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HomeMy WebLinkAbout02-0227PETITION FOR PROBATE and GRANT OF LETTERS To: also kHOWH as Deceased. Social Security No. _J S~ - Oq - ~ ~5 ~ _ 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 ;in the execut in the last will ol the above decedent, dated /~ot,~e. an/a~_.,~-- and codicil(s) dated in the namcd _, 19 8'1 (stale relevant circumstances, e.g. renunciation, death of executor, etc.) D ' · was domiciled at death in ~__w~a~c/tl~ County, Pennsylvania, with ecenaent ' ' ' h~_.~ l.ast family or prlnctpal residence at C.laa..~,Ot"_\ - - I ' -- (list street, number and muncipality) Decendent, then_ ~' ~ ye.ars of age. died Except~as follows, decec~ent did not marry, was not &vorced and &d not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylva, nia situated as follows: /M'C~A/,~. 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 COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF £(IMRFRIAND 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 petitioDerff,-)-o~d that as person~q~L.r-epresen- tative(s) of the above decedent petitioner(s)will w~li~r~5.,.~a~ding to law. Sworn to or affirmed and subscribed ~-,,~/~ s~n//2~_tl~x . ~ ~ before me this q ST day of [ ( ~{ V~ -~ ~ ~' MA~Y C LE~IS "' R~gisler ~ ~5 ~ No. 71 - O? - ??7 Estate Of JOHN E PEIPER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS MARCH~, AND NOW the reverse side hereof, satisfactory pt°of having been presented before me, IT IS DECREED that the instrument(s) dated NOVEMBER 2!, lC~81 described therein be admitted to probate and filed of record as the last will of JOHN E PEIPER TESTAMENTARY and Letters Xl~ 2002, in consideration of the petition on are hereby granted to J CHRISTOPHER PEIPER and MARK R PEIPER FEES Probate, Letters, Etc .......... $ 18.00 Short Certificates(6 ) .......... $ !8.00 Renunciation ................ $ JCP $. ~ .00 TOTAL $. 41 . 00 Filed ..... .M.A.R..C.H..4.,. ?_.0.0. _P, .............. _ Register of Wills~ MARY C LEWIS ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE Z£:Z~ [-~!Vq ZO. Mailed letters to Mark R. Peiper on 3-4-02 0s.90s~s This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. Robert S. (.Zim~erman, Jr., MPH Secretary of Health 0128632 No. Charles Hardester State Registrar FEB 0 Date John Pei ; : Cumberland COMMONWEALTH OF pEIINSYLVANIA ' DEPARTMENT OF HEALTH ' VITAL RECORDS CERTIFICATE OF DEATH Carlisle 110 Hillcrest New Cumberland, Pa 17070 Male 189 -- 09 --4552 Chapel Pointe at Carlisle ,?..~__ PA - ~ 11, 2002 110 ,o~.~ O~berland Valley 17070 Home I.A ST WILL A"3~J TESTANrE2~'T T, d0?iN E. PE?~PER, of Fairview Tawnis`~ip, York Caurtty, Pe~.insyl.~~aniG, bEaing of sound mind, memory and understanding, do make, pu"nl_ish anc3 der.lare t'zi_s as and fax my I..ast Will and 't'estament, '~ereby revoking and making void all. former wills ~°:.r me at any time heretofore made. "ZRST . I direct a 11. my just d.ebr, a~ funera 1 exper~ se s ?~e ful l.y paid and satisfied out of my estate by my personal representative(s) hereir?.after named as soon. as conveniently may be done after my de.ceae. SECOND. ? give, devise and bequeath all. of m~ .'state, real and. personal, to my wife, T'neda S. Peiper, if living, otherwise to my~ c~zildren i_n egial shares or their issue. 1_,AS'1`TY, 7 nominate, constit~rte and appo?n+- my wife, Theda S. Peiper, Executrix, if living, otherwise m~y two sons, J. Christopher Peiper and r~arlc R.. Pe%per, oi: the survivor ar the ogle able to serve, E:{ecui.ars or Executor, of this my Last 6~i_1 aid Testament.:. I:N WITNESS ivJtiEREOF, I have hereunto set my hand and seal this 2-~'Y~da y o f ~6't~-G~G~~~/' , 19 81. ~~j~~ (s~rAl.) Signed, sealed., published and declared by t-he above named Testator, _Tohn E. Peiper, as and for his Last Wi11 and 't'estament, zz~ the presence of us, who, at his request az_~l in his prese~~ce atzd irZ the presence of each other, have he~unto subscribed our names as caitresses thereto. /~~~~, ,~ 