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Home My WebLink About02-0957 Estate of 'IE' d wi" Ii "or. B~"L.Vf'l also known as PETITION FOR PROBATE and GRANT OF LETTERS oflt ~, No, al-O.;t.Q5i To: Register of Wills for the Deceased. County of in the Social Security No, ;;) n G-, - ;;l" - q q </1 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut ll. I X ') in the last will of the above decedent, dated .' .:J('{Vl~ IS and codicil(s) dated named ,1946 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C IJ.. 1/Y\ b &"Ii< \ 0.. Vl d Count~ Pennsylvania, with h \ S last family or principal residence at '-/-( $; 5 N <UA + u c! It' e t- ]:> ~,' IJ-p tln'W\j;1aO-'Y\''''''''''''';'' Me,,1.OUY\lc-"'bLJI'>~ PA- IIOS>D (list street, number and muncipality) Decendent, then (" q 'b ,19 d-b":" at 0 S' ",' "... . Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ .5()~ J ()()() ,00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: 'f 1/", () 00 - tIS.... N_-tv.k-e:l V~; ~-e. t9~IU~,)\I\I~">bv(.L1 T'A ,'/)56 WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters (testamentary; administration c.La.; administration d.b.n.c.t.a.) theron. SToP It FJ:::::e t:~ ~'., Gb~'7 W]",,'" ld-t\d COU 1>-T sO:: 1\^ '- I. " ~_ ,vIlO~ . "'M 1 C. <, "tJ ~ Y -P", 1"10!i>!i> ~O .. = ., in ~ ~aA()(j kM) ftl~~i '7011 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF cmIBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belie f petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will we an truly administer estate according to law. '" 0;;' " .. i< ~ ~ Sworn to or affirmed and subscribed before me this 24th day of OCTOBER 2002 ~ 4~~~~~ { / ~ (I . '" Lyt!(j~() (~ /6./J.-U fJ/C / I ~ -ClIA- OJ No. a'.O~.q5' Estate of EDWIN TYSON BROWN , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW OCOTBER 25, 2002 19_, 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 6 -1 5 - 1 995 described therein be admitted to probate and filed of record as the last will of EDWIN TYSON BROWN TESTAMENTARY JOANNE AUSTIN AND MARCIA BROWN and Letters are hereby granted to FEES Probate, Letters, Etc. ......... $ Shon Cenificates( ).......... $ *~~iftm '?XtF.<'!. p'~g:E!? $ jcp $ TOTAL _ $ 10-25-2002 340.00 9.00 15.00 5.00 369.00 A TIORNEY (Sup. Ct. J.D. No.) ADDRESS Filed PHONE mailed to exec marexaibrown 10-25-2002 '.,"\ (I, H10S.805 REV9f8(, This is to certifY that the infotmation hete given is correctly copied from an original certificate of death duly filed with me as Local Registtar. The original certitlcate will be forwarded to the State Vital Records Off,ce for permanenr filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. p 8385538 No. ~C~iS~ Fee for this ceniflcate, $2.00 CUnt>erland DICE Nl'S USUAL 0CCUPAfl0H ~.=:'.:':',=,::~::r ".. ter S stans Coo OlECEDENT'Sf,&AUNCJADOAESSlSII...~sa..Zipc.a.s.! 4185 Nantucket Drive Mechanicsburg,Pa 17070 ,14JR....va1 NANE OF DECEDE"'T l~.'" M_.l_, 69 son Brown lACIER t 'tEM -,.:..... ,.. 1. E'rl . AGftlMl8orll'l<Wtl OOUHTY OF OEAlH J\J'L 0 9 2.002 Date COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH Jr wtDl!RlDofIW' .-! ""'- so .. $lAfEfIlfNl.JM8lA SQC~l :iE(.;l.IlUf~ t.ll.I..eE.R t).oIiEOFtlENH,_.O'......., 9941 ol.(, \1 ... r ...2i.'L' 1-> Male .. o - 26 Pl.ACEOFOEATHrCt>o,c. ......._......""""'''.....__1 tlOSI'llAl: Philipsburg,Pa _cv ,,,,,,,,-.0 . . 'ilCUNNIIl<<llll'lOl......,......,..O..S1/_~......-, OAfEO#8lRfH 1._,lAo,.'_1 BllUHPlACE lC.,.,~ ~QI'a",,~ ~,O Nov 10,32 .. CII'(. eoRO. twP QF OEIIH ",,0 East Pemsboro IUHDCWIOSlHESS/lNOU$lAV f-I/.>I~ ~.>), Ill-t NIlS D(Nll! AIN US.AflMEDfOflCES7 ,.li!i(I..O SUftYlVlNGSf'OU$f tII....lP'4-~ loiARlTAl.SWUS.~ ~"""*'.~ -....... Divorced .r&L brand DECEDE...rs '"""'" "'SOOEHCE - --- ,. ... uJtJ .....,llKedMlinoI.. ... Pa u..Sl.o.. .. - _.. -' uolD :;...-=:.::"" ,... cumberland .~ MntEA'SNAUElf.sl.~ ~I II. Edwin Tyson Brc::Mn sr 1HfOfIW,HT"$N.wE(l'pIf'mI) Marcia Brown DO"""""'''' OolIMionO =~~IoIIQO RMoOwal'-$I:"'P ... ()# IW. ACTUotGASSUCH lHEWS.NAME"''':It.~.~s...nttmolJ 1'. Edna Mellin OAaW\lf'SWAlUNG ADDRfSS(Slr....