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Home My WebLink About04-0980 PETITION FOR PROBATE and GRANT OF LETTERS Estate of FAYE L. HOOVER No. ~, I- 0 {~ 0q g[] also known as To: Register of Wills for the Deceased. County of Cumberland in the Social SecuriO, No. 204-26-8199 Connnonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner is 18 years of age or older and the Executor named in the last xvill of the above decedent, dated July 28, 1981 and codicil(s) dated none. Sharon A. Souder, first Executor named in the Will is predeceased. Decedent was domiciled at death in Cumberland County, Pennsyh'ania. with his last family or principal residence at 233 F Street, Carlisle, PA, 17013. Decedent, then 71 years of age, died August 26, 2004, at Manor Care Health Services, Carlisle, PA. Except as follows, decedent did not man'y, was not divorced and did not have a child bom nr adopted after execution of the will offered tbr probate; was not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property S unestimated (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: Carlisle Borough $ uncstimated WHEREFORE, petitioner respectfully requests the probate of the last will and codicil(s) presented herewith and .the grant of letters testamentary thereon. Lester Souder 639 Mulberry Lane . . Dillsburg, PA 17019 .z (717) 432-2t03 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND The petitioner above-named swears or affirms that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner and that as personal representative of the above decedent, petitioner will well and truly administer tbe estate according to law. Sworn to or affirmed and subscribed ?/~-5~x' ~ &) before me this ~ ~( day of Lestdr Souder Estate of Faye L. Hoover, Deceased DECREE OF PROBATE AND GRANT OF LETTERS f',~ in consideration of the petition on the reverse side 4 AND NOW, b" (~ L ! 5..k, , hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated July 28, 1981, described therein be admitted to probate and filed of record as the last will of Faye L. Hoover, and Letters Testamentary are hereby granted to Lester Souder. Page / RegisterofWills h?[[~4j;))' FEES ~55 ; ;h Edward L. Scho,pp, Esquire (17495) kk Probate, Leners, Etc. $ ~ - c U A~ORNE~ (Sup Ct ID No) ' Short Certificates( ) $ ~'~. ;) ~) MARTSON DEARDORFF WII.LIAMS & OT70 ~ ~' ~q5 $ ~ ~ l0 East High Street ~ $ I~. ~q~" Carlisle, PA 17013 TOTAL $ ~[i, ~' L'~ (717) 243-3341 Filed WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. 57,07443 August 30, 2004 Faye L. Hoover Female 204-26-8199 8-26-2004 May 11, 1933 New Germantown, PA Manor Care Cumberland Carlisle White Clerk No Divorced 233 F. Street Carlisle PA 17013 Judy S. Cook James F. Nickel Nickel Funeral Home, Loysville, PA 17047 Alzheimer's Dementia XX Darryl K. Guistwite D.O. 522 S. Pitt Street, Carlisle, PA 17013 50-455 August 30, 2004 101 B~rnett St., New Bloomfield, PA 17068 L~qT ItrlLL A~D TFSTA\~x~ OF FAYE L. HOO~rER I, FAYE L. HOOVER, a legal resident of the Borough of Carlisle, Cumber- land County, Pennsylvania, being of sound and dis¢osing mind, memory and under- standing, do hereby make, publish and declare this as and for my Last !'fill and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST: I direct that all my just debts and fl~neral expenses, includ- ing my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. SECOND: I devise and bequeath the residue of my estate, of every nature and wherever situate, to my daughter, Sharon A. Souder, provided she shall survive me by thirty (30) days. Should my daughter, Sharon A. Souder, prede- cease me or die on or before the thirtieth day following my death, I devise and bequeath the residue of my estate, of every nature and wherever situate, to my grandchildren, in equal shares, provided that the share of any grandchild t~o predeceases me or dies on or before the thirtieth day following my death shall be! added to the share or shares for my other grandchildren. THIRD: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction ~nposed, shall be paid from my residuary estate as a part of the expense of the administration of ~m/ estate. FOURIth I nominate, constitute and appoint my daughter, Sbaron A. Soud, r, Executrix of this, my Last