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HomeMy WebLinkAbout03-0286 I REV- 1 500 PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN HARRISBURG, PA17128-0601 RESlBENT BECEBENT .2 _/_-_o _0_0 ,g_ ge COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ Baldwin Erma A. 173 50 2639 ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ,,, January 22, 2003 November 2, 1919 O REGISTER OF WILLS ILl (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER z 0 LU ~-'j 1. Original Return [~]4. Limited Estate [-~J 6. Decedent Died Testate (Attach copy of Will) J~9. Litigation Proceeds Received E~2. Supplemental Return []4a. Future Interest Compromise (date of death after 12-12-82) E~]7. Decedent Maintained a Living Trust (Attach copy of Trust) ~-~ 10. Spousal Poverty Credit (data of death between 12-31-91 and 1-1-95) ] 3. Remainder Return (date of death prior to 12-13-82} ~---] 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes [~11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME David A. Baric, Esquire FIRM NAME IIfApplicable) O'Brien, Baric TELEPHONENUMBEI- 717) 249-6873 & Scherer COMPLETE MAILING ADDRESS 17 West South Street Carlisle, Pennsylvania 17013 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 2,810.96 980.00 5,845.37 13. 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) (11) (12) (13) (14) 2,810.96 6,825.37 (3,790.96) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. x .12 x .15 (15) (16) (17) (18) (19) 0.00 Decedent's Complete Address: STREET ADDRESS 24 Doe Drive Cl~ Carlisle ISTATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty (1) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SD) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements~ and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE O,F PERSON RES.?ONSIBLE FOR FILING RETURN DAT. ,,/,,/~/.f~: ,.~ ~.,/ .- ,, ADDRESS 11 6 Alters Road, Carlisle, PA 1701 3 SIGNATURE O,~P~ARER OT~R~NTATIVE ADDRESS 17 West South Street, Carlisle, PA 17013 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)i The statute does 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 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 paren' 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 a~ individual who has at least one parent in common with the decedent, whether by blood or adoption. ~-$¥~TE OF SCHEDULE E J CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER Include the. proceeds of I~at~on and the date the proceeds were received by the estate. All property jointly-owned with the ~ht of suwivorship must be disclosed on Schedule ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 2,710.96 M & T Bank Checking Account Account No. 401420 Miscellaneous Personalty TOTAL (Also enter on line 5, Recapitulation) 100.00 2,810.96 $ (If more soace is needed, insert additional sheets d the same size) INH~ANCE TAX RE[URN ESTATEOF Erma A. Baldwin SCHEDULE H FUNERAL EXPENSES 8, ADMINISTRATIVE COSTS t FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: 5. 6. 7. DESCRIPTION ADMINISTRATIVE COSTS: Personal Representative's Commissions NarneofPemonalRepresenlalive(s) Fred L. Baldwin Sodal Security Number(s) / EIN Numbar of Pemonal Representalive(s) 116 Alters Road Street Address City Carlisle stam PA 2003 Year(s) Commission Paid: A~mey Fees Family ExemplJon: (If decedent's address is not ~he same as claimant's, attach explanation) Claimant Zip 17013 Street Address City Stata __ Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparers Fees TOTAL (Also enter on line 9, Recapitulation) (If mom space is needed, insert additional sheets of the same size) AMOUNT 200.00 750.00 30.00 $ 980.00 REV.~512 EX+ (7.89) (~.*~('%-,:0 COM,%~ONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Erma A. Baldwin SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABLITIES AND LIENS Please Print or Type FILE NUMBER ITEM NUMBER DESCRIPTION Commonwealth of Pennsylvania Department of Public Welfare (see attached). AMOUNT 5,845.37 TOTAL (Also enter on line 10, Recapitulation) ~ $ 5,845,37 (If more space is needed, insert additional sheets of same size.) LAST WILL AND TESTAMENT OF ERMA A. BALDWIN I, ERMA A. BALDWIN, of Lower Frankford Township, (mailing address: R.D. $$9, Box 360, Carlisle, Pennsylvania 17013), Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills by me at anytime heretofore made. 1. I direct my hereinafter named Executors ~o pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. 