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HomeMy WebLinkAbout03-0435 PETITION FOR PROBATE and GRANT OF LETTERS also known as To: Register of Wills for the Deceased. County of Ct~t$~'~/-~/> in the Social Security No. /at;'-/-/[~-- d/6i,~°~ Commonwealth of Pennsylvania The petition of thc undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut or nan',ed in the last wil} of the above decedent, dated ~4t~/a,,_.t.fi Iff , ~/'2'~/ and codicil(s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~zt~l~r/a~d County, Pennsylvania, with hiS_ last family or principal,residence at lq Wor~ ~; (fist street, number and muncipality) Decendent, then ~ years of age, died ~ lq , ~~., Except a~ follows,'~ced~nt did n~t marry, w~ not divorced and did not have a ~ild born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvani~ $ situated as follows: /~ ~a~ ~a~ ~re~,~a~ ~7re~..~a ~. WHEREFORE, petitioner(s) respectfully .request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters {testamentary; administration c.I.a.; administration d.b.n.c.t.a.) theron. ~ ~. . ~ ~ 7/7- 7~- OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF f~.~r~_L,~D 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 gn~ truly administer the esLate according to law. Sworn to or affirmed and subscribed - ce before me this e~'7' ~ day of ~ No. Estate Of ~.a/,,~- 'ZZ~-,4/V--/-~Y,'4'e- , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW /~,,~,~' o~.~:' ~l~',~.t:~,, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated described therein be admitted to probate and filed of record as the last will of and Letters ~ . are hereby granted to Probate, Letters, Etc .......... $~1~.~_' Short Certificates( ) .......... $~ A'UFORNEY (Sup. Ct. I.D. No.) nunc~auon ................ $ TOTAL Filed .,/r~ -~2~',. ~ ............. ~o~ REGISTER OF WILLS OF O ~Cm6~LA~/b COUNTY OATH OF SUBSCRIBING WITNESS ~) a subscribing witness to the will presented herewith, ~ being duly qualified according to law, depose(s) and say(s) that h e ~ present and saw the testat or , sign the same and that be signed as a witness at the request of testator _~ in h ] ~ presence and ~n the preseace cf cats $:~) (in the presence of the other subscribing witness(es)). ~~ ~ ~~ ~ Sworn to or affirmed and subscribed before ~~ ~' me this ~7 ~ day of e¢~z~s ~-' ~~e~ ~ ~---~~ ]~ .~,~ (Address) Registee (Name) (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-~WITNESS (each) a subscriber hereto, (eael~eing duly qualified according ~law, depose(s) and say(s) that farr~iigr with the signature of N,_ , testat'X. ~one of the subscrib~ ~esses to) the will p~ented herewith and that _ ~~ believes th~ the will is in t~riting of Sworn to o~~d and su~cribed beforex ~ ~N ~ me th~ _ d~ of ~ X (NamO 19 (Addressj Register (NamO (Address) REGISTER .OF WILLS OF COUNTY OATH. __OF ~SUB SCRIBIN~_____~S S (each) a subscribi.ng witn _~o the will presented he~th, (each)being duly qu~ied according to law, depose(s) an~.fsa~that~ ~NX~x ~Nent and saw, the testat---~, s~tName and l~ _ ~ signed as a wi~ss at the request of testat~er) 0'n the presenc~f the other subscribing witness(es)% ~ ~ ~ Sworn to or affirmed and subscribed .before_ x~ ~, N~X me this _ day of ~ ~ (Name)~ ~ (Address) Regt~ter (Name) (Address) REGISTER OF WILLS OF C~m~£feu~,v.~ COUNTY OATH OF NON-SUBSCRIBING WITNESS ~a~eO a subscriber hereto, (.~eh-) being duly qualified according to law, depose(s) and say(s) that is familiar with the signature of ~e'~ffe ~Den,,,t ~/or , testator of _t .... c ,~ .... ~.:~: ..... : ....... '~ the will presented herewith and that ~e believes the signature on the will is in the handwriting of to the best of.. J?~ knowledge and belief. Sworn to or affirmed and subscribed before ~~~ Regtgter (Name) (Address) This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as l.ocal Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. ./,'"'~/~ ~ ~, '~\~ Local Registrar No. ~ Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH STATE FILE NUMBER NAME OF DECEDENT {F~t~ Middle, Laa} SEX ISOCtAL SECURITY NUMBER DATE OF DEATH ,. ~eslle Dean ~aylor ~.mle1~'187 -- 16 -- 4688 ,.~ 19,~3 ,. } . y 26,1922 la, PA ~1~ ~. Silver Spring ~.~4 ~r~ R~d.,~icsburg,PA ]~..~.~.-*.~ ite D~C~O~m'$ USU~ ~U~N I KIND ~ BUSINES~IN~STRY ~S OECEOENT EVER ~ ~CEOENT'S E~I~ I . . ,.nev~ ~i~ ,,. · e~u~ ,, ~,,. Pemsylv~ia 14 ~r~ R~d .~s,~.ce k~icsb~g, PA 17055 ~ .... -- ~rlmd ,,. ~ight Taylor ,,. Ru~ Eliz~ ~. S~ley ~l~s ~ 06 Or--d St. t~icsb~tPA17055 I ~ ~ ~ ,,~y 23,2003 Rolling ~ C~te~ ~r ~len ~.,PA17011 ~. ~ m ~le [ DUE ~ (~ AS A ~SEQUE~E ~: Ontfle~Nloflx~lnltl~l~lnvesllgaflon, nmyopnion delth~cutt~lllhelme date, andplace a~duetolheclule(i)and LAST WILL AND TESTAMENT OF LESLIE DEAN TAYLOR I, LESLIE DEAN TAYLOR, of Silver Spring Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. I hereby declare that I am not now and never have been married and that I have no children living or dead. 3. I hereby make, give, devise, and bequeath the following specific gifts: A. To my sister, LILLIAN W. TAYLOR McCLIMANS, Ten Thousand ($10,000.00) Dollars; B. To my brother, ROBERT D. TAYLOR, SR., Ten Thousand ($10,000.00) Dollars. Both of these above stated gifts are conditioned on survival. In the event either of them or both of them fail to survive me, then his or her share or their shares, as the case may be, shall lapse and shall be considered part of the residue of my estate. 4. All the rest, residue, and remainder of my estate is to be divided into three (3) equal shares and distributed among my three (3) nephews, to wit: ROBERT D. TAYLOR, JR.; DARYL S. McCLIMANS; and BRADLEY E. McCLIMANS. In the event any of my said nephews fails to survive me, then his share shall go to his children in equal shares, per stirpes. In the event any such distribution becomes necessary, Michael Taylor shall be treated as if he were natural bom issue of the whole blood. In the event any of my said nephews fails to survive me and is not survived by children, then his share shall be proportionally divided between my other two (2) said nephews or their children, as the case may be, as is provided for above. 