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HomeMy WebLinkAbout02-0099 PETITION FOR PROBATE and GRANT OF LETTERS Estate of ' .~J O/~,'t ~l ~j l~l~wzlr~ ~ No. 21-02-99 also known as To: Register of Wills for the Social Security No. /~ - 3 Z- ~31 ~, ' Deceased. County of Ca'~berl';~ ~- in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age_or older an the e~,e~ut /q~ ! t~. ~.,,7 ie~.,¢..~ named in the last wilt of the above decedent, dated -~-- and codicil(s) dated -- (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ('" ~ bee /,: ,~t County, Pennsylvania, with h 15 ' last Qamil, y or principal residence at ~o~ C,.eUd3e' Sq.. Ne~ac,.,~bo,/~,vd ,P~t /7e 7n (list street, number and muncipality) Decendent, then. ~Q~ _ years of age, died at //o/,-d 5~>//- /~,r"n/ ¢~,~?/t,// ~,r~/ /'e~, ~,~>~,,p ' Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the.will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate inPe,nnsylvania .-~ $ si/susa.ted as follows: .1 Ow, oW.Z_.. . WHEREFORE, petitioner(s) respectfully request(s) t~e probate of the last will and codicil(s) presented herewith and the grant of letters /'e'~4-a~a~^/ 4n..9 theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF CUMBERLAND ; SS The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this 17th day of __ JANUARy, _ ' ~ No. 21-02-99 Estate Of ao~N W FOGLEMAN. JR ., Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated September 4 2001 described therein be admitted to probate and filed of record as the last will of JOHN W FOGLEMAN JR and Letters TESTAMENTARY JANUARY 29 ............ a~_2_0_02__~_, in cot,~sidermion c' ,'>,: ,,<itio,: on are hereby granted to MICHAEL W FOGLEMAN FEES Probate, Letters, Etc .......... $ 235.00 g. O0 Short Certificates( ) .......... $ 15.00 ~-pa~es. e~lun-mauon ................ $ JCP $ 5.00 TOTAL __ $ 264.00 Filed ... JANUARY..29,. 2.Q02 ............. ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE MAIL TO EXECUTOR 1-29-2002 I05.805 REV 9/86 T4is 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 thc Stare Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 8028033 No. ~ o r~la~t e .t ~, .... 21-02-99 '5.143 Rev 2/87 John W. 60 v~,. Cumberland Fogleman, Jr. COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH . 195 -- 32 -- 2316 July 9, ~o~.~: - ~ 1941 Loysville, PA ~--~ ~ ..~ ~ g. Pennsboro Twp. Nurse rrections De' 803 Coolidge Street New Cumberland, PA 17070 John W. Fogleman, Sr. Michael W. Fog_leman white c~,a 3 (,,=s+) Widowed ,7..s~ P____ennsylvania _ ~ ,m.~.~_ ,~.~Cumberland ,o~? ~ ~.~ ~,.~R.s~,~.~ mew C~moerlano Janua~~~wplain, Perry Co., PA 17006 FD 012 848 L nc.~ , PA 17070-0431 LAST WILL AND TESTAMENT OF JOHN W. FOGLEMAN, JR. 21-02-99 I, John W. Fogleman, Jr., of Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST I direct the payment of my just debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. SECOND It is my express desire that my beneficiaries be allowed to choose personal items they may wish to retain, such personal items to be chosen in accordance with age, the oldest child choosing first, and to be divided in as nearly equal shares as possible. SAIDIS SHUFF, FLOWER &.IINDSAY 2109 Marke~ ~et Camp Hill, PA THIRD I give, devise and bequeath all the rest, residue and remainder of my estate in equal shares unto my children, Christine M. Newsome, Michael W. Fogleman and David J. Fogleman, per stirpes. 1 FOURTH Ail taxes imposed as a consequence of my death shall be paid out of the residue of my estate and considered as a part of the cost of the administration of my estate. SAn)IS SHUFF, FLOWER & LINDSAY 2109 Market Street Cmnp HIll, PA FIFTH In addition to the powers conferred by law, I authorize any guardian, executor or executrix acting under this instrument, in any such fiduciary.s absolute discretion: A. To retain any investments I own at my death and to invest in all forms of real and personal property, without being confined to investments authorized by a statutory list, without being required to diversify and regardless of any principle of law limiting delegation of investment responsibility by any such fiduciary; B. To compromise claims and to abandon any property which, in any such fiduciary,s opinion, is of little or no value; C. To sell at public or private sale, to exchange or to lease for any period of time, any real or personal property, and to give options for sales or leases; D. To join in any merger, reorganization, voting-trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto; E. To borrow from anyone, even if the lender is a fiduciary hereunder, and to pledge property as security for repay- ment of the funds borrowed; SAIDIS SHUFF, FLOWER & LINDSAY 2109 Mntttet Street c~ ~, PA F. To make loans to, and to buy property from, my spouse's executor or administrator; G. To employ and to rely upon advice given by investment counsel, to delegate discretionary authority to make changes in investments to investment counsel, and to pay invest- ment counsel reasonable compensation in addition to any fees otherwise payable to any such fiduciary; H. To employ a custodian, to hold property unregistered or in the name of a nominee (including the nominee of any institution employed as custodian), and to pay reasonable compensation to the custodian in addition to any fees otherwise payable to any such fiduciary; I. To hold two or more accounts hereunder as a combined fund (allocating ratably to such accounts all receipts from, and expenses of, the combined fund) for convenience in investment and administration; provided that any combination of accounts for this purpose shall not alter their status as separate accounts; J. To distribute in cash or in kind; K. To renew or extend the time for payment of any obligation, secured or unsecured, payable to or by any such fiduciary for as long a period or periods of time and on such terms as such fiduciary may determine and to adjust, settle and arbitrate claims or demands in favor or against them; and L. To exercise all elections which any such fiduciary may have with respect to income, gift, estate, inheritance and other taxes, including without limitation, execution of joint income tax returns, election to deduct expenses in computing one tax or another, election to split gifts and election to pay or to defer payment of any tax in all events without any such fiduciary being bound to require contribution from any other person. SIXT~ I do hereby nominate, constitute and appoint my son, Michael W. Fogleman, of Dover, Pennsylvania, to act as executor, of this my Last Will and Testament. If he is unwilling or unable to act as executor, I do hereby nominate, constitute and appoint my brother, Frank Fogleman, of Chambersburg, Pennsylvania, to act as executor. SEVENT~ I direct that no personal representative, guardian, trustee or other fiduciary appointed under this instrument shall be required to give bond for the faithful performance of any such fiduciary's duties in any jurisdiction. SAIDIS SHUFF, FLOWER & LINDSAY 2109 Market Street Cmm]} Hill;~ PA IN WITNESS W-~EREOF, I, John W. Fo~leman, Jr., have hereunto set my hand and seal to this my Last Will and Testament, this /~//% dayOf ~.~/~!~ , 2001. John W/Foglema~F, ~r.~ 4 SAIl)IS S ~Hy~, ~F~.~ .~W~. R &.LINDSAY 2109 Market Street Camp HII~., PA Signed, sealed, published and declared by the above-named Testator, John W. Fogleman, Jr., as and for his Last Will and Testament in the presence of us, who have hereunto subscribed our names at his request as witnesses thereto, in the presence of said Testator and of each other. ADDRESS ADDRESS COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : WE, the undersigned, the Testator, and the witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament and that he signed willingly (or willingly directed another to sign for him), and that he executed it as his free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator signed the will as witnesses and that to the best of their knowledge the Testator was at that time eighteen years of age or older, of sound mind, and under no constraint or undue influence. ohn W. ~og~an~ Jr../' Witness :2109 Market Street Camp ~ PA Subscribed, sworn to and acknowledged before me by the Testator and subscribed and sworn to before me by both witnesses, this ~ day of ~~~ , 2001. 6 OT SEAL AREN $. NOEL, Nma~ Put~c Camp Hill Bom, CUmbe~nd Coun,y . ~,,'"r~'t~on F_xptres Dec. 8, 200~ REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: John W. Fogleman, Jr. Date of Death: January 15, 2002 Will No. 21-02-0099 Admin. No. 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 ~Jan~tor~I ,~_ 0 ,2002. I Name _Address Michael W. Fogleman Christine M. Newsome David J. Fogleman 1815 York Road, Apt. B, Dover, PA 17315 PSC 103, Box 5284, APOAE09603 8800 S. Drexel Road, No. 1404, Oklahoma City, OK 73159 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none Date:_ Thomas E. Flower, Esquire SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: · Personal Representative _. X Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIrVED FROM: FLOWER THOMAS E 2109 MARKET STREET (::AMP HILL, PA 17011 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD O01O57 fold ACN ASSESSMENT CONTROL NUMBER AMOUNT ESTATE INFORMATION: SSN: 195-32-2316 FILE NUMBER: 2102-0099 DECEDENT NAME: FOGLEMAN JOHN W JR DATE OF PAYMENT: 04/1 1/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/15/2002 lOl I 5,9oo.oo REMARKS: TOTAL AMOUNT PAID: MICHAEL W FOGELMAN C/O THOMAS E FLOWER ESQUIRE $5,900.00 CHECK//125 SEAL INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS '02 j~N17 ~9:55 0 ~_n REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: John W. Foglcman, Jr. Date of Death: January 15, 2002 Will No. 21-02-0099 Admin. No. 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 ~j a ~ ti o r, ] ~ 0 ,2002. Nanle Address Michael W. Fogleman Christine M. Newsome David J. Fogleman 1815 York Road, Apt. B, Dover, PA 17315 PSC 103, Box 5284, APOAE09603 8800 S. Drexel Road, No. 1404, Oklahoma City, OK 73159 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none Date: Thomas E. Flower, Esquire SA[DIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: __Personal Representative ~X Counsel for Personal Representative 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 001O57 FLOWER THOMAS E 2109 MARKET STREET CAMP HILL, PA 17011 ESTATE INFORMATION: SSN: 195-32-2316 FILE NUMBER: 2102-0099 DECEDENT NAME: FOGLEMAN JOHN W JR DATE OF PAYMENT: 04/11/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUM BERLAND DATE OF DEATH: 01 / 15/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 J $5,900.00 I REMARKS: TOTAL AMOUNT PAID: MICHAEL W FOGELMAN C/O THOMAS E FLOWER ESQUIRE $5,900.00 SEAL CHECK# 125 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS iiI ~LJ- W 0 0 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 001174 FLOWER THOMAS E 2109 MARKET STREET CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 195-32-2316 FILE NUMBER: 2102- 0099 DECEDENT NAME: FOGLEMAN JOHN W JR DATE OF PAYMENT: 05/14/2002 POSTMARK DATE: 05/1 3/2002 COUNTY: CUMBERLAND DATE OF DEATH: 01 / 15/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3.76 TOTAL AMOUNT PAID: $3.76 REMARKS: THOMAS FLOWER ESQUIRE SEAL CHECK# 1010 INITIALS: AC RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS RE¥-I ~O0~X (&O0) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 - 02 00 99 COUNTY CODE YEAR NUMBER }- Z uJ LU 0 UJ z Z 0 0 x < DECEDENT'S NAME (LAST, FIRST AND MIDDLE INITIAL) Fol~leman, John W., Jr. DATE OF DEATH MM-OD-YEAR) DATE OF BIRTH (MU-OD-YEAR) 31 - 15 - 02 07 - 09 - 41 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST ANO MIDDLE INITIAL) SOCIAL SECURITY NUMBER 195 - 32 - 2316 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 {Attach copy of Will) 1~]9. Litigation Proceeds Received O2. Supplemental Return D4a, Future Interest Compromise (dale of death aner 12-12-82) O7. Decedent Maintained a Living Trust attach acopyof'rrus~) r'-]l o. spousal Poverty Credit (date of death be~een 12-31-91 aad 1-1-95) 1~13. Remainder Return (date ddeath prior lo 12-13-82) F-J5. Federal Estate Tax Return Required O 8. Total Number of Safe Deposit Boxes O11.Election to tax under Sec. 9113(A) attach Sch oo THIS SECTION MUST BE COMPLETED ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO NAME thomas E. Flower, Esquire amis, 5tmii, mower & Li~dsay TELEPHONE NUMBER 717-737-3405 ICOMPLETE MAILING ADDRESS 2109 Market Street Camp Hill, PA 17011 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E} 6. Jointly Owned Property (Schedule F) ~] Separate Billing Requested 7, Inter-Vivos Transfers & Miscellaneous Non-Prohate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent. Mortgage Liabilities. & Liens (Schedule 1) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (1) 51,226.88 (2) none (3) none (4) none 5: (5) 96,782.33 .-~ ?-% (6) none : (7) none ,,.~ (9) 9,371.52 (to) 887.54 (8) 148,009.21 (11) 10,259.06 (12) 137,750.15 13-. Charitable ahd Gogetnmefihil Beqtlests/Sec 9113 Trusts for which3n election to tax has not been~ made (Schedule J) 14, Net Value Subject to Tax (Line 12 minus Line 13) (13) none (14) 137,750.15 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate x.O 137,750.15 x.o 45 (15) (16) 6,198.76 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable al collateral rate x ,15 19. Tax Due (18) (19) 6,198.76 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: I ~TREETADDRESS CITY 803 Coolidge Street New Cumberland ISTATE PA I ZIP 17070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 5,900.00 C. Discount 295.00 3. Interest/Penalty if applicable D. Interest E. Penalty 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due, (1) 6,198.76 Total Credits (A+ B + C ) (2) 6,195.O0 Total Interest/Penalty ( D + E ) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (3) 0 (4) (5) 3.76 (5A) 0 (513) 3.76 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 properly transferred; ................................ [] [] b. retain the right to designate who shall use the property transferred or its income; ................ [] [] c. retain a reversionary interest; or ........................................... F~ ~ 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"(~ayable upon death bank account or security at his or her death? L..J [] 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 penaltlee of perju~/, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belief, It la true, correct and complete. Declaration of preparer other than the personal representative Is based on all Infon~aUon of which preparer has any knowledge. SI~ RETURN ADDRESS C/ 1815 Y,j~k Road, Apt. B, Dover,,PA 17315 Saidis, Shuff, Flower & Lindsa¥, 2109 Market St., Camp Hill, PA 17011 .DATE l'71o z. For dates of death on or after July 1, 1994 and Before January I, 1995, the tax rate imposed on the net value of transfers to or to the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (I)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 RS. §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 RS. §9116(I.2) [72 RS. §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. REV-1502FX - (1-97) (I) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John W. Fogleman, Jr. SCHEDULE A REAL ESTATE FILE NUMBER 21-02-0099 All real property owned solely or as 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 which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER VALUE AT DATE DESCRIPTION OF DEATH Residence at 803 Coolidge St., New Cumberland, PA (see attached settlement sheet) TOTAL (Also enter on line 1, Recapitulation) 51,226.88 51,226.88 (If more space is needed, insert additional sheets of the same size) REV-1508 EX- (1-97) (1) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Johri W. Fogleman, Jr. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-02-0099 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F, ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Allfirst Bank-- C/D #87008140654795 .............................................. principal balance ......... accrued interest ........... ?NC Bank -- checking account #5140344617 ..................................... principal balance .......... accrued interest ........... PNC Bank -- savings account #5130259005 ..................................... principal balance ........... accrued interest .............. PNC Bank -- money market account #5000939731 .......................... principal balance ............ accrued interest .............. PNC Bank -- certificate of deposit #31500086820 .......................... principal balance ............ accrued interest .............. 1992 Mercury Grand Prix LE automobile .............................................................................. household furnishings ............................................................................................................... $ 2,534.81 0.27 13,867.62 3.59 2,034.25 0.73 71,306.10 12.22 2,524.95 2.79 1,995.00 2,500.00 TOTAL (Also enter on line 5, Recapitulation) $ 96,782.33 (If more space is needed, insert additional sheets of the same size) REYA$1 I EX- (1-97}(1} ~ COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDEN? DECEDENT ESTATE OF John W. Fogleman, Jr. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-02-0099 Debts of decedent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A, FUNERAL EXPENSES: 1. ADMINISTRATIVE COSTS: 1. Personal Representative 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 FeesIsaidis, Shuff, Flower & Lindsay J 2. 7,040.00 3. Family Exemption: (if decedents address is not the same as claimant s, attach explanation) Claimant Street Address City. State Zip Relationship of Claimant to Decedent 4, Probate Fees 264.00 5. Accountant s Fees §. Tax Return Preparers Fees Cumberland Law Journal, Advertise estate .................................................. 75.00 7. Patriot News, Advertise estate ..................................................................... 119.95 Register of Wills, filing fee ......................................................................... 15.00 Additional Short Certificates ..................................................................... 12.00 Rowe Appraisals (appraisal of house) ......................................................... 275.00 Kevin Carraway (electrician, repairs to house prior to sale) ..................... 1,250.00 Cost of utilities continued while marketing house prior to sale: UGI (gas) ................... 219.59 PPL (electric) ............. 50.25 PAWC (water) ........... 50.73 + Total miscellaneous administration expenses ......................................... 2,067.52 2,067.52 TOTAL (Also enter on line 9, Recapitulation) $ 9,371.52 (If more space is needed, insert additional sheets of the same size) REV-1612 EX - (t-97) (1) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John W. Fogleman, Jr. SCHEDULE DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS I FILE NUMBER 21-02-0099 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT $ 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. PAWC (water bill) COMCAST (t.v. cable) AAA (membership fee) National Geographic PPL Electric Discover (credit card bill) UGI (gas bill) MBNA (credit card bill) Verizon (phone bill) Delta Dental (dental bill) Andrews & Patel (medical bill) AOL (intemet service) AT&T (phone bill) Boro. of New Cumberland (trash/sewer bill) TOTAL(Also enter on line 10, Recapitulation) s 887.54 (If more space is needed, insert additional sheets of the same size) 14.97 187.66 36.00 14.73 50.32 48.43 141.40 39.30 136.90 64.00 16.00 23.90 56.50 57.43 REV-1513 EX- {1-97) (I) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER 11, SCHEDULE J BENEFICIARIES FILE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Christine M. Newsome PSC 103 Box 5284 APO AE09603 David J. Fogleman 8800 So. Drexel Rd. #1404 OKC, OK 73159 Michael W. Fogleman 1815 York Rd. Apt. B Dover, PA 17315 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) daughter son son AMOUNT OR SHARE OF ESTATE 1/3 1/3 1/3 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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 11 - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (if more space is needed, insert additional sheets of the same size) U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT SETTLEMENT STATEMENT C. NOTE: I B. TYPE OF LOAN: 1.[]FHA 2.DFmHA 3. [-]CONV. UNINS. 4, ~-~VA 6. FILE NUMBER: I 7. LOAN NUMBER'. P-128407 I 526528302 8. MORTGAGE INS CASE NUMBER: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "[POC]" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. 1,0 3/98 (P-128407.pfd/P-128407/24) 5. r~CONV. INS. D. NAME AND ADDRESS OF BORROWER: Susan V. Zvorsky 1801 St. Clair Road New Cumberland, PA 17070 G. PROPERTY LOCATION: 803 Coolidge Street New Cumberland, PA 17070 Cumberland County, Pennsylvania E. NAME AND ADDRESS OF SELLER: ESTATE OF JOHN W. FOGLEMAN, JR. H. SE'I-rLEMENT AGENT: 25-1722090 Capital Region Land Transfer, Inc. F. NAME AND ADDRESS OF LENDER: PLACE OF SETTLEMENT 3310 Market Street Camp Hill, PA 17011 GMAC Mortgage Corporation 100 Witmer Road Horsham, PA 19044 I. SETTLEMENT DATE: March 29, 2002 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: Contract Sales Price 85,000.00 101. Contract Sales Price 85,000.00 401. 102. Personal Property 402. 103. Settlement Charges to Borrower (Line 1400) 104. Personal Property 105. Adjustments For Items Paid By Seller in advance Adjustments For Items Paid By Seller in advance 106. City Taxes to 107. County Taxes 03/29/02 to 01/01/03 108. School Taxes 03/29/02 to 07/01/02 City Taxes to 3,074.91 403. 404. 405. 406. 287.35 407. 260.94 408. 1.19 409. 0.73 410. 411. 412. 88,625.12 420. County Taxes 03/29/02 to 01/01/03 SchoolTaxes 287.35 03/29/02 to 07/01/02 260.94 109. Trash 03/29/02 to 04/01/02 Trash 03/29/02 to 04/01/02 110. Sewer 03/29/02 to 04/01/02 Sewer 03/29/02 to 04/01/02 111. 112. GROSS AMOUNT DUE TO SELLER 120. GROSS AMOUNT DUE FROM BORROWER 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER:. 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 501. Excess Deposit (See InstructionS) 202. Principal Amount of New Loan(s) 68,000.00 502. Settlement Charges to Seller (Line 1400) 203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to 85,550.21 1,270.57 204. 205. 504. Payoff of first Mortgage to Washington Mutual/5004 206. 207. 507. 208. 508. 209. 509. 210. City Taxes 211. County Taxes Adjustments For Items Unpaid By Seller to 505. Payoff of second Mortgage 506. 33,052.76 212. School Taxes to 510. 511. County Taxes - · to Adjustments For Items Unpaid By Seller City Taxes to to 512. School Taxes to 213. 513. 214. 514. 215. ~ 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 68,000.00 520. TO. TAL REDUCTION AMOUNT DUE SELLER 34,323.3: 300. CASH AT SETTLEMENT FROM/TO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER: 301. Gross Amount Due From Borrower (Line 120) 88,625.12 601. 85,550.2' 302. Less Amount Paid By/For Borrower (Line 220) 303. CASH( X FROM) ( TO) BORROWER 68,ooo.oo: 20,625.12 602. Gross Amount Due To Seller (Line 420) Less Reductions Due Seller (Line 520) 603. CASH ( X TO) (FROM) SELLER 34,323.3; 51,226.8~ The undersigned hereby acknowledge receipt of a cOmpleted copy of pages 1&2 of this / Borrower statement & any attachments referred to herein. Seller ESTATE OF JOHN W. FOGLEMAN, JR. ,~.~; /. .; ~' ~, L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price $ @ % Division of Commission (line 700) as Follows: 701. $ to PAID FROM BORROWER'S FUNDS AT SETTLEMENT ?02. $ to 703. Commission Paid at Settlement '04. to BOO. ITEMS PAYABLE IN CONNECTION WITH LOAN 0.2500 % $680 - 510 L 170.00 PAID FROM SELLER'S FUNDS AT SETFLEMENT 801. Loan Origination Fee 802. Loan Discount % to GMAC Mortgage Corporation to 803. Appraisal Fee to 804. Credit Report to 805. Tax Service Contract to GMAC Mortgage Corporation 85.00 POC $325.00b 806. Application Fee 807. Flood Certification to GMAC Mortgage Corporation to GMAC Mortgage Corporation 17.00 108. Document Prep. Fee to GMAC Mortgage Corporation 245.00 809. Life of Loan Flood Cert. to GMAC Mortgage Corporation 2.00 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 03/29/02 to 04/01/02 @ $ 13.040000/day ( 3 days %) 902. Mortgage Insurance Premium for months to 903. Hazard Insurance Premium for years to }04. 905. 1000. RESERVES DEPOSITED VVITH LENDER 1001. Hazard Insurance 3.000 69.75 39'121 1002. Mort~la~e Insurance 1003. City Taxes 1004. County Taxes 2.000 1005. School Taxes 9.000 1006. 1007. 1008. A~re~ate Adjustment 1100. TITLE CHARGES months @ $ months ~ $ months (~ $ months @ $ months @ $ 23.25 per month per month per month 30.81 per month 61.62 82.75 per month 744.7! months (~ $ per month months ~,, $ per month months ~ $ per month -293.58 101. Settlement or Closing Fee 102. Abstract or Title Search 1103. Title Examination !1104. Title Insurance Binder I 1105. Document Preparation to to .to to 106. Notary Fees to Lisa R. Rowe 12.00 8.00 107. Attorney's Fees to Thomas Flower, Esquire POC-S · (includes above item numbers:. · , - .... 1108. Title Insurance (includes above item numbers: to Capital Re,qion Land Transfer, Inc. 1109. Lender's Coverage $ 1110. OwneCs Coverage $ 68,000.00 768.75 85,000.00 1111. 100,300,8.1 to Capital Region Land Transfer, Inc. 150.00 1112. Deed Preparation Capital Region Land Transfer, Inc. 1113. Overnight to Capital Region Land Transfer, Inc. payoff 18.00 1114. Cnty/Boro. Taxes to Robin Gasperetti, Tax Collector 26-23-0543-266 369.74 1115. Tax Certification to Capital Region Land Transfer, Inc. 3.00 1116. Closing Protection Letter to Capital Region Land Transfer, Inc. 35.00 1117. Sewer-Jan. Feb. March to Borough of New Cumberland 21.83 1118. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 25.50; Mortgage $ 53.50; Releases $ I 79.00 I 1202. City/County Tax/Stamps: Deed 850.00; Mortgage I I 850.00 1203. State Tax/Stamps: Deed 850.00I 39-501 1204. Record Second Mortgage 1205. · 1300. ADDITIONAL S~- i i LEMENT CHARGES 850.00;Mort~la~e to Recorder of Deeds 1301. Survey to 302. Pest Inspection to 303. 1304. Wire Fee Capital Region Land Transfer, Inc. 1305. '1400. TOTAL S~- ~ I LEMENT CHARGES (Enter on Lines 103, Section J and 502, Sectior~K) , 3,074.91 Bysgnng a elofthtsstatemenlthes, natonesacknowled erecettofacom ,etedco of a , ofthtst,~vo' ' P g ' , 'g ' g 'P P py p g 2 ' page ~pi~l~R~-~ion Land Transfer, Inc. 'Settlement Agent 1,270.57 allfirst February 11, 2002 Saidis, Shuff, Flower & Lindsay Att: Thomas E. Flower 2109 Market Street Camp Hill, PA 17011 Allfirst Financial Center N.A. P.O. Box 900 Millsboro, DE 19966 Dear Mr. Flower: RE: Estate of John W. Fogleman, Jr. Date of Death: January 15, 2002 Social Security Number: 195-32-2316 In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following account. Account Ttjpe ........................... Certificate of Deposit/13 MOS/3.940000 AccountNumber. ...................... 87008140654795 Ownership (Names of) ...............John W. Fogleman, Jr. _Opening Date ........................... 01/15/97 Balance on Date of Deatlt. ., ...... $ Accrued Interest $ Total ....................................... $ 2,534.81 00.27 2,535.08 If you have any further questions on this account, please contact the branch of record: 344 South l0th Street, Lemoyne, PA 17043, telephone 717-737-3322. We have forwarded your request to close this account to them. Sincerely, Mary Anne Macielag Associate I/CIS (302) 934-2240 PNCBAN< t)bFHN I I'lbl',,I I 41~ (BD ~DD( April 29, 2002 Thomas E. Flower 2109 Market Street Camp Hill, PA 17011 Estatc of John W. Fogleman SSN: 195-322316 DOD: 1/15/2002 Dear Mr. Flower: In response to your request for Date of Death balances for the customer noted above, our records show the following: Certificate of Deposit Account # 31500086820 JOHN W FOGLEMAN JR DOD balance: $2,524.95 + $2.79 accrued interest Established 05/06/1997 Checking Account Account #5140344617 JOI-IN W FOGLEMAN IR DOD balance: $13,867.62 + $3.59 accrued interest Established 02/06/1989 Savings Accounts Account #5000939731 JOHN W FOGLEMAN JR DOD balance: $71,306.10 + $12.22 accrued interest Established 02/07/1997 Account #5130259005 JOHN W FOGLEMAN JR DOD balance: $2,034.25 + $0.73 accrued interest Established 02/06/1989 For Mortgage information, you may call 1-800-736-9090. MTG 0474268 page 1 'of2 Kelley Blue Book Used Car Values Page 1 of 1 New Car Pricing BuiM a Car Inc~ntJve~ My Car':S val~ua Used Car Retail Buy a Kew Car Buy a Used C~ S~I Your Car Hotorcyde~ financir~ Insura~e Lemon Check Wananties Car Reviews 'Car Pre~iews De¢i~ Guides A~ut kbb Home Blue Book Private Party Report Pennsylvania · May 3, 2002 1992 Pontiac Grand Prix LE Sedan 4D Engine: V6 3.1 Liter Trans: Automatic Drive: Front Wheel Drive Mileage: :1:16,234 Equipment Air Conditioning Power Steering Buy a New Car Buy a Used Car List Your Car For Sale Online Financing Quote Insurance Quote Warranty Quote Payment Calculator AM/FM Stereo Consumer Rated Condition: Good "Good" condition means that the vehicle is free of any major defects. The paint, body and interior have only minor (if any) blemishes, and there are no major mechanical problems. In states where rust is a problem, this should be very minimal, and a deduction should be made to correct it. The tires match and have substantial tread wear left. A clean title history is assumed. A "good" vehicle will need some reconditioning to be sold at retail; however major reconditioning should be deducted from the value. Most recent model cars owned by consumers fall into this category. Private Party Value $1,995 Private Party value represents what you might expect to pay for a used car when purchasing from a private party. It may also represent the value you might expect to receive when selling your own used car to another private party. Click to vi: Getl $~ ¢ 3rdPa USed Car Trade-In Value Get Invoice & MSRP on New Cars Copyright © 2002 by Kelley Blue Book Co., All Rights Reserved. May-Jun 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.02050) httv://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb;774511 &;p&723 ;Pontiac; 1992%20Grand%2... 05/03/2002 LAST WILL AND TESTAMENT JOHN W. FOGLEMAN, JR-. I, .John W. Fogleman, Jr., of Cumberland County, Pennsylvania, .being of .sound and~..disposing mind, memory and understanding, do hereby make, Publish and declare this as and for my Last Will and Tesba~nt, 5ereby' reV'oking all other Wills and Codicils. heretofore made by me. FIRST I direct the payment of my just debts and exp~nses of my last illness and...funera! .from my estate as soon after my death as conveniently may be done. SECOND It is my express desire that my benefiCiaries be allowed to choose personal items they may wish to retain, such personal items to be chosen in accordance with age, the oldest child choosing first, and to be divided in as nearly equal shares as possible. SAIDIS SHUFF, FLOWER & LINDSAY 2109 M.rket Street C~mp Hill, PA THIRD I give, devise and bequeath all the rest, residue and r~ma[nd~r of mY estate in equal shares unto my children, Christine M. Newsome, Michael W. stirpes. Fogleman and David J. Fogleman, per SAIl)IS SHUFF, FLOWER & LINDSAY 2109 Market Street C~unp ~ PA FOURTH Ail taxes imposed as a consequence of. my death shall be paid out of the residue of my estate and considered as a part of the cost of the administration of my estate. FIFTH. In addition to the powers conferred by law, I authorize any guardian, executor or executrix acting under this instrument, in any such fiduciary's absolute discretion: A. To retain any investments I own at my death and to invest in all forms of real and personal property, without being confined to investments authorized by a statutory list, without .being required to diversify and regardless of any principle of law limiting delegation of investment responsibility by any such fiduciary; B. To compromise claims and to abandon any property which, in any such fiduciary's opinion, is of little or no value; C. To sell at public or private sale, to exchange or to lease for any period of time, any real or personal property, and to give options for sales or leases; D. To join in any merger, reorganization, voting-trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto; E. To borrow from anyone, even if the lender is a fiduciary hereunder, and to pledge property as security for repay- ment of the funds borrowed; SAIl)IS SHUFF, FLOWER & LINDSAY 2109 M~rket Street Camp ~ PA F. To make loans to, and to buy property from, my sPouse's executor or administrator; G. To employ and to rely upon advice given by investment counsel, to delegate discretionary authority to make changes in investments to investment counsel, and to pay invest- ment counsel reasonable compensation in addition to any fees otherwise payable to any such fiduciary; H. To employ a custodian, to hold property unregistered ~or in the name of a nominee (including the nominee of any institution emPloyed as custodian), and to pay reasonable compensation to the Custodian in addition to any fees otherwise payable to any such fiduciary; I. TO. hold two or more accounts hereunder as a combined fund (allocating ratably to such accounts all receipts from, and expenses of, the combined fund) for convenience in investment and administration; provided that any combination of accounts for this purpose shall not alter their status as separate accounts; J. To distribute in cash or in kind; K. To renew or extend the time for payment of any obligation, secured or unsecured, payable to or by any such fiduciary for as long a. period or periods of time and on such terms as such fiduciary may determine and to adjust, settle and arbitrate claims or demands in favor or against them; and L. To exercise all elections which any such fiduciary may have with respect to income, gift, estate, inheritance and other taxes, including without limitation, execution of joint income tax returns, election to deduct expenses in computing one 3 SAIDIS SHUFF, FLOWER &LINDSAY ATIDRNEYS-AT, LAW 2109 M~rket Street Camp ~ PA tax or another, election to split gifts and election to pay or to defer payment of any tax in all events without any such fiduciary being bound to require contribution from any other person. SIXTH I do hereby nominate, constitute and appoint my son, Michael W. Fogleman, of Dover, Pennsylvania, to act as executor, of this my Last Will and Testament. If he is unwilling or unable to act as executor, I do hereby nominate, constitute and appoint my brother, Frank Fogleman, of Chambersburg, Pennsylvania, to act as executor. SEVENTH I direct that no personal representative, guardian, trustee or other fiduciary appointed under this instrument shall be required to give bond for the faithful performance of any such fiduciary's duties in any jurisdiction. IN WITNESS W-~EREOF, I, John W. Fogleman, Jr., have hereunto set my hand and seal to this my Last Will and Testament, this "/~t~ day of "~J~/7~;A~/) , 2001. /-' J'o~hn W/Foglema~.~, ar.- 4 SAIl)IS SHUFF, FLOWER & LINDSAY AT]DRNEYS,AT, IAW 2109 Marliet Street Cra-rip l'lill, PA Signed, sealed, published and declared by the above-named Testator, John W. Fogleman, Jr., as and for his Last Will and Testament in the presence of us, who have hereunto subscribed our names at his request as witnesses thereto, in the presence of said Testator and of each other. ~ ADDRESS 5 SAIDIS SHUFF, FIDWER & LINDSAY AI~ORI~'~(S*AT. IAW 2109 Market Street Camp ~ PA COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : WE, the undersigned, the Testator, and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sWorn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament and that he signed willingly (or willingly directed another to sign for him), and that he executed it as his free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator signed the will as witnesses and that to the best of their knowledge the Testator was at that time eighteen years of age or older, of sound mind, and under no constraint or undue influence. Witness Subscribed, sworn to and acknowledged before me by the Testator and subscribed and sworn to before me by both witnesses, this ~'J\ day of ~/~,~t,[' ~ ' , 2001. N;t ~-r~ Public 6 BUREAU OF INDIVIDUAL TAXES [NHERTTAHCE TAX DTVXSTON DEPT. 26G601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE NOTICE OF INHER/TANCE TAX APPRAISEMENT, ALLOWANCE OR D/SALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-l;47 EX AFP THOMAS E FLOWER ESQ'0~ SAIDIS ETAL 2109 MARKET ST CAMP HILL JiJL -'! P~,~!~011 DATE 06-Zq-2002 ESTATE OF FOGLEMAN DATE OF DEATH 01-15-2002 FZLE NUMBER 21 02-0099 COUNTY CUMBERLAND ACN 101 I Amoun~ Reai~ad JOHN W MAKE CHECK PAYABLE AND RENZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THZS LZNE ~.~ RETATN LOWER PORTZON FOR YOUR RECORDS ~-~ REV-1547 EX AFP (01-02) NOTZCE OF TNHERZTANCE TAX APPRAZSEMENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FOGLEMAN JOHN WFZLE NO. 21 02-0099 ACN 101 DATE 06-24-2002 TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATZON CONCERNTNG FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Rial Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Partnarship Interest (Schedule C) ($) 4. Nortgages/Notas RaceAvabla (Schedule D) (4) $. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (S) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) B. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS= 9 Funeral Expanses/Adm. Costs/Nisc. Expenses (Schedule H) (9) 10 Deb~s/Hortgage Liabilities/Liana (Schedule I) 11 Total Deductions 12 Net Value of Tax Return 51~226 88 O0 O0 O0 96/78Z.$$ O0 O0 (8) 9,371.5Z (10) 887.54 NOTE: To Ansure proper credAt to your account, submit the upper portion of this form with your tax payment. 15 NOTE: 148,009.21 ZF PAID AFTER DATE /NDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (15) .00 X O0 = .00 (16) 1:57,750.15 X 045= 6,198.76 (17) .00 x 12 = .00 (18) .00 x 15 = .00 (19)= 6,198.76 ANOUNT PAID 5,900.00 :5.76 TOTAL TAX CREDIT 6,213.70 I BALANCE OF TAX DUEI 14.94CR XNTEREST AND PEN. .00 TOTAL DUE 14.94CR ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT IS REQUIRED. ZF TOTAL DUE 1S REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTZONS.) ASSESSMENT OF TAX: 15. Aaoun'l: of Line 14 at Spousal rate 16. Amount of Line 14 taxabXa at LAneal/Class A rata 17. Amount of Line 14 at SiblAng rate 18. Aaount of LAne 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: PAYHENT RECE-r, DISCOUNT (+) DATE NUNBER INTEREST/PEN PATD (-) 04-11-2002 CD001057 $09.94 05-15-2001 CD001174 .00 CharitabXe/Governmantal Bequests; Non-eXacted 9113 Trusts (Schedule J) (13) . O0 Net Value of Estate Subject to Tax (14) 157,750.15 zf an assessment ~as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 ~ill reflect figures that include the total of ALL returns assessed to date. (11) l§ .25g. fl& (12) 157,750.15 RESERVATION: Estates of decadents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class 8 (collateral) beneficiaries of tho decedent after tho expiration of any estate for life or for years, the Commonwealth hereby expressly reserves tho right to appraise and assess transfer Inheritance Taxes at the 1aclu1 Class D (collateral) rate on any such futura interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill tho requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (TZ P.S. Section 91qO). Detach the tap portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NILES, AGENT A refund of a tax credit, which was not requested on the Tax Return, amy be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special lq-hour answering service for forms ordering: 1-800-36Z-ZO50~ services for taxpayers with special hearing and / or speaking needs: 1-800-qq7-3OZO (TT only). Any party in interest not satisfied with the appraisement, alloaanca, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171ZB-lOZ1, OR --eIection to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviee Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6S05. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid aithin three (3) calendar months after the docedent's death, a five percent (SI) discount of tho tax paid is allowed. Tho 1SI tax amnesty non-participation penalty is computed on tho total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the seam manner and in the tho same tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning eith first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .00016~. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 20Z .0005~8 1992 92 .O00Z~7 1983 162 .000~38 1993-1994 7Z .O0019Z 1984 llZ .000301 1995-1998 9Z .000247 1985 13Z .0003S6 1999 7Z .O0019Z 1986 lOX .000Z74 2000 8Z .O00Z19 1987 9Z .000Z47 ZOO1 9Z .000Z47 1988-1991 llZ .000301 200Z 6Z .000164 --Interest is calculated as folloas: INTEREST = BALANCE OF TAX UNPAID X NU)IBER OF DAYS DELINOUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (153 days beyond the data of the assessment. If payment is made after the interest computation data shown on the Notice, additional interest must be calculated. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: John W. Fogleman, Jr. Date of Death: January 15, 2002 No. 21-02-0099 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X; No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes_; No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X; No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. S)'~nhture Name: Thomas E. Flower, Esquire I.D. No. 83993 SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: Personal Representative X Counsel for Personal Representative