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HomeMy WebLinkAbout04-0635PETITION FOR PROBATE and GRANT OF LETTERS Estate of' ~a~¢~ ~. Lou~rt~,e._ also known as No. Deceased. Social Security No. ~ .7~.- ~.g -3. ~q ~ The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut ~ t ~ in the last will of the above decedent, dated IxAa, rcbx Ij I~ttO and codicil(s) dated To: Register of Wills for the County of (u,~e~-Iq~ Commonwealth of Pennsylvania in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in (_vwlao, la~ , County, Pennsylvania, with h 4~V' last fam. ily or p~nci~al residence at ~0~ t~I pA ~ '~.e,o ~ ~o~,+~, ~-~,, (list street, number and muncipality) Decendent, then '7 3 years of age, died ..~v,~ Except as follows, decedent did no¥ marry, was not divorced and did not have a child born or adoptec~ after execution of the wi}l offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: I~cl t.vTo~'r Ma,~. S/'r~e~- 0jexl~[- {01 WHEREFORE, petitioner(s) respectfully request(s) th.e probate of the last will and codicil(s) presented herewith and the grant of letters '[es~o,~e~-~W)r- theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF,PENNSYLyANIA h COUNTY OF ~~A::~c-(C~v,,& . f ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as~onal represen- tative(s) of thc above decedent petitioner(s) will well an~uly adminis~he est~cording to law. Sworn to or a ffir~ and subscribed c ~~ ~ before ~ this ~, day of [ / ' - ~ "-~ ~' · ~ ~~ ~ ~ ~ J// . -~ ~ ~ Estate Of No. DECREE OF PROBATE AND GRANT OF LETTERS ,, Deceased AND NOW the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated ,.~ - described therein be admitted to probate and filed of record as the last will of are hereby granted to .~zr--x~ ~(~ C , in consideration of the petition on FEES Probate, Letters, Etc .......... Short Certificates( ) .......... Filed . ..--~...--.~. 7. Register / '~- ~ ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE OATH OF SUBSCRIBING WITNESS Estate of Nancy J. Loughridge No. ~-~' also known as , Deceased Gerald K. Morrison and Tamatha R. Kauffman (each) a subscribing witness to the ~ codicil(s) (~ will(s) presented herewith, (each) duly qualified according to law depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and that she/he/they signed as a witness at the request of the Testator(rix) in hedhis/their presence and~ in the presence of each other I~ in the presence of the o.tl)er.s~ bscribing witness(es). ~/' ' ~/(S~gnature) Gerald K. Morrison Landisburg / PA 17040 / (Address) Tamatha R. Kauffman Loysville PA 17047 (Address) Sworn to or affirmed and subscribed before me this "7`/4'- day of N ot~,.~ ~ublic My Commission Expires: I NOT~SEAL I I I ~ ~., ~R~ COU~ I ~ ~N ~IR~ MAY 3. ~ (sionature and seal of ~ota~ or ot~er NOT~: To be take~ bY o~cer authorized to ~dmJflister o;ths. Pie;se have o~ci~l qualified to administer o~t~s, S~ow present the orioJn~l or cop7 of instrument(s) ~t ti~e of no~rization. date of expiation of ~ota~s commission,) RW-2 his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local 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 No. Local Registrar dUN 3 0 7_004 Date ~43 Rev. 2/a7 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH STATE FILE NUMBER NAME OF DECEDENT (First, Middle, Last) I SEX ~ SOCIAL SECURITY NUMBER I DATE OF DEATH (Month, Day, Year) I. Nancy J. Loughridge [2 Female 13 272 -- 28 --2893 14 June 27, 2004 AGE (Last Bbthdey) I UNDER 1 YEAR UNDER 1 DAYI DATE OF BIRTH I m~THm AK.= ,r-;~.... ID: ............. ' .. I I Mo'nthS I Days I Ho,am I Mmules ] (Month, Day, Year) I State or F~'eign Counlr/) I HOSPITAl.. ~1~ , 73 m. I I I I 1_9-30-1930 I Beaver Falls.PAl..~...I-] E~O.,.,..[::] DoAI--I ~'OUNTY ....... i I I I I'. . It. --I".. J ur ur-m r~ I CITY, BORe, TWp OF DEATH I FACILITY NAME (If riel institution, give street and number) IWAS DE~.~mOENT OF HIspANIc ORIGIN? IR~CE - Amedcan Indian. Black. Whit~ s~ Cumberland L Carlisle I Sarah Todd Nursin~ Home lee. lsd o t .ex,can, ,-~e.o ,..c,,n, e,c. t Wh i t e DECEDENT'S USUAL OCCUPATION ' I I), ~ tO. I KIND OF BUSINESS / INDUSTRY )~VAS DECEDENT EVER INI DECEDENPS EDUCATION I MARITAL STATUS - M&,,;~. ] SURVIVING SPOUSE (Give k~4 ~ wo~ dm~ durkng moat IU.S. ARMED FORCES?.~u'(S~cffy only h~hell g~adl completed) I Never Manied, WId~ved, .,. Librarian I.,. University / Yesr-] Nor-d,'~I El*~,~ary/S,co~d,~ I . C~,p I Oivo~cadlSpec~) hz ~ ~ Il,. zzl~m I/ i,-~., 1,4. Never Married ,~. DECEDENI'S blAILING ADDRESS (Street. City/Town. State. Zip Code) I DECEDENI'S IACTUAL ¶Ye. Stat, PA o~ ~7c. [~'~Y~,.dec~entav~ Tyronn¢ 149 East Main Street IRESIDENCE decedent twp. ! (See instructions live in · ~S Walnut Bottom, PA 17266 I°"°m'r~de) a?~. coun~Cumberland tow~h~? ~?~.[] No. decedem,v,~ · within actual #mile o~ FATHERS E (Rr~ Mk~ La,t) M ~ N~I ~ , ~ -~ ] OTHER'S NAME (Fks[ Mh~d~e. Maffien Surnarne) dry/bore. [] ~. William t~. Lougnr~(tge ~,. Ruth Louthan "J METHOD OF DISPOS ~ON ~ 12Oh. ~1 Hammond t~oao, wainut Boolean, PA 17266 Wry. ,~..r-I euda~ C I--1 {~DA~TiE.O.F.?.S_,POSmON {PLACEOFDIS?$1TION-.Na. meotC~emetar/ Crematan/~ ILOCATON.Cfly/Tow~ State ZipCode __.eUo~,_.