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Home My WebLink About03-0171Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estateof Arlene R. Still No. 21-03-171 also known as , Deceased Gary Still, Social Security No. 198-44- 9116 Petitioner(s), who is/are 18 years of age or older, apply(les) for: (COMPLETE 'A' or 'B' BELOW:) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut__ the Decedent, dated and codicil(s) dated None named in the last Will of State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration (c.ta.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence Gary Still, II Son (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland 3B W.Green St., Shiremanstown, PA County, Pennsylvania with his/her last family or principal residence at 212 Holly Drive, Hampden, Camp Hill, PA 17011 (list street, number, and municipality) Decedent, then 49 years of age, died 02/15/2003 at Camp Hill, PA Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in Pennsylvania (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania (Location) 120,000.00 38,000.00 situated as follows: 212 Holly Street, Camp Hill, PA Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersi~lned: Signature Typedorprintednameandresidence Gary Still, II 3B West Green Street, Shiremanstown, PA 17011 ~rep~re~ ~y the ~e~Na~ia ~r ~$~o¢Iatio~ Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland 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 Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed Jl/'~t-~ ,~~ Gary ~/~-~1, II before me this 25thday of FEBRUARY 2003 No. 21 - 03 - 171 Estateof Arlene R. Still SocialSecuri~ No: 198-44-9116 DateofDeath: 02/15/2003 AND NOW, FEBRUARY 26 , of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters Deceased 2003 , in consideration r---] Testamentary ~ of Administration (c.t.a.;'~en~dente lite; durante absentia; durante minoritate) are hereby granted to Gary Still, II in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........... $ Short Certificate(s) ..... $ 235.00 30.00 10.00 Register Renunciation ........ $ Attorney: Robert J. Mu]deri~ LD. No: 48619 Turo Law Offices Address: 28 S. Pitt Street Carlisle, PA 17013 Telephone: 717/245-9688 Affidavits ( ) .... $ Extra Pages ( ) .... $ Codicil ........... $ JCP Fee .......... $ Inventory .......... $ Other ........... $ TOTAL ......... $ 27.5.00 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form Ri-1 (1991) CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Arlene R. Still Date of death: February 15, 2003 Will No. Admin. No. c~--)-O ~ j-"'] ~, TO THE REGISTER: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above captioned estate. Name Address Gary L. Still 3B West Green Street, Shiremanstown, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a). Respectfully Submitted TURO LAW OFFICES R'ob~rt Z'.Mulderig, Esquire''u 28 South Pitt Street Carlisle, PA 17013 (717) 245-9688 Capacity as 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 OO3O 1 9 JAMES GARY L ESQUIRE 134 SIPE AVENUE HUMMELSTOWN, PA 17036 ........ fold ESTATE INFORMATION: SSN: 198-44-9116 FILE NUMBER: 2103-01 71 DECEDENT NAME: STILL ARLENE R DATE OF PAYMENT: 09/1 6/2003 POSTMARK DATE: 09/1 5/2003 COUNTY: CUMBERLAND DATE OF DEATH: 02/15/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4,225.92 TOTAL AMOUNT PAID: $4,225.92 REMARKS' GARY L STILL II C/O GARY L JAMES ESQUIRE SEAL CHECK# 154 INITIALS: VZ RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. Z80601 HARRISBURG, PA 171Z8-0601 REV-1500 INHERITANCE TAX RETURI RESIDENT DECEDENT D I DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) E I Still Arlene R. C DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD~YEAR) E D 02/15/2003 10/02/1953 E (IF APPLICABLE) SURV V NG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) N T CA-PLB HP,n EP~'~ CRC Ko sK Co" C R E C A P I T U L A T I O N O M T I O N OFFICIAL USE ONLY FILE NUMBER 21-03 -0171 COUNTYCODE YEAR NUMBER SOCIAL SECURITY NUMBER 198-44-9116 1. OriginaIReturn ~ :;. Supplemental Return 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-8Z) 6. Decedent Died Testate 7. Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) I I 9. Litigation Proceeds Received I 110. Spousal Poverty Credit (date of death between 1Z-31-91 and 1-1-95) NAME Gary L. James Esq. FI R M NAM E (If Applicable) James, Smith, Dietterick & Connelly, LLP TELEPHONE NUMBER 717/533-3280 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or (3) Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) i'-'--I Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11 ) 13. 14. THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (d.ate.of death 3. Remainder Return pnor~o 1Z-13-8Z) 5. Federal Estate Tax Return Required 0~ 8, Total Number of Safe Deposit Boxes I'--] 11. Election to tax under Sec. 9113(A) (Attach Sch O) ~:~~j~~~":':~i~'~~; ......... '' :'~i ~i!~'~:'~"~i .............. ~'; '"' ~':"i ~ ~ ?"' ~'~"i~,,~ .............. i ............. .... ~ ~:~:~:~':*~ ............... . ~'~' ~i~,~ ....... COMPLETE MAILING ADDRESS 134 Sipe Avenue Hummelstown, PA 17036 126,542.90 47,811.49 None None 30,465.75 None 4,625.00 18,616.50 96,919.22 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) OFFICIAL USE ONLY (8) 209,445.14 (11) 115,535.72 (12) 93,909.42 (13) (14) 93,909.42 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 93,909.42 X .0 0 X .0 45 X .12 X .15 (15) 0.00 (16) 4,225.92 (17) 0.00 (18) 0.00 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 212 Holly Drive CI/Y Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 STATE PA (1) Total Credits ( A + B + C ) (2) ZIP 17011 4,225.92 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 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) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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 the use or income of the property transferred; ......................... ~] ~] b. retain the right to designate who shall use the property transferred or its income; ........... c. retain a reversionary interest; or .................................... d. receive the promise for life of either payments, benefits or care~ 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. 0.00 0.00 0.00 4,225.92 0.00 4,225.92 Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements and to the best of my knowledge and belief it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN , Gary L. Still DATE '~. ~' r~, 212 Hol.i~ Drive , ;- i:,×-- ......................... SIGNATUREDFPRE~REROTHER~AN~PRESENTATIVE T----~ ~--~k ~ ~ ' ~ -- ~ 11 .... ~ ~ · 134 Sipe Avenue ....................... -cd 7 surviving spous~ 91 6_ For dates of death on or a~a~ 1,, 1995, ~he tax rate imposed on the net value of transfers to or for the use of the su~iving spouse is 0% [72 P.S. 9116 (a) (1.1) (ii)]. ~statute does not exempt a transfer to a surviving spouse from tax, and the statuto~ require~nts for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficial. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twen~-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2) [72 P.S. 9116(aXl)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(aX1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in com~n with the decedent, whether by blood or adoption. Copyright (c) ZOO0 form software only The Lackner Group, Inc. Form REV-150O EX (Rev. 6-~) REV- 150Z EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Arlene R. Still SS~/ 198-44-9116 SCHEDULE A REAL ESTATE 02/15/2003 FILE NUMBER 21-03-0171 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with ri~]ht of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION Real Estate situate at 212 Holly Drive, Camp Hill, Cumberland County, Pennsylvania - held in decedent's name individually; county assessed value is $125,290 times common level ratio factor of 1.01 = $126,542.90 TOTAL (Also enter on line 1, Recapitulation) VALUE AT DATE OF DEATH 126,542.90 $ 126,542.90 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc, Form