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Home My WebLink About04-0716Estate of also known as PETITION FOR GRANT OF LETTERS JOSEPH MICHAEL SMITH No. ~ [ -. 01'~ "'~ sram , Deceased Social Security No. YAN NING SMrI'H, Petitioner, who is i 8 years of age or older, applies for: 549-06-8123 (COMPLETE "A" OR "B" BELOW: ) [] A. Probate and Grant of Letters Testamentary and aver that Petitioner is the executrix named in the last Will of the Decedent, dated state relevant circumstances, e.g. renunciation, death of executor, etc. Except as fol/ows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution of the documents offered for probate; was not he victim of a kd/ling and was ne;zer adjudicated incompetent: NO exceptions [] B. Grant of Letters of Admlnistration (d.b.n.c.t.a.; pendente lite; durante absentia) Petitioner(s) after a proper search has/have asceitained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relatiomh/~ Residence YanNing Smith Spouse 5218 Cobblestone Drive, Mechauicsburg, Martin Smlt'[i~ co ; . ? <r PA 17055 -- Oq :' Son (m/nor) 5218 Cobblestone Drive, Mechan/csburg, PA 17055 David A..qn~h~' . :~ C~ Son · ~- r-- 19408 Richmond Beach Drive, NW, ~' o ~ ~ Apa~h,,~,,t- Upper, Shoreline, WA 98177 Natalie ~qmit~;~ ~; ~ o ,::~ ~ - 29 Lighthouse Hill Road, Windsor, CT (COMPLET~¢~LL C&SES: '~ 06095 ~ ,~ ,~ ..~ ..~ essary Decedent was domiciled at death(l~C)Cumberland County, Pennsylvama, with his last pr/nc/pal residence at 5218 Cobblestone Drive, Mechanicsburg, East Pennsboro Township, Cumberland Count,/, PA 17055 , Decedent, then 65_5years of age, died.. May 13, 2004, at Holy Spirit Hospital, Mechanicsbur~, PA Decedent at death owned property with estimated values as follows: (if domiciled in PA) All personal property $ 160,000.00 (if not domiciled m PA) Personal property in Pennsylvania $ (if not domiciled in PA) Personal property in County Value of real estate in Pmmsylvan/a situated as follows: Wherefore, Pet/tioners respectfully requests the probate of the last Will and Codicil(s) presented with this Petition and the grant of ate form to the undersi_i_~ned: Form#RW-I Page 1 of 2 T edited, name and residence Yan Ning Smith, 5218 Cobblestone Drive, Mechanicsburg, PA 17055 Prepared by the Pennsylvania Bar Association 1991 Commonwealth of P~nnsylvania County of ~,d : The Petitioner above-named swears or affirms that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the Decedent, Petitioner will well and truly administer the estate acc~ording todlav~ /~ " s ' ( v. before ~ae this c~'-~ day yS~gSmith ~ ~-1~ No. _,.,~11 - Estate of JOSEPH MICHAEL SMITH a/Ida JOSEPH M. SMITH Deceased Social SecurityNo.: 549-06-8123 Date of Death: May 13, 2004 AND Now,C~_IO, xCx~xS-,~ °9')'- t .. ~ 2004, in consideration of the Petition on the reverse side hereon, s~'sfactory proof having been presented before me, IT IS DECREED that Letters [] Testamentary if Of Administration (d.b.n.c.t.a.; pendente lite; durante absenfia) are hereby granted to Yan Ning Smith in the above estate and that the instruments dated __ described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters $~,3~ - cm Short Certificate(s) 6 $ Renunciation $ Affidavits ( ) $ Attorney: Extra Pages ( ) $ I.D. No.: Codicil $ Address: JCP Fee $ Inventory $ Other $ Telephone: Total Register of Wills Nina B. Stryker, Esquire 36531 Obermayer Rebmann Maxwell & Hippel LLP 1617 John F. Kennedy Boulevard - 19m Floor Philadelphia, PA 19103-1895 (215) 665-3057 Form#KW-1 Page 2 of 2 Prepared by the Pennsylvania Bar Assoc/ation 1991 550126 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 fbrwarded to the State Vital Records Office for permanent filing. WARNING; It is illegal to duplicate this copy by photostat or photograp ~u~.t., ~29-259 Joseph H ichael Smith 65 ?eh 16,1939 " Cumberland East Pennsboro construction 5218 Cobblestone Drive PA 17055 Michael Smith , Smith OMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECOR~ : CERTIFICATE OF DEATH (Coroner) ::: ' Male Holy Spirit Hospital 2004 white married an Ning Jiang 5218 _tn ~tay 14, 2004 ,FH Crematory Beck 17055 Grantville, PA 17028 6:47 A May 13, ~004 · Oc~c_l_u[~ve Coronary A~er¥ D~sease eh re Road, Suite Mechanicsburg, Pa. 170S0 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of decedent: JOSEPH MICHAEL SMITH, a/k/a MOSEPH M. SMITH Date of death: MAY 13, 2004 File number: 21-04-0716 To the Register of Cumberland County: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on August .5~ , 2004: Name Address Yan Ning Smith 5218 Cobblestone Drive Mechanicsburg, PA 17055 Martin Smith c/o 5218 Cobblestone Drive Mechanicsburg, PA 17055 David A. Smith Natalie Smith 19408 Richmond Beach Drive NW Notice has been given to ail persons entitled theret/under Rule 5.6. No e~tion~ Date: August 3~ ,2004 ~ ~..~ NINA BOOZ STRYI~R, ESQUIRE X Address: Apt. - Upper Shoreline, WA 981~7~ 29 Lighthouse Hill l~oad Windsor, CT 06095 Capacity: Counsel for Personal Representative Name: Nina Booz Stryker, Esquire Attorney ID No. 36531 Obermayer Rebmarm Maxwell & Hippel LLP One Penn Center, 19th Floor 1617 John F. Kennedy Boulevard Philadelphia, PA 19103-1895 (215) 665-3057 Personal Representative Counsel for Personal Representative 555026 Attorneys At Law Annmarie Robertson Eberling, Paralegal Direct Dial 215-665-3241 E-mail: annmarie.ebcrling@obermayer.c°m One Penn Center- 19th Floor 1617 John F. Kennedy Boulevard Philadelphia, PA 19103-1895 p 215-665-3000 F 215-665-3165 www.obermayer.com December 29, 2004 CERTIFIED MAIL - RETURN RECEIPT REQUESTED PARCEL NUMBER 7003 3110 0004 0164 7388 Register of Wills of Cumberland County Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 Re~ Estate of Joseph Michael Smith, Deceased File No. 2004-00716 Dear Sir or Madam: Enclosed for filing, in duplicate, is the Pennsylvania Inheritance Tax for the above matter, together with a check payable to Register of Wills, Agent in the amount of $3,234.90, in payment of the tax due. Also enclosed for filing, in duplicate, is the Inventory. Very truly yours, Paralegal Enclosures Over a Century of Solutions Philadelphia Harrisburg Pittsburgh Cherry Hill Vineland Wilmington Pennsylvania Pennsylvania Pennsylvania New Jersey New Jersey Delaware 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 004801 SMITH YAN NING 5218 