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HomeMy WebLinkAbout03-0508PETITION FOR PROBATE & GRANT OF LETTERS ADMINISTRATION Estate of DOROTHY M. KOHL also known as Social Security No. 195-28-1051 , deceased. No. 21-03- 50~ To: Rogistor of Wills for tho County of Cumberland Commonwealth of Pennsylvania C'72A The Petition of the undersigned respectfully represents that: Your Petitioners, who is 18 years of age or older and a residual heir named in the Last Will of the above decedent dated June 23, 1984 , and codicils dated none . The Executor named (3. Larry Kohl died March 30, 1999 Renunciations for ^llfirst Trust Co. of Pennsylvania NA, formerly known as F.M.B. Bank, successor by merger to Dauphin Deposit Bank & Trust Company attached hereto. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 210 B .q Spring Road, Newville, West Pennsboro Township Decedent, then 96 years of age, died 210 Big Spring Road, Newville, Pennsylvania January 18 ,2003, at Green Ridge Village, Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the Will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in PA (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania, situated as follows: SI6,000.00 $ $. WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented herewith and grant of letters of administration c.t.a, thereon. Signa. t, qre(s) and Residen.ce(s) of Petitioner(s~1 Carol K. Smith P.O. Box 227 St. Mary's,. PA 15857 814-781-1726 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA · COUNTY OF CUMBERLAND · SS The Petitioner(s) above named swear(s) or afffirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that as personal representative of the above decedent, petitioner(s) will well and truly administer the estate accordin,~to law. Sworn to or affirmed and subscribed before me this 2 3 rd day of June ,2003. Carol K. Smith Donna M. Otto, 1st D~pu/c!~egi.~/~.,~.~, i7 1 7-9 No. 21-03- 5o8 Estate of DOROTHY M. KOHL · deceased. DECREE OF PROBATE & GRANT OF LETTERS C.T.A. AND NOW, June 23rd , 2003, in consideration of the Petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated June 23, 1984 described therein be admitted to probate and filed of record as the Last Will of Dorothy M. Kohl ; and Letters of Administration c.t.a, are hereby granted to Carol K. Smith FEES Probate, Letters, Etc ........ $.50.00 Short Certificates(-2-) ....... $6.00 Renunciation(s) ~.: ) ........ $5.00 JCP .................... $10.00 Other Will pages (-1-) .... $. 3.00 TOTAL: .... $ 74.00 Filed..J.uo.e..2.3..rd~.,.2. OQ .3 ............ Register of Wills / Donna ,M. Otto, 1st Deputy IRWIN McKNIGHT & HUGHES James D. Hughes, Esquire (58884) ATTORNEY (Sup. Ct. I.D. No.) 60 West Pomfret St., Carlisle, PA 17013 ADDRESS 717-249-2353 PHONE Call Attorney on 6/23/2003. REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that present and saw the testat. , sign the same and that signed as a witness at the request of testat__ in h presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19.__ Register (Name) /Address) (NamO ~ (Address) ~ ?- 21-2003-508 REGISTER OF WILLS OF CIIM~RI.AI~I~ COUNTY OATH OF NON-SUBSCRIBING WITNESS James D. Hughes and Carol K. Smith , (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that they are familiar with the signature of Dorothy M_ W'nh] , x~ testat rix of (Otn~.X:Ofx:gl~xr, f~gxm~it~te~e~xl~) the will presented herewith and ~x that each believes the signature on the will is in the handwriting of Dorothy M. Kohl to the best of thier knowledge and belie Sworn to or affirmed and subscribed before _his 23rd day of / J aes~~ (Name) Hug"es June ~/r~ ~ ,. t /¥1:9 2003 / 60 Wi/l~omfret St.. Carlisle. PA Donna M. Otto,ist Deputy ??'