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Home My WebLink About04-0616 PETITION FOR PROBATE and £$tate of Edna M. Yoder No. a/so known as To: GRANT OF LETTERS , Deceased. Social SecuriO, No. The petition of the undersigned respectfully represents that: Your petitioner(s), who is/~-Ye 18 years of age or older an the execut°r in the last will of the above decedent, dated September 25 and codicil(s) dated May 10, 2000 Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the named 1990 Street, (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h. er last family or principal residence atNanor Care Health & Rehab±l±tat±on Center, 1700 Camp It111 Borough, Cumberland County~ Pennsylvan±a (list street, number and muncipality) Decendent, then 86 years of age, died June 16, 2004 ,x~ --, at 1700 Narket Street, Camp I-I±11 Borough, Cumberland County, PA Except as follows, decedent did not marry, was not divorced and did not have ~ child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 200,000.00 Marke WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) k.M~on F. LaFaver ' ~.=o 120 Carol Street, New Cumberland, PA 17070 3o L I OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ~ SS The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and/~at ~s personal represen- tative(s) °f the ab°ve decedent petiti°ner(s) will ~truly .~is~~t~g to law. Sworn to or affirin.e.~T and subscribed ~2~~. ~,, ~/'~-t5 befg~re me this l O dav of. (J. gffVF. LaFaver ''-' '-' Esiate Of Edna M. Yoder q.l.¢q .AND b~O"¢/ '.,_ 9_~, in cor;side~a','.i m~ r)f ~he p,?titlon on [T ;.E DE;.;[tEED ~k,w' *~:' ........... ' ...... ~ September 25, 1990 and Hay t0, 2000 descr:i;~ed ~he;'ein be admkta.i to 0robat~ aod ~i!ed ?,f :ecord a.s the is;[ wii: c~' Edna M. Yoder and codicil of Edna ~. Yod~r : ~.nd .(,e:ttar s Testamentary are hereby granted to Jori F. LaFaver FEES z55.OO Probate,colD, ~ ,t__Letters' Etc ..........$ Short Certificates( )_. ......... ~..~..: p.a~ ...... $ I~.00 ~CP ~ ~o.o0 TOTaZ ~ ;Zql'50 Filed ................................... ATTORNEY (Sup. Ct. I.D. No.) 414 Bridge St., New Cumberland, PA 17070 ADDRESS (717) 774-7435 PHONE REGISTER OF WILLS OF CU~BEP~AND COUNTY OATH OF SUBSCRIBING WITNESS Jon F. LaFaver (exah0 a subscribing witness to the will presented herewith, (amtd¥) being duly qualified according to law. depose(s) and say(s) that he was Edna M. Yoder present and saw the testat_r±x _, sign the same and that he _ signed as a witness at the request of testat r±x in h.. er presence and (~hxH,lreX~Si~[,~ex/~F6~{,l~r:~ (in the presence of the Sworn to or affimed-~d subscribed before . me this ~ [ 5~ day of (Nme~ Jori F. LaFaver (Name) (Address) REGISTER OF WILLS OF COiJNTY OATH OF NON-SUBSCRIBING WITNESS~!:: testat.. that (each) a subscriber hereto, (each) being duly qualified according to law, depose(~)-~and say(s) that familiar with the signature of codicil ' of (one of the subscribing witnesse~ to) the will presented herewith and believes the signature on the will is in the handwriting of to the best of knowledge and belief. Sworn to or affirmed and subscribed before me this day of 19. Register (Name) (Address) (Name) (Address) REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that present and saw the testat__ _. sign the same and that signed as a witness at the request of testat~ in h presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19_ (Name) (Address) (Name) (,4 ddrexs) Register REGISTER OF WILLS OF C~Ea~,~ -' COUNTY OATH OF NON-SUBSCmBING WiTNEs~ Janeen S. LaFaver (~a~'8 a subscriber hereto, (,Z,a~B) being duly qualified according to law, depots) and say(s) that she is familiar with the signature of Edna M. Yode~r ~ ' testatrix_ of (~Si~-xh~x~fli~x-:~l~li~l~lf~x:~i~Cd~x~ the ~11 presented herewith and that she believes the signature on the will is in the handwriting of Edna M. Yoder to the best of Sworn to or affirmed and subscribed before me this ~-%T' -- day of her knowledge and belief. (Name) Janeen S. LaFaver 120 Carol St., New Cumberland, PA 17070 (Address) (Name) (Address) REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS (each) a subscribing witness to the law, depose(s) and say(s) that codicil will presented herewith, (each) being duly qualified according to present and saw the testat_ _. sign the same and that signed as a witness at the request of testat in h presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19. (Name) (Address) Register (Address)c_ ! REGISTER OF WILLS OF CUMBERLAND CgjUNTY OATH OF NON-SUBSCRIBING WITNESS Jon F. LaFaver and Janeen S. LaFaver t~tat~rix of that they (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that they are familiar with the signature of Edna Yoder codicil ' (lm~x:~x~l~tx~x~x~l:Oc the :~li presented herewith and believes the signature on the x~ill is in the handwriting of Edna Yoder to the best of their Sworn to or affirmed and subscribed before me this [ ~ Y day of (fVamO Jon F. LaFaver 120 Carol St., New Cumberland, PA 17070 OC (NamO Janeen S. LaFaver 1 arol Street, New Cumberland, PA 17070 (Addrexx) his is to certify that the information here given is correctly copied from an original certific~tte o: (lea h duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office 10r )ernanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 ~ ~¢/P'L, /¢ ~ ~ Local Registrar (-/ No. '~ Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ,. Edna M. Yoder ~amale ~.172 --24 --8890 une 16,2004 rLemoyne, PA ,. 86 .~ : ! pt. 25,1917 ,~,~ [~ ~o~ .... ~ ~ [] ,-~ ~ ~, [] ~. Cumberland ~.Camp Hill ,.Manor Care i~.,~o~ .... te I KIND OF 8USINESS/INDUS?RY -- OECED~NI EVER 'N DECEDE NT'S EDUCA~,ON I ,,.. clerk ,~.tate government --~ '-;,-~ ~ io-,~ I,,~+, wid~e~~ DECED~NT'S MAILIN~ ADDRESS (~I~W. Cm//lo~n. Sla~. Z* Coo.) DECEOENT'$ 17.. s,.,. Pennsylvania 1700 la~rket St. ~[s,~,c~ ~.~ ,,. Camp Hill, PA 17011 ~'~.) ,~.c~., Cumberland ~n~,? ''~-,m~.o, Camp Hill ,,. William McCandless , .~ora Reneker m. Jon F. ~aver ~.414 Bridge St.,New ~l~d,PA170070 ' ~"~ ~'(~qx ~lj. J~e 21,2004 Rolling Grin ~te~ ~r Allen ~., PA17011 S~UNE~LSE~EL~ENSEE~PE~Ti~S~H ' ILICE.~ NUMAR 21~. ~,.,.,.~?~,~,~,¥~ ~'~°'~.~""~""~"'"*',~.~,,.~0,.~.,,,~ .sse~&~,324 H~i Ave.~o,PA17043 liras 24-28 ~ ~ ~m~t~ ~ TIME ~ BEtH ~S CASE REFE~EO ~ MED OAk EXAMINE~/R~ -- ' ........................................ ,,. . .............................................................. ,,. ~/~ ~ /~ Iz, >,/, JON F. LAFAVER NEW CUMBERLAND, PA LAST WILL AND TESTAMENT OF EDNA M. YODER I, EDNA M. YODER, of Lemoyne, Cumberland County, Pennsylvania, being 3f sound mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament hereby revoking and making void any and all other wills by me at any time heretofore made. I. I direct that my Executor hereinafter named shall pay all my just ~ebts and funeral expenses as soon as conveniently may be done after my decease. II. I hereby give and bequeath all of my jewelry, household furnishings, automobiles and other tangible personal property unto ~'grandqiece, PAULETTE BEB0 ADAMS. £_ III. Ail the rest, residue and remainder of my estate, whether real, )ersonal or mixed, and wheresoever situate, I hereby give, devise and bequeath ~s follows: A. Ten (10%) per cent unto my grandnephew, JEFFREY LEBO, or unto his issue, if any, in equal shares, per stirpes, if he should predecease me. B. Ten (10%) per cent unto my grandniece, TRACY LEBO ANTHONY, or unto her issue, if any, in equal shares, per stirpes, if she should predecease me. C. Ten (10%) per cent unto my grandniece, PAULETTE LEB0 ADAMS, or unto her issue, if any, in equal shares, per stirpes, if she should predecease me. D. Ten (10%) per cent to be divided equally among such of the childre~ ~f JEFFREY LEBO,' TRACY LEBO ANTHONY and PAULETTE LEBO ADAMS, as shall be living at the time of my death. Page one of three Pages JON F, L^FAVER $17 THIRD STREET E. Twenty (20%) per cent unto HOSPICE OF CENTRAL PENNSYLVANIA, with offices in Enola, Pennsylvania. F. Ten (10%) per cent unto the CHRISTIAN CHURCH at 5th and Hummel Avenue, Lemoyne, Pennsylvania. Ten (10%) per cent unto BETHESDA MISSION, Harrisburg, Pennsylvania. Ten (10%) per cent unto the WEST SHORE PUBLIC LIBRARY in Camp Hill, H. Pennsylvania. I. Pennsylvania. Ten (10%) per cent unto HARRISBURG HOSPITAL, Harrisburg, IV. I hereby nominate, constitute and appoint JEFFREY LEBO, TRACY LEBO ANTHONY and PAULETTE LEBO ADAMS as Guardians of the estates of such of their respective minor children as may be entitled to a share in my estate. V. I hereby nominate, constitute and appoint my attorney, JON F. LaFAVER, ESQUIRE, as Executor of this, my Last Will and Testament. If the said Jon F. LaFaver, Esquire, should predecease me,.fail to qualify or cease to act as such, then I nominate, constitute and appoint CCNB BANK, N. A., as Executor. VI. No fiduciary acting under this Will shall be required to post bond in this jurisdiction or in any jurisdiction in which he may act. IN WITNESS WHEREOF, I, EDNA Mi YODER, the Testatrix, have unto this, my Last Will and Testament, set my hand and seal this ~- day of~ D., 1990. / S/ (SEALi Page two of three Pages L.AW OFFICES JON F, LAFAVER · l? THIRD STREET NEW CUMBERLAND, PA SIGNED, SEALED, PUBLISHED and DECLARED by EDNA M. YODER, the above- ~amed Testatrix, as and for her Last Will and Testament, in the presence of us ~ho have hereunto subscribed our names as witnesses at her request, in the ~resence of the said Testatrix and in the presence of each other. S/JON F. La~,~FKR Page three of three Pages O LAW OFFICES 317 THIRD STREET NEW CUMBERLAND, PENNSYLVANIA 17070 O LAST WILL AND TESTAMENT OF EDNA M. YODER I, EDNA M. YODER, of Lemoyne, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare .this as and for my Last Will and Testament hereby revoking and making void any land all other wills by me at any time heretofore made. I direct that my Executor hereinafter named shall pay all my just ~debts and funeral expenses as soon as conveniently may be done after my decease. II. I hereby give and bequeath all of my jewelry~ house'~bld furnishings, automobiles and other tangible personal property unto my gran~t~iece, PAULETTE III. :~, All the rest, residue and remainder of my estate, wh~ther real, personal or mixed, and wheresoever situate, I hereby give, devise and bequeath ~ias follows: A. Ten (10%) per cent unto my grandnephew, JEFFREY LEBO, or unto his issue, if any, in equal shares, per stirpes, if he should predecease me. B. Ten (10%) per cent unto my grandniece, TRACY LEBO ANTHONY, or unto her issue, if any, in equal shares, per stirpes, if she should predecease me. C. Ten (10%) per cent unto my grandniece, PAULETTE LEBO ADAMS, or unto LAW OFFICES JON F. LAFAVER SI? THIRD STREET NEW ~UMBERLAND, PA her issue, if any, in equal shares, per stirpes, if she should predecease me. D. Ten (10%) per cent to be divided equally among such of the children of JEFFREY LEBO, TRACY LEBO ANTHONY and PAULETTE LEB0 ADAMS, as shall be living :at the time of my death. Page one of three Pages LAW OFFICES JON F. LAFAVER $17 THIRD STREET NEW CUMBERLAND, PA E. Twenty (20%) per cent unto HOSPICE OF CENTRAL PENNSYLVANIA, with offices in Enola, Pennsylvania. F. Ten (10%) per cent unto the CHRISTIAN CHURCH at 5th and Hummel Avenue, Lemoyne, Pennsylvania. Ten (10%) per cent unto BETHESDA MISSION, Harrisburg, Pennsylvania. Ten (10%) per cent unto the WEST SHORE PUBLIC LIBRARY in Camp Hill, H. Pennsylvania. I. Pennsylvania. Ten (10%) per cent unto HARRISBURG HOSPITAL, Harrisburg, IV. I hereby nominate, constitute and appoint JEFFREY LEBO, TRACY LEBO ANTHONY and PAULETTE LEBO ADAMS as Guardians of the estates of such of their respective minor children as may be entitled to a share in my estate. V. I hereby nominate, constitute and appoint my attorney, JON F. LaFAVER, ESQUIRE, as Executor of this, my Last Will and Testament. If the said Jon F. LaFaver, Esquire, should predecease me, fail to qualify or cease to act as such, then I nominate, constitute and appoint CCNB BANK, N. A., as Executor. VI. No fiduciary acting under this Will shall be required to post bond in this jurisdiction or in any jurisdiction in which he may act. IN WITNESS WHEREOF, I, EDNA M. YODER, the Testatrix, have unto this, my Last Will and Testament, set my hand and seal this ~J'~ day of~ A. D., 1990. (SEAL) Page two of three Pages SIGNED, SEALED, PUBLISHED and DECLARED by EDNA M. YODER, the above- named Testatrix, as and for her Last Will and Testament, in the presence of us who have hereunto subscribed our names as witnesses at her reBuest, in the presence of the said Testatrix and in the presence of each other. LAW OFFICES JON F. LAFAVER 317 THIRD STREET NEW CUMBERLAND, PA Page three of three Pages CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: EDNA M. YODER Date of Death: June 16, 2004 Will No. 2004-00616 &Ug 17 ?3:38 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court rules was served on or mailed to the following beneficiaries of the above captioned estate on August 16, 2004. Jeffrey Lebo 4270 Aloma Avenue Suite 124 15B Winter Park, FL 32792 Parker O. Anthony % Tracy Lebo Anthony 3001 Lakeshore Drive Mount Dora, FL 32757 Tracy Lebo Anthony 3001 Lakeshore Drive Mount Dora, FL 32757 Lindsay V. Adams % Tracy Lebo Anthony 3001 Lakeshore Drive Mount Dora, FL 32757 Mason R. Anthony % Tracy Lebo Anthony 3001 Lakeshore Drive Mount Dora, FL 32757 Christian Church 5th and Hummel Avenue Lemoyne, PA 17043 Hospice of Central Pennsylvania 98 S. Enola Drive Enola, PA 17025 Bethesda Mission 611 Reily Street Harrisburg, PA 17102 New Cumberland Public Library 1 Benjamin Plaza New Cumberland, PA 17070 Harrisburg Hospital 111 South Front Street Harrisburg, PA 17101 Office of Attorney General Charitable Trusts and Organizations Section 14th Floor, Strawberry Square Harrisburg, PA 17120 Notice has now been given to all persons entitled thereto under Rule 5.6(a). Date: ~-/(~ -~ ~/'~z~; D ~ , quire 414 Bridge Street New Cumberland, PA 17070 717-774-7435 Capacity: Personal Representative X Counsel for Personal Representative 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 O04367 LAFAVER JON F 120 CAROL STREET NEW CUMBERLAND, PA 17070 ........ fold ESTATE INFORMATION: SSN: 172-24-8890 :ILE NUMBER: 2104-0616 DECEDENT NAME: YODER EDNA M DATE OF PAYMENT: 09/1 3/2004 POSTMARK DATE: 09/13/2004 COUNTY: CUMBERLAND DATE OF DEATH: 06/1 6/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $14,400.00 TOTAL AMOUNT PAID' 4,400.00 REMARKS' JON F LAFAVER SEAL CHECK#03 INITIALS' SK RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage. Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: Invoice Date: Estate of: Estate No: 252 3/15/2005 Edna M.'Y oder 21-2004-0616 DAVID HSTONE 414 BRIDGE ST vz NEW CUMBERLAND, P A 17070 Qty 1 Fee Description Additional Probate Fee T otai 35.00 $35.00 T otai: $35.00 Checks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. Register of Wills of Cumberland County. Pennsylvania INVENTORY Estate of Edna M Yoder No.21 04 0616 . Deceased Date of Death 6/16/2004 Social Security No. 172-24-8890 also known as Jon F. LaFaver. 'F:xPC!l1Tnr Personal Representative( s) of the above Estate. deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. l!We verify that the statements made in this inventory are true and correct. l!We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representativ . Name of Attorney: David H. Stone. Esquire I.D. No.: 39785 Jon F. LaFave 414 Bridqe St New Cumberland PA 17070 Address: 414 Bridqe Street New Cumberland Dated PA 17070 Telephone: 717-774-7435 Description Value Commonwealth of PA Refund 189.01 M& T Bank-Cert of Deposit #031003914381684 Prine. $30.000. Int. $24.28 ;0-......) ~Q.024.28 (.~; t M& T Bank-Cert of Dep #031003914381816 Prine. $50,000, Int. $25.65 50,025.65 c)': M& T Bank-Cert. of Dep #031003914381858 Prine. $10,000, Int. $2.37 M& T Bank-Cert. of Deposit #031003914381907 Prine. $10.000, Int. $3.48 (.~,) C1 10.003.48 Manor Care Refund 2,215.89 Total (Attach Additional Sheets if necessary) 281,795.12 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 Continuation of Inventory Edna M Yoder 21 04 0616 Paqe 1 Description of Inventory Description Value PNC Bank-Cert of Dep #21001019656 Prine. $30,000, Int. $14.29 30,014.29 PNC Bank-Cert of Deposit #21001019524 Prine. $5,000, Int. $.41 5,000.41 PNC Bank-Cert. of Deposit #21001019713 Prine. $50,000, Int. $28.42 50,028.42 Waypoint Bank-Cert of Dep #521102144 Prine. $50,000, Int. $16.43 50,016.43 Waypoint Bank-Cert of Deposit #515820949 Prine. $10,000, Int. $13.35 10,013.35 Waypoint Bank-Checking Account #500014331 17,209.26 Waypoint Bank-Checking Aeet. #405009032 17,052.28 Subtotal $ 179,334.44 281,795.12 Grand Total $ ~. ~ 'RE'f',SOO EX ~ (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128..(}601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ~ Z W C W (.) W C w !;( ll::-fI) (,)a::ll:: wD..(,) %00 (,)a::...J 8:1D <C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Yoder Edna M DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) OFFICIAL USE ONLY FILE NUMBER 21 -0 4 0 6 1 6 '"'Caifu"'COOE --VEN\- - - NUii'ER- - SOCIAL SECURITY NUMBER 1 72- 2 4 - 8 8 9 0 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (date of death prior III 12-13-82) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under See. 9113(A) (AIIach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS David H. Stone Es uire 414 Bridge Street FIRM NAME (If Applicable) Stone LaFaver & Shekletski TELEPHONE NUMBER 717-774-7435 New Cumberland PA 17070 z o 5 ~ ~ a: <( (.) w D:: z o i= <( ~ ~ a.. :E o (.) ~ ~ 0.00 X _(15) 0.00 0.00 X _(16) 0.00 0.00 X .12 (17) 0.00 97,827.56 X .15 (18) 14,674.13 (19) 14,674.13 6/16/2004 9/25/1917 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) lli] 1. Original Return o 4. Limited Estate lli] 6. Decedent Died Testate (Attach copy of wlI) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82} o 7. Decedent Maintained a Living Trust (AIIach copy of Trust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) OFFICIAL USE ONLY 281,795.12 (.,,:-'1 I- Z W C Z o D.. fI) W a:: a:: o (,) 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or SoIe-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested (1) (2) (3) (4) (5) 7.lnter-Vrvos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (8) ,'< "'l t".,..'.... 281,795.12 37 ,226.23 (11) (12) (13) 37,226.23 244,568.89 146,741.33 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under See. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE. SURE "J'OANSWERAll QUES"J'IONSON REVERSE SIDE AND. RECHECK MATH <: < (14) 97,827.56 o d' t' C I t Add ece en s omple e ress: STREET ADDRESS 1700 Market Street CITY I STATE I ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 14,674.13 14.400.00 733.71 Total Credits ( A + 8 + C ) (2) 15,133.71 3. InterestJPenalty if applicable D.lnterest E. Penalty Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Une 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than line 2. enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 459.58 0.00 0.00 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; ........................................................................... D 00 b. retain the right to designate who shall use the property transferred or its income; ........................................ D 00 c. retain a reversionary interest; or ...................................................................................................... D 00 d. receive the promise for life of either payments. benefits or care? .............................................. ............... D 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?........................................ -.. ......... .... ...................................... D 00 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. D 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................ .......... .... .... ........ ..................... .......... ...... 