: 14600.00 STATUS: 5 CHANGED: 04/02/03 ***************************** APRIL STATEMENT ***************************** POST REFERENCE TRAN DESCRIPTION' BC ---AMOUNT--- NO ACTIVITY FOUND **** ***************************** APRIL STATEMENT ***************************** PREV BAL - PAY + SALE + CASH + F/C = NEW BAL 221.82 0.00 0.00 0.00 2.84 224.66 PF10=PAGE FORWARD PFll=TRANSACTION SUMMARY PF06=MARCH STMT PF09=FEBRUARY STMT PAl=BEGIN AGAIN 1 PA2=SYSTEM MENU IACO 4-© 1 MBNAIS 192.168.16.20 0013CI05 2/31 IN RE: ESTATE OF ETHEL M ROCHE STATE OF PENNSYLVANIA IN THE PROBATE COURT: CUMBERLAND COUNTY ESTATE NO. 21-03-0297 STATEMENT OF CLAIM 1. MBNA America hereby presents for filing against the above estate this statement of claim in the amount of $ 224.66. 2. The basis for the claim is MBNA account number 4264296024110006 which was opened on 3-7-85. 3. The tax identification number of the claimant is 510331454. 4. The name and address of the claimant is MBNA America, P. O. BOX 15409 Wilmington, DE 19885-5409. 5. This claim IS NOT contingent. 6. This claim IS NOT secured. 7. The last payment made on the account was $127.48 on 3-3-03. Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief. Executed this .z~ day of NICOLE FRESE ,2003 MBNA America Claimant State Of Delaware, County of New Castle IN WITNESS WHEREOF, I have set my hand and notarial seal this ,~ day of ~,~/{ ~ ,2003 My Commission Expires: ~ _/~~~/~F~~ Notary Public X165-1 CUSTOMER INFORMATION SYSTEM MD 05/14/03 * 4264296024110006 * USA 11:16:50 ETHEL*ROCHE CURBAL: 224.66 CYCLE: 17 N 0000000000000000 CR LIN: 14600.00 STATUS: 5 CHANGED: 04/02/03 ***************************** APRIL STATEMENT ***************************** POST REFERENCE ....... TRAN DESCRIPTION BC ---AMOUNT--- NO ACTIVITY FOUND **** ***************************** APRIL STATEMENT ***************************** PREV BAL - PAY + SALE + CASH + F/C = NEW BAL 221.82 0.00 0.00 0.00 2.84 224.66 PF10=PAGE FORWARD PFll=TRANSACTION SUMMARY PF06=MARCH STMT PF09=FEBRUARY STMT PAl=BEGIN AGAIN 1 PA2=SYSTEM MENU IACO 4-© 1 MBNAIS 192.168.16.20 0013CI05 2/31 132181 PROBATE COURT 136V26 NF9019 ESTATE Ven( ETHEL rs: To avoid L4-MAY- 03 5.00 0 . 00 tE :OTALS 5.0 0 0 ~yment delay invoice lines : match DETACH AND RETAIN THIS STATEMENT. THE ATTACHED CHECK i8 IN PAYMENT OF THE ITEM8 DESCRIBED ABOVE, IF NOT CORRECT, PLEASE NOTIFY U8 P MBNA Wilmington, DE 19850 12762325 PROBATE COURT CUMBERLAND COUNTY PROBATE 1 COURTHOUSE SQUARE RM 102 CARLISLE, PA 17013 132181 PROBATE COURT 1276232E 136V26 NF0006 ESTATE Venl ETHEL irs: To avoid MBNA P.O. Box 15546 Wilmington, DE 19850 4-~Y-03 ?OTALS yment dela 12762326 PROBATE COURT CUMBERLAND COUNTY PROBATE i COURTHOUSE SQUARE RM 102 CARLISLE, PA 17013 5.00 5.00 invoice lines 0.00 0 match purchm order lines. 5.00 5.00 Estate Recoveries, Inc. Over 15 Years of Service to the Financial Industry Register Of Wills Cumberland County Courthouse 1 Courthouse .Square Carlisle, PA 17013-3387 June t 7. 2003 Estate Of Ethel M Roche, deceased. Our File#: RFL-38895 Estate #: 2103297 Dear Sir/Madam: Enclosed please find our claim regarding the above captioned estate which is being filed on behalf of Fleet Credit Card Services, L.P., creditor. A copy of this claim is being forwarded to Patsy J. Dunlap, Representative for the estate. If you have any questions concerning the attached claim, please do not hesitate to contact this office. NAP Enclosure Sincerely, Nicole A. Pate, Ext. 149 See Reverse Side For Special State Disclosures. This communication is from a debt collector. This is an attempt to collect a debt and any information obtained will be used for that purpose. P.O. Box 24566, Baltimore, Maryland 21214 · 5543 Harford Road, Baltimore, Maryland 21214 Monday- Friday 8:00 am- 6:00 pm Eastern Time · Telephone: 410-444-8022 · 800-229-8472 · Fax: 410-426-4051 Special State Disclosures Colnrado You may request Estate Recoveries, Inc. to cease calling you tit your place of residence or place of employment. This request must be made in writing aud once received no further contact hy telephone shall be made. It' you refuse to pay the debt or you wish Estate Recoveries, Inc. to cease further communication with 3ou, then tiffs agency will nut communicate ~'urther wilh you ~ith respect to such debt except for a written communication which: a. Advises you that this agency's further efforts are being terminated; b. Notifies you that this agency may invoke specified remedies which are ordinarily invoked by this ageucy; or c. Notifies ynu thai the agenc3 intends to imoke a specified reined3 permitted by law. Es(att Recoveries, luc. is liceused by the Colorado Collection Agency Board, 1525 Sherman Street, Fifth Fit}on Denver, Cnloradn 8tt203. I)o not send payments to this board. Maine The business hours tk~r Estate Recoveries, Inc. are Monday - Friday 8:00 a.m. - 6:00 p.m. Eastern l'ime. This agency may be contacted using the folh)wing nmnbers: 800-229-8472 or 410-444-8022, Fax: 410-426-4051 Massach tisetts Notice of hnportant Rights: You have the right to make a written or oral request that telephone calls regarding your debt not be made to you at your place of employment. Any such oral request will be valid fi)r only ten clays unless you provide written confirmation nf' the request postmarked or delivered within seven days of such re- quest. You may terminate this request by writing to Estate Recoveries, Inc. at 15 Union Street.. l.awrence. MA I)184{t. Hours fur Massachusetts are: Monday - Thursday: 8:00 a.m. - 8:1)0 p.m, Friday: 8:t)0 a.m. - 5:00 p.m.. Saturday: 8:00 a.m. - 12:{}0 p.m. Eastern Time. Minnesota Estate Recoveries, Inc. is licensed by the Minnesota Department of Commerce. New York The license number fi}r Estate Recoveries, lnc. in New York City is as follows: 0976707 : North Carolina The permit number for Estate Recoveries, Iuc. in North Carolina is as fullows: 3523 Tennessee This collection agency is licensed by the Collection Service Board, State Department of Commerce and Insurance, 51}0 James Robertson Parkway, Nashville, Tennessee 37243. IN THE MATTER OF ESTATE OF: ETHEL M ROCHE A/K/A ETHEL MAE ROCHE STATE OF PENNSYLVANIA IN THE ORPHANS COURT OF CUMBERLAND COUNTY ESTATE#: 2103297 DATE OF DEATH: 03/27/03 STATEMENT OF CLAIM 1. The creditor, Fleet Credit Card Services, L.P., certifies that there is due and owing by ETHEL M ROCHE, deceased, the sum of SIX HUNDRED FIVE DOLLARS AND FORTY TWO CENTS ($ 605.42). 2. The nature of the claim is a VISA CARD account 4305500015612081, which was established in 10/03/00. 3. The name and address of the claimant is: Fleet Credit Card Services, L.P., 550 Blair Mill Road, Horsham, Pennsylvania 19044. 4. The name and address of the claimant's agent is: Nicole A. Pate, Estate Recoveries, Inc., P. O. Box 24566, Baltimore, Maryland 21214. 5. This claim is not contingent and is not secured by any liens or judgrnents. The last payment on the account was made on 03/14/03 in the amount of $100.00. 6. This claim is not based on any one instrument. Said balance has accrued since the account was established. On behalf of Fleet Credit Card Services, L.P., creditor, I do solemnly declare and affirm under the penalties of perjury that the information in the foregoing claim is true and correct to the best of my knowledge, information and belief. I have made diligent inquiry and examination, and I believe the claim is just and all legal offsets, payments, and credits made known to the affiant have been allowed. County of Baltffl~0'~, Ma nd: .2) ~ IN WITNESS WHEREOF, I hereunto My Commission Expires: September NICOLE A. PATE Estate Recoveries, Inc. P.O. Box 24566 Baltimore, Maryland 21214 (410) 444-8022 set my hand and Notarial Seal this June 17, 2003. ~ISA M. GERKE, Not'~ry Public IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION I I File No. 2103297 Estate of Ethel M Roche A/K/A ETHEL MAE ROCHE I I I , Deceased NOTICE OF CLAIM by N~COLE A. PATE, AGENT gOR lrI,I~ET CREBIT CARD ~RERVICEg: Filed Pursuant to Section 3532 (b) (2) of the Probate, Estate, and Fiduciary Code, 20 Pa. C.S.A §3532 (b) (2) . To the Clerk of the Orphans' Court Division: Enter the claim o ~co;,r, A. PATE: AGENT FOR FI,EET CREmT eARn ~qERVmEg: ~,.V. (Claimant) in the amount of $605.42 , against the above entitled estate. The Decedent, who resided at New Cumberland, PA 17070-1454 (City) Pennsylvania, died on Mureh 27; 2001 1714 gherwood Rd (Street Address) , C.mherland County, Written notice of said claim was given to Patay J. Dunlap (Personal Representative, or If known to claimant, at 1714 Sherwood Road his Counsel) New Cumberland, PA 17070 ,on June 17.. 2003 Claimant's Counsel: (Address) (Date) NICOLE A. PATE, AGENT , Claimant Post Office Box 24566~ Baltimore~ Maryland 21214 (Address) (Address) COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHAN'S COURT DIVISON NO. 2103297 ESTATE OF: ETHEL MROCHE A/K/AETHELMAEROCHE deceased. Notice of Claim by FLEET CREDIT CARD SERVICES, L.P. f'ded pursuant to Section 3532(b) (2) of the PEF Code. Nicole A. Pate, Agent ESTATE RECOVERIES, INC. P.O. Box 24566 Baltimore, Maryland 21214 (410) 444-8022 Fleet A~ N~4305 5000 1561 2081 ~ ~ ~ h~p:llmy~rd.~Lc~ FLEET CREDIT CARD SERVICE PO BOX 15368 WILI~NGTON DE 19886~8 98865365682! ETHEL M ROCHE 1714 SHERVVOOO RD NEVV CUMBERLAND PA 17070-1454 T[70701434i46[ 4305500015612081 0080275 0001600 ACCOUNT SUMMARY FOR ~-~ E~EL,, .oc.E ~_~ Fleet PLATINUM ~.,~ N..,~. 4305 5000 1561 2081 PAYME~ IN~AT~N ~ ~ $~8.57 h :~&~/':::~ ~ "= ' t08.57 Ca~ ~n~ Avi~ble: ~.00 Total C~'ldlt Umlt: $12,~0.00 Cash Advlnce Umit: Available Credit: $11,197.25 O.O0 2.75 $802.75 II~llln9 Cycie Closing Date: 41 rZ4~3 ~ tn BillinG Cycle: 31 A RECORD OF YOUR CHARGES AND CREDITS ANNUAL PERCENTAGE RATE for purch~.~. ANNUAL PERCENTAGE RATE for ca~ adva~ (Indud~s any flnanc~ charge f~): 1g J00% INFORMATION FOR YOU 4305 5000 1561 2081 ~,,~,~ $a4.o° FLEET CREDIT CARD SERVICE PO BOx t 5368 WILMINGTON DE 19886-5368 ETHEL M ROCHE 1714 SHERWOOD RD NEW CUMBERLAND PA 170T0-1454 !19856536~682! q70701454]46! 4305500015612081 0070284 0001400 ACCOUNT SUMMARY FOR E'mE, M.OC.E 4~._~. Fleet PLATINUM *~-,.,,,~..,-,:. 4305 5000 1561 2081 f:-.:.~. -~.,,. · .02.75 102.75 [!~i:::F~:~ '. :: .: $S,~4)0.00 Cash AASrancm Avallab~e:$~,~O,O0 PAYMENT INFORMATION $0.00 Total CrmJit Umll: $12,000.00 Cash Advance Umlt: Ava#able Credit: S11,2~7.16 0,00 2.~4 $702 Billing Cycle Cioalng Oatl: 07J25~93 Days In Billing CyrJe: 32 A RECORD OF YOUR CHARGES AND CREDITS ANNUAL PERCENTAGE RATE ~, pumhates and balenc~ mms~m (lnclud.~ any flnanca charg~ tees): 9,490% ANNUAl. PERCENTAGE RATE for ca.h ~h,anc~ p~=M~ a.y Ilrmnc* charge fee~); 10.800% INFORMATION FOR YOU TRAVEL. FOR QUESTK)NS ABOUT THIS VALUABLE BENEFIT CALL 1-800-492.2500 O~ WR/TE TO THE CURRENT PI.AN ADMINISTRATOR: ENHANCEMENT SERVICES,PO BOX !0317, RICHMOND. VA 2323~g317. Fleet A~m~ N~mb~r 4305 5000 1561 2081 FLEET CREOIT CARD SERVICE PO BOX 15388 WILb#NGTON DE 19886-5368 !198K65365682! ETHEL M ROCHE 1714 SHERWOOD RD NEVV CUMBERLAND PA 17070-1454 r170701454)46! 4305500015612081 0060542 0001200 ETHEL M ROCHE Fleet PLATINUM A.~.,...,~-: 4305 5000 1561 2081 ~m~!l~a~,.--. :i~"::?"~' $702.~4 I::::?:'. ~::~i"i'~',:':.:' ~,B~.O0 PAYMENT INFORMATION f~'::::' !~""~.:: ".:' ;:: :;'; ~o.60 $t2.00 To~al Credit Umlt: $12,0~0.80 Clsh/dvanca limit: Available Crsdit: $11,3~4,$8 0.00 0,00 2.58 BI#lng Cycle CIo~lng Date: 03/2~03 nays II1 Billing Cycle: ENCLOSED IS OUR UPDATED PRIVACY POLICY, WHICH WE ARE REQUIRED TO PROVIDE YOU EACH YEAR. THIS UPDATED POLICY DESCRIBES OUR PRIVACY COMMITMENT TO YOU AND REPLACES ANY OTHER DISCLOSURES FIRST MADE BEFORE MARCH I, 2003 REGARDING OUR INFORMATION PRACTICES. A RECORD OF YOUR CHARGE~ AND CREDITS ANNUAL PERCENTAGE RATE ~ ANNUAL. PERCENTAGE RATE k= INFORMATION FOR YOU 4305 5000 1561 2081 $24.00 MAY 27, 2003 co.mmw ~ ~ 1-800-492-2500 m ~o~ on to http://mycard.flaeLcom FLEET CREDIT CARO SERVICE PO BOX 15368 WILMINGTON DE 10886.5368 EST OF:ETHEL M ROCHE 17 t4 SHERWOOD RD NEW CUMSERLAND PA 17070-1454 H98865368682! !170701454146! 4305500015612081 0064042 0002400 ACCOUNT SUMMARY FOR ES, O.:E'"E'".OC.E ~ Fleet PLATINUM ~m ~--~,.: 4305 ~ 1~1 2~1 PA~ENTINFO~ATION ' '~1~;~ '": :':' ~5.4Z [ ~,.: :~;~ ~ s~2.~ I o.oo r::':": ' MAY ~, ~31 ~o.~2 Total Or, lit Umll: $12,000.00 Cuh klvan~ Limit: Available Credit: $3,600.06 BIIHng C-/cie CIo~llng Oale: 04/36/03 Ca~.h Advance Available:$0.0ODay, In Billing Cycle: 35 A RECORD OF YOUR CHANGES AND CREDITS ANNUAL PERCENTAGE RATE for purc~ ANNUAL PERCENTAGE RATE fo~ cash advanc~ (Inc~ud.s .ay a~ance char~ f~sl: 1La0O% INFORMATION FOR YOU DUE ;I~MOUNT IMMEDIATELY YOU MAY NOW MAKE ~ N.,.v,b~4305 5000 1561 2081 ~alane. :: $640.42 FLEET CREDIT CARD SERVICE PO BOX 15:368 WILMINGTON DE 1988~5368 EST OF:ETHEL M ROCHE 1 ? 14 SHERWOOD RD NEW CUMBERLAND PA 17070-14~4 4305500015612081 0064042 0003'700 ACCOUNT SUMMARY FOR Es'r OF:GT,,,.,* ,OC, E Fleet P~TINUM PAYMENT INFO~ATION J' "-"~J~:~ :: ~?~ ~ · ~ $~.42 : - o.~ $24.00 $13.00 TO~I Crtdll Umlt: $12,000.00 Cash Ao'v~nc. Ll~lt: Av~lla Me Cr~llt: 0.~0 0.00 $640.42 $3,6QO,OO Billing Cycle Closing D&te: Cash Ad~,ra ncc Ava#a ble: $0.00 Days In Btlllng Cycle: ~0 A RECORD OF YOUR CHARGES AND CREDITS Tm Po~ng AHNUAL PERCENTAGE RATE IM ~mhases and b~n=~ ~ (In,-,~ my Rn.n~ ~ k~):24.9~0% ANNUAL PERCENTAGE RATE l~ ~ a~h~n~.~ 0-"u~s any I~.¢e ~r~ ~ 24.990% INFORMATION FOR YOU 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 002746 STONE DAVID HEAN ESQUIRE 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 ........ fold ESTATE INFORMATION: SSN: 195-26-1860 FILE NUMBER: 2103-0297 DECEDENT NAME: ROCHE ETHEL M DATE OF PAYMENT: 06/27/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/27/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $5,000.00 TOTAL AMOUNT PAID: $5,000.00 REMARKS: PATSY J DUNLAP C/O DAVID H STONE ESQUIRE SEAL CHECK# 07654 INITIALS: VZ RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS MBNA America P. O. Box 15409 Wilmington, DE 19885-5409 David H Stone 414 Bridge St PO Box E New Cumberland, PA 17070 (0937) RE: Estate of Ethel M Roche Account # 4264298468409019 transferred to 4264298997910669 February 2, 2004 Dear Sir or Madam: SATISFACTION AND RELEASE OF CLAIM The undersigned creditor, MBNA America, whose social security or tax identification number is 510331454, has received full payment of the claim filed in this proceeding by the undersigned against the Estate of Ethel M Roche, deceased, on or about, May 20, 2003 or has otherwise settled or compromised said claim, and this Satisfaction and Release of Claim is executed to acknowledge discharge of claim and to release the estate and the Personal Representative of the estate from all further liability with respect thereto. D~ED ~ February 2, 2004 MBNA AMERICA ( eSnifer Uo re (8 8)46 - 262 ~tomer Advocate IN RE: ESTATE OF: ETHEL M. ROCHE DECEASED. ESTATE NO. 2103297 SATISFACTION AND RELEASE OF CLAIM The undersigned, Jaime L. Bengies, Agent for FLEET CREDIT CARD SERVICES, has received a pro-rata distribution of $454.07 equal to 75%, satisfying the claim filed in this proceeding on behalf of the Creditor to the extent of insolvency of the estate. This satisfaction and Release of Claim is executed to acknowledge discharge of the claim and to release the estate and personal representative from all further liability in respect to the date of death liability on account number 4305500015612081. Executed this December 12, 2003. FLEET CREDIT CARD SERVICES Claimant By ~ ,~, c.~?f, ~ ~--o J~J, ME L. BENGIES, Agent v Estate Recoveries, Inc. P.O. Box 24566 Baltimore, MD 21214 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 28O601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) 003345 STONE DAVID HEAN ESQUIRE 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 ........ fold ESTATE INFORMATION: SSN: 195-26-1860 FILE NUMBER: 2103-0297 DECEDENT NAME: ROCHE ETHEL M DATE OF PAYMENT: 1 2/1 9/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/27/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $351.21 TOTAL AMOUNT PAID: $351.21 REMARKS: PATSY J DUNLAP C/O DAVID H STONE ESQUIRE CHECK# 1037 SEAL INITIALS' JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS LLI z Z I- O X I--- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I-7-5 '-7 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Roche, Ethel M a/k/a Ethel Mae DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 03/27/2003 04/22/1934 FILE NUMBER 21 COUNTY CODE OFFICIAL USE ONLY -- 2003 0297 YEAR NUMBER SOCIAL SECURITY NUMBER 195-26-1860 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I X I 1 Original Return I~ 4. Limited Estate ~-~ 6 Decedent Died Teslate (Attach copy of Will) [~ 9. Litigation Proceeds Received L~ 2. Supplemental Return E~ 3. Remainder Return (date of death prior to 12-13-82) E~4a. Future Interest Compromise (date of death after 12-12-82) ~] 5. Federal Estate Tax Return Required [~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) -- 8. Total Number of Safe Deposit Boxes r-~ 10 spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ~] 1 1. Election to tax under Sec. 91 13(A)(^ttac~ Sch O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME David H. Stone, Esquire FIRM NAME (If Applicable) Stone LaFaver & Shekletski TELEPHONE NUMBER 717-774-7435 COMPLETE MAILING ADDRESS 414 Bridge Street New Cumberland, PA 17070 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 Properly (Schedule F) (6) [~-] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 1 0. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1 1. Total Deductions (totat Lines 9 & 10) 12. Net Value of Estste (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) 108,000.00 0.00 0.00 0.00 15,296.71 0.00 37,737.95 (6) OFFICIAL USE ONLY 161,034.66 27,059.62 9,211.31 (11) 36,270.93 124,763.73 0.00 124,763.73 (12) (13) 14. Net Value Subject to Tax (Line 1 2 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 1 5. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 7. Amount of Line 14 taxable at sibling rate 8. Amount of Line 14 taxable at collateral rate. 9. Tax Due 0. O0 x .00 (15) 124,763. 73 x .045 (16) 0.00 x .12 (17) 0.00 x .15 (18) (19) > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 0.00 5,614.37 0.00 0.00 5,614.37 2W4645 1.000 · Deceder~t's Complete Address: STREET ADDRESS 1714 Sherwood Rd. Cl~ New Cumberland STATE ZIP 17070 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 5,000.00 263.16 0.00 0.00 (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) 5,614.37 5,263.16 0.00 351.21 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (5B) 351.21 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~ E~ c. retain a reversionary interest; or ................................ E~ E~ d. receive the promise for life of either payments, benefits or care? ................. E~ E~ 2. if death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................ E~ ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? [~ [~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ [~ [~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATUI:~F..I~PERS,ON RESPONSIBLE FOR FILING RETURN ' 1714 Sherwood Roa~ New Cumberland, PA 17070 SIGNA~ ~~PRESENTATIVE DATE DATE 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.§ 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 statutow 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 1.000 REV-1502EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Roche, Ethel M a/k/a Ethel Mae 21-2003-0297 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to bay or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1. Mechanicsburg, 108,000.00 Baney on October 17, Property located at 35 Greenspring Rd., Cumberland County, PA sold to Jeremy R. 2003 TOTAL (Also enter on line 1, Recapitulation) $ 108 ~ 000.00 2w4695 2.000 (If more space is needed, insert additional sheets of the same size) REV-1508 E;( + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Roche, Ethel M a/k/a Ethel Mae 21-2003-0297 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F, ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2 3 4 5 6 7 8 9 Waypoint-Cert. of Deposit #8000034876 Waypoint-Checking Acct. #90615683 Waypoint-Savings Acct. #10129210 AARP-refund Highmark-refund on premium PNC Bank-refund on service charge TV Guide-refund on subscription The Evening Sun-refund on paper Travelers Insurance-refund on house insurance TOTAL (Also enter on line 5, Recapitulation) $ 5,009.01 602 14 9,007 54 18 00 400 89 0 5O 41 46 97.17 120.00 15,296.71 2W46AD 2.000 (if more space is needed, insert additional sheets of the same size) REV-1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Roche, Ethel M a/k/a Ethel Mae 21-2003-0297 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DATE OF DEATH DECD'S EXCLUSION DECEDENT AND THE DATE OF TRANSFER. A"CI'ACH A COPY OF THE TAXABLE VALUE NUMB ER DEED FOR REAL ESTATE. VALUE OF ASS ET INTEREST (IF APPLICABLE) 1. Waypoint Bank-IRA #1300041453, 37,737.95 100.00 0.00 37,737. 95 Princ. $37,600.55, Int. $137.40 TOTAL (Also enter on line 7, Recapitulation) $ 37,737.95 (If more space is needed, insert additional sheets of same size.) 2W46AF 2.000 , REV-1511 EX +¢1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Roche, Ethel M a/k/a Ethel Mae 21-2003-0297 Debts of decedent must be reported on Schedule I. iTEM NUMBER DESCRIPTION AMOUNT 2 3 4 5. 6. 7. 8 9 10 11 Tota FUNERAL EXPENSES: Feiser Funeral Home-funeral expenses Back Woods Florist-flowers for funeral Patsy Dunlap-Reimb. luncheon, tombstone cards, etc. Patsy Dunlap-Reimb. funeral ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address for grave digging, funeral engraving and miscellaneous on organist and soloist at City State __ Zip Year(s) Commission Paid: AttorneyFeesNante: David H. Stone, Esquire Family Exemption: (if decedent's address is not the same as claimant's, attach explanation) Claimant Dunlap, Patsy J StreetAddress 1714 Sherwood Road City New Cumberland State PA Zip 17070 daughter Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Cumberland County Law letters The Patriot News Co.-advertising PPL-electric at property United Water-water service at property Sweitzer Self Storage-may rental Journal-advertising grant of grant of letters 1 from continuation pages .... TOTAL (Also enter on line 9, Recapitulation) $ 7,469.90 185.50 607.61 175.00 0.00 8,050.00 3,500.00 269.00 0.00 0.00 75.00 217.51 4.32 6.75 94.34 6,404.69 27,059.62 2W46AG 2.000 (If more space is needed, insert additional sheets of same size) Estate of: Roche, Ethel M a/k/a Ethel Mae Schedule H, Part A -- Funeral Expenses Page 2 21-2003-0297 Item No. Description Patsy Dunlap-Reimb. for Pastor Hamsher' services at funeral Amount 125.00 TOTAL. (Carry forward to main schedule) ...... 125.00 Estate of: Roche, Ethel M a/k/a Ethel Mae Schedule H, Part B -- Administrative Costs I tern No. Description 12 Patsy Dunlap-Reimb. on painting supplies for property 13 PPL-electric at property 14 Silver Spring Township-sewer services at property 15 Patsy Dunlap-Reimb. on painting supplies 16 Sweitzer Self Storage-June rental 17 PNC Bank-check printing fee 18 United Water-water service at property 19 PPL-electric at property 20 Debra Basehore Wiest-real estate taxes on property 21 22 Sweitzer Self Storage-July rent M & Z Carpets-on account of new carpet for the property 23 Matt Shelley-services rendered at property 24 PPL-electric service at property 25 United Water-water service at property 26 27 M & Z Carpets-balance due on carpet for property Patsy Dunlap-Reimb. on supplies from Home Depot and Lowes 28 29 Steve Billow-repairs done in kitchen Penn Water-trash services at property from Jan., Feb., and March 2003 30 Sweitzer Self Storage-August rent Page 2 21-2003-0297 Amount 116.24 19.74 80.75 55.90 94.34 27.60 7.00 16.00 282.92 94.34 600.00 80.00 23.60 6.50 1,133.55 330.46 30.00 36.70 94.34 TOTAL. (Carry forward to main schedule) ...... 3,129.98 Estate of: Roche, Ethel M a/k/a Ethel Mae Schedule H, Part B -- Administrative Costs Page 3 21-2003-0297 Item No. Description Amount 31 Patsy Dunlap-Reimb. on supplies at ~ome Depot and Lowes 301.72 32 Patsy Dunlap-Reimb. on supplies from Walmart, Home Depot, and Lowes 199.41 33 Patsy Dunlap-Reimb. on supplies from Country Market, Home Depot, and Lowes 192.70 34 PPL-electric service at property 23.94 35 United Water-water service at property 6.75 36 Patsy Dunlap-Reimb. on supplies from Hepfers True Value, Home Depot, and Weis 196.69 37 Sweitzer Self Storage-September rent 94.34 38 Patsy Dunlap-Reimb. on supplies 32.08 39 Debra Basehore Wiest-school taxes on property 908.17 40 PPL-electric services at property 20.10 41 United Water-water service at property 15.39 42 43 Silver Spring Township-sewer services at property Patsy Dunlap-Reimb. on supplies 80.75 19.04 44 45 Sweitzer Self Storage-Oct., Nov. & Dec. rent Settlement costs on sale of property ($1,179.50) less reimb, on taxes ($720.13) 283.02 459.37 46 47 Postmaster of New Cumberland-stamps PPL Corporation-electric at property 37.00 19.35 TOTAL. (Carry forward to main schedule) ...... 