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HomeMy WebLinkAbout03-0121 PETITION FOR GRANT OF LETTERS Estate of BERTHA V. SMITH No. 21 03 J ~ I , also known as , Deceased Social Secudty No. 188323788 FRANCES E. OILER AND DOROTHY R. SMITH Petitioner(s), who is/am 18 yearn of age or older, apply)les) for: (COMPLETE "A" OR "B" BELOW:) r~ A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execu, t ORS named in the Last Will of the Decedent, dated 11/16199 and codicil(s) dated LAURIE F. SMITH DIED 12/13/01 State relevant circumstances, e.g.. renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: ~ (c.t.a., d.b.n.c.t.a.: pandente, lite, durante abeentia; durante minoritate) B. Grant of Letters of Administration Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survi,~ed by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled .at death in CUMBERLAND County, Pennsylvania, with his/her last family or principal residence at 175 WHISKEY RUN ROAD~ UPPER MIFFLIN TOWNSHIP, NEVVVILLE, PA (list street, number and municipality) Decedent, then 90 years of age, died JANUARY 25 ,2003 , at CARLISLE REG MED CTR (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property ......................................... $ 2~000.00 (if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ 150~000.00 Tetal. .............................................................. ~ .................................................... $ 152,000.00 Real Estate situated es follows: 175 WHISKEY RUN ROAD, NEWVILLE, PA * Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: I 'Signature Typed or pdnted name and residence I I '~~ g', ~-~,'~/~'X~ FRANCES E. OILER I 573 BRANDY RUN ROAD, NEWVlLLE, PA 17241 DOROTHY R. SMITH 510 N. ~)VER ST. CARLISLE PA 17013 Oath of Personal Representative Commonwealth of Pennsylvania County of CUMBERLAND The Petitioner(s) above-named swear(s) and afffirm(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(s) of the Swor,,oan e before me this ~ day of /~~/ FEBRUARY, 2003 dO~Y~ ~M~ ' - DECREE OF REGISTER Estate of BERTHA V. SMITH Deceased No. 21 03 121 also known as Social Security No: 188323788 Date of Death: 1/25/03 AND NOW, FEBRUARY 7 th 2003 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters I~ Testamentary CI of Administration ((c.t.a, d.b.n.c.t.; pendente lite; durante absentia; durante minodate) are hereby granted to FRANCES E. OILER AND DOROTHY R. SMITH in the above estate and that the instrument(s), if any, dated NOVEMBER 16, 1999 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. Letters ................ $ 235.00 .................... ~ ~ster of ~lls Sho~ Ce~ifl~tes(s) ......~ .......$ 3.00 ~~~;~'~:~..~.~... $. E~raPages( 3 ) ............... $ 9.00 $ ................................................ ~ Signature I.T.R ....................................... $ JCP Fee .................................$ [0.00 Afforney: SALLY J. WINDER Invento~ ................................$ I.D. No: 24705 Other ...................................... $ Address: 9974 MOLLY PITCHER HIGHWAY SHIPPENSBURG PA 17257 TOTAL ............................. $ 257.00 . Telephone: 717 532 9476 DATE FILED: ~.R~A~Y 7:2003 ~Z~BP TO ATTO~ 2-3-2003 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as I.ocal Registrar. The original certificate will be.forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. ,, Local Registrar P 9041002 JAN 28 2003 No. '~ Date H105.14~ Rev ~/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS '.,.T CERTIFICATE OF DEATH ,,N~ille, PA 17241 ~ · ~ ~ ~? ,,d.O ~'~ 175 Le, PA 17241 _O /2003 M~rial ~rlisle, PA 17013 FD 012633 L Brothers ~eral H~, ~rlisle, PA 17013 0q33 I ........ . .......... ~.~ ~~% ~, , . 21-03-121 21-03-121 Last Will and Testament of Bertha F. Smith I, BERTHA V. SMITH, of Upper Mifflin Township, Cumberland County, Pennsylvania, being of sound mind and memory declare this to be my Last Will and Testament and revoke any will or codicil previously made by me. ITEM I: I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable af[er my decease as a part of the administration of my estate. ITEM lI: I give, devise and bequeath all of my estate of every nature and wheresoever situate to my husband, Laurie F. Smith, providing he shall survive me by thirty days. ITEM IH: Should my husband, Laurie F. Smith, predecease me or die on or before the thirtieth day following my death, then I give, devise and bequeath the house, barn and approximately eight acres comprising the surrounding curtilage and vicinity of the house and barn, to be surveyed and subdivided as part of the costs of administration of my Estate, to my grandson, Travis W. Smith, his heirs and assigns. ITEM: IV: Should my husband, Laurie F. Smith, predecease me or die on or before the thirtieth day following my death, then I give, devise, and bequeath the rest, residue and remainder of my estate of every nature and wheresoever situate to my i~sue per stirpes share and share alike in shares of equal value. ITEM V: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the expenses of the administration of my estate. ITEM VI: I appoint LAURIE F. SMITH executor of this, my Last Will and