Loading...
HomeMy WebLinkAbout02-1101PETITION FOR PROBATE and GRANT OF LETTERS Estate of Doris E. Stine File No. -~/-o~- ~/o / Late of Southampton Township, To: Cumberland County, PA, deceased. Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania Social Security No. 159-24-7808 The petition of Ray I`Ji. Stine of 1481 Newburg Road, Shippensburg, PA 17257 respectfully represents that: Petitioner is 18 years of age or older and the Executor named in the Will of the above decedent, dated January 29, 1986. Decedent was domiciled at death in Southampton Township, Cumberland County, Penn- sylvania, with her last family or principal residence at 1481 Newburg Road, Shippensburg, PA 17257 Decedent, then 74 years of age, died November 7, 2002 at Penn Hall Nursing Home in Chambersburg Borough, Franklin County, Pennsylvania. 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: Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $15,000 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania situated as follows: WHEREFGRE, petitioner respectfully requests the probate of the Last Will and Testament presented herewith and the grant of Letters Testamentary thereon. Signatures Residence ~_ . ._._ f C Ray ne 1481 Newburg Road Shippensburg, PA 17257 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND ss. The petitioner above-named swears or affirms that the statements in the foregoing petition, are true and correct to the best of the knowledge and belief of petitioner and that as personal representative of the above decedent petitioner will well and truly administer the estate according to law. Sworn to or affirmed and sub- scribed before me this 25'h day of November, 2002. Estate of Doris E. Stine Late of Southampton Township Cumberland County, PA, deceased. For the Register J~""~~~ File No. o2f Oo2- //O/ DECREE OF PROBATE AND GRANT OF LETTERS 5th day of DECEMBER AND NOW, this >~, 2002 in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument dated January 26, 1986, described therei~~be admitted to probate and filed of record as the Last Will and Testament of Doris E. Stine and Letters Testamentary are hereby granted to Ray M. Stlne. **in the form containing the language admissible to probate as set forth in the attached "copy fair" Date of Death: November 7, 2002 Social Security No. 159-24-7808 Letters Testamentary issued ffi ~. Bushman; ATl-ORNEY FAX: [717] 349-2982 Telephone: [717] 349-7657 Sup. Ct. I.D. No. 36406 16767 Path Valley Road P.O. Box 51 Spring Run, PA 17262-0051 ;i` ?~ _..: ~... ,.- '> S i,Z.i'f' r ~CIl i:~ COCI"t:;C~~' C47!eCi `Ti3f'tl 3t7 O1'1 rlh'lf 4rt L ~l -.~ l; -. ~.. ,,. , ,. , l~ . t.:nz-w,t,~c~tc~ rc~ the ~)ta~_ ~',~al ~ ~:., ~ `~ i _ ~ ,~j ., .. , _ ., ~~ `ry. ,., ir?r9~~1 tt~ ~L:;~li~ate this C~s~a~~ ~y ph~t~stat ur ~,fi-, .., ~643~9.6______ :~ 4 ,-= _ ----- ,~ . Mo ~: `~ Q~"'" ' ~~ g 2002 ~~~ , ~~-, NpV 0 k ~~aJ Rev. 987 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH STATE n~LE NUMBER ~~~-~~~~~ SEX W SGCIAL SECURITY NUMBER DAZE OF UUTN:MCnm. Day. earl I NAME OF DECEDENT If:rsr. Mitldle. ,asl .ti.ne :.Femake ]. 159 - 24 - 7808 .. November 7, 2002 ,. Dare ~. S _ AGE (Lass Bxlnday) UNDERIYEM UNDERI DN' OATE OF BIRTH BW IHPUCF ;Ceyaq PLACE Oi DEATH ~t'r,~r.x may n~•e--,ee:nsuucl:ura nn ulnei ~~w1 __ _-_ --- -- nVl HOSPITAL: NTNER: OIMr Montns . Days Howe ,, Minulea- Mon n. OaY. ~eerl Slate cteyn Coun } ~ Sou#h HamN~tan InpalNni ^ EFLOutpawnl ^ DDA ^ „~ p Rsadsnu ^ ISpanNl ^ 74 yn a9-28-1928 7, N. - : COUNTY OF DEATH CffY, BORO. 1WP Of DEATH FACILfTI' NAME pl nut mwlulx)n. y ve slieel arvJ numbers wAS DECEDE N7 OF HISPANIC DRIGIN7 RACE - Amsrrcan Inman. Black, WhAe. etc. 1Stak:dy) aOecM Grban No Ill Yaa ^ 11 yes , . Penn Haab Nur~~.ng Home M."°".P"."aRrcan.«` (Uh~~e .. ,.. Chamber~sbung ad n Franh ~~ . k. . . ... DECEDENT'S USUAL OCCUPATION KIND OF BUSINESS/INOUS7RY WAS DECEDENT EVER IN DECEDENT'S EDUCATION MARITAL STATUS~MarraTO SURVIVING SPOUSE U.S. ARMED FORCEST S i aV n peal rade cone led Never MarrNd, Widowed. III wda. gne rnaelen twnel (Give kmdd work done d°n rre)SI d vgrkrng G/e; w rq1 use reied 1 YK ^ ~ ® Ekmentaryl$ecanwry College Drvaced ISpecdyl lo-,zl 12 I7aws'16 Marr~ ed Ray M. S~~ne . ~duCa~Or „6 . DECEDENT'S MAILING ADDRESS ISIreet. City/Town. Scala. Z1p Coael ~TU~NTS PA Oio t7c.llJ rw, wcewdtivad in Sau~h Hamp.tan tiv ,7a. Stau aecewd 1481 Newbuhg Raad RESIDENCE ISee uwruclnns wen '°'""a"'pT No.decedwtllived -_- 170.^ waMn anrral lanes of cdYlbno. PA 17257 ""~"~`~' Cumber.f?and __ li. 176. County - - Shy evl~sbur FQHER'S NAME (Pest. M Wme. La51) MOTHER'S NAME IFxsl. Mxltlk!. Maiden Sanamel er Ha~~~n th M g ar. a Oxi.~s A. Kerne t9. ,.. INFORMANT'SMAILING ADDRESS ISaeel. Cdy/(own. SIaIe. Zw Codel INFORMANT'S NAME (TypelPrml) Ray St~.ne 2.6.1481 Newbur Road, Shy enebur PA 17257 2w GATE OF DISPOSITKN PUCE OF DISPOSITION - Namq of Ca ry, Cram LOCATION. CiNlTOwn, Slat.. Zp Cow METHOD OF DISPOSITION ey o {~ mar) ar ouI« PMCa Cr ema~t.co n~o c~ - dn M Da - . ~T ~ . a Y• Burial ^ GremalDn ® Rwtroval hom S1aIa ^ ( PA 17109 13 --O a. Harrti~sburg t I ^ , ary 21d. 11t DwWian^ aWr,Spe~dy) - PA Crema~ ~ ___ _. - - . ' . 2,6. 2u. SIGNATUR FUNEMLSEL,VICELN;E PERSON ACTING AS SUCH LICENSE NUMBER NAME ANDADORESSOFFACLLITY Creme-tc.an Sac~ce•ty a - 2,6. 2:a. 00 Jane~~town Raad Hahr~~sbur PA 17109 ~ CrymplNe items Z]ac onN wean wmryi _ IW WsI of my krwwladge, waN occurred al the nme. date and place soled LICENSE NUMBER DATE SIGNED (MOnm. Y. Vearl plryaClNr O nd avadaDle al ume of walh b (SKyrawre Mal / + • ~ L ~•/7 ' wnlty caws of wa1h. I~i( • ~ ~ 236. r 22e. J l~ [ ! . . Gams 2.-28 moat W completed by TIME EATH DATE PRONOUNCED DEAD IM m. Day, year) VM$ CASE REFERR TO ME MINERK:ORONERT ' N ^ • parson who pronounces walh. ~ /'~, ~ Yas Jf~" O _ _ - _ _ _ a 25. ~ M. 25. 