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Home My WebLink About02-1135PETITION FOR PROBATE & GRANT OF LETTERS Estate of JOHN W. MARKERT also known as deceased. Social Security No. 066-10-3099 No. 21-02- / ~.3~" To: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The Petition of the undersigned respectfully represents that: Your Petitioners, who is 18 years of age or older and the Executor named in the Last Will of the above decedent dated May 16, 1996 and codicils dated none .The Executor named none died .Renunciations for _ John Philip Markert and Susan E Chapala attached hereto. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at _ 102 Green Ridae Lane Newville West Pennsboro Township Decedent, then 9?_ years of age, died November 9 , 2002, at Shock Trauma Center Baltimore, Maryland 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: Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $225,000.00 (If not domiciled in PA) Personal property in PA $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania, situated as follows: $ WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented herewith and the grant of letters testamentary thereon. Signature(s) and Residence(s) of Petitioner(s): ~~~~ ~ c~ Roper B. Irwin 60 Weft-F~omfret Street Carlisle. PA 17013 717-249-2353 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss The Petitioner(s) above named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that as personal representative of the above dFCede,~t; petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this ~~. ~ day of December, 2002. ~t~/~.J Reg' t~~ ~~:~~ 0 ~. Rog B. Irwin ~7- /OQ- / .~j6 No. 21-02- Estate of _ JOHN W. MARKERT ,deceased. DECREE OF PROBATE & GRANT OF LETTERS AND NOW, December !~3 2002, 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 May 16, 1996 described therein be admitted to probate and filed of record as the Last Will of John W. Marken • and Letters _ Testamentary are hereby granted to Roger B. Irwin FEES Probate, Letters, Etc........ $ 270.00 Short Certificates(-3- ) .... $ 9.00 Renunciation(s) ........... $10.00 JCP .................... $ 10.00 Other Will Pages (-2-) .... $ 6.00 TOTAL: .... $ 305.00 Filed .................... ........ Regis*.er of vVills~yu~~~,~G~,~,~ ~; , I IN McKNICN"~ :.& HJOHES ~_ `~ I Ro er . Irwm~E~s~. _ 282) ATTO Y (Sup. Ct. I.D. NG.) L. 60 West Pomfret St. Carlisle PA 17013 ADDRESS 717-249-2353 PHONE ALID ONLY WITII TRESSED SEAL DATE ISSUED: DEC U ~ 2002 -~~ THEREBY CERTIFY THAT RECORD ON FILE IN T~ ATTACI-IED IS A TRUE ('OP Y OF A THE DIVISION OF VITAL RECORDS STATE REGIS R O AL RECORDS Please Typte or Print in Black Indelible Ink. Ensure All Copies ~~ ~~ Dr. G813,11/21S/~~d~~Ma('Yland /Department of Health and Mental H Are Legible. Registrar 1• Decedent's Name (First,^Mnild/e, Last) Certificate of Death Y9~er)e ,S' ~h r\ 1 " 10.rk P..~ + Rag. No. 2. Date of Death 4a. Facility Name (//not;nsfitution, Month 3. lime of Death _ give street and number) ` ~ '~ f i uC..k ~ hQ ~ m ~ / ; ~~~ ~ 4b. City, Town, or Location of Oeath qy ZL~ ~L ~ ~ ' ~ Z ,t~ M 5. Social Security Number ~ ~ (-~ ~-t-~ ~ r ~ 4c. County of Death 6. Sex 6~0 ~C 1 O ~ (~ ~ ~? 1 ~ M 2 ^ F 7' Age (fi yrs. last birthday) If Under 1 Year It Usual Residence of Decedent 9 2 Months Under 24 Hrs. 8. Date of Birth Yrs. Days Hours Min. 10a. State O(5 th, Day, VearJ 9. C uniryj (State orFOreign tOb. County 1 Jr 1 i PA loc. City, Town or Location NY 3 Cumberland ~ 10e. Street and Number Newv i 11 e 10d. Inside Ciry Limits 1~2 Green 1a. Zip Code 1~Yes 2l~No ~ 11. Marital Status R 1 dg a Lane 10g. Citizen of What Country? 1r' ~ 12. Was Decedent Ever in U.S. 1 7 2 41 - 1 ^ Never Married 2i] Married Awned Forcesl 13. Was Decedent of His anic Ori m? U • 'S • A . 1 ^Yes l~~yN If Yes, specify Cuban, Mexican Puerto Ri g~ es or No- t rdowed If Yes, Giv o 14. Race - f 4 ODivorced etc.) American Indian, -"-'- Year or Dates: 1 ^ Yes 2~QNo Spec' ~ Black, While, etc. J 15. Decedent's Education ~~ i (SPecity ony higher, grade comp/etedJ ~ 16a. Decedents Usual Occupation SpeCrty: Whit e • Elementary/Secondary (0-12) (Give kind o{ work done Burin ' 12th ra de 4 liege (1-4or 5+) lde. DO NOT use retired) 9 most o/,rorking 118h. Kind of Businessr ~ lndus!ry r 17. Father's Name (First, Middle Last) r$ ~F+nC ]• t neer ' Paul nn-,,,.,----• 7e Naval p~-_,_ .. 