~ [] rematk:m [~emovalfromStale ~ I( th'Oa-~Ye"~-~/1 ~ /'"~/'~ I°r Other Place I.~remaElon ~;oc-i~t-'~ c~- ~ ' ' ' I-=. PA Cremate;y- --' ~' I"". Harrisburg, PA 17109 m~ I~L_G _~ OF FUNER/d. SEJ~VI~ UCENSE~E~R PEP~ ACA'ING AS MILCH ~ I LICENSE NUMBER I NAME AND ADDRESS OF FACILll'~.r ama t~ on l. .100 Jonesto.n oa . ,a== s6urg pA 7109 Comple · items 23a-c on~ when ~d~ylng ~ "re'he best o~ knoMed :'~;ath ' , (.JmJ physician II nol available at time of death to { 'S~natu,- _o~_~my_~_. ge .... d al the time, date and place slated. LICENSE NUMBER IDATE SIGNED ~i~ced~ycaaofdeath' i~ ,v ~-~.~?~/ .~ y, .. -- , -- liMe. th, Day, Year) . ...... ,, .h. --a 7--O7 ~ . ~ 2 I I DATE PRONOUNCED DEAD (Month. Day Year) ' WAS CASE REFERRED TO A iVIED EXAMINER ~pereon who pronouncee death. ~ /~ · __ . A MEDb~ /CORONER? UM easy g,~e ~m~me o~ emeh li~,e. ." Appn3xlfnataPANT I1: Other slgniltr..an~ com~ms co~tdbut~g to death, but , interval be~vean IMMEDIATE CAUSE (Final DUE TO (OR AS A CONSEQUENC~ O~: / Sequ~ ,,-* ax-,dibo~ bm : Enter UNBERLYING = end death not resulting in the unden'ying cause given in PART I. resulting o~ de. th ) LAST · , WAS AN AUTOPSY I WERE AUTOPSY FINDINGS I MANliER OF DEATH I DATE OF INJURY TIME OF INJURY I INJURY AT PERFORMED? I AVAILABLE PRIOR TOi _ ~ . I (Mo~l~, Day, Year)I I IOFI COMPLETIONDEATH? OF CAUSE II Nalural~ Homicide --ir-] I · ,I I I ~ /~'"' [] P.ndin0,.v..,o.~. []l I I Yes [] NO [] I ..- I ..~. -- I I"~&°.~,'~,~' Al, .... ,.,m..~.t, ,.c~. o..~ ~OCAT,O. (S~eet. Ci..o~, S.to) CERTIFIER (Check only one) ' , ... I .... SIGNATU~IE AND TITLE OF C IFIER ~oERthTelFIYI~ImNIGoFHm~"~InCo WI wA~le~Be~edC~jUusee t°~o tdl~ea~e uW~h~ ==,:~a~$rmP~= yslcle~ h~. ,~ mn~ n~ ~ th and ~m~eled it~ 2 3 ) r-- :)~ ~ ~d~l, , .. __a..er a...e ................................................................. I_ ~ .<=r~. ~-. '-. 'PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both p~onounc~g death and certJfylno to causB o! deeth~ LICENSE NUMSER DATE~IGNED (Month, DeV, Year To the belt of my knowledge death occurred el the time date and lace and due to the c~ul ) ' . , p . ,,I,) ,,d m,,;~,* ,, ,,.led ...................... I-- 31~ '(V,"O OL%'4.'-{t *MESCAL EXAMINE~CORONER ,AME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH On the balls of oxamlfletlon and/or InvalUgatlon, In my opinion, death o~curred mt tbe time, date, and place, and due to the CBUIII(I) ln~ -- (Item 27) Type or Pdnt /'~ "~"~" 'to"~ ............................. - ........................................................I__1 C~C., ~)~. ~'- REGISTRAI~ 8IGNATUR~.,~D.I~--~< DAlE FILED (Month, Day, Year) LAST WILL AND TESTamENT OF NANCY J. LOUGHRIDGE I, NANCY J. LOUGHRIDGE of R. D. #1, Stonehouse Road, Green Park, Perry County, Pennsylvania, being of sound and disposing mind, memory and understanding do hereby make, publish, and declare this my Last Will and Testament, hereby expressly revoking all other writings in nature testamentary by me at any time heretofore made. FIRST: I direct that all my debts and funeral expenses be paid as soon after my decease as may be practicable. SECOND: I direct that inheritance tax on property disposed of herein, shall be paid from my residuary estate. THIRD: I hereby give, bequeath and devise all the rest and residue of my estate and property, real, personal and mixed, of whatsoever nature and wheresoever situated, of which I may own aX the time of my death, or to which I may be entitled or of which I may have the right to dispose at the time of my death, including my share of the sale proceeds of The Tannery, to my Friend, Joan M. Covey of 41 Hammond Road, Walnut Bottom, Pennsylvania, if she is living at the time of my death. FOURTH: In the event that Joan M. Covey is not living at the time of my death, or in the event that she and I shall die NANCY°J. LOUG~RIDGE Page one of two (SEAL) simultaneously, then I give, bequeath and devise all my property to The Helen O. Krause Animal Foundation, Inc. of P. O. Box 311, Mechanicsburg, Pennsylvania. FIFTH: I hereby appoint my Friend, Joan M. Covey as Executrix of this, my Last Will and Testament, but in the event that she is unable or unwilling to serve, I then appoint Financial Trust Corp as Executor of this, my Last Will and Testament, and I direct that they shall not be required to give bond or other security in any jurisdiction wherein proceedings may be held in connection with my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 1st day of March, 1996. WITNESS: NANCY% J. LO~GHR~DGE (SEAL) Page two of two CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Nancy ~J. Louqhridqe Date of Death: 06/27/2004 Estate No. SSN: 272-28-2893 File No. Date Letters Granted: 07/08/2004 To the Register: Will No. 21-04-0635 2004-00635 '04 / U6 17 P3:24 I certify that Notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on N/A Address Name Executrix is sole Beneficiary. Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: 08/13/2004 Capacity: Personal Representative X Counsel for Personal Representative Continued on a Separate Page (Signature) Scott W. Morrison, Esquire Name (Please type or print) 4 West Main Street Address P. O. Box 232 New Bloomfield PA 17068 Telephone No. (717)582-2300 LAW OFFICES SCOTT W. MORRISON CENTER SQUARE, P.O. BOX 232 NEW BLOOMFIELD, PA 17068 TELEPHONE: 717-582~2300 FAX: 717-582-4220 September 23, 2004 Cumberland County Courthouse Register of Wills 1 Courthouse Square Carlisle, PA 17013-3387 Re: Estate of Nancy J. Loughridge No. 2004-00635 Date of Death: 6/27/04 To Whom It May Concern: I enclose herewith a check in the amount of $4,000.00 for payment of estimated inheritance tax on the above estate. Very truly yours, Scott W. Morrison, Esquire SWM:trk Enclosure SCOTT W. MORRISON, ESQUIRE CENTER SQUARE P 0 BOX 232 NEW BLOOMFIELD PA I?OEE CUMBERLAND COUNTY COURTHOUSE REGISTER OF WILLS 1COURTHOUSESQUARE CARLISLE, PA 17013-3387 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 2BO601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 0O4431 MORRISON SCOTT W ESQ P O BOX 232 NEW BLOOMFIELD, PA 17068 fold ESTATE INFORMATION: SSN: 272-28-2893 FILE NUMBER: 2104-0635 DECEDENT NAME: LOUGHRIDGE NANCY J DATE OF PAYMENT: 09/27/2004 POSTMARK DATE: 09/24/2004 COUNTY: CUMBERLAND DATE OF DEATH: 06/27/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4,000.00 TOTAL AMOUNT PAID: $4,000.00 REMARKS: SEAL CHECK# 99 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-1500EX + (6.-00) . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 NAfv REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21-040635 COONTYCOi5E -YEAR- - - 'imimR-- I- Z W C W U W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DATE OF BIRTH (MM-DD-Year) SOCIAL SECURITY NUMBER 272-28-2893 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WillS SOCIAL SECURITY NUMBER w !;;: ",_Ol u"'''' w"u ",00 U"'''' "10 .. .. 06/27/2004 09/30/1930 (IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) N/A [X] 1. Original Return D 4.lirnited Estate [X] 6. Decedent Died Testate (Attach copy ofWlU:) D 9. litigation Proceeds Received D 2. Supplemental Retum D 4a. Future Interest Compromise {date ofdea!tl afler12-12-82) D 7. Decedent Maintained a living Trust {Attach COjlyofTrust) D 10. Spousal Poverty Credit (date ofdealh between 12-31-91 and 1-1-95) D 3. RemalnderRetum (dateofdealhprioftol2-1.l-82) D 5. Federal Estate Tax Return Required Q.. 8. Total Number of Sare Depos. Boxes D 11. Election to tax under Sec. 9113(A) (A"'"". 01 THIS SECTION MUST BE COMPLETED. ALLCORRESI'ONIlENCE ANDCONFIDEN ALAr~'INF'ORMATlON SHOULD BE. DIRECTED TO: NAME COMPLETE MAILING ADDRESS Scott W. Morrison Es uire FIRM NAME (If Applicable) I- Z W o z o .. Ol W '" '" o u P. O. Box 232 55,677.60 PA 17068 ~ OFFICIAL USE ONL y~ x) r'\ (\ N i\ 3 o - C j\ n C {, C! _' 0 !l +-' "'1 ~ t .., 7' ,~ " J:>oc ~ 0 1J "0 1"\' 70 S f " p- O "'D 0<) ;: 'to ~ ;: u *' 2 68,893.06 z o ~ ...J ~ l- e:: <( u W 0:: z o ~ I- ~ II.. ::i!i o U ~ v TELEPHONE NUMBER 717 582-2300 New Bloomfield 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partne"hip or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly OWned Property (Schedule F) (6) o Separate Billing Requested (1) (2) (3) (4) (5) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1.7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus line 11) 13. Charitable and GovemmentalBequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 13,215.46 X _(15) X _(16) X .12 (17) 15,013.72 X .15 (18) 2,252.06 (19) 2,252.06 14. NelValue Subjectt. Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, ortransfe" under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Une 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. [8] CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWERALlQUESTIONSONRINERSE SIDE AND RECHECK MATH < < (8) 2,043.00 51.836.34 (11) (12) (13) 53,879.34 15,013.72 (14) 15,013.72 Decedent's Complete Address: STREET ADORESS 149 East Main Street ~ CITY Walnut Bottom I STATE PA I liP 17266 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 2,252.0& 4.000.00 112.60 3. InteresUPenalty if applicable O. Interest E. Penalty Total Credits (A + B + C) (2) 4,112.60 T otallnteresUPenalty ( 0 + E ) (3) 4. If Line 2 is 9reater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Llna 20 to request a refund (4) 5. If Line 1 + Une 3 is greater than Line 2, enter fhe difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Une 5 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or Income of the property transferred: ........................................................................... 0 00 b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 00 c. refain a reversionary interest; or ...................................................................................................... 0 00 d. receive the promise for life of either payments, benefits or care? ............................................................. 0 00 2. if death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?.............. ...................................................... ........................... 0 00 3. Did decedent own an 'in trustfOf' or payable upon death bank account or security at his or her death? ................. 0 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which conlains a beneficiary designation? ....................................................................................................... 