The URL can be used to link to this page

Home My WebLink About03-1037Estate of Ella G. Horsley also known as PETITION FOR GRANT OF LETTERS No. Sheila A. Thurston Petitioner(s), who is/are 18 years of age or older, apply)les) for: , Deceased Social Security No. 356145974 (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut rix [] Decedent, dated 10/16/01 and codicil(s) dated named in the Last Will of the 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 incapacitated: B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland residence at 120 South Filbert Streetr Mechanicsburg~ PA 17055 (list street, number and municipality) Decedent, then 96 years of age, died 11/27 ,2003 , at Seidle Memorial Hospital (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property ......................................... $ (if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ Total Real Estate situated as follows: County, Pennsylvania, with his/her last family or principal 46~000.00 46~000.00 Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Typed or printed name and residence Signature Sheila'~. Thurston 816 Flintlock Ridge Road~ Mech. 17055 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 estate according to law. Sworn to and affirmed and subscribed before me this 17th day of / -' . ., ,~--~. /;::,, _. Donna M Otto,lSt D~puty' ~,/ /" J)_ ~ -~ DECREE OF REGISTER Estate of Ella G. Hor~ley Deceased No. 21-2003-1037 also known as Social Security No: 356145974 Date of Death: 11/27/03 AND NOW, December 18th, , 2003 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [~ Testamentary I~ of Administration ((c.ta., d.b.n.c.t; pendente lite; durante absentia; durante minoriate) are hereby granted to Sheila . Thurston in the above estate and that the instrument(s), if any, dated October 16, 2001 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters .................................... $ 80 o00 Short Certificates(s) .... 2 ......... $ 6.00 Renunciation .......................... $ Extra Pages( 2 ) ............... $ 6o00 I.T.R ....................................... $ JCP Fee ................................. $10.00 Inventory ................................ $ Other ...................................... $ TOTAL ............................. $ 102.00 Put in Attorney Hogg' s file Signature Attorney: Stephen J. Hogg, Esq?~e,- I.D. No: 36812 Address: 19 S. Hanover Street, Ste. 101 Carlisle Telephone: 7172452698 DATE FILED: December 18th, 2003 in Prothonotary' s office PA 17013 his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9641308 No. Registrar COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH Ella G. Horsley 1=. Female1]. 35~ 14 ~ 5974 4. November 2~, 2003 ~. 96 ~". t May 28, 1907 ~. Enola, Pennsylvania Ik- I~ m Cumberland I ]Mechenicsbur9 ~. m~n. ~ ' ~C[O[NI'8~ ~0'~ '"' ~ Seidle ~emorial Hospital ~ · ,~. White ,,.. Nurse ,,~ Health Care I ~ ~,~ I E~,~¢,~) I (,~,~. ~.T's ~ ~ ~.. ~. ~. z~c~ I~CE~.T'S ['*' J'" 1~ .. Widowed 120 South FiIbe~ Street I~ ,..a~ Pe~nsy~v=n!a ~ '~*~ ~ ~ ,~ Mechancsburg, Pennsylvama 1705 ~) '~.~ Cumberland ~? ,~.~.~ Mechanicsburq ~='s~o~. ~ Ba~el M. Basehore ,t Grace Presser ~m~T~ Sheda Thur~ton ~E~ ~. 816 Flintlock Ridoe Road Mechanicsbum Pa. 1705~ "' ~ -' / / / / I .... Dec2 2003 [=,, Mechancsbur9 Cemete~ L, Mechanicsbura Pennsvlvania ~ - -- ~ . _ I*~ FD-012~2-L I~. Mvem Funeral Home Ina 37 East Ma n Streel Mechan ~ 24-~ m~ ~ ~ ~ ~ ~ etCH ~' 4. '7.' 5 ~ ~M ~. November 27 2003 & ~ ~ . - __-. · - I,-. 1-. I~~'~"" [~ _ /) / ~a~'"~~'M'ra ............ ~??~._ /~- ~ ~ ~ '=~t~:::r:~:~t=:= ....... . Ma.c~l~bu~, PA 17055 (~ ~'' 21-2003-1037 LAW OFFICES O1:: STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 WILL OF ELLA G. HORSLEY I, Ella G. Horsley, of Camp Hill, Pennsylvania, declare this to be my last Will and hereby revoke all prior Wills and Codicils. 