Loading...
HomeMy WebLinkAbout04-0487 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of ROBERT A. RANBERG No. ~l- ~)~- ~ ~ 7 a/k/a ROBERT ALFRED RANBERG, Deceased Social Security No. 028-20-7661 SARA E. TORTI Petitioner, who is 18 years of age or older, applies for: (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner is the executrix named in the Last Will of ~'~ the Decedent, dated Nm, ember 2;0~ 2;003 and codicil(s) dated State relevant circumstances, e.g. renunciation, death of Executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not to victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration :" (d.b.n,c.t,a.: pendente lite; durante absentia; durante min(~te) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was surviv~ by the following spouse (if any) and heirs: ~._~ Name Relationship Residencei~i:: teMPI, filE IN ^LI. C^SES: ^ttach additional sh~t$ if nec~&.~rg. Decedent was domiciled at death in Cumbedand County, PennsylYania, with his last family or principal residence at 3'16 Poplar Avenue, Borou.qh of blew Cumberland, Cumberland County, Pennsylvania (List street, number and municipality) Decedent, then 75 years of age, died ~ri129, 2004 at 8 Country Squire Drive, blorfolk, Norfolk County, MASS {t.o~tion) Decedent at death owned property with estimated Yalues as follows: (If domiciled in PA) All personal property .................................................................... $ 2'10,330.00 (If not domiciled in PA) Personal properly in PennsylYania ..................................... $. (If not domiciled in PA) Pemonal property in County .................................................... $. Value of real estate in Ponnsyl¥ania ...................................................................................................................... $ 135~000.00 'rota~ ......................................................................................................... $ 345,330.00 ~eal fistate situated as follows: 3'16 Poplar Avenue, Borou.qh of blew Cumberland, Cumberland County, PA Wherefore, Petitioner respectfully requests the probate of the last Will presented with this Petition and tho grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence SARA E. TORTI c.~//--~''''' . ~ ~. ~ 8 Country Squire Drive ~ ~ Norfolk, MA 02056 Register of Wills Office Cumberland County Courthouse One Courthouse Square~..: Carlisle, PA 17013 r~ Re: Estate of Robert A. Ranberg a/Ida Robe~,~Alfred Ranberg SSN: 028-20-7661 Our File No. 9355-1 Your File No. 2004-00487 Dear Register of Wills Office: Enclosed for filing please find the following documents for the above referenced decedent: 1. 2 Original PA Inheritance Tax Returns. There is remaining tax due in the amount of $1,140.57. Estate Check No. 138 is attached to the Return. 2. 2 copies Pages 1&2 of the Pa Inheritance tax retum, which we ask that you time-stamp and return to us in the enclosed envelope. 3. Inventory 4. 2 copies of Page 1 of the Inventory which we ask that you time stamp and return to us in the enclosed envelope. 5. Our Check in the amount of $34.00 representing filing fees for Inheritance Tax Retum (15.00) and Inventory ($19.00) Should you have any questions, please do not hesitate to contact our office. Thank you for you assistance in this matter. Very truly yours, ~.J~HNSON, DUFFLE, STEWART & WEIDNER .... -Dana L. VVi~seman Legal Assistant c: Sara E. Torti, Executrix #237921 501 M,'\RKET STREET P.O. BOX 109 LEMOYNE. PENr','SYI,V.,\NIA 17045-0109 WWW. II)SW. COM 717.761.4540 FAX: 717.761.3015 MAIL@II)S\V. COM JOHNSON, DUFFLE, STEWART & WEIDNER, P.C. COMMONWEALTH OF PENNSYLVANIA REV-1162 EX{11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004543 TORTI SARA E 8 COUNTRY SQUIRE DRIVE NORFOLK, MD 02056 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold .................. 101 $1,140.57 ESTATE INFORMATION: SSN: 028-20-7661 FILE NUMBER: 21 04-0487 DECEDENT NAME: RANBERG ROBERT A DATE OF PAYMENT: 10/25/2004 POSTMARK DATE: 1 0/22/2004 COUNTY: CUM BERLAN D DATE OF DEATH: 04/29/2004 TOTAL AMOUNT PAID: $1,140.57 REMARKS: RANBERG CHECK//138 INITIALS: CCP SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS OFFICIAL USE ONLY REV-150o E×* (6-001 REV-- 1500 COMMO.WEA,THOFPE..SY'VA.IA INHERITANCE TAX RETURN FILE NUMBER DEPARTMENT OF REVE.UE RESIDENT DECEDENT 21- 04-0487 DEPT. 280601 HARRISBURG, PA 17128-0601 i COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER D~ RANBERG Robert A. 028-20-7661 C DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE RI.ED IN DUPLICATE WITH THE E ED 04/29/2004 I 11/07/1928 REGISTER OF WILLS N (iF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER T H ~date of death  1. Original Return U 2. SupplementaIReturn 3. Remainder Return ~rlorto 12-13-82) C A P B 4. Limited Estate F~ 4a. Future Interest Compromise (date of death after 12-12-82) 6. Federal Estate Tax Return Required H P R L 0 8. Total Number of Safe Deposit Boxes E P I O 6. Decedent Died Testate 7. Decedent Maintained a Living Trust C R A C (Attach copy of Will) (Attach copy of Trust) KOTK ES ~] 9. Lltlgation Proceeds Received [~10. Spousal Poverty Credlt ~-~ 11. Electlon to tax under Sec. 9113(A) (date of death between 12-31-91 and 1-1-95) (Attach Sch O) NAME ;OMPLETE MAILING ADDRESS C OP P.O. Box 109 O Edmund G. Myers R ~ FIRM NAME(IfAppllcable) 301 Market Street R E ~ :lohnson, Duffie, Stewart & Weidner Lemoyne, PA 17043-0109 S T TELEPHONE NUMBER 717/761-454o 1. Real Estate (Schedule A) (1) 151 , 000~._0.~0 OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule B) (2) 67,724;-~4',8 3. Closely Held Corporation, Partnership or (3) N'one ~-~ · Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (4) None R 6. Cash, Bank Deposits & Miscellaneous Personal Property (5) 125,537,60 E (Schedule E) C A 6. Jointly Owned Property (Schedule F) (6) None P I r~ Separate Billing Requested T U 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 197,70~ 129 ~ L (Schedule G or L) ~ 8. Total Gross Assets (total Lines 1-7) (8) 541,963.37 I O 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 25,682.60 N 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 23,098.46 11. Total Deductions (total Lines 9 & 10) (11) 48,781.06 12. Net Value of Estate (Line 8 minus Line 11) (12) 493,182.31 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13). made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 493,182.31 C O SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES M · T I~ 15. Amount of Line 14 taxable at the spousal tax A [ rate, or transfers under Sec. 9116(aX1.2) 0.00 X .0 0 (15) 0.00 X T 16. Amount of Line 14 taxable at lineal rate 493,182.31 X .0 45 (16) 22,193.20 I 17. Amount of Line 14 taxable at sibling rate 0.00 X .12 (17) 0.00 O N 18. Amount of Line 14 taxable at collateral rate 0.00 X .15 (18). 0.00 19. Tax Due (19) 22,193.20 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 316 Poplar Avenue CITY STATE I ZIP New Cumberland PA I 17070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 22,193.20 2. Credits/Payments A. Spousal Poverty Credit 0.00 B. Prior Payments 20,000.00 C. Discount 1 , 052.63 Total Credits ( A + B + C ) (2) 21,052.63 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference, This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1,140.57 A. Enter the interest on the tax due. (SA) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 1,140.57 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 ;. retain the use or income of the property transferred; ......................... · 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? ................................ ~'~ ~'] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all Information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Sara E. TORTI DATE ~/ ~T~' 8 Count.r~ S uire Dr // ~ Norfolk, MA 02056 SIGNATUR~OFPREPAREROTHERTHAN REPRESENTATIVE Johnson, Duffle, Stewart & Wetdner 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. 9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2) [72 P.S. 9116(aXl)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(aXl.