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HomeMy WebLinkAbout02-0594PETITION FOR PROBATE and GRANT OF LETTERS '~ Q Estate of ~ ~ ~ ~a ~ ~ 1) ~ ~ Ct~ ~~''~No. ' , - ~ Z.- .~~ also known as To: Register of Wills for the De eat County of Gu~+~tbet (0.cn c+~ in the Social Security No. ~ ~ Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut v"~ ~ named in the last will of the above decedent dated _~;~~~-~ ~~ ~~ ~ . 19 and codicil(s) dated "- ~`"~----- (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~ County, Pennsylvania, with h+2--s- last family or p 'ncipal residence~,t t -- (list street, n~umber•~and muncipality) S~ , t11 ~ d~ ~ Qfi~~ ~ `~'~' Decendent, then / ~ years of age, died ~~t-z- ~ ~ ~ 1~ - ~~~ at Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: ,, (If domiciled in Pa.) All personal property $ Z~ ~ . C%t° ~ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in Count $ Value of real estate in Pennsylvania ~ ~. ~ Q CyCa situated as follows: I Z Z ~~~~ ~ ~r ~ ~ C~ ~~~ ~" WHEREFORE, petitioner(s) respectfully reque t(s) the probate of th last will and codicil(s) presented herewith and the grant of letters (testamentary; administration c.t.a.; administ tion d.b.n.c.t.a.) theron. ~~~~'/L~ v L- Yl h C PD lu La (` ~ c ,a O p ~Q t.t/Q 15S ji pC~t~ ~ = /U'a zar e7'l~ y~'~9 I ~0 ~'~ ~a ~w ° -- OATH OF PERSONAL REPRESENTATIVE COMMONWE TH OF PEN SYLVANIA 1 ~, COUNTY OF ~~Q. rnl~ ~ ~ ~Q r~ ~_ The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will ;yell and truly administer th tate according to law. Sworn to or affirmed and subscribed ~~ ~r `~~ v, before me this 26th day of a JUNE 002 ~ ARY LEWIS Register No. a~-c~-59~ Estate of ~~ ELIZABETH D CONKLIN ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JUNE 27 2002 19 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, 3-16-1999 IT IS DECREED that the instrument(s) date described therein be admitted to probate and filed of record as the last will of FT T7ABFTH n C'ONKLIN and Letters TESTAMENTARY LYNN C POWER are hereby granted to FEES Probate, Letters, Etc.......... $ 305.00 Short Certificates(j11) .......... $ ~~ n0 Rf~~i eg€tra . pages.. , $ 12.00 TOTAL $ 352.000 Filed 6-27-2002 .... , ..... . ca11ec1 'atty ' 6_2~tX-2002 ~~:J/~ ~ y IS Register of Wills J n Brou'os, Es ~fU6268 ATTORNEY (Sup. Ct. LD. No.) 4 N Hanover St, Carlisle,PA 17013 ADDRESS 717-243-4574 PHONE ulo~ sn> ~zFV s~sc 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 Stare Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. f~er for this certificate, ~Z.00 8481673 No. H705.144 Rev. tf91 PRINT J 1NENT KINK ~~ Loral R~gisrrar ~ JUN 2 5 2102 ~)arr COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (Coroner) SEX SOCIAL SECURITY NUMBER DATE OF DEATH (MOnm. Day, year) NAME OF DECEDENT (FIM, MidMe. Lash 202-18-4550 . 2002 June 16 Female , ,, . ,. Elizabeth D Conklin ,. AGE (Lass Blrthtlay) UNDERI YEAR UNDERtDAV DATE OF BIRTH BIRTHPUCE(Gry antl PLACE OF DEATM (Check only one-see inNruc°ons on Mner sioel (Mpnlh, Day. Veer) Slele or Foreign Ccuntry) HOSPITAL: OTHER: Monlhe Days Houn MinNes Chester InpetbM^ ERlOulpalient^ DOA^ Nursing OIMr Heme ^ Reeidence~ Ispe<iH)^ 75 vre. ay 15, 1927 ,. Penna. ,.. 6 • COUNTY OF DEATH CITY, BOR TWP FDEATN FACILITY NAME(Il npl lnslrtulipn, give greet antl number) WASI~p~ECEDENT OF HISPANIC ORIGIN7 RACE-Ameriunlndian, Black, Whna, alt. IS~~ ^ H yes, species Cuban, No IQ. Yes 122 Stra er Drive Meaicen, PUSno Rben, etc. white th Middleton Y So ,. ,q, u Cumberland ed ee. a°' DECEDENT'S USUAL OCCUPATION KIND OF BUSINESSIINDUSTRV WUSDAR EED FORCES?N DE~EDnNn~E DUtlCeAT10N ~ NAever MerTrNE, Wioowetl, (IISwUite. gl ve"maitlaOn name) S pec'HI (Give kkW Ol work tlone tlu^n og ElemenmrylSecontlary Collage plyprc~( of working Me; ao riot use re~ired.) Yes ~ No ^ W Z Q O W - Registered (D-, 2, n'4 or5+) ,6 ,4 • t,a. 11 D. 12. 13. DECEDENT'S MAILING ADDRESS (Slreet.CMfTOwn, Stale. Zip Code) DECEDENT'S pennsy vents ad ,Tp.[~Ye., decedent lived In South MT ddl eton Mp. ACTUAL 17a. State 122 Strayer Drive RESIDENCE decedent '" ` ,seeingruMi°na Cumberland e ^• 17013 townehlp4 No,decedaMllvsd on Omer sRle) Penna cMtMrp le ^ li . ~ , wnnin eMUel limka of s Car 17D. Coun t7o. 76' FATHER'SNAME(Fug,MWtlle.lass MOTHER'S NAME(Firg, Mkltlle Maiden Surname) Martha Stewart ~homas Cauley ,,. ,e INFORMANT'S NAMEQypelPnnq INFO ANT'S MAILINC;ADDRESS SIreat, Cay/TOwn, Stete.Zp Cotla Pennsylvania 18064 Nazare~h ~90 Weiss E~oad , , yriri Conklin Power 20D ~' DATE OF DISPOSITION PLACE OF DISPOSITION-Name ofGmetery, Crematory LOCATION-CiryROwn, Slats, Zp Code ~ METMODOF DISPOSITION (M Ih yywr aOtnerPace Pennsylvania l Crematbn^ RemovelUan3tate^ 2002 Ashland Cemetery Carlisle ~u~ie '24 ^ ^ , , Bu a z,a ^ . Dwutbn an.rl pacts? zm- z,a SIGNATURE OF NERAL SERVICE LICENSEE ORP SON ACTING AS SUCH LICENSE NUMSER NAME AND ADDRESS OF FACILITY 2,.. ~~1SS1~h L swing Brothers: ,Pgy~g~ egg 13 0 821 9- 0 22D • . Yta. LICENSE NUMBER DATE SIGNED plNe tt ony wMn cenlrying To the 1 my knowletlge, Deem occurred at the time, dale end place elated. (Moran, Day, Ymr) pnyakian is avsasDN at lime of deem to (Signal antl Tlae) xx . urt6yu oldsam. zaa- z3e. NteO Dy TIME OF DEATM GATE PRONOUNCED DEAD (M°nm.Day,Year) WAS CASE REFERREDTO MEDICAL EXAMINERICORONER? WCOm - ^ p Items 24-26 mwt p,,.pnwnpwp^pu^°•ea.aln. pL~pprX• June 21, 2002 V°` NO 26 A 4 . : VU gd, M. :s. injuries or Complbelbns wnicn uuaed me deem. Do riot emar tM mots of dylrg, auto as cardiac m respiratory arrest, anock or heart feilun. ~Appmalmeta PART II: OIMf eigniMSnt wrlenione wmriDUlinp to dsatn, Dui ; interval between tits resulting in ins underlying cause gesso M PART I. tM diseases E , MH 27. PI1RT I: LM only oM uuae on Nth line. ~ oast arW deem RIMEDIATE CAUSE (Final deeaeewp«wabn Hypertensive Cardiovascular Disease reeulerg in tleaml-• •. ~ DUE TO IOR AS A CONSEQUENCE OF): I SeGUanflaaY 6u coMabM D. I Karly, I..drq to immaaste DUE TO (OR ASACONSEOUENCE Off: Goss. EMM UNDERLYING CAUSE(aeease or injury °' DUETO (ON ASACONSEOUENCE OF): I mat'uMiateO everns i renMirq b seam) usT d. Y WERE AUTOPSY FINDINGS MANNER OF DEATH DATE OF INJURY TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED. WAS AN AUTOPS PERFORMEDT AYAIUBIE PRIOR TO (MOnm, Day. year) ^ ^ N o COMPLETION OF CAUSE Vea OF DEATM? Natural ~ Homicide ^ ~j•( A°c10eM ^ Pending lnveatigetbn ^ 70a. 70b. M. 70c. 3qd. Yea ^ No ^ PLACE DFINJURY-At Mme, term, avast, factory, aabe LOCATION ISkeel, GryROwn. Slala) Vy, ^ No c. nc.lSpecily) miMd ^ DuilOlrlg M tl te ^ v ~ , e r Coub not Sublds 301 xw. xeD. za. SIGNATUR Chief Deputy DEIITIFIER (Check oMy ors) •ceRTIFYIND PNYSICIAN (Pnyaicien cMayirp cause M deem wnen enemer D^Yeitian nee pronouroetl tleath aM Completetl Item 23) ... ~,~ C Drone r .................. To 1M Daat of my knowlWga, Death xoumd sus eo tM Gues(s) arts manner as atalao ................................ 71D. LIC SE NUMBE DATE SIGNED (MOnm, Dey, Year) ND CERTIFYING PHYSICIAN(Physicen UDlh pronouncingtlaem antl crMirying to wuae of deem) 3tc. dto. June 22, 2002 ~' • ^ PRONDUNCING A Te tlN DMl of mY kmwNdgs, deem eeeurtad s<IM tlma, dab, and Plaea, eno dw to ms eauaa(q and manner n atsted ......................... ~ NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH (Item 27)Type or Print Todd C. Eckenrode,Chf.Deo. Coroner 'MEDICAL EXAMINER/CORONER 6375 Ba3 eh Ore Rd. ,, Suite ~I1 On theEasNofe:aminatlonand/or lnvestigatlon,Inmyopinlon,dastltxeurradattltetime,data, andpleea,aMduetothaeause(a)amt Mechanicsburg Pa. 17050 , manner as Hatatl ........................................................................... ~ ~ 72. 71a. DATE FlLED(MOnm. DaYV ) REGISTRAR'S SIGNATURE AND NU E n lS ~ ~ 00~ ~ . p-• ea.