00 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. this relum, induding accompanying schedules and statements, and to the best of my knowledge and belief, ~ is true, cooect and complete. . based 01\ aI infarmalion of which preparer has any knowledge. G~~ ~ ~ 2--j- PA 17070 DATE 2- PA 17070 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 exemDt 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 ofthe 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 decedenfs 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 decedenfs siblings is 12% [72 P.S. ~9116{a){1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. , REV-150a EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Yoder. Edna. M SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21 04 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0616 ITEM NUMBER 1 2 3 4 5 7 8 9 10 11 12 13 DESCRIPTION VALUE AT DATE OF DEATH 1 89.01 Commonwealth of PA Refund M& T Bank-Cert of Deposit #031003914381684 Prine. $30,000, Int. $24.28 30,024.28 M& T Bank-Cert of Dep #031003914381816 Prine. $50,000, Int. $25.65 50,025.65 M& T Bank-Cert. of Dep #031003914381858 Prine. $10,000, Int. $2.37 10,002.37 M& T Bank-Cert. of Deposit #031003914381907 Prine. $10,000, Int. $3.48 10,003.48 Manor Care Refund 2,215.89 PNC Bank-Cert of Dep #21001019656 Prine. $30,000, Int. $14.29 30,014.29 PNC Bank-Cert of Deposit #21001019524 Prine. $5,000, Int. $.41 5,000.41 PNC Bank-Cert. of Deposit #21001019713 Prine. $50,000, Int. $28.42 50,028.42 Waypoint Bank-Cert of Dep #521102144 Prine. $50,000, Int. $16.43 50,016.43 Waypoint Bank-Cert of Deposit #515820949 Prine. $10,000, Int. $13.35 10,013.35 Waypoint Bank-Checking Account #500014331 17,209.26 Waypoint Bank-Checking Aeet. #405009032 17,052.28 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 281.795.12 . REV-151t EX + (12-99) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Yoder. Edna. M SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER 21 04 0616 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Musselman's Funeral Home-funeral expenses 7,350.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Jon F. La Faver 14,089.00 Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 120 Carol Street City New Cumberland State PA Zip 17070 Year(s) Commission Paid: 2004/2005 2. Attorney Fees David H. Stone, Esquire 14,089.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills, Cumberland County, PA 291.50 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. US Dept. of Treasury 819.00 8. Cumberland Law Journal-advertising grant of letters 75.00 9. The Patriot News Co.-advertising grant of letters 109.30 10. Register of Wills-filing Inheritance Tax Return and Inventory 30.00 11. PEBIF-Overpayment due 173.43 12. Reserve for closing expenses 200.00 TOTAL (Also enter on line 9, Recapitulation) $ 37 226.23 (If more space is needed, insert additional sheets of the same size) ,"'-"" ex'.. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER Ynrl"'r Edn~ M '1 04 n~1~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1. TAXABLE DISTRIBUTIONS pncIude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1. Jeffrey Lebo Collateral 24,456.89 4270 Aloma Avenue, Suite 124 15B Winter Park, FL 32792 2. Tracy Lebo Anthony Collateral 24,456.89 3001 Lakeshore Drive Mount Dora, FL 32757 3. Lindsay V. Adams Collateral 32,609.18 cia Tracy Lebo Anthony 3001 Lakeshore Drive Mount Dora, FL 32757 4. Parker O. Anthony Collateral 8,152.30 cia Tracy Lebo Anthony 3q01 Lakeshore Drive Mount Dora, FL 32757 5. Mason R. Anthony Collateral 8,152.30 c/o Tracy Lebo Anthony 3001 Lakeshore Drive Mount Dora, FL 32757 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. Hospice of Central PA 48,913.77 98 S. Enola Drive Enola, PA 17025 2. Christian Church 24,456.89 5th and Hummel Avenue Lemoyne, PA 17043 3. Bethesda Mission 24,456.89 611 Reily Street Harrisburg, PA 17102 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 146.741.33 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Yoder, Edna, M Decedent's Name Page 1 21 04 0616 File Number Schedule J - Beneficiaries - 2B B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 4. New Cumberland Library 1 Benjamin Plaza New Cumberland, PA 17070 5. Pinnacle Heath 111 South Front Street Harrisburg, PA 17101 24,456.89 24,456.89 SUBTOTAL SCHEDULE J.2B 48,913.78 ........, 510/00 a~ /f ~ /C:~O ~ W~ ~,d....:/~~ -- Ll+~~ ~ l!.uv- {k~~ fl~~~~ ?-:Lo-L~ / O~-1?tM'~ ~ r L:? ./ )t~/ I .p~ .~(,d ?I~ &~ ?fGJ-d!~~ y, Pennsylvania, being publish and declare ng and making void any " ..-- . . II ""~ .~~ r, I. .-- \ ~ =) ebts and o I direct that my Executor hereinafter named shall pay all my just ....... .... II. i decease .1 I I i ! I ! funeral expenses as soon as conveniently may be done after my ~ I hereby give and bequeath all Sf my jewelry, household furnishings, utomobiles and other tangible personal property unto my grandniece, PAULETTE EBO ADAMS. III. All the rest, residue and remainder of my estate, whether real, ersonal or mixed, and wheresoever situate, I hereby give, devise and bequeath ..AW OFFICES >I F. LAFAVER . THIRD STREET CUMBERLAND. PA I, s follows: II A. Ten (10%) per cent unto my grandnephew, JEFFREY LEBO. or unto his Irssue, if any, in equal shares, per stirpes, if he should predecease me. I, B. Ten (10%) per cent unto my grandniece, TRACY LEBO ANTHONY, or unto lier issue, if any, in equal shares, per stirpes, if she should predecease me. I C. Ten (10%) per cent unto my grandniece, PAULETTE LEBO ADAMS, or unto ~er issue, if any, in equal shares, per stirpes, if she should predecease me. 'I Ii D. Ten (10%) per cent to be divided equally among such of the children I~ft JEFFREY LEBO. TRACY LEBO ANTHONY and PAULETTE LEBO ADAMS, as shall be living r the time of my death. I Page one of three Pages - , ': ! ~. _ J I I .--' :) : . (. ) ",_/ ; : ~ t ; i ~ ~ \ t j : \'-~: ~/ \; ;~:...~> I ! ............/1. LAST WILL AND TESTAMENT OF EDNA M. YODER I I I, EDNA M. YODER, of Lemoyne, Cumberland County, Pennsylvania, being ~f sound mind, memory and understanding, do hereby make, publish and declare thiS as and for my Last Will and Testament hereby revoking and making void any and all other wills by me at any time heretofore made. I! l I direct that my Executor hereinafter named shall pay all my just '! ehts and funeral expenses as soon as c:~venientlY may he done after my decease. II. I hereby give and bequeath all of my jewelry, household furnishings, '. utomobiles and other tangible personal property unto my grandniece, PAULETTE EBO ADAMS. III. All the rest, residue and remainder of my estate, whether real, LAW OFFICES JON F. LAFAVER 317 THIRD STREET ~EW CUMBERLAND. PA or mixed, and wheresoever situate, I hereby give, devise and bequeath s follows: A. Ten (10%) per cent unto my grandnephew, JEFFREY LEBO, or unto his any, in equal shares, per stirpes, if he should predecease me. B. Ten (10%) per cent unto my grandniece, TRACY LEBO ANTHONY, or unto' issue, if any, in equal shares, per stirpes, if she should predecease me. C. Ten (10%) per cent unto my grandniece, PAULETTE LEBO ADAMS, or unto er issue, if any, in equal shares, per stirpes, if she should predecease me. D. Ten (10%) per cent to be divided equally among such of the childre~ 1 f JEFFREY LEBO,. TRACY LEBO ANTHONY and PAULETTE LEBO ADAMS, as shall be living t the time of my death. Page one of three Pages LAW OFFICES JON F. LAFAVER 317 THIRD STREET iEW CUMEilERLAND. PA --';. "~'_~;~I);~';1'h1':i"'~ -,;, "-", -', ; !./ .: ,~ "\ \:' I'..., ., , \,.'