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HomeMy WebLinkAbout03-0384PETITION FOR PROBATE and GRANT OF LETTERS Estate of WILLIAM C. CLARK also known as ,Deceased. To: Social Security No. 170 - 24 - 7035 Register of Wills County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner, who is 18 years of age or older, is one of the personal representatives named in the last will of the above decedent, dated March 30, 2000. Decedent was domiciled at death in CARLISLE BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA, with his last family or principal residence at 1306 RITNER HIGHWAY, CARLISLE, CUMBERLAND COUNTY, PENNSYLVANIA 17013. Decedent, then 70 years of age, died APRIL 25, 2003 at 1306 RITNER HIGHWAY, CARLISLE, CUMBERLAND COUNTY, PENNSYLVANIA 17013. 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 $ 20,000.00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania situated as follows: $ TOTAL $ 20,000.00 WHEREFORE, petitioner respectfully requests the probate of the last will presented herewith and the grant of letters testamentary thereon. SHARON E. CLARK 1306 RITNER HWY CARLISLE PA 17013~1 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND The petitioner above-named swears that the statements in the foregoing petition are true and correct to the best of the knowledge of petitioner and that as personal representative of the above decedent, petitioner will well and truly administer the estate according to law. Sworn to and subscribed ,~,'~t~.~ before me this ~ .5~_ c~ay of SH-~-RON-E. CLARK ' MAY, 2003. ~' Register I~t~-- %.-{~j:~ ~6V L-~VN ~0. Estate of WILLIAM C. CLARK, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, MAY ~2__, 2003, in consideration of the petition attached hereto, satisfactory proof having been presented before me, IT IS DECREED that the instrument dated MARCH 30, 2000, described therein, be admitted to probate and filed of record as the last will of WILLIAM C. CLARK, and Letters Testamentary are hereby granted to SHARON E. CLARK. FEES Probate, Letters, Etc. Short Certificates TOTAL Filed: ~- ~ O.% Register of~Wills ' O ~ ~/ ~ HAROLD S. IRWIN III ({D NO 2~'920) 35 East High Street ~' Carlisle, PA 17013 ~---~" 717-243-6090 105.805 REV 9/86 '77~;s is to certify,' that the information here given is correctly copied from an original certificate of death duly f~led with me as l,o~al Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9283256 No. Local Registrar APR 2 8 200~ Date mo5.;,.3 R~,. Wa? COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH * VITAL RECORDS ""' CERTIFICATE OF DEATH ~ ~.t~illi~ C. Clark I~'__ i~,.~c..,..u... ;0~,..~ ..... ~.-, ~*(t'~ ~ ~-- ........ t.~le ~4 -- 7035 ].. ~25/2007 1306 Ri~er Hig~y ~rlisle PA 17013 ~rl~d ~' ,,*~ ~'~ ~lisle Sharon E. Clark - Kissel 1306 Ritner Carlisle, PA 17013 ~onroe T~p. Mt. Zion Count_~ PA 012633 L Brothers Funeral Hcme, Carlisle, PA 170' ............................ [] ' II~IONOCJNCINI~ AND CEJ~TIFYINCl IIHYSIClAN { P~Cmh ~ ~ On~.y.m~ Oem/~ ~ ~ io caus~ o0 (~eelh) LAST WILL AND TESTAMENT I, WILLIAM C. CLARK, of 1306 Ritner Highway, Carlisle, Cumberland County, Pennsylvania 17013, do hereby make, publish and declare this to be my last will and testament, hereby revoking all wills heretofore made by me. 1. I direct my personal representative to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. I direct that all inheritance taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property, whether or not such property passes under this Will, shall be paid by my personal representative out of my estate. 2. I authorize and empower my personal representative to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefore, in fee simple, as I could do if living. My representative is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said representative. 3. I give, devise and wherever situate as follows: A. bequeath all of my estate of whatever nature and To my daughter, Sharon E. Clark, the following: 1. My 1992 Skyline double-wide trailer contents at the time of my death and 2. All of my Tredagar Stock. and all of its' My Grandson, William L. Clark, shall have the first option to purchase my 1988 Monte Carlo or any vehicle I own at my decease from my estate. 