0 00 1,860.54 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. f)-oS- PA PA 17068 For dates of death on or after July I, 1994 and before January 1, 1995, the tax rate imposed on the net vaiue of transfers to or for the use of the surviving spouse is 3% [72 P.S. S9116 (a) (1.1) (i)]. For dales of death on or after January I, 1995, the tax rate imposed on the net value oltransfers to or for the use olthe surviving spouse is 0% [72 P.s. ~9116 (a) (1.1) (ii)]. The statule does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the nel value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. S9116(a)(I.2)]. The tax rate imposed on the nel value of transfers to or for the use of the decedent's lineal benefiCiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1 )]. Thetax rate imposed on the net value of transfers to or for the use of the decedenfs siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Seclion 9102, as an individual who has at least one parent in common with the decedent, wilether by blood or adoption. 'EV""EX.i1.:I. COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Louohridoe Nancv J 21 04 0635 All real property owned 101e1y or as a tenant in common must be reported at fair market value. Fair marKet value is defined as the price at which property would be exchanged between a wiDing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is jolntly-owned with right of survlYorshln must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Frame dwelling situate in South Newton Township. Cumberland County, Pennsylvania _ assessed value $50,160.00 x common level ratio 1.11 = $55.677.60 - See Cumberland County Record Book 259, Page 1403; being Tax Parcei No. 41-31-2230-062 VALUE AT DATE OF DEATH 55,677.6Q TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 55 677.60 "'''"'''.:'''' '* COMMONWEAl1H OF PENNSYLVANIA INHERJTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK OEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER LOlJohridoe Nancv J 21 04 0635 Include the proceedS of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of ,uN!'Io"hlp mlllt be dilc\o$ed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 17.99 M&T Bank individual account 2. Orrstown Bank Account #103800091 8,677.97 3. Orrstown Bank Account #103004359 4,519.50 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, Insert additional sheets of the same size) 13215.4Q .~EV'''''EX'{';''{. COMMONWEALTH OF PENNSYLVAN<A INHEmTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Louohridae Nancv J 21 04 0635 Debts of decedent musl be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES 1. 8. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Numbe<<s) I EIN Number of Pernonal Representative(s) Street Adcress City State Zip Year(s) Commission Paid: 2. Attomey Fees Scott W. Morrison 1,900.00 3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Glenda Farner Strasbaugh 143.00 5. Accountanfs Fees 6. Tax Return Prepare(s Fees 7. , TOTAL (Also enter on line 9, Recapitulation) $ 2 043.00 (If more space is needed, insert additional sheets of the same size) """"EX:""'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT ESTATE OF Louahridae Nancv J. Include unreimbursed medical expenses. ITEM NUMBER SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER 21 04 0635 1. The Sentinel - estate advertising OESCRIPTION 2. Pharmerica - account 3. Sarah A. Todd Memorisl Home 4. TIM-CREE Assoc. 5. Cumberland Law Journal 6. Orrstown Bank - mortgage #3000173 L - See Cumberland County Record Book 1835, Page 4750 7. Refund Social Security Check AMOUNT 156.83 7.95 1,551.43 914.70 75.00 48,378.43 752.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 51 836.34 REV.,513EX:I* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER , .. , ?1 nil M"''' RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE L TAXABLE DISTRIBUTIONS (indude ou~~rt spousal d~lributions, and transfers under Sec. S116 (a (1.2)) 1. Joan M. Covey None 100% 41 Hammond Road Walnut Bottom, PA 17266 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. , TOTAL OF PART II - 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) FacetWin Screen Print for recdeeds, from "CAMA_Loginll 7/8/2004 12:08:10 PM CUMBERLAND COUNTY ASSESSMENT OFFICE NEIGHBORHOOD: 41 CONTROL # 41000423 1 PARCEL: 41-31-2230-062. I SPEC ID: LOT: ~ Tback: DISTRICT: 41 - SOUTH NEWTON TOWNSHIP SD: I I IShort Name ILAST NAME I FIRST NAME Ic/o NAME IADDRESS1 IADDRESS2 IpOST OFFICE: ISTATE & ZIP: I LOUGHRIDGE, NANCY J LOUGHRIDGE NANCY J I PROPERTY TYPE: R I I SALES DEED BK/PG.....00259-01403 DATE OF SALE...09/15/2003 SELLING PRICE: 63000 149 EAST MAIN STREET WALNUT BOTTOM PA 17266 Situs: 149 E MAIN Prop Descrip.: LAND DESC: LAND LAND USE TYPE: DEEDED ACRES: STREET I CURRENT VALUES I J Assessed Fair Market t, FMV - 50160 L - 14000 I C&G - B - 36160 I approved? -> T 50160 I 101 .36 Screen 1 Number -Switch Down Arrow -Next Enter Selection > Screens, X -Exit, J -Jump Mode, Entry, Up Arrow -Previous Entry, Record: 75138 F -Forms, I -Image ? -Screens, B -Browse ~u7&;3 Act Q(Yl5 ". :~EGLEf: '" ;.:"'~.~:.)r l)EED~.~ "U"\LANll COUNTY":' '03 SEP 15 ArllO 57 Till< Porcel Number. 41-31-2230-062 THIS DEED MADE this -ti!!!- day of 5-(~i ho/! ~-I'A,- ,2003, BETWEEN WAYNE L. LAUTSBAUGH and STACEY A. HOCKENBERRY, now by marriage STACEY A. LAUTSBAUGH, husband and wife, of 15368 State Highway 27, Cadott, Wisconsin, acting by and through HAMILTON C. DAVIS, as Agent under Powers of Attorney, GRANTORS", AND NANCY J. LOUGHRIDGE, of 149 East Main Street, Walnut Bottom, Pennsylvania, "GRANTEE". WITNESSETH, that in consideration of the sum of Sixty-Three Thousand ($63,000.00) Dollars, in hand paid, the receipt whereof is hereby acknowledged, the said GRANTORS do hereby grant and convey in fee simple to said GRANTEE, ALL the following described real estate lying and being situate in South Newton Township, Cumberland County, Pennsylvania, more particularly described as follows: BEGINNING at a point in the center of the Walnut Bottom Road, or state Highway #33 and on the line of the lot now or formerly of Samuel Bowers, Jr.; thence Southerly along said Bowers land 209 feet, more or less, to an iron pipe at corner and land of W. S. Meals and S. Alba Meals, his wife; thence Easterly along said Meals land 75 feet to a stake at corner of said Meals land; thence Northerly 209 feet, more or less, to the center of the Walnut Bottom Road or State Highway #33 aforesaid; thence Westerly along the center line of said Highway #33 75 feet, more or less, to the corner of said Bowers land, the place of BEGINNING. CONTAINING 6 perches, more or less. UNDER AND SUBJECT to a setback line along the Walnut Bottom Road frontage 25 feet back from the'side of the road and no structure or building shall be erected between the setback line and the Road. BEING the same premises conveyed by John K. Lautsbaugh Sr., a.k.a. John K. Lautsbaugh, widower and single man, by deed dated April 7, 1989, and recorded April 10, 1989 in the Office BOOK 259 P,ICE1403 . . of the Recorder of Deeds of Cumberland County, Pennsylvania, in Deed Book "W", Volume 33, Page 691, unto Wayne L. Lautsbaugh and Stacey A. Hockenberry, now by marriage Stacey A. Lautsbaugh, husband and wife, the GRANTORS herein, Hamilton C. Davis is acting as Agent under Powers of Attorney from the GRANTORS dated July 18, 2003 and intended to be recorded immediately prior hereto. AND, the said GRANTORS hereby warrant specially the property herein conveyed, IN WITNESS WHEREOF, the said GRANTORS do hereby set their hands and seals the day and year first above written. Witness; ~~~~ \~- tJ~~ L. 4.~b'\",L(SEAL) W A . LAUTSBAUGH By; Agc;pt 51+<- Jl+ . A . (SEAL) ST . HOCKENBERRY, now~Ym/ 'age STACEY A. LAU~SBAUGH By; ~ r. ;;- \\gent un er 'owef of Attorney c;'9991>t9"'lOl!l!l~lOll'il ~ ~ '" ...." ga~a."~~gj C> gjgj !: on Ii ~ , , lti ~:"':Ii~~~~t:.~ "'" ... 'I!. ~ ~ iillJ!lII!lJ! ...~ ifi~~ :5 .. ..... ItXJ c;r.. -.l ~ :.... !i U) ...... ..... .. '"'" a. =1 , 1 . .... 5l ... ~g """__ --I .. lie..... J6 ;;l ;;"" ~ l'l on <= ..,.'" .="." - '" ... 21< . "" ~ '"'" ~, . ;!l. ii... . ... ~l'! .... '" - kJl .".... - :::.:,.,.. .... 25:1 fACE14.04 ~ ~ ~.... BOO~ => .... ... '" .... "" :!!:. ~ ~~ ~ '""''"'''~ - . . ......t-'o_...... ::: '? _ ....,....,,__IC.'I~ .." ~g~gggg~gg8~~ ii! - .... COMMONWEAL 1H OF PENNSYL VANIA: : ss. COUNTY OF CUMBERLAND On this the l~ day of 5,.PkJ.... 2003, before me, the undersigned officer, personally appeared HAMIL TON C. D~ under Powers of Attorney for WAYNE L. LAUTSBAUGH and STACEY A. LAUTSBAUGH, known to me (or satisfactorily proven) to be the whose name is subscribed to the within instnnnent, and acknowledged that he executed the same for the purposes therein contained, as and for the acts of his principals. WITNESS my hand and official seal the day and year first above written. . i<4"? ,ji>~~ '~,~~ AB:.~i<'!';'".",. .... ~i~~"'~',if::-,~~?'" :::;A~'t,~ 't":~t..~,.,\ ~,J\-':',<_;; -'Y.:~sr'::,'; . ~ <'!(~~~ .' , . a" ,ijt .,,11), , , ':..,~~:: _'?' \ .:>'-/1/ ;_ :'<>'~;~,:.,~. ~~ Notary Public (SEAL) Notarial Seal . H. Anlhony Adams NotlU)' PubU Sh!ppcnsbura Bora C'um"-"--d C C MyCo .. " 1."1:"<<111 t?~lUy mmll..Iot1 ExP1fCI Mb:y IS. 2006 MIInllor'~Ia~",No_ d', I do hereby certify that the precise residence, and complete post office ad!iresl! of the ~itbin named GRANTEE is: I '11 Pc<~<!- f'ro.o., "" ~1 Wo.tl.Ju.t &.lCrr-, l-t... u ~ I)PVb ~..\ \0 ,2003 C) Attorney for HlllI1i1ton C. Davis, Esq. PO Box 40 Shippensburg, PA 17257 (717) 532-5713 1 Certify this to be recorded III Cumberland County PA ,,--.~~r' ~/'" , ".-;: '~; BOO~ :C59 "ACE1405 Fecorder of Deeds 3 ~ M&fBank Manufacturers and Traders Trust Company. 960 Walnut Bottom Road, Carlisle, PA 17013 717 240 4524 FA.x?1? 2417761 8/27/04 Scott W. Morrison Center Square P.O. Box 232 New Bloomfield, P A 17068 Dear Sir: In response to your letter regarding the Estate of Nancy 1. Loughridge, I can tell you that Ms. Loughridge had one open account with M & T Bank at the time of her death. It was an individual account, opened on 8/1111986. On 6/27/2004 the account had a balance of $17 .99. If I can be of further assistance, please call 717-240-4524. Thank you. Sincerely, -r A-,., '''''''Y Tim Parry Assistant Manager Stone hedge Branch 8/18/04 ;'ANCY J LOUGHRI DGE Closed Messages Last stmt balance: Current balance: l~View 6=Print T~Tset Posted Check No S 3/09/04 P 3/10/04 3/10/04 4/11/04 4/11/04 5/10/04 5/10/04 6/10/04 6/10/04 7/11/04 7/11/04 7/19/04 7/19/04 7/19/04 ~ ORRSTOWN BANK Deposit Inquiry Account number: P P .00 .00 TIc AFF 020 C B 160 C B 151 C I 160 C B 151 C I 160 C B 151 C I 160 C B 151 C I 160 C B 151 C I 160 C B 050 D C 151 C I F4~Redisplay F7~Scan forward F16~Sort F17~Top F18~Bottom Last stmt Statement Control: From Debit 8,677.97 F8~Scan backwards F20~Unfold date: cycle: To Credit 1,087.00 4.22 .7000% 5.30 .7000% 4.81 .7000% 5.13 .7000% 5.15 .7000% .66 .0000% F11~Prior bal F22~T/C 14:49:10 103800091 1 of 1 8/10/04 - 10 Balance 8,652.70 8,656.92 8,656.92 8,662.22 8,662.22 8,667.03 8,667.03 8,672.16 8,672.16 8,677.31 8,677.31 l~,677 .97) .00 .00 Bottom F15~EFT F23~Checks 8/18/04 'JANCY J LOUGHRIDGE Closed Messages Last stmt balance: Current balance: :=View 6=Print T=Tset Posted Check No S 6/15/04 189 P 6/16/04 190 P 6/28/04 T 6/29/04 191 P 6/30/04 192 P 7/01/04 C 7/01/04 F 7/02/04 C 7/06/04 193 P 7/11/04 7/11/04 7/19/04 7/19/04 7/19/04 ~ ORRSTOWN BANK Deposit Inquiry Account number: P P .00 .00 T / C AFF 091 0 B 091 0 B 223 C B 091 0 B 091 0 B 163 C B 146 0 B 163 C B 091 0 B 160 C B 151 C I 160 C B 050 0 C 151 C I F4=Redisplay F7=Scan forward F16=Sort F17=Top F18=Bottom Last stmt Statement Control: From Debit 29.78 32.78 26.49 12.32 477.60 2.05 4,519.50 F8=Scan backwards F20=Unfold date: cycle: To Credit 10.50 914.70 752.00 .32 .1000% .05 .0000% F11=Prior bal F22=T/C 14:48:56 103004359 1 of 1 8/10/04 - 10 Balance 3,393.17 3,360.39 3,370.89 3,344.40 3,332.08 4,246.78 3,769.18 4,521.18 4,519.13 4,519.45 4,519.45 (4,519.50..) .00 .00 Bottom Fl5=EFT F23=Checks \y':/IJ " J-d.a.rn.5 .. SD 701 RECORDATION REQUESTED BY: ORR8'TOWN BAlIK ICINQ STREET OFFICE T7 EAST KINO STREET P 0 lOX 2150 SHIPPENSBURO, PA 17257 .:.~-:- ,~. ZIEGLEr. '. ~C'_:\;)f DEE% ,:-'LMH) COUNTY-" WHEN RECORDED MAIL TO: ORlIstOWIl BANK P.O. BOX 250 SHlPPENSBURG, PA 11257 .~3 SEP 15 Rr110 57 SEND TAX NOTICES TO: ORRSTOWN BANK P.O, BOX 250 SHIPPENSIlUIIG, PA 1=7 [Space Above ThIa Una For Recording Data] MORTGAGE DEFINmONS Wordo used In mulllPe sectionl of IhI8 docUll14W 8nI _ below end _ W<Xd8 8nI dellned In Sections 3, 1,. 13, 18, 20 and 21. CenaI\ rues regsrdk\g \he uoage 01 wonls used In 1hI8 document.... 0180 provJcled In SectIon le. (A) '8<<urlly 1"*"_' """'"" lhI8 document, which Is dated September 10, 2OO3,Ioge1hsr wiIh all RIdel1l to IhI8 document. (II) 'Bon"..' Is NANCY J. LOUGHRIDGE. Bomlwer 18 !he rnoItgsgc< under II1Is Security Inslnlnsnt (C) '1Ander' 18 ORRSTOWN BANK. l.8nder Is I organized end exi8ll'1g under !he laws of Pennsylvanl8. Lsnder'1 addf880 18 KING STREET OFFICE, n EAST KING STREET, POBOX 250, SHIPPENSBURG. PA 1=7. L8nde< Is !he mot1gagee under Ihls S8CIlI1ty Instrument. (0) .~. meens \he proml88ory nota 191ed by Borrower and dated S8p1ember 10. 2003. The No1e ltalas tI1et Bomlwer owes Lender Fifty Thousand FOUl Hundred 1Io 001100 0ol8l8 (U.S. $50.400.00) p1UI 1nl8r88t Borrower his promlaed to pay II1Is debt In Iegular PerlodIc Payments end to pay Ih8 d8bl in full notJater II18n 0cIllb8r " 2018. (E) .Property' means lI1e property tI1et Is described below under \he ~ 'Tranafer of Rlglta In \he Prcpet1y." (F) ....... means \he debt ev_ by !he Note, plus InteI1l8t any _ymenl charges end late charges due under lI1e Note, and 41811I11 due under IhI8 Security Inslrum8'1t, plus _ (0) 'R-" meens all Riders 10 11118 Security Inslnl'Tlen1lhat arl 8X8Cuted by 1lo!T0Mr. The following R1ders are 10 be executed by Borrower [chack box as appI/cabie~ o AdJ_ Rate Rider 0 Condominium Rider o BaJ100n Rider 0 PIaMed \Jnl\ Oev&lopmen1 Rider o 1-4 Family Rider 0 Biweekly Plyment Rider (H) 'AppI_ Law' means 8/1 conlllllUng applicable _Ill!, ltale end 1oc8/lta1ul88, regulations. or<lnances end administrative rule8 end orders (lI1at havllhe eIfect 01 few) as ..... as 41 sppIIcablo 1In8I, non-_"'''''' judicial oplnlan8. (I) .ComnaInIty "-IItIon 0-. ..... _ _mentl. II1eWI8 41 dues, f888, ....88m.n18 end o!her charges lhat al1l Imposed on Bomlwer or lI1e ProIl8f\Y by a condominium uaocletlon, homeownon assoclolJon or IImIIor organization. , (J) .E_ Funda Trtnsfer' means any _ 0I1unds, _than I _ orIg)1alad by check, walt. or simllor paperlnalrurnenl, whlch Is initiated II1rough an 8Iectron1c 1anninal, 1eiephonic lnalnInent, computer, or """"* lape so as 10 order. InslruCt, or aulhOltte a financlallnstitullon 10 dobl or cl1ldll an 8CCO\.I1I. Such lenn Includes, bulle not limited 10, poInl-of._ transt8l1l, aulOl1\ated tailor machine _ns, translel1l Inillated by telephone, wire _I1l, end automated clealfnghouselransf8l1l. (I<) 'e- a.M' rnesns Ihoss llemllhat are desc~bed In SecIIon 3. (L) .--..au. p_' means MY COI'IlIl8Il88II. _ent. lward of dam8ges, or proc..