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Home My WebLink About04-0785 CUMBERLAND COUNTY REGISTER OF WILLS AND CLERK OF THE OPHANS' COURT FACSIMILE TRANSMITTAL SHEET TO: FROM: Solicitor Sohonage Glenda Famer Strasbaugh COMPANY: DATE: 8/20/2004 FAX NUMBER: TOT^L NO. ~F~}'ES INCLUDING COVER: PHONE NUMBER: SENDER'S REFERENCE NUMBER: RE: YOUR REFERENCE NUMBER: [] URGENT [] FOR REVIEW [] PLEASE COMMENT [] PLEASE REPLY [] PLEASE RECYCLE NOTES/COMMENTS: Call or write at your convenience. Brother refuses to participate, refuses to renounce, refuses to return calls or communicate in any way 1 COURTHOUSE SQUARE CARLISLE PA 17013 PHONE: 717-240-6345 FAX: 717-240-7797 PETITION FOR PROBATE and GRANT OF LETTERS Estate of CHARLES D. JAMISQN, SR. No. 21-2004-""~ also known as To: Register of Wills for the , Deceased County of ~ in the SocialSecurityNo. 198-22-9365 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older and the ~ dauohter of decedent named in the last will of the above decedent, dated Januarv 29. 1997 and codicil(s) dated None. M&T Bank~ successor to Financial Trust Services Co, the named Executor, has renounced its appointment in favor of Sherrill A. Radabau,qh, as has one of two other children~ Jeffrey L. Jamison; Continued on a Separate Pa,cie (state relevant circumstances, e.g. renunciation, death of executor, etc) Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with h I$ last family or principal residence at 517 S. MIDDLESEX ROAD. CARLISLE. SOUTH MIDDLETON TOWNSHIP, PENNSYLVANIA 17013. (Iist street, number and municipality) Decedent, then 71 years of age, died 10/4/2002 at 517 S. MIDDLESEX ROAD. CARLISLE, PA 17013 Except as follows, decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: NONE Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 5.000.00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant ofletters OVADMINISTRATION, C.T.A. thereon. (testamentary; adminisuation c.t.a.; administration d.b.n.c.t.a,) t~ I .~..~/'J J/) /~.? 517 South Middlesex Road 0, I't t~ ~] Carlisle PA 17013 ~=~ She~rt'~ I~r~dab~u~h d ' .... .. ._~ IL, , ~ · Or2 OATH OF PERSONAL REPRESENTATIVE COUNTyCOMMONWEALTHoF CUMBERLANDOF PENNSYLVANIA t SS Sherril A. Radabaugh 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~state according to lltw. Swum to or affirme..d a.nd subscribed r' ~'~11/~ ~-~-~ .x~3//] ~)~ ~ ]/~ before me this _~ day of / ~ -- - -~/ J , Re 2tt t '~-~L Continuation of Petition for Probate and Grant of Letters CHARLES D. JAMISON, SR, 21-2004- Page 1 Relevant Circumstances the remaining child, Charles D. Jamison, Jr., has refused to participate in the administration of the estate or to sign a renunciation. Estate is likely to be insolvent for tax purposes. No. 21-2oo4- Estate of CHARLES D. JAMISON, SR. , Deceased DECREE OF PROBATE AND GRANT OF LETTERS theAreNvDeNOW ~/J~.ct..~{~ t~3/ 2(~(''/ ,inconsiderationofthe petition on e erse side hereof, satg..,~ctory 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 CHARLES D. JAM[SON, SR. LATE OF SOUTH MIDDLETON TOWNSHIP. CUMBERLAND COUNTY. PENNSYLVANIA ; and Letters OF ADMINISTRATION C.T.A are hereby granted to Sherril A. Radabau,qh RegisterofWills ~v" ~ ,_0_,,L--'~x.~ .~ a...~%FEES i ~. ~ ROGER M. MORGENTHAL, ESQUIRE Probate, Le~ers,C~c ......... $_,-~5,0'~ 17143 Short Certificates ( ~ ) ...... $ ~ ATTORNEY (Sup. Ct. I.D. No.) Renunciat on(.o~'~ ......... $ iO, Ob 2515 N. FRONT STREET ~ {::> $ [ID,OL~ HARRISBURG PA 17110 A TOTAL i, $ ~ 8. OO ADDRESS ....... PHONE RENUNCIATION 2J-o - Ss In Re Estate of Charles D. Jamison, Sr., deceased. To the .Register of Wills of Cumberland County, Pennsylvania. The undersigned, Manufacturers and Traders Trust Company successor to Financial Trust Services Company, Executor of the above decedent hereby renounces the right to administer the estate and respectfully asks that Letters of Administration c.t.a, be issued WITNESS my hand this 27th day of July, 2004. Signature A~.' J//~7~ Shawna L. Scherer, Trust Officer . PrintedName, Title C/o Manufacturers & Traders Trust Company P O Box 220, One West High Street Carlisle, PA 17013 IN THE OFFICE OF THE REGISTER OF WILLS IN AND FOR CUMBERLAND COUNTY, PENNSYLVANIA RENUNCIATION Estate of CHARLES D. JAMISON, SR. No. 21 04 "~ ~ also known as LATE OF SOUTH MIDDLETON TOWNSHIP , Deceased The undersigned,JEFFREY L. JAMISON~ Son of (Relationship) (Capacity) the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters OF ADMINISTRATION, CTA be issued to SHERRIL A. RADABAUGH Witness MY hand this day of JUNE 2004 10315 Allentown Boulevard Grantville PA 17028 (Address) (Signature) ~ (Address) :; (Signature) Sworn to~ffirme~.'and sUb.~ribed before me this r~o~'~y°' of Notary Public My Commission Expires: (Signature and seal of Notary or other NOTE: Renunciations executed outside the Office of Register of Wills are official qualified to administer oaths. Show required in some counties to be notarized. date of expiration of Notary's commission.) RW-3 ~ OF !, CHARLES D JAMISON, SR I, CHARLES D. JAMISON, SR., of 110 E. Springville Road, Boiling Springs, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby expressly revoke all Wills and Codicils heretofore made by me. SECOND: I hereby direct my Executor to pay all my just debts, funeral and administrative expenses out of my estate, as soon as practicable after my death. THIRD: I direct that all taxes which may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid out of my estate as a part of the administration of my estate. FOURTH: I give, devise and bequeath the remainder of my estate in equal shares to those of my children, SHERRIL A. RADABAUGH, CHARLES D. JAMISON, JR., and JEFFREY LYNN JAMISON, who are living on the thirty-first (31st) day following my death. Should any of said children predecease me or not be living on the thirty-first (31st) day following my death, his or her share shall be distributed to his or her issue per stirpes; and in default of any such issue, his or her share shall be distributed to those of my said children, or their issue, who do survive. SIXTH: I nominate and appoint FINANCIAL TRUST SERVICES COMPANY, TRUSTEE of the share of any beneficiary who is under the age of twenty-two (22) years. The income and/or principal of said Trust may be accumulated or