4. The rest, residue and remainder of my estate of whatever nature and wherever situate to my grandson, William L. Clark, 5. I nominate and appoint my daughter, Sharon E. Clark to be the personal representative of my estate, to serve without bond. If she cannot or does not serve, then I appoint my grandson, William L. Clark to be the substitute personal representative, also without bond. 6. I suggest that my personal representative retain the services of Harold S. Irwin, III, Carlisle, Pennsylvania in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 30th day of March, 2000. WI£LIAM C. CLARK (SEAL) Signed, sealed, published and declared by the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. ACKNOWLEDGMENT AND AFFIDAVIT WE, WILLIAM C. CLARK, JOHN J. BARANSKI, JR. and HEATHER A. BARBOUR, 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. J~N ~J. B.~LANSKI, JR. HEATHER A. BAR[~OUR COMMONWEALTH OF PENNSYLVANIA · :SS: COUNTY OF CUMBERLAND . Subscribed, sworn to and acknowledged before me by WILLIAM C. CLARK, the testator herein, and subscribed and sworn to before me by JOHN J. BARANSKI, JR. and HEATHER A. BARBOUR, witnesses, th/i~ay or,March, 2000. Notary Public ~ CERTIFICATE OF NOTICE UNDER RULE 5.6(a) Name of Decedent: WILLIAM C. CLARK Date of Death: Will No. APRIL 25, 2003 2003 - 00384 Admin. No. 21 - 03 - 00384 To the Register: I certify that notice of beneficial interest or 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 May 22, 2003: Name Address SHARON E. CLARK 1306 RITNER HIGHWAY CARLISLE PA 17013 WILLIAM I. CLARK 1306 RITNER HIGHWAY CARLISLE PA 17013 Notice has now been given to all persons entitled/thereto under Rule 5.6(a) except: NONE May 22, 2003 HAROLD S. IRWIN,~tLESQUIRE 35 East High Street, Suite 201 Carlisle, PA 17013 717-243-6090 Attorney for Estate of WILLIAM C. CLARK REV-15'00 EX (6-~0) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 D~-~-uENT'S NAME (LAST, FIRST AND MI DDLE'INITIAL) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT CLARK, WILLIAM C. DATE OF BIRTH I DATE OF DEATH SEPTEMBER 10, 1932 I APRIL 25, 2003 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) ~ SOCIAL SECURITY NUMBER I X 1. Odginal Retum __ 2. Supplemental Return OFFICIAL USE ONLY FILE NUMBER 21 COUNTY CODE SOCIAL SECURITY NUMBER 170 - 24 - 7035 O3 YEAR 0384 NUMBER 7,204.00 18,970.97 15. Amount of Line 14 taxable at the spousal rate 16. Amount of Line 14 taxable at lineal rate $ 17. Amount of Line 14 taxable at sibling rate $ 18. Amount of Line 14 taxable at collateral rate $ 19. Tax due OFFICIAL USE ONLY (8) 18,342.32 x. = (15) x .045 = (16) x .12 : (17) x .15 = (18) (19) (12 (7,832.65) (13) 0.00 (14) (11) 26,174.97 (7,832.65) 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages and Notes Receivable (Schedule D) (4) 5. Cash, Bank Dep & Misc Personal Property (Sched E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers / Misc. Property(Schedule G) (Schedule L) (7) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Sched H) (9) 10. Debts, Mortgage Liabilities & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests (schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 0.00 113.94 0.00 0.00 18,228.38 0.00 __ 4. Limited Estate 4a. Future Interest Compromise (for dates of death after 12-12-82) X 6. Decedent Died Testate __ 7. Decedent Maintained a Living Trust __ 8. Total No. of Safe Deposit Boxes (Attach copy of Will) EX. A (Attach copy of Trust) __ 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death 11. Election to tax (Sec. 9113(A)) between 12-31- ®~ ~ NAME COMPLETE MAILING ADDRESS ~ l~!ll~II~ HAROLD S. IRWIN, III I 35 EAST HIGH STREET, SUITES 2011202 TELEPHONE NUMBER CARLISLE, PA 17013 717-243-6090 I 3. Remainder Retum (dates of death prior to 12-13-82) __ 5. Federal Estate Tax Return Req Decedent's Complete Address: STREET ADDRESS 1306 RITNER HIGHWAY CITY CARLISLE Tax Payments and Credits: 1. Tax Due (Page 1 Line 18) 2. Credits / payments A. Spousal Poverty Credit B. Prior Payments C. Discount STATE I ZIP PA 17013 (1) Total Credits (A+B+C) (2) 3. Interest / Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D+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 interest on the tax due. (5A) B. Enter the total of Line 5+5A. This is the BALANCE DUE. (5B Make Check Pa able to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use of income of the property transferred; ................................... X b. retain the dght 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 care? ............................... ~ 2. If death occurred on or before December 123, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................... N/A 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? ...... X~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than personal representative is based on all information of which preparer has any knowledge. OF PERSON RESPONSIBL,E~=OR FILING RETURN ADDRESS . DATE 1306. RITI~R HWY, CARLISLE, PA 17013 APRIL 21, 2004 S~~PERSONAL REPRESENTATIVE A'I~3'RESS // ) DATE 64 SOUTH PITr STI~EET, CARl/ISLE, PA 17013 APRIL 21, 2004 For dates of death on or r'aft, p~E~y~, 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. Section 9116 (a)(1.1)(i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. Section 9116 (a)(1.1)00]. 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. Section 9116 (a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. Section 9116 (1.2)[72 P.S. Section 9116 (a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. Section 9116 (a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (12-85) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER WILLIAM C. CLARK 2003 - 0384 (Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair market value which is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH NONE TOTAL (Also enter on Line 1, Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-15'03 EX + (4-86) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS AND BONDS ESTATE OF FILE NUMBER WILLIAM C. CLARK 2003 - 0384 ,intly-owned with Ri~lht of Survivorship must be disclosed on Schedule F.) DESCRIPTION (All property j NUMBER 9 SHARES COMMON STOCK - Tredegar Corporation VALUE AT DATE OF DEATH 113.94 TOTAL (Also enter on Line 2, Recapitulation) $ 113.94 (If.more space is needed, insert additional sheets of same size.) REV-1 504 EX -i- (3-92) / I REV-1504 EX + (3-92) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF WILLIAM C. CLARK NONE ITEM NUMBER SCHEDULE C CLOSELY HELD STOCK PARTNERSHIP AND PROPRIETORSHIP DESCRIPTION FILE NUMBER 2003 - 0384 VALUE AT DATE OF DEATH TOTAL (Also enter on Line 3, Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-1507 EX + (6-86) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES AND NOTES RECEIVABLE ESTATE OF WILLIAM C. CLARK FILE NUMBER 2003 - O384 (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH NONE TOTAL (Also enter on Line 4, Recapitulation) NONE (If mom space is needed, insert additional sheets of same size.) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY ESTATE OF WILLIAM C. CLARK FILE NUMBER 2003-0384 (All property ITEM NUMBER ,intl¥-owned with Ri~lht of Survivorship must be disclosed on Schedule F.) DESCRIPTION M & T BANK - Checking Account No. 8892240279 (Value based on bank statement attached as Exhibit "B") ORRSTOWN BANK - Checking Account No. 106 - 002775 (Value based on bank statement attached as Exhibit "C") 1988 CHEVROLET MONTE CARLO (Value based on Kelley Blue Book Valuation attached as Exhibit "D") 1992 CHEVROLET S-10 PICKUP TRUCK (Value based on Kelley Blue Book Valuation attached as Exhibit "E") 1992 SKYLINE SUNWOOD 7526 MOBILE HOME (Value based on appraisal attached as Exhibit "F") TOTAL (Also enter on Line 5, Recapitulation) VALUE AT DATE OF DEATH 98.05 495.33 1,427.50 2,207.50 14,000.00 18,228.38 REV-1509 EX + (12-88) (If mor space is needed, insert additional sheets of samel size.) REV-1509 EX + (12-88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER WILLIAM C. CLARK 2003- 0384 Joint tenant(s): NAME ADDRESS RELATIONSHIP TO DECEDENT Jointly-owned property: ITEM LE1,~:R DATE DESCRIPTION OF PROPERTY TOTAL DECD'S DOLLAR NO. FOR MADE VALUE % INT. VALUE O JOINT JOINT OF ASSET DECEDENT'.