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Home My WebLink About04-0923Estate of DOLORES M. OYLER Register of Wills of CUMBERLAND County, Pennsylvania PETITION FOR GRANT OF LETTERS DOLORES MAE OYLER a/k/a No. <:~ I - (~gL\ - C~ ~."~ Deceased Social Security No. 211-22-6516 Petitioner(s), who is/are 18 years of age or older, apply(les) for: (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner is the executrix named in the Last Will of the Decedent, dated October 9, 1981 and codicil(s) dated Jack Lyman O¥1er~ the appointed Executor, died on January 6, 1980 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 to victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration (d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (:5 7: ~ Name Relationship ~esidence :OMPLETE IN ALL CASES:) Attach additional sheets if nec~sary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 208 Front Street, East Pennsboro Townshin (List street, number and municipality) Decedent, then 76 years of age, died September 20, 2004 at (Location) 208 Front Street, West Fairview 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 ......................................................................................................... $ 100,000.00 80,000.00 180,000.00 Real Estate situated as follows: 208 Front Street, Township of West Fairview, Cumberland County, PA Wherefore, Petitioner respectfully requests the probate of the last Will presented with this Petition and the grant of letters in the appropriate form to the undersigned: ~)nature Typed or printed name and residence Paula K. Smith 555 High Street, West Fairview, PA 17025 155939 1.DOC Register of Wills of Cumberland County, Pennsylvania OATH OF NON-SUBSCRIBING WITNESS Estate of Dolores Mae Oyler Also known as Dolores M. Oyler , Deceased. William C. Smith a subscriber hereto, being duly qualified according to law, depose(s) and say(s) that he is familiar with the signature of Dolores Mae Oyler testatrix of the Will presented herewith, and that he believes the signature on the Will is in the handwriting of Dolores Mae Oyler to the best of his knowledge and belief. Sworn to or affirmed and subs~;ribed before me this I ~'~*~- day of October, 2004. William C. Smith 555 High Street West Fairview, PA 17025 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 tbr this certificate, $2.00 P 10531367 No, Local Registrar COMMONWEALTH OF PENNSYLVANIA · DEPARTMEHT OF NEABTH * VITAL RECORDS CERTIFICATE OF DEATH ~am~.~<r~,u~.~..t) Paul Mifflln Kirk~trlck ,~y garet ~hlck ~NJURYye~ [-1AT NO[]WO"K? 3~",DESCRI~ HOW INJURY O~CURRED LAST WILL and TESTAMENT OF DOLORES MAE OYLER I, DOLORES MAE OYLER, of the Borough of West Fairview, Cumberland County, Pennsylvania, make, publis~ ~and declare,.this to be my Last Will and Testament, hereby revo~ng a~d maR:i~ng CiD void any and all Wills previously made by me. -~ I. I direct that all my just debts and funeral ex~nses', includ~ my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. II. I devise and bequeath all the rest, residue and remainder 'of my estate of every nature and wherever situate to my husband, JACK LYMAN OYLER, provided he survives me by thirty (30) days. III. Should my husband, JACK LYMAN OYLER, predecease me or die'%n or before the thirtieth (30th) day following my death, I devise and bequeath all the rest, residue and remainder of my estate to my issue, per stirpes, living on the thirty-first (31st) day following my death. IV. I nominate, constitute and appoint my husband, JACK LYMAN OYLER, Executor of this, my Last Will and Testament. Should my said husband, JACK LYMAN OYLER, fail to qualify or cease to act as such, then I nominate, constitute and appoint my daughter, PAULA K. SMITH, Executrix of this, my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this .~ day of ~c~o ~ , 19gl . .g Signed, sealed, published and declared by the above-named Testatrix 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 hereunto subscribed our names as witnesses. -2- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: DOLORES MAE OYLER Date of Death: September 20, 2004 Will No.: 21-04-00923 Admin. No.: To the Register: I certify that the Notice of Beneficial Interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on November v_~'7¢'''' , 2004. Name Address Robin Laudenslager 1470 Dartmouth St. Bethlehem, PA 18017 Jackie Confalone Paula K. Smith 217 Wexham Drive Shillington. PA 19607 555 High Street West Fairview, PA 17025 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None. Date: November ,,~ ,2004 Signature Name: Richard W. Stewart, Attorney Johnson, Duffle, Stewart & Weidner Address 301 Market St. P. O. Box 109 Lemoyne, PA 17043-0109 Telephone: (717) 761-4540 Capacity: Personal Representative X Counsel for personal representative W 0 U.I LIJ F'" TO Register of Wills Office Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 SUBJECT: Estate of Dolores Mae Oyler No. 21-04-00923 - DOD: 9/20/04 FROM 3OHNSON~ DUFFTE, STEWART & WE]DNER Attorneys at Law P.O. Box 109 Lemoyne, PA 17043 (717) 761-4540 Fax: (717) 761-3015 DATE: December 16, 2004 Enclosed is a check in the amount of $8,000.00 as a payment on account of Inheritance Tax for the above-captioned Estate, being made within the 90 days to allow for the 5% discount. Happy Holidays to everyone. SiGN El:}.'~C~in?Y~e r, Estate Le~lal Assistant COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX(11-96) NO. CD 004747 STEWART RICHARD W 3RD & MARKET STREETS P. O. BOX 109 LEMOYNE, PA 17043 ESTATE INFORMATION: SSN: 211-22-6516 FILE NUMBER: 2104-0923 DECEDENT NAME: OYLER DOLORES MAE DATE OF PAYMENT: 12/17/2004 POSTMARK DATE: 12/16/2004 COUNTY: CUMBERLAND DATE OF DEATH: 09/20/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $8,000.00 REMARKS: TOTAL AMOUNT PAID: $8,000.00 SEAL CHECK#108 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG, PA 17128-0601 June 20, 2005 Telephone (717) 78133930 FAX (717) 77~;'0412 , -.."j LAW OFFICES JOHNSON, DUFFIE, STEWART & WEIDNER, PC 301 MARKET STREET PO BOX 109 LEMOYNE, PA 17043-0109 (,.J Re: Estate of DOLORES M. OYLER File Number 2104-0923 Dear Sir/Madam: 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 12/20/05. 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, 0{ J .~7A.. . ~?/'-AJ-- , Claudia Maffei, Supe . r Document Processing nit Inheritance Tax Division :'S~ Q.; ~-'--'~~ , 0 lCl '" NO'J", l,i lO~~ :~ " : ~;g ~ ,~ or~ 8 Il tit ~ ~.t~~l~~ 73 l\h 0 ~ 'A~' ~~ ~ <<t..;) Ul ~' .,-'1 ~ ~ 0- l'h.__ NO < ,,_, 002 - - - - - - - - ~ n =~;:.~ ;.::: --< ,.' C ;: < /. ~ ~.~S!;; ........,...;.r-c c _, <..;...: 1- r""e-.~- ,z y...W .0--- " r r ~ , c/) I'-' :Z~ :b~ ~ 'lr~ -, '1 - ' ' -- CO :i en en CO - (.) rJ ~ 1n ~ I \ ... ~ .- \ - U. Q '1= f'\': f,... \:' H \ Q \'i~1....\) J r2~ ~J: -~~': :-:--: ;2 /) - C1' ~ '" co c- ,,:. - ~ '" ;::; ~. ;z: ,,;,0>; 2Q 0 ,~ 0 :20 ;~, 0..; ~ .i 7 "i~ )~ ,,' ,........I :~. n~ ~\ 7~ ~\ ~~ <.I.~r-- -!\)~ l-." -.. .~ 111...11. .... ,....1 . [L _r ,"" C w::C UE-- r-- H 0::: CO i.L<:J M f"'-< 0 M o U:i- I :x.M (fl ?' 4. .-l ,-:1 E-< :J 0 ~ZOr-- H:JlJ:.-l ~O UJJICl:: iJ-< :n p... Oel:J Z 0 - P::~::C~ !iJ...:JE-<H E-<P::O:::W (flW:JH HCDOH lJ~U~ 1iJ:J ICl:: P::c,.-,U ......n.'. ., I . SUBJECT: Estate of Dolores Mae Oyler No. 21-04-00923 000: September 20, 2004 FROM JOHNSON, DUFFIE, STEWART 8r. WEIDNiER Attorneys at Law P.O. Box 109 Lemoyne, P A 17043 (717) 761-4540 Fax: (717) 761-3015 DATE: October 6,2005 TO Register of Wills Office Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Enclosed for filing in the above-captioned Estate are the following: 1. Original Inventory. 2. Original and copy of Inheritance Tax Return. 3. Check in the amount of $1 ,881.05, Inheritance Tax payment. 4. Check in the amount of $30.00 in payment of the filing charges. 5. Copy of the letter from Bureau of Individual Taxes granting the 6 month extension to file the Return. . 6. Please return the tax receipt and the filing receipt to me in the envelope provided. Thank you. f'-....;) .~-=> I'.;, ~w~-I :rJ ; /, C) :J C:) -'l'-, c:~ f-;~ :::=J '::.) l ") "-~": SIGNE . I ~-..J ler, Estate Le al Assistant : ~-';'."