19a. Informant's Name/Relationship (Type, PNn1J Susan E. Cha ale 20a. Method of Disposition X~Burial 2 []Cremation 3 ^Removal from State ` 0 (]Donation 5 ^Other (SpecityJ 21. S,gn r Funeral Service Licensee - ~ r , -- _ 23a. Pa Enter the sh k, or heart f Immediate Cause (Final disease or condition resulting in death) ~ ~y eadrng tolmmed ate cause. Enter Underlying Cause (Disease or injury resulting rnd eath)tLast . or complications that caused the death. Do not enter the mode of dying, -ist ony one cause on each line. a. QOL1- IQC L1Vr~lte l ~ Due to (or as a cons ~ equence b. Duke two (or a a consequence of): c. 1~.,~d! t~~.1 ~r~l A e uue to (or as a con~- equence of): d. _ IF FEMALE: p egnant 23b. Was decedent r 23c. If Yes, outcome of pregnancy in the past 12 months? 1 ~ Live birth 2 ^Fetal death 3 1 Q Yes 2 ~ No 4Qpregnant at time of death QEctopic pregnancy 9 ^ Unknown 9[] Unknown 5 ~ Other (spec ~J~-_ Part II. Other algniflcant conditions contributing to death but not resulting in the underlying cause given in Part I. - ~ ~ .~ r 1 m n.. . 25. Was case referre---d to medical ex mer? 1 [~ r as cardiac or respiratory `Yr~o.,. By e-IsLV_1 I I~erval Bettween Oynset and Death v Y~ D(~C,O..H.j 23d. Date of delivery Month Day Year 23e. Did robe ~-~-- t:co use contribute to the cause of death? 1 ^ Yes 2 [~l0 3 Q probab /` N < Unknown 24a. Was an 246, Were autopsy fi g ailable autopsy prior to completion of cause of Pertortnedy death? Yes i 1 Q Yes 2 Q'No 1 Q Yes f`~ Hospital: 26. Place of Death Check on! one 2 0 27. Manner of Oea h 1 Patient 2 [) ER/Outpatient 3 - ~~r~' 28a. Date of In1'u ^ DOA Otfler. T7~+vaturel 9 (Month, p ry 28b. Time of 4 ^ Nursing Home 6 ^ Residence 6 ^ Pendin ay Year) In 28c. Injury? t 6 QOther (SpecrlyJ 2 C~Accident investi anon lu W rk p 28d. Describe how injury occurred 3^ Suicide 8 ^Could not be ~ u '~ Z a ~(pF M 1 Q Yes t 4 O Homicide determined 28e. Place of Infjury - qt home, farm, street, facto oflice 2 o j~,1 ~,~,` ~ J 1 _ building. etc. (Specity) ry, `" ' ~' ( V Q Y 1 `i,_ ~ k A ~ C I' d ~ n+ ~~ 281. Location (Street and Number or Rural Route Number, 29a. Certifier ~ Ciry or Town, State) (cneckw,ry 1 Certifying Physician: To the best of my knowledge, death occurred at the time, date and place, and due to the _ one/ 2 Msdieal Examiner: On the basis of examination and/or investigation, in m ~~ 1rl .l 29b. Signature and title of certifier and manner stated. y opinion, death occurred at the time, ate and p ac e, and due toehe _ 29c. License number cause(s) ~' `,~ 29d. Date signed (Month, Day, Year) 30. Name and address of person who completed cause f death (Item 23a U~'~ '~~icvle ~~}i~o9~ ~ ~ o~o~. ~~ ~~ L2. ) (Type, Print) - 31. Date filed ~ 1 ~ V~ S• (A~ggr(r, Da 'Year) ~ rG G:/l t ~ L L - ryu V ~ 1 2002 3 Registrar's Signature I ~i(~) ,r ~ y)/t ^ Z (~ I K~CJ/lr d_ ~ =~-i .Mothers Name (First, Middle, Maiden SumameJ 19b. Mailing Address `4 ~ (Street and Number or Rural Route Number, City or Town, State, zip Coda 414 North Kansas S J 20b. Place of Disposition (Name o/ t ' ~ Edward 31 g me/gry, crr,1 alory or omer place) I Date s v i 11 e j ]• 6 2 ~ ) J~j n 2~. Location - Ci c ~QShvf-e~... __ _ ~ tyor7own,State 22. Name d Addre s of Facility Mardi FJ~H West LAST WILL AND TESTAMENT I, JOHN W. MARKERT, of West Pennsboro Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my executors to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I authorize and empower my executors to sell any realty owned by me at my death, and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I devise and bequeath all of my estate of every nature and wherever situate to my children, John Philip Marken and Susan E. Chapala, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 4. I nominate and appoint John Philip Marken and Susan E. Chapala, to be the executors of this my Last Will and Testament; they are to serve as such without bond. Should they die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, Inominate and appoint Roger B. Irwin, as substitute executor, also to serve as such without bond, with the same powers as are given herein to my executors. 