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HomeMy WebLinkAbout02-1049 PETITION FOR PItTOBATE and GR~NT OF LETTERS Estate of _C~1 ~ iq~ +G.h ~. ~"'[~ ~ No. 2 ~ - Q Z " ~ ~ 7 g also known as To: Deceased. Social Security No. l~~-3 4s' - ~© 3O ~ _ Register of ills for the County of t` ~ C~ in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut O t -S named in the last will of the above decedent, dated A ~ r; 1 ~ ~ ~E;~ and codicil(s) dated ' (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~,,,,,~ v~~nQ.^ L~.~ ~ County, Pennsylvania, with h_; S last family or principal residence at _ `~ 3l Y W _ F'; ,,.p ~-p,.~c~} (list street, number and muncipality) at Decendent, then ~ ~ _ years of age, died i~9 ~ ~ , Except as follows, decedent did not marry, was not divorced and did not have a chil rn or adopted after execution of the will 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 $ (7 OC~y . ~~ (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: WHEREFORE, petitioner(s) respectfully re uest(s) the probate of the last will and codicil(s) presented herewith and the grant of letters CS't~G..l+ti2.ti'}+r~. a ~-r (testamentary; administr c.t.a.; administration d.b.n.c.t.a.) theron. G v ~~ v~ ~ ~.~ ~7; rtiav/ ~ f tb - 2~(,rY1CLf ~a 7 0 1YIf' ~~` ~~'~~'-/A ~ ~b (~ S lrl 1 ~- t-,-t~ 1 l Y 1 ' ' w~ ~ / ~t7 5 ~ ~' a m OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1 COUNTY OF _ ~'-urt ~ I Art.. ~ ss 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 and truly administer the estate according to law. Sworn to or affirme~and subscribed ~/: cn bef, owe me this /! day of oo~ ~nm1~J y a u. ;; Re tster No. ~~-n~-io49 Estate of CHRISTIAN H. OTTO Deceased DECREE OF PROBATE AND GRANT OF LETTERS NOVEMBER 22, ~ 2002 in consideration of the petition an AND NOW ' the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated APRIL 14 200 described therein be admitted to probate and filed of record as the last will of CHRISTIAN H. OTTO _ - and Letters TESTAMENTARY .- are hereby granted to MICHAEL C OTTO ANT) TFNNTFFu r uFRMAN ti ~. Register of `Yids FEES Probate, Letters, Etc. ......... ~ 50.00 Short Certificates( ) .......... ~ - . 00 ~.~I~XX •FX • PAGE S • ~ •4 S 12.00 JCP ~ 10.00 TOTAL ~ 87.00 Filed .. NOVEMBER• 22, .2002 JOHN C ZEPP III ESQUIRE 52662 ATTORNEY (Sup. Ct. LD. No.) P 0 BOX 204 ADDRESS YORK SPRINGS, PA 17372 PHONE 717-528-8900 CALLED MIKE OTTO NOVEMBER 22, 2002 This n ro cerrifv that the information here given is correctly copied from an original certificate of death duly filed with me as 1.Ocal Registrar. ~[~he original certificate will he.forwarded ro die Starr Viral Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. I~rc f~tr this certifirue, ;~2.1)O s~ ~7~3890 ~iL. ~ • ~~'a.9.-C.1I'~~ Local }Zegisrrar ~o'r ~ s 2002 I~:,te H105.taa Raw. ,/9, COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH PRINT • VITAL RECORDS CERTIFICATE OF DEATH (Coroner) tNENT K INK NAME OF DECEDENT (Fug, Mgtlb. La&) STATE FILE NUMBER +. Christian H Otto SE% SOCIAL SECURITY NUMBER DATE OF DEATH (MOnM, Day. Year) AGE L S z. N.ale ,, 165-38-0303 November 16 2002 ( ag lrtntlay) UNDERtYEAR UNDERt DAV DATE OF BIRTH BIRTHPLACE(City antl PLACE OF DEATH (Che A. ck only ona-see in v i , MonIM Days Moun Minutes (MOnM. Day. Year? Stale or FOreipn Country) s un ons on anal aide) HOSPITAL: 55 yrs. S Oct. 17, 1947 M~. Ho~-Qy Sp2-l.n OTHER: lyatiam^ ERrodpat»m^ Ow^ " ^ a ' ' COUNTY OF DEATH 7. I tom:^ R•Nllenca~ ( $p ecrilyJ^ ~' Cumberland CITY, BOR W DEATH South Middleton FACILIN A eat erW number) 724 West Pine St WAS DECEDENT OF HISPANIC ORIGIN] •, l "°~ ~••^N RACE-Am risen • IM4n, Sock, WnRe, etc. (s,eci ti > ab• ' k. ~ reet , apsc y swan, r Mexican, PuMO Rken, H0. / . wh.cte DECEDENT S USUAL OCCUPATION (GNe kiMdwpk cone duri g rp of l i Ia G HIND FSU NE 5/WDUS RV WAS DECEDENT EVER IN U.S.ARMED FOR 37 C ~ DECEDENT'S EDUCATION f onl h' nest ratle m t d ~' MARITAL STATUS-Married 10. SURVIVING SPOUSE wor r ; do not use retlre .l D~..apa~chea Thanepoh-ta.t~ on r ~ Yea ^ No L] o a Navr MarrNd, Widowed, EN '^Yn3PrY/SegnderY Calb9e Diwxeed S M) PI wile, prve meitlen name) • nt• . ,tb. ,z (at2) It.aorsil D-(.VORC~[~ DE~SpE/dT',S,MNLyJGAp~RE$SyStreel, CAyROwn, Stets, Zip Codel DECEDENT'S . ,a 1a• 15. '~' ACTUAL n.. state P nn y.Pvan.~a Ddepnedem 17c~ Yea. deceeant lived in_ $OUZi2 M-fdd~eZOn n M-t. HoP.2 S h<n e PA 17065 RESIDENCE y p 9 a ,sea Ingrucecna kve in a 16. an finer gtlel township] Wo, decetlent llvetl FRTHER'S NAMEIFxs 77b. Colin _LIl(llb Pk.QQ n[t __ 17tl.^ shin attual limits of CD.~-E`~tm H. Unto u. INFORMANT'S NAME ypNPnm) ~. M~.chae~ c. Otto METHOD OF DISPOSITION pp~~ BurW ^ Cremation p-I Removal hom State ^ Donnbn^ otn.r (soeciNl. ian M neI 4Ufe 01 LM er•Y oM quw on •ech Ilne. RIMEDUITE CAUSE (Final baaes• a condeion rawAarq in deem)-. ,._ Oe.M) uaT ... x,v,LanrLe_ mye~c4-.. 79. INFORMANT'S MAILING ADDRESS (Street City ,. 23 7n~ne Ave. Mt. DATE OF DISPOSITION PLACE OF DISPOSITION-Name of Cemetery,( (MOMh, Dey, Year or Otllar %aF• ~ Nov. ~0, 2002 Ho.2.2.cngen Cnematohy 21b. Q,.~~t~I s/~ t1c. Ng~/Fq p {~ LICENSV I 1 ~07L TI II~C~~L~~O!"iCi 22b. 22e. 9e, de91h occurred U Ina time, qte antl plea slated. LICENSE N rX. DyiTE PRONOUNCED DEAD (MOnM, Dey, Year) WAS CASE A. M, 2S- November 16, 2002 to o not enter the mode of dylrp, each ea grtllac or reepintory arre9l. ahockor bean fwa,,.. , e..,.....~...... cnrvnmeur IaTM6LE PRIOR TO (MOnM, oay, Year) TIME O~ OF DEA7H1 COMPLETION OF CAUSE Natural ^ Homkide ^ NOV. 16, 2002 Na ^ No ~ Yea ^ No ^ A«aem ^ Pendlrlg mvnglyalion ^ ,w. ,ob. SukkN TSB PLACE OFINJURY-At home, lane, arrest >~• :ab. Jr-~ coddrlabaaatermknw ^ lalalr~y.lxo.(spaciry) Farm 20. :FMIFlER (Check ody ona) •Te 1M beH olP~know N (Phygden certilyinq quae d Oeeln when eroMer physician nes protwuncetl tleeM end competed Item 23) my ladye, warn oeeumd tlue to the eaueN•) aM manror a •tet•d ..................................................... ^ •PRONOVNCINO AND DERTIFYING PHYSICIAN (Phygwn both pronouncirp waM en0 grtayirp to cause d deaM) TO Ule bMl e/ mY krbwletlpe, Oath oeturrrrtl at me tkne, dab, arM pleas, antl dw to the quee(n) and manmr n elated......... , . ^ 'MEDICAL E1(AMINER/CORONER ' On 1M bnh a eaaminatlon arM/or Inveatlyatlon, In my opinion, tleeth xeurrstl at the time, date, antl place, antl due to Ma cause • end manner as atalM ........................... fa. .............................................................. REGISTRAR'S SKiNATURE AND NU gas, PA 17065 )N -atyrtown, slate, zip Clx1a No.~.2y Spx.~ng3,PA17065 yM-t.Ho y Spx.cnq~s, J IIMmM, DeY. Year) zx ~DI~ EXAMINER/CORONER7 ^ JI'`(T NO in PART I. .ae ^ Not7E Intentional Hanging M. 30e. ,ptl- Ibe LOCATION (Street CM/TOwn, Stale) e St.,Mt.Holly Springs,PA iRE AN TI Coroner NUMRE DATE SIGNED (MOnM, Day Near) „a.November 18, 2002 ID ADDRESS OF PERSON WMO COMPLETED CAUSE OF DEATH type or Print Michael L. Norris, Coroner 6375 Basehore Road, Suite lit Mechanicsburg, Pa. 17050 IvO~. (~. d0~a. r LAST WILL AND TESTAMENT OF CHRISTIAN H. OTTO I, CHRISTIAN H. OTTO, Cumberland County, Pennsylvania, being ofsound and disposing mind, memory, and understanding, do hereby publish and declare the following as and for my bast Will and Testament, hereby revoking any and all Wills by me at any time heretofore made. ITEM I I direct that all of my legal debts, the expenses of my last illness, and my funeral expenses be paid from my residuary estate, as soon as practicable after my decease, as part of the expenses ofthe administration of my estate ITEM II I give and bequeath all of my jewelry, automobiles, clothing and other personal effects, as well ~ as all household goods and equipment which I may own, including any insurance thereon to my children, 'Michael C. Otto and Jennifer J. Herman, if they are living thirty (30) days after the date of my death. In the event that any of rr~y children should predecease me, then the share to which that child ~ would have been entitled I hereby give, devise, and bequeath to that child's child. Any of such effects distributed to a minor may be delivered to the person with whom the minor resides, or such other person as may have custody and control of the person of the minor, without the intervention of a guardian, and the receipt