~// , i , ; '\ .~<4/' --." , . , r"-' i ~ E. Twenty (20%) per cent unto HOSPICE OF CENTRAL PENNSYLVANIA, with ffices in Enola, Pennsylvania. F. Ten (10%) per cent unto the CHRISTIAN CHURCH at 5th and Hummel Lemoyne, Pennsylvania. G. Ten (10%) per cent unto BETHESDA MISSION, Harrisburg, Pennsylvania. H. Ten (10%) per cent unto the WEST SHORE PUBLIC LIBRARY in Camp Hill~ II ennSYlVan:~. Ten (10%) per cent unto HARRISBURG HOSPITAL, Harrisburg, ~ ennsylvania. IV. I hereby nominate, constitute and appoint JEFFREY LEBO, TRACY LEBO ~THONY and reSPective PAULETTE LEBO ADAMS as Guardians of the estates of such of their minor children as may be entitled to a share in my estate. V. I hereby nominate, constitute and appoint my attorney, JON F. LaFAVER,~ SQUIRE, as Executor of this, my Last Will and Testament. If the said Jon F. aFaver, Esquire, should pre~ecease me, .fail to qualify or cease to act as such,: then I nominate, constitute and appoint CCNB BANK, N. A., as Executor. VI. No fiduciary acting under this Will shall be required to post bond in this jurisdiction or in any jurisdiction in which he may act. IN WITNESS WHEREOF, I, EDNA M. YODER, the Testatrix, have unto this, y Last Will and Testament, set my hand and seal this ~~~ day Of~ . D., 1990. / - I " 131 (SEAL Page two of three Pages ri"f~~~"'.T ..... I SIGNED, SEALED, PUBLISHED and DECLARED by EDNA M. YODER, the above- ramed Testatrix, as and for her Last Will and Testament, in the presence of us rhO have hereunto subscribed our names as witnesses at her request, in the resence of the said Testatrix and in the presence of each other. LAW OFFICES JON F. LAFAVER 317 THIRD STREET IEW CUhlEilERLAND. PA I I! ! J ;::..",., U \' , UU~ \ 1 j'-; " \..' . \'..--/' \\...~- / ~2t.I/ '._~~ (..,~ r.~.;~ n~::. _ --. J' ~ ~ ~ .;;J" t",,~l:;'{..' itEF.. Ii ;3'/ p, ,:-;-'-' ;:'~.::.~:~-':~ '-'.-'. , 7,':~~~_~,~;r~ I:rs .. I I I ~" I''; i I ! Page three of three Pages rlM&rBank 499 Mitchell Road, MilIsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 July 27, 2004 Stone LaFaver & Shekletski Attorneys At Law 414 Bridge Street P. O. Box E New Cumberland, PA 17070 Re: Estate of Edna M Yoder Social Securitv: 172-24-8890 Date of Death: June 16. 2004 Dear Sir or Madam: Per your inquiry dated July 19,2004, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Certificate of Deposit Account Number 031003914381684 Ownership (Names of) Edna M Yoder Jon F LaFaver Atty, POA Opening Date 05/11/87 (Closed 07/08/04) $30,000.00 Balance on Date of Death Accrued Interest $ 24.28 Total $30,024.28 2. Type of Account Certificate of Deposit Account Number 031003914381816 Ownership (Names of) Edna M Yoder Jon F LaFaver Atty, POA Opening Date Balance on Date of Death 05/11/87 (Closed 07/08/04) $50,000.00 $ 25.65 Accrued Interest Total $50,025.65 FEB-09-2005 21:08 PNCBANK 412 768 3458 P.02 o PNCBAN< February 10, 2005 David H. Stone 414 Bridge Street P.O.BoxE New Cumberland, P A 17070 RE: Estate of Edna M. Yoder, d~ased SSli: 172-24--8890 DOD: 6/1612004 Dear Mr. Stone: In response to your request for Date of Death balances for the custom<< noted above, our records show the following: CerUfkates of Deposit AtcOWlt #21001019524 Established 05/11/1987 EDNAMYODER DOD ba1aDcc: $5,000.00 + $.41 ac:aued interest Acoount #21001019656 Established 05/11/1987 EDNA M YODER DOD balance: $30,000.00 + $14.29 accrued interest ACCOUDt. #2100 1019713 Esa.blished 05/1111987 EDNA M YODER DOD balance: $50,000.00 + $28.42 accrued interest Please note that this office only provides date of death balances foe deposit accounts (IRAs. CDs, Cb~Jring and Savings accounts)_ We do IIOt procell allY fi...nri., traosactiolUl or provide statements. If you need assistance with any oftbcse items, please call1-888-PNC-BANK (1-888-762-2265) or stop by your local PNe Bank branch office. ~fdJli~ Rachelle Wells 1-800-762-1775 P7-PFSC-04-F 500 first Aw. Pittalxugh PA 15219 Mcmbec FDIC ~lWay~i!1J 7/21/2004 STONE LAP AVER & SHEKLETSKI 414 BRIDGE ST PO BOX E NEW CUMBERLAND P A 17070 The information which you requested on the account(s) of EDNA M YODER (Social Security Number 172-24-8890) is/are as follows: Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership SOLE Name of Joint Owner, ifany 405009032 CHECKING 070198 17052.28 0.00 17052.28 500014331 515820949 521102144 CHECKING CERTIFICATE CERTIFICATE 051487 062982 031887 17209.26 10000.00 50000.00 0.00 13.35 16.43 17209.26 10013.35 50016.43 SOLE SOLE SOLE Date Ownership 070198 Was Established 051487 062982 031887 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, ifany Date Ownership Was Established Additional Information Requested A SENIOR SERVICES REP. P.O. Box 1711. HARRISBURG. PeNNSYlVANIA 17105-I7H TolIl=r_ I-RF;.F;._W.6.VPnINT II_RF;.F;._Q;::tq_7'::;;4'::;;\ . IN VnAIt' 4A'::& 717/RIC:-4C:I'Vl . UlAAIUI....""..nfti..+h"...... ......... -,._'....--..._,:,.e__ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR OISALLOWANCE OF OEDUCTIONS AND ASSESSHENT OF TAX BUREAU OF INOIVIDUAL~\ TAlreS INHERITANCE TAX DIVISIDN"- . . - PO BOX 280601 HARRISBURG PA 17128-0601 '( 27 Pi'l12: 35 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-30-2005 YODER 06-16-2004 21 04-0616 CUMBERLAND 101 CLERI-< ORD~i"\I'C' "O.IIPT I I 'I'" , \.i ~---' J\J> I DAVID H2~~ONi' ESII STONE ETAL 414 BRIDGE ST NEW CUMBERLAND PA 17070 *' REV-1547 EX AFP (03-05) EDNA M AlIOunt I..i tted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ IUV-"M~"Yf.,,",wm~'1I!l'.mtm.!II!'.!wtItWJlMM.'tXl['.lWltlTftMMr~.'lrC[WJlMM.lITr.............. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF YODER EDNA M FILE NO. 21 04-0616 ACN 101 DATE 05-30-2005 TAX RETURN WAS: I X) ACCEPTED AS FILED ) CHANGED I~ an asseSSBent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will r~lect ~1gures that include the total ~ ALL returns assessed to date. ASSESSMENT OF TAX: IS. ~ount of Line l~ .t Spousal rate (IS) 16. A.ount of Line l~ taxabl. at Lineal/Class A rat. (16) 17. ADDunt of Lin. 1~ .t Sibling rat. (17) 18. Amount of Line 14 taxable .t Collateral/Class B r.t. (18) 19. Principal Tax Due RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Est.te (Schedule A) 2. Stocks end Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) I~) IS) (6) 171 .00 .00 .00 .00 281.795.12 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral ExPenses/Adn. Costs/Misc. ExPenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. N.t Value of Tax Return 13. Charitable/Govern.