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. Copyright (c) 2000 form software only The Lackr~r Group, Inc. Form REV-1500 EX (Rev. 6-00) REV-1502 EX+ (1-97) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Robert A. RANBERG SS# 028-20-7661 04/29/2004 21-04-0487 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledc,]e of the relevant facts. Real property which is iointly-owned with ric~ht of survivorship must be diaclosed on Schedule F. VALUE AT DATE ITEM DESCRIPTION NUMBER OF DEATH 1 Residence located at 316 Poplar Avenue, New Cumberland, 151,000.00 Pennsylvania. Tax Parcel No. 25-25-0008-081. Deed Book W, Volume 20, Page 191. - Contracted Sales price. Settlement took place on July 29, 2004. A copy of the Settlement Sheet is attached to this Return TOTAL (Also enter on line 1, Recapitulation) $ 151,000.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-150:~ EX (Rev. 1-97) .Er-,503 EX+ It-9?l SCHEDULE B CO.MO.WEA'T. Or PE.NS¥,VAN~^ STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Robert A. RANBERG SS~/ 028-20-7661 04/29/2004 21-04-0487 All property jointly-owned with right of survivorship must be disclosed on Schedule F. VALUE AT DATE ITEM DESCRIPTION UNIT VALUE OF DEATH NUMBER 1 Series EE United States Savings Bonds - 44 Series EE 67,72/+.48 United Stated Savings Bonds issed in February of 2001 at an Interest Rate of 4% with a Final Maturity Date of February 2021. TOTAL (Also enter on line 2, Recapitulation) 67,72/+. 48 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1503 EX (Rev. 1-97) 1508 EX + (1-97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCETAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Robert A. RANBERG SS~ 028-20-7661 04/29/2004 21-04-0487 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH i 2003 Federal Income Tax Return Refund 528.00 2 Health South Refund 31.62 3 Pennsylvania State Employees Credit Union Certificate of Deposit 16,077.12 Account (ID64) 4 Pennsylvania State Employees Credit Union Certificate of Deposit 14,748.86 Account (ID65) 5 Pennsylvania State Employees Credit Union Checking Account 3,595.02 6 Pennsylvania State Employees Credit Union Money Market Account 43,560.96 ( ID07 ) 7 Pennsylvania State Employees Credit Union Savings Account 10.23 8 Refund of Home Owners Insurance 249.70 9 Refund of Insurance on Airstream 67.60 10 Refund of Decedent's Automobile Insurance 150.28 11 Refund of Decedent's Personal Liability Insurance 17.48 12 Residence located at 316 Poplar Avenue, New Cumberland, 1,423.77 Pennsylvania. Tax Parcel No. 25-25-0008-081. Deed Book W, Volume 20, Page 191. - Reimbursement of real estate taxes at settlement. The Settlement Sheet from the sale of the property on July 29, 2004 is attached to this Return 13 State Farm Insurance Premium Refund 4.82 14 UGI Corp - Refund on Account 8.17 15 1988 Airstream RV - Sold to private party 3,000.00 16 2002 GMC Envoy. Valued using Kelly Blue Book Value and attached 23,860.00 to this Return 17 Household Items valued and apprasied - Miscellaneous household 7,085.00 items were valued and apprasied by Claude Wolf & Associates. Appraisal is attached to this Return. 18 Oriental Rugs valued and appraised by Essis & Sons Carpets. 9,622.00 Total of Continuation Schedule(s) 1,496.97 TOTAL (Also enter on line 5, Recapitulation) $ 125,537.60 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) ~EV-15~o EX, 0-97/ SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ~ ESTATE OF FILE NUMBER Robert A. RANBERG SS~ 028-20-7661 04/29/2004 21-04-0487 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THENAME OF THE TRANSFEREE. THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (~F APPLICABLE) 1 Pennsylvania State 47,505.66 47,505.66 Employees Credit Union IRA Beneficiary: Sara Tort i -Daughter 2 Principal Financial Policy 83,403.00 83,403.00 No. 0166434. Single Premium Deferred Fixed Annu ity Beneficiaries: Sara Tort i-Daughter Erik Ranberg - Son 3 Protective Life Insurance 66,792.63 66,792.63 Company. Account No. PX0004232. Non-Qualified Annuity Beneficiaries: Ertk Ranberg- Son, Ian Ranberg-Son, and Sara Tort i - Daughter TOTAL (Also enter on line 7, Recapitulation) $ 197,701.29 (If more space is needed, insert additional sheets of the same s~ze) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1510 EX (Rev. 1-97) REV-1511 EX, (1-S7) I SCHEDULE H COMMONWEALTH OF PENNSYLVANIA I FUNERAL EXPENSES & IN HERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Robert A. RANBERG SS~ 028-20-7661 04/29/2004 21-04-0487 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 8,100.00 Name of Personal Representative(s) Sara F.. '['OR'['[ Social Security Number(s) / EIN Number of Personal Representative(s) Street Address 8 Country Squire Dr Norfolk State MA Zip 02056 Year(s) Commission Paid: 2. Attorney's Fees Johnson, Duffle, Stewart & Weidner 8,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State__ Zip Relationship of Claimant to Decedent 4. Probate Fees Re§ister of Wills 351,00 5, Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Bank Fees for Check Printing 14.50 2 Claude Wolf, Appraisal of Decedent's Personal Property 375.00 3 Expenses incurred by Executrix to secure assets of the Estate; 5,473.90 removal of trash from residence of Decedent; preparation of the residence for sale. 4 Mid State - Repairs to the Decedent's sidewalk prior to the sale 2,848.00 of the Residence 5 Register of Wills Office Filing Fees for Inheritance Tax Return 34.00 Total of Continuation Schedule(s) 486.20 TOTAL (Also enter on line 9, Recapitulation) $ 25,682.60 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) Estate of: Robert A. RANBERG Soc Sec #: 028-20-7661 Date of Death: 04/29/2004 Continuation of Schedule H-B7 (Other Administrative Costs) Item Description Amount ($15.00) and Inventory ($19.00) 6 Reserves held for additional administrative expenses 250.00 7 The Cumberland Law Journal - Notice of Estate Administration 75.00 8 The Patriot News Notice of Estate Administration 133.90 9 United States Post office - Express mail re: Sale of Residence 27.30 486.20 REV-1512 EX + (1-97) SCHEDULE I DEBTS OF DECEDENT, COMMONWEALTH OF PENNSYLVANIA INHERITANCE T~RETURN MORTGAGE LIABILITIES, AND LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Robert A. RANBERG SS# 028-20-7661 04/29/2004 21-04-0487 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 American Ramp Rental 840.00 2 Baer Care - Property Maintenance 455.80 3 Checks of Decedent clearing after date of death 2,929.05 4 CitiCards Account - Final Card Payment 555.00 5 Comcast Cable Television 19.13 6 Franconia Storage - 5 Months 715.50 7 Pennsylvania American Water Company 55.01 8 Pennsylvania Power & Light 179.47 9 Pennsylvania State Employees Credit Union Visa Account 2,156.07 10 Pennsylvania State Employees Retirement System - Reimbursement of 49.51 Overpayment 11 Pinnacle Health Infusion 99.84 12 Quantum Imaging 2.25 13 Residence located at 316 Poplar Avenue, New Cumberland, 14,438.95 Pennsylvania. Tax Parcel No. 25-25-0008-081. Deed Book W, Volume 20, Page 191. Settlement charges for the sale of the Property on July 29, 2004. The Settlement Sheet is attached. 14 State Farm Insurance Premium Payment 110.99 15 UGI Utilities 188.95 16 Verizon Telephone Final Telephone Bill (Pennsylvania) 25.47 17 Verizon Telephone Final Telephone Bill (Massachusetts) 133.50 18 Walpole VNA 60.00 19 Waste Management 83.97 TOTAL (Also enter on line 10, Recapitulation) $ 23,098.46 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Robert A. RANBERC SS~; 028-20-7661 04/29/2004 21-04-0487 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(aX1.Z)] 1 Erik Ranberg Son 1/3 of 8031/2 Selkirk Street Tangible West Palm Beach, FL 33405 Personalty and 1/3 of Residue, IN TRUST 2 Ian Ranberg Son 1/3 of 376 West Chestnut Street Tangible Souderton, PA 18964 Personalty and 1/3 of Residue 3 Sara E. Torti Daughter 1/3rd of 8 Country Squire Drive Tangible Norfolk, MA 02056 Personalty and 1/3 of Residue ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET II, NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONSUNBER SEC. 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 $ 0.