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Home My WebLink About02-0655 PETITION FOR PROBATE and GRANT OF LETTERS Estate of /5Cl.httr4 F .shl'f~ No. 21-02-655 also known as To: Register of \)i,ills fOl the) l Deceased. County of UtYYl~O.ntXAn the Social Security No. 53lf -dl.f- ~II d-' Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or old<e!:Jln the execuV"()( in the last will of the above decedent, dated ~/.::tnih2IJ' .30 and codicil(s) dated named , 19~ (Slate relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in {1/1"Y/W/Q.".,.J , h last family or principal residence at / Lon 'c[;;'-I- , I (list street, number and muncipality) nsylvania, with mlw)dpr . Dece dent, then at . i Except as follows, dece ent 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: ~D;;r- ,J$. Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $(,.,OO,OOD.. CD $ , $ $ WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters robate of the last will and codicil(s) r . istration c.La.; administration d.b.n.c.La.) theron. . .,,- u o " ~3 "" a:" o -00 1::';: ro'':;: -" ",,"- "~ 50 :< o '" on Ke OATH OF PERSONAL REPRESENTATIVE COMMONWEALrH OF&ENNSY~ANIA -, S8 COUNTY OF om '..rIa n ./. J 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 'IS personal represen.. tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affi.rmed and subscribed { ~ n / .x( ~ before me this 19 th day of ~ ~ ~ 'ill 2002 ~ ~~l/{. {//J~I/;~~y ~ /"/-?6 -/0 No. 21-02-655 Estate of BARBARA F SHIPE , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JULY 22 J(JjI2002 ,in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated JANUARY 30, 1998 described therein be admitted to probate and filed of record as the last will of BARBARA F SHIPE and Letters TESTAMENTARY are hereby granted to PATRICIA S KISTLER ~m/(l ~~//"/ ~/u/&::: Re' ero[Wills ~ FEES Probate, Letters, Etc. ......... Short Certificates( ).......... x-pag\,s. RenuncIatIOn ................ JCP $ $ $ $ 5.00 TOTAL _ $ 460.00 ... J.ULY.l.9., .20.0.2................ 410.00 30.00 15.00 ATTORNEY (Sup. Ct. I.D. No.) ADDRESS Filed PHONE LAST WILL AND TEST AMENT OF BARBARA F. SHIPE J ,~ ....c V(J I, BARBARA F. SHIPE, of Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and I hereby revoke any prior wills or codicils previously made by me. ITEM I: I direct that all my just debts and funeral expenses shall be paid from the assets of my estate as soon as practicable after my decease. . 1\ ~ J ITEM II: I give and bequeath the sum of FIVE HUNDRED and NO/lOO ($500.00) DOLLARS to the KAPPA ALPHA THETA FOUNDATION, 8740 Founders Road, Indianapolis, Indiana 46268. ITEM III: I give and bequeath the sum of FIVE HUNDRED and NO/lOO ($500,00) DOLLARS to ST. JOHN'S EPISCOPAL CHURCH OF CARLISLE, Pennsylvania. ITEM IV: I give and bequeath the sum of FIVE HUNDRED and NO/lOO ($500.00) DOLLARS to WASHINGTON STATE UNIVERSITY FOUNDATION, Pullman, Washington. ITEM V: I give and bequeath the sum of ONE THOUSAND and NO/lOO ($1,000.00) DOLLARS to HILLARY ELIZABETH WILT. ITEM VI: I give, devise and bequeath an amount equal to one third (1/3) of my probate estate to be equally divided between my children, J. MICHAEL SAGE, PATRICIA S. KISTLER AND STEPHANIE R. LONG, provided, however, that in the event any of my children should predecease me or fail to survive me by thirty (30) days, his or her share of my estate shall be distributed to his or her then living issue, per stirpes, and in the absence of any then living issue, PAGE 1 OF 6 PAGES the share of my deceased child shall be equally divided between my other children who survive me. A. The rest, residue and remainder of my estate, of every kind and of every situate shall be equally divided between my grandchildren, STEPHANIE J. SAGE, JOHN T. FALLER, CHRISTOPER C. BUSSARD, JOANNA E. KISTLER and MICHAEL W. KISTLER. Provided, ~ .~ -C ./() however, that in the event any of my grandchildren should predecease me or fail to survive me by thirty (30) days, his or her share of my estate shall be equally divided between my deceased grandchild's then living issue, per stirpes, and in the absence of any then living issue, the share of my deceased grandchild shall be equally divided between my other grandchildren who survIve me. C. In the event any of my beneficiaries are under twenty- one (21) years of age, I direct that said beneficiarie's share shall be held IN SEPERATE TRUST by my Trustee, hereinafter named, and shall not be distributed to such beneficiary until such beneficiary has reached twenty-one (21) years of age. 1. My Trustee shall invest and reinvest all funds being held in Trust. Jt ~ --.Q, J 2. My Trustee shall have the right III my Trustee's sole discretion to use the funds being held III Trust for the health, education and general welfare of the beneficiary and shall have the right to pay to the beneficiary or to others on the beneficiarie's behalf funds being held in Trust after first taking into account the other assets available to the beneficiary. 