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HomeMy WebLinkAbout03-0322Es~tta of Mary · ~so k~own a~ Register of Wills of Cumberland County, Pennsylvanla PETITION FOR GRANT OF LEl-rERS Elizabeth Kennedy No. j Dec~a~ed Scc~a] Secud~f No. 202-38-7451 who ~L'a.re ',8 ye&rs of 090 ~ old~. &l::'9~Y('~) ~ ~~ 'A' ~ ~' B~OW:) ~ Pro~te and Grant of Le~e~ Tostamen~ ~ s~r ~l Pe~e~s) ~ ~e ~ n~n~d in ~ ¼~ Wil ~l Except a.~ to~ows. Decedent did not marry, was not divorced, and cid not hav~ · chJk::l bom or adopted si'tar exec~t~ofl of the documents offered for probate; was not l~e vicl~m of · lulling and was never adjucicated inc~mpetmlt: B. Grant of Letters of Administration PetY6oner~s) ·her · propel ~earch ha~hav~ ·~,certaJned l~a! Decedent lelt no W31 ~ wa= survived b~ I~ follow~g spoule.{i{ am/) and heir~: Joseph P. Kennedy Spouse 211 W. Maplewood Ave. Mechanicsburg, PA 17055 (COMPLETE IN ALL CASES:) A~t~ &c~cJicx-~J ~.e~m il ~. ~ent wa~ d~d ~ ~ ~ Cumber land =~p~m,~,t 211 W. Maplewood Ave.~ ~nt~n. 51 ye~ofage, d~ March 9 .~200~m ~ent at ~a~ ~ pm~ ~ e~ma~ ~es ~ ~: (If ~ ~ PA) A~ ~ ~ (If not ~ ~ PA) P~o~ p~ in P~n=~ (~ not ~ ~ PA) P~ p~ In ~ V~ of m~ es~m ~ P~ns~ ~. P~n~lvani~ ~m hi~ ~t fami~ PA 17055 (Mechanicsburg Mechanicsburg ~ Borough) her residence $ 209~000.00 $. $ ~ma~d -, ~,ow,: N/A Wherefore. Petitioner, s) respectfully request(s) Ihe pmbaM of me last Will and Co~m'l(s) I~eSented wi~ mis Petition and lbo grant of le~t~rs in Ihe a,opropr~,te form ti3 ff~e undersignod: /' Z Fo~'m sRW-1 P~ 1 c~ 2 P~ol~ed by ~he Per~sylvn,"~ Ba~ Aiso~Mb'J 1001 Ty~d ~ ~nl~ n~e ~d msi~nm Joseph P. Kennedy 211 W. Maplewood Ave. Mechanicsburg, PA 17055 Oath of Personal Representative Commonwealth of Pennsylvania County o! Cumberland The Petitioner(s) above-named swear(s) or affirm(s} that the statements In the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of before me this 11 th day of April , 2003 1~._~ AND NOW, Estate of Mary Elizabeth Kennedy Social Securfty No: 202-38-7451 Date of Death: April 11 Deceased March 9, 2003 , X~ 2003., In consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me,' IT IS DECREED that Letters I~ Testamentary~ Of Administration ' are hereby granted to Joseph P. Kennedy in the above estate and that the instrument(s) dated N/A described in the Petition be admi~ed to probate and filed of record as the last Will of Decedent. Letlers ..................... Short Certificate(s) Renunciation ............ Affidavits ( ) ........... Extra Pages ( ) ......... Codidl ...................... JCP Fee ................... Inventory .................. Other ....................... TOTAL ............ A~orney: CraigVA. Diehl, Esquire rD. No: 52801 Address: 3464 Trindi~ Road Camp Hilly PA 17011-4436 (717) .763-7613 Telephong! F-orm~l:~N-1 Pa~e2 °4'2 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Mary Elizabeth Kennedy Date of Death: March 9, 2003 Will No. Admin. No. 21-03-00322 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Ap r i 1 1 7, 2 0 0 3 : Name Address Joseph P. Kennedy 211 West Maplewood Avenue, Mechanicsburg, PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/A Date: April 17~ 2003 Name Craig A. Diehl, Esquire Address 3464 Trindle Road Camp Hill, PA 17011-4436 Telephone (717) 763-7613 Capacity: X Personal Representative Counsel for Personal Representative REV-1500 EX (6-00) I-- LU W W ~oo z Z COMMONWEALTH Of PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) KENNEDY r MARY E. DATE OF DEATH (MM-DO-YEAR) DATE OF BIRTH (MM-DO-YEAR) 03-09-2003 01-04-1952 FILE NUMBER 2 1 COUNTY CODE OFFICIAL USE ONLY --03 00322 YEAR NUMBER SOCIAL SECURITY NUMBER 202-38-7451 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER JOSEPH