HomeMy WebLinkAbout03-0943Estate of
Annabelle S. Fanus
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Deceased Social Security No. 201-16-5397
KEVIN M. EDDY
Petitioner, who is 18 years of age or older, applies for:
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner is the executrix named in the Last Will of
~ the Decedent, dated March 11~ 2002
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 to victim of a killing and was never adjudicated incompetent:
B. Grant of Letters of Administration
(d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following
spouse (if any) and heirs:
Name Relationship Residence
COMPLETE IN ALL CASES: Attach additional sheets if necessary.
Decedent was domiciled at death in
Cumberland County, Pennsylvania, with his last family or principal residence at
139 Bosler Avenue, Borough of Lemoyne, Cumberland County, Pennsylvania
(List street, number and municipality)
Decedent, then 79 years of age, died October 16, 2003 at
139 Bosler Avenue, Lemoyne, Pennsylvania
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property ..................................................................... $ 7,000.00
(If not domiciled in PA) Personal property in Pennsylvania ..................................... $
(If not domiciled in PA) Personal property in County .................................................... $
Value of real estate in Pennsylvania ...................................................................................................................... $ 70,000.00
Total ......................................................................................................... $ 77,000.00
Real Estate situated as follows: 139 Bosler Avenue, Lemoyne, Cumberland County, Pennsylvania
Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
Signature Typed or printed name and residence
KEVIN M. EDDY
311 Walton Street
Lemoyne, PA 17043
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND ·
The Petitioner above-named swears and affirms that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the
Decedent, Petitioner will well and truly administer the estate according to 'law.
Sworn to and affirmed and subscribed .
/K~VI-~N M. EDDY -
Before me this ,/~ 7',,'-/' day of
2003.
NO.
Estate of
ANNABELLE S. FANUS
Social Security No: 201-16-5397
Date of Death:
, Deceased
October 16, 2003
AND NOW, ~'"~e./~.~. ,2003, in consideration of the Petition on the reverse side
hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters Testamentary
d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate
are hereby granted to KEVIN M. EDDY in the above estate and that the instrument dated
March 11, 2002 described in the Petition be admitted to probate and filed of record as the last Will
of the Decedent.
FEES
Letters ...........................
Short Certificate(s) $ /C-
Renunciation .............. $
Affidavit ( ) .................. $
Extra Pages ( ) ....... $
Codicil ............................ $
JCP Fee ....................... $ /~.
Inventory ...................... $
Other .............................. $
TOTAL ......... $
Attorney:
I.D. No: 56113
RALPH H. WRIGHT, JR.
Address: Johnson, Duffle, Stewart & Weidner,
301 Market Street, P.O. Box 109, Lemoyne, PA 17043-
Telephone: 717-761-4540
J05.805 REV 9/~16
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 9648721
No.
Local Registrar
Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS
CERTIFICATE OF DEATH
N~iN. AME OF DECE DE NT { ,d, ..... .......
Annabelle S. Fanus ,.Female ~- 201 -- 16 -- 5397 ,October 16, 2003
co~Nr~O~o~r. ; I ug 1 1 , 1924 ork County, p~,~O
~ ~. Cumberland ~emoyne ,139 Bosler Avenue [,~ ...... "~"~ ...... ' ~,~ White
'.$ ,,..Homemaker ,,,. Home ~,~,~
139 Bosler Avenue
Lemoyne PA 17043 ~ ......
,,. ' ~""'~ Cumberland ~-~ ~.~
,, NA
~.Vicki A. Eddy ,~.3]~ Walton Street, Lemovne. PA 17043
~ S~N~U~ ~ FUNE~L~E~EN~ ~N ~Tl~ AS SU~ L~EN~NUMBER ' NAME~-- '--- J '
~ ...... ~.~ .... ~,_ , ....... /~_.~, I'". ~one&MurrayFH408 3rd St New Cumberlan~0~
~ AN AU~SY ~ERE AU~SY FININGS MANNER OF ~ATH
Acc~nl Pendl~ Invesl,g~l~n ~ Y~
·ast ill anb C stam nt
OF
ANNABELLE S. FANUS
I, ANNABELLE S. FANUS, of the Borough of Lemoyne, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make,
publish and declare this as and for my Last Will and Testament, hereby revoking and making void
any and all Wills or Codicils at any time heretofore made by me.
ARTICLE I
DEBTS AND EXPENSES
I direct the payment of all my legal debts, and the expenses of my last illness and funeral
from my Estate as soon after my death as conveniently may be done. I direct that all taxes that
may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction
imposed, shall be paid from my residuary estate as part of the expenses of the administration of my
estate.
ARTICLE II
PERSONAL PROPERTY
I give and bequeath my motor vehicle(s), household and personal effects and other tangible
personalty of like nature (not including cash or securities), together with any existing insurance
thereon, unto my son, PAUL K. KIRK, and my daughter, VICKI A. EDDY, to be divided among
them by my Personal Representative with due regard for their personal preferences in as 'nearly
equal shares as practicable. In the event that my son, PAUL K. KIRK, is not living on the thirty-
first (31st) day following my death, I give and bequeath his share to his then-living issue, per
stirpes. In the event that my daughter, VICKI A. EDDY, is not living on the thirty-first (3 lSt) day
following my death, I give and bequeath her share as follows: one-half (1/2) to my son, PAUL IC
KIRK, or his then-living issue per stirpes, and one-half (1/2) to my son-in-law, KEVIN M.
EDDY. In the event that my son-in-law, KEVIN M. EDDY, is not living on the thirty-first (31 st)
day following my death, his share shall be added to the share of my son, PAUL K. KIRK. Any
such item allotted to a minor, may as my Personal Representative thinks advisable, either be
delivered to the minor or any person to hold for the minor, or be sold and the proceeds paid, in the
discretion of my Personal Representative, either directly to the minor or to the Custodian as
provided in Article IV hereof. If there shall be disagreement as to the disposition of any item or
items described in this Article, I direct that the same shall be disposed of as follows: The name of
each beneficiary of this Article II who wishes to participate in a lottery for such purpose shall be
written on a two inch by two inch square of paper, with the name of each person entitled to a half
share being written on two such squares of paper and the name of each such person entitled to a
one-fourth share being written on one such piece of paper. Each square of paper shall then be
folded into quarters, such that no writing shall be visible and shall be placed a container. Said
container shall be covered and shaken. A disinterested party shall then draw one piece of paper
from the container, and the person whose name appears on the paper shall be the person to whom
the item shall be distributed. The process will be repeated for each item as to which there is
disagreement.
