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HomeMy WebLinkAbout03-0058 PETITION FOR PROBATE and GRANT OF LETTERS Estate of P. atricia I. Cameron No. ~/-t~.~-x~"~ also known as To: Register of Wills for the County of EumlSerland Commonwealth of Pennsylvania Social Security No. 178 _ 38 - ~ 2 ~yceased. The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut in the last will of the above decedent, dated _ and codicil(s) dated in the rix named' September 7 19. 83 October 26~ 1999 ' Renunciation form for Co-Executrix, Patricia C. Nugent, included. (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C u m b e r 1 a n d County, Pennsylvania, with h er last'family or principal residence at 11 Hampton, Messiah Village, Mt. Allen'Drive, Mechanicsburg, PA 17055 (list street, number and muncipality) Decendent, then 97 years of age, died December 6, 2002 at Messia-~ Village, Mechanicsburg, 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 ~ncompetent: 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: 360,000.00 WHEREFORE, 'Petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters t e s t a m e n t a r ¥ · theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) Priscilla C. 'Oppenheimer 131 Bentley lane Iancaster~ P~ 17603 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA -I COUNTY OF LANCASTERj~ SS The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent P~titioner(s) will well and truly administer the estate according to,law. Sworn to or affirmed and subscribed ~=:t~1~./.~.~ ~~~~a~ before this 17th ~ me day of Q_~)c'x,~.?kd.ef Deputy Register S Estate 6f Patricia I. Cameron , Deceased DECREE OF PROBATE AND GRANT-OF LETTERS AND NOW ~~, ~m,% ' ' ~1~,~~°~, in consideration of the petition.on the .reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 9/7/1983 and 10/26/i'999 described therein be admitted to p~obate and filed of record as the last will of Patricia I. Cameron ; and Letters Testamentary are hereby granted'to P r i s c i 11 a C. Oppenhei'mer Probate, Letters,' Etc. Se~uOrt Certificates( ) ...... nciafion ................ - .TOTAL __ ..... ............... . David P. Carson"~ '83843' , A .'I~rORNEY (Sup. Ct. LD. NO.') 220.1 Oregon Pike~ Ianca. ster, PA ADDRESS 17601 717) 569-3850, 569-2311 PHONE RENUNCIATION In Re Estate of Patricia I. Cameron deceased. To the Register of Wills of. Cumberland County, Pennsylvania. The undersigned Patricia C. Nugent, Co-Executrix of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters Testamentary Priscilla C. Oppenheimer be issued to WITNESS my hand this --~ day of (Signature) 2401 Washington Avenue Santa Monica, CA 90403 (Address) (Signature) (Address) (Signature) (Address) SOLE CODICIL OF PATRICIA I. CAMERON I, Patricia I. Cameron, of Upper Allen Township, Cumberland County, Pennsylvania, do hereby ratify, confirm and republish the provisions of my Last Will and Testament, dated September 7, 1983, the sole purpose of this codicil being to make my aforesaid Last Will and Testament self-proving. I further declare this to be the sole codicil to the aforesaid Last Will and Testament. IN WITNESS WHEREOF, I have executed this codicil this ,2ff-fi~day of (~~ ., 1999. PATRICIA I. CAMERON SIGNED, SEALED, PUBLISHED, and DECLARED by PATRICIA I. CAMERON as and for the Sole Codicil to her Last Will and Testament, dated September 7, 1983 on the day and year last above written, in the presence of us, who, at her request, in her presence, and in the presence of each other, all being present at the same time, have hereunto subscribed our names as witnesses: SELF-PROVING AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA · COUNTY OF CUMBERLAND · SS. WE, PATRICIA I. CAMERON, Thomas E. Wood , and Patricia D. Olyarnik , the Testator and the witnesses, respectively, whose names are signed to the attached instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as her Sole Codicil to her Last Will and Testament dated September 7, 1983, and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Sole Codicil as witness and to the best of his or her knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. PATRICIA I. CAMERON, Testator and subscribed and sworn to before me by Thomas E. Wood Patricia D. Olyarnik ,witnesses, this 26thday of October, 1999. Subscribed, sworn to, and acknowledged before me by PATRICIA I. CAMERON, the Testator, , and ' Notarial Seal I _ Cynthia j. Rule, Notary Public I . .Ca_m/~ Hilt Bore, Cumberland C e'OI/..I 'Vd 'oblnggl~l~lYH .L.q3blJ.S irllN"IV~ OI;~-~Og -IYHY~ QNY Ng-I-IV "(]00/¥~ *~l':l.~l':r:l~,l 'bs~ 'pooM 'H me~II~M LAST WILL AND TESTAMENT OF PATRICIA I. CAMERON I, PATRICIA I. C~4ERON, of Camp }{ill, Cumberland County, Pennsylvania, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all Wills or Codicils thereto, by me at anytime heretofore made. ITEM I. I order and direct that all my just debts and funeral expenses be paid out of my estate by my Co-Executrices hereinafter named, as soon as may conveniently be done after my death. ITEM II. I give, devise and bequeath all the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, to my two children, PRISCILLA C. OPPENHEIMER and PATRICIA C. NUGENT, in equal shares, absolutely; Provided that, if either of my two children should not survive me, my residuary estate shall pass to my then living issue, per stirpes. ITEM III. It is my wish that, in distributing my re- siduary estate under ITEM II hereof, my Co-Executrices shall deliver certain items of my tangible personal property in accord- ance with a list which will be in my safe deposit box, the receipt of such items to be considered a part of whatever share of my estate the respective recipients are entitled to receive hereunder. Witnesses: (SEAL) ITEM IV. Ail estate, inheritance, legacy, succession or transfar taxes (including any interest and penalties thereon) imposed by any domestic or foreign laws now or hereafter in force with respect to all property taxable under such laws by reason of my death, whether or not such property passes under this, my Will, and whether such taxes be payable by my estate or by any recipient of any such property, shall be paid by my Co-Executrices out of my general estate as part of