~..c~ - 3.. lane a, . ~. LAST WILL AND TESTAIVIENT OF ELIZABETH D. CONKLIN ~1- oa-- 59~ I, ELIZABETH D. CONKLIN, Social Security Number 202-18-4550, of the Commonwealth of Pennsylvania, declare that this is my LAST WILL AND TESTAMENT and I revoke all other wills and codicils previously made by me. I. I appoint my daughter, LYNN C. POWER of Pennsylvania as my Personal Representative concerning this Will. If my daughter, LYNN C. POWER of Pennsylvania is unable or fails to serve, I then appoint my son, JAMES T. CONKLIN of Maine to serve as my Personal Representative. A. I request that my Personal Representative be permitted to serve without bond or surety thereon and without the intervention of any court, except as required by law. I direct that my Personal Representative act in unsupervised administration so as to administer my estate with a minimum of court supervision. If it becomes necessary to have ancillary administration of my estate in any jurisdiction where my Personal Representative is unable or does not desire to qualify as ancillary legal representative, I appoint as such ancillary legal representative such individual or corporation as my Personal Representative shall designate, in writing. B. I direct my Personal Representative to pay the expenses of my last illness, the expenses of a funeral appropriate to my station in life and custom of living (including a suitable monument or marker for my grave), and written charitable pledges which I have made. I grant my Personal Representative the power to extend or renew any debt for such time as my Personal Representative shall deem appropriate. C. All estate, inheritance, succession and other death taxes with respect to all property passing under this my Will shall be paid from and borne by the principal of my residuary estate, without regard to reimbursement, as if such taxes were administration expenses. My Personal Representative may pay such taxes at any time deemed advisable, whether or not then due and payable. D. My Personal Representative is requested to settle my estate as soon after my death as maybe practicable, and to pay or deliver every legacy or bequest to my Last Will and Testament of ELIZABETH ~CON~KLIN ~--.,_ _ ~ , -~ ~ ~ Page 1 ~~~/" ~~/-~1~ beneficiaries without waiting any time that maybe believed to be customary in probate matters. E. I have served in the Armed Forces of the United States. Therefore, I direct my Personal Representative to consult with a Legal Assistance Attorney at the nearest military installation and with the Department of Veterans Affairs and the Social Security Administration to ascertain if there are any benefits to which my family members are entitled by virtue of my military service. F. I may leave a letter of intent with the executed copy of this Will for the purpose of giving guidance to my Personal Representative concerning the distribution or sale of certain items of my property. I request, but do not require, that my Personal Representative honor my wishes therein expressed. II. I give, devise and bequeath, absolutely and forever, all of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to my daughter, LYNN C. POWER of Pennsylvania, and my son, JAMES T. CONKLIN of Maine, in shares of substantially equal value to be divided as they may agree. A. If any of the persons named above in this paragraph shall not survive me, then the share of that deceased person shall go to the descendants of that person, who are to take per stirpes and not per capita. If any of the persons named above in this paragraph shall not survive me and shall not be survived by any descendants, then the share of that deceased person shall be distributed to those persons named above in this paragraph who survive me and the descendants of any of the persons named above in this paragraph who fail to survive me, in the manner set forth above. B. If they are unable to agree, the division among the persons named above in this paragraph and the descendants of any of those persons named above in this paragraph who fail to survive me shall be made by my Personal Representative, in that person's sole and absolute discretion. I empower my Personal Representative to sell any or all of such property, if such property is not distributed in kind hereunder, and to distribute the proceeds among the beneficiaries under this paragraph in substantially equal shares. Any determination of my Personal Representative as to what should pass or be sold under this paragraph and to whom it should pass or be delivered or at what price it should be sold shall be conclusive. III. Except as otherwise provided in this Will, I have intentionally failed to provide for any other relatives or other persons, whether claiming to be an heir of mine or not. Insofar as I have failed to provide in this Will for any of my issue now living or later born or adopted, such failure is intentional and not occasioned by accident or mistake. Last Will and Testament of ELIZABETH CONKLIN ~~ Page 2 ~'~ 7~~ IV. Any beneficiary who fails to survive until One Hundred and Twenty (120) hours after my death shall be deemed to have predeceased me, and the gift to that beneficiary shall be disposed of accordingly. V. Definitions: A. The term "descendants" as used in this Will means the immediate and remote lawful, lineal descendants by blood or adoption of the person referred to who are in being at the time they must be ascertained in order to give effect to the reference to them. B. The term "children" as used in this Will does not include adopted and afterborn persons. The term "children" as used in this Will shall not include step- children, the natural born or adopted children of a person's spouse who are not the natural born or adopted children of the person. A relationship by or through legal adoption shall be treated the same as a relationship by or through blood for purpose of succession to property under this Will. C. The term "per stirpes" as used in this Will means that whenever a distribution is to be made to the descendants of any person, the property to be distributed shall be divided into as many shares as there are (1) living children of the person, and (2) deceased children, who left descendants who are then living, of the person. Each living child (if any) shall take one share and the share of each deceased child shall be divided among his then living descendants in the same manner. D. The term "Personal Representative" as used in this Will shall have the same meaning as Executor, Executrix, Independent Executor, or any other title of like import which is used to describe such a fiduciary. VI. In addition to any powers granted by the laws of the jurisdiction in which this Will is probated, I hereby authorize and empower the fiduciaries named in this Will, to the extent of the discretion herein granted, to sell, exchange, convey, transfer, assign, mortgage, pledge, lease or rent the whole or any part of my real or personal estate, to invest, reinvest, or retain investments of my estate, to perform all acts and to execute all documents which my fiduciaries may deem necessary or proper in regard to my property. If any of my fiduciaries elect to receive compensation for services, such compensation will be that allowed by law. VII. If any part of this Will shall be invalid, illegal, or inoperative for any reason, it is my intention that the remaining parts, so far as possible and reasonable, shall be effective and fully operative. My Personal Representative may seek and obtain court instructions for the purpose of carrying out as nearly as maybe possible the intention of this Will as shown by the terms hereof, including any terms held invalid, illegal, or inoperative. Last Will and Testament of ELIZABETH CONKLIN ~ ~ /~ ~ 1 Page 3 ~~~~~~ -~~ ~~ ~ -~ This document was prepared under the authority of Title 10 U.S. Code, section 1044, and implementing military regulations and instructions, by DAVID W. STARRATT, a member of The Judge Advocate Legal Service, United States Army, who is licensed to practice law in the Commonwealth of Pennsylvania. IN WITNESS WHEREOF, I have at Carlisle, Pennsylvania, on ~~ `~1~~ 1 ~~ set my hand and seal to this my LAST WILL AND TESTAMENT, consisting of 5 typewritten pages, each page bearing my handwritten signature. .-~.C'~/ /y ~ ~ ~ (SEAL) ELIZABETH D. CONKLIN The foregoing instrument was, at Carlisle, Pennsylvania, on ~ /~'`~-z~'IY ~ ~% ~C/ , signed, sealed, published and declared by ELIZABETH D. CONKLIN, the testator, to be her LAST WILL AND TESTAMENT in the presence of all of us at one time, and at the same time we, at her request and in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses, and we do so verily believe that the said testator is of sound and disposin mind and memory at the date hereof. ~_ ~' Soc.Sec.No. Soc.Sec.No. Soc.Sec.No. D of ~ of of (,mot, ~~ ~ ' r ~ Tai 3 Last Will and Testament of ELIZABETH CONKL ~~ Page 4 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ACKNOWLEDGMENT I, ELIZABETH D. CONKLIN, testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~, 9 ~ (SEAL) ELI ABETH D. CONKLIN AFFIDAVIT We, S'N i (LL._~'I il`~~(..c.l -~J ., ~~1 l.