HomeMy WebLinkAbout03-0091Register of Wills of Cumberland County, Pennsylvania
Estate of
also known as
PETITION FOR GRANT OF LETTERS
Florence F. HessNo. ..1 I-o 3 -ql
· Deceased
-Ann H~ M,,,=~-~ =,~,~ M~=~-,, Lyno_~_
(COMPL~E "A" OR "B" BEL~:)
Social Security No. 033-18-2322
A. Probate and Grant of Letters and aver that Petitioner is the executor named in the Last Will of the
Decedent, dated March 17, 1999 and codicil(s) dated
State mlevlm clmum~lalme~, e.g., reflunciett~l, death of execute', etc.
Exc~ as follows, Decedent did not mann/, was not divorced, and did not have a child bom or adopted after execution of the documents offered for probate;
aras no( the victim of a killing and was never adjudicated incompetent:
NO EXCEPTIONS
B. Grant of Letters of Administration
(d.b.n,c,t.l.: pendente I1~; durante abeen~la; dumate mlnedtale)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
Name Relationship, Residence, , ,
(COMPLy- i m- IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania,
Messiah Village, Mechanicsbur.q, Upper Allen Township, Pennsylvania
with his last family or principal residence at
Decedent, then 78 years of age, died January 18, 2003, at Hob' Spirit Hospital, Camp Hill, Pennsylvania
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) AJI personal property ........................................................................................... $ 260.000.00
(If not domiciled in PA) Personal properby in Pennsylvania ..................................................................... $
(If not domidled in PA) Personal preperty in County ............................................................................... $
Value of mai estate in Pennsylvania ............................................................................................................................ $ 90.000.00
Total ................................................................................................................... $ 350.000.00
Real Estate situated as follows: Messiah Villa.qe, Apt. 811 Tuscarora. Camo Hill. Pennsylvania 17011
Wherefore, Petitioner respectfully requests the probate of the last Will presented with this Petition and the grant of letters in the appropriate form to the
undersigned:
I , Signature Typed or printed name and residence
,Ann Hess Myers
111 Bramblewoocr Lane
Lewisberr~l PA 17339
Mary Lvnch Hess
P.O. Box 1'1
Ashton, MD 20861
Form RW-1 Page 1 of 2 (Dauphin County). Rev. 9/92
459035.1
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumbe~-]a~d
The Petitioners above-named swear and affirm that the statements in the foregoing Petition are true and correct to
the best of the knowledge and belief of Petitioners and that, as personal representatives of the Decedent, Petitioners will well
and truly administer the estate according to law.
Swom to and affirmed and subscribed
before me this <-'~ '2~-/~ day of
2003
No. 21-2003-o7
Estate of Florence Pl~,,fey: ~-Ies.~ /ak'~ :Florence,-F~,-- ~less..? Deceased
Social Secudty No: 033-18-2322 Date of Death: January 18th, 2003
AND NOW, January 30th ,2003 , in consideration of the Petition on the
reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters I~ Testamentary [] of Administration
d.b.n.c.t.; pe~dente lite; dumnte abse~ll; dum~e mtno~lt ,,*e
are hereby granted to .~n Hess Hyers an(:] Hary ~,Y~Ch H~sS
in the above estate and that the instrument(s) dated Ha~ch 17th, 1999
described in the Petition be admitted to probate and filed of record as the last Will of DeCedent.
FEES
Letters ........................... $
Short Certificate(s)....:L:~... $
Renunciation .................. $
Affidavit ( ) ................. $
Extra Pages (1) ............ $
Codicil ..........................$.
JCP Fee ........................ $
Inventory ....................... $.
Other ............................$
TOTAL ................
Form R~/-I Page 2 of 2 (Dauphin County) - Rev. ~/92
305.00
36.00
3.00
10.00
Donna M. Otto, 1st Deputy ,
$. 354.00
Letters will
Attorney: Amy J. Mendelsohn
I.D. No: 81084
Address: Rhoads & Sinon LLPt PO Box 1146
I South Market Square, Harrisburq, PA 17108-1146
Telephone: 717-233-5731
Call First then the
be picked up on January 31,2003 by Attorney
Register of Wills of Cumberland County, Pennsylvania
Estate of
also known as
OATH OF NON-SUBSCRIBING WITNESS
Florence Furfey He~s, a/k/a
Florence F. Hess,- "' ~ ' ",", No. 21-2003-91
, Deceased
Kurt J. Myers
a subscriber hereto, being duly qualified according to law, depose and say that he was familiar with the signature of
Florence F. Hess, testattdx of the will presented herewith, and that such subscribers believe the signature on the will is
in the handwriting of Florence F. Hess to the best of such subscriber's knowledge and belief.
Sworn to or affirmed and subscribed
before me this ~$./-,L day of
,20 O3
Nota~t Public/
Notarial Seal
Cindy J. Wilson, Notary Public
City of Harrisburg, Dauph n County
My Commission Expires May 2, 2005
Form RVV-12 (Dauphin County - Rev. 9/92)
459153.1
Register of Wills of Cumberland County, Pennsylvania
OATH OF NON-SUBSCRIBING WITNESS
Florence Furfey Mess, a/k/a
Estate of Florence F. Hess No. 21-2003-91
also known as '
, Deceased
, of PNC Bank
a subscriber hereto, being duly qualified according to law, depose and say that he was familiar with the signature of
Florence F. Hess, testattrix of the will presented herewith, and that such subscribers believe the signature on the will is
in the handwriting of Florence F. Hess to the best of such subscriber's knowledge and belief.
Sworn to or affirmed and subscribed
before me this :~ ~ day of
~ ~t4%c~ 20 05.
Notary Public /
Notarial Seal
Cindy J. Wilson, Notary Public
City of Harrisburg, Dauphin Coun
~My Commisslotl Expires May 2, 2~(~)5
Form RW-12 (Dauphin County - Rev. 9/92)
459154.1
his is to certify that the information here given is correctly copied fi'om an original certificate of death duly
Local Registrar. The original certificate will be forwarded to thc State \/itel Records (')filet (or permanent 'tlii~,~i::.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 8920344
No.
Local Registrar
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
DECEOENT'S USUAL OCCU P~I(~I
FAIHER'S NAME (F~Sl.
..4,.,/..~' a<'
'MEDICAL EXAMINER/CORONER
On the bllll of elimination and/at Inviltlgilion, In my opinion, death occurred Il the time, date, and p ace. and due o hi ClUll(I) end
21-2003-91
Last Will and Testament
OF
FLORENCE FURFEY HESS
I, FLORENCE FURFEY HESS, a resident of Jackson Township, Stark County, Ohio, being of full age
and of sound mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby
revoking any and all Wills and Codicils by me heretofore made.
ITEM I. I direct that all my just and legal debts and expenses of my last illness and funeral
be paid as soon after my death as may be practicable, except that the payment of
any debt secured by a mortgage or pledge on real or personal property may be postponed at the discretion of my
Executor. I further direct that all estate, inheritance or other succession taxes of any nature arising by reason of
my death shall be paid from my estate as an expense of administration without any right of reimbursement from
beneficiaries of life insurance policies or donees of any gifts which may be included in my taxable estate or any
similar beneficiaries receiving property other than through the administration of my estate.
ITEM II. All the rest, residue and remainder of my estate, be the same real, personal or
mixed, of every kind and description, wheresoever situate, which I may own or
have the right to dispose of at the time of my decease, I give, bequeath and devise to my husband, JACOB F.
HESS, JR., to be his absolutely and in fee simple.
ITEM III. In the event that my husband, JACOB F. HESS, JR., should predecease me, or
in case of the death of my husband and myself in a common casualty or accident
or catastrophe, or under such circumstances that it cannot be readily determined which of us died first, or if by
statute or operation of law it be determined that my said husband predeceased me, then the provisions made for
my said husband in this Will shall not succeed to him, but I give, bequeath and devise all the rest, residue and
remainder of my estate in equal shares to my daughters, ANN HESS MYERS and MARY LYNCH HESS, or
their issue, per stirpes.
ITEM IV. I make, nominate and appoint my husband, JACOB F. HESS, JR., to be the Exe-
cutor of this, my Last Will and Testament, hereby authorizing and empowering
my said Executor to compound, compromise, settle and adjust all claims and demands in favor of or against my
estate, in such manner and upon such terms as he may deem best; and to sell, at private or public sale, at such
prices and upon such terms of credit or otherwise as he may deem best, the whole or any part of my real or
personal property, and to execute, acknowledge and deliver deeds and other proper instruments of conveyance
thereof to the purchaser or purchasers; to execute proxies, and to sell, assign or transfer certificates of stock,
bonds, bank accounts or other securities. In the event that my said Executor should desire to employ the services
of a real estate broker to assist him in the sale of any real estate in my estate, I hereby authorize my said Executor
to employ the services of a real estate broker and to pay such real estate broker the standard and customary
broker's commission therefor. I request that no bond be required of my said husband, Jacob F. Hess, Jr., as such
Executor.
ITEM V. In the event that my husband, JACOB F. HESS, JR., shall predecease me or lack
legal capacity, or refuse to act as Executor, then I make, nominate and appoint
our daughters, ANN HESS MYERS and MARY LYNCH HESS, to be the alternate Executrices of this, my Last
Will and Testament, in which case the powers and authorities granted my Executor as provided in ITEM IV hereof,
shall apply to my alternate Executrices. I further request that no bond be required of my alternate Executrices.
IN WITNESS WHEREOF, I have hereunto set my hand at Canton, Ohio, this / 7'Lt/- day of March,
1999.
Florence Furfe~y Itless
Last Will and Testament of
FLORENCE FURFEY HESS
Page 2 of 2 pages
Signed by the said FLORENCE FURFEY HESS, and by her acknowledged to be her Last Will and
Testament, before us and in our presence and by_..us subscribed as attesting wimesses in her presence and at her
request and in the presence of each other, this /'~7~- day of March, 1999.
residing at
residing at
F.F.H.
c :\willsLhess. furl
OF
FLORENCE FURFEY HESS
LAW OFFICES OF
LESH, CASMER & MILLER
SUITE 606, BELDEN-WHIPPLE BLDG.
4150 BELDEN VILLAGE STREET, N.W.
CANTON, OHiO 44718
Name of Decedent:
Date of Death:
Will No.
To the Register:
CERTIFICATE OF NOTICE UNDER RULE 5.6(a)
Florence F. Hess
January 18, 2003
Adm. No. 2003-00091
I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
February 19, 2003.
Name Address
Ann Hess Myers
111 Bramblewood Lane
Lewisberry, PA 17339
Mary Lynch Hess
P.O. Box 11
Ashton, MD 20861
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NO EXCEPTIONS
Date: February 19, 2003 Signature: ~{Act:~y~ ~ c..~_.~
Name: Am~endelsohn, Esquire
Address:
Telephone:
Capacity:
X
Rhoads & Sinon LLP
One South Market Square, 12th Floor
P. O. Box 1146
Harrisburg, PA 17108-1146
(717) 233-5731
Personal Representative
Counsel for Personal Representative
460240.1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 003590
MENDELSOHN AMY J
1 SOUTH MARKET STREET
PO BOX 1146
HARRISBURG, PA 17108-1146
........ fold
Z-Zo
ESTATE INFORMATION: SSN: 033-18-2322
FILE NUMBER: 2103-0091
DECEDENT NAME: HESS FLORENCE FURFEY
DATE OF PAYMENT: 02/20/2004
POSTMARK DATE: 02/1 9/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 01 /18/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 86,802.36
REMARKS:
TOTAL AMOUNT PAID'
86,802.36
SEAL
CHECK//1015
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
ROBERT H. LONG, IR.z
SHERILL T. PlOYER
]AN P. PADEN
RICHARD B. WOOD
LAWRENCE B. ABRAMS IIIz
]. BRUCE WALTER
JOHN P. MANBECK
FRANK ]. LEBER
PAUL A. LUNDEEN
]ACK F. HURLEY, IR.
DAVID B. DOWLING
DAVID F. O'LEARY
DAVID O. TWADDELL
CHARLES 3. FERRY
STANLEY A. SNITH
lENS H. DAMGAARDz
DRAKE D. NICHOLAS
THOMAS A. FRENCH6
DEAN H. DUSINBERRE
DONNA Pl.]. CLARK
CHARLES E. GUTSHALL
PAUL F. WESSELL
SHAWN D. LOCHINGER
3APlES H. CAWLEY
DEAN F. PIERMATTEI
KENNETH L. JOELt
DEBRA M. KR[ETE
TODD J. SHILL
DAVID Pl. BARASCH
THOPlAS J. NEHILLA
ROBERT ]. TRIBECK
TIPlOTHY J. NIEMAN
LOR[ J. PlcELROY
KEVIN Pl. GOLD
CARL D. LUNDBLAD
JAMES E. ELLISON
RICHARD E. ARTELL
PAUL 3. BRUDER, JR.~
JOANNE BOOK CHRIST[NE
MICHAEL W. WINFIELD3
STEPHAN[E E. D]VITTORE
KATHLEEN D. ~UDER~'s
~E L ~
H~ Z. ~Y
ALSO ADMITTED TO THE DISTRICT OF COLUMBIA BAR
ALSO ADMITTED TO THE FLORIDA BAR
ALSO ADMIT1-ED TO THE MARYLAND BAR
ALSO ADMITFED TO THE NEW IERSEY BAR
ALSO ADMITTED TO THE NEW YORK BAR
NATIONAL BOARD OF TRIAL ADVOCACY CERTIFIED
RHOADS & SINON LLp
ATTORNEYS AT LAW
TWELFTH FLOOR
ONE SOUTH MARKET SQUARE
P.O. BOX 1146
HARRISBURG, PA :1.7].08-1146
TELEPHONE (717) 233-5731
FAX: (717) 232-1459
E M A I L: kmeals@rhoads-sinon.com
W E B S I T E: www.rhoads-sinon.com
October 17, 2003
Re: Estate of Florence Furfe¥ Hess
Cumberland County File No. 00091 of 2003
OF COUNSEL
HENRY W. RHOADS
RETIRED
JOHN C. DOWLING
PAUL H. RHOADS
1907-1984
FRANK A. SINON
1910-2003
3OHN M. MUSSELMAN
1919-1980
CLYLE R. HENDERSHOT
1922-1980
DIRECT DIAL NO.
(717) 231-6671
FILE NO,
8404/01
Register of Wills
Cumberland County
1 Courthouse Square
Carlisle, PA 17013
Dear Sir or Madam:
Enclosed are the following in connection with the above-captioned Estate:
2.
3.
4.
5.
6.
Pennsylvania Inheritance Tax Return, in duplicate, showing tax due.
Check in the sum of $23,053.55 in payment of tax due.
A copy of the Federal Estate Tax Return as filed with the IRS.
Inventory.
Check in the sum of $34.00 in payment of your filing fees for the Return and Inventory.
A copy of this letter, with the first page of Return attached, which we ask that you time
... stamp and return to us.
Enclosures
cc: Mrs. Ann Hess Myers
Ms. Molly Lynch Hess
Joanne Book Christine, Esquire
Very truly yours,
RHOADS & SINON LLP
rimberly Al Me~s
Legal Assistant
491239.1 YORK: AFFILIATED OFFICE: LANCASTER:
STE. 203, 1700 S. DIXIE HWY, BOCA RATON, FL 33432
TELEPHONE (717) 843-1718, FAX (717) 232-1459 TELEPHONE (561) 395-5595, FAX (561) 395-9497 TELEPHONE (717) 397-4431, FAX (717) 232-1459
Z
Z
0
O
Z
COMMONVVEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1 500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Ees s Florence
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
01/18/2003 08/03/1925
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
FILE NUMBER
__2j~ -- _~3__ __009~____
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
033-18-2322
THIS RETURN MUST BE fiLED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
~ 1. Original Return ~ 2. Supplemental Return I-'---I 3. Remainder Return (date of death prior to 12-13-8
~ 4. Limited Estate ~ 4a. Future Interest Compromise (date of d.th after 12-12-82) ~-~ 5. Federal Estale Tax Return Required
~-]§. Decedent Died Testate (Attach copy of Will) ~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) O 8. Total Number of Safe Deposit Boxes
~ 9. Litigation Proceeds Received ~1 10. Spousal Poverty Credit (d,m of de,th between 12-31-9~ ,,d ~-~-gB) ~1 11. Election to tax under Sec. 9113(A) (A~ch ScL
:::~i$::SE~0N::MU~T::BE::CO~Di :~ CORRESPONDENCE::~D: ::CONFiDE:~::TAX:: iNFO R:MAT~O ::::::::::::::::::::::::::::::: :: ::::::::::::::::::::::::::: ::::::
NAME
Joanne Book Christine, Esquire
FIRM NAME (If Applicable)
Rhoads & Sinon LLP
TELEPHONE NUMBER
717-233-5731
COMmiE MAILING ADDRESS
P. O. Box 1146, One S.
Harrisburg, PA 17108
Market Square
1. Real Estate (Schedule A) ( 1 )
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
§. JoinUy Owned Property (Schedule F) (6)
[~] Saporate Billing Requited
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Asseta (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
o. o o :.::::
73,081.54
0.00
0.00
380,019.93
0.00
98,801.13
(8)
37,095.86
2,505.70
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
(11)
(12)
(13)
OFFICIAL USE ONLY
551,902.60
39,601.56
512,301.04
0.00
512,301.04
14. Net Value Subjeot to Tax (Line 12 minus Line 13)
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate. or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.
0.00 x.o 0.00(15) 0.00
512,301.04 x.o45 (10) 23,053.55
0.00 x.12 (17) 0. 00
O. O0 x.15 (18) O. O0
(19) 23,053.55
[#; I ~M [g; I f1:1 i I g,,'JS]lgtl:t ~1 ;I 2alii a.-! i i i,.'q rs,,1 .-t a a ij ~ laze] ~,,1Lq lstTt a el -J.,,.%-4 &Td ~ ~ i a
: ::::::: ::':::':>:>'::BE:SURE:TO:.ANSWER:ALL:QUESTIONS :ON REVERSE- SIDE AND RECHECK MATH < <
HASPXXNUMBER
Oecedent's Complete Address:
STREET ^DDRESS
811 Messiah Village
Cumberland County
CITY
Mechanicsburg
STATE
IZiP
17055
Tax Payments and Credits:
1. Tax Due (Page I Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable D. Interest
E. Penalty
0.00
0.00
0.00
0.00
0.00
(1)
Total Credits (A + B + C) (2)
Total Interest/Penalty (D + E) (3)
23,053.55
0.00
0.00
0.00
23,053.55
4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Une 20 to request a refund
(4)
5. If Line 1 + Line 3 is greeter than Line 2, enter the difference. This is the TAX DUE.
(5)
A. Enter the interest on the tax due.
(5A) 0.0 0
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 23,053.55
Make Check Payable to: REGISTER OF W/U.S, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ....................... r-1 ~
b. retain the right to designate who shall use the property transferred or its income; ......... ~1 [~
c. retain a reversionary interest; or ................................ ~ r-~
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 decadent ov~t 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 peneltie~ of perjury. I ~',~*;.;&,'a that I hlv~ exam~ll~d this return, including aceoml~nl~ng ~heduisa end ~tetement~. and to the be~t of my knowledge and belief, it is ~'ue. correct end complete.
D~lfa~o~ of ~)l'~f~lr ~ thlrl ~ {[]~ol't~l f~l'~llte~l~ il ba~ed on all information of which pr®parer hal any knowisd;~.
SI;NAI~IqE~ OF ~RSON RE~ON~BLE FOR FIIJNG RETURN
DATE
!Lhoads & Sinon LLP, P. O. Box 1146 Harrisburg, PA 17108
ATURE OF PhEPAREB-OTHER THAN REPflESENT. ATLVE
RESS , ,
/oRhoads & Sinon LLP, P. O. Box 1146 Harrisburg, PA 17108
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rata imposed on the net value of transfers to or for the use of the surviving spouse ia 3%
[72 P.S,§ 9916 (a) (1.1) (i)].
For datex of dealt~ on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is O~ [ 72 P.S. § 911 ~ (a) ( 1.1 ) (ii)]
The statuta does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return ara still applicable even if
the aurviving Spouse ia the only benefi~iaW.
For datse of death on or after July 1, 2000:.
The tax rata 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 atepparent of the child ia 0% [72 P,S. § 9116(a)( 1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries ia 4.5%. except aa noted in 72 P.S. § 9116( 1.2) [72 P,S. § 911 §(a}( 1 )].
The tax rata imposed on the net value of transfers to or for the use of the decedent~s siblings is 12% (72 P.S. § 9116(aX 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.
HASPXXNUMBER
ATTACHMENT TO FORM REV-1500
Estate of: Florence Furfey Hess
Date of Death: 1/18/2003
SS#: 033-18-2322
Under penalties of perjury, I declare that I have examined this return, including accompanying
schedules and statements, and to the best of my knowledge and belief, it is tree, correct and
complete.
~Executrix
491078.1
REV-150~ EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
Florence Hess 21 03 0091
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
2
3
66 Shares
Household Intl Inc
Common
New York Stock Excha
CUSIP: 44181510
34 Shares
Phoenix Cos., Inc. New
1,552 Shares
PNC Finl Svcs Group Inc
Common
New York Stock Excha
CUSIP: 69347510
Dividend accrued on 01/18/2003
TOTAL (Also enter on line 2, Recapitulation) $ 7 3,0 81.5 4
HASPXXNUMBER (if more space is needed, insert additional sheets of the same size)
1,859.71
303.19
70,173.68
744.96
R~V-1508 EX ~ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Florence }less 21 03 0091
Include the ~roceecls of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. AT&T Refund 4.98
1997 Mercury Mountaineer Sport
Utility 4D vehicle
TOTAL(Also enter on line 5, Recapitulation)
Average of blue book trade-in
and private party values
Evergreen Cemetery
Burial Plot Lot No. 1319
Farmers refund on insurance
Decedent's husband, Jacob
Hess, Esquire, had some
involvement in the F. Edward
Hess Trust before his death.
