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Home My WebLink About03-0012 PETITION FOR PROBATE and GRANT OF LETTERS Estate of E. Marshall Cushman No. A I--O5 '~ also known as To: Register of Wills for the · Deceased. , County of Cumberland in the Social Security No. 206-10-8071 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 named in the last will of the above decedent, dated March 11. 1999 ,19.~ and codicil(s) dated N/A (state relevant circumstances, c.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h is last family or principal residence at Messiah Village, 100 Mt. Allen Drive, Mechanicsburg, PA 17055 Upper Allen Township (list street, number and muncipality) Decendent, then 83 years of age, died December 29, ,~1~ 2002 , at Messiah Village; 100 Mt. Allen Dr~ve, M~chan~e.~hur~ PA 17055 Except as follows, d~cedent did not marry, was not divorced and did not-have a child born or adoptefi after executiOn of the will offered for pr~)bate; was not the victim of a killing and was never adjudicated · incompetent: None (Note: decedent was a widower and ha~ no natural or adopted issue) Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 150.000, (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: None WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Tes t ~_ment ~_ry theron. (testamentary; administration c.t.a.; administration d.~..n.c.t.a.) Penn~e L. Smith 598 I-l'~ghl~nd St: ~.h...,- "Harricburg DA 1'711'~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF cm h :r] ' 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 ~m~ subscribed v, ~'/~ b~.em~e~,~,,.._. ~X ~-- lOo',',q.,330.day of { - Register NO. 21-2003-12 Estate of E, Marshal] Cashman , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW January 7th ~ 200.~ in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated I/arch 11, 1999 described therein be admitted to probate and filed of record as the last will of E. Marshall ; and Letters Testmentary l?ennie L. Smith are hereby granted to FEES Probate, Letters, Etc .......... $ 235.00 Short Certificates(4 ) .......... $ 12.00 ATTORNEY (Sup. Ct. I.D. No.) Jered L. Hock,Esq, ID# 19211 Renunciation ................ $ 3211 N. Front St x-Pages ( 2 ) $ 6 ..00 ADDRESS JCP 10.00 TOTAL __~ $ PO Box 5300 Filed .3..atg.u..c%~Y.. 7.t.b, ?.0.0.3 ..... $263,00.. n~ ~h,lr~ pA 1711H-~qO~ PHONE 717.238-8187 Called Attorney first, then mail letters. This is to certif;/that the infbrmation here given is correctly copied from an original certificate of death duly filed with me as Ix)cai Registrar. The original certificate will be fo,:wardcd to thc State Vital Records Ofrice for permanent filing WARNING: It is illegal to duplicate this copy by photostat or photograph. Fec for this certificate, 52.00 ~ ~ Local Registrar ~,, ~-2 a~ ..,,~ N o. ~ Date ~3a(' 2'87 COMMONWEALTH OF PENNSYLVANI EPARTMENT OF HEALTH · VITAL RECORDS CERTIFI~.,~I'E OF DEATH s. 83 ~. i , 3-2-19 ~gddfetown,PA '~ 100 Mt. Allen Drive l~ ,,..~,. ,. M chanrcsb~g, PA 17055 ~,.,~ Alb~t Guy C~hman ~or.~,.s,,,~,~,,. BeAtha .... Helen~'~'m"~'~'~M~qrave Jack O. C~hman ~.1170 Hi~hland S~eet, Ob~lin, PA 17113 ~L~ I NAME~O~R~F~UW C~emq~ign Sqc~et~ of.PA 21-2003-12 LAST WILL AND TESTAMENT OF E. MARSHALL CASHMAN I, E. MARSHALL CASHMAN, having my legal residence at Country Meadows, 451 Sand Hill Road, Derry Township, Dauphin County, Commonwealth of Pennsylvania hereby declare this to be my Last Will and Testament, revoking all other Wills and Codicils heretofore made by me. ITEM ONE: I direct that the expenses of my last illness and funeral be paid from my estate as soon as practicable after my death. ITEM TWO: All the residue of my estate shall be divided into as many equal shares as there are children of my deceased brothers and sisters then living. Each then living child of my deceased brothers and sisters shall receive one such share, provided, however, that ELSA KOVALL, daughter of my deceased sister, ROMAINE KOVALL, shall not be entitled to receive a share of my estate; and provided, further, that DeWAYNE BOYER, grandson of my deceased brother, ELMER E. CASHMAN, shall be entitled to receive a share of my estate as if he were a child of my deceased brother. ITEM THREE: All estate, inheritance, succession and other death taxes, imposed or payable by reason of my death, and interest and penalties thereon, with respect to all property comprising my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid out of the principal of my general estate, as if such taxes were administration expenses, without apportionment or right of reimbursement. I authorize my legal representatives to pay all such taxes at such time or times as may be deemed advisable. ITEM FOUR: I appoint PENNIE L. SMITH, Executrix of this Will and direct that she be permitted to serve without bond and without any intervention of any court except as required by law. I authorize my Executrix to sell, encumber, mortgage, invest, distribute in kind, or retain any items of personal property of my estate in such manner as she shall deem proper, limited only by her own discretion. WHEREOF, I have at Hershey, Pennsylvania, this //~day of WITNESS /~ o.,~c-~ , 1999, set my hand and seal to this, my Last Will and Testament consisting of three (3) pages, including the acknowledgment. ? (SEAL) E. MARSHALL CASHMAN SIGNED, sealed, published and declared by E. MARSHALL CASHMAN, the above named Testator, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence and in the presence of each other, have hereunto subscribed our names as witnesses. (~'~I/Z[---~._ Residence ~/~c/'t~,/~ ~ ~'~ Residence 7~~ ///~ ACKNOWLEDGMENT the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly swom, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and that he had signed willingly (or willingly directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witnesses and that to the best of their knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. TESTATOR WITNESS Subscribed, swom to and acknowledged before me by E. MARSHALL CASHMAN, the Testator, and subscribed and sworn to before me by xJl~q,*f'/' t~/-~/,2J~n/ and ~ O' 7o;~ ,witnesses,~is ~/~ day of~O~ ,1999. NOTARY P~LIC / ~ .....~ ................. ~ P ..... c ~ E. MARSHALL CASIiMAN 451 SAND HILL ROAD HERSHEY, PA 17033 LAST WILL AND TESTAMENT YOST & DAWOSON 320 WEST CHOCOLATE AVENUE P.O. BOX 437 HERSHEY, PENNSYLVANIA 17033-0437 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent : E. Marshall Cashman Date of Death : December 29, 2002 Will No.: 2003-00012 Admin. No.: To the Register: I hereby certify that notice of beneficial interest 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 January ~, 2003 . Name Address Janice Knight 6318 South Washington; Lansing, MI 48911 Adam Koval 575 East Lake Street, Apt. 64; South Lyon, MI 48178 Bryon Koval 3032 East Mt. Morris Road; Mt. Morris, MI 48458 James Koval 4395 Corey Circle; Ann Arbor, MI 48103 Edward Cashman 2232 Wabash; Lansing, MI 48910 (continued on attached sheet) Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: January ~, 2003 ~ Name Jered L. Hock, Esquire Address 3211 North Front Street P.O. Box 5300 Harrisburg, PA 17110-0300 Telephone (717) 238-8187 · Capacity: __ Personal Representative X Counsel for Personal Representative Document #: 260005.1 Estate of E. Marshall Cashman DOD: December 29, 2002 Will No. 2003-00012 Page 2 Name Address Kim Wood 4283 Bramblewood Court; Dorr, MI 49323 Jean Felgenhauer 7331 Orchard Lake Road; New Port Richie, FL 34653 Arlene Thompson 3817 Treasure Hill Lane; Timberville, VA 22853 Marty Jane Custer 20 Oakland Manor; Highspire, PA 17034 Dwayne Boyer 17214 Emerson Drive; Silver Springs, MD 20905-3751 Mona Finegan 219 Allen Street; Middletown, PA 17057 Georgian Goff 701 Cassel Road, Lot 87; Manchester, PA 17345 Guy Perelli 701 Cassel Road, Lot 48; Manchester, PA 17345 Michael Perelli One Pine Street; Fredericksburg, PA 17026 George Perelli, Jr. 581 Schubert Road; Bethel, PA 19507-9666 Frank Perelli Three Mars Street; Oberlin, PA 17113 In addition, notices were sent to the following living siblings of decedent, although they are not beneficiaries under the Will: Jack Cashman 1170 Highland Street; Oberlin, PA 17113 Irene Elston 8760 Cockrafi Road; Eaton Rapids, MI 48827 Theda Bulsey 446 High Point, Apt. 1; Mason, MI 48854 Document #: 260005.1 SINCE 1888 3211 North Front Street P.O. Box 5300 September 26, 2003 .('j~ 'c,i:? ~o ~ / i::. "~O Harrisburg, PA17110-0300 '; ....... 717-238-8187 Fax: 717-234-9478 ~-' Other Offices Office of Register of Wills ',-;"~ · Colonial Park Mechanicsburg Cumberland County Courthouse 717-652-7020 717-691-5577 MillersburgShippensburg One Courthouse Square 717-692-5810 717-530-7515 Carlisle, PA 17013 Re: Estate of E. Marshall Cashman No. 2003-00012 Ladies and Gentlemen: Enclosed for filing are original and one copy of Inheritance Tax Return, along with check in the amount of $15 for filing the same and the Executrix' check for $64,129 for payment of taxes. So that I may be sure this mailing has been received and the filing completed, please stamp the extra copy of the summary page with your clock-in stamp and return it to me in the pre-posted envelope provided. Thank you. Very truly yours, SHAM, KNAUSS & ERB, P.C. Jered L. Hock JLH/amm Enclosures cc: Pennie L. Smith James F. Carl Edward E. Knauss, IV* Jered L. Hock Steven P. Miner Clark DeVere Milton Bemstein Bruce J. Warshawsky Francis J. Lafferty, IV David H. Martineau Andrew W. Norfleet 289250-1 Andrew C. Spears Young-Suh Koo * Board Certified in civil trial law and advocacy by the National Board of Trial Advocacy '~t Class Mail II · COMMONWEALTH OF DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN F LE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z Cashman E. Marshall 206-10-8071 LU DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE uJ 12/29/2002 03/02/1919 REGISTER OF WILLS LU (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER "' I x I 1. Return I I 2. Supplemental Return ~ Original , , 3. Remainder Return (date of death I:rior to 12-13-8 u =="~ I a 4. Limited Estate II 4a. Future Intarest Compromise (date of death after 12-12-82) I I 5. Federal EstateTax Return Required 3: Oo n-.~ i~1 5. Decedent Died Testate (Attach copy of Will) II 7. Decedent Maintained a Living Trust (Attach copy of Trb(~t) -- 8. Total Number of Safe Deposit Boxes O ¢{ [~ 9. Litigation Proceeds Received r--] 10. spousal Poverty Credit (da,e of death between 12-31-Sl and 1-1-95) J~] 11. Election to tax under Sec. 9113(A)(A, ach Sch :THiS SECTION :M 0S~: BE: COMPI_~EDi:A~ ~OR RESPO N D E N ~E :AN D CONFiDENTi~ TAX: iNFOR MATibN :SHOU~ BE DiRE~EDi ,,z, NAME COMPLETE MAILING ADDRESS z Jered L. Hock, Esquire 3211 N. Front St.; PO Box 5300 o FIRM NAME (If Applicable) Harrisburg, PA 17110-0300 Met zger Wickersham O TELEPHONE NUMBER 717-238-8187 1. Real Estate (Schedule A) (1) 0 OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule B) (2) 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0 4. Mortgages & Notes Receivable (Schedule D) (4) 0 --~ 5. Cash. Bank Deposits & Miscellaneous Personal Property 2 07, 113 (Schedule E) (5) §. Jointly Owned Property 0 (Schedule F) ¢~ ~1 Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 314,6 3 7 ~) (Schedule G or L) ~' 8. Total Gross Assets (total Lines 1-7) 521, 75 0 ~ (8) LU 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 25,859 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 5, 4 3 9 11. Total Deductions (total Lines 9 & 10) ( 11 ) 3 1, 2 9 9 12. Net Value of Estate (Line 8 minus Line 11 ) (12) 4 90,4 52 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (13) 0 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) ~ 90 ~ ~ 52 SEE INSTRUCTIONS ON REVERSE SIDE FOB APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax Z rate, or transfers under Sec. 911§ (a)( 1.2) 0 x .O 0 . 0 0 (15) 0 O 0 45 0 16. Amount of Line 14 taxable at lineal rate x .0 ( 1 13. 17. Arnount of Line 14 taxable at sibling rate 314 637 37, 756 ~ ' x .12 (17) o ~ 18. Amountof Line 14 taxable at collateral rate. 175, 815 x.l§ (18) 26, 372 X ~- 19. Tax Due (19) 64,129 > > BE SURE TO ANSWER ALL QUESTIONS:ON REVERSE SIDE AND RECHECK MATH < < HASPXXNUMBER RE~1508 EX + (1-97) SCHEDULE E COMMONWEA~H OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX R~URN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF FI~ NUMBER E. Marshall Cashman Include the =roceeds of litigation and the date the proceeds were received ~ ~e es~. All property joint~wned w~h the right of survivorship mu~ be disc~sed on Schedule ITEM VALUE AT DATE NUMBER DESCRIPTION OFDEATH 1. Coins of decedent 356 2 Fulton Bank Certificate of Deposit #033-0170273 60,000 Interest accrued to 12/29/2002 33 3 IRS - income tax refund 4,751 4 PA Benefit Trust Fund - periodic check