-ntal Bequests; Non-el.cted 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 37,226.23 .00 Ill) (12) (13) 11~) NOTE: .00 X .00 X .00 X 97,827.56 X NUHBER CD004367 INTEREST/PEN PAID 1-) 733 . 71 AIIOUNT PAID 14,400.00 DATE 09-13-2004 ~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 00 = 045 = 12 = 15 = (19)= NOTE: To insure proper credit to your account, ~it the upper portion of this fOMII with your tax PIIY.-nt. 281,795.12 ~7.'l'l6 'l~ 244,568.89 146,741.33 97,827.56 .00 .00 .00 14,674.13 14,674.13 15,133.71 459.58CR .00 459.58CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YDU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS.) ~..: ::'~~ED OFFICE OF PO lOX ZH601 DEr;!C:T~C) r,.: HIli: (' HARRISIIURll PA 17121-D60l"' "\,~"v I r.~1 '.j; q,.'. >.) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT . REV-1607 EX AFP (05-05) 2005 JUL 22 Pf1 2: II DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-27-2005 YODER 06-16-2004 21 04-0616 CUMBERLAND 101 ~t R_IUM EDNA M CLERK OF :~~~~ ~~~I'~i~:Q~IR~?~ 414 BRIDGE ST NEW CUMBERLAND PA 17070 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 MDTE: To In_. p.--r orMIlt to your _t. __It t.,. ~r portion of thb fOI"ll with your t_ "_to CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ..........................................~...,...............~.~~............................................ REV-1607 EX AFP (03-05) ... INHERI ANCE TAX STATEMENT OF ACCOUNT ... UTATE OF YODER EDNA M FILE NO.21 04-0616 ACN 101 DATE 06-27-2005 THIS STATEItENT IS PIlOVIDED TO ADVISE OF THE CUIlIIENT STA11lS OF THE STATED AaI IN THE IWlED ESTATE. SHOIIN BELOW IS A SUIIIAIlY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYIlENTS. THE CURRENT IALAllCE. AND. IF APPLICABLE. A PIIO.IECTED Drl'EREST FIIlURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-23-2005 PRINCIPAL TAX DUE: 14.674.13 PAYMENTS (TAX CREDITS), PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-13-2004 CD004367 733.71 14.400.00 06-10-2005 REFUND .00 459.58- TOTAL TAX CREDIT 14.674.13 BALANCE OF TAX DUE .00 INTEREST AND PIN. .00 . IF PAID AnER THIS DATE. SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN U. NO PA YItEIIT IS REllUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR). YOU KAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR IHSTRUCTIONS. ) <i.. . .. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Edna M. Yoder Date of Death: June 16, 2004 Will No. 21-04-0616 To the Register: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. Yes ~ State whether administration of the estate is complete: No 2. If the answer lS No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: (a) Did the personal representative file a final account with the Court? Yes No X (b) The separate Orphans' Court No. (if any) for the personal representative's account is: N/A (c) Did the personal representative state an account informally to the parties in interest? Yes~ No Date: S'-~ ;,()y and (d) Copies of receipts, releases, approvals of formal or informal ~ / the Clerk of the Orphans' Cou~' and report. ,-- Davi 414 Bridge Street New Cumberland, PA 17070 717-774-7435 Capacity: Personal Representative :\j x Counsel for Personal Representative \ ; ,. ~rj\1l \.-<d est\rel\yoder hospice , <( J . IN RE: ESTATE OF EDNA M. YODER LATE OF THE BOROUGH OF CAMP HILL, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0616 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that we, HOSPICE OF CENTRAL PA, being one of the beneficiaries under the will of EDNA M. YODER, do hereby acknowledge that we have received all sums of money and proper- ty due us by virtue of the death of EDNA M. YODER, in full satisfac- tion and settlement of all of our rights and claims under her estate. We further declare, intending to be legally bound, that we hereby waive our right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and we acknowledge that we have had an opportunity to examine copies of the books and records of the said estate, and we agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, We, HOSPICE OF CENTRAL PA, do by these presents, remise, release, quitclaim and forever discharge the Executor, his heirs, successors and assigns, from the acts of the Executor as afore- said, and of and from all actions, suits, payments, accounts, reckon- , ~ II Ii AI ings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and we do hereby consent to the discharge of the said Executor. IN WITNESS WHEREOF, We have hereunto set my hand and seal the ____ {' t ~ 9. I-- day of ~lJqJ~ J , 2005. HOSPICE OF)1?AL, pYJ ~~-I Bv: Witness COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF 'I tt"QL On this, the .~ \ day of rlzr:11 , 2005, before me a Notary Public, the undersigned officer, personally appeared , , I I<l~tt~ PAK!5 (or satisfactorily proven) to be the of HOSPICE OF CENTRAL PA, known to me ~X. UJ f(tCTOI?,\ whose name is subscribed to the within instrument and acknowledged that SH~ executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereu"lto set my hand and seal. the day and year first above written. ~ !.~ / Notary Public I f n NOTARIAL SEAL ROBERT l. GIll, Notary Public EIst Pennsboro Twp., County of Cumberland My Commission Expires May 25, 2009 -2- I II II , I est\rel\yoderchristian IN RE: ESTATE OF EDNA M. YODER LATE OF THE BOROUGH OF CAMP HILL, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0616 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that we, FIRST CHRISTIAN CHURCH, being one of the beneficiaries under the will of EDNA M. YODER, do hereby acknowledge that we have received all sums of money and proper- ty due us by virtue of the death of EDNA M. YODER, in full satisfac- tion and settlement of all of our rights and claims under her estate. We further declare, intending to be legally bound, that we hereby waive our right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and we acknowledge that we have had an opportunity to examine copies of the books and records of the said estate, and we agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed In a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, We, FIRST CHRISTIAN CHURCH, do by these presents, remise, release, quitclaim and forever discharge the Executor, his heirs, successors and assigns, from the acts of the Executor as afore- said, and of and from all actions, suits, payments, accounts, reckon- ~ , II , II ~' ings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and we do hereby consent to the discharge of the said Executor. IN WITNESS WHEREOF, We have hereunto set my hand and seal the ____ ( f 1/' da y 0 f ~ , 2005. FIRST CHRISTIAN CHURCH ~k r; /~ Bv: ~~tf ~ () ~~ Witness COMMONWEALTH OF PENNSYLVANIA: COUNTY OF e.u ~ b \.t.l A^""..l SS: On this, the ~ ~-~ day of S-~p i-:,(I-vv-.. '\ l^- , 2005, before me a Notary Public, the undersigned officer, personally appeared 'J~~& .k ~~'.Jl.L . of FIRST CHRISTIAN CHURCH, known to me (or satisfactorily proven) to be the ?