1 ,~ r ~ `' 21 - O? - ?27 REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS ~(~0)~) a subscribing witness to the will presented herewith, }~e~l~) being duly qualified according to law, depose(s) and say(s) that HE WAS present and saw JOHN E PEIPER "' the testat OR sign the same and that HE signed as a witness at the request of testat OR . in hi S .... presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before ~ / me this 1 ST day of (Name) ~9: ~,~' /JMAR.CW, q ' 1X)X~2~_ ~ ' MA~]~ C LEWIS t Register (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS (~hI~ a subscriber hereto, X0ClgJ0) being duly qualified according to law, depose(s) and say(s) that HE IS familiar with the signature of JOHN E PEIPER , X~Vo~l testat OR of (~X~t(x~hvex)~l~l~x~Ya~(xl~x~ will presented herewith and ,- Xa~V~( HE believes the signature on the will is in the handwriting of that JOHN E PEIPER to the best of HIS knowledge and belief. Sworn to or affirmed and subscribed before me this 1 ST day of - /Name) t M~Y C LEWIS (Name) (Address) REV-1500 EX (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST FIRST, AND MIDDLE INITIAL) I-- ' Z John Peiper U.I DATE OF DEATH (MM-DD-YEAR) t'~ DATE OF BIRTH (MM-DD-YEAR uJ 01/07/02 O 02/23/19 LLI (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~-- 1[~1, Original Return ~ 2. Supplemental Return ~O [ 4~ Limited Estate [~ 4a. Future Interest Compromise (date of death after 12-12-82) -,-oo IFX~I O I~..J I ~ 6. Decedent Died Testate (Attach copy of Will) [~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) OFFICIAL USE ONLY 2 1 -- 0 2 0 0 2 2 ? COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 189-09-4552 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~iJS, Federal Estate Tax Return Required Remainder Return (date of death prior to 12-13-82) z LU Z O O O z Z O O x p. -- 8. Total Number of Safe Deposit Boxes [~] 9. Litigation Proceeds Received [~ 1 0. Spousal Poverty Credit tdate of de~,h bet .... 12-31-91 .nd 4-1-95) [~ 1 1. Election to tax under Sec. 9113(A)(Anach Sch O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME Hark Peiper FIRM NAME (If Applicable) TELEPHONE NUMBER (717) 795-9808 tCOMPLETEMAILINGADDRESS C/O Hark Peiper 110 Hillcrest Dr. New Cumberland, PA 17070 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) ~ 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 0 (10) I 1 Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. 14. 0 43,402~ r. 0 6,293 0 0 4,846 1, 633 (11) Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (12) (13) (14) OFFJCrAL USE ONLY -< 49, 696 6,479 43,217 43,217 5 Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) x.0 __ (15) 16. Amount of Line 14 taxable at lineal rate 43,217 x.0 45 (16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 8. Amount of Line 14 taxable at collateral rate__ x. 1 5 (1 8) ~9 Tax Due 20. ~ (19) > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 1, 945 1, 945 1W4645 1 000 Decedent's Corn plete Address: ST~t- b_ I ADDRESS c/o Mark Peiper 110 Hillcrest Dr. New Cumberland STATE I ZIP PA 17070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments (1) 1,945 A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable Total Credits (A + B + C) (2) D. Interest E. Penalty Total Interest/Penalty (D + E) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 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. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (3) (4) (5) (5A) (5B) 1, 945 1, 945 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................... ~ ~ b. retain the right to designate who shall use the property transferred or its income; ......... [~] [~ c. retain a reversionary interest; or ................................ [~ ~ d. receive the promise for life of either payments, benefits or care? ................. ~ ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? E~ ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . · . I~ ~ IF THE ANSWER TO ANY OF THE ABOVE QUEST ONS I~ '~'I~S' ~O~./;~J~'J;-,-',-.:-..'.,~.~-.:.'-k.'._'-.'..' ........ ~ ~ , ,v,u..~ ~-.~m~'L~'~- ~[.;t'II=DULE 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 ~ the personal representative is based on all~nformation of which preparer has any knowledge DATE 110 Hillcrest Dr.,New Cumberland, PA 17013 SIG~AII~E O~ ~E~.ARE~ QNE~ THA~ ~ERRESE~TAI]VE DATE 236 S.Hanover St.,Carlisle,PA 17013 For dates of death on or after July 1, 1994 and before Jan uary 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72PS.§9916 (a) (1.1) (i)]. For dates of death on or after J an uary 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 im posed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S § 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. § 9116(1.2) [72 P.S. § 9116(a)(1 )]. The tax rate imposed on the net value of transfers to orfor the use of the decedent's siblings is 12% (72 P.S. § 9116(a)(1,3)], A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption, 1W4646 1000 REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS John Peiper FILE NUMBER 21-02-00227 All prope~y jointly-owned with right ~ su~ivomhip must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. Pennsylvania Power & Light(A/C#4925-1450) (480 SHRS.@$32.88/shr.) e-Trade Financial,P.O.Bex 989030,W.Sacramente, CA 2 Janus Worldwide Fund{A/C#41-203798807) (36.996 SHRS.@$44.16/SHR.) P.O.Box 173375,Denver, CO 80217-3375 3 Janus Fund{A/C#42-203798807) 28.361 SHRS.@S25.08/SHR.) Same Address As Item #2 4 Janus Hercury Fund(A/C#48-203798807) (33.978 SHRS.@$21.13/SHR.) Same Address As Item#2 5 Janus Flexible Income Fund(A/C#49-203798807 1069.556 SHRS.@$9.23/SHR.) Same Address As Item#2 6 Janus Balanced Fund(A/C#51-203798807) (29.601 SHRS.@$19.71/SHR.) Same Address As Item#2 7 Janus Short-Term Bend Fund(A/C#52-203798807 (3394.757 SHRS.@$2.94/SHR.) Same Address As Item#2 8 Janus Core Equity Fund(A/C#55-203798807) 150.195 SHRS.@$18.10/SHR.) Same Address As Item#2 9 Janus Global Life Sciences Fund(A/C#59-203798807) (61.234 SHRS.@$17.04/SHR.) Same Address As Item#2 Janus Strategic Value Fund(A/C#61-203798807) 38.048 SHRS.@$9.45/SHR.) Same Address As Item#2 10 95798-9030 TOTAL (Also enter on line 2, Recapitulation) $ VALUE AT DATE OF DEATH 15,782 1,634 711 718 9, 872 583 9, 981 2,719 1,043 360 43, 403 1W4696 1 000 (If more space is needed, insert additional sheets of the same size) · ~EV-1508 ~X+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULEE CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY FILENUMBER John Peiper 21-02-00227 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 2 3 5 DESCRIPTION Janus Honey Market Fund(A/C#37-203798807) P.O.Bo× 173375,Denver,CO 80217-3375 Hember's First Federal Credit Union -Checking (A/C#186983-11) 5000 Louise Dr.,P.O.Be× 40,Hechanicsburg, PA 17055 Hember's First Federal Credit Union-Savings (A/C#186983-00) 5000 Louise Dr.,P.O.Bo× 40,Hechanicsburg, PA 17055 The Old Town Run Heuntain Ledge Carlisle,PA 17013,Club Hembership(Hembership #0154} United States Treasury-2001 Tax Refund TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE OF DEATH $ 6,293 98 5,706 25 2OO 264 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS John Peiper FILENUMBER 21-02-00227 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION FUNERAL EXPENSES: Hoffman Funeral Home-Funeral Expenses Magaro's-Funeral Caterer 5. 6. 7. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State ~ Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees Cumberland Co. Register of Wills Accountant's Fees State Zip Tax Return Preparer's Fees Gerald L.Brenneman, CPA_PA Inheritance Return TOTAL (Also enter on line 9, Recapitulation) AMOUNT 3, 655 735 56 400 $ 4,846 (If more space is needed, insert additional sheets of same size) · REV-1512~X+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John Peiper FILE NUMBER 21-02-00227 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS Include unreimbursed medical expenses· ITEM NUMBER DESCRIPTION 1. Chapel Pointe-Final Nursing Home Bill(January 2002) (Paid 01/22/02;Share Draft#272) 2 Chapel Pointe-Final Nursing Home Bill January 2002-Adjustment) (Paid 03/01/02;Share Draft#278) 3 Omnicare Pharmacies-Medicine Bill(December 2001) {Paid 01/23/02;Share Draft#273) 4 Omnicare Pharmacies-Medicine Bill(January 2002) (Paid 02/15/02;Share Draft#277) 5 Philhaven-Consutation Fee (Paid 03/04/02;Share Draft#279) 6 Belvedere Medical Corp.