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Home My WebLink About01-1134 ) I PETITION FOR GRANT OF LETTERS Estate of Rita M McCann No. 21-01-1134 also known as Rita M McCann 6/"""- Brian 4"'McCann Petitioner(s), who is/are 18 years of age or older, apply)ies) for: , Deceased Social Security No. 165140630 (COMPLETE "A" OR "B" BELOW:) GJ A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut or Decedent, dated 03/01/1999 and codicil(s) dated named in the Last Will of the State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: o B. Grant of Letters of Administration (c.I.a., d.b.n.c.l.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 325 Weslev Drive, MechanicsburQ, PA 17055 (list street, number and municipality) Decedent, then 81 years of age, died November 6 ,lQQ.L. , at Bethany VillaQe, MechanicsburQ, PA 17055 (Location) Decedent 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 ........................................................................................ $ Total ..................................................................................................................... $ 90,000.00 90,000.00 Real Estate situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature ~-- ~ c:e,--... J~ Brian McCann 28 Windfield Drive Berlin NJ 08009 Typed or printed name and residence / 7-e:2 7-~ '~) ii> a> a: a: o r;:\ 0- -=:t ...- c...:l c::::I .:~':::; :b t;.g ~= Gu p . Oath of Personal Representative Commonwealth of Pennsylvania County of The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to and affirmed alnd subscribed before me this 11+th day of 11 DECEMBER 'I04L4'~ mc:i.-C,vr_ ~{.(7 o/'u'r~'(bI/ <4"r i1u,-~/ rIk ~ I jo Estate of Rita M McCann DECREE OF REGISTER Deceased 21-01-1134 also known as No. Date of Death: 11/06/2001 Social Security No: 165140630 AND NOW" DECEMBER 14 2001 ,in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary 0 of Administration BlrrL are hereby granted to Brian4' McCann aka Brian J McCann ((c.I.a., d.b.n.c.l.; pendente lite; durante absentia; durante minoriate) in the above estate and that the instrument(s), if any, dated March 1, 1999 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters .................................... Short Certificates(s) ../Q....... Renunciation .......................... Extra Pages ( ) ............... I.T.R....................................... JCP Fee ................................. Inventory ................................ Other.............. ........... ...... ....... TOTAL .............................$ $ 200.00 ~Hl~u~{f~"b /.Q.,I?~ ISler of Wills $ $ $ $ $ $ $ $ 30.00 12.00 /}~ / . . ature 5.00 Attorney: Marielle F Hazen I.D. No: 68003 Address: 845 Sir Thomas Court HarrisburQ Telephone: 717-541-5550 DATE FILED: PA 17109 247.00 .- <::) c.') C! 0... ""-:t - c..J o ,:',) .- -r.l (';:. ~ w= 00 j'l, ';:) ~..~,) ;':") 25 ":::~"I ~'\ a;' '""cr: ~ o '.1: r:1 CL 0.. "'l:t - i;} (:j '~.::. n, ..0 C~ \1,)== de c..J o - p . , ,,~ '\ .. 21 -01-1134 LAST WILL AND TESTAMENT OF Rita M. McCann I, Rita M. McCann, a resident of Berlin, New Jersey, declare this to be my Last Will and Testament, and I hereby revoke any wills and codicils heretofore made by me. ARTICLE ONE: I direct that all of my just debts, funeral expenses, expenses of my last illness and the cost of administering my estate be paid as soon as practicable after my death. ARTICLE TWO: All federal, state and other death taxes payable on the property forming my gross estate for tax purposes, whether or not it passes under the WILL, shall be paid out of the principal of my residuary just as if they were my debts, and none of those taxes shall be charged against my beneficiary. ARTICLE THREE: Throughout this Will the masculine gender shall include the feminine and the neuter, and the singular number shall include the plural, and vice versa, unless the context of the Will indicates otherwise. ARTICLE FOUR: If any beneficiary shall die simultaneously with me or under circumstances which render it impossible or difficult to determine who died first, I direct that I shall be deemed to have survived such beneficiary. . \ . , .. ARTICLE FIVE: If a minor who is not a child of mine shall become entitled to a share of my estate, I direct that my Executor deliver items of tangible personal property (except cash) to either the minor, the guardian of the minor, or person with whom the minor resides, without bond and receipt signed by such person shall discharge my executor. I direct that cash distributable to a minor shall, in the discretion of my Executor either: 1. Be delivered by my Executor to a person designated by my Executor as Custodian for said minor pursuant to the New Jersey Uniform Gifts to lVfinors Act, as though my Executor were a donor making a gift under the Act pursuant to its terms; or 2. Be deposited into a savings account in the name of the minor, payable to him upon attaining the age of eighteen (18) years, or to said minor's estate ifhe should die before attaining the age of eighteen (18) years. My Executor shall have no further responsibility for funds so deposited. ARTICLE SIX: I grant my Executor (including any subsequent or Alternate Executors) in addition to those powers granted by the law of New Jersey the following powers: 1. To adjust, compromise and settle any claims or obligations. 2. To sell real and personal property at public or private sale upon such price, terms and/or conditions as he may deem advisable in his sole and absolute discretion. 3. To employ agents or advisors, including but not limited to accountants, custodians, attorneys and investment counselors. . f 4. To abandon in any way property which he determines in his sole and absolute discretion not to be worth liquidating. ARTICLE SEVEN: I direct that neither my Executor nor any alternate or substitute be required to furnish bond or other security ARTICLE EIGHT: I nominate my son, Brian McCann to be the Executor of this Last Will and Testament. In the event that my son, Brian McCann predeceases me, or for any reason fails to qualify or ceases to act, I nominate as the Alternate Executor my daughter, Eileen Lapp. ARTICLE NINE: (a) At the time of my death, I may have prepared a document listing the disposition of certain items of tangible personal property, not otherwise specifically disposed of by my will. It is my desire to dispose of the listed items as set forth in this document. (b) I devise my estate to be divided among my children, Eileen Lapp, Brian McCann, Kevin McCann and Kathy Elmgren, equally per stirpes. ^~r :vitne~sl whereoA I have hereunto subscribed my name this I g day of ( If lL'lJlC0A, 19 l{q . L ~ ------, .