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) Z000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) LISTING OF EXHIBITS FOR ESTATE OF ROBERT A. RANBERG EXHIBIT A Last Will and Testament for Robert A. Ranberg signed and dated November 20th, 2003. EXHIBIT B Settlement Sheet for the sale of property located at 316 Poplar Street, Borough of New Cumberland, Pennsylvania. Property sold on duly 29th, 2004. EXHIBIT C Kelley Blue Book Report for 2002 GMC Envoy acquired at kkb. com EXHIBIT D Appraisal of Personal Property by Claude Wolf & Associates. The value of the Rugs are not included on the total on the Return from this Appraisal. EXHIBIT E Appraisal of Oriental Rugs by Essis & Sons Carpets .'237917 'OMB. No. 2502-0265 Paqe 1 of 2 ~UD~I UNIFORM SETTLEMENT STATEMENT ........................................ A. U,S. DEPARTMENT OF HOUSING AND U:' ,N DEVELOPMENT SETTLEMENT STATEMENT B. TYPE OF LOAN 6. File Number: 7. Loan Number: I. ¢' FHA 2 FmHA 3. Conv. Unins. 77774105 4. -- VA 5. __~ Conv. Ins. 8. Mortgage Insurance Case Number: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked '(p.o.c.)' were paid outside the closing; they are shown here for informational purposes and are not included in the totals. NOTE: TIN = Taxpayer's Identification Number D. NAME AND ADDRESS OF BORROWER: E. NAME, ADDRESS AND TIN OF SELLER: F. NAME AND ADDRESS OF LENDER: Brooke R Williazus and Mark J. Miller Estate of Robert A. Ranberq~- Commerce Bank/Harrisburq NA 316 Poplar Avenue c/o 301 Market Street~16A 100 Senate Avenue New Cumberland PA 17070 Lemoyne PA 17043~ Camp Hill PA 17011 20-6209397 G, PROPERTY LOCATION: H. SETTLEMENT AGENT: NAME, ADDRESS AND TIN 316 Poplar Avenue Dorm L. Snyder Agent for FNTIC New Cumberland PA 17070 Saul, Ewing LLP_-_~_-cl010D 25-2.5-0008-081 2 North Second St 7th Floor (717)257-7552 Harrisburg PA 17101-_- (16A PLACE OF SETTLEMENT: I 1. SETTLEMENT DATE: 33!5 Market Street I 07/29/047.': Ce.rap Hill PA 17011 Disbursement Date: 07/29/04 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract sales price I $151,000.0077 (~e~. Contract sales price t 5151,000.00.: 102. Personal property t 402. Personal 103. Settlement charqes to borrower (line 1400) 54,041.48 403. 104. 404. 105. 405. j iustments for items paid by seller in advance ustments for items paid by seller in advance taxes to taxes to 107. County taxes o7/29/o4_- to 12/31/04D $2?6.024 407. County taxes 07/29/0,~ to 12/31/04E $276.02,~ 108. Assessments 07/29/04/, to 06/30/05~ 408. Assessments 07/29/04~ to 06/30/05E 51,147.75 109. 409. 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER $156,465.257 (zl.~;). GROSS AMOUNT DUE TO SELLER $!52,423.77~ 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. Deoosit or earnest money $5, o0o. oo: 501. Excess see instructions ) 202. Principal amount of new loan(s) 5143,45o. ccc (~. Settlement charqes to seller (line 1400) 512,504.26'; 203. Existin( taken subiect to 503. Existin¢ taken subiect to 204. Credit from Seller for radon mir. icratio . $400.00 of first mortqaqe loan. 205. Credit from Seller for repairs Of second mortc loan 206. 506. Credit to Buyers for radon mitiqation $400.00~ 207. 507. Credit to Buyers for repairs $1~500.00t 208. 508. 209. 509. Adiustments for items unpaid by seller ustments for items unpaid, by seller taxes to 510. City/town taxes to 211. County taxes to 511. County taxes to 212. Assessments to 512. Assessments to 213. 513. 214 514. 215 515. APril June $21.83_ 3ril throuc June $21. 217, Trash for July $12.86 517. Trash for July $12.86~ 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER $150,384. (5~9. TOTAL REDUCTION AMOUNT DUE SELLEF $14,438. 300. CASH AT SETTLEMENT FROM/TO BORROWER 600. CASH AT SETTLEMENT TO/FROM SELLER 301. Gross amount due from borrower, 5156,465.25 601. Gross amount due to seller ( line 420 ) I $z-'-f-f;'4--'-~ 302. Less amounts paid by/for borrower, $150,384.6,c 602. Less reduction in amount due seller(I 520) t( $14,438.95)? , 303. CASH ( ¢" FROM) (:_._ TO) BORROWER 56 o80 56 603. CASH (:__¢' TO) (__ FROM) SELLER $137,984.82-- SUBSTITUTE FORM 1099 SELLERS STATEMENT The information contained in Blocks E,G,H and I and on Line 401 ( or if Line 401 is asterisked, Line 403 and 404 ) is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS determines that it has not been repot:ed. tf this real estate is your principal residence, file Form 2119, Sale or Exchange of Principal Residence for any gain, with your income tax return: for other transactions, complete the applicable parts of Form 4797, Form 6252 and/or Schedule D (Form 1040). You are required to provide the Settlement Agent (named above) with your correct taxpayer identification number. If you do not provide the Settlement Agent with your correct taxpayer identification number, you may be subject to civil or criminal penalties imposed by Law Under penalties of perjury, I certify that the number shown on this statement is my correct taxpayer identification number. Seller HUD-1 (3-86) · OMB."No. 2502-0265 Pane 2 of 2 L. SETTLEMENT CHARGES '~ ...... c°~; ?0f.3.TOTAL SALES/BROKER'S commission ed on price $t51, ooo. o.~, 6. ooo %= o6o. oo PAID FROM PAID FROM Division of commission ( tine 700 ) as fohuws: BORROWER' SELLER'S .. 701. 54,555.oo to ~e~a× ~ealty Assoo.tates ]:nc. FUNDS AT FUNDS AT 702 54,5o5.0o to centu='¥ 21 ~'iscionarz SETTLEMEN'I SETTLEMENT 703. Commission paid at Settlement $9, o60. 0022-16A 59,060.00_ 704. 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Oriqination Fee % 802. Loan Discount % 803. Appraisal Fee $2?5. oo to App=,,isal Firm 'mc $275.00 804. Credit Report to 805. Lender's Inspection Fee 806. Mortqaqe Ins. Application Fee to 807. Assumption fee to 808, Underwritin~ Fee - Commerce Bank $245.00;:]---16A 809, Document Preparation - Commerce Bank ($150 Waived) 810. Courier Fee to Commerce Bank ($25 Waived) 81'~. Flood Certification to US Determ3-nation ($6.00 Waived) 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from 07/29/04_- to 07/31/04C_-. (16A~, 25.4000 /day $76.20_-~_ 902. Mortqaqe Insurance Premium for mo. to 903. Hazard Insurance Premiums for yrs. to 90~.. P=ocess.l. ng Fee - $75.00 Waived yrs. to Commerce Bank/Harr'ishu_rg NA 9o5. I 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard insurance 3 mo. ~.. $29.1'72_- /mo. 581 1002. Mortqaqe insurance mo. ~, /mo. / 1003. City property taxes mo. ('~ /mo. 1004. County prooerty taxes 6 mo. ~,, $55.63F-f16A/mO. $333.7@ 1005. Annual assessments 2 mo. (~, $'~O4.98-_-¢'[6A/mo. $209.96_-[/_(16A 1006. mo. ~, /mo. 1007. mo. ~. /mo. . 1008. Aggregate Adjustment ($251,72) I 1100. TITLE CHARGES 1101. Settlement or Closinq Fee to 1102. Abstract or title search to 103. Title examination to 104. Title insurance binder to 105. Document Preparation to 106. Notary fees to 107. Attorney's fees to (includes above item number) 1108. Title Insurance $1,113.75-to Donn L Snyder Aqent for FNTIC $1,113.75 (includes above item number) 1109,., Lender's coveraqe $143,450. oo 1110 Owner's coveraqe 5!52,000. 002_-_-c1006D 1111. Title Endorsements Required by Lender $150.00 1112. Remax Tax Certification $4.00 11113, 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordino fees: Deed $38.502 ;Mortqaqe $58.501£ (z;6{elease $97 .00~ 1202. City/county tax/stamps: Deed $1,510.00 ;Mo~qaqe , $1,510.00 I 1203. State tax/stamps: Deed $1,510. oo::g (l:6/~ortaaqe ; I $1,510.001 1204. 2004-2005 School Tax - West Shore School District I $1,246.812 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to t .1~3~0~. MidLstat~e ($? F;&,0) to cu=b:-n9 & Sidewalk: ~.e=a.:.rs t POC ],JO3. Realtors ~rocessin~ Fees $195.00 $195. 1304. Aaa Warranty I $405.00F 1305 Waste Ma_~a~ement - APril through Ju~e I $40.53 1306. Sewer January ~=ough Marchr i $22.921 1307. Gary Muc=io - Borough Certification re: Ordinance Compliance I $20.00- 1400. TOTAL SETTLEMENT CHARGES ( enter on lines 103 and 502, SectionsJandK) $4,041.481.~ $12,504.26 have carefully reviewed the HUD - 1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a coj~y of the HUD - 1 Settlement Statement. /'") ~ -~,,-4-z"--,_,~ 1~,~..~' ' Seller ~,~L~ ~J[~ tl,ff ~/~/ Borrower / ~ rooke P, "l'l' "'%'= (1-6A To the best of my knowledge the HUD- I Settlement Statement which I have prep,a¢¢~ ,f's a tru~,,a, nd ac, d"pCate account of the funds which~ were received and have been or will be disbt~rsed by the undersigned as I::~o th~en~ this tralnsaction. Settlement Agent /~///'~/"-/{t~, ,,%/' 7',,/~¥'--',,~-~ ~%/.