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Home My WebLink About04-0028 PETITION FOR PROBATE and GRANT OF LETTERS Es,a,e No. also known as Deceased. Social Security No. ~ To: Register of Wills for the County of Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older.ap ~h~executo,'5 in the last will of the above decedent, dated I'ho-~ iq. Icl and codicil(s) dated ~ '1 in the named ,19 (state relevant circumstances, e.g. renunciation, death of executor, etc.) ...... at death in O-~L~'~xL'lt~lq ~ , County, Pennsylvania, with h ~,_~c~nde lntastW?Sam~i~oC~'~.raincipal r~side~nce~t ~ ~,l'~d~, Dt~ ~ ~ fi_,~ ("'~ ~Z ~,q (list street, number ~d muncipality) ~ , Decenaent, then ~ years of age, died ~CEV,B, ~ 2~ ,~c~ Except as follows, decedent did not marry, was not ~vorc~d 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: ~o~'~ eL.- .. 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: $ WHEREFORE, petitioner(s) respectfully .reque.st(s) the p,robate .of the last will and codicil(s) presented herewith and the grant of letters (testamentary; adminislkation c.t.a.; administration d.b.n.c.t.a.) theron. ~° OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF Thc petitioner(s) above-named swear(s) or affirm(s) that thc statements in the foregoing petition arc true and correct to thc best of the knowledge and belief of petitioner(s) and that as personal represen- tative s of thc above decedent petitioner(s) will well and truly administercthe estate according to law. () .~ : Sworn to or aff~med and subscribed f- i,~L yv~ ~.. /15~ore me this dtOz/ . day of / - - ~ Estate Of ~'~4, ~ ~', ~ -~'t~ ~ ~3~, ? ~t , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated_. CC~ ~t, q'-rlq /r'~ ~ described therein be admitted to probate and filed of record as the last will of arid Letters- [~'~-r~rr~rr-,~ ~ ,o{] are hereby granted to ~J~tn~o '-~ '~~ l~::t~, in consideration of the petition on FEES Probate, Letters, Etc .......... Short Certificates( ) .......... nunchation ................ Viled~..~, Register of ~ ~ ~ ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE RENUNCIATION In Re Estate of ~---'~-- ~z_. '~OpY deceased. To the Register of Wills of ~f .k.) ~ ~--~-.-,%~ County, Pennsylvania. The undersigned ~ . .~d_C~'~ .~c/~ , ~-g-A~pJ of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters WITNESS hand this ~?- day of '~/~o.A~ , 20 ac{ . (Address) (Signature) (Address) (Signature) (Address) REG~ WiTNE~OUNTY H OF SUBSCRIBING // (each) a subscribing witness to the presented herewith, law, depose(s) and say(s) that being duly qualified according to present and saw the testat , sign the same and that request of testat__ in h presence and other subscribing witness(es)). signed as a witness at the ence of each other) (in the presence of the Sworn to or affirmed and subscribed me this 19 lay of Register (Address)~ (Name) ~.~ (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified according~to law, depose(s) and say(s) that I ¼~, ~.~ familiar with the signature of · testat~:~., of 0~..e ,-,c th,, u ...... ' ...... :u ...... mg wit~,~s tc,) the will presented herewith and codicil that ~ ]q-'~ ~ believe~the signature on the will is in the handwriting of l to the best of . knowledge and belief Sworn to or affirmed and subscribed before ' /~~ ~~/~) ~"~ ( Reg//ster , ~ame) ~', ~ (Address) his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Ix)cai 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 9898944 No. DEC 2 5 2003 Date =./PRINT 4ANENT H105143 Rev 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH ,. Be.rmie Sue Du[~ ]2. F l,.~/$9-9¥ -?q85 t,.&ce,.~e ~3.~3 1206 Biddle Drive I RESIDENCE dec,eotD~ *i7c. [] Yes. dee~t~,,! lived in ~. FATHER'S NAME (Flint, Middle, LeSt) INFORMAN~"S NAME (Typ~/Pr~t) 20.. Diarm D. Drake l?b. CounW ~rland Io~nship? l?d. [] No. de:*de,,,iv,~ Carlisle *i0. Nancy V. Watford 20b. 1206 Biddle Drive; Carlisle, PA 17013 PLACE OF DISPOSITION; Ne?.of Cemelg~, ~rem~.oloo/_ ILOCATION - City/Town. Stale Zip Code or Other Place Tolec~ o~lnorla± ~arK ~t~. and Mausoleum ~ld. Sylvania, Ohio METHOD OF DISPOSITION DATE OF DISPOSITION ~*i,. ot~(s~.~O) ......... ~ z~b. 1/5/2004 ;IGNORE ~ L SERVICE SUCH LIC EE ~ P N ACT~G AS LICENSE NUMBER N~E ~D ADORESS OF FACILI~ ~ ~ ~ 0~ 3 I ~ I 20. 128b. 120. 13o,. ' · ~Hy~.~v%~{~,~)~9.~g~del~en.~[,o[h~y~,,hasp~ddea~a~i~i~it~23) ..................... ...... . .................. ...... ,., DATE SIGNED_ ./. --(Mo~th' Day, Year) ~E ~D ADDRESS OF PERS~ WHO C~PL~ED ~USE OF (Imm ~ T~ ~ ,,. ~ ~.g-tt6~, DATE FILED (Monlh. Day. Year} of BENNIE SUE DUPY I, Bennie Sue Dupy, of the Borough of Carlisle, County of Cumberland and Commonwealth of Pennsylvania, being of sound mind, memory and understanding, do hereby publish and declare this to be my Last Will and Testament, hereby revoking and declaring null and void any and all wills and Codicils heretofore written by me. x-r~ I. I direct that all my just debts and funeral expenses be paid as soon after my demise as may be convenient to the proper administration of my estate. ITEM II. I give, devise and bequeath the sum of One Thousand ($1,000.00) Dollars to the Bennie Sue Dupy Freshman Improvement Award of Carlisle Civic Club of 264 W. Pomfret Street, Carlisle, Pennsylvania, 17013. ITEM III. I then order and direct