expended for the maintenance, education and support of such beneficiary as my TRUSTEE, in its sole discretion, may determine; and my TRUSTEE, in the expenditure of income and/or principal for such purposes, may, at its discretion, apply the same directly or pay the same to any person having the care or control of said beneficiary or with whom the beneficiary resides, without duty on the part of the TRUSTEE to supervise or inquire into the application of the funds by any person to whom payment is so made. The balance of such income and/or principal shall be paid to such beneficiary upon reaching majority, or to such beneficiary's estate in the event of death prior thereto. SEVENTH: I nominate, constitute and appoint FINANCIAL TRUST SERVICES COMPANY, Carlisle, Pennsylvania, or its successors, to act as Executor of this my Last Will and Testament. I direct that they serve without bond or security in any jurisdiction. EIGHTH: In addition to the powers conferred by case law, by statute and by other provisions of this Last Will and Testament, my personal representative, and any successors in that capacity shall have the following discretionary powers applicable to all real and personal property held by them, which powers shall be effective without Order of any Court and which shall exist and continue until the time of actual distribution: A. To retain any property of any nature received by them for whatever period it shall be deemed advisable; B. To invest and reinvest all or any part of the assets of my Estate without regard to statutes limiting the property which a fiduciary may purchase; C. To sell, transfer, exchange or otherwise dispose of, any part of the assets of my Estate, for cash or on terms, publicly or privately, or to lease, without liability on the purchasers to see to the application of the proceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer; D. To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of this Will; E. To borrow money, if necessary to facilitate the administration and closing of my Estate, including the right to borrow money from any bank, including FINANCIAL TRUST SERVICES COMPANY, and to mortgage or pledge any asset of the estate as security; F. To loan to, and to purchase assets from, my Estate, even if it is also acting as Executor thereof. G. To assume continuance of the status of any beneficiary with regard to death, marriage, divorce, illness, incapacity and similar incidents or matters in the absence of information deemed reliable without liability for disbursements made on such assumption; H. To make any distribution hereunder either in kind or in money, or partially in kind and partially in money, considering of course the reasonable wishes of the beneficiary. Distribution in kind shall be made at the appraised value of the property distributed, as it is set forth in the Inheritance Tax Return filed in my Estate; I. To exercise any subscription right in connection with any security held hereunder, to consent to or participate in any recapitalization, reorganization, consolidation or merger of any corporation, company or association, the securities of which may be held hereunder; and to delegate authority with respect thereto, to deposit investments under agreements, to pay assessments, and generally to exercise all rights of investors; J. To continue in any partnership, joint venture, joint ownership or other business enterprise of which I am a part at the time of my death; K. To compromise claims; L. To continue for whatever period of time my personal representative shall deem necessary any ownership as a tenant in common or as a partner, in real estate or other property and to act as I would have done had I been living; M. To do all other acts in its judgment necessary or desirable for the proper management, investment and distribution of the assets of my Estate; N. I direct that my Executor, FINANCIAL TRUST SERVICES, COMPANY shall be compensated for the services it renders to my Estate in accordance with its prevailing schedule of fees in effect during the time when said services are rendered. O. Should any changes occur in the Internal Revenue Code or Pennsylvania Statutes after the date of the execution of this Will which affect the tax liability of my estate, then to the extent possible and as may be permitted by law, my personal representative shall have the power and discretion to interpret this Will and to administer my Estate in a manner which results in the lowest tax liability possible. P. Should the principal of any Trust herein provided for be or become too small, in the TRUSTEE's discretion, so as to make establishment or continuance of the trust inadvisable, my TRUSTEE or my Executor may make immediate distribution of the then remaining principal and any accumulated or undistributed income outright to the person or persons and in the proportions they are then entitled to income. Upon such termination, the rights of all persons who might otherwise have an interest as succeeding income beneficiary or in remainder shall cease. IN WITNESS WHEREOF, I hereunto set my hand and seal this ~2_ ~' ~ dayof ~~. CHARLI~ D. JAMISON, SR. SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: / 5 COMMONWEALTH OF PENNSYLVANIA : -' SS. COUNTY OF CUMBERLAND : I, CHARLES D. JAMISON, SR., Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. the TesStaWt~ t°hrisaffi]<~°~x~ ackn~aWyleoC~fge~-/~d b~'~°r~m~'~ES D' J ~AM~)~Nt'?c~TR',' CHARLES I~. J~HISON, SR., Testator otary~ Public k,..~ _ - IIOT~IRL S6~L MERLENE MN~EVKA N~a7 P~,~ 6 COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : We, Roger M. Morgenthal and Susan M. Ramsey ., the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we are present and saw Testator, CHARLES D. JAMISON, SR., sign and execute the instrument as his Last Will, that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by Roger M. Morgentnal and Susan M. Rarasey , witnesses this 29th day of January , 199~. Witness Witness NOTAI~IAL SEAL MERLENE M~RI4EVKA, Ne~my Pu~ic 7 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: CHARLES D. JAMISON. SR. Date of Death: 1Q/4/2002 Will No. Admin. No. 2004-00785 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 8/27/2~04 Name Address CHARLES D. JAMISON, JR. 8190 MICHAUX DRIVE FAYETTEVILLE PA 17222 JEFFREY L. JAMISON 10315 ALLENTOWN BOULEVARD GRANTVILLE PA 17028 SHERRIL A. RADABAUGH 517 S. MIDDLESEX ROAD CARLISLE PA 1701~ Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE Date: 8/27/2004 ~ Signature Name: ROGER M, MORGENTHAL. ESQUIRE Address: 2515 N. FRONT STREET. 