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HomeMy WebLinkAbout04-0633PETITION FOR PROBATE & GRANT OF LETTERS Estate of Charles R. Johnson also known as Social Security No. 136-28-4897 , deceased. No. 21-04- ~ ,~ To: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The Petition of the undersigned respectfully represents that: Your Petitioner, who is 18 years of age or older and the Executor named in the Last Will of the above decedent dated May 18, 2004 , and codicils dated none The Executor named none __ died . Renunciations for none attached hereto. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 56 Peachy Ann Drive, Lower Mifflin Township, Newville Decedent, then 67 years of age, died May 23,2004, at his residence Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the Will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in PA (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania, situated as follows: $7,000.00 $ $ $ WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented herewith and the grant of letters testamentary thereon· Signat~e(s) and Resid. enc~s) of Petitioner(s): Vernon E. JM:~son Sr. ---. 171 C.M.E. Newville, PA 17241 717-776-9227 OATH OF PERSONAL REPRESENTATIVE ;',; COMMONWEALTH OF PENNSYLVANIA · · SS COUNTY OF CUMBERLAND · The Petitioner(s) above named swear(s) or afffirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that as personal representative of the above decedent, petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this '7c/~ day of July ,2004. ~ Rdgiste~',~ _ Vernon E. Jo~on Sr. -" No. 21-04- ta~_~ Estate of Charles R. Johnson, deceased. DECREE OF PROBATE & GRANT OF LETTERS AND NOW, July 8 , 2004, 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 May 18, 2004 described therein be admitted to probate and filed of record as the Last Will of Charles R. Johnson ; and Letters Testamentary are hereby granted to Vernon E. Johnson Sr. FEES Probate, Letters, Etc ........ $. 40.00 Short Certificates(-4- ) .... $12.00 Renunciation(s) ........... $__ JCP .................... $. 10.00 Other Will Pages (-3-) .... $ 9.00 TOTAL: ..... $ 71.00 Filed....-']. :.~:.~.. :~'~.Jr ..... '.~-.~... SALZMANN HUGHES & FISHMAN PC James D. Hughes, Esq. (58884) ATTORNEY (Sup. Ct. I.D. No.) 95 Alexander Spring Road, Suite 3 Carlisle, PA 17013 ADDRESS 717-249-6333 PHONE his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Loc;_d Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 10327475 No. Local Registrar HAY 2 4 200~ Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH Charles R Johnson [~.ale I, 136 -- 28 4897,.' l'~a~t°r~, 'a~0154 ,~L.*.~.~, L u~.?~ I ~"'~ I o~. , .~~ 12 .......... ,J' -- 56 Peachy Ann Dr. ~ ,..~ PA Neville PA 17241 ~ ~ ,~.~ Lower M~ffl~ '~ ,,.~ Cumberland ~' ,~.O ,~ David Johnson ~,~ zce Przce ~ Vernon ffohnson J~~~%~'~'~l 7241 I~[~~ I~ ~ ~,~. ~ ~c:::::., ~-_..a, IL~~.~ ~ e::~.~ ~-.~0 [,~04 ~nger Crema%ory IMf. Hol17 Springs PA I .... ~,,,. 1706 5 ..... ·/~~ J~--138~5 L I~~,,ug~[_Home InC 15 Big SDrin- ave I ~ I~ ~ ~ DI I I I ~,r~_~ I~ / Ira. / I ....................... = , ............................ ' ...... D 1~~ ~ K~h ~"-',~,~,-,,,-- ~ - ' ........................... -. ~ ~d ,~, ~A ~7~1 t- LAST WILL AND TESTAMENT I, CHARLES R. JOHNSON, of Upper Mifflin Township, Cumberland County, 'Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. ONE. I direct my Executor or Executrix, as the case may be, to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this Will, ~, hall be paid by the Executor or Executrix of my estate. Further, to the extent that sufficient assets exist in my estate, any and all inheritance or other estate taxes, whether to non-charitable or charitable beneficiaries, shall be paid by my Executor or Executrix from the residuary of my