Will and Testament. In the event of the renunciation, death, resignation or inability to act ~or any reason whatsoever of the said Sharon A. Souder, I nominate, constitute and appoint Lester Souder Executor of this, my Last Igill and Testament. I hereby relieve my Executrix or her suc- cessor from the necessity of posting security, in connection with her or his duties as such in any jurisdiction in ~ich she or he may be called upon to act, insofar as I am able by law to do so. L'~ I~'ITNESS ~IIEREOF, I have hereunto set my hand and seal to this, my Last ~,~ill and Testament, consisting of this one typewritten nage bearing my sig- nature, this 2~>~_f_~day of ~,~ , 1981. · y Hoover ~Signed, sealed, published and declared by the above-named Testatrix, Faye L. Hoover, as and for her Last ~ill and Testament, in the presence of us~ .......... iwho, a[~her request, in her sight and presence, and in the sight and presence ~^~s~ ~c~ of eac~ other ,.. have hereunto subscribed our name~ as witnesses. ACI~OWLEDG~[BNT COb~MON~ALTH OF P~S~V~IA ) : SS. ~ OF ~E~ ) I, ~A~ L. HOO~R , Testatrix , whose ~me is si~ed to the attached or forego~g ~st~ent, having been duly qualified according to law, do hereby ac~owledge that I si~ed ~d executed the ~stm~nt as my Last Will; that I si~ed it willingly; ~d that I si~ed it ~ my free ~d vol~ta~ act for the pu~oses there~ e~ressed. , 198~ S~ , the Testatrix , ~is ~ day of ~ L, ~fFR, or affixed to ~d ac~owl~ed before me bM FA~ ~FIDAVIT My Commission Expires Sept. ]¢, ~~ OF PF~LV~IA ) : SS. ~ OF ~E~ ) We, EDWA~ L. S~O~P ~d ~ ~ ~ the witnesses whose n~es are si~ed to the attached or foregoing inst~ent, berg duly qualified according to law, do depose ~d say that we were present ~d saw Testatrix si~ ~d execute the inst~ent as her Last Will; that FAYE L. HOO~R si~ed will~gly ~d that she executed it as her free ~d vol~ta~ act for the pu~ses therein e~ressed; that each of us in the hearing ~d sight of the Testatrix si~ed the Will ~ witnesses; ~d that to th best of our ~owledge the Testatrix was at that t~e 18 or more years of age, of sold ~nd ~d ~der no constra~t or ~due ~fluence. ~or~ff~med,to ~d subscribed to beforg_~e by ED1~n ~d~ ~~~ , ~messes, this ff~ day' of~ , 1~1 , )~zn9 s .. , u ~. ~ cno~p Witness :ARLI~L~' PENNSYLVANIA MARY~N GORMAN, Nctaw Publio C~rlisle, Cumberland Co., Pa. My Commission Expires Sept. 19, CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Faye L. Hoover Date of Death: August 26, 2004 File No. 21-04~0980 To the Register: I certify that notice of estate administration 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 or about November 3, 2004. Mr. Jon C. Souder Mr. Rhett A. Souder 639 Mumper Lane 61 Powell Road Dillsburg, PA 17019 Kingsland, GA 31548 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A Date: November 3, 2004 Signature ~ Name Edward L. Scho~pp, E~ squire MARTSON DEARDORFF WILLIAMS & OTTO Ten East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Personal Representative PENNSYLVANIA RECEIVED F~: )M: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004664 SOUDI R LESTER 639 M J:LBERRY LANE DILLSE JRG, PA 17019 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 $4,500.00 ESTATE Ih, Ii ORMATION: SSN: 204-26 8199 FILE NUME R: 2104- 0980 ~ DECEDENT' ',lAME: HOOVER FAYE L DATE OF F 'MENT: 11/23/2004 POSTMARI DATE: 11/23/2004 ~ COUNTY: CUMBERLAND DATE OF ATH: 08/26/2004 TOTAL AMOUNT PAID: $4,500.00 REMARKI L SOUDER C CK# C INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS MARTSO EARDORFF WILLIAMS & O'rTO ATTORNEYS & COUNSELLORS; INFOILMATIOI DVICE · ABVOC^C~ WILLIAM F. MARTSON JOFFN B. FOWLER Ill EDWAKD L. SCHORPP DAVIt 10 EAST HI ~TREET DANIEL K. DEARDORFF CARLISLE, ] 4SYLVANIA 17013 THOMAS J. WILLIAMS* TELEPHONE 717) 243-3341 IVO V. Ovro Ill FACSIMILE 717) 243-1850 GEORGE B. FALLER JR.