6. I hereby suggest that my personal representative retain the services of Irwin, McKnight & Hughes, as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~ day of May, 1996. ` ~~ , ~~ SEAL) JOHN W. MARKERT Signed, sealed, published and declared by JOHN W. MARKERT, the above named testator, as and for his Last Will and Testament, in the presence of us, who at his request, in his presence and in the presence of each other have subscribed our names as witnesses hereto. ~!~ ~ ~ 2 ACKNOWLEDGMENT AND AFFIDAVIT WE, JOHN W. MARKERT, BETZI A. MORRISON and CHERYL L. CLELAND, the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as a witness and that to the best of their knowledge the testator was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. COMMONWEALTH OF PENNSYLVANIA . SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by JOHN W. MARKERT, the testator herein, and subscribed and sworn to before me by BETZI A. MORRISON and CHERYL L. CLELAND, witnesses, this w~ day of May, 1996. ~J No~tarv Public ~ri~i Seed 8. k+M~. Notaty Rabic ~ Oct. 3,196 `` J N W. MARKERT 13/ ~~-ate - ~~ ~s RENUNCIATION In regard to the Estate of JOHN W, MARKERT ,deceased. To the Register of Wilts of CUMBERLAND County, Pennsylvania. The undersigned daughter of the above decedent hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters Testamentary be issued to Royer B Irwin WITNESS my hand(s) this ~- day of UPtF~{a f 2 , 2002. ~ J ~ ~/ SIGNAT v Susan E. Chapa 414 North Kansas Street Edwardsville IL 62026-1738 ADDRESS RENUNCIATION In regard to the Estate of JOHN W. MARKERT ,deceased. To the Register of Wills of CUMBERLAND County, Pennsylvania. The undersigned son of the above decedent hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters _ Testamentary be issued to Royer B. Irwin ~~j WITNESS my hand(s) this day of November , 2002. 1 ,~" SIGNAT E John Philip Markert 1100 Raquette River Road South Colton, NY 13687 ADDRESS CERTIFICATION OF NOTICE UNDER RULE 5 6(al Name of Decedent: JOHN W. MARKERT Date of Death: NOVEMBER 9 2002 Estate No.: 21-02-1135'``. To the Register: I certify that notice of the beneficial interest 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 January 14, 2003 . Name Address Susan E. Chapala 414 North Kansas Street Edwardsville IL 62025 J. Philip Markert 1100 Raguette River Road S Colton NY 13687 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none . Date: 01/14/03 ~~~~~ ~ _ Signature /'' IRWIN, McKNt~t~ & HUGHES Name_ Roger B. Irwin, Esquire Address 60 West Pomfret Street Carlisle, PA 17013 Telephone X717) 249-2353 Capacity: Personal Representative X Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 002143 IRWIN ROGER B ESQ 60 W POMFRET ST CARLISLE, PA 17013 fold ESTATE INFORMATION: ssrv: oss-io-aoss FILE NUMBER: 2102-1 135 DECEDENT NAME: MARKERT JOHN W DATE OF PAYMENT: 02/07/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /09/2002 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 59,200.00 TOTAL AMOUNT PAID: REMARKS: ROGER B IRWIN ESQUIRE CHECK#19454 SEAL INITIALS: AC RECEIVED BY: DONNA M. OTTO REV-1162 EX111-96) 59,200.00 DEPUTY REGISTER OF WILLS REGISTER OF WILLS f'I ,-/ ~s; J\ /1-10 {- OFFICIAL SE ONLY REV-15QO EX+ (6-00) CAPB HpRL EplO CRAC KOTK ES C P o 0 R N R 0 E E S N T C o M P T U A T X A T I o N REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER o E C E o E N T COMMONWEAl. TH OF PENNSYLVANIA DePARTMENTOFREVENU~ DEPT. Z80601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Markert John W. DATE OF DEATH (MM-DO- YEAR) 21-02-1135 DATE OF BIRTH (MM-DC-YEAR) CQUNTYCODE YEAR SOCIAL SECURITY NUMBER 066-10-3099 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE NUMBER REGISTER OF WILLS so IALS CURt YNUM8ER X 1. Original Return 4. limited Estate X 6. Decedent Died Testate 3. date of death . RemalOder Return prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Numberof Safe Deposit Boxes (Attact1 copy 01 Will) o 9. Litigation Proceeds Received 2. Supplemental Return 4a. Future Interest Compromise (date o'f death after 12 -12 -82> 7. Decedent Maintained a Living Trust 0 (Attach copy ofT rust) 010. Spousal Poverty CredIt D 11. ElectIon to tax under Sec. 9113(A} (date of death between 12-31-91 and 1-1-95) (Attach Sch 0) ':;:TMIS SE(:TIOflMUST BE eoMPl.mll\'AWcoafisP:l)~ & C,OHFlDENTt~tt.-xt~_A~Ot{Sj{otll.D,BEDIR"C:fli!1).TO'.c', NAME COMPLETE MAILING ADDRESS Ro er B. Irwin Es . FIRM NAME (If AppUcable) IRWIN McKNIGHT & HUGHES TELEPHONE NUMBER 60 West Pomfret Street West Pomfret Professional Bldg. Carlisle, PA 17013 4 - 3 1. Real Estale (Schedule A) (1) None OFFICIAL USE ONLY Z. Stocks and Bonds (Schedule B) (Z) 207,270,;j'l d 3. Closely Held Corporation, Partnership or (3) None VJ Sole-Proprietorship c_ 4. Mortgages & Notes Receivable (Schedule 0) (4) None I::':: f'- R 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 28,608.39 w E (Schedule E) C A 6, Jointly Owned Property (Schedule F) (6) None -G P 0 I Separate Silting Requested T 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 2,000.00 U L (Schedule G or L) A T 8. Total Gross Assets (total Lines 1-7) (8) 237,878.76 I 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 27,763.00 0 N 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule l) (10) 2,550.89 11. Total Deductions (total Lines 9 & 10) (11) 30,313.89 12. Net Value of Estate (Line 8 minus line 11) (IZ) 207,564.87 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value SUbject to Tax (Line 12 minus Line 13) (14) 207,564.87 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(aX 1.2) 16. Amount of line 14 taxable at lineal rate 207,564.87 17. Amount of Line 14 taxable at sibling rate 18. Amount of line 14 taxable at collateral rate 19. Tax Due ZD. X (15) (16) (17) (18) (19) 0.00 9,340.42 0.00 0.00 9,340.42 x X X X .0 0 .0 45 .12 .15 Copyright (c) 2000 form software only The Lackner GroIJp, Inc. Form REV-1SOO EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 102 Green Rid"e Lane CITY I STATE I ZIP Newville PA 17241 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 9,340.42 0.00 9,200.00 467.02 Total Credits ( A + B + C) (2) 9,667.02 3. InteresVPenalty if applicable D. Interest E. Penalty Totalln'erestlPenalty ( D + E) (3) 4. If Line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request 0 refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (s) A. Enter the interest on the tax due. (SA) B. Enter the 'otol of Line S + SA. This is the BALANCE DUE. (5B) Moke Check Payable to: REGISTER OF WILLS, AGENT ::::::iii!!i!!::"i"'--... :::::::q:HH:n:::':;j',:.... 0.00 326.60 0.00 0.00 0.00 "X" i1~;if~~;i~~~i~~~i~ll~~~:;~t8~~~mmm Did decedent make a transfer and: a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest or . d. receive the promise for life of either payments, benefits or cate? 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? . 3. Did decedent own an ~in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Yes No ~~ [K] o []] []] o o Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and tothe best of my knowledge and bElllef, it is true. correct and complete. Declaration of preparer other than the personal representative is based on alllnfarmatlon of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN 3.~ Roger B. Irwin Esq. 60 West Pomfret Street -------------~--------------------------------------- Carlisle, PA 17013 IRWIN McKNIGHT & HUGHES 60 West Pomfret Street - - -Car fl';; i,,-; - PP: - - i 7'6i3 - - - - - - - - - - - - - - - - - - - - - - - - - -- DATE 7jJlltJl DATE For dates of death on or after July 1,1994 and before January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (t)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0'% [72 P.S. 9116 (a) (1.1) (ii)}. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)1- The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5'%, except as noted in 72 P.S. 9116( 1.2) [72 P.S. 9116(aXll). 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(aX1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Copyright (c) 2000 fOfm software only The Lackner Group. Inc. Form REV-1500 ex (Rev. 6-00) REV~1503 EX ...(1-97) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERli ANeE i M RETURN RESIDENT DE'CEDENT ESTATE OF FILE NUMBER 5511 066-10-3099 11/09/2002 John W. Markert 21-02-1135 All property jointty-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 2 3 4 5 DESCRIPTION 6,104.5 shares FBR Mutual Funds - Fund for Government Investors GE Private Asset Management - account #0215481 432.187 shares ING Funds, precious metals 651 shares Nationwide Financial Services, Inc., CUSIP #63861210 - traded NY5E, common T Rowe Price Brokerage Account #30A912259 UNIT VALUE 1.00 5.19 25.72 (If more space is needed, insert additional sheets of the same size) Copytlght(c) 1996 fOl'm software only CPSystems, Inc. TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH 6,104.50 175,134.28 2,243.05 16,743.72 7,044.82 207,270.37 Form REV-1503 EX (Rev. 1-97) REV-150a EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John II. Markert SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY 551ft 066-10-3099 11/09/2002 FILE NUMBER 21-02-1135 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTlDN F&M Trust, checking account #33-07115 VALUE AT DATE OF DEATH 22,343.39 2 Miscellaneous personal property 6,265.00 TOTAL (Also enter on line 5, Recapitulation) $ 28,608.39 (If more space is needed, insert additional sheets of the same size) Copyright (c:) 1996 form software only CflSystems, Irn:. Form REV-1508 EX (Rev. 1-97) REV-15tO EX + (1-97) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCETfJ.X RETURN RESIDENT DECEDENT ESTATE OF John W. Markert 55!1 066-10-3099 11/09/2002 FILE NUMBER 21-02-1135 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY %OF ITEM INCLUDE THE NAMEOFTHE TRANSFEREE THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DEC~DENT AND THE DATE OF TRANSFER. NUMBER ATTACH ACOPYO THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 1 Susan E. Chapala - cash 5,000.00 3,000.00 2,000.00 daughter - 08/07/2002 TOTAL (Also enter on line 7, Recapitulation) $ 2,000.00 (If more space is needed, insert additional sheets of the same size) Copyrlght (c) 1996 form software only CPSystems.lnc. Form REV-1510 EX (Rev. 1-97) REV-1St 1 EX + (1~97) ESTATE OF John W. Markert COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS SSIf 066-10-3099 11/09/2002 FilE NUMBER 21-02-1135 Debts ot decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES, 1 Eby Granite Works 85.00 2 Egger Funeral Home 6,214.00 B. ADMINISTRATIVE COSTS, 1. Persona! Representative's Commissions 10,076.00 Name of Personal Representative(s) Roger B. Irwin Esq. Social Security Number(s) I EIN Number of Personal Aepresentatlve(s) Street Address 60 West Pomfret Street City Carlisle State PA Zip 17013 - Year(s) Commission Paid: 2003 2. Attorney's Fees IRWIN McKNIGHT & HUGHES 10,826.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State - Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 313 .00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Cumberland Law Journal - estate notice publication 75.00 2 F&M Trust - research fee 10.00 3 Register of Wills 25.00 4 Rowe's Auction Service - appraisal fee 85.00 5 The Valley Times Star - estate notice publication 54.00 TOTAL (Also enter on line 9, Recapitulation) S 27,763.00 (If more space is needed. insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems. Inc. Form REV-1511 EX (Rev. 1-97) REV~ 1512 ex .. (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DEceDENT ESTATE OF John W. Markert SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SSfI 066-10-3099 11/09/2002 FILE NUMBER 21-02-1135 Include unreimbursed medical expenses. ITEM NUMBER 1 Cumberland Valley EMS DESCRIPTION AMOUNT 533.00 2 Swaim Health Center 1,773.24 3 VISA, balance due 244.65 TOTAL (Also enter on line 10, Recapitulation) $ 2,550.89 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV~ 1513 E::X + (9~OO) COMMONWEALTH OF PENNSYLVANIA INHERITANCE T~ RETURN RESIDENT DECeDENT SCHEDULE J BENEFICIARIES ESTATE OF John W. Markert NUMBER I. SSfI 066-10-3099 11/09/2002 FILE NUMBER 21-02-1135 AMOUNT OR SHARE OF ESTATE 1/2 remainder 1/2 remainder ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU la, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON- TAXABLE DISTRIBUTIONS, A, SPOUSAL DISTRiBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTiON TO TAX is NOT BEING MADE HELATIONSHIP TO DECEDENT Do NolLisl Trustee(s) 1 NAME AND ADDRESS OF PERSDN(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distrlbutiOf'\s, arid transfers under Sec. 9116(a)(1.2)] Susan E. Chapa1a 414 North Kansas Street Edwardsvi11e, IL 62025 Daughter TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lack.ner GHWp, Inc. 2 J. Philip Markert 1100 Raquette River Alexandria Bay. NY Son Road 13607 B, CHARITABLE AND GOVERNMENTAL DiSTRIBUTIONS 