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Home My WebLink About01-0632 PETITION FOR PROBATE and GRANT OF LETTERS , Deceased. 21-01-632 Mary Lewis Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania Estate of HALE HAMPTON KNIGHT No. also known as Hale H. Knight To: Social Security No. 523-05-9606 The petition of the undersigned respectfully represents that: Your petitioner, who is 18 years of age or older and the Executor named in the last will of the above decedent, dated November 5, 1992 as the designated Executrix and the other designated Executor have renounced serving as Executor. (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 175 Northgate Drive, Camp Hill, Cumberland County, Pennsylvania 17011 VPfEL ~ <fJ~~umber,andmuniCipality) Decedent, then 81 years-of age, died June 18, 2001, at Health South Rehabilitation Hospital, Lower Allen Township, Cumberland County, 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: Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ $ $ $ $ 2.$"00 . Oe,> WHEREFORE, petitioner respectfully requests the probate of the last will and codicil(s) presented herewith and the grant ofletters Testamentary thereon. (testamentary, administration c.t.a.; administraf G-- GREGO H. GHT 19 Brookwood Avenue, Suite 106 Carlisle, P A 17013 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYL VANIA ) SS COUNTY OF CUMBERLAND ) Sworn to or affirmed and subscribed before me this 3rd day of ~LY ,20 01 -- ~t!~w?t;~4P~ eglster ' -, ~ The petitioner above-named swears or affirms that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner and that as personal representative of the above decedent petitioner will well and truly administer the e e according to law. <' I ~ GREGOR ~ K GHT ~~ /6-0'~/-// NO. 21-01-632 Estate of HALE HAMPTON KNIGHT, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JULY 10 ,2001, in consideration ofthe petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument dated November 5, 1992 described therein be admitted to probate and filed of record as the last will of HALE HAMPTON KNIGHT and Letters TEST AMENT AR Y are hereby granted to GREGORY B KNIGHT ~<~ ~~ujP-..//Je.J~uy Regl r of Ills $ 25.00 $ 18.00 1S.00 $ 5:00 $ 5.00 TOTAL $ 68.00 . Filed.... .~~!: x...~.~.. ~QQ ~................................ FEES Probate, Letters, Etc. ........... ~Qrt Certificate(s) ............. -Pa es . enuftCIatlon .... ................... JCP Michael 1. Hanft, Esquire Attorney J.D. No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, PA 17103-9142 (717) 249-5373 ~~ F: \User Folder\Firm Docs\Estates\2283-1 petition-letters. test. wpd 1105.805 REV 9186 This is to certify that the information here given is correctly copied from an original certific~te of death dul~ filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office tor permanent filmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ~\\.~~~~ Local Registrar Fee for this certificate, $2.00 p 7402552 JUN 2 2 2001 Date 21-01-632 '1105,a,JR..... 2181 COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH "1 81 Hale uNOER 1 Yf..',A .....". .,..,. SEX 2. l'iiale !$1"AlE ~'lf SUM8ER SOCtAL SECURITY NU!\olBER 523- 05 - 9606 CATE OF DEATH ,Mcn1h. Oa.... :;.;;~.- "T 'K ,.,,t,ME OF DECEDENT (F,,;-M,daie, !.asrl ,. ,t,GE!La$l~avl ,. .. June 18,2001 v". PlACE OF DEATH IC~ 0f'Iy I)t>e '>ee ,(lSlIUCloOnS on ort'el '3ld81 HOSPlTAL~ - 1np.1~1l!ll. =.,10 S. COUNT'( OF DERH c;(\ Cumberland ... RACE - Amencan Indien, BtKk. While. et(: '_I White OECEOENl"S USUAl. OCCUPATIOM (~:on~Iif~;",,=~:zi,:f ".. Colonel "0. DECf~NTJ UAJLlHG AOOAESS (SIr"'. ClIt.../fown" s.-. ZoCodeI ~7) Northgate vr~ve Camp Hi11,Penna. 17011 MARItAL STATUS. Manied N..,."W_nied. W~. "'Ma'rmd SURVIVING SPOuSE tn..,....grye/'nalOel'l~1 Burkholde DECEDENT'S M:'TUAL AESlDENaO (Seelf'lSll'\.CltOn& on other Sldel ~. ,.. FRHER'S NAME (First M~. LasfJ rreeman fl. -""""""S,,",ME(T-K!lberta 200. METHOO OF OISPOS1l"'S!:'.t . 0 8utiat~ CtlltTlationO R~lromS'.1.0 DonlItion 0tI'lI*r~1 .. 2'.. SIGNATURE Of ,,,,. Cumberland 17d.O ~~'=:OI cif'V/t)arQ DAlE OF DISPOSITION (Monltl.08y......) 0..0. July 10,2001 LICE"SE "Uo'15'6 219- L ..0. MOTHER'S NAME {Fir,a. M>dCIe~ilClen5ul'name) . ~ eanor Belna '"FOR~'jJ;.'V""'~1f'G AIlQf1FSS ,....,.. C"'~, 510", Zop C_, _. ~(~ j~Or~nga~e vr~ve,Camp Hill,Pennsylvania PlACE OF DlSPOSfTION. Name of CafMt.,.,. Cre.,,_tory lOCRJON . CifyfTO'wn. Sl~.. rip Code ..01......... Arlington .,..Arlington National Ce ~.tery. Vir inia "A~EA>tOAOOAESSOFF""L1ty "10 South H;:!n St t ..fwmg Bro"thers: arlrs.u:!, pmrngyHal"iln'Ol l.ICENSE N\JMeER DAlE SIGNED (M()l"IIh.Oay. '!'earl Knight B. Knight [ : L WERE AUTOPSY FINDtNOS AVi'ILABlE PRtOA 10 COMPlETION OF CAUSE OF DER'H1 ~r??'(-7. (,'.("--T:. lOA AS CONSEOUENCE Of), S<.P S:r- OUE rotOR AS A CONSEOVENCE 00: 13b. 23c. WAS C.ASE REFERRED TO MEOtCAl EXAMINERlCORONER? ---./ ~.O ~~ 21. , Approllimate PART n: 0Ihef sigl'lineant CO'dioN tOnIritluting ICl dealh. OUt :== nctrnuRin9in1tMl ~cauMoMninPAffTI. I : DATE PRONOUNCEO DEAD (Month. Day. Year) c,CI<sIQ/ 24. M. 25. 27. Pl\RT I: Enter ~ diM_..s. injUfie$ Ot~"" which ca:uM<Ilhe death, 00 not enler lhe mode' 01 dying. such as cardiac 0' ,espiralory 01"8", mocll; 0' hee" lailur. list oNy OM c_use on eKll n. DOE lO(OA AS A CONSEOUENCE OF): =R OF OEj OATE OF INJURY tMCInI'1. Q.ay. Year) nME OF INJuRY INJURY IJ WORK? DESCRIBE HOW INJURY OCCuAREO. Suic:. o o Pending """'lfgMlon o o o ~E OF IKJURY. AI home. f_nn. sa;". factOfl'. oftIc. M. buiIdInC), Me. 15pec1f'v) _. ... 0 ~O Homicide ........ .IlEotCAl EX.l.MINI.RICORONEf:l On t.... b..i, 01 'lI.minatlon _ndlor inveltlg_lion.ln my opinion, d..th occurred at the time, data, and pllce, and due to the tauseCI) _nd "':::::::':~:~~;~~~'A~O~'~."""""""""""""" .. ~~~ 18.t ll~ \ 101 o v.. 0 ~O eou.ct~"det~ ze.. 28. CEtn'Fll.fIIICNrck oriy one) .CE.RTIfY1HG PHYSICIAN (Ph~ Cf!f111ytng cause 01 dnlh wr.., aooItler physic.." has prOl'1ClUr'lCed dealh ana competed "em 231 To'" binl of my know'-d~. deaCh occurred due 10 the cllU~'lend mannar.. a'-'eel. . . . . . . . . . . . . . . . . . . 29. '''M)NQUNCIHC AND CEJltTIFYINO PHYSICIAN IPhy!iC.an bolh ;lIOOOUncll'"l9 dealh ar'ld cenlfvw;110 cause of dealt'll TotM ~ CoI "'y ~NYW~ft, d.attl oecurted a' the Utna. dale. .nd ~ac'. and du. to lhe c.~.).ncI man".'.' slatH.. oC>\ 21-01-632 LAST WILL AND TESTAMENT OF HALE HAMPTON KNIGHT I, HALE HAMPTON KNIGHT, Social Security Number 523-05-9606, of the state of Camp Hill, pennsylvania, declare that this is my LAST WILL AND TESTAMENT and I revoke all other wills and codicils previously made by me. FIRST: I appoint my Wife, ALBERTA BURKHOLDER KNIGHT, as my Personal Representative concerning this Will. If she is unable or fails to serve, I then appoint my sons, GREGORY and RONALD KNIGHT to serve as my Personal Representative. a. I request that my Personal Representative be permitted to serve without bond or surety thereon and without the intervention of any court, except as required by law. I direct that my Personal Representative act in unsupervised administration so as to administer my estate with a minimum of court supervision. If it becomes necessary to have ancillary administration of my estate in any jurisdiction where my Personal Representative is unable or does not desire to qualify as ancillary legal representative, I appoint as such ancillary legal representative such individual or corporation as my Personal Representative shall designate, in writing. b. I direct my Personal Representative to pay the expenses of my last illness, the expenses of a funeral appropriate to my station in life and custom of living (including a suitable monument or marker for my grave), and written charitable pledges which I have made. I grant my Personal Representative the power to extend or renew any debt for such time as my Personal Representative shall deem appropriate. c. All estate, inheritance, succession and other death taxes with respect to all property passing under this my Will shall be paid from and borne by the principal of my residuary estate, without regard to reimbursement, as if such taxes were administration expenses. My Personal Representative may pay such taxes at any time deemed advisable, whether or not then due and payable. d. My Personal Representative is requested to settle my estate as soon after my death as may be practicable, and to payor deliver every legacy or bequest to my beneficiaries without waiting any time that may be believed to be customary in probate matters. ~~4 PAGE 1 OF 5 PAGES eoxf (JI/JS ~ e. I have served in the Armed Forces of the United States. Therefore, I direct my Personal Representative to consult with a Legal Assistance Attorney at the nearest military installation and with the Department of Veterans Affairs and the Social Security Administration to ascertain if there are any benefits to which my family members are entitled by virtue of my military service. f. I may leave a letter of intent with the executed copy of this Will for the purpose of giving guidance to my Personal Representative concerning the distribution or sale of certain items of my property. I request, but do not require, that my Personal Representative honor my wishes therein expressed. SECOND: I give, devise and bequeath, absolutely and forever, all of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to my Wife, ALBERTA BURKHOLDER KNIGHT, as her sole and absolute property if she shall survive me. THIRD: In the event that my Wife, ALBERTA BURKHOLDER KNIGHT shall not survive me, I give, devise and bequeath, absolutely and forever, all of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to GREGORY, RONALD, DAVID, and GARY KNIGHT and JEANETTE CREIGHTON, SUSAN LOMBARD, and CYNTHIA KNIGHT ZLOGAR and to any child or children that may be born to or adopted by me, in shares of substantially equal value to be divided as they may agree. a. If any of my children shall not survive me, then the share of that deceased child shall go to the descendants of that child, who are to take per stirpes and not per capita. If any of my children shall not survive me and shall not be survived by any descendants, then the share of that deceased child shall be distributed to my surviving children and the descendants of any of my other children who fail to survive me, in the manner set forth above. b. If they are unable to agree, the division among my children and the descendants of any of my children who fail to survive me shall be made by my Personal Representative, in that person's sole and absolute discretion. I empower my Personal Representative to sell any or all of such property, if such property is not distributed in kind hereunder, and to distribute the proceeds among my said children in substantially equal shares. Any determination of my Personal Representative as to what should pass or be sold under this paragraph and to whom it should pass or be delivered or at what price it should be sold shall be conclusive. \\~ ~~ PAGE 2 OF 5 PAGES a(J,xj C--lVS Al:t- - FOURTH: Except as otherwise provided in this Will, I have intentionally failed to provide for any other relatives or other persons, whether claiming to be an heir of mine or not. Insofar as I have failed to provide in this Will for any of my issue now living or later born or adopted, such failure is intentional and not occasioned by accident or mistake. FIFTH: Any beneficiary who fails to survive until one hundred twenty (120) hours after my death shall be deemed to have predeceased me, and the gift to that beneficiary shall be disposed of accordingly. SIXTH: Definitions: a. The term "children" as used in this Will includes adopted and afterborn persons. The term "children" as used in this will shall also include step-children, the natural born or adopted children of a person's spouse. A relationship by or through legal adoption shall be treated the same as a relationship by or through blood for purpose of succession to property under this Will. b. The term "descendants" as used in this Will means the immediate and remote lawful, lineal descendants by blood or adoption of the person referred to who are in being at the time they must be ascertained in order to give effect to the reference to them. c. The term "issue" as used in this Will means all persons who are descended from the person referred to either by legitimate birth to or legal adoption by that person, or any of that descendant's legitimately born or legally adopted descendants. d. The term "Personal Representative" as used in this Will means Executor, Executrix, Independent Executor, or any other title of like import which is used to describe such a fiduciary. e. The term "per stirpes" as used in this Will means that whenever a distribution is to be made to the descendants of any person, the property to be distributed shall be divided into as many shares as there are (1) living children of the person, and (2) deceased children, who left descendants who are then living, of the person. Each living child (if any) shall take one share and the share of each deceased child shall be divided among his then living descendants in the same manner. ~~~~ PAGE 3 OF 5 PAGES ~o4 C!. tv s: AJ::1- SEVENTH: In addition to any powers granted by the laws of the state in which this Will is probated, I hereby authorize an~ empower the fiduciaries named in this Will, to the extent of the discretion herein granted, to sell, exchange, convey, transfer, assign, mortgage, pledge, lease or rent the whole or any part of my real or personal estate, to invest, reinvest, or retain investments of my estate, to perform all acts and to execute all documents which my fiduciaries may deem necessary or proper in regard to my property. If any of my fiduciaries elect to receive compensation for services, such compensation will be that allowed by law. EIGHTH: If any part of this Will shall be invalid, illegal, or inoperative for any reason, it is my intention that the remaining parts, so far as possible and reasonable, shall be effective and fully operative. My Personal Representative may seek and obtain court instructions for the purpose of carrying out as nearly as may be possible the intention of this Will as shown by the terms hereof, including any terms held invalid, illegal, or inoperative. IN WITNESS WHEREOF, I have at Carlisle Barracks, Pennsylvania, on 5 November 1992, set my hand and seal to this my LAST WILL AND TESTAMENT, consisting of 5 typewritten pages, each page bearing my handwritten signature. ~y~~~ (SEAL) ~\\~ PAGE 4 OF 5 PAGES toxl ~4JS ~ The foregoing instrument was, at Carlisle Barracks, Pennsylvania, on 5 November 1992, signed, sealed, published and declared by HALE HAMPTON KNIGHT, the testator, to be his LAST WILL AND TESTAMENT in the presence of all of us at one time, and at the same time we, at his request and in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses, and we do so verily believe that the said testator is of sound and disposing mind and memory at the date hereof. .:t'4k(}.)