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Home My WebLink About04-0320 IN RE: · IN THE COURT OF COMMON PLEAS OF EMMA L. CROSS, a.k.a. · CUMBERLAND COUNTY, PENNSYLVANIA EMMA ADELINE CROSS · · ORPHANS' COURT DIVISION · No: z1---04-3 PETITION FOR ADJUDICATION OF INCAPACITY AND APPOINTMENT OF PLENARY GUARDIAN OF THE ESTATE AND PERSON IN ACCORDANCE WITH 20 PA. CONS· STAT. ANN. § 551:1 TO THE HONORABLE, THE JUDGES OF THE SAID COURT: 1. Petitioner is David M. Cross, son of EMMA L. CROSS, a.k.a. EMMA ADELINE CROSS, the "alleged incapacitated person". 2. The alleged incapacitated person was bom on October 16, 1918, is 85 years of age, is recently widowed and resides at the ManorCare facility in Camp Hill, Pennsylvania. She has resided there since on or about December 6, 2003. 3. The Petitioner is the only living next-of-kin of the alleged incapacitated person. 4. The name and address of the institution providing residential services for the alleged incapacitated person is ManorCare, 1700 Market Street, Camp Hill, PA 17011. The alleged incapacitated person lives in the Arcadia Unit, which provides specialized care for dementia sufferers· 5. To the extent known by Petitioner, the assets of the alleged incapacitated person are valued at approximately $650,000.00 comprising the following: stocks, a former residence in Ohio, Certificates of Deposit and a mutual fund. 6. Petitioner estimates the alleged incapacitated person's annual income to be LAW OFFICES SNELBAKER, BRENNEMAN $45,000. & SPare IN THE ORPHANS' COURT OF ERIE COUNTY No. ~OO~r - 5~O ESTATE O~ ~C~ACITATED GUA~IAN(S) ~VENTORY ESTATE (Location, by whom occupied and rental) ESTIMATED VALUE PERSONAL PROPERTY ho so. no Id eoo JOINTLY HELD PROPERTY (Set forth real and personal property owned by incapacitated jointly with any other person. State whether held as tenants by entireties; if not, whether the right of survivorship exists) ~ ANTICIPATED ASSETS (Set forth property of any kind expected to be acquired hereafter, together with anticipated date of acquisition) TOTAL THE GUARDIAN(S) CERTIFIES that has(gave no.,t been able to find a testamentary writing of the aforesaid incapacitated; and that said ~ritiff~has been submitted to the Court for inspection on by said Guardian(s) or by Institution Name on Acct Account # Sky Melvin or Emma 0312001350 Sky Melvin or Emma 0312001376 Geauga Melvin POD Emma 0033003150 Geauga Melvin POD Emma 0033003151 Geauga Melvin or Emma 0033003148 Geauga Emma or Melv in 0033003149 Sky Melvin or Emma 0315000513 Fifth Third Melvin or Emma 0016782746 Fifth Third Melvin & Emma 0025670174 Morgan Stanley Melvin&Emma 461013359133 Sunoco Melvin & Emma Stock Kerr McGee Sro Melvin&Emma 00001045430 Institution Legg Mason Sunoco Prudential Stock Kmart Kerr McGee Sro Citizens Citizens Name on Acct Account # Estate of Emma L Cross, Dav id M Cross Grdn 363~5784 Melvin & Emma Stock Emma Melvin & Emma Melvin & Emma 00001045430 Estate of Emma L Cross, Dav id M Cross Grdr~ 6245027360 Estate of Emma L Cross, Dav id M Cross Grdn 6205017516 Joint & Individual Accounts held as of 6/20/04 Acct Type Shares Value Balance CD $ 200,000.00 CD $100,00000 CD $ 99,000.00 CD $ 3,000.00 CD $ 99,000.00 CD $ 99,00000 Checking $ 3,264.13 Savings $ 38,609.30 Checking $ 17,275 17 Investment $ $ 141.76 863 $ 61.00 $ 52,643~00 Stock 1844 $ 50.56 $ 93,232.64 $805,16600 ConsolidatedA ccountslAssests held as of 8/2/04 Acct Type Shares Value Balance Investment $600,000 00 863 $ 6100 $ 52,643.00 Stock 13 $ 45.08 $ 586.04 Stock 15000 $ $ Stock 1844 $ 50.56 $ 93,232.64 Savings $ 56,848 98 Checking $ 1,646.51 $804,957.17 Date Closed Deposit Acct Estate of Emma Citizens Savings to Legg Mason Estate of Emma Citizens Savings to Legg Mason 7/20/2004 Estate of Emma Citizens Savings to Legg Mason 7/20/2004 Estate of Emma Citizens Savings to Legg Mason 7/20/2004 Estate of Emma Citizens Savings to Legg Mason 7/20/2004 Estate of Emma Citizens Savings to Legg Mason 6/7/2004 Estate of Emma Citizens Savings 6/7/2004 Estate of Emma Citizens Savings 6/7/2004 Estate of Emma Citizens Savings 4/22/2004 Estate of Emma Citizens Savings iN RE: : IN THE COURT OF COMI,iON PLEAS OF EMMA L. CROSS. a.k.a. : CUMBERLAND COUNTY. PEN%'STLVANIA EMMA ADELEN-E CROSS : ORPHANS' COURT DIVISION : NO: 2004-320 ORDER OF COURT AND .",'OW, this /ti day of May'. 2004, al~er hearing on the Petition for Adjudication of Incapacity, this Court finds as follows regarding Emma L. Cross pursuant to 20 Pa. C.S. § 5511. et seq.: 1. She has severe cognitive impairment with a very severe aphasia which leaves her without the capacity to make and communicate decisions regarding her financial, personal and medical decisions. 2. She is in need of plenary guardianship services based upon the nature or' her condition and lack of capacity to make and communicate decisions. 3. The Petition is granted and her son, David IVl. Cross, is hereby appointed as plenary guardian of the person and plenary guardian of the estate of Emma L. Cross, a.k.a. Emma Adeline Cross. 4 The guardianship shall be of unlimited duration, unless otherwise ordered _by this Court. No bond is required. BY THE COURT, Kevi'n A. Hess Philip H. Spare. Esquire For the Petitioner A TRUE C~Y FROM RECORD SN~A~* In Testimony wh~of, I her~nto eRENN~MAN Michael Whare, Esquire set my h~d a sp**s Court-appointed for Emma L. Cross of ~d Court a¢~, PA 4 is d vof ' Cle~ of t~ Cum~dand ~n~ 7. The alleged incapacitated person suffers from dementia. As a result of her dementia, the alleged incapacitated person is limited to a liquid diet and is confined to a wheelchair. 8. Because of her mental and/or physical condition, the alleged incapacitated person is totally unable to manage her financial affairs, property and business and to make and communicate responsible decisions relating thereto, including the ability to communicate her need for assistance in these areas. 9. Because of her impaired mental and/or physical condition, the alleged incapacitated person lacks the capacity to make or communicate responsible decisions concerning her person and is unable to make decisions in her own best interest. 10. The following alternatives to the appointment of a guardian of the estate have been considered: she relied upon her husband, Melvin G. Cross, to manage all of her affairs as her attomey-in-fact for the past several years. Melvin G. Cross passed away unexpectedly on March 5, 2004. Petitioner is not aware of any viable alternatives to a guardianship. 11. The severity of the alleged incapacitated person's mental and/or physical condition and the lack of viable, less restrictive alternatives necessitate that a plenary guardian of her estate be appointed to manage and handle all aspects of the alleged incapacitated person's estate, specifically including, but not limited to: all issues relating to her cash, checks, and any bank or savings accounts held in her name, her stocks and bonds, her personal property, her real estate, her life and other insurance of which she is a beneficiary, her entitlement to any LAW OFFICES governmental and non-governmental benefit plans, federal, state, and local taxes, claims made or SNELBAKER. BRENNEMAN e S~A~e to be made on behalf of her or against her, the execution of documents, entry into contracts affecting her and the payment of reasonable compensation or costs to provide services for her. 2 12. The following alternatives to the appointment of a guardian of the person have been considered: She relied upon her husband, Melvin G. Cross, to manage all of her affairs as her attorney-in-fact for the past several years. Melvin G. Cross passed away unexpectedly on March 5, 2004. Petitioner is not aware of any viable alternatives to a guardianship. 13. The severity of the alleged incapacitated person's mental and/or physical condition and the lack of viable, less restrictive alternatives necessitate that a plenary guardian of her person be appointed to handle all issues relating to the person of the alleged incapacitated person, specifically including, but not limited to: her living arrangements, her medical and psychiatric care, the administration of medication to her and the employment and discharge of physicians, psychiatrists, dentists, nurses, therapists and other professionals for her physical and mental treatment and care. 14. Petitioner is aware that the alleged incapacitated person signed a power of attorney on or about January 24, 2002 designating Petitioner's father, MELVIN G. CROSS, to serve as her agent over her personal and financial affairs. A copy of said Power of Attorney is attached hereto as Exhibit "A". Petitioner's father, Melvin G. Cross, unexpectedly passed away on March 5, 2004. 15. The proposed plenary guardian of the person of the alleged incapacitated person is David M. Cross, son of the alleged incapacitated person, who resides at 2153 Canterbury Drive, Mechanicsburg, Pennsylvania 17055. 16. The proposed plenary guardian of the person is 56 years of age and is employed LAw of~,ces as a distribution manager for Sunoco. He has been employed by Sunoco for 38 years. SNELBAKEr. BREnNEMaN & SpAre 17. The proposed plenary guardian of the estate of the alleged incapacitated person is David M. Cross, the son of the alleged incapacitated person, who resides at 2153 Canterbury Drive, Mechanicsburg, Pennsylvania 17055. 18 The proposed guardian of the estate is 56 years of age and is employed as a distribution manager for Sunoco. He has been employed by Sunoco for 38 years. 19. The proposed plenary guardian has no interest adverse to the alleged incapacitated person. 20. The Petitioner is executor of Melvin G. Cross' Estate currently keeping the probate papers in Cuyahoga County, Ohio. Emma L. Cross, a.k.a. Emma Adeline Cross, is the sole beneficiary of Melvin G. Cross' Estate. 20. The consent of the proposed plenary guardian is attached as Exhibit "B". 21. No other court has ever assumed jurisdiction in any proceeding to determine the capacity of the alleged incapacitated person. 