-~~ -~.4./ whose name lS subscribed to the within instrument and acknowledged that n-Q... - executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. ~~ Notary Public NOTARIAL SEAL 1 LOUIS J. LORE, Notary Public Camp Hili Bora, Cumberland County My Commission expires Apri/14, 2007 -2- P. est\rel\yoderbethesda IN RE: ESTATE OF EDNA M. YODER LATE OF THE BOROUGH OF CAMP HILL, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0616 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that we, BETHESDA MISSION, being one of the beneficiaries under the will of EDNA M. YODER, do hereby acknowledge that we have received all sums of money and property due us by virtue of the death of EDNA M. YODER, in full satisfaction and settlement of all of our rights and claims under her estate. We further declare, intending to be legally bound, that we hereby waive our right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Cornmon Pleas having jurisdiction over the same, and we acknowledge that we have had an opportunity to examine copies of the books and records of the said estate, and we agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, We, BETHESDA MISSION, do by these presents, remise, release, quitclaim and forever discharge the Executor, his heirs, successors and assigns, from the acts of the Executor as afore- said, and of and from all actions, suits, payments, accounts, reckon- I~ ings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and we do hereby consent to the discharge of the said Executor. IN WITNESS WHEREOF, We have hereunto ~ 9>th day of ~+f'VVlbRr set my hand and seal the ____ , 2005. ~+ ~~~~~ Wltness BET:~ISSION/ )c/ Bv: !2 f/L/~ COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF0~ On this, the cQg't day o~ , 2005, before me a Notary Public, the undersigned officer, personally appeared Po.s~ G. We/'j}'V\q II of BETHESDA MISSION, known to me (or satisfactorily proven) to be the ~ whose name lS subscribed to the within instrum:ntUand acknowledged that ~ executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. ~ /: " , (~L~ -2- COMMONW!ALTH 0,. N.... ~ IA. NOTARIAL SEAL I LAURA A. TARASEWICH, Notary Public Susquehanna Twp.. Dauphin County My Commission Expires Aug. 30. 2008 ? !I est\rel\yoderlibrary . IN RE: ESTATE OF EDNA M. YODER LATE OF THE BOROUGH OF CAMP HILL, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0616 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that we, NEW CUMBERLAND PUBLIC LIBRARY, being one of the beneficiaries under the will of EDNA M. YODER, do hereby acknowledge that we have received all sums of money and property due us by virtue of the death of EDNA M. YODER, in full satisfaction and settlement of all of our rights and claims under her estate. We further declare, intending to be legally bound, that we hereby waive our right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and we acknowledge that we have had an opportunity to examine copies of the books and records of the said estate, and we agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, We, NEW CUMBERLAND PUBLIC LIBRARY, do by these presents, remise, release, quitclaim and forever discharge the Execu- tor, his heirs, successors and assigns, from the acts of the Executor II ~ II . . as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and we do hereby consent to the discharge of the said Executor. IN WITNESS WHEREOF, We have hereunto set my hand and seal the $( 3( =--day of ~~ , 2005. /,/~"'~~- '/ r , /.- /, ,. f '............/ I /" t'" / \ LI.;;_~L.. ~l .~) ~-_. ~ Witness NEW CUMBERLAND PUBLIC LIBRARY By: 'ft~~ I PAUJI , COMMONWEALTH OF PENNSYLVANIA: SS: CO UN T Y 0 F t. v.n..IJ e./.-tftIIJ j) 3 sl- On this, the- I day of ~ , 2005, before me a Notary Public, the undersigned officer, personally appeared E( I Uhe:fI.. .S~, fJ~cb-:1: , of NEW CUMBERLAND PUBLIC LIBRARY, known to me (or satisfactorily proven) to be the p~, whose name is subscribed to the within instrument and acknowledged that ~ executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. ~ V~}::y ~ -2- COMMONWEALTH OF I"ENN$YlVANIA r NOTARIAL SEAL TINA M. BURKEY, Notary Public I New Cumberland Bora, Cumberland Co, i My Commission Expires April 15, 2009 .II I est\rel\yoderpinnacle IN RE: ESTATE OF EDNA M. YODER LATE OF THE BOROUGH OF CAMP HILL, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0616 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that we, PINNACLE HEALTH HOSPI- TALS, being one of the beneficiaries under the will of EDNA M. YODER, do hereby acknowledge that we have received all sums of money and property due us by virtue of the death of EDNA M. YODER, in full satisfaction and settlement of all of our rights and claims under her estate. We further declare, intending to be legally bound, that we hereby waive our right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and we acknowledge that we have had an opportunity to examine copies of the books and records of the said estate, and we agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, We, PINNACLE HEALTH HOSPITALS, do by these pres- ents, remise, release, quitclaim and forever discharge the Executor, his heirs, successors and assigns, from the acts of the Executor as I 'I, aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and we do hereby consent to the discharge of the said Executor. Y-L.-. IN WITNESS WHEREOF, We have hereunto set my hand and seal thep/~ day of H~~~I , 2005. By: C~-;d Sv (> JSec HEALTH HOSPITALS e ~1N.vL)> PINNACLE COMMONWEALTH OF PENNSYLVANIA: COUNTY OF j);quP J-I J,J SS: On this, the ",)~-I::A-day of illltf Yf- , 2005, before me a Notary Public, the undersigned officer, personally appeared fJw~ftJ-phUl P /v1~ of PINNACLE HEALTH HOSPITALS, known to me ( 0 r sa ti s fa eto r il y proven) to be the Sr tiP d SeWm:JWhose name lS subscribed to the within instrument and acknowledged that ~J-- executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. LAN~~~bfp!*O -2- COMMONWEALTH OF PENNSYLVANIA Nolana; Seal .Vicki Y. Potteiger. Notary Public City Of HamstMg, DauPhin County My Commis6ion Expires Nov. 9. 