- 7 / 7 ../ "" /,. / ..'}7 X l~ -~ 47// //~~./e ~ __ The foregoing instrument consisting of this and three preceding typewritten pages, was signed, published and declared by the Testator to be his Last Will and Testament, in the presence of each of us and we, at his request, and in his presence, the Testator signed first, and in the presence of each other, have hereunto SUbSCribr our names as witnesses this 1 <S.t- day of rfv~~. ,19 qq. ~L^,~ uJJl ,C;'Ph~' ~~#~) / \J) ~ r\'~ N_':J L-/ I' d ')-'J r 'f ~/ \\ ~/7~ (/'v cJ2d'''Jr<< /?<.-< T, ~+-M. McCann , t~e :frt;;or: sign /?,y name to this ~~trument this ) day of~~^ 19~andbeingfirst duly sworn, do hereby declare to the undersigned authority that I sign and execute this instrument and my Last Will and Testament, and that I sign it willingly, that I execute it as my free and voluntary act for the purpose act for the purpose therein expressed, and that I am eighteen (18) years of age, or older, of sound mind and under no constraint or undue influence. x~@~hf~~ .' \ . , > . I We 'Lf\-~:V, f) D\ \\.00. and le5~C :;/O,T the witnesses, sign our names to this instrument, and being duly sworn, do each hereby declare to the undersigned authority that the Testator signs and executes this instrument as his Last Will and Testament and that he signs it willingly, and that each of us, in the presence and hearing of the testator, hereby signs this Will as witnesses to the Testator's signing, and that to the best of our knowledge, the Testator is eighteen (18) years of age, or older, ~ L' - . /?~ 7( ... ~ t:.c. / . I . ./:/ STATE OF NEW JERSEY :SS COUNTY OF CAMDEN Sworn and subscribed to, and acknowledged to and before me by Rita M. ~cCan~ the T~a~orland s.worn and subscribed to before me by t\\ ~;\ \ C\ (-~_~ \ l Ul- and ((-"/;;;c 5417- /' r: , the witness this ) <; tday of 0iL~~-,19 qrr THOMAS D. CASTELLANO. JR. NOTARY PUBLIC OF NEW JERSEY Commission Expires 3 /,17 /,2002 ~ ~ 5 ~t:I t'1 ~ ~ ::: Gt ~ ::: ~ ~e ~= ~ rt1 ~ 1::: ::: ..... ~ ~ - .... :::Sd ~ M S Gt ~ ..... ~ Gt ~ c: > ~ ..... . e ::: ~Ul . ..... ~ t"'t\ t:I t'1 e ~ ~ ::: -=-e ~ I.......t at"'t\ ~ rt1 ~ t:I~ ~ ~ ~ ~ := ~ t'1 ::: := e-l..... Gt z:e ~ t'1 S' ~ e ~ ::: a ..... M ~ Ul .;c!'('"'qUUl'J 'U;3)~ OE: L d 17l J I 0 to. ,,-,,j8t! :(~'~1G8 Ii DER: COMPLETE THIS SECTION . . . Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. . Print your name and address on the reverse so that we can return the card to you. . Attach this card to the back of the mailpiece, or on the front if space permits. 1. tlrticle Addressed to: MARIELLE F HAZEN 845 SIR THOMAS COURT HARRISBURG PA 17109 2. Article Number (I,ansfer from service label) PS Form 3811 , March 2001 .fIl.,IJjI:J.:a':a':IJ....."f::(.H.,.'~.I.'..,#.j'l:t:A. A. Received by (Please Print Clearly) x D. Is delivery address diffe t from item 1? If YES, enter delivery address below: 3. Se...r;Yice Type Ef Certified Mail o Registered o Insured Mail Ifi Agent o Addressee DYes ia"No o Express Mail o Return Receipt for Merchandise o C.O.D. 4. Restricted Delivery? (Extra Fee) '1n{)() t'll~ oC) OOd~ Domestic Return Receipt /.c;q ~ 17~1 DYes 102595-01-M-1424 UNITED STATES POSTAL SERVICE First,Class Mail Postage & Fees Paid USPS Permit No. G-10 . Sender: Please print your name, address, and ZIP+4 in this box · REGISTER OF WILLS CUMBERLAND COUNTY 1 COURTHOUSE SQUARE CARLISLE PA 17013 02. 1111111! I! Ill!!! l! llll! 11111 11III 11111 II!!! I! II! 11111! I! II! III r .~. ,~ . ". . '. :::r- -IJ I"'-- r-=r I.rJ POstage $ cr I.rJ Certifil'~d Fee r-=r Postmark I.rJ Return ReceiptC"ee Here ru (En,jarsement Required) 0 Restricted Delivery Fee 0 (Endorsement ReqUired) 0 Total POstage & Fees $ 0 -IJ 0 o o o I"'-- -Ciiy,'State: 'Zip;:i -. --. .".-.-.-..-."-.-.--.-...-..-.-.-.-.-..-.-..-.-.-.-....-.-..-.-.-".- ... ~/- 0 1- an(\ ~resent it wnel\ ma\\inq an inI\UH'/. JRD/June 30, 1992!l7858 . . 'r-U rf' APR 1 1 200' Estate No.: 21-01-1134 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA In Re: Estate of RITA M MCCANN Late of NO. NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT ORPHANS' COURT RULE Personal Representative: BRIAN MCCANN Counsel for Personal Representative: MARIELLE F HAZEN ESQ Date of Grant of Original Letters: DECEMBER 14, 2001 Date of Delinquency Notice: MARCH 24, 2002 The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court Orphans' Comt Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court Orphans' Comt Rules, was given by the Register of Wills on MARCH 24, 2002, and that the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6( e) the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: APRIL 10, 2002 Distribution: Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled for ~ iJ. ! l(1 :iou ;2. at . C;~ -) 0 A-Jt1!n Courtroom No.3. If the Certification of Notice is fil. prior to the hearing date, the hearing will automatically be cancelled. u~!< :; ., \--1,A~} Cl 1. /- /7- 0 i1 cl 1 ,'" 4-- V~ BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Rita M McCann Date of Death: 11/06/2001 Will No_ 2001-01134 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 04/16/2002 Name Address Eileen Lapp 824 Anthony Drive Mechanicsbura PA 17050 Brian J McCann 28 Windfield Drive Berlin NJ 08009 Kevin McCann PO Box 520598 Bic Lake AK 99652 Kathy Elmgren 23205 S Verbena Kennewick WA 99337 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: Date: 04/16/2002 ~111oh l~Jib V LfJn/)/ -/1/ Signature Marielle F Hazen Name: Jan Brown & Associates f- Address: 845 Sir Thomas Court. Suite 12 Harrisbura PA 17109 Telephone(717) - 5415550 -"-! :? ~ , f' ,~.,: ....