of any such person shall be a full acquittance of my Executor as to such distribution. r ITEM III All of the rest, residue, and remainder of my estate, real, personal or mixed, of whatsoever kind and nature and wheresoever situate at the time of my decease, I give, devise, and bequeath to as follows: a. Five Thousand ($5,000.00) Dollars to my granddaughter, Elizabeth C. Herman; b. Five Thousand ($5,000.00) Dollars to my grandson, Spenser C. Otto; and all the rest, residue, and remainder of my estate to my children, Michael C. Otto and Jennifer- J. Herman, if they are living thirty (30) days after the date of my decease, in equal share. The individual gift to either of my grandchildren should not be made to him. or her if he or she in inheriting their parent's share pursuant to ITEM IV. ITEM IV In the event that any of my children should predecease me, then the share to which that child would have been entitled I hereby give, devise, and bequeath as follows: a. Jennifer J. Herman's share to PNC Bank, IN TRUST for the benefit Jennifer's daughter, Elizabeth C. Herman; and b. Michael C. Otto's share to PNC Bank, INTRUST for the benefit ofMichael's son, Spenser C. Otto. The Trusts to be administered, and distributed in accordance with the following provisions 1VIy Trustee shall hold each share as a separate fund and shall pay all the net income there from in quarter-annual installments, to or i=or the beneficiary's benefit until he or she attains the age of twenty-one {21) years. Further, during the period of time that the income is being so distributed, my Trustee is hereby authorized to pay and distribute to or for the benefit of the child so much of the ^~ principal hereof as my Trustee deems advisable for their health, maintenance, support and education. Upon the Trust beneficiary attaining the age of twenty-one (21) my Trustee shall pay to him of her the corpus of the Trust free and clear of Trust. ITEM V I nominate, constitute and appoint my children, Michael C. Otto, and Jennifer J. Herman, to be the Executors of this my Last Will and Testament. If either Co-Executor is unable or unwilling to act or continue as Co-Executor, for any reason whatsoever and whether before or after my death, I direct that the vacancy not be filled and that the then remaining Executor serve alone. . ITEM VI I direct that no bond shall be required of any fiduciary, trustee, executor or guardian, hereunder in any jurisdiction. WITNESS WHEREOF, I, CHRISTIAN H. OTTO, named herein, have hereunto set my hand and seal to this my Last Will and Testament, consisting of three (3) typewritten pages, on this the _`L _ day of _ ~ ; : , 2001. SEAL) CHRISTIAN H. TTO Signed, sealed, published, and declared by the above-named Testator as and for his Last Will and Testament, and we, in his presence and in the presence of each other, and at his request, have subscribed our names as witnesses hereto. z~~ _ ~~~,c~ r Address T ~ ~ ~' s rt Address ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF ADAMS ) I, CHRISTIAN H. OTTO, Testator whose name is signed to the attached or foregoing instrument having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. _ (SEAL) CHRISTIA H. TTO Sworn or affirmed to and acknowledged before me, by CHRISTIAN H. OTTO, this~~.~ _ day of , 2.001. -~ ~. Notary Public e tt10TAR1AL SAL RtCHAR'D E. STAr1E', ~~.~'!~r'g~ P~. ' °'..' Latimore Towr~ti~, A" ,~ ~. (' %t' Ex~tCC:':~ F,'- ~') : ~~; ,d AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF ADAMS ) We, ~ Y~~c~~ __ and 3~~ C• ~~~~--{y ,the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instnzment as his Last Will and Testament; that CHRISTIAN H. OTTO signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge, the Testator was at that time l 8 or more years of age, of sound mind and under no constraint or undue influence. ~ (SEAL) ~~ ~ ~' (SEAL) Sworn and affi~ed to ~~~knowledged Notary Public before me by ,Q~2y /pct and ~: ~ n G, ,witnesses, this the _l~-~h day of ' ~ , ?001. (dOTAFlAL ~?"AL RICHAFt© E. ~T"ia9?~, ~:°°~': ~ e''`` 4.ahmoTe Torv; s ~a e°°.:~ ~ ~ ~ ~~~_ ~ ~ ~ Z m ~ p m n ~ ~ ~ j N °o ~ m 1 Ch (A ~ a ~ a m ~ r. 1 INVENTORY Estate of otto, Christian, H. also known as Deceased No. ~ 1 ~ C~~1 - ~ ~ I~ Date of Deathlvleio2 Social Security No.1s53so3o3 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/V1/e understand that false statements herein made are subject to the penalties of 18 Pa. C S. Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of // Attorney: John C. Z pp, I11 Michael C. Otto I.D. No.: 52662 Address: PO Box 204 York Springs PA 17372 Telephone: 717-528-8900 Checking Account PNC #50-0088-8292 2002 Chevrolet Cavalier 1996 Ford Windstar GL Members 1st Federal Credit Union Acct. No. 224406-11 Members 1st Federal Credit Union Acct. No. 224406-00 MetLife Annuity Acct. No. 0099214052 (Attach Additional Sheets if necessary) Description Jennifer J. Herman Dated Februrary , 2003 Value 25,352.77 9,035.00 5,100.00 1,625.96 20,168.11 5,328.13 Total 123,820.45 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventon-. R W-4 f, . Otto, Christian, H. Description of Inventory Waddell & Reed Acct. No. 35147520 Metl.ife Annuity Acct. No. 760805 AARP Acct. No. 00158489657 Glllys, Paycheck c Description Members 1st Federal Credit Union (dividend) Continuation of Inventory P Knouse Foods Retirement Saving and Investment Plan (401 K) Personal Property Knouse Foods reinvestment account Members 1st Federal Credit Union Acct. No. 224406-05 (MMA Investment Savings) 2002 Federal Tax Return Subtotal $ Grand Total $ Value 8,671.32 22,658.49 1,393.23 24.08 10.56 14,754.19 161.00 8,226.31 1,057.30 254.00 57,210.48 123,820.45 '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 1'7 - /0;),- it REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ,t\F.v-1500EJ..'+(6-00) ./ OFFICIAL USE ONLY FILE NUMBER 21 -02 1 049 ~COiiE -YEA/l:- - - ~R-- I- 2 W C W U W C DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL) Otto Christian H. DATE OF DEATH (MM-DO-Year) DATE OF BIRTH (MM-DO-Year) SOCIAL SECURITY NUMBER 165-38-0303 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER w >- ",S", 0"'''' wlLO rOO of-' lLlIl < 11/16/2002 10/17/1947 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) [R] 1. Original Return o 4. Limited Estate 00 6. Decedent Died Testate (AltachcopyofWiI) o g. UlIgalion Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (dais ofdeath aller 12-12-82) D 7. Decedent Maintained a living Trust (AttacllcopyoITrusl) o 10. Spousal Poverty Credit (dale of death between 12-31-91 and 1-1-95) D 3. Remainder Return (dale of doath prior to 12-13-82) o 5. Federal Estate Tax Return Required !- 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (AlIachSchO) ...tillltlifictiolll Mlilit BE COMPiLfitED.ALiL CORRESPOIIIDEIIICE AND.CONF iDi:NtIAiLtAXINFORMAtlolllsoouilDSEDjRECtfiDtoi.. NAME COMPLETE MAiliNG ADDRESS .John C. Ze III PO Box 204 FIRM NAME Ii Appicabo) Attome At Law TELEPHONE NUMBER 717.528.8900 York S fin s PA 17372 OFFICIAL USE ONLY 2 o i= S ::l l- ii: <( u W 0:: 2 o i= j:!: ::l 0.. :;: o u X j:!: >- z w o z o lL ffl '" '" o o 1. Real Estate (Schedule A) (1) (2) (3) (4) (5) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 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 I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmenta! Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (6) 123,820.45 (7) X _(15) 101,002.59 X .045 (16) 4,545.12 X 12 (17) 1,393.28 X .15 (18) 208.99 (19) 4,754.11 (8) (9) (10) 14, Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPliCABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, Of transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > >BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH "" .. 123,820.45 10,773.32 10,651.~6 ~ :.. (11) (12) (13) 21,424.58 102,395.87 (14) 102,395.87 d Dece ent's Complete Address: STREET ADDRESS 724 W. Pine St. OTY I STATE I zrp Mt. Holly PA 17065 Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 4,754.11 237.71 Total Credits (A + B + C) (2) 237.71 3. InteresUPenalty If applicable D. Interest E. Penalty T otallnteresUPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAVMENT. Check box on P.ge lUne 20 to request a refund (4) , 5 If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the T AA DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the totai of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check to: REGISTER OF WILLS, AGENT 4,516.40 4,516.40 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS f. Did decedent m.ke a tr.nsfer .nd: .. ret.in the use or income of the property tr.nsferred;................... 