~s ,and ~OSr~ /~- Ore?iZ-~ID~' ,the witnesses, sign our names to this instrument, being duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as her Last Will; that the testator signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the will as a witness; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. .,1. ~ - TNESS WITNESS WI SS Subscribed, sworn to and acknowledged before me by ELIZABETH D. CONKLIN, the testator, and subscribed and sworn to before me by ~'~/ ~ ~~ MIL f} ttc}/U r~ , 1~,,~ ,~,-~ , j ~ S ,and ~~pSA ~ ACTit-~~'/ly ,the witnesses, on ~(~ /yJ~~=~ /~~L ~~ _ Notanal Seai NOTARY PUBLIC M Commission Ex fires: Betty R. Standridge. Notary Public Y P sle Boro. Cumberland County My Commission Expires May 14. 2~~C1 Memfi~f na~n:,m ~ ~ ~~~ Last Will and Testament of ELIZABETH CONKLIN Page 5 ~/`~ ~~~~ ~-r~,~ 3-CC~ ~i ~ ~ . ti,-./ s CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Elizabeth D. Conklin Date of Death: Will No.: To the Register: June 16, 2002 Admin. No.: 21-02-0594 I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 10, 2002: Name Address Lynn C. Power 890 Weiss Road, Nazareth, PA 18064 James T. Conklin 41 George Street, South Portland, ME 04106 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: none Date: ~ - I Z-D~- x ~1/L(i~ Gr~~'r~~ Sign re Lynn C. Power 890 Weiss Road Nazareth, PA 18064 Capacity: X Personal Representative Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171 28-0601 RECEIVED FROM: BROUJOS & GILROY ATTYS 4 N HANOVER STREET CARLISLE, PA 17013 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssN: 2o2-ia-4550 FILE NUMBER: 2102-0594 DECEDENT NAME: CONKLIN ELIZABETH D DATE OF PAYMENT: 09/ 1 6/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 06/ 1 6/2002 REV-1162 EX111-961 NO. CD 001620 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 510, 000.00 TOTAL AMOUNT PAID: REMARKS: BROUJOS & GILROY ATTYS CHECK# 2627 SEAL INITIALS: DO RECEIVED BY: MARY C. LEWIS 510, 000.00 REGISTER OF WILLS REGISTER OF WILLS BROUJOS & GILROY, P.C. ATTORNEYS AT LAw 717-243-4574 JOHN H. BROUJOS 4 NORTH HANOVER STREET FAX: 717-243-8227 HUBERT X. GILROY CARLISLE, PENNSYLVANIA 17013 NON-TOLL FROM HARRISBURG AREA: 717-766-1690 e-mail: jbroujos®broujosgilroy.com hgilroy®broujosgilroy.com January 30, 2003 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Estate of Elizabeth D. Conklin; File No. 21-02-0594 Dear Register: Please withdraw my name as attorney for the above estate. `~~ Sin~erely yours, \ ~:. -___ ~~ John H. Broujos /js c: New Attorney for the Estate: Terrence Faul, Esquire Turtzo, Spry, Shrocchi, Faul and La Barre One West Broad Street, Suite 700 Bethlehem, PA 18018 Register of Wills of Cumberland County, Pennsylvania Estate of Conklin, Elizabeth D INVENTORY also known as Deceased No. 21 - 02 - 00594 Date of Death 6/16/2002 Social Security No. 202-18-4550 Lynn C. Power The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: Paul S Frank, Esquire I.D. No.: 65323 Personal Representative Signature: f/l(j~/~, ~__ Ly .Power Signature: Signature: Address: 1 West Broad Street, Suite 700 Address: 890 Weiss Road Bethlehem, PA 18018 Nazareth, PA 18064 Telephone: 610/332-0390 Telephone: 610-746-9501 Dated: 3 24Q 3 _ Personal Property 230.278 units USAA Investment Management Company Account #006435073, USAA 3,445.42 Income Stock Fund #35-35901858282 2841.879 shares VanKampen USA Govt. A 41,406.18 150 shares JLG Industries 1,969.50 400 shares Atmel Corp. 2,820.00 400 shares EMC Corp. 2,800.00 46 shares Eastman Chemical Co. 2,053.90 138 shares Eastman Kodak Co. 4,127.58 100 shares Gillette Co. 3,496.00 60 shares International Business Machines 4,544.40 (Attach additional sheets if necessary) Total Personal Property and Real Estate $419,803.62 Register of Wills of Cumberland County, Pennsylvania INVENTORY continued Estate of Conklin, Elizabeth D No. 21 - 02 - 00594 also known as Date of Death 6/16/2002 Deceased Social Security No. 202-18-4550 17 shares AT&T Wireless 96.22 6 shares Lucent Technology, Inc. 16.74 336.044 shares MSIF Trust Value Port Instl. 4,828.95 200 shares Merck & Co. 10,482.00 60 shares Motorola 942.60 90 shares Philip Morris 4,968.00 1 share Ventas, Inc. 13.19 800 shares Walgreen Company 29,920.00 100 shares Wrigley Wm. Jr. Co. 5,699.00 6 shares General Electric Co. 178.86 753.387 shares MFS Mass Investor Growth Stock 8,362.60 525.301 shares AF New Perspective Fund 10,794.94 150 shares Pfizer, Inc. 5,289.00 384 shares Reliant Energy Inc. Com 5,068.80 15 shares Proctor & Gamble 1,379.10 50 shares United Parcel Service 3,104.00 1051.388 shares Eaton Vance WW Health CL A 8,505.73 378.397 shares Mutual Series Qualified Inc. CL Z 6,133.82 200 shares Mylan Labs 5,108.00 367.250 shares AF Capital World Growth & Income 9,019.66 14 shares MCData Corp. CL A 113.26 200 shares Coca Cola Co. 10,934.00 2 Register of Wills of Cumberland County, Pennsylvania INVENTORY continued Estate of Conklin, Elizabeth D No. 21 - 02 - 00594 also known as Date of Death 6/16/2002 Deceased Social Security No. 202-18-4550 400 shares Wyeth NFS LLC 21,076.00 66 shares Global Santa Fe Corp. 2,127.84 100 shares 3M Corp. 12,534.00 1 share Agere Sys., Inc. 2.44 M & T Bank Checking Account #1084445 14,011.96 Prime Fund Capital Reserves Account with MML Investors Services, Inc. 4,472.44 2001 Oldsmobile Alero GL2 Sedan, VIN # 1 G3NL52E71 C243940 10,100.00 Furniture and personal property, as appraised by S.W. Barrett Real Estate and Appraisal 3,211.00 Services Second Hand Boutique -sale of clothing on consignment 206.98 Tri-Care Insurance -refund of long-term care insurance premium 990.70 Tri-Care Insurance -medical reimbursement 24.66 USAA -refund of car insurance premium 133.86 Refund of county real estate tax upon sale of real property 19.58 Refund of school tax upon sale of real property 862.51 Refund of Condominium Association Fee upon sale of real property 101.57 AAA Auto Club -refund of membership fee 53.00 Delta Dental -refund of insurance premium 81.64 USAA -SSA refund 171.99 Total Personal Property $267,803.62 3 Register of Wills of Cumberland County, Pennsylvania INVENTORY continued Estate of Conklin, Elizabeth D also known as No. 21 - 02 - 00594 Date of Death 6/16/2002 ,Deceased Social Security No. 202-18-4550 Real Estate Residential Real Estate located at 122 Strayer Drive, Carlisle, PA 152,000.00 Total Real Estate $152,000.00 4 KING, SPRY, ,FREUND &. FAUL, LLC ATTORNEYS &COUNSELORS A L L E N T O W N ~ B A ~ BETHLEHEM ~ S T R O U D S B U R G March 12, 2003 E. DRUMMOND KING JEROME B. FRANK DONALD F. SPRY II DOMENIC P. SBROCCHI KENT H. HERMAN TERENCE L FAUL JOHN E. FREUND, III JAMES F. SWARTZ, III' KEVIN C. REID PAUL S. FRANK MICHAEL A. GAUL ANN MARIE T. NASEK JESSICA A. DAVENPORT OF COUNSEL: ANDREW E. FAUST JAMES J. RAVELLE AFFILIATED WITH: LAW OFFICES OF Ira WeIsS PlttsbUrgh, PA 15219 • CertlHed CMI Trlal Advocate by NaUOnal eoaro oP mal AdvapcY VIA OVERNIGHT DELIVERY Ms. Mary C. Lewis Register of Wills -Cumberland County One Courthouse Square Carlisle, PA 17013-3387 Re: File No. 21-02-00594, Estate of Elizabeth D. Conklin Dear Ms. Lewis: Please be advised that this office represents the above-captioned Estate. Enclosed for filing are the following documents: 1. The Inheritance Tax Return, in duplicate, with Estate check number 044, in the amount of $5,946.69, attached; 2. The Inventory; and 3. Estate check number 045, in the amount of $69.00, which includes the $15.00 Inheritance Tax Return filing fee, the $19.00 Inventory filing fee, and the $35.00 excess probate fee. Please file the enclosed documents immediately upon your receipt, and return date and time-stamped copies to me in the enclosed envelope. Thank you for your prompt attention to this matter. Very truly yours, KIN RY, HERMAI~I, FREUND &FAUL, LLC Paul S. Fran PSF/sm Enclosures cc: Ms. Lynn C. Power oNE WEST BROAD STREET • SUITE 700 • BETHLEHEM, PA 18018 • TEL: 610.332.0390 • FAX: 610-332-0314 REV-1162 EX~11-96) 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 FRANK PAUL S ESQUIRE 1 WEST BROAD STREET SUITE 700 BETHLEHEM, PA 18018 fold ESTATE INFORMATION: ssrv: 2o2-~s-455o FILE NUMBER: 2102-0594 DECEDENT NAME: CONKLIN ELIZABETH D DATE OF PAYMENT: 03/13/2003 POSTMARK DATE: 03/12/2003 COUNTY: CUMBERLAND DATE OF DEATH: 06/16/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 ~ 55,946.69 TOTAL AMOUNT PAID: REMARKS: LYNN C POWER C/O PAUL S FRANK ESQUIRE CHECK# 044 INITIALS: CW SEAL RECEIVED BY: DONNA M. OTTO 55,946.69 DEPUTY REGISTER OF WILLS NO. CD 002284 REGISTER OF WILLS &- 'OOEhl'.fO) *' COMM~TH Of PENNSYlVANIA DEPARTMENT Of REVENUE OEPT.280601 HARRISBURG, PA 11128-0601 1.;-72.- :, REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Conklin, Elizabeth D ~ z w o w U w o 06/16/2002 0511511927 (IF APPLICABLE) SURVMNG SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITiAl) OFFICIAL USE ONLY v ALE NUMBER 21 02 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 202-18-4550 00594 NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER . 1. Original Retum [] 2. Supplemental Return ~ [] 4. Limited Estate [] 4a. Futwe Interest Compromise (date of death ~~~ after 12.12-82) lrlELg . 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach ::z::i...l U..m of Will) copy of Trust} .. [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death ~tween " 12.31-91 and 1-1-95 [] 3. emsl er eum aeo e poor 0 [] 5. Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes [] 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 0!z ~ ~ IRM NAME (If applicable) 8 ~ King, Spry, Herman, Freund & Faul, LLC LEPHONE NUMBER 610/332-0390 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o " :3 " 0: 11 w '" 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly OWned Property (Schedule F) o - Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (line 8 minus Line 11) I West Broad Street, Suite 700 Bethlehem, P A 18018 (1) 152,000.00 OFFICIAL USE ONLY (2) 233,361.73 (3) None (4) None (5) 34,441.89 (6) 11,007.97 (7) 5,921.24 (8) 436,732.83 (9) 18,39L10 (10) 52,274.85 (11) 70,665.95 366,066.88 (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 366,066.88 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z 16.Amount of Line 14 taxable at lineal rate 366,066.88 x .045 (16) 0 " ;! ~ 17.Amount of Line 14 taxable at sibling rate .12 (17) .. x '" 0 U ~ 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 16,473.01 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 16,473.01 20. [] Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 122 Strayer Drive CITY jSTATE PA lZIP 17013 Carlisle Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Cred~ B. Prior Payments C. Discount 10,000.00 526.32' Total Credits (A + B + C) 3. Interest/Penalty if applicable D. Interest E. Penalty T otallnterestlPenalty (D + E) 4. It 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 5. If line 1 + line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check Payable 10: REGISTER OF WILLS, AGENT (1) 16,473.01 (2) 10,526.32 (3) 0.00 (4) (5) 5,946.69 (SA) (5B) 5,946.69 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;.......................... ...................................,......... 0 a b. retain the right to designate who shall use the property transferred or its income;.................. 0 a c. retain a reversionary interest; or......................... ................................ ................ .............. . .... 0 EBI d. receive the promise for life of either payments, benefits or care?................................. 0 a 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?.......................... ................ ................. ....................."............ 0 DiD 3. Did decedent own an ~in trust for" or payable upon death bank account or security at his or her death?..... 0 S 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?............. ......................... ................. ................................................... a D 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 retum, including accompanying schedules and statements, and to the best ofrny knowledge and belief. it is tsve, correct and complete. Declaration of preparer other than the personal representative is based on all inforn1alion of whidl preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR F RETURN ADDRESS Lynn Power 890 Weiss Road Nazareth, P A 18064 I West Broad Street, Suite 700 Bethlehem, PA 18018 DATE 3 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 f 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) (Un. The statute does not exemot a transfer to a sUNiving 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 ofthe decedent's siblings is 12% (72 P.S. ~9116 (a) (1.3}l. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. *' SCHEDULE A REAL ESTATE COUMO~l1iOFPENNS'l1....VA.N\J\ INHERITANCe TAX RETURN RESIDENT OEca>ENT ESTATE OF Conklin, Elizabeth D I FILE NUMBER 2\ - 02 - 00594 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would lie exchanged between a willing buyer and a willing selle!, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property whicti is jointly-owned wim right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 152,000.00 Residential Real Estate located at 122 Strayer Drive, Carlisle, PA - Contract sale price, see attached HUD-I Settlement Statement TOTAL (Also enter on Line 1, Recapitulation) \52,000.00 .. SCHEDULE B STOCKS & BONDS COMMO~TH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDeNT DECEDENT ESTATE OF Conklin, Elizabeth D I FILE NUMBER 21 - 02 - 00594 All property jointly~owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION UNIT VALUE VALUE AT DATE NUMBER OF DEATH 1 230.278 units USAA Investment Management Company Account #006435073, 14.962 3,445.42 USAA Income Stock Fund #35-35901858282 2 2841.879 shares VanKampen USA Govt. A 14.57 41,406.18 3 150 shares JLG Industries 13.13 1,969.50 4 400 shares Atmel Corp. 7.05 2,820.00 5 400 shares EMC Corp. 7.00 2,800.00 6 46 shares Eastman Chemical Co. 44.65 2,053.90 7 138 shares Eastman Kodak Co. 29.91 4,127.58 8 100 shares Gillette Co. 34.96 3,496.00 9 60 shares International Business Machines 75.74 4,544.40 10 17 shares AT&T Wireless 5.66 96.22 II 6 shares Lucent Technology, Inc. 2.79 16.74 12 336.044 shares MSIF Trust Value Port Inst!. 14.37 4,828.95 13 200 shares Merck & Co. 52.41 10,482.00 14 60 shares Motorola 15.71 942.60 15 90 shares Philip Morris 55.20 4,968.00 16 I share Ventas, Inc. 13.19 13.19 17 800 shares Walgreen Company 37.40 29,920.00 18 100 shares Wrigley Wm. Jr. Co. 56.99 5,699.00 19 6 shares General Electric Co. 29.81 178.86 Total of Continuation Schedule(s) 101,190.59 TOTAL (Also enter on line 2, Recapitulation) 233,361.73 .. SCHEDULE B STOCKS & BONDS continued COMMONWEAlTH OF PENNSYLVANIA IHHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Conklin, Elizabeth D I FILE NUMBER 21.02.00594 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION UNIT VALUE VALUE AT DATE NUMBER OF DEATH 20 753.387 shares MFS Mass Investor Growth Stock 11.10 8,362.60 21 525.301 shares AF New Perspective Fund 20.55 10,794.94 22 150 shares Pfizer, Inc. 35.26 5,289.00 23 384 shares Reliant Energy Inc. Com 13.20 5,068.80 24 15 shares Proctor & Gamble 91.94 1,379.10 25 50 shares United Parcel Service 62.08 3,104.00 26 1051.388 shares Eaton Vance WW Health CL A 8.09 8,505.73 27 16.21 6,133.82 378.397 shares Mutual Series Qualified Inc. CL Z 28 200 shares Mylan Labs 25.54 5,108.00 29 367.250 shares AF Capital World Growth & Income 24.56 9,019.66 30 14 shares MCData Corp. CL A 8.09 113.26 31 200 shares Coca Cola Co. 54.67 10,934.00 32 400 shares Wyeth NFS LLC 52.69 21,076.00 33 66 shares Global Santa Fe Corp. 32.24 2,127.84 34 100 shares 3M Corp. 125.34, 12,534.00 35 I share Agere Sys., Inc. 2.44 2.44 Page 2 of Schedule B .w SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Cot.1MONMAL TH OF PENNSYLVANIA INHERITANCE TAX RETlJRN RESIDENT DECEDENT I FILE NUMBER 21 - 02 - 00594 ESTATE OF Conklin, Elizabeth D Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshIp must be disclosed on schedule F. ITEM NUMBER I DESCRIPTION VALUE AT DATE OF DEATH 14,01l.96 M & T Bank Checking Account # 1084445 2 Prime Fund Capital Reserves Account with MML Investors Services, Inc. 4,472.44 3 2001 Oldsmobile A1ero GL2 Sedan, VIN #lG3NL52E71C243940 10,100.00 4 Furniture and personal property, appraisal ofS.W. Barrett Real Estate and Appraisal, attached 3,211.00 5 Second Hand Boutique - sale of clothing on consignment 206.98 6 Tri-Care Insurance.. refund of long~term care insurance premium 990.70 7 Tri-Care Insurance.. medical reimbursement 24.66 8 USAA - refund of car insurance premium 133.86 9 19.58 Cumberland County - refund of real estate taxes paid, see HUD-I Settlement Statement, attached South Middleton School District - refund of real estate taxes paid, see HUD-I Settlement Statement, attached 862.51 to II Forest Meadows Condominium Association - refund of Association Fees, see HUD-I Settlement Statement, attached to 1.57 12 AAA Auto Club - refund of membership fee 53.00 13 Delta Dental- refund of insurance premium 81.64 14 USAA - SSA refund 171.99 TOTAL (Also enter on Line 5, Recapitulation) 34,441.89 *' SCHEDULE F JOINTLY -OWNED PROPERTY COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Conklin, Elizabeth D I FILE NUMBER 21 - 02 - 00594 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 A Lynn C. Power ADDRESS RELATIONSHIP TO DECEDENT 890 Weiss Road Nazareth, PA 18064 Daughter JOINTLY OWNED PROPERTY: LETTER DATE T %OF DATE OF DEATH ITEM Include name of financial institution and bank account number DATE OF DEATH NUMBER FOR JOINT MADE or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET DECO'S VALUE OF TENANT JOINT estate. INTEREST DECEDENTS INTEREST I A 12/22/1997 Waypoint Bank Guaranteed Money Fund Account 22,015.94 50% 11,007.97 #20084621 TOTAL (Also enter on line 6, Recapitulation) 11,007.97 *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY CQMMON'v\IEALTH OF PENNSYLVANIA INHERITA~CE TAX RETURN RESIDENT DECEDENT . Conklin, Elizabeth D FILE NUMBER 21 - 02 - 00594 ESTATE OF This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. ITEM DESCRIPTION OF PROPERTY ~ATE OF DEATH %OF Include the name of the transferee, their relationship to decedent and the date of transfer. ALUE OF ASSET DECD'S EXCLUSION TAXABLE VALUE NUMBER Attach a copy of tile deed for real estate. INTEREST (IF APPLICABLE) I Individual Retirement Account with MML Investors Services, Inc., daughter, Lynn C. Power, Beneficiary; See below: Prime Fund - Capital Reserves Fund 1,452.99 100% 1,452.99 RPM, Inc. - 56 shares at $15.28 per share 855.68 100% 855.68 Motorola, Inc. - 165 shares at $15.71 per share 2,592.15 100% 2,592.15 Templeton Growth Fund CL A - 56.377 shares at $18.10 1,020.42 100% 1,020.42 per share I TOTAL (Also enter on line 7, Recapitulation) 5,921.24 '* SCHEDULEH FUNERAL EXPENSES & ADMNIS1RA11VECOSTS COMMONVIIEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDEN1' I FILE NUMBER 21 - 02 - 00594 ESTATE OF Conklin, Elizabeth D Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: I Ewing Brothers Funeral Home - Funeral and related services 8,878.00 2 Ewing Brothers Funeral Home - Bronze memorial plaque 200.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Nurnber(s) I EIN Number of Personal Representative(s): Street Address City State lip - Year(s) Commission paid 2. Attorney's Fees Broujos&Gilroy / King Spry Herman Freund & Faul LLC 7,021.63 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State lip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills, Cumberland County 387.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs I Register of Wills, Cumberland County - Inventory filing fee 19.00 2 Register of Wills, Cumberland County - Inheritance Tax Return filing fee 15.00 Total of Continuation Schedule(s) 1,870.47 TOTAL (Also enter on line 9, Recapitulation) 18,391.10 *' ScheduIeH Funeral ExpeIISBS & Mninislrative Cosls continued COMMONVvEAlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Conklin, Elizabeth D I FILE NUMBER 21 - 02 - 00594 3 Wolfe & Shearer - appraisal of real property 250.00 4 Charles Stringfellow - appraisal of personal property 5 Gap View Storage - 6 months rental of storage unit for personal property 6 PNC Bank - wire transfer fees 7 Citibank MasterCard - reimbursement for UHaul truck rental and gas to move personal property 8 Property Management Corp. - Fee for Condominium Resale Certificate 9 Forest Meadows Condominium Association - replacement of shrubs 10 Federal Express - overnight document delivery fee II Cohick & Associates - copies of tax returns 12 Reserve to close the estate 50.00 721.46 30.00 205.00 37.50 38.Q9 8.42 30.00 500.00 Page 2 of Schedule H '. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMON'o'VEAl..TH OF PENNSYLVANIA. \H1-\ERIT ANeE ;,.;x RETURN RESIDENT DECEDENT ESTATE OF okl' I' b h D Co m, E 1za et I FILE NUMBER 21 - 02 - 00594 Include unreimbu",ed medical expenses. ITEM NUMBER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 DESCRIPTION AMOUNT 1,582,47 Judy Campbell, tax collector - payment of South Middleton School District real estate taxes for 2002-2003 tax year USAA - Car insurance premium due 255,48 Kohls - Credit card balance due 34.36 The Bon Ton - Credit card balance due 85,22 Sprint - telephone service 63,93 AT&T Wireless - cellular telephone service 38.90 Com cast Cable - Cable TV service 40.04 PPL Electric - electric service 586.37 South Middleton Authority - water and sewer service 208.95 Forest Meadows Condominium Association - condominium fees on real property 858.72 Masland Associates - Medical services 15.09 Carlisle Regional Medical Center - Medical services 288.56 Member 1st Federal Credit Union - Balance due on Visa credit card account 130.01 Standard Mortgage Corp. of America - Mortgage payments paid on real property prior to sale 2,097.66 Standard Mortgage Corp. of America - Payoff of real property mortgage, see HUD-I Settlement Statement, attached 43,913.54 Broujos & Gilroy, PC - Attorney's fees, notary fees and reimbursement of express mail fees related to sale of real property, see HUD-I Settlement Statement, attached 483.50 Pennsylvania Department of Revenue - Realty Transfer Tax on sale of real property, see HUD-I Settlement Statement, attached 1520.00 TOTAL (Also enter on Line 10. Recapitulation) 52,274.85 *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued COMUON'M:AL TH OF PENNSYLVANIA INHERITANCE TAX RE'NfItl RESIDENT DECEDENT ESTATE OF Conklin, Elizabeth D I FILE NUMBER 21 - 02 - 00594 Include unreimbursed medical expenses. ITEM NUMBER 18 DESCRIPTION AMOUNT 72.05 South Middleton Township Municipal Authority - Final sewer and water bill on real property, see HUD-l Settlement Statement, attached Page 2 of Schedule I ~ REV.1513 EX+ (9-GO) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Conklin, Elizabeth D I FILE NUMBER 21 - 02 - 00594 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSQN(S} RECEIVING PROPERTY DECEDENT OF ESTATE no "'0' LI t Tru_oS-Is' I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) I Lynn C. Power Daughter One Half (1/2) of the 890 Weiss Road, Nazareth, PA 18064 esiduary estate 2 James T. Conklin Son One Half (1/2) of the 41 George Street, South Portland, ME 04106 residuary estate Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover she t II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHE' T LAST WILL AND TESTAMENT OF ELIZABETH D. CONKLIN I, ELIZABETH D. CONKLIN, Social Security Number 202-18-4550, of the Commonwealth of Pennsylvania, declare that this is my LAST WILL AND TEST AMENT and I revoke all other wills and codicils previously made by me. 1. I appoint my daughter, LYNN C. POWER of Pennsylvania as my Personal Representative concerning this Will. If my daughter, LYNN C. POWER of Pennsylvania is unable or fails to serve, I then appoint my son, JAMES T. CONKLIN of Maine to serve as my Personal Representative. A. I request that my Personal Representative be permitted to serve without bond or surety thereon and without the intervention of any court, except as required by law. I direct that my Personal Representative act in unsupervised administration so as to administer my estate with a minimum of court supervision. If it becomes necessary to have ancillary administration of my estate in any jurisdiction where my Personal Representative is unable or does not desire to qualify as ancillary legal representative, I appoint as such ancillary legal representative such individual or corporation as my Personal Representative shan designate, in writing. B. I direct my Personal Representative to pay the expenses of my last illness, the expenses of a funeral appropriate to my station in life and custom of living (including a suitable monument or marker for my grave), and written charitable pledges which I have made. I grant my Personal Representative the power to extend or renew any debt for such time as my Personal Representative shall deem appropriate. C. All estate, inheritance, succession and other death taxes with respect to all property passing under this my Will shall be paid from and borne by the principal of my residuary estate, without regard to reimbursement, as if such taxes were administration expenses. My Personal Representative may pay such taxes at any time deemed advisable, whether or not then due and payable. D. My Personal Representative is requested to settle my estate as soon after my death as may be practicable, and to payor deliver every legacy or bequest to my Last Will and Testament ofELlZABETII CONKLIN ~~/i9-: ~~ . Page I &L f}:/&~ . .. oenencHmes wnnOUfwamng any lime mat maYDe tieueved to De chstomary In probate matters. E. I have served in the Armed Forces of the United States. Therefore, I direct my Personal Representative to consult with a Legal Assistance Attorney at the nearest military installation and with the Department of Veterans Affairs and the Social Security Administration to ascertain if there are any benefits to which my family members are entitled by virtue of my military service. F. I may leave a letter of intent with the executed copy of this Will for the purpose of giving guidance to my Personal Representative concerning the distribution or sale of certain items of my property. I request, but do not require, that my Personal Representative honor my wishes therein expressed. II. I give, devise and bequeath, absolutely and forever, all of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to my daughter, LYNN C. POWER of Pennsylvania, and my son, JAMES T. CONKLIN of Maine, in shares of substantially equal value to be divided as they may agree. A. If any of the persons named above in this paragraph shall not survive me, then the share ofthat deceased person shall go to the descendants of that person, who are to take per stirpes and not per capita. If any of the persons named above in this paragraph shall not survive me and shall not be survived by any descendants, then the share of that deceased person shall be distributed to those persons named above in this paragraph who survive me and the descendants of any of the persons named above in this paragraph who fail to survive me, in the manner set forth above. B. If they are unable to agree, the division among the persons named above in this paragraph and the descendants of any of those persons named above in this paragraph who fail to survive me shall be made by my Personal Representative, in that person's sole and absolute discretion. I empower my Personal Representative to sell any or all of such property, if such property is not distributed in kind hereunder, and to distribute the proceeds among the beneficiaries under this paragraph in substantially equal shares. Any determination of my Personal Representative as to what should pass or be sold under this paragraph and to whom it should pass or be delivered or at what price it should be sold shall be conclusive. III. Except as otherwise provided in this Will, I have intentionally failed to provide for any other relatives or other persons, whether claiming to be an heir of mine or not. Insofar as I have failed to provide in this Will for any of my issue now living or later born or adopted, such failure is intentional and not occasioned by accident or mistake. Last Will and Testament of ELIZABETIl CONKLIN tAil.ffL(O {L~page2 &J 9tv ~ IV. Any beneficiary who fails to survive until One Hundred and Twenty (120) hours after my death shall be deemed to have predeceased me, and the gift to that beneficiary shall be disposed of accordingly. V. Definitions: A. The term "descendants" as used in this Will means the immediate and remote lawful, lineal descendants by blood or adoption of the person referred to who are in being at the time they must be ascertained in order to give effect to the reference to them. B. The term "children" as used in this Will does not include adopted and afterborn persons. The term "children" as used in this Will shaH not include step- children, the natural born or adopted children of a person's spouse who are not the natural born or adopted children of the person. A relationship by or through legal adoption shall be treated the same as a relationship by or through blood for purpose of succession to property under this WilL C. The term "per stirpes" as used in this Will means that whenever a distribution is to be made to the descendants of any person, the property to be distributed shall be divided into as many shares as there are (1) living children of the person, and (2) deceased children, who left descendants who are then living, of the person. Each living child (if any) shall take one share and the share of each deceased child shall be divided among his then living descendants in the same manner. D. The term "Personal Representative" as used in this Will shall have the same meaning as Executor, Executrix, Independent Executor, or any other title of like import which is used to describe such a fiduciary. VI. In addition to any powers granted by the laws of the jurisdiction in which this Will is probated, 1 hereby authorize and empower the fiduciaries named in this Will, to the extent ofthe discretion herein granted, to sell, exchange, convey, transfer, assign, mortgage, pledge, lease or rent the whole or any part of my real or personal estate, to invest, reinvest, or retain investments of my estate, to perform all acts and to execute all documents which my fiduciaries may deem necessary or proper in regard to my property. If any of my fiduciaries elect to receive compensation for services, such compensation will be that allowed by law. VII. If any part of this Will shall be invalid, illegal, or inoperative for any reason, it is my intention that the remaining parts, so far as possible and reasonable, shall be effective and fully operative. My Personal Representative may seek and obtain court instructions for the purpose of carrying out as nearly as may be possible the intention of this Will as shown by the terms hereof, including any terms held invalid, illegal, or inoperative. Last Will and Testament of ELIZABETH CONKLIN~ t~' jJ a fage 3 r.// 1~M 7",J,",U ~ ~ ~ . ... This document was prepared under the authority of Title 10 U.s. Code, section 1044, and implementing military regulations and instructions, by DAVID W. STARRATT, a member of The Judge Advocate Legal Service, United States Army, who is licensed to practice law in the Commonwealth of Pennsylvania. IN WITNESS WHEREOF, I have at Carlisle, Pennsylvania, on It Pl~ 1t?99, set my hand and seal to this my LAST WILL AND TESTAMENT, consisting of 5 typewritten pages, each page bearing my handwritten signature. h~~j). (?~J') (SEAL) ELIZABETH D. CONKLIN The foregoing instrument was, at Carlisle, Pennsylvania, on I ~ ~ I q 19 , signed, sealed, published and declared by ELIZABETH D. CONKLIN, the testator, to be her LAST WILL AND TEST AMENT in the presence of all of us at one time, and at the same time we, at her request and in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses, and we do so verily believe that the said testator is of sound and disposin mind and memory at the date hereof. ~ ~a'Ik4-~4Z4 Soc. Sec. No. Soc.Sec.No. Of?;~}nc ofa~,M ~?tf/ /7111 J- Sac.Sec.No. of (.tkU, If f ltJ! J Last Will and Testament of ELIZABETH CONKL~ //)_ f}Lp~tiJ2 (7jn~ge~ dJ~):/~ .. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ACKNOWLEDGMENT I, ELIZABETH D. CONKLIN, testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. c!) . }JL /), Crnklr~ ELI~ETH D. CONKLIN (SEAL) AFFIDAVIT We, SlJ I~ f'\<:t..I'\<.X..HLI.v h~Jp ,c:; , and I? O~A 1I-1J1!-77 Z- j1ftJJt'.i{ , the witnesses, sign our names to this instrument, being duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as her Last Will; that the testator signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the will as a witness; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ~~Ltt,.~ u~y~ Subscribed, sworn to and acknowledged before me by ELIZABETH D. CONKLIN, the testator, and subscribed and sworn to before me by SI.f I ~ M"Ut/.AJ:./Iw,J ~T'~~~~ < , and 10$".4 II- ()I!71?7#Jrl'i , the witnesses, on b fJ7. /tJff. ~ ~L4-~ 7~,' NOTARY PUBLIC My Conunission Expires: ---, Nolanal Seal I Betty R. Standridge, Notary Public sle Bora, Cumberland County \ My Commission Expires May 14, 2001 M!mbflt Plll1miVlvani<i ,Il,SSlJc~ation Of Notaries Last Will and Testament of ELIZABETH CONKLrN CA~.~i1,fJ (I!~ Page 5 62leC&l ~ ~, o < o ~ ,.oj m ;1:"';:J""~- ~..;.r-(T:c!:_ - ,.-.;-.;,"/:,7 OJ m --I I o () o Z' ^ r Z f )0 ~ I = g/ I ~ .~ ','lo+ - - - - .... A. B. TYPE OF LAN: -U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.0FHA 2.0FmHA 3.0CONV. UNINS. 