P. KENNEDY I t 2. Supplemental Return r~ 3. Remainder Return (date of death pdor to 12-13-82) J--~ 4a. Future Interest Compromise (date of death after 12-12-82) ~'~ 5. Federal Estate Tax Return Required r~'-~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) 0 8. Total Number of Safe Deposit Boxes [~ 10. Spousal Poverty Credit date of death between 12-31-91 and 1-1-95) [~ I 1. Election to tax under Sec. 9113(A) (Attach sch O) Ix J 1. Original Retum r~4. Limited Estate ~"] 6. Decedent Died Testate (Attach copy of Will) ~-~9. Litigation Proceeds Received NAME CRAIG A. DIEHL, ESQUIRE, C.P.A. FIRM NAME (If Applicable} LAW OFFICES OF CRAIG A. DIEHL TELEPHONE NUMBER COMPLETE MAILING ADDRESS 3464 TRINDLE ROAD CAMP HILL, PA 17011-4436 (717) 763-7613 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) [~] Separate Billing Requested 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) 1 1. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 71,989.25 .00 .00 .00 .00 .00 (8) 1,992.27 122,042.55 (11) (12) (13) OFFICIAL USE ONLY 71,989.25 124,034.82 (52,045.57) .00 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) (52,045.57) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) .00 x.0 00 (15) 16. Amount of Line14 taxable at lineal rate .00 x.0 45 (16) 17. Amount of Line 14 taxable at sibling rate . 00 x .12 (17) 18. Amount of Line14 taxable at collateral rate .00 x.15 (18) 19. Tax Due (19) 20. Decedent's Corn plete Address: STREET ADDRESS 211 WEST MAPLEWOOD AVENUE CIIY ISTA~ MECHANICSBURG zip 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty .00 .00 .00 .00 .0o (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) .00 .00 .00 .00 .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) 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) .00 B. Enter the total of Line 5 + 5A This is the BALANCE DUE. (5B) .00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................... ~ ~ b. retain the right to designate who shall use the property transferred or its income; ......... r-~ ~ c. retain a reversionary interest; or ................................ [-'--] r~ d. receive the promise for life of either payments, benefits or care? ................. ~ ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................ ~ [~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ~ ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a benef c ary designation'~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this retum, including acco.~p,=~ying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of prepar~er other than the personal representative is based on all information of which SIGNATURE,~E~O~FOR FILING I'~t: IURN preparer has any knowledge. ADDRESS /-- 211 WE~T MAPLEWOOD AVENUE,~,~4ECHANICSBURG, PA 17055 SIGNATURF_..OF PREPARER O~:IE~THAN REPRESENTATIVE RES _ 3464 TRIRD~ ROADr CAtv~ HTT,T,r PA 17011-4436 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S.§ 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 for the use of the surviving spouse is 0% [72 P.S. § 9116 (a) (1.1) (ii)] The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. § 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. § 9116(1.2) [72 P.S. § 9116(a)(1 )], The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. § 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 2W4646 1.000 REV-1503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER I~%R¥ E. KENNEDY 21-03-00322 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 19,001 SHARES OF BIOPROGRESS TECHNOLOGIES STOCK 8,379.44 DATE OF DEATH VALUE = $0.441/SHARE 2 o STOCK OPTIONS FROM PA COmmERCE BANCORP, INC. A. CURRENT EXERCISABLE OPTIONS = 5329 B. CURRENT EXERCISABLE COST = $126,567.33 C. CURRENT