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Home My WebLink About03-0900 PETITION FOR PROBATE and GRANT OF LETTERS Estate of Inetta P. Brid1!'e No. ~/.-O 3 - tj tJO also known as Inetta Polly Brid1!'e To: Register of Wills for the , Deceased. County of Cumberland in the Social Security No. 179202726 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner( s), who is/are 18 years of age or older an the execut named in the last will of the above decedent, dated March 16.2002 and codicil( s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at The Woods At Cedar Run 824 Lisbum Road Ant ~07 Canm Hill PA 17011 t II. .I .t..M 11 ~ ~/..-<.J (list street, number and municipality) Decedent, then 88 years of age, died 9/6/03 , at The Woods At Cedar Run Camn Hill Cumberland County PA Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never ajudicated incompetent: Decedent at death owned property with estimated values as follows: I Sf) 0 ()O _ (If domiciled in Pa.) All personal property $ I (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentarY thereon. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) !" K~ l~\.~~" i I I'\\('"P\~\..- 1..., tJ\"1'ft-1'fw.> JI<JAVI~ 1r~Sf Cin.'Q./l, .rul. ~1'dl'~1 c r -"- ~ t~ C:O/Ye1M Pre' 'q,! j./""fjO/lQ.! B~/I~ 0 ( Pe/VJsJ/v~/I,'tL & It; AI. 11(;((1) S"freel- ?r~t/l> 6 v') ~ /.J I~ 6,p / OATH OF PERSONAL REPRESENTATIVE COMMONWEAL TB OF PENNSYL VANIA } ss COUNTY OF Cumberland The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner( s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly admin.ister the estate according to law. sworntoor.afflrmed.ond,",,,nbed 4 ~ -." U/t--=1 ~ before me this 29th day of \p.J l ..J s g OCtober 2003. ~ ) ( ~~ ~ ~~ 171, 6- L:b-; :at- I fJ-Lu . :2: Donna M. otto, 1st DePuty eg~t . . /7-17t./- .3 No. 21-2003-900 Estate of Inetta P. Brid1!'e r ajk"/ -"l Tn~tt Q Pnll y Rr; n0"" , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW October 30th, 2003 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated March 16th, 2002 described therein be admitted to probate and filed of record as the last will of Inetta P. Bridge, a/k/a Inetta Polly Bridge , and Letters Testanentarv are hereby granted to Hiqhview Trust Canpany subsidiary of Carrnerical National Bank Of pennsylvania jj JrJ ~f4l~' .1(A.U'). . t:::I'/I . . ~ &.JI.-<.J Re 'st of Wills I . Donna M. otto,fst Deputy ~ FEES Benjamin J. Butler Probate, Letters, Etc.. . . . . . . . $ 235.00 81948 Short Certificates ( 5 )...... $ 15.00 ATTORNEY (Sup. Ct.I.D. No.) ~x .x,...pages. (.3.). $ 9.00 500N. Third Street, 12lhFloor Harrisbuf1!' PA 17101 $ ADDRESS TOTAL _ $ 269.00 o h 2003 717.236.1485 Filed. octQber .3. :t.,. . . . . . . . . . PHONE Mailed Letters to Attorney on 10/30/2003. '.(1 '1 .'\ .:::J 1 " .~ 9418872 xfpQy" J;ey i dC/B I No. Date H105 :-.JA.... 2187 COMMONWEALTH Of PENNSYLVANIA. OEPARTMENT Of HEALTH. VITAL RECOROS CERTIFICATE OF DEATH YPfJPA1Nl STAff '''If NUfrot8E:R IN ~R"'ANENT NAME Of DECEDENT If.,.sr lIo4oOO1e. ~""I SEX SOCIAL SECURITY "lUM8ER 14.A.C1( INK '1. Inetta .. female .. 179 20 2726 :20Q) AGE: (La. a.m.oayl UNOER 1 YEAR BIRTHPLAa; ;C.ty ~ PUoCE OF OERWfChedoOl'lV'Y'C! -- iee"'SlIUCloansonOC"et 'JIOei -: D.,. tiOI..n f wn..... s.... Ql fa..." Co..w-.,p A HOSPiTAl; 88 v~ Jones Mills ,npal.."cO =~.."O .. ,. ... COUNTY OF DERH FM;JUTY NAME (II nol....U<Uo(:w'l, 00'" 511", ,In(lr'lul'nOe<, RACE '~Indoe". a..ck. WhiI._ Me '''-'vI 1J . Hill :J1 1.. :J OECEOENT"S USUAL OCCUPATION IrMRlTAl STATUS . ~ SUAVNIHG SPOUSE -< Ie;.. ~ c:J '*'01''' 00ne duI'"9"'" ~ ManIllOi. Widowed. 1........9f'\'e~~1 "' 04 wortI"'V life; do n()I vw I.....ed I -(Spoc'Tl 0 ilL Homema ke r n... Home widowed >. DECEDENT'S t.&.\JLING AOOAESS ($IIMe. ClfyfTown. sw..lOCodel DECEDENT'S 17c.O --.~>>-Sin 1110 Cherry Street ACTUAl I h. su.. F~ Did - "' RESIO€HCE - -< Latrobe, PA 15650 ....