1. I direct that all inheritance, estate, transfer, succession and death taxes of any kind whatsoever which may be payable by reason of my death shall be paid out of my residuary estate. 2. I direct that my entire estate be distributed as follows: A. Everything sold and ½ go to the VFW of Camp Hill, Pennsylvania and % to the Seventh Day Adventist Church of Camp Hill, Pennsylvania. 3. I appoint Sheila Thurston as Executrix of this my last Will. 4. The Executrix of this Will shall have the power to distribute my estate in kind or in cash, or partly in either. 5. I direct that no Executrix acting under this Will shall be required to enter bond in any jurisdiction. oft../~~_~ ,2001. ELLA G. HORSLEY LAW OFFICES OF STEPHEN j. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 The preceding instrument consisting of this and one other page was on the day and date hereof signed, published and declared by ELLA G. HORSLEY, as and for her last Will in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. WITNESS '¢~'I'NESS LAW OFFICES Of STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 ACKNOWEEDGMENT State of Pennsylvania County of Cumberland SS I, ELLA G. HORSLEY, the testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last Will; that I signed it willingly and as my free and voluntary act for the purposes therein expressed. ELLA G. HORSLEY Sworn to or affirmed and acknowledged~bef.~e F~e by ELLA G. HORSLEY, the testatrix, this//'~ day of ~.~'~ -- 20CH · ~ - ./ - ~ ! ~"~.~,~~ ~Attorn~/ State of Pennsylvania ss County cf Cumberland We, /~,,-~.~¢~[ P,'~-¢~- and witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last Will; that the testatrix signed willingly and executed it as her free and volunta~ act for the purposes therein expressed; that each subs~ibing witness in the hearing and sight of the testatrix signed the Will as a witness; and that to the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ~Sworn to or a~me~ ~ subscribed to ~fore me by witnesses, this ~_ day of ~~ _/ , 2~01.~ N~. Publi~tt~rn~y~ ~.~,~~ 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, CUMBERLAND COUNTY In re Estate of Ella G. Horsley File No. 21-03-1037 TO: Seventh Day Adventist Church of Camp Hill 200 South Washinq.ton Street , PENNSYLVANIA , deceased, (beneficiary) (address) Mechanicsburg PA 17055 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. The Decedent, Ella G. Horsley , died on 11/27/2003 in Mechanicsburg, PA 17055 X The Decedent died testate (with a Will) The Decedent died intestate (without a Will) Name(s), address(es) and telephone number(s) of all personal representatives appointed: Name Address Sheila Thurston 816 Flintlock Ridge Road, Mechanisburg, PA Telephone 7177668938 ~ftheDecedentdiedtestate~the~i~~hasbeenfi~edwiththe~ffice~ftheRegister~f~i~~s~f: Cumberland County If the Decedent died intestate, a Petition for the Grant of Letters of Administration was filed with the Office of the Register of Wills of: copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the charges for duplication. copy of the Will or Petition is attached. Signature Name Address Telephone Capacity: _ _ Personal Representative X Counsel for Personal Representative 19 S. Hanover Street, Ste. 101 Carlisle 7172452698 PA 17013 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Ella G. Horsley Date of Death: 11/27/2003 Will No. Admin. No. 21-03-1037 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 2/13/2004 · Name Address VFW Seventh Day Adventist Church of Camp Hill Sheila Thurston 2005 Hummel Avenue Camp Hill' PA1 17011 200 South Washington Street Mechanicsburq PA 17055 816 Flintlock Ridge Road Mechanicsburq PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: Date: Capacity: Name: Stephen J. Hoqq, Esquire Address: 19 S. Hanover Street, Ste. 101d Carlisle PA Telephone(717) 2452698 Personal Representative X Counsel for Personal Representative 17013 9969 Allentown Blvd. Grantville, PA 17028 February 23, 2004 Register of Wills 1 Courthouse Square Carlisle, PA 17013 ATTN: Ann Dear Ann: In keeping with my request of today for a copy of the will_for Ella G. Horsley, File No. 21-03-1037, please send a copy of the will to Paul B. Wert, 9975 Allentown Blvd., Grantville, PA 17028. I have enclosed a check for $1.50 to cover the costs. Looking forward to hearing from you. Si~erely, Paul B. Wert Head Elder of the SDA Church 200 S. Washington Street Mechanicsburg, PA 17055 PBW:sfh cc: rf COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURGi PA 17128-0601 October 29, 2004 Stephen J Hogg, Esquire Attorney at Law 19 S Hanover Street Suite 101 Carlisle, Pa. 17013 Telephone (717) 787-3930 FAX (717) 772-0412 Dear Sir or Madam: Re: Estate of Ella G Horsley File Number 2103-1037 This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before 02-23-05. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. Sincerely, / Claudia Maffei, Supervisor Document Processing Unit Inheritance Tax Division REV.1500EX + (6-00) ."",PD' ;\'.)'-" '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT,280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 -0 3 1 037 COCiNTYCODE --VEAR- - - NUMBER-- I- Z W C W () W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Horsle Ella G, DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) SOCIAL SECURITY NUMBER 356-14-5974 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER w .... :x:::!;(1) 0"''' w~(,) J:a::9 OQ.", Q. " 11/27/2003 OS/28/1907 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL) ~ 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (Attach copy of Will) o 9. litigation Proceeds Received D 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy ofTrusQ o 10. Spousal Poverty Credit (date of deall1 between 12-31-91 and 1-1-95) D 3. Remainder Return (date of death prior to 12-t3-S2) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (AlIachSchQ) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIOENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Ste hen J. Ho 19 South Hanover Street FIRM NAME (If Applicable) .... z w c z C Q. '" W '" '" o o Suite 101 z o i= <C ...J ~ l- ii: <C () W 0:: z o i= <C I- ~ D.. :E o () X <C I- 0' TELEPHONE NUMBER 717 245-2698 Carlisle PA 17013 OFFICIAl" USE ONLY 46,981.02 C) (8) 46,981.02 1, Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Morl9ages & Notes Reoeivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separate BiUing 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, Morl9age liabilities, & liens (Sche<lule I) (10) 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) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x _(15) X _(16) X ,12 (17) X .15 (18) (19) 11,123.19 15,864.32 (11) (12) (13) 26,987.51 19,993.51 19,993.51 16. Amount of Line 14 taxable at lineal rate (14) 0.00 17. Amount of Line 14 taxable at sibling rate 0.00 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 18, Amount of Line 14 taxable at collateral rate 19. Tax Due Decedent's ComDlete Address: STREET ADDRESS 820 Lisburn Road Apartment 310 CITY I STATE I ZIP Camp Hill Pa 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits (A + B + C) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty (0 + E) (3) 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) 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 Payable to: REGISTER OF WILLS, AGENT 000 0.00 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; ........................................................................... 