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HomeMy WebLinkAbout02-0433 PETITION FOR PROBATE and GRANT OF LETTERS Estate of 1< L! r /I D [; /J /lJ!J&'? No. 21-02-433 also known as To: Register of Wills for the , Deceased. County of CUMBERLAND in the Social Security No. 195-18-5736 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the ex~c}lt . in the last will of the above decedent, dated .::rI9-/U UHF( ~ c;:;J A/ and codicil(s) dated name~ 19 ?L , (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in t:/-t #J? Ilep /0 //cl County, Pennsylvania, with he (' last family or principal residence at I tn / (V r- 7)4/C L ;::; /Uc C! /} k: L/ 5 L E ;0/1 //;'/J/ .=3 (list street, number and muncipality) I}/Ji?/L at 12 '5 I L . S P -5 // Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (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: 900,(){j $ $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters -t..e.s+a mPn-ta(lV / (testamentary; administration c. La.; administration d.b.n.c.t.a.) theron. '" 'iJ' u " OJ ~3 OJ .... a: OJ " -00 c'O ~'';:: ~OJ ~o.. OJ '- 50 ~ " OJ} (/i KI m rf) e r /1 fit) o<~ Wj~7~/EL6 ;:. (~/tRL . E fJA / /3 f~~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I ss COUNTY OF CUMBERLAND J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. ~;XJY7ZLU~ Sworn to o. r affirmed and SUbscribedU before me this 29th day of ~APRIL. U;; :~02 /. ~r? :;:f1a//-e~h;,.(l//J..~ . /.k v Reglste /"/-60 -/_~ en ciQ' :::s l::l .... ;:: ~ ~ No. 21-02-433 Estate of RUTH D SANDER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW APRIL 30 ~ 200~ 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 JANUARY 23, 1984 described therein be admitted to probate and filed of record as the last will of RUTH D SANDER TESTAMENTARY KIM MERLINO and Letters are hereby granted to '?"'I(J y!:.,m~d R/ /,t;J/,u"'( (,' . glster 0 f Ills . . FEES Probate, Letters, Etc. ......... Short Certificates( ).......... tieJ'J1tft:~cftion ................ JCP $ $ $ $ 5.00 TOTAL _ $ 29.00 . . . . A~InL. .30 J. :z.QOZ..... . . . .. . . . . 18.00 3.00 3.00 ATTORNEY (Sup. Ct. 1.0. No.) ADDRESS Filed PHONE l,.,.."\ C'-J c'-.! P ~ '" "', r ... ,.....;. \0..-.- 21-02-43B REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that present and saw the testat , sign the same and that signed as a witness at the request of testat_ in h presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19_ (Name) (Address) Register (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS ~ )AV)1F. S k f=\ \')~\ \<\ tli ~€R LI/\ ,(~ (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that ----rh~ I (\:xP-..F familiar with the signature of --=K? ,TN -1) ~/.4n("1 @ R , -codicil testat~ of (one of lhc &tl6seribiRB witRe5~e~ t~ the will presented herewith and codicil believe~he signature on the will is in the handwriting of 1-0 ~Tt-4 LJ &ncleR. . , to the best of .lb., "" know ledge and belieL /J __ Sworn to or affirmed and subscribed before fJe/12ui:1 ;p ~L..d:r me this 29th day of?7 (~ame) ~ APRIL ; pi){. 2002 cflJ /..vJ/lc-:>/7//..-,L/ j)~. L/;,ClL/J/-c' ///7,;)/3 ----'u;t'o/m..j,Pnj4~r t~ ;."" UA94rp~) 4 · Register ~ / / ~~c.-O '/ J /~, 1. (l)Ia'J{e).. Ii (-- J' 0)0) W/le[L t-f-ielcf jlJr. !or!I{'~/f>o. / '70/3 that -rh... I j (Address) II , . 21-02-433 LAST WILL AND TESTAMENT OF: RUTH D. SANDER I, RUTH D. SANDER, of the County of Allegheny and Commonwealth of Pennsylvania, being of sound mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. FIRST: I direct my Executor to pay my lawful debts and the expenses of my last illness and funeral. SECOND: I direct that my remains be buried in a plot owned by me in the Lakewood Memorial Cemetery. THIRD: I bequeath all of my jewelry, automobiles, clothing and other purely personal effects, as well as household furnishings and equipment which I may own, including any policies of insurance thereon to my husband,Waldemar L. Sander, if he survives me by thirty (30) days. In the event my husband does not survive me by thirty (30) days, then I devise and bequeath the aforedescribed property to my surviving children, in equal shares" per stirpes. FOURTH: All the rest, residue and remainder of my Estate, I devise and bequeath to my husband, Waldemar L. Sander, if he survives me by thirty (30) days. In the event my husband fails to survive me by thirty (30) days, then I devise and bequeath the same under the same terms and conditions to those " SIXTH: I appoint my husband, Waldemar L. Sander, as Executor of this, my Will. In the event my husband is unwilling or unable to serve as Executor, then I appoint my daughter, Kim Merlino, presently of Gibsonia, Pennsylvania, as Executrix in his stead. SEVENTH: No fiduciary appointed in this Will shall be required to furnish a bond or other security in any jurisdiction in which he or she shall serve. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day Of~' 1984. ;{J~/ if J~/pu RUTH D. SANDER (SEAL) SIGNED, SEALED, PUBLISHED and DECLARED by the above named Testatrix, RUTH D. SANDER, as Testament, in the presence of us, presence and in the presence of subscribed our names as witnesses. and for her Last Will and and at her request, in her each other, have hereunto 'I7~ 7 ~Jz; g A~~& . 15"/0/ ~:I~ 'Witness V7~ 7 Address ~r ~ /~~ / / ':>-1' 0/ c;/ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Date of Death: Ji UtI! ]) S IJ fJ DcR. .tj~ / s - () c;( Name of Decedent: Will No. q;/- 0 01-0 1/3~ Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration 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 "-/ ... IIfJ - t:) ~ : Name Address WCLldemar L: Sander, Jr. d-Y wDccl6'men Dr., ~meMp~ r-t, PeL_ / b 7~1 etCLiJ B ~,-<;al1der", "-1'17 fJaf'tndJe RU-fl, G,hsCJnt'Q/ J1a... /S-l5;/V /}/(21J W,0a/Jder: It> 3 /YJo('JO-nRd,-, B t.L --I fer.' f;a., )~ 66/ t(;m Ii (Yler / I not' Old. wlJea.-L-Aeld Dr,; (1('11 $, ~ 1)A-.1'7~/3 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: ~ - C) -0 ~ ~!/~ Signature ~j Name *1m /I. me r// no Address OJ~ LUAecd:-!)e)d D0 {!/)I2LISL6 p/J //ft)/.:3 ~-< Telephone (?/~ '7 tJ tJ ~ 9.3' 5 L/ Capacity: ~ Personal Representative _Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MERLINO KIM 22 WHEA TFIELD DR CARLISLE, PA 17013 -------- fold ESTATE INFORMATION: SSN: 195-18-5736 FILE NUMBER: 2102-0433 DECEDENT NAME: SANDER RUTH 0 DATE OF PAYMENT: 08/20/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 04/15/2002 NO. CD 001544 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $230.65 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: KIM V MERLINO CHECK# 677 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $230.65 MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-00)1 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OECEOENTS NAME (lAST. FIRST, ANO MIDDLE INITIAL) !z S'1l NDc R tJ TI-/ D, ~ OATE OF OEATH (MM.DO-YEAR) DATE OF BIRTH (MM-OO-YEAR) ~ t!) 5-c:?CJOc;) tJ -/~-/9c?o W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, ANO MIODLE INITIAL) Q ~ ::.::!;w ,,0:'" w"" ,,00 ,,0:.... ..Ill .. C ~1. Original Return o 4. Limited Estate ~ 6. Decedent Died Testate lAttach copy (lImn o 9. litigation Proceeds Receiyed o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12.12.a2) o 7. Decedent Maintained a Living Trust (AtlachcopyofTrusl) o 10. Spousal Poverty Credit (dale oldealh between 12-31-91 and 1-1-95) OFFICIAL USE ONLY v / -60- A.3 .-t2 .Q _!l3. 3. "",""R FILE NUMBER ,..( 6 - .J2 ,;{ COONTY CODE YEAR SOCIAL SECURITY NUMBER /9S-Il' 573 THIS RETURN MUST BE FILEO IN OUPlICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 03. Remainder Retum (d8IeofdealhpmrlDt2.13-a2) o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11. Election 10 tax under Sec. 9113(A)(""",""01 .... z w o z o .. w W 0: 0: o " NAME K, v mERL/}JO COMPLETE MAILING ADORESS FIRM NAME 1'_1 TELEPHONE NUMBER dO,) I>>flE/PTF/EL D DR. p~ 1~,(J/3 (1) (2) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) '71/"f- "790- 935.1/ {}fl7<L/5LE J1 tM..L 9. ?/? f? S 'Yl t>?'l....i2- )1 tf?'U2. ;:., 7_-1, () 0 (6) /0, 19~ ij~ , 7? h'Z.L 4. Mortga9es & Notes Receivable (Schedule 0) 5. Cash, Bank Deposits & Misoellaneous Pe<sonal Property (Schedule E) (4) (5) z o ~ :l l- ii: c( (,) W D:: 6. JoinUy Owned Property (Schedule F) o Separate Billing Requested _.- . OFFICIAL USE ONLY c 1. Real Estate (Schedule A) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (7) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I) 11. Total Oeductions (Iotal Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Une 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Une 12 minus Line 13) (9) ~ (8) 6%,'5, h 9 '7? f1.-.7'7 (J (10) SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES ~. I I ::0, I I I I g / /, . 33 z o !cc I- :l D. ::::liE o (,) ~ 15. 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 17. Amount ofUne 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Oue ,-1. IdD: b' ~ x.O_ (15) x.0~16) x .12 (17) x .15 (18) CHECK HERE IF YOU ARE REQUESTING A REFUNO OF AN OVERPAYMENT (11) (12) (13) h. /'$'5: b 9 .~ /dS /,.,~ -6- 5: IdS. b -s/ - zoO (14) r-o?.:?O, th S (19) eJ.3{). 65 Decedent's Complete Address: STREET ADDRESS / ~ ,.f L"tJ. Ai E CITY E 7cj/3 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credils/Payments A. Spousal Poverty CredIT B. Prior Payments C. Discount -0- -0- -t/- Total CredITs (A + B + C) (2) -0- 3. Inlerest/Penalty if applicable D. Interest E. Penalty -() - -0- 4. Totallnterest/Penalty ( D + E ) If Line 2 is greater than Line 1 + Line 3, enler the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on Ihe tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (1) (3) (4) (5) (SA) (5B) .- . ~ -,.. ';;?3 (J . t:, 5 -0- -0- d3t'J. b 5" -0- c::J3 6. ~ 5 ~- Make Check Payable to: REGISTER OF WILLS, AGENT [1.__< fiii!~_ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Ves a. relain the use or income of the property transferred;.......................................................................................... 0 b. relaln the righllo designate who shall use the property lransferred or ils income; ............................................ 0 c. retain a reversionary interest; or.......................................................................................................................n. 0 d. receive the promise for I~e of either payments, benefils or care? ...................................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 3. Did decedent own an "in trusl fo~ or payable upon death bank account or security at his or her death?.............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probale property which contains a beneficiary designation? ........................................................................................................................ 0 No ~ B' IB' IB' [3- Et ~ 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 oj perJury. I declare lhall have examined this return, induding accompanying schedules and statements, and 10 the best of my kllCl'Medge and belief, it is true, COl'IllCl and complete. Dedaration of pre parer other than the personal representative is based on aH information of ."tlich preparer has any kno'Medge. SIGNATURE OF P RSON ~SPONSIBLE FOR FlUNG RETURN ADDRESS c;(00J /.LJ#E,4TF/€LD SIGNATURE DF PREPARER OTHER THAN REPRESENTATIVE DR , ~1f,R L /5 LE. jJ Il ... ADDRESS afw!Hlnp'~ .-~'~I:I!Illi:i1'--~#':'1mrjE~W jJ t ~~~I!!I'~il:.-'!i 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 Ihe use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statu lory requirements for disclosure of assels and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of dealh 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 Dr for the use of a natural parent an adoptive parent, or a stepparenf of the child is 0% [72 P.S. ~9116(a)(1.2)). The tax rale imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, excepl 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 ieast one parent in common with the decedent. whether by blood Of adoption. . .r 7\ '- , I". ' ~t1~:N' ". . LAST WILL AND TESTAMENT OF. RUTH D. SANDER I, RUTH D. SANDER, of the County of Allegheny and Commonwealth of Pennsylvania, being of sound mind and memory, do make, pUblish an~ declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. FIRST. I direct my Executor to pay my lawful debts and the expenses of my last illness and funeral. SECOND. I direct that my remains be buried in a plot owned by me in the Lakewood Memorial Cemetery. THIRD. I bequeath all of my jewelry, automobiles, clothing and other purely personal effects, as well as household furnishings and equipment which I may own, including any policies of insurance thereon to my husband,Waldemar L. Sander, if he survives me by thirty (30) days. In the event my husband does not survive me by thirty (30) days, then I devise and bequeath the aforedescribed property to my surviving children, in equal shares, per sU rpe s. FOURTH: All the rest, residue and remainder of my Estate, I devise and bequeath to my husband, Waldemar L. Sander, if he survives me by thirty (30) days. In the event my husband fails to survive me by thirty (30) days, then I devise and bequeath the same under the same terms and conditions to those listed in THIRD above. FIFTH. I direct that all death taxes, whether Federal, State or Local, payable because of my death, with respect to the property forming my gross Estate for tax purposes, whether or not passing under this Will, including any interest and penalty imposed in connection with such tax, shall be paid out of the assets of my Estate. 