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. II death occurred after December 12, 1982, did decedent tr.nsfer property within one year of death without receiving adequate consideratiDn?. . 3. Did decedent own an "in trust fo~' or payable upon death bank account or security af his or her death? 4. Old decedent own an Individual Retirement Account, annuity, or other non-probate property Which contains a beneficiary designation?.... ............,.."......... Ves No ..0 (Xl 0 (Xl ..0 (Xl 0 (Xl 0 (Xl 0 (Xl ....0 (Xl IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Undef penslies of pe~llry, t declare thai I have eKsmined this relum, lncuding acoompanying scheduBs and slalemenls, and 10 the best of my knowladge end beief, i1 is true, ccnecI and compels. Dac8rstlOn of prepsrer other then the personal repre6eflletiw is based on allnformallon of which preparer has any knowledge. ftGNATURE~F E ONRESPONSiBlEFORFiliNGRETURN DATE L.c. SIGNATURE OF PR DATE _/0 - tp-.... ADDRESS PA 17372 For dates of death on or after July 1, 1994 and bafore January 1, 1995, the tax rate imposed on the net value 0.' transfers to or for the use oflhe surviving spouse is 3% [72 P.S. ~91l6 (a)(1.1) (i)j. For dates of death on or after January 1, 1995, the tax rate imposed on the net vatue of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the stafutory requirements for disciosure of assets and filing a lax return are slill 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 Of younger at death to or for the use of a natural parent, an adcptive parent, or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)J. The tax rale imposed on the net value of transfers to or for the use of the decedenrs lineal benefici.ries is4.5%, excepl as noled in 72 P.S. ~9116(1.2) [72 P.S. 99116(a)(I)). The lax rafe imposed an the net value of transfers to or for Ihe use of the decedenrs siblings is 12% f72 P.S. ~9116(a)(1.3)J. 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. ."'''~'''~'n '* COMMONWEALTH OF PENNSYLVANIA lNHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Otto Christian H FILE NUMBER 21 02 1049 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 1. DESCRIPTION VALUE AT DATE OF DEATH 25,352.77 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. Checking Account PNC #50.0088.8292 2002 Chevrolet Cavalier 9,035.00 1996 Ford Wlndstar GL 5,100.00 Members 1st Federal Credit Union Acct. No. 224406.11 1,625.96 Members 1st Federal Credit Union Acct. No. 224406.00 20,168.11 MetLlfe Annuity Acct. No. 0099214052 5,328.13 Waddell & Reed Acct. No. 35147520 8,671.32 MetLlfe Annuity Acct. No. 760805 22,658.49 AARP Acct. No. 00156489657 1,393.23 Glllys, Paycheck 24.06 Members 1st Federal Credit Union (dividend) 10.56 Knouse Foods Retirement Saving and Investment Plan (401 K) 14,754.19 'ersonal Property (Defendant resided at Mother's home at time of death and recently divorced) 161.00 Knouse Foods reinvestment account 8,226.31 Members 1st Federal Credit Union Acct. No. 224406-05 (MMA Investment SavIngs) 1,057.30 2002 Federal Tax Return 254.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the Si.'me size) 123.820.45 '''''''''EX<''.'n* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Otto Christian. H. FILE NUMBER 21 02 1049 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1- Hollinger Funeral 4,773.80 2. Hollinger Funeral - Death Certificate 41.00 B. ADMINISTRATiVE COSTS: 1- Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) I EIN Number of Personal Representative(s} Street Address City Slale Zip Year(s) Commission Paid 2, Attorney Fees John C. Zepp, III 5,500.00 3. Family Exemption: (If decedent's address is nollhe same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4, Probate Fees Cumberland County Register of Wills 87.00 5, Accountanfs Fees 6. Tax Return Preparer's Fees George Miller 85.00 7. The Sentinel Legal Notice 129.47 8. Cumberland Law Journal 75.00 9. Michael Otto (Additional Short Certificate) 30.00 10. Liberty Checks (Estate Checks) 7.25 11. Inventory 13.00 12. Inheritance Tax Return 15.00 13. Family Agreement 17.00 TOTAL (Also enter on line 9, Recapitulation) $ 10.773.32 (if more space is needed, insert additional sheets of the same size) REV'''''':'''". COMMONWEALTH OF PENNSYlVANIA INHERIT ANC!:: TAX RETURN RESIDENT DECEDENT SCHEDULEr DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Olio. Christian H Include unreimbursed medical expenses. ITEM NUMBER FILE NUMBER 21 02 1049 DESCRIPTION AMOUNT 1. Sprint Telephone 76.81 2. First USA Bank Credit Card 9,451.37 3. Clti Credit Card 281.09 4. Susan Otto (Balance owed pursuant to divorice agreement) 800.00 5. Michael Otto (Payment for check which cleared after closing PNC Acct.) 10.30 6. Pa. Dept. of Revenue, 2002 Tax Return 23.00 7. Capital Tax. 2002 Local Tax Return 8.69 TOTAL (Also enter on line 10. Recapitulation) $ (If more space ,s needed, insert additional sheets of the same size) 10651.26 ,REV_1513.X+(O-* COMMONWEALTH OF PENNSYLVANIA INHERITANCE T P\I.. RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER ()ttn r.hri.tian I-l_ ?1 n? 1nAQ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee(s) OF ESTATE L TAXABLE DISTRIBUTIONS [include outnght s~ousal distributions, and transfers under See 91161'1 (1 II I. Elizabeth C. Herman 15 East Pine St. Granddaughter 5,000.00 Mt. Holly Springs, PA 17065 2. Spenser M. Otto 23 Trine Avenue Grandson 5000.00 Mt. Holly Springs, PA 17065 3. Susan Otto 115 Peak View Rd. Ex.Wlfe 1,393.26 York Springs, PA 17372 4- Michael C. Otto 23 Trine Avenue Son 1/2 Remainder of Estate Mt. Holly Springs, PA 17065 5. Jennifer J. Hennan 15 East Pine St. Dauther 1/2 Remainder of Eatate Mt. Holly Springs, PA 17065 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 1. B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is ne.ded, insert additional sh.els of the same size) LAST WILL AND TEST AMENT OI~" CHRISTIAN H. OTTO I, CHRISTJAN H. OTTO, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby publish and declare the following as and for my Last Will and Testament, hereby revoking any and all Wills by me at any time heretofore made. ITEM I 1 direct that all of my legal debts, the expenses of my last illness, and my funeral expenses be paid from my residuary estate, as soon as practicable after my decease, as part ofthe expenses ofthe administration of my estate ITEM II ] give and bequeath all of my jewelry, automobiles, clothing and other personal effects, as well as all household goods and equipment which] may own, including any insurance thereon to my children, Michael C. Otto and Jennifer J. Herman, if they are living thirty (30) days after the date of my death. ]n the event that any of my children should predecease me, then the share to which that child would have been entitled 1 hereby give, devise, and bequeath to that child's child. Any of such effects distributed to a minor may be delivered to the person with whom the minor resides, or such other person as may have custody and control of the person of the minor, without the intervention of a guardian, and the receipt of any such person shall be a full acquittance of my Executor as to such distribution ~ ~ ~ ITEM III All of the rest, residue, and remainder of my estate, real, personal or mixed, of whatsoever kind and nature and wheresoever situate at the time of my decease, I give, devise, and bequeath to as follows: a. Five Thousand ($5,000.00) Dollars to my granddaughter, Elizabeth C. Herman; b. Five Thousand ($5,000.00) Dollars to my grandson, Spenser C. Otto; and all the rest, residue, and remainder of my estate to my children, Michael C. Otto and Jennifer J. Herman, if they are living thirty (30) days after the date of my decease, in equal share. The individual gift to either of my grandchildren should not be made to him or her if he or she in inheriting their parent's share pursuant to ITEM IV. ITEM