COBBLESTONE DRIVE MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 549-06-8123 FILE NUMBER: 2104-071 6 DECEDENT NAME: SMITH JOSEPH MICHAEL DATE OF PAYMENT: 01/06/2005 POSTMARK DATE: 1 2/29/2004 COUNTY: CUMBERLAND DATE OF DEATH: 05/13/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3,234.90 TOTAL AMOUNT PAID: $3,234.90 REMARKS: ESTATE CHECK SEAL CHECK# 106 INITIALS: RSK RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECE- DENT CHECK APPRO- PRIATE BLOCKS CDR- RE- SPON DENT RECA- PITULA- TION REV-1500 INHERITANCE TAX RETURN F~LENUMBER 21 RESIDENT DECEDENT ~ 2004 YEAR DECEDENT'S NAME LA~, FIRST, AND MIDDLE INITIAl' SOCIAL SECURITY NUMBER Smith, Joseph Michael 549-06-8123 DATE OF DEATH (MM-OD-YEAR) I DATE OF BIRTH (MM-OD-YEAR) 05/13/2004 02/.16/1939 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Yan Ming Smith 0716 NUMBER OFFICIAL USE ONLY THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISYER OF WILLS NAME ~ina B. Stryker, Esquire FIRM NAME (If Applicable) .Obe rmaye rRebmannMaxwe 11 &Hippe 1 LLP TELEPHONE NUMBER (215) 665-3057 ~ 3. Remainder Return 1. Original Return 2. Supplemental Return (date of death prior to 12-13-82) 4. Limited Estate 4a. Futurelnterest Compromise (date of death after 1Z-1Z-BZ) 5. Federal Estate Tax Return Required 6. Decedent Died Testate 7. Decedent Maintained a Living Trust (Attach copy of Will) (Attach acopyof Trust) 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received 10.Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D 11. Election to tax under Sec. g 113(A) (Attach ScL O) COMPLETE MAILING ADDRESS 1617 JFK Blvd., 19th Floor Philadelphia, PA 19103 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) [-~ Separate Billing Requested (6) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properb/(Schedule G or L) (7) 160,499.81 100.00 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H)(9) 10. 11. 12. 13. 737,003.69 14. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) (8) 16,222.11 604.47 Total Deductions (total Lines 9 & 10) Net Value of Estate (Line 8 minus Line 11 ) Charitable and Governmental Bequests/Sec 9113 Trusts for which an electi6n to tax has not been made (Schedule J) ' Net Value Subject to Tax (Line 12 minus Line 13) (11) (12) (13) (14) OFFICIAL USE ONLY 897,603.50 16,826.5R 880,776.92 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 808, 890. 30X .0 . 00 (15) TAX 16. Amount of Line14 taxable at lineal rate 71, 886. 62X .0 ~ (16) ..... n,~ TATION 18. Amount of Line14 t~able at collateral rate O. 00x.15~U~ 0 PA15001 NTF 29755 Copyright 2000 Greatland/Nelco LP - Forms Software Only 880,776.92 0.00 3,234.90 0.00 0.00 3,234.90 PA REV-1500 EX (6-00) Decedent's Complete Address: ISTREET ADDRESS I5218 Cobblestone Drive · ~CITY / Mechanicsburg Page 2 Tax Payments and Credits: STATE I ZIP PA 17055 1. Tax Due (Page 1 Line 19) 2. Credits/Payments ( 1 ) 3,2 3 4.9 0 A. Spousal Poverty Credit 0. O0 B. Prior Payments 0. O0 C. Discount 0.00 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable 0.0 0 D. Interest 0.00 E. Penalty 0.00 Total Interest/Penalty (D + E) (3) 0.0 0 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 (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 3,2 3 4.9 0 A. Enter the interest on the tax due. (SA) 0.0 0 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) 3,234.90 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING GUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ................................... ~ ~ b. retain the right to designate who shall use the property transferred or its ncome; ................ 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 receivina adeauate cons derat o ~ 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 ~1~ OF* T'HE' ~,B~3VE~ 'QL~ESTi0NS* iS' Y'ESi'" [~ ~ YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I dec are that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and behef, it ~s true, correct and complete. Declaration of preparer other than the personal representative is based on information of which preparer has any knowledge. SIGNATURE OF-,P~SON RE~SP(~INSIB~.E-F(~9'I~'ING RETURN c/o 161,~ JFK Blvd., 19th Floor Philadelphia, SIGNATURE ~F PREP,~EF~OTHER THAN REPRESENTATIVE DATE PA 19103 DATE ADDRESS J 4 1617 JFK Blvd, 19th Floor Philadelphia, PA 19103 ~:~;~ ~:~ ~: ~i~: ~'~'~'~: ~¥~ ~i~ i~ ~;~ ;~'~;a ~:&'~'3';~'~'~ '~'; ~'~'~'~ ~ ~;,-~ i~i~'&'~i ~'~' ~/i~i~6~.~;~~F~i~&~:~i~i~:i~:~ ........................................... [72 P.S. § 9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [7~ P.S. § 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, ?000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [7;> P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 7Z.P.S. § 9116(1.2) [72 P S §9116(a)(1) The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [7:> P.S. §9116(a)(1.3)]. A sibling is defined, under Secti~)r; 9102, as an]'ndividual who has at least one parent in common with the decedent, whether by blood or adoption. 0 PA15002 NTF 29756 Copyright 2000 Greatland/Nelco LP - Forms Software Only ~EV-150'~ EX+ ('~-9~) J I J SCHEDULE B J COMMONWEALTH OF PENNSYLVANIA / STOCKS & BONDS INHERITANCE TAX RETURN j ESTATE OF Joseph Michael Smith FILE NUMBER 21- 04- 0716 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 4 2,284.3740 Shares DESCRIPTION Davis New York Venture Fund C1 10.7900 Shares PBGH Growth Fund 8.8650 Shares PBGH Technology and Communication Fund 2,552.6410 Shares Strong Enterprise Fund 962.6600 Shares T. Rowe Price Emerging Europe and Mediterranean Fund (See attached letter) 2,686.1460 Shares T. Rowe Price International Stock Fund (See attached letter) 28.0200 17.3197 10.2301 21.3800 12.5600 11 TOTAL (Also enter on line 2, Recapitulation) (If more space is needed, insert additional sheets of the same size) Copyriq ht (c) 1997 form software only CPSystems, Inc. VALUE AT DATE OF DEATH 64,008.16 186.88 90.69 54,575.46 12,091.01 29,547.61 $ 160,499.81 Form REV-1503 EX {Rev. 1-97) 'REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Joseph Michael SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Smith FILE NUMBER 21-04-0716 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with ri~]ht of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION Miscellaneous personal effects TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 100.00 $ 100.00 Copyrig ht (c} 1997 form software only CPSystems, I nc. Form REV- 1508 EX (Rev. 1 - 97) REV-lSl0 EX +(1-g7) I SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC, NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF Joseph Michael Smith FILE NUMBER 21-04-0716 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDETHE NAME OFTHETRANSFERE~THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER, NUMBER ATTACH A COPYOF THE DEED FOR REAL ESTATE, VALUE OF ASSET INTEREST (IF APPLICABLE) 1 MetLife/Occidental Petroleum Co. - Decedent was owner of a retirement plan featuring a Joint & Survivor Benefit. His spouse will receive monthly payments of $280.55 for life. No benefits were paid to decedent during his lifetime. 