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Home My WebLink About04-0850Estate of aisc known as Cumberland Register of Wills of County, Pennsylvania PETITION FOR GRANT OF LETTERS Bernice A. Kline , Deceased Social Security No. 187-16-5836 )COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut Decedent, dated NOV. 16, 1999 and codicil(s) dated __ named )n the Last Will of the Except as follows, Decedent did not merry, 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 e killing and was never adjudicated incompetent: B. Grant of Letters of Administration Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse any) and heirs: (COMPLETE IN ALL CASES:) Attach additional :heats if necessary, Decedent was domiciled at death in Cumber[and County, Pennsylvania, with his/her last family or pnnopal residence at ,~1 q 'Pc~-h .q~- _: Npw Ch~mh~r] ~nc] Decedent, then 81 yeats of age, died Auqust 22 ,200__~, at Camp Hill, PA Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property .............................. $80 , 000 o 00 (If not domiciled Jn PA) Personal property in Pennsylvania ................... $ (If not domiciled in PA) Personal property in County .......................... $ Value of rea} estate in Pennsylvania Tot.~ .............................................. $155.000.00 Real Estate sltuated as fol]ows: 419 Fourth Street, New Cumberland Borouqh, CumDerlan~ CO. 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: J Signature Typed or printed name and residence Patricia A. George 1900 Valley Road~ Etters PA 17319 Sandra Kautz 14 Big Spring Terrace, Newville PA 17241 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 Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the est,az~ccording to law. Sworn to end affirmed and subscribed '~-~~ ~' before me this I~--~'-~ day of DECREE OF REGISTER Estate of Bernice A. Kl±ne also known as Deceased No. S°cial,tcurity/--N°: 187-16-5836 Date of Death: August 22, 2004 AND NOW: _k~L_~J)~'J,~Yl.~'~/_^v I(n , :2004 , in consideration of the Petition on the reverse side hereo~, satisfactory proof having been presented before me, IT IS DECREED that Letters [] Testamentary [] of Administration are hereby granted to Patricia A. George and Sandra A. Kautz in the above estate and that the instrument(s), if any, dated November 16 ~ 1999 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........................... $ [~O.OO Short Certificate(s) .......... Renunciation .................. Affidavit ( ) ................. Extra Pages ( ) ............ Codicil .......................... JCP Fee ........................ Inventory & Tax Forms... Other ............................ TOTAL ................ $ --'lq. O0 Attorney: I.D. No: ~ Address: - i8 Old York Road Etters PA 1 731 9 Telephone: 717 938-3396 DATE FILED: q- Ru-7a his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 10529994 No. Local Registrar 4" AUG 2 5 2004 Bernice A. Kline Date COMMONWEALTH OF PEN NSYLVANIA DEPARIq~ENT OF HEALTH · VITAL RECI~r~ ~.~ CERTIFICATE OF DEATH co 187 -- 16 -- 5836 Cumberland Operator 419 4th Street un9,1923 ~ighspire,PA ~ital ~t New Cumberland,PA 17070 r~z~. ,.~omas ~ ~ill I,",?~¥~ra M Sg~ ~t.ooo~oaT,o. ' . 1~.1900 Valley Road, Etters PA 1731 ~::~.;~m~)c;'[ ..... ~.m.~cn~s~gU~c}7,2004 J~podlawnMemG~rdens [.,.Harrisburg, pA 17109 1~'~%~ *o~ ........ I~' ~ u ~ z~qz-L ~.one&MurrayFH408 3rd St New Cum >,~r117 7 · ' !000 N. Fron~ St., Wormleysburg,PA 099999-00034/11.8.99/RHW/KLT/128394.2 ·ast lil( aah stam nt OF BERNICE A. KLINE - I, BERNICE A. KLINE, of the Borough of New Cumberland, Cu~rn~edand: County, Pennsylvania, being of sound and disposing mind, memory and understanding,C~o hereby make )ublish and declare this as and for my Last Will and Testament, hereby_r~evokin.~and,,ming void any and all Wills or Codicils at any time heretofore made by me. o= ARTICLE I I direct the payment of my legally enforceable debts and the expenses of my last illness and funeral from my Estate as soon after my death as conveniently may be done. ARTICLE II I give and bequeath my motor vehicles(s), household and personal effects and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, to my daughters, SANDRA A. KAUTZ and PATRIClA A. GEORGE, to be divided between them by my Executrices with due regard for their personal preferences in as nearly equal shares as practicable. If my daughter, SANDRA A. KAUTZ, does not survive me by thirty (30) days, I give and bequeath her share unto her then-living issue, per stirpes, to be divided among them by my Executrix with due respect to their personal preferences in as nearly equal shares as practicable. If my daughter, PATRIClA A. GEORGE, does not survive me by thirty (30) days, I give and bequeath her share unto her then-living issue, per