IV In the event that any of my children should predecease me, then the share to which that child would have been entitled I hereby give, devise, and bequeath as follows: a. Jennifer J Herman's share to PNC Bank, IN TRUST for the benefit Jennifer's daughter, Elizabeth C Herman; and b. Michael C. Otto's share to PNC Bank, IN TRUST for the benefit of Michael's son, Spenser COtto. The Trusts to be administered, and distributed in accordance with the following provisions: My Trustee shall hold each share as a separate fund and shall pay all the net income there from in quarter-annual installments, to or fur the beneficiary's benefit until he or she attains the age oftwenty-one (21) years. Further, during the period of time that the income is being so distributed, my Trustee is hereby authorized to pay and distribute to or for the benefit of the child so much of the principal hereof as my Trustee deems advisable for their health, maintenance, support and education. ~ t ~ Upon the Tmst beneficiary attaining the age of twenty-one (21) my Trustee shall pay to him of her the corpus of the Trust free and clear of Trust. ITEM V I nominate, constitute and appoint my children, Michael C. Otto, and Jennifer J. Herman, to be the Executors of this my Last Will and Testament. If either Co-Executor is unable or unwilling to act or continue as Co-Executor, for any reason whatsoever and whether before or after my death, I direct that the vacancy not be filled and that the then remaining Executor serve alone. ITEM VI I direct that no bond shall be required of any fiduciary, trustee, executor or guardian, hereunder in any jurisdiction. WJTNESS WHEREOF, 1, CHRISTIAN H. OTTO, named herein, have hereunto set my hand and seal to this my Last Will and Testament, c.onsisting ofthree (3) typewritten pages, on this the _~_ day of !\ I.?~'. L, 2001. r c..~~ ~a. --(SEAL) CHRISTIAN H. TTO Signed, sealed, published, and declared by the above-named Testator as and for his Last Will and Testament, and we, in his presence and in the presence of each other, and at his request, have subscribed our names as witnesses hereto. 'i/lK ~~/IIb.:S /d . Address ~ C ~~ YO'tf( .s.l?l'lltj i Address ~ ~ l ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) ) SS. COUNTY OF ADAJ'vIS ) I, CHRISTIAN H. OTTO, Testator whose name is signed to the attached or foregoing instrument having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~#-&(~EAL) CHRISTlA H. 1'1'0 ~. ~ t ~. AFFIDA VIT COMMONWEALTH OF PENNSYLVANIA ) ) SS. ) COUNTY OF ADAMS We, /7JAfe.Y)( ;J2-#tfE and ~ek 1:... 'l.<e~ , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instmment as his Last Will and Testament; that CHRISTIAN H. OTTO signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge, the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. /;p'~L-Y~-' " ~9C~~1 - ) ~".._- (SEAL) (SEAL) Sworn and affirmed to al}d.3lfknowledged before me by 11!-4/2Y A'" #Jf<!.e' and '[tok... ~.. ~t::.. , witnesses, this the '-Ill dayof I?,L , 2001. . ~A-w( ~\t~~ Notary Public NOTARIAL SE/lL '0 RI~HARD E. STAn!:, t!c''',-y r,,' "" Latimore Town~hlp, ^,j-'f" p,." '! ~'!t~~~!~::.:2:,~"f2::~~'~:.:~.~'~~' '1. ,. . 'J.. \\, ~ G~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Cti, r. s~ i 0.. ~ ~ . O"T "'t O Date of Death: NpV. ! (o ~e~ a Will No.: N O a l- ~ a2 -• /O ~ q 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 whether administration of the estate is complete: Yes g No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes _ No ~] 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 maybe filed with the Clerk of the Orphans' Court and maybe attached to this ort. Date: cZ • 11- 03 ~ ~ 1 Sign tur Name © ~ tax o2©~f Address ~ C~ S ~ `„ S+ l~ Y ~ ~ ?~~, say- ggo c~ 1~~?a Telephone No. Capacity: [] Personal Representative „Counsel for personal representative CERTIFICATION OF NOTICE UNDER RULE 5 6(a) Name of Decedent: Christian H. Otto Date of Death: November 16. 2002 21-02-1049 Will No. Admin No. To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on November 30. 2002 Name Address Elizabeth C. Herman 15 East Pine St. Mt Holly Springs, PA 17065 Spenser A. Otto 23 Trine Avenue, Mt Holly Springs, PA 17065 Jennifer J. Herman 15 East Pine St. Mt Holly Springs, PA 17065 Michael C. Otto 23 Trine Avenue, Mt Holly Springs, PA 17065 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date 11/30/02 ture John C. Zepp, III Name Address PO Box 204 York Springs, PA 17372 Telephone (7171528-8900 Capacity: Personal Representative - X _ Counsel for personal representative Name(s), address(es) and telephone number(s) of all counsel Name Address Telephone John C. Zepp, III PO Box 204, York Springs, PA (717) 528-8900 17372 __ __ -_ Additional information may be obtained from the undersigned. Date 11/30/02 ~> Sign e Name J°hn C. Zepp, III Address Pn Box 204 York Springs, PA 17372 Telephone (7171528-8900 Capacity: Personal Representative X Counsel for personal COMMONWEALTH OP PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 002149 HERMAN JEFFINER J 15 E PINE STREET MT HOLLY SPRINGS, PA 17065 fold ESTATE INFORMATION: ssN: is5-3s-oaos FILE NUMBER: 2102-1049 DECEDENT NAME: OTTO CHRISTIAN H DATE OF PAYMENT: 02/ 1 1 /2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 / 1 6/2002 ACN ASSESSMENT CONTROL NUMBER REV-1162 EX(11-96) AMOUNT 101 ~ 54, 516.40 TOTAL AMOUNT PAID: REMARKS: JENNIFER J HERMAN SEAL CHECK#113 INITIALS: AC RECEIVED BY: DONNA M. OTTO 54,516.40 DEPUTY REGISTER OF WILLS REGISTER OF WILLS G /-I~o2- ~'~ COMMONWEALTH OF PENNSYLVANIA _ BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE `~ INHERITANCE TAX DIVISIDN DEPT. zaBbDi NOTICE OF INHERITANCE TAX HARRISBURG, PA 17128-0601 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 E% AFP (O1-DS) DATE 03-31-2003 ESTATE OF OTTO CHRISTIAN H DATE OF DEATH 11-16-2002 FILE NUMBER 21 02-1049 COUNTY CUMBERLAND JOHN C ZEPP III ATTY ACN 101 PO BOX 204 Amount Remitted YORK SPRINGS PA 17372 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT H OUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ --------------------------------------- -------------------- ----------------------------------------------------- REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF OTTO CHRISTIAN H FILE N0. 21 02-1049 ACN 101 DATE 03-31-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule Al (1) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4l .00 of this form with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 123,820.45 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total assets (g) 123,820.45 APPROVED DEDUCTIONS AND EXEMPTIONS: 10,773.32 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 10,6 51.26 11. Total Deductions (11) 21.424.58 12. Net Value of Tax Return (12) 102,395.87 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) [13) .00 14. Net Value of Estate Subject to Tax (14) 102,395.87 NOTE: If an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 00 0 0 00 15. Amount of Line 14 at Spousal rate [15) • = X . 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 101,002.59 X 045. 4,545.12 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) 1,393.28 X 15 208.99 19. Principal Tax Due (19)= 4,754.11 v„~r DATE NUMBER + INTEREST/PEN PAID (-) AMOUNT PAID 02-11-2003 CD002149 237.71 4,516.40 TOTAL TAX CREDIT 4,754.11 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ 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 AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiraticn of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collatera)l rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). PAYMENT: Detach the top particn of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF 41ILLS, AGENT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service far farms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 CTT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60l days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281D21, Harrisburg, PA 17128-1D21, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions far Inheritance lax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine C9l months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 hear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Oaily Interest Daily Year Rate Factor Vear Rate Factor Year Rate Factor 1982 20% .000548 1987 9% .000247 1999 7% .000192 1983 16% .000438 1988-1991 11% .000301 2000 8% .000219 1984 11% .000301 1992 9% .000247 2001 9% .000247 1985 13% .000356 1993-1994 7% .000192 2D02 6% .000164 1986 10% .000274 1995-1998 9% .000247 2003 5% .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELIN@UENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. In Re: ESTATE OF CHRISTIAN H. OTTO, Deceased IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 21-02-1049 FAMILY SETTLEMENT AND INDEMNIFICATION AGREEMENT Filed on behalf of Michael C. Otto and Jennifer J. Henan Co-Executors of the Estate of Christian H. Otto, Deceased WHEREAS, Christian H. Otto, with his last address at 724 West Pine St. Mt Holly Springs, PA 17065, died testate on November 16, 2002. The Last Will and Testament dated Apri13`a 2001 was duly admitted to probate on by the Register of Wills of Adams County, Pennsylvania on Novem- ber 22, 2002 at the above number and term; and WHEREAS, Michael C. Otto and Jennifer J. Herman, having been duly appointed as Co- Executors of the Estate of Christian H. Otto, Deceased; and WHEREAS, the parties in interest to the Estate of Christian H. Otto, are: (1) Michael C. Otto, Son, Co-Executor (2) Jennifer J. Herman, Daughter, Co-Executor (3) Elizabeth C. Herman, Granddaughter (4) Spenser M. Otto, Grandson (5} Susan Otto, Ex-Wife WHEREAS, all known outstanding debts and obligations ofthe Decedent have been paid in full; WHEREAS, each of the parties to this Agreement has been furnished with a complete list of the estate assets and receipts, attached hereto as Exhibit "A" and disbursements as set forth on the accounting attached hereto as Exhibit "B"; and WHEREAS, it is the desire of the parties to this Agreement, that final distribution of this es- tate be accomplished without a formal accounting to the Orphans' Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania, or any other court of competent jurisdiction, it being the desire of the parties to avoid the expense of a formal ac•~ounting; and WHEREAS, the parties to this Agreement each acknowledge they have received a proposed Summary of Account attached hereto as part of Exhibit "B". WHEREAS, the parties to this Agreement each acknowledge they have received a proposed Schedule of Distribution attached hereto and marked as Exhibit "B"; and WHEREAS, each of the parties to this Agreement does acknowledge their receipt from the Co-Executors the distribution, if any, as evidenced by Approval of Account and Release, which is at- tached hereto and marked as Exhibit "C". NOW, THEREFORE, WITNESSETH, in consideration of the mutual promises, covenants and agreements recited herein, the parties do agree as follows: 1. Each of the parties to this Agreement does hereby release and forever discharge the Co- Executors from any and all liability which may from time to time arise in connection with their service as Co-Executors of the Estate of Christian H. Otto, Deceased. The parties do further agree to in- demnify and hold harmless the Co-Executors from any and all liability which may arise against the es- tate from creditors or other claimants. 2. Each of the parties does hereby acknowledge receipt of the assets, if any, described in the Exhibits attached hereto. 3. Each party to this Agreement acknowledges that this Agreement shall be indexed and re- corded in the estate proceedings in this or any other state, and that the terms hereof shall be binding upon their respective heirs, successors, administrators and assigns. 4. This Agreement shall be governed by the laws of the Commonwealth of Pennsylvania. .~/L Dated at York Springs, Pennsylvania this ~ day of February, 2003. WITNESS: F ( -_- ~_ ~~ Michael C. Otto J nifer J. rma ACCOUNTING OF THE ESTATE OF CHRISTIAr, H. OTTO. DECEASED ASSETS Descri tion Amount PNC Checkin Account #50-0088-8292 25,352.77 2002 Chevrolet Cavalier 9,035.00 1996 Ford Windstar GL 5,100.00 Members 1st Federal Credit Union Acct. No. 224406-11 1,625.96 o. 224406-11 N Members 1st Federal Credit Union Acct. 20,168.11 __ _ MetLife Annuit Acct. No. 0099214052 5,328.13 Waddell & Reed Acct. No. 35147520 8,671.32 MetLife Annuit Acct. No. 760805 22,658.49 AARP Acct. No. 00158489657 __ 1,393.23 -- --------- Gill s, Pa check 24.18 Members 1st Federal Credit Union dividend 10.56 Knouse Foods Retirement Savin and Investment Plan (401K) 14,754.19 Knouse Foods reinvestment account _ 8,226.31 Personal Property, (Defendant resided at Mother's home ~t time of death and recently divorced) _ _ Members ls` Federal Credit Union Acct. No. 224406-OS (MMA In- vestment Savinzs) ___ __- 161.00 1,057.30 - 2002 Federal Tax Return 254.00 Total 123,820.55 Exhibit "A" ACCOUNTING OF THE ESTATE OF CHRISTIAN H. OTTO DECEASED DISBURSEMENTS BY EXECUTOR Description _ Amount __ _ _ Hollin er Funeral 4,773.60 Hollin er Funeral -Death Certificate 41.00 John C. Ze ,III 5,500.00 Cumberland County Register of Wills __`__ _ __ 87.00 The Sentinel Le al Notice 129.47 Cumberland Law Journal 75.00 Michael Otto (Additional Short Certificate) 30.00 Libert Checks Estate Checks _ Y ~--------~ -- 7.25 Invento 13.00 Inheritance Tax Return 15.00 Famil A reement 17.00 S rint Telephone _ _ _ _ 76.81 First USA Bank Credit Card 9,451.37 Citi Credit Card 281.09 Susan Otto (Balance owed ursuant to divorce a reement 800.00 Michael Otto (Payment for check which cleared after closing PNC Acct.) 10.30 Pa_ Deft. of Revenue, 2002 Tax Return_______ 23.00 Ca ital Tax - 2002 Local Tax Return 8.69 Geor e Miller, Tax Pre arer 85.00 Re ister of Wills, A ent 4,516.40 Total 25,940.98 ACCOUNTING OF THE ESTATE OF CHRISTIAN H. OTTO. DECEASED SUMMARY OF ACCOUNT Estate Assets Less Disbursements BALANCE $ 123,820.55 ~ 25,940.98 $ 97,879.57 Name % Amount Elizabeth C. Herman 5,000.00 S enser C. Otto 5,000.00 Susan Otto 1,184.29 Michael C. Otto '/z of Remainder 43,347.64 Jennifer J. Herman '/z of Remainder 43,347.64 Exhibit "B" RECEIPT OF DISTRIBUTION APPROVAL OF ACCOUNT AND RELEASE The undersigned being those interested under the Last Will and Testament of Christian H. Otto, Deceased, desire that the Estate be distributed without the formality of a court accounting. The Co-Executors of the Estate is willing to consent to such distribution upon receipt of a proper release, which is the purpose of this document to provide. In consideration of the willingness of the Co- Executors to make distribution without the formality of a court accounting and agreeing to be legally bound hereby, the undersigned, individually, and on behalf of their respective heirs, personal representatives, successors and assigns, do hereby: 1. Waive the filing of an account of the administration of the Estate in any court. 2. Declare that they have examined the attached informal account and proposed state- ment/schedule of distribution ofthe Co-Executors of the Estate of Christian H. Otto, Deceased; find it to be true and correct in all particulars; accept and approve it with the same force and effect as if it had been prepared and filed with, audited, adjudicated and confirmed absolutely by a court of compe- tent jurisdiction; and as if the balance of principal and income had been awarded by the court in ac- cordance with the statement/schedule of distribution. 3. Warrant that the beneficiaries named in the informal accounts and statements/schedules of distribution are entitled to receive the entire distribution thereof in accordance with the informal ac- count and statement/schedule of distribution. 4. Warrant that they know of no outstanding and unsatisfied claims against the Estate and ap- prove the distribution of the balance of principal and income shown in the informal accounts and statements/schedules of distribution to the persons set forth therein. Exhibit "C" 5. Absolutely and irrevocably release and discharge the Co-Executors their heirs and personal rep- resentatives of and from any and all actions, liabilities, claims and demands relating in any way to the ad- ministration ofthe Estate and distribution in accordance with the informal account and statement/schedule of distribution and without a court accounting and adjudication. 