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HomeMy WebLinkAbout03-0221PETITION FOR PROBATE and GRANT OF LETTERS Estate of DELANCYI M Grace No. also known as To: , Deceased Social Security No. 174208661 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut rix in the last will of the above decedent, dated March 09, 1979 and codicil(s) dated Register of Wills for the County of ~-"m,,,~.c:-,z.~_~.o-o Commonwealth of Pennsylvania in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Southampton 'l'wp/Cumberland County, Pennsylvania, with h er last family or principal residence at 100 Gilbert Road, Shippensburq PA 17257 (list street, number and municipality) Decedent, then 77 years of age, died 2/28/2003 at Chambersburq Hospital, Chambersburq, PA Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never ajudicated incompetent: 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: 100 Gilbert Road, Shippensburg (Southampton Township, Cumberland County) Pennsylvania WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters ~-*,~A-~,~,~,\ ~ thereon. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) Zoffd~. L D~.J~ncy-Ga~o . 99 W Main Street Walnut Bottom PA 17266 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF ~',r~*--~~f 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 affirmed and subscribed before me tills to'~,- day of March, 2003 Estate of DELANCY, M Grace , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW March I~, 2003 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 3/9/1979 described therein be admitted to probate and filed of record as the last will of M Grace Delancy, and Letters Testamentary are hereby granted to '7-o~ Zonda L Delancy-Gallo FEES Probate, Letters, Etc ......... Short Certificates ( ) ...... ' TOTAL Filed. ~.- /.,~% -.0,..~ .............. Register of Wills ~ ~/ 0 Myers, Forest N 8064 ATTORNEY (S~D. No.) 137 Park Place West Shippensburq PA 17257 ADDRESS 532.9046 PHONE MARK AND WEIGLE Attorneys at Law Shippensburg, Pa. LAST WILL AND TESTAMENT I, M. GRACE DELANCY, of R. D. 6, Shippensburg, Southampton Township, Cumberland County, Pennsylvania, being of sound mind, memory and dispos- ition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my just debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give, devise and bequeath all my estate, real, personal and mixed, whatsoever and wheresoever situate, to my beloved husband, LYNN H. DELANCY, absolutely. THIRD. In the event my said husband predeceases me or is not living on the 60th day following my death, I then give, devise and bequeath my said estate to my daughter, ZONDA L. DELANCY, absolutely. FOURTH. I nominate, constitute and appoint my husband, LYNN H. DELANCY, to be the Executor of this my Last Will and Testament; if he be unable to fulfill the duties of Executor, I then nominate, constitute and appoint my daughter, ZONDA L. DELANCY, to be the Executrix of this my Last Will and Testament. IN WITNESS WHEREOF, I, M. GRACE DELANCY, have hereunto set my hand and seal to this my Last Will and Testament, this ~ day of March, 1979. This instrument was by the Testatrix, M. GRACE DELANCY, on the date hereof, signed, p~lished and declared by her to be her Last Will and Tes- tament, in our presence, who at her request and in her presence and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. COMMONWEALTH OF PENNSYLVANIA : : SS COUNTY OF CUMBERLAND : I, M. GRACE DELANCY, the Testatrix whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledg~ that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the pur- poses therein expressed. Sworn or affirmed to and acknowledged before me by M. Grace Delancy, the Testatrix, this 9th day of March, 1979. Mary E'~eavets · , Netary Pubic .Sh~p~ensbur~, PA Cumberland County ~'My Commission Exl~ires July 27, 1982 COMMONWEALTH OF PENNSYLVANIA : : SS COUNTY OF CUMBERLAND : MARK AND WEIGLE r Attorneys at Law Shippensburg, Pa. We, William R. Mark and Nancy J. Monn the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that she signed -2- willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge the Testatrix was at that time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by William R. Mark and Nancy J. Monn , witnesses, this 9th day of March, 1979. ~ Mary E. ~eavers, Notary Public ~,,S~ppensburg, PA Cumberland County ~" My Commksioe Expk~ J4Jly 27, 1982 -3- ~q4ARK AND Wit IGL£ ~ Attorneys at Law ~ Shippensburg, Pa. , M. GRACE DELANCY '¸7 Z MARK AND WEIGLE ATTORNEYS AT LAW 11S EAST KiNG STREET SHIPPENSBURG, PENNA. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Delancy, M Grace DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 02/28/2003 10/06/1925 IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) )!:: ()iAi. {JS[~ ON[ Y ILE NUMBER 21 03 00221 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 174-20-8661 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [] 1. Original Return [] 2. Supplemental Return [] 3. Remainder Return (date of death prior to 12~13-82) [] 4. Limited Estate [] 4a. Future ~nterest Compromise (date of death after [] 5. Federal Estate Tax Return Required 12-12-82) [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 1 8. Total Number of Safe Deposit Boxes of Will) copy of Trust) [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between [] 11. Election to tax under Sec. 9113(A)(AttachSchO) 12-31-91 and %1~95) ~iS SECtiON MU~ BE C~M~E~ED! AL~ ~ORRESP~NDE~E ~D ~ON~i~EN~iA~ TAX i~ATI~N SHOULD BE DiR~TED ~ 717/532-9046 !COMPLETE MAILING ADDRESS 137 Park Place West Shippensburg, PA 172~.