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HomeMy WebLinkAbout03-0841 BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA PETITION FOR GRANT OF LETTERS Estate of Helen P Ward No. c~/" ~)q.~ - ~;;¥"// also known as Helen P Ward , Deceased Social Security No. 116053284 Donald L Ward Petitioner(s), who is/are 18 years of age or older, apply(les) for: (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut or named in the Last Will of the Decedent, dated 05/29/2003 and codicil(s) dated Virginia W Tanzmann, dau,(]hter and named co-executor~ has renounced her ri,cjht to administer the estate in favor of Donald L. Ward. Said Donald L Ward is also named in the Last Will of the Decedent dated 5/29/2003. State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: [] (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) B. Grant of Letters of Administration Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 54 I Street, Borough of Carlisle (list street, number and municipality) Decedent, then 92 years of age, died October 3 ,2003 , at Thornwald Home, Carlisle, Pennsylvania (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA) All personal property ......................................... $ 560~000.00 (if not domiciled in PA) Personal property in Pennsylvania .................... $ (If not domiciled in PA) Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ 130~000,00 Total ..................................................................................................................... $ 690,000.00 Real Estate situated as follows: 54 I Street, Borough of Carlisle, Cumberland County, PA AND parcel in North Middleton Township, Cumberland County, PA Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence ~ _~,~ ~ / "-,, ~ ~,_ c-~ ~ [./'~-~(~-(-'"~ Donald L Ward ~ 400 West Slate Hill Carlisle PA 17013 RW-7 Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Pe.~titioner(s) and that, as persona~ reprAsentative(s) of the Decedent, Petitioner(s) will well and truly administer the estate accor~aw. ~~ Sworn to and affirmed and subscribed 'J" ~ ~ ' Donald L Ward before me this 10th day of October, 2003. ,,~ DECREE OF REGISTER Estate of Helen P Ward Deceased No. 21-2003-841 also known as Social Security No: 1160532~4 Date of Death: 10/03/2003 AND NOW, October 16th 2003 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters I~ Testamentary I-I of Administration (c.t.a., d.b.n.c.t.; pendente lite; durante absentia; durante minoritate) are hereby granted to Donald L Ward in the above estate and that the instrument(s), if any, dated May 29, 2003 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters .................................... $ 410.00 ~~ ~/~. ~2~,/<~i/-~.~lz,~., o. · - RegiSter of Wills ~r ShortCertificate(s)..~..(,_,~...~...,~ $ 12.00 Donna N. Otto,lst DeputLt Renunciation .......................... $ 5.00 Affidavit ( ) ....................... $ Extra Pages (6 @ 3) ..............$ 18.00 Attorney Codicil ................................. $ JCP Fee ................................. $ 10.00 Attorney: Jan L Brown Inventory & Tax Forms ............. $ I.D. No: 67993 Other ...................................... $ Address: 845 Sir Thomas Court Suite 12 Harrisbur~ PA 17109 TOTAL ............................. $ 455.00 Telephone: 717-541-5550 DATE FILED: October 16,2003 BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA RENUNCIATION Estate of Helen P Ward No. 21-03-841 also known as Helen P Ward Deceased The undersigned,Vir,qinia W Tanzmann, daughter and named co-executor of (Relationship) (Capacity) the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters Testamentary be issued to.Donald L Ward Witness my hand ~t~ 371Arroyo~.T~ ~.¢,~~ Pasadena CA 91103 (Address) (Signature) (Address) (Signature) (Address) Sworn to or affirmed and subscribed before me this day of Notary Public My Commission Expires: (Signature and seal of Notary or other NOTE: Renunciations executed outside the Office of Register of Wills are official qualified to administer oaths. Show required in some counties to be notarized. date of expiration of Notary's commission.) RW-3 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 w~ll 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 P 648103 No. ~ Date t43 Rev. 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT (First. Middle, Lasl) SEX ~ SOCIAL SECURITY' NUMBER ~ DATE OF DEATH (Month. Day, Year) ~. Helen P. Ward 2.F~male 13, 116- 05 -3284 J40etober $, 2005 AGE (Last Birthday) ~ UNDER 1 YEAR DATE OF BIRTH 5. 92 Yrs. OTHER: J FACILITY NAME (II not institution, give street and numher} IWAS DECEDENT OF HISPANIC gRIG(N? I RACE - American Indian. Black, Whike. et< I NO[~ Yes [] if yes, specify Cuban. I (Spedfy) ab. oECEOENvsCUmberlandusuALoccuPAT,ON ~. Carlisle lad. Th0r~ld Home IIMe~--~',, Pue Ri ..... to. I so. WhLte (Give kind of work done dudn most IW~.s. ARMED FORCES? [ MARITAL STATUS - Married. SURVIVING SPOUSE / .. r'"l - ~ I' Elemen~arv/S~conda~¥ Co~ Divorced (Specify) ,a. English Teacher ,,.. School J~z'se' ' ,o,,~ l,.l2 (o.,=) 4 ( ..... ) I""- W*~EowcE DECEDENT'S MAILING ADDRESS (Street. City/Town, State, Zip Code) DECEDENT'S ' 54 ISt. aeet ACTUAL l?a. State PA Did 17¢. [] Yes, deceqent lived in ~g. Carlisle, PA 17 0 I .~ (See instructions llve in a o. ~ho, side) ~7b. cou.t~ Cumberland township? 17d. [] No, decedent lived · within actual limit, of Car lLs~e city/bo~o FATHER'S NAME (First, Middle. Lasl) 18. Oarl P~ ~.~d MOTHER'S NAME (First. Middle, Maiden Surname) INFORMANT'S NAME (Type/Print) 19. I.~ma Hale INFORMANI°S MArLiNG ADDRESS (SIreet, Cily/Town, State, Zip Code) _ ~Oa. I~. POn WWWl ~o~.400 WCS~ S£o~e_ H~££, Car£~£e~ P^ 17013 =: METROD DE DIS"OS,T,ON ~ Dl~n2aon [] Burial [] C .... Lion ~ ..... l from SLate [] ( ............ ) oth~r(S,~) i_11~,,.' /~_~_d~., o,O,he, P,ace C~¢ma~on $ocLe~ of I zs~. PA Crcm~o)t~ I~d. Har/Li.Ab£J/[,~. PA ~7109 S'~'~URE~- FFUNE~SERWC--F'~CE"~OR~-/~s°NAcT'NGASsucH IL'cE"SENuMSER NAME AND ADDRESS OE F^C,L,TV C)tCm~J. on $0c~e.~q r I~e'item$23a-conly rSf~..~,,-~ -- · 22c. 4100 Jone~nwn Rna.rt. Hr~'~h:J~n. PA 171(79 physician is not available af. Jm~ o! deall~[o / 'S'-nal --~ ..... ' ' · LICENSE NUMBER ' ! DATE ~'II~NED certify cause o~ death. '~ ~' q~ [1.~/ll~o Il[let I(Month. Day, Year) person who pronounces death TI~.L O~EJA~I~t///~.~ Y,~A~'E PRONOUNCED DEAD (Month Day Year) · ~ ~.1 .... WAS CASE REFERRED TO A MEDICAL EXAMINER/CORONi[R? . ' 27 PART ,' Entar th ........... '.r' ,, , 4~'~' ~ /~ ~'125. ~.~L~ ] J. c.,~i~"~O~ .,~ .25.. Yes 'l~ No/.~-''~ · ' Lilt onl~ e~ ¢&~l~ o~ ~lllc~ ~lrn~c°~r~ ~'~! ~1 which e~t!~e.~ thl de~lh. Do ~i~R intlr Ihl mode et dying, luch Il cardiac m' ri i pli'il~ irrllt, ihock or~llrt lillur I. ~/%op~oxJma ta PART I1: Other significant conditions conbibuting Io death, bet , inte~al between not ~esulti~g in the undedyiog cause given i~ PART I. IMMEDIATE CAUSE (Final ~, <~nset and death Sequentially list conditions b. cause. Enter UNDERLYING CAUSE (Disease or injury c. ', COMPLETION OF CAUSE Natural ~]' Homicide [] OF DEATH? Accident [] Pending l ..... igation [] Yes [] No [] ERTIFIER (Check only one} ' · C~_E ,R~IF~Y_IN.G .PHY~.IClAI~I, (.Physician certifying cause gl death when another -h~sician has ~ron ............ SIGNATURE AND TIr~LF../ ............................................................................ u ~,~. A(--U~ · ~..~:~-'~z,',~, · PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both Ixono~ncmg dealh and certifying to cause ofLICEN~E NU~SE~-) ' [ DATE SIGNED To the bast of my knowledge, death ....... d at the time, date, and place, and due to the caul, ed(s) anddeath)manner aa stated ...................... [] 31 ¢ ~.t O / O .~ I -.5- ~" (moth. pay. Year) 21-2003-841 LAST WILL AND TESTAMENT OF HELEN P. WARD I, HELEN P. WARD, of Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other Wills and Codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement tbr any such taxes which become payable as the result of any property over which I have the power of appointment. Article III I give, devise and bequeath in accordance with any memorandum which I have either handwritten or signed, located with my Will or with my valuable papers and found within 30 days of the probate of my Will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath IN EQUAL SHARES to my daughter, VIRGINIA W. TANZMANN, of Pasadena, California and to my son, DONALD L. WARD, of Cumberland County, Pennsylvania. If VIRGINIA M. TANZMANN predeceases me or fails to survive me by thirty (30) days, I give, devise and bequeath one-third of her share to my son, DONALD L. WARD, and two-thirds to my granddaughter, SEVRA DAVIS, of Pasadena, California. In the event that DONALD L. WARD predeceases me or fails to survive me by thirty (30) days, I give, devise, and bequeath the remainder of my estate, of whatsoever nature and wheresoever situate to his children per stirpes. Article V Ifa beneficiary under this Will has not attained the age of twenty-eight (28) years, the share of the beneficiary shall be placed in a separate trust, for the benefit of that beneficiary according to the terms in Article VI. -2- Article VI In the event that a Trust is created by or as a result of any part of this Will, the terms and conditions of the Trust shall be as follows: A. To expend and apply so much of the net income and so much of the principal of the Trust as the Trustee shall consider advisable for the support, health, care and education of the child until the child attains the age of twenty-eight (28) years. B. Upon attaining the age of twenty-two (22), one-third (1/3) of the child's share shall be distributed outright to the child. C. Upon attaining the age of twenty-five (25), one-third (1/3) of the child's remaining share shall be distributed outright to the child. D. Upon attaining the age of twenty-eight (28), the remaining principal and accumulated income of the child's share shall be distributed outright to the child. E. No beneficiary or remainderman of this Trust shall have any right to alienate, encumber, or hypothecate his or her interest in the principal or income of the Trust in any manner, nor shall any interest be subject to claims of his or her creditors or liable to attachment, execution, or other processes of law. Article VII In order to carry out the purposes of the Trust established by this Will, the Trustee, in addition to all other powers granted by this Will or by law, shall have the following powers over the Trust estate, subject to any limitations specified elsewhere in this Will: -3- (a) to retain in the form received and/or to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file fiduciary/income tax returns and pay the tax due for any year for which such a return is required, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, (i) to conduct along with or with others, any business in which ! am engaged in or have an interest in at the time of my death, and (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. Article VIII I hereby appoint my daughter, VIRGINIA W. TANZMANN, of Pasadena, California, as Trustee of any Trust(s) created in this Will. In the event of the renunciation, death, resignation, or inability to act, for any reason whatsoever of VIRGINIA W. TANZMANN, I nominate and appoint, -4- CANDICE WARD, of Carlisle, Pennsylvania, as Successor Trustee of any Trust(s) created in this Will. Article IX I nominate, constitute, and appoint my daughter, VIRGINIA W. TANZMANN, and my son, DONALD L. WARD, Co-Executors of my Last Will and Testament. I direct that my Co-Executors be permitted to serve without bond and in addition to those powers granted by law, I grant them power to distribute in cash or in kind in like or in unlike shares and to file any qualified disclaimer I could have filed if living. My Co-Executors shall receive reasonable compensation for services rendered to my estate. Article X In addition to the powers conferred by law, I authorize my Co-Executors in his/her absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, -5- (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attomey, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death, and (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, HELEN P. WARD, hereby set my hand to this my Last Will and Testament, on ~ ~,~// ~ ~!(/ 3 ,2003, at Harrisburg, Pennsylvania. HELEN P. WARD In our presence, the above-named HELEN P. WARD signed this and declared this to be her Last Will and Testament, and now at her request, in her presence, and in the presence of each other, we sign as witnesses. Name Address -6- I, HELEN P. WARD, Testatrix, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by HELEN P. WARD, the Testatrix, on ~'3- ~k-~ ,2003. We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me and ~e~g witnesses, on ~:"¢ No~_~blic ~w~ P~ton Twp., ~uph~ ~u~ I -7- LAST WILL & TESTAMENT HELEN WARD JAN L. bROWN & ASSOCIATES ATTORNEYS AT LAW 845 SIR THOMAS COURT, SUITE [2 HARRISBURG, PENNSYLVANIA ~7109 7[7-541-5550 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 003403 BROWN JAN L 845 SIR THOMAS COURT HARRISBURG, PA 17109 ACH ASSESSMENT AMOUNT CONTROL NUMBER ........ fold 101 $33,500.00 ESTATE INFORMATION: SSN: 116-05-3284 FILE NUMBER: 2103-0841 DECEDENT NAME: WARD HELEN P DATE OF PAYMENT: 01/02/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/03/2003 TOTAL AMOUNT PAID: $33,500.00 REMARKS: DONALD WARD C/O JAN L BROWN ESQUIRE CHECK# 136 INITIALS: SK SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH DEPUTY REGISTER OF WILLS REGISTER OF WILLS ESTATE OF HELEN P. WARD · REGISTER OF WILLS OF · CUMBERLAND COUNTY, PENNSYLVANIA NO. 21-03-0841 PRAECIPE TO ENTER APPEARANCE To: The Register of Wills of Cumberland County, Pennsylvania Please enter my appearance on behalf of the Executor of the Last Will and Testament of Helen P. Ward. Frey & Tiley, By Robert G. Frey, Esquire ~ \ ~ Supreme Court Number 46397 5 South Hanover Street Carlisle, Pennsylvania 17013 (717) 243-5838 Date: January 7, 2004 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Helen P. Ward Date of Death: October 3, 2003 Will No. 21-03-841 Admin. No. To the Register: I Certify that notice of beneficial interest 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 December 9, 2003 Name Address Donald L. Ward 400 West Slate Hill Road Carlisle, PA 17013 Virginia W. Tanzmann 371 Arroyo Terrace Pasadena, CA 91103 Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except No Exceptions. Date: ' February 05, 2004 Signature Name Robert G. Frey Vd "07, p~.~!!~qLt.lO Address 5 South Hanover Street !i~D Carlisle, Pennsylvania 17013 Telephone 717-243- 5838 ~0~ 0~' ~ [ ~3~ ~. Capacity: Personal Representative X Counsel for personal ' ~" ? "~" ~ representative PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004604 WARD DONALD L 400 WEST SLATE HILL CARLISLE, PA 17013 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 $4,068.00 ESTATE INFORMATION: $$N: 116053284 FILE NUMBER: 2103 0841 DECEDENT NAME: WARD HELEN P DATE OF PAYMENT: '11/08/2004 POSTMARK DATE: 11/08/2004 COUNTY: CUMBERLAND )ATE OF DEATH: 10/03/2003 TOTAL AMOUNT PAID: $4,068.00 REMARKS: D WARD CHECK// 153 INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF REV'1500 OFFIC,AL USE ONL~ PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RETURN E'~..MB~R 21-o3-o841 DEPT. 280601 i HA~RIS~UR~r PA 1712~'0601 RESIDENT DECEDENT ' , AND MIDDLE INITIAL) ~RNUMBER Ward 116-05-3284 ~M DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 10/3/2003 9/2/~911 REGISTER OF WILLS ~ 2. Supp[emen[al Re[urn ~ 3. Remainde~ Return (~a~e ofdeam .~.'.~ I~.t~) (AHachCOpyO'WU0 ~7 Decede"tMai~[ainedaLiv,ngT~st(At,achcopyofT~s,) ~8 Tota'Nu~bero/SafeDep~il~xes 5 South Hanover Street Carlisle, PA 17013 (~) ~ 68,322_ OFFICIAL U~ ~NLY~ and Bonds (Schedule B) (2) 631,988 able (Schedule D) {4) 100,019 (5) 28,949 ~y(Schedu[e ~) (6) NONE (7) NONE (8) g2~',278 0 o ~ 39,243 0 217 Helen P Ward 116~05-3284 Deceder's Complete Address: , 54~STREET AE RESS eet j I I Carlisle IPA 117013 Tax Pay~ ;nts and Credits: 1. TaxDu ~agel Line19) 2 Credi lyments (1) 39~243 A Spc al Poverty Credit B Pdc ~ayments 33~500 C Disl ~nt 1 ~675 Total Credits ( A + B + C ) (2) 35l'~ 75 3 Interest/ naltyifapplicable E Pen, Total Interest/Penalty ( D + E ) (3) I 0 4 If Line 2 rearer than Line 1 + Line 3, enterthe difference Thisis the OVERPAYMENT J Check box on Page I Line 20 to request a refund (4) 5 Iflinel~ e3isgreaterthanlJne2, enterthedifference This is the TAX DUE l A Enter ~interest on the tax due (5) 4~068 (SA) B Enter ~ total of Line 5 + 5A This is the BALANCE DUE (5B) ! 4,06~ roi ~G!STER OF WILLS, AGENT ."ASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Did decedent make a transfer and: a refain the use or i~come of the properly transferred; . , b re~ain the dght to designate who shall use the properly transferred or its income; . . [] [] d receive the promise for life of either payments, benefi s or care? [] [] if death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . [] [] Did decedent own an Individual Retirement Account, annuity or other non-probate property which contains a beneficiary des gnation? ...... [] [] IF ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. SIGNATURE DATE [HAN REPRE DATE for date AT ! REV-lSO2EX+(I~)(I) SCHEDULE A coMuo~ ~LT~ oF PE..S'~LVAN~^ REAL ESTATE ESTATE OF FILE NUMBER Helen P War 21-03-0841 ALL REAL PF ~ERT'f OWNED SOLELY OR AS A TENANT iN COMMON MUST SE REPORTED AT FAIR MARKET VALUE Pair market value is defined property wourd be changed between a willing buyer and a wi lng se er, neither being compelled to buy or se[J, both having reasonable knowledge of the relevant facts. RE~L PROPER~ WH IS JOrNTLY-OWNED WITH RIGHT OF SURVIVORSHIP MUST BE DISCLOSED ON SCHEDULE F ITEM VALUl AT DATE NUMBER DESCRIPTION OF DEATH 1. 54 "1" Street, Carlisle, Pennsylvania. See HUD-1 settlement statement at~ached I 148,322 2. Vacant land, Slate Hill Road, Nodh Middleton Township, Cumberland County ~ 20,000 I I I TOTAL {Also enteron line 1, Recapitulation $ 168,377 (If more space is needed, insert additional sheets of the same siz~ REV 1503 EX+, SCHEDULE B OOMMO~ ~LT. OEPE.NS~LV^N,^ STOCKS & BONDS INH~ TANCE TAX RETURN ;IDENT DECEDENT ESTATE OF FILE NUMBER Helen P Ward 21-03-0841 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ~TEM VALU[ ! AT DATE NUMBER DESCRIPTION OF DEATH 1. Lincoln Benefit Life Company No. LBF1038767 2. Wachovia Securities account no. 8668-9251 24,986 3. Putnam Voyager A, 2141.133 shares 574,585 32,417 TOTAL (Also enter on line 2, Recapitulation I 631,988 (If more space is needed, inser~ additional sheets of the same size) SCHEDULE D co ~"W~T'OFPENNSYLV^N~^ MORTGAGES & NOTES RESIDENT DECEDENT RECEIVABLE ESTATE FILE NUMBER Helen P ~rd 21-03-0841 I All pi~ ~i[y jointly-owned with the right of survivorship must be disclosed on Schedule F. i L ITEM VALUE AT DLATE NUMBE DESCRIPTION OF DEATH 1, Mortgage owed by Donald L. Ward !100,019 TOTAL (Also enter on line 4, Recapitulation) $ 100,019 AT REV-1508 EX + ?} (I) SCHEDULE E BLT. OF PENNS'~LV^N,* CASH, BANK DEPOSITS, & MISC. C O M IMNO~ ITANCE TAX RETURN ,.E.T CECECENT PERSONAL PROPERTY ESTATE OF FILE NUMBER Helen P W~: 21-03-0841 ITEM VALUE AT DATE NUMBER DESCRIPTION OF ~EATH 1. M & T Bank Account No. 462012 2. Miscellaneous personal properly and household effects 8,301 3. Real Estate tax proration. See HUD-1 se[tlement statement attached 20,000 648 TOTAL (Also enter on line 5, Recapitulation) $ 28,949 (If more space is needed, insert additional sheets of the same size) 217 i REV 1511 EX + (li g) i SCHEDULE H COMMOh *:ALTH OF PENNSYLVANIA FUNERAL EXPENSES & 'NHI TANCE TAX RETURN ]IDEENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Helen P Ward 21-03-0841 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: A~OUNT I i B. ADMINISTRATIVE COSTS: I 1. Personal Representative's Commissions Name of Rersonal Representative (s) Donald L. Ward J Social Security Number(s) / EIN Number of Personal Representative(s) J Street Address 400 West Slate Hill Road j City Carlisle State PA Zip 17013 Year(s) Commission Paid: 2004 i 30,000 2. Attomey Fees J 8,500 3. Family Exemption: (If decedent's address is not the same as claimant's, a~tach explanation) Claimant , Street Address City State Zip. Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees included ~v/atty. fee 6. Tax Return Preparer's Fees included ~N/atty, fee 7. xpenses of sale of real estate. See statement attached. I 10,861 8. inal medical expenses and utility expenses i 7,850 I I I TOTAL (Also enter on line 9, Recapitulation) $ 57,211 SCHEDULE J COMM VEALTH OF PENNSYLVANIABENEFICIARIESi INI ~ITANCE TAX RETURN , ESTATE OF FILE NUMBER Helen P W~ 21-03-0841 RELATIONSHIP TO DECEDENT AMOUN'f OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF E STATE I. AXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1. Vir niaW. Tanzmann 37 Yroyo Terrace Pa dena, CA 91103 daughter 2. Do ~ld L. Ward 50% 40( ~Vest Slate Hill Road Ca~ ~le, PA 17013 son , ~ 50% i i i i ~ ~E 'ER DOLLAR AMOUNTS FOR DISTRIBUTrONS SHOWN ABOVE ON LINES 15 THROUGH 1~S APPROPR~RE~ J~. NON- ,XABLE DrSTRIBUTIONS: A SP ]SAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX rs NOT BEING MADE I B CH~ ITABLE AND GOVERNMENTAL DrSTRIBUTIONS I ! I I TOTAL OF ~ T II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ i (If more space is needed, insert additional sheets of the same size) Expen ~sfromHUD-1 settlement statement 10,860.80 Total E ~enses 10,860.80 J.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT61 r~FHAFiLE NUMBER:2 []FmHA 3 ~]CONV UNINS[ 7 LOAN NUMBER4[]VA 5 E]CONV INS' I SETTLEMENT STATEMENT ARMSTRONGG ~ I I ~EOR~S~m"G ~ ¢ ~ Seller THE EST OF EL N W RD L. SETTLEMENT CHARGES i ~ to Ban~ces/ SHF, PC ~ 35 00 4 !~.~co_rdin Fee~ Deed $ 3850;Mo.gage $ ~.50: ~ ~o I ~ to LLOYOSHOME INSPECT[ON ~ ADDITIONAL DISBURSEMENTS EXHIBIT Borrower; GEORGE E. ARMSTRONG ESTHER G. ARMSTRONG Seller: THE ESTATE OF HELEN WARD Lender: ORRSTOWN BANK Settlement Agent: Salzmann, Hughes & Fishman, P.C. (717)249-6333 Place of Settlement: 95 Alexander Spring Road, Suite 3 Carlisle, PA 17013 Settlement Date: January 15, 2004 Property Location: 54 I STREET CARLISLE, PA 17013 CUMBERLAND County, Pennsylvania pAYEE/DESCRIPTION NOTE/REF NO BORROWER SELLER AHS Home Warranty 425.00 Borough o1 Carlisle Final Wtr/Swr #00037A 30,16 Total Additional Disbursements shown on Line 1305 $ 0,00 $ 455.16 Maa?Bank 499 Mitchell Street, Millsboro, DE 19966 January 6, 2004 Frey & Tfley Attorneys At Law 5 South Hanover Street Carlisle, PA 17013 RE: Estate of Helen P. Ward Date of Death: October 3, 2003 Social Security Number: 116-05-3284 Dear Mr. Frey: In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following accounts. 1. Account Type ........................... Checking Account Account Number. ...................... 462012 Ownership (Names o39 ..............Helen P. Ward Opening Date ........................... 04/01/68 Balance on Date of Deatfz .........$8,300.79 Accrued Interest $ 0.00 Total. ...................................... $8,300.79 lincerely, ? , :harlene Warrington, Associate I 302) 934-2722 Voyager;A (PVOYX) (FUND) US Dollar Date Price High Low Volume 2 tu~:r,th (0~iiy) ':-~,BJq,£har~-,:,)m 10/3/03 15.14 n/a n/a n/a ,', ,.,/,,,all ?Ii., iir''' No Splits a, Get anott 'quote any day after 1/2/1970 1/2/1970 Symbo ~" Date: 110/3/03 ~ lm~o 2mo 3mo 6mo ~yr ~ 52~L Copyright, 1998*2004~BiqChartscom Inc Historical and current Copyright © 2004 Dow Jones & Company, Inc. All Rights Reserved LIN( DLN BENEFIT LIFE Telephone: -800-LBL-WAT$ COMPANY /VWW.L.BL.COM PO Box I 4-69 h,,llh,,I ,,,,,,Ih,ll,h,hl December21, 2002 HELEN F ~/ARD Your Representative 54 I STR CARLISL PA 17013~ TROY H LANDIS LANDIS FINANCIAL SERVICES 44 S HANOVER ST CARLISLE PA 17013-3306 (717)245-9522 Lincoln Benefit Life Tactician Plus Annuity Annual Statement STATEMENT DATE 12/20/02 FOR ANNUITY #: LBF1038767 Owne Helen P Ward Tax Qualification: Non-Qualified Annul' nt: Helen P Ward YOUR CONTRACT VALUE AS OF December 20, 2002 IS: $23,867.14 Year to Date inception to Date 12/20/01 to 12/20/02 12/20/00 to 12/20/02 Contract ummarv Beginnin~ Value $22,516.17 $21,043.15 Additiorl ~1 Payments $.00 $.00 Credite1 Interest $;i,350.97 $2,823.99 WithdrawI Summary Amou~ ~ ~/ithdrawn from Contract $.00 $.00 Withdra, ~,1 Charges $.00 $.00 Withho ng $.00 $.00 Market lue Adjustment (+/-) $.0~0 $.00 Withdn Amount Received $.00 $.00 Endinq V~ $23,867.14 $23,867.14 (Ending Valu~ ~eginning Value + Additiona~ Payments + Credited Interest - Amount Withdrawn from Annuity) R4OGRC51 .N01 '-ORIGINAL -- -- 'N LAST WILL AND TESTAMENT OF HELEN P. WARD I, HELEN P. WARD, of Cumberland County, Pennsylvania, declare this to be my Last Will and' stament. I revoke all other Wills and Codicils that I may have previously made. Article I Myjust debts and expenses of my last illness, funeral, and administration of my estate shall be pa by my Executor from the principal of my residuary estate as soon as practicable after my death. Article ~I All inheritance, estate, and succession taxes (including interest and penalties thereon, but not includ g any generation skipping tax) payable by reason of my death shall be paid out of and be charge generally against the principal of my residuary estate without reimbursement from any person This provision is not a waiver of any right which my Executor has to claim reimbursement for an' ;uch taxes which become payable as the result of any property over which I have the power of app~ ntment. Article II1 give, devise and bequeath in accordance with any memorandum which I have either hand,; ;ten or signed, located with my Will or with my valuable papers and found w/thin 30 days of the pr~ ~ate of my Will. Gifts may only be to persons who survive me or to organizations which exist at my eath, and i£there is a conflict, the memorandum having the latest date shall govern. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate I give, devise and bequeath IN EQUAL SHARES to my daughter, VIRGINIA W. TAN~ ~NN, of Pasadena, Califomia and to my son, DONALD L. WARD, of Cumberland Count Pennsylvania. If VIRGINIA M. TANZMANN predeceases me or fails to survive me by thirty 0) days, I give, devise and bequeath one-third of her share to my son, DONALD L. WARD, and t~ -thirds to my ~anddaughter, SEVRA DAVIS, of Pasadena, California. in the event that DONALD L. WARD predeceases me or fails to survive me by thirty (30) days, I lye, devise, and bequeath the remainder of my estate, of whatsoever nature and xvheresoever situate his children per stirpes. Article V a beneficiary under this Will has not attained the age of twenty-eight (28) years, the share of the ~neficiary shall be placed in a separate trust, for the benefit of that beneficiary according to the ter in Article VI. -2- Article VI In the event that a Trust is created by or as a result of any part of this Will, the terms and con& >ns of the Trust shall be as follows: A. To expend and apply so much of the net income and so much of the principal of the Trust the Trustee shall consider advisable for the support, health, care and education of the child until : ch/Id attains the age of twenty-eight (28) years. Upon attaining the age of twenty-two (22), one-third (1/3) of the child's share shall be distrib ed outright to the child. Upon attaining the age of twenty-five (25), one-third (1/3) of the child's remaining share ~ ill be distributed outright to the child. Upon attaining the age of twenty-eight (28), the remaining principal and accumulated incom, 'the child's share shall be distributed outright to the child. No beneficiary or remainderman of this Trust shall have any right to alienate, encum ', or hypothecate his or her interest in the principal or income of the Trust in any manner, nor sha anY interest be subject to claims ofhis or her creditors or Iiable to attachment, execution, or other p~ cesses of law. Article VII order to carry out the purposes of the Trust established by this Will, the Trustee, in additio~ a all other powers granted by this Will or by law, shall have the following powers over the Trust e te, subject to any limitations specified elsewhere in this Will: -3- (a) to retain in the form received and/or to sell either at public or private sale, any rea[ estat or personal property except that which I specifically bequeath herein, (b) to manage real estate, , (c) to invest and reinvest in all forms of property without being confined to legali inve nents, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, i (f) to file fiduciary/income tax returns and pay the tax due for any year for which such retur s required, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such ~perty, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Exec~ ~r; and to pay from my estate reasonable compensation for all their services, ~i) to conduct along with or with others, any business in which I am engaged in or have an iht .~st in at the time of my death, and to receive reasonable compensation in accordance with their standard schedule of £ees in effe while their services are performed. Article VIII hereby appoint my daughter, VIRGINIA W. TANZMANN, of Pasadena, California, as Trustee )fany Trust(s) created in this Will. In the event of the renunciation, death, resignation, or inabilit to act, for any reason whatsoever of VIRGINIA W. TANZMANN, I nominate and appoint, -4- CAN ~ICE WARD, of Carlisle, Pennsylvania, as Successor Trustee of any Trust(s) created in this Will. Article 1X I nominate, constitute, and appoint my daughter, VIRGINIA W. TANZMANN, and my son, L. WARD, Co-Executors of my Last Will and Testament. I direct that my Co-Executors be serve without bond and in addition to those powers granted by law, I grant them distribute in cash or in kind in like or in unlike shares and to file any qualified disclaimer I could filed if living. My Co-Executors shall receive reasonable compensation for services to my estate. Article X addition to the powers conferred by law, I authorize my Co-Executors in his/her absolute to retain in the form received and to sell either at public or private sale, any real estate or property except that which I specifically bequeath herein, to manage real estate, to invest and reinvest in all forms of property without being confined to legal inw and without regard to the principal of diversification, to exercise any option or right arising from the ownership of investments, to compromise claims without court approval and without consent of any beneficia .fy, -5- (f) to file any federal income tax return for any year for which I have not ~led such retuFn pri{ to mydeath, (g) to make distributions in cash or in k/nd, or in both, and to determine the value of any suc] property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by m~ Exe, ttor; and to pay from my estate reasonable compensation for all their services, (i) to conduct alone or with others, any business in which I am engaged in, or have ag inter in at time of my death, and to recmve reasonable compensation in accordance with their standard schedule of feei in ef~ ct while their services are performed. , IN WITNESS WHEREOF, I, HELEN p. WARD, hereby set my hand to this my Last Will and ~tament, on ~/,~//~..~.~ ~¢x~' ~-~ ~1~5 ,2003, at Harrisburg, Pennsylvania. / HELEN P. ~VARD In our presence, the above-named HELEN P. WARD signed this and declared this to be her LastV ll and Testament, and now at her request, in her presence, and in the presence of each other, we si~ as witnesses. Name Address -6- I, HELEN p. WARD, Testatrix, who signed the foregoing instrument, having been duly qualit :d according to law, acknowledge that I signed and executed this instrument as my Will, and that I ned it willingly as my free and voluntary act for the purposes therein expressed. Sworr , or affirmed and ackno ledged before me by HELl q P. WARD, the Testatrix, on ~ ' ~ ,2003. ~ 'ublic " HELE ARD L~wer Pa~on T~. ~u~ ~ I My Commission E~ M~ ~ ~ 'e, the undersigned witnesses who signed the foregoing instrument, being duly qualified accordi~ ~ to law, depose and say that we were present and saw the Testatrix sign and execute this instrum, ~t as her Will; that she signed and executed it willingly as her free and voluntary act for the purpose Iherein expressed; that each of us in her sight and hear/ng signed the Will as witnesses, and thai ~ best of our knowledge, that she was at that time eighteen (18) years or more of age, of and under no constraint or undue influence. Sworn affirmed and sub to before me Witness witnesse on ~-~°X ,2003. ~ D Witness Lower Paxton Twp., Dauphin COUP,~ | ~ly Commission Expires March ~ ~1 -7- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TA~,~~O?:~:;Ji Ui~\CE CF NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISION ,-' ',( :':'iAPl-RAISEHENT J ALLOWANCE OR DISALLOWANCE PO BOX Z8'601 '--'IIF DEDUCTIONS AND ASSESSHENT OF TAX HARRlS!URG PA 17128-0601 zonE JAil \ 0 Mi 9: 48 ClcP" OF C.lf\ _ ORPHtN'S couP I ROBERT G FRE'C\JMB~n Lij (:J , Fi\ FREY & TILEY 5 S HANOVER ST CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-10-2005 WARD 10-03-2003 21 03-0841 CUMBERLAND 101 Allaunt Re..i tted '* REV.l!i47 EXAFP 112-04) HELEN P 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 ~ REV =iSi,"f-Ex--AFP--ror:03j"-Noi'"icE-ii'F"I"NHEififAiicE-i"A"x-i'-PPRAisEiiENT~.-Ai.rOWANCE-OR------------ - - --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WARD HELEN P FILE NO. 21 03-0841 ACN 101 DATE 01-10-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: IS. AMount of Line l~ at Spousal rat. (IS) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Allaunt of Line 14 at Sibling rat. (17) 18. Amount of Line 14 taxable at Collateral/Class 8 rate (18) 19. Principal rax Due RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule Al 2. Stocks and Bonds (Schedule Bl 3. Closely Held stock/Partnership Interest (Schedule Cl 4. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule El 6. ~ointly Owned Property (Schedule Fl 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (71 168.322.00 631.988.00 .00 100.019.00 28.949.00 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ada. Costs/Misc. Expenses (Schedule Hl 10. Debts/Mortgage Liabilities/Liens (Schedule Il 11. Total Deductions 12. Net Velue of Tax Return 13. Charitable/Govern.ental Bequests; Non~elect.d 9113 Trusts (Schedule ~) 14. Net Value of Estate Subject to Tax (9) (10) 57,211.00 .00 Ill) (12) (13) (14) NOTE: .00 X 872.067. 00 X .00 X .00 X NOTE: To lnsure proper credit to your account, submit the upper portion of this for. with your tax pay.ent. 929,278.00 57.:>11 no 872,067.00 .00 872,067.00 19 will 00 = 045 = 12 = 15 = .00 39,243.00 .00 .00 39,243.00 (19)= TAX CREDITS: . ........ NUi1BER t+, AHOUNT PAID DATE INTEREST/PEN PAID (-) 01-02-2004 CD003403 1.763.16 33,500.00 11-08-2004 CD004604 56.04- 4,068.00 TOTAL TAX CREDIT 39,275.12 BALANCE OF TAX DUE 32.12CR INTEREST AND PEN. .00 TOTAL DUE 32.12CR f t . IF PAID AFTER DATE INDICATED, SEE REVERSE FDR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. tfY\ IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), yOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) 01\ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/15/2005 WARD DONALD L 400 WEST SLATE HILL CARLISLE, PA 17013 RE: Estate of WARD HELEN P File Number: 2003-00841 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 10/03/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge ~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/15/2005 FREY ROBERT G 5 S HANOVER STREET CARLISLE, PA 17013 RE: Estate of WARD HELEN P File Number: 2003-00841 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, w~thin two (2) years of the decedent's death, shall file with the Regi~ter of Wills a Status Report of completed or uncompleted administration. This filing is due by: 10/03/2005 Your prompt attention to this matter will be appreciat$d. Thank You. Sincerely, .~,~~~ GLENDA FARNER STRAS~UGH REGISTER OF WILLS cc: File Personal Representative(s) Judge Lb-- STATUS REPORT UNDER RULE 6.12 Name of Decedent: Helen P. Ward Date of Death: October 3, 2003 Will No. 21-03-0841 Admin. No. 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 if 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 of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be atlaCh~d to thiS. report. r--... 1 q j~ r Date: \\: '-"- V"'-b v '~ LOCI ') V "--.J'---^ ~. _ Signature v) .,.,.j- LD Robert G. Frey Name (Please type or print) 5 South Hanover Street Address ~,~- ,. (717) 243-5838 Telephone No. Capacity: ( ) Personal Representative ( X) Counsel for personal representative '. .~.~ '~:L