22. No other guardian has been appointed for the estate or person of the alleged incapacitated person. WHEREFORE, Petitioner respectfully requests that this Court award a citation directed to EMMA L. CROSS, a.k.a. EMMA ADELINE CROSS, the alleged incapacitated person, and to such other persons as this Court may direct, to show cause why she should not be adjudged a fully incapacitated person, and David M. Cross appointed plenary guardian of her estate and her person. LAW OFFICES i"~~ ~' /~ ~ SNELBAKER, .,~' ~ BRENNEMAN ~' & SPARE 2~'~~=~r . ~ Petitioner 4 Respectfully submitted, SNELBAKER, BRENNEMAN & SPARE, P.C. Pa. Supreme Ct. I.D. # 65200 44 West Main Street P.O. Box 318 Mechanicsburg, PA 17055-0318 (717) 697-8528 Attorneys for Petitioner, David M. Cross Date: March 31, 2004 LAW OFFICES SNELBAKER. BRENNEMAN ~ SPARE 5 VERIFICATION I verify that the statements made in the foregoing Petition for Adjudication of Incapacity and Appointment of Plenary Guardian of the Estate and Person in Accordance with 20 Pa. Cons. Stat. Ann. § 5511 are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904 relating to unswom falsification to authorities. David M. Cross Date: March 29, 2004 LAW Offices SnELbaKEr. BRENNEMAN & SPARE DURABLE POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, That I, EMMA L. CROSS (a.k.a EMMA ADELINE CROSS), of the City of Solon County of Cuyahoga and State of Ohio, have made, constituted and appointed, and by these presents do make, constitute and appoint my husband, MELVIN G. CROSS, of City of Solon County of Cuyahoga and State of Ohio, my true and lawful attorney-in-fact for me and in my name, place and stead, to act for me and on my behalf in all matters affecting my personal affairs, business or property, with the same force and effect to all intents and purposes as though I were personally present and acting for myself, including, but not limited to, the following rights, powers and privileges among others: I. To draw and endorse checks on any commercial account or accounts in my name and to make deposits to my credit therein; to deposit or withdraw sums from any savings account or accounts in my name; to cash certificates of deposit in my name; to cash any coupons or bonds belonging to me; to sell, dispose of, assign, pledge and hypothecate notes, stocks, bonds and mortgages; to have access to and power of depositing in and removing from any safe deposit box standing in my name; and to transact any and all business for me with any bank. 2. To sell, assign, pledge, deliver and endorse for transfer any certificates of stocks, bonds, or other securities which I may own, and for that purpose to make and execute all necessary acts of assignment and transfer; to receive all stock certificates representing such stock and all dividends which are or shall be payable thereon, and to give proper receipts therefor; to vote in person or by proxy upon all such stocks or other securities; to exchange such stock or securities in any corporation for other securities issued by the same or by any other corporation at such time and upon such terms and conditions as shall seem best; to consent to the reorganization, consolidation or merger of any corporation in which I may own stock or other securities, or against which I may have any claim, or to the sale or lease of its property or any portion thereof, or to the lease of any property of other persons or corporations to such corporation, and upon such reorganization, consolidation, merger, sale or lease to exchange any stock or securities therein for securities issued in connection therewith; to exercise any option pertaining to any stocks, bonds or other securities, and to make any and all necessary payments therefor; in general, to exercise in respect of all my stocks, bonds, and other investments and securities all the rights, powers and privileges that I might exercise. 3. To sell or exchange (for cash or upon terms) all or part of any interest which I may own in real or personal property wherever located and to purchase for me any interest in any real or personal property and in connection with any such sale, exchange or purchase, to negotiate, sign, acknowledge, deliver or receive any contracts, agreements, deeds or other documents necessary to transfer or receive title to any such real or personal property; to sign, acknowledge, accept and/or deliver promissory notes, mortgages, assumptions of indebtedness, security interests, financing statements or title retention documents given to secure deferred payments to EXHIBIT A- page 1 of 5 1 be made or received in connection with any such sale, exchange or purchase; to satisfy and discharge any mortgage, lien, title retention instrument or other encumbrance on any of my real or personal property; to discharge, release and receipt for payment on any note or other obligation held by me or on my behalf. 4. To release all my right and expectancy of dower or curtesy in any real property wherever located. 5. To negotiate, sign, acknowledge and deliver leases of any of my real and/or personal property and to effect any assignment, surrender and/or cancellation of any such lease. 6. To contract for casualty insurance coverage on my real and/or tangible personal property; to sign application(s) therefor; to make representation(s) as to the property's condition and value; to pay premiums thereon currently or on deferred payment plan; to surrender, rescind and cause to be canceled any such policy so obtained, or by me heretofore obtained; to collect any dividend, return premiums or deposits payable to me; to sign and transfer any policy insuring any of my property; to file, amend, and compromise claims on any such policy, to collect benefits thereunder, and to give receipts and releases with respect to such benefits; and to do all or anything that I might do under the provisions of any such policy. 7. To institute on my behalf, maintain and prosecute any and all legal proceedings, administrative claims, or suits which I might bring; to discontinue and dismiss the same; to obtain orders and/or judgments thereon; to take all steps necessary to legally enforce any such order or judgment; to defend any action, suit, claim or legal proceedings whatsoever that may be brought or instituted against me; and to compromise and settle any such action, legal proceedings, claim or suit. 8. To prepare, sign on my behalf, and file personal property tax returns and state, federal and/or municipal income tax returns; to take any action with respect to prior, current or future returns, including the filing and prosecution of claims for refunds and collection thereof, the defense and litigation of deficiency assessments, and the negotiation and conclusion of settlements; to take all proceedings necessary to adjust and/or reduce the valuation for real estate tax purposes of any real property owned by me and to obtain any correction, refund or abatement of taxes and/or assessments imposed on such property. 9. To pay premiums on, to arrange for waiver of premiums on, and to file claims for and as applicable collect benefits under any accident, health, life or other similar insurance policy owned by me; to prepare and file on my behalf any claim under Medicare, Blue Cross, Blue Shield, or similar hospital, medical or surgical care plans; to endorse and cash benefit checks or other payments issued pursuant to the provisions of any of said policies or plans; to surrender any such policy for its cash value; to exercise any conversion privilege; and to change any such policy to a paid-up policy. EXHIBIT A - Page 2 of 5 2 10. To make gifts to any members of my family at times and in amounts at the discretion of my attorney, and to continue any program of giving that I may have instituted prior to giving this power of attorney. II. In the event of accident or illness, to take all steps necessary to admit me in any hospital, clinic, nursing facility or similar institution recommended by my medical adviser, including, without limiting the generality thereof, advising the administrative and/or medical personnel of any such facility as to my physical condition, medical history, financial resources, and personal data, signing admission papers, and arranging for payment of charges. 12. This Power of Attorney and the effectiveness thereof shall in no way be revoked, altered, or affected by any disability to which I may become subject during my lifetime. This Power of Attorney shall remain in full force and effect until written notice of its revocation shall have been received by any person or entity acting under the powers I have given herein to my attorney-in-fact. In the event I should die and my attorney-in-fact or his substitute shall do or perform any act or thing authorized under this Power of Attorney after my death but before written notice of my death has been received by any person or entity acting under the authority given in this Power of Attorney, then any and all such acts and things shall be as binding upon my personal representative, heirs, devisees, legatees as such acts and things would have been if I were alive at the time such acts and things were done or performed. 13. To execute, acknowledge and deliver any and all papers and documents which may be necessary to effectuate the purposes of this general power of attorney. 14. In the event it is necessary to appoint a Guardian for my person, my estate, or both. I hereby appoint my husband, MELVIN G. CROSS, as the Guardian of my person or my estate or both to serve without bond. The following is the signature of my husband, MELVIN G. CROSS, my true and lawful attorney-in-fact hereinbefore appointed by me, giving and granting unto my said attorney-in-fact full power and authority to do and perform all and every act and thing whatsoever requisite and necessary to be done in the premises as fully, to all intents and purposes, as I might or could do if personally present, with full power of substitution and revocation, hereby ratifying and confirming all that my said attorney-in-fact or his substitute shall lawfully do or cause to be done by virtue hereof. EXHIBIT A - Page 3 of 5 3 IN WITNESS WHEREOF, I have hereunto set my hand at Chagrin Falls, Ohio, the 24th day of January, 2002. :""':' SIGNED IN THE PP~ESENCE OF: MICHAEL DRAIN EMMA L. CROSS (a.k.a~-MM~ADELINE CROSS " EXHIBIT A - Page 4 of 5 STATE OF OHIO ) ) SS COUNTY OF CUYAHOGA ) Before me, a Notary Public in and for said county and state, personally appeared the above named EMMA L. CROSS (a.k.a EMMA ADELINE CROSS) who did acknowledge to me that the foregoing instrument was signed by said person and that the same was said person's free act and deed. IN WITNESS WHEREOF, I have hereunto set my hand and official seal at Chagrin Falls, Ohio, the 24th day of January, 2002. Notary Public ;!'."i;¥',~ ' - I;".'¢' 'b.:;::;;:::~:..'.: :-i : :,i .:~.: This instrument prepared by: Michael Drain, Esq. Attorney at Law Five South Franklin Street Chagrin Falls, Ohio 44022 [440) 247-3380 EXHIBIT A - Page 5 of 5 CONSENT OF GUARDIAN TO APPOINTMENT I, David M. Cross, hereby consent to act as the Guardian of the Estate and Guardian of the Person of EMMA L. CROSS, a.k.a. EMMA ADELINE CROSS. I reside at 2153 Canterbury Drive, Mechanicsburg, Pennsylvania 17055 and am employed as distribution manager for Sunoco. I have been employed by Sunoco for 38 years. I am a citizen of the United States of America and can speak, read and write the English language. I have no interest adverse to EMMA L. CROSS, a.k.a. EMMA ADELINE CROSS, the alleged incapacitated person. David M. Cross, Proposed Guardian LAW OFFICES SNELBAKER, BrENNEMaN & SPARE EXHIB IT B IN RE: · IN THE COURT OF COMMON PLEAS OF EMMA L. CROSS, a.k.a. · CUMBERLAND COUNTY, PENNSYLVANIA EMMA ADELINE CROSS · · ORPHANS' COURT DIVISION · NO. 21-04~320 ORDER AND NOW, this /~" day of April, 2004, upon consideration of the attached Petition for Adjudication of Incapacity and Appointment of Plenary Guardian of the Estate and Person in Accordance with 20 Pa. Cons· Stat· Ann. § 5511, it is ordered and decreed that a hearing on this matter is set for the 20th day of May, 2004, at 10:30 a.m. in Courtroom Number 4, Cumberland County Courthouse, One Courthouse Square, Carlisle, PA, and that a Citation be issued to EMMA L. CROSS commanding her to show cause why she cannot appear at the aforementioned hearing pursuant to the Petition of DAVID M. CROSS to have EMMA L. CROSS adjudicated an incapacitated person and to have plenary guardians appointed for her person and her estate· Notice of the hearing shall be given to EMMA L. CROSS in accordance with 20 Pa. C.S. § 5511 (a) not less than twenty (20) days prior to the hearing. BY THE COURT, · ~ ¢ K ess, J. Dhilip H. Spare, Esquire ~H ~ ~ ] ~or the Petitioner · L:rlm SHERIFF'S RETURN - REGULAR ~.