ARTICLE III
REST, RESIDUE AND REMAINDER
I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever
nature and wheresoever situate, in equal shares unto my son, PAUL K. KIRK, and my daughter,
VICKI A. EDDY. In the event that my son, PAUL K. KIRK, is not living on the thirty-first
(31st) day following my death, I give, devise and bequeath his share unto his then-living issue, per
stirpes. If my daughter, VICKI A. EDDY, is not living on the thirty-first (31 st) day following my
death, I give, devise and bequeath her share as follows: one-half (1/2) to my son, PAUL K.
KIRK, or his then living issue, per stirpes, and one-half (1/2) to my son-in-law, KEVIN M.
EDDY. In the event that my son-in-law, KEVIN M. EDDY, is not living on the thirty-first (31st)
day following my death, his share shall be added to the share of my son, PAUL K. KIRK.
ARTICLE IV
UNIFORM TRANSFERS TO MINORS ACT
In the event that any beneficiary of my Will shall not have reached the age of twenty-one
(21) years at the time for distribution of his or her share, distribution of said share may be made in
the discretion of my Personal Representative after considering the age and needs of the beneficiary,
either directly to the beneficiary or to a Custodian under the Pennsylvania Uniform Transfers to
Minors Act, 20 Pa. C.S.A § 5301 et seq., or the applicable Uniform Gifts to Minors Act or
Uniform Transfers to Minors Act in the state of residence of such beneficiary as the case may be.
My Personal Representative may designate as such Custodian any institution or person, including
my Personal Representative, qualified to act as a Custodian for such beneficiary under such Act in
effect at the time such distribution is made. A receipt for any payment or distribution so made
shall be a full discharge therefor to my Personal Representative, who shall not be responsible to see
to, or be liable for, the application of such proceeds thereafter.
ARTICLE V
APPOINTMENT OF PERSONAL REPRESENTATIVE
I name, constitute and appoint my son-in-law, KEVIN M. EDDY, Executor of this my
Last Will and Testament. Should my son-in-law, KEVIN M. EDDY, fail to qualify or cease to so
act, I name, constitute and appoint my daughter, VICKI A. EDDY, alternate Executrix to
complete the administration of my Estate. I direct that no fiduciary appointed herein shall be
required to post bond for the faithful administration of the duties required in any jurisdiction.
3
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
and Testament, this /trO~day of ~v~~ ,2002.
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last
Will and Testament, in the presence of us, who at her request, in her presence and in the presence
of each other, have hereunto subscribed our names as witnesses.
4
AFFIDAVIT AND ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA ·
COUNTY OF CUMBERLAND ·
SS
_ ,{rtl 1 tf-/¢. I//'£ , the Testatrix and the witnesses, respectively, whose
names are siffned to the attached or foregoing instrument, being first duly sworn, do hereby declare
to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will
and that she had signed willingly and that she executed it as her free and voluntary act for the
purposes therein expressed, and that each of the witnesses, in the presence and hearing of the
Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at
that time eighteen years of age or older, of sound mind and under no constraint or undue influence.
ANNABELLE S. FANUS
wf ss
Subscribed, sworn to and acknowledged befo~ me by ANNABELLE $. FANUS,
T~s.tatrix, ired sub~ribed and sworn to before me by ~_~[./~ 7-/. //~/rp_..} ~//4.¢j ~r~ and
ffi,¢t¢ ~It.k~...[Sgl. gi...p , witnesses, this /'[~..~t c]~y of ~'~a.~.~d(__ ,
'002.
:155545
Notg~y Public
Nom~l ~
14y Commi~lon E.xplms Dec. 2, 200g
Mem~r, l=~/lvanla Assocla~ of ~
OF
iaJ~NABELT,F. S. F~S
JOHNSON, DUFFLE, STEWART
& WEIDNER
ATTORNEYS AT LAW
LEMOYNE, PENNSYLVANIA
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: ANNABELLE S. FANUS
Date of Death: October 16, 2003
Will No.: 2003-0943
To the Register:
I certify that notice of beneficial interest 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 on
December 26, 2003.
Name Address
VICKI A. EDDY 311 Walton Street
Lemoyne, PA 17043
PAUL K. KIRK 1011 Harvest Moon Drive
Seffner, Florida 33584
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None.
Date: December 26, 2003 ~o:~..~_~,.~.~,~.,
- o'U"d~U'~
Name RALPH H. WRIGHT, JR.
Johnson, Duffie, Stewart & Weidner
Address 301 Market St.
P. O. Box 109
Lemoyne, PA 17043-0109
Telephone (717) 761-4540
Capacity:
Counsel for personal representatiVe
REV- 1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
CA?
EP~I
CR~
KO~
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
cg
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
FANUS ANNABELLE S.
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
10/16/2003 I 08/11/1924
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
1. Original Return ~ 247! Supplemental Return
4. Limited Estate . Future Interest Compromise (date of death after 1Z- 1Z-8Z)
6. Decedent Died Testate Decedent Maintained a Living Trust
(Attach copy of Will) (Attach copy of Trust)
[] S. Litigation Proceeds Received I I 10. spousaiPoverty
Credit
(date of death between 1Z-31-91 and 1-1-95)
NAME
Ralph H. WRIGHT, Jr.
FIRM NAME (If Applicable)
Johnson, Duffle, Stewart & Weidner
TELEPHONE NUMBER
717/761-4540
1. Real Estate (Schedule A) (1)
OFFICIAL USE ONLY
FILE NUMBER
2003-009/,3
COUNTYCODE YEAR NUMBER
SOCIAL SECURITY NUMBER
201-16-5397
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
i (date of,cl~ea.t~h ~,
3. Remainder Return priorto ~-~-o~
5. Federal EstateTax Return Required
i 8. Total Number of Safe Deposit Boxes
[~] Election to tax under Sec. 13(A)
1
1.
91
(Attach Sch O)
;OMPLETE MAILING ADDRESS
P. O. Box 109
301 Market Street
Lemoyne, PA 17043-0109
45,000; - OFFICIALUSEONLY
C
0
M
T
I
0
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11 )
13.
14.