5. ! nominate, constitute and appoint my brother-in-law, STANLEY E. McCLIMANS, to be the Executor of this, my Last Will and Testament. In the event that he should predecease me or for any reason be unwilling or unable to act as such Executor, I nominate, constitute and appoint my nephew, DARYL S. McCLIMANS, to be Executor in his place and stead. In the event that he should predecease me or for any reason be unwilling or unable to act as such Executor, I nominate, constitute and appoint my nephew, BRADLEY E. McCLIMANS, to be Executor in his place and stead. I further direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /z//~ day of , A.D. 2001. LESLIE DEAN TAYLOR ~ Signed, sealed, published and declared by the above-named LESLIE DEAN TAYLOR, as and for his Last Will and Testament, in the presence of us, who at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. 2 CERTIFICATION OF NOTICE UNDER RU!.F. 5.6(a) Name of Decedent: Leslie Dean Taylor Date of Death: May 19, 2003 Will No. Admin. No. 21-03-0435 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 June 4, 2003 Name Address. Lillian W. McClimans 106 Orchard Street, Mechanicsburg, PA 17050 Robert D. Taylor 607 Green Acres Street, Mechanicsburg,, PA 17055 Robert D. Taylor Jr. 3828 Carnage House Drive, Camp Hill, PA 17011 Daryl S. McClimans 109 W. Green Street, Shiremanstown, PA 17011 Bradley E. McClimans 7 Cedar Road, Mechanicsburg, PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: June 3, 2003 CHARLES E. SHIELDS, III 6 Clouser Road Mechanicsburg, PA 17055 Telephone: (717) 766-0209 Counsel for Personal Representative L Z:~ t t NB[' CHARLES E. SHIELDS, III A TTORNEY-A T-LA W 6 CLOUSER ROAD Corner of Trindle and Clouser Roads M£CHANICSBURG, PA 17055 GEORGE M. HOUCK TELEPHONE (717) 766-0209 (1912-1991) FAX (717) 795-7473 August 8, 2003 Ann Capozzi Register of Wills Cumberland County Court House 1 Court Square Carlisle, PA 17013 Re: Estate of Leslie Dean Taylor No. 21-03-435 Dear Ms. Capozzi: Please find enclosed check number 117, drawn on account from the Estate of Leslie Dean Taylor in the amount of $28,500.00. This is an estimated payment for the Inheritance Taxes. Thank you for your kind attention to this matter. Very truly yours, Charles E. Shields, III CES:mmh Enclosure Charles E. Shields III Mechanicsburg, PA 17 7099 Ann Capozzi Register o£ Wills Cumberland County Court House 1 Court Square Carlisle, PA 17013 I,,,lll,,,ltl,,,,,,li,,ll,,,ll,,,ll,,,hh,ll,l,h,l,l,,hh, COMMONWEALTH Of PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD OO2889 SHIELDS CHARLES E III ESQUIRE 6 CLOUSER ROAD MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold .................. 101 $28,500.00 ESTATE INFORMATION: SSN: 187-16-4688 FILE NUMBER: 2103-0435 DECEDENT NAME: TAYLOR LESLIE DEAN DATE OF PAYMENT: 08/1 1/2003 POSTMARK DATE: 08/09/2003 COUNTY: CUMBERLAND DATE OF DEATH: 05/19/2003 TOTAL AMOUNT PAID: $28,500.00 REMARKS: CHARLES E SHIELDS III ESQUIRE CHECK# 11 7 INITIALS: AC SEAL RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH Of PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003184 SHIELDS CHARLES E III 6 CLOUSER ROAD MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold .................. 101 $14,938.79 ESTATE INFORMATION: SSN: 187-16-4688 FILE NUMBER: 21 03-0435 DECEDENT NAME: TAYLOR LESLIE DEAN DATE OF PAYMENT: 10/30/2003 POSTMARK DATE: 10/29/2003 COUNTY: CUM BERLAND DATE OF DEATH: 05/19/2003 TOTAL AMOUNT PAID: $14,938.79 REMARKS: CHARLES E SHIELDS III ESQUIRE INITIALS: SEAL RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS (6-00) REV-1500 PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN DECEDENTS NAME (~ST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURI~ NUMBER DATE OF D~TH (MM-DD-Y~R) DATE OF BIRTH (MM-DD-Y~R) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ~-- /~ --~ ~-- ~ -- /?~ REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (~ST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURI~ NUMBER - _ ~ 1. Original Return ~ 2. Supplemen~l Retum ~ 3. Remainder Return (date of death pdor to 12-13~2) ~ 4, Limited Estate ~ 4a. Future Interest Compromise (date of dea~ after 12-12~2) ~ 5. Federal Estate Tax Retum Required ~ 6. Decedent Died Testate (A~ch copy of Wi~,) ~ 7, DecedentUain~inedaLivingTmst(A~yofT~st) / 8. Total Number of Safe Deposit Boxes ~ 9. Litigation Pro~s Re~ived ~ 10. Spousal Pove~ Credit (date of dea~ be~en 12-31-91 and I-1-95) ~ 11. Election to tax under Sec. 9113(A) (A~ch Sch O) NAME COMPLETE MAILING ADDRESS TELEPHONE NUMBER 1. Real Estate (Sch~uleA) (1) ~j~ ~, ~o OFFICIAL USE ONLY 2. St~s and Bonds (S~ule B) (2) F ~/ 7 ~ ~ 3. Closely Held Corporation, Pa~nemhip or Sole-Pmpdetomhip (3) ~ ~ -- 4. Mo~gages & Notes Remivable (Schedule D) (4) ~ ~ ~ '. 5. Cash, Bank Deposi~ & Uis~llan~us Personal Prope~ (5) ~/~ ~O~ ~ (Schedule E) 6. Join~y ~ned Pmpe~ (Sch~ule F) (6) ~ ~ -- ~ ' ~ Separate Billing Requested 7. Inter-~vos Transfem & ais~llaneous Non-Probate Pmpe~ (7) ~ ~J~/~ (Schedule G or L) 8. Toal Gross ~se~ (to~l Lines 1-7) (8) 9. Funeral Expenses & Adminis~tive Costs (Schedule H) (9) ~ ~ ~ J ~, ~ 10. Debts of De~ent, Mo~gage Liabilities, & Liens (Schedule I) (10) ~ /O ~, ~ 11. Total Dedu~ions (to~i Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been {13) made (Schedule J) 14, Net Value Subje~ to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE ~TES 15. Amount of Line 14 taxable at the spousal tax ~ rate, or transfers under Sec. 9116 (a)(1.2) x .0 ~ (15) 16. Amount of Line 14 taxable at lineal rate ~ x .0 ~ (16) 17. Amount of Line 14 taxa~e at sibling rate ~0~ ~, ~ 18, Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) Decedent's Complete Address: STREET ADDRESS CiTY /J'/E¢/'/'/C/V/C$~UI~. STATE ./¢'.,,,jt' ~ ZIP Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) ~ 73 ~, 7~ 2. Cmdit~Payments A. Spousal Pove~ Credit B. Pdor Payments ~ ~ ~0~- ~ C. Dis~unt ~/~ ~. ~ To~l Cmd~s (A+ B + C) (2) ~ 3. IntemsFPenal~ if appli~ble D. Interest E. Penal~ Total Intems~Penal~ ( 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 ~e T~ DUE. (5) ~/~. A. Enter ~e interest on ~e ~x due. (5A) B. Enter the total of Line 5 + 5A. ~is is the BA~NCE DUE. (5B) ~ ~ Make Check Payab/e to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY P~ClNG AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the pm~ transferred; .......................................................................................... ~ b. retain the right to designate who shall use the pmpe~ transfe~ed or its in.me; ............................................ ~ c. retain a reversiona~ interest; or .......................................................................................................................... ~ d. receive the promise br life of either payments, benefits or ~m? ...................................................................... ~ 2. If death occu~ed after December 12, 1982, did de.dent transfer pmpe~ within one year of dea~ without m~iving adequate consideration? .............................................................................................................. ~ 3. Did de.dent own an "in trust fof' or payable upon death bank ac~unt or secud~ at his or her death? .............. ~ 4. Did de.dent own an Individual Re~mment Ac~unt, annulS, or othe[ non-probate pmpe~ which contains a beneficia~ designation? ........................................................................................................................ ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pedu~, I declare that I have examin~ this tatum, including ac~mpanying s~edules and s~tements, and to ~e best of my ~owl~ge and ~lief, it is tree, ~ffe~ and ~mplete. D~am~on of preparer other than ~e pe~nal repmsentaave is based on all info~ation of whi~ preparer has any ~ledge. SIGNATURE~EPAR~ OTH~ THAN ~~TIV~ DATE 1 ADDRESS~ ~gg~ ~ ~W/~$ ~ For dates of dea~ on or after July 1, 1994 and before Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the sullying s~use is 3% [72 P.S. ~9~6 (a)(~ .~)(i)]. For dates of dea~ on or after Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the su~iving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a sullying spouse from tax, and the statuto~ requirements for disclosure of assets and filing a tax return are still appli~ble even if the suwiving s~use is the only ~neficia~. For dates of death on or after July 1, 2000: The tax rate im~sed on the net value of transfers from a deceased child ~en~ne yearn of age or younger at dea~ to or for the use of a natural parent, an adoptive parent, or a stepparent ofth~ child is 0% [72 FS. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the de,dent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the demden~s siblings is 12% [72 RS. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an indMdual who has at least one parent in ~mmon with the de,dent, whether by bl~d or adop~on. ~ SCHEDULE A COMMO.W~LT, OF PENNSYLV^N,^REAL ESTATE RESIDENT DECEDENT ESTATEOF 7.-/,iZ/i/LD,~, Z~'.~L/,~' ~5. FILENUMBER -,,~/-~.3 - ~3 ~ All real pro~ o~ed sole~ or as a tenant in common must be m~ed at ~ir manet value. Fair manet value is defined as the p~ at which pro~ would ~ exchanged ~een a willing buyer and a willing sel~r, ne~er ~ing ~m~lted to buy or sell. ~ having reasonable kn~l~ge of ~e relevant fa~. Real pm~ ~ich is jointly-o~ed ~ ~ght of suwivomhip must be disclos~ on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF D~TH 1. TOTAL (Also enter on line 1, Recapitulation) $ / ~,.~-~ ~). ~ (If more space is needed, insert additional sheets of the same size) OMB NO. 2502-0265 '11r A. B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.E]FHA 2.E~FmHA 3. [~]CONV. UNINS. 4. r-]VA 5. F-]CONV. INS. 6. FILE NUMBER: I 7. LOAN NUMBER: SETTLEMENT STATEMENT HOS361-03I 0133492777 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "[POC]" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. 1.0 3~98 (HOS361-03.PFD/HOS361-03/6) D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: GREGORY L. HOSLER L. DEAN TAYLOR, ESTATE MEMBERS 1ST FEDERAL CREDIT 2404 WARREN WAY 14 NORTH ROAD UNION MECHANICSBURG, PA 17050 MECHANICSBURG, PA 17050 P O BOX 40 5000 LOUISE DRIVE MECHANICSBURG, PA 17055 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1619811 I. SETTLEMENT DATE: 14 NORTH ROAD CHARLES E. SHIELDS, III, ESQ. MECHANICSBURG, PA 17050 September 30, 2003 CUMBERLAND County, Pennsylvania PLACE OF SETTLEMENT 3414 CHESTNUT ST CAMP HILL, PA 17011 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 160. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price 145,900.00 401. Contract Sales Price 145,900.00 102. Personal Property 402. Personal Property 103. Settlement Charges to Borrower (Line 1400) 8,143.63 403. 1 O4. 404. 105. 405. Adjustments For Items Paid By Seller in advance Adjustments For Items Paid By Seller in advance 106. City/Town Taxes 09/30/03 to 01/01/04 83.32 406. City/Town Taxes 09/30/03 to 01/01/04 83.32 107. County Taxes to 407. County Taxes to 108. SCHOOL TAX 09/30/03 to 07/01/04 804.82 408. SCHOOL TAX 09/30/03 to 07/01/04 804.82 109. 409. 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNTDUE FROM BORROWER 154,931.77 420. GROSS AMOUNTDUE TO SELLER 146,788.14 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 1,000.00 501. Excess Deposit (See Instructions) 202. Principal Amount of New Loan(s) 145,900.00 502. Settlement Charges to Seller (Line 1400) 10,824.70 203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to 204. 504. Payoff of first Mortgage 205. 505. Payoff of second Mortgage 206. 506. 207. 507. (Deposit dish. as proceeds) 208. 508. 209. 509. Adjustments For Items Unpaid By Seller Adjustments For Items Unpaid By Seller 210. City/Town Taxes to 510. City/Town Taxes to 211. County Taxes to 511. County Taxes to 212. SCHOOL TAX to 512. SCHOOL TAX to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 146,900.