1.00 100 0.00 1.0( Alstom Retirement Plan Accoun No. MG74343B (Proceeds payabl. to Yah Ning Smith, spouse): 2 15,179.988 shs. Morgan Stanley Inst Emerging Markets A @ 14.60 221,627.82 100 0.00 221,627.82 3 21,824.190 shs. Fidelity Freedom 2010 Fund @ 12.75 278,258.42 100 0.00 278,258.42 4 259.729 shs. PIMCO Total Return Adm Fund @ 10.52 2,732.35 100 0.00 2,732.35 5 3,042.948 shs. American Funds Cap World Growth & Income Fund A @ 30.07 91,501.44 100 0.00 91,501.44 6 586.580 shs. Fidelity Magellan Fund @ 96.46 56,581.51 100 0.00 56,581.51 7 7,845.559 shs. T. Rowe Price Intl Stock Fund @ 11.00 86,301.15 100 0.00 86,301.15 TOTAL(Alsoenteronline7, Recapitulation) $ 737,003.69 (If more space is needed, insert additional sheets of the same s~ze) Copyright (c) 1997 form software only CPSystems, Inc. Form REV-l,510 EX (Rev. 1-97) I REV~ 1511 EX * (1-97) I I COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Joseph Michael Smith SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS I FILE NUMBER 21-04-0716 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 5. 6. 7. FUNERAL EXPENSES: Yan Ning Smith Reimbursement for payment of funeral bill to Hetrick Funeral Home ($1,340.), floral bill to Stevenson's Flowers ($222.60) and funeral luncheon ($500.) ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Yah N'iD.c~ Sm'{th Social Security Number(s) / EIN Number of Personal Representative(s StreetAddress 6809 Clubhouse Drive, Apt. F3 City Harrisburc~ State PA Zip 17111 Year(s) Commission Paid: 2005 Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Yan Ninc~ Smith Street Address 5218 Cobblestone Drive City Mechanicsburg State PA Zip 17055 Relationship of Claimant to Decedent Spouse Probate Fees Accountant's Fees Tax Return Preparer's Fees Obermayer Rebmann Maxwell & Hippel LLP Reimbursement for administrative costs advanced William J. Mansfield, Inc. Legal advertising of grant of letters testamentary 2 062.60 6 000.00 4 000.00 3,500.00 278.00 0.00 0.00 21.51 360.00 TOTAL (Also enter on line 9, Recapitulation) $ 16,2 2 2.1 1 (If more space is needed, insert additional sheets of the same size) Copyriqht (c') 1997 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97~ REV-1512 EX + (1-97) SCHEDULE I COMMONWEA,TH OF.ENNS¥,VA.~^ DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES, AND LIENS ESTATE OF Joseph Michael Smith FILE NUMBER 21-04-0716 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION Holy Spirit Hospital Medical services rendered to decedent West Shore Emergency Medical Services Debt for medical services rendered to decedent Yan Ning Smith Reimbursement for payments made to West Shore Emergency Medical Services for services rendered to decedent TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 89.90 414 . 57 100.00 $ 604 .47 REV- 1513 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Joseph Michael SCHEDULE J BENEFICIAR lES Smith FILE NUMBER 21- 04 - 0716 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS (include outright spousal distributions) 4 II. Yan Ning Smith 6809 Clubhouse Drive, Harrisburg, PA 17111 Apt. F3 David A. Smith 19408 Richmond Beach Drive NW Apt. Upper Shorline, WA 98177 Natalie Smith 29 Lighthouse Hill Road Windsor, CT 06095 Martin Smith c/o Yan Ning Smith 6809 Clubhouse Drive, Apt. Harrisburg, PA 17111 F3 ;urviving Spouse ~on )aughter Son 808,890.30 23,962.21 23,962.21 23,962.20 ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 17, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1997 form software only CPSystems, Inc. Form REV-1513 EX/Rev. 1-97) T. ROWE PRICE SERVICES, INC. WWW.TROWEPRICE.COM September 7, 2004 Yan Ning Smith Estate of Joseph M Smith C/o Nina B Stryker Esq 1617 John F Kennedy Blvd FL 19 Philadelphia PA 19103-1833 RO. Box 17302 Baltimore, Maryland 21297~1302 4515 Painters Mill Road Owings Mills, Maryland 21117-4903 Subject: Account Information International Stock Fund Account 3700001805-2 Emerging Europe & Mediterranean Fund Account 10184944674 Dear Yan Ning Smith: Thank you for your recent request to transfer the T. Rowe Price fund accounts shown above, which are registered to the late John M. Smith, to an estate registration. We have completed the transfer request and redeemed the assets as instructed in your correspondence. As of Mr. Smith's date of death, May 13, 2004, our records show the following for the accounts' International Stock Fund account 3700001805-2 Number of Shares: 2,686.146 Price per Share: $11.00 Total Value: $29,547.61 Emerging Europe & Mediterranean Fund account 1018494467-4 Number of Shares: 962.660 Price per Share: $12:56 Total Value: $12,091.01 T04-001 TRowePrice a INVEST WITH CONFIDENCE We hope this information is helpful. If you have any questions regarding this correspondence or any of our services, please call us at 1-800-225-5132. Representatives are available Monday through Friday from 7 a.m. to 12 a.m. and Saturday and Sunday from 8:30 a.m. to 5 p.m. eastern time. We appreciate the opportunity to help you with this matter. Sincerely, Patrick Little Senior Account Services Representative Correspondence Number: 00771050 Register of Wills of Cumberland County, Pennsylvania Estate of also known as JOSEPH MICHAEL SMITH INVENTORY No. 2004-00716 JOSEPH M. SMITH Date of Death MAY 13, 2004 , Deceased Social Security No. 549-06-8123 YAN NING SMITH Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are tree and correct. I/We understand that false statement herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to authorities. Attorney: Nina B. Stryker, Esquire