~C = (~' 124,600.007' None 54,499.62 ?:' 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) Non~: 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) Non~ 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 78,065.00 [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 82,543.04 (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 19,659.86 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) Charitable and Governmental Bequests/Sec 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) (8) 339,707.66 19,659.86 320,047.80 320,047.80 (11) (12) (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 16.Amount of Line 14 taxable at lineal rate 320,047.80 x .00 x .045 (15) (16) 14,402.15 17.Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. [] x .12 x .'15 (17) (19) 14,402.15 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 100 Gilbert Road CITY Shippensburg !STATE PA Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 720.11 -IZIP 17257 (1) 14,402.15 Total Credits (A + B + C) (2) 720.11 Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. 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 theTAX DUE A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (4) (5) 13,682.04 (5A) (sa) 13,682.0~t Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ............................................................................. [] [] b. retain the right to designate who shall use the property transferred or its income; ................................ LJ IX] c. retain a reversionary interest; or ............................................................................................................ U d. receive the promise for life of either payments, benefits or care? ........................................................... [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................................................................................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare'that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Zonda L Delancy-Gal~,.~ 99 West Main Street Walnut Bottom, PA 17266 DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Forest N Myers ADDRESS 137 Park Place West Shippensburg, PA 17257 DATE For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving 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)]. The statutedoes not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 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 0% [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116 (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. MARK AND WEIGLE Attorneys at Law LAST WILL AND TESTAMENT I, M. GRACE DELANCY, of R. D. 6, Shippensburg, Southampton Township, Cumberland County, Pennsylvania, being of sound mind, memory and dispos- ition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my just debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give, devise and bequeath all my estate, real, personal and mixed, whatsoever and wheresoever situate, to my beloved husband, LYNN H. DELANCY, absolutely. THIRD. In the event my said husband predeceases me or is not living on the 60th day following my death, I then give, devise and bequeath my said estate to my daughter, ZONDA L. DELANCY, absolutely, FOURTH. I nominate, constitute and appoint my husband, LYNN H, DELANCY, to be the Executor of this my Last Will and Testament; if he be unable to fulfill the duties of Executor, I then nominate, constitute and appoint my daughter, ZONDA L, DELANCY, to be the Executrix of this my Last Will and Testament. IN WITNESS WHEREOF, I, M. GRACE DELANCY, have hereunto set my hand and seal to this my Last Will and Testament, this day of March, 1979. .,1 This instrument was by the Testatrix, M. GRACE DELANCY, on the date hereof, signed, published and declared by her to be her Last Will and Tes- tament, in our presence, who at her request and in her presence and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. COMMONWEALTH OF PENNSYLVANIA : : SS COUNTY OF CUMBERLAND : I, M. GRACE DELANCY, the Testatrix whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledg that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the pur- poses therein expressed. Sworn or affirmed to and acknowledged before me by M. Grace Delancy, the Testatrix, this 9th day of March, 1979. '-'.i!~aW E. Scarers, Not~ry Pubrlc ,Ship.~e~sburq, PA Cumberland County ,.-~.M'y Commissiofl Expirer July 27, 1982 COMMONWEALTH OF PEhFNSYLVANIA : : SS COUNTY OF CUMBERLAND : We, William R. Mark and Nancy J. Monn the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that she signed MARl.( AND V~E IGL. E willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best.of our knowledge the Testatrix was at that time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by William R. Mark and Nancy J. Monn , witnesses, this 9th da~ of March, 1979. ,~ Mary E. ~'ea~ers, Notary Public i~ShlPpefuburg, PA Cumberland County '/dy Comm~sion F. Xpi'es July 27, !~82 -3- COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Delancy, M Grace 21 - 03 - 00221 All real property own, e,d, solely or as.a. te, nant in c.o.,mm.on must .be re..p, orted,,at fair,.mar.ket value. Fa. jr m.ar ,ket value is defined as the price at which property wou~a De excnangea Detwe..en .a wi,ing ouyer ana a willing se,er, neitner being compe,ed to ouy or sell, both having reasonable knowledge of the relevant facts. ~eal property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE Of NUMBER DEATH 1 residence located at 100 Gilbert Road, Southampton Township, Cumberland County, Pennsylvania 124,600.00 TOTAL (Also enter on Line 1, Recapitulation) 124,600.