238.44
None
None
6,721.89
None
None
11,152.05
9,932.05
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made/Schedule J)
Net Value Subject to Tax/Line 12 minus Line 131
(8) 51,960.33
(11) 21,084.10
(12) 30,876.23
(13)
(14) 30,876.23
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
30,876.23
X .0 0
X .0 45
X .12
X .15
(15) 0.00
(16) 1,389.43
(17) 0.00
(18) 0.00
(19) 1,389.43
Copyright (c) ZOO0 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev.
Decedent's Complete Address:
STREET ADDRESS
139 Bosler Avenue
CITY
Lemo.~nne
STATE
PA
ZIP
17043
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
¢. Discount
(1)
69.47
Total Credits ( A + B + C ) (2)
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 Pa§e 1 Line :~0 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB)
1,389.43
69.47
0.00
0.00
1,319.96
0.00
1,319.96
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 No
a. retain the use or income of the property transferred; ......................... [~J ~X]
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. 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
which
contains
a beneficiary designation? ................................ I' []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct and com~blete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAT,URE~'F PERSON RESPONSIBLE FOR FILING RETURN Kevin EDDY DATE
~~ ~.~ 311 Walton Street
-- ............................
SIGNATUREJD~-'1~REPARER~HEJ~THAN REPRESENTATIVE Johnson, Duffle, Stewart & Weidner ~rE
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
survivin9 spouse is 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (ii)]. The statute does not 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 beneficial.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(a)(1 )].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A siblin9 is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) 2000 form software only The Lackner Group, Jnc, Form REV- 1~00 E~ (Rev. 6
REV- 15~92 EX + (1 -~7)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ANNABgT.Lg S. FANUS SS#
201-16-5397
SCHEDULE A
REAL ESTATE
10/16/2003
FILE NUMBER
2003-00943
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable
knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F,
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1 Residence located at 139 Bosler Avenue, Lemoyne, Cumberland
County, PA. Recorded in the Cumberland County Recorder of Deeds
Office in Deed Book V-16, Page 54. property sold on December
29, 2003. Settlement Sheet from such sale is attached hereto.
TOTAL (Also enter on line 1, Recapitulation) $ 45 , 000. O0
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-150;) EX (Rev. ~-97)
45,000.00
' / SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS
INHERITANCE TAX RETU
' , R R. & BONDS
ESTATE OF
FILE NUMBER
^NN^BELLF. $. F^NUS $S~/ 201-16-5397 10/16____/2003 2003-00943
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE
i 2 $25.00 United States Series E Savings Bonds. Savings OF DEATH
Bond Calculator for value at Date of Death is attached. 238.44
TOTAL (Also enter on line 2, Recapitulation)
(if more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
238.44
Form REV-1503 EX (Rev. 1-97)
' ' / SCHEDULE E
CO~Mo"WE^LTHO~pE..S~Lv^.~^ CASH, BANK DEPOSITS & M
2003-009z, 3
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the ricjht of
survivorship must be disclosed on Schedule F. - ....
ITEM
NUMB
DESCRIPTION VALUE AT DATE
i Reimbursement to F:state for taxes paid. - Property sold on OFDEATH
12/29/2003. See Settlement Sheet attached 3.55.02
2 Comcast Cable Television _ Refund on Account
3 Holy Spirit Hospital 3.80
135.34
4 ?NC Bank Priorty 50 Plus Account No. 51-4001-9419
2,300.00
5 Waypoint Bank Passbook Statement Account No. 700114370
3,317.73
6 Miscellaneous Household Items Sold
100.00
7 Proceeds from the sale of certain small kitchen applicances
8 20.00
Zeigler Auction Company, LTD - Proceeds from sale of Decedent's
Personal Property. Attached hereto is a copy of the sales sheets '
dated 11/26/2003. 266 00
9 Zeigler Auction Company, LTD - Proceeds from the sale of
Decedent's personal property. Attached hereto is a copy of the
sale sheet dated 12/25/2003. 324.00
(If more Space is needed, TOTAL {Also enter on line 5, Recapitulationl
Copyright (c) 1996 form software only CPSystems, Inc.
insert additional sheets of the same size)
721.89
Form REV-1506 EX (R.v. ~-97)
REV- 1511 EX + (1
' ~ou~Nw.^Lm o..E .... / SCHEDULE H
ANNABELLE S. FA~S SS// 201-16-5397 10/16/2003
Debt~ of decedent must be repo~ on Schedule 2003 - 00943
ITEM ~ I.
NUMBER
A.
~ DESCRIPTION
Rolling Green Cemetery _ Cemetery Plot
Stone & Murray Funeral Home
.-~_~.AMOUNT
22Z.00
5,688.00
2
3
4
5
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Kevin EDDY
Social Security Number(s) / EIN Num~
Street 3_11 Ralton Street
Address
City Lemo e
State?__~ ~
Year(s) Commission Paid:
Attorney's Fees
Johnson, Duffle, Stew .
Family Exemption:/If decedent's address is not t~-- - art & ~/e~dner
Claimant -~ same as claimant's, attach explanation)
Street Addres~
City
Relationship of Claimant to Decedent State.___._____ Zip
Probate Fees Register of Wills
Accountant's Fees
Tax Return Preparer's Fees
OtherAdministrativeCosts
Cumberland County Register of ~ilis Office _ Filing Fee for
Inventory ($16.00) & Inhertiance Tax Return ($15.00)
Reserve for Estate Ad~ninsitration Costs
The Cumberland Law Journal Notice of Estate Administration
The Patriot News _ NOtice of Estate Administration
geigler Auction Company, LTD _ Commission taken
Decedent,s personal property
(12/26/2003 on sale of
= 43.37 & 12/15/2003 = 83.43)
2,500.00
l, 902.70
234.00
31.00
250.00
75.00
123.55
126.80
Copyright (c) 1996 form software only CPSysterns, nc. insert additional sheets of the same sizel
(If more space s needed,
52.05
REV- 15,12 EX + (1-97)
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER"-
ANNABELLE S. FAN-OS SS~/ 201-16-5397 10/16/2003 2003-00943
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Bankcard Services Account No. 5490 9990 1760 6012
Bon Ton Credit Card Services Account No. 053292942
Borough of Lemoyne - Sewer/Trash Payment
Borough of Lemoyne - Final Sewer/Trash Payment
Comcast Cable Television
Faith A. Nicola, Tax Collector
Faith A. Nicola, Tax Collector
Per Capita Taxes
Real Estate Taxes
Internists of Central PA Account No. 22586
Pennsylvania American Water Co.
Pennsylvania Power and Light
PNC Bank Priorty 50 Plus Account No. 51-4001-9419 check
clearing after date of death
Quantum Imaging & Therapeutic Account No. 169266A93
Residence located at 139 Bosler Avenue, Lemoyne, Cumberland
County, PA. Recorded in the Cumberland COunty Recorder of Deeds
Office in Deed Book V-16, Page 54. Settlement Charges. See
attached Settlement Sheet
Smith Radiology Account No. 064104-00
The Westfield Group
The Westfield Group
UGI Gas Company
Verizon Telephone Bill
Homeowner's Insurance
3,027 31
87 76
53 87
94 00
12 75
11 00
770 14
9 76
72 51
79 46
59 82
29.92
5,013.14
6.54
56.75
20.00
513.16
14.16
TOTAL (Also enter on line 10, Recapitulation) $ 9,932.05
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
REV- 15,1:' EX + (1-~7)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ANNABELLE S. FANUS SS~ 201-16-5397 10/16/2003 2003-00943
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Bankcard Services Account No. 5490 9990 1760 6012
Bon Ton Credit Card Services Account No. 053292942
Borough of Lemoyne Sewer/Trash Payment
Borough of Lemoyne Final Sewer/Trash Payment
Comcast Cable Television
Faith A. Nicola, Tax Collector - Per Capita Taxes
Faith A. Nicola, Tax Collector - Real Estate Taxes
Internists of Central PA Account No. 22586
Pennsylvania American Water Co.
Pennsylvania Power and Light
PNC Bank Priorty 50 Plus Account No. 51-4001-9419 check
clearing after date of death
Quantum Imaging & Therapeutic Account No. 169266A93
Residence located at 139 Bosler Avenue, Lemoyne, Cumberland
County, PA. Recorded in the Cumberland COunty Recorder of Deeds
Office in Deed Book V-16, Page 54. Settlement Charges. See
attached Settlement Sheet
Smith Radiology Account No. 064104-00
The Westfield Group - Homeowner's Insurance
The Westfield Group
UGI Gas Company
Verizon Telephone Bill
3,027.31
87.76
53.87
94.00
12.75
11.00
770.14
9.76
72.51
79.46
59.82
29.92
5,013.14
6.54
56.75
20.00
513.]6
14.16
TOTAL (Also enter on line 10, Recapitulation) $ 9,932.05
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev ~ - 97)
REV-1513 EX + (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ANNABELLE S. FANUS SS# 201-16-5397 10/16/2003 2003-00943
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
2
II.
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116(aX1.z)]
Vicki A. Eddy
311 Walton Street
Lemoyne, PA 17043
Paul K. Kirk
1011 Harvest Moon Drive
Seffner, FL 33584
Copyright (c) 2000 form software only The Lackner Group, Inc.
Daughter
S on
1/2 of Estate
1/2 of Estate
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 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
(If more space is needed, insert additional sheets of the same size)
Form REV-1513 EX ~R~v. 9-00)
LISTING OF EXHIBITS FOR
ESTATE OF ANNABELLE S. FANUS
EXHIBIT A
EXHIBIT B
EXHIBIT C
EXHIBIT D
EXHIBIT E
Last Will and Testament of Annabelle S. Fanus signed
and dated on March Iith, 2002.
Settlement Sheet for Sale of Residence located at 139
Bosler Avenue, Borough of Lemoyne, Cumberland
County, Penna. Sale of property took place on December
29,2003.
Savings Bond Calculator valuing 2 U.S. Savings Bonds for
the month of October.
Consignment Sheet for the sale of Decedent's personal
property at Zeigler Auction Co. on November 26, 2003.
Consignment Sheet for the sale of Decedent's personal
property at Zeigler Auction Co. on December 15, 2003.
EXHIBIT A
· ast ill anh starnCnt
OF
ANNABELLE S. FANUS
I, ANNABELLE S. FANUS, of the Borough of Lemoyne, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make,
publish and declare this as and for my Last Will and Testament, hereby revoking and making void
any and all Wills or Codicils at any time heretofore made by me.
ARTICLE I
DEBTS AND EXPENSES
I direct the payment of all my legal debts, and the expenses of my last illness and fimeral
fi.om my Estate as soon after my death as conveniently may be done. I direct that all taxes that
may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction
imposed, shall be paid fi.om my residuary estate as part of the expenses of the administration of my
estate.
ARTICLE II
PERSONAL PROPERTY
I give and bequeath my motor vehicle(s), household and personal effects and other tangible
personalty of like nature (not including cash or securities), together with any existing insurance
thereon, unto my son, PAUL K. KIRK, and my daughter, VICKI A. EDDY, to be divided among
them by my Personal Representative with due regard for their personal preferences in as 'nearly
equal shares as practicable. In the event that my son, PAUL IC KIRK, is not living on the thirty-
first (31st) day following my death, I give and bequeath his share to his then-living issue, per
stirpes. In the event that my daughter, VICKI A. EDDY, is not living on the thirty-first (3 l~t) day
following my death, I give and bequeath her share as follows: one-half (1/2) to my son, PAUL K.
KIRK, or his then-living issue per stirpes, and one-half (1/2) to my son-in-law, KEVIN M.
EDDY. In the event that my son~in-law, KEVIN M. EDDY, is not living on the thirty-first (31
day following my death, his share shall be added to the share of my son, PAUL K. KIRK. Any
such item allotted to a minor, may as my Personal Representative thinks advisable, either be
delivered to the minor or any person to hold for the minor, or be sold and the proceeds paid, in the
discretion of my Personal Representative, either directly to the minor or to the Custodian as
provided in Article IV hereof. If there shall be disagreement as to the disposition of any item or
items described in this Article, I direct that the same shall be disposed of as follows: The name of
each beneficiary of this Article II who wishes to participate in a lottery for such purpose shall be
written on a two inch by two inch square of paper, with the name of each person entitled to a half
share being written on two such squares of paper and the name of each such person entitled to a
one-fourth share being written on one such piece of paper. Each square of paper shall then be
folded into quarters, such that no writing shall be visible and shall be placed a container. Said
container shall be covered and shaken. A disinterested party shall then draw one piece of paper
from the container, and the person whose name appears on the paper shall be the person to whom
the item shall be distributed. ~The process will be repeated for each item as to which there is
disagreement.
ARTICLE III
REST, RESIDUE AND REMAINDER
I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever
nature and wheresoever situate, in equal shares unto my son, PAUL K. KIRK, and my daughter,
VICKI A. EDDY. In the event that my son, PAUL K. KIRK, is not living on the thirty-first
(31 st) day following my death, I give, devise and bequeath his share unto his then-living issue, per
stirpes. If my daughter, VICKI A. EDDY, is not living on the thirty-first (31 ~t) day following my
death, I give, devise and bequeath her share as follows: one-half (1/2) to my son, PAUL K.
KIRK, or his then living issue, per stirpes, and one-half (1/2) to my son-in-law, KEVIN M.
EDDY. In the event that my son-in-law, KEVIN M. EDDY, is not living on the thirty-first (31st)
day following my death, his share shall be added to the share of my son, PAUL K. KIRK.
ARTICLE IV
UNIFORM TRANSFERS TO MINORS ACT
In the event that any beneficiary of my Will shall not have reached the age of twenty-one
(21) years at the time for distribution of his or her share, distribution of said share may be made in
the discretion of my Personal Representative after considering the age and needs of the beneficiary,
either directly to the beneficiary or to a Custodian under the Pennsylvania Uniform Transfers to
Minors Act, 20 Pa. C.S.A § 5301 et seq., or the applicable Uniform Gifts to Minors Act or
Uniform Transfers to Minors Act in the state of residence of such beneficiary as the case may be.
My Personal Representative may designate as such Custodian any institution or person, including
my Personal Representative, qualified to act as a Custodian for such beneficiary under such Act in
effect at the time such distribution is made. A receipt for any payment or distribution so made
shall be a full discharge therefor to my Personal Representative, who shall not be responsible to see
to, or be liable for, the application of such proceeds thereafter.
ARTICLE V
APPOINTMENT OF PERSONAL REPRESENTATIVE
I name, constitute and appoint my son-in-law, KEVIN M. EDDY, Executor of this my
Last Will and Testament. Should my son-in-law, KEVIN M. EDDY, fail to qualify or cease to so
act, I name, constitute and appoint my daughter, VICKI A. EDDY, alternate Executrix to
complete the administration of my Estate. I direct that no fiduciary appointed herein shall be
required to post bond for the faithful administration of the duties required in any jurisdiction.
IN Vv'ITNESS WHEREOF, I have__hereunto set my hand and seal to this, my Last Will
and Testament, this //'~ay of 'q6'k~ , 2002.
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last
Will and Testament, in the presence of us, who at her request, in her presence and in the presence
of each other, have hereunto subscribed our names as witnesses.
4
AFFIDAVIT AND ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA ·
· SS
COUNTY OF CUMBERLAND ·
_J/~dFt[ ~g 1/~ ,J~ ~/'£ , the Testatrix and the witnesses,-- respectively, whose
and
names are si~ned to the attached or foregoing instrument, being first duly sworn, do hereby declare
to the undersigned authority that the Testatrix si~oned and executed the instrument as her Last Will
and that she had signed willingly and that she executed it as her free and voluntary act for the
proposes therein expressed, and that each of the witnesses, in the presence and heating of the
Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at
that time eighteen years of age or older, of sound mind and under no constraint or undue influence.
ANNABELLE S. FANUS
wi't ss d
2002.
Subscribed,
swom to and acknowledged befo¢ me by AN1SABELLE $. FANUS,
and sworn to before me by ff_~ ~ ~ /4///~/yf/kCj ..~ and
, witnesses, this /'/.,,~t d~y'of .~)~a. JL~J/~ ,
:155545
ot~,~ Public
Notarial Seal
KJlstee K. Myers, Notary Public
Lemoyne Bom, Cumberland County
My Commission Expires Dec. 2, 2002
Member, Pennsylvania Association ot Notmles
EXHIBIT B
U. S.~'~-~RTM~F HOUSING and~LOPMENT
SE'rrLEMENT STATEMENT
--ASSURED LAND TRANSFERS, INC.
301 Market Street
PO Box 109
Lemoyne, PA 17043-0109
(7173 761-4720
~502-0265
Titlepro for Windows'm
B. TYI-'~ OF LOAN
-~ 1. FHA [] 2. FMHA [] 3. CONV.UNINS.
~ 4. VA [] 5. CONV. INS.
~. FILE NUMBER: 17. LOAN NUMBER:
136869
MORT. INS. CASE NO.:
13161-7
NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by ti',,, settlement agent are shown.
Items marked "(p.o.c.)" were paid outside the closing; they are shown here for information purposes and are not included in the totals.
~ORROWER: ~F SELLER: ~DRESS OF LENDER
Kevin M. Eddy, Executor ~GA~H
!lena Huiu of the Will of Annabelle S. Fanus
1/2 West Main Street
;hiremanstown, PA 17011
JL SE'I-rLEMENT DATE:
i. PROPERTY-~CATION: ~NT AGENT: Assured Land Transfers, inc. IDec 29 2003
39 Bosler Avenue 1Monday
emoyne, PA 17043
emoyne Borough
;umberland County, PA
J. SUMMARY OF BORROWER'S TRANSACTION
30. Gross Amount Due From Borrower
31, Contract sales price
PLACE OF SETTLEMENT: 301 Market Street
Lemoyne, Pa 17043
(. SUMMARY OF ~=~ I FR'S TRANSACTION
400. GrOss Amount Due to Seller
401. Contract sales price
-- 402. PemonaiProperty
32. Personal Property
33. Settlement Charges (line 14003
35.
Adjustments for items paid in advance by seller(s)
36. City/Town tax
]7. County/City tax 12/29103 to 12/31103
38. Assessments
39. School Tax 12/29/03 to 06/30/04
t0. Refuse 12/29103 to 12/31103
11.
12.
~_0. Gross Amount Due from Borrower
403.
405.
Adjustments for items pak~ tn advance by seller(s)
406. City/Town tax .
407. County/Citytax 12/29103 to 12131103
-- 408. Assessments
46,507.27
409. School Tax 12/29/03 to 06/30104
410. Refuse12/29103 to 12/31/03
411.
412.
420. Gross Amount Due to Seller
]6. Amounts Paid By Or In Behalf Of Borrower
31. Deposit or earnest money
32. Principal Amount of new loan(s)
33. Existing loan(s) taken subject to
34.
]5.
]6.
)7.
38.
)9
Adjustments for items unpaid by seller
10. City/l'own tax
I1. County/City tax
12. Assessments
13 School Tax
14.
15.
17.
18.
.~0. Total Paid By/For Borrower
1,000.00
1,000.00
)0. CASH AT SETTLEMENT Fromr[o BORROWER
31. Gross Amt. due from borrower (line 1203
)2. Less Amt. paid by/for borrower (line 220)
)3. Cash [] FROM [] TO Borrower
-- 500. Re~-ctions In Amount Due To Seller
501. Ex¢~ deposit (see instructions)
502. Settlement charges to seller (line 14003
503. Existing loan(s) taken subject to
-- 504. Payoff of First Mortgage Loan
~05. Payoff of Second Mortgage Loan
-- ~o6.
507.
508.
509.
Adjustments for items unpaid by seller
510. City/Town tax
511. County/City tax
512. Assessments
513. School Tax
514.
515.
516.
517.
518,
519.
520. Total Reduction Amount Due Seller
5,013.14
600. CASH AT SETTLEMENT To/From SELLER
6~01. Gross Amount due Seller (line 420)
1,000.00 ~02~ Less reduction in Amt.due Seller (line 520)
45,507.27 603. Cash[] TO [] FROM Seller
5,o13.14
5,013.14
tuyer or Borrower's Signature Seller's Signature
~IT CHARGES
00. Total Sales Commission based on Price: $
~~a at: ~-- 3,500.00 Total
~ 1,750.00
~ 1,750.00
03. Commission paid at Settlement --
~onnectlon With Loan --
801. Loan Origination Fee
802. Loan Discou---"::':--'-'-------~nl
to
to
to
~ Required By Lender To Be Paid In Advance
-- from
902. Modgage Ins. Premium 0 Months to
903. Hazard ins. Premium --
~'~i ~ 0 Years to
0 Years to
~epostted With Lender For
1004. County Taxes
005. Assessments
~es
101. Settlement or closing fee
~on
~e Binder
~aration
107. Attorney's fees
(includes above items No.:)
items No.:)
~verage $
1110. Owner"~s coverage $
0 Months ~ $ /Month
0 Months @ $ /~Monih
0 Months @ $ /Month
0 Months ~ $ IMonth
0 Months @ $ /Month
0 Months @ $ /Month
0 Months @ $ /Month
0 Months @ $ -- /Mont~-~
45,000.00
CenturY- Piscioneri
~ye alt y Executives
/Day
Johnson, Duffle, et al
Assured Land Transfers, Inc.
200. Government Recording and Transfer Charges
~s: Deed $ 38.50 Mortgage $ --Re
1202. City/County tax/stamps '. r, ......... ' ~- ' Lea-- $
~~ Fee to Recorder of Deeds
~nt Charges __ Centu~
~es to
~ ~oo Escrow
~ Johnson, Duffle, et al
303. Sewer from 04/07/2003 thru 12/29/2003 to -'"'-~Escrow
~, Nov., and December to
~ to Escrow
Real~Y~s --
~ttlement Charges (enler on lines 103 & 502., Sections J & K)
1,152.25
Parties agree Ihal no liabilily is assumed by Seffiement Agent for the accuracy of information furnished by others as shown on the HUD-1 Settlement Statemenl
IJlave carefully reviewed the ~UD 1 Settlement Sta HUD CERTIFICATION OF BUYERS AND SELLERS
e~'~bu ~ements made on m ~ - lament and lo the best of my knowled · · ·
,._;.?l/rS ~ ~ Y I~:cpunt by me in this transact on Ifudherce,~-.,~-, L gea/.dbe ef it ls a true and accuraie st
,'/1' I~ { .~ , ~" /- / P~ · ,,.,yL.,~ nave received a co-,.~*, u ..... atementofal receipts and
' I,~ ' ' / / ~; ~-,ne.,H~L~-~ ~ettlement Sla ement
Buyers Address & Phone' Seller's Signatu;e f/~' 7'~'~ ~-~/-~--~/f-'~,~/~,/,41,/~z~L~ ~, ~ ~-
The HUD-1 Settlement Statement which I have prepared is a true and accurate accounl of Ibis transaction
.~....~/ / ~ //'-~ I have caused or will cause the funds'to be disbursed in accordance With this
Settle~e // Dale
EXHIBIT C
EXHIBIT D
Savings Bond Calculator Page 1 of 1
Series Denomination Serial Number Issue Date
E Bonds $ 25
# Bonds Total Price
2 $37.5O
Serial Number Issue Date Series Denom
Q6198060521E 08/!977 E $25
Q6185458472E 06/1977 E 25
Total Interest Total Value
$200.94 $238.44
Issue Interest
Price Interest Value Rate
$18.75 $100.46 $119.21 4.00%
18.75 100.48 119.23 4.00%
YTD ln~
$6.9
Next Final
Accrual Maturit3
02/2004 08/200~
12/2003 06/200~
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
Please rate this service.
(Please print and/or save this page before submitting your survey)
Service Excellent Good Fair Poor
Savings Bond Calculator '~", :"'~-.~ '"'" ~ii
t Submit Survey ]lReset,i
· http ://wwws.publicdebt.treas.gov/B C/SBCPrice 12/17/03
EXHIBIT D
ZIEGLER AUCTION COMPANY~ LTD.
1550 SAND HILL RD.
HUMMELSTOWN, PA 17036
717.533.426'7 zieglerauction, com
CONSIGNOR SIATEMENI - -
P~IGE )
CONSIGNOR NU~IBE~: 9215
HAME
~EU)N EDDY
311 ~I_T~ST
LEMOY~? PA [7043
7~TZZ%G922
P-ROB ITM iNU UNIT TOTAL CtBttIiSStON SELLE)t'~ S
UJOE NO, - ...... ITEM LEE~RIPTION ....... NO. QTY PRICE PRICE ~O~IT NET AMOUNT BIDDER
(Mi 1~ CHOICE OF STEIN I 37,58 37.58 25~ 9,38 28,12 2.53
Ri 103 ~)QICE DF STEIN I 12,58 12,50 ~% 3.13 9.37
~1 1~ CU~OO CLOC~ 1 ~.88 ~8.~8 ~5~ 5. B~ 15,~
RI 105 ~]ICE ~ STEIN I 12.58 12,50 25~ 3.13 9,37
R1 1~6 ~ICE ~ STEIN 1 3.~0 3,~ 35% 1.05 t.95
RI 249 FRAUD PRINT 1 7.50 7, 50 35% 2, 63 4, 87 380
R2 2~85 CHOICE ~ BOX OR IT~ 2 20.~8 40,0~ 25% t8,00 30,~0 387
~ E886 CHOICE DF BOX OR ITEM 1 1~,88 i~,88 ~5~ 3,58 1~.58
~ ~7 CHOICE ~ BOX DR ITE~ 1 11,~ 11,~ ~5~ 2,75 8,~5 299
[~ ~88 ~tt~ ~ BOX OR ITE~ 1 5,88 5. b~ 35~ L 75 ~, ~5
~ ~89 ~ALKER, LI~T,C~.EMAN LI~T 1 3.~8 3,88 35~ 1,~5 1,95
CHRISTMAS C~DLE
TOTAL BRL16'S SALE ANOUNT 166,88
ACTUAL SALES TOTAL 16G~88
LESS ~MMISSION 4~37
COMPLE1ED;
YES NO
'TOT~_ NET PROCEEDS 182.63
TOTAL ITEMS: 11
TOTAL DUE TO SELLER 12~.G3
NOTE : TH~4K Y(.)] FO~l YOUR BUSI)(ESS
EXHIBIT E
ZIEOLER AUCTION COMPANY, LTD.
1550 SAND HILL RD.
HUMMELSTOWN, PA 17036
717~533.4267 zieglerauctien, com
- - CONSIG~OR STATEMENT - -
P~E 1
CONGI~R
NOME
~!{. W~TUN ST
LEM~YNE~ ~ 17043
AUC{'ION ~.EDNBER: ~31210
7)777~692R
PRUD IIM INU UNIT T(]T~_ COMMISSION SELLER~ S
CODE NO, - ......... HEM DESCRIPTION ...... NO. QTY PRICE PRICE AMOUNT NET AMOUNT BIDDER
Rt 126 OX)ICE OF BREYERS HORSE 3 1P_.5~) 37,5~) 25)I 9.39 20,11 381
Ri 1~7 2 PUPPlTS 1 17.5~ 17.5~ ~51( 4,38 1,3,12 1t
Ri t28 MARX DIND, ST~{ ~ICKER 1 3~.8~ 3~,~ 25% 7.~ 2~.~ 3~1
RI 1~9 TEEPEE BANK 1 1).~0 1~,~ ~%
~l 13~ S~tT~ RIDING ~EINDEER L~ I tS,~ 15.88 25~ 3.75 11.25 368
R1 {31 ~TORK ~tQ ROSES C~,S~lfl t 3.~ 3.~B ~Z
~TIC D~L, REINDEER ~LES
~]. 13~ ~tND-tP MI~KEY PLAYING D~ i 5,~ 5,~g 35Z t,~ 3,25 368
PI { 33 iA~GE COlM CHANGER, CALEND~R t 1% 5~ 17, 58 25Z
~{ 13~ M{NlflTU~E PflINTED GREEN BENCH 1 28,~ ~8, B8 25Z 5,~
R{ 135 OI.OBASTER VASE ~ .88 .88 0% .~8 ,0~ HOBID
RJ :~13 t.~4 C}tqlR/U~LE 5AM 1 2.~ 2.8~ 35~
~ 3~6~ CHOICE IF BOXES fiN9 I~MS 1 7~.89 78.80 ~5~ 17,5~ 5~,5~
MILiTaRY ITEMS
~3 3~63 ['HDICE ~ BOXES fiND ITEMS { 78,88 7B,~8 25g '17,58 52,5~
IOYS
~? ~'78 CHOICE OF ~]XES I ~2.~ ~E. 50 ~5~
D~_L S, TOYS
R3 3871 3 BOXES 1 2.~ 2,~ 35% ~78 1~ 389
R3 3~73 BO~ES, CIIEMISTRY SET, SEWING I 2.8~ E~8 35Z ,7'~ 1,3~ 336
TOTAL G~OSS GALE ~MDUNT 324, 0(~
ACTUAL SALES TOTAL ~, ~
LESS CD.~ISSION B3. 43
TOTAL NET PROCEEDS E{48.57
TOTAL IIEMS: 17
TOTAl. DUE TO S~.LER ~,l~, 57
NOIE '~ I!~,Y~,)K YOtJ FOR YOUR BUSINESS
Register of Wills of
CUMBERLAND
INVENTORY
County, Pennsylvania
Estate of ANNABELLE S. FANUS
also known as
, Deceased
No. 2003-00943
Date of Death 10/16/2003
Social Security No. 20]_- 16- 5397
Kevin EDDY,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I/We verify that the statements made in this inventory are true and correct, lANe understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney: Ralph H. WRIGHT, Jr.
LD. No.: 56113
Address: P. O. Box 109
Lemoyne, PA 17043-0109
Telephone: 717/761-4540
Personal Representa~
/
Signature:
Address:
Telephone:
Dated:
311 Walton Street
Lemoyne, PA 17043
717/737-3111
Description
(See continuation page(s) attached)
(Attach additional sheets if necessary)
Value
Total: 51,960.33
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may. at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc Form #RW-7 (1992)
Estate of:
Date of Death:
County:
INVENTORY
ANNABELLE S. FANUS
10/16/2003
Cumberland
CASH:
Comcast Cable Television
Refund on Account
Holy Spirit Hospital
PNC Bank Priorty 50 Plus
Account No. 51-4001-9419
Reimbursement to Estate for
taxes paid. Property sold
on 12/29/2003. See
Settlement Sheet attached
Waypoint Bank Passbook
Statement Account No.
700114370
PERSONAL PROPERTY:
Miscellaneous Household Items
Sold
Proceeds from the sale of
certain small kitchen
applicances
Zeigler Auction Company, LTD
Proceeds from sale of
Decedent's Personal
Property. Attached hereto
is a copy of the sales
sheets dated 11/26/2003.
3.80
135.34
2,300.00
355.02
3,317.73
100.00
20.00
166.00
6,111.89
Zeigler Auction Company, LTD
Proceeds from the sale of
Decedent's personal
property. Attached hereto
is a copy of th~ sale sheet
dated 12/25/2003.
324.00
BONDS:
2 $25.00 United States Series
E Savings Bonds. Savings
Bond Calculator for value at
Date of Death is attached.
238.44
REAL EsTATE/PA:
Residence located at 139
Bosler Avenue, Lemoyne,
Cumberland County, PA.
Recorded in the Cumberland
County Recorder of Deeds
Office in Deed Book V-16,
Page 54.
45,000.00
TOTAL RECEIPTS OF PRINCIPAL ...............
610.00
238.44
45,000.00
51,960.33
-2-
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
ANNABELLE S. FANUS
Date of Death:
Will No.
October 16, 2003
2003-0943
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rule, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the Estate is complete:
Yes X No
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No X
b. The separate Orphans' Court No. (if any) for the personal
representative's Account is:
c. Did the personal representative state an account informally to the
parties of interest? Yes X No
d. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans' Court and may be attached
to this report.
Date: June 23, 2004
RALPH W. WRIGHT, JR.
JOHNSON, DUFFLE, STEWART & WEIDNER
301 Market Street
P.O. Box 109
Lemoyne, PA 17043
(717) 761-4540
Capacity: Personal Representative
(x) Counsel for Personal
Representative
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DZVTSTnN
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
RALPH H WRIGHT JR
JOHNSON ETAL
PO BOX 109
LEMOYNE
CONNONNEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF /NHERZTANCE TAX
APPRAZSENENT, ALLONANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
R~c~. ;~! ~:, L ;;~! DATE
~,~i!~ ~; ~iS ESTATE OF
DATE OF DEATH
FILE NUMBER
'Od, ~/~R-5 P3:42c°uNT¥
ACN
05-08-2004
FANUS
10-16-2005
21 05-0945
CUMBERLAND
101
REV-15¢7 EX AFP (01-05)
ANNABELLE S
Aaoun~ Reai~ed I
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF NILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THZS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX
ESTATE OF FANUS ANNABELLE S FILE NO. Z! 05-0943 ACN 101 DATE 05-08-Z00~
TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERS;
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~e (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
$. Closely Held S~ock/Par~narship Zn~eres~ (Schedule C) (3)
q. Nora:gages/No,es Receivable (Schedule D) (4)
E. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) ($)
6. Jointly Owned Propar~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,al Asso~s
APPROVED DEDUCTIONS AND EXENPTZONS:
9. Funoral Exponsos/Ada. Cos:ks/Nisc. Expensos (Schodulo H) (9)
10. Dob~s/Nor~gage Liabilities/Lions (Schodulo T) (10)
11. To,aZ Doduc~ions
12. Ne~ Value of Tax Re~urn
45~000.00
258.44
.o0
.00
6~721.89
.00
.0o
(8)
NOTE: To insure proper
credi~ ~o your account,
subai~ ~ha upper portion
of ~his fora ~i~h your
~ex payaen~.
51,960.$$
11,152.05
9~952.05
(11) 21.08~.10
(12) 30,876.25
15.
14.
NOTE:
Chari~cable/Governaan~al Beques*s; Non-elected 9115 Trusts (Schedule J) (15) . O0
Ne~ Value of Es~a~a Subjec~ *o Tax (14) $0,876.25
~f an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~ill
ASSESSMENT OF TAX:
15. Aaoun~ of Line 1~ a~ Spousal ra~e (15)
16. Aaoun~ of Line 14 ~axable a~ Lineal/Class A ra~e (16)
17. Aeoun~ of Line 14 a~ Sibling ra~e (17)
18. Aaoun~ of Line 14 ~axable a~ Collateral/Class B ra~e (18)
19. Principal Tax Due
reflect figures that include the total of ALL returns assessed to date.
· O0 X O0 = . O0
30,876.Z$ X 045= 1,~89.45
· O0 X 1Z = . O0
· O0 x 15 = .00
(19)= 1,$89.45
RECEIPT
NUHBER
CD005461
DISCOUNT
INTEREST/PEN PAID (-)
69
ANOUNT PAID
TAX CREDITS:
PAYN~NT
DATE
01-16-2004
1,$19.96
ZF PAID AFTER DATE INDZCATED~ SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT 1,389.45
BALANCE OF TAX DUEI .00
INTEREST AND PEN. I .00
TOTAL DUE I .00
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. (~//~'
I'F TOTAL DUE 1'S REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR ZNSTRUCT'rONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYHENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decadent after the expiration of any estate for
life or for years, the Cammonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future Interest.
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (7Z P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF NILLS, AGENT
A refund of a tax cradlt, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at the Office
of the Register of Nills, any of the Z5 Revenue District Offices, er by calling the special Z4-hour
answering service for forms ordering: 1-800-56Z-ZO50; services for taxpayers aith special hearing and / or
speaking needs: 1-800-447-50Z0 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must ob~act within sixty (60) days of receipt of
this Notice by:
--mrittan protest to the PA Department of Revenue, Board of Appeals, Dept. 2810Z1, Harrisburg, PA 171ZB-10Z1, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. IS0601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation af administratively correctable errors.
If any tax duo is paid within three (5) calendar months after the dacedant's death, a five percent (SI) discount of
the tax paid is alloaed.
The 157. tax amnesty non-participation penalty is computed on the totaI of tho tax and interest assessed, and not
paid before January lB, 1996, the first day after the end of tho tax amnesty period. This non-participation
penalty is appealable in tho same manner and in tho the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1} day from tho date of
daath~ to the date of payment. Taxes ahich became delinquent before January l, 198Z bear interest at tho rate of
six (BI) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 19BI mill bear interest at a rate which will vary from calendar year to calendar year aith that rate
announced by the PA Department of Revenue. The applicable interest rates far 19BZ through 2005 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Yea_~.r Rate Factor Yea.~r Rate Factor
198Z ZOZ .000548 1987 9Z .000247 1999 7Z . O0019Z
1985 16Z .000458 1988-1991 112 .000501 2000 82 .000219
1984 Z1Z . 000501 199Z 92 . 000247 ZOO1 9Z . 000Z47
1985 152 .000556 1995-1994 7Z .O0019Z ZOOZ 62 .000164
1986 iOZ .O00Z7q 1995-1998 92 .000Z47 2005 5Z .000157
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELXNgUBNT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (15) days
beyond tho date of the assessment. If payment is made after the interest computation date shown on tho
Notice, additional interest must be caXcuXated.