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HomeMy WebLinkAbout04-0569 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004058 CHADWICK ELAINE A 117 TORY CIRCLE ENOLA, PA 17025 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ ford 101 $2,500.00 ESTATE INFORMATION: SSN: 059-12-8862 FILE NUMBER: 2104-0569 DECEDENT NAME: CHADWICK VICTOR DATE OF PAYMENT: 06/16/2004 POSTMARK DATE: 06/1 6/2004 COUNTY: CUMBERLAND DATE OF DEATH: 03/29/2004 TOTAL AMOUNT PAID: $2,500.00 REMARKS' E A CHADWICK CHECK# 1087 INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Victor Chadwick No. also known as , Deceased Social Security No. 059-12 - 8862 Elaine A. Chadwick Petitioner(s), who is/are 18 years of age or older, apply(les) for: (COMPLETE 'A' or 'B' BELOW:) ---] A. Probate 9nd Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut named in the last Will of the Decedent, dated I//,~%/o! and codicil(s) dated None Testator's spouse, Julia R. Chadwick, predeceased him (7/25/03) State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: ~_~. none [----] B. Grant of Letters of Administration (c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; d3:a;ante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spous~!~f any) and heirs: . · I Name Relationship Residence I (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 117 Tory Circle, Enola, Enola, PA 17025 (list street, number, and municipality) Decedent, then 84 years of age, died 03/29/200zat Holy Spirit Hospital, PA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 3,600.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: none Wherefore, Petitioner(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: I _. Signature, Typed or printed name and residence I 117 Tory Ct., Enola, P^ 17025 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW- 1 (1991 ) Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) or afffirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. ~ Elaine A. Chadwick before me this i ~ da)/of '7-i- Estate of Victor Chadwick Deceased ~%: -: 8ecial Security No: 059-12 - 88(::E~te of Death: 03/29~2004. AND NOW. ,.TI~JI ~-- I L~ , 2(.,}~ , , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me IT IS DECREED that Letters rT--'e-'~tamentary (~ilministration ;..: (c.t.a.; d.b.n.c.ta.; pendente lite; durante absentia; alul, ante minoritate) are hereby granted to Elaine A. Chadwick in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will of Decedent. etters ........... $ Z 5.00 Short Certificate(s, ..... $ t~l. 5 ,{~ ; eg's er .o,, Renunciation ........ $ Attorney: Robert C. Sat4,s' ~>-- , (/ Affidavits ( ) .... $ I.D. No: 214.58 Saidis, Shuff, Flower & Lindsay Extra Pages ( ) .... $ ,,.,l~),t,) L) Address: 2109 Market Street Codicil ........... $ Cam~) Hill, PA 17011 JCP Fee .......... $ I{~,~ Telephone: 717/737-34.05 Inventory .......... $ Other ........... $ TOT^L ......... $ qt. Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW- 1 (1991) This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. ¢/' (}~'' ~0~ WARNING: It is illegal to duplicate this eoplt blt photostat or photograph. ~1~ Local Registrar {~ No. ~ Date Rev. 1/91 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ~/29-233 (Coroner) .... ISEX .. ~ SOCIAL SECURITY NUMBER '--: Io~OF DF. ATH (Month, Cay, Ye~) Victor unaawic~ 12' male 3. 059-12-8862 _.~ ]4. Mmrch 29, 2004 AGE (Last Birihday) UNDER, YEAR J UNDER 1 DAY I ,.D, _ATE~O~ 81 .R. TH I BIRTHPLACE City and I PLACE OF DEATH (Chock only one _ see ir,~ructioos o~ o~he~ s~e) Monffm Days ~ Hours Minutel I [MOnm, [Jay, 'rear) I Stale o~ Foretgn Country) JHOSPITAL: IOTHER: COUNTY OF DF..~H ~ . CITY. BOR~ DEATH FACILITY NAME {Il not ins~ilulion, give slr6el an~ n~unber} WAS DECEDENT OF N~S~N~C ORIG N? IRACE - Ame~.~n mdmn. B~ck. W~e. etc. Cumberland I East Pennsboro I Holy Spirit Hospital I~.~l~. ~..[],,..,t..c.~c.~.. ~.-*~,~..'s u~.~ OccoF<~. I. I,.. I.. ' 1,0. White I .,ND OF SUS,.ES~,.=~.. ~.S DECEDENT EVE.,. DECEDE..'S EOUCAT,O. ~ , otwomtnglife:dorm~userefired) I v~.l"~i ~J~ I Elementary/Secondary CO~ I NlverMarrild, WIdowed, [ (Ifwlfe, give maide~ name) Inst./Specialist ,,~. NYTel I~ ...... 1,12 (~'~) I (,.4~+) Widowed DECEDENT'SUAIUNGADDRE~(SlmetCilyrrown. Stata. ZipC(x~e) [ACTUAL ,?, ~.,. Pennsylvania ,4. 117 Tory Circle · D~ ...[~v.,~..nt,~..~ E. Pennsboro IRESIDENCE decedent t~ Enola, PA 17025 I(s-,.~,~.~ i~. o~, ~ ~r.. co~, Cumber land ~o.,~? No. ~.~.nt ~ ~^*.E.'SNAME{[~,,.M~o.C.,) Stephen Chadwick ~,. Teresa Rek Elaine Chadwick I~. 117 Tory Circle, Enola. PA 1702.5 D~EOFo,s.os.~. i:.a%~,:..os.,o.. No~. ~ ~.,,.~.,.. c,.~.,ory 8u~ [] Cremation [] Removal from Stale [] I(Monlh, Day. D]3,, 4-2-04 I ..~re~er$ck Lo~scher Vets 1,3~ I,,~ Myers-Hamer FH~ 1903 Mkt St? CH? PA 17011 . P~ II no~ ~.il~bM &t tim® of dl~th to i%na~ure .nd Title) UCEN~E NUMBER B,.n~ ~o~, ~eat h. ITIM~ OF DEATH pATE PRONOUNCED DEAD (Month, Day, Year) __ I,4 12:45 AM 12' March 299' 2004 , INASCASERI=FI:I.~i~EDTOMEDICALEXAMINER/CORONER?yea ~ d~,.o,~o. Spt~al Cord Tnjurtes ,m co~d.k~. ~. Cegvtcal Fractures mume. EmerUNDE~LYING Fall in Home ,a~uran~ ~ deem) LAST PERFORMED? ,~/AI LAI~.E PRIOR TO I(Mo~m, I INJURY AT WORK? DESCRIBE HOW INJURY O~CURRED. Aprx. Unwitnessed £all in tl~OM PLETION OF CAUSE ~DEATH? ".,.,., [] .o~,0. [] Mar.28,2004 6 00 P [] No~ home ... [] No~ ., [] No [] I^~'~ I,~. 'M. 3lb. 2S~u.icide [] Couffin~b~m.m,n~ []la~i"~'et~'(s~"Y) Home 20~o~..y C~rcle, Enola~ PA -~ ~. ~ ~ ,-~----~-. ul,*n occurma uue t~ the c~u~e{,) and at~nner aa etat,d .............................. [] ilb._ ' Corol'!er '°'"'""~°""v~"~'~'.~'m~."~-"-".-.".~......~...,~...~o~.=....<.).~m~..m,~ .......................... [] "" I~". March 29. 2004 CAME AND ADDRESS OF PERSON WHO CO~4PLETED CAUSE OF DEATH 'MEDICALEXA¥1NER/CORONER (Item 27) Type or Pdnt Michael L. Norris. Coroner ~nth~m~fex"m~nat~n~nd/~nve~t~gm~en~nm¥~p~n~n~de"th~cu~r~t~het~dme'andp~ace~ndduet~thecau~{~and 6375 Basehore Road~ Suite itl m.......mt.d .................................................................................................. I}~ 3z Meehantesburg. Fa. 17050 ~/l~l /I //1 DATE FILED ,Monlh. Day. Year, VICTOR CHADWICK · I, VICTOR CHADWICK, residing at 58 May Road, Pearl River, New York, being of sound and disposing mind and memory and being mindful of the uncertainties of this life, do make, publish and declare this to be my LAST WILL AND TESTAMENT. FIRST: I hereby revoke all other Wills or Codicils heretofore made by me. SECOND: I direct that my debts and funeral expenses and any estate and similar taxes be paid as soon after my decease as may be practicable out of any trust established under ARTICLE ELEVENTH of this my Will and to the extent that such property is insufficient then out of my residuary estate without apportionment. THIRD: I request that my Executor carry out my intentions and wishes and distribute or deliver any particular items or articles of personal property which I may own, to those persons whom I may name or designate in any letters signed by me which I may leave for that purpose. Because of the confidence which I have in my Executor, this request is precatory and I do not impose any legal or equitable obligation on my Executor, knowing full well that he or she will carry out my intentions. FOURTH: I give, devise and bequeath all the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate of which I may die seized or possessed, and over which I may have power of appointment or to which I may hereafter become entitled, to my beloved wife, JULIA R. CHADWICK, on condition that my wife survives me, to be hers absolutely and forever. FIFTH: If my wife, JULIA R. CHADWICK, shall predecease me, or in the event that my wife and I shall die as the result of a common accident or disaster, or under such circumstances as to render it impossible to determine which one of us survived the other, then I direct my Executor to divide all the rest, residue and remainder of my estate as follows: A. I give, devise and bequeath ONE-THIRD (1/3) of my residuary estate to my son, GARY G. CHADWICK, per stirpes; B. I give, devise and bequeath ONE-THIRD (1/3) of my residuary estate to my son, STEPHEN F. CHADWICK, .pe~~; and C. I give, devise and bequeath ONE-THIRD (1/3) of my residuary~ estate to my daughter, ELAINE A. CHADWICK, per ~. If any of my children shall predecease me or upon the death of any of my children after my death and prior to full distribution to that child of their share under this, my Will, I direct my Executor or Trustee to divide the share of such child which remains into as many equal shares as there may be children of 2 my deceased child, him or her surviving, and to pay and to distribute said sub-shares to the said issue of my deceased child, per stirpes. If my deceased child shall have no issue, then I direct my Executor or Trustee to pay and distribute the share of my deceased child to my surviving children or to their issue if any have predeceased me, per ~, absolutely and forever. SIXTH: I nominate, constitute and appoint my beloved wife, JULIA R. CHADWICK, as the sole Executor of this, my Last Will and Testament. I nominate, constitute and appoint my daughter, ELAINE A. CHADWICK, Testamentary Trustee of the trust, if any, established under ARTICLE ELEVENTH of this, my Will. In the event that my wife shall predecease me or shall fail to qualify as Executor of this, my Will, or having qualified shall become unable to act for any reason, then I nominate, constitute and appoint my daughter, ELAINE A. CHADWICK, as first substitute Executor under this, my Will. In the event that ELAINE A. CHADWICK shall predecease me, or shall fail to qualify or act for any reason, then I nominate, constitute and appoint my son, STEPHEN F. CHADWICK, as second substitute Executor and substitute Testamentary Trustee under this, my Will. In the event that STEPHE~ F. CHADWICK shall predecease me, or shall fail to qualify or act for any reason, then I nominate, constitute and appoint my son, GARY G. CHADWICK, as third substitute Executor and substitute Testamentary Trustee under this, my Will. SEVENTH: I further direct that no bond or other security of any nature be required from any Executor or Trustee for the proper discharge of their duties under this, my Will. EIGHTH: I expressly direct that my Executor and any Testamentary Trustee or any substitute Executor or Trustee shall have full power and discretion as provided by law to act as may be deemed most advantageous and for the best interest of my estate, including, but not limited to the following: (a) To retain any property owned by me at the time of my death for reasonable periods of time; (b) To invest any funds of my estate or any trust hereunder in any stocks, bonds, notes and other securities or property, real or personal, not- withstanding that such investments may not be of the character allowed to executors or trustees by statute or general rules of law, it being my intention to give the broadest investment powers and discretion to my executor and trustee; (c) To hold, sell, lease, mortgage, or otherwise dispose of any property, real or personal, at any time forming a part of my estate or any trust hereunder, for cash or upon credit, in such manner and on such terms and conditions as my Executor and trustee may deem best, and no person dealing with it shall be bound to see to the application of any monies paid; (d) To manage, operate, repair, improve, mortgage and lease for any term (whether longer or shorter than five years or the duration of any trust hereunder) any real estate at any time held by my Executor and trustee; (e) To distribute in cash or in kind upon any division of my residuary estate or the termination of any trust hereunder; ~ (f) For administration purposes to administer the trusts created hereunder as a single entity; this provision shall not apply to any Retirement Plan assets held under any trust established under this, my Will; (g) To borrow any funds needed on behalf of the estate and to provide appropriate collateral; (h) If any portion of my estate or of any trust created by this Will shall vest in absolute ownership in a person under 21 years of age, I authorize my Executor or Trustee without authorization by any Court, to distribute any or all such property to which such person may be entitled, 4 to a Custodian of such person under the New York Uniform Gifts to Minors Act or the New York Uniform Transfer to Minors Act; (i) To continue any enterprise, business or businesses in which I may be interested at the time of my death, whether such interest is wholly or partly an individual or partnership interest or is as a holder of shares of stock in a corporation conducting such business or businesses; to settle and discontinue any of them, at such time or times and upon such terms and conditions which, in the judgment of my Executor or trustee, are for the best interests of my estate or of any trust created by my Will; and, in the discretion of my Executor or trustee, to transfer the assets of any said business to a corporation or corporations to be formed for the purpose of conducting the said business or businesses, and to retain the stock or other securities received in exchange therefor as an investment of my estate or of any trust created by my Will even though the said stock or securities may not be an investment authorized either by law or the provisions of my Will for any Executor or trustee; (and, in the discretion of my Executor or trustee, to use the property of my estate, not invested in the said business or businesses at the time of my death, for the debts and liabilities of the said business or businesses that may be incurred after my death); (j) In general, to exercise all powers in the management of my estate, and any trust hereunder which any individual could exercise in his own right, upon such terms and conditions as they may deem necessary or proper to carry out the purposes of this, my Will. NINTH: If at the time of my death I am the owner of any life insurance, insuring the life of another person, including my spouse, I give and bequeath said policy or policies to my issue, per stirpes. TENTH: If any share of the principal of my estate shall become distributable to a person who has not attained the age of twenty-one (21) years, the share of such person shall vest absolutely but shall remain in the care, control and custody of my Executor, as a separate fund under a power in trust for the benefit 5 of such person, until such person attains the age of twenty-one (21) years or earlier dies, at which time all of such principal and any accumulated income shall be paid over to such person or to their estate; and so much of such principal, and the ~et income therefrom, as my Executor may deem necessary or advisable, meanwhile, shall be paid over or applied by my Executor for the health, education, maintenance and support of such person during the period until such person attains the age of twenty-one (21) years. Any net income not paid to or applied for the benefit of such person shall be accumulated and shall be added to and administered as a part of the principal of such separate fund. In the administration of such separate fund my Executor shall have the same powers and duties as such Executor shall have in the administration of my estate. Such payments of income or principal may, in the discretion of my Executor, be paid to such person or to the parent or guardian of such person, and the receipt of such person, parent or guardian therefore, shall operate as a complete release and discharge of my Executor in respect thereof. ELEVENTH: A. If my wife shall disclaim or renounce the above residuary bequest in whole or in part, or if my wife shall disclaim or renounce any other property which may pass to my wife either under or outside of this Will, as either a testamentary or non- testamentary transfer, then any transfer which is so disclaimed or renounced shall be administered, controlled and disposed of as follows: B. I give any portion of my estate, whether passing under or outside of this Will, (which assets are not "Retirement Plan" assets or "qualified assets" as said term is commonly understood, including assets or distributions from any pension, profit sharing, individual retirement account, or other retirement plan established or existing in accordance with the provisions of Internal Revenue Code) which my wife may disclaim, to my Trustee herein named, IN TRUST, NEVERTHELESS, to invest and reinvest the same and to collect the income therefrom and to deal with the net income therefrom and with the principal thereof as hereinafter set forth. It is the primary purpose of this trust to provide for the support and care of my wife during her survivorship, and to that end my Trustee shall pay over to my wife, or for her benefit, all or such part of the net income of said trust which said Trustee shall deem appropriate in the Trustee's absolute discretion for the care, support, and maintenance of my wife. In addition, my Trustee is authorized from time to time to invade the principal of said trust in the Trustee's sole discretion as deemed necessary to provide for the care, support, and maintenance of my wife, so that my wife will at all times be able to continue to enjoy the same manner and standard of living as we~have enjoyed together. In addition to any payments of income or principal out of this portion of this trust, there shall also be paid to my wife out of the corpus, in cash or in kind, upon her request during the month of December of each calendar year, an amount which shall in no event exceed the amount of Five Thousand ($5,000.00) Dollars or five (5%) percent of the aggregate value of the corpus as then constituted, whichever is greater; provided, however, that if the request is not made for any calendar year, no payment of corpus shall be made in any subsequent year on account of the amount not so requested. This limited power shall not apply to an~Retirement Plan assets held under the provisions of ARTICLE ELEVENTH C of this, my will. C. I give any portion of my estate, whether passing under or outside of this Will, which assets are "Retirement Plan', assets or "qualified assets,, as said term is commonly understood, including assets or distributions from any pension, profit sharing, individual retirement account, or other retirement plan established or existing in accordance with the provisions of Internal Revenue Code which my wife may disclaim, to my Trustee herein named, IN TRUST, NEVERTHELESS, to invest and reinvest the same and to collect the income therefrom and to deal with the net income therefrom and with the principal thereof as hereinafter set forth. (i) My Trustee may elect to receive distributions from any pension, profit sharing, individual retirement account, or other retirement plan ("Retirement Plan") for which my trust is named as beneficiary, or contingent or successor beneficiary, in installments or in a lump sum. (ii) My Trustee shall elect to receive distributions from a Retirement Plan payable to this trust in compliance with the minimum distribution rules of the Internal Revenue Code, if applicable, and also so that at least all income earned by the Retirement Plan which may be distributed in any calendar year is distributed to the trust and allocated to trust income during the year. If distributions from the Retirement Plan total less than all income earned by the Retirement Plan for a calendar year in which any distribution is made, my Trustee shall demand additional distributions equal to at least the shortfall so that my wife will receive all income earned by any Retirement Plan at least annually. My wife shall have full power, in her discretion, to compel my Trustee to demand such distributions and to compel the Retirement Plan trustee to convert any nonproductive property to productive property. Nothing in this provision is to be interpreted as requiring my Trustee to request or compel any distribution before any applicable "required beginning date" as said term is defined and applied under the Internal Revenue Code. (iii) In calculating all income earned by any Retirement Plan, my Trustee shall allocate all Retirement Plan expenses, including income taxes and trustee's fees, that are attributable to principal distributions so that all income distributions from the Retirement Plan are not reduced. D. I specifically authorize my Executor to determine whether any Roth IRAs which are held by me and disclaimed or renounced by my wife are to be treated as ordinary assets or as Retirement Plan assets. E. On the death of my wife, this trust shall terminate and my trustee shall distribute all property then belonging to the principal of the trust, together with any income then on hand or accrued, to my issue who shall survive my wife, in equal shares, per stirpes, in accordance with the provisions of ARTICLE FIFTH of this Will. IN WITNESS WHEREOF, I, VICTOR CHADWICK, have to this, my Last Will and Testament, consisting of ten (10) pages, subscribed my name on November 26, 2001. 'VICTOR CHADWICK SIGNED, SEALED, PUBLISHED AND DECLARED by the above testator, VICTOR CHADWICK, to be his Last Will and Testament in the presence of us and each of us who at his request and in his presence and in the presence of each other have hereunto subscribed our names as witnesses on November 26, 2001. ~ ~ Residing at ~~ ~' ~c4 ~ ~~4~ Residing at~~,--~ ¢~, ~s\disclaim.m98 10 STATE OF NEW YORK ) COUNTY OF ROCKLAND ) SS.: Each of the undersigned, individually and severally being duly sworn, deposes and says: The within Will was subscribed in our presence and sight at the end thereof by VICTOR CHADWICK, the within named testator on November 26, 2001, at Pearl River, New York. Said testator at the time of making such subscription declared the instrument so subscribed to be his Last Will and Testament. Each of the undersigned thereupon signed his name as a witness at the end of said Will at the request of said testator and in his presence and sight and in the presence and sight of each other. Said testator was, at the time of so executing said Will, over the age of 18 years and, in the respective opinions of the under- signed, of sound mind, memory and understanding and not under any restraint or in any respect incompetent to make a Will. The testator in the respective opinions of the undersigned, could read, write and converse in the English language and was suffering from no defect of hearing, or speech, or from any other physical or mental impairment which would affect his capacity to make a valid Will, except a limitation and disability in vision and for this reason the Will was read to Testator in its entirety. The Will was executed as a single, original instrument and was not executed in counterparts. Each of the undersigned was acquainted with said testator at such time and makes this affidavit at his request. The within Will was shown to the undersigned at the time this affidavit was made, and was examined by each of them as to the signature of said testator and of the undersigned. The foregoing instrument was executed by the testator and witnessed by each of the undersigned affiants un~pervision of JAMES K. RILEY, attorney at law. ~ Severally sworn to before me on November 26, 2001 LORRAINE A. PIMENTEL Notary Public, State of New York No. 4981455 Qualified in Rockland County Commission Expires May 13, 2003 SELF PROVING ACKNOWLEDGMENT AND AFFIDAVIT I, VICTOR CHADWICK, the testator, sign my name to this instrument this November 26, 2001, and being duly sworn, do hereby declare to the undersigned authority that I sign and execute this instrument as my Last Will and that I, VICTOR CHADWICK, sign it willingly, that I execute it as my free and voluntary act for the purposes therein expressed, and that I am 18 years of age or older, of sound mind, and under no constraint or undue influence. /~ "- ~ VICTOR CHADWICK JAMES K. RILEY and VIRGINIA M. ARTERBURN, the witnesses, sign our names to this instrument, and, being duly sworn, do each hereby declare to the undersigned authority that the testator signs and executes this instrument as his Last Will and that he, VICTOR CHADWICK, signs it willingly and that each of us, in the presence and hearing of the testator, hereby signs this Will as witness to the testator's signing, and that to the best of our knowledge the testator is 18 years of age or older, of sound mind, and under no constraint or undue influence. VIRGINI~ M. ARTERBURN STATE OF NEW YORK ) CO~TY OF ROCKLAND) SS.: Subscribed, sworn to and acknowledged before me by VICTOR CH~WICK, the testator, and subscribed and sworn to before me by JAMES K. RILEY and VIRGINIA M. ~TERBURN, witnesses on November 26, 2001. LOR~INE A. PIMENTEL Notary Public, State of New York No. 4981455 Qualified in Rockland County Commission Expires May 13, 2003 REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: Victor Chadwick Date of Death: March 29, 2004 Will No. 21-04-0569 Admin. No. To the Register: I certify that notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiary of the above- captioned estate on June 24, 2004. Name Address Elaine A. Chadwick 117 Tory Ct., Enola, PA 17025 Stephen F. Chadwick 2155 Cedar Lane, Enola, PA 17025 Gary G. Chadwick 18 Amarillo Drive, Nanuet, NY 10965 Notice has now been given to ail persons entitled thereto under Rule 5.6(a) except none / Roboft C. Saidis, Esquire 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: Personal Representative X Counsel for Personal Representative LAW OFFICES SAIDIS, SHUFF, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 OF COUNSEL JOHN E. SLIKE TELEPHONE: (717) 737-3405 - FACSIMILE: (717) 737-3407 ALBERT H. MASLAND ROBERT C. SAIDIS EMAIL: attomey@ssfl-law.com GEOFFREY S. SHUFF CARLISLE OFFICE: JAMES D. FLOWER, JR. 26 WEST HIGH STREET CAROL J. LINDSAY CARLISLE, PA 17013 MATTHEW J. ESHELMAN TELEPHONE: (717)243-6222 KIRK S. SOHONAGE FACSIMILE: (717)243-6486 THOMAS E. FLOWER LINDSAY GINGRICH MACLAY REPLY TO CAMP HILL JACLYN SMITH July 26, 2004 Register of Wills Cumberland County Courthouse Carlisle, PA 17013 Re: The Estate of Victor Chadwick File No. 21-04-0569 Dear Ladies: Enclosed is an original and two copies of an inheritance tax return in regard to the above estate. Also enclosed are checks for the filing fee and the balance of tax due. Please return a time-stamped copy of the remm to our office in the envelope provided. Thank you. Very truly yours, SAIDIS, S~UFF, FLOWER & LINDSAY ~'~ l'~st She g ate Paralegal / / /sly Enclosures OFFICIAL USE ONLY REV-1500 EX + (6-00) REV-- 1500 COMMONWEAL "OFPENNSY'VANIA INHERITANCE TAX RETURN FILE NUMBE" DEPARTME.TO REVENUE RESIDENT DECEDENT -Z I DEPT. 280601 HARRISBURG, PA 17128-0601 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER D E Chadwick Victor 059-12-8862 C DATE OF DEATH (MM-OD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) miS RE-RJRN M~ST BE REED IN D~PUCA E D 0~9~/~D04 I 12/03/1919 REGISTER OF WILLS E N (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER T ~ 1. Original Retum ~:~24~' Supplemental Retum ~ 3. Remainder Retum (p%a C A P B 4. Limited Estate . ~a~r~l~ Compromise (date of death after 12-12- 5. Federal Estate Tax Return HpRL E P I O 6. Decedent Died Testate Beqeitedt Maintained a Living Trust 0 6. Total Number of Safe Depo C R A C (Attach copy of Will) (~t"a=,~=aupy of Trust) KOTK ES I~] g' Litigati°nPr°ceedsReceivedl~l10' Spousal Poverty Credit I~l 11. Election to tax under Sec. 9 {dd~{~)f death between 12-31-91 and 1-1-95) (Attach Sch O) NAME COMPLETE IvlAILING ADDRESS co" O Robert C. S~idis R DN FIRM NAME (If Applicable) 2109 H~rket Street ~R NE Saidis, Shu££, ~lower & T.indse7 Camp Nil1, :PA 17011 S T TELEPHONE NUMBER 717/737-3/+05 1Real Estate (Schedule A) (1) None OFFICIAL USE ONLY 2Stocks and Bonds (Schedule B) (2) No~e 3Closely Held Corporation, Partnership or (3) None Sole-Proprietorship ~ ~.C:~ 4Mortgages & Notes Receivable (Schedule D) (4) :~e R 5Cash, Bank Deposits & Miscellaneous Personal Property (5) 3,5~:, 2'84 E (Schedule E) - 6Jointly Owned Property (Schedule F) (6) 65,9 .25 i [::~eparate Billing Requested '"::~ ~ ~ ~:::' !' ':'.~:'! U 7Jnter-Vivos Transfers & Miscellaneous Non-Probate Property (7) L (Schedule G or L) A T 8.Total Gross Assets (total Lines 1-7) .... :;' (8)O=1 ...... 69,5 7 7.0 9 0 9Funeral Expenses & Administrative Costs (Schedule H) (9) 7,89~:~: ~0 N l(%)ebts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 902.46 lfrotal Deductions (total Lines 9 & 10) (11) 8,795.06 l~let Value of Estate (Line 8 minus Line 11) (12) 60,782.03 13Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13). made (Schedule J) l~let Value Subject to Tax (Line 12 minus Line 13) (14) 60,782.03 C O SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES M T UP 150,rnount of Line 14 taxable at the spousal tax ~ [ rate, or transfers under Sec. 9116(a)(1.2) X .0 0 (15) 0.00 T 160,mount of Line 14 taxable at lineal rate 60,782.03 X .0 /+5 (16) 2,735.19 I 1?Amount of Line 14 taxable at sibling rate X .12 (17) 0.00 O N la~u~ount of Line 14 taxable at collateral rate X .15 (18). 0.00 191'ax Due (19) 2,735.19 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00) Decedent's Complete Address: ;TREET ADDRESS 117 Tory Circle :ITY STATE ZIP Enola PA I 17025 Tax Payments and Credits: 1.Tax Due (Page I Line 19) (1) 2,735.19 2Credits/Payments A. Spousal Poverty Credit B. Prior Payments 2,500.00 C. Discount 131.58 Total Credits (A + B + C) (2) 2,631.58 3interest/Penalty if applicable D. Interest E. Penalty Total InterestJPenalty ( D + E ) (3) 0.00 4if Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 0.00 5if Une I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 103.61 A. Enter the interest on the tax due. (SA) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) 103.61 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1Did decedent make a transfer and: Yes No :. retain the use or income of the property transferred; ......................... · 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? ................... 2if death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................ ~ ~'~ 3Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............................................. 4Did 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 tree, correct and complete. Declaration of preparer ether than the personal representative is based on all information of which preparer has any knowledge. SIG~Ii~,T/IdRE OF.PERSON/F~SPONSIBLE F~R FILING RETURN Elaine Chadwick / D ~/~/ ///(~// / ' J 117 Tory. Circle .'~/.~/ ~/ A X///, // ;- .............................. 7 ! SIGNATURE/~F.~EPAR~E,~)THERTHAN//, ,, REPRESENTATIVE Saidis, Shuff, Flower & Lindsay '~/~.~ .i// '-- e (__. / 2109 Market Street i~ A / ' Camp Hill, PA 17011 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 danuary t, 1995, the tax rate imposed on the net value of transfers to or for the use of the survivin9 spouse is 0% [72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only 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. Copy~ght (c) 2000 form software only The Lackner Group, Inc. Form REV-I$00 EX (Rev. 6-00) REV-150{~ EX + (1-97) SCHEDULE E CO~MONWE^.~.OFPENNS¥'W,^ CASH. BANK DEPOSITS. & MISC. ,N.E.,T*"CE T*X.E~U.. PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Victor Chadwick SS# 059-12-8862 03/29/2004 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshq~ must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 HSBC, certificate of deposit, "in trust for" Julia Chadwick 3,588.84 acct. ~/467- 61545-4 Note: Julia Chadwick predeceased her husband, therefore the proceeds from the acct. are payable to the estate and will be disbursed in accordance with decedent's Will. TOTAL (Also enter on line 5, Recapitulation) $ 3,588.84 (If more space is needed, insert additional sheets of the same size) Copyright (c)1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) REV-~O~ EX + 0-.~), SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Victor Chadwick SS# 059-12-8862 03/29/2004 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. Elaine A. Chadwick 117 Tory Circle daughter Enola, PA 17025 JOINTLY-OWNED PROPERTY: LETrER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH Include name of financial institution and bani DATE OF DEATH DECD'S VALUE OF ITEM FOR JOIN'I MADE account number or similar identifying numbe NUMBER TENANT JOINT Attach deed for jointly-held real estate, VALUE OF ASSET INTEREST DECEDENT'S INTERES i/ o~ Commerce Bank checking 1 A / ~ 0l- acct. ~/513307538 1,427.64 50.00Z 713.82 2 A ~//7/0~- Commerce Bank savings 130,548.86 50.00Z 65,274.43 0626054225 TOTAL (Also enter on line 6, Recapitulation) $ 65,988.25 (If more space is needed insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1509 EX (Rev. 1-97) REV-1511 EX + (1-97) SCHEDULE H FUNERAL EXPENSES & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Victor Chadwick SS~; 059-12-8862 03/29/2004 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. "UNERAL EXPENSES: Myers-Harner Funeral Home 6,354.00 Funeral Dinner (New York) 752.60 B. ~DMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney's Fees Saidis, Shuff, Flower & Lindsay 700.00 3. Family Exemption: (If decedent's address is not Ihs same as claimant's, attach explanation) Claimant Street Address city State Zip Relationship of Claimant to Decedent 4. ProbateFees Register of Wills 71.00 5. Accountant's Fees 6. Tax Return Preparer's Fees ?. Other Administrative Costs Register of Wills, filing fee for tax return 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 7,8 92.60 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1511 EX (Rev. 1-97) REV-151,,2 EX + (1-97) SCHEDULE I DEBTS OF DECEDENT, COMMONWEALTH OF PENNSYLVANIA ~..E.,~ANcE ~.x.E~u.. MORTGAGE LIABILITIES, AND LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Victor Chadwick SS~; 059-12-8862 03/29/2004 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 West Shore EMS 561.31 2 Verizon, phone bill 70.15 3 Keystone Rehab 271.00 TOTAL (Also enter on line 10, Recapitulation) $ 902.46 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV-1513 EX + (9-00) ' SCHEDULE J COMMO.WEA'TR OF"ENNS¥'VA"~A BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Victor Chadwick SS~ 059-12-8862 03/29/2004 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. ~XABLE DISTRIBUTIONS [include outright spousel distributions, and transfers under Sec. 9116(a)(1.2)] 1 Elaine A. Chadwick daughter jr. owner on 117 Tory Cr. bank accts. Enola, PA 17025 1/3 of estate 2 Gary G. Chadwick son 1/3 of estate 18 Amarillo Dr. Nanuet, NY 10965 3 Stephen F. Chadwick son 1/3 of estate 2155 Cedar Lane Enola, PA 17025 ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 181 AS APPROPRIATEI ON REV 1500 COVER SHEET II. ~ION-TAXABLE DISTRIBUTIONS: !~. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART I| - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV- 1513 EX (Rev. 9-00) HSBC April 17,2004 To Robert C Saidis 2109 Market Street Camp Hill, PA 17011 Re: Victor Chadwick SS # 059-12-8862 Please be advised that Mr. Chadwick still has one certificate of deposit account with our bank. The account number is 467-61545-4- balance of the account is This account is i~r~ fgl5 Julia Chadwick. , .... To close the above mentioned account we will need: I. Death Certificate (received 4/17/04) 2. Letters of Testamentary Please feel free to contact me if you need an3' additional information. (' ~' Sincerely, O 0 ' ( Consumer Banker HSBC Bank USA ? ' ~ ,!)~ ., HSBC Bank USA Noxth..MiddlgX~n Road Office, 93 North Middletown Road, Pearl River, NY 10965 ~T'-~: (914) 735-295Fax: (914) 735-0065 Commerce May 7, 2004 Saidis, Shuff, Flower & Lindsay A Professional Corporation 2109 Market St Camp Hill, PA 17011 RE: Estate of: Victor Chadwick Social Security #: 059-12-8862 Date of Death: March 29, 2004 Dear Sir/Madam: In reference to the letter regarding the above mentioned Estate, we would like to inform you of the information that we have researched and found. Type: Checking Account #: 513307538 Date Opened: 11/30/02 Primary Owner: Victor Chadwick Secondary Owner: Elaine A Chadwick Secondary Owner: Julia R Chadwick (dec'd 7/25/03) Date of Death Balance: $1,427.64 Accrued Interest: $.07 Type: Savings Account #: 626054225 Date Opened: 5/17/02 Primary Owner: Victor Chadwick Secondary Owner: Elaine A Chadwick Secondary Owner: Julia R Chadwick (dec'd 7/25/03) Date of Death Balance: $130,456.64 Accrued Interest: $92.22 Commerce Bank / Harrisburg, N.A. P.O. Box 8599 100 Senate Avenue Camp Hill, Pennsylvania 17001-8599 Commerce If there are any questions or additional information that is needed, please feel free to contact me at (717) 795-7118 ext. 3151. Sincerely, Wanda J. Morris CIF Team Leader Commerce Bank / Harrisburg, N.A. P.O. Box 8599 100 Senate Avenue Camp Hill, Pennsylvania 17001-8599 RO~,~ P,T P, F,E,30~:,r:?, OF DEEDS ,,..:. ~., . .... ...uNTY- PARCEL ~: os-~4-o~s5;~o '02 RRY 29 RR 8 38 THIS DEED ~ADE THE 23Fd do~ o~ ~a~, i~ the yeoF of ouF LoFd Two Thousand T~o (2002) BETWEEN VICTOR CHADWICK AND JULIA R. CHADWICK, husband and wife, of Cumberland County, Pennsylvania, hereinafter (Grantors) and ELAINE A. CHADWICK, single person, of Cumberland County, Pennsylvania hereinafter (Grantee) WITNESSETH, that in consideration of One Dollar and 00/100 ($1.00) in hand paid, the receipt whereof is hereby acknowledged, the said grantors do hereby grant and convey to the said grantee, her heirs and assigns. ALL that certain piece or parcel of land situate in the Township of East Pennsboro, County of Cumberland and Commonwealth of Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point on the eastern right of way line of Tory Circle, at the southwest corner of Lot No. 163 on the hereinafter described Revised Final Subdivision Plan; thence along the southern line of said Lot No. 163, North 73 degrees 13 minutes 20 seconds East, a distance of 278.93 feet to a point on the western dedicated right of way line for proposed relocated Center Street; thence along the western dedicated right of way line for proposed relocated Center Street, South 16 degrees 46 minutes 40 seconds East, a distance of 24.00 feet to a po~i at i'he r~ot'tYu~asi con)er o~ LO~ m~u. !61 on 'lhe ........... ~'~ ...... '~ ~ ~ .... ; .... Final Subdivision Plan; thence along the northern line of said Lot No. 161, SoutB 73 degrees 13 mi~utes 20 seconds West, a distance of 278.93 feet to a point on the eastern legal right of way line of Tory Circle; thence along the eastern legal right of way line of Tory Circle, North 16 degrees 46 minutes 40 seconds West a distance of 24.00 feet to a point at the southwest corner of Lot No. 1 63 on the hereinafter described Revised Final Subdivision Plan, the point and place of BEGINNING. CONTAINING 6,694.00 square feet, more or less. BEING Lot No. 182, Revised Final Subdivision Pan of Laurel Hills North, Lots No. 2, 6, 8 and 9, dated July 17, 1997, recorded in the Office of tBe Recorder of Deeds of Cumberland County, Pennsylvania in Plan Book 75, page 132. BEING IMPROVED with a townhouse dwelling known as 117 Tory Circle. ~q BEING the same premises which Laurel Hills Development Corp., a PA Corporation, by Deed dated February 7, 2002, which Deed is recorded in the Office of the Recorder of Deeds in and for Cumberland County in Deed Book 250, Page 1808, granted and conveyed to Victor Chadwick and Julia R. Chadwick, husband and wife, Grantors herein.. SUBJECT to an Easement for utility installation and maintenance which is reserved on all lots and such other easements, as may be shown in recorded documents, granted to Public Utility Companies for utility purposes. Electric service will be supplied only from the underground distribution syslem in accordance with then current PP&L Company Tariff provisions. UNDER AND SUBJECT, to Declaration of Covenants and Restrictions applicable to Final Subdivision Plan for Laurel Hills North, Lots 2, 6, 8 and 9, East Pennsboro Township, Cumberland County, Pennsylvania, dated May 20, 1998, recorded in the Office of the Recorder of Deeds of Cumberland County in Miscellaneous Book 577, Page 419. FURTHER UNDER AND SUBJECT to a sixteen (16) foot pedestrian access easement and a twenty-five (25) foot drainage easement across the eastern portion of the premises as shown on the above referenced Revised Final Subdivision Plan. THIS IS a conveyance from parents to daughter and therefore exempt from Pennsylvania Realty Transfer Tax. AND the said Grantors hereby covenant and agree that they will warrant specially the property hereby conveyed. IN WITNESS WHEREOF, said grantors have hereunto set their hands and seals the day and year above written. SIGNED, SEALED AND DELIVERED ' ~ / Vip/tar C,h, adw..ic~.?z £) , · 3~Ulia R. Chadwick COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND · ss On this, the 23rd day of May, 2002 before me, the undersigned naa eared Victor Chadwick and Jutia R. Chadwick, husband perso y pp . . ~. ..~,~,. t factonl raven to be the persons whose nam~ .. _ known to me (or sa is y p ) subscribed to the within instrument, and acknow edged that they e~~E~~~ same for the purposes therein contained. IN WITNESS WHEREOF, I hereuntoP~t my hand ~ ~fficial ~ ~l~ L MURRAY, Notnry Public I ~ ~ ~ ~vv~ ~x ~ [ / U~/v v~ ~ ~ / .... / ~;;I;;I; Boro, Gumb"rl~n~;~A2005J Title of OfficefJ (I ~My C0mmis~lon Expire~ e.ce , j ldo hereby certify fhef the precise residence ~nd complete pod office ~ddress of ~he within n~med grGn~ees is //~ ~,zy C2 .