-~,-~ ~;'~- Date 07/29/o~' WARNING: It is a crime to knowingly make false statements to the United States on this or any similar forq"n':-Penalties upon convict;'on can include a fine and imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. Kelley Blue Book Used Car Values TII~ TRUSTED IhT:SOUR:CE BLUE BOOK PRIVATE PARI REPORT ................................................... Pennsylvania · June 22, 2004 2002 GMC Envoy XL Sport Utility 4D Search Listings for This Car .Us_. Buy a New Car E.c_e..e_... L~ m o n ...C h e.c.!~ Auto Loans from 3.85% APR Engine: 6-CyI. 4.2 Liter Trans: Automatic Print "For Sale" Sig~ Drive: 4 Wheel Drive Payment Calculator Mileage: 17,000 Equipment SLT Cruise Control Leather Air Conditioning AM/FM Stereo Dual Power Seats Power Steering Multi Compact Disc Running Boards Power Windows OnStar. Towing Pkg Power Door Locks Dual Front Air Bags Premium Wheels Tilt Wheel ABS (4-Wheel) Wide Tires Consumer Rated Condition: Excellent "Excellent" condition means that the vehicle looks great, is in excellent mechanical condition and needs no reconditioning. It should pass a smog inspection. The engine compartment should be clean, with no fluid leaks. The paint is glossy and the body and interior are free of any wear or visible defects. There is no rust. The tires are the proper size and match and are new or nearly new. A clean _hi~.t~.~y is assumed. This is an exceptional vehicle. Private Party Value Search Local Listings for This Car $20,860 Private Party value represents what you might expect to pay for a used car when purchasing from a private party. It may also represent the value you might expect to receive when selling your own used car to another private party. Get a Used Car Trade-In Value Get Invoice & MSRP on New Cars ~;et_a Per~orLtq Person.~.u~o.L~.o imp://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb. PA;36 [ 349:PA041 & 17070;suv+p&723 ;GM(... 06/22/2004 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1912 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-761-2763 May t9, 2004 Appraisal for the Estate of Robert A. Ranberg $16 Poplar Avenue, New Cumberland, PA 17070 ENTRY Misc. rocks, fossils & stones 5.00 Misc. books 1.00 LIVING ROOM Floor lamp 2.00 Ottoman 1.00 Rocking chair - worn 10.00 Sony TV 25.00 Emerson VCR 20.00 Yamaha R-300 receiver 25.00 Dual CS- 1268 rotatable 10.00 Polk audio speakers 10.00 Entertainment center 5.00 9.5 x 13 Oriental rug (red & amber) 350.00 Sofa 20.00 Wall hinging tapestry/rug 60.00 Large wall mirror 60.00 Pair of Haeger vases 2.00 Bookcase 60.00 Lamp/stand 8.00 Upholstered chair 5.00 Captain's chair 2.00 Step-back cupboard 295.00 2 Decanters 5.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1912 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-761-2763 Ranberg appraisal Page 2 of 10 LIVING ROOM- continued Misc. Wedgwood dishes 8.00 Misc. crystal 5.00 Blue covered bird 5.00 Milk glass cheese dish 2.00 Pair of brass candleholders 5.00 Misc. sea shells 2.00 Dark wood bookcase 60.00 Belleek condiment jar & stealing silver spoon 20.00 Small Lenox container 4.00 Sterling silver tray, creamer & sugar 60.00 Misc. Irish glassware 8.00 Irish file 4.00 Italian teapot 4.00 Svc/8 Rogers Bros. "Remembrance" flatware 45.00 Alabaster powder container 3.00 Bean pot 2.00 7.5 x 7.5 Oriental carpet - blue 175.00 PIANO ROOM Oriental desk/chest - red 95.00 Bookcase 20.00 Trash basket 1.00 Pair of paneled lamps 5.00 Small table lamp 1.00 t 957 Steinway & Sons upright piano - keys need refurbished 1,200.00 Conrad Gotz 1977 - V115 violin 150.00 C. A. Gotz Jr. 1969 Irffir 71 -Model 426 cello 300.00 Giannini guitar 50.00 3 Captain's chairs 6.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1912 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-761-2763 Ranberg appraisal Page 3 of 10 PIANO ROOM - continued Hitchcock chair (black & natural) 40.00 Bookcase - solid back 40.00 33 1/3 record albums 5.00 Misc. books 5.00 Small desk chair - child's school 5.00 6.2 x 9.4 Oriental carpet - Pakistan - red 150.00 Metronome 10.00 BATtt - [[ALL Bookcase 20.00 Linens 8.00 Scale 1.00 Trash can 1.00 FIRST FLOOR BEDROOM 3-Drawer chest 35.00 GE portable radio 3.00 Clock 1.00 Trash can 1.00 Lamp/stand 8.00 Hitchcock chair (black & natural) 40.00 Single bed 20.00 Modified table 3.00 Table lamp 1.00 Panasonic radio 2.00 Plastic trash can 1.00 HALL Dirt Devil upright vacuum cleaner 18.00 Canister vacuum cleaner 5.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY O~NED SINCE 1912 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-761-2763 Ranberg appraisal Page 4 of lO KITCHEN 2 Hitchcock chairs (black & natural) 80.00 3-Tiered cabinet 1.00 2 Captains chairs 4.00 Amana side by side refrigerator - old 100.00 Server 60.00 Krups broiler 5.00 Sharp Carousel II microwave 10.00 Remote telephone 10.00 Krups coffee maker 3.00 Flatware 3.00 Utensils 3.00 Cast iron Dutch oven 5.00 Blender 3.00 Food scale 1.00 Waffle maker 1.00 Stainless steel bowls 2.00 Cookware 5.00 Plastic trash can 1.00 Round table 35.00 Misc. everyday dishes 6.00 Pink glassware 8.00 15 Goblets 1.00 Misc. contents of kitchen 10.00 SECOND FLOOR LANDING Goose decoy 15.00 Lane cedar chest - green 40.00 Hitchcock - George Washington chair - cane seat 35.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1912 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-761-2763 Ranberg appraisal Page 5 of 10 DEN Plastic table 3.00 Draftsman's lamp 3.00 2 Hitchcock chairs (black & natural) 80.00 Bookcase 1.00 Electric typewriter 1.00 Desk 4.00 Table lamp 1.00 55" x 7' Oriental rug - brown & cream 135.00 JVC boom box 6.00 Swift 8.5 x 44 Audubon binoculars 25.00 Bausch & Lomb 10 x 40 binoculars 25.00 Aquarium 2.00 Camera tripod 2.00 Bookcase 25.00 Misc. books 5.00 Lace 10.00 Green rug 1.00 Olympia portable typewriter 1.00 Misc. toys 50.00 Misc. contents of room 20.00 MASTER BEDROOM 5-Piece Taylor Cherry bedroom suite - queen bed 495.00 Prism table lamp 15.00 2-Lady figurine lamp 20.00 7 × 5 Iranian Oriemal rug - copper, blue, cream, mustard 125.00 Misc. contents of room 10.00 J CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 19~2 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-761-2763 Ranberg appraisal Page 6 of 10 SMALL ROOM 4 x 6.5 Oriental rug - bird pattern - blue, red, cream etc 125.00 Pole light 1.00 Bookcase 10.00 Misc. books 3.00 Mirror 5.00 MII)DLE BEDROOM Book/magazine stand/lamp 12.00 Twin bed - French Provincial 5.00 Bookcase 5.00 Hitchcock (black & natural) 40.00 Portable sewing machine 10.00 4 Small Oriental rugs - $35.00 each 140.00 Floor lamp 2.00 Bed linens 5.00 Christmas decorations 2.00 Radio 2.00 Trash can 1.00 Misc. contents of room 5.00 BASEMENT - RECREATION ROOM Ironing board 1.00 Bookcase 1.00 Bear lamp 2.00 Floor polisher 1.00 Alarm clock 1.00 Kenmore dehumidifier 65.00 Ship model 45.00 Decorated lamp chimney 5.00 Floor lamp/stand 2.00 4-Drawer file cabinet 10.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1912 2009 LINCOLN STREET. CAMP HILL, PA 17011 717-761-2763 Ranberg appraisal Page 7 of 10 BASEMENT - RECREATION ROOM- continued Portable typewriter 1.00 Misc. rugs 10.00 Misc. Oriental rugs 150.00 Exercise bicycle 5.00 Luggage 1.00 National Geographic magazines 1.00 Kitchen Aid mixer 100.00 3 Benches 3.00 Small step ladder 2.00 Large electric fan 2.00 Small electric fan 1.00 Electric iron 2.00 FURNACE ROOM Shop vac 10.00 Metal shelving 1.00 Trouble light 1.00 Clothes rack 1.00 GE washer 100.00 Whirlpool Estate dryer 100.00 Clock 1.00 Misc. picture frames 1.00 Humidifier 1.00 Food processor 1.00 Small Oriental rug - worn 5.00 Halogen lamp 4.00 Misc. contents of room 10.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY' OWNED SINCE 1912 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-761 -2763 Ranberg appraisal Page 8 of 10 WORKSHOP Radio 1.00 100' Measuring tape 5.00 Bench 1.00 Clock 1.00 Hoover canister vacuum cleaner 1.00 Stool 1.00 Stand/lamp 1.00 Trash can 1.00 Large snake 2.00 B&D 7 ¼" circular saw 7.00 Electric heater 2.00 Amprobe 4.00 Soldering gun 2.00 DeWalt drill 5.00 Socket set 2.00 Craftsman electric chain saw 6.00 Bench top 6" grinder 20.00 B&D electric drill 3.00 Misc. hand tools 25.00 Misc. hardware 5.00 Coleman lantern 8.00 Misc. contents of room 25.00 FRONT PORCIt Bench 7.00 Stool 1.