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HomeMy WebLinkAbout02-0132PETITION FOR PROBATE and GRANT OF LETTERS also known as Social Security No. 7/7- o q- ,~¥17ceased' To: Register of Wills for the County of Q~rn~0~--bqd 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 ~--~ X in the last will of the above decedent, dated and codicil(s) dated I I - o23- ? ~> in the named ,19 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~ m 19¢/'Z I~q d c[, County, Pennsylvania, with h~<~ .. last family or principal residence at 1'7 o ~{ (t ~ ~ Sra e e T Ne~ (u~,,be, efAn/3,?~ ~707° (list street, number and muncipality) Decendent, then ~ ~ _ years of age, died ,4-9 ~ec~ Except asdfoll~o~v-s,' decedent did not marry, was not div~r~ed and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (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: 17o7 'thva,* ,57'g~eF~ A/~ ~'~ ~"be'tl'~'J& ;bI'r4'' WHEREFORE, petitioner(s) respectfully request(s) L,.he probate of the last will and codicil(s) presented herewith and the grant of letters (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF ~uw,3~-_ !~,,JeL 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 administer the estate according to law. Sworn to or affirmed and subscribed a/}~~~'. }~7~ ~ · 4TH day of [ ~di~ ~ ~vddi~ ~' before me this ~ ~ ' ~ ,, FE~UARY X~2002} ~ M~Y ~ L~IS Regis~r ~ $0. 21-02-132 Estate Of JOIqN B DUVALL , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW EEBRUARY 6th ...... Xjli2002, in consideration o,: r~e petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated_ NOVEMBER 23rd ~ 998 described therein be admitted to probate and filed of record as the last will of JOHN B DUVALL and Letters ~,ESTAMENTARY ' are hereby granted to ,7i'IDTrPFI A MrIVIDTS FEES Probate, Letters, Etc .......... $ 375.00 Short Certificates(~ .......... $ 24 o 00 R~m~~ .e~tr.a..pa~es$ ~ ~: O0 JCP $ 5.0 0 TOTAL__ S 422_013 FiledF~~ 9~..~9.q¢ ............ mailed to exec. on 2-6-02 MARY ~ L~QI-S~'R/egisterof~'ill$ .... -/ ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as l,ocal Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 8 0 2 8 7 8 4 ~-~ No. '~ Date Local Registrar ~/~ JAN 2, 8 2002 143 Rev 2/~7 John B. Duvall 84 w,. , Cumberland En,qineman COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ' E ~NO c ' ~ITAL S~US- ~ I,,~ Co~¢,g I,,. I,,. 121 I,,.O~dowed I,~ ,,..O,~,~,.,~o, New Cumber£and Boro ~ [] No~ 'MEDICAL EXAMINER/CORONER ~,.~.,..::,..,:,,~..,,..,, .... ,,,~., .... ,,..,,~..,. m, o,,,...,.o.,: .,,:~,.,. ... .~....,, ., ,,. ,,,... ,, ...... ""' ..... .".".~".:'.t'.".:.~:~'.".f:).:~ [] ~ :)ATE FILED(MOnth. Day. ,,..~,,.. oeF 21-02-132 21-02-132 of JO~IN B. DUVALL BE IT REMEMBERED, that I, JOHN B. DUVALL, of 1704 Anna Street, New Cumberland, Pennsylvania 17070, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof by me, at anytime heretofore made. I am a widower. I have one (1) child: JUDITH A. MUNDIS. My social security number is 717-09-5418. ITEM 1. BURIAL AND FUNERAL INSTRUCTIONS: I direct that I be cremated and that my remains be disposed of as my Personal Representative deems appropriate. ITEM 2: DEBTS AND FUNERAL EXPENSES: I direct that all my just debts and funeral expenses appropriate to my station in life and custom of living be paid as soon after my demise as may be convenient. ITEM 3. TANGIBLE PERSONAL PROPERTY: I give and bequeath all tangible personal property owned by me at my death and all insurance policies on such property as follows: a. To those individuals who survive me and who are designated on a list or memorandum signed by me which refers to this Will or is found with a copy thereof, I give and bequeath the items listed beside their names. b. The balance (including any items under subparagraph (a) above dispose of the remaining items of personalty that are to become part of my residuary estate, either in kind or in cash as a result of liquidation thereof, as my Personal Representative, in her sole discretion, deems appropriate under the circumstances. It is my intent, however, that should any beneficiary of my residuary estate desire to receive a particular item in kind which was not specifically bequeathed to that beneficiary, to the extent reasonably possible, my Personal Representative shall attempt, but not be obligated, to follow that beneficiary's request. If any beneficiary of any item of tangible personal property aforesaid has not yet attained the age of 18 at the time of my death, I order and direct that my Personal Representative to hold the items in safekeeping for that beneficiary and to deliver the same to that beneficiary when that beneficiary reaches age 18, or such earlier age as my Personal Representative deems the beneficiary of an appropriate age to receive said items of personalty. For said purposes my Personal Representative shall be entitled to use or set aside from my estate sufficient funds to provide for said safekeeping. ITEM 4. RESIDUARY ESTATE: Ail the rest, residue and remainder of my Estate, of whatsoever nature and wheresoever situate, whether it be real, personal or mixed, including any insurance policies therefor, property over which I have power of appointment, and proceeds from any insurance policies payable to my estate, I give, devise and bequeath to my daughter, JUDITH A. MUNDIS, provided my daughter, JUDITH A. MUNDIS, survives me. ITEM 5. ALTERNATE RESIDUARY ESTATE: In the event my daughter, JUDITH A. MUNDIS, should fail to survive me, my daughter, JUDITH A. MUNDIS'S share of my residuary estate shall lapse, and in which event I give, devise and bequeath my entire residuary estate to my grandchildren, KEITH A. MUNDIS and KATHY A. FURR, or the issue of my grandchildren, KEITH A. MUNDIS and KATHY A. FURR, in ITEM 6. APPOINTMENT OF PERSONAL REPRESENTATIVE: I appoint my daughter, JUDITH A. MUNDIS, as the Personal Representative of my Estate under this my Last Will and Testament, and direct that my Personal Representative shall administer my estate and make the distributions herein provided. Should my daughter, JUDITH A. MUNDIS, predecease me, fail to qualify, cease to act or renounce probate, I then appoint my grandson, KEITH A. MUNDIS, as the Alternate Personal Representative of my Estate under this my Last Will and Testament. ITEM 7. PAYMENT OF TAXES: I direct my Personal Representative to pay all inheritance, estate, succession and legacy taxes of whatsoever nature and kind, to which my Estate or any person receiving the transfer of any property passing hereunder or otherwise passing by reason of my demise, may be subject and to charge such taxes against my residuary estate, it being my intention that none of the aforesaid taxes, either federal or state, or any property required to be included in my gross estate, under the provisions of any state or federal law now in force or hereafter enacted, shall be prorated among the persons interested in my Estate to whom such property is or may be transferred or to whom any benefit accrues. ITEM 8. POWERS OF PERSONAL REPRESENTATIVE: In addition to the powers conferred by law, I authorize my Personal Representative in her absolute discretion: To .nvest and reinvest in all forms of property without being confined to legal investments, and without regard to the principle of diversification; To exercise any option or rights arising from ownership of investments; To compromise claims without court approval and without the consent of any beneficiary; f. To disclaim any interest in property; g. To claim an elective share of the estate of any deceased spouse; To join with any spouse I may have upon my death in the filing of any federal income tax return for any year for which I have not filed such return prior to my death, and to consent to the treatment of any gifts made by my spouse as being made one-half by me for gift tax purposes notwithstanding the fact that such action may result in additional liabilities for my estate. Any income or gift taxes due on such returns and any deficiencies, interest, penalties, or refunds thereon, shall be allocated between my estate and my spouse and my spouse's estate, or all to any of them, in such manner as my Personal Representative and my said spouse may agree. To disburse my estate in kind or by way of liquidation thereof, in whole or in part, as my Personal Representative in her sole discretion may deem appropriate under the circumstances. ITEM 9. NO BOND REQUIRED: I direct that my Personal Representative or her successors shall not be required to give bond for the faithful performance of duties in any jurisdiction. ITEM 10. SURVIVAL: Any person or organization herein named or referred to shall be deemed to have survived me only of such person or organization shall in fact survive me for a period of at least thirty (30) days. Any person or organization named or referred to herein who shall not survive me by a Where appropriate to the context, pronouns or other terms expressed in one number or gender shall be deemed to include the other number or gender, as the case may be. ITEM 12. EXCLUSION: It is not my intention to make provision in this, my Last Will and Testament, for any relative or any other person not expressly provided for herein, except for children born to or legally adopted by me after the date of this instrument, and if any such person has not been expressly mentioned herein, he or she has been omitted by me intentionally and with full knowledge of his or her relationship and existence, and not by any oversight or neglect. ITEM 13. DEFINITIONS: The following definitions shall apply to this Will: The term "children" as used in this Will includes adopted and after-born persons. The term "children" as used in this Will shall not include step-children, the natural born or adopted children of a person's spouse who are not the natural born or adopted children of the person. A relationship by or through legal adoption shall be treated the same as a relationship by or though blood for purposes of succession to property under this Will. bo The terms "descendants" and ~issue" as used in this Will means the immediate and remote lawful, lineal descendants by blood or adoption of the person referred to who are in being at the time they must be ascertained in order to give effect to the reference to them. The term "Personal Representative" as used in this Will means Executor, Executrix, or any other title of like import which is used to describe such a fiduciary. do The term "per stirpes" means that whenever a distribution is to be made to the descendants of any person, the property to be distributed shall be divided into as many shares as there are The term "per capita" means that whenever a distribution is to be made to a person, the property to be distributed to that person shall be distributed only if that person survives me. If that person has not survived me, the distribution to that person shall lapse and be deemed void. IN WITNESS W~EREOF, I have hereunto set my hand and seal this ~_~ay WITNESS: ~AL) B. DUVALL ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : We, JO~IN B. DUVAL~,~~.~~ L - ~ \~(( and Diane G. Radcliff, Esquire the TESTATOR and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the TESTATOR signed and executed the instrument as the TESTATOR's Last Will and that TESTATOR had signed willingly (or willingly directed another to sign for), and that TESTATOR executed it as TESTATOR free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the TESTATOR, signed the Will as witnesses and that to the best of their knowledge the TESTATOR was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Sworn to and subscribed to before me this ~ day WITNESS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER COUNTY CODE YEAR NUMBER uJ Z uJ Z O Q. n, O DECEDENTS NAME (LAST~ FIRST, AND MIDDLE INITIAL) DATE OF DEATH (MM-OD-YEAR) (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-OD-YEAR) SOCIAL SECURITY NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS J~]l. Original Return [~4. Limited Estate ,~6. Decedent Died Testate (Attach copy of Will) ~---19. Litigation Proceeds Received FIRM NAME (llApplicable) TELEPHONE NUMBER '71 - 02- Ig l 0 [~]2. Supplemental Return O 3. Remainder Return (date of ~eath prior to 12-13~2) [~4a, Future Interest Compromise (date of death after 12-12,-82) [] 5. Federal Estate Tax Return Required [~7. Decedent Maintained a Living Trust (A~ch copy of Trust) ~ 8. Total Number of Safe Deposit Boxes [--~10. Spousal Poverty Creqit (date of death between 12-31-91 an~ 1-1-95) [] 11. Election to tax under Sec. 9113(A) (A~ch Sen O) COMPLETE MAILING ADDRESS 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 (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) r-'-~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) Total Gross Assets (total Lines 1-7) Funeral Expenses & Administrative Costs (Schedule H) (9) 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) 9. 10. (8) OFFIC[I~,L USE ONLY 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (11) / 5- $ g. :- (13) O SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 (15) 16. Amount of Line 14 taxable at lineal fate x .0 ~ ~(16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 19 Tax Due · - , ,:~ ,, ~,_ ~ BE SqRE TO ;QUESTIONS OR Decedent's Complete Address: ISTREET^ODRESS /'7 9' ¢7-,z ¢¢' -/- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty ISTATE (1) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. {5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT (3) 0 '1 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; .......................................................................................... [] [] b. retain the dght to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... [] ,[~ d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE 6 AND FILE IT AS PART OF THE RETURN. 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 bei~ef. ~t 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 PERtSO, N RESPONSIBLE FOR FILING RETURN ADDleS SIGNATURE OF PREPAREROTHER THAN REPRESENTATIVE DATE DATE , ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (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 PS. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a survi¢ing spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% {72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102. as an individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEQENT SCHEDULE A REAL ESTATE All real propert-,~ owned ~le~ or ~ a t~ant In mmm~ m~t ~ ~d ~ ~ir ~ ~. Fair ~t ~e ~ ~ as ~ pd~ at which pm~ ~uld ~ exchang~ ~n a w~ling buyer and a waling ~aer, ne~ ~ ~11~ ~ buy or ~11, bo~ having m~nab~ kn~l~ ~ ~e releva~ ~. R~I pm~ ~ich Is Jol~ym~ with dgM of suw~hlp m~ ~ dl~ ~ ~h~ule F. I~M V~UE AT DA~ NUMBER DE~RIPTI~ OF ~ 1. 22,500 SQ FT LOT CO~~G T~ FOLLO~G: ~ fi, ooo, OO B~CK ~CH HOUSE, 1 C~ G~GE, & 1 ~ATTAC~D S~D ~ BACK Y~. T~ HOUSE CONT~S T~ FOLLO~G: 2 BED ROOMS, BATH, ~TC~N, LIV~G ROOM, BASE~~ & ATTIC. TOTAL (Also enter on line 1, Recapitulation) , $¥ (If more space is needed, insert addilJonal sheets of the same size) JACK GAUGHEN REALTOR E 2. I-o.t-- o o ~ 3,2, ,,~echanicsburg Office 101 Old Schoolhouse Lane Mechanicsburg, PA 17055 (717) 697-0822 FAX (717) 697-4673 Office February 25, 2002 Ms. Diane Radcliff o Attorney 3448 Trindle Road Camp Hill, PA 17011 SUBJECT: iMai'k~i'~di~iS"6f 4 1704 Anna Street New Cumberland, PA 17070 (Estate of' John B. Duvall) The market value of subject property is estimated to be $85,0,~--% <.A._L~A~) Furr" Independently Owned And Operated By NRT www.jgr, com III ERK JACK GAUGHEN REALTOF Art Furr Residential/Commercial 101 OM ScbooJho~ Lane Mechanic~u~ PA 17055 (717) 697-4673 O~ce (717) 697-0822 Fax (717] 591-0617 D~ct D~al (717) 795-9895 R~dm~al £mmil: art.furr~jgr, com www.igr, com REV-1503 EX * (1-97) . ~I1~ . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS All property jointly-owned with right of survivorship must be disclosed on Sch~dul~ F. FILE NUMBER ITEM NUMBER DESCRIPTION 1, I PNC STOCK 990 $62.00 EACH OBLIGOR J. DUVALL $61 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O 21 22 23 24 25 26 27 28 29 3O 31 32 SERIES "E" 1 $25.00 OBLIGOR J. DUVALL 02/02 SERIES "E" 1 $25,00 OBLIGOR J. DUVALL 06/02 SERIES "E" I $25.00 OBLIGOR J. DUVALL 10/02 SERIES "E" I $25.00 OBLIGOR J. DUVALL 02/03 SERIES "E" 1 $25.00 OBLIGOR J. DUVALL 06/03 SERIES "E" 1 $25.00 OBLIGOR J. DUVALL 09/03 SERIES "E" 1 $25.00 OBLIGOR J. DUVALL 01/04 SERIES "E" 1 $25.00 OBLIGOR J. DUVALL 05~04 SERIES "E" 1 $25.00 OBLIGOR J. DUVALL 09/04 SERIES "E" I $25.00 OBLIGOR J. DUVALL 12/04 SERIES "E" 1 $25.00 OBLIGOR J. DUVALL 04/10 SERIES "E" I $25.00 OBLIGOR J. DUVALL 08/10 SERIES "E" I $25.00 OBLIGOR J. DUVALL 12/10 SERIES "E" 1 $25.00 OBLIGOR J. DUVALL 03/11 SERIES "E" 1 $25.00 OBLIGOR J. DUVALL 07/11 SERIES "E" I $25.00 OBLIGOR J. DUVALL 12/11 SERIES "E" I $25.00 OBLIGOR J. DUVALL 04/12 SERIES "E" I $25.00 OBLIGOR J. DUV^LL 05/03 SERIES "E" 1 $100.00 OBLIGOR J. DUVALL 02/02 SERIES "E" I $100.00 OBLIGOR J. DUVALL 03/02 SERIES "E" 1 $100.00 OBLIGOR J. DUVALL 05/02 SERIES "E" 1 $100.00 OBLIGOR J. DUVALL 02/12 SERIES "E" I $100.00 OBLIGOR J. DUVALL 07/02 SERIES "E" I $100.00 OBLIGOR J. DUVALL 09/02 SERIES "E" 1 $100.00 OBLIGOR J. DUVALL 11/02 SERIES "E" 1 $100.00 OBLIGOR J. DUVALL 12/02 SERIES "E" 1 $100.00 OBLIGOR J. DUVALL 01/03 SERIES "E" I $100.00 OBLIGOR J. DUVALL 03/03 SERIES "E" 1 $100.00 OBLIGOR J. DUVALL 04/03 SERIES "E" I $100.00 OBLIGOR J. DUVALL 04/03 SERIES "E" I $100.00 OBLIGOR J. DUVALL 05/03 TOTAL (Also enter on line 2, Recapitulatior (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 380.00 208.75 208.71 208.06 206.81 209.33 208.22 205,41 208.35 206.58 207.94 137.67 139.69 140.01 ~126.60 ,126.06 ~126.66 125.36 124.71 504.68 504.76 501.44 492.96 497.76 498.84 498.84 490.16 494.84 496.08 496.08 496.08 496.08 PNCBROKERAGECORP Friday, March 01, 2002 JUDY A MUNDIS EXECUTRIX ESTATE OF JOHN B DUVALL 10 COVENTRY CLOSE CAMP HILL PA 17011-1734 Dear Mrs. Mundis: Please forgive the delay with this, but per request, here is the date-of-death (01/25/02) value for the above estate: · 990 P N C FINL SVCS GRP INC (PNC) @ $62.00 = $61,380.00 Please do not hesitate to contact me if you need more information. Sincerely, Sales Assistant Tel: 717-534-3265 Fax: 717-534-3231 A PNC Bank Company 9 West Chocolate Avenue Hershey www. pncbank.com Pennsylvania 17033 Important ]nvc~tor Information: 5ccuriht'~ broker;igc 3nd ~ld~cr produt'~s ;ind st'r'/~c'e5 art' i)rovidcd by PNC Brokcr3gc ~REV-1504 ~EX+ (1-97,~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER Schedule O-1 or 0-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorshi as. ITEM NUMBER NUMBER DESCRIPTION 1. TOTAL (Also enter on line 3, Recapitulation) VALUE AT DATE Of DEATH (If more space is needed, insert additional sheets of the same size) REV-1505EX* (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 1. Name of Corporation Address City 2. Federal Employer I.D. Number SCHEDULE C-1 CLOSELY-HELD CORPORATE STOCK INFORMATION REPORT ,~~ State of Incorporation Date of Incorporation  Zip Code Total Number of Shareholders . ,, Business Reporting Year Type of Business "~ ~,\ Product/Service TYPE TOTAL NUMBE~R OF~ NUMBER OF SHARES VALUE OF THE STOCK Voting / Non-Voting SHARES OUTSTANDIN(~ PAR VALUE OWNED BY THE DECEDENT DECEDENT'S STOCK Common $ Preferred $ Provide all dghts and restrictions pertaining to each class of stock. 5. Was the decedent employed by the Corporation? [] Yes [] No If yes, Position Annual Salary $ Time Devoted to Business 6. Was the Corporation indebted to the decedent? [] Yes [] No If yes. provide amount of indebtedness $ 7. Was there life insurance payable to the corporation upon the death of the decedent? [] Yes [] No If yes, Cash Surrender Value $ Net proceeds payable $ Owner of the policy 8. Did the decedent sell or transfer stock of this company within one year prior to death or within two years if the date of death was prior to 12-31-827 [] Yes [] No If yes, [] Transfer [] Sale Number of Shares Transferee or Purchaser Consideration $ Attach a separate sheet for additional transfers and/or sales. 9. Was there a written shareholder's agreement in effect at the time of the decedent's death? [] Yes If yes, provide a copy of the agreement. 10. Was the decedent's stock sold? [] Yes [] No If yes, provide a copy of the agreement of sale, etc. 11. Was the corporation dissolved or liquidated after the decedent's death? [] Yes [] No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 12. Did the corporation have an interest in other corporations or partnerships? [] Yes [] No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. Date [] No A. Detailed calculations used in the valuation of the decedent's stock. B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years. C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been secured, attach copies. D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent. E. List of officers, their salaries, bonuses and any other benefits received from the corporation. F. Statement of dividends paid each year. List those declared and unpaid. G. Any other information relating to the valuation of the decedent's stock. REV-1507 EX+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F, ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH TOTAL (Also enter on line 4, Recapitulation) (If more space is needed, insert additional sheets of the same size) SCHEDULE E ~O,~O.W~LT. O~.~N.SYLV^N~ CASH, BANK DEPOSITS, & MISC. '"HERIT~CE T~ R~URN RESIDENT DE. DENT PERSONAL PROPER~ FILE NUMBER Include the proceeds of IKdgat~on and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 DESCRIPTION ALLFIRST BANK ALLFIRST BANK ALLFIRST BANK ALLFIRST BANK ALLFIRST BANK ALLFIRST BANK ALLFIRST BANK BANKERS LIFE BANKERS LIFE BLUE CROSS CITI BANK COMMERCE BANK COMMERCE BANK ESTATE ESTATE GLENBROOK GLENBROOK LIFE LINE PEOPLES BENEFIT PNC BANK PRUDENTIAL INS. WAYPOINT BANK WAYPOINT BANK WAYPOINT BANK CD #80000002027579 CD #80000002027783 CD #80000002027802 CD #87008000147831 INTEREST #80000002027802 IRA #87000266303001 IRA #87000266303002 ANNUITY #7666395 ANNUITY #7673574 REFUND OF PAYMENT REFUND CLOSED C CARD TIME DEPOSIT #~32 TIME DEPOSIT #2305 CAR FURNISHINGS GA206453 GA275050 REFUND PRESCRIPTION REFUND CHECKING INS, POLICY CD #1015820784 CD #8968291654 INTEREST 02~09~02 TOTAL (Also enter on line 5, Recapitulation (If mom space is needed, insert additbnal sheets of the same size) VALUE AT DATE OF DEATH $17,398.87 $19,014.52 $23,O87.43 $2,021.81 $40.72 $2,355.24 $5,772.26 $92,490.54 $48,936.53 $112.45 $42.80 $5,040.88 $10,962.09 $980.00 $2,065.75 $155,401.85 $67,575.86 $7.00 $6.65 $37,907.03 $8,108.78 $20,545.83 $9,740.81 $17.18 allfirst Judith A. Mundis, Executrix For The Estate of John B. Duvall 10 Coventry Close Camp Hill, PA 17011 Allfirst Financial Center N.A. Box 900 Millsboro. DE 19t}~*o Phone (302) 934-2909 F ax (302) 934-2955 February 28, 2002 ge~ Estate qf John B. Duvall Social Security: 717-09-5418 Date qf Death: January 25,2002 Dear Sir or Madam: Per your inquiry dated February 26, 2002, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Account Number Ownershtp (Names of) Opening Date Balance on Date of Death Accrued Interest Total IRA 36-47 Mos 87000266303001 John B. Duvall, Owner Vera A. Dm,all, Beneficiar3'/DECD 01/02/85 $2,346.86 $ 8.38 $2,355.24 Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Accrued Interest Total ItL4 36-47 Mos 87000266303002 John B. Duvall, Owner Vera A. Duvall, Beneficiary/DECD 05/07/85 $5,561.50 $ 210.76 $5, 772.26 Type of Account Account Number Ownership (Names oJ) Opening Date Balance on Date of Death Accrued Interest Total Type of Account Account Number Ownership (Names oJ) Opening Date Balance on Date of Dea& Accrued Interest Total Certificate of Deposit 80000002027579 John B. Duvall, Owner Judith A. Mundis, POA 10/01/99 $17,373.30 $ 25.57 $l 7,398.87 Certificate of Deposit 80000002027783 John B. Duvall, Owner Judith A. Mundis, POA 01/18/00 $18,992.51 $ 22.01 $19,014.52 Type of Account Account Number Ownership (Names oJ) Opening Date Balance on Date of Death Accrued Interest Total Type of Account Account Number Ownership (Names oJ) Opening Date Balance on Date of Death Accrued Inter~st Total Certificate of Deposit 80000002027802 John B. Duvall, Owner Judith A. Mundis, POA 01/31/00 $23,050.65 $ 3678 $23,087.43 Certificate of Deposit 87008000147831 John B. Duvall, Owner Vera A. Duvall, DECD 03/26/84 $2,000. O0 $ 21.81 $2,021.81 ITffs letter does not include an3' accounts in which the deceased may have been listed as Power of Attorney, Custodian of Uniform Transfers, Representative Payee. or Trustee under a Written Agreement. For fi~rther account information, closures and/or reimbursement of funds refer to below branch: WEST SHORE PLAZA OFFICE 1200 MARKET STREET, WEST SHORE LEMOYNE, PA 17043-1417 717-255-2271 Sincerely, Assistant I Cis Services, (302) 934-2909 CR NO: 7666395 PAYEE: MUNDIS JUDITH A CHECK NUMBER: 1777323 DATE: FEB 22, 2002 AMOUNT: $92,490.54 EXPLANATION: 7666395 DEATH BENEFIT $92,490.54 JOHN B DUVAIL, DECEASED A-000366 BANKERS LIFE AND CASUALTY COMPANY CR NO: 7673574 PAYEE: MUNDIS JUDITH A CHECK NUMBER: 1777325 DATE: FEB 22, 2002 AMOUNT: $48,936.53 EXPLANATION: 7673574 DEATH BENEFIT $48,936.53 JOHN B DUVALL, DECEASED Z/-oZ-oo/BZ. A-000368 BANKERS LIFE AND CASUALTY COMPANY Capital BlueCross Pennsylvania BlueShield JUDITH A MUNDIS 10 COVENTRY CLOSE CAMP HILL PA 17011-1754 HARRISBURG, PA. 17177 CHECK NUMBER 264556 AGREEMENT NUMBER 717095418 ************************* EXPLANATION PERIOD OF REFUND - FROM: 02/01/2002 REFUND REASON: CANCELLED DECEASED OF TYPE OF COVERAGE: SECURITY 65 TOTAL REFUND REFUND ************************* TO: 05/01/2002 AMOUNT: REFUND AMOUNT: 8112.45 8112.45 Visit www. citicards.com 318039950838800D00000000014108 I Paymant Must Be Received By Your Total Balance Minimum Amount Duo 102335 MCS 30 08A0032 BR3011358 I,,,llh,,lll,,,I,,,lll ...... II,,I,Ill ..... Il,II .... I,,I,l,l,I JOHN B DUVALL 1704 ANNA ST NEW CUMBERLAND PA 17070-1203 ( ) ( ) Your Account Number Please Enter Amount Of Payment Enclosed CITI CARDS P.O. BOX 8110 S HACKENSACK, NJ 07606-8110 IIl,,,I,,,hll,,ll .... I1,,I,,I .... I1,,,1111 ...... Iil · If you're provldJnq yo~r emell for the first time. please rlote that it Is Citi' Driver's Edge Platinum Select' Card-Charter Rbts Account Number 5424 1803 ggso 8388 Payment must t)e received by 1:00 pm local time on 03/11/2002 Statement/Closinq Date Total Credit Line Available Credit Line 02/14/2002 $5000 $0 Amount Over Credit Line $0. O0 + For Customer Service, call or write 1-800-967-8500 To r epect Mllinq e~r MS. wtlle BOX 6500 tath4is,ddre~s;calllflqwlll SIOUX FALLS, SD not i~ ese~ve your riqhts. 57117 Cash Advance Limit Available Cash Limit New Balance $1soo $o $o.oo Purch/A~v Pas~ Due Mim~ Due Mini~m Amount Due $0.o0 + $0.00 = $0.oo Sale Date Post Date Reference Number Activity Since Last Statement Amount 1/27 9ggggggg REFUND CREDIT BALANCE ..... ,42.80 Good News! Due to your recent payment performance, we are lowerinq your Annual- Percentaqe Rate (APR) to our standard APR You will see the new APR on your next statement. '~ = ~:?~Rerni nder: You ~m~y~'bb assessed ~'an"~Ver-the-credi t- :?lille fee if v°Ur balance exceeds'your'Total Credit Account Summary Previous {+) Purchases (-) Payments Balance & Advances & Credits (+) FINANCE (=) New CHARGE Balance PURCHAS ES $0. O0 $0. O0 - $0.00 $0.00 $0. O0 ADVANCES $42.80- $42.80 .... -- JO.O0 $0.00 $0.00 TOTAL $42.;80-:.. $42.80 $0. O0 S0. O0 $0. O0 ' ' -. -' ........ Days This Blllfnl~ Period: 30 Balance Subject to Periodic Nominal ANNUAL Rate Summery Finance Charge Rate APR PERCENTAGE RATE PURCHASES ~ Standard Purch i'$0,00 ' 0,06847%(0) 24,990% ADVANCE5 $0, O0 O, 06847~(0) ;)4,990% SENO PAYMENTS TO: CITI CARDS P.0. BOX B110 S HACKENSACK, NJ O7600-Rl10 PLEASE FOLLOW PAYMENT INSTRUCTIONS ON REVERSE SLOE. MaKe check or money order payable In U.S. dollars on l U.S. bank to Cltl Cards. Include account number on check or money order. No cash pleaSe. ~4.990% ;)4.990% 10Z:]3S Commerce March 11, 2002 Judith A Mundis 10 Coventry Close Camp Hill, PA 17011 Dear Sir/Madam: RE: Estate of: John B Duvall Social Security #: 717-09-5418 Date of Death: January 25, 2002 In reference to the letter regarding the above mentioned Estate, we would like to inform you of the information that we have researched and found. Type: Time Deposit Account ~: 432 Date Opened: 12/11/85 Date Closed: 02/19/02 Primary Owner: John B Duvall Secondary Owner: Vera A Duvall Date of Death Balance: $5,040.88 Type: Time Deposit Account #: 2305 Date Opened: 12/07/89 Date Closed: 02/19/02 Primary Owner: John B Duvall Date of Death Balance: $10,962.09 If there are any questions or additional information that is needed, please feel free to contact me at (717) 795-7118 ext. 3151. Sincerely, Wanda J. Morris CIF Associate Commerce Bank, N.A. RO. Box 8599 100 Senate Avenue Camp Hill. Pennsylvania 17001-8599 Kelley Blue Book Used Car Values , Page 1 of 2 Kelle Blue Book The Trusted Resource New Car Pridng Build a Car lncenUves My Car's Value Used Car Retail Buy a New Car Buy a Used Car Sell Your Car Pennsylvania ~ FebrUary 25, 2002 Motorcycles Insurance ,/6, ~:~ o ~'/u 7,~ y Lemon Check War~anees ~,'t~ //~' ~. Accessories 1987 Ford Taurus L Sedan 4D Car Reviews ~ Car Previews Derision Guides Advice Engine: 4-Cyl. 2.5 Liter About kbb Trans: Automatic Home Drive: Front Wheel Drive Mileage: 50,408 Click on the image above to visit this advertiser Equipment Air Conditioning Power Steering AM/FM Stereo Buy a New Car ~v a Used Car List Your Car For Sale Online Financing Quote Insurance Quote Warranty Quote Payment Calculator Consumer Rated Condition: Good "Good" condition means that the vehicle is free of any major defects. The paint, body and interior have only minor (if any) blemishes, and there are no major mechanical problems. In states where rust is a problem, this should be very minimal, and a deduction should be made to correct it. The tires match and have substantial tread wear left.. A clean title history is assumed. A "good" vehicle will need some reconditioning to be sold at retail; however major reconditioning should be deducted from the value. Most recent model cars owned by consumers fall into this category. Private Party Value $980 Private Party value represents what you might expect to pay for a used car when purchasing from a private party. It may also represent the value you might ~xpect to receive when selling your own used car to another private party. Get a Used Car Trade-In Value Get Invoice & MSRP on New Cars Copyright © 2002 15y Kelley Blue Book Co., All Rights Reserved. Jan-Feb 2002 Edition. The information in this report was printed from the Kelley Blue Book Web site (www.kbb.com) and is intended for the personal use of the customer only anct may not be sold or transmitted to another party. We assume no responsibility for errors or omissions.(v.02012) http://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb;409355&;p&722;Ford; 1987%20Taurus& 16;I... 02/25/2002 ITEM 1 2 3 4 5 6 7 8 9 '10 11 12 '13 FROM ESTATE ESTATE ESTATE ESTATE ESTATE ESTATE ESTATE ESTATE ESTATE ESTATE ESTATE ESTATE ESTATE .j-d b ,, v / ( FURNISHINGS SOLD ITEM 3 DRESSERS CHAIR DESK DISHES DRUM & COFFEE TABLES KITCHEN TABLE & CHAIRS LIFT CHAIR RUG SOFA & BED TOOLS TV CABNET, TV & DRY SINK WASHER & DRYER YARD SALE ITEMS AMOUNT $200.00 $25.O0 $50.00 $25.0O $75.00 $5O.00 SI,007.00 $100.00 $2O.O0 $100.00 $120.00 $6O. OO $233.75 03/17/02 $2,065.75 Glenbrook Life and Annuity Company P.O. Box 94212 Palatine, IL 60094-4212 GLENBROOK LIFE A Member of Allstate Financial Group February25,2002 Judith A Mundis 10 Coventry Close Camp Hill, PA 17011 Re: Contract Number: John Duvall GA206453 & GA275050 Dear Mrs. Mundis: We have been requested to complete Internal Revenue Service (IRS) Form 712 with regard to the referenced contracts. The purpose of Form 712 is to provide an estate or donor with the value of a life insurance contract or with its proceeds as of certain date (usually the owner's date of death or date of transfer of the contract). The contracts referenced were annuity contracts, which are not reportable on IRS form 712. The following information is provided regarding the value of the annuities and other data as of the date specified: GA206453 Date of Death: January 25, 2002 Annuity Value* as of Date of Death: $155,401.85 Cost Basis: $119,586.84 Named Beneficiary: Judith A Mundis GA275050 Annuity Value* as of Date of Death: $ 67,575.86 Cost Basis: $ 59000.00 Named Beneficiary: Judith A Mundis *The actual amount paid may differ due to Market Value Adjustments and/or any applicable Surrender Charges. If you have any questions, or need further assistance, please contact us at 1-877-499-6418. Lorraine Connin Life and Annuity Claims Overnight Address: 300 North Milwaukee Avenue, Vernon Hills, IL 60061 Toll Free Fax: 1-866-635-4523 PN CBANK March 4, 2002 Judith A Mundis 10 Coventry Close Camp Hill, PA 17011 /scp Estate of John B Duvall (Deceased) SSN: 717-09-5418 DOD: 01-25-2002 Dear Ms Mundis: In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account#5140112197 Established 02-01-1970 JOHN B DUVALL VERA A DUWALL DOD balance: $37,902.43 + $4.60 accrued interest; .-~7 90?, E ~ Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, Erica L Schlegel 1-800-762-1775 P7-PFSC-04-F 500 First Ave, 4th F1 CIF Pittsburgh PA 15219 Member FDIC '~ Prudential Vhe ,ruden.a, Insurance Company Financial of America W dAOD d Benefit [ insured DEATH d DUVALL IPolicy Numbers M52159520 ILetters Statement of Benefit FEB-15-2002 lCheck amount l Certificate no. $8,108.78 Check no. 0171638 Certificate amount Claim Number dMD6888~ Addressee dUDITH A MUNDIS* 10 COVENTRY CLOSE CAMP HILL, PA 17011 Payee dUD[TH A MUNDIS* INCLUDED AMOUNTS $1,950.00 6,090.42 54.60 13.76 $8,108.78 AMOUNT OF INSURANCE PAID UP ADDITIONAL INSURANCE TERMINATION DIVIDEND POLICY OR CONTRACT INTEREST AMOUNT OF PAYMENT llnstructions for Payee on reverse of this form. Pl~ease see paragraph(s) Comb 34771__A j w aup i.n LOOK FOR US. WE'LL GET YOU THERE. 03/04/2002 JUDITH MUNDIS 10 COVENTRY CLOSE CAMP HILL PA 17011 The information which you requested on the account(s) of JOHN DUVALL DECEASED (Social Security Number 717-09-5418) is/are as follows: Account Number Class; of Account Date Opened Principal Balance Accmed Interest Balance at Date of Death Account Ownership SOLE Name', of Joint Owner, if any Date Ownership Was ]Established 1015820784 8968291654 CERTIFICATE CERTIFICATE 08/23/82 07/15/96 20500.00 9703.10 45.83 37.71 20545,83 9740.81 SOLE Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner. if any Date Ownership Was Established Additional Information Requested Si,n/cerely, SENIOR SERVICES REP. ~0. Box 1711. HARRISBURG. PENNSYLVANIA 17105-1711 Toll FrEe I-8GG-WAYPOINT (l-8GG-929-764G) · www.wagpointbank.com Check Date Account; No. 101582(]784 Total: 02/09/02 Int. Pmt. 17.18 17.18 PLEASE RETAIN THIS VOUCHER c~/- O ~- ~-> / 3~__ 053876548 Federal W/H Net Int. Pmt. .00 17.18 .00 17.18 Way p i.n PO BOX 1711 · HARRISBURG, PENNSYLVANIA 17105-1711 235 N. SECOND STREET · HARRISBURG, PENNSYLVANIA 17101 · 717/236-4041 .'OS%&?r~ShS,' ~:O%OOOOOOOI-' hOO?~,:~,' PLEASE RETAIN THIS VOUCHER 053876548 JOHN B DUVALL 1704 ANNA ST NEW CUMBERLAND PA 17070-1203 Wa[Ip i.n PO BOX 1711 · HARRISBURG, PENNSYLVANIA 17105-1711 235 N. SECOND STREET · HARRISBURG, PENNSYLVANIA 17101 · 717/236-4041 COUMONWEALTH OF PENNSYLVANIA INHE~TANCE TAX RETURN RESIDENT DECEDENT If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. FILE NUMBER SCHEDULE F JOINTLY-OWNED PROPERTY SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENTS INTERES] 1. A. TOTAL (Also enter on line 6, Recapitulation) $ (~ (if more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY 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 % OF ITEM ~NCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER~ DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE ATTACH A COPY OF THE DEED FOR REAL ESTATE. NUMBER VALUE OF ASSET INTEREST 1. TOTAL (Also enter on line 7, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) , REV-1511,EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 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___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 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) "The Simple Dignified Choice" Nationwide 1-800-722-8200 Mrs. Judith Mundis 10 Coventry Close- Camp Hill, PA 17011 1-26-2002 John B. Duvall - Deceased 220134 05 X X X Direct Cremation Special-48 Hour Or Weekend Cremation Service Nationwide Guarantee Program Worldwide Travel Protection Program Private Family Viewing/Witnessing Cremation Cremation Container Medical Documents/Courier Fee Honorarium' Cardboard Container Urn Burial Vault Arrange For Burial Cemetery Charges Arrange/Deliver Remains To A National Cemetery Burial At Sea Scattering Charge Packaging And Forwarding Cremated Remains Express.Mall Certified Copies Register :Book Memorlal Folders Thank You Cards-# Convenience Package Flowers X Newspaper Placement-Fee X Pat-News 116 $895.00 $55.00 $0.00 20 @ $2.00 $40.00 X County Coroner Cremation Approval DNA Preservation Other Other Fee $~5.00 TOTAL $1,015.00 1-26-2002 PAID $1,015.00 BALANCE DUE. $0.00 F~3~ (717) 541-9943 With five office locations to serve you... in Harrisburg, Philadelphia, Pittsburgh & Scranton. Diane G. Radcliff, Esquire 3448 Trindle Road Camp Hill, PA 17011 INVOICE DATE 3/I/2002 TC): J-tidith A.' ~[-Undis 10 Coventry Close Camp Hill. PA 17011 AMOUNT DUE $99.75 DATE DESCRIPTION HOURS - ..... ,51/31/2602- --Baia'%e i=or~h~:3 ' - 02/22/2002 2.22.02. intial client consul~tion 0.57 99.75 99.75 ...... (~ ~-R-R ~7T--- i i ~33 0- I~A~/S- P-A~T -~-3;~ '-60-D~S-P-A-S T 6~: 9~- -~?S~~V E ~9~AY S'l DUE DUE : DUE ;: PAST DUE AMOUNT DUE 99 .?5 i 0.00 : 0.00 0.00 0.00 $99 .?5 'TE~§.: NE¥SO-DX--Y~'-I~3-6?X~'ER MONTH SERVICE CHARGE ON UNPAID BALANCE AFTER 30 DAYS. (18% APR). VISA AND MASTERCARD ARE ACCEPTED. RECEIPT FOR PAYMENT Cumberland County - Register Of Wills Hanover and Hiqh Street Carlisle, PA I7013 Receipt Date 2/06/2002 Receipt Time 10:39:56 Receipt No. 1028253 DUVALL JOHN B File Number Remarks 2002-00132 JUDITH A MUNDIS JA Transaction Description PETITION FOR PROBA EXTR3t PAGES SHORT CERTIFICATE JCP FEE Distribution Of Receipt ........................ Payment Amount Payee Name 375.00 CUMBERLAND ~COUNTY GENEP~AL FUN 18.00 CUMBERLAND COUNTY GENERAL FUN 24.00 CUMBERLAND COUNTY GENERAL FUN 5.00 BUREAU OF RECEIPTS & CNTR M.D Check~ 4597 ~422.00 Total Received ......... 422 00 REV 1512 ~× + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE i DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1, TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outdght spousal distributions) FILE NUMBER II. RELATIONSHIP TO DECEDENT DO Not List Trustee(s) AMOUNT OR SHARE OF ESTATE TOTAL OF PART I'!. 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) B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters WHEREAS, on the 6th dated. November 23rd 1998 No. 2002-00132 PA No. 21-02-0132 ESTATE OF DUVALL JOHN B Late of NEW CUMBERLAND BOROUGH ~UM~.I_~L_/ND ~OU~'l'~ , Deceased Social Security No. 717-09-5418 day of February 2002 an instrument was admitted to probate as the last will of DUVALL JOHN (.U~'~', late of NEW CUMBERLAND BOROUGH , CUMBERLAND County, who died on the 25th day of January 2002 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to MI~DIS JUDITH A who ?las duly qualified as Executor(rix) and ?las agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. lin TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the 6th day of February 2002. **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) 21-02-132 BE IT REMEMBERED, of JOHN B. DUVALL that I, JOHN B. DUVALL, of 1704 Anna Street, New Cumberland, Pennsylvania 17070, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof by me, at anytime heretofore made. I am a widower. I have one (1) child: JUDITH A. MUNDIS. My social security number is 717-09-5418. ITEM 1. BURIAL ~ FUNERAL INSTRUCTIONS: I direct that I be cremated and that my remains be disposed of as my Personal Representative deems appropriate. ITEM 2: DEBTS AND FUNERAL EXPENSES: I direct that all my just debts and funeral expenses appropriate to my station in life and custom of living be paid as soon after my demise as may be convenient. ITEM 3. TANGIBLE PERSONAL PROPERTY: I give and bequeath all tangible personal property owned by me at my death and all insurance policies on such property as follows: a. To those individuals who survive me and who are designated on a list or memorandum signed by me which refers to this Will or is found with a copy thereof, I give and bequeath the items listed beside their names. b. The balance (including any items under subparagraph (a) above dispose of the remaining items of personalty that are to become part of my residuary estate, either in kind or in cash as a result of liquidation thereof, as my Personal Representative, in her sole discretion, deems appropriate under the circumstances. It is my intent, however, that should any beneficiary of my residuary estate desire to receive a particular item in kind which was not specifically bequeathed to that beneficiary, to the extent reasonably possible, my Personal Representative shall attempt, but not be obligated, to follow that beneficiary's request. If any beneficiary of any item of tangible personal property aforesaid has not yet attained the age of 18 at the time of my death, I order and direct that my Personal Representative to hold the items in safekeeping for that beneficiary and to deliver the same to that beneficiary when that beneficiary reaches age 18, or such earlier age as my Personal Representative deems the beneficiary of an appropriate age to receive said items of personalty. For said purposes my Personal Representative shall be entitled to use or set aside from my estate sufficient funds to provide for said safekeeping. ITEM 4. RESIDUARY ESTATE: Ail the rest, residue and remainder of my Estate, of whatsoever nature and wheresoever situate, whether it be real, personal or mixed, including any insurance policies therefor, property over which I have power of appointment, and proceeds from any insurance policies payable to my estate, I give, devise and bequeath to my daughter, JUDITH A. MUNDIS, provided my daughter, JUDITH A. MUNDIS, survives me. ITEM 5. ALTERNATE RESIDUARY ESTATE: In the event my daughter, JUDITH A. MUNDIS, should fail to survive me, my daughter, JUDITH A. MUNDIS'S share of my residuary estate shall lapse, and in which event I give, devise and bequeath my entire residuary estate to my grandchildren, KEITH A. MUNDIS and KATHY A. FURR, or the issue of my grandchildren, KEITH A. MUNDIS and KATHY A. FURR, in equal shares per stirpes. ITEM 6. APPOINTMENT OF PERSONAL REPRESENTATIVE: I appoint my daughter JUDITH A. MUNDIS as the Personal Representative of my Estate under this my Last Will and Testament, and direct that my Personal Representative shall administer my estate and make the distributions herein provided. Should my daughter, JUDITH A MUNDIS, predecease me, fail to qualify, cease to act or renounce probate, I then appoint my grandson, KEITH A. MUNDIS, as the Alternate Personal Representative of my Estate under this my Last Will and Testament. ITEM 7. PAYMENT OF TAXES: I direct my Personal Representative to pay all inheritance, estate, succession and legacy taxes of whatsoever nature and kind, to which my Estate or any person receiving the transfer of any property passing hereunder or otherwise passing by reason of my demise, may be subject and to charge such taxes against my residuary estate, it being my intention that none of the aforesaid taxes, either federal or state, or any property required to be included in my gross estate, under the provisions of any state or federal law now in force or hereafter enacted, shall be prorated among the persons interested in my Estate to whom such property is or may be transferred or to whom any benefit accrues. ITEM 8. POWERS OF PERSONAL REPRESENTATIVE: In addition to the powers conferred by law, I authorize my Personal Representative in her absolute discretion: a. To retain in the form received, and to sell either at public or private sale any real or personal property; b. To manage real estate; To invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principle of diversification; do To exercise .any option or rights arising from ownership of investments; To compromise claims without court approval and without the consent of any beneficiary; f. To disclaim any interest in property; To claim an elective share of the estate of any deceased spouse; To join with any spouse I may have upon my death in the filing of any federal income tax return for any year for which I have not filed such return prior to my death, and to consent to the treatment of any gifts made by my spouse as being made one-half by me for gift tax purposes notwithstanding the fact that such action may result in additional liabilities for my estate. Any income or gift taxes due on such returns and any deficiencies, interest, penalties, or refunds thereon, shall be allocated between my estate and my spouse and my spouse's estate, or all to any of them, in such manner as my Personal Representative and my said spouse may agree. To disburse my estate in kind or by way of liquidation thereof, in whole or in part, as my Personal Representative in her sole discretion may deem appropriate under the circumstances. ITEM 9. NO BOND REQUIRED: I direct that my Personal Representative or her successors shall not be required to give bond for the faithful performance of duties in any jurisdiction. ITEM 10. SURVIVAL: Any person or organization herein named or referred to shall be deemed to have survived me only of such person or organization shall in fact survive me for a period of at least thirty (30) days. Any person or organization named or referred to herein who shall not survive me by a period of thirty (30) days shall be deemed to have died before I do. ITEM 11. GENDER AND NIIMBER: Where appropriate to the context, pronouns or other terms expressed in one number or gender shall be deemed to include the other number or gender, as the case may be. ITEM 12. EXCLUSION: It is not my intention to make provision in this, my Last Will and Testament, for any relative or any other person not expressly provided for herein, except for children born to or legally adopted by me after the date of this instrument, and if any such person has not been expressly mentioned herein, he or she has been omitted by me intentionally and with full knowledge of his or her relationship and existence, and not by any oversight or neglect. ITEM 13. DEFINITIONS: The following definitions shall apply to this Will: a o The term "children" as used in this Will includes adopted and after-born persons. The term "children" as used in this Will shall not include step-children, the natural born or adopted children of a person's spouse who are not the natural born or adopted children of the person. A relationship by or through legal adoption shall be treated the same as a relationship by or though blood for purposes of succession to property under this Will. bo The terms "descendants" and "issue" as used in this Will means the immediate and remote lawful, lineal descendants by blood or adoption of the person referred to who are in being at the time they must be ascertained in order to give effect to the reference to them. C ° The term "Personal Representative" as used in this Will means Executor, Executrix, or any other title of like import which is used to describe such a fiduciary. The term "per stirpes" means that whenever a distribution is to be made to the descendants of any person, the property to be distributed shall be divided into as many shares as there are (1) living children of the person, and (2) deceased children, who left descendants who are living, of the person. Each living child, if any, shall take one share and the share of each deceased child shall be divided amongst his then living e o The term "per capita" means that whenever a distribution is to be made to a person, the property to be distributed to that person shall be distributed only if that person survives me. If that person has not survived me, the distribution to that person shall lapse and be deemed void. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~ay WITNESS:  AL) · DUVALL ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : We, JO~_N B. DUVALL, ~-~ L - Off 1~( and Diane G. Radcliff, Esquire the TESTATOR and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the TESTATOR signed and executed the instrument as the TESTATOR's Last Will and that TESTATOR had signed willingly (or willingly directed another to sign for), and that TESTATOR executed it as TESTATOR free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the TESTATOR, signed the Will as witnesses and that to the best of their knowledge the TESTATOR was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Sworn to and subscribed to before me this ~ day WITNESS / 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 000998 MUNDIS JUDITH A DUPLICATE 10 COVENTRY CLOSE CAMP HILL, PA 17011 ACN ASSESSMENT CONTROL NUMBER AMOUNT ........ fold 101 $29,243.97 ESTATE INFORMATION: SSN: 717-09-5418 FILE NUMBER: 2102-0132 DECEDENT NAME: DUVALL JOHN B DATE! OF PAYMENT: 03/25/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/25/2002 REMARKS: TOTAL AMOUNT PAID: $29,243.97 SEAL CHECK# 5 INITIALS: JA RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS JUDITH A. MUNDIS 10 COVENTRY CLOSE CAMP HILL, PA. 17011 717-732-1610 APRIL 09, 2002 TO WHOM IT MAY CONCERN: I HAVE TALKED TO KAREN AT THE INHERITANCE TAX DIVISION AT THE PA DEPARTMENT OF REVENUE ABOUT THIS BILL. MY FATHER JOHN B. DUVALL NEVER TOOK MY MOTHER, VERA DUVALL OFF HIS CHECKING ACCOUNT. SHE IS DEAD. SHE DIED AUGUST 9, 1989. THE BANK MADE A MISTAKE, I SENT BACK THEIR FORMS WITH THIS SAME INFORMATION AND THEY STILL SENT THE TAX IN FOR A DEAD PERSON. I HAVE PAID THE TAX ON THIS ACCOUNT WHEN I FILED THE INHERITANCE TAX MARCH 25, 2002 UNDER FILE NO. 21-02-0132. AT THIS POINT I DO NOT KNOW WHAT ELSE CAN I DO TO FIX THIS. I HAVE GONE TO THE BANK, I HAVE CALLED THE STATE AND THE COUNTY. THIS IS PNC'S MISTAKE NOT MINE. SINCERELY, JUDITH A. MUNDIS, EXECUTRIX VERA A DUVALL REV-I~4$ EX AFP (O~-BI) 10 COVENTRY CLOSE ZNFORHATZON NOTZCE AND TAXPAYER RESPONSE · Oi~ EST. OF JOHN B DUVALL /i?;3 S.S. NO. 717-09-5418 DATE OF DEA~ 01-25-2002 COUNTY CUMBERLAND FILE NO. 21 02-01:52 ACM :~ 02116070 DATE · 04-02-2002 TYPE OF ACCOUNT [] SAVINGS [] CHECKING [] TRUST [] CERTZF. .~,? :~../O REHZT PAYHENT AHD FORFIS TO: REGISTER OF gILLS CUMBERLAND CO COURT HOUSE CAMP HILL, PA . ~ . ,.~ ~i CARLISLE, PA 1701:5 s pro,,.ded ,ho "opor ent el,h ,he tnfor.otion listed bolo,, ub.:h"hes b--" calculating ,he potential tax due. Their records Indicate ,hot at ,he deo,h of the above decedent, you sere · Joint o.ner/boneflclary of this account. T~ you fell ,his information Js Incorrect, please obtain .rttten correction from ,he financial Institution, attach a copy to ,his forl end return, it to the above address. This account Is taxable In ec¢ordarme .ith the Tnherlten=e Tax La*es o~ the COmlmnMeelth O~ Pennsylvania. questions .ay be ~ns~e~d by collie3 (717) 787-85Z7. COMPLETE PART 1 BELO# . . . SEE REVERSE STDE FOR FZL[NG AND PAYMENT TNSTRUCTZONS Account NO. 5:1q0112197 Date ~ 02-01-1970 To Insure proper credit to your account, tee Established (z) copies of this notice .ust occoip.ny your Accoun~ Belaflce :57 · ~07.0:5 payment to the Register of Hills. Hake check payable to: 'Register of #il'Is, Agent'. Percon~ Taxable X : 50.000 Amount Subject ~o Tax Z8,95:5.52 NOTE: if tax payments are mo ei`h~n `hree ($) ~on`hs of the decodent's dote o~ dee`h, Tax Rede X ~ .15 you ~y deduct · 5Z discount of the tax due. Any inheritance tax due ell1 become delJnquent Potential Tax Due ~ 2·84:5.0:5 nine (9) eon,ho o~ter ,he ~. o~ deo,h. PART TAXPAYER RESPONSE CHECK] ONE BLOCK ONLY A. [] The ~,ove information and tax due is correct. 1. You lay choose tO' remit poyumnt to the Register of #Ills ei,h tee copies of ,his,notice to obtain o discount or ovoid interest, or you may check box "A' and return ,his notice to tho Register of #ills and on official assessment mill be issued by `he PA Deportment of Revenue. B. The above asset has been or ell! bo reported and tax paid mf`h ,he Pennsylvania Inheritance Tax return to be ~lled by the decedent's representative. C. [] The above information is incorrect and/or debts and deductions aero paid by you. You oust complete PAINT [] and/ar PART [] bolo.. 2. Accoun~ Balance 3. Percent Taxable 4. Aeount Subject to Tax 4__ 5. Debts and Dacluc~/ons 6. Amount TaxabZo 7. Tax Rets 7._.~ 8. Taxi)tm 8 Zf you indicate a different tax rate, please s~ato your relationship ~o decedent: RETURN - COMPUTATTON OF TAX oN JOINT/TRUST ACCOUNTS 1. Date EstabZishod PART TAX LINE DEBTS AND DEDUCTTONS CLAZ#Fn PART DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line $ of T $ Under penalties of perjury· Z d lure the~ ~ho facts Z have ~epor~ed above ere ~rue, icorrect and complete to the bes~ of mY knowZedge end belief. ,ese c 717 T/~PAYER SIGNATURE ~ · gORK ¢ TELEPHONE NOMBER JUDITH A. MUNDIS 10 COVENTRY CLOSE CAMF' HILL, PA. 17011 717-7~2-1610 AF'RIL 09, 2002 TO WH[]M IT MAY CONCERN: I HAVE TALl<ED TO KAREN AT THE INHERITANCE TAX DIVISION AT THE PA DEPARTMENT OF REVENUE ABOUT THIS BILL. MY FATHER JOHN B. DUVALL NEVER TOOK MY MOTHER, VERA DUVAI_L OFF HIS CHECKING ACCOUNT. SHE IS DEAD. SHE DIED AUGUST 9., 1989. THE BANK MADE A MISTAKE, I SENT BACK THEIR FORMS WITH 'THIS SAME INFORMATION AND THEY STILL SEN]' THE TAX IN FOR A DEAD PERSON. I HAVE PAID 'THE ]"AX ON 'THIS ACCOUNT WHEN I FILED THE INHERITANCE 'TAX MARCH 25, 2002 UNDER FILE NO. 21-02-0132. AT 'THIS POINT I DO NO]" KNOW WHAT ELSE CAN I DO TO FIX THIS. I HAVE GONE TO THE BANK, I HAVE CALLED THE STATE AND THE COUNTY. 'THIS IS PNC'~S MISTAKE NOT MINE. SINCERELY, JUDITH A. MUNDIS, EXECUTRIX ARNING: IT IS ILLEGAL' TO 'ALTER THIS' COPY OR , TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH*. H105 If2REV 1! R5 (FEE FOR THIS i, COMMONWEALTH OF PENNSYLVANIA CERTIFICATE $2 , , DEPARTMENT OF HEALTH-VITAL RECORDS ' ' ! No.2195791 LOCAL REGISTRAR'S cERTIFICATION OF DEATH Rceistcrt.t Full Nmnc .... . -. t a~t Stmel co.,,,v ~~sho~ ~WD ~ ['e,.]svh ;mia Social Sccmitv No. 1 5~ 94 ~ (}C~Ul,mi., .--~hine On v~., , * J'arl J. I)calh was c;m~cd hr: Inlcr~:ll I~ch~cen ()nxcl mid Pcalh ___C_H_ ~: _ Uz:o s e p s i s ........... Accident. Suicide iq' Ih,mi~ hk' ___ Natural ,! ................... Camp Hill, PA.. , ~ ~ 22=2.26 120 .Spruce St. ,. Middletown, PA ..... 17.057. , .8 2 8 9 £NFORHATZON NOTICE FILE NO. 21 02-0152 AND TAXPAYER RESPONSE ACN 0Zl16070 DATE 0q-02-2002 TYPE OF ACCOUNT EST. OF JOHN B DUVALL [] SAVINGS S.S. NO. 717-09-5q18 [] CHECKING DATE OF DEATH 01-25-2002 [] TRUST COUNTY CUMBERLAND F-1CERTIF. REHZT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 nt with the initiation listed below .hich has been used in the death of the above decedent, you .ara a joint o.ner/benaflciary of tain aritten correct[on from the financial institution, attach a copy taxable in accordance with the Inheritance Tax La.s of the Commonwealth 527. SIDE FOR FILING AND PAYMENT INSTRUCTIONS '01-1970 )7.0~ iO.O00 ~$.52 Tax Rate X .15 Potent/al Tax Due Z,B~$. 02 To insure proper credit to your account, (Z) copies of this notice must accompany your payment to the Register of Hills. Hake check payable to: "Register of #[11s, Agent". NOTE: If tax payients are Iada within three (3) ionths of the dacedmnt's data cf death) you iay deduct a SZ discount of the tax due. Any inheritance tax due .ill becoaa delinquent nine (9) aonths after the date of death. PART TAXPAYER RESPONSE A. ~ The above information and tax due is correct. L You .ay choose to remit payment to the Register o~ Hills .[th t.o cop[es o~ this notice to ob~Jn a discount or avoid interest, or you may check box "A" and re~rn this notice to ~e Register of  CHECK ~ .~ns and an o;~c[a[ assessment ~J[[ be issued by ~e PA Department o~ Revenue. ONE BLOCK s. ~ The above asset has been or .[11 be reported and tax paid .ith the Pennsylvania Inheritance Tax return ONLY to be flied by ~e decedent's representative. C. ~ The above ~n;or.at~on Js ~ncorrect and/or debts and deductJons .era paid by you. You must complete PART ~ and/or PART ~ below. LINE 1. Date Established 1 2. Account Balance 2 $. Percent Taxable $ X q. Amount Subject to Tax q $. Debts and Deductions 5 6. Aeount Taxable 6. 7. Tax Rate 7 X 8. Tax Due 8 PART PI DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ Under penalties of perjury, I declare that the facts I have reported above ere true, correct end complete to the bast of ay knowledge and belief. HOME C I 7 ) (::~~ ~', )'~~, ,~-'"~ WORK ( ) T~PAYER SIGNATURE ' TELEPHDNE NUHBER DATE GENERAl INFORMATION 1, FAILURE TO RESPOND HILL RESULT IN AN OFFICIAL TAX ASSESSMENT aith applicable interest based on information subaJttad by the financial institution. Z. Inheritance tax becomes delinquent nine months after the dRcadant's data of death. 5. A joint account is taxable even though the decsdent's name ems added as a matter of convenience. 4. Accounts (incZuding those haZd bataaan husband and wife) ~hich the decadent put in joint names within one year prior to death are fully taxable as transfers. 5. Accounts established jointly between husband and aifa aor~ than one year prior to death ara not taxable. 6. Accounts held by a decedent "in trust for" another or othHrs are taxable fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If tho information and computation in the notice are correct and deductions ara not being claimed, place an in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of tax to tho Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-1S48 EX) upon receipt of the return from the Register of Hills. Z. BLOCK B - If the asset specified on this notice has been or ail1 be reported and tax paid aith the Pennsylvania Inheritance Tax Return filed by the dacedent's representative, place :an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept Z80601, Harrisburg, PA 171Z8-0601 in the envelope provided. 3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts Z and 3 according to the instructions beloa. Sign tee copies and submit thee aith your check for the amount of tax payable to the Register of Hills of the county indicated. The PA Department of Revenue ail1 issue an official assessment (Fora REV-1548 EX) upon receipt of the return from the Register of Nills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter the date the account originally was established or titled in the manner existing at data of death. NOTE: For a decedent dying after 1Z/II/aZ: Accounts ehich the decedent put in joint names within one (I) year of death ara taxable fully as transfers. However, there is an exclusion not to exceed $5,000 par transferee regardless of the value of the account or the number of accounts held. If a double asterisk (ex) appears before your first name in the address portion of this notice, the $$,000 exclusion already has been deducted from the account balance as reported by the financial institution. Z. Enter the total balance of the account including interest accrued to tho data of death. The percent of the account that is taxable for each survivor is determined as foIloas: A. The percent taxabIa for joint assets astabIishad more than one year prior to the decedant's death: 1 DIVIDED BY TOTAL NUHBER OF DIVIDED BY TOTAL NUMBER OF X 1DO = PERCENT TAXABLE JOINT ONNERS SURVIVING JOINT ONNERS Example: A joint asset registarad in the name of thy decedent and two other persons. 1 DIVIDED BY 5 (JOINT ONNERS) DIVIDED BY Z (SURVIVORS) = ,167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created within one year of the decadent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED DY TOTAL NUMBER OF SURVIVING JOINT X ~00 = PERCENT TAXABLE ONNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. 1 DIVIDED BY Z (SURVIVORS) = .50 X 100 = 507. (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable El[ne 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 4). 7. Enter the appropriate tax rata (line 7) as datarainad beloe. Date of Death Spouse I Lineal I Sibling 07/01/9q to 12/S1/9~ 01/01/96 to 06/S0/00 OZ 6Z 07/01/00 to presen~ OX q.$Zx 12Z 15Z mTha tax rata imposed on tho nat value of transfers from a deceased child t~enty-ona years of ago or younger at death to or ~or the usa of a natural parent, an adoptive parent, or a stepparant of the child is OZ. Tho lineal class of hairs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children ahether ar not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the naturaI parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Sibtings" ara defined as individuals oho have at least one parent in common with the decedent, ~hathar by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. CLAIMED DEDUCTIONS - PART $ - DE]iTS AND DEDUCTIONS CLAIMED Allowable debts and deductions ara determined as follows: A. You legally ara responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible ]teas. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being cia[mad lust bm itemized fully in Part 5. If additional space is needed, use plain paper 8 l/Z" x 11". Proof of payment may be requested by the PA Department of Rev ~nue. Name of Decedent: Date of Death: CERTIFICATION OF NOTICE UNDER RULE 5.6{a) Will No. Admin. No. ~, Ol~ --O~3 -~2 ~'~ To the Register: I certify that notice of (beneficial interest) 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 · Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Signature ~ ~.. C~'~t /'t,'l), ~,~ , Telephone c/JT) "7 2 ~-/6 / 0 Capacity: __ Personal Representative Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 FX(11-96) CD 001662 MUNDIS JUDITH A 10 COVENTRY CLOSE CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 717-09-5418 FILE NUMBER: 2102-0132 DECEDENT NAME: DUVALL JOHN B DATE OF PAYMENT: 09/27/2002 POSTMARK DATE: 09/23/2002 COUNTY: CUMBERLAND DATE'. OF DEATH: 01/25/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $82.16 REMARKS: JUDITH A MUNDIS TOTAL AMOUNT PAID: $82.16 SEAL CHECK# 1001 INITIALS: JA RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX (6-00) · / ~ COMMONWEALTH OF ~,.~,~ PENNSYLVANIA ~'~~~',m,. DEPARTMENT OF REVENUE ,¢' ~';;~"~'.,~ ~ '~ DEPT. 280601 ~HARRISBURG, PA 17128-0601 I.- Z u.I Z o Q. U.I (..I REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 08... Iff- (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY qo 3 J_-__o _,2 o O_l COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER '-)/7- oq THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER E~l. Original Return ~2. Supplemental Return [] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after 12-12-82) E~6. Decedent Bled Testate (Attach copy of Will) [] 7. Decedent Maintained a Living Trust (Attach copy of Trust) [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) NAME FIRM NAME (If Applicable) TELEPHONE NUMBER ] 3. Remainder Return (date of death prior to 12-13-82) [~5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes r--] 11. Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS 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 (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses &Administrative Costs (Schedule H) (g) 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. (8) OFFICIAL USE ONLY (11) (12) (13) Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 __ (15) 16. Amount of Line 14 taxable at lineal rate x .0 ~ ~' (16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) Decedent's Complete Address: STREET ADDRESS Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount interest/Penalty if applicable D. Interest E. Penalty STATE (1) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) if Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] C~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, Under penalties of 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 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 PERSON RESPONSIBLE FOR FILING RETURN ADDt~,'- - ' SIGNATURE OF PREI~RER OTHER THAN REPRESENTA/i'IVE " DATE DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (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. §9116 (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 return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV 1503 Ex * (1 97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER ITEM NUMBER DESCRiPTiON TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH September 4, 2002 JOHN B DUVALL C/O JUDITH A MUNDIS 10 COVENTRY CLOSE CAMP HILL PA 17011 1734 PRUDENTIAL JOHN B DUVALL ACCOUNT NUMBER: 2300-9964-5348 Dear Mr. Duvall: Thank you for your inquiry regarding the share balance of the above referenced account. We appreciate the opportunity to be of service to you. On 01/25/2002, account number 9964-5348 held 60.0000 shares. On that date, the closing price was $30.43 per share. If you have questions related to your compensation or general demutualization questions, please call the Demutualization Information Center toll free at 1-800-243-1701 between 8 a.m. to 7 p.m., Eastern Time, Monday through Friday. If you are using a telecommunications device for the hearing impaired (TTY/TDD), please call 1-800-619-2837. A customer service representative will be glad to help you. Reference Number: 01001086 erely,~ ~k Shareholder Services BUREAU OF ZNDZVZDUAL TAXES TNH~*~RZTANCE TAX D/VTSTON DEPT. 180601 HARR:LSBURG, PA 17118-D601 JUDITH A NUNDIS 10 COVENTRY CLOSE CAHP HILL PA 17011 COHHONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE 01-28-2005 ESTATE OF DUVALL DATE OF DEATH 01-25-2002 FZLE NUMBER 21 02-0152 COUNTY CUMIIERLAND ACN 101 I Amount Remitted REV-15ii7 EX AFP C01-05) JOHN MAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGISTER OF MILLS CUMIIERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LONER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DUVALL JOHN IIFZLE NO. 21 02-0132 ACN 101 DATE 01-28-2003 TAX RETURN HAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVAT]:ON CONCERNTNG FUTURE INTEREST - SEE REVERSE APPRATSED VALUE OF RETURN BASED ON: ORIGINAL AND SUPPLEMENTAL RETURN NO. 01 1. Real Estate (Schedule A) (1) 851000.00 NOTE: To insure proper 11. 12. 15. NOTE: 2. Stocks and Bonds (Schodulo B) (2) $. Closoly Hold Stock/PartnorshAp Interest (Schodulo C) ($) 4. Hortgagos/Notos RoceAvable (Schedulo D) (4) S. Cash/Bank Doposits/HAsc. Personal Property (Schodulo E) (5) 6. JoAntly Ownod Property (Schodule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets 72/799.32 .00 .0O 521/524.10 .00 .0O (8) 1,536.75 APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Costs/HAsc. Expenses (Schedule H) (9) 10. Debts/Hortgage LAabilitAes/Liens (Schedule 1) (10) .00 Total DeductAons (11) Net Value of Tax Return (12) Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Net Value of Estate Subject to Tax (14) credAt ~o your account, submit the upper portion of thAs fora wASh your tax payment. 679,323.42 ].536.75 677~786.67 .00 677,786.67 Zf an assessment vas issued previously, lines 14, 15 and/or 16, 17, 18 and 19 Nill re~lect ~igures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of L/ne 14 at Spousal ra~e 16. Amount of LAne 14 taxable at LAneal/Cless A rate 17. Amount of L/ne 14 et SAbling rate 18. Amoun~ of LAne 1~ taxable at Collateral/Class B rate 19. PrAnci =al Tax Due TAX CREDITS PAYNENT RECETpT DISCOUNT (+) DATE NUNBER TNTEREST/PEN pATD (-) 03-25-2002 CD000998 1 , 5:;'5.02 09-2:5-2002 CD001662 .00 IF PAID AFTER DATE /NDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (15) .00 x O0 = .00 (16) 677,786.67 x 045 = :30,500.40 (17) .00 x 12 = .00 (lB) .00 x 15 = .00 (19)= 30,500 AHOUNT PAID 19,243.97 82.16 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 30,851.15 350.75CR .00 350.75CR ( ZF TOTAL DUE IS LESS THAN $1~ NO PAYMENT IS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF TH/S FORM FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decadents dying on or before December 12, 1aDz -- 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 Commonaaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class B (collateral) rate on any such futura interest. To ~ulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Rag[star of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF NZLLS~ AGENT A refund of a tax credit, ahich ams not requested on tho Tax Return, may ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications ara ava(labia at the Off[ce of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Z4-hour ansaering service for forms ordering: 1-800-362-Z050; services for taxpayers #ith special hearing and / or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object Hithin sixty [60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZalOZ1, Harrisburg, PA 17128-1021, 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 Hr[ting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Ray(aw Un[t, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 767-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decadent's death, a five percent (5Z) discount of the tax paid [s allowed. The 152 tax amnesty non-participation penalty is computed on tho 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 [s appealable in the same manner and in the the saaa tiao par[od as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest [s 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 1, 19BI bear interest at the rate of six (62) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which Hill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Rate Factor Year Rate Factor Year Rate Factor Year 1982 lOX .000548 1987 1983 16Z .000438 1988-1991 1984 Ill .000301 1992 1985 1~Z .000356 1993-1994 1986 10Z .000274 1995-1998 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID 92 .000247 1999 72 .000192 112 .000301 ZOO0 82 .000219 9Z .000Z47 ZOOX 9Z .000Z47 7Z .OOO19Z 20OZ 6Z .000164 92 .000247 Z003 5Z .000137 X NUNBER OF DAYS DELINQUENT X DALLY 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 show~ o~ the Notice, additional interest must be calculated. · ~ INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENTS NAME FILE NUMBER John B. Duvall 2102-0132 REVIEWFD BY ACN John Kuchinski 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES E 21 The proceeds of life insurance policies on the life of the decedent are not subject to tax in the decedent's estate. Row Page 1 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT, 180601 HARR:[SBURG, PA 1712B-0601 COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-Z~O7 EX AFP (01-OS) JUDITH A MUNDIS 10 COVENTRY CLOSE CAMP HILL PA 17011 DATE 02-24-2005 ESTATE OF DUVALL DATE OF DEATH 01-25-2002 FILE NUMBER 21 02-0132 COUNTY CUMBERLAND ACN 101 Amount Remitted JOHN B MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper port~on of ~his form w~h your tax peymen~c. CUT ALONG THIS LINE ~" RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) #~ INHERITANCE TAX STATEMENT OF ACCOUNT ~ ESTATE OF DUVALL JOHN B FILE NO. 21 01-0132 ACN 101 DATE 02-24-2005 THIS STATEHENT TS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHONN BELON ZS A SUHNARY OF THE PRINCIPAL TAX DUE, APPLTCATZON OF ALL PAYHENTS, THE CURRENT BALANCE, AND., ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-21-2003 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 30,500.40 PAYHENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 1,525.02 03-Z5-ZOO2 09-23-2002 02-06-Z003 CD000998 CD001662 REFUND .00 .00 29,Z43.97 82.16 350.75- ZF PAZD AFTER THZS DATE, SEE REVERSE SZDE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT" (CR), TOTAL TAX CREDZT 30,500.40 BALANCE OF TAX DUE .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE SZDE OF THTS FORN FOR 'rNSTRUCTZONS. PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF #TLLS, AGENT. -- zf NON-RESIDENT DECEDENT make check or money order payable to: COMMON#EALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which ams not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (RE¥-1315). Applications are available at the Office of the Register of Nills, any of the Z5 Revenue District Offices or from the Department's Iq-hour ansaaring service for forms ordering: 1-800-36Z-lOS0; services for taxpayers with special hearing and / or speaking needs: 1-800-4~7-30Z0 (TT only). REPLY TO: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. PENALTY: The 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. 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 ahich became delinquent before January l, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .00016~. All taxes which became delinquent on and after January l, 198Z mill bear interest at a rate ahich will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 lOX .0005q8 1987 92 .000247 1999 72 .O00lgg 1985 16Z .000q58 198B-1991 llZ .00030X ZOO0 8Z .000219 1985 132 .000556 1993-199q 7Z .OO019Z ZOOZ 6Z .00016~ 1986 IOZ .O00ZT~ 1995-1998 9Z .OOOZq7 ZOO3 5Z .000157 --Interest is calculated as folloas: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (iS) 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. STATUS REPORT UNDER ~RULE 6.1,2. Name of Decedent: Date of Death: dP / - P-,-~- O 52_ win >40.: fl / - ? o o ~--- o/j 3_ A~. ~o.: P~su~t to Rule 6.12 of the Supreme Co~ O~h~' Co~ Rules, I repom the followMg with respect to completion of the a~smation of the above-captioned estate: 1. State whe~er adm~s~ation of~e estate is complete: Yes ~ No D 2. If ~e ~swer is No, state when ~e personal representative re~onably believes ~at ~e a~smation will be complete: Date: If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes _ No [] b. The separate Orphans' Court No. (if any) for the personal representative's account is: ~ c. Did the personal re,~resentative state an account informally to the parties in interest? Yes c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ~(~namre Name Capacity: Address Telephone No. Personal Representative Counsel for personal representative