REV-1502 EX (Rev. 1-97) REV- 1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAXRETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS Arlene R. Still SS# 198-44-9116 02/15/2003 All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21-03-0171 ITEM VALUE AT DATE NUMBER DESCRIPTION UNITVALUE OF DEATH 1 569.476 shares Citizens Investment Services Corp 11.98 6,822.32 Dreyfus Premier Tax Managed Growth Fund - Class B 2 239.349 shares Citizens Investment Services Corp 14.50 3,470.56 Dreyfus Premier Technology Growth Fund - Class B 3 9,925.558 shares Citizens Investment Services Corp 3.78 37,518.61 Oppenheimer Strategic Income Fund - Class B TOTAL(Alsoenteronline2, Recapitulation) 47,811.49 (If more space ~s needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1503 EX (Rev. 1-97) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER Arlene R. Still SS# 198-44-9116 02/15/2003 21-03-0171 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2002 PA Income Tax - refund owing Citizens Bank - Checking Account #6100615359; Opened 02/12/1998 Citizens Bank - Savings Account #6140-204860; Opened 08/08/2001 Citizens Bank - Time Deposits #6140-783038; Opened 11/22/2000 Accrued interest on item 4 to date of death Members 1st Federal Credit Union - Regular Savings Account #149831-00; opened 02/25/1995 in decedent's sole name Members 1st Federal Credit Union - Investment Savings Account #149831-05; opened 07/27/2001 in decedent's sole name Accrued interest on item 6 to date of death TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) 64.00 1,961.78 1,327.21 21,875.42 39.99 46.43 5,147.90 3.02 $ 30,465.75 Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev, 1-97) REV-1510 EX+ (1-97) SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Arlene R. Still SS# 198-44-9116 02/15/2003 21-03-0171 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 INCLUDE THE NAME OF THE TRANSFEREE, 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 (~F APPLICABLE) 1 2001 Pontiac Grand Am - 7,625.00 3,000.0¢ 4,625.00 gifted to son prior to death TOTAL (Also enter on line 7, Recapitulation) $ 4,625.00 (If more space ~s needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1510 EX (Rev. 1-97) REV- 1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Arlene R. Still SS~/ 198-44-9116 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS 02/15/2003 FILENUMBER 21-03-0171 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Funeral Luncheon 3 4 5 Neill Funeral Home, Inc funeral bill ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney's Fees James, Smith, Dietterick & Connelly, LLP Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Register of Wills Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Cumberland Law Journal - estate notice Gary L. Still, II reimbursement for estate account at credit union Members 1st - check charge Reserve for additional administration The Sentinel - estate notice amount needed to open expenses 508.55 7,000.00 6,095.00 3,500.00 275.00 75.00 25.00 12.95 1,000.00 125.00 TOTAL (Also enter on line 9, Recapitulation) 18,616.50 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) Estate of: Arlene R. Still Soc Sec #: 198-44-9116 Date of Death: 02/15/2003 Item Description Continuation of Schedule H-B2 (Attorney's Fees) Amount James, Smith, Dietterick & Connelly, LLP - attorney fees Turo Law Offices - Bill for services performed for estate 5,000.00 1,095.00 6,095.00 Estate of: Arlene R. Still Soc Sec #: 198-44-9116 Date of Death: 02/15/2003 Item Description Continuation of Schedule H-B3 (Family Exemption) Amount Family Exemption 3,500.00 3,500.00 Estate of: Arlene R. Still Soc Sec #: 198-44-9116 Date of Death: 02/15/2003 Item Description Continuation of Schedule H-B4 (Probate Fees) Amount 1 Register of Wills - probate fee 275.00 275.00 REV-151Z EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Arlene R. Still SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SS# 198-44-9116 02/15/2003 FILENUMBER 21-03-0171 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 2 3 4 5 6 7 8 9 10 11 12 13 2002 Federal Income Tax Boscov's credit card bill Citizens Bank - Line of Credit; payoff 06/12/2003 Columbia National Mortgage ~ mortgage payment Columbia National Mortgage account #3877050 Columbia National Mortgage - payoff amount Members 1st - VISA card balance Members 1st Federal Credit Union - Loan Account #149831-01; opened 01/19/2001 in decedent's sole name; new vehicle loan; Collateral 2001 Pontiac Members 1st Federal Credit Union - VISA Credit Card Account 4121449991498317; opened 04/21/1995 in decedent's sole name; payoff 03/07/2003 Pinnacle Health Hospitals - bill PPL Co - final electric bill Sears credit card balance U G I Corporation - final gas bill mortgage payment TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. 535.00 30.77 9,406.62 662.85 662.85 71,187.60 59.28 9,876.02 3,478.95 263.00 99.00 513.75 143.53 $ 96,919.22 Form REV-1512 EX (Rev. 1-97) REV-1513 EX + (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Arlene R. Still SS# 198-44-9116 02/15/2003 21-03-0171 NUMBER II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright s~usal distributions, transfers u~er Sec. 911~aX1.2)] Gary L. Still, II 212 Holly Drive Camp Hill, PA 17011 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Son AMOUNT OR SHARE OF ESTATE 100% of residue 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) ZOO0 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, 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 Membersl FEDERAL CREDIT UNION INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1161 REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Interest Earned from 1/1/03 to Date of Death Name of Joint Owner INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Interest Earned from 1/1/03 to Date of Death Name of Joint Owner LOAN ACCOUNT: Account Number/Suffix Date of Disbursement Principal Balance at Date of Death Loan Description Name of Co-Maker Collateral Securing Loan VISA CREDIT CARD ACCOUNT: Account Number Date Account Opened Balance at Date of Death Name of Joint Cardholder '149831 -00 02/25/1995 $46.43 $.oo $46.43 $.oo None 149831 -05 07/27/2001 $5,147.90 $3.02 $5,150.92 $9.99 None 149831 -01 01/19/2001 $9,876.02 New Vehicle None 2001 Pontiac/ Contractual Pledge of Shares 4121449991498317 04/21/1995 $3,478.95 None Insurance Supervisor April 11,2003 Estate of: ARLENE R. STILL Date of Death: February 15, 2003 Social Security Number: 198-44-9116 CITIZENS INVESTMENT SERVICES CORP, z zoo Hancock Street Quincy, MA ozz69 April 4, 2OO3 James, Smith, Durkin & Connelly LLP Atto: Stephanie L. Gaffey, Paralegal 134 Sipe Avenue Hummelstown, PA 17036 RE: Account Number: 57416891 Registration: Arlene R. Still Dear Ms. Gaffey: We are writing with regard to the above referenced account. Please extend our condolences to the family of Ms. Still. This account was established on November 22, 2000. According to our records, there have been no other registrations associated with this account The following table provides a summary of Ms. Still's account holdings as of the close of business on February 14, 2003. The information provided is as of February 14, 2002 because February 15, 2003 was a Saturday. Dreyfus Premier Tax Managed 569.476 $11.98 $ 6,822.32 Growth Fund-Class B Dreyfus Premier Technology Growth Fund-Class B Oppenheimer Strategic Income Fund-Class B 239.349 $14.50 $ 3,470.56 9,925.558 $ 3.78 $37,518.61 As of February 15, 2003, this account received $166.09 in dividends. There are no accrued dividends on any of the funds Ms. Still held. Should you have any questions, please call Citizens Investment Services Corp Customer Service at 1-800-942-8300. We are available Monday through Friday, 8:00 a~m. to 5:00 p.m. We will be happy to assist you. S! cerely, ,- CISC Operation Specialist 002-05150lOPS Citizens Investment Services Corp. Member NASD, SIPC. One Citizens Plaza, Providence, RI 02903. (800) 942-8300. In Massachusetts, insurance is offered through Citizens Financial Services Insurance Agency, 1200 Hancock Street, Quincy, MA 02169. Citizens Investment Services Corp. and Citizens Financial Services Insurance Agency are affiliates of Citizens Bank. I ° Not FDIC Insured · No Bank Guarantee ° Not A Deposit · May Lose Value · Not Insured By Any Federal Government Agency Register of Wills of CUMBERLAND INVENTORY County, Pennsylvania Estate of Arlene R. Still also known as , Deceased No. 2003-00171 Date of Death 02/15/2003 Social Security No. 198-44-9116 Gary L. Still, 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 true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: Gary L. James Esq. Signature: I.D. No.: 27752 Signature: Address: 134 Sipe Avenue Address: Hummelstown, PA 17036 Telephone: 717/533-3280 Personal Representative Gary L. ~ill - 212 Holly Drive Camp Hill, PA 17011 Telephone: 717/761- 7304 Dated: Description (See continuation page(s) attached) (Attach additional sheets if necessary) Value Total: 204,820.14 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form #RW-7 (1992) Estate of: Date of Death: County: Arlene R. Still 02/15/2003 Cumberland INVENTORY CASH: 2002 PA Income Tax - refund owing Citizens Bank - Checking Account #6100615359; Opened 02/12/1998 Citizens Bank - Savings Account #6140-204860; Opened o8/o8/2ool Citizens Bank ~ Time Deposits #6140-783038; Opened 11/22/2000 Accrued interest through date of death Members 1st Federal Credit Union Regular Savings Account #149831-00; opened 02/25/1995 in decedent's sole name Members 1st Federal Credit Union - Investment Savings Account #149831-05; opened 07/27/2001 in decedent's sole name Accrued interest through date of death 64.00 1,961.78 1,327.21 21,875.42 39.99 46.43 5,147.90 3.02 30,465.75 -1- STOCKS/LISTED: 569.48 shares Citizens Investment Services Corp - Dreyfus Premier Tax Managed Growth Fund - Class B 239.35 shares Citizens Investment Services Corp - Dreyfus Premier Technology Growth Fund - Class B 9,925.56 shares Citizens Investment Services Corp - Oppenheimer Strategic Income Fund - Class B 6,822.32 3,470.56 37,518.61 REAL ESTATE/PA: Real Estate situate at 212 Holly Drive, Camp Hill, Cumberland County, Pennsylvania - held in decedent's name individually; county assessed value is $125,290 times common level ratio factor of 1.01 = $126,542.90 126,542.90 TOTAL RECEIPTS OF PRINCIPAL ............... 47,811.49 126,542.90 204,820.14 -2- I' CLASS MAIL THI SEcuE~-TATi! JAMES SMITH DIETTERICK & CONNELLY LLP Itl I'~, P.O. Box 650 FORM[ '1 ,\ Hershey, PA 17033-0650 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 BUREAU OF INDIVIDUAL TAXES ZNHERTTANCE TAX DTVTSTON DEPT. 280601 HARRISBURC, PA 171Z8-0601 CONNONWEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLONANCE OR DISALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX GARY L JANES ESQ JANES ETAL 134 SIPE AVE HUNNELSTOWN DATE 10-27-2003 ESTATE OF STILL DATE OF DEATH 02-15-2003 FILE NUMBER 21 03-017! ~COUNTY CUMBERLAND ACN 101 Amount Reei4:ted REV-lad7 EX J, FP (01-OS) ARLENE R HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF WILLS CUNBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF STILL ARLENE R FILE NO. 21 03-0171 ACN 101 DATE 10-27-2003 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSF APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) ($) ~. Nortgages/Notes Reca/vable (Schedule D) (~) .00 S. Cash/Bank Deposits/H/sc. Personal Proper~y (Schedule E) (S) 6. Jo/ntly Owned Propar~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 4;6Z5.00 8. To,al Asse~s (8) APPROVED DEDUCTIONS AND EXENPTZONS: 9. Funeral Expanses/Ada. Costs/H/sc. Expanses (Schedule H) (9) 10. Debts/Hot,gage L/ab/1/~ias/Liens (Schedule I) (10) 96,919.22 11. To,al Deductions (11) 12. Ne~ Value of Tax Return (12) 126~542.90 47z811.49 .00 30;465.75 .00 18,616.50 13. 1~. NOTE: Chari*eble/Governmen4:al Bequests; Non-elect:ed 911:5 Trus4:s (Schedule J) Ne~: Value of Es~:a~:e Subjact ~:o Tax (1(~) Z~ an assessment was issued previously, lines 14, 15 and/or 16, 17, ASSESSNENT OF TAX: 15. Aeoun~ of L/ne 1~ a~ Spouse1 ra~e 16. Aeoun~ of Line 1~ ~axable a~ Lineal/Class A ra~e 17. Amoun~ of Line 1~ a~ Sibl/ng ra~e 18. Aaoun~ of L/ne lq ~axable e~ Collateral/Class B ra~e 19. Principal Tax Due TAX CREDITS: PAYNENT I RECEIPI DATE NUHBER 09-15-2003 CD003019 reflect flgures that lnclude the total of ALL returns assessed to date. DISCOUNT (+) INTEREST/PEN PAID (-) NOTE: To /nsura proper cred/~ ~o your account, sube/~ ~he upper por~/on of ~h/s form with your ~ax payment. 209,445.14 115.535.72 93,909.42 IF PAID AFTER DATE IND/CATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .O0 .00 93,909.42 TOTAL TAX CREDZT I 4,225.92 BALANCE OF TAX DUEJ .00 ZNtAREST AND PEN. I .00 TOTAL DUE I .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) 4,225.92 ANOUNT PAID (15) .00 x O0 = .00 (16) 93,909.42 X 045 = 4,225.92 (17) . O0 x 12 = . O0 (18) .00 x 15 = .00 (19)= 4,225.92 18 and 19 will RESERVATION: Estates of decedents dying on ar before December lA, I98Z -- if any future interest in the estate is transferred in possession or enjoyment to Class D (colLateral) beneficiaries of the decedent after the expiration of any estate for Iifa or far years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawfuI Class B (collateral) rate on any such future Interest. PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section ZI~O of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (TI P.S. Section 91~0). 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 HILLS, AGENT A refund of a tax credit, ahich ams not requested on the Tax Return, say be requested by completing an "Application for Refund of Pennsylvania Inheritance end Estate Tax" (REV-IS13). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the specie1 Z~-hour answering service for forms ordering: 1-800-56Z-2050; services for taxpayers with special hearing and ! or speaking needs; 1-800-q~7-SOZO (TT only). Any party in interest not satisfied aith the appraisement, alloaanca, or disallowance of deductions, er assessment of tax (including discount or interest) as shown on this Notice must object aJthin sixty (60) days of receipt of this Notice by: --erittan protest to the PA Department of Revenue, Board of Appeals, Dept. Z81021, Harrisburg, PA 17128-10Z1, 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 ariting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 17LZ8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent CSX) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed an the total of the tax and interest assessed, and not paid before January 16, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the sane manner and in the the same time period as you mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6X) percent par annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOO~ are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Yea.~r Rata Factor 1982 ZOZ .OOOSq8 1987 9Z .0002q7 1999 71 .000191 1983 161 .000~58 1988-1991 llZ .000501 2000 8Z .000119 198q 111 .000301 1992 9Z .0002q7 2001 9Z .0002fi7 1985 13X .000556 1995-199q 7Z .000192 2001 61 .O0016q 1986 101 .000Z7~ 1995-1998 91 .OOOZ~7 ZO0~ 51 .0001~7 --Interest is calculated as folloas: INTEREST = BALANCE OF TAX UNPAID X NUBBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (153 days beyond the date of the assessment. If payment is made after the interest computation date sho~n on the Notice, additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: ARLENE R. STILL Date of Death: February 25, 2003 Will No. Admin. No. 2003-00171 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 No X b. The separate Orphan's 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 X No Date: d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Gary L. Jan)ks, JAMES,SMI.T~,DIETTERICK&CONNELLY, LLP ~-- :'9. 134 Sipe Avenue Hummelstown, PA 17036 (717) 533-3280 Capacity: X Personal representative Counsel for personal representative