-- Capacity: x Personal Representative Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA OEPARTMENT 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 MARIELLE F HAZEN ESQUIRE OLD ENGLISH GAP 845 SIR THOMAS CT SUITE 12 HARRISBURG, PA 17109 __n____ fold ESTATE INFORMATION: SSN: 165-14-0630 FILE NUMBER: 2101-1134 DECEDENT NAME: MCCANN RITA M DATE OF PAYMENT: 08/07/2002 POSTMARK DATE: 08/06/2002 COUNTY: CUMBERLAND DATE OF DEATH: 11/06/2001 NO. CD 001486 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $4,000.00 I I I I I I I I TOTAL AMOUNT PAID: $4,000.00 REMARKS: BRIAN MCCANN C/O MARIELLE F HAZEN ESQUIRE CHECK# 98 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS .. L--.... JAN L. BROWN & ASSOCIATES ATTORNEYS AND COUNSELORS AT LAW OLOE ENGLISH GAP 845 SIR THOMAS COURT SUITE 12 HARRISBURG, PA 17109 EMAIL jlbassoc@ptd.net "CERTIFIED ELDER LAW ATTORNEY BY THE NATIONAL ELDER LAW FOUNDATION TELEPHONE (717) 541-5550 FACSIMILE (717) 541-9223 . ADMITTED IN PA AND DISTRICT OF COLUMBIA JAN L. BROWN* MARIELLE F HAZEN** August 2, 2002 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 Re: Estate of Rita M. McCann File No. 2001-01134 PA File No. 21-01-1134 Gentlemen or Ladies: Enclosed please find a check in the amount of $4,000 payable to the Register of Wills, Agent. This check represents a payment of the Pennsylvania Inheritance Tax for the above- referenced estate. Make sure the check is marked as received within the 9 month payment period. Please forward a receipt to the above address. We have requested an extension of time to file the Pennsylvania Inheritance Tax Return from the Department of Revenue. If you have any questions, feel free to contact this office. Sincerely, I /' II ;J \!Ywzd:c 1- bVphad;- Brenda F. Kephart Legal Assistant bfk Enclosure '\.., 17 -.:2 7- .;2./ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 17128-0601 August 7, 2002 ID Telephone (717) 787-3930 FAX (717) 772-0412 Jan L. Brown & Associates Olde English Gap 845 Sir Thomas Gourt- Suite 12 Harrisburg, Pa.17109 Re: Estate of Rita M. McCann File Number 2101-1134 Dear Ms Hazen: This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before February 6,2003. Because Section 2136 (d) ()f the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. ,~--,.~..,......... Sincerlv..... . ""'0'" .J..'!~ /'! d ;: II ','f 1~ I '1/1 ; /:' .'::.." /"A " i.,..", 'J';' /J..>I.A,.' \..../ '~~'./~/j ~,\",v ,-/'.. / .,L:_.. Jeffrey D. Hollenbush, Supervisor Document Processing Unit Inheritance Tax Division ~ BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of McCann, Rita M No. 2001 01134 also known as Rita M McCann , Deceased Date of Death 11/06/2001 Social Security No. 165140630 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. l!We verify that the statements made in this inventory are true and correct. l!We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of Attorney: Marielle F Hazen 1.0. No.: 68003 Brian McCann Address: 845 Sir Thomas Court Suite 12 Dated 11/26/02 HarrisburQ Telephone: 717 -541-55EiO PA 17109 Description Value Commerce Bank Checking Account 53918615 648.55 Commerce Bank Savings Account 13109616 1,247.87 Equity Bank Checking Account 2200210 51,944.11 Hudson United Bank CD 1164737632; IRA; Estate is beneficiary 5,223.13 Hudson United Bank CD 1230039210; IRA; Estate is beneficiary 4,257.29 Hudson United Bank CD 1230049734; IRA; Estate is beneficiary' 8,420.63 Total (Attach Additional Sheets if necessary) 93,025.87 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 Continuation of Inventory McCann, Rita M 2001 01134 Paqe 1 Description of Inventory Description Value Hudson United Bank CD 123014887; IRA; Estate is beneficiary 2,839.09 Hudson United Bank CD 1230160998; IRA; Estate is beneficiary 2,647.36 Hudson United Bank CD 1230185148; IRA; Estate is beneficiary 5,395.34 Hudson United Bank CD 1230197411; IRA; Estate is beneficiary 1,780.35 Hudson United Bank CD 1230304220; IRA; Estate is beneficiary 1,264.32 Hudson United Bank CD 1230359291; IRA; Estate is beneficiary 1,7 43.43 Hudson United Bank CD 1230455674; IRA; Estate is beneficiary 2,693.75 United States Treasury 1999 federal income tax refund 2,245.79 Bethany Village refund 674.86 Subtotal $ 21,284.29 93,025.87 Grand Total $ . . REV.'$OOEX + (6-00) . REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I- Z W C W () W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) McCann Rita M DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DO-Year) 11/06/2001 11/15/1919 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) w >- .....:!cn ~o:", u"-u woo :1:0:.... U"-lll "- " 00 1, Original Return o 4. Limited Estate [R] 6. Decedent Died Testate (Attach copy afWill) o 9. litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date ofdealh after 12.12-82) o 7. Decedent Maintained a living Trust (Attach copy olTrust) o 10. Spousal Poverty Credit (date of death between 12.31-91 and 1-1-95) >- z w o z o "- '" W 0: 0: o U m1l!H NAME Marielle F Hazen FIRM NAME (If Applicable) Jan L Brown & Associates TELEPHONE NUMBER 717-541-5550 Harrisbur 845 Sir Thomas Court Ste 12 z o I- < ..J :J l- ii: < () W ll:: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole.Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schadule E) 6. Jointly Owned Property (Schadule F) (6) D Separate Billing Requested (1) (2) (3) (4) (5) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schadule G or L) 8. Total Gross Assets (total Unes 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decadent, Mortgage Liabilities, & Liens (Schadule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Une 8 minus Une 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (8) (11) (12) (13) 14. Net Value Subject to Tax (Une 12 minus Une 13) SEE INSTRUCTtONS ON REVERSE SIDE FOR APPLiCABLE RATES (14) z o i= ~ ::J a. :E o () ~ I- 15. Amount of Une 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X _(15) 67,823.86 X .045 (16) X .12 (17) X .15 (18) (19) 16. Amount of Une 14 taxable at lineal rate 17. Amount of Une 14 taxable at sibling rate 18. Amount of Une 14 taxable at collateral rate 19. Tax Due CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 20. [8] ..M;....'+';<m:mn~m~mm . OFFICiAl USE ONLY -~~ J_J_-.d7 FILE NUMBER 21 -01 1 1 34 "'COONTV"'CQDE ----yEA~ - - 'Nii'M8ER- SOCIAL SECURITY NUMBER 1 65- 1 4 - 0 6 3 0 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. RernainderRetum (date 01 death prior to 12-13-82) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (AtlachSch0) PA 17109 OFFICIAL USE ONLY l 93,025871 .~ 93,025.87 12,829.55 12,372.46 25,202.01 67,823.86 67,82386 3,052.07 3,C5227 -- o d t' C I t Add ece en s omDle e ress: STREET ADDRESS aDE Bethanv Villa e, 325 Weslev Drive lower Allen Township CITY T STATE I ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credil B. Prior Payments C. Discount (1) :1.0'17.0 400000 3. InteresVPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 4,000.00 TotallnteresVPenalty (0 + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the inlerest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check to: REGISTER OF AGENT 947.93 0.00 0.00 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retaintheuseorincomeofthepropertylransferred; ... .............. ....................... ............... 0 IZJ b. relain the right to designate who shall use the property transferred or its income; ......... .............................. 