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HomeMy WebLinkAbout03-0140Register of Wills of Cumberland, County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of JAMES D. REHRER , Deceased STEPHEN F. REHRER No. 3-'t'40 Social Security No. 174-20-8373 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner is the Executrix named in the Last Will of the Decedent, dated February 6, 2002 and codicil(s) dated 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 born or adopted after execution of the documents offered for probate; was not to victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration (d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived 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 last family or principal residence at 541 Grandview Avenue, Wormleysburg Borough (List street, number and municipality) Decedent, then 75 years of age, died January 20, 2003, at (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property ..................................................................... $ (If not domiciled in PA) Personal property in Pennsylvania ..................................... $. (If not domiciled in PA) Personal property in County .................................................... $. Value of real estate in Pennsylvania ...................................................................................................................... $ Total ......................................................................................................... $ Holy Spirit Hospital 90,000.00 120,000.00 210~000.00 Real Estate situated as follows: 541 Grandview Avenue, Borough of Wornmleysburg, Cumberland County, PA Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence Stephen F. Rehrer 80 Ridgeview Drive Etters, PA 17319 '1 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 correct 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 13th day of February ,2003 - - , / o Donna M. Otto, 1st Deputy ,Z~~A::2'/3z~o '" s~'EpH~N F: REARER DECREE OF REGISTER Estate of JAMES D. REHRER, Deceased No. 21-2003-140 Social Security No: 174-20-8373 Date of Death: January 20, 2003 AND NOW, February 19th ,2003, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Stephen F. Rehrer in the above estate and that the instrument(s) dated February 6, 2002 described in the Petition be admitted to probate and filed of record as the last Will of the Decedent. FEES Letters ........................... $ 270.00 Short Certificate(s) ( 5)$. 15.00 Renunciation .............. $ Affidavit ( ) .................. $ Extra Pages (?) .......$ 21.00 Codicil ............................ $ JCP Fee ....................... $ 10.00 Inventory ...................... $ Other .............................. $ TOTAL .........$ 316.00 . _ Register of Wills Donna lvj~/otto~J, st~ DePUty- Attorney: Edmund G. Myers I.D. No: 20558 Address: Johnson, Duffie, Stewart & Weidner, 301 Market Street, P.O. Box 109, Lemoyne, PA 17043- Telephone: 717-761-4540 MAILED LERq~RS TO ATIDRNEY ON 2-19-2003. his is to certify that the information here given is correctly copied fi'om an original certificate off death dui;' filed with me as I,ocal Registrar. The original certificate will be forwarded to thc State Vital Records Otiicc for pt'rmantmt fiiing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 8912084 No. 1),~tc i05 ;43dev. 2/87 COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEOENT (F~r~, M~le, La~) Cumberland Plumber 541 Grandview Avenue Camp Hill, PA 17011 James D. Re~ · Ma~( - 174 -- 20 -- 8373 ,,. Lero~ R. Rehrer ..~. Stephen Rehaer ,,. White ,,. B~tha Bu~ [~. 80 Rrd~eview Drive, E~s, PA 17319 I~,, Pen~ylvania Crem~ory J=,~ H~r~b~, PA 17109 4100 Jong I-,- s own ~oad~ H~r~q~ PA 17309 January 21, 2003 (MO¢~, Day, Yea,') L~ENSE NUMBER [DATE ~GNED I (MO~. Day. i;3~. ~,, [] JL DUE TO (OR,~S A CONSEQUENCE 0~: DUE TO (OR AS A CONSEQUENCE 0~: DUE TO (OR AS A CONSEQUENCE 0~: P~q'T I1: Olhlr ti~ co~f4iall conl~ibZing Io ,,.,llh. b~ ,',el reluRing ~ ~he u~ came gr~et m pk.~' i. N JURY AT WORK? IOESCRmE NOW INJURY OCCURRED. DATE SIGNED {Mon~. ,,~AME _AND ADORERS OF PERSON WHO COMPLETED CAUSE OF DEATH Z.-,.' ~' ///'*f.-,,f ,~ //v ¢ ;lATE FILEO (MOnlh Oay 'Mai) SIGNATUREANDT TLEOFLE:~T F ~/ ~ // 21-2003-140 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: JAMES D. REHRER Date of Death: January 20, 2003 Will No.: 2003-00140 Admin. No.: To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on February 19, 2003. Name Address Stephen F. Rehrer, Executor & 80 Ridgeview Drive, Etters, PA 17319 sole beneficiary. Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None. Date: March /~,Z. , 2003 Capacity: Signature Name Edmund G. Myers, Esq. Johnson, Duffie, Stewart & Weidner Address 301 Market St. P. O .Box 109 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Personal Representative X Counsel for personal representative 0127'02-00001/2.1.02/EGM/KLT/153964.1 ast ilI anl estament OF JAMES D. REHRER I, JAMES D. REHRER, of the Borough of Wormleysburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills or Codicils at any time heretofore made by me. ARTICLE I DEBTS I direct the payment of all my legal debts and the expenses of my last illness and fimeral from my Estate as soon after my death as conveniently may be done. ARTICLE II TANGIBLE PERSONAL PROPERTY I give and bequeath my motor vehicle(s), household and personal effects and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, unto my son, STEPHEN F. REHRER, provided he survives me. ARTICLE III REST, RESIDUE AND REMAINDER I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever nature and wheresoever situate unto my son, STEPHEN F. REHRER, provided he survives me. 012702-00001/2.1.02/EGM/KLT/153964.1 If my son, STEPHEN F. REHRER, predeceases me, I give, devise and bequeath the residue of my estate unto his then-living issue, per stirpes. ARTICLE IV ALTERNATE DISPOSITION OF RESIDUE If, at the time of my death my son, STEPHEN F. REHRER has predeceased me, and he is survived by no then-living issue, then, in such case, I give, devise and bequeath all the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate unto MID PENN BANK, Harrisburg, Pennsylvania, in TRUST, to hold, manage, invest and reinvest the same and to pay so much of the principal and income as is necessary as determined by my Trustee for the health and maintenance of my daughter-in-law, STEPHANIE L. REHRER, until such time as my daughter-in-law, STEPHANIE L. REHRER passes away or remarries. Upon the death or remarriage of STEPHANIE L. REHRER, I direct my Trustee to distribute the balance of principal and income in equal shares as follows: A. Fifty (50%) percent thereof unto CAMP HILL CHURCH OF GOD, 123 North 21st Street, Camp Hill, Pennsylvania; and B. Fifty (50%) percent thereof unto the HELEN O. KRAUSE ANIMAL FOUNDATION, INC., of Mechanicsburg, Pennsylvania, for the benefit of the Foster Pet Program. ARTICLE V TRUSTS FOR MINOR BENEFICIARIES In the event that any beneficiary of my Will shall not have reached the age of twenty-five (25) years at the time for distribution of his or her share, I give, devise and bequeath the share of each such beneficiary unto MID PENN BANK, Harrisburg, Pennsylvania, in separate TRUST, to hold, manage, invest and reinvest the shares so received, and the accumulation of income thereon, 012702-00001/2.1.02/EGM/KLT/153964.1 and to use and apply income and principal, or so much thereof as, in Trustee's discretion, may be necessary or appropriate for such beneficiary's support and education (including college education, both graduate and undergraduate, and vocational training beyond high school) at~er considering all resources available to him or her, or to make payment for these purposes without further responsibility to such beneficiary or to any person taking care of such beneficiary. After the beneficiary shall have achieved the age of twenty one (21) years, the Trustee shall pay and distribute to him or her the net income of such Trust periodically, but not less frequently than quarterly. When such beneficiary reaches the age of twenty five (25) years, the Trustee shall distribute the balance of the then-remaining principal and any net undistributed income unto such beneficiary absolutely at which time this Trust shall terminate. In the event any beneficiary dies before receiving his or her final distribution hereunder, the Trust as to that beneficiary shall terminate and the balance of principal and any net undistributed income shall be paid over to such beneficiary's personal representative. ARTICLE VI POWERS OF PERSONAL REPRESENTATIVE AND TRUSTEE My Personal Representative(s) and Trustee shall have the following powers in addition to those vested in them by law and by other provisions of my Will applicable to all property, whether principal or income, including property held for minors, exercisable without court approval and effective until actual distribution of all property: To make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as they may determine. Bo To retain any or all of the assets of my estate, real or personal, without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. 012702-00001/2.1.02/EGM/KLT/153964.1 Co To invest in all forms of property without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. Do To sell at public or private sale, to exchange, or to lease for any period of time any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. Eo To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. F. To compromise any claim or controversy. G° To make such elections, decisions, concessions and settlements in connection with all income, estate, inheritance, girl, generation skipping or other tax refunds and the payment of such taxes without obligation to adjust the distributed share of any person thereby affected. Ho To combine, without prior court approval, any Trust contained in my Will with any other Trust with substantially similar provisions, although such Trust may have been created by separate instrument. ARTICLE VII SPENDTHRIFT PROVISION I direct that the interest of the beneficiaries shall not be subject to anticipation or to voluntary or involuntary alienation. 