~. ~.ZClCodlt) 504 Thomas Ibad canp Hill, Pa 17011 PVoCEOFOISPOSlTIDH...._olCerMlety.O......1OIy LOCAhON.Cill)rtTown.S1....Z.CoM .-...... 21C. Uc. lICENSE: NlJMOER .. 2::llt. . WUi CASE flEfERAED TO MEDlCAll!lWIlHERICOAOHEIl7 d' ... ....Ji!),A;?#~..1"" ,-- '1I'lI......~ :....--".... , , , .... 1ME000QE....H DIllIE Pf\ClNOlJNCEDDfAOlM...... o.~. '$."1 .. O'.U A.. D. :)",,1 8 LcN- 27.MRTl: e.-_---.iftjuriH.,~wllith_.,.....,..OO"._-....,.,.oldp>9. uc.o.OoK......_arory."ftl.._or....n....... LiIl.....,__...HCIlIine. . \ ~ WERlE AUlOPSY flHDlHGS AlMn..Aa1! PAlDA to """""""" DO CAUSE """'" ",0 PART I: eua., 1ignIIIc.... --..... r;rwr--'ID ........ buI fIflI,......in_.......'.~_.-..l'Nn'1 Co."-/)1i.j FH~ ..L--,L......_. 17.4l ..iI ',-;/,....4-<1..- ./.J1r//;:I..~ I DUE ! ~ TIMf:Of~UflV IlUUAVlSv.0AK7 DESCIU8E HOW lHJURV OCClJRAEo. UANNfR OF DEATH DNEOFINJORY .........o.y.-I ..0 -- ...- .s.,;c;.,. ~ o o CoukIIIllIH"-i.''''_ --- o o o f'lA(.t:OFINJURY.,\\I'lomJ..lauI>.1I>nl.-'.ulIiI:. .... buoIoHg,~,.SpIIc.M ,... lOCAlION~_,~." ttaon.,.,. ... 0 ~O a.. 211l. CdTIfIEA~.....,.~ .CUlTlfYWG"""SlClAKIf't'...-~~d-.,...................JIIWK_....Il'-'O....._c~I_"JI 1.__......,....,~.HIIUl___ID...C_II(.I....._....UO-......... .. ."....,,- O:Ull. lICENSE SEA Om./l;cJOvr10bL.-- 31 NAME AND AODAJiSS OF PERSON WHOCONf'lEfED(iAUSE IILrlm21IT)'llIIIOff""" 10.r<p~;" -"<.J.d.,,'.. W'J 0;.'1 \'\o>.J-..~ A---o... \. ',- H I .PRDNOtJftClHOANOClATIfVIHOPH'l'SlCIAJt(f'taysoo;onbQol>\lI'~__~'IClc....a!<Ilo~ To....llfllf;oI....,Mo"""""".dHlh___M__....I.......piK...fId...IO....c.I....1.1afld...................,. "MEOtcAL EXAMINERiCOAOHER Or! 1M...... 01 ,,,amkt.lklnancl/or "w..Itg&UDn.1n my Gpon,,",. d..lh oc<;",..d .1 th. 11m.. dilll'. ilInd p!ilIc.. ..,,,I d".IO Ih. c'''''l.' .nd J,.~..t1I1......~:.;..:_._:.;.~.............._................. ............. . ~ o n. OA:IE fIlE01~Qt '7y 'fea'~ ,W / ,---..! ...- /'1 02/-0.;l-QSl- LAST WILL AND TESTAMENT of EDWIN TYSON BROWN I, EDWIN TYSON BROWN, a resident of the County of Cumberland and the Commonwealth of Pennsylvania, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. FIRST: I direct that the expenses of my last illness and funeral be paid from my estate as soon as practicable after my death. I additionally direct that my remains be disposed of in accordance with the wishes of my personal representative. I request that a Lutheran memorial service be held and that I be laid to rest in the Brown plot. SECOND: I specifically bequest that items of personal property be distributed in accordance with the dictates of a signed memorandum which shall be stored in my safe deposit box or provided to either of my sisters, Joanne Austin or Marcia Brown. THIRD: I give, devise and bequeath my entire estate, property (including rights to property), real, personal and mixed, and insurance thereon, equally to my sisters, Joanne Austin and Marcia Brown, or the survivor of them, provided they shall survive me for a period of thirty (30) days. FOURTH: I devise and bequeath all the rest, residue and remainder of my estate equally to my sisters, Joanne Austin and Marcia Brown, or the survivor of them provided both or either of them, as applicable, survive me by thirty (30) days. FIFTH: Should both Joanne Austin and Marcia Brown predecease me or die on or before the thirtieth day following my death, I devise and bequeath all the rest, residue and remainder of my estate to J~ A ~ L ~ )1rM<, Ac.w~ bC01~ SIXTH: Until actual distribution, no par of the income or principal shall be subject to anticipation or alienation by any beneficiary nor shall it be subject to attachment because of the obligations of any beneficiary. SEVENTH: I direct that all estate, inheritance, transfer and succession taxes, federal, state and foreign of any kind whatsoever, which may be due and payable as a result of my death, together with all interest and penalties thereon, with respect to the property includable for such tax purposes, shall be paid from the principal of my residuary estate. I