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Home My WebLink About02-0351MILFORD I. MCBRIDE, gR. BRENDA K. M--cBRIDE MILFORD L. McBRIDE, T~ MCBRIDE AND MC--BRIDE, P. C. ATTORNEYS AT LAW 211 SOUTH CENTER STREET GROVE CITY, PA. 16127 TELEPHONE (7::~4)458-6640 MILFORD L. McBRIDE 1889-196:~ fa X ( 7 ::~ 4) 458-5401 March 7, 2002 Mary Lewis, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, Pennsylvania 17013 Re: Gary E. Filer Date of Death - February 27, 2002 Petition for Letters of Administration Dear Register of Wills: With respect to the above estate, please find enclosed the following:- 1. A death certificate. 2. A check in the amount of $287.00. This amount includes the $5.00 JCP fee, $3.00 for each Short Certificate (initially we would like 4 issued) and $270.00 the fee of administration. 3. Petition for Letters of Administration. We request waiver of bond, especially since Margaret Hartley is the sole heir. As you can see the decedent resided in Cumberland County at the time of death; however, the Administratrix would like to be sworn in as Administratrix in Mercer County. The Mercer County Register of Wills is Kathleen M. Kloos. The address is Mercer County Courthouse, Mercer, Pennsylvania 16137. The telephone number is 724-662-3800 (Ex~. 2253). Therefore, pursuant ~o Title 20 Pa. C.S.A. Section 3154(a) (1), please forward the paperwork to the Mercer County Register of Wills Office so that the Administratrix can be sworn in. Please ask the Mercer County Register of Wills Office to contact our office when the paperwork has arrived, and we will then arrange the swearing in. Please call if any questions. Thank you for your assistance. Very truly yours, McBRIDE and McBRIDE, P. C. M. L. McBride, Jr. MLM, JR./ch Encls. cc: Margaret G. Hartley BRENDA K. M__CBRIDE MILFORD L. MCBRIDE, MC--BRIDE AND MC--BRIDE, P. C. ATTORN£YS AT LAW ::~11 SOUTH CENTER STREET (~ROVIE CITY, PA. 161::~7 TELEPHONE {724) 4~8-6640 MILFORD L. McBRIDE 188g-lCJ62 FA X March 12, 2002 Mary Lewis, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, Pennsylvania 17013 Re: Gary E. Filer Date of Death - February 27, 2002 Petition for Letters of Administration Dear Register of Wills: Per our understanding of March 12, 2002 with your Solicitor, Ralph Wright, Esquire, I will guarantee the payment of the Pennsylvania inheritance tax on the above estate, and you will waive posting a bond by the sister, Margaret G. Hartley. Thank you for your good cooperation in this matter. Very truly yours, McBRIDE and McBRIDE, P. C. M. L. McBride, Jr. MLM, JR./ch cc: Margaret G. Hartley MARY C. LEWIS Register of Wills & Clerk of the Orphans' Court JERRY R, DUFFLE, ESQ. Solicitor OFFICES OF (~oun~ of (~umh~r~nb One Courthouse Square Carlisle, Pa 17013 (717) 240-6345 FAX (717) 240-7797 KATHLEEN M KLOOS REGISTER OF WILLS MERCER COUNTY COURTHOUSE MERCER PA 16137 DEAR KATHLEEN: RE: GARY E FILER PETITION FOR GRANT OF LETTERS OF ADMINISTRATION ENCLOSED YOU WILL FIND THE ORIGINAL PETITION FOR THE ESTATE OF GARY E FILER. KINDLY TAKE THE AFFIDAVIT OF MARGARET G HARTLEY AND RETURN THE SIGNED PETITION TO OUR OFFICE AS SOON AS POSSIBLE. IF YOU HAVE ANY QUESTIONS PLEASE DO NOT HESITATE TO CALl. US. THANK YOU. MARYC LEWIS REGISTER OF WILLS PETITION FOR GRANT OF LETTERS OF ADMINISTRATION ESTATE OF Gary E. Filer A/K/A SOCIAL SECURITY NO. Deceased. 190-32-2140 REGISTER'S NO. TO: MARY LEWIS REGISTER OF WILLS OF CUMBERLAND COUNTY, PA I Courthouse Square, Carlisle, PA 17013 PHONE: (717) 240-6345 The Petition of the undersigned respectfully represents that: Your petitioner is 18 years of age or older and applies for Letters of Administration (d.b.n.; pendente lite; durante absentia; durante minoriate) Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 402 West Elmwood Avenue, Merchanicsburg, Cumberland County, Pennsylvania (list street, number, township/municipality) Decedent, then 58 years of age, died Cumberland County, Pennsylvania February 27, 2002 at Harrisburg, DECEDENT AT DEATH OWNED PROPERTY WITH ESTIMATED VALUES AS FOLLOWS: (If domiciled in PA) (If domiciled in PA) (If not domiciled in PA) All personal property Personal property in PA Personal property in County 150,000.00+ Value of real estate in PA situated as follows: House and lot at 402 West Elmwood Avenue, Mechanicsburg, Cumberland County, Pennsylvania - $80,000.00+ Petitioner, after a proper search has ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: NAME RELATIONSHIP RESIDENCE 7578 Oxbow Road Margaret G. Hartley Sister Canastota, New York 13032 THEREFORE, Petitioner respectfully requests the grant of Letters of Administration in the appropriate form to the undersigned. SIGNATURE/TYPED NAME RESIDENCE 7578 Oxbox Road Margaret G. Hartley Canastota, New York 13032 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA : COUNTY OF : SS. The Petitioner above named swears or affirms that the statements in the foregoing Petition are true and correct to the best of her knowledge, information and belief and that as personal representative of the above decedent she will truly administer the estate according to law. Sworn to and subscribed before me this day of March , 2002. (Signature) For the Register (Signature) (Signature) REGISTER'S NO. 2002 ORPHANS' COURT DIVISION ESTATE OF Gary E. Filer DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, , 2002, in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED THAT Marcjaret G. Hartley is entitled to Letters of Administration, and in accord with such finding, said Letters are HEREBY GRANTED. THE FOLLOWING DOES HEREBY ACKNOWLEDGE HE IS ATTORNEY OF RECORD: M. L. McBride, Jr. (Name) 211 South Center Street (Address) Grove City, Phone: Pennsylvania 16127 (724) 458-6640 Mary Lewis, Register of Wills SHORT CERTIFICATES: ISSUED: Attorney's I. D. # 06132 10q 81)5 R£V 9/86 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. /2. /ge_. Hr05 144Rev $19t P 8186369 No. ~ Date ERMANENT It. ACK INK SEX ~AL SECURITY NUMBER OmE OF ~ATH ~Monm Oa~ ~ea Car Eugene Filer ~,. role [,. 190-32-2140 ~,.February 27, 2002 ~. ...... ~., ~u~...,... ~ 0.0..,o~. ~ ,~g~,sg'~, I ~:g%tg:~'~',:~ I~;~/~'"'c ............................................... ,o ' J J [~. V. . . ,l'~. ~r' 1~5DECEDtNTOFHIS~NICORIGIN? J~CE-A ..... Dauphin J I. ~rrisburg ~ept. of Revenue, Straw~rry Squarq~ .................. J,. ~lte ~CEOENT'S USUAL ~CUPATI~ KIND OF BUSINES~NDUSTRY J ~S DECEOENT EVER IN 0ECEDENT'S ED~ATI~ MARITAl- STATUS * Marr,~ SURVIVING Accountant~............ ) ,,~tate,gove~ent j .o~ j.. .... ' 12J 4 ....... . ~oo.~ss~s,,., c,,:o., s,.,. z,.c~, 0ECE~,,'S PA ,..~.,..~.,,,..,. Up~r Allen 402 E~o~ Avenue RESIDE~E G. Filer ~". Ellen Schultz ~ Mrs. Margaret F. Hartley ,~ 7578 Oxbow Road, Canastota, NY 13032 e ...... [] o~o~,.~ [] ,,b. ~rch 4, 2002/,,.. Woodland Cemetery 12,..Gr°ve Clty, PA 16127 SIGNATURE VICEI." C""~^SSUCN tC~NSE"UM"ER J,~etrick Fun. Home, Ina , 3125 Walnut St., Hbg. PA ab. ~~ J,,,. 014404-L ,^~E^ND^O~ESSO~^C ..... . I ...... ' ' 6'30 a.m. , Feb~ary 27, 2~ , ' Cardiac dysrhythmia Coronary artery disease 0UE TO (OR AS A CONSEQUENCE OF): ~L~. b~. M. ~0~. . 3,,. J,,~. ~rch 1, 2~2 Grain S. Hetr~ck, ~roner ,.1271 S. 28th St., ~rris~rg, PA 17111 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION ESTATE OF Gary E. Filer A/K/A SOCIAL SECURITY NO. Deceased. 190-32-2140 REGISTER'S NO. O~- 02- ~)~[~ TO: MARY LEWIS REGISTER OF WILLS OF CUMBERLAND COUNTY, PA I Courthouse Square, Carlisle, PA 17013 PHONE: (717) 240-6345 The Petition of the undersigned respectfully represents that: Your petitioner is 18 years of age or older and applies for Letters of Administration (d.b.n.: pendente lite; durante absentia; durante minoriate) Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 402 West Elmwood Avenue, Merchanicsburg, Cumberland County, Pennsylvania (list street, number, township/municipality) Decedent, then 58 years of age, died Cumberland County, Pennsylvania February 27, 2002 at Harrisburg, DECEDENT AT DEATH OWNED PROPERTY WITH ESTIMATED VALUES AS FOLLOWS: (If domiciled in PA) (If domiciled in PA) (If not domiciled in PA) All personal property Personal property in PA Personal property in County $ 150,000.00_+ Value of real estate in PA situated as follows: House and lot at 402 West Elmwood Avenue, Mechanicsburg, Cumberland County, Pennsylvania - $80,000.00+ Petitioner, after a proper search has ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: NAME RELATIONSHIP RESIDENCE 7578 Oxbow Road Margaret G. Hartley Sister Canastota, New York 13032 THEREFORE, Petitioner respectfully requests the grant of Letters of Administration in the appropriate form to the undersigned. SIGNATURE/TYPED NAME Margaret G. Hartley RESIDENCE 7578 Oxbox Road Canastota, New York 13032 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA : : COUNTY OF CUMBFRLAND : SS. The Petitioner above named swears or affirms that the statements in the foregoing Petition are true and correct to the best of her knowledge, information and belief and that as personal representative of the above decedent she will truly administer the estate according to law. Sworn ~o and subscribed before me this .~/~"~ day of March , 2002. For the Register (~ignature) ~ (Signature) (Signature) REGISTER'S N0.2002 ORPHANS' COURT DIVISION ESTATE OF Gary E. Filer DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, APRIL 8 , 2002, in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED THAT Marc~aret G. Hartley is entitled to Letters of Administration, and in accord with such finding, said Letters are HEREBY GRANTED. IV~ary {~ewis, Register of Wills 0 -~' THE FOLLOWING DOES HEREBY ACKNOWLEDGE HE IS ATTORNEY OF RECORD: L. McBride, Jr. SHORT CERTIFICATES: '/ (Name) ISSUED: 211 South Center Street (Address) Grove City, Pennsylvania 16127 Phone: ( 724 ) 458-6640 Attorney's I. D. # 0 613 2 CERTIFICATION OF NOTICE UNDER RUT.~. 5.6 (a) Name of Decedent: Gary E. Filer Date of Death: February 27, 2002 Will No. Administration No. 2002-00351 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above captioned estate on April 18, 2002 Name Address Margaret G. Hartle¥, 7578 Oxbow Road, Canastota, NY 13032 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date April £'18, 2002 McBRIDE and McBRIDE, P.C. Counsel for Personal Representative 211 South Center Street Grove City, Pennsylvania 16127 (412) 458-6640 MILFORD L. M~cBRIDE. BRENDA k. M__CBRIDE MILFORD L. McBRIDE. MCBRIDE AND MCBRIDE, P. C. ATTORNEYS AT LAW ;:~11 SOUTH CENTER STREET GROVE CITY, PA. 16127 TELEPHONE (72.4) 458-6640 MILFORD L. Mc~BRIDE FA X {724) 458-5401 May 22, 2002 Mary Lewis, Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, Pennsylvania 17013 Re: Gary Filer Estate Register's No. 2002-00351 Dear Ms. Lewis: We enclose herewith check in the amount of $57,000.00 on account of the Pennsylvania inheritance tax in the above estate, at discount. Please send us a receipt in the usual manner. Thanking you, we are, Very truly yours, McBRIDE and McBRIDE, P.C. MLM, JR/ps Encl. M. L. McBride, Jr. MCBRIDE AND MC-BRIDE, R ATTORNEYS AT LAW :::ill SOUTH CENTER STREET GROVE CITY, PA. IGI=:~7 RETI~N RECEIPT REQUESTED 7000 1530 0005 9756 0699 Mary Lewis, Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, Pennsylvania 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIWDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001217 MCBRIDE M L JR ESQ 211 SOUTH CENTER STREET GROVE CITY, PA 16127 ........ fold ESTATE INFORMATION: SSN: 190-32-2140 FILE NUMBER: 2102-0351 DECEDENT NAME: FILER GARY E DATE OF PAYMENT: 05/24/2002 POSTMARK DATE: 05/22/2002 COUNTY: CUMBERLAND DATE OF DEATH: 02/27/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $57,000.00 TOTAL AMOUNT PAID: $57,000.00 REMARKS: MARGARET G HARTLEY C/O M L MCBRIDE JR ESQUIRE SEAL CHECK# 101 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS MILFORD 1. M~BRIDE, JR, BRENDA K. M~CBRIDE MIlfORD L. M_cBRIDE, ~l MCBRIDE AND MCBRIDE, P. C. ATTORNEYS AT LAW 211 SOUTH CENTER STREET GROVE CITY, PA. 16127 TELEPHONE (724) 458-6640 MILFORD l. M~BRIDE 1889-1962 FA X (724) 458-5401 November 12, 2002 Cumberland County Courthouse Clerk of Court - Register of Wills One Courthouse Square Carlisle, PA 17013 Re: Inheritance Tax Return - Estate of Gary E. Filer 21-2002-0351 To Whom It May Concern: Enclosed herein, please find two (2) copies of the Inheritance Tax Return for the Estate of Gary E. Filer, along with a check in the amount of $14,208.32 payable to the Register of Wills, Agent to complete the Inheritance Tax payment. We enclose one (1) copy of the Inventory for the above estate and a check in the amount of $136.00 which represents $15.00 for the filing fee, $105.00 for the additional Probate charge and $16.00 for the filin~ of the Inventory. Please file this return at your earliest convenience and send a receipt for same in the enclosed, stamped, self-addressed envelope. If you have any questions, please feel free to contact our office. Thanking you, I am, Sincerely, cc enclosures McBRIDE and McBRIDE, P.C. USAA INVESTMENT MANAGEMENT · U~, ® COMPANY O0lO38 Page 1 of 1 oc INVESTMENT ACCOUNT CONFIRMATION FOR: 02/26/2002 Customer Service in San Antonio TouchLine~ 1-800-531-8448 456-7202 1-800-531-8777 GARY E FILER 402 W ELHWOOD AVE HECHANICSBURG, PA 9800 Fredericksburg Road 17055 USAA NUMBER: 800092 San Antonio, TX 7828~ Account Number: 40900264948 Date Transaction Description Quantity Price Amount 01/01 Beginning Value 929.088 $12.06 $11,204.80 01/29 Earnings Directed Dividend ~ $0.0660/Share 61.32 2~26 ........... Earnings::,: ...................... recteCD Ending Year-to-Date Dividends $122.64 L USAA FUND CODE[ACCOUNT NRJUSAA YR. INVESTMENT 40 [40900264948/000800092 MANAGEMENT S 50.00 minimum COMPANY To add to your account, make check payable to: INCOME FUND ACCOUNT REGISTRATION: GARY E FILER 402 W ELMWOOD AVE MECHANICSBURG, PA 17055 001038 000 1022 Send this stub and your check to: USAA INVESTMENT MANAGEMENT COMPAN' ATTN: SHAREHOLDER ACCOUNT SERVICES 9800 FREDERICKSBURG RD. SAN ANTONIO, TX 78288 i 000 000800092 9 If investing in a retirement accoun6 please indicate: Tax Year IRA Contribution SEP (Employer) Contribution Rollover Contribution For Internal use only 5oo,[] 7oo,[] 7oo2[] 5000 F1 7000 [9 70,0 [9 4090026494 8 0000040 2 7001 1940 0001 5194 6367 Coun%y Courthouse Clerk of Court - Register of Wills 0~e Courthouse Square Carlisle, PA '17013 FIRST CLASS MAIL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) 001842 MCBRIDE M L JR ESQ 211 SOUTH CENTER STREET GROVE CITY, PA 16127 fold ESTATE INFORMATION: SSN: 190-32-2140 FILE NUMBER: 2102-0351 DECEDENT NAME: FILER GARY E DATE OF PAYMENT: 11/14/2002 POSTMARK DATE: 11/12/2002 COUNTY: CUMBERLAND DATE OF DEATH: 02/27/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $14,208.32 REMARKS: TOTAL AMOUNT PAID: MARGARET G HARTLEY C/O M L MCBRIDE JR ESQUIRE $14,208.32 SEAL CHECK# 1112 INITIALS: CW RECEIVED BY.' MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX + (§-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 I RESIDENT DECEDENT 12C~UNT¥CODE OFFICIAL USE ONLY 2002 0351 YEAR NUMBER DECE- DENT CHECK APPRO- PRIATE BLOCKS CDR - RE- SPON DENT R ECA- PITULA- TION TAX COMPU- TATION DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER FILER, GARY E 190-32-2140 DATE OF DEATH (MM-DO-YEAR) ] DATE Of BIRTH (MM-DO-YEAR) 02/27/2002 I 01/23/1944 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ~ ~ 3. Remainder Return 1. Original Return 2. Supplemental Return 1:] (date of death prior to 12-13-82) 4. Limited Estate 4a. Future Interest Compromise (_date of death after 12-12-82) 5. Federal Estate Tax Return Required 8. Decedent Died Testate 7. Decedent Maintained a Living Trust (Attach copy of Will) ~Attach a copy of Trust) 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received 10. Spousal Poverty Credit(date of death between 12-31-91 and 1-1-g5) I--[ 11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME I COMPLETE MAILING ADDRESS M. L. MCBRIDE, JR. FIRM NAME (If Applicable) 211 SOUTH CENTER STREET MCBRIDE AND MCBRIDE~ P.C. GROVE CITY, PA 16127 TELEPHONE NUMBER 724-458-6640 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Pemonai Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) E~ Separate Billing Requested (6) 111,000.00 26,286..8_-4: 0.00 0.00 378 ~368.75 0.00 173,785.20 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (7) 8. Total Groae Assets (total Lines 1-7) (8) 9. Funeral Expenses & Adminis~-ative Costs (Schedule H)(9) 42, 682. 63 10. Debts of Decedent, Mortgage Liabilities, &Liens (Schedule I) (10) 28,355.51 11. Total Deductlone (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11 } (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax (13) has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) OFFICIAL USE ONLY 689,440.79 71,038.14 618~402.65 0.00 618,402.65 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (aX1.2) 0 . 00 1 6. Amount of Line 14 taxable at lineal rate 0 . 0 0 17. Amount of Line 14taxable at siblingrate 618,402.65 18. Amount of L.ine 14 taxable at collateral rate 0 . 0 0 19. Tax Due x .o~ (15) 0. O0 x .o~,% (16) 0. O0 x .12 (17) 74 ~ 208.32 x .15 (18) 0. O0 20. D I~i~:=i~RE iF¥OU~i~EREQUEs~i~A RE~NI~O~EI~PA~EN~ 119) 74,208.32 0 PA15001 NTF 29755 Copyright 2000 Greatland/Nelco LP- Forms Software Only PA REV-15OO EX (6-0o) Decedent's Complete Address: Page 2 STR~-~- ~ ADDRESS 402 WEST ELMWOOD AVENUE ICI'FY I STATE I ZIP I MECHANICSBORG PA 17055 Tax Payments and Credr~s: 1. Tax Due (Page l Line19) (1) 74~208.32 2. Credits/Payments A. Spousal Poverty Credit 0.00 B. Prior Payments 57 t000.00 C. Discount 3 f 000.00 Total Credits (A + B + C) (2) 60,000.00 Interest/Penalty if applicable D. Interest 0.00 E. Penalty 0.00 Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I 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) 14,208.32 A. Enter the interest on the tax due. (SA) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 14,208.32 Make Check Payable 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- retaintheuseorincomeofthepropertytraneferred-., ..................................... . ~ ~ b. retain the right to designate who shaJl use the properly 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 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 secudty at his or her death~ ~-1 ~ ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................ ~ ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties ofoerju~, I declare that I have examined this return, including accompanying schedules and statements and to the best of my knowledge and belief, it is true, correct and complete. Dec aration of preparer other than the personal representative s based on information of which preparer has any know edge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ~DDRESS~il SO~'~'t'[ C~-~"~'~ STREE~ __ GROVE CITY, PA 16127 SIG~N~RE OF~REPARER O_.T. HER THAN 15~z~PRESENTATIVE ADDRESS 211 SOUTt~ ~-~'z'~ ST~-T- DATE DATE ////, GROVE CITY, PA 16127 ! [72 P.S. II 9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate is 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 fro m tax, and the statutory requirements for disclosure of assets an d 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 th e use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(aXl,2)]. The tax rate imposed on the net value of transfers to or for t he use of th e decedent's lineal beneficiaries is 4.5%, except as noted in 72,P.S. § 9116(1.2) [72 P.S. § 9116(aXl)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's si blings is 12% [72 P.S. § 9116(a)(1.3}]. A si bling is defined, un der Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 0 PALCO02 NTF 29758 Copyright 2000 Greatland/Nelco LP- Forms Software Only REV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVAN IA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER FILER, C4~R¥ E 21-2002-0351 All real property owned ~olely or aa a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property whl©h ia Jointly-owned with right of survivorship must be disclosed on Schedule ITEM NO. 1. VALUE AT DATE DESCRIPTION OF DEATH HOUSE ~ LOT ~OTt~ AS 402 WEST ET~WOOD 111,000. O0 AVENUE, CUMBERLAND COUNTY, MECHANICSBURG, PENNSYLVANIA; SOLD FOR: TOTAL (Also enter on line 1, Recapitulation) $ 111,000. O0 (If more space is needed, insert additional sheets of the same size) 0 PA15021 NTF 33299 Copyright 2000 Greatland/Nelco LP- Forms Software Only REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER FILER, GARY E 21-2002-0351 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NO. DESCRIPTION OF DEATH ELEVEN (11) SERIES E $25.00 US SAVINGS BONDS TWO (2) SERIES I $10,000 US SAVINGS BONDS 136 SHARES OF LUCENT TECHNOLOGIES STOCK AT $5.53 PER SHARE 99 SHARES OF DOMINION RESOURCES STOCK AT $20.10 PER SHARE 50 SHARES OF AT&T WIRELESS STOCK AT $10.22 PER SHARE 105 SHARES OF AT&T CORP. (FORMERLY AMERICAN TELEPHONE AND TELEGRAPH) STOCK AT $15.61 PER SHARE 36 SHA~,ES OF AGERE STOCK AT $4.00 PER SHARE 1,250.81 20,000.00 752.08 1,989.90 511.00 1,639.05 144.00 TOTAL (Also enter on line 2, Recapitulation) 2 6,2 8 6.8 4 (If more space is needed, insert additional sheets of the same size) 0 PA15031 NTF 33300 Copyright 2000 Greatland/Nelco LP- Forms Softw=re Only REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER FI~-~ G~,y E 21-2002-0351 Include proceeds of litigation & date proceeds were received by the estate. All prop. jointly-owned with right of survivorship must be d~c!esed on ~eh. F. ITEM VALUE AT NO. DESCRIPTION DATE OF DEATH 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 PA DEPARTMENT OF REVE~ - ~AL EMPLOYERS WAGES PA DEPARTMENT OF REVENUE - FINAL EMPLOYERS PAYMENT FOR RE~AINING SICK TIME BOROUGH OF MECHANICSBURG - ACCOUNT REFUND TRAVEL EXPENSES FROM ESTATE OF FLOYD G. FILER CONSUMERS REPORT - MAGAZINE REFUND PARKING AUTHORITY - ACCOUNT REFUND WAYPOINT BANK - PAYOFF REFUND USAA - HOMEOWNERS PREMIUM REFUND WESTSHORE TAX BUREAU - REFUND UNITED STATES TREASURY - 2001 IRS REFUND STATE OF PENNSYLVANIA - 2001 STATE INCOME TAX REFUND DISCOVER BANK - MONEY MARKET ACCOUNT #3000011546557 WAYPOINT BANK - CHECKING ACCOUNT #90470170 WAYPOINT BANK - SAVINGS ACCOUNT #109011282 WAYPOINT BANK - CERTIFICATE OF DEPOSIT #7100011308 WAYPOINT BANK - CERTIFICATE OF DEPOSIT #8000053235 WAYPOINT BANK - CERTIFICATE OF DEPOSIT #8000053918 WAYPOINT BANK - CERTIFICATE OF DEPOSIT #8000057023 PSECU - SAVINGS ACCOUNT #S1 PSECU - CHECKING ACCOUNT #S4 PSECU - CERTIFICATE OF DEPOSIT #S50 PSECU - CERTIFICATE OF DEPOSIT #S52 PSECU - CERTIFICATE OF DEPOSIT S53 FLOYD FILER ESTATE PROCEEDS REIMBURSEMENT OF COUNTY TAXES AT CLOSING ON REAL ESTATE (HUD LINE 407) REIMBURSEMENT OF SCHOOL TAXES AT CLOSING ON REAL ESTATE (HUD LINE 409) REIMBURSEMENT OF SEWER CHARGES AT CLOSING Total from continuation pages .... TOTAL (Also enter on line 5, Recapitulation) $ 4,411.85 2,025.91 87.00 1,783.65 29.72 105.00 4.00 52.93 7.08 1,086.00 271.00 13,537.85 102.33 6,921.15 9,506.65 27,272.09 22,804.37 22,220.15 43,604.51 9,306.28 20,090.46 20,054.56 20,352.07 150,000.00 253.03 23.98 5.13 2,450.00 378,368.75 (If more space is needed, insert additional sheets of the same size) Copyright 2000 Greatland/Nelco LP- Forms Software Only 0 PA15081 NTF 33305 Estate of: FILER, GARY E Schedule E -- Cash, Bank Deposits & Misc. Personal Property Page 2 21-2002-0351 Item Value at No. Description Date of Death 27 ON REAL ESTATE (HUD LINE 410) 28 USED 1995 PONTIAC BONNEVILLE SE SEDAN 2,450.00 TOTAL. (Carry forward to main schedule) ...... 2,450.00 REV-1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER FZLF_~, C*,,~Y g 21-2002-0351 This schedule must be completed and filed if the answer to any of questions t through 4 on the reverse side of the REV-t$O0 COVER SHEET is yes. DESCRIPTION OF PROP~-HI Y % OF INCLUDE NAME OF THE TRANSFEREE, THEIR ITEM RELATIONSHIP TO DECD & DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NO. ATTACH COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 1. WAYPOINT BANK - IRA ACCOut~T 2,629.11 100.00 0.00 2,629 11 #7100011308 ' 2 USAA - MONEY MARKET ACCOUNT 31,174.93 100.00 0.00 31,174.93 #46900419687 MARGARET G. HARTLEY, SISTER, BENEFICIARY 3 USAA - MONEY MARKET ACCOUNT 39,170.57 100.00 0.00 39,170.57 #42900360252 MARGARET G. HARTLEY, SISTER BENEFICIARY 4 USAA - TERM FUND ACCOUNT 59,437.73 100.00 0.00~ 59,437.73 #44900961883 MARGARET G. HARTLEY, SISTER BENEFICIARY 5 USAA - SHORT TERM FUND ACCOUNT 30,168.06 100.00 0.00 30,168.06 #45900686667 MARGARET G. HARTLEY, SISTER, BENEFICIARY 6 USAA - INCOME FUND ACCOUNT 11,204.80 100.00 0.00 11,204.80 #40900264948 ~RGARET G. HARTLEY, SISTER BENEFICIARY TOTAL (Also enter on line 7, Recapitulation) $ 173,785.20 0 PA15101 NTF 33307 (If mom space ~ needed, insert additional sheets of the same size) Copyright 2000 Gre&tland/Nelco LP- Forms Software Only REV-1511EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER FILER, G~P./' E 21-2002-0351 Debts of decedent must be reported on Schedule I. ITEM NO. AMOUNT 2 3 4 5 DESCRIPTION FUNERAL EXPENSES: CUNNING~ [~cTNE~.L HO1d~ - [~JtTER,a~, EZPENSE WOODLAND CEMETERY - GRAVE OPENING REV. JOHN K. JEFFERIS - MINISTER FOR FUNERAL HARRISVILLE MEMORIALS - GRAVE MARKER GRACE METHODIST CHURCH - FUNERAL DONATION ADM IN ISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Secudty Numbar(s)/EIN No. of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Att0mey Fees Name: MCBRIDE AND MCBRIDE, P.C. 