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Home My WebLink About03-0144PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of Charles L. Wagner, Sr. No. ~l,'O~~ also known as To: Register of Wills for the Deceased. County of Cumberland in the Commonwealth of Pennsylvania Social Security No. 190-26-6961 The petition of the undersigned respectfully represents that: Your petitioner(X), who is/line 18 years of age or older, appl io s for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in Cumberla.~d County, Pennsylvania, with h is last family or principal residence at 32~ ~'~esley Drive, Mechanicsburg,. PA 17055 (list street, number and municipality) Decendent, then 94 years of age, died January 28 s ,~1[~ 200 ~ at Holy Spirit ~tospitals East Pennsboro Townships Cumberlan~.'County, PA Decendent at death owned property with estimated values as folllows: (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 $ situated as follows: ~one 95,000.00 Petitioner the following spouse (if any) and heirs: Name after a proper search ha S ascertained that decedent left no will and was survived by Relationship Daughter Sar~W. Flagg Eva M. Hair [Daughter Richard E. Wagner ISon Charles L. Wagner ISon ! Residence 426 S. High St. Mechanicsburg, PA 17055 8 Mill Road, Carlisle, PA 17013 '717 Grantham Road, Grantham, PA, 1212 Paoli Piko 17027 West Chester~ PA-- THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. - Sara~.~W. Flagg 426 South High St. Mechanicsbur~, PA 17055 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF ~c~v\ooc~,_ The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ~! ~ '~ before me this '1 ~ 'ch day of FEBRUARY 2003~ 19 ~. (~,: ¥~2.~ (,J l~egister Estate of CHARLES L WAGNER SR , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW FFRRI lAItY 1 q; ?fill3 19 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that SARA W FI Agg is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration LETTERS OF ADM!.N-~STR~-T!ON are hereby granted to SARA W FLAGG in the estate of CHARLES L WAG.NER SR FEES Letters of Administration ..... $ ~C~O, ~ Short Certificates( ) .......... $_~o_~7~ Renunciation ................ $ ~, c~ ..-hop $ I~, TOTAL __ $~ i, ~ Filed . .~.g ~.: ~R~ ..... A.D. 19 Register of Wills ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of Charles L. Wagner ~ Sr. No. also known as To: Deceased. Social Security No. ].90-26-6961 Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in last family or principal residence at Decendent, then at years of age, died County, Pennsylvania, with (list street, number and municipality) ., 19. Decendent at death owned property with estimated values as folllows: (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 $ situated as follows: Petitioner the following spouse (if any) and heirs: Name Lee Ann Cica Jill S. Baer Scott A. Wagner after a proper search ha ascertained that decedent left no will and was survived by Relationship Granddaughter Granddaughter Grandson Residence 6100 Bryant St. Pittsburgh. PA 15206 2~ King'~chard Drive i~cMurr ay, PA 15317 ~ Montaque Drive Dillsburg~ PA 17019 THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this day of 19__ Register No. Estate of , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW 19 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to in the estate of Register of Wills FEES Letters of Administration ..... $ Short Certificates( ) .......... $ Renunciation ................ $ $ TOTAL ~ $ Filed ..................... A.D. 19 _ ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE RENUNCIATION In Re Estate of CitARLES L. 5?AG}~E~t~ SR. deceased. To the Register of Wills of Cumberland County, Pennsylvania. The undersigned heirs-at-law of the above decedent, hereby renounce(s) the fight to administer the estate and respectfully ask(s) that Letters of Administration be issued to SARA w :-,. FLAGG WITNESS our hand this /-~-~r'~day of Fobruary ,J~l 2003 (Signature) f~ Mill Road Carlisle, PA 17013 (Address) (Signaturey 717 Grantham Road Grantham: PA 17027 (Address) 1212 Paoli Pike ¥!est Chester~ PA (Address) J. ROBERT STAUFFER A~-FORNEY - AT - LAW MARKEt SQUARE BUILDING MECHANICSBURG, PA. 17055 TELEPHONE {717) 766-9673 February 20, 2002 Office of Register of Wills Cumberlaud County Court House Carlisle, PA 17013 Gentlemen: Please correct the address shown on Page 1 on the Petition for Grant of Letters of Administration for Sara W. Flagg from 426 South High Street to 426 South Frederick Street, Mechanicsburg, PA 17055. Thank you. JRS/akv Very ~y yours ...... -' ~,''~;I' Robert Stauffe~ Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) C~&RLES L. WAG.NEE, SR. Date of Death: January 28, 2003 Will No. 2003-001411- Admin. No. 2003-001411. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Febr!lary 25, 2003 : Name Address Eva M. H , PA 17013 Richard E. Wagner-717 Orantham Road, Orantham, PA 17027 Charles L. Wagner, Jr., 1212 Paoli Pike, West Chester, PA 19380 Leeann W. Cica-6100 Bryant St., Pittsburgh, PA 15206 Jill S. Baer-255 King Richard Drive, McMurray, PA 15317 Scott A. Wagner-9 Montaque Drive, Dillsburg, PA 17019 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except ]~olqe Date: Feburary 25, 2003 ,~Si~nature // Name J. Robert Stauf£er Address Market Square Bldg. ~<~ech~nicsburg, PA 17055 Telephone ~175-766-9673 Capacity: __ Personal Representative - X__~_.Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 002492 STAUFFER J ROBERT ESQUIRE MARKET SQUARE BUILDING MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 1 90-26-6961 FILE NUMBER: 2103-0144 DECEDENT NAME: WAGNER CHARLES L SR DATE OF PAYMENT: 04/25/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/28/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4,000.00 TOTAL AMOUNT PAID' $4,000.00 REMARKS: SARA W FLAFF C/O ROBERT J STAUFFER ESQUIRE SEAL CHECK# 108 INITIALS: SK RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS 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. REV-1162 EX(11-96) CD 002516 STAUFFER J ROBERT ESQUIRE MARKET SQUARE BUILDING MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 190-26-6961 FILE NUMBER: 2103-01 44 DECEDENT NAME: WAGNER CHARLES L SR DATE OF PAYMENT: 05/01/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/28/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $900.38 REMARKS: TOTAL AMOUNT PAID: J ROBERT STAUFFER ESQUIRE $900.38 SEAL CHECK# 110 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS RE',/1500 EX (6-00) ~,'~1'~' COMMONWEALTH OF PENNSYLVANIA ' · ~- DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA !7128-0601 rREV-1500 '"" INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER COUNTY CODE YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ,T&t~l. 1/l!"7 ~:',~ ] ., u REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER }, /& - _ ri ri Z ,.~ Z O (,9 o 0 uJ []1. Original Return [] 2. Supplemental Return [] 3. Remainder Return {date of death prior ~o 12-13-82) [] 4. Limited Estate [] 4a. Future Interest Compromise (date of dealh after 12 12-82) [] 5. Federal Estate Tax Return Required ]6. Decedent Died Testate (Attach copy of Will) [] 7. Decedent Maintained a Living Trusl (Attach copy of Trust) ~O 8. Tolal Number of Safe Deposit Boxes [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit ((late o, death be~ee, t2 31-91 and 1¢95) [] 11. Election to tax under Sec. 9113(A)fAUach S~.h O) 1.Hi~ SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CoNFIDEN~'IAL 1.AX INFORMATION SHOULD BE biRECTED 1'O: ' NAME ,T. .! i o l}~:; z' b S t; a'ul'f e r, /t't;__b_l.~ FIRM NAME Cf Applicable) TELEPHONE NUMBER 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Modgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Properly (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) ] Separale Billin9 Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) Funeral Expenses & Administrative Costs (Schedule H) (7) COMPLETE MAILING ADDRESS j;e,3hatl-[csbu.~j;,t~.% .?,,,\. ].- ~'r' (o 0 .16 O.OO O. OD (8) 119,434.76 6,093. O4 9. (9) 10. Debts of Decedent, Modgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has eot been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) O.00 (11) 6,093.04 (12) 113 , 341. (13) 0. O0 (14) 113,341 · 72 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax O x .0 __ (15) O OD rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable atlineal rate -']- 1.~, 311-1.72 x .o __ (16) 5,1OO .38 17. Amount of Line 14 taxable 31 sibling rate O x .12 (17) O. OD 18. Amount of Line 14 taxable at collateral rate O x .15 (18) O. OD 19. Tax Due (19) 5,1OO. 38 > > BE SURE TO ANSWER ALL QUESTION8 Decedent's Complete Address: S]REETADDRESS CiTY Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount h-, 0OO. O0 200. 