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Home My WebLink About03-1049 PETITION FOR PROBATE and GRANT OF LETTERS Estate of Sara A. Murray No. o--~/-~t 3 ~-/O also known as To: , Deceased Social Security No. 172-01-2967 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut rix in the last will of the above decedent, dated September 6. 2003 and codicil(s) dated Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Gumberland County, Pennsylvania, with h ~1' last family or principal residence at Messiah Villao~ 100 Mount Allen [3rive. Mechanicsb[ffg (list street, number and municipality) Decedent, then 89 years of age, died at Messiah Villaoe Excep~ as follows, decedent did not marry, was not divorced and did not have a child born or adopted after exe~ :ution of the will offered for probate; was not the victim of a killing and was never ajudicated incompe! ent: Decedem at death owned property with estimated values as follows: (If domi¢ iled in Pa.) All personal property $ (If not dc miciled in Pa.) Personal property in Pennsylvania $ (If not dc miciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated ~ follows: WHEI~ EFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary thereon. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) '~ :rances B. Anthony /" Harrisburg PA 17199 OATH OF PERSONAL REPRESENTATIVE COMI~ ONWEALTH OF PENNSYLVANIA COUN~?¥ OF Cumberlandf SS The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition arc tree and dorrect to the best of the knowledge and belief of petitioner(s) and that as personal represen- tat~ve(s) qfthe above decedent pet~tmner(s) wall well and truly administer th~ding to law. sworn to ,r arr. ed and subscribed r /~ before m~ this 17tJtlaw631 / ~ - Donna N. Otto, 1st Deputy Regiffer .~.~,J~~.: 222.300.00 No, 21-2003-104q Estate of Sara A. Murray ., Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW December 22nd, 2003 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated ~[8103 described therein be admitted to probate and filed of record as the last will of Sara A. Murray and Letters Testamentant are hereby granted to Frances B. Anthony FEES Probate, Letters, Etc ......... $ 270.00 Short Certificates ( 6 ) ...... $ 18.00 3. ........ $ 9.00 $ 10.00 TOTAL $ Filed...Dg.c..em.~.r. 22nd, 2003 Maile Letters to Attorney on 12/22/2003 Donna M. ~;g~s;e:;fs~'llLputy ~ William J. Peters, Esquire 09983 ^TTORNEY (Sup. Ct. I.D. No.) 2931 North Front Street Harrisbura PA 17110 ADDRESS 717-283-7555 PHONE 21-2003-1049 REGISTER OF WILLS OF CL~nberland COUNTY OATH OF SUBSCRIBING WITNESS Elizabeth E. Mehar.que and Andrew W. Crosley Donna M. codicil (each) a subscribing witness to the twill~ presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that We were present and saw Sara S. Murray , the testat rix , sign the same and that We signed as a witness at the request of testatrix in haT___ 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 17th day of December ~ 2003 Otto, 1st Deputy (A dress) (Address) RE~'GISTER OF WILLS OF COUNTY O~,.,,TH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto~~ ~e(s) and say(s) thal -~ familia~ith the signature off/ , ....... ~ ./ co~ic!!_ testat.__ of (one of the subscribing w'i~esses to. the will presented herewith and , ,. ~/ .... .c. od. it. il that .... ~ture on the will is in the handwriting of to Sworn to or affirmed and subscribed b~fore -~ me this : day of (Name) 19 (Address) / Register (Name) (Address) his is to certi .fy that the information here given is correctly copied frown 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 9651167 No. Local-Registrar - NOV G 2003 Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH '-.~O~ ~. ,.Female ,. 172 -- O1 --2967 ,.November 23, 2003 ~. Cumberland ~. Upper Allen ~p. ~ I~ .... .~R~ ....... ' I'" ~ite Su-ervisor ] Met. g~fe Insuranc~ '"- ~ ~,,~ ~,~ ~ 1~ ~ ~ I o~=~.~ Widowed 222 Messiah Circle ~CTU~t ,~..S,.,. PA o~ ,~,.~v,.~, Upper Allen Twp. Mechanicsburg, PA 17055 <~'"~ ..... ~. , ,. ,,. George E. Rudy ~, Carrie Mehargue ~. Frances B. Anthony ~. 649 Sandra Ave. Harrisburg, PA 17109 ~,~ ~,<s,~.~""~' ® c,.~,~ ~ ,.~,,~om m,,.~ ~ ("~'"'~ November ~' ~} ~ ~,.,m~. t~A~m~- c~. s,,,,, z~ ~ PA *,.. . 28, 2003 n~. Rolling Green Cemetery '[~,,. Lower Allen Twp. 17011 ,,..~./~, Z/;, ~, ./~15~,.. ~.~O,'~'P~'f -/_ ~ Richardson F.H. 29 S. EnolaDr. Enola PA 17025 ~ = ~ avaa~e al t~ of ~alh Io (~a~ TW~) J ~ ~ j . [ ~ ~ ; LICENSE NUMBER ID~E S~NEO ou~ m EOO~ P~CE 21-2003-1049 LAST WILL AND TESTAMENT OF SARA A. MURRAY I, SARA A. MURRAY, a resident of Messiah Village, Mechanicsburg, Cumberland County, Pennsylvania, being of sound mind and memory do make, publish and declare this to be my Last Will and Testament and revoke any Will previously made by me. ITEM I. I direct that my Executrix hereinafter named shall pay all my just debts and funeral expenses and expenses of my last illness as soon after my decease as may be found convenient. ITEM II. I give and bequeath my diamond engagement ring to my great-niece, Michelle B. Souders, of East Pennsboro Township, Cumberland County, Pennsylvania, as her property absolutely. ITEM III. I give and bequeath my hematite ring to my great-niece, Karen A. Souders, of East Pennsboro Township, Cumber- land County, Pennsylvania, as her property absolutely. ITEM IV. I give and bequeath my ring with the blue stone setting to my great-niece, Wendy L. Merris, of Lemoyne, Pennsyl- vania, as her property absolutely. ITEM V. I give and bequeath the sum of One Thousand Dollars ($1,000.00) to Zion Lutheran Church of Enola, Pennsylvania, to be used as its Council deems advisable. sara A'.'Murray zf ITEM VI. Ail the rest, residue and remainder of my estate I direct my Executrix hereinafter named to convert into cash as soon after my decease as may be found convenient. I direct that upon conversion of the residue of my estate to cash, the same shall be divided into three equal parts which I give and bequeath as follows: (1) a one-third part to my sister, Frances B. Anthony, of Harrisburg, Pennsylvania, as her property absolutely. In the event my sister, Frances, shall predecease me, I give and bequeath to her husband, Randolph L. Anthony, of Harrisburg, Pennsylvania, one-third of her share in my estate, provided however, that said share shall not exceed Four Thousand Dollars ($4,000.00). (2) a one-third part to my nephew, George W. Erford, of Enola, Pennsylvania, and my niece, Kathleen A. Merris, of Camp Hill, Pennsylvania, share and share alike, or the survivor of them. (3) a one-third part to my great-nephew, Kevin T. Merris, of Mechanicsburg, Pennsylvania, and my great-nieces, Wendy L. Merris, of Lemoyne, Pennsylvania; Michelle B. Souders and Karen A. Souders, both of Enola, Pennsylvania, share and share alike, or the survivor of them. ITEM VII. In the event any share of my estate under this Will or otherwise passes to a minor, I direct that the same shall be placed in trust payable to the minor upon attaining the Sara A. Murray -2- age,of twenty-one (21). Such trustee shall have the power to use the principal as well as the income from time to time for the minor's education, support and welfare. I appoint my nephew, George W. Erford, as trustee of any such trusts. ITEM VIII. All taxes and interest and penalties thereon payable by reason of my death with respect to property comprising my gross taxable estate, whether or not passing under this Will, shall be paid from the principal of my residuary estate. ITEM IX. I appoint my sister, Frances B. Anthony, Executrix of this my Last Will and Testament. In the event of her death, inability or refusal to act for any reason whatsoever, I appoint my nephew, George W. Erford, and my niece, Kathleen A. Merris, as Co-executors hereunder. No fiduciary acting hereunder shall be required to post bond or enter surety in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament which consists of four (4) typewritten pages this ~ day of ~~a~ , 2003. Sara A'. Murray Signed, published and declared by Sara A. Murray, the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence, and in -3- the presence of each other, all being present at the same time, haVe hereunto subscribed our names as witnesses. residing at ~f3z~o ~. ~ S~ -4- B re the Register of Wills Cumberland County, Pennsylvania CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Sara A. Murray Date of Death: 11/23/03 Admin. No. 2003-01049 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 Name Address Frances B. Anthony George W. Erford Kathleen A. Merris Kevin T. Merris 649 Sandra Avenue HarrisbvrQ, 215 South Enola Drive Enol~ 407 Penn Ayr Road ¢¢mp Hill 14 Greenway Drive Mechani~burq PA 171O9 pA 17025 PA 17011 PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: Signature Name: William J. Peters Address: 2931 North Front Str~t Harrisburo PA 17110 Capacity: Telephone(717) 2387555 X Personal Representative Counsel for Personal Representative Sara A. Murray Continuation of Certification of Notice Under Rule 5.6(a) Page 1 11/23/03 Names and addresses Name Wendy L. Merris Michelle B. Souders Karen A. Souders Zion Lutheran Church Address 703 Ohio Avenue Lemoyne PA 17043 8 Glenwood Drive, East Camp Hill PA I .'(,: 318 Rosewood Lane Enola~ PA 17025 265 North Enola Drive Enola~ PA 17025 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 REV-1162 EX(11-96) OO3577 PETERS WILLIAM J ESQ 2931 NORTH FRONT ST HARRISBURG, PA 17110 ........ fold ESTATE INFORMATION: SSN.. 172-01-2967 FILE NUMBER: 2103- 1049 DECEDENT NAME: MURRAY SARA A DATE OF PAYMENT: 02/1 9/2004 POSTMARK DATE: 02/1 8/2004 COUNTY: CUMBERLAND DATE OF DEATH: 1 1/23/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 830,000.00 REMARKS: TOTAL AMOUNT PAID: RECEIVED OF FRANCES B ANTHONY IN C/O WILLIAM J PETERS,ESQ $30,000.00 SEAL CHECK//101 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Register of Wills of Dauphin County, Pennsylvania Estate of Sara A. Murray also known as INVENTORY ., Deceased Date of Deeth 11/23/03 $ociel Security No. 172-01-2967 Pemonal 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. INVe 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. Name of Attorney: William J. Peters~ Esquire LO. No.: 09983 Address: 2931 North Front Street Harrisburg PA 17110 Personal Representative: Frances B. Anthony Telephone: 7172387555 Description Metlife Policyholder Trust 38.000 Shares CUSIP #59156R10 Certificate of Deposit Waypoint Bank PO Box 17111 Harrisburg, PA 17105-1711 #900003175 Certificate of Deposit Waypoint Bank #965295062 Certificate of Deposit Waypoint Bank #966229467 Certificate of Deposit Waypoint Bank #966255703 Certificate of Deposit Wachovia Bank - Colonial Park, Harrisburg, PA #247412041188743 (Attach Additional Sheets if necessary) Value 1,346.83 Total !"-" ;,' .' ~ -r ~,205.33 '~ 137,943.40 12,550.02 7,713.65 7,017.84 226,688.22 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 Sara A. Murray Description of Inventory PaRe 1 Blue Cross/Blue Shield refund Quantum Imaging Refund Met Life Annuity #340338RA Waypoint Bank Savings Account #5500031286 Waypoint Bank Checking Account #900033325 Personal Jewelry Description Subtotal Value 273.45 9.00 1,175.00 304.70 43,849.00 300.00 45,911.15 Gmnd To~l $ 226,688.22 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIA O X Murray, Sara A, DATE OF DEATH (MM-DD*Year} 11/23/2003 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DATE OF BIRTH (MM-DD-Year) 01/10/1914 (IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST. AND MIDDLE INITIAL) Not applicable OFFICIAL USE ONLY FILE NUMBER &J_-_o_ - _z o q_fi_ SOCIAL SECURITY NUMBER 1 7 2-0 1 -2 9 6 7 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOClALSECU~TYNUMBER [] 1. Original Return [] 4. Limited Estate ~-16. Decedent Died Testate (Attach copy [] 9. Litigation Proceeds Received [] 2. Suppremental Return r~4a. Future Interest Compmmice (uae orae.~:h ar~ ~2.12.a2) ~]7. Decedent Maintained e Living Trust (At~ My ol Trust) r~ lO. Spaesal Pove~ Credit (d~ of deam be~en 12-31.91and 1.1.95) ]3. Remaieder Return (dateoldeahpriartot2-13-82) ]5. Federal Estate Tax Return Required __ 8. Total Number of Safe Deposit Boxes [--]11. Election to tax under Sec. 9113(A) (~ach sch ol NAME William J. Peters, Esquire FIRM NAME (If Applicable) Peters & Wasilefski TELEPHONE NUMBER 7172387555 1. Real Estate (Schedule A} 2. Stocks and Bonds (Schedule B) 3. Closery Herd Corporation, Partnership or Sole-Proprietorship 4. Morlgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Misceltaneous Personal PropeRty (Schedule E) $. Jointly Chvned Properly (Schedule F) ] Separate Billing Requested 7. Intar-Vivsa Transfers & Miscellaneous Non-Pmbata Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Scheduta 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 ) COMPLETE MAILING ADDRESS 2931 North Front Street Hardsbur,q (1) (2) (3) (4) (5) (6) (7) (9) (lO} 13. Charitable and Govemmental Baques~Sec 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 SIBE FOR APPLICABLE RATES ~, .83 181,187.69 4~,153.70 PA 17110 OFFICIAL USE ONLY (ti) (11) (12) (13) (14) 13,397.13 1,852.23 226~688.27 15,249.36 211 ~438.86 1 ~000.00 210~438.86 15. Amount of Line 14 taxabta at the spousal tax rata, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rata 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collatoral rate 19. Tax Due X (15) X (16) 70,218.03 x .12 (17) 140,567.66 x .15 (18) (re) 8~426.16 21,085.15 29~511.31 'Decedent's Complete Address: I~,~^OeRESS 222 Messiah Circle c~w Mechanicsburg I STA?E PA I ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 30.000.{)0 (1) Total Credits ( A + B + C ) (2) 3. Interesl/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Une I + Une 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 Une 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. (SB) Make Check Payable to: REGISTER OF WILLS, AGENT 29~511.31 30~000.00 488.69 0.00 0.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a traesfer and: Yes No a. retain the use or income of the proberty trensferred; ........................................................................... [] [] b. retain the right to designate who shall use the prepody 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 preperly 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-prebate property which contains a beneficiary designation? ....................................................................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. I~ar a~ao f~p~a~Uo~ rd~Clan~l~ naVa~ ~ta~ ~s ~13 ~l~c~ d~ ~o~n '~o~vhs~ C ~mu ~am ~a~ta~e~nnets~ ~a~dge~' the best of my Imowledge aad bel,ef, ,t ,s true, co.eot aAd complete. SIGNA~TURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS 649 Sandra Avenue Harrisburg SIGNATURE OF PREPARER,OTHER THAN {[EPP~-~SENTATIVE 2931 North Fro~-,~t-- PA 17109 DATE Harrisbur,q PA 17110 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 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 oe the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepperent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the desedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(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. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an indivldual who has at least one parent in common with the decedent, whether by blood or adoption. ?EV-150,3 EX + (6-98) COMMONW~-ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Murrav. Sara SCHEDULE B STOCKS & BONDS I FILE NUMBER All property Jointly.owned with right of sundvor~hlp must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION Metlife Policyholder Trust 38.0000 Shares CUSIP #59156R10 VALUE AT DATE OF DEATH 1,346.83 TOTAL (Also enter on line 2, Recapitulation $ 1 ~346,83 (If mom space is needed, inser~ addi~onal sheets of the same size) , REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Murrav. Sara A, SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER Include the proceeds of Iitiga~n and the date the proceeds were received by the estate. All property jointly.owned with right of survivorship must be dlsclesed on Schedule F. ITEM NUMBER DESCRIPTION 2. 3, 4, 5. 6. 7. 8. 9. Certificate of Deposit - Waypoint Bank PO Box 17111 Harrisburg, PA 17105-1711 #900003175 Certificate of Deposit Waypoint Bank ~965295062 Certificate of Deposit Waypoint Bank 966229467 Certificate of Deposit Waypoint Bank #966255703 Certificate of Deposit Wachovia Bank - Colonial Park, Harrisburg, Pennsylvania #247412041188743 Blue Cross/Blue Shield refund Quantum Imaging Refund Met Life Annuity ~340338RA Personal Jewelry VALUE AT DATE OF DEATH 14,205.33 137,943.40 12,550.02 7,713.65 7,017.84 273.45 9.00 1,175.00 300.00 TOTAL (Also enter on line 5, Recapitulation) $ 181 ~187.6,0 (if more space b needed, insert additional sheets of the same size) , REV-150~EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Murrav. Sara ~, If an asset was made Joint within one year of the decedents date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME RELATIONSHIP TO DECEDENT A. Frances B. Anthony B c ADDRESS 549 Sandra Avenue Harrisburg, Pennsylvania 17109 Sister JOINTLY-OWNED PROPERTY: LE'FrER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD*S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT*S INTERF: 1. ~,. 10/8/02 Waypoint Bank 609.40 50. 304.71 Savings Account #5500031286 2. A. 8/12/97 Waypoint Bank 87,698.0(3 50. 43,849.0~ Checking Account #900033325 TOTAL (Also enter on line 6, Recapitulation) $ ...... 44,153. (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENTDECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER Murray. Sara ~, Debts of decedent must be reporlsd on Schedule ]. ITEM NUMBER DESCRIPTION AMOUNT 2. 3. 4. '7, 8. 9. FUNERAL EXPENSES: Richardson Funeral Home, Inc. Luncheon Postage and Cards Printing Bulletins ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Secu~/Number(syEIN Number of Pemonal Representative(s) Street Address City State Year(s) Commission Paid: Attomey Fees Peters & Wasilefski Family Exemption: (If decedenfs address is not the same as claimant's, allach explanation) Claimant Zip l Street Address C~ty State Relationship of Claimant to Decedent Probate Fees Register of Wills, Cumberland County, Pennsylvania Tax Retum Preparers Fees H&R Block Waypoint Bank - Cost of Checks Coumberland Law Journal The Sentinel Zip 4,696.00 105.00 26.70 20.00 8,000.00 307.00 76.00 3.00 75.00 88.43 TOTAL (Also enter on line 9, Recapitulation) $ 13~397.1,3 (If mom space is needed, insert additional sheets of the same size) ' REV-151"2 EX + (6-98) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES~ & LIENS COMMONW~.ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Murrav. Sara A. Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION Messiah Village Mechanicsburg, Pennsylvania Last month of stay Verizon Phone Bill Messiah Village dry cleaning Quantum Imaging VALUE AT DATE OF DEATH 1,822.39 9.84 10.25 9.75 TOTAL (Also enter on line 10, Recapitulation) $ 1 t852.23 (If mom space is needed, inser~ additional sheets of the same size) COMMONV, rcALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Murrav.: ara A, NUMBER I. 1. 2. 3. 4. 5. 6. 7. II. 1. 1. FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS include outright spousal distributions, and transfers under Sec. 9116 (a) 1.2)] Frances B. Anthony 649 Sandra Avenue Harrisburg, Pennsylvania 17109 George W. Erford 215 South Enola Drive Enola, Pennsylvania 17025 Kathleen A. Merris 407 Penn Ayr Road Camp Hill, Pennsylvania 17011 Kevin T. Merris 14 Greenway Drive Mechanicsburg, Pennsylvania 17055 Wendy L. Merris 703 Ohio Avenue Lemoyne, Pennsylvania 17043 Michelle B. Souders 511 Market Street, Second Floor New Cumberland, Pennsylvania 17070 Karen A. Souders 318 Rosewood Lane Enola, Pennsylvania 17025 Sister Nephew Niece Great-nephew Great-niece Graat-niece Great-niece 33.36% 16.66% 16.66% 8.33% 8.33% 8.33% 8.33% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Zion Lutheran Church of Enola 265 North Enola Drive Enola, Pennsylvania 17025 1,000.00 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE D~STRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 1 ~000.00 (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF SARA A. MURRAY ITEM II. to my great-niece, Michelle B. Souders, Cumberland County, Pennsylvania, as her ITEM III. I give and bequeath my hematite ring I, SARA A. MURRAY, a resident of Messiah Village, Mechanicsburg, Cumberland County, Pennsylvania, being of sound mind and memory do make, publish and declare this to be my Last Will and Testament and revoke any Will previously made by me. ITEM I. I direct that my Executrix hereinafter named shall pay all my just debts and funeral expenses and expenses of my last illness as soon after my decease as may be found convenient. I give and bequeath my diamond engagement ring of East Pennsboro Township, property absolutely. great-niece, Karen A. Souders, of land County, Pennsylvania, as her East Pennsboro Township, property absolutely. I give and bequeath my ring with the blue ITEM IV. to my Cumber- stone setting to my great-niece, Wendy L. Merris, of Lemoyne, Pennsyl- vania, as her property absolutely. ITEM V. I give and bequeath the sum of One Thousand Dollars ($1,000.00) to Zion Lutheran Church of Enola, Pennsylvania, to be used as its Council deems advisable. .sara A. Murray ITEM VI. Ail the rest, residue and remainder of my estate I direct my Executrix hereinafter named to convert into cash as soon after my decease as may be found convenient. I direct that upon conversion of the residue of my estate to cash, the same shall be divided into three equal parts which I give and bequeath as follows: (1) a one-third part to my sister, Frances B. Anthony, of Harrisburg, Pennsylvania, as her property absolutely. In the event my sister, Frances, shall predecease me, I give and bequeath to her husband, Randolph L. Anthony, of Harrisburg, Pennsylvania, one-third of her share in my estate, provided however, that said share shall not exceed Four Thousand Dollars ($4,000.00). (2) a one-third part to my nephew, George W. Erford, of Enola, Pennsylvania, and my niece, Kathleen A. Merris, of Camp Hill, Pennsylvania, share and share alike, or the survivor of them. (3) a one-third part to my great-nephew, Kevin T. Merris, of Mechanicsburg, Pennsylvania, and my great-nieces, Wendy L. Merris, of Lemoyne, Pennsylvania; Michelle B. Souders and Karen A. Souders, both of Enola, Pennsylvania, share and share alike, or the survivor of them. ITEM VII. In the event any share of my estate under this Will or otherwise passes to a minor, I direct that the same shall be placed in trust payable to the minor upon attaining the Sara A. Murray -2- age ~of twenty-one (21). Such trustee shall have the power to use the principal as well as the income from time to time for the minor's education, support and welfare. I appoint my nephew, George W. Erford, as trustee of any such trusts. ITEM VIII. Ail taxes and interest and penalties thereon payable by reason of my death with respect to property comprising my gross taxable estate, whether or not passing under this Will, shall be paid from the principal of my residuary estate. ITEM IX. I appoint my sister, Frances B. Anthony, Executrix of this my Last Will and Testament. In the event of her death, inability or refusal to act for any reason whatsoever, I appoint my nephew, George W. Erford, and my niece, Kathleen A. Merris, as Co-executors hereunder. No fiduciary acting hereunder shall be required to post bond or enter surety in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament which consists of four pages this ~ day of~ , 2003. 0 ' (4) typewritten Sara A. Murray Signed, published and declared by Sara A. Murray, the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence, and in -3- the presence of each other, all being present at have hereunto subscribed our names as witnesses. the same time, at residing at -4- BUREAU C~F P(~ ~U~ 280601 ,,~v , .... 20 fiDEC 29 AH 9:09 CLERK ORPHAN'S COURT PETE~u'& WXS'~ L~KI 29~I H FRONT ST PA ITIIO COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 1Z-ZO-200q MURRAY 11-Z$-2003 Zl 03-10q9 CUMBERLAND 101 Amount Remitted REV-ISq7 EX AFP (gg-B4) SARA A MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MURRAY SARA A FILE NO. 21 03-1049 ACN 101 DATE 12-20-200q TAX RETURN HAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Estate (Schedule A) (1) 2. Stocks end Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) q. Mortgages/Notes Receivable (Schedule D) (q) $. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Nat Value of Tax Return lt346.83 .00 181t187.69 qq1153.70 .00 .00 NOTE: To insure proper cred/t to your account, submit the upper portion .00 of this form with your tax payment. (8) 13,397.13 13. lq. NOTE: ASSESSNENT OF TAX: 15. Amount of Line lq at Spousal rata 16. Amount of Line lq taxable at Lineal/Class A rata 17. Amount of Line lq at Sibling rate 18. Amount of Line lq taxable at Collateral/Class B rata 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT OTSCOUNT DATE NUMBER INTEREST/PEN PAID 02-18-200~ CD003577 1,~28.85 226,688.22 1,852.23 (11) 1~.2~.9.3~ (12) 211,q38.86 1,000.00 AMOUNT PAZD 30,000.00 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT 31,q28.85 BALANCE OF TAX DUEI 2,851.83CR ~NTEREST AND PEN. .00 TOTAL DUE 2,851.83CR ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REgUZRED. IF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU MAY BE DUE · A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTZONS.) %~1C_. (15) .00 x O0 = .00 (16) .00 x Oq5= .00 (17) 99,626.93 x 12 = 11,955.23 (18) 110,811.93 x 15 = 16,621.79 (19)= 28,577.02 reflect figures that lnclude the total of ALL returns assessed to date. Char/table/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) Nat Value of Estate Sub~ect to Tax (lq) 210,q38.86 if an assessment ~as lssued prevlously, l/ems 14, 15 and/or 16, 17, 18 and 19 ~ill REV-1470 EX (6-88) INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG~ PA 17128-0601 DECEDENT'S NAME FILE NUMBER Sara A. Murray 2103-1049 REVIEWED BY ACN Sheila Megonnell 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES F Jointly-Owned Propert7 is taxable outright to the beneficia~ before determining residue. Row Page 1 STATEMENT OF ACCOUNT FRANCES B. ANTHONY EXECUTOR OF THE ESTATE OF SARAA. MURRAY Personal Property Metlife Policyholder Trust Certificate of Deposit - Waypoint Bank Certificate of Deposit - Waypoint Bank Certificate of Deposit - Waypoint Bank Certificate of Deposit - Waypoint Bank Certificate of Deposit - Wachovia Bank Blue Cross/Blue Shield Refund Quantum Imaging Refund Met Life Annuity Savings Account - Waypoint Bank Checking Account - Waypoint Bank Personal Jewelry Total Income Disbursements Richardson Funeral Home Luncheon Postage and Cards Printing Bulletins Peters & Wasilefski - Attorneys Fees Cumberland County Register of Wills H & R Block Waypoint Bank - Cost of Checks Cumberland Law Journal The Sentinel Messiah Village - Last Month of Stay Verizon - Phone Bill Messiah Village - Dry Cleaning Quantum Imaging Inheritance Tax Payment Charitable Bequeath - Zion Lutheran Church of Enola Total Disbursements $1,346.83 $14,205.33 $137,943.40 $12,550.00 $7,713.65 7,017.84 $273.45 $9.00 $1,175.00 $304.70 $43,849.00 $300.00 $226,688.20 $4,696.00 $105.00 $26.70 $20.00 $8,000.00 $307.00 $76.00 $3.00 $75.00 $88.43 $1,822.39 $9.84 $10.25 $9.75 $28,577.02 $1,000.00 $44,826.38 Balance for Distribution $181,861.82 Proposed Distribution to Beneficiaries Frances B. Anthony (33.36%) George W. Erford (16.66%) Kathleen A. Merris (16.66%) Kevin T. Merris (8.33%) Wendy L. Merris (8.33% includes ring) Michelle B. Souders (8.33% includes ring) Karen A. Souders (8.33% inlcudes ring) $60,669.10 $30,298.18 $30,298.18 $15,149.09 $15,149.09 $15,149.09 $15,149.09 Total Distribution $181,861.82 r, , !::J F AMIL Y SETTLEMENT AND FINAbiImLEASE ESTATE OF SARA A. MURRAY ..),- 03-- ,O/q KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Sara A. Murray, late of 222 Messiah Circle, Mechanicsburg, Cumberland County Pennsylvania, Deceased, died Testate on November 23, 2003, having made her Last Will and Testament, which was duly executed on September 6, 2003, and duly recorded in Cumberland County, Pennsylvania December 22, 2003 File No: 2003-010490, Register of Wills; and WHEREAS, the said Sara A. Murray, by her aforesaid Last Will and Testament, named Frances B. Anthony, Executrix of her Last Will and Testament; and WHEREAS, Letters Testamentary on the Estate of the said Sara A. Murray were duly issued by the Register of Wills of Cumberland County, Pennsylvania, to the said Executrix on December 22,2003; and WHEREAS, the said Frances B. Anthony, as Executrix of the Estate of Sara A. Murray, having gathered the assets of the Estate of the said decedent and the assets consist of personal property to a total value of $226,688.20, as set forth in "Exhibit A", which is a statement of account of the said Executrix and which is attached hereto and made a part hereof and marked "Exhibit A"; and WHEREAS, the debts and deductions, including the payment of Pennsylvania Inheritance Tax in the said Estate, amount to $44,826.38, leaving a balance for distribution of $181,861.82 also set forth in the statement of said Executrix, which is attached hereto and marked as "Exhibit A"; and WHEREAS, the balance for distribution as shown in the said statement marked "Exhibit A" has been distributed in accordance with the terms of the Last Will and Testament of the said Sara A. Murray. NOW, THEREFORE, KNOW YE, that I, Frances B. Anthony, Sister, 649 Sandra Avenue, Harrisburg, Pennsylvania 17109; I, George W. Erford, Nephew, 215 South Enola Drive, Enola, Pennsylvania 17025; I, Kathleen A. Merris, Niece, 407 Penn Ayr Drive, Camp Hill, Pennsylvania 17011; I, Kevin T. Merris, Great-Nephew, 14 Greenway Drive, Mechanicsburg, Pennsylvania 17055; I, Wendy L. Merris, Great-Niece, 703 Ohio Avenue, Lemoyne, Pennsylvania 17043; I, Michelle B. Souders, Great-Niece, 511 Market Street, Apartment 2, New Cumberland, Pennsylvania 17070; and I, Karen A. Souders, Great-Niece, 318 Rosewood Lane, Enola, Pennsylvania 17025, being those persons entitled to inherit under the terms of the Last Will and Testament of Sara A. Murray, do hereby acknowledge that we have this day had and received from >- day of IN WITNESS WHEREOF, I hereunto set my hand seal this "/ T/t OZ""V~'-4'-O , 2005. (~'f(l-vt-e.eJ/ d. tl",,-tJ'-C N_j_ ~~ Frances B. Antho ,Executrix, / ~itness [SIGNATURES CONTINUE ON NEXT PAGE] AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SSN: COUNTY OF DAUPHIN ) On this, the 1\ day of ,-{lIllJ.{J.Y Frances B. Anthony, , 2005, before me, a Notary Public, personally appeared known to me (or satisfactorily proven) to be the beneficiary mentioned in the above Acknowledgment and release whose name is subscribed thereto and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. '-r brnJ.. ~ ~WvY\ v]\. Notary Public COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL EBONE' M. TURNER, Notary Public City of Harrisburg, Dauphin County My Commission Expires March 21, 2005 IN WITNESS WHEREOF, I hereunto set my hand seal this 10 --:s p, "----0, ~ ,2005. b~w~ George W. rford . . (' ----->/:/4- Witness [SIGNATURES CONTINUE ON NEXT PAGE] day of -=. AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SSN: COUNTY OF CUMBERLAND ) ~ On this, the '0 day of ~ "''''-''1-1., ' 2005, before me, a Notary Public, personally appeared George W. Erford, known to me (or satisfactorily proven) to be the beneficiary mentioned in the above Acknowledgment and release whose name is subscribed thereto and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. -- (~~~ Notary Public NOTARIAL SEAL ~ ANN L. HAA1lMN, Notary PublIc Silver Sprtng Twp., CUmbel1aud County My Commission ,~xplres Sep'!:'!~:_~_ IN WITNESS WHEREOF, I hereunto set my hand seal this Jot' day of ~l.)llrl ,2005. [SIGNATURES CONTINUE ON NEXT PAGE] AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SSN: COUNTY OF CUMBERLAND ) On this, the .20~ day of Ja.r1Ua.~ appeared Kathleen A. Merris, , 2005, before me, a Notary Public, personally known to me (or satisfactorily proven) to be the beneficiary mentioned in the above Acknowledgment and release whose name is subscribed thereto and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL KENNETH L. FRY JR., Notary Public Camp Hi!! Bora, Cumberland County My Commisslon Exoirt?"' ~"\:'<1 ,r.; ?00:0 " -_"_'~".~.~"._"..~..-~,,,~_. ..~. ..._~'x, NoOry ~-~ IN WITNESS WHEREOF, I hereunto set my hand seal this 13~ day of ~UL4/\~ ,2005. .~~~ K~ : Merris ~ '1Y7. trlfh/I,J,. Whiles' ~>Il~ rH OF PENNSYLVANIA Nmal'itt! Seal .' ~ij~flJI M Jo;. t.lotary ~ubhc 8\.'I\f:l\l@.M')llti'I\.".t . j)~'\uphtn CouiJb, ~. \}l:'ffi\'\;~~l'\'" ;__~~)~.~,,:._~lec. S. ~-=:;;--,,,-.'.,.-. "-"~~-~ [SIGNATURES CONTINUE ON NEXT PAGE] AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND /) ~'-"-- ) SSN: ) On this, the ('3 r-k- day of , 2005, ~,~ before me, a Notary Public, personally appeared Kevin T. Merris, known to me (or satisfactorily proven) to be the beneficiary mentioned in the above Acknowledgment and release whose name is subscribed thereto and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. .L It'~ Notary Putic COMMONWFAITH Of PENNSYLVANIA Notarial Seal Susan M. Joy, Notary Public Susquehanna Twp., Dauphin County My Commission Expires Dec. 8, 2007 IN WITNESS WHEREOF, I hereunto set my hand seal this _-k", -f. \ fC).-I'" day of ~ -1()\\Un,/ ,2005. ;f,. L /'~ ~ V',/ _ Wendy f~s" / ~\~~ Witness [SIGNATURES CONTINUE ON NEXT PAGE] AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SSN: COUNTY OF CUMBERLAND ) On this, the I rj."''.- . J~()OJ>/ , 2005, day of before me, a Notary Public, personally appeared Wendy L Merris, known to me (or satisfactorily proven) to be the beneficiary mentioned in the above Acknowledgment and release whose name is subscribed thereto and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~~ ,I'vl,~,. Notary Public ' NOTARIAL SEAL SUSAN J. MillER, Notary Public Camp Hill Boro, Cumberland County My Commission Expires Sept. 19, 2005 IN WITNESS WHEREOF, I hereunto set my hand seal this JrJ.rlfi/lrt( ,2005. /q day of 1h I 'rr!d I Q ~ ))/}.(ldp i\A Michelle B. Souders ! ;UL~- 0t~-- WitnesS NOTARIAL SEAL TRACEY G, FARNER, Noiary Public Eoola. GumberiJ.nct County My CommIssion Expires May 2, 2005 --'"~- (SIGNATURES CONTINUE ON NEXT PAGEl AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SSN: COUNTY OF CUMBERLAND ) On this, the jq day of , JrJ new r '1 , 2005, before me, a Notary Public, personally appeared Michelle B. Souders, known to me (or satisfactorily proven) to be the beneficiary mentioned in the above Acknowledgment and release whose name is subscribed thereto and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. -c~ C2 '#~ Notary Public NOTARIJl,l SEAL TRACEY G. FARNE~l, Notary Public Enola, Cumberland County My C~Sion ,Expires May 2, 2005 -.......-..,,.-..... IN WITNESS WHEREOF, I hereunto set my hand seal this 1\ +\"\ 'To.~uC\... 'f ,2005. 'Y~,,~ LA. ~G'W~ Karen A. Souders CJ.kW I[;Rf~c WI ss [END OF DOCUMENT] day of AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA '):). . COUNTY 01' C~D ) SSN: ) On this, the \I day of ~n\AQrj , 2005, before me, a Notary Public, personally appeared Karen A. Souders, known to me (or satisfactorily proven) to be the beneficiary mentioned in the above Acknowledgment and release whose name is subscribed thereto and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. '-t bn..L If;:..... )~ k>\ Notary Public COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL EBONE' M. TURNER, Notary Public City of Harrisburg, Dauphin County My Commission Expires March 21, 2005 STATUS REPORT UNDER RULE 6.12 Name of Decedent; Sara A Murrav Date of Death: 11/23/03 Will No. 2003-01049 Admin. No. 21-03-1049 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: I . 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. I is Yes, state the following; a. account with the Court? Did the personal representative file a final 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 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 report. Date: Signature William J Peters ESQuire Name (Please type or print) 2931 North Front Street Harrisbura PA 17110 Address " ( 717 ) 2387555 Tel.No. r' . Capacity: Personal Representative X Counsel for personal representative ("" J STATUS REPORT UNDER RULE 6.12 Name of Decedent: Sara A Murrav Date of Death: 11/23/03 Will No. 2003-01049 Admin. No. 21-03-1049 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: I . 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. I is Yes, state the following: a. account with the Court? Did the personal representative file a final 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 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 report. Date: 1-/,/- r)) L)~:- ~~ Signature Willi<=:lm J Peter~ ESQuire Name (Please type or print) 2931 North Front Street Harrisbura PA 17110 Address l () c) ( 717 ) 2387555 Tel. No. Capacity: Personal Representative X Counsel for personal representative C'. , cd BUREAU OF INOIVIDUALTAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128~D601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV~lU1 EX AfP (12-04l 3 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-24-2005 MURRAY 11-23-2003 21 03-1049 CUMBERLAND 101 SARA A WILLIAM J PETERS ESQ PETERS & WASILEFSKI 2931 N FRONT ST HBG PA 17110 Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HDUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account~ submit the upper portion of this for.. with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ uv:r&?J.,.!r.A'j!"..r5l"-"d'!')........il.."fA~!mfr"f~r.~fl"UAM.W.~tcoOFlY....................... ... ESTATE OF MURRAY SARA A FILE NO. 21 03-1049 ACN 101 DATE 01-24-2005 THIS STATEHENT IS PROVIDED TD ADVISE OF THE CURRENT STATUS DF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY DF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PRO~ECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-13-2004 PRINCIPAL TAX DUE:. 28,577 .02 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-18-2004 l CD003577 1,428.85 30,000.00 01-06-2005 REFUND .00 2,851.83- TOTAL TAX CREDIT 28,577.02 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J ~