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HomeMy WebLinkAbout02-0108Will PETITION FOR PROBATE and GRANT OF LETTERS Will Estate of Richard E. Johnson, late of the Borough of Carlisle, Cumberland County, Pennsylvania, Deceased Social Security No. 199-07-3344 No. 21-02-108 To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner is over 18 years of age and the personal representative named in the last will of the above decedent, dated September 17, 1999. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 555 "F' Street, Carlisle, PA 17013. 2 Decedent, then 86 years of age, died Wednesday, January 23, 00~,, at Carlisle Regional Medical Center, Carlisle, PA. 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.) (If not domiciled in Pa.) (If not domiciled in Pa.) Value of real estate in Pennsylvania situated as follows: All personal property upwards of Personal property in Pennsylvania Personal property in County 555 "I~' Street, Carlisle, PA 17013 $ 50,000.00 $ $ 85,000.00 WHEREFORE, petitioner respectfully requests the probate of the last will presented herewith and the Grant of Letters Testamentary thereon. JGene E. Johnson Address: 1882 Orchard Road Chambersburg, PA 17201 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS The petitioner above named, swears or affirms that the statements in the forgoing petition are true and correct to the best of the knowledge and belief of petitioner and that as personal representative of the above petitioner will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this 31st day of January, 2002. ~ene E. Johnson No. 2~-02-~08 Estate of Richard E. Johnson, Deceased DECREE OF PROBATEAND GRANT OFLETTERS AND NOW, January 31, 2002, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument dated September 17, 1999, described therein, be admitted to probate and filed of record as the last will of Richard E. Johnson and Letters Testamentary are hereby granted to Gene E. Johnson. Documents Attached: Oath of Subscribing Witness(es) [~ ] Oath of Non-subscribing Witness(es) [ ] Oath of Witness(es) to mark [ ] Renunciation(s) [ ] LETTERS TEST. 235.00 X-PAGES 18.00 SHORT CERT 24.00 JCP 5.00 282.00 ~? Register of Wills LeRoy S. Maxwell, Jr. Supreme Court I.D. No. 07320 Maxwell Law Offices Wayne Building 92 West Main Street Waynesboro, PA 17268-1591 Phone: (717) 762-2118 21-02-108 REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESSES LeRoy S. Maxwell, Jr. and Susan E. Kirby, each a subscribing witness to the will presented herewith, each being duly qualified according to law, deposes and says that each was present and saw Richard E. Johnson, the testator, sign the same and that each signed as a witness at the request of testator, in his presence and in the presence of each other. /LeRoy S. M~'xwell, Address: 12 Wynnecrest Drive Waynesboro, PA 17268 Susan E. Address:. :321 North Franklin Street Waynesboro, PA 17268 Sworn to or affirmed and subscribed before me this 28th day of January, 2002. Notary Public rNoi:a~ ;5! Seal Sandra A. Davis, Notary Public Waynesboro Boro, Franklin County My Commission Expires Sept. 21,2002 Member, P~pr~¢y v;J!' ~¢~ .¢,~;';o,.'.iatio,q of Notaries ARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. COMMOiqWEALTH OF PENNS'~ DEPARTMENT OF HE~LI'H VITAL Fi::! :O I):' LOCAL REGISTRAR'S CERTIFICATI(i,I=~ OF CERT. NO. T 5031770 .... 1~25_~2002 Name of Decedent _ _ R~ c~h__a r~d_ ................ _E.__ d ohos o n Sex Male 199~07c3344 1-23-2002 ..... Social Security No. Date of Death _ D~de of Birth __S._ept. 30, 1915 Birthplace Carllsle Regional Place oi Death Me_d_i_cs_l Ce_nt_er Race White Occupation Welder Decedent's Marn;ti Status W_ido__wer _ _ Mailing Address i~fforrnant Gene__E ;_ Johnson Name and Address Funeral Establishment N i c k e i Blain, PA-- .................... Cumberland Carlisle Armed Forces'? (Yes or Nc)) 555 F. Street Carlisle Funeral Director .... Jam_es__F_. N.~ke!. Funeral Home, LoysvilleL~__~7_047_ Pad ! lmm, ediate Cause Yes PA ~7013 Interval Betwee:~ al _ _ Rneu~on_~?~ Part II: (d) Other Significant Conditions Manner of Death Naturai ~X Homicide ~ Ar:ci(i~. .nl ,F ' Pending Investigation LJFq' Suicidc~ Could not be Determined ~] Describe how injury occurred: Name and Title of Certfier Lester Himmelreich M.D. (M.Q ......( Coloner. ME ) l~dc!rei 220 Wilson Street, Carlisle, PA 17013 --his is to certify that the information here given is correctly copied from an or,.g~ai ~:~::,:'~if cate of death duly filed with me as Local Registrar. The original certificate will be forwarded t'~ th } State Vital Records Office for ~ermanent f,,in~~~ ~ ~ , 50-455 1~25~2002 101 Bar_p_9~- St.~__N.e~_.Bloomfield, PA ; 7 T ~=-;,'i~]~'~;~,7~FF~ ~-- Sheet A,]rlrr~s: : ~ ;: , 17068 6L:8~/ L£NVr gO. WILL OF RICHARD E. JOHNSON I, RICHARD E. JOHNSON, of 555 "F" Street, Carlisle, PA 17013, being of sound and disposing mind, memory and understanding, revoke any prior wills and codicils and declare this to be my will. ITEM I. EXPENSES AND TAXES. I direct that as soon as may be convenient after my decease there be paid from my estate all of my just debts, expenses incident to my illness, my funeral expenses and, from the principal of the residue of my estate, all of my state and federal inheritance and estate taxes. ITEM II. RESIDUARY GIFTS. I give the residue of my estate to Gene E. Johnson, if he survives me. If he fsi]s to survive me, then I give my entire residuary estate to Jane C. Johnson, his wife. If both of them fail to survive me, then I give my entire residuary estate to Michael Gene Johnson, my grandson. If all three of them fail to survive me, then i give my entire residuary estate to Christine A. Johnson, wife of my grandson. If o_ll four of them fail to survive me, then I give my entire residuary estate per stirpes to the lineal issue of Michael Gene Johnson as survive me, subject to the provisions of Item III. ITEM III. TRUSTS FOR LINEAL ISSUE. In the event that any lineal issue of mine who would be a beneficiary under Item II of this will is under the age of 21 at the time that item becomes operative, or in the event that any person who would be a beneficiary under (E) or (F) of this item of this will is under said age at the time of distribution, then I direct that the share that would otherwise be given to said beneficiary be given instead in trust to my herein named Trustee to be administered according to the fo]lowing terms and conditions: (A) My said Trustee may accumulate and capits]ize the income until said beneficiary reaches the age of 18. (B) Thereafter, my Trustee shall pay the net income quarterly to such beneficiary or for the benefit of such beneficiary. (C) My Trustee shall distribute to said beneficiary the principal assets available to this trust as fo]lows: (1) The balance of the principal and any remaining income after said beneficiary has attained the age of 21. (2) If this trust is still in existence 20 years and 11 months after the death of the last to die of myself and such of my lineal issue as are living at my death, this trust shall terminate and the balance of the p~incipal and any remaining income shall be distributed to said beneficiary or to financial guardian- ships created hereunder for said beneficiary. (D) At all times during the existence of said trust, my Trustee is authorized, in said Trustee's sole discretion, to use such amount or amounts of income and/or principal as my Trustee shall deem necessary for the proper -2- maintenance, support, medical expenses, and education of said beneficiary. For the guidance of my Trustee, I hereby state that I wish my beneficiary hereunder to have such education beyond the high school level as reasonably can be beneficial to such beneficiary and I wish the assets expended for such education from this trust shall be commensurate with the size of this trust and with other assets available to such beneficiary outside of this trust. (E) In the event such beneficiary should die before receiving all of the principal of his trust, leaving his lineal issue surviving him, my Trustee sh~ll distribute any undistributed income and principal of said trust per stirpes to separate trusts created under this item for the lineal issue of such deceased beneficiary living at his death. (F) In the event such beneficiary should die before receiving all of the principal of his trust, leaving no lineal issue of his to survive him, then my Trustee shall distribute the undistributed income and principal of said trust to said beneficiary's heirs at law, determined as of the death of said beneficiary under the intestate law of my domicile applicable to deaths occurring at that time, or to separate trusts created under this item for them. ITEM IV. FINANCIAL GUARDIAN. In the event that any person who is a beneficiary under this will or who is a beneficiary of insurance proceeds or who is a beneficiary of other property with respect to which I have power to appoint a guardian, is under any legal disability (whether due to minority, due to mental -3- incapacity, or otherwise) at the time of distribution, I appoint my herein named Financial Guardian as guardian of the estate of said legally disabled beneficiary and I authorize my said guardian to use such amount or amounts of income or principal as shall be necessary, in the sole discretion of my said guardian, for the maintenance, support, medical expenses and education of said beneficiary during the period of his legal disability. ITEM V. FIDUCIARY POWERS. In addition to the powers conferred by law, any fiduciary appointed under this will, including any Trustee, any Financial Guardian, and any Personal Representative (unless specifically provided other- wise), shall have the following expressed powers: (A) To hold any property, including real estate, securities and especially including stock of a corporate fiduciary, delivered to it in kind as long as said fiduciary deems the same to be for the best interest of said estate. (B) To invest and reinvest in such securities as my fiduciary deems to be for the best interests of said estate without being restricted to such invest- ments as are considered legal for fiduciaries under the laws of the state of my domicile at death, and without regard to the principle of diversification. (C) To invest in any common trust fund administered by a corporate fiduciary. (D) To buy investments at a premium or discount; to join in any recapitalization, merger, reorganization, consolidation or voting trust plan affecting -4- investments; to subscribe for stock and bond privileges; to give proxies and generally to exercise all rights of a security holder; to carry investments in the name of a nominee or in bearer form. (E) To manage, operate, repair, alter, improve, partition or divide real estate or other property and to lease real estate and other property upon such terms and for such periods as may be considered advisable; and to sell real and personal property for any proper purpose at public or private sale for cash and/or credit without Order of Court and to make, execute, acknowledge and deliver good and sufficient deed or deeds and other assurances therefor. In the event my fiduciary becomes an owner of an interest in residential real estate, my fiduciary is authorized to retain said interest in said residential real estate even though it is not income producing and is further authorized to join with any other owner of an interest in said real estate for the purpose of conveying or leasing same. (F) To borrow money and to pledge or mortgage real or personal property as security and to make, execute, acknowledge and deliver good and sufficient pledges, mortgages and other instruments to effectuate the same. (G) To compromise claims without Order of Court or consent of any beneficiary. (I-I) To make distribution in cash or in kind. -5- ITEM VI. APPOINTMENT OF FIDUCIARIES. I appoint Orrstown Bank as Trustee of all trusts and Financial Guardian of all financial guardianships created hereunder. I appoint Gene E. Johnson as Personal Representative of my estate. If he does not qus]ify or ceases to act, then I appoint Jane C. Johnson as my First Alternate or Successor Personal Representative. If both of them fail to qualify or cease to act, then I appoint Michael Gene Johnson as my Second Alternate or Successor Personal Representative. If all three of them fail to qus]ify or cease to act, then I appoint Christine A. Johnson as my Third Alternate or Successor Personal Representative. If ~]] four of them fail to qualify or cease to act, then I appoint Orrstown Bank as my Fourth Alternate or Successor Personal Representative. ITEM VII. NO BOND. I direct that no fiduciary appointed hereunder shall be required to post bond in this or any other jurisdiction. IN WITNESS WHEREOF, I, RICHARD E. JOHNSON, the Testator, hereby execute on ~ 1~ / ~?/~ , this my will, typewritten upon six (6) sheets of paper. ' I -R~Cha~.d E. -6- In our presence RICHARD E. JOHNSON signed this and declared it to be his will and now at his request, in his presence and in the presence of each other, we sign as witnesses. -7- 6L:8~i JE N~lr ~0. CERTIFICATION OF NOTICE UNDER RULE $.6(a) Name of Decedent · Richard E. 3ohnson Date of Death · _lanuary 23, 2002 Estate No. · 2002-00108 (21-02-0108) To the Register: ! certify that Notice of Estate Administration (beneficial interest) 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 -fig El 81 ~.oo~,- ' Gene E..lohnson 1882 Orchard Road Chambersburg, PA 17201 Notice has now been given to all persons entitled thereto under Rule 5.6(a), without exception. Date: Maxwell Law Offices Wayne Building 92 West Main Street Waynesboro, PA 17268 Phone: 717-762-2118 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 001 O96 MAXWELL LEROY S JR WAYNE BLDG 92 WEST MAIN ST WAYNESBORO, PA 17268 ........ fold ESTATE INFORMATION: SSN: 199-07-3344 FILE NUMBER: 2102-01 08 DECEDENT NAME: JOHNSON RICHARD E DATE OF PAYMENT: 04/22/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/23/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $32,490.00 TOTAL AMOUNT PAID: $32,490.00 REMARKS: GENE E JOHNSON C/O LEROY S MAXWELL JR SEAL CHECK//1 26 INITIALS: SK RECEIVED BY' MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS 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 001758 MAXWELL LEROY S JR WAYNE BLDG 92 WEST MAIN ST DUPLICATE WAYNESBORO, PA ........ fold 17268 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $248.00 ESTATE INFORMATION: SSN: 199-07-3344 FILE NUMBER: 2102-0108 DECEDENT NAME: JOHNSON RICHARD E DATE OF PAYMENT: 10/22/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/23/2002 TOTAL AMOUNT PAID: $248.00 REMARKS: GENE E JOHNSON C/O LEROY S MAXWELL JR ESQUIRE SEAL CHECK# 141 INITIALS: SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS 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 001757 MAXWELL LEROY S JR WAYNE BLDG 92 WEST MAIN ST DUPLICATE WAYNESBORO, PA 17268 ........ fold ESTATE INFORMATION: SSN: 199-07-3344 FILE NUMBER: 2102-01 08 DECEDENT NAME: JOHNSON RICHARD E DATE OF PAYMENT: 10/22/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUM BERLAN D DATE OF DEATH: 01/23/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $133.69 TOTAL AMOUNT PAID: $133.69 REMARKS: LEROY S MAXWELL JR ESQUIRE SEAL CHECK# 143 INITIALS: SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS Cumber/and County, Pennsylvania Estate No. 2002-00308 PA Fi/e No. Znventory and Appraisement Estate of Richard E. $ohn$on, Late of Car~isle Cumberland County~ Pennsylvania PERSONA L PR OPER TY Tanqible Persona/ProPerW_ Household goods and personal effects at appraised value per schedule attached 1990 Dodge Sedan Omni, having Vehicle I.D. No. 1B3XL18D3LC707763, at net proceeds of sale Zntanqible Persona/Properly_: Cash: Checking with Interest Account No. 192-109-6846, Citizens Bank (formerly Mellon Bank), Carlisle, PA accrued interest to date of death Special Statement Savings Account No. 00355-238222, Citizens Bank (formerly Mellon Bank), Carlisle, PA accrued interest to date of death $ 1,389.00 1,100.00 $ 54,077.61 7.42 103,611.26 175.62 2,489.00 Certificates of Deposit: Certificate of Deposit No. 87008000086999, Allfirst Bank, Carlisle, PA; issued 2/5/88; due 2/5/93; rolled over and currently due 2/5/03; interest - 5.0% payable monthly accrued interest to date of death Certificate of Deposit No. 87008000087413; Allfirst Bank, Carlisle, PA; issued 2/25/85; due 2/25/90; rolled over and currently due 3/25/05; interest - 6.39% payable monthly accrued interest to date of death Certificate of Deposit No. 87008000087510, Allfirst Bank, Carlisle, PA; issued 9/8/86; due 9/8/91; rolled over and currently due 9/8/06; interest - 4.72% payable monthly accrued interest to date of death Certificate of Deposit No. 87008000087537, AIIfirst Bank, Carlisle, PA; issued 2/4/87; due 2/4/92; rolled over and currently due 2/4/02; interest- 5.0% payable monthly accrued interest to date of death Certificate of Deposit No. 87008000087634, Allfirst Bank, Carlisle, PA; issued 8/3/87; due 8/3/92; rolled over and currently due 8/3/02; interest- 5% payable monthly accrued interest to date of death Certificate