the expense of the adminis- tration thereof, with no right of reimbursement from any recipient of any such property. ITEM V. I hereby nominate, constitute and appoint my two daughters, PRISCILLA C. OPPENHEIMER and PATRICIA C. NUGENT, as Co-Executrices of this, my Last Will and Testament. In the event either of them shall fail to qualify or cease to act as Co-Executrice, then the other shall have full power to act as sole Executrix. Neither one of them shall be required to give any bond or security in connection with the administration of my estate. ITEM VI. Any property which becomes distributable under ITEM II of this Will to a minor shall be held by C.C.N.B. BANK, N.A. of New Cumberland, Cumberland County, Pennsylvania, or its successor or successors by any merger, conversion or consolidation, as Guardian (SEAL) -2- for such minor during minority. In the case of any such minor, the Guardian may, during minority, apply such amounts of income therefrom as, in its sole discretion, it deems proper for the support, education and welfare of such minor and shall accumulate any unexpended balance of income. Such amounts may be applied directly or may be paid to the person who has the care and control of such minor, without the intervention of any guardian. The Guardian shall not be obligated to supervise or inquire into the application of such amounts by any person receiving them, and the receipt of such person shall be a complete release of the Guardian. Should the amount thus held in Guardianship for any such minor, in the sole opinion of the Guardian, be or become too small to warrant thus holding such fund, or should its administration be or become impractical for any other reason, the Guardian, in its sole discretion, may pay such amount, absolutely, to the parent or other person maintaining said minor, or may deposit such share in the minor's name in a savings account in a savings in- stitution of its choosing, payable to the minor at majority. ITEM VII. I hereby expressly authorize and empower my Co-Executrices and confer sole and absolute discretion upon them: (1) To purchase or otherwise acquire, and to retain, whether originally a part of my estate or subsequently acquired, any and all stocks, bonds, notes or other securities, or any variety of real or personal property, including stocks or interests in (SEAL) investment trusts and common trust funds as may be deemed advisable whether or not such investments be of such character as to constitute legal investments by fiduciaries. (2) To sell, lease, pledge, mortgage, transfer, ex- change, convert or otherwise dispose of, or grant options with respect to, any and all property at any time forming a part of my estate, in such manner, at such time or times, for such pur- poses, for such prices and upon such terms, credits and conditions as may be deemed advisable. Any lease made by my Executrices may extend beyond the period fixed by statute for leases made by fiduciaries. (3) To borrow money for any purpose connected with the protection, preservation or improvement of my general estate whenever it is deemed advisable, and as security to mortgage or pledge any real estate or personal property of which I may die seized or possessed or forming a part of my estate, upon such terms and conditions as may be deemed advisable. (4) To vote in person or by general or limited proxy with respect to any shares of stock or other securities held by them; to consent, directly or through a committee or other agent, to the reorganization, consolidation, merger, dissolution or liquidation of any corporation in which my estate may have any interest, or to the sale, lease, pledge or mortgage of any property by or to any such corporation; and to make any payments and to Wit~9, sses: -4- take any steps which may be deemed necessary or proper for obtaining the benefit of any such transaction. (5) To hold investments in the name of a nominee. (6) To complete, extend, modify or renew any loans, notes, bonds, mortgages, contracts or any other obligations which I may own or to which I may be a party or which may be liens or charges against any of my property or against my estate, although I may not be liable thereon, in such manner as may be deemed ad- visable; to pay, compromise, compound, adjust, submit to arbitra- tion, sell or release any claims or demands of my estate as may be deemed advisable, including the acceptance of deeds of real property in satisfaction of bonds and mortgages, and to make any payments in connection therewith which may be deemed advisable. (7) To make distribution of my estate in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share. (8) To execute and deliver any and all instruments in writing which they may deem advisable to carry out any of the foregoing powers. No party to any such instrument in writing signed by my Executrices shall be obliged to inquire into its validity or be bound to see to the application by the Executrices -5- (SEAL) of any money or other property paid or delivered pursuant to the terms of any such instrument. IN WITNESS WHEREOF, I, PATRICIA I. CAMERON, the Testatrix, have to this Last Will and Testament, written on six (6) sheets of paper, set my hand and seal this ~;~~ay of September, 1983. SIGNED, SEALED, PUBLISHED ) AND DECLARED by the above ) named PATRICIA I. CAMERON,) as and for her Last Will ) and Testament in the ) presence of us who have ) hereunto subscribed our ) names at her request as ) witnesses thereto, in the ) presence of the said ) Testatrix and of each ) other. ) ) ) PATRICIA I. CAMERON (SEAL) -6- SOLE CODICIL OF PATRICIA I. CAMERON KEEFER WOOD ALLEN & RAHAL, LLP 415 FALLOWFIELD ROAD CAMP HILL, PA 17011 (717) 612-5800 Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Patricia I. Cameron Date of Death: December 6, 2002 Will No. 2003 - 00058 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration 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 1/30/2003 : Name Ad,ess Priscilla C. Oppenheimer 131 Bentley lane lancaster, PA 17603 Patricia C. Nugent 2401 Washington Avenue Santa Monica, CA 90403 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Signature Name David P. Carson, Esquire Address 2201 Oregon Pike lancaster, PA 17601 Telephone (71]?) 