/~. ,fl~.LA1..IIJ..~ ~~ SSN 1'7'0 - z,L/- r;D/7 SSN 409- sY-/1~7 SSN ~/6 - CJ7-S7' f'7 OF '121, wtJDdcrfs f Yr-; OF .L/;Jt, !VtJOL>()P#r7 01{ OF CI/ /'-f(Jl>tV61t).jF bdZl ;,.~ -n(~t..h"ln It'S .bU/'7 ' PA. 1'}05"- fh[(!I-h44Jlds b()JU;- flJ-/7cS'C; Lel- //$ Ie / fA. I 71)13 ~"-\~~ PAGE 5 OF 5 PAGES t{)4 (!tUS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ACKNOWLEDGMENT I, HALE HAMPTON KNIGHT, 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 expr ssed. ~~ (SEAL) AFFIDAVIT We, CI"i2'1~ D. ~a (J-ft , (!.IJ R.Ot.. E.- to. $" e () TT , and 1/ UP'/) r YOVtV6 , the witnesses, sign our names to this ins~rument, being duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his Last Will; that the testator signed willingly and executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the will as a witness; 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. ~&:t.irvt e. ;I ti!d - Wit ss ~tu.~ Witness ~~ Subscribed, sworn to and acknowledged before me by HALE HAMPTON KNIGHT, the testator, and subscribed and sworn to before me by Cl.J'1.I.tl.J.O'l1 f). 7 M-H- , c!..14-f20Lf- 10. <:;. C!.. 0 7T, and /jtlY'/t F VtJv#6' , the~it esses, on 5 November 1992. / / /~.~ NOTAR PUBLIC My Commission Expires: 21-01-632 REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that present and saw the testat , sign the same and that signed as a witness at the request of test at in h presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19_ (Name) (Address) Register (Name) (Address) REGISTER OF WILLS OF CUmberland COUNTY OATH OF NON-SUBSCRIBING WITNESS Gregory H. Knight and Alberta B. Kniqht . (each). a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that we are familiar with the signature of Hale Hampton Knight ~ testat or of (one of the subscribing witnesses to) the wHl presented herewith and codicil , that we believes the signature on the will is in the handwriting of testat or believes the signature of the will presented herewith and that we ~ believes the signature on the will is in the handwriting of Hale Hampton Knight to the best of our knowledge and belief. Sworn to or affirmed and subscribed before a ~ 12 ~ h' 3rd d f liIterta B. kn'igh 1 ' me t IS_ ay 0 ame \.?..~.._~~ULY ~ 2001 175 Northgate Drive, Camp Hill, PA 17011 /~t? ~~,~,.~d'~~7"~ (]'d~, U- RegISter ~~~. _ .. ~ Gregory. 1.g ame) 19 Brookwood Avenue, Suite 106, Carlisle, PA 17013 (Address) 21-01-632 RENUNCIATION In Re Estate of HALE HAMPTON KNIGHT, Deceased. To the Register of Wills of Cumberland County, Pennsylvania. The undersigned ALBERTA B. KNIGHT and RONALD KNIGHT of the above Decedent, hereby renounce the right to administer the Estate and respectfully ask that Letters Testamentary be issued to GREGORY H. KNIGHT. hand this Z~) day of :r",,"'1 - , , 2001. WITNESS (}V"~ ~~ 15~ ~~ It BERTAB. KNIGHt 175 N orthgate Drive, Camp Hill, P A 17011 (ii~r~ 'SID SIN7}#- ~lldr f!.YA"'"".5 JIt.4 "2.~ol F:\User FolderlFimt Docs\Estales\2283-1renuncialion.l. wpd ~11t<U a). ~ Notarial Seal Denise L. Nye, Notary Public South Middleton TYiP., Cumberland County My Commission Expires Feb. 26, 2005 Member, Pennsylvania Association Of Notaries COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-06D1 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT KNIGHT GARY R 175 NORTHGA TE DRIVE CAMP HILL, PA 17011 ____h__ fold ESTATE INFORMATION: SSN: 523-05-9606 FILE NUMBER: 2101-0632 DECEDENT NAME: KNIGHT HALE HAMPTON DATE OF PAYMENT: 03/20/2003 POSTMARK DATE: 03/18/2003 COUNTY: CUMBERLAND DATE OF DEATH: 06/18/2001 NO. CD 002315 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01139415 I $242.91 I I I I I I I I TOTAL AMOUNT PAID: $242.91 REMARKS: GARY R KNIGHT CHECK# 393 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS DONNA M. OTTO DEPUTY REGISTER OF WILLS /b-c2~/- /1 \, BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REV-16D7 EX AFP (DI-OSI ,llATE "'!;Ht:tSTATE OF ""':;>DATE OF DEATH FILE NUMBER APR 28 P 2 ~NTY 04-14-2003 KNIGHT 06-18-2001 21 01-0632 CUMBERLAND 01139415 HALE H GARY R KNIGHT 175 NORTHGATE DR CAMP HILL '03 Allount Rellitted PA 17011 (;le'rk CAIf'nt>f6fr larL1 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ii"fv =i6'ifj-ix-AFP-COY=oiY------...-iNHERiTANC'E--YAX-Si''jrfEMfNY-OF'-Accouiif--...------------------ --- ESTATE OF KNIGHT HALE H FILE NO.21 01-0632 ACN 01139415 DATE 04-14-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-05-2002 PR I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 228.96 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-18-2003 CD002315 13.23- 242.91 TOTAL TAX CREDIT 229.68 BALANCE OF TAX DUE .72CR INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .72CR II SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J ()/ dK ORPHANS' COURT DIVISION OF THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: HALE HAMPTON KNIGHT Date of Death: January 18, 2001 Admin. No. 2001-00632 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: Unknown at this time as litigation is still in the discovery stages. 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account IS: c. Did the personal representative state an account informally to the parties in interest? Y es 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 attached to this report. Date: June 12, 2003 Respectfully submitted, ;r & KNIGHT, P.C. r-- '7) ichael J. Hanft, quire Attorney ill No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, Pennsylvania 17013-9142 (717) 249-5373 Counsel for personal representative D- N ..- L) ....0 (V) ",-0 s:: o J3- . ...:"~ ~ F:\Uscr Folder\Firm DocS\Estates\2283-1status.rpi~ ~ -, 'f"" "J Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 5/07/2003 KNIGHT GREGORY 19 BROOKWOOD AVENUE, SUITE 106 CARLISLE, PA 17013 RE: Estate of KNIGHT HALE HAMPTON File Number: 2001-00632 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 6/18/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: J File Counsel Judge ORPHANS' COURT DIVISION OF THE COURT OF COMMON PLEAS OF ReCOfCle6 ()rnes of CUMBERLAND COUNTY, PENNSYL V ANIagister Wills STATUSREPORTUNDERRULE6.12'Q4 JUL 20 Pl:59 Name of Decedent: HALE HAMPTON KNIGHT Date of Death: January 18, 2001 Clerk-C Cumberland LO., PA Admin. No. 2001-00632 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 ---X..- 2. Ifthe answer is No, state when the personal representative reasonably believes that the administration will be complete: Unknown at this time. Litigation is listed for January of2005. 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account IS: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: July 19, 2004 Respectfully submitted, chae1 J. Hanft, squire Attorney ill No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, Pennsylvania 17PI3J;,~)142 (717) 249-5373 ~,':%i.;; Counsel for personal repres~ntative F:\User Folder\Firm Docs\Estatcs\2283-lstatus.rpt.l,wpd /6- C:;'$//- // "" BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' NOTICE OF INHERITANCE TAX APPRAISEMENT~ ALLONANCE OR DISALLONANCE OF DEDUCTION~, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP IDl-Oll GARY R KNIGHT 175 NORTHGATE DR CAMP HILL PA17011 ..,.. :'~~ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 08-05-2002 KNIGHT 06-18-2001 21 01-0632 CUMBERLAND 523-05-9606 01139415 Allount Rellitted HALE H 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 .. iEri=is4-i-Ex--AFP--foi-;o21------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 08-05-2002 ESTATE OF KNIGHT HALE H DATE OF DEATH 06-18-2001 COUNTY CUMBERLAND FILE NO. 21 01-0632 TAX RETURN WAS: S.S/D.C. NO. 523-05-9606 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01139415 FINANCIAL INSTITUTION: MELLON BANK ACCOUNT NO. 00250-454687 TYPE OF ACCOUNT: (~SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 06-07-1991 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x 3,052.77 0.500 1,526.39 .00 1.526.39 .15 228.96 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." x TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 08-13-2002 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 228.96 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 5.56 TOTAL DUE 234.52 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND. ro~~ D~III:'D~1:' rTftl:' ftl:' TUTC' I:'nD" I:'nD TIJIC'TDllrTTn...~ 1 JRD/June 30, 1992/17858 2 D4 In Re: Estate of Hale Hampton Knight Late of Upper Allen Township Estate No.: 2001-632 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-Hale Hampton Knight NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Gregory Knight Counsel for Personal Representative: Michael J. Hanft, Esquire Date o£Decedent's Death: 06/18/01 Date of Delinquency Notice: 07/14/04 The undersigned, Glenda Famer-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on April 30, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 07/14/04 Distribution: er Strasb~/u~h Clerk of the Orphans' Court suSOnal Representative nsel for Personal Representative ate File A hearing is scheduled for at in Courtroom No. 3. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled. George ~l-f~ f{d:, ~ J. [~" ORPHANS' COURT DIVISION OF THE COURT OF COMMON PLEAS OF Raco,~ad. :;~'ice o~ CUMBERLAND COUNTY, PENNSYLV~i~te? o~ ~!iits STATUS REPORT UNDER RULE 6.12.0~ dill 20 P 1 .59 Name of Decedent: Date of Death: HALE HAMPTON KNIGHT January 18, 2001 C~a~nberiand Go., PA Admin. No. 2001-00632 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: State whether administration of the estate is complete: Yes No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Unknown at this time. Litigation is listed for January of 2005. is: C. Yes No If the answer to No. 1 is Yes, state the following: Did the personal representative file a final account with the Court? Yes __ No _ The separate Orphans' Court No. (if any) for the personal representative's account Did the personal representative state an account informally to the parties in interest? d. Copies of receipts, releases, j oinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: July 19, 2004 Respectfully submitted, HANFT & KNIGHT, P.C, Attorney ID No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, Pennsylvania 17013-9142 (717) 249-5373 Counsel for personal representative F:\User Folder~Firm Docs\EstatesX2283-1status rpt.2 wpd Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 5/18/2005 HANFT MICHAEL J 19 BROOKWOOD AVENUE SUITE 106 CARLISLE, PA 17013 RE: Estate of KNIGHT HALE HAMPTON File Number: 2001-00632 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing is due by: 6/18/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~..~~ GLENDA FARNER S~RASBA~ REGISTER OF WILLS cc: File Personal Representative(s) Judge uA JECEIVED jUl 152005 .U Estate of KNIGHT HALE HAMPTON Late of UPPER ALLEN TOWNSHIP ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 21-01-00632 Date: 7/18/2005 NO.: 21-01-00632 KNIGHT GREGORY 19 BROOKWOOD AVENUE, SUITE 106 CARLISLE PA 17013 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6. 12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: KNIGHT GREGORY Personal Representative Counsel: HANFT MICHAEL J Date of Decedent's Death: 6/18/2001 Date of Delinquency Notice: 6/18/2005 The undersigned, Glenda Farner Strasbaugh, Clerk of Orhans' Court, in accordance with rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of cumberland County, that neither the above named personal representative nor their counsel, have filed with the Register of Wills or Clerk of Orphans' Court, his/her Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule, and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orhans' Court Rules, was given by the Clerk of Orphans' Court on 5/15/2005 and that the ten (10) day notice to file the status report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or their counsel. cc: File Personal Representative Counsel ~~~ Glenda Farner Strasbaugh Clerk of Orhans' Court A hearing is scheduled for August 19, 2005 at 9:30 AM in Courtroom No. 03. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled. 'P.J. cd i ,~o EX. (6_00) .... z w C w U w C w .... ~:::CJl J~" .uQ.U ~OO .~..J JQ.CIl Q. <( ..... CJlz Ww ~C ~z 00 UQ. z o ;::: :5 ::l .... n: <( U w ~ z o ;::: <( .... ::l Q. :; o U X <( .... .* REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT 00632 NUMBER FILE NUMBER.. 21 01 ~_.s::QLJNTY CODE _ _ YEAR~__ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 1712a.0601 - ---.. -'---~"'----~-'--_._-- - -----_..~-------- --_.._-----~._._- DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL) Knight, Hale Hampton THIS RETURN MUST BE FILED IN DUPLICATE WITH THE --_._~._- SOCIAL SECURIT'Y NUMBER 523-05-9606 DATE OF DEATH (MM-OD-YEAR) DATE OF BiRT-H-{MM~DD-YE-ARj-------- :06/18/2001 10/31/1919 REGISTER OF WILLS --- ---- -.-...----.--- - ----_._-_.~------~-._-_.._- --.--.---.- -------- -...._---,._-- - ----------.-- · (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Knight, AlbertaB. 443-30-1245 I8l 1. Original Return 0 -2, - suppk;;;:;-~ntal Re;;;;:n~ '- '--'-- .------O-3Remainder Return (cjateof death prior to 12-13-82)' o 4 Limited Estate 0 4a. Future Interest Compromise (date of death after 0 5. Federal Estate Tax Return Required 12-12-82) I8l 6. Decedent Died Testate (Attach copy 0 7. Decedent Maintained a Living Trust (Attach of Will) copy of Trust) o 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between 0 11, Election to tax under Sec. 9113(A) (Attach Sch 0) d_._ ___ ___ . 1Z:c31,~.l.and1.:1:~~)__ '_.__ ___ __.______~_____, ____ ,_ lII:iI.?SECTI()l'l!,,\UST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Sean M. Shultz, Esquire 8. Total Number of Safe Deposit Boxes -. FIRM NAME (If applicable) Knight & Associates, P.C. :rELEPHONE NUMBER 717/249-5373 11 Roadw'ay Drive, Suite B Carlisle, P A 17013 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1 ) None (2) None ---_._._-----~- (3) None (4) None --. -~-~_. ..._'----------"---- (5) 229,208.00 l -.----- - (6) None ~--~--_._- (7) None 3. Closely Held Corporation. Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or l) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) I _-.-J (8) 229,208.00 (9) 149,490.56 10. Debts of Decedent, Mortgage Liabilities. & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) (11 ) 149,490.56 , 12. Net Value of Estate (Line 8 minus Line 11) (12) 79,717.44 13. Charitable and Governmental Bequests/See 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) (13) (14) 79,71 7.44 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) 79,717.44 x .00 (15) 0.00 16. Amount of Line 14 taxable at lineal rate x .045 (16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 0.00 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. >> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH << opyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 175 Northgate Drive CITY STATE PA , ZIP 17011 Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) Total Credits (A + B + C) (2) 3. Interest/Penalty jf applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is theBALANCE DUE (3) (4) (5) (5A) (58) 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 a. retain the use or income of the property transferred;............................................................................. 0 ~: ~:::: ~ :h~e~;~~i~~~~s:~~e~~es~~~. .s~~: I. .~.~.~. .t.~~. :.~.~:.:_~:. .~~~.n.s.f.~ ~.~~.~. .o.~ .i.t~. ~~.~.~.~~~.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'::::::::::::: ......... a d. receive the promise for life of either payments, benefits or care?........................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?................................................................................................................ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?............................ ................................................................................... 0 0.00 0.00 0.00 0.00 0.00 No ~ ~ ~ ~ ~ ~ ~ --....--- .._'-_.~--~,.,---~-_._--_.._----------,----_....---_.-._------------~_._---_._._-----~--- 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 thai 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. Declaralion prep-"r~r_ol~~than 1I1e persor1<jlrel'resen.tatlve is~s"d_OI1_all information ~fwhich preparer hasanYJ<r1o~ledge.,,_~___ SI~~ OF PERSON RESPONSIBLE FO,R F,llING RETURN ADDRESS G~\~g~~ H'~' h '-c) t4- gr~~fe~P~ ?7bV{j Suite B SIGNATURE'OF pJRSONkESPONSlSLE FOR FILING iETuRNu . ADDRESS .-,--~,.,_. 2--~ DATE Ji~ v...Q. UJU 6 DATE DATE b/~3~ 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. S9116 (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. S9116 (a) (1.1) (ii)]. The statutedoes 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, S9116 (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. S9116 1.2) [72 P.S. S9116 (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. S9116 (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. ~. lrJfJ~ SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT --~.. '.---_....----- - -- ______.,___. ..____..___.___________...__.____.u _ . FILE NUMBER 21 - 01 - 00632 ESTATE OF Knight, Hale Hampton Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 4,208.00 1983 Mercedes Benz - 300 SD Turbo Diesel 2 Litigation - Gregory H. Knight as Executor of the Estate of Hale H. Knight, deceased v. Joan B. CalToll, M.D. and the Milton Hershey Medical Center - Court of Common Pleas, Dauphin County, Docket No. 3345-S-200 1 225,000.00 TOTAL (Also enter on Line 5, Recapitulation) 229,208.00 *""... , . i . . ~ SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Knight, Hale Hampton FILE NUMBER 21 - 01 - 00632 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT . FUNERAL EXPENSES: I Ewing Brothers Funeral Home, Inc. - funeral B. I ADMINISTRATIVE COSTS: I Personal Representative's Commissions 1. Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid Zip State 2. Attorney's Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address State Zip 4. City Relationship of Claimant to Decedent Probate Fees Fee to Cumberland County Register of Wills 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs The Sentinel - advertise letters 2 Cumberland Law Journal - advertise letters Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 6,690.00 92.00 110.03 75.00 142,523.53 149,490.56 ~ ~ Schedule H Funeral Expenses & Pdninistrative Costs continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Knight, Hale Hampton FILE NUMBER 21 - 01 - 00632 3 Postmaster - certified mailing 3.94 4 Shrager, Spivey & Sachs - Estate litigation costs 20,085.97 5 Shrager, Spivey & Sachs - Estate litigation legal fees 61,474.21 6 Meciare Lien - Estate litigation 60,959.41 ---~~ -_.~-_..---~------ Page 2 of Schedule H REV-1513 EX- (9-00) ,*' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY FILE NUMBER 21 - 01 - 00632 ESTATE OF Knight, Hale Hampton NUMBER i AMOUNT OR SHARE OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) Alberta B. Knight i 175 Northgate Drive ! Camp Hill, PA 17011 wife 100% residue ! 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 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET .- (~(;;~) - ~~ LAST WILL AND TESTAMENT OF HALE HAMPTON KNIGHT I, HALE HAMPTON KNIGHT, Social Security Number =i23-05-9606, of the state of Camp Hill, Pennsylvania, declare that thi.s is my LAST WILL AND TESTAMENT and I revoke all other wills and codicils previously made by me. FIRST: I appoint my Wife, ALBERTA BURKHOLDER KNIGHT, as my Personal Representative concerning this Will. If she is unable or fails to serve, I then appoint my sons, GREGORY and RONALD KNIGHT to serve as my Personal Representative. a. I request that my Personal Representative be permitted to serve without bond or surety thereon and without the intervention of any court, except as required by law. I direct that TI1Y Personal Representative act in unsupervised administration so as to administer my estate with a minimum of court supervision. If it becomes necessary to have ancillary administration of my estate in any ~iurisdiction where my Personal Representative is unable or does not desiI~e to qualify as ancillary legal representative, I appoint as such ancillary legal representative such individual or corporation as my Personal Representative shall designate, in writing. b. I direct my Personal Representative to pay the expenses of my last illness, the expenses of a funeral appropriate to my station in life and custom of living (including a suitable monument or marker for my grave), and written charitable pledges which I have made. I grant my Personal Representative the power to extend or renew any debt for such time as my Personal Representative shall deeDl appropriate. c. All estate, inheritance, succession and other death taxes with respect to all property passing under this my Will shall be paid from and borne by the principal of my residuary estatE~, without regard to reimbursement, as if such taxes were administration expenses. My Personal Representative may pay such taxes at any timE~ deemed advisable, ~hether or not then due and payable. d. My Personal Representative is requested to settle my estate as soon after my death as may be practicable, and to payor deliver every legacy or bequest to my beneficiaries without waiting any time that may be believed to be customary in probate rnatters. \~\\4 PAGE 1 OF 5 PAGES eo,xf GtoS ~~ e. I have served in the Armed Forces of the United States. Therefore, I direct my Personal Representative to consult with a Legal Assistance Attorney at the nearest military installation and with the Department of Veterans Affairs and the Social Security Administration to ascertain if there are any benefits to which my farrrily members are entitled by virtue of my military service. f. I may leave a letter of intent with the executed copy of this Will for the purpose of giving guidance to my Personal Representative concerning the distribution or sale of certain items of my property. I request, but do not require, that my Personal Representative honor my wishes therein expressed. SECOND: I give, devise and bequeath, absolutely and forever, all of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to my Wife, ALBERTA BURKHOLDER KNIGHT, as her sole and absolute property if she shall survive me. THIRD: In the event that my Wife, ALBERTA BURKHOLDER KNIGHT shall not survive me, I give, devise and bequeath, absolutely and forever, all of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, 1Nherever situated or of whatever nature, be it real, personal, or mixed, to GREGORY, RONALD, DAVID, and GARY KNIGHT and JEANETTE CREIGHTON, SUSAN LOMBARD, and CYNTHIA KNIGHT ZLOGAR and to any child or children that may be born to or adopted by me, in shares of substantially equal value to be divided as they may agree. a. If any of my children shall not survive me, then the share of that deceased child shall go to the descendants of that child, who are to take per stirpes and not per capita. If any of my children shall not survive me and shall not be survived by any descendants, then the share of that deceased child shall be distributed to my surviving children and the descendants of any of my other children who fail to survive me, in the manner set forth above. b. If they are unable to agree, the division among my children and the descendants of any of my children who fail to survive me shall be made by my Personal Representative, in that person's sole and absolute discretion. I empower my Personal Representative to sell any or all .of such property, if such property is not distributed in kind hereunder, and to distribute the proceeds among my said children in substantially equal shares. Any determination of my Personal Representative as to what should pass or be sold under this paragraph and to whom it should pass or be delivered or at what price it should be sold shall be conclusive. ~~ \-\ ~>> PAGE 2 OF 5 PAGES a{JA Q.LUS A61~ - FOURTH: Except as otherwise provided in this Will, I have intentionally failed to provide for any other relatives or other persons, whether claiming to be an heir of mine or not. Insofar as I have failed to provide in this Will for any of my issue now living or later born or adopted, such failure is intentional and not occasioned by accident or mistake. FIFTH: Any beneficiary who fails to survive until one hundred twenty (120) hours after my death shall be deemed to have predeceased me, and the gift to that beneficiary shall be disposed of accordingly. SIXTH: Definitions: a. The term "children" as used in this Will includes adopted and afterborn persons. The term "children" as used in this will shall also include step-children, the natural born or adopted children of a person's spouse. A relationship by or through legal adoption shall be treated the same as a relationship by or through blood for purpose of succession to property under this Will. b. The term "descendants" as used in this Will means the immediate and remote lawful, lineal descendants by blood or adoption of the person referred to who are in being at the time they must be ascertained in order to give effect to the reference t.O them. c. The term "issue" as used in this Will mE!ans all persons who are descended from the person referred to either by legitimate birth to or legal adoption by that person, or any of t~hat descendant's legitimately born or legally adopted descendants. d. The term "Personal Representative" as used in this Will means Executor, Executrix, Independent Executor, or any other title of like import which is used to describe such a fiduciary. e. The term "per stirpes" as used in this ~lill means that whenever a distribution is to be made to the descendants of any person, the property to be distributed shall be divided into as many shares as there are (1) living children of the person, and (2) deceased children, who left descendants who are then living, of the person. Each living child (if any) shall take one share and the share of E~ach deceased child shall be divided among his then living descendants in the same manner. ~~~~~ PAGE 3 OF 5 PAGES eo4 <!. tu 5 flJ:r SEVENTH: In addition to any powers granted by the laws of the state in which this Will is probated, I hereby authorize an<;i empower the fiduciaries named in this Will, to the extent of t~he discretion herein granted, to sell, exchange, convey, transfer, assign, mortgage, pledge, lease or rent the whole or any part of my real or personal estate, to invest, reinvest, or retain investments of my estate, to perform all acts and to execute all documents which my fiduciaries may deem necessary or proper in regard to my property. If any of my fiduciaries elect to receive compensation for services, such compensation will be that allowed by law. EIGHTH: If any part of this Will shall be invalid, illegal, or inoperative for any reason, it is my intention that the remaining parts, so far as possible and reasonable, shall be effective and fully operative. My Personal Representative may seek and obtain court instructions for the purpose of carrying out as nearly as may be possible the intention of this Will as shown by the tE~rms hereof, including any terms held invalid, illegal, or inopera1tive. IN WITNESS WHEREOF, I have at Carlisle Barracks, I'ennsylvania, on 5 November 1992, set my hand and seal to this my L~ST WILL AND TESTAMENT, consisting of 5 typewritten pages, each paige bearing my handwritten signature. ~~~~~ (SEAL) ~~ \\\~* PAGE 4 OF 5 PAGES ~Oxf t!.cus ~ The foregoing instrument was, at Carlisle Barracks, Pennsylvania, on 5 November 1992, signed, sealed, published and declared by HALE HAMPTON KNIGHT, the testator, to be his LAST WILL AND TESTAMENT in the presence of all of us at one time, and at the same time we, at his request and in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses, and we do so verily believe that the said testator is of sound and disposing mind and memory at the date hereof. .4 '4 k to. )/'tii/ . , flUJ..L~~ fl.1 . AcLzc- AJ.u;J 4l1t'<<"':f sSN/'7'O -z,L/- C;o/7 SSNJ!.o9- s-L/-/1"77 SSN-2L'6 -()7-~f'7 OF l/Zt, WODdcHS f YI'--'. OF 7{;c, !<JCD/)(lRfrT 012... OF ClI!I(Ot>rV6/f-J-F b1f<l ;;...? ~~c.h ?11ft'S ~U~i r PA. f105t?' /hE {JIMAj/ds buJl..C- flf/7os-c:; LCt- /,'$ Ie / IA. I 7 Of 3 ~~\\~~~ PAGE 5 OF 5 PAGES ~04 (!tUS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ACKNOWLEDGMENT I, HALE HAMPTON KNIGHT, 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 ~es there~~~s~d. . (SEAL) HALE ~T * AFFIDAVIT We, C/~'1for1 D. ~4()-ft (!1}R.oi.. L to. S~C 0 TT , and /-1 Up'/; r YOVtV6 ,the witnesses, sign our names to this instrument, being duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his Last Will; that the testator signed willingly and executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the will as a witness; 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. t:0t.!rvt e. )/~ Wit ess ~tu.~ Witness Pvd~~ Witness <1 Subscribed, sworn to and acknowledged before me by HALE HAMPTON KNIGHT, the testator, and subscribed and sworn to before me by do/a t/ to \r1 0. 7 tJ.o-H- (!!4-f2o L S It/. ~ c- 0 IT, and Ijtlt7k F YOvNG ,the~it esses, on 5 November 1992. / / /7/ (./ / ~ ~~ .y~ NOTAR PUBLIC My Commission. Expires: -I 15056041169 REV -1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO Box 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT .~ i 6fi o (iCf? 198-22-9630 10222005 Date of Birth 08031928 Decedent's Last Name Suffix Decedents First Name CARL MI SEI':::'H E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW [X] anginal Return D 6 Decedent Died Testate (Attach Copy of Will) o 9 Litigation Proceeds Received o 2, Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach Copy of Trust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) o 3 Remainder Return (date of death prior to 12-13-82) IX] 5. F:ederal Estate Tax Return Required LJ 4 Limited Estate o 8. Total Number of Safe Deposit Boxes o 11 F:lection to tax under See. 9113(.A,) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST B:: COMPLETED, ALL CORRESPONDENC::AND CONFIDENTIAL TAX INFORMATION SHOULD B:: DIRECTED TO: Name Daytime Telephone Number HARVEY DANOWITZ 717-238-8263 Firm Name (If Applicable) REGISTER OF-WILLS USE ONLY City or Post Office HARRISBURG State ZIP Code I L DATE FILED I i I I I i I -----.--J DEVANEY & CO. PC First line of address P.O. BOX 1024 Second line of address PA 17108 Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanYing schedules and statements, and to tho 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 ~F, PERSpN R~9P~BL~f~R ~ILlNG ~ETURN '" /" ." _ _ . DATE ~ U 7-11<. '- f;'h__.<-Ju '7" :<:'-k-,,- L-<.,/ ( ,,;;? 7 -I c..J ,. () G:, E IV ole.... \,)01\0,: ~~,I . ..\.-~I'P1lt 1.':foj,S DATE. #6 l.100 WU'tZ.~t"L (d.. ADDRESS 403S Wc."U.,,;lIC Q.~ SIGNATU~PREPAR~:T~EPRESENTATIVE ADDRESS / ~ 222 S. MARKET STREET, STE. 202, ELIZABETHTOWN, PLEASE USE ORIGINAL FORM ONLY PA 17022 Side 1 L 15056041169 15056041169 -I " '-- -' 15056042160 REV-1500 EX Decedents Name CARL E S!'lITH RECAPITULATION 1. Rea! estate (Schedule A) . 2 Stocks and Bonds (Schedule B) . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3. 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6 Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) D Separate Billing Requested 8. Total Gross Assets (total Lines 1 - 7) . 1. 2 4. 5. 6. 7. 8. Decedent's Social Security Number 198-22-9630 153,000.00 1,540,985.00 118,984.00 1,634,735.00 3,447,704.00 9. Funeral Expenses & Administrative Costs (Schedule H) 63,938.00 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). . . . . . . . . . . 13 Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . 14 Net Value Subjectto Tax (Line 12 minus Line 13) . 9 10. 11. 12 13 14. 11,680.00 75,618.00 3,372,086.00 3,372,086.00 TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 16 Amount of Line 14 taxable at lineal rate x04 5 3 , 372 , 08 6 17. Amount of Line 14 taxable at sibling rate x .12 18. Amount of Line 14 taxable at collateral rate x .15 19. TAXDUE... 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042160 15. 16. 17. 18. 19. 151,743.87 151,743.87 r-' I I '---.J 15!J56042160 -' REV< 500 EX Page 3 File Number 21- 0 5 - 0 j 9 7 Decedent's Complete Address: I DECEDENTS NAME CARL S. SNITH ISTREETADDRESS 6200 WERTZVILLE ROAD CITY EN 0 ~l\ I STATE i ?A ZIP 17025 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A Spousal Poverty Credit B. Prior Payments C. Discount (1) 151,743.87 1LO,000 7,368 Total Credits (A -'- B + C) (2) 147,368.00 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) 5. If Line 1 -:- Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 4,375.87 A Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A This is the BALANCE DUE. (5B) 4,37S.87 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: a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; . 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 consideration? . . . . . . . . . . . 3. Did decedent own an "in trust lor" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No n ~ '--' L'.. n ~ u 0 W '--' 0 ~ II ~ '---' LJ lXJ [Xl u IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G ANID FILE IT AS PART OF THE RETURN. 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 three (3) percent [72 P.S. s9116(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 zero (0) percent [72 P.S. s9116(a)(I.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 zero (0) percent [72 P.S. s9116(a)(I.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. S9116(1.2) [72 P.S s9116(a)(I)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 PS s9116(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. 11 I\)~~I)-" ,)X\ This is to ~ertify that the information here given h correctl~ copied from ,lD \)rigmaJ certificate of death dulv filed with Local Registrar. The original certificate will be forwarded to the Slate Vital Records Office for permanent filing. me as WARNING: It is illegal to duplicate this copy by photostat or photograph. No. /....,"II(~~1"'iirpi;i---____ ","';:"'~~~, ' - ~,r~ !~'<ji!; " - ,~~ ,,,, ~_.!tf' -" ,~-'~ }~/ ,. - ...?~ I~Q; ..:a__ .,!:~ \~U, ,-~~'-. .,;!~i ~* .'~ "J/*~ \\~,--;.' i~l \~~'... /~.., .,.. -(I)~ ~'r "" ''<"---. /MENl \l';; ~ II"" '''''''''''''''HNIIIJ/JJ,III /) h/) rJ!: {Pn/n... /'C /.:;::,,1.4~ Fee for this certificate. S6.00 Local Registrar NOV 0 1 2005 Date Rev, 2187 COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH STATE FILE: NUMBER SEX SOCIAL SECURITY NUMBER 3. ] 9 8 2 2 9630 DATE OF DEATH (Month, Day, Yeer) 4.0ctober 28,2005 ,. AGE (Last Birtnday) ?7 Yrs. 2. (h BIRTHPLACE (City and PLACE OF DEATH Check ani ne . State or Foreign Country) HOSPITAL; Blain, PA lope'"" 0 1. Sa. FACILITY NAME (If not institution, give street and number) ERIOutpat+ent 0 DOA [I Fl.I!IStdenc:e~ ::..vI O' AS DECEDENT EVER IN U.S. ARMED FORCES? Yest] No D 12. ins co n i~~r::Iif~O~eu:n~r:gt . -' M t F m Mobil Pipe Lines 1,.. ,e er ore an l1b. DECEDENTS MAILING ADDRESS (Stre<;t. CltyfTown. Sta'e, Zip Code) MARITAL STATUS - Married, Never Married, Widowed, Divc,rced (Specify) 14Wido'wed RACE ~ American Indian, Black: White, el . (Specify) 10.White SURVIVING SPOUSE (If wife. gnre maide'" "'lime) 8b. Hampden, TWp. KIND OF BUSINESS /INDUSTRY 6200 Wertzville Rd. 6200 Wertzville Rd. 18.Enola PA 17025 FATHER'S NAME (First, Middle, Last) 18.Clarence T. Smith INFORMANrS NAME (TYJ'.elPrinl) 20.. Jean A. ttake - METHOD OF DISPOSITION Donation 0 Bunal [Xl Cremation Uemoval from State 0 21.. Other (Specify) 21b. SIGNATURE OF FUNa<AL SERVICE LICENSEE OR PERSON ACTING AS SUCH 22L/2 ' ,J Comp&ete items 23a-c only when certifying physician is not avaitabM! at time of death to certify cause of death. DECEDENrs ACTUAL RESIDENCE (See instructions on other side) 17a. State PA Cumberland Did decedent live in a township? 11c. []I Yes, decedenlllived in Hampden IWO. 11b. Countv 17d. 0 ~~~e~~~~~li~~ of city/boro 27. PART I: Enter th.dl....... injuries Of compBc.UoMl wNch C8 u.t omy one cau.. on .ach 11M. MOTHER'S NAME (First, Middle, Maiden Surname) 19. Edith C. Gutshall INFORMANrs MAILING ADDRESS (Stree,. CityfTown, State. Zip Code) 20b. 6035 Wertzville Rd. Enola, PA 17025 PLACE OF DISPOS'TION~ Name of Cemetery, CrefTliItOfY LOCATION. CityfTown. State, Zip Code or Other Place 2, 2005 21c. Blain Cemetery NAME AND ADDRESS OF FACILITY 22c.Richardson F. H. Ine. LICENSE NUMBEFt ~4 Blain, PA 17006 Items 24-26 must be completed by per.iOO who pronounces death. DUE TO (OR AS A CONSEQUEH OF): 28. . Approximate : interval between : onset and death PART II: IMMEOIATIO CAUSE (Final disease or condition resulting in death) --. a. SeQuentially lis' conditions if any. leading to immediate cause. Enter UNDERLYING CAUSE (Disease or injury that irlitiated events resulting on death 1 LAST b. l: DUE TO (OR AS A CONSEQUENCE OFY DUE TO (OR AS A CONSEQUENCE OF)' WAS AN AUTOPSY WERE AUTOPSY FINDINGS PE.RFORMED? AVAILABLE PRIOR TO COMPLETION OF CAUSE OF DEATH? MANNER OF DEATH DATE OF INJURY (Month. Day. Year) TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED, Su)cjde g o Homicide D D D 30... 30b. M PLACE OF INJURY - At home, farm. street, factory. office tll.Itld~.etc.{Speclfyl 30e. Yes D No D 30e. Natural Accident Pending Investigation 31b. LICENSE NUMBER E 31c. TI1IJ P/t7 tj J. )' ~ 31d. NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF D TH (Jtem27)TypeorPrint/(~'f'-f..v..J-4 d Co,1"'~ f'L't'tI J.., ) J";'~I{.. j ~ /II/A.. 32. <-+-... /' fh' II , .-1, I 7". If DATE FILED (Month. Day, Year) .-" rf4 il Ves D '0 ~ Yes 0 28.. 28b. CERTIFIER (Check only one) .CERTlFY1NG PHYSICIAN (Physician certifying cause of death when another physician has pronounced death and comp4eted Item 23) To the best ot my knowledge, dlNllth OCCUlTed due to the caus.-(s) and manner as sulad..........--...............,. ..".................. NoD Could not be determIned 29. .PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both pronouncing death and certity;ng to cause of death\ To the best of my knowledge, d..th occurred at the time, date. and place. and due to the eauses(s) and manner as stat.d........ ....... 0 'MEDICAL EXAMINER/CORONER On the basis of examination and/or lnveetigatlon. in my opinion, death occurred at the time, date, and place, .Jond due to the causes(s) and mannef' as stated ............".. . 31.a. RE~R'S SIGN...~~ A~BER o I ~h_J,/./1 "POllll. Oo-e.1l." LAsTSJILL -A)JD T2ST..AM2)JT ,- f of Carl E. Smith I, Carl E. Smith, a resident of Enola, Pennsylvania, being of sound and disposing mind and memory and over the age of eighteen years, do hereby declare this to be my Last Will and Testament, and I expressly revoke all Wills, including codicils, heretofore made by me. ARTICLE I 1.1 I hereby declare that at the time of making this Last Will and Testament that I am a widower. 1.2 I declare that I have the below listed children at this time: Dale E. Smith, Jean A. Bake, Gary L. Smith, Lori J. Moore ARTICLE n 2.1 I declare the entire residue of my estate to the Trustee(s) then in office under that trust designated as "The C. E. Smith Living Trust" established ,Tut f _~, 191]ofwhich I am the grantor. I direct that the residue of my estate shall be added to, administered, and distributed as part of that trust, according to the terms of the trust and any amendment made to it before my death. To the extent permitted by law, it is not my intent to create a separate trust by this will or to subject the trust or the property added to it by this will to the jurisdiction of the probate court. c 2.2 I hereby direct that my Executor or my Trustee(s) may elect to: (1) use administrative expenses as deductions either for estate tax: purposes or income tax: purposes; and (2) to use either date of death values or optional values for estate tax: purposes, regardless of the effect thereof on any of the interests under this Will. 2.3 I further direct that my Executor or Trustee(s) shall not be required to pay any debt in advance of the due date thereof, including installment obligations, but instead may pay the same in installments as each installment comes due. However if the Trustee(s) deem it to the advantage of the estate any or all debts may be paid in advance of their required installments. 2.4 I stipulate that any asset under litigation, lien, or claim that might cause the assets of the aforementioned Trust to be compromised in any fashion, be held separate from the said Trust until it is free of any claim or threat to the integrity of the Trust. ARTICLE ill 3.1 If the disposition in Article n, above, is inoperative or is invalid for any reason, or if the trust referred to in Article n above, fails or is revoked, I incorporate the terms of that trust herein by reference, as if executed on this date, without giving effect to any amendments made subsequently, and I bequeath and devise the residue of my estate to the Trustee(s) named in the trust as Trustee(s), to be held, administered, and distributed as provided in that instrument. c; Signed cC?~ a:-~ _ Page 1 f \ c'" c ARTICLE IV 4.1 I do hereby nominate the following individual(s) as the Executor(s) of this Will, to serve in the order listed: Jean A. Hake and Dale E. Smith, acting together or separately, Gary L. Smith. 4.2 The Executor shall have full power and authority to carry out the provisions of the Will, including the power to manage and operate during the probate of my estate any property and any business belonging to my estate. However, the Executor should not compromise the referenced trust in any fashion by premature transfer of assets that may carry any claim or litigation into the Trust. 4.3 The Executor or Trustee(s) shall serve without bond. However, in the event that one (1) or more bonds are required for one (1) or more such individuals, in their capacities as Executors hereunder, then I request that such bonds be nominal bonds, and, my Executor shall pay any such bond premiums, as bonds premiums are due, as administration expenses of my estate, until the administration of my estate is completed. IN WITNESS WHEREOF, I have hereunto subscribed my name to this dClcument, my last Will and Testament, which consists of two (2) typewritten pages, and for the purpose of identification, I have initialed or signed each page, all in the presence of the persons who are witnessing, at my request, the execution of this, my last Will and Testament on this /&7 f-~day of ju~ y , 19 9' 7 , at L!5' AI" e::>.J.. -4 ' P/l . /7 t3 Z 5'" ~~./2 5~~--- Carl E. Smith Signed cZ?~ ~ ~ -- Page 2 ACKNOWLEDGEMENT OF THE EXECUTION OF THE LAST WILL AND TESTAMENT OF Carl E. Smith We, whose names are signed below, each declare under penalties of perjury: that Carl E. Smith, the testator, executed the foregoing instrument as the testator's last will and testament; that in our presence, the testator signed the testator's signature and declared that such signing was the testator's free and voluntary act for the purpose of executing the testator's last will and testament; that each of the Witnesses thereto,in the presence of the testator (and at the testator's request) and in the presence of each other, signed such instrument which the testator stated to be the testator's last will and testament; and, to the best of our knowledge, the testator was, at the time of the testor's signing and at the time of the signing of the witnesses, eighteen (18) or more years of age and of sound mind. ~1I"l--~ rt"' ~ ~ Carl E. Smith - LI/6 /19~ ~p~ f.1 (' IV 0 '- D ? Je AI .t,..; s (Witness Signature) 7 - /fc- :7'1 Date (Print Name) /5'2. ~ ~. oS,4,... /21), (Address) c- 'ft/1~C.I~,r<: 81.L.~) p~ L"OS"~ (City, State, Zip Code) I -Id.Ld,;dL ~J~;" /0/litness Signature) 7 - (b - "17 Date / 68 '-1::> //=.- A. 6 ./A-c.et/, c:..... (Print Name) " n.., t,J uz. 1" :::/~ d l.e ';2. i) ~ & l-(.1p P p,. It D 2.S (Address) (City, State, Zip Code) c r- ( LAST WILL AND TESTAMENT WITNESS PAGE: We, the undersigned, do hereby certify that Carl E. Smith on this fr. day of J ~ L 1 . 19..lL, declared the above and foregoing instrument, consisting of four (4) pages, each of which is signed by Carl E. Smith, to be his/her Last Will and Testament, and that thereupon he/she asked us to act as witnesses to such Will, and did in our presence of each of us sign his/hcr name to such Will; that, thereupon, we and each of us, in the presence of Carl E. Smith and in the presence of each other, do sign our names as witnesses to such Will. /l.-"e.t PC(J'~ (Witness SignatUIe) ~ 1,./f'7 Date (.J ,. IlJ " c.. 1) ;:> J ~ III /tC,": s (Print Name) I $ 2. ~ r:. 'i. /+c n iV) (Address) JV( ec...I-l"'-lc~61C~5, fl4- I?O~'5 (City, State, Zip Code) /"-liJ~ t3. ~arw~(Witness Sign_e) 7- 1(.,-'1, Date h tH. 'b ,,; A J& iW:.Clh c.. (print Name) fa 1"2.. ( tJ LA- t') chi I ~ {2l) (Address) ~ . ~Trl.A- PA- l102.tS (City, State, Zip Code) c Signed ~___.P. c!S.~ _ Page 4 f c c Certificate of AcknowledgeIllent of Notary Public eonmoawealth or Pennsylvania) is. Cowry of Cumberland) en this I <0 day of :r u \ y . A.D. 199' L appeared before me Carl E. Smith personally kn"........ to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is sll',scribed in this instrument, and acknowledged that he/she executed it. ~ Residing in Notary Public My Commission Expires NOTARY SEAL: Notarial Seal Glenn W. Hebert, Notary Public North Newton Twp., Cumberland County My Commission EXpirM May 8, iOQO \ Signed c;!J;--~ 5~ _ ~,,9JL- Page 3 RE:V-1502 EX+ (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE I INHERITANCE TAX RETURN I RESIDENT DECEDENT i _------::::--==-::-=-===:..~--==~_-----=-====_=______---~-- _-----:::---__===_____ I ____-----:-::==---------:::::::-~~:..=:~===~___=____=___~__=__=_:_:= ESTATE OF FILE NUMBER CARL E. SMITH 21-05-0997 All rea! property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchange between a wiliing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the reievant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBeR 1. DESCRIPTION RESIDENTIAL REAL ESTATE, 6200 WERTZVILLE ROAD, ENOLA, PA 17025 - }\PPRAISED V.LiLOE BY PRODEl\'TIP"L WOOD REAL ESTATE. VALUE AT DATE OF DEATH =_53,000 I TOTAL (Also enter on line 1, Recapitulation) ~ (If more space is needed, insert additional sheets of the same size) 153,000.00 ~ Prudential ....... Prudential Thompsoll Wood Real Estate 3815 Market Street Camp Hill. PA 17011 Bus 717 761-8353 Fax 717761-2563 info@prudentialthompsonwood.com www.prudentialthompsonwood.com November 10,2005 Dale Smith Sr. Jean A. Rake Co-Executors Estate of Carl E. Smith RE: 6200 Wertzville Rd. Enola P A 17025 Dear Dale & Jean: On November 5th 20005 I previewed the referenced property in order to determine the current market value. The property is a 1373 square foot brick ranch home with 3 bedrooms and 1 full bath. There is a 2 car attached garage as well as a detached/shop garage situated on .69 acres in Si~l rr.ng Township. J-/ U f"1 fJ G /1 I have found numerous comparables that have settled in recent months and are similar in size, location and amenities. Based upon its location on a busy road and the need for interior updating, I believe the indicated market value is as follows: One hundredfifty three thousand dollars and 00/100 ($153,000). Should you have any questions or comments, please don't hesitate to let me know. St p n J. Thompson Broker/Appraiser (Lic. # BA003424L) Prudential Thompson Wood RealEstate ......... .~.~ ...____~..~~.... ~...__... __-' _____._...l _~_..._. _" "':"..._ "":...__.....", an...., C"....n .\H;,;....,...,. '..,,. REV-1503 EXT (6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANiA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF --_.__._'-----_.~~----_..__._-_._._-------- ---._----~._----,------_.._-- -..-- FILE NUMBER CP3L E. SMITH 21--05-0997 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 2. 3. 4. 5. 6. 7. 8. 9. 10. ll. 12. 13. " L1 -L " . 15. 16. 17. 18. I I I I I . I 10,000 BOND-MONTGO~ERY CNTY PA HIGHER ED. 5% MATURES 06/01/28 MONTGOMERY CNTY PA HIGHER ED. - ACCRUED iNTEREST 200 SHS. MGE ENERGY, INC. 450 SHS. ERIE INDE~NITY CO. 600 SHS. UGI CORPORATION 400 SHS. CVS CORPORATION 8,338 SHS. EXXON MOBIL CORP. 1,058 SHS. PPL CORPORATION 24 SHS. MEDCO HEAL~H SOL, INC. 200 SHS. MERCK & CO. 109,293.9 SHS. MORGAN STANLEY LIQUID ASSETS FUND OPPENHEIMER & CO.-ACCT.#A09-0019777-128: 0,132 SHS. EXXON MOBILE CORP. 23,078 SHS. LIQUID MONEY FUND 2,359.219 SHS. VANKAMPEN US MORTGAGE CLASS A 6,242.433 SHS. JOHN HANCOCK TAX FREE BOND FUND 495 SHS. ACM INCOME FUND, INC. SM=TH BARNEY CITIGROUP-ACCT.#724-03837-16 SMITH BARNEY CITIGROUP-ACCT.#724-08770-14 1,700 SHS. EXXON MOBIL CORP. 4,900 SHS. EXXON MCBIL CORP. 338.5 SHS. FRANKLIN PA TAX EXEMPT 100 SHS. JOHNSON & JOHNSON 3 14,100 95,727 275,919 3,507 6,295 10,138 204 6,700 23,704 13,878 9,946 464,427 32,131 1,333 5,477 109,294 345,293 23,078 32,132 63,610 4,089 I TOTAL (Also enter on line 2, Recapitulation) I $ 1, 54 0, 9 S 5 . 0 0 (If more space is needed, insert additional sheets of the same size) ~ ~ - )/WVJ ~ j) (J i). .[ s -J-JJ.- ~J .----- SMITH BARNEY..... cltlgroupJ Balances As of 10/28/2005 Carl E Smith 6200 Wertzville Rd Enola PA 17025-1162 ;)repared by FABIAN - FRIEDMAN 717-780-1700 Acct No. 724-03837-16 MARKET VALUE % OF ASSETS INCOME ACCOUNT BALANCE 3.28/ 100.00 TOTAL ACCOUNT VALUE 3.28 100.00% l .. % of Assets reflects account balances as a percentage oflong position & cash rounded to the nearest hundredth. As a result the total may not equal J 00%. l . 'ove summary/prices/quotes/statistics have been obtained from sources believed reliable but are not necessarily complet,e and cannot be guaranteed. '-Iformation contained in monthly account statements and confirmations reflects all transactions processed by Smith Barney, and as such supersedes all other reports for financial and tax purposes. Smith Barney is a dlVision and service mark of Citigroup Global Markets Inc. Member SIPC .;..--- SMITH BARNEY.... cltlgroUpJ Holdings As of 10/28/2005 Carl E. Smith Ttee Fho C.E. Smith Living Trust U/ND 07/16/97 6200 Wertzville Road Enola PA 17025-1162 :Jrepared by FABIAN - FRIEDMAN ""17~ 780-1700 Acct No. 724-08770~14 Quantity 14,082.07 1,700.00 4,900.00 338.50 SymlCDSIP #BDP XOM XOM FRP AX 100.00 JNJ 10,000.00 613604TP20BO (" "- Research Rating Price Description BANK DEPOSIT PROGRAM EXXON MOBil.., CORP 1L EXXON MOBIL CORP 1L FRANKLIN PENNSYL V ANlA TAX FREE JOHNSON & JOHNSON 1L Market Value 14,100.16 v' / 95,727.00 275,919.00/ / 3,506.90/ 6,295.00'/ . / 10,138.70 TOTAL ACCOUNr VALUE 405,686.76 (1bove summary/prices/quotes/statistics have been obtained from sources believed reliable but are not necessarily complete and cannot be guaranteed. '-. ..mfonnation contained in monthly account statements and confirmations reflects all transactions processed by Smith Baml:y, and as such supersedes all other reports for financial and tax purposes. Smith Barney is a division and service mark of Citigroup Global Markets Inc. Member SIPC. Independent, third-party research on certain companies covered by the firm's research is available to clients of the firm at no C\JSt. Clients can access this research at www.smithbamey.com or can call 1-866-836-9542 to request that a copy of this research be sent to them. Citigroup Investment Research's research ratings are displayed Wlthin the Research Rating column in 'Holdings'. Page 2 1.000 56.310 56.310 10.360 62.950 101.387 MONTGOMERY CNTY P A HIGHER ED & Coupon 5% Mature 06/01/28 Accrued Int. $204.16 -~ ........ c0 . d 11::'-1.01 "'-'"00,. ." -, ~ - "- >. '-, '" .... , , '- ,'~ "'~ \_ \ i""'-J " .. J 6 t \.~:' OWW Z~~> ~gj50!Z I-OCD~W Zw _:::l~cn "",WUwUJ .c:;-lUI-a: OaJ<~:::l fE~OCD~ wl->u- ~a:cni!l.L. <w<l-O oaJQZZ WO~OO Ol-I-::!i= >OOZa:(3 W<:::l_ a:a:a:Ol.L. Q.w<>ir wg:::l::.::;w wcnClu> UZl-wa:: a:OO~O a.UZUu.. " ,-~,.""" 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CD < mOo ~~ ~ () . c: 010 .x~ cC '0 0 (l) (l) ~ E 0 0 .... _000 ..J~ ~ '3 ... I~ ~ aI:l )( (5 CD 0 LLE (l) )( ~ E CD,O - CD enC1' 0 'C o>~ Q.12) CD CF 0 0 ::e UJ l.L< O::I: ~ if I- ~~ I-::i .... W ::>()W Cl..1::E ::E,::i .... \. "- , \., \ \ \. , , ) '- '\ '\'\\ '\' '\ (,y!O r-I 1<:;99 <:;<:;c L1L A::JINHI C;-NH["J>4nW ?T~tt C~~?-t~-~~n l2/e~!2eB5 ~l:l~ /.-/tcj~/b~ U"+'t:..Nl-f:.l Mt:..t-: OPPENHEIME~ December 5,2005 Ms. Jean A. Bake, Executor 6035 Wertzville Road Enola. PA 17025.1158 Re: Carl E. Smith Date-of-Death Valuation Dear Ms. Hake: PAc%;' 1::1::' ~ ~ <;0.1.... 1015 Mumma :Ro.d WonDl~t.. PI. 17043 Soo.m.:Z294 M..... 01 All hmoIpo! ~ A5 per your rc:qucst dated November 16, 2005, please find below the date-of-death valuation for Mr. Smith. If you have any further qucstioos, please do not ~~t,te to caD.. Thank you. A87-092090S-128, Carl E. Smith, Individual Retirement Account Name of JJn1'fl$Ime1Il TotoI~ Owru:d Price Per Shon E:xxonMobil COIp 3,552 Ivy Mid Cap Growth Fd A 331.557 Advantage Primary 2,398.540 Liquidity (Money) Fund A09-0019777-128, Cad E. Smith $56.31 11.01 1.00 Name of Investment Total Shares Owned Price Per Share $56.31 1.00 Exxon Mobil Corp 6,132 Advantage Primary 23,078.01 Liquidity (Money) Fund 40-00000396878, Carl E. Smith Trustee, C. E. Smith Living Trust NQ1TJe of Jnvestmolt Total Shares ~d Price Per Shm-e Van Kampen US Mortgage 2,359.219 Class A $13.62 ,Mtrkzt Vahmtion $200,013.12 ~ 3,650.44 ,/ 2.39854 Market Valuation / :$345,292.92 ,/ 23,078.01 )e"- 5 J, e-J J ~ B Marice! Valudion / $32,132.56 rf~~ WORLDWIDE SPONSOR Trade date 09/29/05 10128/05 11/29/05 12(29/05 /CllClVl -=!l::)\:1,-l John Hancock Fund!>, LlC M.Me.R NASI) 1 John Hancock Way, Suite 1000 l:lOSlOn, MA 0221 7 -1 000 Description Div Reinvest Div Reinvest Div Reinvest Div Reinvest Ending value on 1230105 lIIF SHR STM Dulldl amount $236.72 $230.36 $249.04 $24837 $64,358.97 '- 2005 Year end summary January 3, 2005 - December 30, 2005 Page 2 of 7. Slldr~ price $10.29 $ 1 O. 1 9 $10.18 $10.22 $ 1 0.23 Slldr e~ [1 Ii~ transaction 23.005 22.606 24.464 24.302 TOldl shares owned 6,219.827 6,?42 A33 '* 6,266.897 6,291.199 6,291.199 ~ D{)D VaJ",~ f&,,~~~."'~!>><ID./9:. 6s,Ie.IC;;/ r)TW~T ~ I ;:..jn,...l~ Ct"nT7T"'l(T 2 357694 I) 1 OIl:\A549:\ JOH13477 12!.1l/U~ 0 - - - . = - - == ~ NNNNNQ C J C77C" ,1,1 T J /Z / J// d .1fm2/lwncq~ ~- John Hancock Funds. LLC MEMBER NASD 1 John Hancock Way, Suite 1000 Boston, MA 02217.1000 2005 VQar Qnd summary January 3, 2005 - December 30, 2005 Paqe 1 of 2 Investment professinnal Name Dealer Branch WOIU.I.lWrOll $P()NS<lJ\ SH.()()3382IHF.JHI'ZrB16 JEAN A HAKE TTEE DALE E SMITH TTEE C E SMITH LIVING TRUST UtA DTD 7/16/1997 6035 WERTZVILLE RD ENOLA PA 17025.1158 Signatar Investors Signator InveSlors Inc Special Accounts 601 Congress St FI 9 Bo!:ton M^ 02210-280-1 Contact information' .. Web site www.jhfunds.com EASI"Line (24-hour automat,~d line)I-80U-3j8-~u~u JHF customer service 1-800-225-5291 (Monday to Friday, 8:00 a.m. to 7:00 p.m. Eastern Time) Portfolio summary Beginning value as of ~105 Total additions Change in value Ending value as of 12130105 $61.947.96 +2,910.61 -499.60 $64.358.97 Reinvested dividends & short-term capital gains Account details for non retirement account(s) 1p',,1n A H<:lk~ TTEE Dale E Smith TTEE C E Smith Living Trust UJA Otd 7'/1611 997 - - - --- ~ Share price $10.31 $10.36 $10.34 $10.17 $10.32 $10.36 $10.41 $10.36 $10.38 '((:'!,;)tl...', ! Total shares owned 6,008.532 6,029.944 6.052.293 6,078.554 6,101.018 6,123.687 ._.6,149.13.1 6,171.668 6.196.822 ~ ~ Trade date Description Beginning value on 01/03105 o lJ28/05 Div Rcinvc!;t 02/25J05 Div Reinvest 03/30/05 Div Reinvest 04J28/05 Div Rcinvc!;t OS/27 105 Div Reinvest 06/29/05--DivReiFlvest-----'-' - 07/28/05 Div ReinvQst 08/30/05 Div Reinvest Dol ar amount $61,947.96 $221.83 $231.09 $267.07 $231.33 $234.85 $264.93- $233.112 $261 .1 0 IRF $IU( STM : 1 3$7693 1) 108311S49'3 JOB13<177 12(.llillS 0 ~ """""'" - ~ 21.412 22.349 26.261 22.464 22.669 2.5.450 22.531 25.154 ~ =m=: NNNNNO Invest by mail Fund name Tax-Free Bond A Fund-account humber 52 - 5256895 Jean A Hake TTEE Dale [ Smith TTC[ C E Smith Living Trust U1A Dtd 7/16/1997 6035 WeflLville Rd Enola PA 17025-1158 To Invest by mall. fill out thiS slip. detach and mail it in the endoserJ envelope. along with your check milrl.. r"y"h!p tn Inhn H;mrn..1c <;il)niln Irp C;PNlrp, ,n.. Amount enclosed 5 "lease make any address changes on the reverse sid\! and have all registered owners sign and return this slip. 0000 41013Y10 OD0052568~S6 0000052 RE'J-1504 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANC':: AX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER CARL E. SMiTH 21-05-0997 Schedule C-1 or C-2 (including all supporting informationl must be attached for each closely-held corporation/partnership Interest of the decedent. otner tnan a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships ITEM NUMBER 1. N/F_ DESCRIPTION VALUEAT DATt: OF DEATH ! TOTAL (Also enter on line 3, Recapitulation) I S (If more space is needed, insert additional sheets of the same size) REV-1505 EX+ (5-98) i I COMMONWEALTH OF PENNSYLVANIA I INHERITANCE TAX RETURN RESIDENT DECE:DENT , ~~ --_._._---~----_. - ~~.~ SCHEDULE C-1 CLOSELY-HELD CORPORATE STOCK INFORMATION REPORT ESTATE OF FILE NUMBER Cp"RL E. SMITH 21-05-0997 1. Name of Corporation N/.r.. Address City 2. Federal Employer 1.0. Number 3 Type of Business State of Incorporation Date of Incorporation State Zip Code Total Number of Shareholders Business Reporting Year ProducUService 4. STOCK TYPE TOTAL NUMBER OF PAR VALUE NUMBER OF SH.e.RES I VALUE OF THE VotinglNon-Voting SHARES OUTSTANDING OWNED BY THE DECEDENT DECEDENTS STOCK Common i , !$ Preferred i 1$ I I I Provide all rights and restrictions pertaining to each class of stock. 5. Was the decedent employed by the Corporation? If yes, Position Annual Salary $ . . . . . 0 Yes n No Time Devoted to Business 6. Was the Corporation indebted to the decedent? . If yes, provide amount of indebtedness $ ..OYes ONo 7. Was there life insurance payable to the corporation upon the death of the decedent? . . . . . 0 Yes 0 No If yes, Cash Surrender Value $ Net proceeds payable $ Owner of the policy 8 Did the decedent sell or transfer any stock in this company within one year prior to death or within two years if the date of death was prior to 12-31-82? o Yes 0 No If yes, 0 Transfer 0 Sale Number of Shares Transferee or Purchaser Consideration $ Date Attach a separate sheet for additional transfers and/or sales. 9. Was there a written shareholder's agreement in effect at the time of the decedent's death? ..... OYes 0 No If yes, provide a copy of the agreement. 10. Was the decedent's stock sold? . If yes, provide a copy of the agreement of sale, etc. . . . . 0 Yes 0 No 11. Was the corporation dissolved or liquidated after the decedent's death? . . . . . . 0 Yes 0 No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 12. Did the corporation have an interest in other corporations or partnerships? . . . . . . . . . 0 Yes 0 No If yes. report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. THE FOLLOWING INFORMATION MUST BE SUBMITTED WITH THIS SCHEDULE A. Detailed calculations used in the valuation of the decedent's stock. B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years. C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been secured, attach copies. D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent. E. List of officers, their salaries, bonuses and any other benefits received from the corporation. F. Statement of dividends paid each year. List those declared and unpaid. G. Any other information relating to the valuation of the decedent's stock. (If more space is needed, insert additional sheets of the same size) REV-1506 EX~ (9-00) i I I =-L_ PARTNERSHIP COMMONWEALTH OF PeNNSYLVANIA INHERITANCe TAX RCTURN INFORMATION REPORT ReSIDENT DECEDENT -------.---------.....------ ---.- ESTATE OF SCHEDULE C-2 -.-..----... --....-----...--- --.- --------- --- --.-.--..- C=~I\RL E. S}:\lITH FILE NUMBER 21-05-0997 1. Name of Partnership N / A Date Business Commenced Address Business Reporting Year City State Zip Code 2. Federal Employer I.D. Number 3 Type of Business Product/Service 4. Decedent was a [J General [J Limited partner If decedent was a limited partner, provide initial investment S 5. PARTNER NAME PERCENT PERCENT BALANCE OF OF INCOME OF OWNERSHIP CAPITAL ACCOUNT A. I B. I C. I D. _I 6. Value of the decedent's interest $ 7. Was the Partnership indebted to the decedent? If yes, provide amount of indebtedness S . [JYes [JNo 8. Was there life Insurance payable to the partnership upon the death of the decedent? . . . . . [J Yes n No If yes, Cash Surrender Value S Net proceeds payable S Owner of the policy 9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years if the date of death was prior to 12-31-82? [JYes nNo Transferee or Purchaser Attach a separate sheet for additional transfers and/or sales. If yes, [J Transfer [J Sale Percentage transferred/sold Consideration $ Date 10. Was there a written partnership agreement in effect at the time of the decedent's death? . If yes, provide a copy of the agreement . . . [JYes [JNo 11. Was the decedent's partnership interest sold? If yes, provide a copy of the agreement of sale, etc. . . . . . . . . . . . . . . . . . . . [J Yes [J No 12. Was the partnership dissolved or liquidated after the decedent's death? . . . . . . . [J Yes [J No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 13. Was the decedent related to any of the partners? If yes, explain . . . . . [J Yes [J No 14. Did the partnership have an interest in other corporations or partnerships? . . [J Yes [J No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest THE FOLLOWING INFORMATION MUST BE SUBMITTED WITH THIS SCHEDULE I I A. Detailed calculations used in the valuation of the decedent's partnership interest B. Complete copies of financial statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding years. C. If the partnership owned real estate, submit a list showing the complete address/es and estimated fair market value/s If real estate appraisals have been secured, attach copies. D. Any other information relating to the valuation of the decedent's partnership interest. REV-1507 EX+ (6-98) I I I I I ~ SCHEDULE D MORTGAGES & NOTES RECEIVABLE i I I i I I ____ ----L------=~_====c~=~-=-~--~ FILE NUMBER COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CARL E. SMITH 21-05-0997 All property jointiy-owned with right of survivorship must be disclosed on Schedule IF. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DeATH N/A i I I I I L I I TOTAL (Also enter on line 4, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) R'::'J-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONW"ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT --~--------_.__..__._-._- _._~--_._- ~_.-._-_._--- ---~-_.._- ESTATE OF CARL E. SMITH FILE: NUMBER 2l-05-0997 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 ,,:. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. lO. 11. 12. 13. 14. -: c:. ....:....J. DESCRIPTION CITIZENS BANK - CHECKING ACCOUNT - ACCT. NO. 610-0686647 CITIZENS BANK - SAVINGS ACCOUNT - ACCT. NO. 614-0162297 BANK OF LANDISBURG - NON-INTEREST BEARING CHECKING ACCOUNT - ACCT. NO. 2644177 I BANK OF LANDISBURG - CERTIFICATE OF DEPOSIT I NO. 700012821 I ACCRUED INTEREST BANK OF LANDISBURG - CERTIFICATE OF DEPOSIT I NO. 700012494 ACCRUED INTEREST I BANK OF LANDISBURG - CERTIFICATE OF DEPOSIT NO. 70001247l ACCRUED INTEREST 2005 MERCURY SABLE SEDAN 1999 FORD ECONOLINE CARGO VAN HULL TRP\.ILER MISCELLANEOUS HOUSEH0LD ITEMS ADVANCE PUBLICATIONS REFUND PATRIOT NEWS REFUND TOTAL (Also enter on line 5, Re~aPit~1 $ (If more space is needed, insert additional sheets of the same size) VA~UEAT DATE OF DEATH 22,133 7,943 24,368 20,518 9 =-2,331 2 =-l,972 19 ~2,225 3,200 100 4,100 38 26 118,984.00 DEe l2l6 . as 09: 43 FR C I T I ZENS ~-IK 717 ?66 8:JZJ 10 ~I?';J P. ral~1:l1 t:: CITIZENS BANK December 6, 2005 Carl E Smith 6200Wc:rtzville Road Enola, Pa. 17025 RE: CheckiI18 Account 6100686647 Savings Accounl6i40162.297 To Whom It May Concern: Per your request I have included the balances on the above refcrena:d ac<:OUllU as of October 28,2005. / CheckiIli Account 6100686647 $22,132.77 I Savings Account 6140162297 $7,943-28 P1e2Se contact me at 717-766-4743 if you have any additional questions Holly L Me er ASSl Manager Moohi:Ulicliiburg BrCUl~h ~uffi ** TOTAL PAGE.01 ** 7lA/TfA "":::::Jt:'\~~ nTllr-T II 'If! II' r-LI'-'T~T'-"rT 12;:2/2665 11:39 ?~75:JG:J5~2 BAt-IK OF LANDISBURG PAGE el The8an~ of Landisbu~ ESTABLISHED 1903 P.O. eo~ 179 · LANDlSBURG. PA "0.110 Bank recordS indiclde the follOWing account bIIInC8I on 0Cl0ber' 28, 2005 for: C8tI E. Smith SS# 198-22-9630 8200 W8ftzvi11e Road ~ EnoIa, PA 17025 N;d ScIe Jt. /teet.' Account Type Balance InterHt Accrued Opened 0WMfthip WIttl Number Be8MQ lme.wt 1o-1~ Yes 26441n ODA . I No $24.367.89 03-22~ Yes 700012821 CD j Yes $9.44 v' $20,518.54 02.26-04 YflS 700012.94 CD .; Yes $1.62 v' $12.331.04 $11,9n!.28 /' / 12-29-03 Yea 700012471 CD v_ $1Q.50 I R~pectfully. ~(<1~~ Community OffIce r ce~ I.ANDlSalJRG - "'-789-:l21J . IllAlN - 5$6-31'18 . SIICRMAN~~ DALE - ~-8St1 J Gl IhlA ':!Cl\-L.J ClTWCT.J I :>In..Jc Cf..lnT"7T....n C,IC77C,I.'T.' ~~...n ann7/nT tTn Keiiej Blue Book - Private Party Pricing Report - Mercury, Sable ~_' .~~ Kelley Blue Book , : THE TRUSTED RESOURCE . ; kDlu.. .- .' 'S/IMIIf j'~, "'- ' -'~""'."~ - ''-'''---'.- ~-- ..-- . - advertisement What is New (ar Blue Book" ? Page 1 of2 Quick Dealer Price Quote Search Used Car listings List Your C. " USED CARS "' REVIEWS & u.nNGS ADVICE FlNANONG & INSU BLUE BOOK'(' PRIVATE PARTY REPORT Pennsylvania · December 6, 2005 2005 Mercury Sable LS Sedan 40 :~ ......'---.....~\- . ':\~, -.1 ,,- , .~'~ Search Listings for This Car List Your Car For Sale Online Quick New Car Price Quote Free CARFAX Record Check Auto Loans from 5.390/0 APR Insurance Quote Print "For Sale" Sign Payment Calculator Extended Warranty Quote ~~~~ ~ ~ ~..,,- \;<'5'v. .., Engine: V6 3.0 Liter 24V Trans: Automatic Drive: FWD Mileage: 11,670 Equipment Air Conditioning Power Steeri ng Power Windows Power Door Locks Tilt Wheel Cruise Control AM/FM Stereo Single Compact Disc Dual Front Air Bags ABS (4-Wheel) Leather Power Seat Alloy Wheels Consumer Rated Condition: Fair "Fair" condition means that the vehicle has some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. This vehicle has a clean title history, the paint, body and/or interior need work performed by a professional. The tires may need to be replaced. There may be some repairable rust damage. BLUE BOOK CLASSIF' S eulCh U,~a (v Ldilil]~ Quickly brc through 0' 600,000 u~ vehicle listir find exactly the car you want. - advertise mer SEARCH USED CA lISTING~ ON KBB. GwfIj .. "7. More than 600,0 online listings Make: I Acura Model: I Select a Model ZIP Code: GO Power~d by: . Keiley Blue Book - Private Party Pricing Report - Mercury, Sable Private Party Search Local Listings I List This Car for Value Sale $12,225 Private Party Value is what a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than the continuing factory warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation purposes. Get a Used Car Trade-In Value Get Invoice & MSRP on New Cars Get a 15 Minute Response When You Apply for a Blank Check@ Auto Loan _~J~G~~,i Copyright @ 2005 by Kelley Blue Book Co., All Rights Reserved. Nov- Dec 2005 Edition. The specific information required to determine the value for this particular vehicle was supplied by the person generating this report. Vehicle valuations are opinions and may vary from vehicle to vehicle. Actual valuations will vary based upon market conditions, specifications, vehicle condition or other particular circumstances pertinent to this particular vehicle or the transaction or the parties to the transaction. This report is intended for the individual use of the person generating this report only and shall not be sold or transmitted to another party. Kelley Blue Book assumes no responsibility for errors or omissions.(v.05115) Page 2 of2 Kelley Blue Book - Trade-In Pricing Report - Ford, Econoline .~!2!D~~ ove';1S' ye~u:~,_,.,'" ?~','{' _',_ l '" "'_-r - .'~- ;- ~~~..-, advertisement Whot is New (or Blue Book@ ? Page 1 of2 USED CARS C Quick Dealer Price Quote Q Search Used Car Wstings ~ Us REV1E'NS & P.ATlNGS ADV!CE FiNANCING BLUE BOOK1t TRADE-IN VALUE Pennsylvania. November 30, 2005 1999 Ford Econoline E150 Cargo Van ~- .,--J.-. - .- , -=- - - ~-- " . -"7'':.,.<. - ~ _ - Search Listings for This Car l,i~LY.Q.l.Jr.G.:;r EOL~~I~Ql1li!l~ Quick New Car Price Quote F.i~~J;ARf_M. R~cord~hec.!s Auto Loans from 5.39% APR lmuJJgl}ce Qllote payment C.?lGulator - - ---~ , '~ u - ~ -~ -. . Engine: V6 4.2 Liter Trans: Automatic Drive: RWD Mileage: 56,000 Equipment AMjFM Stereo Dual Front Air Bags a/J {,' ~ '-Wv<./~ -p !Lb-' Consumer Rated Condition: Fair "Fair" condition means that the vehicle has some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. This vehicle has a clean title history, the paint, body and/or interior need work performed by a professional. The tires may need to be replaced. There may be some repairable rust damage. Air Conditioning Power Steering Trade-In Value List Your Car For Sale Online $3,225 Trade-in Value is what consumers can expect to receive from a dealer for a trade-in vehicle assuming an accurate appraisal of condition. This value will likely be iess ti".an t ~he Pri~ate Party V~I~e ?ecause the reset.ling de~ler inc~rs the cost of safety ..::;"".A inSpections, recondItIoning and other co~ of dorng ~USI~~~. \ . <' i'rc./'' i2';:'r:.~:Cr NEXT STEP: 0 Get New Car Pr ;..4 ':.1JLIle'80o&":VALUIt :- ,,;' FEEDBACK - BLUE BOOI LIsl Y (l1S1 Car k cars.com other po~ -ad' ~ t ~ Be ~ I. REV-1509 EX + (6-98) COMMONWEAL-;-H OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF I -~-- ~-~~~ -_._~---- C;;RL 2. SMITH FILE NUMBER 21-05-0997 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINTTENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A N/.;; B C JOINTLY-OWNED PROPERTY: L!:FER DATE I DESCRIPTION OF PROPERTY % OF DATE 0; DEATH iTEM FOR JOINT MADE I INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECDS VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1 A. I I I i II TOTAL (Also enter on line 6, RecaPitulationll $ (If more space is needed, insert additional sheets of the same size) REV-1510 EX+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY CARL E. SMITH 21-05-099~ 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 SH"ET is yes. ! DESCRIPTION OF PROPERTY I I : ",IJ~~~D I INCLUDE THE NAME 0, THe TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND . DATE OF DEATH % OF DECDS I EXCLUSION ~ THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF ADPUCABLEi I II 1. SMITH BARNEY CITIGROUP - ACCT. NO. 724-67516-16 - INDIVIDUAL RETIREMENT I ACCOUNT - SEE ATTACHED DETAIL 1779,601 2. MORGAN STANLEY - ACCT. NO. 410-037726- 042 - INDIVIDUAL RETIREMENT ACCOUNT: 200 SHS. ORACLE CORP. 206 SHS. M&T BANK CORP. 5,808 SHS. EXXON MOBIL CORP. 44 SHS. FREESCALE SEMICONDUCTOR 120 SHS. AMERICAN ELECTRIC POWER 500 SHS. GENERAL ELECTRIC CO. 100 3HS. HOME DEPOT, INC. 400 SHS. MOTOROLA, INC. 200 SHS. RITE AID CORP. 200 SHS. TECO ENERGY 8,878.692 SHS. MFS GOVT. SEC. 5,769.761 SHS. MFS GOVT. LIMITED MAT. 1,596.631 SHS. TEMPLETON DEV. MKTS. 5,497.18 SHS. TEMPLETON FOREIGN FUND 32,523.46 SHS. MORGAN STANLEY LIQUID liSS!::T FUND 3. OPPENHEIMER & CO., INC. - ACCT. NO. A87-0920905 - INDIVIDUAL RET. ACCOUNT: 3552 SHS. EXXON MOBIL CORP. 331.557 SHS. IVY MID CAP GROWTH FUND 2,398.54 SHS. LIQUID MONEY FUND COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESID::NT DECEDENT -~ ---~~_._.