6. Agree to indemnify and hold harmless the Co-Executors their heirs and personal representatives from and against any claims, liabilities, loss or expense (including costs and counsel fees) arising from any cause whatsoever, which the Co-Executors may incur as the result of the administration of the Estate and its distribution in accordance with this document to the extent to which they have received distribution un- der this agreement, including, but not limited to, any liability for any Federal Estate Tax, Pennsylvania In- heritance Tax or any other death taxes, and any Federal or Pennsylvania Income Taxes and Pennsylvania Personal Property Taxes, together with any interest, penalties and costs incidental thereto, relating in any way to the Estate and also including, but not limited to, any assets received or payments or distributions made by reason of any negligence or mistake of law or fact. 7. The undersigned hereby acknowledge receipt of those assets as set forth on the proposed statement/schedule of distribution as of the date of the execution of this receipt of distribution, approval of account and release. Date: ~ -!~ ~ ~ WITNESS: ~... - ~ ti \~ ~~ J~.. . ....._ J ~~,~ ~-, -7 ---' -~ c~ ~ '~ ~ ~ ~`\ ,. ,,~ J Michael C. Otto, Son J nifer J. er n, Daughter Jennifer J. Herman Guardian for Elizabeth C. Herman ~7 G Michael C. Otto Guardian for Spenser C1.Otto Susan Otto, Ex-Wife COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIWDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 004205 ZEPP JOHN C III ESQ P O BOX 204 YORK SPRINGS, PA 17372 ........ fold ESTATE INFORMATION: SSN: 165-38-0303 FILE NUMBER: 2102- 1049 DECEDENT NAME: OTTO CHRISTIAN H DATE OF PAYMENT: 07/28/2004 POSTMARK DATE: 07/28/2004 COUNTY: CUM BERLAN D DATE OF DEATH: 11/16/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 96,526.79 TOTAL AMOUNT PAID: 96,526.79 REMARKS: CHECK#6512 SEAL INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS '. I- Z W Cl W o W Cl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENTS NAME (LAST, FIRST, AND MiDDlE INITIAl) Otto Christian, H. DATE OF DEATH (MM-DD-Year) REV.1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2 1 -0 2 1 0 4 9 ""'C'&iNTYCOOE -YEAR- - - 'NUMBER-- SOCIAL SECURITY NUMBER DATE. OF BIRTH {MM-DD-Year) 1 6 5 - 3 8 - 0 3 0 3 THIS RETURN MUST BE FilED IN DUPLICATE wrrH THE REGISTER OF WillS 11/18/2002 10/17/1947 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAl) SOCIAL SECURITY NUMBER ~ ",:S.. " ."" !l!~g ufi! .. " r'J 1. Orillnal Return o 4. Limited Estate ~ 6. OecedentOied Testate (AllachcopyofWiIl) o 9. Litigation Proceeds Received . 2, Supplemental Return o 4a. Future Interest Compromise (date of dealh after 12-12-82) o 7. Decedent Maintained a livIng Trust (Attach copy ofTrustj o 10. SpoosalPoverty Credit (date of dealh belween 12-31.91 arn:l1-1-95) o 3, Remainder Retum {daleofd8alhpriorI012-1J-82) o 5. Federal Estate Tax Retum Required , !!... 8. Total Number of Sale Depostt Boxes D 11. Eleclion to tax underS"", 9113(A)I""'SohOI >- z w Cl z o .. .. W 0: 0: o " THlssE;CTION MUSTBE COMeLE;TEO, AI.L' CORRESPONDENce AND CONfiDeNTIAl.. TAx INFORMATION SHOUI.DBE DIItECTeD.To: NAME COMPLETE MAILING ADDRESS ..John C. Ze III PO Box 204 FIRM NAME (II Ap~'abl,) Attorn. At Law TELEPHONE NUMBER 717-528-8900 York S rln . PA 17372 OFFICIAL USE ONLY 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 1, Inler-Vlvos Translers & M~celIaneous Non-Probate Property (1) (Schedule G or L) 8, Total Gross Assets (total Lines 1-1) 9, Funeral Expenses & Adminisll1llive Costs (Schedule H) (9) 10, Debts 01 Decedent, Mortgage Liabilnias, & Liens (Schedule I) (10) 11. Total Deductlons ltotal Linas9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13, Charitable and Governmental BequestslSec 9113 Trusts lor which an election to tax has not been madelSchedule J) z o 1= ~ :l l- ii: <t o w r:r: 1. Real Estate {Schedule A) (1) 2, Stocks and Bonds (Schedule B) (2) 3, Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortga9es & Notes Receivable (Scheduta D) 14) 5, Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) :D (t: ,::?, o {1~ ~~t ~ In 0 ..,+, 151,673.29 (11) (12) (13) 250.00 151,423.29 14, Net-Value Subject10 Tax (Une 12 minus Une 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 151,423.29 z o 1= <t I- :l l1. :& o o >< <t I- 15. Amount of Line 14 taxable at the spousal tax rate, or translers under See, 9116 (a)(1.2) 16. Arnount of line 14 taxable at lineal rate 11, Amount of Line 14 taxable at sibling rate 18, Amount of Line 14 taxable at collateral rate 19. Tax Due X _(15) 151,423.29 X .045 (16) X ,12 (11) X ,15 (18) (19) 6,814.05 6,814.05 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE S DE AND RECHECK MATH < < Decedents omDlete Address: . STREET ADDRESS . 724 W. PIne St. CITY I STATE I ZIP Mt. Holly PA 17065 . C -, Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credils/Payments A. Spousal Poverty Credil B. Prior Paymenls C. Discounl (1) 6,814.05 287.26 Total Credils (A + 8 + C) (2) 287.26 3. InleresUPenalty if applicable D. Interest E. Penaily TotallnleresUPenalty (0 + E) (3) 4. if Line 2 is greaterlhan Line 1 + Line 3, enterlhe difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request. refund (4) S. If Line 1 + Line 3 is greater Ihan Line 2, enter Ihe difference. This is the TAX DUE. (5) A. Enter the interesl on the lax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 6,526.79 6,526.79 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Old decedent make a transfer and: Yes No a. retain Ihe use or income of the property transferred; ........................................................................... 0 !Xl b. retain Ihe righl to designate who shall use the property transferred or<<s income; ........................................ 0 !Xl c. retaln a reversionary interest; or .,....................,' .." .:.;.....................".................................................. D 00 d. receive the promise for life of either paymenls, benefits or care? ............................................................. 0 !Xl 2. If dealh occurred after December 12, 1982, diddecedenl transfer property within one year of death without receiving adequale consideralion?................................... ...... ............................................... ...... 0 !Xl 3. Did decedent own an 'in trustfor' or payable upon death bank account or security af his or her death? ................. 0 !Xl 4. Did decedent own an individuai Relirement Accounl, annuily, or olher non-probate property which contains a beneficiary designation? ....................................................................................................... 0 !Xl IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pe~ury, I declare that 1 have examined this return, includinQ accompanying schedules and statements, and to the best of my koowledge and belief, JI is true, correct and complete. Declaration of prepBfer other lI1an the personal representative is based on a1lmformatlon of ich preparer has any knowledge. SIGNATURE OF PE ON RESPONSIBLE FOR FILING RET N DATE . ~ 7. .ell SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ~ n,d::> ADDRESS P.O. Box 205 York Springs DATE 7127104 PA 17372 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on Ihe net value of Iransfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)l. Fordetes of death on or after January 1, 1995. the tax rate Imposed on Ihe net value oflransfers to orfor the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The slatute does not exemol a Iransfer to a surviving spouse from tax, end the statutory requirements for disclosure of assets and filing a lax return are slill applicable even if the surviving spouse is Ihe oniy beneficiary. For deles of death on or after July 1, 2000: The tax rate imposed on Ihe net value of Iransfers from a deceased child twenty-one years of age or younger at dealh to or for Ihe use of a natural parent, an adoptive parent. or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)1. The tax rate imposed on the net vaiue 01 transfers to or for the use of the decedenl's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The lax rale imposed on the nel value of transfers to or for the use olthe decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)1. A sibling is defined, under Section 9102, as an individual who has at leasl one parent in common with the decedent, whelher by blood or adopnon. . REV-1"j1-1 EX+ (12-99) * SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Otto Christian H. FILE NUMBER 21 02 1049 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social SeCllnty Numbe~sVEIN Number of Personal Reprasentative(s} Street Addrass City State Zip Yea~s) Commission Paiti: 2. Attorney Fees John C. Zepp, III 250.