I.D. No.: 36531 Address: OBERMAYER REBMANN MAXWELL & HIPPEL LLP ONE PENN CENTER 16t7 J.F.K. BLVD., PHILA., PA 19103-1895 YAN NINI3' SMITH, Administratrix Dated t0Q ~ o)-~0 [ O~[''/ Telephone: (215) 665- 3057 Description 2,284.374 shs. Davis New York Venture Fund ~ 28.02 10.790 shs. PBGH Growth Fund ~ 17.3197 8.865 shs. PBGH Technology and Communication Fund ~ 10.2301 2,552.641 shs. Strong Enterprise Fund ~ 21.38 962.660 shs. T. Rowe Price Emerging Europe and Mediterranean Fund ~ 12.56 2,686.146 shs. T. Rowe Price International Stock Fund $11.00 Miscellaneous personal effects $64,008.16 186.88 90.69 54,575.46 12,091.01 29,547.61 100.00 ±shoo $,NYHdL.qO (attach additional sheets if necessary) ~l~e e~L'Ii~f t~l~rsonal representative, include the Note: The Memorandum of real estate outside the Commonwealth of Pennsylva~jr~, -' ' :'"~ value of each item, but such figures should not be extended into the total of the Inventory. Form RW-7 '~..~ Prepared by the Pennsylvania Bar Association 1991 584415 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '*' BUREAU OF INDIVlDUl1l.;:JlXES~,,! INHERITANCE TAX DIVISION rc( PO BOX Z80601" HARRISBURG PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP 112-04) 1 ~.. A' ""t H' '1,1 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-14-2005 SMITH 05-13-2004 21 04-0716 CUMBERLAND 101 JOSEPH M ^.,t. ":".'..C" c..... ,," NINA B SUiKE~ESQ OBERMAYER ETAL 1617 JFK BLVD 19TH FL PHILA PA 19103 Allount Rellitted 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 ~ RiV :rJ\"f.EX..A~p.rI)T:6!'r.N6T.i'CE.OF.iNHEiti'fANCE.YAX.APPRAiSEM€N'~.ALUrQAN'CE.b1r......_.........- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SMITH JOSEPH M FILE NO. 21 04-0716 ACN 101 DATE 03-14-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets Cl) (2) (3) (4) (5) (6) (7) .00 160.499.81 .00 .00 100.00 .00 737.003.69 (8) NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax pay..ent. 897.603.50 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad... Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) ClO) 16.222.11 604.47 (11) Cl2) Cl3) Cl4) 16.826 58 880.776.92 .00 880.776.92 NOTE: I~ an assessment was issued previously, lines 14, lS and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate 16. Allount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Allount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due Cl5) 808.890.30 X 00 = .00 Cl6) 71.886.62 X 045 = 3.234.90 Cl7) .00 X 12 = .00 Cl8) .00 X 15 = .00 Cl9)= 3.234.90 ~ TAX CREDITS: ..~v~_, , I+J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 12-29-2004 CD004801 .00 3.234.90 TOTAL TAX CREDIT 3.234.90 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS,) IN RE: ESTATE OF JOSEPH MICHAEL SMITH, DECEASED : BEFORE THE REGISTER OF WILLS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 2004-716 NOTICE OF CLAIM TO THE REGISTER OF WILLS: Please enter the following claim of Sylvia Smith against the above-captioned estate. Sylvia Smith was previously married to the decedent, Joseph Michael Smith. Their marriage was dissolved by Judgment entered on July 8, 1996, by the Superior Court of Connecticut, J.D. ofHartford/New Britain, No. FA 94-0537413. Said Judgment incorporated by reference an Agreement of the same date and docket number between Joseph Michael Smith and Sylvia Smith. Paragraph 4.9 of said Agreement provides: "The Husband [Joseph Michael Smith] will transfer 50% of any interest he may have in an Occidental Company Defined Benefit Plan to the Wife [Sylvia Smith] via a Qualified Domestic Relations Order." Neither Joseph Michael Smith nor the personal representative of his estate has fulfilled his obligations under Paragraph 4.9 of said Agreement. Sylvia Smith hereby claims her right to enforce Paragraph 4.9 of said Agreement. GATES, HALBRUNER & HATCH, P.C. ,--, u; ~" ,~ By:~!:7~ Mark E. Halbruner, Esquire Supreme Court I.D. No. 66737 1013 Mumma Road, Suite 100 Lemoyne, P A 17043 (717) 731-9600 (Attorneys for Sylvia Smith) Date: ~-~o-C><) -' 1. '".i \(1 CERTIFICATE OF SERVICE I, Mark E. Halbruner, Esquire, of the Law Firm of Gates, Halbruner & Hatch, P.C., hereby certify that I served a true and correct copy of the foregoing document by certified mail to the following person on the date set forth below: Nina Booz Stryker, Esquire OBERMA YER REBMANN MAXWELL & HIPPEL LLP One Penn Center - 19th Floor 1617 John F. Kennedy Boulevard Philadelphia, PA 19103-1895 (Attorneys for Yan Ning Smith, Personal Representative of the Estate of Joseph Michael Smith, deceased) GATES, HALBRUNER & HATCH, P .C. BY: (~AAf:~(~ Mark E. Halbruner, Esquire Supreme Court J.D. No. 66737 1013 Mumma Road, Suite 100 Lemoyne, P A 17043 (717) 731-9600 Date: 4-Ac0-0~ . I fI1 Q~N~2!11]! Attorneys At Law Nina B. Stryker (215) 665-3057 nina.stryker@obermayer.com One Penn Center - 19th Floor 1617 John F. Kennedy Boulevard Philadelphia, PA 19103-1895 P 215-665-3000 F 215-665-3165 www.obermayer.com October 10,2005 Register of Wills/Clerk of the Orphans' Court of Cumberland County Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 17013 Re: Orphan's Court filing - Administrator's Account i\.~) ~.~-,-~ Dear Sirs: c::) We represent Yan Ning Smith, the administratrix of the Estate of Joseph Michael Srfiith, Deceased. Enclosed for filing are the Administratrix's First and Final Account, in duplicate, and the Petition for Adjudication, also in duplicate. Also enclosed are the original Certificate of Grant of Letters, proofs of publication, a copy of the Inventory and the Inheritance Tax receipts, as well as a Statement of Proposed Distribution and a copy of the Audit Notice mailed October 11,2005. A check in the amount of$195.00 for the filing fee is also enclosed. Kindly timestamp and return the enclosed copy of this cover letter as evidence of your receipt of this filing. It is my understanding that this matter will appear on the Court's audit list for November 22,2005. Please call the undersigned if you have any questions, or require any additional documentation. Thank you very much for your anticipated cooperation. Very truly yours, ~~ Nina Booz Stryker NBS Enclosures cc. Van Ning Smith Mark Halbruner, Esquire Over a Century of Solutions 9A pRnZad;hia Pennsylvania Harrisburg Pennsylvania Pittsburgh Pennsylvania Cherry Hill New Jersey Vineland