2. All of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give,.devise and bequeath to my husband, Fred L. Baldwin, Sr., his heirs and assigns, to the exclusion of my children, bom and unborn, provided my said husband, Fred L. Baldwin, Sr., shall survive me by a period of ninety (90) days. 3. Should my said husband, Fred L. Baldwin, Sr., predecease me or fail to survive me by the aforesaid period of ninety (90) days, then in such event, all of the rest, residue and remainder of the my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal shares to such of my three children as shall survive me by a period of ninety (90) days, their heirs and assigns, but should any of them fail to so survive me, then the share such deceased child of mine would have received shall pass to such of his or her issue as shall survive me by a period of ninety (90) days, per stirpes. My three children are Kenneth E. Baldwin, Fred L. Baldwin, Jr., and Brenda Lee Myers. 4. I hereby nominate, constitute and appoint my said three children, Kenneth E. Baldwin, Fred L. Baldwin, Jr., and Brenda Lee Myers, or any of them, as Executors of this my Last Will and Testament, and I further direct that none of them shall be required to post any bond to secure the faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHE. REOF, I have hereunto set my hand and seal to this my Last Will and Testament, written on one (1) page, this 1st day of March ,1989. ~v4~,~:~ 0~. ~o,~4~/~,_ (SEAL) Emro A. Baldwin Signed, sealed, published and dec ~1~-~ by Erma A. Baldwin, the Testatrix above-named, as and for her Last Will and Testament,'in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting wimesses. OBRIEN BARIC & SCHERER DAVID A BARIC ESQUIRE 17 WEST SOUTH STREET CARLISLE PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG. PA 17105-8486 February 11, 2003 Re: ERMA BALDWIN CIS #: 210159444 SSN: 173-50-2639 Date of Death: 01/22/2003 Dear Attorney Baric: Please be advised that the Department of Public Welfare maintains a claim in the amount of $5,845.37 against the above-mentioned estate. This claim is for restitution of medical assistance granted on behalf of the decedent for which the Probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's itemized statement of claim. A portion of this medical expense, namely $5,845.37, was incurred during the last six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $.00, is to be entered as a priority Class 6 claim against the estate. Please acknowledge receipt of this letter and advise whether the Commonwealth's claim is admitted and when payment may be expected. If the estate accounting is complete, please provide a copy. If the estate contains real estate, please provide copies of the deed, the latest tax assessment, and a current appraisal, if available. Sincerely, Elaine Wiest TPL Program Investigator 717-772-6246 717-772-6553 FAX Enclosure · UREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 DAVID A BARIC ESQ OBRIEN ETAL 17 W SOUTH ST CARLISLE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX Rec.~,c.~.,.. ~?':>-~ ef DATE 05-12-2005 Re~i':~ ~: Qi 'L~;:,S ESTATE OF BALDWIN DATE OF DEATH 01-22-2005 FILE .U.BER 21 05-0286 '03 MAY 16 ~10:47 COUNTY CUMBERLAND ACN 101 Amount Remitted ERMA A MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BALDWIN ERMA A FILE NO. 21 05-0286 ACN 101 DATE 05-12-2005 TAX RETURN WAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN I Real Estate CSchedule A) 2 Stocks and Bonds (Schedule B) $ Closely Held Stock/Partnership Interest CSchedu/e C) Mortgages/Notes Receivable CSchedule D) 5 Cash/Bank Deposits/Misc. Personal Property CSchedule E) Jointly Owned Property CSchedule F) 7 Transfers CSchedule G) 8 Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9 Funeral Expenses/Adm. Costs/M/sc. Expenses CSchedule H) 10 Debts/Mortgage Liabilities/Liens CSchedule I) 11 Total Deductions 12 Net Value of Tax Return C2) CS) CB) C7) 00 2r810.96 O0 O0 O0 NOTE: To insure proper O0 credit to your account, O0 submit the upper portion of this form w/th your tax payment. C9} 980.00 C10) 2,810.96 13 NOTE: ASSESSMENT OF TAX: 15. Amount of Line lq at Spousal rate C15) 16. Amount of L/ne 14 taxable at Lineal/Class A rate C16) 17. Amount of L/ne lq at Sibling rate (17} 18. Amount of L/ne iq taxable at Collateral/Class B rate C18) 19. Pr/nc/pal Tax Due TAX CREDITS 5,845.57 (11) ¢12) 4,014.41- Charitable/Governmental Bequests; Non-elected 9115 Trusts CSchedule J) C15) .00 Net Value of Estate Sub3ect to Tax C14) 4,014.41- If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 w/Il .00 .00 .00 .00 .00 reflect figures that include the total of ALL returns assessed to date. · O0 x O0 = · O0 x 045: · O0 x 12 = · O0 x 15 = C19): PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 C IF TOTAL DUE IS LESS THAN 91, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION= PURPOSE OF NOTICE; PAYMENT: REFUND CCR): OBJECTIONS: ADMIN- IST~TIVE CORRECTIONS; DISCOUNT: PENALTY; INTEREST= 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 Ccollateral) 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 B (collateral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Mills printed on the reverse side. --Make check or money order payable to= REGISTER OF NILLS, Ab"ENT A refund of a tax credit, which was not requested off the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at the Office of the Register of Mills, an~ of the 25 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering; 1-800-562-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-5020 CTT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax Cincluding discount or interest) as shown on this Notice must object within sixty (&O) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, 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. 