1ST FLOOR HARRISBURG PA 17013 Telephone(717) 9094383 ~[: ~ c~ L[ ~ ~70. Capacity: Personal Representative X Counsel for Personal Representative Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/03/2004 MORGENTHAL ROGER M 2450 EAST BAYBERRY DRIVE HARRISBURG, PA 17112-6015 RE: Estate of JAMISON CHARLES D SR File Number: 2004-00785 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6 12) 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 two (2) years of the decedent,s death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 10/04/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge STATUS REPORT UNDER RULE 6.12 Name of Decedent: CHARLES D. JAMISON, SR Date of Death: 10/04/2002 No. 2004-00785 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 xx No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 03/31/05 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. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes __ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. Date: 9/13/04 Signature Name (please type or ~1,~, pdnt)~rgentha~143 2515 N. Front Street, First floor Address e,~ , :i;: Hardsbu r,qLPA 17110-1150 ..... City, State, Zip (717) 909-4383 Telephone Number o_ :i Capacity: __ Personal Representative ~'~ ':~ x Counsel for Personal Representative ':.: ,..: (~ .~ ~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: CHARLES D. JAMISON. SR. Date of DO~h: 10/04/2002 No. 21-jIt0785 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 xx No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 12/31/2005 3. If the answer to NO.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? _Yes _ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. Date: 5/9/05 3 2515 North Front Street Address Harrisbur~PA 17110 City, State, Ip (717~ 909-4383 Telep one Number Capacity: _ Personal Representative ..lL Counsel for Personal Representative ~ REV.l500EX + (6-00) '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128.0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICiAl USE ONLY FILE NUMBER 21 -0 4 078 5 C'OUNTY'COiiE -YEAA- - - NUt:iiiER-- I- Z W C W U W C DECEDENT'S NAME (lAST, FIRST, AND MIDDLE INITIAL) JAMISON CHARLES D. SR. DATE OF DEATH (MM-DD-Year) SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-DD-Year) 1 9 8 - 2 2 - 9 365 THIS RETURN MUST BE FilED IN DUPUCATE WITH THE REGISTER OF WILLS 10/04/2002 12/10/1930 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST. AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER W I- lll::~cn 0.'" w~u :J:D::9 Utili < 001. Original Return o 4. Limited Estate [g] 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death afler 12-12-82) o 7. Decedent Maintained a living Trust {Altach copy of Trust) o 1 Q. Spousal Poverty Credit (date of death between 12.31-91 and 1-1-95) o 3. Remainder Return (dateofdealh priOrto 12.1J.82) o 5. Federal Estate Tax Return Required Q... 8. Total Number of Safe Deposit Boxes o 11. Election to tax under See. 9113(A) (Attach Sch OJ THIS SECTION MUST BE COMPLETEO. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAiliNG ADDRESS ROGER M. MORGENTHAL ESQUIRE 2515 N. FRONT STREET, 1ST FLOOR FIRM NAME (If Ap~icabl.) I- Z W C Z C .. ., w a: a: c o HARRISBURG, PA 17110-1150 TELEPHONE NUMBER 717-909-4383 z o i= < ...I ::::l l- ii: < u w ex: z o i= < I- ::::l II.. ::iii o U >< < I- 1. Reai Eslate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule 0) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [Xl Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non~Probate Property (7) (Schedule G or L) 8. Tolal Gross Assets (tolal Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debls at Oeoedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (tolal Lines g & 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) OFFiCIAL USE ONLY "" c:" C~ en '- c:: , Ul ::x:J -.--.m r'nO r;.-:;)(.""".:) .,,- ::0 (j~ CJ C~: rn _~O C) C) ~n -n :-~:;~ r:-..:: rTl U>C) 'n (') ~O ,.~...~ :r.:t *:JJ-o m-I:O 18,473 1 !f12:!; hi ~f;: ~(j.):n 4._ ~ 18,920.olf.2 80 ,.,'; -n eLl c= , :0 -1f"l-i b__ -u :::c: -----(,.). Cl (8) 37,393.26 14,538.55 3,714.85 (11) (12) (13) 18,253.40 19,139.86 0.00 14. Net Value Subject to Tax (Line 12 minus line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 19,139.86 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount ofUne 14 taxable at sibling rate 18. Amount of line 14 taxable at collateral rate 19. Tax Due 0.00 X _(15) 0.00 19,139.86 X .045 (16) . 861.29 0.00 X .12 (17) 0.00 0.00 X .15 (18) 0.00 (19) 861.29 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT >> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS 517 SOUTH MIDDLESEX ROAD SOUTH MIDDLETON TOWNSHIP CITY I STATE I lIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 861.29 Total Credits (A + 8 + C) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty 215.32 TotallnteresUPenalty (0 + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Une 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 8. Enter the total of Une 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 215.32 0.00 1,076.61 1,076.61 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 [R] b. retain the right to designate who shall use the property transferred or its income; ............................. .......... 0 [R] c. retain a reversionary interest; or .>>>>............................. ................................................... .. 0 00 d. receive the promise for life of either payments, benefits or care? .. ............................................... .......... 0 [R] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?..................... .............. ............................................... .......... 0 [R] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 [R] 4. Did decedent own an Individual Relirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................ ............................................... 0 [R] 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 7/1/2005 ADDRESS PA 17013 DATE 7/1/2005 PA 17110-1150 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 01 death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)J. The statute does not exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the survivin9 spouse is the oniy 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 01 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 oftransfers to or for the use ofthe decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use oflhe decedent's siblings is 12% [72 P.S. ~9116{aX1.3)J. A sibling is defined, under Seelion 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. r") - - - (' - REGISTER OF WILLS CUMBERLAND County, Pennsylvania CERTIFICATE OF GRANT OF LETTERS No. 2004- 00785 PA No. 21- 04- 0785 Estate Of: JAMISON CHARLES D SR {LBst. First, Middls) Late Of: SOUTH MIDDLETON TOWNSHIP CUMBERLAND COUNTY Deceased Social Securi ty No: 198-22-9365 WHEREAS, on the 23rd day of August 2004 an instrument dated January 29th 1997 was admitted to probate as the last will of JAMISON CHARLES D SR (14st. First. MiddleJ late of SOUTH MIDDLETON TOWNSHIP, CUMBERLAND County, who died on the 4th day of October 2002 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: RADABAUGH SHERRIL A who has duly qualified as EXECUTOR(RIXj and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURTHOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set of my office on the 23rd day of August 2004. affixed the seal * *NOTE* * ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) 1JIast Bill anb Qrtshtnuu! OF '1:/' .", CHARLES D. JAMISON, SR. !. CHARLES lJ. JAMISON, SH., lit' 110 E. Springville Road, BoiJing Springs, Cumher:w,d County, Pennsylvania, heing of sounu <lnu disposing mind, memory and unuerst.anding. do make, publish ,wd declare this as and for Ill)' illst Will llnd Tcstarnen:, herehy revoking llnd mak-ing \/oid any and all former Wills. Qlllicils, or ....'TiliIlgs ill the nalure ther",,!, by me at any time heretofore made. ~'IRST; I hereby exptessly tevoke all Wills aml COlJidls heretofore made by Ille, SECQND: I hereby dirc~t my ExeclItor 1ll pay 411 my just dehts, fu.nerJ.1i and administrative expellses Ollt of my estale, as soon as practicable after my death. THIRD: I direct thm all taxes which may he assessed in cOllsequence of my death. of whatever nature ,IOU by wllatever jurisdictioll imposed, shall he palo out of my e,ta!e a, a part of the adt:linistrarlon of my estate. FOURTij: I give, devise and bequeatb the remainder uf my e,tate in equal shares to those of my children, SHERRIL A, RADABAUGH, CHAKLES D. JAMISON, JR" and J~;~'FIU~Y ),YNN JAMISON. who are Ii,ing olllhc thirty.frr,t (3l:it) day following my death. (;. {)~ f.~;'i"' ~ Shoulli any of ,aid children predecease me or not be living on the thirty-firsl (31st) day following my death, his or her share shall he distributed to his or her iS5ce per slirpes: and io ddau]'. of any such issue, his Or her share shall be distrihuted to those of my said children, or their issue, who do survive. SIXTH: I nominate and appoint FINANCIAL TRUST SERVICES COMPANY, TRUSTEE of lhe s/lare of any henetidary who is under the age of twenty-two (22) years. The incon1e and/or principal of said Tmst may be accumulated or expended for the maimenance, education and support of slIch heneficiat)' as my TRUSTEE, in its sule discretion, may determine: and my TRUS1EE, in the expenditure of income and/or principal for such purposes, nmy, at its discretion, apply the same directly or pay the same to any person /laving the care 1'1' control of said heneficiary or "'~th whom the beneficiar; resides, wilhout dmy on the part of the TRUSTEE lo supervise 01' inquire into the application (If the funds by any person to whom payment is so made, The balance of s\Jch income and/m princip,\1 shall be paid to such beneficill.ryuponreaehillg majority,or :0 such bcncliciary's eSlate in the event of death prior thereto. SEVEI"TH: I nominate., eonstilllte and appoint FINA,NCIAL'JlRUST SERVICES COMPANY, Carlisle, Peansy:vania, or its s\lcce~sors, to act a.~.E~e'tJt!lrofthis my Utst wiil and Testament. I direct that they ,erve without hom1 11CSCC\lrity[n any jurisdiction. EIGHTH: "',',' .. '.;..:. "'C> In addition to rhe pOl'crs conferr~dby4sc;law, hy statute and by other provisions of this Last Will and Te.stamcnt, my personal representative, and any successors in that l'apacity shall have the following discretionary powers applicahle l<> all real and 2 a.u;L personal property hdd by them, which powers shall be effective wilhom Order (If any Courl and which shall exist and continue until the time of actual distrib\llion: A. TI.I retain any property of any nature received hy lhem for whatever period it ~hall be deemed advisahle; n, To invest anti reinvcst all or any 'flai'" or~lli~':issctsofmy Estale without regard tl.l statutes limiting th" properlY which' a fiduciary may purchase; C. To ~ell, transfer, exchange nr otherwise dispose of, any pun of Ihe assets of my Estate, for cash or I.IIl lerms, publicly or privately, or tl) lease, without lia!'>;lir)' 011 rl1e purchasers tn see to the application of the proceeth, and 1O give "ptillllS for these purchases withvut the uhligat;on tl' repudiate them in favor of a higher offer; D, To exeClIle and deliver any deeds, leases, assignments or uther instmments ,L, m:;y be necessary to carry out the proVisions of this Will; F.. To borrow money, if necessary to facilitate tbc adminimativn am] closing of my !;,i:lle, including the right to borrow muney frllm any hank, including FINANCIAL TRUST SERVICES COMPANY, and to mortgage nr pledge :lny asset of the estate as security; f. To loan to, and to purchase assets'frotlY,'my Estlltc, CVCIl if it is al,o acting as Exccutor thereof. C. To a'sume continuance of tb&'stllJu~'6faltYbeneficiary with Jegarl1 to deatl1, marriage, divorce, illness, JriCapiidtY :llld'simillu incidents or rmHtcrs in the absence of information dccmedrcfiablc without liability for dishurselllel1l, maLl. Oil such a,sumption; 3 (J~ Ii. To make any dimibution hereunder either to kind or in money, or pl'.nially in kind and partially in money. considering (If course the rea~;onable wishes of the beneficiary. Distribution in kind shall be made at the appraised value of the property distrihuted, as it is set forth in the Inheritance Tax Retum [[led in my ~.tat"; I. To exercise any subscriJltilitlriiWtt~q<)flnectirm whlJ any security held hereunder, to consenttIJ orplll'tic;P\ltl;\\!Jl\lw~ecapitaIizll#on. reorgani7.atinn, consolidation or merger uf ,my eorpora\ioll. . company or uS.'Ocilllion, the securities of which may be held hereunder: and to delegate authority with respecl theretO. ro deposit investments under agreements, to \ pav :LIses.ments, amI generaUy \0 exerci", ull rights of investors; J. To continue in any partnership, joiut VClUure, joint ownership or other busine~s enterprise ,d which I am a part at the time of my death; K, To cOlllpromise claims; L. To <'OIlIU\uC for whatever period of time my perSOI1llJ representative shan deem necessary ally ownership as a tenant in conunolt or as a partner. in real eState or other property and to act as I would havc done had I been living; M. the proper Estate; To do all lither acts in its judgmcrn necessary or desirable for managemen~ inveSllllclll and di~tributiou of [he assets of my N. I direct that my Executor, FINANCIAL TRUST SERVICES. COMl>A,"IY shall be compen~ated for the services it renders to my Estate in accordance with its prev,lilir.g schedule ol fees in eUe.ct during the time wllclt said service~ arc rendered. 4 " QfJjLJ1."m. I i I \ I I O. Should any changes occur in the Internal Revenue Code or Pennsylvania Sl1lttlteS after the date of the execution of this Will which affect the tax liability of my estate, then to the eXlent possiblo and a.\ may be ('ermilled hy law, my personal reprcscntativo shall havo the power and discretion to interpret this Will and to administer my Estate in a manner which results in the lowest tax liability possible. ..,.....c IN WITNESS WHEREOF, I hereulllo set my hand and seal this. 11~1. daYOr~~ ,J9% L cf Ji SIGNEll. SEALEO, PUBLISHED and DECLAREr> in the presence of: 'jM'\fllll)I-J-Z--- / \;''..:~'~.i.dl\ ..") /l/j':(Jj1i 5 I I \ I I I COMMONWEALTH OFPENNsnVANIA COUNTY OF CtJMllERlAl"O .~::,:: " ":(;'.-"';:,:::,... -', '. "",-'::.:n"-:'"v:;2':i;~*f:~tI\q2\:_':,-{i, I; C];P~Rl:$S,tl;~_~~~ forogoing inS!rUnltml, havilig'i)eell"du!yqlJ:alf " . _ that l signed and execlJted the instrument as my Last WiH;'lhal- 'lllgned.!it wiHi'nglY;13qq.that J signed it as my free and voluntary act for the purpo.es therein expressed. Sworn nr affirmed to and acknowledged b, ore me, hy CHARLES D. JAMISON, SR.. .'C 6 / the Testator, thiS '.0>< I A, _ day of. ' flu ..'t. . ~. 1'/'17 U r;f1 ,;'.. o ........~ (~f) J;~~' CHARLES . JAMISON, SR.. Testator . (~... , '-- ...J . L .lkt k .R,) ,( R rYl '.- 9.... '-^~/ Nntary Public _ 1oR1AI.Sl;/~ V<R\ENEllARHeVu._". . c.....~~ . c.mm_,......." 6 C"~ 'cxecu .,e, signed willingly and that he eXCI'Lltcd it (\s hi, free and ....oluntary act for the purposes theriiin expres.ed; that each nf uS in the hearing and sight nr the Testator signed the Will as witne"es; and that In the best of our knowledge the Test.1tor was at that time lR of morc years of age. of sound mind aud under no comtlllint or undue influence, Sworn or affirmed l() and subscribed to before me oy Roger M. Susan ~I. IUlll\56Y , witnesses this 29th Horgenthal and day of _.2~nuary , 19');. I'TDYt1 }'\;1 I"J~' Witness (/1"' ~;V',{I.I. }-"'/ ,-:' .ll'! -<;ll;t;l~;/ Witness / l~f~1~~a ~otary PUDllc NlIALSi-\L Ml~I.ESIi_~_""'" co"'" cu_COIIIY, P. ~Colt.mlnlont:....eNII 7 REV-15QS EX + (6-9S) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF JAMISON CHARLES D. SR FILE NUMBER 21 04 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointty-owned with right of survivorship must be disclosed on Schedule F. 0785 ITEM NUMBER 1. OESCRIPTION SAVINGS ACCOUNT NUMBER 50250813, WAYPOINT BANK, HARRISBURG, PA VALUE AT DATE OF DEATH 1,019.14 2. CHECKING ACCOUNT NUMBER 90849172, WAYPOINT BANK, HARRISBURG, PA 1,559.10 3. 1998 CHEVROLET TRUCK, VIN 1 GCCS19X8W810889, SOLD TO JAMES P REESE ON APRIL 4,2005, COpy OF TITLE FORM ATTACHED 6,000.00 5. 4-WHEELER VEHICLE AND TRAILER, SOLD TO HERB LEBO ON NOVEMBER 24,2004, COPY OF BILL OF SALE ATTACHED REIMBURSEMENT CHECKS FROM DECEDENT'S CANCER MEDICAL INSURANCE 3,750.00 4. 6,144.94 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same Size) 18473.18 10/20/2004 ROGER M MORGENTHAL 2515 N FRONT ST 1STFLR HARRlSBURG PA 17110 ~lWayRoin[ BANK The information which you requested on the account(s) of CHARLES D JAMISON (Social Security Number 198-22-9365) is/are as follows: Account Number Class of Account Date Opened Principal Balance Accrued Interest 50250813 SAVINGS 082094 1019.13 .01 1019.14 Balance at Date of Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership 082094 Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested 90849172 CHECKING 082094 1559.10 0.00 1559.10 SOLE 082094 SinceTPly " z:-cLlCu.'[H ERIN E WATTS SENIOR SERVICES REP. P.O. Box 1711, HARRISBURG. PeNNSYUlANIA 17105-1711 T_II <="~~ U,,,,"'.W4YPnINT 11-866-929-7646) .IN YORK AREA 717/815-4500 . www.waypointbank.com No. 7476807 ..,!!l">\-a;T-....~~Dl(jl r"Yt[V' ~ ~-L[ Tn.oo \(:,(\(\,,\7.riaD~~N 0"," n""" \"~~~. . ""nl')J'''lm...iZy [""I. yLQ.~ r \, I ~ I"'fn ).0(: IAgi!::I,UrH ' ~'~I~I:6;'~ ~~1 _"-1""\'00] 117"JJI )(1 \.......- (on~NI!&SNN.l:I\-. MSh~ UlItlC",NIIAI ~::~ ".... ~~ ..... Y\Dv....,1{ . Y\l"...(\~ Y I'~" II: CQ.f'UncHASEn '".-. ..". 'I 1B~'''''''__ I_ 11l'Stcxnt~ . ..' ! "'E"- -;----\-') \~i.~, ~11~~+' L!.I.~cax ,._'M' ("J}t:r y 11 \ '7'1) nll'K: ~Il rt'~~' ( ...~~ ".._"', ~- MIOO!.Z INrTlAL om:. ACQUlRCDI PUFtC'JIA.';F.1J 4.~l'IIiDnQl' ~1"9"" A. ~i ." ~l B. ~ = 5 C. I ~ ! D. LASTItW.liIORTU.l..DUSINESSNMliI CQ-l'IJlof(;IWiEFl ~_.......- ~1Jt:1ne' 5 I I . . 1; . ~ ! ! E. ~. -~ b F. (~rv .... Z1PCOOC cOUNTY COO~ 11. .1 Irrrll'!(lt;fIlNI'I~:Q('t;" UlrfU';,lNl'lf....Il!';I~ OFI'Nt(:Ol', b.~mlC:Ht!R ~ rw. OIC..dll i-ii'Hi+; .1r;lIrolnr~r.r. MOOtL VEAR IVLIIICLCOCNTIJ"1CATIOIIlNI.JM8ER IIiIODV'rV~I('...,lK...i"L:~1 .-..- 1(;lN]!IIDN I I Do"". ~.'IlQ'_rl!r. MAl([ or VOtCU: D"" DI'DOIl ........... ... o TJWojSRJl OF I'llEVIOUSLY ISSUED PL.JU( o TRANSF;:~ 1 R;;NIiiWiU. OF fIl....1 p ~ Tl'WI5FEn l ne:rlACfMENT or Pl..ATt 114VWID'ltTTN.. T'RANSrt:R or PlATCa AGk.A(:"'MIoNr UI- HoIII:KI-K (hlU9l1DI ~ YRG5863 fVlfENO., , . lRE^,,~~""Hl+.l"IAl:;)''''NI "I 83532 I-~':!.!-: .. _' '11 E3~':;'Il_IoI,'~.N(OI~"TN~Jb""""" .: ......".... . NDTI"':lI"NEVERRC~Jr"~blocItlllr. .............~ I TRANSf'CFlR[O J:FIQM TI1 L.l. NO. I VI'" N\(' '. . to. 'l~' .. .- ...- . '.:.r ..... ....~. M OFIS]~~!f~...li(jNI+HI- IJn.AlIONSIFTO APKll:AN1 " ,.:'~"~'; , RRREOII" ISiRTW\N~I" I ~...cvwn \ lJNI...AD[NWCG~FT IRI<o.~(i,~I<<')!;HW1'" F5Q.AliGl.GFtn88COMa Ie ... r )~.~iUWJ wr.jW"APPI.JC&iIi.i.I ~ I'f'l? T'''I \ \ n,- I ~---~j\.'~j5""'5 -A{:' ~. . "I; ~/) ~"'f- ICfRTPYTtWONMONT'H. VI:' I '\\IfIUY -,...)t :::r IHNCatZO(I!DTOorn;;AMINE'TWifTI-l~V~~:;;1I'4SlH-l)_.~ N. '- ..V Y U\1tA , " INrOR. 1Afil.5IJ~I+.(W'HA'KlNJllTHl-IIH(M-Al"I"IICANT,".. m -,..,... MAlIUN (,~IANCP.~~~IONSOF'fl1fVEHCl[ ODe ~_ ~I ....,. G 1I~~. In.:~5J~_! ~ N" 11<<J\-AN'1c:r.-...ecr.FMI ~ . IS ClAIMEO, ~F'UFlC"~FI.t\'I"'H aiM'....." THAT H-/t;l+ I" AII11<lI1lZED 10 CLAfot S ON.I~Ar.K TtW l)Wf.1AAY LQSEM'f'/Ol.AOPF.IW'1NO flHMll-lti-(MI 0JIl \If'HI(lI F "~8l P(lA FA.lUIFIE TO WJN1NN ~ Rt.sJIONSlllUTv ON THe ~ 100 VW<<1l ~ ,TJoE PEI100 or ~~ I'~ Aa<NOM.fDGf...~...,~~~~Y .r:c. ~:CT TO II ~.... mM 15,000 AND l~~ c. )1 M~ TI-WI ~ YeARS ~ NN ) I. ,or J'g-n'!'~'!-1"""""- :~"I........"".....n ~ -elf". U l., _loot.-'.,, '1....IY1,,/II. S ~- <:0-"""-'''.''_'- "- 717 7'fO - 98JI -...''"''''"' a' u ;iJND nlQlWl"",nl~""~(I"uUlQI1twd'Si(rnel TClLPItONE.NUMIW,R SiwlllllftulSular AR.~tN- ...,. ( I KNT ~!:IICo-Putch.1nnr/TOInlAulhnNllI1~ 0I11011'W.1"LRf ,; OII8ChO"t o I'IA"fT08!IISt.8lBY [WRCAU (PROOf" or IN- Sl.JWIC" wsr!dO AI. """'''"''' (1alT!hrllul I:ienclOnt a_diin TMAnInl" . h\.Lll~= DlIllnHI rUl'm MV-44. ~ll'ItlI'o:~"" H. 6 .'1 i~i NOTE: If a co-purchaser other than ~Our IOpOUIUI il:i listed rind you want the IIU. to b. lilllted as "Joint Tenants With Righi of Survivorship" (On death of one owner. title goes 10 surviving owner.) CHECK I.U=.RE II Otherwise, the 11111 will bill ilt&u"d as "lerumls In Common" (On death ot one owner. Interut 01 deceased owner goet> 10 hi..lher heirs or OSlate), Mm.:. 11+ VI-HK::L1-1S lU AI- u~et)"'l!I A DAlLY ~NTAlOl1L.CASCD\lli:JICUi. alli:CKlllSOl.O(X 0 .IF BL.OD< IS CHECKliD, r.c.tPl1-1.. AMl JIoTTACH fClWMY-<<" MESSENGER NUMBER, ,. BUREAU OF MOTOR VEHICLES Z a611il 100~agZL 1L nllqllpqa T,~~aqs pUll uqor gz:ao SOOZ'gO MiIV ,2005 07:37 John and Sherril Radabau 7172584001 Page 2 /1 jd.tljotj Estate of Charles D. Jamison, Sr. 517 ~outh Middlesex Road (7/1) ~4q-);)I() CarlIsle, Pa. 17013 .. 4 Wheeler and Trailer $3750.00 Deposit -$~QOQ~OQ Balance Due (~_:_$1750.00:~__---~-~,-~:; 113010~ '----- - ---r-nll) , Being sold to Herb Lebo. '(JY 3LliAL~(l d alJo-~ J,2005 07:37 John and Sherri1 Radabau 7172584001 Page 3 ~ tc Q ffi ~ I l2 lil lfi ~ lL ill If: l'l i Q 2: OIl ~ w .., I lL W ;; .. ! >- .... z o z " lii d .. N Ii! OIl 15 z W III ~ 5 m ~ OIl I ... .... OIl TYPE OR PRINT I"IRST MWE IhbDvf FlnST m~E _I'Nll"'- MIODUi INlflAL A iouFlCtlA.<lEf.lI.A.l:lr HAM[; tUl.~'::::~lInl) l.t,bt1 c;o-runcllA,*H. t>\Gr NAM& ' ,-i!' CUOI! 1101~ J~;;.e- CITY CAv'hl ~ D.v 3D 'fAn 0 - "I"' - f( $UBSCRI8~lI .v<<> SW{)fVol '0 MC),.jrH"'~ I ..~[ , ~ ntJ J t'Y\ h lot glCNATURE ()~ II .~'OH ^O.JlINtST'liRI~ OA~ ! ~ t; "'Mllfllr',,'AL.rTY '" it roo TV L. . NH...i..1 ~QftI " CJDdi M. WricIlI. ~ Public sn.... SpriDj: 'fwl>.. t.....bcrlaad ~ . pr. lIBmbor. "A93oCIaffort x OONOTSlr~'~~stl'l'S NAME AND AOOflEGA AI1"~ ^itC.wt: CQMMl!)S1QN s ~. .~ ",...lHCtt,.&.I\LA~r~' (orI"\lIIDIII:inr.ssNMlI_) Io\IDO\.\:. "\N\iIM. I'It'CQ[)[;: nns"l" AAUoE MII)lILJ: INmAL _.~s~-- co.rlJR('.J.l"':iEn ~'IT NA...t: .... " ~ STF1IiETAIl()ftI!$o.'; _...----.- CITY sTAIr. A~D"NL1SWORN'lo- -M~~' -ve;;:;;--"-'-' ccn)loll-tM' ::i1l;INATunc or- ~HSON ^LJWtllISTd1ING~' .-" ~lC.~NATliREOFsEiTIH'- c ~ z < g ~ MUNICIPAlf-Y---'- lJj - COUNT'Y"- $1~OfCOSE"I.Len- '-" x no NOTSiGN'liM.l!iiTHE~ASf~ NAMe ANI) AQOncr...,;; Af"rGAK A.8OVt c.;OMMISSlON l;iPlli!;$ Cz al ~ ;:;~ \\: . ' .---...-. --=--:--.. rl" NO LIEN CHECK~ ____., . ._,_n. LIEN U^II- FlnST I..IFNHOLOCR STn&IT ^OO~,lI':SS---- -,-'-'.-.-' .-'-' CITY .~-.._'~-'-...-ziF~)j)E- "- --- D THE uNnr:RSIONEIJ HEREBY MI\KES AI'PLlCATION FOR CertUir;ate ol1iUlI to the AIJ.Turrrain Vchk:te d~f/l)Cd with.... \tW$ Cel1:ilkille Of TItle su,*,cl \n \nQ ooc~..\IlQJ~ ilOO otnol~l'" set tnr\h it\ $ect\ril' C. SUBscRiG;ij"ANOiiwoRN"iO"" .'~iruAY80 VF;i.ri~'.- -~6r-;;;:;.jC^~~ALITH~Eo ~ i1c"ORI!:Ut . .~~ ~ !;I(~AUR ----..-.~r1~r~l.f- or AlHHt'JRtZED SIGNER w ~ .... ;:: 0;_ o ~ ~ ~ c OJ ~ " ( ~ 1- COONTY _.-L_._______ \l,llN\Clf'l\ COMUISr.ION~-""--' .._-- Wh8n .pptylng for title with a cO-OWner other thin ~our spouse, c:heck Dne of theft block.. " no blQck Ie Checked. I;Ite ..", be issued... "Tonanls In Comm.... A n Jolnl Tenants with Righi of Survivorship (on death of one owner, tI.,. goes to ttJe survMng owner). 8 U Tenanls In Common (on death of one owner, 'nterest goes to his: or her h.lr, or estate). ...._..~-,,-_. ',-'.-..--- REV-1509 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTL Y.OWNED PROPERTY ESTATE OF JAMISON CHARLES D. SR FilE NUMBER 21 04 0785 If an asset was made joint within one year of the decedenfs date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. SHERRIL A. RADABAUGH 517 SOUTH MIDDLESEX ROAD CARLISLE, PA 17013 DAUGHTER B c JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 7/12/97 SAVINGS ACCOUNT NUMBER 169217-00, MEMBERS 1,152.66 50. 576.33 1ST FEDERAL CREDIT UNION, CARLISLE, PA 2. A. 7/12/97 CHECKING ACCOUNT NUMBER 169217-11, 10,528.25 50. 5,264.13 MEMBERS 1ST FEDERAL CREDIT UNION. CARLISLE, PA 3. A, 7/15/98 CERTIFICATE OF DEPOSIT NUMBER 169217-40, 26,159.24 50. 13,079.62 MEMBERS FIRST FEDERAL CREDIT UNION, CARLISLE, PA TOTAL (Also enter on line 6, Recapitulation) $ 18 920.08 (If more space IS needed, Insert additional sheets of the same size) ~ ,., lR MEMBERS 1st FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/2002 to Date of Death Name of Joint Owner Date Joint Ownership Established CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/2002 to Date of Death Name of Joint Owner Date Joint Ownership Established CERTIFICATE OF DEPOSIT: Account NumbenSuffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/2002 to Date of Death Name of Joint Owner Date Joint Ownership Established Estate of: CHARLES D. JAMISON, SR. Date of Death: 10/04/2002 Social Security Number: 198-22-9365 169217 -00 07/12/1997 $1,152.50 $.16 $1,152.66 $26.33 Sherril A. Radabaugh 07/12/1997 169217 -11 07/12/1997 $10,527.37 $.88 $10,528.25 $48.02 Sherril A. Radabaugh 07/12/1997 169217 -40 07/15/1998 $26,153.82 $5.42 $26,159.24 $695.42 Sherril A. Radabaugh 07/15/1998 MEMBERS 1ST FEDERAL CREDIT UNION Denise A. Wolfe Insurance Services Supervisor November 8, 2004 5000 Louise Drive . P.O. Box 40 . Mechanicsburg, Pennsylvania 17055 . (717) 697-1161 . www.members1st.org REV.1511 EX+(12.99) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JAMISON CHARLES D. SR. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 04 0785 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. RONAN FUNERAL HOME, FUNERAL SERVICES 5,979.00 2. ST. JOHN'S LUTHERAN CHURCH, HALL RENTAL AND MINISTER 300.00 3. INNOVATIVE GRAPHIC, FUNERAL ANNOUNCEMENTS 52.75 4. CUMBERLAND VALLEY MEMORIAL GARDEN, DIGGING GRAVE 900.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions . Name of Personal Representative (s) SHERRIL A. RADABAUGH Social Security Numberis)/EIN Number of PelSOnal Representative(s) 204-40-3752 Street Address 517 S. MIDDLESEX ROAD City CARLISLE State PA Zip 17013 Yea~s) Commission Paid: 2005 2. AttomeyFees ROGER M. MORGENTHAL, ESQUIRE 2,50000 3. Family Exemption: (If decedent's address is not the same as claimanfs, attach explanation) 3,500.00 Claimant SHERRIL A. RADABAUGH Street Address 517 S. MIDDLESEX ROAD City CARLISLE State PA Zip 17013 Relationship of Claimant to Deoedent DAUGHTER 4. Probate Fees REGISTER OF WILLS OF CUMBERLAND COUNTY, PA 78.00 5. Accountanfs Fees 6. Tax Return Prepare~s Fees 7. THE SENTINEL, ADVERTISING LETTERS TESTAMENTARY 122.63 8. CUMBERLAND LAW JOURNAL, ADVERTISING LETTERS TESTAMENTARY 75.00 9. REGISTER OF WILLS, FILING INHERITANCE TAX RETURN 25.00 10. SHERRIL A. RADABAUGH, RESERVE FOR ACCOUNTING 500.00 11. SHERRIL A. RADABAUGH, RESERVE FOR MISC. CLOSING EXPENSES 100.00 12. RECORDER OF DEEDS, RESERVE FOR RELEASES 100.00 13. SHERRIL A. RADABAUGH, ADVERTISING FOR SALE OF TRUCK 161.00 14. SHERRIL A. RADABAUGH, TRUCK INSPECTION PRIOR TO SALE 145.17 TOTAL (Also enter on line 9, Recapitulation) $ 14 538.55 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (6.98) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JAMISON CHARLES D. SR. FILE NUMBER 21 04 0785 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. WAYPOINT BANK, BALANCE OWED ON CHEVROLET TRUCK AND PAID BY THE ESTATE VALUE AT DATE OF DEATH 2,356.35 2. FOREST PARK NURSING HOME, BALANCE DUE 18.00 3. NURSEFINDERS, HOME CARE FOR DECEDENT DURING HIS LAST ILLNESS 1,340.50 TOTAL (Also enter on line 10, Recapitulation) $ 3714.85 (If more space is needed, insert additional sheets of the same size) REV_'513EX+(,* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER r'UAOI E!': D. !':R. ?1 n4 n7R<; RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not ListTrustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. SHERRIL A. RADABAUGH Lineal 18,993.34 517 S. MIDDLESEX ROAD CARLISLE, PA 17013 2. JEFFREY L. JAMISON Lineal 73.26 10315 ALLENTOWN BOULEVARD GRANTVILLE, PA 17028 3. CHARLES D. JAMISON, JR. Lineal 73.26 8190 MICHAUX DRIVE FAYETTEVILLE, PA 17222 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. 000 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 0.00 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) 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 RADABAUGH SHERRIL A 517 SOUTH MIDDLESEX ROAD CARLISLE, PA 17013 u___,__ told ESTATE INFORMATION: SSN: 198-22-9365 FILE NUMBER: 2104-0785 DECEDENT NAME: JAMISON CHARLES D SR DATE OF PAYMENT: 07/15/2005 POSTMARK DATE: 07/15/2005 COUNTY: CUMBERLAND DATE OF DEATH: 10/04/2002 NO. CD 005573 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $500.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: SHERRIL RAUDABAUGH CHECK# 105 SEAL INITIALS: RSK RECEIVED BY: REGISTER OF WILLS $500.00 GLENDA FARNER STRASBAUGH REGISTER OF WILLS ~-~\:\>~"'-n r---,0r IV. BUREAU OF INDIVIDU~:: l~~':c} ijci"~r:_~ INHERITANCE TAX DIVISION_"'''_:''-'__r ,.- ~._ ,,' -.. PO BDX Z8D601 -'-'~- --: '. ! '. HARRISBURG PA 171Z8-0601' ' , , COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE XNHERXTANCE TAX STATEMENT OF ACCOUNT *' REV-16D7 EX AFP (03-05) n' l.____ Qhc. ,I,' DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-08-2005 JAMISON SR 10-04-2002 21 04-0785 CUMBERLAND 101 AIJOUnt R_J tt.d CHARLES D ZDDS F!JG i 2 Pi' I: 07 ROGER M(JIlQRGENTHAL 1ST FLR 2515 NORTH FRONT ST HBG PA 17110-1150 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSeF, CARLISLE, PA 17013 NOTE: To insure prop8r credit to your accountJ submit the upper portion of this for. with your tax payment. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS - -----------------.--.------------------------------------------------------ REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF JAMISON SR CHARLES D FILE NO.21 04-0785 ACN 101 DATE 08-08-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOlIN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPtICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 08-08-2005 PRINCIPAL TAX DUE: 861.29 PAYMENTS (TAX CREDITS), INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-15-2005 CD005573 .00 500.00 EREST IS CHARGED THROUGH 08-23-2005 TOTAL TAX CREDIT 500.00 THE RATES APPLICABLE AS OUTLINED ON THE ERSE SIDE OF THIS FORM.~ BALANCE OF TAX DUE 361. 29 INTEREST AND PEN. 80.97 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 442.26 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (eft), YOU MAY BE OUE A REFUND. SEE REVERSE SIDE OF TMIS FORM FOR INSTRUCTIONS. ) .~ ~ 08-08-2005 JAMISON SR 10-04-2002 21 04-0785 CUMBERLAND 101 APPEAL DATE: 10-07-2005 ( See reverse side under Objections) Amount Re.ittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE _ RETAIN LOWER PORTION FOR YOUR RECORDS _ REY:is47-Ex-AFP-ioi:osj-NoTIcE-OF-INHERITANCE-TAX-APPRAIsEMENT:-ALLowANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CHARLES D FILE NO. 21 04-0785 ACN 101 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE RECORDED Om~~1ijE OF INHERITANCE TAX p=(":'TI\P\'RAI~~, ALLDIlANCE DR DISALLDIlANCE , c" ",' "OF" DEDlJctIONS AND ASSESSHENT DF TAX Z01C l!'JW ;! I: 51i -j DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN C7<:: (', ROGER M MORGENTHAL '" 1ST FLR 2515 NORTH FRONT HBG ST PA 17110-1150 ESTATE OF JAMISON SR *' REV-1547 EX AFP (06-05) CHARLES D TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED DATE 08-08-2005 I~ an assess_ent was issued previously, lines 14, 15 and'or 16, 17, 18 and 19 will r~lect ~igures that include the total o~ ~ returns assessed to date. ASSESSMENT OF TAX: 15. A~unt of Line 14 at Spousel rat. (ISJ 16. A.uunt of Line 14 taxable at Lineal/Class A rat. (16) 17. Aoount of Line 14 .t Sibling rat. (17) 18. A~t of Line 14 taxable .t Collateral/Class Brat. (18) 19. Principal Tax Due D T : RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Est.t. (Schedule A) 2. Stocks end Bonds (Schedule BJ 3. Closely Held Stock/Partnership Interest (Schedule C) 4. "ortppslNates Receivable (Schedule D) 5. Cash/Bank Deposlts/"lsc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets 11) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 18.473.18 18.920.08 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Fune~l Expenses/A~. Costs/Misc. Expenses (Schedule H) 10. Debts/Kortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12 . Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) 110) 14,538.55 3.714.85 (11) 112) 113) (14) NOTE: .00 19,139.86 .00 .00 X 00 = X 045 = X 12 = X 15 = AHDUNT PAID DATE NUIIIlER INTEREST/PEN PAID (-) ~ INTEREST IS CHARGED THROUGH 08-23-2005 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 119)= NOTE: To insure proper credit to your account I sub.lt the upper portion of this for. with your tax pay....,t. 37,393.26 18.?1i3 ..0 19,139.86 .00 19 , 139 . 86 .00 861. 29 .00 .00 861. 29 .00 861. 29 83.64 944.93 IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YDU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FoRH FOR INSTRUCTIONS.) \\\, ,,'" ~'~ ."",,:1 ~ rltiIL'.. ;,' :0. ~I ".e (~tt~i";'l\ Vb- ~ UJ <S' -' Q3HI'll'l i "'" ~ , Q) ~ ~ 0 ,_ 0 ~-o Cf U- ..." (/)~~ UJr/),""" ..- . , c ro~~ ~..cID-r- O~l.o-t- 1)Q)+-'''''- -' 0) (f) .::( ,;:: \.- ;-' _Oc.~~ ,:J :2 0 ...., ~ Li: I? ~:E .J ...l ,_ z -9. Q) If) 'c: O'J~ ~ o lO (\l rr:C"lJ: u" ~ Q \ (j) <J) -~ ~ ~;:: ,<-~a> ,-, 0 '- v 0- ro '- :l -::$~U" -:: . rtl c if) c0 -= en ':j (j) ~ _ (j) C .r. 0 -:: IV' I'" '!! r- _ u.. "-' -' ~ -:13)-00..... _,-c..c...... =:::: ro ~ a... -=-.......-~J - ::::oQ)p~ _ Q.. .c 0 (/) ::::,2 E (l)'~ -::~':jcro ~oo00 .J i~ \ ~ \J _:.1'J UJ : 1\ '~'} {lr-' , c.-/\7 , . \ IV 'J\\'~ 3\JJU '~ \0 ,. ! jlJ j-.)l)jV \J.Jv...."'.;--' - - ::::: ('.1 \:n i'.1 ,.'" so' --\- i') .,-1 C) r... , .r' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX i)r-:~lifc{MeN'fFoF ACCOUNT REV-1607 EX AFP (03-05) .I ('._ DATE l; :e:ij'ifATE OF DATE OF DEATH FILE NUMBER , :COUNTY ACN 08-08-2005 JAMISON SR 10-04-2002 21 04-0785 CUMBERLAND 101 CHARLES D 20. j' 2~3 Pd ROGER M MORGENTHAL 1ST FLR 2515 NORTH FRONT ST HBG PA 17110-1150 c~-r ,. r..i \j Amount Remitted I!V2. L6 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- -------------------------------------------------------------------.-------- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT KKK ESTATE OF JAMISON SR CHARLES D FILE NO.21 04-0785 ACN 101 DATE 08-08-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PRO~ECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-08-2005 PRINCIPAL TAX DUE: 861.29 PAYMENTS (TAX CREDITS): INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-15-2005 CD005573 .00 500.00 EREST IS CHARGED THROUGH 08-23-2005 TOTAL TAX CREDIT 500.00 THE RATES APPLICABLE AS OUTLINED ON THE ERSE SIDE OF THIS FORM.* BALANCE OF TAX DUE 361.29 INTEREST AND PEN. 80.97 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 442.26 lIE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J QC , , -1,.:> ) '}-oc .'i STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: CHARLES D. JAMISON, SR. 10/04/2002 No. 21-06-0785 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: XX Yes _No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to NO.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes XX No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? _Yes XX No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. Date: 9/28/2005 C'J 3 L.!.__: c; Ci:~ : I. _.'___ I ! (-:'.: , r~ Harrisbur~ PA 17110 City, State, Lip (717) 909-4383 Telephone Number Capacity: _ Personal Representative ..1L Counsel for Personal Representative en ;:"<~ C'-..' c ") Lbo 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 NO. CD 005721 MORGENTHAL ROGER M 2450 EAST BAYBERRY DRIVE HARRISBURG, PA 17112-6015 ACN ASSESSMENT CONTROL NUMBER AMOUNT ____u__ fold 101 $442.26 ESTATE INFORMATION: SSN: 198-22-9365 FILE NUMBER: 2104-0785 DECEDENT NAME: JAMISON CHARLES D SR DATE OF PAYMENT: 08/23/2005 POSTMARK DATE: 08/22/2005 COUNTY: CUMBERLAND DATE OF DEATH: 10/04/2002 TOTAL AMOUNT PAID: $442.26 REMARKS: CHECK#108 SEAL INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION ' PO BOX 280601 HARRISBURG PA 17128-0601 "....,-,--....., COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP 103-0SJ rt.-. i :i ,. 19 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-19-2005 JAMISON SR 10-04-2002 21 04-0785 CUMBERLAND 101 CHARLES D ROGER M MORGENTHAL 1ST FLR 2515 NORTH FRONT ST HBG PA 17110-1150 Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: CUT ALONG THIS LINE NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 REV-1607 EX AFP (03-05) --------------------------------------------------------------------------- --+ RETAIN LOWER PORTION FOR YOUR RECORDS +- *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF JAMISON SR CHARLES D FILE NO.21 04-0785 ACN 101 DATE 09-19-2005 THIS STATEKENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAKED ESTATE. SHOWN BELOW IS A SUKKARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYKENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-08-2005 PRINCIPAL TAX DUE: 861.29 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-15-2005 CD005573 .00 500.00 08-22-2005 CD005721 80.92- 442.26 TOTAL TAX CREDIT 861.34 BALANCE OF TAX DUE .05CR INTEREST AND PEN. .00 II IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .05CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYKENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU KAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS. ) pt.