-Medical Fee (Paid 03/20/02;Share Draft#282) 7 Gerald L.Brenneman-2001 Tax Preparation Fee Paid 03/19/02;Share Draft#281) TOTAL (Also enter on line 10, Recapitulation) $ AMOUNT 1,085 136 100 6 37 29 240 1, 633 (If more space is needed, insert additional sheets of the same s~ze~, j REV-1513,EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER 21-02-00227 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE John Peiper NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Hark R.Peiper 110 New Hillcrest Dr. Cumberland, PA 17070 J.Christopher ?eiper 1947 Edwood Rd. Balimore,MD 21234-5244 Son Son 1/2 of Residual 1/2 Of Residual 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 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 1W46AI 2000 (If more space is needed, insert additional sheets of the same size) E. -TRADE® .F /N A N P- I A L // April 15, 2002 Mark R Peiper 110 Hillcrest Drive New Cumberland, PA 17070 RE: John E. Peiper Account # 4925-1450 Dear Mr. Peiper, Thank you for your letter dated March 27, 2002. We would like to take this opportunity to provide the date of death value for Mr. Peiper as of January 07, 2002. Assets I Symbol 480 Shares PPL Closing Price 32.88 Enclosed is a January Statement to clarify money market value and other account specifics. Please note, in order to transfer securities or change the account title, it is a legal requirement that certain documents are received in order to process and update the account. We will require the following: · Affidavit of Domicile · New Account application (this form is enclosed) E'TRADE is committed to providing the highest level of service. Should you have any further questions regarding this matter, please call Customer Service at 1-800-786-2575. We are available to you 24 hours a day, 7 days a week. E'Trade Securities P.O. Box 989030 West Sacramento, CA 95798-9030 Attn: Account Services Sincerely, Account Services E'TRADE Securities E~TRADE Securities, Incorporated P.O. Box 989030 West Sacramento, CA 95798-9030 t: 1.800.786.2575 etrade, com '.t.m~er NASDISIPC /~~J A N U S April 4, 2002 Mark R Peiper 110 Hillcrest Dr New Cumberlnd PA 17070-3030 Reference: 01160024 Janus Money Market Fund Account Number 203798807 John E Peiper Dear Mr. Peiper: Thanks for your inquiry to Janus. We received your request for balance information regarding all funds listed under account number 203798807 on April 2, 2002. The account information listed below is unaudited and is being provided to you as an exception to our mailing of an audited statement. 01/07/2002 37-203798807 Balance $1.00 01/0712002 41-203798807 Balance $44.16 01/07/2002 42-203798807 Balance $25.0-------~ 01/07/2002 48-203798807 Balance $21.13 01/07/2002 49-20379~8U7 Balance $9.23 01/07/2002 51-203798807 Balance $19.71 01/07/2002 52-203798807 Balance $2.94 01/07/2002 55-203798807 Balance $18.10 01/07/2002 59-203798807 Balance $17.04 01/07/200_,,,~_____~2 61-203798807 Balanc__,_._~~e $9..