~ TENANT INTEREST NONE TOTAL (Also enter on Line 6, Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-1510 EX + (2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF WILLIAM C. CLARK SCHEDULE G INTERVIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 2003 - 0384 THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES. ITEM DESCRIPTION OF PROPERTY DATE OF NUMBER Include name of the transferee, their relationship to decedent, date of transfer DEATH % OF EXCLUSION TAXABLE VALUE OF DECD'S (if applicable) VALUE ASSET INTEREST TOTAL (Also enter on Line 7. Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-1~11 EX + i7-88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF WILLIAM C. CLARK SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES FILE NUMBER 2003-0384 ITEM DESCRIPTION AMOUNT NUMBER A. Funeral Expenses: 1. EWING BROTHERS FUNERAL HOME, INC. 5,575.00 2. B. Administrative Costs: 1. Personal Representative Commissions: Social Security Number of Personal Representative:: Year Commissions Paid: 2. Estimated Total Attorney Fees: HAROLD S. IRWIN, III 1,500.00 3. Family Exemption: Claimant Relationship Address of Claimant at decedent's death: Street Address City State Zip Code 4. Probate Fees: REGISTER OF WILLS 94.00 C. Miscellaneous Expenses: 1. REGISTER OF WILLS - File Inventory and Appraisement 25.00 2. HAROLD S. IRWIN, III - Notary Fees 10.00 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. TOTAL $ 7,204.00 (If more space is needed, insert additional sheets of same size.) REV-1512 EX + (1-93) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGES, LIABILITIES AND LIENS ESTATE OF WILLIAM C. CLARK FILE NUMBER 2003-0384 ITEM DESCRIPTION AMOUNT NUMBER NORTHWEST CONSUMER DISCOUNT COMPANY - Truck Loan NATIONAL CITY BANK - Mobile Home Loan 5,460.60 13,510.37 TOTAL (Also enter on Line 10, Recapitulation) $18,970.97 (If more space is needed, insert additional sheets of same size.) REV-1513 EX + (2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF WILLIAM C. CLARK SCHEDULE J BENEFICIARIES FILE NUMBER 2003 - 0384 ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR NUMBER SHARE OF ESTATE A. Taxable Bequests: 1. SHARON E CLARK DAUGHTER VARIOUS PERSONAL 1306 RITNER HWY PROPERTY CARLISLE PA 17013 2. WILLIAM L CLARK GRANDSON 100% RESIDUE 1306 RITNER HWY CARLISLE PA 17013 ITEM NAME AND ADDRESS OF BENEFICIARY AMOUNT OR NUMBER SHARE OF ESTATE B. Charitable and Governmental Bequests: NONE TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTs5 (also enter on Line 13, Recapitulation) $ NONE (If more space is needed, ~nsert additional sheets of same size.) EXHIBIT "A" LAST WILL AND TESTAMENT I, WILLIAM C. CLARK, of 1306 Ritner Highway, Carlisle, Cumberland County, Pennsylvania 17013, do hereby make, publish and declare this to be my last will and testament, hereby revoking all wills heretofore made by me. 1. I direct my personal representative to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. I direct that all inheritance taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property, whether or not such property passes under this Will, shall be paid by my personal representative out of my estate. 2. I authorize and empower my personal representative to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefore, in fee simple, as I could do if living. My representative is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said representative. 3. I give, devise and bequeath all of my estate of whatever nature and wherever situate as follows: A. To my daughter, Sharon E. Clark, the following: 1. My 1992 Skyline double-wide trailer contents at the time of my death and 2. All of my Tredagar Stock. and all of its' Bo My Grandson, William L. Clark, shall have the first option to purchase my 1988 Monte Carlo or any vehicle I own at my decease from my estate. 