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Home My WebLink About04-0603 TAX COMPU T ATION 118. Amount of Line 14 taxable at collateral rate X .15 (18) 119. Tax Due (19) 120. 0 ICHt:OkBgI'lEIF'f'CWj.@lEREOQE$TtNGAREFtJND(Jf'.A.NOVERPAYI\IlENtI i REV-1~ DECE- DENT CHECK APPRO PRIATE BLOCK COR- RE- SPON DENT RECA- P ITULA TION ~ o PA15001 -00 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER Lj ;: " f /" {"--v C) " HARRISBURG, PA 17128-0601 RESIDENT DECEDENT "'''f" --.. I , , COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER FANNIE EBY 220-05-6649 DATE OF DEATH (MM-DD-YEAR) rTE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE 06/22/2004 05/11/1917 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 3. Remainder Return ~ 1. Original Return W Supplemental Return 8 (date of death prior to 12-13-82) 4. Limited Estate 4a. FutuiS Interest Compromise 5. Federal Estate Tax Return Required - (date of death after 12-12-82) 6. Decedent Died Testate 7. Decedent Maintained a living Trust 0 8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Altach a copy of Trust) :5 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between 0 11. Election to tax under Sec. 9113(A) 12.31-91 and 1-1-95) (Attach Sch 0) TI-If$SECTJbf\lMl.I$taEC()Mf:i(..EtEI:).AWl...e()RRESpgN.t')ENQE~C()l'JPlbENTlAt.TAXmFbFtMAttClN$H()t.JLt)BEI)IREC;TEl)i()~ NAME COMPLETE MAILING ADDRESS ROSALIE F. EBY ROSALIE F. EBY FIRM NAME (If Applicable) ;7 Lebo Ro~{ - CARLISLE, PA 17015 TELEPHONE NUMBER 717-243-0663 .- OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) .- 2. Stocks and Bonds (Schedule B) (2) 30 Closely Held Corporation. Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal - _0" Property (Schedule E) (5) 1, 039, 507 94 6. Jointly Owned Property (Schedule F) . r.._., 0 Separate Billing Requested (6) ,-_.~'. ......"'" .- 7. Inter-Vivos Transfers & Miscellaneous I Non-Probate Property (Schedule G or L) (7) O. 00 8. Total Gross Assets (total Lines 1-7) (8) 1, 039,507 .94 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 12, 509.72 10_ Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I) (10) 11, 151.11 11. Total Deductions (total Lines 9 & 10) (11 ) 23, 660 .83 12. Net Value of Estate (Line 8 minus Line 11) (12) l 015, 847 11 ~ , 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) has not been made (Schedule J) 14_ Net Value Subject to Tax (Line 12 minus Line 13) (14) 1, 015, 847 .11 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 (15) - 16. Amount of line 14 taxable at lineal rate 1, 015,847.11 x .0 45 (16) 45, 713 .12 - ,- 17. Amount of Une 14 taxable at sibling rate X .12 (17) 45,713.12 ;:..".ElE:SUR~t6AN$Wl$=lA4tQ0EStIQN$QNpAGE2ANDRE"C;I-Jl::QKMAtt-l@/ NTF 29755 Copyright 2000 Greatland/Nelco LP - Forms Software Only PA F1EV-1500 EX (6-00) Dec:edent's Complete Address: STREET ADDRESS 7 . L e -b () -- ROAD Page 2 I STATE I ZIP (1 ) 43,000.00 1,315.79 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E Penalty Total Interest/Penalty (0 + E) 4. 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check (3) (4) (5) (SA) (5B) 45,713.12 44,315.79 1,397.33 117.34 1,514.67 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . c. retain a reversionary interest; or. . .. ............................................... d. receive the promise for life of either payments, benefits or care? ........................ 2. 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? ........................................................ 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 pnnalties of perjury, I declare that I have examined this return including accompanying schedules and statements, and to the best of my knowled!Je and belief, it is true, correct and complete. Declaration 01 preparer other than the personal representative is based on information of which prl3parer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ') ~' ,r' r. '--f-.1l4-c:..f!~ J. [,?<-I. fI. 2 - ;) 3 - t '" ADDRESS () :7 ~ Lebo ROAD CARLISLE, PA 17015' SIGNATURE OF o/AR~'1 I THAN R~~..IESENTATIVE ~~S9 E. J ~I:~O~:V~~-::::TOWN ~ ~~7 Yes No ~ ~ B ; o !8J DATE 08/18/2006 on or on spouse [72 P.S. ~ S 116 (a) (1.1) (i)]. Fo, dates of death on or after January 1, 1995, the tax rate is imposed on tre nel value of transfers to or for the use of the sUlViving spouse is 0% [72 P.S. 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 survivin~' spouse is the only beneficiary. For dates of death on or after July 1. 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a steppamnt of the child is 0% [72 P.S. B9116(a)(1 .2)]. The tax rate imposed on the nef value of transfers to or for the use of the decedent's lineal beneficiaries IS 4.5%, except as noted in 72.P.S. S 9116(1.2) [72 P.S. % 9116(a)(1)1. The tax rate Imposed on the net value of transfers to orlor the use of the decedent's siblings is 12% [72 P.S. B 91 16(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at IE!ast one parent in common with the decedent, whether by blood or adoption. o PA15002 NTF 29756 Copyright 2000 Greatland/Nelco LP . Forms Software Only REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FANNIE EBY SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FilE NUMBER Include proceeds of litigation & date proceeds were received by the estate. All prop. Jointly-owned with right of survivorship must be disclosed on Sch. F. ITEM NO. 1. 2. 3 . 4. 5. 6. 7 . 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. DESCRIPTION DW Land Rent - Before Death Baking and Produce Income Gardens Alive Vendor Credit Cow and Calf MD/VA Milk Retains Machinery and Gate 1984 Ford Ranger Farm Truck Ford Tractor MD/VA Milk Retains Milk Strainer Old Furniture Loan Rec. - Laurel Eby Loan Rec. - Lester Williams Loan Rec. - Galen M Martin Household Goods Farm - 142.82 Acres (Net proceeds) M & T Bank Checking 581186 VALUE AT DATE OF DEATH 787.50 56.95 4.20 1,017.50 204.21 503.00 300.00 6,500.00 170.05 20.00 37.00 13,059.74 19,839.34 41,380.12 4,557.00 948,400.00 2,671.33 o PA150U1 TOTAL (Also enter on line 5, Recapitulation) $ I, 039 , 507 . 