~ -..... ::J OOOlf\eflldel Wp",tmnrplrlnn -' 11..n~~-=o( Latrobe 1. ". lno. ""'-.. FRliEA'S NAMe (F...,!. MoOdIe Lastl "'OTHER'S NAME iF'!!:. ModclIe. Maoclen SurNmllI Anderson '0 Dwight R. Anderson Elizabeth Weaver ". ". w WFCJifUAAHT.S NAME (T ypwPrlf'll:) 1NF0000000T'S MAIUNO AOORESS 'SIr... CCy/Town, sa... Zip eao., w ..d.5 Fortuna Lane Enola, PA 17025 :lJ -. - = WETHOO OF OISPOSfTIOH PlACE OF OCSPOsITaoN . N.me 01 c.m.c.,..,. C,etJ\MOl'y -< . &un.. ~ C'..-n.I11Qrt 0 '" ""'"' ..... ~ o.n., eso.c-vl . " '::! ~ I ZO. '~I. PlUrT II: Otfw siQnif\cMl. ~ canIrtMAing 10....... but ::::-~ nol~"'''''~,*,"gMM''PA1fT1 I . : . I : . I I , DUE 10 (()A AS A. CClNS[OUE NeE Of)' : WERE AUTOPSY FINDINGS WANNER Of OEM... DATE OF INJURV TiIofEOf INJUAv INJURY R WORK? DESCRIBE HON INJVAY OCCURRED. A\MJlA8t.E PRIOR 10 {Month Day, 'tQr1 coe.cPLETlQN OF CAuSE --5" 0 OF OERH1 ........ .......... HaD 0 0 ....0 - --""" ~ Ha0" _0 Ha-8"' 0 o PLACE OF INJURY. AI ~. b1mt, .11.-. factorw. office ... """"'" Could nol ~ detenntned LOCJO'"ION rs-.....~. Scale, - buitdllng.e&c.lSoec"v1 _. ..... n. -. CDfTlFtfR (Check en.,. oroet 'CVlTIFYIHG PHY$JCIAN !Physoc.... c~ ~('J/ ONIh...".,... ~ ohV$lC~ N$plonouncecl de.." M'O c~ea "-n 231 / /I-I.p_ ..#. T...... be.c 01 1ft, know~, donth occ...rr.d.,... d\ot eau-,('I.nd _""'".. lie"", . . . . . . . .. . . . z .~ AAO CERTIFYING PHYSfClAH IPhV$IC"'-' fXJIt, ;JIQnOur\C"'O l>>.Ih.no ce<U'fV'Q IOC....H 01 deiilttll DATE SIGNED l~. DIy. 'tlurl r;: ro tM ~of"', kl\O~f1. de..lhocci,lu" II d\e....... o.le, and place, Incs due 101M C.UM'(IJlnd ml""-'" .r.,... ............ 0 - O~ - 'Z<.X>") :.: 0 .UEDICAl EXAMINER/COAONER .....V (; On Ih. b..l, 0' ..amlnatlon andJrH in'ltestlgalion. in my opinion, d.alh OCcuffed allhe 11m., dat., and place, and due 10 1M C.uM(a) and 0 ~ ),......nn..... ataled... . . '. . . . ... . . . . . .... ..... .............................................................. z 1~6l')S,OI J4. 21-2003-900 Lr-\ . . , '", ..~. c\ ~''''.J . , _~J "', ~:::J , , . LAST WILL AND TESTAMENT c:2.J..03..g0e OF INETTA P. BRIDGE I, INETT A P. BRIDGE, of the Borough of Latrobe, County of Westmoreland and Commonwealth of Pennsylvania, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. FIRST: I direct the payment of my debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. If there be no cemetery lot available for my interment owned by me at the time of my death, I authorize my personal representative to purchase such cemetery lot with a contract for perpetual care, using therefor funds from my estate in such amounts as my personal representative shall consider necessary and desirable, and I authorize my personal representative to cause title to or ownership of such lot so purchased to be vested in any such person as my personal representative shall designate. SECOND: I direct that all estate, inheritance and other taxes imposed by reason of my death on property comprising my gross estate, whether or not such property passes under the terms of my Will, shall be paid ant of the principal of my estate as if said taxes ','/ere administration expenses, without apportionment among the beneficiaries, and I authorize my personal representative to pay such taxes at such time or times as deemed appropriate, EXCEPT, however, my estate shall not be responsible to pay any tax imposed by reason of my death on any bank account which I own jointly with a person other than my spouse, my children, or my grandchildren; AND PROVIDED, however, that this direction shall not apply to the taxes on any property included in my estate solely because of a power of appointment thereover which I possess but have not exercised or to any generation-skipping transfer taxes. THIRD: I give, devise and bequeath all the rest, residue and remainder of my estate unto my son, CHARLES ANDERSON BRIDGE, ifhe survives me by a period of sixty (60) days. In the event that he does not survive me, or does not survive me by said period of sixty (60) days, I