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 10,824.70 300. CASH AT SETTLEMENT FROM/TO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER: 301. Gross Amount Due From Borrower (Line 120) 154,931.77 601. Gross Amount Due To Seller (Line 420) I 146,788.14 302. Less Amount Paid By/For Borrower (Line 220) ( 146,900.00', 602. Less Reductions Due Seller (Line 520) I( 10,824.70', 303. CASH( X FROM)( TO)BORROWER 8,031.77 603. CASH( X TO)( FROM)SELLER 135,963.44 The undersigned hereby acknowledge receipt of a completed copy of pages 1&2 of this statement & any attachments referred to herein. I HAVE CAREFULLY REVIEWED THE HUD-1 SETTLEMENT STATEMENT AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, IT IS A TRUE AND ACCURATE STATEMENT OF ALL RECEIPTS/~D DISBURSEMENTS MADE ON MY ACCOUNT OR BY ME41N THIS TRANSACTION. I FURTHER CERTIFY THAT I HAVE RECEIVE]~ A COPY OF THF HUIb¥1 SETTLEMENT STATEMENT ~ 4 // Borrower ~. Seller GREGORY L. ~IOSLER ' E. DEAN'TAYLOR, E~STATE TO THE BEST OF MY KNOWLEDGE, THE HUD-1 SETTLEMENT STATEMENT WHICH I HAVE PREPARED IS A TRUE AND ACCURATE ACCOUNT OF THE FUNDS WHICH WERE.J;;iF~CEIV,,ED A_ND "/~t~ B.F--~bl OR WILL BE DISBURSED BY THE UNDERSIGNED AS PART OF THE SETTLEMENT OF THIS TRANSACTION. /~~..,~,. ~ ~) ~ETTLEMENT OFFICER Settlement Agent WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE: TITLE 18 U.S. CODE SECTION 1001 & SECTION 1010. ~'age z L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price $ 145,900.00 ~ 6.0000 % 8,754.00 PAID FROM PAID FROM DiVision of Commission (line 700) as Follows: BORROWER'S SELLER'S 701. $ 8,754.00 to RE/MAX REALTY ASSOCIATES, INC FUNDS AT FUNDS AT 702. $ to SETTLEMENT SETTLEMENT ~703. Commission Paid at Settlement 8,754.00 704. PROCESSING FEE to REMAX REALTY ASSOC 150.00 125.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee 1.0000 % to MEMBERS 1ST FEDERAL CREDIT UNION 1,459.00 802. Loan Discount 1.7500 % to MEMBERS 1ST FEDERAL CREDIT UNION 2,553.25 803. Appraisal Fee to 804. Credit Report to 805. Lender's Inspection Fee to 806. Mortgage Ins. App. Fee to 807. Assumption Fee to 808. APPLICATION FEE to MEMBERS 1ST FEDERAL CREDIT UNION 325.00 809. UNDERWRITING FEE to MEMBERS 1ST FEDERAL CREDIT UNION 75.00 810. DOCUMENT PREP FEE to MEMBERS 1ST FEDERAL CREDIT UNION 275.00 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 09/30/03 to 10/01/03 @ $ 24.820000/day ( I days %) 24.82 ,902. Mortgage Insurance Premium for months to 903. Hazard Insurance Premium for 1.0 years to POC 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 3.000 months ~ $ 30.75 per month 92.25 1002. Mortgage Insurance months ~ $ per month 1003. City/Town Taxes 8.000 months ~ $ 27.25 per month 218.00 1004. County Taxes months ~ $ per month 11005. SCHOOL TAX 4.000 months @ $ 89.26 per month 357.04 1006. months (~ $ per month 1007. months ~ $ per month 1008. AGGREGATE ADJUSTMENT months (~ $ per month -225.48 1100. TITLE CHARGES 1101. Settlement or Closing Fee to 1102. CLOSING PROTECTION LETTER to FIRST AMERICAN TITLE INSURANCE COMPANY 1103. Title Examination & HUD PREP to 1104. Title Insurance Binder to ' 1105. Document Preparation to ~1106. Notary Fees to CASH 8.00 6.00 1107. Attorney's Fees to CHARLES SHIELDS III, ESQ. 609.75 (includes above item numbers: ) 1108. Title Insurance to TRI-COUNTY ABSTRACT SERVICE, AGENT 479.00 (includes above item numbers: 1109. Lender's Coverage $ 145,900.00 1110. Owner's Coverage $ 145,900.00 479.00 1111. ENDORSEMENTS 100 300 8.1 to TRI-COUNTY ABSTRACT SERVICE, AGENT 150.00 1112. 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 40.50; Mortgage $ 66.50; Releases $ 107.00 1202. City/Count)/Tax/Stamps: Deed 1,459.00; Mortgage 1,459.00 1203. State Tax/Stamps: Revenue Stamps 1,459.00; Mortgage 1,459.00 1204. RECORD ASSIGNMENT to CUMBERLAND County Register of Deeds 27.00 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to 1302. Pest Inspection to 1303. TAX CERT FEE to TRI-COUNTY ABSTRACT SERVICE REIMBURSEMENT 3.00 1304. HOME WARRANTY to AHS 96669992 385.00 1305. FINAL SEWER BILL to SILVER SPRING TWP. AUTHORITY 1034-1039 92.70 1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K} 8,143.63 10,824.70 By signing page 1 of this statement, the signatories acknowledge receipt of a completed copy of page 2 of this two page statement. SETTLEMENT OFFICER Settlement Agent Certified to be a true copy. ( HOS361-03 / HOS361-03 / 6 ) Tax Parcel # THIS INDENTURE MADE THE ,~o/4 day of ,~-t'~~" , in the year of our Lord two thousand and three (2003). BETWEEN STANLEY E. McCLIMANS, Executor of the Estate of LESLIE DEAN TAYLOR, a.k.a L. DEAN TAYLOR, Deceased, late of the Township of Silver Spring, Cumberland County, Pennsylvania, Grantor AND GREGORY L. HOSLER, of the Township of Silver Spring, Cumberland County, Pennsylvania, Grantee. WHEREAS, the said LESLIE DEAN TAYLOR, a.k.a L. DEAN TAYLOR was vested in his lifetime with title to the premises hereinafter described in the Township of Silver Spring, Cumberland County, Commonwealth of Pennsylvania; and WHEREAS, the said LESLIE DEAN TAYLOR died, testate, on the 19th day of May, 2003, and Letters Testamentary were duly issued to the said Stanley E. McClimans, as Executor, by the Register of Wills of said Cumberland County, docketed to No. 21-03-0435; and WHEREAS, the lands herein-mentioned were not specifically devised. NOW, THEREFORE, THIS INDENTURE WlTNESSETH, that the said Stanley E. McCllmans, Executor, as aforesaid, for and in consideration of the sum of ONE HUNDRED FORTY-FIVE THOUSAND NINE HUNDRED and No/100 ($145,900.00) DOLLARS and other good and valuable considerations, to him in hand paid by the said Grantee, at and before the ensealing and delivery hereof, the receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, released, and confirmed, and by these presents, by virtue of the power and authority in him vested by the Fiduciaries