Testament. Should he fail to qualify or cease to act as executor, then I nominate and appoint FRANCES E. OILER and DOROTHY R. SMITH, Co-executors of this my Last Will and Testament. ITEM VII: I direct that my executor or his successor shall not be required to give bond for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I hereunto set my hand and seal to this my Last Will and Testament, written on Three (03) sheets of paper, dated this/~ day of NOVEMBER, 1999. BERTHA V. SMITH The preceding instrument, consisting of this and One (01) other typewritten page, each identified by the signature of the testatrix, BERTItA V. SMITH., was on the day and date thereof signed, published and declared by BERTHA V. SMITH, the testatrix herein named, as and for her Last Will, in the presence of us, who, at his request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. residing at COMMONWEALTH OF PENNSYLVANIA : : SS COUNTY OF CUMBERLAND : We, BERTItA V. SMITH, the testatrix in, and the undersigned witnesses to, the will, the attached or foregoing instrument, who have signed the instrument, having been qualified according to law do depose and say: (a) that I, the testatrix, do hereby acknowledge that I signed the instrument as my will, that I signed it willingly and as my free and voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the testatrix sign and execute the instrument as her will, that she signed it willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatorix signed the will as a witness 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. BERTHA V. SMITH Witness Witness Subscribed to and subscribed or affirmed and acknowledged before me by BERTHA V. SMITH, the testatRIX and the witnesses whose names are signed above this//~0~clay of NOVEMBER, 1999. $otar~ Pul0ic 8~11¥J, Wi_nder, Notmy Public ! ~hlpp..en~Du. rg)wp., Cumberland Courdy I~M¥ ~omml#lon Expires Feb. 13, 2003 4 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: BERTHA V_. S_MI~TH Date of Death: 1/25/03 Estate No. 21-03-121 SSN: 188-32-3788 File No. Date Letters Granted: 2/7/03 Will or Administration No. 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 2/12/03 Name Address FRANCES E. OILER 573 BRANDY RUN ROAD NEWVlLLE PA 17241 DOROTHY R. SMITH 510 N HANOVER STREET CARLISLE ..... PA 1__7013 PAUL SMITH 185 WHISKEY RUN ROAD NEWVlLLE PA 17241 GERALDINE SMITH 175 WHISKEY RUN ROAD TRAVlS SMITH NEWVlLLE PA 17241 MARIE LEHMAN 30 HILLTOP LANE NEWVILLE .... P,~. 17_24~1 __~ EUGENE SMITH 56 WEST MAIN STREET ................ _N._EWVl LLE ........... P_A. 17__2.41 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: 2/12/03 ~~~L/~ Capacity: SALLY J. WINDER __ Personal Representative Name (Please type or print) 9974 MOLLY PITCHER HIGHWAY _ Counsel for Personal Address - Representative ,., . !. ~ SHIPPENSBURG PA 17257 Telephone No. 717 532-9476 Continuation of Certification of Notice Under Rule 5.6(a) BERTHA V. SMITH 1/25/03 Page 1 Names and addresses Name Address HAZEL SMITH 53 WEST BIG SPRING AVENUE NEWVILLE PA 17241 LOWRIE SMITH 558 MIDDLE ROAD ............... NEWVILLE PA 17241 COMMONWEALTH OF PENNSYLVANIA REV-11 62 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA ?:ECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004463 OILER FRANCES E 573 BRANDY RUN ROAD NEWVILLE, PA 17241 ACH ASSESSMENT AMOUNT CONTROL NUMBER ........ fold .......... 101 $11,691.58 ESTATE INFORMATION: SSN: 188-32-3788 F!LE NUMBER: 2103-01 21 DECEDENT NAME: SMITH BERTHA V D/~TE OF PAYMENT: 10/04/2004 POSTMARK DATE: 1 0/04/2004 COUNTY: CUMBERLAND DATE OF DEATH: 01/25/2003 " TOTAL AMOUNT PAID: $11,691.58 R, EMARKS: SMITH ESTATE ':-: CHECK//131 .... INITIALS: CCP .... SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-1500 c~~~.EV~E INHERITANCE TAX RETURN ~Nm~ DEPT. 2806O1 HARRISBURG. PA 171~1 RESIDENT DECEDENT 2 ~-o 3 o ~ 2 ~ ~ SMI~, BERT~ V. ~ 1 8 8-3 2-3 7 8 8 ~ 01/2~3 I 01~9/1912 REG~ ~ ~ NAME C0M~LETE MAILING ADDRE~ SALLY J. WINDER 9974 MOLLY PI~CHER HIGHWAY 717 532-9476 SHIPPENSBURG PA 17257 1. Rea~ Emte (Sc~edm A) ¢) 276,2~.37 ~ u~ ~Y 3.~~,~~~ ¢) 4.~&~R~~D) (4) 5.~~&~~~ (8 4,7~.00 :~ (~ 6.~~~(~ (6), ~mL) 8. T~e~~.~ ~) 281~010.37 g-~~&M~~(~H) ~) 28,017.4~ 10.~~~~,~(~) p6) 3~058.~ ~. T~~(~9~S6) (~) 31~07~.~ 1Z ~~ ~ 8 ~ ~ 11) . (12) 1~~~ ~9113T~~~m~ (13) ~(~ 14. l~d Vdue Subject m T.x (Line 12 n'dnus Une 13) ('14) 249, 933. ~'~"~  15. Amou~ off-be 14 taxM~ at ~e qx~usal lax I,-. raie, ortrat,.der~Sec. 9116(aXl.2) 249,933.99 X ..045 (15) 11,247.03 ~ 16. Amomff of Une 14 taxable at lineal lab X .. (16)  x .12 (17) 17. Amount (~ Une 14 laxaUe al s~g tale  18. Amou~ o~ Une 14 taxaNe at c~laleml rate X .15 (16) ~ (19) 11 247.03 Decedent's Complete Address: S~::~-! N3ORE$S 175 WHISKEY RUN ROAD N~ILLE J ST^TE PA ] zip 17241 Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. Cmdits/Paymants (1) 11,247.0~ A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interesl/Ponaity if applicable Total Credits ( A + B + C ) (2) D. Interest 444.55 E. Penalty Total Interest/Penalty ( D + E ) (3) 444.5.~ 4. If Line 2 is greater than Line 1 + Une 3, enler the difference. This is the OVERPAYMENT. Checl( box on Page I Uae 20 to request a refund (4) 5. If Une 1 + Une 3 is greater lhan Une 2, enter the difference. This is the TAX DUE. (5) 11,691.56 A. Eoter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) 11,691. 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 ffansfer and: Yes No a. raal. the use or i. come of the propo~ transferred; ........................................................................... [] [] b. retain the fight to designate who s~all use the property transferred or ill income; ........................................ [] [] c. retain a reversionary interesl; or ...................................................................................................... ] [] d. mcalve the promise for life of ~ther poymeots, benefits or care? ............................................................. [] [] 2. ff death occurred alter December 12, 1982, did decedent lransfer properly within one year of death ~heut 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 Reflremer~t Account, annuity, or other non-probate properly which conteins a ban~ciary 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. SIGNATURE OF PERSON RESPON~iRi F-FOR FILING ^~EESS 573 BRANDY RUN ROAD .~ NEWVlLLE S~ltkt'bRE (~F P~F-P^EE~ OTHEE TH~ R[P~NT^TiVE PA 17241 ^Dr.~9 997~ MOLLY PITCHER HIGHWAY S"IPPENSBURG PA 17257 =or dates of death on or after July 1, 1994 and I:~,fore Janua7 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. §91~6 (a) (1.~)(i)]. =or dales of death on or after January 1, 1995, the tax rate imposed on the net value of lransfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. ~ statute does not exempt a transfer Io a surviving spouse from tax, and the statulory requirements for disclosure of assets and filing a tax return are still applicable even if he surviving spouse is the only benefidary. :or dates of death on or after July 1, 2000: 'he 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, ,r a steppare~l of lhe child is 0% 172 P.S. §9116(a)(1.2)]. he lax rate imposed on ~ net value of transfers to or for the use of the decedont's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(12) [72 P.S. §9116(a)(1)]. he tax rate imposed on the net value of ffansfers to or for the use of lhe decedant's s~ings is 12% [72 P.S. a~ividual who has at least one parenl in common with the decedent, whether by blood or adoption. REV-1502EX + (1--q7) SCHEDULE A C0MMONWE^.TH OF PE.NSY.V^N,^REAL ESTATE ,.HER,Th. CE TAX.ETU.. "E~IDENT DECEDENT ESTATE OF FILE NUMBER SMITH, BERTHA V. 21 05 0121 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly.owned with right of survivorship must be disclosed on Schedule F. ITEM I VALUE AT DATE NUMBER I DESCRIPTION OF DEATH 1. 1175 WHISKEY RUN ROAD, UPPER MIFFLIN TWP, CUMBERLAND COUNTY, TAX 121,204.67 IPARCEL 44-06-0037-020, SURVEYED AND SUBDIVIDED PER WILL PROVISIONS ILOT 4 CONVEYED TO TRAVIS SMITH AS SPECIFIC BEQUEST 2. LOT 1, CONTAINING 64.4714 ACRES SOLD BY DEED 8/25/04 RECORDED IN CUMB 148,284.22 CTY 265,PG 389 COPY OF AGREEMENT ATTACHED 3. LOT 5, CONTAINING 6.1468 ACRES, OF SWAMP GROUND SOLD @ 1100/ACRE 6,761.48 TOTAL (Also enter on line 1, Recapitulation) $ 276,250.37 (If more space is needed, insert additional sheets of the same size) EXPLANATION OF REAL ESTATE VALUE FOR Lot 4, specific bequest Lot 4 was a specific bequest to Travis Smith under the terms of the Will of Bertha V. Smith. The assessed value of the improvements on the whole property is $101,740.00. All of the improvements are located on Lot 4 conveyed to Travis Smith. The acreage conveyed to Travis Smith is a total of 8.4629 acres. This land is comparable in nature to that conveyed to Steve Ebedy. The market price negotiated with Mr. Eberly was $2300.00 per acre (see copy of agreement attached). Therefore the land value of the property conveyed to Travis Smith is $19,464.67 which when added to the improvements assessed value gives a total value of $121,204.67 for the specific bequest to Travis Smith as shown on Schedule A. AGREEMENT OF SALE THIS AGREEMENT, made the//~/~ day of August, 2004, between FRANCES E. OILER, EXECUTRIX OF THE ESTATE OF BERTHA V. SMITH, DECEASED, of Upper Mifflin Township, Cumberland County, Pennsylvania, hereinafter whether singular or plural called "SELLER", and STEVEN EBERLY, single man, of 7130 Lanier Street, Annendale, Virginia, hereinafter whether singular or plural called "BUYER." WITNESSETH: 1. SELLER agrees to sell, grant and convey to the BUYER and the BUYER agrees to purchase and accept the conveyance of Lot No. 1 as shown on the Subdivision Plan for the Estate of Bertha V. Smith, dated March 20, 2003, containing 64.4714 acres, situate in Upper Mifflin Township, Cumberland County, Pennsylvania, being part of the property which Oscar M. Showvaker and Fredith H. Showvaker his wife by deed dated March 29, 1955, recorded in Deed Book I, Volume 16, Page 3, granted and conveyed to Laurie F. Smith and Bertha A. Smith, more particularly bounded and described as set forth on Schedule "A" attached hereto. 2. BUYER agrees to pay the sum of One Hundred Forty-Eight Thousand Two Hundred Eighty-four and 22/100 ($148,284.22) Dollars as follows: One Thousand and 00/100 ($1,000.00) Dollars upon the execution of this Agreement of Sale, receipt of which is hereby acknowledged by the SELLER to be non-refundable and held in escrow by Sally J. Winder, Esquire until the date of settlement. 3. Settlement for the within described property shall be held in the office of Sally J. Winder, 9974 Molly Pitcher Highway, Shippensburg, Pennsylvania, or such other place agreeable to 10. This Agreement of Sale is to extend to and be binding upon the heirs, successors, executors, administrators and assigns of the parties hereto 11. If the BUYER fails to comply with these terms and conditions, the SELLER may seek specific performance or may effect a resale of the property at any time thereafter and the BUYER shall forfeit absolutely to the SELLER the amount paid at the time of execution of this agreement, to wit: One Thousand and 00/100 ($1,000.00) Dollars as assessed and liquidated damages, and in addition, the BUYER shall pay to the SELLER any loss sustained by the SELLER in the event that the costs of resale of the property and loss of profit on resale are in excess of the forfeited amount. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year f~st above written. Witness: ESTATE OF BERTHA V. SMITH by FRANCES E. OILER, EXECUTRIX, SELLER STEVEN EBERLY, B EXHIBIT "A" ALL that certain tract of land situate in Upper Mifflin Township, Cumberland County, Pennsylvania, being all of Lot No. I on the Subdivision Plan of the Bstate of Bertha V. Smith, by John R. Kissingcr, R.S. dated March 20, 2003, more particularly bounded and deacribed as follows: BBGINNING at a common comer of Lot No. 1 and Lot No. 4 on the said plan, thence alor~ lands now or formerly of Barry Isaacs and Sharon L. Scarbowugh, lands now or formerly of Albert L. $ohns and Tina Barrick, lands now or formerly of Robert C. and Kathleen Darius, and lands now or formerly of I/twin B. and Ruth K. Wiser North 49 dcgrees 51 minutes 49 seconds Bast a distance of 2,474.75 feet to a set iron pin; thence by lands now or formerly of Wayne and Alice Hurlcy South 18 degrees 59 minutcs I 1 seconds West a distance of 176.55 feet to a set iron pm; thence along lands now or formerly of Douglas K. and Vicki L. Johnson South 06 degrees 42 minutes 30 seconds West a distance of 117.99 feet to a set iron pin; thence continuing by thc same South 12 degre~ 26 minutes 50 seconds West a distance of 2,383.60 feet to an existing post; thence by the same South 53 degrees 55 minutes 32 seconds West a distance of 424.$7 feet to an existing iron pin; thence by lands now or formerly of the Pennsylvania Turnpike Commission South 77 degrees 31 minutes 29 ~.onds West a distance of 673.33 fc~ to a set parker kahlon nail; thence over the cartway of S.IL a013 Whiskey Run Road North '~1 degrees 49 minutes 48 seconds West a distance of 461.61 feet to a set parker kahlon nail; thence by Lot No, 4 of the aforesaid plan North 25 degrees 16 minutes 29 seconds Fast a distance of 758.29 feet to a set iron pin; thence continuing by Lot No. 4 North 40 de~.s 08 minutes 11 seconds West a distance of 500.00 feet to a set iron pin the point and place of BBGINNING. CONTAINING 64.4714 acres, more or less, po' Subdivision Plan ofF. state of Bertha V. Smith. BEING part of thc same properW which Oscar M. Showvaker and Fred/th H. Showvaker, his wife, by Deed dated March 29, 1955 and recorded in Deed Book "T", Volume 16, Pa~e 3, Er'anted and conveyed to Laurie F. Smith and Bertha V. Smith, his wife. Laurie F. Smith died December 13, 2001, survived by B~,ha V. Smith, hi~ wife, thus vesting fhll fee simple title in her. Bertha V. Smith died Sanua~ 25, 2003. Frances £. Oiler and Dorothy R. Sm/th were appointed as Co-l~xecutors of the Bstatc of Beflha V, Sm/th by Letters Testamentary dated February 7, 2003. THE ABOVE-DESCRIBED TRACT BEING thc same premises which Frances B. Oiler and Dorothy R. Smith, Co-Executor~ of the Estate of Bertha V. Smith, deceased, by Deed dated ,2004 and recorded ~.._, 2004 in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Record Book , Page. , granted and conveyed unto Steven W. Bbcrly. ^. Settlement Statement u.s. Department of Rousing and U~ban Development OMB Approval No. 2502-0265 C. Note: This f~m is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent am shown. Items ma~ked "(p.o.c.)" were paid outside closing; they am shown here for informational purposes and not included iff lhe totals AN__N_.A~__D_ALE .... VA ~0_0_3___ _~NEWVILLE PA 17241 G. P~d~Ux~o. .. S.~.~A0., SALLY J. WINDER 175 WHISKEY RUN ROAD, LOT 1 UPPER MIFFLIN TOWNSHIP Ph~,. ~ 9974 MOLLY PITCHER HVVY 8/25/04 NEVVVILLE PA 17241 SHIPPENSBURG PA 17257 100. Gro~lAmd~l~DUe From Bonower ~ (~o~Amount DueTo ~4~er 101 ConOactsales ~ 148 284 _.22~.[491 ConVac~sa~k~_ ~_ 148,284. 102. coun~tox~ .......... ~ ..................... _40_?. co~n__~/~ ........ to .............. 110: ............ to ......... 4t0. to to 411. to 111. 113. to 413. to tt4. to 414. to 12o. C~o~ Amount Due From Borrower 151,013.06 420. Gn)~AmountOue To Sel~ 148,4:38.22 T 1_,_000.00 50~. F. xce~depo~ 20~. 2o?. J. __ ~? .......................... __ AdJL~dW~ fo~ Ibmm unp~d~y se. er __AdJu~tme.~ for ~em. ~M by sMMr ................ 21o. o~owntox~ to ............. 5_~: _c._~/~wn t~x~_ ....... ~ 21~ .............. ~ ...................... 5j~: SCL TAX to 6130/05 ........ 1 3~_9~..6_5 214. _ ................... ~to ............. 514. to 216. to .......... 5~16 ............... to_ ......................... 217. to ........... 517 _to ........ !. 218. to to 220. Tot~Pa~dByForBo,~wer I 1,000.00 520. Tot~RoducUonAmountOueS~er ~,364.99 300. Ca~hAt~(l~wumtFrom/To Bo~ower i20. Ca~hAt.~mentTo/From ~ler 3o~. Czmh [] From [] Tol~ower I 150,013.06 ~ C..h [] To [] FmmSeltor 140,073.2:3 SUBSTITUTE FORM 1099 SELLER STATEMENT The IntonnMk~ contoined in Blocks E. G, H, and I and on line 401 (or, line 40~ and 404) i$ imp(xt~t tox i~ and ~ ~ ~ to ~ ~ ~ retom; for oiher ~ compkl~ ~le 81C)P~M I~lrb~ o4' Form 47~7, Fon~ 6232 ~ncUor ~faedule D, Form 1040)- Y°u ale requi~ to ~ ~ ~ ~ · - ................. ~-- ' ~'- ~ P~id From Paid From 701 $ ......... t~ _. / Fu.ds ~ I Fu.ds At 7~. ~~ ............. ~ ..... ~ ~. ~ ~ ................... ~ ................................ ~ ....... ~ ..... ~ ~o~ ~.~ ~ ........ - ~ .... ~ ......... 1113. - ~~_~ ~ 1 482.~ -~ $ ~ ...... ~ ~. ~ . - ............... ~ ..... ~ ~ 482.84f 1,482.~ ~' ~""~?:' !~: ~ ~ ................ _ ............ 1~. I~. T~ .... (~' ' ~t~'~-'J~2'~:~='~ 2,574.~ 6,~.~ C~ I IFI~TI~ _ .-- ~L~ ~IND~ .......... s~ ...... ,~ ~, ,.x or y~ ROBERT P. ZIEGLER "Q."~ RECORDER OF DEEDS 't,,AJ~ ¢¢' CUMBERLAND COUNTY-PA ZOO] 8EP3 11 SO PA~t ~F T~A~C~NO. ~-0~-00~7- oZo DEED ~E T~~y ofA~, ~ ~e y~ of om ~rd Two ~o~d Fo~ (2~). BE~EN ~CES ~ O~ER ~ ~RO~ ~ S~TH, Co-Ex~to~ of ~ ~tat~ of Be~a V. Smi~ d~~ of Ne~e, Pe~lv~a 17241, he~er c~l~ G~OR S~N W. EBE~Y~ single m~, of 7130 ~er S~e~ ~~e, Vir~i~ 22003h~e~er ~l~ G~E ~~, ~e d~~ B~ V. S~ ~ ~t ~e her ~ Will ~d T~ent ~ Novem~ 16, 1~9, ~e~ she ~d d~y ~t F~ E. ~ler ~d Dom~y R. S~ ~Ex~ ~ ~d ~ W~ ~d Te~en~ ~d WHF.~, in accordance with the terms of said Last Will and Testament of Bertha V. Smith duly probated in thc Register of Wills Office in and for Cumberland County, Pennsylvania, Letters Testamentary were issued appointing Frances E. Oiler and Dorothy R. Smith, Co- Executors of the Estate of Bertha V. Smith, February 7, 2003, W'ITNESSETIt, that for and in consideration of the sum of One and 00/100 ($1.00) Dollars consideration, in hand paid, the receipt whereof is hereby acknowledged, the said Grantors does hereby grant and convey, in fee simple, to the said Grantee, his heirs and assi~ona, ALL that certain tract of land situate in Upper Mifflin Township, Cumberland County, Pennsylvania, being all of Lot No. 1 on the Subdivision Plan of the Estate of Bertha V. Smith, by John R. Kissinger, R.S. dated March 20, 2003, more particularly bounded and described as follows: BEGINNING at a common comer of Lot No. 1 and Lot No. 4 on the said plan, thence along lands now or formerly of Barry Isaacs and Sharon L. Scarborough, lands now or formerly of Albert L. Johns and Tina Barrick, lands now or formerly of Robert C. and Kathlccn Darius, and lands now or formerly of Erwin B. and Ruth K. Wiser North 49 degrees 51 minutes 49 seconds East a distance of 2,474.75 feet to a set iron pin; thence by lands now or formerly of Wayne and Alice Hurley South 18 degrees 59 minutes 11 seconds West a distance of 176.55 feet to a set iron pin; thence along lands now or formerly of Douglas K. and Vicki L. Johnson South 265 P CE 389 06 degrees 42 minutes 30 seconds West a distance of 117.99 feet to a set iron pin; thence continuing by the same South 1'2 degrees 26 minutes 50 seconds West a distance of 2,383.60 feet to an existing post; thence by the same South 53 degrees 55 minutes 32 seconds West a distance of 424.57 feet to an existing iron pin; thence by lands now or formerly of the Penn~lvania Turnpike Commission South 77 degrees 31 minutes 29 seconds West a distance of 673.33 feet to a set parker kahlon nail; thence over the cartway of S.R. 4013 Whiskey Run Road North 41 degrees 49 minutes 48 ,o~,~c, onds West a distance of 461.61 feet to a set parker kahlon nail; thence by Lot No. 4 of the aforesaid plan North 25 degrees 16 minutes 29 seconds East a distance of 758.29 feet to a set iron pin; thence continuing by Lot No. 4 North 40 degrees 08 minutes l l seconds West a distance of 500.00 feet to a set iron pin the point and place of BEGINNING. CONTAINING 64.4714 acres, more or less, per Subdivision Plan of Estate of Bertha V. Smith. BEING all of Lot No. 1 per subdivision plan of the Estate of Bertha V. Smith, dated March 20, 2003, and recorded in the Recorder of Deeds Office in and for Cumberland County Plan Book Page BEING part of the same property which Oscar M. Showvaker and Fredith H. Shovaker, his wife, by deed dated March 29, 1955, recorded in the Recorder of Deeds Office in and for Cumberland County, Deed Book 16 Volume'T', Page 3, granted and conveyed to Laurie F. Smith and Bertha V. Smith, husband and wife. Laurie F. Smith died December 13, 2001, survived by Bertha V. Smith, his wife, thus vesting fee simple title in her. AND the said Grantors covenants and agrees that they will warrant specially the property hereby conveyed. IN WITNESS WHEREOF, said Crmntors have hereunto set their hands and seals the day and year first above written. Signed, sealed and delivered in the presence of.' ESTATE OF BERTHA V. SMITH mX~c~s~ oR~a, 2 265 390 ROBERT ?. ZIE(~LER RECORDER OF DEEDS CU~BERLAND COUNTY-PA ~a ~~ ~~ W. ~ ~ ~ · ~ ~~ly ~t ~ ~ Tm~ W. ~~' ~ ~~ ~ ~ ~ of~d ~ ~H ~d T~mt of~ V. S~ ~y ~~ ~ ~e ~~ of ~ ~ ~ ~ for ~~Imd Co~, P~I~ ~ T~~ S~ C~ ~~ of ~,~~ ~r~ ~~onof~ offend ~ 1. -~- ~ ~t ~ ~ o~~o~ ~ ~o. ~, o. ~ ~~ ~ o~-~ V. S~ B~~G ~ a ~ ~ ~on ~ ~ ~ ~on ~m~ of~t No. ~~°nP~~e~yofSR~13 ~:_,.__~ . ~_ _ 3~sho~on~d ~ ~~ 27 ~n~ W~ ~ o~ ~ ~o~ ~a ~t No. 2 ~ 43 d~ a ~ of2~0 ~t to a ~ ~n ~ ~ ~o~ ~ now or COMMONWEALTH OF PENNSYLVANIA : COUNTY OF : ON this, the_~day of ~)~ ,2004, before me, the undersigned officer, personally appeared France~ E. Oiler and Dorothy R. Smith, known to me to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed same for the purposes therein contained.- IN WITNESS WHEREOF, I hereunto set my hand and official seal. I do hereby certify that the precise residence and complete post office address of the within named Grantee(s) is: Date: Agent for Grantee COMMONWEALTH OF PENNSYLVANIA : : SS COUNTY OF : RECORDED on this day of , A. D., 2004, in the Recorder's Office of the said County, in Deed Book , Page . Given under my hand and the seal of the said office, the date above written. Recorder 3 REV-1588 EX + (1-97) ~ SCHEDULE E BANK & MISC. COMMONWEALTH OF PENNSYLVANIA ~jl~'~ ! UI:::I.~U~I/~, ,,,E,,T^NCETAX RETU,N PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER SMITH. BERTHA V. 21 03 0121 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of sun~ivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. TRACTOR AND ROTOTILLER, SOLD 7/03 1,910.00 2. LEON NEWSWANGER, FIELD RENT 1,500.00 3. BEDROOM SUITE, SOLD 50.00 4. FREEZER, SOLD 125.00 5. SAUSAGE STUFFER, MOWER, GUN CABINET, WASHER, DRYER 300.00 6. SIDEBOARD, SOLD 800.00 7. ROTOTILLER, SOLD FOR PARTS 10.00 8. MISC. HOUSEHOLD ITEMS, SOLD 65.00 TOTAL (Also enter on line 5, Recapitulation) $ 4,760.00 (If more space is needed, insert additional sheets of the same size) REV-1511EX* (1-97) SCHEDULE H COMMONWEALTH"~"~"~v'~'"OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER SMITH. BERTHA V. 21 03 0121 Bebts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. EWING BROTHERS FUNERAL HOME, FUNERAL BILL 5,680.00 2. WESTMINSTER CEMETERY, INC. GRAVE OPENING 945.00 3. WESTMINSTER MEMORIAL GARDENS, GRAVEMARKER 2,294.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Secudty Number(s) / FIN Number of Personal Representative(s) Street Address C~ State Zip Year(s) Commission Paid: 2. AttomeyFees SALLY J. WINDER 7,783.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees LETTERS TESTAMENTARY FILE RETURN 307.00 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. JOHN KISSINGER SURVEYOR, SUBDIVISION PLAN 5,440.00 8. RECORDER OF DEEDS, RECORD SUBDIVISION PLAN 14.00 9. RECORDER OF DEEDS, RECORD DEED TO TRAVIS SMITH 40.50 10. RECORDER OF DEEDS TRANSFER TAX, LOT 1 1,482.84 11. RECORDER OF DEEDS, RECORD SATISFACTION OF MORTGAGE 38.50 12. SALLY. J. WINDER, NOTARY FEE 5.00 13. RECORDER OF DEEDS, TRANSFER TAX, LOT 5 67.61 14. UPPER MIFFLIN TOWNSHIP, SUBDIVISION FEES AND REVIEW 270.00 15. CUMBERLAND COUNTY PLANNING COMMISSION, SUBDIVISION FEE 130.00 16. FRANCES E. OILER, TAX COLLECTOR 2004 CTY TWP TAX 269.28 17. FRANCES E. OILER, TAX COLLECTOR, 03-04 SCHOOL TAX 1,569.82 18. HARLAND, CHECK ORDER 13.00 TOTAL (Aisc enter on line 9, Recapitulation) i $ 28,017.48 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent SMITH, BERTHA V. 21 03 0121 Paqe 1 Schedule H - Funeral Expenses & Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 19. FRANCES E. OILER, TAX COLLECTOR, 2004 CTY TWP TAX 269.28 20. FRANCES E. OILER, TAX COLLECTOR, 04-05 SCHOOL TAX 1,398.65 SUBTOTAL SCHEDULE H-B7 1,667.93 REV-1512 EX + (1-97) ~ SCHEDULE I COMMONWE*'T. OFPE.NS¥'V^N.^ DEBTS OF DECEDENT, ,N.ER,T^NCE T^X RETUR. RESIDENT DECEDENT MORTGAGE LIABILITIES. & LIENS ESTATE OF FILE NUMBER SMITH, BERTHA V. 21 03 0121 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. GRAHAM MEDICAL CLINIC, UOTSTANDING ACCOUNT 20.76 2. CENTRAL PENN MED. DR. EMERG., OUTSTANDING ACCOUNT 28.02 3. BROWN OPTICAL AND HEARING 80.00 REPAIR FRAMES FOR DECEDENT 4. LANCASTER HMA PHYSICIAN, CENTRAL PENN MEDICAL 48.86 ECG, INTERPRETATION ETC, OUTSTANDING ACCOUNT 5. NEWVILLE COMMUNITY AMBULANCE, ACCT 221241 AND 213700 88.19 6. TRISTAN ASSOCIATES, BALANCE OF ACCOUNT 1.75 6. BELVEDERE MEDICAL CORP., BALANCE OF ACCOUNT 6.55 7. FOREST PARK HEALTH CENTER, ACCT 22213fp 56.15 8. CARLISLE IMAGING SERVICES 25.00 9239581 AND 9240899 9. ADAMS ELECTRIC CO-OP, 106.91 JANUARY ELECTRIC BILL 10. MOFFITT HEART & VASCULAR GROUP 59.37 OUTSTANDING BALANCE 11. GRAHAM MEDICAL CLINIC, OUTSTANDING ACCOUNT 115.76 12. MILLVILLE MUTUAL INSURANCE COMPANY 224.00 INSURANCE PREMIUM 13. BAXTER D. WELLMAN, II D.O. 10.38 OUTSTANDING MEDICAL ACCOUNT 14. CUMBERLAND-GOODWILL FIRE RESCUE 82.70 AMBULANCE BILL TOTAL (Also enter on line 10, Recapitulation) $ 3~058.90 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent SMITH, BERTHA V. 21 03 0121 Paqe 2 Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER DESCRIPTION AMOUNT 15. MILLVILLE MUTUAL FIRE INSURANCE COMPANY 224.00 INSURANCE PREMIUM 16. WEST SHORE EMS 479.,~2 AMBULANCE BILL 17. MILLVILLE MUTUAL INSURANCE COMPANY 224.00 INSURANCE PREMIUM 18. APEX ASSET MANAGEMENT LLC 102.69 OUTSTANDING ACCOUNT 19. CARLISLE REGIONAL MEDICAL CENTER, 812.00 ACCOUNT 9239581, OUTSTANDING BALANCE 20. YOUNG'S MEDICAL EQUIPMENT 200.52 BALANCE OUTSTANDING 21. ADAMS COUNTY NATIONAL BANK, FEES 32.00 22. TRACTOR SUPPLY 29.87 TRACTOR BATTERY SUBTOTAL SCHEDULE I 2,104.50 GRAND TOTAL SCHEDULE I $ 3,063.90 REV-1513 EX + (9-r~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER SMITH, BERTHA V. 21 03 0121 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE ]. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a)(1.2)] 1. FRANCES E. OILER DAUGHTER 1/8 NET ESTATE 573 BRANDY RUN ROAD NEVVVILLE, PA 17241 2. DOROTHY R. SMITH DAUGHTER 1/8 NET ESTATE 9914 GAY DRIVE UPPER MARLBORO, MD 20772 3. MARIE LEHMAN DAUGHTER 1/8 NET ESTATE 30 HILLTOP LANE NEWVILLE, PA 17241 4. EUGENE SMITH SON 1/8 NET ESTATE 56 WEST MAIN STREET NEWVILLE, PA 17241 5. HAZEL SMITH DAUGHTER 1/8 NET ESTATE 53 W. BIG SPRING AVENUE NEVVVILLE, PA 17241 6. LOWRIE SMITH SON 1/8 NET ESTATE 558 MIDDLE ROAD NEVVVILLE, PA 17241 7. PAUL SMITH SON 1/8 NET ESTATE 185 WHISKEY RUN ROAD NEWVILLE, PA 17241 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET []. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART [! - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent SMITH, BERTHA V. 21 03 0121 Paqe 3 Schedule J - Beneficiaries - l RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE [ TAXABLE DISTRIBUTIONS (include outdght spousal distributions) 8. GERALDINE SMITH DAUGHTER 1/8 NET ESTATE 175 WHISKEY RUN ROAD NEVVVILLE, PA 17241 9. TRAVIS SMITH GRANDSON REAL ESTATE 175 WHISKEY RUN ROAD SPECIFIC BEQUEST NEWVILLE, PA 17241 COMNONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION NOTICE OF INHERITANCE TAX po BOX 280601 APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE HARR/SBURG, PA 17128-0601 OF DEDUCTIONS AND ASSESSHENT OF TAX REV-l;47 EX AFP ¢09-04) DATE 11-29-200~ ESTATE OF SMITH BERTHA V DATE OF DEATH 01-25-2005 FILE NUMBER Z1 05-0121 COUNTY CUMBERLAND 997q HOLLY PITCHER HWY kmoun~ Reai~ed SHIPPENSBURG PA 17252 HAKE CHECK PAYABLE AND REM/T PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LXNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS REV-15&7 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SMITH BERTHA V FILE NO. 21 05-0121 ACN 101 DATE 11-29-200q TAX RETURN NAS: { X) ACCEPTED AS FILED { ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 276z250.57 NOTE: To insure proper 2. S~ocks and Bonds (Schedule B) (2) .00 credi~ ~o your account, $. Closely Held S~ock/Per~nership In~eres~ (Schedule C) {$). .00 subei~ ~he upper portion q. Nor~gages/No~es Receivable (Schedule D) (q) .00 of ~his fora wi~h your S. Cash/Bank Deposi~s/Nisc. Personal Proper~y {Schedule E) (S) ql760.00 ~ax payment. 6. Jointly Owned Proper~y (Schedule F) ~6) .00 7. Transfers (Schedule G) (7) .00 8. To,al Asse~s {8) 281,010.57 APPROVED DEDUCTIONS AND EXENPT/ONS: 28,017.q8 9. Funeral Expenses/Adm. Cos~s/Hisc. Expenses (Schedule H) (9) 10. Deb~s/Hor~gege Liabilities/Liens (Schedule X) (10) 5;058.90 11. To~el Deductions (11) 12. Ne~ Value of Tax Re~urn (12) 2~9,955.99 13. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (1~) .00 lq. Ne~ Value of Es~a~e SubSec~ ~o Tax (lq) Zq9,955.99 NOTE: Z~ an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 #ill reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amoun~ of Line lq a~ Spousal ra~e (15) .00 X O0 = .00 16. Aaoun~ of Line Iq ~exeble a~ Lineal/Class A ra~e (16) 2~9,955.99 X 0q5: 11,2~7.05 17. Aeoun~ of Line lq a~ Sibling ra~e (17) .00 X [2 = .00 18. Amoun~ of Line lq ~axable a~ Collateral/Class B ra~e (18) .00 X 15 = .go 19. Princi)al Tax Due (19)= 11,2q7.05 TAX CREDITS PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID DATE NUNBER INTEREST/PEN PAID (-) lO-Oq-ZOOq CDOOqq6$ ~.55- 11,691.58 BALANCE OF UNPAID INTEREST/PENALTY AS OF 10-05-200~ TOTAL TAX CREDIT I 11,2~7.05 / I BALANCE OF TAX DUE .00 INTEREST AND PEN. 2.62 TOTAL DUE Z.62 ~ IF PAID AFTER DATE INDICATED~ SEE REVERSE { TF TOTAL DUE TS LESS THAN $1~ NO PAYHENT TS REi~UIRED. FOR CALCULATTON OF ADDITIONAL INTEREST. TF TOTAL DUE TS REFLECTED AS A "CREDIT" (CR)~ YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THTS FORN FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) benaficiaries of the decedent after tha expiration of any estate for life or far years, the Commonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laeful Class B (callataral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of fha Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). PAYHENT: Detach the top portion of this Notice and submit mith your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF #ILLS, AGENT REFUND (CR): A refund of e tax credit, ahich Has not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inharitanca end Estate Tax" (REV-1313). Applications are availabla anlina at awe.revenue.state.em.us, any Register of gills or Revenue District Office, ar from the Department's 24-hour answering service for fores orders: 1-BOO-36Z-ZOSO; servicas for taxpayers aith special hearing and/or speaking needs: 1-BO0-447-30ZO (TT only). OBJECTIONS: Any party in interest not satisfied mith the appraiseent, a11oeance or disallowaflca of deductions or assessment of tax (including discount or interest) as shown on this Notice Bay object within 60 days of the date of receipt of this notice by filing one of the folloeing: A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at aww.boardofeppeals.stata.pe.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to be valid, you must receive a confirmation number and processed date from tha Board of Appeals wabsita. You may also send a eritten protest to PA Department of Ravanua, Board of Appeals P.O. Box 2BiOZ1, Harrisburg, PA 17128-1021. Petitions may not ba foxed. B)Election to have tho matter determined at the audit of the account of the personal representative. ADHIN- C) Appeal to the Orphans' Court. ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Departeent of Revenue, Bureau of Individual Taxes, ATTN: Past Assessment Review Unit, P.O. Box Z80601, 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) far an explanation of administratively corractable errors. DISCOUNT: If any tax due is paid within three (2) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. PENALTY: The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid bafora January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appaalable in the same manner and in the the same time pariod as you would appeal the tax and intarest that has been assessed as indicated on this notice. INTEREST: Intarast is charged beginning eith first day of dalinquency, er nine (9) months and cna (1) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 1982 bear interest at the rate of six (6Z) percent per annum calcuIated at a daily rate of .000164. A11 taxes which became deZinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ lOX .00054B ~'~-1991 llX .000301 ~ 92 .000247 1982 162 .D00438 1992 92 .D00247 Z002 62 .000164 1984 llZ .000301 1992-1994 72 .000192 2002 32 .000137 1985 I$Z .000356 1995-1998 9Z .000247 Z004 4Z .000ILO 1986 10Z .000274 1999 72 .0a0192 1987 loZ .000274 ZOOO 72 .00019z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID 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. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 12/01/2004 WINDER SALLY J 9974 MOLLY PITCHER HIGHWAY SHIPPENSBURG, PA 17257 RE: Estate of SMITH BERTHA V File Number: 2003-00121 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 1/25/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge STATUS REPORT UNDER RULE 6.12 Will No.: o~b '~ [ c~[ Adrnin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion 0fthe administration of the above-captioned estate: 1. State whether administration of the estate is complete: ¥ sr2 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,r~entafive file a final account with the Court? Yes _ No J~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal e.~p,r~entative state an account informally to the parties in interest? Yes~ No c. Copies of receipts, releases, joinders and approval offorma! or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached tothis re~x~j ~)~' T~phone ~,1o. C<r~acity~ [--] Personal Representative Counsel for personal representative Cumberland County - Register Of Wills One Cour~house Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 12/16/2005 WINDER SALLY J 9974 MOLLY PITCHER HIGHWAY SHIPPENSBURG, PA 17257 RE: Estate of SMITH BERTHA V File Number: 2003-00121 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 1/25/2006 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, . ~ V ,A r-~9 fLm~I~~W.~) l GLENDA 'FARNE.Et~ST REGISTER OF WILLS /i /) _ ~'6~.Lg;:~!r 'BAUGB:i ,. '-" cc: File Personal Representative(s) Judge \(~ !';(~;~ I~j . ~-- .,;.-\ J~" ---: -"'7\ \~ V1 ~ - ... OJ - -;; ~ - ~- !J."';"c-eglLi9ltU \v1i:""N~~~;:; .iiiif' CTiILjl01016"ll.W1il ~Ci!li.1n\\.y STATUS REPORT1.Jl'llJER R\JLE 6.12 Name ofDecedent: ----f3a f'thA i. S hv;rf, Date of Death: "dJ-D"")-- 00\2-\ Estate No.: . Pursuant to Rille 6.12 of the Supreme Court OrphanS' Court Rules, 1 report the following with respect to completion of the administration of the above-captioned estate: 1. Sta~~ether administration ofthe estate is complete: Yes~ No 0 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 person~.re resentative file a final account withtbe Couit1 Yes 0 No ~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the pers~epresentative state an account inforrnally to the parties in interest? Yes ~ No 0 c. Copies of receipts, releases, joinders and approval offormal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: 1r:1~v-l()<; ~" Address TelephoneNO'(lll) S3~ 94:7 b Ca.pa.city: Ii -;-._d....,--."" 1 D a._~........s......-4-r>+~....TP ~~Cl;:)Vl.J.a...l. J..'.........y....:; C.lli".c.:.....I..y~ rr:w _ ~ J;r--"'" _""'............,.., ..,........-- .....t::;.- ,..~ c- . . '-.-,.y..1CiS,) 'Ul ",e,,,uHc.ll-Cene""l-l-tc.,,V,-, . .. \