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HomeMy WebLinkAbout03-0110Register of Wills Cumbe. rlandCounty, pennsylvania PETITION FOR GRANT OF LETTERS Estate of Allen M. Peame' also known as. Katherine K. Pearce, , Deceased Social SecuriTM No. 165-38-1475 (COMPLETE "A" OR 'B' BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the executrix I~m Decedent, dated Apdl 3~ 1992 and co(rmcil(s) dated N/A named in the Last Will of the Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate: wa~ not the viotim of a killing and wes never edjudioated immompetent: B. Grant of Letters of Administration Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was su~tived by the following spouse (if any) and heirs: Name Relatim~hip Residence I (COMPLETE IN ALL CASES:) Attach additional I heet~ if neoeaaary. . Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 1945 Sheepford Road, Mechanicsbum, Lower Men Township. Cumberland County. Pennsylvania 17055 Decedent, then 51 years of age, died* January 20 ,2003, at Holy Soirit Hospital, E. Pennsboro Township Cum berland"C'~nty, Pennsylvania Decedent at death owned propertv with estimated values as follows: (If domiciled in PA) All personal property ........................... ;... $ 12,000.00 (If not domiciled in PA) Personal propertv in PmmsvIvania ...................... $ (If not domiciled in PA) Personal property in Ceenty .......................... $ Value of real estate in Pennsylvania ............................................... $ 84,410.00 Total .............................................................. $ 96.410_(~ Real Estate situated ae follows: 1917 Kent Drive, Camp Hill, Bom of Camp Hill, Cumberland Countv. PA 17011 Wherefore. Petitioner(s) raspeotfullv Fequsst(s) the probate of the last ~ and Codicil(s) presented with this Petition and the grant of letterd in the appropriate form to the undersigned: I Signature Typed or printed name and residen~:e I Katherine K. Pearce 1954 sheepford Ro,ad, Mechanicsbur,q, PA 17055 RW-7 Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and (~orrect to the best of. the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to and affirmed and subscribed before me this ~' day of ' ' ~ ~-~t~x~-J~"~..~Z'~L ~z)~ Katherine K. Pearce DECREE OF REGISTER Estate of Allen M. Peame Deceased No. also known as Social Security No: 165-38-1475 Date of Death: Janua~ 20, 2003 AND NOW. ,_~~ ~z_,~ ~P , 20 ~2~, in consideration of the Petition on the reverse side hereon, Satisfac/-t~ory proof having been presented before me, IT IS DECREED that Letters r~ Testamentary I-I of Administration are hereby granted to ' Katherine K. Pearce ~.,.,.~ in the above estate and that the instrument(s}, if any, dated April 3, 1992 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........................... $ o~00, (~) Short Certificate(s) .......... $ Renunciation .................. $ Affidavit ( ) ................. $ Extra Pages ( ) ............ Codicil ....' ...................... $ JCP Fee ........................ $ Inventory & Tax Forms .... $ Other, .......................... $ ,/0. ~o TOTAL .......... '..:... $~,r~q ~. O0 R~l-Ta Attorney: Mark E. Halbruner, Esquire I.D. No: 66737 Address: Gates. Halbruner ~ Hatch, P.C. 1013 Mumma Road, Suite 100, Lemoyne, PA 17043 Telephone: (717)731-9600 DATE FILED: c~- ~- (03 ¢,01-o~- II(.R LAW OFFICES OF KEITH A, BLANK 1940 Market St. Camp Hill, PA 17011 Phone: (717) 737-2670 LAST WILL AND TESTAMENT OF ALLEN M. PEARCE I, Allen M. Pearce of Mechanicsburg, Cumberland County, ~ennsylvania, declare this to be my Last WAll and Testament , hereby revoking all prior wills and codicils. FIRST: The expenses of my last illness and funeral shall ~e paid from the property of my estate. Disposal of my body shall ~e in accordance with instructions that I will leave with my hereinafter named Executor. SECOND: At the time of making this Last Will and Testament, have no specific bequests. If, between now and the time of my eath there are any, I shall leave a signed list of them with my hereinafter named Executor. THIRD: Ail the rest, residue and remainder of my estate I hereby give, devise and bequeath to my wife, Katherine K. Pearce, )rovided that she survives me by thirty (30) days. LAW OFFICES OF KEITH A, ~LANK 1940 Market St. Camp Hill, PA 17011 Phone: (717) 737-2670 FOURTH: In the event that my wife, Ka%herine K. Pearce, does not survive me by thirty (30) days, then I hereby devise the rest, residue and remainder of my estate as follows: 1) In equal shares to all my surviving children. 2) To their issue, should they fail to survive me by thirty (30) days. FIFTH: Any share hereby bequeathed by me to a child who is a minor under the age of 25, shall be held in trust for said child under the following provisions: 1) My hereinafter named trustee shall have the option to hold any items bequeathed to said minor in kind for said minor or to sell at private or public sale, and hold the proceeds of said sale. 2) The said trust shall be for the benefit of said child, and payments shall be made for his needs, including, but not limited to maintenance, support, medical expenses and education, as my trustee shall decide in his sole discretion. The final amount of principal and interest as well as any items held in kind shall be distributed to the child when he has attained the age of 25. 3) The amount to be paid shall be determined from time to time by the needs of said child, and the amounts and LAW OFFICES OF KEITH A. BLANK 1940 Market St. Camp Hill, PA 17011 Phone: (717) 737-2670 times of said payments shall be determined by such need. The said payments may be made by my trustee directly to the said child, or may be made by my trustee directly to any institution entitled to such payment by reason of services rendered to said child. In making said payments, my trustee shall give primary consideration to the individual needs of the child, and to the other sources of income available to the child, and the individual needs of the child shall override any consideration as to the equality of distribution for the purposes mentioned in this paragraph. 4) Any and all payments of any sums, whether in cash or in kind, and for principal or income, payable to the said child, or any beneficiary under this, my Last Will and Testament, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiary. 5) In addition to the powers conferred by law, I authorize the trustee in his sole discretion: to retain in the form received, or to sell either at public or private sale, any real or personal property; to manage real estate; to invest and reinvest in all forms of LAW OFFICES OF KEITH A. BLANK 1940 Market St. Camp Hill, PA 17011 Phone: (717) 737-2670 property without regard to the principal of diversification; to exercise any option or rights arising from ownership of investments; to compromise claims without court approval, without consent of any beneficiary. 6) I nominate, constitute and appoint Victoria J. Wolf-Book as Trustee of said fund and as guardian of the person of any of my surviving children. SIXTH: I nominate, constitute and appoint my wife, Katherine K. Pearce, as Executrix of this, my Last Will and Testament. In the event that she is unable to do so for whatever reason, then I hereby appoint my friend, Barry L. Dando, as Executor of this my Last Will and Testament. SEVENTH: In the settlement of my estate, my Executrix shall possess, among others, the following powers: 1) To retain any investments I may have at my death, including specifically those consisting of stock of any bank even if I have named such bank as executor herein, so long as the executor may deem it advisable for my estate to do so. 2) To vary investments, when deemed desirable by this executor, and to invest in such bonds, stocks, notes, LAW OFFICES OF KEITH A. BLANK 1940 Market St. Camp Hill, PA 17011 Phone: (7t7) 737-2670 real estate mortgages or other securities or in such other property, real or personal, as they shall deem wise, without being restricted to so-called "legal investments", and without being limited by any statute or rule of law regarding investments by fiduciaries. 3) In order to effect a division of the principal of my estate or for any other purpose, including any financial distribution, the executor is authorized to make said divisions or distributions of the personalty and realty partly or wholly in kind, and to allocate specific assets among beneficiaries so long as the total market value of any share is not effected by such division or allocation. 