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HomeMy WebLinkAbout04-0808 PETITION FOR PROBATE and GRANT OF LETTERS Esta,e oS LEO C. JO.NS No. - OS/- - also known as To: Register of Wills for the Deceased. County of Cumberland in the Social Security No. 210-18-9702 Cormmonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner is 18 years of age or older and the Executrix named in the last will of the above decedent, dated July 21, 1999, and codicil(s) dated [none]. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principa! residence at~8 Blue Mountain Vista, Bent Creek Crossing, Mechanicsburg, Silver Spring Township. Decedent, then 77 years of age, died August 26, 2004, at ~8 Blue Mountain Vista, Bent Creek Crossing, Mechanicsburg, PA 17055. Except as follows, decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ unestimated (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner respectfully requests the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary thereon. New Kingstown, PA 17072 (717) 766-3368 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) The petitioner above-named swears or affirms that the statements in the fo.~g$Oing p~ltion and correct to the best of the knowledge and belief of petitioner and that as perso~ ~epres~{~tative ~ft~e above decedent, petitioner will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ~,~ ~ ~.z.~ before me this .~/~- day of /~li/t G. John~ ~// ~ -- Register ~d_g~ ~2~ F AFILES\DATAFILE~ESTATESL5191. l.disclaimer IN RE: ESTATE OF ' IN THE COURT OF COMMON PLEAS OF · CUMBERLAND COUNTY, PENNSYLVANIA · ORPHANS' COURT DIVISION LEO C. JOHNS · ESTATE NO. 2004-0808 DISCLAIMER AND RENUNCIATION I, Julia G. Johns, hereby exercise the rights granted to me in Chapter 62 of the Probate, Estates and Fiduciaries Code (the "PEF Code"), and I hereby irrevocably and unqualifiedly disc!aim and renounce any interest to which I may otherwise be entitled under Item 2 of the Last Will and Testament of Leo C. Johns dated July 21, 1999, in income and principal. IN WITNESS WHEREOF, intending to be legally bound hereby and intending that this Disclaimer and Renunciation shall be filed of record in the Office of the Clerk of the Orphans' Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania, and a copy thereof delivered to Julia G. Johns, Executrix of the Estate of Leo C. Johns, I have hereunto set my hand and seal, this \~' day of ~ , 2004. ~/ Julia G. J~)~ COMMONWEALTH OF PENNSYLVANIA ) · SS. COUNTY OF CUMBERLAND ) Onthis, the /~/~' dayof~/'~~- 2004, beforeme, a notary public, personally appeared Julia G. Johns, known to me to be the person whose name is subscribed to the within instrasnent, and acknowledged that he executed the same for oses therein contained. ~-t.~.. ,~: Notary Public 0 ~ e,,,J I NOTARIAL SEAL 0 ,~'~2, L.,.J VICTORIA L. OTTO, NOTARY PUBLIC  ~ CARLISLE BORO., CUMBERLAND COUNTY ~ MY COMMISSION EXPIRES BEC. 2, 2006 -1- COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004755 JOHNS JULIA G PO BOX 215 NEW KINGSTOWN, PA 17072 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold 101 $204.56 ESTATE INFORMATION: SSN: 210-18-9702 FILE NUMBER: 2104-0808 DECEDENT NAME: JOHNS LEO C DATE OF PAYMENT: 12/21/2004 POSTMARK DATE: 12/21/2004 COUNTY: CUMBERLAND DATE OF DEATH: 08/26/2004 TOTAL AMOUNT PAID: $204.56 REMARKS' J JOHNS CHECK//107 INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES C, EPT 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004653 JOHNS JULIA G PO BOX 215 NEW KINGSTOWN, PA 17072 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold 101 $91,000.00 ESTATE INFORMATION: SSN: 210-18-9702 FILE NUMBER: 2104- 0808 DECEDENT NAME: JOHNS LEO C DATE OF PAYMENT: 11/1 9/2004 POSTMARK DATE: 11/19/2004 COUNTY: CUMBERLAND DATE OF DEATH: 08/26/2004 TOTAL AMOUNT PAID: $91,000.00 REIVIARKS: JOHNS CHECK# 104 INITIALS: CCP SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Estate of Leo C. Johns, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, ~ D,A~ gl ~ DOq , in consideration of the petition on the reverse side 0 hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument dated July 21, 1999, described therein be admitted to probate and filed of record as the last will of Leo C. Johns and Letters Testamentary are hereby ~anted to Julia G. Johns. PageWill Book # -- ' Register ~f Wilis~A (~ _~ FEES Ivo V. Otto III, Esquire (27763) Probate, Letters, Etc. $~[ 05. (D'~) ATTORNEY (Sup. Ct. I.D. No.) Short Certificates(~) $ q. o~ MARTSON DEARDORFF WILLIAMS & OTTO ~n2z~_~ ¢o~eo $ q , ODD 10 BastHigh Street ,~O.~f2 $ I O. c~ Carlisle, PA 17013 TOTAL $?~.~_:_00_- (717) 243-3341 Filed This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 ~ ~ ~1~o ~},j,_~~ P 105899 1 ~ ~, AUG 2 8 200~ ~0. ~,,,,,,,,~ Date ~.T CERTIFICATE OF DEATH 373 ~ ~. Leo C. ~o~s =. ~[e ,. 2[0 ~ [8 -- 9702 A~t 26, 2~ , ~r 3,1927 tzng~n Co , m ~ ~ Silver S~. ~ 28 Blue M ...... ' -. _ ~l ~. ~rl~d I~, -"r' [~ u~,u~zn VlSCa 28 Blue ~tai] Vis~ nE~ ~'~ PA ~tcsb~, PA 170~ ~ LAST WILL AND TESTAMENT I, LEO C. JOHNS, of Silver Spring Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make; publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. 1. I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance!Or oth~i~prop~-~ not passing under this Will. 2. If my wife, JULIA G. JOHNS, is living thirty (30) days after my death, th~ I give, devise and bequeath all of my estate, both real and personal property, unto my Trustee, to be held or distributed by such Trustee as follows: a. The Trustee shall pay the net income, at least quarter-annually, to my wife, JULIA G. JOHNS, for life. In addition, the Truste~, in its sole discretion, may invade the principal of the trust to provide for the proper and adequate support of my wife, JULIA G. JOHNS. b. The Trustee shall pay to my wife, JULIA G. JOHNS, annually, such sum from the principal of the trust as she may request in writing; provided, however, that said sum may not Page 1 of 4 Pages exceed the greater of Five Thousand Dollars ($5,000.00) or five percent (5%) of the aggregate value, at the time of said request, of the principal of the trust hereunder. c. Upon the death of my said wife, JULIA G. JOHNS, my Trustee shall distribute the principal of the trust to my son, WAYNE GROH JOHNS, absolutely. 3. In the event my said wife, JULIA G. JOHNS, is not living thirty (30) days after my death, then I give, devise and bequeath all of my estate to my son, WAYNE GROH JOHNS. 4. I nominate, constitute and appoint my wife, JULIA G. JOHNS, as Executrix and Trustee of my estate. In the event she shall be unable or unwilling to serve in such capacity, then I appoint my son, WAYNE Gl{OH JOHNS, to so serve. 5. I direct that my Executrix(or) shall not be required to file a bond to secure the faithful performance of her(his) duties in any jurisdiction. 6. I authorize and empower my personal r~presentative and Trustee, in their sole and absolute discretion, to purchase or otherwise acqu!re and retain any investments of which I die seized or any real or personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as they may deem advisable; to borrow money for Page 2 of 4 Pages ~' any purposes connected with the protection and preservation of my estate; to mortgage or pledge any real or personal property forming a part of my estate or to join in or secure the partition of same; to compromise any claims or demands of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; to employ agents, attorneys and proxies and to delegate to them such power as my personal representative and Trustee consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as may be necessary to carry out any of these powers. In addition, I direct that my personal representative shall have the power to conduct an inventory of any safe deposit box necessary to the administration of my estate. IN WITNESS WHEREOF I have hereunto set my hand and seal this c~/~day of Ju~t SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testator and of each other. ~ Page 3 of 4 Pages COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND I, Leo C. Johns, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; anj~at I signed it as my free and voluntary act for the purposes therein expressed. . ~ Sworn or affirmed to and acknowledged before me by Leo C Johns, the Testator, this day of ~..}t,c/~,.q~_ ,1999. Notary Public NOTAF:IIA~ SEAL : SS. ,1~ Commission Eil~res Milt ~/, ~ COUNTY OF CUMBERLAND ) the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Leo C. Johns, the Testator, sign and execute the instrument as his Last Will; that the Testator signed willingly and that the Testator executed it as his free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testator, signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Address "~"~ 67~.q--r A/t6V Address ~ dayof ~ ,1999. Sworn or affirmed to and subscribed before me this No'~ P~bl~-c' - ' ~/ - ] C NOT.,~qlAL SEAL Page 4 of 4 Pages I ~ ~~ ~ERTIFICATION OF NOTICE UNDER RULE 5.6(a1 Name of Decedent: LEO C. JOHNS Date of Death: August 26, 2004 Pile No. 21-04-0808 To the Register: 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 following beneficiaries of the above-captioned estate on or about September 7, 2004. Julia G. Johns Wayne G. Johns P.O. Box 215 1952 Martha's Road New Kingstown, PA 17072 Hollin Hills Alexandria, VA 22307-1952 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A Date: Sept~ber %~904 Signature ~'~~ ~. c~ : Name Ivo V. Otto III, Esquire ~ ~' MARTSON DEARDORFF WILLIAMS & OTTO cc Ten East High Street ~ ~ Carlisle, PA 17013 ~/~ .7 (717) 243-3341 ~:: c Attorneys for Personal Representative CO""O~*.T. Or.E..S~.V*.,A INHERITANCE TAX RETURN ' DEPARTMENT OF REVENUE r FILE NUMBER OE..2=o, ' RESIDENT DECEDENT ' 21 2004 00808 HARRISBURG, PA 17128-0601 I i ~OUNT~ CODt= ¥/",a,/~ I DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER i JOHNS, LEO C. 210-18-9702 ~ ~ DATE OF DEATH (MM-aD-YEAR) i DATE OF BIRTH (MM-DD-YEAR) uJ~ i i THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ~ 08/26/2004 ! 03/03/1927 I REGISTER OF WILLS ~3 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) ~ SOCIAL SECURITY NUMBER JOHNS, JULIA G. i [] 1. Original Return [] 2. Supplemental Return [] 3. Remainder Return (date of death pr~:to 12-13~82 < (O [] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after ,,o,, =. 12-12-82) [] 5. Federal Estate Tax Return Required c) ~ ~= [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach ] 8. Total Number of Safe Deposit Boxes ~. of Will) copy of Trust) -- < [] 9. Litigation Proceeds Received r"] l O- Spousal Poverty Credit (date of death between [] 11.ElectiontotaxunderSec. 9113(A)(AttachScho) ',lAME , ,- Ivo V. Otto III, Esquire COMPLETE MAILING ADDRESS ~' ,-, :IRM NAME (ffapplicable) o~.° o Martson Dcardorff Williams & Otto Ten East High Street ~'ELI~PHoNE NUMBER Carlisle, PA 17013 717/243-3341 1. Real Estate (Schedule A) (1) None ~:~:~ ::~ ~:~ :~ · 2. Stocks and Bonds (Schedule B) (2) 2,152,742.93 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None ~C:) ~'~ 4. Mortgages & Notes Receivable (Schedule D) (4) N o ne cz~ :' ~ ~ rm ...... r,-] ~D (7) 5. Cash, Bank Deposits & Miscellaneous Personal Property ~2 ~- (Schedule E) (5) _ 19,081.22 6. Jointly Owned Property (Schedule F) (6) None ' ~ z -- CbC} o [] Separate Billing Requested ~_~ © -r-~ :5 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) -0 ~ (Schedule G or L) :;.] ~ ~ ,~-'r~ < 8. Total Gross Assets (total Lines 1-7) ~ ~l 71 ,~'2~'-~5 ~' 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 38,623.49 -- 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) (11 ) 38,623.49 12. Net Value of Estate (Line 8 minus Line 11) (12) ..... 2,133 ,200.66 ,1 13. madeCharitable(scheduleand GovernmentaIj) Bequests/Sec 9113 Trusts for which an election to tax has not been (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 2,13 3,2 0 0.6 6 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15, Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) ...... . ._ ~ 16. Amount of Line 14 taxable at lineal rate 2,133,200.66 x .045 (16) r- 95,994.03 ~ 17. Amount of Line 14 taxable at sibling rate x .12 (17) ~ 18. Amount of Line 14 taxable at collateral rate x .15 (18) i 19. Tax Due (19) 95,994.03 !20. [] Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: JSTREETADDRESS 28 Blue Mountain Vista Bent Creek Crossing Mechanicsburg ]STATE PA i ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments (1) .... 9`5,994.03 A. Spousal Poverty Credit B. Prior Payments 9 ! ,000.00 C. Discount 4,789.47 Total Credits (A + B + C) (2) 95,789.47 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. (4) Check box on Page 1 Line 20 to request a refund 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE (5) 2 04..5 6 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5B) 204.56 ~ 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 .......................................................................................... 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 cons derat on9 3. Did decedent own an "in trust for" or payable upon death bank account or security at h s or her death? ......... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary des gnat on9 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, Under penalties of 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 preparer other than the personal representative is based on all information of which preparer has any knowledge, S~:~E OF PERSON RESPONSI~I~E FOR FILING RETURN ADDRESS ..... .... DATE ~oh,, / ~ /7 ~'~ /) P.O. Box 215 ~~ ~'~.~t'~_.~, / Sewl(ingstown, PA 17072 _~l{b~,~ ~ TUFTE OF PER"SOI~I;(~-~L'E FO~FeI~G~-i URN ADDRESS --iOATE SIGNA.T'URE~'~R.ER OTHER THAN REPRESENTATIVE ADDRESS .... bATE[ Carlisle, PA 17013 l~\0~''~ For dates of death on or after July 1, 19~ and before Janua~ 1, 1995, the ~x rote imposed on the net value of transfers to or for the use of the sullying spouse is 3% [72 P.S. {9116 (a) (1.1) (i)]. For dates of death on or after Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the su~iving spouse is 0% [72 P.S. {9116 (a) (1.1) (ii)]. The s~tut~s not exempt a transfer to a sullying spouse from ~x, and the statuto~ requirements for disclosure of asse~ and filing a tax return are still appli~ble even if the suwiving spouse is ~e only beneficial. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a debased child ~en~-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% ~2 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. {9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of ~e de.dent'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 paint in ~mmon with the de.dent, whether by blo~ or adoption,  SCHEDULE B STOCKS & BONDS COMMONWEALTH OF' PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JOHNS, LEO C. FILE NUMBER 21 - 2004 - 00808 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM : NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF 1 Investments as itemized on attached Estate Valuation statement marked "Sch. B, ~ DEATH Item 1" 2,062,796.60 2 Municipal Bonds as itemized on attached Estate Valuation statement marked "Sch. B, Item 2" 89,946.33 TOTAL (Also enter on line 2, Recapitulation) 2,152,742.93  : SCHEDULE E ,I CASH, BANK DEPOSITS, & MISC. COMMO~^LT. OF .EN.S~V^.,^ ! PERSONAL PROPERTY INHERITANCE TAX RETURN J RESIDENT DECEDENT j ESTATE OF JOHNS, LEO C. !FILE NUMBER 21 - 2004 - 00808 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 disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF 1 ~s~ ~i' Edw~ds ~c oUn~#6 ~4~[~-77~-9 _ 0~, c-ash- ~--a~-~ ot~t~ ......... + DEATH 13,398.66 2 Hoffman-Roth Funeral Home, refund 503.58 3 PSERS, unused investment of pension contract, paid to Wayne G. Johns 5,178.98 TOTAL (Also enter on Line 5, Recapitulation) 19,081.22 ~ i SCHEDULE G cou,~o.wmT. OF PE..SYLV^.~^ I INTER-VIVOS TRANSFERS & '".ER,T^.CE m RENU.. MISC. NON'PROBATE PROPERTY RESIDENT DECEDENT · , ESTATE OF - - , FILE NUMBER JOHNS, LEO C. 21 - 2004 - 00808 This schedule must be completed and filed if the answer to any of questions 1 tl~r;u~ 4 ;n page 2 is yes. ITEM ! DESCRIPTION OF PROPERTY J DATE OF DEATH J % OF NUMBER I Attach a copy of the deed for real estate. VALUE OF ASSETI DECD'S EXCLUSION TAXABLE VALUE ..... ~ Include the name of the transferee, their relationship to decedent and the date of transfer il .' INTEREST (IF APPLICABLE) 1 i' 7/24/04 transfer of $1,000 to Karen and Lynn Shultz, friend~ 1,000.00i 100% 6,000.00i 0.00 TOTAL (Aisc enter on line 7, Recapitulation) ,~ I SCHEI:XJI.E H ' COMMONWEALTH OF PENNSYLVANIA FUNER~ EXPENSES II~ iNHERITANCE TAX RETURN ESTATE OF JOHNS, I.~EO C. :FILE NUMBER i 21 - 2004 - 00808 Debts of decedent must be reported on Schedule I. ITEM i; NUMBER! DESCRIPTION I AMOUNT A. FUNERAL EXPENSES: 1 Hoffman-Roth Funeral Home, Carlisle, PA 2,943.44 2 Grave marker 2,488.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions = Social Security Number(s) / EIN Number of Personal Representative(s): ~ Street Address City State ... Zip Year(s) Commission paid 2. Attorney's Fees Martson Deardorff Williams & Otto 25,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Julia (3. Johns Street Address P.O. Box 2 ] 5 City New Kingston State PA Zip 17072 Relationship of Claimant to Decedent Spouse 4. Probate Fees Register of Wills 893.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Register of Wills, Additional Probate Fee 350.00 2 A.G. Edwards, account fee 75.00 Total of Continuation Schedule(s) 3,374.05 TOTAL (Also enter on line 9, Recapitulation) 38,623.49 Sch t H COMMONWEALTH OF PENNSYLVANIA Fune~ Expenses & INHERITANCE TAX RETURN . RESIDENT DECEDENT k:~ma~ Costs co~r~ed ESTATE OF $OHNS, LEO C. !FILE NUMBER 21 - 2004 ~ 00808 3 Electronic research to value assets 79.05 4 Commission on stocks sold to pay inheritance and estate tax 2,500.00 5 Register of Wills, filing fee, disclaimer 5.00 6 Register of Wills, filing fee, inheritance tax return 15.00 7 S.W. Barrett Real Estate & Appraisal Services 275.00 8 Reserved for miscellaneous expenses and fees 500.00 Page 2 of Schedule H REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF Pi=NNSYLVANIA ,..E.I'rA.cE T~ RETU.. BENEFICIARIES ' ESTATE OF $OHNS, LEO C. FILE NUMBER 2 ! - 2004 - 00808 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT ...... __ Do NotJ.l~t~.t.~_ . ~ --OF ESTATE Io TAXABLE DISTRIBUTIONS (include outdght spousal distributions) 1 *Wayne G. Johns Son ~ All of estate residue 1952 Martha's Head Road Alexandria, VA 22307-1952 2 *See Disclaimer and Renunciation attached hereto i Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT ;BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Estate Valuation Date of Death: 08/26/2004 Valuation Date: 08/26/2004 Estate of: Leo C. Johns Account: 5191.1 Processing Date: 10/01/2004 Report Type: Date of Death Number of Securities: 21 File ID: 5191-1 Shares Security Mean and/or Div and Iht Security or Par Description High/Ask Low/Bid Adjustments Accruals Value 1) 2000 AMEREN CORP (023608102; AEE) COM NYSE 08/26/2004 46.33000 46.11000 H/L 46.220000 92,440.00 2) 1000 ATMOS ENERGY CORP (049560105; ATO) COM NYSE 08/26/2004 24.90000 24.68000 H/L 24.790000 24,790.00 Div: 0.305 Ex: 08/23/2004 Rec: 08/25/2004 Pay: 09/10/2004 305.00 3) 1000 BP PLC (055622104; BP) SPONSORED ADR NYSE 08/26/2004 52.63000 52.13000 H/L 52.380000 52,380.00 Div: 0.426 Ex: 08/11/2004 Rec: 08/13/2004 Pay: 09/07/2004 426.00 4) 3000 BELLSOUTH CORP (079860102; BLS) COM NYSE 08/26/2004 26.49000 26.11000 H/L 26.300000 78,900.00 5) 3500 BLACK HILLS CORP (092113109; BKH) COM NYSE 08/26/2004 27.89000 27.43000 27.660000 96,810.00 Div: 0.31 Ex: 08/12/2004 Rec: 08/16/2004 Pay: 09/01/2004 1,085.00 6) 3000 CONSOLIDATED EDISON INC (209115104; ED) COM NYSE 08/26/2004 41.31000 41.10000 41.205000 123,615.00 Div: 0.565 Ex: 08/09/2004 Rec: 08/11/2004 Pay: 09/15/2004 1,695.00 7) 6000 CONSTELLATION ENERGY GROUP INC (210371100; CEG) COM NYSE 08/26/2004 40.34000 39.99000 40.165000 240,990.00 8) 2000 ENERGEN CORP (29265N108; EGN) COM New York Stock Exchange 08/26/2004 47.03000 46.50000 H/L 46.765000 93,530.00 Div: 0.1925 Ex: 08/11/2004 Rec: 08/13/2004 Pay: 09/01/2004 385.00 9) 2000 PIEDMONT NAT GAS INC (720186105; PNY) COM NYSE 08/26/2004 42.85000 42.20000 42.525000 85,050.00 10) 2000 PROGRESS ENERGY INC (743263105; PGN) COM NYSE 08/26/2004 43.45000 43.15000 H/L 43.300000 86,600.00 11) 9000 SBC COMMUNICATIONS INC (78387G103; SBC) COM NYSE 08/26/2004 25.90000 25.62000 H/L 25.760000 231,840.00 Page 1 This report was produced with EstateVal, a product of Estate Valuations & Pricin9 Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) SCH. B, ITEM 1 (1/2) Date of Death: 08/26/2004 Valuation Date: 08/26/2004 Estate of: Leo C. Johns Account: 5191.1 Processing Date: 10/01/2004 Report Type: Date of Death Number of Securities: 21 File ID: 5191-1 Shares Security Mean and/or Div and Int Security or Par Description High/Ask Low/Bid Adjustments Accruals Value 12) 3000 SCANA CORP NEW (80589M102; SCG) COM New York Stock Exchange 08/26/2004 37.61000 37.37000 H/L 37.490000 112,470.00 13) 3000 SOUTHERN CO (842587107; SO) COM NYSE 08/26/2004 30.00000 29.85000 H/L 29.925000 89,775.00 Div: 0.3575 Ex: 07/29/2004 Rec: 08/02/2004 Pay: 09/04/2004 1,072.50 14) 3000 VECTREN CORP (92240G101; VVC) COM NYSE 08/26/2004 24.29000 24.12000 H/L 24.205000 72,615.00 Div: 0.285 Ex: 08/11/2004 Rec: 08/13/2004 Pay: 09/01/2004 855.00 15) 4640 VERIZON COMMUNICATIONS (92343V104; VZ) COM NYSE 08/26/2004 39.09000 38.72000 H/L 38.905000 180,519.20 16) 3000 WGL HLDGS INC (92924F106; WGL) COM NYSE 08/26/2004 28.65000 28.35000 H/L 28.500000 85,500.00 17) 1000 WPS RESOURCES CORP (92931B106; WPS) COM NYSE 08/26/2004 47.09000 46.79000 H/L 46.940000 46,940.00 18) 3000 WISCONSIN ENERGY CORP (976657106; WEC) COM NYSE 08/26/2004 32.55000 32.38000 H/L 32.465000 97,395.00 Div: 0.21 Ex: 08/11/2004 Rec: 08/13/2004 Pay: 09/01/2004 630.00 19) 1290.252 CAPITAL INCOME BLDR FD (140193103; CAIBX) SH BEN INT NASDAQ 08/26/2004 48.61000 Mkt 48.610000 62,719.15 20) 3296.507 INCOME FD AMER INC (453320103; AMECX) COM NASDAQ 08/26/2004 17.25000 Mkt 17.250000 56,864.75 21) 2000 TRANSAMERICA INCOME SHS INC (893506105; TAI) COM New York Stock Exchange 08/26/2004 22.44000 22.16000 H/L 22.300000 44,600.00 Total Value: Total Accrual: $2,056,343.10 Total: $2,062,796.60 $6,453.50 Page 2 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) SCH. B, ITEM 1 (2/2) Estate Valuation Oate of Death: 08/26/2004 Valuation 0ate: 08/26/2004 Estate of: Leo C. James Processing Date: 09/28/2004 Report Type: Date of Death Number of Securities: 6 File ID: 5191.~.evp Shares Security Mean and/or Div and Int Security or Par Description High/Ask Low/Bid Adjustments Accruals Value 1) 10000 CARLISLE BORO PA G.O BDS (142291HF3) Financial Times Interactive Data DTD: 03/15/2002 Mat: 10/01/2019 4.8% 08/26/2004 103.68600 Mkt Int: 04/01/2004 to 08/26/2004 103.686000 10,368.60 193.33 2) 10000 FRANKLIN PA REGL SCH DIST G.O. BDS (354592NY9) Financial Times Interactive Data DTD: 09/15/2001 Mat: 08/15/2013 4.45% 08/26/2004 104.13200 Mkt Iht: 08/15/2004 to 08/26/2004 104.132000 10,413.20 13.60 3) 25000 NORTH POCONO SCH DIST PA G.O. SCH (661684HB9) Financial Times Interactive Data DTD: 07/01/2001 Mat: 09/15/2014 4.75% 08/26/2004 106.52200 Mkt Int: 03/15/2004 to 08/26/2004 106.522000 26,630.50 531.08 4) 20000 PLUM BORO PA MUN AUTH SWR REV REF REV B (72919RCZ0) Financial Times Interactive Data DTD: 09/01/2003 Mat: 11/01/2018 4.625% 08/26/2004 102.95400 Mkt Iht: 05/01/2004 to 08/26/2004 102.954000 20,590.80 295.49 5) 10000 SUSQUENITA PA SCH DIST G.O. BDS (869231FP0) Financial Times Interactive Data DTD: 09/15/2001 Mat: 03/01/2018 4.75% 08/26/2004 104.94900 Mkt Int: 03/01/2004 to 08/26/2004 104.949000 10,494.90 230.90 6) 10000 YORK PA CITY SCH DIST G.O. BDS (986846NJ8) Financial Times Interactive Data DTD: 11/15/2001 Mat: 02/15/2013 4.2% 08/26/2004 101.71100 Mkt Int: 08/15/2004 to 08/26/2004 101.711000 10,171.10 12.83 Total Value: Total Accrual: $88,669.10 Total: $89,946.33 $1,277.23 Page 1 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) SCH. B, ITEM 2 F: \FILES\DATAFILE~ESTATES\5191.1. disclaimer IN RE: ESTATE OF ' IN THE COURT OF COMMON PLEAS OF · CUMBERLAND COUNTY, PENNSYLVANIA · ORPHANS' COURT DIVISION LEO C. JOHNS ' ESTATE NO. 2004-0808 DISCLAIMER AND RENUNCIATION I, Julia G. Johns, hereby exercise the rights granted to me in Chapter 62 of the Probate, Estates and Fiduciaries Code (the "PEF Code"), and I hereby irrevocably and unqualifiedly disclaim and renounce any interest to which I may otherwise be entitled under Item 2 of the Last Will and Testament of Leo C. Johns dated July 21, 1999, in income and principal· IN WITNESS WHEREOF, intending to be legally bound hereby and intending that this Disclaimer and Renunciation shall be filed of record in the Office of the Clerk of the Orphans' Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania, and a copy thereof delivered to Julia G. Johns, Executrix of the Estate of Leo C. Johns, I have hereunto set my hand and seal, this \ ¢¢'~ day of ~ , 2004. G. JohnS~../ - - COMMONWEALTH OF PENNSYLVANIA ) 'SS. COUNTY OF CUMBERLAND ) Onthis, the /~gl,. dayof(/~~ 2004, beforeme, anotarypubli.c, personally . appeared Julia G. Johns, known to me to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the up..up.B~oses therein contained. Notary Public I NOTARIAL SEAL I WCTORIA L OTFO, NOTARY PUBLIC I CARLISLE BO~O., CUMBERLAND COUNTYJ 1 MY COMMISSION EXPIRES DEC. 2, 2006 -1- F:WILESXDATAFILE\WILLS\5191REV.WIL LAST WILL AND TESTAMENT I, LEO C. JOHNS, of Silver Spring Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make~ publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. 1. I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. 2. If my wife, JULIA G. JOHNS, is living thirty (30) days after my death, then I give, devise and bequeath all of my estate, both real and personal property, unto my Trustee, to be held or distributed by such Trustee as follows: a. The Trustee shall pay the net income, at least quarter-annually, to my wife, JULIA G. JOHNS, for life. In addition, the Trustee, in itg sole discretion, may invade the principal of the trust to provide for the proper and adequate support of my wife, JULIA G. JOHNS. b. The Trustee shall pay to my wife, JULIA G. JOHNS, annually, such sum from the principal of the trust as she may request in writing; provided, however, that said sum may not Page 1 of 4 Pages exceed the greater of Five Thousand Dollars ($5,000.00) or five percent (5%) of the aggregate value, at the time of said request, of the principal of the trust hereunder. c. Upon the death of my said wife, JULIA G. JOHNS, my Trustee shall distribute the principal of the trust to my son, WAYNE GROH JOHNS, absolutely. 3. In the event my said wife, JULIA G. JOHNS, is not living thirty (30) days after my death, then I give, devise and bequeath all of my estate to my son, WAYNE GROH JOHNS. 4. I nominate, constitute and appoint my wife, JULIA G. JOHNS, as Executrix and Trustee of my estate. In the event she shall be unable or unwilling to serve in such capacity, then I appoint my son, WAYNE GROH JOHNS, to so serve. 5. I direct that my Executrix(or) shall not be required to file a bond to secure the faithful performance of her(his) duties in any jurisdiction. 6. I authorize and empower my personal representative and Trustee, in their sole and absolute discretion, to purchase or otherwise acquire and retain any investments of which I die seized or any real or personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as they may deem advisable; to borrow money for Page 2 of 4 Pages any purposes connected with the protection and preservation of my estate; to mortgage or pledge any real or personal property forming a part of my estate or to join in or secure the partition of same; to compromise any claims or demands of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; to employ agents, attorneys and proxies and to delegate to them such power as my personal representative and Trustee consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as may be necessary to carry out any of these powers. In addition, I direct that my personal representative shall have the power to conduct an inventory of any safe deposit box necessary to the administration of my estate. IN WITNESS WHEREOF I have hereunto set my hand and seal this c~,ta'T'~day of Ju~t Leo C. Jo~s SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testator and of each other. Page 3 of 4 Pages COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) I, Leo C. Johns, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; anC4'hat I signed it as my free and voluntary act for the purposes therein expressed. ~ Swom or' affirmed to and acknowledg Leo C ' day of x-)t,c~dr- , 1999. Notary Public NOTARIAL SEAL CORRINE L. MYERS, Notary Public COMMONWEALTH OF PENNSYLVANIA ) Ca'lis~ Boro, Cumb~~ · SS. M7 Commis,.sion E~ipires May 27, 2003 COUNTY OF CUMBERLAND ) We, the witnesses-- r,.Jwhose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Leo C. Johns, the Testator, sign and execute the instrument as his Last Will; that the Testator signed willingly and that the Testator executed it as his free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testator, signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Address 7'~,d E-a-~-r ,t/t~q Addres ,"i;"', ~,,. ,~ ,' ,~' ~ Sworn or affirmed to and subscribed before me this c9,./~ day of ,1999. ot e; bffc' - ' (J - Page 4 of 4 Pages M,/ Commission E~cires May 27, 2003 \ ~. " .'7 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 REY-41S EX AFP 112-1141 IVO V otto III MARTSON ETAL 10 E HIGH ST CARLISLE ESQ 03-14-2005 JOHNS 08-26-2004 21 04-0808 CUMBERLAND 201 AIIount R_i tteel LEO C PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ REV=it83--EX--AFF.--COr--oi'j-----.i-NifficE-OF--DETERMiifAfiifri-Aifli-AS-SESS-MEWf---------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN .. ESTATE OF JOHNS LEO C FILE NO.21 04-0808 ESTATE TAX DETERMINATION ACN 201 DATE 03-14-2005 1. Credit For State Death Taxes as Verified 27.372.00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 91.204.56 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 91. 204.56 5. Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A ..CREDIT" (CRl, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~,., Q.......::> COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ;,_,:,...,:,,"\/,\,..,:,.-\.,._.,n, BUREAU OF INDIVIDUA!;1~'lC~_S:.:; INHERITANCE TAX DIVISION. PO BOX Z80601 HARRISBURG PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISE"ENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESS"ENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-14-2005 JOHNS 08-26-2004 21 04-0808 CUMBERLAND 101 Il:L~7 C()tJRT IVO V oo[ioEfn/.ESQ(>), MARTSON ETAL 10 E HIGH ST CARLISLE PA 17013 '* REV-1541 EX iFP 112-041 LEO C Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ IE.V :r!""f.Ex..AFlr.r~r-.6J".NoT.fcE.oF.i'N'HErtflA'rcE.T.AX.A.PpIA.isEM.EN'~..ALtowlNCE.OR.............. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF JOHNS LEO C FILE NO. 21 04-0808 ACN 101 DATE 03-14-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will r~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: lS. AIIount of Line 14 at Spousal rate (lS) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. A.ount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due X C TS: RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. ~rtgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/"isc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets U) (2) (3) (4) (S) (6) (7) .00 2.152.742.93 .00 .00 19.081.22 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/Adm. Costs/"isc. Expenses (Schedule H) 10. Debts/"ortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllantal Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) UO) 38,623.49 .00 NOTE: .00 2,133,200.66 .00 .00 X 00 = X 045 = X 12 = X 15 = DATE 11-19-2004 12-21-2004 ~BER CD004653 CD004755 + INTEREST/PEN PAID (-) 4,789.47 .00 A"OUNT PAID 91,000.00 204.56 ~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 2,171,824.15 Ul) (2) (3) (4) 38.623 49 2,133,200.66 .00 2,133,200.66 (9)= .00 95,994.03 .00 .00 95,994.03 95,994.03 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS.) 2005 JUl IS PH /2: 03 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN '* BUREAU OF INDIVIDUAL ~f'\cD OFFICE OC INHERITANCE TAX DIVISION nL~LL.. I f PO BOX ze06Dl 0F. ('\;::-"''"{"''n nor . ~ n ' (\ HARRISBURG PA 11128-0601 ri....Gr..-iILrl -.:; ~1I;, L) 1[V.73'EkaFPU,_IS) ClERK OF OflPHAN'S COURT IVO V orOlJMe~ CO PA HARTSON ETAl ." 10 E HIGH ST CARLISLE PA 17013 07-18-2005 JOHNS 08-26-2004 21 04-0808 CUMBERLAND 202 APPEAL DATE: 09-16-2005 (See reverse side under Objections) Anlaunt Rmi tted I I MAKE CHECK PAYABLE AND REMIT PAYMENT lED C TO: REGISTER OF WIllS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, sub.it the upper portion of this forn with your t.x pay-.nt. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR FILES +- RE-Y=736-e;(AFP-Tlir:.-oiil-----.ii-NOficE"-iinie'fEJiHiiiAfioii-iNinisseiislieNy------------------------ ---- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER .. ESTATE OF JOHNS lED C FILE NO.21 04-0808 ESTATE TAX DETERMXNATXON ACN 202 DATE 07-18-2005 1. Credit For State Death Taxes as Verified 27,372.00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 91,204.56 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 91,204.56 5. Pennsylvania Estate Tax Due .00 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return .00 7. Additional Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMDUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE "'- "<- DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I q", ~ ()tJ U) REGISTER OF WILLS OF CUMBERLAND COUNTY STATUS REPORT UNDER RULE 6.12 (For Resident Decedents Dying After July 1, 1992) Name of Decedent: LEO C. JOHNS Date of Death: August 26, 2005 File No. : 21-04-0808 Social Security No.: 210-18-9702 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 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No x 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 x No d. Copies of receipts, releases, joinders and approvals offormal or informal accounts may be filed with the Cler of the Orphans' Court and may be attached to this report. Date: November 10, 2005 Signature: Name: Address: F:IFILESIDA TAFILEIESTATESISI91.1.srep Ivo V. Otto III, Esquire MARTSON DEARDORFF WILLIAMS & OTTO Ten East High Street Carlisle, P A 17013 (717) 243-3341 :~ Counsel for personal represent~Hr~.: , ,~><.=) 1'1:/(; 6'/ 'd 0 / 1100 . I ( Sil(J, ('''. .:;u :;0, -.iv/j,J() r~, ...!v 1 ,,-. 1J '~.' I/.!. "';Uo(Jn~,. vV.:J1j .~~