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Home My WebLink About02-0794COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA IN RE: HARVEY E. HANSON, An alleged incapacitated person ORPHANS COURT DIVISION No. 21-o2--1qy On the Petition of SELECT SPECIALTY HOSPITAL, CAMP HILL PRELIMINAR~OR~F.B_OF COURT AND NOW, this ~ day of ~~1 \ , 2002, the foregoing Petition having been prese ted in open Co upon consideration thereof and on motion of Christopher S. Lucas, Counsel for the Petitioner, it is ORDERED and DECREED that a Citation be awarded, directed to HARVEY E. HANSON to show cause why he/she should not be adjudged an incapacitated person and a guardian be appointed, returnable ~ 5'``day of ~, 2002, at / ~ 30 o'clock,~v1, prevailing time. The time and place of hearing on the petition for appointment of a guardian of the alleged incapacitated person aze fixed for ,~s''`day of yxlc~y , 2001, at / ~ 3,) o'clock, ~,M, prevailing time, in the Orphans' Court Division, CUMBERLAND County Courthouse, Carlisle, Pennsylvania. At least twenty days, written notice of the hearing shall be given to HARVEY E. HANSON, by serving him/her personally with the Citation and this Order of Court and a copy of the foregoing Petition together with an explanation of the content and terms of the petition and at least ~D days written notice of the petition and hearing shall also be given to the next of kin and to the following parties in interest: either personally or by registered or certified mail. BY THE COURT: ~~a, COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA IN RE: HARVEY E. HANSON, An alleged incapacitated person ORPHANS COURT DIVISION No. On the Petition of SELECT SPECIALTY HOSPITAL, CAMP HILL PETITION TO ADJUDICATE INCAPACITATED AND APPOINT A PLENARY GUARDIAN OF THE PERSON AND THE ESTATE AND NOW, comes SELECT SPECIALTY HOSPITAL, CAMP HILL, by and through its attorneys in this matter, and requests the appointment of a plenary guardian of the person and the estate of HARVEY E. HANSON. 1. HARVEY E. HANSON is an 85 year old accident victim who has suffered extensive injuries and is currently unresponsive to commands and is ventilator dependent. 2. HARVEY E. HANSON is currently being treated at SELECT SPECIALITY HOSPITAL, CAMP HILL at, 503 N. 219` Street, Camp Hill, PA 17011, formerly of 40 Falcon Court Mechanicsburg, PA 17055. 3. HARVEY E. HANSON was bom on December 22, 1916 and is 85 years old. 4. HARVEY E. HANSON was married three times and divorced three times and is not currently married. One ex-wife is known to the Petitioner, one Margaret Griffin 717.796.2281. However, Margaret Griffin is leaving the azea to relocate to Arizona. 5. HARVEY E. HANSON has no known assets. 6. HARVEY E. HANSON'S has serious brain damage. 7. HARVEY E. HANSON was admitted to SELECT SPECIALTY HOSPITAL, CAMP HILL on August 14, 2002. 8. Currently HARVEY E. HANSON is completely non-responsive to commands and his prognosis for recovery is very poor. His life is sustained by tube feeding and a ventilator. 9. HARVEY E. HANSON has no known will. 10. HARVEY E. HANSON's treating physicians are Drs. Kenneth B. Conner and James F. Rich at 207 House Avenue Suite 107 Camp Hill, PA 17011. 11. Other than SELECT MEDICAL HOSPITAL, CAMP HILL and Drs. Conner and Rich, there aze no other medical, residential or institutional providers involved in HARVEY E. HANSON's treatment. 12. No court has ever assumed jurisdiction over this matter. 13. The Petitioner is SELECT MEDICAL HOSPITAL, CAMP HILL. 14. The proposed guardian has no interests adverse to HARVEY E. HANSON. 15. This guardianship is being sought because the physical and mental condition of HARVEY E. HANSON makes it impossible for him to make decisions and less restrictive alternatives are not feasible. WHEREFORE, the Petitioner respectfully requests that the Court, under Section 5511 of the Probate, Estates and Fiduciaries Code, issue a citation to HARVEY E. HANSON, and to such other persons as the Court directs, to show cause why HARVEY E. HANSON should not be adjudged to be an incapacitated person and a guardian appointed for his person and his estate. Respectfully submitted, Date: ~'/.31pL ~-m-rsropnei-s Lucas No. 77903 Attorney for Petitioner 115 Pine Street Harrisburg, PA 17101 717.232.3709 voice 717.232.3740 facsimile COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA IN RE: HARVEY E. HANSON, An alleged incapacitated person ORPHANS COURT DIVISION No. On the Petition of SELECT SPECIALTY HOSPITAL, CAMP HILL VERIFICATION I verify that the statements made in this Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4904, relating to unsworn falsification to authorities. Date: ~!' ~~- ~ 3- ~,~. `~ <n ~^ C~C,c/CZ2Gt~ ~ ~jf~ l ~yC° ~ C Petitioner) x. IN RE: HARVEY E. HANSON, AN ALLEGED INCAPACITATED PERSON IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-2002-0794 IMPORTANT NOTICE CITATION WITH NOTICE A petition has been filed with the Court to have you declared an Incapacitated Person. If the Court finds you to be an Incapacitated Person, your rights will be affected, including our right to manage money and property and to make decisions. A copy of the petition which has been filed by SELECT SPECIALTY HOSPITAL is attached. You are hereby ordered to appeaz at a hearing to be held in Court Room No. 3, Cumberland County Courthouse, Carlisle, Pennsylvania, on SEPTEMBER 25 , 2002, at 1:30 PM. to tell the Court why is should not find you to be an incapacitated Person and appoint a Guazdian to act on your behalf. To be an incapacitated Person means that you are not able to receive and effectively evaluate information and communicate decisions and that you are unable to manage your money and/or other property, or to make necessary decisions about where you will live, what medical caze you will get, or how your money will be spent. At the hearing, you have the right to appear, to be represented by an attorney, and to request a jury trial. If you do not have an attorney, you have the right to request the Court to appoint an attorney to represent you and to have the attorney's fees paid for you if you cannot afford to pay them yourself. You also have the right to request that the Court order that an independent evaluation as to your alleged incapacity. If the Court decides that you are an Incapacitated person, the Court may appoint a Guazdian for you, based on the nature of any condition or disability and your capacity to I~~ make and communicate decisions. The Guardian will be of your person and/or your money and other property and will have either limited of full powers to act for you. If the court finds you are totally incapacitated, your legal rights will be affected and you will not be able to make a contract or gift of your money to other property. If the court finds that you are partially incapacitated, your legal rights will also be limited as directed by the Court. If you do not appear at the hearing (either in person or by an attorney representing you) the court will still hold the hearing in your absence and may appoint the Guardian requested. Clerk, Orphans' Court Divisior. Cumberland County, Carlisle, PA My Commission Expires 15` Monday, January, 2006 ~~~ n ~ zooz COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA IN RE: HARVEY E. HANSON, An alleged incapacitated person ORPHANS COURT DIVISION No. 21.02 - ~qy On the Petition of SELECT SPECIALTY HOSPITAL, CAMP HILL I TERIM ORAER OF AND NOW, this' day of ~ V~\ , 2002, the foregoing PETITION FOR APPOINTMENT OF AN ER NCY GUARDIAN, and upon a hearing on the same, it is ORDERED and DECREED that BRIAN BROOKS d.b.a. PENNSLVANIA GUARDIANSHIP ASSOCIATION be appointed as emergency guardian of the person and estate of HARVEY E. HANSON for a period of 72 hours. If necessary, and before the expiration of the 72 hour emergency appointment, Counsel for Petitioner shall file a Motion to Extend this Emergency Guardianship for 20 days. Counsel for Petitioner has already filed a PETITION TO ADJUDICATE INCAPACITATED AND APPOINT A PLENARY GUARDIAN OF THE PERSON AND THE ESTATE. A citation will issue and a hearing will be scheduled in due course. BY THE COURT: COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA IN RE: HARVEY E. HANSON, An alleged incapacitated person ORPHANS COURT DIVISION No. On the Petition of SELECT SPECIALTY HOSPITAL, CAMP HILL PETITION FOR APPOINTMENT OF EMERGENCY GUARDIAN AND NOW, comes SELECT SPECIALTY HOSPITAL, CAMP HILL, by and through its attorneys in this matter, and petitions for the appointment of an emergency a plenary guardian of the person and the estate of HARVEY E. HANSON. 1. For the reasons detailed in the attached Exhibit "A" PETITION TO ADJUDICATE INCAPACITATED AND APPOINT A PLENARY GUARDIAN OF THE PERSON AND THE ESTATE, the alleged incapacitated person, HARVEY E. HANSON requires the appointment of a guardian. 2. Without the appointment of an emergency guardian, the person or estate of HARVEY E. HANSON may suffer irreparable harm. 3. Because of the serious nature of his illness, HARVEY E. HANSON may be in need of authorization for invasive medical procedures at any time. 4. Because HARVEY E. HANSON may have TriCare military managed care benefits that may require the payment of periodic premiums in order to continue his medical coverage, the estate of HARVEY E. HANSON may suffer irreparable harm unless someone begins to make payment of periodic premiums on his behalf. 