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Home My WebLink About02-1003PETITION FOR PROBATE and GRANT OF LETTERS Estate of _ Mary Elizabeth Kelso also known as Social Security No. -1 -3523 Deceased. lvo. ~.~-oa-look To: Register of Will for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executer named in the last will of the above decedent, dated lanuarv 1 , 194L- and codicil(s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 1694 Walnut Bottom Road, Newville, PA 17241 Penn Township (list street, number and muncipality) Decendent, then 85 years of age, died October 29 ~j 2002 at 7a mop N ing Home MiddlP~P ownGhip Carlisle, PA 17013 Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 300,000. 00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ .~C s yoC7 ~~ ,, situated as follows: tract of land with improvements thereon situate in Penn Township. WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) V G b .~ ~, ./.~~~ y ~ v ~. ~.~ ~.0 1 Fi Pargnn~P $trPPt ~a -~I9zaV-ills, PAk 172-/11 v w. o c m OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF Ctiw-be~.laacL- The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly admi ister the estate according to law. Sworn to or affirmed and subscribed ~~~ t„ before me this 8th day of ~' ~ ~nn~ ~Q"-' egrster A ~. c~'o No. _~.1- Off- l 003 Estate of Mary Elizabeth Kelso Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND IVOW November A ~ 2002 in consideration of the petitiar, on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated_January 1, 1997 described therein be admitted to probate and filed of record as the last will of Mary Elizabeth Kelso Richard L. Webber, Jr., Esquire X49634 and Letters Testamentary ; are hereby granted to Roy W. Kelso FEES Probate, Letters, Etc. ......... X 3 0 5. 0 0 Short Certificates( ) .......... $ 1 S n n Renunciation ................ S $ 10.00 TOTAL ~~, C.~ Filed .... 1.1-.$ -.~ 0 0,2 .... . ............. called atty 11-8-2002 Register of Wills ~~ ATTORNEY (Sup. Ct. I.D. No.) 126 East King Street, Shippensburg, PA 17257 ADDRESS (717) 532-7388 PHONE ,. } 11S iS CO ~',;Ilfl' Chat ih' llCttrCi~aCLOR }7eC('. ;~17'eCl 1S COCCeCC}b' U)})IC(~ Ci0111 <iCl O1.1~1Clal CtCCtt(l:l[l C1 ' c~~,:`,tl {j.Ul`r' rIliLl 'L'tJ? i7~ 3.ti }_ocal Re~istrir. The origin.lJ cer;iEicate will be-fo7tiv<u•ded to the Slate Viral records Office f=01- peg- 1>a~~~~t7t tl~~rl~:.. WARNING: It is illegal to duplicate this copy isy photostat or photograph, d Yc,r th.~ Ltirtifi, ,itt, S'.OG L<,cal ~, r~;ttirr7i ~ 8703607 ^I~ ~loY ~ ~ 2002 ~ ~:,a -noS.;aJ qey. ye7 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH IT Ir I ~~~~~~~--•-~~-~~•~~~~•>. ^+~wn+.;asr SEX SGCIAL SECURITY NUMBER t• Mar _ DATE OF DEATH..MCnm. Day,'2ar, ~ 1. ]. - ~. AGEILas B~nneey) UNDER,YEAR UNDERIDAY DATE OF BIRIH BIRTHPUCE IC~IyaA PIACE OF DEATHICneckonlY M`e_+ea,nsnuclgrn nn olner egel Momns Days Howe • MMAKw !MOnm.Ory.'berl 3lalea Fgegn Counnyl HOSPITAL: OTHER: 8 5.a i April 17 u n t s d a l e, P a Inparimt ^ ERIOMpsli.m ^ DDA ^ "°"'"g ~ otMr S' ' d. 7. rM• Home RwWna ^ rSpeuH7 ^ • COUNTY OF DERH CT', BORO,TWP OFD FACILITY NAME plnq insnggn. gne sreet ano numMr, NN$DECEDENT OF HISPANIC ORIGIN? RACE -Amencan IrWian, &Kk, Vlhke. etc. Cumb No~(~'[~~ ye. ^ n yw, weeny Cuban, Iscecerl 9e. KMiddelsex tw Claremont Nur. Home M•`"~'••P'remoRK.n,«e. DECEDENT'S USUAL OCCUPATION KINOOF BUSINESS/INDUSTRY WAS DECEDENT EVER IN '• ,owh i t e U. S. ARMED FORCES7 DECEDENT'S EDUCATION Matrwd (Give wrrk)gwgk none eurwmgg nqs onl A aoe cam K Never Marti W, WlCnwae. SURVIVING SPOUSE of working Na; ao rql u» r~ K.) ElamenMry/Saconeary p ( ~ 1n mfe. gwe maANn nwnal • ,,.. T e 11 e r „eB ,:. yea ^ Ne Q ,~. (o-,z, 2 ,, ."a :, Di„or~.e spK DECEDENTS MAILING ADDRESS (Slrew.CM~ .SWro.Iq LOeel DECEDENT'S 1e' ,~• ACTUAL 17a. Stare P d D~~m 17e.^ Ma. aaueeM Iivad in P P n n ,moo 16 q 4 Walnut Bottom R sIDENCE Newville Pa onq~r ~~'a '"°'"• t9• ' Cumb rownanip7 No,axseare lfvad ,Te.cen ne.^ wank,.rnwkmdaa FATHER'S NAME (Fks, Mioge, Las) ma cX o. Y MOTHER'S NAME IFns. M~dd19. Maieen Swneme) ,,. Ro F. Kelso t9 INFORMANTS NAME (TypyPrmg INFORMANT'S MAILING ADDRESS ISrreel. Cityrtown, $Mte, Lp Codal Ro W ]o. Kelso . . mn METHOD OF DISPOSITION DATE OF DISPOSITION PUCE OF DISPOSRK)N-NarM Cemetery, Crematory •L C (MOnm, DaY KY . Stria, ZKr Cow yecrl BuMI ~i Cremation ^ Remov l tr r Pl S dM ^ ^ . p a « a IaN r ap °ov"°"^ °inirjSpeC"'" ~Tov 1 2002 ]" Centerville Mem. Gdns • ] ],, Newville ' $IGNA FUNE LSE ICE Pa . , EN$EE OR PERSON ACTING AS SUCH LICENSE NUMBER NAME AND ADDRESS OF fACIIITV ]]. ]]b ~19G ig Spring AVe Camille earns 23a<only wMn uniyi To tM Wn d my krgwlsoge, oaam oCCUrratl at tM lm ,oars aM plMa salao l . p tysinenwnq aveilal+le ar tuna of een (S,pMlur Tnb) LICENS E NUMBER - EQ -7~ I °~, pnM awwaaam. ~ 1\N ~~ ~ 'J V l~ Da. 7eml ~ ~ xx. ]]e Kama 2eQ9 m n W . u :x.li 20L; comlNeraO oY TIME OF~AC r DATE PRONWNCED DEAD IMOnm, Day. year, vaS CASE REFERRED TO parson wM Pronq.ncw Grin. J ` M E SAL EXAMINERrCORONER7 , ~ W ^ - hl ]7. MiiT 1: Enln IM eis°a»a. injuriy or wmpiicariona wKk:K uuleo IM oes . DO nol anler IM rtgoa of Eyirp, f K as Greiec or re.pirarory erreal, SMCk or Men failure, i Approaimala PAgT 11: OIKef a 'KCam Lin ony one pu» on sear Fns. 'mil corloKioru oorNribxm9 ro earn tan , interval Detw9sn I rid resuektq n the uMarlyirq auw P,+n w PART I. IMMEDIATE CAUSE (Fvln I Oneal aria daeM da»»gaaainer, T ~, rwuekgnoeaKq-- Y I~ , s~ R C r ,v o ~/\ - DUE IOR ASACONSEWENCE OFl: SapwMaey Kn taMKiow e. I d arty, Neeklg b knmapiaa DUE 70 (OR AS A CONSEQUENCE OF): _ Cauu. EntM UNDEALYIND 1 CAUSE (Di»wgv+Ary e. ' sNl eNatK •~ DUE TO (OH AS A CONSEQUENCE OF7: raanq n oealKl LAST e . k4A.4 AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF DEATH DATE OFIWURY TIME OFINJURY 1WURV AT WtDRK7 DESCRIBE HOWINJURY OCCURRED PERFORMED? AWtABLE PRIOq TO M . j mm. Day, Year) COMPLETION OF CAUSE ~/ OF DErOH7 Wturn L=i Hpmkiea ~?// AeeieeM ^ PerWinglrnestigation ^ Yea ^ No ^ M ~ ~• ]ge . Yw . ]Oe. , NO Yes ^ No LJ Suicioa ^ CouM nq M Oelerminee ^ PLACE OF INJURY ~ Ar Mme f r u f , a m, s er, attory, oaks LOCATION ($Kes. CMfT vn. 5lala) ]N. ]ss. ]g• Wildnq, ne. ISpectlvl ~ CERTIFER ICl+aak any one, •• ~• 'CERTIFYING PHYSICIAN IPnys¢yn cenmmq caux d seam when arglher pnysv:an rise pOngarce0 deem ano (:gnp141M nem 23, SI RE A D OF CERTIFIER Te d,a Cwt el my knewNega edam aeeurtee dw a m • - , e caueNsl and manner as need ..................................................... Q J ]tb. - •MONOUNCING AND CEriTIFYINfi PHYSICIAN IPnyvcan born prpnounc awm arW cam LICENSE NU DATE SIGNED (Mgan, DsY. }earl to rau» of tleaml ' .. Te IM eetl W my 4rowleegw, ewm eeewred at ma tlrw, dale, aM ec~ aria Ow to N,e ~ ]1a. O.~ ~ C03"Q-~ ~ ~ L. a W sale and manner.. aratw .......................... ^ ],d /0 f a e NAME AND ADDRESS OF PERSON WHO COMPLETEDCAUSE N F~ 'MEDICAL E%AMINER/CORONER (Kam 27)Type or Pnnl ~'Cty~` On tM Deslf of aaaminatlon antlla Investigation, in my opinion 17 C7 r`~ („~ ~ O death occurred at the Ilma dat d l I • . , , a, an p op, and tlue to me eau»p) and m.nnara„Lat.d ........................................................................... ^ ..... ........ ]]. I a 3o Uaoo IbP~ ~ L`-~a41~ P REGIS RAR'S SIGNA7UREA ONUMBER DATE FRED (MOnm. pay, Year, I I ~,. _ o~ • i, aoo~- L ~.,y ~1~- ~ 6i. `~ 9tr~ ~~~ / /!~~ 1 tJ a / - o ~, - /o 0,3 ~ ^ n n _ ~~. ~~ ; .~~ ~~ 1" ~ ~ r .mot ~ ~~ , ~ L.t „-L.~_: ~~~ . ~I ~~~ / 7 t~~ / ~:~~.~,-;-~ C~,~ /' ~ ~ _/ ' ~. ~ ~~, . ~ ~' ~ ~ ~ _ _>---~~ v~~c cL~ ~-k.. ~, '~~-E,-,~~:~-c_ ~.__. -L ~ .~-~~-t~--~,---vim ~ G ~--% T~ .._.. ~ ,~ `t~~, - '~'~- t... ``~ Ctn.-~_.._ ~ ~~,ti~,~~ . ~~, ~,,~ ~ ~ ._ ,-, ~ =~ ~ ,~ ~~ ~.~ vim, C ~~ --,~-~..~ c"~, ,,-~ ~~1 ~ ~~ ~: ~. ~~ ~ ~. ~~"~~. ~_ ~ ~ ~- ~ , ~ ~;~ _ ~ ,~ ~~_ . ~~ r .-~_ ~ ~ ~` i L ~.1,. ~L-t~ u ~--vLL~ ~ ~--~ t..-(~'`f -~0`ti-'~ t~ : ~-' f ~j`t~ , G`'C ,, - --~.~ C i_'~ ~ L_ ti~ G ~ ~~~ ~ .Ll- + ,~ l4-vvL. "" ~L Gt. (.~--~'~ l~`i-~ ~ ~o~ ~. ~ ~~, / y r . ''' ~~ V~ ', , ~. ~..~ ~~fr~ l ) ~_:~/` y~~ rr V li~ _/ 1. ~ L 1. E~`~'1.l~' ~/ •~ '~='~~- ~i~~,v~~~"~ ~'f/V'l ~`~--' ~~ ~~. L~ CL,t.t:~. _~ h ~ ~ , ~ti-k Ct vt..-e- ~~ ~ . /1/'~~ __', ~ ___.. ~, ~'! ~~ l _____.._ ~ r '' ~,,-L,E o~ a\ "~ -f.~ REGIS'~'~OF WILLS OF TH OF SI11~R~ (each~a subscribing wi ess to the will law, depose(s) and say(s) at the testat ,sign the sa request of testat in h_ other subscribing w ness(es)). Sworn to or affirmed me this _ and that subscribed be re day 19 Register (Address) (Name) (Address) REGISTER OF WILLS OF Cumberland COUNTY OATH OF NON-SUBSCRIBING WITNESS oZl- oa,- lao~ Mar M. Kelso and Roy W Kelso (each) a subscriber hereto, each bein dul ' ( ) g y qualified according to law, depose(s) and say(s) that the are familiar with the signature of .-Mary Elizabeth KPl cn testat rix of (one of the subscribing witnesses to) the will presented herewith and that each believes the signature on the will is in the handwriting of Mary Elizabeth Kelso to the best of their knowledge and belief. Sworn to or affirmed and subscribed before me this _~~ day of NOV~,MI3BR 2002 ~.(~~~ ~ ~ -" ` n - ~ Re ster COUNTY G WITNESS esented herewith, each) being y qualified according to present and saw signed a a witness at the and (in t ~ presence of eac~ other) (in the p sence of the /Y`• 16 Parsonage Streeet, Newville, PA 17241 ~ress) 16 Parsonage (S reet, Newville, PA 17241 (Address) ~./~ [N RE: ESTATE OF MARY ELIZABETH KELSO, late of the Borough of Newville, Cumberland County, Pennsylvania, deceased IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE NUMBER 2002-001003 CERTIFICATION OF NOTICE UNDER RULE 5.6 a Name of Decedent: Mary Elizabeth Kelso Date of Death: October 29, 2002 Will No. 2002-001003 To the Register: I certify that notice of 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 December 12, 2002: Anthony Newcomer 1644 Walnut Bottom Road Newville, PA 17241 Centerville Lutheran Church 1874 Walnut Bottom Road Newville, PA 17241 Roy W. Kelso 16 Parsonage Street Newville, PA 17241 Tina Newcomer Fry 1688 Walnut Bottom Road Newville, PA 17241 Centerville Memorial Park Attn: Robert Lloyd 1698 Walnut Bottom Road Newville, PA 17241 Timothy Newcomer 137 Goodyear Road Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a). Date: ~~ 'l~ ~o~ Signature ~~.