~_NO: 2004-0~ COMMONWEALTH~F PENNSYLVANIA: COUNTY OF CUMBERLAND CROSS EMMA L IN RE: VS CROSS EMMA L AKA EMMA ADELINE SHANNON SHERTZER ,~.,~eriff or Deputy Sheriff of Cumberland County, Pennsylvania, who being duly sworn according to law, says, the within ORDER, CITATION, was served upon CROSS EMMA L AKA EMMA ADELINE CROSS the DEFENDANT , at 1650:00 HOURS, on the 19th day of April , 2004 at 1700 MARKET STREET CAMP HILL, PA 17011 by handing to EMMA L. CROSS a true and attested copy of ORDER, CITATION, together with PETITION FOR ADJUDICATION OF INCAPACITY & APPOINTMENT OF PLENARY GUARDIAN and at the same time directing Her attention to the contents thereof. Sheriff's Costs: So Answers: Docketing 18.00 .~~~_~,~ ~~ Service 9.66 Affidavit .00 Surcharge 10.00 R. Thomas Kline .00 37.66 04/20/2004 SNELBAKER BRENNEMAN SPARE Sworn and Subscribed to before By: ~/~.x~/~ ~~ me this ~l ~ day of ~l~ Deputy SheT~ff Z~ A.D. /Y Clerk of Orhans Court~ IN RE: : IN THE COURT OF COMMON PLEAS OF EMMA L. CROSS, a.k.a. : CUMBERLAND COUNTY, PENNSYLVANIA EMMA ADELINE CROSS : ORPHANS' COURT DIVISION : NO: 21-2004-320 NOTICE TO COURT PURSUANT TO 20 PA C.S. § 5511 TO: THE HONORABLE KEVIN A. HESS As required by 20 Pa. Consolidated Statute Section 5511, Petitioner, David M. Cross, takes this opportunity to notify this Honorable Court that counsel has not been retained by or on behalf of Emma Cross, the alleged incapacitated person in this guardianship proceeding. A hearing has been scheduled for May 20, 2004. Petitioner believes it would be in the best interest of everyone concerned to have this Court appoint counsel to represent the alleged incapacitated person. The alleged incapacitated person has sufficient assets to pay the costs of appointed counsel. Respectfully submitted, SNELBAKER, BRENNEMAN & SPARE, P.C. ~;~? By <. l~hilip~. Spa~, Esquire ~ Pa. Supreme Ct. I.D. # 65200 ~'q 44 West Main Street ~ P.O. Box 318 · Mechanicsburg, PA 17055-0318 ~' ~ ~:; ~ (717) 697-8528 D ~ Attorneys for Petitioner, David M. Cross Date: April ~.--~:~ , 2004 SNELBAKER, BRENnEmaN & SPare IN RE: · IN THE COURT OF COMMON PLEAS OF EMMA L. CROSS, a.k.a. · CUMBERLAND COUNTY, PENNSYLVANIA EMMA ADELINE CROSS · ORPHANS' COURT DIVISION · NO: 21-2004-320 NOTICE TO COURT PURSUANT TO 20 PA C.S. § 5511 TO: THE HONORABLE KEVIN A. HESS As required by 20 Pa. Consolidated Statute Section 5511, Petitioner, David M. Cross, takes this opportunity to notify this Honorable Court that counsel has not been retained by or on behalf of Emma Cross, the alleged incapacitated person in this guardianship proceeding. A hearing has been scheduled for May 20, 2004. Petitioner believes it would be in the best interest of everyone concerned to have this Court appoint counsel to represent the alleged incapacitated person. The alleged incapacitated person has sufficient assets to pay the costs of appointed counsel. Respectfully submitted, SNELBAKER, BRENNEMAN & SPARE, P.C. ~ l~hilip~. Spa~, Esquire Pa. Supreme Ct. I.D. # 65200 ~ ~ 44 West Main Street -_~ P.O. Box 318 Mechanicsburg, PA 17055-0318 (717) 697-8528 Attorneys for Petitioner, David M. Cross Date: April, ,2004 LAW OFFICES & SParE IN RE: · IN THE COURT OF COMMON PLEAS OF EMMA L. CROSS, a.k.a. ' CUMBERLAND COUNTY, PENNSYLVANIA EMMA ADELINE CROSS · · ORPHANS' COURT DIVISION · NO. 21-04-320 ORDER AND NOW, this 2q ° day of April, 2004, upon consideration of the attached Notice to Court Pursuant to 20 Pa.C.S. 5511, Michael Whare, Esquire, is appointed to represent Emma L. Cross, the alleged incapacitated person at the hearing to be held on May 20, 2004, at 10:30 a.m. BY THE COURT, Kevi¢. Hess, J. / Philip H. Spare, Esquire For the Petitioner Michael Whare, Esquire Court-appointed for Emma Cross :rlm iN P~: · IN 1-HE COURT OF COMA/ON PLEAS OF EMMA L. CROSS, mki : CUMBERLAND COUNTY, PENNSYLVANIA EMMA ADELINE CROSS : : ORPHANS' COURT DIVISION : NO. 21-04-320 _QORDEK AND NO W, this ~' ~ ' day of A.pri], 2004, upan conaideratJoa of thc at~ached Nolk:e t'o Cou~'t Pua'suant to 20 Pa.C.S. 551 l, Michael Whare, ~squire: is appoh~ted to rcp~.eaen~ Emma L. Cross, the alleged incapacitated person at the hear/tag to be held on IVLay 201.20.04, at 10:30 a.ul, BY TH//COUKT, Philip II. Spare, Esquh-e For the Petitioner Michael Whare, Esquire Court-appointed for Emma Cross ,~ml zT.~Udq 2~:~4PM GERZCHRRDS H0.844 p.~ ~-' ' EMMA L CROSS 4-30-04 office This is an elderly woman and I was asked to render an oplnlon concerning her decision mal(ing capacity. This is an elderly woman who carries a diagnosis Ol'Alzhelmer's disease. ,She was first diagnosed about 4-5 years ago, et that time she was experiencing mainly memory loss but her disease continued to progress. She eventually developed problems with executive function' including ability to maintain the household, do the cooking, do the laundry. She then progressed to impairment of her ADL's with difficulty bathing and dressing and has progressed to the point of incontinence. Her speech has actually deteriorated progressively and currently is fluent but for the most part' is empty of contenL She was living with her husband who was caring.for her up until last Thanksgiving when she was diagnosed with a mild stroke an~l was hospitalized and after that hospitalization was admitted to Manor Care. The husband who was. her Power of Attomey. ha,~ since passed away and she currently has no Power of Attorney and is really unable to sign a Power of Attorney at this time hence the son is pursuing guardianship, The patient is currently residing at Leader, Her appetite is mostly liquids but she is taking nutritional supplements. Her weight had dropped but apparently it is fairly stable at about 75 lbs. She is somewhat emotionally labile, sometimes seems pleasant and happy, other times she is cheerful and other times is agitated and will sometimes resist assistance with her personal care. Past. medical history:. $ignif'mant for hypertension. H/storyo' f'a~al'fibdila[ion. Gait'drsorder. She has a history of a stroke. Her current medications are Aricept 10 ms. at bedtime, B12 t000 mcg. q month, Lis~oprel 10 ms. daily, Lopressor 45 ms. bid, Norvasc 5 mS. daily. Social History: Currently is notamoking or drinidng. She maide.¢ at Mattor Care. Review of Systems: No fevers, chills or sweats. ENT - she apparently does not have any PND. Cardiopulmonary - there is no reports of shortness of breath or chest pain. Gl - no reports o[ constipation or diarrhea or abdominal pain, GU - she is incontinent of urine, O: Blood pressure was 118/78, pulse is 92, respirations 16 and unlabored. Her pupils were myotJc. E~traocular muscles were grossly intact. Her neck was supple. Thyroid was not palpable. Chest was clear to percussion and auscultation. Cardiac exam reveals e non-displaced PMi with a rrorma/S1 and $2, Herabdomen was soft, non-tender. CN's were infect Motor tone showed some increased tone particularly in the upper extremities. She moved all four extremities, She was- able to ambulate with or~ person ass/s~ance. Her speech was I'tueflt t~ur non-senstcal. She at times had neologisms. The patient could not identify a pen ora watch. She could not identify her son by his name. She did not know her data of birth. She did not know her. Place of birth. She could not repeat a simple phrase therefore we were really unable to test her memory. She was unable to read or write and she was really unable to follow any real simple.commands, ^: I. This p~tient has severe cognitive impairment with a very severe aphasia. Based on the history this most likely represents Alzheimer's disease, 2. Hyparte ion. On discussion I feel because of the patient's severe cognitive imps clecision ;'nrr~ent has very impaired making capacity to the point that she is unable to manage h er daily affairs including not on lit frnanciaf But also medicat decisiorm. ! believe she has a progressive disorder which w/Il only c~ntinue to get worse an~l abe will never regain any abilities to make medical or financial decisions. LZ/iab IN RE: EMMA L. CROSS, A.K.A. : IN THE COURT OF COMMON PLEAS OF EMMA ADELINE CROSS : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : : NO. 21-2004-0320 IMPORTANT NOTICE CITATION WITH NOTICE A petition has been filed with the Court to have you declared an Incapacitated Person. If the Court finds you to be an Incapacitated Person, your tights will be affected, including your right to manage money and property and to make decisions. A copy of the petition which has been filed by David M. Cross is attached. You are hereby ordered to appear at a heating to be held in Court Room No. 4, Cumberland County Courthouse, Carlisle, Pennsylvania, on May 4 ,2003, at 1:30 P_:.M. to tell the Court why is should not find you to be an incapacitated Person and appoint a Guardian to act on your behalf. To be an incapacitated Person means that you are not able to receive and effectively evaluate information and communicate decisions and that you are unable to manage your money and/or other property, or to make necessary decisions about where you will live, what medical care you will get, or how your money will be spent. At the hearing, you have the right to appear, to be represented by an attorney, and to request a jury trial. If you do not have an attorney, you have the right to request the Court to appoint an attorney to represent you and to have the attorney's fees paid for you if you cannot afford to pay them yourself. You also have the tight to request that the Court order that an independent evaluation as to your alleged incapacity. If the Court decides that you are an Incapacitated person, the Court may appoint a Guardian for you, based on the nature of any condition or disability and your capacity to make and communicate decisions. The Guardian will be of your person and/or your money and other property and will have either limited of full powers to act for you. If the court finds you are totally incapacitated, your legal fights will be affected and you will not be able to make a contract or gif~ of your money to other property. If the court finds that you are partially incapacitated, your legal rights will also be limited as directed by the Court. If you do not appear at the hearing (either in person or by an attorney representing you) the court will still hold the hearing in your absence and may appoint the Guardian requested. Clerk, Orphans' Court Division Cumberland County, Carlisle, PA ~ st ''on My Commission Expires t M day, January, 2006 IN RE: · IN THE COURT OF COMMON PLEAS OF EMMA L. CROSS, a.k.a. · CUMBERLAND COUNTY, PENNSYLVANIA EMMA ADELINE CROSS · ORPHANS' COURT DIVISION · NO: 21-04-320 ORDER OF COURT AND NOW, this /_~.