4) To sell either at public or private sale and upon such terms and conditions as the executor may deem advantageous to the estate, any or all real personal property or interest owned therein by the estate severally or in conjunction with other persons or acquired after my death by the executor and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the LAW OFFICES OF KEITH A. BLANK 1940 Market St. Camp Hill, PA 17011 Phone: (717) 737-2670 purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary to desirable in carrying out any of the powers conferred upon the executor in this paragraph or elsewhere in my will. 5) To mortgage real estate, and to make leases of real estate. 6) To borrow money from any party, including the executor, to pay indebtedness of mine or of my estate, expenses of administration, legacy, estate and other taxes, and to assign and pledge assets of my estate therefor. 7) To pay all costs, taxes, expenses and charges in connection with the administration of my estate or a trust. 8) To vote any shares of stock which form a part of the estate and to otherwise exercise all the powers incident to the ownership of said stock. 9) In the discretion of the executor to unite with other owners of similar property in carrying out any plans of the reorganization of any corporation or company whose securities form a part of the estate. LAW OFFICES OF KEITH A. BLANK 1940 Market St. Camp H~II, PA 17011 Phone: (717) 737-2670 10) To do all other acts in their judgement deemed necessary or desirable for the proper and advantageous management, investment and distribution of the estate or trust. 11) The corporate fiduciary, if any, shall be entitled to compensation based on its regular schedule of fees for such services in effect at the time of the service rendered. EZGg~g: I direct that no trustee, executrix, or other fiduciary named, nominated or appointed in this my Last Will and Testament, shall be required to post any bond or give any security of any type for any purpose whatsoever, any law or rule of court of the Commonwealth of Pennsylvania or any other jurisdiction to the contrary, not withstanding. NINTH: Ail inheritance, estate and succession taxes (including interest and any penalties thereon) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. IN WZTNHSS W~EP~OF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of ~ typewritten LAW OFFICES OF KEITH A, BLANK 1940 Market St. Camp Hill, PA 17011 Phone: (717) 737-2670 pages, the first -~ of which bear my signature at the bottom for the purpose of identification this ~ day of /~,'~'/~ , 199 ~. Allen M. Pearce WITNESS: / LAW OFFICES OF KEITH A, BLANK 1940 Market St. Camp Hill, PA 17011 Phone: (717) 737-2670 COM~O~ALTH OF PENNSYLVANIA : COUNTY OF ~ ~--~ : and ~Y~.F~~ , the Testator and witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament and that he signed willingly and that he executed it as his 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 will as witnesses and that to the best of their knowledge, the Testator was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. ALLEN M. PEARCE WITNESS: Sworn to and subscribed to before me this~J day of ~~ , 19 ~ · Notar~ Public / H~ co~u~ss'~on expires: ALLEN M. PEARCE KEITH A. BLANK 1940 MARKET ST. CAMP HILL, PA 17011 PHONE: (717) 737-2670 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: File No.: Allen M. Pearce January 20, 2003 2003-00110 To the Register: I certify that notice of 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 February 2.C>, 2003. Name Address Katherine K. Pearce 1954 Sheepford Road, Mechanicsburg, PA 17055 Alex M. Pearce c/o Katherine K. Pearce 1954 Sheepford Road, Mechanicsburg, PA 17055 Amanda C. Pearce c/o Katherine K. Pearce 1954 Sheepford Road, Mechanicsburg, PA 17055 Notice'has now been given to all persons entitled thereto under Rule 5.6(a). Mark ~. Ha~bmner, Esquire Counsel for Personal Representative GATES, HALBRUNER & HATCH, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 (717) 731-9600 Dated: February 2kC>. 2003 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 FILE NUMBER COUNTY CODE OFFIClN. USE ONLY -- 2003 00110 INHERITANCE TAX RETURN RESIDENT DECEDENT NAME (LAST, FIRST, AND MIDDLE INITIAL) ~earce, Allen M. YF-N~ NUMBER SOCIAL SECURI3~ NUMBER ~ 1:3al DATE OF DEATH (MM-DO-YEAR) DATE OF BIRTH (MM-DO-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE m 01/20/2003 4/10/1951 REGISTER OF WILLS ~ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIODLE INITIAL) SOCIAL SECUR/TY NUMBER Pearce, Katherine K. 176-4~-1020 ~ L~ 1. Original Return O Iv I I I 4, Limited Estate ~ ~'~:~ l=~(~--'l 6, Deosdent Died Testata (Attach copy of Will) ~ 9. LitigaUon Proceeds Received ~ 2. Supplemental Return [~] 3. Remainder Return (dale of death prior to 12-13-82) ~'"~ 4a, Future Interest Compromise (date of death after 12-12-82) r-~ 5. Federal Estate Tax Return Required r--"~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) -- 8. Total' Number of Safe Deposit Boxes ~ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1.1-95) ['---] 11. Election to tax under Sec. 9113(A)(Attach Sch O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: COMPLETE MAILING ADDRESS 8 O NAME Mark E. Halbruner, Esquire FIRM NAME (If Applicable) Gates, Halbruner & Hatch, P.C. TELEPHONE NUMBER 717-731-9600 Gates, Halbruner & Hatch, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 290,360.11 1. Real Estate (Schedule A) ( 1 ) 6 2,4 15.7 7 2. Stocks and Bonds (Schedule B) (2) 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0 o 00 4. Mortgages & Notes Receivable (Schedule D) (4) 0.00 5. Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 17,226.66 6. J~ Owned Property (Schedule F) (6) ' 135,780.70 [._._1 Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 7 4,9 3 6 o 9 9 (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (8) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 0 · 0 0 10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedulel) (10) 50; 831.84 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 Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 239,528.27 x.00 0.00 x .045 0.00 x .12 0.00 (15) (16) (17) (18) (19) 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 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 50,831.84 239,528.27 0.00 239,528.27 x .15 > · BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < OFF~-'IAL USE ONLY 0.00 · 0.00 0.00 0.00 0.00 2W4645 1.000 Decedent's Complete Address: I $ ~HE~-~ ADDRESS 1954 CITY 14echan4c sburg ISTATE Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 0.00 0.00 0.00 (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. IzIP 17055 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 0o00 0.00 0.00 0.00 (4) (5) (5A) 0.00 (5B) 0.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................... [-'--] b. retain the right to designate who shall use the property transferred or its income; ......... ~ ['~ c. retain a reversionary interest; or ................................ d. receive the promise for life of either payments, benefits or care? ................. [~ ['~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................ [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? [----] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties o! 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~' -- -- ~'°1 preparer other than the personal represe~tive is based on all information of which preparer has any knowledge. DATE ,,~1~8~"3.~.54 Sh~p£t3'~'d Roa'd~' - -- ~ech&n~.csburg, P& 3.7055 SIGNATURE OF PR~ARE__R OTHI~R ~ESENTATIVE ~.eato3me, P& [?043 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 transfers to or for the use of the surviving spouse is 3% [72 P.S.§ 9916 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. § 9116 (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 stepparant of the child is 0% [72 P.S. § 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. § 9116(1.2) [72 P.S. § 9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. § 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 2W4646 1.000 REV-1502EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Pearce, Allen M. 21-2003-00110 All zeal property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which la jointly-owned with right of eurvlvorshlp must be disclosed on Schedule F. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1. 