0 IKI b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IKI c. retain a reversionary interest; or ...................................................................................................... D 00 d. receive the promise for life of either payments, benefits or care? ............................................................. 0 IKI 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................. 0 IKI 3. Did decedent own an 'in trust fo~ or payable upon death bank account or security at his or her death? ................. 0 IKI 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 IKI IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the pers nal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RES SIBLE FOR FILING R ~~?b~ ~-r DATE ADDRESS PA 17055 DATE ADDRESS Pa 17013 For dates of death on or after July ,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)J. For dates of death on or after January 1, 1995, the tax rale imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)l. The statute does not 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 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 Iransfers 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 Ihe use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)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 al least one parent in common with the decedenl, whether by blood or adoption. REV-150B EX + (6-9B) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Horslev Ella G. FILE NUMBER 21 03 Include the proceeds of litigaUon and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. 1037 ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 45,865.96 M&T Bank Account #10556907 2. Social Security Deposit 577.00 3. Deposit 188.10 4. Interest Earned through March 2005 205.72 5. Reimbursement from Highmark Blue Shield 12.24 6. Reimbursement from Seidle Hospital Resident Fund 32.00 7. Miscellaneous Jewelry 100.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 46981.02 REV-1511 EX + (12-99) * COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX. RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Horslev Ella G. FILE NUMBER 21 03 1037 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Pre-paid Funeral Expenses 6,000.00 B ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions ~J.i>...I4. Name of Personal Representative (s) She!ia.A. Thurston 2,348.75 Social Security Number(s)fEIN Number of Personal Representative(s) Street Address 816 Flintlock RidQe Road City MechanicsburQ State PA Zip 17055 Yea~s) Commission Paid: 1 2. Attorney Fees Stephen J. Hogg, Esquire 2,348.75 3. Family Exemption: (If decedenfs address is nol the same as claimant's, attach explanation) Claimant Street Address City Stale Zip Relationship of Claimant to Decedent 4. Probate Fees 102.00 5. Accountanfs Fees 6. Tax Return Prepare~s Fees 7. Advertising Cumberland Law Journal 75.00 Carlisle Sentinel 98.69 8. Inheritance Tax Return Filing Fee (Est.) 25.00 9. Final Accounting Filing Fee (Est.) 125.00 TOTAL (Also enter on line g, Recapitulation) $ 11123.19 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (6-98) '* SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Horslev Ella G. FILE NUMBER 21 03 1037 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Social Security Repayment VALUE AT DATE OF DEATH 577.00 2. Safe Deposit Box Rental 2.50 3. Pinnacle Health Services 15,284.82 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 15 864.32 REV.,513EX'I* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER Hnr~I"v FII" r::. ?1 O~ 10~7 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 [include outright spousal distributions, and transfers under Sec. 9116 lal (1.2)] 1. 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. Seventh Day Adventist Church 9,996.75 Camp Hill, PA 2. Veterans of Foreign Wars 9,996.76 Camp Hill, PA TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 19993.51 (If more space is needed, insert additional sheets of the same size) INVENTORY , Deceased No.21 03 1037 Date of Death 11/27/2003 Social Security No. 356-14-5974 Estate of Ella G. Horsley also known as 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 the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. IlWe verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of Attorney: Stephen J. HOQQ, Esquire !.D. No.: 36812 Address: 19 S. Hanover Street, Ste. 101 Carlisle Telephone: 717 245-2698 Sheila Thurston Dated PA 17013 Description Value M& T Bank Account #10556907 45,865.96 Social Security Deposit 577.00 Deposit 188.10 Interest C) 205.72 Reimbursement from Highmark Blue Shield 12.24 Reimbursement from Seidle Hopsital Resident Fund 32.00 Total (Attach Additional Sheets if necessary) 46,981.02 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. RW-4 ;:;.-, Continuation of Inventory Ella G. Horsley 21 03 1037 PaQe 1 Description of Inventory Description Value Miscellaneous Jewelry 100.00 Subtotal $ Grand Total $ 100.00 46,981.02 07-25-2005 HORSLEY 11-27-2003 21 03-1037 CUMBERLAND 101 APPEAL DATE: 09-23-2005 ( See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE _ RETAIN LOWER PORTION FOR YOUR RECORDS _ REY:is47-Ex"AFP-io3:osj-NoTIcE-OF-INHERITANCE-TAX-APPRAIsEHENT:-ALLowANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX EllA G FILE NO. 21 03-1037 ACN 101 BUREAU OF INDIVIDUAL TAXES-'n('\,';f'\rr-. n INHERITANCE TAX DIVISION ~---;:. \._ '._.' ~:__) _=~) lv' PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX c',~e~SENENT, ALLOWANCE OR DISALLOWANCE , 1.~'Lo,r DEDUCTIONS AND ASSESSHENT OF TAX nr."'- 11 L", :~, " '".-......... ?2 [:~. l"\_/: ?,.7 I, DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN r;r";" STEPHEN J HOGI'" , STE 101 19 S HANOVER ST CARLISLE ....,. !'"'-:- PA 17013 ESTATE OF HORSLEY TAX RETURN WAS: 00 ACCEPTED AS FILEO I CHANGEO SEE If an asses..ent was issued previOUSly, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. Anount of Line 14 at Spousal rat. (IS) 16. Anount of Line 14 taxable at Lin..l/Class A rat. (16) 17. Amount of Lin. 1'1 .t Sibling ...t. 1171 18. Amount of Line 14 taxable .t Collataral/Class Brat. (18) 19. Principal Tax Due RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R.al Est.t. (Schedul. A) 2. Stocks _ Bonds I Schlldule B I 3. Closely Held Stock/Partnership Interest (Schedule CJ 4. tIortuages/Notes Receivable (Schedule DJ S. Cash/Bank Deposits/Hisc. Personal Property (Schedule EJ 6. Jointly Ownlld Property ISchlIdul. F) 7. Tr8nsfers (Schedule GJ 8. Total Assets III 121 (3) 1'1) 151 161 171 .00 .00 .00 .00 46.981. 02 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad.. Costs/Hisc. Expenses (Schedule HJ 10. Debts/Hortgage Li8bilitles/Llens (Schedule IJ 11. Total Deductions 12. Net Value of Tax Return 13. Charlt.ble/Governnent.l Bequests; Non-elected 9113 Trusts (Schedule JJ 14. Net Value of Estate Subject to Tax (9) 1101 11,123.19 15.864.32 1111 1121 (13) 11'11 NOTE: .00 .00 .00 .00 X 00 = X 045 = X 12 = X 15 = *' REV-1547 EX AFP (06-05) ELLA G DATE 07-25-2005 ATTACHED NOTICE NOTE: To insure proper crec:ll t to your acCCMmt, sub.lt the upper portion of this for. with your tax P8Yllent. 46,981. 02 ?li .9A7 lil 19,993.51 19,993.51 .00 (19)= .00 .00 .00 .00 .00 .AX C DIT": . n '.J AHOUNT PAID DATE _BER INTEREST/PEN PAID I-I TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF AOOITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YDU HAY BE DUE A REFUND. SEE REVERSE SlOE OF THIS FORN FOR INSTRUCTIONS.I - IN RE: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ELLA G. HORSLEY ORPHAN'S COURT DIVISION NO. 21 03-1037 FIRST AND FINAL ACCOUNTING Of the Estate of Ella G. Horsley. Deceased, Late of Cumberland County, Pennsylvania. Filed on behalf of Sheila A.Thurston, Executrix Date of Death: Letters Testamentary Granted: November 27,2003 December 18, 2003 Letters Advertised: Cumberland Law Journal: 02/20/04, 02/27/04, 03/05/04 The Sentinel - Carlisle: 02/26/04 thru 03/11/04 Accounting filed: ACCOUNT FINAL AS OF: LAW OFFICES OF STEPHEN J. HOGG 19S.HANOVERSTREET SUITE 101 CARLISLE, PA 17013 - IN RE: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ELLA G. HORSLEY ORPHAN'S COURT DIVISION NO. 21 03-1037 Purpose of the Account: Sheila A. Thurston, Executrix of this Estate files this Accounting to acquaint interested parties with the transactions that have occurred during his execution. The Account also indicates the proposed distribution of the estate. It is important for the Account to be carefully examined. Requests for additional information or questions or objections can be discussed with the undersigned Attorney for the Estate. Stephen J. Hogg, Esquire 19 S. Hanover Street, Suite 101 Carlisle, PA 17013 (717) 245-2698 Attorney for Estate LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 RECEIPTS OF PRINCIPAL CASH M& T Bank Account#1 0556907 Social Security Deposit Deposit Interest through September 2005 Subtotal REFUNDS Highmark Blue Shield Seidle Hospital Resident Fund Subtotal MISCELLANEOUS Miscellaneous Jewelry TOTAL GROSS ASSETS $45,865.96 $ 577.00 $ 188.10 $ 224.14 $46,855.20 $ $ $ 12.24 32.00 44.24 $ 100.00 $ 46,999.44 LAW OFFICES OF DISBURSEMENTS OF PRINCIPAL EXPENSES AND DISBURSEMENTS Social Security Repayment $ 577.00 Safe Deposit Box Rental $ 2.50 Pinnacle Health Services $15,284.82 $15,864.32 Subtotal ADMINISTRATIVE EXPENSES Pre-Paid Funeral Expenses $ 6,000.00 $ 2,348.75 $ 2,348.75 $ 102.00 $ 75.00 $ 98.69 $ 28.00 $ 130.00 Personal Representative's Commission Attorney Fees Probate Fees Advertisement: Cumberland Law Journal Carlisle Sentinel Inheritance Tax Return Fee Final Accounting Filing Fee Subtotal $11,131.19 NET TOTAL EXPENSES AND DISBURSEMENTS $26,995.51 TOTAL EXPENSES AND DISBURSEMENTS $26,995.51 TOTAL GROSS ASSETS $46,999.44 LESS EXPENSES AND DISBURSEMENTS $26,995.51 STEPHEN J. HOGG NET ESTATE AMOUNT FOR DISBURSEMENT 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 $20,006.93 LAW OFFICES OF STEPHEN J. HOGG J9 S. HANOVER STREET SUITE !OJ CARLISLE, PA 17013 . . VERIFICATION I Sheila A. Thurston, do hereby verify that I am the Petitioner herein, and that the facts set forth in the aforegoing First and Final Accounting are true to the best of my knowledge, information and belief, upon information supplied. I understand that false statements herein are subject to the penalties of 18 Pa, C.S.A. ~4904, relating to unsworn falsifications to authorities. Date: /-o-/7-CS- 'zz . ) ". LL~~fL ~ ./ Sheila A. Thurston Sworn to or affirmed and subscribed to before me by witnesses, this 17m- day of (!)C~~..~ ,2005. (I UwJJ. ~A~.i Notary Public My Commission Expires: Notarial Seal . . d Notary Public Niven J. Brof. be I nd County Carlisle Boro, Cum f a 2 2006 My Commission ExpIres Nov., . Member. pennsylvania Association of Notanes . . . . CONSENT TO DISTRIBUTION I, the undersigned party in interest in the Estate of Ella G. Horsley, aver I have received and read a copy of the attached First and Final Accounting with a proposed final distribution schedule. I understand the proposed distribution and have no objection thereto. Date: / Z> - J 7 -'oS- ~~t2 ~ Sheila A. Thurston LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 " i5a5~g.~:t;~;: ""! ~ ~-ai'n ~5;'\!! ol::J-<~ (;01 ~ :5"01; ~8i ~. . ~~a~ ~ ~!C.i~~ ~5~~~1~~ ~i5if!?5 ~~<D"i~~fI gQ~I'<ff~S. ~Q.s.::Jff:f5.- ::1l f!!. glQ. '3! m i5 Q. 3 ~ Cii (I) 0"2. ::1l ~tll"O::J:t;o~3' . ::]moa5.COtO '" (l) .~ Q ~ V_," i~~a.J~ii~i~ " GUH!i~H! .....'......,~.~.'. ~'l. in f I i ~ i i.. .",~, ~;ilpji~.li~ ~ - ~!~ ~p ~ ;. !!3~[" <:>, !to-< -.. 11>- 'l!: <'!' ..~ ~-IlH'- i :gl:!';~!~ ". ~.; i5ii!! =j 3: Ql..tC~<D"I_2~ (~ ~.3:iiii'''''\1:l)'''.''':s: (1 -:-... 3; 3" em ;=: ~ ~ :; 6" ::::~,.ft. ~ m:.. .-;';. ,'1, <:), ;:-.- , "'<~...,~\, r\~ .\ "':I 30<0 H n ~ C/.l ....)oCJ) r:I:l ~ H "0 - :II . ",,...J: ~I~ t'J ~ ~c;;)o bJ t-' ~ 0 .,...z "Ot'J t-' H:Z: "0 ~JT1~ t'J~ ~ ;1.:0 0 :z:t-' t'J C/.l :g"m z~t-' "' >TJ t'J .~:II C/.lZ~ t'JH 0 -nz~ Z 0 ><10H C/.l:Z: ~<-4 :::: t-' t'J :0:: H~ 0 ~CJ):II <:n 0 ~t-' H -<m ~. 0 ~oo ~ H C/.l -<m >=rn ZC::"':I C/.l t'J~ H ~>-4 H:Z: t-' n ~ .:::l z . ~8 ~H t'J on H ",>~ ><1 ><1 "':10 bJ ""-- c:: c:: '{'....iT! z H ~~- H H ~"'~ H 0 Z Z "' 0 "':I ;'~. :'I ~. ".-) \.:J .; j .: .J ( ,'~; .., ... Cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 10/11/2005 HOGG STEPHEN 19 S HANOVER SUITE 101 CARLISLE, PA J STREET 17013 RE: Estate of HORSLEY ELLA G File Number: 2003-01037 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 is due by: 11/27/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, 1fM!dL.~~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge t-{... LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 IN RE: ESTATE OF ELLA G. HORSLEY IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION NO. 21 03-1037 PROPOSED DISTRIBUTION OF $20,006.93 Paragraph 2Aof Will: VFW of Camp Hill PA 50% share Seventh Day Adventist Church, Camp Hill PA 50% share $ 10,003.46 $ 10,003.46 ,~.) (-; r.....,) t7:'_~:l ,;.::~)o :;,../-' '-0 -v c..) (.)1 , ,/1 c , '. , ' Iii' ~~:. cc1.c :JO~~ 8~ g! ''It :e Q. ID .... 6:, /- u; 1:. /' :.; ~,) :0 :::: g -,' > ,,.'7 :J:: /'"': ':''''." ::I ~C:CIl.a ~-.~= 1/ >olll. I 1_."2V/~: rI _ 0 (; #'=8o~' 2:-. I ~ t~:; " L) c-:' [ t c, Ii.. 0 '-' Z Z o(<)~ 0 H ........~ H H J~ H Z ~Rth ::J ::J -....'t P=I o Ii.. >-< >-< ::;)<(\1 H uo ~ H~ rJ?zr::: i=<:: u H ZH .-<.... H ~~ en Ii..::JZ w::i~ en H i=<:: OO~ (.) .~ w>~ H H~ 0 u:> It ~~ ~C/)u.. ~ ~H :J:: ~ H zen H~>-< Oiz c/)z ~ H~ . ~Zen ~ ex: a:ffio ~ Ii.. '-' H~Z ~ g wa..$ en ~ HZ > .~ 0 ~~ ~ i=<::~ e< OW p.. ZH H ~p.. Z...J. 0 ~ H P=I <~~ i=<:: ~ S :x:...J(\I p.. H fI} . a: _ C/)<" en u ~OE i=<:: H Ii.. .. _.' .(") ,t) .ql ,;.':)_ " (~ ::: u ~ ~ E ~ rE ~ ...:- ;; '$ 'l:il lC '.- '~ :0 .. 'E 'l1l .2 iE? ~ ~ <E ,~ ~J .Ql~ 'I:: :>.:a> '^'" ~ '1tl> :S ~-i~;g.~~~ :J.: lo::<Xll-lll.a.~iii,a. ~ ~"l~llIll"",,:5<Ql'" ~ i~1!l-;~~;!l! ~ ~j~iIE~i f ~ g~~I~B';5S= R"'- !~ !Iihr~i ,~ '^, i It .. j ~J: !,i"~ " ~ g!l;lBI0, ! ; ! ~ il ri ~ ~ jjli8i se;g> .!!~!!!~ ~~i~ ., c: 0 o Q) V> Clw'EE!2:;:.c' ct,)~"" .... ~ =<oO~~o.l\1C!:l ~ 0. () Q} > .... E'- w w - .- W .- (J .s;; "0 .r: c:: 01:5 <0 'a3 ....C~S2cOUc 'O:S >-~ ~o2 8E"i.g ~j- +::;..........cnQ) 0 ga5!Jl~ ~ 101 . 0(0 ~"O~~, i~....ti ~~~15~ii~ ~ ~ :; ~ i I ~ I~,. f~11gi!~~ >- 8 ! ~ ~ S .!it ~ e~i(.)~~~I~ !!? .!9.c: ..."~.... .... _ "/ii ,>-.. \~ '" t"'-.' "',, \ 1,_,' ~ '-.) STATUS REPORT UNDER RULE 6.12 Name of Decedent: Ella G. Horsley Date of Death: 11/27/2003 Will No. Admin. No. 21 03-1037 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. account with the Court? Did the personal representative file a final Yes X No b . The separate Orphans I 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 Clerk of the Orphans' Court and may be attached to this repo . Date: 10/20/2005 Si Steohen J. Haag. Esauire Name (PleJi..se type or print) 19 South H~nover Street, Suite 101 Carlisle PA 17013 Address i ( U') {", (717 ) 2452698 Tel. No . 0_ Capacity : Personal Representative c.J X Counsel for personal representative 01