my hereinafter named Executors to convert my entire estate into cash at either public or private sale, whenever in their discretion it may be most expedient for the proper administration of my estate. In the event of such conversion, I authorize my said Executors to execute a good and sufficient Warranty Deed to the purchaser of any real estate of which I may die seized, in the same manner and capacity as I could if living. ITEM IV. I direct that all inheritance and estate taxes be paid on the proceeds of the above conversion and on all the rest, residue and remainder of my estate from the residue of my estate prior to further distribution. ITEM V. I direct that my hereinafter named Executors shall divide the proceeds from the above-mentioned conversion and all the (c) If my Daughter should predecease me, I direct that all the rest, residue and remainder of my estate be distributed as follows: (1) Ten (10%) percent to Randall V. Drake, my Son-in-Law. (2) Forty-Five (45%) percent to Allison Rand, my Granddaughter, per stirpes and not per capita. (3) Forty-Five (45%) percent to Scott Rand, my Grandson, per stirpes and not per capita. ITEM ¥I. I nominate, constitute and appoint my Daughter, Diann D. Drake, and my Grandson, Scott Rand, Co-executors of this my Last Will and Testament. In the event either of my Co-Executors should predecease me or be unable or unwilling to serve, I then nominate, constitute and appoint my Granddaughter, Allison Rand, who shall act in their place and stead. I direct that my Executors shall not be required to post bond other than their personal assurance for their duties as Executors. IN WITNESS W~RREOF, I, Bennie Sue Dupy, hereunto subscribed my hand to this my Last Will and Testament, this ~ day of May, 1998. Bennie Sue Dup~ SIGNED, PUBLISHED and DECLARED by the above named Bennie Sue Dupy, as and for her Last Will and Testament in the presence of us, who at her request and in her presence and in the presence of each tttil! anil BEBINIE S~ D~ ATTORNEY AT LAW 148 S. BALTIMORE ST. P.O. BOX 421 DILLSBURG, PA 17019-0421 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Bennie Sue Dupy Date of Death: December 23, 2003 Will No. 28 of 2004 Admin. No. 21-04-0028 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 January 28, 2004. Name: Address: Diann D. Drake 1206 Biddle Drive, Carlisle, PA 17013 L. Scott Rand 2203 Hunter Place Lane, Arlington, TX 76006 Alllison R. Graves 1809 County Roadl,~urleson, TX 76028 Civic Club of Carlisle 264 W. Pomfret Street, Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE Date: ,~,'- el "'O l~ Signature Diann D. Drake Name (Please type or print) 1206 Biddle Drive Address Carlisle, PA 17013 717-249-0034 Tel. No. Capacity: X Personal representative Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 0O3666 DRAKE DIANN D 1206 BIDDLE DRIVE CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 457-74-9725 FILE NUMBER: 2104-0028 'DECEDENT NAME: DUPY BENNIE SUE DATE OF PAYMENT: 03/1 2/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 12/23/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $35,000.00 !REMARKS: DIANN D DRAKE CHECK//108 · SEAL TOTAL AMOUNT PAID: $35,000.00 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 FX(11-96) CD O03922 DRAKE DIANN D 1206 BIDDLE DRIVE CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 457-74-9725 FILE NUMBER: 2104-0028 DECEDENT NAME: DUPY BENNIE SUE DATE OF PAYMENT: 05/11/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/23/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,239.00 TOTAL AMOUNT PAID' $1,239.00 REMARKS: DIANN D DRAKE SEAL CHECK//113 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICF~J.. USE ONLY FiLE NUMBER 21 -- 2--00--3 __00__02__8 __ __ COUNTY CODE yE,AR NUMBER SOCIAL SECURITY NUMBER DECEDENTS NAME (LAST. FIRST, AND MIDDLE INITIAL) 457 - 74 - 9725 ~ DUPY, BENNIES Z THIS RETURN MUST BE FILED IN DUPLICATE WITH THE UJ DATE OF DEATH (MM-DD-YEAR) [ DATE OF BIRTH (MM-DD-YEAR) ~3 01/10 / 1914 REGISTER OF WILLS uJ 12/23/2003 (~ SOCIAL SECURITY NUMBER LU (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~-~ 3. Remainder Return (date of death prior to 12-13-82) tU ['~ 1. Original Return L__J 2. Supplemental Return I- n~ [E~ 4 Limited Estate ~ 4a Future Interest Compromise (date of death after 12-12-82) ~ 5, Federal Estate Tax Return Required ~3 6. Decedent Died Testate (Attach copy of Will) ~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) 8. Total Number of Safe Deposit Boxes ~ ir-'-~ 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (~ .... , .....uet ....12.3~-~)~a.d~-1*gs)[---~ 11. Election to tax under Sec, 9113(A)(^iI.chSchO} Z Z Z X THIS SECTION MUST BE COMPLETED. ALI_ CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS DIANN D DRAKE 1206 BIDDLE DRIVE FIRM NAME (If Applicable) CARLISLE, PA 17013 TELEPHONE NUMBER 717-249-0034 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4 Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) F--1 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) (9) 10, Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. %,, o.o~ 479,442.00~ 0.00 0.00 145,757.00 44,658.00 194,639.00 .