This is a testamentary trust
which originated in the
Probate Court of Stark County,
Ohio and now holds assets with
an approximate value of
$14,000. No value has been
assigned to this Trust because
it is uncertain whether
decedent has any beneficial
interest in the Trust or will
ever receive a distribution
from the Trust.
IRS, 2002 Federal Income Tax
refund
Jewelry
Valued per attached appraisal
Kemper refund of insurance
Messiah Village, refund of
acquisition fee for
residential unit in retirement
community
Total from continuation pages
8,612.00
175.00
164.81
0.00
9,283.00
18,733.00
492.00
95,106.75
247,448.39
$ 380,019.93
HASPXXNUMBER (If more space is needed, insert additional sheets of the same size)
Schedule E (Page 2)
Estate of: Florence Hess
Item
No. Description
10 Phoenix Preferred Client
Checking Acct. #600100495
11 PNC Bank Checking Acct.
~50-0354-7741
Interest accrued to 01/18/2003
12 PNC Bank Money Market Acct.
~50-0190-2383
Interest accrued to 01/18/2003
13 PNC Bank Checking Account
#50-0202-6725
Interest accrued to 01/18/2003
14 Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Copies of Agreement of Sale
and amortization schedule are
attached
15 Sale of Walker
16 Household and personal
articles in decedent's
apartment at Messiah Village,
Mechanicsburg, PA
Valued per estimate of
Executrices
17 Travelers Checks
18 Verizon refund
Value at Date
of Death
57,659.53
6,465.31
1.08
158,375.18
165.90
12,531.60
3.82
10,719.37
50.00
1,000.00
450.00
26.60
Total (Carry forward to main schedule) 247,448.39
REV-1510 EX * (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
Florence Hess 21 03 0091
This schedule must be completed and filed if the answer to any of questions I through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DE~RI~ION OF ~OPER~ % OF
ITEM INCLUDE THE NAME OF THE T~NSFEREE THBR RELATION~IP TO DATE OF DEATH DECD'S EXCLUSION
NUMBEF DECEDENT AND THE DATE OF T~NS~R. A~A~ A CON OF THE TAXABLE VALUE
DEED ~R REAL ESTATE. VALUE OF ASSET INTEREST {~F APPU~S~)
1. At her death, decedent was
receiving distributions from
FirstMerit Bank, N.A., Trust
Company, Trustee for the Lesh
Casner & Miller 401(k) plan
and employee rollover accounts
of decedent's deceased spouse
with a total date of death
balance of $49,849.36.
Decedent was the primary
beneficiary on these accounts
during her lifetime.
Contingent beneficiaries are
Decedent's daughters, Ann H.
Myers and Mary Lynch Hess.
These accounts are not
includible in Decedent's
estate as she had no incidents
of ownership in them. 0.00 100.000 0.00 0.00
2 MassMutual Annuity Contract
#I-42434
Beneficiaries: Decedent's
daughters, Ann H. Myers and
Mary L. Hess. 85,769.47 100.000 0.00 85,769.47
3 FirstMerit Bank N.A. IRA
Account #5101-6001-9673.
Beneficiaries: Decedent's
daughters, Ann H. Myers and
Mary Lynch Hess. 8,225.96 100.000 0.00 8,225.96
Interest accrued to 01/18/2003 6.97 100.000 6.97
4 FirstMerit Bank, N.A. IRA Acct
#100-0700-1086.
Beneficiaries: Decedent's
daughters, Ann H. Myers and
Mary Lynch Hess. 4,797.19 100.000 0.00 4,797.19
Interest accrued to 01/18/2003 1.54 100.000 1.54
TOTAL(AI~ en~ronline7oR~apitulation) $
98,801.13
(If more space is needed, insert additional sheets of same size.)
HASPXXNUMBER
Schedule G (Page 2)
Estate of: Florence Hess
Item
No. Description
At her death, dececent was
receiving a monthly annuity
payment of $139.57 under
Hartford Life Contract
#GA20187-0002. All payments
under this Contract ceased at
decedent's death.
DOD Value
of Asset
0.00
% Int.
100.000
Exclusion
0.00
Taxable
Value
0.00
Total (Carry forward to main schedule) 0.00
REV-151~l EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Florence Hess 21 03 0091
Debts of dem~lent must be reported on Schedule I.
ITEM
NUMBER
FUNERAL EXPENSES:
2
DESCRIPTION
Kurt Myers: Post Funeral
Lunch
Lamiell Funeral Home
Funeral Expenses
Neil Funeral Home
Funeral Expenses
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State PA Zip
Year(s) Commission Paid:
Attomey 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
Probate Fees
Accountant's Fees
Tax Return Preparer°s Fees
City of Boston
Charge to Record cemetery lot
change of ownership from
Florence Hess to Ann Myers
Cumberland Law Journal
Legal Advertisement of Letters
Testamentary
Total from continuation pages
AMOUNT
161.96
3,259.40
6,950.64
25,000.00
354.00
5.00
75.00
1,289.86
TOTAL (Also enter on line 9, Recapitulation) $ 37,095.86
HASPXXNUMBER (If more space is needed, insert additional sheets of same size)
Schedule H part 2 (Page 2)
Estate of: Florence Hess
Item
No. Description
Amount
Dauphin County Register of
Wills
Co-Executors Oath
Lesh Casner Miller
Tax preparation fees
RESERVES: Rhoads & Sinon, LLP
Out of Pocket Expenses:
Telephone - $26.33; Federal
Express - $38.19; Postage -
$22.18; Stock Evaluation -
$9.30; Photocopies - $95.55;
Fax - $47.00; Reserves:
Filing first and final
accounting - $25.00;
Additional Expenses - $100.00.
The Patriot-News Co.
Legal Advertisement of Letters
Testamentary
15.00
764.00
363.55
147.31
Total (Carry forward to main schedule) 1,289.86
REV-1512EX+(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS OF DECEDEN%
MORTGAGE LIABlU~ES,& LIENS
ESTATE OF FILE NUMBER
Florence Hess 21 03 0091
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1.
lO
AT&T
Telephone charge
Checks clearing after
Decedent's Death
Kurt Myers
Reimbursement for the
following: PP&L $22.22
(Messiah Village); Verizon
$22.56 (Messiah Village);
Susquehanna Internal Medicine
(medical bill) $1.92; Quantum
(medical bill) $1.26; Moffit
Group (medical bill) $14.79;
Bank One (Credit Card bill)
$55.31; MBNA (Credit Card
bill) $394.69;
Messiah Village
Balance due
Moffit Group (Medical Bills)
PA Department of Revenue
PA 2002 income tax
PP&L Electric Utilities
Electric Bill for Messiah
Village
Quantum Imaging and
Therapeutic
Verizon
Telephone Bill
West Shore Anesthesia
Medical Bill
TOTAL (Also enter on line 10, Recapitulation)
28.34
417.86
512.75
1,101.34
49.47
303.00
17.77
8.74
22.37
44.06
$ 2,505.70
HASPXXNUMBER (If more space is needed, insert additional sheets of the same size)
REV-15~I 3 EX+ (9..00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Florence Hess 21 03 0091
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Eat Trustee(s) OF ESTATE
II.
TAXABLEDISTRIBUTIONS[includeoutHghtspou~ldi~Hbutions, andtransfem
underS~.9116(a)(1.2)]
Mary Lynch Hess
P. O. Box 11
Ashton, MD 20861
One-half annuity and IRA's,
$49,400.57
One-half residue, $179,550.90
Ann Hess Myers
111 Bramblewood Lane
Lewisberry, PA 17339
One-half annuity and IRA's,
$49,400.56
One-half residue, $179,550.89
)aughter
Daughter
228,951.46
228,951.45
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
$
HASPXXNUMBER (If more space is needed, insert additional sheets of the same size)
2.
3.
4.
ESTATE OF FLORENCE FURFEY HESS
SSN: 033-18-2322
DOD: 01/18/2003
PENNSYLVANIA INHERITANCE TAX RETURN
INDEX TO EXHIBITS
Document
Last Will and Testament
Appraisal, Jewelry
Agreement of Sale and Amortization schedule, Boat
Calculation of residue
Return Reference
Page 1, Line 8
Schedule E, Item 7
Schedule E, Item 14
NUMBER
Last Will and Testament
OF
FLORENCE FURFEY HESS
I, FLORENCE FURFEY HESS, a resident of Jackson Township, Stark County, Ohio, being of full age
and of sound mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby
revoking any and all Wills and Codicils by me heretofore made.
ITEM I. I direct that all my just and legal debts and expenses of my last illness and funeral
be paid as soon after my death as may be practicable, except that the payment of
any debt secured by a mortgage or pledge on real or personal property may be postpOned at the discretion of my
Executor. I further direct that all estate, inheritance or other succession taxes of any nature arising by reason of
my death shall be paid from my estate as an expense of a~ninistration without any right of reimbursement from
beneficiaries of life insurance policies or donees of any gifts which may be included in my taxable estate or any
similar beneficiaries receiving property other than through the administration of my estate.
ITEM H. All the rest, residue and remainder of my estate, be the same real, personal or
mixed, of every kind and description, wheresoever situate, which I may own or
have the right to dispose of at the time of my decease, I give, bequeath and devise to my husband, JACOB F.
HESS, JR., to be his absolutely and in fee simple.
ITEM HI. In the event that my husband, JACOB F. HESS, JR., should predecease me, or
in case of the death of my husband and myself in a common casualty or accident
or catastrophe, or under such circumstances that it cannot be readily determined which of us died first, or if by
statute or operation of law it be determined that my said husband predeceased me, then the provisions made for
my said husband in this Will shall not succeed to him, but I give, bequeath and devise all the rest, residue and
remainder of my estate in equal shares to my daughters, ANN HESS MYERS and MARY LYNCH HESS, or
their issue, per stirpes.
ITEM IV. I make, nominate and appoint my husband, JACOB F. HESS, JR., to be the Exe-
cutor of this, my Last Will and Testament, hereby authorizing and empowering
my said Executor to compound, compromise, settle and adjust all claims and demands in favor of or against my
estate, in such manner and upon such terms as he may deem best; and to sell, at private or public sale, at such
prices and upon such terms of credit or otherwise as he may deem best, the whole or any part of my real or
personal property, and to execute, acknowledge and deliver deeds and other proper instruments of conveyance
thereof to the purchaser or purchasers; to execute proxies, and to sell, assign or transfer certificates of stock,
bonds, bank accounts or other securities. In the event that my said Executor should desire to employ the services
of a real estate broker to assist him in the sale of any real estate in my estate, I hereby authorize my said Executor
to employ the services of a real estate broker and to pay such real estate broker the standard and customary
broker's commission therefor. I request that no bond be required of my said husband, Jacob F. Hess, Jr., as such
Executor.
ITEM V. In the event that my husband, JACOB F. HESS, JR., shall predecease me or lack
legal capacity, or refuse to act as Executor, then I make, nominate and appoint
our daughters, ANN HESS MYERS and MARY LYNCH HESS, to be the alternate Executrices of this, my Last
Will and Testament, in which case the powers and authorities granted my Executor as provided in ITEM IV hereof,
shall apply to my alternate Executrices. I further request that no bond be required of my alternate Executrices.
IN WITNESS WHEREOF, I have hereunto set my hand at Canton, Ohio, this / ~/- day of March,
1999.
Florence Furfe~y/teSs
Last Will and Testament of
FLORENCE FURFEY HESS
Page 2 of 2 pages
Signed by the said FLORENCE FURFEY HESS, and by her acknowledged to be her Last Will and
Testament, before us and in our presence and b~ ?7~.~subscribed as attesting wimesses in her presence and at her
request and in the presence of each other, this day of March, 1999.
residing at
c:\wiils~hcss.f~rf
F.F.H.
NUMBER
ESTATE OF FLORENCE FURFEY HESS
Totals from appraisal of jewelry
Total from Page 4
Total from Page 10
Total
Sales Tax Total from Page 4
Sales Tax Total from Page 10
Total Sales Tax
1,690.00
17,043.00
18,733.00
101.40
1,022.58
1,123.98
491152.1
Insurance Replacement Cost Documentation
Prepared
For
Florence Hess
P.O. Box 2'015
811 Messiah Village
Mechanicsburg, PA 17055
Prepared by:
Date:
Linda L. Cunrangham G.G.
Certified Gcmotognst, AGS
I 1/16/2001
Page I of 2
3,,q0 Trindle Road · Camp I-Jill. PA 17011 · (717) -r.-
,. ua-I !99
x~,~,'M,' FIIOLi.~,.[ZjCWelefS. COIl3.
ROLEX
otllers~ho ' "'
Tile intended tnethcd of i'ep~acemcnt is with a new iten~ of like killd.
Evew elTo~ ~as bc¢,~ made to grade the gemstones described in fids docu. ment as accurately as posstNe
within the Retreat a. ad reasonable gemological ranges. Opi~ons of quaii~' and grade nmv vaD' upon
rec.,camioalion by at~orher qualified gemologtst.
Unless other,.~'i~c stated, all gelllStOlle w~:ights, grades and measurements are approximate ;md stones have
not been removed from th.eir mountings
Diamond~ are gradcd with lhe proscribed grading nomenclature of the Oemological Institute of America
and thc use o.t' pre-graded permanent rnasler diamond color comparison stones and are graded under
correcmd light - daylight equivalent.
Urtless othcrx~ tse stated, all colored stones listed on this appraisal report have probably bccn subjected to a
stable and possibly .mdetectable color e~dmncement process. Prevailing market values are based on these
tmk. crsatl) practiced and accepted processes by tile gems and jeweh? trade.
Eve~7 etfor, has been made to determine th.e metal identity and fineness of an5' mounl~tgs described in th. is
doeumeat as accurately as posi;ible without fl~e use of daumging tests.
Unless expressly stated, the condition of the item(s) appraised is good. ,-Mty serious deficiencies and
repairs :irc no[ed Ordinary wear and tear is not noted.
Thc gold market on the date of this report is $279.20 US per otmce.
Certification
I hercb~ :ertifs.' that. to the best of my knowledge a.nd
· Thc statements m tttis document are tree and correct including representation of q'uali~, and quanta>,-.
· [ have made a persomd inspection of the propert>.' unless othem'i$¢ stated.
· Although neither my compenmtion nor the eon.~.mmlation of any sale is contingent upon the reporting
of any prccletermirted replacement co~x, thin document may have been provided as cx, idence of the
quality or a purchase ~tmd¢ fxom Mountz Jew¢lem.
· Tlxe repiacmnent cost estimate is thc most common acrtml salcs price of lh¢ s.'*mc, identical or fiflly
comparable property if sold by Motmtz Jexv¢lcm at this time.
· I am competent to ~den~'. and deterrmne the relative quality of the ~:bject property, which zs szmilax
to imnm normally bought mid sold by Mountz Jewelers. All sigrti.ficm~t characteristics affecting the
replacement co~t have be~n reported.
Lmda L. Cumnngham G.G.
Cert~fi::'d Gemologist, AGS
I 1/,~,..:Ob l
Page 2 of 2
Prcl)ared For:
Box 20 [ 5
[ 00 Mt Allen Drive
Mechantcs~c. rg, PA
7055
Date: 6,'5,'2002
Item I
Tiffaay & Co. "Scribble" Gold Brooctl
One 18K ye[!ow gold brooch, signed "Paloma Picasso ,~ 1983 TIFFANY & CO. I8K". The brooch is 1
7<$" Itmg, approximately [ 3/$" wide, with a tapered zig zag desigm that ends i~ a curved poi~t. The brooch
has a ~m~ged pm and catch on the back. 9.2~.
Total Approximate Retail Value
6.00 % Tax
Total Approximate Retail 'Value Including '['ax
~725.v0
S43
S765.50
Item 2
Gold Heart Necklace
One 14K .x. etiow gold heart pendant,custom made firom a 3.gnm~ wide low domed Plah~ wedding band that
~'as rut into p, vo ?ec~.'s add soldered, rl~e heart ~s I" long, 21. Imm wide a~d. has a solid bail soldered m
the cica. ]'he t~o halves or'the heart overlap at tho bottom. 'llle heart aPpe~s to be en~avcd 'FM.F and
TFH September 1 i. 1949' ,'u~d Js stamped "IFFANY & O 14K". Some of the letters are worn or
obliterated by qoldcr. 5.Sgr.
Chain Attributes
Desigu: Rope
Length \x,'"tdth: 20.00 inches / 1.40 mm
Metal ryp~' 14K yellow gold.
Clasp: Lobster cla,~'
Comments: Stamped "14K"; 3.38'r
Total Approximate Retail Value
6.00. % Tax
Total Approximate Retail Yalue including Tax
S665.00
$39.90
S704.90
Page 3 of 4
item 3
Bracclct
O~qe J.IK >utlo~ '_-'.old bracelet', 7 1 '4" long: 4.5~m wide curb li,~k with hi(lden box c'.aisp a~zd fi'-'ure 8
safer~ No n'ademark. Stamped "14K" on clasp 10.0gr: ~
Total Approximate Retail
6,00 % Tax
Total Approximate Retail Value Including Tax
One thousand seven l~undred ni~i~-one dollars and. forty cen ts
Signature of P,-eparer~L Linda ~.'(Sum.lLrlgham. G.G. ~' .....
Certified Gernotogist, AGS
$30000
Page ,t of 4"
Prepared F'or:
Florence i~ess
PO. Box 20 ', _4
811 Messiah Village
Meclk'~mcsburg. PA 170_55
Date:
Item 1
Ring
Or',¢ ',ady's I4K vcllox~ gold diamond solitaire engagement ring. This nng contaans one old Europea~
diamond in a .s:x pro'ag, wi:itc gold head. The ring is finger size 7 1/2 a~d is stamped "S.C &L Co" on the
inside.
Diamon(! Attributes
Shape axed cut: Old European
.Measurements: 5.01 x 5.06 x 3.25 mm (acttml)
WclghL 0.55 Cts. (estimated)
Clarity: Si-1
Color J
Total ApproyAmate Retail Value
6.00 % Tax
Tolal Approxinmte Retail Value lnchkding Tax
$1,945.00
$116.70
$2,061.70
/tern 2
Ring
One laci?'s i ,XK ','al!ow gold diamond engagement ring. This ring contains one round brilliant cut diall~ortd
set in a s~.x prong platmmil head. The ring is stamped "Tiffa.uy & Co" and halld engr~vcd "JFH to F?vfF '~
1947.'
Diamoud Attributes
Slxape a;~d cut Round brilliant
Measurements' 5,62 x 5.66 x 3.25 mm (actual)
Weight' 0.63 Cts. (e~tix~ted)
Clar~ fy' SI- I
Color' 1
Comlllclltf: C~p on girdle
Total Approximate Retail Vzdue
6.00 % Tax
Total Approxiraat¢ Retail Value Including Tax
$3.36.5.00
$201,90
$3.566.90
Item 3
Ring
One ! gK ycllow gold wedding band. The ring is finger size 7 1/2, is sta.mped "Tiffimy a Co" and hau~d
;ngJ'aved "tuber l 1. 1949 ,rF'H&F?" The ring weighs 2.1 gxams. This ring matches Ltem ;2.
Total Approxinmt¢ Retail Value
6 00 % Tax
Total Approximate Ret;ul Value Including Tax
$175,00
$10.50
$18550
Page 3 of 4
Orlc IJK :.ellow go{d sapphire fashion ring. This ring contains three bead set round cut s~,pphires. The
mig is fiag¢.r srzc 8
Sapphire .'~lclee Am-ibute.~
Measurements 3.5 mm
Nulnl:;er~ 3
Cotof $1icJhtly purplish l:)lue
Total Approximate Retail Value
6.00 % Tax
Total Approxin~- te Retail Value Including Tax
$400.{Y0
$24 00
$424.00
Item $
Earrings
One pair of 14K yellow gold non-pierced scr~v back pearl eamngs. These earrings each contain one 6.5
mm cultured pc~arl. The back of the post is engraved with an "F. ~
Pearl Attributes
N umber: 2
Size: 6-1/2 mm
Color: Cretan/rose
Shape: Mostly round
Luster Low
Nacre fl~ickness: Ttfin
Blemishes: Slightly blemished
Matching: Good
Total Appmxinmte Retail Value
6.00 % Tax
Total Approximate Retail Value Including Tax
$115 O0
$6.90
$121.90
Item 6
B rooch
One lady's 14K >~llow gold pearl pin.
with fourteen 4 - 4.5 mm pearls.
Pearl Attributes
Nurttbcr:
Size:
Color
Shape
Luster:
Nacre ttfickness:
Blemishes:
This pin contains fourleen, 3 - 3.5 mm cultured pearls alternating
14
3 rrut~ to 3-1/2 nun
\Vhitc/rose
Mostly round
Mexlium
Very slightly blemished
Good
Page 4 of 4
14
4 n~n~ to 4~!/2 null
~3,'hite/rose
Mostly round
Medium
Very. slightly blemished
Good
Total Approxlrmtt¢ Retail Value
6,00 % Tax
Total Approximate Retail V-due Includiag Tax
$370OO
S22.20
$392.20
Item 7
Necklace
One lady's 24" knolted pearl necklace. This necklace contains eigh .ty nine pearls. These pearls measure
approximately 6 - 6 5 mm m diamelcr The necklace has a 14K yellow gold. fish hook clasp.
Strung Pearls
Strand length: 24 inches - Matinee
Number of stra~ds: I
Number of pearls: 89
Size. 6 ~mn to 6-1/2 wan
Color: White/rose
Shape: Mostly round
Luster: Medium
Nacre thlckllcSs: .Mediulll
Blemishes: Slightly blemished
MatchJng: Good
Total Approximate Retail Value
6.00 % Tax
Total Approximate Rcm,il Value Includiag Tax
$1,650.00
$99.00
Sl,749.00
Item 8
Necklace
One lady's 15" cultured pearl necklace. This necklace contains ninel.y nine unknottcd pcarts. These pearls
measure approximalely 3.5 - 4 mm in diameter. The clasp is a 14K white gold fish hook style.