then give, devise and bequeath all the rest, residue and remainder of my estate to JUDITH M. HINES-BRIDGE. FOURTH: Any and all payment or payments of any sum or sums, whether in cash or in kind, or whether for principal or income, payable to any person hereunder shall be made upon the receipt of such person and free from anticipation, alienation, assignment, attachment and pledge, and free from control by the creditors of such person. All shares of principal and income herein given shall be free from anticipation, assignment, pledge, or obligations of any person entitled to receive same, and shall not be subject to any execution or attachment. FIFTH: I nominate, constitute and appoint my son, CHARLES ANDERSON BRIDGE, Executor of this my Last Will and Testament. In the event of the renunciation, death, resignation or inability to act for any reason whatsoever of my said son, I nominate, constitute and appoint COMMERCIAL NATIONAL BANK OF PENNSYLVANIA, to be the Executor of this my Last Will and Testament. SIXTH: I realize that executors and trustees are given discretion by law to make various elections which affect the income and estate taxes payable by estates, trusts and beneficiaries, as well as the relative shares of beneficiaries, such as taking administration expenses as deductions for either estate or income tax purposes, selecting options for the payment of employee death benefits, electing to take qualified terminable interests as part of the marital deduction, selecting 2 . alternate valuation dates, postponing the payment of taxes, filing joint income tax or gift tax returns and redeeming corporate stock. The decisions made by my fiduciaries in any of these matters shall be binding upon, and not subject to question by, any affected persons; PROVIDED, however, that if a corporate fiduciary is serving, its decision shall also be binding upon any individual co-fiduciary. I rely upon my fiduciaries to take into consideration the total income and estate taxes payable by reason of their decisions, including those payable by my survivors, and they are authorized in their discretion, but not required, to make adjustments between income and principal as a result thereof. No bond shall be required of any fiduciary hereunder in any jurisdiction. IN WITNESS WHEREOF, I set my hand and seal this 16th day of March, 2002. j7V2dL 11, 18"L.~~<~ (SEAL) Inetta P. Bridge Signed, sealed, published and declared by INETTA P. BRIDGE, the Testatrix, above named, as and for her Will in the presence of us, who at her request, in her presence and in the ~ each other, h~e hereunto subscribed our names as witnesses hereto. Address: 3 9 Attleboro Place Greensburg,P.~ 15601 ~0t.tu:..~/ ,-.;;. 4cct.C~/-<"C2Z-c Address: 1 004 Ligonier Street Latrobe, PA 15650 G: \Bev\ W ord\ WiIls\Bridge.doc 3 . . COMMONWEALTH OF PENNSYLVANIA ) ) ss: COUNTY OF WESTMORELAND ) We, INETTA P. BRIDGE, DONALD J. SNYDER, JR, JANICE M. RUDY, and MARIAN BUCCIARELLI, the Testatrix and witnesses, respectively, whose names are signed to the attached and foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. TESTATRIX: ~-z.,_ tl4~~~ (/ : t4rL, I 2;8:,... ~ ?'!' <..If C}7i. NESS: /..0.Ztt.c~ ';7) du:.cuc.r:..:c~{ / Subscribed, sworn to and acknowledged before me by INETTA P. BRIDGE, the Testatrix and subscribed and sworn to before me by DONALD J. SNYDER, JR., JANICE M. RUDY and MARIAN BUCCIARELLI, witnesses, this 16th day of March, 2002. b/~ !2Aaui\ Notary p, bc Notarial Seal Beverley A. Davis, Notary Publlc Latrobe Boro. Westmoreland County My Commission Expires Feb. 25, 2003 ~ ~;>r"'",,!' ::>'1(\l'1sylv3f1i? As.