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HomeMy WebLinkAbout03-0053 PETITION Estate of Dorothy E. also known as FOR PROBATE and GRANT OF LETTERS Keefer No. ~1--O~-~ To: Deceased. Social Security No. 175- 24- 44 ~ 1 The petition of the undersigned respectfully represents that: Your petitioner(x), who is/x~: 18 years of age or older an the execut or in the last will of the above decedent, dated February 'l 7 t 193~ Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 86 Shippensbur? Mob~]p_ Borough of Shippensbur9 (list street, number and muncipality) Decendent, then 71 years of age, died January 3, 2003 ,~IR , at Chambersbura HosDi~r_a] . Chambo'r.~hnrg. Pamr~yl xr~ ~ =, Except as follows, deledent ~d not m~rry, was not divorced a'nd-di~cl-h~-ha~ f~h'~l~ born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: no exceptions 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: None 15,000.00± 0.00 0.00 0.00 WHEREFORE, petitioner~) respectfully request(s) the probate of the last will :~Idzx~i~ presented herewith and the grant of letters testamentary theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) el) Roafffer 'ID'. Ke~fer 125 Cottonwood Avenue St. Thomas~ PA ]7252 tative(19 of the above decedent petitionerOt) will we. Il a~ truly a~m~state Sworn to or affirmed and subscribed before me this !7th day of | Roq(~/r D.-Keefeff · --~Januarv 2D03 ~ . ' ~k J OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF CUMBERLAND~ ss The petitioner{g) 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 petitioner09 and that as personal represen- according to law. No. ~t-o~.-~% Estate Of Dorothy E. Keefer , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW January 9_ 1 , 2 0 0 3 ~ , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(x) dated February 17, 19 9 9 described therein be admitted to probate and filed of record as the last will of Dorothy E. Keefer ' and Letters Testamentary are hereby granted to Roqer D. Keefer FEES Probate, Letters, Etc .......... $ r~0. 00 Short Certificates( ) .......... $ 1 ?. (3~] Renunciation ................ $9.00 'lcd $ 10.00 TOTAL__ $ 81,00 Filed 1 - 2.1 - ?003 mai]ed to arty 1+-~1-?00~ Robert C. Schollaert #10196 A~ORNEY(Sup. Ct.I.D. No.) 82 West Queen Street Chambersburge PA 17201 ADDRESS 717/264-5194 PHONE LAST WU,L AND TESTAMF NT - I, Dorothy E. Keefer, of 83 Shippensburg Mobile Estates, Shippensburg, Pennsylvania, revoke all my prior wills and declare this to be my Last Will and Testament. 1. I direct the expenses of my last illness, funeral and burial shall be paid from my estate as soon as practicable after my death. 2. I give and bequeath my two (2) glass vases to my son, Roger D, Keefer. 3. I give and bequeath my clock, stereo, and all pictures hanging on the wall of my home to my daughter, Leeona K. Moretz. 4. I give and bequeath my two (2) patch blankets made by Harry Keefer to my daughter, Sheila M. Graham. 5. I give, devise and bequeath all the rest, residue and remainder of my estate of whatsoever kind and wheresoever situate to my three (3) children, Roger D. Keefer, Sheila M. Graham and Leeona K. Moretz, in equal shares. 6. I direct that in the distribution of my estate under Paragraph 5 above, the share of my son, Roger D. Keefer, shall be charged with an advancement of eighteen hundred ($1,800.00) dollars representing a sum of money that I have previously given to him. I nominate, constitute and appoint my son, Roger D. Keefer, as Executor of this my Last Will and Testament. If he fails to act or ceases to serve, I appoint my daughter, Sheila M. Graham, as Executrix in his place with the same powers and duties. I direct that no Executor or Executrix named, nominated or appointed hereunder shall be required to post bond or give any security of any type for any purpose whatsoever, any law or rule of court of the Commonwealth of Pennsylvania or any other jurisdiction to the contrary notwithstanding. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal the /'7~h day of ~-~f~t~, 1999. Dorothy -E.'~eef'~r ~ - Signed, sealed, published and declared as and for her Last Will and Testament by Dorothy E. Keefer, the above-named Testatrix, in the sight and presence of us, who at her request and in the sight and presence of her and each other, have hereunto subscribed our names as witnesses on the day and year last above written. COMMONWEALTH OF PENNSYLVANIA : : SS COUNTY OF FRANKLIN : I, Dorothy E. Keefer, Testatrix 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 and Testament; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by Dorothy E. Keefer, the Testatrix, this /'~ ~ day of ~f~/, 1999. Test~atrix ? Notary ~ COMMONWEALTH OF PENNSYLVANIA : : COUNTY OF FRANKLIN : and ~ObC F'~ SS the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; and that the Testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testatrix signed the will as a witness; and that to the best of our knowledge the Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by ~O~ t~ i~ ~'~' t/'- and [~0~ C, ~ ~0//~f~, witnesses, this /7%~day of ~F~6{~ , 1999. Notary ~ ~ L. ~m, ~ P~ ~~~17,~ M~, ~a~ ~ ~ N~d~ L~ST '~ILL ~ TEST~ENT OF DOROTHY E o KEEFER CERTIFICATION OF NOTICE UNDER RULE 5.6(a} Name of Decedent: Dorothy E. Keefer Date of Death: January 3, 2003 Will No. 2003-00053 Admin. No. 21-03-0053 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 February 12~ 2003 : Name Address Roger D. Keefer, 125 Cottonwood Avenue, St. Thomas, PA 17252 Sheila M. Graham, P. O. Box 144, Fannettsburg, PA 17221 Leeona K. Moretz, 131 East Virginia Avenue, Clearwater, FL 33513 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except no exceptions Date: February 12, 2003 ig ~Jt u~e - U Name Robert C. Schollaert Address 82 West Queen Street Chambersburg, PA 17201 Telephone~17) 264-5194 Capacity:__ Personal Representative X Counsel for personal representative FAMILY SETTLEMENT AND FINAL RELEASE IN THE ESTATE OF DOROTHY E. KEEFER, DECEASED KNOW ALL MEN BY THESE PRESENTS that whereas Dorothy E. Keefer, late of the Borough of Shippensburg, Cumberland County, Pennsylvania, died on January 3, 2003, testate, survived by the following testamentary heirs, Roger D. Keefer, Sheila M. Graham and Leeona K. Moretz, WHEREAS, letters of testamentary in the Estate of Dorothy E. Keefer, were duly issued by the Register of Wills of Cumberland County on January 21, 2003 to Roger D. Keefer; and, WHEREAS, the assets, consisting of personal property, coming into the hands of the Executor, and property and monies received since the date of death of said testatrix, amount to $25,665.28 and the debts and expenses paid total $24,948.66, and the distributions of principal to the beneficiaries total $0.00, leaving a balance for distribution in the amount of $716.62 all of which is more fully set forth in the Statement of Receipts and Disbursements of said Executor attached hereto. NOW, THEREFORE, We, Roger D. heeler, Sheila M. Graham, and Leeona K. Moretz, do hereby acknowledge ~k~.t we have had and_received f{om Roger D. heeler, Executor ~fo~z~sai~in full satlstactlon and payment of all share o~'har~s to,ich we are entitled from the Estate of Dorothy E~ Keefar, .:,~i~ o deceased, the property and/or monies set for[h in ~e !!