4.oVA 5.0CONV.INS. 6. ~!L~, ~~MBER 17. LOAN NUMBER SETTLEMENT STATEMENT 8. MORTGAGE INS CASE NUMBER C. NOTE: This fonn is furnished to give WU a statement of actual settlement costs. Amounts paid to and by the settlement 8(J6.nt are shown. Items marked "{POCr wore paid outside the closing: they are shown here for informational purposes and are not included in the totals. \.0 - (BLOUIN. t.Il.....RCEl.PFDiBLOUlN. MARCEL.I8) D. NAME AND ADDRESS OF BORROWER E. NAME AND ADDRESS OF SELLER F. NAME AND ADDRESS OF LENDER Marcel E. Blouin Lynn C. Power for 61 Strayer Drive Estate of Eliz.a.beth O. Conklin Carlisle, PA 17013 122 Strayer Drive Carlisle. PA 17013 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-2267691 I. SETTLEMENT DATE: 122 Strayer Drive Broujos & Gilroy. PC Carlisle, PA 17013 December 9, 2002 Cumberland County, Pennsylvania PLACE OF SETTLEMENT 4 North Hanover Street Carlisle, PA 17013 J. SUMMARY OF BORR WER'S TRANSACTION K. SUMMARY OF SEL ER'S TRAN ACTI N 101. Contract Sales Price I 152,000.00 401. Contract Sales Price i 152,000.00 102. Personal prooertv 402. Personal ProDertv 103. Settlement Charaes to Borrower (Line 140m 2,714.75 403. ! 104. 404. 105. 405. ; 106. CitvITown Taxes 10 , 406. CitvlTown Taxes to ! 107. County Taxes 12/10/02 to 01/01/03 I 19.58 407. CountvTaxes 12110/02 10 01/01103 I 19.58 108. Assessments 12/10102 10 07101103 i 862.51 408. Assessments 12/10102 to 07/01103 ! 862.51 109. Association Fees 12/10/02 to 01101103 l 101.57 409. Association Fees 12/10102 to 01/01103 i 101.57 110. I 410. , 111. I 411. i 112. I 412. I 120. GROSS AMOUNT DUE FROM BORROWER ! 155,698.41 420. GROSS AMOUNT DUE TO SELLER ! 152,983.66 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Denosit or earnest money I 5,000.00 501. Excess De od (See Instructions' 202. Princinal Amount of New loan s \ I 502. Settlemenl Cha""'s 10 Seller Line 1400) ! 2,075.55 203. Existinn loanis taken subiect to 503. Existina loaiii5'\taken sUblect to : 204. 504. Payoff of first Mortgage 10 Slandard Mortgage Corp ! 43,913.54 205. 505. Payoff of second Mort a e I 206. I 506. 207. I 507. (Deoosll disb. as nroceedSl : - 208. I 508. " 209. , 509. , -Aroustments F6fJtems-Ln I e er AdiustmentS7=Or l[emsT,nnii/rf e er 210. CitvfTown Taxes 10 \ 510. CllvlTown Taxes to I 211. County Taxes 10 I 511. County Taxes 10 , 212. Assessments to \ 512. Assessments to T 213. i 513. 214. I 514. 215. ! 515. 216. i 516. 217. I 517. 218. , 518. 219. I 519. 220. TOTAL PAID BY/FOR BORROWER I 5.000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 45,989.09 300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETT' EMENT TO/FROM SELLER: 301. Gross Amount Due From Borrower (Line 120 I 155,698.41 601. Gross Amount Due To Seller line 420\ I 152,983.66 302. Less Amount Paid BviFor Borrower (Une 220) '( 5,000.00 602. Less Reductions Due SellertLine 520) ~ i( 45,989.09 303. CASH ( X FROM)( TO} BORROWER I 150698.41 603. CASH ( X TO) ( FROM) SELLER J I , 106,994.57 The undersigned her~lt~':led copy of pages 1&2 of this stalement & any t.chments re~'{!; ~ Borrower Seller ' fA #1.0 '"A.I. Marcel E. Blouin Lynn cppower: OMS NO 2502-0265 A'o Estate of Elizabeth D. Conklin HUD.' (3-86) RESPA. HB4305.2 Palle2 L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price 1 IRI n nnnn 0/_ PAID FROM PAID FROM Division of Commission /line 7001 as Follows: BORROlNER'S SELLER'S 701. $ to FUNDS AT FUNDS AT 702.$ to SETTLEMENT SETTLIiMENT 703. Commission Paid at Settlement 704. to EM" PAYABLE E~ IIOAN 801. Loan On ination Fee o.nr % to 802. Loan Discount % to 803. Appraisal Fee to 804. Credit Report to 805. Lender's Inspection Fee to 806. Mortoaoe tns. AnD. Fee to 807. Assumption Fee to 808. 809. 810. 811. Express Mail Fee to Broujos & Gilroy I PC 15.00 1000. ITEMS IRED ENDER Tn 10 IN AOVANCF 901. Interest From to @ $ {day ( days %) 902. MIP Totlns. for LifeOfloan for months to 903. Hazard Insurance Premium for 1.0 vears 10 904. 905. 'nnn I>F"E PO"ITEO ENDER 1001. Hazard Insurance months 6 $ Der month 1002. MortQaoe Insurance months 6 $ nar month 1003. CilvrTown Taxes months , $ rno,r month 1004. CounwTaxes months 6 $ rno,r month 1005. Assessments months @ $ per month 1006. months (iiJ $ ner month 1007. months @ $ per month 1008. months IBJ $ ner month 1100. TITLE C E 1101. Settlement or Closinn Fee to 1102. Abstract or Trtle Search to 1103. Title Examination to 1104. Title Insurance Binder to 1105. Document Precaration to 1106. Notarv Fees to Cash 3.50 1107. Attorney's Fees to Broujos & Gilroy, PC 450.00 (includes above item numbers: J 1108. Title Insurance to Commonwealth Land Title Comnanv 1118.75 (includes above item numbers: 1109. Lender's Coverage $ - 1110. OWner's Coverage $ 152.000.00 1111. ,,- 1112. 1113. Broujos & Gilroy, PC 12 V MENT I>FC"ROIN'" .010 TRANSFER C E 1201. Recording Fees: Deed $ 38.50: Mortgage $ Releases $ 38.50 1202. City/Counlv Tax/Starn s: Deed . Mortnane 1.520.00 1203. State Tax/Stamos: Revenue Stamng ; Mortnane 1.520.00 1204. 1205. 11300. AOOITI NAL "ETTLEMENT CHAR"'E 1301. Survev to 1302. Pest Insoection to 1303. Resale Certificate to Property Manaaement, Inc. 37.50 1304. Exoress Mail Fee to Brouios & Gilrov, PC 15.00 1305. SewerJWater to S. Middleton Township Municipal Authority 72.05 1400. TOTAL SETTLEMENT CHARGES IEnter on Lines 103, Section J and 502, Section Kl 2,714.75 2.075.55 By signing page 1 of this statement. the signatories acknowledge receipt of a completeaJ"?1 of this two page statement. V-A' Certified to be a true copy. Braujos & GilrOY/i Settlement Agent , ( BLOUIN. MARCEL I BLOUIN, MARCEL f B l Jack R. Greenwood, CLU, CFP@ 214 Senate Ave., Suite 303 Camp Hill, PA 17011 Phone: 717-763-7365 Fax: 717-763-1880 Fax To: Paul Frank From; Pat McEvoy Fax: 1-610-332.0314 Pages: 3 Phone: 1-610-332-0390 Date: 03/06/2003 Re: Elizabeth Conklin Estate CG: Lym Power (1.610-746-9502) o Urgent o For Review 0 PI"""e Comment 0 Please a.eply 0 Please Recycle Paul: Attached is the revised coovof Belly's stock and mutual fund prices for 6/14 and 6/17. I have added the Templeton Growth Fund from t,er IRA. In addition, the Prime Fund (money market) is the total of her non.qualified account and her I ~ ($4472.44 + 1452.99). The Prime Fund amount on our Ownership Allocation page printed on July 10 with the values as of 6/14 is incorrect. That value is from the month ending 5/30/2002. I apologize h)r the error and the confusion. Please call me again if you need anylhing else. Confidentiality Note ThiS fax transmission may contain information that is proprietary, privileged, and/or confidential and is intended only for the personal and confidertial use of the person(s) to whom it is addressed. Any use, copyng, retention or disclosure by any person other than the intended recipient or the intended recipient's designees is strictly prohibited. l' you receive this message in error, please notify the sender immediately by return fax or telephone and ,jestroy all copies. -' "'-''-' .0:..............-' ........0:..........,-,., Z ...J ~ Z o () ::x: I- w m ~ ...J W en w () a:: 0- c z ::> u.. ~ <( ::> t- => :!: c z <( ~ () o I- en 'r'<,'-'''' ..................,,,.......'-'~ "" ,'-''-','-''-'..... ,. , ~ ~ ~~~~~O~ ~ ~OO~~~O ON~ ~~O~~WON~~~NN~~Wm~~~OOmNONN -~~~O~m~dN~~~~N~~~~~~m~~~N~ ON~~M~~M,~M~~~N~ro~~~~NMmm~~~ N e ~ ~ ~ ~~~omom 0 ~Oo~o~~ ~~~ ~~~~~~Oo~~~-om~~OmWID_~_~~~~O -O~q~mo~~~N~~~~N~~~~NO~_q~~~ ~~N~~N~~MI~~~~~N~~~~~~NMmm~~~ ~ ~ m~~m~~m _ Omm~N~O 000 .~~N~~~O~~N~W~~~~.~~~N_m.O~~ ~~~-d~ID~ci~~~~~NO~Wm~~ID~~ID~~ ~N~~M~~Mt~~~~~N~m~~~~N~~m~~~ . ",!,.."t";~"":":i:;""";';':""" .' ",',: ',',: ,,:,', "I> :,1"" 1" ~ ,>!,(.. ,..','" ..ihF" ": >:: ~'i". 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'?.tl>6J'2..A ~'\\~e.o~\ W~\\ (Wf>.i.J,JV-( ') P~WER PAGE 04 .U/UtI4U~~ Q~;OO O!~-(qb-~~~L TEL 717 2,3 i62' P C03 , OCT. - 04 02 IFF II 02: J6 BARRF! REAL CST,1rE QAi.1'C y I lJ VINE' <0.>/- <..-. , 1}10/;-.J () QRiLA, 5 ~\@ ~\<:.;~ ~~ ,1c~ ~-:B-.)n;~ ) ~\ WtlW0\ ~\N"..J t'. kcoi"'- 1A~k.... '( ~R',t.!j I :$LP-V'';''i:t; S ""'\A.~ . ~$') ~'"'''''r() C~..e.c....c1,-) i ~&, (}J,~dl..~ (WDD"!) '> I 0 'Y ~\..s-r~~ k K ~~\ R- ~'D.R...,.l<_~ -;,.. ffi \ <'.(2..<.) ('(. (:sm .vv,",,-\ I) , OA\<- BG.oK.CA-S:~ ~-.z. ^ <4 ?~'Ci) BOF\~l':) 6~N.s(' CJ ('l.'^l..f I "',:..".......... ~ I \ ~ '.~ (:)t:,~~~ co 'KS- ~c...~Wi2.. :s~(-"~, Q.\.l~""';' ~ ~<....ct\ sc J '/-;..' x <-t I d.~~ ;;=, ---€" ().SS IN.....' ~~<. WDuV 1'D2M<-Q~1) l."'-' '""~ lAB\..C::j I;-o....i) I-'~ l""\ rd<:.. C\"p.., I{.., D (+ I C';: 'Y v. . j S ., QU ~ Sn(l-}4 11)I,-f € t: J, .~:.h, N~ f:::.W~ ~rp.,€~ (~Ur00) \J~~ "" ~mCT~ LRx~. , G.E:, I W Cl..:::'I-\;~ ~ \-t\(L~"- Q~~\~~~<.i\-l~) ~~\GI~I~ Y. 