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Home My WebLink About03-0415BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 JAMES D HANSEN 814 ARCH ST MECHANICSBURG COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTXCE OF XNHERXTANCE TAX APPRAXSEHENT. ALLOHANCE OR DXSALLOHANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOXNTLY HELD OR TRUST ASSETS Recoro,?c D~ffTE 05- 19- 20 o:~ . :i~STATE OF HANSEN ARLIS R ..~Fj!:;t~: DATE OF DEATH 0~-21-2002 COUNTY CUHBERLAND '03 ~Y 16 ~I~Dc 5o5-5o-7o55 ACN 0212796~ PA 17055 ~¥~K- ~ ~-~i ; ~ ~AEE C~ECE PAVASLE AND RE~[T PAYNENT REGISTER OF ~[LLS CUHBERLAND CO COURT HOUSE Y CARLISLE, PA 1701:5 CUT ALONG THIS LXNE ~ RETAIN LONER PORT[ON FOR YOUR RECORDS ~ REV-1548 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-19-2005 ESTATE OF HANSEN ARLIS Y DATE OF DEATH 04-21-2002 COUNTY CUMBERLAND FILE NO. S.S/D.C. NO. 505-50-7055 ACN TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED 02127965 JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: CITIZENS BANK ACCOUNT NO. 262-108-2664 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ¢ ) TRUST ( ) T[HE CERTIFICATE DATE ESTABLISHED 11-24-1978 Account Balance 5,690.58 Percent Taxable X 0.500 Amount Subject to Tax 1,845.29 Debts and Deduct/ohs .00 Taxable Amount 1,845.29 Tax Rate X .15 Tax Due 276.79 TAX CREDTTS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID INTEREST IS CHARGED THROUGH 05-27-2005 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORH TOTAL TAX CREDXT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE XF PAXD AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. [F TOTAL DUE IS LESS THAN ~1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A **CREDIT** (CR), YOU HAY BE DUE A REFUND. SEE REVERSE STDE OF THIS FORH FOR INSTRUCTIONS. .00 276.79 4.78 281.57 PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S. Section 91~0). PAYMENT= Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. -- Hake check or money order payable to: REGISTER OF HILLS, AGENT. REFUND (CR)= OBJECTIONS= ADMIN- ISTRATIVE CORRECTIONS= DISCOUNT: PENALTY= INTEREST: A refund of a tax credit, which was not requested on the tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-iSIS). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices or by calling the special 24-hour answering service for forms ordering= 1-800-362-2050; services for taxpayers with special hearing and or speaking needs= 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax Cincluding discount or interest) as shown on this Notice may object within sixty (&O) days of receipt of this Notice by= --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in writing to= PA Department of Revenue, Bureau of Individual Taxes, ATTN= Post Assessment Review Unit, DEPT. 280&01, Harrisburg, PA 17128~0&01 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" CREV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three ($) calendar months after the decedent's death, a five percent discount of the tax paid is a11o~ed. The LSX tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before Januar~ 18, 199&, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January i, 1982 bear interest at the rate of six (AX) percent per annum calculated at a daily rate of All taxes which became delinquent on or after Januar~ 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2005 are: Interest Daily Year Rate Factor 1982 20X .000548 1983 16X .000438 1984 11X .000301 1985 13X .00035& 1986 10~ .000274 --Interest is calculated as follows= INTEREST = BALANCE OF TAX UNPAID Interest Daily Interest Daily Year Rate Factor Year Rate Factor 1987 9X .000247 1999 7X .000192 1988-1991 11X .000301 2000 8Z ,000219 1992 9~ .000247 2001 9X .000247 1993-1994 7X .000192 2002 6Z .000164 1995-1998 9Z .000247 2003 5X .000137 X NUNBER OF DAYS DELZNt~UBNT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen C15) 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. LAW OFFICES UNRUH, TURNER, BURKE & FREES A PROFESSIONAL CORPORATION P.O. BOX 289 120 GAY STREET PHOENIXVILLE. PA 19460-0289 Ross A. UNRUH DONALD C. TURNER WILLIAM J. BURKE. III DAVID M. FREES. III' STEPHEN P. LAGOY JOHN K. FIORILLO' ANDREW D,H. RAU DOUGLAS L. KAUNE' BRIAN D. BOREMAN THEODORE F. CLAYPOOLE JOHN P. CONNORS DANIEL P. DWYER SHANNON M. REILLY BRENDAN D. HENNESSY DENISE C. WERKLEY 16101 933-8069 FAX 16101240-9323 MALVERN OFFICE: 116 E. KING STREET MALVERN. PA 19355 16101240-0750 WEST CHESTER OFFICE: P.O. Box 515 WEST CHESTER. PA 19381- 0515 16101692-1371 'ALSO MEMBER, NEW JERSEY BAR March 20, 2006 Cumberland County Register of Wills One Courthouse Square Carlisle, P A 17013 Re: Estate of Arlis Hansen, Deceased File No. 2003-00415 Dear Sir or Madam: Enclosed please find a Status Report for filing. Kindly time-stamp the extra copy and return it to me in the enclosed envelope. Very truly yours, . " I II; : j Tara M. Walters Paralegal tmw Enclosures Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: I- j( I is \ ' \. .'--:/'(l(~"'f~ " Date of Death: j" " I j.J I j D~ Estate No.: ,'" I.., ')1 ' ,- _:I, )i.:~.:' "I..-I t( I ~.~ 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 0 No 00 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: '~,T\ Lt, + h ") 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 0 No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: 1 1/, oC, / /.!,ctV\({ Signature ,/f !I.. l ".,i' "I fit /jL,~), -, ' , t.....:-. >' Y ,''-';. '~t-.y "I "'\":\i, \/ I i( Name r- ( -(("'S. / 1/ '-.- 1 ) J-t,1 (,(1"< f '-< v-'! ~-,- I Address f I; C'1,l It!) I \1 V 1./,_) 'J. Telephone No. ~....._.........;........ '-'apa\.-lL y . n D,...,._r>................l D.o....._al"''O......+......+~.,.TO .L.J. ~ \,.1.1 ':'VJ.la..l J. ,"\..<pJ. v~\.tJ.J.L'.u.J. " v 1X'1 Counsel for personal representative " " 'J", / \\ ,1 LAW OFFICES UNRUH, TURNER, BURKE & FREES A PROFESSIONAL CORPORATION P.O. BOX 289 120 GAY STREET PHOENIXVILLE. PA 19460-0289 Ross A. UNRUH DONALD C. TURNER WILLIAM J. BURKE, III DAVID M. FREES, III' STEPHEN P. LAGOY JOHN K. FIORILLO' ANDREW DH. RAU DOUGLAS L. KAUNE' BRIAN D. BORE MAN THEODORE F. CLAYPOOLE JOHN P. CONNORS DANIEL P. DWYER SHANNON M. REILLY BRENDAN D. HENNESSY DENISE C. WERKLEY 16101 933-8069 FAX 16101240-9323 MALVERN OFFICE: 116 E. KING STREET MALVERN, PA 19355 1610J 240-0750 WEST CHESTER OFFICE: P.O. Box 515 WEST CHESTER, PA 19381-0515 16101692-1371 . ALSO MEMBER, NEW JERSEY BAR March 20, 2006 Cumberland County Register of Wills One Courthouse Square Carlisle, PAl 7013 Re: Estate of Arlis Hansen, Deceased File No. 2003-00415 Dear Sir or Madam: Enclosed please find a Status Report for filing. Kindly time-stamp the extra copy and return it to me in the enclosed envelope. Very truly yours. i I Tara M. Walters Paralegal tmw Enclosures Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: I-J' I de , , ! ~,,) \ , ,'--: /' n" " (i ,.. . Date of Death: /, 'I .Lj ,,). I l ,; .J:. ;; i\J\:/. ')(1 cr' I /.'- .~.x \.> \..i ',_ ~'; '".'" .- ~"~j Estate No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 0 No 00 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: ~ I)'. Cd; + h "; 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 0 No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. > //7 L';,it\/'n J, J / //:'It:) , Signature 7 ~' t,.?rV Date: 1 I /, 0 L, I I " \\;Vf( ..I....'., ! ,- Name ,,r i('S I ,i i .... i . 0' J 0' I I {.... .)...1./ U (c.",j Address I i. i i. C l. / f'ffi (/:-. '" I v 1.../_) v,;._ Telephone No. =:r 0....._,..........;......... L<1jJ<1....JLy. n D........,...,,,..........l Do...........a("t:)........+.....t~"(Ta .L...l J. \",tl.",VJ..1(.L.J. J..'-\.,t!-'.l.""~\".;.l.H"U.U \' v ~ounsel for personal representative J ".. /' \\ ,~ Register of Wills of Cumberland County CERTIFICATION OF NOTICE UNDER RULE 5.6(A) Date of Death: Brit's r Ha~~n 4/.{' /-1- ~ 003 -- 00 'lIS- Name of Decedent: Estate 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 Name h~tt ~s ~ f/O ~r u e llJ ~ bl);LO !-kt 2 f f fA 11 , &1 adt{.'71H ~ ~ /9;1/5 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Lt._ c.: Date: sk;, !O/f ..::1" I / o flv;J vYl /t.AJ?.. ~ Signature ~OlV/ri. rn. (;/tS. IlL ./ Name LL-1 - C) LL' t~: c.) Lu f,~:) t:.~~, () Li-j r-,- {'-.J (") ('cJ /2JJ GCU; St- ~s ~ ~ XVI IIL- teA- / 7t/-(; 0 Telephone I{;""":_- '-.":"::> c::::; c.:::-J C'.J \._-' .-- Capacity: ~PersonalRepresentative X Counsel for personal representative c) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 Date: 05/18/2006 HANSEN BRUCE JAY 5020 HAZEL AVE PHILADELPHIA, PA 19143 RE: Estate of HANSEN ARLIS Y File Number: 2003-00415 Dear Sir/Madam: This notice is to serve as a reminder that the Certificate of Notice under Rule 5.6(a) is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his councel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing is due by: 06/11/2006 Please feel free to contact this office with any questions you may have. If you have already filed your certificate, please disregard this notice. Si~'~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 Date: 05/18/2006 DAVID M FREES III 120 GAY ST PHOENIXVILLE, PA 19460 RE: Estate of HANSEN ARLIS Y File Number: 2003-00415 Dear Sir/Madam: This notice is to serve as a reminder that the Certificate of Notice under Rule 5.6(a) is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July I, 1992, the personal representative or his councel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing is due by: 06/11/2006 Please feel free to contact this office with any questions you may have. If you have already filed your certificate, please disregard this notice. Si~1:~~ v Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) STATUS REPORT UNDER RULE 6.12 BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND , PENNSYLVANIA Name of Decedent: HANSEN, ARLlS Y. Date of Death: 4/21/2002 File No. 00415 - '1 i ~ ,.1- .1\ '- v 1 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to the completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: '....) YES~ NO~~ 2. If the answer is "No", state when the personal representative reasonably believes that the administration will be complete: 3 If the answer to NO.1 is "Yes", state the following: a. Did the personal representative file a final account with the Court? a YES ~_ NO _)(~ b. The separate Orphan's Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? YES~ NO__ d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report.. Date: 7/14/2006 Signature "-:JV--,- K_Pr,.,.J David M. Frees, III Name (Please type or print) 120 Gay Street Address Phoenixville . EA 19460 6109338069 Tel. No. Capacity: Personal Representative ~ Counsel fOI" personal representative REV-\500 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 r ?_L-~.L~~~-L 5 COUNTY COOE YEAR NUMBER- DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) I- Z W o W U W o HANSEN, ARLlS Y. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) SOCIAL SECURITY NUMBER 5 0 5 - 5 0 - 7 0 5 5 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER UJ ~ ~ ~U) ....o::~ Ull.u UJ 00 :I: 0::-, U ll.al ll. < 04/21/2002 07/21/1935 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST. AND MIDDLE INITIAL) D 3. Remainder Return (date of death prior to 12-13-82) D 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) JAMES HANSEN [X] 1. Original Return D 4. Limited Estate [X] 6. DecedentDied Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copyofTrust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAXINFOl'lMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS z o t= <( ...J ::J !:: a.. <( U W 0::: 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) ~ Z UJ o Z o ll. U) UJ 0:: 0:: o U FIRM NAME (If Applicable) TELEPHONE NUMBER OFFICIAL USE ONLY (6) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) ,(-~J (-'-) (7) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 40,518.30 I (8) 40,518.30 40,518.30 X _(15) 0.00 0.00 X _(16) 0.00 0.00 X .12 (17) 0.00 0.00 X .15 (18) 0.00 (19) 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o I- <( I- ::J a.. ~ o u ~ I- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) (11) (12) (13) 40,518.30 16. Amount of Line 14 taxable at lineal rate (14) 40,518.30 17. Amount of Line 14 taxable at sibling rate 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 18. Amount of Line 14 taxable at collateral rate 19. Tax Due Dacedent's Complete Address: STREET ADDRESS 814 N. Arch Street CITY Mechanicsburg I STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 0 + E) (3) 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 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 0.00 0.00 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; ........................................................................... 0 [Xl b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 [Xl c. retain a reversionary interest; or ...................................................................................................... 0 [Xl d. receive the promise for life of either payments, benefits or care? ............................................................. 0 [Xl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................. 0 [Xl 3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death? ................. 0 [Xl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... [Xl 0 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 i ased on all information of which preparer has any knowledge. SIGNATURE OF T--:PONSIBLE FO ING RETURN ~ D~E / i/ ':;' ADDRESS 5020 Haze Av P iladel hia SIGNATURE OFiP tARER OTH~R THA~fEPRESEN!ATIVE I .,,\~ J..~ , PA 1914;3 DAT~ J It/I r; / ADDRESS h/~" 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. S9116 (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. S9116 (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. S9116(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. S9116(1.2) [72 P.S. s9116(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. s9116(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. REV-1510 EX + (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY 00415 ESTATE OF HANSEN. ARLlS Y. FILE NUMBER 03 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 DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER THE DATE Of TRANSfER ATTACH A COPY Of THE DEED fOR REAL ESTATE. VALUE OF ASSET INTEREST VALUE (If APPLICABLE) 1. T. Rowe Price Investment Services, Inc. 14,468.47 1010. 14,468.47 Brokerage Advantage Rollover IRA 30A192456 per attached - Prime Reserve 2. T. Rowe Price Investment Services, Inc. 15,632.55 1010. 15,632.55 Brokerage Advantage Rollover IRA 30A 192456 per attached - GNMA 3. T. Rowe Price Investment Services, Inc. 1,006.07 100. 1,006.07 Brokerage Advantage Rollover IRA 30A192456 per attached - Blue Chip Growth 4. T. Rowe Price Investment Services, Inc. 9,411.21 100. 9,411.21 Brokerage Advantage Rollover IRA 30A 192456 per attached - Equity Income 5. T. Rowe Price Investment Services, Inc. 6,288.32 0.00 Brokerage Advantage Rollover IRA 30A 192456 per attached - New America Growth TOTAL (Also enter on line 7 Recapitulation) $ 40,518.30 (If more space is needed, insert additional sheets of the same size) RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. James D. Hansen Spousal 40,518.30 814 N. Arch Street Mechanicsburg, PA ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS API:JROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ .. SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HANSEN ARLlS Y (If more space is needed, insert additional sheets of the same size) FILE NUMBER 03 00415 T. ROWE PRICE INVESTMENT SERVICES, INC. BROKERAGE WWW.TROWEPRICE.COM P.O. Box 17435 Baltimore. Maryland 21297-1435 4515 Painters Mill Road Owings Mills. Maryland 21117 -4903 Toll-free 800-225-7720 Fax 410-345-6244 March 23, 2006 David M Frees III Esq Unruh Turner Burke & Frees PC PO Box 289 Phoenixville P A 19460 Subject: Estate of Arlis Y. Hansen Brokerage Advantage Rollover IRA 30A192456 Dear Mr. Frees: We received a request from Bruce J. Hansen, the executor of the estate of Arlis Y. Hansen, to provide you with information regarding the T. Rowe Price account of the late Mrs. Hansen. At the time of her death, Mrs. Hansen held with us only the account shown above, which is a Rollover IRA. The account was established June 1, 2000. Below is the requested valuation of the account holdings as of April 21, 2002: Fund Name Number of Share Balance Accrued Shares Price Dividends * Prime Reserve 14,455.690 $1. 00 $14,455.69 $12.78 GNMA 1,632.257 $9.55 $15,588.05 $44.50 Blue Chip Growth 35.727 $28.16 $1,006.07 N/A Equity Income 384.131 $24.50 $9,411.21 N/A New America Growth 217 .288 $28.94 $6,288.32 N/A * Accrued dividends are not included in the balances shown. The Prime Reserve Fund dividends were reinvested on April 30, 2002. The GNMA Fund dividends were reinvested May 2, 2002. T.Rowellice 1i.. INVEST WITH CONFIDENCE The beneficiary designation on the account is as follows: . Primary beneficiary: James D. Hansen, 100%. . Secondary beneficiary: Bruce J. Hanson, 100 % . It is our understanding that the primary beneficiary, James D. Hansen, passed away after Mrs. Hansen. If this is the case, the assets belong to Mr. Hansen's estate. Therefore, to distribute the assets to Mr. Hansen's estate, we need the following: · A completed Inherited IRA Distribution Request Form for Beneficiaries. The executor of James D. Hanson's estate must obtain a signature guarantee in Section 8 by signing it while in the presence of an authorized guarantor. The guarantor will then affix a signature guarantee stamp and sign it. Authorized guarantors include FDIC-insured banks, brokerage firms, securities dealers, trust companies, and dealers that are members of a domestic stock exchange. For signature guarantees from a member of the Medallion Signature Guarantee program, the guarantor should be made aware of the dolIar amount involved to ensure that the level of coverage is sufficient. We cannot accept signature endorsements or guarantees from notaries public or other organizations that do not provide reimbursement in the case of fraud. . A certified copy of the letters testamentary appointing the executor of Mr. Hansen's estate. While a copy is acceptable, it must be certified by the court within 60 days of our receiving it. . A certified copy of the death certificate for James D. Hansen. The copy must be certified by the issuing authority. If you have any questions, please call a Brokerage representative at 1-800-222-7002. Representatives are available Monday through Friday from 8 a.m. to 8 p.m. ET. Sincerely, 6~~ John Donahoe Senior Account Services Representative Correspondence Number: 00969353 Enclosure(s): IRA Distribution Req. for Beneficiaries Envelope (PPD-DB) T.Rowellice 1i.. INVEST WITH CONFIDENCE 2153512535 SHM .. .~_....._..~...... ".IOUI'" allOW VI:;:IIIUI ,."rI:,1r'1...11:13 CERTIFICATE OF DEATH PAGE 02/03 ", 01/23/2005 12:10 ......6'0 'L~tIJ STAT" lOSE ONLY frl'''''"11ll''lll'2In!l-l!lwW b\I ~ll"tltM Olt.(.~_ Tntw>~JToI"~~ ~""ofi."~ '--.-. r----. i "----". V\ ~~ i '1- " ~ it 1 ~ ~ ~ ~ ~ ~ .. (J 1; ;; ~ i I. ""ME 011 OlOCFASeQ (/'1rM1 11IlI\'~111 ~ I "--' ;TATE USE ON~V ~O.rocc ~~I':;j: lACE or /I.CC.. !:lOse Cl.M~. A.l1s Yvonne Hansen C ~Q h~ ~N ;:mYES DNO 1.7055 1'.~It"I'LST^TW o NEVI!;R MARRIED 0 WlOOWeO X>>o1A~:FllliCl l:l DIVOFlC~D 14, KtMO 0'" S\JS"~IF,i3 Ot'\lrmLr.'i;TRY Nurs:!."g 7, o"rr Ot" Or:'.ATJ.4 C.h.\ftK)f.1'l1'B~ ~.~b~11;)~Y 4/21/02 ~ --p-- ~ MIn.,.", O. ~Ocu\'L see. JIll;). 5 055 OTHER, 0001, 0 NURSING HOMe r.J RESIDENC!: Cl OTHER (Sf'Ilcl'YI u.. crry /l'0Wft OR ~OCJ\TIOI't N. a:JUNT'Y Unive~61ty Hnsp. O~ FJII. J:1e!UDtNCJi. BiI. COUNT'!' 1~"'I.1 P8. Cumbp.rland Newa~k Essex EJIof.INSIDI:arrUMrr:>.'I' ~.Z]f"CDDI: Meehenicaburg Ar~h St. 101. ~~~~r:r Mn 'IN ".S. ,1\".0 tDIJ. ~'?d ;~~IT.,t ClYESXiINO N/A U. U5;UAl OCCUroATl()H (I(IN!I af-wt rfQrwIo m_1 GI fir",,, """" tt4.!rwd) Regl~tered Nurse cJ ':::. ,,.., NJ\~AI(DADORt;sa Q;r ~T 1t~(Jn::l\ Health Sou~h M~chanl~5burg Reh~b floep., Mcchanie~bu~g, Pa, 30 AMER INDIAN '1. 'HI""'.'CO'"C'"' 10 M~XICAN 2I:l PUERTO RICAN 40 OTH~R (Specifvl: ,. y~~ ,,,,,,IFV, 3Q CUBAN 4I:J CENT.lSO. AME~ICA o YES ~O 50 OTHER /Spadfy': (~ 2O,~"NAIIl'(C)f=MO'tt1~~~' fUl.tl ~;r ~-oj- '".IIlAc-1! XXl WHITE :2 tJ BLACK tJIi. RAMI; OF FAt"D ~Rrmll :26. :'ii'^ n: 17109 18. t!rt::alR'IT"sel>\lcAnDfll 1'l)Q+l.ttt;""~~H 16 CM/IedI'II1 "'- Le",tcr W. Denn ~l....tiAMeorlN~~.6,M ::l3'_,OIBf'l:) moN' o IIURIAL li'J;lI;REMAilON t:l OTIotEFl (Sl)ecifyl: o ENTOMBMENt JameR H.!InsE!f\ .iI::l'b, NAME (l"l:~"n:ll\'"OPI C~"'T(1AY C~ernatlon Society o~ ?enneylvanla P{1. :tJ.. .iliAA''' "NQ ~~:;s OF FUHEMLttaMli FUMral t-1ome, Inc. 1677 HAn;l,~on St. Ph11a. PII. 19124 :7~, 0", T"E 8fOkC:D IMMEDIATE CAiJSi:(Fina' o'i$:an::01:l ~ condi1iortrn~~r'~- ing In d8B~"1. SnElIl~ntI81fv 1191 cOnditionS,lf 'nY, Icl~d. ina fa ;mlTJlJdls.e- t~USIJ, .ntnrl,lNOERLYlNGCAI,/Se rDln.ase or injury t~81 i~. Ili&tOd DV'R"t, "I~urting In dn.th) LAST. INflmVAt, At;TWEEf\l aN- ~~"'"[I tll!AlM ) ).\..j II'\. 7" l-IJ..JC-- OI5Cf-TSE d, rAIlT "= O'lhlW j.~trtunt r.aMl~loot _"""frlbl~ 1t.e..th bou1",.. "',"HfG. ~e"~ In ""nT I ]1, If.'ff.M^l~wl\::f~~ !l~€QNA"'" A' DJ:"'1l1. 0" AN't'TIMF; 900A"'; MlIDR TO DEAnU ;ZS, YrA:S ...urOr9" PEfI'O~MctI~ t1 yeS CrYliS NO 0110 2'. OEA1~ [ItJ[;j TO: 'llf NATURAL "d ACCIDENT a sUICloe o HOl>/lICJOE .)Oil. bA.Tt c~ ~JVA'l" ,:IQI,TlMfOFIN.1VfIY JOe."'.,II.1nY}-.TWQR"i~ M oy~s ONO o HOME 0 FARM o OFRce BUILDING 0 FACTORY JOd. m;"CPI~1:: HO\~ lfUI.JnY OCCURREO o PENDIIlG IN- VESTIGATION o COUlO NOTSE DETERMINE!> 3()t.J"l.ACJ;; Cl STRHT o OTHER (Sp8ciM' H"'933 ;311.. TO DU: "'EaT 04" M1' lQ'II ~(:TiMAl\I"E Of CRmRF.A JICl'. L.QC^TIOH m l1I..1lJ"RYI1iu~ 11Id':;trwlKl ",'*- ~ ANOAOOM!:;!:O CJJ:'I;I;ATIJ:'IE" C~\.r$ -CheiTj!HllfTownship ...--- THIS WILL HEREBY CERTIFY THAT 'tHE FOREGOING IS A TRUE COpy OF A RECOR)) FILED IN MY OFFICE. WARNING: DO NOT ACCEPT THIS COpy UNLESS THE RAISED SEAL OF T?!OWNSffiP ~F CHERRY lULL IS AFFIXED. MI.. NANCY L AFFOS, REGISTRAR tJ 4- - cJ.3 --Od-- DATE OF ISSUE Last Will And Testament Of ARLIS Y. HA1VSEN I, ARLIS Y. HANSEN of the BOROUGH of MECHANICSBURG, COUNTY of CUMBERLAND, COMMONWEALTH of PENNSYLVANIA, being in good bodily health and of sound and disposing mind and memory, and not acting under duress, menace, fraud, or undue influence of any person whomsoever, merely calling to mind the frailty of human life, and being desirous of disposing my worldly goods while I have the strength and capacity so to do, I do make, publish and declare this my LAST WILL AND TESTAMENT. I hereby revoke, cancel and annul all my former Wills and Testaments, including codicils thereto, by me at any time made, and declare this alone to be my LAST WILL AND TESTAMENT. AS TO SUCH ESTATE IT HAS PLEASED GOD 1:0 ENTRUST ME WITH IN THIS LIFETIME, I DISPOSE OF THE SAME AS FOLLOWS, VIZ: ITEM 1. I direct that my Executors hereinafter named, pay and discharge all of my just debts, funeral and testamentary expenses. ITEM 2. I order and direct that my bodily remains be cremated. Further, I order that my remains be placed for permanent burial at the Fort Indiantown Gap Military Cemetery. ITEM 3. An the rest, residue and remainder of my entire estate, wheresoever situate, and whatsoever it may consist of, I give, devise, and bequeath, absolutely, and in fee, to my dearly beloved husband JAMES D. HANSEN. In the event my dearly beloved husband dies with me in a simultaneous disaster, or fails to survive my death by thirty (30) days, then I give, devise, and bequeath my entire estate, wheresoever situate, and whatsoever it may consist of, to BRUCE J. HANSEN, provided BRUCE J. HANSEN survives by thirty (30) days. In the event that BRUCE J. HANSEN does not survive my death by thirty (30) days, then I give devise, and bequeath my entire estate, whereso,ever situate, and whatsoever it may consist of, to ALFRED T. DENNY, per stirpes. l\r) '9..,,)::::> q, ~W\) ,)J~rn \ ARLIS Y. HANSEN ITEM 5. I nominate and appoint JAMES D. HANSEN as Executor of this my LAST WILL and TEST AMENT. Should the Executor named fail to qualify or cease to act as Executor then I appoint BRUCE J. HANSEN as E'fecutor in his stead. In the event that BRUCE J. HANSEN, cannot serve, then I nominate and appoint ALFRED T. DENNY, in his stead. ITEM 6. I hereby direct that all my personal representatives; as well as their successors, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. ITEM 7. I order and direct that my Personal Representative(s) named herein use the legal services of JAMES M. BACH, as Attorney for my Estate. ITEM 8. I direct that all estate, succession, legacy, inheritance or other transfer taxes, however designated that shall become payable by reason of my death in respect of all property comprising my gross estate for tax purposes, whether or not such property passes under this LAST WILL, shall be paid by my Executor out of my residuary estate. ITEM 9. I grant to my personal representatives herein named, in addition to, but not in limitation of those powers vested by law, to be exercised without prior application to or approval of any court, the power and authority to retain indefinitely any property, to invest and reinvest any assets or the proceeds derived from the sale of assets, although said investments may not be of the character prescribed by law, to sell, convey, assign, transfer and encumber any property, to pay, settle or compromise all claims, to make distribution or divisions in cash or in kind, and in general to exercise all powers in the management of any property hereunder which any individual could exercise in the management of similar property owned in his own right, and to execute and deliver any and all instruments and to do all acts which may be deemed necessary and proper. ~'\~ ~. ~\~ ARLIS . HANSEN WITNESS ~~ WlTN~SriJu. LL U~ LI AM. WADGE ====================END==================== Page 2 of 3 ACKNOWLEDGMmI COMMONWEALTH OF PENNSYLVANIA) ) ss COUNTY OF CUMBERLAND ) I, ARLIS Y. HANSEN, the TESTATRIX, whose name i~ signed to the attached or foregoing instrument, having been duly qualified accerding to law, do hereby acknowledge that I signed and executed the instrument as my LAST WILL; that I signed it willingly; and that I signed it as my free and voluntary act for the purpose therein expressed. Sworn to or affirmed and acknowledged before me, by: ARLIS Y. HANSEN, the TESTATRIX this 30TH day of October ,1997. ~~ ~. \\~') ARLIS Y. \:VIANSEN AITORNEY J NOTARIAL SEAL AMES M. BACH Nofa{y M Cuml:lerlllnd COtJ~ly PlitJ<<c Y CommissIOn Expires May 13, 1 m S M. BACH, ESQUIRE NOTARY PUBLIC Mechanicsburg, PA 17055 My Commission Expires: 05/13/99 AFFIDA VIT COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND We, JOHN NUGENT and LISA WADGE, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw TESTATRIX sign and execute the instrument as her LAST WILL; that the TESTATRIX signed willingly and that she executed it as her free and voluntary act for the purpose therein expressed; that each witness in the hearing and sight of the TESTATRIX signed the WILL as witnesses; and that, to the best of our knowledge, the TESTATRIX was, at the time, 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and acknowledged before me, by: JOHN NUGENT and LISA W ADGE, witnesses, this ~ day of October, 97. WITNESS~_1J. ~ HNN GllNT WITNESS ~' SM. BACH, ESQUIRE NOTARY PUBLIC Mechanicsburg, PA 17055 ommission:Expires: 05/13/99 My Page 3 of 3 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE R'-('0n"rT'I (lrr'I'E ,....,t:: \b,,,<s.JrUtG \j.i:v_ I,); NOTICE OF INHERITANCE TAX BUREAU OF INDIVIDUAL T~'C":J ' '. -lPPRAISEHENT" ALLOWANCE OR DISALLOWANCE INtERITANCE TAX DIVISION . C')..); '-.., ~., OF DEDUCTIONS AND ASSESSHENT OF TAX PO BOX 280601 HARRISBURG PA 17128-0601 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-18-2006 HANSEN 04-21-2002 21 03-0415 CUMBERLAND 101 APPEAL DATE: 11-17-2006 ( See reverse side under Objections) AIIount R_i tted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE" PA 17013 ~~!_~~g~_!~~!_~~~J_-----~--_!!!&J~_~9~!!_~9!!J9~_E9!_!9~!_!!~9!P!__~____________________ REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ARLIS V FILE NO. 21 03-0415 ACN 101 Z006 SEP 18 Pfi 2: 57 DAVID M FR~~~r" 120.GAV ST PHOENIXVILLE PA 19460 ESTATE OF HANSEN TAX RETURN WAS: (X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..l Estat. (Schedule A) 2. Stocks and Bonds (Schedul. B) 3. Closely H.ld Stock/Partnership Interest (Schedule C) 4. HortgageslNotes Receivable (Schedule D) S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets ( ) CHANGED (1) (2) (3) (4) (S) (6) (7) .00 .00 .00 .00 .00 .00 40.518.30 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/A~. Costs/Hisc. Expenses (Schedule H) (9) 10. Debts/Hortgage Liabiliti.s/Liens (Schedul. I) (10) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Govern-.ntal Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subj.ct to Tax I~ an asses~ent was issued previOUSly, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total ~ ~ returns assessed to date. ASSESSMENT OF TAX: IS. A.aunt of Line 14 at Spousal rat. (IS) 16. AMount of Line 14 taxabl. at Lin..l/Class A rat. (16) 17. Mount of Line 14 at Sibling rat. (17) 18. A.uunt of Line 14 taxable at Collat.ral/Class Brat. (18) 19. Principal Tax Due D : NOTE: DATE NUtlBER INTEREST/PEN PAID (-) · IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 .00 (11) (12) (13) (14) 40.518.30 X .00 X .00 X .00 X AttOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE '* REV-1547 EX AFP (06-05) ARLIS V DATE 09-18-2006 NOTE: To insure proper credit to your account" subllit the upper portion of this for. with your tax paYll8l\t. 40,,518.30 nn 40,,518.30 .00 40,,518.30 00 = 045 = 12 = 15 = .00 .00 .00 .00 .00 (19)= .00 .00 .00 .00 [) ( IF TOTAL DUE IS LESS THAN $1. NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) STATUS REPORT UNDER RULE 6.12 Name of Decedent: HANSEN ARLlS Y. Date of Death: 4/21/2002 Will No. 2103-0415 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans I 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 completCt-) Y~ x ~ ~o "c." " ::IJ :go ';~ t;; __"'0 C/) ;.K C) C) C) '11 C :0 If the answer to No. 1 is Yes, state the following: --I -0 ~7 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. a. account with the Court? Did the personal representative file a final Yes No X b . The separate Orphans I Court No. (if any) for the personal representative I s account is: 1'"'--' c::> = CI"' c:> (J .--. I N -xJ ~. r:!..) ~~ t3 ,n CJ (~) :::r"1 ~~; ~ -0 ::n::: .J;:"" ~ -~.' '~'4 co c. Did the personal representative state an account informally to the parties in interest ? Yes No X ~)(eelJ-h> r /5 50\( b-entt, d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans I Court and may be attached to this report. iJ~ vi) ,1CA10 Signature I Date: 9/28/2006 JlI -k David M Frees III ESQuire Name (Please type or print) 120 Gay Street Phoenixville PA 19460 Address (610 ) 9338069 Tel. No . Capacity : Personal Representative '\-:: ' - va....;1 :': ,,'''_','",;1:',11"''/1 ltiilC() ~~'I;\""'~~I~wO-.! IJ .,I . ~,. U4..,."I jO >ldJIQ IS: I Wd Z - IJO 900l X Counsel for personal representative ':) ,II ~'!/~J ]'''-''!;,-,Ij,,c"') /""/""i.'jl ,(""\....\- _..\...... -.J'\..J'1.J--1\ t U--jl 1:>,,< I, 'r,,! '-' ..dl;'vvJd LAW OFFICES UNRUH, TURNER, BURKE & FREES A PROFESSIONAL CORPORATION P.O. BOX 2B9 120 GAY STREET PHOENIXVILLE. PA 19460-0289 Ross A. UNRUH DONALD C. TURNER WILLIAM J. BURKE. 111+ DAVID M. FREES. 1\1- STEPHEN P. LAGOY JOHN K. FIORILLO- ANDREW D.H. RAU DOUGLAS L. KAUNE- BRIAN D. BOREMAN THEODORE F. CLAYPOOLE+ JOHN P. CONNORS DANIEL P. DWYER SHANNON M. REILLY BRENDAN D. HENNESSY DENISE C. WERKLEY 16101 933-B069 FAX 16101 240-9323 MALVERN OFFICE: 116 E. KING STREET MALVERN. PA 19355 16101 240-0750 WEST CHESTER OFFICE: P.O. Box 515 WEST CHESTER. PA 193BI-0515 (6101692-1371 OF COUNSEL ANTHONY T. VERWEY -ALSO MEMBER. NEW JERSEY BAR + LLM IN TAXATION September 28, 2006 Cumberland County Register of Wills One Courthouse Square Carlisle, P A 17013 Re: Estate of Arlis Y. Hansen, Deceased File No. 2103-0415 Dear Sir or Madam: Enclosed please find a Status Report for filing. Kindly time-stamp the extra copy and return it to me in the enclosed envelope. If you have any questions, please do not hesitate to call or contact me. Very truly yours, / I / ~VnW~ Tara M. Walters Paralegal tmw Enclosures Vc_ .\('18 lu(" n,'\"; , Ii,..jO 01 10,-.,11...; ~). ,- ;,:-j..../ :JO >itH18 IS: I ~Id 2- 1JO 900l , . , " .Ji-1 -'('j:J..J(\ cr,..C..;(\":.,',..; _'v JIJ'..;...i'J 'IJ..J'\.Jo\.:>J.;::u Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/07/2006 HANSEN BRUCE JAY 5020 HAZEL AVE PHILADELPHIA, PA 19143 RE: Estate of HANSEN ARLIS Y File Number: 2003-00415 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/21/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, .b~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel v~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/07/2006 DAVID M FREES III 120 GAY ST PHOENIXVILLE, PA 19460 RE: Estate of HANSEN ARLIS Y File Number: 2003-00415 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/21/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, i.1a/t.1.";"P t\~'MJ ~/~N"'.I ; ~; -~," .... ., ,.)' ,.. ' ." .'. -",,-.. .;. . . Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) v'Y