2008 Member. Pennsylvania Association Of Notaries est\rel\YODERjeff ~ IN RE: ESTATE OF EDNA M. YODER LATE OF THE BOROUGH OF CAMP HILL, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0616 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, JEFFREY LEBO, being one of the beneficiaries under the will of EDNA M. YODER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of EDNA M. YODER, in full satisfaction and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution In any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, JEFFREY LEBO, do by these presents, remise, release, quitclaim and forever discharge the Executor, his heirs, successors and assigns, from the acts of the Executor as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, , . claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executor. IN WITNESS WHEREOF, I have hereunto set my hand and seal the r day of s.err; , 2005. '~ ~...~ wftness I --- . . STATE OF FLORIDA COUNTY OF Lp-Ke. ss: On this, the 9' day of S~r , 2005, before me a Notary Public, the undersigned officer, personally appeared JEFFREY LEBO, known to me (or satisfactorily proven) to be the person whose name is subscribed to the wi thin in:3trument and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. ~~ 1\ Shirley J Katz . ~ j My Commission 00173019 ~o,,,,d6' Expires December 22. 2006 ~ ~ ' /(./--=n / Notal'y Public i -2- est\rel\YODERtracey IN RE: ESTATE OF EDNA M. YODER LATE OF THE BOROUGH OF CAMP HILL, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0616 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, TRACEY LEBO ANTHONY, being one of the beneficiaries under the will of EDNA M. YODER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of EDNA M. YODER, in full satisfaction and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, TRACEY LEBO ANTHONY, do by these presents, remise, release, quitclaim and forever discharge the Executor, his heirs, successors and assigns, from the acts of the Executor as afore- said, and of and from all actions, suits, payments, accounts, reckon- JI ,I ,. II ings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executor. ~ IN WITNESS WHEREOF, I have hereunto set my hand and seal the~ day of ~~+ ddl Wi tness /' , 2005. STATE OF FLORIDA SS: COUNTY OF On this, the .:). C1 \--\-\ da y 0 f f-)~ l~ , 2005, before me a Notary Public, the undersigned officer, personally appeared TRACEY LEBO ANTHONY, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowl- edged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. r;<fj';XUYnCc~'h ~ t f , "' Notary Public ~~~r;;~ Rosemary Hall N"C~':~ MYCOMMISSION# 00207655 EXPIRES _ 2 _ \~.~.~~ April 30, 2007 "~p.f.,r..~., BONDED THRU TROY FAIN INSURANCE,INC. :l~' 'DN~,,1SNI NI'I'. ^O~i n~Hi 030NOS ..:o~:il.b'~ LOOZ 'Ox Illctv ~~~~% ,:,:aIrlX3 559LOzaO # NOISSI~~OJA~ ~"\..V./4 IIOH AJoUJ&SO~ <'~;j.\i<\.~'''' "'flit'" est\rel\YODERlindsay . IN RE: ESTATE OF EDNA M. YODER LATE OF THE BOROUGH OF CAMP HILL, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0616 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, LINDSAY V. ADAMS, being one of the beneficiaries under the will of EDNA M. YODER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of EDNA M. YODER, in full satisfaction and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution ln any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, LINDSAY V. ADAMS, do by these presents, remlse, release, quitclaim and forever discharge the Executor, his heirs, successors and assigns, from the acts of the Executor as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, 1 ., claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executor. IN WITNESS WHEREOF, I have hereunto set my hand and seal the ~f)6- day of Au-~ U 5-\- , 2005. C~l- \-..~ ..\ .' - . I I.~ c&v . 7~Vr\l:/ LINDSAY V. ADAMS STATE OF FLORIDA SS: COUNTY OF Lj\..;~ On this, the :1 ~ day of Au ~ \.1-0 \- , 2005, before me a Notary Public, the undersigned officer, personally appeared LINDSAY V. ADAMS, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowl- edged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. ~ MICHELE K. KEMP State of Florida My Comm. Exp. Sept. 30, 2005 C(l~n # DO 061390 '4;").,.h 1'). t;J <'-rJ{,o Notary Publi . .J_.~t- RSON.\llY K,,'. i\1~ BY M:; PROOU~~r. !.~. . -2- , ' ~ est\rel\YODERparker i IN RE: ESTATE OF EDNA M. YODER LATE OF THE BOROUGH OF CAMP HILL, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0616 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, PARKER O. ANTHONY, being one of the beneficiaries under the will of EDNA M. YODER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of EDNA M. YODER, in full satisfaction and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, PARKER O. ANTHONY, do by these presents, remise, release, quitclaim and forever discharge the Executor, his heirs, successors and assigns, from the acts of the Executor as afore- said, and of and from all actions, suits, payments, accounts, reckon- .f . ings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executor. IN WITNESS WHEREOF, I have hereunto set my hand and seal the ~()~ day of ~lXjlA5+ , 2005. Oi~ClvvU~ Witnes PcV74rz/ Q ~~ PARKER O. ANTHONY STATE OF FLORIDA SS: COUNTY OF ~ 'f.-e. On this, the ~C-k. day of ~\.A..~\jG-t , 2005, before me a Notary Public, the undersigned officer, personally appeared PARKER O. ANTHONY, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowl- edged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. 1l' MICHELE K. KEMP State of FlorIda My Conm. Exp. Sept. 30, 2OlI5 Conm.' DO 061390 IQ..PERSONALLY KNONN BY M5 C-~r)I.D..._ 'ZJf- ~ h 1{ 1f. fit /XfJ Notary Publ c -2- Ir.r.. _ " ~ _ est\rel\YODERmason 1 I IN RE: ESTATE OF EDNA M. YODER LATE OF THE BOROUGH OF CAMP HILL, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0616 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, MASON R. ANTHONY, being one of the beneficiaries under the will of EDNA M. YODER, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of EDNA M. YODER, in full satisfaction and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, MASON R. ANTHONY, do by these presents, remise, release, quitclaim and forever discharge the Executor, his heirs, successors and assigns, from the acts of the Executor as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, ... ~ , claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executor. IN WITNESS WHEREOF, I have hereunto set my hand and seal the~~ day of 'Pl\9~3t , 2005. ~. ~~'~......... ~_. <~/1 . . Wi tness . ~H~~ STATE OF FLORIDA COUNTY OF Lu.}t)e SS: ~ On this, the 5) day of V-4~u."i::..+- , 2005, before me a Notary Public, the undersigned officer, personally appeared MASON R. ANTHONY, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. ~ MICHELE K. KEMP State of Florida My Comm. Exp. Sept. 30, 2005 CM"IM. j DO 061390 YJ:f- C ldp. ~ tjeap Notary Pu15li PERSON.\LL Y KNr. NN BY M!: PROOU"':'i:"'" to, '. -2-