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HomeMy WebLinkAbout03-0888Estate of ,q y 1 V i ,~ also known as Register of Wills of County, Pennsylvania PETITION FOR GRANT OF LETTERS , Deceased Social Secur~ No. I ~ ~ - iE Petitioner(s), who is/are 18 years of age or older, apply(les) for: (COMPLETE 'A' or 'B' BELOW:) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the executrix the Decedent, dated 9 / 1 4 / 9 5 and codicil(s) dated None named in the last Will of State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration (c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Decedent was domiciled at death in or principal residence at Messiah Village Decedent, then 7~ years of age, died../_10/23/ ,19 .. Attach additional sheets if necessary. County, Pennsylvania with his/her last family Upper Allen Township.. Mechan~c~b]]r9.. PA (list street, number, and municipality) ~(Lo'cation) ....... "' - -- Decedent at death owned property wi~h 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 request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Si~lnature T~/ped or printed name and residence Prepared by the Pennsylvania Bar Association Copyrlg ht (c) 1996 form software only CPSystems, inc. Form RW-1 (~991) Oath of Personal Representative Commonwealth of Pennsylvania County of 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 representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. before me thi.~w~day of ARLENE E. MYERS ~.,,~_~_.~/ ./-F;or the R.egister No. Estate of Sylvia M- Ep?]~y Social SecUrity 'No: t 8 9 - 1 8- 7 2 9 9 Date of Death: AND NOW, of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary r'-'] of Administration Deceased 10/23/200_3 ~' , in consideration (c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) are hereby granted to Arlene E, Myers in the above estate and that the instrument(s) dated 9 / 1 4 / 1 9 9 5 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. Letters ........... Short Certificate(s) ..... Renunciation ........ Affidavits ( ) .... Extra Pages ( ) .... Codicil ........... JCP Fee .......... $ $ $ FEES Attorne:~..~an M. Wiley,-Esquire I.D. No: 06298 ~ Address: 130 West Church St: Su~t~. 1~ Di 1 lsbur, g~ ~.Pa_~ 1~'!,0 l~r]. Telephone: ( 7 1 7 ) 4 3 2- 9 6 6 6 inventory .......... $ Other ........... $ TOTA' ......... $ Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, lnc. Form RW-1/199~: ?his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Re. gistrar. The original certificate will be forwarded to the State Vital Records Office for permanent ~]ling. WARNING: It is illegal to duplicate this copy by photostat or photograph. Local Registrar P Oe No. ~ ][)ate COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH Sylvia M. Eppley f,'Female t" 189 - 18 - 7299 l'.october 23. 2003 884 Eppley Road Mechanicsburg, PA 17055 Clair Enck Pennsylvania ,r,.~ ~.. ~,..,,,~ ~ Monro~ I,,- Nellie ~ft ~.175 Fam Valle~ Rmd[Wellsville~ PA 17365 ,,,.Trindle S~ing ~te~ a,~.~icsb~t PA 17055 l~.~l~::zi 8 ~pl~ ~~~, ~ 1~5 Arlene Eppley Myers ~m~ c,.,.,-O ~.~.~.0 [] ,,,.October 27t 2003 SYLVIA M. EPPLEY BE IT REMEMBERED, that I, SYLVIA M. EPPLEY, of 884 Eppley Road, Mechanicsburg, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof by me at any time heretofore made. ITEM 1: I direct that all my just debts and funeral expenses be paid as soon after my demise as may be convenient. ITEM 2: Ail the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, whether it be real, personal or mixed, including property over which I have a power of appointment, I give, devise and bequeath unto my husband, ROBERT L. EPPLEY, absolutely, provided he survives me for a period of thirty (30) days. ITEM 3: Should my husband, ROBERT L. EPPLEY, fail to survive me for a period of thirty (30) days, or should we die simultaneously, I then give, devise and bequeath my entire residuary estate unto my children, ARLENE E. MYERS, DELORES E. WIDDERS, MERLE R. EPPLEY and LOIS A. FROMM, in equal shares per stirpes. ITEM 4: I direct my hereinafter named Executor to pay all inheritance, estate, succession and legacy taxes of whatsoever nature and kind, to which my estate or the transfer of any property passing hereunder