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HomeMy WebLinkAbout02-0638STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Estate File No, Dewey J.Crist 7/7/02 21-02-638 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: I.State whether adminisWafion of the estate is complete: Yes No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Dctober 31: 2004 3. If the answer to No. I is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. Did the personal representative state an account informally to the parties in interest? Yes _No Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphan's Court~°rt- Date: W. Scott Staruch Name (Please type or print) 20 Erford Rd., Ste 305 Lemoyne, PA 17043 Address (71] 975-0600 Tel. No. Capacity: Personal Representative Counsel for Personal Representative COMMON YLVANIA DEPARTMENT OF REVENUE DEPT, 280601 HARRISBURG~ PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT W DECEDENTS NAME (LAST, FIRST, AND MIDDLE iNmAL) use a UaDk bl~ t° ~Para~ ~rds :- ~ REGISTER OF WILLS ~ 1.OHgieaIRe~m ~ 2. SupplemenmlRetum ~ 3. RemainderRe~m(~de~=lZl~2} ~ 4. LimRed Es~te ~ 4a. Fu~m In,mst Comp~mi~ (d~r 12-12-82) ~ 5. Federal Es~te Tax Remm R~ui~ ~ 6. D~dent Died T~mte (~h ~y ~m,) ~ 7. D~dent Mainlined a Livi~ Trust (~h ~py ~m~ ~ 8. To~l Number of Safe De~ Box~ ~ 9. L~gafion P~s Re~ived ~ 10. S~u~l Pove~ C~ (d= ~de~ ~n 12-31-91 ~d 1-1-~) ~ 11. Eie~ion ~ ~ under Sec. 9113(A) (A~h ~h O) THIS SECHUN MUST BE CO~TED ALL COP~PONDE~ ~ CONF!D~ T~ ~ORMA~ SHOULD BE O RECTED TO 0 Ul 0 0 1. Real Estate IScheduie A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporaflon. Partnemhie or Sole-PmeedtomhiD (3) 4. Mortgages & Notes Receivable (Schedule Di (4) 5. Cash. Bank Deposits & Miscellaneous Pemonal Property (Schedule E) (5) 6. Jointly Owned Pm~e~ (Schedule F) 7. Inter-Vivos Tmnsfem & Miscellaneous Non-Probate Property (Schedule G or L) (7) 8. Total Gross Assets (k)tal Lines 1-7) 9. Funeral Expenses & Administrative Costs [Schedule H) (9) 10. Debts of Decedent Me,gage Liabilities. & Liens ISchedule I) (10) 11. Total Beductk)ns dotal Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11' (8} (11) 13. Charitable and Governmental Beauests/Sec 9113 Tm~ for which ar e~eo~on to tax has not been I13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 114) 15. Amount of liee 14 taxable See iestru~ons on mveme side for applica~)le percemage 16. Amount of line 14 taxable at §% rote , , x .06 '.16) at 15% rote ~ x 15 (17) (18) 18. Tax Due 4,9,42 .9 2o,6 q.9 -5,592 , >> ~IATH << Unda' peflalties of pedury. I declare that ~ have examined this retuff ncluding accompanying schedules aha statemeofs, and Io the best of my knowledge and beliof, it is true. correct and ccm~ ~l~afion ~ pm~er o~er ~an ~e ~ersona~ ~e~msentafive is based on a~l infownation of which ~reoar~r h&~ any knowledge. S.I~NATURE OF PERSON RESPONSIBLE ~OR FILING RETURN ADDRESS DATE SIGNATUF~E OF ~[EPARE[~ OTRER THAN REprESENTATIVE ADDR~88 DATE Decedent's Complete Address: I STATE ~,¢~ I zlPI"701'~ Tax Payments and Credits: 1. Tax Due (Page 1 Line 18) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C, Discount (1) Total Credits ( A + B + C ) (2) O 3, Interest/Penalty if applicable D, Interest E. Penalty Total Interest]Penalty ( D + E ) (3) 4. If line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT. Check box on Pege I Line t9 to request a rafund (4) 5. If line 1 + line 3 is greater than line 2, enter the differenca. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B, Enter the total of Line 5 * SA. This is the BALANCE DUE, (SS) Make Check Pa 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 No a. retain the use or income of the property transferred; ............................................................. [] [] b. retain the right to designate who shall use the property transferred,or its income; ................ [] [] c. retain a reversionary interest; or ............................................................................................. [] [] d. receive the promise for life of either payments, benefits or care? ......................................... [] [] 2. Ifdeath occurred on or befora December 12, 1982, did decedent within twoyears preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without ~[~ receiving adequate consideration? .............................................................................................. [] [] 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?.... [] ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN 72 P.S. {}9116 (al (1.1) (il provided for the reduction of the tax rate imposed on the net value of transfers to or for the use of the surviving spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January 1, 1995. 72 P.S. §9116 (al (1.1) (ii) provided for the reduction of the rate imposed on the net value of transfers to or for the use of the surviving spouse from 3% to 0% for dates of death on or after January 1, 1995. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. FOR DATES OF DEATH ON OR AFTER JANUARY 1, '1995 - Please answer the following question by placing an "x" in the appropriate space. Did the decedent create a trust or similar arrangement which is solely for the surviving spouse's benefit for his or her entire lifetime? Yes [] No [] If you answered yes to the above question, the tax on the trust or similar arrangement is postponed until the death of the second spouse, at which time it will be fully taxable at the rate(s) applicable to the remainder beneficiary(les). Enter the value of the trust on Schedule J, Part Il, in order to remove it from the calculation of the tax due in this estate. You may wish to file Schedule O in order to make the election available under Section 9113. If the election is made, the trust or similar arrangement is taxed in the estate of the first decedent spouse, the portion of the trust or similar arrangement which benefits the surviving spouse is taxed at the zero tax rate, and the remainder is taxed at the rate(s) applicable to the remainder beneficiary(les). If you choose to make the election, you must attach Schedule O to a timely-filed tax return, along with Schedule(s) K and/or M in order to show the apportionment of the trust or similar arrangement between the surviving spouse and the remainder beneficiary(les). REV-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTA'I~ OF [~wey J. Cdst, Jr. SCHEDULE A REAL ESTATE FILE NUMBER 21-02-0638 All real proper~ owned solely or as a t~ant In commoe must be reposed at fair merkst value. Fair rna~ket value is defined as the price at which proper~ would be exchanged betwea~ a willing buyer and a whling seller, neither being compelled to buy ~ sell, both having reasonable knowledge of the relevant facts. Real property which is Jofntly~ovmed with right of su~vlvomhlp must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 3,800.00 Vacant lot located in County of Highlands, State of Florida, Sec'lion 34, Tract 271, Tax ID C-34- 33 29 010 27t 0 00(~ cop,/e~ A~'eementof o..~e 8l:~ed bembo TOTAL (Nso enter o~ line 1, Recapitulation) 3,800.00 REV'-1511 EX+ (12-99) C~'11'1 OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Dewey J. Crist, Jr. SCHEDULE H FUNERAL EXPENSES & ADMINISIRATIVE COSTS FILE NUMBER 21-02-0638 Oebts of decedent muet be repo~ted o~ Schedule ]. ITEM NUMBER DESCRIPTION A. 1. 5. 6. 7. FUNERAL EXPENSES: Myers Funeral Home ADMINISTRATIVE COSTS: Pemonal Reprseentative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street N~clmss City . State Year(s) Commission Paid: Attorney Fees Family Exemption: (If deeedent's address is not ~e same as claimant's, attach explanation) Claimant Sffeet Addresa City State Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Pmparer's Fees Advertising - Cumberland Law Journal and The SenlJnel AMOUNT 382.48 1,423.84 76.00 75.00 TOTAL (Nco enter o~ line 9, Recapitulatio~ $ 1,957.32 REV-~512 EX+ (12~3) ESTATE OF Dewey J. Cdst, Jr. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE MABILmES, & UENS FILE NUMBER 21-O2-0638 Repo~ debts Incurred by the decedent prior to 6'eat h which remained unpaid as of the date of death, including uflreimbumed medloal expeflse~. ri'EM NUMBER 2. 3. 4. 5. 6. 7. 8. 9. 10. 12. DESCRIPTION Estate Recoveries, Inc. for KMart - File No. CHW-35249 sevedy Enterp~ses, Fort Smith AR - Account No. 50516-03959091536 Sears Roebuck & Co. c/o Balogh Becker, Minneapolis, MN -Acct No. 5484018032665 Cil~corp Credit Services, Inc., Kansas City, MD - Acct No. 4428135060100351 Welmart, Alianta, GA - Acct No. 6032207020290169 PP&L - electric Lelby's Mobile Home Park - Lot Rental East Pennsbero Ambulance Service Debra Wiest, Tax Collector Chades B~aa, Tax Collector Aegis Insaracae Co. Jones accounitng Service VALUE AT DATE OF DEATH 1,253.96 214.50 3,833.68 6,302.54 1,620.52 195.17 4,129.50 30.00 581.82 28.89 142.00 45.00 TOTAL (Nso enter on line 10, RecapJtula~on) $ 18,377.58 REV-~513 EX+ (9-D0] COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Dowey J. Crist, Jr. SCHEDULE J BENEFICIARIES FILE NUMBER 21-O2-O638 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do No~ List Trusfl~(s) OF ESTATE TAXABLE DISTRIBUTIONS [inch~e ou~gflt spousal distributions, and transfers under Sec. 9116 (a) (12)1 No~e ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAX~LE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV*1500 COVER SHEET 0.00 LAST WILL AND TESTA~ENT OF DEWEY J. CRIST, JR. I, DEWEY J. CRIST, JR. now of 3073 Carlisle Pike, Lot i!~, Silver Springs ?ownship, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all other Wills and Codicils previously made by me. ITEM I: I direct that payment of all my just debts, expenses of my last illness, funeral expenses~ and the costs of administering my estate from my estate as soon after my death as conveniently m~¥ be done. ITEM II: I give, devise and bequeath to BONNIE J. ANTHONY, my niece, the sum of $5,000.00° ITEM III: I give, devise and bequeath one-fourth of all of the rest, residue and remainder of my estate, of every nature and wherever situate, together with all insurance pelicies thereon, unto SHANE ANTHONY, TIMOTHY ANTHONY, and HEATHER ANTHONY~ being children of BONNIE ANTHONY, share and share alike. The remaining three-fourths of said rest and residue of my property, I give, devise and bequeath to BONNIE J. ANTHONY,. my niece of 7 Sunny Lane, Dillsburg, PA 17019~ ITEM IV: I direct that any and all taxes that may be assessed in consequence of my death, including all inheritance, estate and transfer taxes imposed upon my estate passing under my Will or otherwise, shall be paid out of the principal cf my adm_n~st_~t_~n of residuary estate as a part of the expense of the ~ ~ ~- ~ my estate. ITEM V: I authorize and empower my personal representative to compromise, adjust, release and discharge in such manner as my personal representative may deem properf all debts and claims owed by or to me or my Estate; to sell, lease or exchange at public or private sale or in such manner~ at such prices, and upcn such terms of credit or otherwise, as my personal representative may deem proper, all or any part of my property~ real or persona!~ to exec ute, acknowledge and deliver instruments of conveyance, including deeds in fee simple; to borrow money for the purpose of paying estate, inheritance or other taxes which are required ~o be paid and to secure any such loans by pledge or mortgage o~ all or any part of my property and to execute the necessary instruments ~o carry out such powers; to distribute my estate in kind or partly in money or partly in kind, and to determine the fair value at which any property so distributed in kind shall be received by the distributees; to conduct any business in which I have an interest at the time of my death, for such period as my personal 2 representative may deem proper, power to borrow money and pledge assets of the business and the power to do all other acts that T in my lifetime, could have done, to delegate such power to any partner, manager or employee without liability for any loss occurring therein and to organize a corporation to carry on said b~siness as capital to such corporation and accept stock in the corporation in lieu thereof and hold such stock for the uses of this my Will, and to vote said stock or sell the same as to my personal representative may seem best; to retain all stocks~ assets, bonds and investments owned by me without being confined to what is known as legal investments; to execute any options to purchase, to apply for stocks~ bonds or other investments, to purchase or otherwise acquire real estate and to execute the same powers thereover as hereinbefore provided, ~o retain indefinitely any part of my assets, real or personal~ which is or may become unproductive or to make sale thereof; to pay carrying charges and expenses of the property out of other principal or income of my estate; to invest and reinvest in all forms of property ~zithout restriction to investments authorized for Pennsylvania fiduciaries~ as my personal representative deems proper,, without regard to the principle of diversification or risk; to exercise any !aw-given option to treat administrative expenses either as income tax or as estate deductions, without regard to whether the expenses were p==~ from principal or income. The powers herein conferred shall be to my named personal representative and all successors thereto and 3 shall be in addition and not in limitation of other powers conferred on said fiduciary. Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for principal or income payable to any beneficiary shall be made upon the sole receipt of the respective baneficia.ry ~o whom the payment is made and free from anticipa~icn, alienation, assignment, attachment, and pledge and free from control by the creditors of any such beneficiary. ITEM VI: All shares of principal and income hereby given shall be free from anticipation, assignment, pledge or obligation of the beneficiaries and any of them and shall not be subject to any execution or attachment, levy or sequestration or other claims of the creditors of said beneficiaries or any of them. ITEM VII: I nominate~ constitute and appoint my niece, BONNIE ANTHONY~ as the sole Executrix of this my Last Will and Testament, to serve without bond. In the event of the renunciation, death, resignation, refusal or inability to act for any reason whatsoever of the said BONNIE ANTHONY, I nominate, constitute and appoint HEATHER ANTHONY, as the Executrix of this my Last Will and Testament, to serve without bond. IN WITNESS WHEREOF, JR.~ have, to this my Last Will and Testament, ~ day o~ , I, DEWEY J. CRIST, set my hand this Signed, sealed, published and declared by DEWEY J. (SEAL) CRIST, JR., the above named Testator on the ~0 day of ~Yk- 29~, as for his Last Will and Testament~ in the presence of us~ who, in his presence~ and in the presence of each other, have~ at his request; subscribed our names as witnesses hereto. Name Name ~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF residing at -Tn'At~ ~ ~ : SS WE, the undersigned, 5he Testator and the witnesses; respectively, whose names are signed to the foregoing instrument, being first du:~ sworn and qualified according to law, do hereby declare to the undersigned authority that we were present and saw the Testator sign and execute the instrumen~ as his Will, and that he had signed willingly and that he executed it as his frae and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed ~na Will as witnesses and that to the best of their knowledge~ ~he Testator was au that time eighteen years of age or older, of sound mind and under no constrain or undue influence, and I, the said Testator, do ~ereby acknowledge that ! signed and executed the instrument as my Last Will and Tes~ament~ that t signed it willingly, and that ~ signed i~ as mi/ free and voluntary ac~ for the purposes thc}rein expressed. v -~?e~r --SE~E~'3[ CRIST~ JR. Witness~/t~ Wit~ess Sworn to and s~.~bscribed before me this ~ d.~y of Notary Public My Comanission } ×pires: iMyNOTARIAL SEAL MARIA L. STROH, Notary Public Lower Allen Tw~., Cumber and I~o., PA Corem ssioo Expires Oct. ?, 2002 5 PROJECT: [~ WALES RIDGE/CARTER CREEK Subdivision: $~bling Hiehlands TAX I.D. C-34-33-29-010-2710-0000 AGREEMENT FOR SALE AND PDRCHASE LOTS I THIS AGREEMENT is made this -- day of ,2~__, between Bonnie Anthony as Exacu~x of thc Estate of I~wcy J. Crist, Jr., whose addr~s is 7 Sunny Lane, Dillshorg, PA 17019, as "seller" and The Nature Conservancy, as Trustee of The Nature Conservancy Charitable Trust, a Florida Land Trust datcd May I I, 1998, whose address is 222 South Westmonte Drive, Suite 300, AItsmonte Springs, Florida 32714-4169, as "Buyer"· I. AGREEMENT TO PURCHASE AND LEGAL DESCRIPTION. Seller agrees to sell to Buyer and Buyer agrees to buy from Seller the real properly hereinafter referred to as the "Prope~, located in Highlands County, Florida, whicb is legally described as follows: SECTION 34, TRACT 271 Thc North 1/2 of the SE I/4 of the SE I/4 of the SW I/4 of the NE I/4 of Section 34, Township 33 South, Range 29 East, Highlands County, Florida; Less the West 30 feet for road, utility and drainage puq~oses. 2. PURCHASE PRICE AND METHOD OF PAYMENT. The purchase price for the Property is Three Thousand Eieht Hundred AND NO/100 Dollars ($3,800.00) C'htitial Purchase Price"). If this Agreement is assigned to the Board of Trustees of the Internal Improvement Trust Fund of the State of Florida (the "Trustees"), whose address is Florida Department of Environmental Protection, Division of State Lands C'DSL"), 3900 Commonwealth Boulevard, Mail Stalion 115, Tallahassee, Florida 32399-3000, the Seller hereby authorizes Buyer, in Buyer's sole discredon, (a) to issue a state warcaut for the purchase price directly to the escrow agent of Buyer's selection, and CO) to require the escrow agent to pay Seller's expenses of sale and real estate taxes, and to issue a check in the net amount of the sales proceeds to the Seller. If the "Initial Purchase Price" exceeds the maximum value of the Property as determined in accordance with Section 259.041(7), Florida Statutes, ("DSL Approved Value''), then the purchase price shall be reduced to the DSL Approved Value· If the DSL Approved Value is less than the Initial Purchase Price originally stated above, Seller shall, in Seller's sole discretion, have the right to terminate this Agreemenl, thereby releasing Buyer and Seller from all further obligations under this Agreement. If Sellar does not so te~ninate this Agreement then the DSL Approved Value shall become thc Final Adjusted Purchase Price. 3. INTEREST CONVEYED. At closing, Seller shall execute and deliver to Bu.ver a statutory wananty deed in accordance with the pmvisioe$ of Section 689.02, Florida Statutes, conveying marketable title to the Property together with all timber rights, tranaferabla development rights, water rights and mineral rights, including phosphate, minerals, metals, fissionable materials, petroleum, and gas rights, and all right, title and interest of Seller in and to any streams, canals, water bodies, drainage ditches, alleN, roads, streets, easements of access and utility rights of way, abutting or adjoining the Property, aud all hareditamcnts pertaining to the Property, in fee simple frc~ and clear of all liens, reservations, restoctions, easements, leases, tenancies and other encumbrances, except for those that are acceptable encumbrances in Ihe sole discretion of Buyer and do not impair the marketability of the title to the Property. 4. SURVEY. Buyer may have the Property surveyed al its expanse. If the survey ("Survey''), shows any encroachment on the Property or that impmvementa intended to be located on the Property encroacb on the land of otbers, the same shall be treated as a title defect. 5.A. ENVIRONMENTAL SITE ASSESSMENT. Buyer, prior to the date of closing and at itu sole cost and expense, may conduct an environmental site assessment of the Properly to determine the existence and extent, if any, of any Hazardous Materials on the Property. For purposes of this Agreement "Hazardous Materials" shall mean any hazardous or toxic substance, material or waste of any kind or any other substance which is regulated by any Environraenta] Law (as hereinafter defined in paragraph ~.B.). 5.B. HAZARDOUS MATERIALS. If the environmental site asseasmenl provided for in paragraph 5.A. confirms the presence of Hazardous Materials on the Property, Buyer, at its sole option, may elect to tennioete this Agrosment and neither party shall have any further obligations under this Agreement. Should Buyer elect not to ermine e his Agreemen Seller shall, at Seller s so e cost and expense and pr or o the date of closing of h~s Agreemen, prompt y comn~nce and d I gan ly pursue any assessment, clean up and monitoring of the Property necessary to bring the Property inlo full compliance with Environmental Law. "Environmental Law" shall mean all federal, state and local laws, including statutes, regulations, ordinances, codes, roles, judgments, orders, decrees, permits, concessions, grants, fTanchises, licenses, agreements and other governmental restrictions relating to the protection of the environmental or human health, welfare or safety, or to the emission, discharge, seepage, release or threatened release of any contaminant, chemical, waste, irritant, petroleum product, waste product, radioactive material, flammable or con-osive substance, explosive, polychlorinated bipbenyl, asbestos, hazardous or toxic substance, material or waste of any kind into the environment, including, without limitation, ambient air, surface water, ground water, or land. However, should the estimated cost to Seller of clean up of Hazardous Materials exosod a sum equal to 10% of the purchase price as stated in paragraph 2., Seller may elect to terminate this Agreement and neither party shall have any further obligations under this Agreement. If Hazardous Materials placed on the Property, ,Suring Seller's owoen:bip of the Property are discov~n'ed af~er closing, Seller shall reroain obligated hereunder, with such obligation to survive the closing and delivery and recording of the deed described in paragraph 3. of this Agreement and Buyer'~ possession of the Property, to diligently pursue and accomplish the clean up of Hazardous Materials in a manner consistent with all applicable Environmental Laws and at Seller's sole cost and expense. Further, if neither party elects to temltoate this Agreement as provided above, Seller shall indanmify and save harmless and defend Buyer, its officers, servants, agents and employees from and against any and all claims, suits, actions, damages, liabilities, expenditures or causes of action of whatsoev~ kind arising from Hazardous Materials placed on the Property during Sellers ownership of the Pmpea~'y. Seller shall defend, at Seller's sole cost and expense, any legal action, claim or proceeding instituted by any pe~on against Buyer as a result of any claim, suit, or cause of action for injuries to body, life, limb or property for which Hazardous Materials placed on the Property during Seller's ownership of the Prope~y ate alleged to be a contributing legal cause. Seller shall save Buyer harmless from and against alt judgments, orders, decrees, attorney's fees, costa, expenses and liabilities in and about any such claim, suit, investigation or defense thereof, which may he entered, incurred or assessed as a result of The limitation herein on Seller's contractual obligation to indemnify Buyer as specified in this paragsaph 5.B. shall not be constcued to limit Seller's legal liability under any Environrn~'ntal Law for Hazardous Materials located on the Property or to limit Buyer's legal and equitable remedies against Seller under any Environmental Law for Hazardous Materials located on the Property. 6, TITLE EVIDENCE: DEFECTS IN TITI.F Buyer may provide evidence of marketable title pursuant to Section 259.041(6), Fire/da Statutes. Seller shall, within 90 days aflec notice dom Buyex, remove all defects in title. Seller agrees to use diligent effort to conent Ihe defcc[(s) in title within the time provided tha~for (exoept thai Seller shall not be.required to bring any lawsuits to e minute defects in title). Defects arising fiom liens against the Property shall be satisfied at closing from Seller's proceeds. If Seller ~s uosucc~sful tn mmowng tha title defects ',,nthm sa~d t~ma, Buyer shall have the ophon to e~lber (a) accept tho t~tla as ~t then is with a reduction in the Purchase Price by an amount mutually agreed upon by the parties, Co) accept the title as it then is with no reduction in the Purchase Price, or (c) terminate this Agre~mant, thereupon releasing Buys' and Seller from all further obligntioos under this Agrosrn~t. 7. ~- At closing seller shag satisfyall real ostate taxes and assessme~nta that areorwhich maybecome a lien against the l~ropecty. If Buyer acquires fee title to the Property between January I and November I, Seller shall place Ibc taxes in esomw with the County Tax Collector in accordance with Section 196.295, Flmida Statutes. If the closing of the sale occurs on or after November I, Seller shall pay to the County Tax Collector an amount equal to the taxes that are determined to be legally due and payable by the County Tax Collector. 8. ~. The clostug shall'be on or before 150 days from the date this Agseement is properly executed by both parties, unless extended by mhet provisions of this Agmemem. If a defect exists in the title tu the Property, title commitment (if any), Survey (if any), or any other documents required to he provided or completed and executad, the closing shall occur either on the original closing date or within 90 days after receipt of documentation curing the defects, whichever is later. In addition to any other extension contained herein, Buyer may, in its sole discretion, elect to automaticsfiy exteod the closing up to an additional (90) days beyond the m'iginal closing date set forth in this paragrapb. This automatic extensiou may be used in addition to any other extension contained herein. Seller hereby waives notice of Ibis automatic extension. The date, time and place of closing shall be set by Buyer. 9. PREPARATION OF CLOSING DOCUMENT~ Buyer shall prepare the statutory warranty deed, Bu~n~"s and Sellers closthg statements and the title, poesession and lien affidavit certified to Buy~ and title insurer on DSL forms provided by DSL, and an environmental affidavit on DSL foam provided by DSL. Seller shall, not less than .t0 days prior to closing, submit to Buyer all executed ctesing documents, and any corrective instrun~nt~ tbat may be required to perfect the title to the Property. I O. EXPENSES. The Seller will pay the doeumenmy revenue stamp tax and all other taxes or costa associaled with the conveyance, ir~luding the cost of recording the stalutory warranty deed and any other racordable instruments that DSL decree necessary to assure good and marketsble title to the Property. 1 I. RISK OF LOSS AND CONDITION OF PROPERTy. Seller assumes all risk of loss or damage to the Property prior to the date of closing and w~m'ante that the Property shall be transferred and conveyed to Buyer in the same or essentially the same condition as of Ibc date of Seller's execution of this Agreement, ordinary wear and tear excopled. If the condition of the Property is altered by an act of God or other natural force beyond the control of Seller, however, Buyer may elect, at its sole option, to terminate this Agreement and neither party shall have any fmther obligntioos under this Agreement. Seller mpmsonts and Wa~Tants that there are no parties other than Seller in occupancy or possession of any part of the Property. Seller warrants that there are no facts known lo Seller materially affecting the value of the Real Property which are not readily observable by Buyer or which have not been disclosed to Buyer. BLA-300, Revised 6/27/02 All ~lls I. onated on the Property shall be duly abandoned at the Seller's sole cost and expense prior to the exercise of the option unless this requirement is waived by Seller agr~cs to clean up and ~.move all abandoned permonal property, refuse, garbage, junk, rubbish, trash and debris (hereafter, "~'ash and debris") from the Property to the satisfaction of DSL prior to the exercise of the option by Buyer. If the Seller does not remove all trash and debris from the Property prior to closing, Buyer at its sole option, may elect to: (al deduct the expense necessary to r~move trash and debris from the Seller's proceeds of sale up to but not to exceed 5% of the purchase price as stated in paragraph 2. and proceed to close, with the Buyer incun'ing any additional {:xpenses necessary to remove all trash and debris and clean up the Property subsequent to closing, (b) extend the amount of time the geller has to remove all trash and debris from the Property, (c) terminate this Ag~ement, and neither party shall have any further obligations under the Agreement. 12. RIGHT TO ENTER PROPERTY AND POSSESSION. Seller agt~s that from the date this Agreement is executed by Seller, Buyer and its agents, upon reasonable notice, shall have the right to enter the Property for all lawful purposes in connection with this agreement. Seller shall deliver possession of the Property to Buyer at closing. 13. TIMId. Time is of essence with regnrd to all dales or times ~et forth in this Agreement. 14. SEVERABILITY. If any of the provisions of this Agreement am deemed to be unenforceable and the unenforceability of said provisions dees not adversely affect the purpose and intent of this Agreement, in Buyer's sole discretion, thc enforceability of the remaining provisions of this A~eement shall not be affected. 15. ASSIGNMENT AND CLOSING CONTINGENCY. This Agreement may be assigned by Buyer, in which event Buyer will providc written notice ofaesignment to Seller. This Agreement may not be assigned by Scllcr. Assignment of this Agreement is subject to approval by thc Trustees, if this Agreement is assigned to the Trustees. If this Agreement is assigned to thc Trustees, the Trustees' agent in all matters shah be DSL. Notwithstanding anything contained herein to thc contrary, in the event this Agreement is not assigned by the Buyer to the Trustees on or before 120 days from the date this Agreement is executed b.¥ Buyer ( 'Contingency Date ), this Agreemcn; may be terminated by Buyer by sending writtun noticc to Seller oFBuycr s election to terminate within 30 days after the Contingency Date, and neither party shall ba',t' any further obligations under lhis AgreemcnL 16. SUCCESSORS IN INTEREST. This Agreement shall bind and insure to the benefit of Seller and Buyer and their respective heirs, legal representatives and successors. Whenever used, the singular shall include the plural and onc gender shall include all genders. 17. ENTIRE AGREEMI~]qT. This Agreement contains the entire agreement between the pertics pertaining to the subject matter contained in it and supersedes all prior and contemporaneous agreements, representations and understandings oftbe parfies. No supplement, modification or amendment to this Agreement shall be binding unless executed in writing by the parties. Notwithstanding the foregoing, the per~ies acknowledge that the legal description contained in this Agreement was prepared based upon historic chain o£ title information, without the benefit ora current survey of tile Property. The parties agree that if, in tile opinion of DSL, it becomes necessary to amend the legal description of the Prop~'ty to correct errors, to more properly describe the Property, to cut out portions of the Property affected by title defects unacceptable to Buyer or which cannot be timely removed by the Seller, or to otherwise revise the legal description of the Property, the legal description to be used in the Survey (if any) and in the closing instruments required by this Ago'cement shall be revised by or at the direction of DSL, and shag be subject to the final approval of DSL. Anything to the conlrary bereinabove notwithstanding, such a revision o£the legal description of the Properly shah not require a written amendment to this Agreement. In such event, tbe Seller's execution and delivery of the closing instruments containing the revised legal description and the Buyer's acceptance of said instruments and of the final Survey (if any) containing the revised legal description shall constitute a full and complete ratification and acceptance oftbe revised legal description of the Property by the parties. Seller acknowledges that thc Trustees have made various delegations of power for the purpose of land acquisition, and not all repreeentatives of the Trust~es or the DSL have authority to act in all situations. Consequently, this Agreement may be terminated by the Trustees pursuant to any provision therefor contained in this Agreement only in writing signed by the person or persons who signed this Agreement on behalf of the Trustees or that person's successor. 18. SURVIVAL. The covenants, warranties, t~prs~ntations, indemnities and undertakings of Seller set forth in this Agreement shall survive thc closing, the delivery and recording of the deed described in paragraph 3. of this Ag~ement and Buyer's possession of thc Property. fF THIS INSTRUMENT IS NOT EXECUTED BY SELLER ON OR BEFORE 12/7/02. BUYER SHALL BE UNDER NO OBLIGATION TO ACCEPT THIS INSTRUMENT. BUYER'S E~ECL,q'ION OF THIS INSTRUMENT IS SUBJECT TO APPROVAL BY THE BOARD OF TRUSTEES OF THE INTERNAL IMPROVEMENT TftUST FLIND OF THE STATE OF FLORIDA. BUYER'S DUTY TO PERFORM HEREUNDER IS CONTINGENT ON: (I) CONFII~MATION T:-LAT THE PURCHASE PRICE IS NOT IN EXC F~S OF THE DSL APPROVED VALUE OF THE PROPERTY, AND (2) D~L APPROVAL OF ALL DOCUMENTS TO BE FURNISHED HEREUNDER. THE STATE OF FLORIDA'S PERFORMANCE AND OBLIGATION TO PAY UNDER THIS AGREEMENT IS CONTINGENT UPON AN ANNUAL APPROPRIATION BY THE LEGISLATURE. THIS IS INTENDED TO BE A LEGALLY BINDING AGREEMENT. IF NOT FULLY UNDERSTOOD, SEEK THE ADVICE OF AN ATTORNEY PRIOR TO SIGNING. DISCLOSURE STATEMENT AND SIGNATUR Pg NOTE: If no response is entered for Seetlon I or 2, the respense to the statements will be deemed to be"None" or"Non-Applicable- DISCLOSURE STATEMENT. Tbe following Disclosure Statement is given in compliance with the provisions of Sections 375.031(1) and 380.08(2), Florida Statutes. TI~ Setler states as I) To the besl of ~ Seller's knowledge, all persons who have ~eceived or who are to receive real estate commissions, attorney's o~ consultant's fees or any ~ incident to the sale oftba Property and the reasons for the payments are: N~{I~ Address ReesonforPawnent None 2) To thc best of thc Seller's knowledge, the following is a tree history of all financial [Tansactions concerning thc Prop~ty which have taken place during thc five years prior to the date o£lhis Disclosure Statement: Name and Add~ess Type of Amount of of Parties Involved Date Transaction Transaction] None known to Executr:Lx BLA-300, Revised 6/27/02 Exhibit "A" SECTION 34, TRACT 271 The North l/2 of the SE1/4 of the SE l/4 of th¢ SW l/4 of the NE 1/4 of Section 34, Township 33 South, Range 29 East, Highlands County, Florida; Less the West 30 feet for road, utility and drainage purposes. as Ex~cuUix of the ~tam ot'D~ $. Cris/, .Ir. Date si~d by Sellcr Phone No. 8 a.m. - $ p.m. Social Sccurlty or F.E.I.N. Wito~ as to Bu)~r Wimass ~s to Burr BUYER THE NATURE CONSERVANCY, ns Trustee of The Nature Conse~ancy Charitable Trust By:_ Name: Maria F. Melchiori As Its: Director of Operations Date Sisned By Buyer BLA-300, Revised 6/27/02 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF I~4iIIrWCE 0:= INHERITANCE TAX-;D,WilSJ.O;N::,'-:: t' - i, c;, PO BOX 280601 I,-',I~", "_ ~ - , HARRISBURG PA 17128:0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE DF DEDUCTIONS AND ASSESSHENT OF TAX P" '1. 14 20D5 Jt\i'l III 11 J' CL' <:-\ \.( (\~ - \ ""\1"\ _." ORFr1f:}!'S,. ,.__~?Tn.. W ~{!'rf STARUCHESQ LAWS ETAL 20 ERFORD RD STE 305 LEMOYNE PA 17043 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-17-2005 CRIST JR 07-07-2002 21 02-0638 CUMBERLAND 101 AtnOUnt Rtmitted *' REV-1541EXAFPU2-04) DEWEY J 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 ~ RE-"; :r!1,"f-Ex--,,~p-.rlir:m--NiiT-Iel--d'F-1:'NHER-I-fAN-CE-i"1iX"7I-pp1l7l-IUWNT;.."CLiiwANcE'.o'R-..._-_._.._- - ..- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CRIST JR DEWEY J FILE NO. 21 02-0638 ACN 101 DATE 01-17-2005 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 8) 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable {Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule FJ 7. Transfers (Schedule G) 8. Total Assets III 121 131 141 151 161 171 3.800.00 .00 .00 .00 11, 142.59 .00 .00 IBI APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule HJ 10. Debts/Mortgage Liabilities/Liens (Schedule IJ 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule ~) 14. Net Value of Estate Subject to Tax 191 1101 1,957.32 18.377.58 1111 1121 1131 1141 NOTE: To insure proper c~dit to your Rccount} submit the upper portion of this form with your tax pay...nt. 14,942.90 20.334 90 5,392.31- .00 5,392.31- 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. NOTE: If an assessment was issued previously, lines reflect figures that include the total of ALL ASSESSMENT OF TAX: IS. Amount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16] 17. Allount of Line 14 at Sibling rat. (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due .00 X 00 = .00 X 045 = .00 X 12 = .00 X 15 = \191= .00 .00 .00 .00 .00 TAX CRI"DTTS: " ,., AHDUNT PAID DATE NUI1BER INTEREST/PEN PAID I-I TOTAL TAX CREDIT .00 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" ICRI, YOU HAY BE DUE .J A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.I~~~ PETITION FOR PROBATE and GRANT OF LETTERS II. C~~S1'" ~A No. ,:J.1-63o-f,d To: Register of Wills for the - Dfcea~Q., County of CI.\.1\o\.8A:"fl.Ul>t"i in the Social Security No. ~ P l - l 'p .' Iv Y y, > Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitionerl)4, who is/_ 18 years of age or older an the executll.l::f:. in the last will of the above decedent, dated Af'fl.\L laRd Elu:lidl(D) diated Estate of --D~\,I)8~ also known as 3 named ,~n~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was d?miciled at death in , ,C ~m: ~_~J~ Coun~ Pennsylvania, Wi~ h t~ last famIlY,( prIncipal reslde:se at ~':.~ p A R,t..\Sl F "'l! I fl.L1S IlL I 170\3 I lYre I A (list street, number and muncipality) Decendent, then 77 years of age, died ~......~ 7 , '.tll M':},~ , at (3';IJI!P.L~ l:UiA1:t\t CI\Rc I GF~s fa ILl:; __ . Except as follows, decedent did not marry, was not dl orced and dId not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (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: $ 'V"-"', llO $ $ $ 1l.OO WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters -r~S."'A 1"\e1\l,.....-A.'1 (testamentary; administration c.La.; administration d.b.n.c.La.) theron. " 'tr u e " :g3 " " "'~ ~.g ro'~ 3~ u~ =0 ;;; e " Vi ~ ~~ ~J ~ u~ 1i~~a~~~~f: 17^1'\ ~t~ -~~';' I - ~,~ kcYM~~1 a~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1 s~ COUNTY OF C U.t'\,IM~ft~"1\J (;) J :s The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. ~, Sworn to or before me this affirmed and subscribed 15th day of '" ,0' " " - " ~ ~ Register t,J. fI. 17-75-7 No. 21-2002-638 Estate of 01SI.lJe~ d. CrtL<;T ..lit. , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW .1....\..':1 15th ~M'l.. , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument('i/ dated 1\",. \1_ .~ I -:1..,,':1.... described therein be admitted to probate and filed of record as the last will of 'Di:' w ~ '1 1-.- C.A.\~T ,I A- and Letters TI!! ,sTj\ 1'\.& tJ1il "-) V- are hereby granted to 6Il1U/lJ.f!. ~ AA'1I'...r~ Probate, Letters, Etc. ......... Short Certificates(3 ) . . . . . . . . . . Renunciation ................ x-PaGES (4) JCP $ 50.00 $ 9.00 $ 12.00 $ 5.0l) TOTAL _ $ 7h.OO Filed J.u1y. .15th.. .2002................ ~'A.6/ ~ A~NEY (Sup. Ct. l.D. No.) JDt) Vdtl.\<- ~o~o/.lUe.JCN6rA~~~ / ADDRESS t ' '](}-77If-,~Jh3 PHONE FEES MAILED LEI'I'ERS 'I\) ATIORNEY ON 7/15/02 H IIh,~Il'i RFV <Jill(, This is to certify that the information here given is correctly copied frOln an original certificate of death duly filed with me as Local Rc;gistTar. The original cenitl.cate will be t()!warded to the Sure Viral Records Office for permanent fIling. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fec for this cenificate, $2.00 No. ----:.iIi-;;ii7;;;;'-:-~;-- \,'IIII~~~lli.QF fil'i~~~..__ l~~' ~<J',., s .~ ~- i~ ~[i;~\ i~i ""--" \I~% i w:, }/j' ,Ii:~ ... \. , . .-' ~ '*~~---~"*' \~\~-'" "', /~l "=:. "%"" ../~l 'oo..!liiEfiT ti\ 't.";",/ "''''....''''N#/''IIIIIII'' till_, ~~ Local P 8482687 9~1 I,:} ,;/00::)... / Date t1l\)5i43A..2i87 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH TYPE/PRINT " HAII,lN!'NT 9l,lCI<INI< 77 v,. Dewey J. Crist, Jr. UNO!:R1D.01W -i...Itl';:'''':- '" Male ~'ATE",'ENU"BEA SOC''''-L SECURlTY NUM9EA J, 201 18 6483 [)A,II' OF DI'AH. ,Me......, Oa,. '_i 4. July 7, 2002 N_EOFD!'CEDENTlf"stM_,l"'l , "GE(la..a"'M~yj UNOt'R1YEAfl - ~~ .- . ~- ~~-- PlACEOFOE:NHIC_''''''''0<<4_ _,...."U(:I."...""."".,,_~ SIlo..", F"'~9"1Coo,..>) HOsPfT.o.L Camp Hill,. 1npaO_ ~ t~I"" 0 ::.,.10 COU..TYOFOE:AJH Adams Rl<CE.......ncon_~.llIao:k,Wl\oI._ """',, White OI;:CEOEtfI'SUSU"'-lOCCUf'jIJ"lOOt IGo..""'dd<o<ltk_du<;:.t."- ol<o<lt~~ecuray "r3'ua-rlJ II. II~ OECEOE:NrSM"'lINGADOAESS{Sor_,C~,_,lIl>C"""1 DECEOEtoll'S 7073 Carlisle Pike lot 116 ~~~~~lNCE Carlisle, Pennsylvania 17013 ::-~:.:.';""" " FNUER.S....MI'IF."M<><M,L....) Dewey J, Crist Sr. " INfOfWM,lT.SNAr.u;:(l\'llel"'....1 IW.SDE:CtDENT~~EAIN USARt.lfDfOflCES1 _19 ....[] " 17b,eo.. -~ - ....... Cumberland -..wp? 11".0 :;""""::".'::01 ...OTt<ER.S.........EIF...M~.Ma.-s...n...,.) Minnie Ditlow " '~oo~''7~~Y!':n':i1\ijrsTlUi91'1''1''1o 19 - I'LACEOf'OI$POSlTlOOt.Nwne"'C.....tety, c.-.....lOoy lOCNION-C;r.""-,, $1_, 2ipCOOOl ._- Rolling Green Memorial Park Camp Hill, Pennsylvania 17011 ,,- IJC.~""',__in r.v.RIT"'-LSTRU$._ ,"_M.,,-.l._, ~~7hed SUAvIIlIHGSf'OOSE (11_,_.........-, " 11..5..l'4 I 'o'er _ P~lng wp. - ,.- o ^ o . _. UOHOOOf'OISPOSlTION _lXIc,_.,.,O -, Bonnie Anthony , R.mow.._Sl...O 21.. 21d. NAUEAHO-'<OllRESSOf'FAClLITY Myers Funeral Home, Inc. 37 East Main Street MeChanicsbufg. lICENSENUMIlER D"'-TESlGNED jNj-i'( I'll -~'''r'/0 ~ ~, l ~ wo.sCASEAEFEAAEDTOMEOlCAl.ElCAMINEf\IC~R1 _D Pa 17055 n._ '\ ~ . J H u<n..c"'a;.<o<'.sp".,e'Y.".."snodo."'hoI....t."",..~""... :=:.= ~AJ~ .~~_.enn~--L:. z+ l)IJElOtOOf<S"CONSEOOENCEOF) ..w. \ P,lRTq,o.r....igMI<4IlI__~to_\Io,t>uI ....-.ng"''''''~__.,'''''''''1 2 .... OUE'lO(OO..~"'-CONSE:OUENCEOf) 1i ~ . wEREAUlOPSYFINOlNGS -'u.8l.EPRIOfIlO COWI'lETIONOfCAUSf: OFOEAfHl ........NER()f.Ol"'-TH , : --- '-~~---r---------' -.l. f,1M'OF INJU#l'l' -~~ ~$ DUElO(OOf<S"'-CoNsEOuit.K:f~--- D.<.TEOf INJURV 1M""",, noy. """'~ IN,JURVAT WOfII(l OESCRleE HOW INJUAVOCCUAflEO _.. Horn",... LJ U U ~E.ciiIH:iuRv.A1"':,-;;.-~-:-j~~,;...!.CIOo)o.Otflc. M tMloUnQ.AlcI$polc,I.1 - _ 0 ....0 - ~- LOC1JlONjSIr_,C~SIoI.) -- OTtHEOl'CERTlI'l _D ~~ ~_. [J rJ P."'""lI'~_l"JlIl"'" - COUj,j_bot<lllI.,,,,,,,,,,, 2&01. 2M Cl'RlWIElliCNoc.""",""-l .eERTIFYINGPKY.,CIAN'Pny""..~c..~'ng~..ul<leoln"'''''".J'"'''''..''''.SO';,i.''"''.~''"",,,"".., "".,nd"""""","",,, "..",J\ T<>_....to....w_......~.....'n<><cu~_.......<.y...(...""m.M.'......... H_ O"'EsiGHE-D;u.;;;...~......, n ,".:~ 9,---il__...._ !~._7__9_=-OL...___. NAMI' .....O"'-OOAESSOF PERSON WHO COMPLETED C"'-USE Of DE~^ _ . (n"",m Type Of Pnnt ...j~ S ).J.. 1Jr"'YYtrV1~ [] W/(JA- ~€L<o ta:l_ MfZJ"t-=L,"" f'A . " OAl"EfllED(Mo<,otl,Day, "'~" c " . PMONOuMCING "'-NO CERTlfVl~ PHYSICIAN <pt,."",.." t>oiI> ~'""O""""'~ u..,n ."" c~'''(~'''<J <0 c.,,'" '" "~."" I.. In....... 01 my k......,.dg... ....tn_<.."....I __.. ......, on" pI..:.. and d_ '0 .n. c.....I.)."" mOM.... .....0 'MEDICAL Ell,lMINER/CORONER On 'I>. to..i. <>. ...mln.II,,~ .~dlo' j~y,,"...,io". in my ,,!,'nion. "Ulll """c.."ed., 'he Itm.. dat., .~d plac~, a"d du.lo tll. e.~..(.).n" m.nn.,usl.led ... od.li!.)Jl V,L~. --- b2LW1.l12l ~ lJ.L. It> ;;, iJO' I f , IN THE COURT OF COMMON PLEAS, CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF DEWEY J CRIST Register's # 21-02-638 Deceased CLAIM To the Clerk of the Orphans' Court Division: Index and make proper entry in your official records of the claim of CITIBANK (SOUTH DAKOTA) NA in the amount of $6302.54 against the estate of the above-named decedent. This claim is filed under Section 3532 (b) (2) PEF Code, 20 Pa. C.S. ss. 3532 (b) (2). The said decedent, whose last known residence was at 7073 CARLISLE PIKE # 116 CARLISLE PA 170139762 Written notice of this claim was given to BONNIE ANTHONY. Executor. 7 SUNNY LANE DILLSBURG PA 170190000 on August I3 2002. '1 l,~ ~ ~IJ~') (Claitna ) KRISTEN WELLS, Manager of Citicorp Credit Services, Inc.,USA under limited power of attorney for CITIBANK (SOUTH DAKOTA) NA 1930 NW 110 Street, Kansas City, MO 64153 (Claimant's Address) 08/1Y2002-9Q Acct. #-44.28135060100351 08/05/02 ~~~~@t~@f~ift~iH $6467. 48 ~ilWii~~~@~ijif:m $393.00 ~~~~~i!~li~t[~i@~~~i~ SITE:KC TM:6300 ACID: 08/03/02 ~ KCB30W 23:11:49: . " . DEWEY J CRIST 7073 CARLISLE PIKE . 116 CARLISLE PA 17013-9762000 CHOICE VISA P.O. BOX 8106 S HACKENSACK, NJ 07606-8106 CHOICE~ F'orCustomllr5ervlce, caUorwritQ 1-800-388-2200 Account Number 4428 1350 6010 0351 CHOICE VISA PaYllent lIlust De rece1veCl by 1:00 plI local tillle on 08/05/2002 To report bUIIOII) erron....lbr to IhI".ddr."c8lll"'!lw1U notpreHI'Y""'lrrlCJMs.. BOX 6248 SIOUX FALLS. SO 57117 Past DUe $260.00 + Available Cash Limit $8100 Purch/Adv Minimum Due $133.00 = New Balance $6467.48 Statement/Closing Date 07/10/2002 TotalCredil Line $18000 AvallableCredlt Line $11532 Amount Over CredIt Line $0.00 + CashAdvanceUmit $8100 Minimum Amount DUll $393.00 7/10 7/10 standard Purch LATE FEE - JUN PAYMENT PAST DUE 66 0000 0 PURCHASES'FINANCE CHARGE'PERIODIC RATE 84 0000 0 35.00 70000000000 129.94 70000000000 The Annual Percentage Rate on your account has been increased due to one of the following reasons stated in your Card Agreement with us: you failed to make a payment to us or any other creditor when due, you exceeded your credit line or you made a payment to us that was not honored by your bank. Iol.{,,?"l~ _ O/O.~O _ \.,.'1.~ '1 Before you step into the sun, remember to SLIP! SlOPl SlAP!(R) Slip on a shirt, slop on sunscreen of SPF 15 or higher. slap on a hat and wrap on UV protected sunglasses - They're your best defense against sun damage and skin cancer. b -a,b? 1$'1. One in five Americans lives with a disability. Easter Seals is committed to helping people with disabilities gain greater independence. To learn more about Easter Seals service and sup~ort, visit www.easter-seals.org or call 1-800-221-6827. Account Summary PrevIous (+) Purchases (-) Payments (+) FINANCE: (=) New B!lance & Advances & Credits CHARGE Balance PURCHASES $6.302.54 $35.00 10.00 $129.94 $6,467.48 ADVANCES $0.00 $0.00 0.00 $0.00 $0.00 TOTAL $6.302.S4 $35.00 0.00 $129.94 $6,467.48 Rate Summary Balance Subject to PeriodiC Nommal ANNUAL Finance Charge Rate APR PERCENTAGE RATE PURCHASES Standard Purch $6.302.54 2.06167%(M) 24.740% 24.740% ADVANCES Standard Adv $0.00 0.06778%(F) 24.740% 24.740% PLEASE RErER TO THE REVERSE SIDE or THE ORIGINAL STATEMENT rOR PAY~ENT INrOR~ATIOH. Make cllllck or money order pa'{able 1n U.S. dollars on a U.s. bank toCltI Cards. Include account number on cho'lc.kor mOM'! order. No c.asl\ !)~aMl. OU1 c2/-{);) -&3 8' LAST WILL AND TESTAMENT OF DEWEY J. CRIST, JR. I, DEWEY J. CRIST, JR. now of 3073 Carlisle Pike, Lot 116, sil ver Springs 'I'ownship, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last will and Testament, hereby revoking all other wills and Codicils previously made by me. ITEM I: I direct that payment of all my just debts, expenses of my last illness, funeral expenses, and the costs of administering my estate from my es~ate as soon after my death as conveniently muv be done. ITEM II: I give, devise and bequeath to BONNIE ANTHONY, my niece, the sum of $5,000.00. ITEM III: I give, devise and bequeath one-fourth of all of the rest, residue and remainder of my estate, of every nature and wherever situate, together with all insurance policies thereon, unto SHANE ANTHONY, TIMOTHY ANTHONY, and HEATHER ANTHONY, being children of BONNIE ANTHONY, share and share alike. The remaining thre~-fourths of said rest and residue of my property, I give, devise and bequeath to BONNIE J. ANTHONY, my niece of 7 Sunny Lane, Dillsburg, PA 17019. 1 ITEM IV: I direct that any and all taxes that may be assessed in consequence of my death, including all inheritance, estate and transfer taxes imposed upon my estate passing under my W'll l__ or otherwise, shall be 0::)';-4 .....~..... Ol'T" af the principal c- f Iay residuary estate as a part of the expense of the administration of my estate. ITEM V: I authorize and empower my personal representative to compromise, adjust, release and discharge in such manner as my personal representative may deem proper, all debts and claims owed by or to me or my Estate; to sell, lease or exchange at public or private sale or in such manner, at such prices, and upon such terms of credit or otherwise, as my personal representative may deem proper, all or any part of my property, real or personal; to exec ute, acknowledge and deliver instruments of conveyance, including deeds in fee simple; to borrow money for the purpose of paying estate, inheritance or other taxes which are required to be paid and to secure any such loans by pledge or mortgage of all or any part of my property and to execute the necessary instruments to carry out such powers; to distribute my estate in kind or partly In money or partly in kind, and to determine the fair value at which any property so distributed in kind shall be received by 1:he distributees; to conduct any business in which I have an interest at the time of my death, f~r ~~ such period as my personal 2 representative may deem proper, power to borrow money and pledge assets of the business and the power to do all other acts that I, in my lifetime, could have aone, ~o delegate such power to any partner, manager or employee without liability for any loss occurring therein and to organize c corporation ~o carryon said !:;~siness as capital to such corporation and accept stock in the corporation in lieu thereof and hold such stock for the uses of this my will, and to vote said stock or sell the same as to my personal representative may seem best; to retain all stocks, assets I bonds alJJ investments owned by me without being confined -:0 what is known as legal investments; to execut:e any options to p-..:rchase, to apply for stocks; bor..ds or ot.her investments: to purchase or otherwise acquire real estate and to exeCUte the same powers thereov,=r as hereinbefore provided, 1:0 retain indefinitely any part of my assets, real or personal, which is or may become unproductive or to make sale thereof; to pay carrying charges and expenses of thp property out of other princi:cal or income of my estate; to invest and reinvest in all forms of property without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representative deems proper" without regard to the principle of diversification or risk; ::0 exercise any , ' ~aw-glven option to treat administrative expenses either as income 1:ax or as estate deductiuns, without regard to whether the expenses were paid f~om principal ~r income. The powers herein conferred shall be to my named personal representative and all successors thereto and 3 shall be in addition and not in l' . .,l,..' _lml't.al-lOn of other powers conferred on said fiduciary. Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for principal or income payable to any beneficiary shall be made upon the sole receip~ of the respective beneficiary to whom the payment is nade ana f~ee from anticipa-':':"2'::; alienation, assignment, attachment, and pledge and free from control by the creditors of any such beneficiary. ITEM VI: All shares of principal and income hereby given shall be free from anticipation, assignment, pledge or obligation of the beneficiaries and any of them and shall not be subject to any execution or attachment, levy or sequestration or other claims of the creditors of said beneficiaries or any of them. ITEM VII: I nominate, constitute and appoint my niece, BONNIE ANTHONY, as the sole Exec~trix of this my Last will and Testament, to serve withom: bond. In 'the event of the renunciation, death, resignation, refusal or inability to act for any reason whLtsoever of the said BONNIE ANTHONY, I nominate, constitute and appoint HEATHER ANTHONY, as the Executrix of this my Last will and Testament, to serve without bond. IN WITNESS WHEREOF, I, DEWEY J. CRIST, JR., have, to this my Last Will and Testament, set my hand this ~((.D day of ----Rf'O<. \\...- . 20 o~ . , ~)_~~~ / ~ Cr~ ,k, (SEAL) Signed, sealed, published and declared by DEWEY J. CRIST, JR., 4 the above named Testator on the i 0 2J~, as for his Last will and Testament, in the who, in his presence, and in the presence of each his request, subscribed our names as witnesses day of-1tf(ZYL presence of us, other, have, a't hereto. ~ resicling at 2~A-~ iJ"'~^~; IIlP' residing at /3 Co7tofC (7 ~erL"l(.5Ju "lA/7C'~D Name ~';/~vL,/~ Name COMMONWEALTH OF PENNSYLVANIA COUNTY OF SS WE, the undersigned, the Testator and the witnesses, respectively, whose names are signed to the foregoing instrument, being first dU"1 sworn and qualified according to law, do hereby declare to the undersigned authority that we were present and saw the Testator sign and execute the instrument as his Will, and that he had signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed tr:e Will as witnesses and that to the best of their knowledge, the Testator was at that time eighteen years of age or older, of sound mind and under no constrain or undue influence, and I, the said Testator, do t,,,reby acknowledge that I signed and executed the instrument as my Last will and Testament, that I signed it willingly, and that ~ signed it as my free and voluntary act for the purposes thnrein expressed. ~~~a/-J4' Tes r - DEW~J. CRIST, JR. Witness~/I.JJt ,,--/. L / / . ;f'~/d U/-,-,:"" fA-At .d Wlt,ess Sworn to and subscribed before me this ~ d~y of ~n/ ~. ~A/f)<<~ub Notary Public / My cow~ission xpires: " \ " NOTARIAL SEAL MARIA L. STROH, Nlllary Public Lower AII611 T~., Cumberland Co., PA My CommiSSion Expires Oct. 7, 2002 5 LAw FIRM BALOGH BECKER, LTD. JAMES A. BALOGH - MN GARVW, BECKER - DC, FL, IL, MN, WI MICHAEL C. CONN - MN CHELSEA A. JAGUSCH - MN, WI ANGELA M. HORN - MN MICHAEL D. JOHNSON - MN CVRENTHIA D. JORDAN - MN 4150 OLSON MEMORIAL HIGHWAY, SUITE 200 MINNEAPOLIS, MINNESOTA 55422-4804 TElEPHONE 763-852-8440 FAX 763-852-8499 TOll-FREE 888-762-9997 Of COUNSEL: llTOW LAw OFFICES, P,C. (IOWA) lUSTIG, GlASER & WilSON, P.c. (MASSACHUSETTS) 10/23/02 CUMBERLAND COUNTY COURTHOUSE I COURTHOUSE SQUARE, #102 CARLISLE, P A 17013 Re: In the Estate of Probate Case No. Social Security No: Last known residence: Our Client: Account Number: Amount of Debt: DEWEY J CRIST 21-02-638 201186483 7073 CARLISLE PIKE TRLR 116 CARLISLE, P A 17013 SEARS, ROEBUCK AND CO. 5484018032665 3833.68 Dear Sir or Madam: Enclosed please fmd a Creditor's claim to be filed in the record with the above-referenced Estate. Please retum a file stamped copy of the claim in the enclosed self-addressed, stamped envelope. Thank you for your assistance. If you have any questions or concerns, please call our firm toll free at 1-888-762-9997. Cordially, /s/ Chelsea A. Jagusch Balogh Becker, Ltd. Attorneys for Claimant Enclosures If applicable, a check for the filing fee cc: Attorney for Estate Personal Representative This letter is an attempt to collect a debt and any information obtained will be used for that purpose. This letter is from a debt collector. PCRTCOV 2345 10/22/2002 841155 AFFIDAVIT OF MAILING I Lucille Roberts , , declare under penalty of perjury that on the date indicated below, I placed the envelope for collection and mailing on the date and place shown below following our ordinary business practices. On the same day that correspondence is placed for mailing, it was deposited in the ordinary course of business with the United States Postal Service in a sealed envelope with postage fully prepaid. Personal Representative: BONNIE ANTHONY 7 SUNNY LANE DILLSBURG, PA 17019 Attorney for Estate: ROBERT MYERS 100 OLD YORK RD NEW CUMBERLAND / ~-- / ~ /' 1/ J5/rJ?_ Date I !By: I \ -- ...---..--'" / -- COMMONWEALTH OF PENNSYLVANIA COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS' COURT DIVISION NOTICE OF CLAIM In Re: The Estate of: Court File No: 21-02-638 DEWEY J CRIST Deceased TO: THE CLERK OF THE ORPHANS' COURT DIVISIONlotice of claim by creditor, Pursuant to Section 3532(b)(2) of the Probate, Estates, and Fiduciaries Code, 20 PA.C.S.A. 93532(b)(2). 1) Claimant's name: SEARS, ROEBUCK AND CO. C/O BALOGH BECKER L TO, 4150 OLSON MEMORIAL 2) Claimant's address: HWY #200 MINNEAPOLIS, MN 55422 8887629997 3) Creditor listed below is the owner and holder of a claim in the amount of $ 3833.68 4) The facts upon which this claim is based is an account for credit evidenced by the attached Affidavit of Account Stated. 5) Decedent's address: 7073 CARLISLE PIKE TRLR 116 CARLISLE, PA 17013 6) Date of Death: 07107102 7) That the claim arose prior to the death of the decedent on or about 8) That the claim is secured by On behalf of the claimant, I do solemniy declare and perjury that they Information and representations to the b t f my nowledge, information and beli . 'rm under the penalties of d herein are true and correct Dated: t Chelsea A. Jagusch/AngeJa M. Horn, Attomey tive and/or his/her counsel aim Written notice of claim was given to Personal Represen as stated below: BONNIE ANTHONY Name 7 SUNNY LANE Address DILLSBURG PA 17019 City /State/Zip _See attached Affidavit of Mailing Date notice mailed IN RE ESTATE OF: DEWEY J CRIST AFFIDAVIT OF ACCOUNT The undersigned, being first duly sworn deposes and states the follows: 1. Your Affiant is authorized by the Claimant as its Attorney-In-Fact to make this Affidavit. 2. Your Affiant has reviewed the account records of the Claimant with respect to the decedent. Your Affiant is familiar with these records and accounts and reviews them as a regular part of her duties. 3. The Decedent purchased merchandise in the amount of $3,833.68 evidenced by account number 5484018032665. 4. The unpaid balance does not include any post-death late payment charges, accrued interest, collection costs or attorney's fees. Further your affiant sayeth not \'\"""," \,\ . R " " ~o\le 06 '" ,'" ,,0 .....~.. A , "-, ""'-" .... oRY ....-.....f ~ ," 0\1' -.oJ" ," '<~ ..-:. " (-{('J\,\\ES... -::. ',\.()\)\,;1: = , : E: :: 0" ..::: ( ." ,C).... ,'-"-:.~~,~~~~ ,'," By: One of its torneys: Michael . Conn _./ Chelsea A. Jagusch L Angela M. Horn_ Michael D. Johnson Cyrenthia D. Jordan_ 4150 Olson Memorial Highway., Suite 200 Minneapolis, MN 55422.4804 763-852-8449 ,2002. _/~ ~- ...-- CLAIM AGAINST DECEDENT'S ESTATE CUMBERLAND COUNTY, PENNSYL VANIA FILE NUMBER_21-02-638 ESTATE OF: DEWEY CRIST, JR. The undersigned hereby presents for filing against the above estate this statement of claim and alleges: BEVERLY ENTERPRISES/DBA CAMP HILL CARE CENTER PO Box 180970 Fort Smith, AR. 72918-0970 The basis of claim is: SEE ATTACHED The amount of the claim is $214.50 that is now due and owing. Under penalties of peljury, I declare that I have read the foregoing, and the facts alleged are truc to the best of my knowledge and belief. Signed on January 14,2003 ~~ SANDRA BURNETT 1 SWEAR mIS STATEMENT IS CORRECT Subscribed and sworn to before me on C}~ } <J- :gW::3 ~J.~~ _. Alma F. Parish 'I N CoUnt)' Or Sebastian otal)' Public. Ark My Commission tK ansas P.08I1.V2012 Notary Public My Commission Expires ~ - t S- - ;;;l c) I -.;;>- BEVERLY ENTERPRISES/DBA CAMP HILL CARE CENTER P. O. BOX 180970 FORT SMITH, AR. 72918-0970 ITEMIZED RESIDENT STATEMENT RESIDENT NAME RESIDENT NUMBER DEWEY CRIST JR. 50516-03959-91536 DATE PREPARED STATEMENT TYPE: D INTERIM DISCHARGE !iJ ITEMIZED 1/13/03 5/14-5/15/02 PART A CO-INSURANCE 2 $203.00 Mav-02 CABLE FEE $11.50 II., A OUNT DUE $0.00 $214.50 $0.00 $214.50 1 d STATE OF PENNSYL VANIA IN THE MATTER OF ESTATE OF: DEWEY J CRIST, JR. IN THE ORPHANS COURT OF CUMBERLAND COUNTY ESTATE#: 21-02-638 STATEMENT OF CLAIM 1. The creditor, Household Retail Services, USA, certifies that there is due and owing by DEWEY J CRIST, JR., deceased, the sum of ONE THOUSAND TWO HUNDRED FIFTY THREE DOLLARS AND NINETY SIX CENTS ($ 1,253.96). 2. The nature of the claim is a KMART account 7101524000177598. 3. The name and address of the claimant is: Household Retail Services, USA, Post Office Box 15522, Wilmington, Delaware 19850-5522. 4. The name and address of the claimant's agent is: Nicole A. Pate, Estate Recoveries, Inc., P. O. Box 24566, Baltimore, Maryland 21214. 5. This claim is not contingent and is not secured by any liens or judgments. The last payment on the account was made on 06/08/02 in the amount of $50.00 . 6. This claim is not based on anyone instrument. Said balance has accrued since the account was established. On behalf of Household Retail Services, USA, creditor, I do solemnly declare and affirm under the penalties of perjury that the information in the foregoing claim is true and correct to the best of my knowledge, information and belief. I have made diligent inquiry and examination, and I believe the claim is just and all legal offsets, payments, and credits made known to the affiant have been allowed. J\1u~tQ ./\.. {JQt~ NICOLE A. PATE Estate Recoveries, Inc. P.O. Box 24566 Baltimore, Maryland 21214 (410) 444-8022 County of Baltimore, Maryland: IN WITNESS WHEREOF, I hereunto set my hand and Notarial Seal this October 22, 2002., My Commission Expires: August 8, 2004. .,.,,'i.,<lI\'I'."';:n~~ ;. '". S,~-..: '. """. , .,.~>~Ol-:m~" " . . ", . , . . . ,,'" I t;j .- \'~.~.. b.-.\IO ...~. , ,'0, .;.vt:l~.' .............J,.I'Q ........ ~ '-;'.#11. 'FiE :tl',,,._ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL V ANlA ORPHANS' COURT DIVISION I I I FileNo. )1-0?-1i1R Estate of Dewey.J Crist, .Jr , Deceased NOTICE OF CLAIM by NTCOT FA PATF, A"-:FNT FOR HOTJ~FHOT n RFTATT ~FRVTCF~. TJ~A Filed Pursuant to Section 3532 (b) (2) of the Probate, Estate, and Fiduciary Code, 20 Pa. C. S. A ~ 3532 (b) (2) To the Clerk of the Orphans' Court Division: Enter the claim 0 NTC'OT.F A PATF A..-:FNT FOR HOTJ~FHOT n RFTATT. ~FRVTC'F~ TJ~A (Claimant) in the amount of $1,251 96 against the above entitled estate. The Decedent, who resided at 7071 Carlisle Pike Tr 116 (Street Address) , Cnmherland County, Carlisle. P A 17013 (City) Pennsylvania, died on .Tnly 07, 2002 Written notice of said claim was given to Ronnie Anthony (Personal Representative, or . If known to claimant, at 7 Sunny Lane his Counsel) ( Address) ,on Octoher 22, 2002 (Date) Dillsburl!. P A 17019 ,,) _N \LoLL. A ~ , Claimant NICOLE A. PATE, AGENT Post Office Box 24566. Baltimore. Marvland 21214 ( Address) Claimant's Counsel: ( Address) COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHAN'S COURT DIVISON NO. 21-02-638 ESTATE OF: DEWEY J CRIST, JR. deceased. Notice of Claim by HOUSEHOLD RETAIL SERVICES, USA med pursuant to Section 3532(b) (2) ofthe PEF Code. Nicole A. Pate, Agent ESTATE RECOVERIES, INC. P.O. Box 24566 Baltimore, Maryland 21214 (410) 444-8022 ARSD Page:' 1 Document Name: untitled r BLOCK CODE 1 BLOCK CODE 2 STATEMENT FLAG STAT CODE BD PH LGC INS STAT GUARANTOR ST CP # SPCL CLASS EMPLOYEE CODE CREDIT CLASS RECENCY FLAG DAYS IN CYCLE NBR OF PLANS PFl=ARMU HRS USA APWM EAST REGION WHIRL PAGE 03 ON-LINE STATEMENT HISTORY DISPLAY o o o o PF4=ARIH 08/28/2002 05:27:35 0007101584000177598 AT STATEMENT TIME ---------* SHORT NAME CRIST DEWEY J CUST NBR 0007101584000177598 ALT CUST REL NBR STORE ORG 550 ID 000024275 OVRLIMT INCLUDED N CURR PMT DUE TOTAL PAST DUE TOTAL PMT DUE FIXED PMT AMT INTEREST FREE BEG BAL DEBITS 2 CREDITS 3 END BAL PF5=ARQB 27.00 .00 27.00 .00 1,284.28 1,361.72 19.56 97.00 1,284.28 PF6=ARQE ORGANIZATION 550 LOGO 600 ACCOUNT *-------- INFORMATION BELOW REFLECTS THE ACCOUNT BILLING CYCLE 17 DATE THIS STMT 05172002 STATE OF RESID PA DATE LAST STMT 04172002 INTERNAL STATUS A CYC/DATE DUE 01 06112002 GRACE EXPIRE 06112002 CREDIT LIMIT 1,600.00 OPEN TO BUY 316.00 CASH LIMIT .00 CASH AVAIL .00 01 Y-T-D INTEREST 101.64 Y-T-D LATE CHG 25.00 Y-T-D OVLM CHG .00 07 LAST YTD INTR 306.08 INT THIS STMT 19.56 F/S BEG BAL E2 F/S EARNED o F/S ADJ 30 F/S DISB 2 F/S END BAL PF2=ARTD PF3=ARIQ Date: 08/28/2002 Time: 8:27:37 AM ARSD page: 1 Document Name: untitled ORGANIZATION RQ EFF POST DATE DATE 0418 0418 PTS= TKT= ORG=OOO 0508 0508 PTS= TKT= ORG=OOO 0517 0517 PTS= SEQ=Ol TKT= ORG=OOO PFl=ARMU HRS USA APWM EAST REGION WHIRL PAGE 04 ON-LINE STATEMENT HISTORY DISPLAY 08/28/2002 05:27:38 550 LOGO ACCOUNT 0007101584000177598 600 CR AMOUNT TXN PLAN *-------- DES C RIP T ION -------* 40.00 C510 0 PAYMENT - THANK YOU o 0 DEPT= REF=00000000002041812495200 AUTH= STORE=OOOOOOOOO SKU=OOOOOOOOO GLS=2 SALESCLERK= P/O= R/REF=41801651000000 ITM=95200 MERCH=OOOOOOOOO CAT=OOOO CARD#/SEQ#=0007101584000177598 0001 57.00 C510 0 PAYMENT - THANK YOU o 0 DEPT= REF=00000000002050810849119 AUTH= STORE=OOOOOOOOO SKU=OOOOOOOOO GLS=2 SALESCLERK= P/O= R/REF=50801510000000 ITM=49119 MERCH=OOOOOOOOO CAT=OOOO CARD#/SEQ#=0007101584000177598 0001 8.84 D714 7 BILLED FINANCE CHARGES o 0 DEPT= REF=10000242750000000262430 AUTH= STORE=000024275 SKU=OOOOOOOOO GLS=l SALESCLERK=P01 P/O= R/REF=OOOOOOOOOCOOOO ITM=62430 MERCH=OOOOOOOOO CAT=OOOO CARD#/SEQ#=0007101584000177598 0000 PF2=ARTD PF3=*TOP* PF4=*BOT* PF5=*BWD* PF6=*FWD* Date: 08/28/2002 Time: 8:27:39 AM Page': 1 Document Name: untitled ARSD HRS USA APWM EAST REGION WHIRL PAGE 04 ON-LINE STATEMENT HISTORY DISPLAY 08/28/2002 05:27:40 ORGANIZATION 550 LOGO 600 ACCOUNT 0007101584000177598 RQ EFF POST DATE DATE 0517 0517 PTS= SEQ=02 TKT= ORG=OOO AMOUNT TXN 10.72 D714 o 0 DEPT= STORE=000024275 P/O= MERCH=OOOOOOOOO CAT=OOOO CR PLAN 7 *-------- DES C RIP T ION -------* BILLED FINANCE CHARGES REF=10000242750000000262440 AUTH= SKU=OOOOOOOOO GLS=l SALESCLERK=P02 R/REF=OOOOOOOOOOOOOO ITM=62440 CARD#/SEQ#=0007101584000177598 0000 *** END OF TRANSACTIONS *** PF1=ARMU PF2=ARTD PF3=*TOP* PF4=*BOT* PF5=*BWO* PF6=*FWO* Date: 08/28/2002 Time: 8:27:41 AM ARSD Page; 1 Document Name: untitled BLOCK CODE 1 BLOCK CODE 2 STATEMENT FLAG STAT CODE BD PH LGC INS STAT GUARANTOR ST CP # SPCL CLASS EMPLOYEE CODE CREDIT CLASS RECENCY FLAG DAYS IN CYCLE NBR OF PLANS PF1~ARMU HRS USA APWM EAST REGION WHIRL PAGE 03 ON-LINE STATEMENT HISTORY DISPLAY o o o o PF4~ARIH 08/28/2002 05:27:44 0007101584000177598 AT STATEMENT TIME ---------* SHORT NAME CRIST DEWEY J CUST NBR 0007101584000177598 ALT CUST REL NBR STORE ORG 550 ID 000024275 OVRLIMT INCLUDED N CURR PMT DUE TOTAL PAST DUE TOTAL PMT DUE FIXED PMT AMT INTEREST FREE BEG BAL DEBITS 2 CREDITS 2 END BAL PF5~ARQB 27.00 .00 27.00 .00 1,253.96 1,284.28 19.68 50.00 1,253.96 PF6=ARQE ORGANIZATION 550 LOGO 600 ACCOUNT *-------- INFORMATION BELOW REFLECTS THE ACCOUNT BILLING CYCLE 17 DATE THIS STMT 06172002 STATE OF RESID PA DATE LAST STMT 05172002 INTERNAL STATUS A CYC/DATE DUE 01 07122002 GRACE EXPIRE 07122002 CREDIT LIMIT 1,600.00 OPEN TO BUY 346.00 CASH LIMIT .00 CASH AVAIL .00 01 Y-T-D INTEREST 121.32 Y-T-D LATE CHG 25.00 Y-T-D OVLM CHG .00 07 LAST YTD INTR 306.08 INT THIS STMT 19.68 F/S BEG BAL E2 F/S EARNED o F/S ADJ 31 F/S DISB 2 F/S END BAL PF2~ARTD PF3~ARIQ Date: 08/28/2002 Time: 8:27:46 AM Page: 1 Document Name: untitled ARSD HRS USA APWM EAST REGION WHIRL PAGE 04 ON-LINE STATEMENT HISTORY DISPLAY 08/28/2002 05:27:47 ORGANIZATION 550 LOGO 600 ACCOUNT 0007101584000177598 RQ EFF DATE 0608 CR AMOUNT TXN PLAN *-------- DES C RIP T ION -------* 50.00 C510 0 PAYMENT - THANK YOU o 0 DEPT= REF=00000000002060811688106 AUTH= STORE=OOOOOOOOO SKU=OOOOOOOOO GLS=2 SALESCLERK= TKT= P/O= R/REF=60801772000000 ITM=88106 ORG=OOO MERCH=OOOOOOOOO CAT=OOOO CARD#/SEQ#=0007101584000177598 0001 0617 0617 9.08 D714 7 BILLED FINANCE CHARGES PTS= 0 0 DEPT= REF=10000242750000000223570 AUTH= SEQ=Ol STORE=000024275 SKU=OOOOOOOOO GLS=l SALESCLERK=P01 TKT= P/O= R/REF=OOOOOOOOOOOOOO ITM=23570 ORG=OOO MERCH=OOOOOOOOO CAT=OOOO CARD#/SEQ#=0007101584000177598 0000 0617 0617 10.60 D714 7 BILLED FINANCE CHARGES PTS= 0 0 DEPT= REF=10000242750000000223580 AUTH= SEQ=02 STORE=000024275 SKU=OOOOOOOOO GLS=l SALESCLERK=P02 TKT= P/O= R/REF=OOOOOOOOOOOOOO ITM=23580 ORG=OOO MERCH=OOOOOOOOO CAT=OOOO CARD#/SEQ#=0007101584000177598 0000 *** END OF TRANSACTIONS *** PF1=ARMU PF2=ARTD POST DATE 0608 PTS= PF3=*TOP* PF4=*BOT* PF5=*BWD* PF6=*FWD* Date: 08/28/2002 Time: 8:27:48 AM . ARSD Page: 1 Document Name: untitled BLOCK CODE 1 BLOCK CODE 2 STATEMENT FLAG STAT CODE BD PH LGC INS STAT GUARANTOR ST CP # SPCL CLASS EMPLOYEE CODE CREDIT CLASS RECENCY FLAG DAYS IN CYCLE NBR OF PLANS PFl=ARMU HRS USA APWM EAST REGION WHIRL PAGE 03 ON-LINE STATEMENT HISTORY DISPLAY o o o o PF4=ARIH 08/28/2002 05:27:50 0007101584000177598 AT STATEMENT TIME ---------* SHORT NAME CRIST DEWEY J CUST NBR 0007101584000177598 ALT CUST REL NBR STORE ORG 550 ID 000024275 OVRLIMT INCLUDED N CURR PMT DUE TOTAL PAST DUE TOTAL PMT DUE FIXED PMT AMT INTEREST FREE BEG BAL DEBITS 3 CREDITS 0 END BAL PF5=ARQB 28.00 27.00 55.00 .00 1,297.84 1,253.96 43.88 .00 1,297.84 PF6~ARQE ORGANIZATION 550 LOGO 600 ACCOUNT *-------- INFORMATION BELOW REFLECTS THE ACCOUNT BILLING CYCLE 17 DATE THIS STMT 07172002 STATE OF RESID PA DATE LAST STMT 06172002 INTERNAL STATUS A CYCIDATE DUE 02 08112002 GRACE EXPIRE 08112002 CREDIT LIMIT 1,600.00 OPEN TO BUY 302.00 CASH LIMIT .00 CASH AVAIL .00 01 Y-T-D INTEREST 140.20 Y-T-D LATE CHG 50.00 Y-T-D OVLM CHG .00 07 LAST YTD INTR 306.08 INT THIS STMT 18.88 F/s BEG BAL E2 Fls EARNED 1 Fls ADJ 30 Fls DISB 2 F/s END BAL PF2=ARTD PF3=ARIQ Date: 08/28/2002 Time: 8:27:52 AM page': 1 Document Name: untitled . ARSD HRS USA APWM EAST REGION WHIRL PAGE 04 ON-LINE STATEMENT HISTORY DISPLAY 08/28/2002 05:27:53 ORGANIZATION 550 LOGO 600 ACCOUNT 0007101584000177598 RQ EFF DATE 0713 POST CR DATE AMOUNT TXN PLAN *-------- DES C RIP T ION -------* 0713 25.00 D701 7 LATE CHARGE ASSESSMENT PTS= 0 0 DEPT= REF=10000242750000000117300 AUTH= SEQ=02 STORE=000024275 SKU;OOOOOOOOO GLS=l SALESCLERK=P02 TKT= P/O= R/REF=OOOOOOOOOOOOOO ITM=17300 ORG=OOO MERCH=OOOOOOOOO CAT=OOOO CARD#/SEQ#=0007101584000177598 0000 0717 0717 8.52 D714 7 BILLED FINANCE CHARGES PTS= 0 0 DEPT= REF=10000242750000000245480 AUTH= SEQ=Ol STORE=000024275 SKU=OOOOOOOOO GLS=l SALESCLERK=P01 TKT= P/O= R/REF=OOOOOOOOOOOOOO ITM=45480 ORG=OOO MERCH=OOOOOOOOO CAT=OOOO CARD#/SEQ#=0007101584000177598 0000 0717 0717 10.36 D714 7 BILLED FINANCE CHARGES PTS= 0 0 DEPT= REF=10000242750000000245490 AUTH= SEQ=02 STORE=000024275 SKU=OOOOOOOOO GLS=l SALESCLERK=P02 TKT= P/O= R/REF=OOOOOOOOOOOOOO ITM=45490 ORG=OOO MERCH=OOOOOOOOO CAT=OOOO CARD#/SEQ#=0007101584000177598 0000 *** END OF TRANSACTIONS *** PF1=ARMU PF2=ARTD PF3=*TOP* PF4=*BOT* PF5=*BWD* PF6=*FWD* Date: 08/28/2002 Time: 8:27:54 AM page~ 1 Document Name: untitled ARSD BLOCK CODE 1 BLOCK CODE 2 STATEMENT FLAG STAT CODE BD PH LGC INS STAT GUARANTOR ST CP # SPCL CLASS EMPLOYEE CODE CREDIT CLASS RECENCY FLAG DAYS IN CYCLE NBR OF PLANS PF1=ARMU HRS USA APWM EAST REGION WHIRL PAGE 03 ON-LINE STATEMENT HISTORY DISPLAY K S o ER 01 o o o o PF4=ARIH 08/28/2002 05:27:55 0007101584000177598 AT STATEMENT TIME ---------* SHORT NAME CRIST DEWEY J CUST NBR 0007101584000177598 ALT CUST REL NBR STORE ORG 550 ID 000024275 OVRLIMT INCLUDED N CURR PMT DUE TOTAL PAST DUE TOTAL PMT DUE FIXED PMT AMT INTEREST FREE BEG BAL DEBITS CREDITS END BAL PF5=ARQB o o 28.00 55.00 83.00 .00 l,297.84 l,297.84 .00 .00 1,297.84 PF6=ARQE ORGANIZATION 550 LOGO 600 ACCOUNT *-------- INFORMATION BELOW REFLECTS THE ACCOUNT BILLING CYCLE 17 DATE THIS STMT 08172002 STATE OF RESID PA DATE LAST STMT 07172002 INTERNAL STATUS A CYC/DATE DUE 03 09112002 GRACE EXPIRE 09112002 CREDIT LIMIT .00 OPEN TO BUY **********.00 CASH LIMIT .00 CASH AVAIL .00 Y-T-D INTEREST 140.20 Y-T-D LATE CHG 50.00 Y-T-D OVLM CHG .00 07 LAST YTD INTR 306.08 INT THIS STMT .00 F/S BEG BAL E2 F/S EARNED 2 F/S ADJ 31 F/S DISB 2 F/S END BAL PF2=ARTD PF3=ARIQ Date: 08/28/2002 Time: 8:27:57 AM , . ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: DplJpy T C':ri!=:T, TR Date of Death: July 7, 2002 Will No, 2002-00638 Admin, No, PA No. 21-02-0638 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5,6(a) of the OThans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 8, 2002 : Name Address Bonnie Anthony' 7 Sunny Lane, Dillsburg, PA 17019 Shane Anthony 627 Overlook Dr., Etters, PA 17319 Timothy Anthony 1)2 Bp.:tnfll r.hllrc:n Tn.. Apt. R, Dill <:::nllrg, PA 1701Q Heather Anthony 162 Logan Rd., Apt. 3D, Dilslburg, PA 17019 Notice has now been given to ail persons entitled thereto under Rule 5.6(a) except Nonp. Date: October 23, 2002 c;a~~~ Signature Name Robert E. Myers Address 100 York Rd. New Cumberland, PA 17070 Telephone ( 71 j 774-3163 Capacity: _ Personal Representative ~Counsel for personal representative