94 (If more space is needed, insert additional sheets of the same size) COPYright 2000 Greatland/Nelco LP - Forms Software Only NTF 33305 REV-1511EX + (1-97) Dl!bts of decedent must be reported on Schedule I. ITEM NO. A. 1. 2. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Rosal ie F. Eby Social Security Number(s)/EIN No. of Personal Representative(s) Street Address 7 L e b 0 Road City Carlisle State PA Zip 1701'; COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FANNIE EBY SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER DESCRIPTION AMOUNT FUNERAL EXPENSES: Hollinger Funeral Home Jones Wagoner - Tombstone Lettering 3,828.00 70.00 Year(s) Commission Paid: 2. 3. Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Rosal ie F. Eby Street Address 7 L . e h 0 City Carlisle Relationship of Claimant to Decedent 3,500.00 ; Road State P A Daughter Zip 1701S 4. Probate Fees 298.00 5. Accountant's Fees 2,500.00 6. Tax Return Preparer's Fees 7. 8 . 9. 10. ll. 12. 13. 14. 15. 16. 17. M & T Bank Check Fee Lawrence Eby - Advertising The Baltimore Sun - Advertising Hauling & Water Testing Water Testing Lester Williams - Water Test Lester William - Land Study Earth Resource Corp - Farm Analysis Daniel William - Advertising Timothy Mesner, Attorney Cj:1eck.s 34.00 659.73 245.80 81.00 85.00 96.00 29.00 800.00 49.19 200.00 34.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 12,509.72 o PA15111 NTF 33308 CopYright 2000 GreatlandlNelco lP - Forms Software Only REV--1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT EST JI,TE OF FANNIE EBY SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER ~Jde unreimbursed medical expenses_ ITEM NO. 1. 2. 3 . 4. 5 . 6. 7. 8. 9. 10. ll. 12. 13. DESCRIPTION Carlisle Regional Medical Center Masland Assoc. Inc. - Medical Expense Amberland Goodwill Ambulance Lancaster HMA Phys. Mgmt Sprint Telephone Laben Horst - Hauling Cow PP&L Heartland Home Health Care Central Penn Med. Group Graham Medical Center Andorra Radiology Assoc. Neighbor Care Postmaster - Outstanding CK 7870 AMOUNT 7,794.62 38.00 857.20 259.00 201.92 35.00 106.50 458.04 432.00 588.00 320.00 53.43 7.40 o PA 15121 NTF 33309 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) COPYright 2000 Greatland/Nelco LP - Forms Software Only 11,151.11 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESlrATE OF FANNIE EBY SCHEDULE J BENEFICIARIES FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUME3ER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1. ROSALIE F. EBY DAUGHTER 20.00% ~7 L e...bo , ROAD CARLISLE, PA 170 15 :2. FERN L. EBY DAUGHTER 20.00% - 7 Le-bo ROAD CARLISLE, PA 170 15 3. JANET M. EBY DAUGHTER 20.00% 7 l-ebC> ROAD CARLISLE, PA 170 1:;- 4. HAZEL VIRGINIA WILLIAMS DAUGHTER 20.00% 51 .3 o( WAYNE R. c ~?( C h~.:W1ber5buej' PA 1720L C' LAWRENCE E. EBY SON 20.00% -) . HC59 BOX 50 CABINS, WV 26855 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 18 AS APPROPRIATE ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX is NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBS. ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) o PA 151a1 NTF 33293 COPYright 2000 GreatlandlNelcJ LP - Forms Software Only ~;UNT NO. L 581186 ACCOUNT TYPE STATEMENT PERIOD PAGE CLASSIC CHECKING JUN,19-JUL.19,2004 1 OF 1 00 2 04345M H 021 234 THEODORE H EBY OR FANNIE H EBY 137 STONEHOUSE RD CARLISLE PA 17013-7413 STONE HEDGE ~: L .NING DEPOSITS & OTHER CURRENT ENDING ANCE OTHER ADDITIONS CHECKS PAID SUBTRACTIONS INTEREST PO IlALANCE NO. I AMOUNT NO. I AMOUNT NO. I AMOUNT 2,671.33 01 0.00 11 7.40 1 I 2,000.00 0.00 663.93 ACCOUNT SUMMARY POSTING DEPOSITS, INTEREST CHECKS & OTHER DAILY DATE TRANSACTION DESCRIPTION & OTHER ADDITIONS SUBTRACTIONS BALANCE ( ~ 06-19-0'+ IlEGINNING BALANCE $2,671.33 06-24-0(, CHECK NUMBER 7870 7.40 2,663.93 06- 28 - 0'1 MISCELLANEOUS DEBIT 2,000.00 " 663.93 ENDING BALANCE $663.93 ACCOUNT ACTIVITY CHECKS PAID SUMM~~Y 7870 06-24-04 7.40 EffECTIVE AUGUST 20, 2004, IF THE AHOUNT Of A WITHDRAWAL, TRANSFER OR OTHER TRANSACTION MADE OR ATTEl1PTED TO BE MADE BY ANY HEANS EXCEEDS THE BALANCE AVAILABLE FOR WITHDRAWAL WHEN THE WITHDRAWAL, TRANSFER OR OTHER TRANSACTION IS CHARGED OR ATTEMPTED TO BE CHARGED AGAINST YOUR ACCOUNT, A $32 INSUFFICIENT FUNDS FEE WILL BE ASSESSED TO YOUR ACCOUNT UNLESS THE EXCESS IS LENT UNDER A LINE OF CREDIT ACCOUNT OR MADE AVAILABLE FROH ANOTHER DEPOSIT ACCOUNT YOU HAVE WITH US THAT IS LINKED TO YOUR ACCOllNT AS PART OF AN OVERDRAFT ARRANGEHENT. IF YOU HAVE ANY QUESTIONS, CALL THE H&T TELEPHONE BANKING CENTER AT 1-800-724-2440. tD 0) C"? i~ 'f;:i N ('-oJ c:> c:> '""" g (T) 0:> (T) ~1'11 (!J L.- (1) 00 t-- (T") +' (.0 ~ ~ en (1) fCI ,:::> Efl- <:0 (") ...~ CO +' Cl c:> "~ 0) C v --or ~'-'~'- , ~ (!J en N -- ~ r- ;!',,\ - nu en "- ~ t>f~ Q) 0 ~.k~ ..'" - a> c - ~ ell c = -~ co c .~ ~ en C> , 0 .:;C. ~ :::l '\:.ln~ .~ c N cD +' <0 I ,~ '>-~ if) co "<r (,t' " ~ (l) N ::J Q) r- \~::'\li;~ :.a Q) IT C I OJ U 0 c:> +' Cl A-C c:> ....- ,,,> g '~- .- a. co 5: c ;a (f) ,-::: .-'t'~!:'t~ -.- OJ I 0 llJ CD 6 Cl ~ ~ aJ co ::l. (.) '0 C~ :}f~'Pl \1) (!,) or' -'<1' ,J) C en -,- OJ :> !- +-' nJ (,.0 a <C! :~ ,,," .-f:t ~ OJ .g tU -.j- l;.") Cl C) o:1J -'c~~1' . -0 c:> L.) Ol "<j' ."'.:J '..;r 0:;) :J C,-) .:~. ,.t ' ;:5 cn COI C OJ ...:0 ....-:. .~r :-;~iI;~.. .r::. .::l (.) - --, 0) ;u ill 0 :>. ">T' ~ co ~ c: >,.- :0 C (lJ U * .u 0 ~ -a - E Q -=* +-' <a +-' +- <0 0 .xl ~ * 0 >- cr::: I-< (.) f- a ~- r'-:J * f- ..::::. ~: yKCv'L~ a~~td.4lC- ?btf,- 7? $12 J;~: ~~.lvw w~').-~ ;'- 7/7-;2~ 3 - ~S5?, ~~ a'n'l.tA-c..t..,'x.t ~u.e. -4--?{.-<.e...~ ~~~.<-L ;</ 0 ~ ~ 9~ I, CJ{/ ~ j q/ e ~1,~ tj ~u.4--K'-1<-i.u..v ~d ~~~(.bu.t.d.) ~ Ad-.f- A.Ut- ~?~(d.4.i; J/:UV ~... t?~~.r -vUtt.4.- ~/ ~rL ~ ~ t/-~~/' ad 9.(,~ d-~ rrL~f ~jLe*-. ~ ~ tJ-1 ~A.-tr I ~.LeA 4 4~'- ~ k ~~4< ~z ' E 4r~ t<1-~~~ -eA-~f6-~ ~ eLuL.-b ~ ~. - ~fd-~)' ~ ~.Ach~.~~.~-LA. ~,~ m~t- ./~~~)~/w ;z.,Lv ~A. . t7j' ~-<-L. P ~~ / 0 <1 -M oS, ~w~ 10 39\td SN'\7IllIM C:l31S3l 6 LE:06 9006/01/80 PRINCIPLE $ 20000.00 RATE .05 PRYMENTS PER YEAR 12 PAYMENT AMOUNT $ 132.'00 BU I, hU~.)L_ r< LL 1\1 D[' f< L,Unl'l ,-,um:.osE. on IE UF LonN - / L~)UREtl' tJ! r r- rU\J N r L ILL l\ 12/15/<)/; DATE It INTEREST PR I t.le I PLE BALPNCE 2/15/03 98 59. IE:, 72.84 1 .:'t 1 ..=' ~t ~ ,_, ~ 3/15/03 SIC) 50. as 73. 15 i.'. (J ~J i ~ '. i.l 4/15/03 100 58.55 73.45 Li':!78. 0~ 5/15/03 101 58.24 73.76 I3CJ()4.2:' 6/15/03 102 57.93 74.07 13830. ..:\) 7/15/03 103 57.63 74.37 l3755.83 8/15/03 104 57.32 7it.68 13681. 15 9/15/03 105 57.00 75.00 1 36 '~'b. 1~ 10/15/03 106 56.69 75.31 1,35,3(J.84 11/15/03 107 56.38 75.62 13455.22 12/15/03 108 56.06 75. ')4 ...-.:......JI l..::. ':"W TOTAL FOR YEAR 2003 693.26 890.73 1/15/04 109 55. 75 76.25 1 3 3 () 3. l.j 2 2/15/04 110 55.43 76.57 13226. tiC 3/15/04 1 11 C'l:' ) 1 76 _ 89 1 -;. 1 " ~ .:=:-, oJ_I. .-l,,'__-Ji 4/15/04 112 54.79 77.21 13022--~ 5/15/04 54.47 77.53 .-~ " 113 <""'.l-? q 9 4 ~ E\.-: .-/ 6/15/04 fd 7/1/~'I 114 54. 15 77.85 1.=q 16. <) B 7/15/04 115 53.82 78. 18 ~ 1. C ...:jo. t. ~j 8/15/04 116 53.49 78.51 1270',).2') 9/15/04 117 53. 17 78.83 12681. t+G 10/15/04 118 52.84 79. 16 I 2 b 02. J ,) 11/15/04 ii<=) =:2.51 7<=).49 12522.81 12/15/04 120 52. 18 7c?,. 82 12442. ,'},), TOTAL FOR YEAR 2004 647.70 936.28 (5., r::>.~ l-t:. p.., '" 'j'I~ t /)-1 1&'-/ .c- (2, '-I'lL!. u.f /jLI.(<: /1.; 7 b ----- j" oS 9. 7i ..--J ....;ft'" sf +. (; I,:s-/ c 'j j ,-) e ,<~ri l:/ i -'-!p 'I - I I-z, /0"; f);.l?,vLt' ~-/ l-I/C!.f LOAN AMORTIZATION SCHEDULE Codt~ - 90 1 Borrower - Galen M Martin Lencler - Fannie Eby Date Description Payment 03/3'1/2004 Beginning Balance ................... 04/30/2004 Interest ...... ........................... 05/3'1/2004 Interest .......... .................... .. ... 06/2~?/2004 Interest.............................. 41,029.26 Total interest for year 2004 350.86 Int. Rate 3.750% 3.750% 3.750% Interest 06/3012004 Loan# 90 1 Balance 126.46 131.08 93.32 41,029.26 41,155.72 41,286.80 41,380.12 / Martin's Auction Service Andrew Martin, ADCI. 717-532-5382 Appraisal for Fannie H. Eby Estate 137 Stone House Rd. Carlisle, Pa. 17013 " Household Items" I estimate the Market Value, as defined, of subject property as of 9/11/04 to be $4,557.00 Appraiser ()y.J/lhJ ~;.. Lic. # J J '2 ~~ L ~'i I' ....~ ,....:}~--- /2.te Prepared: " /1 i~}J Lf ' (~,." ':::> - I ' ;~ype Loan: .' 1~ ',',. ;, 1 '7") ,) 1 ,\ _ a ~ I'dee, " , c,' ._' ,.. (;.;.. ,,' Seller: ,:;: h. II\. i l:.- PropertY: Mortgage Amount: STATEMENT OF ESTIMATED SELLER'S COSTS Cbv ;;;; :IcTc"' I 'ibe following ESTIMATE is given so that the Sellers will understand approximately what costs will be deducted from the Gross Sale Pric" ::.~, _~e tir.:1e of settlement: 1. 2. 3. 4. 5. 6. 7. 8, 9, 10. lL 12, 13, Brcker's COltunission: c % of $ ;: D .La, (rev . s S $ S S $ $ $ $ S $ S / I "7 oJ:.J l <~ . ..:~ l'~ 1 % Transfer Tax .,. .. . . .. ." .,. .., .., ... .. . ... '" ... ... ,... ...........,...,............ 14. 15. 16. Notary Fees ,........ .., '.. ............... ............ ......,.. ........................... Deed Preparation '" . .. ..' . .. ... ... .. . ... ... . .. . .. .... .. ... . .. .., ... .. . . .. ... .. . ... .. '.. Radon Certification .... ................................................................ Wood Infestation Inspection ......... .. .... ...... . .. ... .., .. .... .... .. .. . .. . . .. .. . . .. Private On-Lot Sewage Sy!.tem Inspection... ...... ." ...... ... ...... ... ... .... Water Analysis Report... ... ... ... '" .., ... ... ... ... ... ... ...... .., ... .. . . .. ... ... .. .. Roof Certification ... . . . '" ... ... ... . .. .. . . .. ... ... . .. ... ... ... ,.. .. . . .. ... ... ... '" .. ... Home Wananty Program... ... ... .. . . .. ... ... ... ...... ... ... ... '" ... ... '" ...... '" Home Inspection Fee ... ............................................................. Buyers Closing Costs .....,........,.................................................. Mortgage Discount of Placement Fee ( % of mortgage amount) .., .', '" ... .,. .., ... ... ...,.,...... '" .... Settlement or Disbursement Fee... '" ... ... ... ... .., ... ... ...... .., ... ... . .. ...... FHNV A Fees (5400 average - Fees vary according to lender"') ............ Transaction Fee ... . .. . . . . .. . ., .., , .. .. . . . . ... ... .. . . . . .. . ... .. . ... .. . . .. .. . .. . . . . .. . .. . fe' I ~ /} /\ ,/ >;._....... u . -7""- "":lo S $ S $ $ $ -, 125.00 17. OTIIER: .. . TOTAL ESTIMATED SELLING EXPENSES .....,... ...... ...... ...'" '" ............... 21 / /~()~ I i \.(,..:,,--- , tAbovc estimate includes a total of average fees for one F1WV A Inspection, Flood Certification, Tax Service Fee, Notary and Miscellaneous fees. Total deductions at settlement are estimated as follows: .$ " J, (~O () Estimated Selling Expenses $ 't Estimate Payoff First Mortgage .$ Estimate Payoff Additional Mortgage/Liens $ 7 ~. (AJ{) TOTAL ESTIMA1ED DEDUCTIONS 3as::d on the a1;>ove estimates, approximate proceeds at settlement may be: .$ / . 0 ;ZQ)O(..~ Gross Sale Price S 7/ . G..,uO Less Total Estimated Deductions .$ (/ l;f. L/(X) Estimated Proceeds at Settlement - ( i'he above figures include payoff infonnation provided by Sellers, and may not include payoff of all liens, encumbrances, property [C):es elT ,<p::cial assessments. All payoffs and/or release of existing mortgages and liens will be deducted from your proceeds at .;~ttlement jW e ac~.nowledge receipt of a copy of this Statement of Estimated Seller's Costs, and understand and agree to the above estimated charges. \;;ljL'less: (F /<(.;.I (~ (Seller) (Seller) L(:J. 4/04 r r~msbi 111 Carlisle Reg Med Center 246 Parker St Carlisi", PA 17013 CONTRACT BILLING SUMMARY BILL D!\TE: 06/22/04 PATIENT TYPE: I Lnpatit~t PATIENT NAME EBY, FANNIE H !