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Home My WebLink About01-0552 Estate of Katherine Elaine Perrine also known as PETITION FOR PROBATE and GRANT OF LETTERS ~ l::OJ - ..'5 -? J. No. To: Register of Wills for the Deceased. County of Cumberland in the Social Security No. 331-28-9591 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(a), who is/De 18 years of age or older an the execut rix in the last will of the above decedent, dated May 30 and codicil(s) dated N / A named , 19~ . (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in h er last family or principal residence at Lower Allen Town~hip Cumberland County, Pennsylvania, with 1645 Thompson.Lane. Mechanic~burg, (list street, number and muncipality) Decendent, then 66 years of age, died June 1 m Holy Spirit Ho~pit~l; ~01 North ?l~t ~trpPt. r.~mp Hill. PA 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: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: 1645 Thompson Lane. Mechanic~burg Po~t Township, Cumberland County, Pennsylvania ,:;~ 2001 , 365,000.00 $ $ $ $ 130,000.00 Offirp. Lower Allen WHEREFORE, petitioner(l) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. ~ I~ 4dth ~ An~~ ].g R. R. #3, Box 112D ~'li Newport, PA 17074 .,c.. '1>'.... ~o ~ 00 Vi OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF CUMBERLMID The petitioner(x) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(l) and that as personal represen- tative(x) of the above decedent petitioner(a) will well and truly administer the estate according to law. Swom to 0' afficmed and ,ob,cribed r:tJuiJ, a.-- ~~';) '" before me this 12th day of ~. une , gj-2iliU. ~ l: ~ ~ ~o. 21-2001-552 Estate of Katherine Elaine Perrine , Deceased DECREE OF PROBATE A~D GRA~T OF LETTERS AND NOW June 12th, ~ 2001, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(J) dated May 30, 1995 described therein be admitted to probate and filed of record as the last will of. \ Katherine Elaine Perrine and Letters Testamentary are hereby granted to Elizabeth Ann AndE!rRon FEES Will Book # Page $ 340.00 $ 18.00 $ $ 3.00 JCP TOTAL _ $ ~.uu Filed .June .12th..20P.J. ...... ?~~~~~~... Probate, Letters, Etc. ......... Short Certificates( 6) . . . . . . . . . . Renunciation ................ x-Pages (1) Jered L. Hock, Esquire #19211 ATTORNEY (Sup. Ct. I.D. No.) 3211 N. Front St.' P,O, Box 5300 Harrisburg, PA 17110-0300 ADDRESS (717) 238-8187 PHONE MAIL LETTERS '!O"'ATI'ORNEY WHEN LETTERS ARE FINISHED s.'" f 21-2001-552 LAST WILL AND TESTAMENT OF KA TlIERINE ELAINE PERRINE 1, Katherine Elaine Perrine,of 1645 Thompson Lane, Mechanicsburg, Lower Allen Township, Cumberland County, Pennsylvania being of sound mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all Wills by me at any time heretofore made. ITEM I - 1 hereby direct my hereinafter named Personal Representative to pay all of my just debts, funeral expenses, estate and inheritance taxes as soon after my death as may be found convenient. ITEM II - All the rest, residue and remainder of my estate, whether real, personal or mixed, of whatsoever nature and kind, wheresoever situate and from whatsoever source derived, I give, devise and bequeath unto my three daughters: Stephanie Dawn Lent (maiden) Stephanie Lent Brechbiel (married) Amy Jane Lent (maiden) Elizabeth Ann Lent (maiden) Elizabeth Ann Anderson (married) In equal shares with Exceptions Being: Amy - Less 5,700 Beth - Less what is owed on property ITEM III - 1 hereby nominate, constitute and appoint ELIZABETH ANN ANDERSON, as Executrix of this my Last Will and Testament. In the event that Elizabeth Ann Anderson shall be unable to serve, then 1 nominate Stephanie Lent Brechbiel as Executrix of this my Last Will and Testament. 1995 IN WITNESS WHEREOF, I have hereunto set my ~and and seal this.3hLda~ of f(al ' '. *'f.' . ,/:/ -'. /1,._.. /( {tL"l cL<- L1A_ L/ C (1(,- L L/ _C'['l LHe/ . - Signed, sealed, published and declared by the above Testatrix, as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, we believing her to be of sound mind and memory have hereunto subscribed our names as witnesses. r::t/~/-ii:#7#0 j taL', L oJ d-?:cL{' I / ' of;:~K;,~/Cdt~k ~/'~7' //;:0 /-;://u~ of bell' C-lLe l'LLf /J~c.C {2.r -. 'N 6., J L~_GA.;_ r-L2iL2t._LJ_ Subscribed, sworn to and acknowledged before me by T ~~, and A s\l~s~ril,te~~nd sworn !o before ~e b~ " f'tltL)'-l J /' /j-/~ , WItnesses, thIS r " / ' (I!u {~ if otary Public My Commission Expires: tHrrARlAL s~.- - WENDY A. DAYlD. Notary PubliC" HarriSburg, OatiphlnCCunw. PA My Commission Exp!res July 14, 19&.11 C" -- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent Date of Death Will No.: 2001-00552 Katherine Elaine Perrine June 1. 2001 Admin. No.: To the Register: I hereby certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules Wii~ ,served on or mailed to the following beneficiaries of the above-captioned estate on June '1, 2001 . Name Address Stephanie Brechbiel 50 Cox Road: Huntingtown, MD 20639 Amv Lent 5977 West Aurora Drive: Glendale, AZ 85308 Elizabeth Ann Anderson R.R. 33, Box 112D: NewPort, P A 17074 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: June /y____ 2001 ~~, - - - - - ~--:-'----- Slgnature- .-' Name Jered L. Hock, Esquire Address 3211 North Front Street P.O. Box 5300 Harrisburg, P A 17110-0300 Telephone (717) 238-8187 Capacity: Personal Representative X Counsel for Personal Representative Document #: 208586.1 ., L.LJ ~ ct - >- . 0 VJ (:)0" ~ 000:" .z n.....-:::)OO1:=J <l:COI'-NO .(u/)- ~ (/) ......-I t.:J<I =i ~ ~ cr: --I .. ~I ~ ..... -- - - - - - - - - - - ~ ~ ~ - - - -ai I~... !i~. I~t :z ," o c:::::l ~ c..c [g ." m~ iflg ~ :v'\ \'0 \ ---., ~ \ .--......... '2'~ ~ ;J ~ --t J '0 r 0~ ~ 3t l' ~,r ~ .J ~ -;7 :J -G .:) g:. \ --:1 '<!/ ~-< 0 _ o -( j:: ,~ ~;J ~ -t- ,~ 4.7__~ ru :~-so~ :3 c2" ,:):i 3 CJ 0 -- M ~ ! " ~ ~ o C) o C) ,.r' -- a I --- I"'- U'l .-"I IT" U'l ..0 c:Q ru CJ I"'- ..0 .-"I CJ CJ CJ I"'- ,"', ,:::, '::1' f':1 ..}.. f') ....., () ,.... . ....., COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ANDERSON ELIZABETH ANN R R #3 BOX 1120 NEWPORT, PA 17074 ____n__ fold ESTATE INFORMATION: SSN: 331-28-9591 FILE NUMBER: 21-2001- 0552 DECEDENT NAME: PERRINE KATHERINE ELAINE DATE OF PAYMENT: 08/30/2001 POSTMARK DATE: 08/29/2001 COUNTY: CUMBERLAND DATE OF DEATH: 06/01/2001 NO. CD 000216 ACN ASSESSM ENT CONTROL NUMBER AMOUNT 101 I $23,250.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: ELIZABETH ANN ANDERSON CHECK#123 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS $23,250.00 MARY C. LEWIS REGISTER OF WILLS February 26, 2002 Law Offices of Metzger & Wickersham 3211 North Front St. P.O. Box 5300 Harrisburg, Pa.1711 0-0300 Dear Mr Hock: / t -e23' _ / COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES ~ u DEPARTMENT 280601 HfARRISBURG, PA 17128-0601 C./ '02 MArl -1 :'\1; :23 Telephone (717) 787-3930 FAX (717) 772-0412 Cs. Cl'mLj Re: Estate of Katherine E. Perrine File Number 2101-0552 This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before September 1,2002. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. Sincerely, J,f // ,--'''~-''-- ~,~ ~ .'i 1/1 II :' :., il,.,.,, Jeffrey D. Hollenbush, Supervisor Document Processing-Unit Inheritance Tax Division REV -1500 EX + (6-00) OFFICIAL UsE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 lIP - & 3tv ~ I DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21-01-0552 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Perrine Katherine E 331-28-9591 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 06/0:1./200:1. 10/3:1./1934 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER - - 8 3 Remainder Return CHECK r Original Return ~' Supplemental Return (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required ~a\e of death after 12-12-52) PRIATE 6. Decedent Died Testate 7. ecede"! Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach eopy of Will) ~lIaeh a coPy of Trust) BLOCKS 9. Litigation Proceeds Received 10. pausal Poverty Credit (date of death between 0 11, Election to tal( under Sec. '31 13(A) 12-31-91and 1-1-95) (Attach Sch 0) IBl$i~lQ!jil\l(j$j!!lel:l~\Dlltjj!ij);p~~~~~l'!I_ji@ftAl!IN~Afjpi\UIHQUiP!lll'lpIR~ll!lrtdi NAME COMPLETE MAILING ADDRESS COR- Jered L. Hock, Esquire 3211 N. Front St. i--pe Box 5300 RE- FIRM NAME (If Applicable) Harrisburg, J?A 17:nO-0300:c SPON DENT Metzger Wickersham TELEPHONE NUMBER 717-238-8:1.87 .... SUSPENDED ,;..OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) --- 2. Stocks and Bonds (Schedule B) (2) 203,558 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0 4. Mortgages & Notes Receivable (Schedule D) (4) 0 -- 5. Cash j Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 252,349 6. JoinUy Owned Property (Schedule F) D Separate Billing Requested (6) 0 RECA- PITULA- 7. Inter-Vivos Transfers & Miscellaneous liON Non-Probate Property (Schedule G or L) (7) 61,763 8. Total Gross Assets (total Lines 1-7) (8) 517,670 9. Funeral Expenses & Administrative Costs ISchedule H) (9) 4:1.,915 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 6,688 11. ToIal Deductions (total Unes 9 & 10) (11) 48,603 12. Net Value of Estate (Line 8 minus Line 11) (12) 469,067 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) 0 has not been made (Schedule J) 14. Net Value Subject to Tax (line 12 minus Line 13) (14) 469,067 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Une 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)l.1.2) 0 X .0 00 (15) 0 TAX 16. Amount of Line 14 taxable at lineal rate 469,067 X.O 0.045 (16) 21,108 COMPU- 17. Amount of Line 14 tllxable at sibling rate 0 X .12 (17) 0 TATION 18. Amount of Line 14 taxable at collateral rate 0 X .15 (18) 0 19. Tax Due (19) 21,108 20. 0 ~l:i!J~!(B~R$jf:'ibij~~e;$'t!i\\$!*B.mi!\!Q.!:tI!Hjlit:.~~AjM~\1 * NO REFUND REOUESTED AT THIS TIME. REAL ESTATE, SCHEDULE A, SUSPENDED. ~',}r)t:{::::;::':'::;:: ,.:.:.:,:.:.:.:.:.,,:.:-;,:.:.:,::,,;,:.:-:.:.:.,.:::., ........................,-'-'"..::,:,':'-":'".. ;;,?~ji~;$Il!Wi'Iql'iN$!#!lBil'iU;;il::1Ii$$:'\'l$NaON!~'i!l;;ii;AN!)l!!l$8_iMA!lltiillii?"i ":""",,~,:;,'-''':'::':':',';;::_,'.. , ... ,. ". o PA15001 Copyright 2000 Greatland/Nelco LP - Forms Software Only NTF 29755 C!-.- . E'sr-ate of Name Address Tax ID 331-28-9591 Executors (Page 1) Elizabeth A. Anderson 8901 Creek Road Newport, PA 17074- 191-46-1053 PA REV-1500 EX (6-00) Page 2 Decedent's Comolete Address: STREET ADDRESS 1645 Thompson Lane cumberland County CITY I STATE I ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 21,108 o 23,250 1,224 Total Credits (A + 8 + C) (2) 24,474 3. InteresVPenalty if applicable D. Interest E. Penalty o o TotallnterestJPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund ** 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT ~tgXggX~~!g~fAg~8tC8!i~a8Dggfi8~~~~~rx2i~ax~,:*!!i~fAgX~~~8~~iXfg~C82~gi (3) 0 (4) 3,366 (5) 0 (sA) 0 (58) 0 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; b. retaln 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? Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on information of which re arer has an knowled e. SIG RE P~~N~18LEFORFILlN~~UR\;;~",..0 '1'\\1.. 3. 4. Yes No ~ I B ~ ~ o DATE 6 .:i) CE- Newport, PA 17074 N. Front St.; PO Box 5300 Harrisburg, PA 17110-0300 '.'-'-'.'-',','-',-,",-,'-,-,'-,-"--'-'.'-'-'.'-'-','-'-',",-,-,",-,"--'-.--'-'.'.'-'.'.'-'-',-",-,",-,..,-,-'-._'-'.._'_....'_.,."-,-,._,-,.,-,-,._,.,,,-.'-'-',"',"',-,'-,-,-',-,-'-"-"-'.'-'-','.",' ,'-,-,',-,-,'-,-,'-,-""-'.'-'-','.'-",','-,-'-,-,'-,-,-'-,-".-.'-'-','-'-',"-,-,'-,-,",-,"-,""-'-','-",',",-,",-,-'-,-"-""","',-,",-,'-,-,"-,"""..".,."-,_..,-,.._,-',..,,.,'.... .._'..................,-...,-,.._,...............-.".-..,-..,...,-,-'...'-'.............-.......,.._,-,.,-,.,."-'...............-....,..,-",-,........-...............,..-,...,-...-,-,...,............ ".-.-...,.,-,-,.-,-,.--,..............-.......,.-,.,.,-,-..-,-'............-...-.-,.,-,.,.,-,..,-,-...,...".-.......,.,...,.,..,-,...,-,._._-.'-.-...-.-.....,...,-,..,-,-....,-,--'_..--'-.-'"..',',., -,-,.',-,-.'.-,-,'-'-' "..-.'--,',,',,-,'-,-'-,-'-.'--'.'--.'--.,',',,-,-,",-,"-,-_.._.'._,',',,-,-',-,-'-,-"._-'._-,'.,-,',-,'-,-,'--,"-'-'._-',,-,-,,-,",-,"-,-"-"'._.',-,-,',',',-,'-,-,'-,-,"-"'._.',-",',-,'-,-,',-,-'-,- "'--'._,.,.,..,-,..,-,.._,.._',..__...._,-"-,..,-,_..-,,.,"'-','-,-,',-'-,-,"-""""",--,-,",-,-"-""'"',-,-. ~:;/~~;~~"~/J;~~;k~:~:~:i:~~;;~~:'J~:i:/:t\'J~~:'~:~~::;;i~;~~;:;j~~~~V{:::1'~:~tyg;~::;1~:'~~t~:i~~:~:~~X~:~\~:~::~~t~i::;~;::gfi~:~:~~:f~;:t;:~':g/~~~:\,:~~:'~:~~::~r;=~~;~;J~~:::~i:~~:~:~~~~:~';:: ~:;~':'::-': [72P.S.19116(a)(1.1)(i)]. For dates of death on or after January 1, 1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 19116 (a) (1.1) (ii)]. The statute rln"'~ nnl p.l<P.rnnl a transfer to a surviving spouse trom tax, and the statutory requirements for disclosure of assets and tilin9 a tal< 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. i9116(aX1.2)). The tax rate imposed on the net value ot transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72.P.S. 1 9116(1.2) [72 P.S. 19116(a)(1)]. The tax rate imposed on the net value of transters to or for the use of the decedent's siblings is 12% {72 P.S. 1i9116(aX1.3)]. 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. **NO REFUND o PA 15002 REQUESTED AT THIS TIME. REAL ESTATE, SCHEDULE A, SUSPENDED. NTF 29756 Copyright 2000 Greatland/Nelco LP - Forms Software Only 1 REV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Katherine E. Perrine SCHEDULE A REAL ESTATE FILE NUMBER 21-01-0552 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. 1. DESCRIPTION House located at 1645 Thompson Lane, Mechanicsburg Post Office, Lower Allen Township, Cumberland County, Pennsylvania. Cumberland County Tax Parcel 13-11-0270-046. Home was in need of repair, including certain deficiencies not apparent to assessors. These include, i.a., bad roof, out-moded kitchen appliances, basement problems including but not limited to moisture, painting, and defective chimney. Accordingly, house has not yet been rendered marketable, despite ongoing repair efforts. As per converation of Jered L. Hock, counsel for the Estate, with Paul Deibert on 8/29/02, it is requested that the real estate be suspended. Repair and sale efforts will continue. Assuming that sale is accomplished within the time period an extension is allowed, deductions for maintenance, taxes, repair to render property sellable, etc., will be requested at that time, along with fees and commissions of attorney and Executrix based upon efforts and matters relating to the real estate. A separate document requesting suspension of this asset is being submitted to supplement the request for suspension hereby set forth. (For Title, see deed of 12/5/90 in Cumberland County Deed Book X, Volume 34, Page 1126, setting forth VALUE AT DATE OF DEATH TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 9 PA15021 NTF 10871 Copyright 1999 Greatland/Nelco LP - Forms Software Only Schedule A (Page 2) Estate of: Katherine E. Perrine Item No. Description Value at Date of Death (continued from prevo page) conveyance of single family dwelling on lot 220 ft. x 310.1 ft. x 227.76 ft. x 251.15 ft.) Total (Carry forward to main schedule) REV -1.503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Katherine E. Perrine SCHEDULE B STOCKS & BONDS FI LE NUMBER 21-01-0552 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION 11. 123 Shares DuPont Common Stock High 46.39, Low 45.12, Average 45.76, for a total of $5627.80, but indicated by Charles Schwab as having a value on DOD of $5694. VALUE AT DATE OF DEATH 5,694 2 Schwab Account No. 7025-0895 197,864 9 PA15031 NTF10872 Copyright 1999 Greatland/Nelco LP - Forms Software Only TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 203,558 REV-1.504 EX+ (1-97) SCHEDULE C COMMONWEALTH OF PENNSYLVANIA CLOSELY-HELD CORPORATION INHERITANCE TAX RETURN RESIDENT DECEDENT PARTNERSHIP or SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER Katherine E. Perrine 21-01-0552 Schedule C-1 or C-2 (Including all supponing information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-propiertorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NO. 1. DESCRIPTION VALUE AT DATE OF DEATH 9 PA15041 NTF 10873 Copyright 1999 Greatland/Nelco LP - Forms Software Only TOTAL (Also enter on line 3, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) o REV-1507 EX+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE D MORTGAGES & NOTES RECEIVABLE FILE NUMBER Katherine E. Perrine All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION 1. 21-01-0552 VALUE AT DATE OF DEATH 9 PA 15071 NTF 10874 Copyright 1999 Greatland/Nelco LP ~ Forms Software Only TOTAL (Also enter on tine 4, Recapitulation) S (If more space is needed, insert additional sheets of the same size) o REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Katherine E. Perrine 21-01-0552 Include proceeds of litigation & dale proceeds were received by the eslate. All prop. jointly-owned with right of survivorship must be disclosed on 5ch. F. ITEM NO. 11. DESCRIPTION 1993 Saturn Sedan, sold to Tom Martin since DOD in armIs length transaction for $3500 VALUE AT DATE OF DEATH 3,500 2 Allstate Insurance - refund for car insurance 33 3 Comcast - refund for cable 23 4 First Bank Center - credit card refund 218 5 Furniture of decedent, old and used 1,500 6 Guide Posts - refund for subscription 5 7 Hanover Capital Management Inc. - Home Builders Association 401(k) Plan 5,414 8 Hanover Capital Management Inc. - Rollover IRA Contract No. 01-5288971 9 PA 15081 NTF 10875 Copyrighl1999 GreatJand/Nelco lP - Forms Software Only TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insen additional sheets of the same size) 19,538 2,797 1,018 1,951 148 10,405 24,289 8,513 172,997 S 252,349 9 Hanover Capital Management Inc. - Roth IRA 10 Home Builders Association - paychecks due 11 IRS - tax refund 12 IRS - tax refund for year 2001 13 Kemper IRA Account No. 202-8900067763 14 Kemper High Yield Fund Account #208-133074065 15 Kemper International - non IRA Account #219-133074065 Total from continuation pages Schedule E (Page 2) Estate of: Katherine E. Perrine Item No. Description Value at Date of Death 16 Kemper IRA - Pershing (Cadaret, Grant) 43C538899 4,811 17 Kemper Pershing (Cadaret, Grant) - non IRA #43C 222387 6,428 18 Kemper Small Cap Value - non IRA Account #288-133074065 8,844 19 Kemper Total Return - non IRA Account #202-133074065 20,806 20 Kemper U.S. Gov See - non IRA Account #218-133074065 29,578 21 Patriot News - newspaper subscription rebate 22 PSECU - checking shares (S4) 23 PSECU - regular shares (Sl) 24 U.S. Treasury - personal tax refund for 2001 25 U.S. Treasury - tax refund 3 14/629 87,352 245 300 Total (Carry forward to main schedule) 172,997 REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Katherine E. Perrine SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21-01-0552 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH Include name of financial institution and bank ITEM FOR MADE account number or similar identifying number. DATE OF DEATH DECO'S VALUE OF JOINT NO. TENANT JOINT Attach deed for jointly-held real estate, VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. TOTAL (Also enter on line 6, Recapitulation) $ 0 9 PA 15091 NTF 10876 (If more space is needed, insert additional sheets of the same size) Copyright 1999 GreallandlNelco LP - Forms Software Only REV-1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Katherine E. Perrine SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-01-0552 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV -1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM INCLUDE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DECD & DATE OF TRANSFER NO. ATTACH COpy OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 11. Kemper Gateway Annuity Contract No. GN100385 61,763 100.000 0 61,763 TOTAL (Also enter on line 7, Recapitulation) $ 61,763 9 PA 15101 NTF 10877 (If more space is needed, insert additional sheets of the same size) Copyrlghl1999 Greatland/Nelco LP - Forms Software Only REV-1511EX+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Katherine E. Perrine SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-01-0552 Debts of decedent must be reported on Schedule I. ITEM NO. A. 1. 1 DESCRIPTION AMOUNT FUNERAL EXPENSES: James Gingerich Memorials - headstone balance 1,316 2 Myers Funeral Home, Inc. - funeral services 1,770 Total from continuation pages 580 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Elizabeth A. Anderson Social Security Number(s}/EIN No. of Personal Representative(s) Street Address 8901 Creek Road CityNewport State FA Zip 17074 18,530 Year(s) Commission Paid: 2 ()() Z- 2. 3. AttorneyFees Metzger, Wickersham, Knuass & Erb, P.C. (estimated) 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 18,530 4. Probate Fees 366 5. Accountant's Fees 6. Tax Return Preparer's Fees 270 7. 1 Beth Anderson - reimbursement for postage 4 2 Cumberland Law Journal - publication of Estate Notice 75 3 Metzger, Wickersham, Knauss & Erb, P.C. - reimbursement for fax, copies, phone calls 65 Total from continuation Dages 409 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 41,915 9 PA15111 NTF 10878 Copyright 1999 GreatJandlNelco lP - Forms Software Only Schedule H part 1 (Page 2) Estate of: Katherine E. Perrine Item No. Description Amount 3 Stephanie Brechbiel - reimbursement for deposit for headstone 400 4 Stephanie Brechbiel - reimbursement for interment fee 80 5 Stephanie Brechbiel - reimbursement for minister fee for burial service 100 Total (Carry forward to main schedule) 580 Item No. 4 5 6 7 8 9 Schedule H part 2 (Page 2) Estate of: Katherine E. Perrine Description Amount Register of Wills - Short Certificates Reserve for closing Reserve to file Account Reserve to file Releases The Patriot-News - advertisement for sale of car The Patriot-News - publication of Estate Notice Total (Carry forward to main schedule) 12 60 200 10 19 108 409 REV -1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Katherine E. Perrine Include unreimbursed medical expenses. ITEM NO. 1. 1 AT&T - debt of decedent SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FI LE NUMBER 21-01-0552 DESCRIPTION AMOUNT 41 2 Comcast - debt of decedent 31 3 Lower Allen Township - refuse pickup debt of decedent 44 4 PP&L - debt of decedent 25 5 David L. Reisman Lawn Service - debt of decedent, lawn care pre-DOD 145 6 Susquehanna Oil Co. - debt of decedent 512 7 United States Treasury - IRS assessed tax deficiency for year 2000, $5876.79, paid May 2002, after receipt of deficiency notice 5/877 8 Verizon - debt of decedent 13 9 PA 15121 NTF 10874 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 6,688 Copyright 1999 GreallandlNelco LP - Forms Software Only REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARI ES FILE NUMBER Katherine E. Perrine 21-01-0552 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (al (1.2)] 1 1. Elizabeth A. Anderson ~901 Creek Road $2,850 plus ~ewport, PA 17074 Daughter 1/3 residue 2 tephanie Brechbiel o Cox Road $2,850 plus Huntingtown, MD 20639 Daughter 1/3 residue 3 /\my Lent 5977 West Aurora Drive Glendale, AZ 85308 Daughter 1/3 residue ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 18 AS APPROPRIATE ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -- ENTER TOTAL NON- TAXABLE DISTRIBS. ON LINE 13 OF REV-1500 COVER SHEET $ 0 o PA15131 NTF33293 {If more space is needed, insert additional sheets ot the same size) Copyright 2000 Greatland/Neleo t..P - Forms Software Only RE'V - )514 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN (Check Box 4 on Rev-1500 Cover Sheet) ESTATE OF FILE NUMBER Katherine E. Perrine 21-01-0552 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 death on or after 5-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. D Will D Intervivos Deed of Trust D Other . ......................liliFl$.ESTAiliiINTERIllSTCl\UCUtAtlQN/...(............... NEAREST AGE AT DATE OF DEATH NAME(S) OF LIFE TENANT(S) DATE OF BIRTH TERM OF YEARS LIFE ESTATE IS PAYABLE Term of Years o Life or Term of Years o Ufear Term of Years o Ufeor Term of Years $ 0 % $ o 1. Value of fund from which life estate is payable 2. Actuarial factor per appr~riate table Interest table rate -- U 3 1/2% D 6% 3. Value of life estate (Line 1 multiplied by Line 2) D 10% D Variable Rate o NAME(S) OF ANNUITANT(S) DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM OF YEARS ANNUITY IS PAYABLE D Life or D Term of Years Life or 0 Term of Years D Life or D Term of Years o Life or D Term of Years 1. Value of fund from which annuity is payable $ 2. Check appropriate block below and enter corresponding (nUmbeB Frequency of payout -- D Weekly (52) B Bi-weekly (26) Monthly (12) D Quarterly (4) D Semi-annually (2) Annually (1) Other ( ) 3. Amount of payout per period o o $ o 4. Aggregate annual payment, Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate 0 3 1/2% D 6% D 10% o o Variable Rate % o 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 o $ o $ o 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, 15, 16 and 17. (If more space is needed, insert additional sheets of the same size) 9 PA15141 NTF 10881 Copyright 1999 Greatland/Nelco LP - Forms Software Only REV-1647 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE M FUTURE INTEREST COMPROMISE (Check Box 4a on Rev-1500 Cover Sheet) ESTATE OF FILE NUMBER Katherine E. Perrine 21-01-0552 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 possession 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. nWiII n Trust n Other I. Beneficiaries NAME OF AGE TO BENEFICIARY RELATIONSHIP DATE OF BIRTH NEAREST BIRTHDAY 1. 2. 3. 4. 5. 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. n Limited right of withdrawal n Unlimited ri<lht of withdrawal III. Explanation of Compromise Offer: IV. Summary of Compromise Offer: 1. Amount of Future Interest. $ 0 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) . $ 0 3. Value of Line 1 passing to spouse at appropriate tax rate Check One 06%, 0 3%, 0 0% . $ 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 06%,04.5%. $ 0 (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) . $ 0 6. Value of Line 1 taxable at collateral rate (15%) (also include as part of total shown on Line 18 of Cover Sheet) $ 0 7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1) . $ 0 o PA 16471 NTF 33294 (If more space is needed, insert additional sheets of the same size) Copyrighl2000 Grealland/Nelco LP - Forms Software Only REV -1649 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Katherine E. Perrine 21-01-0552 Do not complete this schedule unless estate is making election to tax assets under Section 9113(A) of Inheritance & Estate Tax Act. If the ejection applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Trust(marital, residual A, S, By-pass, Unified Credit, etc.). If a trust or similar arrangement meets the requirements of Section 9113(A), 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 the 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 property 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 O. The denominator is equal to the total value of the trust or similar arrangement. SCHEDULE 0 ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) 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 Part A Total S 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 9 PA 16491 NTF 10882 Part B Total S (If more space is needed, insert additional sheets of the same size) o Copyrlghl1999 Grealland/Nelco LP - Forms Software Only - 'III 21-2001-552 LAST WILL AND TESTAMENT OF KATHERINE ELAINE PERRINE I, Katherine Elaine Perrine,of 1645 Thompson Lane, Mechanicsburg, Lower Allen Township, Cumberland County, pennsylvania being of sound mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all Wills by me at any time heretofore made. ITEM I - I hereby direct my hereinafter named Personal Representative to pay all of my just debts, funeral expenses, estate and inheritance taxes as soon after my death as may be found convenient. ITEM II - All the rest, residue and remainder of my estate, whether real, personal or mixed, of whatsoever nature and kind, wheresoever situate and from whatsoever source derived, I give, devise and bequeath unto my three daughters: Stephanie Dawn Lent (maiden) Stephanie Lent Brechbiel (married) Amy Jane Lent (maiden) Elizabeth Ann Lent (maiden) Elizabeth Ann Anderson (married) In equal shares with Exceptions Being: Amy - Less 5,700 Beth - Less what is owed on property ITEM ill - I hereby nominate, constitute and appoint ELIZABETH ANN ANDERSON, as Executrix of this my Last Will and Testament. In the event that Elizabeth Ann Anderson shall be unable to serve, then I nominate Stephanie Lent Brechbiel as Executrix of this my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 3{!r~daY of f({I.'! ' /. -00 . JO . A aI1t1A-A,,~CU V O--vvJ:./ .-UVL UL&-> 1995 .....--...--.--.-"---...-..-.- ------_._----_._._-------~----- ~ ""-,.,..,., - . III Signed, sealed, published and declared by the above Testatrix, as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, we believing her to be of sound mind and memory have hereunto subscribed our names as witnesses. Y7~~if'7#'U liJl;n~6uLk! of /cI':.Y&> -1j;,~P-d- ~&0 ,,;T"iP /?/c:U of bOlD CAQ/l.~ ~ q..o- 'f.J c).1.1 J..2_r,~ ,/'>A / ) / / / d / Subscribed, sworn to and acknowledged before me by ~ and sub~d sworn to before me by if/Jd. ' witnesses, this .' ~ My Commission Expires: IlOrAAlAl Sm'/. -' WeIlDY A.IlA\IIil. !iI~r;Wbllil" lIanllbuf1l; llaujlIlln UunlY. PA My Commission expires July 1~. 1900 - - - - - - - - - - - -. .. - - - ... Q) en - :::l 0 -. 'E - :::l r-- 0 ~ 00 u r<) 0 :::l r<) 0- I C [/) r<) :E :::l Q) 0 ~ 0 en r-- ~ U :::l - Q) ';'./ 0 <+-. '0 ..r:: ;5 .J::. r~;;. c () 0 (lj t ... ;:: :::l Q)^ 2 Q) 0 ':'.1 en ..0 U ~ (,.. '@J a Q) ;:: c: f') Q) :::l C (lj :t:: c=: U 0 U <( ...) ..,.. f') .,," ~ .s, r'. 'r~ o o t 8 ~ 0 ..... ...... Cfl t::: I:; ...... 2 0 ~ ~ g ~ ... U') ::l o~..o ~ co 'is """0 a ~~J:: ,. !!! '5 CT (J) LU ~.. u o ::c '- I I ~.'~ :;:::: <: ~/ ........ -... ~.>.. .. ..::.. .~.. "--. .'< ~ 1/ ~:2 ,. _ I:::::::d L-.._:-'-. ::::. --J '0 !!! Q) "-"J c. SINCE 1888 3211 North Front Street P.o. Box 5300 Harrisburg, PA 17110-0300 717-238-8187 Fax: 717-234-9478 September 3, 2002 Other Offices Colonial Park Mechanicsburg 717-652-7020 717-691-5577 Millersburg Shippensburg 717-692-5810 717-530-7515 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Attn: Cheryl Re: Estate of Katherine Elaine Perrine No. 2001-00552 Dear Cheryl: Herewith is the $15.00 check for filing the Inheritance Tax Return, which you indicated you have received. Thank you very much for your help in this matter. Very truly yours, TZGER, WICKERSHAM, KNAUSS & ERB, P.C. ~ Jered L. Hock JLH:cl Enclosure cc: Elizabeth Ann Anderson (no enclosure) Document #: 2415171 James F. Carl Edward E, Knauss, IV* Jered L. Hock Karl R. Hildabrand* Steven E Miner Clark DeVere E. Ralph Godfrey Steven C. Courtney Francis J. Lafferty, IV David H. Martineau Andrew W. Norfleet Melissa L. Van Eck Andrew C. Spears Young-Suh Koo * Board Certified ill civil trial law alld advocacy by the Natiollal Board of Trial Advocacy 16~d3b-/ ~. BUREku OF INDIVIDUAL TAXES " INHERITANCE TAX DIVISION "OEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX JERED L HOCK ESQ METZGER WICKERSHAM PO BOX 5300 HBG PA 17110 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 10-28-2002 PERRINE 06-01-2001 21 01-0552 CUMBERLAND 101 *' REV-1541 EX AFP IDl-OU KATHERINE E Allount Rellitted 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 =i5'4j-Ex-AFp--('oY:o'2Y-NoTlcE--oF-YtiHEifITANCE-TAX-APPRA-ISEHENT~--AiLowAi.fcE-oR-------------- - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PERRINE KATHERINE E FILE NO. 21 01-0552 ACN 101 DATE 10-28-2002 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 469,067.00 X 045 = 21,108.00 .00 X 12 = .00 .00 X 15 = .00 (19)= 21,108.00 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. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 203.558.00 .00 .00 252.349.00 .00 61. 763.00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 41,915.00 6.688.00 (11) (12) (13) (14) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 517,670.00 48.603 00 469,067.00 .00 469,067.00 . 'U:"'I:~"I l+J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 08-29-2001 CDOO0216 1,055.40 23,250.00 TOTAL TAX CREDIT 24,305.40 BALANCE OF TAX DUE 3,197.40CR INTEREST AND PEN. .00 TOTAL DUE 3,197.40CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) RESERVATION: Estates Df decedents dying Dn Dr befDre December 12, 1982 -- if any future interest in the estate is transferred in pDssession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the COMMDnwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRA TIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of SectiDn 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment tD the Register of Wills printed Dn the reverse side. --Make check or MDney order payable to: REGISTER OF HILLS. AGENT A refund Df a tax credit, which was nDt requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register Df Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms Drdering: 1-800-362-2050; services fDr taxpayers with special hearing and I Dr speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance Df deductions, or assessment of tax (including discDunt Dr interest) as shown on this Notice must object within sixty (60) days of receipt of this NDtice by: --written protest tD the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the persDnal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment shDuld be addressed in writing to: PA Department Df Revenue, Bureau Df Individual Taxes, ATTN: Post AsseSSMent Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount Df the tax paid is allDwed. The 15% tax aMnesty nDn-participation penalty is computed on the total of the tax and interest assessed, and not paid befDre January 18, 1996, the first day after the end of the tax aMnesty periDd. This non-participatiDn penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated Dn this nDtice. Interest is charged beginning with first day Df delinquency, Dr nine (9) months and one (1) day from the date Df death, tD the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary frDm calendar year to calendar year with that rate announced by the PA DepartMent of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Daily Interest Factor Year Interest Rate Da ily Interest Factor 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 7Z .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 7Z .000192 1986 10% .000274 2000 8% .000219 1987 9% .000247 2001 9% .000247 1988-1991 11% .000301 2002 6% .000164 --Interest is calculated as fDIIDws: INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax beCOMes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the asseSSMent. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. I' -'" REV-1470 EX (6-88) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME Katherine E Perrine REVIEWED BY Deborah Washington ITEM SCHEDULE NO. INHERITANCE TAX EXPLANATION OF CHANGES EXPLANATION OF CHANGES A 1 Suspended per your request ROW FILE NUMBER ACN 2101-0552 101 Page 1 I 0,; i () i) STATUS REPORT UNDER RULE 6.12 Name of Decedent Date of Death Will No. 2001-00552 Katherine Elaine Perrine June L 2001 Admin No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes No. X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Estimated date would be January 3 L 2004. Please note that a maior problem occurred in the house. requiring complete redoing of several areas. and repair has not been completed. so that the house of decedent cannot yet be sold. 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 X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No X *No accounting yet, as major asset, the house, remains to be liquidated. d. Copies of receipts, releases, . accounts may be filed with the Clerk of the Orph Date: May 1lJ. 2003 rs and approvals of formal or informal o and may be attached to this report. Name Jered L. Hock. Esquire 'jqUItl:J , 'I....,'!") '. Address 3211 North Front Street P.O. Box 5300 Harrisburg. PA 17110-0300 (v: Diu LZ ^lj~~ (0. Telephone (717) 238-8187 ,,)88 Capacity: ;~)e8 Personal Representative X Counsel for Personal Representative 281257-1 ! ~ Cumberland County - Register Of wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 5/07/2003 ANDERSON ELIZABETH ANN R R #3 BOX 112D NEWPORT, PA 17074 RE: Estate of PERRINE KATHERINE ELAINE File Number: 2001-00552 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 will become delinquent on: 6/01/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: JFile Counsel Judge REV-1500 EX+ (6-00) OFFICIAL USE ONL V COMMONWEALTH OF PENNSYLVANIA REV-1500 DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 2~-01-0552 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Perrine Katherine E 331-28-9591 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 06/01/2001 10/31/1934 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER - - 8 3. Remainder Return CHECK ~ ' ""m'_m ~< Supplemental Return (date of death prior 10 12-13-82) APPRO- 4. Umited Estate 4a. Future Interest CompromIse 5. Federal Estate Tax Return Required ~ate of death alter 12-12-8Z) PRIATE 6. Decedent Died Testate 7. ecedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach copy of Will) It'ltaCh a copy of Trust? BLOCKS 9. Litigation Proceeds Received 10. pousal Poverty Cred) [dale ot death between 0 11. Election to tal( under Sec. 9113(A) 12-3H;~1and 1-1-95) (AttachSchO) ffli$_IQNMIJ$tl!l!!lQMl!~$tIt~jj~l\l~~iJ)CQ!l~'!lH'J!lift<<INl@llMlItlQN$iilQP!il~IlI!l1WffillPin;!i NAME COMPLETE MAILING ADDRESS COR- Jered L. Hock, Esquire 3211 N. Front St. ; PO Box 5300 RE- FIRM NAME (It Applicable) Harrisburg, PA 171.1.0-0300 SPON DENT Metzger Wickersham TELEPHONE NUMBER 71.7-238-8187 OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) 80,000 2. Stocks and Bonds (Schedule 8) (2) :_' ,- 0 3. Closely Held Corporation, Partr\Elfshlp or Sole-ProprIetorshIp (3) -- 0 4. Mortgages & Notes Receivable (Schedule D) (4) 0 5_ Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 277 1':,' 6. Jointly Owned Property (Schedule F) .~ 0 Separate Billing Requested (6) 0 RECA- PITULA- 7. Inter-Vivos Transfers & Miscellaneous TION Non-Probate Property (Schedule G or L) (7) 0 8. Total Gross Assets (total Lines 1-7) (8) 80,277 g. Funeral Expenses & Adminls1rative Costs (Schedule H) (9) 34,726 10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I) (10) 0 11. Total Deductions (total Lines 9 & 10) (11) 34,726 12. Net Value of Estate (Line 8 minus Line 11) (12) 45,550 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) 0 has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 45,550 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of LIne 14 taKable at the spousal taK rate, or transfers under Sec. 9116 (aX1.2) 0 X.O 0 (15) 0 TAX 16. Amount of Line 14 taKable at lineal rate 45,550 X.O 0.045 (16) 2,050 COMPU- 17. Amount of line 14 taKable at sibling rate 0 X .12 (17) 0 TATION 18. Amount of Line 14 taKable at collateral rate 0 )(. .15 (18) 0 19. Tax Due (19) 2,050 20. ~ t~$KHg\i!~;\jji~A~f\~mjijQ\jiill$fjjNbi$J;j\\Ntl:N!,\\ji'tiiM~'1 llo -J&O-l . ...........".'--;-"M!i\l;$Ul'reTOiAN$Wl;BAW!:ilIl!ESTi'ON$;;ONPA'OE%ANPfflEPHl;!;KlMTHfii()".'.,...,.... o PA 15001 NTF 29755 Copyright 2000 Greatland/Nelco LP - F"orms Software Only Estate of Name Address Tax ID 331-28-9591 Executors (Page 1) Elizabeth A. Anderson 8901 Creek Road Newport, PA 17074- 191-46-1053 PA REV -1500 EX (6-00) Page 2 Decedent's Comolete Address: STREET ADDRESS 1645 Thompson Lane Cumberland County CITY I STATE I ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 2,050 o 3,197 o Total Credits (A + 8 + C) (2) 3,197 3. Interest/Penalty if applicable D. Interest E. Penalty o o TotallnteresVPenalty (D + E) 4. If line 2 is greater than Line 1 + line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WillS, AGENT (3) 0 (4) 1,148 (5) 0 (5A) 0 (58) 0 .................-..-......................................-...........,............-...-............... .. ","" .....,...-.--,.........--.,..,...,..............-...,.................. ..., ..................................,.....,...,-,-.,...,_....-.........-........................-...'..,-.........-.,...-............... ...... .......... . .........--......,..,..,.. .. ...... .....................'.............."... .,,_.,...,.....,........,....,..,.....,-..'-,..,.-..........,.,......,.,.,.....,...... ..........................-.-.'..................,........-.........................,-...'.-.'..,.......-'........-.........................'.....'... .-..,'......."....'....................,-......,....,....................". ....................-..,-,..'.-...'.'...'............._........-.........................-..........,...............................-. .,.........................................................,.. "fiLEAsEANSWERTHEFOCCOWINGaUESTIONSBYPLACiNGAN 1. "X" 'INTHE ApPROPRIAfE sC6ci(s........... Yes No ~ I B ~ 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 withoutreceiving adequate consideration? . . . . . . . . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account, annuity, or other non -probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OFTHE RETURN. Under penalties of perjury, I declare that I have examined this return including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration at pre parer other than the personal representative is based on information of which preparer has anv knowledqe. SI~~E P ~~O()18lE FWJ;JET , y 8 AT t8 ADD RES ~ D Newport, 17074 N. Front St.; PO Box 5300 Harrisburg, PA 17110-0300 ((Jnnt:ttt:}::::tfttttttit{:)tt))}fJtrttttt)){)tJttt}i{:)ttttlt:j/:itt:ttrj:::)t:r:j{::tt:Htttttt/r:jt:;jt:tt\/tt}:}::tttt::j:j:::::j:::tr:t:)})){fI}tfIJ)::ftj:::{ttJI)):f:::::):f::;::::::}::;::::::: :-:...-.... 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 olthe surv'i'ving spouse '(5'3%" [72P.S. Ii 9116(a)(1.1)(I)]. For dates 01 death on or after January 1, 1995, the tax rale is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. !i 9116 (a) (1.1) (Ii)]. The statute no",!': 0,.,1 AYAmol a transfer to a surviving spouse from tax, and the statutory requirements for disciosure 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 lax 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 parenl, or a stepparent of the child Is 0% (72 P.S. !i9116(aX1.2)]. 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. Ii 9116(1.2) [72 P.S. li9116{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. Ii 9116(aX1.3)]. 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. o PA15002 NTF 29756 Copyright 2000 Grealland/Nelco LP - Forms Software Only 1 REV -1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Katherine E. Perrine SCHEDULE A REAL ESTATE FILE NUMBER 21-01-0552 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. 1. DESCRIPTION House located at 1645 Thompson Lane, Mechanicsburg Post Office, Lower Allen Township, Cumberland County, Pennsylvania. Cumberland County Tax Parcel 13-11-0270-046. Home was in need of repair, including certain deficiencies not apparent to assessors. These include, i.a., bad roof, out-moded kitchen appliances, basement problems including but not limited to moisture, painting, and defective chimney. Accordingly, house was not rendered marketable for more than a year after decedent's death, despite ongoing repair efforts. As per conversation of Jered L. Hock, counsel for the Estate, with Paul Dibert on 8/29/02, a request was made that the real estate be suspended. This request was granted. Now that sale has been accomplished on 7/17/03, deductions for maintenance, taxes, repair to render property sellable, etc., are requested, along with fees and commissions of attorney and Executrix based upon efforts and matters relating to the real estate. (For Title, see deed of 12/5/90 in Cumberland County Deed Book X, Volume 34, Page 1126, setting forth conveyance of single family dwelling on lot 220 ft. x 310.1 ft. x 227.76 ft. x 251.15 ft.) Although this real estate was assessed at $138,780 in the 2000 assessment, the property VALUE AT DATE OF DEATH Total from continuation pages 80,000 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 80,000 9 PA 15021 NTF 10871 Copyright 1999 Grealland/Nelco LP - Forms Software Only Schedule A (Page 2) Estate of: Katherine E. Perrine Item No. Description Value at Date of Death (continued from prevo page) was in such condition that only $80,000 gross was obtainable in an arm's length sale to Capitol Products Group, LLC, on July 17, 2003. Please see HUD Settlement Sheet provided herewith. Reasons for the low gross price included not only conditions of the structure mentioned above (roof, chimney, etc.), but, in addition, major problems because of a IIsteam sauna" type condition in the basement and elsewhere in the dwelling, with resultant mold and other complications that had required remediation, as well as the installation of a new furnace to make the house salable. Accordingly, the house is carried at $80,000 gross, with additional expenses incurred to preserve the house for sale and make it salable listed in Schedule H, along with certain additional fees. 80,000 Total (Carry forward to main schedule) 80,000 REV -1508 EX + <1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Katherine E. Perrine SCHEDULE E CASH. BANK DEPOSITS, & MISC. PERSONAL PROPERTY FI LE NUMBER 21-01-0552 Include proceeds of litigation & dale proceeds were received by the estale. All prop. jointly-owned with right of survivorship must be disclosed on 5ch. F. ITEM NO. 11. DESCRIPTION VALUE AT DATE OF DEATH Real estate tax credits on sale of house 233 2 Refuse credit from sale of house 44 9 PA 15081 NTF 10875 Copyright 1999 Greattand/Nelco LP - Forms Software Only TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 277 REV-1511EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Katherine E. Perrine SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-01-0552 Debts of decedent must be reported on Schedule I. ITEM NO. DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 975 Name of Personal Representative(s) Elizabeth A. Anderson Social Security Nurnber(s)/EJN No. of Persona] Representative(s) Street Address 8901 Creek Road CItyNewport State PA Zip 17074 Year(s) Commission Paid: 2 003 2. Attorney Fees Metzger, Wickersham, Knauss & Erb, P.C. 975 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 AT&T - utility services to premises to retain same and prepare for sale 29 2 Bob Rowe Painting - painting of premises to prepare for sale l,045 Total from continuation pages 31,702 TOTAL (Also enter on line 9, Recapitulation) $ 34,726 (If more space is needed, insert additional sheets of the same size) 9 PA15111 NTF 10878 Copyright 1999 Greatland/Nelc:o LP - Forms Software Only Schedule H part 2 (Page 2) Estate of: Katherine E. Perrine Item No. Description Amount 3 Bonnie K. Miller - real estate taxes to preserve premises for sale 496 4 Bonnie K. Miller - tax certification fee from real estate settlement 4 5 JEM Enterprises - mold testing inspection following furnace deterioration and 11 sauna II developing in basement and affecting house, engaged in order to make house salable 20,800 6 JES Basement Systems - basement water proofing to take care of humidity problems before furnace break and subsequent humidity problems to prepare premises for sale 3,311 7 JRS Plumbing and Heating - new furnace to make house salable 3,385 8 Lowe's - spouting and other drainage/moisture equipment to make premises salable 257 9 Notary fees from real estate settlement 6 10 PP&L - utility services to premises to retain same and prepare for sale 237 11 Realty transfer tax for sale of house 800 12 Reliable Installations - prepare leaking drain to prepare premises for sale 50 13 School real estate taxes from July 1 to July 17, 2003 61 Total (Carry forward to main schedule) 29,408 Item No. ~4 ~5 Schedule H part 2 (Page 3) Estate of: Katherine E. Perrine Description ~o~t susquehanna Oil - fuel services to premises to retain same and prepare for sale Verizon - utility services to premises to retain same and prepare for sale ~6 West Shore School District - school real estate taxes to preserve real estate for sale Total (Carry forward to main schedule) 792 ~28 l,374 2,294 SETTLEMENT STATEMENT 1DFHA 2DFmHA 6. FILE NUM~~~ 8. MORTGAGE INS CASE NUMBER: B. TYPE OF LOAN: 3.0CONV. UNINS. 4.DVA I 7. LOAN NUMBER: A'o, OMB NO. 2502-0265 .... 5. DCONV. INS. A. - U.S, DEPARTMENT OF HOUSING & URBAN DEVELOPMENT C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked 'TPOCr were paid outside the closing; they are shown here for informational purposes and are not included in the totals. 1.0 3198 (PH03227 SMRPFD/PH03227 SMR/8) F. NAME AND AODRESS OF LENDER: E. NAME AND ADDRESS OF SELLER: D. NAME AND ADDRESS OF BORROWER: CAPITOL PROPERTY GROUP, LLC ESTATE OF KATHERINE ELAINE PERRINE a/k1a K. ELAINE PERRINE G. PROPERTY LOCATION: 1645 THOMPSON LANE MECHANICS BURG, PA 17050 CUMBERLAND County, Pennsylvania H. SETTLEMENT AGENT: 25-1648139 PENN HERITAGE TRANSFER COMPANY I. SETTLEMENT DATE: July 17, 2003 PLACE OF SETTLEMENT 3464 TRINDLE ROAD CAMP HILL, PA 17011 J. SUMMARY OF B RROWER'S TRANSACTI N K. UMMARY OF SELLER'S TRAN ACTION 101. Contract Sales Price 102. Personal Property 103. Settlement Charges to Borrower (Line 1400\ 104. 105. 80,000.00 401. Contract Sales Price 402. Personal Prooertv 2,950.90 403. 404. 405. 80,000.00 r I fm v: 106. Townshio Taxes 07/17/03 to 01/01104 102.40 406. Township Taxes 107. CountvTaxes 07/17/03 to 01/01/04 130.69 407. County Taxes 108. School Taxes to 408. School Taxes 109. Refuse Credit 43.50 409. Refuse Credit 110. '410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 83,227.49 420. GROSS AMOUNT DUE TO SELLER 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 2,500.00 501. Excess Denosit See Instructions) 202. Principal Amount of New Loan,s) 502. Settlement Charnes to Seller (Line 1400) 203. ExistinQ loan(s) taken subiect to 503. ExistinQ l()an s) taken sub"ect to 204. ! 504. Payoff of first Mortgage 205. 505. Payoff of second Mortaace 206. 506. Deposit retained bv seller 207. 507. 208. I 508. 209. Closino Costs Paid Bv Seller 509. Closing Costs Paid Bv Seller ustmen s or ems n 81 e af us men s or ems n 81 210. Townshin Taxes to I 510. Township Taxes 211. CountvTaxes to I 511. County Taxes 212. School Taxes 07/01/03 to 07/17/03 61.28 512. School Taxes ~a ~a 214. 514. 215. ! 515. ~a ~a ~~ ! ~~ 218. ! 518. ~~ I ~~ 220. TOTAL PA/D BY/FOR BORROWER I 2,561.28 520. T07AL REDUCTION AMOUNT DUE SELLER 300, CASH AT SETTLEMENT FROMITO BORROWER: 800. CASH AT SETTLEMENT TO/FROM SELLER: 301. Gross Amount Due From Borrower (Line 120 I 83,227.49 601. Gross Amount Due To Seller (Line 420) 302 Less Amount PaId By/For Borrower (Lme22.O.l I( 2,56128) 602. Less Reductions Due Seller (Line 520) 303 CASH! X FROM)! TO)~R./ ! 80,666.21 603 CASH! X TO)! FROM)SELLER The underSIgned her6~fT'Cfwledge ~.~~!..; completed copy of pages 1 &2 of thIS statement & azy lattac~m~ts r~erre~o herem _ Borrower } ~ Seller (l~'1'U,(A/Lt ~M....U.N..Lti(:::v'-, 5:,'ewh-,'", CA~PROPERTY GROUP:=c- -,_. ESTAfE OF KATHERINE ELAINE PERRINE l\ ',_I r e (I V n 07/17/03 to 01/01/04 07/17/03 to 01/01/04 to 102.40 130.69 43.50 80,276.59 8,410.00 2,500.00 I I e er 07101/03 to to to 07117/03 ! ! 61.28 ! ! I 10,971.28 ! !( 80,276.59 10,971 28 69,30531 HUD-1 (3-86) RESPA, H64305.2 Paae2 . L SETTLEMENT CHARGES j-1Q0. TOTAL COMMISSION Based on Price ~ rm OL PAID FROM PAID FROM Division of Commission (line 700) as Follows: BORROWER'S SELLER'S 701. $ to FUNDS AT FUNDS AT 702.$ 10 SETTLEMENT SETTLEMENT 703. Commission Paid at Settlement 704. 10 I Rnn. ITE 'PAYABLE IN ONN TI iid WITH LnAN 801. Loan Oriaination Fee % to 802. Loan Discount % to 803. Wire Transfer Fee to 804. Underwriting Fee to 805. Attorney Fees to 806. Courier and Conv Fees to 807. Repair Funds for Escrow to 808. 809. 810. 811. I.nn ITEM" RFDlIIRFD BY ENDER B PAID IN ADVANGF 901. Interest From to @ $ {day ( days %) 902. MIP Totlns. for UfeOfLoan for months to 903. Hazard Insurance Premium for 1.0 vears to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance months $ ner month 1002. Mortoaoe Insurance months $ er month 1003. Township Taxes months $ er month 1004. County Taxes months $ oer month 1005. School Taxes months @ $ per month 1006. months @ $ oer month 1007. montlls @ $ per month 1008. months (Q) $ oer month 1100. TITLE CHAR ES 1101. ClosinQ Service Letter to 1102. Courier Fee to 1103. Wire Transfer Fee to 1104. Title Insurance Binder to 1105. Escrow for Inheritance Taxes to METZGER WICKERSHAM 3,600.00 1106. Notarv Fees to CASH 6.00 1107. Attorney's Fees to METZGER WICKERSHAM 4.000.00 (inCludes ab6ve item numbers: 1108. Title Insurance to PENN HERITAGE TRANSFER COMPANY 738.75 (includes above item numbers: I 1109. Lender's Coverage $ 1110. OWner's Coverage $ 80,000.00 101271965PAO 1111. 1112. 1113. 12M, (>.OV E T 'ORDIN TRA R GHA""ES 1201. Recording Fees: Deed $ 38.50; Mortgage $ Releases $ 38.50 1202. Citv/Count\! Tax/Starn s: Deed 800.00' Mortoaoe 800.00 1203. State Tax/Stamos: Revenue Stamos 800.00; Mortoaoe 800.00 1204. 1205. 1300. OIT NAL E EMENTf'HARt>ES 1301. Survey to 1302. Pest InsDection to 1303. Tax Certification Fee to BONNIE K. MII..LER 4.00 1304. 2003.2004 School Taxes to BONNIE K. MII..I..ER, TAX COI..I..ECTOR 1,373.65 1305. 1400. TOTAL SETTI..EMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) 2,950.90 8,410.00 By signing page 1 of this statement, the signatories acknowledge receipt of a completed oPY of page 2 of thiS two page statement. Certified to be a true copy. ( PH03227 _SMR I PH03227 _SMR /8 ) nOn::>:l "\J I:1>Z~tT1 CJ ~ ::>:ItT1 CjJ CJ ~ t-' b:lH ru - H n tT1en en 0 ::>:I....., CJ t-'C:::t-'tT1 tT1::>:1I:1>::>:I -r= .....,Z Ir >-tj::r::t::IO CJ 1:1>0 >-rj c::: n CJ en 0 ~ >- tT1 e: H CJ '-./ Z t-' CJ Oen ....., t-' /:-J ~ >-.0 0-<: en we: - "\J - '1:1> n ~ W::>:I 0 L.u WtT1 e: ru ~- 00 ::0 Ir = '.J 1-] :0 ::r:: L.u - 0 "" - I.n - e: == .... ~ en 0> tT1 me CJ 0(:)= =z ""::a ~t1'I -fC':l "'", c:::I_ ~ :n iiJ ,..,. o - m (JJ en ~ t\) -. - Z tT1 ~ o ::>:In """::>:1 tT1 >-tjtT1 1:1>~ ::>:I >-0 b~ '-./ ~ OOntT1 'D'-..en 00....., >- 1:1> tT1....., t-'tT1 H NO 1:1>>-rj b:I ~~ ::r::....., ::r:: 1:1>tT1 Z::>:I ZH Z 1:1>tT1 ~tT1 tT1 ::>:I>-tj entT1 0::>:1 Z::>:I H fiJ C) C) C) C) . '11CJ. ~/~ l~~ ~~ ==- - - - '.J ~=- - "" === -== (-.) - - - == - ~ -== i5f;R. ~0'1 '-.J. Y:8 r" , "" '11 :D Z c: c: m , :Dc") ::E: U) ~ --u-u, OW'.JO:D C:-<::>::O-.-u Z. '.J-iOo -i '.A. U) <::> -u -i N :D :D C) m /6-c23b - I '\. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX JERED L HOCK ESQ METZGER WICKERSHAM PO BOX 5300 HBG .PA 17110 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-29-2003 PERRINE 06-01-2001 21 01-0552 CUMBERLAND 101 '* REV-1547 EX AFP IDl-OS' KATHERINE E Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=is4-j-E3f-AFP--foY:oiY-NoYIcE--oF-YNHEiiffAifci-YA'x-APPRAISEf.fENT-:--AiioWAifci-'(fi------------ ----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PERRINE KATHERINE E FILE NO. 21 01-0552 ACN 101 DATE 09-29-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED NOTE: 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~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS' .00 X 00 = .00 514,617.00 X 045 = 23,158.00 .00 X 12 = .00 .00 X 15 = .00 (19)= 23,158.00 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets NO. 01 80,000.00 .00 .00 .00 277 . 00 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) llO) 34,726.00 .00 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 80,277.00 (11) ll2) ll3) ll4) 34.726 00 45,550.00 .00 514,617.00 . I .., ,',,,..., "".." , l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-29-2001 CDOO0216 1,157.90 23,250.00 TOTAL TAX CREDIT 24,407.90 BALANCE OF TAX DUE 1,249.90CR INTEREST AND PEN. .00 TOTAL DUE 1,249.90CR · IF PAID AFTER DATE INDICATED, 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. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates Df decedents dying Dn Dr befDre December lZ, 198Z -- if any future interest in the estate is transferred in pDssessiDn Dr enjDyment tD Class B (cDllateral) beneficiaries Df the decedent after the expiratiDn Df any estate fDr life Dr fDr years, the CDmmDnwealth hereby expressly reserves the right tD appraise and assess transfer Inheritance Taxes at the lawful Class B (cDllaterel) rate Dn any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRA TIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: TD fulfill the requirements Df SectiDn Z140 Df the Inheritance and Estate Tax Act, Act Z3 Df ZOOO. (7Z P.S. SectiDn 9140). Detach the tDP pDrtiDn Df this NDtice and submit with YDur payment tD the Register Df Wills printed Dn the reverse side. --Make check Dr mDney Drder payable tD: REGISTER OF MILLS. AGENT A refund Df a tax credit, which was nDt requested Dn the Tax Return, may be requested by cDmpleting an "ApplicatiDn fDr Refund Df Pennsylvania Inheritance and Estate Tax" (REV-13l3). ApplicatiDns are available at the Office Df the Register Df Wills, any Df the Z3 Revenue District Offices, Dr by calling the special Z4-hDur answering service fDr fDrms Drdering: l-800-36Z-Z050; services fDr taxpayers with special hearing and I Dr speaking needs: l-800-447-30Z0 (TT Dnly). Any party in interest nDt satisfied with the appraisement, allDwance, Dr disallDwance Df deductiDns, Dr assessment Df tax (including discDunt Dr interest) as shDwn Dn this NDtice must Dbject within sixty (60) days Df receipt Df this NDtice by: --written prDtest tD the PA Department Df Revenue, BDard Df AppealS, Dept. Z8l0Zl, Harrisburg, PA l7lZ8-l0Zl, OR --electiDn tD have the matter determined at audit Df the accDunt Df the persDnal representative, OR --appeal tD the Orphans' CDurt. Factual errDrs discDvered Dn this assessment shDuld be addressed in writing tD: PA Department Df Revenue, Bureau Df Individual Taxes, ATTN: PDSt Assessment Review Unit, Dept. Z8060l, Harrisburg, PA l7lZ8-060l PhDne (717) 787-6505. See page 5 Df the bDDklet "InstructiDns fDr Inheritance Tax Return fDr a Resident Decedent" (REV-150l) fDr an explanatiDn Df administratively cDrrectable errDrs. If any tax due is paid within three (3) calendar mDnths after the decedent's death, a five percent (5X) discDunt Df the tax paid is allDwed. The l5X tax amnesty nDn-perticipatiDn penalty is cDmputed Dn the tDtal Df the tax and interest assessed, and nDt paid befDre January 18, 1996, the first day after the end Df the tax amnesty periDd. This nDn-participatiDn penalty is appealable in the same manner and in the the same time periDd as YDU wDuld appeal the tax and interest that has been assessed as indicated Dn this nDtice. Interest is charged beginning with first day Df delinquency, Dr nine (9) mDnths and Dne (ll day frDm the date Df death, tD the date Df payment. Taxes which became delinquent befDre January 1, 198Z bear interest at the rate Df six (6X) percent per annum calculated at a daily rate Df .000164. All taxes which became delinquent Dn and after January 1, 198Z will bear interest at a rate which will vary frDm calendar year tD calendar year with that rate annDunced by the PA Department Df Revenue. The applicable interest rates fDr 198Z thrDugh Z003 are: Interest DailY Interest Daily Interest Rate FactDr Year Rate FactDr Year Rate Year Daily FactDr 198Z ZOX .000548 1987 9X .000Z47 1999 n .00019Z 1983 l6X .000438 1988-1991 llX .000301 ZOOO 8X .000Z19 1984 llX .000301 199Z 9X .000Z47 ZOOl 9X .000Z47 1985 l3X .000356 1993-1994 n .00019Z ZOOZ 6X .000164 1986 lOX .000Z74 1995-1998 9X .000Z47 Z003 5X .000137 --Interest is calculated as fDllDws: INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any NDtice issued after the tax beCDmes delinquent will reflect an interest calculatiDn tD fifteen (15l days beYDnd the date Df the assessment. If payment is made after the interest cDmputatiDn date shDwn Dn the NDtice, additiDnal interest must be calculated. ~..~. -- ( .28-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' "tVIDUAL TAXES -'ISION REY-IU7 EX AFP (01-03) JERED L HOCK ESQ METZGER WICKERSHAM PO BOX 5300 HBG PA 17110 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 10-14-2003 PERRINE 06-01-2001 21 01-0552 CUMBERLAND 101 KATHERINE E Allount Rellitted 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, subnit the upper portion of this forn with your tax paynent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=i6"ifj-Ex-AFP--[oY:oiY------...--iNHERITANCE-fAx-sTjrfEMENf-cfF'-ACfcouiff--...---------------- ----- ESTATE OF PERRINE KATHERINE E FILE NO. 21 01-0552 ACN 101 DATE 10-14-2003 THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NA"ED ESTATE. SHOWN BELOW IS A SU""ARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAY"ENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-29-2003 PR I NC I PAL T AX DUE: .......................................................................................................................................................................................................................... 23,158.00 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-29-2001 CDOO0216 1,157.90 23,250.00 09-25-2003 '" REFUND .00 1,249.90- TOTAL TAX CREDIT 23,158.00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT"" (CR), YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT. If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Dffice of the Register of Wills, any of the 23 Revenue District Dffices or from the Department's 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-3020 (TT only). REPLY TD: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCDUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (I) day from the date of death, to the date of payment. Taxes which became delinquent before January I, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January I, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20% .000548 1987 9% .000247 1999 7% .000192 1983 16% .000438 1988-1991 11% .000301 2000 8% .000219 1984 11% .000301 1992 9% .000247 2001 9% .000247 1985 13% .000356 1993-1994 7% .000192 2002 6% .000164 1986 10% .000274 1995-1998 9% .000247 2003 5% .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUftBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. JRD/June 30, 1992/17858 ~UL I ~ 2004 In Re: Estate of Katherine Elaine Perrine Late of Lower Allen Township Estate No.: 2001-552 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-Katherine Elaine Perrine 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: Elizabeth Ann Anderson Counsel for Personal Representative: Jered L. Hock, Esquire Date of Decedent's Death: 06/01/01 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: Glenda Famer Strasbaugh Clerk of the Orphans' Court ~rsonal Representative °rC~sel for Personal Representative L/Estate File A hearing is scheduled for at in Courtroom No. 3. If the ~tatus Report is filed prior to the hearing date, the hearing will automatically be cancelled ~?~'~:3 .,~ ~ ~ George ~°f~r, P}J. ~ STATUS REPORT UNDER RULE 6.12 Name of Decedent · Katherine Elaine Perrine Date of Death' 06/01/2001 Will No. 2001-00552 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate' State whether administration of the estate is complete' Yes X No ~ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete · 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a account with the Court ? Yes No X = ~ b. The separate Orphans 'Court No . (if a~yf: for c_ the personal representative's account is' c. Did the personal representative state an account informally to the parties in interest ? Yes X No ~ ~?,:/' d. Copies of receipts, releases, joinders a approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date' '//~.{~),t._ff Jered L. Hock. Esouire Name (Please type or print ) 3211 N. Front St., PO Box 5300 Harrisburq PA 17110-0300 Address (717) 238-8187 Tel. No. Capacity- Personal Representative Counsel for personal representative THE PATRIOT NEWS THESUNDAY PATRIOT NEWS Proof of Publication UnderAct No. 587, Approved May 16, 1929 Commonwealth of Pennsylvania, County of Dauphin} ss Michael Morrow being duly sworn according to law, deposes and says: That he is the Asst. Controller of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or Sunday/ Metro editions which appeared on the 26th day(s) of June and the 3rd and 10th day(s) of July 2001. That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for said County of DaUphin in Miscellaneous Book "M", Volume 14, Page 317. PUBLICATION ................... Me.r, penns~ania NOTICE , I Lifters Testamentary In the EStete of I KATHERINE ELAINE PERRINE; Iota of I Lower Altefl TWlp, CWM~ ~n~, 1 E~ A~ A~ Ex~ix N~, PA 17074 or a~ L. H~ P.O. ~x s~ ~!1 N~h ME-I'ZGER WICKERSHAM A'I-I'N: JERED L. HOCK P.O. BOX 5300 HARRISBURG, PA. 17110 Statement of Advertising Costs To THE PATRIOT-NEWS CO., Dr. For publishing the notice or publication attached hereto on the above stated dates $ 1 03.17 Probating same Notary Fee(s) $ 1.50 Bold Print $ 3.00 Total $ 1 07.67 Publisher's Receipt for Advertising Cost The Patriot News Co., publisher of The Patriot-News and The Sunday Patriot-News, newspapers of general circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have been duly paid. PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 STATE OF PENNSYLVANIA : : COUNTY OF CUMBERLAND : SS. Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz: JUNE 22, 29, JULY 6, 2001 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. Perrine, Katherine Elaine, dec'd. Late of the Township of Lower Allen. Executrix: Elizabeth Ann Ander- son, R.R. #3, Box 112D, Newport, PA ! 7074. Attorneys: Jered L. Hock, Esquire, Metzger, Wlckersham, Knauss & Erb, P.C., P.O. Box 5300, 3211 North Front Street, Harrisburg, PA 17110-0300. ~i~ditor SWORN TO AND SUBSCRIBED before me this 6 day of JULY, 2001_ ;, July 21, 2004 Ms. Glenda F. Strausbaugh Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 SINCE 1888 3211 North Front Street EO. Box 5300 Harrisburg, PA 17110-0300 717-238-8187 Fax: 717-234-9478 Other Offices Colonial Park Mechanicsburg 717-652-7020 717-691-5577 Millersburg Shippensburg 717-692-5810 717-530-7515 Re-' Estate of Katherine E. Perrine No. 2001-00552 Dear Ms. Strausbaugh: Enclosed for filing is Status Report Under Rule 6.12, with Proofs of Publication attached. According to our file, a 6.12 Report had previously been submitted. So that I may be sure this mailing has been received and the filing completed, please stamp the extra copy of the Report with your clock-in stamp and remm it to me in the pre-posted envelope provided. Thank you. Very truly yours, KERSHAM, KNAUSS & ERB, P.C. JLH/amm Enclosures CC~ 309140-1 Elizabeth Ann Anderson (w/enc.) James F. Carl Edward E. Knauss, IV* Jered L. Hock Steven P. Miner Clark DeVere Milton Bernstein Bruce J. Warshawsky Francis J. Lafferty, IV David H. Martineau Andrew W. Norfleet Andrew C. Spears Young-Suh Koo * Board Certified in civil trial law and advocacy by the National Board Qf Trial Advocacy