- paid by any II1lrd perty (oll1er II18n in8wancs proceeds paid under \he covlrages descrl:Jed In SecIIon 5) lor: (I) damage to, or de8truc11on 01, lI1e Properly; (IJ) condemnation or otI1er taI<ing 01 all or any perl of \he Properly; enll convlyance In lieu of condemnetlon; or (Iv) mIsfepfesootallons of. or omloslons as 10, Ihe value end/or condition 0I1h8 Proll8f\Y. (M) .Mortgage _. me8f\lln8txance prol8Ctlng Londer agalnsl tI1e nonpayment of, or default on, lI1e Loon. (N) 'PerIodIc Payment' maens \he .eguIar1y schoduled amount due for (II prinCipal end Int8rool tllder Ihe Note, plus (iI) any amounts under SecIIon 3 of 11118 Security Ins_. (0) 'RESPA. m88ll8 tI1e Real Eal81a SsllIernen1 Proc;edure8 Act (12 U.S.C. S 2tlll1 et seq.) and ita inplsrnen1lng regulolJon, ReguIotIon X (24 C.F.R. Plrt 3500). as Ihey might be smonded from lime 10 time, or any addIlIonaJ or s' lC04880r Iegl8Ia11on or regulation lhat govems 1ha same ~ rna1Ial. As used In Ihls Security InstrumenL 'RESPA' r8l8l1l1o 8/1 requ!11lll14W8 and ""'k"'",," ," tI1et are Imposed In regenlto a"federdy relo.lad ~ loon' IVen K tI1e Loan does not qualify as a _rally related ~ loan' under RESPA. (P) .". c C f II Dr In Inter8It of Borrow..- means any party that has taken tItie 10 the Property. whether or not that party has assumed Bonowe(a obligations under Ihe Notl anpIor Ihls SscurIIy Inllrunent o Sscond Home Rider o 01118<(1) [Ipecify] _ PENNSYLVANIA-Slngle FamUy-Fannl. _roddle Mac UNIFORM INSTRUMENT Page 1 of 7 In==.t~ BK I B3~PG4 750 8/18/04 ~ANCY J LOUGHRIDGE 149 EAST MAIN STREET ~ALNUT BOTTOM PA 17266 Messages Escrow 100% Original loan amt Current balance Accrued interest Late charges due Current payoff Payoff good thru Next period payoff One months interest Interest base Interest rate Per diem Other Charges Balloon Payment Sold balances Fl=Addl functions F6=Messages ~- ORRSTOWN BANK Loan Sold AFT Cr 50,400.00 48,478.65 110.76 .00 48,378.43 8/18/04 .00 201.99 Amortized 5.0000% 6.51580 .00 .00 .00 F3=Exit F8=Maintenance 14:45:50 L024002 Birth date: 9/30/1930 272-28-2893 FHLB FIXED MORTGAGE 3000173 L 1 of 1 JAMES B DUBBS 9/10/03 180 M / 170 10/01/18 8/02/04 9/01/04 9/01/04 .00 .00 477.60 398.56 Int. included 1 M Inquiry Page 01 of 10 CIF number: LOUTHAN Phone: (H) (717) 532-6628 (B) (000) 000-0000 Tax 10 number: Loan type: 35 Loan number: Officer JBDUB Original loan date Loan term/remaining pmts Maturity date Last payment date Next payment due date Next scheduled pay date Amt partially paid Payment suspense Payment amount Prine & Int pmt Payment type/freq F4=Sweep Inquiry F9=Relationships More.. . F5=History F24=More Keys ,.-. ,._~~,~.",,~.,~. LAST WILL AND TESTN~ENT OF NANCY J. LOUGHRIDGE I, NANCY J. LOUGHRIDGE of R. D. #1, Stonehouse Road, Green Park, Perry County, Pennsylvania, being of sound and disposing mind, memory and understanding do hereby make, publish, and declare this my Last will and Testament, hereby expressly revoking all other writings in nature testamentary by me at any time heretofore made. FIRST: I direct that all my debts and funeral expenses be paid as soon after my decease as may be practicable. SECOND: I direct that inheritance tax on property disposed of herein, shall be paid from my residuary estate. THIRD: I hereby give, bequeath and devise all the rest and residue of my estate and property, real, personal and mixed, of whatsoever nature and wheresoever situated, of which I may own ac the time of my death, or to which I may be entitled or of which I may have the right to dispose at the time of my death, including my share of the sale proceeds of The Tannery, to my Friend, Joan M. Covey of 41 Hammond Road, Walnut Bottom, Pennsylvania, if she is living at the time of my death. FOURTH: In the event that Joan M. Covey is not living at the time of my death, or in the event that she and I shall die rJ.....,~ ~. L",t.J.Jr- NANCY 'J. LOUGHRIDGE (SEAL) Page one of two simultaneously, then I give, bequeath and devise all my property to The Helen O. Krause Animal Foundation, Inc. of P. O. Box 311, Mechanicsburg, Pennsylvania. FIFTH: I hereby appoint my Friend, Joan M. Covey as Executrix of this, my Last will and Testament, but in the event that she is unable or unwilling to serve, I then appoint Financial Trust Corp as Executor of this, my Last will and Testament, and I direct that they shall not be required to give bond or other security in any jurisdiction wherein proceedings may be held in connection with my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 1st day of March, 1996. WITNESS: 1'iVlo(dA-101 F K:uy;/ 7;~~'~1 ~4"~ 9. L.~~I..J\'k- NANC J. LO GH DGE ~ ------ Page two of two (SEAL) -I' ;;~" ~~t::t: W~.t, j' :~ I"c", .,":::' ~;{ *' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 17105.8486 August 19, 2004 SCOTT W MORRISON ESQUIRE ATTORNEY AT LAW CENTER SQUARE POBOX 232 NEW BLOOMFIELD PA 17068 Re, NANCY J LOUGHRIDGE SSN, 272-28-2893 Dear Attorney Morrison: Pursuant to your letter dated August 13, 2004, the Department of Public Welfare (DPW), Estate Recovery Program, has reviewed the information you provided regarding the above-referenced individual. It has been determined that this individual did not receive any type of assistance during the questioned period. Therefore, according to the information you provided, the Department's Estate Recovery Program will not seek any recovery from this estate. If you have any questions, please feel free to contact me. sincerely, ~.