569-3850, Capacity: __ Personal Representative 569-2311 x Counsel for personal representative DAVID P. CARSON Attorney At Law 2201 Orego~t Pike L,mcaater, PA 17601 (7t7) 569~3850 , (717) 569-2655 Fax DAVI, D P, ~ARgON, $. D., CPA February 27, 2003 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA ].7013 Re: Estate of Patricia I. Cameron Pile No. 2003-00058 Date of Death 12/06/2002 SSN 178-38-5297 Dear Sirs: Please find enclosed a check in the amount of $16,000.00 for estimated inheritance tax for the above estate. Please acknowledge receipt of this check on the enclosed copy of this letter. Please return the copy of this letter to me in the enclosed self-addressed, stamped envelope. Thank you. Sincerely, David P. Carson David P. Carson 2201 Oregon Pike Lancaster, PA 17601 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 002239 OPPENHEIMER PRISCILLA C 131 BENTLEY LANE LANCASTER, PA 17603 fold ESTATE INFORMATION: SSN: 178-38-5297 FILE NUMBER: 2103-0058 DECEDENT NAME: CAMERON PATRICIA I DATE OF PAYMENT: 02/28/2003 POSTMARK DATE: 02/27/2003 COUNTY: CUMBERLAND DATE OF DEATH: 12/06/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 816,000.00 TOTAL AMOUNT PAID: · ~ 16,000.00 REMARKS: PRICILLA C OPPENHEIMER SEAL CHECK# 99 INITIALS: AC RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND U: being duly sworn Executrix late of ___Upp_er Allen Priscilla C. Oppenheimer according to law, deposes and says thafs he is of +he Estate of Patricia I. Cameron Township_ -, Cumberland County, Pa., deceased and that the within is an inventory made by Priscilla C. Oppenheimer , the said Executrix of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedenf's death. and subscribed before me, 19 Execu.or . Admlnle~ra~or 131 Bentley lane lancaster, PA 17603 Address Date of Death 6 December 2002 Day Month Year INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed wifhln thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. inventory of the real and personal estate of Patricia I. Cameron deceased Common stock- American Electric Power, 110 shares Common stock Avaya, 75 shares Common stock- Comcast, 339 shares Common stock' Citizens and Northern Bank, 5131 shares Convertible preferred stock- Fortune Brands, 55 shares Comm stockd Harsco, 822 shares Common stock-lucent, 904 s~ares Common stock- P,P & i, 400 shares Common stock- A, T & T, 210 shares Common stock~ United Technologies, 960 shares Common stock-Wachovia Bank, 1,952 shares Mutual fund- Nuveen, large Cap Fund, 95 shares Checking account, PNC Bank, account number 50-7010-5572 Personal effect-clothing, etc. Total 2,940 221 7,383 57,726 14,624 24,520 1,455 12,800 5,840 58,896 68,651 1,743 42,027 450 ~99,280 30 25 42 94 5O 26 44 00 10 00 64 25 47 00 57 DAVID P. CARSON Atto~rmy At L~w 2201 Orego~t Pike Lancaster, PA 1760 l (7~.7) $~9~-~0 , (717) 569-2655 F~x DAVID P. CAR~ON, ,% D., CPA September 3, 2003 Register of Wills Cum~.erland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Patricia I. Cameron ~ile No. 2003-00058 Date of Death 12/06/2002 SSN 178-38-5297 Dear Sirs: Please find enclosed the inheritance tax return and a check in the amount of $431.04 for the final inheritance tax for the above estate. I have also enclosed a check'in the amount of $15.00 for the filing fee. Please acknowledge receipt of this tax return and checks on the enclosed copy of this letter. Please return the copy of this letter to me in the enclosed self-addressed, stamped envelope'. Thank you. Sincerely, David ?. Carson COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 002975 CARSON DAVID P 2201 OREGON PIKE LANCASTER, PA 17601 ........ fold ESTATE INFORMATION: SSN: 178-38-5297 FILE NUMBER: 2103-0058 DECEDENT NAME: CAMERON PATRICIA I DATE OF PAYMENT: 09/04/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/06/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 9431.04 TOTAL AMOUNT PAID' 9431.04 REMARKS: PRISCILLA C OPPENHEIMER C/O DAVID P CARSON SEAL CHECK# 1005 INITIALS: DO RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS 217 REV-1500 EX (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT, 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21-03-0058 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER CAMERON, PATRICIA I. 178-38-5297 I- :~ )ATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ~ 12/6/2002 7/11/1905 REGISTER OF WILLS ~ IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 0 0 Z '---]1. Original Return E~4. Limited Estate E~]6. Decedent Died Testate (Attach copy of Will) r--] 9. Litigation Proceeds Received NAME DAVID P. CARSON, ESQUIRE FIRM NAME (If Applicable) TELEPHONE NUMBER 717-569-3850 El2. Supplemental Return E~4a. Future Interest Compromise (date of death after 12-12-82) El7. Decedent Maintained a Living Trust (Attach copy of Trust) E~]10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) COMPLETE MAILING ADDRESS 2201 OREGON PIKE LANCASTER, PA 17601 E~3. Remainder Return (date of death pdor to 12-13-82) ~-'--"] 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes E~I 1. Election to tax under Sec. 9113(A) (Attach Sch O) 1. Real Estate (Schedule A) (1) NONE 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) NONE 4. Mortgages& Notes Receivable (Schedule D) (4) NONE 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Properly (Schedule F) (6). NONE [~ Separate Billing Requested 7. Inler-Vivos Transfer & Miscellaneous Non-Probate Property (Schedule G or L) (7) NONE 8. TOTAL GROSS ASSETS (total Lines 1-7') (8) 9. Funeral Expenses & Adminislralive Costs (Schedule H) (9) 10. Debts of Decedent, Modgage Liabilities, & Liens (Schedule I) 10) 11. TOTAL DEDUCTIONS (total Lines 9 & 10) (11) 12. NET VALUE OF ESTATE (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (13) 14. Net Value Subjecl to Tax (Line 12 minus Line 13) (14) 357455.82 42639.90 OFFICIAL USE ONLY 400095.72 7522.70 8725.85 16248.55 383847.17 383847.17 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amounl cf Line 14 taxable at the spousal tax rale ,or transfers under Sec.9116 (a)(1.2) X .0 __ (15) 16. Amount of Line14 taxable at lineal rate 383847.17 X .0 45 (16) 17. Amount of Line 14 taxable at sibling rate x . 