5. No one has been in HARVEY E. HANSON'S home or attended to his affairs since his accident on or about August 14, 2002. Unless someone enters the home to check into the utilities, pick up mail, etc. irreparable harm may occur to the estate of HARVEY E. HANSON. WHEREFORE, the Petitioner respectfully requests that the Court schedule an emergency guardianship hearing, under Section 5513 of the Probate, Estates and Fiduciaries Code, to appoint an emergency plenary guardian of his person and his estate. Respectfully submitted, Date: y/3/D Z Christopher S. Lucas No. 77903 Attorney for Petitioner 115 Pine Street Harrisburg, PA 17101 717.232.3709 voice 717.232.3740 facsimile COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA IN RE: HARVEY E. HANSON, An alleged incapacitated person ORPHANS COURT DIVISION No. On the Petition of SELECT SPECIALTY HOSPITAL, CAMP HILL VERIFICATION I verify that the statements made in this Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4904, relating to unsworn falsification to authorities. Date: 9 l3 f 0 Z _ ll (Pe i io COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA IN RE: HARVEY E. HANSON, An alleged incapacitated person ORPHANS COURT DIVISION No. On the Petition of SELECT SPECIALTY HOSPITAL, CAMP HILL CERTIFICATE OF SERVICE I, June C. Lee, Esq., have personally served, this 3'~ day of September 2002, upon the alleged incapacitated person, HARVEY E. HANSON, the PETITION FOR APPOINTMENT OF EMERGENCY GUARDIAN with the attached Exhibit A PETITION TO ADJUDICATE INCAPACITATED AND APPOINT A PLENARY GUARDIAN OF THE PERSON AND THE ESTATE and read and explained these papers to him in words he is most likely to understand. Date: 9~o3/d z. ~° - ~ eC.L e,Es . COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA IN RE: HARVEY E. HANSON, An alleged incapacitated person ORPHANS COURT DIVISION No. ZI - Zoo2 _ 07q `-~ On the Petition of SELECT SPECIALTY HOSPITAL, CAMP HILL INTERIM ORDER OF COURT TO EXTEND EMERGENCY GUARDIANSHIP PENDNG HEARING ON SEPTEM R 25 002 AND NOW, this ~ day of , 2002, the foregoing PETITION TO EXTEND EMERGENCY GUA DIANSHIP PENDING HEARING ON SPETEMBER 25, 2002, and upon a hearing on the same, it is ORDERED and DECREED that the appointment of BRIAN BROOKS d.b.a. PENNSLVANIA GUARDIANSHIP ASSOCIATION be extended as emergency guardian of the person and estate of HARVEY E. HANSON for a period of 14 days until a hearing scheduled for September 25, 2002. BY THE COURT: COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA IN RE: HARVEY E. HANSON, An alleged incapacitated person ORPHANS COURT DIVISION No. On the Petition of SELECT SPECIALTY HOSPITAL, CAMP HILL PETITION TO EXTEND EMERGENCY GUARDIANSHIP PENDNG HEARING ON SEPTEMBER 25, 2002 AND NOW, comes SELECT SPECIALTY HOSPITAL, CAMP HILL, by and through its attorneys in this matter, and petitions for the appointment of an emergency a plenary guardian of the person and the estate of HARVEY E. HANSON. 1. On September 6, 2002, the court appointed Brian Brooks, d.b.a. Pennsylvania Guardianship Association as an EMERGENCY GUARDIAN of the person and estate of HARVEY E. HANSON. 2. A hearing on the PETITION TO ADJUDICATE INCAPACITATED AND APPOINT A GUARDIAN OF THE PERSON AND ESTATE is scheduled for September 25, 2002. 3. Over the weekend, the guardian was unable to gain access to HARVEY E. HANSON'S apartment. 4. Today, HARVEY E. HANSON may be in need of authorization for medical procedures. 5. Access to HARVEY E. HANSON'S apartment is still necessary as is authorization for medical procedures he may need. WHEREFORE, the Petitioner respectfully requests that the court extend the EMERGENCY GUARDIANSHIP for a period of 14 days pending the hearing scheduled for September 25, 2002. Respectfully submitted, Date: q I °( I a2 ~- -----Y Christopher S. Lucas No. 77903 Attorney for Petitioner 115 Pine Street Harrisburg, PA 17101 717.232.3709 voice 717.232.3740 facsimile COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA IN RE: HARVEY E. HANSON, An alleged incapacitated person ORPHANS COURT DIVISION No. On the Petition of SELECT SPECIALTY HOSPITAL, CAMP HILL VERIFICATION I verify that the statements made in this Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4904, relating to unswom falsification to authorities. Date: ~ Iq (02 (Petitioner) COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA IN RE: HARVEY E. HANSON, An alleged incapacitated person ORPHANS COURT DIVISION No. On the Petition of SELECT SPECIALTY HOSPITAL, CAMP HILL CERTIFICATE OF SERVICE I, June C. Lee, Esq., have personally served, this 9th day of September 2002, upon the alleged incapacitated person, HARVEY E. HANSON, the PETITION TO EXTEND EMERGENCY GUARDIANSHIP PENDNG HEARING ON SEPTEMBER 25, 2002 and read and explained these papers to him in words he is most likely to understand. Date: l U j- d 2 '~ f oa~F ~. ~~;- J/une. Lee, E q. / / _. Christopher S. Lurras & Associates Harrisburg Charlevoix Place 115 Pine Street Harrisburg, Pennsylvania 17101 Direct dial 717.232.3709 Facsimile 717.232.3740 csl ucas@lucashealth law.com Pittsburgh Chamber of Commerce Building Christopher S. Lucas Pennsylvania and the District of Columbia September 8, 2002 Mary C. Lewis Cumberland County Register of Wills 1 Courthouse Square Carlisle, PA 17013-3387 Re: In Re: Harvev E. Hanson An Alleged Incapacitated Person No 21 2002 0794 Dear Ms. Lewis: Please find enclosed the guardian's Consent to Serve. Please accept the Consent to Serve for filing. Please contact me with any questions. Respectfully, d k t/~ , ~, . ~ •b~. ~ 4a. . y4 ~~Cy~: ,~,~~. .: k,, - ..~ ~ ~,, He'a~7~1;'~tdhri ~~M"PY~rrlatl'~ns www.l ucashealthlaw. com Christopher S. Lucas Encl. SEF-03-2eC~2 14: g3 CHRISTOPHEP LUCKS RSSpC• ^;? 232 _74P F.f~2it~2 COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA IN RE: HA1tVEX E. HANSON, An alleged incapacitated person ORPHANS COURT DIVISION • No. On the Petltlon of SELECT SPECIALTY HOSPITAL, CAMP HILL CONSENT TO pP0 NTMENT AS GUARAIAN The name of the proposed guardian is Brian Brooks, d,b.a, Pennsylvania Guardianship Association. Z• The address of the proposed guardian is Post Office Box 541 York, PA 17405- 0541. 3 ~ The proposed guardian speaks, reads and writes the English language. 4• The proposed guardian does not have an interest adverse to the alleged incapacitated person, save for his status as intestate heir. 5• The proposed guardian is not a fiduciary, or an officer or empioyee of a corporate fiduciary, of an estate in which the alleged incapacitated person has an interest and is not the surety, or an officer or employee of a corporate swety of such fiduciary. 6• The proposed guardian consents to act as guardian for HARVEY E, HANSON. Date: 9/3/02 . . e5` /// ) roraL P.a2 E LoR~ Offices Oj CHRISTOPHER S. LUCAS HEALTH LAW AND GOVERNMENT RELATIONS HARRISBURG OFFICE Charlevoix PTace 115 ~Pitie Street ' " ~ I Harrisburg, Pennsylvania 17101 facsimile 717.232.3740 direct deal 717.232.3709 ~ l:u :per r ~~~~ ~~~ ~Y*~ PITTSBURGH OFFICE Chamber of Commerce Building ~ ~ ^' ~ ? ADMITTED ~ , #i j `n ~ :,~ Pennsy[vaaia and the Distract of Columbia ..+~,t'~r ~ , . g ~ „.# ~p ' "~~t~~~I~~'d~"°~"~` cslucas@lucashealthlaw.com September 18, 2002 Cumberland County Register of Wills Courthouse Hanover and High Streets Carlisle, PA 17013 Re: In Re: Harvev Hanson 2002-00794 Dear Register of Wills: Please mark the pending PETITION TO ADJUDICATE INCAPACITATED withdrawn as Mr. Hanson has died. A hearing is currently scheduled for September 25, 2002. However, it will not be necessary. Please call with any questions, and thank you. Respectfully, -- -- ' op er S. Lucas Register of Wills of Cumberland County, Pennsylvania -.. PETITION FOR GRANT OF LETTERS Estate of HARVEY E. HANSON also known as Ch Petitioner(s), who is/are 18 years of age or older (COMPLETE 'A' or'B' BELOW:) No. 02 ~-~02 - 7 9y Deceased Social Security No. 397-07-0468 ron ~X A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut or named in the last Will of the Decedent, dated 02/01/1977 and codicil(s) dated None Divorce from Margaret N. Hanson on 3/30/94 ar,ri cto~tti, ..v ct..,__ r• ,.____._ .,._,. Slate 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 1at.a.; d. b. n.c.t.a; pendente life; 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: or principal residence at 40 Falcon Court, East Pennsboro Townshi Mechanicsbur PA 17055 (list street, number, and municipality) Decedent, then 85 years of age, died 09/09/2002 at Select Specialty Hospital PA (Location) 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 situated as follows: $ 96,000.00 Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) orecenrerV wish rhle o,..a:.... __~ m_ -_-_. Form RW-1 (i991) _ ---..._.._. _..__._ .. ............o,~. Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last family ~~-/02/- Preparetl by [he Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. ,. 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 Petitioners}andt. as pe~ nal re ntative(s) of the Decedent, Petitioner(s) will well and truly administer the e5tate~eCp r no to la Sworn to or affirmed and subscribed before me this /oZ~day of R. ~d/S~y~~J loll ~',[~ /~ For the. Register 7 ~-¢J /~ No. ~/- O~ - ~r9 ~ Estate of HARVEY E. HANSON Deceased Social Security No: 397-07-0468 Date of Death: 09/09/2002 AND NOW, ~L ~ ~~/ in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ^X Testamentary ~ Of Administration a.; d. b.n.c.t.a.; pendente liter durante absentia; durante minoritate) are hereby granted to John R. in the above estate and that the instrument(s) dated 0 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters . . Short Certificate(s). . Renunciation. . Affidavits ( ) Extra Pages ( ) . . Codicil . . JCP Fee . . Inventory. Other $ $ catLL~, D6 $ ~~ ~ O Register cf Wills ,nay; ~ A _ Attorney: Shelly J. Kunkel, Esquire $ Iv•Do I.D. No: 64485 Skarlatos & Zonarich LLP Address: 204 State Street Harrisburg PA 17101 Telephone: 717/233 -1000 $ ~.LrJL] $ $ l~.Da MAILED LETTERS TO ATTORNEY. 02-12-03 TOTAL. $ r~~-~ Preparetl by the Pennsylvania Bar Association Copyright(c)1996 form software only CPSystems, Inc. Form RW_f (1991) I05.905M RP9. 4196 This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in acwrdance with Acr 66, P.h. 304, approved by the General Assembly, June 29, 7953. WARNING: It is illegal to duplicate this copy by photostat or photograph. CAA ~~ Charles Hardester S ta[e Regis[rar No. moB.,m R...19, ~~, nvEmnxr m pEx,uxaxT BECK IHN O A \ COMMONWEALTN OF PENNSYLVANIA • DEPAgTMENT OF HEALTH • VITAL nECORDa CERTIFICATE OF DEATH (Coroner) 092129 NAME OF DECEpEMIFIN,MMe, 4M1 9EX ECCVLgEWRITY NVMBEPF~ pAIEOF OEAN(MrcM, Wy,yerl +. Harvey E Hannon a. Male ,. 