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Home My WebLink About03-0856Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Charles L. Jackson also known as Leon Jackson , Deceased Susan Lee Stoner and Brenda Ann Robinson Social Security No. 201-18-1990 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 Testamentary and aver that Petitioner(s) is/are the execut rices named in the last Will of the Decedent, dated 11/11/1992 and codicil(s) dated None State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: None B. Grant of Letters of Administration (c.t.a.; d.b.n.c.ta; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN 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 53 South 35th Street, Decedent, then 77 years of age, died 09/24/2003 Hampden Township, Camp Hill, PA 17011 (liststreet, number, and municipality) at Holy Spirit Hospital/E. Pennsboro Tw., (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in Pennsylvania (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania PA 56,426.65 152,066.25 situated asfollows: 53 S. 35th St., Camp Hill; 609 & 611 Market St., New Cumberland 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: Signature Typed or printed name and residence . /~ · I Susan Lee Stoner ~ ~, 11002 Allen Street, New Cumberland, PA 17070 ~ . ~Brenda Ann Robinson ll2 Valle View Road, New Cumberland, PA Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. 17070 Form RW-1 (1991) Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland Sworn to or affirmed and subscribed before me this day of The Petitioner(s) above-named swear(s) or 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 estate according to law. Susan Lee Stoner Brenda ^nh Robinson For the Register No, Estate of Charles L. Jackson Social Security No: 201-18-1990 AND NOW, Date of Death: 09/24/2003 Deceased , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [~] Testamentary E~ Of Administration (c.t.a.; d.b.n.c.ta.; pendente lite; durante absentia; durante minoritate) are hereby granted to Susan Lee Stoner and Brenda Ann Robinson in the above estate and that the instrument(s) dated 11/11/1992 described in the Petition be admitted to probate and filed of record as the last Will of Decedent, FEES Letters ........... $ Short Certificate(s) ..... $ Renunciation ........ $ Affidavits ( ) .... $ Extra Pages ( ) .... $ Codicil ........... $ JCP Fee .......... $ Inventory .......... $ Other ........... TOTAL ......... $ Prepared by the Pennsylvania Bar Association Register of Wills Attorney: James M. Robinson I.D. No: 84133 Turo Law Offices Address: 28 South Pitt Street Carlisle, PA 17013 Telephone: 717/245- 9688 Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (19-91) his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9508151 No. ~--'~i/ ~ ~./ Local Registrar \~ · ~~rS,,' ..~/ Date 105.143 Rev. 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH ' VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT (First, Middle, Lasl) I SEX I SOCIAL SECURITY NUMBER I DATE OF DEATH (Mo~th, Day, Year) ,. Charles Leo.n Jackso. n . Izmale I,. 201 - 18 - 1990 I,..SeotecnPe~,2t/~'~ AGE(kaslBirdMey)I Il UNDER1YEAR I UN•EMI•AY DATE OF BIRTH[ BIRTHPLACE Cityand PtACEOFDEAT{ICheck~olv~ne.seehstm¢lo,~sono{h~r~i~9} ' ' I March 11, I ...... [] ,.,o.,,, .... [] OD. [] I ....n .... n 77 ¥,s.I I I I I,. 1926 ?Keedysvtlle, PAl,.. I "~" t_~ t~ s,.~, I-1 COUNTY OF DEATH ! CITY, BOM•, TWP OF DEATH FACILITY NAME (If riot institulion give street al~d number) ~WAS DECEDENT OF HISPANIC ORIGIN? RACE - American Indian, Black, White et~ Cumberland Jsli. Pennsboro 15ap. Is.. I't oiq .b?~(l, t- lifO&Q, kc, \ I~, ..... v.e~on~.,otc. [~O. white Yes [] No [] Elemenlaef/Second~y ~. Chief of ?olice 1th. Law Enforcement ~2. ~3. 12w'~2~ 0a~,~*l ~4. Ha?tied ~5. Mary Alines grubic DECEDENTS MAILING ADDRESS (SI?eeL, City/Town, State, Zip Code) I DECEDENT'S ACTUAL 17a. S~ta Pennsylvania D,~ .c. [] Yes, decedentlivedin Hampden tw= 53 S. 35th Street RESIDENCE decedent (See thstructiofts live in a PA 17011 o,o~er,~o) .b. cou.ty Cumberland tow.sh~? .d.l--I ao,~c~entnv~ FATHER'S NAME (First, Middle, Lest) William T. Jackson INFORMAN'PS NAME (Type/Print) MOTHER'S NAME (First, MMdle. Maiden Surname) Edna Viola Lowman INFORMANT'S MAILING ADDRESS {SI?eel, City/Town, StaiN, Zip Code) ~. 53 S. 35th Street~ C~m? Hill~ PA 17011 Po~L(~t~Ee~FiaDcle5POsITtON'Neme°fCemem~/'c'ema~°ry,ILOCATION'City/T°wn'Smte'ZipCpee ~t[olling green Memorial Park ]~ower Allen Tap. ~ P~ 17011 Mary Agnes Jackson METHOD OF DISPOSITION [ 0ATE OF DISPOSITION Do•abe• [] Budal l~3 Cremation E]Removal ~'om Stale [] [ ( .......... I 2~e. o~(s~) [] ~.eptember 29, 2003 SIGNATURE OF LICENSE NUMBER NAME ANO ADDRESS OF FAC~LITY Parthemore FH & CS Inc. :~.. ~. YS 0t2 849 L ~,. P.O. Box ~31. Ne~ Cumberland. PA [7O70-O&q! To the best of my knowledge, dealh occurred al tile lime. date and place stated LICENSE NUMBER [DATE SIGNED , at time Gl' death to (Signalure and TilJe) I liMo•th, Day, Yea~) Items 24-26 musl be core,Dieted by TIME OF DEATH DATE PRONOUNCED DEAD (Mo•ih, Day, Year) ~ WAS CASE REFERRED TO A MEDICAL EXAMINER/CORONER? IMMEDIATE CAUSE (Final ~, onset end death disease or c~'~dilion , resu~ng th death)~ a. Entar UNDERLYING CAUSE (Disease or i~jury c. resulting oD death ) LAST d. WAS A~N AUTOPSY ~ WERE AUTOPSY FINDINGS ~ MANNER OF DEATH J DATE OF N JURY ~ TIME OF INJURY I N~JURY AT WORK? I n;~r-mm; .nw ~.~.~v PERFORMED? I AVAIl. ABLE PRIOR TO __ I {l~onth. Day. Year .......................... ~. I COMPLETiON OF CAUSEI N~t,r~ ~ ,~e []1 I I . I I [] Per, ding, ..... '.al.n[]1 I I ..[] .o01 Y,.sO .o~1 Ye,• NoD Is~e [] Co~,.o, bed .... in~, m'°"lm~--- ~ ~-~___ I I ~ I pLACE OF INJURY - At home. farm. Street, lact~ry ot~ce/.~ ~J~)CATION (Slreet, City/Towri, State) '". '-. I /1.-4/,,. ' - ' CERTIFIER (Check only one) ~ --SIGMA tlRl=, tTIF C.~I~TUrU=I~S GNA R IF N~MI~D~RESS OF PERSON' V~NO COMPLETED (~AUSE *MEDICAL EXAMINER/CORONER (item~7~ Tvoe~ Rne[... =----__mi Type t ,,.. /0 .~..~.._~ ................................................................................................................. [] ~. , -~.-.v/'~ E'rl~4:~'~~/-'~~- ~ I · I DATE FILED (M~~' ~ ~ I ~ I / ~ · ep\wills\jackson.dhs LAST WILL AND TESTAMENT OF CHARLES L. JACKSON I, Charles L. Jackson, of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I devise my one half interest in the premises known as 53 South 35th Street, Camp Hill, Pennsylvania to my wife, MARY AGNES JACKSON, together with all policies of insurance or said real proper- ty, without liability for waste, for her life so long as she desires to use such premises as her home and pay all costs and maintenance thereof, including taxes, assessments, insurance and ordinary repairs, said property to be insured in a reasonable amount insuring the interest of the remaindermen as well as herself. I further grant to my wife, MARY AGNES JACKSON, the option to purchase the remainder interest in the premises at 53 South 35th Street, Camp Hill, Pennsylvania from my estate at any time during her life. The purchase price shall be one half of the fair market value of the premises without regard to the actuarial value of her life estate. The fair market value shall be as agreed upon by my wife and my personal representatives; and, in the absence of an agreement, shall be as determined by an appraisal performed by an M.A.I. The proceeds from the said purchase shall be distributed as part of the residue of my estate. The option shall be exercised in writing to my --1-- personal representatives. Settlement shall occur sixty (60) days after the option has been exercised and shall conform to the custom for similar residential real estate closings. Should my wife, MARY AGNES JACKSON, not exercise her option to purchase my interest in the said real estate, then upon the death of my wife or at such prior time as she no longer uses said premises as a home for herself, I direct my personal representatives to join with my wife's personal representative or with my wife, whichever the case may be, to sell said real estate and distribute the net proceeds as a part of the residue of my estate. ITEM II: I devise and bequeath the residue of my estate of every nature and wherever situate in equal shares to such of my children, SUSAN LEE STONER and BRENDA ANN ROBINSON, as survive me. Should any such child predecease me, I devise and bequeath the share of such child to her issue, per stirpes, living at the time of my death; and should any such child of mine leave no such issue living at the time of my death, I devise and bequeath the share of such child to my issue, per stirpes, living at the time of my death. ITEM III: I appoint my Co-Executrices guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this appointment of a guardian shall not supersede the right of any fiduciary in its discre- tion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use --2-- principal as well as income from time t~ time for the minor's support and education (including college education, both graduate and under- graduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM IV: I appoint my children, SUSAN LEE STONER and BRENDA ANN ROBINSON, Co-Executrices of this my last will. ITEM V: I direct that my Co-Executrices and their successors shall not be required to give bond for the faithful performance of his/her duties in any jurisdiction. IN WITNESS WHEREOF, I, CHARLES L. JACKSON, have hereunto set my hand and seal this //~ day of ~r~~ , 1992. SIGNED, SEALED, PUBLISHED and DECLARED by CHARLES L. JACKSON, the Testator above named, as and for his Last Will and Testament, and in the presence of us, who at his request, in his presence and in the pr~~of each)other, have subscribed our names as witnesses. Addre s s Addre s s -3- COMMONWEALTH OF PENNSYLVANIA: :SS: COUNTY OF CUMBERLAND : I, CHARLES L. JACKSON, the Testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. Sworn to or affirmed to and acknowledged before me by CHARLES L. JACKSON, the Testator, this /~ day of ~~ , 1992. I COMMONWEALTH OF PENNSYLVANIA : ~ :SS: COUNTY OF CUMBERLAND : #OTARIAL SEAL and ~/~.~----~/~- ' · the witnesses whose names are signed to the attached or forego- ing instrument, being duly qualified according to law, depose and say that we were present and saw Testator sign and execute the instrument as his last will; that Testator signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator -4- signed the will as witnesses; that to the best of our knowledge, the Testator was at that time eighteen or more years of age, of sound mind and under no constraint or undue influ/~e~_f~~~, r,~,,. Z/-~ ~ _JWitfi~s~' Witness Sworn to or a f fi rmed to and ackn ow ledged before me by .~×~ ~/~ and ~, ~, ~~ , witnesses, this //%~ day of ~ , 1992. NOTARIAL SEAL I(AYE FENEE LUCKEY, Notary Public New Cumberland, Cumberland County My Commission Expires March 2i. !993 -5- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Charles L. Jackson Date of death: September 24, 2003 Will No. 2003-00856 Admin. No. 21-03-0856 TO THE REGISTER: I certify that notice of beneficial interest 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. Name Mary Agnes Jackson Susan Lee Stoner Brenda Ann Robinson Address 53 South 35th Street, Camp Hill, PA 17011 1002 Allen Street, New Cumberland, PA 17070 112 Valley View Road, New Cumberland, PA 17070 Notice has now been given to all persons entitled thereto under Rule 5.6(a). Respectfully Submitted TURO LAW OFFICES Date J~c~a~ i~s ~et! .ppARi t0t~!~0 i~?Z Esquire (717) 245-9688 Capacity as Counsel for Personal Representatives STATE OF PENNSYLVANIA IN RE: ESTATE OF CHARLES L. JACKSON IN THE REGISTER OF WILLS COURT: CUMBERLAND COUNTY ESTATE NO. 21-03-0856 STATEMENT OF CLAIM 1. MBNA America hereby presents for filing against the above estate this statement of claim in the amount of $ 331.04. 2. The basis for the claim is MBNA account number 5490999018454511 which was opened on 3-1-70. 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 $15.00 on 10-10-03. 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 ~ ~ day of ~'-~~2003 NICOLE FRESE MBNA America Claimant State Of Delaware, County of New Castle IN WITNESS WHEREOF, I have set my hand and notarial seal this ~'~,~ dayof ~(~C~v-!~.A~ ,2003 DAWN M. PEUGH Notary Public · State of Delaware My Commission Exoires 12/12/00 My Commission Expires: Notary P~flic X165-1 CUSTOMER INFORMATION SYSTEM MD 11/08/03 * 5490999018454511 * USA 09:48:20 CHARLES L'JACKSON CURBAL: 331.04 CYCLE: 13 N 0000000000000000 CR LIN: 10200.00 STATUS: 5 CHANGED: 10/06/03 ***************************** OCTOBER STATEMENT ***************************** POST REFERENCE TRAN -DESCRIPTION BC AMOUNT--- PAYMENTS AND CREDITS __ 1010 10100352549065 1009 PAYMENT - THANK YOU 15.00CR ***************************** OCTOBER STATEMENT ***************************** PREV BAL - PAY + SALE + CASH + F/C = NEW BAL 341.01 15.00 0.00 0.00 5.03 331.04 PF10=PAGE FORWARD PFll=TRANSACTION SUMMARY 4-© 1 MBNAIS PF06=SEPTEMBER STMT PF09=AUGUST STMT PAl=BEGIN AGAIN 1 PA2=SYSTEM MENU JCI3 192.168.16.20 0014CI05 2/31 COMIdONWEALTH OF PENNSYLVANIA DEPANTMENT OF REVENUE DEFT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 03 00856 COUNTY CODE YEAR NUMEER z z DECEDENT'S NAME (LAS'r. FIRST, AND MIDDLE iNITIAL) Jackson, Charles L DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 09/24/2003 I 03/11/1926 SOCIAL SECURrP( NUMBER 201-18-1990 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS IF APPLICABLE) SURVIVING SPOUSES NAME ( LAST, FIRST AND MIDDLE INmAL) Jackson, Mary Agnes [] 1. Original Return [] 2. Supplemental Return .13-82) [] 4. Limited Estate [] 4a. Future Interest Compromise (date of death LJ 5. Federal Estate Tax Return Required after 12-12-82) [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach __0 8. Total Number of Safe Deposit Boxes of Will) copy of Trust) [] 9. Litigafion Proceeds Received [] 10. Spousal Poven'y Credit (date of death between [] 11.Election to tax under Sec. 9113(A)(AttachSchO) 12-31-91 and 1-1-95) THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND cONFIDENTIAL TAX INFORMATION sHOULD BE DIRECTED TO: qAME James M Robinson :IRM NAME (If applicable) Turo Law Offices rELEPHONE NUMBER 717/245-9688 COMPLETE MAILING ADDRESS 28 South Pitt Street Carlisle, PA 17013 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 142,153.25 None None None~T 104,601.93 None 19,474.47 13,981.95 33,176.02 OFFICIAL USE ONLY (8) :~:: (11) 266,229.65 47,157.97 219,071.68 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not bean made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 219,071.68 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, O. 0 0 x .00 or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 219,071.68 x .045 (15) (16) 9,858.23 9,858.23 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due 20. [] >> BE SURETO ANSWER ALL QuEsTIONs oN REVERSESIDE~D RECHECK MATH << (19) Copyright 2000 form software only The Lackner Group, Inc. Form REV-I$O0 EX (Rev. 6-00) FAMILY SETTLEMENT AND FINAL RELEASE ESTATE OF CHARLES L. JACKSON KNOW ALL MEN BY THESE PRESENTS, that Charles L. Jackson, late of Hampden Township, Cumberland County, Pennsylvania, deceased, died testate on September 24, 2003, having first made his/her Last Will and Testament, which was duty executed on November 11, 1992 and probated in the Office of the Register of Wills of Cumberland County, on October 20, 2003. WHEREAS, the said Charles L. Jackson, by the aforesaid Last Will and Testament, named Susan Lee Stoner and Brenda Ann Robinson. © Last Will and Testament; WHEREAS, Letters Testamentary on the Estate of the sa ~ deceda~unt wem duly issued by the Register of Wills of Cumberland County, Penn~,i~an a~,to the Said Executrices, hereinafter called personal representatives; (30 WHEREAS, the personal representatives have gathered the assets of the Estate of the said decedent and the assets consist of personal and real property with the total value of $266,229.65 as set forth in Exhibit "A~, which is a copy of the Pennsylvania Inheritance Tax Return filed and approved by said personal representatives, and which is attached hereto and made a part hereof, and marked Exhibit "A"; WHEREAS, the debts and deductions, including the payment of inheritance tax in the said Estate, which have now been paid, leave a balance for distribution of $209,213.45, also as set forth in the statement of said personal representatives, which is attached hereto and marked Exhibit "B'; WHEREAS, the balance for distribution as shown in the said statement marked Exhibit "B" has been reduced to cash and has been distributed as herein indicated in accordance with the terms of the Last Will and Testament of the said Decedent; NOW, THEREFORE, Mary Agnes Jackson, Susan Lee Stoner and Brenda Ann Robinson being all of the heirs under the Last Will and Testament of the said decedent, and being those persons entitled to inherit under said Last Will and Testament, do hereby each of us acknowledge that we have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sums of money, legacies, bequests, and devises as are given, devised and bequeathed to each of us BUREAU OF INDIVIDUAL TAXES JANES N RO8XNSON TURO LAN OFFICES 28 S PXTT ST CARLISLE PA 17015 CONNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 08-02-2004 ESTATE OF JACKSON DATE OF DEATH 09-24-2003 FILE NUMBER 21 05-0856 COUNTY CUN8ERLAND ACM 101 Amount; Remi~ed CHARLES L MAKE CHECK PAYASLE AND REMIT PAYMENT TO.' REGTSTER OF MILLS CUHBERLAND CO COURT HOUSE CARLTSLE, PA 17015 CUT ALONG THIS LINE ~ RETAXN LONER PORTION FOR YOUR RECORDS ~ REV-l$47 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF JACKSON CHARLES L FILE NO. 21 03-0856 ACN 101 DATE 08-02-2004 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANDED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) 2. Stocks and Bonds (ScheduZe B) $. Closely Held Stock/Partnership In~eres~ (Schedule C) 4. Nor~gages/Notes Receivable (Schedule D) APPROVED DEDUCTIONS AND EXEHPTZONS: (z) 1~2~155.25 (2) . O0 ($) .00 (4) .00 (s) 10q~,601.95 (6) . O0 NOTE: To insure proper credit to your account, subet~ ~hB upper portion of this Fore wi~h your 15,981.95 (9) (10) $5.176.02 (12) 47.]~7,97 (12) 219,071.68 15. 14. NOTE: ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rata 16. Amoun~ oF Line 14 taxable a~ Lineal~Class A rata 17. Amoun~ of Line 14 a~ Stbling rata TAX CREDITS: 06-10-200~ CDOOq031 .00 reflect f/gures that lnclude the total of AL~L returns assessed to date. (is). .00 x O0 .00 (16). 219,071.68. x 045 = 9,858.25 (i7), .00 X 1Z .00 (18), .00 X 15 = .00 (19)= 9,858.25 9,858.23 ANDUNT PAID 9,858.25 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 Ne~ Value of Estate Subj®c~ to Tax (14) 219,071.68 Z~ an assessment ~as issued prevtousZy, lines 14, 15 and/or 16, 17, 18 and 19 w~11 TOTAL TAX CREDIT [ BALANCE OF TAX DUEJ INTEREST AND PEN. TOTAL DUE .00 .00 .00 ( TF TOTAL DUE IS LESS THAN $]., NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A 'CREDIT" {CR}, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) (7) 19;474.47 (8) 266,229.65 REV-1500 co...~,~ OF.~"~LV~"~DE,.~ O~ ~ INHERITANCE T~ RETURN ~'~ O~. ~, RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDL~ INITIAL) SOCIAL SECURITY NUMBER Jackson, Charles L 201 - 18-1990 09/24/2003 03/11/1926 REGISTER OF WILLS F APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Jackson, Mary Agnes 201 - 16-3628 [] 1. OriginaIRetum [] 2. Supplemental Rntum [] 4. LimitedEstale [] 4a. FuturelnterestComprornise(dateofdeath [] 6. Decedent Died Testate (Ab'ach c~py [] 7. Decedent Maintained a Living T~ust (AEach [] 9. Litigation Proceeds Received [] 10. SpousaJ Poverty Credil (dat~ of death between THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: z [] 5. Federal Estate Tax Return Required ~0 8. Total Number of Safe Deposit Boxos [] 11.Election to tax under Sec. 9113(A) (Attach Sch O) lAME James M Robinson :IRM NAME (If applicable) Turo Law Offices 'EI_EPHONE NUMBER 7 ] 7/245-9688 COMPLETE MAILING AODRESS 28 South Pitt Street Carlisle, PA 17013 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgagse & Notes Rece'rvable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivea Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Admiblstrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 142,153.25 None N~he NOne 104,601.93 None 19,474.47 13,981.95 33,176.02 12. Net Value of Estate (Line 8 minus Une 11) 13. Charitsble and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) OFFICIAL USE OHLY 266,229.65 (11) 47,157.97 (12) 219,071.68 (13) (14) 219,071.68 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, 0.00 or transfers under Sec. 9tl 6(a)(t .2) x .00 (15) 16. Amount of Line 14 taxable at lineal rate 219,071.68 x .045 (16) 9,858.23 17.Amount of Line 14 taxable at sibling rate x .12 18. Amount of Line 14 taxable at collateral rate x .15 19. Tax Due MATH << (17) (18) (19) 9,858.23 Copyright 2000 form software only The Lackner Group, Inc. Form REV-IS00 EX (Rev. 6-00) FAMILY SETTLEMENT AND FINAL RELEASE ESTATE OF CHARLES L. JACKSON KNOW ALL MEN BY THESE PRESENTS, that Charles L Jackson, late of Hampden Township, Cumberland County, Pennsylvania, deceased, died testate on September 24, 2003, having first made his/her Last Will and Testament, which was duly executed on November 11, 1992 and probated in the Office of the Register of Wills of Cumberland County, on October 20, 2003. WHEREAS, the said Charles L. Jackson, by the aforesaid Last Will and Testament, named Susan Lee Stoner and Brenda Ann Robinson t_~s~xec(~'rices ~f.~aid Last Will and Testament; WHEREAS, Letters Testamentary on the Estate of the sai~decedent were duly issued by the Register of Wills of Cumberland County, PennJ~,l~an a~to th~:'Said Executrices, hereinafter celled personal representatives; ~ ~: . WHEREAS, the personal representatives have gathered the assets of the Estate of the said decedent and the assets consist of personal and real property with the total value of $266,229.65 as set forth in Exhibit ~A", which is a copy of the Pennsylvania Inheritance Tax Return filed and approved by said personal representatives, and which is attached hereto and made a part hereof, and marked Exhibit ~A"; WHEREAS, the debts and deductions, including the payment of inheritance tax in the said Estate, which have now been paid, leave a balance for distribution of $209,213.45, also as set forth in the statement of said personal representatives, which is attached hereto and marked Exhibit WHEREAS, the balance for distribution as shown in the said statement marked Exhibit "B" has been reduced to cash and has been distributed as herein indicated in accordance with the terms of the Last Will and Testament of the said Decedent; NOW, THEREFORE, Mary Agnes Jackson, Susan Lee Stoner and Brenda Ann Robinson being all of the heirs under the Last Will and Testament of the said decedent, and being those persons entitled to inherit under said Last Will and Testament, do hereby each of us acknowledge that we have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sums of money, legacies, bequests, and devises as are given, devised and bequeathed to each of us BUREAU OF INDIVIDUAL TAXES COHNONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT) ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX JANES H ROBINSON TURO LAW OFFICES 28 S PITT ST CARLISLE PA 17013 DATE 08-02-200q ESTATE OF JACKSON DATE OF DEATH 09-Iq~ZOO5 FILE NUHBER 21 05-0856 COUNTY CUHBERLAND ACN 101 Amoun~ Remitted CHARLES L HAKE CHECK PAYADLE AND REHIT PAYHENT TO: REGISTER OF NILLS CUHOERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS -M DISALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF JACKSON CHARLES L FILE NO. 21 03-0856 ACN 101 DATE 08-02-200q TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST ' SEE REVERSE APPRAISED VALUE OF RETURN DASED ON: ORIGINAL RETURN APPROVED DEDUCTIONS AND EXEHPTIONS= (1) 1~2~15S.25 (2) . O0 ($) .00 (4) . O0 (s) 10~601 (e) .00 (7) 19z~7q.c~7 (8) (9) 15,981.95 (lO) 55,176.02 15. 14. NOTE: reflect figures that include the total o~ ALL returns assessed to date. NOTE: To insure proper credit to your account) submit the upper portion of this form with your tax payment. 266,229.65 47.~7,97 219,071.68 .00 IF PAID AFTER DATE INDICATED) SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (is). .00 x O0 .00 (16). 219,071.68 x Oq5= 9,858.25 (17). .OO x 12 .00 (18), .00 X 15 = .00 (1~)= 9,858.23 9,858.25 AHOUNT PAZD 9,858.25 TOTAL TAX CREDIT ~ALANCE OF TAX DUEJ INTEREST AND PEN. TOTAL DUE ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)) YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS·) .00 .00 .00 ASSESSNENT OF TAX: 1B. Amount of Line 14 at Spousal rate 16. Amount of Line iq taxable at Lineal/Class A rate TAX CREDITS: 06-10-ZO0~ CD00~051 .00 CharStable/Sovernmental ~equests; Non-elected 9115 Trusts (Schedule J) (15) Net Value of Estate Subject to Tax (14) 219,071.68 I~ an assessment ~as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 03 00856 COUNTY CODE YEAR NUMBER ~ECEOEN~S NAME (LAST, FIRST, AND MIOOLE INI'~IAL) SOCIAL SBCUBITY NuMaEB Jackson, Charles L 201 - 18-1990 09/24/2003 03/11/1926 REGISTER OF WILLS ~oo IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND M~DDLE INITIAL) Jackson, Mary Agnes [] 1. Original Re~um [] 2. Supplemental Retum [] 4. LimiledEstale [] 4a. Euture~nterestC°mpr°mise(dateofdeath after 12-12-82) [] 6. Decedent Died Testate (Affach copy [] 7. Decedent Maintained a Uving Trust (Attach of Will) copy of Trust) [] 9. Litigation Prcceeds Received [] 10. Spousal Poverly Credit (date of death between z SOCIAL SECURITY NUMBER 201-16-3628 [] 5. Federal Eslate Tax Relurn Required 08. Total Number of Safe Deposit Boxes [] 11.Election io tax under Sec. 9t13(A) (Attach Sch O) THIS SECTION MUST EE COMPLETED. ALL CORRESPONDENCE AND coNFiDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: qAME James M Robinson :IRM NAME (If applicable) Turo Law Offices 717/245-9688 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedu~ B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Nates Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Unes 9 & 10) 28 South Pitt Street Carlisle, PA 17013 (11) 12. Net Value of Estate (Line 8 minus Line 11 ) (12) 142,153.25 None N~he None 104,601.93 None 19,474.47 13,981.95 33,176.02 (13) (14) 13. Charitable and Governmental Bequests/Sec 9113 Trusts f~r which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17.Amount of Line 14 taxable at sibling rate 18. Amount of Une 14 taxable at co~laterat rate 19. Tax Due 0.00 x .00 (15) 219,071.68 x .045 (16) x .12 (17) x .15 (18) (19) >> BE Sk~RE~TO ~R ALE:QUEST ONSON ~RSES DE'~D RECHECK MATH << OFFICIAL USE ONLY 266,229.65 47,157.97 219,071.68 219,071.68 9,858.23 9,858.23 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) FAMILY SETTLEMENT AND FINAL RELEASE ESTATE OF CHARLES L. JACKSON KNOW ALL MEN BY THESE PRESENTS, that Charles L. Jackson, late of Hampden Township, Cumberland County, Pennsylvania, deceased, died testate on September 24, 2003, having first made his/her Last Will and Testament, which was duly executed on November 11, 1992 and probated in the Office of the Register of Wills of Cumberland County, on October 20, 2003· WHEREAS, the said Charles L. Jackson, by the aforesaid Last Will and Testament, named Susan Lee Stoner and Brenda Ann Robinson ~s~xecl~'ices ~f[~aid Last Will and Testament; ~ "' ~ WHEREAS, Letters Testamentary on the Estate of the sai~ deced?~nt were· ~uly issued by the Register of Wills of Cumberland County, Penn~lYan a.=to the said Executrices, hereinafter celled personal representatives; ~ ~ ~L (30 WHEREAS, the personal representatives have gathered the assets of the Estate of the said decedent and the assets consist of personal and real property with the total value of $266,229.65 as set forth in Exhibit "A", which is a copy of the Pennsylvania Inheritance Tax Return filed and approved by said personal representatives, and which is attached hereto and made a part hereof, and marked Exhibit "A"; WHEREAS, the debts and deductions, including the payment of inheritance tax in the said Estate, which have now been paid, leave a balance for distribution of $209,213.45, also as set forth in the statement of said personal representatives, which is attached hereto and marked Exhibit "B"; WHEREAS, the balance for distribution as shown in the said statement marked Exhibit 'B" has been reduced to cash and has been distributed as herein indicated in accordance with the terms of the Last Will and Testament of the said Decedent; NOW, THEREFORE, Mary Agnes Jackson, Susan Lee Stoner and Brenda Ann Robinson being all of the heirs under the Last Will and Testament of the said decedent, and being those persons entitled to inherit under said Last Will and Testament, do hereby each of us acknowledge that we have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sums of money, legacies, bequests, and devises as are given, devised and bequeathed to each of us respectively by the said Last Will and Testament, the amounts due us under said Last Will and Testament, which amounts we have received this day or prior to this day; and, each of us do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, we each agree that no account is necessary and we do hereby agree that we do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if they had been filed and confirmed by the Orphan's Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania. THEREFORE, we and each of us, do hereby remise, release, quitclaim and forever discharge the said personal representatives, Susan Lee Stoner and Brenda Ann Robinson, their heirs, executors, administrators and assigns, of and from the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the Estate of the said decedent, and each of us do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this Agreement, we and each of us do hereby covenant and agree with each other and the aforesaid personal representative, that we will contribute pro-rata our share of the Estate to satisfy any and all claims, demands, suits or causes of action which may be successfully prosecuted against the said Estate or the aforesaid personal representative after the signing, sealing and delivery of this Family Settlement Agreement and Final Release. IN WITNESS WHEREOF, we have hereunto set our hands and seals the day and year noted below. Date Date ' Dat~ x V~ess Witnes~ Ma~gne~' Jacks~ Susan Lee Stoner Brenda Ann Robinson BUREAU OF INDIVIDUAL TAXES CONHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX JANES M ROBINSON TURO LAW OFFICES 28 S PITT ST CARLISLE PA 17013 DATE 08-02-2004 ESTATE OF JACKSON DATE OF DEATH 09-24-Z003 FILE NUHBER 21 03-0856 COUNTY CUHBERLAND ACN 101 Amount Remitted CHARLES L HAKE CHECK PAYABLE AND REMZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~.~ RETAIN LONER PORTZON FOR YOUR RECORDS REV 15q7 EX AFP (01 03) NOTZCE OF INHERITANCE TAX APPRAZSENENT, ALLONANCE OR D/SALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF JACKSON CHARLES L FZLE NO. 21 05-0856 ACN 10! DATE 08-02-Z004 TAX RETURN NAS: (X) ACCEPTED AS FILED [ ) CHANGED RESERVATION CONCERNZNG FUTURE INTEREST ' SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) S. Closely Held Stock/Partnership Znterest (Schedule C) q. Nortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hist. Personal Property (Schedule E} 6. Jointly O~ned Property (Schedule F) 7. Transfers (Schedule B) 8. Total Assets APPROVED DEDUCTZONS AND EXENPTZONS: 9. Funeral Expenses/Adm. Costs/Nisc. Expenses (Schedule H) 10. Debts/Nortgage Liabilities/Liens (Schedule Z) 11. Total Deductions 12. Ne~ Value of Tax Return NOTE: (1) 142z155.25 (2) . O0 ($) . O0 (q) . O0 (s) 10~601.9~ (6) . O0 (7) 19 {474.47 (10) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 266,229.65 19. Principal Tax Due TAX CREDITS: PAYflENT RECEIPT DATE NUHBER 06-10-2004 CD004031 15,981.95 55.176.02 (11) 47.1~7-97 (12) 219,071.68 (15) .00 (14) 219,071.68 will .00 x 00 .00 219,071.68 x 045: 9,858.25 .00 x 12 = .00 .00 x 15 .00 (19)= 9,858.25 ANOUNT PAZD 9,858.23 TOTAL TAX CREDIT 9,858.25 BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE INTEREST/PEN PAID (-) .O0 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .0O .00 .00 ( IF TOTAL DUE ZS LESS THAN $1~ NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF TH[S FORN FOR INSTRUCTIONS.) ASSESSNENT OF TAX: 1S. Amount of Line 1~ at Spousal rate 16. Amount of Line 1~, taxable at Lineal/Class A rate (16). 17. Amount of Line 14 at Sibling rata (17). 18. Amount oF Line 1~, taxable at Collateral/Class B rate (18) Charitable/~overnmental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate SubSect to Tax ~: an assessment ~as issued previously, l~nes lq, [S and/or [6, [7, ~8 and 19 re~[ect f$gures that ~nc~ude the fora! o~ ALL returns assessed to date. ~:oo REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT 21 03 00856 DEGEDENT'S NAME (LAST, FIRST. AND MIDDLE INiTIAL) SOCIAL SECURITY NUMBER Jackson, Charles L 201 - 18-1990 z~ , DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ~ 09/24/2003 03/11/1926 REGISTER OF WILLS o jIF APPLICASLE~ SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INiTIAL) SOCIAL SECUR~Y NUMBER Jackson, Mary Ag~es 201 - 16-3628 [] 1. Original Return [] 2. Supplemental Retum [] 4. LimltedEstate [] 4a.Futu~olnterestc°mpr°mise(date°fdeath after 12-1 [] 6. Decedent Died TEstate (Al~ach copy [] 7. Decedent Maintained a Living Trust (A~ach THIS SECTION MUST BE cOMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: O0 James M Robinson :IRM NAME III applicable) Turo Law Offices 717/245-9688 [] 5. Federal Estale Tax Relum Required 0 8. Total Number of Safe Deposit Boxes [] 11.Election to tax under Sec. 9113(A) (At[ach Sch O) COMPLETE MAILING ADDRESS ' 28 South Pitt Street . Carlisle, PA 17013 1. Real Estate (Schedule A) (I) 14 2,1 5 3.2 5 2. Stocks and Bonds (Schedule B) (2) None 3. Closely Held Corporation, Partnership or Sole-Propdatomhip (3) 4. Mortgages & Notes Receivable (Schedule D) (4) [',10ne 5. Cash, Bank Deposits & Miecellaneous Personal Property (5) ] 04,601.9 3 (Schedule E) 6. Jointly Owned Property (Schedule F) (6) None [] Separate Billing Requested 7. Inter-Vires Transfers & Miscellaneous Non-probate Property (7) 19,474.47 (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) ] 3,981.95 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (1 O) 33, ] 76.02 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) c~ OFFICIAL USE ONLY 266,229.65 (11) 47,157.97 (12) 219,071.68 (13) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been mede (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 219,071.68 Z SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at fi3e spousal tax rote, 0.00 x .00 or tmnefors under Sec. 91 t6(a)(1.2) 16. Amount of Line14 taxable at lineal mte 219,071.68 x .045 17.Amount of Line 14 taxable at sibling rate x .12 18. Amount of Line 14 taxable at collateral rate x .15 19. Tax Due (15) Copyright 2000 form software only The Lackner Group, Inc. (16) (17) (18) (19) 9,858.23 9,858.23 Form REV-I$O0 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 53 South 35th Street CITY CampHill IsT^TE PA [ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Intereat/Penaity if applicab~ D. Interest E. penalty Total Credits (A + B + C) (2) Total Interest/Penaity (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page I Line 20 to request a refund 5. IfLinel+Line3isgreaterthanLine2, enterthedifference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) (1) 9,858.23 0.00 0.00 9,858.23 9,858.23 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. re~ain the use or income of the properb/transferred; ..................................................................................... ~ {~ b. retain the fight to designate who shall use the property transferred or its income; ......................................... ~ ~ c. retain a reversionaP/interest; or ..................................................................................................................... d. rec&ve the promise for life of either payments, benefits or care? .................................................................. 2. If death occun'ed after December 12, 1982, did decedent transfer property within one year of death without recek4ng adeq uat e co~Isideretion ?own an .......................................................................................................................... or payable upon or security or ............... [] ~ 3. Did decedent "in trust for' death bank account at his her death? [] 4. Did decedent OWn an Indh~dual Retirement Account, annuity, (3*' ather nm-probate property which contains a beaeficiary designation? ........................................................................................................