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HomeMy WebLinkAbout03-0683PETITION FOR PROBATE and GRANT OF LETTERS t m also known as To: .~; - t 7 ' C~ 3 Deceased. Social Security No. Register of Wills for the County of a~,.c~xX~-~a~,-xc~ Commonwealth of Pennsylvania in the The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut fg~4r ¢c i~ t%. ~o,~ ~' named in the last wilt of the above decedent, dated r9 - ~ ,19 ~ ~ and codicil(s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in t2~,x,~c ~¢,~ a~ -~ _ _- ,. -~x County, Pennsylvania, with last family or principal residence at (list street, number and muncipality) Decendent, then ~':g years of age, died .ff - ~ "/ , 19 tg._~ , 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: ~ WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. request(s) the probate of the last will and codicil(s) (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) /% OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ] COUNTY OF ~L~a_~-rx~r~a..~, f ss The petitioi:er(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed beforf~me this /~"-~"~ day of No. ,e.v ~"~,, l.[ t s "~ { l~. Deceased Estate Of Pqg~t~ n - ' DECREE OF PROBATE AND GRANT OF LETTERS AND NOW the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated described therein be admitted t,g.~obate and filed of record as the last will of and Letters -- are hereby granted to '~ ~t-rR.,c, ~ ~.-~?'~, ~1~'~ in consideration of the petition on FEES Probate, Letters, Etc .......... Short Certificates( ) .......... _~uon ................ TOTAL Filed ~. ~,.. ~ ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE his is to certify that the information here given is correctly copied fi'om 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 ~ling. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9154929 No. Local-Registrar Date 83 ~. Dauphin .... ~lS}fltil~{~ Own Home 210 Maple Ave ~ctu~. Camp Hill, Pennsylvania 17011 F,m,~a.s ~,,~ ,~,=. ,..o,~. L~ Fred Schram COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH Mary Phyllis Boyle I~ Female } . May 21, 1919 ,. Sayre, Pennsylvama t~ Linglestown Carolyn Croxton Slain Hospice Residence ,.,~[~ ~ LU.~,..,~,c,~.. ..ce~^,..,,o.~,...~.,.w~,..~VVhite I ~enn~ylva[lla ~ H~mpd~u twp. Cumberland Mary Laux ts. ~omw.~t.s.,t~rt.,.~.~ Patricia A. Boyle ~;~"-~;;'s~Ao'~O~!'~"~'~sl~fil]~[~d~ 17011 ~ ~ ,~- ~ ~ I~ ........... ' ~. ~ IL~-C~.m~,.Z~ ],~ ~u ~,..~ ~r ......... May 19 2003 '~ Conolite Cremato~ I Schaefferstown, Pa 17088 ~ ~' [~ - ~ 1~ FU-U/q~lO-L I~ Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, Pa 17055 ~~ 7'55 A M ~eO~,~ ~ ~ ~F~..EO m~ ~~.? . :? LAST WILL AND TESTAI'.IENT OF I'.'~ARY PHYLLIS BOYLE Y, ItiR¥ P.i. UZLLIS BOYLE, of the Tovr~]ship of Hampden, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and ali_ prior Wills by me at any time heretofore made. i direct the pa]nnent of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done, a~d in this respect, Z direct that all estate, inheritance and succession taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid out of the principal of my general estate to the same effect as if said taxes were expemses of administration, and that all property includable in my tsxable estate, whether or not passing unde~ this ~'fill, si~all be free and clear thereof. I give and bequeath all my household furnishings and personal effects and other tangible personal property of a like nature, together with any insurance coverage which may be thereon, to my daughter, PATRICIA A. BOYLE, if she survives me. -1- In the event that my daughter, PATRICIA A. BOYLE, should predecease me, then in such event, i give and bequeath all of said household furnishings, personal effects and other tangible personal property to' my four (4) children, to wit, M!CttAEL JOSEPH BOYLE, AI'..~I.~E O7 COI~NELL STONE, JOYCE O7 CONh~ELL HOSFELT and JEANNE O'CONNELL AIfDERSON, share and share alike. I give and bequeath all shat.es of stock which I may own at the time of my death iu the CITIZENS A~ NORTHERN BA~, of Wellsboro, Pennsylvania, to my four (~) grandchildren, to wit: MICHELE M. MA~PELL, CHRISTINE M. ~'LA~YELL, LORI 0'CONNELL NITC~E,~,D%N and WILLIAM DAVID 07 CONNELL, share and share alike. I give and bequeath all my Geneological Papers, including all letters I may possess at the time of my decease from my late husband, JOSEPH F. BOYLE, to my daughter, PATRICIA A. BOYLE, with the request that she maintain full custody of the same during her lifetime and share said information with other members of my family, from time to time, as they may request and that upon her death she turn the same over to other responsible members of my family for safe keeping and preserva- tion. -2- (a) [Iii the event that tl~e above mentioned Geneological Papers a~d letters are pr[utab].e a~'~] of sufficient monetary value, it is my wish that the f~nds ~]erived therefrom be used to set up a~ Educational Trust Fund with a reputable college or educatioual ~.nstitution, in my name and that of my late husband], JOSEfH ?. DOYLE, the sa~e to be available for the use and benefit of a~]y members of my immediate family such as chi!~ren, grandchildren al~d greatgrandchildren. I g-~_ve and bequeath all the rest, residue and remainder of my estate, real, ~ersomat a~5 ~ixed, whatsoever and where- sever situate, to my four (4) children, to wit, MICttAEL J. BOYLE, A]'.[~tE O~CONNELL ST0.N~., JOYCE 0~ CONNELL HOSFELT and JEANNE O~CON1..tELL AI~H)EI. tSOE, share and share alike, per stirpes. LASTLY, [[. nominate, constitute and appoint my daughter, PATRIC~.A A. BOYLE, E::ect~tri.~ of this my Last Will and Testament, and in the eve.