authorize my Executor to pay such taxes at such time or times as she in her absolute discretion, may deem advisable. EIGHTH: I authorize my Executor: (a) to retain and to invest in all forms of real and personal property, including stock and other securities, regardless of any limitations imposed by law on investments by fiduciaries; (b) to compromise claims; (c) to join in any merger, reorganization, voting trust plan or other concerted action of security holders and to delegate discretionary duties with respect thereto; (d) to sell at public or private sale, to exchange or to lease for any period of time any real or personal property and to give options for sales or leases; (e) to borrow and to pledge property of security for any funds borrowed; (f) to allocate any property received or charge incurred to income or principal or partly to each without regard to any law defining principal and income; (g) to exercise any law-given option, to treat administrative or other expenses of my estate as income tax deductions even if they were paid for principal and to value my estate for tax purposes by any optional method permitted by law in force when I die, without requiring adjustments between income and principal for any resulting effect on income or estate taxes; and (h) to distribute in cash or in kind. These authorities shall extend to all real and personal property at any time held by my Executor, and shall continue in full force and effect until the actual distribution of all such property. All powers, authorities and discretion granted by this will shall be in addition to those granted by law and shall be exercisable without leave of Court. NINTH: I appoint my sisters, Joanne Austin and Marcia Brown, as Co-Executrices of this, my Last Will and Testament. In the event either of my sisters predecease me or fail to qualify, I appoint my surviving sister, as sole Executrix of this my Last Will and Testament. TENTH: I direct that my Executrices shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this 1)71 day of --d'~ , 19 q S- i~~~'''b~ Edwin Tyson rown The preceding instrument, (~) other typewritten pages, consisting of this and -fILC,_cJ was on the day and date thereof ,-_\JLuIJ7 IL ^[,n ()" ^l-J'" J~ .~ \U~he signed, published and declared by Testator therein named, as and for his Last Will, in the presence of us, who, at his request, in his presence, and in the presence of each other, have subscribed our names as witnesses hereto. -Xt~ . G--.. .. /" .' . tness ~ ,Ll~/L-,< t{. /'fy~ Witness ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF YORK Before me, a Notary Public in and for said County and Commonwealth, personally appeared the undersigned Testator and witnesses who, being duly sworn according to law, did acknowledge, depose and say: We, \!cLum-7LrsS(5)W:.J?)Yi<-J'fL;) the undersign~d Testa or, and h K a ~ f<rrl fH I t~ and (b{L 'U.-X)J LA. . Ji..- L L' , the undersign d witnesse , whose names are signed t the ttached or foregoing instrument, being first duly sworn and qualified according to law, do hereby depose, declare and acknowledge to the undersigned authority that the Testator signed, declared and executed said instrument as his Last Will in the presence, hearing and sight of the witnesses and that Testator signed willingly and executed said will as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence, hearing and sight of the Testator and of each other, signed said will as witness and that to the best of each affiant's knowledge, the Testator was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. Sworn to and subscribed to before me this /5-fh day of ~Unc) , 19i5. C? _, D I LO L?j {Ii ^ILIS NOTARIAL SEAL TRACY L. LANDIS, Notary Public York, York County My Commr$SIOn Expir~t May 4, 1998 My Commission Expires: ~\~~~g()V o~ ~ness . ~<-<-4_ a, I~'/~ I Witness ()- CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Edwin Tvson Brown Date of Death: Julv 8. 