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HomeMy WebLinkAbout04-0744Register of Wills Cumberlandcounty, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Donna J. Parks also known as Donna Jane Parks , Deceased Ray Richard Strayer, {COMPLETE "A" OR "B~ BELOW:} Social Security No. 164-30-2891 A. Probate and Grant of Letters and aver that Petitioner(sD is/are the execut or named in the Last Will of the Decedent, dated July 7~ 2004 and codicil(s) dated Except as follows, Decedent did nor marry, wes not divorced, and did not have a child horn or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse any) and heirs: Name Ralstionship ~._., ~ Ras~denc.e :~ {COMPLETE IN ALL CASES:) Attach additional = heats if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 1280-A Boiling Springs Road, Boiling Springs, Allen Township, Cumberland County, Pennsylvania 17007 Decedent, then 66 years of age, died August 3 ,20 0~_, at 1280-A Boiling Springs Read, Boiling Springs. Decedent at death owned property with estimated values as follows: en Township, Cumberland County, PA (If domiciled in PA) All personal property .............................. $ 100,000.00 (if not domiciled in PA) Personal property in Pennsylvania ...................... $ (If not domiciled in PA) Personal property in County .......................... Value of real estate in Pennsylvania ............................................... $ 150,000.00 Total .......................................................... s 250 000.00 Peel Estate situated as follows: 1280-A Boiling Spr nqs Road~ Boilinq Sprinqs, Allen Township, Cumbe~an ounty, Wherefore, Petitioner(si respectfully request(s) the probate of the last Witl ar~ Codicil(si presented with this Petition and the grant of letters in the appropriate form to the undersigned: ~/~.*~ Signature Typedorprinted,ameand residence ~'/?C~ /~ ~J.~./~._/ Ray Richard Strayer 889 King Street, Lewisberry, PA 17339 RW-7 Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and ~orrect to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to and affirmed and subscribed before me this ... { /'~- ' day of 2004 /q Strayer DECREE OF REGI Estate of Donna J. Parks also known as Donna Jane Parks Deceased .o.D.I- oq-qq Social Security No: 164-30-2891 Date of Death: August 3, 2004 AND NOW, , 20. , in consideration of the Petition on the reverse side hereon, ~atisfactory proof having been presented before me, iT IS DECREED that Letters [~ Testamentary [] of Administration are hereby granted to Ray Richard Strayer in the above estate and that the instrument(s), if any, dated July 7, 2004 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........................... Short Certificate(s) .......... Renunciation .................. Affidavit ( ) ................. Extra Pages ( ) ............ Codicil .......................... JCP Fee ........................ Inventory & Tax Forms... Other ............................ R~-7a Attorney: Crai,q A. Hatch~ Esquire I.D. No: 76361 Address: Gates, Halbruner & Hatch, P.C. 1013 Mumma Road, Suite 100, Lemoyne, PA 17043 Telephone: (717) 731-9600 DATE FILED: ~ ,,x- Cumberland 1280 A Boiling Springs Road Boiling Springs, Pennsylvania 17007 COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ~onna Jane Parks 2 Female ~ 164 -- 30 2891 HerndonR Strayer Bernice E Gettys 889 King Street Lewisbem/ Pa 17339 Conolite Crematory ~,. Scha~ffers~owr[ Pa 17088 - // '"'"': .... ~' dy Will of Donna J. Parks Part 1. Personal Information I, Donna J. Parks, a resident of the State of Pennsylvania, Cumberland County, declare that this is my will. My Social Security number is 164-30-2891. Part 2. Revocation of Previous Wills I revoke all wills and codicils that I have previously made. Part 3. Children ~ I have the following children now living: Arthur James Parks and Margaret Marie Lee. Part 4. Grandchildren I have the following grandchildren now living: Brian Dominick Yufer, my grea~-grandson and Brian Todd Yufer. Part 5. Dispogition of Property All beneficiaries must survive me for 45 days to receive property under this will. As used in this will, the phrase "survive me" means to be alive or in existence as an organization on the 45th day after my death. All personal and'real property that I leave in this will shall pass subject to any encumbrances or liens placed on the property as security for the repayment ora loan or debt. IfI leave property to be shared by two or more beneficiaries, it shall be shared equally by them unless this Will provides otherwise. IfI leave property to be shared by two or more beneficiaries, and any of them does not survive me, I leave his or her share to the others equally unless this will provides otherwise for that share. "Specific bequest" refers to a gift of specifically identified property that I leave in this will. "Residuary estate" means all property I own at my death that is subject to this will that does not pass under a specific bequest, including all failed or lapsed bequests. I leave my birthstone ring; wedding rings; Mother's ring; big screen television; my Bible; my shawl; and, for reasons best known to her, the amount of one thousand dollars ($1,000) to Margaret Marie Lee. If Margaret Marie Lee does not survive me, I leave this property to Brian Dominick Yufer, my great-grandson. : ) Will of Donna J. Parks I leave the angel pictures and pictures of Christ I painted; my bedroom suite, which is already in his possession; my IBM compatible computer; one (1) of my state quarter collection books; and, for reasons best known to him, the amount of one thousand dollars ($1,000) to Brian Todd Yufer. If Brian Todd Yufer does not survive me, I leave this property to Brian Dominick Yufer, my great-grandson. I leave my adjustable (hospital type) bed to Keith Strayer. IfKeith Strayer does not survive me, I leave this property to Ray Richard Strayer, Rosella Jean House, Nancy May McCoy and Winnifred Ida Kovecevic in equal shares. I leave pictures of my brother and sisters; the bedroom furniture from my second bedroom, which is already in his possession; my roll-top desk; one (1) of my state quarter collection books; and the balance remaining (after satisfying any and all debts owed by me) from the sale of my homes and automobile to be placed in a trust fund I have established at F& M Trust to Brian Dominick Yufer, my great-grandson, the joy of my life. I leave the amount of forty thousand dollars ($40,000) to Ray Richard Strayer, Rosella Jean House, Nancy May McCoy and Winnifred Ida Kovecevic in equal shares. I leave my krugerrand; and, the amount of thirty thousand dollars ($30,000) to Arthur James Parks. If Arthur James Parks does not survive me, I leave this property to Brian Dominick Yufer, my great-grandson. I leave my blue-point Persian cat, Tiffany to Peggy Ann Harter. If Peggy Ann Harter does not survive me, I leave this property to Sandra Lee Massie. I leave my two (2) remaining cats, Pita and Printz; and, the amount of one thousand dollars ($1,000) for the loving care they gave me during my illness to John Backenstoes and Loft Backenstoes in equal shares. I leave the amount of five thousand dollars ($5,000) to the Helen O. Krause Animal Foundation, Inc. I leave the amount of five thousand dollars ($5,000) to the ministry of Dale Danner and the ministry of Kay Danner in equal shares. I leave the amount of one thousand dollars ($1,000) for the loving care she gave me during my illness to Sandra Lee Massie. If Sandra Lee Massie does not survive me, I leave this property to Peggy Ann Harter. Page2of$ Initial,:~/~_~_ --~t~\ Date: Will of Donna J. Parks I leave the amount of one thousand dollars ($1,000) for the loving care she gave me during my illness to Sue Miller. If Sue Miller does not survive me, I leave this property to Owen Strickler, Ashlee Peters, Eric Peters, Amanda Stine and Jacob Stine in equal shares. I leave my residuary estate to Brian Dominick Yufer, my great-grandchild. Part 6. Executor I name Ray Richard Strayer to serve as my executor. If Ray Richard Strayer is unwilling or unable to serve as eXecutor, I name Rosella Jean House to serve instead. No executor shall be required to post bond. Part 7. Executor's Powers I direct my executor to take all actions legally permissible to have the probate of my will done as simply and as free of court supervision as possible under the laws of the state having jurisdiction over this will, including, filing a petition in the appropriate court for the independent administration of my estate. I grant to my' executor the following powers, to be exercised as he or she deems to be in the best interests of my estate: 1) To retain property without liability for loss or depreciation. 2) To dispose of property by public or private sale, or exchange, or otherwise, and receive and administer the proceeds as a part of my estate. 3) To vote stock, to exercise any Option or privilege to convert bonds, notes, stocks or other securities belonging to my estate into other bonds, notes, stocks or other securities, and to exercise all other rights and priv!leges of a person owning similar property. 4) To lease any real property in my estate. 5) To abandon, adjust, arbitrate, compromise, sue on or defend and otherwise deal with and settle claims in favor of or against my estate. 6) To continue or participate in~ any business which is a part of my estate, and to incorporate, dissolve or otherwise change the form of organization of the business. The powers, authority and discretion I grant to my executor are intended to be in addition to the powers, authority and discretion vested in him or her by operation of law by virtue . i..~) ~ ' rC? Page3of5 Initials:~/.~_ /~~Date: ¢~.~&~ Will of Donna J. Parks of his or her office, and may be exercised as'often as is deemed necessary or advisable, without application to or approval by any court. Part 8. Payment of Debts Except for li~ns and encumbrances placed on property as security for the repayment of a loan or debt, I want all debts and expenses owed by my estate to be paid using the following assets in the order listed: any and all bank accounts remaining at the time of my death. Part 9. Payment of Taxes I want all estate and inheritance taxes assessed against property in my estate or against my beneficiaries to be paid in the manner provided for by the laws of Pennsylvania. Part 10. No Contest Provision. If any beneficiary under this will contests this will or any of its provisions, any share or interest in my estate given to the contesting beneficiary under this will is revoked and shall be disposed of as if that contesting beneficiary had not survived me. Part 11. Severability If any provision of this will is held invalid, that shall not affect other provisions that can be given effect without the invalid provision. Signature I, Donna J. Parks, the testator, sign my name to this instrument, this ~ -~-~ day declare that I sign and execute t~s instrument as my last will, that I sign it ~llin~y, ~d that I execute it as my free and volunta~ act. I declare that I am of the age of majority or othe~ise legally empowered to make a will, and under no constraint or undue influence. Signature: ~ '~/~?~, :-~- :--~ '~'~ "-~-~ Witnesses We, the witnesses, sign our names to this instrument, and declare that the testator ~llingly signed and executed t~s instrument as the testator's last will. In the presence of the testator, and in the presence of each other, we sign this will as witnesses to the testator's signing. Will of Donna J. Parks To the best of our knowledge, the testator is of the age of majority or otherwise legally empowered to make a will, is mentally competent and under no constraint or undue influence. We declare under penalty of perjury that the foregoing is true and correct, this dayof _] ~[ q, 2~.,: q ,at Residing at: l 2~ 5 ~.~ .... ~2~. (~5 . ~.~ ~, Witness ~-" .. _ ~. ~ .... 0 ~ ..... 0 ~ ,~ - -- d-~--~' / 70 :: 7 Page 5 of 5 Initials: Affidavit ACKNOWLEDGMENT Commonwealth of Pennsylvania Countyof: ~':c~v~,[.~c'r I£~ ,,cl, I, x ~)/. )~ )/? .~ f'J ',;:/~J, the testator whose name is signed to the attached or foregoing instrument, ha~ng been duly qualified according to law, do hereby ac~owledge that I signed and executed the instrument as my Last Will; and that I signed it willingly ~d ~ my ~ee and volunt~, act~he pu~oses therein expressed. C Testator',. ~- ~ T. ~, ~' ~blic AFFIDAVIT Commonwealth of Pennsylvania witnesses whose names are signed to the attached or foregoing tnstrument, having been duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his/her Last Will; that the testator signed willingly and executed it as his/her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the will as a witness; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by and this '-~>, dayof .'~c,\q , ?~6~t Witness: :~c.~.~;~_' ~'~"1 (..a.~ :_ 1~ . i//~ ~,? ', ~witnesses, ~Carol~ T ~, Notary Public M~'~a~', Pefm-qyiv~a AssoCmtion of N ora rie~ Affidavit -- Page 1 of 1 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Donna J. Parks Date of Death: August 3, 2004 File No.: 21-04-0744 To the Register: I certify that notice of 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 October /'~, 2004. Name Address Margaret M. Lee Arthur J. Parks Brian T. Yufer Brian D. Yufer, c/o Brian T. Yufer Ray R. Strayer Keith Strayer Rosella Jean House Nancy May McCoy Winnifred I. Kovecevie John & Lori Backenstoes Peggy Ann Hatter Sandra Lee Massie Sue Miller Helen O. Krause Animal Foundation, Inc. Dale & Kay Danner 115 North Street, Harrisburg, PA 17101 1067 Shadowridge Drive, g40, Vista, CA 92081 126 Cedar Village Drive, York, PA 17402 126 Cedar Village Drive, York, PA 17402 889 King Street, Lewisberry, PA 17339 436 Clover Road, Etters, PA 17319 815 West Keller Street, Mechanicsburg, PA 17055 Big Springs Terrace, Lot 155, Newville, PA 17241 40 Burwick Drive, Mechanicsburg, PA 17055 1284 Boiling Springs Road, Boiling Springs, PA 17007 1288 Brandt Road, Mechanicsburg, PA 17055 1283 Boiling Springs Road Bc~ifi~ Springs, PA 17~7 1130 Boiling Springs Road, B ~o~t.~j~ Spri~s, PA I~7i307 P. O. Box 311, Mechanicsburgi?A 1705~0311 1 Briarwood Court, Mechanicsburg, PA 12~055 ? Notice has now been given to all persons entitled thereto under Rule 5.6(a). Co r rsonal ~epres e GATES, HALBRUNER & HATCH, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 (717) 731-9600 Dated: October /~, 2004 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF JNDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11 96) NO. CD 004564 STRAYER RAY RICHARD 889 KING STREET LEWISBERRY, PA 17339 ....... f01d ESTATE INFORMATION: SSN: 164-30-2891 FILE NUMBER: 21 04- 0744 DECEDENT NAME: PARKS DONNA J DATE OF PAYMENT: 11/01/2004 POSTMARK DATE: 11/01/2004 COUNTY: CUMBERLAND DATE OF DEATH: 08/03/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $24,000.00 REMARKS: TOTAL AMOUNT PAID: $24,000.00 SEAL CHECK# 118 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE FORM 6.12 YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Will No.: Donna J. Parks August 3, 2004 21-04-0744 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following w~ respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: December 2005 3. If the answer to No.1 is yes, state the following: A. Did the personal representative file a final account with the court? N/A B. The separate Orphans' Court No. (if any) for the personal representative's account is: NI A C. Did the personal representative state an account informally to the parties in interest? NI A D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date: April 28, 2005 Capacity: Counsel for Personal Representative JJf REV-1500EX(& nllPD OFFlClAl USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DE PT 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 COlMY CODE 04 0744 ----- YEAR I'lMlER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) !z Parks Donna ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) ~ 8/3/2003 7/4/1938 W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) C J SOCIAL SECURITY NUMBER 164-30-2891 THIS RETUFIII MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~ [j] 1. Original Retum \.:~CI)D ~ g:~ 4. Limited Estate :J: 00 IJtl o a:.... ~ 6. Decedent Died Testate (Attach copy of Will) lLlIl ~ D 9. Litigation Proceeds Received D 2. Supplemental Return D 3. Remainder Retum (date of death priorto 12-13-82) D 4a. Future Interest Compromise (dale of death after 12-12-82) D 5. Federal Estate Tax Retum Required D 7. Decedent Maintained a Living Trust (Attach copy of Trust) L 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit (dale of death between 12-31-91 and '.1-95) D 11. Election to tax under Sec. 9113(A) (Attach SchO) ... z w C z o lL Ul W a: a: o u THIS SECTION MUST BE COMPLETED.ALLCOFlFlESPONDENCE ANDCONFIDamAi. TAX INP()flMATIoN StiOtJLDsE OIll1ic'lcDToe NAME COMPLETE MAILING ADDRESS Craig A. Hatch, Esquire 1013 Mumma Road, Suite 100 FIRM NAME (If Applicable) Gates, Halbruner & Hatch, P.C. Lemoyne, PA 17043 TELEPHONE NUMBER 717-731-9600 z o j: :s :::l I- ri: cr: Co) W a: 6. J~ Owned Property (Schedule F) L.J Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) (6) $197,992.00 $5,856.16 $0.00 $0.00 $235,713.49 $0.00 OFFICIAL USE ONLY 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 (Schedule E) (5) $29,206.66 8. Total Gross Assets (total Lines 1-7) $468,768.31 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedul.') (10) (8) $49,806.23 $29,443.19 9. Funeral Expenses & Administrative Costs (Schedule H) (9) (13) $79,249.42 $389,518.89 $0.00 11. Total Deductions (total Lines 9 & 10) (11) 12. Net Value 01 ESlate (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) (12) 14. Net Value Subject to To. (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) $389,518.89 15. Amount of Line 14 taxable at the spousal tax $0.00 ..0 ~(15) Z rate, or transfers under Sec. 9116 (a)(1.2) 0 i= 16. Amount of Line 14 taxable at lineal rate $341,018.89 X.O 45 (16) <( ... ::> $40,000.00 I>. 17. Amount of Line 14 taxable at sibling rate x.12 (17) :!! 0 $8,500.00 (,) 18. Amount of Line 14 taxable at collateral rate x.15 (18) >< <( 19. To. Due (19) I- 20. ~ $0.00 $15,345.85 $4,800.00 $1,275.00 $21,420.85 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUE8nONS ON REVERSE SIDE AND RECHECK MATH < < 3W4645 1.000 v- Decedent's Complete Address: STREET ADDRESS 1280-A Boiling Springs Road Cumberland CITY I STATE I ZIP Boiling Springs PA 17007- 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 $24,000.00 $1,200.00 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty $0.00 $0.00 Total Interest/Penalty (D + 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. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. Ma~e Chec;k Pa able to:R~OFWH.LS,AGENT (58) ;'~fali'm~l!~liiit~~^i;',fII0J,~,'F~~ . :~'" $21,420.85 $25,200.00 $0.00 $3,779.15 $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 a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . D b. retain the right to designate who shall use the property transferred or its income; . D c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . D d. receive the promise for life of either payments. benefits or care? . . . . . . . . . D 2. If death occurred after December 12,1982. did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~ 0 IF THE ANSWEFl 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 retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declafalion of preparer other than the personal representative is based on all Information of which preparer has any knowledge. SIGNA RE OF PEAS RESPONSIBLE FOR FILING RETURN No D9 D9 D9 D!l D!l Q!l DATE -:.o~ REPRESENTATIVE Lewisberry, PA 17339 DATE /f /;L 8'" (,:;lO.sS- Lemoyne, PA 17043 f'';';'K'a:.'.iHg&i;;/4?'@8ti*"BT0~TI&.2f~~_w__~~4W'~411!" 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. 89916 (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. 99116 (a) (1.1) (ii)) The statute does not exemot 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. 8 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. S 9116(1.2) [72 P .S. S 9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use oftha decedent's siblings is 12% (72 P.S. S 9116(a)(1.3)]. A sibling is defined. under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 3W4646 1.000 REV-1502 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Donna J. Parks 21 04 0744 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)olntIY-<lwned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION NUMBER 1. Real Estate VALUE AT DATE OF DEATH li197,992.00 Two single-family dwellings, both being Tax Parcel No. 22-28-2401-010; located at 1280 Boiling Springs Road, Boiling Springs, Monroe Township, Cumberland County, Pennsylvania; transferred to Donna J. Parks by the Administrator of Veterans Affairs, an Officer of the United States of America, by its deed dated May 24, 1983, and recorded on June 10, 2083, in the Cumberland County Recorder of Deeds Office at Deed Book F, Volume 30, Page 749. Value is net sales price. See attached copy of Settlement Statement. 3W4695 1.000 TOTAL (Also enter on line 1, Recapitulation) (If more space is needed. insert additionai sheets of the same size) $ $197,992.00 REV-1503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Donna J. Parks 21 04 0744 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1.68 Shares of IBM common stock $5,856.16 noD High $86.80 per share; noD Low $85.44 per share; noD Average $86.12 oer share 3W46961.000 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) $5,856.16 REV.1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Donna J. Parks FILE NUMBER 21 04 0744 Include the proceeds of litigation and the date the proceeds were received by the estate. All property lolntlv-owned with the right 01 survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 1989 Mercedes Benz VIN WOBBA2606KA873160 $5,000.00 value is proceeds from sale 2 AmeriChoice Federal Credit Union Savings Account No. 8412 $1,907.81 3 AmeriChoice Federal Credit Union Checking Account No. 8412 $3,075.59 4 AmeriChoice Federal Credit Union Checking Account No. 8412 $4.07 5 Comcast Cable refund $5.52 6 F&M Trust Checking Acct. No. 34-34273 $211,571.76 Interest accrued to 8/3/2003 $4.62 7 F&M Trust Savings Acct. No. 70-33699 $13,471.10 Interest accrued to 8/3/2003 $5.09 8 Liberty Mutual insurance premium refunds on Policy Nos. A02-563456-804, FN2-281-665162-804 and H32-281-665161-804 $575.15 9 Toews Corporation refund of investment security benefit $92.78 3W46AD 1.000 $235,713.49 TOTAL (Also enter on line 5 Recaoitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Donna J. Parks FILE NUMBER 04 21 0744 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 1tf:llDE TIE tw.E OF TIE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT A~ DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBEF TIE DAlE OF lRANSFeI. ATTIOiACOf"( OF TI-E DEED FOR REAl ESTAlE. VALUE OF ASSET INTEREST IIF APPUCABLE) VALUE 1. Security Benefit Variflex LS Variable Annuity $29,206.66 100.000 $0.00 $29,206.66 Account No. 5500010244 Owner: Donna J. Parks Annuitant: Donna J. Parks Beneficiary: Brian T. Yufer TOTAL (Also enter on line 7, Recapitulation) $ $29,206.66 (If more space is needed, insert additional sheets of the same size) 3W46AF 1.000 REV-1511 EX+(12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Donna J. Parks FILE NUMBER 21 04 0744 ITEM NUMBER A. B. 3W46AG 1.000 Debts of decedent must be reported on Schedule I. DESCRIPTION 1. FUNERAL EXPENSES: Fine Art Photo pictures for funeral service Total from continuation pages 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s} Ray R. Strayer Social Security Number(s) / EIN Number of Personal Representative(s} Street Address 889 King Street City Lewisberry Year(s) Commission Paid: 2004 State PA Zip 17339 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Cumberland Law Journal publication of estate notice 2 Eagle Roll Off, LLC dumpster for trash removal Total from continuation pages TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ AMOUNT $42.19 $3,465.44 $20,000.00 $20,000.00 $313.00 $75.00 $1,032.06 $4,878.54 $49,806.23 Estate of: Donna J. Parks Xtem No. 2 3 Description Gingrich Memorials gravesite marker MYers Funeral Home, Xnc. funeral goods & services Schedule H part 1 (Pagb 2) Amount $600.00 $2,865.44 Total (Carry forward to main schedule) $3,465.44 Schedule H part 2 (Pag~ J) Estate of: Donna J. Parks Xtem No. Description Amount 3 J&D Automotive car inspection $14.46 4 Lawn Maintenance $20.00 5 Liberty Mutual Group insurance premium on house, rental property and vehicle $674.87 6 Mary A. Murray, Tax Collector real estate taxes $1,615.27 7 Maxwell Enterprises fee for preparation of decedent's 2004 incame tax returns $145.00 8 Met-Ed electric utility service $454.91 9 Miscellaneous administrative expenses (postage, paper supplies, etc. ) $40.35 10 Miscellaneous expenses related to home maintenance $100.47 11 Monroe Township Municipal Authority sewer bill for Donna J. Parks and tenant $426.00 12 Patriot-News Co. fee for advertisement of auto for sale $29.20 13 Patriot-News Co. publication of estate notice $211.81 14 Patriot-News Co. ad for sale of personal items $16.00 15 Rick Mayberry clean and prepare vehicle for sale $174.90 Total (Carry forward to main schedule) $3,923.24 Schedule H part 2 (Pag~ .) Estate of: Donna J. Parks Xtem No. 20 Description Amount 16 Robert Stoner, Appraiser real estate appraisal $300.00 17 Supplies and labor for repairs to light fixtures, doors and outside faucet. $154.29 18 Supplies and labor for replacement of door and repair water damage to ceiling. $472 .70 19 The Sentinel ad for sale of personal items $18.00 u.S. Post Office postage $10.31 Total (Carry forward to main schedule) $955.30 REV-1512 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RElURN RESIDENT DECEDENT ESTATE OF Donna J. Parks SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 04 21 0744 Include un reimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH Carlisle Regional Medical Center medical bill $876.00 2 Casey Williams, DMD dental bill $244.00 3 CE Service Center television repair bill contracted for prior to date of death $120.84 4 Internal Revenue Service decedent's 2004 income tax liability $22,654.00 5 Met-Ed electric utility service $66.71 6 Monroe Township Municipal Authority sewer bill for Donna J. Parks and tenant $383.62 7 PA Department of Revenue decedent's 2004 income tax liability $5,089.00 8 Sprint phone service $9.02 3W46AH 1.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) $29,443.19 REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RElURN RESIDENT DECEDENT ESTATE OF Donna J. Parks NUMBER I 1 2 3 4 FILE NUMBER 21 04 0744 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE John Backenstoes 1284 Boiling Springs Boiling Springs, PA Road 17007 None $500.00 Lori Backenstoes 1284 Boiling Springs Boiling Springs, PA Road 17007 None $500.00 Dale Danner 1 Briarwood Court Mechanicsburg, PA 17055 None $2,500.00 Kay Danner 1 Briarwood Court Mechanicsburg, PA 17055 None $2,500.00 Total from continuation pages $383,518.89 ENTER DOLLAR AMOUNTS FOR DISTRIBUllONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, 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 3W46A11.000 B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- 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) $0.00 $ Schedule J part 1 (Pag6 ~) Estate of: Donna J. Parks Item No. Description Relation Amount 5 Peggy A. Harter 1288 Brandt Road Mechanicsburg, PA 17055 None $0.00 6 Rosella J. House 815 West Keller Street Mechanicsburg, PA 17055 $10,000.00 Sister 7 winnifred I. Kovecevic 40 Burwick Drive Mechanicsburg, PA 17050 $10,000.00 Sister 8 Margaret M. Lee 115 North Street Harrisburg, PA 17101 Personal property plus $1,000 cash $1,500.00 Daughter 9 Sandra L. Massie 1283 Boiling Springs Boiling Springs, PA None $1,000.00 Road 17007 10 Nancy M. McCoy Big Springs Terrace, Newville, PA 17241 $10,000.00 Lot 155 Sister 11 Sue Miller 1130 Boiling Springs Road Mechanicsburg, PA 17055 None $1,000.00 12 Arthur J. Parks 1067 Shadowridge Drive, #40 Vista, CA 92081 Son $30,000.00 13 Keith Strayer 436 Clover Road Etters, PA 17319 $500.00 Nephew Total (Carry forward to main schedule) $64,000.00 Estate of: Donna J. Parks Item No. 14 15 16 Description Richard R. Strayer 889 King Street Lewisberry, PA 17339 Brian D. Yufer c/o Brian T. Yufer 126 Cedar Village Drive York, PA 17402 Brian T. Yufer 126 Cedar Village Drive York, PA 17402 Personal property and $1,000.00 cash Beneficiary of Annuity (Sch. G) Schedule J part 1 (Page j) Relation Amount Brother $10,000.00 Great Grandchild $279,099.73 Grandson $30,419.16 Total (Carry forward to main schedule) $319,518.89 :;;\ :~; ~n ,:" 'i'~l!\ nw JTtt: lnjOnd~hl'lii1 JKTC g!'\lcn is '~OrrCC;iY :.'I.:'Pl'.:(! !rOrii ::.m ongin:tl ")'~~i.tl RC~l :i;'~u. ; iu: "l'!~pnal certificat( II be fonvardcd to tlit.: S:aLc: \iital Recor :.:-:~rti~ICW:' oj (jc~liii (Ju~.y l-lk~d ) fri Ct: for Dcrmancnl Ci!inlY. , ~ c' W Hll rne ~l~'~ WARNING: It is illegal to duplicate th~s copy by photostat or phoIograp!1. I-<e'~' ;Ul thL~ cc[tifjcate~ $2.00 'f~~~$k~ . Local Registrar 0 d"' ij- A /! 1.. 1;...) '-' ... ".-' \,) () W=i- fl'1A0d. ~.2<~' l)~ltt' No. HI05,143Rev.2187 COMMONWEALTH OF PENNSYIYANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH TYPElPRlNT ,. PER....NENT bLACK INK NAME OF DECEDENT IFnl, Mir;lIIa.1..QI) SEX ,. Female Donna Jane Parks AGE (lasl 8Il1hdeyl UNDER 1 YEAR ...... .... UNDER 1 0JII1{ I-IooQ I MInut.. ! ' 8IRTHPl...ACE(Cilyand SUIlelll'foruigllCOUnlry) Cartisle, PA. ~':.,YI[J 66 Yrs. .. COUNTY OF OEATH RACE -AmIIlll;an In.;N.n. B/iIc;l<, Whll.. tilt (SlfOCil~) ... Cumberland Allen While ... DECEDENT'S USUAl OCCUP#\TIOH ~':o,"':":M~:a~\J:':'.i::r Administrative Specialist ".. DECEDENT'S MAILING ADDRESS {SIfeel. c.ty/ilwn. 9Ial6, lip COde) 1280-A Boiling Springs Road BOiling Springs, Pennsylvania 17007 KIND OF 6USlNESSIlNDUSTAY VMS DECEDENT EVER IN U,S. ARMED FORCES? ...0 NoliJ IBM MARITAL STIJ"US .Mewed NeverMlrn.d.W~d, DllIllrC8dlSpflCitYI Divorced SUAVIVINB SPOUSE (II woltl.'J'V'",,,,,OIj(j{.nllI'*'l 12. DECEDENT'S ACTUAl RESIDENCe (SeelflBkuclionl ooOltllll'sidt) Pennsylvania 17..51al. "" -- ..... -' FATHEn'SNAME lfirGt. MKJdIlI. lllSl) Herndon R. Strayer Ray Strayer 17 ...u....~=()1 Allen MOTtEA'S NAIIE (Fonl, t.llddle, ~SornatnllJ ... Bernice E. Gettys INFORMANT'S MAILING AOOAESS lSU_, c.tyffown. SIaIe. Zip CodIIJ ,... 889 King Street Lewisberry, Pa. 17339 PLACE OF DI8POEIfTlON . Nan. III Cemet-v. CJ.mlllllf'l' LOCATION . C~~/Town, SllIl", Zop Code w__ Conolite Crematory ~.. Cumberland 17b.eow. .. INFORMANT'S NANf (lVP6iPrintl < ] / )_,/ Cl"_~Refnoy"IfomSlMeD ~-~I'\ Schacffcrstown, Pa 17088 21(:. 21d. NAME AND ADDAESS OF FACILITY :rile. Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, Pa 17055 UCEN. "'NUy)'R f7 .. C. OATE SIGNED t - j;. IMont",Oi.l~"). y---rJ Y 2Jc:. t1 \'AS CASE REFERRED TO MEDICAl EXAMINER/CORONER? ",8 c.ro.w .. NOD '"I -'< " '. -.I ~',J -'-... .. IAflpRl.lmIIl. llnlenoal belwHn I onMllllld dMIh I PART II: OIIllN"~lcanlcondlliMe.Cont'obYlingtodlullh.bu1 ootrftlllllnginllMtuode"y"'g~",,""nPART I C tlHI',...n" f"/;f; \; I: DUE TO (00 ASA CONSEOUENCE OF): <,1 ) '. ~~ '.~ t'":), WERE AUlOPSV FINDINGS """lA8LE PRIOR TO COMPLETION OF CAUSE OFOEJO'H? Yes 0 tkI0 MAHNEROF~H DATE OF INJURV lJ.,4l1nlh.O.v.VurJ T1MeOFINJURV INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED ~ o o o o o ~l.ACEOf'INJURV.At.~,I...m,.,..,~,oItlc:e M. building, etc. (SpeciIv) .... No'"," -- ""- P-..dInglnvelliQitllon Could not be delu.mined ...~ s..- n. ,1.)' R i', ~ /f-? o I?-I I 1iJ-J I I+.I ... STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTIFICATE I, GLENDA FARNER STRASBAUGH Register for the Probate of wills and Granting Letters of Administration in and for CUMBERLAND County, do hereby certify that on the 12th day of August, Two Thousand and Four, Letters TESTAMENTARY in common form were granted by the Register of said County, on the , late of MONROE TOWNSHIP estate of PARKS DONNA J (Last. First, Middle) a/k/a PARKS DONNA JANE in said county, deceased, to STRA YER RA Y RICHARD (Last, First, Middle) and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 12th day of August Two Thousand and Four. File No. 2004-00744 PA File No. 21-04-0744 Da te of Dea th 8/03/2004 S. S. # 164-30-2891 ~o;\:"-\ NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL Will of Donna J. Parks Part 1. Personal Information I, Donna 1. Parks, a resident of the State of Pennsylvania, Cumberland County, declare that this is my will. My Social Security number is 164-30-2891. Part 2. Revocation of Previous Wills I revoke all wills and codicils that I have previously made. Part 3. Children I have the foIlowing children now living: Arthur James Parks and Margaret Marie Lee. Part 4. Grandchildren . :0 C . "T, ::::: n\ 0 'T, -:~' I have the foIlowing grandchildren now living: Brian Dominick Yufej} ihy greit-grlll1d~~~ . (r. ~ . and Brian Todd Yufer. ffi Part 5. Disposition of Property . , :D All beneficiaries must survive me for 45 days to receive property und.er this wilt As \!Se,d ;,! .. ., ...' in this wiIl" the phrase "survive me" means to be alive or in existenct?asan or~nization'bn the 45th day after my death. N All personal and real property that I leave in this will shaIl pass subject to any encumbrances or liens placed on the property as security for the repayment of a loan or debt. . IfI leave property to be shared by two or more beneficiaries, it shall be shared equaIly by them unless this will provides otherwise. IfI leave property to be shared by two or more beneficiaries, and any of them does not survive me, I leave his or her share to the others equally unless this will provides otherwise for that share. "Specific bequest" refers to a gift of specificaIly identified property that I leave in this will. "Residuary estate" means all property I own at my death that is subject to this wiIl that does not pass under a specific bequest, including all failed or lapsed bequests. I leave my birthstone ring; wedding rings; Mother's ring; big screen television; my Bible; my shawl; and, for reasons best known to her, the amount of one thousand doIlars ($1,000) to Margaret Marie Lee. If Margaret Marie Lee does not survive me, I leave this property to Brian Dominick Yufer, my great-grandson. Page 1 of 5 Initials: /i:P I ti.1 ~ Date: 0./oL/ Will of Donna J. Parks I leave the angel pictures and pictures of Christ I painted; my bedroom suite, which is already in his possession; my ffiM compatible computer; one (1) of my state quarter collection books; and, for reasons best knoWn to him, the amount of one thousand dollars ($1,000) to Brian Todd Yufer. If Brian Todd Yufer does not survive me, I leave this property to ~rian Dominick Yufer, my great-grandson. I leave my adjustable (hospital type) bed to Keith Strayer. If Keith Strayer does not survive me, I leave this property to Ray Richard Strayer, Rosella Jean House, Nancy May McCoy and Winnifred Ida Kovecevic in equal shares. I leave pictures of my brother and sisters; the bedroom furniture from my $econd bedroom, which is already in his possession; my roll-top desk; one (1) of my state quarter coIlection books; and the balance remaining (after satisfying any and all debts owed by me) from the sale of my homes and automobile to be placed in a trust fund I have established at F& M Trust to Brian Dominick Yufer, my great-grandson, the joy of my life. I leave the amount offorty thousand dollars ($40,000) to Ray Richard Strayer, Rosella Jean House, ~ancy May McCoy and Witlnifred Ida Kovecevic in equal shares. I leave my krugerrand;and, the amount of thirty tho'usand dollars ($30,000) to Arthur James Parks. If Arthur James Parks does not survive me, I leave this property to Brian Dominick Yufer, my great-grandson. I leave my blue-point Persian cat, Tiffany to Peggy Ann Harter. If Peggy Ann Harter does not survive me, I leave this property to Sandra Lee Massie. I leave my two (2) remaining cats, Pita and Printz; and, the amount of one thousand dollars ($1,000) for the loving care they gave me during my illness to John Backenstoes and Lori Backenstoes in equal shares. I leave the amount of five thousand dollars ($5,000) to the Helen O. Krause Animal Foundation, Inc. I leave the amount offjve thousand dollars ($5,000) to the ministry of Dale Danner and the ministry of Kay Danner in equal shares. I leave the amount of one thousand dollars ($1,000) for the loving care she gave me during my illness to Sandra Lee Massie. If Sandra Lee Massie does not survive me, I leave this property to Peggy Ann Harter. Page 2 of 5 Initials:lDf ~~~) Date:7f~/) <I Will of Donna J. Parks I leave the amount of one thousand dollars ($1,000) for the loving care she gave me during my illness to Sue Miller. If Sue Miller does not survive me, I leave this property to Owen Strickler, Ashlee Peters, Eric Peters, Amanda Stine and Jacob Stine in equal shares. I leave my residuary estate to Brian Dominick Yufer, my great-grandchild. Part 6. Executor I name Ray Ric~ard Strayer to serve as my executor. If Ray Richard Strayeds unwilling or unable to serve as executor, I name Rosella Jean House to serve instead. No executor shall be required to post bond. Part 7. Executor's Powers I direct my executor to take all actions legally permissible to have the pr?bate of my will done as simply and as free of court supervision as possible under the .Iaws of the state having jurisdiction over this will, including, filing a petition in the appropriate court for the independent administration of my estate. I grant to my' executor the following powers, to be exercised as he or she deems to be in the best interests of my estate:, 1) T9 retain property without liability for loss or depreciation. 2) To dispose of property by public or private sale, or exchange, or otherwise, and receive and administer the proceeds as a part of my estate. 3) To vote stock, to exercise any option or privilege to convert bonds, notes, stocks or other securities belonging to my estate into Qther bonds, notes,. stocks or other securities, and to exercise all other rights and privileges of a person owning similar property. 4) To lease any real property in my estate. 5) To abandon, adjust, arbitrate, compromise, sue on or defend and otherwise deal with and settle claims' in favor of or against my estate. 6) To continue or participate in' any business which is a part of my estate, and to incorporate, dissolve or otherwise change the form of organization of the business. The powers, authority and discretion I grant to my executor are intended to be in addition to the powers, authority and discretion vested in him or her by operationoflaw by virtue . Page 3 of 5 Initials: lip ~ cdb- Date: 7/7,;0'1 . Will of Donna J. Parks of his or her office, and may be exercised as'often as is deemed necessary or advisable, without application to or approval by-any court. Part 8. Payment of Debts Except for liens and encumbrances placed on property as security for the repayment of a loan or debt, I want all debts and expenses owed by my estate to be paid using the following assets in the order listed: any and all bank accounts remaining at the time of my death. Part 9. Payment of Taxes I want all estate and inheritance taxes assessed against property in my estate or against my beneficiaries to be paid in the manner provided for by the laws of Pennsylvania. Part 10. No Contest Provision_ If any beneficiary under this will contests this will or any of its provisions, any share or interest in my estate given to the contesting beneficiary under this will is revoked and shall be disposed of as if that contesting beneficiary had not survived me. Part 11. Severability If any provision of this will is held invalid, that shall not affect other provisions that can be given effect without the invalid provision. Signature I, Donna J. Parks, the testator, sign my name to this instrument, this 7 .t!:J. day of '.::>u. \ \j ,;;l(XJ ~ , at (Y\1 re s ,A eneE'. . I declare that I sign and execute this instrument as my last will, that I' sign. it willingly, and that I execute it as my free and voluntary act. I declare that I am of the age of majority or otherwise legally empowered to make a will, and under no constraint or undue influence. Signature: .) - Qi;1J(/ 'ifi rL...-;1:'~k:....' --1.- l/ {U>.I~/ I / {/ Witnesses We, the witnesses, sign our names to this instrument, and declare that the testator willingly signed and executed this instrument as the testator's last will. In the presence of the testator, and in the presence of each other, we sign this will as witnesses to the testator's signing. . .~ ./) III I 11 Page4of5 Initials:!}j' ~~ Date: 717 Arc! I Will of Donna J. Parks To the best of our knowledge, the testator is of the age of majority or otherwise legally empowered to make a will, is mentally competent and under no constraint or undue influence. We declare under pemiIty of petjury that the foregoing is true and correct, this . ','tf,._ day of ~ 2t}cl{ ~.at . , J2Jzl-A "2u>ici,,)., _ \.] ~\ d()IL}~'i., ~/<,~,J;-J P,.. - . I . '~V-1lI<'- Cd 0 I~C Residing at: l2(:>; fL.....\.L"'" _ n. "'0 ~') ~4'\.L..v-td f I{ nOt; I J li ~\ I K \ Witness't0~ (2, ~j\P?~'4AL7^ . Re,;ding at 1-1 E:4 r;o;.t (j~<jL' r;;<J G:d7J ,iJ?r" ~ Witness '# 1: /7(0'7 Page 5 of 5 lit] Initials:~ ~ , I ~Date: 0/,/ Affidavit ACKNOWLEDGMENT Commonwealth of Pennsylvania County of: eLl.. vr-. b eo (- \ C, ..., d I, j () ^-) (. ) /! .f f/;jl2!./< S. the testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; and that I signed it willingly and as m..y free and volunt~ a.ctJ,eri!.. he pUr:Joses th rein expressed. Q.. ,0 . .7!/'-! L/ Testator: /;L:' (:-'7Z/7'<---"'<--- ./ ct./V-/ t' ,/ /7 (-;l'/C-LI.';~i:" .. f ( a 7'"1 SC.7 Officer: NowiliSeal CaroIiae T. Ramoey. Notary Public s~ Twp" o.uphin County My COIIlIIIiIoion Eltpires Jan [6. 2007 Member,l'l!nn9ytvIInia AsSOCIBtlOrl 01 Notanes AFFIDA VIT Commonwealth of Pennsylvania County of: C~(.lI"""'" be,- k j~ We, ~-;- ~ 1\\ J ~ 14- M l1-.5 <;.. ,,: and L (.,,~, fl'-r)c .~ k..-(c ";-l-~ the witnesses whose names are signed to the attached or foregoing instrument, having been duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his/her Last Will; that the testator signed willingly and executed it as his/her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the will as a witness; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by and ""-0-'-',- , dU . . witnesses, this 'f ~.... Witness: Witness: Officer: Nowial Seal CaroIiIoe T. Ramoey, Notary Public S""'Iuc:hanna Twp.. Dauphin County My Commia.ion Eltpires Jan. 16, 2007 Member, Pennsylvania ASsociation of Notaries Affidavit - Page 1 of 1 I, Donna J. Parks of 1280-A Boiling Springs Road, Boiling Springs, Cumberland County, Pennsylvania, 17007, being of sound mind, do hereby make this document a representation of my wishes as to the personal care I receive during my remaining days. As I am aware that I have incurable cancer, my wishes are as follows: (A) I wish to be allowed to remain in my home through this illness; (B) I wish that my friends: Sandi Massie, John Backenstoes, Lori Backenstoes, and Sue Miller be granted access to my home to assist me in any way I deem necessary. I understand that hospice and/or nurses will be called in when this disease renders me to a point that my friends can no longer tend to me alone; (C) I DO NOT wish 'to have any member(s) of my immediate family involved in the care I will receive at home; (D) I DO NOT wish to have any member(s) of my immediate family move into my home during this illness. \1/i7~? , i\.. ,r,)", )'::J.'- t / /}4,/f ,; --./' C"--,, / d..--/ , Donna J. Park; /' Wiln~~ Witness: . 1 Witness: State of Pennsylvania County of Cumberland On :::Ju.~C 30,dCOI-lbefore me, fl"I-c,),',H,,' T rZt';".'J("'V / d '/:. l 0/. ~ J II appeare "I /~,t:,'! " if. L ICy' ,persona y known to me (or proved to me on th basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her authorized capacity. and that by her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument WITNESS my hand and official seal. ) {?--c- T /Z'}'1h: Affiant Type of ID Notarial Seal Caroline T, Ramsey, Nowy Public Su",!""hann8 Twp., Dauphin COOlnty My Commission Eltp\l'1'S Jan. 16, 2007 Member, PeMSylvllnla AssoclaUonofNotaries Signature: Known Produced ID (Seal) \ \ '" \ \ 0 \~ \ I"- \ 0 '" \ oD \ \ ~ \ \ en \ \ i \ \- ff) \ \ ~,r~. i ~ ~ .s \ ;;;. 0 :-;: \ " ra. 10< f:-' po. a 0 4\ " \ i ~ ';Z ." \ ~ g ~ , , '0 i t; ~ \ \ .... ... ';z; g 'i \ ~ ~ , ,_.,,' 't." .f" '\~ ~.."-'\ d\n~.lI ;~ .,. ,.....' ,....:11:1",.. ,()\.I!"W ~"<../' U't? Yc.d1 ,\\j{),""@~' ':...]...1 . ',' '''1f? '" j;'1:7 //7' "~. ,/,J.'- '" ,;;;;;. ,~\:f::'-'-:-- \ ;...Fi\i'"n~ ,.....', .., i 1 ll,uJi VA Form 26-10'. JUL 1982 Section 1820, Title 38 U.S.C.. PENNSYL VANIA THIS INDENTURE made the 24th day of May , 19 83 , between the Administrator of Veterans Affairs, an Officer of the United States of America, whose address is Veterans Administration, Washington, D. C. 20420 hereinafter called the Grantor and DONNA PARKS hereinafter called the Grantee: :-;'1:,',,1,:-;' 5';::.",!"!~;::G~ , _, ',r {I~. ...tIth 1."1 ,U !'i/,J jj c; ::1:'0 ~ ~J :-,--1 In ,S~:itEY Thiusaqa, ~ 00/100 :($60, OOO~'@)D.o~ars -- ,; rn .,:'! C) ''::;) C~' .-q ~ ,..~ :)-[1 -~ ~~2 g .,..., .~n 0 'Tl -l ::r: rn , , WITNESSETH that the said Grantor for and in consideration of the sum of J " tXJM.v\ 0 l'-j WE Ai iii 1)CFARTh\E1","r' ()I'; ";:i_~ , IV r i: i,I!) /l[i' ?- F 1~1J. i I I .,~ <;.;) '-~ the receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, enfeotfs, releases, and con- firms unto the said Grantee and Grantee's heirs or successors and assigns, ALL THAT CERTAIN piece or parcel of land situate in Monroe Township, Cumberland County, Pennsylvania, being bounded and described according to a survey made by Michael C. D'Angelo, Registered Surveyor, dated May 5, 1978, as follows, to wit: BEGINNING at a point on the Northern line of Blacksmith Alley (10 feet wide) at the corner of lands now or formerly of Richwine; said point being measured 102.50 feet to the center line of Main Street (Pa. Rt. 174); thence extending from said point of beginning and along lands of Richwine, North 19 degrees 56 minutes 00 seconds West, the distance of 243.60 feet to an iron pin at the corner of lands of Warner; thence along lands of Warner, North 68 degrees 38 minutes 00 seconds East the distance of 160.10 feet to a point at the corner of lands now or formerly of Lyter; thence along said lands South 24 degrees 14 minutes 26 seconds East, the distance of 164.66 feet to a point un the Northern line of Blacksmith Alley; thence along said line of Blacksmith Alley, South 44 degrees 15 minutes 00 seconds West, the distance of 191.53 feet to a point, the place of BEGINNING. BEING the same premises which Robert n. Failor, Sheriff of Cumberland County, by deed dated November 15, 1979 and recorded November 19, 1979 in the Office for the Recording of Deeds of Cumberland County, Pa. in Deed Book T, Volume 28 page 381, granted and conveyed unto Max Cleland, as Administrator of Veterans Affairs in fee. THE said Max Cleland, Administrator of Veterans Affairs, an Officer of the United States of America, having resigned said office, was succeeded by Harry N. \~alters, by appointment of the President of the United States. BY Quit Claim Deed dated September 4, 1981, and recorded October 19, 1981 in the Office for Recording of Deeds, for Cumberland County, in Deed Book No. Y Volume 29, page 131, Arthur J. Parks conveyed ~nd assigned all his interest in said property under the Installment Contract For Sale of Real Estate to his wife, Donna Parks. ,,')) /jJ." F: " OW'Hlhip of //.(~~'.. J..<::~_ Cumbo Co., PI.I. /,-J, / :de L-v/,?' ,7 ,_ . ,., , ;.,~=, 7 ~~ k~-f' ~c:r /1",,- ;t3htidl blit. Cumb ""=-P ? . \".,,00., a. I I S Real E:d.". Tranaf., T4r. 'Z'q.;,/f,J d'J Ydog 0<10............ Amt............" I O;;J')7l'~ i't:- /7'c;;'~~_,,- :-:.....0. c... Dht, c,1. .'Iut. 7/ '-- L}fff:~'J ,i'L ;4;:) ,~," b",1 !.t~.. T,.....'.. Ta o.'tt.c-, <<~: f. ~c~.Y'c0 ""2"/ . ~ ,. . .. . ..... '......:.' ~--:.._- :c;.:"____ -om to, 'e:;,. 'tit';l. iCtiJ A""iIo ~'---..,",-- TOGETHER with all and singular the improvements, ways, streets, aJleys, passages, waters, watercourses, rights, liberties, privileges, hereditaments, and appurtenances whatsoever thereunto belonging, or in any wise appertaining, and the reversions and remainders, rents, issues, and profits thereof, and all the estate, right, title, interest, property, claims, and demand whatsoever of the said Grantor, in law, equity, or otherwise howsoever, of, in, and to the same and every part thereof. To HAVE AND To HOLD the said lot or piece of ground above described with the hereditaments and appurte- nances, unto the said Grantee and Grantee's heirs or successors and assigns, forever. Grantor covenants to warrant and defend all that hereinabove described against all persons lawfully claiming or to claim the same or any part thereof by, through, or under Grantor. IN WITNESS WHEREOF, Grantor on the day and year first above written has caused this instrument to be signed and sealed on Grantor's behalf by the undersigned, being thereunto duly appointed, qualified and acting pursuant to title 38, United States Code, sections 212 and 1820, and title 38, Code of Federal Regulations, sections 36.4342 and 36.4520, pursuant thereto, as amended, and who is authorized to execute this instrument. / The A~' tor of vrerans Affairs 1 J ,- '.^, II ',' - .' , ,. " (f" J ,I I 7 I . . . .. *By -- 'J_~':...<:~~~J~,::::__~~ftl1:.v.c.~t1..___ [SEAL ] RONALD W. VELTMAN SEALED AND DELIVERED IN THE PRESENCE OF- . . Ii i ,\. 1;7. t I t-/ !I' ''1\/,.,. ,(: / ii) . ,1-""-- -----~--~-~----~- , {: Title: __________.________.____.__J..Qilll_QY.l!!:.~!Y._Q.{Ps..~! . .-------------------------------------------------~-------------------- Veterans Administration Regional Office or STATE OF PENNSYLVANIA, } 88: County of PHILADELPHIA Regional Office & Insurance Center ___ phi l;l _.._J> A. (City) (215) 951-5501 Teleph one---------------------------------------------------- (Area code and number) (Pursuant to a delegation of authority contained in VA Regulations, 38 C.F.R., 36.4342 and 36.4520.) On this date, before me, the undersigned, personally appeared ____ Ronald W. Veltman _,an employee of the Veterans Administration, an agency of the United States Government, signer and sealer of the foregoing instrument and acknowledged that he/she executed the same in the capacity therein stated for the purposes therein contained, and as the deed of the Administrator of Veterans Affairs. ~?\!..!:"'l' ~. ~;~~ .' IN WITNESS WHEREOF, I hereunto set my hand and official seal this the 24 tlL day,ofS'. ~'y. ,"" . '. Jl~ 83'. :.. -'. :) ,.-.:~: .'..f' '.; ~ ~'." , . J---------~- ~:2____?_______~_:~_~~-'" 'c~,,;; 1--~---~ c> '. ,~ ,,/ ..~ My commission expires: G' /i' ~J~~_Y-L6 L~__ . i !,. (} ~. Notary Public in and fo." ths Count1l and State afo..ssaid. I hereby certify that the precise residt!nce of the, within-named Grantee is'", : ., """, ,', , " j .,., !- ' 'I {' 11, .' . 1, ,I 7. ,', ;" I';'" ~\,_ /'l.i . .......:,.. --v--'--:O::~:'''(_:jr.'"L'v-', /;,.-:_/ \.---c..."C~ i ,.L:J....._'L".N-..r:)..c _._J l\-;-""'-,->'C--=-,_~, r,;--.,.. .. f '-~'_' Bo-*--J3, Allen--(.MOnr.beTwp.. )__BoilingSpl'i-ngs';--i'A'- ! r I' - ---------~-?k::,~-~ -<],-------,----------T----_---:--F-T~)~0-~'~------. -----I---~-=---~-:---------::------~'.,'--, /# '.~~,_--....u,-l....-1'"7'-..n:-.+~l:-,._'"., _, I(V,---Ltt~, . 1--1~).".-.-,.~-(.., " 'l.tj'~"~" :_..~' (-~...c~~_.,c...'_/ -*P=;--;::::',:.'-:4-~" zr=-..:.-?:-:==-:~:-.::~--:-:::::-;:~:;::---;:-~-:---:....-: ' ,,----~---....-~--..~.;.~.t..""-..f.--~~--.'~.. '-. . 64/1B/2665 14:43 7177375355 MILLER LIPSITT LLC PAGE 62 A. Settlement statement tT.3. IkpIHcm-totl-L-tme ."~ U,lmn Development 01018 No. :mr...0163 .u. "J:ype nf W.llU I. O~" ~.[JI'",lfII. 3. OCDIlV. Unl.., 4. OVA S.nConY. JIlB. GR05-1003I!EP l" U>tn "u..,~ /N. U...g.te I".. Cu. NlllOOc( C. Thi,Torm i< I\Irni,..~.... .''''''....lor.....r ..UlolT1ellt_. A""",ohopold ~ Illd bf lbo !llltlcmon1'lP't ."',1,..... IIoJ1IO mnr..d (],o.c) .".."e Pliri DUt8lc1c Iho E!lotling; the)' aI'C.,hown fur jl'forrDAtiDnl1 pdr,pofIOjII .nei ,C"8 not Inclooe" In totll.. D.Nlmc:a,..,l\d~rl!lll.DfBl)r'owci- D. ~ . nmnlnd rtflO Len c::r nn.thY F. Straub E,tilte of DoMO J. P,rb Integr1ty Bor<< Colvin II. Willi... III 3J4S Horkel: ,StrllOt CNIlP H11l, P."nsy] Yll!l'I. G. l''''J'Grty Low;on 1280 80111"" Spring. ~o.d Boil1rl\1 $p...."",. pen..ylv."lo 17007 Non,.. T""""htp. CUlltberl.nd CctJrlty I\djvmonfi' for illSlnr p-kf, "y iId'ar ;1I8.t""t'7eD laft. Cityftolm !ami 10 ! 07. I:ounty Illlfl)l CO lOR, ~ 02'~.l2tiolO> 06f30r.!OU~ 10.. 110. Ill: 111. AqJlllllftl'aUI ftlr Iteu" paid ~.Y o.,U., if) adV1'l"M 406. Cilyflllw. 11_ III ~h~"~ ~ .00. ....-..-.. n>'/24fZllOIOo .f30f2005 55 ,!l;..70 Z98,:.l5\ 10,361 210. CIty".".. huolo ':1U.C'O'I.I"tJr'"~ , a12. ^,,","monll :z.l~.. $C\lfe1"/tr-a:;h 11'. ' 115. 116. m. to 01fOl/201lfil III OZf24I200S 7l.!19 '"'Jup:'menll fDt" ,tOnM IJnpll Jt6Iler 510. Clly/'rD1Im Ill... tD SIl. COIllll)lIllXU OUOU,lKHiI 1l.!/24fZOO6 5 .Am_ '" .513. ;"".,.ftra.h ' If1.?fZ4 5J4.. JU. S16. :i1'7. "Ii1". ,i]!l, 1: AdjuellrQlf.:J rDr il'MII unpll'd by ,.,Uer 1/1.2/24 l?ll.70 m 197.!l9, The lnrnrmaUDot"OntJLimd In ~lot;t11 B. a, K8nd r..nd on 11nc:4ul or. J(lfna ,cOl illlllliller'rkttf, lInOl403 llnd ~(14. 1JI in'lportlnt. fOx. ill.f'm-mntionnnd lit bciDI;. t1lml.hed 10 tha JnterQR' bYMlUeSarv4c:o. IfYJr1U IIrc reqll.itl!(11O nJe" rgt""llo" ",<<1~"e8 pgw,lty or oclx'... ,.ncc:jan will be.I'l'IpOl'lJ:~ on YOlllfll1ie item ,,, ftlqlJircd" tCJ be reportW nnd lbc IU dctonnlnaKlI1Rt i't hu not beon rcPQtltod. 04/18/2665 14:43 7177375355 MILLER LIPSITT LLC PAGE 63 WAllNlNO: It Ie. Cli"", to know;lI/lly "."" ,.1.. Olnl....nl. 10 0,. tl.ilccl81R10$ on lhll ., .ny Dill., .Iml'or ro'm. l'olIRlllco upon coo'ie,"", oon Inclt1dc: . fioc 0"" ;"l'ri...mcn~ Por ~clnl1o ...: Trll. U U.S. Cod. SCctiOft 1l1li1'" 1010. SE'l"rIlEMl!:JI"l' S'l'ATBMEm PAGE :.I 10.1. ~ o.:~inoii""" 'Pe. 102.. LDllIl DMCOUl1t 1lIl. "I'pm'on' 1'.. &&II. f...1'eolt ltCpor' IOS. Lender'IJl1lIIfcr.Ugnfea. 1lOG. Morlpg.ln"".nc. ^ppllClllI"" Pee .. 107. ^1lIllU......ti.,., PM 80B. Integr1t,y O."~ . do<; prep 1lO9. Inteqr1ty Oanl - flDOll c.rt BID. m. '0':;. 1001. Jf.,..rd inarranee lD02.. Morwc inlU'mnc:c 1003. CIty pro,""'" .."". 10M. Col'of, prClJ'lStly 1dl8~ ID05. llnnU.' lIll':oumenfl 100 . IIID? lOll.. PAID Pll SllrJJlIl I'UIW~ ~ SIlTIUll< 1.0000. Int~~1ty " tu ,. 10 250.00 15.00 ... 10 per month per It'QI'1th jtCl Imr"'"' 40.66 per mDm:h 133.79110' .....th pat ft10nnl ,per monlh to to GIlSS GRSS tPCX; 5llZ.5o, I;l!~~ GRSS GRSS t:o!5t1 GRSS '. to .. In co ) GRSS (S tewort T1 tIe Gu8ranty) ) 1.4B3.75 lote9rity StrOUbINlll1l111S ~t10.00 ~B7 .92 'R.'..... $ 1 . 2.080.00 70,061),01 .*.: 58J.ur 21>.00 7.4(15.17 10.360 .00 CmlTIl'tCI\:rlDN p..r Settlo:marlt Statel"l'Jeilll 'n~ Iio tllC:' best o(my knolll'letlf.~ belief. Ir if ft true ".,d 'ccun.tc.'~tcment"f 1111 rt:teipfl nnCl nt or by ma. III lb. tmntlldion, 1 rl1rU,c:rccrufy tl1II.tI bftve. l!Il,.~d It ofthc HU.D-J Sel~ermnr Sh.tcmc:nt. Dl1'tlweJ" v, n. ams. S'aJlorB . Tfto, HUD. I teUlomen~ S~twbl~ll ha.,", p/ep_d 'If n lon.l", fllld novu"'lD aOODunt of ~O' In"IDnOt.inro. I hit...,. CIWIlOd Dr ...rlt 1"<<1'''- IIv:o (.I,.JI. tA 'VII tll.hllf'.r:l In llr:cord_nee wlrb tht. .bllcmcnf. l'ifll.t1tfll."",,,,"W'l\*,,,,,,r G,...t Rc;td Sllttl.-nant Sial"vt CD!". LLC February ~4, ZOOS IJnre --- - --- - - ---- .E. ~ oS ':"5- -- - ~ - IBM Corporation Investor Services J gram (ISP) IBM Stockholrlor Services P.O. Box 43C Providence, HI 02940-3073 Telephone: 1-888-IBM-6700 1-781-575-2727 (outside U.S., Canada, and Puerto Rico) g926 2004(09',7 134060 1..,111,..111",11..,1",11.1...11"1...11,1..1,, I,ll" ,,11..1 DONNA J PARKS 1280 BOiliNG SPRINGS RD # A BOiliNG SPRINGS PA 17007.9679 By Facsimile: 1-201-222-4488 E-Mail: ibm@equiserve.com Internet http://www.ibm.com/investor Issue# Account# Stock Symbol 9926 14636-44340 IBM SAVE THIS STATEMENT FOR TAX PURPOSES Investor Services Proaram liSP) Dividend Information Record Date: AUD 10, 20041Pavable Date: SeD 10, 2004 I Dividend Option: All Cash RECORD DATE SHARES FOR REINVESTMENT Amount Withheld From Gross Net Amount Certificate Shares I Isp'shares I Total Shares Rate($) Gross Amount($) Tax($) I Feo($) Reinvested($) I I 0.000 0.18 I Please note: $12.24 was paid to you by check or deposit for the dividend on 68.000 shares which did not reinvest. "Investor Services I'roaram (ISP) Account Activltv Data Description Feos and/or Net Dollar Amount($} P rice per Transac1ion Shares Total Shares Hold Commissions($} sharo($) 01/02/2004 Balance Forward 1,928.352 1,928.352 03/10/2004 Common Dividend Purchase 3.00 397.70 93.214 4.267 1,932.619 06/10/2004 Corrunoll DiviJellu PUld,a:;e 3.00 448.55 90.535 4.\:lt>4 1.93/ .573 07/15/2004 Shares Sold 208.80 162.973.60 84.220 .1,937.573 0.000 07/19/2004 Book-entry Credit 68.000 68.000 Year-To-Date Investment Summary Gross Dividends Reinvested(S} I Tax Withheld($) Fees and/or Commissions Net Owk!ends Reinvest&d($) OptiDnal \nvestments($) I T ola) JnvElstments($) Paid by You($) 852.25 I 6.00 846.25 I 846.25 Total Holdings and Market Value Security COMMON STOCK ISp. Shares 68.000 (As of the close of business on 09/15/2004) Total Shares Price per sharo($) Marl<e\ Vaiue($) 68.000 86.370 5.873.16 --- - --- - ----- ---- ----- ------ --- - - ---.- IBM Corporation Investor Services Program Transac !)Olj /~/:J h L t i;(/ /4 t, 6- / /' /c e /5 Ii t"tA-Z #/r;,,?O !/;:c; Ve! /d /10' /2. Neb site at INTERNET ACCESS IS HERE! We are pleased to announce that you can access your ac htlp :ilwww.ibm.comiinvestor You will need the issue number and account number locat, and your password of 30267793 to gain access to your ac, Iber (if applicable) Partial Withd, ~ates ~ L Issue a certitica1 number of share Issue#: 9926 Account#: 14636-44340 DONNA J PARKS 128 Soli this nllmber Janee or sale and/or Full Withdraw n. Names must be signed exactly ant. (Pal1ner/OfficerfTrustoe icerlTrustss.) Optional Investment Make check payable ro: i"'----l Inveslment Plan Services Amount enclosed in U.S.Dollars: __ Your Optlona' '.nvestmem can be a minimum of $50.00 per Investment and a maximum of $250.000.00 per year D ISS\.Ieat and sell [J 5ell all sha,os 09926 14636 44340 87 Address change or share transfer 0 Mark box and complete tha approprrat... partion on \he reverse side I / \./ PA REV-1500 SCHEDULE E CASH, BANK DEPOSITS & MISCELLANEOUS PERSONAL PROPERTY I-" ..j::::. co co co ..j::::. I-" co _~~"...._..~.~~"..,,~"':9~T!:!,~,~,,2,~.l?9t.~I.~~!:!.!'!f.!LE 9f.,,~Y.THORIZEO SIGNER ~ AmeriChoice ~ 1 FEDERAL CREDIT UNION Building Relationships For Life October 15, 2004 Craig A. Hatch, Esquire Gates, Halbruner & Hatch, P.C. 1013 Mumma Rd. Suite 100 Lemoyne, P A 17043 RE: Estate of Donna J. Parks Account #8412 SS #164-30-2891 The account is as follows: Account Type Date Opened DOD Balance Dividend Paid to DOD Ownership Share-Savings-O 1 Checking-13 Checking-14 4/06/1981 4/06/1981 9/10/1997 Sole owner Sole owner Sole owner $ $ $ $ $ $ 1907.81 3075.59 4.07 11.01 o o The deceased does not have a safe deposit box with the credit union. The account was closed August 13, 2004 for $4,987.47 by Raymond Strayer. Please call me at (717)697-3474 if you need further assistance. Sincerely, " ,jl~iMl~ d r0i0Jlili lru Tracey L. :Milliken Member Service Representative Main Office: 217S Bumble Bee Hollow Road. Mechanicsburg, PA 17055 . Phone: (717) 697-3474 @ '-NCU;q ~D~I~~I~,: ~.''';'.'....,~_ Website: www.amf'richoicf'.org . Fax: (717) 697-3713 ~ tf4 ....IlC... ro__~T~ TT..._..__ @omcast DATE DUE TOTAL AMOUNT DUE None ACCOUNT NUMBER 09547387314-01-0 See Note Visit us on the web at www.comcast.com DONNA PARKS For service at: 1280 BOILING SPGS RD APT A BOILING SPRINGS PA 17007-9679 Summary of Charges Billed from 08/08/04 to 08/19/04 Previous Balance Payments (includes payments received by 08/11/04) Monthly Services Taxes. Surcharges, & Fees 42.41 0.00 47.81 cr 0.12 cr Total Due You have a credit balance of $5.52! $5.52 cr Make No Payment! Detail of Charges on back News from Com cast If your bill reflects a credit balance of $1.00 or over, a refund will be sent to you automatically. If the credit is under $1.00. please return the notice to us or call the Customer Service Telephone number in the upper right corner of your bill. @<?om~~~l~!~ 4008 N DUPONT HWY NEW CASTLE DE 19720-6328 Please detach and enclose this coupon with your payment. Do not send cash. Make checks payable to: COMCASTCABLE~@ON Total Amount Due AMOUNT ENCLOSED $ Dete Due ADDRESS SERVICE REQUESTED See Note None 000-08-04-8-0 Account Number 09547387314-01-0 Credit Balance, Do Not Pay. AY 01 042085 113128185 A**5DGT DONNA PARKS 1280 BOILING SPGS RO APT A BOILING SPRINGS PA 17007-9679 1",111.1""11,1.1"1"1,,,11.11,,,1111,.1,1,,,1,11 COMCAST CABLE POBOX 3005 SOUTHEASTERN PA 19398-3005 1...111",111".11..,111,11,111,11,,1,.,11,1.,1,,1,11'11111,,I 09547 387314 01 0 1 000552 least -- -- - - -- - - - - - - - -- ie n S STATEMENT 7 ITEMS DE~CRIBED^BOVE IrTL Y. NO RH'EIPT DESIRED. 56353855 23.97 1020 09/17/04 5.52*****" './1 GNATURE m.fmtrustonline.com TRUST April 19, 2005 Law Offices of Gates, Halbruner & Hatch, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 RE: Donna J. Parks Ms. Sepkovic: In reference to the above customer, our records show the enclosed information to be accurate as of August 3, 2004. We are waiving our researching fee for this information, as the delay was an oversight on our part. We apologize that your request was not handled promptly. If I may be of any further assistance, please contact me. Sincerely, 1l1~ {} Oa>>i) Karen E. Davis Deposit Operations Manager 717-264-6116 888-264-6116 P.O. Box 6010 Chambersburg, PA 17201-6010 FINANr.IAI ~nIIJTlnN~_ I'RnM pI'nPI I' vnll ICNnw ACCOUNT INFORMATION RE: Donna J. Parks DATE OF DEATH Auqust 3, 2004 x CHECKING SAFE DEPOSIT SAVINGS ____CERTIFICATE OF DEPOSIT SHARES OF STOCK DATE OPENED 01/30/04 ACCOUNT NUMBER 34-34273 ACCOUNT BALANCE AT DATE OF DEATH ACCRUED INTEREST TOTAL ACCOUNT BALANCE INTEREST PAID YTD __$ 13.87 NAME(S) ON ACCOUNT Donna J. Parks REGISTRATION OF ACCOUNT Individual DATE CLOSED 08/13/2004 $ 211,571.76 $ 4.62 $ 211. 576.38 ACCOUNT INFORMATION CHECKING SAFE DEPOSIT X SAVINGS ___CERTIFICATE OF DEPOSIT SHARES OF STOCK DATE OPENED 02/04/00 ACCOUNT NUMBER 70-33699 ACCOUNT BALANCE AT DATE OF DEATH ACCRUED INTEREST TOTAL ACCOUNT BALANCE DATE CLOSED 08/13/04 $ 13,471.10 $ 5.09 $ 13,476.19 INTEREST PAID YTD ____$ 21. 25 NAME(S) ON ACCOUNT Donna J. Parks REGISTRATION OF ACCOUNT Individual ..... ~ \ .... o 'J\ "'" ? '" ~ ) I \ ! I \ '. \ \ \ \ \ I \ I I I . , \ I \ \ I \ \ i . , I i I I . . I . . Q ... ~ g Q ... ~ g \ ..... .... ~ ~ ~ ~ ~\ ;e ~ ..... i ." ~ I ~ ~ .;g \ i ., ..s> ~ 'f ;.t ~. ? <:> '" ..., ~ \ ~ \II ; g '" ............$$ "'~Q. 0 co"". ~~o . .....~- g8..s> 99 99 ..... ~ ." ..... ~ o ~ t:. '2 l , ~ 'is e. .' Q ... g ~ ... ~ ? i ~ :!~ :~~. ",'>1 ,"'!t Vi.<;i-;l/;:, ~:*- 'J\ "11. ~ OS ~;;:;q, _N""",^,,,~ ~... ";" ~g g.... ~~ ~~ ." 7 :::-. g .... ~ ~ Q ... ~ g ~~' l~ . ~ '" ~ ... ~ \II ... 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C .'If. ~ . '.i::ij. '':1,/ . ... Cf~;j{}" ~ ~ '.,,~ g ij. '?fib e,.-.< "\../,;, \ . . .~~ ..f/; "~ ":71.1 ::11.\ "~i '~'~i1/! " i'l TOEWS CORPORATION 1500 Market Street 12th Floor, East Tower Philadelphia, PA 19102 215.665.5634 877.TOEWSCO (877.863.9726) Fa>< 215.665.5755 Thursday, September 16, 2004 Donna J. Parks 1280 A Boiling Springs Road Boiling Springs, P A 17007-9679 Account Registration: Account Type: Investment Company: Account #: Risk Management Portfolio: Refund Amount: Donna J. Parks Non-Qualified Security Benefit 5500010244 Growth $92.78 This letter is to indicate that as of 8/13/2004 the above referenced account at Security Benefit has been liquidated and our management services thus terminated, Please find a check in the amount referenced above. This check represents a return of the pro-rata fee. Please call your representative with any questions. Investment Firm: Representative: H. Beck Inc. Keeler, Danner, & Otto 5249 Simpson Ferry Road Mechanicsburg, P A 17050 717-790-9059 Enc!. PA REV-1500 SCHEDULE G INTER-VIVOS TRANSFERS and MISCELLANEOUS NON-PROBATE PROPERTY eeler & anner Registered Investment Advisor Agents John R. Keeler, CFP Registered Representative FINANCIAL SERVICES LLP Dale E. Danner, RFP Registered Principal 5249 Simpson Ferry Road, Mechanicsburg, PA 17050 James A. Otto Registered Principal Operations Manager (717) 790-9059 (800) 373.5452 Fax (717) 790-9268 October 14,2004 Gates, Halbruner & Hatch, PC Attn: Traci Sepkovic 1013 Mumma Road Ste 100 Lemoyne, PA 17043 RE: Donna J. Parks SSN: 164-30-2891 To Whom It May Concern: The following information is in regards to Donna J. Parks and any accounts she held through us. Product Owned: Account Number: Owner and Annuitant: Account Established: Beneficiary(ies) : Date of Death balance: Security Benefit Variflex LS Variable Annuity 5500010244 Donna J. Parks March 04, 1996 Brian T. Yufer 100% $29,206.66 Should you require any additional information or have questions on the above, please contact me. . QoctfilllYd'\Vl~ --\(t\A~~, 'r- Patricia A. Juliana, Office Mgr. j Securities and Investment Advisory Services offered through H. Reck, Inc. Memher NASD, SIPe Certain individuals are registered representatives of H. Beck, Inc., which is unaffiliated with Keeler & Danner Financial Services, LLP PA REV-1500 SCHEDULE H FUNERAL EXPENSES and ADMINISTRATIVE COSTS MY"fS Funeral Home, Tne. Boyd L. Myers Jr., Supervisor 37 East Main Street Mechanicsburg, Pennsylvania 17055 (717) 766-3421 Fax (717)795-7291 A standard of excellence in Central Pennsylvania since 1910 VVednesday,August25,2004 Mr. Ray Strayer 889 King Street Lewisberry, Pa. 17339 Dear Mr. Strayer, Thank you for selecting our funeral home to provide services for your family during your bereavement. I hope that you found our services to be of the highest standards and that they met your needs and those of your family and friends. The following is a summary of the service charges as previously explained and provided in written form on the serl/ices for: Donna Jane Parks SUMMARY OF EXPENSES TOTAL OF SERVICE RENDERED LES8. Credits granted LESS: Total Payments PLUS Items ordered later CURRENT BALANCE Credits Granted: $167.52 Preneed Adjustment $1,070.0 Package Price Discount $3,180.00 1,237.52 1,942.48 922.96 $922.96 PLUS: Items ordered 'liter Memorilll Service Book Clem' FIO\vers Obit 550.00 65.00 ilJO.OO 65.00 142.96 Interest at the rate of 1.5 % per month ( 18 % per annum) will be added to balance after 30 days. y questions or concerns that remain unanswered, please call me. /J J1)tfj a7 C~ ORDER FORM FIL~ COpy ingricl Since 1921 Foundation BY~ o Carved Lettered o Drawing Required o Drafter o Sandblast By Manufacturer No. 2-20081 Supplier Ack. # Date Rec'd Found. Ordered Position Verified SOLD TO: Th tst~L (if 'Do""",,!).. c(~ Me \(0.,\ \C. St<'t.'1t('/ )l6'~ '<:::I'Y\, Sot rt,-,-T L~wl;)loeYI"If P A '/1"39 Phone (H) qj?- ~Y,1 (W) 'Y~-'lsoa (..r,dD oukl Ro~'t:. H""""G w~~ ih:!.t\l;\\t.cA 5243 Simpson Ferry Road, Mechanicsburg, PA 17050 (717) 766-5622. Fax (717) 766-8007 www.gingrichmemorials.com ~& LlCeuXl'lr Cemetery Location Date of Order f - '?, I - 0 ;- Mf.PhIl.VI;(,S~ Sr.c. n e oW G , q+/ () tk STRAYte I~f- Center Over Graves Lot # "ritl I t'l~ Approx. Date of Completion Lettering "le'" ~""\"'<;, Mt-t'IO\'-Y ~ l DOt-l N l\ J~NE \'I\R~, ; . JULY 4, Iq38 AU&lJ.ST ....,) ?-'\)oy 4- Spelling and dates have been approved. Type of Memorial fk-\- M.e....k Material ~\\lcnv.. \3II.H' Gnbj ~ (,,1l~Je Size ~ X i::-{L x.D..:.!:L Finish ~tl'>p - b.-rJelf" SB Ffl..e.\ Size X X Finish Misc. Design Location o Vase o Corner Posts WHITE-Office YELLOW-Production Price $ Foundation $ $ $ TOTAL de# $ DEPOSIT 13? $ Balance Due Upon Completion $ 5':10.- :?O. Agreement: A 50% deposit is required to commencement of work. Agree to pay stated balance upon erection regardless of labor troubles or shipments or any other good reasons. This order or contact cannot be cancelled by customer unless agreed by both parties. The article herein mentioned shall remain the property of James R. Gingrich Memorials until paid in full and they reserve the right to remove the same is not paid as stated. I agree to carefully proofread all names and dates for accuracy and accept full responsibility for any errors or omissions. THERE WILL BE AN ADDITIONAL CHARGE FOR ANY LETTERING ADDED TO THIS MEMORIAL AFTER ERECTED ON THE CEMETERY. I further agree to pay the balance stated for the work performed under this contract within thirty (30) days of receipt of the final invoice and further agree that interest shall accrue at the rate of one and one-half percent (1~%) per month on the unpaid balance owed to James R. Gingrich Memoriels not paid within thirty (30) days of the invoice date. In eddition thereto, I agree If It becomes necessary for James R. Gingrich to Institute legal proceeding to collect any funds due from me for my account being past duethlrly (30) days, to pay all court costs and attorneys fees Incurred by James A. Gingrich Memorials to collect the same. bOO. - bot), - Dealer ~C~ f25 RECEIPT FOR PAYMENT ------------------- ------------------- Cumberland County - Register Of Wills Hanover and Hiqh Street Carlisle, PA 17013 . Receipt Date: Receipt Time: Receipt No. : 8/12/2004 09:22:09 1037496 PARKS DONNA J 2004-00744 RAY STRAYER JA ------------------------ Receipt Distribution ------------------______ Fee/Tax Description Payment Amount Payee Name Estate File. No. : Paid By Remarks: PETITION FOR PROBA EXTRA PAGES SHORT CERTIFICATE T"n T"'lT""1T""'1 UL.t'" rn.c, 270.00 15.00 18.00 10.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D Check# 1016 Total Received.. ....... $313.00 $313.00 cj;.(I~ l J ~ fJ~ ..1<.0 ,p.. 1'1 ~: &.. I iT '11 J: -{sf9nJ 5870 'Wertzviffe 1(1. ~~~urnv -'3 ~~~1~5 anti !JIu.togfass 732-3588 \- Liberty Mutual Group PO Box 3008 Williamsport PA 17701 ~. PREMIUM NOTICE 08/06/04 Vish our webshe at: www.LlbertyMutual.com For Salas/Service Assistance Contact: 5021 LOUISE DR HECIIANICSBURG 795-8703 DONNA J PARKS 1280A BOILING SPRINGS RD BOILING SPRINGS PA 17007-9679 - Policy Number FN2-288-665162-803 68 Type of Policy FIRE APR or Billing Expense Fee Interest Computed On Minimum Due in Full Due Date $4 PER INSTL 24.50 24.50 08/26/04 PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION YOUR PREMIUM PAYMENTS ARE ~/dL-- NO LONGER BEING PAID VIA THE INSURANCE DEDUCTION PLAN. RECENT DEDUCTIONS MAY NOT YET BE REFLECTED IN THIS STATEMENT. YOUR COVERAGE WILL REMAIN IN EFFECT PROVIDED YOU PAY THE MINIMUM DUE. IF YOU HAVE A QUESTION PLEASE CALL: 1-800-526-1547. Please detach and return the bollom portion with your payment, in the envelope provided. Liberty Mutual Group PO Box 3008 Williamsport PA 17701 ~ PREMIUM NOTICE . 08/06/04 Vlsh our webshe at: www.LlbertyMutual.com For SalesJService Assistance Contact: 5021 LOUISE DR HECHANICSBURG 795-87113 DONNA J PARKS 1280A BOILING SPRINGS RD BOILING SPRINGS PA 17007-9679 Policy Number FN2-288-665162-803 68 Type of Policy FIRE APR or Billing Expense Fee Interest Computed On Minimum Due In Full Due Date $4 PER INSTL 24.50 24.50 08/26/04 PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION YOUR PREMIUM PAYMENTS ARE ~/dL-- NO LONGER BEING PAID VIA THE INSURANCE DEDUCTION PLAN. RECENT DEDUCTIONS MAY NOT YET BE REFLECTED IN THIS STATEMENT. YOUR COVERAGE WILL REMAIN IN EFFECT PROVIDED YOU PAY THE MINIMUM DUE. IF YOU HAVE A QUESTION PLEASE CALL: 1-800-526-1547. Please detach and return the bollom portion with your payment, in the envelope provided. Liberty Mutual Group PO Box 3008 Williamsport PA 17701 ~ PREMIUM NOTICE 08/06/04 Visn our websne at: www.LibertyMutual.com For SalesJService Assistance Contact ~021 LOUISE D~ HECH^NICSBU~G 79~-8703 ESTATE OF DONNA J PARKS C/O RAY STRAYER EXECUTOR 889 KING ST LEWISBERRY PA 17339-9575 Policy Number H32-288-665161-803 88 Type of Policy HOMEOWNERS APR or Billing Expense Fee Interest Computed On Minimum Due In Full Due Date $4 PER INSTL 88.66 88.66 08/26/04 PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION YOUR PREMIUM PAYMENTS ARE NO LONGER BEING PAID VIA THE INSURANCE DEDUCTION ~ (02- PLAN. RECENT DEDUCTIONS MAY NOT YET BE REFLECTED IN THIS STATEMENT. YOUR COVERAGE WILL REMAIN IN EFFECT PROVIDED YOU PAY THE MINIMUM DUE. IF YOU HAVE A QUESTION PLEASE CALL: 1-800-526-1547. Please detach and return the bottom portion with your payment, in the envelope provided. Liberty Mutual Group . PO Box 3008 Williamsport PA 17701 tJt PREMIUM NOTICE 08/06/04 Vlstt our wabsne at: www.LlbertyMutual.com For SaleslService Assistance Contact: 5021 LOUISE DR HECHANICSBURG 795-8703 ESTATE OF DONNA J PARKS C/O RAY STRAYER EXECUTOR 889 KING ST LEWISBERRY PA 17339-9575 Policy Number A02-288-563456-803 58 Type of Policy AUTOMOBILE APR or Billing Expense Fee Interest Computed On Minimum Due In Full Due Date $4 PER INSTL 103.16 103.16 08/26/04 PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION YOUR PREMIUM PAYMENTS ARE NO LONGER BEING PAID VIA THE INSURANCE DEDUCTION ~ PLAN. RECENT DEDUCTIONS ( 02---- MAY NOT YET BE REFLECTED IN THIS STATEMENT. YOUR COVERAGE WILL REMAIN IN EFFECT PROVIDED YOU PAY THE MINIMUM DUE. IF YOU HAVE A QUESTION PLEASE CALL: 1-800-526-1547. Please detach and return the bo"om portion with your payment, in the envelope provided. ~ . '" Ll'l ~ <Xl ...,. '" . '" '" o a. .... o rl o '" " <<: a. 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'" e ",f-, ::s _ u ..., ~ ~ >>-a, ...- ~::r.: ! 1i , "" c . of . ~ . . . . ~ --> r-r--~I PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16,1929), p, L.1784 STATE OF PENNSYLVANIA : ss. COUNTY OF CUMBERLAND : Lisa Marie Coyne, Esquire, Editor ofthe Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exaciiy the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, VIZ: SEPTEMBER 24, OCTOBER 1, 8,2004 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter ofthe aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. \. ('V )K~ C/(, Parks, Donna J., dec'd. Late of Allen Bora, Executor: Ray R. Strayer. 889 King Street. Lewisberry. PA 17339. Attomeys: Craig A. Hatch, Es- quire. Gates. Halbruner & Hatch, P.C., 1013 Mumma Road, Suite 100. Lemoyne, PA 17043. )1.', / Li a Marie Coyne, Ed' or ..-/ SWORN TO AND SUBSCRIBED before me this 8 day of OCTOBER 2004 NOT AR I\L SEAL LOIS E. SNYDER, Notary Public Ca:lisle Bora, Cumberland County My Commission Expires March 5, 2005 I- ei Z Z f- W Z :::J :ii: 0 (.) w (.) <( ~ a: w ::; ::? I- .7- ... '" ~ ." f.Sl :::J "" .". (.) 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'9 i::(1 ,";I ..... z UJO c..>- :;;:!;( c:c..> WO UJ...J ,~ <So ~;o !:~..J ~ ~. "', ':!r~ J & D AUTOMOTIVE ~_RVICES RT 11 & 15 ENOLA, PA 17025 717-909-1400 717-909-4098 717-909-1500 FAX Invoice Date Invoice # 8/30/2004 7050 Bill To License # Donna J. Parks l2S0A Boiling Splmgs Road Boiling Springs, P A 17007 I- I vvdbea26d6ka873160 Due on receipt 95079 8:~=;:nt~ VIN Terms MILES Item Qty Description Rate , ~ Inspection Stic_.. 1 Sticker # IM4 9316427 2.00 2.00T sticker 1 Emission Sticker # IM4 5765705 0.00 O.OOT MCI FEE 1 MeI transmission fee 4.15 4.15T LOF Lube oil & filter 7.49 7.49T I/~ ~/O< Subtotal $13.64 Sales Tax (6.0%) $0.82 Total $14.46 ,C;~ :-. = c,)"-' ..0= .....~ i-l~ ~ . IJ:) o exl IJ:) N ..... . co CO '" r- ...; '" 8 '" to ,0( '"' '" '" ::5 '" to ~ I>l '" tIliil ....00 >< ::> u E-< 0.... '" '"':ii I>l ...; 0: OJ N U .... '" I>l '"' co::;; ~ U .... 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E i , .i ^ .z ... o l) ~ CO ~ CO ., = o ' '13 S CO ..;:: ~ e .- .. 0- 0: -. .~ ]~ -= =::0 <l)~ -5r>1 ~ u co~ ~..... " E rgf-< u ;;... tE ~ ::: ~ii, ti5:E ~ ;: ~ E -;: t "1: ~ " ~ 5: LIBERTY MUTUAL GROUP 5021 LOUISE DR MECHANICSBURG PA 17055 *049941* ~,. .... :\1 _ .L:! PREMIUM NOTICE October 15, 2004 *19001 006986720041015* ESTATE OF DONNA J PARKS C/O RAY STRAYER EXECUTOR 889 KING ST LEWISBERRY PA 17339-9575 For Customer Service Call: (717) 795-8703 Hearing Impaired Customers Call: (800) 243-9801 To Report a Claim Call: (800) 225-2467 Or Contact Us At: www.libertymutua1.com This bill reflects paymcnts rcceived as of 10/15(2004. PLEASE SEE REVERSE SIDE FOR POLICY DETAILS AND IMPORTANT INFORMATION Please pay the current due. Any additional amount paid will reduce the remaining policy balance. ****Liberty Mutual offers an easy and convenient way to pay your bil1**** You can have your payments electronically deducted from your checking account, saving you the time of writing and mailing a monthly check and reducing your monthly installment fees. Just check the box below and complete and return the infonnation on the back of this fonn. Change the batteries in your smoke alarms once a year; replace alanns every ten years. ~~~ ~ ! Please detach and return the bottom portion with your payment, in the envelope provided. ! LIBERTY MUTUAL GROUP 5021 LOUISE DR MEC.HANICSBURG PA 17055 '048754* ~ PREMIUM NOTICE *19001 005242320041015- DONNA J PARKS C/O RAY STRAYER EXECUTOR 889 KING ST LEWISBERRY PA 17339-9575 October 15, 2004 ~ .ti /F~~"=' S.~ire 0.'''(717) 795-8703 Healing Impaired Customers Call: (800) 243-9801 To Report a Claim Call: (800) 225-2467 Or Contact Us At: www.1ibertymutua1.com This bill reflects payments received as of 10/15/2004. PLEASE SEE REVERSE SIDE FOR POLICY DETAILS AND IMPORT ANT INFORMATION Please pay the current due. Any additional amount paid will reduce the remaining policy balance. ****Liberty Mntual offers an easy and convenient way to pay your bill**** You can have your payments electronically deducted from your checking account, saving you the time of writing and mailing a monthly check and reducing your monthly installment tees. Just check the box below and complete and return the information on the back of this form. Change the batteries in your smoke alanns once a year; replace alarms every ten years. 1 Please detach and return the bottom portion with your payment, in the envelope provided. 1 LIBERTY MUTUAL GROUP 5021 LOUISE DR MECIIANICSIlURG PA 17055 *036215* ~. ~ ? PREMIUM NOTICE October 05, 2004 *19001 003093120041005* DONNA J PARKS 889 KING ST LEWISBERRY PA 17339-9575 For Customer Service Call: (717) 795-8703 Heming Impaired Customers Call: (800) 243-980 I To RepOlt a Claim Call: (800) 225-2467 Or Contact Us At: W\vw.libcltymull",l.com This bill reflects payments received as of 10/05/2004. PLEASE SEE REVERSE SIDE FOR POLICY DETAILS AND IMPORTANT INFORMATION Please pay the ClllTent due. Any aclditional amount paid will reduce the remuining policy bulunce. ****Liberty Mutual offers all easy and cOllvenient way to pay your bilI**** You cun have your payments electronically deducted from your checking account, saving you "the time of writing and mailing a montl\1y check and reducing your monthly installment fees. Just check the box below und complete and rcturn the infonnation on the back of this fOlm. 1 Please detach und retull\ the bottom portion with your payment, in the envdope provided. 1 Make Check I'ayahle To: LIBERTY MUTUAL GROUP DONNA J PARKS Please send all payments in the envdope provided. Payments are 110 longer accepted in locul Libclty Mutual ol1ices. . Check here for change of address and entcr infonnution on rcverse side. .. CurrenIDue:/ .~ Pay either t Policy Balone.: Sales Oflice: $ 65.28 atIlOWl! $ 616.85 0357 I Policy Number: Due Date: A02-281-563456-80 4 10/25/2004 AMOUNT ENCLOSED Check here to have future paymcnts automaticlllly deducted from your chccking llccount. $ Libclty Mutual will initiate the transuction on the 5th day of each month for withdrawal [rom your blink two business days lute)". You mllY sclcct a ditlerent day on the buck of this fonn. Scc reverse side for rcquircd signature and additional infollllutioll. . 286176922815634568020041005000005000000000065280061685 'ii~ -<~ g~ 00 rtI--1 ~$< w,l(\\ ~:2 w,~ gm ~-I ;4c rtI~ zrtI $?o 00 (fJ<:: rtIrtI ~;o ~(j ~;o ~o rtIrtI oC ~z og Ortl w,~ '{},o rtlo 01=- ~'A ;.::-1 rtle> 'Oz ~~ rtI~ 3~ -10' ;1:0 '?'A r-m ()~ otll -.1m rn;O (/lo# 'S" g ... u:lPtO Ot->~ t-<\CO t'0 H,(I) '.to."'- G"lu:l0 (l)OO~ tO~ 'C',... '.to '.to G"lG"lc... 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"'w 0'" ",,,, ",a 0< MAXWELL ENTERPRISES 1332 BRANDT AVENUE -- NEW CUMBERLAND, PA 17070 VOICE: 774-7150 FAX: 774-2366 WEB: WWW.ACCOUNTANT-CITY.COM/MENTERPRISES * E-MAIL: ACCTWITHED@COMCAST.NET DONNA J PARKS 1280A BOILING SPRINGS ROAD BOILING SPRINGS PA 17007-9679 INVOICE DATE: 04/11/2004 SS NUMBER: 164-30-2891 TELEPHONE: 717-258-5377 INVOICE NO. : 1 FORM 1040 1 SCHEDULE B, SCHEDULE 1, INTEREST AND DIVIDEND INCOME 1 SCHEDULE E, SUPPLEMENTAL INCOME AND LOSS 3 FORM 1099R, PENSION, ANNUITY, PROFIT SHARING DISTRIBUTIONS 1 FORM 4562, DEPRECIATION AND AMORTIZATION 11 DEPRECIATION WORKSHEETS 1 SOCIAL SECURITY, RAILROAD TIER 1 RETIREMENT WORKSHEET 1 PA STATE RESIDENT RETURN INVOICE 437.00 292.00 Remarks: Copyright form software only, 2003 Universal Tax Systems, Inc, AU rights reserved. 145.00 . / \J Met-Ed A ri"SiEoflf/Y Coo~ I Account Number: 1000207179951 September 21,2004 Page 1 of 4 M72 Bill for: ESTAT.E OF DONNA J PARKS ALLEN ~ .J.! 1280A BOILING SPRINGS RD ~ Iff /;lOlLING SPRINGS PA 17007 Billing Period: Aug 18 to Sep 20,2004 for 34 days Next Reading Date: On or about Oct 18, 2004 Bill Based On: Actual Meter Reading Your previous bill was Total payments/adjustments Balance at billing on September 21, 2004 Current Basic Charges Met-Ed - Consumption ue Residential Time Of Day To avoid a 1.50% Late Payment Charge being added to your bill, please pay by the due date. CUGtomer Service 1-800-545-7741 Automated Outage Reporting 1-888-544-4877 Collections 1-800-962-4848 , ,-0';'jjJt~~,,'~'\+''Y''_'t"';;' ;~;>;~t1i;';i';\,"('1!.'/Ir.,.,."'l""1!'l!"_~~~'!'~."''''_ .''''' ",,,",,',<0;)0'7'''''''' h",_ ..lIal Time Of Day Meter Number Present KWH Reading (Actual) Previous KWH Reading (Actual) Kilowall Hours Used G83271330 2,799 2,258 541 Meter Number Present OnPeak Reading (Actual) Previous OnPeak Reading (Actual) OnPeak KWH Used (48.6%) Off Peak KWH Used (51.4%) G83271330 71,365 71,102 263 278 Page 1 of 4 M72 I Met-Ed A ""'tEnergy CC:npmY" October 20,2004 I Account Number: 1000207179951 Bill for: ESTATE OF DONNA J PARKS ALLEN 1280A BOILING SPRINGS RD BOILING SPRINGS PA 17007 I I Billing Period: Sep 21 to Oct 19, 2004 for 29 days Next Reading Dale: On or about Nov 16, 2004 Bill Based On: Actual Meter Reading To avoid a 1.50% Late Payment Charge being added to your bill, please pay by the due dale. ~ if I (1 ~.~li.~x~i\>l~'''~- - I I Met-Ed A fflIfnetgy~ Novemnber18,2004 I Account Number: 10 00 20 7179 9 51 Bill for: ESTATE OF DONNA J PARKS ALLEN 1280A BOILING SPRINGS RD BOILING SPRINGS PA 17007 Page 1 of4 M72 Billing Period: Oct 20 10 Nov 17, 2004 for 29 days Next Reading Date: On or about Dee 16, 2004 Bill Based On: Actual Meter Reading To avoid a 1.50% Late Payment Charge being added to your bill, please pay by the due dab:!. ~. 111'-5 l'~;):'~'\1;":",::!i, '. ~!t~Qtfr~1Ift!f.~U4I.IIl'PPJ!.'!P'1ian~ ~.Jmq"/ll;t~m~~'"~~;,.iI;;t;,,V11,~1 ~~ December 17, 2004 I Account Number: 1000207179951 Bill for: ESTATE OF DONNA J PARKS ALLEN 1280A BOILING SPRINGS RD BOILING SPRINGS PA 17007 Page 1 of 4 M72 Billing Period: Nov 18to Dee 16, 2004 for 29 days Next Reading Date: On or about Jan 17, 2005 Bill Based On: Actual Meter Reading Residential Time Of Day {I-v-J1 #/d D ';;>l,:li1;')'%lirl~\~:;~:Jft.qt;f1'lli1PIl9"~fQ(~~it(Qnlllm:Q~,gn"mJ;D!eRU<>rlJ~):\"ro"'~;l\~.;;;'\;ii,rl;;;;l~iil Residential Time Of Day Meter Number G83271330 Meter Number G83271330 Present KWH Reading (Actual) 4,674 Present OnPeak Reading (Actual) 71,990 Previous KWH Reading (Actual) 3,678 Previous OnPeak Reading (Actual) 71,654 Kilowatt Hours Used 996 OnPeak KWH Used (33.7%) 336 OtlPeak KWH Used (66.3%) 660 Page 1 of 4 M72 Met-EeJ-. January 19, 2005 I Account Number: 1000207179951 .,c_'c ~ A FITS...... .....~J ompany Bill for: ESTATE OF DONNA J PARKS ALLEN 1280A BOILING SPRINGS RD BOILING SPRINGS PA 17007 Billing Period: Dec 17 to Jan 18, 2005 for 33 days Next Reading Date: On or about Feb 15, 2005 Bill Based On: Actual Meter Reading Prorated Bill Residential Time Of Day cM4F(J' Payments: 01/05/05 -87.84 Total Payments -87.84 Residential Time Of Day Meter Number Present KWH Reading (Actual) - ....... - .. .. .. G83271330 5.737 Meter Number Present On Peak Reading (Actual) ..... . ......... I r"'\ " G83271330 72.350 l '\J RIT1tRS lRIl WUE Ill. 25 " IIlH Sf 1EtWft1r.su&. PIlliUi TIlE 9:12 111 DATE lI8i14Jt4 lEIIII 811915816 1&1 B22I1111996 1RJll TYIt SALE ItXXXXXX)()O()()(X2867 CfR) TYIt /'tASTERcARD SEQIIl83 TICI<ET I _19516 W1It COOE 221876 TOTAL $32.26 III I II US I KUI. V Alllt IIARDIIAllt c5 II HAtN SlIlttl HU)IANICSrnnu; PA I (lI!'!1 711 IIili 16:11 W/Il4/04 00:08 lOOl!i90f) CHRISTINe 11811 lJly Prica AalolSlt 139396 8.44S 8.44 PIi Elimy un:;r I Ull056 1 21.99 21.99 PIN. llRS COHl.1 lUl:K51I CUSTOMER COPY SulJlolal Sales lax lotal Due 30.43 1.83 32.26 Bill ik C,lr d :12. 26 CallI ^c"" ....xxxx09442861 Authorization 221876 dx.A (01 UlAN!( YOIJ Hill SIHnNll AI IIIlIEIIS HOtf)AY- r ILllAY tl:OOAH 10 6:00PM SA TlJlDA Y 8: (lOAH 10 !): OOPM SUNDAY 10:00A" 10 3:00PM Registered No. ..,...'1'l9".....,611S -7 -, "".; 1.-,.'" Q ,/ ~~~ .4o:'0f!" / ~\ ({. I i.,(~ --( , . Reg. Fee $ $7.50 Spec,al $ $0, ..~ DAliveiy $ *n.oo RReturnt $ $1.75 ~ eceip $ Restricted $ 110 00 $1.06 Delivery ;0 . Date Stamp 0339 " ~g ,,-- EO 0- u~ 00- oo~ 010 l- I-\andhng Charge POSt3gC '\-\:1 09117/2004 Domestic Insurance 15 Limited To $25,000; International Indemnity Is Limited (See Reverse) Received by Customer Must Declare Full Value $ ,o,;'OOC 3i1W' fJ ,--,--0/' - / {'~ (')._ -..._'1 -."...\ J f c: -i,. / +-' f --1- ~--T--r-.-'--- '....... -r"-.l--. .., 1// " (/ i--- ..). ~" y. t 'F1.....J-1 I ,-". .-J 17339' ./ p (, '" ~/..., '" n' " ;-- -- . ,I I " 8- >- o l- E i5 ~ E , 0 Uz:;-E- ~'~~ -g ~.E im~ ~ ~ g , / . /) /.-.... ~ ~ l ,'-'-://--II,~ /,- /~') r"--/{__.r " ~ .~ I I - 1----' -,.) , // "if' l- :ij I:::: -- -L'l2~l-c)./,.iC( .'I.1_J...,[rl: t-'...., r 7\,') " VlSTJLJd\ I1?flltl "- , ~ I . .. ,- J /;;,1 /lJ ,.. I ~ /'.,:) 1-" , \ _~-;A /-4./.Y '~,,', /7<, :" I ~--.....",n.r rn'1"";';:;.r:..;:.=,.-t .1u;' !1lauis.tco'ed fv1ail IC....:;tCr;1.]1 C:;P'r') PS rUl r II '>OUU, "'_..... t.J ~ (See Information on Revetse) June 2000 :2' o a: u- "7 (~?~"1~0'7 LEWISBERRY MPO LEWISBERRY. Pennsylvania 173399998 4144060339-0097 09/17/2004 (717)938-6690 02:42:00 PM Sales Receipt Sale Unit Qty Pri ce Final Price Product Description VISTA CA 92081 First-Class Rtn Recpt (Green Card) Registered Insured Value: Article Value: Label Serial #: $1.06 $1.75 $7.50 $0.00 $0.00 RB612978696US -------- -------- Issue PVI: $10.31 Total: Paid by: Cash $10.31 $10.31 ~~ -- All sales final on stamps and postage. Refunds for guaranteed services only, Thank you for your business. Customer Copy Bi 11#: Clerk: 1000300017059 04 Tt-IE liOMC PLF'Ol H-' 11 I 4200 DU<PV ':J ti/\I,r:LUUI\,. i'A : 11 [] { 11]) 5:ji; ra (6 ,-11 t.! OUU10 (Ji)!:.)r) I.J~J/ul/iJd "" r Jl LMI<W/ 11. ';1 /I~1 ~'S~I .~,~, ~'''.''Il " , '. ..:t~..'i Il...-"!lw-'''I~ I .fl."~ ' ~~",\.' ,-i;,' 'I .,' '1-"" ::. ~. )I.l:.f.U~,_\ ;';,1 l.t ;'\I,J\I'\ I;; l. .-'1 Ii !;i!~;1'\ '"~I;\I:i'lL ,j ~rl:;~J:U9:3['2fj F:;FU :~,H.iN ,I IE; i 'lU\1 ';/\1" i.l. l/',r,IL .:x :!.){)()\'\(XX/fi:,~ . i' )j-'11 [n'lli .,11,11 CODf ,'lir,'11 II,..'U;U i # J;)L r',lt~j"~: Li.J 1'/\1 ~K.', &>~ \~ ~ ( ~ . 'I ,1 1 ,,) . ~);,.; J' ',,: J L1L '1:1:' '1'-,1 '" (',' 1\.. ,'oJ {(\ Ii, "fl,' .'1, .,I~I' ~'1,'~:.~' ~;J~I!'1 ill' I; ':1"1': :,: H ~ I, ,I:{ ..; '.'.',Ir "'!ll" .Ii" '1"11. "I". '/"11"'1.1 'I'; , I tl 'I.", ~l' :, '- Yo ~ : I' J. 'r" ,J I i' III Wl,/,ia.; 'I, 1111 HIli :., ,1\ I ill, 1,({i7(1 IJi(\7.'~",,'!iil Iii. d, ': iii' un ON COI iN.1 'i I .'uMI'IFi I ), .,iJl:\'I" hi WWWliOMEDEPOrol'HHON,L:)M ilNi! LIlli,; 10 WIN A $"..000 HOM[ DU"Or LIF1 1,/Ilm' -, . \l '- ('. ('\ \ , . ., \' '< ,,," \."- '" ,/ , I OfficelVlax DfficeMax #322 3823 UNION DEPOSIT ROAD HARRISBURG,PA. 17109 (717) 558-1550 Enter/Win www.officemax.com/store/survey 072782062057 Lb1 Disp 1-1/8x2-5/8 8lue 072782054809 Garage Sale Lbl Pre-Print 0072782054809 Garage Sale Lbl Pre-Print $5.B9 $1.79 $1.79 SubTotal Tax 6.000% MAL $9.57 $0.57 $10.14 $20.14 $10.00 Cash Change 32443516 0322 00003 46205 2 09/08/0~ 00273749 07:00:13 PM ORDER BY PHONE 1-877-0FFICEMAX 111111111111111111111111111111111111111111111111111111111111111\ 032200346200001090804000 - .,\0 " \ ), \\ , OfficelVlax OfficeMax #746 600 CARLISLE PLAZA MALL CARLISLE,PA. 17013 (717) 243-2764 Enter/Win www.officemax.com/store/survey 072782054809 Garage Sale Lbl Pre-Print 072782054809 Gdl dytl 3d ltl UJ 1 Prtl-Pr illl 083392099098 15x19 Garage Sale 083392099098 15x19 Garage Sale $1.79 $1.79 $3.69 $3.69 SubTotal Tax 6.000% TOTAL $10.96 $0.66 $11.62 $20.00 $8.38 Cash Change 42441516 0746 00002 90130 3 09/15/04 00014990 10:09:46 AM ORDER BY PHONE 1-B77-0FFICEMAX 1111111111111111111111111111111111111111111111111\1111\1\11\1111 074600290130001091504002 I, LEWISBERRY MPO LEWISBERRY. Pennsylvania 173399998 4144060339-0097 09/17/2004 (717}938-6690 02:42:00 PM Sales Receipt Sale Unit Oty Price Product Description Final Price $1.06 $1.75 $7.50 $0.00 $0.00 RB612978696US VISTA CA 92081 First-Class Rtn Recpt (Green Card) Registered Insured Value: Article Value: Label Serial II: -------- -------- Issue PVI: $10.31 Total: Paid by: Cash $10.31 $10.31 B1111l: Clerk: 1000300017059 04 -- All sales final on stamps and postage. Refunds for guaranteed services only. Thank you for your business. Customer Copy " 8- l; ~ " l; ~ ~ , 0 O;E- ~.g~ ~';.E am&: ~~~ o ~ c 0 00 c o ;: I- l; W ~ ale li.2 ~5 0,. 00 co. 00,., om I- PS Form 3806, June 2000 Handling Charge Poslage $ -?7 .....;t;/.., 'I :Y <1- 11"f..-f.. Special $ SO.:~ Delivery Return $ Recei t fl.75 Restricted $ Delivery $0.00 C_.._~ Domestic Insurance Is Lirrlited To $25,000; International Indemnity Is Limited (See Reverse) Datft Stamp $ SO.OO 0339 f\p\ 09/1712004 $1.06 Received bV._. .-...-. - '. .. r...... ":':.!::~.~' ~ -= o II: LL f2 THE HOME DEPOT ff4113 4200 DERRY ST HARRISBURG. flA 17111 (717) 558.8105 4113 00010 66570 09/07/04 :.;ALE 11 LMR187 11: 51 AM ......_..._--..-----.....~.-.... 1m,s,> ~) . ~~.... ~ i '\~'l.' ....~";.~ ~~~'-@ 0.151'99394984 lOX1tl AUTO 2 &l 1.29 O!lM130051'1 5HflHPIE 045899393628 FSBO SIGN SUB TOT AL SALES T Al( TOT i'lL XXXXXXXXXX}(X295S HOME DEPOf AUTH CODE 00771111107050 P.O.#/JOfl NAME: OJ PAnKS 2.58 0.81 1~1. 98 1'1 ,-~ , .),1 1.0C $18. '59 18.59 HI JiJ i ~lltj~I~~~t~ll~lIJ~~lJ!~~'JllI~tlJ ill!1 YOUR OPINION COIJNTS! COMPLETE A SUnVEY AT WW'rUIOMEOEPOTOPINlON. COM AND ENTER TO Il'IN A $5,000 HOME DEPOT GIFT CArlO! ; i:t o -:s: '; 4. ... ~~~............ -:J S t- .0 If>I .... ._ roC'l"'" Q..~J>OO __ ~lOOO ., i,~~~~ ~ ~~~)( \'i _ <I>(l.U1U1g *- ~ dlN'" C ::>> 'a~l~ i ~ ';~~'O; " s~~~ _ Q"'i3........ ~lDQ)...... ~~~':::-':::- u1 ~ Z o ~ , <G o G) g ~ ~ o ... e~ o "i cn ~ l> .~ II) 'i ~ ... o - "C :) o ~ "0 "C Ql i ~ in ~ G) ... , .S "0 ~ ~ '& 011 2. 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Gl ~ ~ 1: \0 III r- ., \i) 1: IS I- III \i) 1: % I- ~ 1: IS I- [fJt patriot-Ntw5 Now you know Order Confirmation Ad Order 0001179006 Customer Strayer Customer Account 65198 Pavor Customer Strayer Sales Iford Pavor Account 65198 Order Taker Iford Customer Address 889 King Street Lewisberry PA 17339 USA Pavor Address 889 King Street Lewisberry PA 17339 USA Pavor Phone 717-938-6647 Order Source Phone Customer Phone 717-938-6647 Ordered Bv Ray Special PricinQ None oJ# } I ~ PO Number Customer Fax Customer EMail Tear Sheets o Proofs o Affidavits o Blind Box Promo Tvpe <NONE> Invoice Text (5N1f M(v Ad Order Notes Materials Net Amount $29,20 Tax Amount $0,00 Total Amount $29.20 Pavment Method it Card - MasterCard:: Pavment Amount $29,20 Amount Due $0,00 Ad Number Ad Tvpe 0001179006-0' CPPL Ad Size :1,OX10Li Color New Ad Color Production Method Production Notes Ad Booker External Ad Number Ad Attributes Ad Released No Pick UP 9/3/20049:18:37AM 1 I-:)j ~"'-~ THE PATRIOT NEWS THE SUNDAY PATRIOT NEWS Proof of Publication Under Act No. 587, Approved May 16, 1929 Commonwealth of Pennsylvania, County of Dauphin} ss Michael Morrow, being duly sworn according to law, deposes and says: That he is the Controller of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or Sunday/ Metro editions which appeared on the 24th day(s) of September and the 1st and 8th day(s) of October 2004. That neither he nor said Company is interested in the subject matter of said printed notice or adveltising, and t1Iat all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M", Volume 14, Page 317. COpy ~<---- PUBLICATION LETTERSTESTAMENTARY forth. Es. tate at Donna J. Parks, deceased, late of Al- Ien Boro, Cumberland County, Pennsvlva- nla, were granted to Ray R. Strayer on Au- gust 13, 2004. AII.,erlOns Indebted to the Es- tate are requested to make Immediate pay. ment and thOle having claIms aDOlnst the Estate are requested to present them for settlement without delay to: Ray R. strayer, I!xecutar 889 King street Lewlsberry, PA 17339 orto Craig A. Hatch, ESQUire GATES, HALBRUNER & HATCH, P.C. 1013 Mumma Road, Suite 100 Lemayn., PA 17043 GATES, HALBRUNER & HATCH, P.C. ATTN: TRACl L. SEPKOVIC 1013 MUMMA ROAD, SUITEIOO LEMOYNE, PA. 17043 Statement of Advertising Costs To THE PATRIOT-NEWS CO. For publishing the notice or publication attached hereto on the above stated dates 211.81 Publisher's Receipt for Advertising Cost The Patriot News Co., publisher of The Patriot-News and The Sunday Patriot-News, newspapers of general circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies tlIat the same have been duly paid. By.................................................................... I "v' ~bt patriot-Ntws Now you know Ad Order 0001192045 ~ kkline Order Taker kkline Order Source Phone PO Number Ordered Bv Ray Customer Fax Customer EMail Customer Strayer Customer Account 65198 Customer Address 889 King Street Lewisberry PA 17339 USA Customer Phone 717-938-6647 Order Confirmation Pavor Customer Strayer Payor Account 65198 Pavor Address 889 King Street Lewisberry PA 17339 USA Pavor Phone 717-938-6647 Special PricinQ None Tear Sheets o f!:QQf! o Invoice Text Ad Order Notes Materials Pavment Method it Card - MasterCard:: Affidavits o Net Amount $16.00 Payment Amount $16.00 Blind Box Tax Amount $0.00 Amount Due $0.00 Promo Tvpe Class Level 2 Total Amount $16.00 Ad Number Ad Type 0001192045-0' CPPL Ad Size : 1.0 X 5 Li Production Method Production Notes Ad Booker External Ad Number Ad Attributes Color <NONE> Ad Released No Pick Up 10/13/2004 9:02:38AM c ~~J114}/ff;c~ /d. tv. (54A1SI1 ?/fLEW ft j '''''.~ -~, ,-~, ,," f ~ J: i.f ~); .~ ,1,.., 't)-: j ;J.} QUAN. PRICE AMOUNT -21_ 2\ 12 13 14 #.~ '=CEIVED BL - 24705 APPRAISAL INVOICE Date: September 16, 2004 Prepared for: Ray Strayer 899 Kinq Street Lewisberry, PA 17339 S408051 Property Appraised: Estate of Donna Parks 1280 Boilinq Sprinqs Road Churchtwon. IJA 17055 Work Performed: Single Family Appraisal Report (717) 432-3693 T,)tal Amount Due: Please make checks payable to: Stoner Appraisals Ltd 129 Old York Road Dillsburg, PA 17019 File No.: S408051 ~ -Irj // $300.00 $300.00 !c.- ~ ~ ~ S:::;r I~' ~:~'vV" ~/&f f:- ~ raJ- ~ 3~~'f~~ ~ ~ ~ f}#v~ ~,d.tA~ ;..J-- r ~ fn..-l- ~ " 70, rl.) ,/ rrtt n ^ ' ~'J .... . . . ,. HJ1fJ lJ/(,.A -'.... feci,: () f I,;: i I) cV- (~3 \ ~frY. r"" _,;.;,r- -r;: ,..~~ , \ ":' ~ __;".1 v___ 'j' i.'. ,1 ~ J s'-{ , J q .i -< 7.~~ ./ (.{).../f L. /.~ 7r ,/ -- , 7cJ .5~ [/ J2.f,JY' T HE Hot' DEf->O 1 .<1 L " 6000.CARLLU: PI~E, MECH. 1'1\ 17051) S10HE MANAC,ER M/\RK UunCK (71n79~,-96OL THE HOME DEPOT 41.20 ~ 6000 CARLISLE PIKE, MECH. PA 17055 "TORE MANAGER MARK ULRICH <717>795-9602 ' 4120 00010 82064 10/30/04 11 CS200F 08:37 AM SALE r----"-',---'- __n"'..__'ji;.____ ; "';P'S) I"~' !~~~, @ 032886263590 WIRE SALES TAX TOTAL XXXXXXXXXXXX2958 HOME DEPOT AUTH CODE 030436/8101733 P.O.H/JOB NAME: OJ PARK :. "' 000'i6 53639 lCi/lV(J4 'i1\Ll 1'1 SCOT5f) 10: 32 AM ",.._-~ .....,.... ~. , ~.....,)> \.~~~~ ~S' 1) I~~ @ '12.95 2.58 $'15.53 '15.53 TA 032886263088 WIRE 050169007242 BLANK CO\! 2 ~ 0.37 050169007525 4"SOBXCVFL8L 2 III 0.47 018997108609 CONNECTOR 078477151303 15A OUT BRWN 3 Ij 0.46 050169008645 DUPLEX COVER 3 tj 0.36 05016900660:' 1-7/8"HOY ax 3 If OC7 Jj~JII~III~ll[III~Jllll[IIII~IJj~ IIII SU8TOTAL SALES TAX TOTAL XXXXXXXXXXXX295S HOME DtPOI AUTH CODE 013890/5565027 P.O.#/JOB NAME: DJPARKS YOUR OPINION COUNTSl COMPLETE A SURVEY AT WWW.HOMEDEPOTOPINION.COM AND ENTER TO WIN A $5,000 HOME DEPOT GIFT CAROl 1:) .49 0.7,1 O. ',:1 1.9f: 1. :.i8 ~ ,..!,", .1. ,v' ..un 23.1)0 1.42 $25.02 25.02 TA ~\l~\ll'I~'lltl\l\W~1 YOUR OPINION COUNTS 1 CO~lPLETE A SURVEY AT 'IIWW.HOMEOEPOTOPINION.COM AND ENTER TO WIN A $5,000 HOME DEPOl GIFT CAROl SAMS CLUB 6781 Gra!d!!5CI'p~d'1"" 11 Harri!!5bUre.> * - 8 J:7S 5~t~: 10/19/04 TIME: 10:17 TRAcE: .. 3453 MC~~~~~~~~~~~~*~2867 'APP CODE: 229835 GIFi~TRA~E: 998100SQl ASI ,~ODE. GATEWA'Y : PUMP: PRODUCT: PRICE/GAL: MET/GAL: QUAt~TIT'( : FUEL TOTi' NEi TOTA'- 10 UNLEADE $1.949 $1.899 14.570 $27.86 $27.86 Thlll.n\<. \::iO- .Ocr I !,jour Pat'-'>"'<l,s.,;,' I I Ii'S A e:G DEA~\ , ' Cort'/! 'oack ~oon..' ....... LDWE"S CARLISLE. PA (117)258 -7700 -SALE- SALES I: S1710881 707570 11-07 -04 173407 REPRIR KIT MODEL 12.96 SUBTOTAL: 12.96 TAX 38550 : 0.78 INVOICE 04752 TOTAL: 13.74 BRLANCE DUE: 13.74 MIC : 13.74 H/C XXXXXXXXXXXX2867 321826 AMOUNT: 13.74 ------------------------------------ 1710 TERMINAL: 04 11/07/04 09:16:53 IIII~IIIIIIIIIIIIIII~~II~~IIIII~IIIII THANK YOU RAY STRAYER FOR SHOPPING LOWE'S RECEIPT REQUIRED FOR CASH REFUND. CHECK PURCHASE REFUNDS REQUIRE 15 DAY WAIT PERIOD FOR CASH BACK. STORE HGR: JASON CRRRIER ~ "" ~ tJ~ ~ ~ (J,rr- .... ~ .... ~o{p ~~~~~f- ~~~ J ~./ ,,,~ ;21:<.1 (J III g.., M- " JJ> ~ .;t <fa, crI' f~ (CI ~ I!. ~ tf,?-,1{) ~~ / ..{ @-- ! /(/ {/ ;/ / , ,j LOWE"S CARLISLE. PA (717)258 -7700 -SALE- SALES I: S1710TS1 707599 12-09-04 5996 8' STAIN 268 PIN 9.84 3 @ 3.28 SUBTOTAL: 9.84 TAX 38550; 0.59 INVOICE 10006 TOTAL: 10.43 BALANCE DUE: 10.43 CASH: 20.43 CHANGE: 10.00 1710 TERMINAL: 10 12/09/04 12:13:01 !IIIIII~II~IIII~IIII THANK VOU FOR SHOPPING LOWE'S RECEIPT REQUIRED FOR CASH REFUND. CHECK PURCHASE REFUNDS REQUIRE 15 DAV WAIT PERIOD FOR CASH BACK. STORE MGR: JASON CARRIER o"'~ N8~ .....lr-' .....'" \f I!!. <(~ a.r- I- ;::: O:i~ 1'I<.>::t: ....lJJU WX::t' Cl -...l lJJ~ "'- HX Wa.~ 1:~x 0"'0: HlJJ T-'Cl ......:x.. <(:2 u.. Wox TOlJJ .....00: I-U>:= <n '" :E 0<: "- In r- _N "- .. NCO ,....0 "" (")1"- N"- "'''' '<T:>:: Na. Ol ,.... 0..... o o o o N - '<T " UJ ./ THE HOME DEPOT 4120 6000 CARLISLE PIKE. MECH PA 17(65 STORE MIINIIGEP M/IRK ULRICH om 795-9002 41200000237719 12fOe'04 61 KOM167 10:24 AM c.f\l.E .., .tI":~- ..".~*. ~), ,~~.... ~ l'~~' ~ .z:i, ,~~- @ "I. ,;1:,1,):1900 WHT 32DR ,": ! "!9 mULl.ING SET !~, i iL.:~ IL:ll! FIX ADHESIVE O,j' ,,')006~j 14 12X12Pl.AIN/W ~ @ 21.80 2i " 1 'iCI 12X12 LO @ 0.'55 02B756336291 ORVWALLADH !_~2.ii 724764041511 2X5 SURF, 'liT ; ~ 0.62 72'1 ilJ423753L 2X2BISCUIT 7241b4066002 BGWrSGRCTLEA :! @ 0.1~ I I , SUBTOTAL SALES TAX TOTAL XXX (X)(XXXXXX2958 HOME DEPO T AUTrl CODE 0093~9/5020705 P.O,#/JOB NAME: BJ PARKS 89..JlJ 2(j. :'7 2. ~jY 'n.6') 11.00 -~ .1.' 1. 24 0.10 0.25 177.78 10.67 $188,45 188.45 TA JJ~IIIII~"llt~I)lll~!'1 VOUR OPINION COUNTS! COMPLETE A SURVEY AT WWW.HOMEDEPOTOPINION.COM AND ENTr TO 'rlIN A $5.000 HOME DEPOT GIFT CAf C) OON('\,\N< v U:~C"~~~I- (J;) 1.{),......,...-4M('") N (f') ("")("') ... ~~.~& ~@ a~- .d~'~ ",~~~ L" , " "' . ------- ..... x 0 :ci::: fuC") ..... ON O({).-J (."") ::a~~~gs .:::><t::OOOa.. (,/)(f);..-::CN'J .....ee 0'''1'> LDro .. "'ow ""10"" x....."" XOZ x xwee xoo xo., XO..... x "" xx . x..... 0 x::> . X<:n. UJ -' <: (J) Cl :z: => c:> a:: a:: ..... e> O'>UiNLP OlJ")T-fl!) o 'X ~ LDONO 0> _ ~t!lJOlSJ LOCXJlOn 00;:1'___';:" N I"- .... l"- ll> "" iiiiiiiiiiiiii -N -U7 ~O> -tr") ='" iiiiiiiiiiiiiiO o =N =====.~ -- -~ ===:- C") _N iiiiiiiiiiiiii<:l' -<:I' ===N -0'> ~ -~ -- ~ (, I _ > WC::- >WO 0:..... ct: ~Z.. V>UlU <cOt-- Zu. W""H ..... '-" W"" -'0..... a.<.>0 :>:: .n. OZUJ uOO ..... _.ZW <n.....X .....n.O :20I ~..... 000 un.o WO :20 - OWtt> ....."".... :20 .....::c::.. n. . 03':2 3'H 0: 3' 3' ~ 0.....0 >""..... THE SENTINEL Printed on 09f28f2004 at 08:09 by 28 Ad# 273662 First taken by ?n Last changed by 09f27/2004 13:00 09/28/2004 08:09 (717) 938-b647 Acct# 64192 RAY STRAYER 889 KING ST. Given by RAY STRAYER Start 09/30/2004 Stop 10f02/2004 Transient Bill Expir: Class 443 CHURCHTOWN Index: ESTATE/GARAGE SALE, FRI., OCT. I, S Cols 1 Lines 8 Inches.0.81 Words 26 Box? N LEWISBERRY. PA 17339 Subscr? N Pb# Code Rate 1 YS Base-Charge Addl-Charge Total-Cost 18.00 0.00 18.00 Ins 3 Start Stop 09f30f2004 10f02/2004 SMTWTFS 0000111 TOTAL AD COST redit-Card-# Exp-Date Auth-Code Payments: Date 09/28/2004 ***********2867 04f30/2005 227826U CVV NET DUE ESTATE/GARAGE SALE, Fri., Oct. 1, Sat., Oct.. 2 & Sun., Oct. 3, 8am. 4pm, 1280A Boiling Springs Rd. Household, yard & garden equip. ment, huuoewai65 &: cleaning equipment. ()rJ o1C/~,\~ ~it rY I PA REV-1500 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES and LIENS PATIENT ACCOUNT STATEMENT '{' '~L d'''') CARusLE Jf REGIONAL P.O. Box 4100 ., ME Die ALe EN T E R Cartisle, PA 17013-4100 ADDRESS SERVICE REQUESTED IF PAVING BV CREDIT CARD, FILL OUT BELOW AND SEE REVERSE SIDE CHECK CARD USING FOR PAYMENT .. ~ASTEACAAD . ~SCOVER Zl ~SA ACCOUNT NO. STATEMENT DATE BALANCE DUE 9271726 09/27/2004 -- 10/11/2004 MAKE CHECKS PAYABLE TO: PARKS, DONNA J 889 KING ST :;: lEW1SBERRV PA 17339 <> CARLISLE REGIONAL MEDICAL CENTER 246 PARKER ST. P.O. BOX 4100 CARLISLE PA 17013-4100 1...111,. .111"...,11,.11.11.,,1.1.,11, III ,.111I11,11",1..1,1 1...111...1..11.. .11.1.1..1.1...1.1.1...1.1.1.1..1.1.1.. .1..11 007852 858HMA 000082L - 0 Please check if above address is incorrect and indicate change on reverse side. TO INSURE PROPER CREDIT, DETACH AND RETURN THIS PORTION IN THE ENCLOSED ENVELOPE. PAID Carlisle Regional Medical err . , ,,~-- I 1- DONNA PARKS ESTATE , A. 124 60-430 16 313 1070916 11M "/~J/"r cf)~.~d'''''''f ~ ~ /Ik/-u...!{e~. I $ g;~ S!' ')'~~/?tAJ,.-I ~ ~ oM!-.. ~ ~ 11t!~ &1 e':-~7 F81V1 TRUST _.fmtruslon~ne.com .'i!lf4:ifttIJ . 4~<_Ls;t{~y~~--_.~.!'! I(J~ 1:0:1 UO'" :10(;1: .01ll70Q .(;11" jI30[)(/ / DATE DESCR. ION REFERENCE CHARGES CREDITS 07/15/04 Consultation Donna 0.00 07/19/04 Reline Camp. Mand. Dent Donna 244.00 07/28/04 Statement Sent Account- .. '1 p/er I p (:}~~(/L < CURRENT 30 DAYS 60 DAYS 90 DAYS NEW OUTSTANDING PLEASE PAY BALANCE INSUllAIlCE 244.00 0.00 0.00 0.00 244.00 0.00 244.00 asey J. Williams, D.M.D., 210 Forge Road PO Box 87, Boiling Springs, PA 17007 ,YMENT IS DUE IN FULL UPON RECEIPT! lANK YOU! Next Appt. Day Date Time Reason .~---- ~-- --- m. .~ -- ----. PLEASE GIVE 24 HOURS NOTICE IF YOU ARE UNABLE TO KEEP THE ABOVE APPOINTMENT(S) . INVOICE CE SERVICE CENTER, Ir-.C 500 E NORTH ST, SUITE 1 CARLISLE, PA 17013 27-Jul-04 DONNA PARKS 1280A BOILING SPRINGS RD BOILING SPRINGS PA 17007 INVOICE: 16140 BRAND: PROSCAN MODEL: N SERlAL: N MDSC: TV INVDATE: 7/8/04 BILL DATE: 7/27/04 BALANCE DUE: $120.84 SERVICE PERFORMED GMAS FUSE, 214756 CAPACITOR, 208002 CAPACITOR, 2.2UF@100V CAPACITOR--DIAGNOSE AND REPAIR POWER SUPPLY REGULATOR-ADJUST PICTURE COMPLETED: 7/13/04 WtA :tf / () {--- PARTS/MDSC $19.00 LABOR $40.00 SERVICE CALL $55.00 PICKUP/DEL $0.00 SALES TAX $6.84 TOTAL CHARGES $120.84 DEPOSITS/ CREDIT $0.00 BALANCE DUE $120.84 This Invoice Is Due Upon Receipt Interest of 1 1/2% per month will begin to accrue 30 days after bill date. Any discrepancies or errors must be reported immediately, by contacting us at 717-241-9300. Thank you for your prompt payment. 4'--'JYr-4' ~ "\-\ I ctA1M CHE K ':JVV-('. i'JUllIl JU'='';:';'l, -JUIL";"; .L Carlisle. P!~ t 7013 71].2419300 NAME ADDRESS _ I\Jo Illerchandi:;e rlelivere(j '.vilhout this check. Not responsible lor qoods left over 30 days nor lor 1053 bv lire or theti Form 1MO- V Payment Voucher OMS No. 1545-0074 164-30-2891 ~ Do not staple or attach this voucher to your payment or return. 2 If a JOInt return, SSN shown second on your return 3 Amount you are paying by check or mone order 2004 Department of the Treasury Internal Revenue SelVtce (99) 1 Your social security number (SSN) 4 Your first name, initial. and last name 22,654. Donna J Parks If a joint return, spouse's first name, initial, and last name Home address (number and street) Apt no. 1280-A Boilinq Springs Road City, town or post office State ZIP code Boilinq Sprinqs PA 17007 BAA FDIA8601 10/19/04 --------------------------------------------------------------------. , Detach Here and Mail With Your Payment and Return , COpy , 1"'.'" ''''f','.'- i 'I l""~ Mail Form 1040-V (federal tax payment voucher) to the address listed below. Internal Revenue Service Center P.O. Box 80101 Cincinnati, OH 45280-0001 COpy Make check payable to: Pennsylvania Department of Revenue Mail to: Pennsylvania Department of Revenue Payment Enclosed 1 Revenue Place Harrisburg PA, 17129-0001 Note: Write your SSN (and spouse's ssn if filing joint), daytime phone number and tax year on your check. CUT ALONG DOTTED LINE PAIZ3401 01/04105 r -, 164-3[]-2B91 PA []4[][]918199 PAYMENT AMOUNT PARKS DONNA J $ 5[]89.[][] 121m-A BOILING BOILING SPRIN PA 17[][]7 SPRINGS ROAD DEPARTMENT USE I ONLY I Make check or money order payable to the Pennsylvania Department of Revenue L I Met-Ed August 18, 2004 ~McOO:2Oii11iii~ Page 1 of 4 M72 ~ A Firs/Energy Cnnl''''''Y Bill for: ESTATE OF DONNA J PARKS ALLEN 1280A BOILING SPRINGS RD BOILING SPRINGS PA 17007 Billing Period: Jul 17 to Aug 17, 2004 for 32 days Next Reading Date: On or about Sap 17, 2004 Bill Based On: Actual Meter Reading Your previous bill was T olal payments/adjustments Balance at billing on August 18, 2004 Current Basic Charges Met-Ed - Consumption Met-Ed - Payment Plan Balance Late Payment Charges Total Current Charges o ue P To avoid a 1.50% Late Payment Charge being added to your bill, please pay by the due date. ~ Customer Service 1-800-545-7741 Automated Outage Reporting 1-888-544-4877 Collections 1-800-962-4848 ,011 ~ / //), {'/". 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Parks No. 21-04-0744 also known as Date of Death 08/03/2004 , Deceased Social Security No. 164-30-2891 Ray Richard Strayer, Personal Representativels) of the above Estate, deceased, verity that the items appearing in the following inventory include ail of the personal assets wherever situate and aU of the real estate in the Commonwealth of Pennsylvania of said Oecedent, that the valuation pieced opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this Inventory are true and correct. l!We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn felsification to authorities. Name of Attorney: Craig A. Hatch, Esquire 76361 ;;Rep~te~_ I.D. No.: Address: Gates, Halbruner & Hatch, P.C. Deted (;l! /) :; /J.. tJtl S 1013 Mumma Rd., Suite 10~glIL.QY!J.~.PA 17043 Telephone, (717) 731-9600 ,) Description Value, Real estate located at 1280 Boiling Springs Road $197,992.06" 68 shares of IBM common stock 5,856.16 1989 Mercedes Benz 5,000.00 Arnerichoice Federal Credit Union; Savings Acct. #8412 1,907.81 Arnerichoice Federal Credit Union; Checking Acct. #8412 3,075.59 Arnerichoice Federal Credit Union; Checking Acct. #8412 4.07 Corncast Cable - refund 5.52 F&M Trust; Checking Acct. #343-34273 211,576.38 F&M Trust; Savings Acct. #70-33699 13,476.19 Liberty Mutual - insurance premium refunds 575.15 Toews Corporation - refund 92.78 TOlal: $439,561.65 (Attach Additional Sheets if neces$ary) NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may. at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-8 .)'- PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE FORM 6.12 YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Donna J. Parks Will No.: August 3, 2004 21-04-0744 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: No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: January 2006 3. If the answer to No. I is yes, state the following: A. Did the personal representative file a final account with the court? N/ A B. The separate Orphans' Court No. (if any) for the personal representative's account is: N/A C. Did the personal representative state an account informally to the parties in interest? Nt A D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date: ~~st 4, 2005 t..-) I [,' C' Cra' A. Hatch, Esquire P I.D. # 76361 GATES, HALBRUNER & HATCH, P.c. 1013 Mumma Road, Suite 100 Lemoyne, P A 17043 (717) 731-9600 t.': , c_ c,,; ,~- Capacity: Counsel for Personal Representative ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX BUREAU OF INDIVIDUAL TAXE1h,'v;~rr ,c:r'(J\I'mISEHENT, ALLOllANCE DR DISALLDllANCE INHERITANCE TAX DIVISI"" r"" r) '.", i_"_o;; DEDUCTIONS AND ASSESSHENT OF TAX PO BOX 280601 - ~ HARRISBURG PA 17128-0601 ' ., I '.: DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-25-2005 PARKS 08-03-2004 21 04-0744 CUMBERLAND 101 APPEAL DATE: 09-23-2005 (See reverse side under Objections) Allount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- REV:is4;-Ei-AFP-ioi:osi-NOTicE-OF-iNHERiTANCE-TAi-APPRAisEMENT:-ALLOWANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DONNA J FILE NO. 21 04-0744 ACN 101 "![ ';" c:;') 1; 2: 27 .~ "~' ..... '- :.- '-~- CRAIG A HATC!! 'tSQ- GATES ETAL 1013 MUMMA LEMOYNE RD STE 100 PA 17043 ESTATE OF PARKS *' REV-1547 EX AFP (06-05) DONNA J DATE 07-25-2005 I~ an asses~ent was issued previously, lines 14, 15 and,or 16, 17, 18 and re~lect ~igures that include the total ~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Aaount of Line 14 .t Spousal r.te (IS) 16. ~ount of Line 14 taxable .t Lln881/Class A rat. (16) 17. A~unt of Line 14 at Sibling rat. (17) 18. Amount of Line 14 taxable at Coll.ter81/Class B rete (18) 19. Principal Tax Due TAX RETURN liAS: I X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..l Est.t. (Schedule A) 2. Stocks .nd Bonds ISchaduI. B) 3. Closely Held Stock/Partnership Interest (Schedule Cl 4. Mortgages/Notes Receivable (Schedule DJ 5. CashIBenk DepositslHisc. Personal Property (Schedule EJ 6. Jointly Owned Prop.rty ISchoduI. FI 7. Tnmsf.,.s (Schedule GJ 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expens.s/A~. Costs/Misc. Expenses (Schedule HJ ID. Debts/Hortu-g. Li~iliti.s/Li~s IScheduI. I) 11. Total o.ductions 12. Net Value of Tax Return 13. Ch8ritable/GoV8~ntal Bequests; Non-elected 9113 Trusts 14. Net Value of Estate Subject to Tax NOTE: I I CHANGED III (2) 131 (4) 151 (6) (7) 197,992.00 5.856.16 .00 .00 235.713.49 .00 29,206.66 181 191 110) 49,806.23 NOTE: To insure proper credl t to your account, submit the upper portion of this for. with your tax paYll8l1t. 468,768.31 7Q.?4Q 4? 389,518.89 .00 389,518.89 19 will .00 15,345.85 4,800.00 1,275.00 21,420.85 TAY C DrT$O. ,T, AHOUNT PAID DATE NUI1BER INTEREST/PEN PAID 1-) 11-01-2004 CD004564 1,071 . 04 24,000.00 TOTAL TAX CREDIT 25,071. 04 BALANCE OF TAX DUE 3,650.19CR INTEREST AND PEN. .00 TOTAL DUE 3,650.19CR ~ . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDI~' ICR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 29.443.19 111) 1121 113) 1141 ISchaduI. J) .00 341,018.89 40,000.00 8,500.00 x 00 = X 045 = X 12 = X 15 = 119)= BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRIS8URG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP (03-05) CRAIG A HATCH ESQ GATES ETAL 1013 MUMMA RD STE 100 LEMOYNE PA 17043 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-29-2005 PARKS 08-03-2004 21 04-0744 CUMBERLAND 101 DONNA J Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF PARKS DONNA J FILE NO.21 04-0744 ACN 101 DATE 08-29-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-18-2005 PRINCIPAL TAX DUE: 21,420.85 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 11-01-2004 "'. CD004564 L071.04 24,000.00 08-12-2005 REFUND .00 3,650.19- TOTAL TAX CREDIT 21,420.85 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 .. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) RK. LAW OFFICES OF GATES, HALBRUNER &-HATCH, P.C. 1013 MUMMA ROAD. SUITE 100. LEMOYNE. PENNSYLVANIA 17043 (717) 731-9600 . FAX: (717) 731-9627 December 19, 2005 BRANCH OFFICE: 3 WEST MONUMENT SQUARE. SUITE 304 LEWISTOWN. PA 17044 (717) 248-6909 WEB SITE: www.GatesLawFirm.com CORRESPONDENCE ADDRESS: Lemoyne Office STACEY L. NACE ParalegaVOffice Manager TRACI L. SEPKOVIC Paralegal VALERIE LONG Paralegal LOWELL R. GATES, LL. M. LL. M. in Taxation Also Admitted to Massachusetts Bar MARK E. HALBRUNER Also Admitted to New Jersey Bar CRAIG A. HATCH, CELA Cert~ied as an Elder Law Attorney by the National Elder Law Foundation ALBERT N. PETERLlN Also Admitted to Maryland Bar CLIFTON R. GUISE Also Admitted to practice before the U.S. Patent & Trademark Office BYRON L. McMASTERS, LL.M. LL. M. in Taxation Cumberland County Courthouse Office of the Register of Wills One Courthouse Square Carlisle, P A 17013 ) ~-, , ") r".,~ RE: Estate of Donna J. Parks Estate No. 21-04-0744 i-,) c...) 1'0 , 'V Dear Register of Wills: Enclosed for filing is the final Status Report for the Estate of Donna J. Parks. Please time- stamp the photocopy and return it to our office in the enclosed envelope. Thank you for your assistance in this matter. Sincerely, ':'/((((~a /~(U{/(C. Traci L. Sepkovic Paralegal Enclosures cc: Ray R. Strayer, Executor PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE FORM 6.12 YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Donna J. Parks Will No.: August 3, 2004 21-04-0744 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 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: NtA 3. If the answer to No.1 is yes, state the following: A. Did the personal representative file a final account with the court? No B. The separate Orphans' Court No. (if any) for the personal representative's account is: Nt A C. Did the personal representative state an account informally to the parties in interest? Yes D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date: December 19, 2005 - " ./ . '~....- . , . J ' .. Crai A. Hatch, Esquire P I.D. # 76361 GATES, HALBRUNER & HATCH, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PAl 7043 (717) 731-9600 Capacity: Counsel for Personal Representative ~1;