to decedent 473 5 PA Department of Revenue - income tax refund 416 6 PSECU, Account #0206108071 12 Month Certificate-1 (S50) 22,972 Interest accrued to 12/29/2002 47 7 PSECU, Account #0206108071 12 Month Certificate (S57) 10,777 Interest accrued to 12/29/2002 22 8 PSECU, Account #0206108071 24 Month Certificate (S54) 23,060 Interest accrued to 12/29/2002 55 9 PSECU, Account #0206108071 24 Month Certificate (S55) 12,741 Interest accrued to 12/29/2002 23 10 PSECU, Account #0206108071 Checking Shares (S4) 7,122 Interest accrued to 12/29/2002 8 11 PSECU, Account #0206108071 Regular Shares (Si) 2,257 Total from continuation pages 62,000 TOTAL (Also enter on line 5, Recapitulation) $ 207,113 HASPXXNUM9ER (If more space is needed, insert additional sheets of the same size) Schedule E (Page 2) Estate of: E. Marshall Cashman Item Value at Date No. Description of Death Interest accrued to 12/29/2002 3 12 Waypoint Bank Certificate of Deposit #7100020098 61,834 Interest accrued to 12/29/2002 164 Total (Carry forward to main schedule) 62,000 REV-1510 EX + (1-97) SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER E. Marshall Cashman This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DATE OF DEATH DECD'S EXCLUSION DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE TAXABLE VALUE NUMBEI~ DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 1. Hartford Life Annuity Contract #26173 71,643 100.000 0 71,643 2 Hartford Life Annuity Contract #27854 58,389 100.000 0 58,389 3 MetLife Annuity Contract #030069530MA 120,866 100.000 0 120,866 4 MetLife Annuity Contract #M9100345 63,739 100.000 0 63,739 TOTAL (Also enter on line 7, Recapitulation) $ 314,637 (If more space is needed, insert additional sheets of same size.) HASPXXNUMBER REV-1511 EX + (1-97) SCHEDULE H FUNERAL EXPENSES & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER E. Marshall Cashman Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Rolling Green Cemetery 485 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 12,000 Nameof Personal Representative(s) Pennie L. Smith Social Security Number(s) / EIN Number of Personal Representative(s) 184 - 36 - 5865 Street Address 528 Highland Street City Enhaut, Harrisburg State PA Zip 17113 Year(s) Commission Paid: 2003 2. Attorney Fees Metzger, Wickersham, Knauss & Erb, P.C. (estimated) 12,000 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees ?-63 5. Accountant's Fees 6. Tax Return Preparer's Fees Metzger ~ W±ckersham~ Knauss & Erb, P.C. (est±ma~ed) 450 7. 1 Cumberland County Register of Wills - fee to file Inheritance Tax Return 15 2 Cumberland Law Journal - fee to publish Estate Notice 75 Total from continuation pages 571 TOTAL(Also enter on line 9, Recapitulation) $ 25, 859 HASPXXNUMBER (If more space is needed, insert additional sheets of same size) Schedule H part 2 (Page 2) Estate of: E. Marshall Cashman Item No. Description Amount 3 Dauphin County Register of Wills - oath fee 15 4 Metzger, Wickersham, Knauss & Erb, P.C. reimbursement for photocopies, fax, postage 169 5 Metzger, Wickersham, Knauss & Erb, P.C. - reserve for further postage and photocopies 145 6 Patriot News - fee to publish Estate Notice 118 7 Reserve for closing 75 8 State Employees Retirement Fund - reimbursement for December overpayment 50 Total (Carry forward to main schedule) 571 REV-1512 EX + (1-97) SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER E. Marshall Cashman Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. Messiah Village - ambulance transport, debt of decedent 79 2 Messiah Village - debt of decedent 4,605 3 Pennie Smith - Power of Attorney services for calendar year 2002, debt of decedent 650 4 Pharamerica - debt of decedent 68 5 Philhaven - debt of decedent 37 TOTAL(Also enter on line 10, Recapitulation) i $ 5,43 9 HASPXXNUMBER (If more space is needed, insert additional sheets of the same size) REV- 1513 EX* (9q)O) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER E. Marshall Cashman RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9110 (a) ( 1.2)] 1. DeWayne H. Boyer 17214 Emerson Drive Silver Spring, MD 20905 General Bequests: 10,988 Nephew 10,988 2 Theda Busley 446 High Point Drive Apartment 1 Mason, MI 48854 General Bequests: 104,879 Sister 104,879 Total from continuation pages 374,585 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ HASPXXNUMBER (If more space is needed, insert additional sheets of the same size) Schedule J part 1 (Page 2) Estate of: E. Marshall Cashman Item No. Description Relation Amount 3 Edward C. Cashman 2232 Wabash Road Lansing, MI 48910 General Bequests: 10,988 Nephew 10 988 4 Jack O. Cashman 1170 Highland Street Oberlin, PA 17113 General Bequests: 104,879 Brother 104,879 5 Martha J. Custer 20 Oakland Manor Highspire, PA 17034 General Bequests: 10,988 Niece 10,988 6 Irene L. Elston 8760 Cockroft Road Eaton Rapids, MI 48827 General Bequests: 104,879 Sister 104,879 7 Jean C. Felgenhauer 7331 Orchid Lake Road New Port Richey, FL 34653 General Bequests: 10,988 Niece 10,988 8 Mona M. Finegan 219 Allen Street Middletown, PA 17057 General Bequests: 10,988 Niece 10,988 9 Georgianna Goff 701 Cassel Road, Lot 87 Manchester, PA 17345 General Bequests: 10,988 Niece 10,988 Total (Carry forward to main schedule) 0 Schedule J part 1 (Page 3) Estate of: E. Marshall Cashman Item No. Description Relation Amount 10 Bryon G. Goth-Kovall 3032 East Mt. Morris Road Mt. Morris, MI 48458 General Bequests: 10,988 Nephew 10,988 11 Janice M. Knight 6318 South Washington Avenue Lansing, MI 48911 General Bequests: 10,988 Niece 10,988 12 Adam H. Kovall 575 East Lake Street Apartment 64 South Lyon, MI 48178 General Bequests: 10,988 Nephew 10,988 13 James H. Kovall 4395 Corey Circle Ann Arbor, MI 48103 General Bequests: 10,988 Nephew 10,988 14 George Perrelli Jr. 581 Schubert Road Bethel, PA 19507 General Bequests: 10,988 Nephew 10,988 15 Frank J. Perrelli Three Mars Street Oberlin, PA 17113 General Bequests: 10,988 Nephew 10,988 16 Guy A. Perrelli 701 Cassel Road, Lot 48 Manchester, PA 17345 General Bequests: 10,988 Nephew 10,988 Total (Carry forward to main schedule) 0 Schedule J part 1 (Page 4 Estate of: E. Marshall Cashman Item No. Description Relation Amount 17 Mike Perrelli One Pine Street Fredericksbur9, PA 17026 General Bequests: 10,988 Nephew 10,988 18 Arlene R. Thompson 3817 Treasure Hill Lane Timberville, VA 22853 General Bequests: 10,988 Niece 10,988 19 Klm C. Wood 4283 Bramblewood Court Dorr, MI 49323 General Bequests: 10,988 Niece 10,988 Total (Carry forward to main schedule) 0 21-2003-0012 LAST WILL AND TESTAMENT OF E. MARSHALL CASHMAN I, E. MARSHALL CASHMAN, having my legal residence at Country Meadows, 451 Sand Hill Road, Derry Township, . Dauphin County, Commonwealth of Pennsylvania hereby declare this to be my Last Will and Testament, revoking all other Wills and Codicils heretofore made by me. ITEM ONE: I direct that the expenses of my last illness and funeral be paid from my estate as soon as practicable after my death. ITEM TWO: All the residue of my estate shall be divided into as many equal shares as there are children of my deceased brothers and sisters then living. Each then living child of my deceased brothers and sisters shall receive one such share, provided, however, that ELSA KOVALL, daughter of my deceased sister, ROMAINE KOVALL, shall not be entitled to receive a share of my estate; and provided, further, that DeWAYNE BOYER, grandson of my deceased brother, ELMER E. CASHMAN, shall be entitled to receive a share of my estate as if he were a child of my deceased brother. ITEM THREE: All estate, inheritance, succession and other death taxes, imposed or payable by reason of my death, and interest and penalties thereon, with respect to all property comprising my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid out of the principal of my general estate, as if such taxes were administration expenses, without apportionment or right of reimbursement. I authorize my legal representatives to pay all such taxes at such time or times as may be deemed advisable. ITEM FOUR: I appoint PENNIE L. SMITH, Executrix of this Will and direct that she be permitted to serve without bond and without any intervention of any court except as requLred by law. I authorize my Executrix to sell, encumber, mortgage, invest, distribute in kind, or retain any items of personal property of my estate in such manner as she shall deem proper, limited only by her own discretion. IN WITNESS WHEREOF, I have at Hershey, Pennsylvania, this ///~'day of /&o,~t-- ., 1999, set my hand and seal to this, my Last Will and Testament consisting of three (3) pages, including the acknowledgment. (SEAL) E. MARSHALL CASHMAN SIGNED, sealed, published and declared by E. MARSHALL CASHMAN, the above named Testator, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~'~ Residence ~f,t~ r//,~ ,~j~2- Q~~'~ Residence 7/f~ //~/~ 2 ACKNOWLEDGMENT We, E. MARSHALLCASHMAN, O~o~r~.l~r~.q/ and ~-~ the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and that he had signed willingly (or willingly directed another to sign for him), and that he executed it as' his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence .and hearing of the Testator, signed the Will as witnesses and that to the best of their knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. TESTATOR WITNESS Subscribed, sworn to and acknowledged before me by E. MARSHALL CASH]MAN, the Testator, and subscribed and sworn to before me by and '"~.J~ 2 O' 7~5'7'--- , witnesses, this /77//-> day Of~Q,~C~ , 1999. COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003063 HOCK JERED L ESQ P O BOX 5300 3211 NORTH FRONT STREET HARRISBURG, PA 17110 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold .................. 101 $64,129.00 ESTATE INFORMATION: SSN.- 206-10-8071 FILE NUMBER: 2103-0012 DECEDENT NAME: CASHMAN E MARSHALL DATE OF PAYMENT: 09/29/2003 POSTMARK DATE: 09/26/2003 COUNTY: CUMBERLAND DATE OF DEATH: 12/29/2002 TOTAL AMOUNT PAID: $64,129.00 REMARKS' PENNIE SMITH-EXECUTRIX C/O JEROD L HOCK ESQUIRE CHECK# 124 INITIALS: JA SEAL RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS //~-~--/-//~-~-~ COMMONWEALTH OF PENNSYLVANZA ~BUREAU OF ZNDZVZDUAL TAXES DEPARTMENT OF REVENUE ZNHERITANCE TAX DIVZSION DEPT. 280601 HARRISBURG, PA 171Z8-0601 NOTZCE OF ZNHERZTANCE TAX APPRAZSEMENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCT/ONS AND ASSESSMENT OF TAX REV-1;47[XAFP¢Ol-DS) DATE 11-17-2005 ESTATE OF CASHMAN E M DATE OF DEATH 12-29-2002 FZLE NUMBER 21 05-0012 ~ ' -i ';' COUNTY CUMBERLAND JERED L HOCK ESQ ' ACN 101 METZGER WICKERSHAM I Amount Raait~ad PO BOX 5500 I HBG PA 17~10 MAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS REV-1547 EX AFP (01-03) NOTICE OF INHERZTANCE TAX APPRAZSEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTZONS AND ASSESSMENT OF TAX ESTATE OF CASHMAN E MFZLE NO. 21 05-0012 ACN 101 DATE 11-17-Z005 TAX RETURN NAS: (X) ACCEPTED AS FZLED ( } CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, $. Closely Held Stock/Partnersh/p Tntarast (Schedule C) ($) .00 submit ~he upper portion q. Mortgages~Notes Receivable (Schedule D) (q). .00 of th/s for. w/th your 5. Cash/Bank Deposits~Misc. Personal Property (Schedule E) (E) Z07;115.00 tax payment. 6. Jointly O~nad Property (Schedule F) (6). .00 7. Transfers (Schedule G) (7) 8. Tote1 Assets (8) 521,750.00 APPROVED DEDUCTXONS AND EXEMPTXONS: 25,859.00 9. Funeral Expanses/Adm. Costs~Misc. Expenses (Schedule H) (9} 10. Debts/Mortgage Liabili~/es/Lians (Schedule Z) (10) 5~q~9.00 11. To'al Deductions (11) ~].299.flfl 12. Na~ Value of Tax Re~urn (12) qOO,q52.00 15. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 lq. Na~ Value of Estate Subjac~ to Tax (lq) qOO,qSZ.O0 NOTE: Zf an assess.ent was issued previously, 11nas 1~, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of L/ne lq at Spousal rata (15} .00 X O0 = .00 16. Amount of L/ne lq taxable at L/naal/Cless A rate (16) .00 X Oq5 = .00 17. Amoun~ of L/ne lq at S/bling rata (17) $1q,637.00 x 12 = 37,756.00 18. Amount of L/ne lq taxable at Collateral/Class B rate (18) 175,815.00 x 15 = 26,372.00 19. Pr/nc/pal Tax Due (19): 6q,lZO. O0 TAX CREDZTS: PAYMENT RECEIrl DZSCOUNT (+) AMOUNT PAZD DATE NUMBER ZNTEREST/PEN PAZD (-) 09-Z6-Z00$ CD005065 .00 6q,129.00 TOTAL TAX CREDZT I 6q,129.00 BALANCE OF TAX DUEl .00 ~NTEREST AND PEN. .00 TOTAL DUE .00 I'F pATD AFTER DATE TNDI'CATED, SEE REVERSE ( TF TOTAL DUE TS LESS THAN $1, NO PAYMENT TS REI~UTRED. FOR CALCULATTON OF ADDTTTONAL I'NTEREST. TF TOTAL DUE TS REFLECTED AS A 'CREDTT' (CA), YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR TNSTRUCTI'ONS.) RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any futura interest in the estate is transferred in possession or enjoyment to Class S (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonmealth hereby expressly reserves the right to appraise and assess transfer [nheritance Taxes at the laaful Class D (collateral) rata on any such future interest. PURPOSE OF NOTICE: To ~ulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: REGISTER OF NXLLS, AGENT REFUND (CA): 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-1313). Applications ara available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-362-Z050; services for taxpayers aith special hearing and / or speaking needs: 1-800-447-$020 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, alloaance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object aithin sixty (60) days of receipt of this Notice by: --written protest tothe PA Department of Revenue, Board of Appeals, Dept. ZelOZ1, Harrisburg, PA 17IlS-lOll, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in eriting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 171Z8-0601 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. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (SI) discount of the tax paid is allowed. PENALTY: The 1SI 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 time period as you mould appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: 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 ahich became delinquent before January 1, 19az bear interest at the rate of six (6Z) percent per annum calculated at a dally rate of .00016q. All taxes which became delinquent on and after January 1, 198Z mill bear interest at a rate which mill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates far 198Z through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor XgBZ lOX .O00Sq8 1987 9Z .000Z47 1999 ?Z .000192 1983 16Z .000q38 1988-1991 llZ .000301 ZOO0 8Z .O00Zl9 198q Z1Z .O00~OX 1992 9Z .000247 2001 9Z .000247 1985 13Z .000356 1993-1994 7Z .O0019Z ZOOZ 6Z .000164 1986 lOX .000274 1995-1998 9Z .000Z47 ZOO3 5Z .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST 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 sheen on the Notice, additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent' Marshall E. Cashman Date of Death' 12/29/2002 Will No. 2003-00012 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 X No ~ 2. If the answer is No, state when the personal ::-., representative reasonably believes that the administration will be ~ complete · ' C22' 3. If the answer to No. 1 is Yes, state the following: I a. Did the personal representative file a final account with the Court ? Yes ~ No X ~-'~ 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 X No ~ d. 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 attach~ Signature dered L. Hock, Esquire Name (Please type or print ) 3211 N. Front St., PO Box 5300 Harrisburq PA 17110-0300 Address (717) 238-8187 Tel. No. Capacity' ~ Personal Representative × Counsel for personal representative THE PATRIOT NEWS THESUNDAY PATRIOT NEWS Proof of Publication UnderAct No. 587, Approved May 16, 1929 Commonwealth of Pennsylvania, County of Dauphin} ss JOSEPH A. DENNISON being duly sworn according to law, deposes and says: That he is the Asst. Controller of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or Sunday/ Metro editions which appeared on the 28th day(s) of January and the 4th and 11th day(s) of February 2003. That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M", vo,ume 14, PUBLICATION .................................... ' ...... COPY Sworn to and subscri ~~y~.. ~~_003.~ Notarial Seal Terry L. Russell, Notary Public // City Of Harrisburg, Dauphin County N(~A~ PUBLIC My Commission Expires June 6, 2006 #OTICE LeftersTestclmlntar~lnfheE.s..t~e_ofE_.~; Member, Pennsylvania AssodatJon Of Notaries My commission expires June 6, 2006 shall Cashman, late of Umber Allen 1 .g~?n ~'.m~mrMntl County PennsYIvOrllO~ d~CeCl~ea (died December29,20Q2),havlng .be~n?.?~n.~' METZGER, WICKERSHAM, SNAUSS & ERB, P.O. acid eshate are requ#t~d to .mo.[(. i?m__~_ m_nt ATTN: MICHAEL J. BRODERICK poyment and tlto~e hovlng Claims m themwlttmutdeloyto: P.O. BOX 5300 Pennle L. Smith, ExeCldrlx s2. Xnhbnd Sts'~ HARRISBURG, PA. 17110 Enlmid, H.n. lslx,rll, PA 17113 OR JerMI L. Heck, E~ClUlre MITZGER, WICKERSHAM, SNAUSS Statement of Advertising Costs & IRB, P.C. i p.o. BOX 53e0 ~11 North Front St~t To THE PATRIOT-NEWS CO., Dr. ;.;G,-;-;;,y,:rg, PJ1711~4~M '' For publishing the notice or publication attached hereto on the above stated dates $ 1 1 5.86 Probating same Notary Fee(s) $ 1.75 Total $ 11 7.61 Publisher's Receipt for Advertising Cost The Patriot News Co., publisher of The Patriot-News and The Sunday Patriot-News, newspapers of general circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have been duly paid. By .................................................................... PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 STATE OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in fne Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz: JANUARY 31, FEBRUARY 7, 14, 2003 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. ::::::~ L~sa~Marie Coyne,/Editor Cashman, E. Marshall, dec'd. ~t¢ of the Tow-shiv of Uvper ~- SWORN TO AND SUBSCRIBED before mc this len. Execute: Pe~ie L. Smith, ~2S 14 day of FEBRUARY, 2003 Highland Street, Enhaut, Harr~s- burg, PA 17113. Attorneys: dercd L. Hock, Esquire, Metzger, Wickersham, Knauss & Erb, P.C., P.O. Box 2300, 3211 North Front Street, Harrisburg, PA 17110-0300. COMMONWEALTH CF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 260601 HARRISBURG, PA 17126-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLV ANIA INHERITANCe AND ESTATE T^X OFFICIAL RECEIPT SMITH PENNIE L 528 HIGHLAND STREET ENHAUT, PA 17113 ____u__ told ESTATE INFORMATION: SSN: 206-10-8071 FILE NUMBER: 2103-0012 DECEDENT NAME: CASH MAN E MARSHALL DATE OF PAYMENT: 06/20/2006 POSTMARK DATE: 06/1 9/2006 COUNTY: CUMBERLAND DA TE OF DEATH: 12/29/2002 NO. CD 006853 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $519.54 I I I I I I I I TOTAL AMOUNT PAID: REMARI<S: CHECI<# 101 SEAL INITIALS: MG RECEIVED BY: REGISTER OF WILLS $519.54 GLENDA FARNER STRASBAUGH REGISTER OF WILLS 09-18-2006 CASHMAN 12-29-2002 21 03-0012 CUMBERLAND 501 APPEAL DATE: 11-17-2006 ( See reverse side under Objections) A.ount ReMitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iEv:i5~;-Ei-AFP-(03:05j-NoTicE-oF-iNHiiiTANci-TAi-APpiAiSEMENT:-ALLOWANCE-oi--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX E M FILE NO. 21 03-0012 ACN 501 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE r-.rr"r-."ro "'Ff'I\' I"d" tlU" JHLF ) \) [t,..it I.)t NOTICE OF INHERITANCE TAX BURI;AU OF INDIVIDUAL TA~ ~'~I~';:::"':::C" II A"RAISEHENT, ALLOWANCE OR DISALLOWANCE ~~T~~orAX DIVISION :it<j,~ '~,-: r_'i,\'!:...DF DEDUCTIONS AND ASSESSHENT OF TAX HARRISBURG PA 17128-0601 2006 SEP 18 PH 2: 57 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN CLERK OF Or',r" ',''.,' "~,' ('\1",', ',I[IT 1~-:'rl-":~."i\.; ::'! I'.'.o,)'_.fj 11 JERED L HOC{:~'SQ" ,-, r)/~, METZGER WICKERSHAM PO BOX 5300 HBG PA 17110 ESTATE OF CASHMAN '*' REV-1547 EX AFP (06-05) E M TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED DATE 09-18-2006 If an asses~ent was issued previoUSly. lines 14. 15 and/or 16. 17. 18 and 19 will reflect figures that include the tatal of ALL returns assessed to date. ASSESSMENT OF TAX: 15. A80unt of Line 14 at Spousal rate (15) 16. AMount of Line 14 taxable at Lineal/Class A rate (16) 17. Mount of Line 14 at Sibling rate (17) 18. A~t of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TS: RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN 1. Reel Estate (Schedule A) (1) 2. Stocks and Bonds (Schadule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Hortgagas/Notes Receivable (Schedule D) (4) S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets .00 .00 .00 .00 4.243.59 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/A~. Costs/Hisc. Expenses (Schedule H) 10. Dabts/Hortgaga Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts 14. Net Value of Estate Subject to Tax 780.00 (9) (10) .00 (1U (12) (13) (14) (Schedule ..I) NOTE: .00 .00 .00 3,463.59 X 00 = X 045 = X 12 = X 15 = DATE 06-19-2006 AItOUNT PAID 519.54 NUttBER CD006853 INTEREST/PEN PAID (-) .00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. NOTE: To insure proper credit to your account, subllit the upper portion of this fo~ with your tax paYllBnt. 4,243.59 780 00 3,463.59 .00 3,463.59 (19)= .00 .00 .00 519.54 519.54 519.54 .00 .00 .00 \V ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)