~:::~f FIC[AL USE:ONLY 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) (8) 15,405.00 5,363.00 (11) (12) (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 864,496.00 20,768.00 843,728.00 1,000.00 842,728.00 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(12) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 0. 00 x.00 . (15) 842,728.00 x.045 (16) 0 .00 x .12 (17) 0. 00 x.15 (18) (19) 19. Tax Due 20. ~ = '" ' '11 '' ' iii :~ , -I]1 I ,'~ IT --,'I '~ > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 0.00 37,923.00 0.00 0.00 37,923.00 2W4645 1000 Decedent's Complete Address: S~E~ ADDRESS c/o DIANN DRAKE 1206 BIDDLE DRIVE C~/Y I STATE I ZiP PA 17013 CARLISLE Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B Prior Payments C. Discount 0.00 35,000.00 1~684.00 Interest/Penalty if applicable D. Interest 0. O0 E. Penalty 0. O0 Total Credits (A + B + C) Total Interest/Penalty (D + E) (~) (2) (3) 37~923.00 36,684.00 0.00 1,239.00 0.00 If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I 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 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 1,239.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes N o 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; ....................... ~ ~ b. retain the right to designate who shall use the property transferred or its income; ......... [-~ ~ c. retain a reversionary interest; or ................................ [-~ ~-~ d. receive the promise for life of either payments, benefits or care? ................. ~-~ ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ~ ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ ~ E~ 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 SIGNAT[_JRE OF PERSON RESPON~LE FORJ~'4HG RETURII~ CARLISLE, PA 17013 S,G.* RE oF/ ..ARER O ER ADORESS B O ]BO:~)66B CARLISLE, PA 17013 DATE DATE 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.§ 9916 (a) (1 1)(0]. 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 PS. § 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenrs 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 PS § 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~ 2w4646 i 000 of BENNIE SUE DUPY I, Bennie Sue Dupy, of the Borough of Carlisle, County of Cumberland and Commonwealth of Pennsylvania, being of sound mind, memory and understanding, do hereby publish and declare this to be my Last Will and Testament. h~r~hv.r~v~na and declaring null and void amy and all wills and Codicils heretofore written by me. l~ I. I direct that all my just debts and funeral expenses be paid as soon after my demise as may be convenient to the proper administration of my estate. ITEM II. I give, devise and bequeath the sum of One Thousand ($1',000.00) Dollars to the Bennie Sue Dupy Freshman Improvement Award of Carlisle Civic Club of 264 W. Pomfret Street, Carlisle, Pennsylvania, 17013. ITEM III. I then order and direct my hereinafter named Executors to convert my entire estate into cash at either public or private sale, whenever in their discretion it may be most expedient for the proper administration of my estate. In the event of such conversion, I authorize my said Executors to execute a good and sufficient Warranty Deed to the purchaser of any real estate of which I may die seized, in the same manner and capacity as I could if living. ITEM IV. I direct that all inheritance and estate taxes be paid on the proceeds of the above conversion and on all the rest, residue and remainder of my estate from the residue of my estate prior to further distribution. ITEM V. I direct that my hereinafter named Executors shall divide the proceeds from the above-mentioned conversion and all the rest, residue and remainder of my estate in the following manner: (a) Fifty (50%) percent to my Daughter, Diann D. Drake, if she be living at the time of my death. (b) Twenty-Five (25%) percent to each of my Grandchildren, Allison Rand and Scott Rand. Page 1 of 2 (c) If my Daughter should predecease me, I direct that all the rest, residue and remainder of my estate be distributed as follows: (1) Ten (10%) percent to Randall V. Drake, my Son-in-Law. (2) Forty-Five (45%) percent to Allison Rand, my Granddaughter, per stirpes and not per capita. (3) Forty-Five (45%) percent to Scott Rand, my Grandson, per stirpes and not per capita. ITEM VI. I nominate, constitute and appoint my Daughter, Diann D. Drake, and my Grandson, Scott Rand, Co-executors of this my Last Will and Testament. In the event either of my Co-Executors should predecease me or be unable or unwilling to serve, i then nominate, constitute and appoint my Granddaughter, Allison Rand, who shall act in their place and stead. I direct that my Executors shall not be required to post bond other than their personal assurance for their duties as Executors. IN WITNESS WHEREOF, I, Bennie Sue Dupy, hereunto subscribed my hand to this my Last Will and Testament, this ~{%~day of Ma~, 1998. Bennie'Sue Dupy -'/ ~/~- SIGNED, PUBLISHED and DECLAR~ED by the above named Bennie Sue Dupy, as and for her Last Will and Testament in the presence of us, who at her request and in her presence and in the presence of each Qther, have signed our names as attesting witnesses hereto. , - .~ / / /,.-., ~/ ~' .. ...-~ Page 2 of 2 REV-"1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER DUPY, BENNIES 21-2003-00028 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MPM - SEE ATTACHED BROKER STATEMENT 479,442 . 