estate. TWO. My Executor or Executrix may, at his or her discretion, compromise claims, borrow money, retain property for such length of time as he or she may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as he or she may deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. I authorize and empower my Executor or Executrix to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient/t~eds and/or bills of sale therefor, in fee simple, as I could do if living. My Executor or ~Xecutrix is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said Executor or Executrix2 ~ THREE. I give, devise and bequeath all of my estate of whatever nature and wherever situate in equal shares to my siblings, VERNON E. JOHNSON SR., FREDERICK E. JOHNSON SR. and ELIZABETH N. THOMAS, per stirpes, which provides that the child or children of any deceased beneficiary shall take the share their parent would have taken if living. FOUR. I hereby nominate and appoint VERNON E. JOHNSON SR. to be the Executor of this my Last Will and Testament. In the event for whatever reason he is unable to serve as the Executor of my estate, then in that event I hereby appoint FREDERICK E. JOHNSON SR. to be the Substitute Executor of this my Last Will and Testament, whereby the said substitute personal representatives shall have the same powers as are given to the original Executor hereunder. FIVE. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty (60) days. SIX. No Executrix or Executor acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. SEVEN. No beneficiary may assign, anticipate or pledge its interest in any income or principal held or distributable hereunder, and no beneficiary's creditors may levy, at :ach or otherwise reach any such interest. 2004. IN WITNESS WHEREOF, I have hereunto i,_.~l ~~,~l~~day ~I CHARLES R. JOHNSON of May, (SEAL) Signed, sealed, published and declared by the above-named person as and for a Last Will and Testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. ACKNOWLEDGMENT AND AFFIDAVIT WE, CHARLES R. JOHNSON, JAMES D. HUGHES and KAMELA S. CORNMAN, the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will, and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as a witness and that to the best of their knowledge the testator was, at that ti~~f~en~,rs ~ge or older, Ofn ~ f- ' )'~[~ sou d mind and under no constraint or undue influenc~ ~w v ~ ~{~i~ S R. JOHNSON COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : Subscribed, sworn to and acknowledged before me by CHARLES R. JOHNSON, the testator herein, and subscribed and sworr}g~_ before me by JAMl~Stx D. HUGHES~ and KAMELA S. CORNMAN, witnesses, this ~L~day ~llMay, 200/0,. / (,/- J~i~ L ~, ~ Public ~ ~m~ ~ ~. 14, 2~7 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Estate No.: CHARLES R. JOHNSON May 23, 2004 21-04-0633 To the Register: I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 28, 2004 . Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none . ELIZABETH N. THOMAS 56 PEACHY ANN DRIVE NEWVILLE PA 17241 FREDERICK E. JOHNSON SR. 319 CENTER ROAD NEWVILLE PA 17241 VERNON E. JOHNSON SR. 171 C.M.E. NEWVILLE PA 17241 Date: July 28, 2004 GHES & FISHMAN PC ! James/la. Hughes, Esquire { 95 A/t6xander Spring Road, Suite 3 \ C/adisle, PA 17013 x,.._.-/(717) 249-2353 Capacity: Personal Representative X Counsel for Personal Representative REV-1500EX(6-00) OFFICIAL USE ONLY w .. >::~ <..>It:>:: w"'<"> :c~ <..> ...ID ... .. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 04 0633 ----- R COUN1YCODE ,YEAR SOCIAl SECURITY NUMBER 136-28-4897 TItIS RETURN MUST ac FILED IN OUPUCATE WITH THE NUMBER I- Z w C w o w C DECEDENT'S NAME (LAST, FIRST, AND MIDDL~ INlTlAL) Johnson Charles DATE OF DEATH (MM.DD-YEAR) DATE OF BIRTH (MM-DO-YEAR) 5/23/2004 6/16/1936 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( ST, FIRST, AND MIDDLE INlTlAL) REGISTER OF WILLS SOC~SECURITYNUMBER 00 1. Qngina/Return D 4. Limited Estate 00 6. Decedent Died Testate (Attach copy 01 Jl) o 9. Litigation Proceeds Received o 2. Supplemental Return 0 3. RemainderRetum (date of death priOr to 12-13-82) o 4a. Future Interest Compromise (date of death alter 12-12-82) 0 5. Federal Est_ Tax Retum Required D 7. Decedent Maintained a Living Trust (Attach copy of Trust) _ S. Total NumberofSafeDeposit8~ o 10. Spousal Poverty Credit (data of death batwean 12-31.91 BI'lI:I1_1_9S) 0 11. Election to tax under Sec. 9113(A) (AtUl~h S~hO) ... Z W o Z o ... .. II! 8 THIS SECTION MUST BE COMPLETEO' ALL CORRESPONOENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPloE1E MAILING ADDRESS James D. Hughes, Esqui,je 95 Alexander Spring Road, Suite 3 FIRM NAME (If Applicable) SALZMANN HUGHES, PC Carlisle, PA 17013 TELEPHONE NUMBER 717-249-6333 1. Real Estate (Schedule A) (1) 0 0 0 0 8,288 0 0 (8) 2,600 13,641 (11) (12) 113) 114) (7,953) OFFCW- U~NLY (',~ ) ..:Jl 2. Stocks and Bonds (Schedule B) (2) '- C'~ C) 3. Closely Held Corporation, Partnership or ~ole-ProPrietorshjp 13) 4. Mortgages & Notes Receivable (ScheduleiD) (4) 5. Cash, Bank Deposits & Miscellaneous p~al Property (Sc:hedule E) (5) Z 5. Jointly Owned Property (Schedule F) (5) 0 o Separate Bifflng Requested i" i= :5 7. Inter-Vivos Transfers & Miscellaneous NoI'1-Probate Property (7) ::> (Schedule G or lo) , l- ii: 8. Total Gross Assets (total Lines 1-7) ~ W 9. Funeral Expenses & Administrative Costsj<SchedUIe H) (9) It: 10. Debts of Decedent, Mortgage Liabilities, ~ Liens (Schedule I) (10) , 11. Total Deductions (total Lines 9 & 10) r<~ ) ('-) . C) 8,288 16,241 12. Net Value of Estate (Line 6 minus Line t11) 13. Charitable and Governmental 8eqUest~SElC 9113 Trusts forv.t1ich an election to tax has not been made (SChedule J) " (7,953) o 14. Net Value Subject to Tax (Line 12 min~s line 13) , z o ;: .. .. ::> ... :Ii o <..> x .. to- SEe INSTRUCl1QNS ON REVE E SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spou..L tax rate. Of transfers under Sec. 9116 (a)(112) o o o o x .15 (18) x.O ~115) X.o 45 (16) o o o o o 16. Amount of Line 14 taxable at lineal rate) 17. Amount of line 14 taxable at sibling rmje 1 e. Amount of Line 14 taxable at COllatElfal!rate 19. Tax Out 20.0 x .12 (17) (19) CHECK HERE IF YOU ARE ~EQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 3W4645 1.000 Decedent's Complete Address: STREETAODRESS . 56 Peachyann Drive Cumberland CITY I STAlE TZlP Newville PA 17241- m i : Tax Pay ents and Cred ts 1. Tax Due (Page 1 line 19) 2. Credits/Payments A Spousal Poverty CredIT 8. Prior Payments C. Discount I , ~ I I (1) o o o o Total Credits (A + 8 + C) (2) o 3. InteresUPenalty if applicable D. Interest E. Penalty o o TotallnteresUPenalty (0 + E) (3) 0 4. If line 2 is greater than line 1 + 3, enter the difference. This is the OVERPAYMENT, Check box on Page 1 Line 20 to a refund (4) 0 5. It Line 1 + Line 3 is greater than 2, enter the difference. This is the TAX DUE. (5) 0 A. Enter the interest on the tax (SA) 0 8. Enter the total of line 5 + SA (58) 0 to: AGENT FOLLOWING QUESTIONS BY PLACING AN "X" IN TIlE APPROPRIATE BLOCKS 1. and: Yes No a. retain the use or of the property transferred;. . . . . . . . . . . . . . . D []g b. retain the right who shall use the property transferred or its income; . D []9 c. retain a interestor ........................ D [lg d. receive the for life of either payments. benefits or care? . . . . . . . . . D D 2. If death occurred December 12, 1982, did decedent transfer property within one year of death without receiving consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D ~ 3. Did decedent own "in trust for" or payable upon death bank account or security at his or her death? D ~ 4. Did decedent own Individual Retirement Account, annuity, or other non~probate property which contains a beneficia designation?..... . , . . . . . . . . . . . . . . . . . . . . . . . . 