Act of the Commonwealth of Pennsylvania, does grant, bargain, sell, alien, release, and confirm unto the said Grantee, his heirs and assigns, TRACT NO. 1: ALL THAT CERTAIN piece or parcel of land situate in the Township of Silver Spring, County of Cumberland and Commonwealth of Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point on the Western line of North Road on the hereinafter mentioned Plan of Lots, at the dividing line between Lots Nos. 10 and 11 on said Plan; thence by the dividing line between Lots Nos. 10 and 11 on said Plan, North 62 degrees 51 minutes West, one hundred fifty (150) feet to a point; thence South 27 degrees 09 minutes West, eighty (80) feet to a point; thence South 62 degrees 51 minutes East, one hundred fifty (150) feet to a point on Western line of North Road; thence by the Western line of North Road, North 27 degrees 09 minutes east, eighty (80) feet to a point, the Place of BEGINNING. BEING LOT NO. 11 in the Plan of Lots of Albert C. Troutman, known as "Northfield Farms," which Plan is recorded in the Cumberland County Recorder's office in Plan Book 8, at page 22. BEING THE SAME PREMISES which Albert C. Troutman and Mary Lee Troutman, his wife, by their Deed dated October 3, 1968, and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Deed Book "Y," volume 22, page 925, granted and conveyed to L. Dean Taylor. The said L. Dean Taylor is also known as Leslie Dean Taylor, the decedent and grantor herein. TRACT NO. 2: ALL THAT CERTAIN piece or parcel of land situate in the Township of Silver Spring, County of Cumberland and Commonwealth of Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point on the Western line of North Road at the dividing line between Lots No. 9 and 10 on said Plan; thence by the dividing line between Lots No. 9 and 10, North 63 degrees 51 minutes West, one hundred fifty (150) feet to a point; thence South 27 degrees 09 minutes West, eighty (80) feet to a point; thence by the dividing line between Lots No. 10 and 11 on said Plan, South 62 degrees 51 minutes East, one hundred fifty (150) feet to a point on the Western line of North Road; thence by the Western line of North Road, North 27 degrees 09 minutes East, eighty (80) feet to a point, the Place of BEGINNING. BEING LOT NO. 10 in the Plan of Lots of Albert C. Troutman, known as "Northfield Farms,'which Plan is recorded in the Cumberland County Recorder's office in Plan Book 8, at page 22. BEING THE SAME PREMISES which William L. Whisel and Bernice L. Whisel, his wife, by their Deed dated September 22, 1968, and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Deed Book "Y,' volume 22, page 921, granted and conveyed to L. Dean Taylor. The said L. Dean Taylor is also known as Leslie Dean Taylor, the decedent and grantor herein. HAVING thereupon erected a single brick dwelling known as No. 14 North Road. SUBJECT to certain restrictions and conditions pertaining to the use and occupancy of the land hereby conveyed, as set forth in writing attached to the aforementioned plan. TO HAVE AND TO HOLD the said messuage or tenement and tract of land, hereditaments and premises hereby granted and released, or mentioned and intended so to be, with the appurtenances unto the said Grantee, his heirs and assigns, to and for the only proper use and behoof of the said Grantee, his heirs and assigns, forever. AND THE SAID GRANTOR, Executor as aforesaid, his heirs, executors and administrators, does covenant, promise and agree to and with the said Grantee, his heirs and assigns, by these presents, that the Grantor has not done, 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, or otherwise howsoever. IN WITNESS WHEREOF, the said Executor of the Estate of Leslie Dean Taylor, aka L. Dean Taylor, deceased, Grantor herein, has hereunto set his hand and seal the day and year first above written. WITNESS: (SEAL) STANLEY E. McCLIMANS, Executor of the Estate of LESLIE DEAN TAYLOR, a.k.a L. DEAN TAYLOR, Deceased COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : On this, the day of ., A.D. 2003, before me, a Notary Public, in and for said County and State, the undersigned officer, personally appeared STANLEY E. McCLIMANS, known to me (or satisfactorily proven) to be the person described in the foregoing instrument, and acknowledge that he executed the same in the capacity therein stated and for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notary Public My Commission expires: (SEAL) CERTIFICATE OF RESIDENCE I do hereby certify that the precise and exact post office address of the within Grantee is: Attorney for Grantee REV.1503 EX * (I-97). ~ SCHEDULE B COMMONW~'TH~ Or PENNS¥~VAN,^ STOC KS & BO N DS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ~/~Z~ / Z~/~ ~. FILE NUMBER ~/-& ~ - ~3~ All pmpe~ ~int~-o~ed ~h right of su~Nomhip must ~ disclosed on ~h~ule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. TOTAL (Aisc enter on line 2, Recapitulation) $ ~t 7 ? .5', {If more space is needed, insert additional sheets of the same size) \"i¢~C-IO~!S ~.eculi[leS. il',;. 3nO! Nort~ Front Street. Suite ~0 Ha~-risbur~ PA 're 7i- 238-963~ Fa' 711 238 9789 800 254-821i WAC HOAr/_A. SE CLTP. X~'II~ July 9, 2003 Charles E. Shields, III 6 Clouser Road Mechanicsburg PA 17055 RE: Estate of Leslie D. Taylor Dear Mr. Shields: Per your request dated June 30, 2003, I am providing you w/th the date of death values as of May 19, 2003 for the asset held in the above referenced Estate. Description # of shares High Low Close Louisiana Pacific Corp 326 $8.92 $8.23 $8.30 Should you require additional information, please do not hesitate to give me a call at (717) 231-7234 or (800) 254-8211. Sincerely, Administrative Asst. "The above summary of prices/quotes/statistics contained herein has been obtained from sources believed to be reliable but is not necessarily complete and cannot be guaranteed. In some instances the prices may not reflect the value at which securities could be sold. This summary is for is for informational purposes only. This is not a substitute for a Verification of Deposit (or similar form) or the official statement of account holdings at the firm. Past results are not indicative of future performance." ~;emberNYSE,SIPC ~,.,,,x.,,.,,~ ~ SCHEDULE'E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF _~-,~ft,VZ~D,~a,, ~,-~'L/~- ~, FILE NUMBER ~/-- ~ 3 - ~ 3 ~ Include ~e premeds of lit~a~on and ~e date ~e p~s were ~ived by ~e es~. All pm~ ~in~.o~ ~h ~e right of suwivomhip must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. C. CH~C~/NG ZCc~ ~qq7 -/I ~ ~7~. // /~. ~/ L . /~ ~ ~ ~. ~. ~. ~ ~. ~ //.~/ TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) MEMBERS Ist FEDERAL CREDIT [fNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 48447 -00 Date Account Established 07/25/1985 Principal Balance at Date of Death $6,343.82 Accrued Interest to Date of Death $4.66 Total Principal and Accrued interest $6,348.48 Name of Joint Owner None CHECKING ACCOUNT: Account Number/Suffix 48447 -11 Date Account Established 10/02/1998 Principal Balance at Date of Death $6,279.11 Accrued Interest to Date of Death $2.08 Total Principal and Accrued Interest $6,281.19 Name of Joint Owner None INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix 48447-05 Date Account Established 04/11/1990 Principal Balance at Date of Death $8,360.43 Accrued Interest to Date of Death $5.80 Total Principal and Accrued Interest $8,366.23 Name of Joint Owner None CERTIFICATE OF DEPOSIT: Account Number/Suffix 48447 -42 26 WK 48447 -42 1 YR Date Certificate Established 10/20/1995 11/12/1997 Principal Balance at Date of Death $10,000.00 $15,596.64 Accrued Interest to Date of Death $7.84 $15.61 Total Principal and Accrued Interest $10;007.84 $15,612.25 Name of Joint Owner None None Page 1 5000 Louise Drive, P.O. Box 40, Mechanicsburg, PA 17055 www. memberslst, org Page 2 Leslie D. Taylor CERTIFICATE OF DEPOSIT: Account Number/Suffix 48447 -44 1 YR Date Certificate Established 01/08/2001 Principal Balance at Date of Death $11,000.00 Accrued Interest to Date of Death $11.01 Total Principal and Accrued Interest $11,011.01 Name of Joint Owner None Insurance Supervisor June 27, 2003 Estate of: LESLIE D. TAYLOR Date of Death: 05119/2003 Social Security Number: 187-16-4688 5000 Louise Drive, P.O. Box 40, Mechanicsburg, PA 17055 www. membersIsLorg RO. Box 446  Dillsburg, PA 17019-0446 I~ ,~iI 766-2003 · 432-9614 1-800-522-7283 FAX 717-766-8800 DILLSBURG, PA Rowe's Auction Service 2505 Ritner Highway Carlisle, Pa. 17013 June 16, 2003 RE: Estate of Leslie Dean Taylor 14 North Rd. Mechanicsburg, Pa. 17055 This is to certify that I, W. David Rowe, of the firms Rowe's Auction Service and Linden Hall Antiques, have examined said items and their values are as follows: Garage Misc. garden tools $20.00 2 ladders 10.00 Toro 521 snow blower 150.00 Small Toro snow blower 50.00 Toro push mower 25.00 Lawn cart 10.00 Porch 2 piece wicker set 40.00 Kerosun heater 5.00 2 piece patio set 30.00 Old photos in box 5.00 Kitchen Misc. glass & china 20.00 6 PRR glasses 30.00 3 piece carnival glass set 45.00 Small copper luster creamer & 2 figural pipes 20.00 5 piece maple table & chairs 75.00 Small Zenith t.v. 15.00 Bull fight picture 5.00 Living, Room Platform rocker & ottoman 40.00 3 cushion sofa 50.00 Upholstered chair 5.00 Big screen t.v. 350.00 Old stereo no value Lot old records 25.00 Porch rocker 35.00 2 brass floor lamps 10.00 Exercise bike 15.00 Back Bedroom Maple dresser with mirror 60.00 Telechtron clock 10.00 Workbench w/misc, tools 35.00 Autograph books & old photos 15.00 Costume jewelry with girl shaped whistle 25.00 Machinist drawered chest with tools 35.00 Misc. tools on white shelves 35.00 Misc. tools hanging on wall 40.00 BB gun 15.00 Box of old photos 20.00 Butter bowl & paddles 40.00 Box of Christmas houses 40.00 Green kerosene lamp in box 40.00 Brass lamp in box 15.00 2 irons & old saw 10.00 6 Necco candy jars 90.00 Box old buttons 20.00 Box with chicken on nests 20.00 Box misc. glass & c .hina 20.00' Total,. $2740.00 W. David Rowe 60-184/313 ' (717) "/'74-2 ~'~ ~",w~'~,,,~/ .GSAdministrators ~ e,,,,~ c~.'"~.~ 56'1~4 A CMS Co~ra~ Carrier c~,~,, o, 441 PO Box 8~ 0807~53~ 5 ~~~ Camp Hill, PA 1~9-~ VOID 12 MONTHS ~OM ISSUE DATE FOR HEALTH INSURANCE - ~EDtCARE PAYMENT SOCIAL SECURITY ACT PROV or H ~ C ~0 87- 16-4688A 200731205 PAY TO THE ORDER OF LESLIE D TAYLOR ~ DAY Y~ PAY ~L~S CENTS lq NORTH RD 05 27 03 ~N~37.10 NECHANICSBURG PA 17050-5142 ~~37DOLLARS AND IOCNTS H~TH INSU~CE BENEFITS ~COUNT ~ ~ ~,~.~~ HGSAdministmtors ~=~' A CMS Contract~ Carrier c.:.~.~, o, 441 PO Box 8~ 0807~83 w~ Camp Hill, PA 17~9-~ vOiD 12 MON)HS ~OM ISSUE DATE FOR HEALTH INSURANCE ~Rov o, H ~ C .0 EDiCAR~PAYMENT SOCIAL SECURITY ACT 87-16-q688A) 200730096 _. LESLIE D TAYLOR Zq NORTH RD 05 23 03 ~ ~151.87 HECHAN[CSBURG PA 17050-51A2 -' ~,~151DOLLARS AND 87CNTS H~TH INSU~CE B~EFITS ACCOUNT : -tlGHMARK BLUE SHIELD ' Wilm,ngton. DE 19803 :311 P~O .O Box 8~145 Camp Hill. PA 170119 H[C~ 187166688A CHECK .o 0058975156 PAY 10 THE ORDER OF MUST BE CASHED WITHIN 6 MONTHS LESLIE D TAYLOR DRTE OF CHECK lq NORTH RD Mo NECHAN[CSBURG I PA 17050-5162 CLAIM '$5' ACCOUNT  PEN~S VANIA ~LUE AUTHORIZED SIG~1U~E SHIELD .'00 SBq ? ~ & :~&.' ~10~ & ~,00 ~ ~5~1 A CMS ConTacted Carrier ~ ~-,"*'~ 56-154a '~m,,mme~w~ PO El. ox 890065 ~_o~~,,,,a,,. o. Camp Hill, PA 17089-0065 O,E~O 7,,~1-.~..3,~ 3. 441 FOR HEALTH INSURANCE VO,D 12 MONTHS FROM iSSUE DATE c-D~CARE PAYMENT SOCIAL SECURITY ACT PROV or H I C NO 87- 16-q688A 200728529 PAY TO THE ORDER OF LESL:[E D TAYLOR Mo DAY YEAR PAY DOLLAJ~S CENTS 14 NORTH RD 05 19 03 ~~37.10 MECHAN]:CSBURG PA 17050-5142 ~*~37DOLLAR,' AND 10CNTS 'dNT BATCH VENDOR CODE PAY TO NAME NET TOTAL 2.421 ONETIME ESTATE OF L D TAYLOR $135.10 nLLFmST 60-83/313 triot- nus o. HARRISBURG, PA 17105 ). Box 2265 · : ' ' msburg, PA 17105-2265 VOID AWFER 90 DAYS f ONE H13NDRED THIRTY-FIVE AND 10 t 100 THE ESTATE OF L D TAYLOR I AMOUNT I $135.10] ' MECHANICSBIJ-RG PA 17050-3142 #":t?05 ].:!,." I,:OS &:l, OOfi:t,h,: 05 l, ggfilgq." LOOK FOR Ut:;. WE'LL GET YOU THERE. 