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Delancy, M Grace FILE NUMBER 21 - 03 - 00221 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 residence located at 100 Gilbert Road, Southampton Township, Cumberland County, Pennsylvania 124,600.00 TOTAL (Also enter on Line 1, Recapitulation) 124,600.00 RESIDENTIAL APPRAISAL REPORT Property Location: 100 Gilbert Road Shippensburg, Pa. 17257 Homeowner/Borrower Name: Estate of Lynn & Grace Delancy Prepared for: Prepared by · Attention: Estate of Lynn & Grace Delancy Forest Myers Attorney Zonda L. Gallo Executrix Roy R. Monn, Jr. GA-000688L Date: 4/1/03 File Number: 052 BLAKEWOOD BUSINESS FORMS, INC. 1(800)443-1004 UNIFORM RESIDENTIAL APPRAISAL REPORT Rle I~. 052 100 Gill)eft Road C~ Shi~penst)uf~ 39-13-0104-051 T~(y~r 2003 R.E T~e~ $ SMe Pa. Tm Code 17257 Ce~y Cumberland Execuldx Zonda L Gallo ' R. Mofln Jr. Map R~ 39-t30104-051 Census Tract 0131 Ndghbmla~l boux~e$ mai cflaractmfsgcs: Between Air Port Road and Walnut Dale Road and Baltimore Road % Forest Mygrs - 137 Park Placer Shippensbu~., Pa. 17257 221 East Pa. 17257 t~edondm~ P~mI had un% I.~lmedmge To: 2 79 This ama is and is at the Unive~ and public schools ere at the west end of Sh!~ re?errS_ burg ! .~__~ Chambersbur~ along Route 11. This is a ~ural area with acreage for added appeal to the market. The barn is for a horse and acreage ia fence In, all of this should in this area that coold be considered as typicet for this area aaa 4.~ acres Spe~c~.zming classilicallon and description residential ZolllTtg compliance [] Legal [] [~gai ~o~g (Graldlae'tered use) [] ~Jeg~ [] ~ zal~g residential Public 01ha' Off-file hla'emwas T~e PuNic Private Wale* [] well Sidewalk none [] [] s,~,~s~r [] se~c siree,g~ none [] [] no,~ F-] F-I ~adverse easements or encroachments on this site tha~ could affect thigs ~=__~_~e estimate of value. T0pogral~ level Si~ ,4.6 acres Shape rectangular orame typical Ddveway $u[ta~ black-top App~ea~ none observed rmAs~,~ ~x~ H~ FlY. I~m Didnot observe No. ol Units 1 C.B. Slab Nee S~ R. 916 No. (d S~mies I F_xtedor Walls Alum % Rnished 200/0TM T)~e (OeL/Att.) der. Rod Sadace Basement Full tile 0.1ge (style) eu~s & 0writs. meal Sump P~p ~neted (Yrs.) 1~52 st~/s~,~ .o 1966 no 916 916 Ikmue~ MateMs/C~0n FEAllHG Al'tlC !CAR slrOR~E: Floes T~ee H.A. [] ~ [] I:irq~J~N~ [] ~ [] w~ d~wall oil [] a~ [] ~ [] ~ Tlflt'~rish stock [] Dr~Stair [] Deck [] ~ :eamwam~ lino. cema __ r--,~ [] n~ [] ~ [] ~ 'Dm~ hollow-core Oiler Mionw'am [] H~ded [] P~ [] ~ Ad(atlonalfeatures(speclalene~df~ientitems, etc.): Front porch 6x18 = 108s.f. - I~,way7x20=140s.f. 1 sto,,ybam with loft and horse 30 =600s.f. l-story fr. shed 10x16 =160s.f. condition is the main deprecation vicinity ol the sM~ect ix'~.; Didnol observe an,/adverse environmental condition or) this site that would affect this roaso~___ble .~ of value. R-,~,C~Mac f-~m 70 6p.13 PAGE1 OF2 Pamie MaeR:mnlO04 6/93 alt~s~lo, uNIrUnlW nI:OlUr. NIIAL Al'l'ltlll;i/IL Itl:l'Ulll Rlei~ 052 ESll~TED SITE VALUE ............................................... .= $ 57,500. Con~mlCedAp~xoach(suchas, soarc~ of cost esBmat& site value, ES11MA'ED REPRODUCTION COST-NEW-OF IMPROtEMENTS: square foot calculalim~ md f~r HUB, VA and ~ the es~ rem~Lg~ Dweging 916SQ. FL@$ 58.69 = $ 53,760 ec(~lifeoflheiw~mat%): extra's 916 Sq. FL @$ 5.00 = 4,580 shed lox 16 =160s.f. ~1~6. =960. ext~'s -- = 18,7~. bern 20x30 -600s.f. ~ 21.00 =125°°. ~mt 260 Sq. FL @$ 15.01 = 3,903 Air condition . ~} =3500. TofaiEs~matedCostNew .............................. = $ 81,039 porch 108s.f.{~7.00 = 758. Less PhysicaJ Fmcitm~ Extema~ b-way 7x20 = 140s.~. ~ 7.00 = 980. DepmdalJm 11,570.{ 3,8561 =$ 15,426 totals 18,796. Depreciated Vadue of Improvements .................................. =$ 651613 · As4s' Valnc of Site Improvements .................................... =$ 8,500: INDICATEO YALUE BY COST APPROACH ............................. =~ 131,613 ~ J SUBJECT COMPNV~LE NO. 1 COMPARABLE NO. 2 CO~PARABLE NO. 3 100 Gilbert Road 19 Fairvlew Road ~' 127 Foxhill Road 206 Shady Lane Add~s~ Shlppensburg ShipPenshurg Shipponshu~ ShIppensburg ~ to Subject . .r, ~r .'. ~ V .~' 6-mites *, 6-miles 6-mites Oata md/~ multi-list Vmffica~Jofl Source inspection multi-list multi-list VALUEADJUS~ENm DESC~N OEscm=noN i +(-)$A~1ust. DEscrm,noN i +(-)$MlU~. DESCI~qON i ).oca~oll rural rural ; rural ; rural Le~d/Fee ~ fee simple fee simple ; fee simple ; fee simple Site 4.Gacre4.Gacres 2.47 ar.~es i +21,300. 2.1 ; +25,000 1 2.01 ; Oesian alxl ~peal ranch ranch : ranch : milch Oualilv of Cons'mJclion Alum. Num. ; Num- brick ; -2,0O0.; alum-brick ; -2~0O0 Aoe 1952 1976 ; 1966 ; -2,800! 1986 ; -6,800 Cemittm~. average average ; average ; average ; RoomCount . 4 i 2 i I 5 i 3i I ; 6 i 3 i 2.5 i -3,0O0 6 i 3 ; 2 : -2,000 Gn)ss Liv~ Nea 916Sq. FL 1,120 Sq. R. ;: -4,040 1,664 Sq. R. i -14~960 1,144 Sq. PL i -4,560 Basement & fini ~sl~l 916 full : full : full : Rooms Below G~uJe 20%= 50% finish -2'803. none : +l,(X)O 50% finish : -2'800 Rmctim~l'~ I average average ; average ~ avem.qe HeWmfCo~nfl hotalr- .yes H.A. no ; +3,500 ha- no ~ +3,500 b.a. yes Ene~ El~;ieof Items : 3-car : -4,00O. 2-car : ~2'000 Garanc/CarDmt ,1-car 1-car : )orch - F.P. : ~)mh-w/stove Porch, PaOo, Deck, porch - b--~vay porch - F.P. : none= patio : +2,000. none - shed ! +2,000. Rm~lacels), etc. barn - shed barn - shed : ; Fmce. Pool. etc. fence - pasture fence ; ; ; ; ,, ; of co,~-~o ~:~,~-~~ ...... 11s,~o ......... ......... ~G~.~ I $ ~"'~] $ 124,640. Gros~;. '.~.] $ 125,840 Commer~ m~ Sales Cempa~s(m ~ Ihe sabject pmp~'s compal~lity Io Ihe nct~dmd~ etc,): )J! sales have walls and saptic systoms~aiso from Hopeweit Township wNch is ~e same school district. Ail comparables have smaller lots and are the best available at this time. Sate # 1 is located next to lam:l fill.~ate #2 is most like subject and has a~l~d a barn a~er sale .Due to lot size a substan~al adjustments is ITEM ~JECT COMPARABLE NO. 1 COMP/~,~LE NO. 2 COMPARABLE NO, 3 D~e, Price en~ Data no pr[or sale Pn;)pedy is not for sale at this time, appraisal is to be ,,-~_ tot the estate use. II~TED VALUE BY SAJ.F.S COIIPA~ N~RROAC~ .................................................................................................... $ 124,600. INDIC~TEDVALUEBYINCO~APPROACHpAR~tcable) E~ma~Ma~dqe~ ~ ~'m. x G.~pa~_~..~ =~ T~amai.dismade [~'nJs' F-1~31e~b.~i~%~,rW~.~orc0ncr~mr~edbek~ F-]~b~oftocm~eUonp~plam&~peci~c~on~ C0mitJm~ 0f Apprai~: appraised as is Rnad Recmcilla~on: Emphasis is placed on the market data approach to value, ~his will state what the bm~rs are peying for similar parcels ~s time. This value is suppofled by the cost approach to v~!,,e ,sJI ava[t-hie infom~ation and m~ know~e~, e of this area ~it add s,_¥%p~_.,t to ~s value. and rlTnifi~ c(~m'~, mid market Mue de~ Ihat are et~ iff b,m allached F~e Mac R~m1439/~ lmm 10(NiB ~evi~ 6-93 ). WHICH IS THE DAT~ OF IHSPEC~ AND THE EFFECTIVE DATE OF T~i$ RE]K]i~iI) -R) i~ ' $ 124,600.00 ~PflAISF.~. ' SUP.E~¥1~:~Y APPP. A~I~ (ONLY IF REq~RB)): ~ Roy R,'~On~ Jr. ,'/'-'-- "l'' Nam Inspect Rapat/ !0~ State Ucense # Stye Ornate Uceme ~ :red~e Mac F~m ?0 6/93 PAGE2OF2 From UA2 -- "TOTAL isr Windows" ~ sdtware by a la mode, inc. -- 1 -~IO0-ALAMODE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Delancy, M Grace 21 - 03 - 00221 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 2 3 4 5 6 7 8 9 10 11 12 13 DESCRIPTION Allfirst Bank, checking account #0097204145 Allfirst Bank, certificate of deposit #870081000095787 Allfirst Bank, certificate of deposit #87008100096228 Automobile, 2000 Toyota Camry LE Household goods pension benefit, Heavy and Highway Benefit Account SKF, USA, Pension benefit Independence Blue Cross, medical reimbursement Independence Blue Cross, medical reimbursement Independence Blue Cross, medical reimbursement United States Treasury, 2002 tax refund Medicare reimbursement VALUE AT DATE OF DEATH 14,319.07 10,156.51 11,019.28 12,000.00 4,500.00 43.83 528.77 9.24 23.07 50.61 1,000.00 849.24 TOTAL (Also enter on Line 5, Recapitulation) 54,499.62 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Delancy, M Grace SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 2 ! - 03 - 00221 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME A zonda L Delancy-Gallo ADDRESS 99 Main Street Walnut Bottom PA 17266 RELATIONSHIP TO DECEDENT daughter LE'I-FER ITEM i FOR JOINTI NUMBER! TENANT 1 i A 2 A 3 A 4 A 5 A 6 A 7 A 8 A 9 A JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY DATE Include name of financial institution and bank account number MADE or similar identifying number. Attach deed for jointly-held real JOINT estate. various Series E and EE United States Savings Bonds 06/15/20001 Allfirst Bank Money Market Account #0098121758 02/25/2000 Allfirst Bank, certificate of deposit #1982327 DATE OF DEATH VALUE OF ASSET 28,703.40 34,994.05 11,385.63 07/15/1994 01/13/1997 02~8/1997 07/16/1997 07/16/1997 02/13/1998 Allfirst Bank certificate of deposit #87008100343136 Allfirst Bank certificate of deposit #87008140647446 Allfirst Bank certificate of deposit #87008140709700 Allfirst Bank certificate of deposit #87008140845914 Allfirst Bank certificate of deposit #87008140876615 Allfirst Bank certificate of deposit #87008141054201 10,164.901 13,329.28 19,361.49 13,102.63! 12,694.71 12,393.86 % OF DATE OF DEATH DECD'S I VALUE OF INTERES~ DECEDENT'S INTEREST 14,351.70 17,497.03 5,692.82 5,082.45 6,664.64 9,680.75 6,551.32 6,347.36 6,196.93 TOTAL (Also enter on line 6, Recapitulation) 78,065.00 COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Delancy, M Grace IFILE NUMBER 21 - 03 - 00221 ITEM NUMBER This schedule must be completed and filed if the answer.,t0 a_ny_o_f que_sti0ns 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY DATE F D % OF Include the name of the transferee, their relationship to decedent and the date of transfer O EATH EXCLUSION Attach a copy of the deed for real estate. VALUE OF ASSET DECD'S (IF APPLICABLE INTEREST Dauphin Deposit nbm M&T Bank, IRA Account 52,595.85 #87000072107001 Zonda Delancy-Gallo Beneficiary Allfirst Bank nbm M&T Bank Annuity #FDA230012 Zonda Delancy-Gallo Beneficiary 100% TAXABLE VALUE 29,947.19 100% 52,595.85 29,947.19 TOTAL (Also enter on line 7, Recapitulation) 82,543.04 all rst' Forest N. Myers Attorneys At Law 137 Park Place West Shippensburg, PA 17257 Allfirst Financial Center N.A. P.O. Box 900 Millsboro, DE 19966 Phone (302) 934-2909 F ax (302) 934-2955 March 17, 2003 Re: Estate of Myrtle Grace Delanc¥ Social Security: 174-20-8661 Date of Death: February, 28, 2003 Dear Sir or Madam: Per your inquiry dated March 7, 2003, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: Type of Account Account Number .Ownership (Names oJ) Opening Date Balance on Date of Death Accrued Interest Total Relationship Checking W/Interest 0097204145 M Grace Delancy, Owner 01/28/80 $14,317.68 $ 1.39 $14,319.07 Type of Account Account Number Ownership (Names oJ) Opening Date Balance on Date of Death Accrued Interest Total Money Fund Alternative 0098121758 M Grace Delancy, Owner Zonda L Delancy-Gallo, Owner 06/15/00 $34,984.65 $ 9.40 $34,994.05 Type of Account Account Number Ownership (Names oJ) Opening Date Balance on Date of Death Accrued Interest Total Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Accrued Interest Total Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Accrued Interest Total Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Accrued Interest Total IRA 87000072107001 M Grace Delancy, Owner 02/25/83 $52,512.55 $ 83.30 $52,595.85 Prem Int IRA 87100072107001 M Grace Delancy, Owner 02/25/02 $0.00 $0.00 $0.00 Certificate of Deposit 80~00000'1982327 V/ M Grace Delancy, Owner Zonda L Delancy-Gallo, Owner 02/25/00 $11,382.28 $ 3.35 $11,385.63 Certzficate of Deposit 87008100095787 M Grace Delancy, Owner 04/29/94 $10,000.00 $ 15651 $10,156.51 10. Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Accrued Interest Total Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death ' Accrued Interest Total Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Accrued Interest Total Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Accrued Interest Total Ce~ficate of Deposit 87008100096228 M Grace Delancy, Owner 05/17/94 $11,000.00 $ 19.28 $11,019.28 Certificate of Deposit 87008100343136 ~t M Grace Delancy, Owner Zonda L Delancy-Gallo 07/15/94 $1 O, 000. O0 $ 164.90 $10,164.90 Cernficate of Deposit 87008140647446 ~f M Grace Delancy, Owner Zonda L Delancy-Gallo 01/13/97 $13,304.68 $ 24.60 $13,329.28 Certificate of Deposit 87008140709700 '~ M Grace Delancy, Owner Zonda L Delancy-Gallo 02/28/97 $19,324.05 $ 37.44 $19,361.49 11. 12. 13. 14. 15. Type of Account Account Number Ownership (Names Opening Date Balance on Date of Death Accrued Interest Total Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Accrued Interest Total Type of Account Account Number Ownership (Names Opening Date Balance on Date of Death Accrued Interest Total Type of Account Account Number Ownership (Names oJ) Opening Date Type of Account Account Number Ownership (Names oJ) Opening Date Ceraficate of Deposit 87008140845914 V/ M Grace Delancy, Owner Zonda L Delancy-Gallo 07/16/97 $13,094.61 $ 8.02 $13,102.63 Certtficate of Deposit 87008140876615 v// M Grace Delancy, Owner Zonda L Delancy-Gallo 07/16/97 $12,652.27 $ 42.44 $12,694.71 Cer~ficate of Deposit 87008141054201 / M Grace Delancy, Owner Zonda L Delancy-Gallo 02/13/98 $12,379.33 $ 14.53 $12,393.86 Safe Deposit Box 1000571100004242 M Grace Delancy, Owner Lynn H Delancy, DECD 11/13/98 Safe Deposit Box 1000574100002683 M Grace Delancy, Owner Zonda L Delancy-Gallo Charles W Gallo, DECD 11/13/98 This customer does have Brokerage accounts with Allfirst that are not listed abov& For information or questions regarding these accounts, please contact our Brokerage customer service department at 1-800-527-9210 (option 2). ,~ This letter does not include any accounts in which the deceased may have been listed as Power of ~4ttorney, Custodian of Uniform Transfers, Representative Payee, or Trustee under a Y~Tritten Agreement. For further account information, closures and/or reimbursement of funds refer to below branch: WALNUT BOTTOM OFFICE 28 WALNUT BOTTOM ROAD SHIPPENSBURG, PA 17257 717-532-2414 rely, x Sue ~ Assistant I Cis Services, (302) 934-2909 ) m:OOOOqOOO?m:~3 {~3222~00~q32,' · 7::-- - :--:: L'~' --:.. '20 8661 ;.' - .... ~' :'i ' "'::-: · -'-- ..... _ ~":"-~:: .' '~.~,~',i?'~: ::i ~'~?;. ~ -! ::': __~:::??t~!-::/': FRB PITT · ' : : '~-,-- -", .... :;i.' "":~""'~r~--Z.:~~' ' "-" ' ' '-- : '-:' 0 -- ' L'00 T/'RI=DT I~i'~''~' ..... "--=~:'~' I ....... ~ .,H_IPPENSBURG ~.'-:,,~.,~.-:~ .... .-:;~PA: 1 72~i7- c~,'.n o-':-'-':~.:?' ~";::~--::--';~:~-::--'s~-~-:-:::: .... -:-- ,.llh,'~h,hhhl,h,,Ihh:,hlllh,,i,h',l?-,Ih,,.,Ih,I :. _- -:-:-..: ::-i¥_... ~0'~0--ND~.L DELANC-~,~i~A~LJ'"O~:. ..:' .' :- _T--_~::- :?.-:_:_~_:__-:_%.-_:?~_.j:;:j:Li~.~.~::~. .... 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'lT;;ill,,,[,,l,l,l,l,l,,i[~_~[lll;i~[, ~l.~l_~:Jl,,I :ZONDA L ~fi~C~-~'~[O ~ ~'~'~ '~ '- ......... ,. :~., ':ob'o0'~ qo o:'*,:0 s":~:: oo Savings Bond Calculator Page 1 of 2 '.. ~/2003 [ Bill Series i'EE Bonds Denomination Serial Number Issue Date # Bonds TotaiPrice 26 $2,600.00 Serial Issue Issue Number Date Series Denom Price 5573 01/1984 EE $200 5100.00 5572 11/1983 EE 200 100.00 5571 02/1981 EE 200 100.00 5570 06/1983 EE 200 100.00 5569 03/1984 EE 200 100.00 5568 04/1983 EE 200 100.00 5567 01/1983 EE 200 100.00 5566 11/1982 EE 200 100.00 5565 09/1982 EE 200 100.00 5564 06/1982 EE 200 100.00 5563 04/1982 EE 200 100.00 5562 02/1982 EE 200 100.00 5561 11/1981 EE 200 100.00 5560 09/1981 EE 200 100.00 5559 07/1981 EE 200 100.00 5558 04/1981 EE 200 100.00 5557 08/1983 EE 200 100.00 5556 12/1980 EE 200 100.00 5555 10/1980 EE 200 100.00 5554 07/1980 EE 200 100.00 5553 02/1988 EE 200 100.00 5552ee 12/1987 EE 200 100.00 5551ee 10/1987 EE 200 100.00 5549ee 05/1987 EE 200 100.00 5548ee 02/1987 EE 200 100.00 5547 12/1986 EE 200 100.00 Viewing Bonds 1-26 Total Interest $6,678.32 Interest 5216.16 216.16 347.12 230.24 210.56 241.60 277.28 277.28 295.44 303.36 303.36 311.44 311.44 311.44 319.60 338.32 230.24 347.12 387.76 397.52 128.96 128.96 130.00 134.40 141.28 141.28 Total Value YTD Interest $9,278.32 $66.64 Interest Next Final Value Rate Accrual Maturity Note $316.16 3.05% 07/2003 01/2014 