3. All remaining principal and interest shall be distributed to such beneficiary when he or she reaches PAGE 2 OF 6 PAGES twenty-one (21) years of age. ITEM VII: No interest in Income or principal shall be assignable by, or available to, anyone having a claim against a beneficiary before actual payment to the beneficiary. ITEM VIII: All federal, state, and other death taxes .A) -9::7 -C Vf payable on the property forming my gross estate for tax purposes, whether or not it passes under this Will, shall be paid out of the principal of my residuary estate just as if they were my debts, and none of those taxes shall be charged against any beneficiary. ITEM IX: I authorize my Executrix and Trustee: A. To retain and invest in all forms of real and - tt' ~ ~ ~ personal property, regardless of (i) any limitations imposed by law on investments by executors, (ii) any principle of law concerning investment diversification; B. To compromise claims and to abandon any property which, in my Executrix opinion, is of little or no value; or borrow from, and to sell property to others, and to pledge property as security for repayment for any funds borrowed; C To sell at public or private sale, to exchange or to lease for any period of time any real or personal property, and to give options for sales or leases; D. To join in any merger, reorganization, voting-trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto; E To use administrative or other expenses of my estate as income or estate tax deductions and to value my estate for tax purposes by any optional method permitted by the law in force when I die, without requiring adjustments PAGE 3 OF 6 PAGES ,,) -p -c: VI , jf ~ i ~ - between income and principal for any resulting effect on income or estate taxes; and F. To distribute IN KIND and to allocate specific assets among the beneficiaries III such proportions as my Executrix may think best, so long as the total market value of any beneficiary's share is not affected by such allocation. These authorities shall extend to all real and personal property at any time held by my Executrix and shall continue in full force until the actual distribution of all such property. All powers, authorities and discretion granted by this Will shall be in addition to those granted by law and shall be exercisable without leave of court. ITEM X: I nominate my daughter, PATRICIA S. KISTLER, as the Executrix of this my Last Will and Testament. In the event she is unable to serve as Executrix, for any reason, I then appoint my son J. MICHAEL SAGE, as Executor of my estate. ITEM XI: I appoint my daughter, PATRICIA S. KISTLER, as Trustee of any trust created under this my Last Will and Testament. I further provide that in serving as such Trustee, my daughter, PATRICIA S. KISTLER, shall be entitled to compensation equal or equivalent to the compensation payable to commercial lending institutions serving III an equivalent capacity. ITEM XII: I direct that any fiduciary acting hereunder shall not be required to enter a bond or other security in any court or jurisdiction in which said fiduciary may be called upon to act. PAGE 4 OF 6 PAGES IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ~~ay of ~I\~ ' 1998. ~::r. BARBARA F. SHIP SIGNED, SEALED, PUBLISHED and DECLARED by the above Testatrix as and for her Last Will and Testament, in the presence of us, who thereupon at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~~ ~ /W COMMONWEAL TH OF PENNSYL VANIA ss: COUNTY OF DAUPHIN We, BARBARA F. SHIPE, W/lUi^ W ~Lr and c'ec.-s',O-r'lYlt' J. bJe\;s , the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly and that she executed it as her free and voluntary act for PAGE 5 OF 6 PAGES --- the purposes therein expressed, and that each of the witnesses, III the presence and hearing of the Testatrix, signed the Will as witnesses and that to the best of our knowledge, the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence;.( , ~~~ ~I ~h~~ BA~~~~~~ SHIPE . ~W# WITNESS L. - CL II/oad WITNES! J . SUBSCRIBED, sworn to and acknowledged before me by BARBARA F. SHIPE, the Testatrix, and subscribed and sworn to before me by W~L'f;f1l W'MLr and be.or9"oNle J. bJe'2,<;, the witnesses, on the 3()th day of J 0. nu a l""U 1998. \ ~~r7/~ _ Notarial Seal julie A. Hyde. Notary Public Harrisburg. Dauphin County My Commlosion Expires Oct. 16. 