2002 Will No. 21-02-0957 of2002 Admin. No. To the Register: I certifY that 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 27,2002: Name Address Marcia Brown 504 Thomas Road Camp Hill, PA l70ll Joanne Austin 5627 Moreland Court Mechanicsburg, P A 17055 Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except N/A Date: November 27.2002 ft~- Susan H. Confair, Esquire Reager & Adler, PC 2331 Market Street Camp Hill, PA l70ll (717) 763-1383 Counsel for Personal Representatives COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1 162 EX(1 1-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REAGER & ADLER C/O SUSAN H CONFAIR ESQUIRE 2331 MARKET STREET CAMP Hill, PA 17011 n_u__~ fold ESTATE INFORMATION: SSN: 206-26-9941 FILE NUMBER: 2102-0957 DECEDENT NAME: BROWN EDWIN TYSON DATE OF PAYMENT: 04/10/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 07/08/2002 NO. CD 002409 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 [ $86,319.40 I I I [ [ [ [ I - -- TOTAL AMOUNT PAID: $86,319.40 REMARKS: JOANNE AUSTIN & MARCIA BROWN C/O SUSAN H CONFAIR ESQUIRE CHECK#153 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS -- DONNA M. OTTO DEPUTY 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 - REAGER & ADLER C/O SUSAN H CONFAIR ESQUIRE 2331 MARKET STREET CAMP Hill, PA 17011 _____n~ fold ESTATE INFORMATION: SSN: 206-26-9941 FILE NUMBER: 2102-0957 DECEDENT NAME: BROWN EDWIN TYSON DATE OF PAYMENT: 04/10/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 07/08/2002 NO. CD 002410 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $8,832.92 I I I I I I I I ,- TOTAL AMOUNT PAID: $8,832.92 REMARKS: JOANNE AUSTIN & MARCIA BROWN C/O SUSAN H CONFAIR ESQUIRE CHECK#154 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WillS - DONNA M. OTTO DEPUTY REGISTER OF WillS CJMBb<LAND COUNTY, PENNSYLVANIA v INVENTORY Estate of BROWN, EDWIN TYSON , Deceased No. 21 02 0957 Date of Death 7/8102 Social Security No. 206269941 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. l!We understand that false statements herein made are subject to the penalties of 18 Pa. C.R Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of Attorney: SUSAN H. CONFAIR I.D. No.: 70241 Address: REAGER & ADLER, P.C. CAMP HILL PA 17011 Telephone: 717-763-1383 Description Value Stocks & Bonds SERIES EE BOND - R4603306 EE 270.24 SERIES EE BOND - C931 09937 EE 135.12 SERIES EE BOND - L424538873 EE 49.34 PNCINVESTMENTACCOUNT Account No. 1699-2711 26,353.03 Closely-Held Corporation, Partnership or Sole-Proprietorship Total (Attach Additional Sheets if necessary) 454,041.77 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 BROWN, EDWIN TYSON 21 02 0957 Page 1 Description of Inventory Description Value Mortgages & Notes Receivable Cash, Bank Deposits, & Misc. Personal Property CERTIFICATE OF DEPOSIT PNC Bank - Account No. 31100216915 51,698.97 CHECKING ACCOUNT PNC Bank - Account No. 5080055927 8,814.84 SAVINGS ACCOUNT PNC Bank - Account No. 5080229261 233,395.23 2002 FEDERAL INCOME TAX REFUND 2,014.00 2002 COMMONWEALTH OF PENNSYLVANIA TAX REFUND 56.00 1996 BUICK LaSABRE 5,355.00 Real Estate 4185 NANTUCKET DRIVE, MECHANICSBURG, PENNSYLVANIA contract sales price 125,900.00 Subtotal $ Grand Total $ 427,234.04 454,041.77 REV-1500EX + (6-00) t \-qlo-q Ot REV-1500 if INHERITANCE TAX RETURN RESIDENT DECEDENT '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT, 280601 HARRISBURG, PA 17128-ll601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) I- Z W C W U W C BROWN, EDWIN TYSON DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) 07108/2002 11/10/1932 (I'r APPLICABLE) SUR\J\VlNG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE lNlTIAL) W I- ::.:~(I) u"'''' W&U :r:a::9 Uc..lll c.. '" [E] 1. Original Return o 4, Umited Estate [g] 6, Decedent Died Testate (Attach copy of Will) o 9, Utigation Proceeds Received o 2, Supplemental Return D 4a. Future Interest Compromise (date of death aIler 12-12-82) o 7. Decedent Maintained a Uving Trust (Attach copyofTrust) o 10, Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) OFFICIAL USE ONLY FILE NUMBER 2 -0 2 0 9 5 7 c:5m'r'N"'COOE ""Y"EAA- - - 'NtiMBER-- SOCIAL SECURITY NUMBER 206-26-9941 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return [date 01 death prior to 12-13-82) o 5. Federal Estate Tax Relurn Required .2- 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113{A) (AttachSchO) COMPLETE MAILING ADDRESS REAGER & ADLER, P,C, I- Z W C Z o c.. "' w '" '" o U is NAME SUSAN H, CONFAIR FIRM NAME (If Appl.,ble) REAGER & ADLER, P,C, TELEPHONE NUMBER 717-763-1383 CAMP HILL 2331 MARKET STREET z o i= <( ...J => l- ii: <( u w cr: 1. Real Estate (Schedule A) (1) 2, Slocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole.Proprietorship (3) 4. Mortgages & Notes ReceIVable (Schedule D) (4) 5, Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6, Jointly Owned Property (Schedule F) (6) o Separate Billing 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 & Administratlve Costs (Schedule H) (9) 10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule l) (10) 11. Total Deductions (total Lines 9 & 10) 12, Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election 10 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 z o S => Q. :E o u ~ I- 15. Amount of Une 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X_(15) X_(16) 792,936,04 X ,12 (17) 16. Amount of line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of line 14 taxable at collateral rate X ,15 (18) (19) 19. lax Due CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 20, PA 17011 125,900,00 j ! 26,807,73 Oi=FICIALuSE-ONiY 301,334,04 365,a20,73l. (8) 819,862.50 23,745,67 2,780.79 (11) (12) (13) 26,526,46 793,336,04 400,00 (14) 792,936,04 95,152,32 95,152,32 o ad t' C I t Add ec en s' amole e ress: STRmAOORESS 4185 NANTUCKET DRIVE CITY MECHANICSBURG I STATE PA I liP 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 95,152.32 Total Credits (A + B +C) (2) 3. InteresUPenalty it applicable D.lnterest E. Penalty 4. TotallnteresUPenalty ( D + E) If Line 21s greater than Line 1 + Line 3, enter the difference. This is Ihe OVERPAYMENT. Check box on Page 1 Line 20 to request a relund If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) to: REGISTER OF (4) (5) (5A) (5B) AGENT 5. 95,152.32 A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This Is the BALANCE DUE. Make Check 95,152.32 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 ineeme 01 the property transferred; ........................................................................... 0 IZl b. retain the right to designate who shall use the property transferred or Its income; ........................................ 0 IZl c. retain a reversionary interest; or ..........................................................................................,........... 0 1KI d. receive Ihe promise for life of either payments, benefits or care? ............................................................. 0 IZl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?..............,.................,............................................................. 0 [g) 3. Did decedent own an "in trust for' or payable upon death bank account or securny at his or her dealh? ................. 0 IZl 4. Did decedent own an Individual Retirement Aceeunt, annuity, or other non.probate property which contains a beneficiary designation? ............... .... .................... ..,.........., .............,............,... . ..............,... ~ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ~ ,C<J it.4 'L/ 1(', ATURE OF PREPARER 0 DATE ct/?0.3 2331 MARKET STREET, CAMP HILL, PA 17011 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of translers to orfor the use 01 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 exernot 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 at dealh on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent ofthe chiid 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 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 siblin9s is 12% [72 P.S. ~9116(a)(1.3)J. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedenl, whelher by blood or adoption. RW'W"':".'''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER BROWN EDWIN TYSON 21 02 0957 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchangeQ between a wllllng 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 survivorshiD must be disclosed on Schedule F, ITEM NUMBER 1. DESCRIPTION 4185 NANTUCKET DRIVE, MECHANICSBURG, PENNSYLVANIA contract sales price VALUE AT DATE OF DEATH 125,900.00 TOTAL (Also enter on line 1, Recapitulation) $ (It more space is needed, insert additional sheets of the same size) 125,900.00 R"'.'~m:I"9". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN INN SCHEDULE B STOCKS & BONDS ESTATE OF BROWN EDWIN TYSON All property jointly-owned witI1 right of survivol'$hip must be disclosed on Schedule F. FILE NUMBER 21 02 0957 ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 270.24 SERIES EE BOND - R4603306 EE 2. SERIES EE BOND - C93109937 EE 135.12 3. SERIES EE BOND - L424538873 EE 49.34 4. PNC INVESTMENT ACCOUNT Account No. 1699-2711 26,353.03 5. TOTAL (Also enter on line 2, Recapitulation) $ (If more space Is needed, insert additional sheets of the same size) 26,807.73 '''''''''0>:'''''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF BROWN EDWIN TYSON FILE NUMBER 21 02 0957 Include the proceeds of litigatiof\ and the date the proceeds were rece\'Jed by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 51,698.97 CERTIFICATE OF DEPOSIT PNC Bank - Account No. 31100216915 2. CHECKING ACCOUNT PNC Bank - Account No. 5080055927 8,814.84 3. SAVINGS ACCOUNT PNC Bank - Account No. 5080229261 233,395.23 4. 2002 FEDERAL INCOME TAX REFUND 2,014.00 5. 2002 COMMONWEALTH OF PENNSYLVANIA TAX REFUND 56.00 6. 1996 BUICK LaSABRE 5,355.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space IS needed, Insert additional sheets of the same size) 301,334.04 "''''''':11'''',* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF BROWN EDWIN TYSON FilE NUMBER 21 02 0957 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM INCLUQE THE NAME OF TKE TRANSFEREE,Tl-IEIR RELATIONSHIPTOOECEOENTAND THE DATE OF TRANSFER DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE NUMBER ATTACH A COpy OF TKE DEED fOR REAL ESTATE VALUE OF ASSET INTEREST (IFAPPUCABLE\ 1. ERNST & YOUNG, llC - 401 (K) ACCOUNT 114,387.40 100. 114,387.40 Account No. 2. PNC INVESTMENTS - ANNUITY 146,831.42 100. 146,831.42 Glenbrook Annuity # GA 106624 3. MERRill lYNCH - INDIVIDUAL RETIREMENT ACCOUNT 30,994.22 100. 30,994.22 4. PRICE WATERHOUSE COOPERS - 401 (k) ACCOUNT 73,607.69 100. 73,607.69 TOTAL (Also enteron line 7, Recapitulation) $ 365,820.73 (It more space is needed, insert additional sheets of the same size) ''''''''',:,,.,'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF BROWN EOWIN TYSON FILE NUMBER 21 02 0957 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MYERS HARNER FUNERAL HOME 3,227.00 2 PHILLlPSBURG MARBLE & GRANITE 625.00 3. TRINITY LUTHERN CHURCH - MEMORIAL LUNCHEON 101.93 4. PASTOR PETER HUTCHINSON 100.00 5 PHILLlPSBURG CEMETERY 150.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (5) Social Security Number{s} I EIN Number of Personal Representative(s) Street Address City State lip Year{s) Commission Paid: 2. AttomeyFees REAGER & ADLER, P.C. 5,000.00 3. Family Exemption: (If decedents address ls not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 369.00 5. AooountanfsFees R. WM. WIRE ASSOCIATES, P.C. 1,545.00 6. Tax Return Prepare~s Fees 7. MARK HILBERT - Home Appraisal 275.00 8. CHECK PRINTING FEE 15.99 9. POSTAGE STAMPS 37.00 10. ZIMMERMAN - plumbing and heating repairs for sale of home 475.00 11. EWING ROOFING - repair garage vent 75.00 12 CUMBERLAND LAW JOURNAL 75.00 13. THE SENTINEL 74.75 14. REAL ESTATE COMMISSION - Howard Hanna Detweiler Realty 7,434.00 15. DEED PREPARATION - ReMax Realty Associates 100.00 16. HOME WARRANTY - American Home Shield 385.00 17. NOTARY FEE, TAX CERT & UPCA DOCUMENT FEE 22.00 18. TRANSFER TAX 1,259.00 TOTAL (Also enter on line 9, Recapitulation) $ 23,745.67 (If more space is needed, insert additional sheets of the same size) '''''''''.'''''* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER 21 02 ESTATE OF BROWN EDWIN TYSON 0957 Include unreimbursed medical expenses. ITEM NUMBER 1 2. 3 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. DESCRIPTION AMOUNT 294.00 HAMPDEN TOWNSHIP - trash/sewer (3 quartersO MID PENN UROLOGY 10.00 HOLY SPIRIT HOSPITAL 74.19 VERIZON 89.43 PP&L 173.59 AT&T 7.60 WEST SHORE EMS 659.40 BEAUMONT SQUARE HOMEOWNERS ASSOCIATION October, November & December 2002 150.00 THE HARTFORD - Homeowners Insurance 257.00 UGI 150.84 PENNSYLVANIA AMERICAN WATER COMPANY 61.02 HERSHEY MEDICAL CENTER PHYSICIANS GROUP 342.30 COMCAST CABLE - final bill 32.07 AT&T - final bill 7.60 CENTRAL MEDICAL EQUIPMENT CO 21.19 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert addilional sheets of the same size) 2,780.79 REV'1513,EX:19* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER ?1 n? nq<;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 pnclude outright spousal dislIibutions, and transfers under Sec. 9116 (a){1.2)1 1- JOANNE AUSTIN SISTER 1/2 OF THE ESTATE 5627 Moreland Cour! Mechanicsburg, PA 17055 2. MARCIA BROWN SISTER 1/2 OF THE ESTATE 504 Thomas Road Camp Hill, PA 17011 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. TRINITY LUTHERAN CHURCH 400.00 Balance due to church for amount pledged by decedent prior to his death (see attachedO for their Capital Campaign TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS DN LINE 13 OF REV-1500 COVER SHEET $ 400.00 (If more space is needed, insert additional sheets of Ihe same size) "' h ~.. -".. ",.JO .c.c "l!\~ "'<>~ Ii", .cO .. "' ",",Ill .....11I "'~c b~ .J.c ....J :.c..i~~1 ~ Ii '" --';;.-~~' ... "' t; =-=c. ' iUr ~ Ill"' ~ I ~<> ~ g' ~. ~ t:~:q-- ~ ~ · 0.. ~~_ '1 4\ 0') ~ t . 0 n ~ . _.I , z:. '"', 1 ::;l . -. . , , . (;'...---- ~ " '" ...."'.... 4"'''' u.....1 :z:"'.... 04'" (.) ..... all"'''' :: 4.... "'s::: :z:'" 4,C%)t"""Io. ",4"'~ :>",,,,- ",,,,N(.) 4 ... ~ ",,,, ~% i~ ...'" Do ... ...0 o .... s:~ ';.s: OC.... ...'" ,.4 ~~ s:ca a .... . e . . t\ ., ~ s :z: .... "" ~ ~ tl1 N.....c:;lI C\' ~",=- o Ct0<4 N NCi.-l I l' oc. o-%ClQNLJJ Q3ClQcA ,0' ~ ..oD',....~~ QcAONU ... " .. ... !c- ~l~ s: ~'" ...... ...cal 0...:1 ...o:r.~ ",~"'''':Z::z: ~~~~6U ca...ca...UiC \: III "' ~ .. ~a 'i a'iri l' ,,",1"'1 ~ ?ia ~ co ';: ~~ c ~.. .. ~ 'S'i~j ~,;f.~ Ul CI' .!-l ~i~t 1IIlI!-l~:S: .. o .... Ii ~ .,.. 4 Do .... ... ~ g: ca ~ ... ... ~ ~ Do ..: u ~ U ~ 4 s: '" '" :> o :: ....'" "'~ ",:>0 ...0"" ...o~ .... ",,0 04 u.. ... 0'" :z: - ",4'" "'...... ...."'''' "''''.... ..........1 <!lS:'" ",:>4 ",00 ~ ~ o ,... .... 4 ... , , , , I , . , . , , . . , . , , '. I' , ,'. .. ,. ," ,. ,~ I' CIl,. ca'- "," 01 U'. ..., -," -,' ~ G'l' a\t .,.... '. ",\t 0" ..." ,. :z:' 0" ..." ....\t ~h Do" ,. ,~ "',. ....~ ,,'. 0" ~h ." z'i ...'. oCI _IV jIJ'( ",' I~ " " I.'~ .\c \4 " b. .e " ...'. ~,c ...'. ...' 'D CIt\u ...,.. s:' ....~) III Ill' :z:'r 0'..: .-1'. 4:.'''' " ....'- ':)'" u~c 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 REAGER & ADLER PC C/O MONICA ZERCHER 2331 MARKET STREET CAMP HILL, PA 17011 _nn_n fold ESTATE INFORMATION: SSN: 206-26-9941 FILE NUMBER: 2102-0957 DECEDENT NAME: BROWN EDWIN TYSON DATE OF PAYMENT: 06/13/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 07/08/2002 NO. CD 002678 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $26.07 I I I I I I I I TOTAL AMOUNT PAID: $26.07 REMARKS: REAGER & ADLER PC C/O MONICA ZERCHER CHECK# 14767 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WillS DONNA M. OTTO DEPUTY REGISTER OF WILLS " /-')- ,/6 - '1 ~ BUREAU Of INOIVIOUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE Of INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR OISALLOWANCE Of OEDUCTIONS AND ASSESSHENT Of TAX Flee:' Rel. DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-09-2003 BROWN 07-08-2002 21 02-0957 CUMBERLAND 101 Amount R...itt"d SUSAN H CONFAIR REAGER & ADLER 2331 MARKET ST CAMP HILL '03 JUN 19 P 1 :36 G,:n:. PI\C\lfltlU,. "v: '* REW~lSU U iFP tU-HI EDWIN T 19} IlO} } CHANGEO ll} 12} 13} 14} IS} 16} 17} 125,900.00 26,807.73 .00 .00 301, 334.04 .00 365,820.73 18} 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 ~ REV=is'4j-EiCAf'jQ'iiFo3Y-;JiiYicniF-'fNHEiiiiANCE-YAX-APPRAisEiiE;j:r-,--ALLOWANCE-oli----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BROWN EDWIN T FILE NO. 21 02-0957 ACN 101 DATE 06-09-2003 TAX RETURN WAS: I X} ACCEPTED AS fILEO RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule 8) 3. Closely Held stock/Partnership Interest (Schedule C) 4. Kortgages/Notes Receivable (Schedule DJ 5. Cash/Bank D8Posits/Hlsc. Personal Property (Schedule El 6. .Jointly Owned Property (Schedule F) 7. Transfers (Schedule Q) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Exp.ns.s/A~. Costs/Hisc. Expenses (Schedule Kl 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total _Uons 12. Net Value of Tax Return 13. Charitable/Govern..ntal Bequests; Non-elected 9113 Trusts (Schedule J) 1~. Net Value of Estate Subject to Tax If an asses.-ent was issued previDus1y, lines 14, 15 and/Dr 16, 17, 18 and 19 will reflect figures that include the tDtal Di' ALL returns assessed tD date. ASSESSMENT OF TAX: 15. A.o...,t of Line 14 at Spousal rat. (IS) 16. Aaount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 et Sibling rat. 117} 18. Amount of Line 1~ taxable at Collateral/Class 8 rate (18) 19. Principal Tax Due S: NOTE: NUHBER CD002409 CD002410 INTEREST/PEN PAlO I-} .00 .00 DATE 04-10-2003 04-10-2003 23,745.67 2.780.79 Ill} 1I2} 113} 114} .00 X .00 X 792,936.04 X .00 X AMOUNT PAID 86,319.40 8,832.92 BALANCE OF UNPAID INTEREST/PENALTY AS OF 04-11-2003 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 00 = 045 = 12 = 15 = 119}= NOTE: To insure proper credit to your account I ~.i t the upper portion of this fo~ with your tax paYllent. 819,862.50 ?ft.li?ft 4ft 793,336.04 400.00 792,936.04 .00 .00 95,152.32 .00 95,152.32 95,152.32 .00 26.07 26.07 . If PAID AfTER DATE INDICATED, SEE REVERSE fOR CALCULATION Of ADDITIONAL INTEREST. If TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. If TOTAL DUE IS REfLECTEO AS A "CREDIT" ICR}, YOU HAY 8E DUE A REFUND. SEE REVERSE SIDE OF THYS. FnDM I'nD T~TDlIII"'TT"""''''' " 1'7-9b-9 ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' IEY~ln7EX'FP (II1-UI SUSAN H CONFAIR REAGER 8 ADLER 2331 MARKET ST CAMP HILL 'OJ ,JUL 11 . tAft EStATE OF DATE OF DEATH FILE NUMBER liiuiM' ACN 06-30-2003 BROWN 07-08-2002 21 02-0957 CUMBERLAND 101 OOWtt R...itted EDWIN T ReCUfU" R~-;. PA 17011 c;~! Cn\\;:.,-:: i MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WIllS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper cr~it to your eccount, submit the upper portion of this for. with your tax p.y...nt. CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ... REy:i6ifj-E"x-iiij.--fiiFii3y------.iij(-iNHERi''r'AiicE-Tilc-5TAfEiiENT-OF-iccouiif--j(Ii.--------------------- ESTATE OF BROWN EDWIN T FILE NO. 21 02-0957 ACN 101 DATE 06-30-2003 THIS STATEHEHT IS PROVIDED TO ADVISE OF THE CURREHT STATUS OF THE STATED ACM IH THE NA"ED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYNEHTS, THE CURREHT BALANCE, AND, IF APPLICABLE, A PROJECTED IHTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-09-2003 P R I NCI P AL TAX DUE: ,_______"'_'0'_______",_,_________._________"'"",______"""".------,-. 95,152.32 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-10-2003 CD002409 .00 86,319.40 04-10-2003 CD002410 .00 8,832.92 06-13-2003 CD002678 26.07- 26.07 TOTAL TAX CREDIT 95,152.32 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 PAYHEHT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. ) vv' ok 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: Edwin T Brown Date of Death: .Tuly S, 2002 Will No.: 21-02-0957 Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. lfthe 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 X 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: (d-/803 /6u~ Susan H. Confair, Esquire Reager & Adler, P.C. 2331 Market Street Camp Hill, P A 17011 (717) 763-1383 Counsel for Personal Representative