00 TOTAL (Also enter on line 2, Recapitulation) $ 4 ? 9,4 42.0 0 2w4696 3 o00 (If more space is needed, insert additional sheets of the same size) Quantity COMMON STOCK 2,000.000 42.000 300.000 Security Cedar Fair Ltd. Connecticut Water Service Inc. Health Care REIT Modern Portfolio Management, Inc. PORTFOLIO APPRAISA~L Bennie Sue Dupy 001-1 - C9C1539 74 (De~-~cmber~ Unit Total Cost Cost Price -1.73 -3,468.45 30.79 000 0.01 27.75 15.60 4,679.56 35.19 1,211.12 PREFERRED STOCK 300 Grand Metropolitan Delaware kP 500 National Westminster Adr Set B 25.00 7,500.00 26.76 25.51 12,753.85 25.55 20,253.85 US EQUITY FUNDS 3,195.876 PIMCO ItlGH YIELD CLASS C 9.70 31,003.85 9.75 MUTUAL FUNDS 3,779.7860 2,633.4570 6,263.0000 3,692.0000 21,525.7230 1,383.4710 728.3320 Eaton Vance Tax Mgd Value Class C Goldman Sachs Real Estate Secs Class C Municipal High Income Fund Inc Nuveen Pennsylvania Invesnnent Oppenheimer Stateg~c Inc. Class C State Street Research Global Energy B Thornburg Limited Term Natl Municipal 12.17 46,000.00 12.62 9.50 25,006.51 13.81 8.68 54,350.07 7.66 14.95 55,204.00 15.50 4.69 100,851.72 4.19 t3.76 19,035.30 30.70 13.73 10,000.00 13.93 310,447.60 UNIT TRUSTS 2,321 ND EQUIV. F~rst Trust GNMA Reinvestment Income GRIT National Prime Fund TOTAL PORTFOLIO 10.74 24,925.43 9.52 10,488.28 398,330,13 Market Pct. Value Assets 61,580.00 12.6 1,165.50 O.2 10,557.00 2.2 73,302.50 15.0 8,028.00 1.6 12,775.00 26 20,803.OO 4.2 31,159.79 64 47,700.90 9 7 36,368.04 74 47,974.58 9.8 57,226.00 11.7 90,192.78 18.4 42,472.56 8.7 10,145.66 2.1 332,080.52 67.8 22,095.92 4.5 10,488.28 2.1 489,930,02 100.0 REV-1608 EX * (1-97) COMMONVVF__.ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER DUPY, BENNIE S 21-2003-00028 Include the ~roceeds of litigation and the date the proceeds were received by the estate. All property jointJy-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH MPM- NATIONAL PRIME FU1TD CITIZENS BANK - CHECKING -6200842853 CITIZENS BANK -MM - 6200842861 i$ 10,488.00 1,802.00 133,467.00 145,757.00 TOTAL {Also enter on line 5, Recapitulation) 2W46AD 2000 (if more space is needed, insert additional sheets of the same size) Quantity COMMON STOCK 2,000.000 42.000 300.000 SecuriD' Cedar Fair Ltd. Connecncut \Vater Service Inc. Health Care REIT PREFERRED STOCK 300 Grand Metropolitan Delaware LP 500 National Westminster Adr Set B US EQUITY FUNDS 3,195.876 PIMCO ttlGH YIELD CLASS C Modern Portfolio Management, Inc. PORTFOLIO APPRAISAL Bennie Sue Dupy Unit Total Cost Cost Price -1.73 -3,468.45 30.79 0.00 0.01 27.75 I5.60 4,679.56 35.I9 1,211.12 25.00 7,500.00 26.76 25.51 12,753.85 25.55 20,253.85 9.70 31,003.85 9.75 Market Pct. Value Assets 61,580.00 12.6 1,165.50 0.2 10,557.00 2.2 73,302.50 15.0 8,028.00 1.6 12,775.00 2.6 20,803.00 4.2 31,159.79 6.4 MUTUAL FUNDS 3,779.7860 Eaton Vance TaxMgd 12.17 Value Class C 2,633.4570 Goldman Sachs Real 9.50 Estate Secs Class C 6,263.0000 Municipal High Income 8.68 Fund Inc 3,692.0000 Nuveen Pennsylvania 14.95 Investment 21,525.7230 Oppenheimer Stategic 4.69 Inc. Class C 1,383.4710 State Street Research 13.76 Global Energy B 728.3320 Thomburg Limited Term 13.73 Natl Municipal 46,000.00 12.62 25,006.51 13.81 54,350.07 7.66 55,204.00 15.50 100,851.72 4.19 19,035.30 30.70 10,000.00 13.93 310,447.60 UNIT TRUSTS 2,321 ~D EQUIV. Firs! Trust GNMA 10.74 Remvestment Income GRIT National Prime Fund 24,92543 9.52 10,488.28 TOTAL PORTFOLIO 47,700.90 9.7 36,368.04 7.4 47,974.58 98 57,226.00 11.7 90,192.78 18.4 42,472.56 8.7 10,145.66 2.1 332,080.52 67.8 22,095.92 4.5 ~4,4-88 28~ 2. I 489,930.02:100.0 1-800-773-7373 Carl Citizens' Phoneeank anytime for account information, current rates and answers to your questions. US002 BR28g BENNIE SUE DUPY 1206 BIDDLE DR CARLISLE PA 17013 Citizens Circle Gold Account Statement OF 2 (/~ginning December 17, 2003 ~mugh .lan~uua~ Contents Summary Page 1 Checking Page 2 Citizens Circte Gold Summary Account Account Number Balance Last Statement DEPOSIT BALANCE Checking ~ 5~t,,~d.,.,~,- ~ Circte Gold Checking Hi Interest 620084-285-3 Circle Money Market 62OO84-286-1 Savings - '~ ~,t.~._j,....~t.._ ~ :~ens Circle Savings 6140-272904 1,802.45 133,466.90 82,060.08 Average monthly combined balance to waive monthly fee is Your average monthly combined balance this statement period is 20,000.00 192,535.72 Balance This Statement 1,802.88 133,719.91 .OO BENNIE SUE DUPY Circle Gold Checking Hi Interest 620084-285 -3 Total Deposit Balance 135,522.79 Total Relationship Balance 135,522.7g REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER DUPY, BENNIES 21-2003-00028 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. DRA~E, DIAIFN D 1206 BIDDLE DRIVE CARLISLE, PA 17013 DAUGHTER JOINTLY-OWNED PROPERTY: ~ DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name ol financial institution and bank account number or DATE OF DEATH DECD'S VALUE OF NUMBER T£NANr JOINT similar identifying number Attach deed for jointly-held real estate VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A M&T BANK - CHECKING 7,256.00 50.00 3,628.00 -#617601 2 A CITIZENS BANK-SAVINGS 82,060.00 50.00 41,030.00 TOTAL (Also enter on line 6. Recapitulation) $ 44,658.00 2W46AE 2.000 (If more space is needed, inser~ additional sheets of same size) MarTBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Ms. Diann D. Drake 1206 Biddle Drive Carlisle, PA 17013 Phone (888) 502-4349 Fax (302) 934-2955 l:ebruary 11,2004 Re: Estate of Bennie Sue DupF Social Security: 45 7- 74-9 725 Date of Death: December 23, 2003 Dear Ms. Drake: Per your inquiry dated January 26, 2004, 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 Checking Account Account Number 617601 O'wnership (Names dj) Bennie Sue Dupy Diann D Drake Opening Date 06/29/82 Balance on Date of Death $ 7, 255.14 Accrued Interest $ O. O0 Total $7,255.1 ~ Please be advised there was no safe deposit box found for the above decedent. For further account information, closures and/or reimbursement of funds, please call the Stonehedge Office at # 717-240-4524. Sincerely, Nancy Clagett Records Management 1-888-910-4100 Call Citizens' PhoneBank anytime for account information, current rates and answers to your questions. USO02 BR28g BENNIE SUE DUPy 1206 BIDDLE DR CARLISLE PA 17013 Savings Account Statement 1 ~e~inning December 01, "~rough December 31, 2003 savin'gs- ......... SUMMARY Balance Calculation Previous Balance Withdrawals Deposits & Additions Interest Paid Current Balance TRANSACTION DETAILS 20,000.00 .00 102.21 62,162.29 Balance Average Bally Balance Interest Current Interest Rate Annual Percentage Yield Earned Number of Da. vs Interest Earned Interest Earned Interest Paid this Year 80, 75g. 75 I. 50% 31 102.21 1,384.24 Withdrawals Other Withdrawals Amount - 20,000.00 Description Withdrawal Amount 102.21 OescUpUon Interest Daily Balance Date Balance 12/30 62,060.08 Date 12/31 Balance 62,162.29 Date Balance BENNIE SUE DUP¥ DIANN D DRAKE Citizens Circle Savings 6140-272904 P~revtous IElatanr~:~ Total Withdrawals 20,000. oo Tutal Interest Paid Current Balance 62,162.2~ REV-1510 EX * (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER DI3PY, BENNIES 21-2003-00028 This schedule must be completed and filed if the answer to any of questions 1 throu Ih 4 on the reverse side of the REV-1500 COVER SHEET is yes, DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE N/~ME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE DECEDENTAND THE DATE OF TRANSFER ATTACH A COPY OF THE ~IUMBEF DEED FOR RE. AL ESTATE VALUE OF ASSET INTEREST CF APPLICABLEI 1. JACKSON NATIONAL ANNUITY 194,639.00 100.00 0.00 194,639.00 TOTAL (Also enter on line 7, Recapitulation) $ 194,639.0 O (If more space is needed, insert additional sheets of same size.) 2W46AF 2000 \\ ' ~. ~',. ~,~"e' /, 1645 Indian Wood Circle, Maumee, OH 43537 Arrowhead Pa~k Tuesday, January ] 3, 2004 Diann Drake 1206 Biddle Drive Carlisle, PA 17013 Dear Diann, Bryan asked that I follow up with you and forward the needed information for your mother's accounts. Enclosed are items you will need to handle the brokerage account and the Jackson National Ammity. First, yotlr attorney will need account values as of the date of death. I have provided a statement for her~___ - -~-br°l<erage-~_cc°unt' The Jackson National Annuity Value as of 12/23/'03 wasf$194,639.02. ~ Included are packets with lists of items and required fonns for both tile brokerage account and the Jackson National Ammity. Also, included are applications for new accounts and instructions when you are ready to split the estate in which you will receive 50% of the account value and each of your children will receive 25% of tile account value. When these items are completed, please return them to our office. I have provided a return envelope for your conveience. If you or your attorney have questions, or need assistance, please call Bryan or myself at our office: 1-800-814-1706. Margaret M. Mittendorf Vice President Administration JACKSON NATIONAL LIFE INSURANCE COMPANY 5901 Executive Drive Lansing, Michigan 48911 A Stock Company Will pay the benefits provided in this policy, subject to its terms and conditions. POLICY NUMBER 0038744430 THE 32qNUIT~JqT BENNIES DUPY THE OWNER BENNIES DUPY PLAN SINGLE PREMIUM DEFERRED ANNUITY 7dqTICIPATED MATURITY DATE: POLICY DATE ISSUE DATE AUGUST 9, 2001 AUGUST 9, 1996 AGE 82 FEMALE AUGUST 9, 1996 20-DAY RIGHT TO EXAMINE THE OWNER OF THIS POLICY SHALL HAVE THE RIGHT TO RETURN THIS POLICY TO THE COMPANY OR THE AGENT FROM WHOM THIS POLICY WAS PURCHASED WITHIN 20 DAYS OF ITS DELIVERY FOR CANCELLATION AND RECEIVE A FULL REFUND OF THE PREMIUM PAID. BENEFICIARY DIANN D DRAKE SCHEDULE CURRENT PREMIUM: SINGLE PREMIUM PAYABLE AS FOLLOWS ON THE ISSUE DATE BEGINNING: AUGUST 9, 1996 TOTAL PREMIUM: $133,124.97 THIS POLICY HAS A FIRST YEAR INTEREST RATE BONUS. INTEREST AFTER THE FIRST YEAR WILL BE CREDITED AT THE CURRENT RATE DECLARED BY THE COMPANYS BOARD OF DIRECTORS. BECAUSE OF THE BONUS IN THE FIRST YEAR, RATES IN SUBSEQUENT YEARS WILL BE LOWER THAN THAT CREDITED ON NON-BONUS PRODUCTS. SINGLE PREMIUM DEFERRED ANNUITY. DEATH BENEFIT PRIOR TO MATURITY. MONTHLY INCOME AT MATURITY. NON-PARTICIPATING This contract is signed at the Home Office of Jackson National Life, Lansing, Michigan President REV-1511 EX + (1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF 21-2003-00028 DUPY, BENNIE S Debts of decedent must be reported on Schedule I. ITEM NUMBER 2 3 4 5 B. 5. 6. 7. 