or otherwise passing by reason of my demise, may be subject and to charge such taxes against my residuary estate, it being my intention that none of the )~L%~NE S S .' -1- ( SEAL ) aforesaid taxes, either federal or state, on any property required to be included in my gross estate, under the provisions of any state or federal law now in force or hereafter enacted, shall be prorated among the persons interested in my estate to whom such property is or may be transferred or to whom any benefit accrues. ITEM $: I appoint my husband, ROBERT L. EPPLEY, as Executor of this my Last Will and Testament. Should my husband predecease me, fail to qualify, cease to act or renounce probate, I then appoint my daughter, ~%RLENE E. MYERS as Executrix of this my Last Will and Testament. Should my daughter, ARLENE E. MYERS, predecease me, fail to qualify, cease to act or renounce probate, I then appoint my daughter, DELORES E. WIDDERS, as Executrix of this my Last Will and Testament. Should my daughter, DELORES E. WIDDERS predecease me, fail to qualify, cease to act or renounce probate, I then appoint my son, MERLE R. EPPLEY, as Executor of this my Last Will and Testament. Should my son, MERLE R. EPPLEY, predecease me, fail to qualify, cease to act or renounce probate, I then appoint my daughter, LOIS &. FROMM, as Executrix of this my Last Will and Testament. ITEM 6: I direct that my Executor, or his successor shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /~t~day of ~p~,~r~ ~ , 1995. (SEAL) -2- COMMONWEALTH OF PENNSYLVANIA COUNTY OF YORK : SS We, SYLVIA M. EPPLEY, JAN M. WILEY, ESQUIRE and JANICE E. SHAMBAUGH, the Testatrix and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed this Last Will and Testament as witness and that to the best of their knowledge the Testatrix was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. Sworn to and subscribed before me this /~day of NOTARY PUBLIC MY COMMISSION EXPIRES: SYLVIA M. EPPLEY JAN M. WILEY & ASSOCIATES ATTORNEYS AT LAW 2 Barlo Circle Dillsburg, PA 17019 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: SYLVIA A. EPPLEY Date of Death: October 23, 2003 Estate Number: 21-03-0888 To the Register: I certify that notice of beneficial interest required by Rule 5.6 (a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on November 4, 2003: Name Arlene E. Myers Delores E. Widders Merle R. Eppley Lois A. Fromm Address 175 Farm Valley Road, Wellsville, PA 17365 1256 West Lisbum Road, Mechanicsburg, PA 17055 1165 Rhoda Blvd., Mechanicsburg, PA 17055 289 Sherwood Drive, Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except N/A. Date: November 4, 2003 ~gnature Name: Jan M. Wiley Address: 130 West Church Street Suite 100 Dillsburg, PA 17019 Telephone: (717) 432-9666 Capacity: Counsel for personal Rep. 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 NO. REV-1162 EX(11-96) CD 003465 WILEY JAN M 1 S BALTIMORE STREET DILLSBURG, PA 17019 ........ fold ;.- (' ESTATE INFORMATION: SSN: 189-18-7299 FILE NUMBER: 2103-0888 DECEDENT NAME: EPPLEY SYLVIA M DATE OF PAYMENT: 01/21/2004 POSTMARK DATE: 01/20/2004 COUNTY: CUMBERLAND DATE OF DEATH: 10/23/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3,918.56 REMARKS: TOTAL AMOUNT PAID: $3,918.56 SEAL CHECK# 1004 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH DEPUTY REGISTER OF WILLS REGISTER OF WILLS STATUS REPORT UNDER RULE 6.12 Name of Decedent: O ,eo, Will No. J/-O~-O¢ Admin. No. 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 whe/ther administration of the estate is complete: YesV' No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes . No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the p.ersonal representative state an account informally to the parties in interest? Yes v'/ No Date: 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. ( (/S~natur~- ' /-~ ~ ~". N~me (Please f~pe ~ pri~ Address (3/?) Tel. No. Capacity: Personal Representative Counsel for personal representative Jan M. Wiley David J. Lenox Timothy J. Colgan Christopher J. Marzzacco June 29, 2004 THE WILEY GROUP Attorneys at Law Wiley, kenox, Colgan & Marzzacco, P.C. Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 David E. Hershey Diana Woodside Bradley A. Winnick Jennifer L. Frechette In Re: Estate of Sylvia M. Eppley, deceased File Number 21-03-00888 Dear Register: Enclosed for filing please find an Inventory, the inheritance tax return in duplicate, and the stares report with regard to the above captioned estate. Also enclosed is a check in the amount of $12,599.53 representing the tax due, and a check in the amount of $25.00 representing the filing fee. Please return the recording receipts to my attention in the enclosed envelope. Thank you for your cooperation. Sincerely, /dg encl. 130 W. Church Street, Suite 100 · Dillsburg, PA 17019 · Phone: (717) 432-9666 ° (800) 682-4250 · Fax: (717) 432-0426 Offices in Harrisburg ° York · Carbondale www.wileygrouplaw, com Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Eppley, Sylvia M. No. 21 - 03 - 00888 also known as Date of Death 10/23/2003 , Deceased Social Security No. 189-18-7299 Arlene E. Myers The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of PennsYlvania except that which appears in a memorandum at the end of this Inventory. INVe verify that the statements made in this Inventory are true and correct. INVe understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: Jan M. Wiley, Esq. I.D. No.: 06298 Address: I S. Baltimore St. Dillsburg, PA 17019 Telephone: 717/432-9666 Personal Property PNC Bank Checking Account #5070047392: PNC Bank Savings Account #5001104672: Bethany Village (refund): Personal Representative Signature: Ar~ers~7- ~'~~. Signature: Signature: Address: 175 Farm Valley Rd. Wellsville, PA 17365 Telephone: 717-432-4591 Dated: Total Personal Property 25,698.58 20,577.57 2;286.52 $48,562.67 (Attach additional sheets if necessary) Total Personal Property and Real Estate $48,562.67 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 NO. CD REV-1162 EX(11-96) OO41 O4 WILEY JAN M 1 S BALTIMORE STREET DILLSBURG, PA 17019 ........ fold ESTATE INFORMATION: SSN: 189-18-7299 FILE NUMBER: 2103-0888 DECEDENT NAME: EPPLEY SYLVIA M DATE OF PAYMENT: 06/30/2004 POSTMARK DATE: 06/30/2004 COUNTY: CUMBERLAND DATE OF DEATH: 10/23/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $12,599.53 REMARKS: TOTAL AMOUNT PAID: $12,599.53 SEAL CHECK//1925 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPAR'~MENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 COUNTY CODE 03 00888 YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Eppley, Sylvia M. 189-18-7299 ~ DATE Of DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR} mO THIS RETURN MUST BE FILED IN DUPUCATE WITH THE ,?, 10/23/2003 02/29/1924 REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER [] 1. Original Return [] 2. Supplemental Return [] 3. Remainder Return (date of death pdorto 12-13-82) ~=OO [] 4. Limited Estate [] 6. Decedent Died Testate (Attach copy of Will) [] 9. Litigation Proceeds Received 12-31-91 and 1-1-95 ~IAME Jan M. Wiley, Esq. --IRM NAME (if applicable) The Wiley Group tELEPHONE NUMBER 717/432-9666 ] 4a. Future Interest Compromise (date of death after 12-12-82) [] 5. Federal Estate Tax Return Required [] 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes copy of Trust) [] 10. Spousal Poverty Credit (date of death between [] 11. Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS 1 S. Baltimore St. Dillsburg, PA 17019 9. 14. 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Prope~j (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) Total Gross Assets (total Lines 1-7) Funeral Expenses & Administrative Costs (Schedule H) (9) Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) Total Deductions (total Lines 9 & 10) None None None None 48,562.67 None 345,814.40 18,309.74 4,415.46 Net Value of Estate (Line 8 minus Line 11) OFFICIAL USE ONLY (8) (11) 394,377.07 22,725.20 371,651.87 371,651.87 (12) Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) 16.Amount of Line 14 taxable at lineal rate x .045 (16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 371,651.87 16,724.33 16,724.33 20. [] Copyright 2000 form software only The Lackner Group, Inc, Form REV-I$00 EX (Rev. 6-00) Decedent's Complete Address: ISTREET ADDRESS 884 Eppley Rd. Iq:r~ Mechanicsburg PA 17055 STATE ZIP Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty 3,918.56 206.24 (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page I Line 20 to request a refund If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 16,724.33 4,124.80 0.00 12,599.53 12,599.53 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .................................................................................. ~ ~ b. retain the right to designate who shall use the property transferred or its income; .................................... c. retain a reversionary interest; or .................................................................................................................. d. receive the promise for life of either payments, benefits or care9 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate cons derat on? ....................................................................................................................... [] [] 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 benefic ary des gnat on? ...................................................................................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Arl E. Myers ~~1~0 ~I~RSO~ R~E~PONSIBL~ ~)R FILING RETURN OTHER THAN~ATIVE ADDRESS ADDRESS ADDRESS 175 Farm Valley. Rd. Wellsville, PA 17365 1 S. Baltimore St. Dillsburg, PA 17019 DATE DATE For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the 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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. {}9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. {}9116 1.2) [72 P.S. {}9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. {}9116 (a) (1.3)]. A 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. SYLV~ H. EPPLEY BE IT REMEMBERED, that I, SYLVIA M. EPPLEY, of 884 Eppley Road, Mechanicsburg, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof by me at any time heretofore made. ITEM 1: I direct that all my just debts and funeral expenses be paid as soon after my demise as may be convenient. ITEM 2: Ail the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, whether it be real, personal or mixed, including property over which I have a power of appointment, I give, devise and bequeath unto my husband, ROBERT L. EPPLEY, absolutely, provided he survives me for a period of thirty (30) days. ITEM 3: Should my husband, ROBERT L. EPPLEY, fail to survive me for a period of thirty (30) days, or should we die simultaneously, I then give, devise and bequeath my entire residuary estate unto my children, ARLENE E. MYERS, DELORES E. WIDDERS, MERLE R. EPPLEY and LOIS A. FROMM, in equal shares per stirpes. ITEM4: I direct my hereinafter named Executor to pay all inheritance, estate, succession andlegacy taxes of whatsoever nature and kind, to which my estate or the transfer of any property passing hereunder or otherwise passing by reason of my demise, may be subject and to charge such taxes against my residuary estate, it being my intention that none of the (SEALi aforesaid taxes, either federal or state, on any property required to be included in my gross estate, under the provisions of any state or federal law now in force or hereafter enacted, shall be prorated among the persons interested in my estate to whom such property is or may be transferred or to whom any benefit accrues. ITEM 5: I appoint my husband, ROBERT L. EPPLEY, as Executor of this my Last Will and Testament. Should my husband predecease me, fail to qualify, cease to act or renounce probate, I then appoint my daughter, ARLENE E. MYERS as Executrix of this my Last Will and Testament. Should my daughter, ARLENE E. MYERS, predecease me, fail to qualify, cease to act or renounce probate, I then appoint my daughter, DELORES E. WIDDERS, as Executrix of this my Last Will and Testament. Should my daughter, DELORES E. WIDDERS predecease me, fail to qualify, cease to act or renounce probate, I then appoint my son, MERLE R. EPPLEY, as Executor of this my Last Will and Testament. Should my son, MERLE R. EPPLEY, predecease me~ fail to qualify, cease to act or renounce probate, I then appoint my daughter, LOIS A. FROMM, as Executrix of this my Last Will and Testament. ITEM6: I direct that my Executor, or his successor shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal SY~.7;IA M. EPPLEY t (SEAL -2- COMMONWF2~LTH OF PENNSYLVANIA ' ' COUNTY OF YORK We, SYLVIA M. EPPLEY, JAN M. WILEY, ESQUIRE and JANICE E. SHAMBAUGH, the Testatrix and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed this Last Will and Testament as witness and that to the best of their knowledge the Testatrix was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. /~ITNESS Sworn to and subscribed before me this /~day of 1995. NOTARY PUBLIC MY COMMISSION EXPIRES: COMMON~MF. ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Eppley, Sylvia M. 21 - 03 - 00888 Include the ,~roceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivomh~p must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 2 PNC Bank Checking Account #5070047392: PNC Bank Savings Account #5001104672: Bethany Village (refund): TOTAL (Also enter on Line 5, Recapitulation) 25,698.58 20,577.57 2,286.52 48,562.67 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Eppley, Sylvia M. 21 - 03 - 00888 This schedule must be completed and filed if the answer to_a_nX of questions 1 througt ITEM DATE OF DEATH NUMBER VALUE OF ASSET 1 2 3 4 DESCRIPTION OF PROPERTY Include the name of the transferee, their relationship to decedent and the date of transfer. Attach a copy of the deed for real estate. Glenbrook Life and Annuity Co, Contract #GA0686158: MetLife Annuity Contract #940029775: PNC Bank IRA Account #65001005936: Charney Investment Group (Trust Account for Sylvia Eppley - Wachovia Securities): 10,711.95 82,462.0~ 8,117.04 244,523.32 % OF DECD'S INTEREST 100% 100% 100% 100% _4_pn page 2 is yes. EXCLUSION IF APPLICABLE) TAXABLE VALUE 10,711.95 82,462.09 8,117.04 244,523.32 TOTAL (Also enter on line 7, Recapitulation) 345,814.40 PN CBAN November 2 i, 2003 lan M. Wiley, Esquire i Sou~ Baltimore Street Dillsburg, PA 17019 Estate of Sylvia M. Eppley, deceased SSN: 189-18-7299 DOD: 10/23/2003 Dear Attorney Wiley:, In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account #5070047392 SYLVIA M EPPLEY DOD balance: $25,698.48 + $.10 accrued interest Established 05/04/1989 Savin~ AeeOum Account #5001104672 SYLVIA M ~?PLEY DOD balance: $20,577.33 + $.24 accrued interest Established 01/20/1998 IRA Account Account ~65001005936 Established 02/24/1995 SYLVIA M EPPLEY DOD balance: $8,096.41 + $20,63 accrued interest *Please note, that Sylvia took over ~:he IRA Account on 1/30/1998 after Robert l/ppley passed away. For IRA or Beneficiary informsfion~ p!~se call 1-888-PNC-IRAS. For Brokerage information, please call 1-800-7624 111. (Account) INV #11794575 Page lof 2 18:85 ..... ~-'~'...~K'~'~"-~^~ 412 768 ~458 P.02 Please note that this office only provides date of death bzhnces for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process shy financial transactions or provide statements. If you need assistance with any of~h~e items, please call 1-888-PNC-BANK (1-$88-762-2265) or stop by your local PNC Bank bra_~h office. Sincerely, Rachelle Well, 1-800-762-1775 PT-PFSC-04-F 500 first Ave. Pirt~bu~h PA I :$219 Pat~e 2 of 2 Mernb~ FDIC TOTRL P. 02 Glenbrook Life and Annuity Company P.O. Box 94212 Palatine, IL 60094-4212 GLENBROOK LIFE A Member of Allstate Financial Group November 7, 2003 The Wiley Group Attn: Jan M. Wiley, Esq. 1 South Baltimore Street Dillsburg, PA 17019 Re: Sylvia M. Eppley Contract Number: GA0686158 Dear Ms. Wiley: Thank you for your correspondence to our department dated October 27, 2003. The following is a breakdown of the information you had requested on the above pending annuity claim: !.l Title of Annuity: Sylvia M. Eppley ~ Date of Issue: May 24, 2002 3_1 No Ownership Changes 4_l Value of the Annuity on the Date of Death: $10,711.95 Principal: $10,000.00 Accrued Interest: $711.95 Should you have any questions, or require further assistance, please contact our Customer Care Unit at 1- 877-499-6418. Sincerely, Claims Correspond¥ffce Life and Annuity Claims Copy to: File Overnight Address: 300 North Milwaukee Avenue, Vernon Hills, IL 60061 Toll Free Fax: 1-866-635-4523 November 3, 2003 The Wiley Group Attorneys at Law 1 South Baltimore Street Dillsburg, PA 17019 Attn: Dawn Gladfelter RE: Estate of Sylvia M. Eppley SS# 189-18-7299 Dear Ms. Gladfelter Sylvia M. Eppley was the sole owner of a MetLife Annuity Contract #940029775. The Date of Death Value of this annuity is $82,462.09. The accrued interest to date of death is $2,462.09..