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 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. PATRIOT NEWS - LEGAL NOTICE 8. CUMBERLAND LAW JOURNAL - LEGAL NOTICE 9. SELL TO BUYER ASSISTANCE ON CLOSING COSTS ON REAL ESTATE SALE (HUD LINE 506) 10. COMMISSION PAID AT SETT?.W. MENT TO CENTURY 21 REAL ESTATE ON REAL ESTATE SALE (HUD LINE 703) 11~ MAIL/WIRE FEE FOR REAL ESTATE CLOSING (HUD LINE 111) 12~ STATE TAX/STAMPS AT CLOSING ON REAL ESTATE (HUD LINE 11203) 13.1BARRY L. RECKARD, TAX COLLECTOR, 2002 CITY/TOWNSHIP TAXES DUE ON REAL ESTATE CLOSING (HUD LINE 1204) Total from continuation pages .... TOTAL (Also enter on line 9, Recapitulation) 8,605.00 300.00 100.00 1,400.00 100.00 0.00 15,707.52 0.00 287.00 0.00 0.00 277.78 75.00 3,000.00 7,770.00 15.00 1,110.00 486.09 3,449.24 42,682.63 0 PA15111 NTF 33308 (If more space is needed, insert additional sheets of the same size) Copyright 2000 Greatland/Nelco LP- Forms Software Only Estate of: FILER, GARY E Schedule H, Part B -- Administrative Costs Item Description 14. 15. 16. 17. 18. 19. CENTURY 21, TRANSFEE ON REAL ESTATE CLOSING (HUD LINE 1304) AON HOME WARRANTY, HOME WARRANTY ON REAL ESTATE CLOSING USAA - AUTO INSURANCE PREMIUM DAVID G. HARTLEY - EXPENSES INCURRED TO RETREVE AND CLEAN PERSONAL BELONGINGS OF GARY FILER FROM MECHANICSBURG, PA TO CANASTOTA, NEW YORK DANIEL BOONE - C?.~NING OF MECHANICSBURG PROPERTY IN PREPARATION FOR SA?~ OF REAL ESTATE FED EX - MAIL EXPENSE TO CENTURY 21 REAL ESTATE US POSTMASTER - POSTAGE DANIEL BOONE - MOWING OF LAWN CARRIE JO STEESE - REAL ESTATE TAXES O~POLKAACCOUNTING - PREPARATION OF 2001 TAXES CAR BATTERY US POSTMASTER - POSTAGE Page 2 21-2002-0351 Amount 195.00 399.00 466.12 1,252.61 540.00 18.86 68.81 105.00 111.47 200.00 67.36 25.01 TOTAL. (Carry forward to main schedule) ...... 3,449.24 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER FZLE~., C.*,,a~Ry ~. 21-2002-0351 Include unmimbumed medical expenses. ITEM NO. DESCRIPTION AMOUNT 2 3 4 5 6 7 8 9 10 12 13 14 15 16 PPL ELEC%V~LIC - ACCOUNT GM CARD - ACCOUNT UNITED WATER - ACCOUNT VERIZON - ACCOUNT BOROUGH OF MECHANICSBURG - ACCOUNT PPL ELECTRIC - ACCOUNT UNITED WATER - ACCOUNT PPL ELECTRIC - ACCOUNT UNITED WATER - ACCOUNT VERIZON - ACCOUNT PPL ELECTRIC - ACCOUNT UNITED WATER - ACCOUNT PPL ELECTRIC - ACCOUNT UNITED WATER - ACCOUNT WAYPOINT BANK - MORTGAGE PAYMENT WAYPOINT BANK - MORTGAGE ON PROPERTY LOCATED AT 402 WEST ELMWOOD AVENUE, BOROUGH OF MECHANICSBURG, MECHJ~ICSBURG, C~ COUNTY, PENNSYLVANIA TOTAL (Also enter on line 10, Recapitulation $ 49.79 189.72 10.89 24.49 78.00 263.16 6.61 75.77 6.71 2.79 16.63 6.71 12.46 4.26 267.75 27,339.77 28,355.51 (If more space is needed, insert additional sheets of the same size) Copyright 2000 Greatland/Nelco LP- Forms Software Only 0 PA15121 NTF 33309 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER FILER, GARY E 21-2002-0351 NUMBER I 1. II 1. RELATIONSHIP TO DECEDENT Do Not List Trustee(a) AMOUNT OR SHARE OF ESTATE NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] HARTLEY, MARGARET G SISTER ~ ~ 7578 OXBOW ROAD CANASTOTA, NY 13032 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE1 ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBS. ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) 0 PA15131 NTF 33293 Copyright 2000 Greatfand/Nelco LP- Forms Software Only A. tLS. [)EPAtl [MFN I' OF Itt, t ~:~II,IG dl,d Ut (LAN DEVELOPMEN I SETTLEMENT STATEMENT SECURED LAND TRANSFERS, INC. B. TYPE OF LOAN 5006 East Trindle Road t. I J FHA 2. [ J FMHA 3. I ]CONV. UNINS. Suite 203 '~. I IVA 5. IXCONV. INS. Mechanicsburg, PA 17055 6. FILE NUMBER: I 7. LOAN NUMBER: 503817 623959?2? Phone: (717) 591-8500 FAX: (717) 591-8506 8. MORT. INS. CASENO.: C NOTE: This form is furnished to give you a statement of aclual seltlemenl costs. Amounls paid to and by the se/tlemenl agent are shown. Items marked '(p.o.c.)' were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: E NAME AND ADDRESS OF LENI~ER: A~d:rew ~. Nat::erman Rstal::e o~ Ga~¥ ~. F-iler ABM' AM20 Hort::9age Group, Dawn M. Nomer 'rnc. 777 R. B'ise~hower S"1"~ 700 An~ A~bor MT 48108 G. PROPERTY LOCATION: H. SE'I-FLEMENT AGENT: I. SETTLEMENT DATE: 402 Nest R'lmwood Avenue Secured La~d 'l"rans~ers, ]:nc. 06/24/02 Mechan±csbu~9 BOROUGH PLACE OF SETTLEMENT: CUMBERLAND County 5006 E. Trindle Rd, #203, Mech. PA 17050 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: IOO GROSS AMOUNT DUE FROM BORROWER 4oo GROSS AMOUNT DUE TO SELLER lOl Conlracl sales price 111000 . 00 4Ol Contracl sales price 111000 . 00 io2 Personal property 4o2. Personal property lO3 Setllemenl charges Io borrower (line 1400) 4 8 5 2 . 5 9 403 104. 404 105. 405. Adjustmenls for items paid by seller in advance Adjustments for items paid by seller in advance lO6. cilyfrown lax to 4o5 Cily/'rowr~ lax Io 10?. Counly tax 06/24/02~o 12/31/02' 253.03 ,OT. Coun~ylax 06/24/021o 12/31/02 253.03 108. Assessments Io 408 A$$essri3eRIs 10 ,o9 s:~oo~ 06/24/02~o06/30/02 23.98 .,0, sot~ooZ 06/24/021006/30/02 23.98 ,,0. Ref/Swr:$78/q e~d 6/30 5.13 ,,QRef/Swr:$78/q e~d 6/30 5.13 Ill. 411 112 412 12o GROSS AMOUNT DUE FROM BORROWER 116134.73 42o. GROSS AMOUNT DUE TO SELLER 111282.14 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER 50QREDUCTIONS IN AMOUNT DUE TO SELLER 2Ol. Deposit or earnest money 2 0 0 0 . 0 0 5el.Excess deposit (see inslruclions) 202. Princip.al amount Of new loan(s) 105450 . 00 5o2.Setllement charges lo seller (line 1400) 9975.09 2o3 Existing loan(s) laken subject lo so3.Exisling loan(s) taken subjecl to 204 sea Payoff of First Mortgage Loan Waypoint Bank 27339.77 205. 505Payoff of Second Mortgage Loan 208 (S) to (B) Closing Cost 3000.00 50~ (S) to (B) Closing Cost 3000.00 207. 507 208 , 508. 209. 509. Adjuslmenls for ilems unpaid by seller Adjustmenls for items unpaid by seller 21 o.City/l'own tax Io 51 o. City/Town lax Io 21 I.County tax to 511.Counly lax Io 212. Assossmonls Io 512. Asso$smenls lo 213 School Io 513 School Io 214 514 215 ..... 515. 216. 516. 217. 517. 218. 518. 219. 519 22o. TOTAL PAID BY/FOR BORROWER 1'10450, 00 52o, TOTAL REDUCTION AMOUNT DUE SELLER 40314. 86 3oo. CASH AT SETTLEMENT FROM OR TO BORROWER 6oo. CASH AT SETTLEMENT TO OR FROM SELLER 3Ol. Gross amount due from borrower (line 120) 116134 . ? 3 6el.Gross amount due to seller (line 420) 111282 . 14 302 Less amount paid by/for borrower (line 220) 1 1 0 4 5 0.0 0 ~o2 Less reduction amounl due seller (line 520) 4 0 3 1 4. 8 6 3o3 CASH(~] FROM) ([ ]TO) BORROWER 5684 .73 6o:~CASH ([,,~] TO) ([ ]FROM) SELLER 70967.28 Buyer or Borrower's Signature Seller's Signaluro HUD-1 Rev. 5/86 U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT L. SETTLEMENT CHARGES 503817 700. TOTAL SALES/BROKER.S COMMiSSiON based on prlce $ 111000 . 00 Division of Commission (line 700) as follows: Total: $ 7, ? 7 0.0 0 70t.$ 3305.00 to EP~A N~7~, Inc. 702. $ 4465.00 to OMB No. 2502-0265 1003. 1004. 1005. 10O6. 1007. Centur_y_21 Piscioneri 703. Commission paid at Settlement 704. B-TransFee 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee % 802. Loan Discount % 803. Appraisal Fee Io 804. Credit Report Io 805. Lenders Inspection Fee 806. Mortgage Insurance Application Fee to 807. Assurrlplion Fee 8o8. FloodCert 8o9. LendrAdmin 810. 811. ERA N7~, Inc. Guardian Home Fundinq____ Guardian Home Fundinq_ Guardian Home Fundin~ ABN AMRO 900, ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from 06~7'~-7"0~ to06~-0-7'~2 @$ 902. Mortgage Insurance Premium for rno. to 903. Hazard Insurance Premium for 1yrs. to Erie 904. yrs. to 905. Def Prem 1000. RESERVES DEPOSITED WITH 1001. Hazard Insurance 3 10o2. Mortgage Insurance City/Town tax County tax 5 4 0.51 Assessments School 13 121.56 ate 100. TITLE CHARGES 101. Settlement or closing fee Io 1102. Abstract or title search to 1103. Title e~amination to 1104. Title insurance binder to II05. Document preparation to ~t06. Notary fees to 107. Attorney's fees Io (includes above ilems No.:) 1108. Title Insurance to LENDER FOR mo.@$ mo. @$ mo. @$ mo. @$ mo.@$ mo. @$ mo. @$ mo. @ $ 2 0.14/day Ins Exchq(251. POC) ABNtoGuardian (1449.94POC) 20 . 92 'mo. 'mo. 'mo. 'mo. /mo. /mo. /mo. Z. n. Cash McBride, Esot. ( POC- S ) Page 2 P A I D F R O----'~'~-"~ PAID ~ BORROWER'S I SELLER'S J FUNDS AT I FUND~S~aAcI,, I SETTLEMENT I SETTLEMENT (includes above items No.:) ENDS: 100~00 r109. Lender's coverage $ 1 0 5, 4 5 0 '110. Owner's coverage $ 111, 000 111. Mail z/~ 12. 13. 1200. 1201. 12O2. 1203. Slate tax/stamps: DeedS 1110 . 00Mortgage $ 1204. ' 02Ct~_~ Barry__L. Heckard, Tax 205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to 1302. Pest Inspection to 1303. Hm Inspect Biechler & 1304. S-TransFee Centur[ 21 1305. Secured Land Transfers Secured Land Transfers ClosProLtr First American Title GOVERNMENT RECORDING AND TRANSFER CHARGES Recording fees: Deeds 28.50 MortgageS 52.50 Misc.$ City/counlylax/stamps: Deeds 1110. 00Mortgages 275.00 17.23 18.00 325.00 140.98 62.76 202.55 1580.28 -203 . 96 10.00 35.00 15.00 Ins 35.00 1110 1110.00 Co 486.09 Tillerv(POC-B Piscioneri 195.00 Hm Warr Aon Home Warrant~________ 399.00 400. TOTAL SETTLEMENT CHARGES (enter on lines 103 and 502, Seclions J and K)4 8 5 2.5 99 9 7 5.0 9 Petites agree Ilml ,o liability is assumed by Solllemorll Ageel h)r the eccoracy of r~h)rn a er I J(r s md by olhers as si ewr on ti e IUD- l Se (:me, S a. r er Selllemen .Age ~1 hereby expressl reserves lhe rigf o dopes I a.y amou,ls collecled Iord sbarsemen ~ ar ir eresl bear r g acco j d in a Fedora y rtsured i,slilulio, a,d lo credil any i,loresl so ear,ed Io ils own accou.l as addilior~al tempe,salton lot ils services in Ibis lransaclioe. HUD CERTIFICATION OF BUYERS AND SELLERS I have carelully reviewed the HUD- I Selllemenl Slalemenl and Io Ihe best of my knowledge and belief, i s a true and accurate statement of all receipls and disbursements ~~°ufl/[Y ~" ' 'urlher cerlifY 'hal I have received a copy of the HUD., SetllemenI Slatement. Buye¢ or Borrower's Sigealure Seller's Sig.ature Buyer's Address & Seller's New Address The H~/l~.~m.~fl Statcrnerd which I.~. prepared is a nlJe and accurale accour, I el Ibis Ifaesaclioe I have CalJSod or wiU ca lunds lo be disbursed i, accorda.ce with Ibis slalemenl. s,,,,,~,&,,--- /I / ~ DISCOVER' BANK May 9, 2002 Milford L. McBride Jr. McBride and McBride P.C. 211 South Center Street Grove City, PA 16127 Re: Estate of Gary E. Filer Dear Milford L. McBride Jr. Thank you for your recent inquiry dated 4/29/02. The following is the information that you requested concerning the above referenced estate: Account Number: 3000011546557 · Account Status: Active · Account Title: Gary E. Filer · Account Type: Money Market · Date of Death Balance: $13,537.85 (Including interest paid and accrued to date of death) · 2001 Interest Paid: $516.49 · 2002 Interest Accrued to Date of Death: $38.61 · 2002 Interest Accrued after Date of Death:S29.47 · Current Balance: $13,567.32 · Current Rate of Interest: 1.78% · OpenDate: 6/10/91 · Close Date: N/A · Close Balance: N/A · Maturity Date: N/A · Safe Deposit Box: No If you may have any additional questions or need any additional information, please give us a call at (800) 347-7000. Please be advised if the account is to be closed, we will need to receive a copy of the death certificate, a letter from the court naming the executor of the estate, and a notarized letter of instruction from the executor. Sincerely, PO Box 7112 Dover DE 19903-9955 LOOK I=OR US;. WI~'LL Gt~T YOU THIERI~. 04/09/2002 MCBRIDE & MCBRIDE 211 S CENTER ST GROVE CITY 16127 The information which you requested on the account(s) of GARY FILER DECEASED (Social Security Number 190-32-2140) is/are as follows: Account Number 109011282 1110003907 7100011308 8000053235 8000053918 Class of Account SAVINGS IRA CERTIFICATE CERTIFICATE CERTIFICATE Date Opened 01/27/87 04/10/89 08/10/01 04/07/00 09/14/99 Principal Balance 6915.04 2623.09 9476.72 27141.01 22745.39 Accrued Interest 6.11 6.02 29.93 131.08 58.98 Balance at Date of 6921.15 2629.11 9506.65 27272.09 22804.37 Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership Was Established 90470170 Account Number CHECKING Class of Account 01/27/87 Date Opened o ~ 10~.~1 Principal Balance .(32 Accrued Interest 102.33 Balance at Date of Death SOLE Account Ownership Name of Joint Owner, if any Date Ownership Was Established 8000057023 CERTIFICATE 07/07/00 22139.25 80.90 22220.15 SOLE SOLE SOLE SOLE SOLE Additional Information Requested PLEASE COMPLETE W-9 ? Si~./~4ferely' ' , SENIOR SERVICES REP. P.O. Box 171 I. HARRISBURG. PENNSYLVANIA 17105-1711 Toll Fr~ 1-866-WAYPOINT (I-i366-9[39-7646) · IN YORK AREA 717/~315-4500 · wvvw.wagpointbank.com PSEC the financial link April 16, 2002 Account # 0190322140 M L MCBRIDE JR 211 SOUTH CENTER ST GROVE CITY, PA 16127 Dear MR MCBRIDE: The following is the status of GARY E FILER's account with PSECU as of the date of death. Joint Owner's Name NONE Date Established 10.01. 1987 Date of Death 02.27.2002 Date of Birth 01.23.1944 Share(s) Regular Shares (SI) Checking Shares (S4) 60 Month Certificate-1 (S50) 12 Month Certificate-3 (S52) 24 Month Certificate (S53) Balance Accrued Dividend $43,535.35 $69.16 9,299.65 6.63 20,000.00 90.46 20,000.00 54.56 20,291.80 60.27 Loan(s) Balance Accrued Interest Personal Service Loan (L1) $ 0.00 $ 0.00 VISA (L9) 0.00 0.00 The dividend earned from January 1,2002 through the date of death was $615.34. We do not have safe deposit boxes for our members. If you have any questions, please call 234-8484 in Harrisburg or our toll- free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Sincerely, Member Service Representative Finance Suppor~ Unit PENNSYLVANIA STATE EMPLOYEES CREDIT UNION Main Address: 1 Credit Union Place, Harrisburg, PA 17110-2990 - (717) 234-8484 · (800) 237-7328 Mailing Address: P.O. Box 67013, Harrisburg, PA 17106-7013. (717) 777-2100 (TDD) · (800) 472-1967 (TDD) Web Address: www.~secu.com Savings federally insured up to $100,000 by the National Credit Union Administration Kelley Blue Book Used Car Values Page 1 of 2 New Ca~ Pridng i Buiid a Car i Hy C,~; Va~m i Buy n Used Car ~ C~' Prevt~ i Blue Book Trade-In Report Pennsylvania · October 22.2002 Engine: V6 3.8 Liter Trans: Automatic Drive: Front Wheel Drive Mileage: 100,000 1995 Pontiac Bonneville SE Sedan 4D Buy a New Car Buy a Used Car List Your Car For Sale Online Free Lemon Check Financin.q Quote Insurance Quote Warranty Quote Payment Calculator Equipment Air Conditioning Power Steering Power Windows Power Door Locks Tilt Wheel Cruise Control AM/FM Stereo Dual Front Air Bags ABS (4-Wheel) Consumer Rated Condition: Excellent "Excellent" condition means that the vehicle looks great, is in excellent mechanical condition and needs no reconditioning. It should pass a smog inspection. The engine compartment should be clean, with no fluid leaks. The paint is glossy and the body and interior are free of any wear or visible defects. There is no rust. The tires are the proper size and match and are new or nearly new. A clean title history is assumed. This is an exceptional vehicle. Trade-In Value $2,450 Trade-in value represents what you might expect to receive from a dealer for this consumer owned vehicle. Keep in mind that the dealer must then absorb the cost of making the vehicle ready for sale, advertising, sales commissions, arranging financing and insurance and standing behind the vehicle for any mechanical or safety problems. Get a Private Party Value Get Invoice & MSRP on New Cars k R( at ~ Bt Yc I~ C( V~ Copyright © 2002 by Kelley Blue Book Co., All Rights Reserved. Sep-Oct 2002 Edition. The information in this report was printed from the Kelley Blue Book Web site (www.kbb.com) and is intended for the personal use of the customer only and may not be sold or transmitted to another party. We assume no responsibility for errors or omissions.(v.02091) http://kbb.com/kb/ki.dll/kw.kc.ur?kbb.PA;031946;PA085& 16127;t&278;Pontiac; 1995%.., 10/22/2002 USAA: UN.kA INVEN'I'MI,~NT MANA(;EMI,~NT ('ONllLXNY 9800 I"redcrick, ihur~ Road ~an Antonio, 'I'X 78288 006520 013039 GARY E FILER 402 W ELMWOOD AVE MECHANICSBURG PA 17055 Pa~e I of 2 INVESTMENT ACCOUNT STATEMENT Statement Period: 01/01/2002 - 02/28/2002 Customer Service TouchLinc~ Wcbsite USAA NUMBER: TOTAL ACCOUNT VALUE: 1-800-531-8448 1-800-$31-8777 www.usaa, com 000800092 $31,174. 93 Fund Fund/Account Number USAA Tax Exempt Money Market Fund 46-46900419687 0.20% 0.20% 2.20% Quarter to Year to Date 1 Year II Date ' Total Return Information: This table details.your personalized total return tbr each of your USA.& mutual ~nd accounts. If your account ~as closed (zero balance) within the period, your account's total return w'ill be calculated up to that closing date. If your account was closed xMthin the period and then reopened, your account's total return will be calculated based on the reopen date. Your account's total return is defined as the percentage change in the value of an investment over a given period of time. Your individual total return will be affected by your individual ho ding period and transaction history, and therelbre may be different from the total re,.tm for the underlying investment. Fund Year to 1 Year 5 Year : 10 Year Since Date Inception USAA Tax Exempt 0.20°/,, 2.24% 3.23% 3.13% 4.12% Money Market Fund = .Mumm Fund Performance Information: The pedbrmance data quoted rcpresent~ past performance: the investment return and principal value of an ~nvestment wilt fluctuate so that an nvestofs shares, u. hen redeemed, may be v, orth more or less than their original cost. This rctlccts thc average total return of L'SA.k Mutual Ft~nd.s and does not reflect the perlbrmance of} our individual account JSAA® ,CCOU'NT REGISTRATION FILER ELMWO(')D AVE ECII.L\'ICSBURG PA 17055 3766 Fund46 Code J To add to your account. make chec'k payable to: USAA Tax Exempt Money Market Fund Send this stub and your check to: USAA INVESTMENT MANAGEMENT COMPANY ATTN: SHAREHOLDER ACCOUNT SERV1CES 9800 FREDERICKSBURG RD. SAN ANTONIO. TX 78288 ACCOUNT NR. USAA NR. 46900419687 800092 [ AMOIFNT OF CF{E('[<] ($50.00 minimum) If investing in a retirement accounL please indicate: 'Fax Year IRA Contribution SEP (Employer Contribution) Rollover Contribution , l'or Internal USe only 50°, [] 700~ [] 5009 [] 7009 [] 70°2 [] 7010 [] 4690041968 7 46 0 USAA INYEST,MENT MANA(;E.MENT ('OMI'ANY 98110 I"redcrick, dmr.~ Road San Antonio, 'l'X 732S8 006519 013037 GARY E FILER 402 W ELMWOOD AVE MECHANICSBURG PA 17055 PaRe I of 2 INVESTMENT ACCOUNT STATEMENT Statement Period: 01/01/2002 - 02/25/2002 Customer Sen'ice TouchLinc~ Website 1-800-531-8448 1-800-531-8777 www.usaa, com USAA NUMBER: 000800092 TOTAL ACCOUNT VALUE: $3 9,1 70. 5 7 Fund/Account Quarter to i Year to Date 1 Year ! Number Date I Fund USAA Money Market Fund 42-42900360252 0.27% 0.27% 3.22% ~ Total Return Information: This table details your personalized total return lbr each of your USAA mutual fund accounts. If.~our account was closed (zero balance) within the period, your account's total return will be calculated up to that closing date. If your account was closed within the period and then reopened, your account's total return v, ill be calculated based on the reopen date. Your account's total return is defined as the percentage change in the value of an investment over a given period of time. Your individual total retum will be attb, cted by }our individual holding period and transaction history, and therelbre ma.',' be ditt~rent l?om the total return lbr the underlying investment. Fund Year to 1 Year 5 Year 10 Year Since Date Inception USAA Money Market Fund 0.27% 3.23% 5.05% 4.72% 6.92% = Mutual Fund Perlbrmance Inlbrmation: The performance data quoted represents past perfbrmance: the investment return and principal value of an investment will fluctuate so that an investor's shares, when redeemed, mas' be xxorlh more or less than their original cost. This reflects the a~erage total return of L'S.KA Mutual Ftlnds and does not reflect the performance of your individual account. ISAM CCOUNT REGISTRATION kR\' E FILER ,2 \V ELMWOOD .-\VE I(CH:X-NICSBURG PA 17055 3765 !-0101 Fund Code 42 ACCOUNT NR. us~ NR. 42900360252 800092 To add to your account. make check payable to: USAA Money Market Fund Send this stub and ",'our check to: USAA INVESTMENT MANAGEMENT COMPANY ATTN: SHAREHOLDER ACCOUNT SERVICES 9800 FREDERICKSBURG RD. SAN ANTONIO. TX 78288 [ AMOUNT OF c cKI ($50.0{) minimum) If investing in a retirement account, please indicate: Tax Year IRA Contribution SEP (Employer Contribution) Rollover Contribution l'or internal use only 5001 [] 7001 [] 5009 [] 7009 [] 7002 [] 7010 [] 4290036025 2 42 0 USAA INVESTMENT MANAGEMENT COMPANY 003867 Page 1 of 2 DC INVESTMENT ACCOUNT CONFIRMATION FOR: 02/28/2002 Customer Service in San Antonio TouchLine® 1-800-531-8448 456-7202 1-800-531-8777 GARY E FILER 402 W ELM-WOOD AVE MECHANICSBURG, PA 9800 Fredericksburg Road 17055 USAA NUMBER: 800092 San Antonio, TX 78281 Account Number: 44900961883 Date , Transaction Description Quantity , Price Amount 01/01 . Beginning Value 4,506.272 $13.00 $58,581.54 01/31 Earnings Directed Dividend 238.72 Ending Value 4,506.272 $13.19 $59,437.73 Year-to-Date Dividends $481.58 m m m m m m m m m m m m m m ..mm m USAA INVESTMENT MANAGEMENT COMPANY ACCOUNT REGISTRATION: GARY E FILER 402 W ELMWOOD AVE MECHANIC$BURG, PA 17055 003867 ooo 3063 [FUND COD~ACCOUNT NR]USAANR. l 44 I44900961883[000800092] To add to your account, make check payable to: TAX EXEMPT INTERMEDIATE-TERM FUND Send this stub and your check to: USAA INVESTMENT MANAGEMENT COMPANY ATTN: SHAREHOLDER ACCOUNT SERVICES 9800 FREDERICKSBURG RD. SAN ANTONIO, TX 78288 i 000 000800092 9 AMOUNT OF CHECK S 50.00 minimum] If investing in a retirement account, please indicate: Tax Year IRA Contribution SEF (Employer) Contribution Rollover Contribution For Internal usc only 5oo [] Too,[] 7oo:[] :ooo F1 OlO 4490096188 3 0000044 USAA INVESTMENT MANAGEMENT COMPANY GARY E FILER 402 W ELMWOOD AVE MECHANICSBURG, PA 17055 Page 2 of 2 ac INVESTMENT ACCOUNT CONFIRMATION FOR: 02/28/2002 Customer Service in San Antonio TouchLine® 1-800-531-8448 456-7202 1-800-531-8777 9800 Fredericksburg Road San Antonio, TX 7828~ USAA NUMBER: 800092 Account Number: 45900686667 Date Transaction Description Quantity Price Am ount 01/01 Beginning Value 2,801.120 $10.69 01/31 Earnings Directed Dividend Ending Value $29,943.97 89.43 2,801.120 $10.77 $30,168.06 'Year-to-Date Dividends $178.96 USAA INVESTMENT MANAGEMENT U~,A~ ® COMPANY ~,CCOUNT REGISTRATION: 3ARY E FILER :02 W ELMWOOD AVE ~{ECHANICSBURG, PA 17055 003868 ooo 3064 f.FUND CODEIACCOLTNT NILIUSAA NR. I 45 [45900686667 1000800092 ] To add to your account, make check payable to: TAX EXEMPT SHORT-TERM FUND Send this stub and your check to: USAA INVESTMENT MANAGEMENT COMPAN' ATTN: SHAREHOLDER ACCOUNT SERVICES 9800 FREDERICKSBURG RD. SAN ANTONIO, TX 78288 I goo 000800092 9 AMOUNT OF CHECK If investing in a retirement account, please indicate: Tax Year IRA Contribution SEP (Employer) Contribution Rollover Contribution For Internal use only 4590068666 7 0000045 REGISTER OF WILLS NO.: 2002-00351 PENNSYLVANIA FILE NO.: 21-02-0351 INVENTORY Of all real and personal estate of Gary E. Filer Late of 402 West Elmwood Avenue, Cumberland County, Mechanicsburg, Pennsylvania 17055 NO. 1. 9. 10. 11. 12. 13. 14. ITEMS House and Lot known as 402 West Elmwood Avenue Cumberland County, Mechanicsburg, Pennsylvania; Sold for: Eleven (11) Series E $25.00 US Savings Bonds Two (2) Series I $10,000.00 US Savings Bonds 136 Shares of Lucent Technologies stock at $5.53 per share 99 Shares of Dominion Resources stock at $20.10 per share 50 Shares of AT&T Wireless stock at $10.22 per share 105 Shares of AT&T Corporation (formerly American Telephone and Telegraph) stock at $15.61 per share 36 share of Agere stock at $4.00 per share PA Department of Revenue - Final Employers Paycheck PA Department of Revenue - Final Employers payment for remaining sick time Borough ofMechanicsburg - Account refund Travel Expenses from the Estate of Floyd Filer Consumer Report - Magazine refund Parking Authority - Account refund ESTIMATED VALUE $111,000.00 1,250.81 20,000.00 752.08 1,989.90 511.00 1,639.05 144.00 4,411.85 2,025.91 87.00 1,783.65 29.72 105.00 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. Waypoint Bank - Payoff Refund USAA - Homeowners premium refund Westshore Tax Bureau - refund United State Treasury - 2001 IRS refund State of Pennsylvania - 2001 State Income Tax refund Discover Bank - Money Market Account//3000011546557 Waypoint Bank - Checking Account//90470170 Waypoint Bank - Savings Account//109011282 Waypoint Bank - Certificate of Deposit #7100011308 Waypoint Bank - Certificate of Deposit #8000053235 Waypoint Bank - Certificate of Deposit #8000053918 Waypoint Bank - Certificate of Deposit//8000057023 PSECU - Savings Account/tS t PSECU - Checking Account PSECU - Certificate of Deposit//S50 PSECU - Certificate of Deposit//S52 PSECU- Certificate of Deposit//S53 Floyd Filer Estate Proceeds Reimbursement of County Taxes at closing on real estate (HUD Line 407) Reimbursement of School Taxes at closing on real estate (HUD Line 409) Reimbursement of Sewer charges at closing on real estate (HUD Line 410) Used 1995 Pontiac Bonneville SE Sedan 4.00 52.93 7.08 1,086.00 271.00 13,537.85 102.33 6,921.15 9,506.65 27,272.09 22,804.37 22,220.15 43,604.51 9,306.28 20,090.46 20,054.56 20,352.07 150,000.00 253.03 23.98 5.13 2,450.00 Total estimated value of personal estate ...................... $ Total estimated of real estate (within Commonwealth) .......... $ 404,655.59 111,000.00 MEMORANDUM OF Real estate outside of Commonwealth of Pennsylvania (SEE ATTACHED FOR DESCRIPTION) I, Margaret G. Hartley, verify that the statements made in this Inventory are true and correct. I understand that false statement herein made are subject to the penalties of 18 Pa. C.S.A. 4904, relating to unsworn falsification to authority. Sign-atu~e Of Fiduciary Date BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT, 280601 HARRISBURG, PA 17128-0601 COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX M L MCBRIDE JR MCBRIDE & MCBRIDE 211S CENTER ST GROVE CITY PA 16127-1410 DATE 01-06-2005 ESTATE OF FILER DATE OF DEATH 02-27-2002 FILE NUMBER 21 02-0551 COUNTY CUMBERLAND ACH 101 Amount Remitted GARY E MAKE CHECK PAYABLE AND REMIT PAYMENT TOt REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~'- RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FILER GARY E FILE NO. 21 02-0551 ACN 101 DATE 01-06-2005 TAX RETURN NAS: C X> ACCEPTED AS FILED C } CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN l. Real Estate CSchedule A> 2. Stocks and Bonds (Schedule B} (2} $. Closely Held Stock/Partnership Interest CSchedule 4. Hortgages/Notes Receivable CSchedule D} 5. Cash/Bank Deposits/Misc. Personal Property CSchedule E) &. Jointly Owned Property CSchedule F} C6) 7. Transfers CSchedule G} C7} 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/M/sc. Expenses (Schedule H} (9} 10. Debts/Mortgage Liabilities/Liens (Schedule I} ClO} 11. Total Deductions 12. Net Value of Tax Return llltO00.O0 26r286.84 .00 .00 578r568.75 .00 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 175r785.20 CB> 689,440.79 42,682.65 28,555.51 ell} c12) 618,402.65 TAX CREDITS: PAYMENT I DATE 05-22-2002 11-12-2002 13. 14. NOTE: ASSESSMENT OF TAX: 15. Amount of Line lq at Spousal rate 16. Amount of Line lq taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line lq taxable at Collateral/Class B rate 19. Principal Tax Due RECEIPT DISCOUNT C+} NUMBER INTEREST/PEN PAID CD001217 5,000.00 CD001842 .00 Char/table/Governmental Bequests; Non-elected 9115 Trusts CSchedule J} C15} .00 Net Value of Estate Subject to Tax Clq> 618,402.&5 If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. C15} .00 X O0 = .DO (16) .00 X 045 = .00 (17} &18,402.&5 X 12 = 74,208.52 cia) .00 x 15 = .00 (~9}= 74,208.52 AMOUNT PAID 57,000.00 14,208.52 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 74,208.52.00.00.00 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN 41, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR}, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.} REV'-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECE- DENT CHECK APPRO- PRIATE BLOCKS CDR- RE- SPON DENT RECA- PITULA- T ION TAX COMPU- TATION REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) FILER, GARY E DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DO-YEAR) 01/23/1944 02//27/2002 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AN0 MIDDLE INITIAL) OFFICIAL USE ONLY FILE NUMBER 21 2002 0351 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 190-32-2140 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 1. Odginal Return 4. Limited Estate 6, Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received 2. Supplemental Return 4a. Future Interest Compromise [date of death after 12-12-82) 7. Decedent Maintained a Living Trust (_Attach a copy of Trust) 10. Spousal Poverty Credit(date of death between 12-31-91 and 1-1-95) 3. Remainder Return ~-] (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes -~ 11. Election to tax under Sec. 9113(A) (Attach ach O) NAME M.L. MCBRIDE, JR. FIRM NAME (If Applicable) MCBRIDE ~ MC]~,IDE f P.C. TELEPHONE NUMBER 724-458-6640 COMPLETE MAILING ADDRESS 211 SOUTH CENTER STREET GROVE CITY, PA 16127 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) Separate Billing Requested (6) 0.00 811.72 0.00 0.00 0.00 0.00 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (7) 8. Total Groaa Aaeata (total Lines 1-7) (8) 9. Funeral Expenses & Administrative Costs (Schedule H)(9) 124, 00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 0. 00 11. Total Dedueflona (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax (13) has not been made (Schedule J) 14. Nat Value Subject to Tax (Line 12 minus Line 13) (14) OFFICIAL USE ONLY 811.72 124.00 687.72 0.00 687.72 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 1 5. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (aX 1.2) 0 · 0 0 1 (~. Amount of Line 14 taxable at lineal rate 0. 0 0 17. Amount of Line 14 taxable a~ si bling rate 68 7. 72 18. Amount of Line 14 taxable at collateral rate 0 . 0 0 x .00 (15) 0.00 x .045 (18) 0o O0 x .12 (17) 82.53 x .15 (18) 0,00 82.53 19. Tax Due (19) 0 PA15001 NTF 29755 Copyright 2000 Graatland/Nelco LP- Forms Software Only PA ~EV-1500 EX (8-00) Decedent's Complete Address: ISTR~-~- [ ADDRESS 402 WEST ELMWOOD AVENUE ~HANI CSBURG Page 2 Tax Payme~ and Credits: STATE I ZIP PA 17055 Tax Due (Page 1 Line 19) Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 0.00 0.00 0.00 (t) 82.53 Total Credits (A + B + C) (2) 0.00 Total Interest/Penalty (D + E) (3) 0.00 4.If Line 2 is greater than'Line I + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (4) 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 8 2.5 3 A. Enter the interest on the tax due. (SA) 0.0 0 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 82.53 Make Check Payable to: REGISTER OF WILLS, AGENT ....................... i5i~§~'~':~'§~:~:'~:'~'~6'~6~I~:¥~'~'I~0~¥~:~i:~:~ ~'~:~:i~:~:~:~:~:~~ ~ 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................................... ~ ~ b. retain the right to designate who shall use the property transferred or its income; ................. c. retain a reversionary interest; or ........................................................ d. receive the promise for life of either payments, benefits or care? .............................. 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'~ U ~ ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................ 0 ~ 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 exam ned this return including accompanying schedules and statements, and to the best of my knowledge and belief, t s true, correct and complete. Dec arat on of preparer other than the personal representative is based on information (~f which preparer has any knowledge. SIGNATURE OF PERSON RE~P. ONSlBLE FOR FILING ADDhESS 2~/1 SOUT~ C~'.~'iu~, S'Z'~u~.~'..'.~/~ GROV~ CT'i'~'~ PA 16127 RETURN DATgz SIGNATURE OF PREPARER OTHER TH~N REPRESENTATIVE ADDRESS 211 SOl, TH C'~-~'J.'.'..~ STREET GROVE CITY, PA 16127 [72 P.S. ! 9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, th · tax rate is imposed on th · n et value of transfers to o r for the use of th e su rviving spouse is 0% [72 P.S. § 9116 (a) (1.1) (ii)]. The statute does nat 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 if the surviving spouse is the an ly 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 th e use of a natural parent, an adoptive parent, ora stepparent of the child is 0% [72 P.S. §9116(aX1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4,5%, except as noted in 72,P.S. § 9116(1.2) [72 P.S. § 9116(aX1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. § 9116(a){1.3)]. A sibling is defined, under Section 9102, as an individual who h&s at least one parent in common with the decedent, whether by blood or adoption. 0 PA15002 NTF 29756 Copyright 2000 Greatland/Nelco LP- Forms Software Only REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER FILER, GARY E 21-2002-0351 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NO. DESCRIPTION OF DEATH 1. 811.72 52 SHARES OF AT&T CORP. (FORMERLY AMERICAN TELEPHONE AND TELEgrAPH) STOCK AT $15.61 PER SHARE TOTAL (Also enter on line 2, Recapitulation) $ 811.72 (If more apace is needed, insert additional sheets of the same size) 0 PA15031 NTF 33300 Copyright 2000 Greatland/Nelco LP- Forms Software Only REV-'1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER FILER, GARY E 21-2002-0351 Debts of decedent must be reported on Schedule I. ITEM NO. DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) SociaJ Security Number(s)/EIN No. of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees 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 Probate Fees Accountant's Fees Tax Return Preparer's Fees ~EGISTER OF WILLS - ADDITIONAL PROBATE FEES REGISTER OF WILLS - INVENTORY FILING REGISTER OF WILLS - SHORT CERTIFICATE 0.00 0.00 0.00 0.00 0.00 0.00 105.00 16.00 3.00 TOTAL (Also enter on line 9, Recapitulation) $ 124.00 (If more space is needed, insert additional sheets of the same size) 0 PA15111 NTF 33308 Copyright 2000 Greatland/Nelca LP- Forms Software Only FI, EV~-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER FI~R, G~Y E 21-2002-0351 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY De Not Est Trustee(s) OF ESTATE II TAXABLE DISTRIBUTIONS [include outdght spousal distributions, and transfers under Sec. 9116 (a) (1.2)] HARTLEY, MARGARET G 7578 OXBOW ROAD CANASTOTA, NY 13032 SISTER ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBS. ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) 0 PA15131 NTF 33293 Copyright 2000 Greatland/Nelco LP- Forms Software Only MILFORD L. McBRiDE. ~iR. BRENDA I~. M~CBRIDE MILFORD L. McBRIDE. TFf MCBRIDE AND MCBRIDE, R C. ATTORNEYS AT LAW ~:11 SOUTH CENTER STREET GROVE CITY, PA. I61:=~7 TELEPHONE {7;~4) 458-6640 MILFORD L. M~CBRIDE 1889-1~62~ FA X (724) 458-5401 February 20, 2003 Cumberland County Courthouse Clerk of Courts - Register of Wills One Courthouse Square Carlisle, PA 17013 Re: Supplemental Inheritance Tax Return Estate of Gary E. Filer 21-2002-0351 To Whom It May Concern: Enclosed herein, please find two (2) copies of the Supplemental Inheritance Tax Return for the Estate of Gary E. Filer, along with a check in the amount of $82.53 payable to the Register of Wills, Agent to complete the Inheritance Tax payment. Please file this return at your earliest convenience and send a receipt to our office. If you have any questions, please feel free to contact our office. Thanking you, I am, Very truly yours, McBRIDE and McBRIDE, P.C. M. L. McBride, Jr. MLM,JR./pas Cc enclosures McBRIDE AND McBRIDE, P.C. ATTORNEYS AT LAW 211 SOUTH CENTER STREET GROVE CITY, PENNSYLVANIA 16127 To Cumberland County Courthouse Clerk of Courts - Regis%er of W~lls One Courthouse Square C~rlisle, PA 17013 MILFORD L. McBRIDE~ ~IR. BRENDA I~. McBRIDE MILFORD L. McBRIDEI Tr[ MC--BRIDE AND MC--BRIDE, R C. ATTORNEYS AT LAW 2ii SOUTH CENTER STREET GROVE CITY, Pa. 16127 TELEPHONE (7:='4) 458-6640 MILFORD L. McBRIDE FA X February 26, 2003 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 Attention: Cheryl Re: Gary E. Filer Estate 21-02-0351 Dear Cheryl: Enclosed herein, please find check number 6752 in the amount of $15.00. Said check represents the filing fee for the Estate of Gary E. Filer. Please send a receipt to our office. We have enclosed a stamped, self-addressed envelope for your convenience. If you have any questions regarding the enclosed, please feel free to contact our office. Thanking you, I remain, Very truly yours, Cc enclosures McBRIDE and McBRIDE, P.C. Pame 1 a San ~,o~a \. MCBRIDE AND MCBRIDE, R C. ATTORNEYS AT LAW ::~11 SOUTH CENTER STREET GROVE CITY, PA. 1~1~:7 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128 060'i RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 002205 MCBRIDE M L JR ESQ 211 SOUTH CENTER STREET GROVE CITY, PA 16127 fold ESTATE INFORMATION: SSN: 190-32-2140 FILE NUMBER: 2102-0351 DECEDENT NAME: FILER GARY E DATE OF PAYMENT: 02/24/2003 POSTMARK DATE: 02/20/2003 COUNTY: CUMBERLAND DATE OF DEATH: 02/27/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $82.53 TOTAL AMOUNT PAID: $82.53 REMARKS: MARGARETG HARTLEY C/O M L MCBRIDE JR ESQUIRE SEAL CHECK//117 INITIALS: CW RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280&01 HARRISBURG, PA 17128-0&01 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX M L MCBRIDE JR MCBRIDE & MCBRIDE 211S CENTER ST GROVE CITY PA 16127 DATE 05-24-2005 ESTATE OF FILER DATE OF DEATH 02-27-2002 FILE NUMBER 21 02-0551 COUNTY CUMBERLAND ACN 101 I Amount Remitted GARY MAKE CHECK PAYABLE AND REMIT PAYMENT TO= REGISTER OF NILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS -~ REV-1547 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FILER GARY E FILE NO. 21 02-0551 ACN 101 DATE 05-24-2005 TAX RETURN NAS: C X) ACCEPTED AS FILED ( } CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON= SUPPLEMENTAL RETURN 1. Real Estate (Schedule A} 2. Stocks and Bonds (Schedule B} $. Closely Held Stock/Partnership Interest (Schedule C) ~. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Persona[ Property (Schedule 6. Jointiy Owned Property (Schedule F) 7. Transfers (Schedule G) C7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS= 9. Funeral Expenses/Adm. Costs/M/sc. Expenses (Schedule 10. Debts/Mortgage Liabilities/Liens (Schedule I} C10) 11. Total Deductions 12. Net Value of Tax Return NO. 01 O0 811 72 O0 O0 O0 O0 O0 124.00 .O0 NOTE: To insure proper credit to your account, submit the upper portion of this form w/th your tax payment. 811.72 Cll) 124. fin (12) 687.72 15. 1~. NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and reflect figures that include the total of ALL returns assessed to date. Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J} Net Value of Estate Subject to Tax ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate C16) 17. Amount of Line 14 at Sibling rate C17} 18. Amount of Line 14 taxable at Collateral/Class B rate (18} 19. Principal Tax Due TAX CREDITS: PAYMENT J RECEIPT DATE NUMBER 05-22-2002 CD001217 5,000. O0 11- 12-2002 CD001842 . O0 02-20-2005 CD002205 . O0 DISCOUNT INTEREST/PEN PAID C-) BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-21-2005 .00 619,090.57 19 will · O0 x O0 = . O0 · 00 x 045 = .00 619,090.57 x 12 = 74,290.85 · O0 x 15 = . O0 AMOUNT PAID 57,000.00 14,208.52 82.55 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 74,290.85 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 74,290.85 .00 1.04 1.04 C IF TOTAL DUE IS LESS THAN gl, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR}, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.} BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0~01 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX M L MCBRIDE JR MCBRIDE & MCBRIDE 211 S CENTER ST GROVE CITY PA 16127 DATE 05-24-2005 ESTATE OF FILER GARY DATE OF DEATH 02-27-2002 FILE NUMBER 21 02-0551 COUNTY CUMBERLAND ACN iO1 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -~ REV-1547 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FILER GARY E FILE NO. 2I 02-055i ACN igl DATE 05-24-20015 TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: Real Estate CSchedule A) 2 Stocks and Bonds CSchedule B) $ Closely Held Stock/Partnership Interest (Schedule C) Mortgages/Notes Receivable CSchedule D) Cash/Bank Deposits/Misc. Personal Property CSchedule E) Jointly Owned Property CSchedule F) 7 Transfers CSchedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/Adm. Costs/Misc. Expenses (Schedule H) lO. Debts/Mortgage Liabilities/Liens (Schedule I) Total Deductions 12. Net Value of Tax Return SUPPLEMENTAL RETURN NO. O1 el) .00 (2) 8II .72 c$) .00 (4~ . O0 cs) .go (4) .00 (7) .00 124.00 (9) (lo) .00 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 15. 14. NOTE: ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate l&. Amount of Line lq taxable at Lineal/Class A rate C16) 17. Amount of Line 14 at Sibling rate C17) 18. Amount of Line lq taxable at Collateral/Class B rate C18) 05-22-2002 11-12-2002 02-20-2005 811.72 DISCOUNT C+) INTEREST/PEN PAID C-) 5,000.00 .00 .00 BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-21-2005 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 19. Pr/nc/pal Tax Due TAX CREDITS PAYMENT RECEIPT DATE NUMBER CD001217 CD001842 CD002205 .00 x OO = .00 · 00 x 045 = .00 619,090.57 x 12 = 74,290.85 · O0 x 15 _- . O0 cig)= 74,290.85 AMOUNT PAID 57,000.00 14,208.52 82.53 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE reflect figures that include the total of ALL returns assessed to date. 74,290.851.041.04'00 C IF TOTAL DUE IS LESS THAN ~1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CA), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Charitable/Governmental Bequests; Non-elected 9115 Trusts CSchedule J) ClX) .00 Net Value of Estate Subject to Tax C14) If an assessment was issued previously, lines I4, I~ and/or I~, 17, I8 and lg wiII (11) 12~. O0 cz2) 687.72 MCBRIDE AND MCBRIDE, P. C. ATTORNEYS AT LAW ~:11 SOUTH CENTER STREET GROVE CITY, PA. 161;~7 REGISTER OF WILLS CUMBERLAND COUNTY COURT HOUSE CARLISLE, PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) OO2373 MCBRIDE M L JR ESQ 211 SOUTH CENTER STREET GROVE CITY, PA 16127 ........ fold ESTATE INFORMATION: SSN: 190-32-2140 FILE NUMBER: 2102-0351 DECEDENT NAME: FILER GARY E DATE OF PAYMENT: 04/02/2003 POSTMARK DATE: 03/31/2003 COUNTY: CUMBERLAND DATE OF DEATH: 02/27/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1.04 REMARKS: TOTAL AMOUNT PAID: M L MCBRIDE JR ESQUIRE $1.04 SEAL CHECK//122 INITIALS: AC RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF ZNDTVZDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG,, PA 171Z8-0601 COMHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE ZNHERZ'I'ANCE TAX STATEMENT OF ACCOUNT RE¥-1607 EX AFP (01-D5) H L MCBRIDE JR MCBRIDE & MCBRIDE 211S CENTER ST GROVE CITY Rec.,~u,¢~, .. :~,,~-~ of DATE :.:4 ¥'~:/il!s ESTATE OF DATE OF DEATH FILE NUHBER '0.3 /I. PR28 P3:0~uNTY ACN PA 1612~t~beriarid iL~;o., PA I 04-14-Z005 FILER 02-27-2002 21 02-0551 CUMBERLAND 101 GARY E Amoun'l: Remi~ed HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credit: ~:o your e¢¢oun~, submit: ~he upper portion of ~his fora wi~h your ~:ax payment:. CUT ALONG TH'rS L*rNE ~ RETA'rN LOWER PORT'rON FOR YOUR RECORDS ~ ESTATE OF FILER GARY E FILE NO. 21 02-0551 ACN 101 DATE 04-14-2005 TH/S STATEMENT TS PROV'rDED TO ADV/SE OF THE CURRENT STATUS OF THE STATED ACM TN THE NAMED ESTATE. SHO#N BELO# TS A SUMMARY OF THE PR[NCTPAL TAX DUE, APPLTCAT/ON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, TF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 05-24-2005 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... 74,290.85 PAYMENTS (TAX CREDITS): PAYMENT DATE 05-2Z-ZOOZ 11-12-2002 OZ-ZO-ZO05 03-31-2005 RECEIPT NUMBER CD001217 CD001842 CD002205 CDOOZ575 ZF PAID AFTER TH~S DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE 1S LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE ZS REFLECTED AS A 'CRED/T- {CR}, DISCOUNT (+) INTEREST/PEN PAID (-) 5,000.00 .00 .00 1.04- AMOUNT PAID 57,000.00 lq,208.5Z 82.55 1.04 YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR TNSTRUCTTONS. ) TOTAL TAX CREDIT 74,290.85 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 MILFORD L. MCBRIDE. JR. BRENDA K. MCBRIDE MILFORD L. McBRIDE. ~IT MCBRIDE AND MCBRIDE, P. C. ATTORNEYS AT LAW ;:~11 SOUTH CENTER STREET GROVE CITY, PA. 161~:7 TELEPHONE (724) 458-6640 MILFORD L. MCBRIDE 1889-1962 FA X (7;~4) 458-540i June 19, 2003 Cumberland County Courthouse Clerk of Courts - Register of Wills One Courthouse Square Carlisle, PA 17013 Re: Supplemental Inheritance Tax Return Gary E. Filer Estate 21-2002-0351 dear Jackie: Enclosed herein, please find our check in the amount of $15.00 for the filing of the Supplemental Inheritance Tax Return for the Estate of Gary E. Filer. Please file this return at your earliest convenience and send a receipt to our office. If you have any questions, please feel free to contact our office. Thanking you, I am, MLM,JR./pas cc enclosures Very truly yours, McBRIDE and McBRIDE, P.C. M. L. McBride, Jr. MILFORD L. M~BRIDE, UR. BRENDA K. M~BRiDE MILFORD l. M~BRIDE, TT~ MCBRIDE AND MCBRIDE, P. C. ATTORNEYS AT LAW :~11 SOUTH CENTER STREET GROVE CITY, PA. 161:~7 TELEPHONE (724} 458-6640 FA X June 16, 2003 Cumberland County Courthouse Clerk of Courts - Register of Wills One Courthouse Square Carlisle, PA 17013 Re: Supplemental Inheritance Tax Return Gary E. Filer Estate 21-2002-0351 To Whom It May Concern: Enclosed herein, please find two (2) copies of the Supplemental Inheritance Tax Return for the Estate of Gary E. Filer, along with a check in the amount of $10,764.26 payable to the Register of Wills, Agent to complete the Inheritance Tax payment. Please file this return at your earliest convenience and send a receipt to our office. If you have any questions, please feel free to contact our office. Thanking you, I am, MLM,JR./pas cc enclosures Very truly yours, McBRIDE and McBRIDE, P.C. M. L. McBride, Jr. REV-1500 EX + (6-o0) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 2806O1 HARRISBURG, PA 17128-0601 \'~'REV-1500 l OFF.C,ALUSEO.LY INHERITANCE TAX RETURN F,LENUMBER RESIDENT DECEDENT 21 2002 0351 COUNTY CODE YEAR NUMBER DECE- DENT CHECK APPRO- PRIATE BLOCKS COR- RE- SPON DENT RECA- PITULA- T ION TAX COMPU- TAT ION DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) FILER, GARY E DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 02/27/2002 I 01/23/1944 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 190-32-2140 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 1. Original Return 4. Limited Estate 6. Decedent Died Testate (At~ach copy of Will) 9. Litigation Proceeds Received 2. Supplemental Return 4a. Future interest Compromise ~date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach a copy of Trust) 10. Spousal Poverty Credit(date of death between 12-31-91 and 1-1-95) 3. Remainder Return E] (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes [] 11. Election totaxunder Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS NAME M. L. MCBRIDE, JR. FIRM NAME (If Applicable) MCBRIDE AND MCBRIDE ~ P.C. TELEPHONE NUMBER 724-458-6640 211 SOUTH CENTER STREET GROVE CITY, PA 16127 OFF C AL;~SE ONLY 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. CJosely Held Corporation, Partnership or Sols-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested (6) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (7) 0 .!~0 65,147 .~3 0 .'ro0 0 ."0o 1,558 ;'63 9,502.50 0,00 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H)(9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deducflene (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11 ) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (8) 76,208.86 18.00 0.00 (11) 18.00 (12) 76,190.86 (13) 0.00 (14) 76,190.86 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sac. g116 (aX1.2) 0 . 00 X .00 (15) 0 . 00 16. Amount of Line 14taxable at lineal rate 0 · 00 X .045 (16) 0 · 00 17. Amount of Line 14taxable at sibling rate 76, 190. 86 X .12 (17) 9 ? 142.90 18. Amount of Line 14taxable at collateral rate 0 · 00 X .15 (18) 0 · 00 19. Tax Due (19) 9,142.90 0 PA15001 NTF 29755 Copyright 2000 Greatland/Ne~co LP- Forms Software Only PA REV-1500 EX (6-00) Page 2 Decedent's Complete Address: STREET ADDRESS 402 WEST ELMWOOD AVENUE I St^T I z,P MECHANI CSBURG PA 17055 Tax Payments and Credits: 1. Tax Due (Page I Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit 0.00 B. PdorPeyments 0.00 C. Discount 0.00 9,142.90 Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 0.00 217.33 1,404.03 Total Interest/Penalty (D + E) (3) 1,621.36 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I 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) 10,7 6 4.2 6 A. Enter the interest on the tax due. (SA) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 10,7 6 4.2 6 Make Check Payable 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 or income of the properb/transferred; ....................................... I ~ b. retain the dght to designate who shaJl 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 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. Under penalties of perjury, I declare that I have examined this return including accompanying schedu es and statements and to the best of my knowledge and belief, it is true, correct and complete. Declaration o} preparer other than the personal representative s based on information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS 21~-SbUTH CENTER STREEt' ' GROVE CITY, PA 16127 SIGNATURE OF PREPARER OTHER ~PRESENTATIVE ADDRESS 211 SOUTH CENTER STREET GROVE CITY, PA 16127 [72 P.S. ~ 9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, th e tax rate is imposed on the net value of transfers to or for the use of t h e surviving spouse is 0% [72 P.S. § 9116 (a) (1.1) (ii)]. T h · statute does not exemot a transfer to a surviving spouse fro m tax, and the statutory req uirements for disclosure of assets an d 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, ora stepparent of the child is 0% [72 P.S. §9116(a){1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72.P.S. § 9116(1.2) [72 P.S. § 9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P,S. § 9116(a)(1.3)]. A si bling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 0 PAIBO02 NTF 29756 Copyright 2000 Greatland/Nelco LP- Forms Software Only REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER FIL~.,~, ~Y E 21-2002-0351 All property Jointly-owned with right of survivorship must be dleoloeed on Schedule F. n'EM NO. VALUE AT DATE DESCRIPTION 1371. 8199 SHARES OF V~IZON COI~/ON STOCK AT $47.49 PER SHARE OF DEATH 65,147.73 TOTAL (Also enter on line 2, Recapitulation~, $ 65,147.73 (If more space is needed, insert additional sheets of the same size) 0 PA15031 NTF 33300 Copyright 2000 Greatland/Nelco LP- Forms Software Only REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER FILER~ GARY E -- Include proceeds of litigation & date proceeds were received by the estate. All prep. Jointly-owned with right ef aurvivorehi 3 must be disclosed on Seh. F. ITEM VALUE AT NO. DESCRIPTION DATE OF DEATH 1. 2002 IRS TAX REFUND 1,558.63 TOTAL (Also enter on line 5, Recapitulation) $ 1,558.63 0 PALS081 NTF 33305 (If more space is needed, insert additional sheets of the same size) Copyright 2000 Greatland/Nelco LP- Forms Software Only REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER FIT.mR, GARY E -- If an asset was made joint within one year of the deoedent'a date of death, it must be reported on S~hedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. HARTLEY, MARGARET G SISTER 7578 OXBOW ROAD CANASTOTA, NY 13032 JOINTLY-OWNED PROPERTY: DESCRIPTION OF PROPERTY LETTER DATE Include name of financial institution and bank % OF DATE OF DEATH ITEM FOR MADE DATE OF DEATH DECD'S VALUE OF JOINT account number or similar identilying number. NO. TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES' 1. A 11/19/1981 HOUSE AND LOT LOCATED AT 638 19,005.00 50.00 9,502.50 ~ORTH BROAD STREET EXT., PINE TOWNSHIP, MERCER ~OUNTY, GROVE CITY, PENNSYLVANIA PROPERTY IS ASSESSED AT $5,250 MULTIPLIED BY THE CURRENT COMMON RATIO 3.62 FOR MERCER COUNTY EQUALS FAIR MARKET VALUE OF: TOTAL (Also enter on line §, Recapitulation) $ 9,502.50 0 PA15091 NTF 33306 (If more space is needed, insert additional sheets of the same size) Copyright 2000 Greatland/Nelco LP- Forms Software Only REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER FILER, GARY E 21-2002-0351 Debts of decedent must be reported on Schedule I. REM NO. DESCRIPTION AMOUNT FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Secudty Number(s)/EIN No. of Personal Representative(e) Street Address City State Zip Year(s) Commission Paid: Attorney Fees 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 Probate Fees Accountant's Fees Tax Return Preparer's Fees REGISTER OF WILLS - REGISTER OF WILLS - SHORT CERTIFICATE ADDITIONAL PROBATE FEES 0.00 0.00 0.00 0.00 0.00 0.00 3.00 15.00 TOTAL (PJso enter on line 9, Recapitulation) $ 18.00 (If more space is needed, insert additional sheets of the same size) 0 PALS111 NTF 33308 Copyright 2000 Greatland/Nelco LP- Forms Software Only REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER FILER, GARY E 21-2002-0351 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Bat Truatee(a) OF ESTATE II TAXABLE DISTRIBUTIONS [include outright spousal distributions, and a'ansfem under Sec. 9116 (a) (1.2)] HARTLEY, MARGARET G 7578 OXBOW ROAD CANASTOTA, NY 13032 SISTER entire residue ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE~ ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBS. ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) 0 PA15131 NTF 33293 Col3yright2000 Greatlancl/Nelco LP- Forms Software Only COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 002693 MCBRIDE M L JR ESQ 211 SOUTH CENTER STREET GROVE CITY, PA 16127 fold ESTATE INFORMATION: SSN: 190-32-2140 FILE NUMBER: 2102-0351 DECEDENT NAME: FILER GARY E DATE OF PAYMENT: 06/18/2003 POSTMARK DATE: 06/1 6/2003 COUNTY: CUMBERLAND DATE OF DEATH: 02/27/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $10,764.26 TOTAL AMOUNT PAID: $10,764.26 REMARKS: MARGARETF HARTLEY M L MCBRIDE JR ESQUIRE CHECK# 105 INITIALS: JA SEAL RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTVTSTON DEPT. 280601 HARR/SBURG, PA 17128-060! COMMONWEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUHT REV-lgO? EX AFP (01-OS) '03 JUL 11 M k MCBRIDE JR MCBRIDE 8 MCBRIDE 211S CENTER ST CJ~,, GROVE CITY PA OrBit:7 ........ ; ~i DATE 06-$0-Z005 '} ESTATE OF FILER DATE OF DEATH 0Z-Z7-Z00Z F]:LE NUM~tER 21 02-0551 All :29 COUNTY CUMBERLAND ACN 101 I Amour'l: Remi'l:'~ed GARY E HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o your eccoun';, submi~ ~he upper portion of ~his for;. wit:h your ~:ex payment:. CUT ALONG THTS LINE ~* RETAIN LOWER PORTION FOR YOUR RECORDS -.~ ESTATE OF FILER GARY E FTLE NO. 21 02-0351 ACN 101 DATE 06-30-2003 THTS STATEMENT TS PROVTDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAMED ESTATE. SHONN BELO# TS A SUMMARY OF THE PRTNCTpAL TAX DUE, APPLTCATTON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, TF APPLICABLE, A PROJECTED TNTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-2q-2005 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 7q,290.85 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID ~ SUMMARY OF 06-16-2005 06-16-2005 ZF PAID AFTER TH/S DATE, SEE REVERSE SXDE FOR CALCULATXON OF ADD[TIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT IS REQUXRED. XF TOTAL DUE 1S REFLECTED AS A "CREDIT' (CR), ALL 005 PAYMENTS $,000.00 1.Oq- .00 82,056.15 TOTAL TAX CREDIT 85,055.11 BALANCE OF TAX DUE lO,76q.ZGCR INTEREST AND PEN. .00 TOTAL DUE lO,76q.Z6CR YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR TNSTRUCTTONS. BUREAU OF TNDIVIDUAL TAXES TNHERZTANCE TAX DZVTSTON DEPT. 180601 HARRISBURG, PA 17118-0601 M L MCBRIDE JR MCBRIDE & MCBRIDE 211S CENTER ST GROVE CITY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCT/OHS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUI~ER COUNTY ACN 07-28-2003 FILER 02-27-2002 21 02-0351 CUHBERLAND 101 Amount Reei~ed RE¥-1647 El( RFP (Ol-nS) GARY E HAKE CHECK PAYABLE AND REHTT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LZNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03} NOTZCE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FILER GARY E FILE NO. 21 01-0551 ACN 101 DATE 07-18-2005 TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Reel Estate (Schedule A) 2. Stocks and Bonds (Schedule B) $. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (S) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTXONS: 9. Funeral Expanses/Ada. Costs/Misc. Expenses (ScheduZa H) (9). 10. Dabts/Hortgege Liabilities/Liens (Schedule Z) (10) 11. Total Deductions 12. Nat Value of Tax Return NO. 02 .00 65~ lq7.75 .00 .00 1;558.65 9z501.50 .00 (8) NOTE: To insure proper credit to your account, submit the upper portion of this fora with your tax payment. 76,208.86 18.00 .00 (11) (12) ]8.00 76,190.86 Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Net Value of Estate Subject to Tax (14) Zf an assess, ent Has issued prev/ously, lines 14, 15 and/or 16, 17, 15. 14. NOTE: reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amount of Line lfi mt Spousal rata (16) .00 X O0 : 16. Amount of Line 14 taxable at LinmaX/CXmss A rata (16) .00 X 045 = 17. Amount of Line 14 at Sibl/ng rata (17) 695,281.23 X 12 = 18. Amount of Line 14 taxable at Collatara1/CXmss B rata (18) .00 X 15 = .00 695,281.23 18 and 19 Nill .00 .00 83,433.75 .00 19. Principal Tax Due TAX CREDITS: PAYNEN] RECEXPT DATE NUMBER ~ SUHHARY 0 06-16-2005 DX$COUNT I+) INTEREST/PEN PAXD (-) ALL 05 PAYHENTS ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (19)= 83,433.75 3,000.00 261.19- AHOUNT PAXD .00 82,056.15 TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE 84,794.96 1,361.21CR .00 1,361.21CR TF TOTAL DUE IS LESS THAN $1, NO PAYMENT 'rS REnU'fRED. 'rF TOTAL DUE 'rS REFLECTED AS A 'CRED'rT" (CR}, YOU HAY BE DUE REFUND. SEE REVERSE S'rDE OF TN'rS FORM FOR TNSTRUCT'rONS. } UREAU OF ZNDTVTDUAL TAXES TNHERZTANCE TAX DIVISION DEPT. 280601 HARRTSBURG, PA 17128-060! CONHONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT REV-1;Q7 EX AFP (01-OS) M L MCBRIDE JR MCBRIDE & MCBRIDE 211 S CENTER ST ~. GROVE CITY PA 161!~7 DATE 08-25-2005 ESTATE OF FILER DATE OF DEATH 02-27-2002 FILE NUMBER 21 02-0551 ~!i;';i~[COUNTY CUHBERLAND ACN 101 Amount Remitted d GARY MAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS REV-1607 EX AFP (01-03) INHERITANCE TAX STATEMENT OF ACCOUNT ESTATE OF FILER GARY E FILE NO. Z1 02-0551 ACN 101 DATE 08-25-2005 THIS STATEMENT TS PROV'rDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAHED ESTATE. SHONN BELON TS A SUHNARY OF THE pRTNC/PAL TAX DUE, APPL'rCATTON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLTCABLE, A PROJECTED 'rNTEREST FTGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-28-2005 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................ PAYMENTS (TAX CREDITS): 83,~33.75 PAYHENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID ~ SUMMARY OF ~LL 08-05-2005 08-05-200~ ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. { ZF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' ¢CR), 006 PAYMENTS ~ 3,000.00 261.19- .00 80,69~.9~ TOTAL TAX CREDIT 83,433.75 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU NAY BE DUE A REFUND. SEE REVERSE STDE OF THIS FORH FOR INSTRUCTIONS. ) Name of Decedent: Date of Death: Will No.: STATUS REPORT UNDER RULE 6.12 Gary_ E. February 27, 2002 2002-00351 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 ~] No ~ If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: Did the personal representative file a final account with the Court? Yes _ No The separate Orphans' Court No. (if any) for the Personal representative's account is: Did the personal representative state an account informally to the parties in interest? Yes [] No ['-] Co Date: 2-19-2004 Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Signature M. L. McBride, Jr. Ns/ne 9[: [t~ £Z fi3J ~. -Capacity: 211 South Center Street Address Grove City, PA 724-458-6640 Telephone No. 16127 Personal Representative Counsel for personal representative MILFORD L. MC:BRiDE, JR. BRENDA I~. McBRIDE MILFORD L. MCBRIDE AND MCBRIDE, P. C. ATTORNEYS AT LAW ;~11 SOUTH CENTER STREET GROVE CITY, PA. 161=>7 TELEPHONE (724) 458-6640 MILFORD L. MC:BRIDE 1889-1962 FA X (7;~ 4) 458-§401 March 11, 2003 Cumberland County Courthouse Clerk of Courts - Register of Wills ~ One Courthouse Square ~ Carlisle, PA 17013 ~ I~ Re: Supplemental Inheritance Tax Return Gary E. Filer Estate 21-2002-0351 To Whom It May Concern: Enclosed herein, please find two (2) copies of the Supplemental Inheritance Tax Return for the Estate of Gary E. Filer, along with a check in the amount of $3,801.41 payable to the Register of Wills, Agent to complete the Inheritance Tax payment. Please file this return at your earliest convenience and send a receipt to our office. If you have any questions, please feel free to contact our office. Thanking you, I am, MLM,JR./pas cc enclosures Very truly yours, McBRIDE and McBRIDE, P.C. M. L. McBride, Jr. MILFORD L. McBRiDE, JR. BRENDA ~(. McBRiDE MILFORD L. McBR)DE. ~T~ MC--BRIDE AND MCBRIDE, R C. ATTORNEYS AT LAW ;:>11 SOUTH CENTER STREET GROVE CITY, PA. 161:~7 TELEPHONE (724) 458-6640 MILFORD L. McBRIDE 1889-1962 FA X (7:~4) 4§8-540I March 16, 2004 Cumberland County Courthouse Clerk of Courts - Register of Wills One Courthouse Square Carlisle, PA 17013 Re: Supplemental Inheritance Tax Return Gary E. Filer Estate 21-2002-0351 Dear Jackie: Enclosed herein, please find our check in the amount of $15.00 for the filing of the Supplemental Inheritance Tax Return for the Estate of Gary E. Filer. Please file this return at your earliest convenience and send a receipt to our office. If you have any questions, please feel free to contact our office. Thanking you, I am, · cc enclosures Very truly yours, McBRIDE and McBRIDE, P.C. M. L. McBride, Jr. REV-1500 EX (6-00) COMMONWEALTH OF PEN NSYLVANIA DEPARTMENT OF R EVEN U E DEPT. 280601 HARRISBURG, PA 17128-0601 Z z Z O REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT~S NAME (LAST, FIRST, AND MIDDLE INITIAL) FTT,~..R., GL, a~Y ~.. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DO-YEAR) 02/2?/2002 01/23/1944 (IF APPLICABLE') SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY FILE NUMBER 21 -- 2002 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 190-32-2140 0351 NUMBER 1145 RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [--'-] 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return Idate of death p~l~to 12-13-82) ~ 4. Limited Estste ~ 4a. Futurelnterest Compromise (date of death afta'12-12-82) ~ 5. Federal Estate Tax Return Reduirsd ~ 6. Decedent Died Testate (Attach copy ~ Will) [~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) 8. Total Number of Safe Ceposit Boxes ~] 9. Litigation Proceeds Received ~ 10. Spousal Pove~7 Credit (d.~ or d.m ~.~.~. 12~1-,1 an~ 1-1-~S) ~ 11. Election to ta~ under Sec. 9113(A)(Nta~ s~ o) DDMPI_E"~E MAILING ADDRESS 211 SOUTH CENTER STREET GROVE CITY, PA 16127 NAME M. L. MCBRIDE, JR. 30,344.43 650.00 29~694.43 0.00 29,694.43 FIRMNAME(IfApplicable) MCBRIDE AND MCBRIDE, P.C. TEL~HONE NUMBER ?24-458-6640 1, Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 30,344 3. CioselyHeldCorporafion, Partnership or Sole-Propdetorship (3) 0-i00 4. Mortgages & Notea Receivable (schedule D) (4) 0.00 Cash, Bank Deposits & Miscellaneous Personal Property 5. (Schedule E) (5) 0 :'00 6. Jointly Owned Property (Schedule F) (6) 0 [~ Separate Billing Reduested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 0.00 (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (8) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 650.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 0 · 0 0 11. Total Deductions (total Lines 9 & 10) (11 ) 12 Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bed uests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCllONS ON REVERSE SIDE FOR APPLICABLE RATES 0.00 x.00__ (15) 0.00 0.00 x .04,~ (16) 0.00 29,694.43 x.12 (17) 3,563.33 0.00 x .18 (18) 0. O0 (19) 3,563.33 15. Amount of Line 14 taxabieat thespouasltax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable st sibling rate 18. Amount of Line 14 taxable st collateral rate. 19. Tax Due 2w4645 1.000 Decedent's Complete Address: $ ~ ~<~.1=~ ADORESS 402 WEST ELMWOOD AVENUE CITY MECHANI SBURG Tax Payments and Credits: 1. Tax Due (Page I Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 0.00 0.00 238.08 0.00 Interest/Penalty if applicable D. Interest E. Penalty ISTATE 17055 (1) 3,563.33 Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) 0.00 23S.08 3,801.41 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) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 3,801.41 ..... ~ ...................................... <':<<<~'¥ ............................ =~ ............. ~.k..~ .C...he..?.~y~b/e to: REGISTER OF WILLS, AGENT :::.'...::~..'&<.'.:'.~¥'.~.~= ~.%~$'.~.'.. !.i.-;.~' '"<<.~:,-~:~'~.-'.~.-'.~,'.-'.~.~.:'""".~'"'"":K-'.-'.~,' ~>.'.';:.~..-'.¥"'~":~'.'~:~$~:-~:~:~.'.;~<"'<':'.':~::~:i':''~'=':~<< "<'" <<'< ' ~"" '<-;".:~<<~, ...... ~ .,<~<-.~<<<.x,,<.<....-~ .:< ,~ <<<.<<-,.<<.-.~ .> ........ <...<< PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................... I~ ~ b. retain the right to designate who shall use the property transferred or its income; ......... ~ ~'1 c. retain a reversionary interest; or ................................ I-~ r~l d. receive the promise for life of either payments, benefits or care? ................. [---] ~ 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? r~] ~ 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 I$ YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pequry, I declare that I have examined this tatum, including &¢,;~,~panying schedules and ~[.~monts, and to ~e best of my knowledge and belief, it is true, cool'act and complete. Declaration of preparer other than the personal representative is based on atl infon"naflon of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN SIGNATURE OF ~-vARER OTHER THAN REPRESENTATIVE G~,OVE CTT~, ~A 16127 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S § 9916 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. § 9116 (a) (1.1) (ii)] The statute does not exem pt 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 im posed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. § 9116(a)(1.2}]. The tax rate imposed on the net value of transfers to or for the use of the decadent~s lineal beneticiades is 4.5%, except as noted in 72 P.S. § 9116(1.2) [72 P.S. §9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. § 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption, 2w4646 1.ooo R .EV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER FILER, GARY E 21-2002-0351 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER E~ESCRII=TION OF DEATH I 1190.701 SHARES OF USAA CORNERSTONE STRATEGY F~ND AT $23.15 27,564.73 PER SHARE 334.099 SHARES OF USAA METALS AND MINERALS FUND AT $8.32 PER SHARE TOTAL (Also enter on line 2, Recapitulation) $ 2,779.70 30,344.43 2W4696 3.000 (If more space is needed, insert additional sheets of the same size) RE%{-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT {:~CEDE. NT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER FILER, GARY E 21-2002-0351 Debts of decedent must be reported on Schedule I. ITEM NUMBER 5. 6. 7. DESCRIPTION FUNER,AL EXPENSES: ADMINISTRATIVE COSTS: Personal Repreeentative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: Attorney Fees Name: MCBRIDE AND MCBRIDE, P. C. 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 Probate Fees Accountant's Fees Tax Return Preparer's Fees AMOUNT 0.00 650.00 0.00 0.00 0.00 0.00 TOTAL (Also enter on line 9, Rec_-~_~-~_,_,!~__*i_en) $ 650.00 2W46AG 2.000 (If more space is needed, insert additional sheets of same size) RE'~/-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER FILER, GARY E 21-2002-0351 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE II. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] HARTLEY, MARGARET G 7578 OXBOW ROAD CANASTOTA, NY 1.032 SISTER ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LIN E 13 OF REV-1500 COVER SHEET $ 0.00 2W46AI 1.000 (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003675 MCBRIDE M L JR ESQ 211 SOUTH CENTER STREET GROVE CITY, PA 16127 ........ fold ESTATE INFORMATION: SSN: 190-32-2140 FILE NUMBER: 2102-0351 DECEDENT NAME: FILER GARY E DATE OF PAYMENT: 03/1 5/2004 POSTMARK DATE: 03/11/2004 COUNTY: CUM BERLAN D DATE OF DEATH: 02/27/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3,801.41 '.'REMARKS' ~ .... SEAL CHECK//111 TOTAL AMOUNT PAID: $3,801.41 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF 1NDTVTDUAL TAXES TNHERITANCE TAX DIVTSTOH DEPT. 180601 HARRTSBURG, PA 17118-0601 COMMONHEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-l~li7 EX AFP COl-D3) M L MCBRIDE JR MCBRIDE & MCBRIDE 211S CENTER ST GROVE CITY PA : DATE Oq-Z6-200q ~.**ii'. ESTATE OF FILER GARY E DATE OF DEATH 02-27-Z002 FILE NUMBER 11 02-0551 '04 APR 26 P1:34 COUNTY CUMBERLAND ACN 101 Amoun'l: Romi'l:'l:od HAKE CHECK PAYABLE AND RENZT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~'~ RETAIN LOHER PORTION FOR YOUR RECORDS ~ DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FILER GARY E FILE NO. 21 02-0551 ACN 101 DATE Oq-Z6-200fi TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE ~NTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Real Es~a*e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) 3. Closely Held S~ock/Par~nership In~eres~ (Schedule C) (3) q. Mortgages/No,es Receivable (Schedule D) (~) 5. Cash/Bank Deposi~s/Hisc. Personal Proper~y (Schedule E) ($) 6. Jointly O~nod Propor~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asso~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expensos/Adm. Cos~s/Hisc. Expenses (Schedule H) (9) 10. Dob~s/Mor~gage Liab/1/~/es/Liens (Schedule [) (10) 11. To,al Deductions 12. No~ Value of Tax Re*urn 15. 1~. NO. 05 00 $0~$q~.~3 00 00 00 00 .00 650.00 (8) Charitable/governmental Bequests; Non-elec*ed 9115 Trusts (Schedule J) Ne~ Value of Es~a~o Sub~oc~ ~o Tax NOTE: To insure proper credi~ ~o your account, submi~ ~he upper por~ion of ~his form wi~h your ~ax payment. .00 (11) 650.00 (12) 29,69~.~$ (13) .00 (1~) 7Zq, 975.66 .00 NOTE: reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amoun~ of Line 1~ a~ Spousal ra~e (15) .00 X O0 = 16. Amoun~ of Line lq ~axable a~ Lineal/Class A ra*a (16) .00 X Oq5 = 17. Amoun~ of L/no lq a~ Sibling re~e (17) 7Zq,975.66 x 1Z = 18. Amoun~ of Line 1~ ~axablo a~ Collateral/Class B ra~e (18) .00 X 15 = Z'f an assessment #as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 .00 86,997.08 .00 19. Principal Tax Due TAX CREDITS: PAYMENT RECET PT / DATE NUHBER ~ SUMMARY 0 03-11-200q (193= 86,997.08 BI$COUNT /NTEREST/PEN PAID (-) ALL 07 PAYMENTS 3,000.00 q68.65- ZF PAID AFTER DATE /ND/CATED, SEE REVERSE FOR CALCULAT/ON OF ADDITIONAL /NTEREST. AMOUNT PAID .0o 8~,q96.35 TOTAL TAX CREDIT I I ~ALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 87,027.72 $0.6qCR .00 $0.6qCR ( ZF TOTAL DUE 1S LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE 1S REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TH[S FORM FOR /NSTRUCTIONS.) COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 INHERITANCE TAX HARRISBURG, PA 17128-0601 STATEMENT OF ACCOUNT REV-1607 E% AFP (01-037 DATE 05-24-2004 ESTATE OF FILER GARY E DATE OF DEATH 02-27-2002 FILE NUMBER 21 02-0351 COUNTY CUMBERLAND M L MCBRIDE JR ACN 101 MCBRIDE & MCBRIDE Amount Remitted 2I1 S CENTER ST GROVE CITY PA 16127 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, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1607 EX AFP (01-03) *** INHERITANCE TAX STATEMENT OF ACCOUNT ~~(~( ESTATE OF FILER GARY E FILE N0. 21 02-0351 ACN 101 DATE 05-24-2004 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-19-2004 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 86,997.08 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID *** SUMMARY OF LL 008 PAYMENTS *** 05-10-2004 3,000.00 .00 05-10-2004 468.63- 84,465.71 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), J vn(( Mev RF nUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 86,997.08 .00 .00 .00 `,,~-~