New Jersey Wilmington Delaware DECEDENT'S ESTATE COURT OF COMMON PLEAS OF CUMBERLAND, PENNSYL VANIA ORPHANS' COURT DIVISION ESTATE OF JOSEPH MICHAEL SMITH, DECEASED NO. OF 2005 d. 1- 0 i-i - Olllp PETITION FOR ADJUDICATION AND STATEMENT OF PROPOSED DISTRIBUTION IN CONFORMITY WITH CUMBERLAND COUNTY ORPHANS' COURT DIVISION RULES Name of Counsel: Attorney I.D. No.: Name of Law Firm: Address: Tel. No.: Fax No.: M 651482 Nina B. Stryker, Esquire # 36531 Obermayer Rebmann Maxwell & Hippel LLP One Penn Center, 19th Floor, 1617 John F Kennedy Boulevard, Philadelphia, PA 19103 (215) 665-3057 (215) 665-3165 i i) --~.: ) r'..,;> (' ; ") ") PETITION FOR ADJUDICATION-INTESTATE ESTATE The petition of the undersigned Administratrix of the Estate of Joseph Michael Smith, Deceased respectfully represents: That the First and Final Account was filed in the office of the Clerk of the Orphans' Court Division on and advertised for audit on 1. N ame( s), address( es), and capacity(ies) of petitioner( s): Yan Ning Smith, Administratrix 4280 Avian Avenue Fort Myers, FL 33916 who avers: 2. Decedent died intestate on May 13, 2004. Letters of Administration were granted to ihis surviving spouse, Yan Ning Smith, on August 2, 2004 and the case was docketed by the Register of Wills of Cumberland County as File No. 2004-00716. 3. Was decedent survived by a spouse? YES (yes/no) If yes, name of the surviving spouse. Yan Ning Smith 4. Has the surviving spouse filed to take an elective share? NO (yes/no) (See Section 2201 et seq. of the Probate, Estates and Fiduciaries Code) If yes, date of election: 5. The decedent's surviving children or surviving issue of deceased children are (if none:, so state): David A. Smith Natalie Smith Martin Smith (Minor) 6. The decedent neither married nor had any children following the execution of a Will. 651482 7. Written notice of the audit as required by Pennsylvania Supreme Court Orphans' Court Rule 6.3 and Local Rule 6.3.A. has been or will be given to all parties in interest listed in item 8 below, all unpaid creditors and all claimants listed in item 10 below. In addition, notice of any questions requiring adjudication as discussed in item 15 below has been or will be given to all persons affected thereby. A. If notice has been given, attach a copy of the notice as well as a list oif the names and addresses of the parties receiving such notice. See attached. B. If notice is yet to be given, a copy ofthe notice as well as a list of the] names and addresses of the parties receiving such notice shall be submitted at the aupit together with a statement executed by petitioner or petitioner's counsel certifying thalt such notice has been given. C. If any person entitled to notice is not sui juris (e.g., minors or incapacitated persons), notice of the audit has been or will be given to the appropriat~ representative on such party's behalf as required by Rule 5.2 and Local Rule 5.2.A. ! Notice was given to Yan Ning Smith, Parent and Natural Guardian of Martin Smith, Minor and Son of the Decedent. D. If any charitable interest is involved, notice ofthe audit has been or wUI also be given to the Attorney General as required under Rule 5.5 (see form notice of i charitable gift authorized by the Court of Common Pleas of Philadelphia County, Orphans' Court Division). In addition, the Attorney General's clearance certificate (or proof of service of notice and a copy of such notice) must be submitted herewith or a~ the audit. N/A 8. List all parties (charitable and non-charitable) of whom petitioner has notice or knowledge, having or claiming any interest in the estate. This list shall: A. State each party's relationship to the decedent and the nature of each party's interest(s); B. Identify each party who is not sui juris (e.g., minors or incapacitated persons). For each such party, give date of birth, the name of each guardian and how each guardian was appointed. If no guardian has been appointed, identify the next of kin of such party, giving the name, address and relationship of each; and C. If distribution is to be made to the personal representative of a deceased party, state date of death, date and place of grant of Letters and type of Letters granted. 651482 Name and Address of Each Party in Interest Relationship and Comments, if any Interest Yan Ning Smith 4280 Avian Avenue Fort Myers, FL 33916 Spouse Administratrtrix and 1/2 Interest in Residue David A. Smith Son 19408 Richmond Beach Drive NW Apt. - Upper Shoreline, W A 98177 1/6 Residue Natalie Smith Daughter 29 Lighthouse Hill Road Windsor, CT 06095 1/6 Residue Martin Smith, a minor Son c/o Yan Ning Smith 4280 Avian Avenue Fort Myers, FL 33916 1/6 Residue 9. If any party entitled to distribution is a non-resident, foreign or unknown distributee ! subject to the provisions of Local Rules 6.9.D., and 13.3.A., explain and attach or subPIit at audit the additional documentation required under the applicable Local Rules. N/A. 10. The names and addresses ofthe claimants (other than any family exemption claimant' under item 12 below), and the amounts of their claims, in the order of preference und~r Section 3392 of the Probate, Estates and Fiduciaries Code (with a notation whether orinot preference is claimed and whether or not the claim and preference are admitted), are a$ follows (ifnone, so state): The claimants known to Petitioner are as follows: a. Sylvia Smith c/o Mark E. Halbruner, Esquire 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 Notice to the claimant was presented to her counsel, Mark E. Halbruner, Esquire, 1013 Mumma Road, Suite 100, Lemoyne, PA 17043. The amount of the claim is unknown and the order or preference of their alleged claims under Section 3392 fall within item (6), all other claims. The claim is denied. 651482 11. The Petitioner requests the waiver of a guardian/trustee ad litem to represent the int~rests of Martin Smith since his 1/6 share in the estate will be less than $25,000, and the funds can be held by your Petitioner as Martin's parent and natural guardian in accordance with 20 Pa. Con. Stat. ~ 5101 (a) and 5102. If so required by the Court, Petitioner will place the share otherwise distributable to Martin in a sequestered account pursuant to 20 Pa. Con. Stat. ~ 5103, with a designation that no funds may be withdrawn until the minor obtains majority unless otherwise ordered by this Court. 12. Was family exemption claimed? YES (yes/no). Allowed? YES (yes/no). Family exemption claimant's name and relationship: Yan Ning Smith, spouse~ 13. The amount of Pennsylvania Transfer Inheritance Tax and additional Pennsylvania ~state Tax paid, the date(s) ofpayment(s), and the interest(s) upon which paid, are as folloWs: $3,234.90 01106/2005 Payment with Return. 14. On the date of death, the decedent was not a fiduciary of another estate, nor surety ort the bond of a fiduciary, except as stated: No exceptions. 15. Describe any questions requiring adjudication: a. Petitioner respectfully requests that the Court disallow any and all claims presented by Sylvia Smith. 16. If petitioner has knowledge that a share has been assigned, renounced, disclaimed or attached, provide a copy of the assignment, renunciation, disclaimer or attachment, together with any relevant supporting documentation. N/ A 17. Was decedent adjudicated an incapacitated person? NO (yes/no). If yes, attach a copy of the Order if available; otherwise state Court, term, number, date, and name of Hearing Judge. N/ A . 18. If a reserve is requested, state amount and purpose. No reserve is requested. 19. Is a schedule of distribution requested? NO (yes/no). As to real estate only? NO (yes/no). 651482 . Wherefore, your petitioner asks that distribution be awarded to the persons entitled and suggests that the distributive shares of income and principal (residuary shares being stated in proportions, not amounts) are as follows: A. Income: Proposed Distributee( s) Amount/Proportion Yan Ning Smith 1/2 Balance thereof David A. Smith 1/6 Balance thereof Natalie Smith 1/6 Balance thereof Yan Ning Smith, Parent and Natural Guardian for Martin Smith, A Minor 1/6 Balance thereof B. Principal: Proposed Distributee(s) Amount/Proportion Yan Ning Smith 1/2 Balance thereof David A. Smith 1/6 Balance thereof Natalie Smith 1/6 Balance thereof Yan Ning Smith, Parent and Natural Guardian for Martin Smith, A Minor 1/6 Balance thereof And your petitioner/s will respectfully pray, etc. 651482 Verification of Petitioner The undersigned hereby verifies that the facts set forth in the foregoing Petition for Adjudication and Statement of Proposed Distribution which are within the personal knowledge of the petitioner are true, and as to facts based on the information of others, the petitioner, after diligent inquiry, believes them to be true; and that any false statements herein are made subject to the penalties of 18 Pa. C.S. S 4904 (relating to unsworn falsification to au Y AN NING SMITH, Petitioner 651482 Court of Common Pleas of Cumberland County-Orphans' Court Division COMMONWEALTH OF PENNSYLVANIA ESTATE OF JOSEPH MICHAEL SMITH, DECEASED NO. OF 2005 dl-04-OilL.." STATEMENT OF PROPOSED DISTRIBUTION Principal Balance as per Account $ 128,389.63 Increases and/or Decreases: Less Administratrix Account filing fee - 195.00 Principal Balance for distribution: $128.194.63 Which is awarded as follows: To: Yan Ning Smith Cash $64,097.32 To: David A. Smith Cash $21,365.77 To: Natalie Smith Cash $21,365.77 To: Yan Ning Smith, Parent and Natural Guardian for Martin Smith, A Minor Cash $21,365.77 $128.194.63 Income Balance as per Account Increases and/or Decreases: None $1,449.14 0.00 $1.449.14 Income Balance for distribution: Which is awarded as follows: To:: Yan Ning Smith Cash To: David A. Smith Cash To: Natalie Smith Cash To: Yan Ning Smith, Parent and Natural Guardian for Martin Smith, A Minor Cash $724.57 $241.52 $241.52 $241.53 $1.449.14 651482 ]' , , COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL V Al~IA ORPHANS' COURT DIVISION REGISTER OF WILLS FILE NO. 2004-00716 FIRST AND FINAL ACCOUNT OF Y AN NING SMITH, ADMINISTRATRIX OF THE EST ATE OF JOSEPH MICHAEL SMITH, aIkIa JOSEPH M. SMITH, DECEASED (Late of East Pennsbury Township, Mechanicsburg, Cumberland County, Pennsylvania) Date of Death: May 13,2004 Date of Administratrix Appointment: August 2, 2004 File No. 2l-04~07l6 Date of First Advertisement: August 26" 2004 Accounting for the Period: May 13,2004 to August 31, 2005 Orphans' Court No. N/A Date Adjudicated Incapacitated: N/A Social Security Number: 549-06-8123 Purpose of Account: Yan Ning Smith, Administratrix, offers this account to acquaint interested parties with the transactions that have occurred during this administration. It is important that the account be carefully examined. Requests for additional information, or questions, or objections, can be discussed with: ; : i I Nina B. Stryker, Esquire J.D. No. 36531 Obermayer Rebmann Maxwell & HiPEel LLP 1617 John F. Kennedy Boulevard, 19 Floor Philadelphia, P A 19103-1895 215/665-3057 Gross Estate: $162.048.95 614798 1 gA ]' , , Summary of Account Page Fid. Acq. Value PRINCIPAL Receipts of Principal 3 $160,599.81 Less Losses on Sales 3-4 - 1,707.61 $158,892.20 Disbursements of Principal Debts of Decedent 4 4,739.47 Funeral Expenses 4 5,262.60 Administration Expenses 5 648.60 Federal and State Taxes 5 3,273.90 Fees and Commissions 5 13,078.00 Family Exemption 5 3,500.00 30,502.57 $128,389.63 Distributions of Principal 6 0.00 Principal Balance on Hand 6 $128.389.63 F or Information: Investments Made 7 Changes in Investment Holdings 7 INCOME Receipts of Income 8 $1,449.14 Disbursements of Income 8 0.00 $1,449.14 Distributions of Income 8 0.00 Income Balance on Hand 8 $1.449.14 COMBINED BALANCE ON HAND $129.838.77* * Subject to payment of Orphans' Court Account filing fees estimated at $195. and reserve for additional counsel fees if any in connection with possible litigation of claims regarding the settlement of the estate re Audit. 614798 2 , , Receipts of Principal 11 Assets comprising Decedent's Estate as of May 15, 2004, Date of Death: Fid. Acq. Val~ 2,284.374 shs. Davis New York Venture Fund Cl 10.790 PBGH Growth Fund 8.865 shs. PGBH Technology and Communication Fund 2,552.641 Strong Enterprise Fund 962.660 shs. T. Rowe Price Emerging Europe and Mediterranean Fund 2,686.146 shs. T. Rowe Price International Stock Fund Miscellaneous personal effects TOTAL RECEIPTS OF PRINCIPAL $64,008.16 186.88 90.69 54,575.46 12,091.01 29,547.61 100.00 $160.599.81 Gains and Losses on Sales or Other Dispositions of Principal Net Gain Net Loss 08/2612004 2,284.374 shs. Davis New York Venture Fund Cl Net Proceeds of Sale 64,076.69 Fid. Acq. Val. 64,008.16 68.53 0.00 08/2712004 2.552.641 shs. Stron~ Enterprise Fund Net Proceeds of Sale 52,278.09 Fid. Acq. Val. 54.575.46 0.00 2,297.37 08/30/2004 10.790 shs. PBGH Growth Fund Net Proceeds of Sale 172.64 Fid. Acq. Val. 186.88 0.00 14.24 08/30/2004 8.865 PGBH Technology and Comm. Fund Net Proceeds of Sale 83.24 Fid. Acq. Val. 90.69 0.00 7.45 Balance forward 68.53 2,319.06 614798 3 Balance forward 68.53 2,319.06 09/03/2004 962.660 shs. T. Rowe Price Emerging Europe and Mediterranean Fund Proceeds of Sale 11 ,962.40 Fid. Acq. Val. 12.091.01 0.00 128.61 09/03/2004 2,686.146 shs. T. Rowe Price International Stock Fund Net Proceeds of Sale 30,219.14. Fid. Acq. Val. 29.547.61 671.53 0.00 740.06 2,447.67 Less Gain - 740.06 TOTAL LOSSES ON SALES OR CONVERSIONS OF PRINCIPAL $1.707.61 Disbursements of Principal 12/15/2004 Debts of Decedent Yan Ning Smith - Reimbursement for payments advanced to West Shore Emergency Medical Services for services rendered to decedent West Shore Emergency Medical Services - Balance due for services rendered to decedent Holy Spirit Hospital - Medical services rendered P A Department of Revenue - 2004 Final life period income tax liability United States Treasury - 2004 Final life period income tax liability 3.070.00 $4,739.47 100.00 12/15/2004 12/15/2004 04/14/2005 414.57 89.90 1,065.00 04/14/2005 Funeral EXDenses 12/15/2004 Van Ning Smith - Reimbursement for payment of funeral bill to Hetrick Funeral Horne ($1,340), for flowers for funeral from Stevensons Flowers ($222.60) and for funeral luncheon and acknowledgement cards ($500) $2,062.60 03/22/2005 Yan Ning Smith - Reimbursement for payment of deposit for burial plot 320.00 03/22/2005 Coral Ridge Funeral Horne and Cemetery Inc. Balance due for burial plot 2.880.00 5.262.60 Balance forward 10,002.07 614798 4 l' Balance forward 10,002.07 Administration Exvenses 09/27/2004 Obermayer Rebmann Maxwell & Hippel LLP - Reimbursement for administrative costs advanced for photocopying ($8.20), postage ($4.02), long distance phone ($7.29) and fax ($2) 21.51 09/2712004 William J. Mansfield, Inc. - Legal advertising of grant of Letters of Administration 360.00 To be paid Obermayer Rebmann Maxwell & Hippel LLP - Reimbursement for administrative costs advanced for photocopying ($72.35), postage ($16.81), long distance phone ($42.33), fax ($12), Federal Express ($43.60) and filing fees for Inventory and Inheritance Tax Return ($30) 267.09 648.60 Federal and State Taxes 12/29/2004 Register of Wills, Agent - P A Inheritance Tax 3,234.90 07/26/2005 P A Department of Revenue - 2004 Fiduciary Income Tax for fiscal year ending 3/31/05 39.00 3,273.90 Fees and Commissions 09/27/2004 Obermayer Rebmann Maxwell & Hippel LLP - Reimbursement for probate costs advanced 278.00 To be paid Yan Ning Smith - Administratrix commission 6,000.00 To be paid Obermayer Rebmann Maxwell & Hippel LLP - Counsel fees re Estate administration ($4,500), preparation of final life period income tax returns ($800) and represenatation of Administratrix re Audit ($1,500) 6.800.00 13,078.00 Familv Exemvtion 07/3112005 Yan Ning Smith - Payment of claim for Family Exemption (as allowed by P A Department of Revenue) consisting of payment of miscellaneous personal effects ($100) and Cash ($3,400) 3.500.00 TOTAL DISBURSEMENTS OF PRINCIPAL $30.502.57 614798 5 11 Distributions of Principal to Beneficiaries None Principal Balance on Hand Firstrust Bank Estate Checking Account Firstrust Bank Savings Account $143,792.20 Less unpaid expenses listed in Account: Yan Ning Smith - Cash for balance of claim for Family Exemption 3,400.00 Yan Ning Smith - Administratrix Comm. 6,000.00 Obermayer Rebmann Maxwell & Hippel LLP Counsel fees ($6,800) and costs ($267.09) 7,067.09 16,467.09 TOTAL PRINCIPAL BALANCE ON HAND 614798 6 $1,064.52 127325.11 $128.389.63 Information Schedules - Principal Cost Investments Made None Chane:es in Investment Holdine:s Davis New York Venture Fund C1 05/13/2004 2,284.374 shs. Inventoried at $64,008.16 08/26/2004 (2.284.374) shs. Redeemed (64.008.16) -0- shs. 0.00 PGBH Growth Fund 05/13/2004 10.790 shs. Inventoried at $186.88 08/30/2004 00.790) shs. Redeemed 086.88) -0- shs. 0.00 PGBH Technology and Communications Fund 05/13/2004 8.865 shs. Inventoried at $90.69 08/30/2004 (8.865) shs. Redeemed (90.69) -0- shs. 0.00 Strong Enterprise Fund 05/13/2004 2,552.641 shs. Inventoried at $54,575.46 08/27/2004 (2.552.641) shs. Redeemed (54.575.46) -0- shs. 0.00 T. Rowe Price Emerging Europe and Mediterranean Fund 05/13/2004 962.660 shs. Inventoried at $12,091.01 09/0312004 (962.660) shs. Redeemed 02.091.01) -0- shs. 0.00 T. Rowe Price International Stock 05/13/2004 2,686.146 shs. Inventoried at $29,547.61 09/03/2004 (2,686.146) shs. Redeemed (29,547.61) -0- shs. 0.00 Miscellaneous personal effects 05/13/2004 Inventoried $100.00 08/31/2005 Paid as part of claim for Family Exemption 000.00) -0- shs. 0.00 614798 7 - l' _"'_......"'~""'_.,,_.._......_,...,,...,< .....~O...."';,..".~~~''''-.:,..,,~.. Firstrust Bank Savings Account 09/30/2004 Interest 10/30/2004 Interest 11/3012004 Interest 12/31/2004 Interest 01/31/2005 Interest 02/28/2005 Interest 03/31/2005 Interest 04/30/2005 Interest 05/31/2005 Interest Receipts of Income $122.85 169.57 164.29 169.95 170.14 153.84 170.51 162.22 165.77 $1.449.14 TOTAL RECEIPTS OF INCOME $1.449.14 Disbursements of Income None Distributions of Income to Beneficiaries None Firstrust Bank Savings Account 614798 Income Balance on Hand ~ ,449.14 ~~~:i ~ Y AN NING SMITH, Administratrix 8 , I , I Commonwealth of Pennsylvania 88 County of Philadelphia Y AN NING SMITH, Administratrix ofthe Estate of JOSEPH MICHAEL SMITH, a/k/a JOSEPH M. SMITH, deceased, hereby declares under oath that she has fully and faithfully discharged the duties of her office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting p~riod; that all known claims against the estate have been paid; that, to the best of her knowledge, there are no claims now outstanding against the Estate; that all taxes presently due from the estate have been paid; and that it has been more than four months since the first advertisement of gr t of letters in this estate. , Administratrix S5~CJ11Y IoSCf09D I"i~j~;~~t;' - ~'SfU"J,\'NA SCOTT' ., Jf.