~45 Shares Account Value 98.000 $98.00 36.996 $1 633.74 28.361 $711.29 33.978 $717.96 1,069.556 ~9,872.00 29.601 $583.44 3,394.757 $--9,980.59 150.195 $__2,718.53 61.234 $1 043.43 38.048 $359.55 If you plan to re-register the above-referenced account number 203798807, we'll require the following additional iniormation: A letter of instruction signed in capacity by you and Mr. J. Christopher Peiper as the estate representatives. We'll require both of your signatures to be guaranteed if you are not re- registering the account to the estate or if both of you will not be the sole owners to the account. A new Account Application signed by the new owners. If you plan to split the account equally into two individual accounts, then we'll require a separate Account Application from each of you. Untitled I/7/02 8:09 PM As of 01/0712002 20:09:16, here's a summary of all of your accounts. For detailed information on a specific account, just click on that account. Account SAVINGS CHECKING SHAREACCOUNTS Account # 186983-00 186983-11 Balance $25'00 $5706.22 https://online, members I st.org/Members 1 stOnline/act/act_0 I. htm l Page I of l Filing Instructions Form 1040 U.S. Individual Income Tax Return Taxable Year Ended December 31, 2001 Name: Date Due: Remittance: Mail To: Signature: Other: JOHN E PEIPER April 15, 2002 None is required. The remm shows a total overpayment of $264 which is to be refunded in its entirety. Internal Revenue Service Philadelphia, PA 19255-0002 You should sign and date the return on Page 2. Initial and date the copy, and retain it for your records. Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters WHEREAS, on the 4th dated November 21st 1981 No. 2002-00227 PA No. 21-02-0227 ESTATE OF PEIPER JOHN E (~^S'r, ~'~'~.', Ml~Ub~) l,at~ of CARLISLE BOROUGH CUMBERLAND C©UNTY[ Deceased Social Security No. 189-09-4552 day of March 2002 an instrument was admitted to probate as the last will of PEIPER JOHN E (bA~T, P'IRST, MIDDb~) late of C~RLISLE BOROUGH , CUMBERLAND County, who died on the 7th day bf January 2002 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted I,etters TESTAMENTARY to PEIPER J CHRISTOPHER and PEIPER MARK R who have duly qualified as Executor(rix) and have agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal 4th day of March 2002 . of my Office the Register or ~lllS **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND estate of PEIPER JOHN E ( ~ 'f-~'i', ~'ll/~'l', I~I~L3~ ,~) in said county, deceased, to PEIPER MARK R (LAS'±', ~'±M~'±', Ml~Om~) MARY C. LEWIS SHORT CERTIFICATE Register for the Probate of Wills and Granting Letters of Administration &c. in and for said County of CUMBERLAND do hereby certify that on the 4th day of March A.D., Two Thousand and Two, Letters TESTAMENTARY in common form were granted by the Register of said County, on the , late of CARLISLE BOROUGH PEIPER J CHRISTOPHER (~A~'f, ~'±~'1', and and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 4th day of March A.D., Two Thousand and Two. File No. 2002-00227 21-02-0227 1/07/2002 189-09-4552 PA File No. Date of Death s.s. # ster NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF iNDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PEIPER MARK R 110 HILLCREST DRIVE NEW CUMBERLAND, PA PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT DUPLICATE 17070 NO. REV-1162 EX(11-96) CD 001224 ........ fold ESTATE INFORMATION: SSN.. 189-09-4552 FILE NUMBER: 2102-0227 DECEDENT NAME: PEIPER JOHN E DATE OF PAYMENT: 05/28/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/07/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,945.00 I REMARKS: MARK PEIPER TOTAL AMOUNT PAID: $1,945.00 SEAL CHECK#1023 INITIALS: SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Date of Death: ~'~l'.~. '7, 20C3 ~__ Will No. ~] - O~.~,~ - r'~ ~"] Admin. No. (~c~-~QO~ q 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 [ ' I~'~ 2.-C)Cz, ~ : Name Address u070 2~Z ~__~~ Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Signature Name ~/~~ Address //O ~//z//~ r~ ~J~/'~,.~__ Telephone (rt?) q~f-- ZoO Capacity: _ b~Personal Representative Counsel for personal representative BUREAU OF ZNDZVZDUAL TAXES ZNHERTTANCE TAX DTVTSTON DEPT. 28060! HARRISBURG, PA 17128-0601 HARK PEIPER 110 HILLCREST DR NEN CUHBERLAND COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRATSEHENT, ALLONANCE OR DTSALLO#ANCE OF DEDUCTTONS AND ASSESSHENT OF TAX 'JdL PA 170,70-1058 DATE 07-08-2002 ESTATE OF PEIPER DATE OF DEATH 01-07-2002 FILE NUHDER 21 02-0227 COUNTY CUHBERLAND ACN 101 JOHN E Amount Remitted HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 ..... .... REV Z5~7 EX AFP (0! 