316.16 3.05% 05/2003 11/2013 447.12 4.00% 08/2003 02/2011 330.24 3.04% 06/2003 06/2013 310.56 3.58% 03/2003 03/2014 341.60 4.01% 04/2003 04/2013 377.28 4.00% 07/2003 01/2013 377.28 4.00% 05/2003 11/2012 395.44 4.00% 03/2003 09/2012 403.36 4.00% 06/2003 06/2012 403.36 4.00% 04/2003 04/2012 411.44 4.00% 08/2003 02/2012 411.44 4.00% 05/2003 11/2011 411.44 4.00% 03/2003 09/2011 419.60 4.00% 07/2003 07/2011 438.32 4.00% 04/2003 04/2011 330.24 3.04% 08/2003 08/2013 447.12 4.00% 06/2003 12/2010 487.76 4.00% 04/2003 10/2010 497.52 4.00% 07/2003 07/2010 228.96 4.00% 08/2003 02/2018 228.96 4.00% 06/2003 12/2017 230.00 3.78% 04/2003 10/2017 234.40 4.00% 05/2003 05/2017 241.28 2.96% 08/2003 02/2017 241.28 2.96% 06/2003 12/2016 http://wwws.pubHcdebt.treas.gov/BC/SBCPrice 4/21/2003 Savings Bond Calculator Page 2 of 2 Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty ME Matured (Exchangeable for HH) MN Matured (Not Exchangeable for HH) Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator C' C C C http: //wwws. pub[icdebt.treas.gov/BC/SBCPrice 4/21/2003 Savings Bond Calculator Pa~e 1 of 4 02.[~003 Bill Series Denomination lEE Bon s $i2oo Serial Number Issue Date # Bonds Total Price Total Interest 86 $4,037.50 $15,387.58 Issue Issue Serial Number Date Series Denom Price 5546ee 09/1986 EE 5200 5100.00 r156095545ee 07/1986 EE 200 100.00 5544ee 05/1986 EE 200 100.00 r156095543ee 03/1986 EE 200 100.00 r156095542ee 12/1985 EE 200 100.00 r156095541ee 10/1985 EE 200 100.00 r156095540ee 07/1985 EE 200 100.00 r156095539ee 05/1985 EE 200 100.00 156095538ee 03/1985 EE 200 100.00 r156095537ee 12/1984 EE 200 100.00 r156095536ee 10/1984 EE 200 100.00 r156095535ee 07/1984 EE 200 100.00 r156095534ee 06/1984 EE 200 100.00 [226006915e 01/1974 E 50 37.50 L2226006914e 09/1973 E 50 37.50 L2226006913e 11/1973 E 50 37.50 t2226006912e 08/1973 E 50 37.50 [226006911e 10/1973 E 50 37.50 t2226006910e 07/1973 E 50 37.50 [2226006981e 05/1980 E 50 37.50 [2226006980e 04/1980 E 50 37.50 [2226006979e 02/1980 E 50 37.50 [226006978e 01/1980 E 50 37.50 [226006977e 12/1979 E 50 37.50 t226006976e 11/1979 E 50 37.50 [226006975 10/1979 E 50 37.50 [2226006974e 09/1979 E 50 37.50 Total Value $19,425.08 Interest Next Interest Value Rate Accrual 5164.96 5264.96 4.00% 03/2003 170.24 270.24 4.00% 07/2003 170.24 270.24 4.00% 05/2003 170.24 270.24 4.00% 03/2003 175.68 275.68 4.00% 06/2003 175.68 275.68 4.00% 04/2003 181.20 281.20 4.00% 07/2003 181.20 281.20 4.00% 05/2003 182.40 282.40 3.87% 03/2003 187.84 287.84 4.00% 06/2003 196.56 296.56 3.56% 04/2003 201.76 301.76 3.04% 07/2003 201.76 301.76 3.04% 06/2003 209.48 246.98 4.00% 07/2003 219.16 256.66 4.00% 07/2003 214.12 251.62 4.00% 03/2003 219.12 256.62 4.00% 06/2003 219.16 256.66 4.00% 08/2003 218.56 256.06 4.00% 05/2003 128.56 166.06 4.00% 05/2003 126.88 164.38 4.00% 04/2003 130.18 167.68 4.00% 08/2003 130.18 167.68 4.00% 07/2003 130.18 167.68 4.00% 06/2003 130.18 167.68 4.00% 05/2003 128.60 166.10 4.00% 04/2003 128.60 166.10 4.00% 03/2003 YTD Interest $126.22 Final Maturity Note 09/2016 07/2016 05/2016 03/2016 12/2015 10/2015 07/2015 05/2015 03/2015 12/2014 10/2014 07/2014 06/2014 01/2004 09/2003 11/2003 08/2003 10/2003 07/2003 05/2010 04/2010 02/2010 01/2010 12/2009 11/2009 10/2009 09/2009 http: / /wwws. pu bUcdebt, treas, gov/BC/SBCPrice 4/21 / 2003 Savings Bond Calculator Pa~e 2 of 4 12226006973 08/1979 E 50 37.50 12226006972e 06/1979 E 50 37.50 [2226006971e 05/1979 E 50 37.50 [2226006970e 04/1979 E 50 37.50 [2226006969e 03/1979 E 50 37.50 [2226006968e 02/1979 E 50 37.50 [222606967e 01/1979 E 50 37.50 [2226006966e 12/1978 E 50 37.50 12226006965e 10/1978 E 50 37.50 ~2226006964e 09/1978 E 50 37.50 [2226006962e 08/1978 E 50 37.50 12226006961e 06/1978 E 50 37.50 [2226006963e 08/1978 E 50 37.50 [2226006960e 04/1978 E 50 37.50 [2226006959e 05/1978 E 50 37.50 [2226006958e 03/1978 E 50 37.50 ~2226006957e 02/1978 E 50 37.50 [2226006956e 12/1977 E 50 37.50 [2226006955e 11/1977 E 50 37.50 [2226006954e 10/1977 E 50 37.50 [2226006953e 09/1977 E 50 37.50 [2226006952e 07/1977 E 50 37.50 12226006951e 07/1977 E 50 37.50 [2226006950e 05/1977 E 50 37.50 12226006949e 04/1977 E 50 37.50 [2226006947e 02/1977 E 50 37.50 [2226006946e 01/1977 E 50 37.50 t2226006948e 03/1977 E 50 37.50 [2226006943e 09/1976 E 50 37.50 12226006944e 11/1976 E 50 37.50 [2226006945e 12/1976 E 50 37.50 [2226006940e 06/1976 E 50 37.50 ~2226006941e 07/1976 E 50 37.50 [2226006942e 08/1976 E 50 37.50 [2226006937e 03/1976 E 50 37.50 [2226006938e 04/1976 E 50 37.50 131.92 169.42 4.00% 08/2003 08/2009 131.92 169.42 4.00% 06/2003 06/2009 131.54 169.04 4.00% 05/2003 05/2009 129.92 167.42 4.00% 04/2003 04/2009 129.92 167.42 4.00% 03/2003 03/2009 133.26 170.76 4.00% 08/2003 02/2009 133.26 170.76 4.00% 07/2003 01/2009 133.24 170.74 4.00% 06/2003 12/2008 131.18 168.68 4.00% 04/2003 10/2008 131.18 168.68 4.00% 03/2003 09/2008 134.54 172.04 4.00% 08/2003 08/2008 134.52 172.02 4.00% 06/2003 06/2008 134.54 172.04 4.00% 08/2003 08/2008 143.54 181.04 4.01% 04/2003 04/2008 134.08 171.58 4.00% 05/2003 05/2008 143.54 181.04 4.01% 03/2003 03/2008 173.24 210.74 4.00% 08/2003 02/2008 173.24 210.74 4.00% 06/2003 12/2007 172.66 210.16 4.00% 05/2003 11/2007 191.66 229.16 4.00% 04/2003 10/2007 191.66 229.16 4.00% 03/2003 09/2007 196.24 233.74 4.00% 07/2003 07/2007 196.24 233.74 4.00% 07/2003 07/2007 195.80 233.30 4.00% 05/2003 05/2007 193.50 231.00 4.00% 04/2003 04/2007 198.12 235.62 4.00% 08/2003 02/2007 198.12 235.62 4.00% 07/2003 01/2007 193.50 231.00 4.00% 03/2003 03/2007 195.20 232.70 4.00% 03/2003 09/2006 197.46 234.96 4.00% 05/2003 11/2006 198.12 235.62 4.00% 06/2003 12/2006 199.90 237.40 4.00% 06/2003 06/2006 199.84 237.34 4.00% 07/2003 07/2006 199.84 237.34 4.00% 08/2003 08/2006 197.14 234.64 4.00% 03/2003 03/2006 197.14 234.64 4.00% 04/2003 04/2006 http: //wwws. pu b[icdebt, treas. ~ov/BC/SBCPrice 4/21/2003 Savinss Bond Calculator Pase 3 of 4 [2226006939e 05/1976 E 50 [2226006934e 11/1975 E 50 [2226006935e 12/1975 E 50 [2226006936e 01/1976 E 50 [22226006931e 07/1975 E 50 22226006932e 09/1975 E 50 [2226006933e 10/1975 E 50 i2226006928e 04/1975 E 50 [2226006929e 05/1975 E 50 [2226006930e 07/1975 E 50 t2226006925e 01/1975 E 50 [2226006926e 02/1975 E 50 t2226006927e 03/1975 E 50 [2226006922e 09/1974 E 50 ~2226006923e 10/1974 E 50 [2226006924e 12/1974 E 50 [2226006919e 06/1974 E 50 [2226006920e 07/1974 E 50 t2226006921 08/1974 E 50 [2226006916e 02/1974 E 50 [2226006917e 03/1974 E 50 [2226006918e 04/1974 E 50 [2226006909e 06/1973 E 50 Viewing Bonds 1-86 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 199.36 201.28 201.80 201.82 203.70 198.96 198.96 200.82 203.12 203.70 205.60 205.60 200.82 202.74 202.74 205.64 207.54 207.54 207.54 209.48 204.64 204.64 216.10 236.86 238.78 239.30 239.32 241.20 236.46 236.46 238.32 240.62 241.20 243.10 243.10 238.32 240.24 240.24 243.14 245.04 245.04 245.04 246.98 242.14 242.14 253.60 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.OO% 4.OO% 4.00% 4.00% 4.OO% 4.00% 4.OO% 05/2003 05/2006 05/2003 11/2005 06/2003 12/2005 07/2003 01/2006 07/2003 07/2005 03/2003 09/2005 04/2003 10/2005 04/2003 04/2005 05/2003 05/2005 07/2003 07/2005 07/2003 01/2005 08/2003 02/2005 03/2003 03/2005 03/2003 09/2004 04/2003 10/2004 06/2003 12/2004 06/2003 06/2004 07/2003 07/2004 08/2003 08/2004 08/2003 02/2004 03/2003 03/2004 04/2003 04/2004 04/2003 06/2003 Note DescdptJon NI Not Issued NE Not EHgib[e for Payment P5 Includes 3-month interest penalty ME Matured (Exchanseab[e for HH) MN Matured (Not Exchanseab[e for HH) Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator C' C~ C C' http: //wwws.pubHcdebt.treas.~ov/BC/SBCPdce 4/21/2003 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Delancy, M Grace SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 - 03 - 00221 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER FUNERAL EXPENSES: Fogelsanger-Bricker Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Add ress City State Zip Year(s) Commission paid Attorney's Fees Law Offices of Forest N Myers Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zonda L De]ancy-Oallo Street Address 1 O0 Gilbert Road City Shippensburg State PA Relationship of Claimant to Decedent daughter Probate Fees Register of Wills, Cumberland County Register of Wills, Cumberland County, filing fee Zip 17257 Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Recorder of Deeds, Cumberland County, recording of executors deed Vivian Coy, Tax Collector, 2003 County/Township taxes Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 6,355.80 7,500.00 3,500.00 266.00 14.00 38.50 210.02 1,775.54 19,659.86 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Schedule H Funeral Expenses & Administrative Costs continued 7 8 9 10 11 12 13 14 Delancy, M Grace Sprint Telephone D&L Gulf, inspection of automobile Adams Electric Cooperative Francis Marchal, CPA, preparationof final tax return Borough of Shippensburg, water service Nolt's engine service, repair of lawn mower GEM Group, Pa H&H Pension, reimbursement Chambersburg Hospital, medical services Carlos R Leffier, fuel Chambersburg Hospital, medical services Harold Breon, advertisement for sale of automobile Chambersburg Hospital, medical services FILE NUMBER 21 - 03 - 00221 102.27 21.20 125.09 155.00 39.53 162.08 43.83 23.07 216.99 840.00 28.00 18.48 Page 2 of Schedule H REV-1513 EX+ (9-00) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT SCHEDULE J BENEFICIARIES ES~TATE OF FILE NUMBER Delancy, M Grace NUMBER 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Zonda L Delancy-Gallo 99 Main Street Walnut Bottom PA 17266 21-03-00221 RELATIONSHIP TO DECEDENT Do Not~.iSt Trustee(s) daughter AMOUNT OR SHARE OF ESTATE entire estate II. Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover shee NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BE NG MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEt 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 002591 MYERS FOREST N ESQ 137 PARK PLACE WEST SHIPPENSBURG, PA 17257 fold ESTATE INFORMATION: SSN: 174-20-8661 FILE NUMBER: 21 03-0221 DECEDENT NAME: DELANCY M GRACE DATE OF PAYMENT: 05/20/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 02/28/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $13,682.04 TOTAL AMOUNT PAID: $13,682.04 REMARKS: ZONDALDELANCY-GALLO C/O FOREST N MYERS ESQUIRE SEAL CHECK# 113 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will No. ~:~- ~"27 I Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on ~ ~-- 'Ij 20~3 · Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Signature Address Telephone ( q ~ ~"bL- q~q~ Capacity: '"/Personal Representative __Counsel for personal representative BUREAU OF ZNDZVTDUAL TAXES ZHHERTTANCE TAX D/VTS/ON DEPT. 280601 HARRXSBURG, PA 17128-0601 COHHON#EALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX '0~ JUL-'? FOREST N HYERS F N MYERS LAW OFFICES 157 PARK PLACE WEsT SHIPPENSBURG ~'PA 17257 DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 07-07-2003 DELANCY 02-28-2003 2103-0221 CUHBERLAND 101 Amoun~ Remi~ed RE¥-1647 EX AFP (01-n$) H G HAKE CHECK PAYABLE AND RENZT PAYHENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF DELANCY H GFZLE NO. 2103-0221 ACN 101 DATE 07-07-2003 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRA:ZSED VALUE OF RETURN BASED ON: ORTGINAL RETURN 1. Reel Estate (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) :5. Closely Held Stock/Partnership Tnterest (Schedule C) ($) 4. Nortgeges/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Nisc. Personal Property (Schedule E) ($) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule O) (7) B. Tote1 Assets APPROVED DEDUCTZONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Costs/Nisc. Expenses (Schedule H) (9) 10. Deb~s/Nor~gage Liabilities/Liens (Schedule T) (10) 11. Total Deductions 12. Net Value of Tax Return 14. 