00 Interest/Penalty if applicable 0. O () D. Interest E. Penalty 0.00 ISTATE ]'~A (1) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. JZIP .~,]_00.38 200. O0 0.OO 0.00 9oo. 38 0. O0 A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (EA) (ED) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain tl~e use or income of the properly transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] C. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, Under penalties of perjury, I declare that I have examined this return, includi.g accompanying schedules and stalements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all informalion of which preparer has any knowledge. SIGNATURE OF PERSON~.) RESPONSIBLE~/,_ .~-~.~FOR FILINGi~f O [~ '"r J'~ ?,,,RETURN DATE ,.,~--/.//~ ADD~ESS , ~ ~ ~ ~1-~ So,lth i';redei*iclc ~)t., I~echrlu:i_csbur[;, FA 170~:~ SIGNA~ ~R~TH~~ES~TIVE DATE For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §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 statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even i 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 paten? or a stepparent of the child is 0% [72 RS. §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 RS. §9116(1.2) [72 RS. §9116(a)(1)]. The tax rate imposed on the net value of tmqsfers 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 a~ individual who has at least one parent in cr 'non with the decedent, whether by blood or adoption. PNCINVESTMENTS A dMsion of 3.J.B hilliard. ~.[. ~yons. irc. member NYSE and S PC P.O. Box 32760 Louisville, KY 40232 Account Statement ~1 G ~ ~ ~ 0~ ~,A~. ....... CHARLES L WAGNER 325 WESLEY DR rRM-38 HECHANICSBURG PA 17055-3574 Portfolio Value Summa_ Mutual Funds TOTAL PORTFOLIO VALUE January 31,2003 $55,589.96 Prior Statement $55,886.18 $55,886.18 Financial Consultant: J236 CHARLES LITTLE, CFP PNC INVESTMENTS 2 EAST MAIN STREET MECHANICSBURG, PA 17055 ASST. DONNA POLLOCK Statement Period: Janua~ 1, 2003 - Janua~ 31, 2003 Account Number: Customer Service: 1-800-762-6111 Web Site: WWW.PNCINVESTMENTS,COM Portfolio Distribution The pie chart below Illustrates your positive security holdings, excluding outside assets. [] Mutual Funds 100% Income Summary Dividends from Equity Secs TOTAL INCOME Januar]/31, 2003 $154.77 $154.77 Year to Date $154.77 $154.77 Cash Flow Summary., OPENING BALANCE Dividends/Interest Other Credits/Debits CLOSING BALANCE January 31,2003 $0.00 154.77 (154.77) $0.00 RETIRING OR CHANGING JOBS? ASK YOUR PNC INVESTMENTS FINANCIAL CONSULTANT HOW AN IRA ROLLOVER CAN HELP PROTECT YOUR 401(K) FUNDS FROM TAXATION. J.J.B. Hilliard, W.L. Lyons, Inc. Page 1 of 2 January 2003 Member New York, Amenoan, Chicago arid Boston Stock Exchanges; CBOE; NASD; and SIPC. 0000~111 5,~1 G ~ ~ 0~ 0120~300- ~999 02~J3 i 600838 Portfolio Value ° May Lose Value · No Bank Guarantee Account Number: Investment Consultant: oanuary h zuu~ - 0anuary al, CHARLES L WAGNER 325 WESLEY DR #RM-38 MECHANICSBURG PA 17055-3574 74940879 CHARLES LITTLE, CFP Acct Type Quantity 1 4,936.942 Description BLACKROCK FDS GOVT INCOME PORT CL B Symbol Unit Price PNGBX $11.2600 Sub Total TOTAL PORTFOLIO VALUE Actixdty Details · MUTUAL FUND Acct Date Type Description Activity BLACKROCK FDS DIVIDEND GOVT INCOME PORT CL B 123102 4,936.94200 01102/2003 1 TOTAL Cash Flow Anal},sis Market Value $55,589.96 Total Market Value Amount $154.77 $154.77 Percent of Poi~;uiio 100% Estimated Annual Incom, $1,862.82 $1,862.82 Total Estimated Annual Incoi~.. Acct Date Type Activity Description Quantity Amount BEGINNING BALANCE 01/02/2003 1 DIVIDEND BLACKROCK FDS GOVT INCOME PORT CL B 01/03/2003 1 ACH ACH DIRECT DEPOSIT $154.77 (154.77) $0.00 ENDING BALANCE $0.00 $0.00 J.J.B. Hilliard, W.L. Lyons, Inc. Member New York, American. Chicago al~d Boston Sto~k Exchanges; CBOE; NASD; end SIPC. Page 2 of 2 January 2003 600838 iNVeSTMENTS Louisville, KY 40232 · No Bank Guara.te. Account Statement ~311~ G 2 004~ 0! 01204200-0004 02962 A Sl ....... SARA W FLAGG ADMINISTRATRIX ESTATE OF CHARLES L WAGNER C/O J ROBERT STAUFFER 1W MAIN ST MECHANICSBURG PA 17055-6230 Financial Consultant: J236 CHARLES LITTLE. CFP PNC INVESTMENTS 2 EAST MAIN STREET MECHANICSBURG, PA17055 ASST DONNA POLLOCK Statement Period: February 1, 2003 - February 28, 2003 Account Number: 33586423 Customer Service: 1-800-762-6111 Web Site: WWW PNCINVESTMENTS.COM Portfolio Value Summary Cash & Money Market Funds TOTAL PORTFOLIO VALUE Income Summary TOTAL INCOME February 28,2003 $55,279.63 $55,279.63 February 28, 2003 $0.00 Prior Statement $0.00 $0.00 Year to Date $0.00 Portfolio Distribution The pie chart below illustrates your positive security holdings, excluding outside assets. Cash & Money Market Funds 100% Cash Floxv Summary OPENING BALANCE SecuritiesSold/Deposits CLOSING BALANCE February 28, 2003 S0.00 55,279.63 $55,279.63 L~AN ENJOYABLE RETIREMENT TAKES PLANNING, SAVING AND COMMITMENT. IT IS IMPORTANT TO REVIEW YOUR PORTFOLIO WITH YOU PNC INVESTMENTS FINANCIAL CONSULTANT ON AN ANNUAL BASIS. J.J.B. Hilliard, W.L. Lyons, Inc. Page 1 of 2 February 2003 Member New York, Amencan. Chicago and Boston Stock Exchanges; CBOE; NASD; and SIPC. (xxx)(~'r/ 551199 G 2 004~ Ol 0120420~- (XX~J 02~2. A 600835 Portfolio Value ICASH & MONEY MARKET FUNDS ikYESTMENT:S Inc. mcmi,~'-',,YSE ~nc! SIPC May Lose Value No Bank Guarantee Acct Type Quantity Description 1 CASH BALANCE Sub Total ITOTAL PORTFOLIO VALUE ~00°/o I TOTAL PORTFOLIO VALUE Symbol Unit Price Account Number: Investment Consultant: SARA W FLAGG ADMINISTRATRIX ESTATE OF CHARLES L WAGNER CIO J ROBERT STAUFFER 33586423 CHARLES LITTLE. CFP Market Value $55,279.63 $55,279.63 Total Market Value $55,279.63 Percent of Portfolio Current Yield Estimated Annual Inco~ 100% $0.00 Total Estimated Annual Income $0.00 ActMU' Details IPURCHASES AND SALES Acct Date Type Description Activity Quantity Price 02/27/2003 1 BLACKROCK FDS SALE 4,936.942 11 4000 GOVT INCOME PORT CL B TOTAL Amount $55,279.63 $55,279.63 Cash Flow Analysis ICHRONOLOGICAL TRANSACTION SUMMARY Acct Date Type Activity Description Quantity Amount Balance BEGINNING BALANCE 02/26/2003 1 RECEIVED BLACKROCK FDS 4,936.942 02/27/2003 1 SALE BLACKROCK FDS (4,936.942) GOVT INCOME PORT CL B 55,279.63 $0.00 ENDING BALANCE $55,279.63 $55,279.63 J.J.B. Hilliard, W.L. Lyons, Inc. Member New York, Amencan, Chicago arld Boston Stock Exchanges; CBOE; NASD; and SIPC. Page 2 of 2 February 2003 6DOS3S REV4503 EX + (1 97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER 21: 0}- 01Iii.~ 2 00.3- 0014J1_ .~11 property jointly-owned with right of sun/ivorshlp must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION Account T,To. 7119)~0879 ~.,,tth P]!C Investments, for ]l,9_~(.).9]..1.2 shares of Black]-ook Funds, Government ]~ncome Port CT, B, at ,'?].] .2~ per share. Please l'~o'l;et A, ccou~ ~'To. q3~06]123 is this same ~cco'u¥)~ after 1';he accot:,]~l; ~ras tra.t~sforred l.~i;o 't;he ,:,aza ,.. ]:;'laf~;g,. _ 4dm-i. ni. stratri, x, ~.,state'i' of Charles VALUEAT DATE OF DEATH $ FF, 4o.( o TOTAL (Also enter on line 2, Recapitulation) $ .~ ~, .~)_i.O o 60 (If more space is needed, insed addilional sheets of the same size) PNCBAN( April 9, 2003 Roberl Staug~r Main St. Mechanicsbmg, PA 17055 sep RE: Estate of Charles L Wagner (Deceased) $$N: 826-10-7332 DOD: 01-28-2003 De~' Mr. Stauffer: In response to your request for Date of Death balances tbr the ctmtomer noted above, our records show the following: Certificate of Deposit Account#21 O01011031 E~ablished 09-23-1993 CHARLES L WAGNER DOD balance: $18,000,00 + $5.62 a~rued interest Interest earned 01-01-03 thru 01-28-2003 $34.86 YTD Aecount~31400206228 Established 01-04 -2001 CI-L&RLES [. WAGNER DOD balance: $10,712.24 q- $17.40 accrued interest Interest earned 01.01-03 thru 01-28-2003 $22.47 YTD Aceount#31200205660 Established 01-04-2001 CHARLES L WAGNER DOD balance: $5,000.00 + $8,1:> accrued inter~t Interest earned 01-01.03 thru 01-28-2003 $10A9 YTD Account#31500231973 Established 07-29-2000 CHARLES L WAGNER DOD balance: $25,508.72 + $120.75 accrued interest Interest e~rned 01-01-03 thru 01-28-2003 $0.00 YTD Pag, 1 of 2 ~'~.,--8~-2003 I9:13 PI~:3BANK 412 768 3458 P.82 Account#31300 ! 95061 Established 07-3 i-2000 CHARLES L WAGNER BURIAL RI]SERVE GIBSON-HOLLINGER FUNERAL HOME DOD balance: $5,702.85 + $19.38 accrued interest Interest eamod 01-01-03 thru 01-28-2003 $0.00 YTD Checking Account Account#5070086316 E$tablighed 01-01-1979 CHARLES L WAGNER DOD balma¢o: $3,614.79 + $0.21 acaru~t interest Interest em'nod 01-01-.03 thru 01-28-2003 $1.36 YTD The decedent maintained two investments. # 33586423 and #74940879. Please call thc brokerage department for more information 1-800- 762-6111. Pica,sc tto'tc that this office only provides dato of death balance for deposit accounts (IRAs, CDs, Checking and Savings accounts). Wo do not process any financial transactions or provide statements. If you aood assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sinc~oly, Erica L Schlcgel PNG D~odent Reporting Firataide Cente-r 500 First Ave, 4a Fl CIF Pittsburgh PA 15219-3128 1-800-762-1775 Meml:~r FDIC Page 2 of 2 TOTAL P.02 INIIFRIIAII{:F IAX RF~URi',I RESIUENI UEUEDLI',II SCIIEDULE E CASlt, BANt( DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF SR. FILE NUMBER 21-03_01~.~4 2003-0014JI. Include Ih, proceeds of lilk. lalioa m~d lire dale lire p~oceeds were received by Ih, ,sial,. All pmp..dy Jolully-o~med with Ih. Hght of su~vlvorshl UEM NUMBER e SCRIP 1 IUI I PT.lC Bank, ~T. A., Certtfi..cate of Deposit No. 2].00101- lo31. Interest accrued to 1-2~-03. P~C Bat]If., .U. A., Certificate cC De}~os:tt ~'.~o. ~l~.l. O020- T~i;o¥osb o.<~e~:',~e~l fin :i:nte]t'esb ~ccrued to P~'~C Bamk, ~'~. A., Cer2tfica2e of Deposi'b Uo. 3~5002~- 1973. Interest accr~ed to 1-28-03. PNC Bm~k, N. A., Checki~j Account ~.~o. ~O70086316. Interest accrued to 1-26-O3. Ca~ital B].ue Cross, pre~lium refund. Betha~Village, tell:nd for pro~aid care. TOTAL (Al.~o e.ler o. line §, Recapilulalion) must be disclosed on Schedule F. VALUE AT DATE OF DEATH $ 18,ooo.oo !0,7]-2.2~ ]-7 .)1-0 .5, OO0. O0 8:.12 2~,5o8.72 12o. 75 3,614.79 0.21 197.16 709.1% $ 63,89l. F. 16 REV*IS1 lEX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER 21- 03- OlJlJl. C!IAI~.J',U;;.; l',. !.h'~.G]..~EI~, S]:~. 2003_0014Ji. Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 78. 9. 10. 11. 12. 13. 14.. FUNERAL EXPENSES: ]~ol].:."L~ger Funeral Home, 11:b. llolly Springs, PA, Ito].].inger Funeral Home, Hi;. Holly Springs, PA, Deatll Cert:[r[cates. ADMINISTRATIVE COSTS: Personal Representative's Commissions - ]~ Ol~e Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees ,To l{obe:]?t Gt~uffel"~ I']Sqo, a~.;Ol~'tqe~- fee. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Registe~ of f/ills of Cumberland Century, Penn- · Admznls ti at :i. on. sylvania, Letters of .... Accountant's Fees Tax Return Preparer's Fees Cmnberland Law Journal, Estate :t'lotice. ~egister of Y/ills, Short Certificate. Alert Pharmacy, me<]icatiot'ls, Quantum Imaging & Therapeutic, medical charges. T.ou Critchley, preparing 2002 Tax Returns. The Sentinel, Estate ~'.Totice. ;),uantum Imaging & Therapeu';ic, medical charges. Conner-Rich Associates, medical charges. Register of Wills, filing Account. Register of Wills, filing [(nventory and Pennsylvar~ia Inherltance Tax Return. Public School Employees Retirement System, claim. $ 1,940.68 ].6. oo 0.00 3,000.00 221.00 75. co 3.00 iol .2 Fo.oo 85. oi 8.33 100. O0 llO.O0 25.00 346.5 9 17. TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insed additional sheets of the same size) RE'V- 1513 EX * (1-97) ~ COMMONWE^LTH OF PENNSYLVANIA INHFRIT^NCE TAX RETURN RESIDENT DECEDENI' SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER 21-03-0144_ 200,3- 001~tlI. NUMBER II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) SARA lq. FLAGG )126 Sovth Frederick St. l'~echanicsburg, PA 170~ O Hill Road, Car!isle, PA 717 Gray, btam Road, Gravth. am, CUANLES I.. WAGNER, ~. !2}2 Paoli ?ike i:~ost Chester, PA 19380 LEE AHW CZCA 6100 Bryant St. Pittsburgh, PA 1~206 JILL S. BAER, 2~ Ki.~g Richard Drive ~dc~urr ay, PA 1~317 SCOTT A. WAGN]~ 9 Ho~taque Drive Dill sburg, PA 17019 17o13 ?A 17027 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) I) aught e r Granddaughter AMOUNT OR SHARE OF ESTATE Grands on One-fifth share of estate. One-fifth share of estate. One-fifth share of estate. One-fifth share of estate. One -fifteenth of a share of estate One-fifteenth of a share of estate. One-fifteenth of a share of estate. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART l! - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA '[ COUNTY OF CUMBERLAND j ss: being duly sworn according to law, deposes and says that She iS the Administratrix ........................................ of the Estate of Charles L. ¥/agner, Sr. late of .... Lower Allen Township Cumberland County, Pa., deceased and that the wifhin is an inventory made by. Sara ~. _.F~a.?~ ................. the s~id~dm$ni~tratrix o{ f~e entire estate o~ sa;~ ~ece~enf, cons;sf;n9 o{ al~ f~e personal property an~ real estate, except real estate oufs;~e f~e ~ommonwealf~ o{ Pennsylvania, an~ f~af f~e {~gures opposHe eac~ item o~ f~e Inventory represent it's {air ~alue as o~ f~e ~afe o~ ~ece~enf's ~eaf~. and subscribed before me, I. 00 ~X )~{m~tlnlstrator 4.26 South Frederick St. Mechanicsbur~, PA 170~ Addre,, Date of Death 28th January 200~ Day Month Year INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached es to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. , t o o Inventory of the real and personal estate of CHARLES deceased (1) PNC Bank, N. A., Certificate of Deposit No. 2100!0]_!031. Interest accrued to 1/2~/03. (2) PNC Bank, N. A , Certzf].ca e of Deposit No Interest accrued to 1/28/03. (3) PNC Bank, N. A., Certificate of Deposit No. 3120020~660. Interest accrued to 1/28/03. (l$) P~C Bank, N. A., Certificate of Deposit No. Interest accrued to 1/28/03. (~) P~,~C Bank, N. A., Checking Account ~o. ~070086316. Interest accrued to 1/28/03. (6) Capital Blue Cross, premium refund. (7) Bethany Village, refund for prepaid care. (8) PNC Investments, ~4,936.9~2 shares of Blackrock Funds, Govern- ment Port CL B, at 11.2~ per share. Total ............... $ 6~': L d L- ),~fl, l [0. 1°,7~21 ~4 4o ,o II O0 8 12 ~5,5o8 7a lac 75 3,61~ 79 .21 197 16 7o9 15 ~ ~o 119,.434 76 BUREAU OF /NDZVIDUAL TAXES TNHERTTANCE TAX DIVIS/ON DEPTo 180601 HARR/SBURG, PA 17118-0601 J R STAUFFER MARKET SQ BLDG HECHANICSBURG CONNONNEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE NOTICE OF INHER/TANCE TAX APPRA/SENENT, ALLOHANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF DATE OF DEATH n~ ~ FTdcE NUNDER '03 JUN -6 ~, ,c.~,UUNTy ACN PA 17055 Ct~l~nb~,~ ' ~: 06-05-2005 NAGNER SR 01-28-Z005 21 05-01~4 CUMBERLAND 101 Amount Remitted REV-16~7 EX AFP COl-g3) CHARLES L HAKE CHECK PAYADLE AND REMZT PAYMENT TO= REGISTER OF NILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF ZNHERTTANCE TAX APPRAZSENENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF NAGNER SR CHARLES L FILE NO. 21 03-0144 ACN 101 DATE 06-03-2003 TAX RETURN NAS: (X) ACCEPTED AS F'rLED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) .00 2. Stocks and Bonds (Schedulo B) (2) 55;540.60 $. Closely Held Stock/Partnership Interest (Schedule C) ($) .00 ~. Nortgeges/Notes Receivable (Schedule D) (~) .00 5. Cash/Bank Deposits/Nisc. Personal Property (Schedule E) (5) 63/894.16 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Asse~s (8) APPROVED DEDUCTZONS AND EXENPTZONS: 6,093.04 9. Funeral Expenses/Adm. Costs/Nisc. Expenses (Schedule H) (9) 10. Deb~s/Hortgege Liabilities/Liens (Schedule Z) (10) .00 11. To,al Deductions (11) 12. Net Value of Tax Return (12) 15. (15) lq. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Sub,oct to Tax NOTE If an assessment .as lssued prev/ously, lines 14, 15 and/er 16, 17, re~lect ~igures that lnclude the total o~ ALL returns assessed to date. NOTE: To 1nsure proper credit to your account, submit the upper portion of this form with your tax payment. 119,43~.76 ASSESSNENT OF TAX: 15. Amount of Line 1~ at Spousal rate 16. Amount of Lino 1~ taxable at Lineal/Class A rate 17. Amount of Line 1~ et Sibling rata 18. Amount of Line 1~ taxable at Collateral/Class B rate 19. Princi)al Tax Due TAX CREDZTS PAYH~NT RECEIPT DZSCOUNT DATE NUMBER 1NTEREST/PEN PAID (-) 04-25-2003 CD002492 110.53 05-01-2003 CD001516 .00 113,341.72 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 113,341.7Z 18 and 19 gill (is) .00 x O0 = .00 (lb). 113,341.72 x 045= 5,100.38 (17), .00 x 12 = .00 (18) .00 x 15 : .00 (l~)= 5,100.38 AHOUNT PAID 4,000.00 900.38 TOTAL TAX CREDIT I I DALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 5,110.91 10.53CR .00 10.53CR ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT 1S REgUZRED. IF TOTAL DUE 1S REFLECTED AS A 'CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR /NSTRUCT/ONS.) RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECT[OHS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of tho decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such futura interest. To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with 