~ day of 2004, upon consideration of the attached Petition For Adjudication of Incapacity and Appointment of Plenary Guardian of the Estate and Person in Accordance with 20 Pa. Cons. Stat. Ann. § 5511, it is ORDERED AND DECREED that a hearing on this matter is set for the ~ day of ,2004, in Courtroom No. 5/ . at ./,' ,_~dj /~.M. at the Cumberland County Courthouse One Courthouse Square, Carlisle, Pennsylvania, and that a Citation be issued to EMMA L CROSS commanding her to show cause why she cannot appear at the aforementioned hearing pursuant to the Petition of DAVID M. CROSS to have EMMA L. CROSS adjudicated an incapacitated person and to have plenary guardians appointed for her person and her estate. Notice of the hearing shall be given to EMMA L. CROSS in accordance with .~. Pa. C.8: § 5511 (a) not less than twenty (20) days prior to the hearing. ' " BY THE COURT, J. LAW OFFICES SNEIBaKER. BRENNEmaN & SPARE RO INGER, ¥LEY & WH RE law~romingerlaw.eom .LAW OFFICES www.rominger]aw.com 155 SOUTH HANOVER STREET CARLISLE, PENNSYLVANIA 17013 KARL E. ROMINGER. ESQ. MARK F. BAYLEY, ESQ. TEL: 717-241-6070 MICHAEL j. WHARE, ESQ. FAX: 717-241-6878 FROM: Michael J. Whare, Esquire TO: Ph/lip H. Spare, Esquire Attention: Company Address: City, State, Zip: Phone Number: Fax 697-7681 Message: Re: Emma L. Cross - Incapacitated person .Attached please find Dr. Zimmerman's results of his examination of Emma Cross. Date: 5-19-04 No. of Sheets to Follow: Pages including cover sheet: If you do not receive the amount of pages stated above, please contact us immediately. All information contained in this fax is confidential and privileged. If you receive this fax in error please call 717-241-6070 ADVOCACY. ADVICE - ANSWERS ~=,MAY. 19. ~004 n I~:~3PM GERICHARDS NO, ~4 P. 1 LAW OFFICES law(~romingerI~w.eom i 55 SOUTH HANOVER STREET www.romingerlaw.com CARLISLE~ PENNSYLVANIA 17013 Iq. AR_l_ E. ROMINGER, ESQ. TEl.: 717-241-6070 MARK F. BAYLEY. ESQ. FAX: 71%241-6878 MICI'-{AF..L 1. WHARE, ESQ. FROM: Michael J. W'hare, E~quir¢ TO: Internists of Central Pennsylvania Attention: ~ ~[x'~ ~'~/'~, .. Company O~')rn~a~ ~ ~.. City, State, Zip: Phone Number: Fax 214-9893 ~)~, /~t.'P_, Message: Re: Emma L. Cros.~ - Incapacitated person Please faa.to Mr. Wh~e (241-61178) a copy of Dr. Zimmerman's results of his exam i nation of Emma Cross. I have enclosed ~hc Court Order which appointed Mr. Wha,'e are Emma's attorney. If you have an), questions, pleas~ ca[[ me. Thaa~k you - Jackie Date: 5-19-04 No. orSheets to Follow: I Pages including cover sheet: 2 If you do n. ot receive the amount of pages stated above, please contact u~ immediately. All information contth~ed in this f~x is confidential m~d privileged. lfyou receive this fax in error please call 717-241-6070 ADVOCACY - ADVICE - ANSWERS IN RE: EMMA L CROSS AKA : IN THE COURT OF COMMON PLEAS OF EMMA ADELINE CROSS : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : : NO. 21-2004-320 IMPORTANT NOTICE CITATION WITH NOTICE A petition has been filed with the Court to have you declared an Incapacitated Person. If the Court finds you to be an Incapacitated Person, your rights will be affected, including your fight to manage money and property and to make decisions. A copy of the petition which has been filed by David M. Cross is attached. You are hereby ordered to appear at a hearing to be held in Court Room No. 4, Cumberland County Courthouse, Carlisle, Pennsylvania, on May 20th ,2004, at 10:30 AM. to tell the Court why is should not find you to be an incapacitated Person and appoint a Guardian to act on your behalf. To be an incapacitated Person means that you are not able to receive and effectively evaluate information and communicate decisions and that you are unable to manage your money and/or other property, or to make necessary decisiOns about where you will live, what medical care you will get, or how your money will be spent. At the heating, you have the tight to appear, to be represented by an attorney, and to request a jury trial. If you do not have an attorney, you have the tight to request the Court to appoint an attorney to represent you and to have the attorney's fees paid for you if you cannot afford to pay them yourself. You also have the tight to request that the Court order that an independent evaluation as to your alleged incapacity. If the Court decides that you are an Incapacitated person, the Court may appoint a Guardian for you, based on the nature of any condition or disability and your capacity to make and communicate decisions. The Guardian will be of your person and/or your money and other property and will have either limited of full powers to act for you. If the court finds you are totally incapacitated, your legal tights will be affected and you will not be able to make a contract or girl of your money to other property. If the court finds that you are partially incapacitated, your legal tights will also be limited as directed by the Court. If you do not appear at the heating (either in person or by an attorney representing you) the court will still hold the heating in your absence and may appoint the Guardian requested. Clerk, Orphans' Court Division ,~.~ Cumberland County, Carlisle, PA My Commission Expires 1st Monday, [/ January, 2006 : IN RE: · IN THE COURT OF COMMON PLEAS OF ' EMMA L. CROSS, a.k.a. · CUMBERLAND COUNTY, PENNSYLVANIA EMMA ADELINE CROSS · ORPHANS' COURT DIVISION · NO: 2004-320 ORDER OF COURT AND NOW, this z t" day of May, 2004, after hearing on the Petition for Adjudication of Incapacity, this Court finds as follows regarding Emma L. Cross pursuant to 20 Pa. C.S. § 5511, et seq.: 1. She has severe cognitive impairment with a very severe aphasia which leaves her without the capacity to make and communicate decisions regarding her financial, personal and medical decisions. 2. She is in need of plenary guardianship services based upon the nature of her condition and lack of capacity to make and communicate decisions. 3. The Petition is granted and her son, David M. Cross, is hereby appointed as plenary guardian of the person and plenary guardian of the estate of Emma L. Cross, a.k.a. Emma Adeline Cross. 4. The guardianship shall be of unlimited duration, unless otherwise ordered by this Court. No bond is required. BY THE COURT, ~ -Philip H. Spare, Esquire ~ For the Petitioner LAW OFFICES :~ SNELBAKE ~' ~ BrENNEMA~____~ Michael Whare, Esquire ~ & SPAre ,.. Court-appointed for Emma L. Cross ~n PETITION FOR PROBATE and GRANtQF LETTERS Estate of' EMMA L. CROSS No. d)1- ~- 0320 also known as EMMA ADELINE cOSS To: '* Register of Wills lor t~e . Deceased. County of Cumber and in the Social Security No. 292 -18 - 0 18 4 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execuQr in the last will of the above decedent, dated J anuarv 24. 2002 and codicil(s) dated None It 1S suggested that Melv1n G. Cross died on March 5, 2004. named ,x11j- (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at Manor Care of Camn Hill. Borough of Camp Hi]], ]7011 (list street, number and muncipality) Decendent, then 87 years of age, died November 4. 2005 , ~ at Borough of Camp Hill, Cumberland County, pennsvlvania Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of t~ will offered for probate; was not the victim of a killing and was never adjudicated incompetent: . one .' 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: $qgO~ooo_oo $ $ $ Nonp WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and co$~~l(s) presented herewith and the grant of letters t-p~trimpnt-riry 'H (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. ~ '" 'V' u c ... ~~ "'~ ....... 0::'" c ,,0 c';::: ~'';::: ~... ~o.. "''- 50 '" c 00 Cii ~..J~_ ~ David M. Cross ?1 t; 1 C'rint-prhllry Dr; '\7P M@chQnic~burg, PA17055 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA l ss COUNTY OF CUMBERLAND J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) Wi.ll well and truly a~mi~ter the es ccordl to law. Sworn to or affirme4.... and subscribed { I .-t-r ~ , ~ ~~ . ~. Jt~~ . nmd M. Cl;OSS ~ . .~ ~. .. ~1'\Reg"ter ~ No. ;) J- ~ Lj -~.:3cJ c Estate of EMMA L. CROSS, A/K/A EMMA ADELINE CR~~eceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW All) \,'-( J) )bf/\ /8 W2 0 0 5 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated January 24, 2002 described therein be admitted to probate and filed of record as the last will of Emma L. Cross, also known as Emma Adeline Cross and Letters 'T'I=> ~ t;=t m I=>n +-;=t ry are hereby granted to David M. Cross /1J UIy(\()j:r2)('v FEES $L;tp~' COg Probate, Letters, Etc. ......... Short Certificate~( ).......... $ I d . ()() ~~......... $ 15 or) ...Jt!Y $ / 1) . (lO TOTAL _ $ Filed . J ! .-. ~ ? ~ . Q.~. . . . . . . . . . . . . . . . . . . . . . B 5 (717) 697-8528 PHONE REGISTER OF WILLS OF o TH OF SUBSCRIBING COUNTY ,NESS codicil (each) a su ribing witness to the will presented h law, depose(s) a say(s) that with, (each) being duly qualified cording to present firmed and subscribed before day of 19_ signed as a witness at the (in the presence of the the testat , sign tIi ame and that request of testat_ in presence and (in the presence of each ot other subscribing witness(es)). (Name) (Address) Register (Name) (Address) .1 REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS ;) 1-04 -03d--O David M. Cross and Carol A. Cross (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that each is famili~r with the signature of F.mmi'l To _ C.ross, i'l /k / i'l , Emma Adeline Cross ~~~~ test at rix of (o:mt:xofx:1bcx~iDgxJr~:KX~ the will that each presented herewith and xodioil believes the signature on the will is in the handwriting of Emma L. Cross, a/k/a ~nma Adeline Cross, testatrix, to the best of our knowledge and belief. ~ Sworn to or affir)\\'1d "Jd subscribed before ~ J..,C- '- ~- ../ me this _I ~i-- day of DavldrNahleFx:oss ~,I(liH IYlbI'" ~ dOO5 ~~~~a~f~~~~~~~YpRrp;~~~ , ~~r.;,! .r\~) -...J Ad r 5S) ,0). f-I'I1:;W\:; !.'.r:',' This is to certify that the information here given is correctly copied from an original certificate of death d~ly filed with me as Local Registfoar. The original certificate will be forwarded to the State Vital Records Office for permanent tiling. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. '4'~6^" f5k ~ Local RegIstrar . Fee for this certificate, $6.00 p 12064876 ~~~., . ~ .~ (}--(J ;.r Date c...,,:: c, Hl05 j4)Altll 2167 COMMONWEALTH OF PENNSYlVANIA' DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH i'1'PLPAINT IN "E RMANENT SLACK IHt( H~ME Of DfCEOENllf,I;M,:;;:;;;-:-:;;---....-------~.----..-~~=-~= -----.-.. _.,,",,~........-=--..: -sex 'SlMi"'lE~LJ"'8ER SCCIAl SECuRITY 'lUMBER DAlE OF DEATH,Mcnlli Od~. "'''1 Emma L AGE (lar./a.nno.lrl Cross UNDER' YEAR MoniM DaY;- ,. Female 292 - 18 '.November 4, 2005 8iRHU'l.ACf lC"r """ '5W,leOl t'CUtlogoCOUllllVI PLACE Of: OEATHIC',<<."OII~.,..loI'e"- .~,n$lIut;l"",,,,<)fltJIt>el...u.l HOSPllA.L --~- -~ 1np.a11eRt 0 ERlCMpalu.fl! 0 =""10 $. COO...,..., OF DEA1H 87". .... Cumberland k. ~ :;) ~ Q 'Q ~ z ". fAlHER'S NAME tr,,~ M"kJl" 1..1511 to. Harold Weyhenmeyer INfOAMANrS NAME (TypwPflnl) '00. David M. Cross UOHOO Of' DiSPOSITtON ....,IXI C......~ n -m"~'O!J. Dlh.r tS~""1 t{e.rtOVa.l r I . ~ Cumberland llod -- _d' IOwfnllMp1 "'ARllA\. SlMlI$. .......1IId ,.,.II.,....nled.W~. DfIIOfc.d (Spec...,1 Widowed Upper White SURVIVING SF'OUSoE III...ol'.~""~~1 OfCfOENT'S USUAL OCClJPATION tc...e~otW\)l\o,~dul.rll,)ffiOSI of WQIlunllll'e, 00 noI u~ lell'e(J I 2153 Canterbury Drive Mechanicsburg, PA 17055 .... nil. C~ty t1..0 ::=':::0' ",.