The URL can be used to link to this page

Home My WebLink About03-0779Practice Emphasis: Estate Planning Business Planning Estate Administration Real Estate Corporations Partnerships FRED E. KILGORE, JD, LLM (TAXATION) ATTORNEY AT LAW September 23, 2003 Donna Otto - Register of Wills Cumberland County Courthouse 1 Court House Square Carlisle PA 17013 Attention: Sue 2550 Kingston Road, Suite 323 York, Pennsylvania 17402 Phone: (717) 757-6315 Fax: (717) 757-1441 RE: Estate of Aubrey K. Souders Late of New Cumberland Borough, Cumberland County, PA Date of Death: 09-06-2003; SSN: 195-07-7230 Dear Register of Wills: Enclosed you will find the following documents concerning the above-referenced Estate: 1. Original and copy of the Will of Aubrey K. Souders dated January 30, 2002; 2. A Death Certificate for Aubrey K. Souders; 3. An Estate Information Sheet; 4. A Petition for Grant of Letters Testamentary signed by the Executrix before the Register of Wills of York County; 5. A check payable to the Register of Wills of Cumberland County in the amount of $105.00 for completing probate; and 6. A self-addressed stamped envelope. Please probate the above Will and return the Letters and Short Certificates to me in the self-addressed stamped envelope. I appreciate your attention to this matter. Since,re~j~/, __ /Fred F_~Xi~o ' FEK:nln ~ Enclosures CUMBERLAND Register of Wills ofx e k County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of AUBREY -~. SOUDERS"~ ~.(~" '~ ~' ~ also known as ~,o~:::~,3x.9_~j ~, ~O~_~_-f~'~ ~33~' - Late of New. Cumberland Boro , Deceased SociaISecudty No. 195-07-7230 Petitioner(s) who is/are 18 years of age or older, apply(ies) fo~. (COMPLETE "A' OR "B' BELOW:) [~ A. Probate a nd Grant of Letters Testamentary and aver that Petitioner(s) isJ~ the executeziX named in the last Will of the decedent, dated January 3 0 .. 2 0 0 2 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 bom 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 (d.b.n.c. La.; pendente lite; durante absenlJa; du~ante minD,ate) 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 (COMPLETE IN ALE. CASES:) Attach additional sheets if necessary Decedent was domiciled at death in __ ~4~,~.~..~-;~ County, Pennsylvania. with his/Ike/flast family or principal residence at 330 4th Street, New Cumberland,PA 17070- New Cumberland Borough (liSt street, number, arid mur~icipality) Decedent, then 1 01 years of age, died September 6 ,20 03 Decedent al death owned property with estimated values as follows: (If domiciled in PA) All personal property (if not domiciled in PA) Personal property in Pennsylvania (If not domidled in PA) Personal property in County Value of Real Estate in Pennsylvania situated as follows: .Barbara J. Egan Nursing & ~n~o ~~.) Sh£~w~bu~ yPA $ 10,000.00 $ $ $ 40~000.00 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: ! --~7 / S~ature // Typed or printed name and residence Sandra Jean Bixler Houser 12576 Stamper Road Brogue PA 17309 saace,'W~ls Pet G rantLt/2001 Oath of Personal Representative Commonwealth of Pennsylvania County of York The Petitioner(s) above-named swear(s) or afffirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief or Petitioner(s) and that, as personal representative(s) of the . administaC3he estate according to.~w. / Decedent, Petition(s) will well and truly ~,~ ~ ~ ~. _/_/~,~ ~,,) Sworn to or affirmed and subscribed before me this 23rd day of U ~ September 20 03 -' 0' ~:o.; the I~egister 21-03 - '1'3 Estate of f4.~A rey K. So~ers ' Social Sec' rity No ' I 95- ~7- 723 Q of the Petition on the reverse side hereon, sati~facto~ proof having been presented before me, IT IS DECREED that Letters ~ Testamenta~ ~ Of Administration are hereby granted to Sandra Date of Death: September Deceased 6, 2003 _.inconsideration d.b.n.c.t.a.; pendente lite; dumnte absentia; durante minodtate Jean Bixle~ ~n,,~ in the above estate and that the instrument(s) dated J~nuary 30 r 21313 ? described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ............ $ 8 0.0 0 Short Certificate(s)...$ 9 o 0 0 Renunciation ....... $ Affidavits ( Extra Pages( ) ..... $ 6.00 Codicil ............ $ JCP Fee ........... $ 1 0.00 Inventory ........... $ Automation Fee ..... $ Other .............. $ TOTAL ........ $ 1 o 5. o o _ snaceNVillsPetGrantLt/2001 Attorney:/'P r~_~vZ ~.w~a/ l g~r~. I.D. No: 15842 Address: 25~n w~~ ~ Suite ~q~ ' York_. PA 1'7402 Telephone: (717) 757-6315 I05.805 REV 9/86 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. Thc 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 950736_1 No. Local Registrar 2003 [)ate 43Rev 2/87 1 0 1 ~". : York DECEDENT'S USUAL OCCUPATION COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ct23 190 R . ~ , ~ewCumber~an~ ~ ~. ~ R--,~ ,~,~,~ ~hrewsb~ry I~arba~ G. E~anNurszn~ ~RehaB.I~.~o~ .... KJNO OF BUSINESS;INDUSTRY ';~S ~CEDENT EVER tN DECEDENT'S EDUCATION C~ve k,n(I o~ v,~k do,~ du~ ~ [ S ~MEO FO~ES? I ,,,Auto~chanic ~. ~uaers ~ram~ ~CE~NT'SUNLtNG AD~ESS(~,.. C~. ~..Z~C~l J~CE~.,'S Pa ACTU~ 171. State 330 4th Street ,ES,~ - New Cumberland,PA 17070~'~ ~"'~ Cumberland ,~,~ ,,.George A. Souders ~. Sandra J. Houser ,,.Widowed ,,. ,?d.[] v. mm~m~dlm~o! New Cumberland %% ?T ub i,,~t. Olivet Cemetery I,New Cumberland,PA 17070 DATE OF DISPOSITION (MO~I~,. Day. Yea~) E].~p[. 10, 2003 NAME AND ADORES~ OF FACILITY 1 0 L~.tone&MurrayFH408 3rd St New Cumberland, ~ LICENSE NUMEIE R DATE SIGNED LAST WILL AND TESTAMENT OF AUBREY K. SOUDERS I, AUBREY K. SOUDERS, a resident of New Cumberland Borough, Cumberland County, Commonwealth of Pennsylvania, declare this to be my Will. I revoke any and all Wills and Codicils that I have previously made. I. PAYMENT OF BURIAL EXPENSES AND DEBTS. I direct my executor to pay my burial expenses and all of my debts that my executor in her sole discretion may allow as claims against my estate. II. JOINT ACCOUNT WITH GRANDDAUGHTER. I presently have certificates of deposit in joint names to be payable on my death to my granddaughter, SANDRA JEAN BIXLER HOUSER. I confirm that it is my intention that those certificates of deposit, and any future such accounts that I may title into joint names, shall be payable to my granddaughter or other surviving joint owner or death beneficiary, as the case may be, and not into my estate for distribution. III. DISPOSITION OF ESTATE. Ail the rest, residue and remainder of my estate, I give, devise and bequeath as follows: A. To my son, GEORGE SOUDERS, who may also be know as GEORGE L. MYERS, twelve and one-half (12 1/2%) percent, if he survives me. If he does not survive me, then his share I give to those other persons in this Article III that survive me in the same proportion that they now relate to each other. B. To my granddaughter KRISTI ANN SPIDEL KRICK, twelve and one-half (12 1/2%) percent. If she does not survive me, then her share I give to KRISTI'S daughter, KASSANDRA KRICK which shall vest in her but be held by my executor as trustee until she is twenty five years of age at which time the trust shall cease and the fund distributed in full to her, with the principal and income until such time being used in the trustee's sole discretion for her benefit. If she does not survive me, then this share I give to those other persons in this Article III that survive me in the same proportion that they now relate to each other. C. To my granddaughter, SANDRA JEAN BIXLER HOUSER, thirty seven and one-half (37 1/2%) percent, if she survives me. If she does not survive me, then her share I give to those other persons in this Article III that survive me in the same proportion that they now relate to each other. D. To my granddaughter, DEBRA ELAINE BIXLER RIDER, thirty seven and one-half (37 1/2%) percent. If she does not survive me, then her share I give to DEBRA'S son JEFFREY RIDER. LAST WILL AND TESTAMENT OF AUBREY K. SOUDERS PAGE 2 OF 3 IV. PAYMENT OF TAXES. I direct that all state and federal estate, succession, legacy, inheritance or other transfer taxes, however designated, that shall become payable by reason of my death with respect to any property which is included in my estate for purposes of computing any such taxes, shall be paid from my residuary estate as an expense of administration and without apportionment. My Executors shall have no duty or obligation to obtain reimbursement for any such tax paid by them even though on proceeds of insurance or other property not passing under this Will. V. APPOINTMENT OF EXECUTOR. A. Appointment. I name, constitute, and appoint my granddaughter, SANDRA JEAN BIXLER HOUSER as executor of my estate. If SANDRA shall not survive me, shall refuse or fail to serve as executor for any reason, or shall cease to serve as executor for any reason after having been appointed, Sandra's husband, EDWARD L. HOUSER, shall act as executor. If Edward shall refuse or fail to serve as executor for any reason, or shall cease to serve as executor for any reason after having been appointed, then my granddaughter, DEBRA ELAINE BIXLER RIDER, shall act as executor. B. Bond Not Required. None of the individuals named in this Will as executor shall be required to furnish a bond for the faithful performance of his or her duties as executor. VI. INTERPRETATION. A. Headings. Ail headings used in this Will to describe the contents of each article, paragraph, or other division are provided for convenience only and shall not be construed to be part of this Will. B. Governinq Law. This Will shall be construed in conformity with the law of the Commonwealth of Pennsylvania. IN WITNESS WHEREOF, I, the said Testator, have to this my Last Will set my hand and seal this ~ 7~ day of ~/~,~.~ , 2002. 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, all being present at the same time, have hereunto subscribed our names as witnesses. LAST WILL AND TESTAMENT OF AUBREY K. SOUDERS PAGE 3 OF 3 COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF YORK ) SS I, AUBREY K. SOUDERS, the Testator, whose name is signed to the attached or foregoing Last Will and Testament, having been duly qualified according to law, do hereby acknowledge that I signed and executed my Last Will and Testament; that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn and subscribed to before me, this ~3[~day i- ~1~3~ ' ' ! , , ~E~LTH OF PE~SYLV~IA( ) COMMO l~ ..... -. CO TY YORK ) SS undersigned witnesses whose names are signed to the attached or foregoing Last Will and Testament, being duly qualified according to law, do depose and say that we were present and saw the Testator, sign and execute his Last Will and Testament, that the said Testator signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator, signed the Will as witnesses; and that to the best of our knowledge the Testator, was at that time eighteen or more years o~ge, of sound mind and under no constraint or undue influe~ce~~/~ Sworn and subscribed to before me, this ~C4n day o f ~aC~i , 2 0 0 2% NOTARIAL SEAL T~,AAY ~. DIEI'Z, NOTARY PUBLIC YORK, YORK COUNTY MY COMMISSION EXPIRES FEB. 23, 2004 AUBREY K. SOUDERS FRED E. KILGORE ATTORNEY AT LAW CERTIFIED FINANCIAL PLANNER 2550 KINGSTON ROAD · SUITE 115 · YORK, PENNSYLVANIA 17402 FRED E. I(3LGORE, JD, LLM (TAXATION) ATTORNEY AT LAW Practice Emphasis: Estate Planning Business Planning Estate Administration Real Estate Corporations Partnerships September 25, 2003 2550 Kingston Road, Suite 323 York, Pennsylvania 17402 Phone: (717) 757-6315 Fax: (717) 757-1441 Donna Otto - Register of Wills Cumberland County Courthouse 1 Court House Square Carlisle PA 1 7013 Attention: Sue FAX TRANSMISSION Re: Estate of Aubrey Souders, a/k/a Aubrey K. Souders Dear Register of Wills: Pursuant to your request, I hereby verify that I authorize your office to amend all probate documents relating to the above-named Estate to reflect the change of name from Aubrey K. Souders to Aubrey Souders, a/k/a Aubrey K. Souders. Thank you for your kind cooperation in this regard and should you have any further questions or concerns regarding this matter, please do not hesitate to contact my office. Sincere~ly, FEK/nln FAXED TO 717-240-7797 ON 09-25-03 BY NLN AND MAILED. AUTOMAT I C COVER SHEET ~ATE : S'EP-25-0~ 09:08 AH TO : FAX ~: 171724077~7 FROM : KILGORE FAX :15: 17177571441 PAGES WERE SENT ( I NCLU]] I NC TH I S COVER SHEET TBLBPHON£ (717) 757-e~$15 FAX (717) TBLECOPZER TRANSMITTAL SHEET SENT TO: Donna Otto Register of Wills Attn: Sue TELECOPIER #: 717-240-7797 Number of Pages Including Cover She~: 2 SENT BY: Fred E. Kilgore DATE: September 25, 2003 RE: Aubrey Souders a/k/a Aubrey K. Souders If you do not receive all mater/a/ being transmitted, us at (?17)7~7-6315 MESSAOE please call Dear Suet Per our telephone conversation of yesterday, attached authorization you requested. Please call if necessary. Thank you. Nancy is the ~ONFIDENTIALITYNOTICE THIS TRANSMISSION IS INTBNDED ONLY FOR THE USE OF TH~ INDIYXDUALOR ENTITY TO ~HICH IT IS ADD~ESS~D, AND MAY CONTAIN INFORMATION THAT IS PRIVILE~ED~ CONFIDENTIAL AND~XEMPT F~OM DISCLO~UREUNDE~ APPLICABLE LAW. If ~ha reader o~ the message is no~ =he intenaea recipient, or ~he employea or agent responslble for ~alivering ~he ~e~sage =o the i~tende~ ~ecipien=, you are hereby noti£ie~ that any dissemination, die=rxbu=ion or oopy~ o~ hie telecoD¥ in error, ~lea~e notify us by · -,=~-~ v~ you hay= receive~ C ..... ORIGINAL WILL WILL II~X3U~X ~OLLOW BY M~IL gtt~ttt 1,la~ntng lltttttt Atlsdn~trat~ September 25, 2003 Donna Otto - Register of Wills Cumberland County Courthouse 1 Court House Square Carlisle PA 17013 Attention: Sue Re: FAX TRANSMISSION Estate of Aubrey Souders, a/k/a Aubrey K. S°uders Dear Register of Wills: Pursuant to your request, I hereby verify that I authorize your office to amend all probate documents relating to the above-named Estate to reflect the change of name from Aubrey K. Souders to Aubrey Souders, a/k/a Aubrey K. SOuders. Thank you for your kind cooperation in this regard and should you have any further quesl:ions or concerns regarding this matter, please do not hesitate to contact my office. /~red ~ FEKInln FAXED TO 717-240-7797 ON 09-25-03 BY NLN AND MAILED. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Aubrey Souders, a/k/a Aubrey K. Souders Date of Death: September 6, 2003 Will No./Adm. No.: 21-03-779 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 September 30, 2003: Name Address George L. Myers, a/k/a George Souders RR1 - Box 2032, Blain, PA 17006 Kristi Ann Spidel Krick 913 West Trindle Road Mechanicsburg, PA 17055 Deborah Elaine Bixler Rider RD1 - Box 230, Church Road Elliottsburg PA 17024-9734 Sandra Jean Bixler Houser 12576 Stamper Road, Brogue, PA 17309 Notice has now been given to a%~-npersons entitled thereto under Rule 5.6(a).~---~ . Date ~red /2550 ~ingWton Road, York, Pennsylvania (717) 757-6315 I.D. #15842 Suite 323 17402 Counsel for personal representative Practice Emphasis: E!tate Planning siness Planning tate Administrdtion Real Estate Cp~r~nOratiOns erships FRED E. IOLGORE, JD, LLM (TAXATION) ATTORNEY AT LAW 2550 Kingston Road, Suite 323 York, Pennsylvania 17402 Phone: (717) 757-6315 Fax: (717) 757-1441 June 3, 2004 Register of Wills CERTIFIED MAIL - RETURN RECEIPT REQUESTED Cumberland County Court House 1 Court House Square Carlisle PA 17013 Re: Estate of Aubrey Souders, a/k/a Aubrey K. Souders File No. 2003-00779 PA No. 21-03-0779 Dear Register of Wills: Enclosed you will find for filing the following documents for the above-referenced estate: ,. The original and one (1) copy of the Pennsylvania Inheritance Tax Form; The original and one (1) copy of the Inventory; A check made payable to "Register of Wills, Agent" in the amount of $7,245.23 for the tax due thereon; A check made payable to "Register of Wills" in the amount of $186.00 representing $155.00 in additional probate fees, $15.00 for filing the PIT and $16.00 for filing the Inventory. Should you have any questions or concerns regarding this matter, please do not hesitate to contact my office. Sinc~ Enclosures c: Sandra Houser, Executrix CD COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 004013 KILGORE FRED E ESQ 2600 EASTERN BLVD SUITE 102 YORK, PA 17402 ........ fold ESTATE INFORMATION: SSN: 195-07-7230 FILE NUMBER: 2103-0779 DECEDENT NAME: SOUDERS AUBREY DATE OF PAYMENT: 06/04/2004 POSTMARK DATE: 06/04/2004 COUNTY: CUMBERLAND DATE OF DEATH: 09/06/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $7,245.23 REMARKS: TOTAL AMOUNT PAID: 97,245.23 SEAL CHECK//134 INITIALS: JA RECEIVED BY.' GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS . REV-I$00 co--o-~,.oF,,,~-~v,~ INHERITANCE TAX RETURN DEPARTMENT OF REVENUE DE,.~, RESIDENT DECEDENT -----.____ NARRISBURG, PA 17128-0601 DECEDENT'S NAME (lAST, FIRST, AND MIDDLE INiT/AL) Souders, Aubrey 09/06/2003 10/23/1901 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INmAL) 1. Original Return D 2. SupplementaIRetum [~] 4. Limited Estale [] 4a. Future Interest Compromise (date of death after 12-12-82) [] 6. Decedenl Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach of Will) copy of Trust) [] 9. Litigation Proceeds Received [] 10. Spousal Povedy Credit (date of death between Fred E. Kilgore pplicable) Fred E. Kilgore, Attorney at Law UMBER 717/757-6315 SOCIAL SECURITY NUMBER 195-07-7230 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WIII .q SOCIAL SECURITY NUMBER -~ 3. Remainder Return (date of death priorto 12-13-82) [] 5. Federal Estate Tax Return Required __ 8. Total Number of Safe Deposit Boxes [] 11 .Election !o. tax under Sec. 91 13(A) (Attach Sch O) i" COMPLETE MAILING ADDRESS .":':':';';~ 2550 Kingston Road Suite 323 York, PA 17402 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5). 6. Jointly Owned Property (Schedule F) [] Separate Billing Requested (6) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11 Total DedUctions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 83,000.00 1,653.00 None None 22,551.30 None 85,179.40 24,410.49 6,968.02 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 (8) 192,383.70 31,378.51 (11) (12) (13) i61,005.19 (14) 161,005.19 15. Amount of Line 14 taxable at the spousa tax rate, or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 1 7. Amount of Line 14 taxable at sibling rate 1 ,B. Amount of Line 14 taxable at collateral rate 1~9. Tax Due 0.00 x .00 (15) ]61,005.19 x .045 (16) 0.00 x .12 (17) 0.00 x .15 (18) 7,245.23 20. [] (19) 7,245.23 Form REV-I$00 EX (Rev. 6-00) & Decedent's Complete Address: I~TREEI ADDRESS 330 4th Street CITY ISTATE PA ZIP New Cumberland 17070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 7,245.23 0.00 0.00 7,245.23 7,245.23 (4) (5) (5A) (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS I. Did decedent make a transfer and: Yes No a. retain the use or income of the properly transferred; ..................................................................................... ~ ~ b. retan the right to des gnate who shall use the pmpariy transferred or its income'. ........................................ c. retain a reversionary interest; or .................................................................................... d. receive the promise for life of either payments, beneffis 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 penaffies of perjury, ! 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. Declarat~>nr. xof preparer other than the personal representative is based on all information of which preparer has any knowledge. oF .ERSO. RESPO.S ,.,E FOR F,',.C ^OD.E DATE S Bixle ouser ' ' 12576 S~ .hagtp. er Road ~NATURE OF P~"P~)~ OTH.~f THAN REPRESENq'AT1VE ADDRESS //~rea E. )O]¢or~-~ jJ 2550 KJn[ston Road Suite 323 York, PA 17402 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)]. lhe 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 beneticiary. 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. §911 {5 (a) (1)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)]. 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. LAST WILL AND TESTAMENT OF AUBREY K. SOUDERS I, AUBREY K. SOUDERS, a resident of New Cumberland Borough, Cumberland County, Commonwealth of Pennsylvania, declare this to be my Will. I revoke any and all Wills and Codicils that I have previously made. I. pAY~RNT OF BURIAL ~PENSES AND DEBTS. I direct my executor' to pay my burial· expenses and all of my debts that my executor in her sole discretion may allow as claims against my estate. II. JOINT ACCOUNT WITH GRANDDAUGHTER. I presently have certificates of deposit in joint names to be payable on my death to my granddaughter, SANDRA JEAN BIXLER HOUSER. I confirm that it is my intention that those certificates of deposit, and any future such accounts that I may title into joint names, shall be payable to my granddaughter or other surviving joint owner or death beneficiary, as the case may be, and not into my estate for distribution. III. DISPOSITION OF ESTATE. Ail the rest, residue and remainder of my estate, I give, devise and bequeath as follows: A. To my son, GEORGE SOUDERS, who may also be know as GEORGE L. MYERS, twelve and one-half (12 1/2%) percent, if he survives me. If he does not survive me, then his share I give to those other persons in this Article III that survive me in the same proportion that they now relate to each other. B. To my granddaughter KRISTI ANN SPIDEL KRICK, twelve and one-half (12 1/2%) percent. If she does not survive me, then her share I give to KRISTI'S daughter, KASSANDRA KRICK which shall vest in her but be held by my executor as trustee until she is twenty five years of age at which time the trust shall cease and the fund distributed in full to her, with the principal and income until such time being used in the trustee's sole discretion for her benefit. If she does not survive me, then this~share I give to those other persons in this Article III that survive me in the same proportion that they now relate to each other. C. To my granddaughter, SANDRA JEAN BIXLER HOUSER, thirty seven and one-half (37 1/2%) percent, if she survives me. If she does not survive me, then her share I give to those other persons in this Article III that survive me in the same proportion that they now relate to each other. D. To my granddaughter, DEBRA ELAINE BIXLER RIDER, thirty seven and one-half (37 1/2%) percent. If she does not survive me, then her share I give to DEBRA'S son JEFFREY RIDER. LAST WILL AND TESTAMENT OF AUBREY K. SOUDERS PAGE 2 OF 3 IV. pA%~W~NT OF TAXES,. I direct that all state and federal estate, succession, legacy, inheritance or'other transfer taxes, however designated, that shall become payable by reason of my death with respect to any property which is included in my estate for purposes of computing any such taxes, shall be paid from my residuary estate as an expense of administration and without apportionment. My Executors shall have no duty or obligation to obtain reimbursement for any such tax paid by them even though on proceeds of insurance or other property not passing under this Will. V. APPOINTM~9~f OF EXECUTOR. A. Appointment. I name, constitute, and appoint my granddaughter, SANDRAJEANBIXLER HOUSER as executor of my estate. If SANDRA shall not survive me, shall refuse or fail to serve as executor for any reason, or shall cease to serve as executor for any reason after having been appointed, Sandra's husband, EDWARD L. HOUSER, shall act as executor. If Edward shall refuse or fail to serve as execut°r for any reason, or shall cease to serve as executor for any reason after having been appointed, then my granddaughter, DEBRA ELAINE BIXLER RIDER, shall act as executor. B. Bond Not Required. None of the individuals named in this Will as executor shall be required to furnish a bond for the faithful performance of his or her duties as executor. VI. INTERPRETATION- A. ~ Ail headings used in this Will to describe the .contents of each article, paragraph, or other division are provided for convenience only and shall not be construed to be part of this Will. B. Governinq Law. This Will shall be construed in conformity with the law of the Commonwealth of Pennsylvania. IN WITNESS WHEREOF, I, the said Testator, have to this my Last Will setmy hand and seal this ~~ day of ~~~---, 2002. 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, all being present at the same time, have hereunto subscribed our names as witnesses. LAST WILL AND TESTAMENT OF AUBREY K. SOUDERS PAGE 3 OF 3 COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF YORK ) SS I, AUBREY K. SOUDERS, the Testator, whose name is signed to qualified according to law, do hereby acknowledge that I signed and executed my Last Will and Testament; that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn and subscribed to 4 before me, this <~ ~day of , a~t , 2002 ~OMMONWEkTH OF P E{~SYLVANIA ) COUNTY OF YORK ) SS We, ~[~d 5-k~\qUxJL , and ~'ft~¢~tX k. [~i~Y' the undersigned witnesses~wh°se names are signed to the attached or foregoing Last Will and Testament, being duly qualified according to law, do depose and say that we were present and saw the Testator, sign and execute his Last Will and Testament, that the said Testator signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in 'the hearing and sight of the Testator, signed the Will as witnesses; and that to the best of our knowledge the Testator, was that time eighteen or more years o~-age, of sound mind and under at no constraint or undue influe Sworn and subscribed to before me, this ~0%~ day of , NOTARIAL S~..AL TAMMI' S. DLF'TZ, NOTARY PUBLJC YORK, YORK COUN'IY C0¥~%.. _~ION EXPIRES FEB. 23, 2004 SCHEDULE A REAL ESTATE COMMO~WVEALTH OF PENNSYLVANIA INHERITANCE TM RE~RN RE$1DE~ DECEDI~T ESTATE OF FILE NUMBER Souders, Aubrey 21 - 03 - 0779 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 propert~ would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly.owned with right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION NUMBER ! Two and One-half Story Single-Family Residence with Detached Two-Story Garage located at 330 4th Street, New Cumberland, Cumberland County, PA 17070 - See Attached Settlement Sheet TOTAL (Also enter on Line 1, Recapitulation) VALUE AT DATE OF DEATH 83,000.00 83,000.00 CO~94ONWEALTH LAND TITLE INSURANCE COMPANY A. Settlement Stat. ement U.S. Department of Housing and Urban Development (1MB No. 2502-0265 Title Insurance No. D427902CP ~ iS.Mortgage Insurance Case NO. 1. [ ]FHA 2.[ ]FmKA 3. I ]Conv. Un/ns. I 6.File Number 17.Loan Number 4. [ ]VA 5-[ ]Cony. Ins. C.Note: This form is furnished to give you a statement of actual settlement costs. Amo, mr~ paid to and by the settlement agent are shown. ItemS marked ' (p.o.c) ' were paid outside the closing; they are show~ here for informational purposes and are not i~cluded in the tot~3~. D.Na~e and Address of Borrower First Church of God of New Cumberland G.Property Location 330 4th Street New Cumberland, PA 17070 j£.Name and Address of Seller J sandra Jean Bixler Houser, Executrix New Cumberland Borou h,_ Cumb~PA j. SU~T~%RY OF BORROWER'S TRANSACTIO~ 100. GROSS AMOUNT DUE FROM BORROWER: _ 101.Contract sales price 102.Personal property 103.Settlement charges to borrower (line 1400] __~for items - ~ seller in ac~_ance to 106.City/tOwn taxes 04/13/04 to 12/31/04 107.County taxes 108.SCHOOL TAX 04/13/04 to 06/30/04 of the Estate of Aubrey K. Souders ~F.Name and Address o~ Le_na~r H.Settl~-t Agent Place of Settlement ~I.Settlem~nt Date HARRISBURG, PA 17101 I .April 13; 2004 83000.00 2247.25 221.91 124.67 400. G~.OSS AMOU~NT .DUE TO SELLER 401.Contract sales price 402.Personai property 403. 83000.00 Adj~tments for items ai_~_~ seller in advance 406.City/town taxes 407.County taxes 408.SCHOOL TAX to 04/13/04 to 12/31/04 04/13/04 to 06/30/04 -221.91 ' 124.6~ 120- GROSS AMOUNT DUE FROM BO_RROWER 200. AMCK3NTS.PAID BY OR _IN BF/{AL__FOF BORROWER 201.Deposit of earnest money 202.Principal amount of new loan(s) 203. Existing loan (s) 206. __~ for itemS ~ aid~ller to 210.City/town taxes to 211.County taxes 213.Refuse 04/01/04 to 04/13/04 01/01/04 to 04/13/04 214.Sewer 220. TOTAL PAID'BY/FOR BORROWER 300. TOTAL.AT SET~ FROM/TO_T~._BORROWER 301.Gross amount due from borrower.{line 120) 302.Less amounts paid by/for boz~wer (line 220} 303- CAS~ ( [X.X.] 'Fi:{OM) ( [ ] TO) BORRO%4ER 8S593.83 8500.00 5.15 24.74 8529.89 85593.83 8529.89 77,063.94 420. GROSS AMO[~TT DUE TO SELLER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 501.Excess Deposit (see instructions) S02.Settlement charges to seller (line 1400) 503.Existing loan(s) 506.Deposit or earnest money with seller Adiustments for items~seller 510.City/town taxes to 511.County taxes to 513.Refuse 04/01/04 to 04/13/04 514.Se~er 01/01/04 to 04/13/04 520. TOTAL REDUCTION DUE SELLE~ 600. CASH AT SETTLEMENT TO/FROM SELLER 601.Gross amount due to seller (line 420) 602.Less reductions in amount due seller (line 520) 603. CASH ([X](] TO) {[ ] FROM) SE~T.~l~ FORM 911 (4-88) 83346.58 4830.00 8500.00 5.15 24.74 13359.89 83346.58 13359.89 69,986.69 HUD-1 {3-86) RESPA, .HB4205-2 0427902CP 700. TOTAL SALES/BRqKER'S CO~IS$IONbased on rice $_ 83000.00 Page 2 of Form ~pproved OMB PaID FROM BORR(Y4ER ' S FUNDS AT No. 2502-0265 PAID SELLER'S F'G~"DS AT Division of cv,.--.~ ~sion(line 700) to 701.$ 7 02. $ to 703.Commission Paid at Settlement to 704 .$ as follows: 800. TTEMS pAYABLE IN CONNECTION WITH_LOAN 80i.Loan Origination Fee % to % to 802.Loan Discount to 803.Appraisal Fee to 804.Credit Report 805.Lender0s Inspection Fee 900. I~MS p, EQUIREDBY LENDER.~BE PAID iN_ADVANCE 901.Incerest from to %$ 901.1 Interest from to %$ 902.Mortgage Insurance Premium for mo. to 903.Hazard Insurance Premium for yrs.to /day /day per.m. per mo. per mo. 1100. TITLE CHARGES_ 1101.$etulement or closing fee 1102.Abstract or title search ll03.Title examination 1104.Title insurance binder (includes above item No.: ll08.Title insurance (includes above itemS No.: 1101 - 1104) ll09~Lender's coverage $ lll0.Owner's coverage $ 83000.00 to to to to ) to COMMONWEALTH LAND TITLE ******************************** vs..rs ******************************** ******************************** 1200. GOVERlqMENT_ REcoRDING AND TRANSFER _(~qARGES 1201.R~cording fees: Deed S 40.50 Mortgage $ 1202.City/countY tax/stamps: Deed $ 830.00 Mortgage $ 1203.State tax/stamps Deed $ 830.00 Mortgage $ Releases $ 40.50 830;00 830.00 1300. ADDITIONAl, SETTI~NT CH~%RGES_ 1303.2004 County/Boro Taxes to Robin Gasperetti, Tax Collector 1304.Legal Fees to Radcliff Law Office, P.C. 1305.Escrow~Proof Pay~nent Inheritance Ta to Commonwealth Land Title Ins. Co. 1400.TOTAL SETT~.E~ITT CHARGES (entered oq lines 103_~_SECTION J AND 502. Section [POC $309.15] FORM 912 (4-88) See page 3 for certification and signatures 620.00 I I I I 4000.00 -- 2 247.252 4,830.00 Page 3 of FormAppr°vedOMBN°' 2502-0265 Title Application NO: D~27902CP CERTIFICATION I direct and authorize the Co,many to make the distributions indicated for my account on the attached HUD-1 Settlement Statement. recocjnizin~ that the Com~any is not responsible for the accuracy or validity of disbursement amOUntS or the completeness of disclosure of charges made by others. Disbursements made hereunder are guaranteed by the Company. FundS deposited with the Company in connection with the settlement are not held in trust, and LntereSt or other valuable consideration n%ay be earned and retained by the Company on such settlement fundS I have ca~efull~ reviewed the ~K1D-1 Settlement Statement and to thebest of ~yknowledge a~d beliefo it is a true and accurate statement' of all receipts and disbursements made on~yaccount orby me in this transaction- I further certify that I have received a copy of the I~UD-1 Settlement Statement. Borrowers Address ' ~o ~owingly ~e false s~t~nts to the ~t~ States on ~s or ~Y other sxm~lar fo~- ~: It is a ~lme u ~ ~clude a fine ~d p~alties ~n co--lotion c Section 1010. i have caused or For details see: Title 18 U.S. code Section 1001 and Form 471 (REV. 11/B7) COMMONWEALTH OF pEf~4SYLVANIA IK~ERITANCE TAX RETLIRN RESIDE~I' DECIFDEhrr SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Souders, Aubrey 21 - 03 - 0779 All property jointly-owned with right of survivorship must be disclosed on schedule F. VALUE AT DATE ITEM DESCRIPTION UNIT VALUE NUMBER OF DEATH 1 MetLife - 57 Shares Valued at $28.95 at Date of Death (09/06/03) 29 1,653.00 TOTAL (Also enter on line 2, Recapitulation) 1,653.00 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWF. ALTH OF pEFI~SYLVANIA II~JER IT~J~tCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Souders, Aubrey 21 - 03 - 0779 Include the proceeds of litigation and the date thepr0ceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. VALUE AT DATE ITEM DESCRIPTION NUMBER OF DEATH 1 693.48 9 10 PNC Bank Checking Account No. 5140060497 - Balance Date of Death Fulton Bank Checking Account No. 3622-53754 - Balance Date of Death Refund f~om Blue Shield of Supplemental Insurance Premium Refund from Barbara J. Egan Nursing and Rehabilitation Center, Shrewsbury, PA Prepaid County Taxes on Sale of Real Estate - 04/13/04 to 12/31/04 MetLife Dividend Prepaid School Taxes on Sale of Real Estate - 04/13/04 to 06/30/04 Net Proceeds from Sale of Personal Property and Antiques by Gilbert and Gilbert, Auctioneers, on February 28, 2004 Gross Proceeds fi:om Sale of Personal Property by Gilbert and Oilbert, Auctioneers, on March 27, 2004 Refund from Homeowners Insurance TOTAL (Also enter on Line 5, Recapitulation) 9,906.18 343.10 151.75 221.9i 13.11 124.67 7,704.10 3,148.50 244.50 22,551.30 PNCBAbK Nov~mbor 7, 2003 Fred E. Kilgore 2~50 Kingaton Road, Suite 323 York, PA 17402 Estate of Aubrt~r Soudexs, d~n~ed Sb~l: t95-07-72~0 DOD: 9/6/2003 In rexponse to your request fo~ Date of Death balances for the custom~ noted above, our records show the following: Aeeotmt #5140060497 A K $OUDERS DOD balm: $693.48 (non-~ beau-iag) Established 10/03/1984 Please note that this office only provides date of death balances for deposit accounts (IRAz, CDs, Ch~t-h~g aud Savings accounts). We do not process ~.ay fuum¢t~l traa~actioas or provide statements. If you need assiaiance with any of these items, please call 1-$8$-PNC-BAI~IK (1-$8S-762-2265) or stop by your local PNC Bank branch office. Sinca'~ly, Rach~e Well~ 1-800-762-177~ P7-PFSC-O4-F $00 first A,n~ Pit. burgh PA 15219 Membe~ PDIC TOTAL P.O1 CAPITAL DIVISION · LANCASTER/CHESTER DIVISION DROVERS BANK DIVISION · GREAT VALLEY DIVISION (717)29[~2437 December 12, 2003 Fred E. Kilgore, JD, LLM 2550 Kingston Road, Suite 323 York, Pennsylvania 17402 Dear Mr. Kilgore: RE: Aubrey Souders, a/k/a Aubrey K. Souders, deceased September 6, 2003 In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: Checking # 3622-53605, open 7/22/2003, balance $100,879.05. Titled Sandra J. Houser Grantor, Aubrey K. Souders Trust with Edward L. Houser as Trustee. (reporting under SS #167-40-2072) Checking # 3622-53754, open 4/18/2003, balance $9,906.18. Sandra J. Houser as Power of Attorney. If you should have any further questions, please do not hesitate to contact me. Karen D. Hillegas Credit Inquiry Processor P O Box 4887 Lancaster, PA 17604 www. fultonbank.com 1-800-FULTON-4 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Soudcrs, Aubrey FILE NUMBER 21 - 03 - 0779 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 ~s yes. DESCRIPTION OF PROPERTY DATE OF DEATH % OF EXCLUSION TAXABLE VALUE ITEM Include the name of the transferee, their relationship to decedent and the date of transfer. VALUE OF ASSET DECD'S IF APPLICABLE) NUMBER Attach a copy of the deed for real estate. INTEREST I Transfer to Sandra Houser, Granddaughter of Decedent, on 88,179.40 100% 3,000.00 85,179.40 08/13/03, as follows: See Attached TOTAL (Also enter on line 7, Recapitulation) 85,179.40 SCHEDULE G ATTACHMENT One-half(½) of Fulton Bank CD #503-0189918, in joint names of Aubrey K. Souders and Sandra J. Houser, opened on 08/20/2002, in the amount of $25,355.25/2 = $12,677.63 Transfer $12,677.63 One-half (½) of Sterling Financial CD # 189834, in joint names of Aubrey K. Souders and Sandra J. Houser, which was a transfer of Prudential Bank CD #0423689936 opened on 12/06/96, in the amount of $10,000.00 = $5,000.00 $ 5,000.00 Fulton Bank CD #503-0183630, opened on 8/13/2003, in the amount of $10,061.82 $10,061.82 Fulton Bank CD #503-0199126, opened on 1/10/2003, in the amount of $5,009.24 $ 5,009.24 E. Cash $ 5,430.71 F. Sterling Financial Corporation CDs as follows: CD #189796 in the amount of $10,000.00 CD # 189304 in the amount of $15,000.00 CD #186796 in the amount of $15,000.00 CD #189824 in the amount of $10,000.00 $50,000.00 $50,000.00 TOTAL TRANSFERS $88,179.40 Decedent made the above transfers to Sandra Houser on August 11, 2003. Sandra Houser took such assets and, together with other of her own assets, established a revocable trust for the benefit of the decedent on August 11, 2003. The value of such trust as ofdecedent's date of death was $100,879.05, as shown on the attached statement from Fulton Bank. Sandra Houser was paying decedent's expenses from this trust when decedent died, such expenses being shown as debts of decedent on items #1 and #2 of Schedule I. Bank CAPITAL DIVISION · LANCASTER/CHESTER DIVISION DROVERS BANK DMSION · GREAT VALLEY DIVISION (717)291-2437 November 17, 2003 Fred E. Kilgore, JD, LLM 2550 Kingston Road, Suite 323 York, Pennsylvania 17402 Dear Mr Kilgore: RE: Aubrey K. Souders, deceased September 6, 2003 As requested by phone conversation 11/13/2003, I am writing to provide you with closing dates and balances on the CD accounts maintained by the above referenced decedent before her date of death: '""~ CD # 503-0178975, closing date 7/18/2003, $20,000.00.,J'] "---~' CD # 503-0183639, closing date 8/13/2003, $10,061.82 CD # 503-0189918, closing date 8/13/2003, $25,355..25j-/- .CD # 503-0199126, closing date 8/13/2003, $5,009.24 If you should have any further questions, please do not hesitate to comact me. Very truly yours, Credit Inquiry Processor . GONFIDENTIAt- ,~ oomion ~ expr~ is sub~<t to,chan~e withmd ~': .'- P O Box 4887 Lancaster, PA 17604 www. fultonbank.com 1-800-FULTON-4 April7,2004 ton Bank CAPITAL DIVISION ° LANCASTER/CHESTER DIVISION DROVERS BANK DIVISION ° GREAT VALLEY DIVISION (717) 291-2437 Fred E. Kilgore, JD, LLM 2550 Kingston Road, Suite 323 York, Pennsylvania 17402 Dear Mr. Kilgore: RE: Aubrey K. Souders, deceased September 6, 2003 As requested, I am writing to provide you with information on four CD's held in the above referenced decedent: 503-0178975, open 3/18/2002, joint with Sandra J. Houser, closed 7/18/2003. 503-0183630, open 5/29/2002, in her name only, closed 8/13/2003. 503-0189918, open 8/20/2002, joint with Sandra J. Houser, closed 8/13/2003. 503-0199126, open 1/10/2003, in her name only, closed 8/13/2003. If you should have any further questions, please do not hesitate to contact me. Very truly yours, Karen D. Hillegas Credit Inquiry Processor P O Box 4887 Lancaster, PA 17604 fultonbank.com 1-800-FULTON-4 COMMONWEAL'11-I OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENI' DECEDI~IT SCHEDULE H FUNERAL EXPENSES & ESTATE OF FILE NUMBER Souders, Aubrey 21 - 03 - 0779 Debts of decedent must be reported on Schedule I. ITEM NUMBEF DESCRIPTION AMOUNT 2 FUNERAL EXPENSES: Stone & Murray Funeral Home James R. Gingrich Memorials - Engraving for Grave Marker ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid Attorney's Fees Fred E. Kilgore, Esquire 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 Probate Fees Register of Wills of York County, PA (Filing of Oath) Register of Wills of Cumberland County, PA Register of Wills of Cumberland County, PA - Additional Probate Fees Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs US Postal Service - Certified Mail - Probate Documents to Cumberland County Register of WilL, The Sentinel, Carlisle, PA - Advertising of Executrix's Notice Total of Continuation Schedule(s) TOTAL (Also enter on line g, Recapitulation) 6,366.00 95.00 10,200.00 10.00 105.00 155.00 5.11 95.27 7,379.11 24,410.49 COMMONVVEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SchedubH ESTATE OF FILE NUMBER Souders, Aubrey 21 03 - 0779 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Cumberland Law Journal - Advertising of Executrix's Notice Register of Wills, Cumberland County, PA - Filing PIT Register of Wills, Cumberland County, PA - Filing Inventory Register of Wills, Cumberland County, PA - (2) Additional Short Certificates for Real Estate Sale and Stock Transfer Reserve for Miscellaneous Expenses PPL Electric - Utility Bills Verizon - Telephone Bills U.G.I. Gas Service - Utility Bills Borough of New Cumberland - Sewer and Trash Bills PA American Water Company - Water Bills Chapman Fuel Oil Service - Oil Dehvery Gilbert & Gilbert, Auctioneers - Commission on Sale of Real Estate (March 27, 2004) Gilbert & Gilbert, Actioneers - Commission on Sale of Personal Property (March 27, 2004) Robin Gasperetti, Tax Collector - 2004 County and Mumcipal Real Estate Taxes Donegal Mutual Insurance Company - Homeowner's Insurance 4/7/04 -4/7/05 Sandra Houser - Reimbursement of Miscellaneous Estate Expenses Seller's Prorata Share of Unpaid Refuse Bill - 04/01/04 to 04/13/04 Seller's Prorata Share of Unpaid Sewer Bill - 01/01/04 to 04/13/04 Seller's Share of Transfer Taxes on Sale of Real Estate New Cumberland Fire Department - Donation (Cashed 10/02/2003) 75.00 15.00 16.00 6.00 1,000.00 88.93 83.80 99.66 114.86 93.82 40.86 2,490.00 1,626.50 309.15 259.50 185.14 5.15 24.74 830.00 15.00 Page 2 of Schedule H COMMOt~H OF PEM~SYLVANtA [NHERITA[4CE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Soudcrs, Aubrcy 21 - 03 - 0779 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT Fred E. Kilgore, Esquire - Legal Services Rendered to Decedent Prior to Death Sandra Houser - Payment of August 2003 Nursing Home/Pharmacy Expenses Sandra Houser - Payment of September 2003 Nursing Home/Pharmacy Expenses TOTAL (Also enter on Line 10, Recapitulation) 187.75 5,388.94 1,391.33 REV-1513 EX+ {9-00) ~ SCHEDULE J coMMo.vv~,,, or PE..s~,v^.,^ BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Souders, Aubrey 21 - 03 - 0779 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE I~a Not £14 I. TAXABLE DISTRIBUTIONS (include outfight spousal distributions) 1 George L. Myers, a/k/a George Souders Son One-Eighth RR1 - Box 2032 Blain, PA 17006 2 Kristi Ann Spidel Krick Granddaughter One-Eighth 913 West Trindle Road Mechanicsburg, PA 17055 3 Sandra Jean Bixler Houser Granddaughter Three-Eighths 12576 Stamper Road Brogue, PA 17309-9465 4 Debra Elaine Bixler Rider Granddaughter Three-Eighths R. D. 1 - Box 230 Church Road Elliottsburg, PA 17024 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Register of Wills of Cumberland County, Pennsylvania Estate of Souders, Aubrey also known as Souders, Aubrey I<2 Sandra Jean Bixler Houser INVENTORY , Deceased No. 21-03-0779 Date of Death 9/6/2003 Social Security No. 195-07-7230 The 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 located 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 the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum it the end of this Inventory. INVe vedfy that the statements made in this Inventory are true and correct. I/VVe understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: Fred E. Kilgore I.D. No.: 15842 Personal Representati~/ Sandra Jear~xler Houser ' '-~ Signature: Signature: Address: 2550 Kingston Road Suite 323 York, PA 17402 Telephone: 717~57-6315 Address: 12576 Stamper Road Brogue, PA 17309 Telephone: 717-927-6814 Dated: ~ Personal Property MetLife - 57 Shares Valued at $28.95 at Date of Death (09/06/03) PNC Bank Checking Account No. 5140060497 - Balance Date of Death Fulton Bank Checking Account No. 3622-53754 - Balance Date of Death Refund from Blue Shield of Supplemental Insurance Premium ,653.00 693.48 9,906.18 343.10 Refund from Barbara J. Egan Nursing and Rehabilitation Center, Shrewsbury, PA 151.75 Prepaid County Taxes on Sale of Real Estate - 04/13/04 to 12/31/04 221.91 MetLffeDividend 13.11 Prepaid School Taxes on Sale of Real Estate - 04/13/04 to 06/30/04 124.67 (Attach additional sheets if necessary) Total Personal Property and Real Estate $113336.13 Register of Wills of Cumberland County, Pennsylvania Estate of Souders, Aubrey also known as Souders, Aubrey I<2 INVENTORY continued , Deceased No. 21 - 03 -0779 Date of Death 9/6/2003 Social SecurityNo. 195-07-7230 Net Proceeds from Sale of Personal Property and Antiques by Gilbert and Gilbert, Auctioneers, on · February 28, 2004 7,704.10 Gross Proceeds from Sale of Personal Property by Gilbert and Gilbert, Auctioneers, on March 27, 2004 3,148.50 Refund from Homeowners Insurance 244.50 MetLife- Lffeinsurance Proceeds P~dtothe E~e PolicyNumber630706216MS 1,910.27 MetLife- Life Insurance Proceeds P~dtothe Estate PolicyNumber16678879A 4,221.56 Total Personal Property $30,336.13 2 Register of Wills of Cumberland County, INVENTORY Estate of Souders, Aubrey also known as Souders, AubreyK. continued , Deceased Pennsylvania No. 21 - 03 - 0779 Date of Death 9/6/2003 SociaISecurity No. 195-07-7230 Real Estate Two and One-half Story Single-Family Residence with Detached Two-Story Garage located at 330 4th Street, New Cumberland, Cumberland County, PA 17070- See Attached Settlement Sheet 83,000.00 Total Real Estate $83,000.00 3 7003 0500 0004 0865 6756 FRED E. KILGORE ATTORNEY AT LAW 2550 KINGSTON ROAD · SUITE 3 2 3 YORK, PENNSYLVANIA 17402 Register of Wills Cumberland County Court House 1 Court House Square Carlisle PA 17013 BUREAU OF TNDZVZDUAL TAXE,S TNHERTTANCE TAX DzVTSTON DEPT. 280601 HARR:LSBURG, PA 17128-0601 FRED E KILGORE ATTY STE 523 1550 KIN$STON RD YORK COHNONgEALTH OF PENNSYLVANZA DEPARTHENT oF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSHENT OF TAX '04 JUL 30 A~I :30 DATE ESTATE OF DATE OF DEATH FILE NUNBER COUNTY ACN 08-02-200~ SOUDERS 09-06-2003 21 03-0779 CUHBERLAND 101 Amount RecAP'ted REV-15gi/ EX AFP (Dl-DS) AUBREY K HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGZSTER OF ~ILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THZS LZNE ~ RETAZN LOgER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLOgANCE OR DISALLOgANCE OF DEDUCTZONS AND ASSESSNENT OF TAX ESTATE OF SOUDERS AUBREY K FZLE NO. 21 03-0779 ACN 101 DATE 08-01-200~ TAX RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE ZNTP. REST- SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORZ$INAL RETURN 1. Real Estate (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) :5. Closely Held Stock/PartnershAp /ntarest (Schedule C) (:5) q. Mortgages/Notes RacaAvabla (Schadula D) (~) 5. Cash/Bank Daposits/Nisc. Personal Property (Schedule E) 6. JoAn~ly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expansas/Adm. Costs/HAsc. Expanses (Schedule H) (9) 10. Dab~s/Hortgaga LAabAlitAas/LAans (Schedule Z) (10) 11. Total Deductions 12. Net Value of Tax Return 8~000.00 1~655.00 .00 .00 22~551.~0 .00 NOTE: To insure proper cradAt to your account, submit the upper port/on of ~his fore with your tax payment. 85~179.~0 (e) 192,585.70 1:5. NOTE: ASSESSHENT OF TAX: 1.6. Amount of Lina 1~ at Spousal rata 16. Amount of LAne 1~ taxable at Lineal/Class A rata 17. Amount: of L/ne 1~ at Sibling ra~e 18. Amoun~ of L/ne 1~ ~axable a~ Collateral/Class B ra~e 19. Princi >al Tax Due TAX CREDZTS: PAYHENT R[CEZPT DZSCOUNT DATE NUHBER ~NTEREST/PEN PA~D (-) 06-0~-200~ CD00~015 .00 6~968.02 (11) 31.378.51 (12) 161,005.19 Charitable/Governmental Bequests; Non-elected 911:5 Trusts (Schadula J) (1:5) Net VaZua of Estate Subject to Tax (1re) :;f an assessment Has issued previously, lines 14, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. .00 161,005.19 18 and 19 w111 ZF PA/D AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULATZON OF ADDITZONAL /NTEREST. TOTAL TAX CREDIT BALANCE OF TAX DUEJ .00 ZNTEREST AND PEN. .00 TOTAL DUE . O0 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REI~UZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), YOU NAY BE DUE(~ A REFUND. SEE REVERSE SZDE OF THZS FORN FOR ZNSTRUCTZONS. 7,2~5.25 ANOUNT PAZD (16), .00 X O0 = .00 (15) 161,005.19 X 0~5 = 7,2~5.25 (17) .00 x 12 = .00 (18) .00 X 15 : .00 (19)= 7,2~5.25 RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCDUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 21~0 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S. Section 91qO). Detach the top portion of this Notice and submit with your payment to the Register of Mills printed on the reverse side. --Make check or money order payable to: REGISTER OF MILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513). Applications are available at the Dffice of the Register of Mills, any of the 25 Revenue District Offices, or by calling the special Iq-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-~q7-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty [60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6S05. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the decadent's death, a five percent (5Z) discount of the tax paid is allowed. The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date cf death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .00016q. Al1 taxes which became delinquent on and after January 1, 1982 will bear interest at a rata which w111 vary fram calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 200fi are: Interest Daily Interest Daily Interest Year Rate Factor Year Rate Factor 1982 ZOZ .0005q8 ~'8 - 1991 112 .000301 1985 167. .000q38 1992 92 . O00Zfi7 198q 117. .000301 1995-199q 72 .000192 1985 137. .000556 1995-1998 92 .0002~,7 1986 IOZ , OOOZ7q 1999 72 .000192 1987 102 .O00Z7q ZOO0 72 .000192 --Interest ls calculated as follows: INTEREST = BALANCE OF TAX UNPAID Daily Year Rate Factor ~ 92 .O00Zq7 200Z 62 .OOOl6q 2005 5Z .000157 200~ ~Z .O001lO X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additionaL interest must be calculated. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 phone: (717) 240-6345 Date: 8/15/2005 KILGORE FRED E ESQ 2550 KINGSTON ROAD YORK, PA 17402 RE: Estate of SOUDERS AUBREY File Number: 2003-00779 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. 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: 9/06/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, <~AL~~~~ REGISTER OF WILLS (~J cc: File Personal Representative(s) Judge vR IN RE: IN THE COURT OF COMMON PLEAS OF Cumberland County, PENNSYLVANIA Estate of Aubrey Souders, aka Aubrey K. Souders, late of New Cumberland Borough, Cumberland County, PA ORPHANS' COURT DIVISION NO . 21 - 03 - 0 779 RECEIPT AND RELEASE AND REFUNDING AGREEMENT WHEREAS,Aubrey Souders aka Aubrey K. Souders, late of New Cumberland Borough, Cumberland County, Pennsylvania, died September 6, 2003, testate, and Decedent's Last will and Testament dated January 30, 2002, was duly probated in the Office of the Register of wills in and for Cumberland County, Pennsylvania, on September 26, 2003, and appears of record in File No. 21-03-0779; and, WHEREAS, Letters Testamentary were issued thereon on September 26, 2003 to Sandra Jean Bixler Houser, as Executrix; and, WHEREAS, a Pennsylvania Inheritance Tax Return is about to be filed with the Register of wills Office, as Agent for the Commonwealth of Pennsylvania, on behalf of the Estate, and the inheritance and estate tax due in said Estate will be paid in full upon filing; and, WHEREAS, all known outstanding debts and obligations of the Decedent have been paid in full; NOW THEREFORE KNOW ALL beneficiary of respectively: MEN BY THESE PRESENTS, that the undersigned, a the Estate of the above-named decedent does h~:reby '-;:J ~ n. . .~....~, " ;:,.,. CO) ".~ r--: C:) . . "~J 1. Acknowledge receipt from Sandra Jean Bixler~Ho~er: .~ Executrix under the Last will and Testament of the above-named-:::") '" , :' ) decedent (herein referred to as the "Executrix"), of the f"9'?-lo:W:ing. -~H in full satisfaction of the Beneficiary I s distributive sh~e o~ihe . ~~ Estate of the above-named decedent except to the extenb of~~he ~ undersigned's prorata portion of the reserve shown on the atta~ed account which is not used for claims or expenses of the estate: Cash in the amount of $26,619.03 rA i 2. Acknowledge receipt of the attached Account and Proposed Schedule of Distribution (Exhibit A) prepared by the Executrix, and waives the filing of a formal accounting with any court. 3. Releases and forever discharges the Executrix and the Executrix's successors and assigns and the Executrix's attorney, Fred E. Kilgore, Esquire, from any and all liability arising from any and all matters of any nature whatsoever pertaining to Aubrey Souders, a/k/a Aubrey K. Souders, the distribution of his assets and administration of his Estate. 4. To the extent of the above distributions, agrees (a) to refund to the Executrix, upon receipt of such request from the Executrix, any portion of the above distribution to which the respective Beneficiary is not properly entitled or which shall at any time be necessary to discharge any debt, expense or liability of the Estate, including but not limited to any estate, inheritance, transfer or income taxi and (b) to indemnify and hold harmless the Executrix and the Executrix's successors and assigns from and against any and all liability, expenses and costs which the Executrix may incur in that capacity. This instrument is being signed in counterparts by each beneficiary of the estate and shall be legally binding upon the undersigned Beneficiary and his or her respective heirs and personal representatives regardless of whether a counterpart instrument is signed by all or any lesser number of the beneficiaries of the estate. IN WITNESS WHEREOF, the Beneficiary has hereunto set his or her hand and seal, the day and year set opposite his or her signature. Date: tJ&!o3/0tf Sworn and subscribed to befor~e this ~day of ~ff~, 2004. ~~1:J- ., ~ NOTARIAL SEAL NANCY L. NESS NOTARY PUBlIC SPRINGETTSBURY TWP., YORK COUNTY Y COMMISSION EXPIRES UlY 23 2006 IN RE: IN THE COURT OF COMMON PLEAS OF Cumberland County, PENNSYLVANIA Estate of Aubrey Souders aka Aubrey K. Souders, late of New Cumberland Borough, Cumberland County, PA ORPHANS' COURT DIVISION NO . 21- 03 - 0 779 RECEIPT AND RELEASE AND REFUNDING AGREEMENT WHEREAS, Aubrey Souders aka Aubrey K. Souders, late of New Cumberland Borough, Cumberland County, Pennsylvania, died September 6, 2003, testate, and Decedent's Last Will and Testament dated January 30, 2002, was duly probated in the Office of the Register of Wills in and for Cumberland County, Pennsylvania, on September 26, 2003, and appears of record in File No. 21-03-0779; and, WHEREAS, Letters Testamentary were issued thereon on September 26, 2003 to Sandra Jean Bixler Houser, as Executrix; and, WHEREAS, a Pennsylvania Inheritance Tax Return is about to be filed with the Register of Wills Office, as Agent for the Commonwealth of Pennsylvania, on behalf of the Estate, and the inheritance and estate tax due in said Estate will be paid in full upon filing; and, WHEREAS, all known outstanding debts and obligations of the Decedent have been paid in full; NOW THEREFORE KNOW ALL MEN BY THESE PRESENTS, that the undersigned, a beneficiary of the Estate of the above-named decedent does hereby respectively: 1. Acknowledge receipt from Sandra Jean Bixler Houser, Executrix under the Last Will and Testament of the above-named decedent (herein referred to as the "Executrix"), of the following in full satisfaction of the Beneficiary's distributive share of the Estate of the above-named decedent except to the extent of the undersigned's prorata portion of the reserve shown on the attached account which is not used for claims or expenses of the estate: Cash in the amount of $8,873.01 2. Acknowledge receipt of the attached Account and Proposed Schedule of Distribution (Exhibit A) prepared by the Executrix, and waives the filing of a formal accounting with any court. 3. Releases and forever discharges the Executrix and the Executrix's successors and assigns and the Executrix's attorney, Fred E. Kilgore, Esquire, from any and all liability arising from any and all matters of any nature whatsoever pertaining to Aubrey Souders, a/k/a Aubrey K. Souders, the distribution of his assets and administration of his Estate. 4. To the extent of the above distributions, agrees (a) to refund to the Executrix, upon receipt of such request from the Executrix, any portion of the above distribution to which the respective Beneficiary is not properly entitled or which shall at any time be necessary to discharge any debt, expense or liability of the Estate, including but not limited to any estate, inheritance, transfer or income taxi and (b) to indemnify and hold harmless the Executrix and the Executrix's successors and assigns from and against any and all liability, expenses and costs which the Executrix may incur in that capacity. This instrument is being signed in counterparts by each beneficiary of the estate and shall be legally binding upon the undersigned Beneficiary and his or her respective heirs and personal representatives regardless of whether a counterpart instrument is signed by all or any lesser number of the beneficiaries of the estate. IN WITNESS WHEREOF, the Beneficiary has hereunto set his or her hand and seal, the day and year set opposite his or her signature. Date'~ 7 ;J.oOt/ I /~~ George Souders (Seal) Sworn and bef of subscribed to this 7 day , 2004. ~;tJ~. (Seal) George . Myers N tar Public NOTARIAL SEAL FLOYD H. WEARY, Notary Public Tyrone Twp., Perry County My Commission Expires May 17, 2005 . .... IN RE: IN THE COURT OF COMMON PLEAS OF Cumberland County, PENNSYLVANIA Estate of Aubrey Souders aka Aubrey K. Souders, late of New Cumberland Borough, Cumberland County, PA ORPHANS' COURT DIVISION NO . 21- 03 - 0 779 RECEIPT AND RELEASE AND REFUNDING AGREEMENT WHEREAS,Aubrey Souders aka Aubrey K. Souders, late of New Cumberland Borough, Cumberland County, Pennsylvania, died September 6, 2003, testate, and Decedent's Last Will and Testament dated January 30, 2002, was duly probated in the Office of the Register of Wills in and for Cumberland County, Pennsylvania, on September 26, 2003, and appears of record in File No. 21-03-0779; and, WHEREAS, Letters Testamentary were issued thereon on September 26, 2003 to Sandra Jean Bixler Houser, as Executrix; and, WHEREAS, a Pennsylvania Inheritance Tax Return is about to be filed with the Register of Wills Office, as Agent for the Commonwealth of Pennsylvania, on behalf of the Estate, and the inheritance and estate tax due in said Estate will be paid in full upon filing; and, WHEREAS, all known outstanding debts and obligations of the Decedent have been paid in full; NOW THEREFORE KNOW ALL MEN BY THESE PRESENTS, that the undersigned, a beneficiary of the Estate of the above-named decedent does hereby respectively: 1. Acknowledge receipt from Sandra Jean Bixler Houser, Executrix under the Last Will and Testament of the above-named decedent (herein referred to as the "Executrix"), of the following in full satisfaction of the Beneficiary's distributive share of the Estate of the above-named decedent except to the extent of the undersigned's prorata portion of the reserve shown on the attached account which is not used for claims or expenses of the estate: Cash in the amount of $26,619.03 . "\ 2 . Acknowledge receipt of the attached Account and Proposed Schedule of Distribution (Exhibit A) prepared by the Executrix, and waives the filing of a formal accounting with any court. 3. Releases and forever discharges the Executrix and the Executrix's successors and assigns and the Executrix's attorney, Fred E. Kilgore, Esquire, from any and all liability arising from any and all matters of any nature whatsoever pertaining to Aubrey Souders, a/k/a Aubrey K. Souders, the distribution of his assets and administration of his Estate. 4. To the extent of the above distributions, agrees (a) to refund to the Executrix, upon receipt of such request from the Executrix, any portion of the above distribution to which the respective Beneficiary is not properly entitled or which shall at any time be necessary to discharge any debt, expense or liability of the Estate, including but not limited to any estate, inheritance, transfer or income taxi and (b) to indemnify and hold harmless the Executrix and the Executrix's successors and assigns from and against any and all liability, expenses and costs which the Executrix may incur in that capacity. This instrument is being signed in counterparts by each beneficiary of the estate and shall be legally binding upon the undersigned Beneficiary and his or her respective heirs and personal representatives regardless of whether a counterpart instrument is signed by all or any lesser number of the beneficiaries of the estate. IN WITNESS WHEREOF, her hand and seal, the signature. Date, & ~ 'r / the Beneficiary has hereunto set his or day and year set opposite his or her ~--~~~eal) Debra Elaine ixler Rider Sworn and subscribed to before me this S12/ day ..p- of ...-JUIoJG ' 2004. NOTARIAL SEAl BEATRICE I. LEITER, No~'Y Pubtk: Centre T~wns~iP. Parry Coont\! My CommIaSlOl'l EY:?ir6-2 JuV 27, ~(}07 .....Arrl.'.~ . J~~~~i. ;11<-* Notary Public f" IN RE: IN THE COURT OF COMMON PLEAS OF Cumberland County, PENNSYLVANIA Estate of Aubrey Souders, aka Aubrey K. Souders, late of New Cumberland Borough, Cumberland County, PA ORPHANS' COURT DIVISION NO . 21- 03 - 0779 RECEIPT AND RELEASE AND REFUNDING AGREEMENT WHEREAS, Aubrey Souders aka Aubrey K. Souders, late of New Cumberland Borough, Cumberland County , Pennsylvania, died September 6, 2003, testate, and Decedent's Last Will and Testament dated January 30, 2002, was duly probated in the Office of the Register of Wills in and for Cumberland County, Pennsylvania, on September 26, 2003, and appears of record in File No. 21-03-0779; and, WHEREAS, Letters Testamentary were issued thereon on September 26, 2003 to Sandra Jean Bixler Houser, as Executrix; and, WHEREAS, a Pennsylvania Inheritance Tax Return is about to be filed with the Register of Wills Office, as Agent for the Commonwealth of Pennsylvania, on behalf of the Estate, and the inheritance and estate tax due in said Estate will be paid in full upon filing; and, WHEREAS, all known outstanding debts and obligations of the Decedent have been paid in full; NOW THEREFORE KNOW ALL MEN BY THESE PRESENTS, that the undersigned, a beneficiary of the Estate of the above-named decedent does hereby respectively: 1. Acknowledge receipt from Sandra Jean Bixler Houser, Executrix under the Last Will and Testament of the above-named decedent (herein referred to as the "Executrix"), of the following in full satisfaction of the Beneficiary'S distributive share of the Estate of the above-named decedent except to the extent of the undersigned's prorata portion of the reserve shown on the attached account which is not used for claims or expenses of the estate: Cash in the amount of $8,873.01 '- ,. 2. Acknowledge receipt of the attached Account and Proposed Schedule of Distribution (Exhibit A) prepared by the Executrix, and waives the filing of a formal accounting with any court. 3. Releases and forever discharges the Executrix and the Executrix's successors and assigns and the Executrix's attorney, Fred E. Kilgore, Esquire, from any and all liability arising from any and all matters of any nature whatsoever pertaining to Aubrey Souders, a/k/a Aubrey K. Souders, the distribution of his assets and administration of his Estate. 4. To the extent of the above distributions, agrees (a) to refund to the Executrix, upon receipt of such request from the Executrix, any portion of the above distribution to which the respective Beneficiary is not properly entitled or which shall at any time be necessary to discharge any debt, expense or liability of the Estate, including but not limited to any estate, inheritance, transfer or income taxi and (b) to indemnify and hold harmless the Executrix and the Executrix's successors and assigns from and against any and all liability, expenses and costs which the Executrix may incur in that capacity. This instrument is being signed in counterparts by each beneficiary of the estate and shall be legally binding upon the undersigned Beneficiary and his or her respective heirs and personal representatives regardless of whether a counterpart instrument is signed by all or any lesser number of the beneficiaries of the estate. IN WITNESS WHEREOF, the Beneficiary has hereunto set his or her hand and seal, the day and year set opposite his 9r her signature. Date: ~t:- fj'!i- d-oCJ'/ t7 Sworn and subscribed to before me this '1"11- day Of~e.. , 2004. /~~~ S Notarial Seal Low~~~ ~azza. Notary Public My Commi . wp., Dauphin County SSIOll EXpires Nov. 18 2006 Membe p . r. ennsylvania AsSOCialio Of . n Notanes . Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Aubrey Souders, a/k/a Aubrey K. Souders Name of Decedent: Date of Death: September 6, 2003 Estate No.: 21-03-0779 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 Qg No 0 2. lithe answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No ~ 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 [] No 0 c. Copies of receipts, releases, joinders and approval offonnal orinformal ~ accounts may be filed with the Cler e Orphans' Court an~i~ be :OJ; attached to this report. =1,} n ;...- Date: August 17, 2005 Fred Name 2550 Kingston Rd., Suite 323 Address York, PA 17402 717-757-6315 Telephone No. Capacity: 0 Personal Representative rn. Counsel for personal representative ~ \'., N \J ::=-J -; 1 -, . ,"5 ,,, 'J -", ;;-''",,) ('........) 01 erR