~t that ~y said ~laugb. ter should predecease me, or should she be unable or unwilling to serve in such capacity for any reaso.n, then in such event, I nominate, constitute and appoint my daughter, JOYCE O~ CONI'.IELL HOSFELT, Executrix of this my Last Will a~d Testament, in her place and stead, and in all instances, I direct that my said personal representatives be excused from posting bond or other security for the faithful performance of their duties in any Jurisdiction. IN I?ITNES$ WHEREOF, I have hereunto set my hand and seal this ~4~Qday of February, A. D., 1999. ( SEAl Signed, sealed, published and declared by the above named, ])~:k~£ P]~[LL/S BOYLE, as amd for her Last "./fill and Testament, in the presence of us, who have subscribed our names hereto as witnesses, at the request of said testatrix, in her presence and in the presence of each other. COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) SS. I, :AI ~ .... ~,.Jmo . -, the testat rix 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 and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for the purposes therein contained. day of ~~. Sworn and affirmed to and acknow.le~ged before 7~b ........... i~}~..T_jT,_T__S w~,rr~_)~.~2_,,~, the testat. ~ix , this , A. D., 1999. //~D Notary Public COMMONWEALTIt OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We, the undersigned, J. ~©J3)]:i2T STAUFi~ER and SIiS!IU .t, I.~cCOY , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testatrix , I'~%t~I~ PI~LLIS 7305~j.~ , sign and exe- cute the instrument as kl~her Last Will and Testament; that the said testatrix , ?'IA.R~ PJI~LLIS BOX~E executed it as ~her free and voluntary acc for the purposes therein expressed; that each of us, in the hearing and sight of the testat Pix , signed the Will as witnesses; and that to the best of our knowledge, the testatrix was., at the time, eighteen (18) or more years of age, of sound mind, and under no constraint, duress or undue influence. Sworn and subscribed to b efore~~.~ ~. ~~ me this ~ day, 19°f99, ~ ~/ ~ an E Will ams Nota~ Public ~ ~ M '~.[. ~_._ ~',;mbefiand county ~ [~, ~s~v~ ~iation ot Nm.es O~ J. ROBERT STAUFFER ATTOHNIiY AT LAW M.~KET SQuAmz MECHANICSBURG, PA. 17055 DUNCAN, HARTMAN & DOUGLAS 1 IRVINE ROW CARLISLE PA 17013 TELEPHONE 717-249-7780 GEORGE F. DOUGLAS, m, ESQ. Supreme Court I.D.//61886 IN THE COURT OF COmmON PLEAS OF IN RE: ESTATE OF CUMBERLAND COUNTY PENNSYLVANIA MARY PHYLLIS BOYLE A/K/A MARY P. BOYLE, LATE OF HAMPDEN TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA ESTATE NO. Z1-03-0683 To: Donna Otto, Deputy Register of Wills PRAECIPE Please enter my appearance as attorney for the estate of Mary Phyllis Boyle a/k/a Mary P. Boyle Date:September 30, 2003 Duncan, Hartman & Douglas Gebrge F. ~Douglas, III~, CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Mary Phyllis Boyle a/k/a Mary P. Boyle Date of Death: May 17, 2003 Will No. 21-03-0683 Admin. No. To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court .~ules was served on or mailed to the following beneficiaries of the above-captioned estate on September 29, 2003 : Name Address -I%lf~icia A. Boyle 210Maple Ave., Camp Hill, rA 1/011 Michele M. Mixwell 131 Monument Street, Medford, MA 02155 C~ristlne M. P~Axweli ~ZO Mapiewooa Lane, ~noia, ~A i7025 Lori Nitchman 12 Montsera Road, Carlisle, PA 17013 W111laU. o'uonmell /1 wmse Avenue, Lancaster, PA 17605 Michael J. Boyle 2241 Adrian Street, Harrisburg, PA 17104 ooyce uos~elt 4z courtyard urlve, uarilsie, ~a i70i3 Jeanne Anderson 926 Maplewood Lane, Enola, PA 17025 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE Date: Name George F. Douglas, III, Esquire Address 1 Irvine Row Carlisle, PA 17013 Telephone( 71y 249-7780 Capacity:~ Personal Representative x Counsel for personal representative 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(11-96)/ CD 003444 FOWLER JOHN B III 10 E HIGH STREET CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 006-26-6765 FILE NUMBER: 2103-0863 DECEDENT NAME: LOZIER ROSEMARY C DATE OF PAYMENT: 01 / 16/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/17/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $7,080.87 REMARKS: TOTAL AMOUNT PAID: $7,080.87 SEAL CHECK//104 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV-15~0 EX + PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 NAME (LAST, FIRST, AND MIBDLE INITIAL) Boyle . Mary Phyllis BATE OF DEATH (MM-DB-Year) OATE OF BIRTH (MM-DD-Yea-) 05/17/2003 05/21/! 919 (IF APPLICABLE) SURVIVING SPOUSE'S NAIVE (LAST, FIRST, AND MIDDLE INITIAL) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL U3E ONLY RLE NUMBER 2 1 -0 3 0 0 6 8 3 SOQAL SECURrP( NUMBER ! 8 1-0 7-6 0 8 5 THIS RETURN MUST BE RLED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ['~-] 1. Original Return r-J4. Limited Estate r~]6. Decedent Died Testale (Atm~m~,ofwa) --]9. Litigation Proceeds Received E~]2. Supplemental Return r'-'~ 4a. Future Interest Compromise (~e ~f ~ a.~ 12-12~) r-17. Decedent Maintained a Living Trust (Ntoch cep/ofTru~) O10. Spousal Poverty Credit (a,m of a~h mm,~= 12-31-gl ,,~ 1-~-.~) [--~ 3. Remainder Return (~e of death E~]5. Federal Estate Tax Return Required 0__ 8. Total Number of Safe Deposit Boxes E~] 11. Election to tax under Sec. 9113(A) THIS SECTION MI,~T BE COMPLY. ALL CORRESPONDENCE AND NAME George F. Douglas, III FIRM NAME (ff&opicabb) Duncan, Hartman & Douglas TELEPHONE NUMBER '17-249-7780 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 Recavable (Schedule D) (4) 5, Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) r-] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Prebate Property (7) (Schedule G or L) 8. Total Gross A~,ets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule 1) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Baquests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Une 12 minus Line 13) COMPLETE MAILING ADDRESS 1 Irvine Row 33=660.00 571.20 50,145.46 (8) 23,070.~90 (11) , , (12) (13) , Carlisle, PA 17013 (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X (15) 16. Amount of Line 14 taxable at lineal rate 61,305.76 x .045 (16) 17. Amount of Line 14 taxable at sibling rate ~ X . 12 (17) 18. Amount of Line 14 taxable at collateral rate ~ X .t5 (18) , , 19. Tax Due (19) 20. ~ I~- ........................ ,--, ........ OFFICIAL USE ONLY 84,376.66 23,070.90 61,305.76 61,305.76 2,758.76 2,758.76 Decedent's Complete Address: STREET ADDRESS ~ Irvine Row Carlisle STATE PA Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) A. Spousal Poverty Credit B. Prior Payments C. Discount (1) Total Crec~ (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) .. B. Enter the total of Line 5 * SA. This is the BALANCE DUE. (SB), Make Check Payable to: REGISTER OF WILLS, AGENT 7013 2,75&76 2~758.76 2,758.76 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a tramfer and: Yes No a. retain the use or income of the property lmnsfeffed; ......................................................................... [] [~] b. retain the right to designate who shall use the property Iransferred or its income; ...................................... [] [] c. retain a revemionary interest;.or .................................................................................................. [] [] d. receive the promise for life of eilher payments, benefits or care?. ......................................................... [] [] 2. If death occurred after December 12, 1982, did decedent lransi'er property within one year of death without receiving adequate consideralton? .......................................................................................... [] [] 3. Did decedent own an "in Irust fo~ or payable upon dea~ bank account or sacudty at his or her death2 ............... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designate2 .................................................................................................. [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF Sx~OF PERSON RESPONSIBLE F~R FILING RETURN DATE, ADDRESS ~ ' ' ~ ' THE RETURN. S~NATURE OF PREPARER OTHER THAN P~RESENTATIVE AI~DRESS - · ~ ' For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of lransfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (~]. For dates of death on or after Januar/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) (iO]. The statute _does not exemot a transfer to a surviving spouse from lax, and the statutonj requirements for disclosure of assets and filing a tax return are slill applicable even if the surviving spouse is the only benef~aT. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of lransfers 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 decedenfs lineal beneficiaries is 4.5%, except es noted in 72 P.S. ~q 116(1.2) [72 P:S. §911 $(a)(1 )]. The tax rate imoosed on the net value of transfers to or for the use of the decedanfs sibtines is 12% 172 P.S. Sg1161a~(1.3~]. A siblin~ is defined, under Section 9t02. as an C,OMMONWF_.N. TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECED,EI~, ESTATE OF Boyle Marv Phvllis ,, , All property jointiy-owfled with rigM of suwivorship must be disclosed on Schedule F. SCHEDULE B STOCKS & BONDS ' RLE'NUMBER 21 03 oo6~3 ITEM NUMBER DESCRIPTION 1360 Shams of Citizens &Northem corporation (~ 24.75 per sham TOTAL (Also enter on line 2, Recapitul~on) VALUE AT DATE OF DEATH 33,660.00 33,660.00 I~N-1508 EX + COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Boyle Ma~ Phyllis , , SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER .... 21 . 03 00683 Include the proceeds of litigation and the date the proceeds were received by the estate. All profle~y joinb¥omted with the r~ght of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION Citizens & Northern Bank dividend check TOTAL (AJso enter on line 5. Recapitulation) VALUE AT DATE OF DEATH 571.20 $ 571.20 SCHEDULE F JOINTLY.OWNED PROPERTY · COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OI~ .......... Bovle Marv Phyllis , If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. FILE NUMBER 21 03 00683 SURVIVING JOINT TENANT(S) NAME A. Patdcia A. Boyle C ADDRESS 210 Maple Avenue Camp Hill, PA 17011 RELATIONSHIP TO DECEDENT Daughter JOINTLY.OWNED PROPERTY: U-i 1 ~-R DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Incbde name of lina,,cial institu'~on md bmk account number or similar identif34ng number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for ~ntyheld real estate. VALUE OF ASSET INTEREST DECEDENTS INTERES 1. A. 10/85 PSECU Checking Acct~ 8407578494 4,823.29 50. 2,411.65 2. A. 10/85 PSECU Saving Acct-8 8407578494 95,467.61 50. 47,733.81 TOTAL (Also enter on line 6, Recapitulation) $ 50.145.46 COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Boyle Mary_ Phyllis Debts of decedent must be reported on Schedule I. FILE NUMBER ;~1, 03 ITEM NUMBER 2. 3. 4. 8. 9. 10. 11. 12. 13. DESCRIPTION FUNERAL EXPENSES: Sons of Italy- Roma Madre Lodge ( family luncheon after funeral) Grand Victorian Inn, Sayra Pa. Hotel Rooms for family members 5~75.21 Myers Funeral Home, Inc. Clergy Donation ADMINISTRATIVE COSTS: Personal Representat~e's Commissions Name of Pemonal Representative (s) Social Security Number(s) / EIN Number of Pemonal Representative(s) Street Address City State Year(s) Commission Paid: AttomeyFees Duncan, Hartman, & Douglas Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Patricia A. Boyle street Address 210 Maple Ave. zip city Camp Hill Relationship of Claimant to Decedent State ,Pa Zip 17011 Probate Fees Register of Wills Cumberland County Accountant's Fees Tax Return Preparer's Fees Cumberland Law Journal ( Legal Ad) The Sentinel ( Legal Ad) Register of Wills ( Short Certificate) Hospice of Central Pennsylvania Quantum Imaging Reimburse Overpayment State Employee Retirement Harrisburg Pharmacy TOTAL (Also enter on line 9, Recapitulation) 00683 AMOUNT 484.45 376.05 3,183.80 75.00 4,218.84 3,500.00 133,00 75.00 105.53 6.00 10,500.00 153.00 253.23 7.00 23,070.90 REV-IS13 EX ~-(1-~7) · COMMONWEALTH OF PENNSYLVANIA INHERiTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ......... Boyle I~larv Phyllis NUMBER 1. 2. 3. 4. 5. 1. 