1 Ii;")::: y-;', ~:',:Xl;:, '~\:ii-:::.. :'~::':'! ;'iY~", :;" ,.~ 'T'~:'" .....' {."':'=~ ;~',};:;i..I,>~,~'!;":j.~~~ff:r~,'; '.. "~"L'~i "'l:'f,,'i',;: . :+:]~::;-~: ::: ~:;~,:",.'. )~11!~~1:.~ ~; '/iF' ": ':':~j,~,,:,: "'.W:,:'l:. ~ :J'.t ' ..t;;.,S:t, .' .-( ,,:".: :~; . .~ '."!~::i' .r II l' . I ! , l'j 11 I) ,.. , I I, ! I. ,. , .",'"., \' .1'" ....II:t". 1"~ f".'.., ',. \ SIXTH, I appoint my husband, Waldemar L. Sander, as Executor of this, my Will. In the event my husband is unwilling or unable to serve as Executor, then I appoint my daughter, Kim M~rlino. present~y of Gibsonia, Pennsylvania, as Executrix in his stesd. , ...:,.,...'.:.... .' ;~~;,.~,-) ;. ," . :;1 SBVBNTH, No fiduciary appointed in this will shall be required to furnish a bond or other security in any jurisdiction in which' he or she shall serve. IN WITNBSS WHBRBOF, I have hereunto set my hand and seal this li day of ~~ ,1984. ;:!,.rrl JP J/I-u ~UU RUTH D. SANDER (SEAL) .: ~;;:A~;:i~~t ,,~,,'c,Jr.l", '" .i:':,'~.::VI~~':-'.-:". SIGNBD, SBALBD, PUBLISHBD and DECLARBD by the above named Testatrix, RUTH D. SANDBR, as and for her Last will and Testament, in the presence of us, and at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. .~~ ~ :I~ I I 1 1 .1 .' ')"'1";1:';" . '.' " <L".' ';.: ;,;;:; ;$.;\- . " ;n:~{t;;' . 1/7(; 7 IJMJZ g Address ~ I /J/~ ~ fA ~r 1,/0/ V 717 Address ~ j7~,4 /:>-~o,. 2 WHEREAS, on the 30th dated January 23rd 1984 was admitted to probate as the last will of SANDER RUTH D (LA~l, ~lK~l, M1UUL~) late of MIDDLESEX TOWNSHIP CUMBERLAND County, who died on the 15th day of April 2002 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to MERLINO KIM who has duly qualified as Executor (rix) and has agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, of my Office the 30th day r t ) 1\ Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters No. 2002-00433 PA No. 21-02-0433 ESTATE OF SANDER RUTH D (LA~l, ~lK~l, M~UUL~) Late of MIDDLESEX TOWNSHIP CUl~~KLANU CUUN!l, Deceased Social Security No. 195-18-5736 day of April 2002 an instrument I have hereunto set my hand and affixed the seal of April 2002. ~'-Y~fK1!-'tf'~/ **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) i Ii l~listed in THIRD above.. ,. . -:;t"'\~i~)i~g~~~'5iii d"""eath"taxE;s; whether pe(i:f~~ -..,,~(~'"\ '*' COMMONWEALTH Of PENNSYlVAN(A INHEfijTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF /) j 1 -Lh D 7'\ VI.- "L J Sa I?de (' SCHEDULE B STOCKS & BONDS FILE NUMBER O?OO~ ~ () tJ 7"33 All property jolntlyoOWlled with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH ;;;9)O.A~ (!ommol)j ~ :J~J~' je.tL~ /P#'1'1'/3d)O/{)~ ~ - .3~. '7 d'1J.-W- .3 c:2, 0'/9 ~- ..3~. 37-'1 93c? :?.s TOTAL (Also enter on line 2, Recapitulation) (H more space is needed, IOsert additional sheets of the same size) $ 9Je, RS r G I. ~~~~~i r- -~~,,:o.~.-4k;~Et'~eut::' ~~~~~~~~~~~~. - -- ~~~~~~=~ ~ -~ - - --- i - - >;; -' ~_- -~ ---:: - _ ;i COMMON SrOCK COMMON SroCK NCORl'OAATID lNlf~ TK L1\wsa M SWEOf~.f1!SFl' tH:;nIllft:ATEISTRN<SFl'RAlllf ""'_YO'IK.t.EWYORt:.. JElI5tYOTY.N(W.(ltSFI. .oNI)CANTO"l.~ PAil. VAlUE OF $.01 Prudential Financial, Inc. 1 96 2! SH IfVEl!Sl' FOR W'I.O.INCUNIION:'> FUUY PAlO AN) t-ON-ASSESSABlE SHARES OF THE COMMON SrOCK OF !l}.tldmtld JU,tlllaa!. s;,C. tr<Y~"k 011 tlte I~ glUU cmpOm"NI in}erSOll or & duY mtLhol'a:d attoMf'!/I'fon Slirl'Cmf,.~ g/'t(uS',"Uf/ira.<e~, e1'lF~ .?l,i.l",.c1jl(-O/f"~/I~"aM anla-sCOU//LO>&zal ami "''''')cUred /_.~. SiR. '-~";';;~*,{"inL W~"":~qw,,\ ;; ; ...(,.., ! L-> r. '.. '~.." , 'U-- '(y' _,_ ;r~ty"'r:-""'~__ ,." J~~^ .__ .... '.___ _,,' ._", ~_ _ 1fliRc.r-f.tlitfiu:.vnulc.seal,q/.said eotforatioa.a/UI tllf.!iLCfUlu!e..,fi!?uWUYJ.S e/itJ ttl(& tzildw-l'tied !J!jic.er,s. C()lMT6I9G/'oI'DAl'VIlfGIS1ERED. Doted: June 17. 2002 EouLSERVETRtlSTCQMPAN't',N.A..1IW'fSFU...cfNlANOREGlSlRAJ: , /1. -~_ ~ ---#-?k ~ ~ ~~ ~f'~ AUTliOllllEDOFfIC8! Sl:CRfW/Y ANOCHI[FlXOCl/lMOffICEi: .. ~ " il!!mll! ~ i5 Q <<- iil~ Q a 'i V')a...u; Sf- 0 '" ~ ~ ^ . " CL Z> m m ::r\!~ ~O or ~~ < ~ z Z 50' . 0 m ..r .3 ~-a S- a ~~ c Z m n 0' if n . z 0 ~~ :;; . ' 0 0 ~~ ~ ~g~ S or 3 $: 8.0 3 ~~ r- -0 , , -~ g..ij; ~ 0 .n ..l~ . " 0 'j> <; "0 e e ~oo " a ~~ 0 ~,~ "0 <is " 0:. ~ >. 