0 IZJ c. retain a reversionary interest; or ................................. ....................... ................................. D IX] d. receive the promise for life of either payments, benefits or care? .................... .............................. 0 IZJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?...................................................... ..... 0 00 3. Did decedent own an "In trust fo( or payable upon death bank account or security at his or her death? . .......... 0 IZJ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................... ........ 0 00 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. THER THAN REPRESENTATIVE NJ For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)). For dates of dealh 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 (aJ (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even jf 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 parell', or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value at transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% 172 P.S. 99116(a)(1.3)). A sibling is defined, under Section 9102, as an individual who has alleast one parent in common with the decedent, whether by blood or adoption. --- "'.'~m.""'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF McCann Rita M FILE NUMBER 21 01 1134 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 1. Commerce Bank 648.55 Checking Account 5398615 2 Commerce Bank 1,247.87 Savings Account 13109616 3 Equity Bank 51,944.11 Checking Account 2200210 4 Hudson United Bank 5,223.13 CD 1164737632; IRA; Estate is beneficiary 5 Hudson United Bank 4,257.29 CD 1230039210; IRA; Estate is beneficiary 6 Hudson United Bank 8,42063 CD 1230049734; IRA; Estate is beneficiary 7 Hudson United Bank 2,83909 CD 123014887; IRA; Estate is beneficiary 8 Hudson United Bank 2,647.36 CD 1230160998; IRA; Estate is beneficiary 9 Hudson United Bank 5,39534 CD 1230185148; IRA; Estate is beneficiary 10 Hudson United Bank 1,780.35 CD 1230197411; IRA; Estate is beneficiary 11 Hudson United Bank 1,264.32 CD 1230304220; IRA; Estate is beneficiary 12 Hudson United Bank 1,743.43 CD 1230359291; IRA; Estate is beneficiary 13 Hudson United Bank 2,693.75 CD 1230455674; IRA; Estate is beneficiary 14 United States Treasury 2,245 79 1999 federal income tax refund 15 Bethany Village refund 67486 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 93025.87 - REV.151 lEX + {1'971 '* SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McCann Rita M FILE NUMBER 21 01 1134 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. Costantino Funeral Home 7,781.50 2 Funeral luncheon 884.50 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Yea~s) Commission Paid: 2. Attorney Fees Jan L Brown & Associates 3,256.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant 10 Decedent 4. Probate Fees Register of Wills, Cumberland County 247.00 5. Accountanfs Fees Cipriani & Alfinito, CPAs 420.00 6. Tax Return Prepare(s Fees 7. Cumberland Law Journal, legal advertisement 75.00 8 The Sentinel, legal advertisement 103.55 9 Hudson United Bank, bank charge 20.00 10 Register of Wills; filing fee Inventory and Inheritance Tax Return 25.00 11 Register of Wills; filing fee Family Settlement Agreement 17.00 TOTAL (Also enter on line 9, Recapitulation) $ 12829.55 (If more space is needed, insert additional sheets of the same size) --- ,,,,,,,,,,.,,.on. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEr DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS . ESTATE OF McCann Rita M FILE NUMBER 21 01 1134 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 10,005.44 1. Bethany Village outstanding nursing home bill 2 United States Treasury 2000 federal income tax iiability 1,709.00 3 2000 state income tax liability 114.00 4 Alert Phy at Bethany Village outstanding medical bill 369.02 5 Jan L Brown & Associates outstanding legal bill 175.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 12372.46 --- REV-1513 EX < 19_ COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER "~('~nn Rit"M ?1 n1 11~" RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE L TAXABLE DISTRIBUTIONS Unclude outright spousal d~bibutions, and transfers under Sec. 9116 (a)(1.2)] 1. Eileen Lapp daughter 25% residue 633 Riders Club Rd, Onalaska, WI 54650 2 Brian J McCann son 25% residue 28 Windfield Drive, Berlin, NJ 08009 3 Kevin McCann son 25% residue 10622 Brycant Space #83, Yucaipa, CA 92399 4 Kathy Elmgren daughter 25% residue 23205 S Verbena, Kennewick, WA 99337 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ ----- (If more space is needed, insert additional sheets of the same size) , COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 17128-0601 August 7, 2002 Telephone (717) 787-3930 FAX (717) 772-0412 Jan L. Brown & Associates Olde English Gap 845 Sir Thomas Court- Suite 12 Harrisburg, Pa.171 09 Re: Estate of Rita M. McCann File Number 2101-1134 Dear Ms Hazen: This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before February 6,2003. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. Sincerely, ~- /""'""7".--....-.-_v.._ . ;"'1;) 1 ". Jeffrey D: H&ife)'1~t;r,. S'upervisor ~ '." Dqcument Pr<1ceSSi~iJnit // Inheritance Tax Division - . LAST WILL AND TESTAMENT OF Rita M. McCann I, Rita M. McCann, a resident of Berlin, New Jersey, declare this to be my Last Will and Testament, and I hereby revoke any wills and codicils heretofore made by me. ARTICLE ONE: I direct that all of my just debts, funeral expenses, expenses of my last illness and the cost of administering my estate be paid as soon as practicable after my death. ARTICLE TWO: All federal, state and other death taxes payable on the property forming my gross estate for tax purposes, whether or not it passes under the WILL, shall be paid out of the principal of my residuary just as if they were my debts, and none of those taxes shall be charged against my beneficiary. ARTICLE THREE: Throughout this Will t.1.e masculine gender shall include the feminine and the neuter, and the singular number shall include the plural, and vice versa, unless the context of the Will indicates otherwise. ARTICLE FOUR: If any beneficiary shall die simultaneously with me or under circumstances which render it impossible or difficult to determine who died first, I direct that I shall be deemed to have survived such beneficiary. - ARTICLE FIVE: If a minor who is not a child of mine shall become entitled to a share of my estate, I direct that my Executor deliver items of tangible personal property (except cash) to