\DDRESS 137 STONEHOUSE ROAD CITY, ST, ZIP: CARLISLE PA 17013 GU!\RAW:OR NAME EBY, PANNIE H ADDRESS 137 STONEHOUSE ROAD =ITY, ST, ZIP: CARLISLE PA 17013 GUAR El1PLOYER NAME HOMEMAKER INSUR~,CE COMPANY ADDRESS CITY, ST, ZIP: POLICY NO GROUP NO AUTHORIZATION NO 30SAMI OLD ORDER AMISHiMENN COM ENTER PT'S HOME ADDRESS 220056649 PATIENT NO: 9284418 SOC SEC NO: 220056649 SOC SEC NO: 220056649 COB: 1 ADMISSION DATE 06/11/04 DISCHARGE DATE: 06/18/04 REIMBURSEMENT HAS BEEN CALCULATED BASED UPON: IP S=rvice Charges: 15,589,24 Reim'bursed @ 50% of Charges: TOTAL CHARGES EXCLUDED PHYSICIAN FEES CONTRACTUAL ALLOWANCE REIMBURSEMENT FROM PRIMARY PAYMENTS RECEIVED PROM PRIMARY AND PATIENT: NET DUE FROM PRIMARY 7,794.62 $ $ $ $ $ 15,589.24 0.00 7,794.62 7,794.62 0.00 t2: 794, 62~ ~ C\S I tl4 ,\\V\ \ LAST WILL AND TESTAMENT OF FANNIE HELEN EBY I, FANNIE HELEN EBY, of CUMBERLAND COUNTY, STATE OF PENNA., do hereby make, publish and declare this as and for my Last will and Testament, hereby revoking any and all other Wills, Codicils or Testamentary Dispositions heretofore by me made. ITEM ONE: I direct my personal representatives hereinafter named, the survivor or survivors of them, to pay from my estate all taxes accrued during my lifetime, all of my just debts, administration expenses and funeral expenses. I further direct that all inheritance taxes, including all Federal estate taxes, state estate taxes and all other similar taxes payable by reason of my death, be paid out of my estate and that no person shall be required by my personal representatives or called upon to contribute to the payment of any portion of such taxes. ITEM TWO: I give, devise and bequeath my estate as follows: A. JANET M. household supplies. I give and bequeath to ROSALIE F. EBY, FERN L. EBY, and EBY, living at the time of my death, in equal shares, my furnishings, fixtures, and the non-farm equipment and B. I give and bequeath to each of my daughters, ROSALIE F. EBY, FERN L. EBY, and JANET M. EBY, living at the time of my death, the sum of TWENTY THOUSAND ($20,000.00) DOLLARS, the child or children of any of my said daughters who may be then deceased to take their parent's share by representation. C. It has been my policy to give each of our grandchildren the sum of FIVE HUNDRED ($500.00) DOLLARS at age 18, plus the sum of FIVE HUNDRED ($500.00) DOLLARS when married or at age 21, whichever comes first. In the event any of my grandchildren did not receive these gifts by the time of my decease, I give to such grandchildren an amount to equal the unpaid portions. If under age or not yet married, I give their respective parents their share,to act as trustees for them. D. I then give, devise and bequeath all of the rest, residue and remainder of my property and estate as follows: 1. 'TWENTY (20%) PER CENT thereof to my daughter HAZEL VIRGINIA WILLIAMS, if she is living at the time of my death, otherwise to her descendants, then living, in equal shares and in default of any such descendants, then to her brothers and sisters, i:hen living, in equal shares, the child or children of any of her said brothers and sisters who may be then deceased to take their parent's share per stirpes. 2. TWENTY (20%) PER CENT thereof to my daughter, ROSALIE F. EBY, if she is living at the time of my death, otherwise to her descendants, then living, in equal shares and in default of any such descendants, then to her brothers and sisters, then living, in equal shares, the child or children of any of her said brothers and ~;isters who may be then deceased to take their parent's share per stirpes. 3. TWENTY (20%) PER CENT thereof to my daughter, FERN L. EBY, if she is living at the time of my death, otherwise to her decendants, then living, in equal shares and in default of any such descendants, then to her brothers and sisters, then living, in equal shares, the child or children of any of her said brothers and sisters who may be then deceased to take their parent's share per stirpes. 4. TWENTY (20%) PER CENT thereof to my son, LAWRENCE E. EBY, if he is living at the time of my death, otherwise to his descendants, then living, in equal shares and in default of any such descendants, then to his brothers and sisters, then living, in equal shares, the child or children of any of his said brothers and sisters who may be then deceased to take their parent's share per stirpes. 5. TWENTY (20%) PER CENT thereof to my daughter, JANET M. EBY, if she is living at the time of my death, otherwise to her descendants, then living, in equnl shares a:1d in default. of any such descendants, then to her brothers and sisters, then living, in equal shares, the child or children of any of her said brothers and sisters who may be then deceased to take their parent's share per stirpes. ITEM FOUR: I nominate, consititute and appoint my daughters, ROSALIE F. EBY, FERN L. EBY, and JANET M. EBY, the survivor or survivors of them, to be the personal representatives of my estate, exempt from the necessity of giving bond. I hereby vest and clothe my personal representatives, the survivor or survivors of them, with full power and authority to carry out and give effect to all the provisions of this, my Will, and generally to do all such acts, take all such proceedings, and exercise all such rights and priviledges, although not hereinbefore specifically mentioned, with relation to such'property and estate as if the absolute owners thereof. IN WITNESS WHEREOF, I have hereunto affixed my seal this :Ji day of (iu,,{ / subscribed my name and 19-.LL. /1 ;./. /.." ..i L-~ ?-1,~( ~. ,~.:-l'::-1-\, Fannie HeYen Eby [0.(/ .--' ( SEAL) SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, FANNIE HELEN EBY, 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. : } ('-<-If, .". I, '- ( 'I ..! ,,'" ( - i.:" witfness . c ,-~ ;,"_ ,- . ~ ~ " ! I) ;~-' ~ ,. ( 'i;, /.... /:;',,, wi t'nes~ ;/ .