~:, DATED: ~ ~;g~ ~'~ / Attorney for Grantee i-' i. I t.. (",/I '~ / & kll ^ COMM©NWEALTH OF P,'-mr-;.~ ~ ,._,;.m~', County of :ss RECORDED on this I Cer~ ~i$ to be recorded A.D. 2002, in the Recor~:~l.~fil~ft~Co~llt-~ said County, in Deed Book Vol. Page_~_. office, the date abov~~~ p Deeds VICTOR CHADWICH I, VICTOR CHADWICK, residing at 58 Hay Road, Pearl River, New York, being of sound and disposing mind and memory and being mindful of the uncertainties ef this life, de make, publish and declare this te be my LAST WILL AND TESTAMENT. FIRST: I hereby revoke all other Wills er Codicils heretofore made by me. SECOND: I direct that my,debts and funeral expenses and any estate and similar taxes be paid as seen after my decease as may be practicable out ef any trust established under ARTICLE ELEVENTH ef this my Will and te the extent that such property is insufficient then out of my residuary estate without apportionment. THIRD: I request that my Executor carry out my intentions and wishes and distribute er deliver any particular items er articles ef personal property which I may own, te these persons whom I may name er designate in any letters signed by me which I may leave for that purpose. Because ef the confidence which I have in my Executor, this request is precatery and I de not impose any legal er equitable obligation on my Executor, knowing full well that he er she will carry out my intentions. 1 FOURTH: I give, devise and bequeath all the rest, residue and remainder ef my estate, of whatsoever nature and wheresoever situate ef which I may die seized er possessed, and over which I may have power of appointment er to which t may hereafter become entitled, to my beloved wife, JULIA R. CHADWICK, en condition that my wife survives me, te be hers absolutely and forever. FIFTH: If my wife, JULIA R. CHADWICK, shall predecease me, or in ~he event that my wife and ! shall die as the result ©f a comm©n accident er disaster, or under such circumstances as to render it imp©ssible te determine which one of us survived the ether, then I direct my Bxecutor te divide all the rest, residue and remainder of my estate as follows: A. I give, devise and bequeath ONE-THIRD (1/3) of my residuary estate t~ my son, GARY G. CHADWICK, per stirpes; B. I give, devise and bequeath ONE-THIRD (1/3) of my residuary estate to my sen, STEPHEN F. CHADWICK, .per stirpes; and C. I give, devise and bequeath ONE-THIRD (1/3) of my residuary estate to my daughter, ELAINE A. CHADWICK, per stirpes. If any ef my children shall predecease me er upon the death of any ef my children after my death and prier to full distribution te that child of their share under this, my Will, direct my Executor er Trustee te divide the share ef such child which remains into as many equal shares as there may be children ef 2 my deceased child, him or her surviving, and to pay and to distribute said sub-shares to the said issue of my deceased child, per stirpes. If my deceased child shall have no issue, then I direct my Executor or Trustee to pay and distribute the share of my deceased child to my surviving children or to their issue if any have predeceased me, per stirpes, absolutely and forever. SIXTH: I nominate, constitute and appoint my beloved wife, JULIA R. CHADWICK, as the sole Executor of this, my Last Will and Testament. I nominate, constitute and appoint my daughter, ELAINE A. CHADWICK, Testamentary Trustee of the trust, if any, established under ARTICLE ELEVENTH of this, my Will. In the event that my wife shall predecease me or shall fail to qualify as Executor of this, my Will, or having qualified shall become unable to act for any reason, then I nominate, constitute and appoint my daughter, ELAINE A. CHADWICK, as first substitute Executor under this, my Will. In tlhe event that ELAINE A. CHADWICK shall predecease me, or shall fail to qualify or act for any reason, then I nominate, constitute and appoint my son, STEPHEN F. CHADWICK, as second substitute Executor and substitute Testamentary Trustee under this, my Will. In the event that STEPHEN F. CHADWICK shall predecease me, or shall fail to qualify or act for any reason, then I nominate, constitute and appoint my son, GARY G. CHADWICK, as third substitute Executor and substitute Testamentary Trustee under this, my Will. SEVENTH: I further direct that no bond or other security of any nature be required from any Executor or Trustee for the proper discharge of their duties under this, my Will. EIGHTH: I expressly direct that my ~xecuter and any Testamentary Trustee er any substitute Executor er Trustee shall have full power and discretion as provided by law te act as may be deemed most advantageous and for the best interest of my_estate, including, but not limited te the following: (a) Te retain any property owned by me at the time ©f my death for reasonable periods of time; (b) Te invest any funds ef my estate er any trust hereunder in any stocks, bends, notes and ether securities or property, real or personal, not- withstanding that such investments may not be of the character allowed te executors or trustees by statute or general rules ef law, it being my intention to give the broadest investment powers and discretion to my executor and trustee; (c) To held, sell, lease, mortgage, or otherwise dispose of any property, real er personal, at any time forming a part of my estate er any trust hereunder, for cash or upon credit, in such manner and on such terms and conditions as my Executor and trustee may deem best, and no person dealing with ft shall be bound te see to the application ef any monies paid; (d) To manage, operate, repair, improve, mortgage and lease for any term (whether longer or shorter than five years or the duration of any trust hereunder) any real estate at any time held by my Executor and trustee; (e) To distribute in cash or in kind upon any division ef my residuary estate er the termination of any trust hereunder; (f) For administration purposes to administer the trusts created hereunder as a single entity; this prevision shall not apply to any Retirement Plan assets held under any trust established under this, my Will; (g) Te borrow any funds needed en behalf of the estate and te provide appropriate collateral; (h) If any portion ef my estate or ef any trust created by this Will shall vest in absolute ownership in a person under 21 years ef age, I authorize my Executor or Trustee without authorization by any Court, te distribute any er all such property te which such person may be entitled, 4 to a Custodian of such person under the New York Uniform Gifts to Minors Act or the New York Uniform Transfer to Minors Act; (i) To continue any enterprise, business or businesses in which I may be interested at the time of-my death, whether such interest is wholly or partly an individual or partnership interest or is as a holder of shares of stock in a corporation conducting such business or businesses; to settle and discontinue any of them, at such time or times and upon such terms and conditions which, in the judgment of my Executor or trustee, are for the best interests of my estate or of any trust created by my Will; and, in the discretion of my Executor or trustee, to transfer the assets of any said business to a corporation or corporations to be formed for the purpose of conducting the said business or businesses, and to retain the stock or other securities received in exchange therefor as an investment of my estate or of any trust created by my Will even though the said stock or securities may not be an investment authorized either by law or the provisions of my Will for any Executor or trustee; (and, in the discretion of my Executor or trustee, to use the property of my estate, not invested in the said business or businesses at the time of my death, for the debts and liabilities of the said business or businesses that ma9 be incurred after my death) ; (j) In general, to exercise all powers in the management of my estate, and any trust hereunder which any individual could exercise in his own right, upon such terms and conditions as they may deem necessary or proper to carry out the purposes of this, my Will. NINTH: If at the time of my death I am the owner of any life insurance, insuring the life of another person, including my spouse, I give and bequeath said policy or policies to my issue, per stirpes. TENTH: If any share of the principal of my estate shall become distributable to a person who has not attained the age of twenty-one (21) years, the share of such person shall vest absolutely but shall remain in the care, control and custody of my Executor, as a separate fund under a power in trust for the benefit 5 of such person, until such persen attains the age ef twenty-one (21) years or earlier dies, at which time all ef such principal and any accumulated income shall be paid over te such persen er te their estate; and se much of such principal, and the net income there£rom, as my Executer may deem necessary or advisable, meanwhile, shall be paid ever er applied by my Executor for the health, education, maintenance and supp©rt ef such person during the peried until such person attains the age ©£ twenty-ene (21) years. Any net inceme net paid te er applied fer the benefit ef such persen shall be accumulated and shall be added to and administered as a part ef the principal ef such separate fund. In the administratien ef such separate fund my Executer shall have the same powers and duties as such Executor shall have in the adm±nistration ef my estate. Such payments of inceme er principal may, in the discretien ef my Execeter, be paid te such persen er to the parent er guardian ef such persen, and the receipt ef such persen, parent er guardian therefere, shall eperate as a c©mplete release and discharge e~ my Executer in respect thereef. ' ELEVENTH: A. If my wife shall disclaim or renounce the above residuary bequest in whele er in part, or if my wife shall disclaim er renounce any other property which may pass te my wife either under or eutside ef this Will, as either a testamentary er n©n- testamentary transfer, then any transfer which is se disclaimed er reneunced shall be administered, centrelled and disposed of as follews: B. I give any pertion ef my estate, whether passing under er 6 outside of this Will, (which assets are not "Retirement Plan" assets or "qualified assets" as said term is commonly understood, including assets or distributions from any pension, profit sharing, individual retirement account, or ether retirement plan established or existing in accordance with the provisions ef Internal Revenue Code) which my wife may disclaim, te my Trustee herein named, IN TRUST, NEVERTHELESS, to invest and reinvest the same and to collect tlhe income therefrom and te deal with the net income therefrom and with the principal thereof as hereinafter set forth. It is the primary purpose of this trust te provide for the support and care of my wife during her survivorship, and te that end my Trustee shall pay over to my wife, or for her benefit, all er such part of the net income ef said trust which said Trustee shall deem appropriate in the Trustee's absolute discretion for ~he care, support, and maintenance of my wife. In addition, my Trustee is a~thorized from time to time te invade the principal of said trust in the Trustee's sole discretion as deemed necessary to provide for the care, support, and maintenance of my wife, se that my wife will at all times be able te continue te enjoy the same manner and standard of living as we have enjoyed together. In addition te any payments of income or principal out of this portion ef this trust, there shall also be paid te my wife out ef the corpus, in cash er in kind, upon her request during the month ef December ef each calendar year, an amount which shall in no event exceed the amount ef Five Thousand ($5,000.00) Dollars or five (5%) percent of the aggregate value of the corpus as then constituted, whichever is greater; provided, however, that if the request is not made for any calendar year, ne payment of corpus shall be made in any subsequent year on account ef the amount not s,o requested. This limited power shall net apply te any Retirement Plan assets held under the provisions of ARTICLE ELEVENTH C ef this, my will. C. I give any portion of my estate, whether passing under or outside ef this Will, which assets are "Retirement Plan" assets or "qualified assets" as said term is commonly understood, including assets er distributions from any pension, profit sharing, individual retirement account, or other retirement plan established or existing in accordance with the previsions ef Internal Revenue Code which my wife may disclaim, to my Trustee herein named, IN TRUST NEVERTHELESS, to invest and~ reinvest the same and te collect the income therefrom and to deal with the net income therefrom and with the principal thereof as hereinafter set forth. (i) Hy Trustee may elect te receive distributions from any pension, profit sharing, individual retirement account, or other retirement plan ("Retirement Plan") for which my trust is named as beneficiary, or contingent er successor beneficiary, in installments er in a lump sum. (ii) My Trustee shall elect to receive distributions from a Retirement Plan payable te this trust in compliance with the minimum distribution rules ef the Internal Revenue Cede, if applicable, and also se that at least all income earned by the Retirement Plan which may be distributed in any calendar year is 8 distributed to the trust and allocated to trust income during the year. If distributions from the Retirement Plan total less than all income earned by the Retirement Plan for a calendar year in which any distribution is made, my Trustee shall demand additional distributions egual to at least the shortfall so that my wife will receive all income earned by any Retirement Plan at least annually. Hiy wife shall have full power, in her discretion, to compel my Trustee te demand such distributions and to compel the Retirement Plan trustee te convert any nonproductive property to productive property. Nothing in this prevision is te be interpreted as requiring my Trustee te request er compel any distribution before any applicable "required beginning date" as said term is defined and applied under the Internal Revenue Cede. (iii) In calculating al~ income earned by any Retirement Plan, my Trustee shall allocate all Retirement Plan expenses, including income taxes and trustee's fees, that are attributable to principal distributions se that all income distributions from the Retirement Plan are not reduced. D. I specifically authorize my Executor to determine whether any Roth IRAs which are held by me and disclaimed or renounced by my wife are te be treated as ordinary assets or as ketirement Plan assets. E. On the death of my wife, this trust shall terminate and my trustee shall distribute all property then belonging to the principal ef the trust, together with any income then on hand er accrued, to my issue who shall survive my wife, in equal shares, per stirpes, in accordance with the provisions of ARTICLE FIFTH of this Will. IN WITNESS WHEREOF, I, VICTOR CHADWICK, have te this, my Last Will and Testament, consisting ef ten (10) pages, subscribed my name en November 26, 2001. /VICTOR CHADWICK SIGNED, SEALED, PUBLISHED AND DECLARED by the above testator, VICTOR CHADWICK, to be his Last Will and Testament in the presence ei_-- us and each of us who at his request and in his presence and in the presence of each other have hereunto subscribed our names as witnesses on November 26, 2001. t0 STATE OF NEW YORK ) COUNTY OF ROCKLAND ) SS. : Each of the undersigned, individually and severally being duly sworn, deposes and says: The within Will was subscribed in our presence and sight at the end thereof by VICTOR CHADWICK, the within named testator en November 26, 2001, at Pearl River, New York. Said testator at the time ef making such subscription declared The instrument se subscribed te be his Last Will and Testament. Each ef the undersigned thereupon signed his name as a witness at the end ef said Will at the request of said testator and in his presence and sight and in the presence and sight ef each other. Said testator was, at the time ef so executing said Will, ever the age ef 18 years and, in the respective opinions of the under- signed, of sound mind, memory and understanding and not under any restraint er in any respect incompetent te make a Will. The testator in the respective opinions of the undersigned, could read, write and converse in the English language and was suffering from ne defect ef hearing, er speech, or from any other physical er mental impairment which would affect his capacity to make a valid Will, except a limitation and disability in vision and for this reason the Will was read ~o Testator in its entirety. The Will was executed as a single, original instrument and was not executed in counterparts. Each of the undersigned was acquainted with said testator at such time and makes this affidavit at his request. The within Will was shown to the undersigned at the time this affidavit was made, and was examined by each of them as to the signature of said testator and of the undersigned. The foregoing instrument was executed by the testator and witnessed by each of the undersigned, ,affiants under/~he~ ~upervision of JAMES K. RILEY, attorney at laW. / ~ Severally sworn to before {~{.~ me en November 26, 2001 LORRAINE A. PIMENTEL Notary Public, State of New York No. 4981455 Qualified in Rockland County Commission Expires May 13, 2003 SELF PROVING ACKNOWLEDGMENT AND AFFIDAVIT I, VICTOR CHADWICK, the testator, sign my name te this instrument this November 26, 2001, and being duly sworn, do hereby declare to the undersigned authority that I sign and execute this instrument as my Last Will and that I, VICTOR CHADWICK, sign it willingly, that I execute it as my free and voluntary act for the purposes therein expressed, and that I am 18 years of age or older, of sound mind, and under no constraint or undue influence. VICTOR C~WICK JAMES K. RILEY and VIRGINIA M. ARTERBURN, the witnesses, sign our names to this instrument, and, being duly sworn, do each hereby declare to the undersigned authority that the testator signs and executes this instrument as his Last Will and that he, VICTOR CHADWICK, signs it willingly and that each of us, in the presence and hearing of the testator, hereby signs this Will as witness to tlhe testator's signing, and that to the best of our knowledge the testator is 18 years of age or older, of sound mind, and under no constraint or undue influence.  .~ JAMES K. RILEY VIkGINI~ M. ~TEkBURN STATE OF NEW YORK ) COUNTY OF ROCKLAND) SS.: Subscribed, sworn to and acknowledged before me by VICTOR CHADWICK, the testator, and subscribed and sworn to before me by JAMES K. RILEY and VIRGINIA M. ARTERBURN, witnesses en November 26, 2001. LORP~AINE A. PIMENTEL Notary Public, State of New York No. 4981455 Qualified in Rockland County Commission Expires May 13, 2003 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVAN IA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004200 CHADWICK ELAINE A 117 TORY CIRCLE ENOLA, PA 17025 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold 101 $103.61 ESTATE INFORMATION: SSN: 059-12-8862 FILE NUMBER: 2104-0569 DECEDENT NAME: CHADWICK VICTOR DATE OF PAYMENT: 07/27/2004 POSTMARK DATE: 07/27/2004 COUNTY: CUMBERLAND DATE OF DEATH: 03/29/2004 TOTAL AMOUNT PAID: $103.61 REMARKS' CHADWICK ELAINEA CHECK# 1105 INITIALS: CP SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~N'~ ~-%~-- COMMONWEALTH OF PENNSYLVANZA _~_~, BUREAU OF INDZVZDUAL TAXES DEPARTMENT OF REVENUE INHERZTANCE TAX DIVIS/ON DEPT. 280601 HARRISBURG, PA 17128-0601 NOT/CE OF /NHERITANCE TAX APPRAISEMENT~ ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-i$~?EXAFPCOl-O3) DATE 10-11-200q ~:~" ESTATE OF CHADWICK VICTOR DATE OF DEATH 05-29-200q F/LE NUMBER 21 0~-0569 COUNTY CUMBERLAND ROBERT C SAIDIS '0~ ~*[ l~ ~ :(]~ ACH 101 SAIDIS ETAL Amount Remitted 2109 .ARKET ST ~ CAMP HILL PA ~_ MAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LZNE ~ RETAZN LOWER PORT/ON FOR YOUR RECORDS ~ REV-15~7 EX AFP (01'03) NOTICE OF /NHERITANCE TAX APPRAZSEMENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTZONS AND ASSESSMENT OF TAX ESTATE OF CHADWICK VICTOR FZLE NO. 21 0q-0569 ACN 101 DATE 10-11-200q TAX RETURN NAS: { X) ACCEPTED AS F~LED ( } CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Estate (Schedule A) (1) .00 NOTE: To insure proper 2. Stocks end Bonds (Schedule B) (2) .00 credit to your account, $. Closely Held Stock/Partnership Interest {Schedule C) {$) .00 submit the upper portion q. Mortgages/Notes Receivable (Schedule D) (q) .00 of ~his form with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) {5) ~588.8q tax payment. 6. Jointly Owned Property (Schedule F) (6) 651988.25 7. Transfers (Schedule G) (7) .00 8. Tote1 Assets (8) 69,577.09 APPROVED DEDUCTZONS AND EXEMPTZONS: 7,892.60 9. Funeral Expenses/Adc. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 902.q6 11. Tote1 Deductions (11) ~.7~.0~ 12. Net Value of Tax Return (12) 60,782.05 1~. Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 lq. Net Value of Estate Subject ~o Tax (lq) 60,782.05 NOTE: Z~ an assesseent ~as lssued previously, 11nes 1~, 15 and/or 16, 17, 18 and 19 ,111 reflect flgures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line lq et Spouse1 rate (15) .00 X O0 = .00 16. Amount of Line lq taxable at Lineal/Class A rate (l&). 60,782.05 X Oq5 = 2,735.19 17. Amount of Line lq at Sibling rate (17) .00 X ~2 = .00 18. Amount of Line lq taxable at Collateral/Class B rate (18) .00 X 15 = .00 19. Principal Tax Due (19)= 2,7~5.19 TAX CREDZTS: PAYMENT RECEIPT DZSCOUNT (+! AMOUNT PAID DATE NUMBER INTEREST/PEN PA~D (-) 06-16-200q CO00q058 151.58 2,500.00 07-27-200q CO00qZ00 .00 105.6! TOTAL TAX CREDZT 2,735.19 · ALANCE OF TAX DUEI .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS RE{~UZRED. FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR /NSTRUCTTONS.) RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any futura interest in the estate ls transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years) the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawfu! Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfi11 the requirements of Section Z140 of the Inheritance and Estate Tax Act) Act Z$ of 2000. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit eith your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF NILLS, AGENT REFUND (CA): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application far Refund cf PennsyZvania Inheritance and Estate Tax" (REV-1515). Applications are avaiZable at the Office of the Register of Nills, any of the ZS Revenue District Offices) or by calling the special Z4-hour answering service for forms ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-~0Z0 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions) or assessment of tax [including discount or interest) as shown on this Notice must object within sixty [60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals) Dept. Z81OZl) Harrisburg, PA 171Z8-1Ogl, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes) ATTN: Post Assessment Review Unit) Dept. ZOO601, Harrisburg, PA 17IgB-060l Phone [717) 787-6S0S. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (RE¥-IBOI) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the dacedent's death, a five percent CSX) discount of the tax paid is allowed. PENALTY: The 1BI 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 end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate cf six [6Z} percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 wiIl bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19BI through 2004 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ 20Z .000548 ~'~'~'8-1991 1XZ .O0030X ~ 9Z .0002~7 1985 Z6Z .000438 199Z 9Z .000247 ZOOZ 6Z .000164 19Bq Ill °000301 1993-1994 72 .O0019Z 2003 52 .000137 1985 132 .000~56 1995-1998 92 .000247 2004 42 .000110 1986 lOZ .000274 1999 7Z .O0019Z 1987 IOZ .O00Z7~ ZOO0 7Z .O0019Z --Intsrest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: Victor Chadwick Date of Death: March 29, 2004 Will No. 21-04-0569 Admin. No. 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 X ; No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes __; No X 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 X ; No d. Copies of receipts, releases, joinders and approvals of formal or informal~accounts may be filed with the Clerk of the Orphans' Court an%~ay be attached to this report. Date: /~/~2/OJ S Name: Robert C. Saidis, Esquire I.D. No. 21458 SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: Personal Representative X Counsel for Personal Representative