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(ffJj~ ~7- ~a-3 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INFORMATION NOT I C E BUREAU OF INDIVIDUAL TAXES AN D DEPT. 280661 TAXPAYER RESPONSE HARRISBURG, PA 17128-0661 REV-1545 E% AFP (09-00) LYNN POWER 890 WEISS RD NAZARETH PA 18064 vC/ FILE N0. 21 02-0594 ACN 02149373 DATE 11-25-2002 EST. OF ELIZABETH CONKLIN S.S. N0. 202-18-4550 DATE OF DEATH 06-16-2002 COUNTY CUMBERLAND TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 WAYPOINT BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, You were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. questions may be answered by caning f/1"/) 787-8327. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 20084621 Date 12-22-1997 To insure proper credit to your account, two Established C2) copies of this notice must accompany your payment to the Register of Wills. Make check Account Balance 22, 015.94 payable to: "Register of Wills, Agent". Percent Taxable X 5 0. 0 0 0 NOTE: If tax payments are made within three Amount Subject to TaX 11, 007 • 97 (3l months of the decedent's date of death, you may deduct a 5% discount of the tax due. Tax Rate X ' 15 Any inheritance tax due will become delinquent Potential Tax Due 1,651.20 nine C9) months after the date of death. PART TAXPAYER RESPONSE A. ~ The above information and tax due is correct. ister the Re t t of Wills with two copies of this notice to obtain 1. g o You may choose to remit paymen check box "A^ and return this notice to the Register of a discount or avoid interest, or you may CHECK Wills and an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 CK The B above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y . ~ to be filed by the decedent's representative. ~ The C above information is incorrect and/or debts and deductions were paid by You. . You must complete PART 2^ and/ar PART 3^ below. AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) 5 Under penalties of perjury, I declare that the facts I have reported above aLr/e true, c/orrect and complete to t best of~/ny knowledge and belief. HOME C ~~~ ) 7Ll 1.~~ ~5©! ~iGy~ti~- ~/ .~1 WORK ( ) ~/ ~D Tri GaunuF NIIMRFR DATE REV-1162EX(11-96) 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 DUPLICATE POWER LYNN C 890 WEISS ROAD NAZARETH, PA 18064 ACN ASSESSMENT CONTROL NUMBER fold ESTATE INFORMATION: ssN: zo2-i a-455o FILE NUMBER: 2102-0594 DECEDENT NAME: CONKLIN ELIZABETH D DATE OF PAYMENT: 04/ 23/ 2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 06/16/2002 AMOUNT 02149373 ~ S 1,651.20 TOTAL AMOUNT PAID: REMARKS: LYNN POWERS -NOTE TWO DATES REVENUE 4-13-03 RW 4-22-2003 SEAL CHECK# 045 INITIALS: JA RECEIVED BY: $1,651.20 DEPUTY REGISTER OF WILLS DONNA M. OTTO NO. CD 002480 REGISTER OF WILLS l~ - ~~- 3 COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 NOTICE OF INHERITANCE TAX HARRISBURG, PA 171zs-oboe ppPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX 4FP (O1-OS) p-~ ` DATE 04-21-2003 ~._' _.. ESTATE OF CONKLIN ELIZABETH D DATE OF DEATH 06-16-2002 FILE NUMBER 21 02-0594 •Q3 APR 28 P 3 ~~~OUNTY CUMBERLAND PAUL S FRANK ESQ ACN 101 KING ETAL Anount Remitted 1 W BROAD ST STE 700 ~ ~f~ , BETHLEHEM PA 1801~%t~1~C- ' MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS -~ --------------------- ----- -------------------- ---------------------------------------------------------------- REV-1547 EX AFP (O1-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CONKLIN ELIZABETH D FILE N0. 21 02-0594 ACN 101 DATE 04-21-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN SASED ON: ORIGINAL RETURN 152 00 000 NOTE: To insure proper 1. Real Estate (Schedule A) (1) , 233 . 7 3 361 credit to your account, 2. Stocks and Bonds (Schedule B) (2) , . 00 submit the upper portion 3. Closely Held Stock/Partnership Interest (Schedule C) (3) . 00 of this form with your 4. Mortgages/Notes Receivable (Schedule Dl (4) 34 . 89 441 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) , 11 . 97 007 6. Jointly Owned Property (Schedule F) (6) , 5 . 24 921 7. Transfers (Schedule G) (7) . , 436,732.83 8, Total Assets (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 18,391.10 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 85 274 52 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) _ . , 95 665 70 (11) . . 11. Total Deductions 366, 066 .88 12. Net Value of Tax Return (12) .00 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (131 366,066.88 14. Net Value of Estate Sub.7ect to Tax (14) NOTE: If an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will l of ALL returns assessed to date. t t o a reflect figures that include the ASSESS MENT OF TAX: (15) .00 X 00 = .00 15. Anount of Line 14 at Spousal rate 366,066.88 X 045 = 16,473.01 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 12 - 00 .00 17. Amount of Line 14 at Sibling rate (17) X _ , 15 00 .00 18. Anount of Line 14 taxable at Collateral/Class B rate (18) = . X 473.01 16 (19)= , 19. Principal Tax Due DATE NunatK 09-16-2002 CD001620 03-12-2003 CD002284 ;OUNT l+) AMOUNT PAID /PEN PAID (-) 526.32 10,000.00 .00 5,946.69 TOTAL TAX CREDIT 16,473.01 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, 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.) ~ ~- ~a -~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 LYNN POWERS 890 WEISS RD NAZARETH PA 18064 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT ALLONANCE OR DISALLONANCE OF DEDUCTION, AND ASSESSlIENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP (01-03) DATE 11-17-2003 ESTATE OF CONKLIN ELIZABETH D DATE OF DEATH 06-16-2002 FILE NUMBER 21 02-0594 COUNTY CUMBERLAND SSN/DC 202-18-4550 ACN 02149373 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ --------------- ------ ----------------------------- -- REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 11-17-2003 ESTATE OF CONKLIN ELIZABETH D DATE OF DEATH 06-16-2002 COUNTY CUMBERLAND FILE N0. 21 02-0594 S.S/D.C. N0. 202-18-4550 ACN 02149373 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT N0. 20084621 TYPE OF ACCOUNT: C ) SAVINGS C ~ CHECKING ( ) TRUST C ) TIME CERTIFICATE DATE ESTABLISHED 12-22-1997 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: .00 0.500 .00 _ .00 .00 .15 .00 PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) 04-23-2003 CD002480 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." AMOUNT PAID 1,651.20 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ ( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CR), YOU MAY BE DUE A REFUND. ...-~ nrvrocr crnr nF THIS FORM FOR INSTRUCTIONS. ) 1,651.20 1,651.20CR .00 1,651.20CR STATUS REPORT UNDER RULE 6.12 Name of Decedent: ELIZABETH D. CONKLIN Date of Death June 16, 2002 Wil1No.: 2002-00594 Admen. No.: 21-02-0594 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 admi ation of the estate is complete: Yes n 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 [1 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 L] No n c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed wi Clerk of the. O Dort and maybe attached to this repo /~ r •~ ~ C Date: ~ ~ ~ ~ ~" Signature Paul S. Frank, Esquire Name King, Spry, Herman, Freund & Faul, LLC One West Broad Street, Suite 700 Bethlehem, PA 18018 Address (610) 332-0390 Telephone No. Capacity: Il Personal Representative Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA ~ BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 INHERITANCE TAX HARRISBURG, PA I~IZS-obol STATEMENT O F ACCOUNT REV-1607 EX RFP (O1-OS> DATE 12-15-2003 ESTATE OF CONKLIN ELIZABETH D DATE OF DEATH 06-16-2002 FILE NUMBER 21 02-0594 COUNTY CUMBERLAND LYNN POWERS ACN 02149373 890 WEISS RD Amount Remitted NAZARETH PA 18064 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS -_~- --------------------------------------- --------------------- ---------------------------------------------- REV-1607 EX AFP (01-03) *** INHERITANCE TAX STATEMENT OF ACCOUN *** ESTATE OF CONKLIN ELIZABETH D FILE N0. 21 02-0594 ACN 02149373 DATE 12-15-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-17-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) 04-23-2003 CD002480 .00 11-25-2003 REFUND .00 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. AMOUNT PAID .00 1,651.20 1,651.20- TOTAL TAX CREDIT ~ .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), vn(( wev RF rn1F A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) ` ,r