~/ PETITION FOR PROBATE and GRANT OF LETTERS Estate of. rlJ,..JJJ it;' HFLEN EB Y No. c2/-/J~ bO..!3 also known as ::lhJNi~ EB Y To: r~N,Ali-f! . E b)' Register of Wills fOIL the _ ,-1 , Deceased. County of C iLmo~/~ in the Social Security No. 22.0 - 05- '=-6 Lf9 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the exe.>,utb.(> in the last will of the above decedent, dated tLP8J L 2- <::> and codicil(s) dated named ,19~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C I.( M be'f"ln;o.J&1 h~r last family or principal residence at 137 So. -ro"...Je CARL.I~l.i: ( pf} /,013 (list street, number and muncipality) ;-JCounty, P$1lllsylvania, with I)U~~ It:ollO Decendent, then 87 years of age, died :JI., N~ .'2- 2. , 'Wo 200 LJ. , at 137 S"'n:JAJe Hou1>(i !2aPrO. CI9~J,..;SL.j;, 1-',4 i7c>tJ Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: 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 Pen. nsylvania ,I R') situated as follows: , 31 S 1'-0~ NCuY ct C/-J/h. '})U! j7A 170(3 . $ 50, 0 0 CJ $ $ $ :&'0 CJ. DO 0 WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters ~e 50 ,h{"f(O.-.JrA ,e Y (testamentary; administration c.La.; administration d.b.n.c.t.a.) theron. '" '" u <= '" ~3 '" ... 0::'" <= -00 C::";::: ~'';::: ~'" ~o.. "''- ~ 0 0; <= OJ) CiS ~~ 137 S;CM' ;:k,,~ IZJ (!/lfJl..l:s/e, /i4 ~. " ~. '. ..... OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I ss COUNTY OF J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal'represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. #f~ en QQ" ::lI ~ .... l:: ~ ~ No. c:21-0~-bO~ Estate of hN~/~ /-1 c. / ~A/ ~/5 \/ ./ , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~ ""'e/ ...:7~ -s-' ~ in consideration of the petition on the reverse side h ;;'f, satisfactory proof having~ p~esented hefore me, IT IS DECREED that the instrument(s) dated ~ ~ /0/(") described therein be admitted to probate and filed of record as the last will of ~;t IfeA/X/~ and Letters / a .... ~ are hereby gra~ed t~J?c,;q"?c:,PEg F6e/J//O L . EA y. IAA/c 7 /n /r5\'/ / )~/A~<?a/ A" ~#4j'/6 Rer!l~}'l-L/ ~7 FEES Probate, Letters, Etc. ......... $ 02 //"7. ~ b Short Certificates( . ) . . . . . . . . .. $ /.k: rV) Renunciation ................ $ C)f2f $ /L), CJCJ FiI~~~A~]:'.~~ ~() AITORNEY (Sup. Ct. J.D. No.) ADDRESS PHONE ~/.JO~~~ 3l\egister of Wills of <!Cumberlanb <!Count!' OATH OF NON-SUBSCRIBING WITNESS Estate of f/lf'lAJ1e HE LeN E b Y Also known asHN,.vle ;-1- j; by p;c,,,,, /'-Ii C e- j, "; . , R 0 sf't-ie FMI'f"(* r Et". , L EJ,y , No. , Deceased (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that familiar with the signature of ANA/J'e t/UfV.J Eb,- , testat_ of (one of the subscribing witnesses to) the codicil/will presented herewith and that _ believes the signature on the codicil/will is in the handwriting of RNN~t: HeuN EJ)" to the best of &J l.l,r knowledge and belief. Sworn to or affirmed and subscribed B9re me this c5.y'~ day of IL4Jf/ ,20a!;L ~~~,"".,~",<?~ FortheR i~LL/~.4-v-~ ~tuLu~q J. f~ (Name) /) J f :3 7 5""";0 Nt' rJ.; <J~' I' '" A C-/lRL.I$L~ r;, /70(3 (Address) J~ /.E~ (Name) J)_ RoAd I 37 t}j;,oNf' ffO<J)P C/JIZ /"'/S/..'f /:4 17013 (Address) C:;/...CJ-Y- 6c:J 3 LAST WILL AND TESTAMENT OF FANNIE HELEN EBY I, FANNIE HELEN EBY, of CUMBERLAND COUNTY, STATE OF PENNA., do hereby make, publish and declare this as and for my Last will and Testament, hereby revoking any and all other wills, Codicils or Testamentary Dispositions heretofore by me made. ITEM ONE: I direct my personal representatives hereinafter named, the survivor or survivors of them, to pay from my estate all taxes accrued during my lifetime, all of my just debts, administration expenses and funeral expenses. I further direct that all inheritance taxes, including all Federal estate taxes, state estate taxes and all other similar taxes payable by reason of my death, be paid out of my estate and that no person shall be required by my personal representatives or called upon to contribute to the payment of any portion of such taxes. ITEM TWO: I give, devise and bequeath my estate as follows: A. JANET M. household supplies. B. I give and bequeath to each of my daughters, ROSALIE F. EBY, FERN L. EBY, and JANET M. EBY, living at the time of my death, the sum of TWENTY THOUSAND ($20,000.00) DOLLARS, the child or children of any of my said daughters who may be then deceased to take their parent's share by representation. I give and bequeath to ROSALIE F. EBY, FERN L. EBY, and EBY, living at the time of my death, in equal shares, my furnishings, fixtures, and the non-farm equipment and C. It has been my policy to give each of our grandchildren the sum of FIVE HUNDRED ($500.00) DOLLARS at age 18, plus the sum of FIVE HUNDRED ($500.00) DOLLARS when married or at age 21, whichever comes first. In the event any of my grandchildren did not receive these gifts by the time of my decease, I give to such grandchildren an amount to equal the unpaid portions. If under age or not yet married, I give their respective parents their share,to act as trustees for them. D. I then give, devise and bequeath all of the rest, residue and remainder of my property and estate as follows: 1. TWENTY (20%) PER CENT thereof to my daughter HAZEL VIRGINIA WILLIAMS, if she is living at the time of my death, otherwise to her descendants, then living, in equal shares and in default of any such descendants, then to her brothers and sisters, then living, in equal shares, the child or children of any of her said brothers and sisters who may be then deceased to take their parent's share per stirpes. 2. TWENTY (20%) PER CENT thereof to my daughter, ROSALIE F. EBY, if she is living at the time of my death, otherwise to her descendants, then living, in equal shares and in default of any such descendants, then to her brothers and sisters, then living, in equal shares, the child or children of any of her said brothers and sisters who may be then deceased to take their parent's share per stirpes. 3. TWENTY (20%) PER CENT thereof to my daughter, FERN L. EBY, if she is living at the time of my death, otherwise to her decendants, then living, in equal shares and in default of any such descendants, then to her brothers and sisters, then living, in equal shares, the child or children of any of her said brothers and sisters who may be then deceased to take their parent's share per stirpes. 4. TWENTY (20%) PER CENT thereof to my son, LAWRENCE E. EBY, if he is living at the time of my death, otherwise to his descendants, then living, in equal shares and in default of any such descendants, then to his brothers and sisters, then living, in equal shares, the child or children of any of his said brothers and sisters who may be then deceased to take their parent's share per stirpes. 5. TWENTY (20%) PER CENT thereof to my daughter, JANET M. EBY, if she is living at the time of my death, otherwise to her descendants, then living, in equal shares a:ld in default of any such descendants, then to her brothers and sisters, then living, in equal shares, the child or children of any of her said brothers and sisters who may be then deceased to take their parent's share per stirpes. ITEM FOUR: I nominate, consititute and appoint my daughters, ROSALIE F. EBY, FERN L. EBY, and JANET M. EBY, the survivor or survivors of them, to be the personal representatives of my estate, exempt from the necessity of giving bond. I hereby vest and clothe my personal representatives, the survivor or survivors of them, with full power and authority to carry out and give effect to all the provisions of this, my Will, and generally to do all such acts, take all such proceedings, and exercise all such rights and priviledges, although not hereinbefore specifically mentioned, with relation to such property and estate as if the absolute owners thereof. IN WITNESS WHEREOF, I have hereunto affixed my seal this ~ day of 0bu~ subscribed my name and 19...f12. 1 1M Db- ~. W:rt<1"'J" . 4A/ Fannie HeYen Eby .. (SEAL) SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, FANNIE HELEN EBY, 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. ~<)~u ~.f~~ ~ 11t:l W1 ess -J; ~0u J k;r Cf1~ J~1i 1;' fer 1 ness III(I';~~{]V 'iI'" (f th"lt the information here uiven is correctly copied from an original ce:~.ific~te of death ,ilily IS IS to eel' I y < wl'lbl be t'orwarded to the State Vital Records Otflce tor permane! <t I; I l~~ Local Registrar. The original certificate lill l11) WARNING: It is illegal to duplicate this copy by photostat or photograph. No. liM. ~. ~~~~~~ Local Rq,'l'll~ll Fce for this certificate, $2.00 /1., j,.... .,.'~.,'. ,.~, n J ,. b,!, "', ..- ._," .....J I."\,, wJ..., JUN 2 4.2004 Dale ;; Hl05.14.3 Rh. 2/81 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH INT ~NT "" SEX .. F STATE F....f NUMBER SOCIAL SECURITY NUM8ER ~"TEl;~11:~ oW >-220 - 05 ql v.. S. COUNTY Of OE.ATH =-"0 .;t\ ... Cu.M.6E~U4NO DECEDENT'S USUAL OCCUPAI'ION (~":m~ =;.,"::- =;zt~ ... RACE. AIMtican IndiM.. 8IIIdl. WhIte, 1Ml:. c_ ... \,IIJ l-triE 5UAVMNG SPOuSE (I...... gtwe""'" NrN) ..... _. >t. I Apprujmat. f __erwI...... : 0ftMl Mdduth I I PART -: OlIwSigniftcMlcondlioN~to...... buI '* rHUItIng in.. UI\ICIMtrlno~.... in PAA'T I. b. DUE TOCOA AS' CONSEOUENCE Of). d. WERE A01OP$Y FINOtNQS ~EPAK)ATO COMPlETION Of' CAUSE OF lleRH1 =A Of' OE;; DATE OF INJURY (Month, Day, ""art TIME OF INJURY INJURY ItS WORK? DESCRIBE HON INJURY OCCURRED. HGmicide o o o ~EOFINJURY.Athome.fann.SI"".,actory.otftce M. buitdlnQ. _.1Spec1ty} .... _ 0 NoD NoW _0 NoD - - o o ~ Invesdglilion .UEDtCAL EXAMINER/CORONER On the IMsi. of e.amlnatlon and/or Investigation. in my opinion, death OCcur,1td at IheUme, dale. and place. and due to the CauM(s) and "'anftft.. stated...,.....................................,..............,......,...,.....,........................ 31a. REGISTRAR'S SIGNATURE AND NUMBER o f')f 17 :2 '1.- Coukt not btI det~tned 28L 21b. COI'TIflERIChedl only one} -CERTIFYING PHYSICIAN (PhysIC..... c~ cause d dNttI """*' anoH"ler pt'lySICoan has Pl'0I"I0lInCed dea"" ana Completed IIem 231 To",", ""0''''' II:nowtltdge.de.rhOCCUrreddueIDChec:au.ot(.)endme~..staled.,.....,........",..,....,..",.... ... -PRONOuNCING AND CERTIFYING ,"YStcIAH (Physc.an boIh ;ll'OflOunCong oeath and cer1dy1ng 10 cause 01 deathl TO,....be.-ofmyllnowtedg8.deoaIhOCCUfrMa.lheltme. dele, and piKe. and due to Ihe uuse(.) .nd"'ann.,.. s'eled........,.,......., t\. ~~~~'bJ ~I\ I~ lid ~~I ~oo4 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV- 1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT EBY ROSALIE F 137 STONE HOUSE ROAD CARLISLE, PA 17013 UU~n_ told , ESTATE INFORMATION: SSN: 220-05-6649 FILE NUMBER: 2104-0603 DECEDENT NAME: EBY FANNIE HELEN DATE OF PAYMENT: 09/20/2004 POSTMARK DATE: 09117/2004 COUNTY: CUMBERLAND DATE OF DEATH: 06/22/2004 NO. CD 004403 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $25,000.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK#1013 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WillS $25,000.00 GLENDA FARNER STRASBAUGH REGISTER OF WillS :Jj-o~-~o3 TmllsmiUlIl l)rc)JlIymcllt of Illhcritllu.c~ TlIX [xecufor: w'1-4 ~ I!. , j f:?<J l'JaAIQ alld aatJJ _v.. at ,^..uerney eEltt:i__l J " Yinaneial 1l1oliluti6u: /37 STOtV F II Oil SF +<-0. (,ARLISLE i -PA. /-10(3 Name of Decedent (last, first, middle initial): EBY, FANNIE H. File Number (ifprobale has begun): Dr: = ~2 ::l- I::' n~ g -1 V) rrl -0 N o Datc ofDealh: JUNE 22, 2004 Amount: J, 5/ 0 00 . 00 v Vi 0\ ,~ ; Ifprobate fills IIOt cOl/I/llellcel1 or ifit is II 1I01l-probate estate, additiollal i/lfor/lllltiolllisted belolV will be relll/ire/t. Social Security Number: 220-05-6649 Rcsidcncc al Death (city, borough or township): CARLISLE, PA IIII.erilullce 1"ax Depurtmellt Office of Register of IViIb 81J/91l , 1~ .... ~ J( ~ -~""., " .law Dffia' of 'bo'l.othy .fi.!Ja.dilL~ cfftto'tfl.E.~. cfft .J:aw 3 z ~oufh ']3<<",<< ~h&d CYo,k, Puzn".1&QJ1.io. 17 40 cumberland County courthouse ATTN: Register of Wills One courthouse Square Carlisle, PA 17013-3387 ~tln~) .0 :l \70. ~ Ol d3S , o 1 9S: Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 10/05/2004 EBY ROSALIE F 137 STONE HOUSE ROAD CARLISLE, PA 17013 RE: Estate of EBY FANNIE HELEN File Number: 2004-00603 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 10/05/2004 Your prompt attention to this matter will be appreciated. Thank You. ~l~~ GLENDA FARNER STRASBAUGH Clerk of the Orphans' Court cc: File Counsel Judge Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 10/05/2004 EBY FERNE L 137 STONE HOUSE ROAD CARLISLE, PA 17013 RE: Estate of EBY FANNIE HELEN File Number: 2004-00603 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 10/05/2004 Your prompt attention to this matter will be appreciated. Thank You. cc: File Counsel JUdge r~ GLENDA FARNER S~:~ Clerk of the Orphans' Court Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 10/05/2004 EBY JANET M 137 STONE HOUSE ROAD CARLISLE, PA 17013 RE: Estate of EBY FANNIE HELEN File Number: 2004-00603 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 10/05/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~=~ Clerk of the Orphans' Court cc: File Counsel Judge ( \: \ \ ~1 ~ On v. -~ IJ' o~;o Ol '" 0 ~ .... if> ~(f)~ -..... -- '" 0 CD -~::l m v CD or :t>::c'" ~o ....c aU> ~CD "'::0 o Ol 0. ,. ,,,,,RII/. , I '\:5' "': ~ c- o -o:1J 'Q r ; , __"...__.....J COMMONWEALTH OF PENNSYLVANIA DePARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT EBY ROSALIE F 137 STONE HOUSE ROAD CARLISLE, PA 17013 _n_un fold ESTATE INFORMATION: SSN: 220.05.6649 FILE NUMBER: 2104-0603 DECEDENT NAME: EBY FANNIE HELEN DATE OF PAYMENT: 03/24/2005 POSTMARK DATE: 03/22/2005 COUNTY: CUMBERLAND DATE OF DEATH: 06/22/2004 NO. CD 005119 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $18,000.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 5719 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $18,000.00 GLENDA FARNER STRASBAUGH REGISTER OF WillS LJ COpy March 19, 2005 PA DEPT. OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION - EXT. DEPT 280601 HARRISBURG PA 17128-0601 Re: Fannie H. Eby Estate 137 Stone House Road Carlisle, PA 17013 State file #: 2004-00603 Date of Death: 06/22/2004 Gentlemen: We are hereby requesting a 6 month extension of time to file the PA Inheritance Tax Return. We do not have all the necessary data in order to file the return. Respectfully submitted, Rosalie F. Eby Executor ; '..i Tl"lIllsmiUlIl PI"C))lIYIlICllt of Illhcl"itllu.c~ TlIX [ X e C' LI. -f-(J I .' t/{...M(:C.. N~ung :lud aEfth _...3 of7\TIarney OrP..\:;i_1.:J1 d! riUftueial JllsliLuLi6U: J [.'(,J /37 5TOIJF If {NJ. S L Kn. ( ,A rh ISLE " P4. /l O/~ Name ofDecedenl (last, first, middle initial): EBY, FANNIE H. File Number (if probate has begun): 201:)<1-- oo(o()~ Date of Death: JUNE 22, 2004 ~ 1<2,000. co Amount: '*' \) _ Jfprobute fills 1101 COllllllellcecl or if it is alloll-probate estllte, lulditiolllLl ill/O,.",I/tioll /iJtecl below will be require,l. Social SecurilyNumber: 220-05-6649 ., , Residence at Death (cily, borough or township): CARLISLE, PA __J "'1 '-,", , -~-'J III/Ieri/ullce 1"11-" Vepurlmelll Office of Recut., of lVilLt 1VJ/?3 "; COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG, PA 17128-0601 March 25, 2005 Telephone (717) 787-3930 FAX (717) 772-0412 Rosalie F. Eby 137 Stone House Road Carlisle, PA 17013 Re: Estate of Fannie H. Eby File Number 2104-0603 Dear Sir/Madam: This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before 09/22/05. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. Sincerely, ~~. Claudia Maffei, Supervisor Document Processing Unit Inheritance Tax Division c..:.> _J <:L~~ \ , Register of Wills of Cumberland Coun.ty Name of Decedent: STATUS REPORT lJNDER RULE 6.12 ~ A- N IV Ie 1-1-. E BY Date of Death: ~ 1 I.L h e... ,;l.;J- . .:.l.l> 0 'I Estate No.: JOO f - {)D6 /)3 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 0 No g' 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: . uurk:" 1.2 ~~ , J. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes ONo 0 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 0 No 0 c. Copies of receipts, releases, joinders and approval of fonnal or infonnal accounts maybe filed with the Clerk of the Orphans' Court and maybe attached to this report. Date: s- F-o~ i?~ J ,~ Signature Name R oSltL. (E F E&f I Address L $"B () Rei 1-1,-' -- ~ t./3~- D(, ~ Telephone No. 00 .....,1 ! j ! ..,. ..r '. .", ~v v tl'w 01 A Capacity: Effersonal Representative o Counsel for personal representative . ) .....J ,.@) Cumberland County - Register Ot Wl~~S One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 EBY ROSALIE F 7 LEBO RD CARLISLE, PA 17013 RE: Estate of EBY FANNIE HELEN File Number: 2004-00603 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing is due by: 6/22/2006 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. sr~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel l-UIllDerJ.ana COUIH:Y - rt.e<;:j.L:::iL..(;;:.L VJ.. ".L.L.Le> One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 EBY FERNE L 7 LEBO RD CARLISLE, PA 17013 RE: Estate of EBY FANNIE HELEN File Number: 2004-00603 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/22/2006 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel cumner~and county - Keglscer VL W~~~~ One Courthouse Square Carlislel PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 EBY JANET M 7 LEBO RD CARLISLE, PA 17013 RE: Estate of EBY FANNIE HELEN File Number: 2004-00603 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS. COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/22/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. SincerelYI G~~~ Clerk of the Orphans' Court cc: File ("'ouDsel COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT EBY ROSALIE F 7 LEBO RD CARLISLE, PA 17013 ___~u__ lold ESTATE INFORMATION: SSN: 220-05-6649 FILE NUMBER: 2104-0603 DECEDENT NAME: EBY FANNIE HELEN DATE OF PAYMENT: 08/25/2006 POSTMARK DATE: 08/25/2006 COUNTY: CUMBERLAND DATE OF DEATH: 06/22/2004 ACN ASSESSMENT CONTROL NUMBER 101 TOTAL AMOUNT PAID: REMARKS: ROSALIE F EBY FERNE L EBY JANET EBY CHECK# 1053 SEAL INITIALS: CM RECEIVED BY: REGISTER OF WILLS REV.1162 EX(11-961 NO. CD 007145 AMOUNT $1,514.67 $1,514.67 GLENDA FARNER STRASBAUGH REGISTER OF WILLS ~ V' ~ <I: ~~ [ga~_' ,I:f? a..:X::J~~I:R:2 via..;::;!~(JzgR , :> :::>0_ :::> 3; <Xo ~ "~I ~t11 ;z 5 __ ~ (R. - - - - - =g - 0:::: o o Os - <2 -3 I -r o ~ -' -. '.n o :;---... ~ (l) ~ ~ ~ ~. C:.- ,...) 'fA \Y- '.0 uJ :::>'- c, 1[\ fa 0 - Cl) ". :.. 'c 'U Cl) ~ o :e ~ ::l ('") 8 r<( .i:J .~ C \Il ,9: 0 ::l _ v' t-- o~ Cl)~ U3~4. -o~oO- SO~,;\ 'v '- :l-' "" -cCl)'-ifi Cl)tA6:.c -% '01u <1:) ::lCl)~u uc:t. f\. .~~\\ 6 /.~ U '\~ ~ 10-02-2006 EBY 06-22-2004 21 04-0603 CUMBERLAND 101 APPEAL DATE: 12-01-2006 ( See reverse side under Objections) Dount R_itt.dl I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +- iEV:is4;-Ei-AFP-ioi:os3-NOTicE-OF-iNHEiiTANCE-TAi-APPRAiiEMENT:-ALLONANCE-oi--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX FANNIE H FILE NO. 21 04-0603 ACN 101 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2110601 HARRISBURG PA 171211-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE nDcD n~F\rh~ICE OF INHERITANCE TAX RECOnc I ~~ ~ENT, ALLOWANCE OR DISALLOWANCE (1)F':' ED"UCTIONS AND ASSESSMENT OF TAX 2nGb Gel 3 \ M"\ \O~ 20 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN ROSALIE F EBY 7 LEBO RD CARLISLE CLER\\ Qf, nT ODP\--1.....r.I.Yl~ I i'dMI n ;w,\'".....J.>..;~,~~, ^ I""""" ,1'" " 'J I Dj.\ CULW ,',.. PA 17015 ESTATE OF EBY *' REV-1547 EX AFP (06-05) FANNIE H TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED DATE 10-02-2006 I~ an ass....ent was issu.d pr.viously, lines 14, 15 and/or 16, 17, 18 and refl.ct ~igures that include the total o~ ALL returns as..ss.d to dat.. ASSESSMENT OF TAX: 15. ABOUnt of Li~ 14 at Spousal rate (15) 16. Aaaunt of Line 14 taxable et Li~al/Cless A rate (16) 17. Aaount of Line 14 at Sibling rate (17) 18. ~unt of Line 14 taxable .t Collaterel/Class I rete (18) 19. Principal Tax Due RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..l Estate (Schedule A) 2. Stocks -.,d Bonds (Schedule B) 3. Closely Held stock/Partnership Interast (Schac:lule C) 4. KortgagaslNotes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule g) 8. Total Assets (1) (2) (3) (ft) (5) (6) (7) .00 .00 .00 .00 1.039.501.94 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/A.. CostsIHisc. Expanses (Schac:lule H) 10. DabtslNortgaga Liabilities/Liens (Schedule I) 11. Total Deductions 12. Hat Value of Tax Return 13. Charitab1e/Gove~ental Bequests; Non-elected 9113 Trusts 14. Hat Value of Estate Subject to Tax (9) (10) 12,509.12 11.151.11 (11) (12) (13) (1ft) (Schedule .n NOTE: .00 X 1,015,841.11 X .00 X .00 X AI10UNT PAID 251000.00 18,000.00 1,514.67 DATE 09-17-2004 03-22-2005 08-25-2006 INTEREST/PEN PAID (-) 1,315.79 .00 117.34- NUttiER CD004403 CD005119 CD007145 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE NOTE: To Insura proper credit to your eccount, subIIlt the upper portion of this for. with your tax pay...,t. 1,039,507.94 23.660 83 1,015,841.11 .00 1,015,841.11 19 will 00 = 045 = 12 = 15 = .00 45,713.12 .00 .00 45,113.12 (19)= 45,113.12 .00 .61 .61 If IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYttENT IS REQUIRED. rf4J' . IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)I YOU HAY BE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Cumner.lana LounLY - Kt:':j.L:::H...t:l. V.L 'LL.L.LO One Courthouse Square Carlislel PA 17013 Phone: (717) 240-6345 Date: 6/08/2007 EBY JANET M f',<:' 7 LEBO RD CARLISLE I PA 17013 c RE: Estate of EBY FANNIE HELEN File Number: 2004-00603 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS. COURT RULES I NO. 103 SUPREME COURT RULES DOCKET NO. 11 for decedents dying on or after July 11 1992, the personal representative or his counsell within two (2) years of the decedent's deathl shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/22/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Lumoer.lana LOUIlLY - .t\.e~..Li::>Lt::L VL 'LJ...L.LC> One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 6/08/2007 EBY FERNE L c.. . 7 LEBO RD CARLISLE, PA 17013 r') \...).) RE: Estate of EBY FANNIE HELEN File Number: 2004-00603 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/22/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, .tz_ /_ U l.l'l- ." lJ ~~u~~~_/ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Cumberland. county - J:<.eglsu::L V.l.. VU.L.Lb One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 EBY ROSALIE F ~ '. l ~,_ Date: 6/08/2007 7 LEBO RD CARLISLE, PA 17013 c RE: Estate of EBY FANNIE HELEN File Number: 2004-00603 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/22/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~ V,Lt- t1 .~~j.k0~_4~rlC _. Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Pa. D.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: FANNIE EBY Date of Death: 06/22/2004 File Number: 220-05-6649 (Social Security #) Pursuant to Pa. O.c. Rule 6.12, I report the following with respect to completion ofthe administration of the above-captioned estate: 1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . .. [i]Yes 0 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? . . . . . .. DYes [i]No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ............................... Ii] Yes ONo 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 )t ~Vh.l 014) z.otJ7 ~Ww,"~"';id~"'m~ 7- Capacity: III Personal Representative 0 Counsel Rosalie Eby "fit.A ~').l.;:.,~ r: ~ Name of Person Filing this arm 'Id u " _",:l/',:n I U r. ,",\,.\ ,\ ' " 'Hd' '0 ..LO! \l\..J'.) 011\J~ji' 0 :10 }jtl318 7 Lebo Road Address Carlisle, P A 17015 717-243-0663 I ~ : II WV 2- lllr tOOl Telephone t' ...:, :r'H. jr'; (' :,T'!I'!'> Form RW~-j'a-J;i!v, 1o,'1t:V6J _01 ~-