02) NOTICE OF ZNHERZTANCE TAX APPRAZSEHENT, ~[[~-~- ................. ESTATE OF DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX PEIPER JOHN E FILE NO. 21 02-0227 ACN 101 DATE 07-08-2002 TAX RETURN NAS: (X) ACCEPTED AS FILED RESERVATTON CONCERNTNG FUTURE INTEREST - SEE REVERSE ( ) CHANGED APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Rai! Estate (Schedule A) (z) .00 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnarsh/p Interest (Schidule C) ($) .00 ~. Nortgages/Notas Reca/vabZe (Schedule D) (~). .00 $. Cash/Bank Dapos/ts/H/sc. Persona! Property (SchaduZa E) 6. Jo/ntly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) 8. Tote1 Assets (7) .00 APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funera! Expenses/Ada. Costs/N/sc. Expanses (Schedule H) (9) 4,846.00 10. Debts/Hortgage L/abil/t/as/Liens (Schedule T) 11. Total Deduct/ohs (10).. 12. Nat Value of Tax Return 1~635.00 (11) NOTE: To /nsura proper cred/t to your account, sub./t the upper port/on of th/s form w/th your tax payment. 49,696.00 6.~7q.00 43,217.00 1,945.00 .00 .00 .00 TF TOTAL DUE TS LESS THAN $1, NO PAYNENT .TS REQU.TRED. TF TOTAL DUE TS REFLECTED AS A "CREDTT" (CR), YOU HAY DE DUE REFUND. SEE REVERSE STDE OF THTS FORH FOR TNSTRUCTTONS.) 15. Amount of L/ne lq at Spousal rata (15). .00 X O0 = 16. Amount of L/ne Z~ taxable at L/neaZ/CZass A rata (16) 43,217.00 X 045 = 17. Amount of L/ne 1~ at S/bl/ng ra~e (17) .00 X 12 = 18. Amount of L/ne 1~ taxable at Collateral/Class B rata (18) .00 X 15 19. Principal Tax Due " =  (19)~ _ DATE NU ~. ZNTERES/T PEN p;ZD (_) ANOUNT PAID B_~ANCE OF TAX DUEI 'ZNTEREST AND PEN. ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE TOTAL DUE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. .00 1,945.00 .00 .00 1,945.00 (12) 15. Char~tibia/Governmental Bequests; Non-electad 9115 Trusts (Schedule J) (15) O0 Iq. Nat Value of Estatl Subject to Tax ' (~q) 43,217.00 NOTE: If an assessnent ~as issued Pre¥iously, lines 14, 15 and/er 16, 17, 18 and 19 ~ill reflect figures that include the tote! of ALL returns assessed to date. ASSESSHENT OF TAX.- -. BUREAU OF ZNDZVTDUAL TAXES TNHERZTANCE TAX DIVISION DEPT. Z60&O1 HARRISBURG, PA ITl!s-0601 COMHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEMENT OF ACCOUNT CARL WILLIAM SOU~£RS ...... ~-" 9~ HCALLISTER CHRCH RD CARLISLE ~ PA 17015 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-19-2002 HCLAUGHLIN GRACE V 09-Z~-ZO0! 2! 01-0927 CUMBERLAND !01 ~ Amoun~ R~i~ed HAKE CHECK PAYABLE AND RENZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA !7015 NOTE: To insure proper cred/~ ~o your account, subm/~ ~he upper portion of ~his form wi~h your ~ex Payment. ,!NE - .......... --GV-A~ E .......................... ~vw~K ~URTZON FOR X AFP COZ-O~) ............... YOUR RECO ~ !NH ............. ERZTANCE TAX ~nGn/ uP ACCOUNT ~ ..................... ESTATE OF NCLAUGHLZN GRACE V FILE N0.21 01-0927 ACM 101DATE 08-19-2002 THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACM ZN THE NAHED ESTATE. SHOHN BELOH ZS A SUHHARy OF THE PR!NC!PAL A PROJECTED INTEREST FIGURE. TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND~ ZF APPLICABLE, DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-05-2002 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): DATE NUMBER 12-2~-Z001 CD000690 06-2~-2002 CDOOZ526 DISCOUNT (+) INTEREST/PEN PAID ¢-) AMOUNT PAID 100.00 1,900.00 · 00 ~,502.09 6,502.09 ZF PAZD AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT 15 REQUIRED. TOTAL TAX CREDIT BALANCE OF TAX DU~ INTEREST AND PEN. TOTAL DUE ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 6,302.09 .00 .00 .00 01×~6×200~ 17:00 No.: '~ lo Pale 5.12 of theSupmmc Cotut Orphs.~s, C. aurt Rules. I r~port follow/nl~ wi~h r~spe~t to- ~npietion ofthc _~d~i-lstration of.the above-captioned es~e: ~. Didtl~tmo~_ ~]~m~iv~ f~ a ¢-.~ actium with Y~ _ c. Did ~ personal r~ m iute~o~Y=~ No' ~ - To.hone No. 1'7o70