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HomeMy WebLinkAbout02-0705COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND PETITION FOR GRANT OF LETTERS Estate of HELEN M. STONER also known as Deceased No. 21- a~-1(~5 Social Security No.187140285 Petitioner(s), who is/are 18 years of age or older, apply)ies) for (COMPLETE "A" OR "B" BELOW:) a A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut six named in the Last Will of the Decedent, dated 5/24/88 and codicil(s) dated State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in LowE~ Allen Township, Cumberland County, Pennsylvania, with his/her last family or principal residence at 1915 Kent Drive, Camp Hill, Pennsylvania 17011 (list street, number and municipality) Decedent, then 78 years of age, died duly 23 , 2002 , at Holy Spirit Hospital, Camp Hill, Cumberland County, PA (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property ......................................... $ _~~ (~~ (if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County .............................. $ ow Value of real estate in Pennsylvania ........................................................................................ $ ~ Q, a~~) ,-.- Total .................................................................................................................... b ~ ~ tin Ct o~ L Real Estate situated as follows: Lower Allen Township, Cumberland County, Pennsylvania -~ Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence '.~ t~~~.c~-r: ~''~ ~Lt~~vvy~~'%Y1~-~,i Linda L. Zimmerman, R.R. 1 Box 858 Mifflintown PA 17059 B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Oath of Personal Representative Commonwealth of Pennsylvania COUnty Of Cumberland The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to and affirmed and subscribed ' ' `'"' '"'"''` Linda L. Zimmerman before me this 7th day of AUGUST 2002 MARY ~ L~EWIS DECREE OF REGISTER Estate of HELEN M. STONER Deceased also known as Social Security No: 187140285 No. 2.I--oa ~-105 Date of Death: 7/23/02 AND NOW, AUGUST 7, 2002 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters Q Testamentary ^ of Administration ((c.t.a., d.b.n.c.t.; pendente liter durante absentia; durante minoriate) are hereby granted to Linda L. Zimmerman, Executrix in the above estate and that the instrument(s), if any, dated May 24, 1988 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters ..................... Short Certificates(s) Renunciation ........... $ 115.00 Extra Pages ( ) ............... $ . T. R ................ JCP Fee ......... Inventory ........ Other ............. TOTAL.. 6.00 3.00 5.00 $ ~~a nn executrix waited and picked up 8-7-2002 ...~ Sig t e Attorney: Clyde R. Bomgardner I.D. No: 06395 Address: 10-12 South Main Street, P.O. Box 166 Mifflintown PA 17059 Telephone: 717-436-2119 DATE FILED: 8-7-2002 ARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. :G(v7d11'3^vVE~'+.LTt*. "~r: f'ENh;SY: "a~iNlia f. !'' s:`tTN'E' t-''^-~1.'r Vi"At., i7E°;CJ;il1. IvC~C,~L RE~~I~'~ ~.AI~,''a {.~-.BUiFI~:'a~ ~"IC~IV o0F I~E~~? F`f ~; . R ~~ s \i'~~ ~s o ~ -• .t __ ~+ ~~~ i~. € ~~:. _f.~~ 5 ~ ~ ~ ~ t~ ~ ~ ~ ; _,, ,ate„ •'~I July 25, 2002. ~~ ,, r,`~.r~_ ~dT C,t ~ -- .:r~. Jatr,E. ~ i D.~ :}:. , , .r He1Pl1 M• _ __ ___- _ - -___ _ __ -_Stazer' ~_e: F~le_ `,~~,~a~ ~:=_°curt~,~ No 187-14-0285-_- _____ __ __- i)ate t r [:? -~;"~., July 23,-.2002 Date of Bi~tn _ -- 29~_ 19?3-___-_.._--_-_-. Birfhplace -_-------__ ____Juniata ~.~ PA F„ a ` r, of -' ~ ; , , , Holy Spirit Hospital Q~erlar~d 0~. C~[p Hill _- _- _ - h<~ce--_-~??~~ - .~~:;..ai~atic~ _----~r-- ---- -- __ Armed recces? (~'e ;° rj~; - DF.cedent's r ~, : ~~ , , ~; - Widaa 1915 Kent Drive, H~.ll, PA 17011 J1~< ~~ _ - -- C~9~iifing Address --- - -__ -- - ~~ -------- _____ ---_ --------- - I fo~~nan! Jd~n R. Sher' -- __-_ _ ----__-_ FranP~al Director I~iniel B. Brown _ f~arn~ u°?ca ~: F ~ ~ ~ •~ ~ °a' ~ ., t ~ . ~ ~ .~ ;. Brrr~m FLu~xal Hams ~ Inc. , 100 Bride St. , Mifflintaan, PA 17059 Fa`* ~. ~'1 ,'i'F ~i-i"r' 1 t ~ tilt;~nt l"ld ~fr ~i'~ -: C~liogenic Shock Severe ~rcnary Artery Disuse r; f~~arre r , :. : ~ Describe hog ~~ inji_;rY c< < ,"~~t~c~i: _, N~t~na~ x :~~cir~ - ^, iQc=,t"1` _ ;,;-?. Sri .; ~_ _~c i<;C~ v° I(;il'~E `'3 ~~ .t Cl~_; -~ ,tet"r`~i(led -~- Arr.~eas V~ci, M.D. p~.-~nr: ~~: ~ r , -- - - - -- - ~, i ~ _ ~adr~r,s_> Associated C~iologist, 2802 Old R;ct Rr7., IiarrisV~, PA 17ll0 t'ry'' il"!f0!'"71ai1C)r? hs~re C~IVE?Il IS CoirBCtIV C'aplE'C:i frO~ll -?~'~ E lil:.. ?,r :~,. ~ ~,;1~ ~c. ~~itr•; ;~;r~ as local Registrar. The original certif!ca're .~~~.' k~~. '~-:~. ~ ~>~~ :_ .. _. ~~ ,.,, rr ~ ,. 4 34307 July 24, 2002 109 Path St. Mi in >~ro. r ~~~t IIC ~Tlt~t l~1-E~~~TZtCCYT~ OF HELEN M. STONER ~ i - a ~.- ~l a5 I, Helen M. Stoner, of 1915 Kent Drive in the Borough of Camp Hill, County of Cumberland and Commonwealth of Pennsylvania, being of sound mind, memory and under- standing, do hereby make, publish and declare this to be my Last Will and Testament hereby revoking and making void any former Wills and Testamentary Dispositions by me at any time heretofore made. I order and direct that my body be decently interred and that my funeral be con- ducted in a manner corresponding with my estate and situation in life, and that all my legal debts and funeral expenses be paid as soon as conveniently may be done after my death. I direct that all taxes that may be assessed in consequence of my death of what- ever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the expense of the administration of my estate. III I give and bequeath One Thousand and 00/100 ($1,000.00) Dollars unto each of my grandchildren who are living at the date of my death. IV I give, devise and bequeath the residue of my estate of every nature and wherever situate in equal shares unto my three (3) children, Linda L. Zimmerman of R. D. 1, Box 165-A, Mifflintown, Pennsylvania 17059; Evelyn A. Kocevar of 62 South Fulton Street, Manheim, Pennsylvania 17545; and John R. Stoner of 7 Tall Tree Drive, Camp Hill, Pennsylvania 17011, share and share alike. Should a child predecease me, I then give, devise and bequeath said deceased