'D []g IF THE ANSWER TO ANY OF THE A OVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT PI> PART OF THE RETURN. Under penalties of perjury, I declare that I have &ltatni this retum, including accompanying schedules orld statements. and to the best of my Knowledge and belief, it is true, correct and complete. Declaration 0 reparer other than the personal repres ntalive is based on all information 01 which preparer has any knowledge ER50N RE PO FOR FIL RElURN DA 6/1/2005 Newville, PA 17241 DATE 6/1/2005 Roaq., Suite 3 Carlisle, PA 17013 For dates eath on or after July 1, 1994 and Ibefore January 1, 1995, the tax rate imposed on the net value of transfers to or for the use dthe surviving spouse is 3% {72P.S 916 (a) (1.1) (i)]. i r dates of death on or after January 1, 1995,1 the tax rate imposed 00 the net value of transfers tOOl' for the use cithe surviving spouse is 0% [72 1='.5. ~ 9116 (a) (1.1) (ii)J The statute does not exempt a transfer to a su~ving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still app6cable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of trans~rs from a deceased child twenty..one years of age or younger at death to arfor the use of a natural parent. an adoptive parent, or a stepparent of the child is 0% [72 P.S.~ 9111(a)(1.2)]. The. tax rate ~mposed 00 the net value of tran;t stoorforthe use of the decedent's I.in~ ~neficiaiesjS 4.5%, except as l1OI:ed i~ ~2 P:S. 6 91116(1.2) [72 P.S. ~9116(a)(1)J. The t.ax rate Imposed on the net value ~tran to?" for the use of the dececlenfs slblmgs IS 1~% (72 P.S. 13 9116(a)(1.3)). A Sibling IS defined, under Section 9102, as an indiVIdual who has at least one parent m com \Mth the decedent, whether by blood or adoption. 3W46461.000 REV-1S08 EX + (6-96l COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Charles R. Johnson FILE NUMBER 21 04 0633 lnclud~ the proceeds of litigation and the date the proceeds were received by the estate. All pro....irty jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Adams Electric Coope~ative Inc. 230 2 F&M Trust Company, checking account #33-25040 1,076 3 Misc. personal property: household goods, 199~ Jeep Cherokee, 1974 12ft. 'flat bottom boat, 1980 Windsor Mobile Home 6,982 3W46AD 1.000 TOTAL (Also enter on line 5. Recaoitulation\ $ (If more space is needed, insert additional sheets of1he same size) 8,288 REV.1511 EX+ '12.99) COMMONVvEALTH OF PENNSYLVANIA INl-eRITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Charles R. Johnson SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 2l 04 0633 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Egger Funeral Home 1,553 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Conjamissions . Name of Personal Representative(s) Social Security Number(s) t EIN Number of Personal Representative(s) - - Street Address City State Zip Year(s) Commission Paid; 2. Attorney Fees 750 3. Family Exemption; (If decede~t'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 71 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Cumberland Law Journal 75 2 Dehart's Auction Service 75 3 F&M Trust, researdh fee 5 Total from contin~ation pages 71 TOTAL (Also enter on line 9. Recapitulation) $ 2,600 3W46AG 1.000 (If more space is needed. insert additional sheets of the same size) Schedule H part 2 (Page 2) Estate of: Charles R. Johnson Item No. Descri.ption Amount 4 Register of Wills 5 The News-Chronicle Total CCarrv forward to main schedule) 15 56 71 REV.1512 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Charles R. Johnson SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 04 21 0633 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Andorra Radiology VALUE AT DATE OF OEA TH 23 2 Bronstein Jeffries PA 33 3 Capi tal One 1,327 4 Carlisle Regional Medical Center 2,432 5 Central Penn Medical -Group Emergency 774 6 Graham Medical Clinic 123 7 Lanc. HMA Phys. Mgmt. 238 8 M&T Bank, installment loan 4,575 9 MS Hershey Medical Center 1,346 10 RPC AssocjWalnut Bottom Rad. 188 11 Salzmann Hughes PC 200 12 Sears Card 2,069 13 Verizon Wireless 314 3W46AH 1.