The URL can be used to link to this page

Home My WebLink About03-0366Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of ANNA S. BROUGH also known as , Deceased Donald P. Brough, Jr. and Pamela A. Mulhern Petitioner(s), who is/are 18 years of age or older, apply(les) for: Social Security No. 201-18-4148 (COMPLETE 'A' or 'B' BELOW:) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut ors the Decedent, dated 10/27/1999 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:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last family or principal residence at 1606 Pine Road, Penn Township, Carlisle, PA 17013 (list street, number, and municipality) Decedent, then 77 years of age, died 04/11/2003 at 1606 Pine Road, Carlisle, PA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (if not domiciled in PA) Personal property in Pennsylvania (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania situated as follows: 1606 Pine Road, Carlisle, PA 17013 $ $ $ $ TOTAL 4,000.00 145,000.00 149,000.00 Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Typedorprintednameandresidence Donald P. Brough, Jr. 1370 Centerville Road, Newville, PA 17241 Pamela A. Mulhern 4010 Si~ler Circle, Jefferson, Maryland 21755 /?-/3 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland 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 Sworn to or affirmed and subscribed before me this 22ndday of April , 2003 ~m~la A. Mulhern For the Rfegi~te-7'-/"~'-~ Donna M. Otto,lst Deputy No. 2]-2~i3-366 Estate of ANNA S. BROUGH Deceased Social Security No: 201-18-4148 Date of Death: 04/11/2003 AND NOW, April 25th , 2003 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary [--'] Of Administration (c.t.a.; d.b.n.c.ta.; pendente lite; durante absentia; durante minoritate) are hereby granted to Donald P. Broush, Jr. and Pamela A. Mulhern in the above estate and that the instrument(s) dated 10/27/1999 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. Letters ........... $ 235.00 Donna M. Otto, 1st De~er o, Wills ~ 15. 00 Attorney: Shelly J. Kunkel, Esquire Short Certificate(s).. ( 5. ). $ Renunciation ........ $ Affidavits ( ) .... $ I.D. No: 64485 Skarlatos & Zonarich LLP Extra Pages ( 6 ) .... $ 18.00 Address: 204 State Street Codicil ........... $ Harrisburg, PA 17101 JCP Fee .......... $ 10.00 Telephone: 717/233-1000 Inventory .......... $ Other ........... $ TOTAL ......... $ 278.00 MAILED LET%~ TO ATTORNEY ON 4/25/2003 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) rtl05.805 REV 5t/86 This is to certify that the information here given is correctly copied from an original certificate of death duly flied with me as Local Registrar. The original certificate will be. forwarded to the State Vital Records Office for permanent filing. WAFINING: It is illegal to duplicate this coplt blt photostat or photograph. Fee for this certificate, $2.00 ? 919103S No. H 105.143 Rev. 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH '- Anna S. Brough ,.Female 3. 201 --18 --4148 '. April 1~, '2003 ~N~ OF ~H OF 0~~ ~ ~rland ~ p p 21-2003-366 LAST WILL AND TESTAMENT OF ANNAS. BROUGH I, ANNA S. BROUGH, of Penn Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do make, publish and declare this to be my Last Will and revoke any Wills and codicils previously made by me. ARTICLE ONE Soecific Bequest of Tangible Personal Propert3~ I give and bequeath all of my tangible personal property including, but not limited to, all my automobiles, furniture, fia-nishings, books, pictures, jewelry, china, linen, silver, clothing household effects and personal effects, and other tangible personal property of like nature (not including cash, securities and other property used for the production of income), together with any existing insurance thereon as I may have provided in a memorandum kept with the original of this Will; or, to the extent not so provided or not effectively disposed of in any such memorandum, to my issue, per stirpes. ARTICLE TWO .Residue I give, devise and bequeath all of the rest, residue and remainder of my estate, of whatever nature and wherever situated, to my issue, per stirpes. ARTICLE THREE Protective Provisions The principal of my estate and any trusts created hereunder, and the income therefrom, so long as the same are held by my Executor shall not be subject to anticipation, assignment, pledge, sale or transfer in any manner, nor shall any beneficiary have power in any manner to charge or encumber his/her interest in my estate or any trust hereunder, nor shall the said interest of any beneficiary be liable or subject in any manner while in the possession of my Executor for any Skarlatos & Zonarich LLP Attorneys At Law LAST WILL AND TESTAMENT OF ANNA S. BROUGH Page 1 of 7 liability of said beneficiary, whether such liability arises from said beneficiary's debts, contracts, torts, or other engagements of any type. ARTICLE FOUR Powers of Executor In addition to and without limiting the powers conferred by case law, by statute, and by other provisions hereof, my Executor shall have the following rights and powers exercisable without the need for court approval: (A) Accept and Retain Investments To accept and retain any form of real or personal property received by transfer, devise, bequest or otherwise without being required to diversify and without being limited to the types of investments in which fiduciaries are authorized by law to invest. This authority shall specifically include the authority to accept and retain any stock of a corporate fiduciary hereunder, or in any corporation which controls or is controlled by it, or any other corporation in which it holds any ownership interest, together with any stock dividends received thereon, or any stock acquired in the exercise of subscription rights, or received by reason of any consolidation, merger or reorganization, without liability for such retention. (B) Invest. To invest and reinvest in any form of real or personal property without limitation by any law applicable to investments by fiduciaries. (C) Voting Rights. To vote a security in person or by proxy, to participate in or consent to any merger, reorganization, dissolution, liquidation, voting trust plan, or other action affecting any securities held hereunder, and; to exercise conversion, subscription, and other rights of whatever nature. (D) Title To Property. To register or hold securities and/or other property in the name of a nominee or nominees, including that of a clearing corporation, a depository, in book Skarlatos & Zonarich LLP Attorneys At Law LAST WILL AND TESTAMENT OF ANNA S. BROUGH Page 2 of 7 entry form, or to retain securities and/or other property unregistered or in a form permitting transfer by delivery. (E) Sale, Lease and Other Dealings with Property. To sell, from time to time, at public or private sale, exchange, lease, encumber, option or otherwise dispose of all or any portion of assets held hereunder; to make, execute and deliver deeds, mortgages, leases, assignments and other documents necessary to carry out any of the powers granted hereunder, which shall specifically include the authority to grant leases which extend beyond the period authorized by law, and; to partition, subdivide, improve and impose any restrictions on real estate held hereunder and enter into agreements concerning the partition, subdivision, improvement, zoning or management of any such real estate. (F) Borrow. To borrow money from any person or institution and pledge property as security for repayment of funds. (G) Distributions in Kind. To make distributions in cash or in kind, or partly in each, and; to allot different kinds of property to different shares without regard to differences in the income tax basis of such property. Any such designation, division, allocation, apportionment or valuation of property shall be binding and conclusive on aH parties. (H) Settle Claims. To institute, prosecute and defend any and all legal proceedings; and compromise, release, adjust and/or settle any debt or claim. (I) Employment of Agents. To employ agents including attorneys, accountants, and others to perform administrative duties. (J) Property Distributable to Minors Any property (whether income or principal) distributable to a beneficiary of my estate or any trust created hereunder who is under a disability may be paid directly to such beneficiary, to the parent or guardian of such beneficiary, to a custodian selected by my Executor (other than my Executor) under the Pennsylvania Uniform Transfers to Minors Act or under a similar act of any other state, or to persons caring for or Skarlatos & Zonarich ~ Attorneys At Law LAST WILL AND TESTAMENT OF ANNA S. BROUGH Page 3 of 7 having custody of such beneficiary (other than my Executor) or may be applied for such beneficiary's benefit by payment to such other persons, organizations or institutions (other than my Executor) as my Executor may select, and the receipt of any such payee shall be a full release therefor. The receipt of any such payments by any such person shall be a full acquittance of my Executor as to any amounts so paid. Any beneficiary hereunder shall be considered to be under a disability while under the age of twenty-one (21) years or at any time when, in the opinion of my Executor such beneficiary is incapacitated in any way so as to be unable to properly manage his/her affairs. ARTICLE FIVE Fiduciarie~ (A) Executor. I appoint my children, Donald P. Brough, Jr. and Pamela A. Mulhern, as co-Executors of this Will (my said Co-Executors and any successor Executor or co- Executors shall be referred to herein as my "Executor"). Should either of my said children die, renounce, resign, fail to qualify or cease to act as Executor for whatever reason, I appoint the survivor as Executor of this W'dl. (B) Miscellaneous. Any successor Executor shall succeed to the capacity of its predecessor without re-conveyance or transfer of property and have all of the fights, powers, authorities and discretion conferred upon the original Executor. No succ~sor Executor shall be obligated to examine the accounts, records, or acts of a previous Executor, nor shall any such successor