-This account was originally opened on 03/08/2003. Sylvia's brokerage account #1179-4575 contained the Metlife Annuity and a Glenbrook Annuity. I have contacted Glenbrook and they are going to send you the requested information direct. Thank you, Donna ~ r~2 Charney ~~ Investment 700 South 28th Street Harrisburg, PA 17103 (717) 232-6974 1-888-529-2973 (717) 232-6979 fax November 3, 2003 The Wiley Group Attorneys at Law 1 South Baltimore Street Dillsburg, PA 17019 ATTN: Jan M Wiley, Esquire Dear Jan: I am sending you this letter in reference to the Estate of Sylvia M Eppley. Per your request I have answered the following questions listed in your letter as follows: · Date of Death Value for Sylvia was: $244,523.32 · The type of ownership was a individual trust for Sylvia with Arlene Myers as Trustee · The date that the trust was originally opened was January 16, 2001 Thank yoU for your time and patience in this matter and if you should have any other questions please feel welcome to contact me. Sincerely, Amanda J Balsava~q Client Service Specialist Wachovia Securities, Inc., member New York Stock Exchange and SIPC. COMMONV~-ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Eppley, Sylvia M. 21 - 03 - 00888 Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT ITEM NUMBER A. ! FUNERAL EXPENSES: James R. Gingrich Memorials (Cemetery Inscription): ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid Attorney's Fees Jan M. Wiley, Esquire - The Wiley Group: Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address C~ty Relationship of Claimant to Decedent Probate Fees Register of Wills: State ~ Zip Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Cumberland Law Journal (advertise): Carlisle Sentinel (advertise): David J. Lenox: 100.00 16,800.00 339.00 650.00 75.00 130.74 Total of Continuation Schedule(s) 215.00 TOTAL (Also enter on line 9, Recapitulation) 18,309.74 ~l~dub H COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Eppley, Sylvia M. 21 03-00888 3 Bonnie Miller (taxes): 11.00 PA Dept. of Revenue: 204.00 Page 2 of Schedule H SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Eppley, Sylvia M. 21 - 03 - 00888 Include unreimbumed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT Messiah Village (final bill): Pharmerica (pharmacy): TOTAL (Also enter on Line 10, Recapitulation) 4,330.61 84.85 4,415.46 REV.1513 EX+ (9.00) ~ COMMONVVF_ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Eppley, Sylvia M. SCHEDULE J BENEFICIARIES FILE NUMBER 21 - 03- 00888 NUMBER I. 1 4 II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Arlene g. Myers 175 Farm Valley Rd. Wellsville, PA 17365 Delores E. Widders 1256 W. Lisburn Rd. Mechanicsburg, PA 17055 Merle R. Eppley 1165 Rhoda Blvd. Mechanicsburg, PA 17055 Lois A. Fromm 289 Sherwood Drive Carlisle, PA 17013 RELATIONSHIP TO DECEDENT Do Not Uat Trustee(s) daughter daughter son ~aughter 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 AND GOVERNMENTAL DISTRIBUTIONS AMOUNT OR SHARE OF ESTATE one-fourth of residuary estate one-fourth of residuary estate one-fourth of residuary estate one-fourth of residuary estate TOTAL OF pART!I-ENTER TOTAL NON-TAXABLE DISTRIBUTiO_,s ON LINE 13 OF REV-1500 COVER SHEET 4 0 5 8 M~JLED FROMZ!P CODE THE VZILEY GROUP Attorneys at Law Wiley · kenox Colgan · Marzzacco · P.C. 130 W. Church Street · Suite 100 Dillsburg, PA 17019 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 I,,,111,,,111,,,,,,11,,11,1,,I,I BUREAU OF ZNDTVZDUAL TAXES t'HHERTTANCE TAX DTyTSTON DEPT. 180601 HARRISBURG, PA 1711&-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (01-03) JAN ~:WILE~:dESQ THE i'/TLEY GROUP 1 S:'BA, LTIHC~ ST DI [~S!B.URG ~'L', *=: CUT ALONG THIS LINE ~ DATE 08-25-Z004 ESTATE OF EPPLEY DATE OF DEATH 10-23-2003 FILE NUHBER 21 03-0888 COUNTY CUHBERLAND ACN 101 Alnount Remitted SYLVIA HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 RETAIN LOWER PORTZON FOR YOUR RECORDS *-~ H REV-1547 EX AFP (01-03) NOTICE OF ZNHERITANCE TAX APPRA/SEHENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF EPPLEY SYLVIA HFZLE NO. 21 03-0888 ACN 101 BATE 08-23-2004 TAX RETURN HAS: (X) ACCEPTED AS FTLED ( ) CHANGED RESERVATION CONCERNING FUTURE ZNTEREST- SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) $. CZosaly Held Stock/Partnership Interest (Schedule C) ($) ~. Mortgages/Notes Receivable (Schedule D) (~) 5. Cash/Bank Daposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Exponsas/Adm. Costs/Misc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) 11. Total Deductions 12. Not Value of Tax Roturn 48~562.67 .00 .00 NOTE: To insure propor .00 credit to your account, .00 subeit the upper port/on .00 of this form with your tax payment. 345;814.40 (8) 394,377.07 18,309.74 13. 14. NOTE: (11) 22.72;.2~ (12) 371,651.87 Charitablo/Govornmontal Bequests; Non-elected 9113 Trusts (Schedule J) (15) . O0 Not Value of Estato Subjoct to Tax (14) 371,651.87 :if an assessment was issued prev$ously, 1Shes 14, 15 and/or 16, 17, 18 and 19 ~11 reflect figures that include the total o~ ALL returns assessed to date. (is) .00 x O0 : .00 (16) 371,651.87 x 045: 16,724.33 (17) .00 X 12 = .00 (18) .00 X 15 = .00 (19)= 16,724.33 AMOUNT PAID 3,918.56 12,599.53 ASSESSHENT OF TAX: 1.6. Aeount of L~ne 1~ at Spousal rate 16. Aeount of L~ne lq taxable at L~nea~/C~ass A rata 17. Amount of Line 14 at Sibling rate 18. Aeount of Line lq taxable at Collateral/Class B rata 19. Principal Tax Due TAX CREDITS: PAYIIENT RECE/PT DISCOUNT (+J DATE NUMBER INTEREST/PEN pAID (-) 01-20-2004 CD003465 206.24 06-$0-2004 CD004104 . O0 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDZTZONAL INTEREST. 16,724.33 .00 .00 .00 ( TF TOTAL DUE TS LESS THAN $1, NO PAYHENT TS REQUTRED. TF TOTAL DUE TS REFLECTED AS A "CREDZT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF TH'rS FORN FOR TNSTRUCTTONS.) TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE RESERVATION: Estates of decedents dying an or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of tho decedent after the expiration of any estate for life ar for years, the Commonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADHIN- ISTRATZVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section ZlqO of tho Inheritance and Estate Tax Act, Act Z$ of ZOO0. (TZ P.S. Section 91~0). Detach the tap portion of this Notice and submit eith your payment to the Rag[star of Hills printed an tho reverse side. --Hake check or money order payable to: REGISTER OF NILLS, AGENT A refund of a tax credit, which was not requested an the Tax Return, may be requested by completing an "Application for Refund af Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications ara available at the Office of the Register of Hills, any of the Z$ Ravf;nue District Offices, or by calling the special 2~-hour answering service for forms ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-~7-5020 (TT only). Any party in interest not satisfied with the appraisement, alloaance, or disalloaancs of deductions, or assessment of tax (including discount or interest) as shown an this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Ravenua~ Board of Appeals, Dept. 2810Z1, Harrisburg, PA 17128-10Z1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dapto 280601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for a Res[dent Decedent" (REV-lBO1) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (BI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you could appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .00016~. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate ahich will vary from calendar year to calendar year eith that rate announced by the PA Department af Revenue. The applicable interest rates for 19BI through ZO0~ ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ ZOZ .O005~B 1988-1991 Ill .000301 ZOOl 9Z .OOOZ~7 1983 162 .000~38 1992 92 .OOOZi7 2002 62 .OOO16~ 1984 1XZ .000301 1993-199~ 7Z .O0019Z 2003 5Z .000137 1985 132 .000356 1995-1998 9Z .O00Z~7 200~ ~Z .000110 1986 lOZ .O0027~ 1999 7Z .O0019Z 1987 102 .OOOZ7~ ZOOO 7X .O0019Z --Interest is calculated as folloes: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) 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.