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HomeMy WebLinkAbout04-0125 Stitt and Stitt John W. Stitt Attorneys at Law Phone 717-846-9400 1434 W. Market Street Fax 717-854-9669 Harry C. Stitt, Jr. York, Pennsylvania 17404-5413 E Mail jwstitt@blazenet, net ( 918- 983) February 2, 2004 Cumberland County Register of Wills Attention Sue Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Re: Estate ofALICIA A. STRAUSBAUGH Dear Sue: First and foremost, thank you for your kind assistance when I telephoned you this date. Enclosed find the original Petition for Grant of Letters of Administration (with the Oath taken by the York County Register of Wills); the original Renunciation form; the Estate Information Sheet; the certified copy of the death certificate; and our trust account check in the amount of $262.00. Please issue and forward the original Letters and four (4) short certificates to our office. We do need to advertise the estate administration. Would you please provide me with a telephone number or other information regarding the Legal Journal. I will contact the Carlisle Sentinel, also. Thank you for your time and attention to these matters. Should you have any questions, please feel free to contact me. Very truly yours, STITT AND STITT {Jaflice E. Stitt Estate Paralegal Enclosures hereby c~r~y Ulat written no, ice of ~e filing mis ~t, ~ ~ ~ ~te, ~ ~ ~ w~ ~ ~ ~ ~~ Cou~ ~ c~ ~ ~ ~ t~ ~ ~ ~e wri~en ~to ~, ~ ~v~ ev~ ~ ~ ~ m e~ ~ per~n kn~n to ~ ~ ~ ~e = ~m an ~nter~t in ~ ~ ~ ~' ~' ~eir or ~ ~ ~. ~ ~.o~ o~ - ~' ~ ~ ~ ~ >~m~ ~ ~ ~> ~ · 0 ~ ~ ~ ~o~ O~ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION FIRST AND FINAL ACCOUNT OF CHRISTINE A. STRAUSBAUGH, ADMINISTRATRIX OF THE INTESTATE ESTATE OF ALICIA A. STRAUSBAUGH LATE OF LOWER ALLEN TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED DATE OF DEATH: December 24, 2003 LETTERS TESTAMENTARY ADVERTISED: Cumberland Law Journal: February 20, 27 & March 5, 2004 Sentinel: February 24, March 2 & 9, 2004 ESTATE FILE NUMBER: 21-04-00125 ~: ~. PRINCIPAL PERSONALTY c~ RECEIPTS 1. INVENTORY as previously filed in Office of Register ~ of Wills (copy attached) $11,957.76 2. Federal Income tax refund (calendar year 2003) $ 580.00 3. Proceeds of sale of Durban stock (net loss realized) $357.50 ($327.48) ($ 30.02) $12,507.74 PRINCIPAL PERSONALTY DISBURSEMENTS I. Register of Wills for Letters Testamentary and Short Certificates - admimstration expense $ 272.00 2. Cumberland County Law Journal for legal advertisement - administration expense $ 75.00 3. The Sentinel for legal advertisement - administration expense $ 149.99 4. Register of Wills for filing fees - administration expense $ 23.00 5. Janice Stitt for notary fees - administration expense $ 14.00 6. Christine A. Strausbaugh as reimbursement for preparation of 2003 income tax returns using Turbo Tax on Line - administration expense - UNPAID $ 39.90 Page 1 of 6 7. RESERVE for preparation of fiduciary income tax returns by accountant, Tice Associates - administration expense $ 300.00 8. Clerk of Orphans' Court for filing account - administration expense $ 113.00 9. RESERVE for attorneys' fees to Stitt &Stitt - administration expense $ 5,000.00 10. Christine A. Sttausbaugh and Gregory C. Stransbaugh as reimbursement for funeral expenses to Heffner Funeral Home - UNPAID $ 4,869.00 11. Alcoast Company for removal and disposition of furniture items - administration expense $ 100.00 12. Chronister's Auction service for tangible personalty sale commission and costs - administration expense $ 178.00 13. AT & T Wireless for cellular telephone service - account balance - UNPAID $ 157.80 14. Verizon for telephone service - account balance - UNPAID $ I94.86 15. Hershey Medical Center for services performed within six months of date of death - UNPAID $ 176.00 16. Cigna Healthcare (c/o Primax Collection) as reimbursement for health care services provided within six months of date of death - UNPAID $1,108.00 17. Value City for credit account balance - UNPAID $ 602.57 18. MBNA for credit account balance - UNPAID $ 5,477.87 19. Chase for credit account balance - UNPAID $1,302.72 $19,228.72 $ 924.99 $20,153.71 PRINCIPAL REALTY RECEIPTS 1. Residential real estate located at 321 Manchester Road, Lower Allen Township, Cumberland County, PA (noted on Inventory as previously filed in Office of Register of Wills (copy attached) $124,900.00 2. Real Estate tax prorations upon sale of residence $ 929.20 $125,829.20 Page 2 of 6 PRINCIPAL REALTY DISBURSEMENTS 1. Pennsylvania American Water for utility service to residence $ 31.42 (in lieu of winterizing) 2. PP & L for utility service to residence $ 102.19 (in lieu of winterizing) 3. Lower Allen Township for municipal sewer services $ 265.20 4. UGI for utility service to residence $ 225.44 (in lieu of winterizing) 5. Christine Strausbaugh as reimbursement for payment of UGI provision of utility service to residence (in lieu of winterizing) - UNPAID $ 96.79 6. Washington Mutual Bank for mortgage payoff on residence $116,040.40 7. Home purchaser warranty to AON at sale of residence $ 409.00 8. Century 21 & ERA as sales commissions for residence $ 7,494.00 9. Overnight fee to Purity Abstract for mortgage payoff $ 15.50 10. 2004-05 real estate/school taxes to Bonnie Miller, T.C. $ 953.52 11. 1% transfer tax to Recorder of Deeds $ 1,249.00 12. Transaction fee to ERA realtor $ 100.00 13. Repairs to HVAC required incident to sale of real estate to Bob King HVAC $ 105.00 14. Pennsylvania American Water for utility service to residence - UNPAID $ 13.22 15. PP & L for utility service to residence - UNPAID $ 137.08 $ 247.09 $126,990.67 $127,237.76 Page 3 of 6 INCOME PERSONALTY RECEIPTS NONE INCOME PERSONALTY DISBURSEMENTS NONE INCOME REALTY RECEIPTS NONE INCOME REALTY DISBURSEMENTS NONE RECAPITULATION PRINCIPAL PERSONALTY RECEIPTS $12,507.74 DISBURSEMENTS ($ 924.99) $11,582.75 INCOME PERSONALTY RECEIPTS $ 00.00 DISBURSEMENTS $ 00.00 $ 00.00 PRINCIPAL REALTY RECEIPTS $125,829.20 DISBURSEMENTS ($126,990.67) ($ 1,161.47) INCOME REALTY RECEIPTS $ 00.00 DISBURSEMENTS $ 00.00 $ 00.00 BALANCE REMAINING - AVAILABLE FOR DISTRIBUTION $10,421.28 INTERIM DISTKIBUTIONS TO BENEFICIARIES: NONE Page 4 of 6 PROPOSED SCHEDULE OF DISTRIBUTION BALANCE FOR DISTRIBUTION $10,421.28 LESS unpaid charges of first priority under PEF Code §3392: 1. Stitt & Stitt for attorney fee $5,000.00 2. Tice Associates for accounting services $ 300.00 3. Christine A. Stransbaugh, reimbursement for preparation of 2003 income tax returns $ 39.90 $5,339.90 REMAINING BALANCE FOR DISTRIBUTION: $5,081.38 LESS unpaid charges of second priority under PEF Code §3392: NONE REMAINING BALANCE FOR DISTRIBUTION: $5,081.38 LESS unpaid charges of third priority under PEF Code §3392 (prorata - factor .8101) CHARGES PRORATA 1. Cinistme A. Strausbaugh and Gregory C. Strausbaugh, reimbursement for funeral expenses $4,869.00 $4,021.00 2. Hershey Medical Center, medical services $ 176.00 $ 145.35 3. Cigna Healthcare (c/o Primax Collection), medical services $1,108.00 $ 915.03. $6,153.00 $5,081.38 REMAINING BALANCE FOR DISTRIBUTION: $ 00.00 LESS unpaid charges of fourth and fifth priorities under PEF Code §3392: NONE Claims of creditors of higher priorities under PEF Code §3392 having exhausted the sums available for distribution by payment to them, m full or pro-rata, there remain no sums available for distribution to the remaining creditors, or to decedent's intestate heirs, and no such distribution is proposed: 1. AT & T Witless for cellular telephone service $ 157.80 $ 00.00 2. Verizun for telephone service $ 194.86 $ 00.00 3. Value City for credit account balance $ 602.57 $ 00.00 4. MBNA for credit account balance $5,477.87 $ 00.00 5. Chase for credit account balance $1,302.72 $ 00.00 6. PA American Water for utility service to residence $ 13.22 $ 00.00 7. PP & L for utility service to residence $ 137.08 $ 00.00 8. Christine A. Strausbaugh for UGI service to residence $ 96.79 $ 00.00 9. Christine A. Strausbangh, mother (heir) $ 00.00 10. Gregory C. S~'ansbaugh, father (heir) $ 00.00 Page 5 of 6 Christine A. Strausbaugh, Administratrix for the Estate ofAlicia A. Strausbaugh, now deceased, hereby declares under oath (or by affirmation) that she has fully and faithfully discharged the duties of her office; that the foregoing First and Final Account is la-ue and correct and fully discloses all significant lxansactiuns occurring during the accounting period; that all known claims against the estate have been paid in full (to the extent assets exist sufficient to fund such payment); that, to her knowledge, there are no claims outstanding against the Estate not being properly provided for by this Account; and that all taxes presently due from the estate have been paid, if owing. CHRISTINE A."S'"~O~SBAUGH, ADM1NISTRATRIX COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF YORK : Subscribed and sworn to (or affmned) by Christine A. St~ausbaugh, Admiinstra~ix as aforesaid, who personally appeared before me this 10th day of December, 2004. Notary Public My commission expires: COMMONVV~..ALTH OF PENNSYLVANIA I NOTARIAL SEAL t JANICE E. STITT, Nota~ Public West York Boro., York County My Commission Expires January 12, 2005 Page 6 of 6 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF: NO: 21-04-00125 ALICIA A. STRAUSBAUGH LATE OF: Lower Allen Township, Cumberland County, Pennsylvania, Deceased DATE OF DEATH: December 24, 2003 AFFIDAVIT OF A~-FORNEY COMMONWEALTH OF PENNSYLVANIA COUNTY OF YORK Before me, personally appeared John W. Stitt, Esquire, who being duly sworn according to law, did state that written notice of the filing of the Account and the Proposed Schedule of Distribution was given to every unpaid claimant who has given written notice of his claim to the accountant and to every other person known to the accountant to have or claim an interest in the account as beneficiary, creditor, heir or next of kin. Specifically, the notice stated that the Account and Proposed Schedule of Distribution was filed in the Office of the Clerk of the Orphans' Court of Cumberland County, Pennsylvania, on December 10, 2004. The notice further stated that the Account and Proposed Schedule of Distribution will be called for confirmation by the Court at Cumberland County Courthouse, 1 Courthouse Square, Carlisle, Pennsylvania, 17013, on January 11, 2005 and that any objections to the Account or to the Proposed Schedule of Distribution, or both, must be filed in writing no later than 9:00 A.M. (prevailing time) on January 11,2005, in the Office of the Clerk of the Orphans' Court of Cumberland County, Pennsylvania, in the Cumberland County Courthouse, 1 Courthouse Square, Carlisle, Pennsylvania, 17013. Such notice was given to the following individuals and entities at the addresses listed: Christine A. Strausbaugh Gregory C. Strausbaugh PA American Water 1349 W. Philadelphia St. 465 Swarey Rd. Box 578 York, PA 17404 Miffiinburg, PA 17844 Alton IL 62002-0578 mother father Acct #24~ 1525444-6 P P & L A T & T Wireless Verizon/RCO 2 N. 9th St. Box 129 7171 Mercy Rd. Allentown, PA 18101-1175 Newark, NJ 07101-0129 Omaha, NE 68106 Acct #30060-76029 Acct #159-2200450670 Acct #92490939 Verizon/Collectech Systems Hershey Medical Center Value City Furniture Box 4157 MSHMC Physician Group Box 182121 Woodland Hills, CA 91365 Box 643313 San Antonio, TX 43218-2 Placement ID #0111974025 Pittsburgh, PA 15264-3313 Acct #5856371005793160 Acct #1372670 MBNA/Estates Chase/Estates Primax Collection for Cigna Healthcare Box 15409 Box 15583 Arm John Desmarais Wilmington, DE 19885-5409 Wilmington, DE 19886-1194 Box 7135 Acct ~264293146126382 Acct #5260315210013112 Bloomfield, CT 06002-7135 Case #5023021 Xuan Lam Gary Reid 5516 Blakeslee Ave. 517 Big Sky Dr. Harrisburg, PA 17111 Etters, PA 17319 (contingent claimant - (contingent claimant - motor vehicle accident) motor vehicle accident) Sworn and Subscribed to before me this 10th.day of Decembem 2004 . /"John V~. Stitt, Attorney for the Estate (~.~, ~ (~/~ ~ , 1434.4.4.4.4.4.4.4.4.4~V. Market St., York, PA 17404.-~-7-'~7) 846-9400 // ] ~;-;.~ ::,! ;'1 OF PENNSYLV~I~i. 24826 ',~ /, , ~T^!~L S~L [ ~ANIC~ r~, S)'ITT, Nora7 Public I We~i York Bor~,, York (~ounty Stitt and Stitt Attorneys at Law Phone 717-846-9400 John W. Stitt 1434 W. Market Street Fax 717-854-9669 Harry C. Stitt, Ir. York, Pennsylvania 17404-5413 E Mail jwstitt@blazenet.net (1918-1983) December 10, 2004 To the creditors, heirs and any other individuals or entities interested in the Estate of Alicia A. Strausbaugh, now deceased: Cumberland County File Number: 21-04-0125 Please find enclosed herewith true and correct copies of the First and Final Account with Proposed Schedule of Distribution attached, of Christine A. Strausbaugh, Administratrix of the Estate of Alicia A. Strausbaugh, now deceased, together with the Inventory previously filed, as appear of record in the Office of the Clerk of the Orphans' Court in and for Cumberland County, Pennsylvania, this date. The Account will be called for confirmation on Tuesday, January 11, 2005, at the Cumberland County Courthouse located at 1 Courthouse Square, Carlisle, Pennsylvania, 17013. Any objections to the Account as presented must be filed with the Clerk of the Orphans' Court in the Cumberland County Courthouse, in writing, at or before 9:00 a.m. on Tuesday, January 11, 2005; failure to present such objections, either in person or by counsel, may result in a determination by the Court that no such objections exist or that they have been waived. You will note that the estate lacks assets sufficient to satisfy the claims of all creditors in full, and payment on a pro-rata basis is proposed as appropriate. As a further consequence, no distribution is proposed to the intestate heirs. Anyone wishing to take a position different from the accountant on matters of payment of claims or distribution must appear in person or by counsel at the confirmation to make it known; otherwise, the Court may assume that all are in agreement with the position taken by the accountant (or, in the alternative, have no position on the matter). In any event, in the absence of objections timely filed, in writing, the Court may confirm the account as presently stated. In the absence of the timely filing of objections to the Account, and assuming confirmation of the account as presented, distribution will be accomplished in due course thereafter. Anyone interested in the estate of this decedent, either as a claimant or distributee, or otherwise, may direct any questions or requests for additional information to the undersigned, or to other competent legal counsel of choice. Thank you for your attention and your anticipated cooperation. Very truly yours, ~b~ W. St±tt ~-~S/jes Enclosures copy to Clerk of the Orphans' Court lr':~ ~L~L~_[_~ '~ PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L. 1784 STATE OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that thc Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in thc County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that thc printed notice or publication attached hereto is exactly thc same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz: FEBRUARY 20, 27, MARCH 5, 2004 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. Strau~bangh, ,*Aiei~ .~, dec'd. // Lisa MarieCovl~e. Edtor SYWORN TO ANDSUB~CLiE; before me this Late of Lower Allen Twp. Admlnlstratrlx: Christine A. 5 dayof MARCH 2004 Strausbaugh, 1349 W. Philadel- phia St., York, PA 17404. ~2~ ~ Attomey: John W. St. itt, Esquire, 1434 W. Market SL, York, PA 17404, (717) 846-9400. xT ..... // I N'O~[ltL SEN_a/ I LOIS E. SNYDER, Notary Public I Carlisle Boro, Cumberland County I My Commission Expires March 5, 2005 I PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland. Rich Canazaro, Internet Director of THE SENTINEL, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following dates, viz Copy of Notice of Publication The Sentinel February 24, March 02 & 09, 2004 Affiant further deposes that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and character ~4s4 ~.~u=~a,~ of publication (717) 84~ March 11,2004 11th Sworn to an~L~ubscribed before me this dayof / _'~ March. _~,~004. ~. Notary Public My commission expires: NOTARIAL SEAL DARCIE A. NELL, Notary Public ~ I~ DEPARTMENT OF REVENUE BUREAU OF ZNDIVTDUAL TAXES INHERITANCE TAX OIVlSION NOTTCE OF TNHERZTANCE TAX PO aOX 280601 APPRAZSEMENT, ALLONANCE OR DZSALLONANCE HARRISBURG, PA 171Z8-060! OF OEDUCTTONS AND ASSESSMENT OF TAX eE¥.ISq?EXAFP[~_O~) DATE 11-29-200q ESTATE OF STRAUSBAUGH AL[CTA A DATE OF DEATH 12-2~,-2Q05 FZLE NUMBER Z1 0fi-012S COUNTY CUMBERLAND JOHN N STITT ESQ ACM 101 5TITT & STITT Amount Remit ~cad lqSq N MARKET ST YORK PA 17qOq MAKE CHECK PAYABLE AND REMXT PAYMENT TO: REGISTER OF NTLL$ CUMBERLAND CO COURT HOUSE CARL~[SLE, PA 1701:5 CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS ~-v-: igh-f - ~- -~ ~' '~ ~:'~T '~ ~'z'~ ~' '~ ' ~'~fi ~-z'f R~'~g ' ~'~ ' ~-~ ~'~'g ~'E'~ ~' '~ [L-~O R~g ' B~ ................. DXSALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX ESTATE OF STRAUS~AUGH ALICIA A FZLE NO. 21 0q-0125 ACM 101 DATE 11-29-200q TAX RETURN NAS: (X) ACCEPTED AS F'rLED ( ) CHANGED RESERVATTON CONCERN'rNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: 0RTGTNAL RETURN 1. Real Estate {Schedule A) (Z) 12a,~900,00 NOTE: To lnsura proper 2. Stocks and Donds (Schedule B) (2) ~557.50 credit (o your S. Closely Held Stock/Partnership /n~:erest (ScheduZe C) (~) . O0 submit the upper por~:ion q. Mortgages/Notes Receivable (Schedule D) (q) . O0 of ~hls form with your S. Cash/Sank Deposit:s/Misc. Personal Property (Schedule E) (S) 11r600.26 ~cax payment. 6. Jointly Owned Property (Schedule F) (6) . O0 7. Transfers (SchaduZe S) (7) .00 8. Total Assets (8) 136,857.76 APPROVED DEDUCTXONS AND EXEMPTZONS: 9. FunaraZ Expensas/Adm. Costs/Misc. Expenses (ScheduZa H) {9) 11,075.89 10. Debts/Not,gage LiabtZltias/Liens (Schedule T} (10) 156,208.10 11. Total Deductions (ll} ~ 12. Net Valua of Tax Return (123 10,~26.2~- 15. Chari~cabla/govarnmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) . O0 Zq. Nat Value of Estate SubSect *o Tax (lq) IO,qZ6.Z:5- NOTE: 1'~ an assessment Nas issued previously, 11nes 1~,, 15 and/or 16, 17, 18 and 19 w111 reflect ~'igures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 1S. Amount: of Line 1~ at Spousal ra~ce (1S). . O0 X O0 = . O0 16. Amount of Line lq taxable a~: Lineal/Class A rata (16) . O0 X Oq5 = . O0 17. Aeount of L~na lq at Sibling rate (17) .00 X 12 = .00 18. Amount of Line Zfi taxable at Collateral/Class B rate (18) .00 X ~5 = .00 19. Pr/nc/pal Tax Due (19)= .00 rAX CREDZTS: PAYMENT RECE3CPT U~CSCUUNT t+J AMOUNT PAZD DATE NUHSER TNTEREST/FEN PATO (-) TOTAL TAX CREDZT I .00 ~. ~{ BALANCE OF TAX DUEl .00 ~ib~+ 5 'rNTEREST AND PEN. .00 TOTAL DUE .00 ~ TF pATD AFTER DATE INDTCATED~ SEE REVERSE ( TF TOTAL DUE TS LESS THAN $1, NO PAYMENT TS REQUTRED. FOR CALCULATTON OF ADDTTTONAL TNTEREST. TF TOTAL DUE TS REFLECTED AS A 'CREDTT" (CR)~ YOU HAY SE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR TNSTRUCTZONS. CUMBERLAND COUNTY INVENTORY Estate of STRAUSBAUGH ALICIA A. No. 21 04 00125 also known as Dale of Death 12/24/2003 LATE OF LOWER ALLEN 'RNP., CUMBERLAND COUNTY, PA , Deceased Social Security No. 171621381 CHRISTINE A. STRAUSBAUGH, ADMINISTRATRIX Personal Representative(s) of [he above Es[ate, deceased, vedf~ that the items appearing in the following inventocy include all of [he personal assets wherever situate and ell of the real estate in the Commonwealth of Pennsylvania of said Decedent, that t~e valuation placed opposite each item of said inventory represenLs its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at [he end of this inventory. IRVe ved~ that the statements made in this inventory are true and correct. IRVe understand that false statsmenfs herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. ttorr~y: JOH~'W. STtTT, ESQUIRE"" ~} ' I.D. 'N~26 CHRISTIkNE A. STRAUSBAUGH, ADMINISTRAnt'RIX ' Address: 1434W. MARKETST. Date/d~~'~L~ ~.~ '7½ (;::~ (,--'~")('¢ YORK PA 17404 Telephone: 717/846-9400 Description Value Stocks & Bonds: 125 sh DURBAN ROODEPOORT DEEP LTD @ 2.86 357,50 (PER LE~FFER ATTACHED TO REV1500) Cash, Bank Deposits, & Misc. Personal Property: COMMERCE BANK CK ACCT #513198564 704.35 (PER LETTER) COMMERCE BANK STATEMENT SAV ACCT #0626131411 1,292.01 (PER LETTER) - CLOSING BALANCE KEANE INC FINAL SALARY 8,604.75 Total (Attach Additional Sheets if necessary) 136,857.76 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsyrvania may, at the elecCon of [he personal representa~ve, include [he value of each item, but such figures should not be extended thto the total of [he Inventory. Continuation of Inventory .~ rRAUSBAUGH, ALICIA A, 21 04 00125 Page 1 Description of Inventory Description Value STATE FARM INSURANCE, REFUND UNEARNED PREMIUMS 558,44 108,38 + 24 + 426.06 = EZ PASS REFUND 25.70 CHRONISTER'S AUCTION SERVICE, PROCEEDS OF PUBLIC SALE 413.50 (PER BILL OF SALE) YAEITB, REFUND 1.51 Real Estate: ALL that cedain mai estate situate in Lower Alien Twp., Cumberland County, PA 124,900.00 known & numbered as 321 Manchester Rd., sold to Virginia Underkoffier 7/30/2004 (per copy of HUD1 attached to REV1500) Subtotal $ 125,899.15 . Grand Total $ 136,857.76 DOMMONWEALTHOF REV'1500 e F,e, ,ueeo LY DEPARTMENTOEREVENUE INHERITANCE TAX RETURN F,'ENUM6E. DEPT. 280601 HARRISBURG, PA17128~D801 RESIDENT DECEDENT -o o o DECEDENTS NAME (~ST, F~RST. ANO MIDDLE INITIAl SOCIAL S~CURi~ NUMSER STRAUSBAUGH. ALICIAA. I 7 1 - 6 2 - 1 3 8 DATE OF D~TH IMM-DO-Year) DATE OF BIRTH (MM*OO-Yesr) THIS RETURN MUST 8E FILED ~N DUPLICATE W~H THE REGISTER OF WILLS 12/24/2003 11/14/1972 (IF APPU~BLE) SURVIVING SPOUSE'S NAM~ {~ST. FIRST. AND MIDOLE INITIAL) SOCIAL SECU~ NUMBER ~ mca [] 1. Odginal Return [] 2. Supplemental Re~urn [] 3. Remainder Re~um (,a,.o, dea~ puerto 1z-13-aa) ~:E:~ [] 4. LimitedEstata [] 4a. FuturelnteteetCornpmmise(daleot~ea~ar~r,2-12-82) [] 5. FederalEstateTaxReturnRequired ~:3: a: o, [] 6. Decedent Died Testate (At,ch c~p~'~lWl,) [] 7. Decedent Maintained a Living Trust (A~,ach :op~ o~Tn~s~) 0__ 8. Total Number of Safe Deposit Boxes '< [] 9. Litigation Proceeds Received [] 10. Spousal Pove~ Credit (da~ oldeath ~e~, 12-31-~ and M-9S) [] 11. Election to tax under Sec. 9113(A) (Atach Sc~ O) ~. THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DtRECTED TO: z NAME COMPLETE MAILING ADDRESS z JOHN W. STi~*~ ESQUIRE 1434 W. MARKET ST. O ~ FIRM NAME (l~App~icable) ~ STITT & STIFF O TELEPHONE NUMBER 717/846-9400 YORK PA 17404 1. Resl Estate (Schedule A) (1) 124~900.00 OFFICIAL USE ONLY 2. Stoc~ and Bonds (Schedule B) (2) 357.50 3. Closely Held Corporation, Pad~ership or Sole-Propdetornhip (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Prnpe~ {5) 11,600.26 (Schedule E) 6. Jointly Owned Pmpe~ (Schedule F) (8) ] Separate Billing Requested 7, Intar-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (8) 136,857.76 9. Funeral Expenses & Adrninis[rative Costa (Schedule H) (9) 11 r075.89 10. Debts o[ Decedent, Modgage Liabilities, & Liens (Scheduta I) (10) 136~208.10 11. Total Beduct)ons (total Lines 9 & 10) (11) 147~283.99 12. N et Value et' Estate (Line 8 minus Line 11) (12) -10,426,23 13. Chadtable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) 0.00 made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) -I 0~426.23 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X __ (15) 16. ArnountofLine14taxableatlinealrate -10,426.33 X .045 (16) 0.00 17. Amount of Line 14 taxable at sibling rate X .12 (17) 18. Amounl of Lthe 14 taxable at coltateral rata X .15 (18) 19. Tax Due (19) 0.00 · · BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SI.DF_rAND RECHE~,K MATH< < F .Decedent's Complete Address: STREET ADDRESS 321 MANCHESTER RD. LOWER ALLEN TWP., CUMBERLAND COUNTY CITY I STATE CAMP HILL PA 17011 Tax Payments and Credits: 1. Tax Due(Page 1 Line 19) (1) 0.o0 2. Credits/Payments A. Spousal PoveCty Credit B. Pdor Payments C. Discount Total Credits ( A + B + C ) (2) 3. Interest/Pecalty if applicable B, Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Uno 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYI~ENT. Check box on Page 1 Line 20 to request a refund (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5Al B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ........................................................................... [] [] b. re~ain the dght to designate who shall use the properly transferred or its income; ........................................ [] [] c, retain a reversionary interest; or ...................................................................................................... [] [] d, receive the promise for tile of either payments, benefits or care? ............................................................. [] [] 2. If death occurred after December 12, 1982, did decedent transfer properly within one year of death without receiving adequate consideration?. .............................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? ................. [] [] 4. Did decedent own an Individual Retiremen~ Account, ecnuity, 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 penalfCls of pedury, i declare that I have examined this re[urn, inaludthg accompanying schedules and statements, and lo the best of my knowledge and bedef it is true, co mc and comp e e Oecla~alJon of preparer other tha3 the pe senn representative is based on all informabon of which preparer has any. l~owledge, SIGNATURE OF PERSON RESPONSIB~E~,~R F-C~fq~ RETURN ~ ,, / ADBRESS 134~'W PHILADELPHIA ST ~ ¢' J '"---'"~='~ YORK PA 17404 SIGNATURE~A_R~R OTi~ F_.iR.~TH,~B ¢~.,P R ~ S,ENTAT~VE . TE ,oo,, ss 1b,w MARK.¥ ST For dates of death on or after July i, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the sur,'iving spouse is 3% [72 P.S. §9116 (al (1.1) (i)]. For dates of death on or after January i, 1995, the tax rate imposed on the net value of transfers to er for the use of the surviving spouse is 0% [72 P.S. §9116 (al (1.1) (ii)]. The statute does not exemet a transfer tea surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death co 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. §91 i6(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. §9118(1.2) [72 P.S. §9116(a)(1)]. The tax rate imcosed on the net value of transfers to or fei the use of the decedenrs siblings ia 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. R~Vo1502 EX SCHEDULE A C~MMONW~ALTH OF PENNSYLVANIA REAL ESTATE iNHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER STRAUSBAUGH. ALICIA A. 21 Q4 00125 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 pdce al which properb/would he exchanged be~een a willing buyer and a willing seller, neither being compelled to buy or sell, beth having reasonable knowledge of the relevant facts. Reel propert~ which is jointly-owned with d~ht of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ALL that certain real estate situate in Lower Allen Twp., Cumberland Coun{y, PA 124,900.00 known & numbered as 321 Manchester Rd., sold to Virginia Underkoffler 7/30/2004 (per copy of HUD1 attached to REV1500) TOTAL (Also enter on line 1, RecapilulatJon) $ 124,900.00 (If more space is needed, inse~t addifiona[ sheets of the same size) REv-Ie03, EX + (6-98) SCHEDULE B CO~MMONWSALTN OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER STRAUSBAUGH, ALI¢IA A. 51 04 All property jointly-owned with right of survivorship must be disclosed on Schedule F, ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH I. 125 sh DURBAN ROODEPOORT DEEP LTD @ 2.86 357.50 :~ER LETTER ATTACHED TO REV1500) TOTAL (Also enter on Fine 2, Recapitulation) $ 357.50 (If mom space is needed, inseri additional sheets of the same size) REV-1508 EX + (6-98) ~ SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER STRAUSBAUGH, ALICIA A. ~1 Q4 QQ123 Include the proceeds of litigatioa and the date the proceeds were received by the estate. All proper~y jointly-owned with right of sundvorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. COMMERCE BANK CK ACCT #513198564 704.35 PER LETTER) 2 ;OMMERCE BANK STATEMENT SAV ACCT ¢0626131411 1,292.01 PER LETTER) - CLOSING BALANCE 3 ;FANE INC FINAL SALARY 8,604.75 4 ~TATE FARM INSURANCE, REFUND UNEARNED PREMIUMS 558.44 08.38 + 24 + 426.06 = 5 BZ PASS REFUND 25.70 6 3HRONISTER'S AUCTION SERVICE, PROCEEDS OF PUBLIC SALE 413.50 =ER BILL OF SALE) 7 'AEITB, REFUND 1.51 TOTAL (Also enter on line 5, Recapitulation) $ 11,600.26 (If more space is needed, insert additional sheets of Be same size) REV-1511 EX+ (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER STRAUSBAUGH, ALICIA A. 21 04 00125 Debts of decedent must be reported on Schedule [. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HEFFNER FUNERAL HOME 4,902.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Sodel Security Number(s)/EiN Number ef Personal Representative(s) S~reet Address City State __ Zip Year(s) Commission Paid: 2. Attorney Fees STITTAND STiTT (AGREED UPON) 5,000.00 3. Family Exemption: (If deceden['s address is not the same as claima~t['s, a~ch explaaation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees REGISTER OF WILLS, CUMBERLAND COUNTY - $262.00 272.00 REGISTER OF WILLS, YORK COUNTY - $10.00 5. Acceuntanffs Fees 6. TaxRetum Preparer's Fees TICE ASSOCIATES 300.00 7. CUMBERLAND COUNTY LAW JOURNAL, ADVERTISE ESTATE 75.00 8 THE SENTINEL-LEGAL, ADVERTISE ESTATE 149.99 9 REGISTER OF WILLS, FILING FEES 23.00 10 JANICE E. STITT, NOTARY FEES 14.00 11 CLERK OF ORPHANS' COURT, CUMBERLAND COUNTY 300.00 12 TURBO TAX ON LINE, PAID BY CHRIS STRAUSBAUGH (FINAL 2003 TAX RETURNS) 39.90 TOTAL (Also enter on line 9, Recapitulation) $ 11,075.89 (If mom space is needed, insert additional sheets of the same size) REV-151'2'EX + (6-98) SCHEDULE I DEBTS OF COMMONWEALTH OF PENNSYLVANIA U~-UI' IJ=l~], INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE OF ILE NUMBER STRAUSBAUGHI ALICIA A. 21 04 00125 Include unreimbursed medical expenses. ITEM VALUE AT CATE NUMBER CESCRIPTiON OF DEATH 1. CHRONiSTER'S AUCTION SERVICE, COMMISSION & COSTS 178.00 (PER DiLL OF SALE) 2 PA AMERICAN WATER, WATER 44.64 31.42 PAID + 13.22 UNPAID 3 P P & L, ELECTRIC 239.27 102.19 PAiD + 137.08 UNPAID 4 LOWER ALLEN TWP, SEWER 265.20 161.38 + PAST DUE FROM HUD1 - 80.69 + FROM HUD1 - 7.57 + 15.56 5 UGI, GAS 322.23 114.53 + 110.91 + (96.79 PAID BY CHRIS STRAUSBAUGH) 6 ALLCOAST CO., FURNITURE REMOVAL 100.00 7 WASHINGTON MUTUAL, PAYOFF MORTGAGE 116,040.40 FROM HUD1 8 iON, HOME WARRANTY 409.00 FROM HUD1 9 [EALTOR'S COMMISSIONS 7,494.00 =ROM HUD1 10 'URITY ABSTRACT 15,50 :ROM HUD1 11 ,ONNIE K. MILLER, TAX COLLECTOR 953.52 FROM HUD1 12 :ECORDER OF DEEDS, 1% TRANSFER TAX 1,249.00 FROM HUD1 13 -'RA-NRT, INC 100.00 FROM HUD1 14 ;LOSING COSTS SHORTFALL 433.84 FROM HUD1) 15 IDB KiNG HEATING & AIR CONDITIONING, REPAIR GAS STOVE 105.00 TOTAL (Also enter on line 10, Recapitulation) $ 136~208.1¢~ (If m~m space is needed, insert additional sheets of ~he same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent STRAU. SBAUGH, ALICIAA. 21 04 00125 Decedent's Name Page I File Number Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER DESCRIPTION AMOUNT 16 AT & T WIRELESS, FINAL CELL PHONE (UNPAID) 157.80 17 VERIZON, FINAL PHONE (UNPAID) 194.86 109.43 + 85.43 18 HERSHEY MEDICAL CENTER 178.00 19 VALUE CITY, BALANCE DUE ON CREDIT CARD FOR FURNITURE 602.57 ',UNPAID) 20 VIBNA, BALANCE DUE ON CREDIT CARD 5,477.87 JNPAID) 21 :HASE, BALANCE DUE ON CREDIT CARD 1,302.72 (UNPAID) 22 BANK ONE, BALANCE DUE ON CREDIT CARD 346.68 (UNPAID) SUBTOTAL SCHEDULE I 8,258.50 GRAND TOTAL SCHEDULE I ~ 136,208.10 ' ' '. ' SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER STRAU$ 3AUGH. ALIC1A A, 51 04 001:~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1'. TAXABLE DISTRIBUTIONS ~nclude out~ght spousal distributions, and transfers under Sec. 91'~6 (a) (1.2)] 1. CHRISTINE A. STRAUSBAUGH MOTHER 1/2 OF RESIDUE 1349 W PHILADELPHIA ST YORK PA 17404 (211-38-0808) 2 GREGORY C. STRAUSSAUGH FATHER 1/2 OF RESIDUE 465 SWAREY RD. MIFFLINSURG, PA 17844 (170-44-5978) ENTER DOLLAR AMOUNTS FOR DISTRISUTIONS SHOWN ABOVE ON UNES 15 THROUGH 18, AS APPROPRIATE, N REV-1500 COVER SHEET ~. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1, NONE 0.OO B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. NONE 0.00 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ O.O0 (If mom space is needed, insert additional sheets of the same size) Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of STRAUSBAUGH, ALIClA A. No. 2, J - C)~ - I ~-~ also known as STRAUSBAUGH~ ALICIA ANN late of Lower Allen Township~ Cumberland County~ Pennsylvania , Deceased Social S6%urity No. 171621381 CHRISTINE A. STRAUSBAUGH~ ADMINISTRATRIX Petitioner(s), who is/are 18 years of age or older, apply(les) for: (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut ~ named in the Last Wi!l of the ~'~ Decedent, dated and codicil(s) dated State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: [-~ B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship ' 'Residence CHRISTINE A. STRAUSBAUGH MOTHER 1349 W. PHILADELPHIA ST. YORK~ PA 17404 GREGORY C. STRAUSBAUGH FATHER 465 SWAREY RD:- MIFFLINBURG~ PA 17844 (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his/her last family or principal residence at 321 MANCHESTER RD.~ CAMP HILL, PA 17011 (LOWER ALLEN TOWNSHIP, CUMBERLAND COUNTY~ PA) (list street, number and municipality) Decedent, then 31 years of age, died DECEMBER 24 , 2003 , at M. S. HERSHEY MEDICAL CENTER~ DAUPHIN CO.~ PA (Location) Decedent at death owned preperty with estimated values as follows: (if domiciled in PA) All personal property ......................................... $ 20~000.00 (if not domiciled in PA) Personal property in Pennsylvania .................... $ (If not domiciled in PA) Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ 120~000.00 Total ..................................................................................................................... $ 140~000.00 Real Estate situated as follows: 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: J Signature Typed or printed name and residence I I ( ~ ¥~"J'~"~ (4 .~t~,.,IL~. CHRISTINE A. STRAUSBAUGH 1349 W. PHILADELPHIA ST, YORK~ PA 17404 RW-7 Oath of Personal Representative Commonwealth of Pennsylvania County of YORK The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the es_t,a~aw['~~ Sworn to and affirmed and subscribed ~ ~ CHRISTINE A. STRAUS~A~G~'-J before me this 2ND day of FEBRUARY. 2004 DECREE OF REGISTER Estate of STRAUSBAUGH, ALICIA A. Deceased No. also known as STRAUSBAUGH. ALICIA ANN Social Security No: 171621:~1 Date of Death: 12/24/2003 AND NOW, FEBRUARY C~ , 2004 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters I~ Testamentary [~ of Administration (c.t.a., d.b.n.c.t.; pendente lite; durante absentia; durante minoritate) are hereby granted to CHRISTINE A. STRAUSBAUGH in the above estate and that the instrument(s), if any, dated described in the Petition be admitted to probate and filed of record as the last Will of Decedent. Letters .................................... $ 235.00 \- Register °f Wills O ' 0 Short Certificate(s) ..... ~ ...... $ 12.00 Renunciation .......................... $ 5.oo Affidavit( ) ....................... $ ~ Extra Pages ( ) ..............$ Attorney Codicil ................................. $ JCP Fee ................................. $ 10.00 t: STITT, JOHN VY. ESQUIRE Inventory & Tax Forms ............. $ I.D. No: 24826 Other ...................................... $ Address: 1434 w. MARKET ST. YORK PA 17404 TOTAL ............................. $ 262.00 Telephone: 717/846-9400 DATE FILED: RW-7A 105.112 REV. 8/88 WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR !F~E FORTH~S TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. CERTIFICATE $2.00! COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH VITAL RECORDS LOCAL REGISTRAR'S CERTIFICATION OF DEATH Name of Decedent A1 icia Ann St rausbaugh First Middl~ Last Sex. Female Sociat Security No. 171-62-1381 Date of Death December 24, 2003 Date of Birth Nov. 14, 1972 Birthplace State College, ?A M. S. Hershey Place of Death Medical Center Dauphin Derry Twp. Pennsylvania Facility Name County City, Borough or Township Race White Occupation Recruiter Armed Forces? (Yes or No) No Decedent's Marital Status Never Mailing Address 321 Manchester Road, Camp Hill, PA 17011 Ma r r i e d Number Street City or Town Sta~e Informant Christine A. Strausbaugh Funeral Director Todd E. Eckert Name and Address of Funeral Establishment Heffner Funeral Chapel & Crematory, Inc., 1551 Kenneth Road, York, PA 17404 Interval Between Part I: Immediate Cause Onset and Death (a) Asthma Attack (b) Brain CT Consistent with Anoxic Injury (Severe) (c) (d) Part I1: Other Significant Conditions Manner of Death Describe how injury occurred: Natural x~ Homicide [] Accident [] Pending Investigation [] Suicide [] Could not be Determined [] Name and Title of Certfier Foong-Yen Lim, M. D. (M.D., D.O., Coroner, M.E.) Address M. S. Hershey Medical Center Hershey, PA 17033 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 wilt be forwarded to the State Vital Records Office for permanent filinq~ ·,'~, ~:~ ~. December 26, 2003 ' - ~ ' , stowS; PA 17313 Date Received by Local Registrar Street Address City, Borough, Township DAUPHIN COUNTY RENUNCIATION Estate of STRAUSBAUGH, ALICIA A. No. also known as LATE OF ~ COUNTY~ PENNSYLVANIA Deceased The undersigned,GREGORY C. STRAUSBAUGH~ FATHER of (Relationship) (Capacity) the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters .OF ADMINISTRATION be issued to CHRISTINE A. STRAUSBAUGH, MOTHER Witness MY . hand this / day of JANUA,,RY ,2004 . ~ / /2 (Signatur~,/ ' GRE(~ORY'C. STRAUSBAUGH 465 SWAREY ROAD~ MIFFLINBURG PA 17844 (Address) (Signature) (Address) (Signature) (Address) Sworn to or affirmed and subscribed before me this day of My Commissior~pires: (Signature and seal of Notary or other NOTE: Renunciations executed outside the Office of Register of Wills are official qualified to administer oaths. Show required in some counties to be notarized. date of expiration of Notary's commission.) RW-3 CUMBERLAND COUNTY CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: STRAUSBAUGH. ALICIA A. Date of Death: 12/2~/2003 Will No. ~ / - L~ ZT/- /'"~ ~ Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Name Address CHRISTINE A. STRAUSBAUGH 1349 W. PHILADELPHIA ST. YORK PA 17404 GREGORY C. STRAUSBAUGH 465 SWAREY RD. MIFFLINBURG PA 17{~44 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE Name: STITT. JOHN W. ESQUII~I= Address: 1434 w. MARKET ST, YORK PA 174.04 ~.b.# ~-452~, Telephone(71 7 ) 84 6- 94 0 ~ ~[: 0[~i [[ 8j~J ~70. Capacity: Personal Representative X Counsel for Personal Representative STATE OF PENNSYLVANIA IN RE: ESTATE OF IN THE REGISTER OF WILLS COURT: ALICIA STRAUSBAUGH CUMBERLAND COUNTY ESTATE NO. 21-04-0125 STATEMENT OF CLAIM 1. MBNA America hereby presents for filing against the above estate this statement of claim in the amount of $ 5,477.87. 2. The basis for the claim is MBNA account number 4264293146126382 which was opened on 9-28-00. 3. The tax identification number of the claimant is 510331454. 4. The name and address of the claimant is MBNA America, P. O. BOX 15409 Wilmington, DE 19885-5409. 5. This claim IS NOT contingent. 6. This claim IS NOT secured. 7. The last payment made on the account was $ 348.00 on 12-17-03. Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief. Executed this ay o j ,2004 ,:_~ NICOLE PRESE ~IBNA Am-er~ca -'"Claimant State Of Delaware, County of New Castle IN WITNESS WHE~,~F, I have set my hand and notarial seal this ~ ~ day of ~.~ ~/ ,2004 STATE OF DELAWARE ,., . ' My Commission._EExpire~ry 20, 2006 Notary Public My Commission Expires :~(~c..~ )~.)r]~.~, X165-1 CUSTOMER INFORMATION SYSTEM MD 06/23/04 * 4264293146126382 * USA 14:11:51 ALICIA*STRAUSBAUGH CURBAL: 6041.34 CYCLE: 17 N 0000000000000000 CR LIN: 10500.00 STATUS: 5 CHANGED: 03/02/04 ***************************** JANUARY STATEMENT ***************************** POST REFERENCE TRAN DESCRIPTION BC ---AMOUNT--- PURCHASES AND ADJUSTMENTS 0121 0005376 0121 LATE FEE FOR PAYMENT D C 35.00 LL BEAN COUPON DOLLARS: .00 .00 MONTHLY .00 3.14 AVAILABLE .00 ***************************** JANUARY STATEMENT ***************************** PREV BAL - PAY + SALE + CASH + F/C + LATE CH = NEW BAL 5376.87 0.00 0.00 0.00 101.00 35.00 5512.87 PF10=PAGE FORWARD PF15=MARCH STMT PAl=BEGIN AGAIN 1 PFll=TRANSACTION SUMMARY PF18=FEBRUARY STMT PA2=SYSTEM MENU ACY4 4-© 1 MBNAIS 192.168.16.20 C~P24~2 2/3i COMMONWEALTH OF REV'1500 O F,0,^LUSSO.LY PENNSYLVANIA DEPARTMENTOPREVE.UE INHERITANCE TAX RETURN F,LENUMBER DEPT, 280601 HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 2 1 -0 4 0 0 1 2 B DECEDENT'S NAME (~,ST, FIRST, AND MIDDLE INITIAL SOCIAL SECURITY NUMSER t"' Z STRAUSBAUGH, ALICIAA. 1 7 1 - 6 2 - 1 3 8 1 LU ~ DATE OF DEATH (MM-DD-Yea~) DATE OP BIRTH (MM-DD~Year) THiS RETURN MUST BE FILED IN DOPLICATE WITH THE LU REGISTER OF WILLS O 12/24/2003 11/14/1972 ILl {IF APPUCABLEI SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE iNITIAL) SOCIAL SECURITY NUMSER ~ ~ ~ J []~ 6. Deoedent DlaO Testate I.~h copy ofW~,)r~ 7. Decedent Maintained a Living Tn:st {A*Uch copy et Trus~ 0__ 8. Total Number of Safe Depesit Boxes 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (d~ o~de~ bede. 12-31-91 and 1-1-95) [] 11. Election to tax under Sec. 9113(A) (Attach Sch O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS JOHN W. STITT~ ESQUIRE 1434 W. MARKET ST. FIRM NAME (If Applicable) STITT & STITT TELEPHONE NUMBER 717/846-9400 YORK PA 17404 1. Real Estate (Schedula A) (1) 1:~0.00 ! OFFICI~USE ONLY 2. Stocks and Bonds (Schedule B) (2) C~:::~ 357.50 3. Closely Held Corporation, Partoemhip or Sots-Pmpdetomhip (3) ' ~ 4. Mod, gages & Notes Reoe~vable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Properly (5) ,i:1~600,26 -o (Schedule E) ~ : 6. Jointly Owned Properly (Schedule F) (6) - Billing Requested Separate 7. Inter-Vivce Transfers & Miscellaneous Non-Probate Pmper~ (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (8) 136~857,76 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 11~075.89 10. Debts of Decedent, Mo~age Liabilities, & Liens (Schedule I) (10) 136~208.1(~ 11. Total Deductions (total Lines 9 & 10) (11) 147~283.99 12. Net Value of Estate (Line 8 minus Line 11) (12) -10~426.23 13. Charitable and Govemmenlal Bequests/See 9113 Trusts for which an ela~on to tax has not been (13) 0.00 made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) -10r426.23 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X (15) 16, AmountotLine14taxableatlinealrate -10~426.33 X .045 (16) 0.00 17. Amount of Line 14 taxable at sibling rata X .12 (17) 18. Amount of Line 14 taxable at ~ollateral rate X .15 (18) 19. Tax Due O.00 (19) > > BE SURETO~NSWERAEE[QUEST ONSON REVERSES DE AND RECHECK MATH Ddcedent's Complete Address: 321 MANCHESTER RD. LOWER ALLEN TWP., CUMBERLAND COUNTY CITY i STATE iZlp CAMP HI LL PA 17011 Tax Payments and Credits: 1. Tax Due(Page 1 Line 19) (1) 0.00 2. Credits/Payments A, Spousal Poverty Credit B. Pdor Payments C. Discount Total Credits ( A + B + C ) (2) 3. Interest/Penalty if applicable D, Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 0.00 5. If Une 1 + Line 3 is greater than Line 2, ecter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due, (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) o.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ........................................................................... [] [] b. retain the dght to designate who shall use the property transferred or its income; ........................................ [] [] c. retain a reversionary interest; or ...................................................................................................... [] [] d, receive he prom se for fe of e her paymen s, benefits or care? .............................................................[] [] 2. If death occurred after December 12, 1982, did decedent transfer properly within one year of death wi hout rece v ng adeqca e cons dera on? ............................................................................................... [] [] 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 conta ns a benefic ary des gna on? ...................................................................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE (2 AND FILE IT AS PART OF THE RETURN. Under pen aJ~Jes of per~uty, I decla'e that I have exa-nthed t~is return, including accompanying schedules and statements, and te the best of my knowledge and belief, it is tr~e, correct and complete. [~lara~ of pre ,p~rer other than the persona~ representai~ve is based on all mformat~on of which preparer has any knowledge. SlGNATU~'E'~F pERSON RESPONSlBL"E~OR-Pfb[NG RETURN /~ ...-0 ~ATE ! ADDRESS 1349 W pHi L~DELPHiT& ,~-T YORK PA 17404 CRESS /44,4WMARKE*ST \~/ YORK PA 17404 For dates of death on or after July 1, 1994 and before J an uary 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% F2 P.S, §9116 (a) (1.1)(i)], For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 {a) {1.1 ) (ii)], The statute does not exemet a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedect'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. RE¥-1502 EX; (6-e8) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER STRAUSBAUGH. ALICIA A. 21 04 0012~ All real property owned solely or as a tenant in common must be reported at fair market value. Fair roarket value is defined as the prfce at which property would be exchanged be~'een a willing buyer and a willing seller, neither being coropelled to buy ur sell, both having reasonable knowfadge of the relevant facts. Real proper~7 which is iothtl¥-owned with right of sundvorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, ALL that certain real estate situate in Lower Allen Twp., Cumberland County, PA 124,900.00 known & numbered as 321 Manchester Rd., sold to Virginia Underkoffier 7/30/2004 (per copy of HUD1 attached to REV1500) TOTAL (Also enter on line 1, Recapitulation) $ 124,900.0n mom space is needed, insert additional sheets of the saroe size) REV-1503 EX -~ (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER STRAUSBAUGH. AL1CIA A. 21 04 00125 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 125 sh DURBAN ROODEPOORT DEEP LTD @ 2.86 357.50 PER LETTER ATTACHED TO REV1500) TOTAL (Also enter on line 2, Recapitulation) $ 357.5~ (If more space is needed, insert additional sheets of the same size) REV-lS08 EX ~- (6-98) ~ SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER STRAUSBAUGH. ALICIA A. 21 04 QQ125 Include the proceeds of liUgation and the date the proceeds were received by the estate. All property jointly-owned with right of sun~ivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, COMMERCE BANK CK ACCT #513198564 704.35 PER LETTER) 2 ;OMMERCE BANK STATEMENT SAV ACCT #0626131411 1,292.01 PER LETTER) - CLOSING BALANCE 3 ;EANE iNC FINAL SALARY 8,604.75 4 STATE FARM INSURANCE, REFUND UNEARNED PREMIUMS 558.44 108.38 + 24 + 426.06 = 5 EZ PASS REFUND 25.70 6 CHRONISTER'S AUCTION SERVICE, PROCEEDS OF PUBLIC SALE 413.50 PER BILL OF SALE) 7 (AEITB, REFUND 1.51 TOTAL (Aisc enter on line 5, RecapituratJon) I $ 1 1 (If more space is neede¢ insert additional sheets of the same size) REV-1511 ~X~- (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER STRAUSBAUGH. ALICIA A, 21 04 00125 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A, FUNERAL EXPENSES: 1. HEFFNER FUNERAL HOME 4,902.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Pemonal Representative (s) Social Securi[y Number(s)/EIN Number of Personal Representative{s) Street Address City State Zip Year(s) Commission Paid: 2. AttomeyFees STITTAND STITT (AGREED UPON) 5,000.00 3. Family Exemption: (If decedent's address is not the same as c~aimant's, a~ch explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees REGISTER OF WILLS, CUMBERLAND COUNTY - $262.00 272.00 REG[STER OF WILLS, YORK COUNTY - $10.00 5, Acceuntanfs Fees 6. Tax Return Preparefs Fees TICE ASSOCIATES 300.00 7. CUMBERLAND COUNTY LAW JOURNAL, ADVERTISE ESTATE 75.00 8 THE SENTINEL-LEGAL, ADVERTISE ESTATE 149.99 9 REGISTER OF WILLS, FILING FEES 23.00 10 JANICE E. STITT, NOTARY FEES 14.00 11 CLERK OF ORPHANS' COURT, CUMBERLAND COUNTY 300.00 12 TURBO TAX ON LINE, PAID BY CHRIS STRAUSBAUGH (FINAL 2003 TAX RETURNS) 39.90 TOTAL (Also enter on line 9, Recapitulation) $ 11]075.80 (If mom space is needed, insa~t additional sheets of the same size) REV-1512 EX + (6-98) SCHEDULE I DEBTS OF COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER STRAUSBAUGH. ALIClA A. 21 04 00125 Include unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 3HRONISTER'S AUCTION SERVICE, COMMISSION & COSTS 178.00 ',PER BILL OF SALE) 2 PA AMERICAN WATER, WATER 44.64 31.42 PAID + 13.22 UNPAID 3 P P & L, ELECTRIC 239.27 102.19 PAID + 137.08 UNPAID 4 LOWER ALLEN TVVP, SEWER 265.20 161.38 + PAST DUE FROM HUD1 - 80.69 + FROM HUD1 - 7.57 + 15.56 5 UGI, GAS 322.23 114.53 + 110.91 + (96.79 PAID BY CHRIS STRAUSBAUGH) 6 ALLCOAST CO., FURNITURE REMOVAL 100.00 7 WASHINGTON MUTUAL, PAYOFF MORTGAGE 116,040.40 FROM HUD1) 8 ~ON, HOME WARRANTY 409.00 :ROM HUD1) 9 ~EALTOR'S COMMISSIONS 7,494.00 :ROM HUD1) 10 'URITY ABSTRACT 15.50 (FROM HUD1) 11 BONNIE K. MILLER, TAX COLLECTOR 953.52 FROM HUD1) 12 ~ECORDER OF DEEDS, 1% TRANSFER TAX 1,249.00 FROM HUD1) 13 ;RA-NRT, INC 100.00 FROM HUD1) 14 ;LOSING COSTS SHORTFALL 433.84 FROM HUD1) 15 ~OB KING HEATING & AIR CONDITIONING, REPAIR GAS STOVE 105.00 TOTAL (Als0 enter on line 10, Recapitulation) $ 136~208.10 (If mbm space is needed inse~t additional sheets of t~e same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent STRAUSBAUGH, ALICIAA. 21 04 00125 Oecedent's Name Page 1 File Number Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER DESCRIPTION AMOUNT 16 AT & T WIRELESS, FINAL CELL PHONE (UNPAID) 157.80 17 VERIZON, FINAL PHONE (UNPAID) 194.86 109.43 + 85.43 18 HERSHEY MEDICAL CENTER 176.00 19 VALUE CITY, BALANCE DUE ON CREDIT CARD FOR FURNITURE 602.57 [UNPAID) 20 ~BNA, BALANCE DUE ON CREDIT CARD 5,477.87 iUNPAID) 21 2HASE, BALANCE DUE ON CREDIT CARD 1,302.72 (UNPAID) 22 BANK ONE, BALANCE DUE ON CREDIT CARD 346.68 (UNPAID) SUBTOTAL SCHEDULE I 8,258.5n GRAND TOTAL SCHEDULE I $ 136,208.1 0 SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES ESTATE OF FILE NUMBER STRAUS 3AUGH. ALICIA A. 21 04 00125 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Bo Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal dist~butions, and transfers under Sec. 9116 (a) (1.2)] 1. CHRISTINE A. STRAUSBAUGH MOTHER 1/2 OF RESIDUE YORK PA 17404 (211-38-0808) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET ]~. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. NONE 0.00 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. NONE 0.OO TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 Of REV-1500 COVER SHEET $ 0.0~3 (If more space is needed, insed additional sheets of the same size) CUMBERLAND COUNTY INVENTORY Estate of STRAUSBAUGH, ALICIA A. No. 21 04 00125 also known as Date of Death 1212412003 LATE OF LOWER ALLEN TWP.~ CUMBERLAND COUNTY, PA ; Deceased Social Security No. 171621381 CHRISTINE A. STRAUSBAUGH~ ADMINISTRATRiX Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory, lANe verify that the statements made in this inventory are true and correct, lANe understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. AttorCey: JOHr~W. STITT, ESQUIRE ~ I.D. 'b}O~. 26 CHRISTI E A. ST.I~USBAUGH, ADMINISTI::~FRIX Address: 1434 W. MARKET ST. .Date~/] ~ ~' ~ ~'-~)~-~ YORK PA 174.04 Telephone: 717/846-9400 Description Value Stocks & Bonds: 125 sh DURBAN ROODEPOORT DEEP LTD @ 2.86 ~:; ~2657.50 (PER LETTER ATTACHED TO REV1500) Cash, Bank Deposits, & Misc. Personal Property:. , COMMERCE BANK CK ACCT ¢513198564 r'~ 704.35 (PER LETTER) COMMERCE BANK STATEMENT SAV ACCT ¢0626131411 1,292.01 (PER LE]-rER) - CLOSING BALANCE KEANE INC FINAL SALARY 8,604.75 Total (Attach Additional Sheets if necessary) 136,857.76 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 Continuation of Inventory STRAUSBAUGH, ALICIA A. 21 04 00125 Pa,qe 1 Description of Inventory Description Value STATE FARM INSURANCE, REFUND UNEARNED PREMIUMS 558.44 108.38 + 24 + 426.06 = EZ PASS REFUND 25.70 CHRONISTER'S AUCTION SERVICE, PROCEEDS OF PUBLIC SALE 413.50 (PER BILL OF SALE) YAEITB, REFUND 1.51 Real Estate: ALL that certain real estate situate in Lower Alien Twp., Cumberland County, PA 124,900.00 known & numbered as 321 Manchester Rd., sold to Virginia Underkoffier 7/30/2004 (per copy of HUD1 attached to REV1500) Subtotal $ 125,899.1 ~ Grand Total $ 136,857.76 COHHONWEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE BUREAU OF ZNDZVZDUAL TAXES /NHERZTAHCE TAX DZVZSION NOTZCE OF ZNHERZTANCE TAX PO BOX ZSO6D1 APPRA/SEMENT) ALLONANCE OR DZSALLO#ANCE HARR/SBURG, PA 17118-0601 OF DEDUCTZONS AND ASSESSNENT OF TAX ,EV-~S47 EX AFP (09-04~ : DATE 11-29-200q ESTATE OF STRAUSBAUGH ALICIA A DATE OF DEATH 1Z-Zq-ZO03 FZLE NUHBER 21 0~-0125 ~;:~I~ -~ i.; ;'~i~!i COUNTY CUHBERLAND JOHN W STITT ESQ ACN 101 STITT & STITT Amount Remitted I lq3q W HARKET ST YORK PA HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE) PA 17013 CUT ALONG THZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS REV-1547 EX AFP [01-03} NOTZCE OF ZNHERITANCE TAX APPRAZSEHENT~ ALLOWANCE OR D/SALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF STRAUSBAUGH ALICIA A FZLE NO. 21 0q-0125 ACN 101 DATE 11-29-200q TAX RETURN ~AS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 12qz900.O0 NOTE: To Ansure proper 2. Stocks and Bonds (Schedule B) (2) 357.50 cred/t to your account, $. Closely Held Stock/Partnership ~nterost (Schedule C) ($) .00 subait the upper port/on ~. Mortgages/Notes Receivable (Schedule D) {q) .00 of ~his fora with your 5. Cash/Bank Deposits~Misc. Personal Property {Schedule E} (5) 11~600.26 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. To,al Ass®ts (8) 136,857.76 APPROVED DEDUCTXONS AND EXEMPTZONS: 11,075.89 9. Funeral Expenses/Ada. Costs/Nisc. Expenses (Schedule H) (9) 10. Dobts/Nortgaga Liabilities/Lions (Schodulo 1) (10) 11. Total Deductions (11) ]~7. 12. Not Value of Tax Return (12) 10,~26.23- 15. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13) .00 lq. Nat Value of Estate Subject to Tax {lq) lO,qZ6.Z3- NOTE: Z~ an assesseent ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 w111 reflect figures that lnclude the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of L/no lq at Spousal rate (15). .00 X O0 = .00 16. Amount of L/ne lq taxable at Lineal~Class A rate (16) .00 X Oq5 = .00 17. Amount of L/ne 1~ et Sibling rate (17) .00 X 1~ = .00 18. Amount of L/ne lq taxable at Collateral/Class B rate (18). .00 X 15 : .00 19. Principal Tax Duo (19)= .00 TAX CREDZTS: PAYMENT RECEZPT D/$COUNT (+J AHOUNT PAZD DATE NUNBER INTEREST/PEN PAID (-) TOTAL TAX CREDZT I .00 BALANCE OF TAX DUEl .00 ]:NTEREST AND PEN. .00 TOTAL DUE .00 ]:F PATD AFTER DATE TNDTCATED, SEE REVERSE ( IF TOTAL DUE TS LESS THAN $1, NO PAYMENT TS REIIUTRED. ,~.j~ FOR CALCULAT'rON OF ADDTT'rONAL TNTEREST. TF TOTAL DUE 1'S REFLECTED AS A 'CREDTT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THI'S FORM FOR TNSTRUCTTONS.) RESERVATION: Estates of decedents dying on or before December IZ, i98Z -- if any futura interest in the estate is transferred in possession or enjoyment to Ctass B (coIIataral) 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 Iawful Class D (coIlateral) rote on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section glqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (72 P.S. Section 9lqO). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: RBgXSTER OF #XLLS, AGENT REFUND (CR): 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-1313). Applications are available online at www.ravanue.stata.oa.us~ any Register of Hills or Revenue District Officej or from the Department's Z4-hour answering service for fores orders: 1-800-362-Z050~ services for taxpayers with special hearing and/or speaking needs: 1-800-447-30Z0 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisment, allowance or disallowance of deductions or assessment of tax [including discount or interest) as shown on this Notice may object within 60 days of the date of receipt of this notice by filing one of the following: A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at wwa.boardofappaals.state.pa.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to ba validj you must receive a confirmation number and processed date from the Board of Appeals websita. You may also send a written protest to PA Department of Revanue~ Board of Appeals P.O. Box 2DIOZ1, Harrisburg, PA I71ZD-lOgl. Patltions may not be foxed. D)Election to have the matter determined at the audit of the account of the personal representative. ADMIN- C) Appeal to tho Orphans' Court. ISTRATIVE CORRECTIONS: 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, P.O. Box ZD0601~ Harrisburg, PA 171Z8-0601 Phone (717) 787-650S. Sam page ~ 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 (3) calendar months after the dacedant's death, a five percent (SZ) discount of tho tax paid is allowed. PENALTY: The 1SI 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: Interest is charged beginning with first day of delinquency, or nine (9) months and one (I) day from the date of death, to the date of payment. Taxes which became delinquent before January I, 198Z bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2004 ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ ZOX .000548 ~'8-1991 IIZ .OOO30l ~ 9X ,000Z47 1983 Z6Z .000438 1992 9Z .00024? ZOOZ 62 .000164 1984 llZ .OOO301 1995-1994 7Z .O0019Z ZOO3 5Z .000137 1985 132 .000356 1995-1998 92 .000Z47 2004 42 .000110 1986 lOX .000274 1999 7Z .00019Z 1987 IOZ .000274 ZOO0 72 .O0019Z --Interest is calculated as fallows: INTEREST = BALANCE OF TAX UNPAID X NUHBER 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 mede after the interest computation date shown on the Noticej additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 REGISTER OF WILLS OF CUMBERLAND COUNTY STATUS REPORT BY PERSONAL REPRESENTATIVE Name of Decedent: ALICIA A. STRAUSBAUGH File Number: 21-04-00125 Social Security Number: 171-62-1381 Date of Death: December 24, 2003 Name of Personal Representative: Christine A. Strausbaugh, Administratrix 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 2. If the answer is NO, state when the personal representative reasonably believes that the administration will be complete: n/a 3. If the answer to NO.1 is YES, state the following: Court? a. Did the personal representative file a final account with the yes confirmed 1/11/2005 b. The separate Orphans' Court No. representative's account is: n/a (if any) for the personal c. Did the personal representative state an account informally to the parties in interest? no d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. I certify under penalty of perjury that the following information is correct to the best of my knowledge, information and belief. February 25, 2005 \.,J',',:') IucW &tL J W. Stitt, Esquire 14 ~ W. Market St. ork, PA 17404 717 846-9400 Attorney for the estate I