Executor in any way or manner be responsible for any act or omission to act on the pan of any such previous Executor. No Executor serving hereunder at any time shall be required to file any bond or enter security in any Court or jurisdiction in which said fiduciary may be called upon to act. Skarlatos & Zonarich LLP Attorneys At Law LAST WILL AND TESTAMENT OF ANNA S. BROUGH Page 4 of 7 ARTICLE SIX Interpretation (A) Issue. Whenever the term "issue" is used herein, such term shall be interpreted to include adopted persons as well as natural persons, provided in each instance that the adoptee is under the age of eighteen (18) years at the time of adoption. Such terms are also intended to include persons in gestation at any pertinent time under this Will, provided such persons survive birth by thirty (30) days. (B) Gender and Number. Where appropriate except where the context otherwise requires, whenever used herein, the singular includes and plural, the plural the singular and words of any gender shall be applicable to all genders. (C) Headings/Captions. The headings/captions of Articles, Sections and Paragraphs used herein are for convenience of reference only and shall have no significance in the construction or interpretation of this Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal and mused this my Last Will and Testament, consisting of Seven (7) typewritten pages, including this attestation clause and the following Acknowledgment and Affidavit, to be executed, declared and published this ~ ~ ~ dayof ~~ ,1999, at ~,~~~ Pennsylvania. Skarlatos & ZonarWh LLP Attorneys At Law LAST WILL AND TESTAMENT OF ANNA S. BROUGH Page 5 of 7 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF DAUPHIN ) I, ANNA S. BROUGH, the Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein expressed. ANNA S. BROUGH Sworn or ~ed to and acknowledged before me by ANNA S. BROUGH, the Testatrix this day of ~(~~ ,1999. .-, SEAL) _Commisision Expires: Jean R Zon~ icr;, I'.,~o~:ary Public Harrisburg, D;{~.:~p,hi.,q Cot,'¢3ty My Commissio~ Ex!~ire:: Sep,'.. 14, 2002 Member, PennSylvania_, As,'.;o,r, i;~tio~ ~,! Nataqes Skarlatos & Zonarich LLP Attorneys A t Law LAST WILL AND TESTAMENT OF ANNA S. BROUGH Page 6 of 7 COMMONWEALTH OF PENNSYLVANIA ) ) COUNTY OF DAUPHIN ) SS: w~ ~-.e~e~ s, C~tt~l~ , 2 ;~o~ ~0. a~.~ k , ~d ~}~4 ~ ~[ge~ the ~n~,who~nmes~esi~to the a~ach~ or oregomg ~ent, ~g duly qmlifi~ a~r~g to law, do depose ~d ~y tMt we were pr~ ~d ~w ~A S. BROUG~ si~ ~d ~te the h~em ~ the Testat~'s ~ee ~d vol~t~ ~ for the p~s thereh expresS; t~t tach of us h the h~g ~d si~t of ~e T~a~ si~ ~e Wffi ~ Mme--; ~ tMt to the ~ of~r ~owl~ge, the Temtfix w~ at the ~e ~W-one (21) ~~s o~~ ~d ~d ~der no ~n~ or ~due ~u~. ~ ~l~lO~ this~ day of Skarlatos & Zonarich blic r-~~[, /' My)Commission Exper{s: Jean P. Zonadch, Notary Public [ / J __ Harrisburg, Dauphin County ~ J My Commissior'-~ Expires Sept 14, 2002 Member, Pennsylvania A~qsocJatilhfl Attorneys At Law LAST WILL AND TESTAMENT OF ANNA S. BROUGH Page 7 of 7 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: ANNA S. BROUGH Date of Death: April 11, 2003 Will No. 2003-00366 To the Register: I certify that Notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned Estate on May 16, 2003: Name Donald P. Brough, Jr. Pamela A. Mulhern Address 1370 Centerville Road Newville, PA 17241 4010 Sigler Circle Jefferson, Maryland 21755 Notice has been given to all persons entitled thereto under Rule 5.6(a). Dated: May 16, 2003 Signature Name: Address: Telephone: Capacity: Shelly J. Kunkel, Esquire Skarlatos & Zonarich LLP 204 State Street Harrisburg, PA 17101 (717)233-1000 Counsel for Personal Representative JOHN r. ZONArlCH* ANNA MARIE SOSSONg KATHY SPEAKER MACNeTt JOHN B. ZONArICH Gregory S. CHELAP SHELLY J. KUNKEL TODD f. TRUNTZ t DAVID H. JUDY ANGELO SKAR LATOS * BOARD CERTIFIED IN CIVIL TRIAL ADVOCACY t ALSO ADMITTED IN NEW JERSEY ATTORNEYS AT LAW 204 STate STREET harrisburg, PENNSYLVania 1710! (717)233-10OO Telefax (717)233-6740 WWW.S KAR LATOSZO NAR ICH .COM June 12, 2003 STEeLTON OFFICE MECHAnics SaVInGS BUILDING, STe. 2OI 5 I SOUth FRONT STREEt STeELTOn PEnNSYLVania 17113 (717J 939-9358 MIDDLETOWN OFFIce (717) 944-5109 WRITER'S EMAIL: sjk@skarlatoszonarich.com Office of Register of Wills Cumberland County Court House 1 Courthouse Square Carlisle, PA 17013 Estate of Anna S. Brough No. 21-2003-0366 Dear Sir or Madam: Enclosed please find a check in the amount of $10,000.00 representing an inheritance tax payment on the above-referenced estate. SJK:sks Enclosure cerely, Shelly J. Kunkel A MEMBER OF LAwPACTm - A NATIONAL ASSOCIATION OF INDEPENDENT BUSINESS LAW FIRMS SKARLATOS & ZONARICH LLP ATTORNEY5 AT [-AW 204- STATE STREET HArRISBUrG, PENNSYI-VANIA 17101 Office of Register of Wills Cumberland County Court House 1 Courthouse Square Carlisle, PA 17013 i7013+330t 02 I,,,111,,,111,,,,,,11,,11,,,11,,,11,11,,,,,,111,1,,I,I 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 002681 KUNKEL SHELLY J ESQUIRE 204 STATE STREET HARRISBURG, PA 17101 ........ fold ESTATE INFORMATION: SSN: 201-18-4148 FILE NUMBER: 2103-0366 DECEDENT NAME: BROUGH ANNA S DATE OF PAYMENT: 06/13/2003 POSTMARK DATE: 06/1 2/2003 COUNTY: CUMBERLAND DATE OF DEATH: 04/1 1/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 ,t, 10,000.00 TOTAL AMOUNT PAID: $10,000.00 REMARKS: SHELLYJ KUNKELESQUIRE SEAL CHECK# 1528 INITIALS: VZ RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS January 30, 2004 Skarlotas & Zonarich ,LLP. 204 State St. Harrisburg ,PA 17101 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 17128-0601 Telephone (717) 787-3930 FAX (717) 772-0412 Re: Estate of Anna Brough File Number 2103-0366 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 7/04/04. 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 Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of BROUGH, ANNA S. also known as , Deceased No. 21 -03- 0366 Date of Death 4/11/2003 Social Security No. 201-18-4148 Donald P. Brough, Jr. Pamela A. Mulhern The Personal Representative(s) of the above Estate, deceased, Wrify that th-~-items-appe~ingir{ ~he 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 Decedenrs 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. I/We verify that the statements made in this Inventory are true and correct. I/We 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: Shelly J. Kunkel I.D. No.: 64485 Address: 204 State Street Harrisburg, PA 17101 Personal Representati~ Signature: ~~.~~ Signature: Address: 1370 Centerville Road Newville, PA 17241 Telephone: 717/233-1000 Telephone: 71%486-5149 Dated: .~.-- Personal Property Proceeds from sale of 1990 Oldsmobile Toronado (per Bill of Sale attached hereto as Schedule F~) 2i000.00 Highmark Blue Shield - Unused portion of premium payment Commonwealth of Pemnsylvania - Properly Tax Rebate 121.13 321.00 The Sentinel - Subscription Refund Farmers National Bank of Newville Certificate of Deposit No. 2990101 (per verification and DISCLAIMER attached hereto as Schedule E) 35.54 5,000.00 Farmers National Bank of Newville Certificate of Deposit No. 2990103 (per verification and DISCLAIMER attached hereto as Schedule E) Farmers National Bank Individual Retirement Account No. 9000346 (per verification attached hereto as Schedule E) 5,000.00 42,946.68 (Attach additional sheets if necessary) Total Personal Property and Real Estate $209,031.04 Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of BROUGH, ANNA S. also known as continued , Deceased No. 21 - 03- 0366 Date of Death 4/11/2003 Social Security No. 201-18-4148 Farmers National Bank Individual Retirement Account No. 9000346 (accrued interest to DOD per verification attached hereto as Schedule E) 148.80 Miscellaneous personal property 500.00 Total Personal Property $56,073.15 2 Estate of Register of Wills of Cumberland County, Pennsylvania INVENTORY continued BROUGH, ANNA S. No. 21 - 03 - 0366 also known as Real Estate , Deceased Date of Death 4/11/2003 Social Security No. 201-18-4148 Proceeds from sale of 1606 Pine Road, Carlisle (per Settlement Statement attached hereto as Schedule A) 104,245.92 Additional acreage (4.34) adjoining house listed above 48,711.97 Total Real Estate $152,957.89 3 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER l 21 03 0366 COUNTY CODE YEAR _N_U M_B_ER z DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) BROUGH, ANNA S. DATE Of DEATH (MM-DD-YEAR) 04/1 1/2003 DATE OF BIRTH (MM-DD-YEAR) 01/26/1926 SOCIAL SECURITY NUMBER 201-18-4148 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 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 Retum (date of death priorto i2:~-8~ ] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after 12-12-82) [] 5. Federal Estate Tax Return Required [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes of Will) copy of Trust) -- [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between [] 1 1. Election to tax under Sec. 911 3(A) (Attach Sch O) 12-31-91 and 1-1-95) NAME COMPLETE MAILING ADDRESS Shelly J. Kunk¢l ~vl NAME (If applicable) i Skarlatos & Zonarich LLP 204 State Street ? Harrisburg, PA 1710 l TTELEPHONE NUMBER ! 717/233-1000 , 8. 9. 12. 13. 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 Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 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) 152,957.89 None None None 56,073.15 21,121.93 None 29,842.36 506.67 Net Value of Estate (Line 8 minus Line 11) Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (8) 230, 152.97 (11) 30,349.03 (12) 199,803.94 (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) z 0 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 or transfers under Sec. 9116(a)(1.2) 16.Amount of Line 14 taxable at lineal rate x .045 17. Amount of Line 14 taxable at sibling rate x .12 18. Amount of Line 14 taxable at collateral rate x 19. Tax Due 199,803.94 20. [] (14) 199,803.94 Copyright 2000 form software only The Lackner Group, Inc. (15) (16) (17) (18) (19) 8,991.18 8,991.18 Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: ISTREET ADDRESS 1606 Pine Road Ic[~'Y Carlisle PA T~i-P 17(~13 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 10,000.00 449.56 Total Credits (A + B + C) Total Interest/Penalty (D + 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 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (1) ..... 