8 9 Tot DESCRIPTION FUNERAL EXPENSES: EWING BROTHERS FUNERAL HOME FLORIST CHURCH ORGANIST & HARPIST RECEPTION ~MINISTRATIVE 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 Relationship of Claimant to Decedent Probate Fees Accountant's Fees Name: Tax Return Preparer's Fees RESERVE REGISTER OF WILLS MAILING EXPENSES, ETC State Zip Boyer & Ritter 1 from continuation pages .... TOTAL (Also enter on line 9, Recapitulation) AMOUNT 7,740.00 292.00 500.00 450.00 525.00 0.00 0.00 0.00 0.00 2,500.00 0.00 800.00 388.00 183.00 2,027.00 15,405.00 (If more space is needed, insert additional sheets of same size) 2W46AG 2000 Estate of: DUPY, BENlqIE S Schedule H, Part A -- Funeral Expenses Page 2 21-2003-00028 Item No. 6 TRAVEL Description TRAVEL FOR ENTOMBMENT Amount 1,541.00 486.00 TOTAL. (Carry forward to main schedule) ...... 2,027.00 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGELIABILITIES,& LIENS ESTATE OF FILE NUMBER DUPY, BENNIES 21-2003-00028 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT THORNWALD NURSING HOME - NET CARLISLE REGIONAL MED CTR WEST SHORE EMS VARIOUS MEDICAL EXPENSES PHARMERICA BOYER & RITTER - FINAL 1040 TOTAL (Also enter on line 10, Recapitulation) $ 4,497.00 129.00 109.00 222.00 76.00 330.00 5,363.00 2W46AH 2000 (If more space is needed, insert additional sheets of the same size) R~V-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER DUPY, BENNIES 21-2003-00028 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLEDISTRIBUTIONS[includeoutrights~usaldistributions, andtransfers underSec. 9116(a)(12)] DRAKE, DIA/FN D 1206 BIDDLE DRIVE CARLISLE, PA 17013 RA~D, L SCOTT 2203 R-JNTER PLACE LANE ARLINGTON, TX 76006 GRAVES, ALLISON R 1809 COUNTY ROAD 1021 BURLESON, TX 76028 DAUGHTER GRAIFDSON GRANDDAUGHTER 541,412.00 151,058.00 151,058.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ;IVIC CLUB OF CARLISLE TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 1,000.00 $ 1,000.00 2W46A110OO (If more space is needed, insert additional sheets of the same size) BUREAU OF INDIVIDUAL TAXES TNH£R/TAHCE TAX DTVZSION HARRTSBURG, PA 17128-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RE¥-1;47 EX &FP (DI-IS) DIANN D DRAKE 1206 BIDDLE DR CARLISLE PA 17015 DATE 07-13-2004 ESTATE OF DUPY DATE OF DEATH 12-25-Z005 FILE NUMBER 21 04-0028 COUNTY CUHBERLAND ACN 101 Amount Rem/t'l:ed BENNIE S HAKE CHECK PAYABLE AND REHIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF DUPY BENNIE S FILE NO. 21 04-0028 ACN 101 DATE 07-15-2004 TAX RETURN #AS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnersh/p Interest (Schedule C) (3) q. Mortgages~Notes Rece/vable (Schedule D) (q) 5. Cash/Bank Deposits/M/sc. Personal Property (Schedule E) (S) 6. Jo/ntly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXENPTIONS: 9. Funeral Exponsos/Adm. Costs/N/sc. Expenses (Schedule H) (9) 10. Debts/Hortgaga Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Net Value of Tax Return .0O 479~,442. O0 .00 .0O 145;757.00 44z658.00 194~639. O0 (8) 15,405.00 NOTE: To /nsure proper credit to your account, submit the upper port/on of th/s form w/th your tax payment. 5~365. O0 (11) 20.7G8. O0 (~2) 845,728. O0 15. NOTE: ASSESSHENT OF TAX: 15. Amount of Line lq at Spousal rate 16. Amount of L/ne lq taxable at L/nael/Class A rate 17. Aeount of L/ne lq et S/bl/ng rate 18. Amount of Line lq taxable et Collateral/Class B rate 19. Pr/nc/pal Tax Due TAX CREDITS: PAYMENT RECEII'I D~SCOUNT DATE NUHBER INTEREST/PEN pAID (- 05-12-2004 CD005666 1,842.11 05-11-2004 CD005922 . O0 (15), .00 x O0 : .00 (16) 842,728.~00 x 045: :57,925.00 (17). .00 x 121: .00 (18), .00 x 15 = .00 .~9)= 37,92:5.00 AMOUNT PAID 35,000. 1,259. Char/table/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 1,000. O0 Net Value of Estate Subject to Tax (lq) 842,728.00 If an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~ill reflect flgures that include the total of ALL returns assessed to date. 1F PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADD/TZONAL INTEREST. TOTAL TAX CREDIT 58,081.11 BALANCE OF TAX DUEJ 158.11CR INTEREST AND PEN. .00 TOTAL DUE 158.11CR ( ZF TOTAL DUE TS LESS THAN $1, NO PAYMENT TS REI~U/RED. TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE REFUND. SEE REVERSE SIDE OF THIS FORM FOR TNSTRUCT~ONS.) 864,q96.00 RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class S (collateral) beneficiaries of tho decedent after tho expiration of any estate for life or for years, the Coamoneoalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class B (collateral) rate on any such futura interest. PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To ~ulfill the requirements of Section Zl~O of the Inheritance and Estate Tax Act, Act Z3 of 2000. (72 P.S. Saction 91q0). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF #ILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513). Applications ara available at the Office of the Register of Hills, any of the Z3 Revenue District Offices, or by calling the special Z~-haur answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-~7-30Z0 (TT only). Any party in interest not satisfied aith the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to tha PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171ID-lOll, GE --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 bm addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page S 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 dacadent's death, a five percent (SI) discount of the tax paid is allowed. The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Intarest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to tho date of payment. Taxes which became delinquent before January 1, 1982 bear interast at tha rate of six (6Z) percent per annum calculated at a daily rate of .00016~. AIl taxes which became delinquent on and after January l, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rata announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOO4 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ 2OZ .000548 ~)'~'8-1991 1XZ .OO030X ZOOl 9X .000247 1983 16Z .000¢38 1992 9X .O00Z~7 2002 6X .00016q 198q llX .000301 1993-199~ 7Z .OOOlaZ 2005 5Z .000137 1985 132 .000356 1995-1998 92 .O00Z~7 2004 qZ .000110 1986 IOZ .000274 1999 7Z .O0019Z 1987 lOX .O0027~ ZOO0 7Z .00019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (153 days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must ba calculated. BUREAU OF TNDZVZDUAL TAXES INHERITANCE TAX DIVISION DEPT. 28060! HARRISBURG, PA 17128-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT RE¥-1607 EX AFP DIANN D DRAKE 1206 BIDDLE DR CARLISLE PA 17015 DATE 08-25-200~ ESTATE OF DUPY DATE OF DEATH 12-23-2005 FILE NUHBER 21 0~-0028 COUNTY CUHBERLAND ACN 101 Amoun'k Remi'~'l~ed BENNIE S HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credit: ~¢o your account, sub.i~: ~he upper por~;-on of '~,1~ ~r~f~ or. wi~h your ~ payment. CUT ALONG THIS LINE ~-- RETAIN LOWER PORTION FOR YOUR RECOI~S____~,.,.__ -----~ .....~'* .... REV- eO? EX AFP C0 -05 ZNHERZTANCE TAX STATEHENT OF ACCOUNT-- . ESTATE OF DUPY BENNIE S FILE NO. Z1 Oq-OOZ8 ACN I01 ,~ DATE' 08-25-200~ THTS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHONN BELO# ZSA SUNHARY OF THE PRZNCTPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, ~, ZF APPLICABLE.. A PROJECTED INTEREST FIGURE. ;~ ~ DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: 07-06-200~ PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 57,925.00 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 1,8qZ.11 05-12-200~ 05-11-200~ 08-0~-200~ CD005666 CD005922 REFUND .00 .00 55,000.00 1,259.00 158.11- TOTAL TAX CREDIT 57,925.00 .00 BALANCE OF TAX DUE INTEREST AND PEN. .00 TOTAL DUE .00 IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. [ 1F TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORH FOR INSTRUCTIONS. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Bennie Sue Dupy Date of Death: December 23, 2003 Will No. 21 04 0028 Admin. No. 21 04-0028 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonable believes that the administration will be complete: o If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties of interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: Signature I Capacity: Personal Representative --.J 15056051058 REV-1500 EX (06-05) PA Department of Revenue . Bureau of Individual Taxes . PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number 21 04 0028 Date of Birth 457 -7 4-9725 12/23/2003 01/10/1914 Decedent's Last Name Suffix Decedent's First Name MI DUPY BENNIE SUE (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return <e.:' 2. Supplemental Return 3, Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 1 Q. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number -I 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes DIANN D DRAKE (717) 249-0034 '" Firm Name(lf Applicable) o ............................... ..............c...'c.,,<......(c) REGISTER OF WILLS USE ONty-i f'.:' -J First line of address :r=!J (-) 1<--":, -1 -, 1206 BIDDLE DRIVE --'-"" Second line of address 1.0 , ) . 1'1-, N -) <-'J -.,. 1 City or Post Office State ZIP Code DATE FILED CARLISLE PA 17013 Correspondent's e-mail address: 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. DATE lO-'11..0(. SIGNATURE Ol6E~SON RESPONSIBLE F<;>Jt...FILlNG RETURN ~_......... ~. ~"-Q..'" I ~ ADDRESS , )J) ~ 'B.~~ A lL. Q.A.. rI... ~~"':J.u PA \"O,~ I EPRESENTATIVE ~ CwlV) ~ QA 110) ') PLEASE USE ORIGINAL FORM ONLY DATE l~ ""c." ~c.g L 15056051058 Side 1 15056051058 ...J v --.J 15056052059 REV-1500 EX Decedent's Name: BENNIE SUE DUPY RECAPITULATION 1. Real estate (Schedule A). . . . . . . . . . . .., 1. 2. Stocks and Bonds (Schedule B) .. . . . . . . . . . . . . . . . . . . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3. 4 Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . ., 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) Separate Billing Requested. . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested. 7. 8. Total Gross Assets (total Lines 1-7). . . . . 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). .............. 10. 11. Total Deductions (total Lines 9 & 10)................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.o 45 10,350.00 17. Amount of Line 14 taxable at sibling rate X. 12 18. Amount of Line 14 taxable at collateral rate X .15 2. 8. 9. 19. TAX DUE. . .. . 20. FilL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 15. 16. 17. 18. 19. Decedent's Social Security Number 457 -74-9725 10,350.00 10,350.00 10,350.00 465.75 465.75 15056052059 ....J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME BENNIE SUE DUPY 1---- STREET ADDRESS 1206 BIDDLE DRIVE DECEDENT'S SOCIAL SECURITY NUMBER 457-74-9725 -- CITY CARLISLE I STATE PA !ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 465.75 Total Credits ( A + B + C ) (2) 3. InterestlPenalty if applicable D. Interest E. Penalty TotallnterestlPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (5B) 465.75 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 465.75 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... 0 [i] b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [ij c. retain a reversionary interest; or.......................................................................................................................... 0 [iJ d. receive the promise for life of either payments, benefits or care? ...................................................................... D IKl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 [i] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 [i] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ D [i] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 three (3) percent [72 P.S. 99116 (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 zero (0) percent [72 PS. 99116 (a) (1.1) (ii)l. 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 zero (0) percent [72 P.S. 99116(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 four and one-half (4.5) percent, except as noted in 72 P.S. 39116(1.2) [72 PS. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 39116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX' (6-98) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF BENNIE SUE DUPY FILE NUMBER 21 040028 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION COMM OF PA - UNCLAIMED PROPERTY - CLAIM # 99797409 VALUE AT DATE OF DEATH 10,350.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 10,350.00 - - - - - - - - - - - - - Commonwealth of Pennsylvania Remittance Advice 000125 59 00227014 Acct. Purchase Order Invoice Invoice Control Number Number Date Number WE ARE PRESENTING THIS CHECK FOR YOUR UNCLAIMED PROPERTY, CLAIM #99797409 o 0 09/15/2006 99797409 Payment Amount $10.35000 II:: vnll HA\IF ANY ()( IFSTIONS r:ONCERNING THIS PAYMENT CAll 1-800-222~_2046 Total Payment Amount - $10,350.00- DETACH CHECK AT PERFORATION ---- -- - 481969 CDC '" .- " ',.',' '-. .- '. '.' -. . '.. ....': .'....... ....- :'. ....-.: ::......... ...... .........- '..... '........... ...... M&T Bank .....< . ...... .... i..i./ii: ,,:'< ............i;-..;.;. w....: .I.L..K E.. s.....-.B... A....... '.R .R E '...... P...A. .... ...... ........ ..............:. ......... ...... ..... ........ ....... ........... .......:,.......... ...... ..... '. ..... ...... ...... .......... ........... ....... '. . . .' '. ., . . . '. ' , . . --. .... . VERIFICATIONAV AILAB~E-"POStT.lVEP!J.Y'i pf)OTECn~O' TO THE ORDER OF VOID AFTER 180 DAYS 000125 . . Ii't' . ..... ..:.. ."' ..... .. .. . ....... ,~J) *~:*~.*..***:*10,350~.OO DUPY BENNIE S ESTATE OF DIANN D DRAKE EXECUTRIX 1206 BIDDLE DR CARLISLE PA 17013 ..~i{;PE'NI~SYLV.ANi--.. 7~-"""-- III 0 0 2 2 7 0 . l. III I: 0 ~ . ~ . 8 b . g I : b. 0 0 0 0 0 0 . 2 g l. j 8 III {~W!Q'Tf!IT;~;~P0;::'~~T%;:.5rtfJ;~~~1~iI~~~~'.... ..,.,. .y.~~;;,~.Jt~,~~!~JLtIlli.mJl!1!.n1W~~t~'1)Eml~i!b~~~Ilam~~W'1PJ@.1t~I;~~~~{f"~~'~~~1~; COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT DRAKE DIANN 0 1206 BIDDLE DRIVE CARLISLE, PA 17013 __n__n fold EST ATE INFORMATION: SSN: 457-74-9725 FILE NUMBER: 2104-0028 DECEDENT NAME: DUPY BENNIE SUE DA TE OF PAYMENT: 10/27/2006 POSTMARK DATE: 10/27/2006 COUNTY: CUMBERLAND DATE OF DEATH: 12/23/2003 NO. CD 007355 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $465.75 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: DIANN D DRAKE CHECK# 8393 SEAL INITIALS: eM RECEIVED BY: REGISTER OF WILLS $465.75 GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE :'!" ~"f:'i NoffifE'::OF'INHER IT ANCE TAX 'APPRA:riE'ME~T.',At(OWANCE OR DISALLOWANCE (If! :Dl;lll,Jcno'Ns,AND ASSESSMENT OF TAX DATE 01-02-2007 ESTATE OF DUPY BENNIE S DATE OF DEATH 12-23-2003 FILE NUMBER 21 04-0028 COUNTY CUMBERLAND ACN 501 APPEAL DATE: 03-03-2007 ( See reverse side under Objections) A.ount Re.ittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ~Y!_~~~~~_!~!~-~!~~------~---~~!~!~-~~~~~-~~~!!~~-~~~-!~~~_~~~~~~~__~____________________ REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DUPY BENNIE S FILE NO. 21 04-0028 ACN 501 DATE 01-02-2007 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 200] PH"! -8 Pf"~ 2: 51 u v'r',~ \I' DIANN D DRAKE 1206 BIDDLE DR CARLISLE ("I EG'/ ('\C ./- r!l\ \......11 ORPH:'.J'l'S C~CURT C L!\,:'~ r-v - ,-' '-\1 ~/1, PA 17013 * REV-15~7 EX AFP (06-05) TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate SUbject to Tax If an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TS: NOTE: R C IP NUMBER CD007355 DATE 10-27-2006 * IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 .00 .00 .00 10.350.00 .00 .00 (8) NOTE: To insure proper credit to your account. submit the Upper portion of this form with your tax payment. 10,350.00 (9) (10) .00 .00 (11) (12) (13) (14) .nn 10,350.00 .00 10,350.00 (15) (16) (17) (18) .00 10,350.00 .00 .00 .00 465.75 .00 .00 465.75 X 00 X 045 = X 12 = X 15 = (19)= AMOUNT PAID 465.75 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 465.75 .00 .00 .0 ( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)