( A \~'~ MY COMMISSION # DD099724 I ,.~;,~.,.~! EXi'IRE:j March 13.2006 I ....f..~ondAd Thfl! Notary Public Underwnters t; III ,~.;;:.......;~.i~.t....'';;:::-~"",,",. 614798 9 I' (. , . . PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Tammy Shoemaker, Customer Care/Sales Manager, of The Sentinel, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following date(s) August 26, September 02, 09,2004 COPY OF NOTICE OF PUBLICATION ~NOTICE ESTATE OF JOSEPH MICHAEL SMITH, also known as, JOSEPH M. SMITH, late of the Township of East Pennsboro, Cumberland County, PA. LETTERS ADMINISTRATION on the abov~ Estate have been granted to the undersign.ed, who request all persons having claims or demands against the estate of the decedent to make known the same and all persons indebted to the decedent to makE/ payment without delay to SMITH YAN NING, ADMINISTRATIX. care of Nina Booz Stryker, Esquire, One Penn Center, 19th Floor, Philadelphia, PA 19103-1895. Affiant further deposes that hel she is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and charac r of pub ication are true. ~'" NINA B002 STRYKER OBERMA YEA, REBMANN, MAXWELL & HIPPEL, LLP One Penn Center 1617 John F. Kennedy Boulevard 19th Floor Philadelphia, PA 19103-1895 Or to her Attorney: Sworn to and subscribed before me this 15th day of September, 2004 My commission expires: QQMMQNWEAl.TH OF PENNSYLVANIA NOTARIAL SEAL JACQUEUNE M. WORLEY, Notary PIbIic Boro of Cflrtisle, Cumber1and County My Commission EJcpirea Jan. 10, 2005 . . PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16,1929), P. L.1784 STATE OF PENNSYLVANIA : SSe COUNTY OF CUMBERLAND : Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, ofthe County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been reguLarly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland L$w Journal on the following dates, VIZ: AUGUST 27, SEPTEMBER 3, 10,2004 Affiant further deposes that he is authorized to verify this statement by the Cumberl~d Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. " " Smith, Joseph Michael, a/k/a Jo- seph M. Smith, dec'd. Late of East Pennsboro. Administratrtx: Yan Ning Smith. c/o Nina Booz Stryker, Esquire, One Penn Center, 19th Floor, Philadelphia, PA 19103-1895. Attorneys: Nina Booz Stryker, Es- quire, Obermayer, Rebmann, Max- well & Hippel, LLP, One Penn Center, 1617 John F. Kennedy, Boulevard, 19th Floor, Philadel- phia, PA 19103-1895. SWO 0 AND SUBSCRIBED before me this 10 day of SEPTEMBER 2004 NOT ARI L SEAL LOIS E, SNYDER, Notary Public Carlisle Boro, Cumberland County My Commission Expires March 5, 2005 , ........ - NOV Z ! 2005f Iy Court of Common Pleas of Cumberland.County-Orphans' Court Division COMMONWEALTH OF PENNSYLVANIA ESTATE OF JOSEPH MICHAEL SMITH, DECEASED NO. OF" ~'-04-0'1l.p DECREE OF CONFIRMATION AND DISTRIBUTION AND NOW, to wit, ~o" 2 3- . . 2005, the above-mentioned Account having been examined and audited by the Court, it is decreed that the Account be confirmed, and that the assets in the hands of the accountant( s) be paid and distributed in accordance with the Statement of Proposed Distribution. J. ;\"'1'\ "dd: !. " .'~'\ II '..... 1Uvrr'''-'' c.: i,'dl.\d80 .LO \,-1\.) \..'il 'l . I jO 1\d318 ~S : \ \~d t:Z MJN ~nUl 651482 < '""\ ::"''.'\ -.....:; : l..f' . -r ....LI. :10 38\1\0 03GtluJj(j pt r., o Z 00 ~ 0 <~ t;j f;IilZ ..... ...;I <> ~;:J..........I.O ZOZ~..... 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I \' . . , .. r -~ J II: 10 ~ 0 Ol z ~ co W [Il () r') z ~ 0 00 z W If ~ Ol ~ W W 10 Z~<((l) o u.: 0.. (l) II: Z o I o 0 ...J J lL. f'.. I 5i (l) ~ 10 I ~ C\l W o ~ I 0.. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/29/2006 STRYKER NINA BOOZ 12617 JFK BLVD 19TH FLOOR PHILADELPHIA, PA 19103 RE: Estate of SMITH JOSEPH MICHAEL File Number: 2004-00716 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.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 5/13/2006 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, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/29/2006 SMITH YAN NING 5218 COBBLESTONE DRIVE MECHANICSBURG, PA 17055 RE: Estate of SMITH JOSEPH MICHAEL File Number: 2004-00716 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.1, 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: 5/13/2006 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, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel STATUS REPORT UNDER RULE 6.12 Name of Decedent: JOSEPH MICHAEL SMITH Date of Death: MAY 13, 2004 File No.: 2004-00716 Pursuant to Rule 6.12 of the Supreme Court of Orphans' Court Rules. I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer is 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: 21-04-0716 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 Clerk of the Orphans' Court and may be attache~to this report. Date: March "1> I . 2006 ~ - iX<g1: ~~a B~S~k;~ire #36531 Obermayer Rebmann Maxwell & Hippel LLP One Penn Center - 19th Floor 1617 John F. Kennedy Boulevard Philadelphia, P A 19103-1895 (215) 665-3057 Capacity: _ Personal Representative X- Counsel for Personal Representative ,.., c' 4034957 @ r I I I I ..... .... = Q ~ "tR = tl:l == ~fr ..:g ~ ~"r-- e'.. E!~~~ } J.\Q,.QCZl,..!, o '8t...s=,,- .. ;... .. = ell 0 0, - ~ ~ ~ g ~ ~"'1l0) .. ~ .... of --::C ~,Q Q :l "- T'f=~olli tl:l tl:l = U 0; ,Q "tR = " .- = =: Q t=: "'C ijii~Oc3 - Q .... ... tA & ~ o ~ u:l u:l ... .....a:: u:lzlfj~ ~~~CCI a::~u:lu:la:: ~:oo:ii::; C.............a:: ..... OlD lDO zz::ECLL. "'C1;:)ffio c::;...z>..... u:t:c~... LL.::Er.:l........ ~~~C1~ z.....o:;~ -czz- DD~' o~ ,...:j ~ m u H :E; ::r:\D ~rl ~C' U)O o~ .O<:t' ::r:O E-iO H~ :E; " : ~I o~ 2~ rtl Q) , -Wr-j CJ1...-j ~(r., .. ~ 0:: - .- - - :::: (.:, N '.-. ijI .:../ ~ /it: '1;\1 , (1l (D o::t -:;t- + Ul Ul () ,.... ..... r I ~ One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/29/2006 SMITH YAN NING 5218 COBBLESTONE DRIVE MECHANICSBURG, PA 17055 RE: Estate of SMITH JOSEPH MICHAEL File Number: 2004-00716 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 aeath, shall file with the Register of Wills a Status Report of Gompleted or uncompleted administration. This filing is due by: 5/13/2006 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, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel