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Home My WebLink About01-0899 Will PETITION FOR PROBATE AND GRANT OF LETTERS TESTAMENTARY No. c9/- 0 1- &:,_ To: Hary Lewis Register of Wills for the County of Cumberland Commonwealth of Pennsylvania Helen L. Bashore Estate of also known as Helen Louise Bashore , Deceased. Social Security Number 195-32-2519 The petition of the undersigned respectfully represents that: Your petitione~ ishue 18 years of age or older and the Personal Representati ve(w) named in the will of above decedent, dated June 13 t 19 99 t and codicils dated N/ A Charles E. Bashore named executor died on December 17, 1995 (srare relevant circumsrances, e.g. renunciation, death of exeeulor. ere.) Decedent was domiciled at death in8umber lancCounty, Pennsylvania, with hislher last family or principal residence 208 Hearth Road, Camp Hill, PA 17011-8454 at at Decedent, then 80 years of age, died Camp Hill, Pennsylvania (list street, number and zip code) September 19, 2001 , iSl_ , Except as follows, decedent did not marry; was not divorced; 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 an incompetent; Decedent at death owned property with estimated values as follows: (If domiciled in PA) Personal property $ 5,000.00 (If llQ1 domiciled in PA) Personal property in Pennsylvania $ and Personal property in Cumberland County $ Value of real estate in Pennsylvanif. $ 145,000.00 situate as follows: 208 Hearth Road. Camo Hill. Pennsylvania WHEREFORE, ~titioner(s) respectfully request(s) the probate of the last will and codicils presented herewith and the grant of letters te:s ta.men!=arv thereon. (testamentary, administration, c.t.a., administration d.b.n.c.t.a.) i ~Lfh/77U19tJ3.Jj2~'Y ~~ Pamela B. Gagne eIl_ ~ g ].g 3000 Two Logan Square '" .: ~~ Philadelphia, PA 19103-2799 ]",- j 0 ~ = ~ ~ C;; 10-21 (Rev. 5/95) \1- to - G OATH OF PERSONAL REPRESENTATIVES COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUNBERLAND 55 Sworn to or affirmed and subscribed before me this \ \'-\V'\ day of ~ ~\ \. ffi11( ~ l~ Deputy RegIster VI 0;' :l ~ c: i ~ Estate of No. Gt I - 0 I -. } '1 cr Helen L. Bashore also known as Helen Louise Bashore Deceased DECREE OF PROBATE AND GRANT OF LETTERS TESTAMENTARY AND NOW, () Q., T. f 2- r~~ consideration of the petition on the reverse side satisfactory proof having been presented before me. IT IS DECREED that the instrument(s) dated June 13, 1999 described therein be admitted to probate and filed of record as the last will and codicil(s) of the above named decedent and Letters Tp j:l to ..!:lmpn h:I1'.Y are hereby granted to Pamela B. Gagne Z35.OD Probate................................... ...... $ Short Certificate(s)....................... $ (00,00 Renunciation(s )........... ,..... ........... $ In ventory................................ ...... $ Judicial Computer Project ........... $ .5. a 00 Inheritanc :fa ..~................. $ . t ...~.. $ Affidavit(~) ./)............................. ~ ~..~~(1:~................. $ . Filed () ~ T.To;a~............. A'~1OD I FEES ode rick Gagne, Esqu ire, 1;33249 / P ATIQRNEY (.SIJ1l.. Ct. J.D. No.) C 0 epperHam11ton L~P 3000 Two Logan Square Philadelphia, PA lQ101-?7QQ ADDRESS ,50 (215) 981-4695 TELEPHONE NUMBER 10-21 (Reverse) (Rev. 5/95) HI05.805 REV 9/86 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing, WARNING: It is illegal to duplicate this copy by photostat or photograph. p 7742260 /7 ~..-"') ~ ~f(../ /';'''(' (7~~~~ Local Registrar if Fee for this certificate, $2.00 No. SEP 2 3 Z001 Date ~ /-~/- ~99 43 Rev. 2117 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH .. Helen Louise Bashore AGE (lur lIirlIlcIay) UNDER . YEAR UNDER I DIft Mcwft Oere HcluN!......... SEX STAlE Fll.(_R SOCIAL SECURITY NUMBeR NAME OF DECEDENT If.... ModdIe. l-.! a. female ~. 195 32 2519 8lRTHPUCE IC...., allCl ~ OF DEATH IC,,-" DAy IJf'e -- .. .IlIlrUCloOOS on Olhet __ S-OI fCteqlCounIrVl HOSPITAL: OtHER: ollidayshurg,PA...-R1 ERIOIlIpM..... 0 ~O ::=e 0 ,. FACILITY NAME II not >I\5I>t\JItot>. gwe ""eel and ......-, DECEDIIENT'S USUAL 0CCUM10H (~":=:~O:='::::2.=r tt.. home maker ,.. domestic DECEDENT"S YM.ING ADDRESS jSlo....~. ....lipCodeI DECEDENT'S ACTUAL Al!SIOENCE -- on cIIIIer IIdeI KINO OF IIIJSINESSIINOUSTflY IlIt. Old ...... ... in a Cumberland --..' .7..0 :;"-:::-=of MOTTJmiFIt'h~erSur-1 .t. ~fnmfBRl'aSJ.'t~osra ~~dmoor , UAAItAL swus -......., ~.......... WIdowed. CaII-oe Diworad (SpeclIyt (I..or!>.. 1.P.Ulrried 17C.~ -'~"'ln SUlMYING SPOUSE (I ..... QNe......... rwneI 208 Hearth Road 1..Camp Hill, PA 17011 RlJHER'S HAW fFiltl. Middle. LMI) fa. James Levy Adams INFOAIoWCT"SNAMEjT~ Pamela B. Gagne METHOD OF DlSI'OSl11ON ::~ c-.o. 0 "--'-StaleD .... ~ PA 19038 SEIMCE lICENSEE OR PERSON ACTING AS SUCH LOCRlOH - CilyI1bwn. &.Ie. ZIp eo.. aE~irview Township, PA Inc.,New Cumberland,PA 17070 lICENSE NUUIlER DIlfE SIGNED Day. 'tIIaI .... 2welllUll be c:cmpleted br ...... wlla...-.- dMIk -.sCASE REFERRED 10 UEOICAL EXAMlHEAICOAONEA ... 0 ..11 -.JIATI CAUlII IF"'- .- or c:GnIliliOn ....-ng..-I- L ~~\~ ~~tloft.. DUE lOtQR "CONSEQUENCE Of): 21. I~O '--,*-, :--.... I I I MAT II: 0IIler...... concMione ~to..... ... ..-..uIIinO in 1M undIflWlnlI- ~ in MAT l ~"aandIione . ....1MIIIng to.......... _.e..~ CAUIIE \Ole-. III -..v ... .......,- ........... _I LAST I :. d. DUE lOtQR AS" CONSEQUENCE Of): DUE 10 toR AS A CONSEOUENCE Of): Wi'SAHAUlOPSV WERE AU'IOPSY FIHDlNGS IlMHNEA OF DEATH PERFORMED? ~PfIIOAlO ION OF CAUSE 0 OF DEArH7 NeIureI AccicIM 0 _HI ..0 ...0 NoD S&llcide D DATE OF IHJUAY (MonWl. Oey. 'jIur1 nUE OF INJURY INJUAV AT WOAK7 DESCAtIlE HOW INJURY ClCCUfR:o. Homicide 0 ......... ~lan 0 COuIcI..- be dII-..ct D ... 0 ..0 / l ~,Id'/ II ... 2IIL a. CIIIT.....lOleck only onel -C8ITFYING PHYSICIAN ~~ ~ 01_ -. __ 1lftySIC.... haS ptOllClUl1Ced duII'J and c:omlll8led...... 231 To........of""'knowlOdp...._eccurtW4..........UUM/.I__.................. _...... _.................................... -PRONOUNCING AND cunFfINQ PHYSICIAN (Physaon lloIII ;JIonllUIlCIng"-' _ C8flIIyong 10 cause 01 <lea", To 1IIe..... of "'" Ilnowfedge, ...... 0CCWf80I.,....... d111e. _ pleco. __ Ie die -....I.nct mo_... ......... . . . . . . . . . . . . . . . . . _ . . . . . . "IIEDICAL EXAIIINERICOROt<<A On .......... of ..amlnatlon .-d/., Inve......ion. In my opinion. ..,h occ:urrect ..tho limo. dal.. and place. and due to 'M c_f.) and --.. .,...... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :u.. AEGIST 33. 34. 00/ I "f . ~ ..,. , . ) ~ PHLEGAL: #141719 vI (31CNOl!.WPD) WILL I, HELEN L. BASHORE, of Lower Allen Township, Commonwealth of Pennsylvania, revoke all my prior wills and codicils and declare this to be my will. FIRST: Last Expenses. I direct the payment from my estate of the expenses of my funeral (regardless of amount) including the travel expenses incurred by any of my issue in attending my funeral and my last illness. SECOND: Tangible Articles. A. I expect to leave a memorandum expressing my wishes with respect to the distribution of certain articles of my tangible personal property. Although I ask the beneficiaries of this Article and my executor to be guided by the memorandum, it shall not be probated as part of my will or be legally binding, whether signed or not. Subject to the distributions pursuant to the aforementioned memorandum, I give all of my articles of personal and household use and ornament, including, but not limited to, jewelry, clothing, furniture and furnishings, automobiles, boats, airplanes and all other similar tangible property, together with all insurance thereon, to my husband, if he survives me. If my husband does not survive me, I bequeath any vehicles I may own at my death to my son, Larry D. Bashore, if he survives me, and if not, to his issue, who survive me, to be divided as they may agree or, in the absence of agreement, as my executors, in their sole discretion, may deem fair. If my husband does not survive me, I bequeath all such property and insurance, except for the property bequeathed to my son as set forth hereinbefore, to my daughter, PAMELA B. GAGNE, if she survives me, and if not, to her issue, Pepper Hamilton LLP '"t ~ ., . I: , J PHLEGAL: #141719 vI (31CNOl!.WPD) who survive me, to be divided as they may agree or, in the absence of agreement of if one or more of my daughter's issue is a minor, as my executors, in their sole discretion, may deem fair; provided, however, that if any issue of my daughter predecease me leaving issue surviving me, I direct that such surviving issue, per stir.pes, shall share in the distribution of my said tangible personal property to the same extent as would have such deceased parent if he or she had survived. In the absence of all of the foregoing beneficiaries surviving me, I bequeath all such property passing under this Article Second to my son, Larry D. Bashore, if he is then living, and, if he is not then living, to his issue, per still'es. I direct the payment from my residuary estate of all storage, packing and transportation costs, insurance, customs duties of any country and use taxes charged by any jurisdiction as well as all other charges incident to the preservation and distribution of any or all of my articles of tangible personal property to any beneficiaries recei ving the same. B. The bequests made under Article Second A above shall not include: (1) any and all property used by me in any business operated as a sole proprietorship (other than any office equipment and supplies and non-commercial motor vehicles); (2) cash on hand or on deposit in any bank or bank vault; (3) bearer securities; (4) any type of debt; and (5) any life, health or accident insurance. .. C. Irrespective of any other provision of this will, any article to which a minor may thus become entitled under this Article SECOND shall, as shall seem appropriate to my -2- Pepper Hamilton LLP . t ; . f , c A J PHLEGAL: #141719 vI (31CNOl!.WPD) executors, trustees, custodian, and guardian (anyone of whom or collectively shall be sometimes referred to as "Fiduciary" or "Fiduciaries") and in full discharge of their responsibility, (1) be delivered before or at majority to him upon his own receipt; (2) be delivered during minority to his guardian or to the person with whom he resides; or (3) be sold and the proceeds added to the share of my residuary estate held for him. THIRD: Exercise of Power of Appointment. I hereby exercise the power of appointment granted to me in Item I, Paragraph C of the Irrevocable Intervivos Trust Agreement of Charles E. Bashore, dated October 28, 1987 (the "CEB Trust") by increasing the amount the Trustees of the CEB Trust are to hold under Item IT, Paragraph A for the benefit of my daughter, Pamela B. Gagne, from sixty-five percent (65%) to one hundred percent (100%), eliminating the portion to be held for my son, Larry D. Bashore, under Item IT, Paragraph B of the CEB Trust for the same reasons set forth in Article NINTH, Paragraph N set forth below. FOURTH: Residue. I devise and bequeath all the rest of my estate, real and personal, excluding any property over which I may have a power of appointment, to W. RODERICK GAGNE and PAMELA B. GAGNE and their successors, as Trustees under the Revocable Trust Agreement signed by me on November 24, 1995, as amended or restated, whether in whole or in part, at any time under the provisions thereof, to be added to and become a part of the principal -3- Pepper Hamilton LLP . 'I & . f . C . J PHLEGAL: #141719 vI (31CNOl !.WPD) of the trusts created thereby and to be held, administered and distributed pursuant to the terms thereof. FlFfH: Guardian of Property. I name my daughter, PAMELA B. GAGNE, if she survives me, as testamentary guardian of any property, including but not limited to insurance, which passes to a minor either by a provision of this will or otherwise and with respect to which I am authorized by law to appoint a guardian and have not otherwise specifically done so nor named a trustee or custodian. The guardian shall have the power to apply so much of the income and of the principal as he may consider desirable for the minor's education, health and maintenance. If she shall not survive me or fail to qualify or cease to act, I name W. RODERICK GAGNE as guardian, or if he is unwilling or unable to serve as Guardian, I name LARRY D. BASHORE, as guardian. Any other provision to the contrary notwithstanding, principal payable to any minor may, in the sole discretion of my Fiduciaries, be paid to the person named as the testamentary guardian to hold such property on behalf of the minor as custodian under the Pennsylvania Uniform Transfers to Minors Act. SIXTH: Youth or Disabled Beneficiary Trust. Principal or income payable to any beneficiary who is mentally or physically disabled (as hereinafter defined) (hereinafter called a "Disabled Beneficiary"), or who has not attained the age of twenty-one (21) years (hereinafter called a "Y outh"), shall be retained by my Fiduciaries "in a separate trust which shall be distributable as set forth herein. My Fiduciaries may from time to time distribute as much of the -4- Pepper Hamilton LLP . ., . , , r PHlEGAL: #141719 vI (31CNOl!.WPD) principal and net income, if any, from the trust as they consider desirable for the Youth's or Disabled Beneficiary's education, health and maintenance, which sums shall be paid to such Youth's or Disabled Beneficiary's parent or guardian, to the person with whom he resides or to him if permitted by law, or shall be applied directly for such purposes all as my Fiduciaries shall determine, in my Fiduciaries' sole and absolute discretion, and my Fiduciaries shall not be liable for any choice permitted hereunder. Any income not so paid or applied shall be accumulated. The unexpended principal and income shall be paid to such Youth or Disabled Beneficiary upon his attaining the age of twenty-one (21) years or when his disability ceases, or, upon his death prior thereto, directly to those persons related by blood or adoption to me who would be entitled to his estate under, and in the proportions among such persons provided by, the now existing intestate law of the Commonwealth of Pennsylvania if it were effective upon his death and if the persons so related to me were the only persons so entitled; provided, however, that any such principal and income payable to any person for whom at that time my Fiduciaries are holding a part of my estate in trust or under my Revocable Trust referred to in Article FOURTH shall be added to that trust for administration and distribution. For purposes of this Article SIXTH, the term "disability" shall mean inability to manage and conduct one's own personal or business affairs by reason of age, physical or mental illness (including, but not limited to, drug or alcohol abuse), infirmity, or any other direct cause, or a substantial impairment of one's ability to care for his own property. Disability shall be conclusively established by a written certificate by two -5- Pepper Hamilton LLP . " , l I r PHLEGAL: #141719 vI (31CNOl!.WPD) licensed, disinterested physicians, one of whom shall be the Disabled Beneficiary's regular attending physician, if any, and the other (or both if there shall be no regular attending physician) selected by my Fiduciaries. In the event the two physicians disagree, then a third physician shall be selected by my Fiduciaries, and the majority's decision shall be treated as conclusive. SEVENTH: Taxes. A. I direct that all estate, inheritance, succession, legacy, transfer and other death taxes or duties (by whatever named called), including any and all interest and penalties thereon, imposed under the laws of any jurisdiction by reason of my death, upon or with respect to any and all property which is required to be included in my gross estate for the purpose of such taxes, whether such property passes under or outside of this will (except any taxes described in Article SEVENTH B below, and any interest and penalties associated with said taxes) shall be paid by my Fiduciaries out of the residue of my estate in the same manner as expenses of administration and shall not be prorated or apportioned among or charged against the respective devisees, legatees, beneficiaries, transferees, or other recipients of any such property or charged against any property passing or which may have passed to any of them, and my Fiduciaries shall not be entitled to reimbursement for any portion of any such tax from any such person. B. The foregoing provisions of Article SEVENTH A shall not apply to: (i) the amount, if any, by which said taxes, interest and penalties thereon shall be increased as a result of the inclusion in my gross estate of property in which I may have a qualifying income interest for -6- Pepper Hamilton LLP " , i. PHLEGAL: #141719 vI (31CNOl!.WPD) life, under Code Section 2044 or corresponding provisions of state law, or over which I may have a general power of appointment under Code Section 2041 or corresponding provisions of state law and any taxes, interest and penalties on said incremental amount shall either be paid from said property directly or shall be recovered by my executor from the person holding or receiving said property as provided in Code Sections 2207 A or 2207; (ii) the additional estate tax imposed by Code Section 2032A( c) (or corresponding provisions of federal or state law applicable to my estate and imposing said taxes), and any and all interest and penalties on said Code Section 2032A( c) and comparable state taxes; (iii) any generation-skipping transfer tax imposed under Chapter 13 (and any similar state tax), which tax and any interest and penalty associated with said tax shall be paid from the property constituting the generation-skipping transfer; (iv) any supplemental estate tax attributable to excess retirement accumulations of qualified plan benefits included in my estate under Code Section 4980A, which tax and any interest and penalty associated with said tax shall be apportioned pro-rata against and paid by the person or persons who receive such property; (v) the amount, if any, by which said taxes, interest and penalties shall be increased (after any adjustments under Code Section 2701(e)(6) are taken into account) as a result of an increase in the value of my adjusted taxable gifts or taxable estate under Code Section 2701(d)(1) and (2), or any other special valuation rule contained in Code Sections 2701- 2704, any provision replacing said section or corresponding provisions of state law, and any such taxes, interest and penalties attributable to the amount of the increase shall either be paid from -7- Pepper Hamilton LLP I . , . 1 PHLEGAL: #141719 vI (31CNOl!.WPD) the interest in the partnership, corporation or trust to which it applies directly or shall be recovered by my executor from the person or persons holding or receiving such property; (vi) the amount, if any, by which said taxes, interest and penalties shall be increased as a result of the inclusion in my gross estate of property held in any irrevocable trust created by me at any time; and (vii) such portion or portions of said taxes, interest and penalties which are required to be paid or are advanced to my Fiduciaries by the Trustees or under any trust created for my benefit by my husband which is included in my estate and the taxes on of which are directed to be paid for from said trust by law or the instrument creating the same. C. My Fiduciaries are authorized to reduce to zero, if necessary, the amount to be distributed to any person under this will or any trust created hereunder, instruct the Trustees of my Revocable Trust referred to in Article FOURTH above to make a distribution to my Fiduciaries in an amount equal to any taxes, interest and penalty said person is responsible for under this Article SEVENTH if the property resulting in said additional tax does not bear said tax or if said tax is not paid by or reimbursed to my Fiduciaries by the recipient of said property so that my Fiduciaries must pay said tax from my estate. If my estate is insufficient to satisfy all such taxes, I have directed the trustees of my said Revocable Trust, to make available to my Fiduciaries sufficient assets from said Revocable Trust with which to pay such taxes in full. D. However, if at the time of my death I own any United States bonds redeemable to pay the United States estate tax at par plus accrued interest, I direct my Fiduciaries to redeem -8- Pepper Hamilton LLP " . , , I PHLEGAL: #141719 vI (31CNOl!.WPD) said bonds to the fullest extent possible and to use said bonds ahead of any other assets held in my probate estate to pay said tax, as well as any interest and penalties thereon. To the extent that the Trustees of my Revocable Trust referred to in Article FOURTH do not distribute to my Fiduciaries any such bonds for my Fiduciaries to use in paying said tax, my Fiduciaries shall pay said tax only after first ascertaining from said Trustees the amount of said tax and any interest and penalties thereon which said Trustees can pay by redemption of said bonds held in my Revocable Trust; and thereafter, when my Fiduciaries have received said information, my Fiduciaries shall redeem all said bonds held in my probate estate up to the full amount of any remaining portion of said tax, interest and penalties thereon not payable by redemption of said bonds held by said Trustees. If said Trustees do not hold any such bonds or has distributed all such bonds to my Fiduciaries, my Fiduciaries shall redeem said bonds as directed in this Article SEVENTH. EIGHTH: Powers. In addition to all other powers granted to them by law, my Fiduciaries shall have the following powers to exercise without court approval: A. To retain and hold any property or individual interests therein (including stock and interests in common trust funds of any corporate Fiduciary or of an affiliate or subsidiary of such corporate Fiduciary or of a holding company controlling such Fiduciary) without being confined to legal investments and without regard for the principle of diversification; -9- Pepper Hamilton LLP o. ., PHLEGAL: #141719 vI (31CNOl!.WPD) B. To continue to hold, for as long as my Fiduciaries deem it best, any investments received from me even though the same may be hazardous or doubtful or constitute an unduly large portion of my estate; and at all times and from time to time to vary investments, whether existing at my death or made thereafter; C. To invest or reinvest my estate in any property or undivided interest therein, wherever located, including but not limited to bonds, notes, minerals and other natural resources, stocks of corporations (including stock and interests in common trust funds of any corporate Fiduciary or of an affiliate or subsidiary of such corporate Fiduciary or of a holding company controlling such Fiduciary), personal property, real estate, or any interest therein, and interests in trusts including common trust funds, mutual funds, general and limited partnerships and other property of whatsoever character, located in the United States or abroad, without being limited by any statute or rule of law concerning investments by trustees or executors; without obligation to diversify the same and without liability for any decline in value thereof; D. To grant options to purchase or acquire any such property or sell any property held hereunder and to determine the prices and terms of such sales, exchanges and options; and to execute such deeds and other instruments and to do such other acts as may be necessary or proper to vest a good and valid title, absolutely and in fee simple in the purchaser or purchasers thereof; E. To subdivide, hold, manage, develop and operate all real property and tear down or alter improvements, to release, vacate, abandon and seek zoning changes to any such property -10- Pepper Hamilton LLP '. . I , l . PHl.EGAL: #141719 vI (31CNOl!.WPD) and repair, add to and replace any and all property, whether real or personal; to grant easements, give consents and make contracts relating to real estate and personal property or their uses, and to release or dedicate any interest in real estate; F. To take any action with respect to conserving or realizing upon the value of any estate or trust property; and with respect to foreclosures, reorganizations or other changes affecting the estate or trust property, to collect, pay, contest, compromise, or abandon demands of or against trust or estate assets, wherever situated; and to execute contracts, notes, conveyances and other instruments, including instruments containing covenants and warranties binding upon and creating a charge against estate or trust assets, and containing provisions excluding personal liability; G. To employ servants, agents, accountants, attorneys, auditors, brokers, investment counsel, custodians, depositaries, consultants, other professional advisors, and proxies, with or without discretionary powers; to assist or perform any undertakings or actions authorized in this will, charging expenses against income and principal as my Fiduciaries shall determine; H. To appoint a proxy or proxies, with or without power of substitution, to vote shares of a corporation or association as directed or in such manner as such proxy or proxies shall deem best; I. To enter into any transaction authorized by this Article EIGHTH with the trustee or legal representative of any other trust or estate in which a primary beneficiary or the -11- Pepper Hamilton LLP . I .. , PHLEGAL: #141719 vI (3ICNOI !.WPD) remaindermen hereunder has any beneficial interest, even though any such trustees or legal representative is also the trustee hereunder; J. To determine the date as of which my gross estate shall be valued for the purpose of determining the federal estate tax payable by reason of my death; K. To agree to the present payment of death taxes on any future interest created by this will or in any inter vivos trust into which this will pours (including a future interest subject to a power of appointment), notwithstanding that but for such agreement for the present payment of said taxes said taxes would not have been imposed until a future time or would have been imposed on the estate of the donee of the power of appointment to which such interest is subject; L. To receive any property, real or personal, to be added to and commingled with my estate or any testamentary trust created under this instrument from my spouse or me or from any revocable trust created by me (and if my Fiduciaries consent in writing, from any other person) by lifetime or testamentary transfer or otherwise; provided, however, that my Fiduciaries, in their sole discretion, may require, as a prerequisite to accepting proPerty, that the donating party provide evidence satisfactory and warrant to my Fiduciaries that: (a) the property is not contaminated by any hazardous or toxic materials or substances; and (b) the property is not being used and has never been used for any activities directly or indirectly involving the generation, use, treatment, storage, disposal, release, or discharge of any hazardous or toxic materials or substances; -12- Pepper Hamilton LLP . '. . , . ( PHLEGAL: #141719 vI (31CNOILWPD) M. To use and expend the income and principal of my estate and any testamentary trust created hereunder to: (1) Conduct environmental investigations of any property in my estate or such trust, including but not limited to environmental assessments, audits, site monitoring, laboratory analyses, testing, title histories, serial photographs, public and private records reviews, and any related inquiries arising out of or in any way related to liability or claims under federal, state, local or foreign environmental statutes, regulations, ordinances, requirements, demands of government authorities or policies or under common law ("environmental laws") to determine compliance with any environmental law or regulation thereunder, and to impact and review, or require the inspection and review periodically of any and all property held in my estate or in any trust created under my will for the purpose of determining compliance with any law, rule or regulation affecting such property, with all expenses of such inspection, review and monitoring to be paid from the income or principal of the trust or my estate; (2) Take all remedial action to contain, cleanup or remove any actual or threatened environmental hazard, including a spill, release, discharge or contamination, and conduct site restoration work on the trust property and notify the appropriate federal, state or local authorities either on its own accord or in response to an actual or threatened violation of any environmental law or regulation thereunder; -13- Pepper Hamilton LLP t . J , ) . r PHLEGAL: #141719 vI (31CNOl!.WPD) (3) Institute legal proceedings, claims and demands concerning environmental hazards, contamination or condition of the trust property, or contest, pay, compromise, or settle or comply with legal proceedings, claims, demands, orders, penalties, fines and damages brought by any federal, state, local, or foreign government authorities concerned with environmental compliance, or by a private litigant; and (4) Comply with any local, state or federal agency or court order directing an assessment, abatement or cleanup of any environmental hazards. N. To borrow or lend money to or from any person (including my Fiduciaries, Trustees or any other trustee of a trust created by me or my spouse), mortgaging real property and pledging personal property as security in such amounts and upon such terms and conditions as my Fiduciaries deem proper; O. To lease real property without restriction as to time and to repair, alter, improve, exchange or give options with respect to real property; P. To sell, transfer, conveyor otherwise dispose of any real and personal property at public or private sale for cash and/or credit; Q. To carry investments in bearer form or in the name of a nominee; R. To distribute hereunder in cash or in kind, or partly in each; S. To compromise and settle claims including those arising by reason of my death; -14- Pepper Hamilton LLP 'f I '. . , . I PHLEGAL: #141719 vI (31CNOILWPD) T. To exercise any election or privilege given the Fiduciaries by the federal or state tax laws or any other laws, including, without limiting the foregoing, joinder with my husband in filing income tax returns, consent on gift tax returns to have any gift made by him considered as made in part by me for gift tax purposes, payment of any portion of income or gift tax due under such returns, election of the alternate valuation for federal estate tax purposes, election of the marital deduction or for a trust to qualify for the marital deduction, allocation of generation- skipping transfer tax exemptions, and election to claim deductions for death tax or for income tax purposes; and to make or not make equitable adjustment for the exercise or non-exercise of any such election or privilege; U. To apply principal and income directly for the benefit of any beneficiary entitled thereto by direction of or exercise of discretion under this will who, in the opinion of the Fiduciaries, may be incapable of properly disbursing the same; V. To compromise and pay death taxes on all interests, present and future; W. To buy investments at a premium or discount; X. To determine whether any receipt or disbursement shall be allocated to principal or income, or partly to each; Y. To join in any corporate action, reorganization or voting trust plan, to deposit securities under agreements and pay assessments, to subscribe for stock and bond privileges, to -15- Pepper Hamilton LLP " . . , , PHLEGAL: #141719 vI (31CNOILWPD) give proxies, to grant, obtain or exercise options, and generally to exercise all rights of security holders; Z. To combine or to divide into separate trusts any or all of the trusts created herein; AA. To disclaim all or any part of any interest in any property which I may have or to which I or my estate may be or become entitled; BB. To abandon or transfer for no or nominal consideration any property which my Fiduciaries may consider, in their sole discretion, to have little or no value or to have potential liabilities that are likely to exceed its value; CC. Because it is my intention that my Fiduciaries shall have the broadest powers in dealing with any business interest that may form a part of my estate the Fiduciaries are permitted: (1) To disregard the principle of investment diversification and to retain any part or all of such interest as long as he considers it advisable to do so; (2) To sell any part or all of any interest in any business held by my Fiduciaries at such time or times, to such persons, for such prices upon such terms as the Fiduciaries may deem advisable; (3) To do anything that the Fiduciaries may deem advisable with respect to the operation, incorporation or liquidation of any business, or any change in the purpose, nature or structure of any business; -16- Pepper Hamilton LLP " , . PHLEGAL: #141719 vI (31CNOl LWPD) (4) To delegate authority to any director, manager, partner or employee, and to pay from the income of any business adequate compensation to any such person even though he may also be a Fiduciary, or may be employed by a Fiduciary; (5) To make additional investments in any business which is held by my Fiduciaries in their capacity as a Fiduciary under my will or any trust created by me; (6) To lend money, guarantee debt or otherwise invest, on a secured or unsecured basis, in any company or entity in which I own any interest or in which a trust of which I am a beneficiary owned any interest; and (7) In general, to deal with any business interest with the same freedom of action that I would have if I were living and were the absolute owner thereof; DO. To amend any trust created hereunder to carry out my intentions and to otherwise make any amendments necessary for the Fiduciaries hereunder to perform their duties hereunder in carrying out any instruction or in my intentions hereunder or to interpret any administrative provisions, which intentions, generally, are to reduce taxes in any property passing to my issue to the extent possible and to provide my Fiduciaries with the greatest latitude in dealing with my assets that I would have had if I was then living, without the need to seek court approval, unless it entails changing a beneficiary and the beneficiaries do not concur to the change in writing; -17- Pepper Hamilton LLP " PHLEGAL: #141719 vI (31CNOl!.WPD) EE. To guaranty any loans made by any beneficiary or any business in which I or any such beneficiary has an equity interest pledging assets of my estate or any trust created hereunder as security, as my Fiduciaries shall determine; FF. To construe and interpret any ambiguous language contained in this will; and any determination made by my Fiduciaries in good faith shall be final, binding and conclusive on all parties; GG. To elect to qualify part or all of my Revocable Trust identified in Article FOURTH for the federal estate tax marital deduction, to follow the direction of the Trustees as to whether and to what extent to make said election; and I hereby exculpate and exonerate my said Fiduciaries from any and all liability for following the direction of my Trustees in making said election; and HH. To elect under Code Section 2652(a)(3) to treat me as the transferor of any property which the election to treat said property as qualified terminable interest property was made by my Fiduciaries pursuant to Code Section 2056(b)(7); and my Fiduciaries are hereby authorized in their sole discretion and without court approval, to allocate any portion or all of my exemption from generation-skipping transfer tax available to my estate pursuant to Code Section 2631(a), or any similar exemption, exclusion or other benefit allowable under the law in force when I die, to any property as to which I am the transferor within the meaning of Code Section 2652(a), including any property transferred during my lifetime, to elect out of any deemed -18- Pepper Hamilton LLP . . . f PHLEGAL: #141719 vI (31CNOILWPD) allocation or revoke any prior election out, in whatever manner my Fiduciaries may determine to be appropriate. Except as otherwise provided, no adjustment shall be made between principal and income or in the relative interests of the beneficiaries to compensate for any such election or allocation. NINTH: Administration and Intet:Pretation. A. The interests of the beneficiaries in income and principal shall not be subject to anticipation or to voluntary or involuntary alienation as long as they are in the hands of the Fiduciaries. B. All Fiduciaries and all beneficiaries not referred to by name are for convenience referred to in this will in the masculine singular. C. In this will the word "minor" shall refer to a person less than twenty-one (21) years of age, but if under applicable law the age at which a person becomes legally competent to give an effective receipt is higher than that, the age of such competence shall be substituted for such age. D. I am married to CHARLES E. BASHORE. All references in this will to "my husband" are intended to mean him. Although, I have two children, PAMELA B. GAGNE and LARRY D. BASHORE, all references in this will to "my child" or "my children" are intended to only refer to my daughter and any references to "my issue" are intended to mean my daughter and her descendants, for the reasons set forth in Paragraph N below. -19- Pepper Hamilton LLP , 1 . ( PHLEGAL: #141719 vI (31CNOl !.WPD) E. In this will the word "child," "issue" and words of similar import shall include persons adopted into my line of descent when less than twenty-two (22) years of age and their issue (but not other persons adopted into my line of descent or their issue) and persons related by blood to me even if adopted by other persons. F. In considering the desirability of any discretionary payment of principal, the Fiduciaries may, but are not required to, consider the other income, assets and sources of support, to the extent known to them, of any beneficiary to whom or for whose benefit such payment may be made. G. No Fiduciary who is a beneficiary, or is legally obligated to support a beneficiary, shall participate in a power or in any discretionary decision from which he or any person he is legally obligated to support might benefit or relating to his capacity. H. The word "education," as used in this will, shall include, but not be limited to, public, private, secondary, college, graduate, vocational, technical and professional education. I. The term "per stit:Pes" as used in this will shall mean that a class of beneficiaries (~, my issue, per stit:Pes) shall take by reference to their stock. Thus, a trust that is to be divided per stit:Pes shall be divided into as many equal shares as there shall be then-living persons in the class in the nearest degree of consanguinity to me, and persons in such degree who have died before me survived by issue. One equal share shall pass to each person in the nearest degree of consanguinity to me and one equal share shall pass by representation to the issue of a -20- Pepper Hamilton LLP . . PHLEGAL: #141719 vI (31CNOl!.WPD) deceased person. When the persons who take under this will are all in the same degree of consanguinity to me, they shall share equally. J. The corporate Fiduciary, if any, shall be entitled to receive compensation for its services in accordance with its standard schedule of compensation in effect from time to time as its services are performed. Individual co-Fiduciaries serving with the corporate Fiduciary shall be entitled to receive compensation in addition to that of the corporate Fiduciary, but the total compensation received by all individuals co-Fiduciaries for a period of service shall equal one- half of the compensation received by the corporate Fiduciary for the same period of service. K. Any employee benefits payable to the Fiduciaries shall not be liable for or used for the payment of or lent for the purpose of paying any taxes, liabilities, debts or any other claims or charges against my estate. L. If my husband and I die simultaneously or under such circumstances that the order of our deaths can not be proven, it shall be presumed that I survived my husband. M. No Fiduciaries shall be required to enter bond in any jurisdiction. N. I wish to clarify for informational purposes the reasons for favoring my daughter, PAMELA B. GAGNE, over my son, LARRY D. BASHORE. During my lifetime, my son, LARRY D. BASHORE has received significant financial benefits from me. Furthermore, I am concerned that my daughter's health will continue to deteriorate thus requiring significant monies for her care and maintenance for the remainder of her life. For these reasons, under no duress, I -21- Pepper Hamilton LLP " '. , t . . , \ PHLEGAL: #141719 vI (31CNOl LWPD) acknowledge and state my express intent to provide for my daughter, Pamela, and exclude my son, Larry, from receiving any property under this instrument, except as set forth in Article SECOND hereof. O. When the context so requires, the masculine, feminine and neuter genders shall be sued interchangeably and the singular shall include the plural and vice versa. P. Any references to "Code" or "Section" herein, shall refer to the Internal Revenue Code of 1986, as amended, or the corresponding provisions of any future United States Internal Revenue law. Q. Although my spouse and I may be executing reciprocal wills, this shall not be construed to indicate the existence of a contract between us and, if my spouse survives me, my spouse shall be free to dispose of his estate as my spouse may desire, without any restrictions or limitation. R. The word "Fiduciaries" or if referring to one of the Fiduciaries, the word "Fiduciary" as used herein shall apply, as the context may require, to my executors, trustees, custodians and guardians appointed hereunder whether one or more are then acting at any given time. S. The word "Trustees" as used herein shall refer to the Trustees under my Revocable Trust Agreement referred to in Article FOURTH. -22- Pepper Hamilton LLP I \ f \ PHLEGAL: #141719 vI (31CNOl!.WPD) TENTH: Appointment of Fiduciaries. I name my husband, CHARLES E. BASHORE, and my daughter, PAMELA B. GAGNE, as executors of my will and as trustees of any trusts created hereunder. If at any time both of the named executors and trustees shall fail to qualify or cease to act, I name W. RODERICK GAGNE as successor executor and trustee. If for any reason all of the foregoing named persons shall fail to qualify or cease to act, I name LARRY D. BASHORE and FULTON BANK or its successors and assigns as my successor co-executors and co-trustees. IN WITNESS WHEREOF, I have hereunto set my hand and seal this / 3 day of June, 1999. ~ ~ rS ~ (SEAL) HELEN L. BASHORE, Testatrix Signed, sealed, published and declared by HELEN L. BASHORE, the testatrix above named, as and for her will, in the presence of us who, at her request, in her presence, and in the presence of each other, all being present at the same time, have hereunto subscribed our names as witnesses. ';;:z~~ C~, ta-f, ~ C ~'1t <; "" (1- eFt tfs t'h::.? . ~ ~;11/ c.2'ty ?o/Qo tJ,-/~f) t),Hocm:...? /() I 7 03. ~ / ./ Address SI5~v'~~. fA:)7~'ld,.,..~ f+ ,qo.3'r Andress -23- Pepper Hamilton LLP : . I , \ '. , i . PHlEGAL: #141719 vI (31CNOl!.WPD) COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF 1 \--::> '. / --:) We, HELEN L. BASHORE, LV,,-,, )OO:..ZRf (~~", and r&d1{jljJ~. 6~( , the testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix, in the presence and hearing of both witnesses, signed and executed the instrument as her last will, that she signed willingly, that she executed it as her free and voluntary act for the purposes therein expressed, that each of the witnesses, in the presence and hearing of the testatrix and the other witness, signed the will as witness and that to the best of our knowledge the testatrix was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. r ':f{~ /q73-<--/~/Q7~ " Witness I Pepper Hamilton LLP : . . . . I . ~ 1 PHLEGAL: #141719 vI (31CNOl!.WPD) COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF PHll..ADELPHIA ..-1"iJ On this Ij;) day of June, 1999, before me, the undersigned officer, personally appeared W. Roderick Gagne, known to me or satisfactorily proven to be a member of the bar of the highest court of Pennsylvania, and certified that he was personally present when the Will was signed by Helen L. Bashore and the witness thereto and that he is one of the witnesses. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. '~iC~ Notarial Seal Alexandra Underwood, Notary Pubfic Philadelphia. Philadelphia County My Commission Expires Jan. 22, 2001 Member Pennsylvania AsSDClatlOn of NotaIi&6 Pepper Hamilton LLP ~ . . " ~ \ . I I , , , PHlEGAL: #141719 vI (31CNOl LWPD) COMMONWEALTH OF PENNSYLVANIA 55. COUNTY OF PHll..ADELPHIA -~ On this I,:) day of June, 1999, before me, a Notary Public in and for the State of Pennsylvania, County of Philadelphia, personally appeared William Roderick Gagne known to me to be the person whose name is subscribed to the Will instrument and acknowledged that he executed the same for purposes therein contained. ~c~ My Commission Expires: Notarial Seal Alexandra Unde~ood. N~tary Pu~ Philadelphia. Phll~delph'a CoU~1 My Commission Expires Jan. 22, ~fePlbf:'( Ppnnsvlvania Association ot Pepper Hamilton LLP . 11 \' . .. ~ II , , . PHLEGAL: #141719 vI (31CNOl!.WPD) COMMONWEALTH OF PENNSYLVANIA COUNTY OF p~ i I,A ~f? (fh:c SS. I, W. Roderick Gagne, one of the witnesses whose names are signed to the Will instrument, being first duly sworn, do hereby declare to the undersigned authority that Helen L. Bashore, in the presence and hearing of both witnesses, signed and executed the instrument as beneficiary of the terminating trust, that she signed willingly, that she executed it as her free and voluntary act for the purposes therein expressed, that each of the witnesses, in the presence and hearing of Helen L. Bashore and the other witnesses, signed the Will as witnesses and that to the best of my knowledge Helen L. Bashore was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. ( Subscribed and sworn to before me by the above named witness thisl51'/ay of June, 1999. ~~ Notarial Sea! Pubtic U derwOod. Notary A\9x~ndra hn Philadelphia co~n~01 pnlladelp la. Expires Jan. 2L., My CommIsSIon . ~ "'o.""leS . AsSQC\ation 0\ ~~ "'" Memooc Pennsylvama Pepper Hamilton LLP - t: .-- PA O.C. Rule 5 (b) Form of Certification of Notice. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Helen L. Bashore Date of Death: September 19, 2001 Will Number: 2001-00899 Administration Number To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphan's Court Rilles was served on or mailed to the following beneficiaries of the above-captioned estate on November 30. 2001: NAME ADDRESS Larry David Bashore 51450 KylockDrive, Mechanicsburg, PA 17103 Jill Christine Bashore 51450 K ylock Drive, Mechanicsburg, P A 17103 Samuel Todd Bashore 51450 Kylock Drive, Mechanicsburg, PA 17103 Pamela B. Gagne 515 Cresheim Valley Road, Wyndmoor, PA 19038 Roderick Bashore Gagne 515 Cresheim Valley Road, Wyndmoor, PA 19038 Evan Rhodes Gagne 515 Cresheim Valley Road, Wyndmoor, PA 19038 Brenton Lower Gagne 515 Cresheim Valley Road, Wyndmoor, PA 19038 W. Roderick Gagne, Trustee of the Bashore Trusts c/o Pepper Hamilton LLP, 3000 Two Logan Square Philadelphia, PA 19103-2799 Notice has now been given to all persons thereto under Rille 5.6(a) except None - SignaturG' C:f)~ ~ Date /(/30/01 ~ --- Name (please Print) W. Roderick GagnWEsquire, #33249 Telephone Number: 215-981-4695 Address City State Zip Code Pepper Hamilton LLP 3000 Two Logan Square Philadelphia PA 19103-2799 Capacity: _ Personal Representative X Counsel for Personal Representative 10-134A (Rev. 3/00) PHLEGAL: #993519 vi (L@LROl!.WPD) ~nventory of the real and personal estate of Helen L. Bashore See attached deceased J.-I-O{- f?9~ G ~:a.~~~:a.Z Z;.Z~ II j I ! -' ~--: 1 ......~: ~~- j ....-< c::' COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 55: Pamela B. Gagne being duly sworn executrix according to law, deposes and says that she i ~ t-hp of the Estate of Helen L. Bashore late of __-.LoW.eI_Al1elL T.ownship__ - ---- -- , Cumberland County, Pa., deceased and that the . h" . t d b Pamela B. Gagne h d executrix wit In IS an Inven ory ma e y ., t e sai of the entire estate of said decedent, consisting of all the personal proparty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the te of decedent's death. and subscribed before me, ~~~~~ c/o Pepper Hamilton LLP Notarial.Seal Florence M.Cohen, Notary Public Philadelphia. Philadelphia County My Commission Expires Feb. 21. 2004 Member, Pennsy ania Assocla Ion 0 Notaries Date of Death 19th Day 3000 Two Logan Square, Philadelphia, PA 19103- 279 Addr.ss September Month 2001 Y..r INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV. Fiduciaries Act of 1949. 0'\ ..::t N ('Y') ('Y') .~ ,; >- OJ .c I-l CI.) G) I- W '" IX I- 0 5 CI 0'\ ~ W < .c Q) 0'\ Q" I- CI1 0 U lD 00 0 V') co ~ Q) 0 w w ~ C t7' .... 0 J: IX ~ .., G) I t- Q" .a 0.. c .-I I- ..J u.. . OJ .. 0 Z < 0 ~ ...-4 Q" 0 u.. -J ~ I W < W .-I .-I I > 0 a:: r:: < .,;. N 'I z OJ - Z 0 .-I I-l c II 0 ::s I: V') Z OJ OJ 0 0 IX := ) U Z 'I w < 0 - a. ~ '"'0 c IV I - "'i: II 0 Q) ..Q '"'0 ~ Q) E - ..! 0 CI ::s 0 ...J U u: ca Par Value 15/000 10/000 10/000 10,000 5/000 10/000 15/000 Page 1 Estate Inventory Valued as of Date of Death Bonds, Debentures, T-bills ALLEGHENY CNTY PA HIGHER RV CAP GTD OID@98.406/R/ RTE 5.00% MTE DTE 07/15/09 CALLABLE 7/15/04 @ 102.00 $ Interest to date of death ALLEGHENY CNTY PA HSP RV RFDG HLTH CTR OJ MBIA/R/ RTE 6.000% MTE DTE 9/01/05 CALLABLE 09/01/02@102.00 Interest to date of death ALLEGHENY CNTY PA RFDG C-47 MBIA OID99.841BE/R/ RTE 3.7% MTE DTE 10/01/02 Interest to date of death ALLEGHENY CO PA HSP HLTH RV PT MBIA OID@98.217/R/ MAND SINK FND RTE 5.15% MTE DTE 09/01/12 CALLABLE 9/01/03 Interest to date of death ALLEGHENY CO PA RFDG SER C-42 /R/ RTE 5.0% MTE DTE 10/01/08 CALLABLE 10/01/03 @ 102.00 Interest to date of death ALLEGHENY CO PA SER C-42 OID@98.378 UT /R/ RTE 5.0% MTE DTE 10/01/09 CALLABLE 10/01/03 @ 102.00 Interest to date of death BEAVER PA AREA SCH DIST SER C FSA OID@99.7832/R/ MAND SINK FND RTE 4.15% MTE DTE 01/15/13 CALLABLE 07/15/03 @ PAR 15/703.19 135.42 10/446.30 31.67 10/147.24 222.99 10,293.55 27.18 5,217.20 117.36 10/404.50 234.72 14/799.44 Par Value 5,000 5,000 10,000 20,000 5,000 30,000 Page 2 Estate Inventory (Continued) Bonds, Debentures, T-bills (Continued from previous page) Interest to date of death $ 112.40 BERKS CNTY PENNSYLVANIA GO SER 1998 AMBAC BE /R/ RTE 4.75% MTE DTE 11/15/08 5,304.05 Interest to date of death 82.47 BUCKS CNTY PA B/E OID@99.1985 /R/ RTE 4.5% MTE DTE 5/01/08 5,223.30 Interest to date of death 86.88 BUTLER CNTY PA HOSP AUTH BUTLER FSA OID@99.279/R/ RTE 4.6% MTE DTE 07/01/02 10,173.25 Interest to date of death 100.94 CENTRAL & WESTERN CHESTER CNTY PA REV RFDG FHA /R/ MANn SINK FND RTE 5.75% MTE DTE 02/01/12 CALLABLE 10/28/01 @ 101.00 20,085.59 Interest to date of death 156.53 CENTRAL GREENE SCH AUTH PA SCH REV ESCROW TO MAT RTE 6.375% MTE DTE 12/01/07 CALLABLE 10/28/01 @ PAR 5,802.10 Interest to date of death 96.51 CHELTENHAM TWP PA SID PA FSA B/E /R/ RTE 5.15% MTE DTE 08/15/13 CALLABLE 8/15/05 @ PAR 30,903.42 Interest to date of death 150.21 Par Value 5,000 5,000 10,000 5,000 10,000 10,000 15,000 Page 3 Estate Inventory (Continued) Bonds, Debentures, T-bills DAUPHIN CO PA GENL AU RV REV MBIA /R/ RTE 4.35% MTE DTE 10/01/07 CALLABLE 04/01/03@ PAR $ 5,057.15 Interest to date of death 102.10 EASTON PA AREA JT SCH AU REV MBIA ESCROW TO MAT RTE 5.9% MTE DTE 4/15/02 5,103.45 Interest to date of death 127.01 HARRISBURG PA AU RES REC A FSA B/E OID99.2106 /R/ RTE 4.6% MTE DTE 09/01/08 10,502.20 Interest to date of death 24.28 LEHIGH CNTY PA RFDG FGIC UT /R/ RTE 5.0% MTE DTE 11/15/06 CALLABLE 11/15/04@ 100.00 5,248.45 Interest to date of death 86.81 LUZERNE CNTY PA PUB SCHS AMBAC REV B/Q LT /R/ RTE 5.3% MTE DTE 3/01/05 CALLABLE 10/28/01 @ PAR 10,010.10 Interest to date of death 27.97 MIFFLINBURG BORO PA MUN REV AMBAC /R/ RTE 6.625% MTE DTE 11/01/07 CALLABLE 11/01/01 @ 100.00 10,030.50 Interest to date of death 255.80 MONTGOMERY CNTY PA IDA RV RMKT LOC IS 052389/R/ LETTR OF CRED RTE 7.5% MTE DTE 01/01/12 CALLABLE 01/01/03 @ 100.00 15,350.03 Interest to date of death 246.88 Par Value 10,000 25,000 10,000 5,000 20,000 25,000 Page 4 Estate Inventory (Continued) Bonds, Debentures, T-bills MONTGOMERY CO PENN ESCROW TO MAT RTE 9.0% MTE DTE 8/15/04 CALLABLE 02/15/02 @ 100.00 $ 10,713.35 Interest to date of death 87.50 PA HFA SINGLE FAM MTG RV SER 1996-48 AMT B/E /R/ RTE 5.4% MTE DTE 10/01/05 25,731.75 Interest to date of death 633.75 PA ST HI ED ASST AGY S/L AMBAC AMT ISS12/15/86/R/ PUT BOND RTE 7.050% MTE DTE 10/01/16 CALLABLE 04/01/02 @ 101.50 10,370.85 Interest to date of death 330.96 PA STATE UNIV BDS REF SERIES 1992 /R/ MANn SINK FND RTE 6.250% MTE DTE 03/01/11 CALLABLE 03/01/02 @ 102.00 5,187.90 Interest to date of death 16.49 PA TURNPIKE COMMISSION RV BD SR 92P AMBAC BE/R/ MANn SINK FND RTE 5.75% MTE DTE 12/01/12 CALLABLE 12/01/02 @ 102.00 21,098.80 Interest to date of death 348.19 PENN HFA SFM REV SER 64 AMT BIE OID@99.54 /R/ RTE 4.5% MTE DTE 10/01/10 CALLABLE 10/01/08 @ 101.00 25,386.73 Interest to date of death 528.13 Par Value 15,000 15,000 10,000 15,000 20,000 15,000 10,000 Page 5 Estate Inventory (Continued) Bonds, Debentures, T-bills PENN HGHR ED FAC AU B/E AMBAC OID@97.482 PREF/R/ MAND SINK FND RTE 5.500% MTE DTE 06/15/16 CALLABLE 06/15/04 @ Par $ 15,391.11 Interest to date of death 217.71 PENN INFRASTRUCTURE INVT AU RV A B/E DTD 6/25/92/R/ RTE 5.45% MTE DTE 09/01/03 15,825.14 Interest to date of death 43.15 PENN ST HIGH EDL AU COLL ASSGU BE OID@99.2702 /R/ ESCROW TO MAT RTE 4.4% MTE DTE 03/15/08 10,428.99 Interest to date of death 6.11 PENNSYLVANIA HFA SFM RV 1996-53A AMT B/E /R/ RTE 4.9% MTE DTE 10/01/02 15,223.50 Interest to date of death 345.04 PENNSYLVANIA HFA SGL FAM MTG REV SER 68B B/E /R/ RTE 5.3% MTE DTE 10/01/11 CALLABLE 10/01/09 @ PAR 20,723.58 Interest to date of death 497.61 PENNSYLVANIA HSG FIN AGENCY SFM 1997-57 A AMT B/E/R RTE 5.2% MTE DTE 10/01/05 15,423.14 Interest to date of death 366.17 PENNSYLVANIA HSG FIN AGY SFM 1997-57 A AMT B/E/R RTE 5.1% MTE DTE 10/01/04 10,254.89 Interest to date of death 239.42 Par Value 15,000 20,000 10,000 15,000 5,000 5,000 Page 6 Estate Inventory (Continued) Bonds, Debentures, T-bills PENNSYLVANIA ST HGHR EDL FCS AU HLTH RV A BE /R/ RTE 5.75% MTE DTE 01/01/06 CALLABLE 01/01/04 @ 102.00 $ 15,958.95 Interest to date of death 189.27 PENNSYLVANIA ST HWY B/E /R/ RTE 5.25% MTE DTE 6/15/05 CALLABLE 06/15/03@ 101.50 21,055.88 Interest to date of death 277.08 PENNSYLVANIA ST TPK COMM REV SR M FGIC OlD B/E/R PREREFUNDED RTE 6.5% MTE DTE 12/01/13 PREREFUNDED 12/01/01 @ 102.00 10,279.40 Interest to date of death 196.81 PENNSYLVANIA ST TPK COMM REV SER M FGIC OlD BE/R MAND SINK FND RTE 5.5% MTE DTE 12/01/17 CALLABLE 12/01/01 @ 100.00 15,068.54 Interest to date of death 249.79 PENNSYLVANIA ST TPK COMM TPK RV SR 920 FGIC BE/R/ RTE 5.6% MTE DTE 12/01/05 CALLABLE 12/01/02 @ 102.00 5,274.50 Interest to date of death 84.78 PHILADELPHIA PA ARPT REV PHIL A/S FGIC AMT B/E/R/ RTE 5.25% MTE DTE 6/15/12 CALLABLE 06/15/07 @ 102.00 5,278.80 Interest to date of death 69.27 Par Value 15,000 10,000 5,000 5,000 25,000 10,000 10,000 Page 7 Estate Inventory (Continued) Bonds, Debentures, T-bills PHILADELPHIA PA GAS REV FSA CRC OID@97.9923PR/R/ PRE-REFUNDED RTE 6.375% MTE DTE 07/01/14 PREREFUNDED 07/01/03 @ 102.00 $ 16,294.50 Interest to date of death 209.84 PHILADELPHIA PA MUN REV RFDG SR C FGIC BE OID/R/RTE 5.0% MTE DTE 4/01/06 10,677.99 Interest to date of death 234.72 PHILADELPHIA SCHOOL DIST PA G.O. SER A FSA BE/R/ RTE 4.85% MTE DTE 02/01/10 5,299.00 Interest to date of death 33.01 PHILADLEPHIA PA HOSPS & AMBAC B/E /R/ RTE 4.2% MTE DTE 05/01/08 5,124.50 Interest to date of death 81.08 PITTSBURGH PA URBAN RDV AU MTG RV-A AMT B/E /R/ RTE 5.5% MTE DTE 4/01/07 CALLABLE 4/01/06 @ 102.00 25,888.50 Interest to date of death 645.49 PITTSBURGH PA URBAN REDV AUTH HME IMPT 94B BE /R/ RTE 4.8% MTE DTE 8/01/04 CALLABLE 02/01/04 @ 102.00 10,206.70 Interest to date of death 65.33 STATE PUB SIB PA COLLRV BTLR MBIA OID@99.521 /R/ RTE 6.05% MTE DTE 7/15/07 CALLABLE 07/15/02 @ 100.00 10,195.05 Interest to date of death 109.24 Par Value 10,000 10,000 15,000 10,000 No. of Shares 100 300 100 400 100 500 Page 8 Estate Inventory (Continued) Bonds, Debentures, T-bills UPPER ST CLAIR TWP PA SCH AU SCH BLDG RV ESCROW TO MAT RTE 4.875% MTE DTE 08/01/04 Interest to date of death W. JEFFERSON HILLS PA SD EFDG FGIC UT /R/ RTE 5.5% MTE 08/01/04 CALLABLE 8/01/02 @ 100.00 Interest to date of death WASHINGTON CNTY PA INDL DEV AU REV REF FHA /R/ ACTIV SNK FND RTE 6.650% MTE DTE 01/15/07 CALLABLE 07/15/02 @ 102.00 Interest to date of death WYOMING CNTY PA B/Q /R/ RTE 5.5% MTE DTE 6/01/07 CALLABLE 6/01/03 @ 100.00 Interest to date of death Total Bond, Debenture, T-bill Stocks AMGEN INC APPLIED MATERIALS INC ARIBA INC AVICI SYSTEMS INC BANK OF NY CO INC CMS ENERGY CORP CONV 8.75% PREFERRED Dividend at date of death $ 10,316.20 66.35 10,215.30 74.86 15,620.63 180.10 10,254.75 166.53 $ 629,593.84 $ 5,801.00 9,349.50 214.00 712.00 3,136.00 15,772.50 453.50 No. of Shares Estate Inventory (Continued) Stocks $ 880.7610 Carlisle Companies Inc. 358 10 400 300 200 200 100 1,350 200 100 26,841.19 Fulton Financial Corp 7,815.14 Municipal Investment Trust Fund 80th Monthly Payment Series Acct# 0102626403 4,634.60 NOKIA CORP SPONS ADR FINLAND 6,420.00 PFIZER INC 11,101.50 PUGET ENERGY INC NEW (HOLDING CO) 4,789.00 SCHLUMBERGER LTD NETHERLANDS ANTILLES 8,898.00 Dividend at date of death 37.50 SIEBEL SYSTEMS INC 1,430.50 STANDARD&POORS DEP RCPTS UNIT SER 1 (SPDR TR) 133,056.00 SUN MICROSYSTEMS INC 1,747.00 SURMODICS INC 4,417.50 26.4510 The Municipal Fund lAP Acct# 989 10524528 500 300 Page 9 461.04 WACHOVIA CORP 14,985.00 XEROX CORP 2,379.00 Total Stocks $ 264,451.47 Cash Adjustments for items paid by seller in advance of settlement of 208 Hearth Road $ 976.06 Total Cash $ 976.06 Page 10 Estate Inventory (Continued) Checking/Savings Accounts Fulton Bank - checking acct# 3619-50402 $ Interest to date of death Principal Financial Group Checking Acct# 0590043041 142,107.76 71.05 1,254.74 Total Checking/Savings Accounts Money Market/CMA Accounts Fulton Bank - Money market acct# 9903-71294 $ Interest to date of death Northern Trust (formerly Equitable Life of Iowa) Money Market Acct# 9270025851 D/O/D value 130,241.84 int to D/O/D 305.63 $ 143,433.55 379,171.40 603.97 130,547.47 Total Money Market/CMA Accounts 510,322.84 Tangible Personal Property 1989 Mercedes-Benz automobile 260-E sedan $ Miscellaneous personal property and furniture located at: 208 Hearth Road Camp Hill, PA 17011 Miscellaneous personal property and furniture located at Springfield residence: 551 East Evergreen Avenue Apartment 108 Wyndmoor, PA $ 6,200.00 9,300.00 985.00 Total Tangible Personal Property $ 16,485.00 .. ,. Par Value 92,400 Page 11 Estate Inventory (Continued) Real Property Residence located at: 208 Hearth Road Camp Hill PA 17011 Cumberland County PA $ 158,900.00 Total Real Property Notes Promissory Note Face Value $2,178,443 Obligor - Trustees under E.L. Heim & Co. 401(k) Profit Sharing & Employee Stock Ownership Plan Due Date - 7/1/14 Interest Rate - 5.64% Appraised Value 1,380,000 $ 1,380,000.00 Total Notes $ 158,900.00 $ 1,380,000.00 Savings Bonds 527 US Savings Bonds Series EE $ 96,554.98 Total Savings Bonds Total Inventory $ $ 96,554.98 3,200,717.74 ----------------- ----------------- /7-/() .--3 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *5~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG~ PA 171Z8-0601 REV-l'01 EX AFP (12-00) ReGoruF.... ReL\1sJ[b' DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-22-2002 HUMER 09-20-2001 21 01-0889 CUMBERLAND 101 SUSANNA E PATRICIA E VOGELSONG .02 Jl\N 25 P 2 :05 6315 CHESTERFIELD LN MECHANICSBURG PA ~B~j CiltmbenariU Allount Rellitted PA MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, sub.it the upper portion of this forll with your tax paYllent. ~.!I_~ _~~~_t!!_!_I!I!__I:.!~~_______~____~_~!~~!!_~!J!~!_!.~!!_~~~_!.~!_!~~~__I!!P_~I!!!i____~_________________ -- - -- REV-1607 EX AFP (12-00) ... INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF HUMER SUSANNA E FILE NO.21 01-0889 ACN 101 DATE 01-22-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-21-2002 PR I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 3,253.34 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-07-2001 CDOO0611 162.67 3,090.67 TOTAL TAX CREDIT 3,253.34 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" lCRl, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. l COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT W RODERICK GAGNE ESQUIRE 3000 TWO LOGAN SQUARE 18TH ST PHILADELPHIA, PA 19103-2799 -------- fold ESTATE INFORMATION: SSN: 195-32-2519 FILE NUMBER: 2101-0899 DECEDENT NAME: BASHORE HELEN L DA TE OF PAYMENT: 06/20/2002 POSTMARK DATE: 06/18/2002 COUNTY: CUMBERLAND DA TE OF DEATH: 09/19/2001 NO. CD 001311 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $142,626.67 I I I I I I I I TOTAL AMOUNT PAID: $142,626.67 REMARKS: PAMELA B GAGNE C/O W RODERICK GAGNE ESQUIRE CHECK# 147 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT W RODERICK GAGNE ESQUIRE 300 TWO LOGAN SQUARE 18TH ST PHILADELPHIA, PA 19103-2799 ______n fold ESTATE INFORMATION: SSN: 195-32-2519 FILE NUMBER: 2101-0899 DECEDENT NAME: BASHORE HELEN L DA TE OF PAYMENT: 06/20/2002 POSTMARK DATE: 06/18/2002 COUNTY: CUMBERLAND DATE OF DEATH: 09/19/2001 NO. CD 001312 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $172,174.19 I I I I I I I I TOTAL AMOUNT PAID: $172,174.19 REMARKS: PAMELA B GAGNE C/O W RODERICK GAGNE ESQUIRE CHECK# 148 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS \ /7-/0 -~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG1 PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-05-2002 BASHORE 09-19-2001 21 01-0899 CUMBERLAND 101 '02 1 ~. ~ 11.- :"\ 5 W RODERICK GAGNE ESQ PEPPER HAMILTON 18TH & ARCH STS PHILA PA 19!03 * REV-1547 EX AFP COl-02) HELEN L Allount Rellitted (9) UO) U~) ) CHANGED U) (2) (3) (4) (S) (6) (7) 158J900.00 990J600.29 .00 1J380JOOO.00 671J217.45 97J821.28 18J868.55 (8) MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=is'4-j-ix--AFP--fo1-:oz'Y-NOYici-OF-XNHiifiTANCi-YAX-APPRAisiifENT~--Aii-oWAtici-iri----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BASHORE HELEN L FILE NO. 21 01-0899 ACN 101 DATE 08-05-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED 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) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: IS. Allount of Line 14 at Spousal rate 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: NOTE: 108,447.44 39.478.47 Ul) (2) (3) (4) .00 X 00 = 3,169,481.66 X 045= .00 X 12 = .00 X 15 = NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 3,317,407.57 147.925 91 3,169,481.66 .00 3,169,481.66 (9)= .00 142,626.67 .00 .00 142,626.67 f",,,"cnl Kc"'c~rl (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-18-2002 CDOO1311 .00 142,626.67 TOTAL TAX CREDIT 142,626.67 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) "\., / ~-/CJ- ;:.g BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 W RODERICK GAGNE ESQ PEPPER HAMILTON 18TH & ARCH STS PHILA PA 19103 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN * REV-483 EX AFP (01-02) 10-22-2002 BASHORE 09-19-2001 21 01-0899 CUMBERLAND 201 HELEN L Allount R8Ilitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ RE-V:4i3--EX-~FP--[oi:ij2i-----j(i-NO-ficE--OF-iiETifiMiifAfio-N-~N-D-AS1iESirMEN;r---------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN .. ESTATE OF BASHORE HELEN L FILE NO.21 01-0899 ESTATE TAX DETERMINATION ACN 201 DATE 10-22-2002 1. Credit For State Death Taxes as Verified 321.600.08 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 142.626.67 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) 6,799.22 4. Total Inheritance Tax Assessed 149,425.89 172.174.19 5. Pennsylvania Estate Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-18-2002 CDOO1312 .00 172,174.19 TOTAL TAX CREDIT 172,174.19 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT GAGNE W RODERICK ESQ ONE COMMERCE SQUARE 22ND FL 2005 MARKET ST PHILADELPHIA, PA 19103 ______n fold ESTATE INFORMATION: SSN: 195-32-2519 FILE NUMBER: 2101-0899 DECEDENT NAME: BASHORE HELEN L DATE OF PAYMENT: 03/24/2003 POSTMARK DATE: 03/21/2003 COUNTY: CUMBERLAND DATE OF DEATH: 09/19/2001 NO. CD 002327 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $22,298.88 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: GAGNE W RODERICK ESQUIRE CHECK# 168 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $22,298.88 DONNA M. OTTO DEPUTY REGISTER OF WILLS /1,. /0- /-8 ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG I PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE PENNSYLVANIA ESTATE TAX RECORD ADJUSTMENT * REY-l'25 EX AFP UI-05) .03 DATE ESTATE OF DATE OF DEATH FILE NUMBER P 2 :(:0 COUNTY ACN 07-03-2003 BASHORE 09-19-2001 21 01-0899 CUMBERLAND 201 HELEN L W RODERICK GAGNE ESQ PEPPER HAMILTON 18TH & ARCH STS PHILA f\GO -4 Allount Rellitted i.~ , ," : PA 19~1nL,~ , MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ REY=i623-EY-AFP--fol-:03i-----..-i;€NNSVLVANfA--€sTAfE-i'AX-REcoiiii-ADJuiffMENi'--..-------------------- ESTATE OF BASHORE HELEN L FILE NO.21 01-0899 ACN 201 CODE DATE 07-03-2003 706 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION 1. Credit For State Death Taxes as Verified 343,111.97 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 142,626.67 3. Inheritance Tax Assessed by Other States or Territories o~ the United States (Excluding Discount and/or Interest) 6,925.75 4. Total Inheritance Tax Assessed 149,552.42 193,559.55 5. Pennsylvania Estate Tax Due 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return .00 7. Additional Pennsylvania Estate Tax Due .00 TAX CREDITS: B PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-18-2002 CDOO1312 .00 172,174.19 03-21-2003 CD002327 913.52- 22,298.88 ALANCE OF UNPAID INTEREST/PENALTY AS OF 03-22-2003 TOTAL TAX CREDIT 193,559.55 BALANCE OF TAX DUE .00 INTEREST AND PEN. 4.77 TOTAL DUE 4.77 . IF PAID AFTER THIS DATE, SEE REVERSE SIDE ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY FOR CALCULATION OF ADDITIONAL INTEREST. BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) I/~.- ./' '''v / B~~~ ~~ ~~DIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-1U7 EX AFP COl-D3) ReCOf Geo Re5.3i '::~t(~: { DATE ESTATE OF DATE OF DEATH FILE NUMBER All :48 COUNTY ACN 06-02-2003 BASHORE 09-19-2001 21 01-0899 CUMBERLAND 201 HELEN L W RODERICK GAGNE ESQ PEPPER HAMILTON 18TH & ARCH STS PHILA .03 JUN -6 AMount ReMitted C1E:'rk-- PA 190\1rnbE,f!c,no MAKE CHECK PAYABLE AND REMIT PAYMENT TO: 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 pay.ent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-Y=i6'ifj-ex--AFP--foi-:03i------...--iNiriRI"i'-ANC'E-iAX--STATEME-riy-OF-ACCouiii--.-..--------------------- ESTATE OF BASHORE HELEN L FILE NO. 21 01-0899 ACN 201 DATE 06-02-2003 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 DR RECORD ADJUSTMENT: 10-22-2002 PR I NC I PAL TAX DU E : .................................................................._....................................................................................................................................................... 172,174.19 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-18-2002 CDOO1312 .00 172,174.19 03-21-2003 CD002327 .00 22,298.88 TOTAL TAX CREDIT 194,473.07 BALANCE OF TAX DUE 22,298.88CR INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 22,298.88CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REY-I607 EX AFP UI-03) Recoroec- Req;:J::-, 06-02-2003 BASHORE 09-19-2001 21 01-0899 CUMBERLAND 101 HELEN L W RODERICK GAGNE ESQ PEPPER HAMILTON 18TH & ARCH STS PHILA DATE ESTATE OF DATE OF DEATH FILE NUMBER JUN -6 All :48cOUNTY ACN .03 Allount Rellitted Clen, PA 191~1ftnbe;ld.r;() MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=ii;ifj-ix-AFP--foi-:oil-------...--fNifERITANcE'-TAX-STATEME-riy-OF'-ACCOUNT--...--------------------- ESTATE OF BASHORE HELEN L FILE NO. 21 01-0899 ACN 101 DATE 06-02-2003 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: 08-05-2002 PR I NCI PAL TAX DUE: ........................................................................................................................................................................................................................... 142,626.67 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-18-2002 CDOO1311 .00 142,626.67 TOTAL TAX CREDIT 142,626.67 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "'CREDIT"' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT HAMILTON PEPPER LLP 18TH & ARCH STREETS PHILADELPHIA, PA 19103 ____u__ fold ESTATE INFORMATION: SSN: 195-32-2519 FILE NUMBER: 2101-0899 DECEDENT NAME: BASHORE HELEN L DATE OF PAYMENT: 08/11/2003 POSTMARK DATE: 08/07/2003 COUNTY: CUMBERLAND DATE OF DEATH: 09/19/2001 NO. CD 002885 ACN ASSESSMENT CONTROL NUMBER AMOUNT 201 I $4.77 I I I I I I I I TOTAL AMOUNT PAID: $4.77 REMARKS: PAMELA GAGNE C/O PEPPER HAMILTON LLP CHECK#172 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS DONNA M. OTTO DEPUTY REGISTER OF WILLS 1'1-1C~/~ ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG I PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * REV-l'07 EX AFP (01-05) -:u L- DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-02-2003 BASHORE 09-19-2001 21 01-0899 CUMBERLAND 201 HELEN L W RODERICK GAGNE ESQ PEPPER HAMILTON 18TH & ARCH STS PHILA PA l'lO~ ," () Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: 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 ~ REY=ifiifj-Ex--AFP--foi-.:o31-------...--iNifERi,.-ANc'E-fAx--sTATEMEiii-oF-ACCOUiiy--...--------------------- ESTATE OF BASHORE HELEN L FILE NO. 21 01-0899 ACN 201 DATE 09-02-2003 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A S~ARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-22-2002 PR I NCI PAL TAX DU E : ........................................................................................................................................................................................................................... 193,559.55 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-18-2002 CDOO1312 .00 172,174.19 03-21-2003 CD002327 913.52- 22,298.88 08-07-2003 CD002885 4.77- 4.77 TOTAL TAX CREDIT 193,559.55 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) N -~ tr2 ~.... tr~ ~'" C:cn !l~ 3-f "'''' 2 -f.., ~ >< ~g~!:::g 2",,,,~-f -f -III <20-f C:'1'I'" if 0 ",t:I'1'I ;;o~ it 1\)01\) Qc::....~b:JQ ....3 ~" b:J ' C/) , mQ....=rQ ....loOcc"., ~, ':::0, 1: ~~~ml\) '\ ~IoOQ Q CIoO.... :z iii:.., 2:r -f 00 '1'1'1'1 ;;o"D ",'" <2 "'~ 2< c:,... "'< ~ 2 .... ~ REV-1162 EX(11-9 PENNSYLVANIA r ANCE AND ESTATE TAX OFFICIAL RECEIPT L NO. CD 00341 ~ =r "" m i ACN l"- E m ASSESSMENT AMOUNT ~ ~ ~ CONTROL :: .. NUMBER I .. I"- ~ TE INFORMA1IUI.... J: 195-32-2519 UMBER: 2101-0899 DENT NAME: BASHORE HELEN L OF PAYMENT: 01/07/2004 MARK DATE: 01/05/2004 TY: CUMBERLAND OF DEATH: 09/19/2001 '\ N E N ARKS: CHECK#176 AL 101 I $6,103.45 I I I I I I I I TOTAL AMOUNT PAID: INITIALS: AC RECEIVED BY: REGISTER OF WILLS $6,103.45 GLENDA FARNER STRASBAUGH DEPUTY REGISTER OF WILLS Reco<c~F::^ fie( COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NO. COUNTY -04 MAR 12 P 1 :44ACN '* REV.736 EX AFP (03-971 \ BUREAU 0:: INDIVIDUAL TAXES INHEATANCE TAX DIVISION DEPf." 280601 HARRISBURG. PA 17128-0601 W RODERICK GAGNE ESQ PEPPER HAMilTON 18TH & ARCH STS PHilADELPHIA PA 19103 03-08-2004 BASHORE HELEN L 09-19-2001 21 01-0899 Cumberland 202 Amount Remitted Cl~.Yc',cc Cwnb:' MAKE CHECK PAYABLE AND REMIT PAYMENT TO: Register of Wills Cumberland County Courthouse 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 q RETAIN LOWER PORTION FOR YOUR RECORDS <:=J . -REV:73S-eXAFP(oi=97) ------- --- - --- - -- - - - -- -- ;;-i-ioTlce-oi=-oET-ERNfINA iioN-AND As-sifss-';'-eiif- - -- - - - - -- --- - - - - -- - - - - -- - - - - ---- -- --- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER ** ESTATE OF BASHORE HELEN L FILE NO. 21 01-0899 ESTATE TAX DETERMINATION ACN 202 DATE 03-08-2004 1. Credit For State Death Taxes as Verified 348,783.00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) 4. Total Inheritance Tax Assessed 142,626.67 6,799.22 149,425.89 5. Pennsylvania Estate Tax Due 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return 199,357.11 193,559.55 7. Additional Pennsylvania Estate Tax Due 5,797.56 TAX CREDITS: PAYMENT RECBIPT DISCOUNT ( + ) DATE NUMBER INTEREST/PEN PAID (- ) AMOUNT PAID 01/05/2004 CD003415 6,103.45 TOTAL TAX CREDIT 6,103.45 BALANCE OF TAX DUE 305.89 CR INTEREST AND PEN. .00 TOTAL DUE 305.89 CR * IF PAID APTER DATE INDICATED, SEE REVERSE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. FOR. CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) W RODERICK GAGNE ESQ PEPPER HAMILTON 18TH & ARCH STS PHILA PA 19103 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN * BUREAU OF INDIV1!'JUAL TAXES INHERITANCE (Ax DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 -~ REV-736 EX AFP (01-02l MAKE CHECK PAYABLE 03-08-2004 BASHORE 09-19-2001 21 01-0899 CUMBERLAND 202 HELEN L REMIT PAYMENT TO: REGISTER OF W CUMBERLAND C CARLISLE, P HOUSE NOTE: To insure proper credit to your account, submit the your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR ILES ~ --------------------------------------------------------------------------- ------------------------------------ REV-736 EX AFP (01-02) ** NOTICE OF DETERMINATION AND AS SSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL LOSING LETTER ** ESTATE OF BASHORE HELEN 348,783.00 L ACN 202 DATE 03-08-2004 1. Credit For State Death Taxes as Verified 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 142,626.67 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) 6,799.22 4. Total Inheritance Tax Assessed 149,425.89 5. Pennsylvania Estate Tax Due 199,357.11 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Retu n 193,559.55 7. Additional Pennsylvania Due 5,797.56 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) NTEREST/PEN PAID (-) AMOUNT PAID INTEREST CHARGED THROUGH 03-16-2004 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM.* TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 5,797.56 11.48 5,809.04 *IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~ .. ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG. PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REY-ln7 EX AFP [01-05) G./ Reco(c ::',. .04 W RODERICK GAGNE ESQ PEPPER HAMILTON 18TH 8: ARCH STS PHILA tif\R 1 2 P 1 :45 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-08-2004 BASHORE 09-19-2001 21 01-0899 CUMBERLAND 201 HELEN L Allount Rellitted C,'~ nIt PA \,..\~f03 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=i6oj-i3f-AFP--foi-:oil-------...--iNHERITANc'E-YAX--sT'iffEMENY-OF-ACCouiff--.-..------------------ --- ESTATE OF BASHORE HELEN L FILE NO. 21 01-0899 ACN 201 DATE 03-08-2004 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-22-2002 P R I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 193,559.55 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-18-2002 CDOO1312 .00 172,174.19 03-21-2003 CD002327 913.52- 22,298.88 08-07-2003 CD002885 4.77- 4.77 TOTAL TAX CREDIT 193,559.55 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J \. / 10 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-1607 EX AFP COl-03l ReCCF~ ; Rt,;;:~,. . W RODERICK GAGNE ESQ PEPPER HAMILTON 18TH & ARCH STS PHILA 004 ~lAR 1 2 P 1 DATE ESTATE OF DATE OF DEATH FILE NUMBER :45 COUNTY ACN 03-08-2004 BASHORE 09-19-2001 21 01-0899 CUMBERLAND 202 HELEN L Allount Rellitted r" It. ';- ~... \~, .;:, PAl 9 :(1Jt3r:- MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ii-v: i6'ifj-ix--AFP--foi-:oil-------...--iNirERITANci--YAX--STATEHi-N"y-ifF"-Ac-couiff--...---------------- - - --- ESTATE OF BASHORE HELEN L FILE NO. 21 01-0899 ACN 202 DATE 03-08-2004 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PRO~ECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-08-2004 P R I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 5,797.56 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-05-2004 CD003415 .00 6,103.45 TOTAL TAX CREDIT 6,103.45 BALANCE OF TAX DUE 305.89CR INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 305.89CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) \ l .. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 11128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-IU7 EX AFP (01-05) Rec(}rc..;=:.-- Rr-i i .~ ....~; -04 NAR 12 W RODERICK GAGNE ESQ PEPPER HAMI L T~ 18TH & ARCH ~~I';i-- PHILA ,I , 1''pA 19103 P 1 :45 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-08-2004 BASHORE 09-19-2001 21 01-0899 CUMBERLAND 101 HELEN L Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLEI PA 17013 NOTE: To insure proper credit to your accountl subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-y-=ic,'ifj-ix--AFP-coi-:03i-------...-fNHERITANc'E--TAx-STAiEM'ftiT-OF'-Accouiii--...--------------------- ESTATE OF BASHORE HELEN L FILE NO.21 01-0899 ACN 101 DATE 03-08-2004 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUEl APPLICATION OF ALL PAYHENTSI THE CURRENT BALANCEI ANDI IF APPLICABLE I A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-05-2002 P R I NC I PAL TAX DU E : .....--.................................................................................................................................................................................................................... 1421626.67 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-18-2002 CDOO1311 .00 1421626.67 TOTAL TAX CREDIT 1421626.67 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATEI SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $11 NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRll YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG. PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * REV-1U7 EX AFP (01-05) .04 f1/\ Y -7 P.3:0 3 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-12-2004 BASHORE 09-19-2001 21 01-0899 CUMBERLAND 202 HELEN L W RODERICK GAGNE ESQ PEPPER HAMILTON 18TH & ARCH STS PHILA PA l~tij3~ Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-Y=i6ifj-ix-AFP--fol-:oii-------...--iNifERITANci--fAx--sTA-fEMi-Nf-o-F-Ac-couirf--...--------------- - -- - -- ESTATE OF BASHORE HELEN L FILE NO.21 01-0899 ACN 202 DATE 04-12-2004 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-08-2004 P R I NC I PAL TAX DUE: .........................................................................................................................n.nn...............nm................m.n..............mnmn......................... 5,797.56 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-05-2004 CD003415 .00 6,103.45 03-23-2004 REFUND .00 305.89- TOTAL TAX CREDIT 5,797.56 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) REV-1500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 i 1- /3 DEPARTMENT OF REVENUE /0 - DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 0899 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Bashore, Helen L. 195-32-2519 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 09/19/2001 04/13/1921 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 3. Remainder Return CHECK r Original Return r Supplemental Return ~ (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required (date of death after 12- 12-82) PRIA TE 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach copy 01 Will) (Attach a copy of Trust) BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between D 11. Election to tax under Sec. 911 3(A) 12-31-91 and 1-1-95) (Attach Sch 0) 18~$smttIQNMQ$fijf$dQMeij~j$i.