397-07-0468xDYaE ,September 9, 2002 AOEgY &r"xbVl UXDERIYEW UXCERI DAY ORECF&p!N &I1TXgACEICRyeM PUCE Cf pFRNgnpeµ«ily°ne-Mlrmruc,l°nf cnpyrgM) M°mn. o•n xM,Y MIRM IMO^m. av. rc«I sYb«F°,.,q"camrn xosprtaL' mxER' a. 8$ vM. w Dec.22, 1916 O.ahkoeh, lUI "°"b"~ Ewam.lbm^ Dw^ ~°'I,•bop mma.b~ ~,~ • WUMVOFDE.Dx clrv.aW DEVx FAClvrr xaME UI^NI"AlMlwn,awwMYa~4n ° YeLg DacsDEMagwsPAxq DRlBlx'r RACE.AmeM.^Iml.". m.=F. wnm. nc. Cumberland East Pennsboro Select Specialty Hospital "°® "'~"Y°~°P°"VO.°•^ eoi'm' ,n. ,.. w. MMUn.P"wl°pN.nM=' Wh+.#e CECEDEM'B VSVALCCLVP.QgH pHDCf BUSINESS1NWafflV W4q DECEDEMEVEp IH DECECEHT'a EOVCAfgN e ~m Flrgprp4,brc Wr Ua. ARMEDFORLEB'I MYAmIW giANa~MUrbe WpV1Y1NaaPoUSE rrqq MYa~I, WYbn,J, ^arFM9Xb. a°MUw MUM^41 N,® NO^ EIYn•m,ry9,wim,ry CwNF Mw°,a1gC«Mt Inu1,e,BMmeMn,u^n1 ,.. Commanded „. H. S. Navy ,,. ro,a 1P ~D-. «,., $+ D2voaeea OECECEM'a MAIUMg ACDPE5a15nM. C^yRwn, AeM, LOCW=) CECECENi'g 1°' +a' ACIIIAL ,,..am. 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"^^I•Kf"^•n'b TIMEOFDEAIN OREPRWWIMEDCF1D Mmp. ~~ mC' pwc^Mapm«xlu^,M. ~ ~aY YW W.SCaSEPEFERRE010MEDIGLE%AMIXENCORONERI 2:30 P. M September 9, 2002 n.~ JL w^ v. PANrn iw m•mww., lNurb.«~ml°m.ewawl..°m,a..m.D°~awmr,n,~,waaarrv.wur..°ra.=«r,wr=wr.".n..ma°rn..^uww. m. «MwF.w. «,..rnaM. ~~IIMMwn wMx: MMrwMMMl 1R MiieL~"a. Mnnnw,Ml°a.un, an xK,apurE DAWEIFYI a.«Ylaawln T+m «°waM•Rm wflrl. I°°w",p' e.Nh-~ Renal Failure WEroloq+R. cDXBEWEXLEDFy. '- Eww,YylYlYwxbR e. Multiavetem Oiaan Failure o•RA M.alamlmlrxan. WETDDq RSACWSEWENCEDfI: D:wilaw:.MO«°~"~ c, M 1 e T aumatic In uries MYYYW ewTS p1f 1p IEP f9a CON5E0UENCE OFl: rM4F9MICmN1,YT 0. 8 VMBAX AURIPSY WEpEAV1pPSY FINdppB MaHNEq OFDFRx pAIECf INJUPY THE OFINJUPV INJUMai MVgx'I LESLWSE xO.VIWVPYOLLUPPEO. PE16g1ME09 NJLABIE PPgRI(1 IMmII, pgY. WeU coMPLEnW acausg G Aprx. Operator ran red light, oFDexxv xmw ~ "°'"""' Jul 11,2002 +*• C w~ IIqq "«b'^' ~. P«b"m lnr,NmryNn ^ y a .7.50 p struck vehicle M ^ '+,~, hs^ H° to P{gLELf INJUPV.A,lemp,lum.ebe,l•bM^ry ollbeM LOCRIW (aIrM,CMVM°. 51°,el nIXCNF ^ C°W,wl [.eeIFmIIrIM ^ yYary. me.lBG•eilV a`' "°' ~ ,a•. Street on y Rd,Mechanicaburg fEmIFlGICnecFaNyw-el Y RII%IIq P"YBIGIANIFMti°^^crl"Yi^a°cwd°w°.Mrenypy~g Dµygy^"n gmpvcMCeeNygcdnpel°f ll«n 91 aIDNRUPEAH i FI mw.0•NNRNnm.xW.e••B,°«+RI•eaww,wwwx•Iwm wwRwwMMM..._ ............... _.._.............. _.....__.. ^ ,+ ' Coroner 'N,OXOUXONOAXDCGfxYNDpMYaNXAy LILEN NUMBED fipF W pRq'ml°.'=ayF,e°MMmnme,ltlw\Mw.eN. W Ww... wYMwwry ~In~GbuweCOwlnl ORESXLIEOIMmI", hY.gr) ''"wN•o-^°""^^"°^«.^-"".'-........ ^ ",_. ,m. Se tember 10, 2002 _..... NAME/uVDADOPE9g OFPEREgN WXOCOMPIELEDCAUSEOF OEAIN •xEnqueKAMlxexrcoKOxBa - °'°m nlTrp•ur p""' Michael L. Norris, Coroner oxm.Dr.a,ummmnxwl°,Im,mD.,m^. mRryapINMR,a..m«wN.e.,,n.nY., a•a,.RepMM,.maY mm.w 6375 Basehore Road, Suite #1 wY.,veer.aa ................................................................................ ~.........'.'al.w a" ~~~~ ~,:. Mechanicsbur Pa. 17050 RE018IM11'g8 REANDNUM9~g.; ~ S eiX-MJ /"` c2.(i~-l~-~/~~, al / F DArEpLEDIwm.Dev x,rl » ,. ,,. /' .700 t JAN 2 4 2003 Datee Register of Wills of Cumberland County, Pennsylvania RENUNCIATION Estate of HARVEY HANSON No. also known as ,Deceased The undersigned, Niece of (Relationship) (Capacity) the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters be issued to John R. Zonarich / WITNESS j'r~ hand this _ ~ ~ ~ day of /g xy , , ,~U~ . ~,{ l ~~/V~ ,U ~~a,~t~ (Signature) Na cy Laf ver 7633 E. Vista Drive Scottsdale, AZ 85260 (Address) (Signature) (Address) (Signature) (Address) Sworn to or affirmed and subscribed before me this ~ 7 ~ day OFFICIAL SEAL i of A~ A -Y_,~0~ ~ BERRY C. OLSEN NOTARY PUBLIC-ARIZONA MARICOPA COUNTY M Comm Expires July 23, 2005 , _,_: ~~c,~=Vic...; N ary P My Commission Expires: JVf.Y o2.3/ e~~Qf (Signature antl seal of Notary or other official quallfietl to atlminister oaths. show Gate of NOTE: Renunciations executed outside the Office of Register of Wills expiration of Notary's commission.) in some counties are required to be notarized. Preparetl by the Pennsylvania Bar Association Copyright (ej 1996 form software only CPSystems, Inc. Form MR W-4 (1991) o.~l-off - 79 ~ Register of Wills of Cumberland County, Pennsylvania RENUNCIATION Estate of HARVEY HANSON No. also known as ,Deceased The undersigned, Niece of (Relationship) (Capacity) the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters be issued to John R. Zonarich II//]] ~7 WITNESS ~ (~ hand this ~ ~ ~ day of ~J~y ~ ~Qd~ (Signature) (Address) Sworn to or affirmed and subscribed M Carom. Expues July 23, 2005 ''.saw-yS... ~._ _ ..._ .. . N ryP Coro fission Expires: JVI.Y a3~ o~aQS' (Signature and seal of Notary or other official qualified to administer oaths. Shaw tlate of NOTE: Renunciations executed outside the Office of Register of Wills expiration of Notary's commission.) in some counties are required [o be notarized. before me this / ~ ~~ day ofd ~R.IJVNR~. A° 3 ! OFFICIAL SEAL !' JERRY C. OLSEN NOTARY PUBLIC-ARIZONA MARICOPA COUNTY Prepared by the Pennrylvanla Bar Association Copyright (c) 1996 form software only CPSystems. Inc Form #R W-4 (1991) 15095 N. Thompson Peak Pkwy Apt. 1031 Scottsdale, AZ 85260 (Address) Last gill anD ilLe~tament KNOW .ALI WtEti Bl' THESE PRESI=.N'PS: That I_ ~rv~ E._Haneon i w-I Duplicate of the (~~~'``~{>Xx~~CAY..Borough. of-Dallsa ___..___._____, County of___I'uzerne __-_ and State of__Pennaylvania_ _ ___ __ _ being of sound and disposing mind and memory, do make, publish rind declare the following to he my LAST WILL AND TESTAMENT, hereby revoking al! Wills by me ai any time heretofore made. FlK1/ I d~rc~t m~ E:xrcutrix, hercina(ter named, to pay all my fmtertl expenses, administration expenses of my estate, including inheritance and succession taxes, state or federal, which may be occasioned by the passage of or succession to am interest in my estate under the terms of this instrument, and all my just debts, excepting mortgage notes secured by mortgages upon real estate. SFCtt.~'D All the rest, rc.idue and remainder of my estate, both real and personal, of whatso- ever Aind or ch.uaaer, and wheresoever situated, I give, devise and bequeath to my beloved wife: Margaret N. Hanson ___ _, to be hers absolutely and forever. /I1/K!) It m~ and wife does not survive mc, then 1 give, devise and bequeath such rest, residue and remainder Ot mi C1Uiti tU. Name _Elmer E. Hanson Address.._ 844 Central Street '~.in Sher titreet to be his/hers absoiutely and forever. Oshkosh _ ,_ ____ Wiecona_~r _5494L_ ~~~_~ __ City State FtIC'RTi1. I hrrchv appoint my wife ,_Margaret N. Hanson as Executrix of this my EAST WILL .4ND TES7:Ah1EN"C. If she does not survive me, then I appoint Elmer E. Hannon as Executor/Executrix. 1 direct that no Executor/Executrix serving hereunder shall be required to post bond. IN WITNESS WHEREOF, t have hereunto set my hand and seal at___ _~11aa, Pennsylvania this - ------.__lst - ---------day of_.- Febru9ry------ ---1927__. (sigtt here)__~~~y"",~_~a-~'?~_ _-___-_L.S. Signed, sealed, published and declared to be his LAST WILL AND TESTAMENT by the within named Testator in the presence of us, who in his presence and at his request, and in the presence of each other, have here- unto subscribed our names as witnesses: (1) (2) (3) City X~ City State ~~1 ~ AFFIDAVIT ' , STATE OF- ' ~ h% ~.~ -- --- _. ss:- COUNTY OF _~PB.J ~__ Personally appeared (I)_____~us<~41=, ~~_Yt'--f1 -~- --- _- -. I r -- _ _ _ _ _ _ _-, _ _ _, who being duly sworn, depose and say [hat they attested the said Will and [hey subscribed tine came at the request and in the presence of [he said Testator and in the presence of each other, and the said Testator signed said Will in their presence and acknowledged that he had signed said Will and declared the same to he his LAST WILL AND TESTAMENT and deponents further state that at the time of the execution of said Will the said Testator appeared to be of lawful age and sound mind and memory and (here was nn e~~idence of undue influence. "~fhe deponents make this affidavit at the request of [he Testator. Subscribed and sworn to before me (Notaryy Seal) VERN E. P~I~Cfl+IRD, iVJiRitV PUBLIC YJNGST. N Ill4YNSNlP, LU2ERNE COCY7Y MY CGMMtSSIGN EXPIRES NOV. 2. p;. rg MM~b~r,PmtrtplraRleAssoaiation W wot>~lee (li ~-"~~"~~-----~/ ~_o ~ __--- r~~ :~.~ this--___ ~ =~ __ dac of ~ eb~;.nx ..197__. _ - _-_`~ ~ _ _ ~.a . _ Notary Public CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: HARVEY E. HANSON Date of Death: SEPTEMBER 9, 2002 Will No. 21-02-0794 To the Register: I certify that Notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiary of the above-captioned Estate on February 17, 2003: Name Marene S. Hanson Nancy Lafever 15095 North Thompson Peak Pkwy. Apt. 1031 Scottsdale, AZ 85260 7633 E. Vista Drive Scottsdale, AZ 85260 Notice has been given to all persons entitled thereto under Rule 5.6(a). Dated: Feb. 17, 2003 Signature Name: Shelly J. Kunkel, Esquire Skarlatos G Zonarich LLP Address: 204 State Street Harrisburg, PA 17101 Telephone: (717)233-1000 Capacity: Counsel for Personal Representative - ~ June 4, 2003 Law Offices of Skarlatos & Zonarich 204 State St. Harrisburg, Pa. 17101 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 171'2$-0601 '03 JUid -b NI.:47 Telephone (717) 787-3930 FAX (717) 772-0412 l:: _; Re: Estate of Harvey E. Hanson File Number 2102-0794 Dear Ms Kunkel: This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before December 09,2003. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. J ~/ ~ ___ - Claudia Maffei, Supervisor Document Processing Unit Inheritance Tax Division ~d~f~lf$d.~°ll~&~I~ d~.P ATTORNEYS AT LAW 2U4 STATE STREET HARRISBURG, PEN NSYLVANIA 17101 JOHN R. ZONARICM• ANNA MARIE $OSSONG JOHN B. ZONARICH GREGORY $. CHELAP SCOTT W. PONLMAN ~• SHELLY J. ICUN KEL TODD F. TRUNTZ} DAVID H. JUDY 1]IT1233-1000 TELEFA% []1])233-640 W W W.SKARLATOSZO NAR ICH.COM ANGELO $KARLATOS 11966 - 19811 • BOARD CEflTI FIED IN CIVIL TRIAL ADVOGhCY • ALSO ADMITTED IN NEW YORK } AL50 ADMITTED IN NEW JERSEY September 22, 2003 $TEE LTON OFFICE MECMPNICS $PVING9 BUILDING. STE. 201 51 Sovm FeorvT STnEEi STEELTON PENNSYLVANIA IT113 IT I T 1939-9358 M IDDLETOWN OFFICE ITIT1964-5109 W RrrER's EMAIL: SJk~5A2A81O5Z0R3RCh.C0R1 Office of Register of Wills Cumberland County Court House 1 Courthouse Square f: Carlisle, PA 17013 RE: Estate of Harvey E. Hanson No.21-2002-00794 D.O.D. 09/09/2002 Dear Ladies and Gentlemen: Enclosed for filing are the originals and one copy of the Inheritance Tax Return and Inventory for the above-referenced estate. Please "time-stamp" the extra copies and return to me in the enclosed, self-addressed and stamped envelope. Also enclosed are two checks: one in the amount of $31.00 in payment of filing fees and another in the amount of $16,301.99 in payment of the inheritance tax. If anything further is required, please contact me. Sincerely, ~u" ~ ~ _~° " ~- Sharon K. Shaffer Estate Administrator Enclosures ,!ltE"'f,"E~+ll'io) *' (j-f,Jf-:? REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT 00794 _ NUM_~~__ COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE OEPT,280601 ________J:l_~I'lI~_B_~Fl..G_'_~ 17128--0601 "--- DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) HANSON, HARVEY E. '1:8:1 1. Original Return D-- 2. Supplemental Return o 4. Limited Estate 0 4a. Future Interest Compromise (date of death after 12-12-82) ! 1&1 6. Decedent Died Testate (Attoo" oopy 0 7. Decedent Maintained a Living Trust (Attoo" of Witl) copy of Trust} o 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between 0 11.Election to tax under Sec, 9113(A) (Attach Sen 0) ~". -.--.-:--C-:~~~~":............,...,......,,-...,..::.,....., "',,, .1.~:~,1.-,~t~,n:d)~.1.-95,\ ,..... ,,'''',''.'''': ., ...'ce." .-,:::c~~=.c-,~'~-:::--C-:.:"'..::"-.-c-:: _._~_ .' __ THI$'$l!ttlQ"MI.i$Tn;to)lp~s~.""'~~.llllRll~~IiQI!I!!1iiN~~!jI\l!l~'~!li\i"'I!lilNtrA~t~'II'!FOllillATi9N$i'lOlltD'Be DIFl~"-T!,1) TO:_, AME ;COMPLETE MAILING ADDRESS 3i ~ L~hellYL~unkel ______ Ii! 0 j=IRM NAME (If applicable) 8 i 'Skarlatos & Zonarich LLP __., JE~t;~N;3N_Ut';~~ ". -- 1-' 1.' R~al Estate (Schedule A) w ~ ~4" u~~ w~8 "'i~ u~m ~ ~ z w o w lil o DATE OF DEATH (MM-DD-YEAR) ~~~;;~i~~Hl(~MOD'YEARj , NUMBER 21 2002 gO~~IY~ODE_ YEAR SOCIAL SECURITY NUMBER 397-07-0468 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o o 3. Remainder Return (date of death prior 1012-13-82) 5. Federal Estate Tax Return Required 09/09/2002 - , ___.___.___n _ (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) 8, Total Number of Safe Deposit Boxes 204 State Street Harrisburg, PAl 7 10 1 (1) None (2) (3) (4) (5) (6) (7) None None None 121,710.00 None None (6) 121,710.00 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o " :l " ~ ~ ~ = 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule J) (9) (10) 10,862.52 ----- - 2,167.54 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (11) 13,030.06 (12) 108,679.94 I 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 108,679.94 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x ~ " ~ 17.Amount of Line 14 taxable at sibling rate .12 (17) " x 8 ~ 18. Amount of Line 14 taxable at collateral rate 108.679.94 x .15 (18) 16,301.99 19. Tax Due (19) 16,301.99 20. 0 CHECK HERE IF YOU ARE REOUESTING A REFUND OF AN OVERPAYMENT _ _~, BS lllJRE TO ANSWEk Al,l. QlieS~!lNS 011 REV!"sE SIDE AND RECHECK Mil. TH << Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) , Decedent's Complete Address: STREET ADDRESS 40 Falcon Court -'- CITY Mechanicsburg I STATE PA ZIP 17050 Tax Payments and Credits: " Tax Due (Page 1 Une 19) 2. Credits/Payments A Spousal Poverty Credit B. Prior Payments C. Discount (1) 16,301.99 Total Credits (A + 8 + C) (2) 0,00 3. InteresUPenalty if applicable D. Interest E, Penalty 0.00 TotallnteresVPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) 8. Enter the total of Une 5 + 5A This is the 8At.ANCE DUE. (58) 16,301.99 16,301.99 Make Check 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;.. ........................ ~ I 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 0 receiving adequate consideration?. 3. Did decedent own an ~in trust for" or payable upon death bank account or security at his or her death?.. D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which 0 contains a beneficialY designation?. 181 181 181 IF THE ANSWER TO ANY OF THE A80VE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN. -~---_._-_._-_.._--_.__._~---------- ---.------ ----------- - of pe~ury. I declare that I have examined this return, including accompanying schedules and statements, and 10 the best of my knowledge and belief, it is true, correct and complete_ Declaration of the personal representa' e IS based on all information of whlc.h prepare.r has any_knOwledG!- ~~.SO:J7.P E' ". "LlN. G ."E.N ADDRESS 204 State Street [f.. Harrisburg,P,A 17101 F PERSON RESPO SI LE OR FILING RETURN -- ADDRESS- DATE f~/P- CJ..3 - DATE -DATE 204 State Street Harrisburg, P A 17101 1- / 9. d3 I For dates of death on or atter July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survivin9 spouse is 3% [72 P.S, ~9116 (a) (1.1) (i)). For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)l The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0010 [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. 99116 1,2) [72 P.S. ~9116 <a) (1)). The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% {72 P .5. 99116 (a) (1.3)}. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ESTATE OF *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY 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 NUMBER I 2 3 4 5 6 7 8 9 10 II 12 13 14 15 COMMONWEAL TI-I Of PENN5YI,.. \lANI,e.. INHERITANCE TAX RETURN RESIDENT DeCEDENT HANSON, HARVEY E. I FILE NUMBER 2] - 2002 - 00794 DESCRIPTION Cash in decedent's wallet Cash in decedent's apartment Reader's Digest - Refund USAA - Loss payment on 1991 Ford Escort Ziegler Auction - Proceeds from sale of personal property PNC Bank Checking Account No. 5140238873 (per verification letter attached hereto as Schedule E) PNC Bank Checking Account No. 5140238873 (accrued interest to DaD per verification letter attached hereto as Schedule E) Navy Federal Credit Union Share Savings Account No. 0592114-003 (per verification letter attached hereto as Schedule E) Navy Federal Credit Union Share Savings Account No. 0592114003 (accrued interest to DaD per verification letter attached hereto as Schedule E) Navy Federal Credit Union Share Certificate Account No. 0592114-060-01 (per verification letter attached hereto as Schedule E) Navy Federal Credit Union Share Certificate Account No. 0592114-060-01 (accrued interest to DaD per verification letter attached hereto as Schedule E) Navy Federal Credit Union Share Certificate Account No. 0592114-060-04 (per verification letter attached hereto as Schedule E) Navy Federal Credit Union Share Certificate Account No. 0592114-060-04 (accrued interest to DaD per verification letter attached hereto as Schedule E) Navy Federal Credit Union Share Certificate Account No. 0592114-060-05 (per verification letter attached hereto as Schedule E) Navy Federal Credit Union Share Certificate Account No. 0592114-060-05 (accrued interest to DaD per verification letter attached hereto as Schedule E) Total of Continuation Schedule(s) TOTAL (Also enter on Line 5, Recapitulation) VALUE AT DATE OF DEATH 26.00 332.00 12.80 635.50 578.22 42,158.43 0.92 2,754.25 14.13 7,032.87 7.28 8,700.49 7.40 9,694.33 10.Q4 49,745.34 121,710.00 ESTATE OF *' I SCHEDULE E CASH, BANK DEPOSITS, & MISC. ~" PE~SONAL PROPERTY continued COMMONWEALTH Of PENNSvtVAN\jI.. INHERITANCE TAX RETURN RESIDENT DECEDENT HANSON, HARVEY E. 'IFILE NUMBER 21 - 2002 - 00794 Include the proceeds of litigation and the date the proceeds were received by the estate. All property joln\ly-owned with the right of survivorship must be disclosed on schedule F. -ITEMT----- - - NUMBER DESCRiPTiON "'16' -I N~ryF~d~~~1 Credit U~ion Sh~r~ C~rtiricat;A~count No. 0592114-060-06 (per verification letter , attached hereto as Schedule E) I VALUE AT DATE OF , DEATH 9,280.25 17 i Navy Federal Credit Union Share Certificate Account No. 0592114-060-06 (accrued interest to DOD per I verification letter attached hereto as Schedule E) 8.12 18 Navy Federal Credit Union Share Certificate Account No. 0592114-060-07 (per verification letter attached hereto as Schedule E) 9,425.60 19 Navy Federal Credit Union Share Certificate Account No. 0592114-060-07 (accrued interest to DOD per verification letter attached hereto as Schedule E) 8.25 20 Navy Federal Credit Union Share Certificate Account No. 0592114-060-09 (per verification letter attached hereto as Schedule E) 7,099.14 21 I I Navy Federal Credit Union Share Certificate Account No. 0592114-060-09 (accrued interest to DOD per I verification letter attached hereto as Schedule E) , I , Navy Federal Credit Union Share Certificate Account No. 0592114-060-010 (per verification letter \ attached hereto as Schedule E) \ Navy Federal Credit Union Share Certificate Account No. 0592114-060-010 (accrued interest to DOD per verification letter attached hereto as Schedule E) ! 9.16 6.21 22 7,821.24 23 24 Navy Federal Credit Union Share Certificate Account No. 0592114-060-0] ] (per verification letter attached hereto as Schedule E) 16,076.07 25 Navy Federal Credit Union Share Certificate Account No. 0592114-060-011 (accrued interest to DOD peri verification letter attached hereto as Schedule E) ! 11.30 _.._...L _ Page 2 of Schedule E ESTATE OF *' CQWMONWE!oJ..TH OF PENNS'I'LVI1.NlA INHERITANCE TAX RETURN RESIDENT DECEDENT 1.