12 (17) 18. Amounl of Line 14 taxable at collateral rate X .1 5 (18) (19) 19. Tax Due >;i> ~ ~O-A~ ~ ~S~ION$ ON REVERSE SI DE AND RECHECK MA~H < < 17273.12 17273.12 217 CAMERON, PATRICIA I. Decedent's Complete Address: ISTREET ADDRESS SSIAH VILLAGE, MT. ALLEN DRIVE I MECHANICSBURG 178-38-5297 STATE ZIP 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 Inlerest/Penalty if applicable D. Interest E. Penalty 16000.00 842.08 (1) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (4) If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter lhe total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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; ........... [~ E~ c. retain a reversionary interest; or .............................. [~ E~ d. receive the promise for life of either payments, benefits or care? ................. [~ [] 2. If death occurred after December 12,1982,did decedent Iransfer property within one year of dealh 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. 17273.12 16842.08 431.04 431.04 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, and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowted,qe. /I'S~'"lq'~URE OF PERSON RESP~.SlBLE FOR FILING RETURN DATE ~-¢~DRESS '"--7i,/- b/ ' ' 131 BENTLEY LANE, LANCASTER, PA 17603 S~T~E PARE~_~RE PR ES E NTATIVE ADDRESS 2201 OREGON PIKE~ LANCASTER, PA 17601 DATE For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transl~ers to or for the use of the surviving spouse is 3% [72 P.S. Section 9116 (a)(1.1)(i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 096 [72 P.S. Section 911§ (a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0%[72 P.S Section 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. Section 9116(1.2) [72 P.S. Section 9115(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 Section 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 217 REV-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER PATRICIA I. CAMERON 21-03-0058 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. COMMON STOCK-AMERICAN ELECTRIC POWER, 110 SHARES, FMV $26.73 PER SHAR COMMON STOCK-AVAYA, 75 SHARES, FMV $2.95 PER SHARE COMMON STOCK-COMCAST, 339 SHARES, FMV $21.78 PER SHARE COMMON STOCK-CITIZENS AND NORTHERN BANK, 5131 SHARES, FMV $30.74 PER SH CONVERTIBLE PREFERRED STOCK-FORTUNE BRANDS, 55 SHARES, FMV $265.90 PER COMMON STOCK-HARSCO, 822 SHARES, FMV 29.83 PER SHARE COMMON STOCK-LUCENT, 904 SHARES, FMV $1.61 PER SHARE COMMON STOCK-P, P & L, 400 SHARES, FMV $31.61 PER SHARE COMMON STOCK-A, T & T, 210 SHARES, FMV $27.81 PER SHARE COMMON STOCK-UNITED TECHNOLOGIES, 960 SHARES, FMV $61.35 PER SHARE COMMON STOCK-WACHOVIA BANK, 1952 SHARES, FMV $35.17 PER SHARE MUTUAL FUND-NUVEEN LARGE CAP FUND, 95 SHARES EX-DIVIDEND AMOUNT-AMERICAN ELECTRIC POWER EX-DIVIDEND AMOUNT-UNITED TECHNOLOGIES EX-DIVIDEND AMOUNT-WACHOVIA BANK TOTAL (Also enter on line 2, Recapitulation) (If more space is needed, insert additional sheets of the same size) 2940.30 221.25 7383.42 157726.94 14624.50 24520.26 1455.44 12644.00 5840.10 58896.00 68651.64 1743.25 66.00 235.20 507.52 357455.82 AT RE~-1508 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER PATRICIA I. CAMERON 21-03-0058 Incl~e the proceeds of litigation and the date the proceeds were received by the estate. ALL PROPERTY JOINTLY-OWNED WI]Ti 'n~E RIGHT OF SURVIVORSHIP MUST BE DISCLOSED ON SCHEDULE F ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH CHECKING ACCOUNT-PNC BANK, ACCOUNT NUMBER 50-7010-5572 PERSONAL EFFECTS-CLOTHING, ETC. HEALTH INSURANCE REFUND-PA BLUE CROSS/BLUE SHIELD TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 42027.47 450.00 162.43 42639.90 217 REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF PATRICIA I. CAMERON FILE NUMBER 21-03-0058 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION 5. 6. 7. 8. 9. FUNERAL EXPENSES: CREMATION SOCIETY, NEWSPAPER ARTICLES ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address city Year(s) Commission Paid: Slale Zip Attorney Fees 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 Decedenl Probate Fees Accountant's Fees Tax Return Preparer's Fees MAILING OF WILL EXPENSE-KEEFER WOOD ALLEN & RAHAL LLP ESTATE ADVERTISING FEE-CUMBERLAND LAW JOURNAL ESTATE ADVERTISING FEE-CARLISLE SENTINEL TOTAL (Also enter on line 9, Recapitulation', (If more space is needed, insert additional sheets of the same size) AMOUNT 263.50 6000.00 486.50 600.00 9.27 75.00 88.43 7522.70 F~EV-1512 EX+ (6-98) AT COMMONWEALTH OFPENNSYLVANIA INHERITANCE TAXRETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER PATRICIA I. CAMERON 21-03-0058 Include unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH PHARMERICA-DRUGS AND MEDICINES MESSIAH VILLAGE-NURSING CARE SERVICES YEAR 2002 PENNSYLVANIA INDIVIDUAL INCOME TAX 253.35 8402.50 70.00 8725.85 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 217 REV-1513 EX + (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER PATRICIA I. CAMERON 21-03-0058 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY CHILD CHILD TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] PRISCILLA C. OPPENHEIMER 131 BENTLEY LANE LANCASTER, PA 17603 PATRICIA C. NUGENT 2401 WASHINGTON AVENUE SANTA MONICA, CA 90403 5O% TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18~ AS APPROPRIATE~ ON REV-1500 COVER SHEET RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE 50% LAST WILL AND TESTAMENT OF PATRICIA I. CA2,~RON I, PATRICIA I. C~4ERON, of Camp Hill, Cumberland County, Pennsylvania, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all Wills or Codicils thereto, by me at anytime heretofore made. ITEM I. I order and direct that all my just debts and funeral expenses be paid out of my estate by my Co-Executrices hereinafter named, as soon as may conveniently be done after my death. ITEM II. I give, devise and bequeath all the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, to my two children, PRISCILLA C. OPPENHEIMER and PATRICIA C. NUGENT, in equal shares, absolutely; Provided that, if either of my two children should not survive me, my residuary estate shall pass to my then living issue, per stirpes. ITEM III. It is my wish that, in distributing my re- siduary estate under ITEM II hereof, my Co-Executrices shall deliver certain items of my tangible personal property in accord- ance with a list which will be in my safe deposit box, the receipt of such items to be considered a part of whatever share of my estate the respective recipients are entitled to receive hereunder. Witnesses: .',.