0.00 Form REV-1513 EX (Rev. 9-00) LAST WILL AND TESTAMENT I, JOHN W. MARKERT, of West Pennsboro Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my executors to pay all of my'debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I authorize and empower my executors to sell any realty owned by me at my death, and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I devise and bequeath all of my estate of every nature and wherever situate to my children, John Philip Markert and Susan E. Chapala, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 4. I nominate and appoint John Philip Markert and Susan E. Chapala, to be the executors of this my Last Will and Testament; they are to serve as such without bond. Should they die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint Roger B. Irwin, as substitute executor, also to serve as such without bond, with the same powers as are given herein to my executors. 6. I hereby suggest that my personal representative retain the services of Irwin, McKnight &. Hughes, as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this :,' day of May, 1996. l~w. 14- JOHN W. MARKERT Signed, sealed, published and declared by JOHN W. MARKERT, the above named testator, as and for his Last Will and Testament, in the presence of us, who at his request, in his presence and in the presence of each other have subscribed our names as witnesses hereto. 2 ACKNOWLEDGMENT AND AFFIDA VIT WE, JOHN W. MARKERT, BETZI A. MORRISON and CHERYL L. CLELAND, the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as a witness and that to the best of their knowledge the testator was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. (JurI ~ ~--i) ~Li v(!, Jl~ I~ (i ! JOHN W. MARKERT / 't?~* A.cN~k){{lw\ B ZI A.'MO SON ~ .~~/~ ERYL 1. CLELA COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by JOHN W. MARKERT, the testator herein, and subscribed and sworn to before me by BETZI A. MORRISON and CHERYL L. CLELAND, witnesses, this I.~ day of May, 1996. 7 ~.d,- 'l..~" Nc:lanal S6aI a~~ MIl ~ E>q:hsCU 3, 1996 t'}"'~f,~'r:;:,P~ . T. Rowe Price Brokerage >li';i(j,l ql T. P,r;I!\'I-; Pncf', ;U./1':;':lIr,,:,;!<i SHr'o/iC8S, Inr: 'r'~ L:,(;\ 17:L)/j '~,~,ii!1T Ic'r,~~. !\;I':J(';I;ull.! :,: 1 ::?S)7 -' 4:~!) 4t; I ~l i::'3Irlll;)r" ~ilill r::::CldCl (-::",i'/lr~fJ~ Mills, f\,1[::r/Cl[)rj 21117 ..4S.103 January 3, 2003 ,'~l:n '~','-2(j-/T20 f-"x {J lrJ-~qs '':2,24 Roger B Irwin C/o Irwin McKnight & Hughes West Pomfret Professional Building 60 West Pomfret Street Carlisle PA 17013-3222 ...-....,-- \ '" ~,\ , "'1 lJ I,dl '~'U...J'\l ""'iJ ,\,1: N' -- L. ~H)(y~ :..~ , ' ,.,!.. \. \.,1,: Re: T. Rowe Price Brokerage Account # 30A9l2259 IOI:W\1 ! f: 4J ~ l j , .{ '>~ ~< ;:., ;", ,; )~I Dear Me Irwin: Enclosed, please find the estate valuation you requested for the above referenced account Please be advised that there was no change of registration, no accrued dividends and no other accounts on file. 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Q Z w OJ ",cr en o cr :I: g~ co~ t/) ~~ 8z fb Q..U} 0;20 0 ;:E...J ~(f)~ OCL ~~ ~~~~~~ crm =:lOCl)O!:!:!a: <coQ- *z>->-8~ d5~g~~~:.g~5~ uoCCO:::;::l:::!;;ZWzO zzwO-'QC(jjZJ:<C --:EZ[;:;UZ:EWu:O: cnC/J....J<(C\/u<C:::::lWWC ~>->.c(:JIJ')Z-...I~~~ QU)(f)J:<(O ~Q.<CI-""" "'wwucren;;: en--'zU ';::a:a:f./)I-~>-ewCJLJ.J~ ~~~3~z~czzo c<<(<c<(~<(~Qg3~<( t\.IC\l~ 0000000 0 lO 1O "<toeo 0 C\/ C")I.ON ci o '" " => :;; 0. Ol i!! " .c !/) :IE <(cr III ~~~d 0<(<..:( ~l~ C\/ '" >- N >- OJ ::;; ~~Q "' o ;:: '" '" o 0:> ....0 W ...JOj ...J...J "<tI.OCOI'--CDO) 0'" OM uic;j :;; ..f ....'" 00:> c..;..t "'.... 000 ....-r--." ffl &; ffl fh ....0 Z:I: zO w<( 0.;: ... .... "' ....1;: ::lZIll zo.;: ~;:~ ~ FBR FRIEDMAN BilliNGS RAMSEY ~~(S~UW[~ JAN 1 8 2003 Date of Death Valuation , 'K 'i' " " lllirl,V( IRWiN, J~\c. !tuh) ()11IJUilt. Account Number 4087151 Account Registration John W. Market Fund Name(s) Fund for Government Investors Type of Account Individual Date of Death 11/09/02 Number of Shares 6104.50 On Date of Death Net Asset Value $1.00 (Price on date of Death) Market Value $6,104.50 On Date of Death Accrued Interest N/ A (if applicable) ?:f ,a.~ I /1~103 Authorized Signature Date ,-I i {; /- oS 4.{l r(..4.ci Jt' ~.)e/" v'fUj Title FBR Mutual Funds 4922 ra:rmont Avenue Bethesda, Maryland 20814 301,6571510 O( 800.8213460 www.fbr.com Oi'Oii,b",'nd byf-Bk iltv",ln,,,,,t:;,,,',i,_,c'"_ In, FUNC VM FUND 0001753 QUAL 8501758 LOOKUP: SHAREOWNER MASTER SFFX -- (EA-0001753-00008501758/4) ----------- (COL. BAL. 2,243.05 ) -- JOHN W MARKERT 102 GREEN RIDGE LN NEWVILLE PA 17241-9484 ALPHA CODE.............. MARKEJOHNW LINE CODE........................ 2 TOTAL SHRS..... 432.1870 ISSUED SHRS.... .0000 UNISSUED SHRS.. 432.1870 RESERVED SHRS.. .0000 ESCROW SHRS.... .0000 DAILY DIV..... .00 DEALER/BRANCH.... 123/000 REP NO................... MTRX LVL 0 TAX NO.. 066-10-3099/2 --ACCOUNT OPTIONS-- SOCIAL CODE....... 005 ESCH CODE DIV. . . . . . . . . . . . . . . ., R AUDIO RES ST/LT CAPGAINS.. R / R EXEXCH ES'l;ABLISHED.. 11/19/02 INVESTOR ACTIVITY DTE. 11/19/02 AVGCOST MAl NT DATE... 00/00/00 STOP MAIL DTE 00/00/00 NAV ACCT. . . . . . . . . . .. 0 CUM DISC NO. 0 TAX RESIDENCE CODE PA LOI NO...... 0 FOREIGN TAX %.... 0.0 STATE/COUNTRY.. 037,PA CWR............... N REP NAME... LOOKUP: AS-OF DAILY VALUATION FUNC AB FUND 0001753 QUAL 8501758 SFFX ------ 10001753-00008501758/4) ----------------------------------------------- JOHN W MARKERT 102 GREEN RIDGE LN NEWVILLE PA 17241-9484 FUND NAME.............. PREC MTL A DEALER/BRANCH.. 0000123/000 REP NO......... .. . . .. .. REP NAME.. PRICE DATE...................... ... 12/19/2002 LAST TRANSACTION................ ... 00/00/0000 NET ASSET VALUE.................... 5.1900 TOTAL SHRS................ 432.1870 AS-OF VALUE.............. 2,243.05 fa) Gf Private Asset Management ~ DE FiiJ;JIIClai Compa/l)/ December 18,2002 Roger B. Irwin Irwin McKnight & Hughes West Pomfret Professional Building 60 West Pomfret Street Carlisle, PA 17013 Re: John W. Markert Account Number 0215481 Dear Mr. Irwin: /07:;3 V(',').',~'(a 31\";', S/;i-; 11,-: :;ht;t::idl)i:',J,i'_i, (,:1 <1,'.!1)'1 5 is ?8?J<)'I_) r.IK 8/,'; . iSilEi, " snu 3iii.};' ~:i? V\lv,1"/::/I.'i'.':',I;1['(0,',I;"/ ~~~~uwoc~ DEe 23 2002 IRWIN, McKNIGHT & HUGHES As you have requested, foIlowing is information on the above referenced account: Title of account Date account 0 ened Chan es of ownershi Accounts closed Accrued interest Date of Death balance John W. Markert 9/26/95 None None $2.59 $175,134.28 If you have any questions please feel free to call me at (800) 346-0138 ex!. 270. Sincerely, If t?aI~~ Ken Graham Portfolio Consultant RE: JOHN W. MARKERT DATE OF DEATH 11-9-2002 ACCOUNT INFORMATION x CHECKING SAFE DEPOSIT SAVINGS __CERTIFICATE OF DEPOSIT SHARES OF STOCK --------------------------------------------------------------- ACCOUNT INFORMATION x CHECKING SAFE DEPOSIT SAVINGS ___CERTIFICATE OF DEPOSIT SHARES OF STOCK DATE OPENED 12-5-1995 DATE CLOSED 11-1-2002 ACCOUNT NUMBER 15-738 ACCOUNT BALANCE AT DATE OF DEATH -0- ACCRUED INTEREST NON-INTEREST BEARING ACCOUNT TOTAL ACCOUNT BALANCE -0- NAME(S) ON ACCOUNT JOHN W. MARKERT & ESTHER J. MARKERT REGISTRATION OF ACCOUNT JOHN W. MARKERT & ESTHER J. MARKERT ------------------------------------------------------------------ COMMONWEALTH OF PENNSYLVANIA 'i ss: COUNTY OF CUMBERLAND J Roger B. I being duly sworn __ according to law, deposes and says that he is the Executor of the Estate of John W. yfarkert late of _West_Pennsboro Township __ __ _ ,Cumberland County, Pa., deceased and thet the within is an inventory made by Roder B. Irwin - the said Executor of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death . worn ~ an subscribed before me, f ~, 3r day of 003 Roger B. rw n, Executor ~~ ~~ ~~' ~ _60 West _m ret Street U ~ I Carlisle, PA 17013-3222 ~~~ Ssal Address ! aeline L. lhawbaugh, Nouuy Public ~grliRle Boro, Cumberland County Myf;4tttmLttion Expires Aug. 14, 2003 Date of Death '~~~a 11 2002 Day Month Year INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. $ee Article IV, Fiduciaries Act of 1949. , u, M i N O I N Z i I •~ ~ Z Z J.l ~ LL ~ E- o! a ~ ~ O w ~ ~ W Q Z O ~ H j x W ~ ~ ' x I ~ ~ o H o O >~ i p'' ~ _ O ~ o ~ 0 a c p ~ ~0 y I ' m ~ ~ I ~ ~ w ~~ 3 ~ ~ FY., m `o i .a .~ ~ U m u, .Y O m° w x c7 x H x H ~4 U ~-, z H LYi H Inventory of the real and personal estate of JOHN W. MARKERT deceased 1. 6,104.5 Shares FBR Mutual Funds - Fund for Government Investors. . 2. GE Private Asset Management - Account ~~0215481 . 3. 432.187 Shares ING Funds - Precious Metals . 4. 651 Shares Nationwide Financial Services, Inc. - CUSIP ~~63861210 - Traded NYSE - Common 5. T Rowe Price Brokerage Account ~~30A912259. . 6. F&M Trust - Checking Account ~~33-07115 . 7. Miscellaneous Personal Property. . TOTAL - - - - - - ,~.._ ., ~ •... _ L1 1i =._ rte. V 6,104 175,134 2,243 16,743 7,044 22,343 6,265 235,8; 50 28 05 72 82 39 00 76 BUREAU OF INDIVIDUAL TAXES COMMONWEALTH OF PENNSYLVANIA INHERITANCE 7AX DIVISION DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (01-037 DATE 09-09-2003 ESTATE OF MARKERT JOHN W DATE OF DEATH 11-09-2002 FILE NUMBER 21 02-1135 ROGER B IRWIN ESQ ~-~ ~~NTY CUMBERLAND IRWIN ETAL ACN 101 60 W POMFRET ST Amount Remitted CARLISLE PA 17013 `. MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETA_IN LOWER PORTION FOR YOUR RECORDS ~ -------------- REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR ---------------- ----------------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MARKERT JOHN W FILE N0. 21 02-1135 ACN 101 DATE 09-09-2003 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) (i) .00 NOTE: To insure proper 3. Closely Held Stock/Partnership Interest (Schedule C) (2) 207'27 0 37 credit to your account, 4. Mortgages/Notes Receivable (Schedule D) (3) .00 submit the upper portion your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 28,6 08 39 tax this form with 6. Jointly Owned Property (Schedule F) Payment. 7. Transfers (Schedule G) (6) .00 8. Total Assets (~) 2 •000 00 APPROVED DEDUCTIONS AND EXEMPTIONS: ($) 237,878.76 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 27,76 3.00 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions (10) 2 ~ 550 89 12. Net Value of Tax Return (11) 0 ~1 ~ Ao 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 207'564:00 14. Net Value of Estate Subject to Tax (14) 207, 564.87 NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) .0 0 X 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate (16) 207,564.87 X 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 19. Principal Tax Due TAX CREDITS' DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-07-2003 CD002143 467.02 9,200.( * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 00 _ .00 045= 9,340.42 12 = .00 15 = .00 (19)= 9,340.42 9,667.02 326.60CR 00 326.60CR ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ''CREDIT" (CR), YOU MAY BE DUE A REFUND. SFF orveecr ..~..~ __ _.___ %~-sod? i~ BUREAU OF INDIVIDUAL TAXES INHERITANCE 7AX DIVISION DEPT. 280601 HARRISBURG, pA 17128-0601 ROGER B IRWIN ESQ IRWIN ETAL 60 W POMFRET ST CARLISLE PA 17013 DATE ESTATE OF DATE OF DEA' FILE NUMBER COUNTY ACN 10-14-2003 MARKERT JOHN W TH 11-09-2002 21 02-1135 CUMBERLAND 101 Aeount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subeit the upper portion of this fore with your tax payment. CUT ALONG THIS LINE __-___ RETAIN LOWER P_ORTI_ON FOR YOUR RECORDS ~ ----------------------------- REV-1607 EX AFP (O1-03) ~** -------'-""" ------------------------------- INHERITANCE TAX STATEMENT OF ACCOUNT **~( ESTATE OF MARKERT JOHN W FILE N0. 21 02-1135 ACN 101 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATETESHOWN BELOw003 IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APpLICpgLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-09-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) 02-07-2003 CD002143 467.02 09-26-2003 REFUND .00 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX OFF (01-03~ AMOUNT PAID 9,200.00 326.60- 9,340.42 TOTAL TAX CREDIT 9,340.42 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE I .00 IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) STATUS REPORT UNDER RULE 6.12 Name of Decedent: JOHN W. MARKERT Date of Death: NOVEMBER 9, 2002 No. 21-02-1135 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: X Yes ~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes X No 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? X Yes No Date: d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. Sig IRWIN & 1V~cKNIGHT Roger B. Irwin, Esquire .: Name (please type or print) ~ 60 West Pomfret Street -~'} Address ?: -7, Carlisle, PA 17013 :D ~ City, State, Zip (717) 249-2353 Telephone Number Capacity: X Personal Representative Counsel for Personal Representative