2t. (... 27. PART I: Eder IM diseases, injuries or wmpkcalnra which caused Ire wash. Do rot emer IW moon o1 tlying. such as carouc m respratory riesl, snack or Wean lad a. r ApproaunaN PART N: OBrsr signi/kaM cwrdikore contributing to walh, Dot r uaervW Drdween nq nwhirg m BIa urrdartyog caws gnwr n PART I. L W onN oro cause on eaU kw. ~ tinsel and waN IYYEDIATE CAUSE IFxal ~ r ~ ~~~~~ i mseaseo conmtan ^--~\/ I -_ __ a ,~ r esuaegntleaml-r a. p DUE TO IOR AS A C SEQUENCE OF): SeQlNn/ia9y kfl corwKiona b_ I _. _ ~, it any, Isadin9 b enmadiale DUE 70 (OR AS A CONSEQUENCE OFI: 1 tetras. Ems UNDERLTING I - __- -. . - CAUSE (Disease a mlury c. -- -- mat evbated evenu DUE TO (OR AS ACONSEOUENCE DFI~ I - resraerq n waml LAST r ~-- d M111S ANAUTOPSY WERE AUTOPSY FINDINGS MANNER OF DEATH DATE OF INJURY TIME OF INJURY INJURY AT WORKT DESCRIBE HOW INJURY OCCURRED. PERFORMED? AVAIUBLE PRIOR 10 IMmm, Oay. Vearl COMPLETION OF CAUSE Na1wN OF DEATMT ~ Hortncida ^ Vp ^ No ^ AccWem ^ PerMrrg lnwslgalpn ^ ^ No ~ Yea ^ No m Sr~~• ^ CouN1 noI DB wtermmed ^ PUCE OF INJURY -AI hums. farm, street. lactory, olhca LOCATION ISaeal_ Cdy/Tow*r. 51a1e) V as buikang, arc. ISpecnvl ]Of . _ _. 2N. 216. 29. 30e. SIGNATU AND TITL FCER7IF IER '~-~ CER'fIF1ER ICneck only oral -CERTIFYING PHYSICIAN IPnysic~an cerWymg cause ry deem wren ananer pnvsrc an has prarouncetl deem ano e.omlNeled Item 271 ~ 1 K C. ll' To,M Wet of my knawMdge, death occunad dwbtlre caua<Isl and manner as elated .... .. ..... .... .. ,- ]t6. Y - - _- e TE .. L{CENS,E/1N M R (y/~ OA SI'GN1EDIM,w`im.1~Y. x Wdeaml uf loca y 1~D~ ~ ' 1 ~ ~ ~ yin) u r~V~an Mnl. pi o~uw~c nr)Ueam erW..e: ]t4 ~ .- •pRONOUNCING AND CERTIFYING PHYSICIAN II I_ 71e. v /L (~~ - . 1 -_- -- --1-~+ - ------- - - r l 0 - , . .......................... a e To tW 6es, o, my krwwledg•~ OeaN occurred al Ns 11me, dale, and place, arM dos to the caux(al arW manner as a NAME ANDA DRESS OF PERSON WHOCOMPLE7EOCAUSE OF DEATH , (Item 171 Typaw PnM Jahn Hannah M.D. 'MEDICAL EXAMINER/CORONER in my oprmon, death occurred a, the Ilme. date, and place, and due to the cause(s) and ^ 14 2 5 Ph.~.2ade.2ph2a Avenue amina,ion andlor investigaUOn i f b • , ea s o On,11e as manner aseta,w .................................................................................................. ]z. Cha.mber~bcvc PA 17201 _ - ],e. Y O REGJ6T AR'$SIGNAi.U$FJ{JD - e im . ear1 DATE FIL w a`y. I~M EDy / / ~ .~ ~ LAST WILL AND SESTAMENI OF DORIS E. STINE I, DORIS E. STINE, of Southampton Township, Cumberland County, Pennsylvania, 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 all other Wills and Codicils thereto, heretofore, made by me. FIRSI I direct the payment of my debts and the expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. bra-..-the event i am not the owner of a cemetery lcrt of -the time of my death, I direct my Executor to - purchase such .lot with-a contract for perpetual .care and to i~.pxQU~~> the- lot and- have erected thereon a suitable monument and marker, using therefcsr_ f~:tnds €rc~n-- m~y e~crte-.-i~-:.-such,...amour~t ~ he in his sole discretion sPi[7ill deem Qdv~~SY~. SECDND I give, devise and bequeath all my property, whether real of personal, tangible or intangible, together with all insurance policies thereon, unto my husband, RAY P1. STINE, provided he shall survive me by thirty C30] days. - THIRD I give, devise and bequeath all the rest, residue and remainder of my estate unto my husband, RAY f1. STINE, provided he _,: ~'~~.~' shall survive me by thirty C30] days . 1 FOURTH In the event my husband, Ray f1. Stine, should predecease me, or we should die in a common disaster, I then give, devise and bequeath my estate as follows: A. In the event Amy son, Timothy R. Stine, is stil'1 attending 0 college, I direct that my estate be placed in Trust, for the benefit of Timothy R. Stine, and the proceeds thereof be used for the college education of,ffny son, Timothy R. Stine, including \$uition, room and board, books and fees, clothing, automobile maintenance, and the sum of Twenty-five Dollars 025.00] per week as nllowance for a period of two years from the date of my death. In addition, Timothy is to be given the choice of an ^utomobile or pick-up truck, from motor vehicles which I own at the date of my death. Upon the graduation from college of my son, Timothy R. Stine, he is to receive the sum of Six }~t]ndred Dollars C~600.00J per month, for a period of helve C12J months. Upon my son, Timothy R. Stine's, g'z-aduation from college, and the passage of one C1] year from the date of his `1~~ graduation, I direct that my estate be divided as follows: ~.: r 1. I direct that shall have the right to purchase the farm and farm machinery and vehicles, which I own, situate in Southampton Township, o, Cumberland County, Pennsylvania. The terms of said ~~ purchase shall be as follows: The farm shall be appraised by a competent real estate appraiser, 2 selected by my executors, after consultation with -the attorney representing my estate . ~-~--sc~~;°~~ ~°r~R St•i.ae., shall pay to each of his sisters and brothers, who shall survive him by thirty C30] days, Red S~i~R~~~ an amount equal to twenty-five percent C25o] of the appraised value, payable in monthly payments amortized over a period of thirty C30J years. No interest shall be due on the payment. Ne-~yments sha3.1 be made until two years after the graduation from college of Timothy R--,~='-rte. During the time until ~&•~~~e makes the first payment to his brothers and sisters, my Estate shall be responsible for the taxes, insurance, and maintenance of the property, and shall be responsible for maintaining the heat and electricity in the said property. B. In the event that m~ son, Timothy R. Stine, Pn_..~?.~..._a.a.tt~ 4 ~~-~ ...~~.,~m.~ct~-11~g~ wti~n two years aE the date of my d~a-tki-._~~ termi;x~es that he does not wish to purchase said farm, then en of my other children shall have the option to purchase tie fa upon the same terms and conditions as ~.; those granted to Timo y R. Stine. In the purchase of said s,,..; farm, wheher by Timothy Stine or by other children, the ~,. farm e~~uipment and machine and farm trucks are to be .a ;_ inclined in the sale. ~In the event that more than one child wishes to purchase .ti the farm, I direct that the decision on who shall purchase said farm shall be determined by a lottery, the nature of which shall be determined by my Executors. 3 C. In the event that no child desires to purchase the said farm situate at Southampton Township, Cumberland County, I direct that the farm be sold either at public sale or privately, as determined by my executors, and the proceeds divided in as nearly equal shares as possible; provided, however, that in the event a child or children shall have a mortgage on their home, then my executors shall pay the outstanding balance on said mortgage, or an amount equal to the child's share in the proceeds of the sale of the farm. r~. S -~ ~ , c__, ~.. ~ sLL, D . I-- direct that gam- loans incurred by •- . ,. ! r ~„ .. ~ Gn '~ f „-.n~r~y ~ ar ,I,e,a,~„t,# Stine-6~er+ncrn, incurred for e~Q~i-} ~~°P~"~"Faees , s h a 11 b e paid from my estate . E . ~---$-i-ve--.~. t„oe..,.ta~.._~se•~r.~. _ ..Df-rra i e 3. J ,- . _ 5t i.ne , . ,the sum. of Two l v e ~.}1au~nnd.-.-...~1ca.llars- 012,0043.00), to be paid-. an his- home rr~~tgage; --•-ice.. the event that the home- is still mortgrsB~d at the date of my death. ~tm, i~, TmQthr~°°R., -~t~ne, the sum of Twelve-- -T'hflusnnd~ . _DQi°lr~rs. °°E~3'~~, OD©. QOM ~-r~ a.~~, I give and bequeath to my son, Daniel, the choice of any ^f my books, which he may want. After Daniel has chosen said books, the remaining children shall choose a book or books from my collection of books. In the event .~., _. ~.~ books remain in my collection, I direct tb,at.,,,,,t~}..~r-=~~•~sn shall , ..g~,.Ve the_,~_h~.st~r~ics.1--,,.,.honks. _;.tcl the ~h~'~pe~rs~r~t^r9 ....__.. ~: p ~ g _ r4 ` ~ < ~ I ~ "' r i ~ ~ 6 .M --~, ~ w ~ ? ~" ~ y y ~C .~? T ~ F.~ Al.~ the rest, residue and remainder of the remaining -~ ~, ,/ contents of my house and garage s#~~ be appraised and divided among such of my children who shall survive me by thirty C30] days, in as nearly equal amounts as possible, according to the appraised value. The children shall choose such items they shall want beginning with the eldest child. G. I direct that all the rest, residue and remainder of my estate shall be sold at public auction to be held not on the property, and the proceeds to be put in Trust,1upon the ,. following terms and conditions: a~~a °, ~ ~ ~ ~ P. ,,~~ S~ .. w , is v ~~ ~ {. t v F = '. gs r, r ~ ~ ~. ? ~ • ~~ ~ '~ , 1. The interest on said Trust shall be divided equally among such of my four children as shall survive me by thirty C30] days, p~~ s~i~p~~, Interest shall be paid quarterly or at such other intervals as determined by the Trustee. Z. The principal may be used for the education ^f such of my grandchildren who choose to attend college bey^nd the twelfth year of public school, or in the event of a catastrophic illness of any heir within each of the J Four families. Each family shall be entitled to --~:~ use up to one-fourth C1/`fJ of the principal of said Trust, after which his or her interest in said Trust ~?,._~ shall terminate. 3. At the time all grandchildren shall have reached the ,} a > age of thirty C30J years, any remaining principal shall -- be divided between the Salvation Army, and St. Andrews Episcopal Church of Shi %~ , ppensburg , , ~~ ~, r .. , q) 1 , s .p 5 appoint my four children, Timothy R. Stine, Daniel J. Stine, ebecca S. Stine-Dempsey, and Jeanette E. Stine-Gorman, Co- Executors of this my Last Will and Testament. In the event of a dispute among my Ca-Executors regarding my estate, my daughter, Rebecca S. Stine-Dempsey, shall decide, and her decision shall control, absolutely. I hereby relieve my Executor from the necessity of posting security in connection with his duties as such in any jurisdiction in which he may be called upon to act, insofar as I qm able by law to do so. IN WITNESS WHEREOF, I haue hereunto set my hand and seal to this my Last Will and Testament, consisting of seven C7) typewritten pages, the first six C6) of which bear my signature in the margin far the purpose of identification this ~9}`' day of --~Afi1VA..z~[ ------ ~ 1986 . ----- ---------------------------- Daris E. Stine Testatrix SIGNED, SEALED, PUBLISHED AND DECLARED by the above named Testatrix, DORIS E. SIINE, as and for her Last Will and Testament, in the presence of us who at her request and in her sight and presence and in the sight and presence of each other have hereunto subscribed our names as witnesses: i ;` / ~ willingly and that she executed as her free act and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the lJill as witnesses; and that to the best of our knowledge the Testatrix was"mot the time eighteen or mare years of age and under no constraint or undue influence. ---~'- Sworn to ^nd subscribed before me by L~L~s~ ~~•-Lv~;~" s and 4,~1/~~a~_S_ Ifl~ ~ witnesses , this __''_~%~~' day of _~-!~_~~~~~_,_L iT--' 1986. L C 4 t `_ ` `. ~ °~ ----r -~-~------~ =--------------- Notary public fly Commission Expi[;res: u i. ~. N. ~,1 .. r ~~ s.R ~• it ILt ~i. •~ SfiIJT~;i~~s'°~~; ~ae'dz., 5'f:i~$li;'~i~ %C4a~.1Y ~~ ~~~°Pti'SSEt;~d EXPE~ES.6R~i. 5, ~~~7 Herber, PenRs~i•,~a~iia Assc~ci~fion of ~atarics --~ - ~ ,~ - $. _.~~ 9 COMMONWEALTH OF PENNSYLVANIA . SS COUNTY OF FRANKLIN I, DORIS E. STINE, the Testatrix whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Doris E. Stine Testatrix Sworn ar affirmed to and acknowledged before me by Doris E. Stine, Testatrix, the a~1~ day of _J~~sa•cz.~+! --- 1986. - /~-~~- _-(=.1 ~ _~. c--0«.-cam?-t-i------ Notary Public Jv''rt'4~ A. d,,;'Uu"a ~s{?_^;4iti 6'iiv'.;C SQiJT't?.'.~tr~i% ~~s';°.. r3A~a~ii?9 G^,~;~?Y p1Y CC~~','~4i3Sii~?! £XPiR£S JAN. 5, 1587 MemGe~. r'ernsY;vznia Association of P,ctaries COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF FRANKLIN - We, ---1 ~-'~?=f -w--h~~-~f ~ =------ and __~ ~LI~Ci,J_ ~_ ~~~ `-------- witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Doris E. Stine, Testatrix, execute the instrument as her Last Will and Testament, that she signed it 8 REGISTER OF- OATH S OF CIBSCRIBING (each) a subscribing witness to law, depose(s) and say(s) that _ codicil ~ _ will presented herewith, (each) ~ g duly qualified according present and saw the testat ,sign the same and that _~ request o tat in h presence and (in the other subscribing ess(es)). Sworn to or affirmed and subsc d before me this da f `~ 19 ' ter COUNTY of each other) (in the (Address) a witness at the p ence of the (Name) (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS ~/ l`~ ry' ~ ~`e ,4 V7 ~ ,:_b~_ ~ _ ., ~, (each) a subscriber hereto, (each) being duly qualified .according to law, depose(s) and say(s) that -~"p ,~~ie , familiarh th~ ~e of ,~~ ~~S a~ .r' i v, 1 Lx ~. testate ~ of ( ) the wily;` presented herewith and codicil that believe the signature on the will is in the handwriting of -~ Y ~ s r S-n„~, to the best of __ __- knowledge and belief. Sworn to or affirted and subscribed before e this /~iTfr -._ day of ~~ ~~o~ ~~~~ ~.~~~~ Register vLC L L !Name) ,~ ~/ (A dress) C~% %~:~JL CSC' ~~L~r~~~-'~~, (Name) --, / ~-- ,~ /V t er ~ h ~2~1,~. ~ i (Address) ~~ CERTIFICATION OF NOTICE UNDER RULE 5 . 6 (a ) Name of Decedent: Doris E. Stine Date of Death: November 7, 2002 No.: 2002-01101 PA No.: 21-02-1101 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on January 2, 2003: Name Address Ray M. Stine 1481 Newburg Road Jeanette E. Stine-Gorman Timothy R. Stine Daniel J. Stine Rebecca S. Stine-Dempsey Date: January 2, 2003 Signature: Name: Address: Telephone Capacity: Shippensburg, PA 17257 P.O. Box 2135 Rutherfordton, NC 28139 RD #1, Box 63 Woodbury, PA 16695 12 Apeman Road Shippensburg, PA 17257 Richard L. Bushman, Esquire 16767 Path Valley Road P.O. Box 51 Spring Run, PA 17262-0051 [717] 349-7657 Personal Representative XXXX Counsel for Personal Representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be determined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLr1ND, PENI~TSYLVANIA In re Estate of Doris E. Stine, deceased, No: 2002-01101 of Cumberland County, Pennsylvania TO: Ray M. Stine 1481 Newburg Road Shippensburg, PA 17257 Please take notice of the death of decedent and the grant of letters to the personal representative named below. The Decedent Doris E. Stine, died on the 7`h day of November, 2002, at Penn Hall Nursing Home, Chambersburg, Franklin County, Pennsylvania. The Decedent died testate (with a Will); The personal representative of the Decedent is: Ray v1. Stine 1481 Newburg Road Shippensburg, PA 17257 (717) 532-6128 If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, Cumberland County Court House, Hanover and High Street, Carlisle, PA 17013, (717) 240-6345. A copy of Will is attached. IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION TffiS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be determined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PEl~'NSYLVANIA In re Estate of Doris E. Stine, deceased, No: 2002-01101 of Cumberland County, Pennsylvania TO: Jeanette E. Stine-Gorman P.O. Box 2135 Rutherfordton, NC 28139 Please take notice of the death of decedent and the grant of letters to the personal representative named below. The Decedent Doris E. Stine, died on the 7~' day of November, 2002, at Penn Hall Nursing Home, Chambersburg, Franklin County, Pennsylvania. The Decedent died testate (with a Will); The personal representative of the Decedent is: Ray M. Stine 1481 Newburg Road Shippensburg, PA 17257 (717) 532-6128 If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, Cumberland County Court House, Hanover and High Street, Carlisle, PA 17013, (717) 240-6345. A copy of Will is attached. IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be determined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA In re Estate of Doris E. Stine, deceased, No: 2002-01101 of Cumberland County, Pennsylvania TO: Timothy R. Stine RD #1, Box 63 Woodbury, PA 16695 Please take notice of the death of decedent and the grant of letters to the personal representative named below. The Decedent Doris E. Stine, died on the 7th day of November, 2002, at Penn Hall Nursing Home, Chambersburg, Franklin County, Pennsylvania. The Decedent died testate (with a Will); The personal representative of the Decedent is: Ray M. Stine 1481 Newburg Road Shippensburg, PA 17257 (717) 532-6128 If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, Cumberland County Court House, Hanover and High Street, Carlisle, PA 17013, (717) 240-6345. A copy of Will is attached. IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be determined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA In re Estate of Doris E. Stine, deceased, No: 2002-O1101 of Cumberland County, Pennsylvania TO: Daniel J. Stine 12 Alleman Road Shippensburg, PA 17257 Please take notice of the death of decedent and the grant of letters to the personal representative named below. The Decedent Doris E. Stine, died on the 7~' day of November, 2002, at Penn Hall Nursing Home, Chambersburg, Franklin County, Pennsylvania. The Decedent died testate (with a Will); The personal representative of the Decedent is: Ray N1. Stine 1481 Newburg Road Shippensburg, PA 17257 (717) 532-6128 If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, Cumberland County Court House, Hanover and High Street, Carlisle, PA 17013, (717) 240-6345. A copy of Will is attached. IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE Whether you will receive any money or property will be determined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA In re Estate of Doris E. Stine, deceased, No: 2002-01101 of Cumberland County, Pennsylvania TO: Rebecca S. Stine-Dempsey 213 Hickory Lane Shippensburg, PA 17257 Please take notice of the death of decedent and the grant of letters to the personal representative named below. The Decedent Doris E. Stine, died on the 7~' day of November, 2002, at Penn Hall Nursing Home, Chambersburg, Franklin County, Pennsylvania. The Decedent died testate (with a Will); The personal representative of the Decedent is: Ray M. Stine 1481 Newburg Road Shippensburg, PA 17257 (717) 532-6128 If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, Cumberland County Court House, Hanover and High Street, Carlisle, PA 17013, (717) 240-6345. A copy of Will is attached. -C~~. _ .~ ~-. f---. ~~~`" lid ~ FAMILY SETTLEMENT FINAL RELEASE IN ESTATE OF Doris E. Stine DECEASED KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Doris E. Stine, late of Southampton Township, Cumberland County, Pennsylvania, deceased, died testate on the 7th day of November, 2002, in Southampton Township at 1481 Newburg Road, Shippensburg, Pennsylvania, having made her last will and testament, which was duly executed the 29th day of January, 1986. WHEREAS, the said Doris E. Stine, by her Last Will and Testament appointed Ray M. Stine executor; and WHEREAS, Letters Testamentary on the estate of said Doris E. Stine, were duly issued by the Register of Wills of Cumberland County, Pennsylvania to the said Ray M. Stine, the Register having issued them on the 12th day of December, 2002; WHEREAS, the said Ray M. Stine, as executor of the estate of Doris E. Stine, has gathered the assets of the estate of the said decedent and the assets [consisting of both real property and personal property] to the total value of $13,027.87, as set forth in Exhibit A, which is a statement of account of the said executor and which is attached hereto and made a part hereof, and marked "Exhibit A"; WHEREAS, the debts and deductions, including the payment of the Pennsylvania inheritance Tax in the said estate, amount to $1,949.17, (as shown in Exhibit A) leaving a balance for distribution of 11,078.70; WHEREAS, all real property and personal property has been distributed to Ray M Stine, having survived Doris E. Stine by thirty [30] days, as shown in the said statement marked Exhibit A has been distributed as therein indicated in accordance with the terms of the last will and testament of the said Doris E. Stine,; NOW, THEREFORE, KNOW YE, that we, Ray M. Stine, 1481 Newburg Road, Shippensburg, PA 17257; Jeanette E. Stine-Gorman, P. O. Box 2135 , Rutherfordton, NC 28139; Timothy R. Stine, RD #1, Box 63, Woodbury, PA 16695; Daniel J. Stine, 12 Alleman Road, Shippensburg, PA 17257; and Rebecca S. Stine-Dempsey, 213 Hickory Lane, Shippensburg, PA 17257; being all of the children of the said Doris E. Stine, and heirs under the last will and testament, and being those persons entitled to inherit under the aforesaid will, do hereby, each of us, acknowledge that we have this day had and received from the aforesaid executor, in full satisfaction and payment of all sums or sums of money, legacies, bequests and devises as are given and bequeathed to each of us respectively by the said last will and testament, which amounts we have received this day, and which amounts are in the amount set opposite our respective names in the table and schedule of distribution in the statement attached hereto and marked "Exhibit A"; AND, each of us do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, we each agree that no formal account is necessary and we do hereby agree that we do consent to distribution being made without the filing of a formal account, the same to be with the same force and effect as if they had been filed and confirmed by the Orphans Court Division of the Court of Common Pleas of the 9th Judicial District [Cumberland County] of Pennsylvania; THEREFORE, each of us do hereby, remise, release, quit claim and forever discharge the said Ray M. Stine, executor aforesaid, his heirs, executors, administrators and assigns of and from the estate and from all actions, suits, accounts, payments, claims, and demands whatsoever for or by reason thereof or for any other use, matter, cause or thing, touching upon the Estate of Doris E. Stine, and his deeds as executor of said estate and we do further covenant and agree that should any liability come due to the estate of the said Doris E. Stine, after the signing of the agreement, we and each of us do hereby covenant and agree with each other and the aforesaid executor, that we will contribute. pro rata, our share of the estate to satisfy any and all claims, or demands, suits, or causes of action which may be prosecuted against the said estate of Doris E. Stine, deceased, or the aforesaid executor after the signing, sealing and delivery of this family settlement and final release. IN WITNE HEREOF, we have hereunto set our hands and seals on the dates writ to ur names. Witn '~ ~ ~ Date: 7 ~' Jeanette E. Stine-Gorman .~,. ~ ~~ Ti t y R. tine .- ~ +t ~-~ ~ Daniel J. Stine Rebecca S. Stine- emps y ~~~~L3 Ray E. ' ACKNOWLEDGMENT STATE OF PENNSYLVANIA COUNTY OF FRANKLIN SS. On this, the 18th day of July, 2003, before me, the undersigned officer, personally appeared Jeanette E. Stine-Gorman, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. [SEAL] Notary Pu is Notarial Seal Sherry A. Rosenberry, Notary Public Fannett Twp., Franklin County My Commission Expires May 5, 2007 STATE OF PENNSYLVANIA COUNTY OF FRANKLIN SS. On this, the 18th day of July, 2003, before me, the undersigned officer, personally appeared Timothy R. Stine, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. [SEAL] otary P is Notarial Seal Sherry A. Rosenberry, Notary Public Fannett Twp„ Franklin County My Commission Expires May 5, 2007 STATE OF PENNSYLVANIA COUNTY OF FRANKLIN SS. On this, the 18th day of July, 2003, before me, the undersigned officer, personally appeared Daniel J. Stine, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notarial Seal Sherry A. Rosenberry, Notary Public Fannett Twp., Franklin County My Commission Expires May 5, 2007 STATE OF PENNSYLVANIA COUNTY OF FRANKLIN [SEAL] Notary Pu c SS. ~ CSC-~° On this, the ~~day of , 2003, before me, the undersigned officer, personally appeared Rebecca S. Stine-Dempsey, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~~ ~ ~L ~ d ~l_~..E:~'`~~ [SEAL] Notary Pub 'c Notarial Seal Sherry A. Rosenberry, Notary Public Fannett Twp., Franklin County My Commission Expires May 5, 2007 STATE OF PENNSYLVANIA COUNTY OF FRANKLIN SS. On this, the 30th day of June, 2003, before me, the undersigned officer, personally appeared Ray E. Stine, known tome (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. [ AL] Notary P lic Notarial Seal Sherry A, Rosenberry, Notary Public Pannell Twp., Franklin County My Commission Expires May 5, 2007 Exhibit A FIRST AND FINAL ACCOUNT FIRST AND FINAL ACCOUNT OF Ray M. Stine, Executor FOR ESTATE OF Doris E. Stine, Deceased Date of Death: November 7, 2002 Date of Executor's Appointment: December 12, 2002 Accounting for the Period: November 7, 2002 to June 30, 2003 Purpose of Account: Ray M. Stine, Executor, offer this account to acquaint interest parties with the transactions that have occurred during his administration. The account also indicates the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Richard L. Bushman, Esquire Counsel to the Estate 16767 Path Valley Road P.O. Box 51 Spring Run, PA 17262-0051 2 SUMMARY OF ACCOUNT Fiduciary Current Acquisition Page Value Value Proposed Distribution to Beneficiaries 2 078.71 Principal Receipts Net Gain (or Loss) on Sales or Other Dis- position Less Disbursements: Funeral Expenses Administration Expenses Fees and Commissions Balance before Distributions Risk Distribution to Ray M. Stine Principal Balance on Hand Income Less Disbursements Balance Before Distributions Distributions to Beneficiaries Income Balance on Hand Combined Balance on Hand 907.00 292.17 750.00 13,027.87 0.00 13,027.87 1.949.17 11,078.70 9,000.00 2,078.70 0.00 0.00 0 0.00 2, 078.70 RECEIPTS OF PRINCIPAL Fiduciary Acquisition Value Cash: Allfirst Bank -checking account 12,327.87 12, 327.87 Tangible Personal Property: 1986 Toyota Sedan 1992 Dodge Sedan Realty: [all tenants by entireties; no probate assets] TOTAL RECEIPTS OF PRINCIPAL: 200.00 500.00 700.00 0.00 $13,027.87 4 DISBURSEMENTS OF PRINCIPAL Debts of Decedent 0.00 0.00 Funeral Expenses 01/06/03 Cremation Society of Pennsylvania 907.00 .00 907.00 Administration Expenses 01/06/03 Register of Wills: JCP fee 10.00 01/06/03 Register of Wills: short certificates 15.00 01/06/03 Register of Wills: probate petition 74.00 01/06/03 Cumberland County Law Journal-estate adver- 75.00 tising 01/27/03 The Sentinel--estate advertising 78.17 07/00/03 Register of Wills (recording fee of Family Set- 17.00 tlement Agreement) 07/00/03 Notary Public 8.00 07/08/96 Register of Wills (inheritance tax return filing) 15.00 292.17 Fees and Commissions Ray M. Stine, Executor, 0.00 Executor's fees 07/00/03 Richard L. Bushman, Esquire, attorney's fees 750.00 750.00 $1,949.17 DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES TO: Ray E. Stine 01/06/03 Risk Distribution 9,000.00 TOTAL DISTRIBUTIONS OF PRINCIPAL $9,000.00 TO BENEFICIARIES 5 PRINCIPAL BALANCE ON HAND Cash In kind 1,378.70 700.00 $2,078.70 DISTRIBUTIONS OF INCOME TO BENEFICIARIES None. 0.00 PROPOSED DISTRIBUTIONS TO BENEFICIARIES Current value Fiduciary Per Article SECOND and THIRD of Will: Acquisition Value TO: Ray E. Stine [cash and in kind] 2,078.70 TOTAL: $2,078.70 Ray M. Stine, Executor, under the Last Will and Testament of Doris E. Stine, Deceased, hereby declares under oath that said Executor has fully and faithfully discharged the duties of his office; that the foregoing First and Final Account is true and correct, and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that, to his knowledge, there are no claims now outstanding against the Estate; and that all taxes presently due from the estate have been paid. Ray M. St' , Executor Subscribed and sworn to Nota Public b Ra E. Stine Notarial Seal ry y y Sherry A. Rosenberry, Notary Public this 30th day of June, 2003. FannettTwp.,FrankiinCounty My Commission Expires May 5, 2007 ~, , Notary P blic BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 RICHARD L BUSHMAN 16767 PATH VALLEY PO BOX 51 SPRING RUN COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX ~FP (01-037 DATE 08-11-2003 ESTATE OF STINE DORIS E DATE OF DEATH 11-07-2002 FILE NUMBER 21 02-1101 COUNTY CUMBERLAND ACN 101 RD Amount Remitted PA 17262 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER POR_TION_ FOR YOUR RECORDS ~ --------------------------------------------------- -------------------- REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMEWT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF STINE DORIS E FILE N0. 21 02-1101 ACN 101 DATE 08-11-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 1,949.17 10. Debts/Mortgage Liabilities/Liens (Schedule Il (10) .00 11. Total Deductions (11) 1 .949 17 12. Net Value of Tax Return (12) 328,731.88 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 328, 731.88 NOTE: If an assessment was issued previously, lines reflect figures that include the tot l f 14, 15 andior 16, 17, 18 and 19 will a o ALL returns assessed to da te. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 328,731.88 X 00 _ .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16l .00 X 045 - .00 17. Amount of Line 14 at Sibling rate (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 (19)= . 00 TAX CRE DITS- . DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED A5 A "CREDIT" (CR), YOU MAY BE DUE O RF FIIIJn CCC oX: (ielace crnr ..r ~..~.. ___.. ___ __._-_ (1) .00 NOTE: To insure proper (2) .00 credit to your account, (3) .00 submit the upper portion (4) .00 of this fora with your (5) 20 448.71 tax payment. (6) 310 , 232.34 (7) .00 (g) 330,681.05 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA: ss, COUNTY OF CUMBERLAND The petitioner above-named swears or affirms that the statements in the foregoing petition, are true and correct to the best of the knowledge and belief of petitioner and thafi as personal representative of the above decedent petitioner will well and truly administer the estate according to law. Sworn to or affirmed and sub- scribed before me this 25~' day of November, 2002. For the Register ~, ~~ -~y~ ~~~ ~ ~-r-~ File No, ~` ~~- Estate of Doris E. Stine Late of Southampton Township Cumberland County, PA, deceased. DECREE OI; PROEATE AND GRANT 0~ LETTERS AND NOW, this 25t'' day of November, 2002 in consideration of the petition on the reverse side hereof, satisfactory proof having been presgg ted before me, I7 IS DECRE~p that the instrument dated January 26,'1986, described thereir>'b~ admitted to probate and filed of record as the Last Will and Testament of Boris E. Stine and ~.e#ers Testamentary are hereby granted to Ray M. Stine. .~ ,~;,, ,.tom ~ .,rte .~~ ~.~..y. ~ ' rGr -~ Date of Death: November 7, 2002 Social Security No. 159-24-7808 Letters Testamentary issued _~~, y`... ~. fah ~, Bsebhman-ATTORNEY Sup. Ct. I.D. No. 36406 16767 Path Valley Road P.O. Box 51 Spring Run, PA 17262-0051 FAX: [717J 349-2952 Telephone: [717] 349-7657 REV-1500EX+(6-00) '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 /1.- /()6~7 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY Cf/ FILE NUMBER 21 -0 2 0 1 1 01 "'c51iNh"'COOE ----yEA~ - - NUMBER-- I- Z W Cl W (.) W Cl DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL) Stine Doris E. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) SOCIAL SECURITY NUMBER 159-24-7808 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER w .... ::.:;::g;lI) ,,"'''' w~(,) J:o::g ,,"-., "- " 11/07/2002 09/28/1928 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Stine Ra M. 00 1, Original Return o 4. Limited Estate 00 6. Decedent Died Testate (A\tac;hcopyofWiIl) o 9, Litigation Proceeds Received o 2. Supplemental Return D 4a. Future Interest Compromise (date or death afler 12-12.82) D 7. Decedent Maintained a Living Trust (Attach copy oITrusl) o 10. Spousal Poverty Credit (date of death between 12.31.91 and 1-1.95) D 3. Remainder Retum (date ordealh prior to 12-13.82} o 5. Federal Estate Tax Return Required _ 8, Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (AltachSchO) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATIONSHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Richard L. Bushman 16767 Path Valley Road FIRM NAME (If Applicable} .... z w c z c "- VI W '" '" c " P. O. Box 51 z o i= :3 ::l l- ii: <( (.) W 0::: TELEPHONE NUMBER 717 349-7657 S rin Run PA 17262 - --OFFICIAL USE ONLY c;C ~. d ...; \....o.J r,;! 3. Closely Held Corporation, Partnership or Sole-Proprietorship '--- <= r- 20;448.71 I '-" 4. Mortgages & Notes Receivable (Schedule 0) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10, Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11, Total Deductions (total Lines 9 & 10) 12, Net Value of Estate (Une 8 minus Line 11) 310,232,34 --.0 00 VJ (8) 330,681.05 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) 1,949.17 13. Charitable and Governmental BequestsfSec 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= <( I- ::l a. :!ii o (.) >< <( I- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 19. Tax Due 328,731.88 X L- (15) x _(16) X .12 (17) X .15 (18) (19) (11) (12) (13) 1,949.17 328,731.88 16. Amount of Line 14 taxable at lineal rate (14) 328,731.88 17. Amount of Line 14 taxable at sibling rate 18. Amount of Une 14 taxable at collateral rate 20. [8] CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < '" Decedent's omDlete Address: STREET ADDRESS 1481 Newburo Road , I CITY I STATE I ZIP Shippensbura PA 17257 C Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pnor Payments C. Discount (1) 0.00 0.00 0.00 TotaICredits(A+B+C) (2) 3. IntllfllStJP8Ilalty if applicable D.lnterest E. P8Ilalty 0.00 ODD TotaIlntllfllStJP8Ilalty ( 0 + E ) (3) 4. If Une 2 is greater than Line 1 + Line 3, ente< the dl~ce. This is the OVERPAYMENT. Check box on Page 1 Line 20 to raquest a refund (4) 5. ~ Une 1 +Une 3 is greater than Line 2, 8Ilterthedlfference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BAlANCE DUE. (5B) Make Check to: REGISTER OF AGENT 0.00 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 00 b. retain the nght to designate who shall use the property transferred or its income; ........................................ D IXI c. retain a reversionary Interest; or ...................................................................................................... D IXI d. receive the promise for life of either payments, benefits or care? ............................................................. D 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................. D 00 3. Did decedent own an 'in trustfcx' or payable upon death bank account or secunty at his or her death? ................. D 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................ ...................... ......... D IXI IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ADDRESS / If 8i lYf4vb ADDRESS PA 17262-0051 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 I, 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)). 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 retum 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 linea beneficianes is 4.5%, except as noted In 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(I)J. 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"". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Stine Doris E FILE NUMBER 21 02 01101 Indude 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, Allfirst- checking acc!. # 0025691082 12,323,98 $12,322,80 plus $1,18 accrued interest 2, Allfirst-IRA acc!. #87006167133247 7,424,73 $7,384.49 plus $40,24 accrued interest 3, 1986 Toyota Sedan 200,00 4, 1992 Dodge Sedan 500,00 TOTAL (Aiso enter on line 5, Recapitulation) $ (If more space IS needed, Insert additional sheets of the same size) 20448,71 """'EX."'".. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~>_~a SCHEDULE F JOINTL Y.OWNED PROPERTY ESTATE OF Stine Doris E. If an asset was made joint within one year of the decedenfs date of death, it must be reported on Schedule G. FILE NUMBER 21 02 01101 SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Ray M. Stine 1481 Newburg Road Shippensburg, PA 17257 husband B c JOINTLY-OWNED PROPERTY: LETTER DATE DES~PTION OF PROPERTY %QF DATE OF DEATH ITEM FOR JOINT MADE Include ncmeoffinancial institution and balk account number or similar identifying number. Attam DATE OF DEATH DEWS VALUE OF NUMBER TENANT JOINT deedforjointly./'leldrealestate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. real estate located at 1481 Newburg Road 550,000.00 50. 275,000.00 Shippensburg, PA 17257 tenants by the entireties 2. A. 6/28/81 Allfirst Bank, checking ace!. #0097538175 10,424.41 50. 5,212.21 tenants by the entireties 3. A. 6/04/97 Allfirst Bank, Money Fund ace!. #0098019643 1,022.71 50. 511.36 tenants by the entireties 4. A. 6/04/97 Allfirst Bank, Money Fund ace!. #0098019651 11,11763 50. 5,558.82 tenants by the entireties 5. A. 3/16/84 Allfirst Bank, savings ace!. #87004600435915 1,688.27 50. 644.14 tenants by the entireties 6. A. 1/07/00 Allfirst Bank, CD ace!. #80000002237443 18,208.47 50. 9,104.24 tenants by the entireties 7. A. 1/02/97 Allfirst Bank, CD ace!. #87008140627844 13,960.64 50. 6,980.32 tenants by the entireties 8. A. 4/10/97 Allfirst Bank, CD ace!. #87008140763152 14,042.49 50. 7,021.25 tenants by the entireties TOTAL (Also enter on line 6, Recapitulation) $ 310232.34 (If more space IS needed, Insert additional sheets of the same size) ~'''':X''''''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Stine Doris E 21 02 01101 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Cremation Society of Pennsylvania 907.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (5) Ray M. Stine Social Security Number(s) I EIN Number of Personal Representative(s) Street Address 1481 Newbur~ Road City Shippensbur~ Slate PA Zip 17257 Yea~s) Commission Paid: waived 2. Attorney Fees Richard L. Bushman, P. O. Box 51, Spring Run, PA 17262 750.00 3. Family Exemption: (If decedenfs address is not the same as daimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees JCP fee ($10.00), short certificates ($15.00), probate petition ($74.00) 99.00 5. Accountanfs Fees 6. Tax Return Prepare~s Fees 7. Cumberland Law Journal - advertising 75.00 8. The Sentinel - advertising 78.17 9. Notary Public 8.00 10. Register of V\>1l1s - filing fee for Family Settlement Agreement 17.00 11. PA Inheritance filing fee 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 1949.17 (If more space is needed, insert additional sheets of the same size) REV15~3EX~(* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER Stine Dc ris E. 21 O? 01101 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [indude oU~hts~usal distributions, and transfers under 8ec.9116(a (1.)] 1. Ray M. Stine husband 100% 1481 Newburg Road Shippensburg, PA 17257 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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space IS needed, Insert addlllonal sheets of Ihe same size) a~d Hanover High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/24/2004 BUSHMAN RICHARD L ESQ P 0 BOX 51 SPRING RUN, PA 17262 RE: Estate of STINE DORIS E File Number: 2002-01101 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: 11/07/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLEN-DA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge STATUS REPORT UNDER RULE 6.12 NameofDecedent: btg[~T~ ~-, DateofDeath: hlovem ber WillNo.: ~ - ~//~] A~n. No.: Pursuit to Rule 6.12 of ~he Supreme Coral O~phans' Coral Rules, I repo~ the following with respect ~o completion of ~e admi~stration of the above-captioned estate: 1. State whether a~inismation of~e estate is complete: Yes ~ No ~ 2. If~e ~swer is No, state when the personal representative reasonably believes that the a~s~ation will be complete: :. 3. If the ~swer to No. 1 is Yes, state the follow,g: a.Did the personal representative file a ~al account with ~e Co~ Yes / No ~ b. The sep~ate OCh~s' Co~ No. (if any) for ~e personal repres~ffiative's accost is: c. Did ~e personal representative state an accost i~o~ally to the p~ies ~terest?Yes ~ No ~ c. Copies of receipts, releases, joinders ~d a~ ~offo~ p~ i~o~al accosts may be filed wit~ ~:r~ ~~~ ~dmay be a2ached to t~s repo~~ Telephone No. C~Dacity: ~ Personal Represent~dve ~ounsel for personal representative