__.- ESTATE OF 2,5251 21,734 323,506 998 4,486 16,902 4,010 9,680 679 3,377 84,170 45,004 33,018 I 66,461 32,523 I I 200,013 3,650 2,398 --------- --~_.._._----- -------~-- ---._--- FILE NUMBER 100 I I I TAXABLE VALUE I P79,601 100 100i 1001 1001 1001 1001 looi 1001 1001 100 1nn' ...Lvu! 2,525 ,21,734 ~23,506 998 4,486 16,902 4,010 9,680 679 3,377 84,170 L;5,004 33,018 66,461 100i 1001 100 I I ! ..., n (1 I 1.0vI I I 1001 1001 1001 i I I t 1 ! 32,523 00,013 3,650 2,398 i I I I I i I I I I I -j TOTAL (Also enter on line 7, Recapitulation) I $ :1, 634 , 7 3 5 . 0 0 (If more space is needed, insert additional sheets of the same size) _1 SMITH BARNEY... ifl *** Carl E Smith cltlgroUpJ CGM IRA Custodian Holdings 6200 Wertzville Rd As of 10/28/2005 Eno1a PA 17025-1162 Prepared by FABIAN - FRIEDMAN AcctNo.724-67516-19 717-780-1700 Research Quantity SymlCUSIP Description Rating Price Market Value 38,292.35 #BDP BANK DEPOSIT PROGRAM 1.000 38,339.48 500.00 ABBC ABINGTON COMMUNITY BANCORP INC 12.000 6,000.00 8.00 AGR AGERE SYS INC 10.080 80.64 10.00 AV AVAYAINC IS 11.100 111.00 150.00 BMY BRlSTOL MYERS SQUIBB CO 3M 21.140 3,171.00 300.00 CSCO CISCO SYS INC 1H 1 7.140 5,142.00 400.00 CPRZ CITIGROUP CAPITAL VIII 6.95% 25.340 10,136.00 200.00 KO COCA-COLA CO 2M 42.830 8,566.00 200.00 CMTY COMMUNITY BKS INC MILLERSBURG 27.880 5,576.00 400.00 KNO CORTS TR 1 FORAIG 6.7% 25.200 10,080.00 66.00 DLM DEL MONTE FOODS CO 10.600 699.60 C 100.00 DELL DELL INC 1M 31.060 3,106.00 200.00 DD EIDUPONTDENEMOURS&CO 1M 42.000 8,400.00 7,128.00 XOM EXXON MOBIL CORP 1L 56.310 401,377.68 800.00 GABPRB GABELLI EQUITY TRUST 7.20% 25.590 20,472.00 250.00 GE GENERAL ELECTRlC CO 1L 34.050 8,512.50 200.00 HLSH HEAL THSOUTH CORP 4.100 820.00 600.00 HMYRQ HEILIG MEYERS CO 0.000 0.30 150.00 HNZ H J HEINZ CO 35.710 5,356.50 100.00 HPQ HEWLETT PACKARD CO 2H 27.960 2,796.00 200.00 HD HOME DEPOT INC 2M 40.520 8,104.00 100.00 HON HONEYWELL INTL INC 2H 33.600 3,360.00 100.00 INTC INTEL CORP 1M 23.330 2,333.00 400.00 JPMPRJ JP MORGAN CHASE CAP X 7.0% 25.600 10,240.00 300.00 KNBT KNBT BANCORP INC 15.830 4,749.00 325.00 LU LUCENT TECHNOLOGIES INC 2H 2.790 906.75 18.00 MHS MEDCO HEALTH SOLUTIONS INC 55.750 1,003.50 ( Ibove summary/prices/quotes/statistics have been obtained from sources believed reliable but are not necessarily complete and cannot be guaranteed. \-._, mfOrmatlOn contained in monthly account statements and confirmations reflects all transactions processed by Smith Bamey, and as such supersedes all other reports for financIal and tax purposes. Smith Barney is a division and service mark of Citigroup Global Markets Inc. Member SrPc. Independent. third-party research on certain compames covered b'y the firm's research is available to clients of the firm at no cost. Clients can access this research at www.smithbamey.com or can call 1-866-836-9542 to request that a copy of this research be sent to them. Citigroup Investment Research's research ratings are displayed within the Research Ratmg column m 'Holdings'. Page 2 SMITHBARNEY.... *** Carl E Smith cltlgroUpJ CGM IRA Custodian Holdings 6200 Wertzville Rd As of 10/28/2005 . Enola PA 17025-1162 Prepared by FABIAN - FRIEDMAN Acct No. 724-67516-19 717-780-1700 Research Quantity Sym/CDSIP Description Rating Price Market Value 150.00 MRK MERCK & CO INC 2M 27.540 4,131.00 200.00 MSFT MICROSOFT CORP 1M 25.530 5,106.00 200.00 MWG MORGAN STANLEY CP TR N 6.25% 24.180 4,836.00 400.00 MWJ MORGAN STANLEY CAP TR II 7.25% 25.200 10,080.00 300.00 NRY NATL RURAL UTILITY CFC 7.625% 25.420 7,626.00 100.00 ORCL ORACLE CORP 2H 12.710 1,271.00 200.00 PTV P ACTN CORP 8Z 19.850 3,970.00 97.00 PG PROCTER & GAMBLE CO 2L 55.920 5,424.24 550.00 RAD RITE AID CORP 3.440 1,892.00 425.00 RVTPRB ROYCE VALUE TRUST INC 5.9% 24.370 10,357.25 200.00 SBC SBC COMMUNICATIONS INC 2M 23.890 4,778.00 C 200.00 SO SOUTHERN CO 2L 34.360 6,872.00 200.00 SUNW SUN MICRO SYSTEMS INC 3S 3.880 776.00 200.00 SUSQ SUSQUEHANNA BANCSHARES INC-P A 22.670 4,534.00 40.00 TEN TENNECO AUTOMOTNE INC 16.290 651.60 200.00 TWX TIME WARNER INC 1M 17.750 3,550.00 100.00 TYC *** TYCO INTL LID NEW 1M 26.750 2,675.00 400.00 USBPRC USB CAPITAL N 7.35% 25.450 10,180.00 100.00 VZ VERIZON COMMUNICATIONS 2M 31.700 3,170.00 150.00 WB W ACHOVIA CORP 2ND NEW 1M 50.090 7,513.50 400.00 WSF WELLS FARGO CAPITAL TRUST N 25.460 10,184.00 200.00 WDC WESTERN DIGITAL CORP 2H 11.820 2,364.00 200.00 WGBC WILLOW GROVE BANCORP INC 15.460 3,092.00 100.00 XRX XEROX CORP 2S 13.250 1,325.00 200.00 FWL TZ *** WTS FOSTER WHEELER LID 1.310 262.00 10.00 FWLT *** FOSTER WHEELER L TD BERMUDA 27.530 275.30 C' ')ove summary/pnces/quotes/statistics have been obtained from sources believed reliable but are not necessarily completl~ and cannot be guaranteed. ..,nformation contained in monthly account statements and confirmal1ons reflects all transaCl10ns processed by SmIth Barney, and as such supersedes all other reports for financial and tax purposes. Smith Barney is a division and service mark of Citigroup Global Markets Inc. M':mber SlPc. Independent. third-parry research on certain companies covered by the firm's research is available to clients of the firm at no cost. Clients can access this research at www.smllhbamev.com or can call I -866-836-9542 to request that a copy of this research be sent to them. Citigroup Investment Resear~h's research ratings are displayed within the Research Rating column in 'Holdings'. Page 3 StV1ITH BARNEY..... cltlgroupJ Holdings As of 10/28/2005 *** Carl E Smith CGM IRA Custodian 6200 Wertmlle Rd Eno1a PA 17025-1162 Prepared by FABIAN - FRIEDMAN 717-780-1700 AcctNo.724-67516-19 Quantity SymfCUSIP 20,000.00 GMA.GWF Research Description Rating GENERAL MOTORS ACCEPTANCE CORP Coupon 7.35% Mature 03/15/17 Accrued Tnt. $53.08 Price Market Value 80.863 16,172.60 10,000.00 VZ.IO GTE CORP DEBS-BK/ENTRY Coupon 6.84% Mature 04/15/18 Accrued Int. $24.70 106.037 10,603.70 10,000.00 HI.GAK HOUSEHOLD FIN CORP INTERNOTES Coupon 7.6% Mature 04/15/22 Accrued Int. $27.44 103.000 10,300.00 10,000.00 m.AAH HOUSEHOLD FINANCE CORPORATION Coupon 7.5% Mature 05/15/22 Accrued Int. $27.08 103.500 10,350.00 11,000.00 GM.GL c GENERAL MOTORS CORP Coupon 6.75% Mature 05/01/28 Accrued Tnt. $365.06 FORD MOTOR CO DEL GLOBAL Coupon 6.375% Mature 02/01/29 Accrued Int. $184.87 12,000.00 38374BDD20BO GINNIE MAE SERIES 2003-62 Coupon 5% Mature 07/20/33 20,000.00 05946XGT40BO BANK OF AMERICA FUNDING CORP Coupon 5.75% Mature 10/25/34 12,000.00 F.GX 68.250 8,190.00 67.000 7,370.00 94.000 11,280.00 95.000 19,000.00 TOTAL ACCOUNT VALUE 779,601.14 ( JOVe summary/prices/quotes/statistics have been obtamed from sources believed reliable but are not necessarily complete and cannot be guaranteed. 'hrc'lnformatlOn contained in monthly account statements and confirmations reflects all transactions processed by Smith Barney, and as such supersedes all other reports for financial and tax purposes. Smith Barney is a division and service mark of Citigroup Global Markets Inc. Member SIPc. Independent, third-party research on certain companies covered by the firm's research IS available to clients of the firm at no COSt. Clients can access this research at www.smithbamey.com or can call 1-866-836-9542 to request that a copy of this research be sent to them. Citigroup Investment Research's research ratings are displayed within the Research Rating column in 'Holdings'. Page 4 C0 . d iljlOl -.. 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'-_ l~ ~ ~ . i I ~8000000 CO.....~lO..... ~!..... <0 CD CD Lt) ~Nt'iariuicicO"": t")&oC\lC\lIt)MLt)C\l 00000000 8 U'),.........(l) 0..... 0 ~Q)&O.....O>C\lC\l criNN~..;ai~....: M&OC\lC\J&ON&OC\l 8~88~ffi~gi C\l ~ <0 ~ ~ s: C\ll! I !~ ! , E 0 ~ ~I I I, <CD s u <3 ~ c ~ c 15 'gj ZOo.QOOCf.l ::2 l~u1ieue= ~ Cii~~ ~~"8 8.181~ .noo8~oJ:ae~ I ~ (,.) c u 8 ~ I"C ~ .~ c; ~ ~ cr i ~ I~ I~ UJ I~ 0 W ll. ~ :::E ::i ",\ \\\\, .... C ... o ~ I ~"I""'I C:_"II-Ir'l~nl.l 7T.TT ClAlA?_TlA-~ 12/e5/2BB5 11:19 7177531755 OPPENHEIMER PAGE 02 OPPENHEIME~ Opp-hcimcr tic Co. 11>C. 1015 Mumma. Road Wormb,Y'I\xa:r" PA 17043 80~n2-:U94 December 5,2005 M...,ba of All hiD<lpoJ ~ Ms. Jean A Hakt\ Executor 6035 Wertzville Road Enola. P A 17025-1158 Re: Carl E. Smith Date-of-Death Valuation Dear Ms. Hake: As per your request dated November 16, 2005, please find below the date-of-death valuation for Mr. Smith. If you have any further questions, please do not hesitate to call Thank you. A87-0920905-128, Carl E. Smith, Individual Retirement Accoun:t Name of JJrVeStntent Total Shares Owrn:d Price Per Shan Market Valuation Exxon Mobil COrp 3,552 Ivy Mid Cap Growth Fd A 331.557 Advamage Primary 2,398.540 Liquidity (Money) Fund $56.31 11.01 1.00 $200,013.12 t) ee.. 3,650.44 SChedule. 2,398.54 G- A09-0019777-128, Carl E. Smith Name of Investment Total Shores Owned Price Per Share Market Valuation Exxon Mobil Corp 6,132 Advantage Primary 23,078.01 Liquidity (Money) Fund 40-0??oo396878, Carl E. Smith Trustee, C. E. Smith Living Trust $56.31 1.00 $345,292.921 23,078.01 \ ,0 \ ~ '<ey " (' " ) ('i\ /' ill c"..1 I \ V " '" ~ Name of lnve.stmJtnt Tota/Shores Owned Price Per Share Market Valu(ltion I I $32,132.56 J Van Kampen US Mortgage 2,359.219 Class A $13.62 REV-1511 EX~ (12-99\ I COMMONWEALTH oe PENNSYLVAN" I INHERITANCE TAX RETURN J RESIDENT DECEDENT -------.._._._----_.__.._---~ ----~ -_.~~~ ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS I I I -------- ----'------- ._-----~-- - ------~------ ------ FILE NUMBER 21-05-0997 CARL E. SflHTH Debts of decedent must be reported on Schedule J. ITEM NUMBER A B < I. 2 DESCRIPTION AMOUNT FUNDERALEXPENSES RICHARDSON FUNERAL HOME ~EAN HAKE - MEAL AND EXPENSES IN CONNECTION WITH FUNERAL MEMORIAL STONE INSCRIPTION 7,609 1,105 110 i I I I I I I Social Security Number(s)/EIN Numberof Personal Representative(s) Street Address 6035 AND 6033 WERTZVI:SLE ROAD I ADMINISTRATIVE COSTS :5,000 Personal Representative's Commissions Name of Personal Representative(s) JEAN A. HAKE & DALE E. SMITH City ENOL? State P A ZIP 1 7 0 ~~ 5 Year(s) Commission Paid: 2 0 0 6 Attorney Fees 15,000 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 5. 4. Probate Fees Accountant's Fees 20,000 7. 6. Tax Return Preparer's Fees 8. 9. 10. ADMINISTRATIVE COSTS CONSULTANT FEES MISCELLANEOUS ADM. FEES PRUDENTIAL THOMPSON WOOD - APPRAISAL FEE 3,064 1,400 500 150 I TOTAL (Also enter on line 9, Recapitulation) i $ (If more space is needed, insert additional sheets of the same size) 63,938.00 REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS , ---~-~--- -----"--- ---.------ -- -- -- ESTATE OF Cl-\RL E. SMITH FILE NUMBER 21-05-0997 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUEAT DATE OF DEATH 1. EXPENSE OF FINAL I~LNESS: CONNER RICH ASSOCIATES ASSOCIATED CARDIOLOGIST HOLY SPIRIT HOSPITAL HERITAGE DIAGNOSTIC QUANTUM IMAGING CENTRAL PENN HEM. & MEDICAL c r. L. i 01 88 436 43 " L. . 2005 FEDERAL INCOME TAX RETURN - BALANCE DUE 10,892 3. 2005 PENNSYLVANIA INCOME TAX RETURN - BALANCE DUE 13 I I TOTAL (Also enter on line 10, Recapitulation) I $ I (If more space is needed, insert additional sheets of the same size) 11,680.00 i I I i SCHEDULEJ I . L_BENEFICIARIES.~_~. ~~~___ FILE NUMBER REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CAP,~ E. S!v;ITH NUMBER i I NAME AND ADDRESS OF PERSONrSl RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] JEAN Pi. HPiKE 6035 WERTZVILLE ROAD ENOLA, FA 17025 DALE E. SMITH 6033 WERTZVILLE ROAD ENOLA, PA 17025 GJ\RY L. SMITH 3300 SE 56TH ST OCALA, FL 34471 LORI J. MOORE 7825 TOLEAND AVENUE LOS ANGELES, CA 90045 1. 2 . 3. 4 . 21-05-0997 RELATIONSHIP TO DECEDENT I AMOUNT OR SHARE Do NotListTrustee(s) i OF ESTATE DAUGHTER 25% SON rJ r C C::Jc SON 2:::: c_ -..J-C. DAUGHTER 25% I ENTER DOLLARAMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1S.AS APPROPRIATE. ON REV-1500 COVER SHEET ===--+ ~--_._.._--_._.~._~ ------~~-- ._._--_._===-------_....~- ~-- --------------------====-===-=----=-----------=-=--- ~,--- II l NON-TAXABLE DISTRIBUTIONS: A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE I I . i B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S (If more space is needed, insert additional sheets of the same size) REV-1514 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN (Che_c~_B~~_i_o"--~~V=~~O~ Cove~ Sheet) ESTATE OF =_iCiRL E. SMITH FILE NUMBER 21-05-0997 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of cleath from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. o Will [J Intervivos Deed of Trust o Other NAME(S) OF LIFE TENANT(S) UFE ESTATE INTEREST CALCULATION NEAREST AGE AT DATE OF DEATH DATE OF BIRTH TERM OF YEARS LIFE ESTATE IS PAYABLE D Life or 0 Term of Years o Life or D Term of Years o Life or D Term of Years D Life or 0 Term of Years D Life or D Term of Years N/A 1, Value of fund from which life estate is payable 2, Actuarial factor per appropriate table. . , , , , , , , , , , interest table rate - D 3 1/2% D 6% 010% 0 Variable Rate 5> % 3, Value of life estate (Line 1 multiplied by Line 2) c- " I ANNUITY INTEREST CALCULATION I I NAME(S) OF LIFE ANNUITANT(S) DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEATH ANNUITY IS PAYABLE o Life or 0 Term of Years o Life or 0 Term of Years I n Life or 0 Term of Years I I o Life or 0 Term of Years 1, Value of fund from which annuity is payable '" ,~ 2, Check appropriate block below and enter corresponding (number) Frequency of payout - OWeekly (52) 0 Bi-weekly (26) o Quarterly (4) o Semi-annually (2) OAnnually (1) o Monthly (12) o Other ( ) 3. Amount of payout per period , $ 4, Aggregate annual payment, Line 2 multiplied by Line 3 5, Annuity Factor (see instructions) Interest table rate - 0 31/2% 06% 010% OVariable Rate % 6, Adjustment Factor (see instructions) 7, Value of annuity -If using 3 1/2%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 if using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3 ' , , , , , , , , , , , , , , $ $ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18 (If more space is needed, insert additional sheets of the same size) R'::V-1544 EX+ (3-04) INHERITANCE TAX SCHEDULE L COMMONWEALTH OF PENNSYLVANIA REMAINDER PREPAYMENT INHERITANCE TAX RETURN I RESIDENT DECEDENT ______1 OR INVASION OF TRUST PRINCIPAL ____________~__._ _n_____ ___,_ I i I I I FILE NUMBER 2 =- - 0 5 - 0 9 9 7 I. ESTATE OF SM:::'l'H CARL E (Last Name) (First Name) (Middle Initial! This schedule is appropriate only for estates of decedents dying on or before December 12,1982. This schedule is to be used for all remainder returns when an election to prepay has been filed under the provisions of Section 714 of the Inheritance and Estate Tax Act of 1961 or to report the invasion of trust principal. II. REMAINDER PREPAYMENT: B. Name(s) of Life Tenant(s) or Annuitant(s) N/A (Date) Date of Birth Age on date of election Term of years income or annuity is payable A. Election to prepay filed with the Register of Wills on C. Assets: Complete Schedule L-1 1. Real Estate. . . . . . 3. Closely Held Stock/Partnership . . . . . . . ............. $ $ $ 2. Stocks and Bonds 4. Mortgages and Notes. . . . . . . . . . . . . . . . . . . . .. $ 5. Cash/Misc. Personal Property. . . . . . $ 6. Total from Schedule L-1 . . . . . . . . . . . ............................ $ D. Credits: Complete Schedule L-2 1. Unpaid Liabilities 3. Value of Unincludable Assets. . . . ......... $ ....... $ $ 2. Unpaid Bequests 4. Total from Schedule L-2 . . . . . . . . . . . . . . . . ..$ E. Total Value of trust assets (Line C-6 minus Line D-4) ............................... $ F. Remainder factor (see Table I or Table II in Instruction Booklet) . . . . . . . . . . . . . . . . . . . . . . . . G. Taxable Remainder value (Line E x Line F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ (Also enter on Line 7, Recapitulation) III. INVASION OF CORPUS: A. Invasion of corpus (Month, Day, Year) B. Name(s) of Life Tenant(s) or Annuitant(s) Date of Birth Age on date corpus consumed Term of years income or annuity is payable C. Corpus consumed .......................................................... $ D. Remainder factor (see Table I or Table II in Instruction Booklet) . . . . . . . . . . . . . . . . . . . . . . . . E. Taxable value of corpus consumed (Line C x Line D) (Also enter on Line 7, Recapitulation) ................. $ REV-164? EX~ (9-00) SCHEDULE M FUTURE INTEREST COMPROMISE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT (Check Box 4a on Rev-1~OO Cover Sheet) ESTATE OF FIL!~ NUMBER CARL E. SMITH 21-05-0997 This Schedule is appropriate only for estates of decedents dying after December 12, 1982. This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in pcssession and enjoyment cannot be established with certainty. Indicate below the type of instrument which created the future interest and attach a copy to the tax return. D Will D Trust D Other 1. Beneficiaries NAMe OF BEN"'''ICIARY R"'LATIONSHIP I DATE OF BIRTH AG::TO ~. I ~ N::AREST BIRTHDAY I I -I 1. N/A I 2. I I I I I I 3. I I 4. I 5. I II. For decedents dying on or after July 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within 9 months of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse exercises such withdrawal right. D Unlimited right of withdrawal D Limited right of \lVithdrawal III. Explanation of Compromise Offer: IV. Summary of Compromise Offer: 1. Amount of Future Interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (also include as part of total shown on Line 13 of Cover Sheet) $ 3. Value of Line 1 passing to spouse at appropriate tax rate Check One D 6%, D 3%, D 0% .................. $ (also include as part of total shown on Line 15 of Cover Sheet) 4. Value of Line 1 taxable at lineal rate Check One D 6%, D 4.5% . . . . . . . . . . . . . . . . . . . .. $ (also include as part of total shown on Line 16 of Cover Sheet) 5. Value of Line 1 taxable at sibling rate (12%) (also include as part of total shown on Line 17 of Cover Sheet) $ 6. Value of Line 1 taxable at collateral rate (15%) (also include as part of total shown on Line 18 of Cover Sheet) $ 7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1) . . . . . . . . . . . . . .. $ (II more space is needed, insert additional sheets olthe same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX DIVISION SCHEDULE N SPOUSAL POVERTY CREDIT (AVAILABLE FOR DATES OF DEATH 01/01/92 TO 12/31/94) REV-1648 EX 11 ~ -99)(:) I FI~E N~MBER~ ~ SMI~H I 2~-0~-09~i This schedule must be completed and filed if you checked the spousal poverty credit box on the cover sheet. ~RT I - CALCULATION OF GROSS ESTATE ESTATE OF C.~FL E. 5 PA lottery Winnings. . ... . 16a.1 8 6c 6d u M H- 13 I tl 1:1 1. Taxable Assets total from line 8 (cover sheet) N/i\ 2. Insurance Proceeds on life of Decedent. 3. Retirement Benefits 4. Joint Assets with Spouse 6a. Other Nontaxable Assets: List (Attach schedule if necessary) . 7. 161 r 8. Total Actual Liabilities. . . . . . . . . . 18 I 9. Net Value of Estate (Subtract line 8 from line 7) 19. I If line 9 IS greater than $200.000 - STOP. The estate is not eligible to claim the credit If nol. continue to Part If. ~: 0 . 0 0 PART II - CALCULATION OF JOINT EXEMPTION INCOME - (Attach copies of Federal Individual Income Tax Return for decedent and spouse.) I I 1. ! TAX YEAR: 19 I 1a.! 6 SUBTOTAL (Lines 6a, b. c, d) 0.00 0.00 Total Gross Assets (Add lines 1 thru 6) Income: 2. TAX YEAR: 19 ~I TAX YEAR: 19 I I 13a. 13b.1 E3C' 3d. ~ 0.00 13f. I 0.00 a. Spouse . 12a. 1b.i I b. Decedent . . 2bl I C. Joint ... . 1c. 2c. d. Tax Exempt Income 1d. 2d. e. Other Income not 11e. listed above 2e. f. Total HI 0.00 2f. 4. Average Joint Exemption Income Calculation 4a. Add Joint Exemption Income from above: o . 0 0 + (2f) o . 0 0 + (3f) 0.00 0.00 (1 f) (-c 3) 4b. Average Joint Exemption Income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If line 4(b) is greater than $40,000 - STOP. The estate is not eligible to claim the credit. If not, continue to r:'art III. 0.00 PART III - CALCULATION OF SPOUSAL POVERTY CREDIT FOR RESIDENT AND NONRESIDENT ESTATES 1 Insert amount of taxable transfers to spouse or $100.000, whichever is less. . . . . ... . ..... . 1. 2 Multiply by credit percentage (see Instructions) . . . . .... . .... . ..... . 2. 3. This Is the amount of the Resident Spousal Poverty Credit. Include this figure in the calculation of total credits on line 18 of the cover sheet. . .... . ....... . 3 0.00 4. For Nonresidents. enter the ratio of the decedent's gross estate in PA to the value of the decedent's gross estate . ..... . ...... . ........ . 4. 5 Multiply line 3 by line 4 and enter the total here. This is the amount of the Nonresident Spousal Poverty Credit. Include this figure in the calculation of total credits on line 18 of the cover sheet. . 5. 0.00 REV-1649 EX.,. (6-98) I I i i -------=-=--------==:======-:--==-=--===----------:-_--==---------==--------=-==-----~=~_==_=:::_______==_=_~====___________:::::::__---. t_-------::=====--====-=---___-==----=---~.=:::__~____=__ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 0 ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) ESTATE OF FILE: NUMBER 21-05-0997 CARL E. SMITH Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement a separate form must be filed for each trust This election appiies to the N / A Trust (marital, residual A, B, By-pass, Unified Credit, etci If a trust or similar arrangement meets the requirements of Section 9113(Aj, and a The trust or similar arrangement is listed on Schedule 0, and b The value of the trust or similar arrangement is entered In whole or In part as an asset on Schedule 0, then tne transferor's personal representative may specifically Identify the trust (all or a fractional portion or percentage) to be Included in the election to have such trust or similar proDerty treated as a taxable transfer in this estate, If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule 0, The denominator is equal to the total value of the trust or similar arrangement Part A Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113(A) trust Or similar arrangement. Description Value I I I Part A Total I $ Part B: Enter the description and value of all interests included in Part A for which the Section 9113(A) election to tax is being made Description Value Part B Total S (If more space is needed, insert additional sheets of the same size) ORPHANS' COURT DIVISION OF THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: HALE HAMPTON KNIGHT Date of Death: January 18, 2001 Admin. No. 2001-00632 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 personal representative file a final account with the Court? Yes NoL The separate Orphans' Court No. (if any) for the personal representative's b. account is: nJa c. Did the personal representative state an account informally to the parties in interest? Yes ---.2.L. 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 attached to this report. Date: August 23,2006 Respectfully submitted, KNIGHT & ASSOCIATES, P.c. '~~d~ Attorney ill No. 90946 11 Roadway Drive, Suite B Carlisle, Pennsylvania 17015 (717) 249-5373 Counsel for personal representative F :\Uscr Foldcr\Finn Docs\Estatcs\2283~ 1 slatu~;rpt.~:.....pd \ \ \ q( Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 N f D d t Doris D. Baskin ame 0 ece en : Date of Death: January 2, 2005 Estate No.: 21-05-0204 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 estatf:: I. State whether administration of the estate is complete: Yes [8J NoD 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. I is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No I/8l 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 {gl No 0 Date: c. Copies of receipts, releases, joinders and approval of fO/mal or informal accounts may be filed with the Clerk of the Orphans' Court aRQ may be attached to this report. ,I '~j I ,?~) \ Ci.... I / i I /' I' ;, ( , Signature i I l I /';:: j' (// Michael L. Bangs, Esquire Name 429 South 18th Street Camp Hill, PA 17011 Address (717) 730-7310 Telephone No. ("") Capacity: 0 Personal Representative o Counsel for personal representative 00--, ~ 08-21-2006 KNIGHT 06-18-2001 21 01-0632 CUMBERLAND 101 APPEAL DATE: 10-20-2006 ( See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WIllS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- REv:is47-Ex-AFp-co3:osi-NOTICE-OF-INHERITANCE-TAX-APPRAIsEMENT:-ALLowANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX HALE H FILE NO. 21 01-0632 ACN 101 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE "-'.'NOJilCI!OF INHERITANCE TAX APPRAIS€HENT,AllOWANCE OR DISAllOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX . ",'7 ~ II DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN (0, SEAN M SHULTZ ESQ KNIGHT 8 ASSOCIATES 11 ROADWAY DR STE B CARLISLE PA 17013 ESTATE OF KNIGHT *' Vi REV-1547 EX AFP (06-05) HALE H TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED DATE 08-21-2006 I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ Abb returns assessed to date. ASSESSMENT OF TAX: IS. Amount of line 14 at Spousal rate 16. Amount of line 14 taxable at lineal/Class A rate 17. Amount of line 14 at Sibling rate 18. Amount of line 14 taxable at Collateral/Class B rate 19. Principal Tax Due R TS: RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (S) (6) (7) .00 .00 .00 .00 229.208.00 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage liabilities/liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental BequestSj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) UO) 149,490.56 .00 (11) (2) (13) (14) NOTE: US) 79.717.44 X 00 = (16) .00 X 045 = (7) .00 X 12 = (18) .00 X 15 = (9)= AMOUNT PAID + INTEREST/PEN PAID (-) DATE NUMBER 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. submit the upper portion of this form with your tax payment. 229.208.00 149.490 1i6 79.717.44 .00 79.717.44 .00 .00 .00 .00 .00 .00 .00 .00 .00 ( IF TOTAL DUE IS lESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) JRD1June 30, 1992/17858 NOV 0 6 2001 Estate No.: 21-01-632 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA In Re: Estate of Hale Hampton Knight Late of Upper Allen Twp NO. NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT ORPHANS' COURT RULE Personal Representative: Gregory Knight Counsel for Personal Representative: Michael J. Hanft Esq Date of Grant of Original Letters: July 10, 2001 Date of Delinquency Notice: October 20, 2001 The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk ofthe Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court Orphans' Court Rules, was given by the Register of Wills on October 15, 2001, and that the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e) the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: November 6, 2001 Distribution: Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled for ~~ r:J/'JPai ?)i:3 J ' In Courtroom No.3. If the Certification of Notice is filed prior to the hearing date, the hearing will automatically be cancelled. k. I / 0...0-..2 k_",,---<:-'l (I.. -., LIe -..::.:.., ( F:\User Folder\Firm Docs\Estates\2283~ I certification. notice.wpd CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: HALE HAMPTON KNIGHT Date of Death: June 18,2001 \\Till No.: 21-01-0632 To the Register: I 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 November 13,2001: Name Alberta B. Knight Gregory H. Knight H..ona1d Knight David Knight Gary Knight Jeanette Creighton Susan Lombard Cynthia Knight Zlogar Address 175 Northgate Drive, Camp Hill, P A 17011 19 Brookwood Avenue, Suite 106, Carlisle, P A 17013 454 Main Street, Centerville, MA 02632 2600 Farm Road, Alexandria, VA 22302 44012 Choptank Terrace, Ashburn, VA 22011 169 School Street, Carlisle, MA 01741 128 Harbor View Lane, Largo, FL 33770 39 Canterbury Road, Clifton Park, NY 12065 Notice has not been given to all persons entitled thereto unde /1!13/C/\ I Date: Signatu Name: Michael J. Hanft, Esquire Address: 19 Brookwood Avenue, Suite 106 Carlisle, P A 17013 Telephone (717) 249-5373 Capacity: Counsel for personal representative . ~ '1 \ ~ ~ GH _\~ ~ <=' "0 Q) '{J, .a ~~ )( ci ai ~ e ~ ~ ~ "a ~~ ! ;j l 3"1ii~ ~Ql ~~t:.s~ . ~ .q! ~ "E. "6 ~ ~~~~-'6~ -o~.!QQ)~o. ~~~~Q)8 cJo-oE,sm ;~~t.s~ g en "OQ) """ -0 ~ E'c:Et:~"'" ai"'iiial~o5 ,,;~C:CD~~ Qi~53~! o.~>-~-U~ EEC,salO 8~f~~5 . . . ~ ,J.. . 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