HomeMy WebLinkAbout03-0530Register of Wills of Cumberland County, Pennsylvania
PETITION FOX, GRANT!OF LETTERS
Estate of RICHARD D. ADAMS, SR.
Deceased
DONN L. SNYDER, Petiti ....... ho is 18 y .... rage or older, applies for:
(COMPLETE "A" OR "B" BELOW:)
'03 .itj~N 27 ~ 8 37
Social Security No. 204-09-9988
A. Probate and Grant of Letters Testamentary
State releva,t cirfumstaufes, eg. renunciation, death o f executor, et¢
Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution of the documents offered for probate; was not the
victim ora killing and was never adjudicated incompetent:
[ ~
B. Grant of Letters of Administration
(d b.n.c.t.a.: pendente lite; dur~ulte absentia; durant¢ minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs:
Name Relationship Residence
Richard D. Adams, Jr. [ Son ] I 1 Bluebell Court, Santa Fe, NM 87508-2292
I
[
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 221 South Market Street,
Mechanicsburg, Pennsylvania.
(list street, number and inunieipality )
Decedent, then 88 years of age, died June 7, 2003 at Camp Hill, Pennsylvania.
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property ............................................................................................................. $ 90,000.00
(If not domiciled in PA) Personal property in Pennsylvania ........................................................................................ $
(If not domiciled in PA) Personal property in County .................................................................................................. $
Value of mai estate in Pennsylvania ................................................................................................................................................................ $
Total ............................................................................................................................................................................................... $ 90,000.00
Real Estate situated as follows: 100 North 62nd Street, Harrisburg, PA
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the
undersigned:
Si~gnature ~
Form RW-I Page I of 2 (Dauphin County)
Typed or printed name and residence
Donn L. Snyder, Esquire, Saul Ewing LLP, 2 North Second Street, je Floor,
Harrisburg, Pennsylvania 17101
./2-/'"/9- ~-'
57377.1 6/26/03
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner above-named swears and afffmns that the statements in the foregoing Petition are tree and correct to the best of the
knowledge and belief of Petitioner and that, as personal representative of the Decedent, Petitioner will well and truly administer the estate
according to law.
Sworn to and affirmed and subscribed
before me this~? day of
June, 2003.
No.
Estate of RICHARD D. ADAMS, SR., Deceased
Social Security No: 204-09-9988
Date of Death: June 7, 2003
AND NOW, June,,_qO, 2003, in consideration of the Petition on the reverse side hereon, satisfactory proof
having been presented before me,
IT IS DECREED that Letters __ Testamentary of Administration, X
d.b.n.c t.i pendente lite; durante absentia; dm'ante minofitate
are hereby granted to Donn L. Snyder in the above estate.
FEES
Letters ........................... $
Short Certificate(s)...3....$
Renunciation .................. $
Affidavit ( ) ................. $
Extra Pages ( ) ............ $
Codicil .......................... $
JCP Fee ........................ $
Inventory ....................... $
Other ............................ $
Attorney: DONN L. SNYDER
I.D. No: 06858
Saul Ewing LLP
Two North Second Street, 7th Floor
Hamsburg, PA 17101
(717) 257-7552
TOTAL ................
Forln RW-I Page 2 of 2 (Dauphill Cotlntyl
Regisler of Wills of Dauphin Coumy, Pemlsytvania
57377.1 6/26/03
Register of Wills of Cumberland County, Pennsylvania
RENUNCIATION
Estate of Richard D. Adams,
Deceased
The undersigned, Richard D. Adams, Jr., hereby renounces his right to administer the
estate and respectfully request that Letters of Administration CTA be issued to Donn L. Snyder.
Witness our hand and seal this 1 lth day of June, 2003.
Swom to or affirmed and subscribed
before me this 11 th day '0'f-xJune 2003.
~'~otarymublic ? ~'~ ~.~'~
NOTARIAL SEAL
Maronetta F. Miller, Notary Public
Harrisburg, PA Dauphin County
My Commission Expires Jan19, 2004
Richard D. Adams, Jr.
57379.1 6/11/03
IN RE: ESTATE OF
RICHARD D. ADAMS, SR.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
No. 21-03-530
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
To the Register:
RICHARD D. ADAMS, SR.
JUNE 7, 2003
I certify that notice of estate administration required by Rule 5.6(a) of the Orphans'
Court Rules was served on or mailed to the sole beneficiary of the above-captioned estate on
July 2, 2003:
Name Address
Richard D. Adams, Jr.