- UOTHER"S "'''ME lflll~ M~. J.td.atnl5ulndffielj Unknown 10 2005 ill - 014889 PARtK: ou..a~""'~cooul:lulongIOdulb.but nut r.auaang....... ~ cauM QIIIen in PAfflI ug p -'10--) ilgl'J~ -- --~ ACONSEauf~Of) WERE AUlOPSY fiNDINGS MANNEH Of DEATH AVAILADlE PRIOR 10 ~- COMPLE lION Of CAUSE El Of O€NH1 N"'ural Homo(:. 0 Accld4lnt [) p,ndlng 1I111..119"IIQO fl "".x ", fl No CI s....oclda r-J CouW not be d",l/llfrul,,,d n OA.T~ Of INJURY (MOlllh n.rl'lllou) INJUAV AT v.oRK1 OESCRl,E HOW tNJUR~ OCCURRED Yn 0 ",,0 "\J CfRTIFIt.R Ie"...:'" .)1....'1' U'''I .CERTU=YING PH'1'$ICIAN ,Phylo.~ ,.tn c"""YWhJ (...,:;.e ," ,It'dl" ...t'lll' ..InOlI)ef .......'i.>(.anhd~P<'jlloOO.Jf)u:~d lk!alto oil"-) COII'IJI...ItK] n"m 2:Jl To u.. 0... of m, InlOwledg,. death O(:~uned due 10 Ih, cautel.) and m...".r.. 11_'4'<11, . ~~ [] ::NAlUAE~ LICENSE NUUBEA . AlE SIGNEfIUor\lf1 DityYeMI Ll.! ,,<JtjOQ..~~ llL-lh_,4- NAME AND ADDRESS Of PEASON WHO OMP~TEDCAUSE Of DEAI,,--t-. ....EOICAl fXAMINER/CORONER (ll"m .!'l rYP4JQf Punl CJeiY' R. L\( (C..,t...\\ ~ lie ~:~:~~~.:,~:.~e~:.I'~'.~n.:~:'~...~.:n.m".'~~"~u~: d'~'" u'~U'''.d "Ih~ II..... d....: .~..::"~~ .n.due'o 'h~::'I~ e:_.-: J :;0 ~~~(C~~~~~d <=b. \1\11 1:> " '''G~:S'G~~U:' :N~~U""~y J , ~lL~l1J2J DArE "cW."""." LJ., "... l\.t-~, ,,~~ Il ~ ~~-- \, - 04- - 2_005 ]~ ]~ PlACfOfINJ'lJRV:-A"i't.ufTI. lil'~,-;-'I!.', loK1;V. olfoc:. b...lldtog. _II; 15~tll.,I~1 'Do JOd. <- i-OCAOON I~II" C.tv/To....l,SldI..' 'PRONOUNCING AND CERTIFYING PHl'SlCIAN ,t'hV!.IC1,.I1l t.........' iJr:J....lu....:,j'lJ ll.....lf, ...loLl Lt:'Iloly'n{J WL,ju~of l.U,'.ltll To Ih_ w.tGt ony Ir.no......oSgl't. de...hoc:'uHM.1 ~ Urn_, d.le, it"" pl.ce...Ad dU.lu Ihe c<luse(sl_nam&l'm4It .....,.,ed 0~ 1East Will anb illcstamcnt OF EMMA L. CROSS (a.k.a. EMMA ADELINE CROSS) I, EMMA L. CROSS (a.k.a. EMMA ADELINE CROSS), of the City of Solon, County of Cuyahoga, and State of Ohio, being of full age and sound mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking and annulling any and all Will or Wills heretofore made by me. FIRST: All of the tangible personal property that I may own or have the right to dispose of at the time of my death I give and bequeath to my husband, MELVIN G. CROSS if he survives me. If my husband does not survive me, this bequest shall lapse and such property shall pass as part of my residuary estate. SECOND: If at the time of my death lawn any legal and/or equitable interest in real property then used for my personal residence, I give and devise all of such interest to my husband, MELVIN G. CROSS if he survives me. If my husband does not \. survive me, I give and devise such interest in equal shares to my son, DAVID M. / _f CROSS. If my son, DAVID M. CROSS, does not survive me, I give and devise such interest, in equal shares, to his children and step-children or the issue of said children I: \ and step-children, who survive me, per stirpes. THIRD: All the rest, residue and remainder of the estate, real, personal and mixed, of whatever kind, nature and description and wherever situated, of which I may die seized or possessed or to which I may be legally or equitably entitled at the time of my death, and any property over which I may have any power of appointment, I give, devise and bequeath to my husband, MELVIN G. CROSS, if he survives me. If my husband does not survive me, I give, devise and bequeath my said residuary estate as follows: A. To my son, DAVID M. CROSS; B. If my son, DAVID M. CROSS, does not survive me, I give and devise such interest, in equal shares, to his children and step-children or the issue of said children and step-children, who survive me, per stirpes;; C. In default of all the foregoing takers, to the persons who would take, and in the proportions they would take, from my estate if I were then to die intestate the owner of such property, according to the laws of the State of Ohio then in force and effect. FOURTH: I name as Executor of this, my Last Will and Testament, my husband, MELVIN G. CROSS, and direct no bond be required of him. I hereby authorize and empower my Executor to compound, compromise, settle and adjust all claims and demands in favor of or against my estate upon such terms as he deems best, and to sell, at private or public sale, at such prices and upon such terms of credit or otherwise, as he may deem best, the whole or any part of my real or personal property, and to execute, acknowledge and deliver deeds and other proper instruments of conveyance thereof to the purchaser or purchasers. Said Executor shall also have full power to improve, lease for any term, rent, borrow (including from himself in his nonfiduciary capacity), exchange, hold and control, lend, invest and reinvest any assets of my estate in such manner and upon such terms as he deems best, 2 irrespective of any statutes, rules or practices of courts now or hereafter in force limiting the investments of executors, with full power to exercise options, pledge assets of my estate, retain assets in the form in which they may be at the time of my death or their subsequent acquisition by the Executor, and convert realty into personalty and personalty into realty. Said Executor shall have full power and authority in his discretion to make division and distribution of assets in kind or in money, or partly in kind and partly in money, and to that end to allot property, real or personal, or an undivided interest or interests therein to legatees or devisees hereof. In the absence of abuse of discretion, the judgment of my Executor respecting the value of properties or undivided interests therein for the purpose of such division or distribution shall be binding upon all parties interested in this estate. No purchasers from my Executor need see to the application of the purchase money to or for the purposes of the estate, but the receipt of the Executor shall be a complete discharge and acquittance therefor. My Executor is authorized to continue the operation of any business that I may own at the time of my death, for such period as my Executor deems wise, with full power to operate in my name, in the name of my estate, or under any trade name that I '- \ have used, and in connection therewith to employ and compensate a manager and - '" '" such other persons as my Executor deems wise. My Executor may take such actions without liability for any losses incurred or for any depreciation in the value of any of the assets used. My Executor may liquidate such business or sell the same as a going business. My Executor shall not be required to file any reports with the Probate Court concerning the operation of any such business, except a report of the net income or net loss as a part of the regular accounts filed with the Court. My Executor is authorized to organize or join with others in the organization of 3 corporations to receive title to assets of my estate, to carry on a business, or for any other purpose and may hold or dispose of stock which he acquires in such corporations. My Executor may exercise, in such manner and to such extent as he shall deem advisable, any elections or choices available under the federal or state tax laws, even though such action may be advantageous to one or more of the beneficiaries hereunder and disadvantageous to other beneficiaries. My Executor shall have no duty to make any adjustments in his accounts for the benefit of any beneficiary adversely affected by any such election. The foregoing powers may be exercised without Court order. If my husband, MELVIN G. CROSS, dies or declines, ceases or is unable to serve as Executor, I name as Successor Executor to fill such vacancy, or any vacancy that may thereafter occur, my son, DAVID M. CROSS. I direct that the Successor Executor named herein be permitted to serve without bond. The Successor Executor named herein shall have all the powers, duties, authority, immunity and discretion , , \\ herein and by law granted to the Executrix originally named. FIFTH: I direct that all inheritance, estate, succession and other taxes of a .j , '~ similar nature levied or assessed by reason of my death, together with interest and ',- penalties thereon, if any, whether such taxes be levied or assessed in respect of II property passing under this Will or otherwise, be paid by my Executor from my \v\~, residuary estate; and I direct that my said Executor shall not be entitled to, nor shall he seek, reimbursement or contribution therefor from any person whomever or any property whatever. 4 SIXTH: Where necessary or appropriate to the meaning hereof, the singular and plural shall be deemed to include each other, and the masculine, the feminine, and the neuter shall be deemed to include each other. References herein to a fiduciary in the neuter singular shall include all persons and organizations so named herein and then acting hereunder in such capacity. "Child", "Children", "Issue" and words of similar shall purport include persons whose relationship is such by adoption, as well as the issue of such adopted persons, whether such issue be lineal or by adoption, and shall include any issue adopted by any person. IN WITNESS WHEREOF, I have hereunto set my hand to this, my Last Will and Testament consisting of five (5) pages, each initialed or signed by me, this 24th day of January, 2002. " ,//,'Cfi' . ,/'/ "/. ("'"d EMMA L. CROSS (a.k.a. EMMA ADELINE CROSS) The foregoing instrument was signed by the said EMMA L. CROSS (a.k.a. EMMA ADELINE CROSS) in our presence, and by him published and declared as and for his Last Will and Testament, and at his request and in his presence, and in the presence of each other, we hereunto subscribe our names as attesting witnesses at Chagrin Falls, ~his 2fh day of January, 2002. / ,I' 7\ ... . (/!ttt~~ residing at Five South Franklin Street Michael Drain 1 Cha~rin Falls, Ohio 44022 ~ -fntonio Franceschini residing at Five South Franklin Street Cha~rin Falls, Ohio 44022 5 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT CROSS DAVID M 2153 CANTERBURY CRIVE MECHANICSBURG, PA 17055 -------- fold ESTATE INFORMATION: SSN: 292-18-0184 FILE NUMBER: 2104-0320 DECEDENT NAME: CROSS EMMA l DATE OF PAYMENT: 02/03/2006 POSTMARK DATE: 02/03/2006 COUNTY: CUMBERLAND DATE OF DEATH: 11/04/2005 NO. CD 006287 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $49/000.