4. The rest, residue and remainder of my estate of whatever nature and wherever situate to my grandson, William L. Clark, 5. I nominate and appoint my daughter, Sharon E. Clark to be the personal representative of my estate, to serve without bond. If she cannot or does not serve, then I appoint my grandson, William L. Clark to be the substitute personal representative, also without bond. 6. I suggest that my personal representative retain the services of Harold S. Irwin, Ill, Carlisle, Pennsylvania in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 30th day of March, 2000. WII'LIAM C. CLARK (SEAL) Signed, sealed, published and declared by the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. ACKNOWLEDGMENT AND AFFIDAVIT WE, WILLIAM C. CLARK, JOHN J. BARANSKI, JR. and HEATHER A. BARBOUR, 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. JO?'N "J. BAI~ANSKI, JR. H~ATHER A. BAR'OUR COMMONWEALTH OF PENNSYLVANIA : :SS: COUNTY OF CUMBERLAND : Subscribed, sworn to and acknowledged before me by WILLIAM C. CLARK, the testator herein, and subscribed and sworn to before me by JOHN J. BARANSKI, JR. and HEATHER A. BARBOUR, witnesses, th/~ay of'~- ~- March, 2000. Notary Public EXHIBIT "B" Page: 1 Doc~ent Name: Sessiona STMT CO ACTION PROD CODE DDA CURR CODE ACTN POST EFFECTIVE TRACE ID * 04/24 * 05/02 * 05/06 STFD 1 THF TRANSACTION STMT FORMAT 96 OP EBRN MS 50852 ACTION COMPLETE COID ACCT 03/05/23 8.57.07 8892240279 SHORT NAME CLARK WILLIAM C PAGE 3 SEARCH FROM 103/03/24 THRU 103/05/06 CHECK NUMBER TRAN AMOUNT D/C BALANCE DESCRIPTION 1356 10.50 D 98.05 0033610393 CHECK NUMBER 1356 1,054.00 031036032261977 US TREASURY 303 SOC SEC 46.56 071000154336631 GRLIC INSUR PREM C 1,152.05 D 1,105.49 PF: i-HELP 3-PLVL 6-INQ 7-SB 8-SF 9-ASUM ll-CUTO ..-STSM Date: 5/23/ 3 Time: ~i~1:51 AM EXHIBIT "C" O STOWN BANI( TO: Law Office Harold S Irwin III Attorney-At-Law 35 East High Street Carlisle, PA 17013 FROM: ORRSTOWN BANK P.O. BOX 25O SHIPPENSBURG PA 17257-0250 RE: ESTATE OF William C Clark DECEASED DATE OF DEATH: April 25, 2003 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK: (1) CHECKING ACCOUNTS ACCOUNT NO. TITLE OF ACCOUNT 106002775 William C Clark DATE OPENED 10/7/02 DATE OF DEATH PRINCIPLE & ACCRUED INTEREST 495.33 SAVINGS ACCOUNT ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED DATE OF DEATH PRINCIPLE & ACCRUED INTEREST (3) CERTIFICATES OF DEPOSIT ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED DATE OF DEATH PRINCIPLE & ACCRUEDINTEREST Date: 5/27/03 By: Timothea Customer Service Operator P.O. BOX 250 · SHIPPENSBURG, PA 17257 · TEL. (717) 532-6114 EXHIBIT "D" Yahoo! Autos - Used Car Guide Page 1 of 2 Autos - 1~0 Dangerous Intersections Get a, Jni Rate, Win a M, INI · C:,:e:: ~,. Welcome, Guest Yahoo! 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EXHIBIT "F" Meals Mobile Home Sales 1300 Ritner Highway Carlisle, PA 17013 Phone: (717) 249-5446 Fax: (717) 249-1547 April 30, 2003 RE: William Clark To Whom It May Concern: 1992 28 X 56 Skyline Sunwood 7526 Mobile Home, Serial Number 31-11-0163E. The appraised value of this home is $14,000.00 If you have any questions or need any further information, please do not hesitate to contact me at 717-249-5446. Sincerely, Owen E. Meals OM/jh STATUS REPORT UNDER RULE 6.17 Name of Decedent: WILLIAM C. CLARK Date of Death' 4/25/2003 Will No. 2003 - 00384 Admin. No. 2103- 0384 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: 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: N/A 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~ Date: U2/2.1904 --- Signature - ( ~ ;.~. HAROLD $. IRWIN, Ill I Name (Please type or print ) · ~ 64 SOUTH PITT STREET ~ CARLISLE PA 1701~ Address (717) -2436090 Tel. No. Capacity Personal Representative X Counsel for personal representative BUREAU OF TNDZVZDUAL TAXES THHERTTANCE TAX DZVTSTON DEPT. 280601 HARRTSBURG, PA 17128-0601 COHMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-Z;47 EX AFP (01-0;) HAROLD S IRWIN III STES 201/202 55 E HIGH ST CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-14-2004 CLARK 04-25-2005 21 05-0584 CUMBERLAND 101 Amount Remitted WILLIAM C HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~.