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Home My WebLink About02-0994Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of AUGUSTUS G. FICKES No.~l "V~~ ~ ` also known as Deceased Social Security No. 206-10-8155 James P. Fickes and Barbara F. Mull Petitioner(s), who is/are 1 S years of age or older, applylies) for: (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitionerls) ~/are the execut ors named in thandascodlicolslhdated ®Decedent, dated December 4, 1986 State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: NO EXCEPTIONS B. Grant of Letters of Administration Id.b.n.c.t. a.: pendente lire; durante absentia; durante minoritate) Petitionerls) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/~r last family or principal residence at 325 Wesley Drive, Lower Allen Twp Cumberland Cty PA (list street, number and municipality) Decedent, then 89 years of age, died October 31 , 2002, at Slane Res of Hospice of Central PA, lta~at~o"~A Dauphin County, Decedent at death owned property with estimated values as follows: All ersonal property ................................................................5 200 000 (lf domiciled in PA) P (lf not domiciled in PA) Personal property in Pennsylvania ...............................................5 (lf not domiciled in PA) Personal property in County .......................................................5 Value of real estate in Pennsylvania ...................................................................................................$ ~ 000 Total ................................................................................................................................ _~0~ Real Estate situated as follows: Wherefore, Petitionerls) respectfully requestls) the probate of the last Will and Codicillsl presented with this Petition and the grant of letters in the appropriate form to the undersigned: Si nature Typed or printed name and residence G F.--~~~..~ James P. Fickes Barbara F. Mull 1704 Carlisle Road Camp Hill, PA 1701 Form RW-1 Page 1 of 2 (Cumberland County) -Rev. 9/92 ~-/ i7 /S (COMPLETE IN ALL CASES:) Attach aaaluonal meets ll liot.oaaar r• Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estatf a according to law. Sworn to and affirmed and subscribed ~.G~- ~ ~ ~~ JAMES P. FICKES before me this 5th day of 2002 BARBARA F. MULL No. 21-2002-994 Estate of AUGUSTUS G. FICKES Deceased Social Security No: 206-10-8155 Date of Death October 31, 2002 AND NOW, November 6th , 2002 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ®Testamentary ^ of Administration d.b. n.c.t.; pendente lire; durante absentia; durante minoritate are hereby granted to James P. Fickes and Barbara F. Mull in the above estate and that the instrument(s) dated December 4, 1986 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........................... $ 235.00 Short Certificatels).7........ $ 21.00 Renunciation .................. $ Affidavit ( 1 ................. $ Extra Pages (2 )............ $ 6.00 Codicil .......................... $ JCP Fee ........................ $ 10.00 Inventory ....................... $ Other ............................ $ TOTAL ................ $ 272~.Q_- Form RW-? Page 2 of 2 (Cumberland County) -Rev. 9192 ~.~ Register of Wills Donny M~Cltto, 1st Depu Attorney: ark R. Parthemer, Esq. I.D. No 50875 Address: c/o McNees Wallace & Nurick LLC P.O. Box 1166 , - Telephone ~7~ ~~ ~~7-550 MAILED LETTERS TO ATTORNEY ON November 6th, 2002 l ,..i -,, ; - , ,.; ~ ~ .~__ _tl .,: ,. ~, ,, ,, .. ,, , ,..:. r :. r, ,: , i_ 7 .. - t _ _~... r~rl ~~ i^"~IE.r .a}.£`~'G i.ai b ~.i~f d.,4 P 8643441 __ '~+3 Hev 2187 ._... -"" , _ _ 114 ~ ~ _ 3 ~~OZ _ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH ~TAIE G~IE ~IIMBER ~_~.._-..m ---~- -------- - - NAME OF DECEDENT IF cast. Middle. coal SE% SIiCIAL SECURITY NUMBER DATE OF LfJ\7H vMCnm. Oay rear) ,. Au ustus G. Fickes ,.male ].206 - 10 -155 t.31,2002 g AGEILaslertndayl UNOERIYEAR UNOERI DAY DATE OF BIRTH ~BIRTMPLACE :C•ry xtl PLACE OF UE ATHIinccn gay,li~ xe+~svrr:larn on gher vuei _ __ ~-- _-_-~ -- OTHER Months a Days Flows . Minuisa Munm OaY revel SlawgruerJn Counuyl HOSPITAL y/ ^ OI~ 1 OOA G 1 ^ ~ ^ ' U EFVOutpanem _ Inpatwnl R.sNererw Home 89 Yra c.5,1913 ~-Iarrisburg,PA ~'" / C s e y, • COUNTY OF DEATH CfTY, BORO. TWP OF DEATH FACILITY NAME III nut ~nsr~n,tr,n. gwe asset antl rwmDen WAS DECEDEN--TIlOf HISPANIC ORIGIN? RACE -American Iredan, &ack, wnae. etc. ISpecM) J II ysa sp•cay CUDan No ~ 1'a• L ' . . . . Dauphin Co. Susquehanna Twp. Slane Res. of Hospice of Central PA9•~n•P°•^eRran.y< ebonite w. k. w. DECEDENT'S USUAL OCCUPATION KIND OF BUSINESS/1NDUSTRV WAS DECEDENT EVERIN DECEDENT'S EDUCA710N MARITAL STATUS~Manwd SURVIVING SPOUSE U.S. ARMED fORCES? 5 i au n, icst. ode corn lelgl Newr Marru,d. Widowed. III wJe. 9iw maal~narnel 1Gwe Wntldvgrk dwee Ounrg rtgbt d working Bb; tlo rid use reared l E4mentsrylSecorWary Cdlege Dwaced ISne<sYl Y N ^ ~ • •s o ./ ~ 2 (D 121 Il dq 5.1 widower s stem o ration ectric utllit , . s. Y Pe ,~ Y ,:. , . ,,. . DECEDENT'S MAILING ADDRESS (Sneer. C~IylTOVm, Stale. Z4 Cafe1 ~ m LowerA en DECEDENT'S Penns lvania D y D„ „<-I[]Ve.. M<sd.nl veO ACTUAL 17a. Stale ~ 325 Wesley Dr RESIDENCE o•`•tle" . PA 17055 Mechanicsburg ISee mslructaru Iwe m . Onanervtlel Cumberland '°w"~nw? „'° d°`°dBA1b"ed n e f ^ , tti. in a<tuy rnes o a _cM/DOro. 17D. County 17d. -- ___ _-__ FQHER'S NAME (Full. Midas. Last) MOTHER'S NAME eFrst. MNOIe. MaOen Surname) Charles Fickes „O'Ti11a Myers INFORMANT'S NAME (Typa~Prmp INFORMANT'S MAILING ADDRESS ISvey, C~ty7TUwn, SIBIe, Zip Codel James Pe Fickes ~D704 Carlisle Rd. Cam Hill PA 17011 2w METHOD OF DISPOSITION DATE OF DISPOSITION PUCE OF DISPOSITION-Nama of Cemetery, Crematory LOCATION-CrtylTOwn, Stale, Zp Cow Rural ~ Cremalm ^ Removal horn Stale ^ IMOrun, Day' Year) or OIMI Plxe ~,,,, a„„ ,y, ^ Nov.4,2002 Rolling Green Cem, war Allen Twp.,PA17011 . :,•. ~ 2,D. 2m. rd. ' SIG OF FUNE L 5 VICE LICENSEE OR PERSON LNG AS SUCH LICENSE NUMBER 2=DFD-013163-L NAME AND ADDRESS OF FACILITY < FH &65,324 H~nnp]- Ace.,Iatv7r)e,PA17043 le Gems 23ac only wMn ceniryng _ b tM Dest d my kn0 urred al aM place sealed. LICENSE NUMBER DATE SIGNED IMmdv, DaY, Year ' phydr<Nn brat avaaaDll al llm•Ol dBdlh to ($igrWlure Mlle) - 1 ~' D •7 C1 L ~ t - 3 candy ruse of death. ~ , • aa.. 2]b. ', r 1 2x. X~ Hems 2a-28 must be completetl Dy TIME OF - DE OIM h. Day. Pearl WAS CASE REFERRED TO MEDICAL E%AMINERICORONER? r~tea~(( ~ Ysa ^ NqC h - _ . ,,. parson wrw prorqunces deat ~ ~ -~ fa:~ ~ ) ~ / . 36. 25 r ~~ M . . Ze. 27. PART I: Enter 1M d~seasBS, inlunes or compncaleOru whKh roused tM de th DO rot solar Ih• nwda of dying, such as <yaa<Or resVO Cory auasl, snick Or read IaJwe. I ApprorunaN - PART II: Dlher srgndKaM WredaioK conlriWling to deem. trot ~ ~Mervy Dantean rid resu%up m st• undenyery Wwe 9wM m PRAT 1. Lull Dory OM cause on BaU NM. orual aeW deem ( !" ; - IYYEgATE CAUSE (Final asease °r <orWnwn _ ~(\~ ~ /' p ~~ ~~(}-G~ A3u`' ~-~.L,yv'~YW" l ~- ~ te __ _.-_ 7MI-?(_ ~ ~N/ti a. resulingndeaml-• DUE iD IDA AS ACONSEOUENGE OF): ~ seanerniyry Iqi coetatione D. a arty, I•aMrtg to xnmediate DUE 7D IOR AS A CONSEQUENCE OFD: l I muss. Emw UNOERLYINO - • ~ CAUSE ID~sease a ~nF,ry c. - -t- say Bwaled evems WE lO (OR AS A CONSEQUENCE OF): I . rewYB,g In tleaml uST ~ - d __------ -- --.. - _ _ _ _ WAS AN AUTOPSY WERE AUTOPSY FINDINGS MANNER Of DEATH DATE OF INJURY NME Of INJURY INJURY AT WORK? DESCRIBE FIOVY INJURY OOCURAED. PERFORMED? AVAILABLE PRIOR TO IMmm. Oay, Year) COMPLETION OF CAUSE OF DEAM7 ^ Nywy ~. lloen+cids Yes ^ N° ^ A<cWent ^ Perldsg lnvesngatgn ^ ^ N ~ ^ No ^ Ye Sue<lee ^ COUId rbl Da determined ^ 70a. _ ]9b. M. ]ec. ___ ]Del. _._.-______ PUCE OF INJURY ~ AI Ipme, farm, sIre91. laclory, o11Ke LOCATION ISneet. GryR vn. Swat o . Yes s DuBdng, aK.ISpncavl 2M. 2•D. Ig. ]01. _ CERTIFIERICnak only qwl onq,nced deem erica canu~eled aenr 27I an Has r n ngri sK th r a~ d ' SIGNATUR AN TITLED R R 1T(ry\ ~ , w e a e v dea w CERTIFYING PHYSICIAN IPnyscan ceryy~ng cause ................... T° Ilv Deal O, mV krowNdge, death o<curred due b me <auae(al and manner a• sialed ........................ ~ _~ ~~ ~ ,.I l.f.K- 1 ` _ LICENSE NU ER DATE SIGNEDIMw~m. Uay. Pearl - 'PRONOUNCING AND CERTIFYING PHYSICIAN IPtrvsk. t r: ;1 ow¢rv)Jealnm tlcerLly~ny to r:ar»e cal neeml ~ j~ f _ ("~ ~ C~ ~ ~ \ ~ L ~ `~, ' ]Id. i L.?~ ~ ~ ~ x _ _ _ _ ___ ]le. ~ \` Y "~ ' ,~, TO the bMl OI my kn°wled9e, deem «curred al me Bme, date and place, arW due l0 tM causelal and manner as slated .... .................... __ . - NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH '-' - 'MEDICAL EXAMINER/CORONER (II ~ 271 Type or Pnnl \ ~ ~t'-~~\~ ~h ~``~1 ' On the basis of •aaminstion and/or invesligahon, in my opinion, death occurred al the Ume, date, and place, and due to the cause(s) a manner as stet~d ................................................................ .. .......... .. ..... .. .......... ~A ~~ _ ` - y ~ecl\4 ~ 1~1 \r \1,- ~\ ~ {~1\l~~",~l L' ~ I~ ]2 _ . REGISTRARS SIGNATURE~MBER l~~ L~ !~ DATE FICED IMOrnn Day. Yeail ` ~ rl 1 - 1 17"14 ) _ .,~~,./ n? /~ 71 T~y,~ dOD..L-- LAST WILL AND TESTAMENT OF AUGUSTUS G. FICKES I, AUGUSTUS G. FICKES of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any will previously made by me. I - I direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II - I devise and bequeath all of my estate of whatever nature and wherever situate unto my children, Barbara F. Mull and James P. Fickes, the share of a deceased child to be paid to his or her issue per stirpes. III - I appoint CCNB Bank, N.A., New Cumberland, PA, guardian of any property which passes under this will or otherwise to a minor or an incompetent and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so. Such guardian shall have the power to use principal as well as income from time to time for the minor's education and support or to make payment for those purposes without further responsibility to the minor or to any person taking care of the minor. The said guardianship shall terminate as to each beneficiary when he or she reaches the age of 21 years, if a minor, or when declared competent, if an incompetent. i Page 1 ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP HILL, PA 17011 IV - I appoint my children, Barbara F. Mull and James P. Fickes, or the survivor, Executors of this, my Last Will and Testament, to serve as such without the necessity of posting bond in this or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, the ,n. day o f ~"~..~ --~_-°E.+?~yyt..~ ~...~ 19 8 6 . /~ !,, . 'G' ~1 ~:.~ -~ " ZG,w~ _ ( SEAL ) ugustus G. Fickes i Signed, sealed, published and declared by AUGUSTUS G. FICKES, Testator therein named, on this and one (1) other sheet of paper as and for his Last Will and Testament in our presence, who, in his presence, at his request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. i. ~ ~~, 4 , r Camp iii 11, FA Name Address ~~1~~~1~7r1~rt ~ ~~ ~' ~ Camp Hi11, PA Name Address Page 2 ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP HILL, PA !7011 C0114MONL4EALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND) SS. WE, the undersigned, the testator and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last 4di11 and Testament and that he signed willingly (or willingly directed another to sign f-or him), and that he executed it as his free will and voluntary act for the purposes therein expressed, and that each of the witnesses, i_n tht~ presence and hearing of the testator signed the will as witnesses anc~ that to the best of their kno~~~ledge the testator Baas at that time eighteen years of age or older, of sound mind, and under no constrai.~ or undue influence. /' ,,~ Testator ,~ , Witness Witness Subscribed, sworn to and acknowledged before me by the test~lt~, and subscri ed and s rn to before me by both witnesses, this day o f 19 8 ~ -------- __ otary Public THELMA S. ~,9cCAUS!'^J, PJO~Af',Y J'"^LJC My Commissor, Ex:ires July 3, 2'~c.' Camp Hill, PA CLmberl2~d County ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP NILL, PA !7011 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: AUGUSTUS G. FICKES Date of Death: October 31, 2002 Will No.: Admin. No.: 21-02-0994 To the Register: I certify that the Notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was mailed or delivered to the following heirs and beneficiaries of the above- captioned estate on ~t;y"~yK,f1.~a ~~~ ,~G~~ Barbara F. Mull 134 Coopers Kill Road Delran, NJ 08075 James P. Fickes 1704 Carlisle Road Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/A. .~-, Date: ~ ~l~~v"f 1~~9 ~~,~~ ~~7; r~i ll <-- Mark R. arthemer, Esq. McNEES WALLACE & NURICK LLC 100 Pine Street, P.O. Box 1166 Harrisburg, PA 17108 (717) 237-5250 Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 002108 MCNEES WALLACE & NURICK 100 PINE STREET P 0 BOX 1 166 HARRISBURG, PA 17108 fold ESTATE INFORMATION: ssN: 206-~o-s155 FILE NUMBER: 2102-0994 DECEDENT NAME: FICKES AUGUSTUS G DATE OF PAYMENT: 01 / 31 / 2003 POSTMARK DATE: 01 /30/2003 couNTY: CUMBERLAND DATE OF DEATH: 1 0/31 /2002 REMARKS: MCNEES ETAL CHECK#110 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 59,500.00 TOTAL AMOUNT PAID: INITIALS: AC RECEIVED BY: DONNA M. OTTO REV-1162 EXI11-961 59,500.00 DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 002862 PARTHEMER MARK R ESQ 100 PINE STREET P 0 1166 HARRISBURG, PA 17108 fold ESTATE INFORMATION: SSN: 2o6-io-8755 FILE NUMBER: 2102-0994 DECEDENT NAME: FICKES AUGUSTUS G DATE OF PAYMENT: 08/01 /2003 POSTMARK DATE: 07/31 /2003 CouNTY: CUMBERLAND DATE OF DEATH: 10/31 /2002 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 51,390.91 TOTAL AMOUNT PAID: REMARKS: MARK R PARTHEMER ESQUIRE CHECK#1003 SEAL INITIALS: AC RECEIVED BY: DONNA M. OTTO REV-1162 EX~11-96) 51,390.91 DEPUTY REGISTER OF WILLS REGISTER OF WILLS Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Augustus G. Fickes known as Deceased James P. Fickes & Barbara F. Mull No. 2002-00994 Date of Death 10-31-2002 Social Security No. 206-10-8155 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Personal Represente~Iv Attorney: Mark R. Parthemer, Esq. ~~ - ~~.~ I.D. No.: 50875 Address: McNees Wallace & Nurick LLC Dated ~ r'~-~i ju 3 00 Pine Street, P.O. Box 1 166 ~ Harrisburg, PA 17108 Telephone: (717) 237-5 250 Porm qW-7 (Combadantl County -Rev. 9/921 {A277079:} NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Inventory 12:17 Estate of Augustus G. Fickes From 10/31/2002 To 10/31/2002 Description Ac crued Income Value Total Checking Accounts PNC Bank Checking Account 1.28 7,931.97 Money Market Accounts RMA Money Market Portfolio; Held in Paine 0.14 499.71 Webber Brokerage Account Savings Accounts PNC Bank Savings Account 5.43 30.46 Common Stocks 1766.982 shs. Alliance Americas Govt. Income 29.79 12,133.60 Trust Fund A @ 6.85/share 250 units Commonwealth Income and Growth Fund 2,000.00 @ 8.00/unit 68 shares MetLife @ 24.265/share 1,650.02 250 units PLM Equipment Growth & Income Fund 812.50 VII @ $3.25/unit 500 units PLM Equipment Growth Fund VI @ 5,035.00 10.C7/unit 70 shares PPL Corporation @ 34.155/share 2,390.85 1037.477 shs. Putnam Tax Free High Yield Fd., 22.98 13,001.82 Class A @ 12.51/share 1738 shares Van Kampen High Yield Municipal 17,988.30 Fund A @ 10.35/share 4770.992 shares GNMA Investors Shares @ 217.32 51,410.06 10.73/share 5154.639 shares Vanguard Int. Term Corporate 241.60 51,478.71 Fund Investors shares @ 9.94/share 6291.467 shares Vanguard Int. Term Bond Index 297.80 66,484.06 Fund Inv. shares @ 10.52/share 224,384.92 - 1 - Description Certificates of Deposit Waypoint Bank Certificate of Deposit; See bank letter attached Miscellaneous Property MetLife Insurance Policy No. 2746390M; Insurance payable to estate RMA Monthly Disbursement Check - check issued but uncashed at date of death United Insurance Co. Life Insurance Policies No. PS00493845 and PS00734238; Insurance payable to Estate Van Kampen - Check for dividend dated 10/31/02; Check not received on date of death 62.63 Value Total 12:17 15,062.63 1,737.21 144.64 117.00 92.42 2,091.27 Refunds Asbury Service Affiliates - Nursing Home Refund Hospice Refund U.S. Treasury; Refund re 2002 Income Tax Return 583.09 5,750.00 723.00 7,056.09 257,057.05 Inventory Estate of Augustus G. Fickes From 10/31/2002 To 10/31/2002 Accrued Income - 2 - /7- 19-;U REV~1500 EX (6-DO) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FlLE NUMBER 21 02_ -9994....__ YEAA NUMBER COUN1YCODE I- Z W C w ld c DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Fickes, Augustus G. DATE OF DEATH (MM-Oo..YEAR) DATE OF BIRTH (MM-DD-YEAR) 10/31/2002 12/05/1913 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 206-10-8155 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS $OCIAL SECURITY NUMBER W I- :J::::g;U) 0"'''' w"-O ,,00 0"''''' "-Ill "- '" [Z], D4 D6 D9 Original Return Limited Estate D 2. Supplemental Return D 3. Remainder Return (date of death prior 10 12-13-82) D 4a. Future Interest Compromise (dale of death after 12-12-82) D 5. Federal Estate Tax Return Required [] 7. Decedent Maintained a Living Trust (Allach copy of Trust) _ 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit (dale aldeatn between 12-31.91 ard 1.1-95) D 11. Election to tax under See. 9113(A)(AttaohSd10l Decedent Died Testate (Attach copy of 'Mil) Litigation Proceeds Received .... z w o z o .. .. il! a: o o THIS SECTION MUST BE COMPLETEO. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Mark R. Parthemer, Esq. FIRM NAME (If Applicable) McNees Wallace & Nurick LLC TELEPHONE NUMBER 100 Pine Street P.O. Box 1166 Harrisburg, PA 17108 717-237-5250 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or SoIe.Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Persooal Property (Sdledule E) (5) Z 6. Jointly Owned Property (Schedule F) (6) 0 o Separate Billing Requested i= :5 7. Inter-Vivos Transfers & Miscellaneous Noo-Probate Property (7) :::> (Schedule G 01' L) l- ii: .. Total Gross Assets (total Lines 1-7) <( U W 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 0:: 10. Debts of Decedent, Mortgage Liabilities, & Liens (Sdledule I) (10) 11. Total Deductions (total Lines 9 & 10) d w 0.00 224,884.62 0.00 O. ocr,.) 30,318. 2~:~ 0.00 OFFICIAL. USE ONI.. y Gi = 14,344.37 (6) 14,341. 97 2,073.86 v 269,547.20 l, ~ (13) 16,415.83 253,131.37 0.00 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) (11) (12) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax 0.00 Z rate, or transfers under Sec. 9116 (a)(1,2) 0 ;:: 16. Amount of Line 14 taxable at lineal rate 253,131.37 '" I- ::> 0.00 "- 17. Amount of Line 14 taxable at sibling rate '" 0 0.00 0 16 Amount of Line 14 taxable at collateral rate >< '" 19. Tax Due I- (14) 253,131.37 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT (19) 0.00 11,390.91 0.00 0.00 11,390.91 x .00 _ (15) x ,Q4L- (16) x .12 (17) x .15 (18) > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 2W46451,OOO Decedent's Complete Addres. . STREET ADDRESS 325 Wesley Drive CI1Y TSTAlE I ZIP Mechanicsbura PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 11,390.91 0.00 9,500.00 500.00 Total Credits (A + B + C) (2) 10,000.00 3. Inleresl/Penally If applicable D. Interest E. Pena~y 0.00 0.00 Tolallnterest/Penalty (D + E) (3) 0.00 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 (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1,390.91 A. Enter the interest on the tax due. (SA) 0.00 B. Enter the tolal of Line 5 + SA. (5B) 1,390.91 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . D b. retain the right to designate who shall use the property transferred or its income; . D c. retain a reversionary interest; or ., . . . . . . . . . . . . . . . . . . . . . . 0 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? . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 0 4. Did decedent own an Individual Retirement Account. annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1Xl 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 halll!l examined thi$ return, Including accompanying schedules and statements. and to the best of my knowledge and belief, it is true. correct and complete. DeClaration of preparer other then the personal representative is based on all information of which preparer has any knowledge SIGNA E F PERSON R SP SIBtE FOR FlUNG RETURN /h-... f. F J,..... No 00 00 00 00 IX] IX] ACORE:SS DATE ( (J.f/oJ 1704 Carlisle Road, Camp Hill, PA 17011 DATE r 2. a:t AOOR 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. ~ 9916 (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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: The tax rate Imposed on the net value of transfers from a deceased child twenty.one yElars of age or younger at death to orforthe use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P,S'13 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~ 9116(1.2) [72 P.$. ~9116(a)(1)J. The tax rate imposed on the net 'o'Slue (ff.trsns{era to or tor the use of the decedent's siblings is 12% (72 P.S. S 9116(a){1.3)). A sibllng is defined, under Section 9102. as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 2W46461.000 REV-l503 EX+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS Fickes, Augustus G. FILE NUMBER 21-02-0994 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CESCRIPTlON VAWEATDATE OF DEATH 1. RMA Money Market Portfolio; Asset held in Paine Webber Account No. JH 4572679; See copy of account statement attached. 499.57 Accrued Dividend 0.14 21766.982 shs. Alliance Americas Govt. Income Trust Fund A @ 6. 85/share; Fund held in Paine Webber Account No. JH 4572679 12,103.83 Accrued Dividend 29.79 31037.477 shs. Putnam Tax Free High Yield Fd., Class A @ 12.51/share; Fund held in Paine Webber Account No. JH 4572679 12,978.84 Accrued Dividend 22.98 4 68 shares MetLife @ 24.265/share 1,650.02 570 shares PPL Corporation @ 34.155/share 2,390.85 64770.992 shares GNMA Investors Shares @ 10.73/share 51,192.74 Accrued Dividend 217.32 7 6291.467 shares Vanguard Int. Term Bond Index Fund Inv. shares @ 10.52/share 66,186.23 Accrued Dividend 297.80 85154.639 shares Vanguard Int. Term Corporate Fund Investors shares @ 9.94/share 51,237.11 Accrued Dividend 241.60 91738 shares Van Kampen High Yield Municipal Fund A @ 1D.35/share 17,988.30 10 250 units Commonwealth Income and Growth Fund 2,000.00 Total from continuation pages.... TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 5,847.50 224,884.62 2W46963.000 Estate of: Fickes, Augustus G. Schedule B -- Stocks & Bonds Item No. Description Value at Date of Death 10 @ 8.00/unit 11 500 units PLM Equipment Growth Fund VI @ 10.07/unit 12 250 units PLM Equipment Growth & Income Fund VII @ $3.25/unit TOTAL. (Carry forward to main schedule) . . . . . . Page 2 21-02-0994 5,035.00 812.50 5,847.50 REV-1508 EX+ (1-97) COMMONVVEAL TH OF PENNSYLVANIA tf'iiERITAt-CE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Include the proceeds of litigation and the date the proceeds were received by the estate. All property lolntly-owned with the right of WNlvors.hip must be disclosed on Schedule F. ESTATE OF Fickes, Augustus G. FILE NUMBER 21-02-0994 ITEM NUMBER DESCRIPTION 1. Waypoint Bank Certificate of Deposit; See bank letter attached VALUE AT DATE OF DEATH 15,000.00 Accrued interest 62.63 2 PNC Bank Checking Account; See bank letter attached 7,930.69 Accrued Interest 1.28 3 PNC Bank Savings Account; See bank letter attached 25.03 Accrued Interest 5.43 4 Asbury Service Affiliates - Nursing Home Refund 583.09 5 Van Kampen - Check for dividend dated 10/31/02; Check issued but uncashed at date of death 92.42 6 RMA Monthly Disbursement Check - check issued but uncashed at date of death 144.64 7 Hospice Refund 5,750.00 8 u.S. Treasury; Refund re 2002 Income Tax Return 723.00 2W46AD2.000 TOTAL (Also enter on line 5 RAr.:mltulation) $ (If more space is needed, insert additional sheets of the same size) 30,318.21 REV-15l0 EX + (1-9?) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fickes, Auqustus G. SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-02-0994 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBEF 1. DESCRIPTION OF PROPERTY INCLUDE THE N/lME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT ANOTHE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR RE.Al. ESTATE. MetLife Investors Annuity No. A2051720 DATE OF DEATH VALUE OF ASSET 14,344.37 %OF DECO'S INTEREST 100.00 EXCLUSION IF APPUCABLEl 0.00 TAXABLE VALUE 14,344.37 Value as of 10/31/02 was $14,344.37 per MetLife Representative Beneficiaries - James E. Fickes and Elizabeth A. Fickes (decedent's grandchildren) TOTAL (Also enter on line 7, Recapitulation) $ 14,344.37 2W46AF2.000 (If more space is needed, insert additional sheets of same size.) REV-1511 EX+{1-97) COMMON'h'EALTI-I OF PENNSYLVANIA INHERITANCE TAX RElURN RESIDENT DECEDENT ESTATE OF Fickes, Augustus G. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-02-0994 Debts of decedent must be renorted on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 4,059.00 1. Musselman's Funeral Home 2 Trinity Lutheran Church - Funeral Luncheon 283.85 3 Old Towne Florist - Flowers 243.80 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 0.00 Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Name: McNees Wallace & Nurick LLC 9,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City State Zip Rela.tionship of Claimant to Decedent 4. Probate Fees 307.00 5. Accountant's Fees 0.00 6. Tax Return Preparet's Fees 0.00 7. Cumberland County Register of Wills - Filing Fees re 31.00 PA Inheritance Tax Return and Inventory 8 Cumberland County Register of Wills - Short 6.00 Certificates 9 Cumberland Law Journal - Legal Advertising 75.00 10 McNees Wallace & Nurick - Costs Advanced as follows: 95.81 Duplicating $ 65.40 .,otal. trom continuat~on pages.... "'4U."1 TOTAL (Also enter on line 9, Recapitulation) $ 14,341. 97 2W46AG2.000 (If more space is needed, insert additional sheets of same size) Estate of: Fickes, Augustus G. Schedule H, Part B -- Administrative Costs Item No. Description 10 Long Distance Telephone Postage 3.75 26.66 11 McNees Wallace & Nurick LLC - Reserve for closing costs re duplicating, postage, etc. 12 PNC Bank - Checkbook Charges 13 The Patriot-News - Legal Advertising 14 Vital Records - Death Certificates for Joanna Fickes TOTAL. (Carry forward to main schedule) Page 2 21-02-0994 Amount 100.00 27.60 96.91 16.00 240.51 REV-1512 EX+ (1-97) COMMONlJVE..c\L TI-i OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT ceCEDENT ESTATE OF Fickes, Augustus G. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-02-0994 Include unreimbursed medical eXlKlnses. ITEM NUMBER DESCRIPTlON AMOUNT 1,680.B1 1. Outstanding Check at date of death (PNC Bank Checking Account) 2 Metro Med Services - Balance Due 36.00 3 Alert Phy. at Bethany Village - Pharmacy Expenses 46.48 4 Verizon - Telephone Expense 29.84 5 Harrisburg Pharmacy - Pharmacy Expenses 5.78 6 PA Department of Revenue; Tax Due re 2002 Income Tax Return 234.00 7 West Shore EMS - Balance Due 40.95 2W46AH 2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,073.86 REV-1513 EX-+- (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FickAs Au~'stus G NUMBER I. NAME AND ADDRESS OF PERSON(S) RECEIVlNG PROPERlY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Fickes, James P. 1704 Carlisle Road Camp Hill, PA 17011 1. 2 Mull, Barbara F. 134 Coopers Kill Road De1ran, NJ 08075 3 F~ckQs, James E. c/o James P. Fickes 1704 Carlisle Road Camp Hill, PA 17011 4 Fickes, Elizabeth A. c/o James P. Fickes 1704 Carlisle Road Camp Hill, PA 17011 FilE NUMBER 21-n2 0994 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Son Daughter Grandson Granddaughter AMOUNT OR SHARE OF ESTATE 119,393.50 119,393.50 7,172.19 7,172.18 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 DISllRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 2W46AI1,OOO TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed. insert additional sheets of the same size) $ 0.00 ESTATE OF AUGUSTUS G. FICKES FILE NO. 21-2002-0994 PENNSYLVANIA INHERITANCE TAX RETURN TABLE OF CONTENTS - EXHIBITS A. Miscellaneous Documents 1. Table of Contents 2. Copy of Letters Testamentary issued to James P. Fickes and Barbara F. Mull, and copy of decedent's will dated December 4, 1986 3. Official Receipt: Pennsylvania Inheritance Tax Payment B. Schedule E - Cash, Bank Deposits, & Misc. Personal Property 1. Waypoint Bank (Item 1) 2. PNC Bank (Item 2, 3) Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters No. 2002-00994 PA No. 21-02-0994 ESTATE OF FICKES AUGUSTUS G (LA::;l', ~lK::;'l', M1UUL~) Late of LOWER ALLEN TOWNSHIP CUMbbKLANU CUUN1Y, WHEREAS, on the 6th dated December 4th 1986 was admitted to probate as the last will of FICKES AUGUSTUS G (LA::; 1 , ~lK::;l, M1UUL~i Deceased Social Security No. 206-10-8155 day of November 2002 an instrument late of LOWER ALLEN TOWNSHIP CUMBERLAND County, who died on the 31st day of October 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 FICKES JAMES P and MULL BARBARA 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 6th day of November 2002. u~'~#/'~ **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) eJl"-()d.- -99f LAST WILL AND TESTAMENT OF AUGUSTUS G. FICKES I, AUGUSTUS G. FICKES of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any will previously made by me. I - I direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II - I devise and bequeath all of my estate of whatever nature and wherever situate unto my children, Barbara F. Mull and James P. Fickes, the share of a deceased child to be paid to his or her issue per stirpes. III - I appoint CCNB Bank, N.A., New Cumberland, PA, guardian of any property which passes under this will or otherwise to a minor or an incompetent and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so. Such guardian shall have the power to use principal as well as income from time to time for the minor's education and support or to make payment for those purposes without further responsibility to the minor or to any person taking care of the minor. The said guardianship shall terminate as to each beneficiary when he or she reaches the age of 21 years, if a minor, or when declared competent, if an incompetent. ~ /j /II' l'i~~/o~?k Page 1 ARNOLD k SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET. CAMP HILL, PA 11011 IV - I appoint my children, Barbara F. Mull and James P. Fickes, or the survivor, Executors of this, my Last Will and Testament, to serve as such without the necessity of posting bond in this or any jurisdiction. the IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, Li tf:: day of J.Y~ , 1986. , . ~.~ ----&. //~ , gustus G. Fickes (SEAL) Signed, sealed, published and declared by AUGUSTUS G. FICKES, Testator therein named, on this and one (1) other sheet of paper as and for his Last Will and Testament in our presence, who, in his presence, at his request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. "-. . , 1 ~'-~~-~ p v~ Camp lIill, PA Address .I "I Name ~. / (-/~ tcJ~~ Name Camp Hill, PA Address Page 2 ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP HILL, fA .,011 COMMONWEALTH OF PENNSYLVANIA) 55. COUNTY OF CUMBERLAND) WE, the undersigned, the testator and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will and Testament and that he signed willingly (or willingly directed another to sign for him), and that he executed it as his free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testator signed the will as witnesses and that to the best of their knowledge the testator was at that time eighteen years of age or older, of sound mind, and under no constraint or undue influence. a~tl/~ JIct. i: ,nol{, L.,( oI~ t, S~ Ih tness SUDser'bed, sworn to and acknowledged before me by the tes\~tEf' and subscri ed and s rn to before me by both witnesses, this ~ day of , 198 G. . /~tt ~~( ./_", . otary Public THELMA $, McCAUSLIN. NOTARY p"r.L1C My CommissIon Expires July 3. 1988 .Camp Hill, PA Cumberlltfld County ARNOLD &: SLlKE, ATTORNEYS-AT-LAW. 2109 MAR.KE.T STRU:r. CA,MP HILL,?^ 1'011 COMMONWEALTH Of PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA 17128,0601 REV-1162 EX(11-96\ RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MCNEES WALLACE & NURICK 100 PINE STREET POBOX 1166 HARRISBURG, PA 17108 _u~~___ fold ESTATE INFORMATION: SSN: 206-10-8155 FILE NUMBER: 2102-0994 DECEDENT NAME: FICKES AUGUSTUS G DATE OF PAYMENT: 01/31/2003 POSTMARK DATE: 01/30/2003 COUNTY: CUMBERLAND DATE OF DEATH: 10/31/2002 NO. CD 002108 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $9,500.00 I I I I I I I I I TOTAL AMOUNT PAID: $9,500.00 REMARKS: MCNEES ET AL CHECK# 110 SEAL INITIALS: AC RECEIVED BY: TAXPAYER DONNA M. OTTO DEPUTY REGISTER OF WILLS PlWay~ql!lt LOOK FOR US. WE'LL GET YOU THERE. 12/30/2002 MCNEES WALLACE & NURICK POBOX 1166 HARRISBURG P A 17108 The information which you requested on the account(s) of AUGUSTUS FICKES (Social Security Number 206-10-8155) is/are as follows: Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership Was Established 492283158 CERTIFICATE 03/29/96 15000.00 62.63 15062.63 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested MerelY, . Ji/tb SENIOR SERVICES REP. P.O. Box 1711. HARRISBURG. PeNNSYl.IIANIA 17105-1711 Toll Free 1-866-WAYPOINT (1-866-929-7646)' IN YORK AREA 717/815-4500 . www.waypointbank.com FEB-02-2003 21:00 PNCBANK 412 758 3458 0PNCBAN< February 3, 2003 McNees Wallace & Nurick LLC Altn: Linda M. Eshelman POBox 1166 100 Pine St Harrisburg, PA 17108-1166 scp RE: Estate of Augustus G Fickes (Deceased) SSN: 206-10-8155 ODD: 10-31-2002 Dear Ms. Eshelman: In response to your request for Date of Death balances for the customer noted above, our records show the following: Cheeklng Aeeount Account#5140058346 Established 07-01-1964 AUGUSTUS G FICKES ODD balance: $7,930.69 + $1.28 accrued interest Savings Aeeount Account#5003732795 Established 10-13-2000 AUGUSTUS G FICKES DOD balance: $25.03 + $5.43 accrued interest The decedent did not maintain any safe deposit box at PNC Bank. Please note that this office only provides date of death balances for deposit accounts (!RAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call1-888-PNC-BANK (1-888-762-2265) Or stop by your local PNC Bank branch office. Sincerely, ~ ::1. ~ Erica L Schlegel PNC Decedent Reporting Firslside Center 500 First Ave. 4111 FJ elF Pi"sbo<l<h PA 15219-3128 1-801).762-1775 Memb.. FDIC P.0V01 TOTAL P.01 ~~-9~'-~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX 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 MARK R PARTHEMER ESQ MCNEES ETAL PO BOX 1166 HBG PA 17108 REV-1547 E% ~FP (01-037 DATE 09-15-2003 ESTATE OF FICKES AUGUSTUS G DATE OF DEATH 10-31-2002 FILE NUMBER 21 02-0994 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN 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 c¢rerG n~ FICKES AUGUSTUS G FILE N0. 21 02-0994 ACN 101 DATE 09-15-2003 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) (1) .00 NOTE: To insure proper . (2) 224,884.62 credit to your account, 2. Stocks and Bonds (Schedule B) 00 submit the upper portion 3 Closely Held Stock/Partnership Interest (Schedule C) (3) . . 4. Mortgages/Notes Receivable (Schedule D) [4) .0 0 of this form with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 30,318.21 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) 14,344.37 547.20 269 8. Total Assets (g) , APPROVED DEDUCTIONS AND EXEMPTIONS: 14,341.97 9. Funeral Expenses/Adm. Costs/Misc. Expenses [Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 2.07 3.86 11. Total Deductions (11) 16.415.83 253,131.37 12. Net Value of Tax Return (12) 00 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (131 . 25 3,131.37 14. Net Value of Estate Subject to Tax (14) NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 1 7, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESS MENT OF TAX: 00 00 .00 15. (15) Amount of Line 14 at Spousal rate . X 04 37 131 253 = 5. 11,390.91 16 Amount of Line 14 taxable at Lineal/Class A rate (16) . , X . 17. Amount of Line 14 at Sibling rate (17) • 00 X 12 = . 00 00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 = . 390.91 11 19. Principal Tax Due (1 , 9)= TAX CREDITS' + AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-30-2003 CD002108 500.00 00 9,500.00 390.91 1 07-31-2003 CD002862 . , TOTAL TAX CREDIT 11,390.91 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. pFREFUND.DSEEIREVERSECSIDEAOFATHISEFORM FOR)INSTRUCTIONS,DUE STATUS REPORT UNDER RULE 6.12 Name of Decedent: AUGUSTUS G. FICKES Date of Death: 10/31/02 Will No. Admin No. 2002-00994 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 No 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 partes in interest? Yes x No __ d. Copies of receipts, releases, joinders and approvals of formal or informal aCCounts may be filed with the Clerk of the Orphans' Court and may beattache '.~o this report. 100 Pine St., P.O. Box 1166 Harrisburg, PA 17108 (717) 237-5243 Capacity: Counsel for Personal Representative {A237522:}