~~ Carol K. (Name) - Smith '~'-/--- ~/ P.O. Box 227, St. Marys, PA 15857 (Address) 21-2003-508 RENUNCIATION In regard to the Estate of To the Register of Wills of DORTHY M. KOHL deceased. Cumberland County, Pennsylvania. The undersigned of the above decedent renounce(s) the right to administer the estate and respectfully ask(s) that Letters Testamentary be issued to Carol K. Smith hereby WITNESS hand(s) this c,~-/ day of May, 2003 jq//~ ALLFIRST TRUST CO. OF PENNSYLVANIA, NA; formerly known as F.M.B. Bank successor ~-- by merger to D~phin Dep,~sit Bank & Trust Co. L~eart~a k. Well~ Nofaly Public ~:1~.O. Box 2961; Harrisburg// PA 17105 ADDRESS SIGNATURE ADDRESS SIGNATURE ADDRESS 21-2003-508 LAST WILL AND TESTAMENT OF DOROTHY M. KOHL I, DOROTHY M. KOHL, presently residing and domiciled at 1020 North Union Street, Apt. 504, Middletown, Pennsylvania, declare this to be my Last Will and hereby revoke all Wills which I have )reviou sly made. ITEM I: I appoint my son, G. Larry Kohl, and Dauphin Deposit Bank & Trust Company as Executors of my estate. If my son is unable to serve in this capacity or does not desire to assume the responsibility the institutional Executor alone shall serve. ITEM II: I give the residue of my estate of whatever nature and wherever situate in equal shares to my son, G. Larry Kohl, and my daughter, Carol K. Smith. Should either of my children predecease me leaving issue to survive my death, the issue shall take the parent's share, per stirpes. Should either of my children predecease me without leaving issue to survive my death, the residue of my estate shall be distributed to the child who survives my death, or his issue then living, per stirpes, as the case may be. ITEM III: I direct that all taxes that may de assessed in consequence of my death, of whatever nature and by ~hatever jurisdiction imposed, shall be paid from my residuary state as a part of the expense of administration of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ .... day of ~ ~.0 , 1984. DOROTHY M. K ~O~ ~ (SEAL) The preceding instrument, consisting of this, and one other -_ypewritten page, each identified by the signature of the Testatrix, was on the date thereof signed, published and declared by DOROTHY M. KOHL, the Testatrix therein named, as and for her Last Will, in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses hereto. : ~ Residing at sr. 0 0 0 0 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Estate No.: DOROTHY M. KOHL JANUARY 18, 2003 21-03-0508 To the Register: I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on August 11,2003 . Name Address Michael L. Kohl David S. Kohl Kevin P. Kohl Carol K. Smith 4803 Los Alametos, Midland, TX 79705 216 Ivy_ Lane, Apt. 201, Boeme, TX 78006 4803 Los Alametos, Midland, TX 79705 P.O. Box 227, St. Marys, PA 15857 Notice has now been given to all persons enti~e 5.6(a) except none. Date: 08/11/03 [ i~7' MfKNIG~}'I.T & HUGHES  e James D. Hughes, Esquire Address 60 West Pomfret Street Capacity: Carlisle, PA 17013 Telephone (717) 249-2353 X __ Personal Representative 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 003031 HUGHES JAMES D ESQUIRE 60 WEST POMFRET STREET CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 195-28-1051 FILE NUMBER: 2103-0508 DECEDENT NAME: KOHL DOROTHY M DATE OF PAYMENT: 09/18/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01 /18/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $770.00 REMARKS: TOTAL AMOUNT PAID: JAMES D HUGHES ESQUIRE $770.00 SEAL CHECK# 020243 INITIALS: VZ RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV- 1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21-03-0508 COUNTYCODE YEAR NUMBER SOCIAL SECURITY NUMBER 195-28-1051 T A X HARRISBURG, PA 171Z8-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Kohl Dorothy M. DATE OF DEATH (MM-DD-YEAR) J DATE OF BIRTH (MM-DD-YEAR) 01/18/2003 J 02/08/1906 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) D E C E D E N T R 5. E C A 6. P I T U 7. L A T 8. cAPB HpRL EpIO CRAC voTK c o R R E S I o N c o M T I 0 N ~ 1- Origir~a, Return ~ 41! Supplemental Return 4. Limited Estate · Future Interest Compromise (date of death after 1Z- 12-82) 6. Decedent Died Testate · Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) [~]9. Litigation Proceeds Received r~ 10. Spousal Poverty Credit (date of death between 1:>-31-91 and 1 - 1-95) NAME James D. Hughes Esq. FIRM NAME (If Applicable) IRWIN McKNIGHT & HUGHES TELEPHONE NUMBER 717,/249-2353 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or (3) Sole -Proprietorship Mortgages & Notes Receivable (Schedule D) (4) Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) Jointly Owned Property (Schedule F) (6) ~ Separate Billing Requested Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 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 Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11 )  (date of death 3. Remainder Return prior to 12-13-87) 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS 60 West Pomfret Street West Pomfret Professional Bldg. Carlisle, PA 17013 OFFICIAL USE ONLY No~.p N6he None None 613.42 None 16,172.24 855.00 2,836.14 (8) 16,785.66 (11) 3,691.14 (12) 13,094.52 (13) (14) 13,094.52 (15) O. O0 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) (16) 589.25 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) X .0 0 16. Amount of Line 14 taxable at lineal rate 13,094.52 X .0 45 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 19. Tax Due (17) 0.00 (18) O. O0 (19) 589.25 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 210 Big Spring Road CITY I STATE ZIP Newville IPA 17241 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 770.00 (1) 589.25 770.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 0. O0 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) 180.75 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (54) 0.00 B. Enter the total of Line 5 + 54. This is the BALANCE DUE. (SB) 0. O0 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 . retain the use or income of the property transferred; ......................... ~ ~ . retain the right to designate who shall us~ 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? ................................ [] ~'J 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 schedules and statements, and to the best of my knowledge and belief, it is true, Total Credits ( A + B + C ) (Z) correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Ce.re1 K. Si~il;h DATE · ' P 0 Box 227 SIGNATURE OF i)~I~/~ER'OTHE~THAN RE IRWIN HcKNIG ~i~,at~ O~'or aftel J~l~' 1, ~1994 and before January 1, 19951 the tax rate imposed o; the net value of transfers to or f0'r'the use of the surviving ~ouse is 3% [72 P.S. 9116 (a)(1.1) (i)l. o ~~or d s of death on or after January 1, 1995, the tax rate imposed on the net va ue of transfers to or for the use of the surviving spouse is 0 Ye ~q6-(a) (1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. 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 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. Form REV-1500 EX (Rev. 6-00) Copyright (c) 2000 form software only The Lackner Group, Inc. REV-' 1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSI'rS, & MISC. PERSONAL PROPER'rY FILE NUMBER Dorothy M. Kohl SS~/ 195-28-1051 01/18/2003 21-03-0508 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 NUMBEF DESCRIPTION 1 Allfirst checking account TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 613.42 $ 613.42 Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) REV-~S,0 EX*/~-9;) SCHEDULE G COMMONWEALTH OF PENNSYLVANIA INTER-VIVOS TRANSFERS & INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Dorothy M. Kohl SS~/ 195-28-1051 01/18/2003 21-03-0508 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE. ' VALUE OF ASSET INTEREST (IF APPLICABLE) 1 M&T Investment Group 16,172.24 16,172 24 Trust Under Agreement ' (Revocable) TOTAL (Also enter on line 7, Recapitulation) $ 16,172.24 more space ~s needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1510 EX (Rev. 1-97) REV'- 1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Dorothy M. Kohl SS# 195-28-1051 Debts of decedent must be reported on Schedule I. ITEM NUMBER SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS 01/18/2003 FILENUMBER 21-03-0508 DESCRIPTION FUNERAL EXPENSES: ADMINISTRATIVE COSTS: 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's Fees IRWIN McKNIGHT & HUGHES 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 Register of Wills Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Register of Wills filing fee Vital Records death certificates TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 750.00 74.00 25.00 6.00 $ 855.00 Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) REV'-151Z EX + (1-97) SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN RES~DE.TDECEOENT MORTGAGE LIABILITIES, AND LIENS ESTATE OF Dorothy M. Kohl SS~/ 195-28-1051 01/18/2003 FILE NUMBER 21-03-0508 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Continuing Care RX 2 3 Promed Services Swaim Health Center TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 165.24 39.95 2,630.95 $ 2,836.14 Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV;1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Doro' M. Kohl SS~/ 195-28-1051 01/18/2003 NUMBER I. 2 I1. SCHEDULE J BENEFICIARIES 4 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [J~lude outright spousal distributions, and transfers under S~. 