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Addrass City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountanfs Fees 6. T~ Return Preparer's Fees 7. TOTAL (Also enier on line 9, Recapitulation) $ 250.00 (If more space is needed, insert additional sheets 01 the same size) .REV-15",;'X<I. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER Otto I-l ?1 n? 1rl4!l RElATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS Unclude oU~ht s~usal distTibutions, and transfers under Sec_ 9116 {a (1. )] 1. Michael C. Otto 23 Trine Avenue Son 112 Remainder of Estate Mt. Holly Springs, PA 17065 5. ".nnlfer.J.Herman 15 East Pine St. Dauther 112 Remainder of Estate Mt. Holly Springs, PA 17065 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. - TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ . (If more space is needed, insert additional sheets of the same size) BUREAU OF INDIVIDUAL TAXES ZNHERTTANCE TAX DTV/SZON DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-15gi7 EX AFP JOHN C ZEPP III ATTY PO BOX 20q YORK SPRINGS PA 17572 CUT ALONG THIS LINE ~" DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN I I 09-27-200q OTTO 11-16-2002 21 02-10R9 CUMBERLAND 101 CHRISTIAN H MAKE CHECK PAYABLE AND RF~ZT PAYHENT TO: REGISTER OF W~ILLS --t CUMBERLAND C01 COURT H_~OUSE CARLISLE, PA 17015 RETAIN LOWER PORTION FOR YOUR RECORDS.. -'~0 ~, REV-Z547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE-~OR .... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ~ ESTATE OF OTTO CHRISTIAN H FILE NO. 21 02-10~9 ACN 101 DATE 09-27-200~ TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) $. Closely Meld Stock/Partnership Interest (Schedule C) ($) q. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) ($) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7). 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) 11. Total Deductions 12. Nat Value of Tax Return NO. 01 87~500 O0 O0 O0 O0 6q~175 29 O0 O0 (8) 250.00 .00 (11) (12) 1S. lq. MOTE: ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rata 16. Amount of L/ne 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rata 19. Principal Tax Due TAX CREDITS: PAYMENT RECE/P1 DISCOUNT (+) DATE NUMBER TNTEREST/PEN pAID (- 02-11-200:5 CDO021q9 2:57.71 07-28-200q CDOOq205 . O0 Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Net VaZue of Estate Subject to Tax (14) Zf an assessment was issued previousZy, ~nes 1~, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. ZNTEREST IS CHARGED THROUGH 10-19-200q AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM NOTE: To insure proper credit to your account, submit the upper portion of this fora w~th your tax payeent. 151,67:5.29 151,q2:5.29 .00 255,819.16 18 and 19 will ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADD/TZONAL /NTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT 1S REQUIRED. ZF TOTAL DUE 1S REFLECTED AS A "CRED/T" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TH[S FORM FOR ZNSTRUCTZONS.) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE q,516.qO 6,526.79 AMOUNT pATD 11,280.90 287.26 287.92 575.18 (~5) .00 X O0 = .00 (16) 252,fi25.88 X OtiS= 11,:559.17 (17) .00 X 12 = .00 (lB) 1,:59:5.28 X 15 = 208.99 (19)= 11,568.16 RESERVATION: PURPOSE OF NOT[CE: PAYMENT: REFUND [CR): ODJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (colZataraZ) beneficiaries of the decadent after the expiration of any estate for life ar for years, the Commonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class S (collataral) rate an any such futura interest. To fulfill the requirements of Section 2140 of tha Inheritance and Estate Tax Act, Act Z~ of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Rills printed on the reverse side. --Make check or money order payable to: REGISTER OF NILES, AGENT A refund of a tax credit, ahich was not requested on the Tax Return, may ba requested by completing an "Application for Refund of Pennsylvania lnheritanca and Estate Tax" (REV-iS15). Applications ara available at the Offica of the Register of Mills, any of [ha 25 Revenue District Offices, or by calling the special Z4-hour anseering service for forms ordering: 1-800-562-Z050; services for taxpayers eith special hearing and / or speaking needs: 1-800-447-5020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disalloeanca of deductions, or assessment of tax (including discount or intarast) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --erittan protest to the PA Department of Revenue, Doard of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter detarmined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revanua, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6SOS. Sea page 5 of tho booklet "Instructions for lnheritanca Tax Return for m Resident Decedent" (REV-150I) for an explanation of administratively correctable errors. If any tax due is paid ~ithin three (S) calendar months after the decedent's death, a five percent (5Z) discount of the tax paid is alloeed. Tha 15X tax amnesty nan-participation penalty is computad an the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appaalabla in the same manner and in the the same time pariad as you would appaal the tax and in[ares[ that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became dalinquent before January 1, 1982 bear interest at the rate of six (6Z) percent par annum calculated et a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year eith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through Z004 are: Interest Daily Interest Daily Interest Daily Year Rate Foctor Year Rate Factor Year Rate Factor 1982 ZOZ .OOOS4D ~'~J~'~-1991 XXX .000301 ~ 9Z .000247 1983 162 .0004~8 1992 9X .000247 2002 6X .000164 1984 llZ .000301 1993-1994 72 .000192 2003 52 .0001~7 1985 13Z .000556 1995-1998 9X .000247 2004 4Z .000110 1986 lOX .000274 1999 72 .000192 1987 10Z .000274 2000 7Z .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NURBER OF DAYS DELIN~IUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond [ha date of the assessment. If payment is made after the interest computation date shown on the Notice, additional intarest must be caIculatad. BUREAU OF ZNDZVTDUAL TAXES INHERITANCE TAX DTVTSTON DEPT. 280601 HARRTSBURG, PA 17118-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-I~7 EX AFP (01-03) JOHN C ZEPP III ATTY PO BOX ZOq YORK SPRIN~,~ PA 17372 DATE 09-27-200q ESTATE OF OTTO DATE OF DEATH 11-16-Z002 FILE NUHBER 21 02-10~9 COUNTY CUHBERLAND ACN 101 I Amoun~ CHRISTIAN H HAKE CHECK PAYABLE AND RENIT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 C,,. ,,,,.,.e~¥u~r~ /~E ~ RETAIN LOWER PORTION FOR YOUR RE.C_O_R__D_S. ._.-~_. u.~..~_~v,,~ --, ,:.,. .... .._~_~ ......................................... -;'4'.,~"~'~4~.'1~ '['-'--~)~'::I~DT'ZCE OF ZNHERTTANCE TAX APPRATSEHENT, ALLOWANCE OR ~-~V'15 E .~ ~i~T~ALLOWANCE OF DEDUCTZOHS AND ASSESSHENT OF TAX ESTATE oF'~'* OTTO *~C~- CHRISTIAN H F/LE NO. 21 01-10~9 ACN 101 DATE 09-27-Z00~ TAX RETURN MAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEHENTAL RETURN NO. 01 1. Real Estate (Schedule A) (1) 87;500.00.. NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credi~ to your account, $. Closely Held S~ock/Pertnership Tnterest (Schedule C) ($) . O0 submit the upper port/on ~. Nortgages/Notes Receivable (Schedule D) (q) . O0 of this form wi~h your E. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6~1173.29 tax payment. 6. Jointly Owned Property (Schedule F) (6) . O0 7. Transfers (Schedule G) (7) .00 (8) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPTIONS: 250.00 9. Funeral Expanses/Ada. Costs/Misc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liabilitles/Liens (Schedule 1) (10) . O0 (11) 11. Total Deductions (12) 12. (15) 15. lq. Nat Value of Tax Return Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Ne~ Value of Estate Sub~ect to Tax 151,673.29 NOTE: 250.00 151,q23.29 ASSESSHENT OF TAX: O0 x 00 15. Amount of Line 1~ at Spousal ra~e (15) ' = 16. Amount of Line 1~ ~axable at Lineal/Class A rata (16) 252,~25.88 X 0~5 = · O0 x 12 = 17. Amount of Lina lq at Sibling ra~a (17) 18. Amount of Line lq taxable at Collateral/Class B rata (1G) 1,393.28 x 15 = (19)= 19. Principal Tax Due .00 11,359.17" .00 208.99 11,568.16 TAX CREDITS: DATE 02-11-Z003 07-28-200q INTEREST IS CHARGED THROUGH 10-19-200q AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM RECE~P1 NUMBER CDOOZlq9 CDOOqZ05 D/$COUNT /NTEREST/PEN PA/D (-) 237.71 .00 AMOUNT pATD q,516.qO 6,526.79 TOTAL DUE 575.18 ~ ( TF TOTAL DUE TS LESS THAN $1, NO PAYMENT ZS REQU/RED. IF TOTAL DUE TS REFLECTED AS A "CREDIT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THTS FORM FOR TNSTRUCTTONS.) ¥OYAL TAX CREDIT / 11,280.90 BALANCE OF TAX DUE 287.26 INTEREST AND PEN. 187.91 IF PAID AFTER DATE IND/CATED, SEE REVERSE FOR CALCULATION OF ADD/TIONAL /NTEREST. Zf an assessment was issued previously, lines lq, 15 and/or 16, 17, 18 and 19 w111 reflect f/gures that lnclude the total of ALL returns assessed to date. .00 253,819.16 RESERVATION: PURPOSE OF NOTICE= PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ZSTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z) 19BI -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life er for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes et the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (7Z P.S. Section 91~0). Detach the top portion of this Notice and submit with your payment to the Register of gills printed on the reverse side. --Make check or money order payable to: REGISTER OF NZLLS, AGENT A refund of a tax credit, ehich ems not requested on the Tax Return) may ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at the Office of the Register of Hills) any of the Z5 Revenue District Offices) or by calling the special Iq-hour answering service for forms ordering: 1-800-56Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-80D-~7-30ZO CTT only). Any party in interest not satisfied with the appraisement, allowance) or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object aithin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1) Harrisburg, PA 171ZB-IOZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in eriting to: PA Department of Revenue) Bureau of Individual Taxes) ATTN: Post Assessment Reviaa Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid mithin three (5) calendar months after the decadent's death, a five percent (BI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed an the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period es you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one C1) day from the date of death) to the data of payment. Taxes which became delinquent before January 1) 198Z bear interest et the rate of six (6Z) percent per annum calculated at a daily rate of .00016~. Al1 taxes which became delinquent on and after January 1) 19BZ will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Oepartaant of Revenue. The applicable interest rates far 19BZ through ZOOq ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ lOX .0005~B ~988-1991 11Z .000501 ZOO1 9Z .O00Z~7 1985 16Z .000q3B 199Z 9Z .O00Z~7 ZOOZ 6Z .00016q 198q llZ .000501 1995-199q 7Z .O0019Z ZOO5 5Z .000157 1985 ISZ .000556 1995-1998 9Z .O00Z~7 gO0~ ~Z .000110 1986 IOZ .O00Z7~ 1999 7Z .OO019Z 1987 lOX .O0027~ ZOO0 7Z .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELTNI~UENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (153 days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 004456 ZEPP JOHN C III ESQ P O BOX 204 YORK SPRINGS, PA 17372 ........ fold ESTATE INFORMATION: SSN: 165-38-0303 FILE NUMBER: 2102- 1049 DECEDENT NAME: OTTO CHRISTIAN H DATE OF PAYMENT: 10/01/2004 POSTMARK DATE: 10/0112004 COUNTY: CUMBERLAND DATE OF DEATH: 11 / 16/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $575.18 REMARKS: JOHN C ZEPP III TOTAL AMOUNT PAID: $575.18 SEAL CHECK//6667 INITIALS: SK RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF ZNDZVTDUAL TAXES INHERITANCE TAX DIVISION PO BOX 28060! HARRISBURG:, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TNHERZTANCE TAX STATEMENT OF ACCOUNT REV-I~07 EX AFP (09-0~) JOHN C ZEPP III ATTY~' PO BOX ZOO. YORK SPRINGS P'A 17572 BATE ll-15-ZOOR ESTATE OF OTTO BATE OF DEATH 11-16-2002 FILE NUHBER 21 02-10~9 COUNTY CUMBERLAND ACN 101 Alfloun'l; Rem.i t:'l:ed CHRISTIAN H MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~c ~o your account:, subm.i~ ~che upper portion of ~his form" wi'l:h your ~ex paym.en~. CUT ALONG THZS LZNE lm- RETAZN LOWER PORTZON FOR YOUR RECORDS ~ ESTATE OF OTTO CHRISTIAN H FILE NO. 21 02-10~9 ACN 101 BATE 11-15-200~ THTS STATEMENT TS PROV/DED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACH TN THE NAHED ESTATE. SHO#N BELOW TS A SUHHARY OF THE PR/NC/PAL TAX DUE, APpLTCAT/ON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, TF APPL/CABLE, A PROJECTED /NTEREST FTOURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-27-200q PRINCIPAL TAX DUE: ........................................................................................... PAYMENTS (TAX CREDITS): 11,568.16 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-11-2005 07-28-200~ lO-Ol-ZO0~ CD0021~9 CDOOq205 CDOOR~56 257.71 .00 287.$5- q,516.qO 6,526.79 575.18 ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT' (CR), TOTAL TAX CREDIT 11,568.75 BALANCE OF TAX DUE .57CR INTEREST AND PEN. .00 TOTAL DUE .57CR YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name end address printed on the reverse side. -- If RES[DENT DECEDENT make check or money order payable to: REGZSTER OF WILLS, AGENT. -- If NON-RES[DENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, ~hich ~as not requested on the Tax Return, may be requested by completing an · 'Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available online at ~w.revenue.state.pa.us, any Register of Wills or Revenue District Office, or from the Department's Zq-hour answering service for fores orders: 1-800-36Z-20S0; services for taxpayers with special hearing and/or speaking needs: 1-800-~q7-3020 (TT only). REPLY TO: DISCOUNT: PENALTY: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Texes~ ATTN: Post Assessment Review Unit, P.D. Box Z80601, Harrisburg, PA 171ZB-0601, phone (717) 787-6505. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (eX) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at the rate of six (6X) percent per annum calculated at a daiIy rate of .00016~. All taxes ~hich became delinquent on and after January l, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 200q are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year~ Rate Factor 1982 ZOX .OOOSq8 1988-1991 llX .000301 ZOO1 92 .OOOg~7 1983 16Z .000q38 199Z 92 .0002q7 ZOOZ 62 .00016q 198q llX .000301 1993-199q 7X .00019Z 2003 5Z .000137 1985 132 .000S56 1995-1998 92 .O00Z~7 ZOOq qX .000110 1986 lOX .O00ZTq 1999 7Z .000192 1987 9X .0002~7 2000 BZ .O00ZX9 --Interest is calculated as follows: TNTEREST = BALANCE OF TAX UNPATD X NURBER OF DAYS DELINQUENT X DA/L¥ TNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. NOTICE TO: John Zepp III FROM: Kirk Sohonage, Solicitor for the Register of Wills DATE: January 14, 2005 SUB: Additional Probate Fees Decedent: Christian Otto Estate No.: 21-02-1049 In an annual review of all estates and accounts, it has come to our attention the above listed estate owes additional probate fees in the amount of $ 35.00. Our records indicate that you are the personal representative or counsel for the same in the above listed estate. Probate fees are estimated at the time of petitioning for letters. Final probate fee amounts are determined by the value of the estate as reported on the inheritance tax return filed in our office for the Department of Revenue. The additional probate fee should be made payable to "Register of Wills" and be forwarded in the enclosed envelope within 15 days of this notice. If you fee;1 you have received this notice in error, kindly contact the Register of Wills directly at (717) 240-5411 and she will be happy to review the matter.