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Home My WebLink About04-0483 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Joan G. Moore also known as Joan Groner Moore, Deceased Robed Moore No. ? -©4-q Social Security No. 207-32-9943 Petitioner(s), who is 18 years of age or older apply(ies) for: COMPLETE "A" OR "B" BELOW:) [] A. Probate and Grant of Letters and aver that Petitioner is the executor named in the Last Will of the Decedent, dated November 8, 1986 and codicil dated February 5, 1999. 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 the victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite; durante absentia; durante minodtate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ;?2: Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or princi~l residence at 414 Carol Street, New Cumberland (list street, number and municipality) Decedent, then 67 years of age, died May 12, 2004, at Harrisburg Hospital, Harrisburg, PA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property ................................................................................ $900,000 (If not domiciled in PA) Personal property in Pennsylvania ............................................ $ (If not domiciled in PA) Personal property in County ...................................................... $ Value of real estate in Pennsylvania ................................................................................................... $ Total ..................................................................................................................................... $ Real Estate situated as follows: None Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: .,. r.~.S~n~at~e _ Typed or printed name and residence I ~,/~/,/~~r,' Robert Moore ..... u4,,.- 414 Carol Street New Cumberland, PA 17070 Form RW-1 Page 1 of 3 (Dauphin County - Rev. 9/92) Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner above-named swear and affirm 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 ac~~ Sworn to and affirmed and subscribed before me this ~:~ L~~C~'L-_ day of Estate of Joan G. Moore, Deceased also known as Joan Groner Moore DECREE OF REGISTER No. _~l_ (~_ L~,5 Social Security No.: 207-32-9943 Date of Death May 12, 2004 AND NOW, eti~tion~o r~l'¥ ,20 ~_~._, in consideration of the P the reverse side hereon, satisfactory proof having been presented before me, __ IT IS DECREED that Letters [] Testamentary [] of Administration are hereby granted to Robert Moore (c.t.a.; d.b.n.c.t.; pendente lite; durante absentia; durante minodtate) in the above estate and that the instruments, if any, dated November 8, 1986 and February 5, 1999_described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters .................................. Short Certificate(s) ............... Renunciation ........................ Affidavit ( ) ......................... Extra Pages ( )(~ .................. Codicil .................................. JCP Fee ............................... Inventory & Tax Forms ........ Other .................................... TOTAL .................... $ Register of Wills~_~'¢'"'(~ ~ Attorney: I.D. No.: Address: Telephone: DATE FILED: Robert Moore - ' 06402 --.J 3401 North Front Street Harrisburg, PA 17110-0950 717-232-5000 2 t-oq Form RW-1 Page 3 of 3 (Dauphin County - Rev. 9/92) 398963vl REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS Howell C. Mette and Peter J. Ressler (each) a subscribing witness to the Will presented herewith, (each) having been duly qualified according to law, depose and say that they were present and saw Joan G. Moore, the Testatrix, sign the same and that they signed as a witness at the request of Testatrix in her presence and in the presence of the other subscribing witness. Sworn to or affirmed and subscribed before me this 7~ o/~ day of F~r the Re~ist~r ..--. COMMONWEALTW'0i~ 'PENN S Yt.VANta: M~mber, Penn~vsnim ~l~on o( Not~le~ (Name) 205 North 26th Street, Camp Hill~ PA 17011 (Address) '~ (Name) 2900 Arcona Road, Mechanicsburg, PA 17055 (Address) 398917vl REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS Monica J. Bald, a subscribing witness to the Codicil presented herewith, having been duly qualified according to law, deposes and says that she was present and saw Joan G. Moore, the Testatrix, sign the same and that she signed as a witness at the request of Testatrix in her presence. Sworn to or affirmed and subscribed before me this Zo ~. day of /~'~ ,2004. M~r, p~n~ ~ ~ ~'~ 458 Big Sky Drive, Etters, PA 17319 (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS Robert Moore, a subscriber hereto, having been duly qualified according to law, deposes and says that he is familiar with the signature of Joan G. Moore, Testatrix of the Codicil herewith and that he believes the signature on the Codicil is in the handwriting of Joan G. Moore to the best of his knowledge and belief. ~, ~//; ~. ~.~/~/.~ ~,?~ ~,,~ Sworn to or affirmed and subscribed /t/~~/~~~_ before me this c7~ ~ day of (Name) ,2004. 414 Carol Street, New Cumberland, PA 17070 (Address) - Fo;theRegister'-~ ~ ~ f-.~'~'- 398953vl his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P I0S27988, No. Local Registrar t4AY 1 S 2004 Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ...... [E.~.~. NAME OF DECEDENT {FI;st Middle Last) SEX SOCIAL SECURITY N-MB"~ ~ ' ~ Joan He±.Len Groner Moore 12 female I 207 "2 ...~ ~1 /~/;~/,,. 7'~' "/F~.~Z/ AGE (Last B~ay) I UN~R 1 YEAR I UNDER 1 DAY ~ DATE OF BIRTH 81RTHP~CE (C y a~d~P~CE OF DEATH iChe~ O,~v one s~ I~sl~l~s ~ 9t~r ~{¢9},~" M~s ~ Days ~rs Minums J (M~. Day. Year) Stale or F~eign C~I~) J HO~T~ I s 67 w,~ I I I Fe%%%~ry 8~loomsburg, PA I COUNIYOF DEAIH I CITY. BORO. T~OFDEATH ~FACILITY NAME {If not insliluli~ gwe s~tandnumb~) WASDECE~NTOFHSPANICORIGIN* ~RACE-Ameri~ ~an B~k,~ e.e ,,. uaupnmn I~' .arrlsDurg I". Harrisburg Hospital I~ ..... ,.~., ....,c I,0 white of ~ ~; ~ n~ uae *~re~ IU S ARMED FORCES? I (~ed~ on~ h~e~l ~ade co~,m~d) Never Mama, ~dow~. (If ~. ~ve maiden .ama) I~. Domestic i~z. -. ~ ~4. Hart[ed ~s. Robert Hoore .a. Homemaker DECEDENT'S MA LNG ADDRESS (Street. Cdy/Town. State. Zip Code) DECFD£NT'S ACTUAL 17a. State 414 Carol Street IRESIDENCE I (See instructi~r,s 1L New Cumberland, PA 17070 IOnothers~e) 17b. Ccuntv FATHER'S NAME (First, Middle, Las~) P 'wl~-ennsr ~van~a Do 17c.~1 I Yes, decedent lived in ~p Cumberland townsl~p9 17d.~J~l No, decedenthvecl New Cumberland I MOTHER'S NAME (F rs1. Middle. Maiden Surname) ~. Hannah Law I INFORMANT'S MAILING ADDRESS (Street. City/Town. Slate. Zip Code) I'be' 414 Carol Street, New C,,mberland~ PA 17070 DATE OF DISPOSITION I PLACE OF DISPOSiTiON- Name of Cemetery Creme Dry ILOCATION- City/Town S a e Z p Cocie I (~o~, o,~,, Year) I Or Other Place ' ' ~12,h. May 14, 2004 12.. Fairview Cemetery 2~anville, PA 17303 NAMEANDADDRESSOFFACIUTY Parthemore FH& CS, Inc. z~c.P,O. Box 431, New Cumberland. PA 17070-O4ql LICENSE NUMBER DATE SIGNED 23b.wAS CASE REFERRED TO A MEDICALEXAMINER(MOnth'23C'/CORONER'~Day' Year) 2s. Yes• NO [] ~. Stephen S. Groner INFORMANT'S NAME (Type/Print) ~oe. Robert Moore METHOD OF 21L Other (Specify) S~GNATUR;- OF UCENSEE OR PERSON ACnNG AS SUCH UCENSE NUMSER zze. 2,,. FS 012 849 L TO the best o~ my ki~owledge, death Occurred at the time, date and place stated e o! death ~o (Signature and Title) ce~ly cause m' death. 25a. Items 24-26 must be completed by ~auEe Enter UNDERLYING CAUSE ([~sease ~ injury c DUE TO (OR AS A CONSEQUENCE OF]: DUE TO (OR AS A CONSEQUENCE OF): DUE TO (OR AS A CONSEQUENCE OF): Approx ma e interval belween onset and death resulting on death ) LAST pWEARSF~)O?PSY AV~VA~L~A~ULT~%%Si~RFITNoDINGS MANNER OF DEATH I~AgT~E ODaF, INyJU)RY TIME OF INJURY lIN JURY AT WORK? ,DESCRIBE HOW INJURY OCCURRED , FDEATH? IA,cider, [] Per~d,nginvestigat,on ~1 I Ye, n Nom l CERTIFIER (Check or~y o~e) SIGNATURE AND Ti OF RTIFIER · LICENSE N ER DAlE SIGNE (MO~ Da~. Yea PRONOUNClNG AND CERTIFYING PHYSICIAN (Phy .... bothp*' .... gdoalhandcertilylrigl ...... fcieath) -- N~ // 1~ ~Z/,,~ I ~[EL~ ~;tth.~ . TO the best of my knov~edge, death ....... d at the time, date, and pi ...... dd .... th ....... 1,) and ............ ted ............. L] 31c. ...................... (Item 27) Type o~' Print On ,he bath, of .... In&tl .... d/or ,rivesUgation, IrT my opinion, death ....... d it the lime, date, and pi ..... d due toth ............ d ................................................................................................. REGISTR, AF~'S ~ CODICIL TO THE WILL OF JOAN G. MOORE I, JOAN G. MOORE, of the Borough of New Cumberland, Cumberland County, Pennsylvania, the within named Testatrix, do hereby make and publish this Codicil to my Last Will and Testament, dated November 8, 1986. ITEM I: ITEM FOURTEENTH of said Last Will and Testament is amended in its entirety to read as follows: FOURTEENTH: I appoint my spouse, ROBERT MOORE, as Executor of and as Trustee under this my Will. In the:~ event my said spouse cannot act or continue to act as Executor an'~/or Trustee for any reason, I appoint my said sons, ROBERT M. MOORE and STEPHEN S. MOORE and my daughter, JENNIFER M. ROSE, to act in his place. No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. In all other respects I confirm and ratify my aforesaid Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of February, 1999. JO.