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HomeMy WebLinkAbout04-0060 PETITION FOR PROBATE and GRANT OF LETTERS Estate of Josephine M. Zimmerman No. 21 - 04 - ~> also known as N/A, Deceased. To: Social Security No.: 204-03-2678 Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner who is 18 years of age or older and the Executor named in the last will o~'the above decedent, dated September 9, 1993, and codicil(s) dated NONE. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at Lot 15, 50 Bonny Brook Road, Carlisle, PA 17013 (South Middleton Township). Decedent, then 86 years of age, died January 11, 2004, at Claremont Nursing & Rehabilitation Center, Carlisle, PA 17013. Except as follows, decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: No Exceptions. Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 5,000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: NONE. WHEREFORE, petitioner respectfully requests the probate of the last will and codicil(s) presented herewith and the grant of letters Testamentary th~j.~.~,~/fi/j. ~/~/~t Signature(s) and Residence(s) I-~arry D.fi~tiest of Petitioner(s) 570 "F" tgtreet Carlisle, PA 17013 (717) 243-8072 oATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) ) SS COUNTY OF CUMBERLAND ) The petitioner above-named swears or affirms that the statements in the foregoing petition arc tree and correct to the best of the knowledge and belief of petitioner and that as personal representative of the above decedent petitioner will well and truly administer the estate according to law. Swom to or affirmed and subscribed before me/~h (~~J~ /~ thi~7_~P_._ day of (~?/j~2zt~ ,2004 ~ //J'~' HARRY D. PRIEST / f - - ~ld~da Farner-~Strasbau-gh,/t(eg~ter Signature(s) Estate of Josephine M. Zimmerman, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW January _-~,~--' 2004, in consideration of the petition on thc reverse side hereof, satisfactory proof having been presented before mc, IT IS DECREED that the instrument dated Septernber 9, 1993, described therein be admitted to probate and filed of record as the last will of Josephine M. Zimmerman and Letters Testamentary are hereby granted to Harry D. priest. ~asbaugl{ FEES ~ Probate, Letters, Etc. $ ~65'. ~-2~ - Robert R. Black, Esquire(06267) · ' - 36 South Hanover Street Slao~ C_e_rtificates ( )'" $ ~,. cpo _ ~bt~fi~/~,c~tion ......... $- 6. ~o _ Carlisle, PA 17013 $- /~0 _ (717) 243-3727 Filed: January ~, 2004 PETITION FOR PROBATE and GRANT OF LETTERS Estate of Josephine M. Zimmerman No. 21 - 04 - ~ also known as N/A, Deceased. To: Social Security No.: 204-05-2675 Register of Wills for thc County of Cumberland in thc Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner who is 18 years of age or older and the Executor named in the last will of the above decedent, dated September 9, 1993, and codicil(s) dated NONE. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at Lot 15, 50 Bonny Brook Road, Carlisle, PA 17013 (South Middleton Township). Decedent, then 86 years of age, died January 11, 2004, at Claremont Nursing & Rehabilitation Center, Carlisle, PA 17013. Except as follows, decedent did not marry, was not divorced and did not have a child bom or adopted af~ execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: No Exceptions. Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 5,000.00 (Il'not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: NONE. WHEREFORE, petitioner respectfully requests the probate of the last will and codicil(s) presented herewith and the grant of letters Testamentary t~/~. ~ Signature(s) and Residence(s) ~rry D./l~fitiest of Petitioner(s) 570 "F" gtreet Carlisle, PA 17013 (717) 243-8072 oATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) ) SS COUNTY OF CUMBERLAND ) The petitioner above-named swears or affirms that the statements in the foregoing petition are true and correct to thc best of the knowledge and belief of petitioner and that as personal representative of the above decedent petitioner will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me~ /~~~.. /~ thi~ day of ~,~/_~,_o,~_~ ,2004 ~ //7' HARRY D. PRIEST / (~ - ~l~da Farner-CStrasbau-gh,feg~ter Signaturers) NO. 21- 04-~ Estate of Josephine ]VI. Zimmerman, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW January ~:/a~_._, 2004, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument dated September 9, 1993, described therein be admitted to probate and filed of record as the last will of Josephine M. Zimmerman and Letters Testamentary are hereby granted to Harry D. Priest. Glenda Famer-Strasbaugl~ Probate, Letters, Etc... $~.. ~'~ Robert R. Black, Esquire (06267) dcOrt Certificates ( )... $ . ~. egc)36 South Hanover Street lgt~on ........ $ 6. ~<> Carlisle, PA 17013 $ /~ ~D (717)243-3727 TOTAL $ .,~. ~ ~ Filed: January ~ ,2004 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. 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. No. Date -~os :.3 aev z,a? COMMONWEALTH OF PENNSYLVANIA · OEPARTMENT OF HEALTH · VITAL RECORDS ,~ CERTIFICATE OF DEATH ,. 86 ~,,j j [ 13/26/1917 J Carlisle, PA .... ~[~ . ~rl~d/ Middlesex ~. Clar~nt Nursing a Rehab. ~nter OECE~m'S USUAL ~CUP~'ON ~ KIND ~ BUS]NES~INDUSTRY i ~SDEC ....... ~""I OECEDENT'~EDUCATION '4wi~ed ,,. ,,.. F~isher~ester ,~.Piezo C~stal ~. ,,. ~. 10~o.,~ .... ~, _ ~c,u*~ ,~.. s,.,. o~ ,~..~ ~.~,~. South Middleton 50 ~ybr~k Rd., ~t 15 ,~s,~,c~ - ,,.~rlisle, PA 17013 .......... ~ ,~.Cou.~ ~rland .... ,~,~ ~.~,~ ,,. Har~ F. Clay ,, Mi~ie M. Mullen m. Priest IlNFORMANT'SMAILI~AD~ESSImr~C~n.~,e Zi~C~I ~ 570 Street; ~rllsle, PA 17013 ~ o~,~s~ ~ 1/15/2004 l"~t' Holly Springs ~te~ ~,.Mt. Holly Springs, PA 17065 FD 012633 L .................. LAST WILL AND TESTAMENT OF JOSEPHINE M. ZIMMERMAN I, JOSEPHINE M. ZIMMERMAN, of South Middleton Township, Cumberland County, Pennsylvania, make this Will, revoking all my former wills and codicils. ITEM I: I direct that all my just debts, funeral expenses, and administration expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. ITEM II: I devise and bequeath all of the residue of my estate, of every nature and wherever situate, to my son, HARRY D. PRIEST, or his issue per stirpes. ITEM III: I direct that all taxes which may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. ITEM IV: I appoint my son, HARRY D. PRIEST, Executor of this, my Last Will. ITEM V: I direct that neither my Executor, Guardian, Trustee, nor their successors shall be required to give bond for the faithful performance of their duties in any jurisdiction.  IN WIT~kES$ WHEREOF_ I have hereunto set my hand this day of ~~4~ , 1993. ~ JOSEPHINE M. ZI~RMAN The preceding instrument, consisting of this and other typewritten pages, each identified by the signature of the Testatrix, JOSEPHINE M. ZIMMERMAN, was, on the day and date thereof, signed, published, and declared by JOSEPHINE M. ZIMMERMAN, the Testatrix therein named, as and for her Last Will, in the presence of us, who, at her request, in her presence and in the presence of each other, have subscribed our names as witnesses thereto. COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) e, Josephine M. Zimmerman, Robert R. Black, and ~ ~. ~ , the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will, and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness, and that to the best of their knowledge the Testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. atrix Josephin~/~.'~imme~afi~v~ Witness Robert R. Black Witness Subscribed, sworn to and acknowledged before me by Josephine M. Zimmerman, Testatrix, and subscribed and sworn to beforD mR by R?~ert R. Black a~ ~1~ ~. f~D~ , witnesses,1993, this ~ day of ~ , Notary Public ,,, Carlisle. Cumberl~:l ColJfliy I My Commission Expi lill / LAST W/LL AND TESTAMENT JOSEPHINE M. ZIMMERMAN LAW OFFICES LANDIS BLACK & SCHORPP 36 SOUTH HANOVER STREET CARLISLE, F'ENNSYLVANIA 17013 CERTIFICATION OF NOTICE UNDER RULE 5.6 (c) Name of Decedent: Josephine M. Zimmerman Date of Death: January 11, 2004 Will No.: 21-04-0060 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 · January 30, 2004. Name Address Harry D. Priest 570 "F" Street, Carlisle, Pennsylvania 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None. Robert R. Black, Esq. 36 South Hanover Street Carlisle, Pennsylvania 17013 Telephone (717) 243-3727 Capacity: Personal Representative X Counsel for Personal Representative ~1l-JlfX{6-001 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0001 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFIG!4L USE or'.:L'( w '" :!I:S~ u"u w"o :i..J u.... .. .. FILE NUMBER 21 - --.-oL 006!L. _ _ _ 00Mrv COii: YEAR NlMIER ~ Z W C W U W C DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAl) ZinmaDnan, Josephine M. DATE OF OEA"!H (MM-DIHEAR) DATE OF 81RTH (MM-llO-YEAR) 01-11-2004 03-26-1917 (IF APPlICABlE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDlE INmAL) N/A @ 1. 0rig\l1aI Relum 0 2. Supplemenlal Relum o 4. UmiIed Estate D 43. Future Interest Compromise (dati DldeIItl.'2-'2-82) o 6.llecedent Died T_ __"w.J) 0 7.llecedenI MainIained 0 l.Mng Trusl__"T""'l 09. Utigation Proceeds Received 0 10. Spousal Poverty Credit (d;d8D1de181bBlween12-31.91 1nt1-1-95) THl$seoJtQtt}.~. AU.;.CORJ:U;SpoltO$C. NAME SOCIAL SECURITY IlUt.I8ER 204 - 03 2678 "!HIS RETURN MUST BE RLED IN DUPUCATE WITH 1l REGISTER OF WILLS SOCIAL SBlURfIY NUMBER o 3. Remainder Retum{dIleofdllllhpriorb12-tU2l o 5. Federal ~ Tax Relum Required 8. TO!aI Number of Safe Deposit Boxes o 11.Elec:tionlolaxunderSec.9113(A)_...~ . ttt08 "'lii~1li;D.'tO: .... z w Q Z o .. '" w .. .. 8 Robert R. Black FIRM~I & Black TELEPHONE NUMBER (717) 243-3727 COMPlETE MAIlING ADDRESS Robert R. Black, Esquire Landis & Black 36 South Hanover Street Carlisle, PA 17013 (1) (2) (3) (4) (5) 0.00 0.00 0.00 0.00 17,190.22 OFFfCfAL USE ONLY z o !;i -' ::;) ~ ii: c( u w ~ 1. Real Eslale (Schedule A) 2. _ and Bonds (Schedule 8) 3. Closely Held Corporation, Partnership or SoIe-ProprIetof 4. Mortgages &. Noles _ (Schedule D) 5. Cash. Bank \leposi1s &. __ Personal Property (Schedule E) 6. .klin1ly Owned Pmporty (Schedule F) o SeparaIe BillIng Req- 7. I_-Vivos Transfefs &. Miscellaneous __ Property (Schedule G or L) 8. Total Gross Assels (_ Lines 1-7) 9. F""""" Expenses & _ CosIs (Schedule H) 10. DobIS of De<odenI, Mortgage~. & Uens (Schedule 0 11. ToIaI Ded_(IofaILines 9&. 10) 12. Net VIIue of Estate (Line 8 mioos Una 11) 13. Charitable and Gooemmontal8equesls/Sec 9113 Trusts lor _ an _10 lax has not been made (Schedule J) 14. Net Value Subjecllo Tax (Una 12 minus Una 13) (14) 0.00 I I I (6) 0.00 1-> I' I I L~.._._ (7J 0.00 (8) 17.190.22 (9) 2,780.85 18,465.76 (10) (11) (12) (13) 21,246.61 ( 4,056.39 ) 0.00 z o l;c ~ ::;) 0.. :::E o u ~ SEE INSTRUCTIONS ON REVERSE SlOE FOR APPI.ICAIII.E RATES 15. Amounl of Line 14 _ at the spousal lax raIe. or _ under Sec. 9116 (0)(1.2) x.o_ (15) x.O_ (18) x .12 (17) x .15 (18) (19) 16. Amount of Uno 14_ a11inea1 raIe 17. Amounf of Une 141axabJe at sibflng rate 1&. Amount of Une 14 taxable at coDaterallClte 19. TuOue CHECK HERE IF YOU ARE REQUESTING A REFUND OF A', OVERPAYMENT 200 0.00 . ~ ji.>: ~ Decedent's Complete Address: I SlREET ADDRESS 50 BonnvDrook Road Lot 15 Cl1Y Carlisle PA I ZIP I STATE 170n Tax Payments and Credits: 1. T2x Due (Page 1 Une 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) -0- Total Credits (A + B + C ) (2) 3. InterestlPenalty ~ applicable D. Interest E. Penally TotallnterestlPenally ( D + E ) (3) 4. If Line 2 is 9reater than Une 1 + Line 3, en.... the difference. This is the OVERPAYMENT. Check box on Page 1 line 20 10 request a refund (4) 5. If Line 1 + Line 3 is 9rea.... than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the Iotal of Line 5 + 5A. This is the BAlANCE DUE. (58) -0- Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did _nt make a transfer and: Yes a. retain the use or income of the property transferred;.......................................................................................... 0 b. relain the right to designate wI10 shaD use the property transferred Of its income; ............................................ 0 c. retain a reversionary interest; or.......................................................................................................................... 0 d. receive the promise for r~e of either payments, benetils or care? ...................................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 3. Did decedent own an "n trust foI" or payable upon death bank accounl or securily al his or her death? .............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other no"1'f1lbale property which contains a beneficiary designation? ........................................................................................................................ 0 D. Priest ADDRESS 57 "F" Street, Carlisle, PA 17013 SIGNATUREOFPitt~~~ Robert R. I\lJIJRESS 36 South Hanover Street, Carlisle, PA Black, Esquire 0;;0;(01{ 17013 'or dates of death on or alter 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% np.s. ~9116 (a) (1.1) (I)]. 'or 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. ~116 (a) (1.1) (ii) [he statute does rot exernDl a transfer to a surviving spouse from tax, and the statulory requirements for disclosure of assets and filing a tax return are sfiIl applicable even he surviving spouse is the only beneficiary. 'or dates of death on or alter July 1, 2000: l1e tax rate imposed on the net value of transfers from a deceased chUd lwenly-one years of age or younger at death to or for the use of a natural paren~ an adoptive paren .a stepparent of the chHd is 0% (72 P.S. ~9116(a)(1.2)]. l1e tax rate imposed on the net value of transfers to or for the use of the decedearS lineal beneficiaries is 4.5%, except as noled in 72 P.S. ~116{1.2) (72 P.S. ~9116(a){1)]. lie tax rate imposed on the net value of transfers to or for the use of the decedenfs siblings is 12% (72 P.S. ~116{aX1.3)]. A sibling is defined, under Section 9102, as a 1dividua1 wI10 has alleast one parent in common with the decedent, _ by blood or adoption. SCHEDULEE CASH. BANK DEPOSITS & MISC. PERSONAL PROPERTY Estate of File Number Josephine M. Zimmerman 21-04-0060 locIude the proceeds oflitiptioo and the date the proceeds were m:eived by the estate. (All property joindy-owned _ Right of Survlvonhip mull be disclosed on Schedule F.) Item Number Description 1. M&T Bank, checking account #734217. See attached letter. 2. M&T Bank, savings account #15004204155061. See attached letter. 3. Proceeds from sale of 1981 Sylvan mobile home, VIN #08Ll6489. See Hthlcbed title. 4. Refund, Capital Blue Cross. 5. Refund, mobile home insurance. 6. Proceeds, Attorney-in-Fact account. Value at Date of Death $6,745.72 $122.50 $5,000.00 $195.00 $127.00 $5,000.00 TOTAL (also enter on line 5, Recapitulation) $17,190.22 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Estate of File Number Josephine M. Zimmerman 21-04-0060 ITEM NUMBER DESCRIPTION AMOUNT A 1. FUNERAL EXPENSES: Prepaid B. ADMINISTRATIVE COSTS: 1. Personal Representative Conunissions $500.00 Harry D. Priest SSN: 184-26-2593 570 ''F'' Street Carlisle, PA 17013 Year Commission Paid: 2004 2. Attorney Fees $1,750.00 Landis &. Black. estimated 3. Family Exemption: 4. Probate Fees $230.85 Landis &. Black. advanced 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Reserve for Closing $300.00 TOTAL (Also enter on line 9, RecapituIation) $2,780.85 SCHEDULE I DEBTS OF DECEDENT MORTGAGE LIABILITIES & LIENS Estate of File Number Josephine M. ZWWKalllll11 21-04-0060 Item Number Description Amount 1. Claremont Nursing & Rehabilitation, nursing services $16,907.50 2. Carlisle Regional Medical Center, invoice $840.00 3. Central Pennsylvania Medical Group Emergency, invoice $28.40 4. Carlisle Pathology Associates, invoice $30.17 5. Andorra Radiology Associates, PC, invoice $418.58 6. Lancaster HMA Physicians Management Center, invoice $69.83 7. Yellow Breeches EMS, invoice $117.69 8. Carlisle Hospitalists $53.59 TOTAL (Also enter on line 10, Recapitulation) $18,465.76 SCHEDULE J BENEFICIARIES _or FIle Number Josephine M. Zimmerman 21-04-0060 Reh1Uoosblp to ~Il _orShant Number - - Address orPersoo(s) ~ Property Do Not Ust Tlustee(s) or_ I. TAXABLE DISTRIBUTIONS (Indude ouIrighl spousaI__) 1. Harry D. Priest Son 100% 570 "F" Street Carlisle. PA 17013 SSN: 184-26-2593 ENTER Oou.ARAIIouNT8 foROIslRtBunoNsSttoNNABcNeON lINEs 15 THRouGH 17.As~TE.ON REV 1500COUERSttEeT u. NON-TAXABLE DISTRIBUTIONS A. Spousal __ under SecIIon 9113 for which an eIeclIon to lax Is nal being __ 1. B. ~ and GovemnwIlaIIllslrIIluIIons 1. TOTAL OF PART U - EnlerTaIaI Non-T_ DisIribuIIonson Une 13 of REV 1500Covw Sheet $0.00 LAST WILL AND TESTAMENT OF JOSEPHINE M. ZIMMERMAN I, JOSEPHINE M. ZIMMERMAN, of South Middleton Township, cumberland county, Pennsylvania, make this Will, revoking all my former wills and codicils. ITEM I: I direct that all my just debts, funeral expenses, and administration expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. ITEM II: I devise and bequeath all of the residue of my estate, of every nature and wherever situate, to my son, HARRY D. PRIEST, or his issue per stirpes. ITEM III: I direct that all taxes which may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. ITEM IV: I appoint my son, HARRY D. PRIEST, Executor of this, my Last will. ITEM V: I direct that neither my Executor, Guardian, Trustee, nor their successors shall be required to give bond for the faithful performance of their duties in any jurisdiction. C(~ IN WI~~~ ~9~ I have hereunto set my hand this day of f"'fl::.Mr.>t;. , 1993. 914.JtfJ--{ /1;' ~~4_~..-#mAL) JOS PHlNE M. I RMAN The preceding instrument, consisting of this and other typewritten pages, each identified by the signature of the Testatrix, JOSEPHINE M. ZIMMERMAN, was, on the day and date thereof, signed, published, and declared by JOSEPHINE M. ZIMMERMAN, the Testatrix therein named, as and for her Last Will, in the presence of us, who, at her request, in her presence and in the presence of each other, have subscribed our names as witnesses thereto. ~ ;1--(!:JlWu 1./ - --:7 ~ ,-;- (--7VCC ,111,. .Ij:::; ,fi't COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) We, Jos~phine M. Zimmerman, Robert R. Black, and f.-INOII fl. KIJ#1Itf ' the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will, and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness, and that to the best of their knowledge the Testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~-L~ >n. ~/~?"'"..-?l-"~.4!:~ estatrix Josephin . Zimmerman (l~ fL(3R~ Witness Robert R. Black ~ ~v UQ{ Witness Subscribed, sworn to and acknowledged before me by Josephine M. Zimmerman, Testatrix, and subscribed and sworn to bef~ Robert R. Black ~ ,-,,,,OA A. f) IV , witnesses, this day of 1993. NlJl'MIAL SQL SUSAN It GUYER....,MIIc CarlIsle. CWIbllIlnd ClIuIlr My Commission &plies _ 4. 1995 , . M&fBank 499 Mildtcll Road. Millsboro, DE 19966 Mall Code 501-120 Phone (302) 934-2909 Fax (302) 934-2955 Marth 30, 2004 Landis & Black Attorneys At Law 36 South Hanover Street Carlisle. PA 17013 Re: Estote of Joseohine M Zimmerman Social Securitv: 204-03-2678 Date of Death: Januarv 11.2004 Dear Sir or Madam: Per your inquily dab:d Man:b 22, 2004, please be advised tbat at the time of death, the above-named decedent bad on deposit with this bank the fullowing: 1. Type qf Account Checking Account 734217 Account Number Ownership (Names oj) Jo Zimmerman Harry D Pries~ POA Opening Date 09/01/67 Total $6,745.72 $ 0.00 -lf6.74~72------------------------- Bakmce on DaleqfDeoJh AccruedInterest 2. Type qf Account Account Number Savings Account 15004204155061 Ownership (Names oj) Jo Zimmerman Harry D Priest, POA 02/10/03 Opening Date Bolonce on Dale qfDeoJh $122.50 Total $ 0.00 --iI22.50--------------------------- Accrued Interest For further accouat inform.~ dosares and/or reilnlntrsaneat oUuDds please call the Stondaedge Otf'1CC at #717-240-4514. We were: unable to locate.oy safr: dqKtsit box for the aboft-llle&tioncd decedent. 1NRE: : IN THE COURT OF COMMON PLEAS OF : : CUMBERLAND COUNTY, PENNSYLVANIA EST~ aTE OF JOSEPHINE M. ZIMMERMAN, Deceased : ORPHANS' COURT DIVISION : NO. 21-04-060 FIRST AND FINAL ACCOUNT OF HARRY D. PRIEST EXECUTOR OF THE ESTATE OF JOSEPHINE M. ZIMMERMAN LATE OF SOUTH MIDDLETON TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA Dat~ of Death: January 11, 2004 L~tt ~'rs Testamentary Granted: January 21, 2004 L~tt .'rs Advertised: Sentinel - February 7, 14, 21, 2004 Cumberland Law Journal - February 20, 27 & March 5, 2004 AFc, rant Stated as Final SUMMARY & INDEX l~lq INCIPAL PAGE Re :eipts 17,190.22 Co nversions (Gain) or (Loss) 0.00 Le Disbursements -2,730.85 Balance Before Distributions 14,459.37 Ac~vancements to Beneficiaries 0.00 Prlncipal Balance Remaining 14,459.37 Rqceipts 0.00 L4ss Disbursements - 0.00 [n :ome Balance Remaining 0.00 MBINEDBALANCE REMAINING $14,459.37 RECEIPTS OF PRINCIPAL ~/2 M&T Bank, proceeds o£checking account #734217 $6,010.72 11/2 M&T Bank, proceeds of savings account #1500-4204-155061 $122.50 ]1/2 Proceeds, sale o£ 1980 Sylvan mobile home, V1N 08L16489 $5,000.00 ~2/1 Capital Blue Cross, premium refund $195.00 2/~8 Harry D. Priest, return of Power of Attorney account $5,000.00 3/~3 Mobile-Rec, Inc., refund of mobile home insurance premium $127.00 4/~6 M&T Bank, close checking account #734217 $735.00 Total Receipts of Principal $17,190.22 DISBURSEMENTS OF PRINCIPAL 2~ ~)4 RI SERVED COSTS OF ADMINISTRATION Pursuant to PEF 3392: 1/19 Register of Wills, Probate and Letters Testamentary $46.00 ~8 Cumberland Law ~lournal, advertise Letters Testamentary $75.00 3~ The Sentinel, advertise Letters Testamentary $91.85 3tl 8 Register of Wills, Short Certificate $3.00 6f15 Register of Wills, file Pennsylvania inheritance tax $15.00 / 1~)/1 Register of Wills, file account and closing 1~/1 Harry D. Priest, Executor's fee $500.00 ID/1 Land~s' & Black, attorney's flees $2,000.00 Total Disbursements of Principal $2,730.85 RECEIPTS OF INCOME ~0( 4 N/A 0.00 Total Receipts of Income 0.00 DISBURSEMENTS OF INCOME 2004 N/A Total Disbursements of lncome 0.00 1NRE: : 1N THE COURT OF COMMON PLEAS OF i : CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF JOSEPHINE M. ZIMMERMAN, Deceased : ORPHANS' COURT DIVISION : NO. 21-04-060 SCHEDULE OF PROPOSED DISTRIBUTION COMBINED BALANCE FOR DISTRIBUTION REMAINING ASIPER FIRST AND FINAL ACCOUNT $14,459.37 DISTRIBUTION 1N ACCORDANCE WITH PA ES~FATES & FIDUCIARIES CODE RULE 3392 - Cla{ssification-- and Order of Payment (3). l'(J: Claremont Nursing & Rehabilitation Center $16,907.50 $13,542.37 1000 Claremont Drive Carlisle, PA 17013 Carlisle Regional Medical Center $840.00 $672.00 246 Parker Street, P.O. Box 4100 Carlisle, PA 17013 Central Penn Medical Group Emergency $28.40 $23.00 P.O. Box 619 East Petersburg, PA 17520 Carlisle Pathology Associates $30.17 $24.00 P.O. Box 188 Landisville, PA 17538 Andorra Radiology Associates, P.C. $7.64 $6.00 P.O. Box 892 Concordville, PA 19331 Lancaster HMA Physicians MGT CTR $69.83 $56.00 1104 Mountor Road Loysville, PA 17047 Yellow Breeches EMS $117.69 $93.00 P.O. Box 516 Camp Hill, PA 17001 Carlisle Hospitalists $53.59 $43.00 Apex Asset Management, LLC P.O. Box 7044 Lancaster, PA 17601 TO~rAL BALANCE FOR DISTRIBUTION $14,459.37 [ Harry D. Priest, Executor under the Last Will and Testament of Josephine M. Zimr ~erman, deceased, hereby declares under penalties of perjury that he has fully and faithfully disc[ arged the duties of his office; that the foregoing First and Final Account is true and correct and I Ully discloses all significant transactions occurring during the accounting period; that all knox ~n claims against the estate have been paid in full; that the first complete advertisement of the gran of letters was more than four months from the date the account was filed; that, to his knox ~ledge, there are no claims now outstanding against the Estate; and that all taxes presently due i'om the estate have been paid. He understands that false statements herein are made subject to tl~ e penalties of 18 Pa. C.S.A. 4904 relating to unsworn falsification to authorities. / Harry D. Priest, Executor LAST WILL AND TESTAMENT OF JOSEPHINE M. ZIM-MEI~N I, JOSEPHINE M. ZIMMERMAN, of South Middleton Township, Cu~]~erland County, Pennsylvania, make this Will, revoking all my for]]er wills and codicils. ITEM I: I direct that all my just debts, funeral exp,~nses, and administration expenses, including my grave marker, sba.1 be paid from the assets of my estate as soon as practicable aft,~r my decease. ITEM II: I devise and bequeath all of the residue of my ~state, of every nature and wherever situate, to my son, HARRY D. ~RIEST, or his issue per stirpes. ITEM III: I direct that all taxes which may be assessed in ~onsequence of my death, of whatever nature and by whatever ju~ Lsdiction imposed, shall be paid from my residuary estate as a par of the expense of the administration of my estate. ITEM IV: I appoint my son, HARRY D. PRIEST, Executor of his, my Last Will. ITEM V: I direct that neither my Executor, Guardian, Tru;tee, nor their successors shall be required to give bond for the faithful performance of their duties in any jurisdiction. IN WIT~iES~ WHE~E~OF~ I have hereunto set my hand this day of ~~C~ , 1993. ' / .~ ~ ~d~-;~'~x~SEAL) /' OS PHIN M. Tho precod~nq instrument, cons~st~n~ o~ this and other t~pewritten pa~os, each ~dentif~ed by the signature of the TOs~atr~x, ~OSEPHINE ~. gI~E~, was, on the day and dato the]eof, signed, published, and declared by JOSEPHINE M. ZIM~iERMAN, the Testatrix therein named, as and for her Last Will, in he presence of us, who, at her request, in her presence and in ~he presence of each other, have subscribed our names as wit ~sses thereto. CO~ )NWEALTH OF PENNSYLVANIA ) COU];TY OF CUMBERLAND ) We, Josephine M. Zimmerman, Robert R. Black, and ~ ~ ~D~l, the Testatrix and the witnesses, res])ectively, whose names are signed to the attached or foregoing ins'~rument, being first duly sworn, do hereby declare to the und,~rsigned authority that the Testatrix signed and executed the instrument as her Last Will, and that she had signed willingly (or willingly directed another to sign for her), and that she eXe~uted it as her free and voluntary act for the purposes theiTein expressed, and that each of the witnesses, in the pre~ence and hearing of the Testatrix, signed the Will as witi~ess, and that to the best of their knowledge the Testatrix was at the time eighteen years of age or older, of sound mind and u~d.~r no constraint or undue influence. ~estatrix Josephin~:~.'Zimmerman ~- Witness Robert R. Black Witness Sub::cribed, sworn to and acknowledged before me ]~y Josephine M. Zimmerman, Testatrix, and subscribed and sworn to befor9 me~ by Rob,~rt R. Black ala.~ ~I[~ ~. ~;~;~( . , wit]Leases, this ~ day of ~--~-3~-~ , 199[i. SUSAN K. GUYER, Nola~PIJbflC I Carlisle, Cumberla~ Co~I~y I ~ Commission Expires Sept. 4,1995 ~ [N THE COURT OF CC~VK)N PLEAS OF .-T~4BERLAND COUSTfY, PENNSYLVANIA DRPHANS ' GOHRT DMSION ~0. 21 - 04 - 060 IN RE: ESTATE OF JOSEPHINE M. ZIb~V~qMAN, Deceased I hereby <~'flfy that wfft~e, netice of the filing o~ this Aoooum. am~ otthe date. time and piece when the eame will be i~'eme~ted to the Court FIRST AAD FINAL ACCOUNT for conflmmtl~ and o~ the I~t day to file writter~ A_kD o~eotkx~ to s~d A(xxxzK he~ been given tc SCHEDULE OF PROPOSED DISTRIBUTION eve~ u~oaid clalma~ and to every other perso~ known to the accou~ant to have or claim an interest in the estate as ~editot beneficiary. heir or next of kin. StatelieSt of t~ Dlllt~. and of the date. time and 131m~ wben the came w~l be ~'e~ented to D.illl~fgxltf.(~. ha~, ~ giv~ll to every ul%gaid claimant and to every oftter pefa4)n lelo~t to the accourtlant to A co~gy of sak~ Steteme~ was included ~ the notic~ ROBERT R. BI~CK, ESQUIRE LAW OFFICES LANDIS & BI-ACK 56 SOUTH HANOVER STREET CARLISLE, PENNSYLVANIA 17013 COHHONNEALTH OF PENNSYLVANZA BUREAU OF ZNDZVZDUAL TAXES DEPARTNENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17118-0601 NOTZCE OF INHERITANCE TAX APPRAZSENENT, ALLO#ANCE OR DZSALLOHANCE OF DEDUCTZONS AND ASSESSHENT OF TAX RE¥-IE~7 EX ~FP ~ec~:~'~?~' i;~E ~-~ DATE 08-02-2006 ..... ~,'i:!S ESTATE OF ZIHNERNAN dOSEPHINE N DATE OF DEATH 01-11-2006 FZLE NUNBER 21 06-0060 JUL 30 1:3bOUNTY CUNBERLAND ROBERT R BLACK ESQ ACN 101 LANDIS & BLACK 36 S HANOVER ST ~'ik' ,;C'~i"i A.oun* RaaA*~ad CARLISLE PA 17ol~tmberi~r~d ~.~0~, PA HAKE CHECK PAYABLE AND REH/T PAYNENT TO: REGISTER OF ~ILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 1701~ CUT ALONG THIS LZNE ~'- RETAZN LO#ER PORTZON FOR YOUR RECORDS REV-1567 EX AFP [01-03) NOTICE OF ZNHERZTANCE TAX APPRAZSENENT~ ALLOWANCE OR DISALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF ZIHNERNAN dOSEPHINE NFZLE NO. 21 06-§060 ACN 101 DATE 08-02-2006 TAX RETURN HAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE INTEREST- SEE REVERSF APPRAZSED VALUE OF RETURN ~ASED ON: ORIGINAL RETURN 1. Real Es*e~a (Schedule A) (1) .0§ NOTE: To insure proper 2. S~ocks and Bonds (Schedule B) (2) .00 cradA~ {o your accoun*, $. Closely Held S~ock/Par~na~shAp Zn~aras~ (Schedule C) ($) .00 subeA~ ~ha upper por~Aon ~. Hot'gages/No,es RaceAvabla [Schedule D) (~) .00 of ~h~s fore wi~h your 5. Cash/Bank DaposA~s/NAsc. Personal Propar~y (Schedule E) (5) 171190.Z~ ~ax payment. 6. Jointly O~ned Propar~y (Schedule F) (6) 7. Transfers (Schedule G) (7) .00 8. To,al AssaYs (e) 17,190.22 APPROVED DEDUCTZONS AND EXENPTZONS: 2,780.85 9. Funeral Expanses/Ada. Cos~s/NAsc. Expenses (Schedule H) (9) 10. Dab~s/Hor~gaga LAabAIA*Aas/Llans (Schedule Z) (10) 11. To,al Dadu¢{ions (11) ~1.~6~.~1 12. Na~ Value of Tax Ra~urn (121 6,056.$9- 15. Cha~A~ebla/governaen{el Baques~sj Non-alao~ed 911S Trusts (Schedule J) 1~. Na~ Value of Es~a~a SubSe¢~ ~o Tax (1~1 6,056.59- NOTE: l{ an assessment ~as issued previously, lines 16~ 15 and/Ge 15~ 17, 18 and 19 u111 ~efleot {iguPes that include the total of ALL returns assessed to date. ASSESSNENT OF TAX: 15. kaoun{ of LAne lq a~ Spousal ra~a (151 .00 X O0 = .00 16. Aeoun~ of LAne 1~ ~axabla a~ Lineal/Class A ra~a (16) .00 X 065 = .00 17. Amoun~ of LAne lq e* Sibling re~a (17) .00 X ~Z = .00 18. Amoun~ of LAne lq *axebla e* Collateral/Class B re*a (18) .00 X 15 = .00 19. PrlncApel Tax Due (19)= .00 TAX CREDZTS: PAYHENT RECEZP1 DZSCOUNT DATE NUNBER INTEREST/PEN PA~D (-) AHOUNT PAID TOTAL TAX CREDZT I~ALANCE OF TAX DUEI . O0 I ZNTEREST AND PEN. I .00 TOTAL DUE 1F PAID AFTER DATE 1NDTCATED, SEE REVERSE ( 1F TOTAL DUE TS LESS THAN $1, NO PAYNENT ]:S REQUTRED. FOR CALCULATTON OF ADDTTIONAL INTEREST. :]:F TOTAL DUE lS REFLECTED AS A 'CREDTT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORN FOR 1NSTRUCT:]:ONS. RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for yearsj the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To ~ulfil! the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (TZ P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side. --Hake check or money order payable to: REGIBTER OF NILLS, AGENT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may bm requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-15I$). Applications are available at the Office of the Register of Nills, any of the Z5 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-56Z-ZOSO; services for taxpayers with special hearing and / or speaking needs: 1-800-447-5020 (TT only}. OBJECTIONS: Any party in interest not satisfied with the appraisement, allowancej or disallowance of deductions, or assesSlaent of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written pretest to the PA Department of Revenue, Board of Appeals~ Dept. Z81021, Harrisburg, PA 171Za-lOZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department af Revanua~ Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 171Z6-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (5) calendar months after the decadant's death, a five percent [SZ) discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the tatar of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end 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: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, lgBz bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 19az will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Dapart3~ent of Revenue. The applicable interest rates for 19BI through ZOO4 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ 20Z .000548 ~'~-1991 llZ .000301' ~ 9Z .000Z47 1983 162 .000438 1992 92 .000247 2001 62 .000164 1984 11X °00030! 1993-1994 7X .O0019Z 2003 51 .000137 1985 131 .000356 1995-1998 9X .000247 Z004 4X .000110 1986 lOZ .000274 1999 7X .000192 1987 iOZ .000274 Z00O 72 .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELTN{~UENT 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. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Estate of Josephine M. Zimmerman Date of Death: January 11, 2004 Will No. 21-04-060 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: I. State whether administration of the estate is complete: Yes XX No 2. If the answer is NO, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. I is Yes, state the following: a. Did the personal representative file a fmal account with the Court? Yes XX 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 XX 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: /IZ"1/QS IlJej /1!J~ Robert R. Black, Esquire Landis & Black 36 South Hanover Street Carlisle, Pennsylvania 17013 (717) 243-3727 (.,: ( " Capacity: _ Personal Representative X Counsel for Personal Representative ,,'..'> , , (, ( " ~