of Deposit No. 00164371, Citizens Bank (formerly Mellon Bank), Carlisle, PA; issued 5/16/00; due 7/16/02; interest - 6.532% payable monthly accrued interest to date of death 20,000.00 52.05 12,000.00 63.02 10,000.00 20.69 5,000.00 13.70 10,000.00 28.77 20,000.00 25.07 -;3- Certificate of Deposit No. 01082120, Citizens Bank (formerly Mellon Bank), Carlisle, PA; issued 11/19/01; due 3/19/03; interest- 3.198% payable monthly accrued interest to date of death Certificate of Deposit No. 01176330, Citizens Bank (formerly Mellon Bank), Carlisle, PA; issued 4/16/01; due 4/16/06; interest - 5.1172% (growth CD) accrued interest to date of death Certificate of Deposit No. 19-A20600-C, Citizens Bank (formerly Mellon Bank), Carlisle, PA; issued 2/26/00; due 4/26/02; interest - 6.204% payable monthly accrued interest to date of death Certificate of Deposit No. 190-067508-C, Citizens Bank (formerly Mellon Bank), Carlisle, PA; three year callable) issued 8/2/01; due 8/2/04; interest - 4.879% payable monthly accrued interest to date of death Certificate of Deposit No. 190-069596-C, Citizens Bank (formerly Mellon Bank), Carlisle, PA; issued 10/23/97; due 10/23/02; interest - 4.162% payable monthly accrued interest to date of death Certificate of Deposit No. 190-069794-C, Citizens Bank (formerly Mellon Bank), Carlisle, PA; issued 11/18/97; due 11/18/02; interest- 3.97% payable monthly accrued interest to date of death Certificate of Deposit No. 247412050851017, First Union National Bank, Carlisle, PA; issued 9/1/99; due 7/1/02; interest - 6.3% capitalized 'monthly accrued interest to date of death 40,000.00 14.02 18,706.00 19.84 20,000.00 95.40 20,000.00 61.58 20,000.00 52.52 7,000.00 3.81 23,032.48 91.61 -4- Certificate of Deposit No. 247412051414861, First Union National Bank, Carlisle, PA; issued 12/15/00; due 7/15/02; interest- 6.3% capitalized monthly accrued interest to date of death Certificate of Deposit No. 247412061042854, First Union National Bank, Carlisle, PA; issued 2/4/00; due 8/4/02; interest - 6.53% capitalized monthly accrued interest to date of death Certificate of Deposit No. 247412061098794, First Union National Bank, Carlisle, PA; issued 3/16/00; due 12/16/02; interest- 6.95% compounded monthly accrued interest to date of death Certificate of Deposit No. 5060066131, Orrstown Bank, Orrstown, PA; issued 1/18/01; due 1/18/03; interest - 5.5% payable monthly accrued interest to date of death Certificate of Deposit No. 5060060645, Orrstown Bank, Orrstown, PA; issued 5/22/00; due 5/22/02; interest - 6.75% payable monthly accrued interest to date of death Stocks: 23,659.03 36.77 22,664.32 81.23 31,000.91 47.26 25,019.31 18.44 10,000.00 1.79 $338,809.62 36 shs. MetLife Common (MET) Cusip No. 59156R-10-8 TOTAL PERSONAL PROPERTY @ 29.99 1,079.64 $ 691,161.37 -b- REAL PROPERTY Real estate situate in the Borough of Carlisle, Cumberland County, PA, improved by a dwelling house known as 555 "F' Street and bounded and described as follows: BEGINNING at a point on the northern side of"F' Street on the dividing line between Lots Nos. 55 and 56 on the hereinafter mentioned Plan of Lots; thence by said dividing line, north 2 degrees 30 minutes east 134.46 feet to a point; thence north 86 degrees 38 minutes 30 seconds west 79.01 feet to a point; thence by a line parallel to the dividing line between Lots Nos. 54 and 55 on said Plan of Lots, and 8 feet in a perpendicular distance Westward therefrom, south 2 degrees 30 minutes west 135.75 feet, more or less, to a point on the northern side of "F" Street; thence by the northern side of "F' Street, south 87 degrees 30 minutes east 79 feet to the place of beginning. BEING Lot No. 55 and the eastern 8 feet of Lot No. 54 on the Plan of Lots known as The Diehl Tract as recorded in the office of the Recorder of Deeds for Cumberland County in Plan Book 22, Page 95. By deed dated November 4, 1971, and recorded in Cumberland County Deed Book 324, Page 117, Raymond E. Diehl and wife conveyed the above described real estate to Richard E..lohnson and Ida R. 3ohnson, his wife; Ida R. Johnson died May 21, 1998, thereby vesting full fee simple title by operation of law in Richard E. Johnson, the decedent herein. Net Proceeds of Public Sale $115,000.00 TOTAL REAL PROPERTY TOTAL PERSONAL AND REAL PROPERTY $ 115,000.00 .$ 806:161.37 -6- ROWE · AU 1092L · AU 2275L R. D. 4, Box 353 * Carlisle, PA 249-2677 -- 249-1978 ~o~ ~ A~Uo. Co~ "ROWE"ro~ s~fo~uo. TO: LeRoy S. Maxwell Jr. Attorney At Law Wayne Building 92 West Main street Waynesboro, PA 17268-2118 October 9, 2002 FOR: Gene Johnson Executor FROM: Benny E. Rowe Auctioneer/Appraiser 2505 Ritner Highway Carlisle, Pa. 17013 REF: Richard E. Johnson Estate, 555 "F" Street, Carlisle, Pa. Personal Property Appraisal at the Currrent Auction Market Val "~ ~. .... .. CORRECTION: Appraisal Dated February 18,2002. $1399.00 Total Should be Reduced to a Total of $1389.00 ESTATE OF RICHARD E. JOHNSON SCHEDULE OF HOUSEHOLD GOODS AND PERSONAL EFFECTS GARAGE M W Snow Blower Step Ladder Misc. Small Hand tools 3 Metal Cabinets 25.00 6.00 32.00 12.00 PAGE 1 KITCHEN Microwave Oven 5 Pcs. Kitchenette set Pots/Pans Glass/China Small'Kitchen Accessories Small Electrical appliances Decorators 20.00 15.00 38.00 25.0.0 20.00 26.00 12.00 LIVING ROOM 2 Pcs. Living Room suite 3 Upholstered Chairs Coffee Table & End Stands Table Lights 3 Drawer Pine Chest' 2 Door Bookcase Kitchen accessories Pictures/Prints~ , Decorators '~ '" Luggage Misc. 35.00 15.00 18.00 10.00 15.00 45.00 25.00 10.00 28.00 5.00 35.00 BATHROOM Towels/Bedding 25.00 T V ROOMN R C A Color t V V C R Book Shelf Sewing Machine 2 Upholstered Chairs Chest of Drawers Boom Box Misc. 35.00 15.00 18.00 15.00 10.00 20.00 8.00 28.00 BEDROOMS 3 Pcs. Bedroom Suite Metal stand Fan 4 Pcs. Bedroom Suite Rocking Chair Bedding Hamper Misc. ESTATE OF RICHARD E. JOHNSON SCHEDULE OF HOUSEHOLD GOODS AND PERSONAL EFFECTS 65.00 3.00 5.00 75.00 20.00 5.00 2.00 14.00 PAGE 2 BASEMENT Deep Freezer Treadmill Dehumidifier Wardrobe Jars Vacuum cleaner Step Stool G E Automatic Washer G E Electric Dryer Small Hand tools Fans Misc. STORAGE ~UILDING , Hechinger Riding Mower Rotary Mower Hose Trash Cans Electric Chain saw Edgers Step Ladder Long Handle tools misc. 75.00 5.00 15.00 10.00 5.00 5.00 3.00 85.00 55.00 12.00 5.00 18.00 145.00 35.00 5.00 5.00 10.00 5.00 6.00 35.00 15.00 TOTAL Benny E. Ro~ INVENTOR Y IN RE Estate of Richard E. Johnson, late of Carlisle, Cumberland County, Pennsylvania. STATE OF PENNSYLVANIA : : SS COUNTY OF FRANKLIN : I verify that the statements made in this Inventory are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsifications to authorities. (Date) Gene E. Johnson, Personal Representative of the Estate of Richard E. Johnson COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT · OFFICIAL USE ONLY FILE NUMBER 2 1 - 0 2 __ 0__ 1 0 8 COUNTY CODE ~ NUMBER I-- Z LU ILl LU u,I O O UJ X DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Johnson, Richard E. DATE OF OEATH (MM~YEAR) I DATE OF SIRTH (MM-D~YEAR) January 23, 2002 I September 30, 1915 (IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 199 - 07 - 3344 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [] 1. Odginal Return --]4. Umited Estate ~']6. Decedent Died Testate (~=:~ ~ o~wa) ['"~ 9. I.~gation Proceeds Received [~]2. Supplemental Retum r--~ 4a. Future Interest Compromise (da~ ddeal~ alta'12.12.82) [~'-] 7. Decedent Maintained a Living Trust (~ ~ dT~ · [] 10. Spousal Poverty Credit (~ o~ d.a ~ 12-31~J1 a~ 1-1-~ LeRoy S. Maxwell~ Jr. Maxwell Law Offices TELEPHONE NUMBER (717) 762-2118 --*] 3. Remainder Return (da. d deam p,~or to ~2-~3-a2) r'-] 5. Federal Estate Tax Return Required 2-- 8. Total Number of Safe Deposit Boxes [~] 11, Elec~on to tax under Sec. 9113(A) (Atto~ s~ o) COMPLETE MAILING ADDRESS Maxwell Law Offices 92 West Main Street Waynesboro, PA 17268 1. Real Estate (Schedule A) (1) 115 ~ 000. O0 2. Stocks and Bonds (Sshedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Sank Deposits & Miscellaneous Personal Property (5) 690 ~ 081.73 (Schedule E) 6. Joindy Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (8) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 4, 2,6 7 4.6 2 10. Debts of Decedent, Mortgage Uabilities, & Uens (Schedule I) (10) 5 15.80 li. Total Oeductlo~ts (total Lines 9 & 10) (11) 12. Net Value of Estate (line 8 minus line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts fa'which an election to tax has not been (13) made (Schedule J) .. 14. Net Value Subject to Tax (line 12 minus Line 13) OFFICIAL USE ONLY 806,161~37 762,970.95 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Une 14 taxable at lineal rate 7 6 2,9 70. 9 5 x .0 (15) x .045 '(16) (1 7~,? :qTn: 95 34.333.6q 17. Amount of Une 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) Decedent's Complete .~ddres~s: STREET ADDRESS 555 "F" Street Carlisle I STATE PA ZIP i 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E.. Penalty 32,490.00 1,710.00 (1) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) If Une 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Una 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE. (3) (4) (5) 34,333.69 34.200.00 133.69 A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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 ~nsfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] [] b. retain the fight to designate who shall use the property transferred or its income; ................................. ; .......... [] [] c. retain a reversionary interest; or .......................................................................................................................... [] ' [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer prope .rb.y within one year of death without receiving adequate consideration? ....................................................................................................... ~ ...... [] [] 3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death?.. ........... [] [] 4. Did decedent own an Individual RetirementAccount, 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. Unda' penallJes of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my kno~,~ and belief, it is true, ~,~,~ and ...,,,p;~-~. O~-~b.~-, of ~c-.p~,- other than the personal representative is br.~,~l on all infon~ation of which preparer has any knowledge. DATE ADDRESS Gene E. ~ohnson 1882 Orchard Road, Chmmhersbur8, PA 17201 SIGNATURE OF PREPARER 03;;I~I~R THAN~EPRESENTATIVE ~ ADDRESS ~oy S./Maxwell, Jr. /' Maxwell Law Offices, 92 W~st Main Street, Waynesboro, PA 17268 · DATE -- For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (0]. 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 exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the 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 stapparent 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 w~ the decedent, whether by blood or adoption. WILL OF RICHARD E. JOHNSON Se~tembe~ 26, 2002. I hereby cert. ify that the within is a true and complete copy of the will o£ the within decedent as probated by the Register of Wills for Cumberland County, PA. ~ELL LAW OFFICES ATTORNEYS FOR ESTATE OF RICED E. JOHNSON I, RICHARD E. JOHNSON, of 555 "F" Street, Carlisle, PA 17013, being of sound and disposing mind, memory and understanding, revoke any prior wins and codicils and declare this to be my will. ITEM I. EXPENSES AND TAXES. I direct that as soon as may be convenient after my decease there be paid from my estate all of my just debts, expenses incident to my illness, my funeral expenses and, from the principal of the residue of my estate, all of my state and federal inheritance and estate taxes. ITEM II. RESIDUARY GIFTS. I give the residue of my estate to Gene E. Johnson, ff he survives me. If he f~i!s to survive me, then I give my entire residuary estate to Jane C. Johr~son, his wife. If both of them f~i! to survive me, th~n I give my entire residuary estate to Michael Gene Johnson, my grandson. If all three of them fail to survive me, then I give my entire residuary estate to Christine A. Johnson, wife of my grandson. If nl~ four of them fnil to survive ,ne, then I give my entire residuary estate per stirpes to the lineal issue of Michael Gene Johnson as survive me, subject to the provisions of Item III. __ ITEM III. TRUSTS FOR LINEAL ISSUE. In the event that any lineal issue of mine who would be a beneficiary under Item II of this will is under the age of 2 ! at the time that item becomes operative, or in the event that any person who would be a beneficiary under (E) or (F) of this item of this wffi is under said age at the time of distribution, then I direct that the share that would otherwise be given to said beneficiary be given instead in trust to my herein named Trustee to be administered according to the following terms and conditions: (A) My said Trustee may accumulate and capit~li~,e the income until said beneficiary reaches the age of 18. (B) Thereafter, my Trustee shall pay the net income quarterly to such beneficiary or for the benefit of such beneficiary. (C) My Trustee shall distribute to said beneficiary the principal assets available to this trust as follows: The balance of the principal and any remaining income after said beneficiary has attained the age of 21. (2) If this trust is still in existence 20 years and 11 months after the death of the last to die of myself and such of my lineal issue as are living at my death, this trust shall terminate a~.d the balance of the P~cipal and any remaining income shall be distributed to said beneficiary or to financial guardian- ships created hereunder for said beneficiary. (D) At all times during the existence of said trust, my Trustee is author/zed, in said Trustee's sole discretion, to use such amount or amounts of income and/or principal as my Trustee shall deem necessary for the proper -2- maintenance, support, medical expenses, and education of said beneficiary. For the guidance of my Trustee, I hereby state that I wish my beneficiary hereunder to have such education beyond the high school level as reasonably can be beneficial to such beneficiary and I wish the assets expended for such education ~om this trust shall be commensurate with the size of this trust and with other assets available to such beneficiary outside of this trust. (E) In the event such beneficiary should die before receiving all of the principal of his trust, leaving his lineal issue surviving him, my Trustee shall distribute any undistributed income and principal of said trust per stirpes to separate trusts created under this item for the lineal issue of such deceased beneficiary living at his death. (F) In the event such beneficiary should die before receiving all of the principal of his trust, leaving no lineal issue of his to survive him, then my Trustee shall distribute the undistributed income and principal of said trust to said beneficiary's heirs at law, determined as of the death of said beneficiary under the intestate law of my domicile applicable to dea. ths occurring at that time, or to separate trusts created under this item for them. ITEM IV. FINANCIAL GUAI~_DIAN_. In the event that any person who is a beneficiary under this will or who is a beneficiary of insurance proceeds or who is a beneficiary of other property with respect to which I have power to appoint a guardian, is under any legal disability (whether due to minority, due to mental -3- incapacity, or otherwise) at the t~me of distribution, I appoint my herein named Financial Guardian as guardian of the estate of said legally disabled beneficiary and I authorize my said guardian to use such amount or amounts of income or principal as shall be necessary, in the sole discretion of my said guardian, for the maintenance, support, medical expenses and education of said beneficiary during the period of his legal disability. ITEM V. FIDUCIARY POWERS. In addition to the powers conferred by law, any fiduciary appointed under this will, including any Trustee, any Financial Guardian, and any Personal Representative (unless specifically provided other- wise), shall have the following expressed powers: (A) To hold any property, including real estate, securities and especially including stock of a corporate fiduciary, delivered to it in kind as long as said fiduciary deems the same to be for the best interest of said estate. (B) To invest and reinvest in such securities as my fiduciary deems to be for the best interests of said estate without being restricted to such invest- ments as are considered legal for fiduciaries under the laws of the state of my domicile at death, and without regard to the principle of diversification. (C) To invest in any common trust fund administered by a corporate fiduciary. (D) To buy investments at a premium or discount; to join in any recapitalization, merger, reorganization, consolidation or voting trust plan affecting -4- investments; to subscribe for stock and bond privileges; to give proxies and generally to exercise all rights of a security holder; to carry investments in the name of a nominee or in bearer form. (E) To manage, operate, repair, alter, improve, partition or divide real estate or other property and to lease real estate and other property upon such terms and for such periods as may be considered advisable; and to sell real and personal property for any proper purpose at public or private sale for cash and/or credit without Order of Court and to make, execute, acl~nowledge and deliver good and sufficient deed or deeds and other assurances therefor. In the event my fiduciary becomes an owner of an interest in residential real estate, my fiduciary is authorized to retsin said interest in said residential real estate even though it is not income producing and is further authorized to join v~ith any other owner of an interest in said real estate for the purpose of conveying or leasing s~me. (F) To borrow money and to pledge or mortgage real or personal property as security and to make, execute, acknowledge and deliver good and sufficient pledges, mortgages and other instruments to effectuate the same. (G) To compromise clsims without Order of Court or consent of any beneficiary. ~ To make distribution in cash or in kind. -5- ITEM VI. APPOINTMENT OF FIDUCIARIES. I appoint Orrstown Bank as Trustee of all trusts and Financial Guardian of all financial guardianships created hereunder. I appoint Gene E. Johnson as Personal Representative of my estate. If he does not quslify or ceases to act, then I appoint Jane C. Johnson as my First Alternate or Successor. Personal Representative. If' both of them fsi! to qualify or cease to act, then I appoint Michael Gene Johnson as my Second Alternate or Successor Personal Representative. If all three of them fsi! to qualify or cease to act, then I appoint Christine A. Johnson as my Third Alternate or Successor Personal Representative. If all four of them fail to qusllfy or cease to act, then I appoint Orrstown Bank as my Fourth Alternate or Successor Personal Representative. /' ITEM VII. NO BOND. I direct that no fiduciary appointed hereunder' shall be required to post bond in this or any other jurisdiction. IN WITNESS WHEREOF, I, RICHARD E. JOHNSON, the Testator, , this my will, typewritten upon six (6) -6- In our presence RICHARD E. JOHNSON signed this and declared it to be his will and now at his request, in his presence and in the presence of each other, we sign as witnesses. -7- REV-16~EX * (t~l ~ COMMONV~.ALTH OF PENNSYLVANIA INHERffAN(~ TAX RETURN RE$1OENT OECEDENT ESTATE OF Richard E. Johnson SCHEDULE A REAL ESTATE FIll:NUMBER 21-02-0108 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 properly 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 DESCRIPTION Real estate situate in the Borough of Carlisle, Cumberland County, PA, improved by a dwelling house known as 555 ,,F,, Street and bounded and described as follows: 'BEGTNNZNG at a point on the northern side of"F' Street on the dividing line between Lots Nos. 55 and 56 on the hereinafter mentioned Plan of Lots; thence by said dividing line, north 2 degrees 30 minutes east 134.46 feet to a point; thence north 86 degrees 38 minutes 30 seconds west 79.01 feet to a point; thence by a line parallel to the dividing line between Lots Nos. 54 and 55 on said Plan of Lots, and $ feet in a perpendicular distance Westward therefrom, south 2 degrees 30 minutes west 135.75 feet, more or less, to a point on the northern side of"F' Street; thence by the northern side of "F' Street, south 87 degrees 30 minutes east 79 feet to the place of beginning. BEZNG Lot No. 55 and the eastern 8 feet of Lot No. 54 on the Plan of Lots known as The Diehl Tract as recorded in the office of the Recorder of Deeds for Cumberland County in Plan Book 22, Page 95. By deed dated November 4, 1971, and recorded in Cumberland County Deed BoOk ]24, Page 117, Raymond E. Diehl and wife conveyed the above described real estate to Richard E. Johnson and Ida R. ]0hnson, his'wife; Ida R. 3ohnson died May 21, 1998, thereby vesting full fee simple title by operation of' law in Richard E. Johnson, the decedent herein. Net Proceeds of Public Sale TOTAL (Nso enter on line 1, Recapitulation) VALUE AT DATE OF DEATH $115,000.00 $ 115,000.00 HUD - 1 UNIFORM SETTLEMENT STATEMENT OMB Approval No. 2502-0265 A'~ U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT B. 6. File Number: 7. Loan Number: TYPE OF LOAN 1. X FHA 2. FmHA 3. Cony. Unins. 4. VA 5. Conv. Ins. 8. Mortgage Insurance Case Number NOTE: This form is furnished to give you a statement ofactaal settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.¢.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. NOTE: TIN = Taxpayer's Identification Number D. NAME AND ADDRESS OF BORROWER: E. NAME, ADDRESS AND TIN OF SELLER: ESTATE OF RICHARD E.-JOHNSON GENE E. JOHNSON, EXECUTOR JAMES E. MORTON, JR. AMY J. MAZUTIS G. PROPERTY LOCATION: F. NAME AND ADDRESS OF LENDER: COUNTRYWIDE HOME LOANS 4830 CARLISLE PIKE MECHANICSBURG, PA 17050 717-730-6670 H. SETTLEMENT AGENTNAME, ADDRESSANDT~ 555 "F"'-STREET LISA M. GREASON, ESQUIRE 02-0532562 CARLISLE, PA 17013 50 EAST HIGH STREET, CARLISLE, PA 17013 PLACE OFSETTLEMENT I. SETTLEMENT DATE 06-i9-1643-373 GREASON LAW OFFICE 08/02/2002 CARLISLE, PA 17013 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION I00. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 1Ol. Contract sales price 115,000.00 401. Contract sales price 115,000.00 102. Personal property 402. Personal property 103. Settlement charges to borrower (Line 1400) 5, 1 8 0.5 0 403. 104. 404. 105. 405. Adiustments for items paid by seller in advance Adiustmen'ts for items paid by seller in advance 106. City/town taxes 406. CiW/town taxes 107. County,axes 08/02/2002-12/31/2002 202.73 407. County,axes 08/02/2002-12/31/2002 202.73 108. Assessments 408. Assessments 109. 409. ll0. School Tax 1,006.59 410. School Tax 1,006.59 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 121, 389.82 420. GROSS AMOUNT DUE TO SELLER 116, 209.32 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 1,000.00 501. Excess deposit 202. Principal amount of new loan(s) '- 106,575.00 502. Settlement charges to seller (Line 1400) 203. Existing loan(s) taken subject to 503. Existing loan(s) taken subiect to 204. ' 504. Payoff of first mortgage loan 205. 505. Payoff&second mortgage loan 206. 506. 207. 507. 208. 508. 209.. 509. Adjustments for items unpaid by 'seller Adjustments for items unpaid by seller 210. City/town taxes 510. CiW/town taxes 211. County taxes 51 I. County taxes 212. AssessMents 512. Assessments 213. 513. 214. 514. 215. . - 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 107,57 5.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 300. CAS. AT SETTLEMENT FROM O BORROWER 600. CASH AT SE LEM T FROM O SELLER 301. Gross amount due from borrower (Line 120) I 121,389.82 601. Gross amount due to seller (Line 420) I 116,209.32 302. Less amount paid by/for borrower (Line 220) 10 7,5 7 5.0 0 602. Less reduction in amount due seller (Line 520) ' 9, 4 0 8.7 0 303. CASH FROM BORROWER 13,814.82 603. CASIq TO SELLER SELLER'S STATEMENT The information contained in Blocks E, G, H, and l-and on line 401 (or, if line 401 is asterisked, line 403 and 404) is important tax information and is being furnished to the Internal Revenue Service (see Seller Certification). Ify6u are required to file a re,am, a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS determines that it has not been reported. You are required to provide the Settlement Agent with your correct taxpayer identification number. If you do not provide the Settlement Agent'with your correct taxpayer identification number, you may be subject to civil or criminal penalties imposed by law. Under penalties of perjury, I certify that the number shown on this statement is my correct taxpayer identification number. (Seller's Signature) ESTATE OF RICHARD E. JOHNSON (Seller's Signature) GENE E. JOHNSON, EXECUTOR © EASY SOFT, [nc. 1999 Previous editions are obsolete Page I form HUD-I (3/86) ref Handbook 4305.2 L. SETTLEMENT CHARGES 700. TOTAL SALES/BROKER's COMMISSION based on price $ 1 15,0 0 0.0 0 @ 701. 702.$ Division of Commission (line 700) as follows: $6,900.00 to 6.000% 703. Commission paid at settlement ERA-NRT Inc. 704. Transaction Fee to ERA-NRT Inc. PAID FROM BORROWER'S FUNDS AT SETTLEMENT PAID FROM SELLER'S FUNDS AT SETTLEMENT 6,900.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee $ 802. Loan Discount $ 803. Appraisal Fee to Countrvwide Home Loans POC $350 (cost $325) 804. Credit report to Landsafe POC $25 805. Lender's Inspection Fee Reinspection Fee -25.00 75.00 806. Mortgage Insurance Application Fee to 807. Assumption Fee 808. Flood Check Fee to Landsafe Flood 25.00 809. Commitment Fee 50.00 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from 08/02/2002-08/31/2002 @ $20.070 per day 902. Mortgage Insurance Premium for 903. Hazard insurance Premium for 602.10 1,575.00 904· 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard insurance 3 month{s) @ $21.50 per month 1002. Mortgage insurance 1003. City PropertyTaxes 1004. County Propertv Taxes 8 month(s) @ $40.84 Der month 1005. Annual assessments 1006. School Tax 4 month{s) @ $92.22 Der month 1007. PMI/MIP 1008. Aggregate Accounting Adjustment 64.50 326.72 368.88 -296.45 I I00. TITLE CHARGES 1101. Settlement or closing fee to II 02. Abstract or title search to N iven Bai rd 7 5.0 0 1103. Title Examination to 1104. Title insurance binder to 1105. Document preparation to 1106. Notary fees to l l07. Attome¥'s fees to Maxwell Law Office for Seller POC (includes line numbers: ll08. TitlelnsurancetoGreason Law Office, app atty.for CTIC {includes line numbers: 1101-1111 1109. Lender's coverage $ 115 0 0 0.0 0 lll0. Ownefscoverage $ 115000.00 I111. Owner's End: 500 933.75 1112. Lender's End: 100, 300, 8.1 1113. Closinq Protection Letter payable to CTIC 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 150.00 35.00 1201. Recording fees: Deed $ 2 8.50 Motto, age $ 1202. City/cnW tax/stamps: Deed $ Mortgage $ 1203. State mx/stamps: Deed $ Mortgage $ 1204. Real Estate Transfer Tax 4 2.5 0 Release $ 7 1.0 0 1,150.00 1,150.00 Buyer 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. SurveytoHomechek, Inc for Home Inspection - POC $235 - 1302. Pest inspection to Homechek, Inc - POC $40 - Buyer 1303. Darlene Mover, ~/o CTCB for 2002-2003 school tax 1304. Carlisle Borouqh final water/sewer acct no. 00222A UPS Overniqht packaqe 106.64 37.06 1305. 15.00 1306. 1307. 1308. 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103, Section J and 502, Section K) . 180 50 CERTIFICATION: I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I received a copy of the HUD-I Settlement,~tateme]q. _ · Se.er ES.~?S 0~' arCHeD s. ~TOHNSON Seller " GEh;~ E. JOHNSON ._ ][~'r6')~er // v/~ Jf--MAT. UTIS The HUD-1 Settleme?t Statement which I have prepared is a nme and accurate account oftbe funds di~lSursed or ~ b~disbursed by the undersigned as part of the settlement of // // ~ / // /' /~ // 08/02/2002 S~ntAg~nt .~SA~. ~,~EASON, ESQUrRE ~----~ ..... WA~IN~~m~ ~ow~g~y~ f~ls~ statements to tbe United Sm[~s on this or any other similar fo~. Penalties u~o~ conv~cdon can ~ndude a fine and %m~risonme~~: ~fl~ l~.S. Code Section 1001 and Section 1010. © EASY SOFT, Inc. 1999 Previous editions are obsolete Page 2 form HUD-1 (3/86) ref Handbook 4305.2 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECE~)ENT ESTATE OF Richard E. Johnson SCHEDULE B STOCKS & BONDS 'FILE NUMBER 21-02-0108 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 36 shs. MetLife Common (MET) Cusip No. 59156R-10-8 @ 29,99 TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH 1,079.64 1,079.64 (If more space is needed, insert additional sheets of the same size) RE~4~OI EX · (1~) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Richard E. Johnson SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-02-0108 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-~w, ed with the right of su~ivorship must be disclos~l on Schedule F. ITEM NUMBER DESCRIPTION Tanqib/e Personal Property Household goods and personal effects at appraised value per schedule attached 1990 Dodge Sedan Omni, having Vehicle I.D. No. 1B3XL18D3LC707763, at net proceeds of sale fntanqible Persona/Property_: Cash: Checking with Interest Account No. 192-109-6846, Citizens Bank (formerly Mellon Bank), Carlisle, PA accrued interest'to date of death Special Statement Savings Account No. 00355-238222, Citizens Bank (formerly Mellon Bank), Carlisle, PA accrued interest to date of death Honey Market Account No. 0950222491, AIIfirst Bank, Carlisle, PA accrued interest to date of death Savings Account No. 15004200917093, M & T Bank, Carlisle, PA accrued interest to date of death Savings Account No. 35521, Orrstown Bank, Carlisle, PA accrued interest to date of death' TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE OF DEATH $ 1,389.00 1,100.00 54,077.61 7.42 103,611.26 175.62 99,331.31 131.96 81,595.20 16.43 6,733.95 3.82 CONTINUED /If mnm COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RE'TURN RESIDENT DECEDENT ESTATE OF Richard E. Johnson SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-02-0108 Ir,dude the proceeds of rdigation and the date the proceeds were received by the estate. All property jointly-owned with the fight of survivorship must be disclosed on Schedule F. ITEM NUMBER 10. 11. 12. 13. 14. 15. 16. DESCRIPTION Checks and Refunds: Comcast - refund due t° cancellation of service Erie Tnsurance Group - refund on automobile insurance due to cancellation of policy Everett Cash Mutual Tnsurance Co. - refund due to cancellation of homeowner's insurance upon sale of real estate Tnternational Union of Operating Engineers - refund of dues Patriot News - refund due to cancellation of subscription Pennsylvania Department of Revenue - 2001 PA 40 income tax refund Sprinff- refund due to cancellation of service U. S. Treasury - 2001 1040 income tax refund VFVV Sponsored Voluntary Personal Accident Tnsurance Plan - refund due to cancellation of policy VALUE AT DATE OF DEATH $ 35.27 326.00 80.00 77.00 130.50 23.00 64.08 2,361.00 TOTAL (Also enter on line 5, Recapitulation) $ CONTINUED 1.68 /If mnrn ~n~"n i~ n~'i~H in~nrt nHHifinnal ~h~nt~ nf th~ ~nmn ~i?~/ COMMOI~TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Richard E. Johnson SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-02-0108 Include the proceeds of litigation and the date the proceeds were received ~ the estate. All property Jointly-owned with the right of Survivorship must be disclosed on Schedule F. ITEM NUMBER 17. 18. DESCRIPTION Certificates of Deposit: Certificate of Deposit NO. 87008000086999, Allfirst Bank, Carlisle, PA; issued 2/5/88; due 2/5/93; rolled over and cur. rently due 2/5/03; interest- 5.0% payable monthly accrued interest to date of death Certificate of Deposit No. 87008000087413; Allfirst Bank, Carlisle, PA; issued 2/25/85'; due 2/25/90; rolled over and currently due 3/25/05; interest - 6.39% payable monthly accrued interest to date of death Certifica'te of Deposit No. 87008000087510, AIIfirst Bank, Carlisle, PA; issued 9/8/86; due 9/8/91; rolled over and currently due 9/8/06; interest - 4.72% payable monthly accrued interest to date of death Certificate of Deposit No. 87008000087537, Allfirst Bank, Carlisle, PA; issued 2/4/87; due 2/4/92; rolled over and currently due 2/4/02; interest- 5.0% payable monthly accrued interest to date of death VALUE AT DATE OF DEATH $ 20,000.00 52.05 12,000.00 63.02 10,000.00 20.69 5,000.00 13.70 TOTAL (Also enter on line 5, Recapitulation) $ CONTINUED flf rnnra ~n=ra ie n~'t ine~r~ :arldifinnal ,~h~,,~te nf fha eama ei?a~ I~.l~l]~ E~) (1~7) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT F.$¥ATE OF Richard R. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ., FILE NUMBER Johnson 21-02-0108 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 21. 22. Certificate of Deposit No. 87008000087634, Allfirst Bank, Carlisle, PA; issued 8/3/87; due 8/3/92; rolled over and currently due 8/3/02; interest- 5% payable monthly accrued interest to date of deatl~ Certificate of Deposit No. 00164371, Citizens Bank (formerly Mellon Bank), Carlisle, PA; issued 5/16/00; due 7/16/02; interest - 6.532% payable monthly accrued interest to date of death Certificate of Deposit No. 01082120, Citizens Bank (formerly Mellon Bank), Carlisle, PA; issued 11/19/01; due 3/19/03; interest - 3.198% payable monthly accrUed interest to date of death Certificate of Deposit No. 01176330, Citizens Bank (formerly Mellon Bank), Carlisle, PA; issued 4/16/01; due 4/16/06; interest - 5.1172% (growth CD) accrued interest to date of death Certificate of Deposit No. 19-A20600-C, Citizens Bank (formerly Mellon Bank), Carlisle, PA; issued 2/26/00; due 4/26/02; interest - 6.204% payable monthly accrued interest to date of death 10,000.00 28.77 20,000.00 25.07 40,000.00 14.02 18,706.00 19.84 20,000.00 95.40 TOTAL (Also enter on line 5, Recapitulation) $ CONTINUED AE~-ISOI EX · (1~?) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANC~ TAX RETURN RESIDENT DECEDENT ESTATE OF R-icha~:d F~. Johnson SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-02-0108 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 26. Certificate of Deposit No. 190-067508-C, Citizens Bank (formerly Mellon Bank), Carlisle, PA; three year callable) issued 8/2/01; due 8/2/04; interest - 4.879% payable monthly accrued interest to date of death Certificate of Deposit No. 190-069596-C, Citizens Bank (formerly Mellon Bank), Carlisle, PA; issued 10/23/97; due 10/23/02; interest - 4.162% payable monthly accrued interest to date of death Certificate of Deposit No. 190-069794-C, Citizens Bank (formerly IVlellon Bank), Carlisle, PA; issued 11/18/97; due 11/18/02; interest - 3.97% payable monthly accrued interest to date of death Certificate of Deposit No. 247412050851017, First Union National Bank, Carlisle, PA; issued 9/1/99; due 7/1/02; interest - 6.3% capitalized monthly accrued interest to date of death Certificate of Deposit No. 247412051414861, First Union National Bank, Carlisle, PA; issued 12/15/00; due 7/15/02; interest - 6.3% capitalized monthly accrued interest to date of death 20,000.00 61.58 20,000.00 52.52 7,000.00 3.81 23,032.48 91.61 23,659.03 36.77 TOTAL (Also enter on line 5, Recapitulation) $ CO~T'['ZNURD flf mnr~ cnnre i~ np~l~t inq~rt nclditinnnl ~h~t~ nf th~ cnm~ niT~'l COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Richard E. Johnson SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ., FILE NUMBER 21-02-0108 Include the proceeds of rdJga~on and lhe 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 31. 32. 33. 34. Certificate of Deposit No. 247412061042854,. First Union National Bank, Carlisle, PA; issued 2/4/00;. due 8/4/02; interest - 6.53% capitalized monthly accrued interest to date of death' Certificate of Deposit No. 247412061098794, First Union National Bank, Carlisle, PA; issued 3/16/00; due 12/16/02; interest- 6.95% compounded monthly accrued interest to date of death Certificate of Deposit No. 5060066131, Orrstown Bank; Orrstown, PA; issued 1/18/01; due 1/18/03; interest- 5.5% payable monthly accrued interest to date of death Certificate of Deposit No. 5060060645, Orrstown Bank, Orrstown, PA; issued 5/22/00; due 5/22/02; interest - 6.75% payable monthly accrued interest to date of death $ 22,664.32 81.23 31,000.91 47.26 25,019.31 18.44 10,000.00 1.79 TOTAL (Also enter on line 5, Recapitulation) $ 690,08 !. 73 (If mnr~ ,~nn~'n i¢ n~l~t in~ert nrtclitinnnl ~h~nt~ nf th~ ~nm~ ~i7~ R. D. 4, Box 353 * Carlisle, PA 249-2677 -- 249-1978 "ROWE" TO: LeRoy S. Maxwell Jr. Attorney At Law Wayne Building 92 West Main street Waynesboro, PA 17268-2118 October 9, 2002 FOR: Gene Johnson Executor FROM: Benny E. Rowe Auctioneer/Appraiser 2505 Ritner Highway Carlisle, Pa. 17013 REF: Richard E. Johnson Estate, 555 "F" Street, Carlisle, Pa. Personal Property Appraisal at the Currrent Auction Market Value. ~ ' .... CORRECTION: Appraisal Dated February 18,2002. $1399.00 Total Should be Reduced to a Total of $1389.00 ESTATE OF RICHARD E. JOHNSON SCHEDULE OF HOUSEHOLD GOODS AND PERSONAL EFFECTS GARAGE M W Snow Blower Step Ladder Misc. Small Hand tools 3 Metal Cabinets 25.00 6.00 32.00 12.00 PAGE i KITCHEN Microwave Oven 5 Pcs. Kitchenette set Pots/Pans Glass/China Small'Kitchen Accessories Small Electrical appliances Decorators 20.00 15.00 38.00 25.0.0 20.00 26.00 12.00 LIVING ROOM 2 Pcs. Living Room suite 3 Upholstered Chairs Coffee Table & End Stands Table Lights 3 Drawer Pine Chest 2 Door Bookcase Kitchen accessories Pictures/Prints Decorators Luggage Misc. 35.00 15.00 18.00 10.00 15.00 45.00 25.00 10.00 28.00 5.00 35.00 BATHROOM Towels/Bedding 25.00 T V ROOMN R C A Color t V V C R Book Shelf Sewing Machine 2 Upholstered Chairs Chest of Drawers Boom Box Misc. 35.00 15.00 18.00 15.00 10.00 20.00 8.00 28.00 BEDROOMS 3 PCS. Bedroom Suite Metal stand Fan 4 Pcs. Bedroom Suite Rocking Chair Bedding Hamper Misc. ESTATE OF RICHARD E. JOHNSON SCHEDULE OF HOUSEHOLD GOODS AND PERSONAL EFFECTS 65.00 3.00 5.00 75.00 20.00 5.00 2.00 14.00 PAGE 2 BASEMENT Deep Freezer Treadmill Dehumidifier Wardrobe Jars Vacuum cleaner Step Stool G E Automatic Washer G E Electric Dryer Small Hand tools Fans Misc. STORAGE BUILDING Hechinger Riding Mower Rotary Mower Hose Trash Cans Electric Chain saw Edgers Step Ladder Long Handle tools misc. TOTAL 75.00 5.00 15.00 10.00 5.00 5.00 3.00 85.00 55.00 12.00 5.00 18.00 145.00 35.00 5.00 5.00 10.00 5.00 6.00 35.00 15.00 $1399.00 Benny E. COMMONWEAL~'I OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Richard E. Johnson SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-02-0108 Debts of decedent must be reported on Schedule I. ITEM NUMBER 10. DESCRIPTION FUNERAL EXPENSES: Nickel Funeral Home - funeral services Blain Zion Lutheran Women - funeral luncheon Pastor Jeffrey Diller - honorarium Rice Memorial Works - engraving date of death on grave marker ADMINISTRATIVE COSTS: Personal Represenm~e's Commissions Name of Personal Representa~ve (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City Slate Year(s) Commissien Paid: ^~mey F~ Maxwell Law Offices Famib/~emptJon: (If decedent's address is not t~e same as claimant's, attach explanation) Claimant Z~p Street Address Relationship of C~aimant to Decedent State Z~p P~b~teF~ Cumberland County.Register of Wills Accountant's Fees Tax Return Preparer's Fee~ Ben Rowe, Auctioneer & Appraiser - appraising personal property Cumberland Law Journal- publishing Personal Representative's notice $. W. Barrett Real Estate and Appraisal Service - appraising real estate Borough of Carlisle - water and sewer service 1/22 to 2/20/02 TOTAL (Also enter on line 9, Recapitulation) AMOUNT $ 6,052.50 211.00 100.00 90.00 26,150.00 530.00 75.00 75.00 250.00 13.53 $ CONTINUED (If more space is needed, insert additional st~ts of the same size) ESTATE OF Richard E. Johnson (CONTINUATION) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FiLE NUMBER 21-02-0108 Oebt~ of decedent must be reported on Schedule I. ITEM NUMBI~ 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28, DESCRIPTION 'UGI Utilities, Inc. - gas service 1/22 to 2/24/02 PPL Electric Utilities - electric service 1/25 to 2/25/02 The Sentinel - publishing Personal Representative's notice Sprint - telephone service 2/13 to 3/12/02 PPL Electric Utilities Corp. - electric service 2/25 to 3/25/02 UGI Utilities, Inc. - gas service 2/24 to 3/22/02 Sprint - telephone service 3/13 to 4/12/02 Borough of Carlisle - water and sewer service 4/1 to 4/30/02. UGI Utilities, Inc. - gas service 3/22.to 4/25/02 PPL Electric Utilities - electric service 3/25 to 4/25/02 Sprint - telephone service 4/13 to 5/12/02 Borough of Carlisle - water and sewer service 3/19' to 4/19/02 UGI Utilities, Inc. - gas' service 4/25 to 5/22/02 Sprint - telephone service 5/13 to 6/12/02 Borough of CarliSle - water and sewer service 4/19 to 5/21/02 PPL Electric Utilities Corp. - electric service 4/25 to 5/24/02 Sprint - telephone service 6/13 to 7/12/02 UGI - gas service 5/22 to 6/21/02 ($18.23 less $4.47 refund on cancellation of service) TOTAL (Also e~ter on line 9, Recapilulalian) AMOUNT $ 134.66 65.26 110.03 65.72 24.26 101.40 53.59 13.53 13.76 24.26 28.98 13.53 44.43 27.70 13.53 29.32 27.70 13.76 $ CONTINUED ES'TATE OF Richard E. Joh~so~ (CONTINUATION) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATNE COSTS FiLE NUMBER 21-02-0108 O~t~ of decedent must be repoded on Scfledute I. ITEM NUMBER 29. 30. 31. 32. 33. 34. 35. 36. OE$CRIFrrloN ERA - NRT, ][nc. - commission on sale of real estate in order to administer the estate ERA - NRT, Inc. - transaction fee on sale of real estate in order to administer the estate Cumberland County Recorder of Deeds - one-half Realty Transfer Tax on sale of real estate in order to administer the estate. BorOugh of Carlisle - final bill for water and sewer service United Parcel Service - fee for overnight package in connection with sale of real estate in order to administer the estate PPL Electric Utilities Corp. - final electric bill Tina K. Hough - notary fees Maxwell Law Offices - cl0sing"costs and final attorney's fee TOTAL (Also e~tm' on line AMOUNT $ 6,900.00 100.00 1,150.00 37.06 15.00 18.11 2.00 100.00 $ 42,674.62 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Richard E. Johnson 21-02-0108 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT Sprint - telephone service 1/13 to 2/12/02 Borough of Carlisle - water and sewer service 12/17/01 to 1/22/02 Dr. David L. Hartzok - balance due for eye exam and lenses prior to death Darlene L. rvloyer, Tax Collector - 2002 Real Estate Taxes ($490.05 less $202.73 proration received on sale of real estate in order to administer the estate) Darlene L. Moyer, Tax Collector - Personal County and Municipal Tax Darlene L. Moyer, Tax Collector - School Taxes for 2002- 2003 ($1,106.64 less $1,006.59 proration received on sale of real estate in order to administer the estate) TOTAL (Also enter on line 10, Recapitulatior $ (If more space is needed, insert additional sheets of the same size) $ 65.90 13.53 39.00 287.32 10.00 100.05 515.80 R~V-ISt3 EX * O-97) ~ COUUOHWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF Richard E. Johnson SCHEDULE J BENEFICIARIES FILE NUMBER 21-02-0108 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS (include outright spousal distributions) II. Gene E..]ohnson 1882 Orchard Road Chambersburg, PA 17201 Per Item II of Will - 100% residue TOTAL TAXABLE AT 4.5% Son $ 762,970.95 $ 762:970.95 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 NONE NONE 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) REV-1313 EX (9-96) ~.