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, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (RE¥-1313). Applications are available at the Office of the Register of Wills, any of the 25 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-562-2030~ services for taxpayers with special hearing and / or speaking needs: 1-&00-4~7-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z&1021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (SX) discount of the tax paid is allowed. The 152 tax amnesty nan-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (62) percent par annum calculated at a daily rata of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 ara: Interest Daily Intarast Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 207. · 000546 1987 97. · 000247 1999 77. · 00019Z 1985 167. .000458 1988-1991 112 .000301 ZOO0 87. .000219 1984 117. · 000301 1992 92 . 000247 ZOOl 92 · 000247 1985 XSZ .000556 1993-1994 72 .000192 2002 67. .000164 1986 107. .000274 1995-199& 97. .000247 2003 57. · 000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINI~UENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. -IN THE COU?,T OF C0~[,'i0N PLEAS 0F CUMBERLAi~D COUNTY, PENNSYLVANIA. ~0. 200~_-.p_0_~:44_O.~f~'.,'S' COUNT D:~WS~.0~. FIRST AND FINAL ACCOUNT OF SARA W. FLAGG, AD~.[INISTRATRIX OF THE ESTATE OF CHARLES L. WAGNER, SR., LATE OF THE TOWNSHIP OF LOWER ALLEN,. COUN~I~Z OF CUJ'ltSERLAND AND STATE OF PENNSYLVANIA,. DECEASED. Date of Death: January 28, 2003. Dates of advertisement of Letters of Administration. In the Cumberlaud Law Journal: March 7, 14 and 21, 2003. In The Sentinel: February 27 and March 6 and lJ, 2003. PHINCI PAL ACCOUNT Debits Accountant charges herself with the following receipts and assets of decedent's estate, consisting entirely of personalty as follows, to wit: 1/28 1/28 1/28 1/28 1/28 ~/28 3/4 PNC Bank, N. A., Hilliary Lyons, Inc., 4936.942 shares of Blackrock Funds. PNC Bank, N. A., Checking Account No. 50-7008-6316. PNC Bank, N. A., Certificate of Deposit No. 314002- 06228. PNC Bank, N. A., Certificate of Deposit No. 21001- 011031. PNC Bank, N. A., Certificate of Deposit No. 315- 00231973. PNC Bank, N. A., Certificate of Deposit No. 312- 00205660. Hilliard Lyons, Inc., proceeds from sale of 13.~890 shares of Blackrock Funds. 3/14- ~ Prudential Insurance Company of America, proceeds of Life Insurance policy. 3/18 Capital Blue Cross, premium refund. 3/18 Bethany Village, refund of prepaid care. 5/].4 P~.~lic Employees Retirement System, retirement check. 323.57 GROSS PRINCIPAL ASSETS AND RECEIPTS ........ . ............... $ .!21,878..7~ $ S~,~4o.6o 3,614.79 10,712.24 18,000.00 25,508.72 5,000.00 154.49 2,118.07 197.16 709.15 -1- PRi~CI PAL ACCOUI~I~'~ Credits Accountant asks Credit for the following items paid out of Principal in the Settlement and Administra- tion of decedent's estate, as follows, to wit: 20o 2/19 2/24 2/24 2/26 2/26 2/27 3/7 3/18 3/24 3/26 4/1 4121 4/2/..I- 5/i 5/]- 5,/28 Register of Wills, Letters of Administration. C~mberland Law Journal, t!'.state Notice. Register of Wills, Short Certificate. Alert Physiciaos, medical bill.. Quantum Imaging & Therapeutic, X-rays. ttollinger Funeral Itome, Funeral expenses. Lou Critchley, preparing 2002 Income Tax Re turns. Hilliard Lyons, Inc., deferred sales charge. Hollinger Funeral Home, Death Certificates. The Sentinel, Estate Notice. Quantum Imaging & ~erapeutic, X-rays. Connor-Rich Associates, medical bill. Public School Employees Retirement System, repayment of benefit received. Register of Wills, Agent, on account of Pennsylvania Inheritance Tax. Register of Wills, filing Inventory and Pennsylvania Inheritance Tax Ret~n. Register of Wills, Agent, balance due on Pennsylvania Inheritance Tax. Register of Wills, additional Probate fee. J. Robert Stauffer, Attorney fee. Cash, reserved to preparation of final Fidu- ciary Tax Returns a~d contingencies. Register of Wills, filing Account. TOTAL .PRINCIPAI EX PEIH)ITURES ~ 221.00 75.00 3.00 io4.25 8.i8 i,940.68 50.00 1,001.51 16. O0 85.oi 8.33 lOO. oo 346.59 4,000.00 25.00 900.38 35.oo 3,000.00 500.00 110.00 -2- ])ob i b s Accountant Cilarges herself ~-zith 'b!~e roi. lowing items of Income receive~, to wit: 2/4 2/4. 2/4 2/4 2/2~ 2/2[~ 2/24 2~27 3/11 3/19 4/14 6/14 Hil]_iard Lyons, Inc., dividen~ on Accou.nt ??o. 7~1.