~ -~-~., . /'~ ./ I ,'; . (SEAL) ITEM IV. Ail estate, inheritance, legacy, succession or transfar taxes (including any interest and penalties thereon) imposed by any domestic or foreign laws now or hereafter in force with respect to all property taxable under such laws by reason of my death, whether or not such property passes under this, my Will, and whether such taxes be payable by my estate or by any recipient of any such property, shall be paid by my Co-Executrices out of my general estate as part of the expense of the adminis- tration thereof, with no right of reimbursement from any recipient of any such property. ITEM V. I hereby nominate, constitute and appoint my two daughters, PRISCILLA C. OPPENHEIMER and PATRICIA C. NUGENT, as Co-Executrices of this, my Last Will and Testament. In the event either of them shall fail to qualify or cease to act as Co-Executrice, then th~ other shall have full power to act as sole Executrix. Neither one of them shall be required to give any bond or security in connection with the administration of my estate. ITEM VI. Any property which becomes distributable under ITEM II of this Will to a minor shall be held by C.C.N.B. BANK, N.A. of New Cumberland, Cumberland County, Pennsylvania, or its successor or successors by any merger, conversion or consolidation, as Guardian Wi~esses: (SEAL) -2- for such minor during minority. In the case of any such minor, the Guardian may, during minority, apply such amounts of income therefrom as, in its sole discretion, it deems proper for the support, education and welfare of such minor and shall accumulate any unexpended balance of income. Such amounts may be applied directly or may be paid to the person who has the care and control of such minor, without the intervention of any guardian. The Guardian shall not be obligated to supervise or inquire into the application of such amounts by any person receiving them, and the receipt of such person shall be a complete release of the Guardian. Should the amount thus held in Guardianship for any such minor, in the sole opinion of the Guardian, be or become too small to warrant thus holding such fund, or should its administration be or become impractical for any other reason, the Guardian, in its sole discretion, may pay such amount, absolutely, to the parent or other person maintaining said minor, or may deposit such share in the minor's name in a savings account in a savings in- stitution of its choosing, payable to the minor at majority. ITEM VII. I hereby expressly authorize and empower my Co-Executrices and confer sole and absolute discretion upon them: (1) To purchase or otherwise acquire, and to retain, whether originally a part of my estate or subsequently acquired, any and all stocks, bonds, notes or other securities, or any variety of real or personal property, including stocks or interests in investment trusts and common trust funds as may be deemed advisable whether or not such investments be of such character as to constitute legal investments by fiduciaries. (2) To sell, lease, pledge, mortgage, transfer, ex- change, convert or otherwise dispose of, or grant options with respect to, any and all property at any time forming a part of my estate, in such manner, at such time or times, for such pur- poses, for such prices and upon such terms, credits and conditions as may be deemed advisable. Any lease made by my Executrices may extend beyond the period fixed by statute for leases made by fiduciaries. (3) To borrow money for any purpose connected with the protection, preservation or improvement of my general estate whenever it is deemed advisable, and as security to mortgage or pledge any real estate or personal property of which I may die seized or possessed or forming a part of my estate, upon such terms and conditions as may be deemed advisable. (4) To vote in person or by general or limited proxy with respect to any shares of stock or other securities held by them; to consent, directly or through a committee or other agent, to the reorganization, consolidation, merger, dissolution or liquidation of any corporation in which my estate may have any interest, or to the sale, lease, pledge or mortgage of any property by or to any such corporation; and to make any payments and to Wit. s ses: -4- take any steps which may be deemed necessary or proper for obtaining the benefit of any such transaction. (5) To hold investments in the name of a nominee. (6) To complete, extend, modify or renew any loans, notes, bonds, mortgages, contracts or any other obligations which I may own or to which I may be a party or which may be liens or charges against any of my property or against my estate, although I may not be liable thereon, in such manner as may be deemed ad- visable; to pay, compromise, compound, adjust, submit to arbitra- tion, sell or release any claims or demands of my estate as may be deemed advisable, including the acceptance of deeds of real property in satisfaction of bonds and mortgages, and to make any payments in connection therewith which may be deemed advisable. (7) To make distribution of my estate in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share. (8) To execute and deliver any and all instruments in writing which they may .deem advisable to carry out any of the foregoing powers. No party to any such instrument in writing signed by my Executrices shall be obliged to inquire into its validity or be bound to see to the application by the Executrices -5- (SEAL of any money or other property paid or delivered pursuant to the terms of any such instrument. IN WITNESS WHEREOF, I, PATRICIA I. CAMERON, the Testatrix, have to this Last Will and Testament, written on six (6) sheets of paper, set my hand and seal this M~~ay of September, 1983. SIGNED, SEALED, PUBLISHED AND DECLARED by the above named PATRICIA I. CA~RON,) as and for her Last Will and Testament in the presence of us who have hereunto subscribed our names at her request as witnesses thereto, in the presence of the said Testatrix and of each other. / ~ PATRICIA I. CAS~RON (SEAL) -6- SOLE CODICIL OF PATRICIA I. CAMERON I, Patricia I. Cameron, of Upper Allen Township, Cumberland County, Pennsylvania, do hereby ratify, confirm and republish the provisions of my Last Will and Testament, dated September 7, 1983, the sole purpose of this codicil being to make my aforesaid Last Will and Testament self-proving. I further declare this to be the sole codicil to the aforesaid Last Will and Testament. IN WITNESS WHEREOF, I have executed this codicil this ,,2b'Tr~day of (~k~v" ,1999. SIGNED, SEALED, PUBLISHED, and DECLARED by PATRICIA I. CAMERON as and for the Sole Codicil to her Last Will and Testament, dated September 7, 1983 on the day and year last above written, in the presence of us, who, at her request, in her presence, and in the presence of each other, all being present at the same time, have hereunto subscribed our names as witnesses: SELF-PROViNG AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA · · SS. COUNTY OF CUMBERLAND · WE, PATRICIA I. CAMERON, Thomas E. Wood , and Patricia D. Olyarnik , the Testator and the witnesses, respectively, whose names are signed to the attached instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as her Sole Codicil to her Last Will and Testament dated September 7, 1983, and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Sole Codicil as witness and to the best of his or her knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. PATRICIA I. CAMEROlq, Testator w' ess Witness Subscribed, sworn to, and acknowledged before me by PATRICIA I. CAMERON, the Testator, and subscribed and sworn to before me by Thomas ~.. Wood , and ?atr±c±a D. Olyarn±k , witnesses, this 26tl-day of October, 1999. Not'ky Public /~-//~- BUREAU OF INDIVIDUAL TAXES TNHERZTANCE TAX DZVTSTON DEPT. Z80601 HARRISBURG, PA 171Z8-0601 DAVID P CARSON ESQ 2201 OREGON PIKE LANCASTER PA 1760.1 COMMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOT/CE OF /NHERZTANCE TAX APPRA/SENENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1Gci7 EX ~FP (01-DS) DATE 10-21-2003 ESTATE OF CAMERON DATE OF DEATH 12-06-2002 FILE NUHBER 21 03-0058 ~COUNTY CUMBERLAND ACN 101 I Amoun~ Ramified PATRICIA I HAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS L]:NE l~ RETAIN LOWER PORT:ZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF ZNHER]:TANCE TAX APPRA:ZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF CAMERON PATRICIA I F]:LE NO. 21 03-0058 ACN 101 DATE 10-21-Z003 TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVAT]:ON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON= ORIGINAL RETURN 1. Real Es~a*e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par~nersh/p Zn~ares~ (Schedule C) (3) 4. Not,gages/No,es Reca/vable (Schedule D) (q) 5. Cash/Bank Depos/~s/H/sc. Personal Proper~y (Schedule E) (5) 6. Jo/n~ly Owned Propar~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al AssaYs APPROVED DEDUCTXONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Cos~s/H/sc. Expenses (Schedule H) (9) 10. Deb~s/Hor~gage L/abilities/L/ems (Schedule Z) (10) 11. To,al Deductions 12. Ne~ Value of Tax Re~urn 357/~55.82 .00 ~2,639.90 .00 .00 NOTE: To /nsure proper crad/~ ~o your account, subm1* ~he upper por*ion .00 of ~h/s form wi~h your ~ax payment. .00 (8) 7,522.70 ~00,095.72 8.725.85 (11) (12) 383,8~7.17 1:5. NOTE: CharA~able/Oovernmen~:al Bequests; Non-elected 9113 Trusts (Schedule J) (15) Ne~ Value of Es*a~e Subjec~ ~o Tax (1~) ~f an assess, ent ~as issued previously, lines 1~, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. .00 383,8~7.17 18 and 19 will (15), .00 x O0 = .00 (16) 383,8R7.17 x OR5= 17,273.12 (17), .00 X 1Z = .00 (lB) .00 x 15 = .00 (19)= 17,273.12 AHOUNT PAID ASSESSNENT OF TAX: 15. Amoun~ of L/ne 1~ a~ Spousal re~a 16. Amoun~ of L/ne 1~ ~axabla a~ LLnael/Class A ra~e 17. Amoun~ of L/ne 14 a~ Sibling ra~e 18. Amoun~ of L/ne 1~ ~axable a~ Collateral~Class B ra~e 19. Pr/nci~al Tax Due TAX CREDZTS: PAYHENT RECEZPT DISCOUNT DATE NUHBER INTEREST/PEN PA/D (-) 02-27-2003 CD002239 8~Z.11 09-0~-2003 CD002975 .00 16,000.00 ~31.0~ TOTAL TAX CREDXT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 17,273.15 · 03CR .00 · 03CR ( TF TOTAL DUE TS LESS THAN $1, NO PAYNENT 'rs REI~U'rRED. 'rF TOTAL DUE 'rS REFLECTED AS A "CRED'rT" {CR}, YOU NAY BE DUE A REFUND. SEE REVERSE STDE OF TH'rS FORN FOR 'rNSTRUCTTONS. } RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRAT/VE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class S (collateral) beneficiaries of tho decedent after the expiration of any estate for life or for years, the Comaoneealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (collateral) rate on any such future interest. To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act 23 of 2000. (7Z P.S. Sectlon 91q0). Detach the top portion of this Notice and submit with your payment to the Ragistar of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NZLLS; 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 ers available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special gq-hour answering service for forms ordering: 1-800-562-Z050~ services for taxpayers with special hearing end / or speaking needs: 1-800-q47-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) es 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. 281021, Harrisburg, PA 17128-1021, 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. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sas page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (52) discount af the tax paid is allowed. The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax end interest that has been assessed as indicated on this notice. Interest is charged beginning uith first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent per annum calcuIatad at a daiIy rate of .OO016q. A11 taxes which became deIJnquent on and after January 1, 198g 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 2005 are: /nterest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 ZOZ .O005q8 1987 92 .O00Zq7 1999 7Z .000192 1983 162 .000q38 1988-1991 112 .000301 2000 8Z .000219 1984 112 .000501 1992 92 .000247 2001 92 .OOOZq? 1985 132 .000356 1995-1994 72 .OO019Z 2OOZ 6Z .000164 1986 102 .000274 1995-1998 92 .000247 2003 52 .000137 --Interest is calcuXatad as follows: ZNTEREST= BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELZNQUENT X DAZLY ZNTEREST 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 oust be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Patricia I. Cameron Date of Death: 12/06/2002 Will No.21-2003-0058 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 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: ///~/~ ~~ ~ Si~ffature _d David P. Carson~ Esquire Name (Please type or print) 2201 Oregon Pike ~n~t~r~ PA 17601 Address (717) 569-3850 Tel. No. Capacity: __Personal Representative __Counsel for personal representative (MAH:rmf/AM3) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of : : PATRICIA I. CAMERON : : Late of Upper Allen Township : : Deceased : No. 21-2003-0058 ACCOUNT RELEASE AGREEMENT We, the undersigned, being the heirs of the above Estate, hereby acknowledge receipt of the attached first and final Account, request that distribution be made in accordance with the computations therein contained, waive all rights to a formal court approved accounting, and accept all distributions as appear herein as proper, which are composed of cash, and securities and personal property in kind, in the amount below. Principal-receipts Principal-payments $400,047 . 48 33,338.78 $366,708.70 Income-receipts Income-expenses 8,921.26 .00 8,921.26 Total $375,629.96 TOT/AL FOR DISBURSEMENT WHICH CONSISTS OF: Cash distribution to heirs Securities and personal property in kind to heirs $ 20,227.14 355,402.82 Total $375,629.96 CASH DISTRIBUTION AS FOLLOWS: Priscilla C. Oppenheimer Patricia C. Nugent Total $ 10,109.19 10,117.95 $ 20,227.14 SECURITIES AND PERSONAL PROPERTY IN KIND DISTRIBUTION AS FOLLOWS: Priscilla C. Oppenheimer-105 common shares, A T & T Corporation Priscilla C. Oppenheimer-120 common shares, Agere Systems, Inc Class B Priscilla C. Oppenheimer-55 common shares, American Electric Power Company, Inc. Priscilla C. Oppenheimer-37 common shares, Avaya, Inc. Priscilla C. Oppenheimer-3,848 common shares, Citizens and Northern Corporation Priscilla C. Oppenheimer-170 common shares, Comcast Corporation, Class A Priscilla C. Oppenheimer-27 convertible preferred shares, Fortune Brands, Inc. Priscilla C. Oppenheimer-411 common shares, Harsco Corporation Priscilla C. Oppenheimer-452 common shares, Lucent Technologies, Inc. Priscilla C. Oppenheimer-200 common shares, PPL Corporation Priscilla C. Oppenheimer-480 common shares, United Technologies Corporation Priscilla C. Oppenheimer-976 common shares, Wachovia Corporation Priscilla C. Oppenheimer-personal effects, clothing, etc. Patricia C. Nugent-105 common shares, A T & T Corporation Patricia C. Nugent-9 common shares, Agere Systems, Inc. Class A Patricia C. Nugent-ll9 common shares, Agere Systems, Inc. Class B Patr±cia C. Nugent-55 common shares, American Electric Power Company, Inc. Patricia C. Nugent- 38 common shares, Avaya, Inc. Patricla C. Nugent-3,848 common shares, Citizens and Northern Corporation Patric~a C. Nugent-169 common shares, Comcast Corporation, Class A Patricia C. Nugent-27 convertible preferred shares, Fortune Brands, Inc. Patricla C. Nugent-411 common shares, Harsco Corporation Patric~a C. Nugent-452 common shares, Lucent Technologies, Inc. Patric~a C. Nugent-200 common shares, PPL Corporation $ 2,920.05 152.40 1,470.15 109.15 78,863.47 3,702.60 7,179.30 12,260.13 727.72 6,322.00 29,448.00 34,325.82 225.00 2,920.05 11.34 151.13 1,470.15 112.10 78,863.47 3,680.82 7,179.30 12,260.13 727.72 6,322.00 2 Patricia C. Nugent-480 common shares, United Technologies Corporation Patricia C. Nugent-976 common shares, Wachovia Corporation Patricia C. Nugent-personal effects, clothing, etc. 29,448.00~' 34,325.82~ 225.00 Total $355,402.82 And, therefore, we do hereby by these presents acknowledge such distribution for us as set forth and remise, release, quitclaim, and forever discharge Priscilla C. Oppenheimer, Executrix of the Estate of Patricia I. Cameron, deceased, of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof or of any other act, matter, cause, or thing whatsoever. And, further, we, the undersigned, as the heirs of the above captioned Estate, hereby covenant, promise, and agree to protect, exonerate, defend, indemnify, and save Priscilla C. Oppenheimer, Executrix, as aforementioned, harmless of and from any claims, liability, or actions, along with any expense in connection therewith, including counsel fees, arising or due from or under and by virtue of distribution made pursuant to this release, at my request, by Priscilla C. Oppenheimer, Executrix, aforementioned, in, lieu of any formal Adjudication by the above Court. This Agreement shall be governed by the lpws of the Commonwealth of Pennsylvania. IN WITNESS THEREOF, and with the intent of legally binding ourselves, our heirs, personal representatives, and assigns, we have hereunto set our hands and seals this day of ~C~/~ , 2003, adopting the seal following our signatures as our own. Da ted: C. ~enheimer , k] ( SEAL ) Patricia C. Nugent~ 3 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of PATRICIA I. CAMERON Deceased Date of death: December 6, 2002 Letters of Administration granted: First advertisement completed: No. 21-2003-0058 January 22, 2003 Cumberland Law Journal- February 14, 2003 The Sentinel- February 3, 2003 FIRST AND FINAL ACCOUNT OF PRISCILLA C. OPPENHEIMER, EXECUTRIX ESTATE OF PATRICIA I. CAMERON, DECEASED SUMMARY AND INDEX Principal-receipts Principal-payments $400,047.48 33,338.78 Income-receipts Income-expenses 8,921.26 .00 Net Balance COMPOSITION OF NET BALANCE Cash distribution to heirs: Priscilla C. Oppenheimer Patricia C. Cameron Securities and personal property distribution in kind to heirs: Priscilla C. Oppenheimer Patricia C. Cameron Total $366,708.70 8,921.26 $375, 629.96 $ 10,109.19 10,117.95 177,705.79 177,697.03 $375, 629.96 4 PRINCIPAL RECEIPTS 2002 Assets of decedent per Inventory $ 399,601.87 2003 January No transactions February No transactions March No transactions April 15 Nuveen-mutual fund principal distribution 25 Citizens and Northern Corporation-stock split, received 2,565 common shares 25 Citizens And Northern Corporation-cash in lieu of fractional shares 206.39 0.00 11.00 May 29 Miscellaneous principal receipt 20.00 June No transactions July No transactions August 18 Nuveen mutual fund, sold 95 shares sales price 1,631.15 cost 1,536.86 gain 26 Fortune Brands preferred stock, sold 1 share sales price 292.98 cost 265.90 gain 94.29 27.08 September 12 Miscellaneous principal receipt 86.85 Total $400,047.48 5 PRINCIPAL PAYMENTS 2003 January 28 Pharmerica-pharmacy invoice 28 Veterans-return of insurance 29 Messiah Village-nursing home invoice February 1 Cumberland Law Journal-estate advertising fee 24 Keefer, Wood, Allen & Rahal-fee to mail Will 24 Carlisle Sentinel-estate advertising fee 26 Register of Wills, Agent-estimated Pennsylvania inheritance tax March 7 Register of Wills-probate fees April 4 Cremation Society-services fee 4 Register of Wills-probate fees 4 Newspaper advertising fee May 22 Register of Wills-probate fees June No transactions July No transactions August No transactions September 3 Pennsylvania Department of Revenue-year 2002 individual income tax balance 3 Register of Wills, Agent-final Pennsylvania inheritance tax 3 Register of Wills-probate fees 3 David P. Carson, CPA-year 2002 individual income tax preparation October 6 Register of Wills-probate fees 253.35 109.80 8,402.50 75.00 9.27 88.43 16,000.00 18.00 251.80 413.50 11.70 10.00 70.00 431.04 15.00 390.00 35.00 November 30 Miscellaneous principal payments 30 David P. Carson, CPA-estate income tax preparation 30 David P. Carson, Esquire-attorney fees 30 Register of Wills-probate fees 212.39 210.00 6,315.00 17.00 Total TOTAL PRINCIPAL RECEIPTS TOTAL PRINCIPAL PAYMENTS NET PRINCIPAL $400,047.48 33,338.78 $366,708.70 $ 33,338.78 INCOME RECEIPTS 2003 January 28 28 28 28 28 28 28 28 28 28 PNC Bank-interest Verizon-dividend on common stock Wachovia-dividend on common stock Nuveen-dividend on mutual fund American Electric Power-dividend on common stock United Technologies Corporation-dividend on common stock Comcast Corporation-dividend on common stock Fortune Brands-dividend on preferred stock PPL Corporation-dividend on common stock Citizens and Northern Corporation-dividend on common stock February 24 Nuveen-dividend on mutual fund 24 AT & T Corporation-dividend on common stock 24 Harsco Corporation-dividend on common stock March 13 13 14 21 21 Fortune Brands-dividend on preferred stock United Technologies Corporation-dividend on common stock American Electric Power-dividend on common stock Wachovia-dividend on common stock Nuveen-dividend on mutual fund 121.33 4.96 507.52 9.54 66.00 235.20 16.08 36.71 144.00 1,549.41 19.10 39.38 215.78 36.71 235.20 66.00 507.52 9.94 7 April 1 11 11 15 21 28 PPL Corporation-dividend on common stock Nuveen-dividend on mutual fund Citibank N.A.-interest Nuveen-dividend on mutual fund Citizens and Northern Corporation-dividend on common stock Citizens and Northern Corporation-dividend on common stock May 1 9 15 15 30 AT & T Corporation-dividend on common stock Citibank N.A.-interest Harsco Corporation-dividend on common stock Nuveen-dividend on mutual fund Citizens Bank-interest June 10 10 10 13 16 16 3O American Electric Power-dividend on common stock Fortune Brands-dividend on preferred stock United Technologies Corporation-dividend on common stock Citibank N.A.-interest Wachovia-dividend on common stock Nuveen-dividend on mutual fund Citizens Bank-interest July 1 11 15 21 31 PPL Corporation-dividend on common stock Citibank N.A.-interest Nuveen-dividend on mutual fund Citizens and Northern Corporation-dividend on common stock Citizens Bank-interest August 1 AT & T Corporation-dividend on common stock 8 Citibank N.A.-interest 15 Nuveen-dividend on mutual fund 15 Harsco Corporation-dividend on common stock 29 Citizens Bank-interest September 10 American Electric Power-dividend on common 10 12 16 30 stock Fortune Brands-dividend on preferred stock Citibank N.A.-interest Citibank N.A.-interest Citizens Bank-interest 154.00 12.07 .01 8.35 1,077 . 51 538.65 39.38 .52 215.78 8.27 .46 38.50 36.71 259.20 1.39 566.08 8.40 6.87 154.00 1.47 8.30 1, 616.16 7.11 39.38 1.95 8.30 215.78 7.11 38.50 .67 3.61 .24 6.73 October 31 Citizens Bank-interest November 30 Citizens Bank-interest 30 Citizens bank-interest 6.82 6.60 6.00 Total TOTAL INCOME RECEIPTS TOTAL INCOME EXPENSES NET INCOME $ 8,921.26 .00 $ 8,921.26 $ 8,921.26 I, Priscilla C. Oppenheimer, accountant in the foregoing Account, affirm that the Account as stated is true and correct to the best of my knowledge and belief. · Op~nSe ime r 9 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of : : PATRICIA I. CAMERON : Late of Upper Allen Township : : Deceased : No. 21-2003-0058 INVENTORY SECURITIES AND PERSONAL PROPERTY Common stock-American Electric Power Company, Inc., 110 shares o Common stock-Avaya, Inc., 75 shares Common stock-Agere Systems, Inc. Class A, 9 shares Common stock-Agere Systems, Inc. Class B, 239 shares Common stock-Comcast Corporation Class A, 339 shares Common stock-Citizens and Northern Corporation, 5131 shares Common stock-Harsco Corporation, 822 shares Common stock-Lucent Technologies, Inc., 904 shares 9. Common stock-PPL Corporation, 400 shares 10. Common stock-A T & T Corporation, 210 shares 11. Common stock-United Technologies Corporation, 960 shares 12. Common stock-Wachovia Corporation, 1,952 shares 13. Convertible preferred stock-Fortune Brands, Inc., 55 shares 2,940.30 221.25 11.34 303.53 7,383.42 157,726.94 24,520.26 1,455.44 12,644.00 5,840.10 58,896.00 68,651.64 14, 624 . 50 10 14. Mutual fund-Nuveen PA Trust 15. Checking account-PNC Bank, account number 50-7010-5572 16. Personal effects-clothing, etc. 17. Health insurance refund-PA Blue Cross/Blue Shield 1,743.25 42,027.47 450.00 162.43 TOTAL $399,601 . 87 I, Priscilla C. Oppenheimer, Executrix of the Estate of Patricia I. Cameron, Deceased, affirm that the Inventory as stated is true and correct to the best of my knowledge and belief. C. OpPenheimer 11