2,889.82 Estate of: Roche, Ethel M a/k/a Ethel Mae Schedule H, Part B -- Administrative Costs Page 4 21-2003-0297 Item No. Description 48 United Water-water service at property Amount 9.89 49 Reserve for filing Inheritance tax and Inventory and closing expenses 250.00 TOTAL. (Carry forward to main schedule) ...... 259.89 i~,EV-1512 EX~ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENTDECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES,& LIENS ESTATE OF FILE NUMBER Roche, Ethel M a/k/a Ethel Mae 21-2003-0297 Include ITEM NUMBER 2 3 4 unreimbursed medical expenses. DESCRIPTION Chase Bank-credit card balance Capital One-credit card balance MBNA-credit card balance Hanover General Hospital-services rendered to decedent prior to death Fleet Credit Card-credit card balance TOTAL (Also enter on line 10, Recapitulation) AMOUNT 3,430.00 150.00 179.88 4,997.36 454.07 9,211.31 2W46AH 2.000 (If more space is needed, insert additional sheets of the same size) · R4EV-1513 ES+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Roche Ethel M NUMBER FILE NUMBER a/k/a Ethel Mae 21-2003-0297 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLEDISTRIBUTIONS[includeoutrightspousaldistributions, andtransfers underSec, 9116(a)(1.2)] Dunlap, Patsy J 1714 Sherwood Road New Cumberland, PA 17070 daughter AMOUNT OR SHARE OF ESTATE 124,763.73 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 2W46AI 1.000 (If more space is needed, insert additional sheets of the same size) $ 0.00 · · ep\wills\ROCHEethel\12-01 LAST WILL AND TESTAMENT OF ETHEL M. ROCHE I, ETHEL M. ROCHE, of the Borough of New Cumberland, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I devise and bequeath all of my estate of every nature and wherever situate to my daughter, PATSY J. DUNLAP, if she survives me. Should my daughter, PATSY J. DUNLAP, fail to survive me, I devise and bequeath all of my estate of every nature and wherever situate to her issue, per stirpes. Should neither my daughter, PATSY J. DUNLAP, nor any of her issue survive me, I devise and bequeath all of my estate of every nature and wherever situate to my son-in-law, DARREN WAYNE DUNLAP. ITEM II: Should neither my daughter, PATSY J. DUNLAP, nor any of her issue nor my son-in-law, DARREN WAYNE DUNLAP, survive me, I devise and bequeath all of my estate, of every nature and wherever situate, to the FIRST CHURCH OF GOD OF NEW CUMBERLAND. Page 1 of 5 ITEM III: I appoint my Executrix and her successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this ap- pointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM IV: I appoint my daughter, PATSY J. DUNLAP, Executrix of this my last will. Should my daughter, PATSY J. DUNLAP, fail to qualify or cease to act as Executrix, I appoint my son-in-law, DARREN WAYNE DUNLAP, Executor of this my last will. Should my son-in-law, DARREN WAYNE DUNLAP, fail to qualify or cease to act as Executor, I appoint DAVID H. STONE, Executor of this my last will. Page 2 of 5 ITEM V: No fiduciary acting hereunder shall be required to post bond or enter security for ~he faithful performance of his/her duties in any jurisdiction. IN WITNESS W-HEREOF, I, ETHEL M. ROCHE, have hereunto set my hand and seal this /~" day of ~_~-~z~...'.- , 2001. ETHEL M. ROCHE SIGNED, SEALED, PUBLISHED and DECLARED by ETHEL M. ROCHE, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses. Witness Addre s s ~.':b.'.'"~" .~' Addre s s COMMONWEALTH OF PENNSYLVANIA: : SS: COUNTY OF CUMBERLAND : I, ETHEL M. ROCHE, the Testatrix whose name is signed to the at- tached or foregoing instrument, having been duly qualified according Page 3 of 5 to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. ETHEL M. ROCHE Sworn to or affirmed to and acknowledged before me by ETHEL M. ROCHE, the Testatrix, this /,~k/~ day of . ~~ , 2001. NOTARIAL SEAL R. LUCKEY, Notary Public Oumbed~d Bom. Cumbaland Co. Oc~m~ion E(plms Man~ 27, 211135 COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she executed Page 4 of 5 it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. Witnek~g~' ~ .- Witness /" Sworn to or affirmed to and acknowledged before me by witnesses, this /J'*~ day of i'~.~-,-,~~&-P' , 2001. JNotary Public Page 5 of 5 LOOi( F:QP~ US. W~'LL GET YOU 04/15/2003 STONE LAFAVER & SHEKLETSKI 414 BRIDGE ST NEW CUMBERLAND PA 17070 The information which you requested on the account(s) of ETHEL ROCHE (Social Security Number 195-26-1860) is/are as follows: Account Number 10129210 1300041453 8000034876 90615683 Class of Account SAVINGS IRA CERTIFICATE CHECKING Date Opened 04/02/82 02/10/95 08/04/97 08/08/89 Principal Balance 9004.33 37600.55 5000.00 602.14 Accrued Interest 3.21 137.40 9.01 Balance at Date of 9007.54 37737.95 5009.01 602.14 Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership Was Established 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 SOLE SOLE SOLE Additional Information Requested S~i,~cerely,. ~ SENIOR SERVICES REP. P.O. Box 171 I. HARRISBURG. PENNSYLVANIA 17105-1711 Toll Free 1-866-WAYPOINT (I-866-929-7646) · IN YORK AREA 717/815-4500 · www.wagpointbank.com DEED THIS INDENTURE made the t~' day of~t~¢ , in the year 2003, between PATSY J. DUNLAP, Executrix of the Last Will and Testament of ETHEL M. ROCHE, a/k/a ETHEL MAE ROCHE, late of the Borough of New Cumberland, County of Cumberland and Commonwealth of Pennsylvania, of the first part, hereinafter called the Grantor, JEREMY R. BANEY, of the second part, hereinafter called the Grantees; WHEREAS, the said ETHEL M. ROCHE became in her lifetime seised, as of fee, of and in to a certain tract of land, together with the improvements thereon erected, situate in the 35 Greenspring Drive, Silver Spring Township, County of Cumberland, and Commonwealth of Pennsylvania, and more particularly