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Home My WebLink About03-0528PETITION FOR PROBATE and GRANT OF LETTERS Estate of Mary C. Hill No. also known as To: Register of Wills for the , Deceased. County of Cumberland in the Social Security No. 208-24-4532 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner{~0, who is/m,~ 18 years of age or older an the execut rig named in the last will of the above decedent, dated April 23 , 19137 and codicil(s) dated N/A First named Executor. Earl A. Hill. died July 20. 199~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in. Cumberland County, Pennsylvania, with h" er last family or principal residence at 124Lot 16-A WoOC~ Orivo, Mechanicsburg, PA 17050 (list street, number and muncipality) Decendent, then 71 years of age, died june 16 , Y~d~2003 , at 124 (Lot 16A) Woods Drive. Mechanicsbura. PA 17050 Except as follows, decedent did not marry, was not divorced and did not have a child 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 Pennsylvania situated as follows: $10,000. O0 WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters. Tesearaentary theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) Donna J. Nel~ 834 Wellsville Road Wellsville, PA 17365 Sworn to or affirmed and subscribed b~efore me this ~ day of [ r~ _ [ L4r q -- 3 Regester(j[ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF 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 adn~inister the estate according to law. No. ~.~t - ~_~ - ---~ ;~ Estate of ~ ¢.Hill , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~'-'-L~. Y'~ e _ '~ O l~t 2003 , 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 April 23~ 1987 described therein be admitted to probate and filed of record as the last will of ~ c. H±11 and Letters Testz~en~ are hereby granted to oonna 0'. Nelson FEES Probate, Letters, Etc .......... $. L~ ~. -- Short Certificates( i ) .......... $ 3, -- Renur~iation ................ $ TOTAL __ $ ...~ · Register of Wills ATTORNEY (Sup. Ct. i.D. No.) Jane M. Alexander, Esquire, ID#07355 148 S. Baltimore Street, Dillsburg, PA 17019 ADDRESS (717) 432-4514 PHONE REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS '"'"',., codicil (each) a subscribing witness to th~"'-w~l presented herewithy~ch) being duly qualified according to law, depose(s) and say(s) that 'x,,,,, // present and saw the testat _, sign the same and that ,//x~ signed as a witness at the request of ___ in h pre~l~e and (in th"~resence of each other)(in the presence of the testat °ther subscribing witness(es~// Sworn to or affirmed an~l~'fibscribed before me this day of ~ (Name) 19.__ Register (Name) (Address) REGISTER OF WILLS OF co~-~o COUNTY OATH OF NON-SUBSCRIBING WITNESS Harold Nelson and Evelyn Nelson (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that they familiar with the signature of Mary c. H±11 testat r±x of (O~aX:Ot~ '~ ) the will presented herewith and codicil that they believes the signature on the will is in the handwriting of Mary C. Hill to the best of their knowledge and belief. Sworn to or affirmed and subscribed before . me this t22{_... '~_.V., day of H~old ~els~ (Name) ~j ~ ~ ~ ~ ~~ 844 Wellsville R~d, Wellsville, PA 17365 ~el~ Nelson { (Name) 844 Wellsville R~d. Wellsville. PA 1736% (Address) ----- ~-------~---- I !" :-" . . . ) t:l I-' ~ 1 ~~ H ,.to. s: g ~~ ~.~g I I ~ eptIj 0" g~:T~33 ~~ <D ..... ~ ~..< ~"9- i) ~g.~g:::;;~ :P jFS ." ...L ..,J ::t Cli" ro ; ~ ~. ~ CJ l gggSU$aCD ...,.., ~ tIl 'T\ CJ 'v ........ :J 3 ::1.3 ~ \;;;-' r, l--! :;d :::;;0.... (I) alll ''':..l ~ 2 H ~s~~a:" ~ ru '1J HLl sug.30.0~ U"1 ~ ~~ g(l).....~~su N \;;;-' "'0 0" ~ 0. <" :J 0 Cl :D ("lj cosu(l)-.roo. 0 ... ~g $< ~ ~ I-'tIj ~. 0 -. 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UJ~..c<l.)O l-<;;::: S tI.l t-- <l.)~;::I ;::I....... s~u..8< ~o~t::0-4 ~ l-< 0 ;::I ,-:' ~<l.)>-,O"" "dtn"""'U'OO l::....... l:: ;..:::: ~~5g~ v~uou - = : : : : C'J CI .;:) U LAST NILL AND TESTAHENT OF MARY C. HILL I, Mary C. Hill, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound mind and body, declare this to be my Last Will, hereby revoking all prior Wills and Codicils: ITEM I. I direct that all my just debts, any expenses that may have resulted from my last illness, and my funeral expenses shall be paid from my estate as soon as practicable after my decease. ITEM II. I give, devise and bequeath all my property, real and personal, owned by me at my death, to my husband, Earl A. Hill, provided that he survives me. If the aforesaid Earl A. Hill does not survive me, then I give, devise and bequeath my entire estate, in equal shares to my children, Donna J. Nelson of Wellsville, Pennsylvania, Michael L. Klobetang of Lewisberry, Pennsylvania, and Earl O. Klobetang, Jr., United States Air Force Number 182 40 8083 of Mechanicsburg, Pennsylvania. If any or all of the aforesaid children do not survive me, then his, her or their share shall pass to his, her or their issue, per stirpes. ITEM III. I appoint my husband, Earl A. Hill as Executor of my Estate. If he predeceases me, or is unwilling or unable to serve, I appoint Donna J. Nelson as Executrix of my Estate. Page 1 of 3 ITEM IV. In addition to powers given by law, my Executor or Executrix shall have the fullest power and authority in all matters and questions and to do all acts which I might or could do if living, including, without limitation, complete power and authority to invest (without restriction to investments permitted by law), sell (at public or private sale, for cash or credit, with or without security), mortgage, lease and dispose of and distribute in kind, all property, real and personal, at such times and upon such terms and conditions as may be deemed advisable. ITEM V. No fiduciary acting hereunder as Executor shall be required to post bond or enter security in this or any other jurisdiction. ITEM VI. Ail estate, inheritance, transfer, legacy, succession, and other death taxes of any nature, payable by reason of my death, which may be assessed or imposed upon or with respect to property passing under this Will or property not passing under this Will, shall be paid out of my estate as an expense of administration, and no part of said taxes shall be apportioned or prorated to any legatee or devisee under this Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal this~ day of~ , 1987. ' ~y~~y~ H~L~~ (SEAL) Page 2 of 3 SIGNED, SEALED, PUBLISHED and DECLARED as and for the Last Will ad Testament of MARY C. HILL, the Testatrix, in our presence, who in her presence, and in the presence of each other, and at her request, have hereunto set our hand as subscribing witnesses hereto: d V Residing at: Residing at: ~ ~-__~_~_~_~ Page 3 of 3 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Mary ¢. Hill Date of Death: June 16, 2003 Will No. 21-03-0528 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 2, 2003 Name Address Donna J. Nelson 834 Wellsville Road, Wellsville, PA 17365 Michael L. Klobetang 412 Reno Avenue, New Cumberland, PA 17070 Earl O. Klobetang 6324 Baker Blve. HaltomCity, TX 76118 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Dillsburg, PA 17019 Telephone ( 71~ 432-4514 Capacity: __ Personal Representative x Counsel for personal representative Estate Recoveries, Inc. Over 15 Years of Sen,ice to tile Financial lmlustlw Register Of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 '03 ~!:P i2 ,~,. ..... Sevtember 10, 2003 Estate Of Mary C Hill, deceased. Our File#: HFL-42124 Estate #: 2103528 Dear Sir/Madam: Enclosed please find our claim regarding the above captioned estate which is being filed on behalf of Fleet Credit Card Services, L.P., creditor. A copy of this claim is being forwarded to Donna J. Nelson, Representative for the estate. If you have any questions concerning the attached claim, please do not hesitate to contact this office. ...erel.y, ~ R~c~Hedfnger~~' RJH Enclosure See Reverse Side For Special State Disclosures. This communication is from a debt collector. This is an attempt to collect a debt and any information obtained will be used for that purpose. P.O. Box 24566, Baltimore, Maryland 21214 · 5543 Harford Road, Baltimore, Maryland 21214 Monday- Friday 8:00am- 6:00pm Eastern Time · Telephone: 410-444-8022 · 800-229-8472 · Fax: 410-426-4051 Special State Disclosures Colorado FOR INFORMATION ABOUT THE COLORADO FAIR DEBT COLLECTION PRACTICES ACT, SEE WWW. AGO.STATE.CO.US/CAB.HTM. Maine The business hours for Estate Recoveries, Inc. are Monday - Friday 8:00 a.m. - 6:00 p.m. Eastern Time. This agency may be contacted using the tbllowing numbers: 800-229-8472 or 410-444-8022, Fax: 410-426-4051 Massachusetts Notice of Important Rights: You have the right to make a written or oral request that telephone calls regarding your debt not be made to yon at your place of employment. Any such oral request will he valid for only ten days unless yon provide written confirmation of the request poslmarked or delivered within seven days of such re- quest. You may terminate this request by writing to Estate Recoveries, Inc. at 15 Union Street, Lawrence, MA 01840. Hours ti3r Massachusetts are: Monday - Thursday: 8:t)t} a.m. - 8:00 p.m, Friday: 8:(}1t a.m. - 5:00 p.m., Saturday: 8:1)0 a.m. - 12:00 p.m. Eastern Time. Minnesota ] Estate Recoveries, Inc. is licensed by the Minnesota Department of Commerce. The license number for Estate Recoveries, Inc. in New York City is as fi}llows: 0976707 .North Carolina ] The permit number fi)r Estate Recoveries, Inc. in North Carolina is as Ibllows: 3523 'l~nnessee This collection agency is licensed by the Collection Service Board, State Department of Commerce and Insurance, 500 Jmnes Robertson Parkway, Nashville, ~l~nnessee 37243. IN THE MATTER OF ESTATE OF: MARY C HILL STATE OF PENNSYLVANIA IN THE ORPHAN'S COURT OF CUMBERLAND COUNTY ESTATE#: 2103528 DATE OF DEATH: 06/16/03 STATEMENT OF CLAIM 1. The creditor, Fleet Credit Card Services, L.P., certifies that there is due and owing by MARY C HILL, deceased, the sum of THREE THOUSAND TWO HUNDRED FORTY ONE DOLLARS AND SIXTY TWO CENTS ($ 3,241.62). 2. The nature of the claim is a VISA account 4305500017249783, which was established in 10/13/00. 3. The name and address of the claimant is: Fleet Credit Card Services, L.P., 550 Blair Mill Road, Horsham, Pennsylvania 19044. 4. The name and address of the claimant's agent is: Robin J. Heddinger, Estate Recoveries, Inc., P. O. Box 24566, Baltimore, Maryland 21214. 5. This claim is not contingent and is not secured by any liens or judgments. 6. This claim is not based on any one instrument. Said balance has accrued since the account was established. On behalf of Fleet Credit Card Services, L.P., creditor, I do solemnly declare and affirm under the penalties of perjury that the information in the foregoing claim is true and correct to the best of my knowledge, information and belief. I have made diligent inquiry and examination, and I believe the claim is just and all legal offsets, payments, and credits made known to the affiant have been allowed./ / Estate Recoveries, Inc. P.O. Box 24566 Baltimore, Maryland 21214 (410) 444-8022 County of Baltimore, Maryland: IN WITNESS WHEREOF, I hereunto set my hand and Notarial Seal this September 1 ~-~3. _.~ ~.~'~. · ~OTA~_. ~fe~ ~ ~? '~x~% JE~fw ER I~/~TREHLEIN, Notary Public My Commission Expires: August 8, 2004. am. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION File No. 2103528 Estate of Mary C Hill Deceased I I I ' NOTICE OF CLAIM by RORIN .L I-I~DDINGER; AGENT FOR 17I,EET CREDIT CARD gERVICE,q: I,_P. Filed Pursuant to Section 3532 (b) (2) of the Probate, Estate, and Fiduciary Code, 20 Pa. C.S.A §3532 (b) (2) . To the Clerk of the Orphans' Court Division: Enter the claim o RORn~ J_ m~,nnn~G~n: AGENT FOR I*I,EET CREDIT CARD ,~ERVIClZ, R: I,.P. (Claimant) in the amount of $3..241.62 , against the above entitled estate. The Decedent, who resided at Wellsville, PA 17365-9503 (City) Pennsylvania, died on .hmo 16: 834 Wellsville Rd (Street Address) , Cnmherland Written notice County, of said claim was given his Counsel) to Donna .I. Nelson (Personal Representative, or If known to claimant, at 834 Wellsville Rd Welisville, PA 17365 (Address) ,on · x~t~'~t. , Claimant RO~IN J. HEDDINGER, ~ENT Post Office Box 24566, Baltimore, Maryland 21214 (Address) September 10, 2003 (Date) Claimant's Counsel: (Address) COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHAN'S COURT DIVISON NO. 2103528 ESTATE OF: MARY C HILL deceased. Notice of Claim by FLEET CREDIT CARD SERVICES, L.P. ~ed pursuant to Section 3532(b) (2) of the PEF Code. Robin J. Heddinger, Agent ESTATE RECOVERIES, INC. P.O. Box 24566 Baltimore, Maryland 21214 (410) 444-8022 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 5/18/2005 ALEXANDER JANE M 148 S BALTIMORE ST DILLSBURG, PA 17019 RE: Estate of HILL MARY C File Number: 2003-00528 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 is due by: 6/16/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge ~ Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Mrry C. Hill Date of Death: June 16. 2m3 Estate No.: 2003-00528 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 0 No ~ 2.. If the answer is No, state when the per~onal representath:e reasona!,ly believes 1:h:at the administration will be complete: SlX lIDIlths-there 18 a pending court action 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative :file a :final account with the Com? Yes 0 No 0 b. The separate Orphans' Cotn1 No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, re1eases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: {J II /t?? / I ~ \..,0 M ("'..) ('''1 I ame 148 South BaltiJrore Street Dillsburg, PA 17019 Address (717) 432-4514 Telephone No. Capacity: 0 Personal Representative .!XX Counsel for personal representative ~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 ALEXANDER JANE M 148 S BALTIMORE STREET DILLSBURG, PA 17019 RE: Estate of HILL MARY C File Number: 2003-00528 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing is due by: 6/16/2006 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~dAJ#~ / Glenda Farner Strasbaugh Clerk of the Orphans. Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 NELSON DONNA J 834 WELLSVILLE ROAD WELLSVILLE, PA 17365 RE: Estate of HILL MARY C File Number: 2003-00528 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/16/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ , J Glenda Farner Strasbaug~' Clerk of the Orphans' Court cc: File ,.-,_....___1 In Re: Estate of HILL MARY ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2003-0528 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: NELSON DONNA J Counsel for Personal Representative: ALEXANDER JANE M Date of Decedent's Death: 6/16/2003 The Orphans' Court record indicates that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report. If the required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 7/11/2006 ~~~J#-~ u.s. Postal Service CERTIFIED MAIL RECEIPT (DomestIc Mail Only; No Insurance Coverage Provided) Glenda Farner Strasbaugh Clerk of the Orphans' Court l"- ru ru ....=l I I Postage $ (;.{(I Certified Fee l () dftLrk Return Receipt Fee 11(t I ~'~ (Endorsement ReqUired) Restricted Delivery Fee (Endorsement ReqUired) Total Postage & Fees $ o 3 - 5;;> f ntative CJ C- eO Ul ..D CJ CJ CJ CJ ....=l Ul ru Sent To ....=l _u_Uhun_un CJ CJ l"- Street, Apt No; or PO Box No. .(Siiy,.siaie,-i(;'-;;.;i---.-----:;--.----t)--~------5";J~---------------------- 'O"'flVt /Jet ,{(),\ // _ _ ~ ~ ~.t _ _ _ _ _ __ _ _ __ _ ___ _ _ ___ __ _ _ _ _ _ _ __ __ _~.~_ ____ ____ _ _ _ _ _ _ _ ___ ____ _ ___ __ In Re: Estate of HILL MARY ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2003-0528 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: NELSON DONNA J Counsel for Personal Representative: ALEXANDER JANE M Date of Decedent's Death: 6/16/2003 The Orphans' Court record indicates that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report. If the required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 7/11/2006 ,~k~J~ Glenda Farner Strasbaugh Clerk of the Orphans' Court m o Certified Fee o o Return Reciept Fee (Endorsement Required) o Restricted Delivery Fee U") (Endorsement Required) m ....=! Total Postage & Fees $ (p ./2- I () rlsfm~' 11(, ~0 :" -" 4 Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Mary C. Hill Date of De am: June 16, 2003 Estate No.: 2003-528 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the adm1"1istration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes [] No LID Problem with creditor relative 2. If the answer is No, state when t'he personal representative reasonably believes that the administration will be complete: September 15, 2006 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, releases, joinders and approval offonnal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. M. Alexander Es uire 148 S. Baltimore Street Address Dillsburg, PA 17019 (717) 432-4514 Telephone No. I .... _ /,i . -~~, , '''''"'' --i... ': I ( -: ! I .... {.. I - Capacity: o Personal Representative [Xl Counsel for personal representative c Register of Wi Us of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Mary C. Hill Date of Death: June 16, 2003 Estate No.: 2003-00528 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 0 No [& 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: about Sept 1, 2006 when settlement complete and disputed claim settled 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, releases, joinders and approval of fonnal or informal accounts may be flied with the Clerk of the Orphans' Court and may be (~. ~.. ;:);ttached to this report. Dale:~ Jane M. r, Esquire 148 S. Baltimore St. Address (717) 432-4514 Telephone No. Capacity: 0 Personal Representative I!J Counsel for personal representative 0- -.'-- .- ~7) Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: M:rry C. Hill Date of Death: Jillle 16, 2003 Estate No.: 2003-CD528 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the fol1owing with respect to completion of the administration oft.~e above-captioned estate: 1. State whether administration of the estate is complete: Yes 0 No I:!l 1.. If the answer is No, state wue!1 the personal representative reasonably believes that the administration will be complete: when the court action settle 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a fmal account with the Court? Yes 0 No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, releases, joinders and approval offonnal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. r - , /' _ ~~~~~ 148 S. Palt:i1rore Street, Dillsburg, FA 17019 Address (717) 432-4514 Telephone No. I / Capacity: 0 Personal Representative o Counsel for personal representative \....ULLLUeLLCl.UU \....UUUl-Y - L\.C'::;j-'-':::>l-c.J... V.J... ".J...J...J........ One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 \.--..J o -~ . :.-C) Date: 6/08/2007 r< NELSON DONNA J 834 WELLSVILLE ROAD WELLSVILLE, PA 17365 c RE: Estate of HILL MARY C File Number: 2003-00528 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/16/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ! V #;i/) Mm~ ~A j J4ZM,:t:.h!p4!L, ;u'4/co,c..... ,- . / <I : / Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel -- --- --------- ------1 ...""-:J......_-_......_~ One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 6/08/2007 1',.: ALEXANDER JANE M 148 S BALTIMORE STREET DILLSBURG, PA 17019 c RE: Estate of HILL MARY C File Number: 2003-00528 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/16/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, p r ,,,,"' ", ,) "~#~ ~fr!'/u'JIt!i;y~~~ ,~.. // /' / Glenda Farner Strasbaug~ Clerk of the Orphans' Court cc: File Personal Representative(s) Pa. O.t. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND; , COUNTY, PENNSYLVANIA Name of Decedent: Mary C. HIll Date of Death: June 16, 2003 File Number: 2003-528 Pursuant to Pa. O.c. Rule 6.12, 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: . . . . . . . . . . . . . . . . . . .. D Yes rn No 2. lfthe answer is No, state when the personal representative reasonably believes thatthe adrilinistration will be complete: July. 31, 2007 3. lfthe answer to No.1 is YES, state the following: a. Did the personal representative file a final' account with the Court? . . . . . . DYes DNo b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account infoIDlally to the parties in interest? ..............:................. DYes DNo d. Copies of receipts, releases, joinders and approvals of formal or"informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. (. ~ ., ~~.J Ul Counsel 'tf t- o:: , ::;)0 ~8~ ::x:: c., r,-c..f)Z ........' <( ~~o:! Ua.y: ~~ U CD x: ex 148 South Baltimore Strep-t Add7"eSSDillsburg, PA 17019 N N :z: ::> ...., l""- e::::> e::::> '" (717) 432-4514 Telephone roml R"V-/O rev iOIJ06 J Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 5/30/2008 r> ~~ ~-oO f2~Eil ~a5~ 080 8c1"1 ~ :0 ~~ r-,) = c::l> co (... c= % , c...> ALEXANDER JANE M 148 S BALTIMORE STREET DILLSBURG, PA 17019 ,. :x - - .. ."- ~,.,~ ,'''. C> RE: Estate of HILL MARY C File Number: 2003-00528 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/16/2008 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, 1tIv4~Jtw.7f Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (71 7) 240 - 6345 Date: 5/30/2008 NELSON DONNA J r-.:, 8 = = c:::o ::-~ <- ::~ f{~~a c: :z F! hi I -.,. :0 (...) zcnA Ono :1> ("">0." ::J: 0'- :~ - - .~ .. 0 ; 1 834 WELLSVILLE ROAD WELLSVILLE, PA 17365 RE: Estate of HILL MARY C File Number: 2003-00528 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of ~Jills a Status Report of completed or uncompleted administration. This filing is due by: 6/16/2008 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~fx,t Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: MJ~13Y ~Hil< Date of Death: s~1s~2oo3 File Number: 2003 52s Pursuant to Pa. O.C. Rule 6.12, 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 administration will be complete: Disputed settlement. Hope to settle by August 15, 2008 3. If the answer to No. 1 is YES, state the following: r~r 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 the Orphans' Court and may be attached to this report. e: r I `` 1~fiG~ S,~~!'dNd~O Form RW-10 rev. -10.13:(16 ',' - _ Perso» ^ Personal Representative ~ Counsel of Person Filing this Form 14R S RaltimcxP Sheet Address 717x432.4514 Telephone Cumberland County Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 5/27/2009 ~} r• _~ c_ ~ ._~ _ ALEXANDER JANE M v ~ 148 S BALTIMORE STREET ~ _ _ _ ~ ,... ~~ -.c:, ~, . ~ - DILLSBURG, PA 17019 , . '~,_'t',, . ~ ~Tt 1~ -" --I _~ ~.'~ ~> ~ N RE: Estate of HILL MARY C File Number: 2003-00528 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/16/2009 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, '~1.7~2ycec,/~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) -..! One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 5/27/2009 NELSON DONNA J 834 WELLSVILLE ROAD WELLSVILLE, PA 17365 RE: Estate of HILL MARY C File Number: 2003-00528 Dear Sir/Madam: ~7 , -= ~r~ __ __ ~~"'n i =~ - T., .. > N ._ ~ __ ,r V _ _ ~~-,. - :t,, ~L~ _~ j _"' i~ ~ c~ n:, This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/16/2009 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Via. ~.~. F~~~e 6e~~ S~'l~.i~~ P~~ REGISTER OF Vv ILLS OF Cumberland Name of Decedent Mary C. Hill COU?~iTY, PEN~~SYLV~:tiI? Date of Death: 6/16/03 Fiie Number: 21-03x528 D.~,-....~„++„ D., (1 ('' D„lo ~ 17 T 1e.,.,,-+the f~ll~~ziina ~z;i*}1 recr~Ai'.T to ('.nt"rtY~lcaton of the fi'~illllnl~tratlon GI the above-captioned estate: 1. State whether administration of the estate is complete :................. .. ~ Yes (~ No 2. If the answei is No, state when the personal representative reasonably believes that the administration will be complete: Dis>~uted Settlement not resolved 3. If the answer to No. 1 is YES, state the followinb: 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 maybe filed with the Clerlc of the Orphans' Court and~may be attached to this report. Dnte June 2, 2009 J;=' ~ ~~~0+J _, ;-i ! 1 ~uv~ r arm R61~-!0 i~ev. 10.13.06 e of Person Filinglhis Foyht / ty: ~PersonalRepresentative OCounsel ~/nme afPer;on Filing this Form - II 148 S Baltitrore Sr -- Address 1}i1lGburg, PA 17019 (717) 432 4514 Telephone I N R E ESTATE IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA MARY C. HILL ORPHANS' COURT DIVISION DECEASED NO. ~ ~ - ~ 3 - 4 S ~~ TERM ~ ,. C O ~~. , ,`,i" . ~'.~ I PETITION FOR CITATION ~ ~ ~ ~~ ~ ~`~ ~' '~ ~. V' ... _. ~ -.~ ...: ._,~ TO THE HONORABLE THE JUDGES OF SAID COURT: ~~} o ~ ~ . ~ .. ~ ~ _ _ AND NOW, this ~~`~ day of ~~,--~.~~~ ~~ , :~ ~' ~ , comes the Commonwealth of Pennsylvania, by Robert Freedenberg, Deputy Secretary for Taxation, for Stephen H. Stetler, Secretary of Revenue, who avers: 1. That Mary C. Hill, deceased, (hereinafter referred to as "the Decedent"), died on June 16, 2003. 2. That a Petition for Probate of the Last Will and Testament and for Grant of Letters Testamentary was made by Donna J. Nelson, Executrix, (hereinafter referred to as "the Executrix"). Letters Testamentary were granted to the Executrix on June 30, 2003. Attached hereto and made a part hereof is a copy of a document attesting to said date on which Letters were granted marked Exhibit "A." 3. That on October 27, 2008, a certified demand letter was sent to the Executrix, advising that the Inheritance Tax Return for the Decedent had not been filed. A receipt was signed and returned to the Department of Revenue. Attached hereto and made a part hereof is a copy of said letter and receipt marked Exhibit "B." 4. That as of the date of this Petition no Inheritance Tax Return has been filed by the Executrix of this estate as required by Section 1736 of the Act of December 13, 1982, P.L. 1086, No. 255, (72 P.A. C.S. § 1736). 5. That under Section 2176 of the Act of August 4, 1991, P.L. 97, No. 22, (72 P.S. § 9176), the Secretary of Revenue is authorized to request the Court to issue a Citation directed to those subject to any duty imposed by the aforesaid Act, commanding such persons to appear and show cause why the requirements of this Act should not be met. WHEREFORE, your Petitioner prays your Honorable Court to issue a Citation upon the Executrix, directing the Executrix to appear and show cause why said Inheritance Tax Return in the estate of the Decedent should not be filed as required by law; and to further direct that the costs of this action shall be borne by the.F~xe~tri~c. CON1MOrYW~L`~'Id OF PENNSYLVANIA BY '~l'' ' Robert Fre enberg, Deputy Secr tart' for Taxation FOR: Stephen H. Stetler Secretary of Revenue COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF DAUPHIN Robert Freedenberg, Deputy Secretary for Taxation, for Stephen H. Stetler, Secretary of Revenue, being duly sworn according to law, eposes and says that the facts set forth in the foregoing Petition are true and correct to the bet is ~ wledge, information and belief. Robert Free enberg Deputy Secr ary for Taxation For: Stephen H. Stetler Secretary of Revenue Sworn to and Subscribed before e this "~~ da Y of i ~~~ CE3~v1MOi~vVEALTI-i OP PENNSYLVANIA Notarial Seal Sue E. Hetrick, Notary Public City Of Harrisburg, Dauphin Courrty My Commission Expires Apr. 10, 2010 1Vlember, Pennsylvania Association of Notaries f ' Page l of l 1?.st~tc of . ~~ c.~{i1! ., {)ece~scd Al•~(:,it~,F U~' P~tUDAT~a A~tl~ GRANT' U~' 1.~b:.rr~RS AND NO~~' ~-~~~'--•-`~-~-~-~-°--°~---- }~""' in cansieleraliaa cat tha txtitiun un thr taveiat stile hereof, satltiiaciory pru~f leaving been pracnttd Ixtore ms, IT IS DECRIIL~ tligt the instnrmeni(s) dated_:~- 7-~a's 1 2s, a~~l? ..-...- •__.. _ ~.. descritxd thcrtin tee admllted to probate and tiled of retivrd as the lane will of ?SrixY c,..!ti t i ~_ and l~cltet3 . '1t~eltdrr~.•t1t!*..lY ,_...r--- _ ......:.. ......._ are hereM.ey ~rAnte+f to . ~~*~. a. r~~t __•..._..._.`.~. _..._... l~l.'st'sS t'rabatc, t.crlets, t:tr......... . S tom- -~.--.-= Short Crrttficates(I) ..... ... . S_.__......''rt.~.- Rcnu ~iaciun ............... . 5.,. _ ~. ., . ry Q ~ .~-r1-t~-J ~ . Rt~itltt a! VI°111t r1Trc~xNrt• tSup. c~, t.ty. N~~,r Jarw u. 1-lexvKk-r, ~,arluira, 1i~07155 `?~~..A~,,,,,taaltimrsrn 5trrnt, I)[Iltilx~~rt~~ PA 1'lUiy AtSURfS4 ;'11'1) d32••~51~1 ~....,..., ...:..........._--• ..r.....t.... ryEtc>~E: ` ~ ' t' ~l ' •.,, i qtr<•~,~}} , is E'G`t'1"Y'it)N .~'UIt PROIIAFi'i+~ and GKANT Ole ~.1~.`Iw~'IaK !~ Sta1P of _____..t.''u:X C. tti t i _._. ~... ~_~ Na. ~~._~ _.~`, rjo~ ~ . _ also ktrot+-tt as ..._ _._ .~.,..- ..... Ta: .._....:....._~_____ _.._:._---.__.._..,:.~..._. Reglttcr of ti~'illc Ftr ttrc _. _____.~,.,»_.__...». _ , I)cc~ased. G4Utlty Or CuRtix:r inrd .....:...._.._._.. in tti~' Soclar 3s~cttNty Nr~. ,: ~~~~_i~~ .. ..~ CammOnw•ealtir ut 1'rrrnsylvunla 't'he petition of the undcrsi~rtctl resricct~ully rrpresrnts that: Your pttitiant't{~, whn is/sr:s lt3 years of age of r)ldtt an the oxcti,ut...rix.._.__~__.._ _...~ Warned ty.~~ .._ itr th+: Inst will o(ihc ulxs>,•c decedent, elated ..........:_.l!I?tS1 23 ...::...,,......,_..._._.. snd todicit{s} Baled _._.._.~.1-.X~..,._ _........•,__....:.:..,.,... . .F.irrlit~n'ct 1•~ r,_~ul_i1...~i~~; • di.~~iv 70. t94G _..u....._ ._._ ^_.---.~._....... _ _ (Mile rtk-•int rtfrtufittant-s, e.3. tcnun:ialkit+, dt,i+h c~! t+aarur. clc.t lleccndcnt tuns drsmiriied ttt sit,~yth in ,.,.....:.__~ Gy~tx?rlart~! ....__ . ,... C~onnly. I'cnr,s}~ivan-a, with ~.c...._...... last family nr principal residenrt at 124iR~ iG-A tt<acx3st prig, H+:r.~t>3r-icatau~, t=A t7p°,tt _ (tlir srrrrs, numher a~-J enu>:elpatirft .. - _....._...._._~ .. ........ Fkcrndcnt, thcp _.~ years of arc. died ._._. ~sa,o tG ,.._............._-_- ._--., ~ti$wi~_~.._, at 124_it~v.t..1GAI.J~.7ssirs..Qc1~~~.~..-~+~~s~u~9....1r~,31F:~ 1'xrcFtt as ls5lts,wa~ sieccdrnt did nat marry, ws+3 rust siivorcecl and did not lrtlve~u Cttild trorn or adaptref ctleer cxr~ulion of the will olfcred for ptobxtc; sons rit~t the victim ci[ n killing rind was never :sdjuslicatrd itteor»pctcrtt: ._...._._ - _,:_:_.:.._...., _....:.....w._...____~ Ihticrsdcrtf at death owned property with tstirntsttd vetoes as fnilnws: {lf ciomiriltc! in 1'a.} Alt personal psaptrty ~ 20,~XYi.th _ ._..._ .-. {li Well dprnicitnl ht isrt.} I'rrsonal ptaptrlY its i'tnns~rkania S_..:.:~...:..--.~__.- __._._. (It pot domiciled in Pn.) l'crsnnai prtperty in Counly i.__,:::::.._ _--...__. Yalut of rral estate in i~'cns#sylvattia 5,..:.,.._..~._ ~_..._ sitrtatcd of folla-+s: T.._........,,. ,....__..._ ~...<::.-,..1.:. ._._...__ ...:..:.....:......_. _^______..__ 1YFFF.ItI:F()1ti., ire#itioncr{s} restxetluily regarst(s) the probate of the last s-il) arts! rodicit(s) t+rraentcd herewith alts! the ~r5nt isf trttcrs ~=~~""~"~t~'++~y..:.,.~. (tntant;ntery: edn-intsttati~vt c. t.:t ; a~~rlni+rralsun d b.n r` 1 s. ! { ll~f v rt, ria--a>s J. tFalr ~ ,• l.~,villo ttc'.v! ._., tt~4•.h~.l klsll~vfi lice. _ t'A 17365 .... ,,`~ 3 h ~A'I'fi OF PERSi~NAL REI'RL.~tNTATIVI*. GUA~MUNWF:AI.,TlI O~ PENNSYLVANIA COUNTY OI~ ..531!~~~ ...,_. . ~ $~ The pctitfaaer(s) above-named swear(s) or ai'iirm(s) Iltst the >ttutemcnts in the (4rt~uin~ prtition arc lrUC artd rs,rrcct Icy the bast of the icnowttslgt tsnd belie! of Fxtetioner(s) and that as ttcrsonnl rtpresrn- tativc(s) at' the abavc ds:s=r:dent pctitintttt(s) wiU welt and trot>• adtilirtistcr thr estatr aecsxdinH to taw. Sworn to or alfirrncd and subscribed ~ ~ _.... t •~' ~,-~~,6,,G~J . _.. __ t., tore srto this .:+0'~1.,~~.~..~ _ ~y_~..9 d~rr vt' _,_... ----........_:.:::.. y. r>~ ~, t7t 'ttr (t ~ ~1_~~~ 1~ _~ .~ _. Page 1 of 1 I 1r f HARRI3BUR(3 DISTRICT OFflCE SI7W WBERRY S~_ dill 1k WALAItIT 881188 HARRISBUR[3 PA 17128.0101 COMMON`YEALTH UT' PENNSYLVANIA DEPARTMENT OF REVENUE RBV•869 FO AFP (07.08) Date: 10/27/2008 DONNA J NELSON 834 WELLSVILLE RD WELLSVILLE PA 17365 Estate of: HILL MARY C Date of Death: 6/ 16 / 2 0 0 3 File Number: 21 0 3- 0 5 2 8 (Certified Mail-Return Receipt Requested) Dear DONNA J NELSON Department iecoi•ds indicate you are responsible for the settlement of the above estate or that you represent the responsible party. As of this date, you have failed to resolve Ibis mat#e~•. This is to again advise you that the estate is in delinquent status, as it. remains unsettled. The Inheritance and Estate Tax Act mandates the Cling of a tax return and payment of all outstanding liabilities by a personal representative or a transferee of an estate within nine months of a decedent's death. Deparhnent records show that this estate remains open because: AN INHERITANCE TAX RETTJRN HAS NUT BEEN FILED. If the retui~ was filed, please contact this office iinYnediately. If this estate was opened for the purpose of filing a lawsuit, please provide the teen and docket number of the proceeding in writing to this office so that we znay postpone any further action. Undea• Act 40 of 2005, additional collection costs, including but not limited to fees of up to 39 percent of the amount due and attorney fees incun-ed in securing payment, may be imposed on any liability not paid prior to referral to a collection agency or conh•act counsel. This notice shall serve as a formal demand on you or your client fiom the Department of Revenue. If you fail to file the retut7~, the Deparhnent may file a citation requiring you to appear in court to show cause for your failure to comply with the law. A finding of contempt in this matter could subject you to additional penalties and/or incarceration by the O-phans' Court of Cumberland County. RETURNS SHOULD BE FILED AND CHECKS MADE PAYABLE TO: REGISTER OF ~'VILLS, AGENT Sincerely, Anastasia DiBarto.lomeo Direct any questions regarding this estate to: (717) 7 g 7 - 3 8 6 3 HARRISBURG DISTRICT UFFICE Cc: STRAWBERRY SQ JANE M ALEXANDER 4TH ~& WALNUT STS 148 S BALTIMORE ST HARRISBURG PA 17128-0101 DILLSBURG PA 17019 ~~~ ~ ~ i f 1 f 1' c Q. Q ~ O U a 1 1~ ^Dt] ~ , ~ ~ I ~.. oao d ,., I o ~! d ~ ~ ~ .~ o °` j N ~~- o , Q Ct- J W ~~ ~ s N ~~ ~ ~ ~ ~~~ 4 W s ~ ~ ~ z ~ ~ Q '~ ~ ~ z ~ M M __ _ `~' _ ~ a ~ 6 ~T .. .. ~± .. . ,<, ,- I N R E ESTATE IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA MARY C. HILL ORPHANS' COURT DIVISION DECEASED NO. ~ ~ ~~ ., ~a ~, ~ ~~ TERM ORDER Now, to wit this the j j ~~ day of ~~~ v ~ ~.~ ~ ~ ,upon consideration of the J foregoing Petition, it is ORDERED and DECREED that YOU, Donna J. Nelson, Executrix for the Estate of Mary C. Hill, deceased, are hereby cited to be and appear at Courtroom No. !/ , 1 ~~~'` on the : j~~~ day of ~'~~~t7~~'.'~-~,~t.in the Courthouse of Cumberland County, Pennsylvania, at ~~~~ G~~~' ~` .M., then anal there show cause, if any there be, why the Inheritance Tax return in said estate should not be filed; and to further direct that the cost of this action be borne by the said Executrix; sa~~id citation returnable at ~~-~~ ~~ ~~~-~ ~ ~ .M., on the .~~;~~~- d of ~~~ ~~ ~~~~-~~ ~Y ; , _.' _:.~ 2~~`~ ~; ,.~ g. 7 ~.. . 1 ..' '.._ ~A ~ ...~.- i ..; \~ BY THE CONURT $~_ ,. `~ it QRPHANS' COURT DIVISION COURT OF COMMON PLEAS OF In Re: MARY C. HILL CUMBERLAND COUNTY PENNSYLVANIA N0.21-03-052'8 CERTIFICATE OF SERVICE OF ORDER ORDER DATE: 08/11/09 JUDGE'S INITIALS: JWO TIME STAMP DATE: 08/12/09 1N RE: ORDER SERVICE TO: _A J NELSON, JANE M ALEXANDER ESO O G: ENVELOPES PROVIDED BY: ® USPS ®PETITIONER ^ RRR ^ JUDGE ^ HAND DELIVE D ^ CLERK OF ORPHANS COURT ^ OTHER MAILED: 0 / 3/09 SERVICE. TO: .. ANA T IB T 1vt~ rH~t~ r LNG: ENVELOPES PROVIDED BY: ® USPS ~ PETITIONER ^ RRR ^ JUDGE ^ HAND DELIVE D ^ CLERK OF ORPHANS COURT ^ OTHER MAILED: 0 /8 13109 De Cle of Orphans' Court w ~' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT DUPLICATE ALEXANDER JANE M 148 S BALTIMORE STREET DILLSBURG, PA 17019 REV-1162 EXI11-96) NO. CD 01 1928 ACN ASSESSMENT AMOUNT CONTROL NUMBER told ESTATE INFORMATION: SSN: 208-24-4532 FILE NUMBER: 2103-0528 DECEDENT NAME: HILL MARY C DATE OF PAYMENT: 10/30/2009 POSTMARK DATE: 10/30/2009 COUNTY: CUMBERLAND DATE OF DEATH: 06/16/2003 101 ~ 871 1.50 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 4019 5711.50 INITIALS: DM RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS 15056051047 REV-1500 EX (OS-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes Po sox 2sosol INHERITANCE TAX RETURN 2 1 0 3 ~~ 5 2 8 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 2 0 &y:2 4- 4 5 3 2 0'6 1 6 2 0 0 3 ~ ~` 0 6 I 9 3~ De~.edents La~~t NamF° Suffl?_ Decedents First game MI H I L L M A R Y C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name _ Suffix Spouses First Name MI Spouses Social Security Numher THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW O 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-92) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O s. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) beriveen 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHgULD BE DIRECTED TO: Name Daytime Telephone Number J A N E M A,L E X A N D E R 7 1 7 4 3 2 4 5 1 4 Firm Name (If Applicable) First line of address 1 4 8 S B A L T I M O R E S T R E E T Second line of address City or Post Office D I L L S B U R G State ZIP Code REGISTER OF WVILLS USE ONI!'1`~ c:_a .- .~ `..-- C7 ~ i7,~} 4..,# -- rri t.~ 1 _ ~_ , ..,{_~ ~ - . ~ r.~ nerR_ Fu i'q P A 1 7 0 1 9 C"Y ~' ~r+~ c ~ t .:1 r~ i~-1 _~.. _ ;;:7 -- ~,x. ~ _,: t Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATt1REOF PERSON RESPONSIBLE FOR FILING RETURN ~ ,~ DATE _ ADDRESS 843 Road, Wellslrille, PA. 17365 ci~~~nTi ioo nr o~coe aGa n7uFR TNAALQFPRARFNTATIVF ~ A DATE Side 1 15056051047 15056051047 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-03-0528 DECEDENT'S NAME )`'laT'y C~ ~~ STREET ADDRESS 1Z/+ WOOdS DI'1Ve clTV ,i~~ sTATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) - 0 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments - -- C. Discount - -- _ - - - - Total Credits (A + B + C) (2) _ - 0 3. InteresUPenalty if applicable D. Interest __ --- --- E. Penalty - - -- -- __ Total Interest/Penaliy (D + E) (3) _ o- 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) - 0 - 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) - 0 A. Enter the interest on the tax due. (5A) - 0 - B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) - 0 - Make Check Payable to: REGISTER OF WILLS, AGENT 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 :.......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ c. retain a reversionary interest; or .......................................................................................................................... ^ x d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ ^ 4. Did decedent own an lndividual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ x^ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART Of THE RETURN. 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 three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers #o or for the use of the surviving spouse is zero (O) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or four the use of a natural paren#, an adoptive pares#, or a stepparent of the child is zero (0) percen# 172 P.S. §911fi(a)(1.2)j. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-hal# (4.5) percent, 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 #ransfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)). Asibling isdefined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by bbod or adoption. 15056052048 REV-1500 EX Decedent's Social Security Number Decedent's Name: `~ 7 C Hi]1 2 0 8 2 4 4' 3 2 RECAPITULATION 1. Real estate (Schedule A) .......................................... ... 1. • 2. Stocks and Bonds (Schedule B) .................................... ... 2. • 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. • 4. Mortgages & Notes Receivable (Schedule D) .......................... ... 4. • 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ... 5 .. ... . 1 50 0 0 •0 8 6. Jointly Owned Property (Schedule F} O Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested..... ... 7. ]. 5' $ 1 1 , 1 6 8. Total Gross Assets (total Lines 1-7) ................................. ... 8. 3 0 8 1 1 2 4 9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9 . 6 0 8 5..• 8 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ... 10 .......... ... . 5 5 6 1 1 •5 1 11. Total Deductions (total Lines 9 & 10) ................................ ... 11. 6 1 6 '9 7 . 3 1 12. Net Value of Estate (Line 8 minus Line 11) ....................... 12 13. .... Charitable and Governmental BequestslSec 9113 Trusts for which ... . 0 . 0 0 an election to tax has not been made (Schedule J) ...................... .. 13. ': 14. Net Value Subject to Tax (Line 12 minus Line 13) ............ 14 .......... TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES .. . ~ ~ 8 1 1 ~ 1 6 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 _ 1 5 8 1 1' 1 6 16. 17. Amount of Line 14 taxable ~ 1 1 ~ 5 0 at sibling rate X .12 17. 18. Amount of Line 14 taxable ~' at collateral rate X .15 18 19. TAX DUE ....................................................... .. 19. 7 1 1• 5 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056052048 1505605204..8 O REV-1500 EX Page 3 File Number 21-0'3-0528 Decedent's Complete Address: DECEDENT'S NAME Macy C. Hill STREET ADDRESS 124 WOOd.4 ~~ - CITY ~'CI]ai11C,Sy,, _ _ _ - '~^+~6 sTATE PA zIP 155 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1} - 0 - 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + g + C) (2} - 0 - 3. InteresUPenalty if applicable D. Interest E. Penalty Total InteresUPenalty (D + E) (3) - a' 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) - 0 - 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) - 0 - A. Enter the interest on the tax due. (5A) -0- B. Enter the total of line 5 + 5A. This is the BALANCE DUE. (56) - 0 - Make Check Payable to: REGISTER OF WILLS, AGENT 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 :.......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ c. retain a reversionary interest; or ......................................................................................................................... ^ x d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary 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. 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 three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, 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 decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REY-150~IX • (1.9~ SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHRESIDENTDE~CEpENT~ PERSONAL PROPERTY ESTATE OF Mary C.H;11 FILE N~1528 Indude the proceeds of litigation and the date the proceeds were received by the estate. All property joi ntly-owned with the right of survivorehip must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Messiah V,11,ag~ wage payment 14.93 2 Erie ~~ 9.00 3 Erie Insurance 105.00 4 Mobile Dane - Oaicbrodc 1979 4,900.00 sold to Gary Potteiger & James Potteiger Oct 6, 2003 5 Agway Energy Products -credit balance refund 498:93 6 AT&T 6.15 7 1997 Oldsmobile - VIlV # - 1G3I,~i5?M6VF33456 4,000.00 sold to Joan Gmscost July 17, 2003 8 Fulta~t Bank savings account no. - 1370-58871 1,019.21 9 Fulton Bank classi-c checlang accotmt ~. -2519-23963 698.75 10. Prttdenti al Ins~>rance Policy N0. 602701930 No Beneficiary named, paid to estate 3,748.11 TOTAL (Also enter on line 5, Recapitulation) S 155,000.t~B (If more space is needed, insert additional sheets of the same size) I~ ~ ~ ~ ~ m `s: ~ .~ D m m -~ ,.~ ~ ~ ~ ^,. rt ~, G m ,,, _. a~ rlt © ~' ~ c~ ~zx ~ } . ~, ~. , ,~; ~, s tE. N "~" '~ rn _ _ ~,~y I O E O y D' D r S 0 V N O ~ ~ - i - - NOTICE OF PREMIUM REFUND DP1o4G 7.Ot rll ERIE INSURANCE GROUP DATE ~\ 100 Erie Ins. PI Erie. PA 165J0 E~® MO. DAY YR. 111E 10 13 I03 REFUND AMOUNT $ l OS , OO POLICY NUMBER Q54 1050120 H AGENT NO. AA7646 AGENT'S NAME FETROW INS ASSOC L REASON 1 REF. No. U657877 ~n~~~~nr~~~nn~~~r~~n~~nr~~ CHECK NO. 21657877 ESTATE OF MARY C HILL AA7646 124 WOOD DRIVE LOT ~~16-A MECHANICSBURG PA 17050 NON-NEGOTIABLE _ _. 1 ' Bank of America CustomerConnection 64-1278 Bank of America, N: A. . ERIEINStIRANCE GROUP- s~i ~~~~ Atlanta, Dgkalb County, Georgia F~\ too Erik Ins. PI • Erre, PA 16530 FRjE® DATE CHECK"N0. 21657877 MO. DAY YR. loI:l3loa, PAY ESTATE OF MARY C HILL HE 124 WOOD DRIVE LOT ~~16-A .ORDER MECHANICSBURG PA 17050 $105.00 Of ~~„~. ~.a~... .~idaca. nca~i. onm~e. coDE; EXACTL~~ D 00 CENTS R FoR N POLICY NUMBER AGENT REF. NO. -~ .~~ CHECK' 1^ Q54 1050120 H AA7646 U657877 ?remium Refund Due to - - - Code 1 • Policy Cancelled Code 2 • Poly Expved Cotle 3 • Premium Reduction ~~/-(~ ~ • ~%-r ~...~~ Code 4.OJerpayment AUTHORIZED SIGNATURE 11' 2 L65787711' 1:06 L 11 27881: 3 29 .999 65 1411' ---- ~-~-- _. .~ R,.,,~~~~ 7:324 CERTIFICATE OF TITLE TO A MOTOR VEHICLE OR TRAILER __ _ -.. _ issued in accordance with Section L I DS of theVehic[e Code, Title 7S, Pennsylvania Consolidated Statutes ~~~~i ~~rt ACCOUNT CONTROL NUMBER U 11 ~2Q7t34.12Q1Z2-5~ MARY C KIQBETANZ S EARL A HILL CODE LEGEND R Q O ~Q~ Z• 7C A=ANTIQUE VEHICLE CaRLISLE pA Zt7Q~3 C-CLASSIC VEHICLE E=ELECTRI[ VENici c LIEN HOLDER BY w AUTHORIZED REPRESENTATIVE ~~ '~ IcertifythatreasonablediligencehasbeenusedinexaminingthestatementspresentedintheapplicationforCer- tificate of Title to the vehicle described hereon, and that the proof of ownership of -said uehide presented with said ap Iication warrants the issuance of this certificate naming the applicane as fauifu[ owner of said vehicle. Wherefore,Icertifychatasofthedateinscribedhereon,theoffi- ~ , -'> ,tYY ,,, ,, .o~ cial records of the Pennsylvania Departmentof Transportation ,>_,i ~% ~^ ^ ^ ^ ^ ^ ^ ^ effect that said applicant is the lawful owner of said vehicle. y, """ +~ -~.. ~~~~ ~rnr,^n SECOND LIEN FAVOR OF: LIEN RELEASED DATE UARDIAN ®SAFETV ~OC'kxAe An.erimn BA O MoD I. ~ ® ~m ~ ~ O _ ~ T ~ d~~ ~ ro° a~ z p o J~J/ ~ mN DL7< A ti ~ 171 ~ ~ o Z ~ O gal .: 1~ 7D < HOC p ~ m O~~ ~~ -~ w , ~ma _- r ~ c m ~ Z ~- m~a o ^~ 3 ~ ~ ,' ~ w .: - ~ ~I O ~ I~i O ? i°i ~, I w i~ ru D ~ ° I°I to ~ m _~ ~~i 1 ffl ~ CT1 O 0 '~ ~ N ~ ~, ~, ,~ y~~ A- 3 # - `~ s .._ ~_~ - Agway Energy Products, LCC, P.O. Box 4824 Syracuse, NY 13221-4824 (315) 449-7015 VENDOR NO.: 219099 G$2-:i~~6~1 .SUPPLIER'S 1N VOICE - - - - NUMBER LOCATION DATE - ~ DISCOUNT ~ AMOUNT PAID 028087820079176 CARLISLE PLANT 20 10-SEP-03 CREDIT BALANCE REFUND 498.93 TOTAL /P-i0 si98 DETACH AND SAVE -THIS IS YOUR RECORD AGWAY Agway Energy Products, LLC JPMorgan Chase Bank P:O. BoX 4824, Syracuse, NY 1 322 1-4824 Svrac~sa NY -a3zoz (315) 449-7015 CHECK DATE VENDOR NUMBER 12-SEP-03 219099 Four hundred ninety eight and 93/100 Dollars TO THE MARY C HILL ESTATE 0280878200 ORDER OF ~° ATTY JANE M ALEXANDER P O BOX 421 DILLSBURG, PA 17019 UNITED STATES 498.93 50-937 082-39266.1 273 VOID AFTER 90 DAYS AMOUNT Iii Treasurer, Agway Energy Products LLC P"' ,;~, II'08 2~~r 39 266 L11' ':O 2 1 309 3 79~: 60 ~ 8 60 26 511• -.._ _. ~~i~~ ~..::. ~_:a..i~'iL ~4rG':~~:YS-E:~C ~~l?1~ ~.vl •Y..b""1 •f • . l $ ). f 4_.•. zf ~, , T y z {.y§isSte cdti'~~r"~iY~3ss~C1U.mu~:~5-5~ ~r ~k;~~L~~,•7, ~....a,•.~3~4 L.°_?.'.~'~ r~ ~f=~ ^w!.~°'~ ~I ~v..i?a 1_,::':' ~ .,: ~- A7l~T AT&T Consumer Lease Services SIX AND 15/100 **~****.*..**..*,*****#*..**..*....*,*...***.# PAY TO THE ORDER OF: 618416 0814005937700 M C HILL C/O DONNA NELSON 124 WOODS DR LOT 16A MECHANICSBURG PA 17055 Authorized Signature 11'00598?5711' i:02L309379~:60183306411' V .__. . OFFICE ACCOUNT NUMBER CUSTOMER NAME 618416 0814005937700 M C HILL The Chase Manhattan Bank Payable 50-937 Syracuse NY Check No. Mo.Dy.Yr 213 Account Number 601833064 00598757 08/21/03 NORTH STREET CONSUMER PHONE SERVICES LLC USD ***•****- CASH THIS CHECK WITHIN 180 DAYS Authorized Signature ~-~~ ~ ~ Authorized Signature 082103 963 -CLOSED BILL REFUND A7i~T AT&T Consumer Lease Services CHECK NO. DATE CHECK AMT. FOR INQUIRIES CALL SYSTEM 00598757 08/21 /03 6.15 (800) 555-8111 AT&T CONSUMER LEASE SERVICES ,^ 2834657 8~'•~~ A PA TRIE NUMBER (AS SHOWN ON ATTACHED TITLE) MAKE OF VEHICLE MODEL YEAR PURCHASE . c W k"b ~ ~ ~ ~ ~ • f . PRICE (See note on reverse) D d (~^OO • ENTIFICATION NUMBER J. VEHICLE ID COND ION LESS g r (J"J ~ ~ ^ GOOD ^ FAIR ^ POOR TRADE-IN ^ ^ B. LAST NAME (OR FULL BUSINESS NAME) FIRST NAME MIDDLE INITAL TAXABLE ~ ~ ; I ~ AMOUNT ~ ^00 CO-SELLEq 1. Sales Tax Due x 6% (.06) or x 7% 1.07) see note on reverse). ~ ^DU • C LAST NAME (OR FULL BUSINESS NAME) FlRST NAME MIDDLE INITIAL DATE ACQUIRED/ 1A E mpfion s ' y , 1 rDS ~ (3S L. V !~C PURCHASE~7D - ~ /J ~~~ ~ f e aeon b to 23 or 0) ~jr< 3 CO-PURCHASER 18 Firot AseignrtreRl 18 Second Assignment ' ` STREET COUNTY CODE ~ l b '7 ~lu~ ~ ~~ Sc a 2. Title Fee ^ CITY STATE ZIP CODE REFER TO COUNTY CODES ~n ~ ~ ~ ,.~ LISTING ON REVERSE SIDE 3. Lien Fee OF PINK COPY ^ ^ p LAST NAME (OR FULL BUSINESS NAME) FIRST NAME MIDDLE INITIAL DATE ACQUIRED/ q qe istration or g PURCHASED Processing Fee ^ • CO-PURCHASER Fee Exempt Number ~ ea esaigrtrlLl by the _ Bureau ~ STREET COUNTY CODE 5. Duplicate Reg. F^e c ~` No. of Cards ^ ^ z ~ = CITY STATE ZIP CODE REFER TO COUNTY CODES ^ LISTING ON REVERSE SIDE 6. Transfer Fee OF PINK COPY ~ ^ ~ • E. MAKE OF VEHICLE VEHICLE IDENTIFICATION NUMBER 7. Increase Fee ul o ^ • T ~ MODEL YEAR BODY TYPE (CP, TK, ETC.) CONDI ION t R ~ ^ ^ ^ eplacemen 8. Fee POOR GOOD FAIR ^ ^ F. ORIGINAL PLATE / Check One TRANSFER OF PREVIOUSLY ISSUED PLATE TOTAL PAID g. ' 10. ^ PLATE TO BE ISSUED BY ^ TRANSFER 8 RENEWAL OF PLATE (Add 1 thru 8) ^ D ^ BUREAU (PROOF OF IN- ^ TRANSFER & REPLACEMENT OF PLATE Send One SURANCE MUST BE AT- ~ ^ 11.GRAND TOTAL Check in TACHED.) TRANSFER OF PLATE 8 REPLACEMENT OF STICKER (Add 9 8 10) This Anqunt y ^ EXCHANGE PLATE TO BE ISSUED BY BUREAU R PLATE NO. EASON FOR REPLACEMENT ^LOST ^ DEFACED ^ STOLEN a ~ TEMPORARY PLATE EXPIRES ~ NEVER RECEIVED (LOST W MNLI u ISSUED BY FULL AGENT Month Year (, NOTE: If "NEVER RECEIVED" bock is checked a licant must c to Form MV-aa. TRANSFERRED FROM TITLE NO VIN . I // ~ ~ / OS SI G RE NGN ~ PBE S N HE E RELATIO SHI TO APPL CANT TEMP. PLATE NO ~ W ~ ~~ IS I FERRED (IF OTHER THAN APPLICANT) T. VEHICLE PURCHASED GVWR UNLADEN WEIGHT RE EG. GROSS WT. R EG. GROSS COMB. WEIGHT INFO. INCL DING LOAD IF APPLICABLE) IF APPL1CABt~ INSURANCE PAN NAME A O ~H E pOTICY EFFECTI D UCY EXPIRATION ~ ` T T ( ISSUING I CERTIFY THAT ON MONTH ~ DAY~~' _ YEAR I SUING AGENT (PRINT N E) AGENT NO. AGENT I HAVE CHECKED TO DETERMINE TH T THE VEHICLE IS INSURED AND INFOR- ISSUED TEMPORARY REGISTRATION TO THE ABOVE APPLICANT, IN S N SIG U E TELEPHONE NO. MAT10N COMPLIANCE WITH ALL APPLICABLE PROVISIONS OF THE VEHICLE CODE AND DEPARTMENT REGULATIONS. ) G I/WE CERTIFY THA I/WE HAVE EXAMINED AND SIGNED THIS FORM AFTER ITS COMP NAND THAT THE INFORMATION GIVEN IS TRU C RRECT. IF AN EXEMPTION . IS CLAIMED, THE CHASER FURTHER CERTIFIES THAT HE/SHE IS AUTHORIZED TO CLAIM THIS EXEMPTION. I/WE ACKNOWLEDGE THAT / E MAY LOSE MY/OUR OPERATING PRMLEGE(S) OR HICLE REGISTRATION(S) FOR FAILURE TO MAINTAIN FINANCIAL RESPONSIBILITY ON THE CURRENTLY REGIST RED VEHICLE FOR THE PERIOD OF REGISTRATION. I/ ACKNOWLEDGE THAT I/WE MAY BE ECT TO A FINE NOT EXCEEDING $5,000 AND IMPRISONMENT OF NOT MORE THAN TWO YEARS FOR ANY FALSE STATEME 7 I/ MAKE ON ORM. Signs re of Fi t rc ut ized Sig TELEPHONE NUMBER Signature of Seller SS T ~7 > z 9 ~-- i J 33 ,L NT re of Co-Punch of ulhorized Sig na Co-Seller x v u Sig ure of Second Purchaser or Authorized Signer TELEPHONE NUMBER Signature of Seller 2N ASSIGN ( ) - MENT .•Signature of Co-Purchaser/Title of Authorized Sgrler Signature of Co-Seller H. NOTE: It a co-purchaser other than your spouse is listed and you want the title to be listed as "Joint Tenants With ~ Right of Survivorship" (On death of one owner, title goes to surviving owner.) CHECK HERE ^. Otherwise, the title o~~ will be issued as "Tenants in Common" (On death of one owner, interest of deceased owner goes to his/her heirs or estate). NOTE: IF THE VEHICLE IS TO BE USED AS A DAILY RENTAL OR LEASED VEHICLE, CHECX THIS BLOCK ^ . IF BLOCK I5 CHECKED, COMPLETE AND ATTACH FORM MV-IL. MESSENGER NUMBER: r Fulton Banl~ -- Capital Division Drovers Bank Division Great Valley Division ---- Lancaster/Chester Division MARY C HILL 124 WOODS DR LOT 16A MECHANICSBURG PA 17U50-2790 STATEMENT SAVINGS ACCOUNT: 1370-58871 PREViOIIS DEPOSITS/ WITHDRAWALS/ INTEREST STATEMENT_BALANCE..CREDITS _1 DEBITS`. 1 PAID ENDING 1,019..2.1 .04 1,019.86 BALANCE .61 .00 INTEREST PAID THIS 'YEAR °ACCOUNT/INTEREST INFORMATION _1.49 DATE ACTIVITY DESCRIPTION REFERENCE DEPOSITS/ WITHDRAWALS/ CREDITS DEBITS BALANCE 06-26 BEGINNING BALANCE 06-30 INTEREST CREDIT 61 1,019.21 07-11 MISCELLANEOUS DEBIT 02671000790 07-15 MISCELLANEOUS CREDIT . 41,019.86 1,019.82 04- 07-27 ENDING $ALANCE .0 . .00 .00 *** ANNIIAL PERCENTAGE YIELD EARNED DISCLOSURE FROM 6-26=03 THROUGH ANNUAL PERCENTAGE YIELD EARNED 7-27-03 *** AVERAGE DAILY COLLECTED BALANCE INTEREST EARNED 804.96X .02 SERVICE FEE BALANCE INFORMATION FROM 6-0 AVERAGE LEDGER BALANCE 1-03 THROIIGH 6-30-03 1,019.21 MINIMUM LEDGER BALANCE 1,019.21 AVERAGE COLLECTED BALANCE MINIMUM COLLECTED BALANCE 2 1,019. 1 NEED A LOAN? FULTON BANK HAS VERY, VERY ATTRACTIVE RATES AND TERMS. YOU CAN APPLY FOR THE ANYTHING LOAN ONLINE AT F[JLTONBANK.COM, BY PHONE AT 1-800-FULTON4, OR ANY BRANCH LOCATION. WE HAVE FLEXIBLE TERMS TO MEET YOUR BUDGET. s DIRECT FULTON BANK INQUIRIES T0: CAPITAL DIVISION ,,,,,T Tn*r~,~,. _ DIRECT BANKING CENTER -i-o.3 STATEMENT OF ACCOUNTS 1370-58871 STATEMENT PERIOD FROM THROUGH 6-26-03 7-27-03 PAGE 1 OF 1 0 ENCLOSURES X 7 0 Member F.D.I.C. -nrww.fultonbank. com Fulton Banl~ Capita! Division STATEMENT OF ACCOUNTS Drovers Bank Division Great Valley Division 2519-23963 Lancaster/Chester Division STATEMENT PERIOD FROM THROUGH 6-26-03 7-27-03 MARY C HILL PAGE 1 OF 1 124 WOODS DR LOT 16A MECHANICSBURG PA 17050-2790 1 ENCLOSURES FULTON CLASSIC CHECKING PREVIOIIS DEPOSITS/ CHECKS ACCOUNT: 2519-23963 STATEMENT BALANCE CREDITS 1 DEBITS/ SERVICE ENDING b98.75 198.57 897.32 FEES BALANCE .00 .00 (INTEREST PAID THIS YE,~ ACCOUNT/INTEREST INFORMATION .27 DATE ACTIVITY DESCRIPTION REFERENCE DEPOSITS/ CHECKS/ 06-26 BEGINNING BALANCE CREDITS DEBITS BALANCE 07-01 HIGHMARR RETIREM 00077900000 PENS-PMTS JUL 03 198.57 698.75 208244532 07-02 MELLON-RECLAIM 00077900000 208 24 4532: 198 57 897.32 07-11 07-27 MISCELLANEOUS DEBIT 02671103170 ENDING BALANCE . 698.75 698-"75 :00 .00 NEED A LOAN? FULTON-BANK HAS AND TERMS. YOU CAN .APPLY FOR VERY, VERY THE ANYTHI ATTRACTIVE RATES OCATION~~~M'HAVEPHFOIMEEXIBLE NG N4' I ~~~T LOAN .ONLINE. AT OR ANY BRANCH O MEET YOUR BUDGET. DIRECT FIILTON BANK INQUIRIES T0: CAPITAL DIVISION DIRECT BANKING CENTER /-a3 X 0 0 Member F.D.I.C. WWw fi 1~}Aa{1n ..L .._~ --"-.. _.... .. .vvn~ ~~ Prudential The Prudential ' Insurance Company ~ Financial of America W JAOD J Benefit Insured DEATH M HILL Policy Numbers 602701930 Addressee JANE M ALEXANDER, ATTORNEY PO BOX 421 DILLSBURG, PA 17019-0421 Statement of Benefit Check no. MAR-11-2004 0039549 01t Letters Check amount Certificate no. Certificate amount $3,748.11 Claim Number J I D822604 Payee DONNA J NELSON EXECUTRIX FOR THE* ESTATE OF MARY C HILL* INCLUDED AMOUNTS $3,680.52 AMOUNT OF INSURANCE (INCLUDING PAID UP ADDITIGNAL INSURANCE} 67.59 POLICY OR CONTRACT INTEREST $3,748.11 AMOUNT OF PAYMENT Instructions for Payee on reverse of this form. Please see paragraph(s) 1. Comb 34771 A DBJH01 REV-sD Ex .hail SCHEDULE G COMMONWEALTH OF PENNSYLVANIA INTER-VIVOS TRANSFERS & INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF MARY C. ~~ FILE NUMBER 21-03-0528 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY °~ OF ITEM ,HCLUDE THE NAME OF THE T An~E~~~ ~q~g.Ep E D F RTREAL ESDTATE µ0 THE DATE OF TRANSFER DATE OF DEATH 1MBER DECD'S EXCLUSION TAXABLE VALUE VALUE OF ASSET INTEREST ,FAPPIJCABLE 1. MARY C. HII~. -IRA- Fultz Rarilc Accamt No.- 390--1922039 15,811.16 100 15,811.16 TOTAL (Also enter on line 7, Recapitulation) $ (If more space is needed, insert additional sheets of the cams ci~o1 15,811.16 A DistributiorForm Traditiona]~Zoth, andSIMPLE IRAs IRA OWNER INFORMATION C' l'` NAMEANDADDRESS IRAACCOUNTIJUMB~ERq ~r ~~ ~/ ~ TYPE OF IRA(cheticone): ~aditional 1r1i' ~;` " ~ l ^ n ~ Ui 1,~ SOCL4LSECURriYNUMBER(SSN) 1 SI UU(( ~ E - , ~ ATEOF EA H D IMEP ~c~~ HONE NUMBER E-MAIL MPLE 1 Roth (OPTIONAL) ~. -I - r 9~~- "~ DISTRIBLJTIOI~REASON For further information, see AdditionalInformationincludedwith this f Check One. "` "`~ 1 Premature,no khownexception 1 Correctionof Excess ContributiolforTax Year 1 Premature,exceptionapplies(includesIRS Levy) 1 in sameyear as excess contribution 1 ability 1 in year after excess contributionbutby mytax-filingduedate, including Death extensions 1 ProhibitedTransaction 1 after my tax-filingduedate, includingextensions 1 Revocation Amounlof excess $ 1 Normal Eamingsattributabl~o excess $ 1 Transfer 1 Recharacterization: 1 to my IRA 1 prior tax year regularcontribution/conversidn the currentyear 1 to spouse's IRA due to death(if sole beneficiary) 1 currenttax year regularcontribution/coriversi~ the currentyear 1 to ex-spouse's IRA due todivorceoriegal 1 Direct RolIovertoanEligibleRetirementPlan(notapplicabletoRothIRAs) separation I SIMPLE IRA Distributio»DuringTwo-Year Period(if youngerthanage 59'/z) RecipientInformation(Completefor IRS Levy, Death, Transfer, Recharacterization,andDhect Rollover transactions.) NAMEANDADDRESS ofviv# ~' /t>~/5 ~ ~ ~3 ~ w~~~s~~ ~~~ ~ _ ~ l ~r ~ ! i 7 3 TAXPAYER IDENTIflGTIONVUMBER(TIN)/SSN(IFAPPLIGBLE) IRA ACCOUNTNUMBER(IFAPPLIGBLE) DAYCIMEPHONENUMBER ~" a' ~ 3 v 3 PAYMENT INSTRUCTIONS A. PAYMENTELEC170N HOD ~ C. PAYMENT DETAIL (con/p)eteAby/iaaxcialorgmiiza Non) I electdistribution~ be paidin the followingnannel{selectone): Mail check to me. AmountRequested $ -- PenaltiesCharged (_) iat (1)1 ImmedJ eDist/r~ution (2) 1 Depositedinto my account at Administrativ~ees ( ) ~ / Of $ /~ / ~ /-t/ ~'(J /~~ this flnanClalOrpaniZation. Subtotal(amountsubjectto withholding) $ Accou ~meTax Withheld (-) (2)1 Periodic Distribution I authorizeautomatio3i t ib ti 1 GP ~ j ~ ~ / ieTax Withheld (-) A I J ( (~'~ r s u on.ten a I ccou I Nithheld (_) 1 monthly 1 annual ttPaid $ 1 quarterly 1 other basis, startingon ~ L (3) 1 Other ~ T ~ ~ aidto datenotalreadyreportedo IRA ContinueperiodicdistributionslntilI notifyyou in writingotherwise. ~~y ` / ~tiorprovider(optional).$ ~ ! f ~ -~ y iistributiorclose the IRA? Yes No I (3)1 Other Date of Distribution WITHHOLDIN~LECTION(lvot Applicable to RoTxIRAs) InstructionSoFormW-4P(Withholdingertificate~reincludedntheAdditionallnformatioaectionof thisform. Formal-4P DepartmenaE theTreasury elect not to have Federal income tax withheldfrom my IRA distribution. [nrernaRevenu6ervice I elect to have l0 percentFederal incometax withheldfrom my IRA distribution. OMB No.1545-0415 I wantthefollowingadditionaldollaramount($ ), or additionalpercentage( %) withheldfromeach IRA payment. SIGNATURES I ce thatI am the IRA owner, the beneficiary, or individualegallyy authorizedto completethisform. Icertify the accuracyy of the information set for in this form, and I authorizethis transaction. I understandthe custodian/ trusteatay reqquire the completionof addihonaldocuments before processingany distributionsI understandthatI am responsiblefor any consequencesresultingfrom this distribuHorincludingtaxes and pe owed.I Indemnifyandholdthecustodian/ trustdaarmlessfromany resultinQllabilities.I acknowle atthe custodian/ trusttrmnnot ovidari withlegaladvice,andI agreeto consultwitha tax or legalprofessiona[or guI nce. ®X Ignatureof IRA ner/Beneficiary Date ® i tureof Cust dian/Trustee Date c _ 1998 BankerSystemsJnc.,St. CloudMN FormiRACMBDISLAZRev[3,11)ir329~U rg (E,ag~ ) of 2) M C~ mI "' "'" `~: O .~ ~` ~" QC 00 ~` ~ ~~ ~ _y O .-I 00 M " o g b' N .- ~ r-1 Y w `;r ~ V} ,a -k ,k N ~ _`~ * Cp :. ~ • o ~ Rf ° ~ 5 ~ ' `~ _ • AQ a ~~ * :S~ ,{.F ,cS. z _ t~ ~:r' •~ ~o ~~ > pQ ~; Y:~-v , z .;~ , >~ Q~ a .~o U a A a a H x /° s ti; a ~-- '! 3 < .. ;:~ ~ La. F ~ ~ ~ •W ~ z Z:~ = W pO 4 cn ',Q V ,.V Q' a Q' 0 0 D ~' ,~ ti J r n n rl _ I ~ _ r r C r C C } ~ a Qo" t-FQo 0 REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~[~T~Tr A SCHEDULE N FUNERAL EXPENSES ~ ; ADMINISTRATIVE COSTS V VI ~ `.!• 1LLJ1 ITEM IUMBER A• FUNERAL EXPENSES: t . Ne; l l Funeral Home - Cattp HT11 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s)_~ Nalgrvi Social Security Number(s)/EIN Number of Personal Representative(s) XIIX - XX - 7549 Street Address R`iC~ 11 ciri 11 @ Rd City Wellsville State PA Zip 17365 Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills -Short Certificate 5. Accountant's Fees 6. Tax Retum Preparer's Fees ~~ Reserved for filing First and Final 4,110.80 750.00 1,000.00 59.00 6.00 30.00 130.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) FILE NUMBER 21-03-0528 Debts of decedent must be reported on Schedule I. `~ ~ U~ NEILL FUNERAL HOME-CAMP HILL 3401 MARKET STREET CAMP HILL, PA A Phone:800-638-7239 SEPTEMBER 3, 2003 Donna Nelson 834 Wellsville Road Wellsville, PA 17365 Dear Mrs. Donna Nelson: This letter is a friendly reminder that your account remains open. It may be that circumstances have occurred which have either caused you to forget to mail your payment or the account may merely have been overlooked. Please mail your check or money order for $4,110.80 today. If your payment has been mailed or paid at the funeral home after the date of this letter, please disregard this reminder. Thank you, Account Advisor Customer Finance Department (ref: 3043-1002120-DFF) ~° ~-''~ Li54 E% • (1-97~ ~; SCHEDULE I COMMONWEALTHQFPENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT STATE OF C• H17.1 FILE NUMBER 21-03-0528 Include unreimbursed medical expenses. ITEM DUMBER DESCRIPTION ~. AT&T -debt of decedent 2 PP&L -debt of decedent 28.45 3 B~efic;al -debt of decedent 111.97 4 Fleet Credi-t Card -debt of decedent 4,497.52 3,241.62 5 Lame Bryant -debt of decedent 6 ~~ dal-i~.rt Card -debt of decedent 191.72 7 Discover F' 11,594.35 ~narrial -debt of decedent 8 Area I`~il 0~~ Co• -debt of decedent 8,703.43 9 ~~.~ -debt of decedent 394.21 10 Chniun Financier -debt of decedent 66.67 11 School Real Estate -debt of decedent 3,442.65 12 H~ United Bank -debt of decedent 64.38 AccoTmt No. 00000405471 23,267.54 I"bbile Ilome Loan AMOUNT -- TOTAL (Also enter on line f0, Recapitulation) g 55,611.51 (I(more space is needed, i-~ nsert add;tional sheets of the same size) ,_, Your AT~T Statement Tune l5-July 14, 2003 aBWNCJFM a09180198887011a D 0000764FP10.352B6A09879 ~n~~~~u~~~~nnn~~~~~nn~i~~ M C HILL 148 BALTIMORE ST DILLSBURG PA 17019 Customer ID: 717 697-8557 Page 1 of 5 Customer Service: 1 800 222-0300 Text Phone (TTY): 1 800 833-3232 Internet Address: www.att.com SDAY ' = Extlral Exttral Previous balance ............. ............................. ................. .........19.06 Whatever service you want, Payments ............................................. ........... ................ ...........0.00 whatever service you're in. UNPAID BALANCE DUE UPON RECEIPT ................ ...... $19.06 Whatever branch of the service AT&T AnyHour Saver Plane calls ................ .... ..p 4 2 38 you're in AT&T has calling Plans AT&T direct dialed calls ................................. . .. .......p 4 .. .......... . .......... 5.25 that tit your needs. Other charges and credits ............................. .......p 5 .. ..........0.62 Taxes and surcharges ................................... .......p 5 .. ..........1.14 Current charges due Jul 28, 2003 .............. .........................$9.39 '~ .~ Total amount due $28:~~~. i We did not receive full payment of your previous balance. You will be charged a late payment fee of up to 1.5% on any future unpaid balance. 100000() ,ANCE i lent in fiill. ~llect this balance. or any portion thereof, s notice, this office will fication. If you request address of the original municaiion from a debt Continues on back ~l oian~c $ 28.45 i~~~r~ n ~~~r~~~~ "~ ~~~ S IN C. -~~.- Continues on back ~l 457 NC030a 2498 -~~'i I PPL Etettric Utilities Electric service , :or AARY H[LL WOOD DR; 1;T76A AGCftANICSBURG PA 17(15(1. i i ~ ~.~.:.:.;: ,- Page 1. -_ ~:•-. s326o 7soo~ •' ~' wl. ~... Summary Page Balance as of Aug 7, 2003 Char es:, Tota~PL ELECTRIC U11LI11ES Charges Total (:Barges $ 79.87 ~ '~? 1(1 a ii~.yi Zuestiuns about- hlsbill.? Please ~. ~obt5cftis b.' ?u'g'28 d 1-800=3'12=5775 or ~~~~' t$4-634-~90U r~~" ~rj. '1 -r vvrrte ta: 3tstomer Seiwice ~ I27 Hausman Rd. Xllentown, PA t8I04-9392 vww.pplweb.com Electric >wH -Average Per Day Meter Reading Information Use - ('his graph shows 20 lour electnc use 16 wer the -ast 13 nonths. 12 Cyypes of 1Reter Readin s: g g actual ® 4 3stimated t ' 4 0 eter 770 2 i Aug 7 Actual 977 Jul 9 Actual 688 j '9 Da s IiW~illed -~ Average -Aug 2002 2003 j Tempperature 78F 74F i IiWH Per Day 23 10 Yearly Use: 'Cola! Average Use Monthly Sep 2001 -Aug 2003 6311 526 ~ Sep 2002 -Aug 2003 5646 471 ; ..us omen Q A S O ND J FMAM J J A 2002 Months 2003 Other intporlunt information on back ~ Return this part to address below with a check payable to PYL Electric Utilities Corporation _.. B' :: ~ f`' ;Na s. a p 53260-75008 Aug 2b, 20(.)3 $ 111.97 Amount Enclosed ...~~,,,.,,~.,,.~.~,~~..,.,,.~~.,,~~.~...~,,.,,,,.,.~..,~.~., ^ ^ a. ^ ^ o. a ^ MARY HILL PPL ELECTRIC [I"['ILITIFsS 124 WOOD DR, LT16A 2 NORTH 9TI1 STREET RPC-GENN1 MECHANICSBUR6 PA 17050 -2796 ALLENTOWN PA 18101-117s 1 6700001119770000111975 5326075008 )~ 5 ~' I Lt r! j 1 -~~-~~~. ~-ly~a3 PO 110X D633 ""' ""' rv •v, •C'~'• ELMHURST IL 60126 A TRADITION OF CARING. Statement Of Your AccOUnt A COMMITMENT TO YOU. Payrttent Account Number New Baiance Closfny Data Payment Due Date Minimum Amount Dua Coupon 711714„00-551552-9 4,497.52 OS-042003 OS-26-2003 401.84 ooeuolrena ~nr~~~ur~~~ntr~r~r~~uur~r~~ruf~rln~~nn~~nru~~rr~r~~ Mail Payment To: MARY C HILL ~~~r~r~~~u~~~u~r~~u~r~~~n~~n~~~~r~~r~~u~r~~~ur~~~~~n~~ 124 WOODS DR APT le;A MECHANICSBUR PA 17050-2790 BENEFICIAL POST OFFICE BOX 4153-K CAROL STREAM IL 60197-4153 ~r~~u~~unu~~~r~n~nr~r~n~ur~~r~r~ur~~n~n~~ 0 10004018471177140055155290004497527 FOR ASSISTANCE: gCCOUNT SUMMARY 800-395-4576 Account Number Cleslny Data Payment Due Dab Standard Psyment Amount Past Due Minimum Amount Dua r•11714-00-551552-9 08-04-2003 08-26-2003.. - 132.28 269.56 401.84 Account Detail Since Last Statement Date Tnnssdion Descri lion Intensl and Amount Applied • p Amount Other Charyas To Balance "New Balance 17-18-2003 Starting Baiance 4,497.52 To evaluate and maintain the quality of our service to you, you permit us to listen to and/or record telephone calls between you and our representative. YOUR ACCOUNT IS NOW SERIOUSLY OVERDUE. WE EXPECT YOU TO PAY THE AMOUNT PAST DUE IMMEDIATELY. TO ENSURE PROPEF~ AND PROMPT CREDIT IS APPLIED TO YOUR ACCOUNT, ALWAYS RETURN THE TOP PORTION OF YOUR BILLING STATEMENT WITH YOUR PAYMENT. IF YOUR NAME OR ADDRESS APPEARS INCORRECT, PLEASE LET US KNOW. WE TAKE PRIDE IN ADDRESSING OUR CUSTOMERS PROPERLY. Sign up today for convenience and speed) Log on to BEiJEFICIAL.COM to manage your account and make payments online. BENEFICIALCOM -help is always in site. ' ' 'DELINQUENCY CHARGES ACCRUE AFTER 10 DAYS ' ' ' Page 1 of 1 our Payoff amount may differ from your balance as shown on This statement. If you would like to determine your payoff balance or If ydu ve questions on this Dillinq, please call Customer SeMce at 800-395.1578. /Wdnss written inquiries and all nonpayment correspondence Benancial Customer Ssrvice, PO 80X 8633, ELMHURST IL 80128. Mail paymanl to: BENEFICIAL, POST OFFICE BOX 1153-K, CAROL REAM IL 60197. MT720C (07/03) ~~ Fleet Account Number 4305 5000 1724 9783 7-30 'p PO Box 17192 '- w~imi~yloo, oe IJew Balance $3,241.62 Amount 19e50-7192 --- -_.--_-- -_- ._ Enclosea Minimum Payment $275.84 t?ue Date AUG. 20, 2003 Fa account information calf: Customer Service at 1-800-492-2500 or fog on to http:i/mycard.tleet.com • For change of address please use Corm on back. • Make cfieck payable to Fleet Credit Card Services. FLEET CREDIT CARD SERVICE MARY C HILL sazzs PO BOX 15368 124 WOODS DR WILMINGTON DE 19886-5368 16A ME++CHANICSBURG PA 17050-2790 tn~~~r~lt~n~t~n~u~~nr~r~nr~~u~~n~rr~n~~n~u~nr~t~~ ~nrl~~nr~~~nn~r~t~~ttnt~r~~nf~~r~n~~urr~~nnt~~n~r~~ 430550D017249783 D324162 0027584 Detach at pertoration end return form above with payment N ACCOUNT SUMMARY FOR 7 - ~d - a 3 MARY CHILL -. 4305 50001724 9783. ~~ FIE'C't ~11S~/ItAd118flf3ge Account Number: PAYMENT INFORMATION Amount Past Due $138,92 Minlmum Payment Thls Period $136.92 !. Amount Over Credit Llmit $0.00 i~TAL MINIMUM Pl~FYMENT DUE " $275.84 `Dt1E D~ITE AUG. 20, 2003 A portico of your minimum payment due is your Fixed Payment Option amount of $237.84 Total Credit Limit: $10,000.00 Available Credit: $6,758.38 Previoas;Balahce : $3,182.66 payments & Credits ` 0.00 Purchases/Balance Transfers! !CashAAvances ' + 0.00 Debtt Adjustments t 29.00 Finance Charges/Fees t 29,96 tJEW BALANCE $3,241.62 Cash Advance Limit: $3,000.00 Billing Cycle Closing Date: 07/24/03 Cash Advance Available: $1,996.00 Days In Billing Cycle: 30 ~jt~ Pleat is well positioned as the fvlancial setz~ices company that can deliver the ~ solutions, senrice and guidance that you want, and need. ~tle have the largest ATM Important anti branc)1 networkvt the Noitheast~ ~rith~more Than i;Es00~tirttrciies and :;,~tlU ~ US ATMs. Collie alto any Pleat location and Fuld out all that Pleat has to offer. For a branch near your home or office, access Fleet.rnm or call 1-300-CALL-FLEET. A RECORD OF vn1IR rWeur_rc earn ~o~.,~~ Tra ti P nsac on osbhg Reference Date Date Nwnber Transaction Descripfion Credits Charges 0722 07122 LATE FEE 0724 0724 'FlNANCE CHARGE' PURCHASES 526.65 CASH ADVANCE 63 31 29.00 . 29 96 For information on your account or to reach Fleet's Customer Service: ;S UB TOTAL 1-800.492.2500 . ,':58.96 ; http:l/mycard.fleet com CREDITS O.OD . PO BO% 15480 WILMINGTON DE 19850-5480 P11EVtOU5 BALANCE <~NEW $ALANCE +3,182.66' ! $3,241;62 Average Nominal ; Deity :FINANCE CiHARGE Dally Balance ! Annual Percentage Rate :Periodic !: Rate Oue to Daily Periodic Rate trahsactlon Foes PURCHASES INSTANT ADVANTAGE CASH ADVANCES CASH PROMOTION $O.OD $2,163.91 $DAD $1,033.1.9 14.99°1° 14.99% '19.80°~ 3:909'° ,D41D63'° .04106% .D5424°~ .0106896 .!'$0.00 $26.65 I'$0.00 '! -$3.31 '! $0.00 $OAO I$O.OD ~p.Op ANNUAL PERCENTAGE RATE for purchases and balance transfers (includes arty finance eharge fees]: 14.990°~6 Lane Bryant Gift Certificates Breeze through summer in our Send a friend or relative a Thegift that always fits. cool Venezia® stretch bra top or FREE Lane Bryant Catalog. Available i-t any amount in bra tank. Each with built-in bra $5.00 increments. To order call and in an array of colors! Call 1-800-298-2000 1-800-248-2000. From $12.99! Ask for Operator #9 or visit us at TLS_ • ^^^^~ ^vwnur 5 AC[IVIIy: Tennsaction Credk Transaction >, Date Plan 'Descrippon Locatlo n Am ourrt 062012003 001 PAYMENT -THANK YOU 520.00 CR Or you may write to us at: Lane Bryant, P O.Boxt 821121aColumb s9 OH 43218-2121 Notice- The total amount of any catalog purchase may include shipping, handling and tax. - To inquire about orders already placed, shipping and handling charges, the status of a back order, exchanged or returned merchandise please call 1-800-477-7030.8AM-10PM M-F, 9AM-5PM Sat-Sun EST - To place a catalog order, please call 1-800-248-2000. Anytime. There is more than one way to pay! In addition to mailing your payment, you can make a payment on your Lane Bryant Catalog credit card account by calling us at 1-800.695-7107 or by visiting us at www.mycreditcard.cc/lanebryantcatalog Statement Summary: Account: 746-312-180 Payment Due Date: 07/31/2003 Credit Limit Available Credit 51,610.00 ;1,411.26 Average Daiy Balance DAILY Periodic Rate =206.01 Previous Balance Cbsing Date 07/062003 Nominal Annual 0.06246% + New Charges 50.00 Days in Billing Period Scheduled to Pay 82 510.00 Percentage Rate ?2.8000% + PaymenlsACredits FINANCE CHARGES 520.00 54.12 Pest Due Minimum FlNANCE CHARGE 50.00 ;0.00 ANNUAL PERCENTAGE RATE 22.800096 =New Balance Minimum Payment 5198 72 510.00 NOTfCE: See reverse s/do for lm nt lnlorma8on - Please fear at pertoretion above Account j. r I ~ ~ Payment must reach Number 746-312-180 _ _ ` - -" ` -~ ~ ~ u6 by 12 pm ET on: New Balance Minimum Payment -- _ 07/31/2003 $198.72 $10.00 ^ Yes,1 have moved or updated E-tiiWIL..See Reverse Please make checlas payable to: WFNNB -LANE BRYANT MO Amount Enclosed ~rrr~~~rrr~rr~~rr~~rrr~r~r~r~rtr~r~r~~rrrrr~~rrr~~rr~rr~r~rr~~ ~ ua^^^ . ~^ MARY C HILL 834 WELLSVILLE RD Please return this portion wuh your payment to: NELLSVILLE PA 17365-9503 PO BOX 659728 SAN ANTONIO TX 78265-9728 746312180 013089 9aoloosooao3oo111111010 00 746312180 746312180 001000 019872 J; 1 4.1.__~- O CHASE WQL.*MART~R~- PAYMENT DUE DATE N BALANCE MI IMUM DUE ~ 1 ~ 08/29/03 1,594.35 459.00 ;_. New Address: mad :lephone raar~ber $ nine. log on b vyw.dase.eorrJcards r print Here: Telephone: ( I MARY C HILL aei9z 124 WOODS DR LOT 16 A MECH PA 17050 ~ur~~~nr~~~nn~r~t~~nt~ur~~ ACCOUNT NUMBER: 5260 3603 0151 4461 Enter Amount Enclosed In Boxes Below ^^^^^.^^ Pleaae make oheok or money order payable tc: CHASE MASTERCARD. Yesl I want to help prded rtry aedlt rating. Please enrdl me in the Cheae Payment Protador Plan. I have read and understand the enclosed offer. I understard that enrollment is optional and I may cancel at any lime. ~~ (D RO ) P.O. BOX 15583 WILMINGTON DE 19886-1194 ~ul~~~r~n~n~I~u~n~~unt~~ur~~~r~nt~n~~n~nr~~nl~r~~ 526036030151446101159435000459009100303 _ _ _. Please detach at perforation and return with your payment Wal-Marti MasterCard® from Chase ACCOUNT NUMBER: 5260 3603 0151 4461 NEW BALANCE PAYMENT' DUE DATE , STATEMENT CLOSING DATE DAYS IN BILLING CYCLE ,N. N 11 594.35 08/29/03 08/06/03. 30 TOTAL CREDIT LINE TOTAL AVAILABLE CREDIT CASH ACCE33 UNE AVAILABLE CASH 1 500 905 15500 L_3s 905. N Here is your Account Summary: TOTAL Previous Balance $11,421:13 (-) Payments, Credits 0.00 (+) Purchases, Cash, Debits 35.00. (+) FINANCE CHARGES 138.22 (_) New Balance 11,594.35 Minimum Due 231.00 =-----PauF-F)na-.-P~.I.,,...eaa+el.. - ----~-----nnn~- '--- tiAinimum Payment Due ~ $459.00- Your charges and eredits at a. glance:. IRAN DAT POST D REF. E ATE NO. DESCRIPTION OF TRANSACTIONS CREDITS CHARGES LATE CHARGE -MIN PYMT NOT RECD BY DATE DUE' . 35. ~ rvuar ur your creat[s ana charges .0.00 35.00 Here's how we determined youir Finance Charge*: DAILY AVERAGE DAILY PERIODIC/MIN. FINANCE TOTAL FINANCE ANNUAL PERCENTAGE ANNUAL PERCENTAGE PERIODIC RATE t34LANCE CHARGE CHARGE RATE RATE Purchases V 0.03970% $4,182.99 $49.82 $49.82 4g°,6 14 14 49°k Cash Transferred Balances V 0.05477°ib V 0.03970° $512.96 $6,473.27 $8.43 $77 10- $8.43 $77 10 . 19.99% 14 49% . 19.99° ° Wal-Mart Purchases 0.03011 % $318.56 . $2.87 . $2.87 . 10.99% 14.49 k 10.99% • .o~w aw ,vvvrav sw nrr uarance oompu[anon method and other important information. OuestiOns at~out your account? Credi! Card bst or stolen? Call Chase Customer Service 24 hours a day, 7 days a week, toll-free, at 1-800-543-1987 or write PO Box 15919, Wilmington, DE 19850-5919. Para Servicio al Clients en Espanol: 1-800-545-0464. LEASE REMEMBER TO FOLLOW OUR PAYMENT INSTRUCTIONS WHEN MAILING YOUR PAYMENT. PAYMENT MUST BE RECEIVED BY `S AT OUR POST OFFICE BOX DESIGNATED FOR. RECEIPT OF PAYMENT ON YOUR BILLING STATEMENT BY 12:00 NOON, EASTERN IME, ON A BANK BUSINESS DAY IN ORDER TO BE CREDrrED TO YOUR ACCOUNT AS OF THAT DAY. OR OTHER IMPORTANT INFORMATION REGARDING OUR PAYMENT INSTRUCTIONS, SEE REVERSE SIDE AND THE ENCLOSED NVELOPE. 'snd Payments to: Chase MasterCard, P.O. Box 15583, wlmington DE 19886-i 194. Page 1 of 2 o. b 0 M e N b .. .~.. ._.. 0 0 0 °o e 0 ., Y e e M N DISCtVER CARD payment due date August 12, 2003 minimum payment due $347.00 ...III,~rl~~ll~ril~~~l~lrl~l~~~l~l~ll~~~~~llt~~~ 13 SOPNR801 0017767 MARY C HILL 834 WELLSVILLE RD WELLSVILLE PA 17365-9503 new balance account number 6011 3006 8062 0257 $8,703.34 enter amount enclosed below $~ Please make check payable to Discover Platinum Card. Iltinimum payment due includes a past due amount o/ 5172,1)0. Simplify and Savel Use your Discover Card to pay ott high-rate balances today, You can save money and consoNdate your debt into one convenient Payment. Call 1-800-767-7319 to see i(a special Balance Transfer otter is available for you. PO BOX 15251 III"'ll""..II"II'~II'~1 WILMINGTON DE 19886-5251 Address orte/ephone change? Ptease print change in the space above, In~lli~lulnl~lniuilu~l~lu~l~l~l~lnull~l~luulllrlnl or go to Discovercard.com. 000006011300680620257087033400000000034700 Discover Platinum Card Account Summary account number 601 t 3006 8062 0257 paymentcluedate August•12, 2003 ,~ntnimum payment-due _~ , . $347.00 ,.~ c>edihlimit $12,000 `, ,: ~n~Cevailable _~ . ,. $.3296 cash credit limit $6.;000.00 s dash crtmditavailable X3,296.00 ,. , Closing Date: July 13, 2003 page 1 of 1 previous balance X8,569.27 payments end credits 0:00 pun:hases + 35.00 cash alivanoes + 0.00 .balance transfers `_ + 0_0p rmuyn~.c Ft1AtiGtS '~ 99.07 newbalance - - X8;703.34 - Youmay be able to avoid Periodic .Finance Charges, see t/te ietreiss side for.details. i ~PECIAI_ BALANCE Tf1ANS.FER RATES! 'Save moneyandsimpfirfy.your life by consolidating .your dslri..Gall 1-800-767-7339 odayto see:if an offeris available:foi• youl ; , i 1~QSh64Ck BolnuS~ Cashback$onust~ Anniversary Date: May 13 A~/~/AR{~ PreViou$ Cashback Bonus Award Balance S 4.83 7raditiona}Award This Period. + fl.fl0 F . Other Awards This. Period + 0..00 Caslback.'BonusRward Total 4;83 - ~ ` ' Redemptions This'Period 0.00 Cashback Bonus Award Balance 4.83 Award Available to_Redeem S n nr1 --- ransactions trans: post date date i Other/Miscellaneous Jul 13 Jul 13 LATE FEE $ 35.00 flMN! fflfflf H!-fff "„'" A7TENT10N f!!!!!! ATTENTION f'•"~ ATTENTION ATTENTION ATTENTION 'f'ouracaount is past due. Please paythe past due amount now, orcrontact us rn make ot/terarrangements. Nominal ANNUAL Transaction Average Daily ANNUAL Periodic Fee Daffy Periodic PERCENTAGE PERCENTAGE FINANCE FINANCE Balances Rates RATES RATES CHARGES CHARGES current biliFng period: 30 days -~ G3 _~ DRESS T~' STATE P PHONE /TER ADDRESS CORRECTIONS HERE S x-03 A~~ /(~ ~ Anzona Mail Order Co., Inc. j~'~ P.O. Box 79044 Phoenix, AZ 85062-9044 • OLD PUEBLO TRADERS®• REGALIA® • • INTIMATE APPEAL®• COWARD® • 001067274969000500000394219 NUCMBER 067274969 HILL, M C oTE See Below 124 WOODS DR NO 16A "E'" $394.21 BALANCE MECHANICSBURG, PA 17050-0000 MINIMUM $C,0 ~ OO PAYMENT, ~~ AMOUNT ~ ,yj ENCLOSED PLEASE RETURN THIS STUB WITH YOUR PAYMENT AND MAKE CHECKS PAYABLE TO: ARIZONA MAIL ORDER CO., INC. KEEP THIS PORTION FOR YOUR RECORD ~•M•O .O. Box 79044 hoenix, AZ 85062-9044 Our records indicate a payment on your account is currently due. Please include the top portion of this statement with your payment of $50.00 to keep the good rating on your account. If payment has been mailed, please accept our thanks and disregard this notice. We thank you for your patronage. 15C Account # 067274969 221 Page 1 of 14 ve<i'I~on 717 697-8557-001 56Y _.: Please make aavment to rizon Jul 28 2003 end return thi y s P-~ge wi h your ca e -____ Due I --' mmediately ...................... $66.67 M C HILL C-O JANE ALEXANDER 148 BALTIMORE ST DILLSBURG PA 17019 i~~~lll~~~lll~~~~~~lll~i~~„I~II Fill in Amount Paid T ^ ^ ^ PO Box 28000 Lehigh Vly PA 18002-8000 1177170697B557001002802178999991000000665970000006667000000 R21 028 OM29GI% GIX ]1M IIWI 6]99 12'l~ f]9Y9 Is94 99D095)965 790010, fINSPV OMNIUM Financial Receivable Services' 7171 Mercy Road Omaha, NE 68106 86786269 IMPORTANT NOTICE Statement Date: 0 8! 2 2/ 0 3 Omnium Account Number: 86786269 V Creditor Account Number: 7 1 17 t 40055 t 552 Creditor(s): BENEFICIAL SECURED LOAN ACCOUNT BALANCE: ,-~"$"3 , 442.65• ~~. To: Estate of MARY C H I LL, Please accept our sincere condolences on the death of MARY C HILL. Omnium Financial Receivable Services has been retained to handle this account. The balance owed is $3,442.65. If there is an estate, please forward the Notice of Administration form to our office for processing. (You may obtain this form from the probate court or attorney.) Please send all pa meats and correspondence to the address listed at the top of this letter. To ensure proper handling, please write the account number on your check or money order and include the attached remittance document with your pay meat. Please contact our representatives at 1-800-878-3317 for additional assistance with Phis mafter. Our office hours are Monday -Thursday, 8 a.m, to 8 p.m., Friday, 8 a.m. to 6 p.m. and Saturday, 8 a.m. to 12 p.m., Central Standard Time. We appreciate your cooperation at this difficult time. Sincerely, Omnium Financial Receivable Services NOTICE: See Reverse Side for Important Information. $-28"-~3 _ _ _ _ _ _ _ _ _ _ _ _ _ _ TEAR ALONG LINE AND RETURN LOWER PORTION WfrH PAYMENT_ _ _ _ _ _ _ _ ~_ - - - - - - - - - - - - - - - - - Please note your account number on your check or money order to ensure proper credit to your account P.O. Box 6618, Department 25 Omaha, NE 68106 Address Service Requested 0000057855 *AUTO** MIXED AADC 350 ~~u~~~nr~~~nr~~~~~~~na~~r~~u~~~~~u~~nr~~~wn~~u~r~~ #BWNGMRN #0000116064118908# MARY C HILL 124 WOODS DR APT 16A MF(`HANi!`cgllpl_ DA 17nFn_770n 86786269 Statement Date: 0 2 2 3 Axount Number: 71 171400551552 ACCOUNT BALANCE: $3 442 65 AMOUNT ENCLOSED $ Make Payment to: ~~~~nu~~rur~~~i~ru~~~n~~u~n~n~~r~u~r~r~u~u~r~~~rn~ Omnium Financial Rec Services P.O. Box 956842 St. Louis, MO 63195 1000 MacArthur Boulevard H U DSO N U N I T E D B Mahwah, N) 07430 1-800-HUB-LINK(482-5465) VIA CERTIFIED MAIL AND REGULAR MAIL FAX (201) 818-6457 June 30,2004 ESTATE OF MARY HILL 124 WOODS DR LOT 16A MECHANICSBURG PA 17050 Re: Account Number: 00000408471 Balance Due $ 23,267.54 Payment Past Due: $ 498.56 Late Charges Owed: $ 25.16 Total Owed: $ 523.72 AN K° Dear ESTATE OF MARY HILL You are hereby notified that the above-referenced account is now in default. Therefore, we are exercising our right under the terms of your note to demand that the entire past due payment be paid in full by July 30,2004 Your failure to comply with this Notice and Demand will. result in a legal action being instituted against you, the costs of which, including Attorneys fees will be added to your account. Unless you tell us that you dispute this debt or any portion of this debt within 10 days after you receive this letter, we will assume the debt to be valid. If you notify us in writing, within 10 days after you receive this letter, that you dispute this debt or any portion of this debt, we will obtain verification of the debt, and we will mail a copy of the verification to you. We are attempting to collect a debt, and any information obtained will be used for that purpose. Sincerely, Susan Sherman Collections Department 201-236-2556 www.hudsonunitedbank.com Member FDIC :"wa _. .. 1v v~ .~. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE AF SCHEDULE J BENEFICIARIES M3I'}r C. Hill NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERT I TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1. 1~n J. Ne].san 834 Wellsville Rd Wellsville, PA. 17365 2 ~E112 Ba k~ Ct. ort Worth, Tx, 76138 3 Ptt'~~~chgael~. L~.~K~lod~~etanz NEw timberland; PA. 17070 FILE NUMBER -'-- 21-03-0528 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not Llst Trustee(s) OF ESTATE ~ I 1/3 x~sidee ~ I 1/3 residee San 1/3 residee ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, 0 I REV-1500 COVER SH II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE EET 1. N~ I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. NONE 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) $ Reset Fotm INVENTORY REGISTER OF WILLS OF Ctmberland Cp~'ry, pENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA t COiJNTY OF york f S5 213-0528 File Number Pers~,nal Representative(s) of the Estate of ~' C• N~ 11 deceased, depose(s) and sa}-(s) that the items appearing in the follow=ing inventor}• include all of the personal assets where~~er situate and all of the real estate in the Commonwealth of Petm,~-lvania of said Decedent, that the valuation placed opposite each item of said uiventol}- represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennal-hrania except that which appears in a memorandum at the end of this inventvr~-. I verif}- that the statements made in this Inven- tors- are true and correct. I understand that false state- ments herein are made subject to the penalties of 18 Pa. C. S. j X904 relating tv una-wvrn falsification to authorities. Atturne3• -- {..~Qme) Jane M. Alexander (J'upreme CourtLD.:Vo.) 07355 (Address) 14$ S. Baltinnre St. T}i l l eburg, PA. 17019 (Telephone) DATE OF DEATH LAST RESIDENCE June 16, 2003 124 Woods l?r. Nlechanicsbttrg, PA. 17050 oEC®ENrs soc. sEC. No. ZOPr24-4532 1. Nl~ssiah V;1~ -wage payment 2. Erie Insurance 3. Erie Insurance 4. Mobile Hone - (~lcbroak. 1979 FIGURES MUST BE TOTALED sold to Gary Potteiger & James Potteiger Oct 6, 2003 5. Agway Enexgy Products -credit belar>Ice reftmd 6. AT&T 7. 1997 Oldsmbile - VIN# - 1G3id"152M6VF33456 sold to Joan Groscost July 17, 2003 8. Fulton Bank savins accotmt no. - 1370-58871 9.Fulton Bank r1a~G-ic checld.ng accotmt no. -2519-263 10. Prudential Insurance policy No. 602701930 No Beneficiary tom, paid to estate ~9dach additionol shee/s as needed) 14.93 9.00 105.00 4,900.00 498.93 6.15 4,000.00 1,019.21 698.75 3,748.11 NOTE: The Memorandum of real estate outsiek the Commonevealth of Pcnns~9vania mac. at the election of the personal __ vv item. but such figures should not be eKtraded into the total of the Inventory . /See 2!l f u. C'.S ,~ .~ (II/(~i! representative include the Value of each ox~c~_ ~.-~.,oti.~ FurmRI4"-(lip rev. 1(/.13.16 LAST WILL AND TESTAMENT OF MARY C. HILL I, Mary C. Hill, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound mind and body, declare this to be my Last Will, hereby revoking all prior Wills and Codicils: ITEM I. I direct that all my just debts, any expenses that may have resulted from my last illness, and my funeral expenses shall be paid from my estate as soon as practicable after my decease. ITEM II. I give, devise and bequeath all my property, real and personal, owned by me at my death, to my husband, Earl A. Hill, provided that he survives me. If the aforesaid Earl A. Hill does not survive me, then I give, devise and bequeath my entire estate, in equal shares to my children, Donna J. Nelson of Wellsville, Pennsylvania, Michael L. Klobetang of Lewisberry, Pennsylvania, and Earl 0. Klobetang, Jr., United States Air Force Number 182 40 8083 of Mechanicsburg, Pennsylvania. If any or all of the aforesaid children do not survive me, then his, her or their share shall pass to his, her or their issue, per sti.rpes. ITEM III. I appoint my husband, Earl A. Hill as Executor of my Estate. If he predeceases me, or is unwilling or unable to serve, I appoint Donna J. Nelson as Executrix of my Estate. Page 1 o f 3 ITEM IV. In addition to powers given by law, my Executor or Executrix shall have the fullest power and authority in all matters and questions and to do all acts which I might or could do if living, including, without limitation, complete power and authority to invest (without restriction to investments permitted by law), sell (at public or private sale, for cash or credit, with or without security), mortgage, lease and dispose of and distribute in kind, all property, real and personal, at such times and upon such terms and conditions as may be deemed advisable. ITEM V. No fiduciary acting hereunder as Executor shall be required to post bond or enter security in this or any other jurisdiction. ITEM VI. All estate, inheritance, transfer, legacy, succession, and other death taxes of any nature, payable by reason of my death, which may be assessed or imposed upon or with respect to property passing under this Will or property not passing under this Will, shall be paid out of my estate as an expense of administration, and no part of said taxes shall be apportioned or prorated to any legatee or devisee under this Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal this~3~ day of 1987. ~~... MA Y HIL (SEAL) Page 2 of 3 SIGNED, SEALED, PUBLISHED and DECLARED as and for the Last Wi11 ad Testament of MARY C. HILL, the Testatrix, in our presence, who in her presence, and in the presence of each other, and at her request, have hereunto set our hand as subscribing witnesses hereto: ~ ,!ti , Residing at : 2.3 ~ ~~,.1 ~, ~~_ _'-`' Residing at: l~y L ,~fX19~ /~ . /"~I • /7 /S~ Residingl /at/: s~~, ~t-~,.:u;~ ,~:.~% Page 3 o f 3 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: ESTATE OF MARY C. HILL, DECEASED ORPHANS' COURT DIVISION NO. 21 03-0528 PRAECIPE TO DISCONTINUE WITHOUT PREJUDICE To Glenda Farner Strasbaugh, Clerk of Orphans' Court and Register of Wills: The above-captioned action is a Citation for failure to file an inheritance tax return. Please mark this action discontinued as the Executrix of the Estate filed the inheritance tax return. DATE: October 29, 2009 Lora K Attorney for Petitioner PA Department of Revenue Office of Chief Counsel P.O. Box 281061 Harrisburg, PA 17128-1061 Attorney I.D. No. 69436 ~~ ~~ l~ ~,~'~~ i~ ~~ ~~~ ~ii ~_ IA~~ ~~~~ .J:.. `-~ ~~~ .1 ._...L.1 ~av a ~ coos ~. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: ORPHANS' COURT DIVISION ESTATE OF MARY C. HILL, DECEASED NO. 21 03-0528 ORDER OF COURT AND NOW, this ,~ ~, day of ~©V ~ 2009, upon consideration of a Praecipe to Discontinue the within action, the Motion is granted, the Rule is dismissed and the Citation is discharged. BY THE COURT: r~ .~ - -_~ -:. r:^a .~ , -. ~~~ ~. , '' ~n m ~ -r~ - ,; c~ r ~ _ ~ ~ _- ~ `_l ,~ =f3 --1 ~ ._ iTt -~ ~ -~ ) ~ r~ In Re: Mary C. Hill, Deceased ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-03-0528 ORDER DATE: 11/5 JUDGE'S INITIALS: JWO TIME STAMP DATE: 11/6/09 IN RE: CERTIFICATE OF SERVICE OF ORDER SERVICE TO: Lora A. Kulick METHOD OF MAILING: ® LISPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: 9/09/09 ENVELOPES PROVIDED BY: ^ PETITIONER ^ JUDGE ® CLERK OF ORPHANS COURT SERVICE TO: METHOD OF MAILING: ^ LISPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: ENVELOPES PROVIDED BY: ^ PETITIONER ^ JUDGE ^ CLERK OF ORPHANS COURT ;~ ~ Deputy ,~' 6 Clerk of Orphans' Court __ _ _ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 6/07/2010 NELSON DONNA J 834 WELLSVILLE ROAD WELLSVILLE, PA 17365 RE: Estate of HILL MARY C File Number: 2003-00528 Dear Sir/Madam: ,_r ,~~ ~, ~ ~"~ tat,; ~ ~ 'ors" ~ frt~ t. ?O1~I JUN 11 PM 3: 29 OR~K Q~ c~~~~c.~d~rfl c°o P~ This notice is to serve as a reminder that the Status Repor$ by Personal Representative under Rule 6.12 is due on the below', listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULESk NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or'after July 1, 1992, the personal representative or his counsel, w thin two (2) years of the decedent's death, shall file with the Regi ter of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/16/2010 Please feel free to contact this office with any questions ~ou may have. If you have already filed your Status Report, please disregard this notice. Sincerely, lsG~i,~I~Z Glenda Farner Strasb~ug Clerk of the Orphans'... Court cc: File Counsel ,_ Cumberland County - register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 t,,,~+~,~~n t ~ ~ t* r t i~.l.~~tJ ~ ~i~ w3f- ~ ~: if t~~.~.. 201Q JUN i I PM 3= 2g CLERK (~ Date: 6/07/2010 ~~p p p, CUfi~~. L ALEXANDER JANE M 148 S BALTIMORE STREET DILLSBURG, PA 17019 RE: Estate of HILL MARY C File Number: 2003-00528 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per. the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES; NO. 103 SUPREME COURT RULES DOCKET N0. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, w~.thin two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/16/2010 Please feel free to contact this office with any questions ~ou may have. If you have already filed your Status Report, please~,disregard this notice. Sincerely, l~G~cnat~~~ Glenda Farner Strasb~ug Clerk of the Orphans Court cc: File Personal Representative(s) Y a ~ BUREAU OF INDIVIDUAL TAXES ~~ ~~~ ~ INHERITANCE TAX DIVISION ~~~~~h' ''" ' lwNCE TA Po Bax 2aofel '~~ OF ACCOUNT HARRISBURG PA 17128-0601 2~1~.1-4 AMI~~ 2~ ~~'' , JANE M ALEXANDER ~' 148 S BALTIMORE ST DILLSBURG PA 17019 ~nn~ylvan~a DEPARTMENT OF REVENUE REV-1607 EX AFP C12.09) DATE 05-24-2010 ESTATE OF HILL MARY C DATE OF DEATH 06-16-2003 FILE NUMBER 21 03-0528 COUNTY CUMBERLAND ACN 101 Aa~ount R~wittod MAKE CHECK PAYABLE AND REMIT PAYMENT TOs REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To anaur• proper credit to your account, suboit the upper portion of this form with your tax pay~nant. GUT ALONC THIS LINE ~ RETAIN LOWER PORTIQN FOR YDU RECORDS ~ Vii'-'~'~"S'~"~'~........ * * '3~i"f "1~~"~~3t~'f~l'""~~'dAl~~'.. * ..................... ESTATE OFsHILL MARY C FILE NO.: 21 03-0528 ACN: 101 DATES 05-24-2010 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-12-2010 PRINCIPAL TAX DUE: 711.50 PAYMENTS CTAX CREDITS): PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 10-30-2009 CD011928 .00 711.50 04-30-2010 CD012701 244.54- 244.54 TOTAL TAX PAYMENT I 711.50 BALANCE OF TAX DUET .00 INTEREST AND PEN. ~ .00 TOTAL DUE .00 * IF PAID AFTER TWiS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 5/27/2011 ALEXANDER JANE M 148 S BALTIMORE STREET DILLSBURG, PA 17019 RE: Estate of HILL MARY C File Number: 2003-00528 Dear Sir/Madam: ~ ~ ~~ c-~- - ~ cT ; :J~ n . .....~ w ~.. .. r ~ ~~ ~ ~~. This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET N0. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/16/2011 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (7y7) 240-6345 Date: 5/27/2011 NELSON DONNA J 834 WELLSVILLE ROAD WELLSVILLE, PA 17365 RE: Estate of HILL MARY C File Number: 2003-00528 ~~, a~ a ~ C. ~,, Z ~ ~r N ~ Y--f--~ ~-~~." v ' ~.. »~ ~_ A ~ ~ ~ ...:b •r~ii ,..~. ~ ~ a --~ ~ .. . _- ~ ~..... . ~ 3'' ~ `- T ~- Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET N0. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/16/2011 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~. l~ 'Ma~'+`L~"i~4vci~r'wi~ ~i.v~+`f'i'I~i.(~'/6 j / i~ t~%.~•~^'",ri-'~`a. Glenda Farner Strasbaug Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rine 6.IZ STA'I'NS REPf3R'I' REGISTER OF ~ILI,S OF CI.JR~BERLAND COUNTY, P'ENNS1''L`~`AN1A Name of Decedent: ~R~' C HILL Date of Death: 6/1612003 File Number: 2003-0528 Pursuant to Pa. O.C. Rine 6.12, 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 administration will be complete: OCTOBER 30, 2011 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative f le 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? ....................... CM Yes ^ N ........ o d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and ay be attached to this report. ~~ ~` r~ igna of Person Filt his rm 1 v rt.J ~ Ca city: ~Persana) Representative ~Ct-unset ., ~~ ~'~. _' t..~' '-- ~ -- ~ ~i J E PVC. ALE~NDER ra`.iw ~ " " ..~ . f.. _ t~ Q U C'~ U ~,~ N me of Person Filing this Form _ `~..' - ~' ~ cn .~- 48 SOUTH BALTIMORE STREET l.L..} ...~ -_ __. N W --~ ~ ~~~ ti Address c.- `~:''.~? ~ v ~ ~=-.: DILLS$URG, PA 1701 ~ f:C ~ ~ ==~_ ~ (717) 432-4514 ~.,.~ ~`""` Telephone Form RW-10 rev. 10.13.06 - - (iii Pa. O.C. Rule 6.12 STATUS REPORT ;L~;STER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Mary C. Hill Date of Death: June 16, 2003 File Number: 21-03-0528 Pursuant to Pa. O.C. Rule 6.12, (report the following with respect to completion of the administration of the above-captioned estate: ._. .~ l . State whether administration of the estate is complete :.................... }J `r'es ~ ~~:~ 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? ....... DYes ~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 the Orphans' Court and may be attached to this report. Dat ~ ~ ~ ~ --+~ Sig e of Person Filing this orm :7 tom: _- , ~_, .~ __. t_~G . a city: ©Personal Representative ®Counsel Jane M. Alexander, Esquire ,- °- C ~:_ Lr ~ c~• c_~ ~~ t, ~ J7 :-" cc _ _,_ LL~~y _.I '~.. ('T.. U ~ L.,: n- lY CL" ~- ~ ~. U Name of Person Filing this Form 148 S. Baltimore Street Address Dillsburg, PA 17019 717-432-4514 Telephone Fnrm RW-l0 rev. 10.13.06 COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: MARY C. HILL n -. o .._. -~-, ~, -. , _, ~, ~ ti_-, _ , ', File No. 21-03-0528 ~p `~~-,_~ Late of TOWNSHIP OF EAST PENNSBORO _~ ~:.~ ~~ ':1 c - - _.. - .~:. RELEASE ~' --~ ~ ~.~ G -r, KIVOWALL MENBYTHESEPRESENTS, that we, Donna. J. Nelson, Michael L. Klobetang, and Earl O. Klobetang, all of the heirs of the Estate of Mary C. Hill, deceased, have received all funds due from the said estate as set forth in the First and Final Account. WHEREFORE, we do, by these presents, remise, release, quit-claim and forever discharge said, Donna J. Nelson, her heirs and assigns, Executrix, of the duties of the trust imposed on her and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever for or by reason thereof. IN.~~TNESS WHEREOF, we have hereunto set our hands and seals this -~ % ,~ ~~ = ~-, 2011. ay of WITNESS: ,~ }l ^' Donna J. Nels ~~ /~~ i3: Michael L. ~~~ ~~~~~ ~ . Earl O. Klobetang COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF YORK On this, the l ~ l~ ~ ~~ day of ~.. ~:~~,. .N- ~~ ~ 2011, before me, the undersigned officer, a Notary Public, personally appeared Donna J. Nelson sworn to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal. t COMMONWEALTH OF PENNSYLVANIA ,~i.-l~_~, ,~ ~ Notarial Seal `' - ~ t~ 1 ii~~~ ~t.~__~ Amy M. Hambright, Notary Public Notary P liC _~ Dillsburg 8oro, York county My Commission Expires Sept. 22, 2014 Member, Pennsylvania Assodatlon of Notaries MY Commission Expires: ~ ~ i, ~ . ~ j ,.; t i t_ TH OF PENNSYLVANIA COUNTY OF York On this, the a, ~' undersigned officer, a Notary Pu I! satisfactorily proven) to be the pi acknowledged that he executed tl ~' '' IN WITNESS WHEREOF, a` SS of '~, 2011, before me, the appeared Michael L. Klobetang sworn to me (or name is subscribed to the within instrument and same fo he purpose therein contained. hereunto set hand and notarial seal. Notary Publi~ My Commission On this, the .~ `l~~ day of _ ~ ~ G ti ~ `~ undersigned officer, a Nota Public ~, ~ 2011, before me, the to me (or satisfactorily proven) to be the p son whosernamelis ael L. Klobetang, sworn instrument and acknowledged that he executed the same for the pure se thereine within contained. IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal. '-?`, ~. ~- .,~SZ.. Notary Public My Commission 1=?xpires: ~ " ~ ' } COMMONWFAl7ht OF~ Psa~JNSYf~VAN1R Notarlal5eal '-~-~ j Laura V. Frye, Notary Pui~lEc i' Fafrvlew Twp., York County ~ My Commisslon Expires May Y', 2014 ~~ Member. PennsvivaNa As~,^car:~n ;a~` CEO ;tries i' ii i i i! II I ~I ~~ STATE OF TEXAS COUNTY OF ~4~~n f : SS. On this, the 2~.C day of1~~~ ~ _, 2011, before me, the undersigned officer, a Notary Public, personally appeared Earl O. Klobetang sworn to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same for the purpose therein contained. IN WITNESS WHEREOF, l have hereunto set my hand and notarial seal. -~----~_ ..y -~ ~~ . `~~i~LY SHANNON ~`~' * ~' t Notary Public Notary P lc STATE OF TEXAS ~Y Comm. Exp. Mar. 04, 2012 My Commission Expires: flf p r ~~, ~ ~~~