~atlOnotNotar\es 4 500 North Third Street Tel: 717.236.1485 BLJTLER LAW FIRM Twelfth Floor Fax: 717.236.7777 Harrisburg, PA 17101 lawyers@butlerlawfirm.com Mailing Address: Post Office Box 1004 Harrisburg, PA 17108.1004 Ronald D. Butler December I, 2003 ]ana Butler Toole Benjamin]. Butler Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PAl 70 13 Re: Estate ofInetta P. Bridge a/kla Inetta Polly Bridge File No. 2003-00900 PA File No. 21-03-0900 Dear Sir or Madam: I represent Highview Trust Company, Executor of the Estate ofInetta P. Bridge a/kla Inetta Polly Bridge who died on September 6, 2003. I have enclosed a check from the Estate made payable to the Register of Wills, Agent in the amount of $71 ,250.00 as an advance payment of Pennsylvania Inheritance Tax. This payment is being made within three (3) calendar months after the decedent's death and thus qualifies for the 5% discount. Please send me an official receipt at your earliest convenience. I have enclosed a self-addressed stamped envelope for your convenience. Your cooperation in this matter is appreciated. - ;;;;;&v Benjamin J. Butler BJB/mot Enclosure cc: Highview Trust Company COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-961 DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128.0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003297 BUTLER LAW FIRM POBOX 1004 500 NORTH THIRD STREET HARRISBURG, PA 17108-1004 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold ---------- -------- 101 I $71,250.00 ESTATE INFORMATION: SSN: 179-20-2726 I FILE NUMBER: 2103-0900 I DECEDENT NAME: BRIDGE INETTA P I DATE OF PAYMENT: 12/02/2003 I POSTMARK DATE: 00/00/0000 I COUNTY: CUMBERLAND I DATE OF DEATH: 09/06/2003 I I TOTAL AMOUNT PAID: $71,250.00 REMARKS: COMMERCIAL NAT'L BANK C/O BUTLER LAW FIRM CHECK# 012271 INITIALS: DO SEAL RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS Register of Wills of Cumberland County, Pennsylvania CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Inella P. Bridl!e a/k/a Inella Pollv Bridae Date of Death: 9/6/03 Will No. 2003-00900 Adm. No. To the Register: 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 12/2/03 Name Address Judith M. Hines-Bridge 15 Fortuna Lane Enola PA 17025 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: 12/2/03 !!!:fit--- Name: Beniamin 1. Butler Address: 500 N. Third Street P.O. Box 1004 Han'isburl! PA 171 08-1 004 i Telephone (7 1 7) 2 3 6 I 4 8 5 Capacity: Personal Representative X Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES \", DEPARTMENT 280601 HARRISBURG, PA 17128-0601 Telephone May 4, 2004 '04 MAY -7 F 3 :U4 (717) 787-3930 FAX (717) 772-0412 Butler Law Firm l; :; i 500 North Third Street C l'lrj '=. Twelfth Floor Harrsburg, PA 17101 Re: Estate of Inetta P. Bridge File Number 2103-0900 Dear Sir/Madam: This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before 12/06/03. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. S' ceretV:l / In y, j/--- /) <.....-__.....--(., I <!' /~'i:,'. . .. I ' , I .i .,. 1.. / j ,:...<.-/ ;1 /: . /f / /' ,;.-., ,.....">~._"."/ :' 'I .', I "... "--.- / I " \...._~L4:(/<-..-(--~/ ../1..........---... f .-' / ;/) Claudia Maffei, ~Jpervisor Document Processing Unit Inheritance Tax Division REV-1500 EX + (6.00) REV-1500 OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FILE NUMBER DEPT. 280601 HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 2 1 - 0 3 0 9 0 0 COUNTY"'COOE -VEAR- - - NUMBeR- - DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I- Z Brid e Inetta P. 1 7 9 - 2 o - 2 7 2 6 W DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE C W REGISTER OF WILLS U 09/06/2003 02/21/1915 W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER C - - w [Xl 1. Original Return o 2. Supplemental Retum D 3. Remainder Retum (date of death priortn 12-13-82) I- :.::~(J) o 4. Limited Estate o 4a. Future Interest Compromise (date of death after 12.12.82) o 5. Federal Estate Tax Return Required uO:::':: w~u :c 0:::3 [Xl 6. Decedent Died Testate (Attach copy of Will) o 7. Decedent Maintained a Living Trust (Attach copy ofTrus!) L 8. Total Number of Safe Deposit Boxes u a. co a. c:( o 9. Litigation Proceeds Received o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) I- THIS SECTION MUST BE COMPLi:TED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTJ:DTO: z NAME COMPLETE MAILING ADDRESS w c z Ben'amin J. Butler 500 N. Third Street 0 FIRM NAME (If Applicable) a. (J) w Butler Law Finn P.O. Box 1004 0:: 0:: TELEPHONE NUMBER 0 u 717.236.1485 Harrisbur PA 17108-1004 OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) '21,415.61 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) r .- .-.-, 4. Mortgages & Notes Receivable (Schedule D) (4) I' 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 128,594.67 ;:' Z (Schedule E) 0 6. JoinUy Owned Property (Schedule F) (6) i= o Separate Billing Requested < --, ...J ::> 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 414,776.22 t: (Schedule G or L) Q. < 8. Total Gross Assets (total Lines 1-7) (8) 564,786.50 U W 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 45,416.61 ~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 5,570.02 11 Total Deductions (total Lines 9 & 10) (11) 50,986.63 12. Net Value of Estate (Line 8 minus Line 11) (12) 513,799.87 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 513,799.87 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Z 15. Amount of Line 14 taxable at the spousal tax 0 rate, or transfers under Sec. 9116 (a)(1.2) 0.00 X _ (15) 0.00 I- < 16. Amount of Line 14 taxable at lineal rate 513,799.87 X ~ (16) 23,120.99 I- ::J Q. 17. Amount of Line 14 taxable at sibling rate $0.00 X .12 (17) 000 :l!: 0 18. Amount of Line 14 taxable at collateral rate 0.00 X .15 (18) $0.00 U ~ 19. Tax Due (19) 23,120.99 I- ~ 20. CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT '0 >> BE SURE TO ANSWER ALL QUESTIONS ONREVER$E SfOE AND RECHECKMATH << Decedent's Complete Address: STREET ADDRESS The Woods At Cedar Run 824 Lisburn Road CITY I STATE I ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. T ax Due (Page 1 Line 19) (1) $23,120.99 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments $71 250.00 C. Discount $1 156.05 Total Credits (A -10 8 + C) (2) $72,406.05 3- Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E) (3) $0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) $49,285.06 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) $0.00 A. Enter the interest on the tax due. (5A) SO.OO 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) $0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ...........................................................................0 [Xl b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 [Xl c. retain a reversionary interest; or ...................................................................................................... 0 [Xl d. receive the promise for life of either payments, benefits or care? ............................................................. 0 [Xl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?....................................... ............... ......... ........ ....................... [Xl 0 3- Did decedent own an "in trust for' or payable upon death bank account or security at his or her death? ................. 0 [Xl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 [Xl IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of peDUry. I declare that I have examined this return, including accompanYing schedules and statements. and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative IS based on all information of which preparer has any knowledge. SIGNATURE OF PEf\J:,:rONjLE FOR FILING RETURN DATE "'/~'OLf . l"C~ ADDRESS jq N. MCl/" S1Te~+ Greel'l 5 b "'(J PA jS"ol ATIVE DATE /-7-0 ADDRESS S treer / Po 8c)( I c<> 'i PA 17 leg' -/00 'i For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 39116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 39116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 39116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a){1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 39116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (6-98) . SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Bridae. Inetta. P. 21 03 0900 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real orooertv which is iointlv-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) REV-1503 EX + (6-98) . SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Bridae. Inetta. P. 21 03 0900 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1- 2310.8289 shares Allegheny Energy, Inc. (AYE) @ $9.2675 $21,415.61 '~ TOTAL (Also enter on line 2, Recapitulation) $ 2141561 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) . SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Bridae. Inetta. P. 21 03 0900 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Citizens Bank - Checking Account No. 610202-718-7 $128,594.67 with accrued interest of $0.00 TOTAL (Also enter on line 5, Recapitulation) $ 128.594.67 (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (6-98) '* SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Bridae. Inetta. P. 21 03 0900 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A B C JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTIDN OF PROPERTY '10 OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1- A. TOTAL (Also enter on line 6, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) REV-1510 EX + (6-98) . SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA MISC. NON-PROBATE PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FilE NUMBER Bridqe. Inetta. P. 21 03 0900 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER ATTACH A COPY OFTHE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. Transferred money to open Citizens Account No. 620379-009-9 $95,877.71 100. $500.00 $95,377.71 Date of Transfer: February 3, 2003 New Account: Judith M. Hines Bridge ttee Inetta P. Bridge (Circle Money Market) 2. Transferred money to open Citizens Account No. 620379-009-9 $23,602.44 100. $500.00 $23, I 02.44 Date of Transfer: February 3, 2003 New Account: Judith M. Hines Bridge ttee Inetta P. Bridge (Circle Money Market) 3. Transferred money to open Citizens Account No. 620379-009-9 $10,345.35 100. $500.00 $9,845.35 Date of Transfer: February 3, 2003 New Account: Judith M. Hines Bridge ttee Inetta P. Bridge (Circle Money Market) 4. Transferred money to open Citizens Account No. 620379-009-9 $71,203.09 100. $500.00 $70,703.09 Date of Transfer: February 19,2003 New Account: Judith M. Hines Bridge ttee Inetta P. Bridge (Circle Money Market) 5 Transferred money to open Citizens Account No. 620379-009-9 $168,502.10 100. $500.00 $168,002.10 Date of Transfer: March 3, 2003 New Account: Judith M. Hines Bridge ttee Inetta P. Bridge (Circle Money Market) 6 TransfelTed money to open Citizens Account No. 620379-008-0 $48,245.53 100. 5500.00 $47,745.53 Date of Transfer: February 3, 2003 New Account: Judith M. Hines Bridge ttee Inetta P. Bridge (Circle Gold Checking) TOTAL (Also enter on line 7 Recapitulation) $ 414,776.22 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) *' SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Bridae. Inetta. P. 21 03 0900 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Frederick Funeral Home, Inc. $8,463.75 2. Blue Angels Restaurant - Funeral Reception $175.55 3. Robb's Floral Shop - Flowers $148.40 B. ADMINISTRATIVE COSTS: 1- Personal Representative's Commissions Name of Personal Representative (s) Highview Trust Company $17,869.92 Social Security Number(s)/EIN Number of Personal Representative(s) 56-2394077 Street Address 19 North Main Street City Greensburg State P A Zip 15601 Yea<<s) Commission Paid: 2004 2. Attomey Fees Butler Law Finn $17,869.92 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees $269.00 5. Accountant's Fees 6. Tax Retum Preparer's Fees Christina Suran, CPA - 2003 Income Tax Preparation $150.00 7. Cumberland Law Journal - Estate Advertising $75.00 8. The Sentinel - Estate Advertising $143.15 9. Unishippers - Overnight Mail $12.67 10. Accurint Search $0.25 11. Cumberland County Register of Wills - Additional Short Certiticates $24.00 12. Citizens Bank - Research Fee $190.00 13. Cumberland County Register of Wills - Filing Fee $25.00 TOTAL (Also enter on line 9, Recapitulation) $ 45,416.61 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (6-98) . SCHEDULE. COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Bridqe. Inetta. P. 21 03 0900 Include unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1- The Woods At Cedar Run - Brookview Suite (9/1103 - 9/6/03) $630.00 2. 2003 Federal Income Tax - Tax Due $1,471.00 Expenses incurred by Judith M. Hines-Bridge for the benefit of the decedent that were unreimbursed as of the date of deatl 3 Boscov's - Two Night Gowns purchased for decedent $37.66 4. Pa Department of Revenue - 2002 Estimated Income Tax Underpayment Penalty $10.38 5. Priority Mail $6.30 6. TIps for Moving Men $75.00 7. Alert Pharmacy Services, Inc. $4.89 Items paid by the decedent by check that did not clear until after September 6, 2003 (not reflected in date of death figure) 8. The Woods at Cedar Run $3,255.00 9. Comcast $27.70 10. Alert Pharmacy Services, Inc. $52.09 TOTAL (Also enter on line 10, Recapitulation) $ 5,570.02 (If more space is needed, insert additional sheets of the same size) Rev.'""". .. SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Bridae Inetta P. 21 03 0900 RELA TIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under Sec. 9116 (a) (1.2)] 1. Judith M. Hines-Bridge Lineal $513,799.87 15 Fortuna Lane Enola, PA 17025 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: $71.250.00 Discount: $U56.05 Interest Table Year Days Delinquent Balance Due Interest this time period this year this period Before 1981 1982 1983 1984 11985 1986 1987 i I 1988 through 1991 ! I I 11992 I I I 11993 throu:h 1994 I 1995 throu h 1998 i 1999 I I I 12000 I 12001 , 12002 2003 I I i , ! I ! TOTALS Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: Register of Wills of Cumberland County, PA INVENTORY Estate of Inetta P Bridge NO.21 03 0900 also known as Inetta Polly Bridge Date of Death 9/6/03 , Deceased Social Security No. 179202726 Personal Representative(s) 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 Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. l!We verify that the statements made in this inventory are true and correct. l!We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of \1w ~ r~h:/- Attorney: Benjamin 1. Butler 1.0. No.: 81948 fVl;cAc..el L... M C{+l-A,w~ H'-,hVd'w /(us+ Address: 500 N Third Street, P.O. Box 1004 Dated '11~o~ (am fa/PI Harrisburg PA 17108-1004 Telephone: 717.236.1485 Description Value Stocks & Bonds ---"- .' 2310.8289 shares Allegheny Energy, Inc. (AYE) @ $9.2675 $21,415.61 c c I --' Cash, Bank Deposits, & Misc. Personal Property , . .......'-~ Citizens Bank - Checking Account No. 610202-718-7 _. $128,594.67 with accrued interest of $0.00 Total $150,010.28 (Attach Additional Sheets if necessary) 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 such figures should not be extended into the total of the Inventory. RW-4 ~. COMMONWEALTH OF PENNSYLVANIA '* BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE .. . , INHERITANCE TAX DIVISION PO BOX 280601 NOTICE OF INHERITANCE TAX - HARRISBURG, PA 17128-0601 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV.1541 EX (12.91) PC DATE 11-01-2004 ESTATE OF BRIDGE INETTA P DATE OF DEATH 09-06-2003 FILE NO. 21 03-0900 COUNTY Cumberland BENJAMIN J BUTL~R',l;"'1 -0 .. Q "-'1 ACN 101 BUTLER LAW FIRM OLl I;Ui ./ ,u.1. PO BOX 1004 .' I Am"" ..mll'" I HARRISBURG PA17108 \'. f -', ,. ;,\ :'" MAKE CHECK PAYABLE AND REMIT PAYMENT TO: Register of Wills Cumberland County Courthouse Carlisle, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ . -REV~1547 EX-(06-97)-PC.....-.- - - - - --Notic-E-cfFrN~fERlf A-NCE-t"A5f"Ap-PR-Ais-EME-Nt-, -A-CL.OWANCE'OR" -.. -........................ -.. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BRIDGE INETTA P FILE NO. 2103-0900 ACN 101 DATE 11-01-2004 TAX RETURN WAS: ( ~) ACCEPTED AS FILED ( D) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 0.00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) 21 ,415.61 creditto your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 0.00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) 0.00 of this form with your 5. Cash/Bank Deposits/ Misc. Personal Property (Schedule E) (5) 128,594.67 tax payment. 6. Jointly Owned Property (Schedule F) (6) 0.00 7. Transfers (Schedule G) (7) 414,776.22 8. Total Assets (8) 564,786.50 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 45,416.61 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 5,570.02 11. Total Deductions (11) 50,986.63 12. Net Value ofTax Return (12) 513,799.87 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 0.00 14. Net Value of Estate Subject to Tax (14) 513,799.87 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16,17 and 18 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 0.00 X .00 0.00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 513,799.87 X.045 23,120.99 17. Amount of Line 14 taxable at Sibling rate (17) 0.00 X.12 0.00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 0.00 X .15 0.00 19. PrincipalTaxDue (19) 23,120.99 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 12-02-2003 CD003297 1,156.05 71,250.00 TOTAL TAX CREDIT 72,406.05 BALANCE OF TAX DUE 49,285.06 CR INTEREST 0.00 TOTAL DUE 49,285.06 CR * IF PAID AFTER DATE INDICATED, SEE REVERSE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) <}.L-- q... COMMONWEALTH OF PENNSYLVANIA '* DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX ~~H~~~T~:~~OrAX DIVISION STATEMENT OF ACCOUNT HARRISBURG, PA 17128-0601 REY-UD7 EX AFP <09-m DATE 11-22-2004 ESTATE OF BRIDGE INETTA P DATE OF DEATH 09-06-2003 FILE NUMBER 21 03-0900 COUNTY CUMBERLAND BENJAMIN J BUTLER ACN 101 BUTLER LAW FIOM I .._t "''''od I PO.-OX 1004 U- ~ __ Ou:;.HBg- cf:: PA 17108 . .-.. ..- ~ ~:1 = sc3 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: i:C ---- ::x: LLQU l"h; t,:O: ..a: Q U , o '-....J ~<l)~ REGISTER OF WILLS 90=, r- CCZ'''~ CUMBERLAND CO COURT HOUSE l;_,_l ~ - UJ <C-~ t:E (j~ (...) d:c[L CARLISLE, PA 17013 c::U.~......... Cl.. '..l ~: T~nsure ~~r credit to your account, submit the upper portion of this form with your tax payment. I,b! O::...:r 0 :,:) CU"I'-ALONG gQtIS LINI-' ..... RETAIN LOWER PORTION FOR YOUR RECORDS ..... ~I:V :rg.".,.ft".iI!JI..r8r-.6!,........;...fAIiW!mer'"1'ly.~'lYI!A1'Mf.b'l!'.lcc60W....................... ... ESTATE OF BRIDGE INETTA P FILE NO.21 03-0900 ACN 101 DATE 11-22-2004 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-30-2004 P R I N C I PAL TAX DUE:. ..................,.,.~,...........,........,.....,......~.....................,. 23 , 120 . 99 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 12-02-2003 CD003297 1,156.05 71,250.00 11-01-2004 REFUND "J...~~,,~ .00 49,285.06- TOTAL TAX CREDIT 23,120.99 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 lli IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J ~~~ - STATUS REPORT UNDER RULE 6.12 Name of Decedent: Inetta P. Bridge Date of Death: 9/6103 Will No. 2003-00900 Admin. No. Pursuant to Rule 6. 12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No. state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is : n/a c. Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or mformal accounts may be filed wIth the Oeck 0; <he O"h,o, , em,rt ,"oJ =, be '~,h,,' " <h'~ Date: 6/27/05 . ~J'~ Signature ~ Beniamin 1. Butler Name (Please type or print) 500 N. Third Street, P.O. Box 1004 Harrisbun! PA 17108-1004 Address (717)236]485 Tel. No. Capacity: Personal Representative X Counsel for personal representative , cPf