described hereinafter; and being so thereof seised, died on March 27, 2003, having first made her Last Will and Testament in writing dated December 13, 2001, duly probated and registered in the Office of the Register of Wills of Cumberland County on April 4, 2003, wherein and whereby she appointed as Executrix, the said PATSY J. DUNLAP, to whom Letters Testamentary were duly issued'by said Register of Wills on April 4, 2003, wherein and whereby said premises hereinafter described were not specifically - devised, all as in and by said Will and the records of said Register of Wills more fully appears; NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and in consideration of the sum cf One Hundred Eight Thousand and NO/100 ($108,000.00) Dollars, which has been paid to her by the said Grantee at er before the sealing and delivery hereof, receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, released and confirmed, and by these presents does grant, bargain, sell, alien, release and confirm unto the said Grantee, ALL THAT CERTAIN piece or parcel of land situated in the Township of Silver Spring, County of Cumberland and Commonwealth of Pennsylvania, more particularly bounded and described as follows: BEGINNING at a point on the northern side of Greenspring Drive, at the dividing line between Lots Nos. 92 and 91 as shown on the hereinafter mentioned Plan of Lots; thence along said dividing line between Lots Nos. 92 and 91, North 19 degrees 51 minutes 45 seconds West, a dis- tance of 128.78 feet to a point at lands of others; thence along said latter lands, North 70 degrees 08 minutes 15 seconds East, a distance of 36 feet to a point at the dividing line between Lots Nos. 92 and 93 as shown on said Plan of Lots; thence along said dividing line between Lots Nos. 92 and 93, South 19 degrees 51 minutes 45 seconds East, a distance of 128.78 feet to a point on the northern side of Greenspring Drive; thence along said northern side of Greesnspring Drive, South 70 degrees 08 minutes 15 seconds West, a distance of 36 feet to a point on the same at the dividing line between Lots Nos. 92 and 91 as shown on the hereinafter mentioned Plan of Lots, the place of BEGINNING. BEING Lot No. 92 as shown on the subdivision plan of lots entitled "Final Subdivision Plan of Westfields Phase #3" (revised) as recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Plan Book 58, Page 99. HAVING erected thereon a townhouse style dwelling unit known and numbered as 35 Greenspring Drive. BEING the same premises which Max D. Marbain and Graydon F. Lombard, Co-partners, by their deed dated February 9, 1990, and recorded February 13, 1990, in the Office of the Recorder of Deeds in and for -2- Cumberland County, Pennsylvania, in Deed Book K, Vol. 34, Page 237, granted and conveyed unto Ethel M. Roche, decedent herein. TOGETHER with all and singular the buildings, improvements, ways, streets, alleys, passages, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever, thereunto belonging er in any wise appertaining and the reversions and remainders, rents, issues and profits thereof, and all the estate, right, title, interest, property, claim and demand whatsoever ef her, the said ETHEL M. ROCHE, at and immediately before the time ef her decease, in law, equity, or otherwise howsoever, el, in, to er out of the same. TO HAVE AND TO HOLD the said lot er piece of ground above de- scribed, with the buildings and improvements thereon erected, hereditaments and premises hereby granted or mentioned, and intended so to be, with the appurtenances unto the said Grantees, to and for the only proper use and behoof of the said Grantees, forever. And the said Granter, for herself and her respective heirs, executors and administrators, does covenant, promise and agree to and with the said Grantee, her heirs and assigns, that she, the said Grantor, has not heretofore done or committed any act, matter er thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged, or encumbered in title, charge, estate or otherwise howsoever. IN WITNESS WHEREOF, the said Grantor has hereunto set her hand and seal the day and year first above written. Witness COMMONWEALTH OF PENNSYLVANIA: : COUNTY OF CUMBERLAND : SS: - ~ -i ~.~,~,~k~ { SEAL ) PATSY J. DUNLAP, Executrix of the Last Will and Testament of ETHEL H. ROCHE, a/k/a ETHEL MAE ROCHE On this, the k~e¥' day of~ , 2003, before me a Notary Public, the undersigned officer, personally appeared PATSY J. DUNLAP, Executrix ef the Last Will and Testament of ETHEL M. ROCHE, a/k/a ETHEL MAE ROCHE, known te me er satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereto set my hand and notarial seal. Notary Public -4- I hereby certify tNat the precise address ef the Grantee At'~6~ney fer A. S~ett~le ,men~ ~taternent US Depadment of Housing and Urban Development ~ 'IF ©MB ~o 2502-0255 B Type of Loan 1. [] FHA 2 []FmHA 3 []Cony Unins 4 [] VA 5. [] Cony Ins. File Number 25746 Loan Number Mortgage Insurance Case Number 2179245/002274152 0325545037 6 C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the setdement agent are shown items marked "p o c" were paid outside of dosing; they are shown here for informational purposes and are not included in the totals. D NAME AND ADDRESS OF BORROWER: JEREMYR. BANEY '~4 KINGSWOOD DRIVE, MECHANICSBURG, PA E. NAME AND ADDRESS OF SELLER PATSYJ. DUNLAP, EXECUTRIX FOR THE ESTATE OF ETHEL M. ROCHE F NAME AND ADDRESS OF LENDER: CITIZENS MORTGAGE CORPORATION d/b/a CMO FUNDING CO. 10 TRIPPS LANE, RIVERSIDE, RI 02915 G PROPERTY 35 GREENSPRING DRIVE LOCATION: MECHANICSBURG, PA 17050 H SETTLEMENT AGENT: CEDAR CLIFFABSTRACTAGENCY, INC. PLACE OF SETTLEMENT: 414 Bridge Street, New Cumberland, PA 17070 TIN: 23-2133165 I SETTLEMENT DATE: 10/15/2003 RESCISSION DATE: J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100 GROSS AMOUNT DUE FROM BORROWER: 400 GROSS AMOUNT DUE TO SELLER: lol Con~ract Sales Price ~02 Personal Property 103 Settlements charges to borrower Ifrom line 1400) ~108~000.00 $3,863.39 401 Conlract Sales Price 402 Personal property 403 $108,000.00 104 404. 105 405 ADJUSTMENTS FOR ITEMS PAiD BY SELLER IN ADVANCE: ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: 106 City/town taxes to 406 City/town Taxes to 107 County Taxes10/15/2003 to 01/01/2004 562.41 407 County Taxes 10/15/2003 to 01/01/2004 $62.41 108 Assessments 10/15/2003 to 07/01/2004 $657. 72 408 Assessments 10/15/2003 to 07/01/2004 $657. 72 109 110 111 112 120. GROSS AMOUNT DUE FROM BORROWER: $112,583.52 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 201 Deposit or earnest money $1,000. O0 202 Principal amount of new loan(s) $102,600. O0 203 Existing loan(s) taken subject to 204 205 206 CITIZENS GRANT $1,620. O0 207 2O8 209 ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: 21o. City/town taxes to 409 410 412 420. GROSS AMOUNT DUE TO SELLER: $108,720.13 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 501. Excess deposit (see instructions) $1,000. O0 502. Settlement charges to seller (line 1400) $1,179.50 503 Existing loan(s) taken subject to 504. Payoff of first modgage loan 505 Payoff of second mortgage loan 506. 507. 506. 509. ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: 510. City/town taxes to 211. County taxes to 511. County taxes to 212. Assessments to 512. Assessments to 213. 513. 214 514. 215 216 217. 218 219. 220. TOTAL PAID BY/FOR $105,220. O0 BORROWER: 300. CASH AT SETTLEMENT FROM/TO BORROWER: 301. Gross amount due from borrower (line 120) $112,583.52 302. Less amount paid by/for borrower (line 220) $105,220. O0 3O3. CASH ( [~FROM ) ( [-~ TO ) BORROWER: 57,365.52 515. 516, 517. 518. 519. 520. TOTAL REDUCTION S $2,178.50 IN AMOUNT DUE TO SELLER: 600. CASH AT SETTLEMENT TO/FROM SELLER 601. Gross amount due to seller (line 420) $108,720.13 602. Less reductions in amt. due seller (line 520) $2,179.50 603. CASH (F~FROM) ([~TO) SELLER: $106,540.63 HUD-1 (3-86) - RESPA, HB 4305.2 PAGE 1 HUD*I (Rev. 3186) OMB N0.2B02-026B L. SETTLEMENT CHARGES 700, TOTAL SALES/BROKER'S COMMISSION PAID FROM PAID FROM BASED ON PRICE @ % = BORROWER'S SELLER'S FUNDS FUNDS DIVISION OF COMMISSION (LINE 700) AS FOLLOWS: AT AT 701. to SETTLEMENT SETTLEMENT 702 to 703 to 704 to 7O5 Commission paid al settlemenl 7O6 800. ITEMS PAYABLE IN CONNECTION WITH LOAN: 801 Loan origination fee % to CITIZENS MORTGAGE CORPORATION d/b 802 Loan discoun~ % In CITIZENS MORTGAGE CORPORATION d/b 803 Appraisaifeeto: NATIONAL R.E. INFO SVCES-POC-PD BY LDR (LENDER. PD $275. ooLPoc) 804 Credilrepodto: TI4~ CREDIT NETWORK-POC-PD BY LDR $15.00npoc 805 Lender's inspection fee CITIZENS MORTGAGE CORPORATION d/b/a (L~C F~INDING CO. (LENDER PD 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE: 901. Interestfrom 10/15/2003 ~o 11/01/2003 @ 902. Mortgage insurance premium for mos. Io 903 Hazard insurance premium for1 . 00 yrs. lo ERIE INSUR2M~fCE ( $215. O0 PO C ) 904 Flood insurance premium for yrs to 905. COLTRIER FEE-CITIZENS MORT CORP-POC-$15.50 $50. O0 1000. RESERVES DEPOStlED WIIH LENDER: 1001 Hazard insurance 3. 00 months @ $17. 92 per monlh $53. 76 1002. Mortgage insurance 2. 00 months ~ $76.95 per month $153.90 1003 City property taxes months @ per month 1004 County property ~axes 9 . O0 months @ $23 . 58 per month $212.22 1005 Annual assessmenls months ~ per month 1006 Flood insurance months @ per month 1007 SCHOOL TA3~S 4 . O0 months ~ $77.23 per month $308. 92 1008 months ~ per month 1009. Aggregate Account£r,.9 Escrow Adjustment ($218.85) 11 00. TITLE CHARGES: 11Ol Se/0emenl or closing fee to 1102 Abstract or title search to 1103 Title examination Io 1104 Title insurance binder lo 1105 Document preparation to 1100 Notary fees ID CASH $15. O0 $5, O0 $17.22 I day $292. 69 11o7 Attorney's fees to (includes above dems Numbers: $898. 75 I ) 1109. Lender's coverage ( $102,600. O0 1110. Owner's coverage ( $108, 000. O0 ) 1111 END, 100,300, 8.1 $150. O0 1112 INSURED CLOSING LETTER $35. O0 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES: 1201. Recording fees:Oeed $40.50 ;Mortgage $64.50 :Releases $105.0000 1202 City/county lax/stamps: Deed $2,1 60, 0 0; Mortgage $1,0 g 0. $1, 0 B 0.0 0 1203 State tax/s~amps: Deed : Mortgage 1204 1205. 1300. ADDITIONAL SET[LEMENT CHARGES: 1301. Survey In 1302. Pes[ inspection lo 1304. SILVER SPRING SEWER-FINAL 7/02 TO 10/15/03 $94.50 1305 1307 1400. TOTAL SE'I-rLEMENT CHARGES $3,863.39 $1,179.50 I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement /'3ERF__.~Y R. BAN~. Y PATSY J. DUNLA¢, EXECUTRIX FOR ¥[{F. Date: Sefleror ESTATE OF ETHEL M. ROCHE Borrower: Date: __ Agent: Date: __ The HUn-1 Settlement Statement which I have prepared is a true and accurate account of this transaction I have C~ause the fu/~ds t be disbursed in accordance with this statement Date: SeE, .... ,Agent: D~N~''j~' , Date: / WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and imprison- ment. For details see: Title 18 U.S Code Section 1001 and Section 1010. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS: Patsy J. Dunlap being duly sworn according to law, deposes and says that she is the Executrix of fha Estate of Ethel M. Roche a/k/a Ethel Mae Roche late o{ New__C~u~_~er~l__a_n_d___B_orough , Cumberland County, Pa., deceased and fhaf fha within ;s an inventory made by Patsy J. Dunlap fha said Executrix of the entire estate of said decedent, consisflng of all the personal property and real estate, except real estate outside fha Commonwealth of Pennsylvania, and that fha figures opposite each item of fha Inventory represent it's fair value as of the date of decedenf's death. __ and subscribed before me, 19 Patsy J. Dunlap rzx 1714 Sherwood Rd. New Cumberland, PA 17070 Address Date of Death 27 03 2003 Day Month Year INSTRUCTIONS I. An inventory must be filed wlfhin three months after appointment of personal represenfaflve. 2. A supplement inventory must be filed wifhln thirty days of discovery of additional assets. 3. Additional sheets may be attached as fo personalty or realty 4. See Article IV, Fiduciaries Act of 1949. c Inventory of the real and personal estate of Ethel M. Roche a/k/a Ethel Mae Roche deceased Inventory Estate of Ethel M Roche From 03/27/2003 To 12/17/2003 Description Accrued Income Form 706 Schedule A Residences Prop. located at 35 Greenspring Rd. Form 706 Schedule C Checking Accounts Waypoint-Checking Acct. Savings Accounts Waypoint-Savings Acct. 3.21 Certificates of Deposit Waypoint-Cert. of Deposit 9.01 Form 706 Schedule F Refunds The Evening Sun-refund on paper AARP-refund TV Guide-refund on subscription Highmark-refund on premium Travelers Insurance-refund on house PNC Bank-refund on service charge Value 97 17 18 00 41 46 400 89 120 00 0 5O Total 108,000 ~0 602 L4 9,007 54 5,009 1 14,618 9 678 02 123,296~71 CUMBERLAND COUNTY PROBATE COURT ATTN: REGISTER OF WILLS, 1 COURTHOUSE SQUARE ROOM 102 CARLISLE PA 17013 In the Estate of ETHEL M ROCHE, Deceased Case No. 21-03-297 Release of Claim The claim submitted in the above-captioned estate on behalf of CAPITAL ONE in the amount of $294.00 for account number 4305721747923170 has been otherwise settled or been compromised for $150.00 and this release of claim is executed to acknowledge discharge of the claim, and to release the estate and the Personal Representative of the estate from all further liability with respect thereto. Agent of Claimant Address: 5330 East Main Street, Suite 200, Columbus OH 43213 Telephone: (877) 714-3739 Date of Release: 01/15/2004 EISI Matter No. 909700 CS HANDLERI' COLLEEN MARINELLO BUREAU OF TNDZVZDUAL TAXES ZNHERTTANCE TAX DIVISION DEPT. 16060X HARRXSBURG, PA 17118-0601 COHHONWEALTH OF PENNSYLVANIA BEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RE¥-15¢? EX AFP (01-05) DAVID H STONE ESQ STONE ETAL qlq BRIDGE ST NEW CUMBERLAND ~+:; Of BATE 02-2q-200q ! .~i ~JiliS ESTATE OF ROCHE DATE OF DEATH 05-27-2005 FILE NUHBER 11 05-0297 FEB 27 P 1 ..0ACN~OUNTY CUMBERLAND101 PA 17o'~!i.rlbei;,3.hd Co., PA Amoun~ Ram'i 'l:'l:ad ETHEL H HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND C0 COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-15~7 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT~ ALLOWANCE OR DISALLOWANCE OF DEBUCTZONS AND ASSESSHENT OF TAX ESTATE OF ROCHE ETHEL H FILE NO. 21 05-0297 ACN 101 DATE 02-2~-200R TAX RETURN NAS: (X) ACCEPTED AS FTLED ( ) CHANGED RESERVATTON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON= ORIGINAL RETURN 1. Real Es~e~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par~nership Zn~aras~ (Schedule C) (3) ~. Hor~gages/No~es ReceLveble (Schedule D) (~) 5. Cash/Bank Deposi~s/Misc. Personal Proper~y (Schedule E) (5) 6. JoLn~ly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expanses/Ada. Costs~Misc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liabi11~Aas/Lians (Schedule Z) (10) 11. To,al Deductions 12. Ne~ Value of Tax Re*urn 108~000.00 .00 .00 .O0 15z296.71 .00 37~,737.95 17,059.62 9~211.31 (11) (12) 13. NOTE: Charitable/governmental Bequests; Non-elected 9113 Trusts (Schedule J) Na~ Value of Es~a~e Subjec~ ~o Tax Zf an assessment ~as issued previously, lines lq, 15 and/or AMOUNT PAID 5,000.00 351.21 reflect figures that /nclude the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amount: of Line lq a~ Spousal ra*a (15) . O0 X O0 : 16. Amount: of L/ne lq ~:axable a~ Lineal~Class A ra~o (16) 12q,763.73 X Oq5 = 17. Aaoun~ of Line lq a~ Sibllng ra*e (17) . O0 X 12 = 18. Amoun~ of LAne lq ~axabla a~ Collateral/Class B ra*e (18) . O0 X 15 = 19. Prlnc1}al Tax Due (19)= TAX CREDITS PAYMENT RECEIPT DTSCOUNT (+) DATE NUMBER INTEREST/PEN pATD (-) 06-27-2003 CDOOgTq6 :>63.16 12-19-2003 CDOO33q5 .00 NOTE: To ~nsure proper credi~ ~o your account, submi~ ~ho upper por~Lon of ~h~s form w~h your ~ax payment. 161,03q.66 36.270.93 12q,763.73 (13) .00 (1~) 1Zq, 763.73 16, 17, 18 and 19 ~111 .00 5,61q.37 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDZT[ONAL INTEREST. .00 .00 5,61~.37 TOTAL TAX CREDIT I 5,61q.37 BALANCE OF TAX DUEl .00 ~NTEREST AND PEN. .00 TOTAL DUE .00 ( IF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE 1S REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) _ ~ RESERVATION= PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: 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 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 lawful Class B (collateral) rate an any such future interest. To fulfill the requirements of Section 21q0 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S. Section 91q0). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NILES, AGENT A refund of a tax credit, ahich was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ere available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special 2~-hour answering service for forms ordering: 1-800-362-Z050; services for taxpayers #ith special hearing and / or speaking needs= 1-B00-~7-3020 (TT only). Any party in interest not satisfied aith the appraisement, allomance, or disalloeance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object mithin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in eriting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (52) discount of the tax paid is alloaed. The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same 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, ar nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (62) percent per annum calculated at a daily rata of .00016q. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which mill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 207. . OO05q8 1987 9Z . 0002~7 1999 77. . 000192 1983 167. .000q38 1988-1991 117. .000301 ZOO0 87. .OOOZ19 19Bq 117. . 000301 1992 92 . 0002q7 2001 97. . 0002q7 1985 1SI .000356 1993-199~ 72 .000192 Z002 62 .00016~ 1986 IOZ . O00Z7q 1995-199B 9Z . O00Zq7 Z003 57. .000137 --Interest is calculated as folloas: INTEREST = BALANCE OF TAX UNPAID X NUIIBER OF DAYS DELINI;IUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date sheen on the Notice, additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Ethel M. Roche Date of Death: March 27, 2003 Will No. 21-03-0297 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: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: (a) Did the personal representative file a final account with the Court? Yes No 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' Court and may be attached to this report, v~~E Da squire 414 Bridge Street New Cumberland, PA 17070 717-774-7435 Personal Representative Counsel for Personal Representative