#ijUc~~.~j.CQN~,ptHtiNitN<)NFQRMAj~dN.$HQI.#.QQ$PIR~t~QtQr NAME COMPLETE MAILING ADDRESS COR- w. Roderick Gagne, Equire 3000 Two Logan Square RE- FIRM NAME (If Applicable) 18th & Arch Streets SPON DENT Pepper Hammilton LLP Philadelphia PA 19103-2799 TELEPHONE NUMBER (215) 981-4695 ~- ~ OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1 ) 158,9!HJ.00 2. Stocks and Bonds (Schedule B) (2) 990,600.29 3. Closely Held Corporation. Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 1,380,000.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 671,217.45 6. Jointly Owned Property (Schedule F) D Separate Billing Requested (6) 97,821. 28 RECA- c."..; PITULA- 7. Inter-Vivos Transfers & Miscellaneous TION Non-Probate Property (Schedule G or L) (7) 18,868.55 8. Total Gross Assets (total Lines 1-7) (8) 3',317,407.57 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 108,447.44 10. Debts 01 Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 39,478.47 11. Total Deductions (total Lines 9 & 10) (11 ) 147,925.91 12. Net Value of Estate (Line 8 minus Line 11) (12) 3,169,481.66 13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which an election to tax (13) has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 3,169,481.66 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount 01 Line 14 taxable at the spousal tax rate. or transfers under Sec. 9116 (a)(1 .2) o . 0 0 X .0 _00 (15) 0.00 - TAX 16. Amount 01 Line 14 taxable at lineal rate 3 , 169 , 481 . 66 X .0 .045 (16) 142,626.67 - COMPU- 17. Amount of Line 14 taxable at sibling rate 0.00x.12 (17) 0.00 TATION 18. Amount of Line 14 taxable at collateral rate 0.00x.15 (18) 0.00 19. Tax Due (19) 142,626.67 20. D l~kHe~e'fVOO_~$$.tWOjRa:tlNOdfANQve..AVM~1 ........ ........... ...... ............................ ..<;?,?>~$Ual!irQAk$W~A4tQ14ml~ONeAG.l;~AN.Q.Re:QB~KMAlB%%:.. o PA 15001 NTF 29755 Copyright 2000 GreatlandlNelco LP - Fonns Software Only Page 2 PA REV-1500 EX (6-00) D C ecedent's omolete A ress: STREET ADDRESS 3000 Two Logan Square 18th & Arch Sts CITY I STATE 1ZIP Philadelphia PA 19103-2799 dd Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 142,626.67 0.00 0.00 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 5. TotallnterestJPenalty (D + E) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ... '.' ....................................... . MElk~. c;~ec~~~y~~I~t?:~~91~T:s~8~.~I.~~:;..~.~~~;..... . (3) 0.00 4. 142,626.67 0.00 142,626.67 .............................. . . . . . . . . . . . . . . . . . . . . .. . . . . ....................... ................... ,~[~~~~~~gW~?~iA€~6CC6wi:~riaG@gfi6~~~~~~Ej~h~~ 1. "XU ................................................................................. ..... .................:..............................................................................,........................................................................... ..... IN THE APPROPRIATE BLOCKS Yes No ~ ~ 8 ffi Did decedent make a transfer and: a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . . . . c. retain a reversionary interest; or. . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? .............................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of periury, I declare that I have examined this return including accompanying schedules and statements, and to the best of my' knowledge and belief, It is true, correct and complete. Declaration of preparer other than the personal representative is based on information of which re arer has an knowled e. SIGNATU.R~F .PERS~N RI?)ONSj3LE FOR FILING RETURN DATE t];l'h--vo..J.. (J 1d- .'--<JCv~ce- ~J I") ;--- ADDRESS . C' . 3000 Two Logan Square, 18th & Arch St Philadelphia, PA 19103-2799 SIGNATURE RE! RER OT THAN REPRE~ENTATIVE I ~ o o'L-. & Arch St Philadelphia, PA 19103-2799 F~;d~t~~~fd~~lh8~;;~it~rj~iy..1:f994.~~db~i~r~J;;~8~;;:;.19g5:th~t~~;~I~>;;;;~8~~d8~.th~~~;~~18~8(;;~~~i~~.;~8;i8ith~~~~~nh~~8~i~i~~~p88~;;-i~.3;;;................... '.' . .' . 172 P.S. 99116 (a) (1.1) (i)). For dates of death on or after January 1. 1995. the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P .S. Il 9116 (a) (1.1) (ii)J. The statute does not exemot a transfer to a surviving spouse trom tax. and the statutory requirements for disclosure of assets and lillng a tax retum are slill applicable even If the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tal( rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent. an adoptive parent. or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or tor the use 01 the decedent's lineal beneliciaries is 4.5"/0. except as noted in 72.P.S. Il 9116(1.2) [72 P.S. %9116(a)(I)]. The tax rate imposed on the net value of transfers to or for the use ot the decedent's siblings is 12% [72 P.S. 1l9116(a)(1.3)]. A sibling is defined. under Section 9102. as an individual who has at least one parent in common with the decedent. whether by blood or adoption. ........................... . ....................... ................... o PA 15002 NTF 29756 Copyright 2000 GreatlandlNelco LP . Forms Software Only Pepper Hamilton LLP Attorneys at Law 3000 Two Logan Square Eighteenth and Arch Streets Philadelphia, PA 19103-2799 215.981.4000 Fax 215.981.4750 215.981.4438 cooka@pepperlaw.com July 10, 2002 Register of Wills Cumberland County Attention: Cheryl Winters 1 Courthouse Square Carlisle, P A 17013 Re: Estate of Helen L. Bashore. Deceased File No. 2001-00899 Dear Cheryl: Enclosed is page 2 of the Pennsylvania Inheritance Tax Return, Form PA Rev- 1500, with the original signatures. I understand that you will substitute this page in the return held in the county files. Also enclosed is the Inventory for the estate, filed in duplicate. Please let me know if you require any additional information to complete your files for the estate. Sincerely, A~ Anne B. Cook Senior Estate Administrator ABC/mb Enclosure cc: Pamela B. Gagne W. Roderick Gagne, Esquire PHLEGAL: #1273328 v2B (r@$802B.DOC) 112681-3 Philadelphia Washington, D.C. Detroit New Yotk Pittsburgh Berwyn Cherry Hill Hatrisburg Princeton Tysons Corner Wilmington www.pepperlaw.com , ' REV-1502 EX + (1.97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen L. Bashore SCHEDULE A REAL ESTATE FILE NUMBER 21-01-0899 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledae of the relevant facts. Real property which is iointlv-owned with riaht of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE DESCRIPTION NUMBER OF DEATH 1 Residence located at: 208 Hearth Road Camp Hill PA 17011 Cumberland County PA Value per settlement sheet, copy attached. 158,900.00 TOTAL (Also enter on line 1, Recapitulation) S 158 , 900 . 00 (If more space is needed, insert additional sheets of the same size) Copyright (c) t997 form software only CPSystems. Inc. Form REV -1502 EX (Rev. '-97) ,1 I, REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF 21-01-0899 Helen L. Bashore FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 880.7610 Shares Carlisle Companies Inc. CUSIP NO. 142339100 30.4750 26,841.19 2 358 Shares Fulton Financial Corp CUSIP NO. 360271100 7,815.14 21.8300 3 10 Shares Municipal Investment Trust Fund 80th Monthly Payment Series Acct# 0102626403 CUSIP NO. 626237705 4,634.60 463.4600 4 26.4510 Shares The Municipal Fund lAP Acct# 989 10524528 CUSIP NO. 626211106 461.04 17.4300 5 $92,400 Par 527 US Savings Bonds Series EE See attached detailed lists 96,554.98 UBS PAINEWEBBER INVESTMENT ACCOUNT #PY 0387384 6 $15,000 Par ALLEGHENY CNTY PA HIGHER RV CAP GTD OID@98.406/R/ RTE 5.00% MTE DTE 07/15/09 CALLABLE 7/15/04 @ 102.00 CUSIP NO. 01729EEE3 Interest accrued to 09/19/2001 15,703.19 135.42 104.6879 7 $10,000 Par ALLEGHENY CNTY PA HSP RV RFDG HLTH CTR OJ MBIA/R/ RTE 6.000% MTE DTE 9/01/05 CALLABLE 09/01/02@102.00 CUSIP NO. 01728ABZ8 Interest accrued to 09/19/2001 10,446.30 31.67 104.4630 Total from continuation schedule{s} 827,976.76 TOTAL (Also enter on line 2, Recapitulation) $ 990 , 600 . 29 {If more space is needed, insert additional sheets of the same size} Copyright (c) 1997 form software only CPSystems, Inc. Form REV -1503 EX (Rev. 1-97) SCHEDULE B STOCKS AND BONDS (continued) ESTATE OF: Helen L. Bashore ITEM NO 10 11 DESCRIPTION UBS PAINEWEBBER INVESTMENT ACCOUNT #PY 0387384 (continued) 8 $10,000 Par ALLEGHENY CNTY PA RFDG C-47 MBIA OID99.841BE/R/ RTE 3.7% MTE DTE 10/01/02 CUSIP NO. 0172856AO Interest accrued to 09/19/2001 101.4724 9 $10,000 Par ALLEGHENY CO PA HSP HLTH RV PT MBIA OID@98.217/R/ MAND SINK FND RTE 5.15% MTE DTE 09/01/12 CALLABLE 9/01/03 CUSIP NO. 01728AGL4 Interest accrued to 09/19/2001 102.9355 $5,000 Par ALLEGHENY CO PA RFDG SER C-42 /R/ RTE 5.0% MTE DTE 10/01/08 CALLABLE 10/01/03 @ 102.00 CUSIP NO. 017285V95 Interest accrued to 09/19/2001 104.3440 $10,000 Par ALLEGHENY CO PA SER C-42 OID@98.378 UT /R/ RTE 5.0% MTE DTE 10/01/09 CALLABLE 10/01/03 @ 102.00 CUSIP NO. 017285W29 Interest accrued to 09/19/2001 104.0450 FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 10,147.24 222.99 10,293.55 27.18 5,217.20 117.36 10,404.50 234.72 36,664.74 " SCHEDULE B STOCKS AND BONDS (continued) ESTATE OF: Helen L. Bashore ITEM NO 12 13 14 15 DESCRIPTION UBS PAINEWEBBER INVESTMENT ACCOUNT #PY 0387384 (continued) $15,000 Par BEAVER PA AREA SCH DIST SER C FSA OID@99.7832/R/ MAND SINK FND RTE 4.15% MTE DTE 01/15/13 CALLABLE 07/15/03 @ PAR CUSIP NO. 075313EM4 Interest accrued to 09/19/2001 98.6629 $5,000 Par BERKS CNTY PENNSYLVANIA GO SER 1998 AMBAC BE /R/ RTE 4.75% MTE DTE 11/15/08 CUSIP NO. 084509HH4 Interest accrued to 09/19/2001 106.0810 $5,000 Par BUCKS CNTY PA B/E OID@99.1985 /R/ RTE 4.5% MTE DTE 5/01/08 CUSIP NO. 118565PV6 Interest accrued to 09/19/2001 104.4660 $10,000 Par BUTLER CNTY PA HOSP AUTH BUTLER FSA OID@99.279/R/ RTE 4.6% MTE DTE 07/01/02 CUSIP NO. 123592BUO Interest accrued to 09/19/2001 101.7325 FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 14,799.44 112.40 5,304.05 82.47 5,223.30 86.88 10,173.25 100.94 35,882.73 SCHEDULE B STOCKS AND BONDS (continued) ESTATE OF: Helen L. Bashore ITEM NO 16 17 18 19 DESCRIPTION UBS PAINEWEBBER INVESTMENT ACCOUNT #PY 0387384 (continued) $20,000 Par CENTRAL & WESTERN CHESTER CNTY PA REV RFDG FHA /R/ MAND SINK FND RTE 5.75% MTE DTE 02/01/12 CALLABLE 10/28/01 @ 101.00 CUSIP NO. 152373AX4 Interest accrued to 09/19/2001 100.4280 $5,000 Par CENTRAL GREENE SCH AUTH PA SCH REV ESCROW TO MAT RTE 6.375% MTE DTE 12/01/07 CALLABLE 10/28/01 @ PAR CUSIP NO. 153555BP1 Interest accrued to 09/19/2001 116.0420 $30,000 Par CHELTENHAM TWP PA SiD PA FSA B/E /R/ RTE 5.15% MTE DTE 08/15/13 CALLABLE 8/15/05 @ PAR CUSIP NO. 163501KX6 Interest accrued to 09/19/2001 103.0114 $5,000 Par DAUPHIN CO PA GENL AU RV REV MBIA /R/ RTE 4.35% MTE DTE 10/01/07 CALLABLE 04/01/03@ PAR CUSIP NO. 238259T88 Interest accrued to 09/19/2001 101.1430 FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 20,085.59 156.53 5,802.10 96.51 30,903.42 150.21 5,057.15 102.10 62,353.61 SCHEDULE B STOCKS AND BONDS (continued) ESTATE OF: Helen L. Bashore ITEM NO 20 21 22 23 24 DESCRIPTION UBS PAINEWEBBER INVESTMENT ACCOUNT #PY 0387384 (continued) $5,000 Par EASTON PA AREA JT SCH AU REV MBIA ESCROW TO MAT RTE 5.9% MTE DTE 4/15/02 CUSIP NO. 277659HZ4 Interest accrued to 09/19/2001 102.0690 $10,000 Par HARRISBURG PA AU RES REC A FSA B/E OID99.2106 /R/ RTE 4.6% MTE DTE 09/01/08 CUSIP NO. 41473EAW1 Interest accrued to 09/19/2001 105.0220 $5,000 Par LEHIGH CNTY PA RFDG FGIC UT /R/ RTE 5.0% MTE DTE 11/15/06 CALLABLE 11/15/04@ 100.00 CUSIP NO. 524786QA1 Interest accrued to 09/19/2001 104.9690 $10,000 Par LUZERNE CNTY PA PUB SCHS AMBAC REV B/Q LT /R/ RTE 5.3% MTE DTE 3/01/05 CALLABLE 10/28/01 @ PAR CUSIP NO. 550739BD7 Interest accrued to 09/19/2001 100.1010 $10,000 Par MIFFLINBURG BORO PA MUN REV AMBAC /R/ RTE 6.625% MTE DTE 11/01/07 CALLABLE 11/01/01 @ 100.00 CUSIP NO. 598597CEO Interest accrued to 09/19/2001 100.3050 FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 5,103.45 127.01 10,502.20 24.28 5,248.45 86.81 10,010.10 27.97 10,030.50 255.80 41,416.57 SCHEDULE B STOCKS AND BONDS (continued) ESTATE OF: Helen L. Bashore FILE NUMBER: 21-01-0899 ITEM NO DESCRIPTION VALUE AT DATE OF DEATH UBS PAINEWEBBER INVESTMENT ACCOUNT #PY 0387384 (continued) 25 $15,000 Par MONTGOMERY CNTY PA IDA RV RMKT LOC IS 052389/R/ LETTR OF CRED RTE 7.5% MTE DTE 01/01/12 CALLABLE 01/01/03 @ 100.00 CUSIP NO. 613609MB9 Interest accrued to 09/19/2001 102.3335 15,350.03 246.88 26 $10,000 Par MONTGOMERY CO PENN ESCROW TO MAT RTE 9.0% MTE DTE 8/15/04 CALLABLE 02/15/02 @ 100.00 CUSIP NO. 613579DC2 107.1335 10,713.35 Interest accrued to 09/19/2001 87.50 27 $25,000 Par PA HFA SINGLE FAM MTG RV SER 1996-48 AMT B/E /R/ RTE 5.4% MTE DTE 10/01/05 CUSIP NO. 708792HRO 102.9270 25,731. 75 Interest accrued to 09/19/2001 633.75 28 $10,000 Par PA ST HI ED ASST AGY S/L AMBAC AMT ISS12/15/86/R/ PUT BOND RTE 7.050% MTE DTE 10/01/16 CALLABLE 04/01/02 @ 101.50 CUSIP NO. 709163AD1 103.7085 10,370.85 Interest accrued to 09/19/2001 330.96 Total. (Carry forward to main schedule) . . . $ 63,465.07 SCHEDULE B STOCKS AND BONDS (continued) ESTATE OF: Helen L. Bashore ITEM NO 29 30 31 32 DESCRIPTION UBS PAINEWEBBER INVESTMENT ACCOUNT #py 0387384 (continued) $5,000 Par PA STATE UNIV BDS REF SERIES 1992 /R/ MAND SINK FND RTE 6.250% MTE DTE 03/01/11 CALLABLE 03/01/02 @ 102.00 CUSIP NO. 709235EU5 Interest accrued to 09/19/2001 103.7580 $20,000 Par PA TURNPIKE COMMISSION RV BD SR 92P AMBAC BE/R/ MAND SINK FND RTE 5.75% MTE DTE 12/01/12 CALLABLE 12/01/02 @ 102.00 CUSIP NO. 709223MT5 Interest accrued to 09/19/2001 105.4940 $25,000 Par PENN HFA SFM REV SER 64 AMT B/E OID@99.54 /R/ RTE 4.5% MTE DTE 10/01/10 CALLABLE 10/01/08 @ 101.00 CUSIP NO. 708792XM3 Interest accrued to 09/19/2001 101.5469 $15,000 Par PENN HGHR ED FAC AU B/E AMBAC OID@97.482 PREF/R/ MAND SINK FND RTE 5.500% MTE DTE 06/15/16 CALLABLE 06/15/04 @ Par CUSIP NO. 709174XSO Interest accrued to 09/19/2001 102.6074 FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 5,187.90 16.49 21,098.80 348.19 25,386.73 528.13 15,391.11 217.71 68,175.06 SCHEDULE B STOCKS AND BONDS (continued) ESTATE OF: Helen L. Bashore ITEM NO 33 34 35 36 37 DESCRIPTION UBS PAINEWEBBER INVESTMENT ACCOUNT #PY 0387384 (continued) $15,000 Par PENN INFRASTRUCTURE INVT AU RV A B/E DTD 6/25/92/R/ RTE 5.45% MTE DTE 09/01/03 CUSIP NO. 708836CC3 Interest accrued to 09/19/2001 105.5009 $10,000 Par PENN ST HIGH EDL AU COLL ASSGU BE OID@99.2702 /R/ ESCROW TO MAT RTE 4.4% MTE DTE 03/15/08 CUSIP NO. 7091716Y3 Interest accrued to 09/19/2001 104.2899 $15,000 Par PENNSYLVANIA HFA SFM RV 1996-53A AMT B/E /R/ RTE 4.9% MTE DTE 10/01/02 CUSIP NO. 708792ME3 Interest accrued to 09/19/2001 101.4900 $20,000 Par PENNSYLVANIA HFA SGL FAM MTG REV SER 68B B/E /R/ RTE 5.3% MTE DTE 10/01/11 CALLABLE 10/01/09 @ PAR CUSIP NO. 708792H33 Interest accrued to 09/19/2001 103.6179 $15,000 Par PENNSYLVANIA HSG FIN AGENCY SFM 1997-57 A AMT B/E/R RTE 5.2% MTE DTE 10/01/05 CUSIP NO. 708792PY6 Interest accrued to 09/19/2001 102.8209 FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 15,825.14 43.15 10,428.99 6.11 15,223.50 345.04 20,723.58 497.61 15,423.14 366.17 78,882.43 SCHEDULE B STOCKS AND BONDS (continued) ESTATE OF: Helen L. Bashore ITEM NO 38 39 40 41 DESCRIPTION UBS PAINEWEBBER INVESTMENT ACCOUNT #PY 0387384 (continued) $10,000 Par PENNSYLVANIA HSG FIN AGY SFM 1997-57 A AMT B/E/R RTE 5.1% MTE DTE 10/01/04 CUSIP NO. 708792PWO Interest accrued to 09/19/2001 102.5489 $15,000 Par PENNSYLVANIA ST HGHR EDL FCS AU HLTH RV A BE /R/ RTE 5.75% MTE DTE 01/01/06 CALLABLE 01/01/04 @ 102.00 CUSIP NO. 709172AM2 Interest accrued to 09/19/2001 106.3930 $20,000 Par PENNSYLVANIA ST HWY B/E /R/ RTE 5.25% MTE DTE 6/15/05 CALLABLE 06/15/03@ 101.50 CUSIP NO. 709139WZ8 Interest accrued to 09/19/2001 105.2794 $10,000 Par PENNSYLVANIA ST TPK COMM REV SR M FGIC OlD B/E/R PREREFUNDED RTE 6.5% MTE DTE 12/01/13 PREREFUNDED 12/01/01 @ 102.00 CUSIP NO. 709223KX8 Interest accrued to 09/19/2001 102.7940 FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 10,254.89 239.42 15,958.95 189.27 21,055.88 277.08 10,279.40 196.81 58,451. 70 SCHEDULE B STOCKS AND BONDS (continued) ESTATE OF: Helen L. Bashore ITEM NO 42 43 44 45 DESCRIPTION UBS PAINEWEBBER INVESTMENT ACCOUNT #PY 0387384 (continued) $15,000 Par PENNSYLVANIA ST TPK COMM REV SER M FGIC OlD BE/R MAND SINK FND RTE 5.5% MTE DTE 12/01/17 CALLABLE 12/01/01 @ 100.00 CUSIP NO. 709223KZ3 Interest accrued to 09/19/2001 100.4569 $5,000 Par PENNSYLVANIA ST TPK COMM TPK RV SR 920 FGIC BE/R/ RTE 5.6% MTE DTE 12/01/05 CALLABLE 12/01/02 @ 102.00 CUSIP NO. 709223MJ7 Interest accrued to 09/19/2001 105.4900 $5,000 Par PHILADELPHIA PA ARPT REV PHIL A/S FGIC AMT B/E/R/ RTE 5.25% MTE DTE 6/15/12 CALLABLE 06/15/07 @ 102.00 CUSIP NO. 717817FF2 Interest accrued to 09/19/2001 105.5760 $15,000 Par PHILADELPHIA PA GAS REV FSA CRC OID@97.9923PR/R/ PRE-REFUNDED RTE 6.375% MTE DTE 07/01/14 PREREFUNDED 07/01/03 @ 102.00 CUSIP NO. 717823YS1 Interest accrued to 09/19/2001 108.6300 FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 15,068.54 249.79 5,274.50 84.78 5,278.80 69.27 16,294.50 209.84 42,530.02 SCHEDULE B STOCKS AND BONDS (continued) ESTATE OF: Helen L. Bashore ITEM NO 46 47 48 49 50 DESCRIPTION UBS PAINEWEBBER INVESTMENT ACCOUNT #py 0387384 ( continued) $10,000 Par PHILADELPHIA PA MUN REV RFDG SR C FGIC BE OID/R/RTE 5.0% MTE DTE 4/01/06 CUSIP NO. 717904FT8 Interest accrued to 09/19/2001 106.7799 $5,000 Par PHILADELPHIA SCHOOL DIST PA G.O. SER A FSA BE/R/ RTE 4.85% MTE DTE 02/01/10 CUSIP NO. 7178805KO Interest accrued to 09/19/2001 105.9800 $5,000 Par PHILADLEPHIA PA HOSPS & AMBAC B/E /R/ RTE 4.2% MTE DTE 05/01/08 CUSIP NO. 717825LQ4 Interest accrued to 09/19/2001 102.4900 $25,000 Par PITTSBURGH PA URBAN RDV AU MTG RV-A AMT B/E /R/ RTE 5.5% MTE DTE 4/01/07 CALLABLE 4/01/06 @ 102.00 CUSIP NO. 725299ZU8 Interest accrued to 09/19/2001 103.5540 $10,000 Par PITTSBURGH PA URBAN REDV AUTH HME IMPT 94B BE /R/ RTE 4.8% MTE DTE 8/01/04 CALLABLE 02/01/04 @ 102.00 CUSIP NO. 725293LAO Interest accrued to 09/19/2001 102.0670 FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 10,677.99 234.72 5,299.00 33.01 5,124.50 81.08 25,888.50 645.49 10,206.70 65.33 58,256.32 SCHEDULE B STOCKS AND BONDS (continued) ESTATE OF: Helen L. Bashore ITEM NO 51 52 53 54 DESCRIPTION UBS PAINEWEBBER INVESTMENT ACCOUNT #PY 0387384 ( continued) $10,000 Par STATE PUB SiB PA COLLRV BTLR MBIA OID@99.521 /R/ RTE 6.05% MTE DTE 7/15/07 CALLABLE 07/15/02 @ 100.00 CUSIP NO. 857320EK7 Interest accrued to 09/19/2001 101.9505 $10,000 Par UPPER ST CLAIR TWP PA SCH AU SCH BLDG RV ESCROW TO MAT RTE 4.875% MTE DTE 08/01/04 CUSIP NO. 916490CD5 Interest accrued to 09/19/2001 103.1620 $10,000 Par W. JEFFERSON HILLS PA SD EFDG FGIC UT /R/ RTE 5.5% MTE 08/01/04 CALLABLE 8/01/02 @ 100.00 CUSIP NO. 953470EN7 Interest accrued to 09/19/2001 102.1530 $15,000 Par WASHINGTON CNTY PA INDL DEV AU REV REF FHA /R/ ACTIV SNK FND RTE 6.650% MTE DTE 01/15/07 CALLABLE 07/15/02 @ 102.00 CUSIP NO. 938598AL3 Interest accrued to 09/19/2001 104.1375 FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 10,195.05 109.24 10,316.20 66.35 10,215.30 74.86 15,620.63 180.10 46,777.73 SCHEDULE B STOCKS AND BONDS (continued) ESTATE OF: Helen L. Bashore ITEM NO 55 56 57 58 59 60 61 62 DESCRIPTION UBS PAINEWEBBER INVESTMENT ACCOUNT #PY 0387384 (continued) $10,000 Par WYOMING CNTY PA B/Q /R/ RTE 5.5% MTE DTE 6/01/07 CALLABLE 6/01/03 @ 100.00 CUSIP NO. 983244CH5 Interest accrued to 09/19/2001 102.5475 100 Shares AMGEN INC CUSIP NO. 031162100 58.0100 300 Shares APPLIED MATERIALS INC CUSIP NO. 038222105 31.1650 100 Shares ARIBA INC CUSIP NO. 04033V104 2.1400 400 Shares AVICI SYSTEMS INC CUSIP NO. 05367L109 1.7800 100 Shares BANK OF NY CO INC CUSIP NO. 064057102 31.3600 500 Shares CMS ENERGY CORP CONV 8.75% PREFERRED CUSIP NO. 125896308 Dividend accrued at 09/19/2001 31. 5450 400 Shares NOKIA CORP SPONS ADR FINLAND CUSIP NO. 654902204 16.0500 FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 10,254.75 166.53 5,801.00 9,349.50 214.00 712.00 3,136.00 15,772.50 453.50 6,420.00 52,279.78 SCHEDULE B STOCKS AND BONDS (continued) ESTATE OF: Helen L. Bashore ITEM NO 63 64 65 66 67 68 69 70 DESCRIPTION UBS PAINEWEBBER INVESTMENT ACCOUNT #PY 0387384 (continued) 300 Shares PFIZER INC CUSIP NO. 717081103 37.0050 200 Shares PUGET ENERGY INC NEW (HOLDING CO) CUSIP NO. 745310102 23.9450 200 Shares SCHLUMBERGER LTD NETHERLANDS ANTILLES CUSIP NO. 806857108 Dividend accrued at 09/19/2001 44.4900 100 Shares SIEBEL SYSTEMS INC CUSIP NO. 826170102 14.3050 1,350 Shares STANDARD&POORS DEP RCPTS UNIT SER 1 (SPDR TR) CUSIP NO. 78462F103 98.5600 200 Shares SUN MICROSYSTEMS INC CUSIP NO. 866810104 8.7350 100 Shares SURMODICS INC CUSIP NO. 868873100 44.1750 500 Shares WACHOVIA CORP CUSIP NO. 929903102 29.9700 FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 11,101.50 4,789.00 8,898.00 37.50 1,430.50 133,056.00 1,747.00 4,417.50 14,985.00 180,462.00 ESTATE OF: Helen L. Bashore ITEM NO 71 DESCRIPTION UBS PAINEWEBBER INVESTMENT ACCOUNT #py 0387384 (continued) 300 Shares XEROX CORP CUSIP NO. 984121103 SCHEDULE B STOCKS AND BONDS (continued) 7.9300 FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 2,379.00 2,379.00 REV-1507 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen L. Bashore SCHEDULE D MORTGAGES & NOTES RECEIVABLE FILE NUMBER 21-01-0899 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH Promissory Note Face Value $2,178,443 Obligor - Trustees under E.L. Heim & Co. 401(k) Profit Sharing & Employee Stock Ownership Plan Due Date - 7/1/14 Interest Rate - 5.64% Appraised Value 1,380,000 per Haverford Valuation Services appraisal attached 1,380,000.00 TOTAL (Also enter on line 4, Recaoitulation) S 1, 380 , 000 . 00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1997 form software only CPSystems, Inc. Form REV-1507 EX (Rev. 1-97) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen L. Bashore SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-01-0899 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 VALUE AT DATE OF DEATH DESCRIPTION Adjustments for items paid by seller in advance of settlement of 208 Hearth Road School taxes 910.81 2 Adjustments for items paid by seller in advance of settlement of 208 Hearth Road Sewer/refuse fees 65.25 3 Fulton Bank - checking acct# 3619-50402 Interest accrued to 09/19/2001 142,107.76 71.05 4 Principal Financial Group Checking Acct# 0590043041 1,254.74 5 Fulton Bank - Money market acct# 9903-71294 Interest accrued to 09/19/2001 379,171.40 603.97 6 Northern Trust (formerly Equitable Life of Iowa) Money Market Acct# 9270025851 D/O/D value int to D/O/D 130,547.47 130,241.84 305.63 7 1989 Mercedes-Benz automobile 260-E sedan (Value by appraisal) See attached exhibit 6,200.00 8 Miscellaneous personal property and furniture located at: 208 Hearth Road Camp Hill, PA 17011 (Value by appraisal) See attached exhibit 9,300.00 Total from continuation oaaes(s) 985.00 TOTAL (Also enter on line 5, Recaoitulation) S 671, 21 7 . 45 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1997 fonn software only CPSystems, Inc. Fonn REV -1508 EX (Rev. 1-97) SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PROPERTY (continued) ESTATE OF: Helen L. Bashore ITEM NO DESCRIPTION 9 Miscellaneous personal property and furniture located at Springfield residence: 551 East Evergreen Avenue Apartment 108 Wyndmoor, PA (Value by appraisal) See attached exhibit FILE NUMBER: 21-01-0899 Total. (Carry forward to main schedule) . . . $ VALUE AT DATE OF DEATH 985.00 985.00 REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen L. Bashore SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21-01-0899 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Pamela B. Gagne 515 Cresheim Valley Rd. Wyndmoor PA 19038 Daughter JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank DATE OF DBBlID'S VALUE OF account number or similar identifying number. NUMBER TENANT JOINT At1ach deed for jointly-held real estate. VALUE OF NJ3iIEEST DECEDENTS INTEREST 1 A 10/07/96 "'ulton Bank - checking :lcct# 1201-35769 195,639.88 50 97,819.9 Interest accrued 2.68 50 1.3 4 4 TOTAL (Also enter on line 6, Recapitulation) (If more space is needed insert additional sheets of the same size) Copyright (c) 1997 form software only CPSystems, Inc. $ 97,821. 28 Form REV-1509 EX (Rev. 1-97) . . REV-1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen L. Bashore SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-01-0899 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY %OF ITEM RELA '!rbl,L~~~ t~'b~~~6EOJT TfN'b Tr:r8~~~b~ t~~~SFER. DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 1 Fulton Bank - IRA acct# 120 -1901318 Beneficiary: Pamela B. Gagne 5,051.62 100 0.00 5,051.62 Interest accrued 66.80 100 0.00 66.80 2 Fulton Bank - IRA acct# 120-1901954 Beneficiary: Pamela B. Gagne 5,749.57 100 0.00 5,749.57 Interest accrued 68.66 100 0.00 68.66 3 Fulton Bank - IRA acct# 125-1903991 Beneficiary: Pamela B. Gagne 584.74 100 0.00 584.74 Interest accrued 6.43 100 0.00 6.43 4 Fulton Bank - IRA acct# 125-1907997 Beneficiary: Pamela B. Gagne 7,244.93 100 0.00 7,244.93 Interest accrued 95.80 100 0.00 95.80 TOTAL (Also enter on line 7, RecapittSation) 18,868.55 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1997 form software only CPSystems. Inc. Form REV-151Q EX (Rev. 1-97) REV-1511 EX + (1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen L. Bashore FILE NUMBER 21-01-0899 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. B. DESCRIPTION AMOUNT 1. UNERAL EXPENSES: Gingrich Memorial grave inscription 300.00 2. parthemore Funeral Home Funeral Services 9,802.00 1. ",DMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State _ Zip Year(s) Commission Paid: 0.00 2. 3. Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's. attach explanation) Claimant Street Address City State _ Zip Relationship of Claimant to Decedent N/A 60,000.00 4. Probate Fees 378.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7. AT&T Long distance phone service for 208 Hearth Road 103.19 8. Bennett's Landscaping Landscaping and property clean up for 208 Hearth Road 964.60 9. Commonwealth of PA Title replacement fee for car 22.50 Total miscellaneous exoenses from continuation paqe(s) 36,877.15 TOTAL (Also enter on line 9, Recapitulation) $ 108,447.44 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1997 form software only CPSystems, Inc. Form REV-1511 EX (Rav. 1-97) SCHEDULE H MISCELLANEOUS EXPENSES (continued) ESTATE OF: Helen L. Bashore ITEM NO 10. 11. 12. 13. 14. 15. 16. 17. DESCRIPTION Cumberland County Register of Wills Probate Fee and Exemplified Letters fee for Florida Probate 378.00 Letters 105.00 Samuel T. Freeman, Inc. Appraisal of personal property and furniture located at the Springfield Residence Good's Tree Service Tree removal at 208 Hearth Road Haverford Valuation Services Appraisals of the notes owed to the estate by the Edwin L. Heim Co. Kim Daugherty Clean-out of 208 Hearth Road Lower Allen Township Taxes - 208 Hearth Road William J. Mansfield, Inc. Legal Advertising Mary Ann Prior, Treasurer Real estate taxes for 208 Hearth Road 18. Reserve for additional miscellaneous administration expenses 19. 20. Pennsylvania Power & Light Electric service Robert Ensminger Appraisers Appraisal of personal property and furniture located at 208 Hearth Road FILE NUMBER: 21-01-0899 AMOUNT 105.00 179.00 1,520.00 5,388.28 492.72 50.40 252.37 719.99 2,500.00 154.09 200.00 Total. (Carry forward to main schedule) . . . $ 11,561.85 SCHEDULE H MISCELLANEOUS EXPENSES (continued) ESTATE OF: Helen L. Bashore ITEM NO 21. 22. 23. 24. 25. DESCRIPTION Cost of sale of securities to raise funds for payment of taxes and administration expenses Cost of sale of 208 Hearth Road to raise funds for administration expenses and death taxes. Commission Notary Home Warranty Sewer/Refuse Transfer Tax Pest treatment Seller paid closing costs 11,123.00 8.00 399.00 91.35 1,589.00 1,693.88 2,000.00 Streuwig Insurance Company Premium Payment Verizon phone service - 208 Hearth Road Vital Records Death Certificates FILE NUMBER: 21-01-0899 AMOUNT 6,336.80 16,909.53 1,961.30 74.67 33.00 Total. (Carry forward to main schedule) . . . $ 25,315.30 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen L. Bashore SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS FILE NUMBER 21-01-0899 Include un reimbursed medical expenses. ITEM NUMBER 1 10 11 12 13 DESCRIPTION AMOUNT AT&T Long distance phone service for 208 Hearth Road 128.55 2 City of Boy ton Beach Taxes for Quail Ridge 83.88 3 Comcast Cable Cable bill - Springfield Residence 7.23 4 Fulton Bank Payment of bank credit card debts 1,954.82 5 Holy Spirit Hospital 150.00 6 Marti Hanson decedent's debt for work contracted for apartment at Springfield Residence 16,623.01 7 Messiah Village Nursing Care 10,430.00 8 PA American Water Company water service for 208 Hearth Road 47.24 9 Pennsylvania Power & Light Electric service 717.01 Pulmonary Care Institute 90.00 Quail Ridge Condominium Club membership fee decedent's debt 5,494.78 Springfield Residence Apartment rent 3,520.00 Verizon phone service - 208 Hearth Road 231.95 TOTAL (Also enter on line 10, Recaoitulation) $ 39,478 .47 (If more space is needed. insert additional sheets of the same size) Copyright (c) 1997 form software only CPSystems. Inc. Form REV-1512 EX (Rev. 1-97) REV.1513 EX + (1-97) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen L. Bashore NUMBER I. FILE NUMBER 21-01-0899 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY AXABLE DISTRIBUTIONS (include outright spousal distributions) RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE 1 Pamela B. Gagne 515 Cresheim Valley Rd. Wyndmoor PA 19038 126,974.83 Daughter 2 Larry David Bashore 51450 Kylock Drive Mechanicsburg, PA 17103 406,200.00 Son 3 WR Gagne and PB Gagne, Ttees of the Rev A/T of Helen L. Bashore dtd 11/24/95 (trust will be distr outright to Pamela Gagne (daughter) who has reached the age of distrbtn) c/o Pepper Hamilton LLP 3000 Two Logan Square 18th & Arch Streets Philadelphia, PA 19103-2799 2,536,306.83 None See Schedule Attached... ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 17 AS APPROPRIATE ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: ". SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE ~. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Copyright (c) 1997 form software only CPSystems, Inc. 0.00 Form REV-1513 EX (Rev. 1-97) .' SCHEDULE J BENEFICIARIES (continued) ESTATE OF: Helen L. Bashore FILE NUMBER: 21-01-0899 ITEM NO NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE 4 Sam Bashore Grandson 50,000.00 5 Jill Bashore Granddaughter 50,000.00 , LlA.m1hu' I Q.;vt C t-, 0lt ~. 200 I ~ ooMi Mail to: Florida Department of Revenue 5050 W. Tennessee Street Tallahassee, FL 32399-0155 II Florida Estate Tax Return II for Residents, Nonresidents, and Nonresident Aliens [i] Check here if amended return RIA2 F-706 R.01/03 Decedent's name (first name, middle initial, and last name) Decedent's social security number ROS validation only - Do not wnte or stamp In this space Helen L. Bashore Residence (domicile) at time of death (county and state or foreign country) 195-32-2519 Date of death Name of personal representative or person in pOSSesSion of decedent's property 09/19/2001 Phone number Pamela B. Ga ne Add ress 215.981.4695 c/o 3000 Two Lo an Name of attorney for estate, if any are Phone number w. Roderick Ga Address ire 215.981.4695 Please reply to (check one): Personal representative X Attorney for estate Pre arer Pe er Hamilton LLP, 3000 Two Phila,PA 19103-2799 PART I FLORIDA RESIDENTS 1. Credit for state death taxes (from federal Form 706) 1. 2. Estate, inheritance, or other death taxes properly paid to other states (proof of payment must be submitted) 2. 3. Estate tax previously paid to Florida 3. 4. Estate tax due or overpayment to Florida (subtract Line 2 from Line 1; if the result is a negative number, use zero; subtract line 3 from the result) - Enter on Line 19, Part IV 4. PART II NONRESIDENTS 5. Credit for state death taxes (from federal Form 706) 6. Gross value of Florida assets included in gross estate (from federal Form 706, applicable schedules) 7. Gross value of entire federal estate (from federal Form 706) 8. Portion of gross federal estate value attributable to Florida (Line 6 divided by Line 7 - round to 7 digits) 9. Estate tax payable to Florida (Line 5 times Line 8) 10. Estate tax previously paid to Florida 11. Estate tax due or overpayment to Florida (subtract Line 10 from Line 9) - Enter on Line 19, Part IV 5. 6. 7. 8. 9. 10. 11. 348,783.00 95,600.00 4,793,592.00 0.019943 6,955.78 6,925.75 30.03 PART III NONRESIDENT ALIENS 12. 13. 14. 15. 16. 17. 18. Credit for state death taxes (from federal Form 706-NA) Gross value of taxable property in Florida Gross value of property taxable in U.S. (from Schedule B of federal Form 706-NA) Portion of U.S. property attributable to Florida (Line 13 divided by Line 14 - round to 7 digits) Estate tax payable to Florida (Line 12 times Line 15) / Estate tax previously paid to Florida Estate tax due or overpayment to Florida (subtract Line 17 from Line 16) - Enter on Line 19, Part IV 12. 13. 14. 15. 16. 17. 18. 0.000000 PART IV CALCULATION OF AMOUNT DUE OR OVERPAYMENT 19. Tax due or overpayment (if overpayment, enter on Line 23) 20. Penalty if applicable (see instructions) 21. Interest on underpayment if applicable (see instructions) 22. Total amount due (add Lines 19, 20, and 21) 23. Overpayment to be refunded 19. 20. 21. 22. 30.03 30.031 23. Under penalties of perjury, I declare that I have examined this return, including any additional sheets attached, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which the preparer has any knowledge. (/: /- ; ,., ~ ,-' L' 'cn..Jc!c(......,Je. 12 31 03 ~ 12/31/03 Signature of personal r presentative Date Signature of preparer other than personal representative Date Name W. Roderick Gagne, Esquire Address 3000 Two Logan Square (Print name of preparer) (of preparer) Phone 215.981.4695 City, State, ZIP Philadelphia, PA 19103 -279 9 (of preparer) (of preparer) ATTACH COPY OF FEDERAL ESTATE TAX RETURN (FORM 706 or 706-NA) 2W1180 3.000 Department of the Treasury - Internal Revenue Service Date ~ece!'ied by internal ,~e"enue Waiver of Restrictions on Assessment and Collection of Deficiency and Acceptance of Overassessment Estate. Gift. and Generation-Skipping Transfer Tax (Please see the instructions on the second page of this farm) Part 1. Consent to Assessment and Acceptance of Overassessment I consent to the Immediate assessment and collection of any deficlencies (increase in tax and penalties; and accept any overassessment (decrease in tax and penalties) shown below, plus any interest provided by law. I understand that by my s;~nlng this waIver, a petItion to the United States Tax Court may not be made, unless additional deficiencies are determined. Farm 890 (Rev, Oct. 1988) SerVice Date of Death or Penod Ending 9/19/2001 Item Increase Decrease Tax 106.303 Penalty Total 106.303 If the estate is required to file with the Area Director of Internal Revenue evidence of payment of estate, inheritance, legacy, succession, or generation-skipping transfer taxes to any State or the District of Columbia, I understand that such eVIdence must be fi led by , or the credits for these taxes will not be allowed. I also agree to the assessment and collection of the increase in estate tax and penalties of based on the disallowed credits, plus interest figured to the 30th day after or until this increase is assessed, whichever is ear11er, Estate of Helen L Bashore Executor or Administrator _'\~~I ~lgn\ ~ Here / tfGt. . ,,,..} . Address 3 fIi~(I"t;;Jfbtv",c... . 0 0 0 7w. >"',.,"" 6( ""~ , 8 T II A tV 0 A (~..:Ct.-. <2 f tl. J iJIT. f h Z (f\ OI!l P "I" Q f). I i o~ ) Da t e 12./Z.'llo~ Date Executor or Administrator Sign Here I Address ~ame Address Donor Donor's Signature Date Sign Here Form 890 (Rev, IJ.33; ':J'. Form 1273 (Rev. ) (CG) Name of Decedent Helen L Bashore Name of Person With Whom Findings Were Discussed: Edwa rd Kesse 1 . . Esq 1. Taxable estate shown on return or as previously adjusted Department of the Treasury - Internal Revenue Service Report of Estate Tax Examination Changes : Social Security Number : Date of Death : 195-32-2519 : 9/19/2001 : Agreement Secured I [dYes [INo Shown on Return 4,375,000 242.702 4,617.702 As Corrected 2. Increase <decrease> in taxable estate 3. Taxable estate as corrected (line 1 plus (less) line 2) 4. Adjusted Taxable Gifts 5. Total 683.471 5.058.471 2.422.959 12.384 2.410.575 220.550 o 220.550 2.190.025 683.471 5.301.173 2,556.445 12.384 2,544,061 220,550 o 220,550 2.323.511 6. Tentative Tax 7. Aggregate gift taxes payable (after Dec. 31, 1976) 8. Subtract the amount on line 7 from the amount on line 6 9. Unified Credit against estate tax 10. Adjustment to unified credit 11. Subtract the amount on line 10 from the amount on line 9 12. Subtract the amount on line 11 from the amount on line 8 (not less than zero) 13. Credit for State death taxes 348, 783 Tentatively allowed Submit evidence by (date) 14. Subtract the amount on line 13 from the amount on line 12 15. Credit for Federal gift taxes on pre-1977 gifts 16. Credit for foreign death taxes (Statutory) 17. Credit for tax on prior transfers 18. Credit for foreign death taxes (Special Treaty) 19. Total Credits (add the amounts on lines 15, 16, 17, and 18) 20. Net estate tax payable o 21. Generation-skipping transfer taxes (Schedule R, Part 2, line 12) 22. Section 4980A - increased estate taxes (Schedule S) 23. Total transfer taxes (add the amounts on lines 20,21 and 22) 24. Total transfer tax previously assessed 28. Net penalties - Increase <decrease> (difference between line 26 and line 27) 29. Net tax and penalties payable - Increase <decrease> (add line 25 and line 28) Examiner's Signature An I I I , I I I , I I I , I I , , I , I , I I I Area/T~rritorY/Group Penns lvania Date 12 18 '2003 25. Total transfer tax - Increase <decrease> (difference between line 23 and line 24) 26. Penalty previously assessed 27, Penalties as corrected Form 3228 (Rev , Oct, 1980) (CG) Estate of Helen L Bashore Department of the Treasury - Internal Revenue Service Adjustments to Taxable Estate Schedule Social Security Number 195-32-2519 Date of Death 9/19/2001 1, Gross estate reported on return 4,523,437 2, Increase <decrease> to gross estate B Stocks and Bonds 177.735 c Mortqaqes. Notes & Cash 43.771 F Other Miscellaneous Property 27 . 145 H Powers of Appointment 21.504 3, Net changes to gross estate 4, Corrected gross estate (line 1 & line 3) 5. Total deductions reported on return 148,437 6, Increase <decrease> to deductions J Funeral & Administration Ex. 27,453 7, Net changes to deduct ions 27,453 8, Corrected total deductions (line 5 + line 7) 9, Corrected taxable estate (line 4 less line 8) 270,155 4,793,592 175,890 .t ~-1"'7' ""71"\.-, '+,UII,IV~ Form 3223 (Rav. lQ-aC)(CG) PAGE , Form 886-A (Rev. ~pri1 1968)(CG) NAME OF TAXPAYER EXPLANATION OF ITEMS : SCHEDULE NO, OR : EXHIBIT \ Estate of Helen L Bashore , YEAR/PERIOe ENDED 9/19/2001 Returned Corrected Sch. B, Stocks and Bonds Sch B--Items 1 through 24 990,600 1,168,335 Total of these items 990,600 1,168,335 990,600 Increase to schedule 177,735 ---------------- ---------------- Sch B--The additional stocks are listed on the Supplemental 706 as Items 2 through 24. Returned Corrected Sch. C, Mortgages, Notes & Cash Item 2--Balance on Fulton Bank acct Promissory Note, Face Val 2,178,443 Item 8--UBS Paine Webber 65 1,380,000 o <73> 1,415,988 7,921 ---------------- ---------------- Total of these items 1,380,065 1,423,836 1,380,065 Increase to schedule 43,771 ---------------- ---------------- Returned Corrected Sch. F, Other Miscellaneous Property Item 6--2001 IRS refund Item 7--2001 PA-40 refund o o 25,850 1 ,295 ---------------- ---------------- Total of these items o 27,145 o Increase to schedule 27,145 ---------------- ---------------- Returned Corrected Sch. H. Powers of Appointment Item 4--Note, Face value 1,540,775 980,000 1 ,001 ,504 Total of these items ~ 980,000 1,001 ,504 980,000 Increase to schedule 21,504 ---------------- ---------------- Department of the Treasury - Internal Revenue Service Farm Page 886-,~ i:R2\', ~~68:i,~GJ . Form 886-A (Rev, April 1968)(CG) NAME OF TAXPAYER EXPLANATION OF ITEMS : SCHEDU LE NO, OR : EXHiBIT \ , Estate of Helen L Bashore YEAR/PERrOD ENDED 9/19/2001 Returned Corrected Sch. J, Funeral & Administration Ex. Item B2--Attorney fees Admin Exp #21--Evaluation Svc fee Exp #22~-Hudson Bnk fee Exp #23--PA I.T. interest payable Exp #24--Register of Wills fee Exp #25--Add'1 fee for note appraisals Exp #26--Interest on estate tax payable Total of these items 60,000 o o o o o o 75,000 95 53 1,914 1,023 3,820 5,548 60,000 87,453 60,000 Increase to schedule 27,453 ---------------- ---------------- Interest on the estate tax is deductible as an expense of administration. In this estate, the interest is cal~ulated through Tuesday, January 13, 2004, the expected date of payment. Please see the last two pages of this report for the interrelated calculation of tax and interest. Form 886-A (Rev, 4-68)(CG) Page Department of the Treasury - Internal Revenue Service . Estate of: Helen L Bashore, DD: 9 192001 File Name: C:\Program Files\EST3\Bashore.ET3 Memorandum: Interrelated calculation of tax and interest Inter-Est Version 3.00, Release 105, (Standard Output) (#1373) Date and time of run: Thursday, December 18, 2003, 10:47 AM Inflation factor used for this computation 106.8300000 % MAIN PRINTOUT SECTION Gross Estate Sch. JK&L (before interrelated) Int, Federal Debts & Expenses Marital Deduction Charitable Deduction Total Deductions Taxable Estate Adjusted Taxable Gifts Total Amount Drawing Tax Tentative Tax Aggregate Gift Tax Payable Tax before Unified Credit Unified Credit from Table Adjustment to Unified Credit Net Unified Credit Tax before SDTC State Death Tax Credit Net Tax after State Death Tax Credit Gift Tax Credit Foreign Death Tax Credit (Statutory) Prior Transfer Credit Foreign Death Tax Credit (Treaty) Total Credits Estate Tax Generation Skipping Transfer Tax Total Federal Tax 170,342 5,548 4,793,592 175,890 0 0 175,890 4,617,702 683,471 5,301 ,173 2,556,445 12,384 2,544,061 220,550 0 220,550 2,323,511 348,783 1,974,728 0 0 0 0 0 1,974,728 0 1,974,728 FEDERAL INTEREST OPTION SELECTED Interest Table File: C:\Program Files\EST3\FederaI.lT4 Interest Table Description: Federal (RProc 95-17)(9/03) Special Interest Rate Used (old): 4.0000000 % Special Interest Rate Used (new): 2.0000000 % INTEREST FACTORS USED Regular (100%) Pd # 1 c 4.3662707 % Pd # 2 c 3.8952325 % Special (old) 3.0368153 % 3.3417239 % PART 1 Due Date Pd # 1 Pd #2 Date 6 19 2002 3192003 1 13 2004 Tax Pmt. 1,868,425 87,669 PART 2 P = Period entry for Interest on Penalty Computation Starting Balance Tax Paid Refund 4.3662707 % 3.8952325 % I nt. Pmt. o P o Interest Balance Applied To Balance . Estate of: Helen L Bashore, DD: 9 19 2001 Due Date 1,974,728 1,868,425 Pd # 1 106,303 87,669 Pd # 2 18,634 0 PART 3 Interest Drawing Int. Pd # 1 0 Pd # 2 4,641 Total Interest Deduction Total Amount Drawing Int. 106,303 23,275 LAST LINE OF PRINTOUT o 4,641 5,548 Interest Factor 4.3662707 % 3.8952325 % Page 2 1,868,425 87,669 o Interest 4,641 907 5,548 COHHONNEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTHENT OF REVENUE INHERITANCE TAX DIVISION DEPT. Z80601 INHERITANCE TAX HARRISBURG, PA 171Z&-060! STATENENT OF ACCOUNT REV-J60? EX AFP C0[-03) ~!~ DATE 04-12-200~ ~ ~ ESTATE OF BASHORE HELEN L DATE OF DEATH 09-19-2001 FILE NUHBER 21 01-0899 '04 MAY-7 ~.3:03 COUNTY CUHBERLAND N RODERICK GAGNE ESQ ACN ZO2 PEPPER HAMILTON Amoun~ Remi~ed 18TH & ARCH STS PHILA PA 1~ HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o your accoun*, subm[* ~he upper por*/on of ~his fora wASh your *ax paymen*. CUT ALONG THIS LINE ~-- RETAIN LOgER PORTION FOR YOUR RECORDS REV-1607 EX AFP (01-03) ~ INHERITANCE TAX STATEHENT OF ACCOUNT ESTATE OF BASHORE HELEN L F'rLE NO. 21 01-0899 ACN ZO2 DATE 04-1Z-ZOOq THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACH IN THE NAHED ESTATE. SHO#N BELO# TS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYNENTS, THE CURRENT BALANCE., AND, TF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 05-08-Z00~ PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... 5,797.56 PAYHENTS (TAX CREDITS): PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 01-05-2004 CD005~15 .00 6,105.45 05-25-2004 REFUND .00 $05.89- TOTAL TAX CREDTT 5,797.56 BALANCE OF TAX DUE .00 'rNTEREST AND PEN. .00 TF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE . O0 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. TF TOTAL DUE TS REFLECTED AS A "CREDTT" YOU NAY BE DUE A REFUND. SEE REVERSE STDE OF THIS FORN FOR INSTRUCTIONS. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF NZLLS, AGENT. -- Xf NDN-RESZDENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by coepZeting an "Application for Refund of Pennsylvania 1nheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills, any of the Z$ Revenue District Offices or from the Department's Zq-hour answering service for forms ordering: 1-BO0-36Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-BO0-q&7-3OgO (TT only). REPLY TO: guestions regarding errors contained on this notice should be addressed to: PA Oepartment of Revenue, Bureau of ~ndividue! Taxes, ATTN: Post Assessment Review Unit, Dept. ZB0601, Harrisburg, PA 171ZB-06Ol, phone (717) 787-6505. DISCOUNT: if any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. PENALTY: The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the data of payment. Taxes which became delinquent before January I, 1982 bear interest at the rate of six (67-3 percent per annum calcuIatad et a daily rate of .O0016fi. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOq are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 Z07. .0005q8 1988-1991 117. .000301 gOOZ 97. .O00gq7 1983 167- . O 00q38 199Z 97. .000247 ZOOZ 67- .000164 1984 117- .000301 1993-1994 77. .000192 2003 57. .000137 1985 137. .000356 1995-1996 97. .000Z47 ZOO4 47- .000110 1986 107. .000Z74 1999 77. .000192 1987 97. .000Z47 ZOO0 87. .O00ZX9 --Interest is calculated as follows: I'NTEREST = BALANCE OF TAX UNPAI'D X NUIIBER OF DAYS DELXNI~UENT X DATLy TNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. Tf payment is made after the interest computation date shown on the Notice, additional interest must be calculated. Cumberland County - Register of Wills Hanover and High Streets Carlisle, PA 17013 Phone: (717) 240-6345 Date: 8/03/2004 PAMELA B GAGNE RE: Estate of BASHORE HELEN L File Number: 2001-00899 Dear sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel. Within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 09/19/2004 Your prompt attention to this matter will be appreciated. Thank you. Sincerely, GLENDA FARNER STRASB ~AI:J~GH REGISTER OF WILLS cc: File Personal Representative (s) Counsel Judge STATUS REPORT UNDER RULE 6.12 Name of Decedent: Helen L. Bashore Date of Death: September 19, 2001 File Number: 2001-00899 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to the completion of the administration of the above-captioned estate. 1. State whether administration of the estate is complete: Yes [] No [] 2. If the answer to No. 1 is No, state when the personal representative believes that the administration will be complete? 3. If the answer to No. 1 is Yes, state the following: a.Did the personal representative file a final account with the Court? Yes [--] No b. The separate Orphans' Court No. (if any) for the account is: N/A c. Did the personal representative state an account informally to the parties in interest? Yes [~] No d. Did the personal representatives file receipts, releases, joinders or approvals of formal or informal accounts with the Clerk of the Orphans' Court? Yes Date: September 15, 2004 Signature: ~~ Name: W. Roderick Gagn6, Esquire . ~,~,~::,, ,. Address: Pepper Hamilton LLP ' ~ ~ :-.~ 3000 Two Logan Square Philadelphia, PA 19103-2799 0~: [ d /_-[ d3~ P0, Telephone: (215) 981.4695 ........ ~_~ [-] Personal Representative [~ Counsel for Personal Representative