M~RKET VALUE = $35.52 DATE OF DEATH VALUE = $35.52 x 5329 = $189,286.08 44 SHARES OF JCPENNE¥ STOCK DATE OF DEATH VALUE = $19.00/SHARE 1.5782 SHARES OF PA CO~JERCE BANCORP, INC. @ $34.891/SHARE TOTAL (Also enter on line 2, Recapitulation) $ 62,718.75 836.00 55.06 71,989.25 2W4696 4.000 (if more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) COMMONWEALTH OFPENNSYLVANIA INHERITANCETAXRETURN RESIDENTDECEDENT ESYATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER I"~,-]~.Y E. ~O~NNEDY 21-03-00322 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 5. 6. 7. 8. 9. 10. FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State__ Zip Year(s) Commission Paid: Attorney Fees - LAW OFFICES OF CRAIG A. DIEHL 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 Probate Fees REGISTER OF WILLS, CUMBERLAND COUNTY Accountant's Fees Tax Return Preparer's Fees CUMBERLAND LAW JOURNAL - ESTATE ADVERTISEMENT THE SENTINEL - ESTATE ADVERTISEMENT REGISTER OF WILLS, CUMBERLAND COUNTY - FILING FEE FOR PENNSYLVANIA INHERITANCE TAX RETURN ORPHANS' COURT, CUMBERLAND COUNTY - FILING FEE FOR FAMILY SETTLEMENT AGREEMENT TOTAL (Also enter on line 9, RerApitulation) $ 1,500.00 295.00 75. O0 95.27 10.00 17.00 1 / 992.27 2W46AG 3.000 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAXRETURN RESlDENTDECEDENT ESTATE OF SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER YA~RY E. EENNEDY 21-03-00322 Include unreimbumed medical expenses. ITEM NUMBER DESCRIPTION 2. 3. 4. 5. 6. 7. MELLON/CBSD - CREDIT CARD DEBT MCCBG-JCPENNEY - CREDIT CARD DEBT RICH'S-MACY'S - CREDIT CARD DEBT LORD & TAYLOR - CREDIT CARD DEBT HECHT'S - CREDIT CARD DEBT THE BON-TON - CREDIT CARD DEBT HOMECOMINGS FINANCIAL - SECOND MORTGAGE ON PERSONAL RESIDENCE (SOLELY IN DECEDENT'S NAME) MEMBERS 1ST FEDERAL CREDIT UNION - AUTO LOAN (JOINT DEBT WITH SPOUSE; TOTAL DEBT = $8,291.91) LEMOYNE SLEEPER - DEBT FOR MATTRESS ABN AMRO MORTGAGE GROUP, INC. - FIRST MORTGAGE ON PERSONAL RESIDENCE (JOINT DEBT WITH SPOUSE; TOTAL DEBT = $104,836.00) TOTAL (Also enter on line 10, Recapitulation) $ 2W46AH 3.000 (If more space is needed, insert additional sheets of the same size) VALUE AT DATE Of DEATH 16,478.30 715.86 278.84 131.51 105.88 524.94 46,777.71 4,145.96 465.55 52,418.00 122~042.55 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES [~t~,¥ E. NUMBER I 1. K~mD¥ NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfer., under Sec. 9116 (a) (1.2)] JOSEPH P. KENNEDY 211 WEST M~PLEWOOD AVENUE MECHANICSBURG, PA 17055 JACK H. DREIBELBIS 10 TALL TREE DRIVE CAMP HILL, PA 17011 FILE NUMBER 21-03-00322 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) SPOUSE SON AMOUNT OR SHARE OF ESTATE 50% OF ESTATE 50% OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DiSTrIBUTIONS: /~ SPOUSAL DISTRIBUTIONS 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 DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 2W46AI 2.000 (If more space is needed, insert additional sheets of the same size) FAMILY SETTLEMENT AND FINAL RELEASE IN THE ESTATE OF MARY ELIZABETH KENNEDY KNOW ALL MEN BY THESE PRESENTS, THAT WHEREAS, Mary Elizabeth Kennedy, late of Mechanicsburg Borough, Cumberland County, Pennsylvania, deceased, died on March 9, 2003, intestate. WHEREAS, Joseph P. Kennedy was named Administrator of the estate which was recorded in Cumberland County, Pennsylvania, Estate No. 21-03-00322; WHEREAS, the said personal representative has gathered the assets of the estate of the said decedent and the assets consist of personal property to a total value of $181,546.01, as set forth in Exhibit "A", which is a statement of account of the said personal representative, and which is attached hereto and made a part hereof, and marked