8,991.18 (2) 10,449.56 (3) 0.00 (4) ._ 1~458:38 (5) (5A) (5B) 0o00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred ... . ...... [] b. retain the right to designate who shall use the property transferred or its income; .................................... c. retain a reversionary interest; or ........ . .............................. d. receive the promise for life of either payments, benefits or care? .............. 2. 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 penalties of perjury, l 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. DecJaration of preparer other than the personal representative is based on all information of which preparer has andy knowledge~ SIGNATURE OF PERSON RES~,~{;3~IBLE FOR FILING RETURN ADDRESS ............... DATE Donald P. Bro~.,.,h~.~ 1370 Centerville Road ~' ~ ~~.,~0,. (~-~~ ~lewville, PA 17241 ~IGN-a , URE OF ~ 'L-~$ON RESPONSIBLE FOR FILING RET~'~I-.. 'ADDREss - ~ DATE Shelly J. Kunke, J~"~ ~ .~- DATE / \ I.{ Y//- -- 204 State Street /_ .k.._fl~/A-.¢.-~o"~- Harrisburg, PA 17101 ~ ~-o' (J 'T- 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 decedenrs 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 decedenrs 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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE A REAL ESTATE BROUGH, ^~^ S. FILE NUMBER 21 - 03 - 0366 aA~l rea! prope _rty owned solely or as a t.enant in comm. on must.be r.e. ported,, at fai.r.,mar, ket value. Fa r market value is defined as the price wnicn property/would be excnanged between a willing buyer ano a wimng se,er nekner being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION Proceeds from sale of 1606 Pine Road, Carlisle (per Settlement Statement attached hereto as Schedule A) Additional acreage (4.34) adjoining house listed above (per assessment from Cumberland County Tax Assessment Office) TOTAL (Also enter on Line 1, Recapitulation) VALUE AT DATE OF DEATH 104,245.92 48,711.97 152,957.89 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BROUGH, ANNA S. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21 - 03 - 0366 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshtp must be disclosed on schedule F. ITEM NUMBER 6 DESCRIPTION Proceeds from sale of 1990 Oldsmobile Toronado (per Bill of Sale attached hereto as Schedule E) Highmark Blue Shield - Unused portion of premium payment Commonwealth of Pennsylvania - Property Tax Rebate The Sentinel - Subscription Refund Farmers National Bank of Newville Certificate of Deposit No. 2990101 (per verification and DISCLAIMER attached hereto as Schedule E) Farmers National Bank of Newville Certificate of Deposit No. 2990103 (per verification and DISCLAIMER attached hereto as Schedule E) Farmers National Bank Individual Retirement Account No. 9000346 (per verification attached hereto as Schedule E) Farmers National Bank Individual Retirement Account No. 9000346 (accrued interest to DOD per verification attached hereto as Schedule E) Miscellaneous personal property TOTAL (Also enter on Line 5, Recapitulation) VALUE AT DATE OF DEATH 2,000.00 121.13 321.00 35.54 5,000.00 5,000.00 42,946.68 148.80 500.00 56,073.15 COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF BROUGH, ANNA S. FILE NUMBER 21 - 03- 0366 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME Donald P. Brough, Jr. B Pamela A. Mulhern C Brandy K. Mulhem ADDRESS 1370 Centerville Road Newville, PA 17241 4010 Sigler Circle Jefferson, MD 21755 4010 Sigler Circle Jefferson, MD 21755 see continuation RELATIONSHIP TO DECEDENT Son Daughter Granddaughter JOINTLY OWNED PROPERTY: LETTER ITEM I FOR JOINT .....NUMBERi TENANT I A 2 A 3 A/B 4 A/B 5 B 6 B ? A 8 B DATE MADE JOINT 07/11/1989 DESCRIPTION OF PROPERTY ~ Incl.ud.e. na. ,me .o..f .financial. instit, u. tion, a.nd b,a. nk accou.nt number DATE OF DEATH ] n~:~OnF,~ [ DA~,O,~F2~E'~TH or sim,ar ioenll~ylng number At~acn (3eea tor jointly-neld real I VALUE OF A estate, -' I .... INTERESTI DECEDENTS INTEREST Farmers National Bank of Newville Savings Account I 1,271 #9655557 (per verification attached hereto as [ Schedule F) J 07/11/1989 12/26/2001 12/26/2001 09/02/1999 09/09/1999 03/17/1998 03/17/1998 Farmers National Bank of Newville Savings Account #9655557 (accrued interest to DOD per verification attached hereto as Schedule F) Farmers National Bank of Newville Certificate of Deposit # 158216 (per verification attached hereto as Schedule F) Farmers National Bank of Newville Certificate of Deposit # 158216 (accrued interest to DOD per verification attached hereto as Schedule F) Farmers National Bank of Newville Checking I Account No. 16-104-7 (per verification letter attached I hereto as Schedule F) Farmers National Bank of Newville Checking Account No. 16-104-7 (accrued interest to DOD per verification letter attached hereto as Schedule F) Farmers National Bank of Newville Certificate of Deposit No. 2990060 (per verification attached hereto as Schedule F) Farmers National Bank of Newville Certificate of Deposit No. 2990102 (per verification attached hereto as Schedule F) 'Total of Continuation Schedule(s) 0.60 35,000.00 43.01 1,135.29 0.55 5,000.00 5,000.00 TOTAL (Also enter on line 6, Recapitulation 5o%i 0.30 33.3333[ 33.333%I 50% 5O% 5o%1 50%! 11,666.66 14.34 567.65 0.28 2,500.00 2,500.00 3,236.95 21,121.93 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BROUGH, ANNA S. SCHEDULE F JOINTLY-OWNED PROPERTY continued FILE NUMBER 21 - 03 - 0366 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY IT--'' - Li'~'TEF~ ] DATE IfoRJOINTI MADE .......... TENANT I JOINT ~ C 05/01/1981 10 D 11 E 12 F 13 G 14 I 15 H 10/01/1981 DESCRIPTION OF PROPERTY Incl.ud.e. na..me .o.,f financial, institution and bank account number I DATE OF DEATH ~o~O,.,F,~ DATE OF DEATH or.s?liar ioenfi~ying number. Attach deed for jointly-held real rVALUE OF ASSET ,,~.,.~'~{J~_l VALUE OF estate, ----- r I~/1 DECEDENT'S INTEREST Six (6) $50 Series EE U.S. Savings Bonds (per J 689.00 -- 500/o] 344.50 Inventory attached hereto as Schedule F) Eight (8) $50 Series EE U.S. Savings Bonds (per Inventory attached hereto as Schedule F) 11/01/1981 i Eight (8) $50 Series EE U.S. Savings Bonds (per Inventory attached hereto as Schedule F) 10/01/1081 Eight (8) $50 Series EE U.S. Savings Bonds and two (2) Series E U.S. Savings Bonds (per Inventory attached hereto as Schedule F) 07/01/1981 Seven (7) $50 Series EE U.S. Savings Bonds and one (1) Series E U.S. Savings Bond (per Inventory attached hereto as Schedule F) Eight (8) $50 Series EE U.S. Savings Bonds (per Inventory attached hereto as Schedule F) Eight (8) $50 Series EE U.S. Savings Bonds (per Inventory attached hereto as Schedule F) 10/01/1981 11/01/1981 898.0~ 889.88 1,234.16 974. 898.80~ 889.88 50% 449.00 50%! 444.94 50%, 617.08 50% 487.09 50%~ 449.40 50% 444.94 Page 2 of Schedule F COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BROUGH, ANNA S. SURVIVING JOINT TENANT(S) NAME D CareyF. Mulhem E Luke Mulhern F Shawn M. Mulhem G Heidi J. Brough H Summer D. Brough I Kamm S. Brough ADDRESS 4010 Sigler Circle Jefferson, MD 21755 4010 Sigler Circle Jefferson, MD 21755 4010 Sigler Circle Jefferson, MD 21755 1370 Centerville Road Newville, PA 17241 1370 Centerville Road Newville, PA 17241 1370 Centerville Road Newville, PA 17241 FILE NUMBER 21 - 03 - 0366 RELATIONSHIP TO DECEDENT Granddaughter Grandson Grandson Granddaughter Granddaughter Granddaughter COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BROUGH, ANNA S. FILE NUMBER 21 - 03- 0366 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION 2 3 Bo 2 FUNERAL EXPENSES: Hoffrnan-Roth Funeral Home, Inc. The Whimsical Poppy - Flowers Cumberland Valley Memorial Gardens - Grave Opening 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 Skarlaos & Zonarich LLP Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees Register of Wills State ~ Zip Accountant's Fees Fiduciary Income Tax Return Tax Return Preparer's Fees Final Federal & State Income Tax Returns Other Administrative Costs The Sentinel - Advertise Letters Testamentary Cumberland Law Journal Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) AMOUNT 6,970.00 222.60 945.00 8,750.00 278.00 550.00 100.00 102.11 75.00 11,849.65 29,842.36 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BROUGH, ANNA S. Sd'l~ule H Funera Expams & P4~minis~afJ~ ~ conlinued FILE NUMBER 21 03 - 0366 9 10 11 12 13 14 15 16 17 Settlement Costs on sale of 1606 Pine Road, Carlisle (per Settlement Statement attached hereto as Schedule A) Register of Wills - Filing fee for Releases Pennoni Associates, Inc. - Consult with Surveyor Penn Township - Perk fee, 1606 Pine Road John R. Kissinger Surveyor - prepare subdivision plan Smitty's Excavating - Perk, 1606 Pine Road George L. Ebener & Associates - Appraisal of 1606 Pine Road Oliver Oil - 1606 Pine Road Kuhn Communications - Final cable bill Sprint - Telephone service PPL - Electric Recorder of Deeds - Recording fees, Lot 2 and Lot 3 2003 Real Estate/Personal Taxes 2004 County/Township Real Estate Taxes 2004 School Real Estate Taxes 4,106.00 25.00 325.00 780.00 3,661.00 82.50 175.00 52.35 87.22 143.12 214.88 85.00 307.33 318.11 1,487.14 Page 2 of Schedule H COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BROUGH, ANNA S. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 - 03 - 0366 Include unreimbursed medical expenses. ITEM NUMBER 1 2 3 4 5 6 7 8 DESCRIPTION Belvedere Medical Corporation - Medical bill The Bon Ton - Account balance Oliver Oil - 1606 Pine Road Shelby Casualty Insurance Co. - Partial payment on automobile insurance The Patriot News - Final bill Kuhn Communications, Inc. - Cable Sprint - Telephone service PPL - Electric TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 48.81 9.00 264.09 30.00 4.00 15.54 74.13 61.10 506.67 REV-I$1$ EX+ (9-00) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF BROUGH, ANNA S. FILE NUMBER 21 - 03 - 0366 NUMBER II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Donald P. Brough, Jr. 1370 Centerville Road Newville, PA 17241 Pamela A. Mulhem 4010 Sigler Circle Jefferson, MD 21755 RELATIONSHIP TO [ AMOUNT OR SHARE DECEDENT i OF ESTATE Son One-half estate residue Daughter Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet j NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE One-half estate residue B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER ESTATE OF ANNA S. BROUGH FILE NO. 21 - 03 - 0366 INHERITANCE TAX RETURN - SCHEDULE A OMB NO. 2502-0265 A. B. TYPE OF LOAN: U.S. DE "ARTMENT OF HOUSING & URBAN DEVELOPMENT 1 .r-]FHA 2.