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Home My WebLink About03-0083PETITION FOR PROBATE & GRANT OF LETTERS Estate of LOLA P. ZEILMAN also known as Social Security No. 183-54-5636 , deceased. No. 21-03- To: Register of Wills for the County of Cumber/and Commonwealth of Pennsylvania The Petition of the undersigned respectfully represents that: Your Petitioner, who is 18 years of age or older and the Executrix named in the Last Will of the above decedent dated April 11, 1996 , and codicils dated none The Executor named none __died Renunciations for none attached hereto. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 626 West Penn Street, Carlisle Borough Decedent, then 89 years of age, died December 5 ,2002, at her residence Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the Will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in PA (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania, situated as follows: $107,000.00 $ WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented herewith and the grant of letters testamentary thereon. Signature(s) and Residence(s) of Petitioner(s): Donna Faye Ched{nut ~ 900 West North Street Carlisle, PA 17013 717-243-6388 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA : : COUNTY OF CUMBERLAND : 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 representative of the above decedent, petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this c~'e-h day of January, 2003. ~ . -Re~ist~r 0 Donna Faye ~hestnut No. 21-03- ~.~ Estate of LOLA P. ZEILMAN · deceased. DECREE OF PROBATE & GRANT OF LETTERS AND NOW, January ~ ,2003, 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 April 11, 1996 described therein be admitted to probate and filed of record as the Last Will of Lola P. Zeilman ; and Letters Testamentary are hereby granted to Donna Faye Chestnut FEES Probate, Letters, Etc ........ $ 235.00 Short Certificates(-3- ) .... $ 9.00 Renunciation(s) ........... $ JCP .................... $10.00. Other Will Pages (-3-) .... $ 9.00 TOTAL: .... $. 263.00 Filed .....I.-. ~.~; P...3 .............. \ 15,egi~terofV~/ills (J-I (J ~ IRWIN McKNIGHT & HUGHES James D. Huqhes, Esquire (58884) ATTORNEY (Sup. Ct. I.D. No.) 60 West Pomfret St., Carlisle, PA 17013 ADDRESS 717-249-2353 PHONE c:\wp51 \wills\zeihnan.wil tllill aaa e tamettt OF LOLA P. ZEILMAN I, LOLA P. ZEILMAN, of 626 West Penn Street, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: I have placed certain assets IN TRUST with the DAUPHIN DEPOSIT BANK AND TRUST COMPANY, as Trustee, which assets shall not pass under this Will. THIRD: All the rest, residue and remainder of my estate, be it real, personal or mixed, I hereby give, devise and bequeath to my daughter, DONNA FAYE CHESTNUT, provided she survive me by a period of thirty days. c: \wp51 \wills\zeihn,an.wil FOURTH: In the event that my daughter, DONNA FAYE CHESTNUT, shall predecease me, or not survive me by a period of thirty days, I hereby give, devise and bequeath my residuary estate to my son-in-law, JAY CHESTNUT, provided he survives me by a period of thirty days. FIFTH: In the event neither my daughter, DONNA FAYE CHESTNUT, nor my son-in-law, JAY CHESTNUT, survive me by a period of thirty days, I hereby give, devise and bequeath my residuary estate to my grandchildren, SUSAN CHESTNUT, MICHELLE CHESTNUT and WILLIAM CHESTNUT, in equal shares, per stirpes. LASTLY: I nominate, constitute and appoint my daughter, DONNA FAYE CHESTNUT, to be the Executrix of this my Last Will and Testament. In the event that my said daughter, shall be unable to serve as Executrix for any reason, I appoint, my son-in- law, JAY CHESTNUT, as Executor. No Executor or Executrix shall be required to file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: have hereunto set my hand and seal this , 1996. Lola P~lman 2 c: \wp51 \wills\zeih~mn.wil COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS I, LOLA P. ZEILMAN, 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; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by LOLA P. ZEILMAN, the Testatrix, this 1 Iq4x day of ~ ~ , 1996. P. Zoiljffan, Testatrix "- ~tary p~i~ ,~~ ,, , I TE~J. ~~,~~ I ~,~~,~A 3 ct \wp51 \wills\zeilman.wil COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS We, James D. Flowerr Jr. and Merlene Marhevka 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 Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by ,.Tames D. A and Merlene Marhevka this l] day of /"~~. ( , 1996. Flower, Jr. 4 LOLA.