62,415.77 Two-story, single family dwellingl located at 1917 Kent Drive, Cam~ Hill, ~m~erland County, Pennsylvanial Tax Parcel No. 23-0547-2221 transferred from Lawrence D. Beck and Allen M. Pearce as tenants-in-common, to Allen M. Pearce (decedent) individually, by deed ~ated January 25, 2002, and recorded January 29, 2002, in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, at Deed Book 250, Page 785. On November 17, 1999, Lawrence D. Beck and Allen M. Pearce entered into an Installment Sales Agreement by and between themselves as Sellers and James D. Nelson, Jr., and Jennifer N. Nelson as Buyers. The contract sales price is $65,000.00 with annual interest of 6.254 end a term of 30 years. By Renewal of Installment Sale Agreement dated January 25, 2002, the original Agreement was transferred to Allen M. Pearce as sole owner of the proDerty. The unDaid balance of the contract at date of death was $62,4'15.77. TOTAL (Also enter on line 1, Recapitulation) $ 62,4,15.77 2w4695 2.0oo (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ~"'3~ATE OF Fl' =. NUMBER Pearce, AZ1en M. 2J-2003-00110 Include the )roceeds of litigation and the date the proceeds were received by the estate. NI property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER PNC Bank Certificate of Deposit Acct. No. 31400152615 (includes $9.13 accrued interest) Internal Revenue Service one-half of 2002 income tax refund (filing status married/joint return~ total refund was $5,288) VALUE AT DATE OF DEATH 14,582.66 2,644.00 17,226.66 TOTAL (Also enter on line 5, R~n!t.'.ulation) $ 2W46AD 2.000 (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERiTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY =~, ATE OF FI'.E NUMBER Pearce, AZ1en M. 21;-2003-00110 If an asset was mede joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADORESS RELATIONSHIP TO DECEDENT A. Pearce, Katherine K. Spouse 1954 Sheepford Road Mechanicsburg, PA 17055 JOiNTLY-OWNED PROPERTY: Lm'n~R DATE ~SCRI~ON OF PROPER~ %OF DA~ OF DEATH ITEM FO~ MADE Include name of financia instituti~ and bank ~nt number ~ DA~ OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT similar identifying numar. Ntach deed ~r j~nay-held m~ estate. VALUE OF ASS~ INTERE~ ~CEDENTS INTERE~ 1. A 06/06/1992 Waypoint Bank 2,648.88 50.00 1,324.44 Savings Account Acct. No. 760000069 2 A 12/02/1994 WayDoint Bank 2,974.78 50.00 1,487.39 Certificate of Deposit Acct. No. 760255627 3 A 12/02/1994 Way~oint Bank 2,931.20 50.00 1,465.60 Certificate of Deposit Acct. No. 753255625 4 A 01/02/2002 Way~oint Bank 945.60 50.00 472.80 Checking Account Acct. No. 100255462 5 A 10/17/2000 267 shares of Wa~oint Bank 4,736.58 50.00 2,368.29 coa~aon stockl 01/17/2003 High $17.95 per sharel 01/17/2003 Low $17.60 per sharel 01/17/2003 AV~ $17.78 per sharel 01/21/2003 High $17.93 per share~ 01/21/2003 Low $17.45 per share~ 01/21/2003 AVG $17.69 per share. AVG of 01/17/2003 Total fro~continuation pages .... 128,662.18 TOTAL(Alsoenteronline6, Recapitulation) $ 135,780.70 2W46AE 2.000 (If more space is needed, insert additional sheets of same size) Estate of: Pearce, Date Item Made No. 5ett. ~oint Allen M. Schedule F -- Jointly-0wned Property Description Date of death Value of asset ~ of Decedent's Interest Page 2 2~-2003-00110 Value at Date of Death 6 A 12/01/1997 7 A 12/03/1979 8 A 12/03/1979 9 A 11/20/1991 10 A 06/04/1986 11 A 01/02/2002 12 A 12/03/1979 and 01/21/2003 AVG = $17.74 per share. Way~oint Bank Certificate of Deposit Acct. No. 700002617 New Cumberland Federal Credit Union Checking Account New Cumberland Federal Credit Union Savings Account Way~oint Bank Checking Account Acct. No. 700018452 Two-story, single family dwelling; located at 1954 Sheepford Road, Mechanicsburg, Cumberland County, Peunsylvania~ Tax Parcel No. 11-0270-019B~ transferred to Allen M. Pearce and Katherine K. Pearce on June 6, 1986, by deed recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, at Deed Book 31X, Page 868. Value per co%uxty assessment. Way~oint Bank Checking Account Acct. No. 100256395 New Cumberland Federal Credit Union Christmas Savings Account 1,261.06 465.63 5,906.79 8,653.57 239,590.00 486.20 259.76 50.00 50.00 50.00 50.00 50.00 50.00 50.00 630.53 232.81 2,953.39 4,326.78 119,795.00 243.10 129.88 13 A 02/25/1995 Way~oint Bank 701.34 50.00 350.67 Estate o£: Pearce, Allen M. Date Item Made No. Left. Joint Schedule F -- Jointly-Owned ProDerty ~ of Date of death Decedent's Description Value of asset Interest Page 3 2~;-2003-00110 Value at Date of Death Certificate of DeDosit Acct. No. 753261256 TOTAL. (Carry forward to main schedule) ...... 128,662.18 REV-1510 EX + (1~97) COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Pearce, AZZen M. 2!-2003-00110 This schedule must be completed and filed if the answer to anyof questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ~RI~ON OF PROPER~ %OF I~M INCLUDE THE NNvlE ~ THE 'I'RANSFEREE, THEIR RE~ONSHIP TO DATE OF DEATH DECD'S EXCLUSION ~ ~D THE DA~ OF ~SFER. A~ACH A CO~ OF THE TAXABLE VALUE NUMBER DEED ~R REAL ESTA~. VALUE OF ASSET INTEREST (F APPUCABLE) 1. New Cumberland Federal Credit ~,758.02 100.00 0.00 ~,758.02 Union IRA Share Certificate Beneficiary~ SDouse, Katherine K. Pearce 2 Thrift Savings Plan 60,099.04 100.00 0.00 60,099.04 Retirement Savings Account Acct. No. 165-38-1475 Beneficiary= Katherine K. Pearce 3 Thrivent Financial for 5,000.00[ 100.00 0.00 5,000.00 Lutherans i Annuity Contract No. LC3352813 Owner= Allen M. Pearce Beneficiary~ Katherine K. Pearce ~ New C~m~erland Federal Credit 5,079.93 100.00 0.00 5,079.93 Union IRA Share Certificate Beneficiary= Spouse, Katherine K. Pearce TOTAL(Alsoenteronline7, Recapitul~ion) $ 7~,936.99 (If more space is needed, insert additio~al sheets of same size.) 2W46AF 2.000 R~EV-1511 EX +,(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Pearce, Allen M. 2~-2003-00110 Debts of decedent must be reported on Schedule I. ITEM NUMBER 1. 5. 6. 7. DESCRIPTION FUNER/~EXPENSES: 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 Fees Family Exemption: (If decedent's address is not the same es claimant's, attach explanation) Claimant Street Address City State __ Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees AMOUNT 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL (Also enter on line 9, Recapitulation) $ 0.0 0 2W46AG 2.000 (If more space is needed, insert additional sheets of same size) R~V-1512 EX +'(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTSOFDECEDENT, MORTGAGE UABILITIES,& LIENS ESTATEOF FIIENUMBER Pearce, Allen M. 21-2003-00110 Include unreimbursed medical expenses. ITEM NUMBER 10 11 12 13 14 15 DESCRIPTION Holy Spirit Hospital medical bill Kunkel Surgical Group medical bill Associated Cardiologists medical bill Pulmonary & Critical Care Medicine Assoc. medical bill Kunkel Surgical Group medical bill Internists of Central PA medical bill Moffitt Heart & Vascular Group medical bill ***Billing Co unknown*** medical bill West Shore Tax Bureau 2002 income tax liability New Cumberland Federal Credit Union Visa credit card Quantum Imaging & Therapeutic medlcal bill Pulmonary & Critical Care Medicine Assoc. medical bill Internists of Central PA medical bill Moffit Heart E Vascular Group medical bill Internists of Central PA Total fro~ continuation pages .... TOTAL (Also enter on line 10, Recapitulation) 2W46AH 2.000 (If more space is needed, insert additional sheets of the same size) AMOUNT 24.58 74..78 2.42 102.50 20.00 87.15 6.50 51.25 95.29 2,954.86 3.30 362.50 78.15 10.50 54,. 65 A6,903.41 50,831.84 Estate of: Pearce, Allen M. Schedule I -- Debts of Decedent, MortgaHe Liabilities & Liens Page 2 2~-2003-00110 Item Value at No. Description Date of Death 15 medical bill 16 West Shore Family Practice medical bill 17 Associated Cardiologists medical bill 18 Harrisburg ~astroenterology, Ltd. medical bill 19 PA Department of Revenue one-half of 2002 income tax liability 5.21 1.21 20.00 17.50 20 New Cumberland Federal Credit Union A6,659.49 Second Mortgage on 1954 Sheepford Road, MechanicsburH, PA property (reported on Schedule F, Item 10) 21 Holy Spirit Hospital final medical bill 200.00 TOTAL. (Carry forward to main schedule) ...... 46,903.41 REV-1513 EX'+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Pearce. A11en M. NUMBER II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLEDISTRIBUTIONS[inclu~ ~tH~tspous~di~ri~tions, andtmn~em underS~.9116(a)(1.2)] Pearce, Katherine K. 1954 Sheepford Road Mechanicsburg, PA 17055 FILE NUMBER ~ [-2003-00110 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Spouse AMOUNT OR SHARE OF ESTATE 239,528.27 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.0 0 2W46AI 1.000 (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 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET DEATH CERTIFICATE LAST WILL AND TESTAMENT OF ALLEN M. PEARCE WHEREAS, on the 6th dated April 3rd 1992 Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters No. 2003-00110 ESTATE OF Late of PA No. 21-03-0110 PEARCE ALLEN M (LAs'r, ~'±~S'i', m±oom~) LOWER ALLEN TOWNSHIP CUM~E~_A_NU ~OUN'I'Y, Deceased Social Security No. 165-38-1475 day of February 2003 an instrument was admitted to probate as the last will of PEARCE ALLEN M (~S'i', ~'i~S'i', ~i~U~) late of LOWER ALLEN TOWNSHIP , CUMBERLAND County, who died on the 20th day of January 2003 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, DONNA M. OTTO , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to PEARCE KATHERINE K who has duly qualified as Executor(rix) and has agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the 6th day of February 2003. **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) LAST WILL AND TESTAMENT OF ALLEN M. PEARCE I, Allen M. Pearce of Mechanicsburg, Cumberland County, ,lvania, declare this to be my Last Will and Testament , revoking all prior wills and codicils. FIRST: The expenses of my last illness and funeral shall paid from the property of my estate. Disposal of my body shall in accordance with instructions that I will leave with my ~einafter named Executor. SECOND: At the time of making this Last Will and Testament, have no specific bequests. If, between now and the time of my eath there are any, I shall leave a signed list of them with my · einafter named Executor, THIRD: Ail the rest, residue and remainder of my estate I give, devise and bequeath to my wife, Katherine K. Pearce, ed that she survives me by thirty (30) days. LAW O~FICES OF KEITH A, BLANK 1940 Market St. Camp HII, PA 17O11 Phone: r'/17) 737-2670 LAW OFFICES OF KEITH A. BLANK 1940 Marke~ St. Camp H~, PA 17011 FOURTH: In the event that my wife, Katherine K. Pearce, does not survive me by thirty (30) days, then I hereby devise the rest, residue and remainder of my estate as follows: 1) In equal shares to all my surviving children. 2) To their issue, should they fail to survive me by thirty (30) days. FIFTH: Any share hereby bequeathed by me to a child who is a minor under the age of 25, shall be held in trust for said child under the following provisions: 1) My hereinafter named trustee shall have the option to hold any items bequeathed to said minor in kind for said minor or to sell at private or public sale, and hold the proceeds of said sale. 2) The said trust shall be for the benefit of said child, and payments shall be made for his needs, including, but not limited to maintenance, support, medical expenses and education, as my trustee shall decide in his sole discretion. The final amount of principal and interest as well as any items held in kind shall be distributed to the child when he has attained the age of 25. 3) The amount to be paid shall be determined from time to time by the needs ,~f said child, and the amounts and 2 LAW OFFICES OF KEITH A. BLANK 1940 Merke~ St. Camp Hill, PA 17011 times of said payments shall be determined by such need. The said payments may be made by my trustee directly to the said child, or may be made by my trustee directly to' any institution entitled to such payment by reason of services rendered to said child. In making said payments, my trustee shall give primary consideration to the individual needs of the child, and to the other sources of income available to the child, and the individual needs of the child shall override any consideration as to the equality of distribution for the purposes mentioned in this paragraph. 4) Any and all payments of any sums, whether in cash or in kind, and for principal or income, payable to the said child, or any beneficiary under this, my Last Will and Testament, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiary. 5) In addition to the powers conferred by law, I authorize the trustee in his sole discretion: to retain in the form received, or to sell either at public or private sale, any real or personal property; to manage real estate; to invest and reinvest in all forms of LAW O~cFICES OF KEITH A. BLANK 1940 Market St. Camp Hill, PA 17011 Phone: (717) 737-2670 property without regard to the principal of diversification; to exercise any option or rights arising from ownership of investments; to compromise claims without court approval, without consent of any beneficiary. 6) I nominate, constitute and appoint Victoria J. Wolf-Book as Trustee of said fund and as guardian of the person of any of my surviving children. SIXTH: I nominate, constitute and appoint my wife, Katherine K. Pearce, as Executrix of this, my Last Will and Testament. In the event that she is unable to do so for whatever reason, then I hereby appoint my friend, Barry L. Dando, as Executor of this my Last Will and Testament. SEVENTH: In the settlement of my estate, my Executrix shall possess, among others, the following powers: 1) To retain any investments I may have at my death, including specifically those consisting of stock of any bank even if I have named such bank as executor herein, so long as the executor may deem it advisable for my estate to do so. 2) To vary investments, when deemed desirable by this executor, and to inves~ ~n such bonds, stocks, notes, LAW OFFICES OF KEITH A. BLANK 1940 Marke{ St Camp Hill, PA 17011 ~,hnn~'/'717~ 7.c17J)R70 real estate mortgages or other securities or in such other property, real or personal, as they shall deem wise, without being restricted to so-called "legal investments", and without being limited by any statute or rule of law regarding investments by fiduciaries. 3) In order to effect a division of the principal of my estate or for any other purpose, including any financial distribution, the executor is authorized to make said divisions or distributions of the personalty and realty partly or wholly in kind, and to allocate specific assets among beneficiaries so long as the total market value of any share is not effected by such division or allocation. 4) To sell either at public or private sale and upon such terms and conditions as the executor may deem advantageous to the estate, any or all real personal property or interest owned therein by the estate severally or in conjunction with other persons or acquired after my death by the executor and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser ur pu£chas~rs to see to the application of the LAW OFFICES OF KEITH A. BLANK 1940 Marke{ St. Camp HE, PA 17011 Phone: (717) 737-2670 purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary to desirable in carrying out any of the powers conferred upon the executor in this paragraph or elsewhere in my will. 5) To mortgage real estate, and to make leases of real estate. 6) To borrow money from any party, including the executor, to pay indebtedness of mine or of my estate, expenses of administration, legacy, estate and other taxes, and to assign and pledge assets 'of my estate therefor. 7) To pay all costs, taxes, expenses and charges in connection with the administration of my estate or a trust. 8) To vote any shares of stock which form a part of the estate and to otherwise exercise all the powers incident to the ownership of said stock. 9) In the discretion of the executor to unite with other owners of similar property in carrying out any plans of the reorganization of any corporation or company whose securities form a part of the estate. LAW OFFICES OF KEITH A. BLANK 1940 Market St. Camp Hi, PA 17011 10) To do all other acts in their judgement deemed necessary or desirable for the proper and advantageous management, investment and distribution of the estate or trust. 11) The corporate fiduciary, if any, shall be entitled to compensation based on its regular schedule of fees for such services in effect at the time of the service rendered. EIGHTH: I direct that no trustee, executrix, or other fiduciary named, nominated or appointed in this my Last Will and Testament, shall be required to post any bond or give any security of any type for any purpose whatsoever, any law or rule of court of the Commonwealth of Pennsylvania or any other jurisdiction to the contrary, not withstanding. NINTH: All inheritance, estate and succession taxes (including interest and any penalties thereon) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person.· IN WITNESS W~EP.~OF, I have hereunto set my hand and seal to this, my~Last Will and Testament, consisting of ~ typewritten LAW OFFICES OF KEITH A. BLANK 1940 Mark~ St. Camp HE, PA 17011 Phone: (717) 737-2670 pages, the first -~ of which bear my signature at the bottom for the purpose of identification this ~ day of .,~,tm/~ , 199 ~. Allen M. Pearce WITNESS: / 8 COI~40NWEALTH OF PENNSYLVAN'rA : LAW OFFICES OF KEITH A. BLANK 1940 Market St. Camp Hill, PA 17011 Photo: 17171 737-,'~7(1 and ~~.~~ , the Testator and witnesses respectively, whose n~es are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Test~ent and that he signed willingly and that he executed it as his 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 will as witnesses and that to the best of their knowledge, the Testator was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. ALLEN M. PE~CE this t~d subscribed to before me day of ~ ' , 19 ~ · Nota~. Public / My commission expires: 9 Kathy A. '].b~ ~v. r.!,~,~;~',,' Pub{~c Camp i-',~ii [~orc, My Corer dss o'.'~ Me,, ,,. _ h Pe.r..ns;,'!'.,,anla:*,.s.:~;oc>.-,.,:,:-,r~ cf Notaries PA REV-1500 SCHEDULE A REAL ESTATE LOWER ALLEN TOWNSHIP TAX PARCEL NO. 13-23-0574-222 TItIS DEED is made the?~.~ day of DEED , in the year two thousand two (2002). BETWEEN LAWRENCE D. BECK, now of R.R. 1, Box 52-D, East Waterford, Pennsylvania 17021, and ALLEN M. PEARCE, now of 1954 Sheepford Road, Mechanicsburg, Pennsylvania 17055, as equal fifty percent (50%) tenants-in-common, and not as joint tenants with right of survivorship, together herein referred to as the GRANTORS. AND ALLEN M. PEARCE, now of 1954 Sheepford Road, Mechanicsburg, Pennsylvania 17055, party of the second part, herein referred to as the GRANTEE. WITNESSETH, that said parties of the first part, for and in consideration of the sum of ONE DOLLAR ($1.00), lawful money of the United States of America, well and truly paid by the said party of the second part to the said parties of the first part, at or before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged, have hereby granted, bargained, sold, aliened, enfeoffed, released, conveyed and confirmed, and by these presents do grant, bargain, sell, alien, enfeoff, release, convey and confirm unto the said party of the second part, his heirs, successors and assigns, ALL THAT CERTAIN lot or piece of ground with the buildings and improvements thereon erected, situate in the Township of Lower Allen, County of Cumberland, Commonwealth of Pennsylvania, more particularly bounded and described as follows, to wit: BEGINNING at a point on the southeasterly side of Kent Drive (fifty feet wide), said point being on the dividing line between Lot No. 9 and Lot No. 8, which point is at the distance of two hundred seventy-five feet measured northeastwardly along the said side of Kent Drive from a point the northeasternmost terminus of a radius round corner connecting said side of Kent Drive with the northeasterly side of Letchworth Drive (fifty feet wide); thence northeastwardly along the said side of Kent Drive sixty feet to a point at the dividing line between Lot No. 7 and Lot No. 8; thence southeastwardly by said dividing line a distance of one hundred twenty-five feet to a point on the dividing line between Lot No. 17 and Lot No. 8; thence southwestwardly by said dividing line and along line of Lot No. 16 a distance of sixty and twenty-one one-hundredths feet to a point on the dividing line between Lot No. 9 and Lot No. 8; thence northwestwardly by said dividing line a distance of one hundred twenty feet to a point at the place of BEGINNING. BEING Lot No. 8 Block D on Plan No. 4 of Highland Estates dated March 15, A.D., 1949, and recorded in Plan Book 4, Page 79&C, in the Office for the Recording of Deeds in and for Cumberland County. BEING House No. 1917 Kent Drive. UNDER AND SUBJECT TO certain building restrictions of record. BEING the same premises which Allen M. Pearce, Executor of the Estate of Perry L. Beck, deceased, by his deed dated November 17, 1999, and recorded on November 23, 1999, in the Cumberland County Recorder of Deeds Office in Deed Book 211, Page 972, granted and conveyed unto Lawrence D. Beck and Allen M. Pearce, Grantors herein, as equal filly percent (50%) tenants-in-common, and not as joint tenants with the right of survivorship. THIS IS A TRANSFER FROM TWO BROTHERS TO ONE OF THE BROTHERS ALONE AND IS, THEREFORE, EXCLUDED FROM THE PAYMENT OF REALTY TRANSFER TAX. 72 P.S. §8102-C.3(6). TOGETHER with all and singular the buildings and improvements, ways, streets, alleys, driveways, passages, waters, watercourses, rights, liberties, privileges, hereditaments and appurtenances, whatsoever unto the hereby granted premises belonging, or in any wise appertaining, and the reversions and remainders, rents, issues and profits thereoP, and all the estate, right, title, interest, property, claim and demand whatsoever of the said Grantors, as well at law as in equity, of, in and to the same. TO HAVE AND TO HOLD the said lot or piece of ground above-described, with all and singular the buildings and improvements thereon erected, hereditaments and premises hereby granted, or mentioned and intended so to be, with the appurtenances, unto the said Grantee, his heirs and assigns, to and for the only proper use and behoof of the said Grantee, his heirs and assigns forever. AND the said Grantors, for themselves, their heirs, executors and administrators, do covenant, promise and agree, to and with the said Grantee, his heirs and assigns, by these presents, that they, the said Grantors and their heirs, all and singular the hereditaments and premises hereby granted or mentioned and intended so to be, with the appurtenances, unto the said Grantee, his heirs and assigns, against them, the said Grantors and their heirs, and against all and every person and persons whomsoever lawfully claiming or to claim the same or any part thereof, by, from or under him, her, them or any of them, shall and will, subject as aforesaid, SPECIALLY WARRANT AND FOREVER DEFEND. IN WITNESS WHEREOF, the said parties of the first part have hereunto set their hands and seals, the day and year first written above. SIGNED, SEALED AND DELIVERED IN THE PRESENCE OF ~WRENCE D. BECK ALLEN M. PEARCE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS: On this, the ~9~th day of ,,~,q£/f/~ / ,2002, before me, a Notary Public for the Commonwealth of Pennsylvania, the undersigned/officer, personally appeared LAWRENCE D. BECK and ALLEN M. PEARCE, known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. My Commission Expires: Notarial Seal Stacey L. Nace, Notary Public Fermanagh Twp., Juniata County My Commission Expires Nov. 10, 2003 Member, Pennsylvania Association ol Notaries COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS: RECORDED in the Office for Recording of Deeds, etc., in and for said County, in Deed Book No. , Page . WITNESS my hand and official seal this __day of ,2002. Recorder of Deeds CERTIFICATE OF RESIDENCE I hereby certify that the present residence of the Grantee herein is as follows: Allen M. Pearce 1954 Sheepford Road Mechanicsburg, PA 17055 RETURN DEED TO: Allen M. Pearce 1954 Sheepford Road Mechanicsburg, PA 17055 ,,~- .,. ~7~-~ Mark E. Halbruner, Esquire Attorney for Grantee MORTGAGE SCHEDULE - PRINCIPAL & INTEREST COMPLIMENTS OF: Gates & Associates, P.C. Page:l FILE: BORROWER: SELLER: PROPERTY ADRESS: AMOUNT BORROWED ($) ANNUAL INT RATE (%) TERM OF LOAN (YRS) MONTHLY PAYMENT ($) $65,000.00 6.2500% 30 $400.22 PAYMENT YEARLY YEARLY CHECK MONTH DUE DATE PRINCIPAL INTEREST BALANCE PRINCIPAL INTEREST NUMBER 1 12/01/1999 61.67 338.54 64,938.33 61.67 338.54 3 02/01/2000 62 32 337.90 ~ 64,814.01 124 31 676.12 5 04/01/2000 62 97 337.25 64,688.40 249 93 1,350.94 7 06/01/2000 63 63 336.59 64,561.47 376 85 2,024.45 9 08/01/2000 64 29 335.92 64,433.22 505 10 2,696.63 11 10/01/2000 64 96 335.25 64,303.63 634.69. 3,367.47 13 12/01/2000 65 64 334.57 64,172.69 765.63 4,036.96 15 02/01/2001 66.33 333.89 64~ 040.38 [32.31 668. ~2 17 04/01/2001 67.02 333.20 63,906'. 69 266.00 1,334.86 19 06/01/2001 67.72 332.50 63,771.60 401.09 2,000.21 21 08/01/2001 68.43 331.79 63,635.10 537.59 2,664.14 23 10/01/2001 69.14 331.07 63,497.18 675.52 3,326.65 25 12/01/2001 69.86 330.35 63,357.81 814.88 3,987.71 27 02/01/2002 70.59 329.62 63~ 216.99 140.82 659.61 328.89 63~ 074. ?0 283. ~Z ~ 3~?. 75 31 06/01/2002 72.08 328.14 62, 930.92 426.89 1, 974.41 33 08/01/2002 72.83 327.39 62,785.64 572.17 2~629.56 35 10/01/2002 73.59 326.63 62,638.84 718.97 3,283.20 37 12/0~/2002 74.36 325.86 62,490.51 867.30 3,935.30 39 02/0~/2003 75.13 325.08 62~340.64 149.88 650.55 PA REV-1500 SCHEDULE E CASH, BANK DEPOSITS & MISCELLANEOUS PERSONAL PROPERTY PNCBAN May 1, 2003 Traci L. Sepkovic 1013 Mumma Road Suite 100 Lemoyne, PA 17043 Estate of ,aden M. Pearce, declmscd SSN: 165-38-1475 DOD: 1/20/2003 Dear Ms. Sepkovic: In respons~ to your re, quest for Date of Death balances for thc customer noted above, our records show the following: Cerlificste of Deposit Account #31400152615 ALLEN M PEARCI~ DOD balance: $14,573.53 + $9.13 accrued interest Interest Paid 1/1/2003 - 1/20/2003 ? $20.20 Established 04/06/1999 Please note that this office only provides date of cleath balances for deposit accounts (IRA& CDs, Checking and Savings accounts). We do not process any financial trsassctlons or provide statements. If you nccd ~ssistance with any of these itmm, please call 1-885-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, Rachellc WeBs 1-800-762-1775 P7-PFSC-04~F 500 first Ave. Pittsburgh PA 15219 Member FDIC TOTRL P.01 PA REV-1500 SCHEDULE F JOINTLY OWNED PROPERTY Wag U~()K t=OR US. WE'LL GET YOU THERE. 03/26/2003 GATES HALBRUNE & HATCH 1013 MUMMA ST SUITE 100 LEMOYNE PA 17043 The information which you requested on the account(s) of ALLEN PEARCE (Social Security Number 165-38-1475) is/are as follows: Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established 100255462 100256395 700002617 700018452 753255625 753261256 CHECKING CHECKING CERTIFICATE CHECKING CERTIFICATE CERTIFICATE 01/02/02 01/02/02 12/01/97 11/20/91 12/02/94 02/25/95 945.53 486.16 1259.28 8653.44 2924.49 700.85 .07 .04 1.78 .12 6.71 .49 945.60 486.20 1261.06 8653.57 2931.20 701.34 JTO JTO KATHERINE KATHERINE PEARCE PEARCE 01/02/02 01/02/02 760000069 760255627 SAVINGS CERTIFICATE 06/06/92 12/02/94 2648.81 2970.65 .07 4.13 2648.88 2974.78 JTO JTO KATHERINE KATHERINE PEARCE PEARCE 06/06/92 12/02/94 JTO JTO JTO JTO KATHERINE KATHERINE KATHERINE KATHERINE PEARCE PEARCE PEARCE PEARCE 12/01/97 11/20/91 12/02/94 02/25/95 Additional Information Requested erely~ ,~ P.O. Box 171 I, HARRISBURG, PENNSYLVANIA 17105-1711 Toll Free 1-866-WAYPOINT (I-866-929-7646) · IN YORK AREA 717/1~15-4500 · www. wagpointbank.com COMMON STOCK HARRISBURG, PENNSYLVANIA CHARTERED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA COMMON STOCK CUSIP 946756 10 3 SEE REVERSE FOR CEFCI'AIN DEFINITIONS THISCI~ '~ '-"RI:'"LER' M::'?~,E~RcE ~i,:~:i,-~ ',i. ,,.;.:;i~ ,,, i~.,,: :: ~,.,, :~- : :i:::::~:.:'.~,~¥'.~i~;F~'I~'~!'!.::l~i p~A~'F~ :"~T: :'~EN:i':~', ~. ',,: FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK, $0.01 PAR VALUE PER SHARE, OF The s~es'evl~d ~,ce~flcate::are transferable only o~'the books 'o[~:~av9o fiBF ~[~orD ~,~O ~r~ot}}~ a~YsSA oe;~¢~ornev unon surrendero~l~ee~te~yeA~Orsed;Thefcap~ stockevdencedhemby ~nolan~c t mn ns b.. d~o~, s d"b' theFedera De Dst :::~ ,~ ...... ~ .... ;,~ :.. .... . . . ................. ~ .... ~ ~ . .YP ....... ~ ~ ,, Y P n s u ra nco C~?a~ ~.F~ra[...Or ~tate gove r n me,tal age ~..~¢~.~ ...i~.~ ,~.~. ~ This Certificate is not valid unless countersigned and registered by the Transfer Agent and Registrar. IN WITNESS WHEREOF, Waypoint Financial Corp. has caused this certificate to be executed, by the facsimile signatures of its duly authorized officers and has caused a facsimile of its seal to be hereunto affixed. Dated: RICHARD C. RUBEN, SECRETARY .-< SEAL :a-: ~ ~ 2000 .'a =- g CHARLES C. PEARSON, JR., CHAIRMAN COMMON STOCK HARRISBURG, PENNSYLVANIA CHARTERED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA COMMON STOCK CUSIP 946756 10 3 SEE REVERSE FOR CERTAIN DEFINITIONS FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK, $0.01 PAR VALUE PER SHARE, OF ..~::~.~.'.~!~i~,..'~'~..., ~:~ ' WAYPOINT FINANClAL!CORE;~!~ ~:~-~ ~- ~-'~'~ ~'~':' '~ ' ' ' " ~ :~' '~" .... ":' " " "' :" ~ ' :' ' ' "~' ' '~ "'?'~ ' ' ~ ~ ~ ~"'~ ~" r¢~'~''~"~'~ on The sh~ps',eVm~d ~ertiflcate: are:!,ansfe~bleonly ontthe bo0~ of~ypomnt~,~c~rp. ~~ ~A ~son o f~orney, up surrender o¢~hi~.~ ~ en~rsed~he~c~Pit~l:stock e~id6hced hereby i~6~tan ~t ~ insu~pe~d 'i~s~d ~ t~eral Deposit This Certificate is not valid unless countersigned and registered by the Transfer Agent and Registrar. IN WITNESS WHEREOF, Waypoint Financial Corp. has caused this certificate to be executed, by the facsimile signatures of its duly authorized officers and has caused a facsimile of its seal to be hereunto affixed. Dated: .10/i RICHARD C. RUBEN, SECRETARY 2000 .~ CHARLES C. PEARSON, JR., CHAIRMAN O New Cumberland Federal Credit Union P.O. Box 658 New Cumberland, PA 17070-0658 Phone: (717) 774-7706 · 1-800-716-2328 ° Fax: (717) 774-7996 · Web: www. ncfcuonline.org March 19, 2003 Gates, Halbruner & Hatch, P.C. Attn: Traci Sepkovic 1013 Mumma Road Suite 100 Lemoyne, PA 17043 Dear Ms. Sepkovic, This letter is in response to your recent letter concerning the Estate of Allen M. Pearce. 1. Account is titled Allen M. or Katherine K. Pearce; 2. Joint owner, Katherine K. Pearce; 3. Account was opened 12/03/79; 4. Designated beneficiary on the savings account, LaVan Beck, mother of the deceased; 5. No changes; 6. Balances as of 01/20/03, Savings $5,906.79, Checking $465.63, Christmas $259.76. 1 IRA Share Certificate $5,079.93, 1 IRA Share Certificate $4,758.02; 7. Interest earned 01/01/03 - 01/20/03, Savings $6.16, Checking $.82, Christmas $.26. 8. Visa credit card, Katherine K, Pearce is co-applicant, balance $2,954.86, finance charge i2.90%, no insurance. 2~'a Mortgage balance $46,659.49, daily interest accrual $10.18 (as of the date of this letter), no insurance. Any questions please give our office a call, Monday thru Friday 8:00a.m. to 4:00 p.m. 717-774-4633, ext 214. Sincerely, Sharon Lee NCFCU New Cumberland Federal Credit Union P.O. Box 658 New Cumberland, PA 17070-0658 Phone: (717) 774-7706 · 1-800-716-2328 · Fax: (717) 774-7996 · Web: www. ncfcuonlinc org March 19, 2003 Gates, Halbmner & Hatch, P.C. Attn: Traci Sepkovic 1013 Mumma Road Suite 100 Lemoyne, PA 17043 Dear Ms. Sepkovic, This letter is in response to your recent letter concerning the Estate of Allen M. Pearce. 1. Account is titled Allen M. or Katherine K. Pearce; 2. Joint owner~ Katherine K. Pearce; 3. Account was opened 12/03/79; 4. Designated beneficiary on the savings account, LaVan Beck, mother of the deceased; 5.No changes; 6. Balances as of 01/20/03, Savings $5,906.79, Checking $465.63, Christmas $259.76. 1 IRA Share Certificate $5,079.93, 1 IRA Share Certificate $4,758.02; 7. Interest earned 01/01/03 - 01/20/03, Savings $6.16, Checking $. 82, Christmas $.26. 8. Visa credit card, Katherine K, Pearce is co-applicant, balance $2,954.86, finance charge i2.90%, no insurance. 2~'~ Mortgage balance $46,659.49, daily interest accrual $10.18 (as of the date of this letter), no insurance. Any questions please give our office a call, Monday thru Friday 8:00a.m. to 4:00 p.m. 717-774-4633, ext 214. SiNcerely, Sharon Lee NCFCU Page 2 of 2 REAL PROPERTY TAX ASSESSOR RECORD Tax Roll Certification Date:il-29-2000 Owner Information Current Through:N/A County Last Updated:0i-04-2002 Current Date:01/21/2003 Source:TAX ASSESSOR , CUMBERLAND, PENNSYLVANIA OWNER INFORMATION Owner(s): PEARCE ALLEN M PEARCE KATHERINE K Property Address:1954 SHEEPFOPdD RD MECHANICSBURG PA 17055-6736 Mailing Address:1954 SHEEPFORD RD MECHANICSBURG PA 17055-6736 PROPERTY INFORMATION County:CUMBERLAND Assessor's Parcel Number:ll-0270-019B Property Type:SINGLE FAMILY RESIDENCE - TOWNHOUSE Land Use:SINGLE FAMILY RESIDENCE Lot Size (acres or square feet) :175546 Lot Acreage:4.0300 Width Footage:100 Depth Footage:955 Legal Description:LOT 3 PB 49 PG 550 Lot Number:3 TAX ASSESSMENT INFOP. MATION Tax Year:2000 Land Value:S62,760.00 Improvement Value:S176,830.00 Total Value:S239,590.00 Valuation Method:ASSESSED Tax Amount:S2,976.79 BUILDIN~/IMPROVF~4ENT CHARACTERISTICS Number of Buildings:l Living Square Feet: 2426 LAST SALE INFORMATION Sale Date:06/04/1986 Sale Price:S28,500.00 Deed Type:GRANT DEED Recording Book/Page:Book 31X, Page 868 END OF DOCUMENT Copr. © West 2003 No Claim to Orig. U.S. Govt. Works PA REV-1500 SCHEDULE G INTER-VIVOS TRANSFERS and MISCELLANEOUS NON-PROBATE PROPERTY ***' Thrift Savings Plan ** National Finance Center '~ P.O. Box 61500, New Orleans, LA 70161-1500 THRIFT SAVINGS PLAN March 24, 2003 Law Offices of Gates, Halbruner & Hatch, P.C. Suite 100 1013 Mumma Road Lemoyne, PA 17043 Re: TSP account of Allen M. Pearce, Deceased Dear Ms. Sepkovic: This answers your letter to our office dated March 13, 2003, requesting information about the Thrift Savings Plan (TSP) account of Allen M. Pearce. The TSP is one part of the retirement system created for Federal employees in the Federal Employees' Retirement Savings Act of 1986. (See 5 U.S.C. §§ 8351, 8401-79.) The TSP is a tax-deferred retirement savings plan similar to those authorized under section 401(k)of the Internal Revenue Code for private sector employees. The TSP began accepting contributions from Federal employees in April 1987 and from members of the Uniformed Services in January 2002 and Mr. Pearce's first contribution was accepted in May 1987. Mr. Pearce's TSP account number is his Social Security number and the account is held solely in his name. As of the date of death, Mr. Pearce's TSP account balance was $60,099.04 and there were no outstanding loans. The disposition of a TSP account is a matter of Federal law. The account balance of.a deceased participant is distributed according to the order of precedence found at 5 U.S.C. § 8424(d). First in the order of precedence is the beneficiary or beneficiaries designated by the participant in a properly executed and filed Form TSP-3, Designation of Beneficiary. If there is no designated beneficiary, the account is paid to the participant's surviving spouse. If there is no surviving spouse, the account is paid to the children of the participant, and descendants of deceased children by representation. If there is no child of the participant (or descendants of deceased children), the account is paid in equal shares to the parents of the participant, or entirely to the survivor of them. In the absence of these enumerated beneficiaries, the account is paid to the executor or administrator of the deceased participant's estate (including one authorized to dispose of the estate under small estate procedures). If no estate is administered, the account is paid to the participant's next of kin under the laws of the state of the participant's legal residence at death. New Cumberland Federal Credit Union P.O. Box 658 New Cumberland, PA 17070-0658 Phone: (717) 774-7706 · 1-800-716-2328 ° Fax: (717) 774-7996 · Web: www. ncfcuonline.org March 19, 2003 Gates, Halbmner & Hatch, P.C. Attn: Traci Sepkovic 1013 Mumma Road Suite 100 Lemoyne, PA 17043 Dear Ms. Sepkovic, This letter is in response to your recent letter concerning the Estate of Allen M. Pearce. 1. Account is titled Allen M. or Katherine K. Pearce; 2. Joint owner, Katherine K. Pearce; 3. Account was opened 12/03/79; 4. Designated beneficiary on the savings account, LaVan Beck, mother of the deceased; 5. No changes; 6. Balances as of 01/20/03, Savings $5,906.79, Checking $465.63, Christmas $259.76. 1 IRA Share Certificate $5,079.93, 1 IRA Share Certificate $4,758.02; 7. Interest earned 01/01/03 - 01/20/03, Savings $6.16, Checking $.82, Christmas $.26. 8. Visa credit card, Katherine K, Pearce is co-applicant, balance $2,954.86, finance charge i2.90%, no insurance. 2nd Mortgage balance $46,659.49, daily interest accrual $10.18 (as of the date of this letter), no insurance. Any questions please give our office a call, Monday thru Friday 8:00a.m. to 4:00 p.m. 717-774-4633, ext 214. Si,..ncerely, ~, Sharon Lee NCFCU New Cumberland Federal Credit Union P.O. Box 658 New Cumberland, PA 17070-0658 Phone: (717) 774-7706 · 1-800-716-2328 · Fax: (717) 774-7996 · Web: www.ncfcuonline.org March 19, 2003 Gates, Halbmner & Hatch, P,C. Attn: Traci Sepkovic 1013 Mumma Road Suite 100 Lemoyne, PA 17043 Dear Ms. Sepkovic, This letter is in response to your recent letter concerning the Estate of Allen M. Pearce. 1. Account is titled Allen M. or Katherine K. Pearce; 2. Joint owner, Katherine K. Pearce; 3. Account was opened 12/03/79; 4. Designated beneficiary on the savings account, LaVan Beck, mother of the deceased; 5. No changes; 6. Balances as of 01/20/03, Savings $5,906.79, Checking $465.63, Christmas $259.76. 1 IRA Share Certificate $5,079.93, 1 IRA Share Certificate $4,758.02; 7. Interest earned 01/01/03 - 01/20/03, Savings $6.16, Checking $.82, Christmas $.26. 8. Visa credit card, Katherine K, Pearce is co-applicant, balance $2,954.86, finance charge i2.90%, no insurance. 2nd Mortgage balance $46,659.49, daily interest accrual $10.18 (as of the date of this letter), no insurance. Any questions please give our office a call, Monday thru Friday 8:00a.m. to 4:00 p.m. 717-774-4633, ext 214. Sipcerely, Sharon Le NCFCU rThrivent Financial for LutheransTM 4321 N. Ballard Road, Appleton, WI 54919-0001 Phone: 800-THRIVENT (800-847-4836) E-maih mail@thrivent.com · www. thrivent.com The union of AAL and LB Securities offered through Thrivent Investment Management Inc., 625 Fourth Ave. S., Minneapolis, MN 55415-1665, a wholly owned subsidiary of Thrivent Financial for Lutherans. Member NASD. Member SIPC. April 1, 2003 Traci L Sepkovic Gates, Halbruner & Hatch, PC Suite 100 1013 Mumma Rd Lemoyne, PA 17043 Claim 159301 - Allen M Pearce Dear Traci: Thank you for your letter dated March 13, 2003 regarding the death of Allen M. Pearce. Mr. Pearce had contract LC3352813 in effect at the time of his death. This contract was a Non- Qualified Variable Annuity contract solely owned by Allen Pearce. The contract was issued 8/2/2000 and named Katherine Pearce, spouse, as the beneficiary. The date of death balance on this contract was $5,000. The claim on this Contract has been settled. If you have any further questions, please let me know. Sincerely, Karen Pleshek Death Claim Examiner (800) 847-4836, ext. 2018 Karen. Pleshek@thrivent. com CIF503945474 PA REV-1500 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES and LIENS ]I--IOLY Holy Spirit Hospital 50~ N 215T STREET CAMP HILL PA 17011 717-763-2141 For Account Information, Please Call 717-763-2141 Transaction D~e Description PREVIOUS BALANCE 12/27/02 LEVEL III FC 12/27/02 ED LEVEL Iii PC 01/22/03 BC C/A NOSP OP BO9 361 01/22/03 BC PYNT 0P B09 361 gatimated lmm'ante Dui: -- .00 ,00 312.00 170.00 236.18- 221.24- . ~?-_ - .~ -. .-~:~..: Account lin]ante: YOUR INSURANCE HAS BEEN BILLED.THIS-ISYOUR CURRENT BALANCE. YOUR PAYMENT IS DUE UPON RECEIPT. THANK YOU. B09 361 .00 PLEASE DISREGARD THIS STATEMENT IF YOU HAVE PAID. // 003217L 03130 Kunkel SurglcM Group 090 Poplar Chumh Rd ~210 Camp Hill PA 17011 015355DS FORWARDING SERVICE REQUESTED ACCOUNT NUMBER PEARAL-O1 TF PAY/N9 BY CREDTT CARD, PAGE STATEMENT DATE PAY THIS AMOUNT % AMOUNT//~ - : iI ENCLOSED// $ Kunkel Surgical Group 890 Poplar Church Rd #210 Camp Hill PA 17011 Allen M Pearce 1954 Sheepford Road Mechenicsburg PA 17055 [] PIease check box if abo~,e addressee is incorrect or insurance _A 'Vi ~_ · -*-._-_ · ! _~ information has changeO, and indicate change(s) on reverse side. PLEASE DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT 36.00- 02/05/03 o2/os/o3 o~/O,~/~i .~ O] 12/29/02 93010 3/ 3/03 03/03/03 o~/os/o~ · ~gl-7122 742 1631 X Pulmonary and CriticaI Care Medicine Associates, P.C. 1631 N. FRONT sTREET 0HARRISBURG, PA 17102 PHONE: (717) 234-2561 ROBERT C. GILROY, M.D. WILLIAM M. ANDERSON, III, M.D. FRANKLIN J. MYERS, III, M.D. RICHARD G, EVANS, D.O. TIMOTHY A. CLARK, M.D. AL, LEN PEARCE 1954 SHEEPFORO RO MECHANIC$SURG PA 17055 38304 (i) 1 0 0 0 0 /28/o2 1i51o~ /15/o3 /04/03 /15/o3 ~L6N PEARCE (38304.0) RITICAL CARE 1ST In~ Pmt-8 85 PA Adjustment HOUR EVEL 5 SUBSEQUENT HOSPITA Adjustment $85.00 was applied TO1 A L 250,00:- ./- 01:/09~0.S23: 0X/10~0324' OX/X1/0322 100.00 - '. 20.00~ -: 72.00- ':'5]~2.8l~'o. 0-0 · 30. O0- ---X08.00- 0, O0 ~'.56- 8.00 12.00 ~ROVIDER/ ' NAME INQUIRIES, CALL 717-761-~24~ '-':'- I PAYMENT03/X~/o3 - - . DUE DATE :'" : ~:. 0-,00 20.00 ~ 1~0 I~AYB PLEASE PAY THIS AMOUNT 'ON:YOUR NEXT STATEMENT PAr~ Patient: Allen M, Peame ' -_-" (~i~art N ~'-"~' ..... ~'-" ..... ~'~::-::~"': I:' Paid.by --- ':-'.:~ ~..~ '.:~:-~:~..tO .~ Paid By 9at~ Pmc~ure Cha~e P~ma~:'.... :--. :~'-~:~::~:'~:~{ible Gua~ntor_ Adjustments Remai~er 12/29/02 992~ 193,00 -126,00 :' :-' - ":?::'~ '-53;00 14,00 12/30/02 99231 ~,~ -36,00 ~' ' ~'-~- ~ ~,00 4,00 )1/14/03 99231 ~,00 ~6,~ ~,00 4,00 ~1/15/03 99232 66,00 -58,50 -1,00 6,50 ~1/1W03 99232 66,~ -58,~ _:. -1,00 6,50 3OINSURANCEAMOUNT DUE, PLEASE SI~ID PAYS, THANK YOU Patient: Allen M, Pearce Chart Number. PEAAL000 Case: hosp fed bs Paid by Applied to. ::~id By Dates Procedure Charg~ Primary Deductible :;[G-_uamntor 31/20/03 99232 66.00 -48.75 3OINSURANCEAMOUNT DUE, PLEASE SE~ID PAYIV~flT, THANK YOU STATEM B~rl' NOTICE~ -st Statement - Payment is due upon receipt of stateme.-nt PAYMB~I .)-nd Statement - Past Due -Remit Payment to avoid Lat~e :': ~-rd Statement - 1.5% hterest may be added if n. ot-~:~i~'~v ithing 10:d_ays. __ l-th Statement - Rnal Notice Adjustments Remainder -1,00 16,25 _- QUANTUM IMAGING & THERAPEUTIC BILLING OFFICE / A93 - - 2527 CRANBERRY HIGHWAY WAREHAM MA 02571-5010 800-299-9770 OR 508-295-5556 251792806 FORWARDING SERVICE REQUESTED If you have an HMO please reply promptly 7634 1 AV 0.278 _ KATHY PEARCE A93'232374.- 1954 SHEEPFORD ROAD MECHANICSBURG PA 17055-6736 I,,,lll,,,lll,,,,I,h,l,l,,ll,,I,,,I,,ll,,il,,,I,l,,I,,I,,,lll PAGE 1 01/08/03 HOLY SPIRIT HOSPITAL ~ 74022 789.00 ABD. St=~,III=$ WITH PA C - -' " 66,00 09:4 02/13~03 · a/SP~N~-~'~ ::: ~-.~.~ ~'~' -a.7o 02/13/03 B/S ADJUSTMENT ..... · -33,00 MSG 094 = BLUE CROSS BLUE SHIELD HAS PROCESSED THIS CLAIM. THE BALRNCE SHOWN IS YOUR RESPONSIBILITY. -0- ' FOR A,__F L~9.00 OEARC£ 362., $0 :3e 5. OO &7., SO 0. O0 0. GO ,3. r30 PLEASE MAKE CHECK PAYABLE TO: INTERNISTS of Central Pa. :::LTD." 23-2146427 Peter 1~. Brier, M.D. Michael L. Gluck, M.D. James A. Tyndall, M.D. Ira ]. Packman, M.D. Richard Schreiber, M.D, EA.C.R L. Lynne Britton, M D Lawrence B. Zimmerman, M.D. Michael A. DeMichele, M.D. Carla J. Dente, M.D. Dominic Mirarchi, D.O. Wendy Schaenen, M.D. PaJ~ick Ramasam)5 M.D. An~zej R. Walker, M.D. V. Martha Kapoor, M.D. Vlctceiya K. Abramova, M.D. Dean L. Lehman, PA-C Beth M. Rabedeau, PA-C Michelle L. Latsha, PA-C HARRISVIEW PROFESSIONAL CENTER · 108 LO~ ST. · EO. BOX 107 · LEMOYNE, PA 17043-0107, (717) 774-1366 FAX (717) 7744232 ALLEN M PEARCE 1954 SI-IEEPFORD ROAD MECI{ANICSBURG PA 17055 [] PLEASE CHANGE ADDRESS IF INCORRECT 28206 1158.15 78.15 CHARGES OR PAYMENTS MADE AFTER CLOSING DATE WILL APPEAR ON NEXT STATEMENT, Page No. 2 OlZ~SZo3 02~19~03 02/19~03, PAT~ 1" 15- Ins HOSPITAL] Accept~ Ass i 10.50 MOFFITT 1000 NORTH-: WOP, MLEySBURG, PA' I'ALL~N M-PEARCE GROUP- :. :,T' -':. ' ?Phl( 10.50' ** StaCemen= Due Upon Receipt * Thank You ** * Insurance Pending CLOSING DATE: ACCOUNT 02/13/03 .; NUMBER 28206 INTERNISTS OF CENTRAL PA. · 108 LOWTHER ST. · RO. BOX 107 · LE54OYNE, PA ]7043-0107 · (7]7) 774-1366 FAX (717) 774-4232 STATEMENT Register of Wills Pennsylvania Estate of Allen M. Pearce also known as Katherine K. Pearce Cumberland County, INVENTORY , Deceased No. 23-2003-00110 Date of Death January 20, 2003 Social Security No. 165-38-1475 Personal Representative{s) of the above Estate, deceased, verify that the items appearing in the following inventory include ail of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Oecedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: I.D. No.: Address: Mark E. Halbruner, Esquire 66737 Gates, Halbruner & Hatch, P.C. presentative: ,/ Katherine K. Pearce Dated 1013 Mumma Road, Suite 100, Lemoyne, PA 17043 Telephone: 717-731-9600 RW-8 Description Two-story, single family dwelling located at 1917 Kent Dr Camp Hill, Cumberland County, Pennsylvania; being Tax Parcel No. 23-0547-222. PNC Bank Certificate of Deposit No. Internal Revenue Service income tax refund 31400152615 Value ~ve, $62,415.77 14,582.66 2,644.00 Total: $79,642.43 (Attach Additional Sheets if necessary) ,'.~,':, NOTE: The Memorandum of real estate outside the Commm~wealth of Pennsylvania mav, at the election o! the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. BUREAU OF ZNDZVZDUAL TAXES TNHERZTANCE TAX DIYTSTON DEPT. 280601 HARRISBURG, PA 17128-0601 CONHONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLOHANCE OF DEDUCTZONS AND ASSESSHENT OF TAX MARK E HALBRUNER ESQ GATES ETAL 1015 MUMMA RD STE 100 LEMOYNE PA DATE ESTATE OF DATE OF DEATH FZLE NUHBER COUNTY ACN 11-17-2003 PEARCE 01-20-Z003 21 03-0110 CUMBERLAND 101 Amount Raeltted RE¥-1;1~7 EX AFP (01-05) ALLEN H HAKE CHECK PAYABLE AND RENZT PAYHENT TO: REGISTER OF NTLLS CUHBERLAND CO COURT HOUSE CARLTSLE, PA 17013 CUT ALONG THZS LZNE ~ RETATN LONER PORTTON FOR YOUR RECORDS -M REV-1547 EX AFP (01-03) NOTZCE OF ZNHERTTANCE TAX APPRATSENENT, ALLONANCE OR BTSALLONANCE OF DEDUCTTONS AND ASSESSHENT OF TAX ESTATE OF PEARCE ALLEN HFTLE NO. 21 03-0110 ACN 101 DATE 11-17-2003 TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATTON CONCERNZNG FUTURE TNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A} (1) 2. Stocks end Bonds (Schadula B) (2) 3. Closely Held Stock/PartnarshAp Interest (Schedule C) (3) 4. Nortgagas/Notes RacaAvable (Schedule D) (4) 6. Cash/Bank Daposits/Nisc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) {6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXENPTZONS: 9. Funeral Expensas/Adm. Costs/HAsc. Expanses (Schedule H) (9) 10. Dabts/Nortgaga LiabAIAtAas/L/ans (Schedule 1) (10) 11. Total Deductions 12. Net Value of Tax Return 621415.77 .00 .00 .00 171226.66 135~780.70 74~936.99 NOTE: To insure proper credit to your account, submAt the upper port/on of this fora with your tax payment. 290,360.11 .00 50~851.84 (11) SO.B3].B~ {12) 259,528.27 13. 14. NOTE: ASSESSHENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rata 17. Amount of L/ne 14 et Sibllng rata 18. Amount of LAne 14 taxable et Collateral/Class B rate 19. Pr/nc/pal Tax Due TAX CREDZTS: PAYMI~NT RECEIPT DT$COUNT (+) DATE NUHBER ]:NTEREST/PEN PA:]:D (-) CharAtabla/Governeental Bequests; Non-elected 9113 Trusts (Schedule J) (13) . O0 Net Value of Estate Subject to Tax (14) 239,528.27 Z~ an assessment ~as lssued previously, 11nes 14, 15 and/or 16, 17, 18 and 19 ~ill reflect flgures that /nclude the total of ALL returns assessed to date. (15). 239,528.27 X O0 = .00 (16). .00 X 045= .00 (17) .00 X 12 = .00 (18) .00 x 15 = .00 (19)= . O0 ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ANOUNT PAZD TOTAL TAX CREDZT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE .00 .00 .00 .0O ( ZF TOTAL DUE 1S LESS THAN $1, NO PAYHENT ZS RE~UIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SZDE OF TH[S FORN FOR /NSTRUCTZONS.) ./ RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUNO (CR): OBJECTIONS: ADNIN- ZSTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decadents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class S (collateral) beneficiaries of the decedent after tho expiration of any estate for Zife or for years, the CommonaaaZth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (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 9IqO). Detach thm top portion of this Notice and submit with your payment to the Register of Nills printed on the rmversa side. --Hake check or money order payable to: REGISTER OF #ILLS, AGENT A refund of a tax credit, which wes not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Ester. Tax" (REV-IS13). Applications are available at the Office of the Register of Hills, any of the Z3 Revenue District Offices, or by calling the special Z~-hour ansmering service for forms ordering: 1-800-S6Z-ZO50; services for taxpayers aith special hearing and / or speaking needs: 1-800-~7-$0Z0 (TT only). Any party in intmrast not satisfied mith the appraisement, alloaance, or disallomance of deductions, or assessment of tax (including discount or interest) as sheen on this Notice must object within sixty (60) days of receipt of this Notice by: --aritten protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171Z8-1021, 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 eriting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviea Unit, Dept. 280601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decmdent's death, a five percent (BI) discount of the tax paid is alloeod. 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 end 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 data of death, to the date of payment. Taxes which became delinquent before January l, 198Z boar interest at tho rate of six (SI) percent per annum calculated at a daily rate of .00016~. A11 taxes ahich became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOOS are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 ZOZ .0005~,8 1987 9Z .0002~? X999 7Z . OOOlgZ 1983 16Z .000~,38 1988-1991 117. .OOOSO1 2000 8Z .000219 198q X1Z .000301 1992 97. . O00Z~,7 ZOOl 97. . O002~,7 1985 137. .000356 1995-199o, 7Z .000192 ZOOZ 6X .00016~ 1986 lOX . O00Z7o, 1995-1998 9X . O00Z~,7 ZOOS 5Z .000137 --Interest is calculated as folloes: INTEREST = BALANCE OF TAX UNPATD X NUHBER OF DAYS DELINI~UENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent mill 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 bo calculated. PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE FORM 6.12 YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Will No.: Allen M. Pearce January20,2003 21-2003-0110 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes If the answer is No, state when the personal representative reasonably believes that the administration will be complete: N/A If the answer to No. 1 is yes, state the following: A. Did the personal representative file a £mal account with the court? No Bo The separate Orphans' Court No. (if any) for the personal representative's account is: none Did the personal representative state an account informally to the parties in interest? Yes Do Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date: January 14, 2004 Mark E. Halbruner, Esquire PA I.D. # 66737 GATES, HALBRUNER & HATCH, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 (717) 731-9600 Capacity: Counsel for Personal Representative