~N G. MOORE (SEAL) We, the undersigned, hereby certify that the foregoing Codicil was signed, sealed, published and declared by the above-named Testatrix as and for a Codicil to her Last Will and Testament, in the presence of each of us, who, at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. (SEAL) (SEAL) Residing at :172774 I JOAN G. MOORE I, JOAN G. MOORE, of the Borough of New Cumberland, Cumberland County, Pennsylvania, declare this to be my last Will, hereby revokiag all prior Wills and codicils. FIRST: The expenses of my last illness and funeral shall be paid from my estate. SECOND: I hereby give and bequeath, absolutely and in fee simple, to my spouse, ROBERT MOORE, all my household furniture and furnishings, books, pictures, jewelry, silverware, automobiles, wearing apparel and all other articles of household or personal use or adornment, provided that if my spouse dies before the thirtieth (30th) day following the day of my death, this gift shall lapse or be divested and I make said bequest to my issue, per stirpes, living at the time of my death, to be divided among them as they shall agree. If they cannot agree for any reason, my Executor shall make the decision and its decision shall be final. My Executor shall represent any minor child in any division of such property and shall deliver to the person standing in the place of a parent to such minor, without bond, such portion of the minor's share as my Executor, after considering the minor's wishes, deems appropriate and shall sell the balance and pay the proceeds to my Trustees to be retained for the minor under Item SIXTH hereof. THIRD: The gift to my spouse in this Item is intended to )ire ~ eSta{~{ the marital deduction Page 1 effective under the Internal Revenue Code to reduce Federal estate tax. Any provisions in this Will which conflict with or fail of this intention shall be so reconciled or amplified as to accomplish this objective. If my spouse, ROBERT MOORE, survives me, I direct that my Trustees, hereinafter named, hold, IN TRUST, an amount free of all taxes equal to the maximum marital deduction allowable to my estate for Federal estate tax purposes, reduced by an amount, if any, needed to increase my taxable estate to the largest amount that after allowing for the unified credit and any other credits available to my estate, will result in no Federal estate tax, and pay the net income therefrom not less frequently than quarterly to my spouse for life. My spouse shall have power to appoint all or any part or parts of the principal of this Trust to to a class composed of our issue. This power shall be exercisable by him alone and in all events by specific reference thereto in his Will. My Trustee shall pay to his personal representatives from any unappointed principal the difference between all taxes, interest and penalties which they must pay by reason of his death and those which would be payable by them if such unappointed principal were not taxable in his estate and shall add the balance of such unappointed principal to my residuary Trust. FOURTH: I give and devise the residue of my estate, real and personal, to my Trustee hereinafter named, IN TRUST, as follows: (a) The net income therefrom shall be paid to my spouse, ROBERT MOORE, for life. Page 2 (b) My spouse shall have the power to appoint to himself up to the greater amount of five percent (5%) or $5,000 annually from the principal of the residuary trust under this Item. This power of appointment shall be noncumulative and may be exercised during my spouse's lifetime only by him giving the Trustee written direction other than by his Will. (c) Upon the death of the survivor of myself and my spouse, the principal shall be divided into as many equal shares as there are children of mine then living and children then dead, leaving issue then living. Thereafter: (i) One share shall be paid, per stirpes, to the living issue of each of my deceased children. (ii) The net income from one share may be paid or accumulated, in the absolute and sole discretion of Trustee, to each of my living children until they attain the age of twenty-one (21) years, at which time the income shall be paid to each child for life, provided however, that each such child shall have the right to withdraw his or her share of the principal and accumulated income when he or she shall attain the age of thirty (30) years. The rights of withdrawal may be exercised from time to time in whole or in part and the said rights of withdrawal shall be cumulative. (iii) Upon the death of each of my children who survive the survivor of my said spouse and myself, the share of principal from which he or she is eligible to receive income shall be paid to his or her surviving issue, per stirpes, or in default of such issue, shall be divided among my remaining children and the then living issue of my deceased children, per stirpes, to be held in trust for my remaining children as part of Page 3 the share from which they receive income and to be paid over to the issue of deceased children. (iv) If no issue of my children survive the survivor of my said spouse and myself, the remaining undistributed principal and accumulated income shall be divided into two equal shares and one share shall be paid to my heirs who would be entitled thereto under the Intestate Laws of Pennsylvania in effect at the death of the survivor of myself and my spouse; and the other share shall be paid to my spouse's heirs who would be entitled thereto under the Intestate Laws of Pennsylvania in effect at the death of the survivor of myself and my spouse as if my spouse had then died Intestate. FIFTH: Trustee may use principal of the trust under Item THIRD hereof (Marital Deduction Trust) only for the benefit of my spouse. With the foregoing exception my Trustee may use principal from the trust under Item FOURTH hereof (Residue Trust) for the benefit of my spouse and issue as that Trustee deems necessary: (a) To meet the expense of any accident, illness or other emergency befalling any of them; (b) For maintenance, support and education (including college and graduate school); (c) To pay funeral expenses, including the cost of a grave marker and perpetual care of the grave. Any principal used for the benefit of my issue shall be charged as an advancement from his or her family's share of the trust. Further, any invasion on behalf of any issue cannot Page 4 exceed the amount that would be allocated to his or her family's share of such trust. Notwithstanding the foregoing, the power to consume, invade or appropriate property for the benefit of my spouse and issue shall be limited by ascertainable standard relating to health, education, support or maintenance within the meaning of subparagraph (a) of Section 2041(b)(1) of the Internal Revenue Code of 1954 or any similar provision which may be in effect at the time of my death so that such power will not constitute a general power of appointment. SIXTH: I appoint my Trustee as Guardian to hold for minors all property payable by law to a guardian appointed by my Will and use the same for the minor's maintenance and education, either directly or by payment to any person selected to disburse it, whose receipt shall be a complete acquittance therefor. All unexpended income and principal shall be paid to the minor at majority. For purposes of this Will, majority shall be construed to be when the individual attains the age of twenty-one (21) years. SEVENTH: No provision of this Will is intended to exercise any power of appointment, including any power of appointment granted me under my spouse's will. EIGHTH: Ail taxes, interest and penalties thereon payable by reason of my death with respect to property comprising my gross estate, whether or not passing under this Will, shall be paid from the principal of my residuary estate, provided however, that funds of my Trust created herein may be used to pay taxes, interest and penalties attributed to such trust assets. Page 5 NINTH: No interest of any beneficiary under this Will or any codicil hereto shall be subject to anticipation or voluntary or involuntary alienation, and the personal receipt of such beneficiary shall be the sufficient and only discharge of my Executor and Trustee unless otherwise provided herein. TENTH: In addition to powers given them by law. my Executor and Trustee and their successors and any guardian acting hereunder shall have the following discretionary powers applicable to all real and personal property held by them. effective without court order and until actual distribution: (a) To retain all property received by them including the stock of any corporate fiduciary acting hereunder, provided such property remains productive: (b) To invest in all forms of property without restriction to investments authorized to fiduciaries, so long as such investments are productive; (c) To join in any incorporation, partnership, recapitalization, merger, reorganization or voting trust plan; to delegate authority with respect thereto; to deposit investments under agreements and pay assessments; and generally to exercise all rights of investors; (d) To compromise controversies; (e) To exchange or sell for cash, property or credit, publicly or privately, or to lease, even for a term exceeding five (5) years or the duration of the trusts hereunder, without liability on the purchasers or lessees to see to application of Page 6 the consideration, and to give options for these purposes without obligation to repudiate them in favor of a higher offer; (f) With respect to my residuary trust under Item FOURTH hereof, to allocate items of receipt or disbursement between income and principal as they deem equitable regardless of the character given such items by law; (g) To apply income or principal to which any beneficiary is entitled directly for his or her maintenance and support should they deem such beneficiary incapable of receiving the same by reason of age, illness or any infirmity or incapacity, or to pay the same to such person as they select to disburse it, whose receipt shall be a complete acquittance therefor, without the intervention of any guardian; (h) To borrow money, including the right to borrow from any corporate fiduciary acting hereunder, and mortgage or pledge as security; (i) To hold investments in the name of a nominee: (~) To distribute in cash or kind or partly in each at valuations fixed by them; (k) To assume continuance of the status of any beneficiary with reference to marriage, divorce, illness, incapacity or other change in the absence of information deemed reliable without liability for disbursements made on such assumption; (1) To elect to value my gross estate for Federal estate tax purposes as of the date of my death or as of the Page 7 alternate valuation date as allowed for such purposes, and to claim as income tax deductions expenses that would otherwise qualify as estate tax deductions and other elections allowable under law: (m) Except to the extent necessary in order that the trust under Item THIRD hereof qualify for the marital deduction allowable under the Internal Revenue Code, it shall not be necessary to segregate investments as belonging to a particular trust or share therein and all interests may be held in undivided form in a single fund from which proportionate distributions are made based on current reappraisals: (n) To merge any similar trust established by my spouse where the terms of the same are identical; and (o) In the event that I am the beneficiary of a qualified terminal interest trust and the same is taxable in my estate, I direct that my Executor shall seek reimbursement from said trust for all taxes due by my estate because of the inclusion of such trust in my estate, said computation of taxes due to be computed by taking taxes owed by my estate and such property included therein as compared to the taxes my estate would owe in the event said property were not taxable in my estate; and (p) To undertake any and all acts deemed necessary and proper by it for the proper and advantageous management of any trust and the settlement of my estate. ELEVENTH: No fiduciary who is a beneficiary of my residuary trust created in Item FOURTH hereof shall participate in the exercise of any discretionary power to Page 8 use the principal thereof for the benefit of any person or to apportion or allocate items of charge or credit between principal and income of such trust. TWELFTH: Any person, other than my spouse, who shall have died within thirty (30) days of my death, shall be deemed to have predeceased me. If my spouse and I die simultaneously, or under such circumstances that the order of our deaths cannot be established by proof, my spouse shall be deemed to have predeceased me. Any person (other than myself) who shall have died at the same time as any then recipient of income or in a common disaster with such beneficiary, or under such circumstances that it is difficult or impossible to determine who died first, shall be deemed to have predeceased such beneficiary. THIRTEENTH: If my spouse predeceases me, I appoint my son, ROBERT M. MOORE, guardian of the person of my minor children. FOURTEENTH: I appoint my spouse, ROBERT MOORE, as Executor of, and my spouse, ROBERT MOORE, and my son, ROBERT M. MOORE, as Trustees under this my Will. In the event my said spouse cannot act or continue to act as Executor and/or Trustee for any reason, I appoint my said son, ROBERT M. MOORE, to act alone in his place. No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. seal this IN WITNESS WHEREOF, I have hereunto set my hand and ~ day of _~f~/_~~// , 19~ to Page 9 this and the preceding nine (9) pages, and I have also placed my initials on each preceding page for better identification and greater security. JOAN,. MOORE SIGNED, SEALED, PUBLISHED and DECLARED by the above- named Testatrix, JOAN G. MOORE, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses: CERTIFICATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: JOAN G. MOORE, a/k/a JOAN GRONER MOORE Date of Death: May 12, 2004 Will No. 2004-00483 Admin. No. 21-2004-00483 To the Register: I certify that notice of 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 June 29, 2004: Name Robert Moore Address 414 Carol Street, New Cumberland, PA 17070 Jennifer M. Rose 6 Nita Court, Mechanicsburg, PA 17050 Robert M. Moore 3344 West Ivanhoe Street, Chandler, AZ 85224 Stephen S. Moore 101 Charlestown Hunt Dr., Phoenixville, PA 19460 Robert Moore, Trustee 414 Carol Street, New Cumberland, PA 17070 Joan G. Moore Trust Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: June 29, 2004 ~~~/K~~~~ ~'-~- _ . _ Signature Robert Moore, Esquire Name 3401 North Front Street Harrisburg, PA 17110 Address (717) 232-5000 Telephone Capacity: X Personal Representative Counsel for Personal Representative 401787vl METTE, EVANS & WOODSIDE http://www, mette.com August 9, 2004 VIA CERTIFIED MAlL RETURN RECEIPT REQUESTED Glenda Farner Strasbaugh Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 OF COUNSEL JAMES W. EVANS * MARYLAND BAR Re: Estate of Joan G. Moore File No. 21-0483-2004 Dear Ms. Strasbaugh: Enclosed is a check in the amount of $30,000.00 payable to "Register of Wills, Agent" representing a prepayment of Pennsylvania Inheritance Tax in the above-referenced estate proceeding. Please send a receipt for this payment. Thank you for your assistance. Very~ truly yours, Lisa J. Knode"~ Paralegal LJK: Enclosure cc: Robert Moore, Executor 404559vl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF ~NDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 004251 MOORE ROBERT 3401 NORTH FRONT STREET HARRISBURG, PA 17110-0950 ........ fold ESTATE INFORMATION: SSN: 207-32-9943 FILE NUMBER: 2104-0483 DECEDENT NAME: MOORE JOAN G DATE OF PAYMENT: 08/10/2004 POSTMARK DATE: 08/09/2004 COUNTY: CUMBERLAND DATE OF DEATH: 05/12/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $30,000.00 REMARKS: CHECK# 649 SEAL TOTAL AMOUNT PAID: 930,000.00 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS 3401 NORTH~IO~T STRE~[T 7000 0520 0024 5316 92~82 i,,,lll,,,lll,,,,,,ll,,ll,,,Ih,,ll,h,l,l,,Jl'l"l'l"l'l"l Glenda Farner Strasbaugh Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 , . REV-1500 EX (6-00) OFFIC1Al. USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FilE NUMBER 21 04 0483 ----- COUNlY CODE YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ MOore Joan ~ DATE OF DEATH (MM~DD.YEAR) DATE OF BIRTH (MM-DD-YEAR) ~ 5/12/2004 2/8/1937 ~ (IF APPLICABLE) SURVNlNG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Robert Moore G SOCIAL SECURITY NUMBER 207-32-9943 ~IS RETURN MUST BE FILED IN OUPL.ICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 193-28-0873 W I- ~:!;CI) u"'" w..u :t~O ()a..~ .. < [KJ 1. [].. [KJ 6. [J 9. Limited Estate Decedent Died Testate (Attach copy of 'Nill) Litigation Proceeds Received D 2. Supplemental Return 0 3. Remainder Retum (date of death prior to 12-13-82) o 4a. Future Interest Compromise (date of death after 12-12-82) [X] 5. Federal Estate Tax Return Required o 7. Decedent Maintained a Living Trust (Allach copy of Trust) _ 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit (date Qldulh between 12-31-91 and 1-1-95) 00 11. Election to tax under Sec. 9113(A)IAltachSchol Original Return ... Z w C Z o .. '" w 0: [lj <J THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Vicky Ann Trimmer, Esquire 3401 N. Front Street, PO Box 5950 FIRM NAME (If Applicable) METTE, EVANS & WOODSIDE lELEPHONE NUMBER 717-232-5000 Harrisburg, PA 17110-0950 1. Real Estate (Schedule A) (1) 0.00 OFFICIAl... USE ONLY 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) .. Mortgages & Notes Receivable (Schedule D) (') 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) Z 6. Jointly Owned Property (Schedule F) (6) 0 D Separate Billing Requested i= :5 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) :J (Schedule G or L) l- ii: a. Total Gross Assets (total Lines 1-7) ~ W 9. Funeral Expenses & Administrative Costs (Schedule H) (9) a: 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 1,294,769.00 0.00 0.00 33,480.00 0.00 C) 2. Stocks and Bonds (Schedule B) (2) 0.00 (a) 38,178.47 0.00 $:~" 1,32c 49.60" (131 38,178.47 1,290,070.53 0.00 {111 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) {121 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABlE RATES (14) 1,290,070.53 15. Amount of Line 14 taxable at the spousal tax 527,930.61 ~(15) Z rate, or transfers under Sec. 9116 (a)(1.2) x .0 0 i= 16. Amount of Line 14 taxable at lineal rate 762,139.92 x .0 45 (16) i!' ::> 0.00 .. 17. Amount of Line 14 taxable at sibling rate x .12 (17) :l! 0 0.00 U 18. Amount of Line 14 taxable at collateral rate x .15 (18) S 19. Tax Due ('9) 0.00 34,296.30 0.00 200 0.00 34,296.30 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON ReveRSE SIDE AND ReCHECK MATH < < 3W46451,OOO C Add Decedent's omDlete ress: SlREET ADDRESS 414 Carol Street Cumberland CIW TSTATE I ZIP New Cumberland PA 17070- 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . D b. retain the right to designate who shall use the property transferred or its income; . D c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . D d. receive the promise for life of either payments, benefits or care? . . . . . . . . . D 2. If death occurred after December 12, 1982. did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D [lg 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 01 perjury, I declare that I have examined this return, including accompanying schedules and statemants, and 10 the besl 01 my knowledge and beief, il is trua, correct and complete Decl,malion of pre parer otharthan the sonalrepresentativeisbasedonallinformationofwhichpreparerhasanyknowledge, SIGNATUR OF ERSON RESPO I L OR RN Robert Moore ADDHESS 414 Carol Street SIGNATURE OF PREPARER OTHER lHAN REPRESENTAllVE Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 30,000.00 1,578.95 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 Total Interest/Penalty (0 + E) (3) 4. If Line 2 is 9reater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) Make CheCkliiillia able to: REGISTER OF WH..LS,AGENT ; ',"hi.,""'" "",",,?'"i', ,J' ""''',','':'','',',''):,''",'''l,''i'!,''",'f,'1i'''i'I'f,' , :t~" ,,'W""" , . -~,\\!,...i"'i,0;"I.,!l:~".lt1!t..';lft.!;i!iVI,I;J",,,t'dll!i)il~I';'1j,!l1iHii,'l,ilmlc it!~!i,~lJ~4W!,,,, ~_\i1l':"";"""';"'$K>~#(,,",',""";;""""_":\'.:",j'h',';;',-,...':'""""",_".. '<~",,,_, . _.,.:i:i:1JL,#!~N411'i:"","ij~",*~0:!!i:, PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS New Cumberland, 34,296.30 31,578.95 0.00 0.00 2,717.35 0.00 2,717.35 t~_ No ~ ~ ~ ~ og QlI ~ PA 17070 DATE :2/;u ,,0J Vicky Ann Trimmer, Esquire ADDHESS 3401 N. Front Street, PO Box 5950 Harrisburg, PA 17110-0950 if~2L'~"~''''': ;::,~!.'"_,;,':L,t;'1:iyYfi'Jf'iX\i"'i:"A:,0L;-:';':' .,";; ,:fT{Pm~1 'i"j/g:!;,~;;Jtl m'f'''''' "":;';:\:;;~ilf1!\0!: l?I2,~~f~1 .:,""'H1i~ For elates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~ 9916 (a) (1,1) (i)l. 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) Oi)1 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 retum are still applicable even if the liurviving 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 lax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~ 9116(1.2) (72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. ~ 9116(a)(1.3)1. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, v.tlether by blood or adoption. 3W46461_000 REV.15031~+(6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Joan G Moore 21 04 0483 All property Jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 906 Shares ACNB Corp. common stock CUSIP: 000868109 DESCRIPTION VALUE A T DATE OF DEATH 22,680.20 2 3,384 Shares Allied Irish Banks common stock CUSIP: 019228402 96,088.68 3 81 Shares Arvinmeritor, Inc. common stock CUSIP: 043353101 1,485.54 4 26 Shares Boeing Co. common stock CUSIP: 097023105 1,121.64 5 2,520 Shares Columbia Financial Corp. common stock CUSIP: 197642101 60,480.00 6 328 Shares Conexant Systems, Inc. common stock CUSIP: 207142100 1,392.52 7 120 Shares Duquesne Lt Hldgs, Inc. common stock CUSIP: 23329J104 2,137.80 8 170.0924 Shares M&T Bank Corp. common stock CUSIP: 55261F104 14,330.28 9 2,292 Shares Medco Health Solutions, Inc. common stock CUSIP: 58405U102 82,901. 64 Total from continuation pages 1,012,150.70 3W46961,OOO TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,294,769.00 Schedule B (Page 2) Estate of: Joan G Moore Item No. Description Value at Date of Death 10 19,008 Shares Merck & Co., Inc. common stock CUSIP: 589331107 882,541. 44 11 109 Shares ~ndspeed Technologies, Inc. common stock CUSIP: 602862106 529.20 12 1,322.0641 Shares Pennsylvania Commerce Bancorp, Inc. common stock CUSIP: 708677109 66,103.21 13 660 Shares PNC Financial Services Group, Inc. common stock CUSIP: 693475105 34,874.40 14 164 Shares PPL Corp. common stock CUSIP: 709051106 6,628.06 15 328 Shares Rockwell Automation, Inc. common stock CUSIP: 773903109 10,646.88 16 328 Shares Rockwell Collins, Inc. common stock CUSIP: 774341101 9,802.28 17 115 Shares Skyworks Solutions, Inc. common stock CUSIP: 830088M10 1,025.23 T'otal (Carry forward to main schedule) 1,012,150.70 REV.1508EX+(6-98) ESTATE OF Joan G Moore COMMONVVEAL 1H OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21 04 0483 ITEM NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All propertv lolntly-owned with the right of survivorship must be disclosed on Schedule F. DESCRIPTION VALUE AT DATE OF DEATH 1 2002 BMW sedan - VIN WBAEU33402PF66650 23,430.00 2 Items of tangible personal property 10,000.00 3 Uncashed Federal Express Travelers Check #HG400065 50.00 3W46AD 1.000 TOTAL 'Also enter on line 5 Recaoitulation\ $ (If more space is needed, insert additional sheets of the same size) 33,480.00 REV-1511 EX+ (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Joan G Moore FILE NUMBER 21 04 0483 Debts of decedent must be reported on Schedule I. 1. M ER DESCRIPTION AMOUNT FUNERAl EXPENSES: Grave Marker 2,925.00 Parev's - funeral luncheon 1,106.70 Total from continuation pages 9,525.41 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number{s) I EIN Number of Personal Representative(s) - - Street Address City State Zip Year(s) Commission Paid: Attorney Fees 20,000.00 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Robert Moore Street Address 414 Carol Street City New Cumberland State PA Zip 17070 Relationship of Claimant to Decedent SPOUSE Probate Fees 846.50 Accountant's Fees Tax Return Preparer's Fees Cumberland Law Journal 75.00 Estate Valuation 63.55 Sentinel 136.31 TOTAL (Also enter on line 9, Recapitulation) $ 38,178.47 (If more space is needed, insert additional sheets of the same size) ITE NUMB A. 2 B. 2 3 4 5 6 7 1 2 3 3W46AG1,OOO Estate of: Joan G Moore Item No. 3 Description Parthemore Funeral Home, New Cumberland, PA Schedule H part 1 (Page 2) Amount 9,525.41 Total (Carry forward to main schedule) 9,525.41 REV.151:3 EX... (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Joan G Moore FILE NUMBER 21 04 0483 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under Sec. 9116 (8)(1.2)] RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE 1 Joan G. Moore Credit Shelter Trust c/o Robert Moore, Trustee 414 Carol Street New Cumberland, PA 17070 Remainder interest of children Trust 762,139.92 Total from continuation pages 527,930.61 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 3W46Alt.OOO TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV.1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) $ 0.00 Schedule J part 1 (Page 2) Es'tate of: Joan G Moore Item No. Description Relation Amount 2 Robert Moore 414 Carol Street New Cumberland, PA 17070 2002 BMW sedan - VIN WBAEU33402PF66650 Inventory Value: 23,430.00 Items of tangible personal property Inventory Value: 10,000.00 Life estate (income interest) in Credit Shelter Trust Surviving Spouse 527,930.61 ']~otal (Carry forward to main schedule) 527,930.61 COMMONVIJEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE K LIFE ESTATE,ANNUITY & TERM CERTAIN Check Box 4 on Rev-1500 Cover Sheet REV-151" EX+ (6-98) FILE NUMBER Joan G Moore 21 04 0483 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. [K] Will 0 Intervlvos Deed of Trust 0 Other LIFE ESTATE INTEREST CALCULATION NAME(S) OF LIFE TENANT(S) DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM OF YEARS LIFE ESTATE IS PAYABLE Robert Moore 7/12/1935 69 Term of Years Term of Years Term of Years Term of Years 1. Value of fund from which life estate is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Actuarial factor per ap~riate table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Interest table rate - U 3 1/2% 0 6% 0 10% [K] Variable Rate 3.80000% 3. Value of life estate (Line 1 multiplied by Line 2) ......................... . $ Term of Years 1,256,640.53 0.3935 $ 494,500.61 ANNUITY INTEREST CALCULATION NAME(S) OF LIFE TENANT(S) DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TEFtMOF YEARS ANNUITY IS PAYABLE Term of Years Term of Years Term of Years 1. Value of fund from which annuity is payable . . . . . . . . . . . . . . . . . . 2. Check appropriate block below and enter corresponding (number) . . . . . . Frequency of payout -0 Weekly (52) 0 Bi-weekly (26ln Monthly (12) o Quarterly (4) 0 Semi-annually (2) 0 Annually (1) OOther ( ) 3. Amount of payout per period .............. 4. Aggregate annual payment, Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate D 3 1/2% D 6% D 10% 0 Variable Rate O. oooam 6. Adjustment Factor (see instructions) .................... 7. Value of annuity -If using 31/2%,6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 . . . . . If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3. . . . . . . . . . . . . . . . . . . . . . . . . Term of Years 0.00 0.000 . $ 0.00 0.00 $ 0.0000 0.0000 $ 0.00 $ 0.00 NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15, 16 and 17. (If more space is needed, insert additional sheets of the same size) 3W46AJ1,OOO REV-1649 1;)(+ (1-97) COMM()NVVEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Joan G Moore 21 04 0483 Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A} of the Inheritance & Estate Tax Act. II' the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Joan G. Moore Unified Credi t Trust (marital, residual, A, B, By-pass, Unified Credit, etc.) If a trust Dr similar arrangement meets the requirements of Section 9113(A), and: a. T~le trust or similar arrangement is listed in Schedule 0, and b. TtIe value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identity the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value oflhe trust or similar property is Included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arranaement included as a taxable asset on Schedule O. The denominator is eaualto the total value of the trust or similar arranaement. PART A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's survivina SCQuse under a Section 9113(A) trust or similar arranaement. OESCRIPTlON VALUE Joan G. Moore Credit Shelter Trust 1,256,640.53 Parl A Total $ 1,256,640.53 PART B: Enter the descriotlon and value of all Interests included In Part A for which the Section 9113 Al election to tax is bein" made. DESCRIPTION VALUE Joan G. Moore Credit Shelter Trust 1,256,640.53 3W46E2UlOO Part B Total $ (If more space is needed, insert additional sheets of the same size) 1,256,640.53 ESTATE OF JOAN G. MOORE CALCULATION OF THE JOAN G. MOORE CREDIT SHELTER TRUST Items Third and Fourth ofthe Last Will and Testament of JOAN G. MOORE provide for two possible trusts to be established. The trust established under Item Third is a Marital Trust. The Marital Trust under Item Third will not be funded. Item Fourth provides that the residue of her estate pass into a Credit Shelter Trust. The Credit Shelter Trust will hold the amount which can pass free of federal estate tax by reason of the credit up to the maximum applicable credit of $1,500,000.00. Basis of Calculation All references are to the Federal Estate Tax Schedules Gross Estate 1,683,580.00 Less Property Passing to Spouse: Schedule D ( 40,719.78) Schedule E to Spouse ( 314,611.22) Schedule F to Spouse ( 33,430.00) Less Deductible Charges: Schedule J ( 13,557.11) Remaining Balance of Gross Estate 1,281,261.89 Less Pennsylvania Inheritance Tax: 32,717.35 Net to Distribute 1,248,544.54 Calculation of The Joan G. Moore Credit Shelter Trust Credit Trust - Initial Calculation: Maximum amount sheltered by applicable credit: 1,500,000.00 Less: Taxable Gifts: 0.00 Less: Schedule E, Part 2 Propertv 0.00 Subtotal: 1,500,000.00 Plus State Death Tax Shelter Amount: 0.00 Less Pennsylvania Inheritance Tax: 32,717.35 Joan G. Moore Marital Trust - not funded 0.00 Maximum Funding for Credit 1,500,000.00 Shelter Trust: Joan G. Moore Credit Shelter 1,248,544.54 Trust Joan G. Moore Estate SUDDortinl! Schedule Pennsvlvania Inheritance Tax Return Allocation of Assets to Beneficiaries of Estate Total Gross Assets 1,328,249.00 Less: Schedule F, Items I & 2 to ( 33,430.00) Spouse Less: Schedule H ( 38,178.47) Less: Schedule I 0.00 Net Value of Estate for Pennsylvania Inheritance Tax Purposes 1,256,640.53 Net to divide in trusts 1,256,640.53 Joan G. Moore Marital Trust - not funded 0.00 Joan G. Moore Credit Shelter Trust 1,256,640.53 Pennsvlvania Inheritance Tax Return Calculation of The Joan G. Moore Marital Trust The Joan G. Moore Credit Shelter Trust Credit Shelter Trust - Initial Calculation Maximum amount sheltered by applicable credit: 1,500,000.00 Less: Taxable Gifts: 0.00 Less: Property joint with Person other than spouse: 0.00 Subtotal: 1,500,000.00 Plus State Death Tax Shelter Amount: 0.00 Joan G. Moore Marital Trust - not funded 0.00 For Pennsylvania Inheritance Tax Purposes: Maximum Funding for 1,500,000.00 Credit Shelter Trust For Pennsylvania Inheritance Tax Purposes: Joan G. Moore Credit 1,256,640.53 Shelter Trust 416141vl IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: ESTATE OF JOAN G, MOORE, aIkIa JOAN GRONER MOORE, Late of New Cumberland Borough, Cumberland County, Pennsylvania, deceased Estate No. 2004-00483 DISCLAIMER I, Robert M. Moore, hereby declare that I am the son of Joan G. Moore, a/kJa Joan Groner Moore, who died on May 12, 2004. I hereby irrevocably and completely disclaim and refuse to accept any and all rights, title and interests that I may be entitled to receive pursuant to Item Fifth of the Last Will and Testament of Joan G. Moore dated November 8, 1986, during the lifetime of my father, Robert Moore, which section permits the invasion of principal for my benefit. I hereby state and certify that I have not accepted any benefits or interest pursuant to Item Fifth of the Last Will and Testament of Joan G. Moore dated November 8, 1986, with regard to any invasions of trust principal for my benefit. This document is intended to qualify as a disclaimer under Section 2518 of the Internal Revenue Code of 1954, as amended, and under Chapter 61 of the Pennsylvania Probate, Estates and Fiduciaries~. '1/J Dated this 1 day of ~ ,2005. 0- ~Y&~a . . "'tetq;rjJ/JL~L) 330278_1 ACKNOWLEDGMENT I 5TATEOF )jt'.-!Z(:IU/-l COUNTY OF /'-11-+(0 Ce PI-! 55, -- On this 7t:!: day of ;=:e7Stt/'lf~ ' 2005, before me, the undersigned officer, a Notary Public in and for the said county and s ate, personally appeared Robert M. Moore, who, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Disclaimer are true and correct to the best of his knowledge, information, and belief and that he executed the same as his voluntary act and deed for the purposes therein contained. i) NOla, ry Public State of Arizona Maricopa County Stacie R Maddio Expires July 11, 2005 :7{.,e~;~7 /l/4'(' {~ Notary Public 2 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: ESTATE OF JOAN G. MOORE, alkla JOAN GRONER MOORE, Late of New Cumberland Borough, Cumberland County, Pennsylvania, deceased Estate No. 2004-00483 RECEIPT OF DISCLAIMER Robert Moore, being duly sworn according to law, depose and say that he is the Executor under the Last Will and Testament of Joan G. Moore dated November 8, 1986, and that on the date and place as hereinafter set forth, he received the foregoing signed Disclaimer from Robert M. Moore. ESTATE OF JOAN G. MOORE, a/k/a ~' De",,,, Robert Moore, Executor D.le ;~~UaL PI... r;/J1uIlltfA, SWORN TO AND SUBSCRIBED before me this ~ day of 2005. ~ ~~/- Notary Public f' COMMONWEALTH OF PENNSYLVANIA Notarial Seal Monica J. Bald, Notary Public Susguehanna T~., Dauphin County My Commission Expires July 12, 2008 Member, Pennsylvania Assod~tiofl of Notaries 415826v1 3 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: ESTATE OF JOAN G. MOORE, alk/a JOAN GRONER MOORE, Late of New Cumberland Borough, Cumberland County, Pennsylvania, deceased Estate No. 2004-00483 DISCLAIMER I, Stephen S. Moore, hereby declare that I am the son of Joan G. Moore, a/kla Joan Groner Moore, who died on May 12, 2004. I hereby irrevocably and completely disclaim and refuse to accept any and all rights, title and interests that I may be entitled to receive pursuant to Item Fifth of the Last Will and Testament of Joan G. Moore dated November 8, 1986, during the lifetime of my father, Robert Moore, which section permits the invasion of principal for my benefit. I hereby state and certify that I have not accepted any benefits or interest pursuant to Item Fifth of the Last Will and Testament of Joan G. Moore dated November 8, 1986, with regard to any invasions of trust principal for my benefit. This document is intended to qualify as a disclaimer under Section 2518 of the Internal Revenue Code of 1954, as amended, and under Chapter 61 of the Pennsylvania Probate, Estates and Fiduciaries Code. Dated this qtl\ day of --.J;b{l.{QlY ,2005. ~ f'V\ ocQ-{'./ (SEAL) Witness: St S. Moore 330278_1 ACKNOWLEDGMENT STATE OF ~Y'll'\~II'Q.I\'I" COUNTY OF ~tIt;T1 SS. On this ~ day of f-tluuuzflff-' 2005, before me, the undersigned officer, a Notary Public in and for the said county a state, personally appeared Stephen S. Moore, who, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Disclaimer are true and correct to the best of his knowledge, information, and belief and that he executed the same as his voluntary act and deed for the purposes therein contained. ~~~ C MM NWEALTH OF I'ENNSYLVANIA Notanal Sea! Monica J Bald, Notary Public Susquehanna Twp., Dauphin County My Commission Expires July 12, 2008 Member, Pennsvlvania ll.ssociation of Notaries 2 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: ESTATE OF JOAN G. MOORE, a/k/a JOAN GRONER MOORE, late of New Cumberland Borough, Cumberland County, Pennsylvania, deceased Estate No. 2004-00483 RECEIPT OF DISCLAIMER Robert Moore, being duly sworn according to law, depose and say that he is the Executor under the last Will and Testament of Joan G. Moore dated November 8, 1986, and that on the date and place as hereinafter set forth, he received the foregoing signed Disclaimer from Stephen S. Moore. ESTATE OF JOAN G. MOORE, a/k/a JOAN GRONER MOORE, Deceased ~; Robe oore, xecutor Date: ~ ~dC():s Pl,re ~ IJ SWORN TO AND SUBSCRIBED before me this CJn1 day of ~ 2005. VUon-u; ~ Notary Public 1 COMMONWEALTH OF PENNSYLVANIA Notarial Seal Monica J. Bald. Notary Public Susquehanna Twp., Dauphin County My Commission Expires July 12, 2008 Member. Pennsylvania Association of Notaries 415842v1 3 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: ESTATE OF JOAN G. MOORE, a/k/a JOAN GRONER MOORE, Late of New Cumberland Borough, Cumberland County, Pennsylvania, deceased Estate No. 2004-00483 DISCLAIMER I, Jennifer M. Rose, hereby declare that I am the daughter of Joan G. Moore, a/kla Joan Groner Moore, who died on May 12, 2004. I hereby irrevocably and completely disclaim and refuse to accept any and all rights, title and interests that I may be entitled to receive pursuant to Item Fifth of the Last Will and Testament of Joan G. Moore dated November 8, 1986, during the lifetime of my father, Robert Moore, which section permits the invasion of principal for my benefit. I hereby state and certify that I have not accepted any benefits or interest pursuant to Item Fifth of the Last Will and Testament of Joan G. Moore dated November 8, 1986, with regard to any invasions of trust principal for my benefit. This document is intended to qualify as a disclaimer under Section 2518 of the Internal Revenue Code of 1954, as amended, and under Chapter 61 of the Pennsylvania Probate, Estates and Fiduciaries Code. Dated this s day of ,2005. Witness: ~krM. r~AL) Jennifer M. Rose }{rLJlCcoA:1)j. 07~ 330278_1 ACKNOWLEDGMENT STATE OF ;4.1'\n.bt#~ COUNTY OF ~ SS. On this 8'(t-\ day of , 2005, before me, the undersigned officer, a Notary Public in and for the said county and tate, personally appeared Jennifer M. Rose, who, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Disclaimer are true and correct to the best of her knowledge, information, and belief and that she executed the same as her voluntary act and deed for the purposes therein contained. ~~Q }~ N6tary Public COMMONWEALTH OF PENNSYLVANIA Notarial Seal Monica J. Bald, Notary Public Susquehanna Twp., Dauphin County My Commission Expires July 12, 2008 Member, Pennsylvania Association of Notaries 2 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: ESTATE OF JOAN G. MOORE, a/k/a JOAN GRONER MOORE, Late of New Cumberland Borough, Cumberland County, Pennsylvania, deceased Estate No. 2004-00483 RECEIPT OF DISCLAIMER Robert Moore, being duly sworn according to law, depose and say that he is the Executor under the Last Will and Testament of Joan G. Moore dated November 8, 1986, and that on the date and place as hereinafter set forth, he received the foregoing signed Disclaimer from Jennifer M. Rose. D,je ~ 1; 2 ~tJj ESTATE OF JOAN G. MOORE, a/k/a J~ 0.00'''' Robert Moore, Executor ~;). Place: SWORN TO AND SUBSCRIBED before me this gH1 day of ~, 2005. ~ COMMONWEALTH OF PENN~YLVANIA Notarial Seal Monica J. Bald. Notary Public Susquehanna 1\vo., Dauphin County My Commission gxpires July 12, 2008 Member, Pennsylvama Association of Notaries 415844V1 3 Date of Death: Valuation Date: Processing Date: 05/12/2004 05/12/2004 07/15/2004 Shares or Par Security Description Estate Valuation High/Ask 1322.0641 PENNSYLVANIA COMM BANCORP INC (708677109) COM NASDAQ Bank - Insurance 05/12/2004 50.00000 Low/Bid 50.00000 H/L 52.36000 H/L 28.08000 H/L 25.50000 H/L 24.50000 H/L 17.64000 H/L 31. 82000 H/L 40.01000 H/L 83.51000 H/L 42.70000 H/L 24.00000 H/L 24.00000 H/L 111 Div: 0.15 Ex: 04/29/2004 Rec: 05/03/2004 Pay: 05/14/2004 19008 MERCK & CO INC (589331107) COM New York Stock Exchange 05/12/2004 Estate of: Moore, Joan G. Account: File No. 12142-0001 Report Type: Date of Death Number of Securities: 17 File 10: moore.joan.estate Mean andlor Div and 1nt Security Adjustments Accruals Value 50.000000 66,103.21 11 21 660 PNC FINL SVCS GROUP INC (693475105) COM New York Stock Exchange 05/12/2004 53.32000 28.71000 25.60000 25.05000 17.99000 33.10000 40.82000 84.99000 43.58000 24.00000 24.00000 47.00000 Page 1 45.86000 H/L 52.840000 34,874.40 31 3384 ALLIED IRISH BKS P L C (019228402) SPON ADR ORD New York Stock Exchange 05/12/2004 28.395000 96,088.68 41 906 ACNB CORP (000868109) COM NASDAQ Bank - Insurance 05/10/2004 05/13/2004 25.033333 22,680.20 51 120 DUQUESNE LT HLDGS INC (23329J104) COM New York Stock Exchange 05/12/2004 17.815000 2,137.80 61 328 ROCKWELL AUTOMATION INC (773903109) COM New York Stock Exchange 05/12/2004 32.460000 10,646.88 71 164 PPL CORP (709051106) COM New York Stock Exchange 05/12/2004 40.415000 6,628.06 81 170.0924 M & T BK CORP (55261FI04) COM New York Stock Exchange 05/12/2004 84.250000 14,330.28 91 26 BOEING CO (097023105) COM New York Stock Exchange 05/12/2004 43.140000 1,121. 64 101 2520 COLUMBIA FINL CORP (197642101) COM NASDAQ Bank - Insurance 05/10/2004 05/14/2004 24.000000 60,480.00 378.00 46.430000 882,541. 44 T:~is report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.3) . Date of Death: Valuation Date: Processing Date: 05/12/2004 05/12/2004 07/15/2004 Shares or Par Security Description High/Ask Low/Bid Estate of: Moore, Joan G. Account: File No. 12142-0001 Report Type: Date of Death Number of Securities: 17 File 10: moore.joan.estate Mean and/or Div and lnt Security Adjustments Accruals Value 121 115 SKYWQRKS SOLUTIONS INe (83088MI02) COM NASDAQ - Industrial 05/12/2004 9.20000 8.63000 H/L 8.915000 1,025.23 13) 328 ROCKWELL COLLINS INe (774341101) COM New York Stock Exchange 05/12/2004 30.14000 29.63000 H/L 29.885000 9,802.28 14) 81 ARVINMERITOR INe (043353101) COM New York Stock Exchange 05/12/2004 18.68000 18.00000 H/L 18.340000 1,485.54 15) 2292 MEDea HEALTH SOLUTIONS INe (58405U1021 COM New York Stock Exchange 05/12/2004 36.68000 35.66000 H/L 36.170000 82,901.64 161 109 MINDS PEED TECHNOLOGIES INe (602682106) COM NASDAQ - Industrial 05/12/2004 5.00000 4.71000 H/L 4.855000 529.20 17) 328 CONEXANT SYSTEMS INC (207142100) COM NASDAQ - Industrial 05/12/2004 4.38100 4.11000 H/L 4.245500 1,392.52 Total Value Total Accrual Total $1,295,147.00 $1,294,769.00 $378.00 Page 2 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.3) Kelley Blue Boo~- Private Party Pricing Report - BMW, 3 Series . Pa~ 10f2 -~..= Capita'( )w' I au-r tlliiHKP Torj,t'~' 'S ,Jlltn lo.lll APRs .]'j 10\>\, Zl'S UBED CAlli REV'EWS &. RATI.NGS ADVICE flijANCING &. IN::'U~ANCE o F... Doe." P.... QuaIAI 0 SiletcIl Uoed c.'Ulllngo ( BLUE BOOK PRIVATE PARTY REPORT Pennsylvania' August 3, 2004 A, Equipment Air Conditioning Power Steering Power Windows Power Door Locks Telescoping Wheel Dual Front Air Bags Cruise Control Front Side Air Bags AM/FM Stereo ABS (4-Wheel) Single Compact Disc Traction Control . 2002 BMW 3 Series 325xi AWO Sedan 40 Search Listinos for This Car List.Y-9JJL CarJor_2.<!le On!in~ Buva New Car Free Record Check Auto Loans from 3.95% APR Insurance .Quote Print "For Sale" Sion Payment Calculator Engine: 6-Cyl. 2.5 Liter Trans: Automatic Drive: All Wheel Drive Mileage: 14,000 Consumer Rated Condition: Good "Good" condition means that the vehicle is free of any major defects. The paint, body and interior have only minor (if any) blemishes, and there are no major mechanical problems. In states where rust is a problem, this should be very minimal, and a deduction should be made to correct it. The tires match and have substantial tread wear left. A clean tiJle.l1istoIY is assumed. A "good" vehicle will need some reconditioning to be sold at retail; however major reconditioning should be deducted from the value. Most recent model cars owned by consumers fall into this category. Private Party Value S~9rch Local Listinos for This Car $23,430 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 Get a Person to Person Auto Loan http://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb.P A;54 7800;P A097 & 17834;+p&722;BMW;200... 8/3/2004 Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of JOAN G. MOORE No. 21-2004-0483 also known as JOAN GRONER MOORE Date of Death February 23, 2004 late of New Cumberland Borough, Cumberland County, Pennsylvania , Deceased Social Security No. 207-32-9943 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 aU 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 dale 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. IftNe verify that the statements made in this Inventory are true and correct. INlle understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Telephone: 3401 N. Front St., PO Box 5950, Harrisburg, PA 17110 (717) 232-5000 Personal Representative: Robert Moore, Executor ~ , Dated: ~ J /e:? /,,~ . , Name of Attorney: Vicky Ann Trimmer, Esquire 1.0. No.: 49679 Address DESCRIPTION VALUE SEE SCHEDULES A TTACHED HERETO o -.~.., TOTAL $1,328,249.00 i",J ,",,) (Attach Additional Sheets If Necessary) 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. 416115v1 FormRW-7(Daup/llnCounly)_Rev.9J92 ESTATE OF FILE NUMBER Joan G Moore 21 04 0483 ITEM Nl./MBEH 1.906 Shares ACNB Corp. common stock CUSIP: 000868109 DESCRIPTION VALUE AT DATE OF DEATH 22,680.20 2 3,384 Shares Allied Irish Banks common stock CUSIP: 019228402 96,088.68 3 81 Shares Arvinmeritor, Inc. common stock CUSIP: 043353101 1,485.54 4 26 Shares Boeing Co. common stock CUSIP: 097023105 1,121.64 5 2,520 Shares Columbia Financial Corp. common stock CUSIP: 197642101 60,480.00 6 328 Shares Conexant Systems, Inc. common stock CUSIP: 207142100 1,392.52 7 120 Shares Duquesne Lt Hldgs, Inc. common stock CUSIP: 23329J104 2,137.80 8 170.0924 Shares M&T Bank Corp. common stock CUSIP: 55261F104 14,330.28 9 2,292 Shares Medec Health Solutions, Inc. common stock CUSIP: 58405U102 82,901.64 10 19,008. Shares Merck & Co., Inc. common stock CUSIP: 589331107 882,541. 44 11 109 Shares ~ndspeed Technologies, Inc. common stock CUSIP: 602862106 529.20 12 1,322.0641 Shares Pennsylvania Commerce Bancorp, Inc. common stock CUSIP: 708677109 66,103.21 13 660 Shares PNC Financial Services Group, Inc. common stock CUSIP: 693475105 34,874.40 H 164 Shares PPL Corp. common stock CUSIP: 709051106 6,628.06 l!i 328 Shares Rockwell Automation, Inc. common stock CUSIP: 773903109 10,646.88 16 328 Shares Rockwell Collins, Inc. common stock CUSIP: 774341101 9,802.28 1'7 115 Shares Skyworks Solutions, Inc. common stock CUSIP: 830088M10 1,025.23 18. 2002 BMW sedan - VIN WBAEU33402PF66650 23,430.00 19. Items of tangible personal property 10,000.00 20. Uncashed Federal Express Travelers Check #HG400065 50.00 COMMONWEALTH OF PENNSYLVANIA DI,PARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT,280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MOORE ROBERT 3401 NORTH FRONT STREET HARRISBURG, PA 17110-0950 nn_n_ told ESTATE INFORMATION: SSN: 207-32-9943 FILE NUMBER: 2104-0483 DECEDENT NAME: MOORE JOAN G DATE OF PAYMENT: 02/10/2005 POSTMARK DATE: 02/10/2005 COUNTY: CUMBERLAND DATE OF DEATH: 05/12/2004 NO. CD 004932 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,717.35 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK#104 SEAL INITIALS: CCP RECEIVED BY: REGISTER OF WILLS $2,717.35 GLENDA FARNER STRASBAUGH REGISTER OF WillS IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: ESTATE OF JOAN G. MOORE, aIkIa JOAN GRONER MOORE, late of New Cumberland Borough, Cumberland County, Pennsylvania, deceased Estate No. 2004-00483 DISCLAIMER I, Robert M. Moore, hereby declare that I am the son of Joan G. Moore, a/kla Joan Groner Moore, who died on May 12, 2004. I hereby irrevocably and completely disclaim and refuse to accept any and all rights, title and interests that I may be entitled to receive pursuant to Item Fifth of the last Will and Testament of Joan G. Moore dated November 8, 1986, during the lifetime of my father, Robert Moore, which section permits the invasion of principal for my benefit. I hereby state and certify that I have not accepted any benefits or interest pursuant to Item Fifth of the last Will and Testament of Joan G. Moore dated November 8, 1986, with regard to any invasions of trust principal for my benefit. This document is intended to qualify as a disclaimer under Section 2518 of the Internal Revenue Code of 1954, as amended, and under Chapter 61 of the Pennsylvania Probate, Estates and Fiduciaries ~. '1' /J Dated this 1 dayof ~ ,2005. () ~ YJL ~ AWtl LsEkt q .A~rt . Moore ,----,. . . 330278_1 C,~) C,,) ., U"I 'II J ACKNOWLEDGMENT I STATE OF Ift:/ZCIU /-f COUNTY OF /'-/P(2.J Ccpfl 55. ---- On this 7t:!: day of f-e-gtt'/ll't.j , 2005. before me, the undersigned officer, a Notary Public In and for the said county and state, personally appeared Robert M. Moore, who, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Disclaimer are true and correct to the best of his knowledge, information, and belief and that he executed the same as his voluntary act and deed for the purposes therein contained. i) Notary Public State of Arizona Maricopa County Stacie R Maddio Expires July 11,2005 .:~ 1a~':"- i?' / L/tfC)(: Notary Public 2 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: ESTATE OF JOAN G. MOORE, a/k/a JOAN GRONER MOORE, Late of New Cumberland Borough, Cumberland County, Pennsylvania, deceased Estate No. 2004-00483 RECEIPT OF DISCLAIMER Robert Moore, being duly sworn according to law, depose and say that he is the Executor under the Last Will and Testament of Joan G. Moore dated November 8, 1986, and that on the date and place as hereinafter set forth, he received the foregoing signed Disclaimer from Robert M. Moore. ESTATE OF JOAN G. MOORE, alkla ~'De"'" Robert Moore, Executor D"'1~~Ut({ PI,,, ~A, SWORN TO AND SUBSCRIBED before me this ~ day of 2005. ~t,~ Notary Public f COMMONWEALTH Of PENNSYLVANIA Notarial Seal Monica J. Bald, Notary Public Susquehanna Twp., Dauphin County My Commission Expires July 12, 2008 Member, Pennsylvania Assocu;ltlOn of Notaries 415826v1 3 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: ESTATE OF JOAN G. MOORE, a/k/a JOAN GRONER MOORE, Late of New Cumberland Borough, Cumberland County, Pennsylvania, deceased Estate No. 2004-00483 DISCLAIMER I, Stephen S. Moore, hereby declare that I am the son of Joan G. Moore, a/kla Joan Groner Moore, who died on May 12, 2004. I hereby irrevocably and completely disclaim and refuse to accept any and all rights, title and interests that I may be entitled to receive pursuant to Item Fifth of the Last Will and Testament of Joan G. Moore dated November 8, 1986, during the lifetime of my father, Robert Moore, which section permits the invasion of principal for my benefit. I hereby state and certify that I have not accepted any benefits or interest pursuant to Item Fifth of the Last Will and Testament of Joan G. Moore dated November 8, 1986, with regard to any invasions of trust principal for my benefit. This document is intended to qualify as a disclaimer under Section 2518 of the Internal Revenue Code of 1954, as amended, and under Chapter 61 of the Pennsylvania Probate, Estates and Fiduciaries Code. Dated this qtlt day of f;bruQfY ,2005. Witness: (SEAL) '<.-"" O(~ St S. Moore i-J_ '::::~l 330278_1 ul ACKNOWLEDGMENT STATE OF ~Y\1'\~va.^'14 COUNTY OF d>zu,~;,-, SS. On this ~ day of fdJuuzfll-' 2005, before me, the undersigned officer, a Notary Public in and for the said county a state, personally appeared Stephen S. Moore, who, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Disclaimer are true and correct to the best of his knowledge, information, and belief and that he executed the same as his voluntary act and deed for the purposes therein contained. ~~~ Notarial Seal Monica J Said, Notary Public Susquehanna Twp., Dauphin County My Commissiofi ExpJrcs July 12, 2008 Member, Penl1SVlV3ni<'l 1\':1:>0cialion of Notaries 2 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: ESTATE OF JOAN G. MOORE, a/k/a JOAN GRONER MOORE, late of New Cumberland Borough, Cumberland County, Pennsylvania, deceased Estate No. 2004-00483 RECEIPT OF DISCLAIMER Robert Moore, being duly sworn according to law, depose and say that he is the Executor under the last Will and Testament of Joan G. Moore dated November 8, 1986, and that on the date and place as hereinafter set forth, he received the foregoing signed Disclaimer from Stephen S. Moore. ESTATE OF JOAN G. MOORE, a/k1a JOAN GRONER MOORE, Deceased ~; Robe oore, xecutor Date: ~ ~dco~ PI,re ~ & SWORN TO AND SUBSCRIBED before me this qtz1 dayof ~. 2005. ~~~ Notary Public 7 COMMONWEALTH OF PENNSYLVANIA Notarial Seal Monica J. Bald, Notary Public Susquehanna Twp., Dauphin County My Commission Expires July 12, 2008 Member. Pennsylvania Association of Notaries 415842v1 3 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: ESTATE OF JOAN G. MOORE, a/k/a JOAN GRONER MOORE, Late of New Cumberland Borough, Cumberland County, Pennsylvania, deceased Estate No. 2004-00483 DISCLAIMER I, Jennifer M. Rose, hereby declare that I am the daughter of Joan G. Moore, a/kla Joan Groner Moore, who died on May 12, 2004. I hereby irrevocably and completely disclaim and refuse to accept any and all rights, title and interests that I may be entitled to receive pursuant to Item Fifth of the Last Will and Testament of Joan G. Moore dated November 8, 1986, during the lifetime of my father, Robert Moore, which section permits the invasion of principal for my benefit. I hereby state and certify that I have not accepted any benefits or interest pursuant to Item Fifth of the Last Will and Testament of Joan G. Moore dated November 8, 1986, with regard to any invasions of trust principal for my benefit. This document is intended to qualify as a disclaimer under Section 2518 of the Internal Revenue Code of 1954, as amended, and under Chapter 61 of the Pennsylvania Probate, Estates and Fiduciaries Code. Dated this 8 day of ,2005. Witness: ~krM. r~AL) Jennifer M. Rose }{ rAjjJ Oroi:1)j. 07~ 'f) C) (':,:J 330276_' ~ ACKNOWLEDGMENT STATE OF ~t'\n.b<<#~ COUNTY OF ~ 55. On this g'fk day of , 2005, before me, the undersigned officer, a Notary Public in and for the said county and tate, personally appeared Jennifer M. Rose, who, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Disclaimer are true and correct to the best of her knowledge, information, and belief and that she executed the same as her voluntary act and deed for the purposes therein contained. ~~Q }~ N6tary Public COMMONWEALTH OF PENNSYLVANIA Notarial Seal Monica J. Bald, Notary Public Susquehanna Twp.. Dauphin County My Commission Expires July 12, 2008 Member, Pennsylvania Association of Notaries 2 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: ESTATE OF JOAN G. MOORE, a/k/a JOAN GRONER MOORE, Late of New Cumberland Borough, Cumberland County, Pennsylvania, deceased Estate No. 2004-00483 RECEIPT OF DISCLAIMER Robert Moore, being duly sworn according to law, depose and say that he is the Executor under the Last Will and Testament of Joan G. Moore dated November 8, 1986, and that on the date and place as hereinafter set forth, he received the foregoing signed Disclaimer from Jennifer M. Rose. ESTATE OF JOAN G. MOORE, a/k/a J~D~~d Robert Moore, Executor D,le 1&1;2 ~~J Place: ~J SWORN TO AND SUBSCRIBED before me this gH1 day of ~, 2005. ~ COMMONWEALTH OF PENN~YLVAN1A Notarial Seal Monica 1. Bald, Notary Public Susquehanna Twp., Dauphin County My Commission Expires July 12, 2008 Member, Pennsylvania Association of Notaries 415844v' 3 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX BUREAU OF INDIVmuA1!ffMICD rp:V:F ni=APPRAISEIIENT. ALLDIIAHCE OR OISALLDIIANCE INlERITAMCE TAX DIVISIoN' - ..~,! ,\...~ -' OF DEDUCTIONS AND ASSESSHENT OF TAX PO lOX 2118601 HARRISBURG PA 17128-0601 ~",rr: I.u~.. DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04"25-2005 MOORE 05-12-2004 21 04-0483 CUMBERLAND 101 AIoount R_ittlld 29 1'0'02 ..-. , ',-, . CLEF~r(. VICKY A"":qr~i~~~ (l~~m METTE ETA!. PO BOX 5950 HBG PA 17110 '* REV-1547 EX AFP (03-05) JOAN G MAKE CHECK PAYABLE AND REMIT PA~MENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ... 1I1V-"l'!4"Yf.m.'l'lJJ~1.'lftltm.tft!".!MftmJM!I!'.mr.1l'Jllflllm""~.'X'c:r.'lIII'JM!I!'.DI'.............. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX JOAN G FILE NO. 21 04-0483 ACN 101 ESTATE OF MOORE TAX RETURN liAS: I X I ACCEPTED AS FILED I I C_EO I~ .n &S......nt w.. i..ued previously, lines 14, 15 .nd'or 16, 17. 18 ~nd r~lect: ~igure. that include the total 01' ab!:. return. .......d to date. i ASSESSMENT OF TAX: 15. AIoount of Li... 1'1 .t Spousal r.t. 1151 16. Aaount of Li... 1'1 t....1. .t Li....l/Class A rat. 1161 17. Aaount of U... 1'1 .t Sibling rat. 117l lB. _...t of U... 1'1 t....l. .t Coll.t.rallCl.ss Brat. I1BI 19. Principal Tax Dua RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..1 Est.t. ISchedu1. Al 2. Stocks _ _. ISchaclul. BI 3. Closaly 1Ia1d Stock/P.rt...rship Int.r.st ISchadul. CI 'I. Ilort_sINot.s _i_I. ISchadul. 01 5. Cashl_ _.itslllisc. P.rsona1 Property ISchadul. EI 6. Jointly _ Property ISchedul. FI 7. Tr8nsfers (Schedule 8) 8. Tot.l A...t. III 121 131 I'll 151 161 171 .00 1.294.769.00 .00 .00 33.480.00 .00 .00 IBI APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Exp.n..s/~. Costs/Misc. ExPense. (Schedule H) ID. Dabtslllort_ Li..iliti../Lian. ISchadu1. II 11. Tot.l Daductions 12. N.t V.lue of Tim(. Retum 13. Charitable/80v.~t.l Bequests; Non-.lacted 9113 Trusts 14. ...t Value of Est.t. S\Djact to Tax 191 I1DI 38.178.47 .00 1111 1121 1131 11'11 ISchadu1. .J) NOTE: 527.930.61 X 762.139.92 X .00 X .00 X AIlDUIlT PAID 30.000.00 2.717.35 DATE 08-09-2004 02-10-2005 IlITEREST/PEII PAlO I-I 1.578.95 .00 _ER CD004251 CD004932 ~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE DATE 04-25-2005 I NOTE: Tt in..,.. proper Gredlt 0 your account, .....i t ... _r portion of thlsifonD with your tax _to 1,328.249.00 , r-17A 47 1.2 0.070.53 ; .00 1.2 0,070.53 , 19 will 00 = 045 = 12 = 15 = 1191= .00 ~4.296.30 I .00 , .00 ~4.296.30 3..296.30 .00 .00 .00 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN tl, NO PAYIIENT IS RElIUIREO. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.I nc-(Y)Lll:Ii." (yc-'AC rc- .UREAU OF INDIVIDwll:.U._-",,:U v'rf-iGL Jr- INHERITANCE TAX DIVISIDfr4-"f.....~'-'..rn"\ PO lOX 2BUOl ijtt:;0! l::'h, HARRISBURG PA 1712B~O'Ol COMMONWEALTH OF PENNSYLVANIA DEPARTMEMT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN *' REV-4.3 EX AFP (03-05) Oir," VICKY M'TRIMMER ESQ METTE ETAL PO BOX 5950 HBG PA 17110 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-25-2005 MOORE 05-12-2004 21 04-0483 CUMBERLAND 201 JOAN G 2005 29 Pi! 3: 09 Amount Re.itted I: MAKE CHECK PAYABLE AND REMIT PA~MENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 NOTE: To Insure proper credit to your account, submit the upper portion af this for. with your tax pay..nt. CUT ALOMG THIS LINE ~ RETAIN LONER PORTION FOR YOUR FILES ~ ie:,;:4i!r.Ex.1rFp.(.oi:o.5)......~.No~ici..oF.jjEiEirHiN;rfio;r.lN1i.ls1rEssM.ENt................~._......._.. OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN .. ESTATE OF MOORE JOAN G FILE NO.21 04-0483 ACN 201 DATE '4-25-2005 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified .00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 32.717 . 35 3. Inheritance Tax Assessed by Other States or Territories of the United states (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 32.717. 35 5. Pennsylvania Estate Tax Due .00 TAX CREDITS. PAYMENT RECEI PT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT i .00 BALANCE OF TAX DUE I .00 i INTEREST AND PEN. .00 TOTAL DUE .00 .IF PAID AFTER THIS DATE. SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN .1. NO PAYMENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU HAY BE ~~, DUE ~ REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~ VICKY ANN TRIMMER ESQ METTE ETAL PO BOX 5950 HBG PA 17110 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 REY-7U EX AFP ("-Il!il 08-01-2005 MOORE 05-12-2004 21 04-0483 CUMBERLAND 202 APPEAL DATE: 09-30-2005 (See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT JOAN G TO: REGISTER OF WILLS CUMBERLAND CO CDURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account I subnit the upper portion of this forn with your tax pay..nt. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR FILES +- iii-y:'73(,--EiCA'FP-Tiii':.-cizi-----ii.-Noffi:riii:--DE1'ifiiiiiiA'iicf'niilnssEssIiENy---------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER .. ESTATE OF MOORE JOAN G FILE NO.21 04-0483 ACN 202 DATE 08-01-2005 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified .00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 32,717.35 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 32.717.35 5. Pennsylvania Estate Tax Due .00 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return .00 7. Additional Pennsylvania Estate Tax Due .00 PAYMENT RECEIPT DISCOUNT (+) ~~.' .~ ,en r:h AMOUNT PAID b """ n DATE NUMBER INTEREST/PEN PAID (-) ~.1 .- CJ --.~:~ t:=.i ":--0 1::::J " I ;-~;---;t . --~ U>j CJ /~ - 0 ~, c> :-'::0" I .1 _-'no - " - -- ~5 - -- ,-n .. en .(-::) \.0 TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 c) "" = ~ --" TAX CREDITS: -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU KAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.I "':::.,L <:;>.." METTE. EVANS & WOODSIDE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 3401 NORTH FRONT STREET P.O. BOX 5950 HARRISBURG, PA 1 '7110-0950 VICKY ANN TRIMMER, ESQ. IRS NO. 23-198:'100:'1 E-MAIL ADDRESS vatrimmer@mette.com TELEPHONE (717) 232-:'1000 FAX (717) 236-1816 HTTP://WWW.METTE.COM January 4,2006 Glenda Farner Strasbaugh Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 RE: ESTATE OF JOAN G. MOORE, A/K/A JOAN GRONER MOORE File No. 2004-00483 Dear Ms. Strasbaugh: Enclosed for filing is the original and one (1) copy of a Status Report Under Rule 6.12. Please file the original and return a date-stamped copy to my attention in the enclosed envelope. Please note that administration of this estate is complete. Thank you for your assistance. Very truly yours, - " \~ I '-/:, LisaJ. Kn~ 1 Paralegal to'Vf~ky Ann Trimmer r, r, \ -.. 'Y\, (j \_~ LJK: Enclosures 440277vl Wyomissing Office 11105 Berkshire Boulevard, Suite 320 I Wyomissing, P A 19610 I Telephone (610) 374-11351 Facsimile (610) 371-9510 PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF THE ESTATE IS NOT COMPLETED, FILE A 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: JOAN G. MOORE. a/k/a JOAN GRONER MOORE Date of Death: Mav 12, 2004 Will No. 2004-00483 Admin. No. 21-04-0483 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate. 1. State whether administration of the estate is complete: Yes [SI No D 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 D No [SI b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes [SI No D d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: f / r1\Jh dA' 4", k~~~~ 0 Signahfte Vickv Ann Trimmer. Attornev LD. #49679 Name (Please type or print) 3401 North Front Street, P.O. Box 5950 Address Harrisburg, PA 17110-0950 (717) 232-5000 Telephone Capacity: D Personal Representative [SI Counsel for Personal Representative 440276vl \ft. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/06/2006 NICHOLSEN KATHRYN J 2122 ORRSTOWN RD SHIPPENSBURG, PA 17257 RE: Estate of BYERS OLIVE M File Number: 2004-00482 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 3/28/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/06/2006 BYERS RICHARD A 300 N FAYETTE ST SHIPPENSBURG, PA 17257 RE: Estate of BYERS OLIVE M File Number: 2004-00482 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing is due by: 3/28/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~J~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/06/2006 DEWALT KIMBERLY J 300 N FAYETTE ST SHIPPENSBURG, PA 17257 RE: Estate of BYERS OLIVE M File Number: 2004-00482 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 3/28/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~.~~J~ , >' Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel