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HomeMy WebLinkAbout02-1048PETITION FOR PROBATE and GRANT OF LETTERS Estate of =~f~ L ~ 2 also known as r' Deceased. Social Security No. 1~~~ - ~ ~ ~ 5~~5"~' i Your petitioner(s), who is/are 18 years of age or older an the e~cut oR S named in the last will of the above decedent, dated / 8 ~ daN c,F Fl ~ ~T , 19 and codicil(s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~u,r-. F3 a z../va~ County, Penns Ivan~,a, ith h ~r ~ last fami y or principal resi ence at i'a~ v W wT~ S T 1~~2,/ ~ l~ ~~ ~ 7~ ~~ ~<~ ~. a ~.~_ C3 ~ Lei? ~ /s /LO (list street, number and muncipality) Decendent, then ~C7 years of age, died f ~ - /d , ~o Z at /C'c"c^ its : ~or_~Tl. S7" ~".Q-,r~~ c ~- ~'n. /7~' /',3 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 $ ,3~'0~~ (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: ~~ ~ The petition of the undersigned respectfully represents that: No. 21-02-1048 To: Register of Wi is for the County of > in the Commonwealth of Pennsylvania WHEREFORE, petitioner(s) respectfully request s) the probate of the last will and codicil(s) presented herewith and the grant of letters /~ s % ~ ~ t~l~~~ (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. U b n N ~ ~i C ~0 0 ~~ ~.. ~~ ~° ~~ /v ~. Q % j .~ Ctn.?-live` ,St ~~~~ ' ~s ~~ i7~~1S" /~ T C OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1 ss COUNTY OF ~'~ : ~e'~ C~ti~ 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 according to law. Sworn to or affirmed and subscribed before me this 22nd day of NOVEMBER ~~2002 Register .~ ry ~ ~ ~ A 0 /~ ID o2-/~ Np, 21-02-1048 Estate of PEARL V FRY ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW NOVEMBER 25 ~~j2002 , in consideration of the petition nn the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated AUGUST 18, 1978 described therein be admitted to probate and filed of record as the last will of PEARL V FRY -, and Letters ` TESTAMENTARY ~ _-_- are hereby granted to MARLIN E FRY ANIl ('ARV R FRY FEES Probate, Letters, Etc. ......... ~ 25.00 Short Certificates( ) .......... ~ 3.00 ~a~es. 3.00 e u Batton ................ ~ JCP ~ 10.00 TOTAL $ 41.00 Filed ..NQVE~$~~ .25,..2,Q02 ............ . Register of Wills ATTORNEY (Sup. Ct. LD. No.) .ADDRESS PHONE 02 I Dot - I p .~ REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that present and saw the testat ,sign the same and that signed as a witness at the request of testat in l~_ presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of (Name) 19 Register (Address) (Name) (Address) REGISTER OF WILLS OF ~ ~-~.,h.~ ~ COUNTY OATH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) berg duly qualified according to la~depose(s) and say(s) that r~,i ~~'F familiar with the signature of F r~ L i/~. ~, ciadi~ci~- testat ~ ~~ of (one of the subscribing witnesses to) the will presented herewith and _ cvtiicT that L~` 1= b-~..~~ .,~ ~ believes the signature on the will is in the handwriting of ~._. to the best of i !/,~ i ~' __ knowledge and belief. Sworn to or affirmed and ~sbscribed before me this 22nd _ day of R ~~ ~~ ~~~~~, ~- Register !Name) ,~ ~ ,,/ (Address) ~ / (Name) (Address) ~ ~ ~ } t 21-02-1048 LAST t1ILL AND TESTAT~IENT OF PEAfiL V. FRY I, PEARL V. FRY, of Dickinson Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, in manner and form following: 1. I hereby expressly revoke all t:Jills and Codicils hereto- fore made by me. 2. I hereby direct my Executor to pay all my just debts, funeral and administrative expenses out of my estate, as soon as practicable after my death. 3. Should my husband, John L. Fry, survive me for a period of thirty days fo17_owing my death, I de~Tise and bequeath the re- mainder of my estate to John L. Fry. 4. Should my husband, John L. Fry, predecease me or die on or bE:fore the thirtieth day following my death, I devise and bequeath the remainder of my estate to my issue living on the thirty-first day following my death, per stirpes. 5. I nominate and appoint my husband, John L. Fry, as Executor of this my Last t,Ti11 and Testament; and as substitute Executors I nominate and appoint my children, Marlin E. Fry and Gary R. Fry. I further direct that my personal representatives shall not be required to file bond or security in any jurisdiction, IN tTITNESS t~THEREOF, T have hereunto set my hand and seal this ~ ~"---- day of I:~~"'-~~ ~vt~ , 1978. __ I~e~-~r~V: ry G' ~ _ Signed, sealed, published and declared by the above named Testatrix, PEARL V. FRY, as and for her Last 4Ji11 and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ----,_ _ __ ~~. U~-^~..,n,c.~ ~ - ~ ~2 _Q__, r- - 2 - ro ~ r c ~ ~~ ;~ ~c ~~ CERTIFICATION OF NOTICE UNDER RULE 5.6(al Name of Decedent: PEARL V . FRY Date of Death: November 10, 2002 Will No. 21- 0 2 -10 4 8 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiazies of the above-captioned estate on December 3 0 , 2 0 0 2 Name Address Alfred L. Fry 200 Burnett Road, Rm. 914, Ft. [dorth, TX 76102 Kenneth L. Fry 308 Walnut Street, Boiling Springs PA 17007 Marlin E. Fry 11 S. Walnut Street, Mt. Holly Springs PA 17065 Linda L. Carver 440 C Street, Carlisle PA 1701:3 Patricia A. Shanholtz 121 E. South Street, Carlisle PA 17013 Gary R. Fry 1462 Goodyear Road, Gardners PA 17324 Notice has now been given to all persons entitled thereto under Rule 5.6(a) ~cP~l~ Date: December 31, 2002 ~~~,w~~~~~'yfj-L,,.~.~ Signature Name Patricia R. Brown Address 10 West Pomfret Street Carlisle PA 17013 Capacity: Telephone( ) 717-249-3024 Personal Representative R Counsel for personal representative EV.1500E'O::6-00: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 HARRISBURG, PA 17128-0601 11-(OJ.~13 REV-1500 ONLY v ()i;;,CiJ\'~. w ..., ::s:::!cn u"'''' w"-u ,,00 u"'~ ,,-", "- '" FILE NUMBER 21_02 048 INHERITANCE TAX RETURN RESIDENT DECEDENT o 1 COUNTY CODE YEAR NUMBER I- Z W C W o W C OECEOENTS NAME (LAST, FIRST, ANO MIOOLE INITIAL) FRY, PEARL V. OATE OF OEATH (MM-OO-YEAR) OATE OF BIRTH (MM-OO-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER SOCIAL SECURITY NUMBER 162 36 9561 11/20/02 3 18 13 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, ANO MIOOLE INITIAL) ~ 1. Original Return D 4. Limited Estate ~ 6. Decedent Died Testate (Atlach copy afWill) D 9. Litigation Proceeds Received D 2, Supplemental Return D 4a. Future Interest Compromise (date 01 death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy ofTrust) D 10. Spousal Poverty Credit (dale 01 death between 12-31-91 and 1-1-95) D 3. Remainder Return (date of death prior 10 12-13-82) D 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) ..., Z W C Z C "- '" w '" '" C u tHl$$RTl()1il NAME .. Patrlcla R. Brown COMPLETE MAILING AOORESS FIRM NAME (II ApPlicable) 10 West Pomfret Street Carlisle PA 17013 TELEPHONE NUMBER (717) 249-3024 1, Real Estate (Schedule A) (1) (2) (3) (4) (5) o o o o 12,249.74 z o !;;: ...J :J !::: 11. <C o w 0:: 2 Stocks and Bonds (Schedule B) 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) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (7) o (6) o (8) 12,249.74 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) 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) (9) 10,819.82 92,612.72 (10) (11) (12) (13) 103,432.54 14. Net Value Subject to Tax (Line 12 minus Line 13) (91,182.80) (14) SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES z o !;j: I-' :J 11. ::i: o o ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) ,0_ (15) x.O_ (16) x .12 (17) x .15 (18) 0 (19) 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 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS 1000 West South Street (Sarah A. Todd Memorial Home) CITY I STATE FA I z'f7013 Carlisle Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) o Total Credits (A + B + C ) (2) 3. InteresUPenally if applicable D. Interest E. Penalty TotallnteresUPenalty ( D + E ) (3) 4. If Line 2 is 9reater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (58) A. Enter the interest on the tax due. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS o ...........0 ...........0 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;.. .. b. retain the right to designate who shall use the property transferred or its income;.. c. retain a reversionary interest; or.... d. receive the promise for life of either payments, benefits or care?.. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .. 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.. 4. Did decedent own an Individual Retirement Account, annuity, or other non~probate property which contains a beneficiary designation? . Yes o .............0 .....0 ...0 No [R] [R] [R] [R] ~ ~ Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete Declaration of preparerother Ihan Ihepersonal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS 3 03 SIGNATURE;:U; PREPARER OTHER THAN REPRESENTATIVE \I-"'~ . ~ ADDRESS DATE 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. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii) 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)]. 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. 99116(a)(1.3)]. 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. . LAST HILL AND TESTAMENT OF PEARL v. FRY 1, PEARL V. FRY, of Dickinson Township, Cumberland County, Pennsylvania, declare this instrument to be my Last will and Testament, in manner and form following: 1. 1 hereby expressly revoke all wills and Codicils heret fore made by me. 2. I hereby direct my Executor to pay all my just debts, , , funeral and administrative expenses out of my estate, as soon E " " practicable after my death. 3. Should my husband, John L. Fry, survive me for a peril of thirty days foHowing my death, I devise and bequeath the rl mainder of my estate to John L. Fry. 4. Should my husband, John L. Fry, predecease me or die, or before the thirtieth day following my death, I devise and bequeath the remainder of my estate to my issue living on the thirty-first day following my death, per stirpes. 5. I nominate and appoint my husband, John L. Fry, as Executor of this my Last Will and Testament; and as substitutl Executors I nominate and appoint my children, Marlin E. Fry al Gary R. Fry. I further direct that my personal representativ shall not be required to file bond or security in any jurisdi IN vITTNESS HHEREOF, I have hereunto set my hand and seal this lt~ day of ~~ , 1978. ,r .~ ,~{",,,{ <i F'/'l ear V. ry ? Signed, sealed, published and declared by the above named Testatrix, PEARL V. FRY, as and for her Last will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. , , ~tJ~ ~ \i-~<,-- 'F' I~I .~ _ IJ.vL -'.~ ~, ,evl""""''''''. COMMONWEALTH OF PENNSYLVANlA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER FRY, PEARL V. 21-02-01048 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Sc.hedule F. ITEM NUMBER 1. DESCRIPTION Citizens Bank Checking Account Acct. 6100681335 . VALUE AT DATE OF DEATH 3,83t,.93 2. Citizens Bank Funeral Plan Acct. 289E61047 8,414.81 TOTAL (Also enter on line 5, Recapitulation) $12, 249 . 74 (If more space is needed, insert additional sheets of the same size) "".'''''''1'''1. COMMONWEALTH OF PENNSYLVANIA INHERIT ANeE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER 21-02-01048 FRY, PEARL V. Debls of decedenl must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1 Ewing Brothers Funeral Home 6,490.00 Professional Services & Equipment Opening Grave, death certificates, misc. 1,253.00 Food service after funeral (Country Butcher Shop) 197.82 Flowers 98.00 Transportation costs (from Alaska & Alabama) 880.00 B. ADMINISTRATIVE COSTS: 1 Personal Representative's Commissions Name ofPe<sonal Representalive(s) Marlin E. Fr) and Gary R. Fry ~1': ( ) 750.00 Social Security Numbe~5) I EIN Number 0 arsonal Representa 've(s Street Address (N. Frv) 11 S. Walnut St. Nt. Hollv Spring c('1 State FA Z 17065 G. Fry) 1462 Goodyear Rd, Gardners pt 17324 Year(s) Commission Paid: 200, ($375.00 each) 2. Attorney Fees Patricia R. Brown, Esquire 1,000.00 3. Famlly Exemption: {If decedent's address is not the same as claimant's, attach explanation} Claimant Street Address City Slale Zip Relalionship of Claimant to Decedent 4. Probate Fees Petition, Short Certs 41. 00 5. Accountant's Fees 6. Tax Relurn Preparer's Fees 7. File PA Inheritance Tax, Closing Papers, Misc. final costs 110.00 TOTAL (Also enter on line 9, Recapitulation) $ 10,819.82 (It more space is needed, insert additional sheets ot the same size) RfV_IS12EX<(I 9l) ~_ ~~ '~~~ COMMONWEALTH OF PENNSYLVANIA lNHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FRY, PE}I;RL V. FILE NUMBER 21-02-01048 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. Sarah A. Todd Memorial Home (final statement) 833.00 2. Department of Public Welfare Claim Class 3 - $22,724.59 Class 6 - $69,055.13 (see attached letters) 91,779.72 TOTAL (Also enter on linE: 10, Recapilulalion) $ (If more spaCE is needed, mser\ additional sheets of the same size) 92,612.72 ....""-> .' . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT Of' PUBLIC WELFARE BUREAU OF FINANCIAl- OPERA-lIONS ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 17105-8486 January 07, 2003 PATRICIA R BROWN ESQUIRE 10 WEST POMFRET STREET CARLISLE PA 17013 Re: PEARL FRY CIS n: 440149023 SSN: 162-36-9561 Date of Death: 11/10/2002 Dear Ms. Brown: Please be advised that the Department of 'Public Welfare maintains a claim in the amount of $91,779.72 against the above-mentioned estate. This claim is for restitution of medical assistance granted on behalf of the decedent for which the Probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective August IS, 1994, as amended by Act 20-95. effective June 30, 1995. Enclosed is the Department's itemized statement of claim. A portion of this medical expense, namely $22,724.59, was incurred during the last six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C,S.A. 3392(3). The balance of the claim, namely $69,055.13, is to be entered as a priority Class 6 claim against the estate. Please acknowledge receipt of this letter and advise whether the Commonwealth's claim is admitted and when~~ayment may be expected. If the estate accounting is complete, please provide a copy. If the estate contains real estate. please provide copies of ~he deed, the latest tax assessment, and a current appraisal, if available. Sincerely, ),' ./ "'Y" , /' "f' Y'{J',- I /, L i /t" v "c- Nicole L. Early TPL Program Investigator 717-772-6606 717-772-6553 FAX Enclosure ''''"''''',.,,'''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE lAX RETURN RESIDENT CEDENT ESTATE OF NUMBER I. SCHEDULE J BENEFICIARIES FRY, PEARL V. FilE NUMBER 21-02-0148 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include oulright spousal dislributions) No beneficiaries will receive property due to insolvency of estate RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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 I $ (If more space is needed, insert additional sheets of the same size) C- ESTATE OF-PE,PsRL V. FRY NO. 21-02-01048 ~__ W_._ .. ___-_ ~.---' FAMILY SETTLEMENT AND FINAL RELEASE KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Pearl V. Fry, late of Carlisle, Cumberland County, Pennsylvania, deceased, died testate on November 20; 2002; having first made her last Will and Testament, which was duly executed on August 18, 1978, and is duly recorded at the Register of Wills in Cumberland County, Pennsylvania. WHEREAS, letters of testamentary on the estate of the said decedent were duly issued by the Register of Wills of Cumberland County, Pennsylvania, to Marlin E. Fry and Gary R. Fry, Executors, hereinafter called personal representatives; WHEREAS, the said personal representatives have gathered the assets of the estate of the said decedent and the assets consist of only personal property, to a total value of $12,249.74, as set forth in Exhibit A, which is a statement of account of the said personal representatives, and which is attached hereto and made a part hereof, and marked Exhibit A; WHEREAS, the debts and deductions amount to $102,552.54 leaving no balance for distribution, also as set forth in the statement of the said personal representatives, which is attached hereto and marked Exhibit A; Page 1 of 4 WHEREAS, the following is a list of all known unpaid creditors, said creditors having been informed by letter of the insolvency of the estate, and the amount of their claims, which will not be paid due to said insolvency: Name Amount PA Dept. of Public Welfare $91,779.72 Paid on account ($ 1472.92) NOW, THEREFORE, KNOW YE, that we, Marlin E. Fry and Gary R. Fry, Alfred L. Fry, Kenneth L. Fry, Linda L. Carter, and Patricia A. Shanholtz, being all of the children of the said decedent, and being those persons entitled to inherit under said last will and testament, do hereby acknowledge that because of the insolvency of the estate there are no funds for distribution; AND, each of us does hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, we agree that no account is necessary. THEREFORE, we and each of us does hereby remise, release, quitclaim and forever discharge the said personal representatives, Marlin E. Fry and Gary R. Fry, their heirs, executors, and administrators and assigns, of and from the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever touching upon the estate of the said decedent, and we do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this agreement, we do Page 2 of 4 hereby covenant and agree with the aforesaid personal representatives that we will contribute pro rata our share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representatives after the signing, sealing an delivery of this family settlement agreement and final release. IN WITNESS WHEREOF, we have hereunto set our hands and seals this 07© day of ~-~-~r~-~~ , 2003. Witn ~ Witness COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. /~ ,.., Marlin E. F~ryy .. `~ Gary R. l~ry On this, o?~ ~- day of , 2003, before me, a notary public, the undersigned officer, personall appeared Marlin E. Fry and Gary R. Fry, (known to me or satisfactory proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and offic~i/al seal. _~ `y'am ~ ~k x-~-e~cc~ Notary Public ANN~~ ~ ~~ fNIRI.l3LE lORO ql ERIJIND t~UI~tTY MAY I3 2007 EXHIBIT "A" Page 3 of 4 .....,......«., ~ .;~ S~ ~ ~w~ . • ASSETS: 1. Personal Property: CITIZENS BANK Checking Account Acct# 6100681335 2. CITIZENS BANK Funeral Plan Acct# 289E61047 Total Assets DEBTS AND DEDUCTIONS: 1. Deductions: Funeral Expenses Administrative Costs Total Deductions 2. Debts: Nursing Home PA Dept of Public Welfare Total Debts TOTAL DEBTS 8a DEDUCTIONS: BALANCE FOR DISTRIBUTION: Heirs: Alfred L. Fry Kenneth L. Fry Marlin E. Fry Linda L. Carver Patricia A. Shanholtz Gary R. Fry Page 4 of 4 $ 3,834.93 $ 8,414.81 $ 12,249.74 $ 8,038.82 $ 1,901.00 $ 9,939.82 $ 833.00 $ 90,302.80 $ 91,135.80 $ 101,075.62 None ($ 88,825.88) Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/24/2004 FRY GARY R 1462 GOODYEAR ROAD GARDNERS, PA 17324 RE: Estate of FRY PEARL V File Number: 2002-01048 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: 11/10/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge STATUS REPORT UNDER RULE 6.12 Name of Decedent: Pearl V. Fry Date of Death: Will No. 21-02-01048 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 X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes X No~.Filed Family Settlement Agreement with Register of Wills b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. g_~/~" / Signature ~q Patricia R Brown Esquire ~- Name (Please type or print) (2f3 - . 10 West Pomfret Street Carlisle~ PA ~ 17013 cD ' '~': Address ( 717~ 249-3024 Tel. No. Capacity: Personal Representative X Counsel for personal representative (MAH:rmf/AM3)