\I&Q Ronald D. Hill, Manager TPL - Casualty Unit (717) 772-6604 (717)772-6553 FAX 06-27-2005 LOUGHRIDGE 06-27-2004 21 04-0635 CUMBERLAND 101 APPEAL DATE: 08-26-2005 (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:is4;-iX-AFP"C03:0s3-NOTicE-OF-iNHERiTANCE-TAX-APPRAiSEMENT:-ALLOWANCE-OR--------------- DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX NANCY J FILE NO. 21 04-0635 ACN 101 BUREAU OF INDIVIDUAl-TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESSKENT OF TAX P '"' .-.,' DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN ,.; "':: "II, ,;; .../"i '\ (\~!" SCOTT W ~RISON PO BOX 232 NEW BLOOMFIELD ESQ PA 17068 ESTATE OF LOUGHRIDGE ... REY-1547 EX AFP (06-05) NANCY J TAX RETURN WAS: (X I ACCEPTED AS FILED ( I CHANGED DATE 06-27-2005 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule AI 2. Stocks and Bonds (S_dule BI 3. Closely Held Stock/Partnership Interest (Sehedule C) 4. Hortgages/Notes Receivable (Schedule D) ,s. Cash/Bank Deposlts/l1isc. Personal Property (Schedule EJ 6. Jointly Owned Property (S_dule FI 7. Trans~.rs (Schedule SJ 8. Total As_ts III (21 (31 (41 (51 (61 (7) 55.677.60 .00 .00 .00 13.215.46 .00 .00 (81 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/AdJJ. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule II 11. Total Deductions 12. Net Value of Tax R.turn 13. CharitablalGoY.r~ntal Bequestsi Non-elected 9113 T~usts 14. Net Value of Est.te Subject to Tax 2,043.00 (91 1101 51.836.34 1111 1121 1131 (141 (Schedule J) NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total of ALL ASSESSMENT OF TAX: IS. AlIOunt of Line 14 .t Spousal rat. US) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. AltOUnt of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B ~.t. l18J 19. P~inciP81 Tax D\M T C : NOTE: To insur8 p~oper credit to your account, sub.i t the upper portion of this form with your tax pay_nt. / 68,893.06 1;3.R7lJ 34 15,013.72 .00 15,013.72 14, 15 and/Dr 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = .00 X 045 = .00 x 12 = 15,013.72 X 15 = 1191= INTEREST/PEN PAID (-I 112.60 AHDUNT PAID 4,000.00 DATE 09-24-2004 NUIlBER CD004431 ~ 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 2,252.06 2,252.06 4,112.60 1,860.54CR .00 1,860.54CR ( IF TDTAL DUE IS LESS THAN $1, NO PA YI1ENT IS RE/lUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU KAY BE DUE A REFUND. SEE REVERSE SIDE DF THIS FORM FOR INSTRUCTIONS.I BUREAU OF INDIVIDUAL llMl,E,y:;ncf' r',CCf'C I,r INtERITANCE TAX DIYISION 1:_'v'\I ',_I:....;) '..I I ,),,/L ',.'! PD BOX 280601 '-,- , I I '_ HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE J:NHERJ:TANCE TAX STATEMENT OF ACCOUNT * REV-1607 EX AFP (03-05) ?!'Jr;r: ii:llr' /2 .uUJ j ","J PI1 I: 05 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-18-2005 LOUGHRIDGE 06-27-2004 21 04-0635 CUMBERLAND 101 _aunt R..i tted NANCY J n:= SCOTT W MO~g~~' E;li: 'iT PO BOX 2320' NEW BLOOMFIELD PA 17068 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this for. with your tax p.y..nt. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS - .----------------.--.--.--.-------------------.--.------------------------- REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF LOUGHRIDGE NANCY J FILE NO.21 04-0635 ACN 101 DATE 07-18-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A sunHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT: 06-20-2005 PRINCIPAL TAX DUE: 2,252.06 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-24-2004 ~ CD004431 112.60 4,000.00 06-30-2005 REFUND .00 1,860.54- TOTAL TAX CREDIT 2,252.06 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 PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIr' (CRI, YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. I ~X- "'- Cumberland County - Register Ot Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 MORRISON SCOTT W ESQ POBOX 232 NEW BLOOMFIELD, PA 17068 RE: Estate of LOUGHRIDGE NANCY J File Number: 2004-00635 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: 6/27/2006 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 - Reglster Ot Wllls One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 COVEY JOAN M 41 HAMMOND ROAD WALNUT BOTTOM, JA 17266 RE: Estate of LOUGHRIDGE NANCY J File Number: 2004-00635 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: 6/27/2006 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, G~~~ Clerk of the Orphans' Court cc: File Counsel Register of Wi Us of Cumberland CCHLflty STATUS REPORT tJNDERRULE 6.12 Name of Decedent: Nancy J. Loughri c1gp. Date of Death: June 27, 2004 Estate No.: 21-04-0635 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 IX! No 0 2. If the 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? Yes 0 No [Xl 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 IKl No 0 c. Copies of receipts, releases, joinders and approval offonnal or infonnal accounts may be filed with the Clerk 0 e Orphans' Court and may be attached to this report. Date: 5 / 2 / 0 6 Scott W. Morrison, Esquire Name 6 West Main Street New Bloomfield, FA 17068 Address (717) 582-2300 Telephone No. Capacity: 0 Personal Representative IX! Counsel for personal representative r1' ('0f