1. SCHEDULE J BENEFICLARIES NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include ou~,~h{ spousal ~{Hbulions) Patricia A. Boyle 210 Maple Ave Camp Hill, PA 17011 William D. O'Connell 71 Wise Ave Lancaster, PA 17603 Lorl Nitchman 12 Montsera Road Carlisle, PA 17013 Christine M. Maxwell 926 Maplewood Lane Enole, PA 17025 Michele M. Maxwell 131 Monument Street Meaford, MA 02155 FIE~ NUMBER ..... ' 21 03 00689, RELATIONSHIP TO DECEBENT AMOUNT OR SHARE Bo Not List Tnm~ee{_,m) OF ESTATE Daughter Grandson Granddaughter Granddaughter Granddaughter 100% Remainder 340 Share of Stock 340 Sham of Stock 340 Sham of Stock 340 Sham of Stock ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLEDIsTRIBUTIONS: "'" ' ' ' ' ' ' A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART !'! - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ /If mnm. 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Powered by Page generated 9/29/2003 3:35 PM eastern time http://moneycentral.msn, com/scripts/webquote, dll?iPage=qd& Symbol=US%3ACZNC 9/29/2003 MSN Money - US:CZNC Chart: Investor rng~ J m ~ Markets Sto¢l(s Funds Insight B~okers CNBCTX/ quote, Chart~ News Snapshot Quotes Charts Historical Real-'~me In~aday Key Developments Recent News Research Company Report SEC Filings Advisor FYI Stock Rating Earnings Estimates Analyst Ratings Financial Results Insider Trading Ownership Community Guided Research Research Wizard Find Stocks Stock Screener Power Searches Top Rated Stocks Related Links E-mail & Alerts IPO Center Messaqe Boards Capital Gains Analysis Name or SymbohJUS:CZNC I Find Symbol Pdnt Report Citizens & Northern Cp Date Higi~ Low Close Volume 6/30/2003 25.81000 25.81000 25.81000 0 6/27/2003 26.00000 25.80000 25.81000 9,200 6/26/2003 26.00000 26.00000 26.00000 200 6/25/2003 26.15000 26.00000 26.00000 3,100 6/24/2003 26.00000 26.00000 26.00000 3,100 6/23/2003 26.00000 26.00000 26.00000 0 6/20/2003 26.50000 26.00000 26.00000 2,800 6/19/2003 26.75000 26.00000 26.00000 4,900 6/18/2003 26.85000 26.00000 26.25000 700 6/17/2003 26.00000 26.00000 26.00000 1,400 6/16/2003 26.00000 26.00000 26.00000 200 6/13/2003 26.95000 25.75000 26.85000 6,800 6/12/2003 25.75000 25.00000 25.75000 800 6/11/2003 25.75000 25.00000 25.75000 5,400 6/10/2003 25.50000 25.50000 25.50000 0 6/9/2003 25.50000 25.50000 25.50000 300 6/6/2003 25.00000 25.00000 25.00000 0 6/5/2003 25.25000 25.00000 25.00000 9,100 6/4/2003 25.00000 24.80000 25.00000 400 6/3/2003 25.25000 24.75000 25.25000 300 6/2/2003 25.00000 25.00000 25.00000 300 5/30/2003 25.00000 25.00000 25.00000 0 adv( VISA http://m~ney~entra~~msn~c~m/invest~r/charts/chartd~~asp?Symb~~=US%3 ACZNC&DateRa~~~ 9/29/2003 MSN Money - US:CZNC Chart: Investor Page 2 of 2 5/29/2003 25.00000 24.35000 25.00000 900 5/28/2003 24.30000 24.30000 24.30000 0 5/27/2003 24.30000 24.30000 24.30000 600 5/23/2003 24.40000 24.25000 24.25000 3,400 5/22/2003 24.50000 24.50000 24.50000 200 5/21/2003 24.75000 24.30000 24.75000 600 5/20/2003 24.75000 24.75000 24.75000 0 5/19/2003 24.75000 24.75000 24.75000 1,100 5/16/2003 24.75000 ':2~ ~:~ 500 5/15/2003 24.40000 24.25000 24.25000 1,400 5/14/2003 24.40000 24.40000 24.40000 7,000 5/13/2003 24.90000 24.40000 24.40000 3,500 5/12/2003 25.10000 24.50000 24.75000 2,600 5/9/2003 24.50000 24.50000 24.50000 200 5/8/2003 24.85000 24.85000 24.85000 400 5/7/2003 25.00000 25.00000 25.00000 700 5/6/2003 24.75000 24.25000 24.75000 300 5/5/2003 24.00000 24.00000 24.00000 200 24.00000 24.00000 0 5/2/2003 24.00000 5/1/2003 24.00000 24.00000 24.00000 100 ~! h~://www.[:~ida~.com Try H$i~ Internet 5;oftware for FREE! NSN Home I ~f17 HSN ~ Hotmai~ j Shoppin~ ] ~oney ~ People &Chat Search ~2003 Microso~ Corporation. Att dghts resei~ed. Terms of Use Adve~ise TRtJSTe Approved Privacy Statement GetNetWise http : //m~ney centra~~msn~ c~m/invest~r/charts/chartd~~asp ? S ymb~~=U S%3 A CZNC&DateRa~ ~ ~ 9/29/2003 ERTIFICATE NO. DATE CER T/F/CA TE OF COMMON S TOCK S.ARES CITIZENS & NORTHERN CORPORATION '~ ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA I 10412 ?his is to c~fy that the holder named I~low is the re&fist=red owner of the number of shares specified above of Common Capital Stoc~ of Citizens & Northern Corporation, with apar.v~[ue of ~!,00 p( re, transferable only on the books of the Corporation by the holder hereof in person, or by duly authorized attorney, u~on the surrende~ of this certific.~te properly endorsed. ' ' · n witness whereof, the Corporation has caused this certificate to be signed by its duly authorized officers and to be sealed with the seal of this Corporation. PA ~AR¥ PHYLLIS BOYLE £i9 MAPLE AVENUE, OAK~OOD PARK CA~P HILL 17011 L PRESIDENT CORPORATE SE~/~T~ARy ERT, FICATE NO. CERT/FICA TE OF COMMON STOCK SHARES ~?~ CITIZENS & NORTHERN CORPORATION DATE /14/9E [ ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA cus,P ~7292~,0~ r- 1 3'3 7 0 ~st~[ tns°ferCrab[~otn~t o~nethheO~o~ksm oofedthebecl~ ,s t~. r~s?e~ ~ .... f the n=~r of s~r. ,p~fi~ .~v. of C .... ~p,~ Sto~ of ................. w~ wh~f, the Co~orafion ~ ~ thi- ~:~ ...........~. ,, y ~y au~r~z~ attorney, upon the s~r~d~ of ~- ~.n ......... · t~.~ ~ ~ pe ~ARY PNYLLZS ~OYLE 4017~ CAMP HILL PA ~7011 ~/~,~ P~SIDE~ L j , ~,~.~:~ .... ~.~.. :.RTIFICATE NO, 38678 DATE 1/19/01 CERTIFICATE UI- UUIV/IV/UIV ~ / uc,/~ SHARES CITIZENS & NORTHERN CORPORATION ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA CUSIP 172922106 his is to certify that the holde~ named below is the registered owner of the number of shares specified above of Common Capital Stock of Citizens & Northern Corporation, with a par value of $1.00 per ~e, transferable only o~ the books of the Corporation by the holder hereof in person, or by duly authorized attorney, upon the surrender of this certificate properly endorsed. t witness whereof, the Corporation has caused this certificate to be signed by its duly authorized officers and to be sealed with the seal of this Corporation. ~'-HARY PHYLLIS BOYLE E1 0 NAPLE AVE CAHP HILL PA 17011 ~RTm,CATE%. '~ cERT)FICA TE OF COMMON STOCK SHARES -~s~_~7 CITIZENS & NORTHERN CORPORATION ~ 1 DATE - /E~O/O 0 I ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA ~tn~s wh~f, the Co.ration has ~u~ ~Js ~ ...... [~ ~ereo~.m ?~on, or oy d~y authorized atto~ev u~ ,~.P~_..~t~ck ~.~Qze~ ~ No.bern Co.ration. ~th ~ ~ ' .... B .... y 1~ d~y authodz~ o~ ..... d to be ~;~ ~'~, ?,[c~fi~te prop~ly endorsed ~P~ ~.e ~ $~ p~ ~.1 0 HAPLE AVE CAMP HILL PA 17011 /~' f PRESIDEI~'/ : ORPO~ SECTARY :RTIFICATE NO. 334~0 ] DATE CERTIFICATE OF COMMON STOCK CITIZENS & NORTHERN CORPORATION ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA SHARES ,,~o,,~, ] cus,P 17~9~2106 334 20 1 ~tn~s wh~f; ~e:~ration h~ au~ ,h ...... mt la pe~on, or Dy a~y authori~d atto .v . ~ & NoVon Comoradon, ~tb ~;Pa; ;~i~e~0f'¢l==~ per PA 17011 CORPORATE SECRETARY -MARy PHYLLIS BOYLE '~:10 HAPLE AVE CAMp~HILL ~ERTIFICATE NO. DATE 1/IS/98 [ CERTIF/CATE OF COMMON STOCK SHARES CITIZENS & NORTHERN CORPORATION cus,P ~,~,of~]?o.a~t o~t~o~o~k,~o~a~p~r.,t~o.~,~,~.,~o~1.~.~o~o. °ofrSb~vr? .spec'.~...ed.ab?v. of ~o .... Capital Stock of Citizens & Northern Corporation. w~th 'a paf-~a~,¢.of $I 00 p~r L PA 17011 4017--1 ~ ' ~ ~oRPOP, A~TE S~RETARY ~-~ARY PHYLLIS BOYLE EIO HAPLE AVE CAMP HILL ] CITIZENS & NORTHERN CORPORATION J 340 0815O DATE I ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA _ ~,,o~s~oI 08160 This is to certify that the holder named below is the registered owner of the number of shares specified above of Common Capital Stock of Citizens & Northern Corporation, with a p~r vaI~e of $1,~ per  , tr~fgable oily on ~e books of the Co~orafion by the holder hereof in person, or by duly authorized attornq, upon the smrend~ of t~s certificate pro~rly ~dors~. witness whereof, the Corporation ~ caned ~s ~rtificate to be signed by its duly authorized officers ~d to be s~led with the seal of this Corporation. P-10 MAPLE .AVENUE, OAKUOOD PARK CAMP HILL PA - 1 7 0 1 1 PP,~SIDENT CORPORATE SECRI~ARY :ERT~F~CATE .O. CER T/FICA TE OF COMMON S TO CK SHARES 1 ~oo7 CITIZENS & NORTHERN CORPORATION 4,4 DATE ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA I o114,,~4 cus,P ~292~o6 ~.his.ls t&~f? ~t ~o~.n~ ~ow h ~e r~st~ o~c[of th~ numb~ of sh~ s~ifi~ a~ve of Co~on Ca.mi Stock of a~ & No~h~n Co.ration, ~tb~ ~l~f'~,~ per ~-~?a~l~ame omy on me ~s ol the ~rpor~bon o~ the ~ld~ ~ereof m p~on, or by ~uly aut~o~ attorney, u~n ~I0 HAPLE AVE OAKUOOD PARK CAHP H~LL PA 17011 P~SIDE~ CO~O~ S~TARY ERTIFICATE NO. CER T/F/CA TE OF COMMON STOCK SHARES ~,~o~ CITIZENS & NORTHERN CORPORATION DATE I ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA ~t93 CUSIP 172922106 1 4 9 0 ~e'~s. t~m~f~aC~lYeYot~l~totnhetbbe°~ok~oofe~ebeCIOo~Wni~S.~t~[~:~_~.~{ ~e. number of ,~ ~p~.ab .... , C ..... Capi,~ ~k of ~fiz~ & No.hem Cor~rafion, ' '. . ~'~'~""~ ~ "'~ -~m~ n~m~ m ~mn, or Dy auly au~onz~ attorney, upon the s~rend~ of this ~fi~m properly ~or~. ~ .~:~ vaJue ~f~.~ ~r EI O HAPLE AVE OAKUOOD PARK ~ CAMP HILL PA 17011 P~SIDENT CO~O~ SEC~TARY ;ERTIFICATE NO. CER T/FICA TE OF COMMON STOCK I SHARES o88s~ CITIZENS & NORTHERN CORPORATION *.5~** DATE ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA 2/4/ 1 I 08854 Chis is to certify that the holder named below is the registered owner of the number of shares specified above of Common Capital Stock of Citizens & Northern Corporation, witha pa~ value of $fJ~0 per xe, transferable only on the books of the Corporation by the holder hereof in person or by duly authorized attorney upon the surrender of this certificate properly endorsed. ~ :n witness whereof, the Corporation haz caused this certificate to be signed by its dul~ authorized officers and to be s~led with the seal of this Corporation. = Mary Phyllis Boyle 210 Maple Ave., Oakwood Park Camp Hill, Pa. 17011 L 4017 PRESIDENT CORPORATE SECRETARY 2ERTIFtCATE NO. DATE CER TIF/CA TE OF COMMON STOCK CITIZENS & NORTHERN CORPORATION SHARES 1/li~/96 J ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIAcusIP 172922106 2 3 7 8 6 J ~he,S.~Sa~t_o~ce~!fy th, at th~.ho?er.namf~, b~ow ts the te, g,s~.erct~, o.w. ne~ of the number of shares specified above of Common Capital Stock of Citizens & Northern C ..... tion with a r' V~lue of t. ~,~tm'stera~me %my.?n~tne noox. s 0,~ t~e c;orP0ra}]on Dy. the no[der I}ereo£ in person, Or by du y authorized attorney, uPOn the surrender of this certificate vroDerlv ~P~orsed ' pa $1.00 per .- --[.ness wnereo~, mc c.orporat~on nas caused this certificate to b¢ signed by Its duly authorized officers and to be sealed With the seal of this Corporation~ - - V' ~i ~;i / ~ARY PHYLL%$ BOYLE 4017--~ /: / //:~ L_ j PA t7011 PRESIDENT CORPORATE SECRETARY EST,~[C^TE .O. CER TIF/CA TE OF COMMON STOCK SHARES 1~ CITIZENS & NORTHERN CORPORATION DATE I ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA 1/14/94 I cus,P 17~2~o6 - 16 8 4 6 J ills/s to certify that the ho~ ~ below is ~e re~st~ed ow~ of ~e number of sh~es sp~ified a~ve of Common Qpi~ Stock of Qtiz~s & North~n ~rporaQon w~ re, ~a~f~le o~y on ~ ~s of the C~ra~on b~ the ~ld~ h~f in ~on, or by duly a~horized attorney, u~n the su~d~ of this ce~ifi~t ..... Iv ~ ' ~' '~": [.~ per ~tn~s wa~J, the Corpora~on has ~u~d t~s ~fi~te W ~ signed by its duly authodz~ o~c~s and to be ~ with the s~ of t~s ~'-r'''; ~RESIDE~ ;ERTIFICATE NO. 21040 J DATE CERTIFICATE OF COMMON STOCK CITIZENS & NORTHERN CORPORATION ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA SHARES ~/~' ~.t. ~f.Y__t_,h.a.,..t_th_e.,hol. der e~ bel w / the egtstered of th' ' ' ' ' ,, :~, ,.,, .-,sff~s--°tcc~. u,uy ~n um ~ook~ao~ theC~rpoSratio~ by the h~l~erne~nnumber of s.har? ,specified ab .... f Co .... Capital Stock of Citizens & Northern· n witness whereof, the Corporation ha~ caused this ce-;n ........... p~r.son, or Dy amy authorized attorney upon the surrender ~¢ o~: ....... Corporation. wit~!'a ~r:~at~i/'~bt~O ~er ~ARY PHYLLIS BOYLE · 10 HAPLE AVE OAKUOOD PARK CAHP HILL PA 17011 4017~ L PRESIDENT ~ "? CORPO~ SE~ETARY -=RTIFICATENO. / CERTIF/CATE OF COMMON STOCK SHARES e.