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HomeMy WebLinkAbout03-0410PETITION FOR PROBATE and GRANT OF LETTERS Estate of Frederick M. Mummert also known as Deceased. Social Security No. 182-22-901 4 No. To: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who dare 18 years of age or older an the execut ors in the last will of the above decedent, dated March 28 and ~ Sherrv Lvnn Haaer. the other Co-Ex~:n~tor namo~ in .~aid Will renounced h~r ~iqht ~o ~erve as a Co-Executor in the named ., 19 96 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Dece~ident was domiciled at death in Ctanberlan0 County, Pennsylvania, with h is last family or principal residence at 317 West Main S~reet, Sh~remanstown, (list street, number and muncipality) ...... ~//3 1' Dece~ldent, then 74 years of age, died October 18. 2002 at Holy Spirit Hospital :w~-~t Pen~.~horo Twp.. CL~rland County..--pk~d~ Except as follows', decedent did not marry, was not divorced and did not have a child horn or adoptefi after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: None Dece~(dent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ Undetermined (If not domiciled in Pa.) Personal property in Pennsylvania $ N/A (If not domiciled in Pa.) Personal property in County $ ~/A Value of real estate in Pennsylvania $ Undetoann~n~cl situated as follows: CabSn - Rte #1 Bi,el.. Elk County Pennsylvan±a Residence - 317 West Ma~n Street.. Shiremanstown.. PA 17011 WHEREFORE, petitioner(s) respectfully requestS) the probate of the last will ~ presented herewith and the grant of letters Testamentary theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) ~ ~rbara A. R.q _b~rto ~a/k/a- Barbara A. Mummert ~ 3952 Brookridqe Drive ~ o Mechanicsburg: PA %~ ._~ ~9 Thomas O. Mummer~_ 1 71 Old Cabin Hollow Road Dillsburq, PA 1701 9 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA -~ COUNTY OF Cumberland f ss The petitioner(s) above-named swear(x) or affirm(x) 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 a~~t,~h~ io~ law' Sworn to or affirmed and subscribed before me.this /~ day of No. o~ ! - O$- ,41o Estate Of frederick M. Mumo~ , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~0x~ I.~, ll~00~, in consideration of the petition on the reverse side hereo(q', satisfactory proof having been presented before me, IT IS DECREED that the instrumentOt) dated March described therein be admitted to probate and filed of record as the last will of Frederick M. Mummert ; and Letters Tes~omm-ntawy are hereby granted to t~n_rbara A. Roberto: a/k/a Rarbara A. Mummert: and Thomas O. Mumm~-rt X)._~ro_ Qa_~_o FEES q, o o Probate, Letters, Etc .......... $ eQ35. oo Short Certificates( ) .......... $ 15. oo Renunciation ................ $ $. o o TOTAL ~ .¢~74 coo Filed .~..-: .[~..-: .0..~. ..................... {,~ Register of Wills ~ William L, Sumda¥ /06354 Mechanicsburg, PA 17055-6230 ADDRESS (717) 766-9622 REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS .9, t--O& James D. Bogar (c=ael~) a subscribing witness to the will presented herewith, (:eaala~ being duly qualified according to law, depose(s) and say(s) that T w&$ present and saw Frederick M. Mummert the testator , sign the same and that T signed as a witness at the request of testat or in h ± s presence and (4n=t:h~ p~es~n~=~f:e~=o~h~) (in the presence of the other subscribing witness(~),, Cather±ne/~rra~ Sworn to or affirmed and subscribed before ( ~///~~ m~this J/~ day of ~ t/~>J~..~) / , /492003 1 West Ma~n S~. Shiremanstown , ., / , ,PA ~/~. i . ' ~'. , '~tddress) Notary~Public ~~ U~~~ ' L Wolf, Nota~ Public So~.. _M'__l~.on. Twp., Cumberland ~ My ~.;om~ Expires Jan. 7, 2006 J ~,~-~ber, Pennsylvania Assodation Of Notaries (Name) (Address) REGISTER OF WILLS OF '~ COUNTY OATH OF NON'SUBSCRIB~'NG WITNESS ....... ~ . '~ codicil ~ t~ of (one of the subscribing~tnesses to) t'~ will presented herewith~d t h~~~ ~] 1~ _ %~~t~e~cOt~t dS cfi he h~dwri ting of tothebesto~ . :n~belief. ~ ~ Sword ~b~ribed ~for~ ~ me t~ x~ day of ~~ ~(Nal9 ~ me) ~ Register ~~ 1 7011 (Address) '03 ~1~¥ 15 ~]052 Otlmbe(i~no Co., PA REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS ~1-o~ -qlo Catherine J. Barra (~an:h) a subscribing witness to the will presented herewith, (oath) being duly qualified according to law, depose(s) and say(s) that T was present and saw Frederick M, Mummert the testator , sign the same and that T signed as a witness at the request of testator in hi s presence and (:i~: t~ ~:or,~a~l'=~t,h=otl~) (in the presence of the other subscribing Witness(~s~), James D. Sworn to or affirmed and subscribed before me this \~)/L day of g9 2003 No~ary Public Bogar ;l~amO ~-~therine J. 1041 Mountain Roadt DauphintPA (Address) (Name) (Address) .... .,.." REGISTER OF WILLS OF --,, COUNTY OATH OF NON-SUBSCRIBING TNESS (each) subs n a c 'her_hereto, (each) being duly qualifie'e'e"~ccording to law, depose(s) and'X~(s) that c-"-,,,~~ ,familiar wit! the signa~odiciI x,~. , testat, of (one of the s'~ribing witnesses to) the 'N~I presented herewith and ~ ........ x"~.c°,dicil that~ ~he signature on the wi~handwriting of tO the best of~"~ knowledge and belief. ~ ~ ame) Sworn to or affirmed and s~ribed before me this ~,~ay of Register Barra 17018 (Name) (Address) '0.3 MAY 15 ¢,10 ~2 Ottmbe~i-3r~d ~3o., PA RENUNCIATION In Re Estate of Frederick M. Mummert deceased. To the Register of Wills of Cumberland County, Pennsylvania. The undersigned Sherry Lynn Hager, a/k/a Sherry Lynn Mun~ert, Daughter of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters Tes~mentary Sworn To and Subscribed this / / of 2003 -- N'6'6~-y Public be issued to my sister, Barbara A. Roberto,a/k/a Barbara A. Mummert and to my brother, Tho~as O. Mun~mert, the other Executors named in said Will. WITNESS ~herr~ Ly~- (Signature) Hager, a/k/a Sherry Lynn Mummert ' 407 East Russell Street Barrington, Illinois 60010 (Address) My CommisionExpires ~7-~'"(J~)~/ . (Signature) "OFRCIAL SEAl.' Philomena T. Lafata No,au Public. Stated Illinois Kane County My Commission Expires June 5, 2004 (Address) (Signature) ~D CD · 3a (Address) his is to certi~ that the information here given is :orrectly 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 '}]ling. WARNING: It is illegal to duplicate this copy by photostat or photograph. , ! '.(,cai Registrar No. ~ Date ,.. Paul Mummert ~,. Barbara A. Mu~mert COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH SEX SOCIAL SECURITY NUMEIER [',. mole ,. l~,,e [] ' ,,..October 22~ _2002 ,,.. FD-014889-L ,o. White i Z:c~w O( la( 1 I,AST WILL AND TESTAMENT OF FREDERICK Mo M~RT I, FREDERICK M. MUMMERT, of the Borough of Shiremans- town, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I give and devise my hunting camp, which includes a hunting cabin and approximately four and one-half (4- 1/2) acres, same being located at R.D. No. 1, Sigel, Elks County, Pennsylvania, to my son, THOMAS O. MUMMERT, provided, however, that should he predecease me, then equally to my daughters, BARBARA A. ROBERTO and SHERRY LYNN HAGER. SECOND: I give and bequeath all of my guns, hunting equipment, snowmobile and trailer, and Honda Ail Terrain Vehicle to my son, THOMAS O. MUMMERT, provided, however, that should he predecease me, then equally to my daughters, BARBARA A. ROBERTO and SHERRY LYNN HAGER. THIRD: I give and bequeath the sum of Twenty-Five Thousand and No/100 ($25,000.00) Dollars to MARGARET J. NICHOLSON, of Shiremanstown, Pennsylvania, provided, however, that should she predecease me, then I direct that this bequest lapse and be and become a part of my residuary estate to be distributed in accordance with the provisions of Clause FIFTH hereinafter. FOURTH: I give and bequeath the sum of Five Thousand and No/100 ($5,000.00) Dollars to my brother, DEAN B. MUMMERT, provided, however, that should he predecease me, then I direct that this bequest lapse and be and become a part of my residuary estate to be distributed in accordance with the provisions of Clause FIFTH hereinafter. FIFTH: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, in equal shares, to my children, BARBARA A. ROBERTO, THOMAS O. MUMMERT, and SHERRY LYNN HAGER, provided that should any of my children predecease me, I give and bequeath such child's share unto his or her issue per stirpes by representation, and if there be a failure of same, then I give and bequeath such deceased child's share to my surviving children as provided herein. SIXTH: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the 2 Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will, and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. SEVENTH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of the principal of my residuary estate. EIGHTH: I nominate and appoint BARBARA A. ROBERTO, THOMAS O. MUMMERT and SHERRY LYNN HAGER, or the survivor thereof, Co-Executors of this, my Last Will and Testament. I direct that my Co-Executors, and their successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ~ day of FRedERICK M. MUMMER~ 3 Signed, sealed, published and declared by the above- named Testator as and for his Last Will and Testament in our presence, who, at his request, in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address { Address C/ -- 4 OF FREDERICK M. MUMMERT JAMES D. BOGAR LAW OFFICES JAMES D. BOGAR, ESQUIRE ANDREW C. SHeELY, ESQUIRE I WEST MAiN STREET SHIREMANSTOWN, PENNSYLVANIA 17011 Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Frederick M. Mummert Date of Death: October 18, 2002 Will No. 2003-00410 21-03-041 0 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 /v/,~/ ~37 2003 : Name Address Thomas O. Mummert- 171 Old Cabin Hollow Road, Dillsburg, PA 17019 Barbara A. Roberto a/k/a Barbara A. Mummert - 3952 Brookridge Drive, Mechanicsburg, PA 17050 Sherry Lynn Mummert - 407 East Russell Street, Barrington, IL 60010 Dean B. Munm~rt - 2039 A Swatfira Street, Harrisburg, PA 17104 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Date: /[~/~ ? ~ 7 2003 Name William L. Sunday Address 39 West Main Street Mechanicsburg, PA 17055-6230 Telephone (71~ 766-9622 Capacity: X Counsel for personal representative · IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be deter- mined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or prop- erty will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA In re Estate of Frederick M. Mummert , deceased, Estate No. 2003-0041 0 PA File No. 21-03-041 0 (Name and Address) TO: Thomas O. Mummert 171 Old Cabin Hollow Road Dillsburq, PA 17019 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. The Decedent Freder-ick FI. Mutr~ner~ , died on the 18Ch day of October , 2002 , at Ct.unberland Pennsylvania. County, The Decedent died testate (with a Will); or The personal representative of the Decedent is (name, address and telephone number). Roberto a/k/a Barbara A. Mummert 3952 Brookridge Drive Mechanicsburg, PA 17050 (717) 732-0261 Thomas O.-Mummert 171 Old Cabin Hollow Road Dil]~Burg, PA 17019 (717) 432-3876 If the Decedent ltied testate, the will has been filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 If the Decedent died intestate, a Petition for the Grant of Letters of Administration was filed with the Office of the Register of Wills of Cumberland County, I Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 A copy of the ....... is attached hereto. Date: ~ ~5 2003 Signature: Name (print) William L. Sunday Address .. 39 West MaSn Street Mechanicsburg, Pa 17055-6230 Capacity: Telephone (71 7) 766-9622 Counsel for personal representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be deter- mined wholly or partly by the decedent's will· If the decedent died without a will, whether you will receive any money or prop- erty will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA In re Estate of Frederick M. Mummert , deceased, Estate No. 2003-00410 PA File No. 21-03-0410 (Name and Address) 3952 Brookridge Drive Mechanicsburg, PA 17050 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. The Decedent Frederick M. M~t , died on the 18th day of October , 2002 , at Cumberland Pennsylvania. County, The Decedent died testate (with a Will); or The personal representative of the Decedent is (name, address and telephone number). Roberto a/k/a Barbara A. Mummert 3952 Brookridge Drive Mechanicsburg, PA 1 7050 (717) 732-0261 Thomas O.- Mummert 1 71 Old Cabin Hollow Road Di 11 ~burg, PA 1701 9 (717) 4.32-3876 If the Decedent'died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 If the Decedent died intestate, a Petition for the Grant of Letters of Administration was filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 Date: ~e.f,, ~f~ 2003 Signature: ~"~ ~,,a"~ Name (print) William L. Sunday Address 39 West Ma~n Street Mechanicsburg, Pa 17055-6230 Capacity: Telephone (717) 766-9622 Counsel for personal representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be deter- mined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or prop- erty will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA In re Estate of Fre~ea2J.¢k M. Mtaxr~ , deceased, Estate No. 2003-0041 0 PA File No. 21-03-041 0 (Name and Address) TO: Sherry Lynn Mummert 407 East Russell Street Barrington, I1 6001 0 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. The Decedent Fre~or±ck M. Mummer~ , died on the 18~h day of October , 2002 ,at ~land Pennsylvania. County, The Decedent died testate (with a Will); or The personal representative of the Decedent is (name, address and telephone number). Barbara A. Roberto a/k/a Barbara A. Mummert 3952 Brookridge Drive Mechanicsburg, PA 17050 (717) 732-0261 Thomas O.- Mumm~ 1 71 Old Cabin Hollow Road Dillsburg, PA 1701 9 (717) 432-3876 - -If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 If the Decedent died intestate, a Petition for the Grant of Letters of Administration was filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 Name (print) William L. Sunday Address 39 West M~n Street Mechanicsburg, Pa 17055-6230 Capacity: Telephone (717) 766-9622 Counsel for personal representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be deter- mined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or prop- erty will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA In re Estate of Frederick M. Mun~nert , deceased, Estate No. 2003-0041 0 PA File No. 21-03-041 0 (Name and Address) TO: Dean B. 'Mummer~ 2039 A Swat~ra Street Harrisburg, PA 17104 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. The Decedent Frederick M. Mummer-t , died on the 18th day of October , 2002 , at Oambe~land Pennsylvania. County, The Decedent died testate (with a Will); or The personal representative of the Decedent is (name, address and telephone number). Barbara A. Roberto a/k/a ~rbara A. Mummert 3952 Brookridge Drive Mechanicsburg, PA 17050 (717) 732-0261 Thomas O.- Mummert 1 71 Old Cabin Hollow Road Dillsburg, PA 1701 9 (717) 432-3876 If the D~cedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 If the Decedent died intestate, a Petition for the Grant of Letters of Administration was filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 A copy of the Will .r~.~i~i.n:ma~-t~:~aiaa-.u-. ............... xs attached hereto. Date: ,~.~,fi, ~5 2003 Signature: ~~ ~~ Name (print) William L. Sunday Address _ 39 West M~n Street Mechanicsburg, Pa 17055-6230 Capacity: Telephone (717) 766-9622 Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2 1 -_0_0_3_3 COUNTY CODE YEAR 0 4 I 0 NUMBER Z W LLI LU uJ I..- z z 0 IAI n, 0 (D x DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Mummert, Frederick M. DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) October 18, 2002 J August 24, 1928 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) N/A SOCIAL SECURITY NUMBER 182 - 22 - 9014 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER -- N/A -- E~l. Original Return E~4. Limited Estate J--~6. Decedent Died Testate (Attach copy of Will) ~----19. Litigation Proceeds Received [~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) l'--110. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) r--] 3. Remainder Return (date of death prior to 12-13-82) DS. Federal Estate Tax Return Required 1 8. Total Number of Safe Deposit Boxes [-'~ 11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME William L. Sunday FIRM NAME (If Applicable) TELEPHONE NUMBER (717) 766-9622 COMPLETE MAILING ADDRESS 39 West Main Street Mechanicsburg, PA 17055-6230 1. Real Estate (Schedule A) (1) $ 183000. O0 2. Stocks and Bonds (Schedule B) (2) 5971 ~ 62 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 22840.04 (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 16531.41 E~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 0. O0 (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (8) 9. Funeral Expenses &Administrative Costs (Schedule H) (9) 20238.21 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 456.6~ 11. Total Deductions (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) OFFICIAL USE ONLY C_ F-- 228343.07 20694.84 207648.23 207648.23 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax 0 rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 202648.23 5000. O0 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 0 19. 20. x .o 45 x ,12 x .15 Tax Due (15) 0 (16) 91 I 9_ 1 7 (17) 600. O0 (18) 0 (19) 971 9.17 Decedent's Complete Address: · , ISTREETADDRESS 317 West Main Street ZIP I CITY Shirema~stown I STATE Pa 1 701 1 / Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 0 B. Prior Payments 0 C. Discount O 3. Interest/Penalty if applicable D. Interest 0 E. Penalty O (1) 9719.17 Total Credits ( A + B + C ) (2) O Total Interest/Penalty ( D + E ) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (3) 0 (4) (5) 9719.17 0 (5A) B. Enter the total of Line 5 + EA. This is the BALANCE DUE. (EB) Make Check Payable to: REGISTER OF WILLS, AGENT 9719.17 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS * Except as an incident of Yes No 1. Did decedent make a transfer and: Join~ Ownership []. 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 prepare4d~as any knowledge. SIGNATURE OF BERSON~t~SPONSIBLE FI2IE, FILIN~G RETURNA, __ ' .... ~ _--'--, ADDRESS 3952 Brookridge Drive 1~1 Old Cabin Hollow Road Mechanicsburg, PA 17050 Dillsburg¢ PA 17019 SIGNATURE~O~ P~REPARER OT~ER T~N REPRESENTATIVE ADDRESS 39 West M~in Street, Mechanicsburg PA 17055-6230 D~E July 9, 2003 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 statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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 transfem 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. · ' SCHEDULE A ' COMMONWEALTH OF PENNSYLVANIA / REAL ESTATE Frederick M. Mummert FILE NUMBER 21-03-0410 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 pdce 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 properly which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH ALL those two certain adjoining tracts of land Bounded and described as follows: TRACT NO. 1' ALL that certain tract of land situate in the Borough of Shiremanstown, County of Cumberland and State of Pennsylvania, more particularly bounded and described as follows: BEGINNING at a point along the northern right of way line of Simpson Road, now known as West Main Street, said point being North 76 degrees 15 minutes east one hundred sixty and ninety-three one hundredths (160.93) feet from the eastern right of way line of Washington Avenue extended; thence from aforesaid point along the eastern property line of lands now or late of Engles, north 14 degrees 0 minutes west one hundred eighty-two and one hundredths (182.01) feet to a stake; thence through lands formerly of Ed. Gundaker, now tract No. 2 herein, north 76 degrees '15 minutes east sixty (60) feet to a stake at the western property line of lands now or late of Robert Woods; thence by aforesaid western property line south 14 degrees 0 minutes east one hundred eighty-two and one one-hundredths (182.01) feet to a stake on the northern right of way line of Simpson Road, now know as West Main Street; thence along aforesaid northern right of way line south 76 degrees 15 minutes west sixty (60) feet to a stake, the place of BEGINNING. CONTAINING 0.25 acres. }lAVING TItEREON ERECTED a brick dwelling house known and numbered as 317 West Main Street, Shiremanstown, Cumberland County, Pennsylvania TRACT NO. 2 ALL that certain piece or parcel of land situate in the Borough of Shiremanstown, County of Cumberland and State of Pennsylvania, bounded and described as follows, to writ: BEGINNING at a point marked by a concrete monument on the northern boundary of Tract No. 1 herein, which point is 237.4 feet form the center line of West Main Street; thence in a generally northwardly direction north 14 degrees Carried forward (If more space is needed, insert additional sheets of the same size) REV-tSO2EX * (1-$7~ COMMONWEALTH OF PENNSYLVANIA INHEPJTANCE TAX RETURN SCHEDULE A I RESIDENT DECEDENT ~ ESTATE OF Frederick M. Mummert FILE NUMBER 21-03-0410 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 suwivorshi m~e disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. con't Brought forward 0 00 minutes west 193.20 feet to a point marked by a pipe; thence in a generally eastwardly direction north 56 degrees 52 minutes east 63.00 feet to a point marked by a pin; thence in the same direction north 56 degrees 52 minutes east 0.50 feet to a point; thence in a generally southwardly direction south 14 degrees 00 minutes east 213.18 feet to a point marked by a concrete monument; thence in a generally westwardly direction along the boundary of tract No. 1 herein south 75 degrees 12 minutes west 60.00 feet to a point marked by a concrete monument, the place of BEGINNING. BEING known and numbered as Rear 317 West Main Street, and being made a part and parcel of Tract No. 1 herein known and numbered as 317 West Main Street. Tax Parcel No.:. 37-23-0557-011 and 37-23-0557-012 Assessed Value: 136010 + 5120 = 141130 Valued ~ Appraisal: 140,000.00 2. ALL those certain parcels of land situate in Millstone Township, Elk County, Pennsylvania, bounded and described as follows: PARCEL No. 1: BEGINNING at a point, the southeast comer of this tract and southwest comer of the lot sold by Oliver Aharrah, et ux. to Kenneth E. Rhoads, et ux. by Deed dated August 11, 1958 and recorded in Elk County Deed book 145, page 227; thence west 829 feet along lands now or late of Oliver Aharrah to a set pipe on line of land, now or lateof Mede Park; thence along lands now or late of the said Merle Park north 203.5 feet to an old pipe comer common to lands now or formally of Oliver Aharrah and land now or late of Bertha Zimmerman Estate; thence east along lands nowor formally of Bertha Zimmerman Estate 786 feet to a point; thence along land sold by Oliver Aharrah, et ux. to Kenneth E. Rhoads, et ux. South 12 degrees East 208 feet to the place of BEGINNING. Carried forward 140,000.00 (If more space is needed, insert additional sheets of the same size) ' SCHEDULE A COMMON VE^'TH OF PENNSYLVAN,A / REAL ESTATE I INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF Frederick M. Mummert FILE NUMBER 21-03-0410 All real prope~-y 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 NUMBER DESCRIPTION 2. con't Brought forward PARCEL No. 2: On the north by lands of John Zimmerman; On the east by a Public State Highway; On the south by other lands of Oliver Aharrah of which this lot was a part; On the west by the same. CONTAINING one (1) acre, this lot fronting 208 feet on the State Highway on the east and extending westerly therefrom in a uniform width a sufficient distance to make one acre of land, measured form the middle of the State Highway. Map Tax Parcel No.: 08-10-017-5477 Assessed Value · $3360. Valued ~ Appraisal: $ 43000. TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 140,000.00 43000.00 183000.00 ' R~'v.~,~e3 ~ + (i-gz) ,~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Frederick M. Mun~ert 21-03-041 0 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 187 shs of John Hancock Financial Services, Inc - Common ~ 31.685 Dividend paid 12/11/02 to holders of record on 11/18/02 (1) $50.00 United States Savings Bond - Series EE No L496367903 EE Issued Dec. 26, 1991 to Frederick Mummert in his Individual name. TOTAL (Also enter on line 2, Recapitulation) (if a-~o[e space is needed, insert additional sheets of the same size) 5925.10 (not taxable) 46.52 $ 5971.62 REV-1508 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Frederick SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER M. Mummert 21~3-0410 Include the ITEM NUMBER o 9. 10. 11. )roceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshi ~ must be disclosed on Schedule F. DESCRIPTION United American Ins. Co - Premium Refund (Oct premium) Stonebridge Life Ins. Co. - Premium Refund (Accidental Death) Montour Oil Service - Credit Balance Accrued Interest 18/31 x .66 AARP - Daily hospital Benefits Department of VA Affairs - Refund (over payment) 2002 U. S Income Tax Refund Coins in Safe Deposit Box: ~ appraised value (1) 1964 Kennedy Half Dollar (Box) (6) 1964 Kennedy Half Dollars (1) 1989 United States Mint Proof Set (1) 1887 Liberty Silver Dollar (1) 18920 Liberty Silver Dollar (1) 1922 Peace Silver Dollar (1) 1924 Peace Silver Dollar (1) 1925 Peace Silver Dollar (1) 1964 Washington Quarter (1) 1940 Nickel (1) 1964 Dime 1.00 .50 2000 Ford Explorer 1984 Honda (3 Wheeler) 1986 Kodiak (Trailer) Appraisal Appraisal Appraisal 1982 Yamaha Snowmobile ~ Appraisal carried forward $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 63.34 8.75 159.80 .38 1845.00 6.87 1231.00 1.00 3.00 8.50 22.00 22.00 19.00 15.00 18.00 .25 .05 .10 14000.00 500.00 500.00 300.00 18724. 04 ~EV-1508 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Frederick M. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ~t FILE NUMBER 21-03-0410 Indude the ITEM NUMBER 12. 13. ~roceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshi DESCRIPTION _~uns and Hunting Equipment ~ Appraisal Guns reloader items 222 Remington w/Scope Bolt Action 22 CA Mossburg & Sons Semi Auto Long Rifle 12 GA Side by Side Lefever 12 GA Pump 67 Series C Savage 30-06 MDL 760 Remington pump w/scope 308 CA Revelation Western Auto Bolt Action 12 GA MDL 25 Winchester Pump Shotgun 32 Pistol Liver Johnson Arms 22 CA H & R Trapper MDL Pistol Starter Revolver (Vangaurd) 22 Long Rifle Target Pistol (Victor) Ammo Duck Calls broughtforward Household Goods, Furniture and Tangible Personal Property - ~ Apprasial Sofa Recliner Rocker Recliner End Tables 2 ~ 10.00 each Stand WD Rocker Odd Chair Table Lights Picture Stand Stool Book -Misc TV & Stand (older model) Stand Dining Room Suite Wall Plates ~ 15.00 each Microwave Refrigerator Pots, Pans, Corelle Dishes, Flatware, Bowls, Utensils Towels 3 pc Bedroom Suite Stand Table Carried forward (If more space is needed, insert additional sheets of the same size) must be disc:,_-.-_-~_~ on Schedule F. VALUE AT DATE OF DEATH 18724.04 100.00 125.00 100.00 75.00 75.00 325.00 150.00 150.00 50.00 35.00 10.00 40.00 25.00 15.00 6.00 40.00 50.00 20.00 25.00 35.00 10.00 10.00 30.00 45.00 8.00 3.00 5.00 2.00 350.00 135.00 25.00 110.00 75.00 20.00 275.00 35.00 21313.04 $ · ~ ' ' '~ J SCHEDULEE I COMMONWEALTH'~'FPE~NSYLVANIA J CASH, BANK DEPOSITS, & MISC I INHERITANCE TAX RETURN / ~M~AAI ' ........... I / ESTATE OF Frederick M. Mummert FILE NUMBER 21-03-0410 Include the ITEM NUMBER 13. (con't) ,mceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshi ~ must be disclosed on Schedule F. DESCRIPTION brought forward Household Goods, Furniture, etc (continued) Rocker Table Lights WD Desk Metal File Cabinet Child Rocker Secretary Desk Lights Sweepers Gun Cabinet Single Beds 2 ~ 50.00 each Small Cupboard Chest of Drawers Chair Floor Fan Fan Christmas Items Trunks 2 ~ $10.00 each Hats in Boxes VCR Washer Dryer Stepladder WD Chairs 3 @ 10.00 each Floor Light Cupboard Iron Board Bar Stools 3 @ 8.00 each Bar Stool Bar Items Compact Refrigerator Fish Poles Hose & Reel Power Mower Spreader Refrigerator (older) Weeder Traps Clamps, Saws, Hammers, Screwdrivers, Misc. hand Tools Drill Press Radial Arm Saw Bench Grinder Carried forward (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 21313.04 40.00 5.00 3.00 10.00 15.00 75.00 2.00 15.00 70.00 100.00 10.00 7.00 15.00 I0.00 2.00 3.00 20.00 25.00 10.00 100.00 10.00 2.00 30.00 2.00 2.00 1.00 24.00 10.00 10.00 20.00 30.00 8.00 50.00 3.00 20.00 8.00 30.00 100.00 40.00 100.00 30.00 $ 22380.04 REV-1508 EX * (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Frederick M. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Mu[r~ert FILE NUMBER 21-03-0410 Include the ITEM NUMBER 13. (con't) 14. ~mceeds 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. DESCRIPTION Household Goods, Furniture, etc (continued) Workbench & Vise Electric Power Tools Hatchets - Tool Items Ladders (2) Long Handled Garden Tools Grill Folding Lawn Chairs Drill Sander Chainsaws Misc. Garage items Clothing Brought forward TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 22380.44 20.00 75.00 30.00 75.00 30.00 25.00 10.00 15.00 55.00 100.00 25.00 $ 22840.04 ' ' I SCHEDULEF I I I ESTATE OF [~e(:].P_rick M. M~t FILE NUMBER 21-03-0410 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 Barbara A. Roberto a/k/a Barbara A. Mummert 3952 Brookridge Drive Mechanicsburg, PA 17055 Daughter JOINTLY-OWNED PROPERTY: LEI I ~R DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S NUMBER TENANT JOINT deed for joinUy-held real estate. VALUE OF VALUE OF ASSET INTEREST DECEDENTS INTERESi 1. A. Prior to Personal Checking with interest Account 12/23/99 # 610071-681-3 in Citizens Bank Principal Balance 17641.00 50% 8820.50 Accrued Interest 3.08 50% 1.54 2. A. Prior Statement Savings Account # 6140 to # 171016 in Citizens Bank 12/23/99 Principal Balance 15416.61 50% 7708.31 Accrued Interest 2.12 50% 1.06 TOTAL (Also enter on line 6, Recapitulation) $ 16531.4 ] si I, insert additional sheets of the same s~ze) SCHEDULE G COMMONWEALTH OF PENNSYLVANIA / INTER-VIVOS TEANSFERS & J INHERITANCE TAX RETURN ~ROBATE PROPERTY I RESIDENT DECEDENT ESTATE OF Fredrick M. Mummert FILE NUMBER 21-03-041 0 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 INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. °./o OF NUMBER ATTAC, A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE VALUE OF ASSET INTEREST iiF APPLICABLE 1. Individual Annuity # SI3000620 Issued May 24, 1989 by John Hancock Mutual Life Insurance Company to Frederick M. Mummert Annuitant: Frederick M. Mummert No value Annuity payments for guaranteed period of 10 years and thereafter during Annuitant's lifetime Ten year Date of first payment: 9/1/89 certain Payment interval: Monthly 0 0 0 expired Beneficiary: Barbara Ann Roberto, Daughter 9/1/99 2. Individual Annuity # SI3000621 issued May 24, 1989 by John Hancock Mutual Life Insurance Company to Frederick M. Mummert Annuitant: Frederick M. Mummert Annuity payments for guaranteed Period of 10 years and thereafter during annuitant's lifetime No value Date of first payment: 9/1/89 0 0 0 Ten Year Payment Interval: Monthly Beneficiary: certain Barbara Ann Roberto, Daughter expired 9/1/99 None ... TOTAL (Also enter on line 7, Recapitulation) $ ;1: ~s ~, insert additional sheets of the same size) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA I FUNERAL EXPENSES & I INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Frederick M. ~rt FILE NUMBER 21-03-0410 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 5. 6. 7. FUNERAL EXPENSES Malpezzi Funeral Home - Funeral Expense Office of Catholic Cemeteries - Install VA marker West Shore Elks - Luncheon Tom Mummert - Reimburse for Funeral Flowers ADMINSTRATIVE COSTS Personal Representative's Commissions Name of Personal Representative (s): Social Security NO. (s) / EIN Number of Personal Representative · 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: Relationship of Claimant to Decedent: Zip: Probate Fees Accountant's Fees ( 2002 Income Tax Returns) Tax Return Preparer's Fees Register of Wills - (5) Short Certificates Filing Renunciation 15.00 5.00 Cumberland Law Journal - Executors Notice carried forward (If more space is needed, insert additional sheets of the same size) $ 8315.95 200.00 279.15 185.50 9500.00 254.00 95.00 20.00 75.00 18924.60 R~EV-1511EX * (1'97) ~ I · · J SCHEDULE H COMMOI~NEALTH'~F PENNSYLVANIA I FUNERAL EXPENSES & INHERITANCE TAX RETURN m ADMINISTRATIVE COSTS ESTATE OF Frederick M. Mummert FILE NUMBER 21-03-0410 Debts of decedent must be reported on Schedule I. ITEM NUMBER 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. DESCRIPTION broughtforward The Sentinel - Executors Notice PP & L - Electric 12/02/02 PA WC - Water 12/05/02 Verizion - Final Bill 12/11/02 PP & L - Electric 1/2/03 Waste Management - Trash (Jan, Feb, and March 2003) PA WC - Water (1/7/03) Lower Allen Township - Sewer 2/3/03 ( Jan, Feb, and March 2003) PA WC - Water (2/4/03) PP & L - Electric - (3/3/03) PA WC (3/4/03) PP & L - Electric - (4/1/03) PA WC - Water (4/4/03) Citizens Bank Safe Deposit Box Rent Advantage Appraisals - Real Estate Appraisal ( Elk Co.) Lower Allen Township - Sewer 5/1/03 ( April, May, June) Hardy's Auction Service - Appraisal (household goods, guns, coins and Snowmobile) carried forward (If more space is needed, insert additional sheets of the same size) AMOUNT 18924.60 112.37 24.51 21.75 12.60 39.25 32.96 10.61 24.00 10.63 8.52 10.63 11.65 10.63 23.00 300.00 24.00 25.00 $ 19626.71 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Frederick M. Mummert continued SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-03-0410 Debts of decedent must be reported on Schedule I. ITEM NUMBER 26. 27. 28. 29. 30. 31. 32. DESCRIPTION brought forward Central Penn Apprasials, Inc. Real Estate Apprasal (Shiremanstown) Register of Wills ( Cumberland County) Exemplified copy of Letters Testamentary and Will Register of Wills - Additional Probate Fee Register of Wills - Certificate of Payment of PA Inheritance Tax Register of Wills - (Elk County) Filing Exemplified Record and Certificate of Payment Register of Wills - Filing PA Inheritance Tax Return and Inventory Gail Minnich - Notary Fees Reserved for Filing Account, Releases, Decree, Additional Short Certificates, Etc. TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 19626.71 275.00 42.50 35.00 4.00 25.00 34.00 21.00 175.00 $ 20238.21 REV-1512 F_~* (1.9'7) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Frederick M. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS Mumme~d: FILE NUMBER 21-03-0410 Include unreimbursed medical expenses. ITEM NUMBER 3. 4. 5. 6. 7. 8. 9. DESCRIPTION Outstanding Check # 527 dated Oct. 16, 2002 payable to Trugreen Chemlawn Drawn on Joint Account # 610071-681-3 (Item 1 Sch F) which cleared the bank on Oct. 21, 2002 Verizon - Account payable Waste Management - Account Payable ( Oct, Nov, and Dec 2002) West Shore EMS - Account Payable (9/19/02) Dept of VA Affairs - Account Payable (8/29/02) Health South Rehab - Account Payable United Electric - Account Payable (Camp) PP& L Electric Utilities Account Payable (home) Lower Allen Township - Account Payable (sewer) TOTAL (Also enter on line 10, Recapitulation) AMOUNT 160.11 20.18 34.19 120.40 21.00 35.44 18.85 22.46 24.00 $ 456.63 (Ifmorespaceisneeded, inse~additionalsheetsofthesamesize) ' '~ / SCHEDULE J I c ° M~ .°~".w,~Tc~ °~ ~E""~S~A"'A / BENEFICIARIES J ESTATE OF Frederick M. Mummert FILE NUMBER II. 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outdght spousal distributions) Dean B. Mummert, 2039 A Swatara St. Hamsburg, PA 17104 Margaret J. Nicholson ( died (4/28/02) Thomas O. Mummert, 1~1 Old Cabin Hollow Road, Dillsburg, PA 17019 Real Estate - Elks County, PA Guns and Hunting Equipment Snowmobile and Trailer (300. + 500.) Honda ATV Barbara A. Roberto a/k/a Barbara A. Mummert 3952 Brookridge Drive Mechanicsburg, PA 17050 Sherry Lynn Hager a/k/a Sherry Lynn Mummert 407 East Russell St. Barrington, I1 60010 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Brother Friend Son Daughter Daughter 21~3-041 0 AMOUNT ORSHARE OF ESTATE $5000.00 None - Bequest lapsed per Will at her death $43000.00 1275.00 800.00 500.00 One-tNrd (1/3)residue One-third (1/3) residue One-third (1/3) residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET 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 (If more space is needed, insert additional sheets of the same size) None None $ None Inventory of the real and personal estate of Frederick M. Mummert deceased con't p 4 Clothing Clamps, Saws, Hammers, Screwdrivers, Misc. hand Tools Drill Press Radial Arm Saw Bench Grinder Workbench & Vise Electric Power Tools Hatchets - Tool Items Ladders (2) Long Handled Garden Tools Grill Folding Lawn Chairs Drill Sander Chainsaws Misc. Garage items Summary Real Estate Personal Property Total Probate Estate $183000.00 _ 28811.66 Brought forward Total 28081 66 100. 00 40. 00 100. 00 30. 00 20. 00 75. 00 30 00 75 00 30 00 25 '00 10. 00 15. 00 55. 00 100 00 25. 00 28811 56 Inventory of the real and personal estate of Frederick M. Mummert deceased con't p 3 Microwave Refrigerator Pots, Pans, Corelle Dishes, Flatware, Bowls, Utensils Towels 3 pc Bedroom Suite Stand Table Rocker Table Lights WD Desk Metal File Cabinet Child Rocker Secretary Desk Lights Sweepers Gun Cabinet Single Beds 2 ~ 50.00 each Small Cupboard Chest o£Drawers Chair Floor Fan Fan Christmas Items Trunks 2 ~ $10.00 each Hats in Boxes VCR Washer Dryer Stepladder WD Chairs 3 ~ 10.00 each Floor Light Cupboard Iron Board Bar Stools 3 @ 8.00 each Bar Stool Bar Items Compact Refrigerator Fish Poles Hose & Reel Power Mower Spreader Refrigerator (older) Weeder Traps Brought forward Carried forward 26744 66 25 00 110.00 75 00 20 00 275 00 35 00 40 00 5 00 3.00 10.00 15.00 75 00 2 00 15 00 70 00 100 O0 10.00 7 O0 15 O0 10 O0 2 O0 3 O0 20, O0 25,00 O0 100 O0 10 O0 2 O0 30, O0 2,00 2.00 1.00 24 00 10 00 10 00 20 00 30 00 8.00 50 00 3 00 20 00 8 00 30 00 28081 66 Inventory of the real and personal estate of Frederick M. Mummert deceased con't p 2 Personal Property (con't) 2000 Ford Explorer Appraisal 1984 Honda (3 Wheeler) ~ Appraisal 1986 Kodiak (Trailer) ~ Appraisal 1982 Yamaha Snowmobile @ Appraisal Guns and Hunting Equipment ~ Appraisal Guns Reloader items 222 Remington w/Scope Bolt Action 22 CA Mossburg & Sons Semi Auto Long Rifle 12 GA Side by Side Lefever 12 GA Pump 67 Series C Savage 30-06 MDL 760 Remington pump w/scope 308 CA Revelation Western Auto Bolt Action 12 GA MDL 25 Winchester Pump Shotgun 32 Pistol Liver Johnson Arms 22 CA H & R Trapper MDL Pistol Starter Revolver (Vangaurd) 22 Long Rifle Target Pistol (Victor) Ammo Duck Calls Household Goods, Furniture and Tangible Personal Property - @ Apprasial Sofa Recliner Rocker Recliner End Tables 2 @ 10.00 each Stand WD Rocker Odd Chair Table Lights Picture Stand Stool Book - Misc TV & Stand (older model) Stand Dining Room Suite Wall Plates ~ 15.00 each Brought forward 9395. 14000. 500. )0 50O )0 300. 100. )0 125. )0 I00. )0 75. )0 75. 325. 150. 150. )0 50. ,)0 35 10. )0 40. 25 15. 6. )0 40. 5O 20. 25. 35. 10. 10. 30. 45. 8. 3. 5. 2. 350. 135. Carried forward 26744. 66 Inventory of the real and personal estate of FredefickM. Mumme~ deceased REAL ESTATE ALL those (2) two certain tracts of land situate in the Borough of Shiremanstown, County of Cumberland and State of Pennsylvania, known and numbered as 317 West Main Street and rear 317 West Main Street, Shiremanstown, Pennsylvania Valued ~ Appraisal ALL those two (2) parcels of land situate in Millstone Township, Elk County, Pennsylvania Valued ~ Appraisal TOTAL REAL ESTATE PERSONAL PROPERTY Stock and Bonds 187 shs of John Hancock Financial Services, Inc ~31.685 (1) $50.00 Untied States Savings Bond- Series EE Issued 12/26/91 Cash, Bank Deposits & Misc Personal Property United American Ins, Co - Premuim Refund Stonebridge life Ins. Co - Premium Refund Montour Oil Service - Credit Balance Accrued Interest AARP - Daily Hospital Benefits Dept of VA Affairs - Refund 2002 U.S. Income Tax Refund Coins in Safe Deposit Box @ Appraisal (7) 1964 Kennedy Half Dollar (Box) (1) 1989 United States Mint Proof Set (1) 1887 Liberty Silver Dollar (1) 18920 Liberty Silver Dollar (1) 1922 Peace Silver Dollar (1) 1924 Peace Silver Dollar (1) 1925 Peace Silver Dollar (1) 1964 Washington Quarter (1) 1940 Nickel (1) 1964 Dime (~ 1.00 $140000 O0 43000,00 $18300O. O0 $ 5925.10 46. 63. 34 8. 159. 38 1845. 6. 17 1231 4 00 8. 50 22. 22.00 19.00 15.00 18.00 25 05 10 carried forward 9395.66 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND P~_rbara A. Roberto,a/k/a Barbara A. Mumme~ and Thomas O. Mummert being duly s~orn according to law, deposes and says that they a~e Executors of the Estate of Fred_Brick M. Mummert late of ShiremanstQ_wn___.Bo~gugh , Cumberland County, Pa., deceased and that the within is an inventory made by ~ef[t , the said Executors of the entire estate of said decedent, consisting of all the ~ersonal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and fhaf the figures ~pposlfe each item of the Inventory represent ~t's fair value as of the date of decedenf's death. Sworn to and subscribed before me, O .-~-~~ ~hoEIaSoO. Executor - Admlnlsfrafor MLlm~e=t ~9 2003 GeJl P. Minnicb, Nota~%~ Public Mechanicsbur§ 8oro, Cumberland Coun~ My Cornmi~ion Expires Dec. 9, 2006 Member, Pennsylvsnia Association Of Notaries- 3952 Brookridge Drive, Mechanicsburg PA 1'/050 171 Old Cabin Address Hollow Rd. Dillsburg PA 17019 (Respective) October 2002 Date o'f Death 18 Day Month Year INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed wifhln thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty ~ ~ 4. See Article IV, Fiduciaries Act of 1949. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 WILLIAM L SUNDAY $9 W MAIN ST HECHANICSBURG CUT ALONG THIS LINE REV-1547 EX AFP (01-03) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF ZNHERZTANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX PA 17055 DATE 08-25-2005 ESTATE OF HUMMERT DATE OF DEATH 10-18-2002 FZLE NUHBER 21 05-0410 /~.C:O, II~ITY CUMBERLAND ACN 101 Amount Remitted REV-lg~i? EX I~Fp (01-n5) FREDERICK N HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR ESTATE OF MUMMERT DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX FREDERICK HFZLE NO. 21 05-0410 ACN 101 DATE 08-25-2003 TAX RETURN NAS: (X) ACCEPTED AS FZLED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1)_ 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) (3) ~. NortH,gas/Notes Receivable (Schedule D) (~) 5. Cash/Bank Daposits/HLsc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expanses/Ad.. Costs/Misc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 11. Total D.ductions 12. Net Value of Tax 183,000.00 5/971.62 .00 .00 22,840.04 16/551.41 .00 (8) 20,238.21 456.65 (11) . NOTE: To insure proper credit ~o your account, subm/t the upper portion of this form wi~h your ~mx payment. ZZ8,5"t5.07 20.694.8~ 207,648.25 DISCOUNT (+) INTEREST/PEN PAXD (-) .O0 ZF PA/D AFTER DATE /NDZCATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. AMOUNT PAID 9,719.17 TOTAL TAX CREDIT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE 9,719.17 9,719.17 .00 .00 .00 ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REI~UZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT" (CR), YOU NAY BE DUE REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) TAX CREDITS: PAYMENT DATE 07-16-2003 RECEXPI' NUMBER CDOOZ809 (12) 13. Charitable/Governmental Bequests; Non-eXacted 9113 Trusts (Schedule J) (13) .00 lq. N.t Value of Esta*m Subject ~o Tax (1fi) 207,648.25 NOTE: Z~ an assessment ~as issued previously, 11nas 14, 15 and/er 16, 17, 18 and 19 ~111 reflect flgures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 1~ at Spousal rata (15) .00 X O0 = .00 16. Amount of Line 1~ taxable at Lineal/Class A rate (16). 202,648.25 X 045 = 9,119.17 17. Amount of Line lq m~ Sibling rata (17).. 5,000.00 X 12 = 600.00 18. Amount of Line 1~ taxable mt Collateral/Class Brm*. (18) .00 X 15 = .00 19. Principal Tmx Due (19)= RESERVATION: Estates of decedents dying on or before December 12, 19aZ -- 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 Coemonaeelth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z~ of ZOO0. (TI P.S. Section 9140). PAYNENT= Detach the top portion of this Notice and submit mith your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REG/STER OF NZLLS, AGENT REFUND (OR): A refund of a tax credit, Hhich Has not requested on 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 Hills, any of the Z5 Revenue District Offices, or by calling the special Z4-hour ansHaring service for forms ordering= 1-BOO-56Z-Z050~ services for taxpayers Hath special hearing and ! or speaking needs= 1-800-447-50Z0 (TT only). OBJECTIONS: Any party in interest not satisfied Hath the appraisement, e11oHance, or disalloHance of deductions, or assessment of tax (including discount or interest) as shoHn on this Notice must object Hithin sixty (60) days of receipt of this Notice by: --Hrittan protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 171ze-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADNIN- ISTRATIVE CORRECTIONS= Factual errors disuovared on this assessment should be addressed in Hriting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment RaviaH Unit, Dept. 280601, Harrisburg, PA l?128-060X Phone (?l?) 787-650S. Sam page ~ of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-ISO1) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid Hithin throe (3) calendar months after the dacedant's death, a five percent (S2) discount of the tax paid is elloHad. PENALTY: The 1~2 tax amnestY non-participation penaltY is computed on the total of the tax 8nd interest assessed, and not paid bi,ore January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in tho same manner and in the the same time period es you Hou]d appeal tho tax and interest that has bean assessed es indicated on this notice. INTEREST: Interest is charged beginning Hath first day of delinquency, or nine (9) months and one (1) day from the date of death, to tho date of payment. Taxes .hich became delinquent before January l, 1gl2 bear interest at the rata of six (62) percent par annum calculated at a daily rate of .000164. All taxes Hhich became delinquent on end after January l, 1982 Hill beer interest et e rata Hhich Hill vary from calendar year to calendar year Hath that rata announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are= Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Yea.__r Rate Factor 1982 202 .00054B 1987 9Z .000247 1999 72 .000192 1983 16Z .000458 1988-X991 112 .000301 ZOO0 8Z .000219 1984 llZ .00030! 1992 92 .000247 ZOO1 92 .000247 1985 13X .000356 X993-1994 72 .000X92 2002 62 .000X64 X986 lOX .000274 1995-1998 9X .000247 2003 5X .000137 --Xntarest is calculated as folXoHs: INTEREST = BALANCE OF TAX UNPAID X NUNBBR OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent wiX] reflect an interest calculation to fifteen (15) days beyond the date of the assessment. Xf payment is made after the interest computation date shoHn on the Notice, additional interest must be calculated. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) 002809 SUNDAY WILLIAM L ESQUIRE 39 WEST MAIN STREET MECHANICSBURG, PA 17055-6230 ........ fold ESTATE INFORMATION: SSN: 182-22-9014 FILE NUMBER: 2103-0410 DECEDENT NAME: MUMMERT FREDERICK M DATE OF PAYMENT: 07/1 6/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/18/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $9,719.17 REMARKS: TOTAL AMOUNT PAID: BARBARA A MUMMERT C/O WILLIAM L SUNDAY ESQ HAND DEL $9,719.17 SEAL CHECK# 564 INITIALS: SK RECEIVED BY.' DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS JRD/June 30, 1992/17858 In Re: Estate of Frederick M Mummert Late of Shiremanstown Borough Estate No.: 21-03-410 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-03-410 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Barbara Roberto and Thomas Mummert Counsel for Personal Representative: William Sunday Date of Decedent's Death: 10/18/2002 Date of Delinquency Notice: 08/11/04 The undersigned, Glenda Famer-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on April 30, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 11/08/04 Distribution: Glenda Famer Strasbaugh Clerk of the Orphans' Court Personal Representative (s) Counsel for Personal Representative Estate File A hearing is scheduled for at in Courtroom No. 3. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled. ~ ~ ~ ~ ~ George E~d~J'p~ mdz\forms\estadm\statusreport.form November 8, 2004 PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Frederick M. Mummert Date of Death: October 18, 2002 Will No.: Admin. No.: 21-03-0410 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is yes, state the following: A. Did the personal representative file a final account with the court? Yes No X Bo The separate Orphans' Court No. (if any) for the personal representative's account is: Did the personal representative state an account informally to the parties in interest? Yes No X Beneficiaries executed Receipts and Releases not being filed herewith. Date: ~ D. ~2Copies of receipts, releases, '.:~ :_:accounts may be filed with attached to this report. joinders and approvals of formal or informal the Clerk of the Orphans' Court and may be Da~ag~r,~Esq~ e/~ Reager & Adler, P.C. 2331 Market Street Camp Hill, PA 17011 (717) 763-1383 Counsel for Personal Representative IN RE: ESTATE OF FREDERICK M. MUMMERT, LATE OF BOROUGH OF SHIREMANSTOWN, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS COURT DIVISION NO. 21-03-0410 PRAECIPE FOR WITHDRAWL and ENTRY OF APPEARANCE To: The Register of Wills and Clerk of the Orphans Court, Please withdraw my appearance on behalf of the Estate of Frederick M. Murnffi~rt effective as of August 25, 2003, the date I was discharged by the Executors.. January. /~" 2004 Date William L. Sunday / Attorney for the Estate of Frederick M. Mummert. Please enter my appearance on the behalf of the Estate of Frederick m. Mummert. ~J'~u~-~'O ° 2004 Reager and Aldler Date By. November 8, 2004 PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE 1S NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedem: Frederick M. Mummert Date of Death: __October 18. 2002 Will No.: Admin. NO.: 21-03-0410 Pursuam to Rule 6.12 of the Supreme Court O'q~hans' Court Rules, l report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No If the answer is No. state when the personal representative reasonably believes that the administration will be complete: _ If the answer to No.1 is yes, ~tate the following: A. Did the personal representative file a final account with the court? Yes ,. No X Date: The separate Orphans' Court No. (if any) for the personal representative's account is; __ the persona representative state an account informally to [he pa'ties m mterest? Yes No X Beneficiaries executed Receipts and Releases not beii~g fded ~erewith. a~al [, Z9/- aP3N xed '~ D. :.: ECopies of receipts, releases, joindcrs and approvals of formal or intbrmal · u,~accounts may be filed with the Clerk of the Orphans' Court and may be Reager & Adler, P.C. 2331 Manket Sheet Camp Hill, PA 17011 (717) 763-1383 Counsel for Personal Representative