11 Bluebell Court, Santa Fe, NM 87508-2292
Notice has been given to all persons known to the undersigned to be entitled thereto
under Rule 5.6(a)
D6IqN L. SNYtS~ER'' --4
Saul Ewing LLP
Penn National Insurance Plaza
Two North Second Street, 7th Floor
Harrisburg, PA 17101
:~::;' '.i:~:3 (717) 257-7552
'; :,:'! Attorney for Estate
[():ZiS L-l[li' £0.
62176.1 7/3/03
REV-I~5g,' ~X (6-00) .
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FILE NUMBER
DEPT. 280601 /2 0 0 0
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT
DECEDENTS NAME (~S~ FIRS~ AND MIDDLE INITIAL) SOCAL SECURI~ NUMBER
Adams Rlcha~d D S~ 20~-09-9988
DATE OF DEATH (M~DD-Y~R) DATE OF BIRTH (M~DD-Y~R) ~IS R~RN MUST BE FILED IN DUPLICA~ ~TH
06-0F-2003 04-12-2003 REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (~ST FIRST, AND MIDDLE iNITIAL) SOCIAL SECURI~ NUMBER
[] 1. OriginaIReturn
[] 4. Limited Estate
[] 6. Decedent Died Testate (Attach copy of Will)
[] 9, Litigation Proceeds Received
[] 2. Supplemental Return
] 4a. Future Interest Compromise (date of death after 12-12-82)
[] 7. Decedent Maintained a Living Trust (Attach copy of Trust)
] 10. Spousal Poverty Credit (date el death between 12-31-91 and 1-1-95)
] 3. Remainder Return (date of death prior to 12-13-82)
[] 5 Federal Estate Tax Return Required
__ 8. Total Number of Safe Deposit Boxes
[] 11. Election to tax under Sec 9113(A) (Attach Sch O)
THIS SECTION MUST BE COMPLy- I ~-D. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME
Dorm L. Snyder, Esquire
FIRM NAME (If Ap¢icable)
Saul gwing LLP
TELEPHONE NUMBER
(717) 257-7524
COMPLETE~ILINGADDRESS
2 North Second Street, 7th Floor
Harrisburg, PA 17101
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Modgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1 - 7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9& 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax(Line 12 minus Line 13)
ii'
1, 169.21
87,201.10
OFFICIAL USE ONLY
I
(8) 88, 370.31
16,466.75
611.52
(11) 17,078.27
(12) 71,292.04
(13)
(14)
71,292.04
SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) (15)
16. Amount of Line 14 taxable at lineal rate (16)
17. Amount of Line 14 taxable at sibling rate X . 12 (17)
18. Amount of Line 14 taxable at collateral rate x . 15 (18)
19. Tax Due (19)
20. [] J CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT J
0.00 x.o
71,292.04 x.o 45
3,208.14
3,208.14
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
STF PA42021F 1
Decedent's Complete Address:
STREET ADDRESS
221 South Market Street
CITY
Mechanicsburq I STATE PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit 0,0 0
B. Prior Payments 0.0 0
C. Discount 160.00
InterestJPenalty if applicable
D. Interest
E. Penalty
(1)
Total Credits (A + B + C) (2)
0.00
0.00
Total Interest/Penalty (D + E) (3)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB)
Make Check Payable to: REGISTER OF WILLS, AGENT
17055
3,208.14
160.00
0.00
0.00
3,048.14
0.00
3,048.14
PLEASE ANSWER THE FOLLOVVING 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 ....................................................... [] []
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.
belief, it is true, correct and complete.
DATE
8 - ~- 03
Under penalties ofll~rjury, I declare that I have j~mined this return including accompanying schedu es and statements and to the best of my knowledge and
Declaration of pre~aler other thar~Lhe p,~rsonal~r~presentative is based on all information of which preparer has any knowledge.
S'GNATURE.EI _SO ON,, f% _lNG RETURN
ADDRESS .... J~. - -,~
2 North Second Street, 7th Floor, Harrisburg, PA 17101
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)].
The statute does not exempt a transfer to a surviving spouse fi.om tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even
if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive
parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §gn 6(a)(1 )].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
STF PA42021F 2
REV-15OS, EX + (1-97) (I)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Richard D. Adams, Sr. 21-03-0530
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disd_nsed_ _ on Schedule E
ITEM
NUMBER
DESCRIPTION
Holy Spirit Hospital - Refund
Country Meadows - Refund
TOTAL (Also enter on line 5, Recapitulation)
VALUE AT DATE
OF DEATH
28.02
1,141.19
$ 1,169.2~
(If more space is needed, insert additional sheets of the same size)
STF PA42021F 9
REV-1509 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Richard D. Adams, Sr.
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
21-03-0530
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. RDA, Jr. Son
11 Bluebell Court
Santa Fe, New Mexico
87508
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and ba~ acco~ number or similar identifying number DATE OF DEATH DECUS VALUE OF
NUMBER TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A. 3-00 Smith Barney 169,699.51 50% 84,849.76
2. A. 3-00 Key Bank - 328427004770 1,676.24 50% 838.12
3. A. 3-08 Key Bank - 328420024890 3,026.44 50% 1,513.22
TOTAL (Also enter on line 6, Recapitulation)$ 8 7,2 0 1. 1 0
(If more space is needed, insert additional sheets of the same size)
STF PA42021 F. 10
"REV-151% E,X + (1-97)(I)
COMMONV~r_ALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Richard D. Adams, Sr.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-03-0530
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A.
1,
5.
6.
7.
8.
9.
FUNERAL EXPENSES:
Musselman Funeral Home, Inc.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Donn L. Snyder, Esquire
s~iai s~y Number(s) / EIN Number of Per.al Repr~iv~s)
S~Address2 North Second Street, 7th Floor
City Harrisburg S~e PA
Year(s) Commission Paid:
AttomeyFees- Saul Ewing LLP
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
.zipl7101
Street Address
City State Zip
Relationship of Claimant to Decedent
ProbateFees - Saul Ewing LLP
Accountant's Fees
Tax Return Preparer's Fees
Patriot News - Advertise Grant of Letters
Cumberland Law Journal - Advertise Grant of Letters
Saul Ewing LLP - Copies, Postage and Miscellaneous
Filing Fees
TOTAL (Also enter on line 9, Recapitulation)
7,551.52
4,000.00
4,340.00
230.00
170.23
75.00
100.00
$ 16,466.75
(If more space is needed, insert additional sheets of the same size)
STF PA42021F. 12
"REV-151~ EX + (1-97) (I)
COMMONV~c. ALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Richard D. Adams, Sr.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21-03-0530
Include unreimbursed medical e.~
ITEM
NUMBER
DESCRIPTION
West Shore EMS
TOTAL (Also enter on line 10, Recapitulation)
AMOUNT
611.52
$ 611.52
(Ifmorespace is needed, insert additional sheets ofthesame size)
s"rFPA42021F. 13
"REV-151~3 EX + (9-00)
COMMONV~r_ALTH OF PENNSYLVANIA
INHERiTANCE TAX RETURN
RESIDENT DECEDENT
ESTATE O F
Richard D. Adams,
NUMBER
I.
STF PA42021F. 14
SCHEDULE J
BENEFICIARIES
Sr.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLEDISTRIBUTIONS[includeoutdghtspousaldistdbutions, andtmns~m
underS~.9116(a)(l.2)]
Richard D. Adams, Jr.
11 Bluebell Court
Santa Fe, New Mexico 87508
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINE,<
FILE NUMBER
21-03-0530
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Son
AMOUNT OR SHARE
OF ESTATE
100%
15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DiS ~ ~IBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART I1 - 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)
SMITH BARNEY_
c t gmupT'
July 8, 2003
Account originally opened in the name of Richard D. Adams Sr 2/16/00
Account title - Richard D. Adams, Sr.
Added Richard D. Adams Jr. to account 3/00
Account title - Richard D. Adams, Sr and Richard D. Adams, Jr. JTWROS
Opened new account in Richard D. Adams, Jr. name only and joumalled
Joint account to individual account - 8/02
Account title - Richard D. Adams, Jr.
Value of account on June 7, 2003 - $169,699.51
This information is being provided at your request
and does not replace or supersede your monthly
Smith Barney customer statement. This information
~ he',ed upu, ;Itc ma,kef val_qo of your ac~oun} a~
and is subject to daily mar o luct at,on.
Citigroup Global Markets Inc. Monarch Tower, Suite 1400 3424 Peachtree Road NE Atlanta, GA 30326-1121 Tel 404 264 4000 Fax 404 262 2926 Toll-fie, 81 ,) ~,
THE INFORMATION SET FORTH WAS OBTAiNED FROM SOURCESWHICHWEBELIEVERELIABLEBUTWEDONOTGUARANTEEiTSACCURACYORCOM?i~ 7~ ~ -
NEITHER THE INFORMATION NOR ANY OPINION EXPRESSED CONSTITUTES A SOLICITATION BY US OF THE PURCHASE OR SALE OF AN'~
KeyBank
P.O. Box 93885
Cleveland, OH 44101-5885
Key Saver
Statement
June 30, 2003
I,,,111,,,111,,,,I,1,,I,1,,11,,,,11,,,I,I1,,,I,,I,1,,,11,,,111
T 0842 SNAP S IQ SS
RICHARD D ADAMS
RICHARD D ADAMS JR
221 SOUTH MARKET ST
MECHANICSBURG PA I7055-6327
Questions about your account?
1-800-KEY2YOU (1-800-53g-2968)
Or, write us:
KeyBank National Association
P.O. Box 94825
C/eve/and, Ohio 44101
Enroll in Online Banking today at Key. com.
Access your available accounts, transfer funds and view your transactions right from your PC.
Account tit/e: R/CHARD D ADAMS
R/CHARD D ADAMS JR
$696.75
Current interest rate
Number ol= days this statement period 73
1,468.68 Interest paid (5-16-03) $0.37
0.91 Interest paid (6-18-03) $0.54
Interest paid year-to-date $2.44
Balance on Apr 18, 2003
Additions
Deposits
Interest
Deductions none
Balance on Jun 30, 2003 $2,166.34
variable
Deposits
Date Description
4-29 Direct Deposit,
5-29
Nyslrs
Amount
Pension Pr -$489.56
__ Pension Pr
Pension Pr 4~9.56
Direct De_Posit, Nyslrs
Direct De~Do___sit_~,. Nyslrs
8-27
Total
489.56
$1,468.68
~ Member FDIC 328427004770 * 03290
Page ! of 2 76578
~Mernber FDIC 328427004770 - 03290
Page 2 of 2 76578
CONSUMER ACCOUNT DISCLOSURES
The following disclosures apply only to accounts covered by the Federal Truth-in-
Lending Act or the Federal Electronic Funds Transfer Act, as amended, or similar state
IN CASE OF ERROR OR QUESTIONS ABOUT YOUR ELECTRONIC TRANSFERS:
Call us at the phone number indicated on the first page of this statement, OR write us at
the address listed there, as soon as you can, if you think your statement or receipt is
wrong or if you need mere information about a transfer listed on the statement or
receipt. We must hear from you no liter than sixty (60) days after we sent you the
FIRST statement on which the problem or error appeared.
· Tell us your name and Account number;
· Describe the error or transfer that you are unsure about, and explain as
clearly as you can why you believe if is an error or why you need mere
infor,,~ticn;
* Tell us the dollar ameunt of the suspected error.
If you tell us orally, we may require that you send us your compliint or question in writing
within ten (10) business days.
We will investigate your complaint and will correct any error promptly. If we take mere
than ten (10) business days to do this, we will recredit your account for the amount you
think is in error, so that you will have use of the meney during the time it takes us to
complete our investigation.
COMMON ELECTRONIC TRANSACTION DESCRIPTIONS:
XFER TO SAV - Transfer to Savings Account
XFER FROM SAV - Transfer from Savings Account
XFER TO CKG - Transfer to Checking Account
XFER FROM CKG - Transfer from Checking Account
PMTTOCRCARD - Payment to Credit Card
ADV CR CARD - Advance from Credit Card
Praauthorlzed Credits: If you have arranged to have direct deposits made to your
Account at least once every sixty (60) days from the same parson or company, you can
call us at the number indicated on the reverse side to find out whether or not the deposit
has been made.
IMPORTANT LINE OF CREDIT INFORMATION
Billing Rights Summary: In oase of Error or Questions About Your Bill: If you
think your statement is wrong, or if you need mere information about a transaction on
this statement, write us on a separate sheet at the address shown on your statement as
soon as possible. We must hear from you no liter than six'o/(60) days after we sent
you the FIRST statement on which the error or problem appeared. You can telephone
us, but doing so will not preserve your rights.
In your litter, give us the following information:
· Your name and account number;
· The dollir ameunt of the suspected error;
· Describe the error and explain, if you can, why you believe there is an error.
If you need more information, describe the item you are unsure about
You do not have to pay any amount in question while we are investigating, but you are
still obligated to pay the part~ of your bill that are not in question. While we investigate
your question, we cannot report you delinquent or take any action to collect the amount
you question.
Explanation of Finance Charge: Your Finance Charge is computed on alicash
advances from the date each cash advance is made until we receive payment in full.
We figure the Finance Charge on your line of credit by applying the daily periodic rate to
the "Average Daily Balince" (Finance Charge Balince) of your line of credit including
current transactions. To get the average daily balance we take the beginning balance of
your line of credit each day, add any new cash advances or debits, and subtract any
payments or credits, fees and unpaid Finance Charge. This gives us your daily balance.
Than we add up all daily balinces and divide this total by the number of days in the billing
cycle to get the average daily balince. Then we multiply the average daily balince by
the daily periodic rate times the number of days in the billing cycle. The Daily Periodic
Rate is figured by dividing the Annual Percentage Rate by the number of days in a year
(365/366 days).
CREDIT INFORMATION: If you believe we have reported inaccurate information about
your account to a credit reporting agency, you may contact the credit reporting agency
or write to us at:
Key Credit Research Department
P.O. Box 94518
Clevelind, Ohio 44101-4518
Please include your account number, a copy of your credit report reflecting the
inaccurate information, name, address, city, state, and zip code, and an explination of
why you believe the information is inaccurate.
BALANCING YOUR ACCOUNT
Please examine your statement and canceled
checks upon receipt. Erasures, alterations or
irregularities should be reported promptly in
accordance with your account agreement.
The suggested steps below will help you
balance your account.
INSTRUCTIONS
O Verify and check off in your' check register each deposit,
check or other transaction shown on this statement.
Enter into your check register and SUBTRACT:· Checks or other deductions shown on our statement that
you have not already entered.
· The "Service charges", if any, shown on your statement.
Enter into your check register and ADD:· Deposits or other credits shown on your statement that
you have not already entered.
· The "Interest earned" shown on your statement, if any.
TOTAL* $
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of Richard D. Adams, Sr. No. 21-03-0530
also known as Date of Death June 7, 2 003
, Deceased Social Security No. 204-09-9988
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all
of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that
the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and
that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum
at the end of this inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that
false statements herein are made subject to the penalties of 18. Pa. C.S. Section 490~ relating to unsworn falsification to
authorities.
Name of
Attorney:
I.D. No.:
Address:
Telephone:
Dorm L. Snyder
06858
2 North Second Street, 7tn Floor
Harrisburg, PA 17101
(717) 257-7524
Personal Representative
Dated: August __, 2003
Real Estate
Personal Estate (See
(Attach Additional Sheets if necessary)
Description
Attached)
Value
None
$1,169.21
Total: $1,169.21
Note: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the
value of each item, but such figures should not be extended into the total of the Inventory.
99203.1 7/30/03
REV-1508,EX + (1-97) (I)
' SCHEDULE E
COMMONnArcALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
RES~OE.T~CEOENT PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Richard D. Adams, Sr. 21-03-0530
Include the proceeds cf litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disc!_ _,'~_ _ on Schedule F
ITEM
DESCRIPTION
NUMBER
Holy Spirit Hospital - Refund
Country Meadows - Refund
TOTAL (Also enter on line 5, Recapitulation)
VALUE AT DATE
OF DEATH
28.02
1,141.19
$ 1,169.21
STF PA42021F.9 (If more space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(I 1-96)
CD 002902
SAUL EWING LLP
C/O MARONETTA F MILLER
2 NORTH 2ND STREET, 7TH FLOOR
HARRISBURG, PA 17101
........ fold
ESTATE INFORMATION: SSN: 204-09-9988
FILE NUMBER: 2103-0530
DECEDENT NAME: ADAMS RICHARD D SR
DATE OF PAYMENT: 08/14/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 06/07/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $3,048.14
REMARKS:
TOTAL AMOUNT PAID:
MARONETTA F MILLER C/O
SAUL EWING LLP-HAND DELIVERED
~3,048.14
SEAL
CHECK# 12284
INITIALS: SK
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DONN L SNYDER ESQ
SAUL EWING
2 N 2ND ST 7TH FL
HBG
PA 17101
DATE 09-22-2003
ESTATE OF ADAMS SR
DATE OF DEATH 06-07-2003
,,"~F_ILE NUM$~R 21 03-0530
COUNTY CUMBERLAND
ACM 101
Amount Remitted
REV-1547 EX AFP (01-03)
RICHARD D
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF MILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF ADAMS SR RICHARD D FILE NO. 21 03-0530 ACM 101 DATE 09-22-2003
TAX RETURN WAS: C X} ACCEPTED AS FILED C } CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSF
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate CSchedule A}
2. Stocks and Bonds CSchedule B) CE}
$. Closely Held Stock/Partnership Interest CSchedule
~. Mortgages/Notes Receivable CSchedule D}
5. Cash/Bank Deposits/Misc. Personal Property CSchedule E} C5}
6. Jointly Owned Property CSchedule F}
7. Transfers CSchedule G} C7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H) C9}
10. Debts/Mortgage Liabilities/Liens CSchedule
11. Total Deductions
12. Net Value of Tax Return
.00
.00
.00
.00
lr169.21
87r201.10
.00
16,466.75
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
NOTE:
88,370.31
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
reflect figures that include the total of .ALL returns assessed to date·
· O0 x O0 = . O0
71,292.04 x 045= 3,208.14
.00 x 12 = .00
· O0 x 15 = . O0
(19)= 3,208.14
AMOUNT PAID
3,048
ASSESSMENT OF TAX:
15. Amount of L/ne 14 at Spousal rate C15)
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of L/ne 14 at Sibling rate C17}.
18. Amount of Line 14 taxable at Collateral/Class B rate C18}
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID C-}
08-14-2003 CD002902 160.41
TOTAL TAX CREDIT I 3,208.55
BALANCE OF TAX DUEJ .41CA
INTEREST AND PEN. I .00
TOTAL DUE I .41CR
C IF TOTAL DUE IS LESS THAN 91, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR}, YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.}
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J} C13} .00
Net Value of Estate Sub3ect to Tax (14} 71,292.04
If an assessment was issued previously, lines 14, 15 and/or l&, 17, 18 and 19 will
611.52
c11) . 17.078.27
(12) 71,292.04
RESERVATION~
Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class 8 Ccollateral) rate on any such future interest.
PURPOSE OF
NOTICE~
PAYNENT=
REFUND
OBJECTIONS=
ADHIN-
ISTRATIVE
CORRECTIONS=
DISCOUNT=
PENALTY=
INTEREST=
To fulfill the requirements of Sect/on 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side.
--Hake check or money order payable to= R~{~XS~E~ OF NXLLB, A~
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an '~pplication
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office
of the Register of Hills, any of the 25 Revenue District Offices, or by calling the special 24-hour
answering service for forms ordering= 1-800-362-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-3020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as sho~n on this Notice must object within sixty (60) days of receipt of
this Notice by=
--written protest to fha PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to= PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SY.) discount of
the tax paid is allowed.
The 15Y. tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before Januar~ 18, 1996, the first day after the and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1962 bear interest at the rate of
six (6X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
Januar~ 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Y e a.__~ Rate Factor Yea.__.~ Rate Factor
m
1982 20Y. .000548 1987 9Y. .000247 1999 7X .000192
1983 16Y* .000438 1988'1991 11X .000501 2000 BY. .000219
1984 11~. .000501 1992 9Y. .000247 2001 9~ .000247
1985 15~ .000356 1993-1994 7Y. .000192 2002 ~. .000164
1986 IOY. .000274 1995-1998 9Y. .000247 2003 5~. .000157
--Interest is calculated as follows:
TNTEREST = BALANCE OF TAX UNPATD X NUNBBlt OF DAYS DELTNQUBNT X DATL¥ TNTEREST FACTOi~
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date sho~n on the
Notice, additional interest must be calculated.
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
Register File No.
Richard D. Adams, Sr.
June 7, 2003
21-03-0530
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 x No
If the answer to #1 is No, state when the personal
representative reasonably believes that the administration
will be complete:
3. If the answer to #1 is Yes, state the following:
Date:
ao
bo
c°
do
September 22, 2003
Did the personal representative file a final
account with the Court? Yes No
X
The separate Orphans' Court No. (if any) for
the personal representative's account is:
Did the personal representative state an account
informally to the parties in interest? Yes X No
Copies of receipts, releases, joinders and
approvals of formal or information accounts may
be filed with the Clerk of the Or >hans' Court
and may be attached to this repc :t.
Donn L Snyder, Esquire
Saul Ewing LLP
Post Office Box 1291
Harrisburg, PA 17108
Attorney for Estate
54463.1 9/30/03
ESTATE SETTLEMENT AGREEMENT
This Agreement made this Iii/q'' day of September, 2003, by and between Donn L. Snyder,
Administrator of the Estate of Richard D. Adams, Sr., and Richard D. Adams, Jr., sole beneficiary
of said Estate.
In accordance with the desire that the settlement and distribution of the Estate of Richard D.
Adams, Sr. be resolved as expeditiously as possible and without the delay of a formal Court
accounting, the undersigned, in consideration of the mutual covenants herein expressed, and of the
sums received, and intending to be legally bound hereby, agree that:
1. The said Richard D. Adams, Sr. died June 7, 2003 testate. On June 30, 2003,
Richard D. Adams, Jr. renounced his right to serve as Executor and on June 30, 2003, Letters of
Administration were granted to Donn L. Snyder.
2. The undersigned hereby agrees that the entire estate be distributed as set forth in the
Schedule of Distribution attached as Exhibit "A" and hereof made a part. Without intending to
limit the rights of remedies of the personal representative, the undersigned further agrees to
indemnify the personal representative and save him harmless against all liability, loss and expense
(including, but not limited to, costs and counsel fee) which the personal representative may incur,
whether due to the personal representative's negligence or otherwise, as a result of making the
above distributions without formal court audit or other formal estate administration.
3. The undersigned hereby forever fully release, compromise, settles and discharges
any and all claims, demands, actions or causes of action, legal or equitable, absolute or contingent,
vested or hereafter to accrue, which they may have against any other party hereto or against the
100131 I 9/16/03
Estate of Richard D. Adams, Sr., deceased or the personal representative thereof, by reason of any
matter, cause or thing growing out of or relating to any property or assets of the said Estate of
Richard D. Adams, Sr., or growing out of or relating to any act of the personal representative in his
individual handling of said Estate, even if attributable to negligence, and agrees that any period for
the limitation of actions for the collection or any erroneous distribution or distributions shall
commence only at such time as the personal representative shall have obtained actual knowledge of
such erroneous distribution and that in no event shall the period of collection of any erroneous
distribution be less than two years after the actual discovery thereof by the personal representative.
4. The undersigned agrees to execute such additional releases as the personal
representative may submit in order to confirm his discharge from any further liability to the parties
in connection with said Estate.
5. This Agreement, shall be binding upon the undersigned, their heirs, next of kin,
personal representative, successors and assigns.
IN WITNESS WHEREOF the undersigned has hereunto set her hand and seal the day and
year first above written.
RICHARD D. ADAMS, JR.
Sworn/to and subseribed
befg~,me this,~--~ ~
d~:6f Se~mbeD603.
Nota~ ~!ic' ~ ' fi'
I omca sm
1001311 9/Ib/O3 ] ~*; Notary Public - New Mexico
[NOTRRY BOND FILED WITH
IN WITNESS WHEREOF the undersigned has hereunto set his hand and seal the day and
year first above written.
~bNN L. S~XlYDErR
Administrator of the Estate of
Richard D. Adams, Sr.
Sworn to and subscribed
before me this .?
d~Y 9f SeptembeT~
/Not~ublic
NOTARIAL SEAL
Maronetta F. Miller, Notary Public
Harrisburg, PA Dauphin County
My Commission Expires Jan19, 2004
1001311 9116/03
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
COMMONWEALTH OF PENNSYLVANIA
ESTATE OF RICHARD D. ADAMS, SR.
LATE OF THE BOROUGH OF MECHANICSBURG
CUMBERLAND COUNTY, PENNSYLVANIA
PROPOSED SCHEDULE OF DISTRIBUTION
It is recommended that the proposed distribution in equities and cash totaling $68,337.30 be
approved as follows:
Richard D. Adams, Jr.
$68,337.30
TOTAL
$68,337.30
1001311 9/16/03
IN RE: THE ESTATE OF
RICHARD D. ADAMS, SR., DECEASED
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
:
: ORPHANS' COURT DIVISION
:
: FILENO. 21-03-0530
SATISFACTION AND AWARD
The undersigned, hereby acknowledge that Donn L. Snyder, Administrator of the Estate of
Richard D. Adams, Sr., deceased, has distributed to the undersigned cash in the amount of Sixty
Eight Thousand Three Hundred Thirty Seven and 30/100 Dollars ($68,337.30) as full payment of
all sums due pursuant to the Estate of Richard D. Adams, Sr., directs and authorizes the Clerk of the
Orphan's Court Division to mark satisfied of record the award which may be made in his individual
favor.
WITNESS WHEREOF, the undersigned has caused these presents to be executed this
C~_',~f~/d~y of September, 2003.
Witness:
RICHARD D. ADAMS, JR.
Social Security No. ~ 2. l - 3 Z- e q 3 fi
1001311 9/16/03
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
COMMONWEALTH OF PENNSYLVANIA
ESTATE OF RICHARD D. ADAMS, SR.
LATE OF THE BOROUGH OF MECHANICSBURG
CUMBERLAND COUNTY, PENNSYLVANIA
FIRST AND FINAL ACCOUNT OF
DONN L. SNYDER, ADMINISTRATOR
Date of Death: June 7, 2003
Account Stated to: September 15, 2003
Estate No. 21-03-0530
Donn L. Snyder, Esquire
Saul Ewing LLP
Post Office Box 1291
Harrisburg, Pennsylvania 17108
717-257-7552
Attorney for Estate of Richard D. Adams, Sr.
1001311 9/I 6/03
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
COMMONWEALTH OF PENNSYLVANIA
ESTATE OF RICHARD D. ADAMS, SR.
LATE OF THE BOROUGH OF MECHANICSBURG
CUMBERLAND COUNTY, PENNSYLVANIA
FIRST AND FINAL ACCOUNT OF
DONN L. SNYDER, ADMINISTRATOR
SUMMARY AND INDEX
PAGE
PRINCIPAL
Receipts
$88,484.54
Less Disbursements
$20,154.41
6
Balance Before Distribution
Distribution to Beneficiaries
$68,330.13
-0-
TOTAL PRINCIPAL BALANCE REMAINING
$68,330.13
INCOME
Receipts
Disbursements
7.17
-0-
TOTAL INCOME BALANCE REMAINING
7.17
COMBINED BALANCE REMAINING
FOR DISTRIBUTION
$68,337.30
100131.1 9/16/03
COMPOSITION OF BALANCE
Smith Barney
Key Bank - Two Accounts
$64,849.75
3~487.55
$68,337.30
1001311 9/16/03
PRINCIPAL RECEIPTS
Inventory Filed
Per copy of Inventory Attached
$88,370.31
To which is added:
New York State Retirement System
$114.23
TOTAL PRINCIPAL RECEIPTS
$88,484.54
100131 I 9/16/03
PRINCIPAL DISBURSEMENTS
Schedule H Attached
Schedule I Attached
Register of Wills - Inheritance Tax
Register of Wills - Filing Fee
Total Disbursements
$16,466.75
$611.52
$3,048.14
$28.0O
$20,154.41
100131 I 9/16/03
r~EV-1511 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Richard D. Adams, Sr.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-03-0530
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
5.
6.
7.
8.
9.
FUNERAL EXPENSES:
Musselman Funeral Home, Inc.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Represmtative(s) Donn L. Snyder, Esquire
So, al Security Number(s) / EIN Number of Personal Representative(s) 205 - 18 - 3634
Str~Address 2 North Second Street, 7th Floor
City Harrisburg State PA
Year(s) Commission Paid:
A~0meyFees - Saul Ewin9 LLP
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
zipl7101
Street Address
City ~ate Zip
RelationshipdClaimanttoDec~
ProbmeF~s - Saul Ewing LLP
~countant'sF~s
T~RatumPmp~er'sF~s
?atr±ot News - Advert±se Grant oE Getters
Cumberland Gaw Journal - Advertise Grant oE Getters
Saul Ew±n9 GGP - Cop±es, Postage and Hisce[laneou$
Fi[in9 Fees
TOTAL (Also enter on line 9, Recapitulation)
AMOUNT
7,551.52
4,000.00
4,340.00
230.00
170.23
75.00
100.00
$ 16,466.75
(Ifmorespace is needed, insed additional sheets 0fthesame size)
STFPA42021F.12
RFV-1512 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Richard D. Adams, Sr.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21-03-0530
Include unreimbursed medical expenses.
ITEM
NUMBER
West Shore EMS
DESCRIPTION
TOTAL (Also enter on line 10, Recapitulation)
AMOUNT
611.52
611.52
(If more space is needed, inseA additional sheets of the same size)
STFPA42021F.13
PRIOR DISTRIBUTION
None
100131.1 9/16/03
PROPOSED SCHEDULE OF DISTRIBUTION TO BENEFICIARIES
Richard D. Adams, Jr.
Key Bank Accounts
Smith Barney
$3,487.55
$64,849.75
Total to be Distributed
$68,337.30
1001311 9/16/03
INCOME RECEIPTS
Key Bank
$2.72
Key Bank
$4.45
$7.17
1001311 9/16/03
INCOME DISBURSEMENTS
None
100131 I 9/16/03
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
COMMONWEALTH OF PENNSYLVANIA
ESTATE OF RICHARD D. ADAMS, SR.
LATE OF THE BOROUGH OF MECHANICSBURG
CUMBERLAND COUNTY, PENNSYLVANIA
PROPOSED SCHEDULE OF DISTRIBUTION
It is recommended that the proposed distribution in equities and cash totaling $68,337.30 be
approved as follows:
Richard D. Adams, Jr.
$68,337.30
TOTAL
$68,337.30
100131.1 9/16/03
COMMONWEALTH OF PENNSYLVANIA ·
COUNTY
OF
SS
Donn L. Snyder, Administrator of the Estate of Richard D. Adams, Sr., deceased, being
duly sworn according to law, deposes and says that the foregoing account is true and correct to the
best of his knowledge, information and belief, and that no persons claiming to be interested in said
Estate as creditors, legatee, next of kin or otherwise, have given notice of their claim to the
deponent, in writing or to Saul Ewing, his attorney, in writing.
DdlX~q ~_. SNYDER "' ' '
Sworn to and subscribed
., before me this
", day of September, 2.003·
/ ~otaryPublic ' ' /'~ -
NOTARIAL sEA~'
Maronetta F Miller, Notary Public
Harrisburg, PA Dauphin County
My Commission Expires Jan19, 2004
1001311 9/16/03