~ '" : ,'5 :Tl enj U,I \> REV - 1500 EX + (6-00) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OYLER, DOLORES MAE I- Z W o W () W o DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 09/20/2004 04/05/1928 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) ~ 1. Original Return 0 2. Supplemental Return w I- 0 0 Future Interest Compromise (date of death after :.::;!;CIl 4. Limited Estate 4a. ()~:.: 12-12-82) wl1.() ~ 0 :1:00 6. Decedent Died Testate (Attach copy 7. Decedent Maintained a Living Trust (Attach ()~...J l1.CD of Will) copy of Trust) l1. <l: 0 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between I- Z W o z o l1. THISS NAME RICHARD W. STEWART FIRM NAME (If applicable) JOHNSON, DUFFIE, STEW ART & WEIDNER TELEPHONE NUMBER 7I 7/761-4540 1 . Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (9) (10) FILE NUMBER 21 04 COUNTY CO.DJO__--"'EAR__ SOCIAL SECURITY NUMBER 00923 ,NLJMBEB. 211-22-6516 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder-Retum(date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11 Election to tax under Sec. 9113(A) (Attach Sch 0) 19,482.24 1,922.95 13. Charitable and Governmental Bequests/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) I COMPLETE MAILING ADDRESS 301 Market St. Lemoyne, PA 17043-0109 (1 ) 80,000.00 (2) 134,031.30 (3) None (4) None (5) 2,548.89 (6) None (7) 33,760.48 (8) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES CJl Ul n) ., 1 250,340.67 (11 ) 21,405.19 228,935.48 (12) (13) (14) 228,935.48 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z 228,935.48 .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x j::: <l: I- :::> l1. 17.Amount of Line 14 taxable at sibling rate x .12 (17) :;; 0 () >< 18. Amount of Line 14 taxable at collateral rate <l: x .15 (18) I- 19. Tax Due (19) 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 10,302.10 10,302.10 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500lX (Rev. 6-00) Decederrt's COliflplete Address: STREET ADDRESS 208 FRONT ST. CITY STATE PA WEST FAIRVIEW Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 8,000.00 -------------- 421.05 Total Credits (A + B + C) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theDVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE Make Check Payable to: REGISTER OF WILLS, AGENT II I ZIP 17025 (1 ) 10!,302.10 -1- (2) 8,421.05 (3) 0.00 (4) (5) 1,881.05 (5A) (5B) 1, 81.05 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;............................................................................. ~ I ~: ~::::~ :h~e~;~;i:~~~s:~~e~:s~~~. ~~~I.I. .~~~. ~~~. ~~~~~~:. .~~~.~.~~.~~.~~.~. .~.~ .it~. i.~.C.~.~~;..............................~~::::::::::: ..~..... d. receive the promise for life of either payments, benefits or care?.......................................................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?........................................................... no.................................................. D D ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?...... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?......................................................................................... no................... ~ ~ D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART F 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, corre t and complete. Declaration preparer other than the person~1 rep~e_~_~'!_!~!i~e_i~~_~~~~~_a~~~rn_~~C?_~_~J_~h_i~_~.J~[~.eaE~r_hasany k!1~~iedge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS _1J~THr< ~ LN-l (.., SIGNATURE OF PERSON RESPONSIBLE FOR FILING R~UR~ ADDRESS 555 HIGH ST. WESTFAIRVIEW,PA 17025 ADDRESS 301 Market St. Lemoyne, P A 17043-0109 DATE /() t/ r- -)..6 (I 5." I=- r .- Lc~ - 0 f- 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 u e of the surviving spouse is 3% [72 P ,So 39116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value [72 P.S. 39116 (a) (1.1) (ii)). The statutedoes not exempt a transfer to a surviving sp l")Je. ,;2 'Ie of assets and filing a tax return are still applicable even if the surviving spouse is the R-t9. 3 'S API~ (JU ou 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 parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S, 39116 (a) (1.< 'bc-;- _ 0 D The tax rate imposed on the net value of transfers to or for the use of the decedent', 1.2) [72 P.S. S9116 (a) (1 )]. g-_~t The tax rate imposed on the net value of transfers to or for the use of the decedent' under Section 9102, as an individual who has at least one parent in common with II I ving spous~ is 0% lents for difclosure I I I Jr the use ~f a natural I lotedin 72~,S'39116 I]. A sibling liS defined, ,no SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF OYLER, DOLORES MAE FILE NUMBER 21 - 04 - 00923 All real property owned solely or as a tenant in common must be reported at fair market valUEF.air market value is defined as the price at which property would be excnanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 80,000.00 Real Estate - No. 208 Front St., Borough of West Fairview, Cumberland County, Pennsylvania. Book R, Volume 25, Page 952. Sale Price - copy of Settlement Statement attached. TOTAL (Also enter on Line 1, Recapitulation) 80,000.00 U. S. DEPARTMENT OF HOUSING and URBAN DEVELOPMENT '~ S!=TTLEME"lT STATEMENT ),- - ASSURED LAND TRANSFERS, INC. 301 Market Street Lemoyne, PA 17043-0109 (717) 761-4720 OMB No. 2502-0265 Titlepro for Windows ™ 01.FHA D4.VA 6. FILE NUMBER: 5049 B. TYPE OF LOAN o 2. FMHA 1:8]3. CONV.UNINS. o 5. CONV. INS. 17. LOAN NUMBER: 100687243 MORT. INS. CASE NO.: 14168-1 C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they are shown here for information purposes and are not included in the totals. D. NAME AND ADDRESS OF BORROWER: Trevar W. Scheuch, Jessica A. Scheuch E. NAME AND ADDRESS OF SELLER: Estate of Dolores Mae Oyler F. NAME AND ADDRESS OF LENDER Countrywide Home Loans, Inc. 4830 Carlisle Pike G. PROPERTY LOCATION: 208 Front Street H. SETTLEMENT AGENT: Assured Land Transfers, Inc. Mechanicsburg, PA 17050 East Pennsboro Township West Fairview, PA 17025 PLACE OF SETTLEMENT: 301 Market Street, Lemoyne, PA I. SETTLEMENT DATE: Sep 27 2005 Tuesday 04:00 AM J. SUMMARY OF BORROWER'S TRANSACTION 100. Gross Amount Due From Borrower 101. Contract sales price 102. Personal Property 103. Settlement Charges (line 1400) 104. 105. Adjustments for items paid in advance by seller(s) 106. Cityrrown tax 107. County/City tax 09/27/05 to 12/31/05 108. Assessments 109. School Tax 09/27/05 to 06/30/06 110. 111. Sewer 09/27/05 to 09/30/05 112. 120. Gross Amount Due from Borrower 200. Amounts Paid By Or In Behalf Of Borrower 201. Deposit or earnest money 202. Principal Amount of new loan(s) 203. Existing loan(s) taken subject to 204. 205. 206. 207. 208. 209. Adjustments for items unpaid by seller 210. Cityrrown tax 211. County/City tax 212. Assessments 213. School Tax 214. 215. 216. 217. 218. 219. 220. Total Paid By/For Borrower 300. CASH AT SETTLEMENT Fromrro BORROWER 301. Gross AmI. due from borrower (line 120) 302. Less AmI. paid by/for borrower (line 220) 303. Cash i:8J FROM 0 TO Borrower Buyer or Borrower's Signature K. SUMMARY OF SELLER'S TRANSACTION 400. Gross Amount Due to Seiler 80,000.00 401. Contract sales price 402. Personal Property 3,499.80 403. 404. 405. Adjustments for items paid in advance by seller(s) 406. Cityrrown tax 62.34 407. County/City tax 09/27/05 to 12/31/05 408. Assessments 716.86 409. School Tax 09/27/05 to 06/30/06 410. 3.75 411. Sewer 09/27/05 to 09/30/05 412. 84,282.75 420. Gross Amount Due to Seiler 500. Reductions In Amount Due To Seiler 1,000.00 501. Excess deposit (see instructions) 76,000.00 502. Settlement charges to seller (line 1400) 503. Existing loan(s) taken subject to 504. Payoff of First Mortgage Loan 505. Payoff of Second Mortgage Loan 506. 507. 508. 509. Adjustments for items unpaid by seller 510. Cityrrown tax 511. County/City tax 512. Assessments 513. SchoolTax 514. 515. 516. 517. 518. 519. 77,000.00 520. Total Reduction Amount Due Seiler 600. CASH AT SETTLEMENT To/From SELLER 84,282.75 601. Gross Amount due Seller (line 420) 77,000.00 602. Less reduction in Amt.due Seller (line 520) 7,282.75 603. Cash i:8J TO o FROM Seiler Seller's Signature ~ g lfJ 80,000.00 62.34 716.86 3.75 80,782.95 800.00 800.00 80,782.95 800.00 79,982.95 " .. L. SETTLEMENT CHARGES Case # 5049 Paid From Paid From 700. Total Sales Commission based on Price: $ % Borrower's Seller's Division of Commission at: $ Total Funds At Funds At 701. Settlement Settlement 702. 703. Commission paid at Settlement I 704. I 600. Items Payable in Connection With Loan 601. Loan Origination Fee Countrywide Home Loans, Inc. 602. Loan Discount Countrywide Home Loans, inc. 603. Appraisal Fee to Landsafe Appraisal Service 310.00 604. Credit Report to Countrywide Home Loans, inc. 35.00 605. inspection Fee to 606. Mortgage Insurance to 607. Assumption Fee to 606. Flood Check Fee to Landsafe Flood 26.00 609. Tax Service Fee to Countrywide Tax Service 90.00 610. Document Preparation Fee to Countrywide Home Loans, Inc. 400.00 611. 900. Items Required By Lender To Be Paid In Advance 901. Interest from 09/27/05 to 09/30/05 @ 12.2300 /Day 46.92 902. Mortgage Ins. Premium 1 Months to Countrywide Home Loans, Inc. 50.03 903. Hazard Ins. Premium 1 Years to Capital Region Insurance Agency 275.00 904. 0 Years to 905. 0 Years to 1000. Reserves Deposited With Lender For 1001. Hazard Insurance 3 Months @ $ 22.92 /Month 66.76 1002. Mortgage Insurance 0 Months @ $ 50.03 /Month 1003. CitylTown Taxes 9 Months @ $ 19.96 /Month 179.64 1004. County Taxes 0 Months @ $ 19.96 /Month 1005. Assessments 0 Months @ $ /Month 1006. School Taxes 5 Months @ $ 79.00 /Month 395.00 1007. 0 Months @ $ /Month 1006. Aggregate Adjustment 0 Months @ $ 79.00 /Month (277.60) 1100. Title Charges 1101. Setllement or closing fee to 1102. Abstract or title search 1103. Title Examination 1104. Title Insurance Binder 1105. Document preparation 1106. Notary fees 1107. Attorney's fees (includes above items No.:) 1106. Title Insurance Assured Land Transfers, Inc. ,.. (inCludes above items No.:) 1101 thru 1104 and 1106/ Basic 1109. Lender's coverage $ 76,000.00 1110. Owne~s coverage $ 60,000.00 1111. Endorsements 100, 300 and 900 to Assured Land Transfers, Inc. 150.00 1112. Closing Protection Letter to First American Title Insurance Company 35.00 I 1113. Wire Fee to Assured Land Transfers, Inc. 20.00 I 1200. Government Recording and Transfer Charges 1201. Recording Fees: Deed $ 39.00 Mortgage $ 66.50 Release $ 105.50 1202. City/County tax/stamps: Deed $ 600.00 Mortgage $ 600.00 1203. State tax/stamps: Deed $ 600.00 Mortgage $ 600.00 1204. Electronic Document Fee to Assured Land Transfers, Inc. 25.00 1205. Overnight Courier Fee (package) to Assured Land Transfers, Inc. 25.00 1300. Additional Settlement Charges 1301. Survey to 1302. Pest Inspection to 1303. 1304. 1305. 1400. Total Settlement Charges (enter on lines 103 & 502, Sections J & K) 3,499.60 600.00 ... Parties agree that no liability is assumed by Settlement Agent for the accuracy of information furnished by others as shown on the HUD.1 Settlement Statement. HUD CERTIFICATION OF BUYERS AND SELLERS I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlemerlt Statement. ~ J,~/<~U ~24C - ~""..~_ , LVt~L. , Buyer's Address & Phone: Seller's New Address & Phone: The HUD.1 Settlement Statement which I have prepared is a true and accurate account of this transaction. I have caused or will cause the funds to be disbursed in accordance with this statement. ~_ . -~ i'/f /j?A- Settlement Agent iZzh ~ Date ESTATE OF COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT OYLER, DOLORES MAE SCHEDULE B STOCKS & BONDS I FILE NUMBER 21 - 04 - 00923 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 2 2,500 Shares PNC Financial Common @? $53.27 per share. 81.864 Shares - Vanguard GNMA fund @ $10.46 per share. DESCRIPTION UNIT VALUE TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH 133,175.00 856.30 134,031.30 '. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF OYLER, DOLORES MAE FILE NUMBER 21 - 04 - 00923 Include the proceeds of litigation and the date the proceeds were received by the estatEAII property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 Household Goods - appraised value DESCRIPTION VALUE AT DATE OF DEATH 1,360.00 2 1991 Buick Park Avenue 4 Door Sedan - 110,000 miles Date of death value 100.00 3 Highmark - refund 52.11 4 Internal Revenue Service - refund - 2004 income tax 898.00 5 Comcast and Erie Insurance - cable and automobile insurance refunds 138.78 TOTAL (Also enter on Line 5, Recapitulation) 2,548.89 SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT OYLER, DOLORES MAE I FILE NUMBER 21 - 04 - 00923 ESTATE OF ITEM NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. ___~_~~_ ___ ~___~~~____~______~ ___~ u________~~- ~-- ~ --- DESCRIPTION OF PROPERTY . DATE OF DEATH' % OF . ' Include the name of the transferee. their relationship to decedent and the date of transfeLI ! DECD'S ! EXCLUSION ! TAXABLE VALUE Attach a copy of the deed for real estate VALUE OF ASSET: ' (IF APPLICABLE) , . ! INTEREST Thrivent Financial for Lutherans Single Premium Deferred Annuity Contract Number: B3142356 Beneficiaries: Daughters - Jackie Confalone; Paula K. Smith and Robin Laudenslager 33,745.98 33,745.98 2 PNC Bank - Checking Account No. 51-4011-1362 Joint with Paula K. Smith, Daughter as of 1/20/2004 Date of death balance 1,794.421 100% 3,000.00, ! 0.00 3 PNC Bank - Savings Account No. 50-0360-0469 Joint with Paula K. Smith, Daughter as of 1/20/2004 Date of death balance 14.501 100% 14.50 TOTAL (Also enter on line 7, Recapitulation) 33,760.48 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF OYLER, DOLORES MAE SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS , FILE NUMBER 21 - 04 - 00923 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: Musselman's Funeral Home - funeral expenses 2 Rolling Green Cemetery - interment charges 6,299.18 895.00 100.00 1,426.20 500.00 3,500.00 260.00 75.00 109.30 6,317.56 19,482.24 Social Security Number(s) / EIN Number of Personal Representative(s): 210-40-1935 Street Address 555 HIGH ST. City WEST F AIRVIEW Year(s) Commission paid , .) Reverend George DeFrehn - funeral service 4 Knights of Columbus - funeral lunch B. ADMINISTRATIVE COSTS: 1 . Personal Representative's Commissions PAULA K. SMITH State P A Zip 17025 2. Attorney's Fees Johnson, Duffie, Stewart & Weidner 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees Register of Wills - Cumberland County 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Cumberland Law Joumal- advertise letters 2 The Patriot-News - advertise letters Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) Schedule H Funeral Expenses & Mninistrative Cos1s continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 3 Register of Wills - short certificate FILE NUMBER 21 - 04 - 00923 I I 3.00 ESTATE OF OYLER, DOLORES MAE 4 Chuck Bricker - household goods appraisal 80.00 5 L. G. Connor Real Estate - Appraisal 208 Front St., West Fairview 300.00 6 PP&L - electricity charges 436.49 7 PA American Water Co. - water charge 167.91 8 East Pennsboro - sewer/refuse charges 452.50 9 Comcast - cable charges 126.70 10 UGl - gas charges 2,034.79 11 Verizon - telephone charges 189.70 12 PNC - service charges - Estate account 14.00 13 UGI - Service Contract 79.00 14 Alicia D. Stine, Tax Collector - Township/County real estate taxes (208 Front St. - West Fairview) - 111/2005 - 9/2712005 177.16 15 Erie Insurance Group - Homeowner's Insurance Premium (208 Front St. - West Fairview) 480.00 16 Bruner's - automobile repairs 50.00 17 Titan Tree Service - removal of damaged tree - 208 Front St. 550.00 18 Recorder of Deeds - Sale of 208 Front St., West Fairview 1 % Transfer Tax 800.00 19 Alicia D. Stine, Tresurer - 2005 School District Real Estate Taxes (208 Front St. - West Fairview) - 7/112005 - 9/27/2005 231.16 20 PNC Bank - Estate check printing charge 15.15 21 Register of Wills - file Inventory & Inheritance Tax Return 30.00 22 Reserve for close-out costs 100.00 Page 2 of Schedule H *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE I LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF OYLER, DOLORES MAE Include unreimbursed medical expenses. ITEM NUMBER I Kristin Schultz - Nursing services DESCRIPTION 2 Carolyn Bucher - Nursing services 3 Carol Case - Nursing services 4 Joan Stalks - Nursing Services 5 Griswold Special Care - services to decedent 6 Carefor People - services to decedent 7 Bank One - decedent's account balance 8 Brown, Schultz - Accountants - preparation of decedent's 2004 income tax returns FILE NUMBER 21 - 04 - 00923 TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 243.00 330.00 50.00 585.00 291. 00 189.00 9.95 225.00 1,922.95 REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF OYLER, DOLORES MAE I FILE NUMBER 21 - 04 - 00923 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do_No_tLlstIrustee(lil- _ AMOUNT OR SHARE OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) Robin Laudenslager 1470 Dartmouth St. Bethlehem, PA 18017 Daughter ! One-third residue 2 Jackie Confalone 217 Wexham Dr., Shillington, PA 19607 Daughter One-th:ird residue 3 Paula K. Smith 555 High St., West Fairview, PA 17025 i Daughter One-third residue Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover she~t I II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEr II Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of OYLER, DOLORES MAE No. 21-04-00923 Date of Death 912012004 also known as , Deceased Social Security No. 211-22-6516 PAULA K. SMITH ---- The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Invehtory include all of the personal assets wherever situate and all of the real estate located 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 the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. l!We verify that the statements made in this Inventory' are true and correct. l!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. Attorney: RICHARD W. STEWART Personal RepresentaAve _ Signature: ---fI~ JL ~ tL ~_L.~___ _ PAULA K. SMITH I.D. No.: 18039 Signature: Signature: Address: Address: 555 HIGH ST. WESTFAIRVIEW, PA 17025 301 Market St. Lemoyne, PA 17043-0109 Telephone: 717/761-4540 Telephone: (717) 732-2465 Dated: 10- _S- - .) ()() ~/ Personal Property 2,500 Shares PNC Financial Common @ $53.27 per share. 133,175.00 81.864 Shares - Vanguard GNMA fund @ $10.46 per share. ,...j56.30 ,.~_r{).'. ,.... ~ ) fr,) '-i' ;p!~ >f,t60.00' ~3 I - l.) . ; I' ""1 -...,-.1100.00 -::7 ~.~ ; 'a ~-15 (~O) -r 52.11 ','1 " t1 '.' )! ) (~h CI 898.00 Household Goods - appraised value 1991 Buick Park Avenue 4 Door Sedan - 110,000 miles Date of death value Highmark - refund Internal Revenue Service - refund - 2004 income tax Comcast and Erie Insurance - cable and automobile insurance refunds 138.78 Total Personal Property I $136,580.19 (Attach additional sheets if necessary) Total Personal Property and Real Estate $216,580.19 ~ Register of Wills of Cumberland County, Pennsylvania INVENTORY continued Estate of OYLER, DOLORES MAE No. 21 - 04 - 00923 Date of Death 9/20/2004 Social Security No. 211-22-6516 also known as , Deceased II Real Estate Real Estate - No. 208 Front St., Borough of West Fairview, Cumberland County, Pennsylvania. Book R, Volume 25, Page 952. Sale Price - copy of Settlement Statement attached. 80,000.00 Total Real Estate $80)000.00 2 11 COMMONWEALTH OF PENNSYLVANIA OEPARTMENT 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 NO. CD 005873 STEWART RICHARD W 3RD & MARKET STREETS P. O. BOX 109 LEMOYNE, PA 17043 ACN ASSESSMENT AMOUNT CONTROL NUMBER __n_n_ fold ---------- -------- 101 I $1,881.05 ESTATE INFORMATION: SSN: 211-22-6516 I FILE NUMBER: 2104-0923 I DECEDENT NAME: OYLER DOLORES MAE I DATE OF PAYMENT: 10/07/2005 I POSTMARK DATE: 10/06/2005 I COUNTY: CUMBERLAND I DATE OF DEATH: 09/20/2004 I I TOTAL AMOUNT PAID: $1,881.05 REMARKS: CHECK#1032 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASB~UGH REGISTER OF WILLS REGISTER OF WILLS 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 NO. CD 006083 STEWART RICHARD W 3RD & MARKET STREETS P. O. BOX 109 LEMOYNE, PA 17043 ACN ASSESSMENT CONTROL NUMBER AMOUNT n____n fold 101 $27.83 ESTATE INFORMATION: SSN: 211-22-6516 FILE NUMBER: 2104-0923 DECEDENT NAME: OYLER DOLORES MAE DATE OF PAYMENT: 12/09/2005 POSTMARK DATE: 12/08/2005 COUNTY: CUMBERLAND DATE OF DEATH: 09/20/2004 TOTAL AMOUNT PAID: $27.83 REMARKS: JOHNSON, DUFFIE ET AL CHECK# 16972 SEAL INITIALS: RSK RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS r--~~--------- foo" ..,1 (:) 1..1. (A) ..jo. e,) C.,) (.1 (~t c:. t.... c-, () C) ,,) - : ~ ~~c ~C/) Fi12 -- ,./ :::- ~. -, .r O.....OAl )>ocm AlO:5:G) rCOJ(J) (J)Alm-l r-lAlm .f11IIAl \JO~O )>CO"Tl .....(J) < -....Jmo< O(J)Or .....ocr 'fCZ(J) t5)>-lO (X)Al-<"Tl -....JmO"Tl 00 cm Al -l I o C (J) m I tn ( (r') l~ \ 0 \ ~. ~\~~ ~ 5\ .fii ~) II,' " . < c~ ~ s: C, c) P. 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Z ..... .... 1"1I C m Z ;::c x -I m .. ." -I VI '0 0 ~ = '" Z I = ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX nAPPRAISEMENT, ALLOWANCE OR DISALLOWANCE ,- OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-05-2005 OYLER 09-20-2004 21 04-0923 CUMBERLAND 101 APPEAL DATE: 02-03-2006 (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 ~Y!_~~9~9_!~~~_~~~~______~___~~!~!~_~~~~~_~~~!!~~_E~~_y~y~_~~~~~~~__~____________________ REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DOLORES M FILE NO. 21 04-0923 ACN 101 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax BUREAU OF INDIVIDUALr-;T~,;-,~~, INHERITANCE TAX DIVISION: -,"AI: .' tu PO BOX 280601 HARRISBURG PA 17128-0601 r'. (' 9 ' ~ ,) RICHARD W STEWART JOHNSON ETAL 301 MARKET ST LEMOVNE PA 17043 ESTATE OF OVLER TAX RETURN WAS: (X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets NOTE: If an assessment was issued previously, lines reflect figures that include the total of ALL ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: DATE 12-16-2004 10-06-2005 + INTEREST/PEN PAID (-) 421.05 .00 NUMBER CD004747 ......... CD005873 BALANCE OF UNPAID INTEREST/PENALTV AS OF 10-07-2005 · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ) CHANGED (1) (2) (3) (4) (5) (6) (7) 80,000.00 134,031. 30 .00 .00 2,548.89 .00 33,760.48 (8) '* REV-1547 EX AFP (06-05) DOLORES M (9) (10) 19,482.24 DATE 12-05-2005 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 250,340.67 21.405 19 228,935.48 .00 228,935.48 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 10,302.10 .00 .00 10,302.10 10,302.10 .00 27.83 27.83 pt 1.922.95 (11) (12) (13) (14) .00 X 00 = 228,935.48 X 045 = .00 X 12 = .00 X 15 = (19)= AMOUNT PAID 8,000.00 1,881.05 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) BUREAU OF INDIVIDUAL TAXES-- INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP (03-05) ... ," '''''~. 1 ,- , ~.. to, (... ~ j .:;... C DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-27-2005 OYLER 09-20-2004 21 04-0923 CUMBERLAND 101 DOLORES M ('-, RICHARD W STEWART JOHNSON HAL 301 MARKET ST LEMOYNE Allount Rellitted PA 17043 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF OYLER DOLORES M FILE NO.21 04-0923 ACN 101 DATE 12-27-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-05-2005 PRINCIPAL TAX DUE: 10,302.10 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-16-2004 CD004747 421.05 8,000.00 10-06-2005 CD005873 .00 1,881.05 12-08-2005 CD006083 27.83- 27.83 TOTAL TAX CREDIT 10,302.10 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 II IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) pt PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: DOLORES MAE OYLER a/k/a DOLORES M. OYLER Date of Death: SEPTEMBER 20. 2004 Will No.: 21-04-00923 Admin No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ~ 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 X 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 ~ 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: //().:JhcJo~ / ----//)~/# ~ '--#.::.1 ,,//:1/ ~&.._ . Signature . Richard W. Stewart, Attorney Johnson, Duffie, Stewart & Weidner 301 Market Street, P.O. Box 109 Lemovne, PA 17043-0109 Address (717) 761-4540 Telephone No. Capacity: Personal Representative ~ Counsel for Personal Representative ~~