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HomeMy WebLinkAbout04-0658 PETITION FOR PROBATE and GRANT OF LETTERS Estate of Mary R. Homart ~_~/ NO. also known as To: Register of Wills for the · Deceased. County of .Cumberland SociaI Security No. 184-38-8272 in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut or named in the last wilt of the above decedent, dated. M~v ~1. 20 and codicil(s) dated ~ - , (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at deathin Cumberland County, Pennsylvania, with h last family or principal residence at · ~ 32 i - 'r'v .......... ~ic ur PA 170 5 (list street, number and muncipality) Decendent, then. 91 years of age, died Ju'ly 1 r 2004 at Bethany Villaqe - , t~ Except as follows, decedent did not marry, was not divorced and did not have a child horn or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $1 2 0,0 0 0 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania situated as follows: ~ $- WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) ..~ George T. Homan 4050 Mountain View Road Mechanicsburq, PA 17050 OATH OF· PERSONAL REPRESENTATIVE COMMONWEALT,]-I OF pENNSYLVANIA COUNTY or t' u tcoaA } The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as person~ represen- tative(s) of the above decedent petitioner(s) will well~ truly administ~the estate according to law. Sworn to or affirmed ~d subscribed ~[~~~ before~ this [~ , day of [ /' eg, 'er Estate Of Mary R. Homan ., Deceased DECREE OF PROBATE AND GRANT OF LETTERS the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated ~ - -~ -- O~-~ st will of ."~0-- , in consideration of the petition on FEES Probate, Letters, Etc .......... $. 235.00 Short Certificates( )..- ....... $ '°°" $. I0.o~ TOTAL -.--- ~Q~]{' Ob. Filed .... .~ r. ~ .~...' .=7.9° ~.-. '" ~avid w. Knauer~ Esq- 21592 ATTORNEY (Sup. Cz. I.D. No.) 411-A E. Main St.~ Machanicsburg ADDRESS 717-795-7790 PHONE One Courthouse Square Carlisle, PA 17013 phone: (717) 240-6345 Date: 5/31/2006 HOMAN GEORGE T 4050 MOUNTAIN VIEW ROAD MECK~ICSBURG, PA 17050 RE: Estate of HOMAN MARY R File Number: 2004-00658 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS I 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 decedent1s death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing lS due by: 7/01/2006 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~~ U Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel egi ter of giII5 of umherIanl ountl, Estate of ~J4 Also known as / OATH OF NON-SUBSCRIBING WITNESS ,Deceased }ach) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that (~ familiar with the signature of /L(F.2~,~ ~_ ~//.,Z:~ ,testattg~:xof (one of the subscribing witnesses to) the codicil/will p[esented herewith and that ~ % believes the signature on the codicil/will is in the handwriting of ~ /1_ ~ ~ 0 Pt.C-~49 to the best of k,~' knowledge and belief. (Name) (Address) /~-~'1! .1~ ~]~~, '/ l Sworn to or affirmed.and subscribed Before me this ll--~ day0f -,.~'~&k~ ,20 C-->~l- ~ame)~ ~f/~ For the Re~ste~- - - ~q~o ~/~ ~~ (Address) his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local 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. Fee for this certificate, $2.00 P 10599488 No, ocal Registrar ,u n 72004 Date 91 v- Cumberland COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH Sales 325 Wesley Drive Mechanicsburg, PA 17055 ' : Dec 9,1912 MechantcsburS George Clifford Reed Geoz T. Homan 6, 2004 010338-L Female 184- 38 -- 8272 ~ July i, 2004 Priscilla Krumrine 4050 Mountain View Mechantcsburg, PA 17050 County Memorial Park State College, PA 16801 Koch Funeral Home, State College, PA 16801 JUN 0 2 2004 LAST WILL AND TESTAMENT OF MARY R. HOMAN KNOW ALL MEN BY THESE PRESENTS, That I, MARY R. HOMAN, of the Township of Lower Allen, County of Cumberland, and Commonwealth of Pennsylvania, do make, publish, and declare this instrument to be my Last Will and Testament, hereby revoking and making void any and all former Wills by me at any time heretofore made. FIRST: I direct the Executor hereof to pay all my just debts, funeral expenses and costs of administration as soon as conveniently may be done after my death. I further direct the Executor hereof to pay all inheritance, estate, transfer and succession taxes which may be levied or assessed upon any property which is included as part of my gross estate for the purpose of any such tax. SECOND: I give and bequeath unto the following grandchildren the sum of $1,000 each: A) B) C) D) E) F) Kimberly A. Homan Kathryn E. Emrich Jeffrey A. Homan Kenneth B. Homan Michael D. Homan Morgan W. Homan I have not given and bequeathed any gift and bequest to Nicholas A. Homan because on the date of the execution of this my Last Will and Testament, he still owes me the sum of $27,000, being the balance of my loan to him. However, if he should repay me -1- the $27,000 balance on my loan to him, I give and bequeath unto him the sum of $1,000. In the event that he does not repay the aforesaid balance of my loan to him, then in that event, I give and bequeath unto his sister, Kimberly A. Homan, an additional gift and bequest of $1,000 or the combined total of $2,000. THIRD: I give and bequeath unto St. Paul's Lutheran Church of Pine Grove, Pennsylvania, the sum of $5,000. FOURTH: I direct that in addition to the advertisement of my death in the Cumberland Legal Reporter and The Sentinel that my death also be advertised in the Center County Legal Reporter and the Center Daily Times. FIFTH: I give, devise and bequeath all the rest, residue and remainder of my estate in equal shares, share and share alike, to my Sons, GEORGE T. HOMAN, EDWARD W. HOMAN, and MICHAEL R. HOMAN, perstirpes, provided that they are living on the date of my death. In the event that one or more of my sons are not living on the date of my death, then in that event the share of my son who has predeceased me shall be given, devised and bequeathed as hereinafter set forth in paragraph SIXTH of this my Last Will and Testament. SIXTH: In the event that one or more of my aforesaid sons have died prior to the date of my death, I give, devise and bequeath the share of the rest, residue and remainder of my estate that my son who has predeceased would have received but for his death to his widow, to wit; GEORGE T. HOMAN whose wife is DEBRA A. HOMAN -2- and EDWARD W. HOMAN, whose wife is BARBARA E. HOMAN, and MICHAEL R. HOMAN, whose wife is DARLA J. HOMAN, per stirpes. SEVENTH: I appoint my Son, GEORGE T. HOMAN, to be Executor of this my Last Will and Testament. In the event that he predeceases me or is unable or unwilling to be my Executor of this my Last Will and Testament, then in that event I appoint my Son, EDWARD W. HOMAN, as the successor or contingent Executor of this my Last Will and Testament. In the event that my son, EDWARD W. HOMAN, predeceases me or is unable or unwilling to be my Executor, then in that event I appoint my Son, MICHAEL R. HOMAN, to be my Executor of this my