012702-00001/2.1.02/EGM/KLT/153964.1 ARTICLE VIII POWER TO TERMINATE SMALL TRUSTS If at any time during the continuance of any Trust created hereunder, the Trustee in its sole and absolute discretion determines that the size of any individual Trust has become so small as to be impractical to continue to hold in Trust and uneconomical to continue to administer as a Trust, then in such circumstances, the Trustee may without further authorization distribute the balance of principal and income in such Trust to the beneficiary then-entitled to the income therefrom, or after considering the age and needs of the beneficiary, distribute same to minor's guardian or custodian under the Pennsylvania Uniform Transfers to Minors Act or similar state law in effect in which the minor resides, including a custodian selected by my Trustee, and upon such distribution, the Trustee shall be released from further obligation with respect to the Trust and shall not be subject to any claim from any person who may have had a future interest in such Trust had it been continued in Trust. ARTICLE IX TAX CLAUSE I direct that estate, inheritance, transfer and other taxes of similar nature payable by reason of my death, together with any interest or penalties thereon, and imposed with respect to any property, whether or not disposed of by this Will, shall be paid out of the residue of my Estate as an expense of administration. 012702-00001/2.1.02/EGM/KLT/153964.1 ARTICLE X PERSONAL REPRESENTATIVE I name, constitute and appoint my son, STEPHEN F. REHRER, Executor of this my Last Will and Testament. If my son, STEPHEN F. REHRER, fails to qualify or ceases to so act, I name, constitute and appoint my daughter-in-law, STEPHANIE L. REHRER, alternate Executrix to complete the administration of my Estate. I direct that no fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required in any jurisdiction. ARTICLE XI COMPENSATION Any fiduciary who is an individual shall be entitled to receive reasonable compensation for the services hereunder and shall be reimbursed for all expenses incurred in connection with the administration of my Estate or any Trust established herein. Compensation for any corporate fiduciary for its services hereunder shall be in accordance with its published fee schedule in effect at the time said services are performed. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ~ ~-~ day of 'f~ ,2002. / J~[VII~S. D. REHREI~[ - (SEAL) 012702-00001/2.1.02/EGM/KLT/153964.1 Signed, sealed, published and declared by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, in his presence and in the presence of each other, have hereunto subscribed our names as witnesses. AFFIDAVIT AND ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA : : SS COUNTY OF CUMBERLAND : We, JAMES D. REHRER, ~._~l//'~ ~. L~A//~L and ~_.J_/3(_~g'~ ~. tO/{~rl~[~ ~ , the TesYator andthe 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 that he had 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 witness and that to the best of his/her knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Witness Witness 012'702-00001/2.1.02/EGM/KLT/153964.1 Subscribed, swom to and acknowledged before ute by JAMES D. REHRER, Testator, and subscribed and sv/om to before me by Jj,.t/// ~. ~,~j'/2K and ~'-d/~//l'/J ~. ]QItJ~,~ ,witnesses, this ~J'~ dayo~F~"~(3/~/~C/___ ,2002. d My Commission Expires Dec. 2, 2002 Me1111~r, Permsvk, anta AssoolatlOfl Of Notaries 8 of JAMES D. REHRER JOHNSON, DUFFLE, STEWART & WEIDNIER ATTORNEYS AT LAW LEMOYNE, PENNSYLVANIA TO Register of Wills Office Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 SUBJECT Estate of James D. Rehrer No. 21-03-00140 DOD: January 20, 2003 FROM .]OHNSON, DUFF:[E, STEWART & WE:[DNER Attorneys at Law P.O. Box 109 Lemoyne, PA 17043 (717) 761-4540 (717) 761-3015 DATE: April 11,2003 Enclosed is a check in the amount of $8,500.00 as a payment on account of Inheritance Tax for the above-captioned Estate, being made within the 90 days to allow for the 5% discount. Please forward the receipt to this office in the enclosed envelope, Thank you. SIGNED: Edmund G. Myers/Cindy Hubler Estate Administration LAW OFFICES JOHNSON, DUFFLE, STEWART g WEIDNER 301 MARKET STREET P. O. BOX 100 LEMOYNE, PENNSYLVANIA 17043-O100 REGISTER OF WILLS OFFICE CUMBERLAND COUNTY COURTHOUSE 1 COURTHOUSE SQUARE CARLISLE, PA 17013-3387 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) OO2439 JOHNSON DUFFLE STEWART WEIDNER 301 MARKET STREET P O BOX 109 LEMOYNE, PA 17043-0109 ........ fold ESTATE INFORMATION: SSN: 174-20-8373 FILE NUMBER: 2103-01 40 DECEDENT NAME: REHRER JAMES D DATE OF PAYMENT: 04/14/2003 POSTMARK DATE: 04/11/2003 COUNTY: CUMBERLAND DATE OF DEATH: 01/20/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $8,500.00 REMARKS: STEPHEN F REHRER C/O JOHNSON ETAL CHECK//112 SEAL TOTAL AMOUNT PAID: $8,500.00 INITIALS: DO RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS TO Register of Wills Office Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 SUBJECT: Estate of James D. Rehrer No. 21-03-00140 FROM 3OHNSON, DUFFI~E, STEWART & WE[DNER Attorneys at Law P.O. Box 109 Lemoyne, PA 17043 (717) 761-4540 Fax: (717) 761-3015 DATE: May 20, 2003 Enclosed for filing in the above-captioned Estate are the follow ng~:',~'., 1. Original Inventory. 2. Original and copy of Inheritance Tax Return. 3. Check in the amount of $31.00, filing charges. 4. Check in the amount of $483.70, Inheritance Tax balance. SIGNED: Edmund G. Myers csh JOHNSON, DUFFLE, !~TEWART & WEIDNER 301 MAR~ET STREET P. O. :; OX lOg '~lll ..... REGISTER OF WILLS OFFICE CUMBERLAND COUNTY COURTHOUS 1 COURTHOUSE SQUARE CARLISLE, PA 17013-3387 REV - 1500 EX + (6,~0) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT l FI L EcNoUuMN~;]Rco D E OFFICIAL USE ONLY 03 00140 YEAR NUMBER SOCIAL SECURITY NUMBER 174-20-$373 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) REHRER, JAMES D. DATE Of DEATH (MM-DD-YEAR) i DATE OF BIRTH (MM-DD-YEAR) 01/20/2003 02/03/]927 !(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ,, REGISTER OF WILLS SOCIAL SECURITY NUMBER [] 1. OriginalReturn [] 2. SupplementalRetum [] 3. Remainder Return (date of death pdor to12-13-82) [] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after 12-12-82) [] 5. Federal Estate Tax Return Required [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes of Will) copy of Trust) [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between [] 11. Election to tax under Sec. 9113(A) (Attach Sch O) ~ 12-31-91 and 1-1-95) NAME ]coMPEE'FE MAILiN~ ADDRESS EDMUND G. MYERS FIRM NAME (If applicable) Johnson, Duffie, Stewart & Weidner rELEPHONE NUMBER 717/761-4540 9. 11. 12. 13. 14. 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) Total Gross Assets (total Lines 1-7) Funeral Expenses & Administrative Costs (Schedule H) (9) Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) Total Deductions (total Lines 9 & 10) 301 Market Stxeet P. O. Box 109 Lemoyne, PA 17043-0109 135,900.0~ 3,794.1~' Non~:! None.., 91,163.03 Non~?~ None 17,852.00 3,425.75 (8) (11) Net Value of Estate(Line 8 minus Line 11) (12) Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) Net Value Subject to Tax(Line 12 minus Line 13) (14) 230,857.18 21,277.75 209,579.43 209,579.43 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) 16.Amount of Line 14 taxable at lineal rate x .045 (16) 17.Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) (19) 209,579.43 19. Tax Due 9,431.07 9,431.07 20. [] Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedefit's Corhplete Address: ISTREET ADDRESS ClW~ Camp Hill STATE PA 541 Grandview Ave. 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 8,500.00 447.37 Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. (4) Check box on Page I Line 20 to request a refund If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS I ZIP I 17011 (1) 9,431.07 8,947.37 0.00 483.70 483.70 No Did decedent make a transfer and: Yes 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? ................................................ If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?. ................................................................................................................ [] Did decedent own an "in trust for" or payable upon death bank account or security at his or her death2 ....... [] Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?. ............................................................................................................... [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Stephen F. Rehrer ,~ ,, ' O SIBLE FO~,,~ILING ~E"I"URN ADDRESS 80 Ridgeview Drive Etters,'PA 17319 DATE 5-- o-o3 DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS EDMUj~I) G. MYERS 301 Market Street DATE /7,, , ,'~ ~- P.O. Box 109 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. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) {1.1 ) (ii)]. The statutedoes not exempta transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (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. SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF REHRER, JAMES D. FILE NUMBER 21 - 03 - 00140 All real property owned solelv or as a tenant in common must be reported at fair market valu~air market value is defined as the price at which property/would be exchanged between a willing buyer and a w ling 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 NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 135,900.00 Real Estate - No. 541 Grandview Avenue, Borough of Wormleysburg, Cumberland County, PA Sale Price - copy of settlement sheet attached TOTAL (Also enter on Line 1, Recapitulation) 135,900.00 SETTLEMENT STATEMENT ..~Ti~epro f~do~-~,-~ 307 Market Street B. TYPE OF LOAN Lemoyne, PA 17043-0109 _il. FHA I~2. FMHA ~]3. CONV.UNINS. (717) 441-1555 r-~ 4. VA r-] 5. CONy. INS. 6. 133621 FILE NUMBER: 7. LOAN NUMBER: MORT. INS. CASE NO.: C. NOTE: This fo,. is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they are shown here for information purposes and are not included in the totals. D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER Sally A. Langianese Estate of James D. Rehrer ABN AMRO Mortgage Group, Inc. G. PROPERTY LOCATION: H. SE'[TLEMENT AGENT: Riverside Land Transfers I. SE'T-rLEME~'I' DATE: 541 Grandview Avenue May 01 2003 ~/o Lot 16, Sec. A, Riverview West Thursday Wormleysburg Borough PLACE OF SETTLEMENT: 10:00 AM Cumberland County, PA J, SUMMARY OF BORROWER'S TRANSAC'NON ~ K, SUMMARY OF SELLER'S TRANSACTION 100. Gross Amount Due From Borrower 400. Gross Amount Due to Seller 101. Contract sales pnce 135,900.00 401. Contract sales price 135,900.00 102. Personal Property 402. Personal Property 103. Settlement Charges (line 1400) 6,130.70 403. 104. 404. 105. 405. Adjustments for items paid in advance by seller(s) Adjustments for items paid in advance by seller(s) 106. City/Town tax 406. City/Town tax 107. County/City tax 05/01/03 to 12/31/03 314.06 407. County/City tax 05/01103 to 12/31/03 314.0~ 108. Assessments 408. Assessments 109. School Tax 05101/03 to 06/30/03 205.92 409. School Tax 06/01/03 to 06/30/03 205.9; 110. Sewer 05/01/03 to 06~30~03 50.00 410. Sewer 06/01/03 to 06/30/03 50.0[ 111. Refuse 05/01/03 to 06/30/03 24.67 411. Refuse 05/01/03 to 06~30~03 24.67 112. 412. 120. Gross Amount Due from Borrower 142,625.35 420. Gross Amount Due to Seller 't36,494.6.~ 200. Amounts Paid By Or In Behalf Of Borrower 500. Reductions In Amount Due To Seller 201. Deposit or earnest money 3,000.00 501. Excess deposit (see instructions) ~.02. Principal Amount of new loan(s) 129,100.00 502. Settlement charges to seller (line 1400) 12,067.00 -)03. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to )_04. 504. Payoff of First Mortgage Loan -~05. 505. Payoff of Second Mortgage Loan )_06. 506. )_07. 507. ~08. 508. ~09. 509. Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. City/Town tax 510. City/Town tax 211. County/City tax 511. County/City lax 212. Assessments 512. Assessments 213. School Tax 513. School Tax 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid By/For Borrower 132,100.00 520. Total Reduction Amount Due Seller 12,067.0{ 300. CASH AT SETTLEMENT From/To BORROWER 600. CASH AT SETTLEMENT To/From SELLER 301. Gross Amt. due from borrower (line 120) 142,625.35 601. Gross Amount due Seller (line 420) 136,494.6! 302. Less Amt. paid by, or borrower (line 220) 132,100.00 602. Lees reduction in AmLdue Seller (line 520) 12,067.0( 303. Cash [] FROM [] TO Borrower 10,525.35 603. Cash [] TO [] FROM Seller 124,427.6,~ Buyer or Borrower's Signature Seller's Signature HUD-1 L. SE'I-rLEMENT CHARGES Paid From Paid From 700. TotaISales Commission based on Price: $ 135,900.00 7.00 % Borrower's Seller's Division of Commission at: $ 9,513.00 Total Funds At Funds At 701. 4,781.50 Century 21 Walak Associates Settlement Settlement 702. 4,731.50 Century 21 At The Helm II 703. Commission paid at Settlement 9,513.0£ 704. 800. Items Payable in Connection With Loan ' 801. Loan OHginafion Fee ABN AMRO Mortgage Group, Inc. 802. Loan Discount 803. Appraisal Fee to 804. Credit Report to 805. Inspection Fee to 806. Mortgage Insurance to 807. Assumption Fee to Express Mail to Allied Home Mortgage 50.00 808. Processing Fee to Allied Home Mortgage 295.00 809. Lender Administration to ABN AMRO Mortgage 375.00 810. Application Fee to Allied Home Mortgage 350.00 811. Flood Cert to Allied Home Mortgage 10.00 900. Items Required By Lender To Be Paid In Advance 901. Interest fi*om 05/01103 to 06/01/03 @ 21.07 /Day 653.17 902. Mortgage Ins. Premium 0 Months to 903. Hazard Ins. Premium 1 Years to Ede Insurance 271.00{poc} 904. 0 Years to 905. Deferred Premium 0 Yearn to ABN AMRO to Allied Home Mtg $2420.63 1000. Reserves Deposited With Lender For .. 1001. Hazard Insurance 3 Months ~ 22.59 /Month 67.77 ~ 1002. Mortgage Insurance 0 Months @ $ /Month ~ 1003. City/Town Taxes 0 Months @ $ /Month alaalaamaaamama 1004. County Taxes 4 Months~}$ 38.27 /Month 153.08 ma~m~mm~ 1005. Assessments 0 Months @ $ /Month ~ 1006. SchoolTaxes 12 Montlls@$ 102.03 /Month 1,224.36 1007. 0 Months @ $ /Month ===a=a.,aa=am~ 1008. Agg. Adj. 0 Months (~ $ /Month (220.93) aaaam~a~m~m 1100. Title Charges 1101. Settlement or closing fee 1102. Abstract ortitie search 1103. Title Examination 1104. 'ritie Insurance Binder 1105. Document praparation Johnson,Duffle, Stewart & Weidener POC 1106. Notary fees Cash 10.00 10.00 1107. Attorney's fees (includes above items No.:) 1108. Title Insurance Riverside Land Transfers 1,188.75 (includes above items No.:) 1101-1104,110S basic 100/300/8.1 ~ ~ .1109. Lender's coverage $ 129,100.00 1110. Owner's coverage $ 135,900.00 1111. Wire Fee to Riverside Land Transfers 20.00 1112. Closing Service Letter to Riverside Land Transfers 35.00 1113. Express Mail to Riverside Land Transfers 22.50 1200. Government Recording and Transfer Charges 1201. Recording Fees: Deed $ 38.50 Mortgage $ 64.50 Release $ 103.00 1202. City/County tax/stamps: Deed $1,359.09 Mortgage $ 1,359.00 1203. State taX/Stamps: Deed $1,359.00 Mortgage $ 1,359.00 1204. Recorder of Deeds 1205. 1300. Additional Settlement Charges 1301. Survey to 1302. Pestlnspection/Homelnspection to Biechler&Tillery 310.00 1303. Transaction Fee to Century 21 At The Helm 125.00 1304. Transaction Fee to Century 21 Walak 125.00 1305. T~i[,~;[~ Treatment to Home Paramount Pest Control 1,060.00 1400. Total Settlement Charges (enter on lines 103 & 502, Sections J & K) 6,130.70 12,067.00 PaRes agree that no liability is assumed by Settlement Agent for the accuracy of information fumished by others as show~ on the HUD-1 Settlement Statement. HUD CERTIFICATION OF BUYERS AND SELLERS I have carefully reviewed the HUD--1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all raceipta and disbursements made on my account by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. ~u~r ~ ~ $i~a~ 8e~at~ $i~rs HU~.I Seffiement S I have red is a true and accurate account of this tmnsa n. have caused or will cause the funds to be disbursed in accordance with this .... ts to the Unitad Stat .... thi ..... Dy sirni,ar f~rm; Penaltta. upon convicti .... include afi .... d ,rnpri .... t. For details COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF REHRER, JAMES D. FILE NUMBER 21 - 03 - 00140 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION UNIT VALUE DEATH 1 1 - $50.00 Series EE Bond - dated 12/1987 57.24 Date of death value 200 Shares - Waypoint Financial Corp. Common ~ $17.775 per/share 10.2341 Shares - Waypoint Financial Corp. Investment Account No. 023535706 ~ $17.775 per/share TOTAL (Also enter on line 2, Recapitulation) 3,555.00 181.91 3,794.15 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF REHRER, JAMES D. FILE NUMBER 21 - 03- 00140 Include the proceeds of litigation and the date the proceeds were received by the estate0,11 property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 PNC Bank - Checking Account No. 51-4005-1937 7,494.02 Date of death balance 8 9 10 11 12 13 14 Pennsylvania State Employees' Credit Union - Acct. No. 8305238290 01 - Share Account - date of death balance Pennsylvania State Employees' Credit Union - Acct. No. 8305238290 04 - Checking Account - date of death balance Pennsylvania State Employees' Credit Union - Acct. No. 8305238290 51 - Certificate of Deposit- date of death balance Local 520 U.A. Federal Credit Union - Account No. 157 01 - Regular Account Local 520 U.A. Frederal Credit Union - Account No. 157 60 - 6 Month Certificate of Deposit Local 520 U.A. Frederal Credit Union - Account No. 157 62 - 6 Month Certificate of Deposit - The Patriot-News - subscription refund Household Goods - appraised value Automobile - 1997 Nissan Maxima Sedan - Sale Price PEBTF - refund - health insurance premium Civil Action - Asbestos Lawsuit - James D. Rehrer vs. ACands, Inc., et al Complaint filed - August 20, 2002 Dauphin County Docket No. 2002-CV-381 O-AS. Still in litigation United Association of JAPPI - Plumbers and Pipefitters Union Benefit due decedent as a long term Union Member. Erie Insurance - refund - homeowner's insurance premium TOTAL (Also enter on Line 5, Recapitulation) 191.56 602.26 9,005.42 4,409.66 7,316.32 47,915.94 208.00 2,215.00 8,700.00 356.85 0.00 2,500.00 248.00 91,163.03 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAl.. EXPENSES & ADMIN~TIVE COSTS ESTATE OF R~EHRER, JAMES D. FILE NUMBER 21 - 03- 00140 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 2 3 4 FUNERAL EXPENSES: Cremation Society of Pennsylvania - death certificates Cremation Society of Pennsylvania - Memorial Service package Cremation Charges - Coroner services The Patriot-News - Obituary Notice ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid Attorney's Fees Johnson, Duffle, Stewart & Weidner Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent Probate Fees Register of Wills - Cumberland County Zip 28.00 80.00 25.00 74.00 4,000.00 316.00 Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Cumberland Law Journal - legal advertisement The Patriot-News - legal advertisement Total of Continuation Schedule(s) 75.00 105.73 13,148.27 TOTAL (Also enter on line 9, Recapitulation) 17,852.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Sdledule H ESTATE OF REHRER, JAMES D. iFILE NUMBER 21 - 03 - 00140 9 10 11 12 13 14 15 16 17 18 Register of Wills - short certificates Connor Real Estate - appraisal Chuck Bricker - household goods appraisal Register of Wills - file Inventory & Inheritance Tax Return Verizon - telephone charges West Shore Oil Co. - heating oil PPL - electric service PA Water Company - water service Century 21 - Walak/Helm - real estate commission Notary fees Recorder of Deeds - 1% transfer tax Century 21 Walak - transaction fee Home Paramount Pest Control - termite treatment Real Estate Taxes - portion of County due at settlement Borough of Wormleysburg - portion of sewer/trash due at settlement Lawn mowing prior to settlement 6.00 275.00 75.00 31.00 26.86 355.02 37.81 37.15 9,513.00 10.00 1,359.00 125.00 1,060.00 145.10 37.33 55.00 Page 2 of Schedule H COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF REHRER, JAMES D. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 - 03 - 00140 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION United States Treasury - tax due on decedent's Form 1040 - 2002' Moffitt Heart & Vascular Group - decedent's account balance Cummings Associates, P.C. - decedent's account balance Brenner Nissan - automobile inspection/sticker West Shore Veterinary Hospital - boarding decedent's dogs during his illness and funeral Checks that cleared after death - PNC Bank - Account No. 51-4005-1937: 1/21/2003 - Check No. 8597 - Discover Account charges 1/23/2003 - Check No. 8598 - Wormleysburg Sewer/Refuse 1/22/2003 - Check No. 8601 - Stephen F. Rehrer, Son - Gift I/21/2003 - Check No. 8602 - PEBTF - health insurance premium 520.38 112.00 500.OO 526.78 Rolling Green Cemetery - death of decedent's family dog. Burial charges for the plot, and the opening/closing of the grave were prepaid. Charge for the grave marker. TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 4.59 58.41 51.97 2.12 1,138.50 1,659.16 511.00 3,425.75 REV-1513 EX+ (9-00) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF REHRER, JAMES D. SCHEDULE J BENEFICIARIES FILE NUMBER 21 - 03 - 00140 NUMBER II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Stephen F. Rehrer 80 Ridgeview Drive Etters, PA 17319 RELATIONSHIP TO DECEDENT DO Not List Trustee(s) Son i Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheE !NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS AMOUNT OR SHARE OF ESTATE Tangible personalty; residue TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEL Register of Wills of Cumberland County, Pennsylvania Estate of REHRER, JAMES D. also known as Stephen F. Rehrer INVENTORY , Deceased No. 21-03-00140 Date of Death 1/20/2003 Social Securi~ No. 174-20-8373 The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, 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 the 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 unswom falsification to authorities. Personal Representative Attorney: EDMUND G. MYERS Signature: ~ '~j_~.~ Stephdn F. R'ehrer I.D. No.: 20558 Signature: Signature: Address: 301 Market Street Address: 80 Ridgeview Drive P. O. Box 109 Etters, PA 17319 Lemoyne, PA 17043-0109 Telephone: 717/761-4540 Telephone: (717) 932-2470 Dated: ~'-- .~<:9 dJ~ ~ Personal Property 1 - $50.00 Series EE Bond - dated 12/1987 Date of death value 57.24 200 Shares - Waypoint Financial Corp. Common ~ $17.775 per/share 3,555.00 10.2341 Shares - Waypoint Financial Corp. Investment Account No. 023535706 @ $17.775 per/share 181.91 PNC Bank - Checking Account No. 51-4005-1937 Date of death balance Pennsylvania State Employees' Credit Union - Acct. No. 8305238290 01- Share Account - date of deathbalance ~7: 0[~J [~ X~ld ~0. 7,494.02 191.56 Pennsylvania State Employees' Credit Union - Acct. No. 8305238290 04 - Checking Account - date of death balance ~, ~ ..... ~ ~ :~7~'!(~O~j 602.26 (Attach additional sheets if necessary) Total Personal Property and Real Estate $230,857.18 Register of Wills of Cumberland County, Pennsylvania Estate of REHRER, JAMES D. also known as INVENTORY continued , Deceased Pennsylvania State Employees' Credit Union - Acct. No. 8305238290 51 - Certificate of Deposit - date of death balance No. 21-03-00140 Date of Death 1/20/2003 Social Security No. 174-20-8373 9,005.42 Local 520 U.A. Federal Credit Union - Account No. 157 01 - Regular Account Local 520 U.A. Frederal Credit Union - Account No. 157 60 - 6 Month Certificate of Deposit Local 520 U.A. Frederal Credit Union - Account No. 157 62 - 6 Month Certificate of Deposit - The Patriot-News - subscription refund Household Goods - appraised value Automobile - 1997 Nissan Maxima Sedan - Sale Price PEBTF - refund - health insurance premium Civil Action - Asbestos Lawsuit - James D. Rehrer vs. ACands, Inc., et al Complaint filed - August 20, 2002 Dauphin County Docket No. 2002-CV-381 O-AS. Still in litigation United Association of JAPPI - Plumbers and Pipefitters Union Benefit due decedent as a long term Union Member. Erie Insurance - refund - homeowner's insurance premium 4,409.66 7,316.32 47,915.94 208.00 2,215.00 8,700.00 356.85 0.00 2,500.00 248.00 Total Personal Property $94,957.18 2 Estate of also known as Register of Wills of Cumberland County, Pennsylvania INVENTORY continued REHRER, JAMES D. No. 21 - 03 - 00140 Real Estate Real Estate - No. 541 Grandview Avenue, , Deceased Borough of Wormleysburg, Cumberland County, PA Sale Price - copy of settlement sheet attached Date of Death 1/20/2003 Social Security No. 174-20-8373 135,900.00 Total Real Estate $135,900.00 3 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 002594 MYERS EDMUND G ESQUIRE 301 MARKET STREET P O BOX 109 LEMOYNE, PA 17043 ........ fold ESTATE INFORMATION: SSN: 174-20-8373 FILE NUMBER: 2103-0140 DECEDENT NAME: REHRER JAMES D DATE OF PAYMENT: 05/21/2003 POSTMARK DATE: 05/20/2003 COUNTY: CUMBERLAND DATE OF DEATH: 01/20/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $483.7O TOTAL AMOUNT PAID: $483.7O REMARKS: STEPHEN F REHRER C/O EDMUND G MYERS ESQUIRE SEAL CHECK#125 INITIALS: JA RECEIVED BY' DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF 'rNDZV~DUAL TAXES TNHERTTANCE TAX DIVTSTON DEPT. 180601 HARRISBURG, PA 1711~-0601 EDNUND G NYERS JOHNSON ETAL PO BOX 109 LEHOYNE COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF ZNHER/TANCE TAX APPRA/SEHENT, ALLO#ANCE OR DISALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX . ~ DATE 07-07-2003 ~i'~,: ESTATE OF REHRER DATE OF DEATH 01-20-Z003 FZLE NUNBER 21 03-0140 ,JUL 11 ~l :28 COUNTY CUMBERLAND ACN 101 Amount Remitted REV-ISII7 EX &FP (01-05) JANES D HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE I1~ RETAZN LOWER PORTION FOR YOUR RECORDS REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF REHRER JAHES D FILE NO. 21 03-0140 ACN 101 DATE 07-07-2003 TAX RETURN NAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVATZON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) (3) ~, Nortgages/Notes Receivable (Schedule D) (q) $. Cash/Bank Deposits/Nisc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTZONS AND EXENPTZONS: 9. Funeral Expanses/Adm. Costs/Nisc. Expenses (Schedule H) (9) 10. Debts/Hortgage Liabilities/Liens (Schedule 1) (10) 11. Total Deductions 12. Nat Value of Tax Return 135/900.00 3/794.15 .00 .0o 91/163.03 .00 .0o (8) 17,852. O0 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 15. 1~. NOTE: 230,857.18 3,425.75 (11) 21.277.75 (12) 209,579.43 Charitable/Governeental Bequests; Non-elected 9115 Trusts (Schedule J) (13) Net Value of Estate Sub,act ~o Tax (1~) Zf an assess;ent was issued previously, lines 14, 15 and/or 16, 17, reflect figures that lnclude the total of ALL returns assessed to date. .00 209,579.43 18 and 19 will TOTAL TAX CREDIT BALANCE OF TAX DUE ~NTEREST AND PEN. TOTAL DUE ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 9,431.07 .00 .00 .00 ASSESSNENT OF TAX: 15. Amount of Line 1~ st Spousal rats 16. Amount of Line 1~ taxable at Lineal/Class A rate 17. Amount of Line lq at Sibling rate 18. Amount of Line lfi taxable st Collateral/Class B rate 19. Principal Tax Due TAX CREDZTS: PAYNENT KECEZPT OISCOUNT DATE NU~ER INTEREST/PEN PAID (-) 04-11-2003 CD002439 447.37 05-20-2003 CD002594 .00 8,500.00 483.70 AHOUNT PATD (is) .00 x 00 = .00 (16) 209,579.43 x 045 = 9,q31.07 (17) .00 X 1Z = .00 (18) .00 x 15 = .00 (19)= 9,431.07 RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 11, 1981 -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the leafu! Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 1140 of the Inheritance and Estate Tax Act, Act 25 of Z000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit aith your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF NILLS, AGENT A refund of a tax credit, ahich ems not requested on the Tax Return, amy be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-I:SI$). Applications ere available at the Office of the Register of Mills, any of the Z:5 Revenue District Offices, or by calling the special gq-hour ansaaring service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-4q7-$010 (TT only). Any party in interest not satisfied with the appraisement, alloaence, or disalloeance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 171Z8-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factua! errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, Dept. Z80601, Harrisburg, PA 17lie-0601 Phone (717) 787-6505. Sas page 5 of the booklet "Instructions for inheritance Tax Return for a Resident Decedent" (REV-1501) for an exptanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decadant's death, a five percent (SX) discount of the tax paid is allowed. The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. Thls non-participation penalty is appealable in the same manner and in the the same time period as you mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 1982 bear interest at the rate of six (61) percent per annum calculated at a daily rate of .00016~. 211 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 1981 through 2003 ars: Interest Da ily interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rata Factor 1982 ZOZ . O 005~,8 1987 91 . O002q7 1999 77. .000191 1983 16Z . 000~,:58 1988-199X 117. .000301 ZOO0 87. .000219 198q 111 .000301 1991 9X .000247 2001 91 .000247 1985 1:57. .000:556 1993-1994 71 .000192 ZOOZ 61 . O0016q* 1986 107. .000274 1995-1998 92 .0001~.7 Z003 57. .0001:57 --Interest ls calculated as follows: /NTEREST = BALANCE OF TAX UNPATD X NUIIBER OF DAYS DELTNQUENT X DATLY /NTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to flfteen (15) days beyond the date of the assessment. If payment is made after the interest computation date sheen on the Notice, additional interest must be calculated. {EV-1470 EX (6-88)  INHERITANCE TAX EXPLANATION COMMONVVEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 ~)ECEDEN'FS NAME FILE NUMBER James D. Rehrer 2103-0140 REVIEVVED BY ACN ANITA MCCULLY 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES E 12 The value of this item has been suspended from the appraisement of the return until the final value can be determined. A supplemental return must be filed when the value of the suspended item is determined. Row Page 1 PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: JAMES D. REHRER Date of Death: January 20, 2003 Will No.: 21-03-00140 Admin No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X (Civil Action - Asbestos Lawsuit - still in litigation Schedule E, Item 12 - could be years before any settlement is reached, if any). 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: . 3. If the answer to No. 1 is yes, state the following: A. Did the personal representative file a final account with the Court? Yes No X B. The separate Orphans' Court No. (if any) for the personal representative's account is:. C. Did the personal representative state an account informally to the parties in interest? Yes No X The Executor was the sole beneficiary. D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: 99 ";" 9- gq~ fO. Capacity: Signature Edmund G. Myers Johnson, Duffle, Stewart & Weidner 301 Market Street, P.O. Box 109 Lemoyne, PA 17043-0109 Address (717) 761-4540 Telephone No. Personal Representative X Counsel for Personal Representative