stirpes, to be divided among them by my Executrix with due regard for their personal preferences in as nearly equal shares as 3racticable. Any such item allotted to a minor, may, as my Executrix thinks advisable, either be delivered to the minor or any person to hold for the minor, or be sold and the proceeds paid, in the 099999-00034/11.8.99/RHW/KLT/128394.2 discretion of my Executrix, either directly to the minor or to the Trustee as provided in Article IV hereof. ARTICLE III I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever nature and wheresoever situate, in equal shares to my daughters, SANDRA A. KAUTZ and PATRICIA A. GEORGE. If my daughter, SANDRA A. KAUTZ, does not survive me by thirty (30) days, I give, devise and bequeath her share to her then-living issue per stirpes. If my daughter, PATRIClA A. GEORGE, does not survive me by thirty (30) days, I give, devise and bequeath her share to her then-living issue per stirpes. ARTICLE IV In the event that any beneficiary of my Will shall not have reached the age of twenty-one (21) years at the time for distribution of his or her share, I give, devise and bequeath the share of each such Beneficiary unto my grandson, ROBERT L. GRAMM, JR., IN SEPARATE TRUST, to hold, manage, invest and reinvest the share so received, and the accumulation of income thereon, and to use and apply the income and principal, or so much thereof as, in Trustee's discretion, may be necessary or appropriate for such beneficiary's support and education (including college education, both graduate and undergraduate, and vocational training beyond high school) without regard to his or her ability to provide for such support or education or to make payment for these purposes, without further responsibility, to such beneficiary or to any person taking care of such beneficiary. Trustee shall distribute one-third (1/3) of the then-remaining principal and any income accumulated thereon unto such beneficiary when such beneficiary shall reach the age of twenty- one (21) years, and the balance of principal and any net undistributed income thereon unto such beneficiary when such beneficiary shall have reached the age of twenty-five (25) years. In the event any beneficiary dies before receiving his or her final distribution hereunder, the Trust as to that beneficiary shall terminate and the balance of principal and any net undistributed income shall be paid over to such beneficiary's personal representative. 2 099999-00034/11.8.99/RHW/KLT/128394.2 ARTICLE V I direct that the interest of the beneficiaries shall not be subject to anticipation or to voluntary or involuntary alienation. ARTICLE VI I name, constitute and appoint my daughters, PATRICIA A. GEORGE and SANDRA A. KAUTZ, Co-Executrices of this my Last Will and Testament. Should both of my daughters, PATRIClA A. GEORGE and SANDRA A. KAUTZ, fail to qualify or cease or act as Executrices, I appoint my grandson, ROBERT L. GRAMM, JR., as Executor of this my Last Will and Testament. direct that my Executrices or Executor shall not be required to post bond for the faithful administration of the duties required in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ~._F~day of.,/'~'O/,,'~'x~, _~'"A· ,1999. BERNICE A. KLINE (SEAL) Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the 3resence of each other, have hereunto subscribed our names as witnesses. 3 099999-00034/11.8.991RHWIKLTI128394.2 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : We, BERNICE A. KLINE, ~~- J'~. ~ ~ and ~"'~.-.~,,..3,~ ~.X,',3r..,._x,...~g .'Ao~ , the Testatrix and the witnesses, respectively, whose names are signed to t~ attac~ed or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly and that she executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence, BERNICE A. KLINE Sworn to or affirmed to and subscribed to before me by BERNICE A. KLINE, Testatrix, and '~-~-¢..._~. c-'~.~-,_.x,-,~, and ~ ~.~ ~ ,~,3~ ,0~- , witnesses, this I te'~'~day of "~~ ,1999. ('~ "~ Notary Public My Commission Expires: 4 NOTARIAL SEAL DIANNE LENIG, Notary Public Lemoyne Borough Cumberland Co. My Commiss~ion___Expires Dec. 21,200'1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 25060~ HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 004519 GEORGE PATRICIA A i900 VALLEY ROAD ETTERS, PA 17319 ........ fold !STATE INFORMATION: SSN: 187-16-5836 FILE NUMBER: 2104-0850 DECEDENT NAME: KLINE BERNICE A )ATE OF PAYMENT: 10/21/2004 ,OSTMARK DATE: 10/21/2004 COUNTY: CUMBERLAND DATE OF DEATH: 08/22/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3,484.13 TOTAL AMOUNT PAID: 93,484.13 REMARKS: "'SEAL CHECK# 6722 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANtA DEPARTMENT OF REVENUE BUREAU OFINDIVlDUAL TAXES DEPT 280601 HARRISBURG, PA 1712B-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(1%96) NO. CD 004520 KAUTZ SANDRA A 14 BIG SPRING TERRACE NEWViLLE, PA 17241 ...... fold -ESTATE INFORMATION: SSN: 187-16-5836 FILE NUMBER: 2104-0850 DECEDENT NAME: KLINE BERNICE A DATE OF PAYMENT: 10/21/2004 POSTMARK DATE: 10/21/2004 COUNTY: CUMBERLAND DATE OF DEATH: 08/22/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 83,484,13 TOTAL AMOUNT PAID: ~3,484.13 REMARKS: · SEAL CHECK//5384 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS .' (& ..... ,./ ~t' " ~t',.. . ..... ~ tV ~- , , .*" v . ~~ , vr- , . ", " ., ~ .- ", ,., ,:1 f,:J ", ", ~ ~ 1 -- ", .- " <1l ~ ,,:" 's. y '" ~ ~ e~ -~- .ir...... ~ !5l CJ r;:3 ri .-..: rJ ,..,..... J o N c) .0 e1 !;:l ~ Cl " ~ t:' "'\ f> ~ (\) 00 ::l ~ o U (\) ~;;...., 00 S g.- ~Ocf)o s:u(\)~ ?."oo<t, 'Ogg~ \)"ij,€~ "t>A~ ::leE ";;b u;; (\) cx:u-u .-l .-l .10 t...,.. O::l C' \J.1 ~ U- C' ", ,:; ~ ,J .", e' ", ~ ", (---:~ t' (J ", ... V ", f1' \D t/I l"'- r-4 r '1 . r" l , u:i . ,- I Joel O. Sechrist, Esquire Attorney at Law 568 Old York Road Etters PA 17319 717 938-3396 Facsimile 717 938-9613 February 11,2005 Register of Wills Cumberland County Courthouse I Courthouse Square CarlislePA 17013 RE: Estate of Bemice A. Kline #21-04-850 To Whom It May Concern: Enclosed are two copies of the Pennsylvania Inheritance Tax return together with a check made payable to "Register of Wills, Agent" in the amount of$611.63 representing the Inheritance Tax and a check made payable to "Register of Wills" in the amount of$15.00 representing the filing fee. Thank you very much for your assistance in this matter. Very truly your~",,'" .' /"" '" ,//' (,. ;.t/,"'V Joel 0, Sechrist JOS:lm Enclosures COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 AEV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT GEORGE PATRICIA A 1900 VALLEY ROAD ETTERS, PA 17319 -------- fold ESTATE INFORMATION: SSN: 187-16-5836 FILE NUMBER: 2104-0850 DECEDENT NAME: KLINE BERNICE A DATE OF PAYMENT: 02/14/2005 POSTMARK DATE: 02/11/2005 COUNTY: CUMBERLAND DATE OF DEATH: 08/22/2004 NO. CD 004942 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $611.63 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK#126 SEAL INITIALS: CCP RECEIVED BY: REGISTER OF WILLS $611.63 GLENDA FARNER STRASBAUGH REGISTER OF WILLS REV-1500EX(6-00) Rev-1500 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 OFFiCiilj_ USE ONLY ~~fY FILE NUMBER INHERITANCE TAX RETURN 04 850 RESIDENT DECEDENT County Code Yea, Numbe, SOCIAL SECURITY NUMBER 187.16.5836 THIS RETURN MUST BE FILED IN DUPLICATE WITH REGISTER OF WILLS SOCIAL SECURITY NUMBER 3. Remainder Return (date of death prior to 12- 5. Federal Estate Tax Return Required x 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received 7. Decedent Maintained a Living Trust (Attach a ",-,py of Trust) 8. Total Number of Safe Deposit Boxes 1 O. Spousal Poverty Credit (date of death between 12-31-91 and 1_1_95) D 11. Election to tax under Sec. 9113{A) ~o 8~ Otll~lmiIl, TO~ " $84,000.00 ~ $2.373.49 i $0,00 ~ $0,00 ~ " ') OFFICIAL YSE ONt Y I- Z W Cl w U w Cl DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Kline. Bernice A, DATE OF DEATH (MM-DD-YEAR) 08.22-2004 e", $95,277.30 $0,00 c, $6,873.74 (8) $9,610.81 $2,321,83 (11) (12) (13) (14) (15) (16) (17) (18) (19) $188,524.53 !l;11 Q~?f\4 $176,591.89 !l;n no $176,591.89 $0,00 $7,946.64 $0.00 !l;O no $7,946.64 DATE OF BIRTH (MM-DD-YEAR) ~.19~ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) . ,,::.:::ffi(l.l u"~ . "'0 .c:e.2 U ~aJ '" x 1. Original Return 4. Limited Estate 48. Future Interest Comprise (date of death after 12-12~) 2. Supplemental Return = '" ~ = 8- ~ ~ C> <-> tillS $~CTIOIII MUIIT Bl; ~IlIlPLlf'lU!, NAME Patril:i8AGeo $: andSandraiA~Kflutt FIRM NAME (If Applicable) ALL CORRElIPOIIIQl!!IIlle AIlOOOlllF1D~1'flIJII. TAl< INFORMA'l'lOH COMPLETE MAILING ADDRESS TELEPHONE NUMBER 717938.3396 1. Real Estate (Schedule A) (1) (2) (3) (4) (5) (6) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o !;( ...J => I- a. <( () w a:: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. InterNivos Transfers & Misc. Non-Probate Property (Schedule G or l) (7) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) (10) 10. Debts of Decedent, Mortgage Liabilities & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) z o i= ~~ >-" ~ ~ o () 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (aX1.2) x 16. Amount of line 14 taxable at lineal rate $176,591.89 x .045 17. Amount of line 14 taxable at sibling rate x ,12 18. Amount of line 14 taxable at collateral rate 19. Tax Due x ,15 20D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS 419 Fourth Street . CITY I~ATE 1ZIP NewCumbertand 17070 Tax Payments and Credits: 1. Tax Due (Page 1 line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) $7,946.64 SR~R8?A ~"AAi'" Total Credits (A + 8 + C) (2) $733501 3. InteresVPenalty if applicable D. Interest E. Penalty 4. TotallnteresUPenalty (D + E) (3) If line 2 is greater than line 1 + line 3. enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) If line 1 + line 3 is greater than line 2. enter the difference. This is the TAX DUE. (5) $611.63 $0.00 5. A. Enter the interest on the tax due. (5A) (58) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. $611.63 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN X IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; c. retain a revisionary interest; or d. receive the promise for life of either payments, benefits or care? If death occurred after December 12, 1982, did decedent transfer property within on 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 Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? Yes No ~ B ~ EB 2. 3. 4. Ii x I IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. I I Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer other than the personal representative is based on all the information of which preparer has any knowledge. or For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P .S. ~9116 (a) (1.1) (ii)l. The statute does not exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116(a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P .S. ~9116(1.2) [72 P.S. ~9116(a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P .S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. i ~ 099999-00034111.8.99IRHW/KL T/128394.2 11Jnlit lIIill nub w.elitnm.ent OF BERNICE A. KLINE I, BERNICE A. KLINE, of the Borough of New Cumberland, Cumberland County, Pennsyivania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills or Codicils at any time heretofore made by me. ARTICLE I I direct the payment of my legally enforceable debts and the expenses of my last illness and funeral from my Estate as soon after my death as conveniently may be done. I -I ARTICLE" 1 give and bequeath my motor vehicles(s), household and personal effects and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, to my daughters, SANDRA A. KAUTZ and PATRICIA A. GEORGE, to be divided between them by my Executrices with due regard for their personal preferences in as nearly equal shares as practicable. If my daughter, SANDRA A. KAUTZ, does not survive me by thirty (30) days, I give and bequeath her share unto her then-living issue, per stirpes, to be divided among them by my Executrix with due respect to their personal preferences in as nearly equal shares as practicable. If my daughter, PATRICIA A. GEORGE, does not survive me by thirty (30) days, I give and bequeath her share unto her then-living issue, per stirpes, to be divided among them by my Executrix with due regard for their personal preferences in as nearly equal shares as practicable. Any such item allotted to a minor, may, as my Executrix thinks advisable, either be delivered to the minor or any person to hoid for the minor, or be sold and the proceeds paid, in the ti99009.00034I11.8.9!liRHWiKLT112i=4.2 ... discretion of my Executrix, either directly to the minor or to the Trustee as provided in Article IV hereof. ARTICLE III give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever nature and wheresoever situate, in equal shares to my daughters, SANDRA A. KAUTZ and PATRICIA A. GEORGE. If my daughter, SANDRA A. KAUTZ, does not survive me by thirty (30) days, I give, devise and bequeath her share to her then-living issue per stirpes. If my daughter, PATRICIA A. GEORGE, does not survive me by thirty (30) days, I give, devise and bequeath her share to her then-living issue per stirpes. ARTICLE IV In the event that any beneficiary of my Will shall not have reached the age of twenty-one (21) years at the time for distribution of his or her share, I give, devise and bequeath the share of each such Beneficiary unto my grandson, ROBERT L. GRAMM, JR., IN SEPARATE TRUST, to hold, manage, invest and reinvest the share so received, and the accumulation of income thereon, and to use and apply the income and principal, or so much thereof as, in Trustee's discretion, may be necessary or appropriate for such beneficiary's support and education (including college education, both graduate and undergraduate, and vocational training beyond high school) without regard to his or her ability to provide for such support or education or to make payment for these purposes, without further responsibility, to such beneficiary or to any person taking care of such beneficiary. Trustee shall distribute one-third (1/3) of the then-remaining principal and any income accumulated thereon unto such beneficiary when such beneficiary shall reach the age of twenty- one (21) years, and the balance of principal and any net undistributed income thereon unto such beneficiary when such beneficiary shall have reached the age of twenty-five (25) years. In the event any beneficiary dies before receiving his or her final distribution hereunder, the Trust as to that beneficiary shall terminate and the balance of principal and any net undistributed income shall be paid over to such beneficiary's personal representative. 2 .~34111.8.99IRHWIKL TI128394.2 ARTICLE V I direct that the interest of the beneficiaries shall not be subject to anticipation or to voluntary or involuntary alienation. ARTICLE VI I name, constitute and appoint my daughters, PATRICIA A. GEORGE and SANDRA A. KAUTZ, Co-Executrices of this my Last Will and Testament. Should both of my daughters, PATRICIA A. GEORGE and SANDRA A. KAUTZ, fail to qualify or cease or act as Executrices, I appoint my grandson, ROBERT L. GRAMM, JR., as Executor of this my Last Will and Testament. I direct that my Executrices or Executor shall not be required to post bond for the faithful administration of the duties required in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, thisi(rudayof /VOV'j!F/'tt'E-'? ,1999. . 1J~.~~;'- IC/. U,....o. "BERNICE A. KLINE (SEAL) Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~h~ ~~?d 3 . _.~c,,~._,,_ 111.a:99IRHWIKL T1128394.2 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 55. We, BERNICE A. KLINE, ~.. <::J J.:::::,. ~~ and ~~ \~.\N~ ~ ' the Testatrix and the witnesses, respectively, whose names are signed to t~ attacl\ed or foregoing instrument, being first duly swom, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly and that she executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. P; "A~... .:. ~ ':+. I~....: 4- BERNICE A. KLINE ~s1)1r- ~~P~L?' ~//<:::; Sworn to or affirmed to and subscribed to before me by BERNICE f!t.. KLINE, Testatrix, and ~. C\ ~.~~ and <<~ '~.'W~ ~. witnesses, this l\o~dayof ~ ,1999. .~~~~ Notary Public . My Commission Expires: NOTARIAL SEAL DIANNE LENIG, Notary Public Lemoyne Borough Cumberland Co. 4 My Commission Expires Dec. 21, 2001 REV-1502EX = (1-97)(1) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Kline. aEllnlce A. FILE NUMBER 67-04-850 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Real Estate located at 419 Fourth Street. New Cumberland. Cumberland COunty. PA as sold VALUE AT DATE OF DEATH $84.000.00 TOTAL (Also enteron line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) $84.000.00 REV-1503EX = (1-97)(1) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Kline. Bernice A. FILE NUMBER All property jointlYooOwned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2. 3. DESCRIPTION VALUE AT DATE OF DEATH $133.30 $121,59 $2,118.60 U.S. Savings Bond U.S. Savings Bond 58 Shares of MetLife s10ck al $36.5275Ishal'll TOTAL (Also enter on line 2. Recapitulation) (If more space is needed. insert additional sheets of the same size) $2,373.49 REV.150a EX+ (1-97)(1) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF 67-04-850 Kline, Bernice A. FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2. 3. 4. 5, 6, 7. 8_ 9. DESCRIPTION VALUE AT DATE OF DEATH $400,50 $82,156.55 $6,678.31 $731.73 $4,518,54 $60.16 $75.35 $464.48 $171,68 Personal Properly as sold at auction PNC Bank checking account M& T Bank checking account M&T Bank savings account Waypoint Bank certificate of deposit Anthem Medical refund Patriot News refund Proration of taxes on sale of real estate Stale Farm Insurance refund TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) $95,277.30 REV-1510 EX+(1-97)(1) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Kline, Bernice A. FILE NUMBER 67-04-850 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER 1. DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE % OF DECO'S DATE OF DEATH INTEREST VALUE OF ASSET EXCLUSION (IF APPLICABLE) TAXABLE VALUE American Funds IRA Distribution to Patricia A. GeorQll. daughter. 1900 Valley Etters PA 17319 - payable upon deat/! American funds IRA Distribution to Sandra Kautz. daughter. 14 Big Sprlng Terrace. Newville. PA 17241- payable upon death $3.436.87 $3.436,87 2. $3.436,87 $3.436.87- TOTAL (Also enter on line 7, Recapitulation) (If more space is needed, insert additional sheets of the same size) $6,873.74 REV-1511 EX + (1-97)(1) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF 67-04-850 Kline, Bernice A. FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER A. 1. B. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. DESCRIPTION AMOUNT FUNERAL EXPENSES: Gingrich Memorials $35.00 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Zip State Probate Fees Accountant's Fees Tax Return Preparer's Fees Patriot News - Ad Cumberland Law Journal - Ad Register ofWilis - File Return Register of Wills - File Releases Absolute Real Estate Appraisers $211.81 $75.00 $15.00 $5.00 $300.00 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $9,610.81 REV-1512EX+(1-91)(1) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF Kline, Bernice A. FILE NUMBER Include unrelmbursed medical expenses. ITEM NUMBER 1. Patrlcla George - reimburse house expenses 2. UGI 3. PA American Water 4. Verizon 5. Check Fee 6. PP&L 7. UGI 8. Family Physicians 9. PA American Water 10. Carter Lumber. Water Heater for house 11. UOl 12. Sandre Kautz. reimburse for plumbing supplies 13. PP&L 14, PA American Water 15. Borough of New Cumberland. sewer and trash 16. UGI 17. PP&L 18. PAAmerican Water 19. Sandra Kautz - reimburse for replacement 01 light In bedroom 20. UGI 21. UGI 22. SettlemSflt Charges on sale of house 23. PP&L 24. Moffit Heart and Vascuiar 25. PA American Weter 26. Wayne Myers - auclfoneer's comml>lsion 27. Moffit Heart and Vascular 28. Holy Spirit Hospftal DESCRIPTION AMOUNT $171.27 $27.20 $13.85 $11.19 $8.62 $26.99 $8.78 $10.10 $12.17 $249.10 $41.95 $57.97 $19.71 $12.76 $60.43 $63.n $14.45 $12.17 $43.45 $139.98 $26.38 $868.97 $11.16 $215.53 $12.17 $125.45 $37.61 $18.65 TOTAL (Also enter on line 10, Recapitulation) (If more space is needed. insert additional sheets of the same size) $2.321.83 REV-1513 EX + (9-00)) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT BENEFICIARIES ESTATE OF Kline. Bernice A. FILE NUMBER 67-04-850 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE 1. Patricia Georg& 1900 Vaney Road Etters PA 17319 2. Sandra A. I<:ault 14 Big Spring TetraCe' . Newville PA 17241 daughter one half daughter one half ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) $0.00 A. Settlement Statement U.S. Department of Housing and Urban Development B. Typ8ofLoa.n OMB No. 2502-0265 REV. HUD-l 13/86\ FINAL 1. OF.HA 2 OFmHA 3. DConY, Unlns, \ 6.. File Number 11.lcar.Number 1 a. Mortgage lnslJrance Case Number 4. nVA 5. oeonv, Ins. MT2005.100JES C, Note: It~s marked ~'(~OC,)"~: ~~ ~~l$id'::~ ~o~; ~ ar~:h~~\.irlll~i~fOfm~io~ ~rpJ'SIIsaa~~ a~:;:;::1 ~ud:~~~~:rOtals 1 Tlt\eExpl"ess Settlement System ~~~l~~~\~n~~~\?n~=~~:~~~~a :~d:~~~~~T~~~I~S~at~~~ ~~i6nal~fri~a~ds\T:r:rn'1~anah'as upon Printed 12123/2004 al 10:39 KLl D, NAME OF BORROWER: Charles B. Ewing and Charles D. Ewing ADDRESS E. NAME OF SELLER: Estate of Sernice A. Kline ADDRESS', F. NAME OF LENDER: Cash ADDRESS: G. PROPERTY ADDRESS: 419 Fourth Street, New Cumberland, PA 17070 New Cumberland Borou"h H. SETTlEMENl AGEN1: Saidls, Shun, Flower & lindsay, Telephone: 717.243.6222 Fax: 717.243-6486 PLACE OF SETTLEMENT: 2109 Market Street Camn HlIJ PA 17011 L SETTLEMENT DA.TE: 12121/2004 J. SUMMARY OF BORROWER'!; TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER 101 Conlract sales nrice 84000.00 401, Conlraclsalesorice 84000.00 102 Personal Pronertv 402 Personalprooertv 103 Selllementcharnes to bOrrower line 1400\- 1568.98 403. 104 404 105 405, Adiustments for items oaid bv seller in advance Adiustments for items paid 't.v seller in advance 107 Countvtaxes 12127/041012131104 6.43 4{)7. Countv(aJl.es 12121/04<012/31/04 6.43 108. School Taxes 12127/041006130/05 455.94 408. School Taxes 12/27/0410 06130/05 455.94 109. Trash 12/27/041012131/04 2.11 409. Trash 121271041012131/04 2.11 110. 410. 111. 411. 112 412 120. GROSS AMOUNT DUE FROM BORROWER 86 033.46 420. GROSS AMOUNT DUE TO SELLER 64464.48 200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201 Oenositorearneslmonev 3000.00 501. ExcessOeoosil seelnslruclionsl 202 Princioalamountofnewloans 502. Seltlemenl charaes 10 seller lline 1400\ 844.00 20J Ex'lslinaloanlsllakensubieclto 503. Existinnioan[sllakensubiecllo 204, 504 PavoffofFlrst Mortnane Loan 205 50S. 206. 506. 207. 507. 208. Sewer 10/01/041012127/04 24.97 508, Sewer 10/01/041012127104 24.97 209 50'. Adjustments for items unoaid bv seller Ad ustments for items unDaid bv seller --'lL- 513. 214 514. 215 515. 216. 516. 217, 517. 218. 518. 219. 519, 220.10TAL PAID BYIFOR BORROWER 3024.97 520. TOTAL REDUCTION AMOUNT DUE SELLER 868.97 3GO. CASH A1 SEHLEMEN1 FROM OR 10 BORROWER 600. CASH A1 SEnLEMEN1 10 OR FROM SELLER 301 Gross amounl due from borrowerlline 1201 86033.46 60t Gross amount due to seller Iine420\ 84464.48 302. Less amounls naid bvlfor borrower line 220 3024.97 602. less reduction amount due selle( 'line 520' 868.91 303. CASH FROM BORROWER 83008.49 603. CASH TO SELLER 83595.51 SU8STlTUTlO FORM 1099 $ELLlOR STATEMENT Th8 intormation,cootalned herein is imp<l(LBOt lax Information and I," being furnished to the Inl....nsl Re"anue Service. K you.s'" r"'lulred lolil.. a "'turn. ~..:'ee~me~b~V~ec6~~I:;';I~~h~eSG~~~~~~~~d';'Jf;t:'~':",1tW1 <\em ~recy.w;ed \O"",~ed 1\l:\<:I\t\D IRS ~\MlI1","\I\&\ II loa, 00\ bnn T~. ThEI Ctmlrllc\ Salas Pnce dascri'oo<lon ~~~~I~~'~~~I~~geN:a~ ::!if~: :1~r ~~yS25!:~k,~I~i~d~I':'b fi(IF:~~t.M9, Sele or Elcd1ange of Principal Ru;dance, for eny gain, wilh your Income laX return: lor other t<ansaclK>no, ~~, r~i.';:'a~btal~~':';:ilt~ ~~I::i~~~I:~ ~ag,::d' ~~I:: LJMer pan.altlao 01 pe~~I)I~ ~~~J: ~ea~u:;;'~~~~I~\~~~~:~~:n'tUlo~~~n':~:!;au:e..a:~:;ii~~"t",.;~~~fi""tion "" SELLER($)SIGNATUflE($): SELLER(S) NEW MAILING AOORESS Exhibit for Schedule A OCT-13-2004 17:26 PNC8ANK 412 768 3458 o PNCBAN<. October 14, 2004 . Joel O. Sechrist Attorney at Law 568 Old York Rd. Etters, PA 17319 scp RE: Estate of Bemice Kline (Deceased) SSN: 187-16-5836 DOD: 08-22-2004 Dear Mr. Sechrist: In response to your request for Date of Death balances for the customer noted above, our records show the following; Checking Account Account #5140082602 Established 02.25.1985 BERNICE KLINE DOD balance: $82,151.23 + $5.32 accrued interest Interest paid 01-01-04 tbm 08-22-2004 $79.93 YfD Please note that this office only provides date of death balances for deposit accounts (lRAs, CDs, CheCking and Savings accounts). We do not procesl aDY fiDaDelal lraasactioDS or provide statemoats. If you need assistance with any of these items, please call 1-888-PNC-BANK (1.888-762-2265) or stop by your local PNC Bank branch office, Sincerely, f..< ~... -:I. ~ Erica L Schlegel 1-800-762-1775 P7-PFSC-04-F 500 Firs, Ave. Pinsoursh PA 15219 Memo.. FDIC Exhibit for Schedule E p,0vm TOTAL P.01 "'Way~qint LOOK FOR US. WE'LL GET YOU THERE. 9/16/2004 JOEL 0 SECHRIST ESQUIRE 568 OLD YORK RD ETTERS PA 17319 The information which you requested on the account(s) of BERNICE A KLINE (Social Security Number 187-16-5836) is/are as follows: Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership SOLE Name of Joint Owner, if any 765311885 CERTIFICATE 071197 4477.35 4I.l9 4518.54 Date Ownership Was Established 071197 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Estab lished Exhibit for Schedule E Additional Information Requested RIN E WATTS SENIOR SERVICES REP. P.O, 80x 1711. HARRISBURG, PENNSYlYANIA 17105-1711 Toll Free 1-866-WAYPOINT (1-866-929-7646) . IN YORK AREA 717/815-4500 . www.waypointbank.com rl:1M&rBank 499 Mitchell Road, MiIlsboro, DE 19966 Mail Code DE.MB-12 Phone (888) 502-4349 Fax (302) 934-2955 September 22, 2004 Joel O. Sechrist, Esquire Attorney At Law 568 Old York Road Etters, PA 17319 Re: Estate of Bernice A. Kline Social Securitv: 187-16-5836 Date of Death: AUf!ust 22. 2004 Dear Sir or Madam: Per your inquiry dated September 13, 2004, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 51723735 Ownership (Names oj) Bernice Kline Opening Date 10/28/68 closed 9/16/04 Balance on Date of Death $6,678. 13 Accrued Interest $ 0.18 Total $6,678.31 1nterest Paid YTD $ 5.26 (Accrued interest is not included) 2. Type of Account Savings Account Account Number 015004208613578 Ownership (Names oj) Bernice Kline Opening Date 1/3/92 Balance on Date of Death $731.63 Accruedlnterest $ 0.10 Total $731.73 1nterest Paid YTD $ 1.32 (Accrued interest is not included) Please be advised, there was no safe deposit box found for the above decedent. For further account information, regarding ownership, closures andJor reimbursement of funds, etc., please call tbe Highland Park OffICe # 717-737- 3322. Sincerely, '/{~CCa~ Nancy Ch~~ett t/ Records Management Exhibit for Schedule E _.---'_.~~_...._-'~_._,~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHEHT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIOllS AND ASSESSIIEHT OF TAX "* BUREAU OF IIGlIVI~ TAll"$. INHERITANCE TAX DIVISr.-('tlt'J"i,:..r! PO lOX 280611 ' "._~":" ,'J .t) HARRISILIlG PA 17128-06Df'--~.--: REV-1547 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-25-2005 KLINE 08-22-2004 21 04-0850 CUMBERLAND 101 _t _itt... '....g ""." 02 / ,-. c~ it; .~ f". . , '---,. I 11 :c_" , BERNICE A CLE}X OF P A TR ICIAOilJi;EtJ.laltC. r">'".,-."....,. .. _ .'-' C/O J ~!SECHRIST ESQ 568 OLD YORK RD ETTERS PA 17319 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ IIf"-".L'!C"'rf.m.m~'.""'Im.tII!'.IRI'rt'IM!I!'.m.1MflllmM!llt~."lrCtWIM!!'.Mt'.............. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KLINE BERNICE A FILE NO. 21 04-0850 ACN 101 DATE ,04-25-2005 TAX RETURH liAS: (X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..l Est.t. (Schadul. A) 2. stocks _ _. (_1. BI 3. C10..1y H.1d Stock/Psrt...rohll> Int....st (_1. CI ~. Hortgsg8.lNot.. Rsc.ivsbl. (Sch8dul. DI S. ~ !l8po.1tslHi.... P.r._l Pr_rty (Sc_1. EI 6. Jointly 0Wnsd Property (Sch8dul. FI 7. Tr8hsf.rs (Sch.dul. Q) 8. Tot.l Asset. ( I CHAHllED 84,000.00 2.373.49 .00 .00 95.277.30 .00 6,873.74 (81 NOTE: T~' Insunl proper creell to your 8CCOUnt" _It _r !>DrUon of th~~r. with your t.K I> t. , (11 (21 (31 (~I (Jil (61 (7) 188,524.53 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funer.l Expenses/AdII. Costs/Mlsc. EXPMS8S (Schedul. H) 10. DsbtslHortgsg8 Llsbll1ti.slLI8ns (Sch8dul. II 11. Tot.1 D8ductlon. 12. N8t Valu. of T8X R.turn 13. Chorltsbl8180V8rn58nt.1 B8qu8.t.; Non-.1..ted 9113 Trust. 1~. H.t V.1uo of E.t.t. Subj..t to T8K 9,610.81 (91 (101 2.321.83 (Ill 1121 (13) 11~1 ~1.Q3? &6 i76,591.89 I .00 176,591. 89 I (Sch8du1. JI If an esse.s.ent was issu.d previou.lY. lin.. 14. 15 and'or 16. 17. 18 .nd 19 will reflec1: figures that include the tcrtal of ALL return. a.s....d to date'l ASSESSMENT OF TAX: IS. _t of U... 1'1 .t Si>Du..1 ...t. (1!i1 16. Asount of Lln8 1~ t8Ksb1. .t Lln88l1C1.ss A r8t. (161 17. _t of U... 14 .t SlbUng r8t. un 18. Asount of Lln8 1'1 t8Ksb1. .t Co11.t.r81/C1... B r8t. (181 19. Prlnclp.1 T8K Duo NOTE: .00 x 176,591.89 x .00 x .00 x 00 = 045 = 12 = 15 = .00 7,946.64 .00 .00 7,946.64 U9J= AIllIUHT PAID 3,484.13 3,484.13 611.63 DATE 1 -21-2004 10-21-2004 02-11-2005 MHlER CD0045 9 CD004520 CD004942 IHTEREST/PEN PAID (-I 183.38 183.38 .00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 17,946.65 .01CR .00 .0ICR v; . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATIDH OF ADDITIONAL IHTEREST. ( IF TOTAL DUE IS LESS THAN n, NO PAYHEHT IS RElIUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT'" (CRI, YDU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRII FOR INSTRUCTIOllS.) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION IN RE: Estate of BERNICE A. KLINE No. 21-04-850 Late of New Cumberland Borough, Cumberland County, Pennsylvania RELEASE KNOW ALL MEN BY THESE PRESENTS, that I, PATRICIA A. GEORGE, do hereby acknowledge that I have this date received from Patricia A. George and Sandra A. Kautz, Executrices of the Estate of Bernice A. Kline, my share of the Estate of Bernice A. Kline. I therefore release and forever discharge the said Patricia A. George and Sandra A. Kautz, individually and as Executrices ofthe Estate of Bernice A. Kline, their heirs, Executors, and administrators, of and from all actions, duties, claims and demands whatsoever from the beginning of the world to the date of these presents. And I hereby consent and agree that the Orphans' Court of Cumberland County, Pennsylvania, may discharge the said Executrices upon application and without further notice to me. AND the undersigned, in consideration of said payment and transfer, does hereby agree, upon written request of the Executrices to refund to the said Estate pro-rata whatever assets, in kind or in cash, that may be necessary in the future to discharge any liabilities of the Estate. IN WITNESS WHEREOF, I have hereunto set my hand this ,2005. day of WITNESS: Vd~o~ Patricia A. George SSN: /r& -s>,?-- J/d...< - IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION IN RE: Estate of BERNICE A. KLINE No. 21-04-850 Late of New Cumberland Borough, Cumberland County, Pennsylvania RELEASE KNOW ALL MEN BY THESE PRESENTS, that I, SANDRA A. KAUTZ, do hereby acknowledge that I have this date received from Patricia A. George and Sandra A. Kautz, Executrices of the Estate of Bernice A. Kline, my share of the Estate of Bernice A. Kline. I therefore release and forever discharge the said Patricia A. George and Sandra A. Kautz, individually and as Executrices of the Estate of Bernice A. Kline, their heirs, Executors, and administrators, of and from all actions, duties, claims and demands whatsoever from the beginning of the world to the date of these presents. And I hereby consent and agree that the Orphans' Court of Cumberland County, Pennsylvania, may discharge the said Executrices upon application and without further notice to me. AND the undersigned, in consideration of said payment and transfer, does hereby agree, upon written request of the Executrices to refund to the said Estate pro-rata whatever assets, in kind or in cash, that may be necessary in the future to discharge any liabilities of the Estate. IN WITNESS WHEREOF, I have hereunto set my hand this ,2005. day of WITNESS: ~3~_j~,~~~~.c- Sandra A. Kautz <-- SSN: \\s, <~ - -S~ - \-::,-\ ~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Bernice A. Kline Date of Death: April 22, 2004 Will No. 21-04-R~n Admin. No. Pursuant to Rule 6.12 of the Supreme Couxt Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasonably believes that the aQministration 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 Cerk of the Orphans' Court and may be attached t this report. Jt Date'~1 ~~! ~S I oel O. Sechrist, Name (Please type 568 old York Road Etters PA 17319 Address Esquire or print) ( 717) 938-3396 Tel. No. Capacity: Personal Representative x Counsel for personal representative wf (MAH:rmf/AM3)