124~600.00 .00 .00 .00 54z499.62 78z065.00 82z545.04 (B) 19,659.86 Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Subject to Tax .00 NOTE: To insure proper credit to your account, submi~ the upper portion of this form with your tax payment. NOTE: 339,707.66 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDZT/ONAL /NTEREST. ASSESSHENT OF TAX: 15. Amount of Line lq at Spousal rate 16. Amount of Line 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 ra~a 19. Principal Tax Due TAX CREDITS: PAYNENT RECETpT D/SCOUNT (+J DATE NUNBER TNTEREST/PEN PAID (-) 05-Z0-2003 CD002591 720.11 (1~) .00 x 00 = .00 (16) $20,047.80 x 045= 14,402.15 (17) . O0 x 12 = . O0 (lB) .00 x 15 = .00 (19)= 14,402.15 ANOUNT PAID 13,682.04 reflect figures that include the total of ALL returns assessed to date. TOTAL TAX CREDIT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE 14,402.15000000 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS RE~UXRED. ZF TOTAL DUE XS REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF TH/S FORH FOR XNSTRUCTZONS.) :Zf an assessment was lssued previously, 11nes 1~, 15 and/or 16, 17, 18 and 19 w111 (11) ]9 .&~;9 -~6 (12) 320,047.80 (15) . O0 (.~,~) SZO, 047.80 RESERVATION: 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 (collateral) beneficiaries of the decedent after the expiration 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 D (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECT[OHS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To RJlfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 13 of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register cf Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT 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" (RE¥-1315). Applications ara available at the Office of the Register of Hills, any of the 13 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-361-Z050; services far taxpayers with special hearing and / ar speaking needs: 1-800-447-3010 iTT only). Any party in interest not satisfied with the appraisement, allowance, or disalloeance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of race[pt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 2810Z1, Harrisburg, PA 17118-1011, 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 writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17118-0601 Phone (717) 787-6505. See page S of the booklet "Instructions for [nheritance Tax Return for a Resident Decedent" (REV-15Ol) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the dacedant's death, a five percent (SX) discount of the tax paid is allowed. The 151 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 tiaa period as 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 (1) day from the date of death, to the data of payment. Taxes which became delinquent before January l, 1981 boar interest at tho rate of six (BX) percent par annum calculated at a daily rata of .000164. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which ail1 vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through Z003 ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 lOX .000548 1987 9Z .000247 1999 7Z .O0019Z 1983 16Z .000438 1988-1991 llZ .000301 lOgO 8Z .000219 1984 llZ .000301 199Z 9Z .000Z47 IDOl 9Z .OODZ47 1985 13Z .000356 1993-1994 7Z .O0019Z ZOOZ 6Z .000164 1986 IOZ .000174 1995-1998 9Z .000247 ZOO3 51 .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY 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. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 1/10/2005 MYERS FOREST N ESQ 137 PARK PLACE WEST SHIPPENSBURG, PA 17257 RE: Estate of DELANCY M GRACE File Number: 2003-00221 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: 2/28/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge u__ C> STATUS REPORT tiNDER RULE 6.12 Name ofDecedent: ---D E LA IJ C ~ ) rv\ 9 (0. cY Date ofDeath: -=te 6 ()B, (}'r/J~~ Will No.: Admin. No.: ~(X)3 - ~~ \ Pursuant to Rule 6.12 of the Supreme Court O'l)hai1s' Comi Rules, I report the fol1owing with respect to completion ofthe administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ~ No 0 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 fol1owing: a. Did the personal representative file a final account with the Court? Yes No jg[ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal.r;presentative s. tate an account informally to the parties in interest? Yes k'S,j No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date:~'1/~S = \ -"'~2s- Signature -=trrest- P0 fV\1~(S Name M <'J ('.J LL J~i- ~k r\ LU Address S 'p peA) b '^ f' a fA 0-l-=B 5 3 ~ . 9 ~<.f<D Telephone No. CD I,r:' C::"} c.:, <--J LL, 0:::,' o Capacity: n Personal Representative ~ Counsel for personal representative of