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: D CROSS CHECK# 108 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS $49/000.00 GLENDA FARNER STRASBAUGH REGISTER OF WillS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT CROSS DA VI 0 M 21 53 CANTERBURY CRIVE MECHANICSBURG, PA 17055 -------- fold ESTATE INFORMATION: SSN: 292-18-0184 FILE NUMBER: 2104-0320 DECEDENT NAME: CROSS EMMA L DATE OF PAYMENT: 05/09/2006 POSTMARK DATE: 05/09/2006 COUNTY: CUMBERLAND DATE OF DEATH: 11/04/2005 NO. CD 006672 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,339.63 I I I I I I I I TOTAL AMOUNT PAID: $2,339.63 REMARKS: DAVID M CROSS CHECK# 110 SEAL INITIALS: eM RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS . . REV-1500 EX (6-00) OFFICIAL USE 0 NL Y COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ~L COUNTY CODE -9L 0320 ___ YEAR NUMBER I- Z W C w o w c DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Cross Emma DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 11/4/2005 10/16/1918 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) L SOCIAL SECURITY NUMBER 292-18-0184 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~ [X] 1. Original Return ~ ~CJ) D U O::::~ 4. Limijed Estate wQ.U ::I: 00 ~X U O::::....J LAJ 6. Decedent Died Testate (Attach copy of Will) Q.CQ ~ D 9. Litigation Proceeds Received D 2. Supplemental Return D 3. Remainder Return (date of death priorto 12-13-82) D 4a. Future Interest Compromise (date of death after 12-12-82) D 5. Federal Estate Tax Return Required D 7. Decedent Maintained a Living Trust (Attach copy ofTrust) L 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit (date of death between 12.31-91 and 1-1-95) D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS I- Z W o Z o D- en w 0: 0:: o o Richard C. Snelbaker FIRM NAME (If Applicable) Snelbaker & Brenneman, P.C. TELEPHONE NUMBER 44 West Main Street Mechanicsburg, PA 17055 717-697-8528 (6) 0.00 191,884.84 0.00 0.00 1,018,454.37 0.00 OFFICIAL USE ~ c-_:; :~~~; Cl ~~-- 1. Real Estate (Schedule A) (1 ) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) :;-"''':-1 (5) ~'::--Ipf z o ~ :3 ::J .... c: <C o w 0:: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) (4) I \_::J . i -.-1 l.;.) 0.00 (' ,) I j ",-,- 1 O. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) (8) 14,345.60 668.48 1,210,339.21 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) (13 ) 15,014.08 1,195,325.13 0.00 11. Total Deductions (total Lines 9 & 10) (11 ) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for Vvtlich an election to tax has not been made (Schedule J) ( 12) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14 ) 1,195,325.13 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 18. Amount of Line 14 taxable at collateral rate 0.00 1,195,325.13 0.00 0.00 x.D ~ (15) x.D ~ (16) x .12 (17) x .15 (18 ) ( 19) 0.00 53,789.63 0.00 z o i= <C .- ::::I Q. :!: o o >< <C .- 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 19. Tax Due 0.00 53,789.63 20. [KJ CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDEAND RECHECK MATH < < 3W4645 1.000 v De~edent's Complete Address: S1REET ADDRESS Manor Care of Camp Hill Bora of Camp Hill, Cumberland County 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) 53,789.63 0.00 49,000.00 2,450.00 Total Credits (A + B + C) (2) 51,450.00 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 Total Interest/Penalty (0 + E) (3) 0.00 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 (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 2,339.63 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE Make Check (58) 2,339.63 to: REGISTER PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? . . . . . . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 4. Did decedent own an Individual Retirement Account, annuity, or other I - ---h...+o r"Irrmprtv which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETI Yes No [1g ~ ~ ~ ~ ~ D D D D cutor N REPRESENTATIVE 2: sj1/(JJc ~. feC/ ;(1 IC/ 10_) atv? ;;l U:>l1dlfl 17&/{ dt{.LQ OL(-)l () G~ For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net [72P.S,g 9916 (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 fc The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements 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 YC_..",_. or a stepparent of the child is 0% [72 P.S. 9 9116(a)( 1.2)). The tax rate imposed on the net value of transfers to odor the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. S 9116(1.2) [72 P.S, S 9116(a)(1)). The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P,S. 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. 3W4646 1,QOO REV-1503 EX + (6-98) , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Emma L. Cross 21 04 0320 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. Kerr-McGee Corp 1,844 shares of common stock valued at $86.69 per share VALUE AT DATE OF DEATH 159,856.36 2 Sunoco Inc. 432 shares of common stock valued at $74.14 per share 32,028.48 TOTAL (Also enter on line 2, Recapitulation) $ 191,884.84 3W4696 1.000 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Emma L. Cross FilE NUMBER 21 04 0320 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Citizens Bank savings account #6245027360 2,041.28 2 Citizens Bank checking account #6026800656 22,361.98 3 Citizens Bank checking account #6205017516 14,722.51 4 Ryan Beck Company investment account 977,209.60 5 United States Treasury refund on 2005 Final Individual Income Tax Return 2,119.00 3W46AD 1.000 TOTAL (Also enter on line 5, Recaoitulation) $ (If more space is needed, insert additional sheets of the same size) 1,018,454.37 REV-1511 EX+ (12-99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Emma L. Cross FILE NUMBER 21 04 0320 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Malpezzi Funeral Home, Inc. funeral services 6,364.00 Total from continuation schedules . 3,759.00 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions B. Name of Personal Representative(s} Social Security Number(s) I EIN Number of Personal Representative(s} Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Snelbaker & Brenneman, P.C. 1,750.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 702.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Cumberland Law Journal Advertising Executor's Notice 75.00 2 Patriot News Advertising Executor's Notice 132.60 Total from continuation schedules . 1,563.00 3W46AG 1.000 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 14 345.60 Estate of: Emma L. Cross 292-18-0184 Item No. 2 Schedule H Part 1 (Page 2) Description Amount Tabone Funeral Home funeral services and disposition in Ohio 3,759.00 Total (Carry forward to main schedule) 3,759.00 Estate of: Emma L. Cros$ 292-18-0184 Schedule H Part 7 (Page 2) 3 Register of Wills short certificates 48.00 4 Register of Wills filing fee for Inheritance Tax Return 15.00 5 Reserve for filing fees, accounting fees and other miscellaneous costs associated with the administration of Decedent's Estate 1,500.00 Total (Carry forward to main schedule) 1,563.00 REV-1512 EX + (12-03) COMMONWEAL TH OF PENNSYL VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Emma L. Cross SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 04 0320 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH Commonwealth of Pennsylvania Income tax due on 2005 Final Individual Income Tax Return 160.00 2 Manor Care of Camp Hill resident care 27.40 3 Neighbor Care Pharmacy Services medical expense 481.08 3W46AH 2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 668.48 . REV-15130 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Emma L. Cross NUMBER I 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] David M. Cross 2153 Canterbury Drive Mechanicsburg, PA 17055 100% of Residue: 1,195,325.13 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21 04 0320 AMOUNT OR SHARE OF ESTATE Son ~,195,325.13 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPR1A TE, ON REV-1500 COVER SHEET " NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 3W46Al 1.000 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART \I ~ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) $ 0.00 (\:' , ) -<::I' \ ..J \.. " ~. \~\~ -- ~ Nas! 1lUill aub QrrS!alUrn! OF EMMA L. CROSS (a.k.a. EMMA ADELINE CROSS) I, EMMA L. CROSS (a.k.a. EMMA ADELINE CROSS), of the City of Solon, County of Cuyahoga, and State of Ohio, being of full age and sound mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking and annulling any and all Will or Wills heretofore'made by me. FIRST: All of the tangible personal property that I may own or have the right to dispose of at the time of my death I give and bequeath to my husband, MELVIN G. CROSS if he 'survives me. If my husband does not survive me, this bequest shall lapse and such proJ?~rty shall pass as part of my residuary estate. SECOND: If at the time of my death I own any legal and/or equitable interest in real property then used for my personal residence, I give and devise all of such interest to my husband, MELVIN G. CROSS if he survives me. If my husband does not I " \. survive me, I give and devise such interest in equal shares to my son, DAVID M. CROSS. If my son, DAVID M. CROSS, does not survive me, I give and devise such interest, in equal shares, to his children and step-children or the issue of said children and step-children, who survive me, per stirpes. THIRD: All the rest, residue and remainder of the estate, real, personal and mixed, of whatever kind, nature and description and wherever situated, of which I may ~....J.. ". .. 'c->{ ..."._~~ \ \ 'oJ die seized or possessed or to which I may be legally or equitably entitled at the time OT my death, and any property over which I may have any power of appointment, I give, devise and bequeath to my husband, MELVIN G. CROSS, if he survives me. If my husband does not survive me, I give, devise and bequeath my said residuary estate as follows: . A. To my son, DAVID M. CROSS; B. If my son, DAVID M. CROSS, does not survive me, I give and devise such interest, in equal shares, to his children and step-children or the issue of said children and step-chil!dren, who survive me, per stirpes;; C. In default of all the foregoing takers, to the persons who would take, and in the proportions they would take, from my estate if I were then to die intestate the owner of such property, according to the laws of the State of . Ohio then in force and effect. FOURTH: I name as Executor of this, my Last Will and Testament, my husband, MELVIN G. CROSS, and direct no bond be required of him. I hereby authorize and empower my Executor to compound, compromise, settle and adjust all claims and demands in favor of or against my estate upon such terms as he deems best, and to sell, at private or public sale, at such prices and upon such terms of credit or otherwise, as he may deem best, the whole or any part of my real or personal property, and to execute, acknowledge and deliver deeds and other proper instruments of conveyance thereof to the purchaser or purchasers. Said Executor shall also have full power to improve, lease for any term, rent, borrow (including from himself in his nonfiduciary capacity), exchange, hold and control, lend, invest and reinvest any assets of my estate in such manner and upon such terms as he deems best, 2 irrespective of any statutes, rules or practices ot coUrts noW orheraaner In Torce limning the investments of executors, with full power to exercise options, pledge assets of my estate, retain assets in the form in which they may be at the time of my death or their subsequent acquisition by the Executor, and convert realty into personalty and personalty into realty. Said Executor shall have full power and authority in his discretion to make division and distribution of assets in kind or in money, or partly in kind and partly in money, and to that end to allot property, real or personal, or an undivided interest or interests therein to legatees or devisees hereof. In the absence of abuse of discretion, the judgment of my Executor respecting the value of properties or undivided interests therein for the purpose of such division or distribution shall be binding upon aU parties interested in this estate. No purchasers from my Executor need see to the application of the purchase money to or for the purposes of the estate, but the receipt of the Executor shall be a complete discharge and acquittance therefor. My Executor is authorized to continue the operation of any business that I may own at the time 'Of my death, for such' period as my Executor deems wise, with full power to operate in my name, in the name ~f~y estate, or under any trade name that I ~~\ 1,'-'\ have used, and in connection therewith to employ and compensate a manager and i ' \ \ ~... ~\\ , \\ \ -~ ~, such other persons as my Executor deems wise. My Executor may take such actions \' without liability for any losses incurred or for any depreciation in the value of any of the assets used. My Executor may liquidate such business or sell the same as a going business. My Executor shall not be required to file any reports with the Probate Court concerning the operation of any such bus'iness, except a report of the net income or net loss as a part of the regular accounts filed with the Court. My Executor is authorized to organize or join with others in the organization of 3 ~. \ \ v ..... J , 1 (~ .>.J "-..l l\ ~ ~\~\ '.:, ...... -.; corporations to receive title to assets of my eState, to carry on a Duslness, or Tor any [ other purpose and may hold or dispose of stock which he acquires in such corporations. My Executor may exercise, in such manner and to such extent as he shall deem advisable, any elections or choices available under the federal or state tax laws, even though such action may be advantageous to one or more of the beneficiaries hereunder and disadvantageous to other beneficiaries. My Executor shall have no duty to make any adjustments in his accounts for the benefit of any beneficiary adversely affected by any such election. The foregoing powers may be exercised without Court order. If my husband, MELVIN G. CROSS, dies or declines, ceases or is unable to serve as Executor, I name as Successor Executor to fill such vacancy, or any vacancy that may therea.fter occur, my son, DAVID M. CROSS. I direct that the Successor Executor named herein be permitted to serve without bond. The Successor Executor named herein shall have all the .powers, duties, authority, immunity and discretion herein and by law granted to the Executrix originally named. FIFTH: I direct that all inherit~~ge,. estate, succession and other taxes of a similar nature levied or assessed by 'reason of my death, together with interest and ~ penalties thereon, if any, whether such taxes be levied or assessed in respect of '..;, property passing under this Will or otherwise, be paid by my Executor from my residuary estate; and I direct that my said Executor shall not be entitled to, nor shall he seek, reimbursement or contribution therefor from any person whomever or any property whatever. 4 .", I '... SIXTH: Where necessary or appropriate to the meaning hereof, the singular and plural shall be deemed to include each other, and the masculine, the feminine, and the neuter shall be deemed to include each other. References herein to a fiduciary in the neuter singular shall include all persol}s and organizations so named herein and then acting hereunder in such capacity. "Child", "Childrenll, "Issue" and words of similar shall purport include persons whose relationship is such by adoption, as, ~ell as the issue of such adopted persons, whether such issue be lineal or by adoption, and shall include any issue adopted by any person. IN WITNESS WHEREOF, I have hereunto set my hand to this, my Last Will and Testament consisting of five (5) pages, each initialed or signed by me, this 24th day of January, 2092. C,".,b,-'....~ ~:.e-.' ;{,,,) / , .~,t~' ?'}.f -'<-.... --"'"'J d"f ") /,,,;.., t";'< c,:;:..-1 ~ ...-....:~:'n'~"';:7:, ....... ... ~,~~;~~~~. ~MIViA L. CROSS (a.k.a. EMMA ADELINE CROSS) The foregoing instrument was signed by the said EMMA L. CROSS (a.k.a. EMMA ADELINE CROSS) in our pre~enGa, and by him published and declared as and for his Last Will and Testament, and, at his request and in his presence, and in the presence of each other, we hereunto subscribe our names as attesting witnesses at Chagrin Falls, ~hiS 2~h day of January, 2002. :t1 'I~ · (/t:t,a~~ ~. residing at Five South Franklin Street Michael Drain 1 I/I;:;;~ ~/ Antonio Franceschini ./ ChaQrin Falls, Ohio 44022 residing at Five South Franklin Street ChaQrin Falls, Ohio 44022 5 Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Emma L. Cr os s Date of Death: November 4, 2005 Estate No.: 21-04-0320 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: . Yes 0 No [] 2. If the answer is No, state when the personal repr.esentative reasonably believes that the administration will be complete: Appr ox~ma tely 6 man ths 3. lfthe answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk the Orphans' Court and may be attached to this report. ~ Date: 5/31/06 ---) Signatu: Richard C. Snelbaker Sneluaker & Brenneman, P.C. Name 44 West Main Street Mechanicsburg, PA 17055 Address ~.., I . ., C1 (' (717) 697-8528 Telephone No. \.-."'"-' c. , (i Capacity: 0 Personal Representative []. Counsel for personal representative '':~\ \~- 06-26-2006 CROSS 1l-04-2005 21 04-0320 CUMBERLAND 101 APPEAL DATE: 08-25-2006 (See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- ------------------------------------------------------------------------------------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX EMMA L FILE NO. 21 04-0320 ACN 101 BUREAU OF INDIVIDUAL TAXE$,'.,~,\....,-, INHERITANCE TAX DIVISION'.:.... " - PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX ~rf"IW.p~ISEHENT, ALLOWANCE OR DISALLOWANCE ;.n-',_'OF DEDUCTIONS AND ASSESSHENT OF TAX ~ :' q DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN I') - I:j .. j Ie: Oil RICHARD C SNEL&AKER SNELBAKER & BRENNEMAN 44 W MAIN ST MECHANICSBURG PA 17055 ESTATE OF CROSS *' REV-1547 EX AFP (06-05) EMMA L TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED DATE 06-26-2006 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets ll) (2) (3) (4) (5) (6) (7) .00 191.884.84 .00 .00 1.018.454.37 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adn. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) 1l0) 14,345.60 668.48 lll) (12) (13) (14) NOTE: I~ an assessment was issued previoUSly, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. Anount of Line 14 at Spousal rate (15) 16. Anount of Line 14 taxable at Lineal/Class A rate (16) 17. Anount of Line 14 at Sibling rate (17) 18. Anount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: NOTE: To insure proper credit to your account, subnit the upper portion of this forn with your tax paynent. 1,210,339.21 15.014 08 1,195,325.13 .00 1,195,325.13 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = 1,195,325.13 X 045 = .00 X 12 = .00 X 15 = (19)= .00 53,789.63 .00 .00 53,789.63 / NUHBER (+J AHOUNT PAID DATE INTEREST/PEN PAID (-) 02-03-2006 V~D006287 2,578.95 49,000.00 05-09-2006 CD006672 .00 2,339.63 TOTAL TAX CREDIT 53,918.58 BALANCE OF TAX DUE 128.95CR INTEREST AND PEN. .00 TOTAL DUE 128.95CR ", . 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'" (CR), YOU HAY BE DUE ...., A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) ~ ~ RECEIPT AND RELEASE WHEREAS, Emma L. Cross A/KIA Emma Adeline Cross, late of Camp Hill Borough, County :')f Cumberland and Commonwealth of Pennsylvania, died on November 4, 2005, having first made her Last Will and Testament in wrj.~ing probated before the Register of Wills of said Curr,b:::rland County on Novembel" 13,2005, and Letters Testamentary were issued on the same date to David M. Cross, the Executo~ named in the Last Will and Testament of said Decedent; and W2EREAS, said Executor has entered upon and completed his administration of said Decedent's Estate as set fcrth in his First and Final Accou~t attached hereto, and intends to distribute the net balance of the assets of said Estate to the persons named in the 3tate~€nt of Prcposed Distrihuti~G also attached hereto, hoth of said documeDts being i~corporated herei.! by refer~nce thereto; and NOW KNOW ALL MEN BY THESS PRES8NTS, that I, David M. Cross being the principal legatee and distributee named ip the Will of said Decedent and ths person entitled to share in the residuary distributicn of the Estate of said Decedentr do hereby dp-clare and say that I have examined the attached Account and Statement cf Proposed DistribG~ion, a~a find the same to be true and c~rr0ct, and in st.rist accordance with the.terms and provisions LAW OFFICES SNELBAKER & BRENNEMAN. P.C. 1 ~ ,1 ~ ! ,I , : L- v ~ ..oJ - :J ,... c.Y- J10 G. of said Will, and I do hereby acknowledge that I this day have, had and received of and from David M. Cross, Executor of the Estate of Emma L. Cross A/K/A Emma Adeline Cross, the cash, personalty and/or real estate set opposite my name in the above Statement of Proposed Distribution, in full satisfaction, payment and discharge of all such sum or sums of money, legacies and bequests, share or shares, purports and dividends which were due, owing and payable and belonging to me by any means whatsoever, for or on account of my full share, part or dividend of the Estate of Emma L. Cross A/K/A Emma Adeline Cross, Deceased. NOW, THEREFORE, I the said David M. Cross, do by these presents, remise, release, quit-claim and forever discharge the said David M. Cross, his heirs, executors and administrators, of and from my said shares or dividends of the Estate aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason thereof, or of any act, matter, cause or thing whatsoever, from the beginning of the world to the day and date of these presents. AND, desiring to avoid the delay and expense of the settlement of said Estate by filing the foregoing Account of said administration in the Office of the Register of Wills of said Cumberland County and by having the balance in the hands of the Executor, as shown by said Account, distributed by the Court of Common Pleas of Cumberland County - Orphans' Court Division, I do hereby agree that the foregoing Account and Statement concerning LAW OFFICES SNELBAKER & BRENNEMAN. P.C. 2 the matter of settlement may be recorded with the same effect upon me as if the same had been reported upon by said Court, in a decree of distribution made on such proposed Statement of Distribution by the said Court of Common Pleas - Orphans' Court Division. AND in consideration of the aforesaid settlement being made without the aid of such Court of Common Pleas - Orphans' Court Division, that I do hereby agree that if any debts or demands other than those included in the above referenced First and Final AccouDt, as hereinbefore set forth, shall be hereafter recovered against the Estate of said Decedent and be legally payable out of the same, that I will return to the said Executor such amounts thereof as may be necessary to pay such debts or demands. IN WITNESS WHEREOF, we have hereunto set our hands and seals this IqM'-day of (x:d'cJ:.)Q,Jt. 2006. WITNESSED BY: ~th~.~. ~EAL) David M. Cross CbJ)6G;J,,~r'jY ta.o- '--.' I. Notarial Seal I I Chri~tllla M. McElroy, Notary Public 1 . We;:! Ch~;1;t{'i Bora Chester (~~ ; ~'-'!,Y'~ C~";i i,':'~-;,\j" ~'.' LAW OFFICES SNELBAKER & BRENNEMAN, P.C. 3 LAW OFFICES SNELBAKER & BRENNEMAN, P.C. -~ COMMONWEALTH OF PENNSYLVANIA) COUNTY ~~V- On thi s the 111- SS. Oc~~Y- 2006, before me, a day of Notary Public in and for said State and County, the undersigned officer, personally appeared David M. Cross, 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 hereunto set my hand and official seal. Notarial Seal Cbrist;Pa M. McElroy, Notary Pub!" \'ves' Chc'<ite' Bom, Chester Count ," 'llSS.:;,' Exp;res Jan. 16. 200 Notary Public \ II Ii 4 ESTATE NO. 21-04-0320 FIRST AND FINAL ACCOUNT AND STATEMENT OF PROPOSED DISTRIBUTION OF AND BY DAVID M. CROSS, EXECUTOR OF THE ESTATE AND UNDER THE LAST WILL AND TESTAMENT OF EMMA L. CROSS A1K/A EMMA ADELINE CROSS, DECEASED, LATE OF CAMP HILL BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA David M. Cross, Executor as aforesaid and Accountant herein, avers as follows: DATE OF DECEDENT'S DEATH: DATE LETTERS TESTAMENTARY ISSUED: November 4, 2005 November 18, 2005 DATES EXECUTOR NOTICE ADVERTISED: Cumberland Law Journal Patriot-News December 2, 19,16,2005 December 6, 13, 20, 2005 FIRST AND FINAL ACCOUNT PERSONALTY - PRINCIPAL ACCOUNT DEBITS The Accountant charges himself with the receipt of the following items of Decedent's Personalty valued as of the date of Decedent's death: 1. Kerr-McGee Corp, 1,844 shares of common stock valued at $86.69 per share 2. Sunoco, Inc., 432 shares of common stock valued at $74.14 per share 3. Citizens Bank, savings account #6245027360 4. Citizens Bank, checking account #6026800656 5. Citizens Bank, checking account #6205017516 6. Ryan Beck Company, investment account 7. United States Treasury, refund on 2005 Final Individual Income Tax Return 8. Met-Life-Comer, pension 9. Commonwealth of Pennsylvania, refund on Inheritance Tax TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, DEBITS: PERSONALTY - PRINCIPAL ACCOUNT CREDITS LAW OFFICES SNELBAKER & BRENNEMAN, P.C. he Accountant claims credit for the payment of the following items from Decedent's Personalty Account: Snelbaker & Brenneman, P.C., reimburse for costs advanced for probate fees Neighborcare Pharmacy, medical expenses HCT ManorCare, resident care Malpezzi Funeral Home, Inc., funeral services Neighborcare Pharmacy, medical expenses Register of Wills, Agent, estimated Inheritance Tax payment Register of Wills, Agent, Inheritance Tax Register of Wills, filing fee for Inheritance Tax return Register of Wills, additional probate fee 10. Citizens Bank, service fee and wire fees 11. Tabone Funeral Home, funeral services and disposition in Ohio 12. Citizens Bank, the following checks were written from account # 6205017516 a. HCT Manorcare, resident care, check number 607 b. Mobile-Imaging, medical expenses Page 1 13,260.00 7.38 $ 159,856.36 32,028.48 2,041.28 22,361.98 14,722.51 977,209.60 2,119.00 239.78 128.95 $ 1,210,707.94 $ 702.00 241.54 27.40 6,364.00 239.54 49,000.00 2,339.63 15.00 150.00 23.50 3,759.00 13,278.33 c. Dr. Clem Ciccarelli, medical expenses 13. Snelbaker & Brenneman, P.C., attorney services 14. Snelbaker & Brenneman, P.C., costs advanced: a. Cumberland Law Journal, advertising Executor's Notice b. Patriot-News, advertising Executor's Notice TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, CREDITS: PERSONALTY - INCOME ACCOUNT DEBITS The Accountant charges himself with the receipt of the following income from the investment of Personalty Principal: 1. Citizens Bank, checking account # 6206800656 & 6245027360, interest 2. Sunoco, Inc., dividend 3. Kerr-McGee, dividend TOTAL, PERSONALTY, INCOME ACCOUNT, DEBITS: PERSONALTY - INCOME ACCOUNT CREDITS he Accountant claims credit for the payment of the following items from the Personalty Principal Account: United States Treasury, estimated tax payment PA Department of Revenue, estimated tax payment PA Department of Revenue, tax due on Final Individual Income Tax Return TOTAL, PERSONALTY, INCOME ACCOUNT, CREDITS: REAL ESTATE - PRINCIPAL ACCOUNT DEBITS he Accountant charges himself with the receipt of Decedent's Real Estate as follows: TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, DEBITS: REAL ESTATE - PRINCIPAL ACCOUNT CREDITS he Accountant claims credit for the payment of the following items from Real Estate Principal Account: TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, CREDITS: REAL ESTATE -INCOME ACCOUNT DEBITS he Accountant charges himself with the receipt of the income from the investment of Real Estate Principal Account: TOTAL, REAL ESTATE, INCOME ACCOUNT, DEBITS: LAW OFFICES SNELBAKER & BRENNEMAN. P.C. Page 2 10.95 1,750.00 207.60 75.00 132.60 $ 78,097.54 $ 35.36 810.67 959.00 1,805.03 $ $ 600.00 500.00 160.00 1,260.00 $ $ NONE $ NONE $ NONE $ NONE $ NONE $ NONE LAW OFFICES SNELBAKER & BRENNEMAN. P.C. REAL ESTATE -INCOME ACCOUNT CREDITS The Accountant claims credit for the payment of the following items from the Real Estate Income Account: TOTAL, REAL ESTATE, INCOME ACCOUNT, CREDITS: $ NONE $ NONE Page 3 PERSONAL TY: PRINCIPAL ACCOUNT: Debits Credits Balance INCOME ACCOUNT: Debits Credits Balance TOTAL PERSONAL TV REAL ESTATE: PRINCIPAL ACCOUNT: Debits C red its Balance INCOME ACCOUNT: Debits C red its Balance TOTAL REAL ESTATE: TOTAL FOR DISTRIBUTION: LAW OFFICES SNELBAKER & BRENNEMAN. P.C. RECAPITULATION Page 4 $ $ 1,210,707.94 78,097.54 $ $ 1,805.03 1,260.00 $ NONE $ NONE $ NONE $ NONE $ 1,132,610.40 $ $ NONE $ NONE 545.03 $ 1,133,155.43 $ NONE $ 1,133,155.43 LAW OFFICES SNELBAKER & BRENNEMAN, P.C. STATEMENT OF PROPOSED DISTRIBUTION David M. Cross, Executor and Accountant herein, proposes to distribute the balance of the Estate of Emma L. Cross a/k/a Emma Adeline Cross, Deceased, to wit: $ 1,133,155.43 in accordance with the Last Will and Testament of said Decedent as follows: 1. David M. Cross 100% of residue as per item #3A of Will TOTAL FOR DISTRIBUTION: Page 5 $ 1,133,155.43 $ 1,133,155.43 LAW OFFICES SNELBAKER & BRENNEMAN, P.C. COMMONWEALTH OF PENNSYLVANiA COUNTY OF David M Cross being duly 8W0f!1 according to law deposes and says: 'f SS: that he is the Executor of the Estate ;!nd under the Last Will and Testament of Emma L. Cross a/kJa Emma Adeline Cross. Deceased, and the Accountant herein; that there are no unpaid creditors or claimants of said Estate; that there are no persons interested in the distribution of said Estate other than as stated in the foregoing Statement of Proposed Distribution and that the facts set forth in the foreqoing First and Final Account and Statement of Proposed Distribution are true and correct to the best of his knowledge, information an~ );, _ ~ David M. Cross Executor and Accountant Sworn to and subscribed before me '1 II II thi;, \ ~ay of ~ 2006 (~~l.~(l ( ~, Notary Public Notarial Seal I Christina M. McElroy, Notary Public West Chester Boro, Chester County My CommissiOl1 Expires Jail. ! 6, 2007 ! .._._.. i ~A6m~!::r. P?~nS\.ltv8.,:if! ;1j.s:<y:~i..:,fL:~:-, of Notqri€€ Page 6 { COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } ss: David M. Cross being duly s wo rn according to law, deposes and says that he of the Estate of Emma L. Cross A/K/A Emma Adeline Cross 1S the Executor Camp Hill Borough C b I de P d d d h h late of ____________n___n___. I um er an ounty. a., ecease an t at t e within is an inventory made by David M. Cros s ., the said Executor of the entire estate of said decedent, consisting of all the personal propc!rty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. Swo rn and subscribed before me, !darJJ~ c;;? ~lcJ- dr)(} ;\ C1- , (V b j;.1Jt: A) """ ' ~ 2006 Executor. Aaministrator David M. Cross, Executor 4051 Steeplechase Drive Collegev111e, PA 1~426 Notarial Seal Cl'Jistlna M. McElroy, Notary Public West Chester Bom, Chester County My Commission Expires Jim. 16, 2007 Merr'JJer p(>'1Jlsvlvanial\ssooRtioo of Notaries 4th Death Day Address r.,,) November (_2 2005 ? .~ ~, t.:./'. Date of Month Year ~~ .. INSTRUCTIONS r",-:, -.; J. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty G) 4. See Article IV, Fiduciaries Act of 1949. 01 00 00 0 l-l U OJ i=l 'rl r-I OJ "0 . , <t: m ..c co '"tJ 0 >- S ::l N G) I- W ~ 0 lit C""l ~ c::: I- l-l fl:l l-l 0 W -< ~ 0 CI) OJ I Q" I- -- I=Q u Q)..!:G ...j" 0 V) ::.::: CI) 0 0 w w -- r-I C O'co ~ c::: fl:l,..Cl G) I I- :r: 0.. ~ r-I 0.. r-I C .......; Z I- ,.;.I U. . , 'rl fl:l OJ '- N ...J -< 0 00 ::x:: 0.. i=l 0 u. == W 0 -< w 00, >. Cf.) > Z c::: 0 0... -< l-l S - Z 0 c C u co ::l U ci V) z u 0 c::: () "0 Z W -< H ... l-l 0.. '"tJ co co c ...c::: S fl:l ... -.: (j S 0 CI) 'rl ~ ..0 ~t:ri CI) E '"tJ ... ..! 0 /\ fl:l ::l 0 ...J - () u: co U Inventory of the real and personal estate of EMMA L. CROSS A1K1A EMMA ADELINE CROSS, Deceased PERSONAL TY: 1. Kerr-McGee Corp, 1,844 shares of common stock valued at $86.69 per share 2. Sunoco, Inc., 432 shares of common stock valued at $74.14 per share 3. Citizens Bank, savings account #6245027360 4. Citizens Bank, checking account #6026800656 5. Citizens Bank, checking account #6205017516 6. Ryan Beck Company, investment account 7. United States Treasury, refund on 2005 Final Individual Income Tax Return $ 159,856.36 32,028.48 2,041.28 22,361.98 14,722.51 977,209.60 2,119.00 TOTAL PERSONALTY: $ 1,210,339.21 REAL ESTATE: 1. Decedent did not own any real estate at the time of her death $ 0.00 TOTAL PERSONALTY AND REAL ESTATE: $ 1,210,339.21 Page 1 Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Emma L. Cross A/K/A Emma Adeline Cross Name of Decedent: Date of Death: 11 /4/ 2 00 5 Estate No.: 21-04-0320 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration ofthe above-captioned estate: 1. State whether administration of the estate is complete: . Yes irn No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. Ifthe answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No ~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, releases, joinders d approval of formal or informal accounts may be filed with the Cl of he 0 h attached to this report. re Richard C. Snelbaker Sneloa~er & Brenneman, P.C. Name 44 West Main Street Mechanicsburg, FA 17055 Address Date: loj'2.sjD6 \..- .. (717) 697-8528 Telephone No. Capacity: 0 Personal Representative a Counsel for personal representative BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX Z8D6Dl HARRISBURG PA 171Z8-D601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INH~~A~(\cr~ nC STA TEMe~t~:~f~~~~9~t [jL\..F\)i'-.,I ....,j. -i,i,L.-,.J REV-1607 EX AFP (03-05) RICHARD C SNELBAKER SNELBAKER & BRENNEMAN 44 W MAIN ST MECHANICSBURG PA 17055 2n06 SEP:;l:~J: 20 DATE OF DEATH ell" (J(UMBER ORP~OOURT CUMBEMttfm CO.. PA I 07-31-2006 CROSS 11-04-2005 21 04-0320 CUMBERLAND 101 EMMA L Anount Renitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subnit the upper portion of this forn with your tax paynent. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF CROSS EMMA L FILE NO. 21 04-0320 ACN 101 DATE 07-31-2006 THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NA"ED ESTATE. SHOWN BELOW IS A SU""ARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAY"ENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-19-2006 PRINCIPAL TAX DUE: 53,789.63 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-03-2006 CD006287 2,578.95 49,000.00 05-09-2006 CD006672 .00 2,339.63 07-12-2006 REFUND .00 128.95- TOTAL TAX CREDIT 53,789.63 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl, YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. l ~