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1912 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-761 -2763 Ranberg appraisal Page 9 of 10 BACK PORCH / PATIO Charcoal grill 1.00 Chaise lounge 2.00 Chair 1.00 Trash can 2.00 Cabinet 55.00 Snow shovel 1.00 Table & benches 5.00 Dresser - French Provincial 40.00 Misc. contents 5.00 GARAGE Step ladder 10.00 Extension ladder 10.00 Multi-ladder 30.00 Wheel barrow 5.00 B&D edger 8.00 Small air compressor 10.00 Plastic tub/container 5.00 Bird house 4.00 Small vacuum cleaner 2.00 Trailer hitch parts 5.00 Sprinkling can 5.00 Toro 6.5 hp lawn mower 100.00 Misc. garden tools 7.00 Misc. contents of garage 10.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 19~2 2009 LINCOLN STREET · CAMP HILL, PA 17011 71 7-761-2763 Ranberg appraisal Page 10 of 10 APPRAISAL TOTAL $ 6,635.00 This Fair Market Value appraisal is true and correct to the best of my ability as an auctioneer and appraiser with 35 years experience. Member: Certified Appraisers Guild of America CLAUDE C. WOLFE & ASSOCIATES W. K. Dusty Chapman, CAGA · '59:6 · FURNITURE CL"EAN IN G 'r MOTH PRO~)F lNG burg Store CLEANING r--] 4637 Jonestown Road ~ 6220 Carlisle Pike ~ 1512 Lincoln Way Ea,t Harri~urg, Pa. 17109 ~M~nic~urg, Pa. 17055 Chambe~urg, Pa. 17201 REPAIRING Phone 545~2~ 'Pho~ 697-9423 Phone 263-5772 STO'~GE CL&88: Wo~kihop V~ll~ WEAVE: Flat Ave Knot ~n~ ~r WARP Wool.l C011on:lSdk. Ll~n. Colo~ el Warp WEFT .W~I~ Cotton', ~dk. Linen, Color of Weft: ~ep, Memum. :Tmn~ Commem. K~OReO w/Ke.m f K~ott~ w/~m ' OWNER: F Jar waive - Other: Otn~ Comment' P~e: SIDES. Original ~stored Selvedge Ove~Ca~l WHERE ACQUIRED: Male~al Purchase Fam,ly COLORS AND DYES: ~lalls on b&C~ of page WHEN: CONDITION (For ADe) REPAIR: ,. , ~ / Supe[~o~ Pr~or Yes No ul~ M~TF~' / CLASS: Workshop Vdl&p4 · :~ymn,ilr~;aJ ' ' A.lymm~u~caJ KNOT: IGmor~.} ~ Ave Knot ~nN~ , WARP Wool. IC0tton:lSdk. Color gl Warp WEFT W~l~ Co{ton. ~ilk. Linen. Color gl Welt: ~ep. Medium :Tmn~ Commen~:  ENDS.. O.nmal Restored R~ulnr ~u~ ~ Regular w/Kel~m ~u~ wlKlhm KnotleO wlKe.m f Knoit~ ~/~m OWNER: Warp Enas W~rp Ena~ Other; Oi~r Comment: SIDES: : Or,grail ~e: Selvedge Over ca~t WHERE ACQUIRED: Material Purchase Famdy COLORS AND DYES: ~a~ls on b~Ck of page WHEN: APPROXIMATE AGE C.ca _' - ~ .... .., , , ." AnliQue 5em~- AnliQue nion al ~ For ce~la,n legal purposes a rug musl be over ~OB ~ears old I0 be ' Tb~ '~, classlhed ANTIOUE Super,or Pr~or Yes No PLEASE NOTE~' ~,.~~ .. ' We nave a mas,er copyotlh'srepo"'n( ~V(~ ~' Mal°r I~on In case your recoras a~e lOSt or ~n NeeOea Now Yes ~0 0uphcate copras ,r lOt Aadmonal Comments on Condition or Repairs) etc. RETAILERS OF AMERICA ES, SIS & SONS CARI'E~ 1 NAME 4637 Jonestown Rd. · Harrisburg, PA . Phone 545-4248 ADDRESS 6220 Carlisle Pike · Mechanicsburg, PA · Phone 697-9423 1363 Lincoln Way East · 1320 Manheim Pike · Lancaster, PA 393-2880 2808 E. Prospect St. · York, PA · Phone F f, ok T LR ESSIS & SONS CARPET NAME 4637 Oonestown Rd, · Harrisburg, Pa · Phone 545-4248 ADDRESS 6220 Carlisle Pike · Mechanicsburg, PA · Phone 697-9423 1363 Lincoln Way East · 1320 Manheim Pike · Lancaster, PA 393-2880 2808 E. Prospect St. · York, PA, Phone ~.--? 31 Register of Wills of C E LAND County, Pennsylvania INVENTORY Estate of Robert A. RANBERG No. 21-04-0487 also known as Robert Alfred Ranber~; Date of Death 04/29/2004 , Deceased Social Security No. 028-20-7661 Sara E. TORTI, , Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I ANe verify that the statements made in this Inventory are true and correct, lANe understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: Edmund C. Myers Signature: Sara E. TORTI I.D. No.: 20558 Signature: Address: P. O. Box 109 Address: 8 Country Squire Dr Lemoyne, PA 17043-0109 Norfolk, I~ 02056 Telephone: 717/761-4540 Telephone: 508/384-0250 Description (See continuation page(s) attached) (Attach additional sheets if necessary) Total: 348,068.73 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form IYRW-7 (199z) INVENTORY Estate of: Robert A. RANBERG Date of Death: 04/29/2004 County: Cumberland CASH: 2003 Federal Income Tax Return 528.00 Refund Health South Refund 31.62 Pennsylvania State Employees 16,077.12 Credit Union Certificate of Deposit Account (ID64) Pennsylvania State Employees 14,748.86 Credit Union Certificate of Deposit Account (ID65) Pennsylvania State Employees 3,595.02 Credit Union Checking Account Pennsylvania State Employees 43,560.96 Credit Union Money Market Account (ID07) Pennsylvania State Employees 10.23 Credit Union Savings Account Refund of Home Owners 249.70 Insurance Refund of Insurance on 67.60 Airstream Refund of Decedent's 150.28 Automobile Insurance Refund of Decedent's Personal 17.48 Liability Insurance Residence located at 316 1,423.77 Poplar Avenue, New Cumberland, Pennsylvania. Tax Parcel No. 25-25-0008-081. Deed Book W, Volume 20, Page 191. - Reimbursement of taxes paid at Settlement consisting of County taxes and Assessments. The Settlement Sheet from the sale of the property on July 29, 2004 is attached to this Return SBLI Life Insurance Policy 3,806.65 Account No. 14-019015 State Farm Insurance Premium 4.82 Refund U.S. Treasury Annuity Payment 1,485.45 UGI Corp Refund on Account 8.17 85,765.73 PERSONAL PROPERTY: 1988 Airstream RV - Sold to 3,000.00 private party 2002 GMC Envoy. Valued using 23,860.00 Kelly Blue Book Value and attached to this Return Decedent's Personal Items 1,450.00 Household Items valued and 5,635.00 apprasied - Miscellaneous household items were valued and apprasied by Claude Wolf & Assosiates. Appraisal is attached to this Return. -2- Oriental Rugs valued and 9,622.00 appraised by Essis & Sons Carpets. Apprasial is attached to this Return Thrifty-Shopper - Proceeds 11.52 from sale of Decedent's personal items 43,578.52 BONDS: United States Savings Bonds 67,724.48 Bonds were calculated using Savings Bond Calcuator. Calculations are attached to this Return 67,724.48 REAL ESTATE/PA: Residence located at 316 151,000.00 Poplar Avenue, New Cumberland, Pennsylvania. Tax Parcel No. 25-25-0008-081. Deed Book W, Volume 20, Page 191. Contracted Sales price. Settlement took place on July 29, 2004. A copy of the Settlement Sheet is attached to this Return 151,000.00 TOTAL RECEIPTS OF PRINCIPAL ............... 348,068.73 -3- ')N DUFFLE : ~,KET STREET 109 IqE, PA 17043-0109 REGISTER OF WILLS OFFICE Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Oath of Personal RepreSentative COMMONWEALTH OF PENNSYLVANIA · COUNTY OF CUMBERLAND · The Petitioner above-named swearS and affirms that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the Decedent, Petitioner will well and truly administer the estate according to law. Sworn to and affirmed and subscribed ~ ~ ~:' ~ Before me this day of ., 2004. Estate of ROBERT A. RANBERG a/k/a ROBERT ALFRED RANBERG ~'-..~ , Deceased Social SeCurity No: 028-20-7661 Date of Death: April 29, 2004 AND NOW, ~C~ J ,-~..~'~ ,2004, in consideration of the Petition on the reverse side hereon, satisfactor~(l~'o'~f ~-aving been presented before me, IT IS DECREED tha'tl_etters Testamentary d.b.n.c. La.; pendente lite; durante absenfla; durante mino~ltate are hereby granted to SARA E. TORTI in the above estate and that the instrument(s) dated November 20th, 2003 described in the Petition be admitted to probate and filed of record as the last Will of the Decedent. FEES Letters ........................... $ Register of-Wills Short Certificate(s) $ Renunciation .............. $. Affidavit ( ) .................. $. Extra Pages (-i) ....... $. ~_L _ o(..~ Codicil ............................ $. JCP Fee ....................... $ lo · ~ Attorney: Edmund G. Myers Inventory ...................... $. I.D. No: 20558 Other· ............................. $. Address: Johnson, Duffle, Stewart & Weidner, 301 Market Street, P.O. Box 109, Lemoyne, PA 17043- TOTAL .........$ ~.~l. t3E) Telephone: 717-761-4540 ill e6tament OF ROBERT A. RANBERG I, ROBERT A. RANBERG, of the Borough of New Cumberland, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, · ~ . publish and declare this as and for my Last Will and Testament, hereby revoking ~ making¥o~d any and all Wills or Codicils at any time heretofore made by me. ARTICLE I DEBTS .: I direct the payment of all my legal debts and the expenses of my last illness and fimeral from my Estate as soon after my death as conveniently may be done. ARTICLE II TANGIBLE PERSONAL PROPERTY I give and bequeath my motor vehicles(s), household and personal effects and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, unto those of my children, SARA E. TORTI, IAN H. RANBERG and ERIK N. RANBERG, who survive me, to be divided among them by my Personal Representative with due regard for their personal preferences in as nearly equal shares as practicable. In the event there is disagreement as to the disposition of any particular item or items, I direct that the same shall be distributed in accordance with Article Ill hereof. ARTICLE III REST, RESIDUE AND REMAINDER I give, devise and bequeath all the rest, residue and remainder of my Estate, of whatsoever nature and wheresoever, unto my daughter SARA E. TORTI; my son, IAN H. RANBERG; and my son, ERIK N. RANBERG, subject to the following special considerations: A. I have given to my son, IAN H. RANBERG, the sum of Fifty Thousand ($50,000.00) Dollars during my lifetime and direct that his share of the residue of my estate be reduced by such sum. B. To calculate the rest, residue and remainder for purposes of the fractional division hereafter, I direct that my Personal Representative determine the actual rest, residue and remainder of my estate, reduced to a dollar figure, and then add to that figure the sum of Fifty Thousand ($50,000.00) Dollars (the life-time gift to my son, IAN H. RANBERG) and to make distribution of the rest, residue and remainder augmented by the Fifty Thousand ($50,000.00) Dollars as follows: 1. One-third (1/3) thereof unto my daughter, SARA E. TORTI; 2. One-third (1/3) thereof less the sum of Fifty Thousand ($50,000.00) Dollars unto my son, IAN H. RANBERG; and 3. One-third (1/3) thereof unto my son, ERIK N. RANBERG, subject to the provisions of Article IV hereafter, provided he survives me. Should any child named in this Article llI predecease me, I give and bequeath such child's share unto his or her then-living issue, per stirpes, and if there be a failure of same, I direct that the deceased child's share shall be distributed pro-rata among those of my children named herein who survive me and the then-living issue, per stirpes, of a child named herein who predeceases me. I do not include my son, KARL RANBERG, in the distribution of any portion of my estate. 2 ARTICLE IV TRUST FOR THE BENEFIT OF MY SON, ERIK N. RANBERG I direct that my Personal Representative deliver the share of my son, ERIK N. RANBERG, pursuant to Article HI hereof, unto my TRUSTEE, hereafter named, IN TRUST, to hold, manage, invest and reinvest the same for the benefit of my son, ERIK N. RANBERG, for a period of nine years from the date of funding of the Trust, and to make distributions to him as follows: A. One day after funding, to distribute ten (10%) percent of the principal and net undistributed income; and B. On each anniversary thereafter, to distribute the following fractions of the remaining principal and net undistributed income (the amount to be determined one month before each such anniversary): 1. First Anniversary 1/9 2. Second Anniversary 1/8 3. Third Anniversary 1/7 4. Fourth Anniversary 1/6 5. Fifth Anniversary 1/5 6. Sixth Anniversary 1/4 7. Seventh Anniversary 1/3 8. Eighth Anniversary 1/2; and 9. The balance on the Ninth anniversary of funding of the Trust. Upon the final disbursement set forth above, the Trust shall terminate. In the event that my son, ERIK N. RANBERG, dies before receiving his final distribution as set forth above, I direct that my Trustee shall distribute the same unto his then-living issue, per stirpes, and if there be a failure of same, then accordance with Article III hereof. ARTICLE V UNIFORM TRANSFERS TO MINORS ACT In the event any beneficiary of my Will has not reached the age of twenty-five (25) years at the time for distribution of his or her share, distribution of said share may be made in the discretion of my Personal Representative after considering the age and needs of the beneficiary, either directly to the beneficiary or to a Custodian for such beneficiary until age twenty-five (25) under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa. C.S.A § 5301 et seq., or the applicable Uniform Gifts to Minors Act or Uniform Transfers to Minors Act in the state of residence of such beneficiary as the case may be. My Personal Representative may designate as such Custodian any institution or person, including my Personal Representative, qualified to act as a Custodian for such beneficiary under such Act in effect at the time such distribution is made. A receipt for any payment or distribution so made shall be a full discharge therefor to my Personal Representative, who shall not be responsible to see to, or be liable for, the application of such proceeds thereafter. ARTICLE VI TRUSTEE I name, constitute and appoint my daughter, SARA E. TORTI, TRUSTEE of the TRUST created under Article IV of this my Last Will and Testament. In the event she fails to qualify, ceases to so act, resigns or fails to undertake the office of Trustee, I name, constitute and appoint my son-in-law, EMANUEL TORTI, ALTERNATE TRUSTEE. Should he also fail to qualify for the above reasons, then I direct that my Personal Representative select an individual successor Trustee. I direct that no individual Trustee should be required to post bond. ARTICLE VII POWERS OF PERSONAL REPRESENTATIVE AND TRUSTEE My Personal Representative(s) and Trustee(s) shall have the following powers in addition to those vested in them by law and by other provisions of my Will applicable to all property, whether principal or income, including property held for minors, exercisable without court approval and effective until actual distribution of all property: A. To make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as they may determine. B. To retain any or all of the assets of my estate, real or personal, without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. C. To invest in all forms of property without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. D. To sell at public or private sale, to exchange, or to lease for any period of time any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. E. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. F. To compromise any claim or controversy. G. To make such elections, decisions, concessions and settlements in connection with all income, estate, inheritance, gift, generation skipping or other tax refunds and the payment of such taxes as my Personal Representative and/or Trustee shall deem appropriate, without obligation to adjust the distribfltive share of any person thereby affected. H. To combine, without prior court approval, any Trust contained in my Will with any other Trust with substantially similar provisions, although such Trust may have been created by separate instrument. ARTICLE VIII PERSONAL REPRESENTATIVE I name, constitute and appoint my daughter, SARA E. TORTI, Executrix of this my Last Will and Testament. Should my daughter, SARA E. TORTI, fail to qualify or cease to so act, I name, constitute and appoint my son, IAN H. RANBERG, alternate Executor to complete the administration of my Estate. I direct that no fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this .~{) "'- day of /t~or)~r~/ 2003. ROBERT A. RANBERG Signed, sealed, published and declared by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, in his presence and in the presence of each other, have hereunto subscribed our names as witnesses. AFFIDAVIT AND ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA : : SS COUNTY OF CUMBERLAND : We, ROBERT A. RANBERG, -g'~x C~ ~.-.c.c,, ~ and ~X'~ ~'. ~<'<x ~ , the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instnunent as his Last Will and that he had signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of his/her knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Wi~ss W~ess Subscribed, sworn to and acknowledged before me by ROBERT A. RANBERG, Testator, and subscribed and swom to before me by ~ ~-~. ~ ~ and ,K ~-..,~..~-'}. ~ ~ '~..,~. ",c,c, ,,.,,r.-~ , witnesses, this ~L).C~day of _'N.~_~4tA,~ ¢,-- ,2003. Edmund G. Myers Attorney I.D. #20558 COMMONWEALTH OF PENNSYLVANIA : : SS-' COUNTY OF CUMBERLAND : On this, the ~ ~_X', day of ~ ~ ~ ,2003, before me, the undersigned officer, personally appeared EDMUND G. MYERS, I.D. #20558, known to me (or satisfactorily proven) to be a member of the bar of the highest court of Pennsylvania and certified that he was personally present when ROBERT A. RANBERG whose name is subscribed to the within instrument executed the same, and that the said person acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. -~~,~ ,,..-..,_. ~~ (SEAL) Notary Public Q"3 '~-'% NO'[ARIAL SEAL D!ANNE LENIG, Notary Public t_emoyne Borough Cumberland Co. ! My__..C?_?:~,i_.s.~.jg.n' ~_x.p~e~s O.__e.c. 21,2005 :2205035 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: ROBERT A. RANBERG a/k/a ROBERT ALFRED RANBERG Date of Death: April 29, 2004 Will No.: 2004-00487 To the Register: I certify that notice of beneficial interest 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 June 1, 2004. Name Address SARA E. TORTI 8 Country Squire Drive Norfolk, MA 02056 lAN H. RANBERG 376 West Chestnut Street Souderton, PA 18964 ERIK N. RANBERG 803 ¼ Selkirk Street West Palm Beach, FL 33405 KARL RANBERG c/o Pam Ranberg 2534 West Lafayette Avenue Baltimore, MD 21216 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None. Date: June 1, 2004 ~-¢¢~7~~ Signature Name: EDMUND G. MYERS Johnson, Duffle, Stewart & Weidner Address: 301 Market St - ~:~,i.l:.~ P.O. Box 109 ~ ~r' '~ Lemoyne, PA 17043-0109 Telephone: (717) 761-4540 Capacity: Counsel for personal representative LAW OFFICES JOHNSON, DUFFIE, STEWART & WEIDNER A Professional Corporation JERRY R. DUFFLE 301 MARKET STREET RICHARD ~ STEWART P.O. BOX 109 HOP~CE A. JOHNSON C. ROYWEIDNER, JI~ LEMOYNE, PENNSYLVANIA 17043-0109 F. LEESHIPMAN EDMUND G. MYERS BRUCE.L GROSSMAN* DAVID ~ DELUCE WEB$ITE: www.jdsw.¢om JEFFERSON J. SHIPMAN OF COUNSEL RALPH H. WRIGtt~, JR. MARK C. DUFFLE TELEPHONE 717-761-4~40 *Admitted in JOHN R. NINOSKY FACSIMILE ?17-761~015 New York on~v MICHAEL.L CASSIDY E-MAIL: mail~jdsw.¢om MELISSA PEEL GREEFY ROBERTM. WALKER WADED. MANLEY WRITER'S EXT. NO. 114 E-MAIL dlw~jdsw.com July 28, 2004 Register of Wills Office = ~6' Cumberland County Courthouse ~r '~' ~. One Courthouse Square Carlisle, PA 17013 ~ Re: Estate of Robs Ranl~rg a/Ida Robert Alfr~l Ranl3[trg SSN: 028-20-7661 Our File No. 9355-1 Your File No. 2004-00487 Dear Register of Wills Office: Enclosed please find Estate Check No. 124 in the amount of $20,000.00. This payment represents the three-month prepayment in order to qualify for the discount. The decedent died on Apri 29, 2004. Please time stamp the enclosed copy of this correspondence, and return to me in the enclosed self-addressed stamped envelope. Thanks for your assistance in this matter. Should you have any questions, or require any additional information, please feel free to contact me. Very truly yours, ~NSON, DUFFLE, STEWART & WEIDNER Legal Assistant c: Sara E. Torti, Executrix #228680 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004204 MYERS EDMUND G 301 MARKET STREET P O BOX 109 LEMOYNE, PA 17043 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold .......... 1 01 820,000.00 ESTATE INFORMATION: SSN: 028-20-7661 FILE NUMBER: 2104-0487 DECEDENT NAME: RANBERG ROBERT A DATE OF PAYMENT: 07/27/2004 POSTMARK DATE: 07/26/2004 COUNTY: CUMBERLAND DATE OF DEATH: 04/29/2004 TOTAL AMOUNT PAID: $20,000.00 REMARKS: CHECK# 124 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS , o ~ ~m~ ~0~ ~0~ 0 : COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU Of INDIVIDUAL f(~~,?D;:D ()TICE OF NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISION .',\1:,\ \ '~PPRA.ISEHENT, A.LLOWANCE OR DISALlOWANCE PO BOX ZB.601 ' . .'..'., OF DEDUCTIONS AND ASSESSMENT OF TAX HARRISBURG PA 17128-0601 2005 JMII 0 Ml g: ll9 CLEPK OF ORPt-'AN'S CQiJRT . _" ',1.1'-' ,,", 1\:.' EDMUND G Mmi',:,'1 I, ' " I. ",' JOHNSON ETAL PO BOX 109 LEMOYNE PA 17043 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-10-2005 RANBERG 04-29-2004 21 04-0487 CUMBERLAND 101 Alloun't RBlftitted *' REV-15~1 EX AFP (12-04) ROBERT A I CHANGEO III 121 (31 141 151 161 [71 151, 000.00 67.724.48 .00 .00 125.537.60 .00 197. 701. 29 181 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV :iS4"rix--,\fj'--('oi":oiY"NoT"ici--oF-iNHiiiifANcE-YAx-iiPPRA-isiMiNi'~--ALiiiwANcE-CjR----"---"----- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF RANBERG ROBERT A FILE NO. 21 04-0487 ACN 101 DATE 01-10-2005 TAX RETURN WAS: I X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule CJ 4. Hortgages/Noi.as Receivable (Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) &. Jointly Owned Property (Schedule FJ 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage liabilities/Liens (Schedule X) 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 25,682.60 23.098.46 1111 (121 (131 (141 191 [101 NOTE: To insure proper credit ~o your account) submit the upper portion of this for. with your tax pay..nt. 541,963.37 48.78] 06 493,182.31 .00 493,182.31 NOTE: I~ an assessmen~ was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: IS. Amount of Line 14 at Spousal rate (IS) 16. Anount of Line 14 taxable at Lineal/Class A rat. (16) 17. Amount of Line 14 at Sibling rat. (17) 18. Amount of Line 14 taxable at Collateral/Class Brat. (18) 19. Principal Tax Due .00 X 00 = .00 493,182.31 X 045 = 22,193.20 .00 X 12 = .00 .00 X 15 = .00 (191= 22,193.20 TAX CREDITS: '>J AHOUIIT PAID DATE NUMBER INTEREST/PEN PAID I-I 07-26-2004 CD004204 1,052.63 20,000.00 10-22-2004 CD004543 .00 1,140.57 TOTAL TAX CREDIT 22,193.20 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE i/ A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I :>/\ STATUS REPORT UNDER RULE 6.12 Name of Decedent: ROBERT A. RANBERG a/kJa/ ROBERT ALFRED RANBERG Date of Death: APRIL 29. 2004 Will No. 2004-00487 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rule, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the Estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's Account is: 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. ~MYE~ JOHNSON, DUFFIE, STEWART & WEIDNER 301 Market Street P.O. Box 109 Lemoyne, P A 17043 (717) 761-4540 Capacity: Personal Representative (x) Counsel for Personal Representative ) CJ""\ Cl"; Qate: March 3, 2005 REV.15DO EX + (6.00) '. OFFICIAL USE ONLY *' w .... ,,"Ul oil< w~g % -' o .. .. " COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 260601 HARRISBURG, PA 17126-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER n COUNTY COOE Y~IL SOCIAL SECURITY NUMBER ... Z W o W U W o DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITll>.l) RAN BERG, Robert A DATE OF DEATH (MM.DD.YEAR) I DATE OF BIRTH (MM-DD-YEAR) 04-29-2004 (IF APPLICABLE) SURVIVING SPOUSE'S NI>.ME (lI'.ST, FIRST I>.ND MIDDLE INITII>.L) JOOi- 1J67 NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [I. Original Return I X I 2. Supplemental Return I [ I I I I 10 Spousal Povert~ Credit (date of death betweel1 [[ . 12-31-91 and 1-1-95) "W'_RlfE!1i5Im:eNPa~-:~m51f'"" COMPlETE MAILING ADDRESS .... z ~ ~ Ul l:! ~ o I i 4. Limited Estate I I 6. Decedent Died Testate (Allach copy of Will) I I 9. Litigation Proceeds Received 1I'lilIS~SEjCTIQNIMQ'$Ilell'i" NAME Edmund G. Myers FIRM NAME (II applicable) Johnson, Duffie, Stewart & Weidner I TELEPHONE NUMBER 717-761-4540 I I I I 3. Remainder Return (dale of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust} 6. Total Number of Safe Deposit Boxes 11.Election to tax under Sec, 9113(A) (Allach Sch OJ P.O. Box 109 Lemoyne, PA 17043 (1) 151,000.00 (2) 67,724.48 (3) None (4) None (5) 125,537.60 (6) None (7) 197,701.29 (8) 541,963.37 (9) 26,007.60 (10) 29,121.46 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o ~ ::l l:: a. .0( u W It: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) I : Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) I I Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities. & Liens (Schedule I) i 19. Tax Due "_." _ i ..~"~~ ....,i~".".. ..:Wili&.?ii~~>> BE:SU~EiTO'AN~we~iAC~1:QU~f!r;lN~I1Q~tfl.~~~li1l91!~~1I!F~~~~i 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o t= .0( 5 a. ::E o u >< ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) x .00 0.00 16. Amount of Line 14 taxable at lineal rate 486,834.31 x .045 (16) 17. Amount of Line 14 taxable at sibling rate X .12 0.00 0.00 X .15 18. Amount of Line 14 taxable at collateral rate CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Copyright 2002 form software only The Lackner Group. Inc. ~ (11) 55,129.06 486,834.31 0.00 (12) (13) (14) 486,834.31 (15) 0.00 21,907.54 (17) 0.00 (18) 0.00 21,907.54 (19) "';."i":;;<"<" :;'1:\!i*m);;!i '~';";'.";D;;0ii;;..~ Form REV-1500 EX (Rev. 6-00: '. Decedent's Complete Address: STREET ADDRESS 316 Poplar Avenue CITY New Cumberland ISTATE PA IZlP17070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 21,907.54 21,140.57 1,052.63 Total Credits (A + B + C) (2) 22,193.20 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPAYMENT. (4) Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. (5) A. Enter the interest on the tax due. (5A) 8. Enter the total of Line 5 + 5A. This is theBALANCE DUE (58) Make Check Payable to: REGISTER OF WILLS, AGENT 285.66 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;............................................................................. x b. retain the right to designate who shall use the property transferred or its income;................................ x c. retain a reversionary interest; or..............................._............................................................................ x d. receive the promise for life of either payments, benefits or care?........................................................... x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................. __................................................................................. II 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death.?....... I I 4. Did decedent own an Individual Retirement Account. annuity, or other non-probate property which contains a beneficiary designation?............................................................................................................... I I I x 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. Under penalties of perjury, I declare thai I have examined this return, including accompanying schedules and statements. and to lhe best of my knowledge and belief, It Is true. correcl and complete. Declaration 01 prepar~r other than the personal representative is based on all jnfor~lio_rl_of.which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS ~~_'; ~ortif _ ~ .. f..-yV) SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Ixl I x [ DATE 8 Country Squire Drive Norfolk, MA 02056 7-/(/ /D\ DATE ADDRESS SIGNATURE OF PRE PARER OTHER THAN REPRESENTATIVE ~Mers ADDRESS DATE P.O. Box 109 lemoyne, PA 17043 7-d-DJ For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. !}9116 (a) (1.1) (i)J. For dates of death on or after January 1, 1995, the tax rate imposed on the net vall [72 P.S. 99116 (a) (1.1) (ii)J. The statutedoes not exemDta transfer to a surviving! of assets and filing a tax retum are still applicable even if the surviving spouse is II 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-c natural parent. an adoptive parent, or a stepparent of the child is 0% [72 P.S. 991 The tax rate imposed on the net value of transfers to or for the use of the de cede 99116 1.2) [72 P.S. !}9116 (a) (1)J. '.-- .~ ..,. fnr the use of the surviving spouse is 0% "-~ments for disclosure f\\ A P ...D r for the use of a ,s noted in 72 P.S. The tax rate imposed on the net value of transfers to or for the use of the decedl defined under Section 9102, as an individual who has at least one parent in corr T (\ . M\J..ST' 1.3)J. A sibling is d or adoption. Rey.15D2 EX> (6.98) . SCHEDULE H-B6 TAX RETURN PREPARER'S FEES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT RANBERG, Robert A IFILE NUMBER 21-- ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Larry T. Crown, CPA 310.00 Subtotal 310.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-86 (Rev. 6-98) . J ~" Rev.1512 EX> (6-96) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT RANBERG, Robert A FILE NUMBER 21-- ESTATE OF Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 23.098.46 2 2004 Individual Income Tax Return - Tax Due 6.023.00 TOTAL (Also enter on Line 10, Recapitulation) 29,121.46 (If more space is needed. additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) . 09-26-2005 RANBERG 04-29-2004 21 04-0487 CUMBERLAND 101 APPEAL DATE: 11-25-2005 ( See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 9YI_~~9~~_I~~~_~~~~______~___~~!~~~_~~~~~_~~~!~~~_~~~_y~y~_~~~~~~~__~____________________ REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ROBERT A FILE NO. 21 04-0487 ACN 101 DATE 09-26-2005 TAX RETURN WAS: ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE BUREAU OF INDIVIDUAL- -IAXEli>- ~ ~ INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX j DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN EDMUND G-MYERS JOHNSON ETAL PO BOX 109 LEMOYNE PA 17043 ESTATE OF RAN BERG REV-1547 EX AFP (06-05) ROBERT A I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~1gures that include the total o~ ~ 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 TAX CREDITS: nunl::", 1<1::\.1::.11" I+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07 26-2004 " CD004204 1,052.63 20,000.00 10-22-2004 "' CD004543 .00 1,140.57 TOTAL TAX CREDIT 22,193.20 BALANCE OF TAX DUE 284.99CR INTEREST AND PEN. .00 TOTAL DUE 284.99CR RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN NO. 01 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule BJ (2) 3. Closely Held Stock/Partnership Interest (Schedula C) (3) 4. Mortgages/Notes Receivable (Schedule DJ (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ (5) 6. Jointly Owned Property (Schedule FJ (6) 7. Transfers (Schedule G) (7) 8. Total Assets .00 .00 .00 .00 .00 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Lians (Schedule IJ 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmantal Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 310.00 6.023.00 (11) (12) (13) (14) NOTE: (15) (16) (17) (18) .00 486,849.31 .00 .00 X 00 = X 045 = X 12 = X 15 = (19)= · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. .00 6.333 00 6,333.00- .00 486,849.31 .00 21,908.21 .00 .00 21,908.21 IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) pJ. RI;V.T470 EX (6.88) *' INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME FILE NUMBER Robert A. Ranberg 2104-0487 REVIEWED BY ACN Sheila Megonnell 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES H&I Accepted additional debts. ROW Page 1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE -r. or(1C~ nC BUREAU OF INDIVIDUAL TA~CORDt.LJ \ ["\ i - ;'! INHERITANCE TAX INHERITANCE TAX DIVISION "STATEMENT OF ACCOUNT PO BOX Z80601 i' ,- ' HARRISBURG PA 171Z8-0601 10-24-2005 RANBERG 04-29-2004 21 04-0487 CUMBERLAND 101 I}OM: LU ij I) 28 rr"l 3: 01 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN EDMUND G MYERS): JOHNSON ETAL PO BOX 109 LEMOYNE Allount Relli tted PA 17043 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 '* REV-1607 EX AFP (03-05) ROBERT A CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +- NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT KKK ESTATE OF FILE NO. ACN DATE THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-26-2005 PRINCIPAL TAX DUE: 21,908.21 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-26-2004 CDo04204 1,052.63 20,000.00 10-22-2004 CDo04543 .00 1, 140.57 10-07-2005 REFUND .00 284.99- TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 21,908.21 .00 .00 .00 (;~