Exhibit "A"; WHEREAS, the debts and deductions paid, including the payment of inheritance tax in the said estate, amount to $72,316.82, leaving a balance for distribution of$109,229.19, also as set forth in the statement of the said personal representative, which is attached hereto and made a part hereof, and marked Exhibit "B"; NOW THEREFORE, KNOW YE, that we, Joseph P. Kennedy and Jack H. Dreibelbis, being the heirs of the said decedent under the intestate statutes and being the persons entitled to inherit under said intestate statutes, do hereby acknowledge that we have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sum or sums of money that we are entitled to by law, and which is the amount set opposite our names in the table and schedule of distribution in said statement attached hereto and marked Exhibit "C"; AND, we do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, we agree that no account is necessary and we hereby agree and consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if it had been filed and confirmed by the Orphans' Court Division of the Court of Common Pleas of Cumberland County. THEREFORE, we do hereby remise, release, quitclaim and forever discharge the said personal representative, his heirs, executors, administrators and assigns, of and from the said estate and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, touching upon the estate of said decedent, and we do further hereby covenant and agree that we will contribute our share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement agreement and final release. WITNESS WHEREOF, we have hereunto set our hands and seals this of ..<~ ~t~~ ,2004. day WITNESS: oseph P. Ker~nedj~ COMMONWEALTH OF PENNSYLVANIA : COUNTY OF CUMBERLAND : SS. On this ! day of ~ ,2004, before me, the undersigned officer, personally appeared Joseph P. Kennedy,%cnown to me (or satisfactorily proven) to be the individual whose name is subscribed to the foregoing instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. COMMONW]~ALTH OF pI~IN'NSYLVANIA_ Notarial S~al Helen E. Rasmussen, Notary Public Camp Hill Bore, Cumberland County My Commission Expires Aug. 2, 2007 Member, pennsylvania Association of Notaries 2 COMMONWEALTH OF PENNSYLVANIA : COUNTY OF CUMBERLAND : SS. On this [ 0144~ dayof~ ~wn , 2004, before me, the undersigned officer, personally appeared Jack H. to me (or satisfactorily proven) to be the individual whose name is subscribed to the foregoing instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. COMMONWI~A~TH OF P~'N~YLVANIA Helen E. Rasmussen, Notary Public Camp Hill Boro, Cumberland County My Commission Expires Aug. 2, 2007 Member, Pennsylvania Association of Notaries FIRST AND FINAL ACCOUNT OF THE ESTATE OF MARY ELIZABETH KENNEDY LATE OF MECHANICSBURG BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA DATE OF DEATH: MARCH 9, 2003 PRINCIPAL ACCOUNT DEBITS: Your Accountant charges himself with the following: Personal Property 19,001 shares of Bioprogress Technologies Stock Value as of 1/15/04 = $1.21/share Stock Options from PA Commerce Bancorp, Inc. Current Exercisable Options = 5622 Current Exercisable Cost = $127,326.97 Current Market Value = $49.626/share 44 shares of JCPenney Stock Value as of 1/15/04 = $26.45/share Owned jointly with Daniel B. Dreibelbis 127 shares of PA Commerce Bancorp, Inc. Value as of 1/15/04 = $49.626/share TOTAL PRINCIPAL DEBITS Value $22,991.21 $278,997.37 -$127,326.97 $151,670.40 $1,163.80 x.50 $581.90 $6,302.50 $181,546.01 EXHIBIT "A" 4 CREDITS Your Accountant asks credit for payments made from Principal Account as follows: Description Law Offices of Craig A. Diehl - Attorney Fees Register of Wills, Cumberland County - Probate Fee Cumberland Law Joumal- Estate Advertisement The Sentinel - Estate Advertisement Register of Wills, Cumberland County - Filing Fee for Pennsylvania Inheritance Tax Return Orphans' Court, Cumberland County - Filing Fee for Family Settlement Agreement Mellon/CBSD - Credit Card Debt MCCBG-JCPenney - Credit Card Debt Rich' s-Macy's - Credit Card Debt Lord & Taylor - Credit Card Debt Hecht's - Credit Card Debt The Bon-Ton - Credit Card Debt Homecomings Financial - Second Mortgage on Personal Residence Members 1 st Federal Credit Union - Auto Loan (Joint debt with spouse; Total debt = $8,291.91) Lemoyne Sleeper - Debt for Mattress TOTAL PRINCIPAL CREDITS EXHIBIT "B" 5 Amount $2,200.00 $295.00 $75.00 $95.27 $10.00 $17.00 $16,478.30 $715.86 $278.84 $131.51 $105.88 $524.94 $46,777.71 $4,145.96 $465.55 $72,316.82 RECAPITULATION Principal Debits Principal Credits $181,546.01 -$72,316.82 TOTAL AMOUNT TO BE DISTRIBUTED $109,229.19 EXHIBIT "B" 6 PROPOSED DISTRIBUTION The Personal Representative proposes distribution of the Total Balance for Distribution to the following heirs as described: Name/Address Inheritance Value/Amount Jack H. Dreibelbis 10 Tall Tree Drive Camp Hill, PA 17011 50.0% of Bioprogress Techn. Stock 100.0% of JCPenney Stock 50.0% of PA Commerce Bancorp Stock Minus: Broker Commission $11,495.61 $581.90 $78,986.45 - $1,221.82 $89,842.14 Joseph P. Kennedy 211 West Maplewood Avenue Mechanicsburg, PA 17055 100.0% of Rest, Residue and Remainder of Estate $19,387.05 TOTAL DISTRIBUTED $109,229.19 EXHIBIT "C" NO. 21-03-00322 FAMILY SETTLEMENT AND FINAL RELEASE IN THE ESTATE OF MARY ELIZABETH KENNEDY LAW OFFICES OF CRAIG A. DIEHL 3464 TRINDLE ROAD 119 W. HANOVER STREET CAMP HILL, PA 17011 SPRING GROVE, PA 17362 (717) 763-7613 (717) 225-1929 FAX (717) 763-8293 STATUS REPORT UNDER RULE 6.12 Name of Decedent: Mary Date of Death: March 9, File No: 21-03-0322 Elizabeth Kennedy 2003 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: State whether administration of the estate is complete: Yes x No o If the answer is No, state when the personal representative reasonably believes that the administration will be complete: If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X bo Co Did the personal representative state an account informally to the parties in interest? Yes X No Copies of receipts, releases, joinders and approvals of formal or Informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: February 2, 2004 Signature[/ Craig A. Diehl~ Esquire Name (Please type or prim) 3464 Trindle Rd., Comp Hill, PA 17011 Address (717) 763-7613 Tel. No. Capacity: X __.Personal Representative Counsel for Personal Representative BUREAU OF ZNDTVZDUAL TAXES INHERITANCE TAX DTVZSTON DEPT. Z6060! HARRTSBURG, PA 17128-0601 CRAIG A DIEHL ESO C A DIEHL LAW OFFICES $~64 TRINDLE RD CAMP HILL PA 17011 COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLOHANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER 'COUNTY ACN 02-02-2004 KENNEDY 03-09-2005 21 03-03ZZ CUHBERLAND ZOZ Amoun'l: Remitted REV-154? EX AFP HARY E HAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KENNEDY HARY E FILE NO. 21 03-0322 ACN 101 DATE 02-02-2004 TAX RETURN NAS: (X} ACCEPTED AS FILED ( } CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSF APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedulo A) 2. S~ocks and Bonds (Schedule B) $. Closely Hold S~ock/Par~norship Zn~eros~ (Schedule C) ~. Hor~gages/No~os Receivable (Schedule D) (~) $. Cash/Dank Deposits/Misc. Personal Proper~y (Schedule E) 6. Jointly Owned Propor~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. FuneraZ Expenses/Adm. Costs/Hisc. Expenses (ScheduZe H) (9) 10. D®b~s/Nor~gage LiabiZi~ios/Liens (Schedule I) (10) 11. To,al Deductions 71z989.25 .00 .00 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion .00 of ~his form with your · 00 tax payment. .00 .0o 1,992.27 12. 1:3. Iq. NOTE: ASSESSMENT OF TAX: 1.6. Amount of Line lq a~: Spouse1 ra~:e 16. Amoun~ of Line lq ~axable a~ Lineal/Class A ra~e 17. Amount of Line lq a~ Sibling rate 18. Amount of Line lq ~axablo a~ Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: PAYIIENT RECi;TpT DISCOUNT (+) DATE NUMBER INTEREST/PEN PATD (-) 122~0~2.55 (11) 71,989.25 52,045.57- TOTAL TAX CREDIT BALANCE OF TAX DUE ZHYEREST AND PEN. TOTAL DUE ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .oo .oo .oo .oo ( IF TOTAL DUE I'S LESS THAN $1, NO PAYMENT IS RE{)UIRED. IF TOTAL DUE IS REFLECTED AS A "CRED/T" (CR), YOU NAY BE DUE_~_--,, A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )'~-[~ ~/ AHOUNT PAID (15) .00 x O0 = .00 (].6), .00 x 045= .00 (17) . O0 x 12 = . O0 (~8) .00 x 15 = .00 (19)= . O0 Ne~ Value of Tax Re~urn (12) Charitable/Governmental Bequests; Non-elected 911:3 Trusts (Schedule J) (1:3) . O0 Ne~ Value of Es~a~e Sub~oc~ '1:o Tax (1~) 5Z,O~5.57- Zf an assess;ant ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~ill reflect figures that include the total of ALL returns assessed to date. RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class D (collateral) beneficiaries of the decadent after the expiration of any estate for life or for years, the Coeeonweelth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class S (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed an the reverse side. --Hake check or money order payable to: REGXSTER OF NILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513). Applications are available at the Office of the Register of Hills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour answering service for fores ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and / er speaking needs: 1-BOO-447-30ZO (TT only). Any part~ in interest not satisfied with the appraisement, alloaance, or disallowance of deductions, or assesseent of tax (including discount or interest) as shown on this Notice must object aJthin sixty (60) days of receipt of this Notice by: --written protest to the PA Oeparteent of Revenue, Deard of Appeals, Dept. ZBIOZ1, Harrisburg, PA 171LB-lOLl, OR --election to have the matter detereinad at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviea Unit, Dept. LB0601, Harrisburg, PA 17lIB-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent' (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent*s death, a five percent (BZ) discount of the tax paid is allowed. The 1SZ tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the saee manner and in the the same time period as you would appeal the tax and interest that has bean assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the data of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (BZ) percent per annum calculated at a daily rate of .000164. All taxes mhich became delinquent on and after January l, 198Z will bear interest at a rate which will vary free calendar year to calender year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2003 are: Interest Daily Interest Daily Interest Daily Rata Factor Year Rate Factor Year Rate Factor Yea.~r 198Z LOX .000548 1987 92 .000247 1999 7Z .O00Xez 1985 162 .000438 19B8-1991 llZ .000301 ZOO0 8Z .O00Z19 1984 Ill .000501 1992 9Z .000247 ZOOX 9Z .000247 1985 15Z .000356 1995-1994 7Z .O0019Z ZOOZ 6Z .000164 1986 102 .000274 1995-1998 9Z .000247 ZOO3 52 .000137 --Interest is calculated as follows: XNTEREST= BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the data of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated.