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HomeMy WebLinkAbout04-0759PETITION FOR PROBATE and GRANT OF LETTERS Ewate of Romaine E. Richacds Soc al Security No. Deceased. 16672~7T' To: Register of Wills fm the County of Cumberland Commonx~calth of Pennsylvania itl the The petition ol the undersigned respectfully represents that: Your petitioner(s), Mlo is/a~ 18 years of a~e or older an the execut rix named in tile last will of the above decedent, dated ~3une 18, 2001 ,~ and codicil(s) dated Michael A. Richards, named Co-Executor renunces in favor_o2f Linda Stumpff, named Co-Executor. Decendcnt x~as domiciled at death in Cumberland County, Pennsylvania, with h e~_ last famdy or principal residence at /455 DeLancy_ Court, Lower Allen Township Cumberland Counti, Pennsylvania Decendent, then 77 years of age, died June 18, 2004 at St. Luke's Hospital, 'Jacksonville, Duval County_. Except as t'ollox~s, decedent did not marry, was not divorced and did not have a child born or adopted after executio;; of the will offered for probate; was not tile victim of a killing and was never adjudicated Decendent at death owned property with estimated values as follows: llf 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 P, edms~lv, ania $ 1 10,000. O0 situated as follows: ~ ueuancy Court, Mechanicsburg, Cumberland County~ PA WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters_ testamentary (testamentary; administration c.t a.; administration d.b.n.c.t.a.) Linda Stump f 5~036 Grand Lakes Dr~ve Jacksonville, FL 32258 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF ELr~BERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. before ma this ____, .9- ___ __ d_a,y, o? Register No...2~- o4 - '15 q FEES Probate, Letters, Etc ......... 5 Short Certificates( ) .......... $ Renunciation ................ $_ TOTAL Filed ................................... AiWORNEY (Sup. Ct. I.D. No.) 414 Bridge St., New Cumberland, PA 17070 ADDRESS (717) 77~-7~35 PHONE RENUNCIATION In Re Estate of--R°maine E. Richards deceased. To the Register of Wills of Cumberland County, Pennsyb/ania. The undersigned Michael A. Richards, named Co-Executor and son of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters Testamentary ~ Linde Srumof, named Co-Executor ~n~ d~qnghter ~£ decedent~ WITNESS STATE OF COUNTY OF _'~}%(A~,q(~t%()l'\"Yi~ Sworn to and shbscribed before me this~',5''~ da~f -7~,,~k/ ~.. 2004. --' U ~otary Public [~'~ ~ Commission N~r 72~ hand this day of (Signature) MICHAEL A. 64 Bellevue Avenue Council Bluffs, lA 51503 (Address) 2004 RICHARDS (Signature) (Address) ) (Signature) (Address) OCAL FrLE NO. S NAME OFFICE of VITAL STATISTICS CERTIFIED COPY CERTIFICATE OF DEATH FLORIDA F~RST MIDDLE LAST ROMAINE E. June ?Ofl4 166-20-4577 October 1926 4 vani a ER/Outpatienl -- DCA St. Luke's Hospital RICHARDS 3acksonvi 1 le , ~ ¢e~ a 1 e 8 WAS DECEDENT EVER tN US 9b INSIDE ~J~Y~LIMITS? Duval Homemaker Own Home Widowed Pennsylvania Cumber1 and Mechanicsbur§ No 17055 Carrol HaTer Linda StL X 13d STREET AND NUMBER 445 Delancy Court 15 RACE - American Indian, 116 DECEDENTrS EDUCATION White (o rm Alice Snyder 5036 Grand Lakes Drive 3acksonvill 32258 2Ob PLACE OF DISPOSITION (Name of ceme ery crernator]4 or 20c LOCATION - City or Town, State Rolling Green Cemetery Lower Allen Twp., 172r3 PA 21c NAM AND ADDRESS OF FAC ¢TY Hol~oway Funera~L Home, PO Box 11ztR 117 Bayview Blvd. 01dsmar FL 34677-11.,tR t~ o 6:40P 6hris B. Rathburn~ M.D. 3627 Universit, Blvd. June 2004 IMMEDIATE CAUSE (Final disease or condition DUE TO (OR AS A C~ONSEOUENCE OF): b ,,, DUE TO (OF{ AS A CONSEQL~E~CE OF) ~ DUE ~b (OR AS A CONSEC PERFORMED? [ Yes or NO) No 23b DATE SIGNED (Mo Da~ YO I 23<; HOUR OF DEATH 23d MEDICAL EXAM,NER'S CASE # Florida 32216 I I Jacksonville, I M THIS IS A CERTIFIED TRUE AND CORRECT COPY OF THE OFFICIAL RECORD ON FILE IN THIS O.~'~J(~ 28 · 200 ~ BY ~ ¢' '. - ' i LAST WILL AND TESTAMENT OF ROMAINE E. RICHARDS I, ROMAINE E. RICHARDS, of Mechanicsburg, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I direct that pay all my just debts and funeral be done after my decease from the ITEH II: I give and bequeath Dollars to each of my grandchildren who death. my Ce Executors hereinafter named shall expenses as soon as conveniently may residue ef my estate. the sum ef Ten Thousand (Si0,000.00) are living at the time ef my ITEM III: I devise and bequeath the residue of nature and wherever situate as follows: my estate of every A. One third thereof to my son, MICHAEL A. RICHARDS. Should my son, MICHAEL A. RICHARDS, fail to survive me, his one-third share shall be distributed to his issue, per stirpes. Page 1 of 6 B. One third thereof to my daughter, LINDA STUMPF. Should my daughter, LINDA STUMPF, fail to survive me, her one-third share shall be distributed to her issue, per stirpes. C. One third thereof to the Co Trustees hereinafter named, IN TRUST, for the following uses and purposes: 1. To expend and apply so much of the net income and the principal of the trust for my daughter, JODY A. LUCIA, as the Co- Trustees shall, in their sole discretion, deem advisable for my daughter, JODY A. LUCIA's support, medical care, and during emergen cies after taking into consideration her other sources of income and readily available assets. 2. Upon the death of my daughter, JODY A. LUCIA, her share shall be distributed to my issue, per stirpes. ITEM IV: I appoint my Co-Executors and their successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guard ian and have not otherwise specifically done so, provided that this appointment of a guardian shall not supersede the right of any fidu ciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have Page 2 of 6 the power to use principal as minor's support and education graduate and undergraduate) without ability to provide for such support well as income from time to time for the (including college education, both regard to his or her parent's and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM V: The interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation. ITEM VI: I appoint my daughter, LINDA STUMPF, and my son, MICHAEL A. RICHARDS, Co-Trustees of any trust created under this my Last Will and Testament. Hy Ce-Trustees, LINDA STUMPF and MICN~AEL A. RICHARDS, er the survivor of them, shall have the power and authority te appoint a successor corporate Trustee te act upon the death or resignation of the surviving Trustee. In the event a successor Trustee has net been appointed, I appoint MID PENN B~kNK as successor Trustee. ITEM VII: MICHAEL A. I appoint my daughter, LINDA STUMPF, and my son, RICHARDS, Ce-Executors of this my last will. Page 3 of 6 ITEM VIII: No fiduciary acting hereunder shall be required to post bond or enter security fer the faithful perfermance ef his er her duties in any jurisdiction. IN WITNESS WHEREOF, I, ROMAINE E. RICHARDS, have hereunto set my hand and seal this I~ day of -_~i~,{ , 2001. ROMAINE E. RICHARDS SIGNED, SEALED, PUBLISHED and DECLARED by ROMAINE E. RICHARDS, the Testatrix abeve named, as and for her Last Will and Testament, and in the presence ef us, whe at her request, in her presence and in the presence of each other, have subscribed our names as witnesses. Address Witness ti Address COMMONWEALTH OF PENNSYLVANIA: : COUNTY OF CUMBERLAND : SS: I, ROMAINE E. RICHARDS, the Testatrix whose name is signed to the attached or foregeing instrument, having been duly qualified according Page 4 of 6 to law do hereby acknowledge that I signed and executed this instru ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. ROMAINE E. RICHARDS RICHARDS, the Testatrix, this Sworn te er affirmed to and acknowledged before me by ROMAINE E. ,/,~ day of iN,~ 2001. Notary Public NOTARIAL SF_AL P~TRIOHIA L YOTER, Notary Public ~ Cumber~tr~.8ofo. Cucnberland My Commis~n ~xpires Nov, ~8, 2002. COHHONWEALTH OF PENNSYLVANIA SS: the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she executed Page 5 of 6 it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influen~i~ Witness Sworn to or affirmed to and acknowledged before me by witnesses, this ~ day of -~.