0 " " i~ 5~Q 0 > .n , , , 3 5 \I- ~: .0 ~.~~ ~ a ~ ~~ ~ ~ 8 , a...~~ n " .< n-o :> li'it (D ~ .;;; r ~: .0 g. ~g~ .![ S " !l-= " . , 0 ;;; ~ S n ,,< ~~.(1( , n 8 Cl-; ~ 0 a ~ " 7 "- . 3 C - 8 . or , . 0 ::>~3C ~ 3 < . it ~ g 0'" - r " 00 S~ I!:..=ro 8 ~ ~~ it .,,!-" 0 .![ ';;:' 0 jji" ~~ ~lg f ~ <L ~: or ... ::> !!! ~ g.,: . ~, 3 g ~~3 ~, 'J. c ~ g 5!Q. 5; ~6~~ it: ~~ ;!~_... >< >< " 3-: > 0 Z .- 0- f'i= 0 0 or ~' is '" '" ' = Uimtu ro S [ ~. ="'0 ~, Ii" Gl ~ =1 ""l "- or n '" ~ ., 30 ai~~ S' i ;: ~ i ~ z "- ~-g ...-"11 " ~. . $: 1; ~ ~. ~ _zfi~ " ~ Z . i'>....i 0 ii .![ Z 0 l!z;; 3 0 ,. ~ <l.' . " c" ,. I;...!"!:I CL -~ n ^ 00 -::;= ~ ~ n ~~9-R-;'~~ ~ Q ~ , ~ 0 .i! Q ~ii~ n , ~ 0 , ,- n :s a CL .. g 3 0 ~ 0 ...e '8 , CL "- ~ S~ CL n . ~ . ;!! ~ <D ~: ~ . = 0 c -n: . ~6= Q. 0 0 , ~ ~: .. Q -~. " , ~ Q: 0 , " g- O !! = . 0 ~ " =!:.~ " " ~' CL 0 ;; " 0' ~ i! ~ ~~~ " <,:>: ~ !i. !i. ;; ~ ~ ~: ~ ~ " '" ~ 1L 2.5 e.. :5-: = [ p " ." Z2~ " if " "- 8- ~C! = . S": < a ~ ,. ,.,.-R i~g G 0 ~ a g n 0 , 0 ~ Q...~ ~ge ] 0 i5 , " - ,. 'li~ ~ g:: g $: J &2 ~ ", nx; h ~ 3 ~ ..1'1 )> n i ~ 1- i o - 0 ~' .0. 0= ~ 0' . .. .~~j t}L~! OZ~ -0 ~ c Q F~ ., c 0 , ~~ . iii ~ _i! ~ ro ~ 0 CUSO FioonOOl Sel'lices, member NASD/SIPC 7220 Imde 51., STE 115 Son 1Mgo, CA 92121 858.530.4400 MllllllrNAlD.SIPC .'1MUII1"':WZ; for the account of ESTATE OF AIJIH D. SANlER KIN IlERUI<<l EXEQJT[Jl 22 lItEATFIELD lIUVE CMLISLE PA 17013 trade and account Information Account Number 4882-9183 Trade SettlemMtType of Date DQt~ Tn:rn.~ 07/03/02 07/09/02 06 DescriPTion Type of Account CASH Buv/ -Symbol sill sell PIlLI 744320-10-2 Cusip PIUlENTIAL Flit.. II'(; l.NSDLICITED trade confirmation rap Information MARIAN KINTER LOCA TED AT PSECU P.O.BOX 67013 HARRISBURG,PA 17106 QualltitJ. Price Money Type Mone)' Amount 29 30.95 Pr-;nctpal o::mni ss; on SEC Fee Net Am:urt 897 . 55 45.26 0.03 852.26 ... DETACH HERE Make checks payable to E*lRADE Securities, Im:oxporated, member NASD/SIPC, and enclose your check and this deposit slip in the envelope provided. Endorse securities by (I) appointing E*lRADE Securities, lDcmporated as attorney and (2) signing exactly as name appean; on certificBll:. Satisfactory proof of stock ownenhip is required on sale of bearer securities. Please mail securities directly to E*lRADE Securities, Incorporated, 10951 White Rock Road, Rancho Cordova, CA 95670. o My address has changed as indicated on revone QEOSF1 Rev: ~ DETACH HERE use this deposit slip to odd to this account: 4982-9183 Amount Enclosed IS E*TRADE SECURITIES INC PO Box 8160 Boston MA 02266,8160 111,,,,,1,1,,1,1,11,,,11,,11,,,11,,.11,,,,,,11.11.,11,..1,,,11 070320029901 111498291835 _'''''''.1'''' *' r n COI.tMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN SIDENT DECEDENT ESTATE OF 7{ u- -I:: h SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY 'D. Stalder FILE NUMBER c::?6{Jd:?- t)6~3 3 Include the proceeds oIliligalion and the date the proceeds Wen! received by the estate. All properly jolntly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. d, 3. "TV 7C(epho()co (2/othes / so. 60 o?S.06 50 (). 06 TOTAL (Also enter on line 5, Recapitulation) $ 0 t; 5- {) D (If more space is needed, insert addlllonal sheets of the same size) ~.~.~* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 'J) 7\ 7") ()-rH fJ, SCHEDULE F JOINTL Y.OWNED PROPERTY S/J /lJ Dc R FILE NUMBER .d:?~O~ -60 .y 3..3 . In "181_ IIlIde joint within one yell of the decedenr. dati 01 death, "mull be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADllRESS RElATIONSHIP TO DECEDENT B. Sam es; R: 1Y1er) (nD ;;;~ wIJeCL-f-Pt e Id Vr, (!o.(I/tg!e PC<.. /7tJ/3 J d~ LUheCL-t-Pt e./ d D", C!.Cl-1^ I i oS Ie) (.)(L /7613 J)Cli.<.8h-t e r A--Kt M v. filer / J'n D S6fl- ; VI - WiD c. JOINTLY-OWNED PROPERTY: lETIER DATE DESCRIPTION OF PROPERTY "OF DATE OF DEATH ITEM FOR JOINT MADE Include name offincn:ial institution and balk account nurriler or simila' identifying number. Attach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deed forjoinUy-held real eslate. VAlUE OF ASSET INTEREST DECEDENT'S MEREST 1. A. Z/;jzM PSf{! Lt.) P. 0. Box: (, 7013, Harn 5bl.Lr~J Po. ./?/tJb-lJtJ/ 3 33~ /, b 'l Set lJ /05S Ftcc-t.=P- / 9.5 J &'573'" .506 B. 7/r~ " d d .;;{, R. ~~~~ Ched<i05 fk.d, 4f/95/r? 5''l'3 b g 1/5'1 g <2 S3'k ~'615. 3/ 13 ]/~6~ JI " JJ 3. ft z)~o '9;;;J~ ~ F! 161 tJt) 5()~ '73go. S /~'I. 70~ mP~ ~',;7 ,,~ -, 7 17,.;t 5'~_.J. 1/9 TOTAL (Also enter on line 6, Recapitulation) $ 10; 197. "/f? 6 (If more space is needed, insert additional sheets of the same size) P.O. Box 67013 (717) 234-8484 (Harrisburg) Harrisburg, PA 17106-7013 (800) 237-7328 (Nafianwide) website . http://_.psecu.com PCI111sylV0l110 SIDle Employees Credit Union GET YOUR FREE CREDIT REPORT! SEE YOUR CREDIT RATING AND LEARN HOW YOU CAN IHPROVE IT. VISIT WWW.PSECU.COH FOR DETAILS. 1".111".111"""11.,11.1,1"11,,,11,,,,1,,1,,1,1,,1,1",111 RUTH D SANDER ZZ WHEATFIELD DR CARLISLE PA 17013-9004 JOWl' OWNER KIM Y IERLINO PAGE 1 nUIII:WUIY/l'" I' I..... ..- webslte . http://www.psecu.com GET YOUR FREE CREDIT REPORT! SEE YOUR CREDIT RATING AND LEARN HOW YOU CAN IMPROVE IT. VISIT WWW.PSECU.COM FOR DETAILS. JOINT OWNER KIlt V HERLIltO RUTH D SANDER PAGE Z I J __."0__ "::_~~:--.- .~ - -~~::s:2~.~~~~~~_;;~~;~~~~i~~~~~~~,t "-~~"~~~:~~-~ .:~~'M~~~i~~~ ~... . . , ' TITLE NUMBER (AS SHONN ON ATTACHED TITLE) - at ' 44978969401 i VEHICl.E IDENTIFICATION NUMBER VAFLM19A30409CM B. I LAST NAME lOR FULL BUSlNE5S NAMEI ; McBride,Dawn L III Co-SEUER \; i Ii ~ ~ . MAKEOFVEHaE ~r~YEAA PUACHASE . CLAREMON I A. PACE ... '''' (See note on 18'tIl!1'lMI) rI 1\1 CONDf11ON LESS Ol06D OF.'JR o POOR TRADE-IN O_I\~ l'L O( FIRST NAME MIDDLE INITIAL. ""'ABLE AMOUNT t'l I\~ " nr c. LAST NAtE (OR FULL ~S1NESS NAME) Sander.,Ruth D CD-PURCHASER I 1. Sales Tax Due '6~1.061'" li: 7'" .07 See note al rewnel. lAE_ Re8IaonCode.(rnust ~ A ~~ from 1 .,,- !~/JI /' /,' ::::;:7.'-' '-- ..,.. "" ... n t'l 1\' ARST NAME MIDDLE INITIAL. DATE ACQUlREDI PURCHASED 02/19/01' Merlino,Kim V smEET COUNTY C " rNJT ... n, 2. TltleFee ~ 161 Cedar Lane CITY St\TE Carl;~l~ 06 171\1"'1 D. LAST NAME (OR FULL BUSINESS NAME) ZIP CODE REFER 10 COUNTY CooES 3. Lien USTlNGONRE~~1 Fee .. n ~ ^, ARST NAME MIDDLE INITlAL. DATE ACOLRREDI PURCHASED / / 4. Registralionor _Fee '" n" .. IV Ii I . . ~ . ~ ~ ~ ~ E. ~o ~~ F. CO-PURCHASER Fee Exert1't Number asaasipnecf~lhe ""'""' 5. D.JpIicale Reg. Foe No. of Cards 6. Transfer Fee ,. ",. STREET I COUNTY CODE "r I ,. ^ CITY STATE ZIP CODe REFER 10 COUNTY CODES l.lSTNGOORE'o'E~~o;" ,. ",., ,. ", I VEHICLE IOENTlFICATlON NUMBER I BODY TYPE (CP, TK, ETC.) ICONomON I 0 GOOD ORIGINAL Pi-ATE d Check One 0 yo TRANSFER OF PREVIOUSLY ISSUED PlATE o PLATE TO BE ISSUED BY 0 TRANSFER &. RENEWAL OF PLATE BUREAU (PROOF OF IN- SURANCE MUST BE AT. 0 TRANSFER & REPLACEMENT OF PLATE TACHED.) 0 TRANSFER OF PLATE & REPLACEMENT OF STICKER EXCHANGE PlATE TO BE ISSUED BY BUREAU TEMPORARY PLATE ISSUED BY FUll AGENT MAKE OF VEHICLE 7.lncreaae Fee ,. n, ,. ^" MODEL YEAR 8. Replacement Foe o F.'JR o POOR ,. n, ,. n" 9 10. TOTAL PAID ,Add 1 thru8) .,.... "", ,., n" So"" One Check in This Amounl ~I I~ o o 11.GRANO TOTAL (Add 9 &. 10) I REASON FOR REPLACEMENT I OLOST 0 DEFACEO 0 STQLfN I ONEVER RECEIVED (LOST IN MAJL) NOTE: If "NEVER RECEIVEO" block is checked a.......icanl musl .............u..te form MV-44. I"" . . PLATE NO. EXPIRES Month Year TRANSFERRED FROM TITLE NO. G. ~TU\t,TEOF,S '~,'iJ1!' ~~ "SIGN >ERE T ..... T L E FERRED UF OTHER THAN APf'LICANT) P ..... IUNLADEN WEIGHT I~U~~Gcr.~~ss WT. I POLICY NO. (OR I ATTACH BlNOER) I CERTlFY THAT ON MONTH CAY YEAR I HAVE CHECKED TO DETEAMNE THAT THE VEHICLE IS INSURED AND ~~E~ ~E~~~Jt:~~~vJ/.::J~~ COOE Iss;,;:r~G A-:lENi elGWmJRE AND DEPARTMENT REGLJI..AllON5. ( ) I/WE CERTIFY THAT I/WE HAVE EXAMINED AND SIGNED THIS FORM AFTER ITS COMPLETION AND THAT THE INFORMATION GIVEN IS TRUE AND CORRECT. IF AN eXEMPTION IS CLAIMED, THE PURCHASER FURTHER CERTlFES THAT HEISHE IS AUTHORIZED TO CLAIM THIS EXEMPTION. l/WE ACKNOWLEDGE THAT llWE MAY LOSE MY lOUR OPERATING PRlVILEGE(S) OR VEHICLE REGISTRATlOfi(.8) FOR FAILURE TO MAlNT.AJN FINANCIAL. RESPONSlBII.1TY ON THE CURRENTLY REGISTERED VEHICLE FOR THE PERIOD OF REGISTRATION. l/lNE ACKNOWLEDGE TH.(r I/WE MAY BE SUBJECT 10 A FINE NOT EXCEEDING 55,000 AND IMPRISOmENT OF NOT MORE THAN TWO YEARS FOR NlY FALSE S'TA.TEMENT THAT I/WE MAKE ON THIS FORM. 1ST, ~"j)""-~. ~I~U'~~J~~~--~ 1 RELATIONSHIP TO APPlJCANT ONLYI REO. REG. GROSS COMB WT. (IF APPUCABLE) POUCY EFFECTIVE DATE TEMP. PLATE NO. VEHICLE PURCHASED .....GVWR W'~~\ r INSURANCE COMPANY NAME: I ~UCY EXPIRATION I DATE AGENT NO. ISSUING AGENT INFQR. MA~ON ISSUING AGENT lPRINT NAME) TELEPHONE NO. I . " TELEPHONE NUMBER ( l ~~~'", ~ P1~{I.,^:..1 n SignatureotCo-SelIer Signature 01 Second Purchaser or AultJ:Jrized Signer TELEPHONE NUMBER ( l Signature of Seller 2ND ASSIGN- MENT Signature 01 eo.PurchaserlTltIe 01 Authorized Signer Signature Of eo.SeJler H. I~~ .~ ~ NOTE:. If a co-purchaser other than your spouse is listed and you want the title to be listed as "Joint Tenants With Right of Survivorship. (On death of one owner, title goes to surviving owner.) CHECK HERE D. Otherwise. the title will be issued as "Tenants in Common" (On death of one owner, interest of dBceased owner goes to his/her heirs or estate), NOTE: IF THE VEHICLE IS BEING lEASED, CHECK THIS BLOCK 0 . IF BLOCK IS CHECKED, COMPLETE AND ATTACH FORM MV.IL xx MESSENGER NUMBER: : "UREltV6F'Mb~o~ WHT~i\) 054006 02/21/00 RI:iIlI.1511 ~ (12-99) . ,. '*' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ru....;6h P ..Sa. ndGJr FILE NUMBER c:J()6 ~- Dc) Y 3 .3 Debls of decedent must be reported on Schedule J. ITEM NUMBER A. DESCRIPTION FUNERAL EXPENSES: 'R~ R. ~,~ :I~ctJt1771..L 02 &'.<; / tV!) 6cLetvwol. ~, t1LLuJthL Pa~ fi.... ~~a.tizL~ /5/.:'/ ~VO~ .:irMol~ :J-~ Juw-J- ~ B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 1. Name of Personal Representative(s) Social Security Number(s)fEIN Number 01 Personal Representative{s) Street Address City State_Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's. attach explanation) Claimant Street Address Cily State _ Zip Relationship of Claimant 10 Decedent 4. ProbaleFees ~(i ti?J. ~ ~ ~ Accountant's Fees 5. 6. Tax Retum Preparer's Fees 7. ctU:11A.a::Qx;:12&mViCLvrJ) ~~ g, ~&-6~~~~(56%) 9, ~'#V~~j)Jue-~~ AMOUNT ~d9/. It!) /.50.06 5'96. {)6 /55". I ~ 8' &'. IS / R, {J,;j ?t?6o QJO. CJC> I ~ So. {)6 /js,d. 9 TOTAL (Also enter on line 9. Recapitulation) $ &:, 6 ~ s: t, 9' (If more space is needed, insert addilional sheets of the same size) _ . _.._._ __ ___...... ~....... oOII....."&""~ :N:L.I:\..'I:LI Charges are only for those items that you selected or that are required. If we are required by law or by cemetery or crematory to use any items, we wil~plain~ writing below. If you selected a funeral that may require embalming, such as a funeral with viewing, you may have to pay for embalnfing. You do not have to pay for embalming you did not approve if you selected arrangements such as direct cremation or immediate burial. If ~ we charged for embalming, we will explain why below. ~ For the Service of: Ruth D. Sander Charge to. Kim Merlino Name 22 Wheat Field Dr. Address Carlisle, aty Date of Death,April15, zooz PA 17013 State and Zip code $ .m-... $ included $ 000 $ included _ pil.'.luded $ 000 $ included $ 000 SUB-TOTAL OF FACIUllES &. EQUIPMENT 3. AUTOMOTIVE EQUIPMENT Removal and transfer vehicle Local.. . . . ................ Hearse ( Casket COach ) Local........... .......... $ included $indll.v..rl ~'.!I~~ $000 $ indll.v..rl $ included ,"1_ $ 401000 $ 000 $ 0.00 $ 0.00 I / $ 0.00 $ 0.00 Acknowledgement cards. , . Register book(s). . . . . . . . . . . . . . . MemoryFolders.............. . Prayer Cards. "......,........ Temporary grave marker. . . . . . . . . Bur.aIClothlng............,.. . Otherdothlng................ . Cremation urn. . . . . . . . . . . . . , , , . ( DescrIption ) $ included $ included $ 000 $ 1000 $ 000 $ 000 $ 000 $ 000 SUB-TOTAL OF PROFESSIONAL SERVICES 2. FAQLJT1ES AND SERVICES Use of fadlltles and serviCeS for vieWlng(VlSltatlon/Wake). . . . . . . Use of fadlltleS and services for funeral ceremony. . . . . . .... Use of fadllties and servIces for Memorial Service. . . . . .. . . . ... Use of equipment and servIces for graveside service. . . . . . . . . . Other use of fadlltieS A. CHARGE FOR SERVICES SELECTED 1. PROFESSIONAL SERVICES Seovlces of runeral dlrectollstaff. . . Embalming.. ....... . . . . . . . . . . Other preparation of the bOdy . . . . . UmouSine Local................. . . .. Family Car Local.. ................... Flower car or floral disposition Local........... .......... Lead car I Oergy car locaL............... , , , . . Car for pallbearers Local... . ... . ............. Out of town transportation. . . . . . . . """"'-, Casket package. .............. {DE:SCrtptlon} inrllJrI""th~r:lc:Il''''''r1P<:1TiI'\Pl1 :>JMVP :>Inri .::IrlrllHnn;a1 grvvlc: ;Inri q>rvtcP<;; InrlJr;:atM nn thic: d";ilh'mpnt :>1<:' In.-II IrlM (' ) Other receptacle. . . . . . ( DescrIption) ""...