____ SCHEDULE H FUNERAL EXPENSES & ADMINIS1RATlVE COSTS I FILE NUMBER __ 21:2002 - 00794 Debts of decedent must be reported on Schedule I. HANSON, HARVEY E. ITEM i ;~~1BER r FUNERAl. EXPENSES: 1 PREPAID ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions John R. Zonarich Social Security Number(s) I EIN Number of Personal Representative(s): 199-34-9016 Street Address 204 State Street City Harrisburg State P A Vear(s} Commission paid Attorney's Fees Skarlatos & Zonarich LLP B. 2. DESCRIPTION AMOUNT Zip 17101 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 4. City Relationship of Claimant to Decedent Probate Fees Register of Wills State Zip 5. Accountant's Fees 6. 7. I 2 Tax Return Preparer's Fees Ray's Tax Service. Final Income Tax Return Other Administrative Costs Capital Self Storage - Storage Unit for decedent's personal property Information Network Associates - Investigative research in locating heirs Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 2,434.20 6,085.50 241.00 168.25 267.12 225.00 1,441.45 10,862.52 . Schedule H Funeral Expenses & Administrative Cosls continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ." RESIDENT DECEDENT ESTATE OF HANSON, HARVEY E. I FILE NUMBER 21 - 2002 - 00794 3 Cremation Society of P A - Newspaper Obituary 4 Wesley Park Townhouses - Packing and moving personal belongings to storage shed 5 Cumberland Law Journal - Advertise Letters Testamentary 6 The Sentinel - Advertise Letters Testamentary 7 Skarlatos & Zonarich LLP - Costs and Expenses 8 Vital Records - 12 Death Certificates 9 Register of Wills - Filing fee for Inheritance Tax Return and Inventory lO Register of Wills - Filing fee for Releases II Milwaukee County - Fee to obtain Certified Court Record of James Hanson's Birth Record --~_._-- - ------- - --- - -- 1. Page 2 of Schedule H 75.60 1,100.00 75.00 91.85 36.00 26.00 26.00 11.00 *' ~THOFPENNS'1\.V.I>.N\A INHERITANCE TAX RETURN RESIDENT DECEDENT ________1______ ----- -----~_.-----.'--_. ---..--- ESTATE OF HANSON, HARVEY E. Include un reimbursed medical expenses. ITEM NUMBER 1 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS Verizon, 40 Falcon Court, Mechanicsburg DESCRIPTION 2 Comcast Cable, 40 Falcon Court, Mechanicsburg 3 Reader's Digest - subscription Wesley Park Townhouses - Rent, 40 Falcon Court, Mechanicsburg 4 5 Cumberland County - 2000/01 Township/Percapita Tax __I FILE NUMBER 21 - 2002 - 00794 TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 85.00 116.03 25.41 1,912.60 28.50 2,167.54 . REV-1&1'3 ~,,+ (9..QOI *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVI\NII\ INHERITANCE TAX RETURN RESIDENT DECEDENT -------------------------------- ----- L NUMBE~ -~- FILE NUMBER 21 - 2002 - 00794 I AMOUNT OR SHARE OF ESTATE ESTATE OF HANSON, HARVEY E. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY 1..RELATIONSHIP TO. DECEDENT _ _ uno Nor I ..r Iwatu(&) _ I Niece lone-half estate residue I. '.l ::B~:f~:::RIBU;.IONsiinclude outright sp~usal c1istributi~nS) - "\' 7633 E. Vista Drive Scottsdale, AZ 85260 2 I Marene S. Hanson . 15095 N. Thompson Peak Pkwy. Apt. 1031 Scottsdale, AZ 85260 Niece I One-half estate residue I I : Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet I II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE i I I I \ IB" CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I I I i I I I I TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET, ! ESTATE OF HARVEY E. HANSON FILE NO. 22 - 2002 - 00794 INHERITANCE TAX RETURN - SCHEDULE E RPR-23-2003 18:01 PNCBANK 412 768 3458 P.01/01 0PNCBAN< April 24, 2003 Shelly J. Kunkel 204 State Street Harrisburg, P A 171 0 I RE: Estate of Harvey E. Hanson, deceased SSN: 397-07-0468 DOD: 9/9/2002 Dear Ms. Kunkel: In response to your request for Date of Death balances for the customer noted above, our reCOl"ds show the following: Checking Account Account #5140238873 Established 09/0111980 HE HANSON DOD balance: $42,158.43 + $,92 accrued interest Interest Paid 1/1/2002 - 9/9/2002 - $50.32 *Please send all future requests for date of death balances to the address listed below. Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not p~ess any fiuandal transactions or provide statements. If you need assistance with any of these items, please call1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, ~/JhdJJIM aJ..&f~ lJ~e; 1-800-762-1775 P7-PFSC-04-F 500 first Ava PittsbllTgh PA 1$219 Member FDIC TOTAL P.01 NAVY (I FEDERAL CREDIT UNION .. PO Box 3000. Merrifield VA. 22119-3000 In reply refer to: 18 April 2003 Skarlatos & Zonarich, LLP Attorneys at Law 204 State Street Harrisburg, P A 17101 ATTN: John R. Zonarich, Esq. RE: Harvey E. Hanson (Deceased) Navy Federal Account No. 0592114-003 (Closed) Navy Federal Share Certificate Account No. 0592114-060 (Closed) Dear Mr. Zonarich: Weare very sorry to learn that Harvey E. Hanson passed away in September 2002 and, on behalf of Navy Federal's staff and membership, we wish to extend our heartfelt sympathy to his family. Commander Hanson maintained a share savings account and a share certificate account with us at the time of his death. We have completed settlement of his accounts and I hope that the following information is of assistance to you. . Commander Hanson's share savings account was opened on 17 October 1977. No joint owner was . designated. His share savings account reflected a balance of$2,754.25 on 9 September 2002. Due to his age, the shares earned no Life Savings Insurance. Our explanatory brochure is enclosed. The date of death balance included dividends totaling $66.32 that had been credited in 2002 prior to his death. Dividends accrued in the third quarter but not yet credited to the account as of the date of death totaled $14.13. Total third quarter dividends of $17. 75 were credited to the shares on 1 Oc- tober 2002. We also credited dividends of$12.23 and $10.30 to the shares on 1 January and 1 April 2003, respectively. After the transactions, the share savings balance was $2,794.53. Our member had eight share certificates with us when he passed away. The certificates did not reflect joint owners. The opening/renewal dates of the certificates are as follows: Control No. 0001 0004 OveningfRenewal Date 07/30/02 08/23/02 Account Number 0592114-003 Page 2 of3 0005 0006 0007 0009 0010 0011 08/1 7/02 04/21/02 07/27/02 03/15/02 08/11101 06/11/02 The following table reflects the date of death balances, total diyidends posted in 2002 prior to the date of death and diyidends accrued but not yet posted as of the date of death: Control No. Date of Death Balances 0001 0004 0005 0006 0007 0009 0010 0011 $ 7,032.87 $ 8,700.49 $ 9,694.33 $ 9,280.25 $ 9,425.60 $ 7,099.14 $ 7,821.24 $16,076.07 Total Diyidends Posted in 2002 Prior to the Date of Death $235.30 $346.75 $329.19 $275.80 $345.17 $195.96 $243.45 $438.06 Dividends Accrued But Not Yet Posted as of the Date of Death $ 7.28 $ 7.40 $10.04 $ 8.12 $ 8.25 $ 6.21 $ 9.16 $11.30 The next table reflects total diyidends credited to the certificates after the date of death and the closing balances of the certificates: Control No. 0001 0004 0005 0006 0007 0009 0010 0011 Diyidends Posted After the Date of Death $182.78 $185.33 $251.97 $203.47 $206.65 $155.65 $230.28 $282.36 $ 7,215.65 $ 8,885.82 $ 9,946.30 $ 9,483.72 $ 9,632.25 $ 7,254.79 $ 8,051.52 $16,358.43 Closing Balance For the purpose of disbursement, the closing balances of the share certificates were transferred to Commander Hanson's share sayings account on 11 April. On the same date, additional diyidends of $1.15 were credited to his shares. After the transactions, his share sayings balance was $79,624.16. Since no joint owner was designated on Commander Hanson's share sayings account or share certificates, his estate is entitled to the combined balances. The enclosed check for $79,624.16 has been made payable to you as Administrator. We are also returning the certified copy of our Account Number 0592114-003 Page 3 on member's Death Certificate. In addition, his share savings account statement covering the period from I January through 31 March is enclosed. His accounts are now closed and the final statements wili be forwarded at a later date. Should you have any questions, please caU me, toU-free at 1-800-883-3323, extension 7503, between 8:00 a.m. and 4:30 p.m., Monday through Friday. You may also reach me by fax at 1-703-255-7963. Sincerely, .~. Robin Parker TP:rt Enclosures: Statement Insurance Brochure Check No. 2600240911 Certified CopylDeath Certificate ESTATE OF HARVEY E. HANSON FILE NO. 22 - 2002 - 00794 INHERITANCE TAX RETURN LAST WILL AND TEST AMENT '1;;f"uyn'"-ClI<.- "last Will anb ~t5tl1mtnt KNOW ALL \iES BY THESE PRESENTS: That L.~}~rv~L.E--" HanB~_ of the- (X.J\J,1XK'ilKXiK Borough. of-Dallaa. ._~_._., County oL_!JJ.zer!le and Stat' of Pennsylvania b" f d d." . . d d d k t: ~,-,~.- --_~ d.'~_._,_.__u..________. cmg 0 soun an ulsposmg mm an memory~ 0 rna e, I'uhl,," and declarc' rhe r,'lI,'wing to /:oe my LAST WILL AND TESTAMENT, hereby revoking aU Wills by me at any time heretofore made:. FI R)f I dltcoct m) Executrix. hereinafter named, 10 pay aU my funeral expenses, administration expenses of my estatl.'. incluJing mhcritancc and succession taxes. state or federal, which may be occasioned by the passage of or successIOn to an\' interest in my estate under the terms of this instrument, and aJl my just debts, excepting mortgage notes secured by mortgages upon real estate 0 .\'f:COS f). Ail the rest, rf'liduc and remainder of my estate, both real and personal. of whlitso- ever kind or "h:H<l(otcL J.1l(l whert'soever situated. I give. devise and bequeath to my beloved wife: I II /Ii J) . _~!:.!!;...re~j'{._~nsoJl_.___._ "_~___' to be hers absolutely and forever. (SEE ATTACHED DECREE IN DTVORrR \ 11 0"1.\ <;a:J ~I,;lfedoes not survlv\: mC', then I gi\'c:lf~!tc and bequeath such rest, residue and remainder of 111 ~ 1.''0' ~1lt: ill Name ..ElmeI_~E!_!lanson_-LD@'JLQE-DEATH=--~-1+2~~~_~__~ ~_ Address..._~ _~_~~4..~e.~~!e..!..S_t.r,,-e~__.~__~hko~.h_.___ Wisepnsl.n.. ')4901 !'>..::mlher 'streel City State to be his/hers absolutely and forever. fOURTH I here/:oy appoint my Wife _ ._Ma.r...gar"i..JiI....J~Jl~.n..