Last Will and Testament, and I do hereby give to the Executor hereof full power, discretion and authority at any time or times to sell, at private or public sale, mortgage, lease, pledge, exchange or otherwise deal with or dispose of the property comprising my estate as deemed best, to settle and compound any and all claims in favor of or against my estate as deemed best and, for any of the foregoing purposes, to make, execute and deliver any and all deeds, mortgages, contracts, leases, bills of sale or other instruments necessary or desirable therefor. LASTLY: I direct that no fiduciary appointed by this, my Last Will and Testament, shall be required to give bond and that if, notwithstanding this direction, any bond is required by any law, statute or rule of court, no surety shall be required thereon. -3- IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of four (4) typewritten pages on the margin of which (except this page) I have affixed my initials this 3rd day of May, A.D. 2002. MARY R. HOMAN " Signed, sealed, published and declared by MARY R. HOMAN, the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, and each of us, who at her request, and in her presence, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. I~th Myers Amy Kn~ -4- County of Cumberland Commonwealth of Pennsylvania SS. ACKNOWLEDGMENT AND AFFIDAVIT We, MARY R. HOMAN, the testatrix, and the undersigned witnesses to the Will, the attached or foregoing 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 the instrument as her last Will, that she signed it willingly and as her free and voluntary act for purposes therein expressed; that each of us in the hearing and sight of the testatrix 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. Sworn to or affirmed before me by MARY R. HOMAN, testatrix, and Beth Myers and Amy Knauer, witnesses, this 3rd day of May, 2002. MARY R. HOMAN ' By: David W. Kn~u~r Attorney I.D. #21582 Beth Myers ' / -------- Amy K~ -5- CERTIFICATION OF NOTICE UNDER RULE 5.6(~) Name of Decedem: Plfd~ ~j~ ~. Date of Death: ,~q$--"{ 1/ ~OOC/ Will No. ,;)-oC~/-oo~,T~ 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 Name Addre_s_s b(~.,~,~.~.7 f~ hi':',~.~ 3 ,o,q,~./.~ P/d4cc: ,O~T~C .~/~-T~mo{?C--, /a~,. 0.1237 t(t=/v,¥6-r/¢ 8- /'4/ T, ec.~Kct ~ E- Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: 0c.7' t ~ ~oo'-/ / Signature Telephone ('7l Capacity: ~ Personal Representative Counsel for personal representative Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 10/05/2004 KNAUER DAVID W 41lA E MAIN ST MECHANICSBURG, PA 17055 RE: Estate of HOMAN MARY R File Number: 2004-00658 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) 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 ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 10/24/2004 Your prompt attention to this matter will be appreciated. Thank You. cc: File Personal Representative(s) Judge Sincerely, ENDA FARNER ~ Clerk of the Orphans, Court Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 10/05/2004 HOMAN GEORGE T 4050 MOUNTAIN VIEW ROAD MECHANICSBURG, PA 17050 RE: Estate of HOMAN MARY R File Number: 2004-00658 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPH3~NS, 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 ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 10/24/2004 Your prompt attention to this matter will be appreciated. Thank You. CC: File Counsel Judge Sincerely, ENDA FARNER ~ Clerk of the Orphans' Court CERTIFICATION OF NOTICE UNDER RULE 5.6(a~ To the Register: I certify that notice of (beneficial interest) ~ required by Rule 5.6(a) ofjcl~e Qrphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on ('~t ~.,t~., I~, ~ -. Name Address Notice has now been given to ail persons entitled thereto under Rule 5.6(a)except Date: Signature Name Address Capacity: __ Personal Representative /~Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96l RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT HOMAN GEORGE T 4050 MOUNTAIN VIEW ROAD MECHANICSBURG, PA 17050 -------- told EST A TE INFORMATION: SSN: 184-38-8272 FILE NUMBER: 2104-0658 DECEDENT NAME: HOMAN MARY R DATE OF PAYMENT: 02/18/2005 POSTMARK DATE: 02/18/2005 COUNTY: CUMBERLAND DATE OF DEATH: 07/01/2004 NO. CD 004970 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $9,008.73 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 118 SEAL INITIALS: MW RECEIVED BY: REGISTER OF WILLS $9,008.73 GLENDA FARNER STRASBAUGH REGISTER OF WillS lllV-'MIOlXlMlll I . --\P0 '* COMMONWEALTIlOF PENNSYl.VANIA DEPARTMENT OF REVENUE DEPT. 280101 HARRISBURG! PA 1712f.Ol101 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NU_ 2'\ _ 04 0658 CiiimCiiiE -_- - iiiiER- - - SOCIAL SECURITY N_ 184-38-8272 .. Z III la ~ Q oeceDENT'S _ (WIT. FIRST, NIl MlDlILE INITlAl) Mary R. Homan DATE OF DEATH (Mt.Il)D.VEAR) DATE OF BIRTH (MM-Do-YEAR) 07/01/201M 12/09/1912 (IF APPlICABLE) SlRVMNG SI'OUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAl.) THIS RETURN MUST BE FILED IN DllPUCATE WITH TIE REGISTER OF WILLS SOCIAL SECURITY NUMBER ''''', III [!] 1.0l1g1nal1lollln 04.UmIIed* [!] 6. DecedenlDied Toolale_..,ofWlj 09. lilgalon""-<is ~ o 3. Remainder floMn I"'". _... .,"~ o 5. Federal E$lale Ta. Retum RoqIirad ..L 6. TOIII Nlxnbor of Sale 00p>sIt a- D 11.E_ntotaxunderSac.9113(A)_...ot o 2. Supplamantal Rel1.m o 48. Future Interest Compromise (dall of dIIlh.. 12.12..t2) o 7. Decodenl Malnlailad a Living Trust ~..."." of ''''''l o 10. Spousal Poverty Cred~ (_ Q' deIIIt bttwMn 12.31"11nd 1.1-951 I = e T. Homan FIRMN 1'_1 COMl'lETE MAILING ADORESS George T. Homan 4050 Mountain VIew Rold Mechanlcsburg, PA 17050 B (71r) 732-5530 ~ E i 1. Rea ESIlIe (SdleduleA) (1) 2 Slocks and Bonds (Sdledulo B) (2) 3. Closo~ Hold Corpolllllon, Partnorsllip or Solo.ProplIoIOIIhIp (3) 4. Mo~s & -. RoceIvabio (SchadiM D) (4) 5. Cash, Bank Dopooi1s & lhoononeous Porsooal property (5) (Schedule E) 6. Jo~Uy Ownad Propolty (Scheduio F) (6) o Soporale Billing Roquootod 7. Inlor.Vlvos Transfers & MIsoollanoous Non.Probate Propor1y (7) (Schaduio G Of l) 6. TotaIGnll._ (1oIa1LInos H) 9. Funeral Expenses & Adml~otrallve CoSIS (SchediM H) (9) 10. Oobls of Oooodont, Mortgaga Lio~nlles, & Lions (Schedulol) (10) 11. TDlalDoduoflOlll (totalLlnOl 9 & 10) 12. Hot Va. of E.1aIo (lilo 6 minus Line 11) 13. Charitablo end GoYommonlal Boquests/Sac 9113 Trusts for which an olootion 10 II' has nol boon modo (Schadula J) 14. Hot Val... Subjoct to Ta (Line 12 "*'uslile 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES 15. Amotrlt of Line 1418llabloallho spoulSll tax ralo, Of translars undor Sac. 9116 (a)(12) 0.00 36.231.68 0.00 0.00 25,774.02 OFFICIAL USE ONLV , .~"l ~'::J 2,188.07 c, 151,885.76 ..t~._~,._.__':;:"2. ,i C:) (8) 10,885.58 0,00 218,079.11 (11) (12) (13) 10,881.11 205,193.93 5.000.00 (14) 200.193.13 ~ ~ A. ~ U ~ '.0_ (15) ~m____200,1!l3.93 '.O~ (18) 9,008.73 18. Amounl of Uno 141axabl. al nnoal raIe 17. Amount of Line 14 I8llabio al sibling rat. 18. Amourt of Uno 14 _ al_,81 rate . .12 (17) . .15 (18) (18) 9.008.13 19. Ta Due '"..."....". ....~ Decedent's Complete Address: I~~~"M CITY Meehan/csbu Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. CredittlPaymtnts A. Spousal Povally Credl B. Prior Payments C.DISCOI.rlt j I STATEpA \ ZIP 17055 (1) 9.008.73 Total Credits (A' B'C) (2) 0.00 3. InterastIPenalty If applicable D. Intem! E. Panally Totallnl.r.sllP.nalty ( D . E ) 4.. If Li"" 21s gr.alerthan Un. 1 + Une 3, enter the dllf.rence. This is the OVERPAYMENT. Check box on PIllf 1 Line 20 to request I refund (3) (4) (5) (SA) 0.00 0.00 9,008.73 5. If Lln. 1 + Lin. 31s grelter than Un. 2, enter 111. dlff.rence. Th~ is the TAX DUE. A. Enter the interest on lI1e tax due. B. Ent.r the lotal of Una 5 + SA. This is th. BALANCE DUe. (58) Make Check Payable to: REGISTER OF WILLS, AGENT r~'::,':,x~r;:l. '--I~l:', i~~. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN .X"IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer end: Yes No a. reteln the use or Income of lhe property transf.""d;...................................................................................... 0 Iil b. retain th. right to d.slgnat. who shall use th. property transf.rred 01 its Incoma;........................................... 0 Iil c. retain a rev.rslonary Inter.s~ Of.......................................................................................................... .............. 0 Iil d. receive the promise fo! life of .ither paym.nts, ben.~ts or care? ................................................................... 0 Iil 2. ~ d.ath occurred an., December 12, 1982, did decedent transf.r property ..lI1in on. y.ar of deall1 withoul rece~ng adequate consideration? ......................................................................................................... 0 Iil 3. Did decedent own an -., trust for' or payable upon death bank account or security at his or her death?.............. 0 !iI 4. Did d.cedenl own an Individual R.tirem.nt Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... !iI 0 IF THE ANSWER TO ANY OF THE ABOVE QUESnONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. U:'lder pen.... of perjury,! dtelare 'lilt [have examined this return, tncludlng Icco""lnylng schedules and statements, and 10 the belt of my knowledge and berte', ~ is true, correct end ~. OtdIratIcn at prepnr other thtn !he peraonII rlprttenlltlYl is bold on aIIlnfonnlaon of which preplrer hal In\, knowledge, SIG E OF PERSON RESPQN ISLE FOR FILING RETURN DATE ---------- H:JL.-IiJ. JooS-- , 9,008.73 ORE 'toS-o l'1o<<,.,T'T/N lJa:<,J RD. H€CI-f~~Jl~ Pt;, SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE '-I-'--'-' I 70 S'CJ DATE ADDRESS II IIJrr~ II lIUtl'. \i'} ;'~;-toiW; .!~;(.;1;f~~#i,~I~lL&_~ ~or dates of d.ath on or after July 1, 1994 and bef~ Jenual)' 1, 1995, th. tax rate impos.d on the n.1 valu. of transfers to or for the us. of the surviving spouse Is 3% 172 ?S. ~9116 (a) (1.1) (I)]. For dates of death on or after January 1, 1995, 111. tax rat. imposed on th. net valu. of transfers to or for 111. use of the surviving spouse is 0% 172 P.S. ~9116 (a) (1.1) (UlI. The statute does nat ...mol a lransf.r to a survl~ng spouse from tex, end the staMory requlrem.nts for disclosure of ass.ts and fiilng a tax retum are stII1 applicable even ff Ill. surviving spouse Is the ony ben.ficiery. For dales of deall1 on or after July 1, 2000: The tax rsle Imposed on the net VIIlue of transf.rs !rom e deceased child twenty-on. years of age or young.r el death to or for 111. use of a natural parent, .n edopUve pet8llt, or a stepparent of !he child Is 0% 172 P S. ~9116(a)(1.2)J. The tax rate Imposed on Ihe net VllIu. of trensf.rs to or for the use ofth. deced.nt's iln.al ben.ficlerles Is 4.5%, .xcept as noted In ?2 P.S. ~9116(1.2) [72 P.S. ~9116(e)(1)J. The tax rat. Imposed on th. net valu. of translers 10 or for the us. of 111. deced.nt's siblings is 12% [72 P.S. ~9116(aX1.3)1. A sibling is d.fined, under Sectk>n 9102 as an indlviou~ who has at I.ast one parent In common with th. decedent, wheth.r by blood or adoption. ' ReV.,.03 ex. 16.9'-*, COMMON\oVEALTH OF PENNSYLVANIA INHERITANce TAX RETURN ReSIDENT DeceDeNT SCHEDULE 8 STOCKS & BONDS ESTATE OF Mary R. Homan FILE NUMBER 21-04-0658 All proporty Jolotly-owneel wtt~ right of ....Iv...hlp .....t bt dl.clOHd on Scheelull F. ITEM NUMBER I DESCRIPTION VAlUE AT DATE OF DEATH 2. 3. 89 Shrs of MeUife Common @35.78 74 Shrs of Sears Roebuck & Co. @37.89 1622.499 Shrs of Columbia Acom Fund Select Fund Cia6s C @ 18.64 July 1, NAV 3,184.42 2,803.86 30,243.38 TOTAL (~so enter on lioe 2, Recap;t'i.'oo) S (If more space Is needed, Insert additional sheets of the same size) 36,231.66 ;: i -v..oo~ ~ ii~!I;JI ." C> '" ~>i J ~i~ i ~~~;'i t i I ~~~5. I J ~oi I · >l!l - ~iI!'> J~~i I .. : f ~l.. I. j 0 11> ! 6' I ~I i ;:l I ~i,~ :I: I. 81~ .' 2. a; Q ~ ,I 1= I I .. .. ""'" $. Cl. - I ~ ~ ~ =l:l'1:Il -. ~ ,"Q ~ ~ ~ ~ Q -a 'i< ::, >... 0 '" !::1il:ll i ! ~ 0 = j~ '" 5' ~ '~ ~. ~ ci' c: ~F; ! ~' ~ ,., a ;; If r ~ a ~ i z ;:; ,. ~~ .. :J: a I i I ~ i ~ i' ~I r '8 r J!l J!l4' r '" 8 8~ 8 g '" "" ~ ~ I I .. ;; '" '" ~ \ ~l ,. '" f- a 8 c \~t ~ i I ~ ~ '~\ I I '" e eJ'" f f l 1v '-t: f ... -:= f 'l- ~ ',-~ a G~ '" . . I '" -l. ~ 'I ~ .:.. ,( -( Ii '" II,. .., la b 11 '" if t~ I .. r ! I[ a H I I F? ! U H ~ :If l~_ It Il Il s :1' j C ~ J Illl 1Q o . I . ,. t~ Ii iil , ~ H _ II ~ g P f l( i ~ \w '" j ~~ :.. ~ ::I ~ ..... .. I111 1M 11111 11111111111 ~III m 111111111111111111.111111111 . S: Historical Prices for SEARS ROEBUCK - Yahoo! Finance YlIMQl MY XII!lQQ! Mill YASOOr,FINANCE ~!!~s~~Signup.ui] l'age 1 01" SUfl.h the Web Search I Finance Home - Help Welcome, Guest [Sign In] Friday, November 12,2004, 8:23PM ET - U.S. Markets Closed. To track stocks &. r Quotes & Info Enter Symbol(s}: e.g, YHOO,"Dj[ Sears, Roebuck and Co (S) ,,~! 30"~'ltrades ~ . ".,. ,. I AM~ ~ rlo'A.['t ^ Scottrade $7 Online Trades Get FREE Streamer $6 Trades Just $500 to Open! Historical Prices GO Symbol Lookup I Finance Searc At 4:01PM ET: 46.01 t' 0.46 (1 ~'::K~l Free Trades GO Get Historical Prices for: ADVERTISEMENT SET DATE RANGE Start Date: Jun ili:1 27 End Date: Jul ~~ 5 Daily Weekly Monthly Dividends Only 2004 Eg. Jan 1, 2003 2004 Get Prices First I Pre v I Next I Last PRICES Date Open High Low Close Volume Adj Close' 2-Jul-04 37.79 37.82 36.40 36.84 3.137.600 36.43 C1-Jul-OY ~ 38.303l<~~ 37.47 ~2.348.oo0 37.52 30-Jun-04 38.00 38.97 .45 37.76 3.889,800 37.54 29-Jun-04 38.42 38.43 37.43 38.26 2,708,500 38.04 28-Jun-04 39.26 39.33 38.58 38.63 1,931,400 38.41 25-Jun-04 39.66 39,69 39.25 39.25 2,403,300 39,02 . Close price adjusted for dividends and splits. First I Prev I Next I Last A Download To Spreadsheet http://finance,yahoo.com/q/hp?s=S&a=05&b=27 &c=2004&d=06&e=5&f=2004&g=d 11/12/2004 MetLife Statement of Trust Interests Februa<y.2000 At the time MetLife demutualizes, you will be allocated shares of MetLrte, Inc. Common Stock, which will be held for you in the MetLife Policyholder Trust The number of Trust Interests you own is equal to the number of shares of MetLife, Inc. Common Stock held for you in the Trust This Statement of Trust Interests tells you how many Trust Interests you will own at the time MetUfe demutualizes (in other words, how many shares of MetLile, Inc, Common Stock will be allocated to you and held for you in the Trust). If you want to buy more shares of MetLife, Inc. Common Stock to be held for you in the Trust, you should use the form printed below to submit a Purchase Instruction. You are only eligible to purchase additional shares if you are being allocated less than 1,000 shares. Stock can be purchased through the Purc~ase and Sale Program on the first trading day following the 90th day afler the date MetLife's demutualizalion becomes eHecflve. Purchase Instructions received before the purchase program begins will not be processed until the commencement 01 the purchase program. If you want to sell the shares of MetUfe, Inc. Common Stock held for you in the Trust, you should use the form printed on the reverse side of this page to submit a Setllnstruction. Stock held In the trust can be sold afler the IPO distribution Is completed, which should be no more than 30 days after the plan etteclive date, Sell Instructions received before the sale program begins will not be processed unlll the commencement 01 the sale program, All such purchases and sales will be on a commission-free basis. - - - - - AUTO .._........ '~DIGIT 17013 HARY _ _N 1 ALLIANCE D_ APT 30. CARLISLE PA 17013-4135 1,..111"'111.... ..1\..11..1..\ ...11..11..1.1.1..1.,.11.,1..11 Sl '" i ... Plaase be sure the correct address appears in lhe window 01 Ihe envelope " you are submltllng a Purchase or Sale Instruction. The attached instruction card identifies the correct address lor each Iype 01 transaction. LL2 N5.692 PLEASE RETAIN FOR YOUR RECORDS Name /lA_V R HCIlWI R.laln this number lor luture relerenca .. Inve.tor 10 e067 07" 1147 Number 01 Tru.t Intereat. 119 Sequence Number "0034257711 PLEASE READ THE IMPORTANT INFORMATION ON THE BACK OF THIS FORM AND IN THE ENCLOSED BROCHURE Use ONLY if a transaction is requested. Unless you wish to Inlllatea transaction, no acllon Is required. PURCHASE INSTRUCTION Change ot address: !lOb7 0758 ],].iI? (See reverse side to SELL) IlARV R _N ChaseMellon Shareholder Services PO Box 382200 Pittsburgh PA 15250-8200 Sianature' {if adrlres.o; beino chancedl Make check, In U.S. dollars, payable 10: Metlife Purcbase Program Amount Enclosed 1",11.1,1,.,1.1.1.1,11...1..1...1.111".11...11...11".1...11 ~ Please be sure this address appears in the envelope window for Purctlases ONLY! Minimum investment $250. 00 (except as I described in the enclosed brochure)::::J 0000101 102 80b7075!lll47 b LL2 N5'692 4. '"...llVV ~ .1. LlldH\;t: Y~hoo! My Yil1mtl MiH "YA.HOO! FINANCE ~~!~~~ Sign uP~ Page 1 of2 S~-j{ch the Web searc~ Finance Home - Help Welcome, Guest [Sign In] Frld~y, November 12, 2004, 8:36PM ET - U.S. M~rkels Closed. To track stocks &. r Quote.,. .'\, Info Enter Symbol(s): e.g. YHOO, "'OJ1 MetLife Ine (MET) 30 trades! . ~ ! AMUlTU.OE ^ I Get FREE Streamer ~:.~i Free Trades .~ $8 Trodes Historical Prices GO Symbol Lookup I Finance Sear( lust $500 to Open! GO SET DATE RANGE Gel Hlstorlca' Prices for: ADVERTISEMENT Start Date: Jun., 23 End Date: Jul Ii. 6 Daily Weekly Monthly Dividends Only 2004 Eg. Jan 1, 2003 2004 Get Prices First I Prev I Next I Last PRICES Dale Open High Low Close Volume Adj Close" 6-Jul-04 35.35 35.59 35.26 35.41 1,140,100 34.99 2-Jul-04 35.72 35. 5.47 35.52 680,600 35.10 ~ ~ 36.2~.s:7P 35.30 ~ 1 ,326,800 35.24 30-Jun-04 35.70 35.97 35.43 35.85 1,288,100 35.42 29-Jun-04 35.51 35.72 35.41 35.60 924,600 35.17 28-Jun-04 35.72 35.94 35.47 35.51 944,900 35.09 25-Jun-04 35.50 35.69 35.16 35.52 2,281,900 35.10 24-Jun-04 35.34 35.72 35.30 35.49 1,381,900 35.07 23-Jun-04 35.48 35.49 35.09 35.43 1,374,900 35.01 " Close price ~djusled for dividends and splits. FiCst I Prev I Next I Last A Download To Spreadsheet http://financc.yahoo.comlqlhp?s=MET &a=OS&b=23&c=2004&d=06&e=6&f=2004&g=d 11/12/2004 REV-1S08EX+(6-98) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Mary R. Homan FILE NUMBER 21-04-0658 lndude the proceeds of litigation and the date the proceeds were received by the estate. All property Jolntly..owned with right of lurvlvorshlp must b, dl.clOled on Schedule F. ITEM NUMBER DESCRIPTlON Prepaid Burial Expenses - VauK, Marker and Property VAlUE AT DATE OF DEATH 2 AllianceBemslein Capital Resv 2,322.50 8,451.52 15,000.00 3 Payment received for a quK claim deed to her grandfathe~s abandoned property (right-aI-way) TOTAL (Also enler on line 5, Recapilulation) $ (If more space is needed, insert additional sheets of the same size) 25,774.02 ]1 :!; ~I ~" ~ 0 i ~l fl it "'liI " \ z.~ 0 I 61 \ ," lS .~ \h ~ ).1 .. . ~ n ." " '" IH - - - ,- ..,. ;I <h '" ~ N . '" S EN c:i.-' ! 8~ ." ~i "1 J,I *16 lJ .. ... . 11 "': "': - - z; d ~I~ '" ~ !2! I ~ :=; OS 5 t~~ :;; el . Jj ~ '" ~ ~ i'~~ ~ '" ~ en 1 .. ::I~ '" ~ ~ j~1 ~ .I v II '" '" ~ ~ ,en i~ I <5, I:;) 10...: '0-' ii ~ ~I ~ 0 I~ " !a ~ :;! j~ N , ~ I I: ~ )'E ~. ~ 0 N ~ 0 \ i en - "'I ~ 0 ,S E l , i .. i ~~ I ! - ~ I N Ii ~~ to PI I _ N fg? i , :::> .e II u -00 ~ 1i 0 ~j J! '" ~ UZ tu E -->- ! I II i} :::I .......J9 ~\..U .z:. 1 " z~?Q5 t;;CJ ~j ,- " '6,=o~",z'::i i 0 I ~ ~~Vl<..cl..U-' - ~ ~~2~~~8 - ~\I I ~ i , " 1::- uJ~V'l~ I ~ ., l'J.,oI~~-1-l-f"l< ~s ) ~, 3 >- ~o ;;c:f~;:;;t;~ 0 ~-I'I c, A. "" >- 0 ---- 0 , l.lUll ('1<11111 11o..,....d Deed MADE the 3rd day of September in the )car T\\o Thousand Foll\' (2110-l). IlllWI I-N: GEORGE HOMAN, !x<:eutor ot'111e btalc of MARY REED HOMAN, parl~ "I' the lirs\ IXlrl. (,RANTOR -AN D- GRD PARTNERSHIP. 265 Blue COllrse Drile. C I. State College. PeJlns) ilani~L pC\r\~ 01' the second pmt. (j RA N Tl:J. WIT\ESSETI-I. I'hat inl'lJIlsidmltion ol'FIFTEEN THOUSAND AND OOilOO DOLLARS ($ 15,OO(l.OO). in hand p.lid. the re<:eipt \\her<::ol' is hc'ITb\ :I<::knol\ kdgc'lL the s:lid (ir.lll\o[' do h<::rcby remis<:. rekase and quit <:Iaimto tl1<: "lid Ciranl<:e. ALL that certain l11esslIC1(!.e. \cnelllent C1lld tract or hnd situate in f'erguson To\\nship. Centre County. l'enn:iyhani,l. being designated as the property orthe Krul11rine lleirs by property suney l1f Scott Tudor. Registered Professional Land Surveyor No. 0423] I-F. dated May 17.2004. BEGINNING at an imn pin on the western right of way of U.S. Route 322 (North Atherton Street) at the intersection with lands now or formerly of Bobubhai L. and Kaneh,mben B. Pall'\: thence ,1long the common boundary of lands of Patel and now or formerly ofearll!. and .loan L elmk and the lands herein conveyed. South 67 degrees 29 minutes 41 seconds West. a distance of 336.0R lCel to a point: thence on a eliI've to the left with a radius of 50 li:et. a chord bearing of SOllth ::0 degrees 52 minutes 03 seconds West. n chord distance of 43.61 feet and a length of 4:'.13 ICl't to " pin 011 thc northcr right OeWa) ofOrlnndo Avellue. a 50 foot right of way: thence ,dong the right of\\ay of()rlando ^\cnlle on a curve to the len with a radius 01'200 kc\. a chord bC'<1ring of North 69 degrees m~ minutes.t5 seconds Wes\. H chord clist<1nee 01' 63.29 i'c:".t aJld" length \,r 63.:'6 \'cetlo n pin <1t tl1l' inkrsection 01' unkllll\\ n bnds: thence along. the CO\11n1\1n b\1undary \lith lInklllm n lands. North II deg.rces 45 minutes () 1 seconds Ens\. ,\ distance of 46. 2X [\:etto a pin al the intersection \\ith lands JlO\\ or formerly ofRonnlcl I!. and Joan E. Clark and n()\\ or forlllerh bnds of/\rthur P. and ^udrv J. Buch.:r: thence along the comll1on boundary of . '" ..... .. lands 0 r Bucher and Brewneer Renlty and lnnds now or formerly of Orvis M. Poonn,lI1 Tract I. :--;orth 67 degrees 30 minutes 07 seconds East. a distance of 388.22 feet to an iron piJl on thl' \\esterly rig.ht of way of U.S. Route 322: thence along the right 01'\\'<1) ofll.S. Rouk 322. Sllulh Ie) (kgrees 57 minutes 53 seconds East. a distance: of 50 1celto a pin. the point or beginning Containing 20.830 square feet. BEING the residuc ol'the Adam Krllmrine Eslate. the said /\d<1m Krumrine having died and his \\ ill being pwb<1ted Jul) 13. 1932 leli to survive him t\\O daughters. Katie Krumrine Reed and M,lry Knllmine (lamer.! he said K<1tie Krumrine Reed died and !en to suni\ e her Mar) Reed Ilon1<ln. The ",id Mary Krllmrinc (,arneI' died and Ict\ to stll'\i\'c lwr ^d,\l11 Krumrine (i,m1CT. hl'l \)nl\ S"Il. \lhll <1\-'0 h<1vinl!. died \ell to sllr\'i\ e him his son Charles William (,amer ,lIld a qC!, . , d.\ugh\er Ikll\ ('<1rbriek \\ho S11:111 COJl\'l') their interests tll the Gr<1ntee herein by decds to be recorded lonlcmporancullsly herc\\ith. (ieorge 110111nn is the \.:\cclltor urthe Estate uCMary Rced I h'l1lan. \\11l1 died 2004. l'NOF:R AND SUBJECT, NEVERTHELESS, to all e.v:istil1Q.easements. conditions. rcstricti\'ns :Jnd e()('c:n:mts of rc:cord. r-;~~.-::-T(5:C-8~OAJ \'cL~ /0 vt1z... II,..\,''''_.-~I..r,' t . " ';;";'" 1" '''1",,;-..t('1 ~ -5 - 0 " . '.... ;,r __ L' ,...:. ') c, '~"I,(."'~'. ',I..-.~...,,',",,-,",,_.~ .' ,. l' t{ , . '''',,' .. 1: :Jill ....\'(:~~~,,:, - L:7. f ,."_.,,,,~.:-' ..'. . --..-- if' L?-<:._.:::..~~~~~!~~lldent ler AND lh,' said liranlor will QUIT CLAIM nnd reiL-ase the property hereby conveyed. IN WITNESS WHEREOF. said Cirantm does hereby hereunto set his handss nnd senlss. the dn: ~\I1d : e,11' lirsl ~\bt)\'e-\\rillen. \,',01,,1 ;lIld ,1;.'1,\,'''.',1111 Ilk PI'l'~l'lll'l' (\1 1/ ..../ j~~o---__ George lIt m\l1. ["eeutor (SEAL) COMMONWEALTH OF PENNSYLVANIA ) ) SS: COliN IY 01 CENTRE ) 011 lhis. the _3rd day 01' September . 2()()4. berore me a NolaI': Public. thl' undersigned onieer. personally appeared lieorge 1101lWll. kilOl1 n to me or satisl(lclOril: pro\ c'l1 \d be lll,' person \\h()se n.lI\\e is subscribed 10 the \\ ilhin instrument. ,\I1d aekn()\\lcdged tklt he l'\,'c'ull'd the same fell' lhe purpose therein conlained. IN WITNESS WHEREOF. I have hcreunlD selm)' hand and oflicial seal. r~~;X~~t~~t~~~-~l t J!'~'erl ~;f;!t;;'~G, r,~;\:",rf."..r~; t t ~'~'.'<; J'~'.~'.":?'~':.;;:>-'~'.:'; ,,-,> ," ~,:'. ~: . ... rC'" ~- . /.L) . _ _.. '.':Mt--_/2__!.~e-?-u~-J Notal' 'ublic (/ Ivl: Commission ["pires: REV.1S09 EX+ (&-98) .. COMMON~TH CIF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Mary R. Homan FILE NUMBER 21-04-0658 If In 1.lIt wu mid. Joint within on. Y.lr of thl dlC.dlfltl, dltl of dlath. It mutt be "'portld on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO OECEDENT A. George T. Homan 4050 Mountain View Road Mechanlcsburg, PA 17050 Son B Edward W. Homan C. Michael R. Homan 489 Rock Road Slate College, PA 16803 Son 227 Hillcrest Avenue State College, PA 16803 Son JOINTLY.OWNED PROPERTY: LmER DATE DESCRIPTION OF PROPERTY %Of DATE. Of DEATH ITEM FOR JOINT MAIle INClUDE JrfAME Of FINANC\Al.INSTITUTION AND BANK ACCOUNT NUMBER OR SINILAR DATE. Of DEATH DECD'S ""UEOf NUMBER TalANT JOlNT IDENTIFYING NUMBER. AnACH DEED FOR JDINn.V.HELD REAl. ESTATE. VALUE OF ofoSSET INn.REST DECEDENT'S INTEREST 1. A. 04/24/1997 M & T 8ank Checl<ing Aceount# 13611311 3,897.52 50 1,948.76 2. abe 04127/1990 PA State Employees Crell" Union Account # 184-3U272 Reg. Sheres 848.85 25 212.21 3. abe 04/27/1990 PA State Employees Crell" Union Account # 184-38-8272 Checking Acet 105.61 25 26.40 4. abe 04127/1990 PA State Employees Crad" Union Account # 184-38-8272 Money Market 2.80 25 0.70 TOTAL (Also enter on line 6, Recapitulation) $ 2,188.07 (If more &p8ct Is needed. Insertlddtlonar sheets of the same Ilze) !:1 M&I'Bank STATEMENT PERIOO PACE 1 OF 1 ACCOUNT NO. .. ACCOUNT TVPE 1361139 CLASSIC CHECKING JUL.03-AUG.03,2004 00 2 04345H Il 021 1654 GEORGE THOMAN 4050 MOUNTAIN VIEW RD MECHANICSBURG PA 17050 STONMIlllE ACCOUNT SUMMARY A OS S I OTIlER A TI S NO. AIlOUMT CIl C S PA 0 NO. ANOUNT NO. I TER ST A ANt 3,.97.52 o 0.00 1,276.07 ACCOUNT ACTIVITY , A PT T 07-03- aEGINNING aALANCE 07-06-04 AARP HEALTH CARE PRE"IUM 07-01-04 IlDAG'S CATERING SERVICE 8142380824 07-08-04 CENTRE CDUNTV MEH 5621 814-237-41 07-08-04 CHECK NU"BER 0630 07-14-04 CENTRE COUNTV "Ell 5621 8142374108 07-16-04 CHECK NUN8ER 0631 07-26-04 SPACE MART SELF STORACE STATE CDLL 148 . 75 571.68 935.00 150.0 480.00 281.00 55.12 t3,897.52 3,748.77 3,177.19 2,092.19 l,b12.19 1,331.19 1,276.07 ENDING BALANCE n,276.07 CHECKS PAID SUIlIlARV 630 07- 08- 04 150.00 631 07-16- 04 281.00 FOR QUESTIONS ABOUT VDUR ACCOUNT CALL 1-800-724-2440. DO VOU HAVE "LESS-THAN-PERFECT" CREDIT DR ARE YOU SELF-EHPLDVED? "IT'S ALTERNATIVE LENDING IlDRTGAGES ARE DESIGNED FOR THOSE: . WITH HIGH HONTHLV BILLS. . WHO HAVE DIFFICULTV DOCUMENTING THEIR INtONE. NOW AVAILAaLE IN NEW YORK, PENNSYLVANIA, MARYLAND, VIRGINIA AND WASHINGTON DC. TO FIND OUT "ORE, CALL US AT 1-800-436-0798. "&T IS AN EQUAL HOUSING LENDER. LOO6A (903) 2033 0002 5042 Y FINANOA~ll- TRUST CORP STATEMENT OF ACCOw~S 001361139 STATEMENT PERIOD FROM THROUGH 4-24-97 5-04-97 0 PAGE 1 OF 1 x MARY R HOMAN GEORGE THOMAN 770 S HANOVER ST APT 308 CARLISLE PA 17013 o ENCLOSURES 5 1111111111111111111111111.1 CHECK PLUS ACCOUNT ....,,=-..0:..."'_ _" _____._____n PREVIOUS DEPOSITS/ CHECKS! STATEMENT BALANCE CREDITS 2 DEBITS .00 1,045.82 ACCOUNT: 001361139 SERVICE o FEES .00 .00 ~ ENDING BALANCE 1,045.82 INTEREST PAID THIS YEAR ACCOUNT/INTEREST INFORMATION .50 FED TAX WITHHELD THIS YEAR .00 DATE ACTIVITY DESCRIPTION REFERENCE BEGINNING BALANCE IT INTER ENDING BALANCE .00301706790 DEPOSITS! CHECKS/ CREDITS DEBITS BALANCE '" .----._ . ..........-...-----...-...-...-----ciOJ 1,045.32 .---.-- 1.0~ .scr ......--......- 1,045.82 1,045.82 , , \ *** ANNUAL PERCENTAGE YIELD EARNED DISCLOSURE FROM ANNUAL PERCENTAGE YIELD EARNED AVERAGE DAILY COLLECTED BALANCE INTEREST EARNED 4-24-97 THROUGH 1.76% 950.29 .50 5-04-97 *** C'~,!':l/~ 7JtV~'iI/ DIRECT FINANCIAL TRUST COMPANY, NOBLE BOULEVARD OFFICE INQUIRIES TO: NOBLE BLOULEVARD & SOUTH WEST STREET CARLISLE, PA 17013 TELEPHONE: 717-243-3212 PSECt; 111111111 PO 6ax 67013 (717) 234-8464 (Harrisburg) Harrisburg, PA 17106-7013 (800) 237-7328 (Nationwide) webslte . http://www.psecu.com Pell",yl,"m" SI"le Employees Credit Umol1 VISA PAGE 1 0184XXXXXX .08/25/04 0.00 0.00 .. .... NUl! M'It.\1II<T AfolOlIlT lH<C\.08ID "_"7 ;;,.,....;"..;-;..:..~:.;.: 0.00 __MIl ~QII'1IAl1i 'Il:>TAl. "WWNA 0.00 _RI\lITI>UE 'I- C_T........N.TllUIl 1,"111,"111,",1,1,11","1,1",11"11"1"1,1,1,11,,,,,1,11 MARY R HOMAN 4050 MOUNTAIN VIEW RD MECHANICSBURG PA 17050-2134 'Mly waste time & money on writing checks al"1d paling postage> n l"" or. going 10 moIco pl' Yillo poymont uoIng 0 PSECU c~ock,1og 1"" onlln. bonIcIng ond tono_ _ YIoo poymonll Or, eel uo.. (800) 237-7328 no_d. 01 (717) 234-848410 Howlollurv. Ao 1110 m,"" 0""., onlof 44. Uoton to Iho ooloctlon and Io8ow .,. m.~IonI, (Vou'll need your eccounl numb.- ond PIN hendy.) Eithtlr Way ~ No eo.t, Quick I. E..y. Avallabl. 2""ho&;~. o.yl 3090184388272 TO REPORT A LOST OR STOL!;:N CARD' CALL OUR BUSINeSS NUMBERS USTEO ATl1iE TOP OF EACH STATEMENT PAGE FROM 7 /oM . 6 PM MONDAY 10 FRIDAY AND ,IN. 10 12 PM SA1IJRDAY, OTHERWISE CALI. .....66&6878 ."...~ ~~tr:.'t:~... Mn.wrMR, ...Q.,.:4...;t.."... "".._~"_. .. _ .. "',...", u.._.._u.,.," ""1 0184XXXXXX 07/31/04 08/25/04 6500.00 0.00 ~BEFORE 1 DETACHING HERE T .A~~. 0.00 6500.00 ADDITIONAL JOINT OWNERS. ItICHAEL R HOltAN EDWARD W HOltAN ID 09 VISA LOAN POST TRAN REFERENCE DESCRIPTION AItOUNT YTD FINANCE CHARGE, YEAR TO DATE 0.00 :~."" ~ 0.00 ~,:"',. .00.. 0.00 +- ~~' ~ -+ ::...~i).rr~~L:':+ 0:0 0.00 ~~. .00 0.00 ,.:~~:..~(>"'~/ D.OO -If.:'-' A\'Ii~..... llAuiHoE PER""'" 1RANiSAC'OON "'TAl. '1.'100% 12.'100% 0.82500% 1.07500% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 02010002 2009823 PSECr4t, " IIIIH" P.O. Box 67013 (717) 234-B484 (Hanisburg) Harrisburg, PA 17106-7013 (BOO) 237.732B (Nationwide) webslte - h"p://www.psecu.com I Pellmylvolllo 5101<- Employee, Cred'l UIIIOIl USE YOUR PSECU VISA FOR BACK TO SCHOOL PURCHASES. MARY R HOMAN JOINT ONNER QEORGE THOMAN PAGE 2 1~:~~l~~l ~ . . : ... ",:-::', :::::C' ,:':'::,:::,::','_:':,:,:':'--:,'::::::'::,':::':,';::-';;:::.;,'f::': I. . '. POST EFF 1I~$CRtPnON . .' . '. : . trill ..'111> 01. REGOLAR SHARES bEGINNING BALANCE . I 0706PAYI1ENT; DIRECT DEPOSIT MET LIFE . TYPE, ANNUITYPAY ID, 9039565104 WITHDRAWAL DIRECT DEPOSIT I1ET LIFE 3319.45- 343.35 om' "PAy~::~,U:~~riE:':~;~::l04. .' . .... '. ........ 0.'5 849.30 A~NUAl PERCENTA~ YIELD EARNEl!O .15% FROI1 07/01/04 THltOUGH 01/31104 . BASED ON AVERAGE DAILY BALANCE OF 1,491. 32 . . ENDING BALANCE 349.30 DIVIDEND YTD, YEAR TO DATE 17,33 ., ".'. . . At!OUNT ..'.. ... BALANCE .' .41L 85 4163.30 0712 0731 I I I I , \ l : ,ilIJ~Q",:W.;;;..j=.raill:.;;;=:~.liI'#_'=..;;..=III..=.=;;;;J;;;;:;;,.=;;;'==:;:;';;;;::;;;;;==:....,f;:;;;=!lII!.1Ir<l!;=.=~~ai~~*=:w,.~wai.,.=:;..illlll= \ '.' '. POST. eFf l!ESCRIPTIQN '. . At!QI,lNT' B"LANG!:: n.oi . ". III 04 MllNEVHANl!lER BEGINNING BALANC!:: .. '105.61 0731 PAYI1ENi, DIVIDENti 0.250~ 0.02 105.63 L ANNUAL PERCENTAGE YIELD EARNED 0.22% FRat! 07/01/04 THROUGH 07/31/04 BASED ON AVERAGE DAILY BALANCE OF 105.61 ' -~7"1" ''''''''''''fHt!. IALANCE .' --.". .---- .- lQ5U ." \ ... . 1llVIPENP YTD, YEAR TO PATE 0.14 . ~;:::,:;:;~>,~~.:~';~:.:...:~..:;.i..'_.......~.*.*..~.~~=.==~=.~=~~...lil,==-~=..=*........'....,.......==..=. I .~~~~ EFF ~~S~~I~~~~~t!ARKET BEGINNING BALANCE A"OUNT BAL~~~~ 0706 DIVIDENP RATE CHANGEP FRat! 1.33% TO 1.83% .... 0712. <, "!llVI.PENP RATE CHANGEll FROH 1.83% TO '. ..... '.' 0719 ... .:. tlIVtDENP. RATe CHANG.Ell FROM 1.79% TO . tU1...' EH~IHG JAlAN<:E .', . .... .... . tiIVIDEND YTD. YEAR TO DATE ~==..=============================:===============.================...============ ... ANNUAL PERCENTAGE RATE 12.900% ... PERIODIC RATE (DAILY) .035342% 02020002 2009824 REV-1S10 EX_ 16-98. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE Of Mary R. Homan FILE NUMBER 21-04-0658 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAMe Of THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXClUSION TAXABlE NUMBER THE DATE OF TRANSFER. AITACtl ACOPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IFAPPUCASLE} VALUE 1. AXA Equitable Invesbnenl Annuity - This contract was purchased on 9/16/02 124,898.79 50 62,449.40 with George T. Homan (her son) as the annuitant. 2, Metlife Annuity ID # 000829276R8 89,436.36 100 89,436.36 100 100 100 TOTAL (Also enter on line 7 Recapitulation) $ 151,885.76 (If more space is needed. insert additional sheets of the same size) \'~urrABLE M~""__", /~S'; ~~ \ ;~\MULATOR ~~_ P.O. BOX 1547, SECAUCUS, NEW JERSEY 07096-1547 .'0."'" fit Quarterly Account Review Statement Period: April 01, 2004- June 30, 2004 3C2635893 003373302 AT 0 517 .'AUTO T30 9301 17050 3 1...111...11111..1.1,1111...1.1.1111..11..1..1.1.1.11.....1.II Mary R Homan / George THoman 4050 Mountainview Rd Mechanicsburg PA 17050-2134 Contract Number: 302 635 893 Contract Type: Equitable Accumulator" (NQ) GMDB Election: Greater of Roll up or Ratchet Contract Date: September 16, 2002 Contract Owner: Mary R Homan / George THoman Annuitant Name: George THoman Effective on or about September 7, 2004, subject to regulatory approval, The Equitable Life Assurance Society of the United States will change its name to AXA Equitable Life Insurance Company. The name change has no impact on the terms and conditions of y'QW policy or contract. If you have any questions, contact your financial professional. GE-29026 Now you can be notified bye-mail whenever your Annuity Quarterly Statement becomes available online. Visit www.equitable.com. enroll for online access to your annuity contract and sign up for Electronic Delivery. Quarter Account Activity Summary 4/1/2004-6/30/2004 if(~..Y~JM11!lil\:.\It",{IRm~~:'1i~';!jj;:Jl1;;jjf;ij';';!jlJjiji:;i:;iil!!JI1~.~i~gj~1;~;i;.!! ~~*~ ROO Requested Withdrawals ($10,000.00) 1i.;_.IIM~::I~gl'-l~~~~r~:f:~]1;fit:~r~~~::;:i!~ili:ili:li~mji~I:::::i,;~!i~i;jili[f~1!~i:ili:~:i.i::~m:~8r;i:1m:!:rifd8:~~iili:~~ill: Variable Investment Option Results ($411.29) Guaranteed Interest Option Interest $280.87 Year-To-Date 1/1/2004-6/30/2004 Since Purchase 9/16/2002-6/30/2004 $0,00 ($10,000.00) $118,988.63 ($10,000,00) Your Account Allocation Your Account Value is currently invested among the asset classes below. Totals may not be exact due to rounding. To review your investment strategy, contact your registered representative IIIlIII 39% Large Company Stocks ~ 26% Domestic Bonds G::J 31 % Guaranteed.Fixed o 4% High Yield Bonds For Assistance. Contact: Your Financial Professional: David Smith /l\XA Advisors, LLC Suite 426b 315 S AllenStreeL__._. _ State College PA 16801 _. 814-234-4414 You can obtain current account information, including balances and "nit values, any time you wish. . Call our TOPS voice response system 1-888-909-7770, or . Visit our Website: www.equitable.com and click on EQAccess If you want to speak to one of our Customer Service Representatives please call 800-769-7771 8.30 - 5:30 ET Monday - Friday =- - IE - - - .. - - !!ii!iiiiiii ~ !iIiiiii!! 0033733 00SS397 Page 1 of 4 Please review this statement and retain it with your Accumulator papers. Financial information Continued on Revelse Side IIAXA EQUITABLE ~... - . J .. 0 . ......~ co ....~ ~o"..u",c." ACCUMULATOR P.O. BOX 1547, SECAUCl!S, NEW JERSEY 07096-1547 3C2 635 a93 003394701 AT 0292 "AUTO T6 C 9401 17050 0 1".111",11',",1.1.11"...1.1,"11..11..(..1.1.(.1111,..1.11 George THoman 4050 Mountainview Rd Mechanicsburg PA 17050-2134 e Quarterly Account Review Statement Period: July 01, 2004-September 30,2004 Contract Number: 302 635893 Contract Type: Accumulator (NQI GMDB Election: Greater of Roll up or Ratchet Contract Date: September 16, 2002 Contract Owner: George THoman Annuitant Name: George THoman Great Newsl On October 25, 2004, AXA Equitable will expand your investment choices by adding six Enterprise variable investment options to your current investment option line-up, The options are: EQ/Enterprise Equity, EQ/Enterprise Equity Income, EQ/Enterprise Growth, EQ/Enterprise Growth and Income, EQ/Enterprise Small Company Growth and EQ/Enterprise Small Company Value, For a prospectus containing more information .. . including investment objectives, risks, charges and expenses, call your financial professional. GE-29728(B\ (8104) Quarter Year- To-Date Since Purchase 1/1/2004-9/30/2004 1/1/2004-913012004 9/1612002-9/30/2004 Account Activity Summary iI~~q~I)!l~i9.il!i:~:;.{.~!;!:j~'!';.:;;i!i,;i,!;j!!'i! " Contributions Requeste~ l/Vit~dr~wa.l.s .. ...... . ;:.iil?lul!illli!'i~ll!I!~J:!;BiQ!~lii:)i.!:;;!I: i1,!: O,1!i' Variable Investment Option Results Guaranteed Interest Option Interest iii;ii;i~I!U~~;,7!U';! $0.00 $0.00 ";:::,:;~:r,}';:::::; ..............:.:::;;" """""'.;,,;.,.:.: $0.00 ($10,000.00) $118,988.63 ($10,000.00) ........." .;,,::,:' ;':),;;" ::::::;:::;:::H~N: :-,,:,,;,;<,;':"';". ......'..,..-.....b ($1,044.59) ($51.30) ~li..t.:I.i'..liv:lqlii>;;;:!,i;liili!ii::lji!i!!lii.l~rllir.~.I~!;;J Your Account Allocation Your Account Value is currently invested among the asset classes below. Totals may not be ..ael due to rounding."o review your investment stl<lte)lY, contact your registered representative. . 36% Large Company Stocks ~ 27% DomestiC Bonds ~ 31 % Guaranteed~Fixed o 4% High Yield Bonds 00339470056321 For Assistance, Contact: Your Financial Professional: David Smith AM Advisors, LLC Suite 426b 315 S Allen Street State College PA 16801 814-234-4414 You can obtain current account Information, including balances and unit values, any time you wish. . Call our TOPS voice response system 1-888-909-7770, or . Visit our Website www a.a-eqUltable.com and click on EQAccess If you want to speak to one of our ellstomer Service Representatives please call 800-789-7771 8:30 - 5:30 ET Monday - Friday Please review this statement and retain it with your Accumul~tor papers. Financial informa.tion Continued on Re'lerw Side .. Iii ~ - - Iii !!ii!i!!i III - iii - ~ Pa~€ i of 4 REV.'511 EX. 112'99* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAl EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Mary R. Homan FILE NUMBER 21-04-0658 Debts of decedent mull be reported on Schedule L ITEM NUMBER A. DESCRIPTION AMOUNT ,. FUNERAL EXPENSES: Koch Funeral Homan Haag's Catering Centre County Memorial Park Osiris Holding of PA Rev. Robert Rohlbaugh Prepaid Vau~ - Marker- Property 6,426.50 571.58 935.00 480.00 150.00 2,322.50 2. 3. 4. 5. 6. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City _State Zip Year(s) Commission Paid: 2. Attorney Fees 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 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ (It more space is needed, insert additional sheets of the same size) 10,88558 REV.1513W(!>OO) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Mary R. Homan FILE NUMBER 21-04-0658 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under Sec. 9116 (0)(1.211 1 Michael D. Homan 227 Hillcrest Avenue Stale College, PA 15803 Grandson 1,000.00 2 Morgan W. Homan 227 Hillcrest Avenue Slate College, PA 15803 Grandson 1,000.00 3 Kenneth B. Homan 141 Treasure Lake DuBois, PA 15801 Grandson 1,000.00 4 Jeffrey A. Homan 116 Wesley Olive Mechanicsburg, PA 17055 Grandson 1,000.00 5 Kathryn E. Emrich 450 Roman Court York, PA 17404 Granddaughter 1,000.00 6 Kimberly A. Homan 3 Paula Place Apartment 3C Baltimore. MD 21237 Granddaughter 2,000.00 7 Michael R. Homan 227 Hillcrest Avenue State College, PA 15803 Son 43,581.51 8 Edward W. Homan 489 Rock Road Slate College. PA 16803 Son 43,581.51 9 George T. Homan 4050 Mountain View Road, Mechanicsburg, PA 17050 Son 106,030.91 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH lB, AS APPROPRIATE. ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Saint Paul's Lutheran Church P.O. Box 2000 Pine Grove Mills, PA 16868 5,000.00 TOTAL OF PART 11- ENTER TOTAl NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-I500 COVER SHEET $ 5,000.00 (If more space is needed. insert additional sheets of the same size) LAST WILL AND TESTAMENT OF MARY R. HOMAN KNOW ALL MEN BY THESE PRESENTS, That I, MARY R. HOMAN, of the Township of Lower Allen, County of Cumberland. and Commonwealth of Pennsylvania, do make, publish, and declare this instrument to be my Last Will and Testament, hereby revoking and making void any and all former Wills by me at any time heretofore made. FIRST: I direct the Executor hereof to pay all my just debts, funeral expenses and costs of administration as soon as conveniently may be done after my death. I further direct the Executor hereof to pay all inheritance, estate, transfer and succession taxes which may be levied or assessed upon any property which Is Included as part of my gross estate for the purpose of any such tax. SECOND: I give and bequeath unto the following grandchildren the sum of $1,000 each: A) Kimberly A. Homan B) Kathryn E. Emrich C) Jeffrey A. Homan D) Kenneth B. Homan E) Michael D. Homan F) Morgan W. Homan , have not given and bequeathed any gift and bequest to Nicholas A. Homan because on the date of the execution of this my Last Will and Testament. he stili owes me the sum of $27,000, being the balance of my loan to him. However, if he should repay me . 1 . '/I)f? I( the $27,000 balance on my loan to him, I give and bequeath unto him the sum of $1,000. In the event that he does not repay the aforesaid balance of my loan to him, then in that event, I give and bequeath unto his sister, Kimberly A. Homan, an additional gift and bequest of $1,000 or the combined total of $2,000. THIRD: I give and bequeath unto SI. Paul's Lutheran Church of Pine Grove, Pennsylvania, the sum of $5,000. FOURTH: I direct that in addition to the advertisement of my death in the Cumberland Legal Reporter and The Sentinel that my death also be advertised In the Center County Legal Reporter and the Center Daily Times. FIFTH: I give, devise and bequeath all the rest, residue and remainder of my estate in equal shares, share and share alike, to my Sons, GEORGE T. HOMAN, EDWARD W. HOMAN, and MICHAEL R. HOMAN, ~ slimes. provided that they are living on the date of my death. In the event that one or more of my sons are not living on the date of my death, then in that event the share of my son who has predeceased me shall be given, devised and bequeathed as hereinafter set forth in paragraph StXTH of this my Last Will and Testament. SIXTH: in the event that one or more of my aforesaid sons have died prior to the date of my death, I give, devise and bequeath the share of the rest, residue and remainder of my estate that my son who has predeceased would have received but for his death to his widow, to wit; GEORGE T. HOMAN whose wife Is DEBRA A. HOMAN -2- m f/f II and EDWARD W. HOMAN, whose wife is BARBARA E. HOMAN, and MICHAEL R. HOMAN, whose wife is DARLA J. HOMAN, ~ stiroes. SEVENTH: I appoint my Son, GEORGE T. HOMAN, to be Executor of this my Last Will and Testament. In the event that he predeceases me or is unable or unwilling to be my Executor of this my Last Will and Testament, then in that event I appoint my Son, EDWARD W. HOMAN, as the successor or contingent Executor of this my Last Will and Testament. In the event that my son, EDWARD W. HOMAN, predeceases me or is unable or unwilling to be my Executor, then in that event I appoint my Son, MICHAEL R. HOMAN. to be my Executor of this my Last Will and Testament, and I do hereby give to the Executor hereof full power, discretion and authority at any time or times to sell, at private or public sale, mortgage, lease, pledge, exchange or otherwise deal with or dispose of the property comprising my estate as deemed best, to settle and compound any and all claims in favor of or against my estate as deemed best and, for any of the foregoing purposes, to make, execute and deliver any and all deeds, mortgages, contracts, Jeases. bills of sale or other Instruments necessary or desirable therefor. LASTLY: I direct that no fiduciary appointed by this. my Last Will and Testament, shall be required to give bond and that if, notwithstanding this direction, any bond is required by any law, statute or rule of court, no surety shall be required thereon. -3- J?-J ~ If IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament. consisting of four (4) typewritten pages on the margin of which (except this page) I have affixed my initials this 3rd day of May, A.D. 2002. mmo~Af~.r.~, Signed, sealed, published and declared by MARY R. HOMAN, the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, and each of us, who at her request, and in her presence, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ~~~.. seth Myers Amy Knauer '-<-V .4. County of Cumberland Commonwealth of Pennsylvania ss, ACKNOWLEDGMENT AND AFFIDAVIT We, MARY R. HOMAN, the testatrix, and the undersigned witnesses to the Will, the attached or foregoing Instrument, having been qualified according to law do depose and say: (a)thatl, 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 the instrument as her last Will, that she signed it willingly and as her free and voluntary act for purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the Will as a witness and thetto the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue Influence. Sworn to or affirmed before me by MARY R. HOMAN, testatrix, and Beth Myers and Amy Knauer, witnesses, this 3rd day of May, 2002, 171~ 1?~Q~ MARYR.HOMAN . ~ ' ,. " . -, . /Seth M~ers -~~ ~~1~ Attorney I.D. #21582 - 5- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Marv R. Homan Date of Death: 07/01/2004 Will No.: 21-04-0658 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 07-14-2004 Name George T. Homan Edward W. Homan Michael R. Homan Kimberly A. Homan Kathrvn E. Emrich Jeffrey A. Homan Kenneth B. Homan Michael D. Homan Moraan W. Homan Address 4050 Mt. View Road, Mechanicsbura, PA 17050 489 Rock Road, State Colleae. PA 16803 227 Hillcrest Avenue. State Colleae. PA 16803 3 Paula Place, Apartment 3C. Baltimore. MD21237 450 Roman Court. York, PA 17404 116 Wesley Drive. Mechanicsbura. PA 17055 141 Treasure Lake. DuBois. PA 15801 227 Hillcrest Avenue. State Colleoe. PA 16803 227 Hillcrest Avenue. State Colleoe, PA 16803 Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except Non Date: March 18. 2005 >- David W. Knauer 411 A E. Main Street Mechanicsbura, PA 17055 Telephone: (717) 795-7790 Capacity: _ Personal Representative -L Counsel for personal representative 06-20-2005 HOMAN 07-01-2004 21 04-0658 CUMBERLAND 101 APPEAL DATE: 08-19-2005 ( See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- REy:is47-Ex-AFP-io3:osi-NOTICE-OF-INHERITANCE-TAX-APPRAIsEHENT:-ALLowANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MARY R FILE NO. 21 04-0658 ACN 101 BUREAU OF INDIVIDUA~ TAXES INHERITANCE TAX DIVISIDM PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLDWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX p ::1 v.._.,~ I j I,' I. ~I 'il ," 0'+ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN O~~' ,.,,,,, Ht....I--:;,.:..'\;\1 ;:; GEORGE !Tl!llOHAN 4050 MOUNTAIN VIEW RD MECHANICSBURG PA 17050 ESTATE OF HOMAN *' REV-1547 EX AFP (06-05) MARY R TAX RETURN WAS: I X) ACCEPTED AS FILED DATE 06-20-2005 CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..I Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule DJ S. C.sh/Bank Deposits/Hisc. Personal Property (Schedule E) 6. .Jointly Owned Property (Schedul. f) 7. Transfers (Schedule G) 8. Total Assets 11) (2) (3) (4) (5) (6) (7) .00 36.231. 66 .00 .00 25.774.02 2.188.07 151,885.76 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. ExP8nses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) 110) 10,885.58 I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ~ returns assessed to date. ASSESSMENT OF TAX: 15. ~unt of Line 14 at Spousal rat. (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rat. (17) 18. Anount of Line 14 taxable at Collateral/Class Brat. (18) 19. Principal Tax Due S: NOTE: + DATE 02-18-2005 _BER CD004970 INTEREST/PEN PAID 1-) .00 .00 Ill) 112) 113) 114) .00 X 200,193.93 X .00 X .00 X AHDUNT PAID 9,008.73 ~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 00 = 045 = 12 = 15 = 119)= NOTE: To insure proper credit to your account, submit the upper portion of this for. with your tax P.y....,t. 216,079.51 1 n .RRIi IiR 205,193.93 5,000.00 200,193.93 .00 9,008.73 .00 .00 9,008.73 9,008.73 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FDR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YDU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) - One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 5/31/2006 KNAUER DAVID W 411A E MAIN ST MECHANICSBURG, PA 17055 RE: Estate of HOMAN MARY R File Number: 2004-00658 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. 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: 7/01/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Gl~/!f':!r~ Clerk of the Orphans' Court cc: File Personal Representative(s)