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HomeMy WebLinkAbout04-0477PETITION FOR PROBATE and GRANT OF LETTERS Estate of /...dC) ~ ~.o~ ~9~Dd h also known as ~ . Deceased. Social Security No. The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an'~}eexecuto in the last will of the above decedent, dated x] O~-'~ and codicil(s) dated To: ~z Register of Wills for the County of C O,~tW-.~..~O b COmmonwealth of Pennsylvania in the named , 19:_~L~ (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~-/..J,~ ~ g. ~ L, ~ _A}.~ County, Pennsylvania, with h 1=2 P last family or principal residence at ~, I "7 .-ZS. I ~ W'q4 sd'F, (list street, number and muncipality) Decendent, then ~7[ years of age, ~d~u ,~/~17 tt3 ~ ]~ Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of thc 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: ,z~. /'liFt $ ~5-0. o c30. $ $ e9~ oo $/OD} DO. ,, WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters. theron. request(s) the probate of the last will and codicil(s) (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEAI,~TH OF PENNSYLVANIA COUNTY OF 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 l~etitioner(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 affir~i~c~and subscribed bef. om me this ,~C) ~v~. day of . ~ . - ~ ~ 19 ' --- ~ ~. ~ Regi~ No. Estate Of ro,,~t,~ CC~D , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW MAY 20, 2004 ];ff .....in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated --3-O-Dc'~ - kCl'~/~ described therein be admitted to probate and filed of record as the last will of IZKIANN Gg3OD ; and Letters are hereby granted to WILLIAM ~(_-~ ~r~O FEES Probate, Letters, Etc .......... Short Certificates( ) .......... Renunciation ................ TOTAL Filed .. ~.: ~ Q.';~.9~ Register of Wi C' . ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE 05/18/04 08:44 FAX 17172492611 CPARC ~02 RENUNCIATION _ deceaacd. County, Pennsylvania. of the above dacL. dant, hereby renounce(s) the right to achnini~r the estate and respectfully ink{s) that Le£t~rs be issu~l to (Addr~ra} (-~iSnnmre} (Address} LAW SNELBAK;ER, MCCALEB & ELICKER LAST WILL AND TESTAMENT I, LOU ANN GO0~ of the Borough of Camp Hill, County of Cumberland and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and. declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils by me at any time heretofore made. FIRST. I order and direct that all my just debts and funeral expenses be paid by my Executors, Executrix or Executor, as the case may be, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated, in equal shares unto my two (2) children namely, LESLIE B. HARRAL and WILLIAM B. HARRAL, share and share alike, absolutely and in fee simple. THIRD. If either of my said children should predecease me and not leave lawful issue to survive me, I order and direct that my entire residuary estate shall be distributed unto the child so surviving. FOURTH. If either of my said children should predecease me and leave lawful issue to survive me, I order and direct that share or interest attributable hereunder to such deceased child shall be distributed unto his or her lawful issue per stirpes by representation and not per capita. FIFTH. I order and direct that the distributive share hereunder to any beneficiary who has not attained the age of twenty-two (22) years at the time of such distribution shall be paid over and delivered unto COmmONWEALTH NATIONAL BANK of LAW OFFICES SNELBAI(ER, MCC, ALEB & ELiC:KER Harrisburg, Pennsylvania, as my testamentary trustee, IN TRUST, NEVERTHELESS, to hold, manage, invest and reinvest for the use and benefit of said beneficiary until said beneficiary attains the age of twenty-two (22) years, and upon the beneficiary~s attainment of age twenty-two (22) years, I order and direct that the trust be terminated and the then remaining net assets thereof, if any, shall be distributed unto the beneficiary absolutely. During the existence of said Trust or trusts, I authorize and empower my said Trustee to use, expend and apply from time to time such amounts of both income and principal as it in the exercise of its discretion shall deem to be necessary and proper for the respective bene- ficiary's support, care, maintenance and education, including college or other post-high school vocational training or education LASTLY. I nominate, constitute and appoint my two (2) children, namely, LESLIE B. HARRAL and WILLI~ B. HARRAL, to be the Executors of this, my Last Will and Testament, each and both to serve without bond or other security as a condition of qualifi- cation hereunder. If either of my said children should fail to qualify as my personal representative hereunder or cease so to serve, I nominate, constitute and appoint the one so qualifying os remaining to be the sole personal representative hereunder. IN WITNESS WHEREOF, I, LOU ANN GOOD, have hereunto set my hand and seal to this, my Last Will and Testament which consists of two (2) typewritten pages to each of which ! have affixed my signature this day of ~ , A.D., One Thousand Nine Hundred Eighty-two (1982). ~ ~ ; The preceding instrument, consisting of this and one (1) other typewritten page, each identified by the signature of the Testatrix, was on the date thereof signed, seale~, published and declared by LOUANN GOOD the Testatrix therein named~ as and for her Last Will and ?estament, in the j~resence of us, who, at her reouest, in her presence, and in th'~res~ce~of each other, have subscribed our names as witnesses ~e~./? / LAW OFFIC£~ SNELBAI~ER, MCCALEB & ELIC~ER COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We,LOU ANN GOOD,RICHARD C. SNELBAKER and JANET M. FORRY, the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his or her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ../~e s~at r~ix Witness Subscribed, sworn to and acknowledged before me byLOU ANN GOOD, the Testatrix, and subscribed and sworn to before me by RICHARD C. SNELBAKER and JA.~ET M. FORRY, witnesses, this 1982. Notary Public C/~JHf, r~li~E E, I~OLT~UM, tqOl'A!~¥ PI~(~LIC ~CtlANiCS~U~G t~O~O. CUM~Et~LANO C~NT~ ~Y COMMiSS~N EXPIRES FEB. 27, 1986 Mem~r, Pennsyl~nia Assertion of Notaries day of No. Estate Of ~o-m,~ aCX~D , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW MAY 20~ 2004 ]:~ ..... in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated described therein be admitted to probate and filed of record as the last will of LLLIANN GOOD ; and Letters ~RTa~,r~x~y are hereby granted to InI~L,L~AM B HARRAYJ x/._%.x~~ ~ND FEES Probate, Lex~ters, Etc .......... Short Certificates( ) .......... Renunciation ................ TOTAL Filed .. ~.: ~ ~.':~.Q~ ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFIND~WDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(1%96) NO. CD 004466 HARRAL WILLIAM B 937 FACTORY STREET CARLISLE, PA 17013 ESTATE INFORMATION: FILE NUMBER: 2104-0477 DECEDENT NAME: GOOD LOUANN DATE OF PAYMENT: 10/04/2004 POSTMARK DATE: 10/04/2004 COUNTY: CUMBERLAND DATE OF DEATH: 05/13/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $8,041.42 R:EMARKS: TOTAL AMOUNT PAID: $8,041.42 SEAL CHECK# 1122 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I- Z UJ z o 0 o x REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ~ECEDENT'S NAME(LAST, FIRST, AND MIDDLEINITIAL) Good, Lou Ann OFFICIAL USE ONLY FILE NUMBER 21 2004 0477 3ATE OF DEATH (MM-DD-YY) DATE OF BIRTH (MM-DD-YY) THISwITHMUSTTHEBEREGiSTERFILED IN oFDUPLICATEwlLLS F APPLICABLE) SURVIVING SPOUSE'S NAME SOCIAL SECURITY NUMBER ~ 1. Original Return ~ 4. Limited Estate ~ 6. Decedent Died Testate [] 2. Supplemental Return [] 4a. Future interest Compromise [] 7. Decedent had Living Trust Credit [] 3. Remainder Return [] 5. Fed. Est. Tax Return Req'd 0__ 8. Total number of SDB's 11. Election to tax w/Sec. 9113(A) NAME: Ronald E. Johnson, Esquire FIRM NAME: ~ndrews & Johnson TELEPHONE NUMBER ?17 243-0123 COMPLETE MAILING ADDRESS: Ronald E. Johnson, Esq. Andrews & Johnson 78 W. Pomfret St. Carli~eCPA 17.013 ~ I. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) iCIosely Held Corporation, Partnership or Sole-Prop. (3) ¢. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Misc. Pers'bnal Prop.(Sch. E) (5) 5. Jointly Owned Property (Schedule F) (6) n-1 Separate Billing Requested 7. Inter-Vivos Transfers & Misc. Non-Propate Prop. (7) 5. Total Gross Asssts (total lines 1-7) i Funeral Expenses & Administration Costa (Sch H) (9) 10. Debts of Decedent, Mortgage liabilities, & Liens (10) 11. Total Deductions (total lines 9&10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequesta/Sec 9113 Trusts for which an election to tax has not been made 14. Net Value Subject to Tax (Line 12 minus Line 13) $110,69 ;li $50,54~ :53 $0.oo $8,005:70 $o.0o $16,366.72 (s) $185,620.14 OFFICIAL L~E ~NLY $5,535.25 $1,386.61 (11) $6,921.86 (12) $178,698.28 (13) (14) $178,698.28 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amnt of Line 14 taxable at the spousal rate, or trensfers under Sec.9116(a)(1.2) ~ 6. Amount of Line t4 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due x.0_ (15) $0.00 $178,698.28 x. O45 (16) $8,041.42 $0 x.12 (17) $0.00 $0 x.15 (18) $0.00 (19) $8,041.42 20 [] CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: ISTREET ADDRESS CITY STATE ZIP Tax Payments and Credits: 1. Tax Due 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discounts $8,041.42 Total Credits (A+B+C) 3. Interest/Penalty if applicable D. Interest E. Penalty Total InterestfPentaity (D+E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT Check box on Page 1 Line 20 to request a refund (2) (3) (4) $0.00 $0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) $8,041.42 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) $8,041.42 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent rc~ke a transfer and: yes no a. retain the use or income of the property transferred: r'~ P~] b. retain the dght to designate who shall use the property transerred or its income: ~ p~ c retain a reversiona~ interest: or ~ p~ d. retain the promise for life of either payments or care? [~ ~ 2. If death occuned after December 12, 1982, did decedent transfer pmpedy within one year of death without receMng adequate consideration? ~ [~ 3. Did decedent own an "in trust for'' or payable upon death bank account or security at his or her death? ['~ p~ 4 Did decedent own an Individual Retirement Account, annu~y, or other non-probate pmpeqy which contains a beneficialy disignation? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES~ YOU MUST COMPLETE SCHEDULE O AND FILE IT AB PART OF THE RETURN. _ciao 78 West Pomfret S~*eet,~"~rlisle, PA 17013 - "- /// .... - ,' ,' ...~ ~o 7S ~est P~et SSeet, Ca~j?e, PA 17013 '04 I'l,~}' 20 ':[i :i7 Cumberland and Commonwealth of Pennsylv~ia~ being of sound and FIRST. I order and direct that all my just debts and funeral expenses be paid by my Executors, Executrix or Executor, as the case may be, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated in equal shares unto my two (2) children namely, LESLIE B. HARRAL and WILLIAM B. HARRAL, share and share alike, absolutely and in fee simple. THIRD. If either of my said children should predecease me and not leave lawful issue to survive me, I order and direct that my entire residuary estate shall be distributed un~o the child so surviving. FOURTH. If either of my said children should predecease me and leave lawful issue to survive me, I order and direct that share or interest attributable hereunder to such deceased child shall be distributed unto his or her lawful issue per stirpes by representation and not per capita. FIFTH.~ I order and direct that the distributive sha~e hereunder to any beneficiary who has not attained the age of twenty-two (22) years at the time of such distribution shall be paid over and delivered unto COMMONWEALTH NATIONAL BANK of Harrisburg, Pennsylvania, as my testamentary trustee, IN TRUST, NEVERTHELESS, to hold, manage, invest and reinvest for the use and benefit of said beneficiary until said beneficiary attains the age of twenty-two (22) years, and upon the beneficiary's attainment of age twenty-two (22) years, I order and direct that the trust be terminated and the then remaining net assets thereof, if any, shall be distributed unto the beneficiary absolutely, puring the existence of said Trust or trusts; ~ authorize and empower my'said Trustee to use, expend and apply from time to time such amounts of both income and principal as it in the exercise of its discretion shall deem to be necessary and proper for the respective bene- ficiary's support, care, maintenance and education, including college or other post-high school vocational ~training or education LASTLY. I nominate, constitute and appoint my two (2) children, namely, LESLIE B. HARRAL and WILLIAM B. HARRAL, to be the Executors of this, my Last Will and Testament, eack and both to serve without bond or other security as a condition of qualifi- cation hereunder. If either of my said children should fail to qualify as my personal representative hereunder or c~ease so to serve, I nominate, constitute and appoint the one so qualifying remaining to be the sole personal representative hereunder. IN WITNESS WHEREOF, I, LOU ANN GOOD, have hereunto set my hand and seal to this, my Last Will and Testament which consists of two (2) typewritten pages to each of which I have affixed my signature this day ,,~/~/~ , A.D., One Thousand Nine of Hundred Eighty-two (1982). The preceding instrument, consisting of this and one (i) other typewritten page, each identified by the signature of the Testatrix, was on the date thereof signed, sealed, published and declared by LOU~N GOOD the Testatrix therein named, as and for her Last Will and Testament, in the ~resence of us, who, at her request, in her presence, and in ~h~'~r~nce~ of each o~her, h~ve subscribed our names as witnesse~ ~e~e~. ~~ / COF~4ONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We,LOU ANN GOOD,RICHARD C. SNELBAKER and JANET M. FORRY, the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the T~statrix signed and executed the instrlunent as'her Last Will and Testament and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his or her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Subscribed, sworn to and acknowledged before me by LOU ANN GOOD, the Testatrix, and subscribed and sworn to before me by RICHARD C. SNELBAKER and JANET M. FORRY, witnesses, this ;~?~ day of SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Leu Ann Good 21-04-0477 ITEM NUMBER All real estate owned solely or as a ~a~ant in common should be repot~d al fair market value with is defined as the price at whioh propeaty would be exchanged between a willing buye~ and a willing seller, neither being oompelled to sell, both having reasonable knowledge of the relevant facts. Property jothtly-owned with Right of Survivorship must be disclosed on Schedule F, DESCRIPTION VALUE AT DATE OF DEATH ALL THAT CERTAIN tract of land situate in Camp Hill Borough, Cumberland County, Pennsylvania known and numbered as 217 South 19th Street, Camp Hill, Pennsylvania 17011 Being the same premises which Max Cleland as Administrator of Veterans Affairs by bis deed dated September 26, 1977 and recorded in the Office of the Recorder of Deeds in and for Cumberland County in Deed M, Volume 27, Page 127 granted and conveyed unto Leu Ann Good Net proceeds from the sale of the property on July 30, 2004 see settlement statement attached) $110,698.19 Total (also enter on Line 1, Recap) $110,69 8.19 OMB NO. 2502-0265 -~ A.. B. TYPE OF LOAN: : U.B. DEPARTMENT OF HOUBING & URBAN DEVELOPMENT 1.[~FHA 2.1--1FmHA 3. r"] CONV. UNiNS. 4.~]VA 9.E]CONV. INS. · 6. FILE NUMBER: LOAN NUMBER; SETTLEMENT STATEMENT BOCK.D 6439096 9. MORTGAGE INS CASE NUMBER: C. NOTE: This form is fomished to give you a siatamen of ac ue sei6ement costa Amounls paid to and by the seffiement ~gent are shown. terns marked "[POC]" were paid outside the dosing; lhey ere shown here tot Informational purpose$ and are not included in the totals, D, NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F, NAME AND ADDRESS OF LENDER: DANNY J, BOCK PRINCIPAL RESIDENTIAL WILLIAM B. HARRAL, EXECUTOR MORTGAGE, INC. of the Estate ef Leu Ann Good 711 HIGH STREET DES MOINES, IA 50392-0740 G. PROPERTY LOCATIO~i ' H. SE]-TLEMENT AGENT: 23-2402316 I. SETTLEMENT DATE: 217 SOUTH 19TH STREET, I CAMP HILL, PA 70 ;, PURITY ABSTRACT COMPANY July 30, 2004 CUMBERLAND Count,/, Pe~taylvanla PLACE OF SETTLEMENT · 3329 Market Street $ge receipt of a completed copy of pages 1 &2 of this statement & any att~achmenta referred to herein. BANNY~ ~ WILLIAM B. HARRAL, EXECUTOR SCHEDULE B STOCKS AND BONDS ESTATE OF FILE NUMBER Lou Ann Good 21~04-0477 All ]property joinfly-ownefl wtfl~ Right of Survivorship must be disclosed on Schedule F ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH New England Securities Brokerage acct no: 4NE-309303 (See attached statement provided by account representative $50,549.53 TOTAL (~d~o on l~o 2, Recapitulation) $50,549.53 ~ NEW E N G LAN D SE_C_~ ~T.I.E S ' N.F ............ Brokerage LOU ANN GOOD 217 SOUTH 19TH ST CAMP HILL PA 1701 1-5518 Your Registered Representative: M. WAYNE NEFF (610) 325-6100 Asset Allocation Cash and Cash Equivalents Mutual Funds Account Total (Pie Chart) Account Number. Statement ~ Valuati~ Beginning Account Value ~ Dividends/interest / Chan~e in Account Value /Ending Account Value [ Estimated Annual Income ll~[~ Period 75.85 -32630 $50,981.34 $1,544.87 volue Volue Percenl tod Pmiod This Period ?0,660.53 ~'o~1;~,9,~ 20,669.20 41% 30,571.26 Z ~, ~d .~-..~~ 30,312.14 59% $$1,251.79 $50,981.34 100% m Asset Nlocation percentages are rounded to the nearest whole percentage. Pie Chart allocation excludes all asset classes which net to a liability. PAR.02~J~r SHIEET PQge I Of 5 NEW ENGLAND SECURITIES' Brokerage A ount Statement Transactions by Type of Activity (continued) Setl~emenl Date Adivily Type Description / Transac~ons Summa[y Total Amount UNITED STATES DOLLAR 8.67 The price and quantity diepJayed may have been rounded. Income Summary Dividends and Interest Mutual Fond Dividends- Current Year Money Fund Income Total Dividends and Interest Statement Period: 05/01/2004 - 05/31/2OO4 Quon~il'f USD r. unoutPedod Taxo~ Naa Taxable Price Accrued Inlerest Your-to-Data Amount Non Taxable 67.18 0.00 513.01 0.00 8.67 O.O0 35.16 O.O0 $75.85 $0.00 S548.17 $0 o. Money Market Fund Detail Dote ActNity Type Description Sweep Money Market Fund SNORT TERM ~NCOME CLASS B Account Number: 0000012316 Current Yield: 0.51% AdhAty Ending: 05/28/04 05/01/04 Opening Dalance INCOME REINVEST 05/15/04 Deposit Amount 20.660.53 8.67 Share Bolom:e 20,660.53 20,669.20 $20,669.20 05/28/04 CIosingBalance $20,669.20 Total All Money Market Funds Account Number: 4NE-309303 LOU ANN GOOD Page 5 o( 5 SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANIOUS PERSONAL PROPERTY ESTATE OF FILE NUMBER Lou Ann Good 21-04-0477 Include the proceeds of litigation and the date the proceeds were received by the estate All property jointly-owned with Right of Survlvorslflp must be disclosed on Schedule F ITEM ! DESCRIPTION NUIvlBER 1 2 3 4 5 6 7 8 Cash Checking acct no: 5080275129-PNC Bank DOD balance accured interest see letter attached) /risc. household items and furniture :omcast - refund ~,apital Bue Cross - refund PP&L - refund State Farm Insurance - refund Penn Waste Inc. - refund VALUE AT DArE OF DEATH $200.00 $7,014.12 $0,38 $500.00 $21.72 $189.14 $20.00 $33.18 $27.16 TOTAL (mo onii~ ~, Recapitulation) $8,005,70 PNCBANK July 28, 2004 Andrews & Johnson 78 W Pomfret St. Carlisle, PA 17013 RE: Estate of Lou Ann Good (Deceased) DOD: 05-13-2004 /sop Dear Sir or Madam: In response to your request for Date of Death balances for the eustoruer noted above, our records show the following: Checking Account Established 03-07-1994 Account #5080275129 LOU ANN GOOD DOD balance: $7,014.12 + $0.38 accrued interest 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 stateruents. If you need assistance with any of these iterus, 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 pT-PFSC-04-F 500 First Ave. Pittsburgh PA 15219 Member FDIC ESTATE OF SCHEDULE G TRANSFERS FILE NUMBER LouAnnGood 21-2004-0477 e answer of the ae~ion on the rever~e of the cover is yes. ITEM DESCRIPTION OF PROPERTY TOTAL VALUE DECD.% EXCLUSION TAXABLE NUMBER ~^~o~ ~m~ ^~r~c~^cowov ~mVOR~T*Z~ OF ASSET INT (if applicable)VALUE 1 687.10 shares-AIM Balanced Fund Class A - IRA DOD value ~ 23.32/share $16,366.72 I00% $16,366.72 Tranferees: 50% to William B. Harral (son) and 50% to Leslie B. Mathieson (daughter) (See statement atlached) 2 344 shares - AIM Balanced Fund Class B - IRA DOD value ~ 23.75/share Tranferees: 50% to William B. Harral (son) and 50% to Leslie B. Mathieson (daughter) (See statemem attached) ~16 ~66 '/2 TOTAL (also on llne 7, Re'~p;~''t'41nn) ision'- AccOunt Value by Date > Account Details ,ccount Value by Date ;tatements ;_tatements f'ransactions ~chang_e qaintenance ~utp Aqreements )etails ~c_ct overview ~cct Value by Date 'ransaction Hi~tory [ack-End _Sale_s ;hprqe~a_!culator Lank Infqrmatio ~n gepeficiarv & ;ontribution Details ,.i_g h ts of ~ccum~ulat!o~n Account #: 5017044867 Tax ZD/SSN: Registration: ANTC CUST ROLLOVER IRA FBO LOU ANN GOOD 217 S 19TH ST CAMP HiLL PA 17011-5518 Phone #: - Day: (717) 761-2101 Enter a price date to retrieve an account value from a previous day. Price Date:I0S/13/200 Current Price Date: 05/27/2004 Current Net Asset Value: $24.200 Current Total Shares: 687.100 Current Value: $16,627.82 Page i of 1 To_~o 9f Daoe AIM ZNVESTMENT Mgmt Co: AIM iNVESTMENTS Fund Name: AIM BALANCED FUND - CLASS A V e__w Fund Details Fund Code: 1506 Ticker: AMBLX Total Shares: 687.1000 CUSZP: 008879744 Account Value: $16,627.82 Price Date: 05/13/2004 Net Asset Value: $23.8200 Total Shares: 687.1000 Value: $16,366.72 ~on~t_act Us I D s~claime_r Copyright © 2004 DST Systems, Inc, All Rights Reserved. v'isio~ - AcCount Value by Date ~ H~L~sets > Share~earth> Search Results Account Value blt Date Statements Transactions E_~(chanq_e Maintenance Auto A eements Details &¢ct Ore_fyi e_w Acct Value by Date T_r~ n s a ctio n~Hi _s~ory ~.a.i~teq {!Bce History 6ack-End Sales Char e Calculator ~uto Redemetiona 6a~k lnformst_ion 3eneflclarv & ~_~ntribution D~tall_s 2__003 Tax Summa_~2/ [QO4 Ta~ Summa_~ ~i_g~_ts of ~ccumulation > Account Details Account #: 5017044867 Tax ID/SSN: Registration-' ANTC CUST ROLLOVER IRA FBO LOU ANN GOOD 217 S 19TH ST CAMP HILL PA 17011-5518 Phone #: - Day: (717) 761-2101 Enter a price date to retrieve an account value from a previous day. Page 1 of I JAIM INVESTMENT Mgmt Co: AIM INVESTMENTS Fund Name: AiM BALANCED FUNe - CLASS tB Vi~ew Fund Details Fund Code: 2506 Ticker: ABLBX Total Shares: .3440 CUSIP: 008879736 Account Value: $8.30 Current Price Date: 05/27/2004 Price Date: 05/13/2004 Current Net Asset Value'. $24.120 Net Asset Value: $23.7500 Current Total Shares: .3440 Total Shares: 0.3440 Current Value: $8.30 Value: $8.17 To~Ef paqc ¢_optact Us I D~_sclaime_r Copyright © 2004 DST Systems, Inc. All Rights Reserved, SCHEDULE H FUNERAL EXPENSES, ADIvffNISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ESTATE OF FILE NUMBER Lou Ann Good 21-04-0477 Debts of de--a~ must be reported on Schedule I. rr~;M DESCRI]Y~ON AMOUNT NUMBER 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Funeral Expenses: Hoffman Roth Funeral Home ~assy Gourmet - catering at memorial service Administrative Costs: Personal Representive Commissions Name of Personal Representative(s) Social Security Number of Personal Representative: Street Address: City: State: Zip: Year(s) commissions paid: Attorney fees to Andrews & Johnson Family Exemption Claimant Street: City: Relationship of Claimant to Deeedant: Probate Fees to Register of Wills Accountant Fees Tax Return Preparer's Fees State Farm Insurance - homeowners premium PP&L - utilfity bill Todd Harral - mowing and house maintenance Penn Waste, Inc. - trash bill State Farm Insurance - homeowners premium UGI - gas bill Veriznn - phone bill Pennsylvania American Water - bill PP&L - ufiltity hill UGI - gas bill Danny Bock - repair allowance to buyer of home Boyd Diller, Inc. - furniture disposal UGI - final gas hill Verizon - phone bill IPennsylvanla American Water - final bill ]Vefiznn - final phone bill IWilliam B. Hanal - reimbursement for executors expenses ]Overnight mail fee State & Zip $1,651.94 $358.81 $1,425.00 $271.00 $70.47 $152.95 $150.00 $4O.74 $35.00 $93.18 $71.86 $42.76 $75.98 $34.79 $200.00 $40.78 $14.37 $34.86 $9.61 $16.42 $316.08 $13.65 25 26 Register of Wills - PA Inheritance Tax Return -filing fee ~serve for closing and accounting $15.00 $4OO.OO TOTAL (also on line 9, Recapitulation) $5,535.25 SCHEDULE I DEBTS OF DECEDENT MORTGAGE LIABILITIES AND LIENS FILE NUMBER ESTATE OF 21-04-0477 Lou Ann Good . · ainefl,a~ idasofth~dat*ofdoath,i~"h'ai~'~unreimbursodraeflicalexpen*e$- ITEM DESCRIPTION VALUE AT DATE OF DEATH NUMBER I 2 3 4 5 6 7 dd Hah-al - mowing and house maintenance Peggy l_ago - in home care Metro Medical Services - ambulance Moffitt Heart & Vascular - medical bill United Church of Christ Home - medical care Bank of America - master_card credit card balance ?harMerica - medical bill $90.00 $195.00 $120.00 $49.52 $462.99 $467.43 $1.67 TOTAL (also on line 1o, gecapi",l,~i'~) $1,386.61 SCHEDULE J BENEFICIARIES FILE NUMBER ESTATE OF 21-04-0477 Leu ,akrffl rl'l~M NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE Do Not List Truste~(s) OF ESTATE I 1 William B. Harral ~37 Factory Street, Carlisle, PA 17013 son 50% 2 Leslie B. Mathieson 1185 Latrobe Drive, Annapolis, MD 21401 daughter 50% ............. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I- Z LU W f~ REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Good, Lou Ann DATE OF DEATH (MM-DD-YY) DATE OF BIRTH (MM-DD-YY) IF APPLICABLE) SURVIVING SPOUSE'S NAME OFFICIAL USE ONLY FILE NUMBER 21 2004 0477 ;OUNTY CODE YEAR NUMBER THIS MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~[] t. Odginal Return '--~ 4. Limited Estate ~ 6. Decedent Died Testate 9. ~ec'd [] 2. Supplemental Return [] 4a. Future interest Compromise [] 7. Decedent had Living Trust Credit [] 3. Remainder Return [] 5. Fed. Est. Tax Return Rsq'd 0~ 8. Totalnumper of SDB's 11. Election to tax w/Sec. 9113 ~AME: ;~eaald E. Johnson, Esquire :IRM NAME: TELEPHONE NUMBER 117 243.-0123 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3.Closely Held Corporation, Partnership or Sole~Pmp. (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Misc. Pers'bnal Prop.(Sch. E) (5) 6. Jointly Owned Property (Schedule F) (6) [~] Separate Billing Requested 7. Inter-Vivea Transfers & Misc. Non-Propate Prop. (7) 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses & Administration Costs (Sch H) (9) 10. Debts of Decedent, Mortgage liabilities, & Liens (10) 11. Total Deductions (total lines 9&10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bsquests/Sec 9113 Trusts for which an election to tax has not bean made 14. Net Value Subject to Tax (Line 12 minus Line 13) COMPLETE MAILING ADDRESS: Ronald E. Johnson, Esq. Andrews & Johnson 78 W. Pomfret St. Carli,~ 17013 $110,69~119 OFFICIAL ~E 0NLY $50,54~9.53 ~cT $ o.oo $8,005.70 -~ $[Lo0 ~ $16,366.72 (8) $185,620.14 $5,535.25 $1,386.61 (11 ) $6,921.86 (12)$178,698.28 (13) (14) $178,698.28 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amnt of Line 14 ~xable at the spousal rate, or transfers under Sec.9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due x.O._ (15) $0.00 $178,698.28 x. O45 (t6) $8,041.42 $0 x. 12 (17) $0.00 $0 x.15 (13) $0.00 20 [] CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT('1 g) SRN4._,__ 1 .-.~'~' :~.~ ~ .... ~... . ........ . ........ ~ ..................... Decedent's Complete Address: Tax Payments and Credits: 1. Tax Due 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discounts STATE ZIP $8,041.42 Total Credits (A+B+C) Interest/Penalty if applicable D. Interest E. Penalty Total Intereet/Pentalty (D+E) If Line 2 is greater than Line 1 + Line 3, enter the difference This is the OVERPAYMENT Check box on Page t Line 20 to request a refund (2) (3) (4) $0.00 $0.00 If Line 1 + Line 3 is greater then Line 2, enter the difference. This is the TAX DUE. (5) $8,041.42 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) $8,041.42 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLAClNe AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a retain the use or incoroe of the property transferred: b. retain the dght to designate who shall use the property transerred or its income: c. retain a reversiona~, interest: or d. retain the promise for life of either payments or care? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? Did decedent own an "in trdst for" or payable upon death bank account or security at his or her death? Did decedent own an Individual Retirement Account, annu~y, or other non-probate properly which contsins a beneficia~ disignation? yes no IF THE ANSWER TO AHY OF THE ABOVE QUESTIONS IS YESt YOU MUST COMPLETE ECH~r, ULE G AND FILE IT AB PART OF THE RETURN. SIGNATURE OF PERSON R~S ONSIBLE FO ILING RETURN ~ ~./~) c/~o 78 West Pomfret S~eetv~rlisle, PA 17013 SIGNA R EPAR O E AN ~ " WE ADo.r. y'- - "- /// .... - /; of_.., c/o 78 West P(~et Street, Carlisle, PA 17013 LAST WILL AND TESTAMENT I, LOU ANN GO0~ of the Borough of Camp Hill, Counfy of Cumberland and Commonwealth of Pennsylv~ia' being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils~by me at any time heretofore made. ~ FIRST. I order and direct that all my just debts and funeral expenses be paid by my Executors, Executrix or Executor, as the case may be, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated in equal shares unto my two (2) children namely, LESLIE B. HARRAL and WILLIAM B. HARRAL, share and share alike, absolutely and in fee simple. THIRD. If either of my said children should predecease me and not leave lawful issue to survive me, I order and direct tha my entire residuary estate shall be distributed unto the child so surviving. FOURTH. If either of my said children should predecease me and leave lawful issue to survive me, I order and direct that share or interest attributable hereunder to such deceased child shall be distributed unto his or her lawful issue per stirpes by representation and not per capita. FIFTH.' I order and direct that the distributive share hereunder to euny beneficiary who has hot attained the age of twenty-two (22) years at the time of such distribution shall be over and delivered unto COMMONWEALTH NATIONAL BANK of Harrisburg, Pennsylvania, as my testamentary trustee IN TRUST, NEVERTHELESS, to hold, manage, invest and reinvest for the use and benefit of said beneficiary until said beneficiary attains the age of twenty-two (22) years, and upon the beneficiary,s attainment of age twenty-two (22) years, I order and direct that the trust be terminated and the then remaining net assets thereof, if any, shall be distributed unto the beneficiary absolutely. During the existence of said Trust or trustsl ~authorize and empower my~said Trustee to use, expend and apply from time to time such amounts of both income and principal as it in ~he exercise of its discretion shall deem to be necessary and proper for the respective bene- ficiary's support, care, maintenance and education, including college or other post-high school vocational training or education LASTLY. I nominate, constitute and appoint my two (2) children, namely, LESLIE B. HARRAL and WILLIAm4 B. HARRAL, to be the Executors of this, my Last Will and Testament, eack and bot~ to serve without bond or other security as a condition of qualifi- cation hereunder. If either of my said children should fail to qualify as my personal representative hereunder or cease so to serve, I nominate, constitute and appoint the one so qualifying remaining to be the sole personal representative hereunder. IN WITNESS WHEREOF, I,LOU ANN GOOD, have hereunto set my hand and seal to this, my Last Will and Testament which consists of two (2) typewritten pages to each of which I have affixed my signature this c~day of ~y , A.D., One Thousand Hundred Eighty-two (1982). ~,,~~X_ ~ ~/~~ (SEALi The preceding instrument, consisting of this and one (1) other typewritten page, each identified by the ~ignature of ~he Testatrix, was on the date thereof signed, sealed, published and declared by LOUA~N GOOD the Testatrix therein named, as and for her Last Will and Testament, in the ~resence of us, who, at her request, in her presence, and in ~h~rss~nce~ of each other have subscribed our names as witnesse~e~.. ~/ / ' ~ COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We, LOU ANN GOOD,RICHARD C. SNELBAKER and J~/qET M. FORRY, the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the T'estatrix signed and executed the instrument as 'her Last Will and Testament and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the ~estatrix, signed the Will as witness and that to the best of his or her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Subscribed, sworn to and acknowledged before me byLoU ANN GOOD, the Testatrix, and subscribed and sworn to before me by RICHARD C. SNELBAKER and JANET M. FORRY, witnesses, this ~?~/~'~ day of ~¢c.~ , 1982. Notary Public SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Lou Ann Good 21-04-0477 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH ALL THAT CERTAIN tract of land situate in Camp Hill Borough, Cumberland County, Pennsylvania known and numbered as 217 South 19th Street, Camp Hill, Pennsylvania 17011 Being the same premises which Max Cleland as Administrator of Veterans Affairs by his deed dated September 26, 1977 and recorded in the Office of the Recorder of Deeds in and for Cumberland County in Deed M, Volume 27, Page 127 granted and conveyed unto Lou Ann Good Net proceeds from the sale of the property on July 30, 2004 (see settlement statement attached) $110,698.19 Total (also enter on Line 1, Recap) $110,698.19 U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT I.E~FHA 2.[~FrnHA 3.[~CONV. UNINS. 4. ~]VA 5,[~CONV, [NS. SE~LEMENT STATEMENT BOCK.D I 7. LO~ NUMBER: 10. ~ ~o~. ~ ta ~ ta ~py of pages 1&2 of this statement & any attachments referred to herein, SCHEDULE B STOCKS AND BONDS ESTATE OF FILE NUMBER Lou Ann Good 21-04-0477 All property jointly-owned with Right of Survivorship must be disclosed on Schedule F DESCRIPTION VALUE AT DATE OF DEATH ITEM NUMBER New England Securities Brokerage acct no: 4NE-309303 See attached statement provided by account representative $50,549.53 TOTAL (mso on line 2, Recapitulallon) $ 50, 549.53 ~ NEW ENGLAND SECURITIES' N~F ............... 8rokerage Account Statement LOU ANN GOOD 217 SOUTH 19TH ST CAMP HILL PA 17011-5518 Your Registered Representative: M. WAYNE NEFF (61 O) 325-6100 Asset Allocation Cash and Cash Equivalents Mutual Funds Account Total (Pie Chart) Account Number. Statement P~fi01~-.' 05/01/2004 - 05/31/2~ Valuation at a Glance Beginning Account Value Dividends/Interest Chan~e in Acesunt Value Ending Account Value Estimated Annual Income DoT) Value Value Percent Period 1~isPerled Allocation 20,6~.53 ~9,~ 20,66920 30,571.26Z%~,3~ 30,312.14 59% s~o,~.~ ~bPeriod $51,231.79 75.85 -32630 $50,981.34 $1,544.87 Asset Nlocatlon percentages are rounded to the nearest whole percentage. Pie Chart allocation excludes all asset classes which net to a liability. Po~a I of 5 Transactions by Type of Activity (continued) I'rocess/ Se0lement Date Adivii,/Type Doscripiion Transactions Summary Total Amount UNITED STATES DOLLAR 8.67 The price and quantity displayed may have been rounded. Income Summary Dividends and Interest Mutual Fund Dividends - Current Year Money Fund Income Tot~ Dividends and Interest Statement Period: 05/01/2004 - 05/31/2004 Quantity Fdce Accruedlnterest Amount Curren~ USu Cmrent Period Taxable Non Taxdge 67.18 0.00 8.67 0.00 S75.85 So. Oo Yeor-~Dote Taxable 513.01 35.16 $548.17 Non Taxable 0.00 O.O0 $O.(,p Money Market Fund Detail Dote Aclivily Type Doscdp~ion Sweep Money Market Fund SHORT TERM iNCOME CLASS R Account Number: 000~012316 Current Yield: 0.51% AdivJty Ending: 05/28/04 05/01/04 Opening Balance 05/15/04 Deposit INCOME REINVEST Amount 8.67 SJmreBalence 20,660.53 20,669.20 05/28/04 Closing Balance $20,669.20 Total All Money Market Funds S20,669.20 Account Number: 4NE-309303 LOU ANN GOOD Page 5 of 5 SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANIOUS PERSONAL PROPERTY ESTATE OF FILE NUMBER Lou Ann Good 21-04-0477 Include the proceeds of litigation and the date the proceeds were received by the estate Ail property Jointly-owned with Right of Survivorship must be disclosed on ScheduIe F ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1 2 3 4 5 6 7 8 ',ash ',hecking acct no: 5080275129-PNC Bank DOD balance accured interest (see letter attached) Misc. household items and furniture Comcast - refund Capital Bue Cross - refund PP&L - refund State Farm Insurance - refund Penn Waste Inc. - refund $200.00 $7,014.12 $O.38 $500.00 $21.72 $189.14 $20.00 $33.18 $27.16 TOTAL (also on lin* s, Recapitulation) $8,005.70 PNCBAN< July 28, 2004 Andrews & Johnson 78 W Pomfret St. Carlisle, PA 17013 /scp Estate of Lou Ann Good (Deceased) SSN: DOD: 05-13-2004 Dear Sir or Madam: In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Established 03-07-1994 Account #5080275129 LOU ANN GOOD DOD balance: $7,014.12 + $0.38 accrued interest 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. Il'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. Pittsburgh PA 15219 Member FDIC SCHEDULE G TRANSFERS ESTATE OF FILE NUMBER LouAnnGood 21-2004-0477 ~ scheihfle te be completed a~ filed ff the a..zwer of the question on the reverse of the cover is yes. ri'gM DESCRIPTION OF PROPERTY TOTAL VALUE DECD.% EXCLUSION TAXABLE NUMBER *mDA~ovm ^rrnc~^covt OV~D~rO~STA~. OF ASSET INT (il'applicable) VALUE I 687.10 shares-AIM Balanced Fund Class A - IRA DOD value ~ 23.32/share $16,366.72 100% $16,366.72 Tranferees: 50% to William B. Harral (son) and 50% to Leslie B. Mathieson (daughter) (See statement attached) 2 344 shares - AIM Balanced Fund Class B - ~ DOD value ~ 23.75/share Tranferees: 50% to William B. Harral (son) and 50% to Leslie B. Mathieson (daughter) (See statement attached) TOTAL (al~o on lin* 7, R~e~aoitulation) $16,366.72 ision'- Account Value by Date My AsSetS ~ ~ H A~ > S_hBreholder Name Search> _S~arch Results > Account Details ,ccount Value by Date ;tatements ;t_atements transactions !~change Vlaintenance ~ _u.f~o Aqreements )etails ~Gct Overview Lcct Value by Date 'ransaction History Lack-End Sales :harne Calculator }_a!!k Information lqneficiarv IA :0ntribution Details :Q04 Tax u~ ',!g hts of ~ccurn_ulation Account #: 5017044867 Tax ID/SSN: Registration: ANTC CUST ROLLOVER IRA FBO LOU ANN GOOD 217 S 19TH ST CAMP HiLL PA 17011-5518 Phone #: - Day: (717) 761-2101 Enter a price date to retrieve an account value from a previous day. Price Date: 10~/13/20c)lIIi ~ Current Price Date: 05/27/2004 Current Net Asset Value: $24.200 Current Total Shares: 687.100 Current Value: $16,627.82 Page 1 of 1 _Tgp of aaq~ ATM TNVESTMENT Mgmt Co: AIM INVESTMENTS Fund Name: AIM BALANCED FUND - CLASS A View Fund Detai~s Fund Code: 1506 Ticker: AMBLX Total Shares: 687.1000 CUSIP: 008879744 Account Value: $16,627.82 Price Date: 05/13/2004 / Net Asset Value: $23.8200 Total Shares: 687.1000 . Value: $~ 6,366.72 qgntact Us I Disclaimer Copyright © 2004 DST Systems, Inc. All Rights Reserved. ¢isioh - Account Value by Date Assets > S_ha_reholder Name Search > Search Result~ > Account Details Account Value by Date Statements Statements Transactions E_xchanqe Maintenance Auto Aareements Details ~,CCt Overview Acct Value by Date Transaction History ~laintenance History Sack-End Sale__s Charoe Calculator Auto Redemotions 13ank Information ~neflciarv & ;_o!!tribution Details 200:3 Tax Summary 2004 Ta~ Summary ~.~_q~_ _t~s of ~cqumulation Account #: 5017044867 Tax [D/SSN: Registration: ANTC CUST ROLLOVER IRA FBO LOU ANN GOOD 217 S 19TH ST CAMP HILL PA 17011-5518 Phone #: - Day: (717) 761-2101 Enter a price date to retrieve an account value from a previous day. Price Date:[05/13/200"i ~ Page I of 1 JA$M [NVESTMENT Mgmt Co: AIM INVESTMENTS Fund Name: AIM BALANCED FUND - CLASS B View Fund Details Fund Code: 2506 Ticker: ABLBX Total Shares: .3440 CUSTP: 008879736 Account Value: $8.30 Current Price Date: 05/27/2004 Price Date: 05/13/2004 Current Net Asset Value: $24.120 Net Asset Value: $23.7500 Current Total Shares: .3440 Total Shares: 0.3440 Current Value: $8.30 Value: $8.17 Tgp of paq~ Contact US J Disclaimer Copyright © 2004 DST Systems, Inc. All Rights Reserved. SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ESTATE OF FILE NUMBER Leu Ann Good 21-04-0477 Debt~ of decedent must be reported on Schedule L ITEM DESCRIPTION AMOUNT NUMBER 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Funeral Expenses: Hoffman Roth Funeral Home Sassy Gourmet - catering at memorial service Administrative Costs: Personal Represenfive Commissions Name of Pemonal Representative(s) Social Security Number of Personal Representative: Street Address: City: State: Zip: Year(s) commissions paid: Attorney fees to Andrews & Johnson Family Exemption Claimant Street: City: Relat/onship of Claimant to Decedent: Probate Fees to Register of Wills Accountant Fees Tax Return Prepaxer's Fees :State Farm Insurance - homeowners premium PP&L - ufillity bill Todd I4arml - mowing and house maintenance jPerm Waste, Inc. - trash bill !State Farm Insurance - homeowners premium UGI - gas bill Verizon - phone bill Pennsylvania American Water - bill ?P&L - utiltity bffi UGI - gas bill Danny Bock - repair allowance to buyer of home Boyd Dfller, Inc. - furniture disposal UGI - final gas bill Verizon - phone bill Pennsylvania American Water - final bill Verizon - final phone bill William B. Harral - reimbursement for executors expenses Overnight mail fee State & Zip $1,651.94 $358.81 $1,425.00 $271.00 $70.47 $152.95 $150.00 $40.74 $35.00 $93.18 $71.86 $42.76 $75.98 $34.79 $200.00 $40.78 $14.37 $34.86 $9.61 $16.42 $316.08 $13.65 25 26 Register of Wills - PA Inheritance Tax Return -filing fee Reserve for closing and accounting $15.00 $400.00 TOTAL (also on linc ~, R~capitulatlon) $5,535.25 SCHEDULE I DEBTS OF DECEDENT MORTGAGE LIABILITIES AND LIENS ESTATE OF FILE NUMBER Lou Ann Good 21-04-0477 ITEM NUMBER DESCRIPTION Todd Harral - mowing and house maintenance Peggy Lego - in home care Metro Medical Services - ambulance Moffitt Heart & Vascular - medical hill lnited Church of Christ Home - medical care ~k of America - maste[card credit card balance PharMerica - medical bill rALUE AT DATE OF DEATH $90.00 $195.00 $120.00 $49.52 $462.99 $467.43 $1.67 TOTAL (also on lin~ 10, Recapitulation) $1,386.61 SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Lou Ann Good 21-04-0477 ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHAP~ NUMBER Do Not List Tru~*(s) OF ESTATE 1 William B. Harral 937 Factory Street, Carlisle, PA 17013 son 50% 2 Leslie B. Mathieson 1185 Latrobe Drive, Annapolis, MD 21401 daughter 50% TOTAL CHmUT~,BLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation) $0 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. CD 004466 HARRAL WILLIAM B 937 FACTORY STREET CARLISLE, PA 17013 ESTATE INFORMATION: F!LE NUMBER: 2104-0477 DECEDENT NAME: GOOD LOUANN DATE OF PAYMENT: 10/04/2004 POSTMARK DATE: 1 0/04/2004 COUNTY: CUMBERLAND DATE OF DEATH: 05/13/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $8,041.42 TOTAL AMOUNT PAID: $8,041.42 R:EMARKS: SEAL CHECK# 1122 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF TNDZVZDUAL TAXES I'NHERZTANCE TAX DTVI'STON PO BOX 280601 HARRISBURG, PA 17128-0601 CONNONNEALTH OF PENNSYLVANZA DEPARTNENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOHANCE OR DZSALLOHANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-1547 EX AFP (09-04) RONALD E JOHNSON ESQ ANDRENS & JOHNSON 78 N PONFRET ST CARLISLE PA~17015 DATE ESTATE OF DATE OF DEATH FILE NUNBER COUNTY ACN 11-29-2004 GOOD 05-15-2004 21 04-0477 CUNBERLAND 101 Amount Rem/fred LOUANN HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF NILLS CUNBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~.~ REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSENENT, ALLONANCE OR DZSALLONANCE OF DEDUCTTONS AND ASSESSNENT OF TAX ESTATE OF GOOD LOUANN FZLE NO. 21 04-0477 ACN 101 DATE 11-29-2004 TAX RETURN #AS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST- SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN I Real Estate (Schedule A) 2 Stocks end Bonds (ScheduZe B) $ CZosely Held Stock/PartnarshAp Interest (Schedule C) Nortgages/Notas RecaAvable (Schedule D) 5 Cash/Bank DaposAts/HAsc. Personal Property (ScheduZa E) 6 JoAntly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXENPTZONS: 9. Funeral Expenses/Adm. Costs/HAso. Expanses (Schedule H) 10. Dabts/Nortgage Liabilities/Liens (ScheduZa Z) 11. Total Deduct/ohs 12. Net Value of Tax Return (1) (2) (3) (4) (6) (7) (9) 110~698 19 50~549.55 O0 O0 8~005 70 O0 16~$66.72 5,535.25 (10) 1~$86.61 (11) (12) 15. 14. NOTE: Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (1:5) Net Value of Estate Subject to Tax (14) ~f an assess.ant ~as lssued previously, 11nes 1~, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. NOTE: To insure proper credit to your account, submit the upper portion of thAs form wAth your tax payment. 185,620 ASSESSNENT OF TAX: 15. Amount of LAne 14 et SpousaZ rate 16. Amount of LAne 14 taxable at Lineal/Class A rate 17. Amount of LAne 14 et SiblAng rate 18. Amount of LAne 14 taxable at Collateral/Class B rate 19. PrAncipal Tax Due TAX CREDZTS: PAYNENT RECE/PT DZSCOUNT (+J DATE NUHBER ~NTEREST/PEN PAZD (-) 10-04-2004 CD004466 .00 I78,698.28 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 178,698.28 18 and 19 Hill ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE [S REFLECTED AS A 'CREDIT' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) TOTAL TAX CREDIT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE 8,041.42 AHOUNT PAID 8,041.42 .00 .00 .00 (15} .00 X O0 : .00 (16) 178,698.28 X 045 = 8,041.42 (17) . O0 x 12 = . O0 (18) .00 x 15 = .00 (19)= 8,041.42 RESERVATION: PURPOSE OF NOT[CE: PAYMENT: REFUND (CR): OBJECTIONS: ADH/N- ISTRATIVE CORRECTIONS: OISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Zj 198Z -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (cottateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraisa and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 210`0 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (TI P.S. Section 910`0). Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, 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-IS13). Applications ara available online at www.revanua.state.ma.us, any Register of Hills or Revenue District Office, or from the Department's Z0`-hour answering service for forms orders: 1-800-36Z-2050~ services for taxpayers with special hearing and/or speaking needs: 1-800-0`0`7-30Z0 (TT only). Any party in interest not satisfied with the appraisment, allowance or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within 60 days of the date of receipt of this notice by filing one of the following: A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at wwa.boardofappeals.state.pa.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to be valid, you must receive a confirmation number and processed date from the Board of Appeals wabsite. You may also send a written protest to PA Department of Revenue, Board of Appeals P.O. Box ZEIOZ1, Harrisburg, PA 17128-10Z1. Petitions may not be foxed. B) Election to have the matter determined at the audit of the account of the personal representative. C) Appeal to the Orphans" Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenuaj Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box Z80601~ Harrisburg~ PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decadent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid aithin three (3) calendar months after the decedent's death, a five percent (SZ) discount of the tax paid is allowed. The 1SI 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 and 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. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6X) percent par annum calculated at a daily rate of .000160`. Al! taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The appticabla interest rates for 198Z through Z000` ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ ZOZ .00050`8 1988-1991 11Z .000301 ~ 9Z ·OOOZa, 7 1983 16Z . 0000`38 199Z 9Z . OOOZ0`7 ZOOZ 6Z . 000160` 1980` 117. .000301 1993-1990` 77. .000192 2003 5Z .000137 1985 132 .000356 1995-1998 92 .00020,7 2000` 0`Z .000110 1986 107. .0 O0 Z70` 1999 77. . O0019Z 1987 102 .000270` ZOO0 72 .00019Z --Interest is calculated as folloes: 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 (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. Cumberland County - Register Of Wills One Courthouse Square Carlislel PA 17013 Phone: (717) 240-6345 Date: 3/29/2006 HARRAL WILLIAM B 937 FACTORY STREET CARLISLE I PA 17013 RE: Estate of GOOD LOUANN File Number: 2004-00477 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES I NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 11 1992, the personal representative or his counsell within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 5/13/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. sr~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Register of Wills of Cumberland County Name of Decedent: STATUS REPORT UNDER RULE 6.12 LotJ,H.v.v G Ck)b Date of Death: Estate No.: AClOY- ~77 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)8' No 0 2 If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No 0 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 in interest? Yes p No 0 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. I&mw &, J;#~J/~ Na7~ /t!" /'~rr~ f ~ t-: Odf7;flZ; //1 /7?J/3. Address ,?YY-tJ/Z ,:r Telephone No. Date: 7P )C f Capacity: 0 Personal Representative ~ Counsel for personal representative {}