~I CITIZENS & NORTHERN CORPORATION DATE 1/! S/971 ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA ~s w~[ ~ "~ tu= ~auon O~ ~ ho a~ h~: in ~rsOn or by d~ on~ .tiff--. P f Qtize~ & No,em Co ration with a pir~-~e.'o~$l.~ ~r ~-, ~e~t~onn~m~l~s~fl~e o~..i~.: .... ' .._ ,~a~ d ........... y, up~e~rr~of~fi~te r ~ ' FMARY PHYLLIS BOYLE 210 HAPLE ~VE CAMP HILL PA 17011 40t 7--] J L 0000369 COMMON STOCK CITIZENS & NORTHERN CORPORATION INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA ¢N0~44'79 11697 SEE REVERSE FOR CERTNN DERNITIONS CUSIP 172922 10 6 FOLLY PND AND NON-ASSESSABLE SHARES OF 'IHE COMMON STOCK, $1.0D PAR VALUE PER SHARE, OF transforabl~b'~~l,~ ~~~~h~fic~~i~~;al,d unle-o countersign~b~e~l~fe~lIJ~n~eg~re~ll~h~e~tr'~ ~_~' ~' r~l~r'~' ~[ ~ ~'-"-~ '~'~-~' ~-~'~ IN Wl~~~g~n~ ~~~. ~s ~~~n facsimile. Dat~: APRIL 21e 2003 ~Dl1697 O000Qd ~*~ ~r~Dr~s~.enc~ ~o CORPORATE SECRETARY CHAIRMAN, PRESIDENT AND CHIEF EXECUTIVE OFFICER 0000358 COMMON STOCK CITIZENS & NORTHERN CORPORATION INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA £N~DBO46& 11697 SEE RLC~RSE FO~ CERTNN DEFINITIONS CUSIP 172922 10 6 FULLY PNO AND NON-ASSESSABLE SHARES OF THE COMMON STOCK, $1.00 PAR VALUE PER SHARE, OF transferab,~ ~~~r'~ ;~ ~~~eO~t ~fi~~i~~valid unless Dated: JANUARY 18e 2002 11697000000 ~ CORPORATE SECRETARY 1987 CHAIRMAN, PRESIDENT AND CHIEF EXECUTIVE OFFICER 0000368 COMMON STOCK CITIZENS & NORTHERN CORPORATION INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA CN0002667 11697 SEE REV£,~tSE FOR CERTAIN DEFINITIONS CUSIP 172922 10 6 FOLLY PAID AND NON-ASSESSABLE SHARES OF THE COMMON STOCK, $1.00 PAR VALUE PER SHARE, OF CO U'~ ewr ~iTgU~~J~rpo~., ~~'t ,~igJ~i~ile ~~rize~i ~'s~O~~in facsimile' Dated: JANUARY 21, 2003 11697000000 ~ CORPORATE SECRETARY CHAIRMAN, PRESIDENT AND CHIEF EXECUTIVE OFFICER COHNONHEALTH OF PENNSYLVANIA DEPARTNE~T OF REVENUE BUR~OF INDIVIDUAL TAXES D~PT. 280601 HARRISBURG, PA 17128-0601 REV-1E4S EX AFP ¢09-00) INFORMATION NOTZCE AND TAXPAYER RESPONSE FILE NO. 21 ACN 03127158 DATE 07-25-2003 EST. OF NARY P BOYLE S.S. NO. 181-07-6085 DATE OF DEATH 05-17-2003 COUNTY CUNBERLAND PATRICIA A BOYLE 210 NAPLE AVE CANP HILL PA 17011 TYPE OF ACCOUNT [] SAVZNGS [] CHECKING [] TRUST [] CERTZF. RENZT PAYNENT AND FORHS TO: REGISTER OF NTLLS CUNBERLAND CO COURT HOUSE CARLISLE, PA 17013 PSECU has provided the Departaent aith the information listad helen which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to tho above address. This account is taxable in accordance with the Inheritance Tax Laws of tho Commonwealth of Pennsylvania. Uuesticns may =m answered by caiilng (717) 787-53Z7. COMPLETE PART 1 BELOW x x ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 8qO7578qgq Date 10-01-1985 Established Account Balance 95, q67.61 Percent Taxable X 5 0.0 0 0 Amount Sub,act to Tax 47,733.81 Tax Rata X .045 Potential Tax Duo 2,148.02 To insure proper credit to your account, tho (Z) copies of this notice must accompany your payment to the Register of Hills. Hake check payable to: "Register of Wills, Agent". NOTE: If tax payments ara made within three ($) months of the decedent's date of death, you may deduct a SZ discount cf the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE A. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Hills with two copies of this notice to obtain CHECK a discount or avoid interest, or you may check box "A" and return this notice to the Register of ONE ~ Hills and an official assessment will ba issued by the PA Department of Revenue. BLOCK ~ s. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by the decadent's representative. C. [] The above information is incorrect and/or debts end deductions were paid by you. You must complete PART [] and/or PART [] below. PART Tf you indicate · different tax rata, please state your relationship to decadent: TAX RETURN - CONPUTATZON OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established I 2. Account Balance 3. Percent Taxable q. Amount Subject to Tax $. Debts end Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART DATE PAID DEBTS AND DEDUCTZONS CLAZNED PAYEE DESCRIPTION AHOUNT PAID TOTAL (Enter on Line $ of Tax Computation) Under penalties of perSury, Z declare that the facts I have reported above ara true, correct and complete to the best of my knowledge and belief. HOME ( ) WORK ( ) TAXPAYER SIGNATURE TELEPHONE NUNBER DATE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171Z8-0601 REV-1E4S EX AFP (09-00) ZNFORHATZON NOTZCE AND TAXPAYER RESPONSE FILE NO. 21 ACN 05127157 DATE 07-25-2005 EST. OF NARY P BOYLE S.S. NO. 181-07-6085 DATE OF DEATH 05-17-2005 COUNTY CUMBERLAND PATRICIA A BOYLE 210 HAPLE AVE CAMP HILL PA 17011 TYPE OF ACCOUNT [] SAVINGS [] CHECKING [] TRUST [] CERT/F. REHIT PAYHENT AND FORHS TO: REGISTER OF NTLLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 PSECU has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at tho death of the above decedent, you mare a joint oHner/baneficiary of this account. If you feel this information is incorrect, please obtain aritten correction from the financial institution, attach a copy to this fora and r.turn it to the above address. This account is taxable in accordance eith the Inheritance Tax Lams of the Commonwealth of Pennsylvania. Uuastions may be ansaered by ca~iing COMPLETE PART 1 BELON x x ~ SEE REVERSE SIDE FOR FILING AND PAYMENT ZNSTRUCTZONS Account No. 8407578494 Date 10-01-1985 Established Account Balance 4,825.29 Percent TaxabZe X 50.000 Amount Sub,eot to Tax 2,411.65 Tax Rate X .045 Potential Tax Due 108.52 To insure proper credit to your account, tWO (Z) copies of this notice must accompany your payment to the Register of #ills. Hake check payable to: "Register of Hills, Agent". NOTE: If tax payments ara made within three (3) months of the dacadent's date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due ail! become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE A. [] The above information and tax dui is correct. 1. You say choose to tacit payaant to the Register of Hills eith tho copies cf this notice to obtain CHECK , discount or avoid interest, or you lay check box "A" and return this notice to the Register of l- ONE ~ Hills and an official assessment will be issued by the PA Department of Ravanua. BLOCK j B. [] The above asset has been or ail1 be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by tho dacedent's representative. C. [] The above inforaation is incorrect and/or debts and deductions acre paid by you. You must complete PART [] and/er PART [] belcH. Zf you /nd/cate a different tax rate, please state your reZationship to decedent: RETURN - CONPUTATZON OF TAX ON JOINT/TRUST ACCOUNTS 1. Dire Established I PART TAX LINE 2. Account Balance ~ 3. Percent Taxable $ ~ q. Amount Subject to Tax ~ $. Debts and Deductions $ - 6. Amount Taxable ' 6 7. Tax Rate 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line $ of Tax Computation) Under penalties of perSury) Z declare that the facts I have reported above are true, correct and complete to the best of ay knowledge and belief. HOME ( ) NORK ( TAXPAYER STGNATURE TELEPHONE NUNBER DATE LAST WILL AND TESTAI~,iENT OF MARY P}PZLLIS BOYLE I, I~t~RY P}UZLLiS BOYLE, of the Tow~]ship of Hampden, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. i direct the pa~nent of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done, and in this respect, Z direct that all estate, inheritance and succession taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of administration, and that all property includable in my taxable estate, whether or not passing under this Will, shall be free and clear thereof. I give and bequeath all my household furnishings and personal effects and other tangible personal property of a like nature, together' with any insurance coverage which may be thereon, to my daughter, PATRICIA A. BOx~.~,~?'~ if she survives me. -1- In the event that my daughter, PATRIC!A A. BOYLE, should predecease me, then in such event, i give and bequeath all of said household furnishings, personal effects and ether tangible personal property to' my four (~$) children, to wit, MICHAEL JOSEPH B0'~LE, ANNE 0t CONNELL STONE, JOYCE 0~ CONI\~LL HOSFELT and JEAN~'~E 0t CONNEDL ANDERSON, share and share alike. ' I give and bequeath all shat.es of stock which I may own at the time of my death in the CITIZENS AND NORTHERN BANK, of Wellsboro, Pennsylvania, to my four (4) grandchildren, to wit: MZCHELE M. MAkqgELL, CHRISTIN'E M. MA~.~ELL, LORZ 0~CONNELL NITC~E~N and WILLIAM DAVID 0~ CONNELL, share ~nd share alike. I give and bequeath all my Geneological Papers, including all letters I may possess at the time of my decease from my late husband, JOSEPH F. BOTLE, to my daughter, PATRICIA A. BOYLE, with the request that she maintain full custody of the d same urzng her lifetime and share said information with other members of my family, from time to time, as they may requesb and that upon her death she turn the same over to other responsible members of mY family for safe keeping and preserva- tion. -2- (a) Iu the event that tl.~e above mentioned Geneological Papers a~']d letters are pri~table and of sufficient monetary value, it is l~y wish that the. funds (]erived therefrom be used to set up an Educational Trust Fund with a reputable college or educational institution, in my name and that of my late husband, JOSEPH ~'. DOYLE, the sa~:]e to be available for the use and ben'efit of any members of mil immediate family such as childre.~'], grandchildren and greatgrandchildren. I give and bequeath all the rest, residue and remainder of my estate, real, persooal and mixed, whatsoever and where- sorer sit%~.te, to ~y four ([~) children, to wit, MICHAEL J. BOYLE, A]~-~.~NE O'CONNELL STONE, JOYCE 0'CONNELL HOSFELT and JEANNE 0'CONNELL A1..H3ERSON, share and share alike, per stirpes. LASTLY, I nominate, constitute and appoint my daughter, PATRICIA A. BOYLE, Executri~ of this my Last Will and Testament, and in the event that my said da.ughter should predecease me, or should she be tunable or unwilling to serve in such capacity for any reason, then in such event, I nominate, constitute and appoint my daughter, JOYCE 0~ CONNELL HOSFELT, Executrix of this my Last Will and Testament, in her place and stead, and in all instances, I direct that my said personal representatives be excused from posting bond or other security for the faithful performance of their duties in an~' jurisdiction. -3- IN WITNESS WHEREOF, I have hereunto set my hand and seal this ..?~_~ ~Pday of February, A. D., 1999. ( SEAl Signed, sealed, published and declared by the above named, Mt~RY ?.~-LLIS BOYLE, as and for her Last Will and Testament, iu the presence of us, who have subscribed our names hereto as witnesses, at the request of said 'testatrix, in her presence aud in the presence of each other. COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) SS. i, ~O~ARY P!{!~LLIS BO:fiji, , the testatrix 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 and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for the purposes therein contained. day of ~~ Sworn and affirmed to and acknowledged before ~b~ P!DZLLIS BOICLE , the testat rix~ , this , A. COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We, the undersigned, J. ROBERT STAUF~EIR and SUf~A]~ A. 1.~oOO]~ , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testatrix , I.~%t~Y PI'~f. LLIS B0~qS~ , sign and exe- cute the instrument as ~ti~her Last Will and Testament; that the said. testatrix , ~ ~'.'IAR~ P!'iYLLIS BO%~T~E , executed it as P0RIi~her free and vo-untary act for~. "the purposes therein expressed; that each of us, in the hearing and sight of the testat~i~l , signed t.he Will as witn.esses; and that to the best of our knowledge, the testatl~ix was', at the time, eighteen (18) or more years of age, Sworn and subscribed to b efore.~ '~_~=~z i~-"~~-~ m~this ~f~ day of ~/ ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: DOUGLAS GEORGE F III 1 IRVINE ROW CARLISLE, PA 17013 ESQ PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT DUPLICATE NO. CD REV-1162 EX(t 1-96) 003497 ........ fold ESTATE INFORMATION: SSN: 181-07-6085 FILE NUMBER: 2103-0683 DECEDENT NAME: BOYLE MARY PHYLLIS DATE OF PAYMENT: 01/30/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 05/17/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2,758.76 REMARKS: PATRICIA BOYLE CHECK//96 SEAL TOTAL AMOUNT PAID: $2,758.76 INITIALS: VZ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COHHONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 17128-060! NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DISALLOWANCE OF DEDUCT/OHS AND ASSESSHENT OF TAX 'O4 ~IA~ 1 ~ GEORGE F DOUGLAS III DUNCAN ETAL ~' 11RVINE ROW '- CARLISLE PA 17015 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN I 05-15-200R BOYLE 05-17-2005 21 05-0685 CUMBERLAND 101 Amount Remitted REV-l;47 EX AFP COl-D3) MARY P HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LZNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF BOYLE HARY P FILE NO. 21 03-0683 ACN 101 DATE 05-15-2004 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (ScheduZa C) (3) 4. Hortgages/Notas Receivable (Schedule D) (4) E. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) ($) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Ada. Costs/Hisc. Expanses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Nat VaZue of Tax Return 15. 14. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Subject to Tax .00 $$~,660.00 .00 .00 571.20 50z1~5.46 .00 (8) 25,070.90 .00 NOTE: To insure proper credit to your account, submit t~ upper portion of this fore with your tax payment. NOTE: 84,$76.66 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ~%~ IF TOTAL DUE IS REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULAT/ON OF ADDITIONAL INTEREST. ASSESSMENT OF TAX: 15. Aaount of L/ne 14 at Spousal rata 16. Amount of L/ne 14 taxable at L~neal/Class A rata 17. Aeount of Line 14 at S/bl/ng rata 18. Aeoun~ of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: PAYHENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) 01-30-200~ CD003497 .00 (15) .00 x O0 = .00 (16) 61,305.76 x 045= 2,758.76 (iT) .00 x 12 = .00 (18) .00 x 15 = .00 (19)= 2,758.76 AHOUNT PAID 2,758.76 TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE reflect figures that include the total of ALL returns assessed to date. Z,758.76 .00 .00 .0O A REFUND. SEE REVERSE SIDE OF THTS FORH FOR INSTRUCTIONS. ) Zf an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 Nil1 (zz) 23.070.90 (12) 61,305.76 (ii) .00 (14) 61,305.76 RESERVATION: Estates of decedents dying on or before December 12, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decadent after the expiration of any estate for 1ifa or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the tawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CA): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (TZ P.S. Section 91q0). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NZLLSj AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications ara available at the Office of the Register of #ills, any of the 25 Revenue District Offices, or by calling the special gq-hour answering service for forms ordering: 1-800-562-Z050~ services for taxpayers with special hearing and / or speaking needs: 1-800-qqT-3OZO (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 shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z81021, Harrisburg, PA 171ZS-lOZ1, 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. Z80601, Harrisburg, PA 17128-0601 Phone (717) 787-650S. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decadent" (REV-IS01) for an explanation of administratively correctable errors. If any tax duo is paid within three (5) calendar months after the dacedant's death, a five percent (5X) discount of the tax paid is allowed. Tho 15Z tax amnesty non-participation penalty is computed on the total of tho tax and interest assessed, and not paid before January 18, 1996, tho first day after the and of the tax amnesty period. This non-participation penalty is appealable in the s-ama 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, 198Z bear interest at the rate of six (6X) percent par annum calculated at a daily rate of .OOO16q. All taxes which became delinquent on and after January I, 19AZ 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 198Z through ZOO4 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ 2OZ .OOO5q8 ~'8-X991 XZX .OOO~01 ~ 9Z .OOOZq? 1985 16Z .O00q58 1992 9Z .0002q7 ZOO2 6Z .O0016q 198q llZ .000501 1995-199q 72 .00019Z ZOO5 5Z .000157 1985 15Z .000356 1995-199& 9Z .0002q7 200q qZ .000110 1986 XOZ .O0027q 1999 7Z .OO019Z 1987 IOZ .O0027q ZOO0 7Z .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUFIBER OF DAYS DELINQUENT X DATLY ZNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/15/2005 DOUGLAS GEORGE FIll ESQ 1 IRVINE ROW CARLISLE, PA 17013 RE: Estate of BOYLE MARY PHYLLIS File Number: 2003-00683 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: 5/17/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~~~ GLENDA FARNER~~;~~; REGISTER OF WILLS cc: File Personal Representative(s) Judge ~ (I) Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Mary Phyllis Boyle, aIkIa Mary P. Boyle Name of Decedent: Date of Death: Estate No.: 5/17/2003 21-03-0683 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: Date: N -=t 0"'1 r- I. State whether administration of the estate is complete: Yes [8] No 0 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. I is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No.l8l b. The separate Orphans' Court No. (ifany) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes ~ No 0 c. Copies of receipts, releases, 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. ~lf~/o'- be. ~;;.. George F. Douglas, III, Esquire Name 26 West High Street Carlisle, PA 17013 Address 717-243-6222 Telephone No. Capacity: 0 Personal Representative Qg Counsel for personal representative vt