___as Executrix of this my LAST WILL AND TESTAMENT. If she does not survive me, then I appoinL_Elmer E. Hanson as Exccutor!E,ecutri,. I direct that no Executor/Executrix serving hcreunder shall be required to post bond. IN WITNESS WHEREOF, I have hereunto set my hand and seal aL_.~Dallas, Pennsylvania this..~...____.__.!.s..!o..~____.__day of_ FebruBrY_____!9II_. (sign here)_~'/ L ~~~_~__.L.S. Signed. scaled, published and declared to be his LAST WILL AND TESTAMENT by the within named Testator in the presence or us. who in his presence and at his request. and in the presence of each other, have here- unto subscribed our nam~s as witnesses: ")H~~ (z)/;12-r-r e"d",vtJ_Of (3)mi~~Ci.Lf.Aj ~-C0~Of of ~~f~ ( ~. C', ., y /J) cth~'l~ City \,?c,- ~~ ;;-::'V31 ~ L ' State ~ II(,' ~A~:I_ State c--L A JJ:: ~ d City ~ <'LA.. . t ----~ :::::FOF : :: ~ '~_~_____m___HJ ss: (!)___.;I;~e'pa~yc_~~_~_________ _________ ______ i.:::: "A... "___._and (3)____.,J (,IL' TA.___~,,-~'t'" ,,_,._ (2) Personally appeared t? NNC.rJ., who being duly sworn, depose and say that they attested the said Will and they subscribed the same at the reque and in the presence of the said Testator ;:md in the presence of each olher. and the said Testator signed said W in their presence and acknowledged that he had signed said Will and declared the same to he hIS LAST WI LL AN TESTAMENT and deponents further stale that at the time of the execution of said Will tht- said Testator appeare to be of lawful age and sound mind and memory and there was no evidence of undue influence The deponen! make this affidavit at the request of the Testator. (I) -~_'<;-tf/:L:;;Ycb1/Y'~~~^'_! ,....- (2L~--{r~~~6--_-- (3)_L!.bP____~-::-~~~ ~-b ~:~:~;~~~:;:,~~~ m, ;>,iL... .... . L~ ...~...:J~~!',B:~~:7J. IIlNGST. N IOWNSHJP, LUZERNE COUNTY MY COMMISSION EXPlJlE. NOV. 2. !~!~ ........PfllDl1!rIJl/aASsllclatio.of~ 2 I "'- .~'f::.::< >::+;';:, '::,::.x:::.::.::<}::.::<~..::.x ~;.::.:< x:.::< :;.::+::{ x.;~.~:>::.::< ..'0::+;.:: :.,.::+;.:: :-;::+::;.;: >::+>, >::+;.:: ::;::+::.::: ;::+::;:. .::.::<.=.;: >:::.::O~>::.;{;:i:::.X>::.::~;::~;~:::.::~;;:::"::.;<>::.::;:;: ::.:::.X>::.X;:;'~i / ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ;.:.::'(::.o>>::.~ ):+;;<"'~::'-;." ~.) Y:) ~ "'" ,;~. ~ i"; II ~ ~.~ ~ ~ ~.~ i '.' i:.~ ~ ;.:.~ ~ ~ ~ ~.~ ~ ~.~ ~ N ~ ~ ~ ~': ~ ~ ~.~. ~ ~ ~ t.: ,., ~ ~ .' '-,; ,". ~ IN THE COURT OF COMMON PLEAS OF CUMBERLAND ~ COUNTY STATE OF PENNA. ~ ~.~ ~ '.' MARGARET N. HANSON. ....hh..u... I II I N (). 4.~~.4........:~vi~............ 19 92 .,', ~ tt1 ~.~ ~ y Plaintiff Versus ~ ~.' ...HAR\lEY. .E...HANSON,.. u.. ~ '.' ....h....Defendant . ~ ~.I A ~ N i ~.~ DECREE IN DIVORCE ~ '.' ANDNOW.......March.30.............., 1993...., it is ordered and decreed that... .~ '~" .IW-!~q~. .. .. . . . ... . . . . . . .. .. " .. .., plaintiff, and......... .HARVEY.E. . HANSON. .............................., defendant, are divorced from the bonds of matrimony, The court retains jurisdiction of the following claims which have been raised of record in this action for which a final order has not yet been entered; TW.1l. j\~~t. Dt:. ~ J.!l.. J..9.9.3. ,il>. A~.bY. .incp.:r:pp:r::a.t.ep, .i.llt.Q. . . .. ., " .. . . , :tP~. r;i~. P;iy!,!~. ~~P."~... . . .. .. .. .. .. .. .. . . . . . . .. . .. . . . . .. . .. .. . . . . . . .. .. . ny The Courl: /s/ J. Wesley Oler, Jr. Allesl: HH9~lJJ 'H{/)~r .0t1!~th~~~la~;"" ~ <l" ...fi . ~P'i-~-ssUED-1'EBRYAm',..~,h..-l,994-.~-~~ ~ "'. <::.::+;., --:.:.-::.;..::+:::-.::+;...::+:. .::+::. .::.~. .::.~. .::.~. .::.~."'-.~.Y-'.~"'":. .':N'......-{ .........' ...".-.......". ........ .'"...... ~.~ * ~ ~.~ ~ ~ ~ N ~ ~'i l, ~ ,.s ~ ;+; ~ ~ ~'j ~ ~ ~..~ ~ ,'S ~ ~.~ ltJ ~; ~.;. ~ ~ ~ ~~ ~ ~.~ .:. ~ ~ ~.~ ~.~ ~ ~ .~.~ $ ~ ~.~ ~ .... ~ ~.~ ~ ~.~ *- v ~ ~ ~ ~ '.' J. ~ a ~ v Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 8/03/2004 ZONARICH JOHN R 204 STATE STREET HARRISBURG, PA 17101 RE: Estate of HANSON HARVEY E File Number: 2002-00794 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: 9/09/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of HANSON, HARVEY E. No. 21 - 2002 - 00794 also known as Date of Death 9/9/2002 Deceased Social Security No. 397-07-0468 John R. Zonarich -- __ _-_ - _- The 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 located 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 the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. IANe verify that the statements made in this Inventory are true and correct. IANe understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: I.D. No.: Address: Personal Repr entat Shelly J. Kunkel Signatu -_ __ ' hn R. onarich 64485 Signature: 204 State Street Harrisburg, PA 17701 Signature: Address: 204 State Street Harrisburg, PA 1710] Telephone: 717/233-1000 _ Telephone:717-233-1000 __ _ - _ _ __ Dated: ~ ' ~ _/ ' ~3 Personal Prooertv Cash in decedent's wallet 26.00 Cash in decedent's apartment 332.00 Reader's Digest -Refund 12.80 USAA -Loss payment on 1991 Ford Escort 635.50 Ziegler Auction -Proceeds from sale of personal property 578 22 PNC Bank Checking Account No. 5140238873 (per verification letter attached hereto as 42 158.43 Schedule E) , PNC Bank Checking Account No. 5140238873 (accrued interest to DOD per verification letter 0.92 attached hereto as Schedule E) Navy Federal Credit Union Share Savings Account No. 0592114-003 (per verification letter .2,754.25 attached hereto as Schedule E) (Attach additional sheets if necessary) Total Personal Property and Real Estate 5121,710.00 Register of Wills of Cumberland County, Pennsylvania INVENTORY continued Estate of HANSON, HARVEY E. No. 21 - 2002 - 00794 -_ --- - __ _- __ also known as Date of Death 9/9/2002 Deceased Social Security No. 397-07-0468 Nary Federal Credit Union Share Savings Account No. 05921 14003 (accrued interest to DOD Iq,13 per verification letter attached hereto as Schedule E) Nary Federal Credit Union Share Certificate Account No. 05921 ]4-060-01 (per verification 7,032.g7 letter attached hereto as Schedule E) Navy Federal Credit Union Share Certificate Account No. 0592 1 14-060-0 1 (accrued interest to 7.2g DOD per verification letter attached hereto as Schedule E) Navy Federal Credit Union Shaze Certificate Account No. 0592114-060-04 (per verification 8,700.49 letter attached hereto as Schedule E) Navy Federal Credit Union Shaze Certificate Account No. 0592114-060-04 (accrued interest to 7,q0 DOD per verification letter attached hereto as Schedule E) Nary Federal Credit Union Share Certificate Account No. 0592114-060-OS (per verification 9,694.33 letter attached hereto as Schedule E) Nary Federal Credit Union Share Certificate Account No. 05921 14-060-OS (accrued interest to 10 04 DOD per verification letter attached hereto as Schedule E) . Navy Federal Credit Union Share Certificate Account No. 05921 14-060-06 (per verification letter attached hereto as Schedule E) 9,280.25 Navy Federal Credit Union Shaze Certificate Account No. 0592114-060-06 (accrued interest to 8 12 DOD per verification letter attached hereto as Schedule E) . Nary Federal Credit Union Share Certificate Account No. 0592114-060-07 (per verification letter attached hereto as Schedule E) 9,425.60 Nary Federal Credit Union Share Certificate Account No. 0592114-060-07 (accrued interest [o D 8 25 OD per verification letter attached hereto as Schedule E) ' Navy Federal Credit Union Shaze Certificate Account No. 0592114-060-09 (per verification letter attached hereto as Schedule E) 7,099.14 Nary Federal Credit Union Share Certificate Account No. 05921 14-060-09 (accrued interest to DOD per verification letter attached hereto a S h d l 6'21 s c e u e E) Navy Federal Credit Union Share Certificate Account No. 0592 1 14-060-0 1 0 (per verification letter attached hereto as Schedule E) 7,821.24 Nary Federal Credit Union Share Certificate Account No. 0592] ]4-060-010 (accrued interest 9.16 to DOD per verification letter attached hereto as Schedule E) 2 Register of Wills of Cumberland County, Pennsylvania INVENTORY continued Estate of HANSON, HARVEY E. No. 21 - 2002 - 00794 also known as Date of Death 9/9/2002 - _ _ - ,Deceased Social Security No. 397-07-0468 Navy Federal Credit Union Share Certificate Account No. 0592114-060-011 (per verification 16,076.07 letter attached hereto as Schedule E) Nary Federal Credit Union Share Certificate Account No. 0592 1 1 4-060-O1 I (accrued interest 11.30 to DOD per verification letter attached hereto as Schedule E) Total Personal Property $121,710.00 3 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1]128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SKARLATOS & ZONARICH LLP C/0 JOHN R ZONARICH 204 STATE STREET HARRISBURG, PA 17101 Iola ESTATE INFORMATION: ssrv: asp-o~-oars FILE NUMBER: 2102-0794 DECEDENT NAME: HANSON HARVEY E DATE OF PAYMENT: 09/25/2003 POSTMARK DATE: 09/23/2003 COUNTY: CUMBERLAND DATE OF DEATH: 09/09/2002 ACN ASSESSMENT CONTROL NUMBER REV-1162 EX111-961 NO. CD 003053 AMOUNT 101 ~ 516,301.99 TOTAL AMOUNT PAID: REMARKS: JOHN R ZONARICH ESQUIRE C/P SKARLATOS & ZONARICH LLP CHECK#1854 SEAL INITIALS: SK RECEIVED BY 516,301.99 DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS SK,AR~LE\TOS ~ ~!p;N:~RiCH LLP 20~ StatR Street tl:u•rishur~, PA i 7 i 01 OI~t~ice of Rc!!ister of ~~~'ills __ C'alml~crland County Court 1-louse I Courthouse Syunrc C.1. ~ I aCC. ~~/~ ~ ~I~) ~ ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUHEAU OF INDI VIpUAL TAXES DEPT. 280601 HARRISBURG, PA 1]1260601 RECEIVED FROM: SKARLATOS & ZONARICH 204 STATE STREET HARRISBURG, PA 17101 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssN: 3s7-o~-oase FILE NUMBER: 2102-0794 DECEDENT NAME: HANSON HARVEY E DATE OF PAYMENT: 12/01/2003 POSTMARK DATE: 11/18/2003 COUNTY: CUMBERLAND DATE OF DEATH: 09/09/2002 FEV-1162 EXI11-961 NO. CD 003289 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 5236.74 TOTAL AMOUNT PAID: REMARKS: SHELLY J KUNKEL C/0 SKARLATOS & ZONARICH CHECK# 2046 INITIALS: AC SEAL RECEIVED BY 5236.74 DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS \l7-lei- ~' y BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 288681 NgRRISBURG, Pp 17128-8681 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF 7AX REY-150 FX RFR [R1-RSl SHELLY J KUNKEL SKARLATOS 8 ZONARICH 204 STATE ST HBG PA 17101 CUT ALONG THIS LINE - RETAIN_LO_WER REV-1967 CY eee Fn~_nii-:.:.r:A~ G~ ~:: __c__~ DATE 11-10-2003 ESTATE OF HANSON HARVEY E DATE OF DEATH 09-09-2002 FILE NUMBER 21 02-0794 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 FOR YOUR RECORDS ~ alsRLLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ~ ~~ ESTATE OF HANSON HARVEY E FILE NO. 21 02-0794 ACN 101 DATE 11-10-2003 TAX RETURN HAS: [ X] ACCEPTED AS FILED ( ) CHANGED R1,ED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property lSChadula F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses [Schedule H) [q) 10,862.52 30. Debts/Mortgage Liabilf {ias/Liens (Schedule I) [10) 2.167 54 11. Total Deduc{ions (11) 13,030.06 12. Net value of Tax Return 108 679 94 13. Charitable/Governmental Bequests) Non-elected 9113 Trusts (Schedule J] [12) (13) , . .00 14. Net Value of Estate Subject to Tax [ly) 108,679.94 NOTE: if an assessment was issued previously, lines 14, 15 and/or 16 17 18 d refiect figures that include the total of ALL returns assess , , ed to date an 19 will ASSESSMENT OF TAX: . 