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HomeMy WebLinkAbout02-1074PETITION FOR PR/OBATE and GRANT OF LETTERS Estate of `/e'N`YJL'[" ~~ ~•~~ No. .21 -`)~~ - 1 ~ also known as To: D ceased. Social Security No. © ~ _ - D Register of Wills for the County of Cwnberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executrix named in the last will of the above decedent, dated ~,4/"~' .T ,~}~/" and codicil(s) dated . _ , (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in _ ~u~~~~~A~~ County, Pennsylvania, with h ~ 3 last family or princi~al residence at ~3~ G.E'~ ~ ,(~2//~Gc.= ~E' I~ l ~, s~7/-~ f~/~C... (list street, number and muncipality) Decendent, then _~~ yea s of age, died L~tJ • ~ ~ '~,~;,~~ at ~=~1~~J l~_5~3~:'e~' • ti'~~e?~13~/~riT~ Td~r~~I~Ca~~rJ , 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 $~rrJ ~.. (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvani $ situated as follows: ~,~30 e~~ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters theron. v V C 'C3 .-. 6J ~. ~. C -p O C ~ '~ ~a vw ~ o ao r ~~~ ~---- OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1 COUNTY OF Oberland ~ Ss The petitioner(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 acuprding o law. / Donna M. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) oo' a a ~fl~~f Sworn to or affirmed and subscribed No. 21-2002-1074 Estate of Lawrence F. Lee ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW December 3rd _Y~~ 2002, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated__ Apri]_ 5th, 2001 described therein be admitted to probate and filed of record as the last will of Lawrence F. Lee and Letters T are hereby granted to Kath] een Ross, a/k/a Kath7 een L Ross FEES Probate, Letters, Etc. ......... ~ 235.00 Short Certificates( l~. • • • ...... ~ 45.00 extra. pages, . , ~ 15.00 ~~l:~~x (5) ~ 10.00 JCP 305.00 TOTAL ~ Register of Wills Donna M.Otto, 1st Deputy ATTORNEY (Sup. Ct. LD. No.) .ADDRESS Filed December . 3x~ci,•2002.... • • • • • • • • • • • PxoNE MAILED LETTERS AND ORDER 'TO EXECUTRIX ON DECEMBER 3RD, 2002 f LAST WILL AND TESTAMENT OF LAWRENCE F. LEE I, LAWRENCE F. LEE, now of Hampden Township, Cumberland County, Pennsylvania, do hereby declare this to be my Last Will and Testament and hereby revoke all prior Wills and Codicils made by me. ITEM I. I direct that all of my just debts and funeral expenses, including the cost of my gravemarker, if any, shall be paid from my residuary estate as soon as practical after my decease as a part of the administrative expenses of my estate. ITEM II. I give and devise all of my estate of every nature and wherever situate to my wife, LORRAINE C. LEE. ITEM III. Should my wife, LORRAINE C. LEE, predecease me or die on or before the thirtieth (30th) day following my death, I give and devise all of my estate of every nature and wherever situate in equal shares to my children, KATHLEEN ROSS, BARBARA ANN BINGAMAN and JAMES L. LEE, or their respective issue, per stirpes. Should any such child predecease me and die without issue, I give the share of such child in equal shares to my surviving children, or their issue, per stirpes, as the case may be. ITEM IV. If any income or principal shall be payable to any person who shall be a minor or who shall be incapacitated for any reason, my personal representative, as trustee, shall C,~ Lawrence F. Lee r hold such income and principal during minority or incapacity and shall be entitled to apply such income and principal to the health, maintenance, support and education of such person during minority or incapacity, without the appointment of any guardian or committee or any authority of court, and shall be entitled to make direct application hereunder or to make application by payment thereof to the parent or other person in charge of such minor or incapacitated person, or to his or her guardian or to a custodian under the Uniform Transfers to Minors Act. Any remaining income and principal to which such person shall be entitled shall be paid and distributed to such person upon the termination of minority or incapacity. ITEM V. I appoint my wife, LORRAINE C. LEE, Executrix of this my Last Will and Testament. Should she fail to qualify or cease to act in such capacity, I then appoint my daughter, KATHLEEN ROSS, Contingent Executrix of this my Last Will and Testament No bond shall be required by my personal representative in any jurisdiction. ITEM VI. In addition to the powers given by law to my personal representa- tive(s) and trustee(s) [hereinafter fiduciaries) in the administration of my estate and of any trust(s) created herein, they shall have the following discretionary powers applicable to all real and personal property held by them, including property held for minors, effective without court order until actual distribution. A. To retain any property owned by me at my death and to invest any funds held by them in any stocks, bonds, notes or other securities or property, real or personal, including common trust funds, mutual funds and money market deposit accounts operated or offered by my corporate trustee, if any, or any affiliate of it. Lawrence F. Lee ~ 2 r B. To sell or otherwise dispose of any property, real or personal, at any time forming a part of my estate or the trust estate, for cash or upon credit, in such manner and on such terms as they see fit, and no one dealing with the fiduciaries shall be bound to see to the application of any monies paid. C. To manage, operate, repair, improve, mortgage or lease for any term [even if beyond the duration of the trust(s)] any real estate at any time held or owned by them as fiduciaries. D. To hold investments in the name of a nominee and exercise and dispose of warrants. E. To engage in litigation and compromise, arbitrate or abandon claims and property. F. To conduct any business in which I am engaged or in which I have an interest at the time of my death for such period as the fiduciaries deem advisable, with the power to borrow money and to pledge the assets of the business and to do all other acts which I, in my lifetime, could have done, or to delegate such powers to a partner, manager or employee without liability for any loss occurring therein. G. To allocate items of receipt or disbursement between principal and income as the fiduciaries deem equitable regardless of the character given such items by law; to distribute in cash or kind or partly in each at valuations fixed by the fiduciaries. H. To borrow money, including the right to borrow from any corporate trustee, if any, and to mortgage or pledge as security or to hold its own stock if a corporate trustee. Lawrence F. Lee 3 I. To join in any merger, reorganization, voting trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto. J. Should the principal of any trust herein provided for be or become too small in trustee's opinion so as to make establishment or continuance of the trust inadvisable, my trustee(s) may make immediate distribution of the then remaining principal and any accumulated or undistributed income outright to the person or persons and in the proportion they are then entitled to income. Upon such termination, the rights of all beneficiary(ies) who might otherwise have an interest as succeeding income beneficiary(ies) or in remainder shall cease. K. In general, to exercise all powers in the management of the assets of my estate or the trust estate which any individual could exercise in the management of similar property owned in his own right, upon such terms and conditions as the fiduciaries may deem best, and to execute and deliver all instruments and to do all acts which the fiduciaries may deem necessary or proper to carry out the purposes of this will or any trust(s) created herein. L. To apply income or principal to which any beneficiary is entitled, directly for his or her comfort, maintenance and support, should the fiduciaries deem such beneficiary incapable of receiving the same by reason of age, illness, infirmity or incapacity, or to pay the same to such person or persons as the fiduciaries select to disburse it, whose receipt shall be a complete acquittance therefore without the intervention of any guardian. M. To assume continuance of the status of any beneficiary with reference to death, marriage, divorce, illness, incapacity or other change in the absence of information deemed reliable without liability for disbursements made on such assumptions. ,ate Lawrence F. Lee 4 N. All principal and income shall, until actual distribution to any beneficiary, be free of the debts, contracts, alienations and anticipations of any beneficiary, and the same may not be liable for any levy, attachment, execution or sequestration while in the hands of any fiduciaries. Provided, however, any beneficiary may assign any part or all of the beneficiary's interest in my estate or the trust(s) to any one or more of the beneficiaries or my descendants. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~ day of » ~ , 2001. Lawrence F. Lee The preceding instrument, consisting of this and four other pages, identified by the signature of the testator, was on the day and date thereof signed, published and declared by Lawrence F. Lee, the testator therein named, as and for his last Will, in the presence of us, who, at his request, in his presence, and in the presence of each other, subscribed our names as witnesses hereto. ~~ ~~ ~ ~ ~ s ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS. I, LAWRENCE F. LEE, testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last Will, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. Lawrence F. Lee Sworn or affi ed to and acknowledged before me, by Lawrence F. Lee, testator, this ~ ~ day of _ ,( n ~ , 2001. Notary Public My Commission E pirg~, NUTARIAL SEAL ?TULLY S. KIRK, Notar Public Harrisburg, Dauphin County AFFIDAVIT h;y Commission Expires Feb. 15, 2003 COMMONWEALTH OF PENNSYLVANIA . SS. COUNTY OF DAUPHIN We, ~~,Q oS'. ,~'~,P CinD~. ~ ~--l1 ~i~0~ ~ ~~~G'~~ , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testator sign and execute the instrument as his last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testator signed the Will as witnesses; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ,~ , `~ _ ~~ Sworn to and subscribed before me this V~ ~ day of ~ r~ ~ , 2001. ~ ' Notary ubliC NOTARIAL SEAL HOLLY S. KIRK, Notary Public Harrisburg, Dauphin Counly h9y Commission Expires Feb. 15, 2003 My Commission Expir ----~---~ __.. _.~._, \.~ / ~~C~iON OF NOTICE: UNDFR RUI E ~. Name of i)ecedent: ~~~~~~~ ~ ~~~ _..____.~.~.~. Date of Death: ~~~</L~~ ~~ ~ ~~U Will No. _ ~~ ~~~C> ~ - ~ ~ h~__._..W... Admin. No. To the Register: ~~ ~~ ~ ~Q ~~ -_~lC~ ~ rww__~~.~n_~.~ 1 certify that notice of (benefkia! interest) ~y~g adminigtratlon rryuired by Rule 5.6(a) of the Urphans' COUrt RUIL4 ~t'a5 served an or mailed to the following beneficiaries of the above-captioned estate on _---~~~L~~ Name r cs ~l /~ l .------~ /~~ i~ iC~ / X ~~~~~" d Notice has now been given to all persons entitled thereto under Rule S.b(a) except_~ :__ Date: ~ ~~ C %~~~ ._____.~.-- ---~--~- ~~t'C~erz~lJ~ ~C~'~- ____M..~.___- Signature r~- N.~me __~~~~~ ~(_-~% _ ~ - ~ ~~ S S _ Address ~j ~~/ t /~ G Talephane ~~ ~JJ~~- ,~` ~~~ ..~L_-.._..._ .~ i.._. ._..~ Capacity: ,_._~~Perscmal Representative _~('ounsel fcx~ personal representati~~e .i~inuai-v ? I.2oo I~:S"hn"hE OI~: LA\~~RENCE F LEE I)I~C'L.nSED ( NO. 10238031002 ( IN THE PROBATE COURT: (CUMBERLAND TX RECEIPT AND RELEASE I'lie undersigned hereby acknowledges receipt of payment and complete satisfaction of the lien previously tiled in this cause of action by CITIBANK (SOUTH DAKOTA), N.A., Tax ID #li-266591 1, for Account Number(s) 4492280002114572. "this is also a RELEASE of the Estate and all persons acting for or on behalf of such Estate with respect to any and all claims or demands which the undersigned may have with respect to the Estate of any of its assets. ~ CITI13A1~,(~OUTH DAKO~jA) C3Y: V S~hATT OT' MISSOURI KRIS T 1 LLS Manager for Citicorp COUNTY Oh PLA'hTE Credit Services. Inc(USA) under limited power of attorney for Citibank (South Dalcota) N.A. ~fhis instrument was acknowledged before me on .lamiary 21, 2003, by KRISTEN WELLS of ('I~1~(I3ANK (SOU"1,II DAKOTA), N.A., in said capacity and on behalf of said corporation. C ~~~ ~ ~ ~~ Notary Pub ic, State of Missouri CHERYL PRESTON Notary Public -Notary Seal State of Missouri Clay County My Commission Expires June 11, 200fi ~-fir, EV-1500EX 1(..;)Oi *' COMMONWEALTH OF , PENNSYLVANIA :'illi1 DEPARTMENT OF REVENUE DEPT 280601 " HARRISBURG, PA 17128-0601 w ..., ::t:~U) U"'''' w"u ,,00 U"'-' ..Ill .. < DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) I- Z W C W U W C ~~'(;J_~BO ~ INHERITANCE TAX RETURN RESIDENT DECEDENT DATE OF BIRTH (MM,DD,YEAR) I-OJ,:20o~ q-I'(, l'f~ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Of HCIAL USE ONLY FILE NUMBER ~~-_!L~ COUNTY CODE YEAR -L~:2-'::L_ NUMBER ~ 1. Original Return D 4. Limited Estate m 6. Decedent Died Testate (Attach copy olWilii D 9. litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date o/death after 12.12-82) D 7. Decedent Maintained a Living Trust IAttach oopyo/Trust) D 10. Spousal Poverty Credit {date of death between 12.31-91 and 1-1-95) SOCIAL SECURITY NUMBER OCfS-- / ~ '(I? THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (dateD/death prior to 12-13-82) D 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11 Election to tax under Sec. 9113(A) {Attach Sch 0) ..., Z W C Z o .. Ul W '" '" o u r.. 4Ttf L,ofN FIRM NAME II/Applicable) TELEPHONE NUMBER 17 q3/r- 1. Real Estate (Schedule A) 2 Stocks and Bonds (Schedule B) oS'S' COMPLETE MAILING ADDRESS '-/0 <f /-fILLS ,W ItJE /0f'.W CUI'1ge,'-<Jf"J) fit /7070.Jo.?'7 01~ (1) (2) (3) (4) (5) /33, /J..t - '8-,-/, 3It,o;l. 3, Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested z o ~ ::l l- ii: <I: U W D:: I 7 :2., 'i F>;1, "I 2 (6) 7, Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G orl) (7) 8. Total Gross Assets (total Lines 1-7) 9 Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent Mortgage liabilities, & liens (Schedule I) 11. Total Deductions (total lines 9 & 10) (9) (10) /'!,/13,'(fJ 1,-/,3'13,3'( 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) 14. Net Value Subject to Tax (line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPliCABLE RATES z o !;( I-' ::l ll.. :E o U >< ~ 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16 Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of line 14 taxable at collateral rate 19. Tax Due 3 sC '-I:l~ ;;1.0 x.O_ (15) x.OI.../~ (16) x .12 (17) x .15 (18) (19) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 20.0 :->r: . OFFIcIAL USE ONLY d :tJ iW :1) 1,- !;;; ~ f'"' 3 -'. c, ~ b ~". I~ g; i i (8) 3?rQ, "II, '-I 9'1 (11) (12) (13) 33,S3t,7,-/ 3s/;, 'f,;).,'if'.:J..(; (14) 3S(" 'id-..[?',J-.{) I t. , 03 1, ~ '/ /t,()31.{}.,? Decedent's Complete Address: STREET ADDRESS ,If" CITY C4 If.- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount /t.,D3'L :2-7 . Total Credits (A + B + C ) (2) () 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty ( D + E ) 4. 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.. ..................................................... ..................... D m ~. ;:;::~ :h~e~;~;i~~:~sii~~~:es;:~ shal! use thepropertytransferre~~r 't~'nco~e;...... ....... ....... ......... ......... ...... B i d. receive the promise for life of either payments, benefits or care? .................................... ................................ D ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .......... ................................................................................................... D l)g 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.. D 1&1 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ D ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best 01 my knowledge and beliel, it is true, correct and complete Declaration of preparer other than the personal representative is based on all information of which preparerhas any knowledge DATE eo ~;(, 7MG €5~ ",;:: ~~eneG /7t:ec' DDRESS 109 Jh/t&rfJt: ~e /JeVt!v.mb~Jd-"l-n~ 1,.,(- l701CJ SIGNATURE OF PREPARER OTHER THAN RePRESENTATIVE DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% 172 P.S. 99116 (a) (1.1) (i)J. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to orfor the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii) The statute does not exemot 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 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 paren or a stepparent of the child is 0% [72 P.S. 99116(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. 99116(1.2) [72 P.S. 99116(a)(1 )1. The tax rate imposed on the net vaiue of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(1.3)J. A sibling is defined, under Section 9102, as al individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX. (6-9* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER LIJ-WI?.~UCh LCfZ ~I -0:2- /07'( 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 seifer, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is Jolntly.owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION yf,/.I',-C rl}~/(_'( f(h'S/1/6"-'CC- L-pc/t! r,." ~r- '-13" OIVu P"'-II}fJ ,eo ClU...1' f-l-/LL,f/J 1'/0/1- !v(1f1[; SIU';P II\; ~crVA.l Sk/i d~ /f-tfh IiJrJl. n; - t 1t7/ (I s VALUE AT DATE OF DEATH .; f 3 3 I;;tG , TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 133.1;l..{, REV-1503 EX... (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER LIf Wil-fDKt F, Lc Ii d...1 - 0;;" - /67'f All property Jolntly..owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. VALUE AT DATE OF DEATH ;)./37 slies .:t. TRhvctCkJ 3 IflA vi! t tf-~ J" DESCRIPTION pC Cl71GIUJuY COHI1C(...> @ .37. 6j /r/f/1 CtJf1l'ro}'-.4 '1:J.. SI-/(S e f?{}; '-(S8". oS- 13.i7 {3.'17 II ;;"'S7 . {, 'i ;;;".''1(;.33 COM,., 01-- 8 f f?''f S'HIlJ e TOTAL (Also enleron line 2, Recapiluialion) $ fry, 3S6. O~ (If more space IS needed, Insert add,tronal sheets of the same size) 1iE\/.\'iIlaEX<(1-91\ '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF LIf LV IVi t/(. If r, elf: K FILE NUMBER ;::;21- 0 d..- /0 71..( Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of &uNivol'$hip must be disclosed on Schedule F. ITEM NUMBER 1. ;;;l. 3, '1, s, r;" 7, ~, 1, I t/ , I :l, {l {:fj, DESCRIPTION 1<!J IG 1M Or e () 1-"/7 /lur IJ/J"cnrr fOl-IL'I t; 0;2.10 ;;.q;u' 1<.. I--"{ wr..r or' CUL..v/'1#'<I #/J}..IVtr", p15UC.</ " cJ l'f'f 2S-~'I K~ic;ttr.J' 0"- CtJl-vnRw X X-/f f()I.../~ 'I I? QI'f73/dJ.'( Tor t-/rt' Fi-{'1lllcf" 4"1/,1<1'7<< r r}-I" t-Irl' (=tNXtVc1 ;9-pJw.ry If <{..3 00... .;;.. '-f I '1 Ei' 0 'I r1' 1'?tJO _ 3 (( J O1.;;Vj>' VALUE AT DATE OF DEATH ,;< 'is, i/?.?./' '7 'f ;;;",0 '-Iff.?,j' S; C,5r. 'I '1 .::z..s; ';;I."I7..;z <J IJ, '1<(.:1..,1(7 'f/li'17,J(. c.., 'lU.,!J t" 03:J..OIf' II 'il"!, '() 1/ lOA, ,j''1 / oJ . 0", {f?, I sJ rc f?,rt'~1 p'f'-'r (?/lfv!< ,!I.qr (;(3030 IF ;2..dF \;.;p,'-(t'",#r B 41-' I<. /i-Lu 0,)0000 f'7:J't Vt/1't'(PPlwr CO 17 ;)...30000.>f'' 1'1' W/T'f/'o,,,", c.fJ v 2,.3 06 0 13 JJ)... vA 't p,,,prr c.tj tf ;;L.3 (, I ::l. "1(.;;'5 J V" nii,v;" ;,T c/<l (((;it Ip II/.J-,J U ,..r _ " 1"i4S<A-> tr IJ UJ" S'.4,n;l./6J P",AJP.r JEA/It f:/i C.JI !Jo,l/Pr! TOTAL (Also emer on line 5, Recapitulation) $ I 7:<". 'f 8-:1...1.;1.. (If more space Is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS L/fw /LIE IJC,{ f. L /- t;k Debts of decedent must be reported on Schedule 1. FILE NUMBER ;;)...{ -(}.2- I07'f ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Nt:l/.~IJ ~V1--"'h !f0"7/; 7,/:1..r- Yo C'-& J<(,'f (O 0 .00 C ffutl.c.u- OIl.'~IVIJr c t+ull-c'" S"4t.QIS'r ..., '>-00 7.)-'", B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative{s) k. I!TW U If IJ F /!. aJ'J R; OOO,Of} Social Security Number(s}/EIN Number of Personal Representatlve(s) {(}.. Street Address '10"1 /I tt...t.StP,t' -'14; City tJt:w c.</~Jh.,f,LA~P State~Zip 17070 Year(s) Commission Paid: ;;l.od 7' 2. Attorney Fees 3. Family Exemption: (If decectent's address is not the same as claimant's, attach explanation) Claimant /L~ TN '-~ t: /oJ F- R~.J' . tf[ y.tf c (/ TJ(, " 3 I S ClO . 1:1/ Street Address '10'1 IhLI..A"j),j" AIJ!! City AJ{;w C4lf'1Uh;{LJI."." State ..!..fL...Zip /707tJ Relationship of Claimant to Decedent 019 U('iJnf/{ 4. Probate Fees 3 ('I-ou 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ /:J.llc:r~~ IJ (If more space is needed, insert additional sheets of the same size) ~~ ~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT REV-1512EX.(1-91) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF '- f) V' fL ~ ;.<.tf ~_ L" L- 1::'" FILE NUMBER d-t -0:1..- It>7'1 Include unreimbursed medical expenses. ITEM NUMBER 'jill, 31 3~. 3' ),,- 3/. 3(" :J 7. 3~ 3q 'f l/. 1:.(1 'f:z. . 'I} If,; ,-/.r. "f t" '17 'f r. 'i't j-/X -.>-/. Sd... S'3. . SI{. Sif- sr. DESCRIPTION fldV':'<!: cui/JI-I-;".. or- -eIfi:JlO",;""C;, L'f3'ollu /i'1!. J?O) (:1..(,9/01) J"'",,,, ;(4"''''''''-<.- [LlttIo,) IO'r-4-rl{ CIr€'<"k.I'" ~C'V""", cihf<..NJ w~Sr- J tf"U S-u-<:,...-II.;- pll v,s PU'-i<1o'-'/M_Y /l-5fo<.. H JiJLI r-A-(.4 C;1-1? ho L cc,.rr, C J/2 '() [JluJ ( J( ::L~ ) AMOUNT .f 7".6t> .;;JJ'.Oo .g'00 8"'~,'?"f '7 ~"') 0l.O!J- 3d, ~;l.. '-t'? 6& 3:;L'1.7~ ;;t.' {,8" .0(; 37./0 'ir'..1'$ 'Ie. 71 7'1,fj.JJ 3i"./:J... :2.,:1113:<' 7 'i -d..o /03,00 ~7.~{, b? "/"1 13, 'C(; I Cf 7cS"J d..<>I' 31' '.5'-, "'-. 3' I {, 31?o , (. 'f f"tO'."'" 7T for C4<OItlt. CLI'-'tc c" S~ 19-,-,..."..,p t-I G Il-<..rlt- S' "".H- C](:l.~ I /<~rl/.tI-'lV FGmo'-'. TAY-C"i-t.tf'c/"vt -PIW,Y..tt...y iJl/-.'t.. uS. T,"-/i'./J.Sut.'( - :J.oo~ FlilJli'(9L-' TNc.""'e -rt<!x LA"' /J 5' efl./J. LIi (j- h (V)) &.u~IvTv"" .r"t"',,,,o (J(JI.,) CfHl/srlti~ Gt.&I.II' 5'15'/(,)) f'/,zOI<..IJ.-<. LIt-'-"-' J/lLvtu; #LLfTt>-n L /-101<,( <>",,,,,,.;,u ItvSJ fl/JtU#c.LIE /h,IJ.t.;r1/ C#IHUJJ'iJuH /'IOJI'.rt7-t) i-/'twllI _nf.ILU,c.1i &t~tp 1<';''>-(/,<-0 J'PC/4-<.. J'E'C.vdl/"1 cJ</L/l.r';J>("'4(,1f (II.//j~rdnvr (J~") T"1 f'A-c..r Nli-btclfJ-c. J<..ICJ c."''f P;' HdW'()1-' I}/lfi'-'LfJIVc.fC Ltr.v~ 5';:::/1 Vie II' C. (0-(1/0 r iC/J' v LA- T ,p,v f- d^ YJ {. 01\ Jlj' jJJt.I.J>6,-{ f{)'O c.lllt'tJ,r- C 1/ II:]!"',,} -t'c",S/P(V (ovl'f,dl'l)'(l1.;tfl4) ~ /nioJ) II.2.rI~.o }!.c.I'I}.c(f?lrvT pr rP..L (/11t/.2- .5IiW~ ---'tp'i<.4J'w WI!-rn"- TOTAL (Also enter on line 10, Recapitulation) $ 1'7,3 '13,3 'I (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-{)O) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESlDEN1 DECEDENT ESTATE OF LA- ""' ll~ucE r:: LG:h" NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under Sec. 9116 (al (1.2)] k/J.-THUIiAJ F. (ZoJS Lf 0<1 (+1<-<.50)" lfo./6 /-J/;.... L'-'I'1J1{(tl'-~P f4 17070 [J I'll.. /J/Ht1J. B /,fJ(;, If 1"1 ~/J It, ;to I C.4/Vl...,,v C/}!.l.L" W/L(J4/eJOf) NO bJo'lu TII-M;[J L. uft: y'{IO /lMu6/l F&-I/!. S,filJ I}IV r,;M 0 / T'f.. 7 S' :2..s-v FILE NUMBER :;)...1-0 ~- 107'1 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE pl}-r.J"Wr';-~ f)AUI,.-/ rt:A J'6'1U 113 '/.:1 1/7 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 16. AS APPROPRIATE. ON REV.1500 COVER SHEET II NON.TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 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) STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTIFICATE I, DONNA M. OTTO Register for the Probate of Wills and Granting Letters of Administration &c. in and for said County of CUMBERLAND do hereby certify that on the 3rd day of December A.D., Two Thousand and Two, Letters TESTAMENTARY in common form were granted by the Register of said County, on the estate of LEE LAWRENCE F , late of HAMPDEN TOWNSHIP (LAbl, tlKbl, M1UUL~) in said county, deceased, to ROSS KATHLEEN F \LAbl', tlKbl, lVUUULb) ROSS KATHLEEN AKA (LAbT, t lKbi, lVUUULJ:;) and and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 21st day of April A.D., Two Thousand and Three. File No. 2002-01074 PA File No. Date of Death S.S. # 21-02-1074 11/03/2002 095-18-0417 ~X,cL'<'<\.~\d ~~, .:hS~~,,~0~ Register ( ~.~ NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL WHEREAS, on the 3rd dated April 5th 2001 was admitted to probate as the last will of LEE LAWRENCE F (LA~l, ~1~~1, MIVVL~) late of HAMPDEN TOWNSHIP Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters No. 2002-01074 PA No. 21-02-1074 ESTATE OF LEE LAWRENCE F (LA~l, ~lK~ll MLUULb) Late of HAMPDEN TOWNSHIP LUM~~K~~U CUUNlt, Deceased Social day Security No. 095-18-0417 of December 2002 an instrument CUMBERLAND County, who died on the 3rd day of November 2002 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to ROSS KATHLEEN AKA and ROSS KATHLEEN F who have duly qualified as Executor (rix) and have agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the 3rd day of December 2002. il....,;?/.~=_ **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) 21-2002-1074 LAST WILL AND TESTAMENT ill: LAWRENCE F. LEE I, LAWRENCE F. LEE, now of Hampden Township, Cumberland County, Pennsylvania, do hereby declare this to be my Last Will and Testament and hereby revoke all prior Wills and Codicils made by me. ITEM I. I direct that all of my just debts and funeral expenses, including the cost of my gravemarker, if any, shall be paid from my residuary estate as soon as practical after my decease as a part of the administrative expenses of my estate. ITEM II. I give and devise all of my estate of every nature and wherever situate to my wife, LORRAINE C. LEE. ITEM m. Should my wife, LORRAINE C. LEE, predecease me or die on or before the thirtieth (30th) day following my death, I give and devise all of my estate of every nature and wherever situate in equal shares to my children, KATHLEEN ROSS, BARBARA ANN BINGAMAN and JAMES 1. LEE, or their respective issue, per stirpes. Should any such child predecease me and die without issue, I give the share of such child in equal shares to my surviving children, or their issue, per stirpes, as the case may be. ITEM IV. If any income or principal shall be payable to any person who shall be a minor or who shall be incapacitated for any reason, my personal representative, as trustee, shall ~~~_.~ Lawrence F. Lee ?~ hold such income and principal during minority or incapacity and shall be entitled to apply such income and principal to the health, maintenance, support and education of such person during minority or incapacity, without the appointment of any guardian or committee or any authority of court, and shall be entitled to make direct application hereunder or to make application by payment thereof to the parent or other person in charge of such minor or incapacitated person, or to his or her guardian or to a custodian under the Uniform Transfers to Minors Act. Any remaining income and principal to which such person shall be entitled shall be paid and distributed to such person upon the termination of minority or incapacity. ITEM V. I appoint my wife, LORRAINE C. LEE, Executrix of this my Last Will and Testament. Should she fail to qualifY or cease to act in such capacity, I then appoint my daughter, KATHLEEN ROSS, Contingent Executrix of this my Last Will and Testament No bond shall be required by my personal representative in any jurisdiction. ITEM VI. In addition to the powers given by law to my personal representa- tive(s) and trustee(s) [hereinafter fiduciaries] in the administration of my estate and of any trust(s) created herein, they shall have the following discretionary powers applicable to all real and personal property held by them, including property held for minors, effective without court order until actual distribution. A. To retain any property owned by me at my death and to invest any funds held by them in any stocks, bonds, notes or other securities or property, real or personal, including common trust funds, mutual funds and money market deposit accounts operated or offered by my corporate trustee, if any, or any affiliate of it. cx?:'~ J - ~ 7l ~-e-c Lawrence F. Lee I 2 B. To sell or otherwise dispose of any property, real or personal, at any time forming a part of my estate or the trust estate, for cash or upon credit, in such manner and on such terms as they see fit, and no one dealing with the fiduciaries shall be bound to see to the application of any monies paid. C. To manage, operate, repair, improve, mortgage or lease for any term [even if beyond the duration of the trust(s)] any real estate at any time held or owned by them as fiduciaries. D. To hold investments in the name of a nominee and exercise and dispose of warrants. E. To engage in litigation and compromise, arbitrate or abandon claims and property. F. To conduct any business in which I am engaged or in which I have an interest at the time of my death for such period as the fiduciaries deem advisable, with the power to borrow money and to pledge the assets of the business and to do all other acts which I, in my lifetime, could have done, or to delegate such powers to a partner, manager or employee without liability for any loss occurring therein. G. To allocate items of receipt or disbursement between principal and income as the fiduciaries deem equitable regardless of the character given such items by law; to distribute in cash or kind or partly in each at valuations fixed by the fiduciaries. H. To borrow money, including the right to borrow from any corporate trustee, if any, and to mortgage or pledge as security or to hold its own stock if a corporate trustee. ~/_- ~~4~ Lawrence F. Lee 3 1. To join in any merger, reorganization, voting trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto. J. Should the principal of any trust herein provided for be or become too small in trustee's opinion so as to make establishment or continuance of the trust inadvisable, my trustee(s) may make immediate distribution of the then remaining principal and any accumulated or undistributed income outright to the person or persons and in the proportion they are then entitled to income. Upon such termination, the rights of all beneficiary(ies) who might otherwise have an interest as succeeding income beneficiary(ies) or in remainder shall cease. K. In general, to exercise all powers in the management of the assets of my estate or the trust estate which any individual could exercise in the management of similar property owned in his own right, upon such terms and conditions as the fiduciaries may deem best, and to execute and deliver all instruments and to do all acts which the fiduciaries may deem necessary or proper to carry out the purposes of this will or any trust(s) created herein. 1. To apply income or principal to which any beneficiary is entitled, directly for his or her comfort, maintenance and support, should the fiduciaries deem such beneficiary incapable of receiving the same by reason of age, illness, infirmity or incapacity, or to pay the same to such person or persons as the fiduciaries select to disburse it, whose receipt shall be a complete acquittance therefore without the intervention of any guardian. M. To assume continuance of the status of any beneficiary with reference to death, marriage, divorce, illness, incapacity or other change in the absence of information deemed reliable without liability for disbursements made on such assumptions. ~.,~, Lawrence F. Lee -- ~~. 4 .., N. AlJ principal and income shall, until actual distribution to any beneficiary, be free of the debts, contracts, alienations and anticipations of any beneficiary, and the same may not be liable for any levy, attachment, execution or sequestration while in the hands of any fiduciaries. Provided, however, any beneficiary may assign any part or alJ of the beneficiary's interest in my estate or the trust(s) to anyone or more of the beneficiaries or my descendants. IN WIlNESS WHEREOF, I have hereunto set my hand and seal this~ day Upnl of ,2001. ~-,~---fL =7~ Lawrence F. Lee The preceding instrument, consisting of this and four other pages, identified by the signature of the testator, was on the day and date thereof signed, published and declared by Lawrence F. Lee, the testator therein named, as and for his last Will, in the presence of us, who, at his request, in his presence, and in the presence of each other, subscribed our names as witnesses hereto. //i" ;tfu.'/A/paJ A:?~<4k"?'{5;60.e6. J/7//C P C/ 0 ;1.r ~3/1 d tf;;'.J (Y fA Mil fl., / / 'A 5 . ............. COUNTY OF DAUPHIN I, LAWRENCE F. LEE, testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last Will, that I signed it willingly, and that I signed it as my free and voluntary act for the pmposes therein expressed. , ~A~' ~~. ~ ~~~ Lawrence F. Lee Sworn or affilf~ t9 and acknowledged before me, by Lawrence F. Lee, testator, this S--r~ day of r..q.. n I , 2001. ~ -X!J Ku:J Notary Public .. . NOTARIAL SEAL My CommIssIon E plr%iLLY S. KIRK. Notary Public Harrisburg, Dauphin County AFFIDAVIT My Commission Expires Feb. 15,2003 COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF DAUPHIN We,~/I,!J. ;,kIf anti.. !2cha.((}.. L P/G~ the witnesses whose names are signed to the attached or foregoing instrument, bemg duly qualified according to law, do depose and say that we were present and saw testator sign and execute the instrument as his last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testator signed the Will as witnesses; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to and subscribed before me this 0'-h) day of Or n j ,2001. ublic NOTARtAL SEAL HOLLY S. KIRK, Notary Public Haflisburg, Dauphin County M C .. E . My Commission Expires Feb. 15, ' 2003 Y ommlSSIOn xplr. -._-- ,--- A.' U.S. DEPARTMENT OF HOUSING and URBAN DEVELOPMENT OMS No. 2502-0265 SETTLEMENT STATEMENT lJTLEPRQ SECURED LAND Laserprinl TRANSFERS, INC. B. TYPE OF LOAN 5006 East Trindle Road 1. [ I FHA 2. [ I FMHA 3.:l[ J.CONV. UNINS. Suite 203 4. [ ] VA 5. [ ] CONV. INS. Mechanicsburg, PA 17055 6. FILE NUMBER: I 7. LOAN NUMBER: 505146 0023896921 Phone: (717) 591-8500 FAX: (717) 591-8506 8. MORT. INS. CASE NO.: C. NOTE: This form is furnished to give you a statement of aclual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked '(p.D.C.)' were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F NAME AND ADDRESS OF LENDER: Gregg R. Williams Lawrence F. Lee Estate ERA Mortgage Martina R. Williams 3000 Leadenball Road Mount Laurel NJ 08054 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: r. SETTLEMENT DATE: pine Brook 436 Orr's Bridge Road Secured Land Trans f ers, Inc. 06/17/03 Hampden TOWNSHIP PLACE OF SETTLEMENT: CUMBERLAND County 101 Old schoolhouse Lane, Mech. PA 17055 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER 4oo.GROSS AMOUNT DUE TO SELLER 101. Contract sales price 149000.00 401 Contract sales price 149000.00 102. Personal properly 402.Personal property 103. Settlement charges to borrower (line 1400) 6458.20 403 104. 404 105. 405 Adjustments for iten \5 paid by seller in advance Adjustments for items paid by seller in advance t06. CityfTown tax to 406,CilyfTown lax to 107, County lax 06/17/0310 12/31/03 181.59 407.County lax 06/17/03to12/31/03 181.59 108. Assessments to 408.Assessments to 109. School 06/17/ 03to 06/30/03 45.23 409 School 06/17 /03to 06/30/03 45.23 Swr/Ref:$99/q ellld 6/30 14.10 Swr/Ref:$99/q etI5ld 6/30 .. 14.10 110. 410. 111 411. 1\2. 412. 120. GROSS AMOUNT DUE FROM BORROWER 155699.12 420, GROSS AMOUNT DUE TO SELLER 149240.92 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. Deposit or earnest money 1000.00 501.Excess deposit (see instructions) 202. Principal amount of new loan( 5) 149000.00 502.Setllement charges to seller (line 1400) 24025.00 203. Existing loan(s) taken subject to 503.Existing loan(s) taken subject to 204 504,Payoff of First Mortgage Loan NONE 205 505.Payoff of Second Mortgage Loan Points Paid Upfront 250.00 206 C/C Paid by ERA Mortgage 848.70 506 207 507. 208. CST - (B) Croslng Costs 4000.00 508. (S) - (B) closlng Costs 4000.00 20' 509. Adjustments for itBms unpaid by selier Adjustments for items unpaid by seller 210. CityfTown tax 10 510.CityfTown tax to 211. County tax 10 511,Countytax to 212, Assessments '0 512,Assessments to 213 School [0 513 School to 214 514 215 515. 216 516. 217 517. 218 518 219. 519. 220. TOTAL PAID BY/FOR BORROWER 155098.70 520,TOTAL REDUCTION AMOUNT OUE SELLER 28025.00 300. CASH AT SETTLEMENT FROMOR TO BORROWER 600.CASH AT SETTLEMENT TO OR FROM SELLER 301, Gross amount due from borrower (line 120) 155699.12 601.GroSS amount due to seller (line 420) 149240.92 302. Less amount paid by/for borrower (line 220) 155098.70 602.Less reduction amount due selier (line 520) 28025.00 303. CASH (1XI FROM) ([ ] TO) BORROWER 600.42 603CASH ([XI TO) ([ ] FROM) SELLER 121215.92 Buyer or Borrower's Signature Seller's Signature \ \ \ HUD-1 Rev. 5/86 505146 PAID FROM PAID FROM L. SETTLEMENT CHARGES BORROWER'S SELLER'S 700 TOTAL SALES/BROKER'S COMMISSION based on price $ 149000.00 6.0 FUNDS AT FUNDS AT Division of Commission (line 700) as follows: Total: $8,940.00 ~ 701. $ 8940.00 to ERA-NRT, Inc. $ to ;: .;.;" .. t:::;::~ ;.A::::,:=:=%:.:: 702. .' ....... .....' 894Cl.6Cl" 703. Commission paid at Settlement 704 Trans Fee ERA-NRT, Inc. I 100.00 100.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee .375 % ERA Mortqaqe 558.75 802. Loan Discount % 803. Appraisal Fee to STARS 300.00 804. Credit Report to FNMA, CBC Systems 19.20 805, Lenders Inspection Fee 806. Mortgage Insurance Application Fee to 807. Assumption Fee 80B. Aoolic Fee ERA Mortqaqe 425.00 B09. Doc Preo ERA Mortqaqe 85.00 810. Flood Cert STARS 19.50 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from 06/17/03 to06/30 /03 @$ 25.55/day 357.70 902, Mortgage Insurance Premium for mo. to 903. Hazard Insurance Premium for lyrs. to State Farm ($334.POC) 904. yrs. to 905. 1000. RESERVES DEPOSITED Wlnl LENDER FOR 1001. Hazard Insurance 3 mo.@$ 27.83 Imo 83.49 '....' 002. Mortgage Insurance mo.@$ Imo. 003. CityfTown lax, mo. @$ Imo. 004. County lax 7 mo. @$ 28.04 Imo. 196.28 1006. Assessments mo. @$ /mo. 1006. School tax 13 mo. @$ 106.11 /mo 1379.43 1007. mo.@$ Imo. 1008. Aqqreqate mO.@$ Imo. -223.90 .:...., :,.:.:~ :.:.:...:.:.:.:.:.',:,:,.:-;,.:.:,.,:,.:.,: 1100. TITLE CHARGES 101. Settlement or closing teeto 1102. Abslracl or title search 10 103. Title examination 10 104. Title insurance binder 10 105. Document preparation 10 Secured Land Transfers 75.00 106. Notary fees to Cash 10.00 10.00 1107. Attorney's fees to (includes above items No.:) :iiiimmJFmJ@H#m#m~@m::@t~:A%M iiiiittMHtl%HMb 1108. Title Insurance to Secured Land Transfers 11IIIII (includes above items No 0) Ends:100/300/900 :: 1109 Lender's coverage $ 149,000 110. Owner's coverage $ 149,000 ':~',:,'~:N:N: .~:~::::3::;:::::::::..::::::~:::::.::::. ,~ 111. Wire Fee Secured Land Transfers 20.00 1112. EstTaxEsc Secured Land Transfers 13410.00 1113. 200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees: Deed $ 38.50 Mortgage $ 70.50 Misc. $ 109.00 202. City/county tax/stamps: Deed $ 1490.00Mortgage$ 1490.00 1203. Stale tax/stamps: Deed $ 1490 .00 Mortgage $ 1490.00 1204. 205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey 10 1302. Pest Inspection to Homesoec 40.00 1303. Home Insp Homespec 235.00 1304. 1305. 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 and 502, Sections J and K) 6458.20 24025.00 u.s. lJlYAH I MoN I OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT OMB No. 2502-0265 Page 2 Parties agree that no liability is assumed by Settlement Agenltor the accuracy 0' information lurnished by others as shown on the HUD.l Selllement Slatemenl. Settlement Agent hereby expressly reserves the right to deposit any amounts collected lor disbursement in an inlerest bearing account in a Federally insured institution and to credit any interest so earned to its own account as addilional compensation tor its services in this transaction HUe CERTIFICATION OF BUYERS AND SELLERS I have carefully reviewed the HUO., Settlement Slatement and to the best of my knowledge and belief. it is a true and accurate statement of all receipts and disbursements made on my account by me in tris tr~n!";action, I further certify that I have received a copy of the H~U.D.1. S tlement Statement. 4.<s" L. ~.-/k.-. ----c- ~ #...~ - V,,,,,-e.., .riii.,c I'hlldi lI'n J<. U, J J 11" Tl1 L1. Buyer or Borrower's Signature Buyer's AddresS & Phone: SeUet'sSignature Seller's New Address & Phone . h I have prepared is a true and accurate account 01 this transaction. I have caused or will cause the funds 10 be disbursed in accordance with this slatement. ~I (1101 For details see HUD.l Rf!v 5/86 r ESTATE OF LAWRENCE F. LEE &ill!23" 127 409 HILLSIDE AVE 2313 NEW CUMBERLAND, PA 17070 OlOO'~r\ --70'./.)/1,}nJ3 I ~o/~-_:,!L'" '~I $ ~:rd ~ I ~ ~~- ...{,-=rr tD -- o 1'" WayP..Qint BANK . /J / ~M' ... H: 2:!.:! 72:!B 71:0 lrOO .abl, 7 711' ~- /}/)(Jf=71C>VHl /0 .,fpc.C" (Y()/J77<'r'7C"7 .:5nc&-/C- ~ -....1 ~~ ~~ [7 (/-je (-c--:> r u r/1 [ /0 v v ,ctJ.,C /YezU /,ocJF ~, EQUISERVE" STATEMENT OF HOLDINGS Post Office Box 43010, Providence, RI 02940-3010 - www.EquiServe.com Comr.anv Name TRAVELERS PROPERTY 3032-10 kAl~lEEN f R~SS ADM EST LAWRENCE flEE 4~9 filLlSlmE AVENUE hE. C~~BERLAN8 PA 17070-3037 Account Number 2009-5095 PLEASE REFER TO THE REVERSE SIDE OF THIS STATEMENT FOR AN EXPLANATION OF TERMS AND FOR INFORMATION REGARDING THE SALE OF STOCK AND THE ISSUANCE OF A CERTIFICATE Stoiemerrt Dote --I 04/24/03 I 9-01/0102003 XR K204323 SHARE BALANCE AS Of: 4/23/03 Shares Held By You Shares Held By The Agent Total Shares 92.0000 92.0000 Year-lo-Date Actlvltv Transaction Date Trans(lction Description $ S,?~ice $ Net Amount Invested $ Price Per Share Transaction Shares $ Tax Basis Per Share Total Shares Held by Agent 1129 UNSHR IN 4/24 ALE Cf S~ARES 5.00 C~k SENT SEPARATE 1,432.10 15.7293 1,432.10 92.0000 -92.0000 92.0000 Current Value IMPORTANT ALL REQUIRED INFORMATION REGARDING THE SALE OF SHARES IS BEING FURNISHED TO THE INTERNAL REVENUE SERVICE. RETAIN THIS STATEMENT FOR YOUR INVESTMENT AND TAX RECORDS. Market Price ".ut Market Value 1,509.12 ~EQUISERVE' CASH INVESTMENT AND OTHER TRANSACTION FORM OPTIONAL CASH DEPOSITS Amount Enclosed: TRA~ELE'S PROPERTY 2(JC9-5095 3032-10 Please make checks payable to "EquiServe" in US dollars, Do not send cash. Do not send third party checks. $ ACCOUNT NO.: kAltiLEE~ f a~ss AIM EST lAWRE~CE FLEE 4C9 tillL~I.E A~E~UE ~E~ CUMEEfilAND fA 17070-3037 NO CASH ALLOWEt Send Deposffs Only to: Make necessary corrections to address above. Mark Box for ~ deposit of certificates or withdrawals. (See reverse) ......... EQUISERVE P.O. BOX 9223 CHELSEA, MA 02150-9223 00C113V321COZOC95095400000000000000000Z17 ~... EQUISERVE' Post Office Box 43010. Providence, RI 02940-3010 - www.EquIServe.com STATEMENT OF HOLDINGS Componv Name TRAVELERS PROPERTY 3032-05 ~AIMLEE~ f HeSS AI~ EST L#~RE~CE fLEE 4t~ tillLSIIE AVENUE NE. [L~BERlAND fA 17070-3037 Account Number 200'-5095 PLEASE REFER TO THE REVERSE SIDE OF THIS STATEMENT FOR AN EXPLANATION OF TERMS AND FOR INFORMATION REGARDING THE SALE OF STOCK AND THE ISSUANCE OF A CERTIFICATE Statement Date 04/24/03 I 25-01/0102003 XR K204322 SHARE BALANCE AS OF: 4/23103 Shares Held By You Shares Held By The Agent Total Shares 1119.0000 119.0000 Year-lo-Date Actlvltv Transaction Date Transaction Description $ S~~ice $ Net Amount Invested $ Price Per Share Transaction Shares $ Tax Basis Per Share Total Shares Held by Agent 11;29 IlUSfEll IN 4/24 ALE 01 S~ARES 5.00 CtiK SENT SEP#RATE 2,959.73 15.7393 ;2,959.73 139.0000 -1119.0000 119.0000 Current Value IMPORTANT ALL REQUIRED INFORMATION REGARDING THE SALE OF SHARES IS BEING FURNISHED TO THE INTERNAL REVENUE SERVICE. RETAIN THIS STATEMENT FOR YOUR INVESTMENT AND TAX RECORDS. Market Price Market Value ". " . .' . 10.510 3,HO.:U ~EQUiSERV( CASH INVESTMENT AND OTHER TRANSACTION FORM OPTIONAL CASH DEPOSITS Amount Enclosed: 1RAVELERS PROPERlY 211iJ9-51195 3032-05 Please make checks payable 10 "EquiServe" in US dollars. Do not send cash. Do not send third party checks. $ ACCOUNT NO.: KJIHlEE' I i~SS JIM ES1 LA~.Ea(E fLEE 411~ ~llL~I'E AVE~UE NEW CUMBERLAND PA 17070-3037 NI CASH AILIWEa Send Deposits OnTy to: Make necessary corrections to address above. Mark Box for ~ deposit of certificates or withdrawals. (See reverse) 11II""""" EQUISERVE P.O. BOX 9223 CHELSEA, MA 02150-9223 1l(]1l11~03~(]5C2(]1l951195400000(]00000000000214 . .~ .~ E g . . . E .. , ~~l ~ ~ 5 ;-is. ~~~ rn - o ... "' . "'I'- .24' ~ -#' o .. ~... ,; . 1 1 N_ ci<Jl zo "'N "l~ '-' ~~ '" o ...... .... -5N Ii..... c~ :>0 ~ ~ 'el'!'l ~o "'0 ~N E'8&~ Oftlc.2 ~... &at; -.="5 ftl "Ze.:Jr: gmris - " "- M .. a- o ... ~ 1! ~ Jl i I -~ ,." ~i ~ ~- '" o II. a.. >to u'" 00.. ~ III III Q( u.w O...J c u.J ,gw> .@-..Jc ~ < Q( oV)..... 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Harrisburg, PEnnsylvania 17105-1711 Member FDIC STATEMENT DATE 11-30-02 LAWRENCE FLEE OR LORRAINE C LEE 436 ORRS BRIDGE RD CAMP HILL PA 17011-1443 013-1580 'ONLINE BILL PAYMENT' IS WAY BETTER! JUST THINK... NO MORE WRITING CHECKS OR POSTAGE STAMPS' PAYING ALL YOUR BILLS WITH A FEW CLICKS IS SIMPLE. GO ONLINE AT WWW.WAYPOINTBANK.COM TO FINO HOW EASY IT IS. ACCOUNT TYPE OF ACCOUNT 2303015205 GMFA 30 DAY AVERAGE BALANCE 5.079.53 ---------------------------------------------------------------------------- PREVIOUS BALANCE DEPOS ITS WITHDRAWALS CHARGES INTEREST ENDING BALANCE * - - - - - - - - - ",-' ctnEREST SUMMARW, - INTEREST EARNED FROMi1;0/31h-02TO 11/30]02 DAYS IN PERIOD IN TE RES TEAR NED ANNUAL PERCENTAGE YIHDlARNED INTEREST PAID THIS YEAR INTEREST WITHHELD THIS YHR: * - - - - - - - - - - - - TRANSACn.oN SUMMARY- , 'DEPOSITS/ DATE TRANSACTION DESCRIPTION CREDITS 11/01 US TREASURY 303/S0C SEC 941.00 11/01 US TREASURY 220/VA BENEFIT 103.00 11/15 ATS - CHECKING TD CHECKING 500.00 11/29 US TREASURY 220 VA BENEFIT 103,00 11/30 INTEREST PAYMENT 1.21 3.773.36 1 .6.4] ,. 00 :00 .00 1.21 5.421.57 - - * 29 1. 21 .30 % 31.32 .00 * HECKS/ EBITS BALANCE 4714,36 4817.36 5317,36 5420.36 5421. 57 --'- /' THANK YOU FOR BANKING AT WAYPOINT BANK Customer Service Toll-Free 1-866-WAYPOINT (1-866-929-7646) . In York Area 717/815-4500 www.waypointbank.com POD-502 (8102) "'Way~qi!'J p.o. Box 1711. Harrisburg, Pennsylvania 17105-1711 Member FDIC LAWRENCE FLEE LORRAINE C LEE DECD 436 ORRS BRIDGE RD CAMP HILL PA 17011-1443 STATEMENT DATE 11/08/02 FDCUS -1 PAGE * * T RAN SAC T ION A C C 0 U N T SUM MAR Y * * ACCOUNT TYPE OF ACCOUNT: INTEREST PAID ANNUAL PERCENTAGE YIELD DAYS IN CYCLE YEAR TO DATE EARNED (APYEl 0500008739 FOCUS 50 FREE INTEREST 12.22 .38 % 32 AVERAGE 8ALANCE 5.665.95 * * I N V EST MEN T A C C 0 U N T SUM MAR Y * * ACCOUNT TYPE OF ACCOUNT: INTEREST PAID YEAR TO DATE AVERAGE INTEREST RATE 2358316181 CERTIFICATE OF DEPOSIT .00 3.35000 % ENDING 8ALANCE .00 -TYPE-OF-ACCOUNT,--FOCUS-SO-FREE-INIEREST---------ACCOUNT#--OS00008739-------------ENC[OSUREs----II------------------------ PREVIOUS 8ALANCE DEPOSITS . WITHDRAWALS CHARGES INTEREST ENDING 8ALANCE 1.86141 lli., 571. 78 13.215.37 .00 1.90 5.219.72 DATE ACTIVITY DESCRfPTION DEPOSITS WITHDRAWALS 8ALANCE 10/15/02 DEPOSIT 15.000.00 16.861. 41 10/15/02 ATS - CHECKING l'O<CHECKING 500.00 16.361.41 10/15/02 CHECK #6263 7,016.76 9,34465 10/16/02 PAWClPAYMENT 15.87 9.328.78 10/16/02 CHECK #6219 329.30 8,999.48 10/16/02 CHECK #6223 43.80 8.9 5 5.6 8 10/16/02 CHECK #6220 21.33 8.934.35 10/16/02 CHECK #6217 12.50 8.921.85 10/17/02 CHECK #6218 72.D0 8.849.85 10/18/02 CHECK #6264 125.00 8.72485 10/22/02 ATM WITHDRAWAL/EFT TRANSS9~394 201.50 8,523.35 11555 8ANDERA ROAD SAN ANTOIIIO. IX 10/22/02 ATM WITHDRAWAL/EFT TRANS 59~394 1.00 8.522.35 SERVICE CHARGE WID CHECKING 10/22/02 CHECK #6265 3.253.15 5.269.20 10/23/02 POS PURCHASE CHK/EFT TRANS VISATE 261.05 5.00815 H.E. 8UTT #235 SAN ANTONIO TX 10/31/02 HAMPDEN TOWNSHIP/8ANKDRAFT 98.00 4.910.15 10/31/02 CHECK #6224 85.D0 4,825.15 11/01/02 E8S C-3N 021024/PENSIONS 1.512.31 6.337.46 1lI01/02 METLIFE PENSIONS/PENSION 59.47 6,396.93 11/04/02 POS PURCHASE CHK/EFT TRANS 03992 145.84 6.251.09 2015 SOUTHWEST LOO SAN ANTONIO TX Customer Service Toll-Free 1-866-WAYPOINT (1-866-929-7646) . In York Area 717/815-4500 www.waypointbank.com POD"502(8I02) . ~IWay~qi!lJ p.o. Box 1711, Harrisburg, Pennsylvania 17105-1711 Member FDIC 1...111...111......11...11...11.1..1.1..1..11...11..11..1.1..1 LAWRENCE FLEE LORRAINE C LEE DECO 436 ORRS BRIDGE RD CAMP HILL PA 17011-1443 STATEMENT DATE 11108/02 FOCUS 50 FREE INTEREST 0500008739 PAGE 2 -1 - - ACCOUNT 0500008739 CONTINUED - - OATE ACTIVITY DESCRIPTION DEPOSITS WITHDRAWALS BALANCE 11104/02 pas PURCHASE CHK/EFT TRANS 036218 20.16 6.230 93 DIAMOND 2245 SHAMR SAN ANTONIO TX 11/04/02 CHECK #6227 600.00 5.630.93 11105/02 POS PURCHASE CHK/EFT TRANS 014171 170.11 5.46082 WAL-MART SUPERCENT SAN ANTONIO TX 11/06/02 PP/ELEC BILL 143.00 5,31782 11107/02 CHECK #6225 10000 5,217.82 11108/02 INTEREST EARNED 1. 90 5,219 72 DATE 10/16/02 10/17/02 10/16/02 10/16/02 ,MiouN1' 12.50 72.00 329..30 21.33 CHECK SUMMARY * indicates skip in check numbers DATE CHECK NO. AMOONT 10/16/02 .6223* . 43.BO 10/31/026224 85.00 11 / 07 / 02 6225 100.00 11/04/02 6227* 600.00 Af10UNT 7,016.76 125.00 3,253.15 CHECK NO. 6217 6218 6219 6220 DATE 10/15/02 10/18/02 10/22/02 CHECK j,O. 6263* 6264 6265 TOTAL ENCLOSURES: 11 On Iy WaypOlntoff~rs the Beat- The-C lOCk 'LoanGuarantee. App Iy for any Installment"Personal Unsecured. Fixed Rat~Hom~Equity Loan or Line of Credit and we guarantee a credit decisjon the same daY - or we' 11 pay you $100 cash.Stop,by your local Waypotnt br,anch, or call 1-866-929-7646 to apply tOday! Certain conditions may apply -see bank for camp lete details. . POD"S02(8102) Customer Service Toll-Free 1-866-WAYPOINT (1-866-929-7646) . In York Area 717/815-4500 www.waypointbank.com . KNIGHTS OF COLUMBUS SUPREME OFFICE 1 COLUMBUS PLAZA NEW HAVEN CONNECTICUT 06510-3326 (203) 752-4000 ANNUITY ANNUAL STATEMENT FOR PERIOD ENDING 02/13/2003 POLICY NUMBER: 0101495524 ISSUE DATE: 02/13/92 SOC SEC NUMBER: 095-18-0417 TAX QUALIFICATION: 0 NON QUAL LAWRENCE FLEE 436 ORRS BRIDGE RD CAMP HILL PA 17011-1443 THIS STATEMENT GIVES THE CURRENT STATUS OF YOUR POLICY AND SUMMARIZES THE ACTIVITY FOR THE PERIOD SHOWN BELOW. CONTACT YOUR KNIGHTS OF COLUMBUS AGENT OR THE SUPREME OFFICE IF YOU HAVE ANY QUESTIONS. MONTHLY ACTIVITY FOR PERIOD ENDING 02/13/03 POL GROSS GROSS MO. PREMIUMS LOADING WITHDRAWALS FEB 0.00 0.00 0.00 MAR 0.00 0.00 0.00 APR 0.00 0.00 0.00 MAY 0.00 0.00 0.00 JUN 0.00 0.00 0.00 JUL 0.00 0.00 0.00 AUG 0.00 0.00 0.00 SEP 0.00 0.00 12222.22 OCT 0.00 0.00 0.00 NOV 0.00 0.00 0.00 DEC 0.00 0.00 0.00 JAN 0.00 0.00 0.00 FEB 0.00 0.00 0.00 TOT 0.00 0.00 12222.22 POLICY SUMMARY 02/13/2002 51,785.67 SURRENDER VALUE 0.00+ 0.00- 12,222.22- 2,485.38+ -------------- 02/13/2003 ACCUMULATION VALUE 42,048.83 SURRENDER VALUE ACTIVITY DURING 2003 FOR TAX YEAR 2002: GROSS PREMIUMS 0.00 GROSS WITHDRAWALS 0.00 ACCUMULATION VALUE GROSS PREMIUMS LOADING GROSS WITHDRAWALS INTEREST AWARDED 51,785.67 42,048.83 THE INTEREST AMOUNT SHOWN ON THIS STATEMENT WAS CALCULATED USING THE RATES THAT WERE IN EFFECT DURING THE STATEMENT PERIOD. THE RATES USED TO CALCULATE THE INTEREST AWARDED DEPENDED ON THE DATES THAT PREMIUMS WERE RECEIVED. PAYMENTS RECEIVED BEFORE THE END OF THIS STATEMENT PERIOD WILL CONTINUE, OR RENEW, AT RATES THAT HAY BE HIGHER OR LOWER THAN THE CURRENT RATE. THE CURRENT RATE ON NEW PAYMENTS RECEIVED PRIOR TO THE END OF THE CALENDAR QUARTER IN WHICH THIS STATEMENT WAS PRINTED IS 4.00%. COUNCIL: 10685 PRINTED 02/13/03 F04JAEV'Oao . KNIGHTS OF COLUMBUS SUPREME OFFICE 1 COLUMBUS PLAZA NEW HAVEN CONNECTICUT 06510-3326 (203) 772-2130 ANNUITY ANNUAL STATEMENT FOR PERIOD ENDING 11/18/2002 POLICY NUMBER: 0101473124 ISSUE DATE: 11/18/91 SOC SEC NUMBER: 095-18-0417 TAX QUALIFICATION: 4 IRA LAWRENCE FLEE 436 ORRS BRIDGE RD CAMP HILL PA 17011-1443 THIS STATEMENT GIVES THE CURRENT STATUS OF YOUR POLICY AND SUMMARIZES THE ACTIVITY FOR THE PERIOD SHOWN BELOW. CONTACT YOUR KNIGHTS OF COLUMBUS AGENT OR THE SUPREME OFFICE IF YOU HAVE ANY QUESTIONS. MONTHLY ACTIVITY FOR PERIOD ENDING 11/18/02 POL GROSS GROSS MO. PREMIUMS LOADING WITHDRAWALS NOV 0.00 0.00 0.00 DEC 0.00 0.00 0.00 JAN 0.00 0.00 0.00 FEB 0.00 0.00 0.00 MAR 0.00 0.00 0.00 APR 0.00 0.00 0.00 MAY 0.00 0.00 0.00 JUN 0.00 0.00 0.00 JUL 0.00 0.00 0.00 AUG 0.00 0.00 0.00 SEP 0.00 0.00 0.00 OCT 0.00 0.00 0.00 NOV 0.00 0.00 0.00 TOT 0.00 0.00 0.00 POLICY SUMMAR Y 11/18/2001 ACCUMULATION VALUE 5,371.80 SURRENDER VALUE 5,371.80 GROSS PREMIUMS 0.00+ LOADING 0.00- GROSS WITHDRAWALS 0.00- INTEREST AWARDED 286.69+ -------------- 11/18/2002 ACCUMULATION VALUE 5,658.49 SURRENDER VALUE 5,658.49 ACTIVITY DURING 2002 FOR TAX YEAR 2001: GROSS PREMIUMS 0.00 GROSS WITHDRAWALS 0.00 THE INTEREST AMOUNT SHOWN ON THIS STATEMENT WAS CALCULATED USING THE RATES THAT WERE IN EFFECT DURING THE STATEMENT PERIOD. THE RATES USED TO CALCULATE THE INTEREST AWARDED DEPENDED ON THE DATES THAT PREMIUMS WERE RECEIVED. PAYMENTS RECEIVED BEFORE THE END OF THIS STATEMENT PERIOD WILL CONTINUE, OR RENEW, AT RATES THAT MAY BE HIGHER OR LOWER THAN THE CURRENT RATE. THE CURRENT RATE ON NEW PAYMENTS RECEIVED PRIOR TO THE END OF THE CALENDAR QUARTER IN WHICH THIS STATEMENT WAS PRINTED IS 4.00%. COUNCIL: 10685 PRINTED 11/18/02 F04lREV'OOO FOR PERIOD ENDING: lZ/31/UZ 2002 STATEMENT FOR PARTICIPANTS TAX QUALIFIED ACCOUNT FROM: KNIGHTS OF COLUMBUS 1 COLUMBUS PLAZA PO BOX 1670 NEW HAVEN CT 06507-0901 TYPE: 4 IRA SUBSTITUTE FORM 5498 OMB NO. 1545-0747 06-0416470 LAWRENCE FLEE 436 ORRS BRIDGE RD CAMP HILL PA 17011-1443 SOC. SEC. NO. 095-18-0417 CONTRACT NO. 0101473124 TO: VALUE FOR 2002 BOX 1 BOX 2 BOX 3 REGULAR 0.00 ROLLOVER 0.00 ROTH CONVERSION 0.00 BOX 4 BOX 5 RECHARACTERIZED CONTR. 0.00 FAIR HARKET VALUE 5,694.31 (AS OF 12/31/02) SURRENDER VALUE 5,694.31 (AS OF 12/31/02) BOX 6 BOX 7 COST OF INSURANCE 0.00 THIS IS AN IRA THE SURRENDER VALUE REFLECTS THE CHARGES, IF ANY, WHICH WOULD HAVE BEEN TAKEN IF THE POLICY HAD BEEN TERMINATED ON 12/31/02. THE INFORMATION IN BOXES 1,2,4,5 AND 6 IS BEING FURNISHED TO THE INTERNAL REVENUE SERVICE. YOU MAY USE THE AMOUNT SHOWN UNDER BOX 1 LESS THE AMOUNT PAID FOR LIFE INSURANCE, IF ANY, WHEN CALCULATING THE AMOUNT PAID INTO THE IRA. IF THIS AMOUNT IS GREATER THAN $3,000.00 ($3,500.00 IF AGE 50 OR OLDER), PLEASE REVIEW YOUR RECORDS. REPORT ANY CORRECTIONS TO THE ANNUITY SERVICES DEPARTMENT. THE AMOUNT CONTRIBUTED CANNOT EXCEED THE AMOUNT PERMITTED BY LAW. FORM 5498 WILL BE MAILED IN MAY TO ALL IRA POLICYHOLDERS WHO MADE DEPOSITS FOR THE 2002 TAX YEAR. IF YOU MADE NONDEDUCTIBLE CONTRIBUTIONS TO A TRADITIONAL IRA FOR THE 2002 TAX YEAR, YOU MUST FILE IRS FORM 8606 WITH YOUR RETURN. .'KDFC.-' ~. '''J KNIGHTS OF COLUMBUS SUPREME OFFICE 1 COLUMBUS PLAZA NEW HAVEN CONNECTICUT 06510-3326 (203) 772-2130 ANNUITY ANNUAL STATEMENT FOR PERIOD ENDING 11/03/2002 POLICY NUMBER: 0102102928 ISSUE DATE: 11/03/97 sac SEC NUMBER: 095-18-0417 TAX QUALIFICATION: 0 NON QUAL LAWRENCE FLEE 436 ORRS BRIDGE RD CAMP HILL PA 17011-1443 THIS STATEMENT GIVES THE CURRENT STATUS OF YOUR POLICY AND SUMMARIZES THE ACTIVITY FOR THE PERIOD SHOWN BELOW. CONTACT YOUR KNIGHTS OF COLUMBUS AGENT OR THE SUPREME OFFICE IF YOU HAVE ANY QUESTIONS. MONTHLY ACTIVITY FOR PERIOD ENDING 11/03/02 POL GROSS GROSS MO. PREMIUMS LOADING WITHDRAWALS NOV 0.00 0.00 0.00 DEC 0.00 0.00 0.00 JAN 0.00 0.00 0.00 FEB 0.00 0.00 0.00 MAR 0.00 0.00 0.00 APR 0.00 0.00 0.00 HAY 0.00 0.00 0.00 JUN 0.00 0.00 0.00 JUL 0.00 0.00 0.00 AUG 0.00 0.00 0.00 SEP 0.00 0.00 0.00 OCT 0.00 0.00 0.00 NOV 0.00 0.00 0.00 TOT 0.00 0.00 0.00 POLICY SUMMARY 11/03/2001 ACCUMULATION VALUE GROSS PREMIUMS LOADING GROSS WITHDRAWALS INTEREST AWARDED INTEREST EONDS 43,054.98 SURRENDER VALUE 0.00+ 0.00- 0.00- 2,321. 05+ 107.6','" 41,371. 76 11/03/2002 ACCUMULATION VALUE 45,483.67 SURRENDER VALUE ACTIVITY DURING 2002 FOR TAX YEAR 2001: GROSS PREMIUMS 0.00 GROSS WITHDRAWALS 0.00 THE INTEREST AMOUNT SHOWN ON THIS STATEMENT WAS CALCULATED USING THE RATES THAT WERE IN EFFECT DURING THE STATEMENT PERIOD. THE RATES USED TO CALCULATE THE INTEREST AWARDED DEPENDED ON THE DATES THAT PREMIUMS WERE RECEIVED. PAYMENTS RECEIVED BEFORE THE END OF THIS STATEMENT PERIOD WILL CONTINUE, OR RENEW, AT RATES THAT HAY BE HIGHER OR LOWER THAN THE CURRENT RATE. THE CURRENT RATE ON NEW PAYMENTS RECEIVED PRIOR TO THE END OF THE CALENDAR QUARTER IN WHICH THIS STATEMENT WAS PRINTED IS 4.00%. 43,805.20 COUNCIL: 10685 PRINTED 11/01/02 FD43 R~Vlg00 " .. .. .. 0 .. .. .. .. 8 " :is :is :is 0 :is :is :is :is ~ .. .. .. ,; .. .. .. .. g .!! .!! .!! ... .!! .!! .!! .!! 8 1: is. is. is. is. is. is. is. .. ~ U a. a. a. a. a. a. a. II - .. .. .. .. .. .. .. U E G - '0 - - '0 - '0 ~ B 0 0 0 0 z z z z z z Z II <Ii III .. " II .. _C ~ co a. ".c )( 8a. " 11- " " " CJ) " " " " en C "c :is :is :is ... :lS :lS :is :lS ... U.!! .. li~ .; 00 C{!C1) U .~ .~ .. .. .. .~ .. .;: >" .!! CD .!! .!! .!! Ul ~ - ~ i is. 2: is. CJ) is. is. is. is. en ""'0) ~ ! Oil... a. a. a. a. c. c. >1i~ .. 