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03-1012
PETITION FOR PROBATE and GRANT OF LETTERS Estate of Lois,. Reber No. ~/-~ "/_/~ / ~ also known as To: Deceased. Social Security No. 180-26-7377 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/~tFe 18 years of age or ~t,er ~}[3(~e execut rix in the last will of the above decedent, dated may and codicil(s) dated Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the named .,~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 824 Lisburn Rd., Lower Allen Township~ Cumberland County, PA (list street, number and muncipality) Decendent, then 77 years of age, died November 20, 2003 ~cl~ , 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 adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: 100,000.00 WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. Lisa R. Noll 1700 Kent Road Camp Hill, PA 17011 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affi.rmed and subscribed before me this ~ day of Lish R. Noll Estate Of LOIS M. REBER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~XJ~~e-r ~ )k~ 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 May 19, 2003 described therein be admitted to probate and filed of record as the last will of Lo±s M. Reber and Letters Testamentary are hereby granted to Lisa R. Noll FEES obate, Letters, Etc .......... $ Sho~ ~?~rtificates( ) .......... $ ?..~ Renunciation ................ $ ~ S TOTAL __ File~~.~.~...g,...~..~'...~. .... ATTORNEY (Sup. Ct. I.D. No.) 414 Br±dge St., New Cumberland, PA 17070 ADDRESS (717) 774-7435 PHONE REGISTER OF WILLS OF C~BE~AND COUNTY OATH OF SUBSCRIBING WITNESS David H. Stone Bis) a subscribing witness to the will presented herewith, (~P.q¥) being duly qualified according to law, depose(s) and say(s) that he was present and saw Lois M. Rebec the testat r__~x , sign thc same and that he signed as a witness at the request of testat rix in h er presence and (~:tq~,x~tces~5F~~) (in the presence of the other subscribing witness(es)). ~~.~... Sworn to or affirmed and subscribed before DA~-~ ,3~-~ame) me this _ ~7-,~,/ day of ~c~Ae¢ ~~ 414 Brid~e St., New Cumberland, PA 17070 (Name) (,4ddre~) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS testat that (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that familiar with the signature of codicil of (one of the subscribing witnesses to) the will presented herewith and believes the signature on the will is in the handwriting of to the best of knowledge and belief. Sworn to or affirmed and subscribed before me this day of 19 Register (Name) (Addrers) (Name) (Address) REGISTER OF WILLS OF - C~B~,RL~D COUNTY OATH OF SUBSCRIBING WITNESS Kaye R. Luckey (eatdv) a subscribing witness to the will presented herewith, :(eac~ being duly qualified according to law, depose(s) and say(s) that she was Lois M. Reber present and saw the testat~rix . sign the same and that she signed as a witness at the request of testat rix in h er presence and ~#:t/la:1~~~ (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before -~xthis ~, ~%~ day of Register NOTAFllAL SEAL C~0L L. T~0×ELL, Nota~/Publk New Cum~and Boro. ~ C~mi~lon 414 Bridge St., New Cumberland, PA 17070 (Adch'ess) (Name/ bqddress/ REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS testat_ that (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that familiar with the signature of codicil of (one of the subscribing witnesses to) the will presented herewith and believes thc signature on the will is in the handwriting of to the best of knowledge and belief. Sworn to or affirmed and subscribed before me this day of 19 Register (Name) (Address/ (Name/ (Address/ his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9650824 No. Loc Registrar Date ~'AME OF OECEDENT tF~r~l. M;Odle. COMMONWEALTH OF PENNSYLVANIA ° DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH v~ I t February 17. i..,~ [] emo~o~,.m [] ~ 77 : t , 1926 ,Chambersburg. PA ~[] I.~.. [] Cumberland 'm Upper Allen ~p ~ ~k,x ' ~ KX 'XX ~ --~...--,~o~. ~_~ I I US ~MEO¢O~ESl s~~a~e~-m~, I ;~.lL'2~222L~.:~a'~~ I ~lV~S~ ... Clerk Typist I,,,.State Governmmnt I', I', 12(°"~) ] ( .... s. I widowed ~CE~NT'~ M~I~ A~ESS (~. C~. ~. Z~ ~ ~CEOENT'S ' ' / 114. cu ...s,.,..Pennsylvania ~ ,~,.~ v,.~ Lower Allen 824 Lisburn Road .~s,~ ~., ,, Camp Hill. PA 17011 ~"~'~ ,m.c~ Cumberland '~ ,,,.~ . ,,. Miles Umbrell ~,,. Olive Glenn INFORMANT'S NAME 0'ypWP~l) ~. Lisa R, Nell rNFO~;J~A'%~T'SMAIUNGADORE~(SI~e~'C~I~/'F~wn'Slale'Z'kOc°de) ~. 1700 Kent Road~ Camp Hill~ PA 17011 ~[,,,November 21 2003 ],,.. Yorkto~e Crematory [,,,. York, PA 17404 -'- ~'-' m ~ __ rarcnemore ~'H ~ ~. inc. ~~-~ ,, ~ ~,~ () : I ~cA~ ~ I c, I I j~*~__ I ~<~ac~oueNce~. j I - I I~ B "~'~ ..... *,~ ~lhebllilOflxamlnlUonan~ot nvlst gl on ~myopiniofl dellhoccurredll bellini date n t,, PA~T Il: ~l~hM ~lnlllf:~ ~ ki Wh. bu~ n(x re~umn~ mi i.~den./~ CMM ~lw~ in F~T i. iNJURY AT WORK? ep\wills\REBERlois LAST WILL AND TESTAMENT OF LOIS M. REBER I, LOIS M. REBER, of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I direct that my Executrix hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease from the residue of my estate. ITEM II: I bequeath such of my tangible personal property which is set forth in a separate unsigned memorandum which I shall place with this will to the persons therein designated. The aforesaid memorandum may be prepared before or after this will and may be changed from time to time in the future. My personal representative should follow the directions contained in the last such memorandum prepared before my death. ITEM III: I devise and bequeath all the rest, residue and remainder of my estate, of every nature and wherever situate, as follows: A. One-half thereof to my daughter, LISA R. NOLL. B. Two-sixths thereof to my son, MICHAEL M. REBER. Page 1 of 4 C. One-sixth thereof to my granddaughter, KATIE REBER. ITEM IV: Should any person entitled to a share of my estate not have attained the age of twenty-one (21) years at the time for distri- bution to him or her, I devise and bequeath this share of each such person to my trustee hereinafter named, IN SEPARATE TRUST, to hold, manage, invest and reinvest the share so received, and the accumula- tion of income thereon, and to use and apply the income or principal, or so much thereof as, in trustee's discretion, may be necessary or appropriate for the beneficiary's support and education, (including college education, trade school and graduate school) without regard to his or her parent's ability to provide for such support or education, or to make payment for these purposes, without further responsibility, to such beneficiary or to such beneficiary's parents or to any person taking care of such beneficiary. Any principal or income not so applied shall be distributed to such beneficiary absolutely when he or she attains the age of twenty-one (21) years. If the said beneficiary dies before attaining the age of twenty-one (21), the trust shall terminate and such share shall be distributed to his or her issue, per stirpes, and in default thereof shall be distributed to my issue, per stirpes. ITEM V: I appoint my daughter, LISA R. NOLL, Trustee of any trust created under this my Last Will and Testament. Page 2 of 4 ITEM VII: my last will. ITEM VIII: ITEM VI: I appoint my Executrix and her successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this ap- pointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. I appoint my daughter, LISA R. NOLL, Executrix of this No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of her duties in any jurisdiction. IN WITNESS WHEREOF, I, LOIS M. REBER, have hereunto set my hand and seal this I~ day of ~~ , 2003. LOIS M. REBER Page 3 of 4 SIGNED, SEALED, PUBLISHED and DECLARED by LOIS M. REBER, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses. A~dress - Page 4 of 4 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Lois Reber Date of Death: November 20, 2003 Will No. 21-03-1012 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 January 9, 2004. Lisa R. Noll 1700 Kent Road Camp Hill, PA 17011 Michael M. Reber 521 North 3rd Street Wormleysburg PA 17043 Katie Reber 118 31st Street Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a). David'Ni'"Stone, Esquire 414 Bridge Street New Cumberland, PA 17070 717-774-7435 Capacity: X Personal Representative Counsel for Personal Representative 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 003587 STONE DAVID HEAN 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 ........ fold ESTATE INFORMATION: SSN: 180-26-7377 FILE NUMBER: 2103- 1012 DECEDENT NAME: REBER LOIS DATE OF PAYMENT: 02/20/2004 POSTMARK DATE: 02/1 9/2004 ~COUNTY: CUMBERLAND DATE OF DEATH: 1 1/20/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3,250.00 TOTAL AMOUNT PAID: $3,250.00 !REMARKS: :- SEAL RECEIVED OF LISA R NOLL IN C/O DAVID H STONE, ESQ. CHECK# 99 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS DAVID H. STONE GERALD J. SHEKLETSKI ELIZABETH B. STONE STONE LAFAVER & SHEKLETSKI ATTORNEYS AT LAW 414 BRIDGE STREET POST OFFICE BOX E NEW CUI~IBERLAND. PA 17070 www. stonelaw, net August 19, 2004 OF COUNSEL CHARLES H. STONE JON F, LAFAVER TELEPHONE (717) 774-7435 FACSIMILE (717) 774-3869 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 RE: Estate of Lois Reber No. 21-03-1012 Greetings: Enclosed please find an original and one copy of the Inheritance Tax Return and Inventory for the above mentioned estate. Please clock in the copy of the Inventory and send it back to my office along with any receipts in the enclosed stamp addressed envelope. Also, enclosed is check #1888 in the amount of $223.00 for payment of the inheritance tax and check #1889 in the amount of $25.00 for filing the return and inventory. Please note the timely postmark of this correspondence. Very truly yours, STO~qE LaFAVER & SHEKLETSKI David H. Stone DHS/tmb Enclosures 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. CD REV-1162 EX(11-96) 004294 NOLL LISA R 1700 KENT ROAD CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 180-26-7377 FILE NUMBER: 2103- 1012 DECEDENT NAME: REBER LOIS DATE OF PAYMENT: 08/20/2004 POSTMARK DATE: 08/1 9/2004 COUNTY: CUMBERLAND DATE OF DEATH: 1 1/20/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 9223.00 REMARKS: TOTAL AMOUNT PAID: CK FROM MICHAEL NOLL 9223.00 SEAL CHECK# 1888 INITIALS: GFS RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 COUNTY CODE -- 03 1012 YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ Reber Lois Z 180-26-7377 ILl DATE OF DEATH (MM-DO-YEAR) DATE OF BIRTH (MM-DO-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE LU 11/20/2003 2/17/1926 REGISTER OF WILLS UJ (IF APPLICABLE) SURVIVING SPOUSES NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER LU = OO I.- Z 0 a. 0 z ~ 1. Original Return ~'-] 4. Limited Estate ~--~6. Decedent Died Testate (Attach copy of Will) --]9. Litigation Proceeds Received J~2. Supplemental Return E~4a. Future Interest Compromise (date of death after 12-12-82} [-~7. Decedent Maintained a Living Trust (Attach copy of Trust) J--~ 3. Remainder Return (date of death pdor to 12-13-82) ~'~5. Federal Estate Tax Return Required -- 8. Total Number of Safe Deposit Boxes J-"--'] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) J'~ 1 1. Election to tax under Sec. 9113(A) (Attach Sch O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS David H. Stone, Esquire 414 Bridge Street FIRM NAME (If Applicable) Stone LaFaver & Shekletski New Cumberland, PA 17070 TELEPHONE NUMBER 717-774-7435 (8) USE ONLY __."= ~.~ 0 93,401 0 0 0 0 750 10,654 81,997 (11) 12,428 80,973 0 (12) (13) (14) 80,973 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 Properly (Schedule E) (5) 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) 1. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 0 x.0 0 (15) 80,973 x .0 45 (16) 0 x .12 (17) 0 x .15 (18) (19) 0 3,644 0 0 3,644 Z I- I- O X < I- 1 5. 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 1 8. Amount of Line 14 taxable at collateral rate. 9. Tax Due 20. 10,141 2,287 · · BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 3W4645 1~000 Dec'dent's Complete Address: S~E~ ADDRESS 824 Lisburn Rd. Cumberland County CI~ STAT ZIP Camp Hill PA 17011- 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 0 3,250 171 0 0 (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) 3,644 3~421 0 0 223 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5^. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (5B) 223 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; ....................... E~ [~ b. retain the right to designate who shall use the property transferred or its income; ......... [-~ [~ c. retain a reversionary interest; or ................................ E~ [~ d. receive the promise for life of either payments, benefits or care? ................. E~ E~ 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, SIGNATUI~E OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS 1700 Ken~ ~. ~ ~ Camp Hill, PA 17011 SIG~R, ~'~,OTHER ~. 414 Bridge Street DATE New Cumberland, PA 17070 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.§ 9916 (a) (1.1)(0]. 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 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 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. 3W4646 1.000 REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Lois Reber 1012 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 DESCRIPTION IRS-refund on decedent's 2003 federal income tax return Members 1st-Rebate Miscellaneous deposit VALUE AT DATE OF DEATH 619 4 127 750 TOTAL (Also enter on line 5, Recapitulation) 3W46AD 1.000 (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Lois Re~er 1012 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Noll, Lisa R Camp Hill, PA 1700 Kent Rd., 17011 Daughter JOINTLY-OWNED PROPERTY: L~Tr~R DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINTMADE INCLUDE NAME OF FINANCIAL iNSTiTUTiON AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT NLMBER OR S~MILAR IDENTIFYING NUMBER. A~rACH DEED FOR JOIN~_Y-I-ELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. I A 3/3/1991 Members 1st Federal Credit Union-Checking Acct. #2820.11 made joint w/Lisa R. Noll, Princ. $21,380.22, Int. $1.82 21,282 50.000 10,641 2 A 3/3/1991 Members 1st Federal Credit Union-Savings Acct. #2820-00 joint w/Lisa R. Noll 25 52.000 13 TOTAL (Also enter on line 6, Recapitulation) $ 10,654 3W46AE 1.000 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Lois ;Reber 1012 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM I~ ~ NAME OF ~ TRANSFEREE, ~EIR RE~T)O~HIP TO DECEOE~ ~D DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER ~ ~ OF ~. AWACHA ~ OF T~ DEED FOR R~L ESTATE. VALUE OF ASSET IN.REST (IF ~PLICABLE) VALUE 1. American Funds-CB&T Cust. IRA Acct. #64710303, 119.526 shs. SmallCap World Fund Cl A @ $25.21 per share-bene, is Lisa R. Reber Noll and Michael M. Reber 3,013 100.000 0 3,013 2 1,296.52 Shares American Funds-l,296.52 shs. The Cash Management Trust of America A @ $1.00 per sh. TOD to Lisa R. Reber Noll 50% and Michael M. Reber 50% 1,297 100.000 0 1,297 3 1,384.908 Shares American Funds-l,384.908 shs. The Income Fund of America Cl A @ $16.13 per share TOD to Lisa R. Reber Noll 50% and Michael M. Reber 50% 22,339 100.000 0 22,339 4 1,543.475 Shares American Funds-l,543.4750 shs. of The Bond Fund of America Cl A @ $13.41 per share TOD to Lisa R. Reber Noll 50% and Michael M. Reber 50% 20,698 100.000 0 20,698 5 566.605 Shares American Funds-566.6050 shs. The Investment Company of America Cl A @ $27.06 per sh. TOD to Lisa R. Reber Noll 50% and Michael M. Reber 50% 15,332 100.000 0 15,332 6 723.101 Shares American Funds-723.101 shs. New Perspective Fund Cl A @ $22.65 per sh. TOD to Lisa R. Reber Noll 50% and Michael M. Reber 50% 16,378 =100.000 0 16,378 Total from continuation pages 2,940 TOTAL(AIsoenteronline7, Recapitulation) $ 81,997 (If more space is needed, insert additional sheets of the same size) 3W46AF 1 ~000 Schedule G (Page 2) Estate of: Lois Reber Item No. Description DOD Value of Asset Exclusion TaxabJ Val American Funds-CB&T Cust. IRA Acct. #64710303, 167.929 shs. The New Economy Fund C1 A @ $17.51 per sh.-bene, is Lisa R. Reber Noll and Michael M. Reber 2,940 100.000 2,940 Total ~Carrv forward to main schedule% 2.940 REV-1511 EX'+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Lois Reber FILE NUMBER 1012 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION 5. 6. 7. FUNERAL EXPENSES: Funeral expenses-items purchased for memorial service, food, and flowers Total from continuation pages ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Checks written by decedent but not cleared by bank until after death Total from continuation pages AMOUNT 510 3,703 4,670 231 533 494 TOTAL (Also enter on line 9, Recapitulation) i $ 10,141 3W46AG 1.000 (II more space is needed, insert additional sheets of the same size) Estate of: Lois Reber Item No. Description Schedule H part i (Page 2) Amount 2 Parthemore Funeral Home funeral expenses Rolling Green Cemetery-Interment fees The Woods-funeral expenses 2,918 485 300 Total (Carry forward to main sch~dul~ 3.703 Schedule H part 2 (Page 3) Estate of: Lois Reber Item No. Description Amount 2 3 Cumberland Law Journal-adv. grant of letters Register of Wills-Filing Inheritance Tax Return and Inventory Reserve for closing expenses The Patriot News Co.-advertising grant of letters Verizon-telephone service 75 25 200 113 81 Total (Carry forward to main schedule% 494 REV-1512 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Lois Reber 1012 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION Messiah Village-services rendered Pharmerica-debt of decedent Pinnacle Health Hospice services rendered Sue Tobias-balance due at The Woods TOTAL (Also enter on line 10, Recapitulation) $ VALUE AT DATE OF DEATH 1,323 206 698 60 2,287 3W46AH 1000 (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Lois Reber 1012 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 [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Lisa R. Noll 1700 Kent Rd. Camp Hill, PA 17011 50% Residue: 40,487 Katie Reber 118 31st St. Camp Hill, PA 17011 25% Residue: 20,243 Daughter Granddaughter 40,487 20,243 20,243 Total from continuation pages ENTERD~LLARAM~NT~F~RD~TR~B~N~H~NAB~VE~NLINE~15THR~GH18~A~APPR~PR~ATE~NRE~15~C~ERsHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0 3W46AI 1.000 (if more space is needed, insert additional sheets of the same size) Schedule J part i (Page 2) Estate of: Lois Reber Item No. Description Relation Amount Michael M. Reber 521 North 3rd St. Wormleysburg, PA 17043 25% Residue: 20,243 Son 20,243 Total tCarrv forward to main sehedul~J 20.243 ATTORNEYS AT LAW 414~TrEET - ~ - NEW GUMBERLAND, PA 17070 LAST WILL AND TESTAMENT OF LOIS }4. REBER I, LOIS M. REBER, of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I direct that my Executrix hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease from the residue of my estate. ITEM II: I bequeath such of my tangible personal property which is set forth in a separate unsigned memorandum which I shall place with this will to the persons therein designated. The aforesaid memorandum may be prepared before or after this will and may be changed from time to time in the future. My personal representative should follow the directions contained in the last such memorandum prepared before my death. ITEM III: I devise and bequeath all the rest, residue and remainder of my estate, of every nature and wherever situate, as follows: A. One-half thereof to my daughter, LISA R. NOLL. B. Two-sixths thereof to my son, MICHAEL M. REBER. Page 1 of 4 C. One-sixth thereof to my granddaughter, KATIE REBER. iTEM IV: Should any person entitled to a share of my estate not have attained the age of twenty-one (21) years at the time for distri- bution to him or her, I devise and bequeath this share of each such person to my trustee hereinafter named IN SEPAi~ATE TRUST, to hold, manage, invest and reinvest the share so received, and the accumula- tion of income thereon, and to use and apply the income or principal, or so much thereof as, in trustee's discretion, may be necessary or appropriate for the beneficiary's support and education, (including college education, trade school and graduate school) without regard to his or her parent's ability to provide for such support or education, or to make payment for these purposes, without further responsibility, to such beneficiary or to such beneficiary's parents or to any person taking care of such beneficiary. Any principal or income not so applied shall be distributed to such beneficiary absolutely when he or she a~t~lns the age of twenty-one (21) years. If the said beneficiary of twenty-one (21) , the t~usl dies before attaining the age be dis=ri'buted~.~ h~ i~i~2i terminate and such share shall · ' .... ' '~ '~. '; --~'~{4~ stirpes, and in default thereof shall be d~stributed tO'~"~! ITEM V: I appoint my daughter, LISA R. NOLL, Trustee of any trust created under this my Last Will and Testament. Page 2 of 4 ITEM VI: I appoint my Executrix and her successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect te which I am authorized te appoint a guardian and have net otherwise specifically done so, provided that this ap- pointment efa guardian shall net supersede the right ef any fiduciary in its discretion to distribute a share where possible te the minor er to another for the minor's benefit. Such guardian shall have the power te use principal as well as income from time te time for the minor's support and education (including college education, beth graduate and undergraduate) without regard to his or her parent's ability te provide for such support and education, or to make payment for these purposes, without further responsibility, to the miner er te the miner's parent or te any person taking care of the minor. I appoint my daughter, LiSA R. NOLL, Executrix ef this ITEM VII: my last will. ITEM VIII: No fiduc!ar=' v acting hereunder shall be required post bond or enter security for the faiYhful performance of her duties in any jurisdiction. IN WITNESS WHEREOF, I, LOIS M. REBER, have hereunto set my hand and seal this 'I~ day of [~{~ , 2003. LOIS M. REBER Page 3 of 4 SIGNED, SEALED, PUBLISHED and DECLARED by LOIS M. REBER, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses. Address A~dress ~ ' Page 4 of 4 st MEMBERS 1st FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established 2820 -00 03/09/1954 $25.00 $.00 $25.00 Lisa R. Noll 03/03/1991 2820 -11 01/22/1991 $21,38O.22 $1.82 $21,382.04 Lisa R. Noll 03/03/1991 IV~EMBERS lSF~EDERAL CREDIT UNION wenise A. Wolfe Insurance Supervisdi- December 29, 2003 Estate of: LOIS M. REBER Date of Death: 11/20/2003 Social Security Number: 180-26-7377 51)fl{} Louise Drive · P.O. Box 4(} · Mcch;micsburg, l~em~svlx,ani:~ 17(155 · (717) 697-1161 · wwxx:memberslst.org Vision - Account Value by Date Page 1 of l My Assets > Shareholder Name Search > Search Results > Account Details Account Value by Date Statements Statements Details Acct Overview Acct Value by Oate Transaction History Maintenance History 2002 Tax Summary 200:3 Tax Summary Rights of Accumulation Account #: 63995623 BIN #: 997881 Tax [D/SSN: 180o26-7377 Registration: LOIS M REBER PA/TOD LISA R REBER 50% MICHAEL M REBER 50% 824 LISBURN RD APT 407 CAMP HILL PA 17011-7100 Phone: H: Not On File B: Not On File Ext. JAMERJ[CI Mgmt Co: AMERICAN FUNDS Fund Name: 09 THE CASH MANAGEMENT TRUST OF AMERICA-A View Fund Details Fund Code: 9 Ticker: CTAXX Total Shares: .0000 CUSIP: 147548101 Account Value: $0.00 Enter a price date to retrieve an account value from a previous day. Price Date: 111/20/2003 I 'Search I Current Price Date: 12/29/2003 Price Date: Current Net Asset Value: $1.0000 Net Asset Value: Current Total Shares: .0000 Total Shares: Current Value: $0.00 Value: 11/20/2003 $1.0000 1,296.5200 $1,296.52 'Top of pag~ Contact Us I Disclaimer Copyright © 2003 DST Systems, Inc. All Rights Reserved. https://www3.financialtrans.com/tf/Vision 12/30/2003 Vision - Account Value by Date Page 1 of 1 1.~:,L~ My Assets > Shareholder Name Search > Search Results > Account Details Account Value by Date Statements Statements Details Acct Ore rview Acct Value by Date Transaction History Maintenance History Cost Basis 2002 Tax Summary 2003 Tax Summary Rights of Accumulation Account #: 63995623 BIN #: 997881 Tax ID/SSN: 180-26-7377 Registration: LOIS M REBER PA/TOD LISA R REBER 50% MICHAEL M REBER 50% 824 LISBURN RD APT 407 CAMP HILL PA 17011-7100 Phone: H: Not On File B: Not On File Ext. JAMER~C/ Mgmt Co: AMERICAN FUNDS Fund Name: 06 THE INCOME FUND OF AMERICA- CLASS A V!ew Fund Details Fund Code: 6 Ticker: AMECX Total Shares: .0000 CUSIP: 453320103 Account Value: $0.00 Enter a price date to retrieve an account value from a previous day. Price Date: 111/20/2003 I' search I Current Price Date: 12/29/2003 Price Date: Current Net Asset Value: $17.1300 Net Asset Value: Current Total Shares: .0000 Total Shares: Current Value: $0.00 Value: 11/20/2003 $16.1300 1,384.9080 $22,338.57 'Top c~f Page Contact Us I Disclaimer Copyright © 2003 DST Systems, Inc. All Rights Reserved. https://www3.financialtrans.com/tf/Vision 12/30/2003 Vision - Account Value by Date Page 1 of 1 My Assets > Shareholder Name Search > Search Results > Account Details Account Value by Date Statements Statements Details Acct Overview Acct Value by Date Transaction History Maintenance History Cost Basis 2002 Tax Summary 200:3 Tax Summary Rights of Accumulation Account #: 63995623 BIN #: 997881 Tax ID/SSN: 180-26-7377 Registration: LOIS M REBER PA/TOD LISA R REBER 50% MICHAEL M REBER 50% 824 LISBURN RD APT 407 CAMP HILL PA 17011-7100 Phone: H: Not On File B: Not On File Ext. JAMERIC/ Mgmt Co: AMERICAN FUNDS Fund Name: 08 THE BOND FUND OF AMERICA-CLASS A View Fund Details Fund Code: 8 Ticker: ABNDX Total Shares: .0000 CUSZP: 097873103 Account Value: $0.00 Enter a price date to retrieve an account value from a previous day. Price Date: 111/20/2003 I 'Search I Current Price Date: 12/29/2003 Price Date: Current Net Asset Value: $13.5000 Net Asset Value: Current Total Shares: .0000 Total Shares: Current Value: $0.00 Value: 11/20/2003 $13.4100 1,543.4750 $20,698.00 Contact Us I D~sciaimer Copyright © 2003 DST Systems, Inc. All Rights Reserved. https ://www3 .financialtrans.com/t f/Vision 12/30/2003 Vision - Account Value by Date Page 1 of 1 ~i~.~,~,:~,~;~; My Asse~s > Shareholder Name Search > Search Results > Account Details Account Value by Date Statements Statements Details Acct Overview Acct Value by Date Transaction History Maintenance History Cost Basis 2002 Tax Summary 2003 Tax Summary Rights of Accumulation Account #: 63995623 BIN #: 997881 Tax TD/SSN: 180-26-7377 Registration: LOIS M REBER PA/TOD LISA R REBER 50% MICHAEL M REBER 50% 824 LISBURN RD APT 407 CAMP HILL PA 17011-7100 Phone: H: Not On File B: Not On File Ext. JAMERZCl Mgmt Co: AMERICAN FUNDS Fund Name: 04 THE INVESTMENT COMPANY OF AMERICA-CLASS A View Fund Details Fund Code: 4 Ticker: AIVSX Total Shares: .0000 CUSIP: 461308108 Account Value: $0.00 Enter a price date to retrieve an account value from a previous day. Price Date: 111/20/2003 I "" Search J Current Price Date: 1212912003 Price Date: Current Net Asset Value: $28.7900 Net Asset Value: Current Total Shares: .0000 Total Shares: Current Value: $0.00 Value: 11/20/2003 $27.0600 566.6050 $15,332.33 Contact Us I Disclaimer Copyright © 2003 DST Systems, Inc. All Rights Reserved. https ://www3 .financialtrans.corn/t f/Vision 12/30/2003 Vision - Account Value by Date Page 1 of 1 ~.~;;;.~.~g;,.,_~.~: IViy Assets > Shareholder Name Search > Search Results > Account Details Account Value by Date Statements Statements Details Acct Overview Acct Value by Date Transaction History Maintenance History Cost Basis 2002 Tax Summary 2003 Tax Summary Rights of Accumulation Account #: 63995623 BIN #: 997881 Tax ID/SSN: 180-26-7377 Registration: LOIS M REBER PA/TOD LISA R REBER 50% MICHAEL M REBER 50% 824 LISBURN RD APT 407 CAMP HILL PA 17011-7100 Phone: H: Not On File B: Not On File Ext. JAMERICl Mgmt Co: AMERICAN FUNDS Fund Name: 07 NEW PERSPECTIVE FUND~;LASS A View Fund Details Fund Code: 7 Ticker: ANWPX Total Shares: .0000 CUSIP: 648018109 Account Value: $0.00 Enter a price date to retrieve an account value from a previous day. Price Date: I11/20/2003 I 'Search I Current Price Date: 12/29/2003 Price Date: Current Net Asset Value: $24.4500 Net Asset Value: Current Total Shares: .0000 Total Shares: Current Value: $0.00 Value: 11/20/2003 $22.6500 723.1010 $16,378.24 Con~_ac~ L~s I Disc~aipner Copyright © 2003 DST Systems, Inc. All Rights Reserved. https://www3.financialtrans.com/tf/Vision 12/30/2003 ~y Date Page 1 of 1 ~ ~eholder Name Search > Search Results > Account Details ~y Date ---.unt #: 64710303 #: 1120914 ID/SSN: 180-26-7377 istration: CB&T CUST IRA LOIS M REBER/DEC'D 824 LISBURN RD APT 407 CAMP HILL PA 17011-7100 ~le: H: Not On File B: Not On File Ext. AHERICl Ngmt Co: AMERICAN FUNDS Fund Name: 14 THE NEW ECONOMY FUND-CLASS A View Fund Details Fund Code: 14 Ticker: ANEFX Total Shares: .0000 CMS[P: 643822109 Account Value: $0.00 a price date to retrieve an account value from a previous day. Date: 111/20/2003 [.Sea-ch J ~='nt Price Date: 12/29/2003 Price Date: ~nt Net Asset Value: $18.6800 Net Asset Value: ~nt Total Shares: .0000 Total Shares: Bent Value: $0.00 Value: 11/20/2003 $17.5100 167.9290 $2,940.44 Copyright © 2003 DST Systems, Inc. All Rights Reserved. ~tns.com/t f/Vision 12/30/2003 Search > Search P,c~su t~ > Account Details Account Value by Date Statements Details Acct Value by Date 'r~'ansact~on N~$tory i'4ah~tenance H~story Accumulation Account #: 64710303 BIN #: 1120914 Tax ID/SSN: 180-26-7377 Registration: CB&T CUST IRA LOIS M REBER/DEC'D 824 LISBURN RD APT 407 CAMP HILL PA 17011-7100 Phone: H: Not On File B: Not On File Ext. Mgmt Co: AMERICAN FUNDS ~ AMERZC~ Fund Name: 14 THE NEW ECONOMY FUND-CLASS A Vie,/,, Fund Details Fund Code: 14 Ticker: ANEFX Total Shares: .0000 CUSZP: 643822109 Account Value: $0.00 Enter a price date to retrieve an account value from a previous day. Price Date:,i11/20/2003 [ ,Search } Current Price Date: 12/29/2003 Price Date: Current Net Asset Value: $18.6800 Net Asset Value: Current Total Shares: .0000 Total Shares: Current Value: $0.00 Value: 11/20~003 $17.5100 167.9290 $2,940.44 Contac~ Us I D~¢c~aimo'¢ Copyright © 2003 DST Systems, Inc. All Rights Reserved. https://www3.financialtrans.corn/fi/Vision 12/30/2003 V151L)II - ZALJUUUIIt V a,*lUU Dy IJi:lt~ · c~3~, · u~ · ',!',/,-.,,ss~ts > Sharehcfider f'~arne Search > Sea'ri-~ !~es:_di:s > Account Details Account Value by Date Statements State~e~ts Details Acct Value by Date 2002 ~ax ~u~marV Account #: 64710303 BIN #: 1120914 Tax ID/SSN: 180-26-7377 Registration: CB&T CUST IRA LOIS M REBER/DEC'D 824 LISBURN RD APT 407 CAMP HILL PA 17011-7100 Phone: H: Not On File B: Not On File Ext. YAMERICI Mgmt Co: AMERICAN FUNDS Fund Name: 35 SMALLCAP WORLD FUND-CLASS A ',/iew F~m~ Detaiis Fund Code: 35 Ticker: SMCWX Total Shares: .0000 CUSIP: 831681101 Account Value: $0.00 Enter a price date to retrieve an account value from a previous day. Price Date: i11/20/2003 [ ,Search } Current Price Date: 12/29/2003 Price Date: Current Net Asset Value: $26.7300 Net Asset Value: Current Total Shares: .0000 Total Shares: Current Value: $0.00 Value: r,2p O~ p~(Je 11/20/2003 $25.2100 119.5260 $3,013.25 Contac~ iJ$ I oisdai~,~r Copyright © 2003 DST Systems, Inc. All Rights Reserved. https://www3.financialtrans.com/tf/Vision 12/30/2003 COMMONWEAL?N C~ ?EHNSYLVAN~A COUHT¥ O~ ~' ...... ~' ~ SS: Lisa R. Noll bein: July _swo:r~3 according +o law, ~e~oses and says fha+she ~_~ of +he Es+a+e of Lois Reber la+e o[ - Upper Allen Twp. ~ Cumber;an~ Coun+y. Pa., deceased and fha+ fh e ~i+hin ;s an ~nven~ory made by L~ R .... ~ .... +he said Executrix s~ f~ enf~e es+ale ~ said deceden+, cons~sfin9 o~ all ~he personal property an~ real esfa+e, excepf real e~+afe outside ~he Ocmmonweaffh s' ?ennsy~vania, and fha~ fhe ~gures op~osiie each ;~em c~ fhe Invenfory repre~enf if's ~a;r value as of the dale of :Jece~enf's deafh. and :ubscribed before me, 19 Lisa R. Noll,E=e:~ rix 1700 Kent E~. ~0b ~,~'~ Camp Hill, PA 17011 A~dr~ ~,afe of L~eatn _._ 20 11 2003 Day ~onfh Year .An invenfory musf be flied wifhin fhree monfhs offer appoinfmen+ of personal represenfafive. 2. A. :uppiemenf :nvenfary musf be filed wifhln fhirfy days of discovery of addifianal assefs. 2. Addifional ~h~¢ may be ~' ' ' · _ .... , a,~acnecl as fo personally or real~y See ArflcJe iV, Fiduciaries Acf of ] 949. CD r~ Inventory of the real and personal estate of Lois Reber deceased Personal Property 1. IRS-refund on decedent's 2003 1040 Federal income tax 2. Members 1st Credit Union-rebate 3. Miscellaneous deposit TOTAL PERSONAL PROPERTY Real Property NONE 619 00 4 23 127 00 $750 25 LAW OFFICES OF STONE LAFAVER & SHEKLETSKI 414 BRIDGE STREET POST OFFICE BOX E NEW CUMBERLAND, PA. 17070 ~gister of Wills lmberland County Court Courthouse Square ~rlisle, PA 17013 House BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-154? EX AFP cnz-GS) DAVID H STONE ESQ STONE ETAL qlq BRIDGE ST NEW CUMBERLAND DATE 10-25-200q ESTATE OF REBER LOIS M DATE OF DEATH 11-20-2005 FILE NUMBER Z1 05-1012 COUNTY CUMBERLAND ACN 101 R~PTO Amount: Ram/~ad 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 (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF REBER LOIS M FILE NO. 21 05-1012 ACN 101 DATE 10-25-200q TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par~nership Zn~aras~ (Schedule C) q. Mor~gagas/No~as Receivable (Schedule D} S. Cash/Bank Deposits/Misc. Personal Propar~y (Schedule E) ($) 6. Jointly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To'al Assa~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/Ada. Cos~s/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. To,al Deductions 12. Ne~ Value of Tax Ra~urn 750.00 .00 NOTE: To 1nsura proper .00 cred1~ ~o your account, .00 subei~ ~ha upper portion .00 of ~his form w~h your ~ax payment. 10~65q.00 81~997.00 (B) lO,lql. O0 15. lq. NOTE: 95,q01.00 (1;) .00 x 00 = .00 (16) 80,975.00 x 0q5 = $,6fiq.00 (17) .00 x 12 = .00 (lB) .00 X 1.5 = .00 (19)= $,6qq. 00 AMOUNT PAID ASSESSHENT OF TAX: 16. Aeoun~ of L/ne lq a* Spousal ra~e 16. Aeoun~ of Lin,,, lrt ~exabla a~ Lineal/Class A ra~a 17. Aeoun~ of Line lq e~ Sibling ra~:a 18. Amount: of L~na lq ~axabla a~ Collateral/Class B ra~a 19. Principal Tax Due TAX CREDITS: PAYHENT RECE/PT D~SCOUNT DATE NUMBER INTEREST/PEN PAID (-) 02-19-200~ CD005587 171.05 08-19-200~ CDOO~29q .00 3,250.00 Z23.00 ZF PAID AFTER DATE INDZCATEDz SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT I I BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 5,6qq.05 .05CR .00 .05CR ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A 'CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Chari~able/Govarnean~al Bequests; Non-elected 9115 Trus*s (Schedule J) (15) .00 Ne'l: Value of Es~a~a Subjac~ ~:o Tax (lq) 80,97:~.00 Tf an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~ill reflect flgures that /nclude the total of ALL returns assessed to date. 2~287.00 (11) ]2.~28.0g (12) 80,975.00 RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 198Z -- 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 llfe or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (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 91q0). Detach the top portion of this Notice and submit with your payment to the Register of #i118 printed on the reverse side. --Hake check or money order payable to: REGISTER OF RILLS, AGENT A refund of a tax credit, mhich 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 Hills, any of the 23 Revenue District Offices, or by calling the special Zq-haur ansmeri~g service for forms ordering: 1-800-36Z-ZOSO; services for taxpayers with special hearing and / or speaking nemds: [-800-qqT-30ZO (TT 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 mi[bin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZSlOZ1, Harrisburg, PA 171ZS-10Z1, 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 Reviem Unit, Dept. Z8060[, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (RE¥-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, [996, 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 aith first day of delinquency, or nine (9) months and one ([) day from the date of death, to the date of payment. Taxes which became delinquent before January l, [98Z bear interest at the rata of six (6Z) percent per annum calculated at a daily rate of .O0016q. All taxes which became delinquent on and after January 1, 198Z 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 ZOO4 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ 20Z .OOOSq8 1988-199[ 11Z .OO05O[ ZOO1 9Z .O00Zq7 1983 16Z .000q38 1992 9Z .O00Zq7 ZOOZ 6Z .00016~ 198q 112 .000301 1993-199~ 7Z .O0019Z 2003 5Z .000137 1985 13Z .000356 1995-1998 9Z .O00Zq7 ZOOq ~Z .000110 1986 IOZ .OOOZ7~ 1999 7Z .O00ZgZ 1987 iOZ .O00Z7q ZOO0 7Z .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPA/D X NUNBER OF DAYS DELINQUENT 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.