* November 23, 2004 ~D DELIVERED C :e of Register of Wills C lberland County Courthouse C isle, PA 17013 RE: Estate ofFaye L. Hoover Estate No. 21-04-0980 ! Date of Death: August 26, 2004 Clerk: Enclosed with this letter is estate check number C in the amount of $4 lent of Pennsylvania Inheritance Tax in the above-referenced estate. Will you please issue the appropriate receipt and forward it to me at the above k you in advance for your prompt attention to this matter. Very truly yours, MARTSON DEARDORFF WILLIAMS & Edward L. Schorpp i ;/vlo losure INFORMATION ADVICE ADVOCACY SM ~,~ REV.l_U+{1I..oG1 w ~ ~S U~ W~ ~:i U~ ~ < *' REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FilE NUMBER 21 04 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 00980 NUMBER 1&1 1. Original Return 0 2. Supplemental Return o 4. Limited Estate 0 4a. Future Interest Compromise (date of death after 12-12-82} 181 6. Decedent Died Testate (Attach copy 0 7. Decedent Maintained a Living Trust (Attach of Will) copy of Trust) o 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between 0 11 ,Election to tax under See, 9113(A) (Attach Sch OJ . ------.~-. .,' ---'~.-:,'. - --.~-~: ..'~-:-:::--~' .' C~', -.,C--:---~~', :,c.c-::--:~:.J#,~~~,.,~d"1..-1.,-~--?-h-c~:c::,,..:C'~.c,'..~,-,,-::;:;-__.- ,,:.C:c-,:-:,c:....,;,-.-.---.---..,-:-'.'.- :c-.-,-,--: .:''-.' -C~'.'-' ,"'-;:;--:..',:.'---:-',',: ..-..:-:----~- 1ll!lS'$ElmOII'''U$T$eCO''''l;ll!TI!j),'A\.l:!C~E$I'()l>!I\lI!il!l,,'AMtl'!lQNl!ll>~A..TAltjI!l!l'O~TIO1\I$!!OU~l\llle.tlI!!Ell:rEQm, NAME COMPLETE MAILING ADDRESS Edward L. Schorpp, Esquire COMMONWEALTH OF PE.NNSYLV,l.,NI,l., OEPARTMENT OF REVENUE OEPT280601 HARRI.!!BURG, PA 17.!3.'.'-0601 DECEDENrs NAME (lAST. FIRST, AND MIDDLE INITIAL) ~ z w c w U w c HOOVER, FAYE L DATE OF DEATH (MM-DD-YEAR) DATE OF-BIRTH (MM.DD-YEAR) 08/2612004 05/11/1933 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST AND MIDDLE INITIAL) ,;, ~ o u FIRM NAME (If applicable) Martson Deardorff Williams & Otto TELEPHONE NUMBER 717/243-3341 1. Real Estate (Schedule A) z o ~ 5 ~ ~ ~ < M ~ 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 Owne<l Property (Schedule F) o Separate Billing Requested 7, \nter-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) 204-26-8199 THIS RETURN MUST BE FilED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3 Remamder Return (date of deatn prior to 12-13.82) o 5. Federal Estate Tax Return Required 8, Tolal Number of Safe Deposit Boxes Ten East High Street Carlisle, PA 17013 (1) 69,900.00 (2) 1,530.90 (3) None (4) None (5) 32,222.65 (6) 10,873.01 (7) 46,494.34 (9) 28,611.60 (10) 9,150.58 (,,':, 0'\ (8) 161,020.90 (11) 37,762.18 (12) 123,258.72 (13) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subjectto Tax (Une 12 minus Line 13) (14) 123,258.72 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 5,546.64 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 5,546.64 20. 0 >> 810 811I<15 TO AN_ALL Ql)18t1!!lN8'OIl RevilR$E SIDE ANi:i:ii'ecHEcK MilTH << "'-------"--_.~_...~.._--- Copyright 2000 form software only The Lackner Group. Inc. 15,Amount of Line 14 taxable at the spousal tax rate, X .00 (15) or transfers under See, 9116(a)(1.2) z 123,25S.72 X .045 (16) 0 16.Amount of Line 14 taxable at lineal rate ~ ~ " (17) ~ 17. Amount of Line 14 taxable at sibling rate x .12 ~ 0 u ~ 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 233 F Street CITY ! STATE PA ZIP 17013 Carlisle Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 4,500.00 236.84 Total Credits (A + B + C) 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnteresuPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. 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 (1) 5,546.64 (2) 4,736.84 (3) 0.00 (4) (5) 809.80 (5A) (5B) 809.80 Make Check to: REGISTER OF AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;...." ................. b. retain the right to designate who shall use the property 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 property 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-probate property which contains a beneficiary designation?........ ................ ............... '~ I o .......0 ~ fZl fZl o IF THE ANSWER TO ANV OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pe~ury. I declare thai I have examined this return. including accompanying schedules and statements, and to the best of my knowledge and belief. it is true, correct and complete Declaration preparer other lha~ th_ePf3~onal reP:E!sE!nlalive isnbCised on all information of which. preparer has anyknowle<lge SIGNATURE OF PERSON RESPONSIBLE FOR FIL.lNG RETURN ADDRESS Lester Souder AOORESS 639 Mum!,er Lane Dillsb_urg, P A 17019 ~SP~S~lEFORFING SIGNATURE OF PREPARE~ REPRESE Edward L. Schorpp, Esquire ADDRESS Ten East High Street Carlisle, P A 17013 DATE ..;?