~ii!! Distributions of Principal to Beneficiaries .~nd Proposed? pistr~butions to Beneficiaries attached here[© andK~nade alpart nereoz, ,:.:, AND we do hereby stipulate that, in ord~::to avoid ~e expense and time involved in the filing of ~ ~'Orm~ Accou-ht and Schedule of Distribution, no Account is necessary and we do hereby agree that we do so consent to distribution being made without the filing of such Account and Schedule, with the same force and effect as if they had been filed and confirmed by the Court of Common Pleas of the 9th Judicial District, Pennsylvania, Cumberland County Branch, Orphans' Court Division, THEREFORE, we do hereby remise, release, quitclaim and forever discharge the said Roger D. Keefer, Executor as aforesaid, his heirs, executors, and administrators, of and from the said estate and of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever for or by reason thereof, or of any other use, matter, cause, or thing whatsoever. We do further hereby agree to indemnify and hold harmless Roger D. Keefer, Executor, and his heirs, personal representatives, successors, or assigns from and against any and all claims, losses, liabilities, and damages which they may suffer or to which they may be subjected by reason of his administration of the Estate of Dorothy E. Keefer, deceased, and that in the event it should become necessary for Roger D. Keefer, Executor to pay any further expenses of or claims against the Estate, whether for taxes or otherwise, the Beneficiaries shall be liable therefor, and they shall refund to the Executor to the extent of distribu- tions received, in pro rata shares, the amounts necessary to enable the Executor to make such payments, and they shall further refund any portion of the distributions to which they are not properly entitled, even, if distributed through negligence. IN WITNESS~WHEREOF, w~have hereunto set our hands and seals this /~day of~~z~~/ 2004 Witness: Rog~/~.~ Keefe~. L/ ~_~ ./ Sheila M. Graha~ ~C~ ( SEAL ) 'Leeona K. Moritz ~ -2- COMMONWEALTH OF PENNSYLVANIA: : SS COUNTY OF FRANKLIN : On this, the ~ay of ~f~r~ , 2004, before me, the undersigned~ficer, personally appeared Roger D. Keefer, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Title: My commi~ion ~xpires: I maintain my office ~n COMMONWEALTH OF PENNSYLVANIA: : SS COUNTY OF FRANKLIN : On this, the ~ay of ~~/,~ ~ , 2004, before me, the undersigned officer, persOnaIly appeared Sheila M. Graham, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. seal. IN WITNESS WHEREOF, I hereunto set my hand and official Title: My commission expmres: I maintain my office in !OTARIAL SEAL an M Baker, Notary Public I1, Metal Twp., Franklin Co., PA sion Expires Becembe[ 11, 2008 -3- STATE OF FLORIDA : : SS COUNTY OF' ~;~-~ ~IIR~ : On this, the ~Z~ day of ~~ , 2004, before me, the undersigne~[-~-fficer, personall~ appeared Leeona K. Moretz, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. seal. IN WITNESS WHEREOF, I hereunto set my ~aand and official My commission expires: I maintain my office in -4- IN THE COURT OF COMMON PLEAS OF THE 9th JUDICIAL DISTRICT OF PENNSYLVANIA, CUMBERLAND COUNTY BRANCH ORPHANS' COURT DIVISION NO. 21-03-0053 ESTATE OF DOROTHY E. KEEFER, DECEASED ACCOUNT OF Roger D. Keefer, Executor Date of Death: Date of Executor's Appointment: Date of First Advertisement of Letters: Accounting for the Period: January 3, 2003 January 21, 2003 January 29, 2003 January 3, 2003 to February 10, 2004 Purpose of Account: Roger D. Keefer, Executor, offers this account to acquaint interested parties with the transactions that have occurred during this administration. It is important that the account be carefully examined. Re- quests for additional information or questions or objections can be discussed with: Robert C. Schollaert Attorney Identification No. 10196 Black and Davison 82 West Queen Street Chambersburg, PA 17201 717/264-5194 SUMMARY OF ACCOUNT Estate of Dorothy E. Keefer, Deceased For Period of 01/03/2003 through 02/10/2004 Proposed Distributions to Beneficiaries PRINCIPAL Receipts: Per Inventory Filed This Account Net Gain (or Loss) on Sales or Other Disposition Page 6 1-2 Less Disbursements: Debts of Decedent 2-3 Funeral Expenses 3 Administration Expenses 3-4 Federal and State Taxes Fees and Commissions 4 Family Exemption Balance before Distributions Distributions to Beneficiaries Principal Balance on Hand For Information: Investments Made Changes in Investment Holdings This Account INCOME Receipts: Net Gain (or Loss) on Sales or Other Disposition 5 Less Disbursements Balance Before Distribution Distributions to Beneficiaries Income Balance on Hand Investments Made Changes in Investment Holdings COMBINED BALANCE ON HAND Current Value 716.62 Fiduciary Acquisition Value 0.00 12,524.11 5,015.00 4,509.55 0.00 2,900.00 0.00 24,907.33 0.00 24,907.33 24,948.66 (41.33) 0.00 (41.33) 757.95 0.00 757.95 0.00 757.95 0.00 757.95 716.62 SCHEDULE A RECEIPTS OF PRINCIPAL 01/03/03 lO/O9/O3 12/15/03 01/15/03 01/03/03 01/03/03 i0/i6/03 04/17/03 03/11/03 01/03/03 CASH: Adams Electric Cooperative, Inc. - patronage capital retirement payment received in 2002 Adams Electric Cooperative, Inc. - overpayment of electric service Agway Energy Products, LLC refund of credit balance Erie Insurance Group - refund on policy premium MetLife - trust interest paid decedent in 2002 MetLife Total Control Account #403-0738058 - date of death balance Millerville Mutual Insurance - refund of policy premium The Chambersburg Hospital - refund on overpayment The Baltimore Life - death claim benefits paid to estate Policy A 0655930 United States Treasury - refund on 2002 personal income tax return 8.83 75.14 19.72 105.00 7.14 385.12 27.00 7.25 2,000.00 2,283.00 Fiduciary Acquisition Value 4,918.20 01/03/03 12/31/03 PERSONAL PROPERTY: 1995 Skyline Mobile Home Serial #3411-0416H - contract sale price Adams Electric Cooperative, Inc. - patronage capital retirement 19,000.00 78.09 01/03/03 STOCKS/CLOSELY HELD: MetLife - sale proceeds of trust interest 911.04 19,078.09 911.04 TOTAL RECEIPTS OF PRINCIPAL ............... 24,907.33 SCHEDULE C DISBURSEMENTS OF PRINCIPAL 03/20/03 02/10/04 02/10/04 02/10/04 02/10/04 SCHEDULE C-1 DEBTS OF DECEDENT Adams Electric Cooperative, Inc. debt of decedent Discover Card - debt of decedent Household-Beneficial - debt of decedent Lowe's - debt of decedent Orbisonia Rockhill Fire Company Ambulance - debt of decedent 202.80 10,745.00 604.03 704.74 88.80 02/10/04 02/10/04 02/10/04 Smith and Horton Accounting - ~reparation of 2002 personal income tax returns 30.00 SPRINT - debt of decedent 111.67 Comcast - debt of decedent 37.07 TOTAL DEBTS OF DECEDENT ............................. 12,524.11 02/10/04 SCHEDULE C-2 FUNERAL EXPENSES John L. Agett Funeral Home - funeral expense 5,015.00 TOTAL FUNERAL EXPENSES .............................. 