9116(aX1.Z)] David S. Kohl 216 Ivy Lane, Apt. 201 Boerne, TX 78006 Kevin P. Kohl 4803 Los Alamitos Midland, TX 79705 Michael L. Kohl 4803 Los Alamitos Midland, TX 79705 Carol K. Smith P.O. Box 227 Saint Marys, PA 15857 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Grandson Grandson Grandson Daughter FILE NUMBER 21-03-0508 AMOUNT OR SHARE OF ESTATE 1/6 remainder 1/6 remainder 1/6 remainder 1/2 remainder ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 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 DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) 0.00 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) LAST WILL AND TESTAMENT OF DOROTHY M. KOHL I, DOROTHY M. KOHL, presently residing and domiciled at 1020 North Union Street, Apt. 504, Middletown, Pennsylvania, declare this to be my Last Will and hereby revoke all Wills which I have previously made. ITEM I: I appoint my son, G. Larry Kohl, and Dauphin Deposit Bank &'Trust Company as Executors of my estate. If my son is unable to serve in this capacity or does not desire to assume the responsibility the institutional Executor alone shall serve. ITEM II: I give the residue of my estate of whatever nature and wherever situate in equal shares to my son, G. Larry Kohl, and my daughter, Carol K. Smith. Should either of my children predecease me leaving issue to survive my death, the ~lssue shall take the parent's share, per stirpes. Should either of my children predecease me without leaving issue to survive my ~ideath, the residue of my estate shall be distributed to the child l~bo survives my death, or his issue then living, per stirpes, as ilthe case may be. ITEM III: I direct that all taxes that may i~e assessed in consequence of my death, of whatever nature and by h~ atever jurisdiction imposed, shall be paid from my residuary state as a part of the expense of administration of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this _- day of ,~,~i , , 1984. DOROTHY M. KO~ (SEAL) The preceding instrument, consisting of this, and one other typewritten page, each identified by the signature of the I~.estatrix, was on the date thereof signed, published and declared !by DOROTHY M. KOHL, the Testatrix therein named as and for her fLast Will, in the presence of us, who at her request, in her resence and in the presence of each other, have subscribed our llnames as witnesses hereto. jj j 'f-~'--"~ ~'"-' ~d~~ · Residing at ~ u., ~' ~' ~.( 'x. ~ ~,. a~.~.; ' ~ x~ l /~ ~/':LL~'A REVOCABLE TRUST AGREEMENT by and between DORO'I'B~ M. KOitL Settlor and Dauphin Deposi~ Bank and Trust Company, Tmst~, 7/89 ~o~O~ ~. 1~o~I. (Settlor) of XI~D~EI'0~N, PA ~r~by ~ to Daup~ De.sit ~ ~ T~t Com~an~ (herem~ter ca~ o. n~r~ contempor~eo~ly h~~ or at su~ time or ~es ~eat~r. to ~ ~M m in~st m~ follows: FIleT: l.)ifFositive Provisions For My l~nefit: During my lifetime: A, All of the net income sh~l be paid to me at least quarterly or st/all bo paid nr ~,ccumulated and added to principal, as I may direct ]~ writin$,; B.A.s _much of the principal a~ I may from time to time request in wrignff shall he paid to me, or as I may utherwi.te' direct; . C. If, tn the Trustee's o]~inion, I am ~,t ~nv time unable to act or to apvlv the p.aymen~s to rn.v own host interest and advmttage, the Trustee _may ap'E~y directly for my benefit as much of the income and/or principal aa tim ~'u.stee may, from time to I/me, c[~n ap~?.opriate for my welfare, comfort, ~upport or e .m.~rgen .c3r n. eed. s, d/rectly and w~thout the intervention of a guardian, and may add to prmc~p~ ~.~ muck of the incon~ m tho 'frust~ dc~n~ ad~rt~.ahln. D. T~xmtee ~haJl keep true ~nct correct book~, of ~ccount, wh/ch bool~ of account shall .at. aJ~, reasonable times_be open to the inspection of Settlor or his duly appmntea r. epr .esentative. Trustee ~lmll ~,o quarterly render Settlor a detail, ed stat. e .mont showang all receipts and disbursements on account of the trust estate and the manner and form in which the trrmt et~ti~te is inve~ted at the time of the rendition of such statement. SECOND: Oispositive imvi~ions A~te~ My Death. l. rpon my deattt wl~ile the tnmt continues, the Trustee shall pay th~ th~n-renxaining principal and income to my Executor or Admi~t~ator for disposition as part of my Estate. THII~. -- Ril~t to Revoke/md .A~, end: I re,~rvc the risht to revok~ or amend this trust, m wh.vl~ or hr part, at mty time and from time to Ume by an imtrument in wrtttn_g.; deli.vet.ed .tn the Trustee and httended, to take effect during my lifetime; except mat t~te auues, powers ~nd liabiliti~ of the Trustee shall not be changed ,~w~,.