~rC /~~=' `_~~ Name: Richard L. Webber, Jr., Esquire Address: Weigle & Associates, P.C. 126 East King Street Shippensburg, PA 17257 Telephone: (717) 532-7388 Capacity: Personal Representative X_Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 77128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT WEBBER RICHARD L JR ESQUIRE 126 EAST KING STREET SHIPPENSBURG, PA 17257 fold ESTATE INFORMATION: ssN: 183-t2-3523 FILE NUMBER: 2102-1003 DECEDENT NAME: KELSO MARY ELIZABETH DATE OF PAYMENT: 01 /27/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 0/ 29/ 2002 ACN ASSESSMENT CONTROL NUMBER REV-1162 EX~11-961 NO. CD 002092 AMOUNT 101 ~ 546,200.00 TOTAL AMOUNT PAID: REMARKS: RICHARD L WEBBER JR ESQUIRE CHECK#116 INITIALS: JA SEAL RECEIVED BY: 546, 200.00 DONNA M. OTTO DEPUTY 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 WEBBER RICHARD L JR ESQUIRE 126 EAST KING STREET SHIPPENSBURG, PA 17257 -------- fold ESTATE INFORMATION: SSN: ~ s3-~ 2-3523 FILE NUMBER: 2102-1003 DECEDENT NAME: KELSO MARY ELIZABETH DATE OF PAYMENT: 07/30/2003 POSTMARK DATE: 00/00/0000 couNTY: CUMBERLAND DATE OF DEATH: 10/29/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 ~ $24,408.93 TOTAL AMOUNT PAID: REMARKS: ROY W KELSO EXECUTOR C/O RICHARD L WEBBER JR ESQ CHECK# 151 SEAL INITIALS: JA RECEIVED BY: DONNA M. OTTO 524,408.93 DEPUTY REGISTER OF WILLS REV-1162 EX(11-961 NO. CD 002854 REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: WEIGLE & ASSOCIATES 126 EAST KING STREET SHIPPENSBURG, PA 17257 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER -------- fold ESTATE INFORMATION: SSN: 1 s3-~ 2-3523 FILE NUMBER: 2102-1003 DECEDENT NAME: KELSO MARY ELIZABETH DATE OF PAYMENT: 10/03/2003 POSTMARK DATE: 00/00/0000 couNTY: CUMBERLAND DATE OF DEATH: 10/29/2002 AMOUNT 101 ~ 53.34 TOTAL AMOUNT PAID: REMARKS: WEIGLE & ASSOCIATES SEAL CHECK# 1915 INITIALS: AC RECEIVED BY: DONNA M. OTTO 53.34 DEPUTY REGISTER OF WILLS REV-1162 EX111-96) NO. CD 003081 REGISTER OF WILLS /7- jQ- ii BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17126-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 IX AFP (01 -03) DATE 09-22-2003 ESTATE OF KELSO MARY E DATE OF DEATH 10-29-2002 FILE NUMBER 21 02-1003 . - COONTY CUMBERLAND RICHARD L WEBBER JR ESQ ACN 101 WEIGLE 8, ASSOCS Amount Remitted 126 E KING ST SHIPPENSBURG PA 17257 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS -~ ---------------------------------------------------------------------------------------------------------------- REV-1547 EX AFP CO1-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KELSO MARY E FILE N0. 21 02-1003 ACN 101 DATE 09-22-2003 TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) 75, 000.00 NOTE: To insure proper (2) 157, 390.85 credit to your account, (3) .00 submit the upper portion (4) .00 of this form with your (5) 365, 308.35 tax payment. (6) .00 (7) 33 , 195.92 (e) 630,895.12 APPROVED DEDUCTIONS AND EXEMPTIONS: 13,552.10 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 2,4 22.14 11. Total Deductions (11) 15.974.24 12. Net Value of Tax Return (12) b14,920.88 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) C13) 7,0 00.00 f Estate Subject to Tax N t V l (ly) 607, 920 .88 14. ue o e a NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate C15) • 00 X 00 = . 00 16. Amount of Line 14 taxable at Lineal/Class A rate C16) .00 X 04 5 = .0 0 17. Amount of Line 14 at siblins rate (17) 604,920.88 X 12 = 72,590.51 18. Amount of Line 14 taxable at Collateral/Class B rate C18) 3, 000.00 X 15 450.00 19 Principal Tax Due C19). 73, 040 .51 . ~~ PAYMENT~~ DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 01-27-2003 CD002092 2,431.58 4b,200.00 07-30-2003 CD002854 .00 24,408.93 BALANCE OF UNPAID INTEREST/PENALTY AS OF 07-31-2003 TOTAL TAX CREDIT 73,040.51 BALANCE OF TAX DUE .00 INTEREST AND PEN. 3.34 TOTAL DUE 3.34 * IF PAID AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE w oc c~lun ccr ocVCOCC cTTG Ac TLJTC C!)ON G!)D TNCTDIIrTTnNC 1 ~~~ ~9 ~9 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-D601 RICHARD L WEBBER JR ESQ WEIGLE & ASSOCS 126 E KING ST SHIPPENSBURG PA 17257 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX RFP t01-V3) DATE 10-20-2003 ESTATE OF KELSO MARY E DATE OF DEATH 10-29-2002 FILE NUMBER 21 02-1003 -- COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS t ---------------------------------------------------------------------------------------------------------------- REV-1607 EX AFP (01-031 *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF KELSO MARY E FILE N0. 21 02-1003 ACN 101 DATE 10-20-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-22-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 73,040.51 PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID (-) AMOUNT PAID 01-27-2003 CD002092 2,431.58 46,200.00 07-30-2003 CD002854 .00 24,408.93 10-03-2003 CD003081 3.34- 3.34 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. * IF PAID AFTER THIS DATE, SEE REVERSE l TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YDU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 73,040.51 .00 .00 .00 ~~-~d~- l~ COMMONWEALTH OF PENNSYLVANIA ~, BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280661 INHERITANCE TAX HARRISBURG, PA 17128-0661 STATEMENT OF ACCOUNT REV-1607 EX ~FP (01-037 RICHARD K HOSKINSON HOSKINSON & WENGER 147 E WASHINGTON ST CHAMBERSBURG PA 17201,, DATE 10-20-2003 ESTATE OF KENDIG MERRILL S DATE OF DEATH 10-31-2002 FILE NUMBER 21 02-1032 -- .COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this fore with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1607 EX AFP (01-03) *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF KENDIG MERRILL S FILE N0. 21 02-1032 ACN 101 DATE 10-20-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-15-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 10,891.33 PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 01-23-2003 CD002089 500.00 9,500.00 07-29-2003 CD002853 .00 707.11 10-03-2003 CD003082 1.54- 185.76 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. TOTAL DUE 10,891.33 .00 .08 .08 IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 2002-01003 EXECUTOR ACCOUNT FIRST AND FINAL ACCOUNT OF Roy W. Kelso, Executor For ESTATE OF MARY E. KELSO, Deceased Date of Death: October 29, 2002 Date of Executor's Appointment: November 8, 2002 Dates of Advertisement of Letters: The Valley Times-Star: December 18, 2002; December 25, 2002; and January 8, 2003 Cumberlin County Law Journal: December 20, 2002; December 27, 2002; and January 3, 2003 Accounting for the Period: October 29, 2002 to October 24, 2003 Purpose of Account: Roy W. Kelso, Executor, offers this account to acquaint interested parties with the transactions that have occurred during his administration. The account also indicates the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Richard L. Webber, Jr., Esquire Weigle & Associates, P.C. 126 East King Street Shippensburg, PA 17257 (717)532-7388 1 WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 726 EAST KING STREET - SHIPPENSBURG, PA 172 57-7 39 7 Summary of Account Fiduciary Current Acquisition Page Value Value Beneficiaries t i ib 8 $ $110,834.51 o on ut Proposed Distr Principal 4 $ 522,662.78 Receipts Less Disbursements: 5 14 $3619 Debts of Decedent . Funeral Expenses 5 6418.00 Family Exemption 5 0.00 Administration Expenses 6 3814.77 Federal and State Taxes 6 70611.77 Fees and Commission 6 3469.15 -$ 87,932.83 Balance before Distributions 7 434,729.95 Distributions to Beneficiaries 7 -337,015.26 Principal Balance on Hand $ 103,334.83 Income Receipts 7 7499.68 Less Disbursements 7 0.00 Balance before Distributions $ 7499.68 Distributions to Beneficiaries 0.00 Income Balance on Hand 8 7499.68 _ Combined Balance on Hand 8 $110,834.51 2 WEIGLE & ASSOCIATES. P. C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 Fiduciary Current Acquisition Value Value Cash and Cash Equivalents: 9. Allfirst Certificate of Deposit #80000001982088 28,750.00 Accrued interest to date of death 154.40 10. Treasury Direct 3-7/8 note 5-03 10,000.00 Accrued interest to date of death 126.34 1 1. Allfirst Certificate of Deposit #80000001982197 11,000.00 Accrued interest to date of death 16.33 12. Allfirst Certificate of Deposit #80000001982212 10,000.00 Accrued interest to date of death 39.50 13. Allfirst Certificate of Deposit #87008140219282 10,000.00 Accrued interest to date of death 18.21 14. Allfirst Certificate of Deposit #87008141004646 3,017.32 Accrued interest to date of death 1.43 15. Farmers National Bank Checking Account #12-165-7 9,022.87 Accrued interest to date of death 2.99 16. Farmers National Bank Savings Account #9615067 9,095.28 Accrued interest to date of death 11.89 17. Farmers National Bank Money Market Account #158224 21,500.00 Accrued interest to date of death 30.34 18. Farmers National Bank Money Market Account #160308 10,000.00 Accrued interest to date of death 27.91 19. Farmers National Bank Money Market Account #160320 6,000.00 Accrued interest to date of death 9.12 20. Farmers National Bank Money Market Account #160335 6,000.00 Accrued interest to date of death 16.65 21. Farmers National Bank Money Market Account #160364 10,000.00 Accrued interest to date of death 29.03 4 WEIGLE & ASSOCIATES. P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397 Fiduciary Current Acquisition Value Value Farmers national Bank Money Market Account #3990774 22 4,100.00 . Accrued interest to date of death 17.57 Farmers National Bank Money Market Account #3991044 23 30,700.00 . Accrued interest to date of death 160.91 Farmers National Bank Money Market Account #4990770 24 10,000: . Accrued interest to date of death 66 25. Cash in safe deposit box 16,116.78 Tangible Personal Property: Proceeds of public sale held on March 22, 2003 $ 20,463.10 Stocks 7477 Shares of Adams County National Bank common stock at $21.05 per share $157,390.85 Receipt subsequent to date of death (Valued when received) 3/3/03 AARP refund 19.00 3/5/03 Washington National Insurance refund 1.72 4/15/03 Auto Insurance Refund 120.99 5 WEIGLE & ASSOCIATES. P.C. -ATTORNEYS AT LAW - 128 EAST KING STREET - SHIPPENSBURG. PA 17257-1397 4/16/03 Sprint refund 5.47 4/16/03 Walnut Bottom Radiology refund 50.96 4/16/03 Walnut Bottom Radiology refund 58.92 4/25/03 U.S. Treasury net refund 964.00 5/16/03 Pa. Dept. of Revenue net refund 9.00 5/16/03 Gas company refund 55.16 5/23/03 2003 County/Township real estate taxes -refund at settlement 127.45 5/23/03 2002-03 School taxes -refund at settlement 98.54 6/6/03 Everett Mutual refund on house insurance 202.00 TOTAL PRINCIPAL RECEIPTS $522,662.78 6 WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 726 EAST KING STREET - SHIPPENSBURG. PA 77257-1397 Fiduciary Current Acquisition Value Value Disbursements of Principal Debts of Decedent 11/30/02 Sprint $ 33.66 11/30/02 Koughs Oil Service 130.62 11/30/02 PP &L 47.83 12/02/02 MSHMC Physicians Group 6.58 12/06/02 Social Security Administration returned check 895.00 12/09/02 PPC Associates 58.92 12/20/02 Carlisle Imaging 64.45 12/20/02 Sprint 33.14 12/20/02 Koughs Oil Service 302.00 12/20/02 Everett Mutual Insurance Co. 302.00 12/29/02 Aaron Zimmerman -Care 63.00 01/05/03 PP & L 54.00 01/05/03 MSHMC Physicians Group 5.18 11/12/03 Sprint 33.14 01/12/03 Koughs Oil Service 126.00 01/28/03 Pat Palmer -Care 64.00 01/31/03 Koughs Oil Service 181.48 01/31/03 Kemper Auto Insurance 158.32 02/03/03 PP & L 52.51 02/14/03 Sprint 33.30 02/20/03 Koughs Oil Service 176.70 02/20/03 Medicare Adjustment 223.62 02/02/03 Kemper Auto Insurance 82.17 02/27/03 Mabel G. Stitt, Tax Collector -Real Estate Tax 209.55 03/08/03 PP & L 49.45 03/14/03 Sprint 33.28 03/24/03 Koughs Oil Service 170.78 03/24/03 PP & L 28.46 Total $3619.14 7 WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 1Z6 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 Funeral Expenses 12/09/02 Egger Funral Home 06/09/03 EEF Redding & Son Family Exemption None Administration Expenses 6228.00 190.00 Total $ 6418.00 11/08/02 Cumberland County Register of Wills -probate fee 333.00 12/03/02 Cumberland County Register of Wills -short certificates 6.00 01/14/03 Cumberland County Register of Wills -short certificates 9.00 12/12/02 Cumberland Law Journal -legal advertisement 75.00 12/12/02 Shippensburg Postmaster -certified mail 4.42 03/11/03 Valley Times-Star -legal advertisement 62.00 12/06/02 Farmers National Bank -lock box fee 10.00 12/23/02 Newville Postmaster -stamps 37.00 12/23/02 The Sentinel -advertisement for newspaper 29.99 O l /21 /02 Adams County National Bank -fee for checks 12.00 01/21/02 Newville Hardware -locks for house 19.91 03/20/03 DTD Septic 68.90 03/24/03 Shippensburg Postmaster 4.65 03/24/03 Fire Police -parking for public sale 192.00 03/24/03 Luke Fry -snow removal 50.00 03/24/03 Howard's Accounting 105.00 03/24/03 Cumberland County Register of Wills -short certificate 12.00 03/24/03 Michelle Cornman 15.00 8 WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBVRG, PA 17257-1397 Fiduciary Current Acquisition Value Value Previous Distributions 06/09/03 To: Anthony Newcomer 1,000.00 Tina Newcomer 1,000.00 Timothy Newcomer 1,000.00 Centerville Lutheran Church 5,000.00 Centerville Memorial Park 2,000.00 $ 10,000.00 See attached Receipt, Release and Funding Agreement for each beneficiary. 