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 13,641 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECENING PROPERlY 00 Not List Trustee{s) Of ESTATE I TAXABLE DISTRIBUTIONS [inctwde outright spousal distributions, and transfers under SeC. 9116 (a) (1.2)J 1 Frederick E. Johnson 319 Center Road Newville, PA 17241 Brother 0 2 Vernon E. Johnson 171 CME Newville, PA 17241 Brother 0 3 Elizabeth N. Thomas 56 Peachy Ann Drive Newville, PA 17241 Sister 0 ENTER OOLLAR AMOUNTS FORi DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONSI A. SPOUSAL DISTRIBUTlONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II . ENTER TOTAL NON-TAXABLE DISTRBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0 REV-1513 EX... (9-00) SCHEDULE J BENEFICIARIES COMMON\t1JEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESrDENTDECEOENT ESTATE OF Charles R. Johnson FILE NUMBER 21 04 0633 3W46AI 1,000 (If more space IS needed. Insert additional sheets of the same sIZe) LAST WILL AND TESTAMENT I, CHARLES R. JOHNSON, of Upper Mifflin Township, Cumberland County, Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. ONE. I direct my Executor or Executrix, as the case may be, to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this Will, ~ hall be paid by the Executor or Executrix of my estate. Further, to the extent that sufficient assets exist in my estate, any and all inheritance or other estate taxes, whether to non-charitable or charitable beneficiaries, shall be paid by my Executor or Executrix from the residuary of my estate. TWO. My Executor or Executrix may, at his or her discretion, compromise claims, borrow money, retain property for such length of time as he or she may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as he or she may deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. I authorize and empower my Executor or Executrix to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufticient deeds and/or bills of sale therefor, in fee simple, as I could do if living. My Executor or Executrix is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said Executor or Executrix. THREE. I give, devise and bequeath all of my estate of whatever nature and wherever situate in equal shares to my siblings, VERNON E. JOHNSON SR., FREDERICK E. JOHNSON SR. and ELIZABETH N. THOMAS, per stirpes, which provides that the child or children of any deceased beneficiary shall take the share their parent would have taken if living. FOUR. I hereby nominate and appoint VERNON E. JOHNSON SR. to be the Executor of this my Last Will and Testament. In the event for whatever reason he is unable to serve as the Executor of my estate, then in that event I hereby appoint FREDERICK E. JOHNSON SR. to be the Substitute Executor of this my Last Will and Testament, whereby the said substitute personal representatives shall have the same powers as are given to the original Executor hereunder. FIVE. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty (60) days. SIX. No Executrix or Executor acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. SEVEN. No beneficiary may assign, anticipate or pledge its interest in any income or principal held or distributable hereunder, and no beneficiary's creditors may levy, at ach or otherwise reach any such interest. 