[--JFmHA 3. [~]CONV. UNINS. 4. r-]VA 5. r-]CONV. INS. 6. FATFILE4.68NUMBER: I 7. LOAN NUMBER: SETTLEMENT STATEMENT 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is fumished to give you a statement of actual seffiement costs. Amounts paid to and by the settlement a. ent are shown. Items marked "[POC]" were paid outside the closing; they are shown here for informational purposes and are not ~gn~uded in the totals. 1.0 3/98 (BROUGH SUMMER. PFD/FAT 4-68/17 ) D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: SUMMER D. BROUGH ESTATE OF ANNA S. BROUGH ADAMS COUNTY NATIONAL BANK 1606 PINE ROAD 675 OLD HARRISBURG ROAD CARLISLE, PA 17013 GETTYSBURG, PA 17325 G. PROPERTY LOCATION: H. S~- I I LEMENT AGENT: 25-1802264 I. SETTLEMENT DATE: 1606 PINE ROAD CHESAPEAKE ABSTRACT COMPANY CARLISLE, PA 17013 CUMBERLAND County, Pennsylvania PLACE OF SETTLEMENT June 3, 2004 204 STATE STREET HARRISBURG, PA 17101 101. Contract Sales Pdce 104,000.00 401. Contract Sales Pdce 104,000.00 102. Personal Pr~erty ~ 402. Personal Pro~oe~ 103. Settlement Charges ~ Borrower~ 2,805.4~0 403. 104. t 404. 105. n r m ri v n 405. ~ n I rIn n ~/Town Taxes to 406. City/Town Taxes to 107. County Taxes 06/04/04 to 01/01/05 175.45 407. County Taxes 06/04/04 to 01/01/05 t 175.45 =108 School 06/04/04 to 07/01/04 70.47. 408. School 06/04/04 to 07/01/04 70.47 109. ~ 409. 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 107,051.32 420. GROSS AMOUNT DUE TO SELLER 104,245.92 200, AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500, REDUCTIONS IN AMOUNT DUE TO SEI 201. Deposit or earnest money 501. Excess Deposit (See Instructions) 202. Principal Amount of New Loan(s) 82,160.00 502. Seffiement Charges to Seller (Line 1400) 106.00 203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to 204. 504. Payoff of first Mortgage 205. 505. Payoff of second Mortgage 206. 506. 207. 507. 208. 508. 209. Seller paid t 4,000.00 509. Seller paid 4,000.00 Adiustments For Items Unpaid By Se//er Adiustments For Items Unpaid By Seller 210. City/Town Taxes to 510. City/Town Taxes to 211. County Taxes to 511. County Taxes to 212. School to 512. School to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 86,160.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 4,106.00 300. CASH AT SE I I LEMENT FROM/TO BORROWER: 600. CASH AT S,- I rLEM_ ENT TO/FROM SF;~ I ~=R: 301. Gross Amount Due From Borrower (Une 120) 107,051.32 601. Gro~.~ Amount Due To Seller (Line 420) 104,245.92 302. Less Amount Paid By/For Borrower (Line 220) ( 86,160.00 602. Less Reductions Due Seller (Line 520) 4,106.00 303. CASH ( X FROM) ( TO) BORROWER 20~891.32 603. CASH ( X TO) ( FROM) SELLER 100,139.92 The undersigned hereby a_cknowled~e receiot of a comnlet~d r. nnv nf n~,~=,e 1~'~ ~ ,,;~ ~o~ ..... o .......... SU~fMER D. BROUGH - ' pag atement & a~/ch~ents referred ~er.p_.~3. Seller / . ~.4,o_ ~ '¢2/''-',//~_ . /' J ,~ BROOGH HUD-1 (3-86) RESPA. HB4305.2 L. SETTLEMENT CHARGES ~ ~ION Based on Price .._[ ~ % PAID FROM PAID FROM D;;~ision ot Commission (line 700) as Follows: ~ 701. $ to BORROWER'S SELLER'S 702. $ to FUNDS AT FUNDS AT 703. Commission Paid at Settlement s~ rLEMENT SETTLEMENT 704. to · ~a~lon ~-ee % to ~-----.-------.-. 802. Loan Discount % to ADAMS COUNTY NATIONAL BANK 410.80 POC' 803. Appraisal Fee to ADAMS COUNTY NATIONAL BANK 175.00 804. Credit Report to ADAMS COUNTY NATIONAL BANK 9.0( 805. Assignmenl Fee to ADAMS COUNTY NATIONAL BANK 30.50 806. Unde~Fee to ADAMS COUNTY NATIONAL BANK 245.00 ~ 807. Flood Certification to ADAMS COUNTY NATIONAL BANK 10.00 808. Document Preparation to ADAMS COUNTY NATIONAL BANK 85.00 809. Overnight Fee to ADAMS COUNTY NATIONAL BANK 27.00 810. 811. · M B E E E AID V ~ 901. Interest From 06/03/04 to 07/01/04 @ $ /day ( 28 days %) -25.1( 902. Mortgage Insurance Premium for months to 903. Hazard Insurance Premium for 1.0 },ears to 904. 905. 1000. RESERVE DEPOSITED WITH LENDER '~ 1001. Hazardlnsurance 6.000 months (~ $ 35.67 per month 214.0'~'~"~~ 1002. Mortgage Insurance months ~ $ per month 1003. City/TownTaxes months ~ $ per month 1004. County Taxes 5.000 months ~ $ 25.36 per month 126.80 1005. School 12.000 months @ $ 79.60 per month 955.20 1006. months___~ $ per month 1007. months ~ $ ~ per month ~~ 1008. A r ateAd'uslment months .~._$ per month -340.77 1101. Settlement or Closing Fee to Skarlatos & Zonadch LLP 1102. Additional chain of title to Sentinel Agency 100.00 1103. Closin~ Protection Letter to First AuT,~dcan Title Insurance Company 35.00 1104. Wire Fee to CHESAPEAKE ABSTRACT COMPANY 1105. Federal Express to CHESAPEAKE ABSTRACT COMPANY 15.00 1106. Notary Fees to CHESAPEAKE ABSTRACT COMPANY 12.00 6.00 1107. Document Preparation - deed to Skadatos & Zonadch LLP ~{includes above item numbers: 100.00 1108. Title Insurance to Chea~_..~_~ake Abstract Company )'- ~~ (includes above item numbers: 878.75 ~ 1109. Lender's Coverage $ 82,160.00 ) ~ 1110. Owner's Coverage $ 104,000.00 878.75 ' 1111. Endorseme~;.s 100, 300, 8.1 to CHESAPEAKE ABSTRACT COMPANY 150.00 1112. 1113. RN F 1201. Recording Fees: Deed $ 42.50; Mort. gage $ 60.50; Releases $ 103.00 1202. Ci /Coun Tax/Stam s: Deed ~ 1203. State Tax/Stamps: Revenue Stamps ; Mortoe0e 1204. 1205. 1301. Survey to 1302. Pest Inspection to 1303. 1304. 1305. 1400· TOTAL S~- i I i I=MENT CHARGES (Enter on Lines t03, Section J and 502, Section K) 2,805.40 106.00 By signin.(:l paoe 1 of this statement th~_ ;:innclfnri~e ar,L'nn,,a=,'~ ..... ; ............. ~ . . ~ Certified to be a true copy. Ige pt of a completed/~:l~f page Settlement Agent ( FAT 4-68 1 FAT 4-68/ 18 ) ESTATE OF ANNA S. BROUGH FILE NO. 21 - 03 - 0366 INHERITANCE TAX RETURN - SCHEDULE E MOTOR VEHICLE BILL OF SALE KNOW ALL MEN BY THESE PRESENTS, that the undersigned, PAMELA A. MULHERN, of 4010 Sigler Circle, Jefferson, Maryland, 21755 and DONALD P. BROUGH, JR., of 1370 Centerville Road, Newville, Pennsylvania, 17241, Co-Executors of the Estate of Anna S. Brough (the "Seller"), in consideration of the sum of Two Thousand Dollars ($2,000.00) and other good and valuable consideration, the receipt of which is hereby acknowledged, does hereby grant, bargain and sell. transfer and se~ over unto PAMELA A. MULHE~, of 4010 Sigler Circle, Jefferson, Maryland, 21755 (the "Purchaser"), the following property to wit: one 1990 Oldsmobile Toronado, VIN 1G3EZ13C3LU308395 and does warrant that the Seller is the true and lawful owner of the aforesaid vehicle. Seller will warrant and defend the same against the lawful claims and demands of all persons claiming the same by, from, and under Seller. It is understood by Purchaser that this Estate vehicle is being purchased "as is", and no warranties of any kind are made by Seller. It is further understood by Purchaser that Purchaser assumes any and all costs incurred to transfer title. Date: 7' ~ + , 2003 Date: ~.4 , 2003 PA~4ELA A. 593LHERN, Co-Executor of the Estate of Anna S. Brough, Seller DONALD ~'~ BROUGH JR., Co-Executor of the Estate of Anna S. Brough, Seller I, PAMELA A. MULHERN, do hereby acknowledge receipt of delivery of the 1990 Oldsmobile Toronado, VIN 1G3EZ13C3LU308395. Date: L~ A MULH'E~N] Purchaser FARMERS NATIONAl. BANK May 19, 2003 Shelly J. Kinkel, Esquire Skarlatos & Zonarich LLP 204 State Street Harrisburg, PA 17101 RE: Estate of Anna S.Brough Dear Ms. Kunkel: Mrs. Brough had the following accounts with this bank - Checking account #16-104-7 in the names of Anna Brough or Pamela A. Mulhern, opened 9/2/99, death of death balance $1,135.29 plus .55¢ accrued interest, 'with year to date interest of $$3.49. Certificate of deposit #2990060, Anna or Donald Brough Jr., opened 3/17/98 in the amount of $5,000.00, no accrued interest, YTD interest $65.47. Certificate of deposit #2990101, Anna or Martin $. Mulhern, opened 3/17/98 in the amount of $5,000.00, no accrued interest, YTD interest $65.47. Certificate of deposit #2990102, Anna or Pamela A. Mulhern, opened 3/17/98 in the amount of $5,000.00, no accrued interest, YTD interest $65.47. Certificate of deposit #2990103, Anna or Linda M. Brough, opened 3/17/98 in the amount of $5,000.00, no accrued interest, YTD interest $65.47. Individual Retirement Account #9000346, Anna S. Brough opened 11/8/96 with a balance of $42,946.68 plus $148.80 accrued interest, YTD interest $261.77 There were no loans and no safe deposit box for Mrs. Brough. Sincerely yours, Executive Vice President PO. Box 156, Ncwville, PA 17241 · (717) 776-5312 ESTATE OF ANNA S. BROUGH, Deceased IN THE COURT OF COMMON PLEAS. CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 2003 - 00366 DISCLAIMER AND RENUNCIATION I, MARTIN J. MULHERN, hereby state as follows: 1. My mother-in-law, ANNA S. BROUGH, died on April 11, 2003, as evidenced by her death certificate attached hereto. 2. At the time of my mother-in-law's death, my mother-in-law and I owned Farmers National Bank, A Division of Adams County National Bank, Certificate of Deposit # 0101 as joint tenants with fights of survivorship. 3. I hereby irrevocably disclaim and renounce my entire survivorship interests in Certificate of Deposit # 0101. 4. I hereby acknowledge that Farmers National Bank, A Division of Adams County National Bank, as a result of my disclaimer and renunciation of my survivorship interest in Certificate of Deposit # 0101, may liquidate this certificate and issue a check for the entire proceeds of this account payable to the Estate of ANNA S. BROUGH (TiN 25-6835819). 