07/09/2003 CHARLES SHIELDS III 6 CLOUSER RD MECHANICSBURG PA 17055 The information which you requested on the account(s) of LESLIE TAYLOR (Social Security Number 187-16-4688) is/are as follows: Account Number 1800004801 504093868 554221464 Class of Account CERTIFICATE CERTIFICATE CERTIFICATE Date Opened 11/12/97 09/05/86 11/01/91 Principal Balance 42915.11 7003.53 10000.00 Accrued Interest 25.18 2.94 4.19 Balance at Date of 42940.29 7006.47 10004.19 Death Account Ownership SOLE SOLE SOLE Name of Joint Owner, if any Date Ownership Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Accoum Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Sincerely - Information ~r~- ~/~~ Requested KATI~IY~YO~G SENIOR SERVICES REP. RO. Box 171 I, HARRISBURG. PENNSYLVANIA 17105-1711 Toll FrEe 1-866-WAYPOINT (I-1~66-929-76~,6) · IN YORK AREA 717/E~15-4500 · www. wauoointbank.com PNCBA August 7. 2003 Charles E Shields, Ill Attorney at Law 6 Clouser Rd Mecha:nicsburg, PA 17055 RE: Estate of Leslie Dean Taylor (Deceased) SSN: 187-16-4688 DOD: 05-19-2003 Dear Mr. Shields: in response to your request for Date of Death balances fbr fl~e customer noted above, our records show the fbliowing: Certificate of Deposit Account~31600138139 Established 09-05-1998 LESLIE D TAYLOR DOD balance: $10,000.00 * $2 88 accrued interest Checking Account Account5140240498 Established 06-13-1933 LESLIE D TAYLOR DOD balance: $3,199.39 Non interest bearing account The deced~t did not mainta/n any safe deposit box at PNC Bank. Page 1 of 2 Please note that this office only provides date of death balance~: f0t' deposi, t accounts (IRAs, CDs, Checking and Savings accomits). ~ e do not proces:~ an)' financial transactions or provide statement~. If you need assist,'m¢c w~th any of these items, please call t-888-PNC-BANK ~-888-7o,.-2,,ov) or stop b.¥ your local PNC Bank branch office. Sincerely, Erica L Schlegel PNC Decedent Reporting Firstside Center 500 First Ave, 4'}' FI CIF Pittsburgh PA 15219-3128 1-800-762-1775 Member FDIC Page 2 of 2 TOTAL P. 3'7._' CAPITAL DIVISION '° LANCASTER/CHESTER DIVISION DROVERS BANK DIVISION ° GREAT VALLEY DIVISION (717)291-2437 June 30, 2003 Charles E. Shields, III 6 Clouser Road Comer of Trindle and Clouser Roads Mechanicsburg, Pennsylvania 17055 Dear Mr. Shields, III: RE: Leslie Dean Taylor, deceased May 19, 2003 In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date o£ death: The decedent has a safe deposit box # 279 at our Hummelstown Branch, joint with G. Haverstick. If you should have any further questions, please do not hesitate to contact me. Very truly yours, Karen D. Hillegas Credit Inquiry Processor t;ONE:IOEN'T% t' P O Box 4887 Lancaster, PA 17604 www. fultonbank.com 1-800-FULTON-4 · SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE T~ RETURN MISC, NON-PROBATE PROPER~ RESIDENT DECEDENT ESTATE OF ~L ~ ~L/~ ~. FILE NUMBER ~ -~ ~ _ ,~ ~ ~ This s~ule must be ~mpleted and filed if~e an~er to any of questions 1 ~mugh 4 on ~e mveme side of~e REV-1500 COVER SHEET b yes. DESCRIPTION OF PROPER~ % OF ITEM INCLUDETHEN~EOFTHE~SFEREE,~EIR~TIONSHIPTODECEDENT~D~E DA~ OFT~S~R, DATE OF DEATH DECD'S EXCLUSION TA~BLE VALUE NUMBER VALUE OF ASSET INTEREST (iF A~C~LE) TOT~ (Also enter on line 7, Re~pitulation) $ 8 ~, 7 / ~./~ (If mom spa~ is n~, inse~ add~ional sh~ts of the same size) EV-1511 EX+ (12-99) SCHEDULE fl COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) ~'7'~1/'~:~' ~'. /JC~L//}C/C/L/~ Social Security Number(s)/EIN Number of Personal Representative(s~ ~ --/~-- ~ 7 Street Address /~ ~~ City ~~/C~ ~ State ~ Zip Year(s) Commission Paid: 2. A~orneyFees ~H~ ~ ~/~ ~ I1~ ¢~, 3. Family Exemption: (If decedent's address is not the same as oJaimant's, aBach explanation) Claimant ~ ~ ~/6 /~ [ ~ Street Address City State __ Zip Relationship of Claimant to Decedent 5. Accountant's Fees e~ ~/~/ ~/~i ~, ~. ~g~ 6. Tax Return Preparer's F 7. ~/~/p~ ~W~ ~/~/c~ ~¢ /¢.o~ TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) R~cV-1512 EX~ ' .¢~ SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT q. ,,y',,C/~,w..r ,,'H~,~ T~,4,', ,,~,.~//¢'-r~/.~ 'T '~"'t.Z.oo TOTAL (Aisc enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) SCHEDULE J CO.MONWE^LT. OF PENNSV'V^N,^ BENEFICIARIES RESIDENT DECEDENT ESTATE OF '~"~)/L o,~' /~¢: J'L/~' .Z~>. FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE ]. TAXABLE DISTRIBUTIONS (include outdght spousal distributions) /~ g- e,e'd 4/l e ,S',a ~/e.~ , ,0,4 "~ ~ ~-~ ~ D . '--~ y~ o ,,~ , J"~. ~m/a H/z<, Ac~,q /7~11 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF LESLIE DEAN TAYLOR I, LESLIE DEAN TAYLOR, of Silver Spring Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. I hereby declare that I am not now and never have been married and that I have no children living or dead. 3. I hereby make, give, devise, and bequeath the following specific gifts: A. To my sister, LILLIAN W. TAYLOR McCLIMANS, Ten Thousand ($10,000.00) Dollars; B. To my brother, ROBERT D. TAYLOR, SR., Ten Thousand ($10,000.00) Dollars. Both of these above stated gifts are conditioned on survival. In the event either of them or both of them fail to survive me, then his or her share or their shares, as the case may be, shall lapse and shall be considered part of the residue of my estate. 4. All the rest, residue, and remainder of my estate is to be divided into three (3) equal shares and distributed among my three (3) nephews, to wit: ROBERT D. TAYLOR, JR.; DARYL S. McCLIMANS; and BRADLEY E. McCLIMANS. In the event any of my said nephews fails to survive me, then his share shall go to his children in equal shares, per stirpes. In the event any such distribution becomes necessary, Michael Taylor shall be treated as if he were natural born issue of the whole blood. In the event any of my said nephews fails to survive me and is not survived by children, then his share shall be proportionally divided between my other two (2) said nephews or their children, as the case may be, as is provided for above. 5. I nominate, constitute and appoint my brother-in-law, STANLEY E. McCLIMANS, to be the Executor of this, my Last Will and Testament. In the event that he should predecease me or for any reason be unwilling or unable to act as such Executor, I nominate, constitute and appoint my nephew, DARYL S. McCLIMANS, to be Executor in his place and stead. In the event that he should predecease me or for any reason be unwilling or unable to act as such Executor, I nominate, constitute and appoint my nephew, BRADLEY E. McCLIMANS, to be Executor in his place and stead. I further direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /z//~ day of , A.D. 2001. Signed, sealed, published and declared by the above-named LESLIE DEAN TAYLOR, as and for his Last Will and Testament, in the presence of us, who at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. 2 . CONNONNEALTH OF PENNSYLVANTA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280~0! HARRISBURG, PA 17128-0~01 NOTICE OF INHERITANCE TAX APPRATSENENT, ALLOtdANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (01-05) DATE 12-22-2005 ESTATE OF TAYLOR LESLIE D DATE OF DEATH 05-19-2005 FILE NUMBER 21 05-0455 ~ COUNTY CUMBERLAND CHARLES E SHIELDS III ACN 101 6 CLOUSER RD ~ Amount Remltted MECHANICSBURG PA 17055. HAKE CHECK PAYABLE AND REMIT PAYHENT TO= REGISTER OF MILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~" RETAIN LONER PORTION FOR YOUR RECORDS REV-1547 EX AFP (01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF TAYLOR LESLIE D FILE NO. 21 05-0455 ACM 101 DATE 12-22-2005 TAX RETURN NAS: (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) 1451900.00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) 2t795.45 credit to your account, $. Closely Held Stock/Partnership Interest (Schedule C) ($) .00 submit the upper port/on 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this form w/th your 5. Cash/Bank Deposits/Hlsc. Personal Property (Schedule E) (5) 1451507.44 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) 58t714.16 8. Total Assets c8) 552,917.05 APPROVED DEDUCTIONS AND EXENPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 27,219.86 I0. Debts/Hortgage Liabilities/Liens (Schedule I) (lO) [05.20 11. Total Deductions (11) 12. Net Value of Tax Return (12) 505,591.99 15. Charitable/Governmental Bequests; Non-elected 911~ Trusts (Schedule J) (15) .00 14. Net Value of Estate Sub3ect to Tax (14) 505,591.99 NOTE: If an assessment uas Issued previously, lines 14, 15 and/or 16, 17, 18 and 19 uill reflect figures that lnclude the total of ALL returns assessed to date. ASSESSMENT OF TAX= 15. Amount of L/ne 14 at Spousal rate (15) .00 X O0 = .00 16. Amount of L/ne 14 taxable at Lineal/Class A rate C[6) .00 X 045 = .00 17. Amount of L/ne 14 at Sibling rate (17) 50,000.00 x 12 = 5,600.00 18. Amount of L/ne 14 taxable at Collateral/Class B rate C18) 275,591.99 x 15 = 41,558.79 19. Principal Tax Due (19)= 44,958.79 TAX CREDITS= PAYHENT / RECEIPT* I DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID 08-09-2005 CD002889 1,500.00 28,500.00 10-29-2005 CD005184 .00 14,958.79 TOTAL TAX CREDIT ~ 44,958.79 BALANCE OF TAX DUEl .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN ~1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if anY future interest in the estate is transferred in possession or en§oyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. I72 P.S. Section 91401. PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Hake check or money order payable to: i~I~G~S~I~ OF ~[LLS) AGEIqT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an 'Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13131. Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-$62-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 CTT only). OBJECTIONS: Any par~J in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty ¢60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (7171 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501] for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent ¢5X) discount of the tax paid is allowed. PENALTY: The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before JanuarY 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six C6X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will hear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2005 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Yea.~r Rate Factor Yea._...r Rate Factor 1982 20~ .000548 1987 9~ .000247 1999 7~ .000192 1983 1~ .000438 1988-1991 11~ .000301 2000 8~ .000219 1984 11~ .000301 1992 9~ .000247 2001 9~ .0002q7 1985 13~ .000356 1993-1994 7~ .000192 2002 &~ .000164 198~ 10~ .000274 1995-1998 9~ .000247 2003 5~ .000137 --Interest is calculated as follows: XNTEREST = BALANCE OF TAX UNPAXD X NUNBER OF DAYS DEL/NQUENT X DAXL¥ XNTEREST FACTOR --AnY Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. Ann Capozzi Register of Wills r Cumberland County Court House ~ ~' 1 Court Square Carlisle, PA 17013 STATUS REPORT UNDER RULE 6.12 Name of Decedent: Z-~r~Z/~ 2>. Date of Death: .~--/~- 2oo.~ Will No. Admit. No. ~/-D~ 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 ~ No.. 2. If the answer is No, state when the personal representative reasonably believes that the a~inistration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes~ No. b. The separate Orphans' Court No~ the personal representative's account is: c. Did the personal representative st~tel an account informally to the parties in interest7 Y~S d. Copies of receipts, releases, j.oinder.~ and.~ approvals of formal or informal accounts may be fi~ed w~ the Cerk of the Orphans' Court and may be attached to this report. Signature Name (Please type or print) Address ~e~/~ffZ~, ~ 1705X-- Tel. No. Capacity: ~Pe=sonat Rep=esen~a[ive  Counsel for pe=sonal (~: r~f/~] ) representative