280&01, Harrisburg, PA 17128-060] Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" CREV-ISO1) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the decedent's death, a five percent CSX) discount of the tax paid is allo~ed. The 15~ tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before Januar~ 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 is charged beginning with first day of delinquencY, or nine (9) months and one C1) day from the date of death, to the date of payment. Taxes which became delinquent before JanuamJ I, 1982 bear interest at the rate of six (&Y.) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after JanuamJ 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 2005 are= Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20X .000548 1987 9~ .000247 1999 7~ .000192 1985 16~ .000458 1988-1991 11~ .000501 2000 8~ .000219 1984 11~ .000501 1992 9~ .000247 2001 9~ .000247 1985 ISX .000556 1995-1994 7X .000192 2002 6X .000164 1986 I0~ .000274 1995-1998 9~ .000247 2005 5X .000157 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTI~EST 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. ~EV~1470 EX (6-88)  INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 FILE NUMBER DECEDENTS NAME ERMA A BALDWIN 2103-0286 ACN REVIEWED BY John Kealy 101 ITEM EXPLANATION OF CHANGES SCHEDULE NO. The value of the estate has been adjusted as the result of the correction of an error in arithmetic. Row Page 1 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. ESTATE OF ERMA A. BALDWIN PETITION UNDER SECTION 3102 OF THE PROBATE, ESTATES AND FIDUCIARIES CODE FOR THE SETTLEMENT OF A SMALL ESTATE TO THE HONORABLE JUDGES OF SAID COURT: 1. Your Petitioner, Fred L. Baldwin, Jr., 116 Alters Road, Carlisle, Pennsylvania, 17013, is an adult individual and one of three (3) surviving children of Erma A. Baldwin, deceased on January 22, 2003, S.S. # 173-50-2639. 2. The Decedent, Erma A. Baldwin, was born on November 2, 1919 and was eighty- three (83) years of age at the time of her death. Her residence was Thornwald Home, 24 Doe Drive, Carlisle, Pennsylvania 17013. She was a single woman at the time of her death. 3. Her sole heirs as set forth in her last will and testament, a true and correct copy of which is attached hereto and incorporated as Exhibit "A", are her three children, all of whom have signed a consent to the relief requested in this Petition. They are identified as follows: A. Kenneth E. Baldwin B. Fred L. Baldwin, Jr. C. Brenda Lee Myers 4. Kenneth E. Baldwin, Fred L. Baldwin, Jr. and Brenda Lee Myers were nominated in Decedent's last will and testament as executors, together or separately. 5. Decedent had no interest in real property at the time of her death. 6. The Decedent's sole assets are as follows: A. M & T Bank checking account # 401420 with a balance of $2,710.96. B. Miscellaneous personalty with a value of approximately $100.00. 7. Decedent had been receiving medical assistance from the Department of Public Welfare in connection with her residing at a skilled nursing facility prior to her death. 8. It is requested that the assets of the Decedent be turned over to the Petitioner to pay the administration expenses and medical assistance. 9. The Petitioner has filed a Pennsylvania Inheritance Tax Return and has received acceptance of the return. A copy of the response from the Department Of Revenue is attached hereto Exhibit "B." WHEREFORE, Your Petitioner prays that an Order be made authorizing distribution of the accounts as set forth in the foregoing to Petitioner for him to apply against the expenses of administration and debts. O'BRIEN, BARIC AND SCHER~R David A. Baric, Esquire ID# 44853 17 West South Street Carlisle, PA 17103 (717) 249-6873 Attorney for Petitioner dab.dir/estates/baldwin/estate.pet VERIFICATION I verify that the statements made in the foregoing Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to authorities. Fred L. Baldwin, Jr. Date: CONSENT The undersigned acknowledge, pursuant to the penalties of 18 Pa.C.S.A. Section 4904 relating to unswom falsification to authorities, that they are the sole heirs of Erma A. Baldwin; that they are adults; that the statements made in the Petition filed by Fred L. Baldwin, Jr. are true and correct to the best of their knowledge, information and belief; that they concur and consent to the proposed distribution to Erma A. Baldwin. WITNESS: DATE DATE Kenneth E. Baldwin · ' Brenda Le; MY~i~ LAST WILL AND TESTAMENT OF ERMA A. BALDWIN I, ERMA A. BALDV~'IN, of Lower Frankford Township, (mailing address: R.D. #9, Box 360, Carlisle, Pennsylvania 17013), Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills by me at anytime heretofore made. 1. I direct my hereinafter named Executors io pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. 2. All of thc rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath to my husband, Fred L. Baldwin, Sr., his heirs and assigns, to the exclusion of my children, born and unborn, provided my said husband, Fred L. Baldwin, Sr., shall survive mc by a period of ninety (90) days. 3. Should my said husband, Fred L. Baldwin, Sr., predecease mc or fail to survive mc by thc aforesaid period of ninety (90) days, then in such event, all of the rest, residue and remainder of the my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal shares to such of my three children as shall survive me by a period of ninety (90) days, their heirs and assigns, but should any of them fail to so survive me, then the sham such deceased child of mine would have received shall pass to such of his or her issue as shall survive me by a period of ninety (90) days, per stirpes. My three children am Kenneth E. Baldwin, Fred L. Baldwin, Jr., and Brenda Lec Myers. 4. I hereby nominate, constitute and appoint my said three children, Kenneth E. Baldwin, Fred L. Baldwin, Jr., and Brenda Lee Myers, or any of them, as Executors of this my Last Will and Testament, and I further direct that none of them shall be required to post any bond to secure the faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, written on one (1) page, this 1st day of March 1989. ~'.~.,.a:a~'6L ~)..~..~_ (SEAL) Erma A. Baldwin Signed, sealed, published and dec.?l~red by Erma A. Baldwin, the Testawix above-named, as and for her Last Will and Testament, m our presence, who, in her presence, at her request, and in thc presence of each other, have hereunto subscribed our names as attesting wimesses. EXHIBIT "A" BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280~01 HARRISBURG, PA 17125-0~01 DAVID A BARIC ESQ OBRIEN ETAL 17 W SOUTH ST CARLISLE COMMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE PA 17015 NOTICE OF INHERITANCE TAX APPRAISEMENT, ~LLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 05-12-2005 ESTATE OF BALDWIN ERMA A DATE OF DEATH 01-22-2005 FILE NUMBER 21 05-0286 COUNTY CUHBERLAND ACN 101 I Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~'- RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BALDWIN ERMA A FILE NO. 21 05-0286 ACN 101 DATE 05-12-2005 TAX RETURN WAS: ( } ACCEPTED AS FILED (X} CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A} (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. 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/N/sc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) Il. Total Deductions 12. Net Value of Tax Return 2r810.96 .00 .00 NOTE: To insure proper .00 credit to your account, .00 submit the upper portion · OD of this form with your tax payment. .00 (8} 980.00 13. 14. NOTE: 2,810.96 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. EXHIBIT "B" ASSESSMENT OF TAX: 15. Amount of L/ne 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate C16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line l~ taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) · O0 x O0 = . O0 · 00 x 045: .00 · O0 x 12 = . O0 · O0 x 15 : . O0 (19)= .00 AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE C IF TOTAL DUE IS LESS THAN 41, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Char/table/Governmental Bequests; Non-elected 9115 Trusts CSchedule J) C15) .00 Net Value of Estate Subject to Tax C14) ~,01~.~l- If an assessment was lssued previousIy, Iines I4, I5 and/or I6, Il, I8 and Ig wiiI .00 .00 .00 .00 reflect figures that include the total of ALL returns assessed to date. 5~845.57 c[2) 4,014.41-  INHERITANCE TAX 'COMMOI~VEALTH OF PENNSYLVANIA EXPLANATION DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDEN~'S NAME FILE NUMBER ERMA A BALDWIN 2103-0286 REVIEWED BY ACN John Kealy 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The value of the estate has been adjusted as the result of the correction of an error in arithmetic. ORIGINAL Page 1 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 2 00 - ESTATE OF ERMA A. BALDWIN AND NOW, this DECREE ~_~day of ~ ,2003, upon consideration of the attached Petition, the Court authorizes Fred L. Baldwin, Jr. to have distribution of the personalty of the estate, and directs any commercial bank to negotiate any checks payable to Erma A. Baldwin and to close any account and distribute the balance to Fred L. Baldwin, Jr. upon his signature in accordance with the Last Will and Testament attached to the Petition. BY THE COURT,