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HomeMy WebLinkAbout04-0593PETITION FOR PROBATE and GRANT OF LETTERS also known as Deceased. Social Security No. ~ol- i~(00 '~ To: Register of Wi~ for th~A County of c~._ ~x< ~o · Commonwealth of Pennsylvania in the The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut named in the last will of the above decedent, dated ~ / ~//-7a:~ ' ,19. and codicils) dated __ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in t'~~ ~3~t{~, ,0-4xw.~ County, Pennsylvania, with h~ last family or principal reside~'c~ at ~'0% ~5, L0.~t.'{-- ~, (list street, number and muncipalityO De~ ~ yea. rsofage, died. ~(.~_~.~ ,19~Y~4, Except as follows, dec~le~t did r~ot marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (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: WHEREFORE, petitioner(s) respectfully reqpest(s) the l~robate of the last will and codicil(s) presented herewith and the grant of letters *'L~.~,A ~x ~43'-~ , ~..j ' ~&, (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH QF PENNSY~LVANIA _~ COUNTY OF [~_~ ~q~e~a~d , ss 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. before me this l~' ,~ , day of[ I/L _ T..... e is No. DECREE OF PROBATE AND GRANT OF LETTERS AND NOW the reverse side h~eof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated8 described therein be admitted to, p~obate and filed of re,~ord ~ the last will of and Letters ~LL~LA~X~- _ /) are hereby granted to ~LL) v ~//~ , in consideration of the petition on FEES Probate, Letters, Etc .......... $,.~ Short Certificates(3)...' ....... $ Renunciation ................ $ ~Q, TOTAL ~ Filed ...~.L~R .:~.q ............... Register o'f WiIL~ t~ - ~ - ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE RENUNCIATION In re Estate of GERTRUDE F. LINE, Deceased To the Register of Wills of Cumberland County, Pennsylvania: The undersigned, a dUly authorized officer on behalf of Mellon Bank, N.A., corporate successor to The Commonwealth National Bank, named as alternate Executor under the Decedent's Will dated August 8, 1970, hereby renounces its right to administer said Estate and respectfully requests that Letters of Administration c.t.a, be issued to the person or persons entitled thereto. Witness my hand this 3'y/~ day of June, 2004. Attest: MELLON BANK, N.A., By: Vice President Sworn to and su~cribed bef.or, r~me this Of/C] day of ~lvly tzomm~ssio?~exp~res: COMMONWEALTH OF PENNSYLVANIA ~o~ s~l I - Th0resa Oglesby, Notary Public City of__Phil .~Fphia' Philadelphia County My Commission Expires Apr. 7, 2007 Member, Pennsylvania Association of Notaries Register of Wills of C~av-~QwC,~ CountY, Pennsylvania Estate of Gertrude F. Line also known as RENUNCIATION The undersigned, Cheryl L. Line Kunkel, daughter , Deceased of (Relationship) (Capacity) the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters be issued to SamesM. Line WITNESS by her hand this / (~ 7~/~ day of d//./~p, , 2004 RR 1 Box 24, Port Trevorton, PA 17864 (Address) (Signature) (Address) (Signature) Sworn to or affirmed and subscribed before me this ]~ ~ day of_.~.~Z~~, 2004 uy Co~ission E.r.s: ~ -o~ ¢-'~ (Signature a~ ~at ~ Nola~ or other ~fi~at q~llfl~ to ad~nlster ~ths. Show date of expiration of Nota~'s commission.) (Address) , N~ ~a ' J. ~ Sa~e ~l~, N~ hblic l ~P ~1 Bom, C~md ~un~ , My Co~ission E~ims M~. 29, 2~8J J NOTE: Renunciations executed outside the Office of Register of Wills in some counties are required to be notarized. Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form #RW-4 (1991) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS Henry L. Stuart, a subscribing witness to the codicil/will presented herewith, being duly qualified according to law, deposes and says that was present and saw Gertrude L. Line, the Testatrix, sign the same and that he signed as a witness at the request of Testatrix in her presence. Henry L. ~tuaZ~ - .... ~' (Addk e s s ) Sworn to or affirmed and su;b~ribed before me this ~ day of.~i]-~/Le_ , 2004. REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA OATH OF NON-SUBSCRIBING WITNESS James Line, subscriber hereto, being duly qualified according to law, deposes and says that he is familiar with the signature of Gertrude L. Line, Testatrix of the Will presented herewith and that he believes the signature on the Will is in the handwriting of Gertrude L. Line to the best of his knowledge and belief. ine Sworn to or affirmed and subscribed before me this ~ day of ~(~a _,A2004..~ 1- (For the Regi~t~r)~ his. 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 1.0327229 No. tIA¥ 1 4 200 . Date COMMONWEALTH OF PENNSYLVANIA · CEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ; ~rlisle Cumberland 503 South West: St. Carlisle, PA 17013 James M. Line Gertrude F. Line ,. ,. 201- 18 --7003 I" May 13, 2004 Carlisle, PA ..E~ E~o~.~O , ional Medical Center ~,a 8 ("'=*" Widowed ,,. ,. ~ ch,,,,,h,.,,.1 ~nd '~'~" I~1 ,~;~,'~ ~,,,~ Carlisle · _~-"~, 1/4. d ~.- ,~, Ida Gut:shall O{{,, ~y 15, 2~ I,,~sminster C~te~ /,,. ~rlisle, PA 17013 White [] 0 m i, GE~.TIUDE F. LI?I[, OF C~rlisle, Cumberland County, Pennsy!- vaaia, being o.f sound mind, memorysnd understanding, do make, publish and declare this as and for my last will. and testament, ' ~-:'v ~.,~._~,~ by me at any ~er~_b~ revoking and making void all former *.~ time heretofore m~de. FIRST. I di~'ect all my just debts and funeral expenses, including all inheritance t~xes, be fully paid and satisfied out of my estate by my Executor hereinafter named as soon as conveniently may be after my decease. SECOnd'S. i give, devise and bequeath all of my estate, real and persopal, to my husband, Ralph !I. Line, to be his absolutely. THIRD. in '~he event that my said husband should predecease me or we s;~_ould both die as a result of a common disaster, then I give, devise and bequeath all of my estate, real and personal, in equal shares, share and share alike, to my daughte~~, Cheryl L. Line, and to my son, James M. Line, or their issue; and if either my said daughter or son or any of their issue shall Be a minor, then I nominate, constitute an:J appoJ, nt The Commonwealth National Bank, of Harrisburg, Pennsylvania, to be their Guardian during their minority. LZSTLY, I nominate, coms~itute snc] appoint my said husband, Ralph H. Line, Executor of ~his my last will an~ testament and in case he should p~'edecesse me, then I nominate, constitute and appoint The Comonweslth National E~nk successor Executor. this I~,[ WITNESS ~{EBEOF, I have hereunto set my hand and seal ~"2~-day of 7~ugust, A.D. 1970 s ~AL) Signed, sealed, published and declared by the above named Testatrix, Gertrude F. Line, as and for hez last ~ill and testament, i~ the presence of us, t~ho, at her request and in he~ presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto. REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will No. 21-04-0593 To thc Register: Gertrude F. Line May 13, 2004 Admin. No. 2004-00593 I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above- captioned estate on July t7 ,2004. Name James M. Line Cheryl L. Kunkel Address 98 Chester Street, Carlisle, PA 17013 RR 1 Box 24, Port Trevorton, PA 17864 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none Date: Capacity: Thomas E. Flower, Esquire SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Personal Representative X Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFINDIVlDUAL TAXES DEPT280601 HARRISBURG, PA 171280601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1 162 EX(11-961 NO. CD 004260 LINE JAMES M 98 CHESTER STREET CARLISLE, PA 17013 ESTATE INFORMATION: SSN: 201 187003 FILE NUMBER: 2104-0593 DECEDENT NAME: LINE GERTRUDE F DATE OF PAYMENT: 08/12/2004 POSTMARK DATE: 08/12/2004 COUNTY: CUMBERLAND DATE OF DEATH: 05/13/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 8675.00 TOTAL AMOUNT PAID: 8675.00 REMARKS: J M LINE SEAL CHECK# 103 INITIALS: VZ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 Z LLI REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Line, Gertrude F. DATE OF BIRTH (MM-DD-YEAR) 12/13/22 DATE OF DEATH (MM-DD-YEAR) 05/13/04 FILE NUMBER 21 _ 04 0593 COUNTY CODE Ytl~R NUMBER 0 z SOCIALSECURITYNUMBER 201-18-7003 THIS RETURN MUST BEFILEDIN DUPECATE WITHTBE REGISTER OF WILLS ~]1. Odgleal Return [~4. Limited Estate ~]6. Decedent Died Testate (A~ach ~p~ of [~9. Utlgatlon Proceeds Received NAME Thomas E. Flower, Esquire FIRM NAME Saidis, Shuff, Flower & Lindsay TELEPHONE NUMBER (717) 737-3405 [~2. Supplemental Return r-~7. Decedent Maintained a Living Trust {A~ac~ ropy of Tr~stl COMPLETE MAILING ADDRESS 2109 Market Street Camp Hill, PA 17011 [~5. Federal Estate Tax Return Required __ 8. Total Number of Safe Deposit Boxes [~11. Election to tax under Sec. 9113(A) (^~ch Sc~ o) 1. Real Estate (Schedule A) (1) 2, Stocks and Bends (Schedule B) (2) 3. Closely Held Ceqmratlen, Partnership or Sole-Propdetorchip (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Properly (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [~ Separate Billing R~uesled 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gm~s Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) Ith 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. Charitable and Gevemmental Bequests/Sec 9113 Trusts fer which an election lo tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) 0.00 0.00 0.00 0.!~~ 15,687.~ 2,497.85 0.00 ' r'.J (8) 18,185.39 12,286.60 69.72 (11) 12,356.32 5,829.07 (12) (14) 5,829.07 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the spousal tax mfe, or transfers ueder Sec. 9116 (a)(1.2) 16. Amount of Une 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Une 14 taxable at collateral rate 19. Tax Due 0.00. x ,0 (15) .... ~,.8_29.07 x .0 45 (16) 0.00 x .12 (17) 0.00 x .15 (18) (19) 0.00 262.31 0.00 0.00 262.31 UJ LU (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 1:3 Decedent's Complete Address: ~ ~ ADDRESS 503 South West Street CITY Carlisle IsTATE PA I zIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 675.00 C. Discount 13.12 262.31 Total Credits ( A + B + C ) (2) 688112 Interest/Penalty if applicable D. Interest E. Penalty Total thtarestJPenalty ( D + E ) (3) 0.00 If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 425.81 5. If Line 1 + Line 3 is greater than Line 2, entar the differenca. This is the TAX DIJE. A. Enter the interest on the tax due. (5) (5A) (5S) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decadent 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 premise 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 decadent OWn an "in trust for' or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Refireement Acoount, annuity, or other non.prebate property which contains a beneficiary designation? ........................................................................................................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF TIlE RETURN. Under penalties of pedu~'/, I declare that I have examined ff~is return, including accompanying schedules and statements, and to the best of my Imowledge and belief, it is true, correct and complete. Declaredon of preparer fiber than the personal repressatative is pased on all information of which preparer has any knowledge. SIGNAT.,,~ OF PERSON RESPONSIBLE FO~ RETURN ADO,,~SS' 98 Chester Street, Carlisle, PA 17013 DATE . SIGNA.T'ORIE OF PREPARER OTHE~H.~ REPRESENTATIVE ~ DATE,.. 2109 Market Street, Camp Hill, PA 17011 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfem to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a)(1.1) (i)]. For dates of death on or after January 1, 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 exemot 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 sullying spouse is the only beneficiary. For dates of deatfl on or after July 1, 2000: The tax rate imposed on the net value of transfem 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 i~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 RS. §9116(a){1)]. The tax rate imposed on the net value of transfers to or for the use of the decedenfis siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gertrude F. Line SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-04-0593 include the proceeds of litigation and the date the proceeds were received by the estate. All property Jothtly-owned with right of survivorship must be disclosed on Schedule F. iTEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2. 3. 4. 5. 6 7. 8. 9. 10. Citizens Bank Account Number 6140-798132 Citizens Bank Account Number 6140-798140 coins, pins and pocket watches - per attached appraisal Donegal Insurance Company - refund of apartment insurance Sprint refund Sentinel refund Comcast Cable refund Elwood Gardens refund/return of security deposit Commonwealth of Pennsylvania - rent rebate United Health Care - AARP refund of medicine allowance 7254.57 7265.95 224.18 116.00 22.63 60.26 2.95 99.00 500.00 142.00 TOTAL (Also enter on line 5, Recapitulation) $ '15,687.54 (If more space is needed, insert additional sheets of the same size) REV~1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gertrude F. Line SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21-04-0593 If an asset was made Joint within one year of the decedent'e date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. James M. Line 98 Chester Street, Carlisle, PA son JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH tTEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SiMiLAR DATE OF DEATH DECD'E VALUE OF NUMBER TENANT ~OINT IDENTIP¢ING NUMeER, ATTACH DEED FOR JOINTLY~tELD REAL ESTATE. VALUE OFASEET INTEREST DECEDENT'E INTEREST 1. A. 6/6/96 Citizens Bank Account Number 6100731413 4995.70 50 2497.8 TOTAL (Also enter on line 6, Recapitulation)$ 2,497.8~ (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gertrude F. Line SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-04-0593 Debts of decedent must be reported on Schedule [. ITEM NUMBER DESCRIPTION AMOUNT 2. 3. 4. 5. 6. 7. 8. FUNERAL EXPENSES: Hoffman-Roth Funeral Home: Funeral services $3590.00 Casket 2950.00 Interment Receptacle 1260.00 Grave opening 1185.00 Clergy Offering 65.00 Death certificates 20.00 Flowers 238.50 Hairdresser 35.00 Less ($100) VA Burial Allowance The Deacons - funeral reception ADMINISTRATIVE COSTS: Personal Representative*s Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Pemonal Representative(s) Street Address City State Zip Year(s) Commission Paid: Atlorney Fees Family Exemption: (if decedent's address is not the same as claimant's, altach explanation) Claimant Street Address City State __.ZIP Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Cumberland Law Journal - estate advertising notice The Sentinal - estate advertising notice Ibis Appraisal Services - appraisal of watches and coins 9243.50 85.90 2,500,00 82.00 157.00 188.20 30.00 12,286.60 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF Gertrude F. Line SCHEDULE I DEBTS OF DECEDENT, MORTGAGE L AB L T ES, & LIENS FILE NUMBER 21-04-0593 include unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Sprint - telephone bill PP&L - utility bill 37.43 32.29 TOTAL (Also enter on line lO, Recapitulation) $ 69.72 (If more space is needed, insert additional sheets of Ihe same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gertrude F. Line SCHEDULE J BENEFICIARIES FILE NUMBER 21-04-0593 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Ti'ustee($) OF ESTATE t TAXABLE DISTRIBUTIONS [include oubight spousal distributions, and transfers under Sec. ti116 (a) (1.2)1 James M. Line 98 Chester Street Carlisle, PA 17013 Cheryl L. Kunkel RR 1 Box 24 Port Tmvorton, PA 17864 son daughter 5O% 5O% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AN D GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of/he same size) LAST WILL AND TESTAMENT I, GERTRUDE F. LINE, OF Carlisle, Cumberland County, Pennsyl- vania, being of sound mind, memory and understanding, do make, publish and declare khis as and for my last will and testament, hereby revoking and making void all former wills by me at any time heretofore made. FIRST. I direct all my just debts and funeral expenses, including all inheritance taxes, be fully paid and satisfied out of my estate by my Executor hereinafter named as soon as conveniently may be after my decease. SECOND. I give, devise and bequeath all of my estate, real and personal, to my husband, Ralph H. Line, to be his absolutely. THIRD. In the event that my said husband should predecease me or we s~ould both die as a result of a common disaster, then I give, devise and bequeath all of my estate, real and personal, in equal shares, share and share alike, to my daughter, Cheryl L. Line, and to my son, James M. Line, or their issue; and if either my said daughter or son or any of their issue shall be a minor, .then I nominate, constitute and appoint The Commonwealth National Bank, of Harrisburg, Pennsylvania, to be their Guardian during their minority. LASTLY, I nominate, constitute and appoint my said husband, Ralph H. Line, Executor of this my last will and testament and in case he should predecease me, then I nominate, constitute and mnnnint The Commonwealth National Bank successor Executor. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ....~ay of August, A.D., 1970. Signed, sealed, published and declared by the above named Testatrix, Gertrude F. Line, as and for her last will and testament, in the presmnce of us, who, at her request and in her presence and in the pcesence of each other, have hereunto subscribed our names as witnesses thereto. CITIZENS BANK Account Number 6140-798132 Account Title GERTRUDE F E LiNE Date Opened 7/6/2001 Account Type Time Deposits Principal Balance as of DOD $7,254.57 Interest from Last Posting to DOD $2.94 Account Balance as of DOD $7,257.51 YTD Interest to DOD $44.85 CITIZENS BANK Account Number 6140-798140 Account Title GERTRUDE F E L1NE Date Opened 7/6/2001 Account Type Time Deposits Principal Balance as of DOD $7,265.95 Interest from Last Posting to DOD $3.46 Account Balance as of DOD $7,269.41 YTD Interest to DOD $56.23 CITIZENS BANK Account Number 6100731413 Account Title GERTRUDE F E LINE Date Opened 6/6/1966 Account Type Checking Principal Balance as of DOD $4,995.70 Interest from Last Posting to DOD $ .00 Account Balance as of DOD $4,995.70 YTD Interest to DOD $7.00 Safety Deposit Box Contents Estate of Gertrude F. Line d.o.d. May 13, 2004 Atty. Tom Flower # Container Description Value 1 Coins. Eighteen Kennedy half dollars. $9.00 2 Coins. Four quarters. $1.00 3 Coins. One 1967 Kennedy half dollar. 40% silver. $0.75 ; ~ox : ; 4 Currency. Five 1976 $2.00 bills. $10.00 5 Coins. Seven Eisenhower dollars. $7.00 6 Coins. Five Kennedy half dollars. $2.50 7 Coins. Two 1966 Kennedy half dollars. 40% silver. $1.50 8 Coins. Three Susan B. Anthony dollars. $3.00 9 Coins. Twenty-four bi-centennial quarters. $6.00 10 Coins. Thirteen miscellaneous foreign coins. $0.65 11 Coin. 1943 steel penny. $0.50 12 Coin. One wheat penny. $0.02 13 Coin. One buffalo nickel. $0.50 14 Coin. One holed nickel. $0.05 15 Coin. 1923 Peace silver dollar made into a key chain. $8.00 16 Pin. 1851 $5.00 gold piece altered to make a love token. $75.00 Monogrammed. 17 Pin. Gold-filled etched pin. Not marked. $0.50 18 Pocket Watch. Monogrammed open-face Elgin gold- $25.00 filled pocket watch, dated 1932. The Keystone, 15 jewels. #33713270. Not working. 19 Pocket Watch. Open-face Elgin gold-filled pocket $70.00 watch, dated 1902, with gold-filled watch fob. #10357209. Works. 20 Coins. Four miscellaneous foreign coins. $0.20 21 Coin. One large holed cent. $3.00 22 Coin. One Lincoln cent. $0.01 Total $224.18 2 UNITED HEALTH CARE PO BOX 740819 ATLANTA, GA 30374-0819 INSURED MEMBER: GERTRUDE F. LINE* Citibank Delaware One Penn's Way New Castle, DE 19720 ****SIXTEEN DOLLARS AND 50 CENTS**** THE ESTATE OF GERTRUDE F LINE* 503 S WEST ST APT B CARLISLE PA 17013 PAY TO THE ORDER DF 1077482726 62~20 311 DATE: JUNE 30, 2004 PAY: $*********16.50*~ ,'~077h8272~"' ':05[~OO20q': 5SS~2~t,~l' Lee Procurement Solutions Co. THE SENT][NEL , PAY TO THE ORDER OF 6/07/2004 Sixty and 26710'0 Dollars RALPH **************************** 503 WEST ST APT B 9¥: CARLISLE PA 17013 $*********60.26 Void after 90 days COMCAST FINANCIAL AGENCY CORPORATION 56145029 06/23/04 PAY EXACTLY: TWO AND 95/100 TO THE ORDER OF: RALPH LINE SUBSCR BER ACCOUNT NUMBER 09547-368802 AIJ TH OJ{I ZED 81GNATIJllE ELWOOD GARDENS ASSOCIATES SECURITY ACCOUNT F/--~'/-~ ~ ,/ DOLLARS North Fork Bank UNFFED HEALTH CARE PO BOX 740819 ATLANTA, GA 30374-0819 INSURED MEMBER: GERTRUDE F. LINE* Citibank Delaware One Penn's Way New Castle, DE 19720 1077400346 DATE: JUNE 28, 2004 62-20 311 *~**SIXT¥ FIVE DOLLARS AND 00 CENTS**** PAY TO THE ORDER OF THE ESTATE OF GERTRUDE F LINE* 503 S WEST ST APT B CARLISLE PA 17013 %RSB 2 ********************* CDC FUND DEPT PREP DATE VOUCHER WARRANT ID ~" i ' : NATIONAL C~TY BANK VERIFICATt0N AVA ~BLE - "POSITIVE PAY~ PROTECTED ONL~~ CTS CTS TO THE ORDER OF GERTRUDE F LINE E)LN 037000336255 REV REBATE 503 S WEST ST APT B CARLISLE PA 17013-3838 28 05537559 O7/0 t/2004 DATE VOiD AFTER 180 DAYS $ ***********'500.00 TREASURER OF PENNSYLVANIA ,'DSS=,?55q,' .:Dt,~.;~D~,RRS,: D~.~.SF=[,~.,' UNITED HEALTH CARE PD BOX 740819 ATLANTA, GA .30374-0819 INSURED MEMBER: GERTRUDE F. LINE* Citibank Delaware One Penn's Way New Castle, DE 19720 1077364061 DATE: JUNE 25, 2004 62-20 311 ****SIXTY DOLLARS AND 50 CENTS**** PAY TO THE ORDER OF GERTRUDE F. LINE* 503 S WEST ST APT B CARLISLE PA 17013 PAY: $*********60.50** - Sprin& 06/21/2004 Sprint United Management Company Paying Agent on Behalf of ItseJf and Sprint Corporation's Affiliates P. 0. Box 7977 Shawnee Mission Kansas S6207 1-877-604-8464 001 O28332O 56-3821412 PAY ***********w**'22 DOLLARSAND53 CENTS 00005198 I lib 0.309 01 *:*********AUTO*=MIXED AADC 6GO V01D IF NOT CASHED WITHIN t80 DAYS RALPH H L'rNE 503B S WEST ST Au~homized Sfgna~u~,e CARLISLE PA 17013-3838 DONEGAL ~IELLON BANK PITTSBURGH ~ INS[IRANCECOMPANIE5 ISSUE]) ~¥: FOR RETURNED PREHIUH G 1059496 INSURED: LINE RALPH It & GERTRUDE F I--LINE RALPH }t & GERTRUDE F PAY TO THE ORDER C/O JAMES LINE OF 98 CHESTER STREET CARLISLE PA 17013 60-160 433 DONEGAL MUTUAL INS. CO. DATE: JUNE 14, 2004 CHECK NO. 2385940 pAy J ,.~' ...... ~ ] $" ~'~'~'"'~'~""~ 116.00 CHECK IS VOID OVER $5,000.00 WITHOUT TWO SIGNATURES VOID IF NOT PRESENTED WITHtN E MONTHS FROM ISSUE DATE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DZYTSTON PO BOX 280601 HARRISBURG, PA 1712&-0601 COMHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX REV-15gi7 EX AFP C09-Ogi) THOMAS E FLOWER ESQ SAIDIS ETAL 2109 HARKET ST CAHP HILL PA 17011 DATE 11-ZZ-ZO0~ ESTATE OF LTNE GERTRUDE F DATE OF DEATH 05-15-200~ FILE NUHBER 21 0~-0595 COUNTY CUH~ER LAND ACN 10 I*: HAKE CHECK PAYABLE AND R~IT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~.- RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF LTNE GERTRUDE F FILE NO. 21 0~-0595 ACN 101 DATE 11-22-200~ TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Raal Esta~a (Schadula A) (1) 2. Stocks end Bonds (Schedule B) (2) 3. Closely Hald Stock/Partnarship Interest {Schedule C) (3) q. Mortgagas/Notas Raceivabla (Schadula D) 5. Cash/Bank Daposits/Nisc. Personal Property {Schedule E) 6. Jointly Offned Property (Schadula F) (6) 7. Transfers (Schadula G) (7) B. Total Assets APPROVED DEDUCTIONS AND EXENPTIONS: 9. Funeral Expansas/Adm. Costs/Nisc. Expenses (Schedule H) (9) 10. Dabts/Nortgaga Liabilitias/Lians (Schedule I) (10) 11. Total Deductions 12. Nat Value of Tax Ra~urn 15. 1~. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schadule J) Net Value of Estate Subject to Tax .00 15z687.5~ Z;q97.85 .00 .00 NOTE: To insure proper .00 credit to your account, .00 submit the upper portion of ~his form ~i~h your tax payment. (8) 12,286.60 69.72 NOTE: 18,185.$9 (11) 12.356.32 (22) 5,829.07 (13) .00 (l~) 5,829.07 If an assessment was issued previously, lines 14, 15 and/or 16, 17, reflect flgures that include the total of ALL returns assessed to date. ASSESSNENT OF TAX.' 15. Amount of Line lq at Spousal rate 16. Aaount of Line lq taxabla et Lineal/Class A rata 17. Amount of Line lq at Sibling rata 18. Amount of L/ne 1~ ~axabla et Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: PAYNENT RECEIPT DI'SCOUNT DATE NUNBER INTEREST/PEN PAID (-) 08-1Z-ZOOq CDO0~Z60 15.12 18 and 19 will ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (is) .00 x O0 = .00 (16) 5,829.07 x 0~5= 262.$1 (17) .00 x 12 = .00 (18) .00 x 15 = .00 (~)= 262.$1 ANOUNT PAID 675.00 TOTAL TAX CREDIT 688.12 BALANCE OF TAX DUEI RZ5.81CR INTEREST AND PEN. .00 TOTAL DUE RZ5.81CR ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.)~--~ RESERVATION: Estates of decedents dying on ar before December 1Z, 19AZ -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND [CR): OBJECTIONS: ADMIN- iSTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section 9140). Detach the top portion of this Notice and submit eith your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: REGXSTER OF NXLLS, AGENT A refund of e tax credit, which ems not requested on the Tax Return, may be requested by completing an "AppiLcation for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available online at wew.revenue.state.ca.us, any Register of NL11s or Revenue District OffJce, or from the Department's Z4-hour answering service for forms orders: 1-BOO-36Z-ZOSO; services for taxpayers with special hearing and/or speaking needs: 1-BOO-447-30ZO (TT only). Any party in interest not satisfied eith the appraisment, allowance or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object withtn 60 days of the date of receipt of this notice by filing one of the following: A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at www.boardefappsels.stata.pa.us on or before the expLration of the sixty-day appeal period. In order for an electronJc protest to be valJd, you must receive a confirmation number and processed date from the Board of Appeals website. You may also send a written protest to PA Department of Revenue, Board of Appeals P.O. Box ZBIOZ1, Harrisburg, PA 171lB-lOg1. Petitions may not be foxed. B) Election to have the matter determined at the audit of the account of the personal representative. C) Appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box lB0601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. Sea page 5 of the booklet "'Instructions for Inheritance Tax Return for a Resident Decedent" (REV-iS01) for an explanatton of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allomed. The 15Z tax amnesty non-participation penalty is computed on the total of tho tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. ThLs non-participation penalty is appealable in the same manner and in the the same tiao period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning aith first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear Lnterest at the rata of six (6X) percent per annum calculated at a daily rate of .000164. A11 taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19BI through ZOO4 ara: Interest Daily Interest Daily Interest Year Rate Factor Year Rate Factor ~ 20Z .000548 ~1~'~-1991 11Z .000301 1983 16Z .000q38 1992 92 .000247 1984 llZ .000301 1993-1994 72 .00019Z 1985 13Z ,000356 1995-1998 92 .000247 1986 IOZ .000274 1999 72 .00019Z 1987 10Z .000274 ZOO0 7Z .O00lgz --Interest is calculated as follows= INTEREST = BALANCE OF TAX UNPA/D Daily Year Rate Factor ~ 9X .000Z47 ZOO2 62 .000164 2003 5Z .000137 2004 42 .000110 X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (lB) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. cry'C'""'" ~crrr C'- BUREAU OF INDIVIDUAR::J:.A~,:'! C,;:-I'I~,A~_ -,,':- INHERITANCE TAX DIVISION 1 ' PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-ii01 EX AFP (l2-D~l zons Jr31 i 4 F;', 3: llO CI.If::1< OFP::'!' THOMAS E cPfOWE'R' ESQ SAIDIS ETAL 2109 MARKET ST CAMP HILL PA 17011 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12"27"2004 LINE 05"13-2004 21 04-0593 CUMBERLAND 101 GERTRUDE F Allount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this for.. with your tax pay.ent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ~~:r&b,r.!5r.A~~..rG1~iS!l...........:rA~!fA~e1r"fl5r.~tA"fr~.b~.l~i:60frr...il..........._.........' ESTATE OF LINE GERTRUDE F FILE NO.21 04"0593 ACN 101 DATE 12-27"2004 THIS STATEMENT IS PROVIOEO TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11"15-2004 PRINCIPAL TAX DUE:. 262.31 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (") 08"12"2004 COO04260 13.12 ~ 675.00 12-09-2004 REFUND .00 425.81- TOTAL TAX CREDIT 262.31 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J ~"S."- IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: Gertrude F. Line Date of Death: Mary 13, 2004 Will No. 21-04-0593 Admin. No. 2004-00593 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion ofthe 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 in interest? Yes X; No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk ofthe Orphans' Court and may be attached to this report. Date: 5 - 10-0-;- ~.~ Signature Name: Thomas E. Flower, Esquire J.D. No. 83993 SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 l .. c..::: Capacity: _ Personal Representative X Counsel for Personal Representative r?-