~o. ut its ,written co .n?ent. The Tn~steo reserves the ligl~t, at any time upon thir~ ioo~ days advance written notice to me, to resign the trust az~d deliver the trust estate to me, alter deductinlg them/rom its fees and any o.~penses thea~ due and payable. FOURTH: Additions to Trust; Subject to the approv~ of the 'trustee, either I or azty other ~rdit-jr r~a? add l~roperty, real mxd Fcr~onal, fo the principal of ~ ~rust. FIFrH: tmstee's Powers: Ill udditiol~ £o the power~ ~?nted by law, my Trustee sh?l,ha,ve..rh.e foliowi.'n~.disc.r.etio .n~-y pow?r~, apFlicavle to principal and incomc, wtuctt ShaLl. oe pxerClSnole w~t~tout leavo, ot court and ulmll co~tti~ue urttil dislTibutinn is actually made_' ~ To. accept and.retaiz}..any or .all pr?per?at arty t~me hereafter delivered or m _ ,v ?met I~tanner ~.e. re~tter acquared, including stock or other securities of zru.stee, or of a holaml~ company controlling the Trustee:. B.. To invese in ail forms of properer (including, but ~ot by way of limitation, [eal.e,stat~ all ,hrpes of atocl?, bonds; option~, and particil:~ition~ in common r__r~__t z~t_~s~a~m ~.m.z~ey u?r~t fun.ds); without being coruEinec[ to investments pre.smveu ay stature aaa wnnout being required to diversi/7; C. To buy investments ar a premium or cttscount; D. To ttoid propert~r unregiatered or xtt the name of a nnmtnee; E. To give proxies, both ministerial and disCretionary; To compromise claims; G. To join in any merger, Consolidation, reorganization, voting trust plan, or w~tn respect r. nereto; H.. To bo ~n'ow from Daupki~. Deposit Bank and Trust Company or from others, and to. pleage real o.r persona/prOlr~_r~ as securi? therefor; to loan cash or ~-~'untic~ upon ~uch ter~m and conditions as trustees deem appropria~. L To sell at public or private sale for cash or credit or partly for each eo exclmnge, to ~improve or to lease for any perio~l of time, any r-cai or personal property; and to give optiom for ~alt~, e~'clmg,m, or J. To allocate any Erope_rty r~,c~.tvpd or charge recurred to Erincipal or incom~ or partly to each, without being obliged to apply the usual rt~le~ o1' Lru~t accounhng; K. To distribute in cash or in kind or partly in eactt; L. _To retain anypart or all of my busings interests held in ~ 'l'r~st as long as the trustee considers it advisable't0 do so; and to conduct, alone or with other~, an.,.v, such bu~'.mess in whid~ I am. engaged, with ail the power~ of an owner or w~m rospect thereto, including the power to delegate discretionary duties to others and to pay ~decluatp compensation ro any such person; to ilxv~st other property in sucl~ business, and ~o incorporat, it or change its form. SIXTH: Compensal/mu The tru~ee ~.Imll be com~ed ~dard s~ed~e of se~s, a~ ~ cum~fion a~ be p~d ~ p~ap~ or income or ~a~lv ~om each r~ei~ ot T~tee s ~nt f~ ~e. S£VENTH: Non-Aseil~ment: No part of the income ur pr/ndpal of the property held under hhis Trust ~ be subje& to attachmetqt, levy or seizure by aav creditor, ~l>OUSe, a.ssi~nec or .t~"u~_tee or receiver in banknTtey prior [o act~lal receipt ~hered. The Tnmtee shall pay' over the net income and-the princi.'pal to tile persons he. zeht desi&na~ed, as their interests may appear, wi6~ut resard, to any atte.mpted anticipat~un (except aa apeciacally pr'owded in this a~reement), - pledgLng or a~il~xnent uitdel' Ilxe ~'rust, and ~ithout rcKazd to an}, claim the:eto or atten~ted levy, attachment, aeizure or other proce~ a~nst me. EIGHTH: Guazdia~l~_'l~: I/at any, time hereafter, a proceedin~ ia initiated in any, jurLsdiction to have a Guardian appointed for my estate, iL is n? expresa intention _flint U~e Court making such a determination, .appo~t Dauphin Depoait lhnk and Tnlat Coml~my, ot il~ succe~or, as the Guard/an of my estate. NINTH: Law Govenfing Tma~ This truat is created and accepted in the Commonwealth ot Permsy'lvania and shall in all respects be l~verned by' its laws and shall hav~ irs situs at cIA~m~ County, Fezm.~lvania. ~/xecut~i on ~.~~, 19~ Before executing this document vou may wane to consult with your ALLo~tey to ' aa~Lre that your wishes are being ~et forth -ccu~tely grid m proper lesal ~n'n. The/orel~oin§ trust is hereby accepted. Executed, on /~3~o DaupIfin Deposit Bank and Trust Company Vice P~esident and Trust Df&er WrrNESS my hand and notarial se~. My Cdn'ullission Expires: I/CH~DUI,B $3.2,000. $10.000. $ 8,000. SZO,O00. $14,00fl. $16,000, $11,000. $ 7,UUU. $12,000. Dauphin Deposit Ban~ Cerr/flcate or Dupu~it, 0.0§% due 7/2/03, #93172, dated ?/2/91 (new #~0N0239841, 3.90%, due 7/2/93 Dauphin Depos/t Bank CerUficate of Deposit, 6.25%, due 8/8/92, #93143, dated 6/8/91 (new #8000213768, 3.6~%, due 10/8193) Dauphin Deposit Bank Certificate of Deposit, 4.10~, due 1/2/93, #J. O52NO, dated 1/2/93 (new ~1961106300, 3.25% duo 1/2'/94) Dauphin Deposit Bank Certi6aste of Deposit. 4.10%, due 1/2193, ~106201, dated 1/2/92 (now ~tSNflN240029. 3.:/5%, due 1/3/94) Dauphi~t Deposit Bank Certificate of Deposit, 8%, due 8/Z5/91, #70480, dated 7/35/90 (new #8000242907, 3.35%, Z/2519~) Dauphin Deposit Bsnl~ Certificate uf Deposit, ?.85%, due 10115/91, #70529, dated 8/15/'90 (new //8000242966, 3.35%, due 3/'16/0~) Dauphin Deposit Bank Ce~Hfieate' of Depnntt, 7.8~%, due 10/16/91, #70532, dated 8/16/90 (new #800024:2974, 3.35% due 2116/94) Dm~phin Depvslt Bank Certiflcatc of Deposit, 7.85~, dU~ 11126/91, #77401, dated 9/26/90 (new #80002430?5, 3.35%, due 3/28/94) Cheek #119 - dated 51~19~ Jacqueline Drawbaugh From: Sent: To: Subject: James D. Hughes (External) Friday, October 17, 2003 2:40 PM Jacqueline Drawbaugh FW: Dorothy Kohl, T/A We,4dy COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 'L Carol K. Smith being duly sworn according fo law, deposes and says that she is the Administratrix C.T.A. of the Estate of Dorothy M. Kohl late of __ _W_e_$JL~Pe_nn~s_boro ~own~shJ. p , Cumberland County, Pa., deceased ~nd fhef fha within is an inventory made by Carol K. Smith , the said ~tratr~ C.T.A. of the enflre estate of said decedent, consisting of all +he personal property and real estate, except real estate oufslde the Commonwealth of Pennsylvania, end fhef the figures opposite each item of the Inventory represent it's fair value as of the date of decedenf's death. Sworn and subscribed before me, this /0 day ok r, Carol K. Smith, Administratrix C.T.A. P. O. Box 227 Saint Marys, PA 15857 Addre,, Date of Death 18 O1 2003 Day Month Year INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed wifhln thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduclar~es Act of 1949. ? O O Inventory of the real and personal estate of DOROTHY M. KOHL deceased 1. Allfirst - Checking Account ........................ TOTAL ................. 4I 613 613 BUREAU OF ZNDZVZDUAL TAXES ZNHERZTANCE TAX DTVTSZON DEPT. 28060! HARRTSBURG, PA 17128-0601 COHNONWEALTH OF PENNSYLVANZA DEPARTNENT OF REVENUE NOT/CE OF /NHERZTANCE TAX APPRAZSENENT, ALLONANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSNENT OF TAX JAMES D HUGHES ESQ IRWIN ETAL 60 W POMFRET ST CARLISLE PA 1701:5 DATE ESTATE OF DATE OF DEATH FZLE NUMBER COUNTY ACN 12-29-200:5 KOHL 01-18-200:5 21 0:5-0508 CUHBERLAND 101 Amount REV-].;~? EX AFP (01-05) DOROTHY M HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGZSTER OF WZLLS CUMBERLAND CO COURT HOUSE CARLZSLE, PA 1701:5 CUT ALONG THZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~ REV-15q7 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLOWANCE OR ESTATE OF KOHL DZSALLOWANCE OF DEDUCTZONS AND ASSESSNENT OF TAX DOROTHY HF~LE NO. 21 0:5-0508 ACN 101 DATE 12-29-200:5 TAX RETURN NAS: (X) ACCEPTED AS FZLED RESERVAT]:ON CONCERNZNG FUTURE ~NTEREST - SEE REVERSE ( ) CHANGED APPRAZSED VALUE OF RETURN BASED ON: ORZGZNAL RETURN 1. Real Estate (ScheduZe A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership ZnterBst (Schedule C) ($) fi. Mortgages/Notes Receivable (Schedule D) (fi) 5. Cash/Bank Deposlts/NLsc. PersonaZ Property (Schedule E) ($) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTZONS AND EXENPTZONS: 9. Funeral Expenses/Ada. Costs/M/sc. Expanses (Schedule H) (9) 10. Debts/Mortgage L/ab/lit/es/L/ans (Schedule 1) (10) 11. Total Deduct/ohs 12. Net Value of Tax Return 61:5.q2 .00 .00 NOTE: To /nsura proper .00 cred/t to your account, .00 subm/t the upper port/on .00 of th/s form w/th your tax Payment. 16z172.2~ (8) 16,785.66 855.00 2,8:56.1q (11) . ~.~9].]q 1:5,09q.52 RECE].PT NUMBER CD00:50:5]. OZ$COUNT ZNTEREST/PEN PAZD (-) .O0 TOTALT-~'~---CR-'~'~'~T BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. 770.00 180.75CR ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS RE~UZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORN FOR ZNSTRUCTZONS.) TAX CREDZTS: PAYHENT DATE 09-18-200:5 (12) 15. Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 lq. Nat Value of Estate Subject to Tax (1~) 13,09q.52 NOTE: Z~ an assessment was issued previously, lines lq, 15 and/er 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSNENT OF TAX: " 15. Amount of L/ne lq at Spousal rata (16) .00 X O0 = .00 16. Amount of L/ne lq taxabZe at L/neaZ/CZass A rata (16) 1:5,09q.52 X Oq5: 589.25 17. Amount of L/ne lq at S/bl/ng rata (17) .00 X 12 = .00 18. Amount of L/ne lfi taxable at Collateral/Class B rata (18) .00 X 15 O0 19. Pr/nc/pal Tax Due = ' 589.25 RESERVATION: Estates of decedents dying on or before December 1Z, lgeg -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after tho expiration oF any estate for life or for years, the CoamanHaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laeful Class B (collataral) rate on any such Future interest. PURPOSE OF NOTICE: To ~ulfill the requirements of Section glqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Sect[on 91qO). PAYMENT: Detach the top portion of this Notice and submit Hith your payment to the Rmgistmr of Nills printmd on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT REFUND (CR): A refund of a tax credit, Hhich Has not requested on the Tax Return, may be requested by completing an "Application for ReFund of Pennsylvania Inheritance end Estate Tax" (REV-X313). Applications arm available at tho Office of the Register oF Hills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour ansHering service for forms ordering: 1-800-36Z-ZOSO~ services For taxpayers Hith special hearing and / or speaking needs: 1-BOO-q47-30ZO (TT only). OBJECTIONS: Any partY in interest not satisfied Hith the appraisement, alloHancm, or disalloHanca oF deductions, or assessment of tax (including discount or interest) as shoHn on this Notice must object eithin sixty (60) days of race[pt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 17128-10ZI, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in eriting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment RavieH Unit, Dept. ZB0601, Harrisburg, PA 171ZB-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions far Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid aithin three (3) calendar months after the dacedent's death, a five percent (SI) discount of the tax paid is alloHed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the First day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you Hould appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning Hith first day oF delinquency, ar 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 (eX) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z Hill bear interest at a rate which will vary from calendar year to calendar year Hith that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO3 ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate_ Factor Year Rate Factor 1982 gOZ .O00S4B 1987 9Z .000247 1999 7X .00019Z 1983 16X .00043B 1988-1991 llX .000301 ZOO0 8Z .000Z19 1964 112 .O0030X 1992 92 .000247 ZOO1 92 .000247 1985 13Z .000356 X993-1994 7Z .00019Z ZOOZ 6Z .000164 1986 XOZ .000Z74 1995-1998 9Z .000Z47 2003 5Z .000137 --Interest is calculated as folloHs: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (IS) days beyond the date of the assessment. If payment is made after the interest computation date shoHn on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES ,INHERITANCE TAX DZVTSZDN DEPT. Z8060! HARRISBURG, PA 171Z8-0601 C011110NWEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT JANES D HUGHES ESQ IRWIN ETAL 60 W PONFRET ST CARLISLE .~. ~ O~lATE Wills ESTATE OF DATE OF DEATH FZLE NU11BER p1 PA 17oz$ct;mba¥;~,~ Co., PA 02-02-2004 KOHL 01-18-2005 Z1 05-0508 CU11BERLAND 101 Amount: Rem/'l:'l:ed I~EV-I~I? EX AFP (11-65) DOROTHY N 1lAKE C11ECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF WILLS CUNBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper cred/~ ~o your account, submi~ ~he upper por~:ion of ~his fore wi~:h your ~ax payment. CUT ALONG THIS LZNE I1~ RETAIN LOWER PORT'rON FOR YOUR RECORDS REV-1607 EX AFP (01-03} """ ]:NHER'rTANCE TAX STATENENT OF ACCOUNT ESTATE OF KOHL DOROTHY II FILE NO. 21 05-0508 ACN 101 DATE 02-02-2004 TH'rs STATEHENT TS PROVTDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACH TN THE NAHED ESTATE. SHOI./N BELON ZSA SUHHARY OF THE PRZNCZPAL TAX DUE, APPLZCATZON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPL/CABLE, A PROJECTED INTEREST FZOURE. DATE OF LAST ASSESS11ENT OR RECORD ADJUST11ENT: 1Z-Z9-2005 PRINCIPAL TAX DUE: PAYHENTS (TAX CREDITS): PAYNENT RECEIPT DISCOUNT (+) DATE NUN~ER INTEREST/PEN PAID (-) A110UNT PAID 09-18-2005 CD005051 .00 01-12-2004 REFUND .00 ZF PAID AFTER THTS DATE, SEE REVERSE 770.00 180.75- TOTAL TAX CREDIT BALANCE OF TAX DUE 589.Z5 .00 589.25 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ~F TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS RE~UZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT' YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR ~NSTRUCTZONS. INTEREST AND PEN. TOTAL DUE .00 .00 PAYNENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESZDENT DECEDENT make check or money order payable to: REGZSTER OF HZLLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: CONNONNEALTH OF PENNSYLVANZA. REFUND (CR): A refund of a tax credit, Nhich Nas not requested on the Tax Return, may be requested by compXating an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-iS13). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices or from the Department's [4-hour ensnaring service for forms ordering: 1-800-36Z-[OeO; services for taxpayers Nith special hearing and / or speaking needs: 1-800-447-3020 (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessqaent RevieN Unit, Dept. 180601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid Nithin three (3) calendar months after the decedent"s death, a five percent (5Z) discount of the tax paid is ailoNed. PENALTY: The lex tax amnesty non-participation penalty is computed on the total cf the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. iNTEREST: interest is charged beginning Nith first day of delinquency, or nine (9) months and one ri) day frae the date of death, to the date of payment. Taxes ~hich became delinquent before January l~ 19BZ bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .O0016q. All taxes Nhich became delinquent on and after January l, 1981 Nill bear interest at a rate Nhich Nili vary from calendar year to calendar year with that rate announced by the PA gepart~ant of Revenue. The applicable interest rates for 1981 through ZOO3 ara: Interest Daily Interest Daily Znterest Daily Rate Factor Year Rate Factor Year Rate Factor 198Z ZOX .000548 1987 9X .000Z47 1999 7Z .00019Z 1985 16Z .00043B 1988-1991 XXZ .O0030X 2000 8Z .O00Zl9 1984 XXZ .O0030X 1992 92 .000247 ZOOl 92 .000247 1985 13Z .000356 1993-1994 72 .00019Z ZOOZ 62 .000164 1986 lOX .000274 1995-1998 92 .000247 2005 5Z .000137 --Interest is calculated as follows: XNTEREST = BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELTNQUENT X DATLY XNTEREST FACTOR --Any Notice issued after the tax becomes delinquent Nill reflect an interest calculation to fifteen (1S) days beyond the date of the assessment. If payment is made after the interest computation date sho~n on the Notice, additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: DOROTHY M. KOHL Date of Death: No. 21-03-0508 January 18, 2003 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: X Yes __ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes X No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? X Yes No Date: 5/4/04 Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Ft~ Cler/k~ rphan's Court and may be attached to this report~~7~ / ES & FISHMAN Ja.a.a~es D. Hughes, Esquire k._~me (please type or print) 95 Alexander Spring Road, Suite 3 Address Carlisle, PA 17013 City, State, Zip (717) 249-6333 Telephone Number Capacity: X Personal Representative Counsel for Personal Representative