07/29/03 Roy W. Kelso TOTAL 321,395.12 Principal Balance on Hand Cash Receipts of Income Interest for Year 2002 (10/29/02 to 12/31 /02) 2515.51 Dividend for Year 2002 2093.56 Interest for Year 2003 1320.44 Dividend for Year 2003 1570.17 Total Disbursements of Income None 10 $331,395.12 $103,334.83 $ 7499.68 WEIGLE & ASSOCIATES. P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-7397 Distributions of Income to Beneficiaries None Income Balance on Hand Cash $ 7499.68 Combined Princiual and Income Balance on Hand Cash $110,834.51 SCHEDULE OF PROPOSED DISTRIBUTION TO: Roy W. Kelso 16 Parsonage Street Newville, PA 17241 Residue of Estate pursuant to Paragraph of WILL $110,834.51 TOTAL $110.834.51 11 WEIGLE & ASSOCIATES. P. C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 77257-1397 IN RE: ESTATE OF MARY E. KELSO IN THE COURT OF COMMON LATE OF THE TOWNSHIP OF :PLEAS OF CUMBERLAND COUNTY PENN, NEWVILLE, CUMBERLAND :ORPHANS' COURT DIVISION COUNTY PENNSYLVANIA N0.2002-01003 CERTIFICATE OF SERVICE I do hereby certify that on October 24, 2003, I served the Notice, First and Final Accounting, and Schedule of Proposed Distribution to each of the persons and entities listed below by mailing a copy of the same by U.S. (Certified) First Class Mail, Return Receipt Requested: Roy W. Kelso 16 Parsonage Street Newville, PA 17241 WEIGLE & ASSOCIATES, P.C. Date: / ~~ ~ Z'/~ ``? ~ By: ,-'''~--~ ~-~ ,---- Richard L. Webber, Jr. Attorney for Executor 126 East King Street Shippensburg, PA 17257 (717) 532-7388 12 WEIGLE be ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 ROY W. KELSO, Executor of the Estate of MARY E. KELSO, deceased, hereby declares under oath (penalties of perjury) that he has fully and faithfully discharged the duties of his office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that, to his knowledge, there are no claims now outstanding against the estate; and that all taxes presently due from the estate have been paid. <;'~ Roy W elso, Executor Subscribed and sworn to by Roy W. Kelso before me this ~~/° ~ day of <~``fc~ /-- , 2003. Notary Public NOTARIAL SEAL RICHARD L, WEBBER JR., NOTARY PUBLIC SHIPPENSBURG BORO, CUMBERLAND COUNTY MY COMMISSION EXPIRES JULY 15, 2006 14 WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 726 EAST KING STREET - SHIPPENSBURG, PA 77257-7397 _~~~ / / `1 `~, / . Y .. ~~ ~~~ ~ ~~~~ ~ ~J . J lc~.~ ~~. w' 1 7 ~~ .J~~w ~ c~ .~ ~ ,~_ , ` {~ a ~J I/~ / ~~ /~//~n ,/ ~ ~ ~ ~f ~ ,(///) ~.., ~ti-~- ~ ~ ~ ~. z ~ w .~,C ~. mac. , ~.;~~, ,^ ' n ~ ~ ~ J~ ~~-1/l.~t rw .~~ ~-C~J U. . Q.J . C G -~--J ( ~ ~~vl.~ a -a- [["~ -~- (~ - ~ .~U / ~-V~, C~,-v~, l~rvv,-t~~--~ G.~.-~_ CSC-v`~-L~. ~ ~ ~\ ~. ~ ~ ~. ~~-w~ ~ -~ ~=c. vim., CC..~ v~-c..~ ci.~-~- w ,~,~~ ~~~~~w `r~~ ~ ~ ~1 ,. , ~ ` u~'~ s- Z d o Z ll ,-~[('' ~ -~-r ~ ~ (J _ C tiL 1. ~~~- ~- vim,, ~ ~ ~.~,`,-~o--Y--. ~ J..~~ ~ 0`z~-~ - o~-~' 77"" ~~ ~ r ~ ~ ~~ ~ ~ EXFIIBIT A t i vv. w 1 UUl~bANVU V. • wu~.c ,,, THE VALLEY TIMES-STAR COUNTY OF CUIvIBERLAND COMMONWEALTH OF PENNSYLVANIA VWPA Heidi E. Carpenter, being duly sworn according to law, deposes and says that she is the Editor of "The Valley Times-Star", which is a wcekly newspaper of general circtiilation published in Shippensburg Township, Cumberland County, Pennsylvania, by the News-Chronicle Company, a corporation duty organized and e~dsting tinder the laws of the Commonwealth of Pennsylvania having it's principle place of business at 1011 Rimer Highway [P.O. Box 100), Shippensburg, Pennsylvania; that she is authorized to and does make this affidavit on it's behalf; that the printed notice, advertisement or publication attached hereto is the same as was printed in the regular editions & issues of "The Valley Times-Star" on the following date(s): December 18, December 25, 2002 and JanuarX 1 200 Copy of Notice of Publication Affiant further deposes that neither she nor "T'he Valley Times-Star" and The News- Chronicle Company have any interest in the subject matters of the aforesaid notice or advertisement, and that the facts set forth in the foregoing affidavit are tn~e 8t correct. Sworn and subsc~rib`ed before me this ~f-~ day of 1 ~' ~ c~~~ Notary iblic ~--- Notarial Seal Grace M. Keifer, Notary Public Shippensburg eoro. Cumberland Cour>ty t`/lY Commission Expires June 9, 2006 Member. Pennsylvania Assoaation OF Notaries To: "The News-Chronicle" Shippensburg, PA 17257 For publishing the notice attached hereto: On the stated date[s] ..... S 6 0. 9 0 Affidavit ............... S 2 . 0 0 Total .................. S 6 2. 9 0 EX~CUTbIt NOTICE Estate of Mary Elizabeth Kelso, deceased.. Letters testarpen- tart' in°the estate of Mary Elizabeth Kelso, late of Fgnn."Cnbvtt= ship, Cutnberlarjd County, Pennsylvar}ia,~ Have be~tf granfed Co the undersigned. All persons knowing themselves td be tedebted to: said estate .are requested to make payment, and those haying claims will present them, without delay, for settlement to: Roy W. Kelso 16 Parsonage Street Newville, PA 17241 1;xecutor Rikhard: L. Webbet, Jr., Esquire - WEIGLE & A5SOCIATES, P. C. 1~6 East King Street Shippensburg, PA 1?257 Adv. VTS Dec, 18,25; Jan, l E%HIBIT B PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 STATE OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND : Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, 1~i/c:J/Mt3t/K 20, 27, 2002, JANUARY 3, 2003 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. Kelso, Mary Elizabeth, decd. Late of Penn Township. Executor: Roy W. Kelso, 16 Paz- sonage Street, Newville, PA 17241. Attorneys: Richazd L. Webber, Jr., Esquire, Weigle & Associates, P.C., 126 East King Street, Shippens- burg, PA 17257. Ro r M. Morgenthal, Editor SWORN TO AND SUBSCRIBED before me this 3 day of JANUARY 2003 y ', _ - ~ ~ a , d i~ . , .. ,. ... - E%HIBIT C r~ ESTATE OF MARY ELIZABETH KELSO RECEIPT RELEASE AND REFUNDING AGREEMENT KNOW ALL MEN BY THESE PRESENTS, that the undersigned, for and- in consideration of the sum of ONE THOUSAND DOLLARS ($1000.00), the receipt of which is hereby acknowledged, as full payment of his distributive share of the said estate, does hereby remise, release and forever quitclaim unto ROY W. K.ELSO, EXECUTOR, of the said estate, any and all manner of actions, causes of actions, debts, dues, claims, etc., both at law and in equity against him in his capacity as Executor and against the said estate or in any other capacity he had, now have or ought to have for or by reason of the administration of the said estate to the date of these presents. And further, I agree that I will refund to said ROY W. KELSO, EXECUTOR all sums up to the total amount to be distributed hereunder should the same be or become necessary for the satisfaction of claims lawfully arising in the course of the administration of the said estate. IN WITNESS WHEREOF, I hereunto set my hand and seal, intending to be legally bound hereby and intending to bind my heirs and assigns, this / day of ~V i~l~~--~- , 2003. WITNESS: ..~ , BY: ' L~Ce ,~ (SEAL) ~' ANTHONY NEWCOMER E%HIBIT D 9~f'~. ESTATE OF MARY ELIZABETH KELSO RECEIPT, RELEASE AND REFUNDING AGREEMENT KNOW ALL MEN BY THESE PRESENTS, that the undersigned, for and in consideration of the sum of ONE THOUSAND DOLLARS .($1000.00), the receipt of which is hereby acknowledged, as full payment of his distributive share of the said estate, does hereby remise, release and forever quitclaim unto ROY W. KELSO, EXECUTOR, of the said estate, any and all manner of actions, causes of actions, debts, dues, claims, etc., both at law and in equity against him in his capacity as Executor and against the said estate or in any other capacity he had, now have or ought to have for or by reason of the administration of the said estate to the date of these presents. And further, I agree that I will refund to said ROY W. KELSO, EXECUTOR all sums up to the total amount to be distributed hereunder should the same be or become necessary for the satisfaction of claims lawfully arising in the course of the administration of the said estate. IN WITNESS WHEREOF, I hereunto set my hand and seal, intending to be legally bound hereby and intending to bind my heirs and assigns, this /'x',/~ day of 2003. WITNESS: TIMOT ~~ NEWC ER t: EXHIBIT E ESTATE OF MARY ELIZABETH KELSO RECEIPT RELEASE AND REFUNDING AGREEMENT KNOW ALL MEN BY THESE PRESENTS, that the undersigned, for and in consideration of the sum of ONE THOUSAND DOLLARS ($1000.00), the receipt of which is hereby acknowledged, as full payment of her distributive share of the said estate, does hereby remise, release and forever quitclaim unto ROY W. KELSO, EXECUTOR, of the said estate, -any and all manner of actions, causes of actions, debts, dues, claims, etc., both at law and in equity against him in his capacity as Executor and against the said estate or in any other capacity he had, now have or ought to have for or by reason of the administration of the said estate to the date of these presents. And further, I agree that I will refund to said ROY W. KELSO, EXECUTOR all sums up to the total amount to be distributed hereunder should the same be or become necessary for the satisfaction of claims lawfully arising in the course of the administration of the said estate. IN WITNESS WHEREOF, I hereunto set my hand and seal, intending to be legally bound hereby and intending to bind my heirs and assigns, this ~ ~ ~'? day of UR P , 2003. WITNESS: _1 , BY: ~ c.c~~ " (SEAL) TINA NEW OMER FRY E%HIBIT F ESTATE OF MARY ELIZABETH KELSO RECEIPT RELEASE AND REFUNDING AGREEMENT KNOW ALL MEN BY THESE PRESENTS, that the undersigned, for and in consideration of the sum of TWO THOUSAND DOLLARS ($2000.00), the receipt of which is hereby acknowledged, as full payment of its distributive share of the said estate, does hereby remise, release and forever quitclaim unto ROY W. KELSO, EXECUTOR, of the said estate, any and all manner of actions, causes of actions, debts, dues, claims, etc., both at law and in equity against him in his capacity as Executor and against the said estate or in any other capacity he had, now have or ought to have for or by reason of the administration of the said estate to the date of these presents. And further, it does agree that it will refund to said ROY W. KELSO, EXECUTOR all sums up to the total amount to be distributed hereunder should the same be or become necessary for the satisfaction of claims lawfully arising in the course of the administration of the said estate. IN WITNESS WHEREOF, this organization does hereby execute this Receipt and Release, by its officers authorized to do so, intending to be legally bound hereby and intending to bind its heirs and assigns, this C ~ da of y ~`' `'~ ~-- , 2003. ATTEST: CENTERVILLE MEMORIAL PARK E%HIBIT H WEIGLE & ASSOCIATES. or ..-r~-...-..._.. ._ __. - PETITION FOR PROBATE and GRANT OF LETTERS No. ~2_002=IM003- Estate of' Mar Eli To: Register of Wills for the also known as &~: County of ~a in the ......... 183-12-3523 ' Deceased. '::: commonwealth of Penn y Social Securtty ~o. The petition of the undersigned respectfully represents that: ~- _ ~v~ ?~ named Your petitioner(s), who is/are 18 years of age or old~n t~~exe~ut- ~, 19~ in the last wilt of the above decedent, dated ~ 1 2, 2003. .. · ember and co~icil~).datea.xecut~ of~[ ' - ..... survSved b h~s w~fe ~ar ' ' etc.) (state relevant circumstances, e.g. renunciation, death of executor, County, Pennsylvania, with Decendent was domiciled at death in ~ ~ ' .. · 7241 ~ last'family or principal residence at ~ (Pe~ (list street, number and muncipality) Decendent, then ~ years of age, ~ed 0~ober 29. . ~,~ 2002 , ' ~i ~rlisle PA 1 1 · a~. Clarem~~-=~d~ T~s Excep~ as follows, dec~dent did no~ marry, was not divorced and d~d not have a child born or adopmd afmr execution of the will offered for probam; was no~ ~he victim of a k~H~ng and was never ad~udicamd incompe~m: ~. Decenden~ a~ death owned prop~r~Y with estimated values as follows: ~ 450 000.00 (If domiciled in Pa.) A~1 personal prop~r~Y (If no~ domiciled ~n Pa.) personal prop~r~Y in Pennsylvania (If no~ domiciled in Pa.) Personal prop~r~y in County Yalu~ of real esmm in p~n~lvania sl~u~md ~s follows: ~ respectfully request(s) ~h~ probate of ~he las~ will and codicil(s) ~MERB~ORB, petitioner(s) ofle~ers of administra~on d.b.n, c t a presented herewith and ~he gran~ (~esmmenmrY; administration c. La.; mdmlnis~rafion d.b.n.c. La-) ~heron. 16 Parsona~ Street Neville PA 17241 CO~ O~ Cumberland ' ] a~ ~he smmmen~s in ~h~ foregoing p~fifion are ifion~ffs) abo~e-na~ed swear(? or affirm(sit, of efifioner(s) and ~hat as p~rson~} The p~ ~. 2~ .~ ~,~ o~ ~he know~edge and ~h ~ . P, -~--;-;~*~r ~he ~smm accormng ~o ~ · wue an~ corm~t ,o ~-..~] ..... qfioner~s) will we~ aha ~rmy ~ ....... ~ ~ tauve() ~,~ ~ ~,~. f~'), ~~ swo~n to 2r a~Tff and s~s~ ~¢ ~ bqfore me tins ~ ~~ ~' No. ~.9/- DO.- Estate Of Mary M. K~X~o , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~ ? ~ 200fi4n consideration of the petition on the reverse side hereof, sa~factory proof having been presented before me, IT IS DECREED that the instrument(s) dated January 1, 1997 described therein be admitted to probate and filed of record as the last will of Nary ~- ~1 .~o _ and Letters of Adm±nistration d ,b. n. c. t. a. are hereby granted to Mary M. Kelso FEES Probate, Letters, Etc .......... Short Certificates( ) .......... $ t,~./57~) ATTORNEY (Sup. Ct. I.D. No.) Renunciation ................ $- Richard L. Webber, Jr., Esq. #49634 $ 126' East King I~reet Shippensburg, PA 17257 TOTAL Filed ~ ...~-.. o~.~ZSP- '~'~' (717) 532-7388 .......... PHONE , ,EV-1500EX (6.DD) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 HARRISBURG, PA 17128-0601 C(~- 1 \ n- REV-1500 OFFICIAL USE ONLY ---'~'-'.'.._._-'-- '~---'''---------'-'--'-'-'-'- FILE NUMBER Ll-!LL ~lJLJL~ COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 183 - 12 - 3523 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C W U W C DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) Kelso, Mary E. DATE OF DEATH (MM-DD-YEAR) 10-29-02 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3, Remainder Return (dale of death prior 10 12-13-82) D 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) DATE OF BIRTH (MM-DD-YEAR) 04-17-17 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) w "' ",~Ul 0"'''' w"-O ",00 0"'-' "-Ill "- " [j 1. Original Return o 4. limited Estate [!] 6. Decedent Died Testate (AUach copy of Will) o 9. litigation Proceeds Received o 2. Supplemental Return o 4a. Future Jnterest Compromise (dale aldeath after 12-12-82) o 7. Decedent Maintained a living Trust (AlIacl1 copy 01 Trust) o 10. Spousal Poverty Credit (date afdeath betwetln 12.31-91 and 1-1-95) "' Z W " Z o "- Ul w '" '" o o NAME Ri h d c r L. Webber, Jr., Esquire COMPLETE MAILING ADDRESS FIRM NAME (If Applicable) (717)532-7388 126 East King Street Shippensburg, PA 17257 x.O_ (15) x.O_ (16) x .12 (17) 72,590.51 x .15 (1B) 450.00 (19) 73,040.51 Weigle & Associates, P.C. TELEPHONE NUMBER 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 75,000.00 157,390.85 (1) (2) (3) (4) (5) 365,308.35 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) z o ~ ...J :J !::: 0.. c( U W n: 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Properly (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) (10) 13,552.10 2,422.14 (6) (7) 33,195.92 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule J) 11. Total Deductions (tolal Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an eleclion to tax has not been made (SShedUleJj 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !ci: I-' :J 0.. ::E o u ~ 15. Amount of Line 14 taxable al the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 604.920.88 3,000.00 18. Amount of Line 14 taxable at coilateral rate 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT f.) ~~ OFFICIAL USE ONLY r,- ~ '^' c -, J .' I~i , (8) 630,895.12 (11) 15,974.24 (12) 614,920.88 (13) 7,000.00 (14) 607,920.88 Decedent's Complete Address: STREET ADDRESS 1694 Walnut Bottom Road I STATE PA I liP 17241 CITY Newville Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 46,200.00 2,431.58 Total Credits (A + B + C ) (2) 3. InteresUPenalty if applicable D.lnterest E. Penalty TotallnteresUPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to reque.t a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This Is the TAX DUE. (5) (SA) (5B) A. Enter the interest on the tax due. 73,040.51 48,631.58 24,408.93 24,408.93 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. 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: a. retain the use or income of the property transferred;......... .......................................... b. retain the right to designate who shaH use the property transferred or its income; c. retain a reversionary interest; or.... ..........."..................................................... .......................... d. receive the promise for fife of either payments, benefits or care? 2. If death occurred after December 12, 1982, did decedenttransfer property within one year of death without receiving adequate consideration? .................. .................... 3. Did decedent own an "in trust for" or payable upon death banI< 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? . ................. . ............... ...............'" Yes o o o ............0 ....0 ....0 No (Xj [j] [j] [j] ~ ~ ww IXJ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. PERSON RESPONSIBLE FOR FILING RETURN '2-(/ ') Under penalties of perjury, I declare that I have ex.amined this return. including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal represenlalive is based on all information of which preparer has any knowledge. 16 Parsonage Street, Newvil;le, FA 17241 SIGNATURE OF PREPARER OTHER THAN REPRESE~TIVE ~~~ 4- ADDRESS 126 East King Street, Shippensburg, PA 17257 DATE )-1 )9 ).",,,,1 DATE 7/ ~,Io.l 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. 99116 (a) (1.1) (i)]. For dates of death on Of after January 1, 1995, the lax rate imposed on the net value of transfers to or for the use of the surviving spouse Is 0% [72 P.S. 99116 (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 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 paren or a stepparent of the child Is 0% [72 P.S. 99118(a)(1.2)]. The tax rate imposed on the net value of transfers to or forthe use of the decedent's lineal beneffciaries is 4.5%, excepl as noled in 72 P.S. 99118(1.2) [72 P.S. 99116(a)(I)J. 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. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as a, individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (12+951 -!f'J- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL EST A TE l FILE NUMBER 21-02-1003 ESTATE OF Mary E. Kelso Estate (Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should b. reported at fair market value which is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or ,ell, both having reasonable knowledge of the relevant facts. ITEM NUMBER DESCRIPTION 1. Real estate, together with improvements thereon, situate at 1694 Walnut Bottom Road, Newville, Penn Township, Cumberland County, Pennsylvania, containing 0.390 acres. VALUE AT DATE OF DEATH $75,000.00 S 75.000.00 TOTAL (Also enter on line 1, Recopit.ulotion) (If more space is needed, insert additional sheets of same size.) REV-1503 EX + (4-86) ~k SCHEDULE B STOCKS AND BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Mary E. Kelso 21-02-01003 {All property jointly-owned with Right of Survivorship must b. disclosed on Schedu'e F.) ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 7477 shares of Adams County National Bank Common Stock at $21.05 per share $157,390.85 "' ____ .____ :_ _~_.J_-1 :_~~~ ~,J..J;~:........I rh..",fc nl 0..",'" ..;7'" I TOTAL (Also enter on lin. 2, Recapitulation) S 157,390.85 REV-l508 EX. (1-97) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Mary E. Kelso 21-02-1003 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 NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH SEE EXHIBIT TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) SCHEDULE E Cash, Bank Deposits and Miscellaneous Personal Property ESTATE OF Mary E. Kelso Item Number Description 1. M&T Bank Savings Account #15004198396664 Accrued interest to date of death 2. Orrstown Bank Checking Account #102000297 Accrued interest to date of death 3. Orrstown Bank Certificate of Deposit #4000000318 Accrued interest to date of death 4. Orrstown Bank Certificate of Deposit #5020065406 Accrued interest to date of death 5. Orrstown Bank Certificate of Deposit #5020068556 Accrued interest to date of death 6. Orrstown Bank Certificate of Deposit #5020068578 Accrued interest to date of death 7. Orrstown Bank Certificate of Deposit #5020068596 Accrued interest to date of death 8. AlIfirst Money Fund All. Account #0098368044 Accrued interest to date of death 9. AlIfirst Certificate of Deposit #80000001982088 Accrued interest to date of death 10. Treasury Direct 3-7/8 note 5-03 Accrued interest to date of death 11. AlIfirst Certificate of Deposit #80000001982197 Accrued interest to date of death 12. AlIfirst Certificate of Deposit #80000001982212 Accrued interest to date of death 13. AlIfirst Certificate of Deposit #87008140219282 Accrued interest to date of death Page 1 00 File Number 21-02-1003 Value at Date of Death 4157.75 1.02 12,683.29 5.04 13,203.84 22.34 26,407.52 46.88 20,000.00 23.78 10,200.00 22.71 11,200.00 18.23 39,142.73 19.38 28,750.00 154.40 10,000.00 126.34 11,000.00 16.33 10,000.00 39.50 10,000.00 18.21 SCHEDULE E Cash, Bank Deposits and Miscellaneous Personal Property ESTATE OF Mary E. Kelso File Number 21-02-1003 Item Number 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 25. CONTINUATION PAGE Description Value at Date of Death Allfirst Certificate of Deposit #87008141004646 Accrued interest to date of death 3,017.32 1.43 Farmers National Bank Checking Account #12-165-7 Accrued interest to date of death 9,022.87 2.99 Farmers National Bank Savings Account #9615067 Accrued interest to date of death 9,095.28 11.89 Farmers National Bank Money Market Account #158224 Accrued interest to date of death 21,500.00 30.34 Farmers National Bank Money Market Account #160308 Accrued interest to date of death 10,000.00 27.91 Farmers National Bank Money Market Account #160320 Accrued interest to date of death 6,000.00 9.12 Farmers National Bank Money Market Account #160335 Accrued interest to date of death 6,000.00 16.65 Farmers