2000 8h1bfi:r Ponl1.y'~IlI. Aii60. on 0 0 IS PAGE 6 OF 6 PAGES rf CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: /lxL,,- bllrd r ..5IJ/lJi?__ I Date ofDeath: .:7Zt/y 7-1 CJ,.OO?r' Will No. j. bOt:!. - OOh~':>.-' Admin. No. c)./ - O.J. - 06>5'5'" To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the OI]lhans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on .4v!jL/![,r /,(FI9, DJ,tJ06" : Name Address /~~j}pa AIf')-,tJ7I1rl1t, hvf?(iuhi>17 f7-LfO rollndu::; f<d"; :If-vf/()fti:foJi~ ~Me '/bJJ" ~.J;1'1n7 tpiqDfa./ f'hJfdJ Po.8ox biz.) rArhsieJ ffl- l=kJi8 /)JM>hi~~. Vf1/(. FDVf1!a-hfY7 Po, Eot b'-I/Dtf.r, fJvJJrnlfJ,tu/J. qtj'/tJ,f f~illtv'A 'G. l,lJil-r tv, gO'/. 15,~=1- /,(",a.:fiLL Ut.u.A1ii qt,.:;da ~ ) I 11 tHXA- Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: ,:4-vJ lJ<;;1 (3.0, ::Aoor gd+;~A~6'~Vv Signature Name R-Irft:l/J_ 5. K j {,+Je/ Address if La/&hldR_ 1/,. ?D Box. :;-tj /J'/f- /hI/of 51 r/yZ1~ fit / fflh;' I .I Telephone <?-/.1/ 19ro. 7- 3/3 Capacity: ~ersonal Representative _Counsel for personal representative .;:r AA '-chael ~<<;Je-- ,/CjC}O cS- DOT'i>' Nailor; Ell rcr# Ory; /YfJ) ';'10'/,; S-I-.ephar1ie 1<. Lo:} 7-/01 t1vtlclQ/vjlr?- 51-.:&/0/, 4v'7f1l7, Txt-J1-.s-if' fi,kfhri/1ie J. S1Je 5mimov '/(; .JAtiff.harn Cirtle..J EI7jI.ewoo~ /l1J 6%:3 ;J;iJl'1 t. Fp,//<< SOb .1,i-e/v///e Sf. I Ih/lade/fh/ttl jJfl /1113 L/1rj~l-ofh.e( C t3ue;~1 fJ. 0 . GOY; d- Olllt../j II-Ll'7h~ 7X 7-RldD -1111 ;J;;(U1flCi. J</'7fJer- (~)be-r+ t, 5. 5jlvlU1'f(.4v~ I~-Il()()r; trO( k./e~9~ fIJ /' .' 1 9() if6 7'30 AI?0 Rd) car/Is/e) Pit Ik/3 Po 80y. ':f-tI Pi ;/oIly Stq~ 1ft J:mb~ A)../cha.el W. K/~.fW fa. fn' Ci C{ ~'. K i s+/~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT METZLER CAROL E ESQUIRE 113 SOUTH MARKET STREET ELlZABETHTOWN, PA 17022 _nnu_ fold ESTATE INFORMATION: SSN: 534-24-2112 FILE NUMBER: 2102-0655 DECEDENT NAME: SHIPE BARBARA F DATE OF PAYMENT: 01/21/2003 POSTMARK DATE: 01118/2003 COUNTY: CUMBERLAND DATE OF DEATH: 07/07/2002 NO. CD 002060 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $31,763.92 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: PATRICIA S KISTLER C/O CAROL E METZLER ESQUIRE CHECK# 118 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS - $31,763.92 DONNA M. OTTO DEPUTY REGISTER OF WILLS l'lE'I"l~EX.Ill.o:rt" . /1- ifEV~ 500 INHERITANCE TAX RETURN RESIDENT DECEDENT """ c..... OFFICIAL USE ONLY ;i~E'Nu'MB~'R""""'"'''''''''''''' ............................................. COMMOtM'EAlTH OF P~lVANlA DEPARTMENT OF REVEMJI!: OEPT.29ll6Qt tiAAR1SBURG.PA 17128-ll601 ~ w " w C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SHIPE, BARBARA F 21 02 COUNTY CODE YEAR SOCIAL SECURnY NUMBER 534-24-2112 00655 NUMBER 07/07/2002 06/24/1916 THIS RETURN MUST BE FILE!'D IN DUPLICATE WITH THE DATE OF DEATH (MM-Do..YEAR) DATE OF BIRiH (loAM-DD-YEAR) REGISTER OF WILLS SOCIAL SECURITY NUMBER w '" ~~"' ,,"'~ w"" ~Oo ,,"'~ .." .. < (IF APPLICABLE) SU~VIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INmAL) 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 6. Decedent Died Tes.tate tAttach copy ofWilJ) 9. Litigation Proceeds Received o 48. Future Interest Compromise (date of death afler12-12-82) o 7, Decedent Maintained a Living Trust (Attach copy of Trust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95 _1!!@f@~Mmt.jl#iM@lm!i$;ij$ll9~iOOll$~~@#fi:l~Fii5ii#i~lii*'j~~tjllij$~4Ui$Iii!~jl#~i:U'iiiI COMPlETE MA1L1NG ADDRESS IRM NAME (If applicable) Felty & Co., L.L.P. ELEPHONE NUMBER 717/367 -9396 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) z o " :l => '" ii: ~ '" '" 3. Closely Held Corporation. Partnership or Sole-Proprietorship 4. Mortgages & Noles 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) o 4. Limited Estate 1&1 o w'" ~ifi "c 8~ Carol E Metzler o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11.Election to tax under Sec. 9113(A) (Attach Sch O) .:.:.:.:-:.,.;.,. :,::::::::,::,:: ~:.:.~;;:~;;;.;<+di@tJj! 113 South Market Street Elizabethtown, P A 17022 11. Total Deductions (total Lines g & 10) 12. Net Value of Estate (Line 8 minus Line 11) (1) (2) (3) (4) (5) (6) (7) None r.....................oF;;iCiAl..USEONLy...............,.....1 I ' I ! I i I i l : , , i 1 L..............................................._....................j 727,712.62 None None 21,639.76 None None (8) 749,352.38 (9) (10) 39,738.58 5,748.96 (11) 45,487.54 703,864.84 1,500.00 702,364.84 (12) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. NetValueSubjecl to Tax (Line 12 minus Line 13) (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES 31,538.92 225.00 31,763.92 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Copyright 2000 form software only The Lackner Group, Inc. "".,.,.,.,-,., "':':':)/'. ..._,...., ~,.tJIn.{.t.i.t{j 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z 700,864.84 .045 (16) 0 16. Amount of Line 14 taxable at lineal rate x " " ~ .. 17. Amount of line 14 taxable at sibling rate X .12 (17) " 0 " ~ 18. Amount of Line 14 taxable at collateral rate < 1,500.00 x .15 (18) '" 19. Tax Due (19) 20. 0 .. ....N .............,...... ..................................{...iii!1!!i~~tiiAA$~j(~i:iiiQ:tiQ~!l\'t~!\i'l~i\il!:i!~.IM!fflii!ii@ '................,.::,.,.,. :-:.,."... ..,.. Form REV-1500 EX (Rev. 5.ll0} Decedent's Complete Address: STREET ADDRESS CUMBERLAND CROSSING LONGSDORF WAY CITY ISTATE PA IZIP 17013 CARLISLE Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credtt B. Prior Payments C. Discount Total Credtts (A . B. C) 3. Interest/Penalty if applicable D. Interest E. Penalty TolallnteresUPenalty (D . E) 4. If Line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 . 5A. This Is the BALANCE DUE. (1) 31,763.92 (2) 0.00 (3) 0.00 (4) (5) 31,763.92 (SA) (5B) 31,763.92 Make Check Payable to: REGISTER OF WILLS, AGENT *ti@f14\Efff~Wt@N!iMI~B0r.~WJMWi~gg}tMaNM?BfU1%{infi%W$!fIftWmMfiiMm~flwfNtllmt~H@iJ8{f{@~@tmWt~&JWf%mWmMtll~fftf~~$W;film PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS 1. Old decedent make a transfer and: Yes No a. retain the use or income of the propertytransferrecl;.................. ...................................... ......................... E3 ~ :: ~::::~ :h~e~~:i~~:~~i;~~:t:~.~~.~.I~. ~~~.~~~.~~~~.~:~~~~~~~. ~~.~~ .j.~.~~~::::::::.........::::::::::::::::::::::::: 0 [<1 d. receive the promise for life of either payments, benefits or care?..............................,..................."h............ D y ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ...................... ..................................................................,... D y ~ Dy ~ Dy ~ 3, Did decedent own an ~in trust for" or payable upon death bank account or security at his or her death?......,....... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ..... ........................ .................., .................................................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 4 LAKESIDE DRIVE P.O. BOX 74 Mf HOLLY SPRINGS, P A 17065 Under penalties of perjury. I declare that I have examined this return, including accompanying schedules and statements. and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on aU information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FlUNG RETURN ADDRESS PATRICIA S. KIST t; ADDRESS SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Carol E Metzl ADDRESS ~lt: ~m:lJjdMt~dM%~tiH~NW~;@MJ:.n~~MJilir&~~M~~Njj~%j6;4~(:;~?~iliigj;iWftMlft%:ji ,m~:knW:iiW}~N}hi:: ;dfJ DATE I DATE For dates of death on or after July 1, 1 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 (al (1.1) (i)J. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemct 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 Of for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116 (al (1.2)j. 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 (al (1)j. 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)J. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption, '* SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT -----.----,.------..--.. ------_..__.__._~------_._--_._~----~-_._.__..._----- --_._---_...._~.._--- --- ----....----- '---- ..- .'-~---- - ----------~--..._-._..__._--~-_.._"._- ESTATE OF SHIPE, BARBARA F FILE NUMBER 21 - 02 - 00655 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER __n'_____ _____....._._.____"__._.__.____,_~ _._______"____________..___,.___.__ ] . 500 EQUITY RESIDENTIAL PFD CUM REDEEMABLE SER L; 7,625% DESCRIPTION UNIT VALUE I VALUE AT DATE OF . DEATH 24.60 12,30000 2 ' 1,000 FPC CAPITAL 1 CUM PFD STK 7,]% i 3 ' 1,700 HRPT PROPERTIES TRUST CUM RDM PFD SHRS SRS A 9,875% 8 1,000 DOMINION RES CAP TR II DEF INT TRHST PFD SECS 8A% IAN 20, .2041 i 9 600 USB CAPITAL III DEF INT TR PED CAP SECS 7,750% MAY 1,2031 24.59, 24,59000 26,52 i 45,084.00 24,50\ 3,675,00 ! 24,[ 12,050,00 24,741 12,370,00 26,981 26,980.00 ! 26.301 26,300,00 I 25,67 . 15,402,00 25,65 25,650,00 25,61 : 25,610,00 25,56 25,560,00 24,60 36,90000 27,65 ' 55,300,00 4 150 HOUSEHOLD INTERNATIONAL DEPOSITORY SHRS PFD CUM 7,6% 1 PERPETUAL 5 i 500 HIGHWOODS PROPERTIES PFD STK 8% PERP CUM SERIES B 6 ! 500 HEAL THCARE PROP INV INC PFD CUM SER A 7,875% 7 ],000 TECO CAPITAL TR I DEF INT TRUST PFD SECS 8.50% IAN 31, 2041 iCUM 10 1,000 BEAR STE~"IS CAP TR III DEF INT TR ORG PFD SECS 7,80% MAY 15,2031 11 i 1,000 NAT RURAL UTILITY QTLY INCOME CAP SECS 7,625% JUNE 15, 2050 12 1,000 ANZ EXCHANGE PFD TR TR UTS EXCHNGBL PREF SHS 8,00% I PERPETUAL NON CUM 13 1,500 WEC CAPITAL TRUST I TRUST PREFERRED SECS 6,850% MAR 31, 2039 CUM 14 2,000 HOUSEHOLD CAPITAL TRST V DEF INT TRUST PFD SECS 10,00% ruN 30, 2030 Total of Continuation Schedule(s} 379,941,62 TOTAL (Also enter on line 2, Recapitulation) 727,712,62 *' >' ., !;'" ' SCHEDULE B STOCKS & BONDS continued COMMONWEALTH OF PENNSYLVANIA I~HERITANCE TAX RETURN RESIOENT DEGEDENl" ___1.__ -~_._-'- "-----._--- ESTATE OF SHIPE, BARBARA F , FILE NUMBER 21 - 02 - 00655 AU property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER -----,------ 15 DESCRIPTION UNIT VALUE ._~ __ ___.__. ~_____._._..__.._._.___L_.__ 1,289 PREFERRED PLUS TR CCR-I COUNTRYWIDE CAP TRST III 8.05% 24.58 JUNE 15,2027 CUM VALUE AT DATE OF DEATH - ___ ___'0- 31,68362 I 16 \,000 COMERICA CAPITAL TRUST I DEF INT TRUST PFD SEC 7.60% WL I, ! I 2050 CUM 18 2,000 PLC CAPITAL TRUST 1\1 DEF INT TROIG PFD SECS 7.50% AUG 22, 2031 I 25,470.00 25.471 i 26.25 ' 26,250.00 25.12 50,240.00 17 i 1,000 MA YTAG CORP PUBLIC INCOME NOTES 7.875% AUG 1,2031 CUM \9 800 FLEET CAP TRUST VII DEF INT TRUST PFD SECS 7.20% DEC 15,2031 24.75\ 19,800.00 " CUM " 2,000 LINCOLN NA TL CAO VDEF INT TR PFD SEC 7.65% NOV 1,2050 I 20 25.35 i 50,700.00 21 350 MISSISSIP PWR CAP TR II DEF INT TR II DEF INT TR ORIG PFD SECS 251 8,750.00 7.20% DEC 30, 2041 CUM 22 \,500 PREFERRED PLUS TR ELP-I EL PASO CORP CL-A 7.650% JAN \5, 2032! 21.151 31)25.00 23 300 PUBLIC STORAGE INC PFD CUM SER B 9.20% 25.52 7,656.00 24 200 PUBLIC STORAGE IN PFD CUM SER D 9.50% 26.61 ' 5.322.00 25 641 PROLOGIS PFD CUM STK 8.540% PERPETUAL SERIES C 50 32,050.00 26 2,000 PUBLIC STORAGE INC DEP SHRS 1/1000 PFD SR-R 8.0% PERPETUAL 25.15 50,300.00 CUM 27 500 SIMON PPTY GROUP INC PFD SER F CUM REDEEMABLE 8.75% 26.15 13,075.00 28 200 UNITED DOMINION RL TY TRS CUM PFD STOCK 8.60% 25.70, 5,\40.00 Page 2 of Schedule B *' SCHEDULE B STOCKS & BONDS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESrDENTDECEDENT ESTATE OF SHIPE, BARBARA F . FILE NUMBER 21 - 02 - 00655 All property jointly-owned with right of survivorship must be disclosed on Schedule F, ITEM DESCRIPTION UNIT VALUE I VALUE AT DATE OF NUMBER , . DEATH ._---------,-_._---,- -----.,..~-.,~ --_.---_._-,_._.-------._~._- ._~_...---+---~--_._-~ ----.-.----.---,- 29 880 PREFERRED PLUS TRMSD-I MORGAN STANLEY CL-A 7.05% APR I, 24.751 21,78000 I 2031 ' , Page 3 of Schedule B *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMOtfIoIEAl.1H OF P~YLVANlA fNiERfTANCE TAX RETURN RESIDENT PECEDENT ESTATE OF SHIPE, BARBARA F I FILE NUMBER 21.02.00655 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION MERRILL LYNCH CASH MANAGEMENT MONEY MARKET ACCOUNT #872.46251 VALUE AT DATE OF DEATH 21,639.76 TOTAL (Also enter on Line 5, Recapitulation) 21,639.76 *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEAlTli OF PEhNS'(LVANLf, IN-tERlTAHCETAX RETURN RES11>ENT oECl:OEKT ESTATE OF SHIPE, BARBARA F I FILE NUMBER 21 - 02 - 00655 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: I HOFFMAN ROTH FUNERAL HOME 25\.10 2 GEORGE'S FLOWERS 50.82 B. ADMINISTRATNE COSTS: 37,467.62 1. Personal Representative's Commissions PATRICIA S. KISTLER Social Security Number(s) I EIN Number of Personal Representalive(s): Street Address 4 LAKESIDE DRIVE, P.O. BOX 74 City MT HOLLY SPRINGS state PA Zip 17065 - Year(s) Commission paid 2002,2003 2. Attorney's Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees REGISTER OF WILLS CUMBERLAND COUNTY 460.00 5. Accountant's Fees FELTY & CO. L.L.P. 1,325.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 CUMBERLAND LAW JOURNAL 75.00 , ADVERTISING Total of Continuation Schedule(s) 109.04 TOTAL (Also enter on line 9, Recapitulation) 39,738.58 *' Schedule H Funeral Expenses & Administrative Costs continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SHIPE, BARBARA F I FILE NUMBER 21 - 02 - 00655 2 THE SENTINEL ADVERTISING 74.39 3 MOUNT HOLLY SPRINGS POST OFFICE MAILING CORRESPONDENCE TO BENEFICIARIES 34.65 Page 2 of Schedule H *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS CONM~1HOFP~LVAN~ ltt-lERlTAHCE TAX RETURN ftESlnarr OECEcerr ESTATE OF SHIPE, BARBARA F I FILE NUMBER 21 - 02 - 00655 Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION AMOUNT 5,612.80 CUMBERLAND CROSSING RETIREMENT COMMUNITY 2 VERIZON WIRELESS 40.16 3 MEDCO HEALTH SOLUTIONS 30.00 4 PENROSE CLEANERS 66.00 TOTAL (Also enter on Line 10. Recapitulation) 5,748.96 REV-1~13 EX+ ('-00) *' SCHEDULE J BENEFICIARIES , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SHIPE, BARBARA F I FILE NUMBER 21 - 02 - 00655 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE I. TAXABLE DISTRIBUTIONS (include outrightspousai distributions) I HILLARY ELIZABETH WILT Niece 1,000.00 P.O. Box 1527 Kea'au, Hawaii 96749 2 1. MICHAEL SAGE Son 11.11% OF ESTATE 4990 C5 Dorsey Hall Dr. Ellicott City, MD 21042 3 PATRICIA S. KISTLER Daughter I 1.1 1% OF ESTATE 4 Lakeside Drive P.O. Box 74 Mount Holly Springs, P A 17065 4 STEPHANIE R. SAGE Daughter 11.11% OF ESTATE 7101 Guadalupe St #101 Austin, Tx 78752 See Continuation Schedule(s) attached Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet 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 1 KAPPA ALPHA THETA FOUNDATION 500.00 8740 FOUNDERS ROAD INDIANAPOLIS, INDIANA 46268 2 WASHINGTON STATE UNIVERSITY FOUNDATION 500.00 PULLMAN, WASHINGTON 3 ST. JOHN'S ESPISCOPAL CHURCH 500.00 CARLISLE, P A TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-l500 COVER SHEET 1,500.00 . SCHEDULE J BENEFICIARIES continued ) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SHIPE, BARBARA F I FILE NUMBER 21 - 02 - 00655 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT 00 Not List Trustee(s) OF ESTATE I. IrAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(0)(1.2)1 5 STEPHANIE 1. SAGE SMlRNOV Grandchild 13.334% OF ESTATE 45 Markham Circle Englewood, NJ 07631 6 JOHN T. FALLER Grandchild 13.334% OF ESTATE 506 Melville St Philadelphia, PA 19143 7 CHRlSTOPHER C. BUSSARD Grandchild 13.334% OF ESTATE P.O. Box 8392 Austin, TX 78713 8 JOANNA E. KISTLER CULBERT Grandchild 13.334% OF ESTATE 6 S. Sylvania Ave I st Floor Rockledge, P A 19046 9 MICHAEL W. KISTLER Grandchild 13.334% OF ESTATE 730 Pine Rd. Carlisle, PA 17013 10 MARY NEIDIGH Friend 500.00 209 Frytown Road Carlisle,PA 17013 I I Page 2 of Schedule J STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTIFICATE I, MARY C. LEWIS Register for the Probate of Wills and Granting Letters of Administration &c. in and for said county of CUMBERLAND the 22nd day of do hereby certify that on July A.D., Two Thousand and Two, Letters TESTAMENTARY estate of SHIPE BARBARA F (LA~l, rlK~l, M1UUL~) in common form were granted by the Register of said County, on the , late of SOUTH MIDDLETON TOWNSHIP in said county, deceased, to KISTLER PATRICIA S (LA~l, rlK~l, M1UUL~i and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 22nd day of July A.D., Two Thousand and Two. File No. 2002-00655 PA File No. 21-02-0655 Date of Death 7/07/2002 S.S. # 534-24-2112 '>yN"/,d// ~//'" -;<'l/Y, /,~.z JLJ<."","l"" Register NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL &it ..........., Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters , , "" }.:.\) "t i \~ ' '"' . . 1_, ,I' "..l//'" -.J",.' " '- -, '~, ". /',' ., \ \11 '~.\l" "1 ~: /1. ..1:: ,:,' \ ) ;': . ,';j:" :-: ~ I ,. ..- .;', :: ,i. ~ " 'I.;;"..:';\'l\~')" J \\ .' I,U:U.'I.,i....... No. 2002-00655 PA No. 21-02-0655 ESTATE OF SHIPE BARBARA F (UA~l, rl~~l, M1UUL~) Late of SOUTH MIDDLETON TOWNSHIP LUl"l~bKLA.NLJ CUUN'l:r: I Deceased Social Security No. 534-24-2112 WHEREAS, on the 22nd day of July 2002 an instrument dated January 30th 1998 was admitted to probate as the last will of SHIPE BARBARA F (UAbl, rlK~l, M1UUL~) late of SOUTH MIDDLETON TOWNSHIP CUMBERLAND County, who died on the 7th day of July 2002 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to KISTLER PATRICIA S who has duly qualified as Executor (rix) and has agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the 22nd day of July 2002. ~m/ a~'i~,g{ .t;{({l-"y **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) OF tDfl LAST WILL AND TESTAMENT BARBARA F. SHIPE j ,Sb- -C vp rr ~ ~ ~ I, BARBARA F. SHIPE, of Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and I hereby revoke any prior wills or codicils previously made by me. ITEM I~ I direct that all my Just debts and funer::.l expenses shall be paid from the assets of my estate as soon as practicable after my decease. ITEM II: I give and bequeath the sum of FIVE HUNDRED and NO/IOO ($500.00) DOLLARS to the KAPPA ALPHA THETA FOUNDATION, 8740 Founders Road, Indianapolis, Indiana 46268. ITEM III: I give and bequeath the sum of FIVE HUNDRED and NOnOO ($500,00) DOLLARS to ST. JOHN'S EPISCOPAL CHURCH OF CARLISLE, Pennsylvania. ITEM IV: I give and bequeath the sum of FIVE HUNDRED and NOnOO ($500.00) DOLLARS to WASHINGTON"STATEUNIYERSITY FOUNDATION, Pullman, Washington. _._._ ___._____ - 0-- _ ~"'_' . "ITEM'V:" I give' and' bequeath the sum of ONETHOUSANIYiliiCf"C Nonoa ($1,000.00) DOLLARS to HILLARY ELIZABETH WILT. ITEM VI: I give, devise and bequeath an amount equal'to one third (113) of my probate estate to be equally divided between my children, J. MICHAEL SAGE, PATRICIA S. KISTLER AND STEPHANIE R. LONG, provided, however, that in the event any of my children should predecease me or fail to survive me by thirty (30) days, his or her share of my estate shall be distributed to his or her then living issue, per stirpes, and in the absence of any then living issue, PAGE I OF 6 PAGES the share of my deceased child shall be equally divided between my other children who survive me. A. The rest, residue and remainder of my estate, of every kind and of every situate shall be equally divided between my grandchildren, STEPHANIE J. SAGE, JOHN T. FALLER, CHRISTOPER C. BUSSARD, JOANNA E. KISTLER and MICHAEL W. KISTLER. Provided, however, that in the event any of my gnndGhPdf"il should )l ~ C- O predecease me or fail to survive me by thirty (30) days, his or her share of my estate shall be equally divided between my deceased grandchild's then living issue, per stirpes, and in the absence of any then living issue, the share of my deceased grandchild shall be equally divided between my other grandchildren who surVIve me. C. In the event any of my beneficiaries are under twenty- one (21) years of age, I direct that said beneficiarie's share shall be held IN SEPERA TE TRUST by my Trustee, hereinafter named, and shall not be distributed to such beneficiary until such beneficiary has reached twenty-one (21) years of age. I. My Trustee shall invest and reinvest all funds being held in.Irust._ 2. My-Trustee shall have. the right in my Trustee'S sole discretion to use the funds being held III Trust for the health, education and general welfare of the beneficiary and shall have the right to pay to the beneficiary or to others on the beneficiarie's behalf funds being held in Trust after first taking into account the other assets available to the beneficiary. 3. All remaining principal and interest shall be distributed to such beneficiary when he or she reaches PAGE 2 OF 6 PAGES t ~ .l1 ~ twenty-one (21) years of age. ITEM VII: No interest in mcome or principal shall be assignable by, or available to, anyone having a claim against a beneficiary before actual payment to the beneficiary. ITEM VIII: All federal, state, and other death taxes , It ~ ~ '9J payable on the property forming my gross estate for tax purposes, whethF.r or not it passes under this Will, shall be paid out of the principal of my residuary estate just as if they were my debts, and none of those taxes shall be charged against any beneficiary. ITEM IX: I authorize my Executrix and Trustee: A. To retain and invest in all forms of real and .N ,b -C /f personal property, regardless of (i) any limitations imposed by law on investments by executors, (ii) any principle of law concerning investment diversification; B. To compromise claims and to abandon any property which, in my Executrix opinion, is of little or no value; or borrow from, and to sell property to others, and to pledge property as security for repayment for any funds borrowed; C To sell at public or private sale; to exchange or to lease for any period of time any real or personal property, and to give options for sales or leases; D. To join in any merger, reorganization, voting-trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto; E To use administrative or other expenses of my estate as income or estate tax deductions and to value my estate for tax purposes by any optional method permitted by the law in force when I die, without requiring adjustments PAGE 3 OF 6 PAGES between income and principal for any resulting effect on income or estate taxes; and , if ~ i ~ F. To distribute IN KIND and to allocate specific assets among the beneficiaries in such proportions as my Executrix may think best, so long as the total market value of any beneficiary's share is not affected by such allocation. These authorities shall extend to all real and personal property at any time held by my Executrix and shall continue in full force until the actual distribution of all such property. All powers, authorities and discretion granted by this Will shall be in addition to those granted by law and shall be exercisable without leave of court. ,,) p .c ? ITEM X: I nominate my daughter, PATRICIA S. KISTLER, as the Executrix of this my Last Will and Testament. In the event she is unable to serve as Executrix, for any reason, I then appoint my son J. MICHAEL SAGE, as Executor of my estate. ITEM XI::. I appoil)l my daughter, PATRICIA S. KISTLER, as Trustee of any trust created under this my Last Will and Testament. I further provide that in servingas.suc:l:J Trus}ee, IllY daughter, .PATRICIA S. KISTLER, shall be entitled to compensation equal or equivalent to the compensation payable to commercial lending institutions serving III an equivalent capacity. ITEM XU: I direct that any fiduciary acting hereunder shall not be required to .enter a bond or other security in any court or jurisdiction in which said fiduciary may be called upon to act. PAGE 4 OF 6 PAGES IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ~~ay of ~I\U 1998. <<i~~~he~AU BARBARA F. SHIP SIGNED, SEALED, PUBLISHED and DECLARED by the above Testatrix as and for her Last Will and Testament, in the presence of us, who thereupon at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~.~IW COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF DAUPHIN We, BARBARA F. SHIPE, vvr>L'ft^ W IMLT and (.;;<:c>rs',a.nnf' ...J. ~e<;s: , the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly and that she executed it as her free and voluntary act for PAGE 5 OF 6 PAGES the purposes therein expressed, and that each of the witnesses, III the presence and hearing of the Testatrix, signed the Will as witnesses and that to the best of our knowledge, the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influenc~ ' ~ ~I ~h~L.J ~'~~f WITNESS ~~W WITNES / SUBSCRIBED, sworn to and acknowledged before me by BARBARA F. SHIPE, the Testatrix, and subscribed and sworn to before me bY. Wf1L~1l WYJ, t:r and (;;:eors"a.nr1e J. ~, the witnesses, on the 3()-thday of JQnUQI1.-\ 1998. ... ~'7/~- ~ Lie. ...: _ Notarial Seal. Julie A. tiyde, NotarY Public Harrisburg, Dauphin County My Commlosion ExpIres Oct. \6,2000 em . r, Ponn.V'l~f11a ..loa. on 0 0 es PAGE 6 OF 6 PAGES Patricia S. Kistler 4 Lake,side Drive, P. O. Box 74 Mt. Holly Springs, Pennsylvania 17065 .J.d-. ~~ ;;>'00.3 ~~, ~-~~~~ ~ ~~O /1"?U- ft ~ ~ ~ 1>~O.()() ~ ~ ~ ~ ~~ ~ce ftA/~. ,J-k -$I. ,:1./0d- Of9s5' ~/e~r ~ ~~#; ~ ") , (jJ~ ~ . /?-?b-/D ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX CAROL E METZLER FELTY & CO 113 S MARKET ST ELIZABETHTOWN DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-14-2003 SHIPE 07-07-2002 21 02-0655 CUMBERLAND 101 * REV-1547EXAFP10I-05J BARBARA F Allount Relnitted PA 17022. 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=i5'4;-EX--AF:j.--coFiiirNoYiciniF-YNHEifiTANcrfA"inrpPRlmiEi'-ENT~--ALi-oWAiicE-Cj"R----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SHIPE BARBARA F FILE NO. 21 02-0655 ACN 101 DATE 04-14-2003 TAX RETURN WAS: I X I ACCEPTED AS FILED I CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule BJ 3. Closely Held stock/Partnership Interest (Schedule CJ 4. Mortgages/Notes Receivable (Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule GJ 8. Total Assets III [21 131 141 [51 (61 171 .00 727 .712.62 .00 .00 21. 639.76 .00 .00 181 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 191 1101 39,738.58 5.748.96 1111 [121 1131 1141 NOTE: To insure proper credit to your account~ submit the upper portion of this form wiih your tax paYllent. 749,352.38 4~ 487 ~4 703,864.84 1,500.00 702,364.84 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ~ returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 700,864.84 X 045 = 31, 538.92 .00 X 12 = .00 1,500.00 X 15 = 225.00 [191= 31,763.92 CAme", 'NUllBER INTEREST/PEN P~+{D [-I AMOUNT PAID DATE 01 18-2003 CD002060 .00 31, 763.92 TOTAL TAX CREDIT 31,763.92 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. [ IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE DF THIS FORH FOR INSTRUCTIONS. I Will No.: ~2'ltPO~ - 06~/~ 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 wh.e~er administration of the estate is complete: Yes 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer tO No. 1 is Yes, state the following: Did the personal representative file a final account with the Court? The separate Orphans' Court No. (if any) for the personal representative's account is: ~ c. Did the personal rep~aentative state an account informally to the parties in interest? Yes ~ No ['-I Date: Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the. Orphans' Court and may be attached to this report. Signature Address Telephone No. Capacity: ~ersonal Representative {-] Counsel for personal representative