~ -~,~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 APPLICATION FOR REFUND OF PENNSYLVANIA INHERITANCE/ESTATE TAX TO: FROM: PA Department of Revenue Bureau of Individual Taxes Dept. 280601 Harrisburg, PA 17128-0601 Official Representative Name CHERYL A. WINTERS, 2nd DEPUTY REGISTER OF WILLS Address CUMBERLAND COUNTY COURTHOUSE 1 COURTHOUSE SQUARE, ROOM 102 CARLISLE~ PA 17013 Phone Number (717) 240-5340 Decedent Data Name of Decedent RICE~..RD E. JOHNSON File Number 21-02-0].08 Date of Death .TANU,~Y 23, 2002 Social Security Number ].99-07-3344 The undersigned requests a refund in the amount of $ $248.00 referenced decedent's estate. for the above REFUND REQUESTED ON: Original o_r Supplemental [~ Joint/Trust Assets [~ Remainder Return [~ Estate Tax Probate Return EXPLANATION OF OVERPAYMENT $248.00 WAS DEPOSITED AS A ZNHERITANCE TAX PAYMENT TO REVENUE ON 10-23, 2002, THIS PAYMENT WAS AN ADDITIONAL PROBATE FEE. S245.00 AND $3.00 FOR ONE SHORT CERTIFICATE. Date Please allow four to six weeks for the processing of your refund request. RECEIPT FOR PAYMENT Cumberland County - Register Of Wills Hanover and Hiqh Street Carlisle, PA ~7013 Receipt Date Receipt Time Receipt No. 1/23/2003 09:01:27 1031736 JOHNSON RICHARD E File Number 2002-00108 Remarks REFUND FROM DEPT OF REV FOR ADD PROBATE FEE & SC CW ........................ Distribution Of Receipt ........................ Transaction Description Payment Amount Payee Name ADD PROBATE FEE SHORT CERTIFICATE 245.00 3.00 CUMBERLAiqD COUNTY GENEHAL FUN CUMBERLAND COUNTY GENERAL FUN Check# 08898370 $248.00 Total Received ......... $248 00 Received of.. ~-/~,..~ ~:;~. ~ Page No. Estate No. 21 Estateof ~~~ ~~ Social Security No. /&q' ~ ~' Died /'- ~3-~ ~ Paia /z~ - ~ ~- e 'z Postmark Date~ ~~ x ~ REMITTANCE ADVICE Invoice Number PO Number Invoice Date 18 TAX REFUND AM# 96520939 ESTATE OF RICHARD E. JOHNSON AM# 96520939 96520939 0000000000 12/20/2003 Payment Amount Total Payment Amount - $ 248.00 IF YOU HAVE ANY QUESTIONS CONCERNING 'FHI~ PAYMENT CALL 717-705-4470 ** PLEASE DETACH CHECK AT PERFORATION ** BUREAU OF INDIVIDUAL TAXES /NHERTTANCE TAX nTVZSTnN DEPT. 280601 HARRISBURG, PA 17128-0601 LEROY S MAXWELL JR MAXWELL LAW OFFICES 92 W MAIN ST WAYNESBORO COHNONWEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE NOTZCE OF TNHERZTANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSMENT OF TAX PA 17268 DATE 12-10-2002 ESTATE OF JOHNSON DATE OF DEATH 01-2:3-2002 FTLE NUHBER 21 02-0108 COUNTY CUHBERLAND ACN 101 I Amoun~ Roml~ed REV-15~i7 EX AFP C01-02) RICHARD E HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:3 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-Z547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF JOHNSON RICHARD E FILE NO. 21 02-0108 ACN 101 DATE 12-10-2002 TAX RETURN WAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~o (Schedule A) 2. S~ocks end Bonds {Schedule B) (2) 3. Closely Held S~ock/Par~nership Zn~oros~ {Schedule C) ($) q. Nor~gagos/No~os Receivable (Schedule D) $. Cash/Bank Deposits/Misc. Personal Propor~y (Schedule E) (5) 6. Jointly Owned Propor~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Assa~s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expansas/Adm. Cos~s/Hisc. Expenses (Schedule H) (9) 10. Dobbs/Mortgage Liabilities/Liens (Schedule 1) (10) 11. To,al Deductions 12. Na~ Value of Tax Ra~urn 1151000.00 lz079.6q .00 .00 690~081.7:3 .00 .0O (8) NOTE: To insure proper crodi~ ~o your account, submi~ ~ho upper por~ion of ~his fore wi~h your ~ax payment. 806,161.:37 qZ,67q.62 515.80 (11) (12) 762,970.95 13. lq. NOTE: Charitable/Governmental Bequests; Non-olec~ad 9115 Trusts (Schedule J) (13) No~ Value of Es~a*o Sub,ac* ~o Tax (lq) If an assesseent was issued previously, lines lq, 15 and/or 16, 17, reflect flgures that /nclude the total of ALL returns assessed to date. 'qSMENT OF TAX: Amoun~ of Line lq at Spousal rail (15) · ~n'l: of Line lq ~axable a~ Lineal/Class A re~a (16) of Line lq a~ Sibling ra~a (17) ",ina lq ~axabla a'l: Colla:~oral/Class B ra~o (lB). Ouo gEIPT OlSCOUNT 'gER INTEREST/PEN PAID (-) q96 1,710.00 '~7 . O0 · O0 x O0 = 762,970.95 x Oq5= · O0 x 12 = · O0 x 15 = (19)= AHOUNT PAID :32,q90.00 1:3:3.69 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 762,970.95 ,ATED, SEE REVERSE ZTZONAL INTEREST. 18 and 19 will .00 :3q,:3:33.69 .00 .00 :3q,:3:3:3.69 3q,333.69 .00 .00 .00 ( ZF TOTAL DUE 1S LESS THAN $1, NO PAYMENT IS REQUIRED. ZF TOTAL DUE 1S REFLECTED AS A "CREDIT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12j 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class D (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Coemoneaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class D [collateral) rate on any such futura interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section ZlqO cf the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side. --Make check or money order payabIe to: REGISTER OF HILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may ba 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 #ills) any of the Z3 Revenue Distrlct Offices, ar by calling the special Z4-hour answering service for fores ordering: 1-800-36E-ZOSO; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, 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 --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg~ PA 171Z6-0601 Phone (717) 787-6505. Ssa page 5 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 eithin three (3) calendar months after the decedant's daath~ a five percent (SI) discount of the tax paid is allowed. The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessedj and not paid before January 18~ 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you #ould appeal the tax and interest that has been assessed as indicated on this notice. Xntarest is charged beginning with first day of delinquency, or nine (9) months and one (l) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 19aZ bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January l, 19az 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 1esl through 200Z are: Year Interest Rate Daily Interest Factor Year interest Rate Daily Interest Factor 19aZ lOX .000548 199Z 9Z .000Z47 1963 162 .000438 1993-1994 7Z .OOOl9g 1984 IlZ .000301 1995-1998 9Z .000Z47 1985 132 .000356 1999 7Z .O0019Z 1986 102 .O00Z7q ZOO0 8Z .000219 1987 9Z .000Z47 ZOO1 9Z .000Z47 1988-1991 llZ .000301 ZODZ 6Z .000164 --Interest is calculated as follaas: ZNTEREST= BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELZNQUENT X DAXLY /NTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) ~ beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. October 18, 2002 Maxwell Law Offices Wayne Building 92 West Main St. Waynesboro, Pa. 17268-1591 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 17128-0601 Telephone (717) 787-3930 FAX (717) 772-0412 Dear Mr Maxwell: Re: Estate of Richard E. Johnson File Number 2102-0108 This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before April 23,2003. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. Sincer~y, Jeffrey Hollenbush, Supervisor Document Processing Unit Inheritance Tax Division STATUS REPORT UNDER RULE 6.12 Name of Decedent · Richard E. Johnson Date of Death · January 23, 2002 Will No. · 2002-00108 (21-02-0108) Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, T 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 ~/ 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 ~ 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 ~/ No 4. 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. LeRo~ S. Maxwell, ~ - Maxwell Law Offices Wayne Building 92 West Main Street Waynesboro, PA 17268 (717) 762-2118 Counsel for Personal Representative