~,~ 2001. Notary Publ i-c Page 6 of 6 STATE OF PENNSYLVANIA COUNTY COURT-PROBATE DIVISION PROBATE COURT COUNTY OF CUMBERLAND In Re: Estate of Romaine Richards Deceased Court File No. WRITTEN STATEMENT OF CLAIM TO THE PERSONAL REPRESENTATIVE OF THE ABOVE NAMED ESTATE: Claimant, Mayo Foundation, 200 First Street SW, Rochester, MN 55905, states: 1. Claimant claims that the Estate is indebted or will become indebted in the amount of $74.32 for medical services at Mayo Clinic Jacksonville and $4,594.31 for St. Luke's Hospital, for a total amount of $4,668.63; 2. That the nature of the claim is for reasonable and necessary medical expenses; 3. That the claim arose prior to the death of the decedent on or before 6/18/04; 4. That the claim is not secured; and 5. That the claim is due and payable. Date: ~ l~rynn J.~Culloton, Claimant Charles S. Bierman Agent for Claimant Mayo Foundation 200 - 1st Street SW Rochester, MN 55905 Presentation of claim does not Commence proceedings Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 11/01/2004 STONE DAVID HEAN 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 RE: Estate of RICHARDS ROMAINE E File Number: 2004-00759 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 11/22/2004 Your prompt attention to this matter will be appreciated. Thank You. cc: File Personal Representative(s) Judge Sincerely, NDA FARNER ST~SBAU~~ Clerk of the Orphans, Court Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 11/01/2004 STUMPF LINDA 5036 GRAND LAKES DRIVE JACKSONA;ILLE, FL 32258 RE: Estate of RICHARDS ROMAINE E File Number: 2004-00759 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS, COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 11/22/2004 Your prompt attention to this matter will be appreciated. Thank You. cc: File Counsel Judge Sincerely, ARNER STP~A~ Clerk of the Orphans' Court CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Romaine E. Richards Date of Death: June 18, 2004 Will No. 2004-00759 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court rules was served on or mailed to the following beneficiaries of the above captioned estate on November 10, 2004. Michael A. Richards 64 Bellevue Avenue Council Bluffs, IA 51503 Michael Stumpf 25 Jefferson Street West Harrison, NY 10604 Linda Stumpf 5036 Grand Lakes Drive Jacksonville, FL 32258 Antoinette Freeman 4064 Quarterhorse Court Jacksonville, FL 32223 Jody A. Lucia 4 Towpath Road Duncannon, PA 17020 Michael Richards 2829 Xavier Ridge Avenue Las Vegas, NV 89086 Lindsey Ryan 227 Lafayette Council Bluffs, IA 51503 Karen Richards 64 Bellevue Avenue Council Bluffs, IA 51503 Notice has now been Rule 5.6(a). Date: //~o- given to all persons entitled Capacity: thereto under Davi~~qu~re 414 Bridge Street New Cumberland, PA 17070 717-774-7435 Personal Representative X Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT STUMPF LINDA 5036 GRAND LAKES DRIVE JACKSONVILLE, FL 32258 _nn___ fold ESTATE INFORMATION: SSN: 166-20-4577 FILE NUMBER: 2104-0759 DECEDENT NAME: RICHARDS ROMAINE E DATE OF PAYMENT: 03/15/2005 POSTMARK DATE: 03/15/2005 COUNTY: CUMBERLAND DATE OF DEATH: 06/18/2004 NO. CD 005060 ACN ASSESSM ENT CONTROL NUMBER AMOUNT 101 I $13,008.98 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: LINDA C STUMPF CHECK# 1018 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS $13,008.98 GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of Romaine E Richards No. 21 04 0759 , Deceased Date of Death 6/18/2004 Social Security No. 166-20-4577 also known as Linda Stiunpf Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedenfs death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. IfWe verify that the statements made in this inventory are true and correct. IfWe understand that false statements herein made are subject to the penalties of 18 Pa, C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of Attorney: David H. Stone, Esquire 1.0. No.: 39785 Linda Sturn f (/ ~d';t C"x:lrJ€ Address: 414 Bridge Street New Cumberland Telephone: (717) 774-7435 Dated (/3 J D 'I /O-C:; I I PA 17070- Description 2000 Toyota Solara at blue book value Value .....'t 1655.00 Blue Cross Refund checks 39.44 ',.- Erie Insurance Refund on premium 33.00 Medicare Refund checks (,,) o 36.60 2529.05004882813 shares Merrill Lynch-American Bond @ $13.19 each Fund of America CI B-2,529.047 shs. 33358.13 1428.27001953125 shares Merrill Lynch-American Funds American @ $1 .55 each Balanced Fund B-1,428.27 shs. 25066.14 Total (Attach Additional Sheets if necessary) 226,082.13 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-4 Continuation of Inventory Romaine E Richards 21 04 0759 Page 1 Description of Inventory Description 1477.34997558594 shares Merrill Lynch-American Funds Income @ $16. 2 each Fund of America B-1,477.348 shs. Value 24996.73 5000 shares Merrill Lynch-Pittsburgh @ $100.60 each PA Series D RFDG OlD FGIC-5000 shs. 5030.00 Midland Nat. Life Check received 328.76 Miscellaneous deposit 266.00 PNC Bank Checking Acct. #5140304009 7687.63 Property located at 445 Delancy Ct. Upper Allen Twp., Cumberland County, PA sold to Susan J. Rogers on September 27,2004 Travelers Indemnity Proceeds on insurance claim in ceiling repair 120000.00 576.70 -2992.00 shs. Merrill Lynch CMA Acct. Margin Debit wi int. accrual of -$13.36 -2,992.00 Subtotal $ 155,893.82 226,082.13 Grand Total $ ReW-l500 EX. (6.00) NO prDD L. ~RO . DUE> . REV -1500 OFFIC~LUSEONLY INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I- Z W C W o W C w ~ :ll:: _U1 (.) a::ll:: w Q. (.) :I:~9 (.)~1Il c( DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Richards Romaine E DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) FILE NUMBER 21 -0 4 0 7 59 '"'CWi'rvCOiiE -YEAR- - - NiiiBER- - SOCiAl SECURITY NUMBER 1 66- 2 0 - 4 5 7 7 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS SOCiAl SECURITY NUMBER o 3. Remainder Retum (dateotdealhprior/lJ12-13-82) o 5. Federal Estate Tax Retum Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under See. 9113(A) (Attach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND COHf:IDENTtAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS David H. Stone Es uire 414 Bridge Street FIRM NAME ('f Applicable) Stone La Faver & Shekletski TELEPHONE NUMBER 717-774-7435 6/18/2004 10/11/1926 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDLE INITIAL) 00 1. Original Retum o 4. Limited Estate 00 6. Decedent Died Testate (AltachcopyolWil) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-ll2) o 7. Decedent Maintained a Living Trust (Attach copyoiTrusl) o 10. Spousal Poverty Credit (dale ofdealh between 12-31-91 and 1-1-95) (8) PA 17070 120000;00 85,459.00 o~J!iCIAL USE ONLY (,',"1 : .J ~ Z W C Z o Q. UI W a: II:: o (.) New Cumberland _,.,: I .......-..., (1) (2) (3) (4) (5) z o ~ ..J ::) !:: n. c( o w 0:: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous PE!ISOIl8I Properly (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 20,623.13 (-,:') o 106,156.17 332,238.30 43,149.86 (11) (12) (13) 43,149.86 289,088.44 7. Inter-Vivos Transfers & MisceUaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ I- ::) n. :IE o o ~ I- 15. Amount 01 Line 14 taxable atlhe spousal tax rate, or transfers under See. 9116 (a)(1.2) 0.00 X _ (15) 289,088.44 X .045 (16) 0.00 X .12 (17) 0.00 X .15 (18) (19) (14) 289,088.44 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable atcoHateral rate 19. Tax Due 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SORE TOANSVVERAI..L QOES....'bNS ON .REVI:RSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS 445 Delancv Court CITY I STATE I ZIP Mechanicsburg PA 17055- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 13,008.98 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty T otallnterest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Une 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Une 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. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 13,008.98 13,008.98 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ................... ........................................................ 0 00 b. retain the right to designate who shall use the property transferred or its income; .........................-.............. 0 00 c. retain a reversionary interest; or .............................................. ........................................................ 0 00 d. receive the promise for life of either payments, benefits or care? ..... ........................................................ 0 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?................................. ...... .. ....... ................... ................. ........... 0 00 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............................................... ........................................................ 00 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ADDRESS FL 32258 DATE 'S.-Ij-()J/ ADDRESS 414 Bn New Cumberland PA 17070 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax ratelmposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)). The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value oftransfers to or for the use of the decedenfs siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (6-98) '* SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Richards. Romaine. E 21 04 0759 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 wiUing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real nrOftAftv which Is iointlv-owned with r1aht of survlvorshio must be disclosed on Schedule F. DESCRIPTION ITEM NUMBER 1 Property located at 445 Delancy Ct. Upper Allen Twp., Cumberland County, PA sold to Susan J. Rogers on September 27. 2004 VALUE AT DATE OF DEATH 120000.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 120 000,00 REV-1503 EX + (6-98) '* SCHEDULE B STOCKS & BONDS COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Richards. Romaine. E FILE NUMBER 21 04 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0759 ITEM NUMBER 1. DESCRIPTION 2529.05004882813 shares Merrill lynch-American Bond @ $13.19 each Fund of America CI B-2,529.047 shs. 2 1428.27001953125 shares Merrill lynch-American Funds American @ $17.55 each Balanced Fund B-1 ,428.27 shs. 3 1477.34997558594 shares Merrill lynch-American Funds Income @ $16.92 each Fund of America B-1 ,477.348 shs. 4 5000 shares Merrill lynch-Pittsburgh @ $100.60 each PA Series 0 RFDG OlD FGIC-5000 shs. 5 -2992.00 shs Merrill lynch CMA Acct. Margin Debit and accrued intest of -13.36 VALUE AT DATE OF DEATH 33358.13 25066.14 24996.73 5030.00 -2,992.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 85459.00 REV-1508 EX + (6-98) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Richards. Romaine. E FILE NUMBER 21 04 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0759 ITEM NUMBER 1 DESCRIPTION 2000 Toyota Solara at blue book value VALUE AT DATE OF DEATH 11655.00 2 Blue Cross Refund checks 39.44 3 Erie Insurance Refund on premium 33.00 4 Medicare Refund checks 36.60 5 Midland Nat. life Check received 328.76 6 Miscellaneous deposit 266.00 7 PNC Bank Checking Acct. #5140304009 7687.63 8 Travelers Indemnity Proceeds on insurance claim in ceiling repair 576.70 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 20623.13 REV-1510 EX + (6-98) '* SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Richards. Romaine. E FILE NUMBER 21 04 0759 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 INClUllE 1ME _ CE 1ME TRANSFEAEE, THEIR RElATIONSHIP TO OECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER THE DATE CETRNISfER. ATTACHACOP'I CE THE DEED FOR REAl. ESTATE. VALUE OF ASSET INTEREST VAlUE (IF APPI.JCASlE) 1. Midland National Life-Annuity Contract No. 8500037572 36,785.21 100. 36,785.21 w/Michael Richards, Linda Stumpf, and Jody A. Lucia benef. 2. Midland National Life-Annuity Contract No. 8500031028 69,370.96 100. 69,370.96 wI Michael Richards, Linda Stumpf, and Jody A. Lucia benef. TOTAL {Also enter on line 7 Recapitulation} $ 106156.17 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) '* COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Richards. Romaine. E SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER 21 04 0759 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Musselman's Funeral Home-funeral expenses 6,758.94 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (5) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City Stale Zip Year(s) Commission Paid: 2. AlIomey Fees David H. Stone, Esquire 16,289.00 3. Family Exemption: (If decedents address is not the same as claimants, allach explanation) Claimant Street Address City Stale Zip Relationship of Claimant to Decedent 4. Probate Fees Cumberland County Register of Wills 321.00 5. Accountants Fees 6. Tax Retum Preparer's Fees 7. Alex R. Szeles Inc. ceiling repairs 826.70 2 PNC Bank checkbook 27.60 3 Comcast 157.35 4 Delancy Court Condo Assoc. fees 217 .00 5 Jody Lucia gas and expenses 200.00 6 Jody Lucia reimb. on storage rental 110.68 7 Linda Stumpf airline tickets and gas reimb. 3,555.03 8 Mayo Clinic 56.69 9 Michael Richards airline tickets and gas reimb. 3927.9 10 Midland National Life Ins. Co. reimb. on return of payment 328.76 11 PPL Utilities 156.96 12 PPL Utlities 26.76 TOTAL (Also enter on line 9, Recapitulation) $ 43149.86 (If more space is needed, insert additional sheets oflhe same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Richards, Romaine, E Decedent's Name Page 1 21 04 0759 File Number Schedule H - Funeral Expenses & Administrative Costs - 87. ITEM NUMBER AMOUNT 13 14 15 16 17 18 19 20 21 22 23. 24. 25. 26. DESCRIPTION PPL Utilities PNC Bank return check charge Settlement charges ($10,629.47) less reimb. on taxes ($1,274.87) United Water Co. United Water Co. United Water Co. Verizon Verizon Waste Management Waste Mangement Cumberland Law Journal-advertising grant of letters The Patriot News Co.-advertising grant of letters Register of Wills-filing Inh. Tax Return and Inventory Reserve for closing expenses 7.82 31 9354.6 26.49 11.08 2.26 154.92 46.63 35.39 105 75.00 109.30 30.00 200.00 SUBTOTAL SCHEDULE H-B7 10,189.49 ""v-"" "'.'W COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFIC~RIES FILE NUMBER Richards Romaine. 1= ?1 n4 n7!'i~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [InClude outright spousal distributions, and transfers under Sec. 9116 (al (1.2)) 1. Michael A. Richards Lineal 79,696.14 64 Bellevue Ave. Council Bluffs, IA 51503 2. Linda Stumpf Lineal 79,696.15 5036 Grand Lakes Dr. S Jacksonville,FL 32258 3. Jody A. Lucia Trust Lineal 79,696.15 4 Towpath Road Duncannon,PA 17020 4. Lindsey Ryan Lineal 10,000.00 227 Lafayette Council Bluffs, IA 51503 5. Michael Richards Lineal 10,000.00 2829 Xavier Ridge Ave. Las Vegas, NV 69086 6. Karen Richards Lineal 10,000.00 64 Bellevue Avenue Council Bluffs, IA 51503 7. Michael Stumpf Lineal 10,000.00 25 Jefferson Street West Harrison, NY 10604 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 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) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Richards, Romaine, E Decedent's Name Page 2 21 04 0759 File Number Schedule J - Beneficiaries - 1 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousal distributions) 8. Antoinette Freeman Lineal 10,000.00 4064 Quarterhorse Court Jacksonville,FL 32223 ". ~ ep\wills\tichard~.~om\S-Ol LAST WILL AND TESTAMENT OF ROMAINE E. RICHARDS I, ROMAINE E. RICHARDS, of Mechanicsburg, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I direct that my Co-Executors hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease from the residue of my estate. ITEM II: I give and bequeath the sum of Ten Thousand ($10,000.00) Dollars to each of my grandchildren who are living at the time of my death. ITEM III: I devise and bequeath the residue of my estate of every nature and wherever situate as follows: A. One-third thereof to my son, MICHAEL A. RICHARDS. Should my son, MICHAEL A. RICHARDS, fail to survive me, his one-third share shall be distributed to his issue, per stirpes. Page 1 of 6 ~ B. One-third thereof to my daughter, LINDA STUMPF. Should my daughter, LINDA STUMPF, fail to survive me, her one-third share shall be distributed to her issue, per stirpes. C. One-third thereof to the Co-Trustees hereinafter named, IN TRUST, for the following uses and purposes: 1. To expend and apply so much of the net income and the principal of the trust for my daughter, JODY A. LUCIA, as the Co- Trustees shall, in their sole discretion, deem advisable for my daughter, JODY A. LUCIA's support, medical care, and during emergen- cies after taking into consideration her other sources of income and readily available assets. 2. Upon the death of my daughter, JODY A. LUCIA, her share shall be distributed to my issue, per stirpes. ITEM IV: I appoint my Co-Executors and their successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guard- ian and have not otherwise specifically done so, provided that this appointment of a guardian shall not supersede the right of any fidu- clary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have- Page 2 of 6 the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM V: The interests of the beneficiaries hereunder shall not be s~bject to anticipation or to voluntary or involuntary alienation. ITEM VI: I appoint my daughter, LINDA STUMPF, and my son, MICHAEL A. RICHARDS, Co-Trustees of any trust created under this my Last Will and Testament. My Co-Trustees, LINDA STUMPF and MICHAEL A. RICHARDS, or the survivor of them, shall have the power and authority to appoint a successor corporate Trustee to act upon the death or resignation of the surviving Trustee. In the event a successor Trustee has not been appointed, I appoint MID PENN BANK as successor Trustee. ITEM VII: I appoint my daughter, LINDA STUMPF, and my son, MICHAEL A. RICHARDS, Co-Executors of this my last will. Page 3 of 6 ITEM VIII: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his or her duties in any jurisdiction. IN WITNESS WHEREOF, I, ROMAINE E. RICHARDS, have hereunto set my hand and seal this '-l I u day of ~-~ , 2001. /? n.Tl~,-,---,.u E ;C L-t A~ '- ~. ROMAINE E. RICHARDS SIGNED, SEALED, PUBLISHED and DECLARED by ROMAINE E. RICHARDS, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the ~~ eT o~r. have W"t " )l~.~ ., ~ ss . subscribed our names as witnesses. !?rd' j [U~~~cl4<.-V? /!; , Address r Ai.~l--rL J l ~ Witness ''}.)).. t...h'~ (" I) 1 /,t.- ' I!~ .I'-_~ i..... :.J \}. . ('1 - /1 . .r .I I U:.<-() __'''--/11...0,1:-> t..c<l j(/f_ _' Address , '-;7 COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF CUMBERLAND I, ROMAINE E. RICHARDS, the Testatrix whose name is signed to the-- attached or foregoing instrument, having been duly qualified according Page 4 of 6 1 to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. J:, ~~ f. .tC'~~~_~4// ROMAINE E. RICHARDS Sworn to or affirmed to and acknowledged before me by ROMAINE E. RICHARDS, the Testatrix, this i,Q day of 1)1.1'(. , 2001. ,/) , . / ~(~. . ,..' 7?' 1/(:' ~. . ,~-.' "/ T/ _.7-11.. 'L//t,. , ~.. <VL. (_ Notary Pub . c NOTARIAL SEAL PATRICHIA L. YOTER. Notary Public New Cumberland Bora. COOIberland Co. My Commission Expires Nov. 18. 2002 COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND : CtJ;~.~~j~/ and ,. I 'j . ..<.. ,j-,-t...- /L.iL- '1)- J . f:. ./...,,-h / , '(. [ ,- I r~ .... .' j;---<.. ',' f' ....J We, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last-will; that Testatrix signed willingly and that she executed Page 5 of 6 .1. it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnessesj that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influen~J " -" d_t"- Wi nes's ~ _ r /ij \ ;;fl., r .:\ L:.t'7tr--n..<. .I)J ! +-:/ .-.Lz i (- ;l ,,;-'r Witness ~ Sworn to or affirmed to and acknowledged before me by ~J'-' ~-~~ and '-, I )..-:' n ,)."l )1-,'-. /-i<, -I-~r 1/, ) ,-;. J witnesses, this (t:. day of ~J~ , 2001. NOTARIAL SEAL . PATRICHIA L YOTER. Notary PublIC New Cumberland Bom. Clfllbefland Co. My Cammi~ Expires Nov. 16.2002 //-, '" ~ l _--I- -~ ;,:/ -- '---;7'" I / ...L J' /t' (. '/I'-'l.fJ /1 .;-/1. l../ r-::" (. '- I Notary Publi~ Page 6 of 6 ~ J.,\ re\ded\RICHARDSexe.wpd DEED THIS INDENTURE made the \ '\ day of S('r"e""~r , in the year 2004, between LINDA STUMPF, Executrix of the Last Will and Testament of Romaine E. Richards, late of Lower Allen Township, County of Cumber- land and Commonwealth of Pennsylvania, of the first part, hereinafter called the Grantor, -AND- SUSAN J. ROGERS, of the second part, hereinafter called the Grantee; WHEREAS, the said Romaine E. Richards became in her lifetime seised, as of fee, of and in to a certain tract of land, together with the improvements thereon erected, situate in Upper Allen Township, County of Cumberland, and Commonwealth of Pennsylvania, and more particularly described hereinafter; and being so thereof seised, died on June 18, 2004, having first made her Last Will and Testament in writing dated June 18, 2001, duly probated and registered in the Office of the Register of Wills of Cumberland County on August 12, 2004, wherein and whereby she appointed as Executrix, the said Linda Stumpf, to whom Letters Testamentary were duly issued by said Register of Wills on August 12, 2004, wherein and whereby said premises herein- after described were not specifically devised, all as in and by said Will and the records of said Register of Wills more fully appears; -l- I . NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and in consideration of the sum of One Hundred Twenty Thousand and NO/100 ($120,000.00) Dollars, which has been paid to her by the said Grantee at or before the sealing and delivery hereof, receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, released and confirmed, and by these presents does grant, bargain, sell, alien, release and confirm unto the said Grantee, ALL THAT CERTAIN dwelling unit situated in Delancey Court Condominium, Upper Allen Township, Cumberland County, Pennsylvania, being desig- nated as Unit No. 445 in the Declaration and Declaration Plans of said Condominium, recorded in the Recorder of Deeds Office of Cumberland County, Pennsylvania, in Miscellaneous Book 298, Page 856, and Plan Book 46, Page 72, respectively, and Amendments to Declaration and Declaration Plan recorded in the Recorder of Deeds Office of Cumber- land County, Pennsylvania, in Miscellaneous Book 302, Page 890, and Plan Book 47, Page 36, respectively, and in Miscellaneous Book 305, Page 972, and Plan Book 47, Page 146, respectively, under the provisions of the Uniform Condominium Act of July 2, 1980. TOGETHER with all right of title and interest of, in and to the Common Elements as more fully set forth in the aforesaid Declaration of Condominium and Declaration Plans, as amended from time to time. The Grantee, for and on behalf of the Grantee and the Grantee's heirs, personal representatives, successors and assigns, by the acceptance of this deed, covenants and agrees to pay such charges for the mainte- nance of, repairs to, replacement of and expenses in connection with the Common Elements as may be assessed from time to time by the Executive Board in accordance with the Uniform Condominium Act of Pennsylvania; and further covenants and agrees that the Unit conveyed by this deed shall be subject to a charge for all amounts so assessed and that, except insofar as Section 3315 of said Uniform Condominium Act, may relieve a subsequent Unit owner of liability for prior unpaid assessments, this covenant shall run with and bind the land or Unit hereby conveyed and all subsequent owners thereof. The Grantee, for and on behalf of the Grantee and the Grantee's heirs and assigns, by acceptance of this deed, acknowledges that this -2- .\ conveyance is subject in every respect to the Declaration, the Declaration Plans and all amendments thereto; and the Grantee further acknowledges that each and every provision of the foregoing is essential to the best interest and for the benefit of all Unit owners therein. Grantee and all owners of Units in said Condominium covenant and agree, as a covenant running with the land, to abide by each and every provision of said documents. BEING the same premises which Allendale Properties, a Pennsylvania limited partnership, by deed dated June 18, 1985, and recorded June 19, 1985, in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Deed Book r-31, Page 1, granted and conveyed unto Romaine E. Richards, decedent herein. TOGETHER with all and singular the buildings, improvements, ways, streets, alleys, passages, waters, water-courses, 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, claim and demand whatsoever of her, the said Romaine E. Richards, at and immediately before the time of her decease, in law, equity, or otherwise howsoever, of, in, to or out of the same. TO HAVE AND TO HOLD the said lot or piece of ground above de- scribed, with the buildings and improvements thereon erected, hereditaments and premises hereby granted or mentioned, and intended so to be, with the appurtenances unto the said Grantee, to and for the only proper use and behoof of the said Grantee, forever. And the said Grantor, for herself and her respective heirs, executors and administrators, does covenant, promise and agree to and -3- II . r with the said Grantee, their heirs and assigns, that she, the said Grantor, has not heretofore done or committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged, or encumbered in title, charge, estate or otherwise howsoever. IN WITNESS WHEREOF, the said Grantor has hereunto set her hand and seal the day and year first above written. Witness r (SEAL) Executrix of the Last Will and Testament of Romaine E. Richards STATE OF FLORIDA COUNTY OF 'DltvJ SS: On this, the /7'/:1 day of S<zjJ.J..:pd/ /;tr, 2004, before me a Notary Public, the undersigned officer, personally appeared LINDA STUMPF, Executrix of the Last Will and Testament of Romaine E. Richards, known to me or satisfactorily proven to be the person whose name is sub- scribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereto set my hand and notarial seal. _~#td~tdf Notary Public -4- ./A\ ::::-~= a My CQIlIll. expItes .. al. 3001 Jh 00 2IlI817 I . ., I hereby certify that the precise address of the Grantee is Attorney for -5- ~ .errill Lyncb Client Advisory Group The Brennan Group Mark J. Brennan, CFM Resident Director Vice-President Senior Financial Advisor Jere A. Lindemuth, CFM Investment Associate Linda M. Goodling Resident Director's Assistant Registered Client Associate Gretchen C. Read, CFM Registered Client Associate February 10,2005 96 South George Street Y orIc, Pennsylvania 17401 717771 0027 800 348 4397 Toll Free FAX 717 7710026 Law offices Stone LaFaver & Shekletski 414 Bridge Street P.O. Box E New Cumberland, Pa. 17070 RE: Estate of Romaine E. Richards Merrill Lynch Account 898-61327 Dear Attorney Stone: Attached is the requested information regarding the assets held by the above decedent at Merrill Lynch at the time of her death on Friday June 18,2004. The valuation was based on the closing price on Friday June 18, 2004. If you have any questions please feel free to call me. M J. Brennan, CFM Resident Director Vice President Sr. Financial Consultant Inc!. Estate Valuation for account 898-61327 Asset Valuation Romaine E. Richards as of June 18, 2004 SavinglInvestment Acct 898-61327 Accrued Approx. Shares Asset High Low Close Interest Value CMA Account #898-61327 -2,992.000 Margin Debit 1.000 1.000 1.000 -13.36 -$2,992.00 5,000.000 Pittsburgh Pa Series D RFDG 100.600 75.34 $5,030.00 OlD FGIC OCT98,05.000%,SEPT01 21 1,477.348 American Funds Income Fund of 16.920 $24,996.73 America Class B 1,428.270 American Funds American 17.550 $25,066.14 Balanced Fund Class B 2,529.047 American Bond Fund of America 13.190 $33,358.13 Class B Sub-Total 61.98 $85,459.00 Total $85,520.98 We are providing the above information as requested. The information provided is obtained from sources we believe to be reliable. Merrill Lynch considers your confirmations and monthly statements to be the official record of your transactions. JHN-~~-~~~~ l~i~( t-'NI..l:lHNK 41~ "(btj ~~~ t-'.~l/lal o PNCBAN< January 20. 2005 David H. Stone 4 J 4 Bridge Street Post Office Box E New Cumberl8Dd. PA 17070 RE; Estate of Romaine E. Richards. deceased SSN: 166-20-4577 DOD: 6/1812004 Dear Mr. Stone: In response to your request for Date of Death balances for the customer noted above, our records show the following; CheddDg Accoaat Account #5140304009 Established 08/0111982 ROMAINE E RICHARDS DOD ba1aDce: S7,687.63 (non-interest bearing) Please note that tbis office only provides date of death balaDCes for deposit accounts (lRAs, CDs, ~ aDd Savings accounts). We do IIOt procesl uy flu.... tra....ctio.. or proride statelDelD. H you need assistance with any of these items, please call1-888-PNc-BANK (1-888-762--2265) or stop by your local me Bank branch office. Sincerely, ~lJJ.LIh RacbeUc Wells 1-800-762-1775 P7-PFSC-04-F 500 first A vc. Pittsburgh PA JS2J9 Member FDIC TOTAL P.01 Kelley Blue Book - Priyate Party Pricing Report - Toyota, Solara Page 1 of3 .~-= . i t :.~., I '( ., ~ -f 1 ,.. I ~~Q~l ~-;~:~;-;;/:j~~~~;,~~ale~- Te~-:;l- ..;;.,;. _. . UHO CAllS REV EWS & RATINGS ADVICE FIN;' ~C'N::; ~ ~~URA~CE o FfM OHiO, Plic& al.ote 0 SeIA:lI.. eertitlingt 0 UtiyOUt Cl BlUE 1001 PRlYATI PAIn REPORT Pennsylvania · October 28, 2004 2000 Toyota Solara SLE Coupe 2D Search Listings for This Car List Your Car For Sale Online Buy a New Car Free Record Check Auto loans from 3.65% APR Insurance Quote Print tlF or Sale" Sign Payment Calculator Engine: V6 3.0 Liter Trans: Automatic Drive: Front Wheel Drive Mileage: 30,000 Equipment Air Conditioning Power Steering Power Windows Power Door locks Tilt Wheel Cruise Control Dual Front Air AM/FM Stereo Bags Cassette ABS (4-Wheel) Single leather Compact Disc Power Seat Premium Alloy Wheels Sound Consumer Rated Condition: Good ~~~.~-------------- AdvlOrtlsemEtr "Good" condition means that the vehicle is free of any major defects. This vehicle has a clean title history, the paint, body and interior have only minor (if any) blemishes, and there are no major mechanical problems. There should be little or no http://www.kbb.com/kb/ki.dll/kw.kc.ur.?kbb.P A;OO 1497:P A041& 17055;+p& 722:Toyota:2000%2... 10/28/2004 August 10, 2004 Charles H. Stone Stone Lafaver & Sheldetski 414 Bridge Street P.O. Box E New Cumberland, PA. 17070 In regards to our recent conversation regarding the passing of Romaine Richards, please see the enclosed information concerning her two Midland National Life fixed annuities: Contract Number Approx. Cost Basis Value at Death Beneficiaries 8500031028 $20,000 $69,370.96 3 children 8500037572 $25,000 $36,785.21 3 children Beneficiary Options 1. Lump sum 2. Additional settlement options are available and described on the beneficiary paperwork. Midland National needs to be provided with addresses and telephone numbers of the beneficiaries before sending out claim forms. (877-880-6367). Thank you, Sincerely, ~4 ~. -', Timothy D. Gay 1725B Oregon Pike, Suite 206 Lancaster, P A. 17601 717-560-8858 717-560-4766(FAX) cc: Michael A. Richards, Executor 2.02 5 ,-. A., . B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.QFHA 2.QFmHA 3.!IDCONV. UNINS. 4.oVA 5.0CONV. INS. 6. FILE NUMBER: T7. LOANNUMBER: SETTLEMENT STATEMENT P-139556 2179120032 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form Is furnished to give you a staf6merd of actual S6ttIement rosts. Amounts paid to and by the S8/1Jement agent am shown. Items marlced "fPOCr _ paid outside the closing; they.... shown hel8 for InformatiOnal purposes and 818 not Included In the totals. . 1.0 _ tp-l_.PFIlIP.l_e) D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: Susan J. Rogers Estate of Romaine E. Richards Citizens Mortgage Corp 113 Lancaster BMI. 10 Tripps Lane Mechanlcsburg. PA 17055 R~.RI02915 G. PROPERTY LOCATION: H. SETTLEME:NT AGENT: 25-1722090 I. SETTLEME:NT DATE: 445 DelanCey Court CapltaI RegIon Land Transfer. Inc. Mechanicsburg. PA 17055 September 27. 2004 CumbelIand County. Penns)4vania PLACE OF SETTLEMENT Upper Allen Township 3310 MaIket Street Camp Hill. PA 17011 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sates PrIce 120.000.00 401. Contract Sates Price 120 000.00 102. Personal Prooerlv 402. Personal Prooertv . 103. SelIIemenl cI1lImes 10 Borrower (Line 14001 4463.55 403. 104. 404. 105. 405. AdJustments For /lems Paid BY SeIJer In IIdvanctI Adjustments For /lems Paid Bv SeIJer In advanc:e 106. CIlv T_ 10. 406. Citv Taxes 10 107. CounIvTaxea 09/27104 10 01101105 81.54 407. CounIYTaxes 09/27104 eo 01101105 81.54 108. School Taxes 09/27104 10 07101105 1179.20 408. .SchooI Taxea 09/27104 eo 07101105 1179.20 109. Assoclation dues 09/27104 eo 10101104 14.13 409. Association dues 09/2710410 10101104 14.13 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT OUE FROM BORROWER 125,738.42 420. GROSSAMOUNT OUE TO SEU.ER 121,274.87 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO saJ.ER: 201. rloooMlt or earnest '""""" 1 000.00 501. Excess rloooMlt (See InsIrucIionsI ~ofNewloan(s\ 96.000.00 502. SelIIemenI r'-"- eo SeIer liJnS 14001 10,129.47 203. sl lBken!lUbl&ctlo 503. Exlstina !oan(sl \aken subIecllo 204. Bank CRA Grant 1 800.00 504. Pa~ of first Mortgage 205. 505. PallOff of semnd Mot1Daoe 206. 506. 207. 507. (Oeposltdlsb.as~1 208. 508. 209. SeIfer assist In closlno costs 500.00 509. Seller assist In cIosl"" costs 500.00 AdjustmentS For /terns Unnaid BY SeIJer Adjustments For /terns Unoald Bv Seller 210. CIlv Taxes to 510. City Taxes 10 211. CountvT_ 10 511. CounIYT_ to 212. School Taxes to 512. School Taxes 10. 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BYIFOR BORROWER 99.300.00 520. TOTAL REDUCTION AMOUNT DUE SEU.ER 10,629.47 300. CASH AT SETTLEMENT FROMfTO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SELLER: 301. Gross Amount Due From Borrower (line 1201 125.738.42 601. Gross Amount Due To SelIerllJn&42QI 121,274.87 302. Less Amount Paid BviFor Bon'ower (line 2201 ( 99,300.00 602. Less Reductions Due Seller (line 520) 10.629.47 303. CASH ( X FROM) ( TO) BORROWER 26.438.42 603. CASH ( X TO)( FROM) SELLER 110.645.40 OMS NO 250 6...... -~4r 'Seller The undersigned hereby acknowtedge receipt of a completed copy of pages 1&2 of this statement & any attachments referred 10 ----~,.,--- ...---------. L. SETTLEMENT CHARGES . 700. TOTAL COMMISSION Based on Price $ 120,000.00 rm 6.0000 % 7,200.00 PAlO FROM . PAID FROM Division of Commission (fine 700 as Follows: BORROWER'S SELlER!S" 701. t a.1l2S.00 10 The Homestead Group Realtor. Inc. FUNDS AT FUNDS AT 702. $ 3,575.00 10 HOWARD HANNA DETWEILER REALTY SETTLEMENT SETTLEMENT. 703. Commission Paid al Settlement 7,200.00 704. 10 SOO.ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Orioination Fee % 10 802. Loan Disrount % 10 803. Appraisal Fee 10 National Real Estate $325.00 by lender 804. Credit Report 10 Credil Network $15.00 by lender 805. Flnallnspection 10 National Real Estate 100.00 806. AooIication Fee 10 Citizens Mortoaoe Core 325.00 807. Tax Service Fee 10 First American Tax Service 57.00 808. Document Prep.Fee 809. Flood Cert Fee 10 First American Flood Data Service 11.00 810. AU Underwriting Fee FNMA $20.00 by lender 811. Underwriting Fee 10 Citizens Mortgage Corp 300.00 812. Citizens Mortgage Corp 813. 814. 815. 816. 817. 818. 819. 820. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 09/27/04 to 10/01104 @ $ 14.470000/day ( 4 days %) 57.88 902. Mor1I:Iaae Insurance Pl8mium for months 10 903. Hazard Insurance Premium for vearslo 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance months $ per month 1002. Mortoaoe Insurance months $ per month 1003. Cilv Taxes months $ Der month 1004. Countv Taxes months $ Der month 8 months x $25.3875 203.10 1005.. School Taxes months @ $ per month 4 months x $126.895 507.58 1006. months IBl $ per month 1007. months IBl S oer month 1008. Aaol'flOate Ad usbnent months IiJJ - $ per month -101.61 1100. TITLE CHARGES 1101. Declaration of Condo Bv-Laws 10 Delancev Court Condominium Assoc. 15.00 1102. October Condo Assn Dues 10 Delancev Court Condo Aslin 106.00 1103. TItle Examination 10 1104. TItle Insurance Binder 10 1105. Document Preoaration to 1106. Notarv Fees 10 Unda McBeth 12.00 1107. Attorney's Fees 10 flne/udes above item numbers: ) 1108. TIlle Insurance 10 Caoltal Reolon Land Transfer Inc. 958.75 flne/udes above item numbers: ) 1109. Lender's Coverage $ 96,000.00 1110. Owner's Coverage $ 120,000.00 1111.100,300,8.1,810 10 Capital RegIon Land Transfer, Inc. 200.00 1112. Deed Preparation David Stone, Esq. POC 1113. Ovemighl 10 Capital Region Land Transfer, Inc. 15.50 1114. Closing Protection Letter 10 Commonwealth Land TItle Insurance Company 35.00 1115.2004 School Taxes 10 Marlin A. Yohn, Sr. 1,553.82 1116. ElecIronlc Transmillal Fee 10 Capital Region Land Transfer, Inc. 25.00 1117. Tax Carl 10 Capital Region Land Transfer, Inc. 5.00 1118. Working capital fund 10 Delancey Court Condominium Assoc. 318.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 40.50; Mortgage $ 73.50: Releases $ 114.00 1202. CitvlCounIvTax/Stamos: Deed 1,200.00' Mortaaae 1,200.00 1203. State Tax/Stamos: Deed 1,200.00: Morin""" 1 200.00 1204. Record Mortoaoe Asskiiiment Recorder of Deeds 1205. 1300. ADDmONAL SETTLEMENT CHARGES 1301. Survev 10 1302. Pest Insoection . 10 Home Paramounl Pesl Control POC Bu-r 1303. &lwer Jul...sentemberl to UDDer Allen TownshlD Munlcloal Aulhoritv AccI. 419023 4.35 95.65 1304. Wire Fee to Caoital Reoion Land Transfer, Inc. 15.00 1305. Hauling fee 10 Russen Brown 60.00 1400. TOTAL SETTLEMENT CHARGES (Enler on Lines 103, Section J and 502, Section K) 4,463.55 10,129.47 By Ilgning page 1 0I1h1s Slalement, the slgnolOlfeS ocknolMedge IllCeIpt 010 completed copy 01 page 2 0I1h1s IWD page ~ I ~/ .. AJ /:1 / /. / C~ R6gion Land Transfer, Inc. Selllemenl Agenl (P.f39556/P.139556/19 ) L\. c.:~" ,- U.J C) Li~ L.; STATUS REPORT UNDER RULE 6.12 Name of Decedent: Romaine E. Richards Date of Death: June 18, 2004 Will No. 21-04-0759 To the Register: 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: l. Yes ~ 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: Date: - -~ c") r",i C Ll.l i' C:.-\ I c.c c:" c: u -., cr 3. If the answer to No.1 is Yes, state the following: (a) Did the personal representative file a final account with the Court? Yes No X (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? Yes~ No (d) Copies of receipts, releases, joinders approvals of formal or informal accounts may be the Clerk of the Orphans' Court :;tp.d...-m be att report. / I 2 - \ -0 'S and filed with hed to this Capacity: Personal Representative X Counsel for Personal Representative 0- I ( I C) \.... C..J u-:-) C:~:~l C.:..'-) ~--.J L) c.; I....; ~ II I I I I' est\rel\RICHARDSlinda IN RE: ESTATE OF ROMAINE E. RICHARDS LATE OF THE TOWNSHIP OF LOWER ALLEN, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0759 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, LINDA STUMPF, being one of the beneficiaries under the will of ROMAINE E. RICHARDS, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of ROMAINE E. RICHARD, in full satisfaction and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, LINDA STUMP~ do by these presents, remise, release, quitclaim and forever discharge the Executrix, her heirs, successors and assigns, from the acts of the Executor as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, II .,r II I II . , I , claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executrix. IN WITNESS WHEREOF, I have hereunto set my hand and seal the q-k day of ~ , 2005. ".7 Witness ~~, E~~rL STATE OF FLORIDA COUNTY OF J)lA-VO~ SS: On this, the q day of S~tt-v-Y)b~ , 2005, before me a Notary Public, the undersigned officer, personally appeared LINDA STUMPF, known to me (or satisfactorily proven) to be the person whose name 1S subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. o ~cJ.;d-1. .~ Notary Public "'~1l~ """ JUDt L. TRIPP i ~ Notary Public. Stale of Florida My comm. expires Dec. 16. 2005 No. DO 078981 -2- II Ii. est\rel \RICHARDSmlchael IN RE: ESTATE OF ROMAINE E. RICHARDS LATE OF THE TOWNSHIP OF LOWER ALLEN,CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0759 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that: I, MICHAEL A. RICHARDS, being one of the beneficiaries under the will of ROMAINE E. RICHARDS, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of ROMAINE E. RICHARD, in full satisfaction and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed In a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, MICHAEL A. RICHARDS, do by these presents, remise, release, quitclaim and forever discharge the Executrix, her heirs, successors and assigns, from the acts of the Executor as afore- said, and of and from all actions, suits, payments, accounts, reckon- lngs, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executrix. IN WITNESS WHEREOF, I have hereunto set my hand and seal the 30 iM, SafYti~_A- day of , 2005. Witness l1.J!)od?~ MICHAEL A. RICHARDS --- STATE OF IOWA COUNTY OF PO+ro.Wa.t\o.ffi\ e; ~ On this, the ~ - day of SS: 5 -er ~ ('(\ tJe r , 2005, before me a Notary Public, the undersigned officer, personally appeared MICHAEL A. RICHARDS, known to me (or satisfactorily proven) to be the person whose name lS subscribed to the within instrument and acknowl- edged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. cl1~~h~~~t~~ Notary Public :A~ ,,,,,- DEBORAH L. EARLEYWINE C~'P.:,ssIOO Number 198761 -'II"\OM!A~~N ~~ES -2- est\rel\RICHARDSjody IN RE: ESTATE OF ROMAINE E. RICHARDS LATE OF THE TOWNSHIP OF LOWER ALLEN, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0759 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, JODY A. LUCIA, being one of the beneficiaries under the will of ROMAINE E. RICHARDS, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of ROMAINE E. RICHARD, in full satisfaction and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, JODY A. LUCIA, do by these presents, remise, release, quitclaim and forever discharge the Executrix, her heirs, successors and assigns, from the acts of the Executor as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executrix. IN WITNESS WHEREOF, I have hereunto set my hand and seal the I~L~ da y 0 f /l/vr./en-, 6Q y 9~{;!- Witness , 2005. COMMONWEALTH OF PENNSYLVANIA: COUNTY OF pit2!l.LI __J YA On this, the /h . SS: day of NtJ Y't 1111 h '-t:' ~ , 2005, before me a Notary Public, the undersigned officer, personally appeared JODY A. LUCIA, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. .~ -- ~~~tt~~ ~ COMMONWEALTH OF PENNSYLVANIA , '*AataI SeeI 1 JOOy M. Heminger, NotaJy Public l CIty Of Hanisburg, Dauphin County _ My CommissioI. Expires May 25, '}JJ()7 ilAemhe<. ~nsvlvani:3 Association Of Nolaries -2- II I est\rel\RICHARDSJodytrustl IN RE: ESTATE OF ROMAINE E. RICHARDS LATE OF THE TOWNSHIP OF LOWER ALLEN, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0759 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, LINDA STUMPF, CO-TRUSTEE of the Jody A. Lucia Trust, being one of the beneficiaries under the will of ROMAINE E. RICHARDS, do hereby acknowledge that I have re- ceived all sums of money and property due me by virtue of the death of ROMAINE E. RICHARD? in full satisfaction and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, LINDA STUMPF, CO-TRUSTEE of the Jody A. Lucia Trust, do by these presents, remise, release, quitclaim and forever discharge the Executrix, her heirs, successors and assigns, from the acts of the Executor as aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoev- er, and I do hereby consent to the discharge of the said Executrix. IN WITNESS WHEREOF, I have hereunto set my hand and seal the d7~ day of ~,,,,,--, , 2005. Witness LINDA STUMPF, Jody A. Lucia of the ~ / .I STATE OF FLORIDA COUNTY OF i\V\I""\ SS: On this, the ;)7 day of S e p+eW\h{' (' , 2005, before me a Notary Public, the undersigned officer, personally appeared LINDA STUMPF, CO-TRUSTEE of the Jody A. Lucia Trust, known to me (or satis- factorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. fL l'lllt~:t,Q \,-,,,- ~ ,,~~ Notary Public ~__~'" ,""~.,_",,""~=,~c, "'~ "" BRIAN E. BRUNK lK'Pi, '10>,,, Po'" ""1001 ""!d, !,;$ My comm. expires Nov. 06, 2006 . No. DD163537 ;ny....~ -2- 11 :,. est\rel \RICHARDSjodytrust2 IN RE: ESTATE OF ROMAINE E. RICHARDS LATE OF THE TOWNSHIP OF LOWER ALLEN, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0759 RECEIPT, RELEASE AND WAIVER OF ACCOUNTING KNOW ALL MEN BY THESE PRESENTS, that I, MICHAEL A. RICHARDS, CO-TRUSTEE of the Jody A. Lucia Trust, being one of the beneficiaries under the will of ROMAINE E. RICHARDS, do hereby acknowledge that I have received all sums of money and property due me by virtue of the death of ROMAINE E. RICHARD, in full satisfaction and settlement of all of my rights and claims under her estate. I further declare, intending to be legally bound, that I hereby waive my right to require the filing of a First and Final Account and Proposed Schedule of Distribution in any Court of Common Pleas having jurisdiction over the same, and I acknowledge that I have had an opportunity to examine copies of the books and records of the said estate, and I agree to the final distribution of the estate without further formalities, and with the same force and effect as if a First and Final Account and Proposed Distribution had been filed in a Court of Common Pleas of Pennsylvania having jurisdiction over the same and duly audited and confirmed. AND THEREFORE, I, MICHAEL A. RICHARDS, CO-TRUSTEE of the Jody A. Lucia Trust, do by these presents, remise, release, quitclaim and forever discharge the Executrix, her heirs, successors and assigns, from the acts of the Executor as aforesaid, and of and from all II " I actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or any other act, matter, cause or thing whatsoever, and I do hereby consent to the discharge of the said Executrix. IN WITNESS WHEREOF, I have hereunto set my hand and seal the 3oY!, day of ~~.^-- , 2005. Witness r1Jj)ol<d~_ MICHAEL A. RICHARDS, CO-TRUSTEE of the Jody A. Lucia Trust STATE OF IOWA COUNTY OF Pot\- ctwatto..m 1''<- ~ SS: On this, the ~O * day of 5.e.p te fY\ '<:W 'f me a Notary Public, the undersigned officer, personally appeared , 2005, before MICHAEL A. RICHARDS, CO-TRUSTEE of the Jody A. Lucia Trust, known to me (or satisfactorily proven) to be the person whose name is sub- scribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. AJe htrlaJU( ~{~ Notary Public !l.~ "... DEBORAH L EARl.E.YWINE Commission !l.,u~~: 1J:~~~1 MY C~!!",,"~EX!"'n'F1 -2- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX `~ BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX PO BOX 280601 REV-1547 EX AFP (03-OS) HARRISBURG PA 17128-0601 _ _ DATE 05-30-2005 "' `' ESTATE OF RICHARDS ROMAINE E DATE OF DEATH 06-18-2004 - _ FILE NUMBER 21 04-0759 COUNTY CUMBERLAND DAVID H',570NE ESQ ACN 101 STONE ETAL Amount Remitted 414 BRIDGE ST NEW CUMBERLAND PA 17070 ~1 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~- RETAIN LOWER PORTION FOR YOUR RECORDS ~ dCd~'Y~~Y~9t'7~'A'tV#"tt+5~'1,TdT'i'~"tip'11~A~1E~YYdl~lt'~'YAX'~~!!A'Y'~~F~Tf ;'~YC'ti4TdiaL~'bff.••••••••••••• ••• DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF RICHARDS ROMAINE E FILE N0. 21 04-0759 ACN 101 DATE 05-30-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED [ ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 120, 000.00 NOTE: To insure proper (2) 85.459.00 ~=redit to your account, 2. Stocks and Bonds [Schedule B) :submit the upper portion 3. Closely Held Stock/Partnership Interest (Schedule C) (3) •00 of this form with your 4. Mortgages/Notes Receivable (Schedule D) (4) .00 •kax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 20.6 23.13 b. Jointly Owned Property (Schedule Fl (6) .00 7. Transfers (Schedule G) (7) 106,156.17 ($) _ 332,238.30 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 43,149.86 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00 11. Total Deductions (11) _ 43.149.86 (12) _ 289, 088.44 12. Net Value of Tax Return .00 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) _ 289,088.44 14. Net Value of Estate Subject to Tax (14) . NOTE: If an assessment was issued previously, lines 14, 15 andior 16, li-, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: (15) .00 X 00 = .00 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 289, 088.44 X 045 = 13, 008.98 17. Amount of Line 14 at Sibling rate (17) .0 0 X 12 = .00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 = .00 (19)= 13, 008.98 19. Principal Tax Due TAX GRE)7i t ~' + AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-15-2005 CD005060 .00 13,008.98 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT 13,008.98 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE`DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.).