~ RETAIN LONER 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 CLARK WILLIAM C FILE NO. 21 05-0584 ACN 101 DATE 06-14-2004 TAX RETURN #AS: C X) ACCEPTED AS FILED C ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Sch®dula C) ~. Mortgages/Notes Receivable CSchedule D) (~) 5. Cash/Bank Daposits/Nisc. Personal Property (Schedule E) 6. Jointly Owned Property CSchadule F) (6) 7. Transfers (Schedule G) C7) 8. Total Assets APPROVED DEDUCTIONS AND EXENPTIONS: 9. Funeral Expansas/Ade. Costs/N/sc. Expenses CSchadule H) {9) 10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) 11. Total Deductions 12. Nat Value of Tax Return .00 115.94 .00 .00 18~228.58 .00 .00 (8) NOTE: To insure proper credit to your account, submi~ the upper portion of this form with your tax payment. 18,$42.52 7,204.00 18.970.97 c11) (12) 26.17~.97 7,852.6~- 15. 1~. NOTE: Charitable/Governmental Bequests; Non-elected 911t Trusts (Schedule J) (13) Net Value of Estate Subject to Tax (1~) If an assessment was issued previously, lines 14, 15 and/or 16, 17, reflect flgures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line l~ at Spousal rata (16) 16. Amount of Line 1~ taxable at Lineal/Class A rata (16) 17. Amount of Line lq at Sibllng rate (17) 18. Amount of Line 1~ taxable ai ColXataral/Class B rata (16) DISCOUNT INTEREST/PEN PAID (-) · 00 x O0 = · O0 x 045 = · O0 x 12 = · O0 x 15 = (19)= AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE] INTEREST AND PEN. TOTAL DUE 19. Principal Tax Due TAX CREDITS: PAYNENT RECE TPI DATE NUHBER .00 7,852.65- 18 and 19 will .00 .00 .00 .00 .00 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 .00 .00 .00 ( IF TOTAL DUE TS LESS THAN $1, NO PAYHENT IS REI~U:]:RED. IF TOTAL DUE TS REFLECTED AS A "CREDIT" (CR), YOU HAY BE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. RESERVATION: Estates of decedents dying on or before December lZ, 19BI -- if any future interest in the estate is transferred in possession ar 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 laeful Class B (collateral) rate on any such futura interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CA): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act ZS of ZOO0. (7Z P.S. Section 9140). Detach the top portion of this Notice and submit aith your payment to the Register of Rills printed on the reverse side. --Make check or money order payable to: REGISTER OF NZLLS) AGENT A refund of a tax credit~ which aaa not requested on the Tax Return, amy be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications are available at the Office of the Register of Wills, any of the 13 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-B00-361-2050; services for taxpayers with special hearing and / or speaking needs: 1-BOO-q47-~OZO (TT only). Any party in interest not satisfied with the appraisement, allowance, or disalloeance of deductions, or assessment of tax (including discount er interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 17128-1011, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue~ Bureau of Individual Taxes, ATTN: Post Assessment Reviae Unit, gept. 180601, Harrisburg, PA 17118-0601 Phone (717) 787-6505. Sea page 5 af the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-la01) for an explanation of administratively correctable errors. If any tax due is paid aithin three (3) calendar months after the decadent's death, a five percent (51) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa 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 ahich became delinquent before January l, 1982 bear interest at the rata of slx (6X) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January l, 1981 will bear interest at a rate ahich will vary from calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable interest rates for 19BI through Z004 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 ZOZ .0005q8 1983 162 .000438 1991 91 .000247 ZOOZ 61 .000164 1984 112 .000301 1993-1994 72 .000192 2003 52 .000137 1985 13Z ,000356 1995-1998 91 .000247 2004 42 .000110 1986 IOZ .000274 1999 7Z .000192 1987 lOX .000274 ZOO0 7Z .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELIN{~UENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the data of the assessment. If payment is sade after the interest computation date shown on fha Notice, additional interest must bm calculated.