~ h.......l rn I Ptttsburgh Post Gazette $ 14110 Tribune Review Newspaper $ 3500 &.itIef EaOe $ 30 00 TOTAL MERCHANDISE SELECTED. . . . . . . C,SPECIALCHARGES forwarding of remains to: $ 000 Receiving of remains from: $ 000 $ 4246.10 Immediate burial. .............. $ 000 Dlrectcrematlon............. . $ ClOO $ 000 TOTAL SPECIAL CHARGES. . . . . . , . . . . . . $ 0.00 D. CASH ADVANCED ITEMS $ 000 Grave OpenIng Cemetery Equipment $ 000 Coroners Cremation AuthoriZation $ 000 Shipping or Airfare $~- Oergy and/or Mass Offering $ 000 AoriSt expenses $ 000 Headstone Engraving or Purchase $ 000 Other Newspaper Notice $ 000 Other Newspaper Notice $ 000 ProfessJonal Hairstylist $ ''100 Certified Copied oftne Death Certificate $ :nloo $ 000 TOTAL CASH ADVANCES. .. . .. . . . . . .. . SUMMARY OF ALL CHARGES A. ProfessiOnal services, Fadlitles and Equipment, and Automotive Equipment..... ............. B. Merchandise................. C. Spedal Olargcs. .. .. .. .. .. .. .. D. Cash Advanced Items. . . . . . . . . , $ 000 $ 424610 $ 000 $ 4500 $ 000 $ 000 $ 000 $ 0.00 SUB-TOTAL OF AUTOMOTIVE EOUIPMENT TOTAL OF PROFESSIONAL SERVICES, FACILITIES AND AUTOMOTIVE EQUIPMENT. . . . . . . . ., . . . . . ., . .. . B. CHARGE FOR MERCHANDISE SELECTFn Casket........,',........... ~ hKied (Description) Batesvllle-Hardwood TOTAL OF ALL SECTIONS. . . . . . . . . DISCOUNTS AND ALLOWANCES. . . . PAID AT TIME OF OR PRIOR TO ARRANGEMENTS............... . BALANCE DUE. . . .. . . .. .. .. .. .. $ 45.00 $ 4291.10 $ 0.00 $ 0,00 $ 4291.10 REASON FOR EMBALMING If arry law, cemetery, or crematory requirements have required the purchase of any Items above, It is explained below. Embalmina 8DDroved-VisitationJviewil1G REV-~'S:('-S7\ :.~. ,.~ COMMOHWEALTH OF PENNSYLVANIA INHERITANce TAX RETURN RESIDENT DEceDENT ESTATE OF :;(u:i; h .D ~ SCHEDULE J BENEFICIARIES (l/J er o?CJtJ 0) - t)C) '-/3.3 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Nol List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal dislributions) 1. iUa.ltkmtJUu::/ ~a/Y)~ ~. SO/J c:2s% Sbc.Au.;/t') 9"/-30 -73 '7 / .;;;..j lj)~c~ &. ~/fb..lp 7"19 ~ c2 ~v:~ <:9$% It.. S-.J./O.d:l3'1/ dcX w~iQ/lJ. ~.J PCt-. /70/3 03, ~e.~ ~61o ~ "-IJ../.02 7 3;;:; ~<l7P~bun, 06//) OiS'% ~,,6a.. /:S-Ol/V 1 ~ w. ~oUv 0b?G eX S o/.,s I ~/. .J./~-c::)/J1?' ~ 10.3 /Y)~&./ ,Pa. /660/ ENTER DOLlAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON- T AXABLIE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELlECTION TO T AA IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART D . ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ d FILE NUMBER (n more space is needed, insert addITional sheets of the same size) " /? - 60 - t<-.!3 )p BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND A~SESSHENT OF TAX KIM MERLINO 22 WHEATFIELD DR CARLISLE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-30-2002 SANDER 04-15-2002 21 02-0433 CUMBERLAND 101 '* REY-1547 EX AFP (01-021 RUTH D Allount Rellitted PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=i5'4j-EX-AFP--('OY:02Y-No7ficE--OF-YNHEifiTANCE-YAirA" PPRA"isEi"-ENT~--A[rOWANCE-(rR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SANDER RUTH D FILE NO. 21 02-0433 ACN 101 DATE 09-30-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 938.85 .00 .00 675.00 10.197.48 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 6,685.69 .00 (11) (12) (13) (14) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 11,811.33 6.685 69 5,125.64 .00 5,125.64 14, IS and/or 16, 17, 18 and 19 will returns assessed to date. NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ Abb ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX DITS: .00 X 00 = 5,125.64 X 045 = .00 X 12 = .00 X 15 = (19)= DATE 08-20-2002 NUHBER CD001544 + INTEREST/PEN PAID (-) .00 AHOUNT PAID 230.65 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 230.65 .00 .00 230.65 230.65 .00 .00 .00 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) Name of Decedent: Date of Death: Will No.: STATUS REPORT UNDER RULE 6.12 (9~hD,,f~~ ,~._.~ 3 Admin. No.: 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: State whether administration of the estate is complete: Yes I~ No [-1 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: Did the personal representative file a final account with the Court? Yes_ No 1~. 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 ['-1 Date: Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the. Orphans' Court and may be attached to this report. Si~gnature Name Address ~-~( r / /S,,/'~, / 7DI Telephone No. Capacity: ~ Personal Representative [--] Counsel for personal representative