5. The address of record for the new account titled in the name of the Estate of ANNA S. BROUGH should be as follows: Estate of ANNA S. BROUGH, c/o Skarlatos & Zonarich LLP, 204 State Street, Harrisburg, Pennsylvania, 17101. IN WITNESS WHEREOF, and intending to be legally bound hereby, and intending that this Disclaimer and Renunciation may be filed of record with the Dauphin County Court of Common Pleas, O~hans' Court Division, I have hereunto set my hand this 57Q~ ~2~ day of Swom and subscribed to before me this ~___..~_~.r~6~ day of ~. ,2003. My Commission Expires: 31 ]~]'2_OOtJf ESTATE OF ANNA S. BROUGH, Deceased IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 2003-00366 DISCLAIMER AND RENUNCIATION I, LINDA M. BROUGH, hereby state as follows: 1. My mother-in-law, ANNA S. BROUGH, died on April 11, 2003, as evidenced by her death certificate attached hereto. 2. At the time of my mother-in-law's death, my mother-in-law and I owned Farmers National Bank, A Division of Adams County National Bank, Certificate of Deposit # 0103 as joint tenants with rights of survivorship. 3. I hereby irrevocably disclaim and renounce my entire survivorship interests in Certificate of Deposit # 0103. 4. I hereby acknowledge that Farmers National Bank, A Division of Adams County National Bank, as a result of my disclaimer and renunciation of my survivorship interest in Certificate of Deposit # 0103, may liquidate this certificate and issue a check for the entire proceeds of this account payable to the Estate of ANNA S. BROUGH (TIN 25-6835819). 5. The address of record for the new account titled in the name of the Estate of ANNA S. BROUGH should be as follows: Estate of ANNA S. BROUGH, c/o Skarlatos & Zonarich LLP, 204 State Street, Harrisburg, Pennsylvania, 17101. IN WITNESS WHEREOF, and intending to be legally bound hereby, and intending that this Disclaimer and Renunciation may be filed of record with the Dauphin County Court of Common P~hans' Court Division, I have hereunto set my hand this ,2003. LINDA M. BROUGH day of Sworn and subs?i~d')o before me this c-~ dayo~.~:5 ,2003. Notary Public. i~' ',~/ ..... / / My Commission Expires: 7-/~'L ESTATE OF ANNA S. BROUGH FILE NO. 21 - 03 - 0366 INHERITANCE TAX RETURN - SCHEDULE F FARMERS NATIONAl. BANK June 10, 2003 Shelly J. Kunkel, Esquire Skarlatos & Zonarich LLP 204 Slate Street Harrisburg, PA 17101 RE: Estate of Anna S. Brough Dear Ms. Kunkel: Mrs. Brough also had the following accounts with this bank which were missed in the earlier letter: Savings account #9655557 in the names of Anna S. Brough or Donald P. Brough Jr. opened 7/11/89 with a balance as of April 11, 2003 of $1,271.50 with 60¢ accrued interest; and Certificate of deposit #158216 for $35,000.00 opened 12/26/01 in the names of Anna S. Brough or Pamela A. Mulhern or Donald P. Brough Jr. with $43.01 accrued interest. This certifcate is a renewal of #40011654 which was opened 6/23/00. Sincerely yours, Executive Vice President PO. Box 156, Newville, PA 17241 · (717) 776-5312 FARMERS NATIONAl, BANK May 19, 2003 Shelly $. Kinkel, Esquire Skarlatos & Zonarich LLP 204 State Street Harrisburg, PA 17101 RE: Estate of Anna S.Brough Dear Ms. Kunkel: Mrs. Brough had the following accounts with this bank - Checking account #16-104-7 in the names of Anna Brough or Pamela A. Mulhern, opened 9/2/99, death of death balance $1,135.29 plus .55¢ accrued interest, 'with year to date interest of $$3.49. Certificate of deposit #2990060, Anna or Donald Brough Jr., opened 3/17/98 in the amount of $5,000.00, no accrued interest, YTD interest $65.47. Certificate of deposit #2990101, Anna or Martin J. Mulhern, opened 3/17/98 in the amount of $5,000.00, no accrued interest, YTD interest $65.47. Certificate of deposit #2990102, Anna or Pamela A. Mulhern, opened 3/17/98 in the amount of $5,000.00, no accrued interest, YTD interest $65.47. Certificate of deposit #2990103, Anna or Linda M. Brough, opened 3/17/98 in the amount of $5,000.00, no accrued interest, YTD interest $65.47. Individual Retirement Account #9000346, Anna S. Brough opened 11/8/96 with a balance of $42,946.68 plus $148.80 accrued interest, YTD interest $261.77 There were no loans and no safe deposit box for Mrs. Brough. Sincerely yours, ough / ~/ Executive Vice President EO. Box 156, Ncwville, PA 17241 · (717) 776-5312 0 0 0'3 0 0 Ir'Il 0~,,) C.)-~ ~0~0 ~ ~ ~ 0 ~ ~V ~0 /~ ~ 0 ~Ex j~ 0~ 0 /~ ~ ~'-- ~-- 0 I~z ~Z ~ ~ ~ 00~ 0 0 I o m c: '~ o m ~ 0 0 0 0 ..-. 0 0 ESTATE OF ANNA S. BROUGH FILE NO. 21 - 03 - 0366 INHERITANCE TAX RETURN LAST WILL AND TESTAMENT LAST WILL AND TESTAMENT OF ANNA S. BROUGH I, ANNA S. BROUGH, of Penn Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do make, publish and declare this to be my Last Will and revoke any Wills and codicils previously made by me. ARTICLE ONE Specific Bequest of Tangible Personal Property I give and bequeath all of my tangible personal property including, but not limited to, all my automobiles, furniture, furnishings, books, pictures, jewelry, china, linen, silver, clothing, household effects and personal effects, and other tangible personal property of like nature (not including cash, securities and other property used for the production of income), together with any existing insurance thereon as I may have provided in a memorandum kept with the original of this Will; or, to the extent not so provided or not effectively disposed of in any such memorandum, to my issue, per stirpes. ARTICLE TWO Residue I give, devise and bequeath all of the rest, residue and remainder of my estate, of whatever nature and wherever situated, to my issue, per stirpes. ARTICLE THREE Protective Provisions The principal of my estate and any trusts created hereunder, and the income therefrom, so long as the same are held by my Executor shall not be subject to anticipation, assignment, pledge, sale or transfer in any manner, nor shall any beneficiary have power in any manner to charge or encumber his/her interest in my estate or any trust hereunder, nor shall the said interest of any beneficiary be liable or subject in any manner while in the possession of my Executor for any ,Vkarlatos & Zonarich ~ LAST WII. I. AND I'ESTAMENI' OF ANNA S. BROUGH Page I c?f 7 liability of said beneficiary, whether such liability arises from said beneficiary's debts, contracts, torts, or other engagements of any type. ARTICLE FOUR .Powers of Executor In addition to and without limiting the powers conferred by case law, by statute, and by other provisions hereof, my Executor shall have the following rights and powers exercisable without the need for court approval: (A) Accept and Retain Investments, To accept and retain any form of real or personal property received by transfer, devise, bequest or otherwise without being required to diversify and without being limited to the types of investments in which fiduciaries are authorized by law to invest. This authority shall specifically include the authority to accept and retain any stock of a corporate fiduciary hereunder, or in any corporation Which controls or is controlled by it, or any other corporation in which it holds any ownership interest, together with any stock dividends received thereon, or any stock acquired in the exercise of subscription rights, or received by reason of any consolidation, merger or reorganization, without liability tbr such retention. (B) Invest. To invest and reinvest in any form of real or personal property without limitation by any law applicable to investments by fiduciaries. (C) Voting. To vote a security in person or by proxy, to participate in or consent to any merger, reorganization, dissolution, liquidation, voting trust plan, or other action affecting any securities held hereunder, and; to exercise conversion, subscription, and other rights of whatever nature. (D) _Title__To Property. To register or hold securities and/or other property in the name of a nominee or nominees, including that of a clearing corporation, a depository, in book Skarlatos & Zonartch A ttorne),s d t Law ~A3 T W/LL AN/) TESTAMENT OF ANNA 3: BROUGH Page 2 of 7 entry fbrm, or to retain securities and/or other property unregistered or in a form permitting transfer by delivery. (E) _Sale, Lease and Other Dealings wit___h_h Prop_erty. To sell, from time to time, at public or private sale, exchange, lease, encumber, option or otherwise dispose of all or any portion of assets held hereunder; to make, execute and deliver deeds, mortgages, leases, assignments and other documents necessary to carry out any of the powers granted hereunder, which shall specifically include the authority to grant leases which extend beyond the period authorized by law, and; to partition, subdivide, improve and impose any restrictions on real estate held hereunder and enter into agreements concerning the partition, subdivision, improvement, zoning or management of any such real estate. (F) Borrow_. To borrow money from any person or institution and pledge property as security for repayment of funds. (G) Distributions in Kind. To make distributions in cash or in kind, or partly in each, and; to allot different kinds of property to different shares without regard to differences in the income tax basis of such property. Any such designation, division, allocation, apportionment or valuation of property shall be binding and conclusive on all parties. (H) Settle Claims. To institute, prosecute and defend any and all legal proceedings; and compromise, release, adjust and/or settle any debt or claim. (I) Employment of Agents To employ agents including attorneys, accountants, and others to perform administrative duties. (J) Property_ Distributable to Minors. Any property (whether income or principal) distributable to a beneficiary of my estate or any trust created hereunder who is under a disability may be paid directly to such beneficiary, to the parent or guardian of such beneficiary, to a custodian selected by my Executor (other than my Executor) under the Pennsylvania Uniform Transfers to Minors Act or under a similar act of any other state, or to persons caring for or Skartatos & Zonarich LLP Attorneys lit Law LAST WILL AND IY£STAMENT OF ANNA S BROU(;H Page 3 q£ 7 having custody of such beneficiary (other than my Executor) or may be applied for such beneficiary's benefit by payment to such other persons, organizations or institutions (other than my Executor) as my Executor may select, and the receipt of any such payee shall be a full release therefor. The receipt of any such payments by any such person shall be a full acquittance of my Executor as to any amounts so paid. Any beneficiary hereunder shall be considered to be under a disability while under the age of twenty-one (21) years or at any time when, in the opinion of my Executor such beneficiary is incapacitated in any way so as to be unable to properly manage his/her affairs. ARTICLE FIVE Fiduciarie~ (A) Executor. I appoim my children, Donald P. Brough, Jr. and Pamela A. Mulhern, as co-Executors of this Will (my said Co-Executors and any successor Executor or co- Executors shall be referred to herein as my "Executor"). Should either of my said children die, renounce, resign, fail to qualit~ or cease to act as Executor for whatever reason, I appoint the survivor as Executor of this Will. (B) Miscellaneous. Any successor Executor shall succeed to the capacity of its predecessor without re-conveyance or transfer of property and have all of the rights, powers, authorities and discretion conferred upon the original Executor. No successor Executor shall be obligated to examine the accoums, records, or acts of a previous Executor, nor shall any such successor Executor in any way or manner be responsible for any act or omission to act on the part of any such previous Executor. No Executor serving hereunder at any time shall be required to file any bond or enter security in any Court or jurisdiction in which said fiduciary may be called upon to act. Skarlatos & Zonarich Lt,p ~.Ittorne),s .4t Law LAST WILL AND TESTAMENT OF ANNA 3'. BROUGH Page 4 of 7 ARTICLE SIX Interpretation (A) Issue.. Whenever the term "issue" is used herein, such term shall be interpreted to include adopted persons as well as natural persons, provided in each instance that the adoptee is under the age of eighteen (18) years at the time of adoption. Such terms are also intended to include persons in gestation at any pertinent time under this Will, provided such persons survive birth by thirty (30) days. (B) Gender and Number. Where appropriate except where the context otherwise requires, whenever used herein, the singular includes and plural, the plural the singular and words of any gender shall be applicable to all genders. (C) Headings/Captions. The headings/captions of Articles, Sections and Paragraphs used herein are for convenience of reference only and shall have no significance in the construction or interpretation of this Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal and caused this my Last Will and Testament, consisting of Seven (7) typewritten pages, including this attestation clause and the following Acknowledgment and Affidavit, to be executed, declared and published this o~ ~ ~ day of _, 1999, at · , Pennsylvania. ANNA S. BROUGH 3'karlatos & Zonarich LJ~' , Ittorne)'s , ~! Law LAST WIIJ; AND TEST..4MENI' Otv AN/Vd S. BROUGH Page 5 of 7 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF DAUPHIN ) I, ANNA S. BROUGH, the Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein expressed. ANNA S. BROUGH ~om or affirmed to and acknowledged before me by ANNA S. BROUGH, the Testatrix this day of ~~, . 1999. N~tary Public ~ M~ Commission Expires: Skarlatos & Zonomch Z~d~ .q ttorne),s 1I t [ c*w LAS]' WILL AN/) iES1AMt,.'NT' OF ANNA X BRO(?GH Page 6 t~' 7 ~F~A~T COMMONWEALTH OF PENNSYLVANIA ) ) COUNTY OF DAUPHIN ) SS: /., /'7 ' and. /,'~_/~-,t t~,l:~ ,3 ?/,,I ~:.-,--- the witnesses, whose names are signed to the attached or t. foregoing instrument, being duly qualified according to law, do depose and say tMt we were present and saw ANNA S. BROUGH, sign and execute the instrument as the Testatrix's flee and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge, the Testatrix was at the time twenty-one (21) o o~ars of~~t~e~l mind and under no constraim or undue irrfluence . ' ' ,/ -/' Sworn or affirmed to and ackno.~ledged before ~ne by this~x_~_ a%y _ ( ../~ ~ , 9. ,-' , ., ." N~taty Public '---- , .......... - ,. My)Commission Expires: ~ - !'.'~,¢i'fi i, .... . $~'arlatos & Zonarich LLP d ttorneys .1 t Lmv LAS/' WILL ANI) TESTAMENT' OF ANNA S. BROI/GH Page 7 q£ 7 ESTATE OF ANNA S. BROUGH, Deceased IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE NO. 21 - 2003 - 0366 RECEIFT~ RELEASE AND INDEMNIFICATION AGREEMENT For Full Distribution This Receipt, Release and Indemnification Agreement (here nafter referred to as "A ement" ts g yen this /3 day of :-~ ~ ,2004, by DONALD P. BROUGH, JR., of 13'/0 Centerville Road, Newville, Pennsylvania, 17241 (hereinafter referred to as "Beneficiary"). WITNESSETH: WHEREAS, Anna S. Brough, (hereinafter referred to as "Decedent"), late of Penn Township, Cumberland County, Pennsylvania, died testate on April 11, 2003, having first made a Last Will and Testament, duly executed on October 27, 1999, which is recorded in the Office of the Register of Wills of Cumberland County, Pennsylvania; WHEREAS, Letters Testamentary on the Estate of the said Decedent were duly issued on April 24, 2003, by the Register of Wills of Cumberland County, Pennsylvania, unto Donald P. Brough, Jr. and Pamela A. Mulhern, who by the Decedent's aforesaid Last Will and Testament were appointed as Co-Executors of the Estate (hereinafter referred to as "Co-Executors"); WHEREAS, the Co-Executors have paid all the debts, taxes and expenses of the Estate known to them as detailed in the Pennsylvania Inheritance Tax Return and Tax Assessment Notice, and they have no knowledge of any unpaid claim which may be asserted against the Estate, nor do they have any reason to believe that there are any such claims; WHEREAS, the Beneficiary, pursuant to the Decedent's Last Will and Testament is beneficially interested in the above referenced estate; and WHEREAS, it is the desire of the Beneficiary that distribution be made without the formality of an accounting, and the Co-Executors are willing to make such distribution upon the receipt of a proper release and indemnification, which it is the purpose of this Agreement to provide. NOW, THEREFORE, intending to be legally bound hereby, the Beneficiary represents, warrants, covenants and agrees as follows: 1. Waiver of Accounting The Beneficiary hereby waives the necessity for an accounting and directs the Co-Executors to dispense with a formal audit of the same. 2. Receipt. The Beneficiary requests the Co-Executors to make distribution of the following property (adjusted for subsequent income and expenses) and effective upon delivery to the undersigned of the property shown as distributable, acknowledges receipt of such property: S:/I Skarlatos & Zonafich LLP OPEN FILE SX, Est at esX, B ROUGH, ANNA - NEW~ReI~se. Full Distribution. Donald P Brough. Jr dee Page 1 of 3 Cash - $79,820.58 The Beneficiary does farther acknowledge that the aforesaid distribution, in addition to any partial distribution made prior to the date of this Agreement, represents the Beneficiary's entire interest in the above-referenced estate, as detailed in the Informal Accounting attached hereto as Exhibit A. 3. Release. Upon having received the above described property distribution, the Beneficiary does by these presents remise, release, quit-claim and forever discharge from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, (a) the Co-Executors for or by reason of the Co- Executors's administration of the above-referenced Estate, or any other act, matter, cause or thing whatsoever; and (b) Skarlatos & Zonarich LLP, its employees, successors and assigns, for or by reason of their representation of the Co-Executors, or any other act, matter, cause or thing whatsoever. 4. Indemnification. In exchange for the Co-Executors's willingness to make the distribution hereunder without first securing the benefit of a formal court audit, the Beneficiary agrees to indemnify Co- Executors and Skarlatos & Zonarich LLP, its employees, successors and assigns, and hold them harmless, to the extent of any funds or assets received by the Beneficiary hereunder, from and against the Beneficiary's then pro rata share of any and all liabilities, losses, damages, costs, verdicts, judgments, awards and expenses (including attorney's fees and other costs or expenses of defense) to which (i) the Co-Executors may be subjected by reason of the Co-Executors's administration of the above referenced Estate, as well as the settlement thereof by means of an informal distribution; and (ii) Skarlatos & Zonarich LLP, its employees, successors and assigns may be subjected by reason of their representation of the Co-Executors. The Beneficiary further agrees to: a. Refund or return, promptly upon the Co-Executors's written demand, any funds or assets distributed by the Co-Executors to the Beneficiary, if the distribution thereof is determined at any time to have been an erroneous or negligent distribution to the Beneficiary, whether such error or negligence was or was claimed to have been premised upon a mistake of law or of fact. b. Modify and displace any otherwise applicable period limiting the time within which the Co-Executors's action to collect an erroneous or negligent distribution must be commenced, so as to provide that the Co-Executors need not commence an action to collect an erroneous or negligent distribution to the Beneficiary until two (2) years at, er such time as the Co- Executors shall have obtained actual knowledge of such error or negligence. 5. Miscellaneous a. The provisions of this Agreement shall be deemed severable in the event that one or more thereof shall be deemed invalid or unenforceable, with the effect that the remaining provisions shall persist as if such invalid or unenforceable provision had never been a part hereof. In addition, the construction, effect, validity and performance of this Agreement shall be governed in all respects by the laws of the Commonwealth of Pennsylvania, without regard to its conflict of laws provision. b. This Agreement shall bind the Beneficiary, the eneflcmry s he,rs, representatives, successors, and assigns together with any person with respect to whom the Beneficiary is a natural or appointed guardian. c. The Beneficiary hereby acknowledges that this Agreement may be filed at any time, at the discretion of the Co-Executors with any court of competent jurisdiction, and the Page 2 of 3 Beneficiary consents to any such filing. IN WITNESS WHEREOF, the Beneficiary has executed and sealed this Agreement on the date first above inscribed. WITN£ - '// DONALD P. BROUGH, JR. Social Security Number: 197-40-6011 COMMONWEALTH OF PENNSYLVANIA COUNTYOF ~'~&'A4./~. SS: authority, personally appeared DONALD P.'BROI~GH, JR., known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Release and acknowledged that the Beneficiary executed the same for the purpose therein contained. Witness my hand and official seal the day and date aforesaid. OTARY PU~L_~ My Commission Expires: Page 3 of 3 SKARLATOS AND ZONARICH LLP ATTORNEYS AT LAW 204 STATE STREET HARRISBURG PENNSYLVANIA 17101 (717)233-1000 FAX (717)233-6740 Accounting Of: Estate of Anna S. Brough As Of: August 30, 2004 Description Adams County National Bank - Close CD Lee Procurement Solutioons Co. - Sentinel Refund PP&L Oliver Oil Co., Inc. Kuhn Communications, Inc. Hoffman-Roth Funeral Home, Inc. Belvedere Mecial Corp. The Patriot News The Whimsical Poppy - Funeral Service Cumberland Law Journal - Adv. Ltrs. Testamentary Sprint Adams County Bank - Interest Commerce Bank - Interest Mable G. Stitt - 2003 Real Estate/Personal Taxes Mable G. Stitt- 2003 Real Estate School Taxes Mable G. Stitt- 2004 Real Estate Taxes Register of Wills - Inheritance Tax The Sentinel - Estate Advertisement Prudential Financial - Death Claim Farmer's National Bank - IRA Death Distribution PA Department of Rev. - Property Tax Rebate Skarlatos & Zonarich LLP - Reimb. Probate Fee Farmer's National Bank - Close CD's The Bon-Ton Shelby Casualty Ins. Co. Pamela Mulhern - Proceeds From Car Sale George L. Ebener & Associates - Appraisal Donald P. Brough, Jr. - Subdivision, Perk, Survey Donald P. Brough, Jr. - Reimb. Pennoni Assoc. Nick Chelap - Prepare 2003 Fed. & State Tax Returns Recorder of Deeds - Record Deeds Pam and Don Brough Chesapeake Abstract Co.- Sale of Real Estate Register of Wills - Filing Fee for Inheritance Tax Register of Wills - Additional Probate Fee Highmark - Premium Refund Skarlatos & Zonarich LLP - Fee Skarlatos & Zonarich LLP - Costs (postage, copies, etc.) Preparation of Fiduciary Income Tax Return Filing Fee - Releases Estimated Inheritance Tax Refund Reserve Pending Estate Finalization Deposits 35,082.12 35.54 264.06 970.91 2,777.92 43,396.84 321.00 10,015.69 2,000.00 100,139.92 121.13 1,458.38 Disbursements 275.98 316.44 102.76 6,870.00 48.81 4.00 222.60 75.00 217.25 307.33 1,487.14 318.11 10,000.00 102.11 278.00 9.00 30.00 175.00 4,523.50 325.00 100.00 85.00 31.00 35.00 8,923.50 52.45 550.00 19.00 1,458.38 159,641.15 Exhibit A Report Date: 9/9/2004 SKARLATOS AND '7ONARICH LLP ATTORNEYS AT LAW 204 STATE STREET HARRISBURG PENNSYLVANIA 17101 (717)233-1000 FAX (717)233-6740 Accounting Of: Estate of Anna S. Brough As Of: August 30, 2004 Description Final Distribution Pamela A Mulhern Donald P. Brough, Jr, Deposits Disbursements 79,820.57 79,820.58 159,641.15 Exhibit A Report Date: 9~9/2004 ESTATE OF ANNA S. BROUGH, Deceased 1N THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT D1VISION ESTATE NO. 21 - 2003 - 0366 RECEIPT, RELEASE AND INDEMNIFICATION AGREEMENT For Full Distribution Thi,s .l].~e~ipt, Release and Indemnification Agreement (hereinafter referred to as "Agreement") is given this ] ~/"' day of -.~. ~'~4'~ f~-.4~ , 2004, by PAMELA A. MULHERN, of 4010 Sigler Circle, Jefferson, Maryland, 21755 (hereinafter referred to as "Beneficiary"). WlTNESSETH: WHEREAS, Anna S. Brough, (hereinafter referred to as "Decedent"), late of Penn Township, Cumberland County, Pennsylvania, died testate on April 11, 2003, having first made a Last Will and Testament, duly executed on October 27, 1999, which is recorded in the Office of the Register of Wills of Cumberland County, Pennsylvania; WHEREAS, Letters Testamentary on the Estate of the said Decedent were duly issued on April 24, 2003, by the Register of Wills of Cumberland County, Pennsylvania, unto Donald P. Brough, Jr. and Pamela A. Mulhem, who by the Decedent's aforesaid Last Will and Testament were appointed as Co-Executors of the Estate (hereinafter referred to as "Co-Executors"); WHEREAS, the Co-Executors have paid all the debts, taxes and expenses of the Estate known to them as detailed in the Pennsylvania Inheritance Tax Return and Tax Assessment Notice, and they have no knowledge of any unpaid claim which may be asserted against the Estate, nor do they have any reason to believe that there are any such claims; WHEREAS, the Beneficiary, pursuant to the Decedent's Last Will and Testament is beneficially interested in the above referenced estate; and WHEREAS, it is the desire of the Beneficiary that distribution be made without the formality of an accounting, and the Co-Executors are willing to make such distribution upon the receipt of a proper release and indemnification, which it is the purpose of this Agreement to provide. NOW, THEREFORE, intending to be legally bound hereby, the Beneficiary represents, warrants, covenants and agrees as follows: 1. Waiver of Accounting. The Beneficiary hereby waives the necessity for an accounting and directs the Co-Executors to dispense with a formal audit oftbe same. 2. Receipt. The Beneficiary requests the Co-Executors to make distribution of the following property (adjusted for subsequent income and expenses) and effective upon delivery to the undersigned of the property shown as distributable, acknowledges receipt of such property: S:/I Skarlato$ & Zonahch LLP OPEN FILESkEstatea~BROUGH, ANNA - NEW~P. elease. Full Distribution - Pamela A Mulhem doc Page 1 of 3 Cash - $79,820.57 The Beneficiary does further acknowledge that the aforesaid distribution, in addition to any partial distribution made prior to the date of this Agreement, represents the Beneficiary's entire interest in the above-referenced estate, as detailed in the Informal Accounting attached hereto as Exhibit A. 3. Release. Upon having received the above described property distribution, the Beneficiary does by these presents remise, release, quit-claim and forever discharge from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, (a) the Co-Executors for or by reason of the Co- Executors's administration of the above-referenced Estate, or any other act, matter, cause or thing whatsoever; and (b) Skarlatos & Zonarich LLP, its employees, successors and assigns, for or by reason of their representation of the Co-Executors, or any other act, matter, cause or thing whatsoever. 4. Indemnification. In exchange for the Co-Executors's willingness to make the distribution hereunder without first securing the benefit of a formal court audit, the Beneficiary agrees to indemnify Co- Executors and Skarlatos & Zonarich LLP, its employees, successors and assigns, and hold them harmless, to the extent of any funds or assets received by the Beneficiary hereunder, from and against the Beneficiary's then pro rata share of any and all liabilities, losses, damages, costs, verdicts, judgments, awards and expenses (including attorney's fees and other costs or expenses of defense) to which (i) the Co-Executors may be subjected by reason of the Co-Executors's administration of the above referenced Estate, as well as the settlement thereof by means of an informal distribution; and (ii) Skarlatos & Zonarich LLP, its employees, successors and assigns may be subjected by reason of their representation of the Co-Executors. The Beneficiary further agrees to: a. Refund or return, promptly upon the Co-Executors's written demand, any funds or assets distributed by the Co-Executors to the Beneficiary, if the distribution thereof is determined at any time to have been an erroneous or negligent distribution to the Beneficiary, whether such error or negligence was or was claimed to have been premised upon a mistake of law or of fact. b. Modify and displace any otherwise applicable period limiting the time within which the Co-Executors's action to collect an erroneous or negligent distribution must be commenced, so as to provide that the Co-Executors need not commence an action to collect an erroneous or negligent distribution to the Beneficiary until two (2) years after such time as the Co- Executom shall have obtained actual knowledge of such error or negligence. 5. Miscellaneous a. The provisions of this Agreement shall be deemed severable in the event that one or more thereof shall be deemed invalid or unenforceable, with the effect that the remaining provisions shall persist as if such invalid or unenforceable provision had never been a part hereof. In addition, the construction, effect, validity and performance of this Agreement shall be governed in all respects by the laws of the Commonwealth of Pennsylvania, without regard to its conflict of laws provision. b. This Agreement shall bind the Beneficiary, the Beneficiary's heirs, representatives, successors, and assigns together with any person with respect to whom the Beneficiary is a natural or appointed guardian. c. The Beneficiary hereby acknowledges that this Agreement may be filed at any time, at the discretion of the Co-Executors with any court of competent jurisdiction, and the Page 2 of 3 Beneficiary consents to any such filing. IN WITNESS WHEREOF, the Beneficiary has executed and sealed this Agreement on the date first above inscribed. Social Security Number: 179-44-8220 STATE OF ~ ~II~ co rv OF Pt4, SS: this, the / tl~.~ day of ~..)~tt0~t~/5~r , ,2004,. befo~,,er~e, the undersigned On authority, personally appeared PAMELA A. IVI~I~HERN, known to me [or safisfact...il: proven) to be the person whose name is subscribed to the within Release and acknowledged that the Beneficiary executed the same for the purpose therein contained. Witness my hand and official seal the day and date aforesaid. ~'--/~Iy Commission Expires: ~e~n p. 7jme~h, No~y P~IIo Page 3 of 3 SKARLATO.S AND'ZONARICH LLP ATTORNEYS AT LAW 204 STATE STREET HARRISBURG PENNSYLVANIA 17101 (717)233-1000 FAX (717)233-6740 Accounting Of: Estate of Anna S. Brough As Of: August 30, 2004 Description Adams County National Bank - Close CD Lee Procurement Solutioons Co. - Sentinel Refund PP&L Oliver Oil Co., Inc. Kuhn Communications, Inc. Hoffman-Roth Funeral Home, Inc. Belvedere Mecial Corp. The Patriot News The Whimsical Poppy - Funeral Service Cumberland Law Journal - Adv. Ltrs. Testamentary Sprint Adams County Bank - Interest Commerce Bank - Interest Mable G. Stitt - 2003 Real Estate/Personal Taxes Mable G. Stitt- 2003 Real Estate School Taxes Mable G. Stitt - 2004 Real Estate Taxes Register of Wills - Inheritance Tax The Sentinel - Estate Advertisement Prudential Financial - Death Claim Farmer's National Bank - IRA Death Distribution PA Department of Rev. - Property Tax Rebate Skarlatos & Zonarich LLP - Reimb. Probate Fee Farmer's National Bank - Close CD's The Bon-Ton Shelby Casualty Ins. Co. Pamela Mulhern - Proceeds From Car Sale George L. Ebener & Associates - Appraisal Donald P. Brough, Jr. - Subdivision, Perk, Survey Donald P. Brough, Jr. - Reimb. Pennoni Assoc. Nick Chelap - Prepare 2003 Fed. & State Tax Returns Recorder of Deeds - Record Deeds Pam and Don Brough Chesapeake Abstract Co.- Sale of Real Estate Register of Wills - Filing Fee for Inheritance Tax Register of Wills - Additional Probate Fee Highmark - Premium Refund Skarlatos & Zonarich LLP - Fee Skarlatos & Zonarich LLP - Costs (postage, copies, etc.) Preparation of Fiduciary Income Tax Return Filing Fee - Releases Estimated Inheritance Tax Refund Reserve Pending Estate Finalization Deposits 35,082.12 35.54 264.06 970.91 2,777.92 43,396.84 321.00 10,015.69 2,000.00 100,139.92 121.13 1,458.38 Disbursements 275.98 316.44 102.76 6,870.00 48.81 4.00 222.60 75.00 217.25 307.33 1,487.14 318.11 I0,000.00 102.11 278.00 9.00 30.00 175.00 4,523.50 325.00 100.00 85.00 31,00 35.00 8,923.50 52.45 550.00 19.00 1,458.38 159,641.15 Exhibit A Report Date: 9/9/2004 SKARLATOS AND ZONARICH LLP ATTORNEYS AT LAW 204 STATE STREET HARRISBURG PEN NSYLVANIA 17101 (717)233-1000 FAX (717)233-6740 Accounting Of: Estate of Anna S. Brough As Of: August 30, 2004 Description Final Distribution Pamela A Mu~hern Donald P. Brough, Jr. Deposits Disbursements 79,820.57 79,820.58 159,641.15 Exhibit A Report Date: 9/9/2004 BUREAU OF INDZVTDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COHHONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX RE¥-1547 EX AFP (g1-05) SHELLY J KUNKEL SKARLATOS & ZONARZCH 204 STATE ST HBG PA 17101 BATE 08-16-2004 ESTATE OF BROUGH BATE OF BEATH 04-11-2005 FILE NUHBER 21 03-0566 COUNTY CUHBERLAND ACN 101 I Amoun~ Remi~ed ANNA S HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGTSTER OF WTLLS CUHBERLAND CO COURT HOUSE CARLTSLE, PA 17013 CUT ALONG TH*rS LZNE ~ RETA*rN LONER PORTZON FOR YOUR RECORDS *~ REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLONANCE OR BZSALLONANCE OF DEDUCTIONS ANB ASSESSHENT OF TAX ESTATE OF BROUGH ANNA S FILE NO. 21 03-0366 ACN 101 BATE 08-16-2004 TAX RETURN WAS: (X) ACCEPTED AS FTLED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST- SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORZGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) 5. Closely Held S~ock/Par~nership Zn~eres~ (Schedule C) ($) 4. Hot,gages/No,es Receivable (Schedule D) (4) $. Cash/Bank Daposi~s/Hisc. Personal Proper~y (Schedule E) (5) 6. Jointly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTZONS ANB EXEHPT*rONS: 9. Funeral Expenses/Adm. Cos~s/Hisc. Expanses (Schedule H) (9) 10. Deb~s/Nor~gage Liabilities/Liens (Schedule Z) (10). 11. To,al Deductions 12. Na~ Value of Tax Re~urn 152z957.89 .00 .00 .00 56z073.15 21 ~ 121.93 .00 (8) 29,842.36 506.67 (11) (12) 15. 14. NOTE: reflect figures that lnclude the total o~= ALL returns assessed to date. ASSESSHENT OF TAX: 15. Aeoun~: of Line 14 e~: Spousal ra~e (16) . O0 X O0 = 16. Aeoun~ of Line 14 ~axebla a~ Lineal/Class A ra~e (16) 199,803.94 X 045 = 17. Amoun~ of Lins 14 a~ Sibling re~e (17) . O0 X 12 = 18. Amoun~c of Line 14 ~:axable e~ Collateral/Class B re'ce (18) . O0 X 15 = Charitable/Governmental Bequests; Non-elected 9113 Trus~cs (Schedule J) (15) Na~ Value of Es~a~e Subjac~ ~:o Tax (1~,) *rf an assessment ~as issued previously, lines 14, 15 and/or 16, 17, NOTE: To insure proper cradi~ ~o your account, submi~ ~he upper portion of ~his form ~i~h your ~ax payment. 230,152.97 DISCOUNT ZNTEREST/PEN PAID (-) 449.56 ZF PA/D AFTER DATE /NDZCATED, SEE REVERSE FOR CALCULATION OF ADDIT/ONAL INTEREST. (19)= AHOUNT PAID 10,000.00 31]. 349. I]3 ].99,803.94 TOTAL TAX CREBZT BALANCE OF TAX BUE INTEREST AND PEN. TOTAL BUE .00 199,803.94 18 and 19 gill .00 8,991.18 .00 .00 8,991.18 10,449.56 1,458.38CR .00 1,458.38CR ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REDUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR)~ YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) RESERVAT[ON: PURPOSE OF NOT[CE: PAYNENT: REFUND (CR): OBJECTIONS: ADMiN- iSTRATiVE CORRECTIONS: DISCOUNT: PENALTY: iNTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer [nheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill tho requirements of Section 21~0 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on tho reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which was not requested on tho Tax Return, may be requested by completing an "Application for Refund of Pennsylvania inheritance and Estate Tax# (REV-Z315). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Iq-hour answering service for forms ordering: 1-800-362-Z050~ services for taxpayers with special hearing and / or speaking needs: 1-800-4q7-3020 (TT only). Any party in interest not satisfied with tho appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as sheen on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17126-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to tho Orphans' Court. Factual errors discovered on this assessment should bo addressed in writing to: PA Department of Revenue, Bureau of individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "instructions for inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. [f any tax due is paid within three (5) calendar months after the docedont's death, a five percent (52) discount of tho tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of thc tax end 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 tho same manner and in tho the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from tho data of death, to the data of payment. Taxes which became delinquent before January l, 1982 bear interest at the rate of six (62) percent per annum caIculated at a daiIy rate of .O0016fi. A11 taxes which became delinquent on and after January l, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOOq ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ ZOZ .000548 ~'~)"~'8-1991 11X .000301 ~ 9Z .OOOZq7 1985 162 .000~38 1992 92 .0002q7 2002 62 .00016~ 198q 112 .000301 1993-199q 72 .000192 2003 52 .000137 1985 152 .000356 1995-1998 9Z .0002q7 ZOOq ~Z .000110 1986 lOX .O00Z7q 1999 72 .000192 1987 102 .00027~ 2000 72 .000192 --Xnterast is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after tho tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. [f payment is made after the interest computation date shown on tho Notico~ additional interest must bo calculated. BUREAU OF ZNDZVTDUAL TAXES INHERITANCE TAX DTVZSION DEPTo Z80601 HARRISBURG, PA 171Z8-0601 COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-I&G7 EX AFP Cgl-DS) '04 0(][ 15 SHELLY J KUNKEL SKARLATOS 8 ZONARICH 20q STATE ST ~' · DATE 09-13-200q ESTATE OF BROUGH DATE OF DEATH 0~-11-Z003 PILE NUMBER 21 03-0366 1--~ :~,7 COUNTY CUMBERLAND ACN 101 Aeoun'~ RemJ.~'l;ed ANNA S MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ ~o your account:, submi~ ~:he upper por~Lon of ~:his fore wi~h your ~cax payment. CUT ALONG THIS LINE ~'* RETAIN LONER PORTION FOR YOUR RECORDS ~ ESTATE OF BROUGH ANNA S FILE NO. 21 03-0366 ACN 101 DATE 09-13-200q THIS STATEMENT TS PROVTDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACM TN THE NAMED ESTATE. SHO#N BELON TS A SUMMARY OF THE PRZNCTPAL TAX DUE, APPLTCATTON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, TF APPLICABLE, A PROJECTED TNTEREST F~[OURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-09-Z00~ PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 8,991.18 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 06-12-2003 08-2q-200q CD002681 REFUND qq9.56 .00 10,000.00 1,q58.38- IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. { ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT 1S REQU/RED. ~F TOTAL DUE IS REFLECTED AS A 'CREDIT' (CR), TOTAL TAX CREDIT 8,991.18 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU MAY BE DUE A REFUND. SEE REVERSE SZDE OF THTS FORM FOR TNSTRUCTZONS. Cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 phone: (717) 240-6345 Date: 3/03/2005 KUNKEL SHELLY J 204 STATE STREET HARRISBURG, PA 17101 RE: Estate of BROUGH ANNA S File Number: 2003-00366 Dear Sir/Madam: It has corne to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) 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 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: 4/11/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, p~~~ GLENDA FARNE~;T~~G~ REGISTER OF WILLS cc: File Personal Representative(s) Judge cJ STATUS REPORT UNDER RULE 6.12 Name of Decedent: ANNA S. BROUGH Date of Death: APRIL 11, 2003 Will No.: 0366-2003 Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report that following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No 2 . representative be complete: If the answer is No, state when the personal reasonably believes that the administration will 3. following: If the answer to No. 1 is Yes, state the a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative account informally to the parties in interest? Yes X state an No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ':.'-...1 ~^ Signature ~ Gregory S. Chelap Name (Please type or print) Date: March 8, 2004 Skarlatos & Zonarich LLP 17 S. Second Street, 6th Floor Harrisburg, PA 17101 Address (717)233-1000 Tel. No. uK Capacity: Counsel for Personal Representative