child's one-third (1/3) share of my estate in equal shares unto my children who are living at the date of my death, share and share alike. V My personal representative hereinafter named shall have the following powers in addition to those vested in her by law and by other provisions of my will, applicable to all property, whether principal or income, and effective until actual distribution of all property: A. To retain any or all of the assets of my estate, real or personal, without Page 1 of 2 Pages regard to any principle of diversification or risk. B. To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduciaries, as she deems proper, without regard to any principle of diversification or risk. C. Ta sell at public or private sale, to exchange or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as she deems proper. D. To exercise any law-given options to treat administrative expenses either as income tax or as estate tax deductions, without regard to whether the expenses were paid from principal or income, and without requesting reimbursement. VI I nominate, constitute and appoint my daughter, Linda L. Zimmerman of R. D. 1, Box 165-A, Mifflintown, Pennsylvania 17059, as the Executrix of this my Last Will and Testament, and should my said daughter be unable to serve as executrix for any reason whatsoever, I then nominate, constitute and appoint my daughter, Evelyn A. Kocevar of 62 South Fulton Street, Manheim, Pennsylvania 17545 as the Executrix of my estate. VII No personal representative named herein shall be required to give bond or furnish sureties for the faithful performance of her duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my Hand and Seal this ~- y day of y-Z'~?~~~ A.D., 1988. r ~~ ~~.rn Helen M. Stoner ~ The preceding instrument, consisting of two (2) typewritten pages, was on the date thereof, Signed, Sealed, Published and Declared by Helen M. Stoner, Testatrix therein named, as and for her Last Will and Testament, in the presence of us, who, at her request, and in her presence and in the presence of each other, have subscribed our names as witnesses hereto. ~~~~: ~~~~J~~. ~~rf.~.~1 Residing at .~~iG~~G'~Lat~`C,~~~~f ~~~ ~~~T ~,~~tcrX~~f1 i! ! ~ ' `i / ~ - `_ ; /'~=act ~;~ ~ r r ~ ~ ° ~C~"l Ys'~r' ?-,~~ Residing a '' ,/~. `~, _ ~ ~ ~? / .~r',L-£ ~~%>:_~~ ~ C,L ~' 71 ~ ,-.--- Page 2 of 2 Pages REGISTER OF WILLS OF _ COUNTY OATH OF SUBSCRIBING ~TNESS codicil (each) a subscribing witii~s to the will presented he ith, (each) being duly qualifie ccording to law, depose(s) and say(s) that presen nd saw the testat ,sign the same and that _ signed as a witness at e request of testa in h presence and the presence of each ier) (in the presence of th other subscribing wit s)). Sworn to or affirmed and sub 'bed before me this y of (Name) ~~ J 19 (Ad s) Register (Name) ~~~ ~s (Ada'ress) REGISTER OF WILLS OF CUMBERLAND _ COUNTY OATH OF NON-SUBSCRIBING WITNESS ~.1-02- "1oS l~~ct ~ ~ i d~Y,r1~ (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that UHF T~ familiar with the signature of HELEN M STONER codicil testat RIX of (one of the subscribing witnesses to) the will presented herewith and codicil that SHE believes the signature on the will is in the handwriting of HELEN M STONER to the best of HER ltnowledge and belief Sworn to or affirmed and su'vscribed before me this _ x~~' ~~~~ ~t~l -day of AUGUST z e o z Y.x~x MARY Q~4y~ iste ~ ~ ~ ~U !Ncr e (Address) (Name) (Address) COMMONWEALTH OF PENNSYLVANIA COUNTY OF JUNIATA OATH OF SUBSCRIBING WITNIESS Estate of HELEN M. STONER No. ~ ~ - ~~ --105 also known as ,Deceased Brenda C. (Clark) Duncan (each) a subscribing witness to the ^ codicil(s) Q will(s) presented herewith, (each) duly qualified according to law depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and that shelhe/they signed as a witness at the request of the Testator(rix) in her/his/their presence and] in the presence of each other ^ in the presence of the other subscribing witness(es). //~.. ~f~~~" I~~C. EaZ.C.I (Signature) Brenda C. (Clark) Duncan R.R. 3, Box 930, Mifflintown PA 17059 (Address) (Signature) (Address) Sworn to or affirmed and subscribed before me this-~ h.c>~,-day of August 2002 Notary Public My Commission Expires: aept;~,,;tt_j~tarotwiils 4 tUy Cc-nn, 'x,.:c 9 t iv~nrnrGYy `' ~ ~ 1^c (Signature and seal of Notary or other NOTE: To be taken by officer authorized to administer oaths. Please have official qualified to administer oaths. Snow present the original or copy of instrument(s) at time of notarization. date of expiration of Notary's commission.) RW-2 JRDIJune 30, 1992/17858 In Re: Estate of HELEN M STONER Late of LOWER ALLEN TOWNSHIP Estate No. `~ 21-d2-~ ~:. ORPHANS' CC-URT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA N0.21-2002-705 NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT ORPHANS' COURT RULE Personal Representative: LINDA L ZIMMERMAN Counsel for Personal Representative: CLYDE R BOMGARDNER ESQ Date of Grant of Original Letters: 08-07-2002 Date of Delinquency Notice: 11-17-2002 The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its certification required by Rule :~.6(e), Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e;l, Supreme Court Orphans' Court Rules, was given by the Register of Wills on NOVEMBER 17, 2002, and that the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e) the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 11-19-2002 ~ ~~ ,Register of Wi is Distribution: Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled for ~ /~ - D .~ at y~- ~a •~.~ Courtroom No. 3. If the Certification of Notice is filed prior to the hearing date, the hearing will automatically be cancelled. George E. of + CERTIFICATION OF NOTICE UNDER RULE 5 f~ Name of Decedent: Helen M. Stoner Date of Death: July 23, 2002 Will No. Admin. No. 21-2002-705 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate ono~r before August 31, 2002 Name Address John R. Stoner ~ 7 Tall Tree Drive, Camp Hill, PA 17011 Evelyn A. Kocevar R.R. 2, Box ,Port Royal, PA 17082 Linda L. Zin;rrterrnan R.R. 1, Box 858, Mifflintown, PA 17059 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Decern ber 31, 2002 Signature ~~ ~ ~ ~Q,~--' Name Clyde R. Bomg;ardner Address 1 ~_ i ~ Srn rth Alain Ctraat P n Rnv 1 ti~ Mifflintown, PA 17059 Telephone (717J 436-21 19 Capacity: Personal Representative X Counsel for personal representative OMMONWEALTH OF ' ~`"°°°`~' REV -15 0 0 OFFICIAL iJSE o,y,"Y C PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RETURN fyLE NUMBER HARRIS URG?P8A~1~7128-0601 ECEDENT a ~-~ 2 ~ ~ ~ ~ RESIDENT D ~~ 6ECEDENTS NAME (LAST, FIRST, ANA MIDDLE INITIAL) Ii0CU1L SECURITY NUMBER W O DATE OF DEATH (MM-0D-YEAR) ' GATE OF BIRTH (MM-0D-YEAR) ~ i ~r a 3 a~~ THIS RETURN MUST BE FILED Mt DUPLICATE WITH THE TER OF WILLS W ~ ;, `~ 2 ~ z Q a ~ - ~! (~ ~ ~ / , REGIS W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDOLE INITIAL) :i0CU1l SECURITY NUMBER ~ ~ - - ~ s ®1.Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Retum (mr a ate, poor ro ~arsazl c x ~ o ~ 4. Limited Estate ~ 4a. Futuna Interest Cmnpiomise Ware a aam ~Rer ~2-~2a21 ~ 5. Federal Estate Taz Redxn Required ~ ~ m ®6. Decedent Died Testate (~ moy ar wat ~ 7. Decedent Maintained a Living Taut (~ espy d tnsq ~ 8. Total Number Of Sake Deposit Boxes 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credt War d a.en eelwsen uai~r sa ~-t-9~ry ~ 11. Election tD tax under Sec. 9113(A) Nme~ Sd~ o- - ' . Z o COMPLETE MAILING ., NAME ~~ E .~c~m ~i l~~- C .~~n~ v~iZ~n~ ~ ~-~7F FIftU NAME (x~pgna.) (~ , l •~ S, J~ ~ I ~ ~; ~ , m ~ TELEPHONE NUMBER P, ~ \~ Gx- ~ I'o fo 1 Real ~~ ( ~ (1) .~~., ~ ~ ~} ~ ~ OFFICIAL USE ONLY 2 Stocks and Bonds (Sdredule 8) (2) 3. Ckuey Held Corporation, Partnersfup or Sale-?raprietorship (3) d . 4. Mortgages 6 Notes Receivable (Schedule D) (4) C~ 5. Cash, Bank Deposits d Miscellar>Qous Persaral PropeAy {5) ~ 3 ~~. ~' d Z {Schedule E) 0 6. Jointly owned Property (schedule ~ (s) b ^ Separate Bilaig Requested -~ 7. Inter-lfrvos Transfers 3 Miscellaneous Non~Probate Propery m C~ L a W Z 0 H a O V (Sdredule G or L) 8. Total Gross Assets (total Lines 1-n 9. Funeral Expenses & AdrtunLstrative Costs (Schedule H) (9) _ ~2! ~- ~~i ~ ~~ 10. Debts of Decedent, Mortgage LiaWlities, !4 Liens (sa,ea,le q (10) 3. ~' (o I , 1 ~' 11. Total Deductions (total Lines 9 & 10) (11) _ Z ~, ~ C`f . ~~ 12. Net Value of Estate (Line 8 minus Line 11) (t2) ~ ~ ~ ~ ~, ~~ 13. Charitable and Governmental 8equesisl5ec 9113 Tnists for which an election in tax has not been (13) _, C't made (Schedule J) . 14. Net Value Sut~ec! to Tax (Line 12 minus Line 13) (14) _ JC' ~F~o ~i L V SEE INSTRUCTWNS ON REVERSE SIDE FOR APPLICABLE RATES ' 15. Anaunt of tine 14 taxable at the spousal fax x .0 _ (15) - rate, ar 6ansfers under Sec. 9116 (aK1.2) t c_~ 16. Amowit of tine 14 taxable at ram rate 5~--"7C,$, '~t~ x A ~,z (1s) - Z~ •S ~ X? . ~s~) 17. Amount of Line 14 taxable at s~tirrg rate 18. Amorxrt at Line 14 taxable at rx>Aa~at rate 19. Tax Due Z0. ^ e x .12 (17) -- DecedEnt's Complete Address: I CRY ~~IMY ~ 1 (n L- STATE ~ ZIP t ~ ~ , I Tax Paymetnts and Credits: Tax Due (Page 1 Line 19) (1) '~ ~~Ct ~, ~~ CreditslPayments A. Spousal Poverty Credit C B. Prior Pale ~ ~~ C. Discount ~^g IntepesUPenalty iF applicable Total Cted'rts (A + B + C) (2) C D. Interest (;} E. Penalty Total Interesf/Penalty (D + E) (3) Cl If Line 2 is greater than Line 1 + line 3, enter the difference. This is the OVERPAYMENT. Check box om Page 1 Une 20 to request a refund (4) ~~ ff L'me 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Fester the Interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5} Z. S ~l~. ~ (58) ~. SSA r~1 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred :.......................................................................................... ^ b. retain the right to designate who shag use the property transferred or its income : ............................................ ^ . o. retain a reversionary interest; or .......................................................................................................................... d. receive the promise for fife of either payments, benefits a care? ...................................................................... ^ 2. If death acatrred after December 12,1982, did decedent transfer property wlThin one year of death without receiving adequate consideration? .............................................................................................................. ^ 3. Did decedent own an "m trust for or payable upon death bank account or security at his or her death? .............. ^ 4. Did decedent own an Individual Retkernent Account, annuity, or other non-probate property which • contains a beneficiary designation? .......................................................................................................... No Q~ 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 penaNies d perjury. I declare that I have examined tlas realm. hdudn9 D~7nli sdredules and statements, and b the best or my Imowledge and belief. it is hue. oared and mrtplete. Declaration or preparer o0ier than the personal represenla6ve is based an aN intamration or which preparer has any krgwledge. SIGNATURI;,~F PERSON RESPANSIBLE~OR FILING RETURN _ DATE t3y-23~4~ ADDR;~ - t ~ Sa.~;-a-~- t~~~-~,\u.-~ ~i . , ~. c~-3nx I i~~, ISM t~~~lnni ~~ ~ , lp~ t 7 0 szL___ For dates of death on or after July 1,1994 acrd before Jarxtary 1, 1995, the tax rate imposed on the net value of transfers b or for the use of the surviving spouse is 396 (72 P.S. §9118 (a) (1.1) (i)1. For dates of death on or after January 1, 1995, the tax rate unposed on the net value of transfers b or for the use of the surviving spouse is 096 [T2 P.S. §9116 (a) (1.1) (671. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requ'memertts for disclosure of assets and filing a tax return are stN applicable even if the sttrvlving spouse is the only beneficiary. For dates of death an or after July 1.2000: The tax rate unposed an the net value of Uansfers from a deceased child twenty-0ne 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% (J2 P.S. §9118(a)(12)J. The tax rate unposed on the net vaitre of transfers to or for the use of the decedent's lineal beneficiaries Ls 4.5%, except as noted in 72 P.S. §9118(1.2) [72 P.S. §9116(a)(1)1. The fax rate imposed on the net value of transfers to or for the use of tfte tiecedtxtt's s is 1296 (72 PS. §9116(a)(1.3}). A siblm' g 6; defined, under Sedan 9102, as an u~vidual who has at least one parent in common with the decedent, whether by blood or adaptiort. SIGNATI)UE OF PREPAR~Q~TFUW REPRESENTATIVE GATE aEwmtfx•tt+A SCHEDULE A CQA~gNMVEAt.Tti ~ pErarsrtvAt~gA REAL ESTATE NNiERfTAtrCE TAX RETURN esraTE of 5~ N~ ( (~ ~ ~ ~~ ~ t Fn.E ~~R 2 t - U 2 - C V`-I d An real property owned solely or as a trarraat in col~nanocti nxrst be reported at fair market value. Fa'r market value is dented as ~ price at which property would be exchanged between a wing buyer and a wiling seNer, neAher being compeped to buy a sell. both havug reasonable knowledge of the relevant facts. Real propert)- whid- is jotrdty-owned with right c REM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~. S tX ((c ~cn+~ S`iV«-~ C~'4QE c-a -~ f-~pv~ ~ tt.; ~m~i - 5'rR3}~-~ i ~J (..Ocu ~- l~-4,hE~.-u •"~b~~tJ~stt t'~, Cc~ rvrn~8~.>~~ 6 ~~ ~ ~^-~ ~ ~~ c ~~ ~~7 ~tr ~ tai tit ~ t- l~r` 1 S Q,.r'Z3~ tL~~l~ i kf C ~ ~ ~ i~-L~RN~ ~t~ t~ l.,T`~ ~ Fc'.~~ 1~ LQ lam- ~t IV (~ . '2 `f P/t~' ~`-~18- ~ ~ 1~5i h t`+ ~'~ ~s t~l l S- l~~rs- ~R.t v ~ ~ TOTAL (Also enter on line t, Recapitulation) I S ~ ~; 0 O ~ . U r~ (If more space is needed, insert additional sheets of the same size) SEP 09 2002 16:25 FR SECURED LAND 717 591 8506 TO COLONIAL PARK P.02i03 i A, V.S. DEPARTMENT OP HOUSING and URBAN DEVELOPMENT SETTLEMENT STATEMENT ~ OMB No. 2502-026' nrLewta ~a.orpnm SECURED LAND I ' TRANSFERS, INC. 8. TYPE OF LOAN 5006 East Trindle Road ~j~11t0 20'3 t. [ 1 FHA 2. (j FMHA 3. [ ] coNV. UNINS. 4. ( ) VA 5. (xCONV. INS. Mechanicsburg, PA 17055 fi. PoLE NUMBER: 130026 7. LOAN NUMBER: 0020053518 I Phane_ (717) 591-8500 FAX: (717) 591-8506 C. NOTE: This form is furnished to give you a statement of actual senlement costs. Amou '(p.o.c.)' were paid outside the cbsMg; they are shown here for infortnetional B.MORT.INS CASENO.: nts pa[d to and by the settlement agent are shown. Items marked purposes and are not included in the totals. D. NAME AND ADDRESS DF BORROWER: Karen M. Stepanik , PROPERTY LOCATION: 1915 Kent Drive Lower Allen TOWNSHIP CC]MBSRLAI3D County E. NAME AND ADDFiE55 OF SELLEA: r. NAME AND ADDRESS OF LENDER; Ests~te of__ ERA Mortgage Helen M. Stoner --a--~- ---------- - 3000 Leadenball Road Motmt Laurel NJ 08054 H. SETTLEMENT AGENT: I. SETTLEMENT DArE: Secured Land Transfers, Inc. 09/09/02 PLACE OFSETTLEMEM: 5050 Linglestown Rd, Harrisburg PA 17112 J. sUYYARY OF BORROWER'S TRANSACTION: 100. GRO38 AMOUNT D-1E PROM BORROWER +o1.Contradsalesprice 78000.00 102. Personal property 1os. Settlement charges to twrrower (fine '1400} I 5 1 . 1 104. K. SUMMARY OF SELLER'S tpANSACTION: 4o0.GROSS AMOUNT DUE TO SELLER 4ot.Contractsalespnce ~7 0 4az.Personal property 4HS. 404. { 105. 4(15. j Ad{ttstments for items paid by sa6ar in advance Adjustments for items paid by seller in advance I tot. City/town tax l0 4os.ClryrTown tax to I ~ ,o7.Countylax 02to12 31 02 118.4 40zCountytax 09 09 02to12 31 0 118.46 t08. ASSOSS<1bRta b 40a,Aseetamenle to 109. sclwol 09 09 02to 06 30 03i 812 .96 40o eehool 09 09 U2to 0 03 812 .9 ,to. wr a 67.50 en 9 30 15.53 ,10. Swr&Re 67. 0 Iq ~z 0 15.53 +,+. 4,,. nz. I atz. ,2a GROSSAYOUNTDUEFROAIBORROWER 81538.06 4aa.GROSSAY0UNT0UETOSELLER 78946.95 200. AMOUNTS PAID BY OR IN BENALF OF BORROWER 500, REDUCTIONS IN AMOUNT DUE TO SELLER r zo1. Deposit or earnest money 10 0 0 . 0 0 scl.Excess deposit (see instructions) zo2. Principal amount of new ban(s) I 0 . 0 0 sOZ.Settletnent charges to seller (line 1400) j 4 . zo9. Existing loan(s) taken subject to I sos.Existing loan(s) taken subject to I pe, Points Paid Upfront 250.00 z05. I zas.S to B C osing Costs 2340.00 so4.Payoff of First Mortgage Loan None sos.Payoff of Second Mortgage Loen 5os5 to 8 C os~ng osts 340.00 2m, soz I z0a. soe, 209. 509. Adjustments for items unpaid by salter Adjustments for items unpaid by seller zw.ClryiTowntalc to '~ s,O.City/fowntax to 2t1. County tax to 51 t.Counry tau to ~ 2t2. As:ossmonr to Sii'.Aesassments fo I 2t9. school to 513 school to 214. 514. I 215. 515, I 216. 516. ' ~ 217. 51i. ~ 21H. H7H. I 219, ~ 519. 2z0.TOTALPAIOBY/FOR BORROWER ~ 79250.00 sea.TOTALREDUCTIONAYOUNTDUE9E.LLER 8994.29 900. CASH AT SETTLEMENT FROM OR TO BORROWER HCO.CASH AT SETTLEMENT TO OR FROM SELLER 90t. Gross amount dus from borrower (line 120) 81 3 8.06 t01.Gross amount due to seller (line 420) I 7 8 9 4 . 9 5 '; a02. Less amount paid by/1or borrower (fine 220) 2 aOZ.Less reduction amount due seller (line. 520) 8994.29 a09 CASH (Qfl FAOY} ([ ] TO) BORROWER 2288.06 soa.CASH (Oq TO) ([ ] FRDY) SELLER j 69952.66 f BYYer or Borrower's Signature SCller'S SlOnaluro HUD-t Rev. 5/96 SEP 09 2002 16 25 FR SECURED LAND 717 591 @506 TO COL~tIAL PARK P.03i03 U.S. Uht'AHI MrN I Vt r7UlJSINto AIVU UfttlA1V UCVGLUr'Ml:rv I veto Ivu. Cu~c-ua[+u SETTLEMENT STATEMENT Page 2 owm cenu L. BETTtEYENTCHAiiOES 130026 X00, TOTAL SALES/BROKER'S COMMISSION based en pNe^ S 7 B 0 0 0 . 0 O 6 . O Division of Commisson (title 700) asfoflows: Total : 4 , 680 , 00 ,o,.$ 4680.00 to Jack Gau hen Realtor ERA BORAOWEW'S FUNDS AT SETTI.EYENT SELLER'S FUNDS aT SETTLEMENT 702• $ to 7pg, Commission paid at settlement ~oe.Trans Fee ERA-NRT, Inc. I ( :L00.00 4680 .00 100.00 800. IT£M9 PAYABLE IN CONNECTION WITH LOAN ~- e01. Loan Origination Fee 96 eaz. Loan Olseount ~ I I 803. Appraisal Fee to eoa. Credit Report to eo6. Lenders Inspection Fea ~ 1706, Mortgage tnsurlinee Application Fee to em. Assumption Fee I I __._.1 eoe. ~. I 810. + 811. gOD. ITEMS REOUIRHD BY LENDER TO BE PAID IN ADVANCE ~ , I got. Interesttrom 09 09 02 to09 30 02 ®$ 14.71/day i :323.62 i~ _ goy. Mortgage Insurance Premium for mo. to I i g09. Hazard insurance Premium for !yrs. to Allstate ($249 POC-B} i I 906, yrs. to I __._ ,aos. ' 000. RESERVES DEPOSITED WITH LENDER FOR Dot. Hazard Insurance 3 mo. ®$ 20.75 Imo. ! 002. Mortgage tnsuranee mo. e4 $ 61.16 Imo. 009. CitylTotNn tax mo. Q $ lfllG. 62.25 , ooa. County tax t3 mo.®$ 27.72 /mo. 121.76 005. Assessments mo. ®$ /mo. tw6. School Tax 4 mo.®$ 84.11 /mo. 336.44 om. rrlo. ®$ Imo. tx>e.A rAd ust mo. 1@$ /mo. -222.71 ;:. .. ,... 700. TITLE CHARGES tnt. Settlement or closing See to 702, Abstract or tltle search to 7D3. Title examination to ~ t0a. Title irtsurence binder to ~ 706. Document preparation to Secured Land Transfers 75 .00 706. Notary fees to Cash 10.00 10.00 107. Attorney s tees W ~ (includes above items Na.:) ~?S . ..:. _ar':3 _,.: ~ , ' .. ; ',' : , 109. Title Insurance tc Secured Land Transfers 876.75 (includes above items Nc.:) end. 100 , 300 , 900 y. . r ~~ w. ' ~""'' ' tog. Lender's coverage $ 75 , 660 y a it0 owner's coverage $ 78 , 000 ~' -,a. .:~;;: ":~~`rr?':~' '.rn 777. 172. I 173. 200, GOVERNMENT RECORDING AND TRANSFER CHARGES zOt. Recording fees: Oetxi$ 28.50 Mortgage$ 54.50 Misc$ ~ 83.00 i I 2D2. City/countytax/stamps: Deed$ 780.ODMortgage$ i 780.00 i 203. State taxlatamps: Dead S 7 9 0. 0 0 Mortgage $ , 7 8 0 .00 zoa. I 205. I 30o ADD1710NAL SETTLEMENT CHARGES Sot Survey to I I 302, Pestlnspection to HOUSemaSteT (POC-B) I I 3D3.Home Ins Housemaster (POC-B} I 3w r02Sch1Tax Bonnie K. Miller, TC i I 1009.29 3g6.Wire Fee Secured Land Transfers :20.001 600. TOTAL SETTLEMENT CHARGES (orator an linos 703 and 602, Soclions J and K) 25'91 .11 I 66 54 .29 i Padips apnea flier nd Gabi9ly i. sewmed by S^Idsmenl A9sm Idr the eceuraey of Inlpmwlbn lyrniahed ray olhen as shown on the HUIYt Sel9emenl 54dumenl. Setlbmenl Agenl hereby espremly reeervea the rlgfll le tlepoWl any ^maWlta GeRBCIM la diabunemenl in an iMerdal beemig account in a Fddarally inwrnd inslitulbn end lp crpdp arty intnrotn ap earned to h5 own aCGOUhI ^i adduional e:pngenerlbn Im ile sdNCde m lhC lnwraaelipn. HUD CERTIFiCAT10N OF BUYERS AND SELLERS I carofully rwwwed th HUD-7 omont Sta[emant and to the boat of my knovAOtlge and bollof, It Is a vu^ and accurate etat^ment of a0 receiPls and disburcomenls Ina n my accoun me ' is ctioa I 1 artily that 1 havo rocoivod a copy of tho HUD•7 Sottloment 5tatomont. euypr o. epmpwp: c slsnpw seun.'e sgnwwre auy^rc Addr^ss 6 Phone' Snlldr's New Address S Pnone: The H 1 meat SI m which 1 pamd is a vun and accunlo sGnqunl of tnq Iranaaelgn. I nave p wll uee the tune!; m he disbwsod in accordane^ w9h Iraq atalwlllenl. ` ~~ ~~U ~" tt rat Ati^nt Due APNING: II b. erbva rd 6N eYS islet N la la [N Unnsa SIwYS pn Ins M q,y. sana.r tum~. hnsilws upon eonvwlipn tan include • line antl mprbonmont. For dpWrs see TGtn 7a; U.S, Codo wn 1001 and Sect 1010. HUD-1 Rav. 6196 a:* TOTAL PAGE.03 *>r aEV•~sce ~ • t'-~n a ~ SCHEDULE E rcMeecNwEUnioFar~wsnvaNw CASH, BANK DEPOSITS, ~ MISC. INkEr'iIIIUVCE TAX Rt:FtliiN PERSONAL PROPERTY RESIDENT DECECENT _ _ ESTATE OF FILE NUMBER Include the proceeds of fitiga6en and d:e date the proceeds wen: received 5Y the . Att property pisttly-owned w9th t7hs right of survivorship must be disclosed on Schedule ITEM VALUE AT OAT_ NUMEER CESCRIP?!CN OF Cf:Ain ~. ~~~~-~t~sT ,n ~, ~.~rmn~! t~~= ~FF~i ~ , 3' ~f-~ S. I 0 -~- ~~ rr~rno~FN~, v1~ 1"10`t 3 C ~t~~ZK- INS ~cct~,~ `~"- 'Z"21 o3~t-~r >iv i 11c~ 1~ D~ ~ ~- X4-1..1 C~ O ~ Tr ~ ~ -~~ ~- ~ ~v~-N ~ ~v i~ ~~v R-~r s t~ f t~ bs ~~~ . ~ t~ ~~~N c.~= ~4"~C- t ~ t~ ~-~- "l~~v~ r ~~rr.P ~'I ~.~., ~~- t~pk { vt'~hV~~ A-~ 1. C~ bp, 00 3: ~As~~c'bi~ ~vN7 t~ ~RE~TS p~cr...~i ~~x:.~4~~ tt31,I~ TOTAL (Also enter on line 5, Recapitulation) I S ~, ~ ~„ ~! (N more space is needed, insert additional sheets of the same size) aEV-~s„o~•t+~1 SCHEDULE H ~~, ~ ~,,,,,~,,~~,~,~ FUNERAL EXPENSES 8 INt~RtTANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE t)f jl ~ FILE NUMBER Debts of decedent must be repor6ed on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: B. 6. 11~w~s'~0~~ U-~~-~v-r-~v~ ~?'luru~m~v~ ~---, it l ~ 3.oC 1~+1EraS~a-1k ~-V~~/~ ~t+U~L}}-`~ ~'v~~E- ,j"r-~Jirt_,~ $~•~' ~ Tkl~.. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Repteserdative (s) ~ / N't A~ ~.. ~ t l{I f!V~ ~i`~~ t~ ~ Soaal Security Nurrlber(s) ! EIN Number aF Personal Representative(s) Sheet Address City State Zip Year(s) Conrrnission Paid: 2. Attorney Fees ~ :...,~laE . ~ , ~~f'Y1 t:V A~~ N1'~~-- 3. Famiy Exemption: (If deoedenYs address is not the same ass claimant's, attach explanation) claimam NeT }~ ~~~ ~.~-~51.~ Street Address COY State Zlp Relationship of Claimant to Decedent Q 1 ~ ~ q, Proba>!e Fees ~~~ r'h ~ N -~ ~r U (J ~'''{ t~Z is 1~-=~ r-1 v v 614- -- ~ t ~ fl N~ R~~~%~~ 5, Accorrntar>rs Fees g. ~ Tax Return Preparers Fees ~. SGcvS-~J G~~~'C~{~us-~r ~t~t,-~Cti~s~,~L Ccs+3 ~~t~-~ ~~/AQ ~I Htr-e Y~ ~~i~FN~-~C W ~ ~~ L-~~> C S~ ~e Q ~ G ~- ~ET~ L,~l~lt Entt' S ~'~ r~TChc71a=-+7 ~~ SCµsh~~ ~, fP~ IJ ll hem .Stio,G4 G' CU ''~ TOTAL (Also enter on line 9, Recapitulation) ~ S ~ ~ ~ ~ ~ S~, (If more space is needed, insert additional sheets of the same size) gEW)St2R•Ila+) SCHEDULEI ' ~ DEBTS OF DECEDENT, ca~+oNwEA~THOFaENNSnvaNIA MORTGAGE LIABILITIES, ~ LIENS INHERITANCE TAX RETURN """" ESTATE OF "` """""•• /~ FfLE NUMBER S~ ~ ~~ L-E~ ~ ~' ` ~ - Z ~ " U'~ - (1 O7 d ~ Include unre imbursed rrredical expenses. REM R OESCRIP710N ~ AMOUNT - i NUMBE 1. y1,1r--i~;L~~,., ~ ~ C1~1~\~ ~~~'16h6G 1ST y ~~-.06.00 ~tSS 6 ~ a. ~ ri,. ~ ~ ~ ~- a ~ F~r~ r rr,~ Q R-/~=~ ~.~ ~G ~ ~ - ~, . 11 -- (~ ~ prt~1 TU iry'~ 61fY1.A,~ i P+ G -_'~.''_ t 2. vt,h~+~~~, Z ~~i. a ~- " `333, 7 ~ ~~ L- ltv Q©.Od `~,bf~ TOTAL (Also enter on finri:l0, Recapitufadan) ` S `3, `E l01 . ~ 0 more space is needed, insert additional sheets of the same size) ~ SCHEDULE J ~m ~ P~NN~V~ BENEFlCfARiES u~wranu~ Tax ~nrRN ESTATE OF ~~~ - ,/i„ ` i7LE NUMBER ~ t ' C1 Z " C1 Cl ~~ ~ S~N~, ~r~ NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List: Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousa{ d'~stnbutions) • 1. tb.~a~rz~ L, l<~PNGiL, ~ R. ~ . F'ylt TCt~Et...~ Je~'~pN~jL ~~~~~~~5 i, ~ 6 a.0O ~~ ~ " i F l ~ 3, ( F L iN; Ut,1 NI Y~l i R . R , t .~ o x f ~l 1 .~^ -~ ~ ~~~tv~ ~Q~ST~~ L.*~NIJ~(""irV~I,~ rr..,, ^^ ~ i~~Q..I.JI.J --~++ ~ ~" ~ l"~c~-N) S~ Cv(~-r~s S~~eR- G~~7~f~~ 11U~Q~QQ (c ~ ~ ~}-,,,~ ~ . ~ IAN ~ . ~ ~`p~ a~ `T(L-~ 71 ~,, C~ P 4-~>~-.1~,4- t~l~ 11 ~a ~.~ ~~:3 ~T~'~~~ ~~ ~V°Eh''~ IJ f~, Ka~~~•~- ~ ' i~ F4v6N; i~Q- ~~3 ~S; ~4ic~f-~1~~1 R.R. Z , Po~T Q-~ ~~A~-. ~d~- ~7~~2.._ ~-. i.tN~~ ~... ~ ~ ~.~~.rw..~,..s ~,~~~ N~ tf-~ ~ P-~~a~ R,i2.~, `~3~x ~~, N1~1r ~~tr>,.- c~~~N~ ~~ ~1bS~r ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIAT E, 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 1. ~dT /~-P~hl ~~$~.~ B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ,. No ~~ TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 CGVER SHEET ~ S (IF more space is needed, insert additional sheets of the same size) _ ~ .-, "~~rt~~~ trX ~~~ C`~~~~~x~.e~~ OF HELEN M. STONER I, Helen M. Stoner, of 1915 Kent Drive in the Borough of Camp Hill, County of Cumberland and Commonwealth of Pennsylvania, being of sound mind, memory and and<>.r- stand'sng, do hereby make, publish and declare this to be my Last Will and Testament hereby revoking and making void any former Wills and Testamentary Dispositions by me at any time heretofore made. I I order and direct that my body be decently interred and that my funeral be con- ducted in a manner corresponding with my estate and situation in life, and that all my 6ega1 i debts and funeral expenses be paid as soon as conveniently may be done after my death.. I direct that all taxes that may be assessed in consequence of my death of what- { ever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the expense of the administration of my estate. III I give and bequeath One Thousand and 00/100 ($1,000.00) Dollars unto each of my grandchildren who are living at the date of my death. IV I give, devise and bequeath the residue of my estate of every nature and wherever situate in equal shares unto my three (3) children, Linda L. Zimmerman of R. D. 1, Box 165-A, Mifflintown, Pennsylvania 17059; Evelyn A. Kocevar of 62 South Fulton Street, Manheim, Pennsylvania 17545; and John R. Stoner of 7 Tall Tree Drive, Camp Hill, Pennsylvania 17011, share and share alike. Should a child predecease me,I then give, devise and bequeath said deceased child's one-third (1/3) share of my estate in equal shares unto my children who are living at the date of my death, share and share alike. V My personal representative hereinafter named shall have the following powers in addition to those vested in her by law and by other provisions of my will, applicable to all property, whether principal or income, and effective until actual distribution of all property: A. To retain any or all of the assets of my estate, real or personal, without Page 1 of 2 Pages . t regard to any principle of diversification or risk. B. To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduciaries, as she deems proper, without regard to any principle of diversification or risk. C. To sell at public or private sale, to exchange or to lease, for any period of any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as she deems proper. D. To exercise any law-given options to treat administrative expenses either as income tax or as estate tax deductions, without regard to whether the expenses were paid ~ ' from principal or income, and without requesting reimbursement. VI I nominate, constitute and appoint my daughter, Linda L. Zimmerman of R. D. 1, Box 165-A, Mifflintown, Pennsylvania 17059, as the Executrix of this my Last Will and Testament, and should my said daughter be unable to serve as executrix for any reason whatsoever, I then nominate, constitute and appoint my daughter, Evelyn A. Kocevar of 62 South Fulton Street, Manheim, Pennsylvania 17545 as the Executrix of my estate. VII _ No personal representative named herein shall be required to give bond or furnish sureties for the faithful performance of her duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my Hand and Seal this .Z y day . of y,'('cz.~r. A.D., 1988. /J ~' / f g /~-~-~e.?c_ ~`( 5:.~~~IZL,~ (SEAT.) Helen M. Stoner The preceding instrument, consisting of two (2) typewritten pages, was on the (date thereof, Signed, Sealed, Published and Declared by Helen M. Stoner, Testatrix therein ',named, as and for her Last Will and Testament, in the presence of us, who, at her request, 'and in her presence and in the presence of each other, have subscribed our names as witnesses hereto. i / J _y ,,/ `JL-'G~iL~r~.~. ~~~LE/~'.:' Residing at~'?4a5N~~tt2"~Cx~~(er~{ ,'Y/_~{~,7"~,,~t..CZ~3it~L ~ ri ,p , ~ : ~ ~. ~ _~=~ ~ ~~ :r : i ~ ~ ,.~~r~G~_ Residin at~~ ~ ' ~ `! ~_ ,~'~ ~ ;' t J Page 2 of 2 Pages COMMONWEALTH OF PENNSYLVANIA DEPAR7MENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BOMGARDNER CLYDE R ESQUIRE 10 SOUTH MAIN STREET MICCLINTOWN, PA 17059 ACN ASSESSMENT CONTROL NUMBER -------- 104 ESTATE INFORMATION: ssN: ~ a7-i 4-o2a5 FILE NUMBER: 2102-0705 DECEDENT NAME: STONER HELEN M DATE OF PAYMENT: 04/25/2003 POSTMARK DATE: 04/23/2003 couNTY: CUMBERLAND DATE OF DEATH: 07 j 23/ 2002 AMOUNT 101 ~ 52,596.89 TOTAL AMOUNT PAID: REMARKS: LINDA L ZIMMERMAN C/O CLYDE R BOMGARDNER ESQUIRE SEAL CHECK# 22 INITIALS: AC RECEIVED BY; DONNA M. OTTO 52,596.89 DEPUTY REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 002488 REGISTER OF WILLS /~- ~'~ - ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 CLYDE R BOMGARDNER 10-12 S MAIN ST PO BOX 166 MIFFLINTOWN PA 17059 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 EX 4FP t01-03) DATE 06-09-2003 ESTATE OF STONER HELEN M DATE OF DEATH 07-23-2002 FILE NUMBER 21 02-0705 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYAEtLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, Pi4 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT' OF TAX ESTATE OF STONER HELEN M FILE N0. 21 02-0705 ACN 101 DATE 06-09-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANIGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1l 78,000.00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit #o your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. MortgageslNotes Receivable (Schedule D) (4) .00 of this fora with your 5. Cash/Bank Deposits/Misc. Personal Property [Schedule E) (5) 5,388.68 tax payment. 6. Jointly Owned Property (Schedule Fl (6) .00 7. Transfers [Schedule G) (7) .00 a. rotas Assets ($) 83,388.68 APPROVED DEDUCTIONS AND EXEMPTIONS: 22,218.80 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9l 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 3 461.1 11. Totai Deductions (11) 25.679.98 12 . Net Value of Tax Return (12 ) 57 , 7 D 8.7 0 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule Jl (13) .00 14. Net Value of Estate Subject to Tax (14) 57,708.70 NOTE: if an assessment was issued previously, lines 14, 15 and,~or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) •00 X 00 = .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 57,708.70 X 045. 2,596.89 17. Anount of Line 14 at Sibling rate (17) .00 X 12 .00 18. Anount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 .00 19. Principal Tax Due (lg). 2,596.89 TAY f_RFTITTC~ DATE NUMBER + INTEREST/PEN PAID (-) AMOUNT Pi4ID 04-23-2003 CD002488 .00 2,596.89 TOTAL TAX CREDIT 2,596.89 BALANCE OF TAX DUE .DO INTEREST AND PEN. .00 TOTAL DUI. .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN Sl, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on ar before December 12, 1982 -- if any future interest in the estate is transferred in possession ar enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life ar for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (collateral) rate an any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). PAYMENT: Detach the tap portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF WILLS, AGENT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Dffice of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-SDO-447-3020 (TT only). 08JECTIONS: Any party in interest net satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty C60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Oept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS; Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Texas, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (7177 787-6505. See page 5 of the booklet ^Instructions for Inheritance Tax Return for a Resident Decedent° (REV-15011 for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three Cal calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and net paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1] day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six C6%] percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates far 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rata Factor 1982 20% .000548 1987 9% .000247 1999 7% .000192 1983 16% .000438 1988-1991 11% .000301 2000 8% .000219 1984 11% .000301 1992 9% .000247 2001 9% .000247 1985 13% .000356 1993-1994 7% .000192 2002 6% .000164 1986 10% .000274 1995-1998 9% .000247 2003 5% .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen C15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA- ORPHANS' COURT DIVISION In Re: Estate of Helen M. Stoner, deceased late of Lower Allen Township Cumberland County File No. 2002-00705 Pennsylvania File No. 21-02-0705 ESTATE RELEASE KNOW ALL MEN BY THESE PRESENTS, that I, JOHN B. STONER, of 7 Tall Trees Drive, Camp Hill, Pennsylvania 17011, hereby acknowledge that I have this day had and received of and from LINDA L. ZIMMERMAN, Executrix of the ESTATE of HELEN M. STONER, Cumberland County Estate No. 2002-00705, Estate assets with a total value of Nineteen Thousand Four Hundred Thirteen and 75/100 ($19,413.75) Dollars, consisting of a furniture, furnishings, coin, IN KIND, with the value of Thr<:e Hundred Sixty-Seven 06/100 ($367.06) Dollars plus Nineteen Thousand Forty-Six 69/100 ($19,046.69) Dollars of US currency, in full satisfaction and payment of my one-third (1!3) residuary bequest in accord with the provisions of paragraph IV of Helen M. 5toner's, May 24, 1988, Last Will and Testament. AND THEREFORE, I JOHN B. STONER, the residuary .beneficiary of an U.S. LAW OFFICES CLYDE R. BOMCARDNER IO SOUTH MAIN STREET MIFFLINTOWN, PA 17059 (717)43(x2119 currency and furniture, furnishings, coin IN KIND bequest with a total value of Nineteen Thousand Four Hundred Thirteen and 75/100 ($19,413.75) Dollars from the Helen M. Stoner Estate, do by these presents remise, release, quit-claim and forever discharge the said Linda L. Zimmerman, Executrix, or her estate personal representaitive(s), of and from the said residuary bequest under the provisions of paragraph IV of the Last Will and Testament of Helen M. Stoners, May 24, 1988, and of and from all actions, suits, payments, accounts, .~, , , ~ reckonings, claims and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatever, from the beginning of the world to the day of the date of these presents. AND I hereby consent and agree that the Orphan's Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania, may discharge the said Linda L. Zimmerman, Executrix of the Helen M. Stoner Estate, upon application, without further notice to me. ~ ~~ IN WITNESS WHEREOF, I have hereunto set my hand and seal the ~ ~h' day of -3~y-, 2003. WITNESS: ~ (SEAL) J 8'. Stoner ~• COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF ,J v ~) ~ ~~. . On this, the `~ ~ day of July, 2003, before me, the undersigned Notary Public, personally appeared JOHN B. STONER, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Estate Release, and acknowledged that she executed same for the purposes therein contained. LAK' OFFICES CLYDE R. BOMGARDISER I O SOUTH MAIN STREET MIFFI.INTOWN, P.4 {70$9 (7171436-2119 IN WITNESS WHEREOF, I hereunto set my hand and official seal. L) Notarial Seal Notary lic Clyde R. Bomgardner, Notary PL~h!ir. ~ ~ p ~~ ~3r ~4 Y Mifflintown Boro, Juniata Cocr'y ~ My Commission expires: / My Commission E~ires Aug. 23, 2C0~: Member, PemsyhrsMa Association of Notaries ~ a n I I ~ _~. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA- ORPHANS' COURT DIVISION In Re: Estate of Helen M. Stoner, deceased late of Lower Allen Township Cumberland County File No. 2002-00705 Pennsylvania File No. 21-02-0705 ESTATE RELEASE KNOW ALL MEN BY THESE PRESENTS, that I, EVELYN A. ZIMMERMAN R.R.2, Box 504, Port Royal, Pennsylvania 17082, hereby acknowledge that I have this day had and received of and from LINDA L. ZIMMERMAN, Executrix of the ESTATE of HELEN M. STONER, Cumberland County Estate No. 2002-(10705, Estate assets with a total value of Nineteen Thousand Four Hundred Thirteen and 75/100 ($19,413.75) Dollars, consisting of a furniture, furnishings, coin, IN KIND, with thE; value of Three Hundred Sixty- Seven 06/100 ($367.06) Dollars plus Nineteen Thousand Forty-Six 69/100 ($19,046.69) Dollars of US currency, in full satisfaction and payment o:f my one-third (1/3) residuary bequest in accord with the provisions of paragraph IV of Helen M. Stoners, May 24, 1988, Last Will and Testament. AND THEREFORE, I EVELYN A. ZIMMERMAN, the residuary beneficiary of an LAW OFFICES CLYDE R. BOMC.ARDNER IOSOUTN MAIN STREET MIFFLINTOWN, PA 17059 (717)436-2119 U.S. currency and furniture, furnishings, coin IN KIND bequest with a total value of Nineteen Thousand Four Hundred Thirteen and 751100 ($19,413.75) Dollars from the Helen M. Stoner Estate, do by these presents remise, release, quit-claim and forever discharge the said Linda L. Zimmerman, Executrix, or her estate personal representative(s), of and from the said residuary bequest under the provisions of paragraph IV of the Last Will and Testament of t • Helen M. Stoners, May 24, 1988, and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatever, from the beginning of the world to the day of the date of these presents. AND I hereby consent and agree that the Orphan's Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania, may discharge the said Linda L. Zimmerman, Executrix of the Helen M. Stoner Estate, upon application, without further notice to me. IN WITNESS WHEREOF, I have hereunto set my hand and seal the ~ ~' day of ~U 2003. WITNESS: 1 ( U L/! !~ ~. ~] i111,(i~lh1 (SEAL) Evelyn . Zi rman COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF JUNIATA ~- ~uc~v s~ On this, the ~S- day of may-, 2003, before me, the undersigned Notary Public, LAN' OFFICES CLt'DE R. BOMGARDNER IO SOUTH MAIN STREET MIFFLINTON'N, P.A 170$9 (717)4J6-2119 personally appeared EVELYN A. ZIMMERMAN, known to Mme (or satisfactorily proven) to be the person whose name is subscribed to the within Estate Release, and acknowledged that she executed same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. .. ~Il (SEAL) Notarial Seal Notar ublic Clyde R. Bomgardner, Notary P~.~blic Mifflintown Boro. Juniata Couni;~ My Commission expires: August 23,2004 "~9y Commission Ergrires Aug. 23, 2C0= Member, Pennsylvania Association of Notares c IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA- ORPHANS' COURT DIVISION In Re: Estate of Helen M. Stoner, deceased late of Lower Allen Township Cumberland County File No. 2002-00705 Pennsylvania File No. 21-02-0705 ESTATE RELEASE KNOW ALL MEN BY THESE PRESENTS, that I, LINDA L. ZIMMERMAN, of R.R.1, Box 858, Mifflintown, P nnsylvania 17059, hereby acknowledge that I have this day had and received of and from LINDA L. ZIMMERMAN, Executrix of the ESTATE of HELEN M. STONER, Cumberland County Estate No. 2002-00705, Estate assets with a total value of Nineteen Thousand Four Hundred Thirteen and 76/100 ($19,413.76) Dollars, consisting of a furniture, furnishings, coin, IN KIND, with the value of Three Hundred Sixty- Seven 07/100 ($367.07) Dollars plus Nineteen Thousand Forty-Six 69/100 ($19,046.69) Dollars of US currency, in full satisfaction and payment oaf my one-third (1/3) residuary bequest in accord with the provisions of paragraph IV of Helen M. Stoners, May 24, 1988, Last Will and Testament. AND THEREFORE, I LINDA L. ZIMMERMAN, the residuary beneficiary of an LAN' OFFICES CLYDE R. BOMGARDNF.R O SOUTH MAIN STREET MIFFLINTOWN, PA 17059 (717)J36-2119 U.S. currency and furniture, furnishings, coin IN KIND bequest with a total value of Nineteen Thousand Four Hundred Thirteen and 76/ 100 ($19,413.76) Dollars from the Helen M. Stoner Estate, do by these presents remise, release, quit-claim and forever discharge the said Linda L. Zimmerman, Executrix, or her estate personal rf:presentative(s), of and from the said residuary bequest under the provisions of paragraph IV oil the Last Will and Testament of Helen M. Stoners, May 24, 1988, and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason thereof, or any other act, • matter, cause or thing whatever, from the beginning of the world to the day of the date of these presents. AND I hereby consent and agree that the Orphan's Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania, may discharge the said Linda L. Zimmerman, Executrix of the Helen M. Stoner Estate, upon application, without further notice to me. IN WITNESS WHEREOF, I have hereunto set my hand and seal the ~ ~ day of July, 2003. WITNESS: ~~~ ~ ~ 'V1'Yt~(~r1~.~ (SEAL) Linda L. ZimmerT.nan Social Security No~ . 17 ~ 3~ ~ ~{ l ~ COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF JUNIATA . On this, the ;3~ ~ day of July, 2003, before me, the undersigned Notary Public, LAN' OFFICES Cl.ti'DE R. BOMGARDNF.R IOSOUTH MAIN STREET MIFFLIN'TOWN. PA 17059 (717)J36-2119 personally appeared LINDA L. ZIMMERMAN, known to me; (or satisfactorily proven) to be the person whose name is subscribed to the within Estate Rele;ase, and acknowledged that she executed same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand andl official seal. i d'~"' (SEAL) ~~ Notarial Seal Notary blic ctyde R. Bomgardner, Notary Public M Commission ex Tres: Au ust 23,2004 MittWltown Boro, Juniata Coun'y Y P g My Commission E~ires Aug. 23, ZC~ Member, Pennsylvania Association of Nctaries STATUS REPORT UNDER RULE 6.12 Name of Decedent: Helen M Stoner - Date of Death: 0.7/~~/~nn~ Will No.: PA No. 21-02-0705 Admin. No.: 2002-00705 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes n No n 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 ~] 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 ~] No II Executed, witnessed and notarized Estate Release have been filed previou:~~.y c. Copies of receipts, releases, joinders and approval of formal or informal accounts maybe filed with the Clerk of t:he. Orphans' Court and maybe attached to this report. (~ Date: 06/18/04 +i~~ Signa Clyde R. Bomgardrier Name 10-12 South Main Street. P.O. Box 166, Miff~intown Address PA. , 17059 (717) 436-2119 Telephone No. Capacity: Il Personal Representativf: Counsel for personal representative ,~~