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HomeMy WebLinkAbout03-0649PETITION FOR PROBATE and GRANT OF LETTERS Estate ~ Charles C. Chronister also known as Deceased. Social Security No. 2 0 7- 0 7- 9 7 ~ 6 To: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut rix in the last will of the above decedent, dated June 11 and codicil(s) dated in the ,19.nagr¥d (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in. Cumberland County, P_ennsylvania, with ~ last family or principal residence at 700 Walnut Bottom Road Borough of Carlisle, Pennsylvania (list street, number and muncipality) Decendent, then 87 years of age, died July 11, 2003 at Carlisle. Pennsylvania ' 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: N/A,, Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ unknown (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: unknown 8 Mountain Street, Mount Holly Springs, Pann.~vl rani a WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) Arlene Marie Koser RR1, Box 120 A Thompsontown, PA 17094 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF 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 represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed .~- '~~ ff/ff~ /~/~d.~ before me t~s . . 7fac day of ! Arlene Marie Koser 'tg;. (I2~~' ]t4~_ ~,~t , _~txl~ J~l Rill, Box 120 A Thompsontown. PA 17094 NO. 21-03-649 Estate Of Charles C. Chronister , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW this 7th day of August ~ 200,3in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated June 11, 1993 described therein be admitted to probate and filed of record as the last will of Charles C. Chronister ; and Letters Test_m_mentary are hereby granted to Arlene Marie Koser Filed FEES Probate, Letters, Etc.. ........ $ 18.00 Short Certificates(2) .......... $. 6.00 9.00 - il~ua~i~[~ ~xl;ra..pages... $ JCP $ 10.00 T. OTAL $ 43.00 . ............... Register of Wills A~ORNEY(Sup. Ct.I.D.N~ Keith O~ Brenneman 47077 44 W. Main Street, Mechanicsburg, ADDRESS PA 17055 (717) 697-5153 PHONE CALLED ATTORNEY AUGUST 7, 2003 £- 09'0 ,_cO. 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 ~ ~.~ Local Registrar P 9449186 JUL 2003 No. '~ Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH 700 Walnut Bottom Rd. ACTUAL Carlisle, PA 17013 (~'~ ~ ~ ~*,b.7/15/2003 b,.Cumbertand VaStly Mem. l,,.Oartis~e, PA 17013 L~:"*~5~89L ~A~~T~:~Cr emator yMt. Ho~y Springs, PA 17065 ,y. Year) Il o~oo~ ,,,. r~ o/~2 ER./._ I,,~.,./,,/v//, WAS CASE REFERRED TO MEDICAL EXAMINERB~ORONER? r' O~c OE,ATH ? Natural ~ Hor~,ci~ [] .ICENSE NUMBER DATE S O O~E FILED (Mon~ Day 21-03-649 21-03-0649 OF CHARLES C. CHRONISTER I, CHARLES C. CHRONISTER, of Mount Holly Springs, Cmberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. 1. I hereby order and direct my Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. 2. I give, devise and bequeath all of my property, of whatsoever nature, and kind, to my wife, MAE I. CHRONISTER, absolutely and in fee simple, so long as she survives me by at least thirty (30) days. 3. Should my wife, MAE I. CHRONISTER, fail to survive me by at least thirty (30) days, then I give my entire estate, to my children, ARLENE MARIE KOSER, of R.D. #1, Box 120 A, Thompsontown, Pennsylvania 17094 and CONNIE CUPID BALATRI, of Via Del Porcellana 51, Firenze, Italia 50123, per stirpes. 4. I nominate, constitute and appoint my daughter, ARLENE MARIE KOSER, to be the Executrix of this my Last Will and Testament. Should she be unable to act for any reason, then I appoint my daughter, CONNIE CUPID BALATRI, to act as executrix in her place and stead. No executrix shall be required to file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of ' ~_-~'~ ~, ~_ , 1993. CHARLES C. CHRONISTER SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: COMMONWEALTH OF PENNSYLVANIA : : COUNTY OF CUMBERLAND : SS I, CHARLES C. C[4RONISTER, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by CHARLES C. CItRONISTER, the Testator, this j;~h~ day of "_~/~ ~ , 1993. CHARLES C. CHRONISTER, Testator Notary Public COMMONWEALTH OF PENNSYLVANIA : : ss COUNTY OF CUMBERLAND : We, "~"~x~ ~. ~/~~ and .~..~ -_1~. C~0~$~-e~f , the witnesse~'whose names are signed ~ the at~ched or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Tester sign and execute the instrument as his Last Will; that CHILES C. CHRO~STER signed willingly and that he executed it as his free and volun~ry act for the purposes therein expressed; that each of us in the hearing and sight of the Tester signed the Will as witnesses; and that to the best of our knowledge the Tes~tor was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed ~ before me by~~ ~. ~.~n~f and ~e ~' ~'~~.C this )/~-day of ~ ~ ' , 1993. Witness Notary Public CHARLES C. CHRONISTER I LAW OFFICES MANCKE AND WAGNER 2233 NORTH FRONT STREET HARRISBURG, PA 1 71 10 LAW OFFICES SNELBAKEr. BRENNEMAN & SPARE CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Charles C. Chronister Date of Death: July 11, 2003 Will No. 21-03-0649 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 sole beneficiary of the above-captioned estate on August 12, 2003. Name Connie C. Balatri Arlene M. Koser Address Via Del Porcellana 51 Firenze, Italia 50123 RR1, Box 120 A Thompsontown, PA 17094 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None. Date: August 12, 2003 2 Keith O. Brenneman, Esquire Snelbaker, Brenneman & Spare, P. C. 44 W. Main Street Mechanicsburg, PA 17055 (717) 697-8528 Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) 003090 SPARE PHILIP ESQUIRE 44 W MAIN STREET MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 207-07-9796 FILE NUMBER: 2103-0649 DECEDENT NAME: CHRONISTER CHARLES C DATE OF PAYMENT: 10/06/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 07/1 1/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2,300.00 TOTAL AMOUNT PAID: REMARKS' ARLENEM KOSER C/O PHILIP SPARE ESQUIRE SEAL CHECK# 60-1021/313 INITIALS: SK RECEIVED BY: $2,300.00 DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS · ,%, EV- 500 ~ PENNSYLVANIA A~,z~~j, DEPARTMENT OF REVENUE · DEPt. 280801 INHERITANCE TAX RETURN '~ HARRISBURG, PA 17128-0601 RESIDENT DECEDENT ILl 0 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Chrnn~ .~er, Char_les C. DATE OF DEATH (MM-DD-YEAR) ] DATE OF BIRTH (MM-DD-YEAR) 07/11/2003 [ 01/27/1916 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) FILE NUMBER 21 0 3 0 0649 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 207 - 07 - 9796 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER N/A [~1. Odginal Return [~4. Limited Estate [~6. Decedent Died Testate (Atlach copy of Will) [~9. Litigation Proceeds Received [~2. Supplemental Return [~4a. Future Interest Compromise (date ddea[h after 12-1292) [~7. Decedent Maintained a Living Trust (AUad~ copy of Trust) [~Jl0. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) [~3. Remainder Return (date of death pdor to 12-13-82) [~5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes ~-~ 11, Election to tax under Sec. 9113(A) (Attach Sch O) NAME Keith O. Brenneman, Esquire FIRM NAME (If,Applicable) COMPLETE MAILING ADDRESS 44 W. Main Street Mechanicsburg, PA 17055 X 1. Real Estate (Schedule A) 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 (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) J~ 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) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (1) 74,000.00 5,105.10 6,113.69 (lO) 21,916.18 (8) 13. Charitable and Govemreental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (11) (12) (13) (14) 79,105.10 28,029.87 51,075.23 51,075.23 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) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due x .0 (15) 51,075.23 x .o 45 (16) x ,12 (17) x .15 (18) (19) 2,298.39 2,298.39 Decedent's Complete Address: STREET ADDRESS 700 Wal_nut Bottom Road CIRCarlisle ] STATE PA ] ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 2,298.39 2,300.00 114.91 Interest/Penalty if applicable Total Credits ( A + B + C ) (2) 2,414.91 D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 116.52 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) (5A) (5B) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B Enter the total of Line 5 + 5A. This is the BALANCE DUE. 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; .......................................................................................... [] ~X] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] c. retain a reversionary interest; or ................................................................. [] d. receive the promise for life of either payments, benefits or care? ...................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate cons derat on? ............................................................................. [] [] 3. Did decedent own an "in trust for'' or payable upon death bank account or security at h s or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary 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 return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. RSON RESPONSIBLE FOR FILING P,~'TURN /'t/~- , Executrix DATE RR1, Box 120A, Thompsontown, PA 17094 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE - AO . ss 44 W. Main Street, MechanicsburgLPA 17055 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. {}9116 (a)(1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not 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. REV-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE A REAL ESTATE FILE NUMBER Charles C. Chronister 21-03-00649 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the pdce at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION t. Ail that certain land improved with a residential dwelling located in the Borough of Mount Holly Springs, Cumberland County, Pennsylvania, commonly known as 8 Mountain Street, Mount Holly Springs and more fully described in the Deed recorded in the Recorder's Office for Cumberland County in Deed Book "K", Volume 14, Page 542: TOTAL (Also enter on line 1, Recapitulation) $ (if more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH $74,000.00 74,000.00 REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Charles C. Chronister 21-03-0649 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH e Checking Account No. 56-234426-5, The Valley Bank Blue Cross/Blue Shield refund Juniata $4,805.10 TOTAL (Also enter on line 5, Recapitulation) $ 5,105.10 (If more space is needed, insert additional sheets of the same size) 300.00 REV-1511 EX+ (12-99~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER Charles C. Chronister 21-03-00649 Debts of decedent must be reported on Schedule I. iTEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1, 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: A~0rneyFees to Snelbaker, Brenneman & Spare, P. C. Family Exemption: (If decedenrs address is not the same as claimant's, attach explanation) Claimant Street Address City State __Zip Relationship of Claimant to Decedent Probate Fees to Register of Wills Accountant's Fees , miscellaneous filing fees and reserve ~R~m~x~z~x Advertise grant of letters a. Cumberland Law Journal: $ 75.00 b. Patriot News 205.69 Real estate commission/transaction fee to ERA NRT, Inc. Realty transfer tax TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) 1,000.00 43.00 250.00 280.69 3,800.00 740.00 $6,113.69 REV-1512 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Charles C. Chronister 21-03-00649 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH o Se Cost to repair basement/foundation of real estate (see Schedule A) necessary for sale and closing: Three Spring Family Practice - payment on account Met Ed - payment on account of electric utility Continuing Care - payments on account of prescription expense ($32.04; $196.15) Forest Park Health Center - payment on account TOTAL (Also enter on line 10, Recapitulation) $ $7,610.00 29.10 33.61 228.19 14,015.28 21,916.18 (If more space is needed, insed additional sheets of the same size) REV-1513 EX+ (900) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Charles C. Chronister SCHEDULE J BENEFICIARIES FILE NUMBER 21-03-00649 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE ! TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under H Sec. 9116(a)(1.2)] Arlene M. Koser RR1, Box 120A Thompsontown, PA 17094 Connie C. Balatri Via Del Porcellana 51 Firenza, Italia 50123 Daughter Daughter 1/2 of residue 1/2 of residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. 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 $ (If more space is needed, insert additional sheets of the same size) CHARLES C. CHRONISTER I, CHARLES C. CHRONISTER, of Mount Holly Springs, Cmberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. 1. I hereby order and direct my Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. 2. I give, devise and bequeath all of my property, of whatsoever nature, and kind, to my wife, I~AE I. CHRONISTER, absolutely and in fee simple, so long as she survives me by at least thirty (30) days. 3. Should my wife, MAE I. CltRONISTER, fail to survive me by at least thirty (30) days, then I give my entire estate, to my children, ARLENE MARIE KOSER, of R.D. #1, Box 120 A, Thompsontown, Pennsylvania 17094 and CONNIE CUPID BALATRI, of Via Del Porcellana 51, Firenze, Italia 50123, per stirpes. 4. I nominate, constitute and appoint my daughter, ARLENE MARIE KOSER, to be the Executrix of this my Last Will and Testament. Should she be unable to act for any reason, then I appoint my daughter, CONNIE CUPID BALATRI, to act as executrix in her place and stead. No executrix shall be required to file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I ~___ day of _ '~--~'~.~ ~ have hereunto set my hand and seal this , 1993. CHRONISTER SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: COMMONWEALTH OF PENNSYLVANIA : : COUNTY OF CUMBERLAND : SS I, CHARLES C. CHRONISTER, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by CIiARLES C. CHRONISTER, the Testator, this ]?'?'~ day of "_~ ),~ ~ , 1993. CHARLES C. CHRONISTER, Testator Notary Public 3 COMMONWEALTH OF PENNSYLVANIA : : SS COUNTY OF CUMBERLAND : , the witnesses 'whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will; that OHARLES C. CHRONISTER signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by~-~ ~ ,/~eL~a~(' and /~,q ~Xe ~ f.' jh 4-~ i~ ~(- this .[ ~' day of .~-~;m ~ , 1993. Witness Notary Public COMMONWEALTH OF PENNSYLVANIA iL COUNTY OF CUMBERLAND Arlene Marie Koser belng dul~ sword according to'law, deposes and says that She is the .Executrix of the ~tate of Charles C. Chronister late of the Borouc~k_o_~____C._arlisle , Cumberland County, Pa., deceased and that the within is an inventory made by Arlene Marie Koser , the said Executrix of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's-death. and subscribed .before me, Executor - Administrator RRI Box 120A Thompsontown, PA 17094 Address 2003 2. 3. 4. Day Month Year INSTRUCTIONS An inventory must be filed wlfhln three months after appointment of personal representative.j_... A supplement inventory must be filed within th;dy days of discovery of additional assets. Additional sheets may be attached as to personalty or realty See Article IV, Fiduciaries Act of 1949. , , Inventory of the real and personal estate of Charles C. Chronister deceased II. I. REAL ESTATe. Ail that certain land improved with a residential dwelling located in the Borough of Mount Holly Springs, Cumberland County, Pennsylvania, commonly known as 8 Mountain Street, Mount Holly Springs and more fully described in the Deed recorded in the Recorder's Office for Cumberland County in Deed Book "K", Volume 14, Page 542: $74,000 TOTAL VALUE, ALL REAL ESTATE: PERSONALTY. Checking Account No. 56-234426-5, The Juniata Valley Bank Blue Cross/Blue Shield refund: TOTAL VALUE, ALL PERSONALTY: TOTAL VALUE, ALL PROPERTY: $4,805.10 300.00 $74,001 $ 5,105.1__0 $79,105,10 BUREAU OF TNDZVTOUAL TAXES ZNHERTTANCE TAX DTVISTON DEPT. ZSO60Z HARRISBURG, PA ZTZZS-0601 COMMONWEALTH OF PENNSYLVAN:[A DEPARTMENT OF REVENUE ZNHERZTAHCE TAX STATEMENT OF ACCOUNT KEITH 0 BRENNEMAN ESQ SNELBAKER ETAL 4Q W MAIN ST MECHANICSBURG ,~;:~C~!~ 3~ DATE 02-02-2004 r~i:,~.~:~ ~ ~/ViilS ESTATE OF CHRONISTER DATE OF DEATH 07-11-2005 FILE NUMBER 21 05-0649 '04 FEB 27 P1:02 COUNTY CUMBERLAND ACN 101 ~:g:~i:~ ;~ =~OU~[ J Amoun~ Remi~ed PA l~hbei-ia[]d 00., PA I REV-1607 EX AFP C01-03) CHARLES C HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o your account, submi~ ~hm upper portion of ~his form w~h your ~ax payment. CUT ALONG TH'rS L'rNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -~ REV-1607 EX AFP (01-03) ### INHERITANCE TAX STATEMENT OF ACCOUNT ~ ESTATE OF CHRONISTER CHARLES C FZLE NO. 21 05-06Q9 ACN 101 DATE 02-02-2004 THIS STATEMENT TS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACM ZN THE NAMED ESTATE. SHO#N BELOH ZSA SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FTGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-05-2004 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 2,298.59 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 10-06-2005 01-15-2004 CD005090 REFUND 114.92 .00 ZF PAID AFTER THZS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDZTZONAL INTEREST. ( Z~ TOTAL DUE ZS LESS THAN $1, I~ PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR}, 2,500.00 116.55- TOTAL TAX CREDZT 2,298.59 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTZONS. PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGTSTER OF #ILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMON#EALTH OF PENNSYLVANTA. REFUND (CR): REPLY TO: DISCOUNT: PENALTY: A refund of a tax credit, ehich was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13}. Applications are available at the Office of the Register of gills, any of the 13 Revenue District Offices or frae the Department's Iq-hour answering service for forms ordering: 1-800-36Z-ZOSO~ services for taxpayers with special hearing and / or speaking needs: 1-800-q47-$0Z0 (TT only). guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17lZB-0601, phone (7173 787-6505. If any tax due is paid within three (3) calendar months after the dacedent's death, a five percent [5Z3 discount of the tax paid is allowed. The 1SI tax amnesty nan-participation penalty is computed on tho total of the tax and interest assessed, and not paid before January lB, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day fram the date of death, to the date of payment. Taxes which became delinquent before January 1, 1981 bear interest at the rate of six (61) percent per annum caZcuZetad at a daily rate of .00016q. Ali taxes which became delinquent on and after January 1, 1981 will bear interest at a rate which ail1 vary from calendar year to caIendar year with that rate announced by the PA Department of Revenue. Interest Daily Year Rate Factor Year The applicable interest rates for 1981 through Z005 ara: Interest Daily Interest Daily Rate Factor Year Rate Factor 1981 ZOZ .000S48 1987 9Z .000147 1999 7Z .000191 1983 161 .OOOfi38 1988-1991 llZ .000301 2000 8Z .000219 1984 11Z .000301 199Z 9Z .OOOZfi7 Z001 91 .000247 1985 131 .0003S6 1993-199~ 72 .000192 ZOOZ 62 .O0016q 1986 IOZ .000274 1995-1998 91 .OOOZq7 2003 SZ .000137 --Interest is calculated as follo~s: ZNTEREST= BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELZNI;~UENT X DAZLY TNTERBST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15] days beyond the date of the assessment. If payment is made after the interest computation date shown an the Notice, additional interest must be caiculatmd. RECEIPT AND RELEASE WI~R~,'~HX-"--~;I~ C. CHRONISTER, late of the Borough of Carlisle, County of Cumberland and Commonwealth of Pennsylvania, died on the 11 th day of July, 2003, having first made his Last Will and Testament in writing dated June 11, 1993, which since his decease was duly probated before the Register of Wills of Cumberland County and Letters Testamentary were issued to ARLENE MARIE KOSER, the Executrix named in the Last Will and Testament of said decedent. NOW KNOW ALL MEN BY THESE PRESENTS, that we, ARLENE M. KOSER and CONNIE C. BALATRI, being the only surviving beneficiaries named in the Will of said decedent and the persons entitled to share in the residuary distribution of the Estate of said decedent, do hereby declare and say that we have examined the attached Account and Schedule of Proposed Distribution attached hereto as "Exhibit A" and "Exhibit B", respectively, and find the same to be true and correct, and in strict accordance with the terms and provisions of said Will, and we do hereby acknowledge that we this day have, had and received of and from ARLENE M. KOSER, Executrix of the Estate of CHARLES C. CHRONISTER, the cash and/or personalty set opposite our names in the above stated Schedule of Proposed Distribution, in full satisfaction, payment and discharge of all such sum or sums of money, legacies and bequests, share or shares, purparts and dividends which were due, owing and payable and belonging to us by any means whatsoever, for or on account of our full share, part or dividend of the Estate of CHARLES C. CHRONISTER, Deceased, and all interests accrued thereon. NOW, THEREFORE, we, the said ARLENE M. KOSER and CONNIE C. BALATRI, do by these presents, remise, release, quit-claim and forever discharge the said ARLENE MARIE KOSER, her heirs, executors and administrators, of and from our said share or dividend of the Estate aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason thereof, or of any act, matter, cause or thing whatsoever, from the beginning of the world to the day and date of these presents. AND, desiring to avoid the delay and expense of the settlement of said Estate by filing a formal Account of said administration in the Office of the Register of Wills of Cumberland County and by having the balance in the hands of the Executrix, as shown by said Account, distributed by the Court of Common Pleas of Cumberland County - Orphans' Court Division, we do hereby agree that the foregoing schedule concerning the matter of settlement may be recorded with the same effect upon us as if the same had been reported upon by said Court, in a Decree of Distribution made on such report by the said Court of Common Pleas - Orphans' Court Division. AND in consideration of the aforesaid settlement being made without the aid of such Court of Common Pleas - Orphans' Court Division, that we, the undersigned, do hereby agree that if any debts or demands other than those included in the First and Final Account of the said ARLENE MARIE KOSER, Executrix of the Estate of CHARLES C. CHRONISTER, Deceased, as hereinbefore set forth, shall be hereafter recovered against the Estate of said decedent and be legally payable out of the same, that we will return to the said Executrix such amounts thereof as may be necessary to pay such debts or demands. -2- IN WITNESS WHEREOF, we have hereunto set our hands and seals the respective dates as set forth below. WITNESSED BY: Arlene M. Koser (SEAL) Connie C. Balatri Date: -3- LAW OFFICES SNeLBakEr. BrENNEmAN & Spare FIRST AND FINAL ACCOUNT OF ARLENE MARIE KOSER, EXECUTRIX OF THE ESTATE OF CHARLES C. CHRONISTER, LATE OF THE BOROUGH OF CARLISLE, CUMBERLAND COUNTY, PENNSYLVANIA ARLENE MARIE KOSER, EXECUTRIX aforesaid and Accountant herein avers as follows: DATE OF DECEDENT'S DEATH: DATE LETTERS TESTAMENTARY ISSUED: July 11, 2003 August 7, 2003 LETTERS TESTAMENTARY WERE ADVERTISED AS FOLLOWS: The Patriot News: Cumberland Law Journal: DATE OF FILING OF RULE 5.6(A) CERTIFICATION: August 15, 22 and 29, 2003 August 22, 24 and September 5, 2003 August 13, 2003 PERSONALTY - PRINCIPAL ACCOUNT DEBITS The Accountant charges herself with receipt of the Decedent's goods and personalty as more fully set forth in the Inventory and Appraisement filed with the Register of Wills on October 31, 2003 and consisting of the following: Checking Account No. 56-234426-5, the Juniata Valley Bank Blue Cross/Blue Shield refund TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, DEBITS: $4,805.10 295.74 $5,100.84 EXHIBIT A 1AW OFFICES SNELBAKER, BRENNEMAN & SPARE PERSONALTY - PRINCIPAL ACCOUNT CREDITS The Accountant claims credit for payment of the following items from Decedent's personalty principal account: Three Spring Family Practice - payment on account Continuing Care - prescription payment on account Forest Park Health Center - payment on account Snelbaker, Brenneman & Spare, P. C. Reimbursement of costs advanced: Register of Wills - Probate fee: Patriot News - advertise letters: Certified mail postage: Cumberland Law Journal - advertise letters: Register of Wills - filing fee: $ 43.00 205.69 4.42 75.00 25.00 Total: Legal fees to February 13, 2004: Register of Wills - additional probate fee: Register of Wills, Agent - payment of inheritance tax (net of$116.53 refund): Expenses paid and items posted after death and prior to.close of Decedent's checking account: Home clearing: Continuing Care: Mt. Holly springs Borough Emergency fund donation: $405.00 196.15 15.00 100.00 Total: Reserve for filing fees, and final attorney's fees TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, CREDITS: -2- $ 29.10 32.04 14,015.28 353.11 2,152.50 82.00 2,183.47 1,016.15 500.00 $20,063.65 LAW OFFICES SNelbakEr. BRENNEMaN & SPare PERSONALTY - INCOME ACCOUNT DEBITS The Accountant charges herself with receipt of the following items of income from personalty: Interest posted to Decedent's checking account after death and prior to closing: TOTAL, PERSONALTY, INCOME ACCOUNT, DEBITS: PERSONALTY - INCOME ACCOUNT CREDITS The Accountant claims credit for payment of the following items from personalty income: TOTAL, PERSONALTY, INCOME ACCOUNT, CREDITS: REAL ESTATE - PRINCIPAL ACCOUNT DEBITS The Accountant charges herself with receipt of the following of Decedent's real estate: House and lot known as 8 Mountain Street, Borough of Mount Holly Springs: Prepaid real estate taxes recovered upon sale of real estate, above: TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, DEBITS: -3- $6.98 $6.98 NONE NON_~__E=E_ $74,000.00 719.26 $74,719.26 LAW OFFICES SNELBAKER, BRENNEMAN & SPARE REAL ESTATE - PRINCIPAL ACCOUNT CREDITS The Accountant claims credit for payment of the following items attributable to Real Estate principal: Met Ed- payment of electric utility expense: Arlene Koser - reimbursement of cost expended for basement repair: Agent's realty commission and transaction fee (ERA, NRT, Inc.): Notary fees: Realty Transfer Tax: Home warranty - AON: 2003 School taxes to M. Satteson, tax colllector: Borough of Mount Holly Springs final water, sewer and trash assessment: TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, CREDITS: REAL ESTATE - INCOME ACCOUNT DEBITS The Accountant charges herself with receipt of the following income received from Decedent's real estate: TOTAL, REAL ESTATE, INCOME ACCOUNT, DEBITS: REAL ESTATE - INCOME ACCOUNT CREDITS The Accountant claims credit for payment of the following items from Decedent's Real Estate Income Account: TOTAL, REAL ESTATE, INCOME ACCOUNT, CREDITS: -4- $ 53.99 7,610.00 3,800.00 4.00 740.00 399.00 924.81 70.47 $13,602.27 NONE NONE NONE NONE LAW OffICES SNELbAkEr, BrENNEMAN & SPARE RECAPITULATION II. PERSONALTY A. PRINCIPAL ACCOUNT Debits $ 5,100.84 Credits 20,063.65 Balance B. INCOME ACCOUNT Debits $ 6.98 Credits -0- Balance C. NET BALANCE OF PERSONALTY: REAL ESTATE A. PRINCIPAL ACCOUNT Debits $74,719.26 Credits 13,602.27 Balance B. INCOME ACCOUNT Debits -0- Credits -0- Balance C. NET BALANCE OF REAL ESTATE: III. NET BALANCE OF ESTATE FOR DISTRIBUTION: -5- ($14,962.81) $ 6.98 $61,116.99 -0- ($14,955.83) $61,116.99 $46.,161.16 LAW OFFICES SNELBAKER. BRENNEMAN & SPARE TO: TO: SCHEDULE OF PROPOSED DISTRIBUTION ARLENE M. KOSER, per Item 3 of Will: one-half of residue of Estate: CONNIE C. BALATRI, per Item 3 of Will: one-half of residue of Estate: TOTAL PROPOSED DISTRIBUTION: EXHIBIT B $23,080.58 $23,080.58 $46,161.16 COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND ) SS. ARLENE MARIE KOSER, being duly sworn according to law deposes and says: that she is the Executrix of the Estate of Charles C. Chronister, Deceased; that she is the Accountant herein; that the foregoing accounting is true and complete; that there are no unpaid claimants who have given notice to the said Executrix; that the foregoing Schedule of Proposed Distribution contains the names of all persons interested in said Estate as distributees; and that the facts set forth in the within Account are true and correct to the best of her knowledge, information and belief. Arlene M. Koser Sworn to and subscribed before me this c~/'zt day of '7~',~-~l~/d-Z-ff ,2004. /' -Nota~P~¢li~' ' ~ ' ~ ~ --COMMONWEALTH OF PENNSYLVANIA Notadal Seal Susan L Malmzi, Notary Public Mechanicsburg Boro, Cumberland County My Commission Expires Nov, 24, 2007 Member, Penneylvania Association Of Notaries Name of Decedent: STATUS REPORT UNDER RULE 6.12 Charles C. Chronister DateofDeath: July 11, 2003 Will No.' 21-03-00649 Admin. No.: 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 ~ No ['"] 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 xxPersonal representative file a final account with the Court? Yes _ No [--1 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 Date: c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this reip~~ Mar.ch 17, 2004 Signature Keith O. Brenneman Sa/ne ·; 44 W. Main Street : Mechanicsburg, PA · ' Address 5 (717) 697-8528 ,:~ = Telephone No. Capacity: 17055 ["-1 Personal Representative ~ Counsel for personal representative BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DZVXSTON DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOHANCE OR DISALLOHANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-15~7 EX AFP (01-05) KEITH 0 BRENNEMAN ESQ SNELBAKER ETAL qq W MAIN ST MECHANICSBURG PA 1705S DATE 01-05-200q ESTATE OF CHRONISTER DATE OF DEATH 07-11-2005 FILE NUMBER 21 05-06q9 COUNTY CUMBERLAND ACN 101 Amount Remitted CHARLES C MAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CHRONISTER CHARLES C FILE NO. 21 05-06q9 ACN 101 DATE 01-05-200q TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN I Real Estate (Schedule A) 2 Stocks and Bonds (Schedule B) $ Closely Held Stock/Partnership Interest (Schedule C) Mortgages/Notes Receivable (Schedule D) $ Cash/Bank Deposits/M/sc. Personal Property (Schedule E) 6 Jointly Owned Property (Schedule F) 7 Transfers (Schedule G) 8 Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/M/sc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Lions (Schedule I) 11. Total Deductions 12. Nat Value of Tax Return (1) (2) (3) (q) (6) (7) 7q/O00.O0 O0 O0 O0 51105.10 O0 O0 (9) (8) 6,115.69 (10) NOTE: To insure proper cred/t to your account, submit the upper portion of this form with your tax payment. 15. lq. NOTE: 79,105.10 IF PAID AFTER DATE ZND/CATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ASSESSMENT OF TAX: 1.6. Amount of Line Xq at Spousal rate 16. Amount of L/ne lq taxable a~ LinoaX/CXass A rata 17. Amount of Line lq at SibXing rata 18. Amount of Line lq taxable at CollatoraX/Class B rata 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT DATE NUMBER ZNTEREST/PEN PAID (- 10-06-200:5 COO0:5090 11q.92 . O0 x O0 = . O0 51,075.2:5 x Oq5= 2,298.:59 .00 x 12 = .00 . O0 x 15 = . O0 (19)= 2,298.:59 AMOUNT PAID 2,:500.00 reflect figures that lnclude the total of ALL returns assessed to date. TOTAL TAX CREDIT I , BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE Z,qlq.9Z 116.5:5CR .00 116.5:5CR ( XF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS RE~U[RED. IF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU MAY BE D~ A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTZONS.)~ Char/rabiD/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13) . O0 Not VaXum of Estate Sub,eot to Tax (lq) 51,075.2:5 Zf an assessment ~as issued previously, 11nos 1~, 15 and/er 16, 17, 18 and 19 ~ill 21,916.18 (11) 28.02g .87 (12) 51,075.Z:5 RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: 01SCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 11, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collataral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Coaeoneealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements cf Section Z140 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (71 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of NilZs printed on the reverse side. --Make check or money order payable to: REGISTER 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-131S). Applications are available at the Office of the Register of Nills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour answering service for fores ordering: 1-800-$62-ZOS0~ services for taxpayers aith special hearing and / or speaking needs: 1-800-4q7-3020 (TT only). Any party in interest not satisfied eith the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 181021, Harrisburg, PA 17118-1021, --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. OR Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within throe (3) calendar months after the decedent's death, a five percent (51) discount of the tax paid is allowed. The 15Z 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 same manner and in the the same tiaa period as you would appeal the tax and interest that has been 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 date of payment. Taxes which became delinquent before January 1, 1981 bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. Tho applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 ZOZ · OOOS4B 1987 9Z . 000247 1999 7Z . O0019g 1983 16Z .000438 1988-1991 117. .000301 ZOO0 8Z .000219 1984 llZ .000301 1992 9Z . OOOZq7 ZOOl 97. . O00Z~7 1985 132 .000356 1993-199~ 7Z .O0019Z ZOOZ 62 .O0016q 1986 IOZ .O00Z7~ 1995-1998 97. .000Z~7 ZOO3 57. · 000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NURSER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued aftmr the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF ZNDZVZDUAL TAXES TNHERTTANCE TAX DI'¥TSZON DEPT. 180601 HARRTSBURG, PA 17118-0601 COHNONHEALTH OF PENNSYLVANZA DEPARTNENT OF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLOHANCE OF DEDUCTZONS AND ASSESSHENT OF TAX RE¥-I;~i7 EX &FP (01-§3) KEITH 0 SRENNEHAN ESQ SNELSAKER ETAL Rq N HAZN ST NECHANICSBUR$ PA 17055 CUT ALONG THZS LZNE ~ DATE 01-05-2004 ESTATE OF CHRONISTER BATE OF DEATH 07-11-1005 FILE NUNBER 21 05-0649 COUNTY CUHBERLAND ACN 101 Amount Remitted, I RETAZN LO#ER PORTZON FOR YOUR RECORDS CHARLES HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF gILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 C DZSALLONANCE OF DEDUCTZONS AND ASSESSNENT OF TAX ESTATE OF CHRONTSTER CHARLES C FZLE NO. 21 05-0649 ACN 101 DATE 01-05-2004 TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATXON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN I Real Estate (Schedule A) Stocks and Bonds (Schedule B} $ Closely Held Stock/Partnership Znterest (Schedule C) Nortgeges/Notes Receivable (Schedule D) Cash/Bank Daposits/Hisc. Personal Property (Schedule E) 6 Jointly Owned Property (Schedule F) 7 Transfers (Schedule G) 8 Tote/ Assets APPROVED DEDUCTZONS AND EXENPTZONS: 9 Funeral Expenses/Adm. Costs/Hisc. Expanses (Schedule H) 10 Debts/Hortgage Liabilities/Liens (Schedule Z) 11 Tote1 Deductions 12 Nat Value of Tax Return (1) 74~000.00 (2) .0o ($) .OO (,~) .O0 (s) 5~105.10 (6) .O0 (7) .OO (8) (9) 6,11:3.69 (lO) 21,916.~8 (11) (12) lq NOTE: CharitabXe/Governmentel Bequests; Non-elected 911:5 Trusts (Schedule J) Nat Value of Estate Sub~ect to Tax zf an assessment Has lssued previously, lines 1~, 15 and/or reflect figures that include the total of ALL returns assessed to date. ASSESSNENT OF TAX: 15. Amount of Line lq at Spousal rate (15) .00 X O0 = 16. Amount of Line 1~ taxable at L/neal/Class A rate (16) 51,075.2~ X 045 = 17. Amount of L/ne 1~ at SibXing rate (17) .00 X 12 = 18. Amount of Line lq taxable et Collateral/Class B rate (18) .00 X 15 = 19. Principe! Tax Due (19)= TAX CREDZTS: PAYHENT RECE/PT DZSCOUNT DATE NUNBER ZNTEREST/PEN PAZD (-) 10-06-2003 CD005090 114.92 AHOUNT PAZD 2,300.00 ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 79,105.10 28.o29~87 51,075.2~ TOTAL TAX CREDZT'I BALANCE OF TAX DuE XNTEREST AND PEN. TOTAL DUE 2,414.92 116.53CR .00 116.53CR ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS RE~UZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR), YOU NAY BE DI~-~ A REFUND. SEE REVERSE SZDE OF THZS FORN FOR ZNSTRUCTZONS.)~./~) .00 .00 2,298.$9 2,298.$9 (15) . O0 (1~) 51,075.23 16, 17, 18 and 19 will .00 RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADH/N- [STRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December II, 19BZ -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after tho expiration of any estate for life or for years, the Commonwealth hereby exprsssly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To ~ulfi11 the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act g$ of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF NILES, AGENT A refund of a tax credit, which Has not requested on the Tax Return, may be requested by completing an "Application far Refund of Pennsylvania Inheritance and Estate Tax" [REV-ISI~). Applications ara available at the Office of the Register of Niils, any of the Z3 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-BOO-36Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-30Z0 (TT Any party in interest not satisfisd with the appraisement, alloNance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (603 days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 17128-1021, --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. OR Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 171ZB-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 ($) calendar months after the dscadent's death, a five percent (SX) discount of the tax paid is alloNed. The 15Z 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 ihs end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the sams time period as you would appeal the tax and interest that has been 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 date of payment. Taxss which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and aftsr January i, 198Z Nil1 bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19BI through Z005 ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 19AZ ZOZ .000548 1987 97. .000Z47 1999 77. .00019Z 1983 16Z .00043B 1988-1991 117. .000501 ZOOO 87. .OOOZ19 198~, 117. .000301 199Z 97. .000247 2001 97. .000247 1985 137. .000356 1993-1994 77. .O0019Z ZOOZ 67. .000164 1986 107. .OODZ74 1995-199B 97. .000Z47 ZO05 57. .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELTNQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the dots of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must ba calculated.