~9~i.0879. PNC Bank, N. A., interest on Certificate 1,To. 31400206228. PI?C Bank, N. A., interest on Certificate ~o. 3t20020~660. PNC Bank, ~[. A., interest on Certificate Uo. ~0-7008-6316. PNC Bank, N. A., interest on Certificate No. 21001011031. PNC Bank, N. A., ing~rest on Certificate No. 31~1.00206228. PNC Bank, N. A., interest on Certificate No. 31200205660. PNC Bank, N. A., Hilliard Lyons, Inc., gain on sal~ of 4936.942 shares of Blaokrock F~ds. PNC Bank, N. A., Hilliard Lyons, Ino.~ dividend on Blaokrook F~ds. PN0 Bank~ N. A.~ interest on Accost 5o-0 45-aaov. PN0 Bank, N. A., interest on Account 5o-o 45-aao7. PNC Bank~ N. A., interest on Account ~o. 5o-o~45-~g07. PNC Bank, N. A., interest on Aocount No. 50-0~45-2a07. G~oss TNCO~ .......................................... .$ INCOME ACCOUNT Credits Accountant asks Credit for the following items charge against Income, to wit: 22.47 lO. 49 .60 34.86 13.78 6.43 740.00 33.10 35 ~ 05 31.55 None $ 0.00 TOTAL INCO~E DISBURS~IENTS AI~) CHARGES. Q. O0 Principal Account Debits Credits Income Account Debits Credits S U M M A R Y 121,878.79 1,116.35 0.00 BALANCE IN ]IA~Do OF ACC01~W.UANT ].'OR D.[S~UR.[BUTION ..... $ 109,349.86 116.35 -4- SCHHN3ULE OF PROPOSED DISTRIBUTION Suggestion is made, that the balance in hands of Accountant for Distribution, to wit, the sum of $110,~[66.21 be made in Cash the Shepherdstown United MethodistChurch and the following named individuals, in the amounts set opposite their names, to wit: To SttEHII~IDSTOWN UNITED METItODIST CI~RCH, ten (l~f~) per cent. of decedent's distributable estate. To SARA W. FLAGG, one-fifth of residue. To EVA M. t~IR, one-fifth of residue. To RICIIARD E. t~AGNER, one-fifth of residue. To CHARLES L. WAGNer, JR., one-fifth of residue. To LEE A~ CICA, one-fifteenth of residue. To JILL S. BAER, one-fifteenth of residue. To SCOTT A. WAGNer, one-fifteenth of residue. 11,046.62 19,883.92 19,883,92 19,883.92 19,883.92 6,627.97 6,627.97 .... 6,627-9~ -5- Personally appeared before me, the undersigned officer, a ?~otary Public, in and for said Corm~.~onwea!th and County, SAR.& W. FLAGG, Administratrix of the Estate of CHARLES L. WAGNER, LATE of the Township of Lo~¢er Allen, County of Cumberland and State of Pennsylvania, deceased, who being duly sworn according to law, deposes and states, that she is the Accountant in the annexed Account and that said Accoont is true and correct to the best of her knowledge, information amd belief, and that there are no unpaid creditors to be notified of this Account and the day of proposed, decree of confirmation has been given to all parties who have an interest in the estate as beneficiaries and deponent further avers that the foregoing Schedule of Proposed Distribution of the net assets of the estate of CHARLES L. WAGMER, deceased, is true and correct, and is ~nade in accordance with the provisions of the laws of the Co~.maonwealth of Pennsylvania, ali.plicable thereto. Sara W. F~gg Sworn and subscribe ~.d~efore me tb. day , 2003. NOTARIAL SEAL MAURA A. JENKINS, Notary Public Mechanicsburg Bore, Cumberland County My Commission Expires November 10, 2003 -6- IN T~_[E COURT OF UOim~lu~ r~,ma~ OF CUFIBE~RLAND COUNTY, PENNA. ORPHANS' COURT DIVISION. IN RE: THE FIRST AkrD FINAL ACCOUNT OF SARA W. FLAGG, ADIdiNISTRATRIX OF THE ESTATE OF CItARLES L. WAGNER, SR., LATE OF THE TOWNSI~IP OF LOWER ALLE~, COUNTY OF CUMBERLAED AND STATE OF PENNSYLVANIA, DECEASED. FIRST A~.~D FINAL ACCOUNT AND SCHEDULE OF PROPOSED DISTRIBUTION. hereby certify that written notige of fire filing of ~ Account, and of the date, time and place when the same will be pmea-~e~ to the Court M.~t~K~T S~2UA~ BUILDI~O MECHANICSBURG, PA. 17055 '03 ,JbL -.3 absolutely and distribution decreed in accordance with propoeed $ched- STATUS REPORT UNDER RULE 6.12 Name of Decedent: CHARLES L. WAG~R, SR. Date of Death: Will No. January 28, 2003 Admin. No. 2003-001tI;I 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: State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes x No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may b~attached to this report. Date: Nov. 17, 2003 ~// / /ignature J. Robert Stauf Name (Please type or print) Market Square Bldg. Mechanicsburg, PA 17055 Address (717) 766-9673 Tel. No. Capacity: __Personal Representative x __Counsel for personal representative (MAH:rmf/AM3)