1;; .. .. .. .. .. .. .. .. .wE'" IIN .! '0 '0 '0 '0 15 '0 "0 c" Uo"l' =E z z z z z z Z 11_0 ..... .c"o Co 0 Ue(co O.c - - .. - C = 0 - :t - i !I& " " " .... " " " .. - :lS :lS :lS ... :lS :lS :lS :lS !!!!!! II li" .. .. .. ,.: .. .. .. .. ~ - " >~ .!! .!! .!! .... .!! 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" " ::>Cii .. )( ~.. .~ ...- E !i ;i'O i- '> ii Cl: - c " o !l Cl: gl1J;l1JgcPSCDS ~ oE'oE'oE'oE'o 0 tL~8~g~g~gE8 <( uc( oct uc( U<("iij<C ~ ~HHHH"ll(jll "; E,~z.~=,~z.~.::.~:.~ .. >.LL c: LL c: LL. eLL c: LL nI LL ~.f 8 8 8 8 ~ N o o N ." ~~ ..- ag N o o N ;;; N N o N o o N - !2 '" o N o o N - o M ;;; o N o o N ;;; ~ ~ - M o o N - o - N o . KNIGHTS OF COLUMBUS MA.K1NG A DIFFERENCE FOR lifE April 24, 2003 Kathleen F. Ross 409 Hillside A venue New Cumberland, P A 17070 Council: 10685 Voucher: 03-3567 Re: 1495524 Deferred Annuity for Lawrence F. Lee Dear Ms. Ross, In accordance with your instructions, you have received the proceeds from the death benefit on the above mentioned Annuity. In January 2004, a 1099R tax form will be sent to you reporting the distribution. Listed below are the amounts that will be reported: Gross:$14,151.43 Taxable:$3,735.09 Withholding:$O If you should have any questions, please feel free to contact the Claims Department. ~:l~ Louise K. Vets Vice President, Member Benefits LKV/tdv Agency: 8283 1 COLUMBUS PLAZA. NEW HAVEN, CONNEOTICUT 06510-3326. TEL, 203-752-4000. HTTP://WWW.KOFC.ORG . KNIGHTS OF COLUMBUS MAKING A DIFFERENCE FOR LIFE April 24, 2003 Kathleen F. Ross 409 Hillside Avenue New Cumberland, P A 17070 Council: 10685 Voucher: 03-3573 Re: 2102928 Deferred Annuity for Lawrence F. Lee Dear Ms. Ross, In accordance with your instructions, you have received the proceeds from the death benefit on the above mentioned Annuity. In January 2004, a 1099R tax form will be sent to you reporting the distribution. Listed below are the amounts that will be reported: Gross:$15,532.54 Taxable:$2,356.42 Withholding:$O If you should have any questions, please feel free to contact the Claims Department. Sincerely yours, ~~llk Vice President, Member Benefits LKV/tdv Agency: 8283 1 COLUMBUS PLAZA, NEW HAVEN, CONNECTICUT 06510-3326' TEL, 203-752-4000' HTTPJ/WWW.KOFc'ORG . KNIGHTS OF COLUMBUS MAKING A DIFFERENCE FOR LIFE April 22, 2003 Subject: Policy(ies): Council: Voucher: Lawrence FLee 2102928 10685 03573c $15532.54 Ms. Kathleen FRoss 409 Hillside Ave New Cumberland, P A 17070 Dear Ms. Ross, Enclosed find our check in satisfaction of your portion of the death benefit payable under the above captioned policy(ies) insured by the Knights of Columbus. Be assured of our prayers which are offered in the Masses celebrated daily at Saint Mary's Church, New Haven, Connecticut. Sincerely, ~.,~~ /: /(a; Louise K. Vets Vice President Member Benefits cc: Agency - 8283 Enclosure 1 COLUMBUS PLAZA, NEW HAVEN, CONNECTICUT 06510-3326' TEL, 203-752-4000' HTTP://WWW.KOFC.ORG . KNIGHTS OF COLUMBUS MAKING A DIFFERENCE FOR LIFE April 22, 2003 Subject: Policy(ies): Council: Voucher: Lawrence FLee 1473124 10685 03566c $1927.97 Ms. Kathleen FRoss 409 Hillside Ave New Cumberland, P A 17070 Dear Ms. Ross, Enclosed find our check in satisfaction of your portion of the death benefit payable under the above captioned policy(ies) insured by the Knights of Columbus. Be assured of our prayers which are offered in the Masses celebrated daily at Saint Mary's Church, New Haven, Connecticut. Sincerely, bt<",~ 1: ~ Louise K. Vets Vice President Member Benefits cc: Agency - 8283 Enclosure 1 COLUMBUS PLAZA, NEW HAVEN, CONNECTICUT 06510-3326. TEL. 203-752-4000. HTTP://WWW.KOFC.ORG . KNIGHTS OF COLUMBUS MAKING A DIFFERENCE FOR LIFE April 22, 2003 Subject: Policy(ies): Council: Voucher: Lawrence FLee 1495524 10685 03567c $14151.43 Ms. Kathleen FRoss 409 Hillside Ave New Cumberland, P A 17070 Dear Ms. Ross, Enclosed find our check in satisfaction of your portion of the death benefit payable under the above captioned policy(ies) insured by the Knights of Columbus. Be assured of our prayers which are offered in the Masses celebrated daily at Saint Mary's Church, New Haven, Connecticut. Sincerely, bI:.~..~~ / ~ Louise K. Vets Vice President Member Benefits cc: Agency - 8283 Enclosure 1 COLUMBUS PLAZA, NEW HAVEN, CONNECTICUT 06510.3326. TEL. 203.752.4000. HTTP,IIWWW.KOFC.ORG CERTIFICATE TRANSCRIPT LAWRENCE FLEE & LORRAINE LEE JT TEN 436 ORRS BRIDGE ROAD CAMP HILL PA 17011 Pr.pared by Shareholder Services Suit. 4650 POBox 2500 Jersey City, NJ 07303-2500 DATE PREPARED: 11/26/02 7331 CITIGROUP INC COMMON ACCOUNT# 10871-76384 FROM 3/23/01 TO 11/25/02 CERTIFICATE NUMBER ISSUE CLOSING SURRENDER CLOSING NUMBER OF DATE MARKET DATE MARKET SHARES PRICE PRICE 344394 2,137 3/23/01 42.850 I ..... PRICE INFORMATION DOES NOT APPEAR ON OUR RECORDS. PLEASE CONSULT WITM YOUR PUBLIC LIBRARY. "........ ........ ... ',".. .............. ...".......--.. .._-,..,-,-".. ... ...--..,.,.,-..-........... ..... ",',''',-'' -',",' ',-'," ..-,-,-,......... ""............... ...,.... .........._,-_.. -- -,.. -- ---"" , ........,_.. --, ........... ...... ... ...--..-.. -,-, ,... -. ....... ,- .........---.-.- .. '.,.--.-.... ...._,.. ....c.., _,..-" .., _,',._ ...,,-_', .. _""""_,_,_,. ....... """'_,_.. _...._.. .. ... -..... _._",-" ,.,..........- ,-- ,---,,---- ------ --- . THE MARKET PRICECS) PROVIDED AllOVEIS FOR INFORMATIONAL PURPOSES ONLY AHOMAY NOT REPRESENT YOUR ACTUAL COST BASIS.. WE SUGGEST YOU CONSULT YOUR TAX OR LEGAL ADVISOR WITH ANV QUESTIONS ON HOW THIS tNFORMATlON MAY BE USED FOR TAX REPORTING O.R OTHER PURPOSES.. . CLOSING MARKET PRICE AS OF 11/22/02 38.540 1 S'Cottrade Execution Confmnations Sco P. o. Box 31759 III. Loulo, 1010 83131 Phone 3144eS-1S55 Page 1 of2 CONFIRMATION NOTIC. _........1 Member: N__stI<ln 01 SOClltlles DeIlIem & S/JCIJaIOS _ _ cllIJlMIi'I<JIl ESTATE OF LAWRENCE FLEE KATHLEEN F ROSS EXECUTRIX 409 HILLSIDE A VB NEW CUMBERLAND PA 17070-3037 ICOdes IICITlGROUP I I ISymbOIII~:ount II Trade No IIAT*IIMkt*llcap*IIAI*II~::e I ~:~ement I Office I Ic !I51542385110149D33Z IDDD[]5/29/2003116/3/2003 1!37D I EJIQuantity I ~~:~r I Security Description I Coupon Maturity ISOLD 112137.000 11172967101 IICITlGROUPINC 11% I I Price II Principal II Commission II State Tax/Interest II SEC Fee" Mise II Interest II Net Amount I 141.001187617.00 1112.00 110.00 114.11 110.00110.00 1187600.89 I ADDITIONAL INFORMATION: ,~-~,~~~~....---,.,_._-----.-,-----,_.,---------.-~._,"~-~---.--.-~"---.~--"",,,-~~-''''''~'-'~--"----''-''~--~'--~'- UNSOLICITED ORDER WE MAKE A MARKET IN THIS SECURITY DUPLICATE CONFIRM IN ACCORDANCE WITH YOUR INSTRUCTIONS WE ARE PLEASED TO CONFIRM THE ABOVE UNSOLICITED TRANSACTION FOR YOUR ACCOUNT AND RISK SUBJECT TO TERMS LISTED BELOW. AGREEMENT It 15 .greed between Seottnde IDe. .ad the Customer: 1. That all transactions are subject to the rules and regulations ofthc US Securities and Exchange Commission, the Federal Reserve Board and any Exchange:. Market or Clearing Corp. that may have jurisdietion over this transaction, any transaction executed in tbe Over the Counter Market is subject to the Unifonn Practice Code of the National Association of Securities Dealers Inc. 2. That all securities carried in a tnaf8in account may at any time be hypothecated and commingled with securities carried for the: account of other customers and loaned or pledged by Soottrade Inc. for a Bum not to exceed 140% of the aggrega.b: i.OOcbtedneu oftha.t margin ~oount. 3. Customer agrees to deliver llCCurities sold, and payment for securities bought, to Scottrade Inc. no later than the !lCttlement date. Otherwise, the securities may be bougbt in or sold out at the discretion ofScottrade Inc. Failure to meet settlement may also result in the cancellation oft1\is EXPLANATION OF CODED SYMBOLS A T. ~ ACCOUNT TYPE O. Broker Dealer !. Cub 2. General Margin 3. Short 4. Special Subscription MKT. . MARKET IN WHICH THE TRANSACTION WAS EXECUTED N, O. Over. The-Counter 1. New York Stock Exchange Inc. 2. American Stock Exohange Inc. 3. Chicago Stock Exchange Inc. C. Cincinnati Stock Exchange Inc. $. Chicago Board of Options Exchange 9. Exchange Listed Over the Counter Other Market Codes available on request CAP<. CAPACITY IN WHICH THE FIRM ACTED 1. As Agent for you we: have sold or bought this security. 2. As Principal we have 1IOId to you or bougbt from you https://www l.scottsave.comlscriptslHistConfirm.dIl?TID89954 73=Details&ACCOUNT=5... 6/23/2003 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: REV-1162 EX111-961 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 002738 ROSS KATHLEEN AKA 409 HILLSIDE ROAD NEW CUMBERLAND, PA 17070 ~o~d ESTATE INFORMATION: ssN: os5-i e-o4i 7 FILE NUMBER: 2102-1074 DECEDENT NAME: LEE LAWRENCE F DATE OF PAYMENT: 06/26/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /03/2002 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ S 13, 410.00 TOTAL AMOUNT PAID: REMARKS: SECURED LAND TRANSFERS C/O KATHLEEN ROSS CHECK# 277614 SEAL INITIALS: JA RECEIVED BY: DONNA M. OTTO REGISTER OF WILLS S 13,410.00 DEPUTY REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 7 28-0601 RECEIVED FROM: REV-1162 EX~11-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 002737 ROSS KATHLEEN AKA 409 HILLSIDE ROAD NEW CUMBERLAND, PA 17070 fold ESTATE INFORMATION: ssrv: os5-is-o4i~ FILE NUMBER: 2102-1074 DECEDENT NAME: LEE LAWRENCE F DATE OF PAYMENT: 06/26/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /03/2002 REMARKS: CHECK#128 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 52,629.27 TOTAL AMOUNT PAID: INITIALS: JA RECEIVED BY: DONN,4 M nTTn 52,629.27 DEPUTY REGISTER OF WILLS REGISTER OF WILLS BURET{J OF'INbIVIDUAL TAXES INHERITANCE 7AX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 08-04-2003 ESTATE OF LEE LAWRENCE F DATE OF DEATH 11-03-2002 FILE NUMBER 21 02-1074 KATHLEEN F ROSS ~~-~ ~.~ ';_> -n ; '', COUNTY CUMBERLAND 409 HILLSIDE AVE ACN 101 NEW CUMBERLAND PA 1;7.070 Amount Remitted ~, ~, ; MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE _- RETA_IN LOWER PORTION FOR YOUR RECORDS ~ -------------------------- REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR ----------------------------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF LEE LAWRENCE F FILE NO. 21 02-1074 ACN 101 DATE 08-04-2003 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 133,1 26.00 NOTE: To insure 2. Stocks and Bonds (Schedule B) proper (2) 84,356.02 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule Dl .00 submit the upper portion (4) .00 of this fora with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 172,48 2.92 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets (8) 389,964.94 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (g) 15,693.4 0 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 14,343 34 11. Total Deductions 12. Net Value of Tax Return (11) 0.036 74 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 359,928:00 14. Net Value of Estate Subject to Tax 359, 928.20 (14) NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) .00 X 00 _ .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 359,928.20 045 = 17. Amount of Line 14 at Sibling rate X 16,196.77 (17) .00 X 12 = .00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00 19. Principal Tax Due TAX CREDITS• (19)= 16,196.77 DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 06-26-2003 CD002738 .00 06-26-2003 CD002737 13,410.00 .00 2,629.27 INTEREST IS CHARGED THROUGH OS-19-2003 TOTAL TAX CREDIT AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 16,039.27 REVERSE SIDE OF THIS FORM 157.50 INTEREST AND PEN. .35 TOTAL DUE 157.85 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT•' [CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: intpossessioncodeenj yment to ClassfBrCcellateral)2beneficiariesaof theudecedent after the expirationtofnanyrastate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P. . Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable tc: REGISTER OF i(ILLS, AGENT REFUND (CR): foreRefundfof PennsylvaniawInheritancetandgEstate Taxth(REVx1313)rn~ApplicationsearedavailableeatnthenDfficeication of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forns ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 CTT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, ar disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must ab]ect within sixty (60) days of receipt of this Notice by: OR --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of evenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DePt• 280601, Harrisburg, PA 17128-0601 Phone C717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent^ CREV-1501) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3l calendar months after the decedent's death, a five percent C5%l discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, ar nine C9) months and one C1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six C6%l percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar Year to calendar year with that rate announced by the PA Oepartment of Revenue. The applicable interest rates for 1982 through 2Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1987 9% .000247 1999 7% .000192 1982 20% .000548 ,000301 2000 8% .000219 1983 16% .000438 1988-1991 11% 2001 9% .000247 1984 11% .000301 1992 9% .000247 6~ .000164 .000356 1993-1994 7% .000192 2002 1985 13% .000247 2003 5% .000137 1986 10% .000274 1995-1998 9% --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST 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. REV-1470 EX (6-68) ~#%Y` ~-~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME Lawrence F. Lee REVIEWED BY Sheila Megonnell INHERITANCE TAX EXPLANATION OF CHANGES FILE NUMBER 2102-1074 ACN 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES H B_3 The claim for the family exemption has been disallowed. The claimant must be a spouse or if no spouse, a parent or child living in the same household as the decedent as of the date of death. ROW Page 1 ~~ ~ ~~~ ~t ~ ~. ~a ~ ~ ~, > ~, •4 ~ ~ ` O ^~`' V ~ .~ 1 ~ \ ~~ a~ ~ ~~ ~, fi, ~ ~~ ~,:r v~ ~ ~ ~ ~ `~1 ~ ~ ~ ~ i. ;,~~ ~~. ~ ~ '~! ~ ~ \~ \: ,~ 4 3 ~.~ ~~ ~~~ ~~i \\V !.„ Z ~ ~ ' "~ ~r! a M Z J~ Z ~ a~ O ~ F- W Jg 3 ~ ~Q O W aF 0 aQ° ~HH V O W Foy f'1Wy =Qa Hoo ~~a oavi W ,p z°w~ a° o Q N W X aZ o ~ H o M 00 ~ N ~„~ N r.l Z X ~ ~ ~ a LL W o _j~,u~oc~ ro ~ •m w v z W 3 Q M N ~ A O O ^ Z O O O Q N Nry~ i ~ ~ ~ ~' M N W o O O as i C+p W ,y H ~ O o '~ .-~ N V ti O ~W W FW-OZ~. 1-FFW- WZ J ~ Z A W A !~ V Q f„ +_ ~. 1~ CJ O: ,~ fem. C _,` ~-- a a W N ~ c a ca ~ W Q W M ~ 2 ~ W W H F _ _ ~..~ ~ ~ 3 Q O W Y ~7 Z 0 f- Z W F ~- a - a W F- N M ~ g O W S ~ a' N M Z N ~ O Q -+ o n H V ~ y .WI $ O p Q L~ U ~ C' } C A W d Maui ~; Y ~ ~' N a. V W W H ~ W H Cq .~ ~ _ ~' F fY ~' ~ ~ U V ~ W ~ Y g Z H - F ~a 07LL ayc ~' W' Of J _- M N W: ~: `e R ~- ~y L ~:k IW L!' Z ~ 1~ J a 1~fti Q'i~-t e~ 1- '' ~ V ~. m m c a -i ~. 0 z m m ,+ d m m 0 -h a m n m a m h VI a m 0 Q m 0 m 0 m n m 3 Q m N N r ~o .. m +• N I .l ~ ~ ~ 7 K C rt C m 7 R m 1 m N rt j w rT 7 U1 m 7 . m 7 N m a i m ~ m ~ y~ O COMMONWEALTH OF PENNSYf-VANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-96) NO. CD 002881 ROSS KATHLEEN AKA 409 HILLSIDE ROAD NEW CUMBERLAND, PA 17070 folG ESTATE INFORMATION: ssN: o95-i 8-o4i ~ FILE NUMBER: 2102-1074 DECEDENT NAME: LEE LAWRENCE F DATE OF PAYMENT: 08/08/2003 POSTMARK DATE: 08/07/2003 couNTY: CUMBERLAND DATE OF DEATH: 1 1 /03/2002 REMARKS: KATHLEEN F ROSS ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ S 157.85 TOTAL AMOUNT PAID: $157.85 CHECK#133 INITIALS: AC SEAL RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS \ , BUREAU OF INDIVIDUAL Taxes COMMONWEALTH OF PENNSYLVANIA V INHERITANCE TAX DIVISION DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX HARRISBURG, PA 17128-0601 STATEMENT OF ACCOUNT REY-1607 EX ~FP (O1-SS) DATE 08-25-2003 ESTATE OF LEE LAWRENCE F DATE OF DEATH 11-03-2002 FILE NUMBER 21 02-1074 ~' ~ - ~~ COUNTY: CUMBERLAND KATHLEEN F ROSS ACN 101 409 HILLSIDE AVE NEW CUMBERLAND PA 17070 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE "- RETAIN LOWER P_ORTI_ON FOR YOUR RECORDS __~ ----------------------------- --------------------- _____ REV-1607 EX AFP (01-03) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ~~~ --""""""""""" ESTATE OF LEE LAWRENCE F FILE N0. 21 02-1074 ACN 101 DATE 08-25-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-04-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 16,196.77 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 06-26-2003 CD002738 .00 13,410.00 06-26-2003 CD002737 .00 2,629.27 08-07-2003 CD002881 .09- 157.85 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. * IF PAID AFTER THIS DATE, SEE REVERSE I TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 16,197.03 .26CR .00 .26CR PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed an the reverse side. -- If RESIDENT DECEDENT make check ar money order payable to: REGISTER OF WILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): 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-1313). Applications are available at the Office of the Register of Nills, any of the 23 Revenue District Dffices or from the Department's 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). REPLY TD: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCDUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent C5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9l months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 hear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20% .000548 1987 9% .000247 1999 7% .000192 lgg3 16'/. .000438 1988-1991 11% .000301 2000 8% .000219 1984 11% .000301 1992 9% .000247 2001 9% .000247 1985 13% .000356 1993-1994 7% .000192 2002 6% .000164 1986 10% .000274 1995-1998 9% .000247 2003 5% .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen C15) 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. Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/24/2004 ROSS KATHLEEN F RE: Estate of LEE LAWRENCE F File Number: 2002-01074 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 will become delinquent on: 11/03/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASB~UGH REGISTER OF WILLS cc: File Counsel Judge STATUS REPORT UN-DER RULE 6.1 ? Name ofDecedent: ~ r Date ofDeath: _ WillNo.._ -~,.OO~. d/O'7~' I~et~t.o&.lo-T7 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 is complete: Yes No [] 2. I£ the answer is No, state when the personal representative reasonably believes that the admin/stration will be complete: 3. If the answer to No. 1 is Yes, state the fo/lowing: a. Did the personal representative file a final account with the Court? Yes _ No /~. · b. The separate Orphans' Court No. (if any) for the persona/representative's account is: c. Did the personal representative state an account informally to the part/es in interest? Yes ~ No [] 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. ~/~/'gnature :':' '//)C: '-w ": Add~ess ' - ..... /7c;7c) Telephone No. ,- f-~ Counsel £or personal representative