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Home My WebLink About02-0943 PETITION FOR PROBATE and GRANT OF LETTERS Estate of73t'yl'7/(~ I. ,'!)ufe. No. ~-Oa.-ql./3 atso known as To: Register of Wills for the fJOec7ea~ed. County of in the Social Security No. /u 7 Jif ~'-.:! Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older~n the ~l'ecutd y in the last will of the above decedent, dated I it- _41 v I / and codicil(s) dated named ,19~ (state relevant circnmst~nces, e.;, r.enunciation. death Of~:';~t~.~ .tlrf:} Decendent was domiciled at death in . ~r 1. fi " ^. "fJ.f'c County, Pennsylvania, with h Q r last family oJ p'rincipal r~dence ilt '/ ' t" &/L/t'ht", c...l1Y/~ {clrJ7'/-("' -Penh.- (list street, nukber and muncipality) Decendent7thep" years of age, died J::.o~ d / ,I:!l: ;} 00 1, at r /. k (1, V Except as follo s, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the wil offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ .so O()O - (P 0 tJ Of) $) ) $ $ WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters re+uest(~) the pr9bate of the last will and codicil(s) eJ'rdfr1~ .,hrJ-j (testamentary; admimstration c.La.; administration d.b.D.c.La.) theron. S:rOP ~ ~ " o ~ " :-2-;;:; ~- V" 0:" ~ -CO t:::';:: (lj''::: 3~ v~ ~o " ~ '" u; ~' r/LJ ..\ e :/.& ~~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss 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 represen- tative(s) of the above decedent petitioner(s) will well nd truly ~dminister the ~ tate a ording to law. "" . G.. affirmed and "" ,"' " .. .. ~ ~ 17 ~95' -IJ- No. dJ -DOl-QH3 Estate of BERNICE I DUKE , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW OCTCJBER 2 1, 200 2 ~, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 4 1:) 1 q R" described therein be admitted to probate and filed of record as the last will of BERNICE I DUKE and Letters rpR~'T'nMJ;'l\T'T'n ov are hereby granted to BENJAMIN C DUKE JR FEES Probate, Lellers, Etc. ......... Short Certificates( ).......... Renunciation ................ extra pages $ 115.00 $ 12.00 $ 5.00 15.00 ice $ :>.UU TO A -$ 147.88 .... .lO.~2.l.~2.o02................ mailed to exec 10-21-2002 A TIORNEY (Sup. Ct. I.D. No.) ADDRESS Filed PHONE 1'- r. . H10'i.llO'5 REV 9/B6 This is ro certify that the infotmation hete given is correctly copied from an otiginal certificate of death du!y filed with e as Local Registrar. The otiginal certificate will be. forwarded to the State Vital Records Offlce for permanent hlmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. No, a-OJ'" ~. ~eu..~ Fee for this certificate, $2.00 Local Registrar p 8608389 SEP 26 2002 Date ~'" ~ 1(,. ~ ~'. '1 p,.\~C<?-'l)t"'I~' ~o.:. ~~, ~ \~()\3 'i4/0~~~~. Hl05.144R.....l.IS11 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (Coroner) :/PRINT W "."" ::KIMK ~OFOECEDENT(F...""""".1..nl;j Bernice UNDER t YEM ..... "'" ""'~........ SEX SOCiAl SECuFUTY HUMllEA I Duke .Femele ., 169-14-6073 yNlXP.101:1' tlI\tEOf8lR'\"t4 8ll'lT'rlP\JlCElCIvar>cl PLACEOfOE.ldJ.lp.;:ktrlyOllll _~""CIIhtr~ HoIn"'" \MOI1fI, o.y. ""'l SIN or Foreign CounIryj HO$PlTAL' OTHER: Oct. 8,1921 Berwick, PA 1....-0 E~o\lO ~D , ~, F'OFDEATH FACIUTYH.....EjnnotirSUicltl.g;,.._....a'1lllnber1 OATEOFDEAl'HIMonr>.'-- 4. September 21 2002 ". PA Old 17c.O....~nv.d - .... Cumberland -...Jp7 tH.1!9 :r....~::: Carlisle t.$OTHEIl'SNAME(FirIll.MiddII. ~Sun'\IlM\ 1 . Adah B. Bower INFOA .ShlAlLlNGAOORESS(Slr.-.CIyfbvm.Sla<<I,ZipCOClll 6347 Stephens Crossing, Mechanicsburg PA 1705 PLACEOF SPOSITION-N.....", l.ClC.fJ1ON. .ZIpeo. <<01,*,....,. ./ 2002 Yorktowne crematory York PA .. o -.- Carlisle 8 Alliance Drive OENT.S PA:l"IOJf ~~=:.,~~ Secrete Court House QECa)ENT.S hIAIUHCl AOORESSlSlr.-. Ctyfr-,. SIlU. Z1pQ:llJl) PECEOEHt.S "".... """,,,.,, - 0IIl"'~ KINOF8USI/lIESSIINOIJ$TRY I,c:::r"'l r.wlf'11<LSWl,lS.MatrItd Htoer~~. ......- Divorced '"""""'" (f....."~ 249 S. Hanover St. carlisle PA 17013 17a.&- :::::~'?:) ". toIUMBE "'" , -,.,.., ,,-"-,ffom&.l40 OERH prx. 10:00 P. ., %I.MIITI: ~u.___lrljurIMIor~__IM-'DoIlCll_IM_oIc:1'1lt1l1.""'''_OI''''Ulf)'''I1IIl..-.ckor~NIt''''''''. "'Od1__on__. P OEAO\~.~.~ September 23, 2002 o SONACTINGASSUCH . Ch anie Obstructive Pulmonar ~1C\op'~"CONSEQlENCtOFj: Disease !==-. !__dut~ EDm:JqALEXAMIHEA/COAON M60 F\UlT1I:0t'*.-~~,", noll....nlng"'....-'YInlI_ghoHln w , ,. 0UE1O\op'ASACONSEOUENCt:0F): DllElO(OAI>S4CONSEOUENCEOF): ...0 ..0 ...... ..... ~ o o - -'- DREOI'INJUF!Y {MOnIh.CMy."""" o o O Pl.ACEOFINJl/RY-AlllclrM.""""_.~.aIb lluIIlInlI.eIC.~ -, TIMEOI'INJUAY DESCl'lIlleHONINJURYOCCUflREO. PIE I'lNOlNO& ........."""'''' COMPL.ETION OF CAUSE "''''''''' MANNER OF 0fRH - ... CU1lFIIER(OllICIcanly~ "UJIlT1'YlNCI1'tfYSICIAN~~_oI~""''''''''~''fJfOIIOU''I*l'''''''_~bm23l ......."'...,............---.............-..-.,..................................... ...- .. CouIclnot~~ ,nc. 0 INCIMJANDCUI'TlI'TINOHl'l'SICIANlI'hY*iInllallllf(lnllUl"Clnoa..fl-.d~IO_oId-.tll ........"'..,............--..............-,...................,----.--..................,...... Caron ORESIG (McINh. 'lMI) o "e. Se tember 2 . N4MEN<<I4OOFlE8$OF VYttOCOMPLnEDC4USlEQlFOUIM (Ilem27)iypeorPrlnl Michael L. Norris, Carone 6375 Basehore Road, Suite Mechan1csburg, Pa. 17050 2002 '1I!DICAL EXA....UVCOftONIER OntMbe-"ot..8IIIlnMIon1llCll_1IwwtIrpllon.1n m,.CIflInklIl.dHlhDllCl.lfnd .tthellrae.dtlt., ...~,1Md .....lOlh.e...-{.I..-d __..stsleCf................................................."........................,...................... ... AE_f1WIrS8lGlWUP.E ." ~.~~ L:l! 1'-'lJ 1,01 1 .., a.OO~ :lJ - 02.-9"'3 LAST lULL AnD TESTAMENT OF BERNICE 1. DUKE I, Bernice I. Duke, of Cumberland County, Pennsylvania, being 0 sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last vJill. ;md Testament, here revoking any and all prior Wills and any and all Codicils thereto, by me at anytime heretofore made. ITEM I: I direct that the expenses of my last illness and funeral shall be paid from my estate as an administrative expense. Further, in this connection, I authorize my personal representa ~ L , ~ j; p,..E- vr1"iD :7!~~~'~ ~~.~ ;1\ tive to expend funds from my estate in such amount as my personal representative shall consider necessary and desirable for the purcha erection and inscription of a suitable marker for my grave." /e -, , It is my desire that there be no viewing of my remains nor serv e at my funeral. ITEM II: I give, devise and bequeath the sum of One Hundred ($100) Dolla unto Garrison Memorial Cemetery of Berwick, Pennsylvania, in memory of Clarence and Minerva Bower. ITEM III: I give, devise and bequeath the sum of One Hundred ($100) Dolla . ---/J _- r -~,~ ,^,~ Page One of Five Pages Bern1.ce I. Du e unto Eaton Cemetery of Dallas, R.D. #3, Luzerne County, Pennsylvania in memory of Thomas and Mary Price. ITEM IV: I give, devise and bequeath all the rest, residue and remainder of my estate, whether real, personal or mixed, and of any nature wha - soever and wherever situated unto my beloved brother, Benjamin C. Duke, Jr., provided that he is living on the thirtieth (30th) dayaf r the date of my death. ITEM V: In the event my beloved brother does not survive, or does not survive me by said period of thirty (30) days, I then give, devise and bequeath all the rest, residue and remainder of my estate unto June Duke of Tokyo, Japan, IN TRUST, however, to act as Trustee upon the following terms and conditions: A. To pay the income and so much of the principal as may, in the sole discretion of my Trustee be necessary for the general welfare, maintenance, support, medical expenses, and education of Noriko Susan Duke, Kimiko Ann Duke and Christopher Kenji Duke. R. The payments authorized by Subparagraph A. above shall be made without any regard to equality of distribution to the said children. The amount to be paid for the benefit of any of the said children shall be determined from time to time by the need of each of the said children, and the amounts and times of said payments sha I be determined by such needs. Said payaments may be made by my said Page Two of Five Pages ~A'~ Bern~ce I. Du e Trustee directly to the said children, or to such of them as may be, in the sole opinion of my Trustee, of such age and ability to handle properly the funds so paid to such child, or may be made by my said Trustee directly to the person having the custody and care of any of the said children, or may be made by my said Trustee directly to any institution entitled to such payment by reason of services rendered or to be rendered to any of the said children. In making the afore- said payments, my said Trustee shall give primary consideration to t individual sources of income available to each such child, and the individual needs of each of the children shall override any consider tion as to any equality of distribution for the purposes mentioned i this subparagraph. C. To pay the accumulated income and principal then remain ing in its hands to the said children, share and share alike, upon each child's attaining the age of twenty-one (21) years. ITEH VI: No interest of any beneficiary under this Will or any Codicil hereto shall be subject to anticipation or voluntary or involuntary alienation. ITEM VII: In addition to the powers conferred by law, I authorize my Executor and/or Trustee in his or her absolute discretion: A. To retain in the form received, and to sell either at public or private sale, any real or personal property; Page Three of Five Pages ,~~ B. To manage real estate; C. To invest and reinvest in all forms of property without being confined to legal investments, and without regard to the prin- cipal of diversification; D. To exercise any option or rights arising from owner- ship of investments; E. To compromise claims without Court approval, and without the consent of any beneficiary; F. To distribute in cash or kind or both at such valuations as he or she may fix. ITEM VIII: I direct that any and all inheritance, estate and transfer taxes imposed upon my estate passing under my Will or otherwise, shall be paid out of the principal of my residuary estate. ITEM IX: No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. ITEM X: I appoint ~ichard A. Jameson, Executor of this Will. If Richar A. Jameson does not act or continue to act, I appoint Benjamin C. Duke, Jr., Executor in his place with the same Dowers and duties. IN WITNESS ~rnEREOF, I set my hand and seal to this my Last Will and Testament consisting of this and four (4) other pages at the end Page Four of Five Pages .~"^.. Bern~ce I. Du e of which I have also set my hand and affixed my seal for greater security and better identification this f)~ day of ~ ,19 5. Page Five of Five Pages j,~ We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above named Testatrix as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year above written, and we certify that at the time of execution thereof, said Testatrix was of sound and disposing mind and memory. RESIDING AT COMMONWEALTH OF PENNSYLVANIA: :55. COUNTY OF DAUPHIN I, Bernice I. Duke, Testatrix, whose name is signed to the attached instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn to and acknowledge~~;fJre we by Bernice T. Duke, the Tes tatrix, this IJ.'"' day of ~ ' 1985. 4~ J.~~ Bern~ce I. Duke (SEAL) 1~~OT{?f:1t-~ DIANE L. HUIlElt, Notary PublIC H.rri,burg, Dauphin Co.,'" My Cerro",iisi.n ExpirO$ Sept. 27, 1986 COMMONWEALTH OF PENNSYLVANIA: :55. COUNTY OF DAUPHIN We, 3Q.AA m. TAmol-l5 and 6JPtlI/I'fJ -r: Cuh6 , th witnesses whose names are signed to the attached instrument, being duly qualified according to law, do depose and say that we were pres t and saw Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix si~led the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time eighteen (18) years of age, of sound mind and under no constraint or undue influence. swo~to and day of 'J/;) subscribed before me by the witnesses, this , 1985. /J'tfJ (SEAL) DIANE L. HUBLER. Notary Public Harrisburg, Dauphin (0., PI. My Ccmmi;>$ion ExfJires Sept. 27, 1986 21-02-QY3 RICHARD A. JAMESON & ASSOCIATES A PROFESSIONAL CORPORATION ATTORNEVSATLAW 500 L STREET, SUITE S02 ANCHORAGE, ALASKA 99561 TELEPHONE (901) 272.9377 FAX (997) 272-9319 OF COUNSEL LEVIN, FISHBEIN, SEDRAN ERMAN 510 WALNUT STREET, SUI 500 PHILADELPHIA, PA 19 (215) 592-1500 : i, '\ FAX (215) 592-4663 li October 15, 2002 Register of Wills Cumberland County 1 Courthouse Square Carlisle, PA 17013 RE: Estate of Bernice Duke Gentlemen: Kindly be advised that I hereby renounce my appointment as Executor in the Last Will and Testament of Bernice Duke. It is my understanding that Benjamin C. Duke, Jr., who is Bernice Duke's brother will take over the administration of the estate. If you need anything further from me in this regard, please advise me accordingly. 7lJicl Richard A. Ja es n COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA INHERITANCE AND ESTAT OFFICIAL RECEIPT RECEIVED FROM: DUKE BENJAMIN C JR 6347 STEPHENS CROSSING MECHANICS BURG, PA 17050 _u_n~_ fold ESTATE INFORMATION: SSN: 169-14-6073 FILE NUMBER: 2102-0943 DECEDENT NAME: DUKE BERNICE I DATE OF PAYMENT: 12/16/2002 POSTMARK DATE: 12/13/2002 COUNTY: CUMBERLAND DATE OF DEATH: 09/21/2002 TOTAL AMOUNT REMARKS: DR BENJAMIN C DUKE JR CHECK# 1485 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS REV-1 162 EX(11-96) E TAX NO. CD 001957 ACN SSESSMENT AMOUNT CONTROL NUMBER --- -- 101 I $10,000.00 I I I I I I I I PAID: $10,000.00 DONNA M. OTTO DEPUTY REGISTER OF WillS A r;) -0\ '__c. t ~ ~~ J, r-. . "- ':;r- ,,' ~~~~, ~ ~ ~ ~. ~ <;:::---~~ ~~- -> = "'- "'" i\ ~ ':\ o .... i,} -\' ,~ ~'l t:, ',' - ::- ~ ::- ~ :.:::. ~ - ::- ~ ;::. ~ ~ ;::. ::- ::- ~ ~ ::- ::- - """ '- '" "-- :s .::1 -:s '" ""'- ~ ~$'i2 'l>3~ . "-\'0, "~? Q \ o~ >1lq .. 'tj,. ~1 s '" ~ '\--;. ~~ ~ ~ "-- ~. ~ ~ ') ~ ';--... """' .....s ~ ~ "4 1, I. ~ ~ I',":::'C) l.c .;:) \\l....,\;y ~--- , v> CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: (" T v Will No. c;-J/- {J d d- () 0 'd - () 0 0/ ljJ Admin. No. Date of Death: To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of served on or mailed to the following beneficiaries of the above-captioned estate on s Name Address C:~. I .-) d ~. (l, ')j C1 it & n '/~C'hICj.lA r C Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: I- J 1-()] (It Signature Name Hrf] t Address C] I( '7 !7rt/'C' h l:.r -fl{ J- "J ~ /1 --.Ji Telephone ( "7/'7 '79t 777J Capacity: _ Personal Representative _Counsel for personal representative BENJAMIN C DUKE 6347 STEPHENS CROSSING MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER .CfilUNTY .SSN,DC ACN 03-31-2003 DUKE 09-21-2002 21 02-0943 CUMBERLAND 169-14-6073 03103324 AllDUnt Relli ttlOd F} - 96-= /,2/ " BUREAU OF INDIVIOUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF IlIHERITANCE TAX APPRAISEllEHT t.LLOHt.HCE OR DISt.LLOHt.NCE OF DEDUCTION~, t.ND t.SSESSftENT OF Tt.X ON JOINTLY HELD OR TRUST t.SSETS MAKE CHECK PAYABLE AND REMIT PAYMENT 0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-Y=is4-i-EiC-AFii-roi-=03i----------------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 03-31-2003 ESTATE OF DUKE BERNICE I DATE OF DEATH 09-21-2002 COUNTY CUMBERL D FILE NO. 21 02-0943 TAX RETURN WAS: S.S/D.C. NO. 169-14-6073 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 03103 24 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 33432-11 TYPE OF ACCOUNT: () SAVINGS (lO CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 07-05-1997 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 3,523.86 0.500 1,761.93 .00 1,761.93 .12 211 . 43 NOTE: TO INSURE PROPER CREDIT YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NO CE WITH YOUR TAX PAYMENT TO HE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CH K OR MONEY ORDER PAYABLE T "REGISTER OF WILLS, AGEN " TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID PAYMENT MUST BE MADE BY 06-22-2003*. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI, YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORB FOR INSTRUCTIONS. I 211. 211. BUREAU Of INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8D6Dl HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEftENT~ ALLOWANCE OR DISALLOWANCE OF DEDUCTION" .~NO ASSESSNENT OF TAX DN JOINTLY H~LD OR TRUST ASSETS REV.UU U IF U-Ul BENJAMIN C DUKE 6347 STEPHENS CROSSING MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER . COUNTY SsN/DC ACN 03-31-2003 DUKE 09-21-2002 21 02-0943 CUMBERLAND 169-14-6073 03103323 A_a...,t R...t tted BERNIC I I .,'\ MAKE CHECK PAYABLE AND REMIT PAYMENT 0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE;;=is4ii-Erx--AFP--foi-=03i----------------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 03-31-2003 ESTATE OF DUKE BERNICE I DATE OF DEATH 09-21-2002 COUNTY CUMBER LA D FILE NO. 21 02-0943 TAX RETURN WAS: S.S/D.C. NO. 169-14-6073 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 03103 3 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 33432-05 TYPE OF ACCOUNT: (Xl SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 07-05-1997 Account Balance Percent Texable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 41,564.51 0.500 20,782.26 .00 20,782.26 .12 2,493.87 NOTE: TO INSURE PROPER CREDIT VOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NO CE WITH VOUR TAX PAVMENT TO HE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CH K OR MONEV ORDER PAVABLE T "REGISTER OF WILLS, AGEN " TAX CREDITS: PAVMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID PAVMENT MUST BE MADE BV 06-22-2003*. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . If PAID AfTER THIS DATE, SEE REVERSE fOR CALCULATION Of ADDITIONAL INTEREST. . ( If TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. If TOTAL DUE IS REfLECTED AS A "CREDIT" ( CRI, YOU HAY BE DUE A REfUND. SEE REVERSE SIDE Of THIS fORH fOR INSTRUCTIONS. I .0 2,493.8 .0 2,493.8 \ I?- f'6=-/.:J/ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 171Za.06Dl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX JOHN R SROGONCIK DEVANEY II CD 222 S MARKET ST ELIZABETHTOWN '03 AGO-4 DATE ESTATE OF DATE OF DEATH FILE NUMBER P 2 :(;OCOUNTY ACN 07-28-2003 DUKE 09-21-2002 21 02-0943 CUMBERLAND 101 AlIOunt R..itted 202 l.,c' PA 170~lIr,t,,; IEV~lSl(l El if 1).-lSl BERNIC I MAKE CHECK PAYABLE AND REMIT PAYMENT 0: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... RE-,;=is4-iTCAFP-niFoiT"NoTIci--oF-YNHiifITANcE-TAitA'PPRA'Isiii"ENT.--AL.'i.-owANcE-oi----------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DUKE BERNICE I FILE NO. 21 02-0943 ACN 101 DATE 07-28 003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Rael Est.t. (Schedule A) 2. stocks end Bonds (Schedule BJ 3. Closely Held Stock/Partnership Interest (Schedule CJ 4. Hortgages/NotBs Receivable (Schedule OJ 5. c.shIBank Deposits/Hisc. Personal Property (Schedule E) 6. ..Jointly Owned Property (Schedule f) 7. Transf....s (Schedule G) 8. Tot.l Assets 11) (2) (3) (4) IS) (6) (7l .00 .00 .00 .00 45.526.93 22.544.19 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Acm. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgege Liabi1iti.s/Li.ns (Schedu1. I) 11. Total Deductions 12. Net Value of Tax Return 13. Ch.rltabl./80Yer~ental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Est.t. Subject to Tax (9) 110) 962.00 .00 (11) 112) 1l3) 114) NOTE; To Insur credit to your sub"it the of this for. '" tax pay...,t. proper ccount, portion h your 68,071.12 67,109 12 100 0 67,009 2 NOTE: I~ an assessment was issued previOUSly. lines 14, 15 and/or 16. 17. 18 and 19 ill rll'flect: ~i9ures that include the total 01' aY.. returns assessed to date. ASSESSMENT OF TAX: IS. AIIOunt of Une 14 at Spousal rat. IlS) . 00 X 00 = 0 16. Aeount of Lin. 14 taxable .t Li....I/CI.ss A rate 1l6) .00 X 045 = 0 17. Anount of Line 14 .t Sibling rete 117l 67,009.12 X 12 = 8,041 9 18. AlIOunt of Line 14 taxable at Collateral/Class 8 rat. (18) .00 )( 15 = 0 19. Princip.l T.x Due 119)= 8,041 9 T D + AIIOUNT PAID 10,000.00 DATE 12-13-2002 _BER C0001957 INTEREST/PEN PAID (-) 402.05 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 10,402.0 2,360.9 R .0 2,360.9 R I IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIP' ICR), YOU HAY DUE A REFUND. SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIO ~ 1 RE'I-1~OE)(6"()()) w ~ ",$Vl u"'''' Wo.U ",00 u"'~ a."' a. <( 7 (.,.,~ /'7 . ... - " I - /J - COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-<)601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER II ~I -lllt. -- - COLMY CODE YEAR --5-!Ll rulBE.1:l: I- Z W o w () w o DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITLilL) DUKE, BERNICE I. DAlE OF DEATH (MM-DD.YEAR) DAlE OF BIRTH (MM-DD.YEAR) SOCLilL SECURITY NUMBER 169-14-6073 THIS RETURN MUST BE FILED IN DUPUCAlE W1lH lHE REGISTER OF WILLS SOCIAL SECURITY NUMBER N/A 3. Remainder Retum (dateofdeahplIOfto 12-13-82) 5. Federal Estate Tax Retum Req~red ---2 8. Talal Number of Safe DepOSit Boxes 11. Election to tax uooer Sec. 9113(AIiAll.",,,,,OJ THIS SECTION MUST BE COMPlETED. AlLCORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ~ z w Cl Z o a. Vl w '" '" o u NAME . JOHN R. SROGONCIK FIRM NAME ~If Appilcablel DEVANEY & CO., P.C. lELEPHONE NUMBER 1-800-823-3432 COMPLET.E MAILING ADDRESS 222 S. MARKET STREET SUITE 202 ELIZABETHTOWN, "CPA 17022 ;. 8 " ?'~ t:;" j."'~ ,.H. ~FICIALtJ$E ONLY ~- 09-?1-2002 10-06-1922 (IF APPLICABLE) SURVIVING spouses NAME (LAST, FIRST, AND MIDDLE iNITIAL) N/A X 1.0n9inatRelum 2. Supplemental Retum 4. limited Estate X 6. Deceden1DiedTestate(AllacllcopyofW~ 9. Utigation Proceeds Received 4a. Future Interest Compromise (dae of death after 12-12-82) 7. Decedent Maintained a livil\l Trust (Atlachcopy ofTfI5t) 10. Spoosal Poverty Credij (date of death beIw1!en 12-31-91 atIlt-1-9S) c-- ~3 ~ (4) (5) 45,526.93 f-,.j N z o ~ :::l l- ii: <I: () w a:: (6) 22,544.19 .0_ (15) 0_ (16) 67,009.12 .12 (17) 8,041.09 .15 (18) (19) 8,041.09 (7) 4. Mortgages & Nales Receivable (Schedule 0) 5. Cash. Bank Deposits & MiscellaleWS Personal Property (Schedule E) 6. JOlf1tlyOwned Property (ScheduleF) SepCl'ate Billing Requested 7. Inter-Vivos Transfers & Miscell3leOUS Non-Probate Property (Schedule G or L) 8. Total Grass Assets (Iatal Lines 1- 7) 9. Funeral Expenses & Administrative Casts (Schedlle H) 10. Debts of Decedent, Mortgage Uabiities, & Liens (Schedlle I) 11. Total Deductions (talal Unes 9 & 10) (9) (to) 1. Real Estate (Schedule A) 2. Slacks and Bonds (Sched~e B) (1) (2) (8) 962.00 68,071.12 3. Closely H~d Corporation, Partnership or Sole-Prapnelarship (3) 12. Net Value of Estate (Line 8 minus Une 11) 13. Chantable and Governmental Bequests/See 9113 Trusts far \\l1ich <II ~ectian to tax has no! been made (Scl1edule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS FOR APPUCABLE RAlES z o !;( I- :::l 0.. :::!i! o () >< ~ 15. Amount of Line 14 taxable al the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Une 14 taxable at lineal rale 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at coilcieral rate (11) (12) (13) 962.00 67,109.12 100.00 (14) 67,009.12 19. Tax Due 20. :< I CHECK HERE IFYOU ARE REQUESTING A REFUND OF AN OVERPAYMENT I > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < STFPA42021F ~ Decedent's Complete Address: STREET ADDRESS C HA PEL POINT, 8 ALLIANCE DRIVE APARTMENT 203 CITY CARLISLE I STATE PA I ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credn B. Prior Payments C. Discount (1) 8,041. 09 10,000.00 Total Credns (A B C) (2) 10,000.00 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty (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) 1,958.91 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 5A. This is the BALANCE DUE, (5B) Make Check Payable to: REGISTER OF ~LLS, AGENT 0.00 PLEASE ANSINER TliE FOLLO'MNG QUESTIONS BY PLACING AN "X" IN TliE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property tr>l1sferred; .................................... b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . c. retain a reversioncry interest; or . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promse for life of either payments, benelits 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 fo!' or payable upon death bank account or security at his or her death? . 4. Did decedent own an Incividual Retirement Account, annuity, or other non-probate property which contains a beneliciary designation? . . . . . . . . . ....... . . . . . . . . . . . . . . . . . . . . . . . . . . . . X IF THE ANSWER TO NIY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT /lS PART OF THE RETURN, Under penalties of perj1JY, I declc:re that I have excrnined this return, including ac:canpanying sd1edules and statements, and 10 the best of my knowledge and belief, it is true, correct and complete. Declntion of prepa'er othertha1the anal rep alive is based on aU information of whidl prepa-er has any kncmledge. SIGNATU PERS S ONSIB FOR FILING RETURN I "--L- Yes No X X X X X X DATE .rJ3 ADDRE S 6347 STEPHEN'S CROSSING, MECHANICSBURG, PA SIGNATU 0 PREPARER OTHER THAN REPRESENTATIVE :. " C~A 17050 DlIT~ G. ~(t3 MARKET STREET, STE. 202, ELIZABETHTOWN, PA 17022 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to orforthe use ofthe survivirrg spouse is 3% [72 PS. S9118 (a) (1.1)(i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use ofthe suniving spouse is 0% [72 P.S. S9116 (a) (1.1) ~i)]. The statute does not exempt a transfer to a sunivirrg spouse from tax and the statutory reqLirements for disclosure of assets and filing a tax return are still applicable even if the suniving spouse is the only beneliciary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value 01 transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. s9116(a)(1.2)). The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneliciaries is 4.5%, except as noted in 72 P.S. S9116(1.2) [72 P.S. s9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. s9116(a)(1.3)]. A sibling is defined, under Section 9102, as an inclvidual who has at least one parent in common with the decedent, whether by blood or adoption. STFPA42021F2 REV.1502 EX... (1-97) (I) COMMONv..AlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESlDENT DECEDENT SCHEDULE A REAL ESTATE ESTATEQF FILE NUMBER DUKE, BERNICE T 2102-0943 At, re;D propertY owned solely or as a tenant in common must be reporred at fair market value. Fair m<Jic:et value is defined as the price a: >M1id1 property waJld be exchanged bE!ween a wlllirlg ouyer and a willing seller. neither bemg compelled to buy or Sell, bOih having reasonaole knowledge at the relevn f<lis. ReaJ property \\ftich is jointfy-owned with right of surviV0f5lUp must be disclosed on Sd\edule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. NONE TOTAL (Also enter on line 1. Recapitulationl S (If more spa:e IS needed. Insert add~ion;j sheets 01 the same sIze) STFPA42021F 3 REV-1S03 EX + (1-97) (I) COMMON't,fALTH OF PENNSYlVAN~ INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF DUKE, BERNICE I. FILE NUMBER 2102-0943 All property jointly..owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. NONE VALUE AT DATE OF DEATH TOTAL (Also enter on line 2. Recapitulation) S (If more space IS nooded. insert add.iona sheets of the same sIZe) STfPA42021F4 REV-1504 EX + (1-97) (I) COMMONllfAlTH OF PENNSYlVAN~ INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARlNERSHIP or SOLE.PROPRlETORSHIP ESTATE OF DUKE, BERNICE I. FILE NUMBER 2102-0943 Schedule C-1 or C-2 (Including all suppating infCllTfl3ion) must be attached fer eacl1 closely-held c:orpa;DJwpcrlllffShip int8'"est of the decedent, other than a sole-proprietorship. See instructions for the supporting informatioo to be submitted for SQIe-pro~:lIietorships. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NONE TOTAL (Also enter on line 3. Recapitulation) S Ilf more space is needed. Insert add.ion~ sheets of the sarne sIZe) STFPA42021F 5 REV-1505 EX + (1-97) (I) COMMON'v\EALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT CECEDENT SCHEDULE C-1 CLOSELY-HELD CORPORATE STOCK INFORMATION REPORT ESTATE OF DUKE, BEFNICE I. FILE NUMBER 2102-0943 1. Name of Corporation N / A Address City 2. Fed",a1 Employ'" I.D. Numb", 3. Type of Business State of Incof1loraion Date of Incorporaion Total Numb", of Shareholders Business Reporting Year State Zip Code Pro<lJctlSe<vite 4. I STOCK TYPE TOTAL NUMBER OF NUMBER OF SHARES VALUE OFTHE Voting I Non-Voting SHARES OUTSTANDING PAR VALUE OWNED BY THE DECEDENT DECEDENT'S STOCK Common S - Preferred S Pro~de all rights and restrictions pertaining to each class of stock. 5. Was the decedent employed by the Corporation? If yes, Position 6. Was the Corporation indebted to the decedent? If yes, provide amount of indebtedness $ ? Was th",e life insurance payable to the corporation upon the dealh of the decedent? Yes No An",a1 Salary $ lime Devoted to Business Yes No Yes No If yes, Cash Sunender Value S Net proceeds payable S Own", of the policy 8. Did the decedent sellar transfer stock of this company within one year plior to dealh or within two years if the date of death was priorto 12-31-82? Yes No If yes, Transfer Sale Number of Shares Transferee or Purchaser Attach a sepa'ate sheet for addiiona t""sfers and/or saes. Consideration $ Date 9. Was there a written shareholder's agreement in eff1!ct at the time of the decedent's dealh? If yes, pro~de a copy of the agreement. 10. Was thedecedenl's stock sold? Yes No If yes, pro~de a copy of the agreement of sale, etc. 11. Was the corporation dissolved or liqLidated after the decedent's dealh? Yes No Yes No If yes, provide a breakdown of distributions rece;ved by the estate, including dates and ,,"ounts rece;ved. 12. Did the corporation have an interest in other corporations or partnerships? Yes No If yes, report the necessary information on a separate sheet, including a Sched..e C-l or C-2 for each interest. THE FOllOWING INFORMATION MUST BE SUBMITTED WITH THS SCHEDULE A. Detailed calculallons used in the valuation of the decedent's stock. B. Complete copies of financial statements or Federal Corporate Income Tax retums (Form 1120) for the year of death and 4 preceding years. C. If the corporaion owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been secured, attach copies. D. List of prinCIpal stockholders at the date of death, number of shares held and their relationship 10 the decedent. E. List of officers. their salaries. bonuses and any other benents received lrom the corporation. F Statement of diVidends pad each year. List those deeared and unpaid. G. Any o\\1er intormation relating to Ihe valuation of the decedent's stock. STFPA42021F6 REV-1506 EX + (1-97) (I) CQMMON\f'.fAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C-2 PARTNERSHIP INFORMATION REPORT ESTATE OF DUKE, BERNICE I. FILE NUMBER 2102-0943 1. Name of Partnership N / A Address City 2. Federal Employer 1.0. Number 3. Type of Bu~ness Date Bu~ness Commenced Bu~ness Reporong Year State Zip Code 4. Decedent was a General Product!Ser;;ce Lim~ed partner. If decedent was a limited partner, provide initial in"",tment $ 5. PERCENT OF PERCENT OF BALANCE OF PARTNER NAME INCOME OWNERSHIP CAPITAL ACCOUNT A. . - B. C. D. 6. Value of the decedent's interest $ 7. Was the Partnership indebted to Ihe decedent? Yes No If yes, provide amount of indebledness $ 8. Was Ihere life insurance payable 10 Ihe partnership upon Ihe death of the decedent? Yes No II yes, Cash Sunender Value $ Owner ollhe policy 9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years iflhe date of death was prior to 12.31-82? Yes No If yes, Transfer Sale Percentage transferred/sold Net proceeds payable $ Transferee or Purchaser Con~deraion $ AttacI1 a sepRe sheet for add~ooaI t"'-;njJor sales. Date 1 O. Was there a written partnership agreemenl in effect at the time ollhe decedent's death? Yes II yes, pro'oide a copy 01 the agreement. 11. Was the decedent's partnership interest sold? No Yes No Ilyes, proudea copy of the agreement 01 sale, etc. 12. Was Ihe partnership dissolved or liquidated after the decedent's death? Yes No If yes, prolide a breakdown of distributions received by the estate, including daes and amounts received. 13. Was the decedent reiated to any of the partners? Yes No If yes, explain Yes No t4. Did the partnership have an interest in other corporations or partnerships? If yes, report Ihe necessary information on a separate sheet, Including a Schedule C-t or C-2 for each interest. THE FOLLOWING INFORMATION MUST BE SUBMITTED W1lH THS SCHEDULE A. Detailed calculations used in the valuation of the decedent's partnership interes\. B. Complete cOples of financial statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding years. C. if the partnership owned real estate. submit a list showing the compiete address/es and esflmaled fair market value/s. If real estate appn;isals have been securoo, attach copies. D. Any other Informahon relating 10 the valuation ot Ihe decedent's partnership Interest. STFPA42Q21F~ REV-1507 EX -I" (1-97) (I) COMMON~lT1l OF PENNSYlVANIA INHERITANCE TAX RETURN RES1DENT DE.CEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF DUKE, BERNICE 1. FILE HUMBER 2102-0943 All property jointJy-owned with the rigllt of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. NONE VALUE AT DATE OF DEATH TOTAL (Also enter on line 4. Recapitulation) $ (If more space IS needed. Insert addrtiona sheets of the same size, SiF PA42021F8 REV-1508 EX + (1-97) (I) COMMON\'.EAlTH OF PENNS'/lVANl< INHERITANCE TAX RETURN RE$lDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF DUKE, BERNICE I. FILE NUMBER 2102-0943 Include the proceeds of litigation and the date the proceeds were received by the estate. All property joindy-owned withthe right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. RETIREMENT APT. ENTRANCE FEE REFUNDABLE 42,750.00 2. CUMBERLAND CTY. EMP. RET. CUST. 569.93 3. VEHICLE - 95 BUICK CENTURY 2,000.00 4. VEHICLE INSURANCE REFUND 207.00 TOTAL (Also ""tar on line 5. RecapHulation) S (If more space IS needed. ,nsef1 addrtiona sheets ofthe same size, 45,526.93 STFPA42021F 9 REV-1509 EX + (1-97) (I) COMMON\'\EALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF DUKE, BERNICE I. FILE NUMBER 2102-0943 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. BENJAMIN C. DUKE 6347 STEPHEN'S CROSSING MECHANICSBURG, PA 17050 BROTHER B. BENJAMIN C. DUKE 6347 STEPHEN'S CROSSING MECHANICSBURG, PA 17050 BROTHER c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPT!ON OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE IrcWe rame of firartial institlJionan:l bark accolllt runberorsiniiar identityi~ runber. DATE OF DEATH DECOS VALUE OF NUMBER TENANT JOINT Attach deed forjoiritf.f1eld real estate VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 1995 MEMBERS 1ST FCU 3,523.86 50 1,761.93 A/C NO. 33432-11 2 . B. 1995 MEMBERS 1ST FCU 41,564.51 50 20,782.26 A/C NO. 33432-05 TOTAL (Also enter on line 6. Recapitulation) S ~~ 544. l 9 ~~ (If more space is needed. 'nsert addniona sheets of the same sIZe) STFPA42021F 10 REV-1510 EX + (1-97) (I) COMMON\'\EALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT a:CEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF DUKE, BERNICE I. FILE NUMBER 2102-0943 This schedule must be completed a1d filed if the answer 10 alY of questioos 1 through 4 on the reverse side of the REV-15CO COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF rrEM IIICl.lllE TIE NAAlE OF T1-E TRANSFEREE. T1-EIR RELAno~P TO DECEDENT iWJ Tt-E DATE DATE OF DEATH DECO'S EXCLUSION TAAABLE VAlUE NUMBER OF TPANSfER AITACH A COPY OF n-e DEED FOR REI>L ESTATE. VAlUE OF ASSET "TEREST OF!~PPUCM3LE1 1. NONE - - TOTAL (Also enter on line 7, Recapitulation! S (If more sp..,. 's neeoed, ,nsert addnional sheets of the same size) STFPA42021F 11 REV~1511 EX + (1-97) (I) COMMON\\EALTH OF PENNSYlVANl<\ INHERITANCE TAX RETURN RES1DENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINIS"lRAllVE COSTS eSTATE OF DUKE, BERNICE I. FILE NUMBER 2102-0943 Debts of docedenl muot be reported on Schedule!. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1- - - B. ADMINISTRATIVE COSTS 1. Personal Representative's Commissims Named P<<sonaI Representative(s) Soclal SecurityNU11ber(s) I EIN NU11ber of Personal Representative(s) Street Address City Slate Zip Year(s) COl11mi~ Paid: 2. Attorney Fees 3. Family Exemptia1: (If decedent's address is not the same as claimant's, attad1 expJalatia1) ClalTlllll StreetAddtess City Slate Zip Relliionship d Clamant to Decedent 4. Probate Fees 147.00 5. _sFees 600.00 6. Tax Re\um Prepll1!!'sFees 7. ADMINISTRATION COSTS 215.00 TOTAL (Also enter on line 9, Recapitulation) $ 962.00 (If more space '5 nee<led, ,nsert addITional sheets of the same size) STFPA42021F 12 REV-1S12 EX + (1-97) (I) COMMON'AEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT CECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABlUTIES, & UENS ESTATE OF DUKE, BERNICE I. FILE NUMBER 2102-0943 Include unreimbursed medical expenses. ITEM NUMBER 1. NONE DESCRIPTION AMOUNT TOTAL (Also enter on line 10. Recapttulation) $ (If more sp:>:e '5 needed. ,nsert add~lon,. sheets of the same size, ST'FPA42021F ,3 REV-1513 EX" (9-00) COMMONIl\EALTH OF PENNSYLVANIA INHERITANCE TAX RE11JRN RESIDENT DECEDENT SCHEDULE J BENEACIARlES ESTATE OF DUKE, BERNICE I NUMBER I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include cutright spousal distnbutions, and tr<J1sfers under Sec. 9116 (a) (1.2)\ BENJAMIN C. DUKE 1. 6347 STEPHEN'S CROSSING MECHANICSBURG, PA 17050 FILE NUMBER 2102-0943 RELATIONSHIP TO DECEDENT Do Not Us! Trustee(s) BROTHER AMOUNT OR SHARE OF ESTATE 100% RESIDUARY ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON.TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE STFPA4:2:021F14 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. GARRISON MEMORIAL CEMETERY BERWICK, PA 100.00 TOTAL OF PART ll- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 130F REV-1500COVER SHEET S (If more space IS needed. Insert add.iona sheets oithe same size) 100.00 REV-1514 EX + (1-97) (I) COMMOll'I\€AlTH OF PENIlS'IlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K UFE ESTATE, ANNUITY & TERM CERTAIN (Check Box 4 on Rev.1500 Cover Sheet) IWXEXI S J JMP I RfQ flV HYOIO FIVRMGI "2 654614=87 This schedule is to be used for all single life, joint or successive life estate and term certain calculations For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. 9 Will 9 Intervivos Deed ofTrust 9 Other UFE ESTATE INTEREST CALCULATION REQI,W-SJ RIEVIWX 8<1 EX XIV Q SJ JIEV W PMJl IW XEXI I'll PMJl XIRERX ,W- HE XI SJ Fl'lVXL HEX! SJ HIEXL TEJEFP I 9 LiEor 9 Term of Years - 9 Life or 9 Term of Years 9 Life or 9 Term of Years 9 Lifeor 9 Term of Years 1. Value of fund from which life estate is payable 2. Actuarial factor per appropriate table Interest table rate - 3 1/2% 9 6% 9 10% 3. Value of life estate (line 1 multiplied by line 2) ANNUITY INTEREST CALCULATION $ 9 Variable Rate % $ RE Q I,W-S J R IE V IW X 8< I EX XIVQ SJ ]IE VW ER RY M(ERX 1101- HE XI SJ Fl'lVXL HE XI SJ HIE X L ERR YMXJ N TEJEFP I 9 Life or 9 Term of Years 9 Lifeor 9 Term of Years 9 Lifeor 9 Term of Years 9 Life or 9 Term of Years 1. Value of fund from which annuity is payable $ 2. Check appropriate block below and enter corresponding (number) Frequency of payout - 9 Weekly (52) 9 Bi-weekly (26) 9 Monthly (12) 9 Quarterly (4) Semi-annually (2) 9 Annually (1) 9 Other ( ) 3. Amount of payout per period $ 4. Aggregate annual payment, Line 2 muftiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate 31/2% 9 6% 9 10% 9 Variable Rate % 6. AdjusbTlent Factor (see instructions) 7. Value of annuity -If using 3 1/2%, 6%, 10%, or if variable rate and period payout is at end of period. calculation is: line 4 x Line 5 x line 6 $ If using variable rate and periOd payout is at beginning of period, calculation is: (line 4 x Line 5 x line 6) + Une 3 $ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on lines 13, 15. 16and 17. (If more space is needed. Insert addrtional sheets of the same size) STfPA42021F 15 REV-1647 EX + (9-00) SCHEDULE M FUTURE INTEREST COMPROMISE COMMON\\fALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT (Che<:k Box 4a on Rev-1500 Cover Sheet) ESTATE OF FILE NUMBER HYOIO FIVRMGI M2 654614=87 This schedule is appropriate only for estates of decedents dying after December 12, 1982. This schedule is to be used for all future interests where the rate of tax whk:h will be applicable when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument which created the future interest and attach a copy to the tax return. Will Trust Other I. Beneficiaries NAME OF BENERCIARY DATE OF BIRTH AGE TO RELATIONSHIP NEAREST BIRTHDAY 1. 2- - 3. 4. 5. IL For decedents dying on or after July 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal Voithin 9 months of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse exercises such withdrawal right. Unlimited right of withdrawal Limited right of withdrawal !II. Expianalion of Compromise Offer: IV. Summary of Compromise Offer: 1. Amount of Future Interest. ............. ... ...... ........ ..... ............. ............... $ 2. Value of Une 1 exempt from tax as amount passing to charities, etc. (also include as part of total shown on Une 13 of Cover Sheet) ...... .. $ 3. Value of Une 1 passing to spouse at appropriate tax rate Check One 6%, 3%, 0% ...... ... ...... ". .... $ (also include as part of total shown on Une 15 of Cover Sheet) 4. Value of Une 1 taxable at lineal rate Check One 9 6%, 4.5% . ...... $ (also include as part of total shown on Une 16 of Cover Sheet) 5. Value of Une 1 Taxable at sibling rate (12%) (also include as part of total srown on Une 17 of Cover Sheet) ........... $ 6. Value of Une 1 Taxable at collaeral rnte {15%) (also include as part of total srown on Une 16 of Cover Sheet) . ." .... S 7. Total value of Future Interest (sum of Unes 2 thru 6 must equal Une 1) . S , ljq sviwtegi !Ill riihihOl1'wiv>ehhrarep Ii ii>w s jJd.. i We'::! i ....i- STfPA42021F.~5 REV-1649 EX oj. (1-97) {I} COMMON\o\€ALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT CECEOENT SCHEDULE 0 ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) ESTATE OF FILE NUMBER HYOIO FIVRMGI M2 654614=87 Do not complete this schedule unlESS the estate is making the election to tal< assets under Section 9113 (A) ofthe Inheritance& Estate Tax Act. If the election app~es to more th.., one trust or similar arralgement, a separate form must be filed for each trust. This election app~es \0 the Trust (marital, residua A, S, By.pass, Unified Credit, etc.). If a trust or similar arrangement meets the requirements of Section 9113 (A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar ammgement is entered in whole orin part as an asset on Schedule 0, then the transferors pefsonal representative may specifically identify the trust (all or a fractional portion or percentage) to be included In /he election to have such trust or similar property treaJed as a taxable transfer in this estate. If less than Ihe entire value of the trust or similar property is included as a ta>mble transfer on Schedule 0, the pelSonal representative shall be considered \0 have made the election orly as to a fraction of the trust or similar arrangement. The numerator of this fraction Is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of Ihe trust or similar arrangement. PART A: Enter the description and value of all interests, both taxable and non.taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113 (A) trust or similar arrangement ~R1PTlON VAlLE Part A Total $ PART B: Enter the description and value of all interests included in Part A for which the Section 9113 (A) election to tax is being made. OESCRlM1OH v.ou..E Part B Total $ (If more space's needed. ,nsert addnlonal sheets of the sarne Size) STFPA42021F17 BENJAMIN C DUKE 6347 STEPHENS CROSSING MECHANICSBURG PA ~1055 , \'\ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER 'p 2 '.J COUNTY =::: - ",.. SSN,IDC ACN ( . '......' I '.....1 C..;.\:, J.. ". \ '.:....,../,JI'" -~~~j~.~~ ~,..;~~, \, 1,,/- P$-- /.2r BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 28D601 HARRISBURG, PA 17128-0601 REVwln4EXAFP( -lIS) '0) 08-20-2003 DUKE 09-21-2002 21 02-0943 CUMBERLAND 169-14-6073 03103323 AllOUlt R...i tted BERNICE I MAKE CHECK PAYABLE AND REMIT PAYMENT REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... ---------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (01-03) __ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 08-20-2003 ESTATE OF DUKE BERNICE I DATE OF DEATH 09-21-2002 COUNTY CUMBE LAND FILE NO. 21 02- 0943 ADJUSTMENT BASED ON: S.S/D.C. NO. 169-14-6073 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 03103 23 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 33432-05 TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 07-05-1997 Account Balance .00 NOTE: TO INSURE PROPER CREDIT TO Y R Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PO ION Amount Subject to Tax .00 OF THIS NOTICE WITH YOUR TAX Debts and Deductions .00 PAYMENT TO THE REGISTER OF W LS Taxable Amount .00 AT THE ADDRESS SHOWN ABOVE. Tax Rate X .12 MAKE CHECK OR MONEY ORDER PA BLE Tax Due .00 TO: "REGISTER OF WILLS, AGE n TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS.) o o o BENJAMIN C DUKE 6347 STEPHENS CROSSING MECHANICS BURG PA 17055 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER " ., \,:i) -2 CQUNTlfq U J . ~I SS'N/DC' ACN BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 IEY-l""EllAFP -OJ) I. f' ,,( 08-20-2003 DUKE 09-21-2002 21 02-0943 CUMBERLAND 169-14-6073 03103324 Amount Relll tted BERNIC I MAKE CHECK PAYABLE AND REMIT PAYMENT 0: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (01-03) __ INHERITANCE TAX'RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 08-20-2003 ESTATE OF DUKE BERNICE I DATE OF DEATH 09-21-2002 COUNTY CUMB LAND FILE NO. 21 02-0943 ADJUSTMENT BASED ON: S.S/D.C. NO. 169-14-6073 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 0310 24 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 33432-11 TYPE OF ACCOUNT: () SAVINGS (X) CHECKING ( ) TRUST () TIME CERTIFICATE DATE ESTABLISHED 07-05-1997 Account Balance .00 NOTE: TO INSURE PROPER CREDIT TO Y UR Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PO TION Amount Subject to Tax .00 OF THIS NOTICE WITH YOUR TAX Debts and Deductions .00 PAYMENT TO THE REGISTER OF W LLS Taxable Amount .00 AT THE ADDRESS SHOWN ABOVE. Tax Rate X .12 MAKE CHECK DR MONEY ORDER PA ABLE Tax Due .00 TO: "REGISTER OF WILLS, AGE T." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYI1ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) o o o REV-1410EX(6-88) '* INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME Duke Bernice FILE NUMBER 2102- 943 REVIEWED BY ACN Emerson Luciano 03103323-03 3324 SCHEDULE ITEM EXPLANATION OF CHANGES NO. The above referenced ACN has been reduced to zero, as this account was reported on the Probate return. aQe 1 /?- 90- " BUREAU OF INDIVIDUAL TAXES IMtERlTANCE UX DI\lISIDN DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE :INHER:ITANCE TAX STATEMENT OF ACCOUNT REY-l'01 EX IF' l~U) '03 DATE ESTATE OF DATE OF DEATH FILE NUMBER !r ~NTY ACN 08-18-2003 DUKE 09-21-2002 21 02-0943 CUMBERLAND 101 AIIO...-.t R..l tted BERNIC I JOHN R SROGONCIK DEVANEY & CO 222 S MARKET ST ELlZABETHTOWN UJI -2 202 <... PA HOn:\ MAKE CHECK PAYABLE AND REMIT PAYMENT 0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper crlKf1t to your account.. subllit the ~"I" portion of this for. with your t.x p t. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ..... iiif.i=i6ifj-EiCAFP--foFii3r-----ii..-iNHERi"ANcrTAiCsTATEit'ENT-oFTccoUiii--.iii--------------- ESTATE OF DUKE BERNICE I FILE NO.21 02-0943 ACN 101 DATE 08-18 003 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE HAftED ESTATE. SHOWN BE IS A SunKARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABL A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT, 07-28-2003 PRINCIPAL TAX DUE, ........_________..._______..........._______....______ 8 0 .09 PAYMENTS (TAX CREDITS), PAYMENT DATE 12-13-2002 07-28-2003 RECEIPT NUMBER ~7 ~ DISCOUNT (+) INTEREST/PEN PAID (-) 402.05 .00 AMOUNT PAID 10,000.00 2,360.96- TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. 8,041. . IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORII FOR INSTRUCTIONS. ) TOTAL DUE Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 8/03/2004 DUKE BENJAMIN C JR 6347 STEPHENS CROSSING MECHANICSBURG, PA 17050 RE: Estate of DUKE BERNICE I File Number: 2002-00943 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within 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 will become delinquent on: 9/21/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Will No.: ~ / - ~:' .~% - (; , '7 ~, Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, ! 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 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 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes [~ No [--] c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this repgrt. ,!7, , / Date: ,~"'--"/~ 'd"'/ Si~ture ,' : (:! / Name(~,.3:.f ::::: o Address · ~ ,~ Telephone No. ~z ::'?r:~ .:; ~. Capacity: [--] Personal Representative ' r.~ ~ [--] Counsel for personal representative