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE O AND FILE IT AS PART OF THE RETURN. SiGNA~.JRE OF PERSON RESPONSIBLE FOR FILING RE'OJRN ADDRESS OA~E Sas ~e Stoner New ~b~l~ PA 17070 ~' ¢~-d~ SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DA~ ,._.Brenda Ann Robinson~ 112 Valle/View Road New Cumberland, PA 17070 ,_.,Ro,.o. ~.j~M Robin ~./] 28 South Pitt Street on er after July 1, 1994 and before January 1, '~995, the tax rate imposed on the ne~ value of transfers to or for the use of the sur~ivi~ spouse is 3% [72 P.S. §~ ~ (a) (1.1) For dates of deeth on or atter January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survMng spouse is 0% [72 P.S. §0116 (a) (~.q) (ii)]. The statute does n(~ exem~ a transfer to a surviving spouse frorn tax, and the statutory requirements for disclosure of assets and filing a tax r~etum are still applicable even if the sur~iving spouse is the only beneficiary. For dales of death on er after July 1, 2000: The tax rate impceed on the nel value of transfers from a deceeaed child twenty-one years of age or younger at death to or for the use of a natural perent, an adoptive parent, or a stepparent o~ the child is 0% [72 P.S. §91'1~ (a) (1.2)]. The tax rate impceed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is ~.2) [72 P.S. §g~ (a) (t)]. The tax rate impceed on the net value of transfers lo or for the use of the decepect'a siblings is 12% [72 P.S. §g116 (a) (~.;3)]. A sibling ia defined, under Section 9~02, as an indMdual who has at least one parent in common with the decedent, whether by blood or adoption. SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Jackson, Charles L 21 - 03 - 00856 A ma property owned so ely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable.knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 53 South 35th Street (I/2 interest) Hampden Township, Cumberland County, Pennsylvania 609 Market Stre~ New Cumberland Boro, Cumberland County, Pennsylvania 611 Market Street New Cumberland Boro, Cumberland County, Pennsylvania 39,474.75 52,678.50 50,000.00 TOTAL (Also enter on Line 1, Recapitulation) 142,153.25 SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Jackson, Charles L 21 - 03 - 00856 Include the proceeds of litigation and the date the~oroceeds were recek, ed by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule ~-. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH M & T Bank - Acct. No. 310039145800278 M & T Bank - Acct. No. 98206133 PNC Bank - Acct. No. 51-4003-1629 Waypoint Bank - Acct. No. 750008119 Waypoint Bank - Acct. No. 5500032825 Waypoint Bank - Acct. No. 754188774 Waypoint Bank - Acct. No. 754220189 2001 Chevrolet Malibu Sedan 30,463.84 21,626.16 4,177.30 28,053.57 120.54 8,160.52 10,000.00 2,000.00 TOTAL (Also enter on Line 5, Recapitulation) 104,601.93 SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEAL~I OF PENNSYLVANIA ]NHERITAiqCE TAX RE~IJRN RESIOENT DECEDENT ESTATE OF FILE NUMBER Jackson, Charles L 21 - 03 - 00856 This schedule must be completed and filed if the answer to any of questions 1 throu ~ 4 on page: is yes. DESCRIPTION OF PROPERTY DATE OF DEATH ' % OF ITEM Ir~lude the name of the transferee, their relationship to decedent and the date of trensfef. VALUE OF ASSE'f DECD'S EXCLUSION TAXABLE VALUE NUMBER A[lach a copy of the deed for real estate, iNTEREST F APPLICABLE 1 M&T Bank IRA Acct. 35004201785499 1,907.23 100% 1,907.23 2 M&T Bank [RA Acct. 35004201785506 6,466.22 100% 6,466.22 3 Waypoint Bank IRA Acct. 125504829 4,653.75 100% 4,653.75 4 Waypoint Bank IRA Acct. 125507635 3,957.99 100% 3,957.99 5 Waypoint Bank IRA Acct. 725510151 2,489.28 100% 2,489.28 TOTAL (Also enter on line 7, Recapitulation) 19,474.47 SCHEDULE H FUNERAL EXPENSES & ADfv'I~IIS'TRATIVE COSTS ESTATE OF FILE NUMBER Jackson, Charles L 21 - 03 - 00856 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER 2 3 FUNERAL EXPENSES: Parthemore Funeral Home & Cremation Services, Inc. Rolling Green Cemetery Stephenson's Flowers ADMINISTRATIVE COSTS: Personal Representative's Commissions SociaJ Security Number(s) / EIN Number of Personal Representative(s): Streat Address City State __ Zip Year(s) Commission paid Attorney's Fees Fa'nib/Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Mary Agnes Jackson Streat Address 53 South 35th S~eet C~ Camp Hill State PA Relationship ot Claimant to Decedent Spouse Probate F~s Cumberland County Register of Wills Cumberland Law Journal The Sentinel - Legal Accountant's Fees Zip 17011 Ta0( Retum Prepamr's Fees R. Calhoun & Associates, Inc. Other Administrathte Costs TOTAL (Also enter on line 9, Recapitulation) 8,795.70 870.00 44.38 3,500.00 384.00 75.00 112.37 200.50 13,981.95 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER ESTATE OF Jackson, Charles L 21 - 03 - 00856 include unmimbumed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 PNC Bank - Credit Line - Acct. No. 40-03-048001988683 M & T Bank - automobile loan Keystone Oil - heating oil for 609 Market Street, N. Cumb. State Farm Insurance Co. - homeowners ins. on 609 & 611 Market Street, lq. Cumb. Freysinger Pontiac - outstanding auto repair bill Wachovia Bank - credit card balance MBlqA America - credit card balance Sears - credit card balance Varizon Bore. of New Cumberland - sewer & trash for 609 & 611 Market St., N. Cumb. State Farm Insurance Co. - automobile policy PPL Electric Utilities Monumental Life Insurance Co. - Rachel Lloyd Commonweallh of Pennsylania - duplicate car title & registration renewal Costs to prepare 611 Market Street for sale Robin Gasparetti, Tax Collector - 2004 County/Bore. Real Estate Tax Recerder of Deeds - record deed to 609 Market Street, lq. Cumberland PA Dept. ofRevcaue - 2003 Income Tax Washington Mutual Home Loans - 1/2 Mortgage Balance Freysinger Pontiac Inc. - Inspect car in preparation for sale 900.23 2,182.33 938.00 622.00 180.39 234.04 331.04 87.50 125.72 272.91 322~.6 8.03 125.35 58.50 365.10 263.14 39.50 5.00 26,005.69 109.29 TOTAL (Also enter on Line 10, Recapitulation) 33,176.02 EXHIBIT "B" GROSS ESTATE $266,229.65 LIABILITIES A. Register of Wills, Agent (Inheritance Tax) B. Parthemore Funeral Home C. Family Exemption D. Rolling Green Cemetery E. Stephenson's Flowers F. Register of Wills G. The Sentinel H. Cumberland Law Journal I. R. Calhoun & Associates, Inc. J. Washington Mutual Home Loans K. M & T Bank L. State Farm Insurance Co. M. Keystone Oil N. PNC Bank O. Costs to Prepare 611 Mkt. St. for Sale P, MBNA America Q. Borough of New Cumberland R. Robin Gasperetti, Tax Collector S. Wachovia Bank T. Freysinger Pontiac U. Verizon V. Monumental Life Insurance W. Freysinger Pontiac X. Sears Y. Commonwealth of Pennsylvania Z. Recorder of Deeds AA. PPL Electric Utilities BB. PA Department of Revenue 9,858.23 8,795.70 3,500.00 870.00 44.38 384.00 112.37 75.00 200.50 26,005.69 2,182.33 944.26 938.00 900.23 365.10 331.04 272.91 263.14 234.04 180.39 125.72 125.35 109.29 87.50 58.50 39.50 8.03 5.00 AMOUNT REMAINING TO BE DISTRIBUTED $209,213.45 AMOUNT DISTRIBUTED TO: Susan Lee Stoner Brenda Ann Robinson $104,606.73 104,606.72 TOTAL DISTRIBUTION $209,213.45 Decedent's Complete Address: STREET ADDRESS CITY 53 South 35th Street STATE PA I ZIP 17011 Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 9,858.23 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. (4) Check box on Page I Line 20 to request a refund 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 9,858.23 9,858.23 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; ..................................................................................... ~] l~ b. retain the right to designate who shall use the property transferred or its income; ......................................... r-~ [] c. retain a reversionary interest; or ..................................................................................................................... d. receive the promise for life of either payments, bener~s or care? .................................................................. [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .......................................................................................................................... [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ............... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belie[, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all infonmatian of which preparer has any knowledge. SIGNA'IIJRE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE Sa Lee Stoner ,~l ~u~ ~ee ~to.c~ 1002 Allen Street ~r)~~~ New Cumberland, PA 17070 ~ ~q-Zg~/ SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE Brenda Ann Robinson ~ ' 112 ValleyView Road ~~ ~>-~r,-,~.~"~ ~..~ New Cmberl~d, PA 17070 ~-~' SI~RE OF PREPARER O~ER ~REPRESENTA~E ADDRESS DA~ Jame M Robin~n" . imam Robin ~ /) ~ 28Sou~PI~SWcct __ ~ /~~ZT. ~ C=lisle, PA 17013 ~ -~-O ~ ~ ~ J u~ 1, 1~ and ~ Janua~ 1, 1~5, the t~ ~e im~ ~ the na ~1~ d tmnsf~ to ~ f~ the use ~ the suing spouse is 3% ~2 P.S. {9116 (a) (1.1) (i)]. F~ d~ ~ d~h ~ or ~ Janua~ 1, 1995, the t~ rae im~ on the n~ ~lue ~ tmnsf~ to ~ for the use ~ the suing s~se is 0% ~2 P.S. ~9116 (a) (1.1) (ii)]. The sta~e d~ n~ ~ a tmnsf~ to a suing s~se fr~ t~ and the st~ r~ui~ f~ discl~um ~ ~s~ and filing a t~ r~um am still ~pli~ ~n ~ the suing s~se ~ the ~ ~ciaff. F~d~ ~d~h ~ or ~ Ju~ 1, 2~: The t~ r~e im~ ~ the n~ ~lue ~ transf~ f~ a d~ chiM ~e ~m ~ ~e ~ ~n~ a d~h to ~ f~ the use ~ a nauml pa~t, an ~ pa~t, or a st~a~t ~ the chiM is 0% ~2 P.S. {9116 (a) (1.2)]. The t~ r~e im~ ~ the n~ ~lue ~ transf~ to ~ f~ the use ~ the d~t's lin~l ~cia~ is 4.5%, ~t ~ n~ in 72 P.S. {9116 1.2) ~2 P.S. {9116 (a) (1)]. The t~ r~e im~ ~ the na ~lue ~ tmnsf~ to ~ f~ the u~ ~ the d~t's siblings ~ 12% ~2 P.S. {9116 (a) (1.3)]. A sibling is d~in~, und~ S~ion 9102, ~ an ind~ual ~o h~ a ~t ~e pa~t in ~m~ ~h the d~t, ~ by bl~ ~ ~ti~. SCHEDULE A REAL ESTATE FILE NUMBER ESTATE OF Jackson, Charles L . 21 - 03 - 00856 aAtll ,rea! prope .r~y owned, solely or as. ,a tenant in c.,o. mm. on mus,t be ..m.. port~..d at fa.i.r m,arket value. Fair m.arket value is defined as the price wnicn property would De excnange(] between a willing buyer ana a wi#ing sel~r, neitner being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1 39,474.75 53 South 35th Street (1/2 interes0 Hampden Township, Cumberland County, Pennsylvania 609 Market Street New Cumberland Boro, Cumberland County, Pennsylvania 611 Market Street New Cumberland Boro, Cumberland County, Pennsylvania TOTAL (Also enter on Line 1, Recapitulation) 52,678.50 50,000.00 142,153.25 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Jackson, Charles L FILE NUMBER 21 - 03 - 00856 Include the. 0mceeds of litigation and the date thepmceeds were received by the estate. All property jointly-owned with the right of survivomn,p must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH M & T Bank - Acct. No. 310039145800278 M & T Bank - Acct. No. 98206133 PNC Bank - Acct. No. 51-4003-1629 Waypoint Bank - Acct. No. 750008119 Waypoint Bank - Acct. No. 5500032825 Waypoint Bank - Acct. No. 754188774 Waypoint Bank - Acct. No. 754220189 2001 Chevrolet Malibu Sedan TOTAL (Also enter on Line 5, Recapitulation) 30,463.84 21,626.16 4,177.30 28,053.57 120.54 8,160.52 10,000.00 2,000.00 104,601.93 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jackson, Charles L SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21 - 03 - 00856 ITEM NUMBER This schedule must be completed and filed if the answer to a~_~f questions 1 througl DESCRIPTION OF PROPERTY Include the name of the transferee, their relationship to decedent and the date of transfer. Attach a copy of the deed fo~ mai estate. M&T Bank IRA Acct. 35004201785499 M&T Bank 1RA Acct. 35004201785506 Waypoint Bank IRA Acct. 125504829 Waypoint Bank IRA Acct. 125507635 Waypoint Bank IRA Acct. 725510151 DATE OF DEATH % OF VALUE OF ASSET DECD'S INTEREST 1,907.23 100% 6,466.22 100% 4,653.75 100% 3,957.991 100% 2,489.28 100% TOTAL (Also enter on line 7, Recapitulation) 4 on page 2 is yes. EXCLUSION IF APPLICABLE) TAXABLE VALUE 1,907.23 6,466.22 4,653.75 3,957.99 2,489.28 19,474.47 ESTATE OF Jackson, Charles L FILE NUMBER 21 - 03 - 00856 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION NUMBER A. FUNERAL EXPENSES: 1 Parthemore Funeral Home & Cremation Services, Inc. 2 Rolling Green Cemetery 3 Stephenson's Flowers B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees 3. Family Exemption: (If decedent's address is nnt the same as claimant's, attach explanation) Claimant Mary Agnes Jackson Street Address 53 South 35th Street City Camp Hill State PA Relationship of Claimant to Decedent Spouse 4. Probate Fees Cumberland County Register of Wills Cumberland Law Journal The Sentinel - Legal 5. Accountant's Fees 6. lax Return Preparer's Fees R. Calhoun & Associates, Inc. Other Administrative Costs Zip 17011 TOTAL (Also enter on line 9, Recapitulation) AMOUNT 8,795.70 870.00 44.38 3,500.00 384.00 75.00 112.37 200.50 13,981.95 ESTATE OF Jackson, Charles L SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER , 21 - 03 - 00856 Include unreimbursed medical expenses. ITEM NUMBER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O DESCRIPTION PNC Bank - Credit Line - Acct. No. 40-03-048001988683 M & T Bank - automobile loan Keystone Oil - heating oil for 609 Market Street, N. Cumb. State Farm Insurance Co. - homeowners ins. on 609 & 611 Market Street, N. Cumb. Freysinger Pontiac - outstanding auto repair bill Wachovia Bank - credit card balance MBNA America - credit card balance Sears - credit card balance Verizon Boro. of New Cumberland - sewer & trash for 609 & 611 Market St., N. Cumb. State Farm Insurance Co. - automobile policy PPL Electric Utilities Monumental Life Insurance Co. - Rachel Lloyd Commonwealth ofPennsylania - duplicate car title & registration renewal Costs to prepare 611 Market Street for sale Robin Gasperetti, Tax Collector - 2004 County/Boro. Real Estate Tax Recorder of Deeds - record deed to 609 Market Street, N. Cumberland PA Dept. of Revenue - 2003 Income Tax Washington Mutual Home Loans - 1/2 Mortgage Balance Freysinger Pontiac Inc. - Inspect car in preparation for sale TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 900.23 2,182.33 938.00 622.00 180.39 234.04 331.04 87.50 125.72 272.91 322.26 8.03 125.35 58.50 365.10 263.14 39.50 5.00 26,005.69 109.29 33,176.02 ep\wills\jackson.dhs LAST WILL AND TESTAMENT OF CHARLES L. JACKSON I, Charles L. Jackson, of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I devise my one half interest in the premises known as 53 South 35th Street, Camp Hill, Pennsylvania to my wife, MARY AGNES JACKSON, together with all policies of insurance or said real proper- ty, without liability for waste, for her life so long as she desires to use such premises as her home and pay all costs and maintenance thereof, including taxes, assessments, insurance and ordinary repairs, said property to be insured in a reasonable amount insuring the interest of the remaindermen as well as herself. I further grant to my wife, MARY AGNES JACKSON, the option to purchase the remainder interest in the premises at 53 South .35th Street, Camp Hill, Pennsylvania from my estate at any time during her life. The purchase price shall be one half of the fair market value of the premises without regard to the actuarial value of her life estate. The fair market value shall be as agreed upon by my wife and my personal representatives; and, in the absence of an agreement, shall be as determined by an appraisal performed by an M.A.I. The proceeds from the said purchase shall be distributed as part of the residue of my estate. The option shall be exercised in writing to my --1-- personal representatives. Settlement shall occur sixty (60) days after the option has been exercised and shall conform to the custom for .similar residential real estate closings. Should my wife, MARY AGNES JACKSON, not exercise her option to purchase my interest in the said real estate, then upon the death of my wife or at such prior time as she no longer uses said premises as a home for herself, I direct my personal representatives to join with my Wife's personal representative or with my wife, whichever the case may be, to sell said real estate and distribute the net proceeds as a part of the residue of my estate. ITEM II: I devise and bequeath the residue of my estate of every nature and wherever situate in equal shares to such of my children, SUSAN LEE STONER and BRENDAANN ROBINSON, as survive me. Should any such child predecease me, I devise and bequeath the share of such child to her issue, per stirpes, living at the time of my death; and should any such child of mine leave no such issue living at the time of my death, I devise and bequeath the share of such child to my issue, per stirpes, living at the time of my death. ITEM III: I appoint my Co-Executrices guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this appointment of a guardian shall not supersede the right of any fiduciary in its discre- tion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use --2-- principal as well as income from time t~ time for the minor's support and education (including college education, both graduate and under- graduate) without regard to his or her parent's ability to provide for such support and education, or to make pa~ent for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking Care of the minor. ITEM IV: I appoint my children, SUS~ LEE STONER and B~NDA ANN ROBINSON, Co-Executrices of this my last will. ITEM V: I direct that my Co-Executrices and their successors shall not be required to give bond for the faithful perfo~ance of his/her duties in any jurisdiction. IN WITNESS WHEREOF, I, CHARLES L. JACKSON, have hereunto set my hand and seal this ~ ~ day of ~A~L~4~ , 1992. SIGNED, SE~ED, PUBLISHED and DECLARED by CHARLES L. JACKSON, the Testator above n~ed, as and for his Last Will and Test~ent, and in the presence of us, who at his request, in his presence and in the pr~e of each ~other, have subscribed our n~es as witnesses. Address Address -3- COMMONWEALTH OF PENNSYLVANIA: :SS: COUNTY OF CUMBERLAND : I, CHARLES L. JACKSON, the Testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein~contained. Sworn to or affirmed to and acknowledged before me by CHARLES L. JACKSON, the Testator, this .//~ day of ~~_/~~ , 1992. JI[IT~I~ ~ COMMONWEALTH OF PENNSYLVANIA : :SS: COUNTY OF CUMBERLAND : and __, the witnesses whose names are signed to the attached or forego- ing instrument, being duly qualified according to law, depose and say that we were present and saw Testator sign and execute the instrument as his last will; that Testator signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator -4- signed the will as witnesses; that to the best of our knowledge, the Testator was at that time eighteen or more years of age, of sound mind and under no constraint or undue Witness Sworn to or affirmed to and acknowledged before me by ~ ~/~ and ~' ~. ~~ , witnesses, this //~ day of ~ , 1992. NOTARIAL SEAL Y~'Y,E RENEE LUCKEY, N0mU Public Ne~ Cumberland, Cumberland County Commission Expi~ Mamh 27, !993 -5- HUD - 1 UNIFORM SETTLEMENT STATEMENT © EASY SOFT, Inc. SE'I"f LEMENT STATEMENT A. U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 6, File Number: 7. Loan Number: B. TYPE OF LOAN 1. FHA 2. FmHA 3. X Conv. Unins. 4. VA 5. Conv. Ins. 8. Mortgage Insurance Case Number 364282 2004-07 NOTE: This form is furnished to give you a stat~nent of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.¢,)" were paid outside the closing,, they are shown here for informational purp6ses and are not included in the totals. NOTE: TIN-- Taxp~yWs Identification Number D. NAME ANDADDRESSOFBORROWER: David J. Heckarfl . 420 Lafayette Street Enola, PA 17025 O. PROPERTY LOCATION: 611 Market Street New Cumberland, PA 17070 25-24-0811-053 E. NAME, ADDRESS AND TIN OF SELLER: Susan Lee Stoner, Executrix Brenda Ann Robinson, Executrx 112 Valley View Road New Cumberland, PA 17070 06-6536565 H. SETTLEMENT AGENT NAME, ADDRESS AND TIN F. NAME AND ADDRESS OF LENDER: Chase Manhattan Mort. Corp. 55 Quince Ordhard Rd. Suite 650 Gaithersburg, MD 20878 TUR0 LAW OFFICES 25-1616709 28 South Pitt Street, Carlisle, PA 17013 PLACE OF SETTLEMENT 112 Valley View Road New Cumberland, PA 1. SE'IITLEMLwNTDATE 03/11/2004 J. SUMMARY OF BORROWER'S TRANSACTION I~L SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE ,I~OM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contxaet sales price 50,000.00 401. Contriver sales price 50,000.0C 102. P~rsonal ~operty 402. Personal property 103. S~tlement c~mrges to borrower (Line 1400) 3, 6 9 8.7 0 403. i04. 404. 105. 405. Adju~h,,e-m for it~,,~ paid by seller in advance Adjustment~ for items paid by seller in advance 106. City/town taxes 406. City/town taxes 107. Countymxes 03/11/2004-01/01/200.5 241.07 .40.7. Countymxes 03/11/2004-01/01/2005 241.0'. 108. Assessments 408. Assessments 109. 409. 110. School Tax 173.68 410. School Tax 173.6~ 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 54,113.45 420. GROSS AMOUNT DUE TO SELLER 50, 414.7'. 200. AMOUNTS PAID BY OR IN BEI-IAI.F OF BORROVqER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 20i. Deposit or em,,~ money 500.00 50!. Excess deposit 500.01 202. Principal amount ofn~w loan(s) 4 7,5 0 0.0 0 502. Settlement charges to seller (Line 1400) 8 5 2.4 { 203. Existing loan(s) ~lte., subject to 503. Existing loan(s) taken subject to 204. 504. Payoffof first mortgage loan 205. 505. Payoff of second mortgage loan 206. 506. 207. 507. 208. 508. 209. 509. ...... ._Ad_j,,~maent~ for item~ ,,,.naid .by ~lle~. Adjustment~' !~or items unpaid by seller 210. City/town taxes 510. City/town taxes 211. County taxes 511. County taxes 212. Asse~ne~ts 512. Assessments 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 51'8. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 48,000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 1,352.4 300. CA~I:I AT SETTLEMENT FROM/TO BORROWER 301. Gross amount due from borrower (Line 120) 5 4,1 1 3.4 5 5 0, 4 1 4.7 ,~ 48,000.00 1,352.4( 600. CASH AT SETTLEMENT FROlvt/TO SELLER 601. Gross amount due to seller (Line 420) 602. Less reduction in amount due seller (Line 520) 603. CASH TO SELLER 302. Less amount paid by/for borrower (Line 220) 303. CASH FROM BORROWER 6, 1 1 3.4 5 49,062.3,~ SUBSTITUTE FORIVl 1099 SELLER STATEMENT The information contained in Blocks E, G, H, and I and on line 401 (or, if line 401 is asterisked, line 403 and 404) is important tax information and is being fomished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS determines that it has not been reported. If this real estate is your principal residence, file Form 2119, Sale or Exchange of Principal Residence, for any gain, with your income tax return; for other transactions, complete the applicable parts of Form 4797. Form 6252 and/or Schedule DOVorm 1040). You are required to provide the Settlement Agent (named above) with your correct taxpayer identification number. If you do not provide the Settlement Agent with your correct taxpayer identification number, you may be subject to civil or criminal penalties imposed by law. Under penalties of perjury, I cegix~ that the number shown on this statement is my correct taxpayer identification number. (SellofsSignature) ' Susa~ Lee Stet{er', Executrix (S~llefsSignamre) Br~n~a~k~n Robinson, Executrx L. SETTLEMENT CHARGES © EASY SOFT, Inc. 700. TOTAL SALES/BROKER's COMMISSION based on price $ 5 0, 0 0 0.0 0 @ Division of Commission (line 700) as follows: 701. $ PAID FROM BORROWER'S FUNDS AT SETTLEMENT 702. $ 703. Commission paid at Settlement 704. 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee 1. 500% $ 712.50I PAID FROM SELLER'S FUNDS AT SETTLEMENT 802. Loan Discount $ 803. Appraisal Feeto Appraisals Express 804. Credit mpo~ to Equi fax 805. LendefsInspectionFceTax Rel. Svc. Fee to 1st American 806. Mortgage lmurance Applicafon Fee to Flood Determination/Certification to 1st Amc 807. Assumption Fee 808. Underwriting Fee to Chase Manhattan Mortgage Corp. 809. Processing Fee to A Lending Hand 810. Bonus from ChaSe Manhattan to ALH $75.00 POC 811. Yield Spread Chase Manhattan to ALH $1068.75 POC 900.1TEMSREQUIREDBYLENDERTOBEPAIDINADVANCE 901.Interest~m03/11/2004-03/31/2004 @ $6.990 per day 902. Mortgage Insurance Premium for 903. Hazard insurance Premium for 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. H~zardinsurance 3 month (s) @ $24.09 per month 1002. Mortgage insurance 1003. City Property Taxes 1004. Countypropen3, Taxes 2 month (s) @ $48.03 per month I005. Annual assessments 1006. School Taxes 10 month(s) @ $48.03 per month 275.00 9.65 69.00. 18.00 370.00 400.00 146.79 1007. 1008. Aggregate Accounting Adjustment - 3 12.62 1100. TITLE CHARGES 796.062.27 480.30 1101. Settlement or closing fee to 1102. Abstract or title search to Tri-County Abstract Service POC 1103. Title Examination to 1104. Title insurance binder to 1105. Document preparation to 1106. Notary fees to 1107. Attorney's fees to (includes line numbers: ll08. TitlelnsurancetoTuro Law Off., Agt fOr ConeStoga (includes line numbers: 1101 - 1110 1109. Lendefscoverage $ 47500.00 1110. Ownefscoverage $ 50000.00 llll. Lender's Endorsements 100, 300, 8.1 Title InS' 1112. Closinq Protection Letter to Conestoga Title Ins. Co. 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees: Deeds 38.50 MortgageS 64.50 Releases I 103.0o 558.75 15o-ooI 35.00 1202. City/cnty mx/stamps: Deed $ 5 0 0.0 0 Mortgage $ 1203. State tax/stamps: Deed $ 5 0 0.0 0 Mortgage $ 1204. 1205. 500.00 500.00 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to 1302. Pest inspection to 1303.2004 County/Borough Tax to Robin Gasperetti, Tax 1304. Overniqht Courier/Postage to Ron Turo, Esquire 1305. Final Sewer to Borough of New Cumberland Collector 15.00 299.29 53.11 1306. 1307. 1308. 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103, Section J and 502, Section K) 3, 6 9 8.7 0 8 52.4 0 CERTIFICATION I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief; it is a tree and accurate statement of all receipts and disbursements on my account or by me in this transaction. I further certify that I received a copy of the HUD-1 Settleme~tt~lj~'ment. 'Seller Sa~an Lee Stone~ ' ~d~wer ~ ' D~vid J. Heckard Seller Brerida"'Ann Robinson \ Borrower To the best of my knowledge the HUD-I Settlement Statement which I have prepared is a tree and accurate account of tile lands which were received and have been or will be disburse~e~./~ ~ffie~etion. 03/11/2004 Settle~l(enfl,~(gent TU~ LAW OFFICES Date ' WAP~G: ~ isa crime to ~o_w!ngly make false statements to the United States On this or any other similar form. Penalties upon conviction can include a fine and ~nt. For details se[: Title 18 U.S. Code Section 1001 and Section 1010. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD OO4O31 ROBINSON JAMES M 28 SOUTH PITT STREET CARLISLE, PA 17013 ........ foJd ESTATE INFORMATION: SSN: 201-18-1990 FILE NUMBER: 2103-0856 DECEDENT NAME: JACKSON CHARLES L DATE OF PAYMENT: 06/1 0/2004 POSTMARK DATE: 06/1 0/2004 COUNTY: CUMBERLAND DATE OF DEATH: 09/24/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $9,858.23 TOTAL AMOUNT PAID: 89,858.23 REMARKS: J ROBINSON SEAL CHECK# 138 INITIALS: VZ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF ZNDZV'rDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z&0601 HARRISRURG, PA 17128-0601 JAMES M ROBINSON TURO LAW OFFICES 28 S PITT ST CARLISLE PA 17015 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOT/CE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX '04 JUL 30 08-O2-ZOOq ESTATE OF JACKSON BATE OF DEATH 09-Iq-Z00:5 ~I~E NUMBER 21 0~-0856 COUNTY CUMBERLAND ACN 101 Aeoun~ RecLined REV-15~7 EX AFP (01-05} CHARLES L HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:5 CUT ALONG TH'rS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~,~ REV-1547 EX AFP (01-03} NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF JACKSON CHARLES L FILE NO. 21 05-0856 ACN 101 DATE 08-02-200~ TAX RETURN NAS: (X} ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1 Real Es~a~e [Schadule A) 2 S~ocks and Bonds (ScheduZa B) $ Closely HeZd Stock/Partnership Zn~eres~ (Schedule C) Mortgages/No,es Receivable (Schadule D) S Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) 6 Jointly O~ned Proper~y (Schedule F) 7. Transfers (Schadule G) 8. To,al AssaYs APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Ada. Costs/Misc. Expanses (Schedule H) 10. Debts/Hot,gage Liabilities/Liens (Schedule Z) 11. To*al Deductions 12. Ne* Value of Tax Re~urn (1) 1~2~ 15:5.25 (a) .00 ($) .00 .00 (~) 10~/601.95 (6) .00 NOTE: To insure proper credi~ ~o your account, subei~ ~he upper portion of ~his form wi~h your ~ax payment. (7) 19/q7q.q7 (a) 266,229.65 1:5,981.95 (9) :5:5,176.02 (11) ~7.]~7.97 (12) 219,071.68 15. lq. NOTE: ASSESSMENT OF TAX: 15. Amoun~ of Line lq a~ Spousal ra~e 16. Aeoun~ of Line lq ~axable a* Lineal/Class A ra~e 17. Aaoun~ of Line lfi a~c Sibling ra~a lB. Amoun'l: of Line lq taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDZTS: PAYMENT RECEIPT DISCOUNT DATE NUMBER INTEREST/PEN PAID 06-10-ZOOq CDOOqO:51 (10) Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) . O0 Ne"l: Value of Es~a~e Sub~ec~ ~:o Tax (lq) 219,071.68 Tf an assesseent #as issued peeviously~ lines 1~ 15 and/or 16~ 17, 18 and 19 ee~lect ~iguees that include the total o~ ALL returns assessed to date. (15) .00 X O0 : .00 (16) 219,071.68 x Off5 = 9,858.25 (17) . O0 x 12 : . O0 (18) .00 x 15 = .00 (19)= 9,858.2:5 .00 AMOUNT PAID ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 9,858.2:5 TOTAL TAX CREDIT I 9,858.23 BALANCE OF TAX DUEJ .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 ( ZF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ZSTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for 1ifa or for years, the Comeonmealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class B (collateral) rate on any such futura interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (71 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Hilts printed an the reverse side. --Make check or money order payable to: REGISTER OF RILLS, AGENT 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-1513). Applications are available at the Office of the Register of Hills, any of tho 13 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-361-ZOS0; services for taxpayers with special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). Any party in interest not satisfied with the appraisement, aZloaanca, or disalIowance of deductions, or assessment of tax (including discount or interest) as shown an this Notice must object aithin sixty (60) days of receipt of this Notice by: --aritten pretest to the PA Department of Revenue, Board of Appeals, Oept. 181011, Harrisburg, PA 17118-1011, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg, PA 17118-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for e Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. if any tax due is paid within three (3) calendar months after the dacadent's death, a five percent (SX) discount of the tax paid is alloaad. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6X) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1981 will bear interest at a rate which mill vary from calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through Z004 ara: Interest gaily Interest Daily Interest Dail~ Year Rate Factor Year Rate Factor Year Rate Factor 1981 201 .OOOSq8 T~'8-1991 iix .000301 ~ 9Z .O00Zq7 1983 16Z .000438 1992 9Z .000247 2002 6Z .000164 1964 11Z .000301 1993-1994 72 .O00leZ 2003 52 .000157 1985 1~Z .000356 1995-1998 9Z .000247 2004 41 .OOOXXO 1966 lOX .000274 1999 72 .000192 1987 IOZ .000Z74 ZOO0 7Z .00019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINI~UENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent ail1 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. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ROBINSON JAMES M 28 SOUTH PITT STREET CARLISLE, PA 17013 uu____ fold ESTATE INFORMATION: SSN: 201-18-1990 FILE NUMBER: 2103-0856 DECEDENT NAME: JACKSON CHARLES L DATE OF PAYMENT: 02/24/2005 POSTMARK DATE: 02/24/2005 COUNTY: CUMBERLAND DATE OF DEATH: 09/24/2003 NO. CD 004984 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $196.90 I I I I I I I I TOTAL AMOUNT PAID: $196.90 REMARKS: J M ROBINSON CHECK# 523 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS ..v-~EX.'" III ... ~:!!l. UIII:~ .,lL8 :I:~... UlLlII lL oC . REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFiCIAL USE Ot'JL Y I COII~lH Of' PENNSYLVANA DEP_BIT Of' REVEMJE DEPT. 28OllO1 tWlRISIIURG, PA 17128-OllO1 ... Z ~ ~ DECEDENT'S NAME (lAST, FIRST, AND MIDDlE INITIAl) Jackson, Charles L ALE NUMBER 21 03 00856 COUNTY CODE YEAR NUMBER SDaAL SECURITY NUMBER 201-18-1990 THIS RETURN MUST Be FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 201-16-3628 3. Remainder Return (dale of death prior to 12-13-82) o 4. Umited Estate 0 4a. FuIure Inlerest Compromise (dale of death allBr 12-12-82) 181 6. Decedent Died Testate (AlIach copy 0 7. Decedent Maintained a Living Trust (Atlach of WilO copy of Trust) o 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (dale of death ~ 12-31-81 and 1-1 1ltIS.C110IUIU8TIIII~AU.OOR.""~MDCOfIIIIIDEItTW. TAX~_~8E~'iuto: AME COMPLETE MAlUNG ADDRESS James M Robinson 20. 0 CHECK HERE IF YOU ARE ~EQUESTI'.G A REFUr\D OF A', OVERPAY"ErH ..,......toU..va_QUEST..OM Rl!'v'I!MI!IIJiEMDftIICItEcK MA11f<< Fonn REV-1600 EX (Rev. 6-00) Copyright 2000 fann software only The Lackner Group, Inc. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 09/24/2003 03/11/1926 o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11.Eleclion to tax under Sec. 9113(A) (Attach Sch 0) -0- 4,375.65 OF APPLICABLE) SURVMNG SPOUSE'S NAME (LAST, ARST AND MIDDLE INITIAL) Jackson, Mary Agnes 1. Original Return 2. SUpplemental Return None None -0- None -0- (8) 4,375.65 .... .,z 1II:l!l III:z 8f RM NAME (If applicable) Turo Law Offices 28 South Pitt Street Carlisle, PA 17013 0.00 0.00 (11 ) (12) (13) (14) 0.00 4,375.65 13. Charitable and Governmental BequestsfSec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Une 12 minus Une 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 4,375.65 E NUMBER 717/245-9688 z o ~ j ::;) ... iL M III: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or SoIe-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-VIVOS Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Unes 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Unes 9 & 10) (9) (10) 15. Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15) or transfers under Sec. 9116(a)(1.2) z 4,375.65 .045 (16) 0 16. Amount of Line 14 taxable at lineal rate x ~ ~ ::;) lL 17. Amount of Une 14 taxable at sibling rate x .12 (17) :E 0 U ~ 18. Amount of Une 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) (1 ) (2) (3) (4) (5) (6) (7) 12. Net Value of Estate (Une 8 minus Une 11) 196.90 196.90 Decedent's Complete Address: STREET ADDRESS 53 South 35th Street CTIY Camp Hill I STATE PA IZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) (1) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 196.90 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 Total Interest/Penalty (D + E) 4. If Line 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Une 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Une 5 + SA. This is the BALANCE DUE. (3) 0.00 (4) (5) 196.90 (SA) (5B) 196.90 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;..................................................................................... ~ e ~: ::~~:=7::.~.~.~.~~~:~.~.~.i.~:::::::::::::::::::::::::::::::::::::::::: d. receive the promise for life of either payments, benefits or care?................................................................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................. ..... ......................... ... ............................................. ..... ......... 0 ~ 3. Did decedent own an .in trust for" or payable upon death bank account or security at his or her death?.............. 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?................................... ....................... ......................................................... .... 0 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPlETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of peljury, I declare 1hat I ha\Ie examined this retum, including accompanying schedules and -..ems, and to the best of my knowledge and belief, it is true, com!Ct and complete. 0ecIanIIi0n of prepare< other than the personal reprllSefIlalMt is based on aM inbmation of which prepare< has any knowtedge. SIGNATURE OF PERSON RESPONSIBLE FOR FlUNG RETURN ADDRESS DATE s..n Stoner 1002 Allen Street New Cumberland, P A 17070 ADDRESS 112 Valley View Road New Cumberland, P A 17070 ADDRESS 28 South Pitt Street Carlisle, P A 17013 ;;l.-~s-oS- dates of death or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net va\ue of transfers to or for the use of the surviving spouse is 3% [72 P.S, 59116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net vaJue of transfers to or for the use of the surviving spouse is ()'l(, [72 P.S. 59116 (a) (1.1) (iQ). The sIatute does not exemot 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 ()'l(, (72 P.S. 59116 (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 n P .S. 59116 1.2) [72 P.S. 59116 (a) (1)). The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 59116 (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. *' SCHEDULE B STOCKS & BONDS COMIIONII'IEAI.1H OF PENNSYlVANIA IlltERlTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jackson, Charles L I FILE NUMBER 21 - 03 - 00856 AI property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION UNIT VALUE VALUE AT DATE NUMBER OF DEATH 1 Met1ife, Inc. common stock 28.23 4,375.65 TOTAL (Also enter on line 2, Recapitulation) 4,375.65 BUREAU OF INDIVIDUAL TAXES INHERITANt[ TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REY-1547 EX AFP lUl-D31 JAMES M ROBINSON TURO LAW OFFICES 28 S PITT ST CARLISLE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-02-2004 JACKSON 09-24-2003 21 03-0856 CUMBERLAND 101 CHARLES L Allount Rellitted PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV= iS4j-EX-AFP-foY=03Y-NoYicE--OF-YNHEifiTAirCE-YA'X-APPRAysEPfitrr:--ALrOwANcE-cfi------------- ---- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF JACKSON CHARLES L FILENO. 21 03-0856 ACN 101 DATE 08-02-2004 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 142,153.25 .00 .00 .00 104,601.93 .00 19,474.47 (8) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 266,229.65 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 13,981.95 33.176.02 (11) (12) (13) (14) 47.157 97 219,071. 68 .00 219,071.68 NOTE: l~ an assessment was issued previously, lines 14,15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ~ returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate 16. Allount of Line 14 taxable at Lineal/Class A rate 17. Allount of Line 14 at Sibling rate 18. Allount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due (15) .00 X 00 = .00 (16) 219,071 .68 X 045 = 9,858.23 (17) .00 X 12 = .00 (18) .00 X 15 = .00 (19)= 9,858.23 TAX CREDITS: 1(~l,;~.l1"1 l+J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 06-10-2004 CD004031 .00 9,858.23 TOTAL TAX CREDIT 9,858.23 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) REV -1600 EX of. (6.ool . REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE OI\!L Y I FILE NUMBER 21 03 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 00856 NUMBER COMMONWEAL lH OF PENNSYlVANIA OEPARTMENT OF REVENUE OEPT.280601 HARRISBURG, PA 171:z8.0601 DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Jackson, Charles L .... z UJ c UJ o UJ c DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 09/24/2003 03/11/1926 REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) Jackson, Mary Agnes 1. Original Return 2. Supplemental Return 201-16-3628 3. Remainder Retum (date of death prior to 12-13-82) UJ ~ ~ I/) 0 4. Limited Estate 0 4a. Future Interest Compromise (dale of death 0 5. Federal Estate Tax Return Required 1d g: G after 12-12-82) 5 fi1 9 181 6. Decedent Died Testate (Attach copy 0 7. Decedent Maintained a Living Trust (Attach 0 8_ Total Number of Safe Deposit Boxes It m of Wil~ copy of Trust) <( 0 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between 0 11.Election to tax under Sec. 9113(A) (Attach Sch 0) 12-31-91 and 1-1-95 T....IS SECTION MUS'fBE C()I\IIPLETED.ALLCORRESPONDENCE AND CONFJDENTIALTAxINFORMATJ(jN SHOULD BE DIRECTED TO: AME COMPLETE MAILING ADDRESS , .... James M Robinson I/)z ::! ~ IRM NAME (If applicable) 2l t5 Turo Law Offices 00.. z o ;:: :3 ~ .... n: <( ld 0: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6_ Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-VIVos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 28 South Pitt Street Carlisle, P A 17013 (1 ) 142,153.25 (2) N o.!l~_ . .. (3) None (4) None (5) 104,601.93 (6) None (7) 19,474.47 (9) 13,981.95 (10) 33,176.02 OFFICIAL USE O~JL Y ELEPHONE NUMBER 717/245-9688 ,(~ 266,229.65 (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 47,157.97 219,071.68 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 219,071.68 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15) or transfers under Sec. 9116(a)(1.2) z 219,071.68 .045 (16) 0 16. Amount of Line 14 taxable at lineal rate x ~ .... ~ (17) 0.. 17. Amount of Line 14 taxable at sibling rate x .12 :IE 0 0 ~ 18. Amount of Line 14 taxable at collateral rate x .15 (18) .... 19. Tax Due (19) 9,858.23 9,858.23 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. .... .., <"'. \,>;,,;;;~i~E"SQRjS\JQ~~swEifkL;Q(jES'riONS':c5N'~$ESlbEMb~HECK MATH << Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) D~cedent's Complete Address: STREET ADDRESS 53 South 35th Street CITY Camp Hill ISTATE PA !lIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 9,858.23 Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund S. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line S + SA. This is the BALANCE DUE. (3) 0.00 (4) (5) 9,858.23 (SA) (5B) 9,858.23 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;..................................................................................... n 15<1 ~: ~:::~ :~e::i:::i~t=~~:.~.~.~.I~.~~~.~~~.~~~~.~~~~~.~~~~~.~~.~~..i.~.~~:::::::::::::::::::::::::::::::::::::::::: ~ ~ d. receive the promise for life of either payments, benefits or care?................................................................. [j ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?..... .......................... .................... ............ ..................... ............................. ........ 0 o ~ ~ ~ o 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 IndMdual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?.. ..... ................ .............................. .... ......... ....................... ........................ ... ... IF THE ANSWER TO AtN OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties eX perjUl}', I declare that I have examined this return, including accompenying schedules and slalements, and to the best of my knowledge and belief, it is true, COITllCl and complele. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DAlE Sus Lee Stone~ 1002 Allen Street ~Cl')u, New Cumberland, PA 17070 t -/5tj-()l.j SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DAlE Brenda Ann Robinson 112 Valley View Road New Cumberland, PA 17070 ADDRESS 28 South Pitt Street Carlisle, P A 17013 &> -b'1-Ct( dates of deat on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if the 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 decedent's siblings is 12% [72 P.S. ~9116 (a) (1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. . SCHEDULE A REAL ESTATE COMMONl'lEAl.THOF PE/oIIISYlVAIIIA IIotERITANCE TAX RETUlN RESIDENT DECEDENT ESTATE OF Jackson, Charles L I FILE NUMBER 21 - 03 - 00856 All real properw owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be excnanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable. knowledge of the relevant facts. Real property which is jointly-owned with right of sUlVivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 39,474.75 53 South 35th Street (1/2 interest) Hampden Township, Cumberland County, Pennsylvania 2 609 Market Street New Cumberland Bora, Cumberland County, Pennsylvania 52,678.50 3 611 Market Street New Cumberland Boro, Cumberland County, Pennsylvania 50,000.00 TOTAL (Also enteron Line 1, Recapitulation) 142,153.25 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONI'IEALTH OF I'ENllSYlVAIIIA IIotERITANCE TAX RETlRN RESIDENT DECEDENT ESTATE OF Jackson, Charles L I FILE NUMBER 21 - 03 - 00856 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of . survivorship must be disclosed on schedule F. .. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 30,463.84 M & T Bank - Acct. No. 310039145800278 2 M & T Bank - Acct. No. 98206133 3 PNC Bank - Acct. No. 51-4003-1629 4 Waypoint Bank - Acct. No. 750008119 5 Waypoint Bank - Acct. No. 5500032825 6 WaypointBank-Acct. No. 754188774 7 Waypoint Bank - Acct. No. 754220189 8 2001 Chevrolet Malibu Sedan 21,626.16 4,177.30 28,053.57 120.54 8,160.52 10,000.00 2,000.00 TOTAL (Also enter on Line 5, Recapitulation) 104,601.93 *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEAL iH OF PENNSYLVANIA INHERITANCE TAX RElURN RESIDENT DECEDENT Jackson, Charles L I FILE NUMBER I 21 - 03 - 00856 ESTATE OF This schedule must be com Dieted and filed if the answer to any of Questions 1 throuQh 4 on Dage 2 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF NUMBER Include the name of the transferee, their relationship to decedent and the date of transfer. VALUE OF ASSET DECO'S EXCLUSION TAXABLE VALUE Attach a copy of the deed for real estate. INTEREST (IF APPLICABLE) 1 M&T Bank IRA Acct. 35004201785499 1,907.23 100% 1,907.23 2 M&T Bank IRA Acct. 35004201785506 6,466.22 100% 6,466.22 3 Waypoint Bank IRA Acct. 125504829 4,653.75 100% 4,653.75 4 Waypoint Bank IRA Acct. 125507635 3,957.99 100% 3,957.99 5 Waypoint Bank IRA Acct. 725510151 2,489.28 100% 2,489.28 TOTAL (Also enter on line 7, Recapitulation) 19,474.47 . SCHEDULE H FUNERAL EXPENSES & ADlVNSTRATIVE COSTS COMMONI\IEAL TH OF PENolSYLVMlA I'*ERlTANCE TAX RETl.F<N RESIDENT DECEDENT ESTATE OF J ks Ch 1 L ac on, ar es I FILE NUMBER 21 - 03 - 00856 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: Parthemore Funeral Home & Cremation Services, Inc. 8,795.70 2 Rolling Green Cemetery 870.00 3 Stephenson's Flowers 44.38 1. ADMINISlRA lIVE COSTS: Personal Representative's Commissions B. Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City Year{s) Commission paid 2. Attorney's Fees State _ Zip 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Mary Agnes Jackson Street Address 53 South 35th Street City Camp Hill 3,500.00 Relationship of Claimant to Decedent State P A Spouse Zip 17011 4. Probate Fees Cumberland County Register of Wills Cumberland Law Journal The Sentinel- Legal Accountant's Fees 384.00 75.00 112.37 5. 6. Tax Return Preparer's Fees R. Calhoun & Associates, Inc. 200.50 7. Other Administrative Costs 1 TOTAL (Also enter on line 9, Recapitulation) 13,981.95 . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMOIW1lEALTHOF PEl\NSYLVMlA II'I-ERITANCE TAX RET1.RN RESIDENT DECEDENT I FILE NUMBER 21 - 03 - 00856 ESTATE OF Jackson, Charles L Include unreimbuFSed medical expenses. ITEM NUMBER 1 DESCRIPTION AMOUNT PNC Bank - Credit Line - Acct. No. 40-03-048001988683 900.23 2 M & T Bank - automobile loan 2,182.33 3 Keystone Oil- heating oil for 609 Market Street, N. Cumb. 938.00 4 State Farm Insurance Co. - homeowners ins. on 609 & 611 Market Street, N. Cumbo 622.00 5 Freysinger Pontiac - outstanding auto repair bill 180.39 6 Wachovia Bank - credit card balance 234.04 7 MBNA America - credit card balance 331.04 8 Sears - credit card balance 87.50 9 Verizon 125.72 10 Boro. of New Cumberland - sewer & trash for 609 & 611 Market St., N. Cumbo 272.91 11 State Farm Insurance Co. - automobile policy 322.26 12 PPL Electric Utilities 8.03 13 Monumental Life Insurance Co. - Rachel Lloyd 125.35 14 Commonwealth ofPennsylania - duplicate car title & registration renewal 58.50 15 Costs to prepare 611 Market Street for sale 365.10 16 Robin Gasperetti, Tax Collector - 2004 County/Boro. Real Estate Tax 263.14 17 Recorder of Deeds - record deed to 609 Market Street, N. Cumberland 39.50 18 PA Dept. of Revenue - 2003 Income Tax 5.00 19 Washington Mutual Home Loans - 1/2 Mortgage Balance 26,005.69 20 Freysinger Pontiac Inc. - Inspect car in preparation for sale 109.29 TOTAL (Also enter on Line 10, Recapitulation) 33,176.02 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT JAMES M ROBINSON TURD LAW OFFICES 28 S PITT ST CARLISLE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-28-2005 JACKSON 09-24-2003 21 03-0856 CUMBERLAND 101 Allount RelliUed PA 17013 '* REV-1607 EX AFP (03-05) CHARLES L MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ................................................................................................~............... REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF JACKSON CHARLES L FILE NO.21 03-0856 ACN 101 DATE 03-28-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE. AND. IF APPLICABLE. A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-02-2004 PRINCIPAL TAX DUE: 9.858.23 PAYMENTS (TAX CREDITS): PAYMENT DATE 06-10-2004 02-24-2005 RECEIPT NUMBER CD004031 CD004984 DISCOUNT (+) INTEREST/PEN PAID (-) .00 .00 AMOUNT PAID 9.858.23 196.90 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE. SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) (."t,.,,' --..\ 10.055.13 196.90CR .00 196.90CR CSL<:::''''- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX Z806111 HARRISBURG PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF XNHERITANCE TAX APPRAISEHENT, .AUOWANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX J :~5 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-16-2005 JACKSON 09-24-2003 21 03-0856 CUMBERLAND 101 " JAMES M ROBINSON TURO LAW OFFICES 28 S PITT ST CARLISLE *' REV-1547 EX AFP (03-05) CHARLES L Amount Remitted SL.o MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ it!V_~~,."ft.mwm~m'.W'tM.!II!'.!MftAWUW.m.llWnYlMJtW1'~.'m:r.w~m:y.aW'.............. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF JACKSON CHARLES L FILE NO. 21 03-0856 ACN 101 DATE 05-16-2005 PA 17013 TAX RETURN WAS: [X I ACCEPTED AS FILED I CHANGED NOTE: I~ an assessment was issued previDusly, lines 14, 15 and/Dr 16, 17, 18 and 19 will re~lect ~igures that include the tDtal D~ ALL returns assessed tD date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS. .00 X 00 = .00 223,447.33 X 045 = 10,055.13 .00 X 12 = .00 .00 X 15 = .00 (191= 10,055.13 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Real Estate {Schedule AJ (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule DJ (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (S) 6. Jointly Owned Property (Schedule f) (6) 7. Transfers (Schedule G) (7) 8. Total Assets NO. 01 .00 4.375.65 .00 .00 .00 .00 .00 [81 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax .00 .00 ll11 ll21 ll31 ll41 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 4,375.65 on 4,375.65 .00 223,447.33 . .t~t!., I'J AHOUNT PAID DATE NUHBER INTERESTIPEN PAID (-I 06-10 2004 CD004031 .00 9,858.23 02-24-2005 CD004984 .00 196.90 BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-25-2005 TOTAL TAX CREDIT 10,055.13 BALANCE OF TAX DUE .00 INTEREST AND PEN. 5.60 TOTAL DUE 5.60 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADOITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" [CRI, YOU HAY BE OUE A REFUND. SEE REVERSE SlOE OF THIS FORH FOR INSTRUCTIONS. I RESERVATION: Estates of decedents dying on or before Decsllbsr 12, 1982 -- if any futurs interest in ths sstats is transfBrred in posssssion or snjoymsnt to Class B (collateral) bsnsficiaries of ths dscedsnt aftsr the expiration of any sstats far lifs or far years, ths Co.monwsalth hsrsby exprsssly rsssrvss the right to appraiss and assess transfer Inhsritancs Taxss at ths lawful Class B (collateral) rats on any such futurs intsrsst. PURPOSE OF NOTICE: To fulfill ths rsquirellsnts of Section 2140 of the Inhsritancs and Estats Tax Act, Act 23 of 2000. (72 P.S. Section 9140), PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Detach ths tap portion of this Notice and subllit with your paymsnt to the Register of Wills printed on ths reverse side. --Maks check or money ordsr payable to: REGISTEROFWn.LS,AGENT. Failure to pay ths tax~ intersst, and penalty due .ay result in ths filing of a lien of rscord in the appropriats county, or the issuancs of an Orphan's Court citation. A rsfund of a tax credit, which was not rsquested on ths Tax Return, may bs requested by completing an "Application for Rsfund of Pennsylvania Inheritancs and Estate Tax" (REV-13l3). Applications are available online at www.revsnus.state.Da.us. any Register of Wills or Revenus District Office, or from the Departllent"s 24-hour answering service for farms orders: 1-800-362-2050; ssrvices for taxpaysrs with special hearing and/or speaking nssds: 1-800-447-3020 (TT only). Any party in intersst not satisfisd with ths appraisment~ allowance or disallowance of deductions or asssssment of tax (including discount or intersst) as shown an this Notice .ay object within 6D days of the date of receipt of this notice by filing one of the fallowing: A) Protest to the PA Departmsnt of Revenus, Board of Appsals. You may objsct by filing a protsst online at www.boardofaDDeals.stats.Da.us on or bsfore the expiration of the sixty-day appeal period. In order for an electronic protest to be valid, you must receivs a confirmation numbsr and procssssd date froll the Board of Appeals website. You .ay also send a written protest to PA Department of Revsnus, Board of Appeals P.O. Box 281021, Harrisburg, PA 17128-1021. Pstitions may not bs faxed. B) Election to have ths matter detsrmined at the audit of the account of the personal rspresentative. C) Appsal to the Orphans' Court. Factual errors discovsred on this assess.ent should be addrsssed in writing to: PA Department of Revenue, Bursau of Individual Taxes, ATTN: Post Assessmsnt Review Unit~ P.O. Box 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the book 1st "Instructions far Inheritance Tax Return for a Resident Decedent" (REV-150l] far an explanation of administratively correctable errors. If any tax due is paid within thres (3) calendar months aftsr the decsdent.s death, a fivs percent (5X) discount of the tax paid is allowed. Thu 15X tax amnesty non-participation penalty is co.puted an the total of the tax and interest asssssed, and not paid befors January 18, 1996, the first day after the end of the tax a.nesty period. This non-participation penalty is appealabls in the salle lIanner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notics. Interest is chargsd bsginning with first day of delinquency~ or nine (9) .onths and ons (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bsar interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rats which will vary from calendar year to calendar year with that rate announcsd by the PA Dspartment of Revenue. The applicable interest ratss for 1982 through 2005 are: Interest Dally Interest Daily Interest Rate Factor Year Rats Factor Year Rats ~ -:00= !ml-1991 --rr:r-:1!i!i!'JliI" 2liiil. --.:r- l6X .000438 1992 9% .000247 2002 6X 11% .000301 1993-1994 7% .000192 2003 5% 13X .000356 1995-1998 9% .000247 2004 4X lOX .000274 1999 n .000192 2005 5% 10% .000274 ZOOO n .000192 Year rn!2 1983 1984 1985 1986 1987 Daily Factor ."/i'ii"iiZ4T .000164 .000137 .000110 .000137 --Intersst is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issusd after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of ths assessment. If payment is made aftsr the intsrest computation date shown on the Notice, additional intersst must bs calculated. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA 17128.0601 REV-1162 EX(11-96l RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ROBINSON JAMES M 28 SOUTH PITT STREET CARLISLE, PA 17013 .,,_uu f"ld ESTATE INFORMATION: SSN: 201-18-1990 FILE NUMBER: 2103-0856 DECEDENT NAME: JACKSON CHARLES l DATE OF PAYMENT: OS/20/2005 POSTMARK DATE: OS/20/2005 COUNTY: CUMBERLAND DATE OF DEATH: 09/24/2003 NO. CD 005348 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $5.60 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 553 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $5.60 GLENDA FARNER STRASBAUGH REGISTER OF WillS BUREAU OF INDIVIDtMir)-1XE1V INHERITAI<<:E TAX DIVISI'oN:-'-. ,--. PO BOX Z80601 HARRISBURG PA 171Z8-06DI COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX '* REY-1547 EX AFP (03-05) Z005 MAY 20 FlilZ: 41 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-16-2005 JACKSON 09-24-2003 21 03-0856 CUMBERLAND 101 ~unt Re.ltted CHARLES L CLERK OF ORP'~"""C' I~I~" '"'T ! li,: 'J ":) j,)un JAMES MCJt~~~IlIt( Ci~ TURD LAW OFFICES 28 S PITT ST CARLISLE PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ... 1UV-"MIl,."tf.WJ.m~'1I!'.'lftJm!I!.!II!'.!N\JtIrt'lM!'t.mr."Wft"mM.'ltt'~.'lrC[WIB.DYr.............. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF JACKSON CHARLES L FILE NO. 21 03-0856 ACN 101 DATE 05-16-2005 TAX RETURN WAS: (X I ACCEPTED AS FILED I CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. R..l Estate (Schedule A) (1) 2. Stocks ~ Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. MOrtgages/Notes Receivable (Schedule DJ (4) S. Cash/Bank D.posits/Hisc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets NO. 01 .00 4.375.65 .00 .00 .00 .00 .00 181 NOTE: To insure propel" credit to your account, s~lt the upper portion of this for. with your tax pay_nt. 4,375.65 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adn. Costs/Hisc. Expenses (Schedule H) (9) 10. Debts/Hortgage Liabilities/Liens (Schedule X) (10) 11. Total Deductions 12. Net Value of Tax Return 13. Ch8ritable/Gover~ental Bequests; Non-elected 9113 Trusts (Schedule ~) 14. Net Value of Estate Subject to Tax .00 .00 1111 1121 1131 11~1 nn 4,375.65 .00 223,447.33 NOTE: If an assessment was issued previOUSly. lines reflect figures that include the total of ~ ASSESSMENT OF TAX: IS. Amount of Lin. 14 at Spousal rate (IS) 16. Anount of Lin. 14 taxable .t Lineal/Class A rate (16) 17. AROUnt of Line 14 at Sibling r.t. (17) 18. A.aunt of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due AX C 14. 15 and/Dr 16. 17. 18 and 19 will returns assessed tD date. .00 X 00 = 223,447.33 X 045 = .00 X 12 = .00 X 15 = 1191= .00 10,055.13 .00 .00 10,055.13 DATE 06-10-2004 02-24-2005 NUI1BER CD004031 CD004984 + IHTEREST/PEN PAID (-I .00 .00 AI1DUNT PAID 9,858.23 196.90 , BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-25-2005 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 10,055.13 .00 5.60 5.60 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS.I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ROBINSON JAMES M 28 SOUTH PITT STREET CARLISLE, PA 17013 ---~---- fold ESTATE INFORMATION: SSN: 201-18-1 990 FILE NUMBER: 2103-0856 DECEDENT NAME: JACKSON CHARLES L DATE OF PAYMENT: 02/24/2005 POSTMARK DATE: 02/24/2005 COUNTY: CUMBERLAND DATE OF DEATH: 09/24/2003 NO. CD 004984 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $196.90 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: J M ROBINSON CHECK# 523 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS $196.90 GLENDA FARNER STRASBAUGH REGISTER OF WILLS BUREAU OF INOIVIDUAL<TAXES ' INHERITANCE TAX DIVISIDH,- PO BOX 280601 HARRISBURG PA 171lB-D6Dl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REY-1607 EX AFP (03-05) .. r., _~ ,).) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-20-2005 JACKSON 09-24-2003 21 03-0856 CUMBERLAND 101 CHARLES L JAMES MROBINSON TURD LAW OFFICES 28 S PITT ST CARLISLE A.aunt H...i tted PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this for. with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ................................................................................................................ REV-1607 EX AFP (03-05) ~*~ INHERITANCE TAX STATEMENT OF ACCOUNT KKK ESTATE OF JACKSON CHARLES L FILE NO.21 03-0856 ACN 101 DATE 06-20-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-16-2005 PRINCIPAL TAX DUE: 10,055.13 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-10-2004 COO04031 .00 9,858.23 02-24-2005 CD004984 .00 196.90 05-20-2005 CD005348 5.60- 5.60 TOTAL TAX CREDIT 10,055.13 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 . ~ SIDE FDR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIr' ICRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Charles L. Jackson Date of Death: September 24, 2003 Estate No.: 2003-00856 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 !Xl No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No !Xl 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 JX] No 0 Date: c. Copies of receipts, releases, joinders and approval offonnal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. , ~ aoptember 12, 2005 N ,''") Name 28 South Pitt Street Carlisle, PA 17013 .. .~ '. (',j Address c~' , (717) 245-9688 Telephone No. Capacity: o Personal Representative ua Counsel for personal representative ~~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 8/30/2005 ROBINSON JAMES M 28 SOUTH PITT STREET CARLISLE, PA 17013 RE: Estate of JACKSON CHARLES L File Number: 2003-00856 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 9/24/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, .~ L~1A) ~ ~ JJ , ~ GLENDA FAP~~ER STP~,SBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge ep