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HomeMy WebLinkAbout04-0560H~:,rold W. Gleason, Jr. iP, egi.,:;b:.;r W Wills of Cumberh~r,d County, Panr~sytvar, ia PETITION FOR GRANT OF Deceased LETTERS No. Social Security No, _04._7..1,2~_5.6_ who 1',),3r¢ lC, y,'.~ar.¢ ct agrt or old,~r, appiy(,~.s) tot. E'i'E "A" OR "B" BEt.OW:) A, P~ob,':~te al'~d GrRrcf of I.ettars and aver that Petilioner(s) is/are the execut o,...r_~ named in tho L~st Will of the St,',W relevnnt circumsl;.~nccs, Q ~., ronunc¢.~tlon, do[~!,ll o! execdor, e. to Ex,'o::Ft as r¢llows. Dec~dent did ~ot m.';.rry, v,',,..; n,,~l divor~:Ld 3nd did not havo a child bom or adopted after execution of for p~ob;~ic, w4~r~ r,'.,t tl~e victim of a Idll;r,9 and w~s nev,~r adjud~c~lerJ (if ;~l,y) and lit. irs; [:L Cr~t of t.cW~fs of Adl;lir, istrafion (c I.~. d b d c t,a.. porulenle file. du~anl,', ab~entia; duranto mfnodtuto) f'cdtir>ner(S) r~/tcr n proper so3rch ha,JIl~v) a~cortain, ,I lhe Decedent left no Will and was sw~ived by tho following spouse :(COMPL[[:'I't'~ IN Al.l,. CASES:) All, ach r4dditional sheets if necessary. t')¢;i;~xiel;l w~s doff,( iliad r~t dealh in ~[[J.nD[~r[;~¢. ............................. County, Pennsylvania, with his/her last family or principal rm. idon¢:,~ m ~lj E~?~))~tj~p.~_~[.~.~,.[~grg.[J~l~ 9[~)~f~.~E~E[~}S~.M&?land County, Pennsylvania (li~l St,~et, number and municipalily) (Location) 0f dOmk;ilud in PA) All personal propei'ty ......................................... $__ __ 500,000.¢~ Jif rl¢[ d~srrltcilc-d in PA) Pursonal property in Pennsylvania .................... (if nnt (Inr~htii,~d in I.'A) Personal property in County .............................. VWuo d' rc,~l e~,ta~c In F ~,1¢-]1v,1~12 ................................................... $ 0.00 'l'~tal ..................................................................................................................... $__ 500 000,00 P,Wfi4,¢er(s) rcspccdul[y f~.quest(.,.) the prob:~le of the I.aSt Will and Codicil(s) presenied wiW this Petition and the gr~mt of letters in tho ~ W,;~,si(~n,~d: ~~ ~ ~J~u ~ Ty~,d or pdntcd name and residen~ I ~.r~8~,l~;.~Ll~(h Vice Presiden~Trust OMcer,. Orrstown ................................................................................ Bank~.( O.~o~E~_.~hj~2~rD.~u~g~ p~ 17~o~ ....................... f {W.'7 Oath of Personal Representative Comrnonwe ltl' of Pennsylvanb OOt:lFl[y Of Cun'~horland "i ho P6.-tilioner(s) above-named swear(s) and affirm(s) that tho staternents in the [oregoin9 Pe[idon are true ;:,~nd correct I.o ti~¢.~ best of the kno'wledg0 ~¢~f.I belief of Petitioner(s) and that, as~ representative(s) of the Decedent, 5;W0r'n Lo and affkmcd and subscribed -~ .....~~ ~~ ~ .......... Bradley S. G~~PresidenCTrust Officer Orrss[own Bank bef.::,re I'~u ti~isJ~ ............................ day of 0ECREE OI-; REGtS'f'ER CtJMRERI..AND COUN'rY E i.;k~i',? Cfi J:.t.¢.O,.~id ~.~,,..~J!~.g..O.~J.r.~. Deceased Social Srmuri[y No: _~-_t.7. J_'Z'.C. '-.':%~ .... Date of Death: 6/5/2004 AND NOW, ,.J.t.,~?:~ ............... ~...,~.. ................................2004 , in consideration of tho Petition on thc., reverse side I~er¢~on, ~,atir~r;~clory proof h~',cing been presented before me, I']' IS I]~CREt.:L) that I.et[ers C~ l"esk~mer, ta~ ~ of Adminislration (C I a., d.b.n c.t.; pendcnte hte; dura,to ~bsonl~a; (luJ~nte minor~tale) ir~ !lie @bov~..., est3te and ~:l~at the instrument(s), if any, da[ed ~N~v..e_rn_b~r.~_:6~_~2g..0..L ............................................ d,i:scdb(xJ in tho Pe. til:ion be adc niJtc:d to probate and filed o1' record as the last Will of Decedent. FEES I.,::;R¢:rs ................................... $ ..... 37500 Renur'~c{ation ......................... $ ................................ Xlfi,t.,..', il ( ) ....................... ['[x'tr;~, I:'~,~,gc',,"; ( 7 ) .............. $ ............ _2_1_:.0_0_ [,',Odicil ................................. $ .ICP I::e;~ ................................. $ .................. J._O.,,p_O_ h'w,:,,ntoW & Tax Forms ............. $ .................. (')lh~;~r. .................................... $ .................. r~W-7^ A[!.omey Attorney: Joel R, Zull[n_Q?, Esq,. u-¢ I.D. No: 17516 :_~ Address: 14 No,th Main S!:reot, Suite 200 Chambersbur,q PA 17201 l'elephone: 717-264-6029 DATE FILED: 611512004 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 ~~ "' '~'?/:'?"Local ~Registrar No. ~ Date // //29-275 COMMONWEALTH OF PENNSYLVANIA a DEPARTMENT OF HEALTH · VITAL RECORDS --~ CERTIFICATE OF DEATH (Coroner) STATE Fli. E NUMBER ~-~ ",,ME OF CECEDENT (F*~. M~., Harold AGE (LaM B~rthday) UNDER 1 yEAR Momh~ Days 80 ~,,. COUNTY OF DEATH Cumberland Professor 201 South Queen Street Shippensburg, PA 17257 ISEX ISOClAL SECURITY NUMBER o . IDA'rE OF DEATH (M(~lh. Day, Ye.a~) W Cleason, Jr. ,- Male 3. 047-12-2556 :.~ 4. June 5~ 2004 UNDER 1 DAY DATE OF BIRTH I BIRTHPLACE (C~' and PLACE OF DEATH (Chr~ck only one -- see I~str UCFOhs on O1~ S~) Hours MinutesI (M,~. Da,. ,.0 I .st.c, Fo,oig. co~.,ry) IHOSmTAL: IOTHER: .ec 30,1923 ?. Hartford, CT ~.~'"~ ER/OutpaUertt[~ DOA(~ NOffi~ [] R.~Ce~ (Spec2fy)[] . CITY. I{U~RO~ITW P OF DEATH IFAClLITY NAME (If nol ms°lull)n, give steel and n~mber) IWAS DECEDENT OF HISPANIC ORIGIN? I RACE - American Indian. Black. White. elc. ,.' Shippensburg .-.- 201 S. Queen Street ..?'~""'P"r~R~"~'"¢' ,,.'~ White KIND OF RUShSIES~INDUSTB¥ WAS DECEDENT EVKR IN DECEDENT'S EDUCATION ~ MARIIA[ ST~U~; - Married ~ SURVIVING SPOUSE DECEDENT'S ACTUAL 17a. Slate P ~ -~ l~ani~ D~ 17©.[] Y~, decede~ ~ved In F~'st, M ,:Jdie. Last) Harold Willard Gleason (Type/Print) Elisabeth C. Humez O~TE OF mSPOS,T,ON dETHOO OF ~SPOSrT~N (MOnth, Day, Year] oone,~.[-I o.~(s~) [] ~. June 10, 2004 [ UCENSE,UMSER death occurred at the time. dele and place slated. LICENSE NUMBER DATE SIGNED ' {(Mor~h. Day. Year) ~3a. DATE PRONOUNCED DEAD (Mo~th, Day. Year) WAS CASE REFERRED TO MED L EXAMINER/CORONER? only One cam on each line. ~ ~t °~'val belwean mx resulting in Iha underlying mum° given in PART 1. . , Chronic Obstructive Pulmonary Disease t Hypertensive Cardiovascular DUE TO (OR AS A CONSEQUENCE OF): I disease. OFDEATH? Natural ¢ Hom~:i~e [] Yes [] No [] ToUte~lotm¥1mowl~<Jg~,dealhoccurredduetoU~ecaul~(s)and ..... toted ..................................................... I I .~. /I~(D~/ '~ - Coroner MOTHER'S NAME ~Fkst, Middle, MaVen Surname) ~. Constance Coleman INFORMANT'S MAILING ADDRESS (S~reet, City/Town. Stale. Zip Code) a~ 21 Parker Street, Lexington, MA 02421 PLACE OF D{SPOSITION - Name of Corn°tory. Ct°ma{my I LOCATION - City/Town, Slate. Z~p Code orOtherPinca Cremation Society I~'~- of Pennsylvania Cremator~,~. Harrisburg, PA 17109 N*MEANDADORESSOF~C~L~Crematlon ~oclety ot Yennsylvania I,,~. 4100 Jonestown Road, Harrisburs~ PA 17109 'MEDICAL EXAMINER/CORONER On the haiti of examlnlt ion IndJor Investigation, in my opinion, death occurred ii th° time, dM°, and pile°, and due lo the caul°ia) arid .ICEN~ NUMRER I DATE SIGNED (Mort{h, Day. Year) .c. 3,,. June 8, 2004 ~AME AND ADDRESS OF N O b'TED OF 6375 Basehore Rd., Suite #1 ~. Mechanicsburg, Pa. 17050 DATE FILED (Mon{h. Day. Year) // JRZ 5.1 gleason.1 November 9, 2001 LAST WILL AND TESTAMENT I, Harold W. Gleason, Jr., of 201 South Queen Street, Shippensburg, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby declare this to be my will, hereby revoking any and all former wills and codicils thereto by me heretofore made '~j ~ · ~ I. ,,~q I direct that all my just debts and funer~ expenses, including all expenses of my last illness, shall be paid from my estate as soon as practicable after my decease as a part of the expense of the administration of my estate. II. I give, devise and bequeath the residue of my estate of every nature and wherever situate as follows: A. Five percent thereof to my granddaughter, Emily Gleason, subject to the trust provisions set forth in paragraph IV. In the event my said granddaughter, Emily Gleason, predeceases me or dies on or before the thirtieth day following my death, her share shall be distributed to her brother, Evan Gleason, under the terms of subparagraph B Bo Co Do herein. Five percent thereof to my grandson, Evan Gleason, subject to the trust provisions set forth in paragraph IV. In the event my said grandson, Evan Gleason, predeceases me or dies on or before the thirtieth day following my death, his share shall be distributed to his sister, Emily Gleason, under the terms of subparagraph A herein. Ninety percent thereof to Patricia Duran Gleason, provided, however, should the said Patricia Duran Gleason, predecease me or die on or before the thirtieth day following my death, her share shall be distributed to my granddaughter, Emily Gleason, and my grandson, Evan Gleason, in equal shares, provided that said share shall not be distributed outright but shall be distributed to Orrstown Bank, Orrstown, Pennsylvania, in trust, for the benefit of Emily Gleason and Evan Gleason, under the terms of the trusts provisions set forth in subparagraph IV, subparagraph E, of the will of my late wife, Rose P. Gleason. In the event both Emily Gleason and Evan Gleason predecease me or die on or before the thirtieth day following my death, their share shall be distributed to their mother, Patricia Duran Gleason. Pa~e 2 III. In the event my grandchildren, Emily Gleason and Evan Gleason, and my daughter-in-law, Patricia Duran Gleason, predecease me or die on or before the thirtieth day following my death, I give and devise the residue of my estate of every nature and wherever situate as follows: A. Twenty-five percent thereof to my sister, Elizabeth G. Humez, of Lexington, Maine, provided, however, should my said sister predecease me or die on or before the thirtieth day following my death, her share shall be distributed as set forth in subparagraph B of this Paragraph III. B. Seventy-five percent thereof to my nephew, Nicholas D. Humez, of Maplewood, New Jersey. IV. In the event that anyone entitled to a share of my estate shall be under the age of twenty-five years at the time for distribution to such beneficiary, I constitute and appoint the Orrstown Bank, with offices in Shippensburg, Pennsylvania, as trustee of any property which passes either under this will or otherwise to said beneficiary. Said trustee shall in the trustee's sole discretion and without order of court, use principal as well as income from time to time as may appear to be necessary for the Page 3 beneficiary's welfare, comfort, medical care, recreation, support and education, without responsibility to the beneficiary or to any person taking care of the beneficiary; and the remaining balance in the hands of said trustee shall be distributed to said beneficiary when the beneficiary attains the age of twenty-five years. If such beneficiary dies prior to attaining the age of twenty-five years, said trustee is authorized in the trustee's discretion to pay part or all of the beneficiary's funeral expenses and the remaining balance in the hands of said trustee shall be distributed to the beneficiary's personal representative. In the event the funds held by the trustee for any beneficiary become in the opinion of the trustee too small for proper and efficient administration, the trustee, in the trustee's sole discretion, may deposit such funds in a savings account in the name of the beneficiary. Vo Any fiduciary under this will shall have the following powers in addition to those vested in them by law and by other provisions of my will applicable to all property whether principal or income, including property held for minors, exercisable without Court approval, and effective until actual distribution of all property: A. To retain any and all of the assets of my estate, real or personal, without regard to any principle of diversification of risk. B. To invest in all forms of property including stock, Page 4 Co Do Eo common trust funds and mortgage investment funds without restriction to investments authorized for Pennsylvania fiduciaries as they deem proper, without regard to any principle of diversification of risk. To sell at public or private sale, to exchange or to lease for any period of time any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. To compromise any claim or controversy. To distribute in cash or in kind or partly in each. To hold property in their names without designation of any fiduciary capacity or in the name of a nominee or unregistered. VI. I direct that all taxes that may be assessed in consequence of my death of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. Page 5 VII. I appoint the Orrstown Bank, with offices in Shippensburg, Cumberland County, Pennsylvania, as executor of this my will. VIII. The interest of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation; and the principal and income shall be paid by the trustee or guardian directly to or for the use of the beneficiary entitled thereto, without regard to any assignment, order, attachment or claim whatever. IX. No bond shall be required of any fiduciary hereunder in any jurisdiction. IN WITNESS WHEREOF, I hereunto set my hand and seal to this my last will and testament, consisting of eight typewritten pages, the first five of which bear my signature in the margin for the purpose of identification this ._~,--~ay of /~,/~ , 2~O/. Page 6 Signed, sealed, published and declared by the above-named testator as and for his last will and testament in our presence, who in his presence, at his request and in the presence of each other have hereunto set our hands as attesting witnesses. whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his last will and testament and that he executed it as his free and voluntary act for the purposes therein expressed and that each of the witnesses, in the presence and hearing of the said testator signed the will as witnesses and to the best of their knowledge said signer was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~ ~-esta6or ~ Page 7 Subscribed, sworn to and acknowledged before me by the above-named signer and subscribed and sworn to before 9e by the ~b~¥~-named/witnesses this ~,~ay of ti- Notary P~bii&--~- ~ I Nl{3hole J. ~ Notary Public I .ShlpL~lnli~.rg Bom, CUmbe~ County [My ~ommlsslon F-.xptres Aug, 18, 200~ Page 8 NOTICE ~ -o~-5~O TO: Department of Public Welfare Thi~.d Party Liability Unit Estate Recovery Program P.O. Box 8486 Willow Oak Bx'~.ildin~ I{a~"~:'isburg, PA 17105-8486 D A',F~¥1): Jur~e 14, 2004 YOu are hereby noti.fi¢,d that Harold W. Gleason,~'i.-!Jr. born Dec.~,mber ~%0, 1923, S/S 1~0.I-7--12-2556, died on J~,,ne 5, 200..%. At the tinge of d~.':a~;h, the decedent r~sided at 201 Souttl Que~.~ Street, Shipp~.~.n£:bur,~, Penllsylvania. 'l'he approximate value of decedent'~.',' .qro~':s est',ate i~,'~ $500,000.00. You are r~-~,quz~s~ed to provide a statemen~ of all 1nedical ~'.~-]sist;~n¢?e provided to ~.he decedent~ within five years preceding d~-z:t:h. A clair~t t~L~%st 13e su]')mitted to the estate by the Department O.t t"~lblic Welfare witl].~n thirty days of receipt of this notice, or t.h~: claim shall be for£eited, Orrst ow~i~ank, Executor Box 250 Shippensburg, PA 17257 La~ Of ficc~ ZULLINGER - DAVIS PROFESS ION~tL CORPORATION 14 Nor'~h Main Stee,::t 20 En~t Burd street ~:uite ~00 $ufte 6 (h~n~'~err, hurg, FA 17201 Shippen~burg, PA 17257 717-?~4-60~o ' FAX: 717-26~,18&4 FAX= 717-530-5~22 June 14, 2004 D~7'.~],~'r't~.Y~c~z~-[: of Public Welfare 'l'hil'd, Pa:uty l,'[g~bility Unit I~s~',at,~ Recovery Program 17.0. Box 8486 Wi'liow 0~: Bl.litdin~ ltarrisbur~, PA 3.73-05-8486 RE: Estate of }Iarold W. Gleason, Jr. 3: reprex~ent tlxe Estate of Harold W. Gleason, Jr. who died on ,')'eyre 5 2004 ]~;nclosed J.s the noU, ice required ttnder 62 P.S ,.,t=c[:ic)n .].4]..2. Y'our response shou].d be directed to me as attorney Very truly yours, Joe], R. Zu3,1inDer Estate of Harold W. Gleason, Jr. Cumberland County CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Harold W. Gleason, Jr. Date of Death: 6~5~2004 Will No. 2004-00560 Admin. No. 21-04-0560 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on $u1¥ 7, 2004 · Name Address Emily Gleason 962 Clyde Lane Philadelphia PA 19128 Evan Gleason 962 Clyde Lane Philadelphia PA 19128 Patricia Duran Gleason 962 Clyde Lane Philadelphia PA 19128 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:, no exceptions Date: July 7, 2004 Capacity: Signature-- Name: Joel R. Zullinger Address: 14 North Main Street, Suite 200 Chambersburq PA 17201 Telephone(264) - 6029 X Personal Representative CoUnsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BURFAU 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 004341 ORRSTOWN BANK P.O. BOX 250 SHIPPENSBURG, PA 17257 ........ fold ESTATE INFORMATION: SSN: 047-12-2556 FILE NUMBER: 2104-0560 DECEDENT NAME: GLEASON HAROLD W JR DATE OF PAYMENT: 09/03/2004 POSTMARK DATE: 09/03/2004 COUNTY: CUMBERLAND DATE OF DEATH: 06/05/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $28,000.00 TOTAL AMOUNT PAID: $28,000.00 REMARKS: ORRSTOWN BANK SEAL CHECK# 17851 INITIALS: CCP RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS 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. CD REV-1162 EX(11-96) OO4829 ORRSTOWN BANK P.O. BOX 25O SHIPPENSBURG, PA 17257 ........ foJd ESTATE INFORMATION: SSN: 047-12-2556 FILE NUMBER: 2104-0560 DECEDENT NAME: GLEASON HAROLD W JR DATE OF PAYMENT: 01 / 12/2005 POSTMARK DATE: 01/1 2/2005 COUNTY: CUM BERLAN D DATE OF DEATH: 06/05/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 ~10,080.15 TOTAL AMOUNT PAID: $10,080.15 REMARKS: SEAL CHECK# 019185 INITIALS: MW RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 _ 04 0560 COUNTYCODE YEAR NUMBER I-. Z UJ UJ LU LU z r~ z 0 0 X DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) GLEASON, HAROLD W. JR. DATE OF DEATH (MNI-DD~YEAR) I DATE OF DIRTH (MM-DB-YEAR) 06/05/2004 ] 12/30/1923 (iF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 047-12-2556 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER r~l. Original Return [~4. Limited Estate [~]6. Decedent Died Testate (A~ach copy F---~ 9. Litigation Proceeds Received E~]2, Supplemental Return [~4a. Future Interest Compromise (date of death after 12-12-82) r--] 7. Decedent Maintained a Living Trust (A~ch copy of'rrustl F-Il O. Spousal Povedy Credit (dale of death between 12-31-91 and 1-1-95) F~3. Remainder Return (da[e of death prior to 12-13-82] E~5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes r--] 11. Election to tax under Sec. 9113(A) (A~ch Sch O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME BARBARA E. BROBST FIRM NAME (iFApplica~le) ORRSTOWN BANK TELEPHONE NUMBER (717) 530-2605 COMPLETE MAILING ADDRESS P.O. BOX 250 SHIPPENSBURG, PA 17257 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 Properly (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) E-]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, Modgage Liabilities, & Liens (Schedule I)(10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. 14. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) 430,939.02 289,570.75 4,096.25 193,519.81 (8) 918,125.83 64,511.29 8,281.87 (11) 72,793.16 (12) 845,332.67 (13) 0.00 (14) 845,332.67 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 Line 14 taxable at collateral rate 19. Tax Due 826 786.42. x .o 45 .......... 14 45_0_._0~0 x .12 ....... 4 096.25 x .15 (15) (16) 37,205.39 (17) 1,734.00 (18) 614.44 (19) 39,553.83 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH ¢ < Decedent's Complete Address: 201 SOUTH QUEEN STREET CITYsHIPPENSBURG Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 28,000.00 1,473.68 l STATEpA 3. Interest/Penalty if applicable Total Credits (A + B + C ) (2) D. Interest E. Penalty ZIP 17257 Total Interest/Penalty ( D + E ) (3) 4.If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) ,5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE, (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT (1) 39,553.83 29,473.68 10,080.15 10,080.15 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; .......................................... [] [] c. retain a reversionary interest; or .......................................................................................................................... [] [] 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 consi~eration'~ 3. Did decedent own an "in trust for or payable upon death bank account or security at his or her dea h? . t ............... [] [] 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 belief, it is true, correct and complete. on of preparer otber than the ~hich preparer has any knowl e. 0 PREPARER OTHER TH~,~ RE~RES~N'~A'I:IV-E ..... ~ DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute ..d.oes not exempt a transfer to a surviving spouse from tax. and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only 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 RS. §9116(a)(t)]. 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. REV-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GLEASON, HAROLD W. JR. SCHEDULE B STOCKS & BONDS FILE NUMBER 21-04-0560 All property jointly-owned with right of survivorship must be disclosed on Schedule F, ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 25,000 PAR CAPITAL ONE FDIC CD 4.15% MATD 10/24/2004; CUSIP 14040VDD3 ACCRUED INTEREST ON ITEM #1 200 SHS CENTRAL VA BANCSHARES, CUSIP 155792104 ACCRUED DIVIDEND ON ITEM #3 15,000 PAR CUMBERLAND VALLEY S/D 4.9% MATD 11/15/2017; CUSIP 230822MA3 ACCRUED INTEREST ON ITEM #5 10,000 PAR DAUPHIN COUNTY PA 4.85% MATD 11/15/2014; CUSIP 238253NU8 ACCRUED INTEREST ON ITEM #7 15,000 PAR DOWNINGTOWN PA S/D 4% MATD 6/1/2015; CUSIP 261097QS1 ACCRUED INTEREST ON ITEM 10,000 PAR FEDERAL HOME LOAN MTG CORP 4.75% MATD 10/1/2012; CUSIP 3128XOBD0 ACCRUED INTEREST ON ITEM #11 10,000 PAR FEDERAL FARM CREDIT BANKS 3.06% MATD 5/11/2007; CUSIP 31331TE64 ACCRUED INTEREST oN ITEM #13 25,000 PAR FEDERAL HOME LOAN BANKS 4.53% MATD 10130/2006; CUSIP 3133MJAL4 ACCRUED INTEREST ON ITEM #15 10,000 PAR HOPEWELL TWP. PA 4% MATD 11/1/2015; CUSIP 439663FL4 ACCRUED INTEREST ON ITEM #17 9408.864 SHS LORD ABBETT AFFILIATED FUND A; CUSIP 544001100 28345.04 SHS FEDERATED MONEY MARKET FUND ~51; CUSIP 60934N625 ACCRUED DIVIDEND ON ITEM #20 15,000 PAR NORTH ALLEGHENY CO. PA 3.1% MATD 5/1/2009; CUSIP 656678KZ1 ACCRUED INTEREST ON ITEM #22 10,000 PAR NORTH ALLEGHENY CO PA 4.15% MATD 5/1/2015; CUSIP 656678LCl ACCRUED INTEREST ON ITEM (If more space is needed, insert additional sheets of the same size) 25,260.75 115.28 5,403.00 30.45 15,323.55 38.79 10,406.30 25.60 14,698.80 6.67 9,544.57 71.25 9,841.26 221.00 25,763.30 113.25 9,918.30 27.78 129,136.66 28,345.04 3.79 14,863.80 42.63 9,937.20 38.04 1,/ OMMONWEALTH OF PENNSYLVANIA/ STOCKS & BONDS INHE.,T^.CE R URN / GLEA$ON, HAROLD W. JR. (CONTINUATION $HEET 2) FILE NUMBER 21-04-0560 ITEM NUMBER 1. 26 27 28 29 30 31 32 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. DESCRIPTION 6096.0293 SHS NUVEEN MUNICIPAL BOND FUND CLASS R; CUSIP 67065Q400 25,01:)0 PAR PA HIGHER ED 5% MATD 6/15/2019; CUSIP 7091744R4 ACCRUED INTEREST ON ITEM #27 30,000 PAR UPPER STRASBURG PA 0% MATD 4/1/2021; CUSIP 863475HW2 467.728 SHS VANGUARD S/T CORP ADM FUND ~39; CUSIP 922031836 25,000 PAR WEST CHESTER PA S/D 2.6% MATD 11/15/2009; CUSIP 952030RU0 ACCRUED INTEREST ON ITEM # 31 VALUE AT DATE OF DEATH 54,620.42 25,423.25 600.69 12,431.10 4,971.95 23,680.25 34.30 TOTAL FROM CONTINUATION SHEET 2 121,761.96 (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~[STATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER GLEASON, HAROLD W. JR. 21-04-0560 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O 21 22 DESCRIPTION ORRSTOWN BANK CHECKING ACCOUNT #103002646; SOLE OWNERSHIP ACCRUED INTEREST ON ITEM #1 ORRSTOWN BANK IRA ACCOUNT # 0960 ACCRUED INTEREST ON ITEM # 3 PERSONAL PROPERTY AS APPRAISED BY DENNIS L. GOTSHALL, AUCTIONEER 1993 FORD TAURUS 4D SEDAN; 37,000 MI; APPRAISED BY DENNIS GOTSHALL, AUCTIONEER JEWELRY (6 LOTS); AS APPRAISED BY GEM ONE GEMOLOGIST APPRAISERS PERSONAL PROPERTY DESTROYED BY FIRE; APPRAISED BY USAA INSURANCE COMPANY M&T BANK CHECKING ACCOUNT ¢~7260339; JT OWNERSHIP WITH ROSE P GLEASON (DECEASED 11/2000) ACCRUED INTEREST ON ITEM ~9 PENTAGON FEDERAL CREDIT UNION SAVINGS ACCOUNT # 874257-01-7 CASH FOUND IN WALLET MBNA, CREDIT BALANCE DUE DECEASED AMERICAN EXPRESS, CREDIT BALANCE DUE DECEASED DISCOVER CARD, CREDIT BALANCE DUE DECEASED SPRINT, REFUND OF CREDIT BALANCE AFT SUBSCRIPTION SERVICES, CANCELLATION REFUND COMCAST, REFUND OF CREDIT BALANCE PSERS, FINAL BENEFIT PAYMENT FLEET BANK, CHECKING ACCOUNT 008125875 (SOLE OWNERSHIP) ACCRUED INTEREST ON ITEM #20 FLEET BANK, SAVINGS ACCOUNT # 0186125875 (If more space is needed, insert additional sheets of the same size) VALUE AT DATE Of DEATH 8,486.68 0.47 51,541 .O2 6.66 12,817.00 2,160.00 2,900.00 40,866.99 115,610.35 7.42 150.76 218.00 84.79 17.47 2.60 19.97 162.56 37.40 470.58 54,007.42 1.61 1.00 2.89,570.75 REV-1509 ,EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER GLEASON, HAROLD W. JR. 21-04-0560 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. ERIKA L. STEVENS FRIEND 1010 CLEARFIELD RD, SHIPPENSBURG, PA 17257-9346 JOINTLY-OWNED PROPERTY: LE'~ ~K DATE DESCRIPTION OF PEOPEI~TY % OF DATE OF DEATH ITEM FOR JOINTMADE INCLUDE NAME OF FINANCIAL INSTITUTION NdD BANK ACCOUNT NUMBER OR SiMiLAR DATE OF DEATH DECD'S VALUE OF _NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLYd-IELD REAL ESTATE. VALUE OF ASSET Ih~t~t:~lDECEDENT'S INIt:KE3 I 10/08/2003 ORRSTOWN BANK CHECKING ACCOUNT# 103004554 8,192.50 50. 4,096.25 _ TOTAL (Also enter on line 6. RecaDitu ati0nl $ 4,096.25 (If more space is needed, insert additional sheets of the same size) REV-1510, EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GLEASON, HAROLD W. JR. SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-04-0560 This schedule must be completed and tiled if the answer to any of questions 1 thm, ~h 4 on the revl '; -' ~1 ......... u,,uU~l,i ~ uH u,~; I~;Vt:l~ ~lU~ UI [lIB r~rV-I:IUU !~UVll( ~11-l- I es yes. ITEM DESCRIPTION OF PROPERTY NUMBEF INCLUDETHE NAME OFTHETRANSFEREE, THEIRRELATIONSHIPTODECEDENTAND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE THE DATE OF TRANSFER. ATTACHACOPYOFTHEDEEDFORREAJ. ESTATE. VALUE OFASSET INTEREST OF~PUC_.~LE) VALUE 1. TEACHER INSURANCE AND ANNUITY CONTRACT ~]-813370-4; 14,450.00 100 14,450.00 DEFERRED ANNUITY; BENEFIClARY-ELISABETH G. HUMEZ-SISTER; 2 TEACHERS INSURANCE AND ANNUITY CONTRACT ~]U24729-2; COLLEGE RETIREMENT EOUITIEIS FUND; BENEFICIARY-PATRICIA D. GLEASON (DAUGHTER-IN-LAW) 129,544.57 100 129,544.57 3 TEACHER INSURANCE AND ANNUITY CONTRACT #1E70064-7; BENEFICIARY-PATP, ICIA D. GLEASON (DAUGHTER-IN-LAW) 49,525.24 100 49,525.24 TOTAL (Also enter on tine 7 Recapitulation) $ 1 93,519.81 ~pace is needed, insert additional sheets of the same size) REV-15f1 EX+ (12~99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~STATE OF GLEASON, HAROLD W. JR. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-04-0560 Debts of decedent must be reported on Schedule [. ITEM NUMBER DESCRIPTION AMOUNT 5. 6. 7. 8 9 10 11 12 FUNERAL EXPENSES: CREMATION SOCIETY OF PENNSYLVANIA ADMINISTRATIVE COSTS: Personal RepresenlatJve's Commissions Name of Personal Representative(s) ORRSTOWN BANK Sodal Security Number(s)/EIN Number of Personal Representative(s) StreetAddrees 77 EAST KING STREET Cb SHIPPENSBURG .State PA Zip 17257 Year(s) Commission Paid: 2005 AttomeyFees JOEL R. ZULLINGER, ESQUIRE Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State . Zip Relationship of Claimant to Decedent Probate Fees AccountanPs Fees TUCKEY RESTORATION SERVICES, PREPARING B00KSFFOR AUCTION CUMBERLAND LAW JOURNAL, ADVERTISING LET]'ERS CARL L. SPIDEL, SERVICES FOR PUBLIC SALE DENNIS L. GOTSHALL, AUCTIONEER SERVICES THE NEWS-CHRONICLE, ADVERTISING LETTERS GEM ONE, JEWELRY APPRAISAL FOR ESTATE LITTMAN JEWELERS, JEWELRY APPRAISAL FOR ESTATE 304.46 30,000.00 30,000.00 451.00 1,826.88 75.00 50.00 1,227.95 101.00 i5o.00 325.00 (If mom space is needed, insert additional sheets of the same size) REV-1512 EX+ ('12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER GLEASON, HAROLD W. JR. 21-04-0560 Re )orr debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2 3 4 5 6 7 8 9 10 AMERICAN EXPRESS, CREDIT CARD BALANCE DUE USAA, CREDIT CARD BALANCE DUE DISCOVER CARD, CREDIT CARD BALANCE DUE CARE AD, FINAL BALANCE DUE FOR SERVICES TO DATE OF DEATH PENELEC, BILL DUE AT DATE OF DEATH BOROUGH OF SHIPPENSBURG, BILL DUE AT DATE OF DEATH CHAMBERSBURG IMAGING ASSOCIATES, BALANCE DUE SPRINT, BALANCE DUE AT DATE OF DEATH VERIZON WIRELESS, BALANCE DUE AT DATE OF DEATH CHAMBERSBURG HOSPITAL, FINAL BALANCE DUE BANK OF AMERICA, RETURN BENEFIT PAYMENTS PAID AFTER DATE OF DEATH TOTAL (Also enter on line 10, Recapitulation) $ 28.07 27.95 274.94 3,551.38 113.92 122.53 5.18 255.48 33.82 52.00 3,816.60 8,281.87 (If more space is needed, insert additional sheets of the same size) EX'+ (9-0o) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER GLEASON, HAROLD W. JR. 047-12-2556 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1 II TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under ORRSTOWN BA~,S11~EE FBO EMILY GLEASON P.O. BOX 250 SHIPPENSBURG, PA 17257- ORRSTOWN BANK, TRUSTEE P.O. BOX 250 SHIPPENSBURG, PA 17257 EVAN GLEASON PATRICIA J. DORAN 962 CLYDE LANE PHILADELPHIA, PA 19128 granddaughter gcandson 5% of Estate ($40,288) 5% of Estate ($40,288) daughter-in-law 90% of Estate ($725,200) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS residue residue residue (If more space is needed, insert additional sheets of the same size) HAROLD W. GLEASON JR. ESTATE FILE # 21-04-0560 PROPERTY DISTRIBUTED TO LINEAL HEIRS @ 4.5%: SCHEDULE B-STOCKS & BONDS SCHEDULE E-CASH, BANK DEPOSITS, MISC PERSONAL PROPERTY SCHEDULE G-ANNUITIES LESS: DEDUCTIONS TOTAL TAX DUE @ 4.5% PROPERTY DISTRIBUTED TO SIBLINGS @ 12%: SCHEDULE G-ANNUITY TAX DUE @ 12% PROPERTY DISTRIBUTED TO COLLATERAL HEIRS @ 15%: SCHEDULE F-JOINTLY OWNED PROPERTY TAX DUE @ 15% VALUE $430,939.02 $289,570.75 $t79,069.81 -$72,793.16 $826,786.42 $14,450.00 $4,096.25 $37,205.39 $1,734.00 $614.44 TOTAL INHERITANCE TAX DUE $39.553.83 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX BARBARA E BROBST ORRSTOWN BANK PO BOX 250 SHIPPENSBURG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-28-2005 GLEASON JR 06-05-2004 21 04-0560 CUMBERLAND 101 '*' REV-1547 EX AFP (03-05) HAROLD W Allount Rellitted PA 17257 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 ~ IUv.-.t!1:"Yf.m.m~'1M1.wtm.W.!MMArr4M.'r.m.~m~mJtWf~.')ftr.!N'4Atr.r.l'.............. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GLEASON JR HAROLD W FILE NO. 21 04-0560 ACN 101 DATE 03-28-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED I~ an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and r~lect ~igures that include the total o~ ~ returns assessed to date. ASSESSMENT OF TAX: lS. AIIount of Line 14 at Spousal rate (lS) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) lS. AlIOunt of Line 14 taxable at Collateral/Class B rate (lS) 19. Principal Tax Due AX CRED TS: 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. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. ~ointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets ll) (2) (3) (4) (S) (6) (7) .00 430.939.02 .00 .00 289.570.75 4.096.25 193.519.81 (S) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/AdII. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts 14. Net Value of Estate Subject to Tax 64.511.29 (9) 1l0) 8.281.87 Ill) (12) (13) lllt) (Schedule ~) NOTE: .00 X. 826.786.42 X 14.450.00 X 4.096.25 X + INTEREST/PEN PAID (-) 1.473.68 .00 AMOUNT PAID 28.000.00 ' 10.080.15: DATE 09-03-2004 01-12-2005 NUMBER '- CD004341 CD004829 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 00 _ d~: 1:2'TJ '::"J = IS= :..j :: . ( 19}~i NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYll8nt. 918.125.83 72.793 16 845.332.67 .00 845.332.67 19 will i~; . 00 ;~7 .205.39 ~?:.:~ 1 . 73ti; ;00 :::J 614 ~4~ ..39. 553 ;8~ w u; 39.553.83 .00 .00 .00 . 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" (CR). YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~'5 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 ZULLINGER JOEL R 14 NORTH MAIN STREET,SUITE 200 CHAMBERSBURG, PA 17201 RE: Estate of GLEASON HAROLD W JR File Number: 2004-00560 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS. COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/05/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~=::=~ Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Ot Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 ORRSTOWN BANK P.O. BOX 250 SHIPPENSBURG, PA 17257 RE: Estate of GLEASON HAROLD W JR File Number: 2004-00560 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. ~s per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. rhis filing is due by: 6/05/2006 ~lease feel free to contact this office with any questions you may nave. If you have already filed your Status Report, please disregard this notice. Sincerely, Jt~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court :::c: File ('nlln.c::el Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Harold W. Gleason, Jr Date of Death: June 5. 2004 Estate No.: 21-04-0560 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 ~ 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 Kl b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the persor~ representative state a...~ account informally to the pa..-rties in interest? Yes 0 No IKl c. Copies of receipts, releases, joinders and approval offormal or infotn'1al accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. iJ'. .' ~~ Date: May 2, 2006 . ~~,(!-6~ --.:J, S' a e -."...... I (.>) _J Daniel K Baer Name PO Box 250 Shippensburg, PA 17257 Address 717-530-3903 Telephone No. Capacity: !:Xl Personal Representative o Counsel for personal representative '^' U 1-\ \,'V \,