either the minor, the guardian of the minor, or person with whom the minor resides, without bond and receipt signed by such person shall discharge my executor. I direct that cash distributable to a minor shall, in the discretion of my Executor either: 1. Be delivered by my Executor to a person designated by my Executor as Custodian for said minor pursuant to the New Jersey Uniform Gifts to Minors Act, as though my Executor were a donor making a gift under the Act pursuant to its terms; or 2. Be deposited into a savings account in the name of the minor, payable to him upon attaining the age of eighteen (18) years, or to said minor's estate if he should die before attaining the age of eighteen (18) years. My Executor shall have no further responsibility for funds so deposited. ARTICLE SIX: I grant my Executor (including any subsequent or Alternate Executors) in addition to those powers granted by the law of New Jersey the following powers: 1. To adjust, compromise and settle any claims or obligations. 2. To sell real and personal property at public or private sale upon such price, terms and/or conditions as he may deem advisable in his sole and absolute discretion. 3. To employ agents or advisors, including but not limited to accountants, custodians, attorneys and investment counselors. """ .~.-.._._...,~""-,--_.,"""~-,-_.-" , 4. To abandon in any way property which he determines in his sole and absolute discretion not to be worth liquidating. ARTICLE SEVEN: I direct that neither my Executor nor any alternate or substitute be required to furnish bond or other security ARTICLE EIGHT: I nominate my son, Brian McCann to be the Executor of this Last Will and Testament. In the event that my son, Brian McCann predeceases me, or for any reason fails to qualifY or ceases to act, I nominate as the Alternate Executor my daughter, Eileen Lapp. ARTICLE NINE: (a) At the time of my death, I may have prepared a document listing the disposition of certain items of tangible personal property, not otherwise specifically disposed of by my will. It is my desire to dispose ofthe listed items as set forth in this document. (b) I devise my estate to be divided among my children, Eileen Lapp, Brian McCann, Kevin McCann and Kathy Elmgren, equally per stirpes. Ig . In witness. whereof; I ,have hereunto subscribed my name this (lYLl\.Aj~J~, 19 l{ICi. day of .......---. ,/i X }~~d t~:;~ /".:?/>~", ___ ' ~.)/~ ~-. 14r~ / -- The foregoing instrument consisting of this and three preceding typewritten pages, was signed, published and declared by the Testator to be his Last Will and Testament, in the presence of each of us and we, at his request, and in his presence, the Testator signed first, and in the presence of each other, (Sot day have hereunto subsCrib\d our names as witnesses this of rfv^v~lJ'v~ ~ , 19 q C1. IHl'~vi- /JJJJz~~;I" r,~lsc -R~~ !Jj ,~"',! , / 1// "," (I/,-!.tf'.- c.. . --', ," ) - /'c.- r[/;::h/? / _.-1 .' /,,..-:"././ /'? .~d L/ / v' u I, Rjta M. McCann, the Trtator,' Si~" Y name to this i9tstrument this ) ...:c,;+- r./\/ If\. ,1 '. uCt day of --.-J f L-L ,-" ' '-- 19 ~, and being first duly sworn, do hereby declare to the undersigned authority that I sign and execute this instrument and my Last Will and Testament, and that I sign it willingly, that I execute it as my free and voluntary act for the purpose act for the purpose therein expressed, and that I am eighteen (18) years of age, or older, of sound mind and under no constraint or undue influence. // +-0' ~.. X ~::;"-/,h/ ~,,/" /;Jl;e; /::f 4/]/),4 ~ .._.,.~m""..~_,._.__~_.^'_'_~'__'__'_'''__ , We 'iJ'\~\'cI'j )~\ \~~ and LC5!;;; ~/J / T the witnesses, sign our names to this instrument, and being duly sworn, do each hereby declare to the undersigned authority that the Testator signs and executes this instrument as his Last Will and Testament and that he signs it willingly, and that each of us, in the presence and hearing of the testator, hereby signs this Will as witnesses to the Testator's signing, and that to the best of our Imowledge, the Testator is eighteen (18) years of age, or older, of sound mind, and under no constraint or tmdue influence. l!'Q"\ r .. 1\ ( ! ,0~,uj)t~~U:':;, ) ) l~\ :\ .. ,{ \ , JJ JV& \\ 'L; /\j'j ~. ' - ,/' I_/'/ . 7 J .. /... th /'.. v/ / " ~/ ( ~;~.:.., (' ,/~ if-Lz:/~ ~;,~- / v STATE OF NEW JERSEY :SS COUNTY OF CAMDEN Sworn and subscribed to, and aclmowledged to and before me by Rita M. ~c~~nn re Tis\,atorlan~ sworn and subscribed to before me by t-\ \ ~ '\: \,\. !<j \ [Vi-. and /~f;/; 5'{F ,/ r-- , the witness this ) S. tday of ,yiLCLj~~L V , 19 no 1'1. ~ ~.<.J7 GJ~)/ THOM~S D. C~STELLANO. JR. NOT~RY PUBLIC OF NEW JERSEY Commission Expires 3/,17 {ZfJ02 --- ~ III e ~QI ... ,., III = = ,..~ Gl l$l= ~ ~ "t:l a -. ft} g= - ~ ~ S fa ~ ... -. ~ . = Gl ~ in' . ~ Gl ... -, ~ Q III ,., Q '"" = .s.= ~ QI . Q Q "" -'"" ~ Qll$l ft} ,~ ,., ,., ... = =:: ~ ~ ~...., =:: -. Q III ... Gl ~ in' l$l Q ,., = a -, ~ l:l STATUS REPORT UNDER RULE 6.12 Name of Decedent' Rit0 M McCann Date of Death: 11/06/2001 Will No. 2001-01134 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 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 account with the Court Did the personal representative file a final Yes ~ No X 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 X No ~ 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. Family Agreement and Final Release gn&g~ filed with Reg of Wills. Date' 3/22/2004 Si Jan L Brown & Associates Name (Please type or print ) 845 Sir Thomas Court Suite 12 Harrisburg PA Address 17109 (717) 541-5550 Tel. No. Capacity Personal Representative X Counsel for personal representative \.,/?~ ~/- c:v BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MARIELLE F HAZEN JAN L BROWN 8 ASSOCS 845 SIR THOMAS CT 12 HBG PA 17109 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-17-2003 MCCANN 11-06-2001 21 01-1134 CUMBERLAND 101 '* REV-1547 EX AFP (01-05) RITA M Allount Rellitted 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 ~ ftfv =i547-E3c-AFP--[oY:oiY-Noi"-icE--o':-YNHEifiTANcE-YA"x-A-PPRjrisEifENT~--ALToWAirCE-ori------------ --- -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MCCANN RITA M FILE NO. 21 01-1134 ACN 101 DATE 02-17-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of Abh returns assessed to date. ASSESSMENT OF TAX: 1.5. Allount of Lints 14 at Spousal rate (1.5) 16. Allount of Linls 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Linll 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 67,823.86 X 045 = 3,052.07 .00 X 12 = .00 .00 X 15 = .00 (19)= 3,052.07 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. Mortgages/Notes Receivable (Schedule D) .5. Cash/Bank Deposits/Misc. 