2004. (SEAL) CHARLES R. JOHNSON 2 Signed, sealed, published and declared by the above-named person as and for a Last Will and Testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. I ~. CtV/fl\.A/l , .J ACKNOWLEDGMENT AND AFFIDAVIT WE, CHARLES R. JOHNSON, JAMES D. HUGHES and KAMELA S. COR."IMAN, the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn. do hereby declare to the undersigned authority t'lat the testator signed and executed the instrument as his Last Will, and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as a witness and ilia, '0 ilia b," on""" knowled" ilia .-, w"' "' ilia, <irj, ~ttrf(." ~' "' 01"", of w=d m'rnf ,rnf =,~ 00 00",",'0'", ""0' i'fl",",~ \?, l)'ll ~ 'M{I.~~ S R. JOHNSON ES D. HU~ES .s. LJLniYUU1 KAMELA S. CORNMAN COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by CHARLES R. JOHNSON, the testator herein. and subscribed and sworI). ~ before me by JAM D. HUGHES and KAMELA S. CORNMAN, witnesses, this ~day May,20 , .f COMMONWEAlTH OF PENNSYLVANIA NljIarial Seal Jacqueline L DIBwbaugh. Notaly Public Ca~isle lloIoJ Cumbef\and County MyCanm~Expi","Aug.14. 2007 Meml>e<.~_Ot- "_.",-+--_...-~-. 07/02/2004 14:37 FAX 717 245 2255 , RE/MJLl STERLING ASSOC. ~002 DeHart's Audion SePJice Appraisal 7/1/2004 ITEM AMOUt<lT gas heater S25.00 shoes $0.00 nd stand S10.00 in ens $5.00 ~ fans 55.00 ir cleaner $5.00 neadboard 52.00 'ishino rod 55.00 washer&dryer $125.00 win bed $25.00 !chest of drawers $25.00 !niaht stand $0.00 14 fishing rods S20.00 sectional $75.00 chair $0.00 2 bar stoo's " S20.00 ~S"t" $30.00 ~cr $10.00 W stand 520.00 ~orner stand $10.00 _I'ld stand 5500 amp $5.00 able lamp 510.00 ~nack trays 510.00 pictures $20.00 5 IK dinnette set $25.00 mise kitchen Goods 565.00 microwave S10.00 rhicken cooker 510.00 oaster O\t~n 55.00 1990 jeeD cherokee lilnted 4x4 54 000.00 1974 '2ft flat bottomi bass boat w/trailer $400.00 1980 windsor 2 bedrdom mobile home aslis $2.000.00 . CRAND TOTAL $6982.00 "THINKING AUCTION? THINK DEHARTS" Page 1 RE: CHARLES R. JOHNSON DATE OF DEATH 5-23-2004 ACCOUNT INFORMATION x CHECKING SAFE DEPOSIT SAVINGS __CERTIFICATE OF DEPOSIT SHARES OF STOCK DATE OPENED 5-23-2004 DATE CLOSED ACCOUNT NUMBER 33-25040 ACCOUNT BALANCE AT DATE OF DEATH ACCRUED INTEREST -0- TOTAL ACCOUNT BALANCE NAME(S) ON ACCOUNT REGISTRATION OF ACCOUNT STILL ACTIVE $1.075.74 $1. 075.74 CHARLES R. JOHNSON INDIVIDUAL ACCOUNT ACCOUNT INFORMATION CHECKING SAFE DEPOSIT SAVINGS ___CERTIFICATE OF DEPOSIT SHARES OF STOCK DATE OPENED ACCOUNT NUMBER ACCOUNT BALN"CE AT DATE OF DEATH DATE CLOSED ACCRUED INTEREST TOTAL ACCOUNT BALANCE NAME(S) ON ACCOUNT REGISTRATION OF ACCOUNT 08-22-2005 JOHNSON 05-23-2004 21 04-0633 CUMBERLAND 101 APPEAL DATE: 10-21-2005 ( See reverse side under Objections) A.ount 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 +- REY:is47-Ex-AFP-coi:osj-NoTIcE-OF-INHERITANCE-TAX-APPRAISEMENT:-ALLOWANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CHARLES R FILE NO. 21 04-0633 ACN 101 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE r. ' NOTICE OF INHERITANCE TAX BUREAU OF INOIVlDUAfVWI~')~n OFFiCE 0FAPPRAISENENT, ALLOWANCE DR DISALLOWANCE INHERITANCE TAX DIVISION. __v'.,... - ._~ "":" OF DEDUCTIONS AND ASSESSMENT OF TAX PO BOX Z8D60l " t HARRISBURG PA 171Z8-0601 2n~r; /'1:0. ")-0 PI-.' !,__: 21. U.;u ,',..~" 'i DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN r:! ;'::"i< I~:C opr~-~~f,:-,;I>: ,:: JAMES D ij\I~ES ESQ SALZMANN HUGHES 95 ALEXANDER SPRNG RD CARLISLE PA 17013 r,' ESTATE OF JOHNSON *' REV-1547 EX AFP (06-05) CHARLES R TAX RETURN liAS: I X) ACCEPTED AS FILED ) CHANGED DATE 08-22-2005 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..1 Est.t. (Schedule A) 2. Stocks and Bonds ISchBdu1. B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. HortgageslNotes Receivable (Schedule OJ 5. Cash/Bank Deposlt~isc. Personal Property (Schedule EJ 6. Jointly Owned Property (Schedule F) 7. Tr8nsfers (Schedule G) 8. Total Assets III (2) (3) (4) IS) (6) 171 .00 .00 .00 .00 8.288.00 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ada. Costs/Hisc. Expanses (Schedule H) 10. Debts/Kortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Govern..ntal Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 2,600.00 13.641. 00 Ill) (12) (13) (14) NOTE: I~ an assess.ent Nas issued previously, lines reflect ~igures that include the total o~ Abb ASSESSMENT OF TAX: IS. A.ount of Line 14 at Spousal rate (IS) 16. A.ount of Line 14 taxable at Lineal/Class A rate (16) 17. A.ount of Line 14 at Sibling rate (17) 18. A.ount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due T : NOTE: To insure proper credit to your account, s~it the upper portion of this for. with your tax paYlIIIIlt. 8,288.00 1;; 141 00 7,953.00- .00 7,953.00- 14, 15 and/or 16, 17, 18 and 19 Nill returns assessed to date. .00 X 00 = .00 x 045= .00 x 12 = .00 x 15 = (19)= + AHIlUNT PAID DATE NUHBER INTEREST/PEN PAID 1-) ~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION DF ADDITIONAL INTEREST. .00 .00 .00 .00 .00 .00 .00 .00 .00 I IF TOTAL DUE IS LESS THAN $1, ND PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CR), YDU NAY BE DUE A REFUND. SEE REVERSE SIDE DF THIS FORN FOR INSTRUCTIONS.) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/29/2006 HUGHES JAMES D 95 ALEXANDER SPRING RD SUITE 3 CARLISLE, PA 17013 RE: Estate of JOHNSON CllARLES R File Number: 2004-00633 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 5/23/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/29/2006 JOHNSON VERNON E SR 171 C M E NEWVILLE, PA 17241 RE: Estate of JOHNSON CHARLES R File Number: 2004-00633 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 5/23/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel STATUS REPORT UNDER RULE 6.12 Name of Decedent: CHARLES R. JOHNSON. Date of Death: May 23~ 2004 No. 21-04-0633 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 X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: OS/24/2007 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No 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 No d. Copies of receipts, releases, joinders and ~rovals of formal or informal accounts may be filed with th eJ;l( of;brphan's Court and may be attached to this repoJ7-""'- ../ " Date: 4/25/06 SALZ~ANN HUGHES PC J es D. Hu hes Es uire ame (please type or print) 354 Alexander Spring Road~ Suite 1 Address Carlisle~ P A 17013 City, State, Zip (717) 249-6333 Telephone Number II :6 fUt 'or L2 i!clU 0.')01112 -'-l" }Ij x Personal Representative Counsel for Personal Representative Capacity: (} ~ Pa O.c. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: CHARLES R. JOHNSON Date of Death: MAY 23. 2004 File No. 21-04-0633 Pursuant to Pa.O.C. Rule 6.12, 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 D No 2. Ifthe answer is NO, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is YES, state the following: a. Did the personal representative file a final account with the Court? ........................................................ DYes 5l'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? ........................ tsfies D No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cler Orphan's Court and may be attached to this report. Personal Representative 'ji'counsel Date: 3/5/07 co ~. -' co :2 1.0 I ZMANN HUGHES PC James D. Hughes. Esquire Name (please type or print) 354 Alexander Spring Road. Suite 1 Address Carlisle. P A 17015 City, State, Zip (717) 249-6333 Telephone Number r- (':7::'1" r:.:.....J ,,----...l