Strunll Pearls
Strand length: 15 inchcs- Choker
..Number of strands: 1
Number of pearls: 99
Size: 3-1/2 mm to ~ ntm
Color: WkiteJgreen
Shape. Mostly round
Luster: Medium
Nacre thickness: Medium
Blemishes: Slightly blemished
M'at ching: Good
Page 5 of 5
Item 9
Necklace
Total Approxmlate Rer,'ul Valuu
(, 0,(} %,
Total :kpproximat¢ Retail Value Lnclud.mg Tax
5475.0,0
S503 50
One lady's 14K ycllo~v gold bead necklace. Tiffs 15" pendant rope chain contains sixty linc. 6 0 mm
hollow gold beads. 'l'he necklace weigh 3.94 DWT and kas a spring ring
Total Appro.xinmtc Retail Value
6.00 % Tax
Total Approxinmt¢ Retail Value [nclu4ing Tax
$278.00
$16.68
$294 68
Item 10
Earrings
One pair of lady's 14K yellow gold, non-pie~reed, ser~v back. diamond earrings. The is one round brilliant.
cut. diamond prong set itl each earring.
Diamond Melee Attributes
Shape and cut: Round full cut
Measurements: 3.62 mm
Number of diamonds: 2
Total Weight: .38 cts, (estimated)
Clarity: S1-2
Color: I
Comments:
Total Appro,,dmate Retail Value
6.00 % Tax
Total Approxiroat, Retail Value Including Tax
$725.00
$43.50
$768.50
Item 1.1
Necklace
One lady's 14K yellow gold bead ru: 'cldacc. The 18" pendant rope chain contains ninety s}x, 5 mrrk hollow
gold beads. The necklace weighs 3.8l DWT and N~s a spnng ring clasp.
Total Apprommate Retail Value
6.00 % Tax
Total Appro.xmmte Retail Value Including Tax
$26000
$t5.60
$275.60
Page 6 of 6
Item 12
Brnoch
Onc 1SK :,cllow gald Paloma Picasso. Hug & Kisses brooch. This ))i~'~ weighs appro.,.imatci~ 2 97 DWT
2aid is stanip_ed-" 1983 Tiffany & Co."
Total Approximate Retail Value
6,00 % Tax
Total Apptoxima£e Retail Value Including Tax
$525.00
$31.50
$556,50
Item 13
Brooch
One 18K yellow gold Paloma Picasso wave brooch. This pin weighs approx-imately 2.3 D~VT and is
sh~npcd "T&Co."
Total Approxirmlte Retail Value
6.00 % Tax
Total Approximate Retail Value Including Tax
$495.O0
$29.70
$524.70
Item 14
Brooch
One 14K yellow gold A,G.A. Cortes lovers knot pin. This pin weighs appro,xi.n~tely 2.3 DWT and is
stamped "A G. ^."
Total Appro,ximate Retail Value
6.00 %
Tolal Apprommate Retail Value hlclucling Tax
$26000
$2?5.6O
Item 15
Brooch
One 18K yellow gold A.G.A. Cortes .large sailboat brooch. The brooch weighs 2.70 DVv~I' and is stamped
"A.G.A."
Total Approxmu~tc Retail Value
6.00 % Tax
Total Approximate l~etml Value l. ncludi.ng Tax
S320.00
$I9.20
$339.20
Page 7 of 7
hem 16
Bracelet
One 14K yellow gold rope bracelet. This bracelet measures approximately 7" long and 4 tmn ~-ide. The
bracelet is stamped "I 4K" and "PAT 4170809" and weigh~ 10.69 grams "
Tolal Approximate Retail Value
6.00 % Taxx
Total Approxinmte Retail Value Including Tax
Item 17
Brooch
One 14K yellow gold free/btm pin.
The pin is hollow a. nd weighs 1.31 DWT.
$29500
S17.70
$312.70
Total Approx/matc Retail Valuc
6.00 % Tax
Total Approximate Retail Value [ncludfl~g Tax
$135.00
$8.10
$14}.10
Item 18
Brooch
One l SK yello~ gold Tiffany ~eagull brooch. The brooch weighs 4.17 DWT and is stamped "Tiffany &
Co.'
Total Approximate Retail Value
6.00 % Tax
Total Appro,,cimate Retail Value Including Tax
$600.O0
$36O0
$636O0
Item 19
Earrings
One pair 14K yellow gold, non-piercexl, screw back. button earrings. The earm~gs are
diameter.
Total Approximate Retail Value
6.00 % Tax
Total Appromrmate Retail Value Including Tax
$90.00
$5.40
$95.40
Page 8 of 8
£an'iags
One parr i *K y¢llox~ golct. ~ade, non-pterced, screw back e,qrrings, These earrings each contain one heart
shaped p~e,¢ {>l-lade p~ong scl itl a rtbben designed mounting.
Total Approxinmte Retail Valu~
6.00 % Tax
Total Approxinmte Retail Value Including 'Fax
$280.00
516.80
$296.80
Item 21 ' ·
B rooch
One 14K yetlow gold. Jade brooch. This piece contain two oval, cabochon cut pieces of Jade/'or prong set
in a ribbon designed mounting. The brooch is 10.5 x 6.7 nun.
Total Approximate Retail Value
6.00 % Tax
Total Appro.,amate Rctail Value Inclmting Tax
$350.00
$2t.00
$371.00
Item 22
Pendant
One sterling silver locket. This locket measures 1 1/4" in diameter. The front of this piece is en~aved
with a flower design and the back is engraved with the dates 9-1149 and'9-11.7¢.
Total ApProximate Retail Value
6.00 % Tax
Total Appro.,dnmt¢ Retaul Value laicludh~g Tax
$40:00
$2.10
$4240
Item 23
Pendant
One latly. 's 14K yellow gold pendant and chain. The pendant contains one bezel ~t 2.8 mm round cut light
blue sapphire mount-o:l above ,~mzen, 1.$ mm ged pearls. This penfl,'mt hangs from a 16" trace chain that is
1.3 nlm v~-id~ with a spring ri~ clasp.
Total Approximate Retail %flue
6.00 % Tax
Total Approximate Re/al Value Including Tax
$300.00
$18.00
$318.00
Item 24
Bracelet
One 5even iuch. 14K yellow gold charnl bracelet contain/ag the following nine charms: Sailboat, red and
white pennant trice flag with blue stars, blue pennant flag with gold stars, Chesapeake Bay map charm
two. 0] carm, single ;ut diamonds, large clipper ship. Martha's Vineyard tmq~ cham~ wtth two, .0 l
single C[ll din mortals, cross section of a boat engraved "Florence Oakland Oyster Bay.' Long Island Sound
Page 9 of 9
:nap eh:lrm wttli tv, o, 0l carat, single cut dtamunds, and ~vhite and red flags Tile dlamOrtd.q are all SI m
clant~ and H-I :n color. Thc bracelet x~zighs 36 60 DWT.
Total Approximate Retail Value
6.00 % Tax
Total Approximate Retail Value lnc[ucling Tax
$1,700.00
$.102.00
$I.802 00
Item 25
One seven i~mh. t4K yellow gold chan~ bracelet containing the following eight nmrlt~me charms: yellow
flag ~ith black spot. yellow and black checkered flag, red and yellow diagonal flag, white flag with red
"X," btue ~md red llonzot~tal flag, yellow flag with red diagonal stripes, yellow and red diagonal flag~ red
auld white checked flag. Thc br,ncele! ~x~ighs 15.9l DWT
Total Approximat~ Retail Value
6.00 % Tax
Total AplXoxjm~e Retail Value Including Tax
$1,395.00
$83.70
$1,478.70
Item 26
Watch
One lady's 14K yellow gold Hamilton watch.
T386172. seventeen .jewel.
Ca~ ~S337060, calibre 911, movement serial nmnber
Total Aplxoximate Retail Value
6.00 % Tax
Total Appro.,dmate Retatl Value hlclucKng Tax
$500.00
$30.0O
$530.00
Eighteen thousand .sixty-five dollars and fifty-eight cents
Linde L. Cunningham G.G. /
Certified C-emologi~t~ AGS ~
Page 10 of IO
NUMBER
AGREYM'ENT ~. ~'
A!~'~m_cnt enter~cl into at Massillon, Ohio effective the 20'~ day o£March. 2000 by and
between FLORENCE F. HESS (IlF_..SS) of Massillon, Ohio and SEAN McLINI)EN, M.D.
(McLINDEN) of Sewickley, PA,
WITNESSETH:
WlIEPd2AS, Hess is interested in selling her Florence Oakland sailboat and is willing to
provide financing to the buyer upon certain terms and condition~, and
WIJfl~REAS, McLinden is w~tllng to purchase such sailboat upon such proposed terms.
NOW, THE. REFORM, in consideration of the foregoing and of the mutual provisions and
obligations set forth herein tl~e parties agree that:
(l) Ilcss agrees to sell and McLinden agrees to purchase the l:]orencc Oakland sailboat
for thc purchase price of $25,000.00 and subjec~ to the terms ofthi~ Agreement grants immediate
possession of the Sailboat to McLinden. McLinden shall pay back purchase price together witk
interest at the rate of five percent (5%) per annum in 60 equal monthly installments of not less
than I;471.79 each with the tint such installment paid upon signing this Agreement and each
subsequent installment to be due on thc same day of each month thereafter until 4--1-2005 when
the remaining bal,'mce of purchase price and othcr charges is fully due and payable. McLinden
may prepay the purchase price in whole or in part any time without penalty. If any installment is
eot recc4ved on or before its duo date, a late ch~ge of 820.00 shall be imposed. It' any monthly
inmallmcn[ is not received when duc, Hess shall notif7 McLinden ofguch default by mailing a
written notice to McLindcn at 247 Dawson Ave., Sewickley, PA. 15143 or to suclt other addrezs
a~ may be provided to Hess by McLinden in writimg ~rom time to time. ' Such notice shall be
cfl~ctive wb. cn rmfiled. If any irmtallmen~ is not paid within fifteen (15) days after its due date,
tho entire balance w/ll be immediately due and payable.
(2) Until thc purchaze pric= and other chargcs provided herein are paid in full. the sailboat
will remain titled to. Iless. Eac}x year Iless will license and insure the sailboat. The casualty
insurance coverage will be $25,000.00. lfat anytime Hess i~ unable to obtain such insurm~ce or
il' a[ anytime the premiums for mcr insurance is unreasonably high in MeLinden's judgment,
McLinden may ~cl. ect an insuramce carrier to provide such coverage m Hess. In the evem of los,
thc proceed.~ from stroh po[icy shall be retained by Hess to the extent of the balance due to her
under this agreement and she will remit thc surplu.% if any, to McLin&n. From time to time,
Hess will provide McLinden with w'rit~en evidence ofl~cr expenditures for licensing and
insurance and a statement requesting reimbursement. Upon receipt of such stazemcnt, McLinden
.shall promptly reimbume Hess for such. expenses. Such reimbumement shah bo due and payable
no later than r. lfizty (30) days after suclx statcment is received by McLinden. Failure to pay any
ZO0~ (IHO¥ ~gt9 ~A~ ZI~ .VYH ~0:~I 00/$Z/£0
such reimbursement when due slmll entitle Iless to declare the ~ntire r~maining contract balance
to be immediately du~ and payable.
During the terms of this Agreement, McLindcn shall maintain public liability insurance
upon thc sailboat, if not provided under the IIcss policy. The policy Iimits lbr such coverage
shall be not less than $$00,000.00 and the policy will designate both Hess and McLinden as
insured$. McLinden will provide Itcas each year with a certifica~ of such insunmee coverage.
McLinden will indemnify and hold Hess harmless from loss) damages, liability and
cxpcrtse t~sulting from and/or MeL/nden's possession and use ofth~ ~,xilboat during the terms of
this Agrecment.
(3) McLindea acknowledges that he is buying the sa/lbo~t in its "as is" condition and th~:t
it ct:rrcntly is in nccd of'some repairs. McLindcn will be solcly respons£ble for all maintenance
and repairs to the sailboat.
{4) In the evcnt that McLind~n d~l'aults in payment of any obligations to Hess pursuant to
this Agr~',.mcnt, I-tess sha/l be entitled to immediate possession oft/ac sailboat -,nd McLinden
shall Lhen, immcdiatcly upon demand, deliver tho sailboat to Hes.~ in Massillon, Ohio. In
addition, Hess shall bc entitled to all oth~ remedies available under law.
(5) 'llfis Agreement stroll be governed by the laws o£the etat~ o£Ohio and sets forth the
entire understanding of the parties. Both parties consent to jurisdiction over their person in 8turk
County, OMo and waive th:ir right to jta. y trial.
TN WITNESS W~I:L~OF, we have hereunto set our hands this
day o '_/qaax, L ,2ooo.
Signed and acknowledged in thc
presence of':
FLORENCE, F. HESS
~00~ (IH2¥ R~a ~LR ~f X'YJ 90:~1 O0/6Z/~O
Hess Estate- Boat
Compound Period ......... ' Monthly
Nominal Annual Rate .... ' 5.000 %
CASH FLOW DATA
Event Date
1 Loan 03/20/2000
2 Payment 04/20/2000
3 Payment 07/20/2000
4 Payment 08/20/2000
5 Payment 09/20/2000
6 Payment 11/20/2000
7 Payment 02/20/2001
8 Payment 10/20/2001
9 Payment 11/20/2001
10 Payment 03/20/2005
Amount
25,000.00
471.79
327.32
3,039.93
414.00
480.67
414.00
1,388.90
414.00
601.94
10/06/2003 9:55:57 AM Page 1
AMORTIZATION SCHEDULE - Normal Amortization
Date Payment
Interest Principal Balance
Loan 03/20/2000 25,000.00
1 04/20/2000 471.79 104.17 367.62 24,632.38
2 05/20/2000 471.79 102.63 369.16 24,263.22
3 06/20/2000 471.79 101.10 370.69 23,892.53
4 07/20/2000 327.32 99.55 227.77 23,664.76
5 08/20/2000 327.32 98.60 228.72 23,436.04
6 08/20/2000 3,039.93 0.00 3,039.93 20,396.11
7 09/20/2000 414.00 84.98 329.02 20,067.09
8 10/20/2000 414.00 83.61 330.39 19,736.70
9 11/20/2000 480.67 82.24 398.43 19,338.27
10 12/20/2000 480.67 80.58 400.09 18,938.18
2000 Totals 6,899.28 837.46 6,061.82
11 01/20/2001 480.67 78.91 401.76 18,536.42
12 02/20/2001 414.00 77.24 336.76 18,199.66
13 03/20/2001 414.00 75.83 338.17 17,861.49
14 04/20/2001 414.00 74.42 339.58 17, 521.91
15 05/20/2001 414.00 73.01 340.99 17,180.92
16 06/20/2001 414.00 71.59 342.41 16,838.51
17 10/20/2001 1,388.90 282.40 1,106.50 15,732.01
18 11/20/2001 414.00 65.55 348.45 15,383.56
19 12/20/2001 414.00 64.10 349.90 15,033.66
2001 Totals 4,767.57 863.05 3,904.52
20 01/20/2002 414.00 62.64 351.36 14,682.30
21 02/20/2002 414.00 61.18 352.82 14,329.48
22 03/20/2002 414.00 59.71 354.29 13,975.19
23 04/20/2002 414.00 58.23 355.77 13,619.42
Number Period End. Date
1
3 Monthly 06/20/2000
2 Monthly 08/20/2000
1
2 Monthly 10/20/2000
3 Monthly 01/20/2001
5 Monthly 06/20/2001
1
40 Monthly 02/20/2005
1
Hess Estate - Boat
Date
Payment
414.00
414.00
414.00
414.00
414.00
414.00
414.00
414.00
4,968.00
24 05~0/2002
25 06/20/2002
26 07/20/2002
27 08~0/2002
28 09/20~002
29 10~0/2002
30 11/20/2002
31 12/20/2002
2002 Totals
32 01/20/2003
33 02/20/2003
34 O312O~20O3
35 04/2012003
36 05/20/2003
37 06/20/2003
38 07/20/2003
39 08/20/2003
40 09/20/2003
41 10/20/2003
42 11/20/2003
43 12/20/2003
2003 Totals
414.00
414.00
414.00
414.00
414.00
414.00
414.00
414.00
414.00
414.00
414.00
414.00
4,968.00
10/06/2003 9:55:57 AM Page 2
44 01/20/2004
45 02/20/2004
46 03~20~2004
47 O4/20/2004
48 05/20/2004
49 06/20/2004
50 07/20/2004
51 08/20/2004
52 09/20/2004
53 10/20/2004
54 11/20/2004
55 12/20/2004
2004 Totals
414.00
414.00
414.00
414.00
414.00
414.00
414.00
414.00
414.00
414.00
414.00
414.00
4,968.00
56 01~0~005
57 02/20D005
58 03/20~005
2005 Totals
414.00
414.00
601.94
1,429.94
_l~terest Principal ......... Bala~.ce
56.75 357.25 13,262.17
55.26 358.74 12,903.43
53.76 360.24 12,543.19
52.26 361.74 12,181.45
50.76 363.24 11,818.21
49.24 364.76 11,453.45
47.72 366.28 11,087.17
46.20 367.80 10,719.37
653.71 4,314.29
44.66
43.13
41.58
40.03
38.47
36.91
35.33
33.76
32.17
30.58
28.98
27.38
432.98
25.77
24.15
22.53
20.90
19.26
17.61
15.96
14.30
12.64
10.96
9.29
7.60
200.97
5.91
4.21
2.50
12.62
369.34
370.87
372.42
373.97
375.53
377.09
378.67
380.24
381.83
383.42
385.02
386.62
4,535.02
10 350.03
9 979.16
9,606.74
9.232.77
8 857.24
8 480.15
8 101.48
7 721.24
7 339.41
6 955.99
6,570.97
6,184.35
388.23
389.85
391.47
393.10
394.74
396.39
398.o4
399.70
401.36
403.04
404.71
406.40
4,767.03
5,796.12
5,406.27
5,014.80
4,621.70
4,226.96
3,830.57
3,432.53
3,032.83
2,631.47
2,228.43
1,823.72
1,417.32
408.09
409.79
599.44
1,417.32
1,009.23
599.44
0.00
Grand Totals 28,000.79 3,000.79 25,000.00
NUMBER
Register of Wills of Cumberland County, Pennsylvania
Estate of Florence F. Hess
also known as
INVENTORY
No. 00091 of 2003
Date of Death January 18, 2003
, Deceased Social Secudty No. 033-18-2322
We, Ann Hess Myers and Mary Lynch Hess
Personal Representatives of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventor/represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory.
We verify that the statements mede in this Inventory are true and conect. We understand that false statements, hereir~ als made
subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities.
Name of Personal Representatives:
AttorneY:i.D. No.: ,oann. Book Christine. Esquire82028
Address: Rhoads & Sinon LLP, P.O. Box 1146
Harrisburg, PA 17108-1146 Ann 'He'ss Myers U
Telephone: (717) 233-5731
Date
Mary Lynch Hess
See attachment
(Attach Additional Sheets if necessary)
Des~p~n
Value
$453,101.47
Total: $453,101.47
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the
value of eac~ item, but such figures should not be extended into the totel of the Inventor/.
Fora1R'W-7 ~:~Jif/dzl Cou~y - Rev. ~/~2)
462422.1
472550.1
Register of Wills of Cumberland County, Pennsylvania
Estate of Florence F. Hess
also known as
INVENTORY
No. 00091 of 2003
Date of Death January 18, 2003
, Deceased Social Secudty No. 033-18-2322
We, Ann Hess Myers and Mary Lynch Hess
Personal Representatives of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedents death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory.
We verify that the statements made in this Inventory are true and correct. We understand that false statements herein are made
subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities.
Name of
Attomey: Joanne Book Christine, Esquire
I.D. No.: 82028
Address: Rhoads & Sinon LLP, P.O. Box 1146
Harrisburg, PA 17108-1146
Telephone: (717) 233-5731
Personal Representatives:
Date
Ann Hess Myers
See attachment
Description
(Attach Additional Sheets if necessary)
Value
$453,101.47
Total: $453,101.47
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the
value of each item, but suc~ figures should not be extended into the total of the Inventor.
Fen~ RW-7 (Oau~in ~. Rev.
462422.1
472550.1
Estate of Florence Hess
Estate Inventory
Valued as of Date of Death
No. of
Shares
66
34
1,552
Cash & Cash Equivalents
AT&T Refund
Farmers refund on insurance
Kemper refund of insurance
Phoenix Preferred Client
Checking Acct. %600100495
PNC Bank Checking Acct.
%50-0354-7741
Interest at Date of Death
PNC Bank Money Market Acct.
%50-0190-2383
Interest at Date of Death
PNC Bank Checking Account
%50-0202-6725
Interest at Date of Death
Travelers Checks
Verizon refund
Total Cash & Cash Equivalents
Stocks
Household Intl Inc
Common
New York Stock Excha
Phoenix Cos., Inc. New
PNC Finl Svcs Group Inc
Common
New York Stock Excha
Dividend at Date of Death
Total Stocks
Tangible Pemonal Property
4.98
164.81
492.00
57,659.53
6,465.31
1.08
158,375.18
165.90
12,531.60
3.82
450.00
26.60
1,859.71
303.19
70,173.68
744.96
236,340.81
73,081.64
(1)
Estate Inventory
Tangible Personal Property
1997 Mercury Mountaineer Sport
Utility 4D vehicle
Jewelry
Sale of Walker
Household and personal
articles in decedent's
apartment at Messiah Village,
Mechanicsburg, PA
Total Tangible Personal Property
8,612.00
18,733.00
50.00
1,000.00
28,395.00
Miscellaneous
Evergreen Cemetery
Burial Plot Lot No. 1319
Decedent's husband, Jacob
Hess, Esquire, had some
involvement in the F. Edward
Hess Trust before his death.
This is a testamentary trust
which originated in the
Probate Court of Stark County,
Ohio and now holds assets with
an approximate value of
$14,000. No value has been
assigned to this Trust because
it is uncertain whether
decedent has any beneficial
interest in the Trust or will
ever receive a distribution
from the Trust.
IRS, 2002 Federal Income Tax
refund
Messiah Village, refund of
acquisition fee for
residential unit in retirement
community
Proceeds receivable under
Agreement. of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Total Miscellaneous
175.00
0.00
9,283.00
95,106.75
10,719.37
115,284.12
(2)
Estate Inventory
Real Property
Real property situate in
Chatham, Barnstable County,
Massachusetts, valued at
$475,000
Total Real Property
Total Inventory
0.00
0.00
453,101.47
(3)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
CD
REV-1162 EX(11-96)
003135
RHOADS & SINON
ONE SOUTH MARKET STREET
P O BOX 1146
HARRISBURG, PA 17108-1146
........ fold
ESTATE INFORMATION: SSN: 033-18-2322
FILE NUMBER: 2103-0091
DECEDENT NAME: HESS FLORENCE FURFEY
DATE OF PAYMENT: 1 O/17/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 01 /18/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $23,053.55
TOTAL AMOUNT PAID'
$23,053.55
REMARKS: ANN HESS MYERS
C/O RHOADS & SINON
SEAL
CHECK# 107
INITIALS: DO
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
REV~ SD0 EX (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1 500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Z
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Hess Florence
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
01/18/2003I 08/03/1925
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
FiLE NUMBER
OFFICIAL USE ONLY
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
033-18-2322
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
~-I 1. Original Return I'---] 2. Supplemental Return I---1 3. Remainder Return (date of death prior to 12-13-8
~--~ 4. Limited Estate ~ 4a. Future Interest Compromise (date of 4,~h after 12-12432) ~-~ 5. Federal Estate Tax Return Required
~-I 6. Decedent Died Testate (Attach copy of Will) ~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) O 8. Total Number of Safe Deposit Boxes
[~ 9. Litigation Proceeds Received I-~ 10. Spousal Poverty Credit (damof death between 12-31-91 and 1-1-95) ~1 11. Election to tax under Sec. 9113(A)iAttac~ s~
NAME
Joanne Book Christine, Esquire
COMPLETE MAILING ADDRESS
P. O. BOX 1146, One S.
Harrisburg, PA 17108
Market Square
FIRM NAME (If Applicable)
Rhoads & Sinon LLP
TELEPHONE NUMBER
717-233-5731
0.00
73,081.54
0.00
0.00
380,019.93
0.00
98,801.13
(8)
37,095.86
OFRCIAL USE ONLY
2,505.70
Charitable and Governmental Bequesta/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
551,902.60
(11) 39,601.56
(12) 512,301.04
(13) 0.00
(14) 512,301.04
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(schedule E) (5)
O. Jointly Owned Property (Schedule F) (6)
~'] ,~perata Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costa (Schedule H) (9)
10. Debts of Decedent. Mortgage Liabilities. & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
14.
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
15. Amount of Line 14 taxable at the spousal tax 0.0 0 0. 0 0 0
rate. or traosfers under SOc. 911§ (a)(1.2) x.O 00(15) ·
16. Amount of Line 14 taxable at lineal rate 512,301.04 x.O 45 (16) 23, 053.55
17. Amount of Line 14 taxable at sibling rate 0. 00 x. 12 (17) 0.00
18. Amount of Line 14 taxable at collateral rate 0. 00 x. 15 (18) 0. 00
19. Tax Duo (19) 23,053.55
20. ~-~
Z
: :: ::: :: :::::>:>:': BE-: SURE:TO:'ANSWER :ALL: QUESTIO NS: :ON:.:REVERS E SIDE:AND: RECH:ECK MATH: :<:< :::: :: : :: :: ::.:::.:::
HASPXXNUMBER
Decedent's Complete Address:
STI%E ET ADDRESS
811 Messiah Village
Cumberland County
ciTY
Mechanicsbur~r
Tax Payments and Credits:
1. Tax Due (Page I Line 19)
2. Credits/Payments
~c Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable D. Interest
E. Penalty
J STATE
PA
0.00
0.00
0.00
0.00
0.00
Total Credits (A + B + C) (2)
Total Interest/Penalty (D + E) (3)
IzIP
17055
(1) 23,053.55
0.00
0.00
4. If Line 2 is greater than Line I + Line 3. enter the difference. This is the OVERPAYMENT.
Check box on Page I Une 20 to request a refund
(4) 0.0 0
5. If Line 1 + Line 3 is greater than Line 2. enter the difference. This is the TAX DUE.
(5) 23~053.55
A. Enter the interest on the tax due.
(5A) 0.0 0
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 23 ~ 053.55
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decadent make a transfer and: Yes No
a. retain the use or income of the property transferrad; ....................... r-"] ~
b. retain the right to designate who shall use the property transferred or its income; ......... [~] [~
c. retain a reversionary interest; or ................................ E~ [-X-"l
d. receive the promise for life of either payments, benefits or care? ................. 1-~ E~]
2. if death occun'ed after December 12, 1982, did decedent transfer properly within one year of death
without receiving adequate consideration? ............................ [] []
3. Did decadent own an 'in trust for' or payable upon death bank account or security at his or her death? ~-I [~]
4. Did decadent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation7 ................................ ~ []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Unde,' i~naltiee of I:~jury. I ~,'s ~%at I hav~ ~,~,,~,,,1¢1 thi, return, including aczomf~anying ~hedul~ and ~to~ment~ and to ~%e be~ of my knowledge and b~ief, it is t~ue, correct and coml:)l®to.
Declaration of preflaret other than the {~o~sl rl~'eeentath~ i~ be~ed on 4ell inforrnat~on of whic~ Ixe~ar~r has 4any knowledge.
SlGNATI~I~ OF PERSON RESPONSIBLE FOR FILING RETURN
DATE
A~.~'~rl~ ESS ~
P~hoads & Sinon LLP, P. O. Box 1146 Harrisburg, PA 17108
ATURE OF PREPAREI~,,~THER THAN REPRESENT. ATI~VE TE
ffRESS , ,
~/c/o~oads & Sinon LLP, P. O. Box 1146 Harrisburg, PA 17108
~r da~ of ~ ~ ~ a~ JuN 1. 1994 a~ ~fore Janua~ 1, 1995. ~e ~ ra~ im~ ~ ~ ~t val~ of ~ansf~a ~ ~ f~ ~ u~ of ~e su~ing s~ is 3%
[72 P.S. ~ 9916 (a) (1.1) (i)].
~ da~ of ~ on ~ a~ Jan~ 1, 1995, ~e ~ ra~ im~ ~ ~ net value of ~ans~rs ~ or f~ ~e u~ of ~ ~uw~ng ~ is ~ [ 72 P.S. ~ 9116 (a) ( 1.1 ) (ii)]
The ~ ~ ~t ~empt a ~a~f~ ~ a suwNing s~u~ ~ ~ a~ ~ s~ r~uiremen~ ~ di~l~ure of a~ and filing a ~ re~rn are s~ll applicable ~en if
~r ~ of d~ ~ or a~r JuN 1.2~
The ~ ra~ im~ ~ ~e net val~ of ~ans~re ~ a d~ chi~ ~e y~rs of age or younger at d~ to or ~ ~e ~ of a na~ral ~ren[ an adopts ~ren[
~ a s~rent of ~e chi~ is ~ [72 P.S. ~ 911 ~a)( 1,2)].
~e ~ ra~ im~ ~ ~e net val~ of ~ans~rs ~ or for ~e u~ of ~e d~enfs lin~l ~eficiaries is 4.5%. ~cept as no~ in 72 P.S. ~ 911 ~ 1.2) [72 P.S. ~ 9110(a)( 1 )].
The ~ rate im~ on ~e ~t value of ~ansfers ~ or for ~e u~ of ~e d~ent's siblings is 12~ (72 P.S. ~ 9110(a)( 1.3)]. A sibling is define, under ~fion 9102, as an
i~Nidual ~o has at I~st one ~rent in common ~ ~e d~ent ~e~er ~ bl~ or adoption.
HAS--NUMBER
ATTACHMENT TO FORM REV-1500
Estate of:
Date of Death:
SS#:
Florence Furfey Hess
1/18/2003
033-18-2322
Under penalties of perjury, I declare that I have examined this return, including accompanying
schedules and statements, and to the best of my knowledge and belief, it is tree, correct and
complete.
~Executrix
491078.1
REV-1503 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
Florence Hess 21 03 0091
All property jointJy-owned with right of survivorship must be disclosed on S0hedule F.
ITEM VALUE AT DATE
NUMBEF DESCRIPTION OF DEATH
1.
66 Shares
Household Intl Inc
Common
New York Stock Excha
CUSIP: 44181510
34 Shares
Phoenix Cos., Inc. New
1,552 Shares
PNC Finl Svcs Group Inc
Common
New York Stock Excha
CUSIP: 69347510
Dividend accrued on 01/18/2003
TOTAL (Also enter on line 2, Recapitulation) $ 73,081.54
HASPXXNUMBER (If more space is needed, insert additional sheets of thesame size)
1,859.71
303.19
70,173.68
744.96
REV-1508 EX ~ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Florence Hess 21 03 0091
Include the 3roceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on S=hedulo
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. AT&T Refund 4.98
1997 Mercury Mountaineer Sport
Utility 4D vehicle
Average of blue book trade-in
and private party values
Evergreen Cemetery
Burial Plot Lot No. 1319
Farmers refund on insurance
Decedent's husband, Jacob
Hess, Esquire, had some
involvement in the F. Edward
Hess Trust before his death.
This is a testamentary trust
which originated in the
Probate Court of Stark County,
Ohio and now holds assets with
an approximate value of
$14,000. No value has been
assigned to this Trust because
it is uncertain whether
decedent has any beneficial
interest in the Trust or will
ever receive a distribution
from the Trust.
IRS, 2002 Federal Income Tax
refund
Jewelry
Valued per attached appraisal
Kemper refund of insurance
Messiah Village, refund of
acquisition fee for
residential unit in retirement
community
Total from continuation pages
8,612.00
175.00
164.81
0.00
9,283.00
18,733.00
492.00
95,106.75
247,448.39
$ 380,019.93
TOTAL(Also enter on line 5, Recapitulation)
HASPXXNUMBER (If more space is needed, insert additional sheets of the same size)
Estate of:
Item
No.
10
Florence Hess
Schedule E
Description
Phoenix Preferred Client
Checking Acct. #600100495
11 PNC Bank Checking Acct.
#50-0354-7741
Interest accrued to 01/18/2003
12 PNC Bank Money Market Acct.
#50-0190-2383
Interest accrued to 01/18/2003
13 PNC Bank Checking Account
#50-0202-6725
Interest accrued to 01/18/2003
14 Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Copies of Agreement of Sale
and amortization schedule are
attached
15 Sale of Walker
16 Household and personal
articles in decedent's
apartment at Messiah Village,
Mechanicsburg, PA
Valued per estimate of
Executrices
17 Travelers Checks
18 Verizon refund
(Page 2)
Value at Date
of Death
57,659.53
6,465.31
1.08
158,375.18
165.90
12,531.60
3.82
10,719.37
50.00
1,000.00
450.00
26.60
Total (Carry forward to main schedule) 247,448.39
I;IEV-1510 EX * (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
Florence Hess 21 03 0091
This schedule must be completed and filed if the answer to any of questions I through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DE~RI~ION OF PROPER~ % OF
ITEM I~WDE THE NAME OF THE T~NSFEREE THEIR RELATION~IP TO DATE OF DEATH DECD'S EXCLUSION
DECEDENT AND THE DATE OF T~NS~R. A~ACH A ~ OF THE TAXABLE VALUE
NUMBEF DEED ~R R~L ESTATE. VALUE OF ASSET INTEREST {IF APflU~B~)
1. At her death, decedent was
receiving distributions from
FirstMerit Bank, N.A., Trust
Company, Trustee for the Lesh
Casner & Miller 401(k) plan
and employee rollover accounts
of decedent's deceased spouse
with a total date of death
balance of $49,849.36.
Decedent was the primary
beneficiary on these accounts
during her lifetime.
Contingent beneficiaries are
Decedent's daughters, Ann H.
Myers and Mary Lynch Hess.
These accounts are not
includible in Decedent's
estate as she had no incidents
of ownership in them. 0.00 100.000 0.00 0.00
2 MassMutual Annuity Contract
#I-42434
Beneficiaries: Decedent's
daughters, Ann H. Myers and
Mary L. Hess. 85,769.47 100.000 0.00 85,769.47
3 FirstMerit Bank N.A. IRA
Account #5101-6001-9673.
Beneficiaries: Decedent's
daughters, Ann H. Myers and
Mary Lynch Hess. 8,225.96 100.000 0.00 8,225.96
Interest accrued to 01/18/2003 6.97 100.000 6.97
4 FirstMerit Bank, N.A. IRA Acct
#100-0700-1086.
Beneficiaries: Decedent's
daughters, Ann H. Myers and
Mary Lynch Hess. 4,797.19 100.000 0.00 4,797.19
Interest accrued to 01/18/2003 1.54 100.000 1.54
TOTAL(Al~en~ronline7, R~apitulation) $
98,801.13
(If more space is needed, insert additional sheets of same size.)
HASPXXNUMBER
Schedule G (Page 2)
Estate of: Florence Hess
Item
No. Description
At her death, dececent was
receiving a monthly annuity
payment of $139.57 under
Hartford Life Contract
#GA20187-0002. All payments
under this Contract ceased at
decedent's death.
DOD Value
of Asset
0.00
% Int.
100.000
Exclusion
0.00
Taxable
Value
0.00
Total (Carry forward to main schedule) 0.00
REV-1511 EX + (1-97)
COMMONVVEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Florence Hess 21 03 0091
Debt~ of decedent must be reported on Schedule I.
ITEM
NUMBER
DESCRIPTION
FUNERAL EXPENSES:
Kurt Myers:
Lunch
Post Funeral
Lamiell Funeral Home
Funeral Expenses
Nell Funeral Home
Funeral Expenses
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State PA Zip
Year(s) Commission Paid:
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
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
City of Boston
Charge to Record cemetery lot
change of ownership from
Florence Hess to Ann Myers
Cumberland Law Journal
Legal Advertisement of Letters
Testamentary
Total from continuation pages
TOTAL (Also enter on line 9, Recapitulation) $
AMOUNT
161.96
3,259.40
6,950.64
25,000.00
354.00
5.00
75.00
1,289.86
37,095.86
HASPXXNUMBER (If more space is needed, insert additional sheets of same size)
Schedule H part 2 (Page 2)
Estate of: Florence Hess
Item
No. Description
Amount
Dauphin County Register of
Wills
Co-Executors Oath
Lesh Casner Miller
Tax preparation fees
RESERVES: Rhoads & Sinon, LLP
Out of Pocket Expenses:
Telephone - $26.33; Federal
Express - $38.19; Postage -
$22.18; Stock Evaluation -
$9.30; Photocopies - $95.55;
Fax - $47.00; Reserves:
Filing first and final
accounting - $25.00;
Additional Expenses - $100.00.
The Patriot-News Co.
Legal Advertisement of Letters
Testamentary
15.00
764.00
363.55
147.31
Total (Carry forward to main schedule) 1,289.86
REV-1512 ID{+ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABIUTIES, & LIENS
ESTATE OF FILE NUMBER
Florence Hess 21 03 0091
Include unroimbursed medical expenses.
ITEM
NUMBER
10
DESCRIPTION
AT&T
Telephone charge
Checks clearing after
Decedent's Death
Kurt Myers
Reimbursement for the
following: PP&L $22.22
(Messiah Village); Verizon
$22.56 (Messiah Village);
Susquehanna Internal Medicine
(medical bill) $1.92; Quantum
(medical bill) $1.26; Moffit
Group (medical bill) $14.79;
Bank One (Credit Card bill)
$55.31; MBNA (Credit Card
bill) $394.69;
Messiah Village
Balance due
Moffit Group (Medical Bills)
PA Department of Revenue
PA 2002 income tax
PP&L Electric Utilities
Electric Bill for Messiah
Village
Quantum Imaging and
Therapeutic
Verizon
Telephone Bill
West Shore Anesthesia
Medical Bill
TOTAL(Also enter on line 10, Recapitulation)
AMOUNT
28.34
417.86
512.75
1,101.34
49.47
303.00
17.77
8.74
22.37
44.06
$ 2,505.70
HASPXXNUMBER (If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Florence Hess 21 03 0091
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee(s) OF ESTATE
II.
TAXABLEDISTRIBUTIONS[includeoutdghtspou~ldistHbutions, andtmnsfem
underS~.9116(a)(1.2)]
Mary Lynch Hess
P. O. Box 11
Ashton, MD 20861
One-half annuity and IRA's,
$49,400.57
One-half residue, $179,550.90
Ann Hess Myers
111 Bramblewood Lane
Lewisberry, PA 17339
One-half annuity and IRA's,
$49,400.56
One-half residue, $179,550.89
Daughter
Daughter
228,951.46
228,951.45
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
HASPXXNUMBER (If more space is needed, insert additional sheets of the same size)
BUREAU OF TNDTVZDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 1712B-0601
COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHER/TANCE TAX
APPRAISEMENT, ALLO#ANCE OR DZSALLOHANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
*04 I i ¥-7
JOANNE BOOK CHRISTINE ESQ
RHOADS & S'rNON
PO BOX 11q6
HBG PA 17108
DATE
ESTATE OF
DATE OF DEATH
.g~LE NUHBER
' ~OUNTY
ACN
05-10-200q
HESS
01-18-2005
21 05-0091
CUMBERLAND
101
Amoun~ Remi~ed
REV-15q7 EX &FP (01-05)
FLORENCE F
MAKE CMECK PAYABLE AND REHZT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LONER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HESS FLORENCE F FILE NO. 21 05-0091 ACN 101 DATE 05-10-200q
TAX RETURN NAS: ( ) ACCEPTED AS F/LED (X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Reel Es~a~a (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (P)
$. Closely Held S~:ock/Par~:nership /n~eras~ (Schedule C) (3)
q. Mar*gages/No'cas Receivable (Schedule D) (q)
E. Cash/Bank Deposi~cs/Misc. Personal Proper~y (Schedule E) (5)
6. Join~cly Owned Proper~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To~el Asse~s
APPROVED DEDUCTIONS AND EXEMPT:IONS:
9. Funeral Expenses/Adm. Cos~:s/M/sc. Expanses (Schedule H) (9)
10. Debts/Mortgage Liabili:kles/Lians (Schedulm I) (10)
11. To~el Deductions
12. Ne~ Value of Tax Ra~urn
75~081.5q
.00
$80~019.95
.00
.00 NOTE: To insure proper
credi~ ~o your account,
subm/~ ~he upper para,on
.00 of ~h~s fora wi~h your
~ax payment.
lq8~650.q9
(B)
601,751.96
$7,095.86
2~505.70
(11)
(12)
562,150.~0
15.
lq.
NOTE:
Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (1:5)
Ne~c Value of Es~:e~e Sub.~ac~c *o Tax (lq)
]:f an assess, ent ~as lssued previously, 11nes 14, 15 and/or 16, 17,
reflect f/gures that include the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Amoun~ of Line 1~ a~ Spousal ra~e
16. A.oun~ of L~ne 1~ ~axable a~ Lineal~Class A ra~e
17. Amoun~ of L/ne 1~ a~ Sibling ra~a
18. Amoun~ of L/ne lq ~axabla a~ Collateral~Class B ra~a
19. Principal Tax Due
TAX CRED/TS:
PAYMENT RECE~P1 DISCOUNT
DATE NUNBER INTEREST/PEN PAID (-)
10-17-2005 CD003135 .00
(15) .00 x O0 =
(16) 562,150.q0 x Oq5=
(17) . O0 x 12 =
(lB) .00 x 15 :
(19)=
AMOUNT PAID
23,053.55
TOTAL TAX CREDZT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
INTEREST IS CHARGED THROUGH 05-25-200q
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
.00
562,150.q0
18 and 19 w111
.00
25,296.77
.00
.00
25,296.77
25,055.55
2,2q$.22
58.77
2,301.99
ZF PA/D AFTER DATE ZND/CATED, SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT IS REQUIRED.
FOR CALCULAT/ON 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.)
RESERVATION:
PURPOSE OF
NOTZCE:
PAYHENT:
REFUND
OBJECTIONS:
ADNIN-
ISTRATZVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 11, 1981 -- if any futura interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Coaeoneealth hereby expressly reserves the right to appraise and assess transfer Inherltanca Taxes
at the laafui Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section ZI~O of the Inheritance and Estate Tax Act, Act 13 of ZOO0. (71 P.S.
Section 91~0).
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILLSj AGENT
A refund of a tax credit, mhich ems not requested on the Tax Return, amy be requested by completing an "Application
for Refund of Pennsylvania inheritance end Estate Tax" (REV-1315). Applications are available at the Office
of the Register of #ills, any of the Z3 Revenue District Offices, or by calling the special Iq-hour
enamoring service for forms ordering: 1-800-561-2050; services for taxpayers eith special hearing and / or
speaking needs: 1-800-qq7-3010 (TT only).
Any party in interest net satisfied with the appraisement, allowance, or disalloeanca of deductions, or assessment
of tax (including discount or interest) as sheen on this Notice must object aithin sixty (60) days of receipt of
this Notice by:
--written pretest to the PA Department of Revenue, Board of Appeals, Dept. ZBlOZl, Harrisburg, PA 171Z8-10Z1, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in eriting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment RevieN Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-650S. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-ISOi) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (SI) discount of
the tax paid is allowed.
The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January lB, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated an this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day frae the date of
death, to the date of payment. Taxes which became delinquent before January l, 1981 bear interest at the rate of
six (61) percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after
January l, 19BZ ail! bear interest at a rate which mill vary from calendar year to calendar year aith that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through Z004 are:
Interest Daily Interest Daily
Year Rate Factor Year Rate Factor
~ ZOZ . 0005q8 ~rs- 1991 llz . 000301
1983 162 .000q38 1992 91 . O00Z~7
19B~ 11Z .000301 1995-199~ 71 .O0019Z
1985 13Z .000356 1995-1998 9Z .O00Z~7
1986 ZOZ . O0027~ 1999 72 . O0019Z
1987 lOZ .000Z74 ZOO0 72 .000192
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
Interest Daily
Year Rata Factor
~ 9Z .0002~7
ZOOZ 61 .O0016q
2003 5Z .0001~7
200~ qZ .000110
X NUI~BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date sheen on the
Notice, additional interest must be calculated.
{EV-1470 EX 1~6-88)
INHERITANCE TAX
' EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURGi PA 17128-0601
FILE NUMBER
DECEDEN'CS NAME Florence Hess 2103-0091
ACN
REVIEWED BY ANITA MCCULLY 101
ITEM EXPLANATION OF CHANGES
SCHEDULE NO.
G 1 The balance of the 401K is fully taxable to the beneficiaries.
ROW Page 1
BUREAU OF ZNDZV/DUAL TAXES
XNHE~ZTANCE TAX DXVXSXON
DEPT. 280601
HARRISBURG, PA 1712&-D601
cOHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSENENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
REV-IS~I7 EX AFP (01-05)
JOANNE BOOK CHRISTINE ES~)
RHOADS & SINON
PO BOX 11q6
HBG PA
DATE
ESTATE OF
DATE OF DEATH
FILE NUHDER
ACN
05-10-200q
HESS
01-18-2005
21 05-0091
CUHBERLAND
101
Amount
FLORENCE F
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF HESS FLORENCE F FILE NO. 21 05-0091 ACN 101 DATE
TAX RETURN gAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (SchaduZa A) (1)
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Partnersh!p Zntarest (Schedule C) (:5)
~. Nortgagas/Notas Receivable (Schedule D) (~)
5. Cash/Bank Deposits/Nisc. Personal Property (Schedule E) ($)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTZONS:
9. Funeral Expansas/Adm. Costs/Misc. Expanses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10)
11. Total Deductions
12. Net Value of Tax Return
O0
75~081.5~
00
00
580~019.95
00
1~8~650 ~9
(8)
57,095.86
2~505.70
(11)
(12)
1:5.
lq.
NOTE:
ASSESSHENT OF TAX: 15. Amount of L/ne 1~ at Spousal rate
16. Amount of Line lq taxable at Lineal/Class A rate
17. Amount of L/ne lq at Sibling rata
18. Amount of Line lq taxable at Collateral/Class B rata
NOTE: To insure proper
cradLt to your account,
submLt the upper portion
of thls fora with your
tax payment.
601,751.96
39.601.56
562,150.~0
Charitable/Governmental Bequests; Non-elected 911:5 Trusts (Schedule J) (15)
Net VaZua of Estate Sub,act to Tax (1~)
]:~ an assess;ant ~as lssued previously, 11nas 14, :15 and/or :16, 17,
reflect flgures that lnclude the total of ALL returns assessed to date.
(15), .00 x O0 =
(16). 562,150.~0 x 0c~5=
(17) .00 x 12 =
(18) .00 x 15 =
(19)=
.00
562,150.~0
19. Princ/pal Tax Due
TAX CREDZTS:
PAYMENT RECETpT
NUNBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
~ATE
CD005155
.00
10-17-2005
ANOUNT PAID
23,055.55
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
18 and 19 will
( IF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REDUZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU MAY BE DUE
ZF PA/D AFTER DATE ZNDZCATED~ SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
REVERSE SIDE OF THIS FORH
INTEREST IS CHARGED THROUGH 05-25-200~
AT THE RATES APPLICABLE AS OUTLINED ON THE
25,055.55
2,2~5.22
58.77
2,501.99
.00
25,296.77
.00
.00
25,296.77
REV-1470 EX (~-~8)
INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURGI PA 17128-0601
DECEDENT'S NAME FiLE NUMBER
Florence Hess 2103-0091
REVIEWED BY ACN
ANITA MCCULLY 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
G 1 The balance of the 401K is fully taxable to the beneficiaries.
ORIGINAL Page 1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003957
MENDELSOHN AMY J
1 SOUTH MARKET STREET
PO BOX 1146
HARRISBURG, PA 17108-1146
........ fold
ESTATE INFORMATION: SSN: 033-1 8-2322
FILE NUMBER: 2103- 0091
DECEDENT NAME: HESS FLORENCE FURFEY
DATE OF PAYMENT: 05/20/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 01 / 18/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,301.99
TOTAL AMOUNT PAID:
$2,301.99
REMARKS:
SEAL
CHECK# 114
INITIALS' JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
IN THE MATTER OF THE ESTATE OF ) IN THE COURT OF COMMON PLEAS OF
) CUMBERLAND COUNTY, PENNSYLVANIA
FLORENCE FURFEY HESS, DECEASED ) ORPHANS' COURT DWISION
)
) NO. 00091 OF 2003
APPROVAL OF ACCOUNT, RECEIPT~ RELEASE AND INDEMNIFICATION
WltEREAS, FLORENCE FURFEY HESS (the "Decedent") ~ied Janu~y 18, 2003,
::
leaving a Will dated March 17, 1999, which was duly probated in Cumberland COunty, ~tnsylyania;
WHEREAS, Ann Hess Myers and Mary Lynch Hess, were named as Co-Executors of
the Estate;and
WHEREAS, Item 1II of the Will bequeaths the rest, residue and remainder of
Decedent's Estate to her daughters, Ann Hess Myers and Mary Lynch Hess (the "Beneficiaries"); and
VOtEREAS, the Beneficiaries desire that distribution of the estate be made without the
expense, delay and formality of a court accounting; and
WHEREAS, the Co-Executors are willing to consent to making such distributions upon
receipt of a proper approval of account, receipt, release and indemnification, which it is the purpose of
this Agreement to provide.
NOW THEREFORE, the undersigned, jointly, separately and severally, for
themselves, their heirs, administrators, and assigns:
1. State that they have examined the First and Final Accounts and Proposed
Schedule of Distribution which are attached hereto as Exhibit "A", Exhibit "B" and Exhibit "C",
530802.1
respectively (the "Account") and approve the transactions set forth or proposed therein (and the
administration of the Estate generally) as though they were contained in a formal Accounting which
had been confirmed absolutely by the Court having jurisdiction over the Estate.
2. State that they have examined the Statement of Proposed Distribution attached
to the Account and they approve calculation of shares therein and the distributions proposed therein as
though they were ordered by the Court having jurisdiction over the Estate.
3. Waive the filing of the Account in any Court and agree that any Court having
jurisdiction over the Estate may confirm the Account.
4. Hereby acknowledge receipt from the Co-Executors of the assets shown as
distributed or distributable to them in the said Account or Statement of Proposed Distribution in
absolute payment of and in full satisfaction of the bequests under Decedent's Will.
5. Do hereby absolutely and irrevocably release, remise, quitclaim and forever
discharge the said Co-Executors, their heirs and personal representatives, of and from all actions, suits,
payments, accounts, reckonings, claims and demands whatsoever for or by reason of their actions as
Co-Executors, as set forth in the Account.
6. Do hereby release all real estate of the Decedent and of the Co-Executors from
all liens, claims, actions, suits, payments, accounts and demands whatsoever for or by reason of their
actions as Co-Executors, as stated in the Account.
7. Do hereby absolutely and irrevocably release the Co-Executors fi'om filing any
Account, Petition for Distribution or other document with the Court of Common Pleas of Cumberland
County, Pennsylvania, or in any other jurisdiction in connection with the Estate of the said Decedent.
-2-
8. Do hereby agree that if, at any time in the future, the said Co-Executors receive
any demand or claim for any amount claimed to be due and owing from them, as Co-Executors, and
approve said demand or claim, they shall, at the request of the said Co-Executors, pay to the said Co-
Executors the amount of any such demand or claim, or if it has been paid by the said Co-Executors,
then reimburse them for the amount paid by them, provided that the amount of such requested payment
or reimbursement shall not exceed the total of the assets paid or distributed by said Co-Executors to the
Beneficiaries as set forth in the attached Account.
9. Hereby agree to indemnify the Co-Executors and hold them harmless, to the
extent of the Estate assets received by them, f~om and against any and all claims, loss, liability or
damage (including legal fees and costs) which they may suffer or to which they may be subjected by
mason of the administration of the Estate or the distribution of the assets of the estate without having
formal approval of the Court of Common Pleas, Orphans' Court Division, of Cumberland County,
Pennsylvania, or any other jurisdiction.
10. Do hereby agree that this Agreement may be signed and acknowledged by the
parties hereto in counterparts and a complete set of executed counterparts, containing the signature of
all parties, shall constitute an original and complete instrument.
This instrument shall be legally binding upon the undersigned, their heirs,
administrators and assigns.
-3-
IN WITNESS WHEREOF, the undersigned have hereunto set their hands and seals this
] ~z]~ day of~o_~, 2004.
WITNESS:
ANN HESS MYERS, indivi~aat~lly and as Co-Executor
MARY LYNCH HESS, individually and as Co-Executor
-4-
IN WITNESS WHEREOF, the undersigned have hereunto set their hands and seals this
day of ,2004.
WlTNESS:
ANN HESS MYERS, individually and as Co-Executor
~ ~q~H HESS, individually and as Co-Executor
COIvIMONWEALTH OF PENNSYLVANIA )
) SS:
COUNTY OF ~t~ )
On this, the I~day of ~a~. ,2004, before me, a Notary Public, the undersigned
officer, personally appeared ANN HESS MYERS, individually, known to me (or satisfactorily proven)
to be the person whose name is subscribed to the within inshamaent, and acknowledged that she
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
N~tary Public t '
My Commission Expires:
(SEAL)
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Kimberly A. Meals, Notary Public
Cit~ of Harrisburg, Dauphin County
My Commission Expires Mar. 11, 2007
Member, Pennsylvania Association of Notaries
STATE OF MARYLAND
co YoF
)
) SS:
)
On this, the ~t~day of ..~le, a~, 2004, before me, a NotaW Public, the undersigned
officer, personally appeared MARY LYNCH HESS, individually, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she
executed the same for the proposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
Notary Public
ANNIE y. YANG
· . Notary_Public, State c~ Ma I
My Comm]ss~m~by~t~,~. _ . ~ ~
,-,:, ~n~ssfon e. Xp~res au y 1, 2006
(SEAL)
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 00091-2003
FIRST AND FINAL ACCOUNTING OF
Ann Hess Myers and Mary Lynch Hess
Co-Executors
For
ESTATE OF Florence Furfey Hess, Deceased
The PNC Estate Checking and Money Market Account
and Remainder of Estate
Date of Death:
Date of Appointment:
Date of First Complete
Advertisement of Letters:
Accounting for the Period:
January 18, 2003
January 30, 2003
February 18, 2003
January 18, 2003
to August 26, 2004
Purpose of Account: Ann Hess Myers and Mary Lynch Hess, Co-Executors, offer this account to acquaint
interested parties with the transactions that have occurred during their administration.
The account also indicates the proposed distribution of the estate.
It is important that the account be carefully examined. Requests for additional information, or questions, or
objections, can be discussed with:
Joanne Book Christine, Esquire
Rhoads & Sinon LLP
One South Market Square
12th Floor P.O. Box 1146
Harrisburg, PA 17108-1146
(717) 233-5731
494653.1
Estate of Florence Hess
Summary of Account
Principal
Receipts
Net Gain on Sales or Other Dispositions
Less Disbursements:
Debts of Decedent
Funeral Expenses
Administrative Expenses
Federal & State Taxes
Fees & Commissions
Balance Before Distributions
Less Distributions to Beneficiaries
Principal Balance On Hand
For Information:
Investments Made
Unpaid Expenses
Unrealized Gains and Losses
Income Receipts
Net Gain on Sales or Other Dispositions
Less Disbursements:
Balance Before Distributions
Less Distributions to Beneficiaries
Income Balance on Hand
For Information:
Investments Made
Unpaid Expenses
Unrealized Gains and Losses
Combined Balance on Hand
Page
2
5
10
16
21
22
28
28
28
32
33
34
35
36
36
36
$ 2,968.79
10,372.00
3,750.41
73,579.91
29~000.00
$ 931,882.09
607.07
$ 932,489.16
119,671.11
$ 812,818.05
327,274.55
$ 485~543.50
$ 4,016.98
0.00
$ 4,016.98
0.00
$ 4,016.98
0.00
$ 4~016.98
$ 489,560.48
(1)
Estate of Florence Hess
Receipts of Principal
No. of
Shares
66
34
1,552
Cash and Cash Equivalents
AT&T Refund
Farmers refund of insurance
Kemper refund of insurance
Phoenix Preferred Client
Checking Acct. #600100495
PNC Bank Checking Acct.
#50-0354-7741
Interest to Date of Death
PNC Bank Money Market Acct.
#50-0190-2383
Interest to Date of Death
PNC Bank Checking Account
~50-0202-6725
Interest to Date of Death
Travelers Checks
Verizon refund
Total Cash and Cash Equivalents
Stocks
Household Intl Inc
New York Stock Exchange
Phoenix Cos., Inc. New
PNC Finl Svcs Group Inc
Common
New York Stock Exchange
Dividend at Date of Death
Inventory Value
01/18/2003
$ 4,98
164.81
492.00
57,659.53
6,465.31
1.08
158,375.18
165.90
12,531,60
3.82
450.00
26.60
$
Inventory Value
01/18/2003
$ 1,859.71
303.19
70,173.68
744.96
236,340.81
(2)
Receipts of Principal (Continued)
No. of
Shares
Stocks
Total Stocks
Inventory Value
01/18/2003
73,081.54
Tangible Personal Prope~y
1997 Mercury Mountaineer Sport
Utility 4D vehicle
Jewelry
Sale of Walker
Household and personal
articles in decedent's
apartment at Messiah Village,
Mechanicsburg, PA
Household articles in
Massachusetts house
Total Tangible Personal Property
Miscellaneous
Evergreen Cemetery
Burial Plot Lot No. 1319
IRS, 2002 Federal Income Tax
refund
Messiah Village, refund of
acquisition fee for
residential unit in retirement
community
proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Total Miscellaneous
Inventory Value
01/18/2003
8,612.00
18,733.00
50.00
1,000.00
3,230.00
Inventory Value
01/18/2003
175.00
9,283.00
95,106.75
10,719.37
31,625.00
115,284.12
(3)
Receipts of Principal (Continued)
Real Property
475,000
Real property situate in
Chatham, Barnstable County,
Massachusetts, more
particularly described in Deed
dated February 2, 1990, and
recorded in the Office of the
Recorder of Deeds in and for
Barnstable County at Book 980,
page 79
Total Real Property
Total INVENTORY
RECEIPTS SUBSEQUENT TO INVENTORY
04/14/2003
Check Printing Fee Refund
04/24/2003
Check Order Refund
09/29/2003
Nstar Refund
01/29/2003
At her death, decedent was
receiving a monthly annuity
payment of $139.57 under
Hartford Life Contract
#GA20187-0002. All payments
under this Contract ceased at
decedent's death.
01/31/2003
PERS Retirement - Ohio
Total RECEIPTS SUBSEQUENT TO INVENTORY
Total Receipts of Principal
Inventory Value
01/18/2003
$ 475,000.00
$ 475,000.00
$ 931,331.47
$ 21.20
48.80
17.53
139,57
323.52
550.62
$ 931,882,09
(4)
Estate of Florence Hess
Gains and Losses on Sales or Other Dispositions of Principal
Net Gain
01/29/2003 Colle~ion
At her death, decedent was
receiving a monthly annuity
payment of $139.57 under
Hartford Life Contract
#GA20187-0002. All payments
under this Contract ceased at
decedent's death.
Net Proceeds $
Carried at
139.57
139.57
01/31/2003 Collection
PERS Retirement - Ohio
Net Proceeds $
Carried at
323.52
323.52
02/05/2003 Collection
PNC Bank Checking Acct.
#50-0354-7741
Net Proceeds $
Carried at
6,384.19
6,384.19
02~5/2003 Collection
PNC Bank Money Market Acct.
#50-0190-2383
N~Proceeds $
Carried at
5,000.00
5,000.00
02/05/2003 Collection
PNC Bank Money Market Acct.
#50-0190-2383
Net Proceeds $
Carried at
154,286.04
154,286.04
02/05/2003 Collection
PNC Bank Checking Account
#50-0202-6725
Net Proceeds $
Carried at
12,662.85
12,662.85
02/05/2003 Redemption
Travelers Checks
Net Proceeds
Carried at
450.00
450.00
Net Loss
(5)
Gains and Losses on Sales or Other Dispositions of Principal (Continued)
Net Gain Net Loss
02/21/2003 Sale
Sale of Walker
Net Proceeds $ 50,00
Carried at 50.00
02/27/2003 Collection
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Net Proceeds $
Carried at
370.87
370.87
0~10~003 Cotle~ion
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Net P~ceeds $
Ca~ied at
368.50
368.50
03/25/2003 Collection
Farmers refund of insurance
Net Proceeds $
Carried at
164.81
164.81
03/25/2003 Collection
Kemper refund of insurance
Net Proceeds $
Carried at
492.00
492.00
03/25/2003 Collection
Verizon refund
Net Proceeds
Carried at
9.13
9.13
04/14/2003 Collection
Check Printing Fee Refund
Net Proceeds $
Carried at
21.20
21.20
(6)
Gains and Losses on Sales or Other Dispositions of Principal (Continued)
Net Gain Net Loss
04/16/2003 Collection
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Net Proceeds $
Carried at
373.97
373.97
04/16~003 Collection
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Reimbursement for insurance
Net Proceeds $
Inventoried at
550.00
0.00
550.00
04/24/2003 Collection
Check Order Refund
Net Proceeds
Carried at
48.80
48.80
05/19/2003 Collection
Messiah Village, refund of
acquisition fee for
residential unit in retirement
community
NetProceeds $
Carried at
95,106.75
95,106.75
05/22/2003 Collection
AT&T Refund
Net Proceeds
Carried at
4.98
4.98
05D7~003 Collection
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Net Proceeds $
Carried at
375.53
375.53
(7)
Gains and Losses on Sales or Other Dispositions of Principal (Continued)
Net Gain Net Loss
05/27/2003 Collection
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Boat Insurance
Net Proceeds $
Inventoried at
75.00
0.00 $ 75.00
06/18/2003 Collection
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Net Proceeds $
Carried at
377.09
377.09
07/17~003 Colle~ion
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Net Proceeds $
Carried at
378.67
378.67
07/17/2003 Collection
Verizon refund
Net Proceeds
Carried at
17.47
17.47
08/26~2003 Sale
34 Shares
Phoenix Cos., Inc. New
Inventoried at $
Net Proceeds
303.19
285.26
17,93
08/26~003 Collection
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Net Proceeds $
Carried at
380.24
380.24
(8)
Gains and Losses on Sales or Other Dispositions of Principal (Continued)
Net Gain Net Loss
09/12/2003 Collection
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Net Proceeds $
Carried at
381.83
381.83
09~9/2003 Collection
Nstar Refund
Net Proceeds
Carried at
17.53
17,53
10/28/2003 Collection
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Net Proceeds $
Carried at
383.42
383.42
11/12~003 Collection
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Net Proceeds $
Carried at
385.02
385.02
12/11~003 Collection
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Net Proceeds $
Carried at
386.62
386.62
Total Gains and Losses
Net Gain
$ 625.00
$ 607.07
$ 17.93
(9)
Estate of Florence Hess
Disbursements of Principal
Date Paid
Amount Paid
01/22/2003
01/23/2003
O2/08/2003
Claims presented, allowed, paid, credited and
appearing in the Summary Statement
Checks clearing after
Decedent's Death
Paid from PNC Bank Money
Market Account
~50-0354-7741
Checks clearing after
Decedent's Death
Paid from PNC Bank
Checking Account
#50-0202-6725
Kurt Myers
Reimbursement for the
following: PP&L $22.22
(Messiah village);
Verizon $22.56 (Messiah
Village); Susquehanna
Internal Medicine
(medical bill) $1.92;
Quantum (medical bill)
$1.26; Moffit Group
(medical bill) $14.79;
Bank One (Credit Card
bill) $55.31; MBNA
(Credit Card bill)
$394,69;
Check Number 2
82.20
335.66
512.75
02/08/2003
02/15/2003
Moffit Group (Medical
Bills)
Check Number 3
Messiah Village
Balance due
Check Number 4
16.71
665.00
(lO)
Disbursements of Principal (Continued)
Date Paid
02/22/2003
02/26/2003
03/08/2003
03/08/2003
03/15/2003
03/27/2003
03/27/2003
03/2712003
Claims presented, allowed, paid, credited and
appearing in the Summary Statement
PP&L Electric Utilities
Electric Bill for Messiah
Village
Check Number 7
Ver±zon
Telephone Bill
Check Number 6
PP&L Electric Utilities
Electric Bill for Messiah
Village
Check Number 11
West Shore Anesthesia
Medical Bill
Check Number 12
Messiah Village
Balance due
Check Number 15
AT&T
Telephone charge
Check Number 16
Hartford Life
Payment owed to annuity
contract No. GA20187-002
Check Number 17
Quantum Imaging and
Therapeutic
Check Number 18
Amount Paid
12.62
22.37
5.15
44.06
436.34
28.34
139.57
8.74
(11)
Disbursements of Principal (Continued)
Date Paid
Amount Paid
04/02/2003
Claims presented, allowed, paid, credited and
appearing in the Summary Statement
PA Department of Revenue
PA 2002 income tax
Check Number 20
$ 303.00
05/02/2003
Moffit Group (Medical
Bills)
32.76
05/08/2003
01/31/2003
OPERS
Refund of Pension
Overpayment
Total Claims presented, allowed, paid,
credited and appearing in the Summary
Statement
Funeral Expenses
Kurt Myers: Post Funeral
Lunch
323.52
$ 2,968.79
161.96
02/08/2003
02/08/2003
Lamiell Funeral Home
Funeral Expenses
Kurt Myers paid this bill
and was reimbursed from
the estate checking
account (check no. 2).
Neil Funeral Home
Funeral Expenses
Kurt paid this bill and
was reimbursed from the
estate checking account
(check no. 2).
Total Funeral Expenses
3,259.40
6,950.64
$ 10,372.00
(12)
Disbursements of Principal (Continued)
Date Paid
Amount Paid
02/26/2003
Administration Expenses
Kurt Myers
Moving expenses
Check Number 5
312.00
03/01/2003
City of Boston
Charge to Record cemetery
lot change of ownership
from Florence Hess to Ann
Myers
Check Number 8
5.00
03/15~2003
03/30/2003
Molly Lynch Hess
Moving Expenses
Check Number 14
The St. Paul
Boat Insurance
Check Number 19
129.76
550.00
04/24/2003
04/24/2003
05/12/2003
05/15~2003
05/20/2003
PNC Bank Account No.:
50-0000-2869
Check Printing Fee
PNC Bank Account No.:
50-0000-2869
Check Printing Fee
Lesh Casner Miller
Tax preparation fees
West Chatham Antiques
Appraisal of personal
property, Massachusetts
The St. Paul
Boat Insurance
27.60
48.80
764.00
85.00
75.00
(13)
Disbursements of Principal (Continued)
Date Paid
Amount Paid
07/30/2004
10/21/2003
Administration Expenses
RESERVES: Rhoads &
Sinon, LLP
Out of Pocket Expenses
Total Administration Expenses
Federal and State Taxes
Register of Wills, Agent
Payment of Inheritance
Tax Due
$ 1,753.25
$ 3,750.41
23,053.55
10/27/2003
10/28/2003
05/21/2004
06/10/2004
06/22/2004
U.S. Treasury (IRS)
Payment of tax on 706
Check Number 108
Commonwealth of
Massachusetts
Payment of Estate Tax
Check Number 110
Register of Wills, Agent
Payment of Inheritance
Tax Due
Check Number 114
U.S. Treasury (IRS)
Payment of tax on 706
Additional Tax Due
Commonwealth of
Massachusetts
Payment of Estate Tax
Additional Tax Due
Total Federal and State Taxes
16,365.48
15,973.71
2,301.99
15,503.40
381.78
$ 73,579.91
(14)
Disbursements of Principal (Continued)
Date Paid
07/30/2004
07/31/2004
Fees and Commissions
RESERVES: William R.
Ha~kmatt, Esquire -
Massachusetts real estate
transfer
Attorney fees and
expenses
RESERVES: Rhoads &
Sinon, LLP
Attorney's Fees
Total Fees and Commissions
Total Disbursements of Principal
Amount Paid
$ 4,000.00
25,000.00
$ 29,000.00
$ 119,671.11
(15)
Estate of Florence Hess
Distributions of Principal to Beneficiaries
Distribution Value
Mary Lynch Hess
02~08/2003
Cash
To open PNC Cape Account for
property expenses.
03/06/2003
Cash
To open an account at Cape Cod
Bank
3,192.13
1,000.00
03/25/2003
04/16~2003
Cash
Distribution from PNC Money
Market account to deposit into
PNC Cape Account
Jewelry
on account of one-half
residuary share per Item III
of the Will
5,000.00
9,903.00
05/12/2003
05/17/2003
05/20/2003
05/2012003
07122/2003
Cash
Distribution from PNC Money
Market account to deposit into
PNC Cape Account
IRS, 2002 Federal Income Tax
refund
on account of one-half
residuary share per Item III
of the Will
1997 Mercury Mountaineer Sport
Utility 4D vehicle
Cash
One-half Phoenix-Jacob:
Phoenix Preferred Client
Checking Acct. #600100495
on account of one-half
residuary share per Item III
of the Will
Cash
One-half proceeds from sale of
Messiah Village Apartment
on account of one-half
residuary share per Item III
of the Will
2,500.00
4,641.50
8,612.00
28,829.77
47,553.38
(16)
Distributions of Principal to Beneficiaries (Continued)
Distribution Value
Mary Lynch Hess
11/06/2003
Jewelry
1/2 of value of jewelry buried
with decedent
2,130.00
11/06/2003
Household and personal
articles in decedent's
apartment at Messiah Village,
Mechanicsburg, PA
on account of one-half
residuary share per Item III
of the Will
1,000.00
11/06/2003
Household articles in
Massachusetts house
on account of one-half
residuary share per Item III
of the Will
1,615.00
01/05/2004
01/30/2004
01/30/2004
02/12/2004
02/20/2004
03/24/2004
Cash
Distribution for deposit into
PNC Cape Account
18 Shares
HSBC Holdings PLC
776 Shares
PNC Finl Svcs Group Inc
Common
New York Stock Exchange
Cash
Distribution for deposit into
PNC Cape Account
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
Cash
Distribution from PNC Money
Market account to deposit into
PNC Cape Account
5,000.00
956,42
35,086.84
5,000.00
3,278.81
5,000.00
(17)
Distributions of Principal to Beneficiaries (Continued)
Distribution Value
Mary Lynch Hess
06/26/2004
Cash
Distribution from PNC Estate
Checking account to deposit
into PNC Cape Account
07/12/2004 Cash
Transfer to Cape Cod 5 Account
Ann Hess Myers
02/08/2003
Cash
To open PNC Cape Account for
property expenses.
03/06/2003
Cash
To open an account at Cape Cod
Bank
$ 500.00
250.00
$ 3,192.13
1,000.00
171,048.85
03/25/2003
03/30/2003
04/16/2003
Cash
Distribution from PNC Money
Market account to deposit into
PNC Cape Account
Evergreen Cemetery
Burial Plot Lot No. 1319
Jewelry
on account of one-half
residuary share per Item III
of the Will
5,000.00
175.00
4,570.00
05/12/2003
05/17/2003
Cash
Distribution from PNC Money
Market account to deposit into
PNC Cape Account
IRS, 2002 Federal Income Tax
refund
on account of one-half
residuary share per Item III
of the Will
2,500.00
4,641.50
(18)
Distributions of Principal to Beneficiaries (Continued)
Distribution Value
Ann Hess Myers
05/2012003
Cash
One-half Phoenix-Jacob:
Phoenix Preferred Client
Checking Acct. #600100495
on account of one-half
residuary share per Item III
of the Will
28,829.76
05/22/2003
Cash
One-half proceeds from sale of
Messiah Village Apartment
on account of one-half
residuary share per Item III
of the Will
47,553.38
11/06/2003
Jewelry
1/2 of value of jewelry buried
with decedent
2,130.00
11/06/2003
Household articles in
Massachusetts house
on account of one-half
residuary share per Item III
of the Will
1,615.00
01/05/2004
01/30/2004
01/30/2004
02/12/2004
02/20/2004
Cash
Distribution for deposit into
PNC Cape Account
17 Shares
HSBC Holdings PLC
776 Shares
PNC Finl Svcs Group Inc
Common
New York Stock Exchange
Cash
Distribution for deposit into
PNC Cape Account
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
5,000.00
903.29
35,086.84
5,000.00
3,278.80
(19)
Distributions of Principal to Beneficiaries (Continued)
Distribution Value
Ann Hess Myers
03/24/2004
Cash
Distribution from PNC Money
Market account to deposit into
PNC Cape Account
06~26/2004
Cash
Distribution from PNC Estate
Checking account to deposit
into PNC Cape Account
07/12~004 Cash
Transfer to Cape Cod 5 Account
Total Distributions of Principal
$ 5,000.00
500.00
250.00
$ 156,225.70
$ 327,274.55
(20)
Estate of Florence Hess
Principal Balance On Hand
Valued as of August 26, 2004
Inventory Value
Cash and Cash Equivalents
PNC Bank Estate Account NO:
50-0000-2869
Estate Money Market
PNC Bank Account No.:
50-0205-5913
1,468.88
9,074.62
Total Cash and Cash Equivalents
$ .10,543.50
475,000
Real Property
Real property situate in
Chatham, Barnstable County,
Massachusetts, more
particularly described in Deed
dated February 2, 1990, and
recorded in the Office of the
Recorder of Deeds in and for
Barnstable County at Book 980,
page 79
475,000.00
Total Real Property
Total Balance on Hand
$ 475,000.00
$ 485,543.50
(21)
Estate of Florence Hess
Information Schedules - Principal
Exchanges and Stock Distributions
1997 Mercury Mountaineer Sport
Utility 4D vehicle
01/18/2003
05/20/2003
Received
Average of blue book trade-in
and private party values
Distribution
To Mary Lynch Hess
Inventory
Value
$ 8,612.00
(8,612.00)
Evergreen Cemetery
Burial Plot Lot NO. 1319
01/18/2003
03/30/2003
Received
Distribution
TO Ann Hess Myers
$ 175.00
(175.00)
At her death, decedent was
receivin~ a monthly annuity
payment of $139.57 under
Hartford Life Contract
#GA20187-0002. All payments
under this Contract ceased at
decedent's death.
01/29/2003
01/29/2003
Decedent's husband, Jacob Hess,
Esquire, had some involvement in
the F. Edward Hess Trust before
his death. This is a
testamentary trust which
originated in the Probate Court
of Stark County, Ohio and now
holds assets with an approximate
value of $14,000. No value has
been assigned to this Trust
because it is uncertain whether
decedent has any beneficial
interest in the Trust or will
ever receive a distribution from
the Trust.
01/18/2003
Received
Collected
Received
$ 139.57
(139.57)
$ 0.00
(22)
Information Schedules - Principal (Continued)
Exchanges and Stock Distributions
Household Intl Inc
Common
New York Stock Exchange
01/18/2003 66
08/22/2003 (66)
Shs.
Shs.
Received
Changed Name
to HSBC Holdings PLC
Name change effective on
8/22/2003
Inventory
Value
$ 1,859.71
(1,859.71)
HSBC Holdings PLC
08/22/2003 (31)
Shs.
Received via split
Reverse Stock Split at a rate
of 1.20
(31) Shs. On Hand
08/22/2003 66 Shs.
35 Shs.
01/30/2004 (17) Shs.
18 Shs.
01/30/2004 (18) Shs.
Changed Name
from Household Intl Inc
Common
New York Stock Exchange
Name change effective on
8/22/2003
On Hand
Distribution
TO Ann Hess Myers
On Hand
Distribution
To Mary Lynch Hess
$ 0.00
0.00
1,859.71
$ 1,859.71
(903.29)
$ 956.42
{956.42)
IRS, 2002 Federal Income Tax
refund
01/18/2003
05/17/2003
Received
Distribution
To Ann Hess Myers
on account of one-half
residuary share per Item III
of the Will
On Hand
$ 9,283.00
(4,641.50)
$ 4,641.50
(23)
Information Schedules - Principal (Continued)
Exchanges and Stock Distributions
IRS, 2002 Federal Income Tax
refund (Continued)
05/17/2003
Distribution
To Mary Lynch Hess
on account of one-half
residuary share per Item III
of the Will
Inventory
Value
$ (4,641.50)
Jewelry
01/18/2003
04/16/2003
04/16/2003
11/06/2003
11/06/2003
Received
Distribution
To Mary Lynch Hess
on account of one-half
residuary share per Item III
of the Will
On Hand
Distribution
To Ann Hess Myers
on account of one-half
residuary share per Item III
of the Will
On Hand
Distribution
To Ann Hess Myers
1/2 of value of jewelry
buried with decedent
On Hand
Distribution
To Mary Lynch Hess
1/2 of value of jewelry
buried with decedent
$ 18,733.00
(9,903.00)
$ 8,830.00
(4,570.00)
$ 4,260.00
(2,130.00)
$ 2,130.00
(2,130.00)
Messiah Village, refund of
acquisition fee for residential
unit in retirement community
01/18/2003
05/19/2003
Received
Collected
$ 95,106.75
(95,106.75)
(24)
Information Schedules - Principal (Continued)
Exchanges and Stock Distributions
PERS Retirement - Ohio
01/31/2003
01/31/2003
Received
Collected
Inventory
Value
323.52
(323.52)
Phoenix Cos., Inc. New
01/18/2003 34 shs.
08/26/2003 (34) Shs.
Received
Sold
$ 303.19
(303.19)
PNC Finl Svcs Group Inc
Common
New York Stock Exchange
01/18/2003 1,552 Shs.
01/30/2004 (776) Shs.
776 Shs.
01/30/2004 (776) Shs.
Received
Distribution
To knn Hess Myers
On Hand
Distribution
To Mary Lynch Hess
$ 70,173.68
(35,086.84)
$ 35,086.84
(35,086.84)
Real property situate in
Chatham, Barnstable County,
Massachusetts, more particularly
described in Deed dated February
2, 1990, and recorded in the
office of the Recorder of Deeds
in and for Barnstable County at
Book 980, page 79
01/18/2003
Received
On Hand
$ 475,000.00
$ 475,000.00
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD
01/18/2003
02/27/2003
03/10/2003
04/16/2003
Received
Collected
On Hand
collected
On Hand
Collected
$ 10,719.37
(370.87)
$ 10,348.50
(368.50)
$ 9,980.00
(373.97)
(25)
Information Schedules - Principal (Continued)
Exchanges and Stock Distributions
Proceeds receivable under
Agreement of sale dated March
20, 2000, between decedent and
Sean McLinden, MD (Continued)
04/16/2003
05/27/2003
05/27/2003
06/18/2003
07/17/2003
08/26/2003
09/12/2003
10/28/2003
11/12/2003
12/11/2003
02/20/2004
02/20/2004
On Hand
Collected
Reimbursement for insurance
On Hand
Collected
On Hand
Collected
Boat Insurance
On Hand
Collected
On Hand
Collected
On Hand
Collected
On Hand
Collected
On Hand
Collected
On Hand
Collected
On Hand
Collected
On Hand
Distribution
To Ann Hess Myers
On Hand
Distribution
To Mary Lynch Hess
Inventory
Value
$ 9,606.03
0.00
$ 9,606.03
(375.53)
$ 9,230.50
0.00
$ 9,230.50
(377.09)
$ 8,853.41
(378.67)
$ 8,474.74
(380.24)
$ 8,094.50
(381.83)
$ 7,712.67
(383.42)
$ 7,329.25
(385.02)
$ 6,944.23
(386.62)
$ 6,557.61
(3,278~80)
$ 3,278.81
(3,278.81)
(26)
Information Schedules - Principal (Continued)
Exchanges and Stock Distributions
Sale of Walker
01/18/2003
02/21/2003
Received
Sold
Inventory
Value
$ 50.00
(50.00)
Household articles in
Massachusetts house
01/18/2003
11/06/2003
11/06/2003
Received
Distribution
To A~n Hess Myers
on account of one-half
residuary share per Item III
of the Will
On Hand
Distribution
To Mary Lynch Hess
on account of one-half
residuary share per Item III
of the Will
$ 3,230.00
(1,615.00)
$ 1,615.00
(1,615.00)
Household and personal articles
in decedent's apartment at
Messiah Village, Mechanicsbur~,
PA
01/18/2003
11/06/2003
Received
Valued per estimate of
Executrices
Distribution
TO Mary Lynch Hess
on account of one-half
residuary share per Item III
of the Will
1,000.00
(1,000.00)
(27)
Estate of Florence Hess
Receipts of Income
Income Collected
PNC Bank Estate Account No:
50.0000-2869
02/25/2003 Interest
03/26/2003 Interest
04/25/2003 Interest
05/27/2003 Interest
06/25/2003 Interest
07/28/2003 Interest
08/26/2003 Interest
09/25/2003 Interest
10/28/2003 Interest
11/24/2003 Interest
12/26/2003 Interest
01/27/2004 Interest
02/24/2004 Interest
03/26/2004 Interest
04/27/2004 Interest
05/25/2004 Interest
06/25/2004 Interest
07/27/2004 Interest
08/26/2004 Interest
1.65
1.00
1.03
1.10
1.04
1.27
1.09
1.09
1.23
1.13
1.44
1.46
1.28
1.42
1.46
1.28
1.41
1.31
1.19
23.88
Estate Money Market
PNC Bank Account No.:
50-0205-5913
02/25/2003 Interest
03/26/2003 Interest
04/25/2003 Interest
05/27/2003 Interest
06/25/2003 Interest
07/23/2003 Interest
86.24
102.16
94.68
115.33
113.16
111.00
(28)
Receipts of Income (Continued)
Estate Money Market
PNC Bank Account No.:
50-0205-5913
08/26/2003 Interest
09/25/2003 Interest
10/28/2003 Interest
11/24/2003 Interest
12/26/2003 Interest
01/27/2004 Interest
02/24/2004 Interest
03/26/2004 Interest
04/27/2004 Interest
05/25/2004 Interest
06/25/2004 Interest
07/27/2004 Interest
08/26/2004 Interest
Estate Refund PA
08/09/2004 Miscellaneous Income
Household Intl Inc
Common
New York Stock Exchange
01/31/2003 Dividend on 66 Shares
05/13/2003 Dividend on 66 Shares
HSBC Holdings PLC
10/14/2003 Dividend on 35 Shares
69.67
69.74
73.08
37.48
45.09
41.02
31.63
31.50
27.82
24.18
21.91
21.87
23.86
$ 1.24
$ 16.50
57.38
42.00
1,141.42
1.24
73.88
42.00
(29)
Receipts of Income (Continued)
Phoenix Cos., inc. New
07/30/2003 Dividend on 34 shares
PNC Bank Checking Acct.
#50-0354-7741
01/22/2003
Interest
Less accrued portion
02/04/2003 Interest
PNC Finl Svcs Group Inc
Common
New York Stock Exchange
01/24/2003 Dividend on 1,552 Shares
Less accrued portion
05/06/2003
07/31/2003
11/07/2003
Dividend on 1,552 Shares
Dividend on 1,552 Shares
Dividend on 1,552 Shares
PNC Bank Money Market Acct.
#50-0190-2383
01/22/2003
Interest
Less accrued portion
02/05/2003 Interest
PNC Bank Checking Account
#50-0202-6725
01/22/2003
Interest
Less accrued portion
02/05/2003 Interest
5.44
$ 1.15
(1.08)
0.46
$ 744.96
(744.96)
744.96
744.96
776.00
175.01
(165.90)
59.55
$ 4.05
(3.82)
1.54
5.44
0.53
2,265.92
68.66
(30)
Receipts of Income (Continued)
PNC Bank Checking Account
#50-0202-6725
1.77
Proceeds receivable under
Agreement of sale dated March 20,
2000, between decedent and Sean
McLinden, MD
02/27/2003 Interest
03/10/2003 Interest
04/16/2003 Interest
05/27/2003 Interest
06/18/2003 Interest
07/17/2003 Interest
08/26/2003 Interest
09/12/2003 Interest
10/28/2003 Interest
11/12/2003 Interest
12/11/2003 Interest
Total Income Received
$ 43.13
45.50
40.03
38.47
36.91
35.33
33.76
32.17
30.58
28.98
27.38
392.24
4,016.98
(31)
Estate of Florence Hess
Gains and Losses on Sales or Other Dispositions of Income
Net Gain
Net Loss
0~05/2003 Colle~ion
PNC Bank Checking Acct.
~50-0354-7741
N~Proceeds $
Ca~ied at
0.53
0.53
02~05/2003 Collection
PNC Bank Money Market Acct.
~50-0190-2383
Net Proceeds $
Carried at
68.66
68.66
02/05/2003 Collection
PNC Bank Checking Account
~50-0202-6725
Net Proceeds $
Carried at
Total Gains and Losses
No Gain or Loss
1.77
1.77
$ 0.00
$ o.oo
$ 0.00
(32)
Estate of Florence Hess
Disbursements of Income
Date Paid
Amount Paid
Total Disbursements of Income
0.00
(33)
Estate of Florence Hess
Distributions of Income to Beneficiaries
Distribution Value
Total Distributions of Income
0.00
(34)
Estate of Florence Hess
Income Balance On Hand
Valued as of August 26, 2004
Inventory Value
Cash and Cash Equivalents
PNC Bank Estate Account NO:
50-0000-2869
Estate Money Market
PNC Bank Account No.:
50-0205-5913
2,760.16
1,256.82
Total Cash and Cash Equivalents
Total Balance on Hand
4,016.98
4,016.98
(35)
AFFIDAVIT
Ann Hess Myers and Mary Lynch Hess, Co-Executors, under the Last Will and Testament of
Florence Furfey Hess, deceased, hereby declare under oath that they have fully and faithfully discharged
the duties of their office; that the foregoing Account is true and correct and fully discloses all significant
transactions occurring during the accounting period; that all known claims against the Estate have been
paid in full; that, to their knowledge, there are no claims now outstanding against the Estate; that all
taxes presently due from the Estate have been paid; and that more than four months have elapsed since
the first complete advertisement of the granting of letters in tbJs Estate.
Ann Hess Myers, Co-Executor
Mary Lynch Hess, Co-Executor
Sworn to and subscribed before me this
,2004.
day of
NOTARY PUBLIC
MY COMMISSION EXPIRES:
AFFIDAVIT
Ann Hess Myers and Mary Lynch Hess, Co-Executors, under the Last Will and Testament of
Florence Furfey Hess, deceased, hereby declare under oath that they have fully and faithfully discharged
the duties of their office; that the foregoing Account is true and correct and fully discloses all significant
transactions occurring during the accounting period; that all known claims against the Estate have been
paid in full; that, to their knowledge, there are no claims now outstanding against the Estate; that all
taxes presently due from the Estate have been paid; and that more than four months have elapsed since
the first complete advertisement of the granting of letters in this Estate.
Ann Hess Myers, Co-Executor
Mary Lynch Hess, Co-Executor
Swom to and subscribed before me this [~ay of
NOTARY PUB£IC'
MY COMMISSION EXPIRES:
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Kimberly A. Meals, Notary Public
City of Harrisburg Dauphin Count,
My Commission Expires Mar. 11, 2007
Member, Pennsylvania Association of Notaries
AFFIDAVIT
Ann Hess Myers and Mary Lynch Hess, Co-Executors, under the Last Will and Testament of
Florence Furfey Hess, deceased, hereby declare under oath that they have fully and faithfully discharged
the duties of their office; that the foregoing Account is tree and correct and fully discloses all significant
transactions occurring during the accounting period; that all known claims against the Estate have been
paid in full; that, to their knowledge, there are no claims now outstanding against the Estate; that all
taxes presently due from the Estate have been paid; and that more than four months have elapsed since
the first complete advertisement of the granting of letters in this Estate.
Ann Hess Myers, Co-Executor
Ma~JLyn~ Hess, Co-Executor
Sworn to and subscribed before me this ~;~ day of
.~-4bfF', 2004.
NOT ~ARY ~7~ LIC(~
ANNIE Y YANG
MY COMMISSION EXPIRES' Nota- p .... '
· ry uDI~c, State of Maryland
My Commission Expires July 1,200~
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 00091-2003
FIRST AND FINAL ACCOUNTING OF
Ann Hess Myers and Mary Lynch Hess
Co-Executors
For
ESTATE OF Florence Furfey Hess, Deceased
The PNC Cape Account
Date of Death:
Date of Appointment:
Date of First Complete
Advertisement of Letters:
Accounting for the Period:
January 18, 2003
January 30, 2003
February 18, 2003
January 18, 2003
to August 5, 2004
Purpose of Account: Ann Hess Myers and Mary Lynch Hess, Co-Executors, offer this account to acquaint
interested parties with the transactions that have occurred during their administration.
The account also indicates the proposed distribution of the estate.
It is important that the account be carefully examined. Requests for additional information, or questions, or
objections, can be discussed with:
Joanne Book Christine, Esquire
Rhoads & Sinon LLP
One South Market Square
12th Floor P.O. Box 1146
Harrisburg, PA 17108-1146
(717) 233-5731
494653.1
Estate of Florence Furfey Hess
Summary of Account
Principal
Receipts
Net Gain on Sales or Other Dispositions
Less Disbursements:
Administrative Expenses
Balance Before Distributions
Less Distributions to Beneficiaries
Principal Balance On Hand
For Information:
investments Made
Unpaid Expenses
Unrealized Gains and Losses
Income Receipts
Net Gain on Sales or Other Dispositions
Less Disbursements:
Administrative Expenses
Balance Before Distributions
Less Distributions to Beneficiaries
Income Balance on Hand
For Information:
Investments Made
Unpaid Expenses
Unrealized Gains and Losses
Combined Balance on Hand
Page
2
5
9
25
26
27
27
27
27
29
30
31
32
33
33
33
$ 65~ 136.42
$ 6,960.18
$ 66,324.26
0.00
$ 66,324.26
65~136.42
$ 1,187.84
0.00
1,187.84
$ 8,670.42
0.00
$ 8,670.42
6~960.18
$ 1,710.24
0.00
1,710.24
2,898.08
(1)
Estate of Florence Furfey Hess
Receipts of Principal
RECEIPTS SUBSEQUENT TO INVENTORY
02/08/2003
Cash from Ann Hess Myers
02/08/2003
Cash from Mary Lynch Hess
03/25/2003
Cash from Ann Hess Myers
03/25/2003
Cash from Mary Lynch Hess
05/12/2003
Cash from Ann Hess Myers
05/12/2003
Cash from Mary Lynch Hess
o5/17/2oo3
Cash from Ann Hess Myers
05/17/2003
Cash from Mary Lynch Hess
01/05/2004
Cash from Ann Hess Myers
01/05/2004
Cash from Mary Lynch Hess
01/16/2004
Cash from Ann Hess Myers and
Mary Lynch Hess pertaining to
the sailboat
Interest to Date of Death
01/29/2004
DIV HSAC
02/12/2004
Cash from Ann Hess Myers
3,192.13
3,192.13
5,000.00
5,000.00
2,500.00
2,500.00
4,641.50
4,641.50
5,000.00
5,000.00
388.23
25.77
21.00
5,000.00
(2)
Receipts of Principal (Continued)
RECEIPTS SUBSEQUENT TO INVENTORY
02/12/2004
Cash from Mary Lynch Hess
o2/17/2oo4
Cash from Ann Hess Myers and
Mary Lynch Hess pertaining to
the sailboat
Interest to Date of Death
03/13/2004
Cash from Ann Hess Myers and
Mary Lynch Hess pertaining to
the sailboat
Interest to Date of Death
03/24/2004
Cash from Ann Hess Myers
03/24/2004
Cash from Mary Lynch Hess
04/14/2004
Cash from Ann Hess Myers and
Mary Lynch Hess pertaining to
the sailboat
04/27/2004
Cash from Ann Hess Myers and
Mary Lynch Hess pertaining to
the sailboat
Interest to Date of Death
04/27/2004
Cleaning Refund
06/29/2004
Cash from Ann Hess Myers
06/29/2004
Cash from Mary Lynch Hess
5,000.00
389.85
24.15
391.47
22.53
5,000.00
5,000.00
2,500.00
393.10
20.90
240.00
500.00
500.00
(3)
Receipts of Principal (Continued)
RECEIPTS SUBSEQUENT TO INVENTORY
07/21/2004
Cleaning Refund
Total Receipts of Principal
240.00
66,324.26
(4)
Estate of Florence Furfey Hess
Gains and Losses on Sales or Other Dispositions of Principal
Net Gain
02/08/2003 Collection
Cash from Ann Hess Myers
Net Proceeds $
Carried at
3,192.13
3,192.13
02/08/2003 Collection
Cash from Mary Ly~nch Hess
Net Proceeds $
Carried at
3,192.13
3,192.13
03~25/2003 Collection
Cash from Ann Hess Myers
Net Proceeds $
Carried at
5,000.00
5,000.00
03/25/2003 Collection
Cash from Mary Lynch Hess
Net Proceeds $
Carried at
5,000.00
5,000.00
05/12/2003 Collection
Cash from Ann Hess Myers
Net Proceeds $
Carried at
2,500.00
2,500.00
05/12/2003 Collection
Cash from Mary Lynch Hess
Net Proceeds $
Carried at
2,500.00
2,500.00
05/17/2003 Collection
Cash from Ann Hess Myers
Net Proceeds $
Carried at
4,641.50
4,641.50
05/17/2003 Collection
Cash from Mary Lynch Hess
Net Proceeds $
Carried at
4,641.50
4,641.50
Net Loss
(5)
Gains and Losses on Sales or Other Dispositions of Principal (Continued)
Net Gain Net Loss
01/05/2004 Collection
Cash from Ann Hess Myers
Net Proceeds $
Carried at
5,000.00
5,000.00
01/05/2004 Collection
Cash from Mary Lynch Hess
Net Proceeds $
Carried at
5,000.00
5,000.00
01/16/2004 Collection
Cash from Ann Hess Myers and
Mary Lynch Hess pertaining to
the sailboat
Net Proceeds $
Carried at
388.23
388.23
01/29/2004 Collection
DIV HSAC
Net Proceeds
Carried at
21.00
21.00
02/12/2004 Collection
Cash from Ann Hess Myers
Net Proceeds $
Carried at
5,000.00
5,000.00
02/12/2004 Collection
Cash from Mary Lynch Hess
Net Proceeds $
Carried at
5,000.00
5,000.00
02/17~004 Colle~ion
Cash from Ann Hess Myers and
Mary Lynch Hess pertaining to
the sailboat
Net Proceeds $
Carried at
389.85
389.85
(6)
Gains and Losses on Sales or Other Dispositions of Principal (Continued)
Net Gain
03/13/2004 Collection
Cash from Ann Hess Myers and
Mary Lynch Hess pertaining to
the sailboat
Net Proceeds $
Carried at
391.47
391.47
03/24/2004 Collection
Cash from Ann Hess Myers
Net Proceeds $
Carried at
5,000.00
5,000.00
03/24/2004 Collection
Cash from Mary Lynch Hess
Net Proceeds $
Carried at
5,000.00
5,000.00
04/14/2004 Sale
Cash from Ann Hess Myers and
Mary Lynch Hess pertaining to
the sailboat
Net Proceeds $
Carried at
2,500.00
2,500.00
04~27/2004 Collection
Cash from Ann Hess Myers and
Mary Lynch Hess pertaining to
the sailboat
Net Proceeds $
Carried at
393.10
393.10
04/27/2004 Collection
Cleaning Refund
Net Proceeds
Carried at
240.00
240.00
06/29/2004 Collection
Cash from Ann Hess Myers
Net Proceeds $
Carried at
500.00
500.00
Net Loss
(7)
Gains and Losses on Sales or Other Dispositions of Principal (Continued)
Net Gain Net Loss
06~29~2004 Collection
Cash from Mary Lynch Hess
Net Proceeds $
Carried at
500.00
500.00
07121/2004 Collection
Cleaning Refund
Net Proceeds
Carried at
240.00
240.00
Total Gains and Losses
No Gain or Loss
$
$
0.00 $
0.00
0.00
(8)
Estate of Florence Furfey Hess
Disbursements of Principal
Date Paid
Amount Paid
01/15/2004
02/22/2003
03/22/2003
05/01/2003
05/17/2003
06/26/2003
07/28/2003
09/02/2003
09/20/2003
10/23/2003
11/26/2003
12/2912003
Administration Expenses
All Cape
Check Number 197
AT&T
Telephone Bill
AT&T
Telephone Bill
AT&T
Telephone Bill
AT&T
Telephone Bill
AT&T
Telephone Bill
AT&T
Telephone Bill
AT&T
Telephone Bill
AT&T
Telephone Bill
AT&T
Telephone Bill
Check Number 176
AT&T
Telephone Bill
Check Number 185
AT&T
Telephone Bill
Check Number 195
967.50
6.00
8.26
5.89
25.81
9.21
14.58
10.61
28.24
11.68
7.60
63.19
(9)
Disbursements of Principal (Continued)
Date Paid
01/23/2004
02/2712004
03/26/2004
04~27/2004
05/27/2004
12/11/2003
01121~2004
05/18/2004
05/24/2004
05/27/2004
07/29/2003
Administration Expenses
AT&T
Telephone Bill
Check Nunfoer 201
AT&T
Telephone Bill
AT&T
Telephone Bill
Check Number 216
AT&T
Telephone Bill
Check Number 232
AT&T
Telephone Bill
Barnstable Insurance
Check Number 191
Barnstable Insurance
Check Number 199
Barnstable Insurance
Ben Franklin Crafts
BJ Wholesale
Supplies
Bon-Ton
Miscellaneous
Amount Paid
7.24
7.24
11.98
11.09
13.73
16.00
1,079.00
82.00
28.81
82.66
53.98
(10)
Disbursements of Principal (Continued)
Date Paid
05/05/2003
05131/2003
04/24/2003
06/23/2003
11/28/2003
02/10/2004
04/07/2004
07/18~2003
07/30/2004
12/08/2003
01/29/2004
05/13/2004
03/07/2003
03/30/2003
Administration Expenses
Cape Cutter Landscaping
Landscaping Services
Cape Cutter Landscaping
Landscaping Services
Chatham Hardware
Chatham Hardware
Chatham Hardware
Chatham Hardware
Check Number 207
Chatham Hardware
Chatham Village Realty
Chatham Village Realty
Check Number 265
Clean Sweep Chimney
Check Number 188
Clean Sweep Chimney
Check Number 203
Clean Sweep Chinuley
Comcast
Cable Bill
Comcast
Cable Bill
Amount Paid
49.00
210.00
63.01
7.32
17.84
40.00
17.62
275.00
265.00
75.00
1,036.00
525.00
5.39
95.90
(11)
Disbursements of Principal (Continued)
Date Paid
05/02/2003
06/09/2003
07/08/2003
07/30/2003
08/29/2003
09/26/2003
10/29/2003
12/10/2003
03/31/2004
05/0512004
06/08/2004
Administration Expenses
Comcast
Cable Bill
Comcast
Cable Bill
Comcast
Cable Bill
Comcast
Cable Bill
Comcast
Cable Bill
Comcast
Cable Bill
Comcast
Cable Bill
Check Number 180
Comcast
Cable Bill
Check Number 187
Comcast
Cable Bill
Check Number 221
Comcast
Cable Bill
Check Number 237
Comcast
Cable Bill
Check Number 246
Amount Paid
45.70
45.71
45.71
45.71
45.71
45.70
45.70
42.84
90.41
48.94
49.02
(12)
Disbursements of Principal (Continued)
Date Paid
07/07/2004
07~30/2004
04/21/2003
04/19/2004
04/21/2003
08/21/2003
11/25/2003
04/05/2004
05/06/2003
10/05/2003
03/23/2004
05/28/2004
04/21/2003
07/18~2003
Administration Expenses
Comcast
Cable Bill
Check Number 257
Comcast
Cable Bill
Check Number 268
Flood Insurance
Flood Insurance
Check Number 228
Hinckley Home Center
Hinckley Home Center
Hinckley Home Center
Hinckley Home Center
Home Depot
Materials for Cape House
Home Depot
Materials for Cape House
Home Depot
Materials for Cape House
Home Depot
Materials for Cape House
Intercity Alarm
Intercity Alarm
Amount Paid
48.98
48.98
1,008.00
1,015.00
34.30
19.68
22.33
46.18
139.63
126.14
190.13
8.98
68.00
68.00
(13)
Disbursements of Principal (Continued)
Date Paid
10/04/2003
10/10/2003
0'1/26/2004
01/28/2004
04/21/2004
04/26/2004
0712112004
09/27/2003
03120/2003
03/20/2003
04/23~2003
05/12/2003
05~23~2003
06130/2003
Administration Expenses
Intercity Alarm
Intercity Alarm
Intercity Alarm
Check Number 204
Intercity Alarm
Check Number 205
Intercity Alarm
Check Number 230
Intercity Alarm
Check Number 233
Intercity Alarm
Check Number 262
J. Eldridge Construction
John Hammond
Repairs
John Hammond
Fence
John Hammond
John Hammond
Door
John Hammond
Basement
John Hammond
Amount Paid
73.50
68.00
156.00
169.58
68.00
84.00
68.00
65.00
1,515.50
1,100.00
1,669.69
1,000.00
3,476.00
7,724.25
(14)
Disbursements of Principal (Continued)
Date Paid
02/18/2004
02/27/2004
03/30/2004
04/07/2004
07/07/2004
05/10/2003
08/18/2003
09/08/2003
10/04/2003
11/13/2003
12/11/2003
01/16/2004
02/13/2004
03/09/2004
Administration Expenses
John Hammond
John Hammond
John Hammond
Check Number 218
John Hammond
Check Number 224
John Hammond
Check Number 258
Keyspan
Keyspan
Keyspan
Keyspan
Keyspan
Check Number 182
Keyspan
Check Number 190
Keyspan
Check Number 198
Keyspan
Keyspan
Check Number 215
Amount Paid
6,000.00
4,000.00
6,008.18
831.71
992.00
72.18
19.28
29.68
13.07
38.74
35.34
107.74
163.47
126.47
(15)
Disbursements of Principal (Continued)
Date Paid
04/15/2004
05/12/2004
06/15/2004
07/16/2004
04/05/2004
04/14/2003
02/'12/2003
02/22/2003
03/08/2003
03/30/2003
03130/2003
04/'14/2004
07/14/2004
Administration Expenses
Keyspan
Check Number 227
Keyspan
Keyspan
Check Number 252
Keyspan
Check Number 260
Killian Fireplace Center
Kohl's
Kurt Myers
Reimbursement of phone
and electric
Kurt Myers
DVD
Kurt Myers
Door knobs
Kurt Myers
Radios
Kurt Myers
Cable Supplies
Kurt Myers
Supplies
Check Number 229
Kurt Myers
Mousehold Item
Amount Paid
104.81
81.45
24.89
23.64
42.27
239.51
245.08
351.77
132.32
95.35
80.18
75.34
16.18
(16)
Disbursements of Principal (Continued)
Date Paid
06/01/2003
07/07/2003
07/29/2003
04/05/2004
07/08/2003
10/28/2003
06/04/2004
03/14/2003
04/29/2003
07/21/2003
07/26/2003
07/31/2003
08/15/2003
08/19/2003
Administration Expenses
Check Number 261
Linens N Things
Linens N Things
Linens N Things
Linens N Things
Mid Cape Pest Control
Mid Cape Pest Control
Check Number 177
Mid Cape Pest Control
Nickerson, Ben
Trash/Cleaning
Nickerson, Ben
Trash/Cleaning
Nickerson, Ben
Trash/Cleaning
Nickerson, Ben
Trash/Cleaning
Nickerson, Ben
Trash/Cleaning
Nickerson, Ben
Trash/Cleaning
Nickerson, Ben
Trash/Cleaning
Amount Paid
44.50
72.90
21.19
23.30
230.00
250.00
155.00
75.00
100.00
45.00
60.00
60.00
24.00
60.00
(17)
Disbursements of Principal (Continued)
Date Paid
Amount Paid
Administration Expenses
09/03/2003
Nickerson, Ben
Trash/Cleaning
60.00
09/08/2003
Nickerson, Ben
Trash/Cleaning
78.00
10/04/2003
Nickerson, Ben
Trash/Cleaning
7.00
11/14/2003
Nickerson, Ben
Trash/Cleaning
Check Number 183
40.00
12/16/2003
Nickerson, Ben
Trash/Cleaning
Check Number 189
9.50
03/23/2004
Nickerson, Ben
Trash/Cleaning
Check Number 214
45.00
04/07/2004
Nickerson, Ben
Trash/Cleaning
Check Number 223
100.00
04/27/2004
Nickerson, Ben
Trash/Cleaning
Carolyn Nickerson
Check Number 234
30.00
07/14/2004
Nickerson, Ben
Trash/Cleaning
Check Number 256
45.00
08/02J2004
Nickerson, Ben
Trash/Cleaning
Check Number 264
30.00
(18)
Disbursements of Principal (Continued)
Date Paid
02/22/2003
03/08/2003
O6/23/2OO3
07/24/2003
08/25/2003
09/20/2003
10/21/2003
11/25/2003
12/23/2003
01/21/2004
02/20/2004
03/23/2004
04/20/2004
05/25/2004
06/24/2004
Administration Expenses
NSTAR
NSTAR
NSTAR
NSTAR
NSTAR
NSTAR
NSTAR
Check Number 175
NSTAR
Check Number 184
NSTAR
Check Number 193
NSTAR
Check Number 200
NSTAR
NSTAR
Check Number 217
NSTAR
Check Number 231
NSTAR
NSTAR
Amount Paid
17.53
17.53
121.74
45.99
80.87
69.06
19.06
32.13
45.76
27.74
38.42
40.26
46.25
28.75
34.44
(19)
Disbursements of Principal (Continued)
Date Paid
07/23/2004
04~25~2003
04/28/2003
04/28/2003
08/21/2003
08/25/2003
11/25/2003
04/08/2004
04/15/2004
05/21/2004
06/18/2004
06/30/2004
Administration Expenses
Check Number 253
NSTAR
Check Number 266
Ocean State Job Lot #2
Tables/Deck
Ocean State Job Lot #2
Tables/Deck
Ocean State Job Lot #2
Tables/Deck
Ocean State Job Lot #2
Tables/Deck
Ocean State Job Lot #2
Tables/Deck
Ocean State Job Lot #2
Tables/Deck
Ocean State Job Lot #2
Tables/Deck
Perry Borden
Check Number 226
Perry Borden
Perry Borden
Check Number 251
Perry Borden
Check Number 255
Amount Paid
53.64
73.45
76.05
27.28
57.73
41.99
21.85
11.52
1,139.00
1,726.00
158.35
330.00
(20)
Disbursements of Principal (Continued)
Date Paid
02/13/2003
06/23/2003
04/13/2004
06/08/2004
05/24/2003
06/12/2003
09/18/2003
10/14/2003
03/08/2004
04/12/2004
05/06/2004
11/07/2003
05/12/2004
06/04/2004
Administration Expenses
PNC Bank
Cape Account Checks
R.H. White Plumbing
R.H. White Plumbing
Check Number 225
R.H. White Plumbing
Check Number 250
Rpm Carpets Inc.
Rpm Carpets Inc.
Rpm Carpets Inc.
Rpm Carpets Inc.
Rpm Carpets Inc.
Rpm Carpets Inc.
Sean McLinden
Boat
Check Number 236
Greg Small Landscaping
Landscaping at Cape House
Check Number 181
Greg Small Landscaping
Landscaping at Cape House
Greg Small Landscaping
Landscaping at Cape House
Amount Paid
15.99
709.75
273.61
94.00
1,247.93
1,247.92
850.00
708.51
1,139.49
1,139.49
414.00
150.00
240.00
140.00
(21 )
Disbursements of Principal (Continued)
Date Paid
07/20/2004
05/28/2004
04/24/2003
04/24/2003
03/31/2004
04/05/2004
04/05/2003
04/05/2003
07/30/2003
10/11/2003
t2/24/2003
01/21/2004
04/0612004
07/20/2004
Administration Expenses
Gre~ Small Landscaping
Landscaping at Cape House
Check Number 259
Stop & Shop
Supplies
Tale of the Cod
Tale of the Cod
Tax - Real Estate
The Bombay Company
Town of Chatham
Town of Chatham
Town of Chatham
Town of Chatham
Town of Chatham
Check Number 194
Town of Chatham
Check Number 202
Town of Chatham
Check Number 222
Town of Chatham
Check Number 263
Amount Paid
175.00
20.85
93.45
40.43
1,256.82
51.94
1,211.78
21.00
33.00
57.50
1,256.82
21.00
21.00
33.00
(22)
Disbursements of Principal (Continued)
Date Paid
05/12/2003
03/02/2003
03/30/2003
05/01/2003
05/24/2003
06/27/2003
07/27/2003
08/28/2003
09/26/2003
10/29/2003
12/05/2003
12/31/2003
Administration Expenses
UPS-Faucet
Verizon
Telephone Bill
Verizon
Telephone Bill
Verizon
Telephone Bill
Verizon
Telephone Bill
Verizon
Telephone Bill
Verizon
Telephone Bill
Verizon
Telephone Bill
Verizon
Telephone Bill
Verizon
Telephone Bill
Check Number 179
Verizon
Telephone Bill
Check Number 186
Verizon
Telephone Bill
Check Number 196
Amount Paid
17.04
28.86
28.86
28.84
28.81
29.77
32.00
31.36
32.21
32.21
33.15
32.20
(23)
Disbursements of Principal (Continued)
Date Paid
01/28/2004
03/04/2004
03/31/2004
04/28/2004
06/0712004
06/2912004
0712812004
Administration Expenses
Verizon
Telephone Bill
Check Number 206
Verizon
Telephone Bill
Check Number 213
Verizon
Telephone Bill
Check Number 220
Verizon
Telephone Bill
Check Number 235
Verizon
Telephone Bill
Check Number 247
Verizon
Telephone Bill
Check Number 254
Verizon
Telephone Bill
Check Number 267
Total Administration Expenses
Total Disbursements of Principal
Amount Paid
$ 32.84
32.17
32.25
32.77
40.07
39.05
41.87
$ 65,136.42
$ 65~ 136.42
(24)
Estate of Florence Furfey Hess
Distributions of Principal to Beneficiaries
Distribution Value
Total Distributions of Principal
0.00
(25)
Estate of Florence Furfey Hess
Principal Balance On Hand
Valued as of August 26, 2004
Inventory Value
Cash and Cash Equivalents
PNC Bank Cape Account
Total Cash and Cash Equivalents
Total Balance on Hand
$ 1,187.84
$ 1,187.84
$ 1,187.84
(26)
Estate of Florence Furfey Hess
Receipts of Income
02/17/2004
03/13/2004
04/27/2004
Income Collected
Cash from Ann Hess Myers and Mary
Lynch Hess pe~aining to the sailboat
01/16/2004 Interest
Less accrued portion
Interest
Less accrued portion
Interest
Less accrued portion
Interest
Less accrued portion
PNC Bank Cape Account
11/07/2003 Miscellaneous Income
Cleaning
12/22/2003 Miscellaneous Income
ATT
Rent received from Massachusetts
prope~y
02/18/2003 Rent
Shirmeier
05/31/2003 Rent
06/26/2003 Rent
06/30/2003 Rent
08/11/2003 Rent
11/12/2003 Rent
11/20/2003 Rent
12/01/2003 Rent
06/02/2004 Rent
07/22/2004 Rent
07/30/2004 Rent
$ 25.77
(25.77)
24.15
(24.iS)
22.53
(22.53)
20.90
(20.90)
40.00
50.42
490.00
700.00
700.00
1,400.00
1,400.00
490.00
490.00
490.00
700.00
1,020.00
700.00
0.00
90.42
(27)
Receipts of Income (Continued)
Rent received from Massachusetts
property
Total Income Received
8,580.00
$ 8,670.42
(28)
Estate of Florence Furfey Hess
Gains and Losses on Sales or Other Dispositions of Income
Net Gain
Net Loss
No Gain or Loss
$ 0.00
(29)
Estate of Florence Furfey Hess
Disbursements of Income
Date Paid
06/02/2004
03/14~2003
05125/2004
07/23/2003
08/20/2003
09/20/2003
Administration Expenses
John Eammond
Kurt Myers
Stove
Linens N Things
Greg Small Landscaping
Landscaping at Cape House
Greg Small Landscaping
Landscaping at Cape House
Greg Small Landscaping
Landscaping at Cape House
Total Administration Expenses
Total Disbursements of Income
Amount Paid
$ 3,462.50
2,979.87
67.81
150.00
150.00
150.00
$ 6,960.18
$ 67960.18
(3O)
Estate of Florence Furfey Hess
Distributions of Income to Beneficiaries
Distribution Value
Total Distributions of Income
0.00
(31)
Estate of Florence Furfey Hess
Income Balance On Hand
Valued as of August 26, 2004
Inventory Value
Cash and Cash Equivalents
PNC Bank Cape Account
$ 1,710.24
Total Cash and Cash Equivalents
Total Balance on Hand
1,710.24
1,710.24
(32)
AFFIDAVIT
Ann Hess Myers and Mary Lynch Hess, Co-Executors, under the Last Will and Testament of
Florence Furfey Hess, deceased, hereby declare under oath that they have fully and faithfully discharged
the duties of their office; that the foregoing Account is true and correct and fully discloses all significant
transactions occurring during the accounting period; that all known claims against the Estate have been
paid in full; that, to their knowledge, there are no claims now outstanding against the Estate; that all
taxes presently due from the Estate have been paid; and that more than four months have elapsed since
the first complete advertisement of the granting of letters in this Estate.
Mary Lynch Hess, Co-Executor
Sworn to and subscribed before me this I ~Y of
_-~,D~. ,2004. ly2t ~hCl ~ ~
NO~)kRy PUI~IC' ' -
MY COMMISSION EXPIRES:
COMMONWEALTH OF PENNSYLVANIA
Notarial Sea ]
Kimberly A Meals, Notary Public I
~ City of Harrisburg Dauph n County
[ My Comraiss on Expires Mar. I 1, 2007
AFFIDAVIT
Ann Hess Myers and Mary Lynch Hess, Co-Executors, under the Last Will and Testament of
Florence Furfey Hess, deceased, hereby declare under oath that they have fully and faithfully discharged
the duties of their office; that the foregoing Account is true and correct and fully discloses all significant
transactions occurring during the accounting period; that all known claims against the Estate have been
paid in full; that, to their knowledge, there are no claims now outstanding against the Estate; that all
taxes presently due from the Estate have been paid; and that more than four months have elapsed since
the first complete advertisement of the granting of letters in this Estate.
Ann Hess Myers, Co-Executor
Mal~yr~ Hess, Co-Executor
Sworn to and subscribed before me this lb'~ day of
..~4.~r' , 2004.
NOT z. r. zy PUBLIC
ANNIE Y. YANG
MY COMMISSION EXPIRES: Notary Public, State of Marylan¢~
My Commission Expires July 1, 2006
ESTATE OF FLORENCE FURFEY HESS
Schedule of Proposed Distribution
PNC Bank Estate Account No.: 50-0000-2869
Principal
Income
TOTAL
PNC Estate Money Market Account No.: 50-0205-5913
Principal
Income
TOTAL
TOTAL CASH
1,468.88
2,760.16
4,229.04
9,074.62
1,256.82
10,331.44
EXHIBIT "C"
TO: ANN HESS MYERS
Previous Distributions made throughout the accounting period to date
Cash and Cash Equivalents
Adjustment to equal distribution to Mary Lynch Hess
PNC Estate Money Market Account No.: 50-0205-5913
Principal
Income
TOTAL
PNC Bank Estate Account No.: 50-0000-2869
Principal
Income
TOTAL
TOTAL CASH
Real Property
Massachusetts Real Estate
156,225.70
9,074.62
1,256.82
10,331.44
1,468.88
2,760.16
4,229.04
$14.560.48
$237,500.00
TOTAL
TO: MARY LYNCH HESS
Previous Distributions made throughout the accounting period to date
Real Property
Massachusetts Real Estate
TOTAL
TOTAL DISTRIBUTIONS
171,048.85
$237,500.00
$408.548.85
$816.835.03
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
Florence Furfey Hess
Date of Death: January 18, 2003
Will No. Admin. No. 2003-00091
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete:
Yes
o
If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
No X
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
543516.1
Co
parties in interest? Yes
Did the personal representative state an account informally to the
X No
d. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this
report.
Date:
(,~'/~ature
~ $oanne E. Book
Name (Please type or print)
Rhoads & Sinon LLP
One South Market Square~ 12th Floor
Harrisburg~ PA 17101
Address
(717) 233-5731
Telephone No.
Capacity: Personal Representative
X Counsel for Personal Representative
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 12/01/2004
MENDELSOHN AMY J
1 SOUTH MARKET STREET
PO BOX 1146
HARRISBURG, PA 17108-1146
RE: Estate of HESS FLORENCE FURFEY
File Number: 2003-00091
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 AMENDMENTS 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: 1/18/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc:
File
Personal Representative(s)
Judge
BUREAU OF *rND'rV'rDUAL TAXES
I'NHERTTANCE TAX DTVTSZnN
DEPT. ZSn601
HARRZSBURG, PA 17128-0601
COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF DETERMZNATZON AND
ASSESSMENT OF PENNSYLVANIA
ESTATE TAX BASED ON FEDERAL
ESTATE TAX RETURN
REV-ii83 EX AFP CD1-05)
JOANNE BOOK CHRISTINE ESQ
RHOADS & SINON
PO BOX 11q6
HBG PA 17108
DATE 07-05-2004
ESTATE OF HESS
DATE OF DEATH 01-18-200:5
FILE NUMBER 21 0:5-0091
COUNTY CUMBERLAND
ACN 201
I Amount Remit'l:ed
FLORENCE F
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF NILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 1701:5
NOTE: To /nsure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR FILES
OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN
ESTATE OF HESS FLORENCE F FILE N0.21 0:5-0091 ACN 201 DATE 07-05-2004
ESTATE TAX DETERMZNAT'rON
1. Cred/t For State Death Taxes as Vet/f/ed
2. Pennsylvan/a Inher/tance Tax Assessed
(Excluding O/scount and/or Interest)
:5. Inher/tance Tax Assessed by Other States
or Territories of the United States
(Excluding D/scount and/or Interest)
4. Total Inheritance Tax Assessed
5. Pennsylvania Estate Tax Due
TAX CREDZTS:
25/296.77
.00
19/016.:52
25~296.77
.00
PAYMENT RECEIPT DISCOUNT (+) --
DATE NUMBER INTEREST/PEN PAID ¢-) AMOUNT PAID
aZF PAID AFTER THIS DATE, SEE REVERSE SIDE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT I .00
BALANCE OF TAX DUEl .00
INTEREST AND PEN. .00
TOTAL DUE . O0
(IF TOTAL DUE TS LESS THAN $1,, NO PAYMENT TS REQUIRED
TF TOTAL DUE TS REFLECTED AS A "CREDTT" (CR), YOU MAY BE
DUE A REFUND. SEE REVERSE SIDE OF THTS FORM FOR TNSTRUCT'rONS.)
PURPOSE OF
NOTICE:
PAYMENT:
REFUND [CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
PENALTY:
INTEREST:
To fulfill the requirements of Section 2160 (b) of the Inheritance and Estate Tax Act, Act Z3 of ZOO0.
(7Z P.S. Section 9140).
Detach tho top portion of this Notice and submit aith your payment to the Register of Hills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF HILLS) AGENT.
A refund of a tax credit may be requested by completing an "Application for Refund of Pennsylvania
Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills,
any of the Z3 Revenue District Offices or free the Department's ZB-hour answering service for fores ordering:
1-800-36Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-BOO-667-30ZO (TT only).
Any party in interest not satisfied with the assessment of tax as sheen on this notice may object aithin
sixty (60) days of receipt of this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171ZB-1OZ1,
--electing to have the matter determined at audit of the personal representative, OR
--appeal to the Orphans' Court.
OR
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. gm0601, Harrisburg, PA 171ZB-0601,
Phone (717.) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
For dates of death on or after 10-3-91, Pennsylvania Estate Tax based on the Federal Estate Tax
return becomes delinquent at the expiration of nine (093 months from the date of death.
For dates of death prior to 10-3-91, Pennsylvania Estate Tax based on the Federa! Estate Tax return
becomes delinquent at the expiration of eighteen [18) months from the date of death.
Taxes ahich became delinquent before January 1, 1982 bear interest at the rate of six (6g) percent per annum
calculated at a daily rate of .000166. All taxes which became delinquent on or after January 1, 1982 will bear
interest at a rate which will vary from calendar year to calendar year aith that rate announced by the PA
Department of Revenue. The applicable interest rates for 198Z through 2004 are:
Interest Daily Interest Daily
Yea_._.r Rate Factor Yea__r Rate Factor Yea__r
1982 ZOX .000568 1988-1991 11Z .000301 2001
1983 16Z .000638 1992 97. .000267 2:002
1986 X1Z .000301 1993-1996 7Z .OOO19Z 2003
1985 13Z .000356 1995-1998 9Z .000247 2:006
1986 XOZ .OOOZT6 1999 7Z .O00Xgz
1986 IOZ .000276 2:000 BZ . O00ZX9
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
Interest Daily
Rate Factor
9Z .000Z67
6Z .000166
5Z ,000137
6Z .000110
X NUMBER OF DAYS DELIN~IUENT X DAILY 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. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
BUREAU OF ZNDZVTDUAL TAXES
TNHERZTANCE TAX DTVZSZON
DEPT. 280601
HARRISBURG., PA 171Z8-0601
JOANNE BOOK CHRISTINE ESQ
RHOADS &SINON
PO BOX 1146
HBG PA 17108
CONNONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF DETERMINATION AND
ASSESSMENT OF PENNSYLVANIA
ESTATE TAX BASED ON FEDERAL
CLOSING LETTER
DATE 07-15-2004
ESTATE OF HESS'
DATE OF DEATH 01-18-2005
FILE NUHBER Z1 05-0091
COUNTY CUMBERLAND
ACM Z0Z
Amoun'l: Remi~:~ed
REV-?$6 El( &FP
FLORENCE F
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credi~ ~o your account) submi~ ~he upper portion of ~his form )~i~h your ~cax payment.
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR FILES ~
REV-736 EX AFP (01-02) x# NOTICE OF DETERMINATION AND ASSESSMENT
OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER x~
ESTATE OF HESS FLORENCE F FILE NO.2! 0:5-0091 ACN Z02 DATE 07-1:5-Z004
ESTATE TAX DETERHZNATZON
1. Credit For State Death Taxes as Verified 19,016.:52
Pennsylvania Inheritance Tax Assessed
(Exclud/ng Discount and/or Interest)
25,296.77
.00
5,
Inher/tance Tax Assessed by Other States
or Terr/tor/es of the Un/ted States
(Excluding D/scount and/or Interest)
4. Total Inher/tance Tax Assessed
Z5~Z96.77
5. Pennsy/van/a Estate Tax Due
.0O
6. Amount of Pennsylvan/a Estate Tax Prev/ously Assessed
Based on FederaZ Estate Tax Return
.00
7. Add/tional Pennsylvan/a Estate Tax Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
DATE NUNBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT
BALANCE OF TAX DUEJ
INTEREST AND PEN.
TOTAL DUE
~ZF PAID AFTER THIS DATE) SEE REVERSE SIDE (IF TOTAL DUE ZS LESS THAN $1) NO PAYMENT ZS REQUIRED
FOR CALCULATION OF ADDITIONAL INTEREST. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR)) YOU HAY BE
DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
.00
.00
.00
.00
.00
PURPOSE OF
NOTICE:
PAYNENT:
To fulfill the requirmmants of Section Z140 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (7Z P.S.
Section 91q0).
Detach the top portion of this Notice and submit with your payment to the Ragister of Hills printed on fha
raverse side.
-- Hake check or money order payable to: REGISTER OF HILLS, AGENT.
REFUND (CR): A refund of a tax credit may ba requested by completing an "Application for Refund of Pennsylvania
Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of the Register of Nills,
any of the Z3 Revenue District Offices or from the Department's Z~-hour ansaaring service for forms ordering:
1-BOO-36Z-Z050~ sarvicas for taxpayers eith special hearing and/or speaking needs: 1-600-~47-3020 (TT only).
OBJECTIONS: Any party in interest not satisfied with the assessment of tax as shoen on this notice may object within
sixty (60) days of receipt of this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 261021, Harrisburg, PA 17128-1021,
--electing to have tha matter determined at audit of the personal representative~ OR
--appeal to the Orphans' Court
ADHIN-
ISTRATIVE
CORRECTIONS:
PENALTY:
INTEREST:
OR
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unitj Dept. 280601, Harrisburg, PA 171Z8-0601,
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
The 1SZ tax amnesty non-participation penalty is computed on the total of the tax and interest asssssed~ and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you mould appeal the tax and interest
that has been assessed as indicated on this notice.
Additional Pennsylvania Estate Tax assessed as a rasult of a change on the Federal Estate Tax closing
latter becomes delinquent at fha expiration of one (1) month from the date the final notice of the increase
in Faderal Estate Tax is received.
Taxes ehich became delinquent before January 1, 198Z bear interest at tha rate of six (6X) percent par annum
calculated at a daily rate of .00016~. All taxes which became delinquent on or after January 1, 196Z will bear
interest at a rate which will vary from calendar year to colander year with that rate announced by the PA
The applicable interest rates for 198Z through ZO0~ ara:
Department of Revenue,
Interest Daily Interest Daily Interest Daily
Yea~ Rate Factor. Yea~ Rate Factor Yea~ Rate Factor
1982 ZOZ .0005~8 1988-1991 X1Z .000301 ZOO1 9Z .000Z~7
1983 162 .000~38 1992 92 .0002~7 ZOOZ 6Z .00016~
198~ 1IX .000501 1993-1994 72 .000192 ZOO3 52 .000137
1985 132 .000356 1995-1998 92 .O00Zq7 ZO0~ 4Z .000110
1986 lOX .00027~ 1999 7Z .00019Z
1967 9Z .O00Z~7 2000 8Z .O00Z19
calculated as follows:
--Interest is
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINI~UENT X DAILY INTEREST FACTOR
--Any Notice issued after tha tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shoan on the
Notice, additional interest must be calculated.
BUREAU OF INDTVTDUAL TAXES
TNHERTTANCE TAX DZVZSTON
DEPT. Z8060!
HARRTSBURG, PA 171Z8-0601
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
ZNHERTTANCE TAX
STATEHENT OF ACCOUNT
RE¥-i&g7 EX &FP CDI-aS)
JOANNE BOOK CHRISTINE ESQ
RHOADS & SINON
PO BOX 11~6
HBG PA 17108
DATE 06-1q-200~
ESTATE OF HESS
DATE OF DEATH 01-18-2005
FILE NUHBER 21 05-0091
COUNTY CUHBERLAND
ACH 101
Amour'l: Rem ~.'l"l~ed
FLORENCE F
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his fore wi~h your ~ex payment.
CUT ALONG TH'rS L/NE I1~ RETAIN LOWER PORT'rON FOR YOUR RECORDS *-~
ESTATE OF HESS FLORENCE F FILE NO. 21 05-0091 ACN 101 DATE 06-1~-200~
TH'rS STATENENT .rS PROVTDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NANED ESTATE. SHO#N BELO#
TS A SUNNARY OF THE PRINC/PAL TAX DUE, APpLTCAT'rON OF ALL PAYNENTS, THE CURRENT BALANCE, AND, IF APPLTCABLE,
A PROdECTED 'rNTEREST FIGURE.
DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 05-10-Z00~
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYHENTS (TAX CREDITS):
25,296.77
PAYHENT RECEIPT DISCOUNT ¢+)
DATE NUHBER INTEREST/PEN PAID (-) ANOUNT PAID
10-17-2005
05-20-200~
CD003135
CD003957
.00
57.55-
23,053.55
2,$01.99
TOTAL TAX CREDIT
IF PAID AFTER TH/S DATE, SEE REVERSE
SIDE FOR CALCULAT.rON OF ADD.rT.rONAL /NTEREST.
( ZF TOTAL DUE 1S LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A 'CRED.rT' (CR),
25,298.01
BALANCE OF TAX DUE 1.2~CR
ZNTEREST AND PEN. .00
TOTAL DUE 1.2~CR
YOU NAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORH FOR 'rNSTRUCT'rONS. )
PAYNENT:
Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check er money order payable to: REGISTER OF WILLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: CONHONtCEALTH OF PENNSYLVANIA.
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at
the Office of the Register of Hills, any of the 23 Revenue District Offices or from the Department's Z4-hour
answering service for fores ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-30Z0 ITT only).
REPLY TO:
guastions regarding errors contained on this noticm should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone
[717) 787-6505,
DISCOUNT:
If any tax due is paid within three (3) calendar months after the dacedant's death, a five percent (SI) discount
of the tax paid is allowed.
PENALTY:
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18j 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 date of payment. Taxes which became delinquent before January 1j 198Z bear interest at the rate of
six (SI) percent per annum calculated at a daily rate of .000164. Alt taxes which became delinquent on and after
January I, 198Z will bear interest at a rata which will vary free calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 19SI through ZOO4 ara:
Interest Daily Interest Daily Interest DaiIy
Year Rate Factor Year Rate Factor Year__ Rate Factor
1982 ZOZ .000548 1988-1991 llZ .000301 2001 9Z .000247
1983 16Z .000438 199Z 9Z .000Z47 ZOOZ 6Z .000164
1984 Ill .000301 19g$-1994 7Z .000192 2003 5Z .000137
1985 13Z .000356 X995-1998 9X .000247 2004 4X ,O00llO
1986 XOZ .000274 1999 7Z .OOD19Z
1987 9Z .000Z47 ZOO0 8Z .000Z19
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUI~BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
BUREAU OF ZNDTVTDUAL TAXES
/NHERITANCE TAX DTVT$ION
DEPT. IR0601
HARRTSBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
RE¥-1607 EX AFP (01-05)
JOANNE BOOK CHRISTINE ESQ
RHOADS & SINON
PO BOX 11q6
HBG PA 17108
DATE 07-26-200q
ESTATE OF HESS
DATE OF DEATH 01-18-2003
FILE NUMBER 21 03-0091
COUNTY CUMBERLAND
ACN 101
I Amoun~ Remi~ed
FLORENCE F
MAKE CHECK PAYABLE AND REMXT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credi( ~o your account, submi~ (he upper potation of ~his fore wi~h your ~ax paymen~c.
CUT ALONG THIS L'rNE ~ RETAIN LOWER PORT'rON FOR YOUR RECORDS *~
ESTATE OF HESS FLORENCE F FILE NO. 21 03-0091 ACN 101 DATE 07-26-200q
THTS STATEMENT TS PROVTDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAMED ESTATE. SHOWN BELON
TS A SUMMARY OF THE PRINCIPAL TAX DUE, APpLTCATZON OF ALL PAYMENTS:. THE CURRENT BALANCE, AND, TF APPL/CABLE,
A PROJECTED TNTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-03-Z00q
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
Z5,Z96.77
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
.00
10-17-2003
05-20-~00q
07-1Z-Z~i0~
CD003135
~REFUN~
57.53-
.00
23,053.55
Z,301-.99
1.2q-
TOTAL TAX CREDIT
25,296.77
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
ZF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( ZF TOTAL DUE ZS LESS THAN $1,
NO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.