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 .00 .00 .00 93,025.87 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value I~f Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value (~f Estate Subject to Tax (9) (10) 12,829.55 12,372.46 (11) (12) (13) (14) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 93,025.87 25.?02 01 67,823.86 .00 67,823.86 . ~...~... n~_~.. l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-07-2002 CDOO1486 .50- 4,000.00 TOTAL TAX CREDIT 3,999.50 BALANCE OF TAX DUE 947.43CR INTEREST AND PEN. .00 TOTAL DUE 947.43CR IE IF PAID AFTER DATE :[NDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class 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 on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND [CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. [72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF WILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax [including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of thi s 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 writing 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-lSOl) 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 [SZ) discount of the tax paid is allowed. The lSZ tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. 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, or nine (9) months and one [1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six [6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest DailY Interest Daily Interest Rate Factor Year Rate Factor Year Rate Daily Factor Year 1982 20Z .000548 1987 9Z .000247 1999 n .00019Z 1983 16Z .000438 1988-1991 llZ .000301 2000 8Z .000219 1984 llZ .000301 1992 9Z .000247 2001 9Z .000247 1985 13Z .000356 1993-1994 n .000192 2002 6Z .000164 1986 10Z .000274 1995-1998 9Z .000247 2003 SZ .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen [IS) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. ~/1-d-7~C:V BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REV-1U7 EX AFP 101-05) MARIELLE F HAZEN JAN L BROWN & ASSOCS 845 SIR THOMAS CT 12 HBG PA 17109 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-24-2003 MCCANN 11-06-2001 21 01-1134 CUMBERLAND 101 RITA M Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV: i6'ifj-E3f-AFP--f oy:ijiY-----...--iNi.fERITANCE--TAX--STA-fEME-NT-O-F-AC-co[itff--.-..---------------- -- --- ESTATE OF MCCANN RITA M FILE NO.21 01-1134 ACN 101 DATE 03-24-2003 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-17-2003 PR I NC I PAL TAX DUE: .......................................................................................................................................................................................................................... 3,052.07 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-07-2002 CDOO1486 .50- 4,000.00 03-03-2003 REFUND .00 947.43- TOTAL TAX CREDIT 3,052.07 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 It SIDE 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. ) PAYMENT: Detach the tDP pDrtiDn Df this NDtice and submit with YDur payment made payable tD the name and address printed Dn the reverse side. If RESIDENT DECEDENT make check Dr mDney Drder payable tD: REGISTER OF WILLS, AGENT. If NDN-RESIDENT DECEDENT make check Dr mDney Drder payable tD: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund Df a tax credit, which was nDt raquested Dn the Tax Return, may be requested by cDmpleting an "ApplicatiDn fDr Refund Df Pennsylvania Inheritance and Estate Tax" (REV-13l3). ApplicatiDns are available at the Dffice Df the Register Df Wills, any Df the 23 Revenue District Dffices Dr frDm the Department's 24-hDur answering service fDr fDrms Drdering: 1-800-362-2050; services fDr taxpayers with special hearing and I Dr speaking needs: 1-800-447-3020 (TT Dnly). REPLY TO: QuestiDns regarding errDrs cDntained Dn this nDtice shDuld be addressed tD: PA Department Df Revenue, Bureau Df Individual Taxes, ATTN: PDSt Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phDne (717) 787-6505. DISCDUNT: If any tax due is paid within three (3) calendar mDnths after the decedent's death, a five percent (57-) discDunt Df the tax paid is allDwed. PENALTY: The 157- tax amnesty nDn-participatiDn penalty is cDmputed Dn the tDtal Df the tax and interest assessed, and nDt paid befDre January 18, 1996, the first day after the end Df the tax amnesty periDd. INTEREST: Interest is charged beginning with first day Df delinquency, Dr nine (9) mDnths and Dne (1) day frDm the date Df death, tD the date Df payment. Taxes which became delinquent befDre January 1, 1982 bear interest at the rate Df six (67-) percent per annum calculated at a dailY rate Df .000164. All taxes which became delinquent Dn and after January 1, 1982 will bear interest at a rate which will vary frDm calendar year tD calendar year with that rate annDunced by the PA Department Df Revenue. The applicable interest rates fDr 1982 thrDugh 2003 are: Interest Daily Interest Daily Interest Daily Year Rate FactDr Year Rate FactDr Year Rate FactDr 1982 207- .000548 1987 97- .000247 1999 n .000192 1983 167- .000438 1988-1991 117- .000301 2000 87- .000219 1984 117- .000301 1992 97- .000247 2001 97- .000247 1985 137- .000356 1993-1994 n .000192 2002 67- .000164 1986 107- .000274 1995-1998 97- .000247 2003 5)( .000137 --Interest is calculated as fDllDws: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any NDtice issued after the tax becDmes delinquent will reflect an interest calculatiDn tD fifteen (15) days beYDnd the date Df the assessment. If payment is made after the interest cDmputatiDn date shDwn Dn the NDtice, additiDnal interest must be calculated. ....'" -../.1 "0 I.r] "0 r:r- ' L~___ POStage "'_ _~_._ -- ----- Certlfleo Fee "_ ___________./ Fleturn FI (Endorsement eee'Pt Fee .___.______ / FleqOlreo) ---- f}eStriCfect D -------I (/'Odorsement elivery Fee ____ . ReqUited) 1(>1"1 POSt j ",", '/;;' '~'. $ = o~~Seo';'-;'1Ot N..c(<<-z.- >, /~ .2--;~ _ ""...60"-""0 - '''-<..-<~....c..-/,~ ._ Q, ';';-"e .~ i':.' "'_~ ". <5'::f,( ~ . '~/Z'~<i "" . .... ...~ '~.-tl--l'L<-2;7':.""~~c:?< ,,-;r......__ '. c <-< -l_.~ //. "'<~~ Z/ ~<- / /~/O ---_____ -~--. POStmark Here ~.~ ';:'0 'Jf.' 'f:\ .,.,,~'i PLETE THIS SECTION .1l.ll~J:J.=-I_;a.:I"~"f::{I1II.J..t..Jl'..J~..'J=t:,y -~~I~:~ . Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. . Print your name and address on the reverse so that we can return the card to you. . Attach this card to the back of the mail""~ or on the front if space permits. .c. ""'1 1. Article Addressed to: . }?l&/2 ~J2.J:.'l~~1 itIa;:f'1~ . . X {/() (j :-:t:JL~i:.14/;.('i/J(/ /ClP-. ;.ttJ.-1U:rdf.{.{/:!! fl(./ /f j ////() Express Mail o Return Receipt for Merchandise o C.O.D. 4. Restricted Delivery? (Extra Fee) DYes 2. Article Number (Transfer from 51 7 0 0 1 2 5 1 0 0 0 0 6 5 8 61 9 8 9 4 PS Form 3811, August2001 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE " I First-Class Mail , Postage & Fees Paid USPS Permit No. G-10 · Sender: Please print your name, address, and ZIP+4 in this box · REGISTER OF WILLS & CLERK OF ORPHANS' COURT ctlMBERLAND COUNTY COURTHOUSE 1 COURTHOUSE SQUARE CARLISLE, PA 17013 ATIN: SUE ;)2 I" _.j:".~!;A4~I,~~JI~!fl'II.tlll)~~;!M . JRD/June 30, 1992/17858 . " DEe 0 4 2003 V In Re: Estate of Rita M. McCann Late ofLowe~r Allen Township ORPHANS ' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLV ANIA Estate No.: 21-2001-1134 NO. 21-2001-1134 NOTICE O]~ FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING ])URSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Counsel for Personal Representative: Marielle F. Hazen, Esquire Date of Decedent's Death: 11-06-2001 Date of Delinquency Notice: 10-10-2003 The undersigned, Donna M. Otto, Register of Wills, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Register of Wills on 10-10-2003, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Distribution: Personal Representative Counsel for Personal Representative Estate File Date: 12-3-20103 J -& -0 t/ 9"30 A Pl' A hearing is scheduled for at in Courtroom No.3. If the Status Report is filed prior to the hearing date, the hearing will automatically be cane I~~ ~.'~.~ "-.-J.~ ,l ~ ~' Geor 01/28/2004 15:47 71 75419223 JAN L BROWN & ASSOC PAGE 01 J .Ian L. Brown, ~ire. Jacqueline A. Kelyt Esquire JAN L BROWN & ASSOCIATES AlTORNEY AND COUNSELOR AT LAW Oule ENcJu.t GN>> 845 SIt THCIMI CcutT Scm12 H---. PA 17109 EmaiI: jlb..OCOI*f.net TElSIHC:lNE (717) 541..e550 F~ (717) 541-9223 EnndI F. KephIrt LegII Aul1 It . PdI K. 'M1It, I..egII AIIiIeIn "MIm1B). PA AMJlII11'CT Of ~ January 28, 2004 . VIA FAX 717-240-7797 AND US MAIL Attn: Sue Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A ll70 13 Re: Estate of Rita M. MeCaDD Soda) See1Irity No. 165-14-0630 File No. 2001-01134 Gentlemen or Ladies: Attached please find the Status Report Under Rule 6.12 advising that this estate should remain open. We anticipate closing this estate by year's end. Be advised that Ian L. Brown is the attorney of record in this matter. The Petition for Probate tiled ~)n or about December 14, 2001, listed Marlelle F. Hazen as the attorney. Please be advised that Ms. Huen was an employee of Ian L. Brown & Associates at that time. She no longer works here; and we continue to represent the personal representative of this Estate. We apologize for any confusion regarding the current status of this estate file. S~'_'9. B~ Ian ~wn JLBlbtk Enclosure 01/28/2004 15:47 71 75419223 JAN L BROWN & ASSOC PAGE 02 } S'{A11JS REPORT UNDER RULE 6.12 Name of Decedent: Rita M MOCann Date of Death: 11/0612001 Will No. 2001..01134 Admin. No. PursU8llt to Rule 6. 12 of the Supremo Coun Orphans I Court Rules, I report the following with respect to completion of the administration of the above-aptioned estate: 1 . State whether administration of the estate is complete:. Yes No x 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: FSA/AccountinQ remains outst.anding; we believe administ.rat.ion will be complete on or before 12/31/04. 3 . If the answer to No. I is Yes, state the following: a. ~count with the Court? Did the personal representative file a final Yes ~o b . The separate Orphans' Court No. (if any) for the personal representative t s account is: c . Did the personal representative state an account infunnally to the parties in interest ? Yes No d . Copies of receipts. releases. joinders and approvals (.r formal or infonnal accounts may be filed with the Clerk of the Orphans t Court and may be attached to this report. Date: 0112812004 ~~~ Signa .- Jan L Brown & AMael8tM Name (Please type or print) 845 Sir Thomas COurt Suite 12 Harrilllbura PA 1710Q Address ( 717 ) 541- 5550 Tel. No . Capacity : Personal Represontative x Counsel for personal representative STATUS REPORT UNDER RULE 6.12 IV / v()K Name of Decedent: Rita M McCann Date of D(~ath: 11/06/2001 Will No. 2001-01134 Admin. No. Pursuant to Rule 6. 12 of the Supreme Court Orphans I 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 1S complete: Yes No X 2 . If the answer is No, state when the personal representative reasonably believes that the administration will be complete: };'SA/Account ing rema ins outstanding; we bel ieve admini stra t ion will be complete on or before 12/31/04. 3 . If the answer to No. 1 is Yes, state the following: a. account with the Court? Did the personal representative file a final Yes No b . The separate Orphans I Court No. (if any) for the personal representative I s account is : c . Did the personal representative state an account infiJrmally to the parties in interest? Yes No 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. Date: 01/28/2004 ~;RB~ SignatUl: "",,,-,. Jan L Brown & Associates Name (Please type or print) 845 Sir Thomas Court Suite 12 Harrisbura PA 17109 Address ( 717 ) 541- 5550 Tel. No. Capacity : Personal Representative X Counsel for personal representative IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION ESTATE OF RITA M. MCCANN, DECEASED FILE NO. 2001-01134 c;2 FAMILY AGREEMENT AND FINAL RELEASE THIS AGREEMENT by and between BRIAN MCCANN, as Executor offb'e Estate of RITA M. MCCANN, Deceased, and EILEEN LAPP, BRIAN MCCANN, KEVI.N MCCANN and KATHY ELMGREN, individually. WHEREAS, RITA M. MCCANN, late of Lower Allen Township, Cumberland County, Pennsylvania, died testate on November 6,2001, having first made her Last Will and Testament dated March 1, 1999, which instrument was admitted to probate and is recorded in Cumberland County Courthouse, Register of Wills, File No. 2001-01134; WHEREAS, BRIAN MCCANN has been duly appointed as Executor of the Estate of Rita M. McCann, Deceased; and WHEREAS, the parties in interest under the Last Will and Testament of Rita M. McCann, Deceased, are: 1. Eileen Lapp, daughter; 2. Brian McCann, son; 3. Kevin McCann, son; and 4. Kathy Elmgren, daughter. WHEREAS, EILEEN LAPP, BRIAN MCCANN, KEVIN MCCANN and KATHY ELMGREN are each entitled to twenty-five percent (25%) of the residuary estate; Page 1 of7 ~~. WHEREAS, each ofthe parties to this Agreement have been furnished with a complete listing of the estate assets, receipts and disbursements as set forth on the Statement of Account as attached hereto and marked as Exhibit A; WHEREAS, it is the desire of the parties to this Agreement that administration of this estate be completed and accomplished without a formal accounting to the Orphans' Court Division of the Court of Common Pleas of Cumberland County, it being the desire of the parties to avoid the expense, delay and publicity of a formal accounting; WHEREAS, the parties to this Agreement each acknowledge to have received a proposed Schedule of Distribution attached hereto and marked as Exhibit A. NOW, THEREFORE, WITNESSETH, in consideration of the mutual promises, covenants and agreements recited herein, the parties do agree as follows: 1. Each of the parties to this Agreement does hereby release and forever discharge the said Executor, BRIAN MCCANN, his heirs, executors, administrators and assigns, JAN L. BROWN & ASSOCIATES, attorneys at law, and JAN L. BROWN, ESQUIRE from any and all liability which may from time to time arise in connection with their service as Executor and Attorneys of the Estate of Rita M. McCann, Deceased. The parties do further agree to indemnify and hold them harmless from any and all liability which may arise against the estate from creditors or claimants. 2. Each of the parties does hereby acknowledge receipt of the assets described on the Schedule of Distribution attached hereto. Page 2 of7 3. Each of the parties acknowledges that this Agreement shall be indexed and recorded in the estate proceedings and that the terms hereof shall be binding upon their respective heirs, successors, administrators and assigns. 4. Each of the parties do further agree with each other and the aforesaid Executor that should any liability come due to the estate ofthe said decedent after the signing of this Agreement, each will contribute pro rata his share of the estate to satisfy any and all claims, demands, suits or causes of action which may be successfully prosecuted against the said estate or the aforesaid Executor after the signing, sealing and delivery of this Agreement. 5. This Agreement shall be governed by the laws of the Commonwealth of Pennsylvania. Page 3 of7 IN WITNESS WHEREOF, I have hereunto set my hand and seal this '~ day of ~"'I>JG.''l'''''''''' .... , 2004. WITNESS: ~-s, -~'-.,c, ,""- f3~11lc~ BRIAN MCCANN, Executor and Beneficiary STATE OF NEW JERSEY SS: COUNTY OF On this the '~ day of ~'l-....'-O!<-. - , 2004 before me, a Notary Public, the undersigned officer, personally appeared BRIAN MCCANN, known to me or satisfactorily proven to be the person whose ~~e is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~. . .~ '~<:A..,-' Notary pu~ Lynda J. Miller My Commission Expires Nov. 18th, 2006 Page 4 of7 '];L. W~ESS WHEREOF, I have hereunto set my hand and seal this .) IJ ' , 2004. ..91 day of WITNESS: E~~{t1p,~~l~f2 3 -,;-- d'f STATE OF WISCONSIN COUNTYOF I~ ~ d' /J On this the S - day of Y? I a/L,~ SS: , 2004 before me, a Notary Public, the undersigned officer, personally appeared EILEEN LAPP, known to me or 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 hereunto set my hand and official seal. Notary Public ~t?, Page 5 of7 IN W][TNESS WHEREOF, I have hereunto set my hand and seal this ~1i day of ~tv ,2004. WITNESS: 4~~ L\\t~QllnQv:J i/ . ;(~ hc~ KEVIN MCCANN, Beneficiary STATE OF ALASKA SS: COUNTY OF On this the ~~ day of L{('\p.j\.n'^-.- , 2004 before me, a Notary Public, the undersigned officer, personally appeared KEVIN MCCANN, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~I/ Jv\a/'rJ-p-/5( J-jUJt Notary Public \ ' ' In j L 0'('{\(YUSJ I (VI ~*-f7LAC~ II--{J) :..at Page 6 of7 " "';,...... IN WITNESS WHEREOF, I have hereunto set my hand and seal this sv/, dayof - tl\G.-~~~ ,2004. WITNESS: < ~"'" {\. r'7 t' . L c_':<..:..---' f1~ -urn. KATHY ELMGREN, Be~ STATE OF WASHINGTON ) -+--- ~ij ~~'^'-- SS: COUNTY OF On this the c: ....- ) - day of /ll CLA-cL , 2004 before me, a Notary Public, the undersigned officer, personally appeared KATHY ELMGREN, known to me or 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 hereunto set my hand and official seal. {~ Page 70f7 STATEMENT OF ACCOUNT OF THE ESTATE OF RITA M. McCANN Personal Property Commerce Bank accounts Equity Bank account IRA accounts, estate is beneficiary U.S. Treasury, 1999 tax refund Bethany Village refund Total Assets Income earned since date of death Expenses Funeral Legal fee; Jan L Brown & Assoc Accountant fee; Cipriani & Alfinito Administrative costs Debts of decedent Inheritance Tax Total ]~xpenses Net Assets Available for Distribution $1,896.42 $51,944.11 $36,264.69 $2,245.79 $674.86 -$8,666.00 -$3,256.00 -$1,520.00 -$514.67 -$13,197.39 -$3,052.57 SCHEDULE OF DISTRIBUTION ACCORDING TO TERMS OF WILL* Eileen Lapp, 25% of residue Cash distribution; 6/03 Cash distribution; final Brian 1. McCann, 25% of residue Cash distribution; 6/03 Cash distribution; final Kevin McCann, 25% residue Cash distribution; 6/03 Cash distribution; final Kathy Elmgren, 25% of residue Cash distribution; 6/03 Cash distribution; final Total Histribution $15,438.56 $498.69 $15,438.56 $498.68 $15,438.56 $498.69 $15,438.56 $498.69 *Final cash distribution may be increased or decreased based on interest accrued, market value of assets, presentation of an obligation and/or payment of additional charges. After final distribution is made, the beneficiaries agree to reimburse the personal representative if called upon to pay further liabilities of the decedent in the future. 2/26/2004 Exhibit A $93,025.87 $929.75 -$30,206.63 $63,748.99 $63,748.99 STATUS REPORT UNDER RULE 6.12 1\ 1/ V ~'lK Name of Decedent: Rita M McCann Date of Death: 11/06/2001 Will No. 2:001-01134 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: 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. account with the Court? Did the personal representative file a final Yes No X 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 X No 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. Family Agreement and Final Release !-.D ~ filed with Reg of Wills. ~ _~ Date: 3/22/2004 Signat Jan L Brown & Associates Name (Please type or print) 845 Sir Thomas Court Suite 12 Harrisburg PA 17109 Address I',~ (717 ) 541- 5550 Tel. No . .' - ~ l ('f") ('-J 1.--- ~- Capacity : Personal Representative o..;;:/" p X Counsel for personal representative J ~ - - ,r..., .....,1-