15. Amount of Line 14 at Spousal rate (15) .00 00 _ OD 16. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 X X 045 - . .00 17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00 18. Amount of Line 14 taxable at Collateral/Class B rate [18) 108,679.94 X 15 16,301.99 19. Principal lax Dua AX CR D TS• [14)= 16,301.99 DATE NUMBER INTEREST/PEN PAID (-] AMOUNT PAID 09-23-2003 CD003053 00 . 16,301.99 BALANCE OF U NPAID TNTFRFCT/pFN Al rv nc nr 09-24-2003 TOTAL TAX CREDIT 16,301.99 BALANCE OF TAX DUE .00 INTEREST AND PEN. 236.74 TOTAL DUE 236.74 (1) .00 NOTE: To insure proper f2) .00 credit to your account, f3) .00 subait the upper portion (4) .00 of this fora with your [5) 121.710.00 tax paynen{. (6) .00 m .00 (a) 121,710.00 N IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF 70TAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A '•CREDIT•' [CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR TNSTRUrrrnuc 1 BUREAU OF INDIVIDUAL Taxes COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA% DIVISION DEPARTMENT OF REVENUE DEPT. 280681 HARRISBURG, pa 1712a-8681 NOTICE OF INHERITANCE TAX APPRAISENENT, ALLONANCE OR DISALLDNANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-154) FR RF, nl-R5~ DATE 11-10-2003 ESTATE OF HANSON HARVEY E DATE OF DEATH 09-09-2002 FILE NUMBER 21 02-0794 SHELLY J KUNKEL COUNTY CUMBERLAND SKARLATOS & ZONARICH ACN 101 204 STATE ST Amount Remitted HBG PA 17101 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS t REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISENENT, ALLOWANCE OR --'-------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HANSON HARVEY E FILE NO. 21 02-0794 ACN 101 DATE 11-10-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( )CHANGED AASED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership In{crest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly ONnad Property [Schedule F] 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H7 (q) 10,862.52 18. Debts/Mortgage Liabilities/Liens (Schedule I) (10). 2.167.54 11. Total Deductions 12 (117 7$.030.06 . Net Value of Tax Return (12) 108,679.94 13. Charitable/Governmental Bequests) Non-elected 9113 Trus ts (Schedule J) (13) .00 14. Net Value of Estate Sub,iaet {o Tax (ly) 108,679 .94 NOTE: If an assessment was issued previousiy, lines refiee± finFJres tha± ;nrl~ul th 14, 15 andior 16, 17, 18 and 19 will e e ±Dtal Df ASSESSMENT OF TAX: ALL returns assessed #e datA, 15. Amount of Lina 14 at Spousal rate (15) .00 X 00 _ DO 16 Amount f L . . o ine 14 4axable at Lineal/Glass A rate (16) .00 X 045 - 00 17. Amount of Line 14 at Sibling rata (17) .00 X 12 - . 00 18 Amount f Li . . o na 14 taxable at Collateral/Class B rate (18) 108,679.94 X 15 - 16 301 99 19. Principal Tax Due , . A C ED T (19)- 16,301. 99 DATE 09-23-2003 NUMBER INTEREST/PEN PAID (-) AMOUNT PAID CD003053 .00 16,301.99 BALANCE OF U NPATD TNTFAFCT 7D E:u n~ Tv n~ ..~ 09-24-2003 TOTAL TAX CREDIT 16,301.99 BALANCE OF TAX DUE .00 INTEREST AND PEN. 236.74 TOTAL DUE 236.74 [1) .DO NOTE: To insure proper [2) .00 credit to your account, (3) .00 submit {he upper portion (4) .00 of this ;orn with your (5) 121.710.00 tax payment. (6) .00 m .00 (g) 121,710.00 n IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED pS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCnags.l ~~~ iii-~ BUREAU OF INDIVIDUAL TAxes COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA% aIVI5I0N DEPARTMENT OF REVENUE REpT. zaobol HARRI58lIRG, pp 171za-x601 INHERITANCE TAX STATEMENT OF ACCOUNT REY-160) F! RFV f01-Bn DATE 12-08-2003 ESTATE OF HANSOM HARVEY E DATE OF DEATH D9-09-2002 FILE NUMBER 21 02-0794 SHELLY J KUNKEL COUNTY CUMBERLAND SKARLATOS & ZONARICH ACN 101 2D4 STATE ST Anount Ranittad HBG PA 17101 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this Porn with your tax paynant. ALONG THIS LINE x** ESTATE OF HANSOM HARVEY E FILE N0. 21 02-0794 ACN 101 DATE 12-08-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-10-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 16,301.99 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 09-23-2003 CD003D53 .00 16,301.99 11-18-2003 CD003289 236.74- 236.74 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. • IF PAID AFTER THIS DATE, SEE REVERSE I TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS TXAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ••CREDIT•' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TNIS FORM FOR INSTRUCTIONS. ) LOWER PORTION FOR YOUR RECORDS ~ 16,301.99 .00 .00 .OD In the Orphans' Court Division of the Court of Common Pleas of Cumberland County COMMONWEALTH OF PENNSYLVANIA No. 21-02-00794 Estate of HARVEY E. HANSON, Deceased Late of East Pennsboro Township, Cumberland County, Pennsylvania FIRST AND FINAL ACCOUNT of JOHN R. ZONARICH, EXECUTOR Date of Death: September 9, 2002 Letters Granted: February 12, 2003 First Complete Advertisement of Grant of Letters: March 21, 2003 Account Stated to: December 1, 2003 SUMMARY & INDEX PRINCIPAL Pa es Receipts 2 Net Gain or (Loss) on Conversions 3-4 $ 121,234.55 Adjusted Balance Less Disbursements 6 $ 121,234.55 Balance before Distributions _ (32,528.86) Distributions to Beneficiaries 6 $ 88,705.69 Principal Balance Remaining _ INCOME Receipts 7 8 Less Disbursements $ 2,391.48 9 Balance before Distributions Less Distributions to Beneficiaries $ 2,391.48 9 _ Income Balance Remaining COMBINED BALANCE REMAINING INVESTMENTS CAPITAL CHANGES AFFIDAVIT OF ACCOUNTING PARTY SCHEDULE OF PROPOSED FINAL DISTRIBUTIONS 5 5 9 Exhibit A (at Page 11) $ 88,705.69 2,391.48 $ 91,097.17 COMPOSITION OF NET BALANCES Total Principal and Income Combined Cash Commerce Bank Estate Escrow Direct Account Market Value Decemb~rl 2003 91, 097.17 Account Value TOTAL PRINCIPAL AND INCOME COMBINED PRINCIPAL RECEIPTS Per Inventory Filed 91,097.17 91,097.17 91,097.17 121,710.00 Per Copy of Inventory attached to the Petition for Distribution as Exhibit "C" Adjustments to Account Vatues Auto debit from PNC Checking for direct pay electric bill after date of death Auto debit from PNC Checking for direct pay electric bill after date of death Auto debit from PNC Checking for direct pay AARP premium after date of death Auto debit from PNC Checking for direct pay AARP premium after date of death TOTAL PRINCIPAL RECEIPTS (101.00) (76.95) (148.75) (148.75) 121,234.55 Page 2 CONVERSIONS INTO CASH 02/21/03 PNC Bank Checking Account # 51402238873 Gain Loss Proceeds Inventoried at 42,158.43 42,158.43 02/21/03 PNC Bank Checking Account # 514022388 73 ,Accrued Interest Proceeds Inventoried at 0'92 0.92 04/24/03 Navy Fed. Credit Union Savings # 0592114-003 Proceeds Inventoried at 2,754.25 2,754.25 04/24/03 Navy Fed. Credit Union Savin s # 0592114 g -003 ,Accrued Interest Proceeds Inventoried at 14.13 14.13 04/24/03 Navy FCU CD # 0592114-060-0001 Proceeds 7,032.87 Inventoried at 7,032.87 04/24/03 Navy FCU CD # 0592114-060-0001 ,Accrued Interest Proceeds 7 28 Inventoried at 7.28 04/24/03 Navy FCU CD # 0592114-060-0004 Proceeds 8,700.49 Inventoried at 8,700.49 04/24/03 Navy FCU CD # 0592114-060-0004 ,Accrued Interest Proceeds 7.40 Inventoried at 7.40 04/24/03 Navy FCU CD # 0592114-060-0005 Proceeds Inventoried at 9,694.33 9,694.33 04/24/03 Navy FCU CD # 0592114-060-0005 ,Accrued Interest Proceeds Inventoried at 10.04 10.04 04/24/03 Navy FCU CD # 0592114-060-0006 Proceeds 9,280.25 Inventoried at 9,280.25 Page 3 04/24/03 Navy FCU CD # 0592114-060-0006 ,Accrued Interest Proceeds 8 12 Inventoried at 8 12 04/24/03 Navy FCU CD # 0592114-060-0007 Proceeds 9,425.60 Inventoried at 9,425.60 04/24/03 Navy FCU CD # 0592114-060-0007 ,Accrued Interest Proceeds 8 25 Inventoried at 8.25 04/24/03 Navy FCU CD # 0592114-060-0009 Proceeds 7,099.14 Inventoried at 7,099.14 04/24/03 Navy FCU CD # 0592114-060-0009 ,Accrued Interest Proceeds 6 21 Inventoried at 6 21 04/24/03 Navy FCU CD # 0592114-060-0010 Proceeds 7 621 24 Inventoried at 7 821 24 04/24/03 Navy FCU CD # 0592114-060-0010 ,Accrued Interest Proceeds 9 16 Inventoried at 9.16 04/24/03 Navy FCU CD # 0592114-060-0011 Proceeds 16,076.07 Inventoried at 16,076.07 04/24/03 Navy FCU CD # 0592114-060-0011 ,Accrued Interest Proceeds 11.30 Inventoried at 11.30 04/08/03 USAA -Loss Payment on 1991 Ford Escort Proceeds 635.50 Inventoried at 635.50 06/05/03 Zeigler Auction Proceeds Proceeds 578.22 Inventoried at 578 22 TOTAL TRANSFERRED TO SUMMARY Page 4 PRINCIPAL INVESTMENTS 11/05/02 Initial Cash deposit, Legacy Bank, Estate Checking Account 26.00 12/31/02 Cash deposit, Commerce Bank, Escrow Direct Account 26.00 Close Legacy Bank Estate Checking and transfer funds to Commerce Bank PRINCIPAL CAPITAL CHANGES Legacv Bank Estate Savings Account 11/05/02 Deposit -Cash from Decedent's wallet 26.00 12/29/02 Withdrawal -Transfer funds to Commerce Bank Distribution Account 26.00 Commerce Bank Estate Distribution/Checking Account 12/29/02 Deposit -Transfer all funds from Legacy Bank to Commerce Bank 26.00 02/20/03 Deposit -Cash found in Decedent's apartment 332.00 02/21/03 Deposit -Close out of PNC Bank account 41,721.29 04/24/03 Deposit -Close out of Navy Federal Credit Union Accounts 79,624.16 Page 5 PRINCIPAL DISBURSEMENTS 02/21/03 Capital Self Storage Mechanicsburg -unit fee for storage of personal items 02/27/03 Skarlatos &Zonarich, LLP -retainer 89.04 03/06/03 Information Network Associates -private investigation and heir search 1,600.00 03/06/03 Margaret N. Griffin -reimbursement for obituary expenses 150.00 03/06/03 Wesley Park Townhouses -final rent 75.60 03/06/03 Wesley Park Townhouses -packing and moving personalty to storage shed 1,912.60 03/06/03 Verizon - 40 Falcon Court -telephone bill 1,000.00 03/06/03 Comcast Cable - 40 Falcon Court -cable bill 85.00 03/06/03 Reader's Digest -balance due on subscription 116.03 03/24/03 Capital Self Storage Mechanicsburg -unit fee for storage of personal items 25.41 03/27/03 Skarlatos &Zonarich, LLP -retainer 04/22/03 Skarlatos &Zonarich, LLP -costs reimbursed 800.00 04/29/03 Skarlatos &Zonarich, LLP -retainer 260.91 05/29/03 Skarlatos &Zonarich, LLP -retainer 800.00 06/04/03 Skarlatos &Zonarich, LLP -costs reimbursed 800.00 06/27/03 Skarlatos &Zonarich, LLP -retainer 407.39 07/02/03 Information Network Associates -private investigation and heir search 800.00 07/30/03 Skarlatos &Zonarich, LLP -retainer 75.00 08/04/03 Ray's Tax Service -preparation of final 1040 800.00 08/21/03 Skarlatos &Zonarich, LLP, retainer 168.25 08/26/23 The Sentinel -Estate advertisement 2,000.00 08/27/03 Skarlatos &Zonarich, LLP, retainer 91.85 09/04/03 Milwaukee County -Certified Copy of James H. Hanson Birth Record Testimony 906.05 1 09/22/03 Cumberland County Register of Wills -inheritance tax payment 1.00 09/23/03 Cumberland County Register of Wills -filing fee for PA 1500 and inventory 16,301.99 09/26/03 Skarlatos &Zonarich, LLP -retainer 31.00 09/30/03 Cumberland County Register of W ills -Additional probate fee 800.00 11/17/03 H&R Block Premium -Preparation fee for 1041 and PA 41 fid i 35.00 11/17/03 uc ary returns PA Department of Revenue -interest on inheritance tax 450.00 12/10/03 Cumberland County Register of Wills -Filing fee for First and Final Account 236.74 Reserve for final fiduciary income tax return 150.00 RESERVE FOR FINAL EXPENSES 550.00 1,000.00 TOTAL PRINCIPAL DISBURSEMENTS 32,528.86 PRINCIPAL DISTRIBUTIONS TO BENEFICIARIES NONE Page 6 INCOME RECEIPTS Commerce Bank Estate Account 02/28/03 Interest 03/31/03 Interest 2.34 04/30/03 Interest 29.16 05/31 /03 Interest 33.37 06/30/03 Interest 95.35 07/25/03 Interest 97.78 08/31/03 Interest 93.93 09/30/03 Interest 96.14 10/31/03 Interest 92.04 11/30/03 Interest 76.74 79.21 Navv Federal Credit Union CD # 0592114 060-0001 09/30/02 Dividend from DOD through 9/30/03 10/31/02 Dividend 17.03 11/30/02 Dividend 25'22 12/31/02 Dividend 24.49 01/31/03 Dividend 25.40 02/28/03 Dividend 25.48 03/31/03 Dividend 23.10 04/11/03 Dividend from 4/01/03 through close 25.66 9.12 Navv Federal Credit Union CD # 0592114-060-0004 09/30/02 Dividend from DOD through 9/30/02 10/31/02 Dividend 17 31 11/30/02 Dividend 25.60 12/31/02 Dividend 24'85 01/31/03 Dividend 25.75 02/28/03 Dividend 25.83 03/31/03 Dividend 23.39 04/11/03 Dividend from 4/01/03 through close 25.97 9.23 Navv Federal Credit Union CD # 0592114 060-0005 09/30/02 Dividend from DOD through 9/30/02 10/31/02 Dividend 23.48 11/30/02 Dividend 34.76 12/31!02 Dividend 33.76 01/31/03 Dividend 35.01 02/28/03 Dividend 35.13 03/31/03 Dividend 31.84 04/11/03 Dividend from 4/01/03 through close 35.36 12.59 Navv Federal Credit U nion CD # 0592114 060 0006 09/30/02 Dividend from DOD through 9/30/02 10/31/02 Dividend 19.00 11/30/02 Dividend 28.10 12/31/02 Dividend 27'28 01/31/03 Dividend 28'27 02/28/03 Dividend 28.36 03/31/03 Dividend 25.68 04/11/03 Dividend from 4/01/03 through close 28.52 10.14 Page 7 Naw Federal Credit Union CD # 0592114-060-0007 09/30/02 Dividend from DOD through 9/30/03 10/31/02 Dividend 19 29 11/30/02 Dividend 28'54 12/31/02 Dividend 27'71 01/31/03 Dividend 28'71 02/28/03 Dividend 28'80 03/31/03 Dividend 26.09 04/11/03 Dividend from 4/01/03 through close 28.96 Nav v Federal Credit Union CD # 0592114-060 0009 10.30 09/30/02 Dividend from DOD through 9/30/02 10/31/02 Dividend 14.53 11/30/02 Dividend 21.50 12/31/02 Dividend 2087 01/31/03 Dividend 21.63 02/28/03 Dividend 21.69 03/31/03 Dividend 19.65 04/11/03 Dividend from 4/01/03 through close 2181 Navv Federal Credit Union CD # 0592114-060-0010 7 76 09/30/02 Dividend from DOD through 9/30/02 10/31/02 Dividend 21.43 11/30/02 Dividend 31.74 12/31/02 Dividend 30.83 01/31/03 Dividend 3199 02/28/03 Dividend 32.12 03/31/03 Dividend 29.13 04/11/03 Dividend from 4/01/03 through close 32.37 Naw Federal Credit Union CD # 0592114-060-0011 11.51 09/30/02 Dividend from DOD through 9/30/02 10/31/02 Dividend 26.40 11/30/02 Dividend 39.05 12/31/02 Dividend 37 88 01/31/03 Dividend 39.23 02/28/03 Dividend 39.34 03/31/03 Dividend 35.60 04/11/03 Dividend from 4/01/03 through close 39.52 Navv Federal Credit Union Savings # 0592114-003 14 04 10/01/02 3rd Quarter 2002 Dividend from DOD through 10/01/02 01/01/03 4th Quarter 2002 Dividend 3.62 04/01/03 1st Quarter 2003 Dividend 12 23 04/11/03 Dividend from 4/02/03 through close 10.30 1 15 PNC Bank Checking Account # 51-4023-8873 10/04/02 Interest from DOD through 10/04/03 11/05/02 Interest 5.73 12/05/02 Interest 7 31 01/07/03 Interest 6.84 02/05/03 Interest 7 51 02/21/03 Interest from 2/05/03 through close 6.59 3.41 TOTAL INCOME RECEIPTS 2,391.48 Page 8 1 INCOME DISBURSEMENTS NONE INCOME DISTRIBUTIONS TO BENEFICIARIES NONE Page 9 In the Orphans' Court Division of the Court of Common Pleas of Cumberland County COMMONWEALTH OF PENNSYLVANIA No. 21-02-00794 Estate of HARVEY E.HANSON,Deceased Late of East Pennsboro Township, Cumberland County, Pennsylvania AFFIDAVIT OF ACCOUNTING PARTY COMMONWEALTH OF PENNSYLVANIA DAUPHIN COUNTY JOHN R. ZONARICH, ESQUIRE, EXECUTOR, being duly sworn according to law, deposes and says that he is the Accountant in the Estate above named, and that the FIRST AND FINAL ACCOUNT stated to December 1, 2003 contains according to the best of his knowledge and belief a true statement of all his receipts and disbursements on account of the Estate and of all moneys or other property belonging to the Estate which have come into his hands or been received by any other person by our order or authority for his use and that he does not know of any error or ommission in the account to the prejudice of any creditor of r person interested in, the Estate; and that the Grant of Letters Test enta nd the first ~COmpl ertisement th of o curved more than four (4) months before filing the Fir and Fidel count. ~/ R. Sworn aytd Subscribe~dybE~fore me this ~ day of ~'p d~~r Q~~ ~~~ ~ ~`.s ~ Notary Public' '~ Notarial Seal Sharon K. Shatter, Nolan y City of Harrisbur , t ublic MY Commission Ex aesaSeir~ County P p.. h, ?004 Member; Pennsylvaniagssxiation afNotaries Page 10 In the Orphans' Court Division of the Court of Common Pleas of Cumberland County COMMONWEALTH OF PENNSYLVANIA No. 21-02-00794 Estate of HARVEY E. HANSON, Deceased Late of East Pennsboro Township, Cumberland County, Pennsylvania SCHEDULE OF PROPOSED DISTRIBUTION Balance for distribution as per Dated December 1, 2003 FIRST AND FINAL ACCOUNT $ 91,097.17 Distribution Marene S. Hanson Principal Cash (residue) Income Cash (residue) Nancy Lafever Principal Cash (residue) Income Cash (residue) Market Value Decembert 2003 $ 44,352.85 $ 1,195.74 $ 44,352.85 $ 1,195.74 $ 91,097.17 Cost Basis 44,352.85 1,195.74 44,352.85 1,195.74 Proposed Distribution Page 1 of 2 STATEMENT OF THE REASONS FOR THE PROPOSED DISTRIBUTION The above distribution is proposed in accordance will COMMONWEALTH OF PENNSYLVANIA ) ss. COUNTY OF DAUPHIN ) JOHN R. ZONARICH, ESQUIRE, being duly sworn according3a Executor and the Accountant in the Estate above named, and that the facts Reasons for the Proposed Distribution are true and correct. Sworn a d Subscribed b fore me this day of ~!t 0: ~~t llJ7 '~~~~-- Notary Public / 7i` ---~_ _._ Notarial Seal Sharon K. Shaffer, Notary pubBe Ciry of Harrisburg, Dauphin County My Commission Expires Sept, 6, 2004 Member, PennsyNan is Assp~iation of Notaries deposes and says that he is the orth in the Statement of the Proposed Distribution Page 2 of 2 In the Orphans' Court Division of the Court of Common Pleas of Cumberland County COMMONWEALTH OF PENNSYLVANIA Na. 21-02-00794 Estate of HARVEY E. HANSON, Deceased Late of East Pennsboro Township, Cumberland County, Pennsylvania SCHEDULE OF DISTRIBUTION of Schedule of Distribution in accordance with Adjudication dated J., upon the First and Final Account of John R. Zonarich, Esquire, Executor. Balance for distribution as per FIRST AND FINAL ACCOUNT Dated December 1, 2003 $ 91 097 17 Distributions to Beneficiaries oer Account CERTIFICATION OF SCHEDULE OF DISTRIBUTION I hereby certify that the foregoing Schedule of Distribution is correct and in conformity with the intestate laws of the Commonwealth of Pennsylvania. Attorney fo ccountant STATUS REPORT UNDER RULE 6.12 Name of Decedent: ]~/q~ Date of Death: ~'- ~- Will No.: ,.POo,,~.. _ 00"7 Admin. No.: 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: 1. State w~he, cther administration of the estate is complete: Yes l_.d" 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 re,.~pre,~entative 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 [~2 Date: 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 report. Signature Name Capacity: Address o Telephone No. ~-] Personal Representative fiJ~Counsel for personal representative /-71o/