5,015.00 02/05/03 02/12/03 03/03/03 04/04/03 04/29/03 05/22/03 06/25/03 07/14/03 SCHEDULE C-3 ADMINISTRATION EXPENSES Checkbook charge Millerville Mutual Insurance - fire insurance premium 01/2/-04/28/03 Mary C. Lewis, Register of Wills - short certificate Millerville Mutual Insurance - fire insurance premium 04/28/-07/28/03 Adams Electric Cooperative, Inc. - electric service Adams Electric Cooperative, Inc. - electric service Adams Electric Cooperative, Inc. - electric service Mary C. Lewis, Register of Wills - short certificate 7.99 101.00 6.00 101.00 32.10 55.53 56.85 3 .00 -3- 07/14/03 07/15/03 08/26/03 08/27/03 09/20/03 09/20/03 09/22/03 09/22/03 09/22/03 09/22/03 09/23/03 Sollenberger's Messenger Service, Inc. - fee for duplicate mobile home title Millerville Mutual Insurance - fire insurance premium 7/28/03-10/28/03 Adams Electric Cooperative, Inc. - electric service Nealy/Rine Enterprises - lawn mowing service M&T Bank - stop payment order Shippensburg Mobile Estate - lot rent due Adams Electric Cooperative, Inc. - electric service Black and Davison - expenses advanced as per statement Black and Davison - reserve for closing costs Mary C. Lewis, Register of Wills - filing inheritance tax Sailhamer Real Estate - commission on sale of mobile home 36.50 101.00 3.65 256.20 30.00 1,245.00 44.82 268.91 150.00 10.00 2,000.00 TOTAL ADMINISTRATION EXPENSES ....................... 4,509.55 09/22/03 09/22/03 SCHEDULE C-5 FEES AND COMMISSIONS Black and Davison - attorney's fees Roger D. Keefer - executor's commission 1,450.00 1,450.00 TOTAL FEES AND COMMISSIONS .......................... 2,900.00 -4- TOTAL DISBURSEMENTS OF PRINCIPAL .................... 24,948.66 SCHEDULE G RECEIPTS OF INCOME SCHEDULE G-2 INTEREST MetLife Total Control Account #403-0738058 04/12/03 2 .77 TOTAL INTEREST INCOME ..................... 2.77 SCHEDULE G-3 OTHER INCOME The Baltimore Life 03/li/03 755.18 TOTAL OTHER INCOME ........................ 755.18 TOTAL RECEIPTS OF INCOME .................. 757.95 -5- PROPOSED SCHEDULE OF DISTRIBUTION TO BENEFICIARIES As per Paragraph 5 of Will: Sheila M. Graham P. O.. Box 144 Fannettsburg, PA 17221 Cash 358.31 Leeona K. Moretz 131 East Virginia Lane Clearwater, FL 33759 Cash 358.31 As per Paragraph 6 of Will: Roger D. Keefer 125 Cottonwood avenue St. Thomas, PA 17252 0.00 TOTAL PROPOSED DISTRIBUTIONS TO BENEFICIARIES ................... 716.62 -6- COMMONWEALTH OF PENNSYLVANIA: : SS COUNTY OF FRANKLIN : AFFIDAVIT Roger D. Keefer, Executor under the Last Will and Testament of DOROTHY E. KEEFER, deceased, hereby declares under oath that he has fully and faithfully discharged the duties of his office; that the foregoing Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the Estate have been paid in full; that, to his knowledge, there are no claims now outstandinq against the Estate; that all taxes presently due from the Estate h~ve been paid; and that more than four months have elapsed since the first complete advertisement of the granting of letters in this Estate. Subscribed and sworn to by Roger D. Keefer, Executor before me this ~h-' day of , ' ~N6ta~y P~lic -7- FAMILY SETTLEMENT AND FINAL RELEASE IN THE ESTATE OF' DOROTHY E. KEEFER, DECEASED FROM: TO: THE HEIRS OF THE ESTATE OF DOROTHY E. KEEFER, DECEASED ROGER D. KEEFER, EXECUTOR OF THE ESTATE OF DOROTHY E. KEEFER, DECEASED STATUS REPORT UNDER RULE 6.12 Name of. Decedents. Dorothy E. Keefer Date of Death: January 3, 2003 Will No. 2003-00053 Admin. No. 21-03-0053 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 final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: March 1, 2004 ~ ~/~r~ /Sieursv -~_~ Robert C. Schollaert ¥/.~ .-~--, -~-¥"~qUl~%3 Name (Please .type or print) ~:- ~i~ 82 West Quee~ Street Chambersburg, PA 17201 Address Z :ZW ,(717) 264-5] 94 Tel. No. __Personal Representative (MAH: rmf/AM3) X Counsel for personal representative CUMBERLAND COUNTY PROBATE COURT ATTN: REGISTER OF WILLS, 1 COURTHOUSE SQUARE ROOM 102 CARLISLE PA 17013 In the Estate of DOROTHY KEEFER, Deceased Case No. 21-03-53 Release of Claim The claim submitted in the above-captioned estate on behalf of DISCOVER FINANCIAL SERVICES, INC in the amount of $10,745.00 for account number 6011002283500890 has been otherwise settled or been compromised for $10,745.00 and this release of claim is executed to acknowledge discharge of the claim, and to release the estate and the Personal Representative of the estate from all further liability with respect thereto. Agent of Claimant Address: 5330 East Main Strect, Suite 200, Columbus OH 43213 Telephone: (877) 714-3739 Date of Release: 03/02/2004 EISI Matter No. 906025 CS HANDLER1: NATASHA MCDANIEL REV- 1500 EX * (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. Z80601 HARRISBURG, PA 171z8-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'SNAME(LAST, FIRST, ANDMIDDLEINITIAL) Keefer Dorothy E. DATE OF DEATH (MM-OD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 01/03/2003 I 11/21/1931 CAPB HpRL EpIO CRAC KOTK ES (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Co" 1. Original Return ~ 24i Supplemental Return 4. Limited Estate · Future lnterest Compromise (date of death after 1Z-lg-87) 6. Decedent Died Testate Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) II 9. Litigation Proceeds Received b_J 10. Spousal Poverty Credit (date of death between 1Z-31-91 and 1-1-95) NAME Robert C. Schollaert FI RM NAME (If Applicable) Black and Davison TELEPHONE NUMBER 717,/264- 5194 4o R 5. E C A 6. P I T U 7. L A T 8. I O 9. N 10. 11. 12. 13. 14. C O M TU" T I O N OFFICIAL USE ONLY FILE NUMBER 21-03-0053 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 175- 24-4461 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER U (date of death 3. Remainder Return prior to 1Z-13-8Z) 5. Federal Estate Tax Return Required i 8. Total Number of Safe Deposit Boxes --] 11. Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS Real Estate (Schedule A) (1) Stocks and Bonds (Schedule B) (2) Closely Held Corporation, Partnership or (3) Sole-Proprietorship Mortgages & Notes Receivable (Schedule D) (4) Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) Jointly Owned Property (Schedule F) {6) r---] Separate Billing Requested Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) Total Gross Assets (total Lines 1-7) Funeral Expenses & Administrative Costs (Schedule H) (9) Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) Total Deductions (total Lines 9 & 10) Net Value of Estate (Line 8 minus Line 11 ) 82 West Queen Street Chambersburg, PA 17201 911.04 None 21,796.34 1,364.44 None 12,819.81 13,604.74 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (2,352.73) 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(aX1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate OFFICIAL USE ONLY (8) 24,071.82 (11) 26~424.55 (lZ) (2,352.73) (13) (14) (2,352.73) X .0 0 (15) 0.00 X .0 45 (16) 0.00 X .12 (17) 0.00 X .15 (18). 0.00 19. Tax Due (19) 0. O0 Copyright (c) ZOO0 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS Shippensburg Mobile Estates ~/86 CITY Shippensburg STATE ?A Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) Z. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits ZIP 17257 (1) O. 00 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) O. 00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) O. O0 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ......................... ~ ~ b. retain the right to designate who shall use the property transferred or its income; ........... c. retain a reversionary interest; or .................................... d. rece ve the prom se for fe of either payments, benefits or care? ................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................ [-~ ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............................................. [~ ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ [] ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU OF PERSON RESPONSI FOR~~ Roger D. Keefer DATE ~ A~ ~ ~--~ 125 Cottonwood Avenue ...................... SI~NA~ff~OFPREP OTHERTI ~RE~RESENTATIVE Black and Davison DATE For dates of death on or after July 1, 1994 and before Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 9116 (a) (1.1)(i)]. For dates of death on or after Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the su~iving spouse is 0% [72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statuto~ requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficial. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twen~-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2) [72 P.S. 9116(a~1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Copyright (c) ZO00 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) REV- 1504 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Dorothy E. Keefer SS~/ SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP or SOLE-PROPRIETORSHIP 175-24-4461 01/03/2003 FILENUMBER 21-03-0053 Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM VALUE AT NUMBER DESCRIPTION DATE OF DEATH 1 MetLife - sale proceeds of trust interest 911.04 TOTAL (Also enter on line 3, Recapitulation) $ 911.04 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSysterns, Inc. Form REV-1504 EX (Rev. 1-97) REV- 1508 EX + {1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Dorothy E. Keefer SS# SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY 175-24-4461 01/03/2003 FILENUMBER 21-03-0053 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 retirement 8.83 2 3 4 5 6 Adams Electric Cooperative, Inc. - patronage capital payment received in 2002 MetLife - trust interest paid decedent in 2002 Erie Insurance Croup - refund on policy premium MetLife Total Control Account #403-0738058 - date of death balance The Chamersburg Hospital - refund on overpayment United States Treasury - refund on 2002 personal income tax return 1995 Skyline Mobile Home Serial #3411-0416H - contract sale price 7.14 105.00 385.12 7.25 2,283.00 19,000.00 TOTAL (Also enter on line 5, Recapitulation) $ 21,796.34 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev, 1-97) REV- 1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Dorothy E. Keefer SS# SCHEDULE F JOINTLY-OWNED PROPERTY 175-24-4461 01/03/2003 FILENUMBER 21-03-0053 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. Sheila Keefer Graham Daughter P. O. Box 144 Fannettsburg, PA 17221 JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH Include name of financial institution aM bank ITEM FOR JOINTi MADE account numar or similar Identi~i~ number. DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT Attach d~d forJoint~-held realestate. VALUE OF ASSET INTEREST ]ECEDENT'S INTERE5 1 A 03/01/96 M&T Bank Checking Account 2,163.05 50.00% 1,081.53 #670960, joint with Sheila Keefer Graham - date of death balance 2 A 11/01/95 M&T Bank Christmas Club 175.10 50.00% 87.55 #25004920129407, joint with Sheila Keefer Graham - date of death balance 3 A 03/01/96 M&T Bank Savings Account 390.71 50.00% 195.36 #15004200952700, joint with Sheila Keefer Graham - date of death balance TOTAk(Alsoenteronline6, RecapRulation) $ 1,364.44 (If more space is needed insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev, 1-97) EV- 1511 EX +{1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Dorothy E. Keefer SS~ 175-24-4461 01/03/2003 21-03-0053 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT Ao 1 2 3 4 5 6 FUNERAL EXPENSES: John L. Agett Funeral Home funeral expense ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Ro~er D. Keefer Social Security Number(s) / EIN Number of Personal Representative(s) Street Address 125 Cottonwood Avenue C~y Saint Thomas State PA Zip17252 Year(s) Commission Paid: 2003 Attorney's Fees Black and Davison Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Adams Electric Cooperative, Inc. electric service Adams Electric Cooperative, Inc. ~ electric service Adams Electric Cooperative, Inc. - electric service Adams Electric Cooperative, Inc. - electric service Barry L. Negley, Tax Collector - 2003 county/township taxes Barry L. Negley, Tax Collector - 2003-2004 school taxes 5,015.00 1,450.00 1,450.00 32.10 55.53 56.85 3.65 68.24 207.84 Total of Continuation Schedule(s) 4,480.60 TOTAL (Also enter on line 9, Recapitulation) $ 12,819.81 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software onty CPSystems, Inc. Form REV- 1511 EX (Rev. 1-97) Estate of: Dorothy E. Keefer Soc Sec #: 175-24-4461 Date of Death: 01/03/2003 Continuation of Schedule H-B7 (Other Administrative Costs) Item Description Amount 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 Black and Davison - expenses advanced as per statement Black and Davison - reserve for closing costs Checkbook charge M&T Bank - stop payment order Mary C. Lewis, Register of Wills Mary C. Lewis, Register of Wills Mary C. Lewis, Register of Wills Mary C. Lewis, Register of Wills filing inheritance tax short certificate short certificate account filing fee Millerville Mutual Insurance - fire insurance premium 01/2/-04/28/03 Millerville Mutual Insurance - fire insurance premium 04/28/-07/28/03 Millerville Mutual Insurance - fire insurance premium 7/28/03-10/28/03 Nealy/Rine Enterprises - lawn mowing service Sailhamer Real Estate - commission on sale of mobile home Shippensburg Mobile Estate - lot rent due Sollenberger's Messenger Service, Inc. fee for duplicate mobile home title 268.91 150.00 7.99 30.00 10.00 6.00 3.00 134.00 101.00 101.00 101.00 286.20 2,000.00 1,245.00 36.50 4,480.60 REV-151? EX + (1-97} SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Dorothy E. Keefer SS~ 175~24-4461 01/03/2003 21-03-0053 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 2 3 4 5 6 7 8 9 10 Adams Electric Cooperative, Inc. debt of decedent Comcast - debt of decedent Discover Card - debt of decedent Fulton County Medical Center - debt of decedent Household-Beneficial - debt of decedent Kirk W. Davis, DPM - debt of decedent Lowe's debt of decedent Orbisonia Rockhill Fire Company ~nbulance - debt of decedent Smith and Horton Accounting - preparation of 2002 personal income tax returns SPRINT - debt of decedent 202.80 160.52 10,745.00 17.93 604.03 9.61 742.01 977.00 30.00 115.84 TOTAL (Also enter on line 10, Recapitulation) $ 13,604.74 (if more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1 $1:~ EX (Rev. 1-97) REV- 1513 EX * {9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Dorothy E. Keefer SS# 175-24-4461 SCHEDULE J BENEFICIARIES 01/03/200B FILENUMBER 21-03-0053 NUMBER II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(aX1.z)] Roger D. Keefer 125 Cottonwood Avenue St. Thomas, PA 17252 Sheila M. Graham P. O. Box 144 Fannettsburg, PA 17221 Leeona K. Moretz 131 East Virginia Avenue Clearwater, FL 33515 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) S on Daughter Daughter AMOUNT OR SHARE OF ESTATE 1/3 share of residuary estate 1/3 share of residuary estate 1/3 share of residuary estate ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) Copyright (c)ZOO0 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) ULACK AND DAVISON ATTORNEYS-AT~~W LAST WILL AND TESTAMENT I, Dorothy E. Eeefer, of 83 Shippensburg Mobile Estates, Shippensburg, Pennsylvania, revoke all my prior wills and declare this to be my Last Will and Testament. I direct the expenses of my last illness, funeral and burial shall be paid from my estate as soon as practicable after my death. 2. I give and bequeath my two (2) glass vases to my son, Roger D, 3. I give and bequeath my clock, stereo~ and all pictures hanging on the wall of my home to my daughter, Leeona A. Moretz. 4. I give and bequeath my two (2) patch blankets made by Harry Keefer to my daughter, Sheila M. Graham. 5. I give, devise and bequeath all the ~est, residue and ~emainder of my estate of whatsoever kind and wheresoever situate to my t~ree (3) children, Roger D. ~eefer, Sheila ~. Graham and Leeona ~. Moretz, in equal shares. 6. I direct that in the distribution of my estate under Paragraph 5 above~ the share of my son, Roger D. Aeefer, shall be charged with an advancement of eighteen hundred ($1,800.00) dollars representing a sum o£ money that I have previously given to him. 7 o I nominate, constitute and appoint my son, Roger D. Keefer, as Executor of this my Last Will and Testament. If he fails to act or ceases to serve, I appoint my daughter, Sheila M. Graham, asI Executrix in his place with the same powers and duties. I direct: that no Executor or Executrix named, nominated or appointed hereunder shall be required to post bond or give any security of any type for any purpose whatsoever, any law or rule of court of the Commonwealth of Pennsylvania or any other jurisdiction to the contrary notwithstanding. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal the / 7~h day of ~f~O~, 1999. Doroth~y ~E .-~ee f~r ~, - Signed, sealed, published and declared as and for her Last Will and Testament by Dorothy E. Keefer, the above-named Testatrix, in the sight and presence of us, who at her re,est and in the sight and presence of her and each other, have hereunto subscribed our names as witnesses on the day and year last above written. 2 COMMONWF~%LTH OF PENNSYLVANIA : : SS COUNTY OF FRANKLIN : I, Dorothy E. Keefer, Testatrix 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 and Testament; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by Dorothy E. Keefer, the Testatrix, this /~ ~r~day of ~,~br~r~/, 1999. COMMONWEALTH OF PENNSYLVANIA COUNTY OF FRANKLIN > , SS and the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; and that the Testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testatrix signed the will as a witness; and that to the best of our knowledge the Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. this Sworn to or affirmed and subscribed to before me by ~ I~ ~'~ ~ and ~0~ C, ~ hO[/~f~, witnesses, ]7~k%day of P~b~0~ , 1999. N6tary ~ ~~~ 17,~ M~, ~anl~ ~ ~ N~a~ 4 C 14 (l~l 0~q:S,q~ S~t lh~mor R~I Est~t~ 71V,%3051H! p.2 ~TANDARII AGrEeMENT FOR TIlE ~AI,E OF A MOBiI,E/MANUFACTUIIED HOME, REAl. PROI'ERTY NOT IN(~LUI)ED Broker is NOT the Agent for Seller aud is gan: ~ AGENT FOR BUYER ~ TRANS.&CTION LICENSEE BUYER'S BUSINESS RELT~ WITII PA LICENSED BROKER BROKER IS THE AGENI FOR BUYER. Designated Agent(si for Buyer, u apparatus ....... OR - · · m -~u~.r ~nu ~1 LEg ~ SUBACENT FOR SELLER ~ I'leNSACTION LICENSEE J Broker is NOT Ihs Agenl for Buyer ann ts ~an: ~ a~ ......... ' ~ Whr'~n~t h~-san~ Broker is Agent for Sell ..... d Agent for Buyer Broker isa Dual Agent. All of B raker s licens ....... lad I}ual Agents UNLESS there arc ~eparate Designaled Agents Iht Buyer aud SeBer. If Ihs same Licensee Is designated for SoBer aud Buyer, ~l~e I ,icen~e is a Dual Agent. 2. PROPERTY (5-01 } Seller agrees to sefl and convey ~ Bayer, who arras to buy ~e following i~obil~nlanufactu~d hume and acce~ory which will be paid lo Seller by Buyer ~s Ibllows: I 1'} Cash or check at signing this Agreemcut: ___ ~r~d $ (4) Cash, cashier's or certified cbeck al time of scttlemenl: ~~ ...... (B~ De.sits paid on aecounl ol pm'chase price to ~ hekl by Broker I'm Seller, unless otherwise stated here: m, the following will be b s twill Bayel and SelleL mlmbursmg where applicable: Notice Regarding State and Local Taxesi; ICilY; illiel'eSt O~ loan assmnptions; water and/or sewer fees. if any: lefuse [~s; cable television fees: and othe~ dmilar chaises Thc chases a~e to be pro-rated for the pencils) covered: Seller will pay up to and including the date of Ilea~ilt: Buys: x~ill pay for all days tollowing seltlement, ut]less oOlerwise stated brae: 4. FIXTURES AND I'E~SONAL ~ROPERTY (~01) (A) INCLUDED io dtis sale and purchase price m'e all e~isting ilems ~rmanemly installed in Ihs Properly, h'~ ol Iiell[. Also illel~ded: ~ buih-m appliances ~wall Io wall ea.peting ~refdgeratm ~ghting fixlmes (including chandclie~ and ceiling fans~ dryer air conditioner., "~ window coveting hardw~ue, sltades, blinds [] television antennas and/ol satellite dishes shmbbery. plantings and unpoued trees hsd(si kmmg tcps cxisting screens aO~.y remalining heatl, ng and cooki~g lusts owned by Seller and servici,g ale Property al thc time o~ s~tttement LEASED items ( lei Is ot n~ned by Seller): ~ heating luel lallk{S} ~ ~ cooking ~uel tank(q) ~ Pennsylvania Association of RFAI}'OR~~ A/S-MH I'age I .f ~ Seller Initials: f~]~ - 14 03 O.q:Sqa Sat lhamer Real Estate is subj~'l to the approval or Buyer's applicalion by Lot O~ner. Owne]/M~nag~ Address ..... ~ Phone/Fax munbc~qs) (C)Ii Buyer's apl)Jicalion is rejoin, all deposit monies p~d on accool~t o1' purclmse price will will be VOID ~ Water ~Tmh ~ Cable lelevision 6. SPEC~L CLAUSES (5-01) ~A) ~ bllowing are part of t~s Agreement if choked: ~ Sale & Seulemeot ol Othe~ Pro~y ~ Seffieo~nt el' O~ Pr~y Conting~cy A~um (P~ F~m Contingency Addendunl (PAR Fo, m 130/SSP) ~ %nanI-Occupied Pro.ay Ad~ndum (P~ Fo~ TOP) ~ Sale & Settlement Of Olher Propc:ly Contingency with Right to Cmmnue Mm'kefing Addendum ~ (PAR Form 1311SSF-CM) 7. DAT~IME IS OF THg ~SENCE by agrecxt to ~ of file essence of this Agl'eelllell{ a~tJ are binding. ~. FINANC~G CONTBGRNCY (5-0~) ~ WAIVED ~i~ ~Me is NOT contingent on loan linmlcing. ELE~ED I. Amou,,t of loan $~_,~O, O q 2. h4umnum Term fi' O _ yea~ 3 Buyer agr~ to aeeepl the inle~sl rate ~ may I~ com~ffitt~ by ~e lender, not ~ses of a~isfing m ~e loan p~ ~, ~ c I~ condi~oned u~n Ihe ~h' and settlement of any other p~rty, OR 4. l[ Buym has not beeo ~ploved lot a loan. o~ if this Agr~ment ~s te~ninated insuzance wiih exten(l~ cove~'age, t, cancellation f~. if ally. AND/OR appraisal l~s and ch~ges paid tn ~vance to Jemler ~ NOT APPLICABLE 9. INSPECTIONS ltl PROPERT~ INSPECTION U{INI'INGENC~ (5-01) 14 03 0~3:54a Sallhamer Real Estate 717530518! p.4 in~eclions J. .,Xc.~el,~ ~he Prolx'~y w~th lhe mfom~:~mm ~ta~ed i. thc mpo~Usi :md agree ~o the RL;I.~ASE ~ct fm~ in p~'agu~ph ?~ ~1' this ~emem. IIiOlliCS I~iucl OI1 accoum ol ptu-chase puce will be letUfllOd pmmplt5r lo Bus'er and this Agleclnent wi~ be VOID, OR *githiu Ihe lime give~l for completing inspeclio.s WOOD IN~'Lq'[ATION cONT~G~CY Opmatol. BUYER WAIVES THIS OPTION and agtec~ lo the RI¢t. EASE scl forth m pm'agraph 23 ~,1 tht; Agreement. ~ ELECD I{D ColIII'O[ O~ralof l[~ SctlcL ~c re.t1 is Io bc made salislacto~ to aed in cnmpliance with apphcable laws and lendo, an~o~ Fede,al Insudag and Gm~ameeiug Agcucy tfiqtureme ts. if any, I'he inspeclion will mclude all readily visible m~d accessible i~e~s of alt .IrtlClUre~ on the Lot e~cept fl~c lollowing s~uctm~, which will n~ be respected: ~ ally acce~able m Buyer ~d Scl[er. Buyer may, within 5 days ol karmng of ~uch relus~. [cmlinale t~s Agreemel;t. '"' ~d a proposal to re~ fl~e ~mage. Buyer will deliver the s~ctural dmim~e ~1 anti con. live pro~sal to · by wood-de~uoying ~.gaoisms * · . S~/I~ wuhm days of deli vem~g tl~e mspection ~ (D}W h ~ 5 daw ol ~eiving Ihe suuctmal damage repo~ and co.clive pmpo~l. Selle* wig advi~ Buyer Buyer agr~s Io acce~ the Pr~y tis ~epa~ ~d ag~es to IIz ~LEASE · . set [oah m pm'a,,raph 2~ of t tis Ag,~ement = 's.uttm~l damage ~eve~aled by the re~ll or fails to ~nd ~thin fl~e time Well Buyo. within 5 days of ~,: (F}If Sel~e~ chooses nol to repair . rect-iving Seller's notice, will nofil3 Seller in x~ uting of Buyer's thrace ,, I Accept I c P~o~rtv with tlz defects reveal~ by the msp~t~tm, without abatemem of p6cc and ng~ ~;'O gri~ph 25 of Ibis Agreement, OR 2 M.~c the repairs before scnlement. ~f r~mred by the letter, if any, al Buyer's ex~se and with Seller's %! ua~eas~ably withheld, m ~hich case Brayer accepts the probity and ag~es lo the REt.EASE set fo,~h m pm'agmph 23 of this Agr~u~ellt. Agt~n~nt will ~ VOID 12. ~SIDENTIAI- LEAD-BASED PAINT HAZARD ~DU~ION A~' NO'rICE REQU~D FOR PROPE~I~$ BUILT BEFORE 1978 (5~1) ~ NOT APPLICABLE APPI.ICABL[ ~ ~. p~ol~tty, unless checked co~cermug Seller's ~owledge of ~he p~ escnce of lead-ba~ ~int m~d/or le~-hased pail l Ii~ ) ~ (B) R~ord~Reports: Selle~ has no re~x~ or ~:ot~ perishing Io lead bared palm au~ot l~ad-b~q~ pamt ha~ds in o~ about the Pro~)', unless checked Seller ha~ pro'~ided Buyer with all a'~ailahte ~ecords and i~¢pods pertaining to lead-based paint and/or lead-based pamt hazards mot about the ;,~, (C)Buyer's Acknowledgeme,lt: ::; Buyer has iccci,.,ed Ihe p~unphlel Ihuu,~t Yom Familyfl'om &.ad in Your Home ired h~ r~ad ~e L~d Warning Statement cunlamed in this :',Jo Agreemellt ~See Lead Based Pant No icc~ Bu).cl has ~viewed Seller's disclosure of ~low]l lead ba~d paiul all~or lead b~ paint hazm'ds. .:;.~ a~ tdeutilicd tn parag~ aph 12[A~ and ha~ mceiv~ the ~o, ds and repo is, d auy. t~tlammg to lead-ba~ pmut ml~ur lead-based paint 2tis identified in paragraph 12(B) ~te .~,/ (D)~SK ASS~SME~I'ANSPEC I'ION: Buyer ac~ow}~ges llmt betom Buyel is obligaied to buy a residenti d dwellm~ ~llt ~fore 1978, 2 ~, lead ba~ pallu author lead-ba~d paml ham,~s BUYER W~VES THIS ~GHT and agrees Io fl~e I~LEASE scl fo.h m paragraph 23 ol :,; ~ ELEC'iED fltJ~ 14 03 0.~):%5a (~allhamer Real Estate VI'?~30SIIIt p.5 4 Upon ~eceiving ~he cowcct~ve prop, sal. Buyer. witl~n 5 days, will Accepl the con-eclive p, opo*al :md file ~Ol~lt} m ~nting, arid a~oe {o ~le REt.EASt s q u~th in pan~aph 21 of this A~eement. OR to Bu) er ami this A~-eement will t~ VOID Shoutd Seller tail In submil a x~ dtten c°rredlv~ Prop°~d *~i{~n the time set f°~h in paragraph 12(DD' °f dfi~ Ag~ceme't' Ihcn Buyer' wilhln 5 fl~, will: a Accept the Propctl~ m wlln,g. ~ld a~ee Io ihe RFLEASE sel Iorth ill pmag~aph 2~ oi INs Agt~mem, OR 6. Buyer's [ailure Io exercise any of Buyer's options wi~in Ihe time [~i~ specified id this paragraph will consBtule a WAI~R this contingency and Bayer accep~ file r~rly and ages to ~c I~LEASE ~t forth in pa~graph 13 of lids Ag~ment. :.;~8 (E) Cerfificaliou: By signing thi~ Agreement. Boyer and Seller cerlify the accuracy of their ~espcctive ~taielllen~s, to thc ~sl ol their ?Yi13.STATUS OF X~A'['ER (5~1) ~ Public Water ~ None (B) WA"~ 5~R~IC~ INSR~C~ION CONI'ING~NC~ i:i~ ~WAIVED Buyer acknowlcdg~ Ibal Buyc~ has Ibe optioo to r~uest an insyhon Of the water selvice for ~e Property BUYER WAIVES '~S C TH~ OPTION and agrees to the REL~SE se~ Iorfll in ~ugwaph 23 of this Agreement. ,~xq ~ ELECTFD 2,"; I ~uvct has 01e oplion, within ~ days of ~e ex~ution of [his Agar. meal and at Buver'q. . expense, to delivm to SeIIel a written insp~- 2~? 2. If the teD. t ~eveal~ ~Ii~ ~le water se~i~ d~s not lu~ the mmmtum stands of an~ appbcable COVet nulenl;O aufl~ori~y m}tFor f~ls to :,52 salisl3 Ihe mquireu~nts for quality all~Ol quantity ~t by ~tc lmxder, il any. Seller ~ill pa*mpdy notify Lot Owner of ~e ~esuits of t~ ;!ha mxpccnon mpurt, and geller, witNn~ days of ~eiN of ~ ~P~. will notify Buyer m wmmg of lhe Mt Owner's choice ~o: 255 a. Upgrmle fl~e water m~vi~ to the miniulum accept~le levels, ~l'ore sen}e ne , in which case Boyer accepts file P~pelly :,,h to the ~LEASE <t Io~ in p~agraph 23 oI tins Agmemcm. OR :;6 3. Il thc Lot Ownel ch~s not Lo upgrade tile ~t vice to minimnm accep~ble levels, or ff SeUer lails lo i~nfl within Iht time Wen. - Buyer and this Agr~n~nt will ~ VOID. 20, 14. STATUS OF SEWER {$-O~) ~,b ~ Public Sea. er ~a ~ Individual On-lot Sewage Dis~sM System ZUb ~ lmtividual On lot Sew~e Dis~sal System m Proximity to Well (See Sewage Notice) Z~[i ~ Co,nnltlnlty Sewage Dis~sal System ;h, .' ~ ttuldmg Yank erg(BI Seller has no knoMedge of sewer Iglaled pl~blems, except ~ follows: ~ 2~,: 15. NO'I'IC~$, ASS~SMENTS & CE~ICATES OF OCCUPANCY (1-00) or mD, one on Seller's ~1~t', including noti~'s relating to violations of ZOlUng. housing, boildnig, safety or fire ordinates whic~ rcm~n (B} SeJJe~ knows of no o~er pmenli~ ao~ces ({ncluding ~JoJalions) mid 8sS~Slll~nls excepl as fo 19. iCI Buyc~ is advised Ihat access to a public road may require issuance of a highway occopancy perm. from the Depiu-t:neta of Transptmation. rD) Ii m eqtmed by law, wifl~n . days of the execution of t~s Age. meat, Seller will order I0[ dehvex~ A ccrtilkalion from the a~iopl'iate municipal depmlment or deponents disclosing notice of any uncon ecl~ violation of zoning, ho~- m~ bttildiog, ~tlet), or will withm 5 ~ys ~ Sel~rk r~eipt of the rmluimoents, notify Buyer of timh m pm'ag~aph 23 of ~s Agl~ment. Scltm's denial tel inmate Ibis Ag~ement, m which case ali de.sit monies ~id on account of pumhase pace will 16. TITLE AND COSTS {5-01) lA) Thc l'ro~ly ~ to be com'ey~l free and cle~ of all dens and encumbrance& 2 Appt amd fecs and chmges p~d in adv~mce 17. ZONING CLASSIFICATION (5~1) Zoning Cl~ific"ation: ~C~ Fttjg 14 03 O-Cl:SGa Sal lhamer f~eaI Estate '/17.S.')O~I}lt Z0. DEPOSlP ~NB RECOVERY FI;ND (5-01) Ihe ~rso. designaled as payee, ~ ill ~ paid m U S Dallas to Brokcl or pa~y identified in pa-agraph 3qBL x~lm will l~tam them m an escrow ~ ' tiered as deposil ma} be held pen&ag thc acceptance tfl Ibis utter (D) A Real Estate Recmea fund exisls Io reimburse any persous who have obtained a fia~ civil judgmem against a Peunsylvania real eslale ins all legal and equitable ~el~dieg For complete delafls about fl~ Fond, call (717) 783-3658, o 1800~ 882 2113 (within Pennsylvania) and ~, (717) 783-4854 (tmt~ ~ Pem~ylvmua), 21. MAINTENANCE AND RISK OF ~S O-00) s~cific~ly sch~ul~ herein in its present coodition, normal we~ and tear exccple~ item. Seller will prom~ m~il'y Buyer in writing of SelleCs choice sel thrill in paragraph 23 of flus Agr~ment, OR case Buyes will ootify Seller in writing within 5 days o~ before setllement, whichever is s~me~ that Buyer will: 1~ and this Agreement ~ill ~ VOID. e~y included in this sale t~t is not ~epaired ol replac~ prior 1o settlemenL Buycl will have Iht ~>tion of reschlding this Ag~menl and ~? 2Z WAIVER OF CONTINGENCI~ (1~) rtgh~ to ms~ an~' rcpmr Iht P~o~y. Buyer's fsilure tn exemise any of Buyer's op~ons wilhin ~e lime limi~ s~cifi~ in ~e ~nliugency provision(s) will conslitute a WAIVER of fllal couti,gency and Buyer acce~ and ag~es to the I~L~SE ~1 forOl in paragraph g3 of this Agmeme.t. 23. ~LEASE (l-00) Buyer lereb~ rele~es, quit cla~s and forever discharg~ SELLER, ALL BRO~ their LICENSE~, EMPLOY- EF3, and any OFFICER or i'ART~R of ~y one ~ them and any other PERSON, FI~I, or CO~TION who may ~ liable by or ~'! lhmugh them, from any and all claims, I~q or demand~ IncludillR, but ~t li~tflted to, pelto,al injur~ and pro~y ~agc and all of lead-ba~ed paint hamrds, en~mnmental mzards, auv d~e~ in Ibc individual ot*-Iot ~wage d~al system or de~iencies iu the on-file water ~rvi~e sy~e n. or any defec~ or c~dltio~ on lhe ProperU. This ~lease still survive ~ttlemcnl. 24. ~PRESE~ATIONS(5'0~} s~cifically scheduled herein), or has waiv~l the righI t° d° s°, a~td has agr~ t° put~hase il in its pre~nt c°nditi°u unl~ °~e~se ;~ s~k'd in Bfis A~menL Buyer ackn°wl~g~ that Brokers' their licensees' empl°ye~' °fficc~ °r par~eo have n°t made mt indepen' (Ci Auy mpaim mquir~t by dfis Agreement will ~ completed in a worBnanlike m~net. (D) Brokm(s) may perl~rm selw4ccs to assist m~ep rscntcd p~ies in complying with Ihe ~erms ol dus 25.DEFAULT (5-01) :r~ Should Buyer: ~: (A)Fail ~ m~e any mlditionM paymenls as s~cified in p~uagrapb 3; OR I (B)Futoish false m incomplete mionna6on ~o Seller, Broker for Seller, Bmke~ for Bayer. o~ the lender, if any. concerning Buyer's legal or finan- ?' (C) Violate o~ [~l Io fulfill and ~donn any oth~ terms or condilious ot ~is Ag~emcut; 3~ 2) ns momes to be appli~ to Seller's damagm, or 3) ~s liquidated d~aees loi such b~each, as Seller amy el~t, u~e~ otherw~ ~kM 3~ ",, ~ Selim is limited to miauuug sums paid by Buyer, including de~sil monies, as liquidated damages :4; If Seller elects to ]emm all sums paid by Buyer. h~clnding de.sit montes, as liquidated damages. Buyer aod Seller will be iglmlscd from ,¥,26.MEDIATION (7-~) ~a: ~ NOT AVAILABLE ~ ELE~ED Rug 14 03 O9:57a Sai lhamer Real Estate 7175305181 ~02Bu}er ackno~lcdges ~cei~ng a cop; of the Rules and Rcgulatio~ Ib[ the Mobile Home Pa/k ident~ in paragraph Z, if applkable (~ Notice 4aSa~garding Mobile Itome Park Rights AclL a04 4~4 CONTRACT. Retmn by facsimile transmi~ion (FAX) of this ~05NOTICE ~ PA~: ~tEN SIGNED, T~S AGREEMENT IS A BiNDinG · ' · advised ' Bnyer has rec~v~ a ~atement ~ Buyer's estimat~ cl~ing cosls bet0~ s g~g this Ag~ent. Buyer bas ~ceiv~l the Seller's Property Dis¢l~ure Statement ~Io~ signing t~ Agl~mcnL if ~qid~d by law. (S~ Noflte, a l~ ~ hffonnution Rega~g the Real Es~te Se~er ~closu~ Law.) ll:i ~ Buyer ~ ~eiv~[ thc Depot Money N~ce (for c~pcraflve sales when Broker for ~er is hol~lg de.sit money) before sig~ ala ll~ Ag~ment. e~s~e no~ces and expiratory infgr~t~ s~ forth in t~s Ag~ement. 41(, BUYER_ E-M~I .... ~za BUrR DA~E 4;e WITN~S SS ~ Buy~ Name (pnnt) ~ az2 E-Mail ~33 ~ ~il~ he.by ap~ve~ fl~e a~ve con.ct t~s (date) _ _ ~ ~ ~~ 435 Euyer, ~ller agrees to 0ay ~e na~d B~ for Seller a [~ of ~ ~ ~ ¢$~otTf~m &e ~in ~cified sale ptice, tn ~e event Buyer defaul~ he.under, auy mom~ pad on ~uxa ~ll M &v 438Seller, Broker for ~lier, but in no evenl will ~e suni paid to ~c B~ker tbr SeDer be m ~sa of file a~ve s~ified B~ker's ~ at~ ~n on at a Code ~353M ~1 ~r has received a s~t~ent of ~ler's ~fi~ted d~ng cos~ b~o~ s~ng th~ ag~e 442 442 ~ Seller h~ ~ ~d unde~t~ds ~e nofic~ and explanatory itff~afion ~t fo~ in t~ Ag~menL ~45WITN~ SELLER_ ~6 Buyer Name (prinQ 44'~ M~ling Ad&'~s 448 n48 -- E-Mail 449 '~49 Phone #s FAX # 45o DATE_ 45~~TNESS SELLER .... - SS ~ ~5~ Buyer Nal~ ~nt) .... 453 45a Mailing Ad. ss ~5~ 454 E-Mail 455 455 I'hofle #~ FAX # 4aQ nSfi DATE 457 ,~5,~ WITNESS ~ SELLER SS ~ 4bb ~8 Buye~ N~e ~6nt) a~ 459 Mailing Ad.ess 460 460 E-Mail _. 46t 461 Phone #s FAX # 462 45a [] Regarding Lead-Based Paint Hazards Disclusure: Reqnin'd il' P~fly was Milt ~fore 1978: The undersigned Lic~see involv~ in 4~a 465 ~s trmlsactton, on I~[t~f of ~mselves and fllek b~ke~, ceittfy that ~e~ statemenk~ ~ uue to ~e ~st of ~ir knowl~ge mid ~hef. 46~ 46a A~n~' A~owledg~nt: ~ Agents iuvolv~ m t~s u~c~ou have infon~d Sel~r of Seller's obfigafions ~der ~e R~i~ufal ~ ~8~ P~nl H t~ Reducuon Act 49 U S C 4852(d) and are a wm'e of ~eir l~l~ibility to cnso~ comphance. 467 46~ ~ Regarding M~ialion: Tile andersigned ~ Broker for Seller ~ Broke' f~ Buyer a~ lo subnfi~ to mediation in acc~ce ~th a6~ ~ pm-agraph 26 of this Ag{eemenL 41~ ~ BROK~ FOR SELLER (C~pm ~ DA ~2 al3 T ~ ~~ ,U4 ,~ ACC~ED BY BROKER FOR BUYER (Company Name) DATE ACCEFrEDBY _ _ __ A/$-Mtt Page 6 of 6 Robert C. Schollaert BLACK AND DAVISON Attorneys-at-Law 82 West Queen Street Chambersburg, PA 17201-0513 (717) 264-5194 Elliott B. Sulcove Jan G. Sulcove Estate of Dorothy E. Keefer Attn: Roger D. Keefer BILLING DATE 09-22-03 ACC'T NO. RCS16686.01 RE: General DATE EXPENSES 01-10-03 Cumberland Co Register of Wills-probate 01-23-03 Cumberland Law Journal - legal ad 01-23-03 Cumberland Co Register of Wills refund 02-24-03 The Sentinel - legal ad 08-04-03 Travel expenses 08-05-03 Travel expenses $84 00 $75 oo -3 00 $108 95 $2 52 $1 44 TOTAL FOR THE ABOVE EXPENSES TOTAL FOR CURRENT PERIOD PREVIOUS BALANCE $268.91 $268.91 $o.oo TOTAL TOTAL PAYMENTS AMOUNT DUE $268.91 $o.oo $268.91 Please write the above account number on your check and make your check payable to Black and Davison **THANK YOU** BUREAU OF INDIVIDUAL TAXES 1NHERTTANCE TAX DTVTSTON DEPT. 280601 HARR/SBUR% PA 17128-0601 ROBERT C SCHOLLAERT BLACK & DAVISON 82 N QUEEN ST CHAHBERSBUR$ COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX PA !17201 RE¥-15~7 EX AFP DATE 11-17-2005 ESTATE OF KEEFER DATE OF DEATH 01-05-2005 FILE NUHBER 21 05-0053 COUNTY CUHBERLAND ACN 101 Amount Remitted DOROTHY E HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGTSTER OF NTLLS CUHBERLAND CO COURT HOUSE CARLTSLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF KEEFER DOROTHY E FILE NO. 21 03-0053 ACN 101 DATE 11-17-2003 TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) ($) 4. Hortgages/Notes Receivable (Schedule D) (4) S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Nortgaga Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Net Value of Tax Return 911.04 21~796.34 .00 .00 NOTE: To insure proper .00 credit to your account, submit the upper portion .00 of this fore with your tax payment. (8) 12,819.81 15. 1~.. NOTE: ASSESSHENT OF TAX: 15. 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 TAX CREDITS: PAYMENT R/CEIPT DISCOUNT (+) DATE NUMBER TNTEREST/PEN PAID (-) 24,071.82 13,604.74 (11) 2~ .42~. 55 (12) 2,352.73- Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13) . O0 Net Value of Estate Subject to Tax (14) Z,352.73- ]:f an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~ill reflect f/gures that include the total of ALL returns assessed to date. IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (15) .00 x O0 = .00 (16) .00 x 045= .00 (17) . O0 x 12 : . O0 (,,8) .00 x 15 = .00 (19)= . O0 AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 ( TF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CRED/T" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such futura interest. To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (TZ P.S. Section 91q0). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF RILLS, AGENT A refund of a tax credit) which was not requested on the Tax Return) may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills, any of the Z$ Revenue District Offices) or by calling the special gq-hour answering service for forms ordering: 1-800-56Z-gOSO; services for taxpayers with special hearing and / or speaking needs: Z-800-qq7-sozg (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue) Board of Appeals, Dept. g810gl, Harrisburg, PA 17lIS-lOg1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes) ATTN: Post Assessment Review Unit, Dept. gS060l, Harrisburg) PA 17lIS-060! Phone (717) 787-6505. See page S 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 (5) calendar months after the decadent's death) a five percent (SI) discount of the tax paid is allowed. The lex 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 and of the tax amnesty period. This non-participation 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 on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one Il) day from the date of death, to the date of payment. Taxes which became delinquent before January 1) 198Z bear interest at the rate of six (SI) percent per annum calcuIated at a daily rate of .OOOiSq. AIl taxes which became delinquent on and after January 1, 198Z will bear interest et · 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 198g through ZOO3 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198Z gOZ .OOOSq8 1987 9Z .OOOgq7 1999 7Z .OOO19Z 1983 16Z .OOOq38 1988-1991 IIZ .000301 gOOO 8Z .000219 198q llZ .OD0301 199Z 9Z .O00Zq7 ZOOZ 9Z .O00Zq7 1985 13Z .000356 1993-199q 7Z .00019Z ZOOZ 6Z .00016q 1986 iOZ .O00Z7q 1995-1998 9Z .O00Zq7 ZOO3 5Z .0001~7 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPATD X NUNBER OF DAYS DELTNQUENT X DALLY TNTEREST 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 sade after the interest computation date shown on the Notice, additional interest must bm calculated. ARTHUR K. OILS DIANE M. OILS 0~&0~ ATTORNEYS AT LAW 1017 NORTH FRONT STREET HARRISBURG, PENNSYLVANIA 17102 PHONE (717) 233-8743 FAX: (717) 233-2567 June 21, 2005 Cumber1an County Register of Wills ATTN: 01 nda Farner Strasbaugh Cumberlan County Courthouse One Court ouse Square Carlisle, P 17013 RE: Estate of Alfreda L. Williamson No. 21-2003-553 Dear Ms. S rasbaugh: Enclosed a e an original and one copy of a Motion to Make Rule Absolute to be filed in you office in connection with the above-captioned action. Also enclos d is a self-addressed, stamped envelope to return the copy to me after considerati n by the Court. Thank you or your assistance in this matter. DMD/daf Enclosures Y~~ruly yours, cc: Sharo B. Williamson (with enclosure) '1 "-,) In Re: Esta e of ALFREDA L. WILLIAMSON Late of HAMPDEN TOWNSHIP ORPHANS' COURTDIVISIW COURT OF COMMON PLE~$ OF CUMBERLAND COUNTY, PENNSYL VANIA ) .1 Estate No.: 1-03-553 '""'-' NO. 21-2003-53 MOTION TO MAKE RULE ABSOLUTE AN NOW, this 21 st day of June 2005, comes Diane M. Dils, Esquire, and respectfull avers the following: 1. Yo r Movant is Diane M. Dils, Esquire, whose office is located at 1017 No h Front Street, Harrisburg, Pennsylvania 17102. 2. Yo r Movant filed a Petition to Withdraw as Counsel in connection with the bove-captioned action on May 12, 2005. 3. ay 16, 2005, your Honorable Court, the Honorable Edgar B. Bayley, ente ed a Rule returnable fifteen (15) days after service upon the Personal Rep esentative, Sharon B. Williamson, to show cause why, if any, said Peti ion should not be granted. 4. Atta hed hereto and marked Exhibit "A" is the return receipt signed by Joh R. Worley, agent for Sharon B. Williamson, at the address of 609 Grant Street, Palmyra, Pennsylvania 17078. Said mailing was rece'ved by John R. Worley on May 26, 2005. 5. Fi een days have elapsed since the service of the Petition to Withdraw as Co nsel and Rule. 6. No answer has been filed by the Personal Representative, Sharon B. Wi hamson. WH REFORE, your Movant, Diane M. Dils, Esquire, respectfully prays your Hon rable Court to grant this Motion making the Rule Absolute and permitting her to withdraw as counsel on behalf of the Estate of Alfreda L. Williamso . Respectfully submitted, BY: iane M. Dils, Esquire 1017 North Front Street Harrisburg, PAl 71 02 (717) 232-9724 I.D. No. 71873 . . '- C r -", Ceo !zcn~ o-<mQ. ~or-tD . C~ .,,~;;:z (joma . om' ~c:;~~ .0 -'" z (") ~j[ t.[)EFl: COMPLETE Tiff'; SI CTlON .. ~/\ pleteltem8 1,2, end 3. Alto oompltte 4 If Restrlct~ Delivery '- dealred. . Pri your name \and addreea on the TeV8lW 10 hat we~ Altum the card to, you. . ch this card to the bac~ ,of the mallpl~~ or n the front If apace perml1a. '.. Ie AddI'9S$8d to: B. O. Is dellvely address dlffenll1t from Item 11 If YES, enter delivery address below: .ol II.A' "- ~~ &o? ~~~ .~ PA I /707 F 3. ~'ce 'JYpe & Certified Mall 0 ExpI'8S8 Mall o Registered 0 Retum Receipt for Merchandise [J Insured Mall 0 C.O.D. 4. Reatrfcted Delivery? (Extra Fee) [J Yes ++--7001 '11"40 0000 9827 1360 DomeatIo Retum Receipt 1~*1540 VERIFICA TION I v rify that the statements made in this Motion to Make Rule A solute are true and correct. I understand that false stateme ts herein are made subject to the penalties of 18 Pa. 4904 relating to unsworn falsification to authorities. ~_Aj)& / Diane M. Dils, Esquire Date: June 21,2005 CERTIFICATE OF SERVICE I, Dane M. Dils, Esquire, hereby certify that a true and correct copy of the within M tion to Make Rule Absolute has been served upon the following individual y first class, United States mail, postage prepaid, by depositing same at the post of Ice in Harrisburg, Pennsylvania, on the 21 st day of June 2005, addressed as follows: Sharon B. illiamson 609 North rant Street Palmyra, P 17078 Respectfully submitted, BY: ffiM1/~tflL- / Diane M. Dils, Esquire 1017 North Front Street Harrisburg, P A 17102 (717) 232-9724 LD. No. 71873 Date: June 21, 2005