National Bank Money Market Account #160364 Accrued interest to date of death 10,000.00 29.03 Farmers national Bank Money Market Account #3990774 Accrued interest to date of death 4,100.00 17.57 Farmers National Bank Money Market Account #3991044 Accrued interest to date of death 30,700.00 160.91 24. Farmers National Bank Money Market Account #4990770 Accrued interest to date of death 10,000.00 12.66 Cash in safe deposit box 16,116.78 Page 2 00 SCHEDULE E Cash, Bank Deposits and Miscellaneous Personal Property ESTATE OF Mary E. Kelso File Number 21-02-1003 CONTINUATION PAGE 26. Proceeds of public sale held March 22, 2003 20,463.10 27. Refund of county/township tax at settlement 127.45 28. Refund of school tax at settlement 98.54 29. AARP refund 19.00 30. Washington National Insurance refund 1.72 31. Sprint refund 5.47 32. Walnut Bottom Radiology refund 50.96 33. Walnut Bottom Radiology refund 58.92 34. Auto insurance refund 120.99 35. U.S. Treasury net refund 964.00 36. Pa. Dept. of Revenue net refund 9.00 37. Gas company refund 55.16 38. Everett Mutual refund on house insurance 202.00 TOTAL $365.308.35 Page 3 00 . REV-EilO EX+ (2-87\ .. SCHEDULE G TRANSFERS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT PLEASE PRINT OR TYPE ESTATE OF Mary E. Kelso FILE NUMBER 21-02-1003 THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES. ITEM DESCRIPTION OF PROPERTY TOTAL YALUE DECO. DOllAR VALUE EXCLUSION % OF DECEDENT'S NUMBER Include name of the transferee, fheir relationship to decedent, date of transfer. OF ASSET INT. INTEREST l. PNC Investments - Metlife Premier 33,195.92 100% 33,195.92 Select Annuity Control II 17001939 Transferee Roy W. Kelso 16 Parsonage Street Newville, PA 17241 Relationship Brother of Decedent TOTAL (Also enter on line 7, Recapitulation) S 33,195.92 (If more space is needed, insert additional sheets of same size.) REV.151l EX.;. (7-88) ESTATE OF ITEM NUMBER A. 1. 2.. B. 1. 2. . SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Please Print or Type FILE NUMBER 21-02-1003 Mary E. Kelso DESCRIPTION Funeral Expenses: Egger Funeral Home EEF Redding & Son - engraving on tombstone Administrative Costs: Personal Representative Commissions Social Security Number of Personal Represen101ive: Year Commissions paid Attorney Fees Weigle & Associates. P.C. 3. Family Exemption Claimant Address of Claimont at decedent's death 4. C. 1. 2. 3. 4. 5. 6. 7. 8. Relationship Street Address Cily State Zip Code Probate Fees Cumberland County Register of Wills Miscellaneous Expenses: Cumberland County Register of Wills - short certificates Cumberland County Regaster of Wills - short certificates Cumberland Law Journal - legal advertisement Valley Times-Star - legal advertisement Farmers National Bank - lock box fee Newville Hardware - locks for house Newville Postmaster - stamps The Sentinal - advertisement for newspaper (SEE CONTINUATION PAGE) TOTAL (Also enter on line 9, Recopitulation) $ (If more space is needed, insert additional sheets of same size.) AMOUNT 6.228.00 190.00 3.500.00 333.00 6.00 9.00 75.00 62.90 10.00 19.91 37.00 29.99 SCHEDULE H Funeral Expenses, Administrative Costs and Miscellaneous Expenses ESTATE OF Mary E. Kelso Item Number 9. 10. 11. 12. 13. 14. 15. 16. 17. File Number 21-02-1003 Descrivtion Amount Adams County National Bank - fee for checks 12.00 DTD Septic 68.90 Fire police - parking for public sale 192.00 Luke Fry - snow removal 50.00 Howard's Accounting 105.00 Cumberland County Register of Wills - filing fee for Inheritance tax return 15.00 Cumberland County Register of Wills - filing fee for First and Final Accounting 125.00 Commonwealth of Pennsylvania - realty transfer tax 750.00 Carl Ocker, Auctioneer 1.733.40 TOTAL $13.552.10 Page 1 of 1 REV-1512EX<p-97) ~ ~ SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Mary E. Kelso FILE NUMBER 21-02-01003 Include unreimbursed medical expenses. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. DESCRIPTION Sprint Kougs Oil Service PP&L MSHMC Physicians Group PPL Associates Carlisle Imaging Sprint Koughs Oil Service Aaron Zimmerman - Care PP & L MSHMC Physicians Group Sprint Koughs Oil Service Pat Palmer - Care Koughs Oil Service Kemper Auto Insurance PP & L Sprint Koughs Oil Service M~dicare Adjustment Kemper Auto Insurance Mabel G. Stitt, Tax Collector - Real Estate Tax PP & L Sprint Koughs Oil Service PP & L AMOUNT 33.66 130.62 47.83 6.58 58.92 64.45 33.14 302.00 63.00 54.00 5.18 33.14 126.00 64.00 181. 48 158.32 52.51 33.30 176.70 223.62 82.17 209.55 49.45 33.28 170.78 28.46 TOTAL (Also enter on line 10, Recapitulation) $ 2422. 14 (If more space is needed, insert additional sheets of the same size) REV-15j3EX~(1.97J SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mary E. Kelso NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY 1. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. Anthony Newcomer 1644 Walnut Bottom Road Newville, PA 17241 2. Tina Newcomer Fry 1688 Walnut Bottom Road, Newville, PA 17241 3. Timothy Newcomer 137 Goodyear Road, Carlisle, PA 17013 4. Roy W. Kelso 16 Parsonage Street Newville, PA 17241 FILE NUMBER 21-02-1003 RELATiONSHIP TO DECEDENT Do Not List Trustee(s) Unrelated Unrelated Unrelated Brother AMOUNT OR SHARE OFESTATE $1000.00 $1000.00 $1000.00 Residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON liNES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET 11. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTiONS 1. Centerville Lutheran Church 1874 Walnut Bottom Road Newville, PA 17241 2. Centerville Memorial Park c/o Robert Lloyd 1698 Walnut Bottom Road Newville, PA 17241 $5000.00 $2000.00 TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 7000.00 - (If more space is needed, insert additionaisheets of the same size) A. Settlement Statement U.S. Department of Housing and Urban Development ,..... ,.. OMB Approval No. 2502-0265 ~!t~~!_~~!!____________.__'__m 1. 0 FHA 2. 0 FmHA 3. 0 Conv. Unins. :6._fila Number 4 0 VA 5. 0 Conv. Ins. 7. Loan Number e. Mortgage Insurance Case Number c. Not~~T-hi;fc;~-i~-fu-~~i;;hed to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent aTe shown, Items marked "(p.D.C.)" were paid outside closing; they are shown here for informational purposes and not i!1~!~~~Q.in_!!!~1Qtals.... ._ F. Name and Address of Lender D. Name and Address of Borrower E. Name and AddreS5 of Seller ROBERT Z. PAGEL SHANNON M. HECKMAN 252 CHESTNUT STREET DOWt-JIt-JC3TQWt-lm_Y-"_ ESTATE OF MARY E. KELSO ROY W. KELSO, EXECUTOR NEWVILLE PA 17241 H. Settlement Agent SALLY J. G. Property location 1694 WALNUT BOTTOM ROAD WINDER L SettlemenlDale Place of Settle men I NEWVILLE PA 17241 5/23103 SHIPPENSBURG PA 17257 DisbursemenlDale Lot: Block ~_._~~~~~__~f_ ~~~OW!0~,:,,~~a~tion 100 Gross Amount Due From Borrower _."'~--'''-'-- -- ------.---.---.- _._---- -. - -.-'- _101, C9_n.!~':l.~~~I~~J?~~.._________._ _ _---.l5,000.00' _401. Contract sales price 75,000.00 1Q?:.-~~_~9~~I_p~9~.~_ 402. Personal property _._._~--.._--- lQL_~~!!!~~~I1~.~~~D;j~~_to b9~~~_i~~.~.400) 1,163.50 403. -..--,,-. .- l~______ 404 - _.- .._---------~- -. 105 -----'" 405. ------.-..---- ----- /" - _~~~~~!'1~~~ !?~".i~~~~~d b'L~~~ler in advance Adiustments for items paid by seller, in advance 1<l",-c:ily/to,,"taxe,-- gil~103 to 12/31/03 127.45 406. City/town !8XeS 5/23/03 to 12/31/03 127.45 .- 10~:.~9~!Y~~~_---____ to -. 407, County taxes to 198. As~ess~~~!~ to 408. Assessments to ----.-.. _.---- . -.-- 1 09 Sc:;LT.AJ<. 5/~~/Q~mt0J3/30/03 - 98.54 409 SCL TAX 5/23/03 to 6/30/03 98.54 l_lL-_ to ----- 410. -- to -- ___ _______n_._._____ .- 111.:____ to 411 to ------ -- ----.--.- - !.l~_ to .- 4n. to ------.-..-- -- 113 !~---~- 413 to "----- -. . .------------. "'-~_A_________ to m~ 414. to -----.".-..-.....-.- _.~---. 115, to 415. - to _..~---- ....-- --- __.n______ --,.-.- 120. Gross Amount Due From Borrower 76,389.49 420. Gross Amount Due To Seller 75,225.99 K. SummaI)' of Seller's Transaction 400 Gross Amount Due To Seller ~~~o~~~J)!~_~'i..Q~.!~_~~half Of Borro~e~ ~g!~~~~_~~_~~~~~~9_f")~_.______ ~~~_!!~9.e~\~~~~~!_9fT"l~~~!l{~L ~Q~,----~!<J~~Lf")llIQ~!l{~)!~~E:!Il.~.~~jecl t9-__," ?9~ . - -- --------.--- ~g~------ ~Q~~----""- ------ ---------, 207. ____~_~___ ~2~:._______.___ .--------- ~2.~____._ _ ---------.---- __~~~_~!..'!!~!l~ .f~r !!~!!ll!~lll?aid by seller._ ~1g:..,g~ty!!9~~ ta.x~~__.~__ .______ to ~.1"1_:....foUIl!Y_!~~~~__. to 500. Reductions In A.mount Due To S~~ler 7 ,500.00 ~9.!. Excess de~slt (see instructions) 502. Settleme'l~_charges to seller (Ii~e 1400) ._,,_______ ._ 503. Ex!~!!!:!gloan(s) take!1 subject to 504~ ~ayoff of first l110rtgage loa~ 505. Pa}'Q!!_C?t second mortgage loan 50S 507. 508. 1,250.00 509. ~bnents for,,!tems unpal~EY selle~ 51 o. Citylt~ taxes to to 519. to to to to to to to to to 218. 219. to 511. Coun taxes 51?-. AssessmelJ!s 513. 514. 515. ._~_516. 517. 51. -- 2 !_?..:._Ass~~~f!1~J~____" to to to ~11~_______ 214. ~~--_... ~~!'!-'----- ~~~----- to to to 7,500.00 520. Total Reduction A.mount Due Seller 600. Cash At Settle~ent To-ffrom S~lIer 76,389.49 601. Gross amou!"t due to seller (line 420) .e....:.L-7,500.00) ~~2 Less redl,!~\o!1s in amt due seller {line 520t.. 1,250.00 220. Total Paid BylForBorrower 300 __~~.~~.~! Se:!!I~~_ent F,!om'!9- ~l?!1.:ower ~Q!:_.Qros~~~2!:.!..n.!_due from borrower (line 120) ~~2. Le~~_~~,?:~~~ ~~~~!fOr OOrrOwer (\if\e 22~1 75,225.99 1,25Q.00) 73,975.99 ,( 303. Cash IKI Fmm o To Borrower 68,889.49 .a.. Ca.h IKI T~ o From Seller ~v'O SUBSTITUTE FORM 1099 SELLER STATEMENT ' "7 Srdo"'-<jIt-'? The information contained in Blocks E. G, H, and I and on line 401 (or, Ilne 403 and 404) is important tax _information and is being fumished to the Internal Revenue 66 - LJ G Service. If you are required to file a relum, a neghgence penalty or other sanction witl be imposed on you If this item IS required to be reported and the lRS determines )~JS. -, t that it has not been reported. If this real estate is your principal residence, file Form 2119. Sale or Exchange of Principal Residence, for any gain, with your income tax return; for other transactions, complete the applicable parts of Form 4797, Form 6232 and/or Schedule D, Form 1040). You are required to provide the Settlement Agent (named above} 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 pe~ury, , certify that the number shown on this statement is my correct taxpayer identification number. (Selier's Signature) '=:~~~'!!~~~ ~~_'!~.a~_ __._.___...__. ~~Q:,.,.!~~L~~~~_~T~~~(..!E~l"!1rnission-Eased o!l~Erice $ _ _. Di'J_i_~L~~_~?_~!T'j~~iol'li!Ll'le 7_Q.~ as ~\_\ows: !g.~.:._,L_________.________...,_~__ to ?~:__!_--. --------,,- -_..-~---~--------.~---- 75,000.00@ %= Paid From Borrower's Funds Al Settlement Paid From Seller's Funds At Settlement ~~~:.._Q~~!lli~sil:J~_p~L~__~~ ~~ttle_f!l~~!_________"_____.__ 704 ~Q.Q~~~~~_f'!'i'!!!~_!~_<?~~Il_~!!~~ ~~!.~_ Lo~~____~_____.____ ~,~~.:...!:~~_rl_gr!9ir!~i?rl_f_~_~ ~__.._~,~__ ~___~ __ ~~:..H~_~~gi~u["\t _~~_ ~g~~f'-e~~i~~I_f=.~~_ ____~_~.!o ~_~. Cr~~!!.~e~r!_____ ______.~__~_ ~~:,_ ~~0t!~(~_'n_~~lion.f~~_..~ ~g~;_~?ft~.9~ Irl~~E<if)~~eE.!~!ig!l Fee to _ . ~2.?~~~~f!!e!iSJ~__~~E? B08. 809. 810. ---------. ~~_.._- 812. ---.' 813. ~QQ:_,!!l:!ITl~_~~9~~r~d_ 8,y_'=~rl~~~.!'? ~~~~~.~'! Advance ~Ql." l!!!~r~~~from ________________!2___,_~~. _~~de last day in cales - line 901 Iday mont~~.~.________~__ ~g~~~~g_~.2~~ ~n~~~I1.~_~rem_i~~",~2!:..__..____~_,_ ~Q.~~__!i_~!~E1!lQ~':l~~I1~~ pr~~!~_fl:Jf. ____.___. ~~- years to 904, -----_.---,,------ 905. 1000. _~~~~~~~_!2~pos!!.~_~!!!!.!:~I1~~~_,_ 1001..~~~a!d insura~~~ _~__ months@$ 1 002'~_l:J_.r!9~9':.~~~l;Ir~Q~____.1_. months@$. 1003 _gi!Y_er~e~_r!t_!~_x.~~_____L_ months@$ " 1004, .g~~~tYfl~l:JP~r!Y_~~~__1.__ m.onths@$ .!2Q.~:..f'~~ua\ assessm~~~__.J_____ mcnths@$ }.9_~______ ___~________1____._. _~l~s@$ ~007. __....________ ____,J____.____~~~~@L_._ 1006. Aggregate Accounting Adjustment .!.~Q~:..!_i!l~_~~~~~~___,._ _______________.___~___~___ ____._ 1.~Q_~~_~ettl~~~'!!2X5:!!?~i~2._~~___ .___. ____.!g,,__ ___,,___ .__~_" .!.!~g~ ~~~Jf~~~~r_~!!':_ ~,!arch to ....~~--- per month per month per ml:J~__ per month per month per month 11 03. __Tlli~~~?_~~~~~~_ 1104, Title insurance binder to ..-~-,-_._-- to 110~~_ ~~~In~l'lter~p~r~~2..n__.. "._______,.___.. ~___ 1106'_~l:J!~~J~~~__ _..______._ ______~_ 1'07 Atlomey" fee'___--"'_~"'LL l'L\i\lI/IlpER/ WEIGLE &_A.~SOCIA TEL ~_{!r:!?~Ll9~~_~~(J\I_!:_i!~rn~~~.~~~ ________,,______,___~_ 1 1_!0~,J-itlf: in~urar:'~~_ _________._..________ to ___._____ __lll!~ILJ9~s ~~~~ it~rT"I~~_~~_~~~:...___ 1109.~~~d~r'~ ~~\lE:!r~9~__ 375.00 _.___500.0() 111 0 __Q~~€:r'~~~~~~\l~ 1111. 111~~ 1113. $ ~-- !200:.Q~'!'~!r:'!!!~~!B~~~!11.9il~~ rran~~!!: Ch~~ gQ~.:_ Re~~~i~9J~~~:_'_Q...~_~_._. 38.50 ; Mortga9~----L_ 1~9~:_g!!Y~~_'!!Y_~!!~~!~~~g~~~~__ 750,00 _; ~age $ !~U~t~,~~xJ~~~.P~~g~?__~______ ____~_,,_~rt~~ $ 1204. 1205. 3650 750.00 750.00 ~ Releases $. !~~.l!:.....~~~~!!?~_~~~!tl!.f!l_~~!_~!1.!~ge~______.~.___, l~9.!:~~~~_______._ to ___,,_,___~'___ 1302 ~~~t!n~~~~il:Jr) ,_ _.J.~~______~~___~ ._.__.~.__~________~___,.___._ 1303. l~Q4. J~2?:__,,_ 1306. !~Q7 1)08. 1400. Total Settlement Charges (enter on lines 103, Section J and 502, Section K) CERTIFICATION I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all r ipts and disbursements on my account or by me in thIS tra"action. I further certify that I have received a copy olthe HUD-1 ~nt _.____________ ' Seller _ ~ ~TATE ~MARY E. KELSO ~o~~r z. P('f5l'- _ ~~~~,g~ Seller ~ AN~~'HR~-aorrower To the best f my knowledge the HUD-1 Settlement Statement which I have prepared IS a true and accurate accou~t of the funds whIch were receIVed and have been or WIll b<91~9urs by the un~rsl)edia~artff t~e settlement of thiS transaction S-td ~ I . _ _ UU--~ ~___ Sett,lementAgent ~ Date A [ NDER WARNING It IS a crtme to knowingly make false statements to the U(lI\ed States en thIS or any other slml\ar iorm PenaltIes upon co 'Jlctlon can Include a fine and imprisonment. for details see: Title 18 U.S. Code Section 1001 and Section 1010 1,163.50, 1 ,250.00 Borrower u_!O. GlJIJERMMEIfI" PIllKTI~ OffICI:; \'ilIS ..'""~~ . .\;.- c rJ~/ LJ. / Ll::'Jtl..:f . 10;'1-,:;1 (1 (O.jL~LI::I':I ,n" .'? /' (;1'05 OM\-- ) r O(Y~'" ~t l/ t- , ,-r '7 TffiS AGREEMENT made this ,.2....5 day of ~ ~2003, by 8Ild between ROY W. KELSO, EXECUTOR OF THE ESTATE OF ARY E. KEL&O, hereinafter referred to as "SELL R", and .6 ..e- A- L tI ~ ~ ~ in. , hereinafter referred to as "PURCHASER". . . W~l~L~ & Ab~U~LAI~~ ,<< , -\--- (L')" ,," {U' (".<J<'- k t-f; k 'l" (AGREEMENT OF SALE t""Al::lt:. l::JL I,V. 1,5. ~cr.e/ {O--' /b-~;" 1 ( FILE S'.~~ I WITNESSETH, that f~ in consideration of th. e sum of :5e./e~ ,r=r've- . -:.s~)::>I. ~ ~']:>~~J. ($ 1'5: d' e'J. ".. ), to be paid by the Purchaaer to the Seller IIlI hereinafter provided, the Seller agrees to convey to Purchaser a tract of real estate located in the Township of Penn, Cwnberland County, Pennsylvania, more fully described in Exhibit "An attached hereto and incorporated by reference herein upon the following terms; 1. DOWNPAYMENT, FINAL SETTLEMENT. Purchaser shall pay ten percent (10%) of the purchase price upon execution of this Agreement. The balance of the purchase price shall be paid at final settlement, which shall be held within 45 days of the date oflhis Agreement. Time is of the essence. 2. WARRANTY OF TITLE. At settlement, Seller will execute to Purchaser a deed containing a Standard Executor's Warr8llty, stating that the Executor has not done or caused to be done sny act that impeaches, charKo9 or encumbers title to the property, excepting however, existing buildlnlls .Jnd use restrictions, ordinsnces, easements (visible 8Ild of record) and utility right of ways. Said title shall be good and marketable and imurable by a reputable title insurance compsny licensed to do business in Pennsylvania. Seller warrants that the restrictions affectiOll the premises, if any, will not be violated at the date of settlement hereunder. . 3. IF TITLE DEFECT. If Seller is unable to convey good and marketable title, Purchaser .shall have the option of taking such title as the Seller can give without " abatement of price, or of being repaid all monies paid on account by Purchaser to Seller and the Purchaser shall also be reimbursed for any title examination costs incurred; and in the latter event, there shall be no further liability or obligation by either pmos hereunder and this agreement shall become null and void. Seller Is obligated to take reasonable steps and, expemJ.. reasonabl~ sums to clear title of any liens, encwnbrances, defects or clouds which might appear on the title. '."" .. . .~, 4. RISK OF LOSS. Seller shall bear the risk of loss until final settlement and shall continue to insure the premises until that time. , '. n~.~~~ ~ ~~~~~~~,_~ '-......... ....... 5. TAXES, ETC. Any real estate taxes, rents, water and sewer expenses and the like sha11 be apportioned pro rata as of the date of scttIement based upon the calendar or fiscal year of the respective government authority. 6. REALTY TRANSFER TAX. All realty transfer taxes shall be borne equally by P~haser and Seller; however, Purchaser shall be liable for all realty transfer taxes if his rights are assigned to a third party. 7. POSSESSION. Seller sha11 deliver full and complete possession of the premises to PlII'Chaser on the date of settlement. 8. DEFAULT BY PURCHASER. In the event Purchaser fails to make settlement as provided, violates, fails to perform or fulfill any of the terms or conditions of the Agreement, then in such case all deposit money and other sums paid by the Purchaser on account of the purchase price, whether required by this Agreement or not, may be (a) retained by Seller on account of the purchase, or (b) as monies to be applied to Seller's damages, or (c) as liquidated damages for such breach, as the Seller may c1ect, and in the event that Seller elec15 to retain the monies as liquidated damages in accordance with this paragraph, the Seller shall be released from all liability or obligations and this Agreement shall be null and void and all copies will be returned to Seller for cancellation. 9. SETTLEMENT LOCATION. Settlement shall be held at the office of Weigle & Associates, p.e., at 126 E. King Street, Shippensburg, Pennsylvania 17257 or at such other location agreed by the parties. 10. PRIVATE SEWER SYSTEM. There Is no currently existing commlUlity sewage system available for the subject property, Section 7 of the Pennsylvania Sewage Facilities Act provides that no person shall install, comtruct, request bid proposals for construction, alter. repair or occupy any building or structure for which an individual sewage system is to be Installed without first obtaining a permit. Purchaser is advised by this notice that, before signing this Agreement of Sale, Purchaser should contact the loa! agency charged with administering the Act to determine the procedure and requirements for obtaining a permit for installinll, repairing, etc., an individual sewage system. This local agency charged with administering the Act will be the municipality where the Property is located or that municipality working cooperatively with others. 11. PRIVATE WATER SYSTEM. There is no public water system servicing the premises. 12. PURCHASE "AS IS". Purchaser hereby purchaslls the premises "as is". ,~~/~~/~OQ~ ~O.~~ (" (;J~<i::.;';~Q:J rHUt:. t.J'i > . 13. RECORDING OF AGREEMENT. This Agreement shall not be recorded in the Office: of the Recorder of Deeds or in any other office or place of public record. 14. DISCLOSURE FORMS. Purchaser acknowledges receipt of Sellers Disclosure Statement ami Lead Paint Disclosure as required by law. 1'. UNDERGROUND STORAGE TANK. There Is an underground swrage tank located on the premises. SELLER hereby transfers all rights and obligations relating to said underground storage tank. PURCHASER shall assume full responsibility for the said tank. PURCHASER agrees to indemnify and hold SELLER harmless from any liability or obligations relating to the tank. 16. RESERV AnON. Seller reserves. the right to reject any and all bids. Seller shall accept a bid only via the signing of this Agreement of Sale. 17. ENTIRE AGREEMENT. This A1P'eement contains the whole agreement between the Seller and the Purchaser and there are no other tem18, obligations, covenants, representations, statements or conditions, oral or otherwise of any kind whatsoever. IN WITNESS WHEREOF, the parties hereto have set their hands and seals the day and year first above written, intending to be legally bOWld hereby. WITNESSETH; SELLER MARY E. KELSO n,~)7J,~ ~-..;?g -1!.3 .. ~U:/~~~ oy . Kelso, Executor PURCHASER .J!.Sz. c-#~;t77V"'r $7;- Plll"""'--',.......... PA ~., '!$,s- 3 ~~~;i.e',/ ~lf. . ~' ADAMS COUNlY NATIONAL BANK December 23,2002 Roy W. Kelso 16 Parsonage Street Newville, PA 17241 RE: Mary E. Kelso Dear Mr. Kelso: With reference to your letter dated December 19, 2002 pertaining to the shares of ACNB Corporation common stock registered in your sister's name, we request that you contact our transfer agent, Registrar and Transfer Company of Cranford, New Jersey at their toll free number (800)368-5948 to receive the necessary documents for the transfer. According to our records, there are 7,477 shares of stock registered in the name of Mary E. Kelso, and the par value of this stock is $2.50. In your letter you requested that all future correspondence pertaining to the accounts of Mary E. Kelso from Farmers National Bank of Newville, a division of Adams County National Bank, be forwarded to your address. An estate account must first be established in order to fulfil this request. Therefore, please contact Doug Lindsay at our Newville office (776-5312) to schedule an appointment for the purpose of establishing this estate account. A Short Certificate and Death Certificate will also need to be presented at the time of your appointment with Mr. Lindsay. We apologize for any inconvenience these procedures may cause you, and we extend our sympathy to you and your family. Sincerely, Lisa A. Smith ExecutiveIFinancial Secretary LAS/Is cc: Richard 1. Webber, Jr., Esquire D. R. Lindsay Lincoln Square Office" 2 Chambersburg Street, Gettysburg, PA 17325 .. (717) 334-3161 wtuw. acnb. com r!1 M&rBank Manufacturers and Traders Trust Company, 1100 Wehrle Drive, P.O. Box 767, Buffalo, NY 14240-0767 December 26, 2002 ~ECEIVEO JAN RE: Estate Search The Estate of: Date of Death (D.O.D.) MARY E KELSO 10/29/2002 To Whom It May Concern: Identified below is the account information requested. 1. M&T Bank accounts in which the decedent's name appears: Account Type Account Number Account Title Opening Branch D.O.D. Balances (Includes Accr. Int.) $4157.75 SAY 15004198396664 MARY E KELSO 4341 2. Loans, Mortgages, or other obligations titled in'the decedent's name Account Number Amount Owed Account Description No Safe Deposit Box titled in the Decedent's name existed at our office. 