~P. ZEILMAN LAW OFFICES FLOWER, MORGENTHAL, FLOWER & LINDSAY, P. C. 11 EAST HIGH STREET CARLISLE, PENNSYLVANIA 17013 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Estate No.: LOLA P. ZEILMAN DECEMBER 5, 2002 21-03-0083 To the Register: I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on February 21, 2003 . Name Address Donna F. Chestnut 900 West North Street, Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Date: 02/21/03 I IRWIVcKNIGHT & HUGHES James D. Hughes, Esquire Address 60 West Pomfret Street none. Carlisle, PA 17013 Telephone {717) 249-2353 Capacity: __ Personal Representative X __ Counsel for Personal Representative 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 002248 HUGHES JAMES D ESQUIRE 60 WEST POMFRET STREET CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 183-54-5636 FILE NUMBER: 2103-0083 DECEDENT NAME: ZEILMAN LOLA P DATE OF PAYMENT: 03/04/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUM BERLAN D DATE OF DEATH: 12/05/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $5,378.61 TOTAL AMOUNT PAID. $5,378.61 REMARKS: JAMES D HUGHES ESQUIRE SEAL CHECK//19552 INITIALS: AC RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. :)8060 ! HARRISBURG, PA 171;>8-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Zeilman Lola P. OATE12/05/2002OF DEATH (MM-DO-YEAR) DATE 11/26/1913OF BIRTH (MM-DO-YEAR) (IF APPLICABLE) SURV V NG SPOUSE'S NAME (LAST, FIRST, AND MI DOLE INITIAL) D E C E D E N T 1. Original Return U 2. Supplemental Return C A P B 4. Limited Estate ~ 4a. Future Interest Compromise (date of death after 12-12-82) HpRL · E P I O 6. Decedent Died Testate ?. Decedent Maintained a Living Trust C R A C (Attach copy of Will) (Attach copy of Trust) KOTK E S ~ 9. Litigation Proceeds Received ~] 10. SpousaI Poverty Credit (date of death between 12-31-91 and 1'- 1-95) Co" S T R E C A P I T U L A T I O N C O M A 'T T I 0 OFFICIAL USE ONLY FILE NUMBER 21-03-0083 COUNTYCODE YEAR NUMBER NAME James D. Hu~hes Esq. FIRM NAME (If Appli~ble) IRWIN McKNIGHT & HUGHES TELEPHONE NUMBER 717/249-2353 SOCIAL SECURITY NUMBER 183-54-5636 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or (3) Sole-Proprietorship 4. Mortgages & Note~ Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) ~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines g & 10) Net Value of Estate (Line 8 minus Line 11 ) 12. 13. 14. THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER . (date of death 3, Remainder Return priorto 12-13-82) 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS 60 West Pomfret Street West Pomfret Professional Bldg. .Carlisle, PA 17013 None Nbne None None 111,558.90 None 29,671.29 15,113.75 301.14 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 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 19. Tax Due X .0 0 X .0 45 X .12 X .15 125,815.30 OFFICIAL USE ONLY (8) 141,230.19 (11) 15,414.89 (12) 125,815.30 (13) (14) 125,815.30 (15) 0.00 (16) 5,661.69 (17) 0.00 (18). O. O0 (19) 5,661.69 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 626 West Penn Street CITY Carlisle STATE ?A ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2, Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 283.08 Total Credits ( A + B + C (1) (2) 5,661.69 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E (3) 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) 5. 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. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) 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 ~se the property transferred or its income; ........... c. retain a reversionary interest; or .................................... d. receive the promise for life of either payments, benefits or care? ................... 2. If death occurred after December 12, 1982, did de~:edent 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. 283.08 0.00 0.00 5,378.61 0.00 5,378.61 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. SIGNATURE OF PER~SON RESPONSIBLE FOR~SJ.