-I ~ -OS- DATE ;;;2-/ b-ClS DATE 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. S9116 (a) (1.1) (i)J. 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) (ji)). The statutedoes not exemcta transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the chlld 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. S9116 (a) (1)J. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116 (a) (1.3)). A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. *' SCHEDULE A REAL ESTATE COMMONWEALTH 01' PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HOOVER, FA YE L FILE NUMBER 21 - 04 - 00980 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 excl1anged between a willing buyer and a wining 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 69,900.00 Residence situate at 233 F Street, Carlisle, Cumberland County, PA, known as parcel No. 06-19-1643-063, being described in Deed dated February 18, 1972, and recorded in Cumberland County, PA, Deed Book "M", Volume 24, Page 692, and being conveyed to Faye L. Hoover. See attached settlement statement. TOTAL (Also enter on Line 1, Recapitulation) 69,900.00 *' SCHEDULE B STOCKS & BONDS COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DeCEOENT ESTATEOF HOOVER,FAYEL I FILE NUMBER 21 - 04 - 00980 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION UNIT VALUE 36.45 VALUE AT DATE OF DEATH 1,53090 42 shares, MetLife CUSIP #S9156R108 TOTAL (Also enter on line 2, Recapitulation) 1,530.90 *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF HOOVER,FAYEL FILE NUMBER 21 - 04 - 00980 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 M&T Bank checking account #43909248 DESCRIPTION VALUE AT DATE OF DEATH 3,259.17 2 7 Series E US Savings Bonds, see attatched savings bond calulator (Tommy Smith predeceased) 9,757.00 3 MetLife Annuity #072 977 651 AB, beneficiary estate 15,29380 4 Cumberland Valley Memorial Gardens, 4 burial plots 2,000.00 5 Shipley Energy, refund 179.75 6 Real estate tax proration 385.48 7 Fahnestock's Auction Service, net proceeds from sale of household property 1,347.45 TOTAL (Also enter on Line 5, Recapitulation) 32,222.65 . SCHEDULE F JOINTLY -OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HOOVER, F AYE L FILE NUMBER 21 - 04 - 00980 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A Lester Souder 639 Mumper Lane Dillsburg, PA 17019 Son-in-law JOINTLY OWNED PROPERTY: ITEM LETTER NUMBER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY "Ii OF DATE OF EAT Include name of financial institution and bank account number DATE OF DEATH DECO'S. VALUED OF H or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET INTEREST DECEDENT'S INTEREST estate. A 05/07/1996, Members 1 st savings account \ # 108494-00 05/07/1996 Members 1st checking account #108494-11 20,454.37' 50% 10,227.19 2 A 1,29\.63\ 50% 645.82 TOTAL (Also enter on line 6, Recapitulation) 10,873.01 . SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HOOVER, FAYE L FILE NUMBER 21 - 04 - 00980 ITEM NUMBER This schedule must be completed and filed if the answer to any of questions 1 throul!h 4 on page 2 is yes. DESCRIPTION OF PROPERTY . % OF Include the name of the transferee, their relplionship to decedent and the date of IrclnSfer.!VDATEEOOF DAESASTHT: DECO'S EXCLUSION TAXABLE VALUE AtIach a copy Of Ihe deed for real estate. ALU F E I INTEREST i (IF APPUCABLE) m___ _~ MetLife IRA #073016242: issued 12/12/1995. Beneficiaries: Jon C. Souder, 50%; and Rhett A. Souder, 50%; grandsons 46,494.34! 100% 46,494.34 TOTAL (Also enter on line 7, Recapitulation) 46,494.34 *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HOOVER, FAYE L SCHEDULEH FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 - 04 - 00980 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Lester Souder Social Security Number(s) I EIN Number of Personal Representative(s): Street Address 639 Mumper Lane City Dillsburg Year(s) Commission paid FUNERAL EXPENSES: Nickel Funeral Home, Loysville, PA 2 Pastor Schoenkey, ministerial donation B. DESCRIPTION AMOUNT State PA Zip 17019 2. Attorney's Fees Martson DeardorffWilhams & Otto (estimated) 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 Cumberland County Register of Wills 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs Cumberland Law Journal, advertising letters testamentary 2 The Sentinel, advertising letters testamentary Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 7,359.32 200.00 6,131.00 7,830.00 260.00 75.00 144.29 6,611.99 28,611.60 *' ScheckIIe H Funeral Expens e s & AI:tr1nistraIiv CosIs cootiruld COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HOOVER, FAYE L 3 Register of Wills, filing fee, Inheritance Tax return 4 Certified mailing, Department of Public Welfare 5 Copies of Death Certificates for Sharon Souder 6 Register of Wills, Short Certificates 7 Carlisle Borough, sewer/water pending disposition of real estate 8 County of Cumberland, I % realty transfer tax 9 Darlene Moyer, 2004 real estate taxes 10 George Ebener Associates, conunission on sale of real estate II PPL, electric service pending sale of real estate 12 Ahold USA, Inc., reimbursement of pension overpayment 13 Additional filing fees and miscellaneous expenses FILE NUMBER 21 - 04 - 00980 Page 2 of Schedule H 15.00 4.42 34.00 6.00 21.57 699.00 337.27 4,194.00 39.65 76\.08 500.00 *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HOOVER, F AYE L Include unreimbursed medical expenses. ITEM NUMBER I 2 3 4 5 6 7 8 9 DESCRIPTION HRC ManorCare, Carlisle, account payable Arden Courts, Susquehanna, account payable Guistwite Family Practice, account payable Shamokin Area Conunuuity Hospital, account payable Pinnacle Health Hospitals, account payable PPL Electric Utilities, account payable Albert J. Zanetti, DO, account payable Shipley Energy, account payable Metro Med Services, account payable FILE NUMBER 21 - 04 - 00980 TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 2,518.50 4,867.20 98.55 876.00 81.75 61.00 10.83 333.00 303.75 9,150.58 REV-1513 EX+ (9-00) '* SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HOOVER, F AYE L FILE NUMBER 21 - 04 - 00980 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT 00 Not Ust Truatee{ll\ AMOUNT OR SHARE OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Jon C. Souder 639 Mumper Lane Dillsburg, PA 17019 Grandson One-half of estate residue 2 Rhett A. Souder 61 Powell Road Kingsland, GA 31548 Grandson One-half of estale residue 3 Lester G. Souder 639 Mumper Lane Dillsburg, P A 17019 Son-in-law 10,873.01 (Sch. F) Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover she~t 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 TOTAL OF PART 11_ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEIr LAW OFFICES LANDIS ec BLACK :ARLlSLE, PENNSYLVANIA @@~v LAST WILL AND TESTAMENT OF FAYE 1. mOVER I, FAYE L. HOOVER, a legal resident of the Borough of Carlisle, Cumber- land County, Pennsylvania, being of sound and disposing mind, memory and under- standing, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST: I direct that all my just debts and funeral expenses, includ- ing my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. SECOND: I devise and bequeath the residue of my estate, of every nature and wherever situate, to my daughter, Sharon A. Souder, provided she shall survive me by thirty (30) days. Should my daughter, Sharon A. Souder, prede- cease me or die on or before the thirtieth day following my death, I devise and I bequeath the residue of my estate, of every nature and wherever situate, to my grandchildren, in equal shares, provided that the share of any grandchild who predeceases me or dies on or before the thirtieth day following my death shall be added to the share or shares for my other grandchildren. THIRD: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of Imy estate. FOORTH: I nominate, constitute and appoint my daughter, Sharon A. Soud r, Executrix of this, my Last Will and Testament. In the event of the renunciation, death, resignation or inability to act for any reason whatsoever of the said Sharon A. Souder, I nominate, constitute and appoint Lester Souder Executor of this, my Last Will and Testament. I hereby relieve my Executrix or her suc- cessor from the necessity of posting security in connection with her or his duties as such in any jurisdiction in which she or he may be called upon to act, insofar as I am able by law to do so. IN WITNESS WHEREOF, I have hereunto Last Will and Testament, consisting of this nature, this ';;U:;>'t:lZday of ~LY set my hand and seal to this, my one typewritten page bearing my sig- , 1981. JcU-W f ~~ (SEAL) Faye}1' Hoover Signed, sealed, published and declared by the above-named Testatrix, Faye L. Hoover, as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence, and in the sight and presence of e"ch~;;J~;;~"'"ibed =c "~:.'::'"'"'' , ACKNOWLEDGMENT COMMONWEALlli OF PENNSYLVANIA ) SS. COUNTI OF CUMBERLAND ) I, FAYE L. HOOVER , Testatrix , whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before ~,bk:AYE L. HOOVER, , the Testatrix, this o;dq: day of r--tf ' 1981. AFFIDAVIT COMM)NWEALlli OF PENNSYLVANIA) SS. COUNTI OF CUMBERLAND ) /~~~ We, EDWARD L. SCHORPP and the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testat rix sign and execute the instrument as her Last Will; that FAYE L. HOOVER signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to th best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. and jiw9rn. o~af~;mt,:dLto and subscribed to befor~.jlle by EDW D L. SCHORPP ~ ",-. ~ , witnesses, this :lr""-dayof , 19l1 ) WltnjSs/i .- . 'e () t L (- \{( / Wi ness E L. />3,((, ~ Schorpp (SEAL) L.AW OFFICES LANDIS 8: BLACK RLISLE. PENNSYLVANIA MARY N GORMAN, Notary Public Carlisle, Cumberland (0., Pa. My Commission Expires Sept. 19, 1983 ,-- B.LOAN TYPE: A H.UD. SETTLEMENT STATEMENT f------- Leelyn Corporation OUR FILE #: RE04-31 5 Lender: f--' - C.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.e.c. were paid outside closing. D. NAME OF BORROWER: E NAME OF SELLER: Canterbury Partnership, LLC Faye L. Hoover Estate G. PROPERTY LOCATION: H. SETTLEMENT AGENT: I. SETTLEMENT DATE: 233 "F" Street, Carlisle, Pennsylvania 17013 DUNCAN & HARTMAN, P.C. Friday 17-Dec-04 1 IRVINE ROW Carlisle Borough, Cumberiand County CARLISLE, PA 17013 10:00 a.m. J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION -- 100 GROSS AMOUNT DUE FROM EORROWER 400 GROSS AMOUNT DUE TO SELLER 101 Contract Sales Price $69,900.00 401 Contract sales price $69,900.00 .. 102 Personal Property 0.00 402 p[3rsonal Property 0.00 103 Settlewent Charges (line 1400) 1743.75 403 104 0.00 404 105 Adjustments items prepaid by seller: Adjustments items prepaid by seller: 405 Local taxes to 31-DeilC-04 11.53 ~?_6 Local taxes. to 31-Dec-04 11.53 406 Assasaments 107 Assessments to 407 School tax@s to 30-Jun-05 373.95 lOB School taxes to 30-Jun-OS 373.95 408 109 409 120 GROSS DUE FROM BORROWER 72029.23 420 GROSS DUE TO SELLER 70285.48 200 AMOUNTS PAID 8Y OR FOR BORROWER 500 REDUCTIONS IN AMOUNT DUE TO SELLER 201 Deposit or Earnest Money-Loan Advancement 2000.00 501 ElCcess depo2.it 202 New Mortgage Amount: 74000.00 502 Settlement charges 5251.84 203 Existing l.oans taken subject to S03 Existing loans taken 204 504 0.00 20S 505 ... 206 506 ~9-7 507 Adjustments for items unpaid by seller SOB 210 Local Taxes to 17-0ec-04 0.00 Adjustments for items unpaid by Seller ~' Assessments to 510 Local taxes 17-Dec-04 0.00 212 School Taxes to 17-0ec-04 0.00 511 Assessments to 215 512 School tax9S to 17 Dac-04 0.00 216 513 217 514 --.. 1220 TOTAL PAID BY BORROWER 76000.00 520 TOTAL REDUCTIONS SELLER 5251.84 1300 CASH FROM/TO BORROWER 600 CASH TO/FROM SELLER ~' Gro" amount due from borrower 72029.23 601 Gross amount to seller 70285.48 .302 Less amounts paid by/for bonower 76000.00 602 Reductions to seller 5251.84 303 CASH FROM (TO) BORROWER: ($3,970.77) 603 CASH TO (FHc)M) SELLER: $65,033.64 I have carefully reviewed the HUD-l 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 or on my behalf and I have received a copy of th~s HUD-l for my ree _L{::::...~,-,=~-.:7l!L~fL:~___~-:::::';L_ -,.~ Canterbury Partnership, LLC Faye L. Hoover Estate ----~--~---~--------~---~-~-~~~ -------~--~--~~~~~~~-~~-~-~-~~~-~-- ,-- f M ' , c c~c L (/I'" ,? Fv' D""-<...~ I PAGE #2 HUD DISCLOSURE/SETTLEMENT STATEMENT PAID BY BORROWER PAID BY SELLER 700 TOTAL REAL TOR'S COMMISSION 6% X $69,900.00 4194.00 701 listing Agency: Ebener & Associates $2122.00 702 Selling Agency: Sailhamer Real Estate $2072.00 703 Transaction Fee: 0.00 800 ITEMS PAYABLE IN CONNECTION WITH LOAN 801 Origination Fee 0.00 802 Loan Discount 803 Appraisal Fee 804 Credit Report 805 Underwriting Fee 806 Document Preparation Fee 807 Flood Certification 80B Tax Service Fee 809 Lender Administration fee 810 Overnight Mail/Wire Charges 0.00 0.00 900 ITEMS LENDER REQUIRES TO BE PAID IN ADVANCE 901 Interest from 17-Dec-04 to 01-Jan-05 902 Mortgage insurance 903 Hazard insurance 904 1000 RESERVES DEPOSITED WITH LENDER Escrows collected: # mos. due: X $ per mo.: 1001 Hazard insurance 0 0.00 0.00 1002 Mortgage insurance 0 0.00 0.00 1003 County/Local taxes 0 0.00 0.00 1004 School taxes 0 0.00 0.00 1005 Aggregate Adjustment 1100 TITLE CHARGES 1101 Settlement or closing fee: 1102 Abstract or title search: 1103 Overnight/Wire/Email Charges 0.00 0.00 1104 Title insurance binder: 0.00 1105 Docu ment preparation: Duncan & Hartman, P.C. 150.00 1106 Notary fees: Notary 6.00 1107 Attorney's fees: Martson Deardorff Williams & Otto 0.00 POC (includes above item numbers): 1108 Title Insurance: WILLIAM A. DUNCAN, AGENT FOR FIDELITY NATIONAL TITLE 714.75 (includes above item nurnbers):1101-11 04 Endorsements 100300 8.1 $150 1109 Owner's coverage $69,900.00 1110 Lender's coverage $74,000.00 $714.75 1111 Insured Closing Letter: Fidelity National Title 0.00 1200 GOVERNMENT RECORDING AND TRANSFER CHARGES 0.00 1201 Deed 38.50 Mortgage 50.50 89.00 1202 Release/Satisfaction 0.00 Assignment/Stip 0.00 0.00 0.00 1203 County/Local transfer tax (1 %) 699.00 1~04 Pa. State transfer tax (1 %) 699.00 1300 ADDITIONAL SETTLEMENT CHARGES . 1301 Radon testing 0.00 ]_~-9_~ Pest inspE!cti<:Jn Gilberts Pest 85.00 0.00 . 1303 ~~ter & Sewer Reading #620-A Carlisle Borough , 21.57 13042004 Cty&Boro Real Estate Taxes Darlene Moyer, Tax Collector --L~ 337.27 1400 TOTAL SETTLEMENT CHARGES: 1743.751 5251.84 (also entered on line 103 for Borrower; line 502 for Seller) Nov 09 04 11:06a p.l P:!M&fBank 499 Mitchell Road. Miflsboro. DE 19966 Mail Code DE~M8.12 Phone (888) 502-4349 Fax (302) 934-2955 November 9, 2004 Fax: 717-243-1850 MDW & 0 Attorneys At Law 10 East High Street Carlisle, Pennsylvania 17013 Re: Estate or- Fave L. Hoover Social Securilv: 204-26-8199 Date or Death: August 26. 2004 Dear Sir or Madam: Per your inquiry dated November 1, 2004, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: J. Type of Account Checking Account A ccount Number 43909248 Ownership (Names oj) Faye L Hoover Opening Date 8/28/64 Closed 10/29/04 Balance on Date of Dealh Total $3,259.8 $ 0.09 J;jJ5977" .'...,. Accrued Interest Please be advised, there was no safe deposit box found for the above decedent. For further account information, regarding ownership, closures andlor reimbursement of funds, etc., please call the High Street Carlisle Omce # 717-240-4536. Sincerely, , }:0?/?"ff~.d Nancy clagett Records Management (" / ./~, ~ c: I c./...<cL. lc,~ V"'>^<. I Savings Bond Calculator Page I of I 108/2004 7,1:I""'~ ~~l!ZJ CALCUJ Savinc Value As Of Bond Info Series I E Bonds Denomination Serial Number Issue Date .:J $1100 .:J Results # Bonds Total Price Total Interest Total V Blue YTD In 7 $1,425.00 $8,332.00 $9,757.00 $100. Issue Interest Next Final Serial Number Issue Date Series Denam Price Interest Value Rate Accrual Maturit) C481935352E 12/1967 E $100 $75.00 $450.12 $525.12 1211997 C481935350E 12/1967 E 100 75.00 450.12 525.12 1211997 C481935351E 12/1967 E 100 75.00 450.12 525.12 1211997 C476020150E 06/1967 E 100 75.00 438.84 513.84 06/1997 DI04590499E 03/1975 E 500 375.00 2,154.20 2,529.20 4.00% 09/2004 03/2005 D89118858E 0811967 E 500 375.00 2,194.00 2,569.00 0811997 DI03024755E 01/1974 E 500 375.00 2,194.60 2,569.60 01/2004 Le end Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty ME Matured (Exchangeable for HH) MN Matured (Not Exchangeable for HH) Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator \0 r r r .~1,f\:l~!1~1,f~l!' I J!lll~t I .,., ( ! I '--.>..' f.r(f." '( f .: http://wwws.publicdebt.treas.govIBC/SBCPrice 12/21/2004 REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established Estate of: FAYE L. HOOVER Date of Death: 08/26/2004 Social Security Number: 204-26-8199 ~1~ MEMBERS 1st FEDERAL CREDIT UNION 108494 -00 05/11/1989 $20,440.37 $14.00 $20,454.37 Lester Souder 05/071.1996 108494 -11 03/11/2004 $1,291.63 $.00 $1,291.63 Lester Souder 05/07/1996 'I f II k JLcj; ~' ! 0'" <'" A ' F " r .Lv- tL ~ c(.-fC y z-- IMBERS 1ST FEDERAL CREDIT UNION . 1/41< /I/tJ<<L . D nise A. Wolfe "/ Insurance Services Supervisor December 16, 2004 5000 Louise Drive' Po. Box 40 . Mechanicsburg, Pennsylvania 17055 . (717) 697-1161 . www.memberslst.org COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 AEV-1162 EX{11-96} RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SCHORPP EDWARD l 10 EAST HIGH STREET CARLISLE, PA 17013 _n_nn fold EST A TE INFORMATION: SSN: 204-26-8199 FILE NUMBER: 2104-0980 DECEDENT NAME: HOOVER FAYE l DATE OF PAYMENT: 02/18/2005 POSTMARK DATE: 02/18/2005 COUNTY: CUMBERLAND DATE OF DEATH: 08/26/2004 NO. CD 004966 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $809.90 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK#107 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $809.90 GLENDA FARNER STRASBAUGH REGISTER OF WillS BUREAU OF INDIVIDUAL ,TIIlES- INHERITANCE TAX DIVISION - - . PO BOX Z80601 HARRISBURG PA 171Z8-060} COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX (~PPRAISEHENT, ALLDIIANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ZuD5 Ili\Y 20 PM 12: 42 DATE ESTATE OF DATE OF DEATH FILE NUIIBER COUNTY ACN CLERi< OF EDWARD L ~~~,*'~JWJUriT MARTSON Et'A'r "", , 10 E HIGH ST CARLISLE PA 17013 05-16-2005 HOOVER 08-26-2004 21 04-0980 CUMBERLAND 101 *' REY-1547 EX AFP (03-05) FAYE L AlIOunt Re.itted 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 ~ Il~V-"MI:,."ft.m.m~'II!1.'lftJtm'!II!".!MftI'l"t'4M.T.'tW.l'WlllmJtWt'~.YC[!IIl'4M.T.IlYr.............. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HOOVER FAYE L FILE NO. 21 04-0980 ACN 101 DATE 05-16-2005 TAX RETURN WAS: 'I X) ACCEPTED AS FILED ) CHANGED APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Hort~ge Liabilities/Liens (Schedule Il 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/GovernDBnt.l Bequests; Non-elected 9113 Trusts [Schedule J) 14. Net Value of Estate Subiect to Tax RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..l Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule Cl 4. Hortgages/Notes Receivable (Schedule DJ S. CashlBank Oeposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets 11) (2) (3) (4) IS) (6) (7) (9) 110) 69,900.00 1.530.90 .00 .00 32.222.65 10,873.01 46,494.34 (8) 28,611.60 9.150.58 NOTE: To insure proper credit to your account, sub.it the upper portion of this fo~ with your tax payment. 161,020.90 111) 112) 113) 114) '37.767 IR 123,258.72 .00 123,258.72 NOTE: I~ an assessment was issued previously, lines 14, lS and/or 16, 17, 18 and 19 will re~lect ~igures that include the total af ~ returns assessed to date. ASSESSMENT OF TAX: IS. Amount of line 1*\ at Spousal rate (IS) 16. Anount of Line 1*\ taxable at Lineal/Class A rate (16) 17. hount of Line 1*\ at Sibling rate (17) 18. Amount of Line 1*\ taxable at Collateral/Class B rate (18) 19. Principal Tax Due .00 X 00 = .00 123,258.72 X 045 = 5,546.64 .00 X 12 = .00 .00 X 15 = .00 119)= 5,546.64 TAlC p~~: '.J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID 1-) 11-23-2004 CD004664 236.84 4,500.00 02-18-2005 CD004966 .00 809.90 TOTAL TAX CREDIT 5,546.74 BALANCE OF TAX DUE .10CR INTEREST AND PEN. .00 TOTAL DUE .10CR ~ . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) k6w REGISTER OF WILLS OF CUMBERLAND COUNTY STATUS REPORT UNDER RULE 6.12 (For Resident Decedents Dying After July 1, 1992) Name of Decedent: FAYE L. HOOVER Date of Death: August 26, 2004 File No.: 21-04-0980 Social Security No.: 204-26-8199 Pursuant to Rule 6.12 of the Supreme Court Otphans' 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.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 x No Date: d. Copies of receipts, releases, joinders and approvals of formal or informallJ5counts may be filed with the Clerk of the Orphans' Court and may be alftlched to th~epo~ f.~3, August 25,2005 Signature: . 0 ,"Si,. ~ :~~ ~ Name: I Hillary A. D , Esquire . ',::-.; ~ (9 Address: MARTSON DEARDORFF WILLIAMS:&::orrO :> c:> '-'.,-"" -0 l-n Ten East High Street " '/- -,. 'I' . -- c-:> Carlisle,PA 17013 N ,_ rT1 (717) 243-3341 0/) Q, Counsel for personal representative N F:\FlLES\DA TAFILE\ESTATES\11359.I.srep ~