9 2UUJ Accrued Interest $1.02 If you have any questions about the information provided, please contact our Records Department at (716) 635-4010 or 1-800-724- 2440 outside of the Buffalo, NY calling area. Thank you. Sincerely, M&T BANK CORPORATION BY: . tf~ 1-, .-.{~~ Authorized Signature DATE: I 2.~ "2.-("v 0'-- ~ ORRSTOWN BANK TO: Weigle & Associates, P.C. Attorneys-at-Law 126 East King Street Shippensburg, PI'. 17257 FROM: ORRSTOWN BANK P.O. BOX 250 SHIPPENSBURG PI'. 17257-0250 DECEASED RE: ESTATE OF Mary E Kelso DATE OF DEATH: October 29,2002 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK: (1) CHECKING ACCOUNTS ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED 102000297 Mary E Kelso 12/2/99 (2) SAVINGS ACCOUNT DATE OF DEATH PRINCIPLE & ACCRUED INTEREST 12,683.29 5.04 DATE OF DEATH ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST (3) CERTIFICATES OF DEPOSIT ACCOUNT NO. 4000000318 5020065406 5020068556 5020068578 5020068596 TITLE OF ACCOUNT Mary E Kelso Mary E Kelso Mary E Kelso Mary E Kelso Mary E Kelso DATE OPENED 10/4/02 12/2/99 2/15/02 3/5/02 3/14/02 Date: 12/26102 By: Timothea Customer Service Operator P.O. BOX 250 SHIPPENSBURG. PI'. 17257 . DATE OF DEATH PRINCIPLE & ACCRUED INTEREST 13,203.84 22.34 26,407.52 46.88 20,000.00 23.78 10,200.00 22.71 11,200.00 18.23 . TEL. (717) 532-6114 ib~111.(Dtd. 20(0) Malllhg' Number: 021019747 t.., TREASURY DIRECT' www.lraasurydlrect.gov HlOD- 722-287' 1-817.994-5500 (but9ld9 ihg U.S.) MARY E KELSO 1~94 WALNUT BOTTOM RD NEWVILLE PA 17241-9520 TREASURY DIRECT P.O.BOX 2076 BOSTON MA 02106-2076 PHONE: (800) 722.2678 :i:L.t~~~~~~~~.~!jl,~~r.~~fJ1~~~,~~n!!!ii!jifi!lWii!):i!i!iii!!!j!i!iii!iWi!i!!iiiiiFi!Hi!li!iimiW!i;j!li!!miiiliilij!ili!W:Hi!i!Bi!ii!!i!i!i! I I I Payments made by direct deposit to: ADAMS COUNTY NATIONAL BANK Routing Number: 031309945 . Naii\e on Account! MARY E KELSO" CHECKING Account Number: 12-165.7 . I . , mJ~:J!~9!1~!m!l1!!I1!~~~l~jirl (717) 776-527 I "'I~liiiP'li~~!li~!!~llnfi~~~~!!!!!!l191ffit- ...., 183'12'3 523 ~lij~~~~!!,~~j~P.~ilii~~~i!~J;~il No withholding . :.:i;'i:::'::"~"'.!~~~~~~~f~i~J[:.' ACCOUNT HOLDINGS )j.:r.rrw:::r:r::rrr@:.$l!)lWmnj\y,r$tlWAG.m:mWfJ:r.::' ,...,.,.. ...... 9128277A4 01 5 7/8 NOTE 5 05 07/51/03 10,000 10,000 07/31/01 99.829 3.965 01/31/03 In-l:.I"..t 193.75 i--:-~'-"<-'---"-' i TllANSACTlONHIST01lY For 08/03/2001 to 11/31/2002 .,,' ........-., :. ,.. ....:.:-:.;.:-:.;.;.;,...;.:-..;.;. . . .' , :::i;:;;::::::;:;::::i:;::~::;;;: ~ i[~11~;i[i~ !~j: iii ~j[ i!m [~j!1 iii ~:: i ili~j:!::; ~i(""':: ~::;::::. ........................... ..................................... :-:.:-:-:.!.:-:.;-:........................................'..........-.-...............-.-...-.......:'..;.:-:::,:::;: ................,........-.,-.-....... .....,... :'!j,.J:;!.j,.,~~I~~~~~~~~~i:~~~~~~.fM~; .....J.::j..I....~~;6;g~~.~...i..., ......-..,.: [.t ............... :-:.:-:.:-:.:.; .;.;.;.;.:.;. 01/31/02 9128277A4 3 718 NOTE S 03 . 07131/02 9128277A4 5 718 NOTE 5 03 In*_I"..* P.ym.ni . tnt.I"..* Payment 195.75 193.,75 .......-N........... .................... ~ ~~ j ?i~ ~ ~!~~:n~~~~ ~ r:j![i ~ ~ [ij i ....,.....-.........,...,.. .,..,..................,... .....,...,..;.;.:.;.:.;.... "'," . ....... ..... .~. ......,.................-...............,........... ....-_..............-.<...._.............,.... .........,.......,'................,.-...............,..'.'.:. .............,...........,....' :;:;:;:;:;:;:::::::::::;:;:;:::;:::;:;:::;:;:;:;:;:::;:;:;:;:;:;:;:.:, :.,... .N. .".jil\lfui'~~.~~lMi~~~iii;ll;;;1);~~rl: '.' ..............'r$10;0001 ... ,'::. :.:.;.:.;.;.;.:.;.;':.......... :.":':.::::::::::~::;:::}:/::::/::::::::::::::::::::i::::::-:.:->:.:-:->:.:-:-:-:-:-:':-:-:.:.:-:-:':.:-:...... ..... ...... ....... ........:.:.:.:'::~:.:.:.... . .................... :.:-:.-.:-:.:-:.:.:.:.:-:.:.:-:-:-.-:-............. ::::1:;1;':::1::':':' :.:-:+: :::::?~:!:)}:::::::::::;;:::::: ::1 '.' .... .....,. II"""" .....11r::""TJ...UIO i"!f1....I,..~D....llldn TUI,~ .QTATJ::;W:;t-./1" pl'FA~F coNTACT YOUR Tr9urJrvDfrsctOFFICE AND PROVIDE YOURAOCOUNT NUMBER '" !EASURY I J. DIRECT@ ~JIIIIIlI G) JOHN DOE POD JANE DOE 123 PINE STREET ANYWHERE, USA 55555 ,[ 1k':']f'" "il/f.W; (555) 555-5555 Or (555) 555-5555 J23-4S61"89 9U79SIlC8 JO,ooo " 10,000 01/JlIDl 97.561 5.0/4 4.825 11ll/0J 8. UlLL ,,, 07/11/Dl 10,000.80 9. 91279SGS4 IO,OOO " JD;oon O~'11101 98.011 3.945 3.n5 10/11101 IllLI.. 1'.,- lUlll/Ot lO,OOO.OO I - Sample Statement - ~2.[02""91~Q Q 06/04/01 9J17951/C8 UJI,L01IlUOJ Tund.rlll +lO,OOO 06/04/01 91179SGS4 nIl,LIO/lI/tll Trnlld.rlll +10,000 ,y; 1 "''''''I\"''J!~ ~"''1;\-' '-r -V-T-- - 'c jIJ ~ ~', ~ -] t':i. \ 'f' .tl Il' I'; '? ;\1)1 l'l If. '1' l \ I ' i1. ), i ~ '/ '~ ,j \ ',',' L I' -' p, ~ ~ \ l( "- ., 'I ~)J,~~rl\j,lhdjHllirl"J1\til',i:J'';I:;; ,>", ,r_t:, '\,-It I" (- \,' II' ,!~ 1 ~ ,}y, ) \' "" J :' -j \ . ) \ I ' _ , I" ~ " , . , IMPORTANT MESSAGE TRBASURYD1RBCT liAS A NEW TOLL-ToREE CUSTOMER SERVICE NUMBER: I_BOO"122_267a. YOU CAN USE THE NUMBER fNSlIJE TilE u.S. TO MAKE A PURCHASE, REJNVEST YOUR SECURITY, OR CHECK YOUR ACCQUN'r BALANCE THROUGH TREASURYDlRECT ELECTRONIC SERVICES, AND TO OBTAIN AUCTION INFORMATION, ORDER FORMS, OR SPEAK TO A CUSTOMER. SERVICE REPRESENTATIVE. OUR "TOLL" NUMllBR FOR ACCESS OUTSIDE THE V.S.IS: 617-j)!14_5500. INVESTOR ACCOUNT INFORMATION 1. Account registration, mailing address, telephbne number, taxpayer identification number (confidential), and tax withholding stalus of this TreaswyDirect account. 2. Contact your TreasuryDirect office with questions about account holdings or changes to your investor information. 3. All payments will be deposited directly to this financial institution account. This is. also the account which will be debited if you elect Pay Dir~ct. when'maloog a nevi pUl:chase. c4!.-! l'Please refer'to your~TreasuryDirect.'a,6eormt.jn1llilbel'whed contacting your TreasuryDirect office, 5. The date of this statement and .yourtotalpar.J1Q1dings. as .of that date. ..... ... , ACCOUNT HOLDINGS 6. Identification and total par amount of all sub-accounts for each security. . 7. Securi1y holdings itemized by sub-account. . Yield/Rate* - the annual rate of return or yield to mat.urity on notes/bonds (yield) or bills (investment rate). Based on purchase price and 'calculated on a 365-day basis. . Discolmt Rate* - an annualized rate of return on bills. Based on par and calculated on a 3GO-day basis. ... Displayed only for securities purcha~ed !fol1competitively 'at originaNJ,:riJe. . Number and term of remaining scheduled reinvestments for this sub-account. ',.1 The payment amount for each secmity reflects the total amount due for all sub-accounts. Par payments exclude any amotirits scheduled for reinvestment. 1 TRANSACTION mSTORY 10. Beginning and ending dates for stalement period. 11. Total par holdings as of the start of business on the beginning date of this statement. 12. A detailed description of all transactioos including payments I . and changes in securi1y holdings. Possible transaction 1ypeS!i include:. '". :'. '~'?'! Account Consolidation The merging of two or more accOlmts with tpe '/,;:" .. same name and taxpayer identification nuinbef into a single TreasuryDirect account. I Aocount Rece.ivnble Amoun~ withheld to satisfy a debt to the Tte~swY; , Interest Paymellt Interest paid on a note or bond. Par Payment Principal paid on a manu.ed bill. ' .... Par and Interest Payment Combined principal and interest paid on a' matured note or bond. Ref1llld Payment Difference between amount submitted for purchase and tbe actual purchase price of a seCllrity. Release ofI-Ield Payment Payment released to you after being previously . . ' held. IRS Withholding Amount withheld fot payment to the IRS., See c : "Tax Witb1101ding Stahls" on page one of the statement for type of withholding. . , New Purchase Purchase 'originated by a tender application. I I. Does not include reinvestments. ~~ Reinveshrient Purchase Purchase originated by a reinvestment oi"the \./ proceeds froni a niahued security. , Redemption A reduction in total par at a security's m;tttirity:" ; which results iri either a payrrient or a rejnv~tM ment. Transfer In Security deposited to this account from a commercial bank or broker, or from another : TreasuryDirect account. Transfer Out Security withdrawn from this account and transferred to a commercial bank or broker, to another TreasuryDirect account; or to the Federal Reserve Banlc of Chicago ((iell Dill:Cr-j, 13. Total par holdings as of the close of business on the ending date of this statement. "I) p,.,,, T)j""f'1 M','l S,',,1/ nl"..", 0'-" ~"";","rp,-1 h~,-1~_h~l'M ~l'.,.~ OH~M._n _....L. "",,' ,. ~,. 'rD !lj11 (0.0.2.000) Mailing Number: 021019747' t~". IMPORTANT MESSAGE ';',1." TREASURY1)IRECT STATEMENTS ARE AUTOMATICALLY SENT TO YOU TO CONFIRM SECURITIES TRANSACTlONS, OTHER THAN lNTEREST PAYMENTS, WE NOTE YOU'VE NOT RECEIVED A STATEMENT RECENTLY, WE ARE, THEREFORE, PROVID1NG THIS ONE AS A SERVICE TO YOU IN MAINTAIN1NG YOUR RECORDS, THANK YOU FOR INVESTING WITH TREASURYDIRECT, YOU MUST CONTACT US TO CHANGE YOUR ADDRESS IF YOU MOVE PERMANENTLY, THE MAILING METHODS WE USE DO NOT ALLOW TREASURYDIRECT MAIL TO FORWARD WHEN THE ADDRESSEE HAS MOVED PERMANENTLY, HOWEVER, IF YOUR ADDRESS CHANGE IS TEMPORARY YOU DO NOT HAVE TO CONTACT US, JUST LET THE POST OFFICE KNOW YOUR MOVE IS TEMpORARY AND THEY WILL FORWARD YOUR TREASURYDIRECT MAIL. . ' ,.,..-' .....~,.-'..._"--'--,,_....- .' , --.-..,,---- i -'---"'-..,.- .,-~". .,., ".....11 UWI; nl JI;(:TliiN.q r.n/Jr.~RtJltJ~ TJ-jIS STATEMENT, plEASr; OONTACT YOUR Tr9lUuryDfr9CIOFFICE AND PROVIDE YOURAOOOUNT NUMBER " . !EASURY I. DIRECT@ G) JOHN DOE POD JANE DOE 123 PINE STREET ANYWHERE, USA 55555 91Z79511C8 10,0110 "' 10,000 0//1,11111 97.561 5.Dl4 4.815 7/l2J1I1 8. 1l1l,L rAl" o7/iml 10,000.00 9. 91~795GS4 10,01111 "' tn,unD IloIlU/OJ 98.1171 3.'45 3.0J5 10/11/0J nIl.L PM lOlli/OJ 111,000.110 - Sample Stalement - -- @ 06/04101 91279511C$ IIlLL01/JlIUI 1'r.".f",'J" +10,000 06/04/01 9Jt7950S4 lllJ.!,JOnr/llJ T"""f~J' III +10,00D IMPORTANT MESSAGE TREASURYDIRECT liAS ^ Nl!W TOLL_PRRll CUSTOMER SERVICE NtJMBEn, ].aOO_721_2IJ78. YOU CAN USE THE NIJMBER lNS1D/1 Tim U,S. TO MArellA PURC.HASE, REJNVE$TYOUR SECURlTY, Oil CI-JECK YOUR ACCOUNT BALANCE nJR01JGH TRnASUl~YllJRECT ELECTRON1C SERVICES, AND TO OBTAIN AUCTION lNFOltMATlON, ORDER FORMS, Olt SPEAK TO A CUSTOtvlHn SERVICE REPRHSENTATIVE. OUR "TOLL" NUMIl!!/t l'o/t ACCESS OIJ'fSIDllTfIG U.$, IS, GI?-99~-5500. ~.........."""""~~ .-."'.. 1. INVESTOR ACCOUNT INFORMArION Account registration, mailing address, telephone number, taxpayer identification number (confidential), and tax wilbholding status ofthis TreasuryDirect accotml. Contact your TreasuryDirect office with questions about account holdings or changes to your investor infonnation. All payments will be deposited directly to Ibis financial institution aCCOlmt. This is also the account which will be debited if you elect Pay Directe when making a new purchase. Please refer to your TreasuryDirect account number when contacting your TreasuryDireci office. The date of Ibis statement and your total par holdings as of that date. 2. 3. 4. 5. ACCOUNT HOLDINGS 6. Identification and total par amount of all sub-accounts for each security. 7. Security holdings itemized by sub-account. t Yield/Rate* - the annual rate ofrelurn or yield to !fiahldty 011 notes/bonds (yield) or bills (investment rate). Based on purchase price mid calculated on a 365-day basis. ' 'Discount Rate'" ~ an annualized rate of return on bills. Based on par and calculated 011 a 360-day basis. '" Displayed only for securities purchased noncompetitively at original issue, Ntunber and terin of remaining scheduled reinvestments for this sub-account. The payment amount for each security reflects the .total amount due for all sub-accounts. Par payments exclude any amounts scheduled for reinvestment. TRANSACTION HISTORY 10. Begimling and ending dates for statement period. II. Total par holdings as of tbe start of business on the beginning date ofthis statement. 12. A detailed description of all transactions including payments and changes in security holdings. Possible transaction types include: Account Consolidation The merging of two or more accounts with the same name and taxpayer identificatioJ,l number into a single Treastlry.Direct account. Account Receivable Amoun~. withheld to satisfy a debt to the -Treasury. Interest Payment Interest paid on a note or bond. Par Payment Principal paid on a ma1ured bill. Par and Interest Payment Combined principal and interest paid on a matured note or bond. Refund Payment Difference between amount submitted for purchase 'and the actual purchase price of a security. Release of Held Payment Payment released to YOll after being previously held. IRS Withholding Amount withheld for payment to the IRS. See "Tax Withholding Status" on page one of the statement for type of withholding. New Purchase Purchase originated by a tender application. Does not include reinvestments. ' Reinvestment Purchase Purchase originated by a reinvestment of the proceeds from a matured security. Redemption A reduction ill total par at a secllrity'smaturity which results in either a payment or a reinvest- ment. Transfer In Security deposited to this account from a commercial bank or broker, or fl'om anotner TreasuryDirect account. Transfer Out Secmity withdrawn fi-om this aCcOlmt and transferred to a commercial bank or broker, to another TreasuryDirect account, or to the Federal Reserve Banlc ofCbicago (Sell D;,-ecrll). 13. Total par holdings as of the close of busiuess on Ibe encling elate of this statement. ~ If. Pay Direct, and Sell Direct are registered trademarks of the Bureau of tbe Public Debt. !l allfirst December 1 7, 2002 Weigle &Associates, P.c. Attn: Richard L. Webber, Jr., Esquire 126 East King Street Shippensburg, PA 17257-1397 Allfirst Financial Center N.A. PO. Box 900 Millsboro, DE 19966 RE: Estate of Mary E. Kelso Date of Death: October 29,2002 Social Security Number: 183-12-3523 Dear Mr. Webber: In response to your request, please be advised of the following accounts the above-named decedent had with this bank and the balances on the date of death. 1. Account Type........................... Money Fund AIt. Account Account Number....................... 0098368044 Ownership (Names of)................ Mary E. Kelso; Roy W. Kelso, POA Opening Date........................... 10/13/98 Balance on Date of Death...........$ 39,142.73 Accrued Interest....................... 19.38 Total......................................$ 39,162.11 2. Account Type........................... Certificate of Deposit/IS MOS/2.970000 Account Number....................... 80000001982088 Ownership (Names of)................ Mary E. Kelso; Roy W. Kelso, POA Opening Date........................... 03/25/99 8alance on Date of Death........... $ 28,750.00 Accrued Interest....................... 154.40 Total......................................$ 28,904.40 . Page 2 December 17, 2002 3. Account Type........................... Certificate of Deposit/13 MOSI2.580000 Account Number....................... 80000001982197 Ownership (Names 01)................ Mary E. Kelso; Roy W. Kelso, POA Opening Date........................... 08/09/99 Balance on Date of Death........... $ 11,000.00 Accrued Interest...................... 16.33 Total......................................$ 11,016.33 4. Account Type........................... Certificate of Deposit/26 MOSI2.720000 Account Number....................... 80??oo01982212 Ownership (Names 01)................ Mary E. Kelso; Roy W. Kelso, POA Opening Date........................... 09/07/99 Balance on Date of Death........... $ 10,000.00 Accrued Interest...................... 39.50 Total......................................$ 10,039.50 5. Account Type........................... Certificate of Deposit/60 MOS/4.430000 Account Number....................... 87008140219282 Ownership (Names 01)................ Mary E. Kelso; Roy W. Kelso, POA Opening Date........................... 04/15/96 Balance on Date of Death...........$ 10,000.00 Accrued Interest....................... 18.21 Total......................................$ 10,018.21 . Page 3 December 17, 2002 6. Account Type........................... Certificate of Deposit/22 MOS/3.450000 Account Number....................... 87008141004646 Ownership (Names 01)................ Mary E. Kelso; Roy W. Kelso, POA Opening Date........................... 11/25/97 Balance on Date of Death........... $ 3,017.32 Accrued Interest...................... 1.43 Total......................................$ 3,018.75 This response does not apply to any pssets held with AI/first Brokerage, where AlIffrst Bank is selVing as a trustee, nor to any credit cards owned by Bank of America bearing Allfirst Bank's name. For further account infonmation, closures and/or reimbursement of funds refer to below branch . 28 Walnut Bottom Road, Shippensburg, PA 17257, telephone 717-532-2414. Sincerely, m.a ~.a~&f Mary Anne Macielag Associate I/CIS (302) 934-2240 ~ FARMERS NATIONAL BANK OF NEWVILLE ADivisionofAdamsCounlyNationalBank December 17, 2002 Richard L. Webber, Jr., Esquire Weigle & Associates, P.C. 26 East King Street Shippensburg, PA 17257 RE: Estate of Mary E. Kelso Dear Mr. Webber: Mary E. Kelso had the following accounts with this bank, all of which were in her name alone - Checking account #12-165-7 with a balance of $9,022.87 plus 2.99 accrued interest was opened 4/7/97; Savings account #9615067 opened 1/3/74 with $9,095.28 balance plus 11.89 accrued interest; Money Market account #1593838 opened 12/30/83 with $22,725.75 plus 30.25 accrued interest; and the following certificates of deposit: #158224 - $21,500.00 dated 1/8/02 with 30.34 accrued interest #160308 - $10,000.00 dated 4/4/02 with 27.91 accrued interest #160320 - $ 6,000.00 dated 4/13/02 with 9.12 accrued interest #160335 - $ 6,000.00 dated 5/4/02 with 16.65 accrued interest #160364 - $10,000.00 dated 6/3/02 with 29.03 accrued interest #3990774 - $4,100.00 dated 2/22/00 with 17.57 accrued interest #3991044 - $30,700.00 dated 2/7/01 with 160.91 accrued interest #4990770 - $10,000.00 dated 2/17/00 with 12.66 accrued interest Mary also had a safe deposit box #518. Sincerely yours, ~~r~~~ Carolyn H. Kough Executive Vice President PO. Box 156, Newville, PA 17241. (717) 776-5312 SAFE DEPOSIT BOX INVENTORY INSTRUCTIONS (1) Cash: Report 10101 only. (2) Stocks: list in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, narrie in which stock is registered, and number of shares and class of stock. (3) Obligations of U. S. Government: Number pF items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: Stafe name of depositor, number of book, last dote appearing in book, name of bank and branch, and balance. (6) Jewelry, Coi~s, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: list and describe as fully as possible. (8) All other contents. Poge 1 of 1 ITEM NO. ITEM DESCRIPTION 1 2 Cash $16,116.78 ACNB Cor oration common stock certificate #AC 32133 for 7 477 shares re istered Mar E. Kelso. 5 Certificates of deposit- ACNB #4990770 dated 2/17/00 for $10 OOO.OO'ACNB #3990774 dated 158224 d ACNB #160364 dated 6/3/02 for $10,000.00; .00 #80000001982088 dated 3/5/02 for #87008140219282dated 1/15/02 for CCNB #000021001055637 dated 6/3/01 for $30 000.00 7 Mutual of New York Life Insurance contract #N-6100-G1 5 152.00 8 Birth certificate 28 750.00' 10 000.00 . I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COpy OF CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY: SIGNATUR ~ SIGNA URE Carolyn H. Kough Roy W. Kelso PRINT TITlE CHECK APPROPRIATE SOX: Executive Vice President ~Execu!Or(lrix, DAdminislrator(trixl o Eslate Representative 0 Joint owner of safe deposil box NOTE: Attach additional 81/2>; x 11>; sheet (s1 if necessary or use duplicates of this page of form. FINAL SETTLEMENT Date 3022 -03 ~~~~1 ~~ ~~ ~~)u~(jfflufuy- Date of Sale ~ "L"2-- O~ Auctioneer CA12-\ () C\uu- I G i \ \ OWNE~ Addres Sale location lYk..trer~cashierJ);n S '~ Llyt Other PROCEEDS OF SALE, Cash....hmh.hm.hhm.mhmohmmh. $ Other Seller's Expenses Advanced by Auctioneer: f\Eh~^1l Sl~ ~o U{> /)rbDi2. Lj 1 N <<) IS uPrloUiL % 30 '(Lj t\) IS 3 .). Ji f/ -n;., ~.''''e-e !rr.../--( n...J:; '/.,'IJo';;'<"'A ilflle -?, -IN" RI!','fIi "" "'". fu/p"", S.,t.~ Miscellaneous (see attached list) h...OOhh...Oh......O DEDUCT TOTAL SELLER'S SALE EXPENSEh''''h$~ S LJ () , ~ D TOTAL NET PROCEEDS TO SELLERh....o$ dO LJ b3, ID Checks.hhhh.hh...mmh.hmhhhhh. Otherhhh.mhh___h'h'hh'hhmhhhhhm.mhh___h0m~hm...... ~~01,SO 2/994,25 [)OO I d,~S - Miscellaneous (see attached list)h....hh.hoohh.hhhh....hh TOTAL PROCEEDS OF SALEhh....hmhhhmhh...o$ LESS SELLER'S SALE EXPENSE, 1 Auctioneer's Fee ..m........Ohh...h..hlQhh...~..hh.O... $ Z,5W,Lj~ ~\.lS 70S. 00 lj 53./S /'5:2., ,jf) S" 1; 6C! ;)500Y, ~~~ 1l3"3. L\D -to Cwu- Deter I, (or we), the seller of goods, merchandise, and/or property soid at public auction on above date and location, acknowledge and accept this settlement of proceeds of sale. I (or we) agree to accept all re- sponsibility for providing merchantable title to all goods, merchandise, and/or property sold, and for delivery of t,itle to the purchaser. 4 ) '3\,)-"lk:J . ,---~/r.:~.,. f2/~, C.' (D ~ 0;. P /'.. (Seller', Sighature) A~eer or cash~" Signalu1e (Seller's Signature) FINAL SETTLEMENT -Form No. FS~69. $.2.00 per p&:d, 10 pads a1 $1.50 each, 20 or more at $1.25 each. Reorder from: MISSOURI AUCTION SCHOOL. 1600 Genessee . 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JRD/June 30, 1992/17858 ~fO!/ @ ~ 20[ In Re: Estate of Mary Elizabeth Kelso ' ORPHANS' COURT DIVISION Late of Penn Township · COURT OF COMMON PLEAS OF · CUMBERLAND COUNTY Estate No.: 21-02-1003 ' PENNSYLVANIA NO. 21-02-1003 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Mary Kelso Counsel for Personal Representative: Richard Webber Date o£Decedent's Death: 10/29/2002 Date of Delinquency Notice: 08/11/04 The undersigned, Glenda Farner-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on April 30, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 11/08/04 . ~, i ~.~J taienaa yarner Strasbaugh ~ff Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled for at in Courtroom No. 3. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled. Ge°rg~;~r~V~' '~} ~ STATUS REPORT UNDER RILE 6.12 Name of Decedent: Mary E. Kelso Date of Death: October 29, 2002 Will No.: 21-02-1003 Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes I-fi 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 follow/ng: 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 haterest? Yes [-'] No ['x] c. Copies of receipts, releases, joinders and approval o£forma! or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this re~ort. Date: l( [ c/ ~°V ~') '~-~-~-'~,j~~' ,z, Signature Richard L. Webber, Jr., Esquire Name 126 East King Street Shippensburg, PA 17257 :z: Address (717) 532-7388 Telephone No. C&¢acity: [--] Personal Representative ~] Counsel for personal representative