~ING RETURN Donna F. Chestnut f7 ~/~-~' ///' ~ 900 West North St. ~~~'~ - -~l-f~ i~-; - Pi- - - iY~i § ........................... DATE DAlE SIGNATURE OFPREPAR~E,,,~)~THAN REPRESENTATIVE IRWIN McKNIGHT & HUGHES - -- 60 West Pomfret Street O sur~,'Mng spouse~ 3% [72 P.S. 9116 (a) (1.1) (i)]. Fo~dates of~th on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surwving spouse is 0% [72 ~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. 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(aX1)]. 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(aX1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Copyright (c) ZOOO form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) REV- 1508 EX +(1-97) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Lola P. Zeilman SS~ 183-54-5636 12/05/2002 21-03-0083 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION Allfirst Bank, checking account Jacqueline L. Powell & Associates #5AD-386259 Miscellaneous personal property Inc. - Pershing account TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE OF DEATH 1,634.15 107,120.75 2,804.00 $ 111,558.90 (If more space is needed, insert additional sheets of the same size) Copydg ht (c) 1996 form software only CPSystems, Inc. Form REV- 1508 EX (Rev. 1-97) .~-~s~o Ex+It-97! SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC. NON-PROBATE PROPER'IT RESIDENT DECEDENT ESTATE OF FILE NUMBER Lola P. Zeilman SS~ 183-54-5636 12/05/2002 21-03-0083 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCR PT ON OF PROPERTY % OF ITEM INCLUDETHE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (~F APPLICABLE) 1 The Security Benefit Group 29,671.29 29,671.29 of Companies TOTAL (Also enter on line 7, Recapitulation) $ 29,671 . 29 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1510 EX (Rev. 1-97) REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Lola P. Zeilman SS~/ 183-54-5636 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS 12/05/2002 FILENUMBER 21-03-0083 Debts of decedent must be reported on Schedule I. ITEM NUMBER 2 1 2 3 4 DESCRIPTION FUNERAL EXPENSES: Cumberland Valley Memorial Garden Ewing Brothers Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address · City State Zip Year(s) Commission Paid: Attorney's Fees IRWIN McKNIGHT & HUGHES 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 Register of Wills Accountant's Fees Tax Return Preparer's Fees OtherAdministrativeCosts Cumberland Law Journal - estate notice publication Register of Wills - filing fee Roy D. Gottshall Auctioneer - appraisal fee The Sentinel Legal - estate notice publication TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 900.00 7,106.75 6,600.00 263.00 75.00 25.00 55.00 89.00 $ 15,113.75 Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1,~11 EX (Rev. 1-97) REV-151Z EX + (1-97) SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Lola P. Zeilman SS~ 183-54-5636 12/05/2002 21-03-0083 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 2 Live-In Care of PA Yellow Breeches EMS Inc. TOTAL (Also enter on line 10, Recapitulation) $ 222.00 79.14 301.14 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems. Inc. Form REV-1512 EX (Rev. 1-97) R£V-1513 lEX * (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESlOENT DECEDENT ESTATE OF Lola P. Zeilman SS~; 183-54-5636 NUMBEF SCHEDULE J BENEFICIARIES II. 12/05/2002 NAME AND ADDRESS Of PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright s~usal distributions, and transfers u~er Sec. 9116~1.2)] Donna F. Chestnut 900 West North Street Carlisle, PA 17013 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter FILENUMBER 21-03-0083 AMOUNT OR SHARE OF ESTATE remainder 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 u - 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) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) c.\wp51 \~ills\zeihuan.wil OF LOLA P. ZEILMAN I, LOLA' P. ZEILMAN, of 626 West Penn Street, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, .Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: I have placed certain assets IN TRUST with the DAUPHIN DEPOSIT BANK AND TRUST COMPANY, as Trustee, which assets shall not pass under this Will. THIRD: All the rest, residue and remainder of my estate, be it real, personal or mixed, I hereby give, devise and bequeath to my daughter, DONNA FAYE CHESTNUT, provided she survive me by a period of thirty days. c: \wp51 \wills\zeihmm.wil FOURTH: In the event that my daughter, DONNA FAYE CHESTNUT, shall predecease me, or not survive me by a period of thirty days, I hereby give, devise and bequeath my residuary estate to my son-in-law, JAY CHESTNUT, provided he survives me by a period of thirty days. FIFTH: In the event neither my daughter, DONNA FAYE CHESTNUT, nor my son-in-law, JAY CHESTNUT, survive me by a period of thirty days, I hereby give, devise and bequeath my residuary estate to my grandchildren, SUSAN CHESTNUT, MICHELLE CHESTNUT and WILLIAM CHESTNUT, in equal shares, per stirpes. LASTLY: I nominate, constitute and appoint my daughter, DONNA FAYE CHESTNUT, to be the Executrix of this my Last Will and Testament. In the event that my said daughter, shall be unable to serve as Executrix for any reason, I appoint, my son-in- law, JAY CHESTNUT, as Executor. No Executor or Executrix shall be.required to file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I , / / day of f~t'¢~'/"~' l SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: have hereunto set my hand and seal this , 1996. Lola P? _~¢llman 2 c:\wp51 \willsXzcilman.wil COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS I, LOLA P. ZEILMAN, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to Jaw, do hereby acknowledge that i signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by LOLA P. ZEILMAN, the Testatrix, this' I i4'-Fk day of '~'~- ~. , 1996. Lola P. Zeii~m"an, Testatrix ,/ / / ." ....... / - , : ¢, /?..; , :-."'"'~. : . ./'/./. // o? ~ Oomm~eio~ Ext~s ~. 21, c:\wp~ l \wills~,zcilm:,n.wil COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS We, James D. Flower, Jr. and Merlene Marhevka 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 Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our kr)owledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. and Sworn or affirmed to and subscribed to.before me by Jam~s D. Merlene Marhevka this. l t4-k day of /~,,~%C ( Flower, ,1996. 4 Jr. The Security Benefit Group of Companies Statement of Account LOLA P ZEILMAN 626 W PENN ST CARLISLE PA 17013-2238 One Security Benefit Place Topeka, KS 66636-0001 1-800-888-2461 www.securitybenefit.com Your Representative MARY V SPALDING EXECUTRIX/FREDERICK SPALDING EST 2671 CHAMBERSBURG RD BIGLERVILLE, PA 17307-9546 This statement is sent by Se.___cudty Distributors. Inc.. on behalf of the representative above acting as,~agent. Contract Information Annuitant: LOLA P ZEILMAN Contract Date: October 31, 1988 Security Mark Annuity Statement As of December 31, 2002 Previous Contract Number: 1083530 1083530 Contract Number: 1301083530. Contract Type: - Non-Qualified Annuity Contract History January 01, 2002 through December 31, 2002 Beginning Value Purchases Withdrawals Current Quarter Year To Date Inception To Date $29,343.91 $28,393.57 $0.00 0.00 0.00 13,707.31 0. O0 0.00 L:-~ ~ ~, Ending V=lua $29,671.2.~ $29,671.29 $29,671.29 Your account values are based on the first and last working day of the period, not last calendar date. Please note that your contract number has changed. Your new and old contract numbers are set forth above, and you may want to keep a copy of this statement for future reference. Tax law changes have increased contribution limits for all types of IRAs. With tax season approaching, now might be an excellent time to consider increasing your IRA contributions or opening a new IRA. Talk to your financial representative to see how one of these might fit with your financial portfolio. Please read this statement carefully. Any errors must be reported within 30 days. Page I of 4 43A Bwokwood Avenue, §uite 6, Cadisle, PA 1 7013 (71 7) 258-075I; fax (717) 258-9731 TO: FROM: SUBJECT: DATE: MEMORANDUM JAaMES HUGHES SABRINA WEAVER LOLA ZEILMAN'S DATE OF DEATH VALUES JANUARY 8, 2003 Dear Jim, Please fred below the date of death values for Lola Zeilman's Individual Pershing account number 5AD-386259. ~mbol Name i PriceYShare# ~of Shares Net : AIB Alliedlrish i CVLY CodorusValley i PNC PNC Bank ~A CR Money_Market $26.58 ......... 49~3.0_~0~ $15.351 2, 683. 00! $41,184.05 $40~ 80~ 1, 256. 00~ $51,244. $1. O0! 1,587.94 $1,587.9~ TOTAL $107,120.7.$ Also, please provide our 'office with the following documents so we may proceed in establishing the Estate account. Once our office receives these documents, we will have Donna come in and sign the necessary forms. 1) Estate Tax ID Number 2) Short Certificate 3) Death Certificate If you have any questions or need further information, please feel free to call me at (717) 258-0751. Sincerely, Sabrina Weaver Jacqueline L. Powell & Associates, Inc 43A Brookwood Avenue, Suite 6 Cadisle, PA 17013 (717) 258-0751 sabrina~jpowellassoc.com Securities offered through Financial Ne~ork Investment Co~poration. Member SIPC. Registered Broker/Dealer Jacqueline L. Po~,ell & Associates, Inc. and Financial Net~oork are not affiliated. IMII 01/:90/O3 LOLA P ZEILMAN OR N S ZEILMAN 900 N NORTH ST BEGINNING BALANCE 4970.93 DATE CK NBR 12/03 12/03 4926 12/03 4927 12/¢4 4924 12/04 4928 12/05 12/¢6 4932 12/06 4929 12/¢6 4925 1 2/¢9 4930 12/¢9 4933 12/1¢ 4931 PF1 - PAGE FMD DDA STATEMENT HISTORY ACCOUNT DATE LAST STATEMENT DATE THIS STATEMENT *****DDA TRANSACTIONS***** CHECKS/OTHER DEBITS DEPOSITS/OTHER CREDITS NBR TOTAL AMOUNT NBR TOTAL AMOUNT 22 7488.21 2 3789.00 12.07.00 PAGE 001 - 000- 0000- 0092698905 I I /06/02 01 /30/03 ENDING BALANCE 1271.72 PF2 AMOUNT TP TRANSACTION DESCRIPTION 1289.00 ACH CREDIT 108.62 CHECK 50.96 CHECK 1883.33 CHECK 82,63 CHECK 152.75 ACH DEBIT 132,22 CHECK 45.34 CHECK 40.81 CHECK 80.00 CHECK 24.51 CFIECK 39.55 CHECK PAGE BKMD BALANCE 391 2.44 3803.82 3752.86 1 869 53 I 786 90 1634 15 1 5¢1 93 1 456 59 1415 78 1 335 78 1311 27 1271 72 ..~ ~:~;~%r~ ~,,.~ ,~';,.? .~ ~. ~ ~.,.c ...... ~ .... ~ Inventory of the real and personal estate of LOLA P. ZEILMAN deceased 1. Allfirst Bank - Checking Account ...................... 2. Jacqueline L. Powell & Associates, Inc. - Pershing Account #5AD-386259. 3. Miscellaneous Personal Property ...................... TOTAL .................. 1,634 15 107,120 75 2,804 O0 111,558 90 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND J Donna F. Chestnut being duly sworn according to law, deposes and says that she is the Executrix of the Estate of Lola P. Zeilman late of the Borou_g_h pf___C_arlisle , Cumberland County, Pa., deceased and that the within is an inventory made by Donna F. Chestnut , 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 decedent's death. Sworn and subscribed before me, { / ' [ Notarial Seal ~t I Jacqueline L. Drawbaugh, Notary Public [ Carlisle Boro, Cumberland County I L My Cammission Expires Aug. 14. 2003 j Date of Death ~,lemt.~ei,Pen,~.an!a^ssoc:iationotNot-:~es Donna F. Chestnut, Executrix 900 West North Street Carlisle, PA 17013 Address 12 2002 Day Month Year INSTRUCTIONS I. An inventory must be filed within three months after appolnfment of personal representative. 2. A supplement inventory must be filed wifhln thirty days of discovery of addifional assets. 3. Addlfional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. ? I, ZJ BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTyTSTON DEPT. 280601 HARRTSBURG, PA 17128-0601 JANES D HUGHES ESQ IRWIN ETAL 60 W POHFRET ST CARLISLE COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTZCE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE ASSESSHENT OF TAX DATE ESTATE OF .~.DATE OF DEATH '03 APR 28 P3.UI zLE NUHBER COUNTY L: ~ ' ACN PA 17015 04-21-2003 ZEILHAN 12-05-2002 21 05-0083 CUHBERLAND 101 Amount: Rami~ed REV-15~7 EX IFP LOLA P HAKE CHECK PAYABLE AND RENZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG TH]:S LXNE ~ RETA]:N LOWER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOT]:CE OF ZNHER]:TANCE TAX APPRA]:SEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTXONS AND ASSESSHENT OF TAX ESTATE OF ZETLHAN LOLA P F]:LE NO. 21 03-0083 ACN 101 DATE 04-21-2003 TAX RETURN NAS: (X) ACCEPTED AS FTLED ( ) CHANGED RESERVATXON CONCERNXNG FUTURE ZNTEREST - SEE REVERSE APPRA/SED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks end Bonds (Schedule B) (2) $. Closely Held S~ock/Par~nership Interes~ (Schedule C) (~) q. Nor~gages/No~es Receivable (Schedule D) (q) $. Cash/Bank Deposi~s/Nisc. Personal Proper~y (Schedule E) (5) 6. Jointly O~ned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Cos~s/Hisc. Expenses (Schedule H) (9) 10. Dobbs/Hot*gage Liabilities/Lions (Schodulo I) (10) 11. To,al Doduc~ions 12. Ne~ Veluo of Tax Ro~urn 00 00 00 o0 111z558.90 00 29z671 29 (8) 15,113.75 301.14 NOTE: To insure proper credit ~o your account, submi~ ~he upper portion of ~his form wi~h your ~ax payment. 13. NOTE: 141,250.19 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (15) .00 x O0 = .00 (16) 125,815.30 x 045= 5,661.69 (17) .00 x 12 = .00 (18) .00 x 15 : . O0 (19)= 5,661.69 AHOUNT PAZD 5,378.61 TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE 5,661.69 .oo .oo .oo ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUZRED. ZF TOTAL DUE TS REFLECTED AS A 'CREDZT' {CR), YOU HAY BE DUE A REFUND. SEE REVERSE SZDE OF THIS FORN FOR INSTRUCTTONS.) ASSESSHENT OF TAX: 15. Amoun~ of L/ne 1~ a~ Spousal ra~e 16. Amoun~ of Line lfi ~axable a~ Lineal/Class A ra~e 17. Amoun~ of Line 1~ a~ Sibling re~e 18. Amoun~ of Line lq ~axable e~ Collateral/Class B ra~a 19. Principal Tax Due TAX CREDITS: PAYHENT RECEIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) 03-04-2003 CDOOZZ48 Z83.08 (13) . O0 (14) 125,815.30 16, 17, 18 and 19 will Chari*eble/Governmen*al Bequests; Non-eXacted 9115 Trusts (Schedule J) Ne~ Value of Es~a*e Subjec~ ~o Tax Zf an assessment ,as issued previously, lines 1~, 15 and/or reflect figures that include the total of ALL returns assessed to date. (11) 1S.~ll.89 (la) 125,815.30 RESERVATION: PURPOSE OF NOT/CE: PAYNENT: REFUND [CR): OBJECTIONS: ADNIN- [STRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z) 19BI -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (collateral) rate on any such future interest. To fulfill the requirements of Section Zl~O of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (TI P.S. Section 91~0). Detach the top portion of this Notice and submit with your payment to the Register of #ills printed an the reverse side. --Hake check or money order payable to: REGISTER OF NZLLS, AGENT A refund of a tax credit, ahich was not requested on the Tax Return, amy be requested by completing an "Application for Refund of Pennsylvania Inheritance end Estate Tax" (REV-1515). Applications are available at the Office of the Register of gills) any of the Z$ Revenue District Offices, or by calling the special 2~-hour answering service for forms ordering: I-BO0-S6Z-20SO; services for taxpayers with special hearing and ! or speaking needs: 1-800-4qT-$OZO (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions) or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 171ZB-lOZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN= Post Assessment Reviea Unit, Dept. ZBO601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1SOI) for an explanation of administratively correctable errors. If any tax due is paid within three ($) calendar months after the decedent's death, a five percent (5Z) discount of the tax paid is allowed. The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the 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 (1) day from the date of death, to the data of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .O0016q. AIl taxes which became delinquent on and after January 1, 1982 mill bear interest at a rate which mill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO5 are: Interest Daily Interest Oaily Interest Dally Year Rate Factor Year Rate Factor Year Rate Factor 1982 ZOZ .000548 1987 9Z .000147 1999 7X .000192 1985 16Z .0004~8 1988-1991 11Z .000301 ZOO0 8Z .000219 198~ llZ .000301 1991 9Z .000147 ZOOi 91 .OOOZ~7 1985 13Z .OOO~S6 1993-199~ 7Z .000192 ZOOZ 6Z .00016~ 1986 lex ,000Z7~ 1995-1998 9Z .000Z47 2003 5Z .000137 --Interest is calculated XNTEREST = BALANCE OF as follows: TAX UNPAXD X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: LOLA P. ZEILMAN Date of Death: DECEMBER 5, 2002 No. 21-03-0083 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: X Yes ~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes X No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? X Yes No Date: 6/20/03 d. Copies of receipts, releases, joinders and ~O.l~provals of formal or informal accounts may be CJ~fk 9{' Orphan'sfiled with the Court and may be attached to thisreport.~ m [ IR~gflN,~M~KN. IGI-I~T & .HUGHES ~ ~. ,[,,._.,.//James D. Hughes, Esquire ~ Name (please type or print) 60 West Pomfret Street : ,: Address ~ ~ Carlisle, PA 17013 o City, State, Zip o :" --- (717) 249-2353 · :~ r~ Telephone Number Capacity: X Personal Representative Counsel for Personal Representative