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HomeMy WebLinkAbout02-0267 PETITION Estate of U /~ /f /~ also known as Deceased. Social Security No. ~ b~-O o -rJ ~'~r/ FOR PROBATE and GRANT OF LETTERS /~-/? / ? ~ No. ~ To: Register of Wills for the County of Cmnberland Commonwealth of Pennsylvania The petition of the undcrsigned respectfully represents that: Yonr petitioner(s), xvho is/are 18 years of age or older an lhe execulo/{' in the lasl will of the above decedent, dated ..,q~/ $o and codicil(s) dated in the named , (staTe relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in /z:/?~/V/e'~,~)' County, Pennsylvania, with last family or principal residence at i)~g /?~eS'o'~o ~/ I?w~oO, J-'/-//r~r'~'~';oo.~.4 (list streel, number and muncipality) Decendent, then ~ years of age, died ~ 5~/z~ , ~ , 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 (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: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters .7-z': s:~ ;-.,';',°t£x/7~ ,~ 5' (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. before me this . ~5th day of| __ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF C~nberland J 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 belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. No. 21-2002-267 Estate Of c~R~ A. PERRY , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW March 15th, t9~ 200..2, 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 Au_aust 30~-h: 10q0 described therein be admitted to probate and filed of record as the last will of Clara A. Perry ; and Letters Testamentary_ are hereby granted to Harrison I. Perrv FEES Probate, Letters, Etc .......... $ 18.00 Short Certificates(1) .......... $ 3.00 Renunciation ................ $ x-Pa~es (4) $ 12.00 JCP TOTAL __ $ 5.00 Filed M..a.rc..h.. ~_.5.t.h.,. ~.0.0.~. :...$38...00 .... ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE MAILED LES~I~RS AND ORDER TO EXF_LTri~R ON MARCH 15th LAST WILL AND TESTAMENT I, CLARA A. PERRY, of 226 Roxbury Road, Shippensburg, Cumberland County, Pennsylvania, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my just debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give, devise and bequeath all my estate, real, personal and mixed, whatsoever and wheresoever situate, to my beloved husband, HARRISON I. PERRY, absolutely. THIRD. In the event my said husband should predecease me or is not living on the sixtieth (60th) day following my death, I then give, devise and bequeath my said estate to my daughter, MARY LOUISE BECKER, absolutely. FOURTH. In the further event that the said Mary Louise Becker should also predecease me or is not living on the sixtieth (60th) day following my death, I then give, devise and bequeath my said estate, in equal shares, to my grandchildren. FIFTH. In the event that any beneficiary of this my Last Will and Testament is under the age of twenty-five (25) years, I then give and bequeath said beneficiary's share to and appoint as Trustee of any property which passes under this Will or otherwise, DAUPHIN DEPOSIT BANK AND TRUST COMPANY, Shippensburg Region, AS TRUSTEE, NEVERTHELESS, to invest and re-invest the same until the said beneficiary reaches the MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA. 17257 age of twenty-five (25) years, with the following powers in addition to those presently given by law: Ao The power to expend the income towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; The power to expend the principal, within the discretion of the said Trustee, if the income is insufficient, towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; The power to sell any and all real estate, within the discretion of the said Trustee; De The power and obligation to distribute the balance of principal and interest, if any remaining, when the said beneficiary reaches the age of twenty-five (25) years, without the necessity of a formal adjudication of the Trustee's Account in the Court of Common Pleas of Cumberland County, upon the receipt of a good and valid release; and me The principal of the Trust and the income therefrom shall be free from the debts, liabilities, and engagements of those beneficially interested therein, and shall not be subject to assignment by him or her, nor to attachment or execution under any legal, equitable or other process for the enforcement of judgments or claims of any sort against them, either individually or collectively. SIXTH. I nominate, constitute and appoint my husband, HARRISON I. PERRY, to be the Executor of this my Last Will and Testament. In the event that the said Harrison I. Perry be unable to serve as Executor, I then nominate, constitute and appoint my daughter, MARY LOUISE BECKER, to be the Executrix of this my Last Will and Testament. In the further event that neither Harrison I. Perry nor Mary Louise Becket be able to serve as Executor, I then nominate, constitute and appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY to serve as Executor of this my Last Will and Testament. -2 (S~L) MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA. 17257 SEVENTH. I direct that my personal representatives and Trustee shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, CLARA A. PERRY, have hereunto set my hand and seal to this my Last Will and Testament, written on three pages, the first two pages signed for identification only, this~ day of ~~~ , 1990. This instrument was by the Testatrix, CLARA A. PERRY, on the date hereof, signed, published and declared by her to be her Last Will and Testament, in our presence, who at her request and in her presence and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. -3- MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA. 17257 COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw CLARA A. PERRY, Testatrix, sign and execute the instrument as her Last Will; that she 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 the best of our knowledge the Testatrix was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before he by -T~?.,~[-. ~.~6. t~T , witnesses, this ~o~Z day o~ - ' ~ ~ 1990. / MARK, WEIGLE AND PERKINS -- ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSI3URG, PA. 17257 COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : I, CLARA A. PERRY, the Testatrix whose name is signed to the 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 me by CLARA A. PERRY, the Testatrix, this.~9~ day of ~i(~z~.~ , 1990. NOTARIAL SEAL Mary E. Seavers, Notary Public Shippensbur~, PA Cumbe~and County My Commission Expires July 27, 1994 MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA. 17257 Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) INn/,, / Date of Death: Will No. ~/--~ 2 - To the Register: Admin. No. I certify that notice of (beneficial interest) 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 : I ?~'? Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except ()~ lj~'!,! ?~0. Capacity: Signature Name ::/b&a. aX.O_.~_.-~.-~ l Telephone (,~/~,) ~-?Q. ? F ~ersonal Representative __.Counsel for personal representative ~-I~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 · ~,~r~,-~ HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2 1-0 2 0 2 6 7 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z Perry, Clara A. 202 - 20 - 0481 t't DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ILl February 25, 2002 March 30, 1926 ' REGISTER OF WILLS LU (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Perry, Harrison I. I-- Z LU Z 0 0 [-~1. Odginal Return r'~4. Limited Estate ~--'~ 6. Decedent Died Testate (Attach copy of Will) [~2. Supplemental Return J'---] 4a. Future Interest Compromise (date of death after 12-12-82) E~7. Decedent Maintained a Living Trust (Attach copy of Trust) L.J 9. Litigation Proceeds Received J'~ 10. Spousal Pover~ Credit (date of death between 12-31-91 and 1-1-95) NAME R. Thomas Murphy FI.~M NAME (IfApplicable~. ~atterson ~ Kiersz, P.C. TELEPHONE NUMBER 717-762-3170 I-~3. Remainder Return (date of death prior to 12-13-82) ['"'-~ 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes J---~ 11. Election to tax under Sec. 9113(A) (^~ch Sch O) COMPLETEMAILINGADDRESS 239-B East Main Street Waynesboro, PA 17268-1681 1. Real Estate (Schedule A) (1) 2. Stocks and Bond§ (Schedule B) (2) 3. Closely Held Corporation, Padnership or Sole-Proprietorship (3) 4. Modgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [~ Separata 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 & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (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 to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 6,916.83 213,602.37 (8) OFFICIAL USE ONLY 220,519.20 (11) (12) 220,519.20 (13) (14) 220~519.20 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 220,519.20 x.0__ (15) 16. Amount of Line 14 taxable at lineal rate x .0 __ (16) 17. Amount of Line 14 taxable at sibling rate x .12 {17) 18. Amount of Line 14 taxable at collateral rate x .15 08) 19. Tax Due (19) 20.[~ II III ,~ I]1 · ~ l? ~' ,~ Decedent's Complete Address: I STREETADDRESS226 Roxbury Road Shippensburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount ISTATE PA (1) ZiP 17257 Total Credits ( A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total InterestJPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) Make Check Payable to: REGISTER OF WILLS, AGENT 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; .......................................................................................... [] [] b. retain the dght to designate who shall use the property transferred or its income; ....................................... .. .... [] [] c. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the premise 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? ........................................................................................................................ [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT Under penalties of perjury, I declare that t have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the persona[ representative is based on all information of which preparer has any knowledge. AS PART OF THE RETURN. .,8'2~N~J~I..I~ OF PERSON RESPC~'I~LE FOR FILING RETURN ~A'~)IJRESS ~ 226 Roxbury Road, Shippensburg, PA 17257 DATE May c~t, 2002 DATE May S-I, 2002 ADDRESS 239-B East Main Street, Waynesboro, PA 17268-t681 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 RS. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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 child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1509 EX * (1-9~) ~ COMMONWEALTH OF PENNSYLVANIA rNHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Clara ~. Perry If an asset was made joint within one year of the decedent's date of death, it must be reported o. Schedule G. FILE NUMBER 21-02-0267 SCHEDULE F JOINTLY-OWNED PROPERTY SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Harrison* I. Perry. Spouse 226 Roxbury Road ShipPensburg, PA 17257 JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES' 1. A. ~1/28/~} Altfirst Bamk checking account no: 97448265 13,833.66 50 6,916.83 TOTAL (Also enter on line 6, Recapitulation) $ 6,916.83 (If more space is needed, insert additional sheets of the same size) REV. 1510 EX+ (2.87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE G TRANSFERS PLEASE PRINT OR TYPE FILE NUMBER Clara A. Perry 21-02-0267 THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER: ITEM DESCRIPTION OF PROPERTY TOTAL VALUE DECD. DOLLAR VALUE % OF DECEDENT'S NUMBER Include name af the ~ans~ree, their relationship to decedent, date of trans~r. EXCLUSION OF ASSET INT. INTEREST 1. Life Insurance Policy No: 909030841177004 with American Express, wherein Clara A. Perry was the owner and beneficiary, and her spouse, Harrison I. Perry, was the insured~ 60,851.19 100% 60,851.19 2. Mutual Fund No: 010625139729002 with American Express, transferred to spouse, Harrison t. Perry. 38,567.60 100% 38,567.60 3. Mutual Fund No: 011525139728002 with American Express, transferred to spouse, Harrison I.'Perry. 107,134.14 100% 107,134.14 4. Annuity No: 931030182949004 with American Express, transferred to spouse, Harrison I. Perry.. 7,049.44 100% 7,049.44 See attanhed valuation letter from American Express. TO?AL(AlsoenteronllneT, Recapitulation) S 213,602.37 (If more space is needed, insert additional sheets of same size.) April 30, 2002 IDS LIFE INSURANCE COMPANY AMERICAN EXPRESS FUNDS AMERICAN EXPRESS CERTIFICATE COMPANY AMERICAN EXPRESS BROKERAGE 70100 AXP Financial Center Minneapolis, MN 55474 IDS Life Insurance Company 70100 AXP Financial Center Minneapolis, MN 55474 HARRISON I PERRY 226 ROXBURY RD SHIPPENSBURG, PA 1725%1124 Dear HARRISON I PERRY: Thank you for your recent inquiry regarding CLARA A PERRY's accounts. These are the values of the accounts as of 02/25/2002. Mutual Funds Account Number Total Value # of shares 01062513972 9 002 $38567.6 1623.899 01152513972 8 002 $107134.14 24182.214 Annuities - Post 1985 Account Number 93103018294 9 004 Total Value $7049.44 Life Insurance Account Number 90903084117 7 004 Total Value $60851.19 We appreciate the opportunity to be of service to you. Please contact us if you have any questions. Sincerely, Alan J Newton Life Insurance Claims 70302 AXP Financial Center Minneapolis, MN 55474 888-723-8476 Enter 11088 Asset Value Per Share 23.750 4.410 CC: ROGER ALLAN PLACE DSO 449 Rep 097349 Insurance and annuities are issued by IDS Life Insurance Company, an American Express company. 21-2002-267 LAST WILL AND TESTAMENT I, CLARA A. PERRY, of 226 Roxbury Road, Shippensburg, Cumberland County, Pennsylvania, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my Just debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give, devise and bequeath all my estate, real, personal and mixed, whatsoever ~'and wheresoever situate, to my beloved husband, HARRISON I. PERRY, absolutely. THIRD. In the event my said husband should predecease me or is not living on the sixtieth (60th) day following my death, I then give, devise and bequeath my said estate to my daughter, MARY LOUISE BECKER, absolutely. FOURTH. In the further event that the said Mary Louise Becker should also predecease me or is not living on the sixtieth (60th) day following my death, I then give, devise and bequeath my said estate, in equal shares, to my grandchildren. FIFTH. In the event that any beneficiary of this my Last Will and Testament is under the age of twenty-five (25) years, I then give and bequeath said beneficiary's share to and appoint as Trustee of any property which passes under this Will or otherwise, DAUPHIN DEPOSIT BANK AND TRUST COMPANY, Shippensburg Region, AS TRUSTEE, NEVERTHELESS, to invest and re-invest the same until the said beneficiary reaches the MARK. WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA. 17257 age of twenty-five. (25) years, with the following powers in addition to those presently given by law: me Bo The power to expend the income towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; The power to expend the principal, within the discretion of the said Trustee, if the income is insufficient, towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; Ce The power to sell any and all real estate, within the discretion of the said'Trustee; De ge The power and obligation to distribute the balance of principal and interest, if any remaining, when the said beneficiary reaches the age of twenty-five (25) years, without the necessity of a formal adjudication of the Trustee's Account in the Court of Common Pleas of Cumberland County, upon the receipt of a good and valfd release; and The principal of the Trust and the income therefrom shall be free from the debts, liabilities, and engagements of those beneficially interested therein, and shall not be subject to assignment by him or her, nor to attachment or execution under any legal, equitable or other process for the enforcement of Judgments or claims of any sort against them, either individually or collectively. SIXTH. I nominate, constitute and appoint my husband, HARRISON I. PERRY, to be the Executor of this my Last Will and Testamed%. In the event that the said Harrison I. Perry be unable to serve as Executor, I then nominate, constitute and appoint my daughter, MARY LOUISE BECKER, to be the Executrix of this my Last Will and Testament. In the further event that neither Harrison I. Perry nor Mary Louise Becket be able to serve as Executor, I then nominate, constitute and appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY to serve as Executor of this my Last Will and Testament. (SEAL) -2 SEVENTH. I direct that my personal representatives and Trustee shall not be required to give bond for the faithful performance of their duties in any Jurisdiction. IN WITNESS WHEREOF, I, CLARA A. PERRY, have hereunto set my hand and seal to this my Last Will and Testament, written on three pages, the first two pages signed for identification only, this3~ day of ~ , 1990. This instrument was by the Testatrix, CLARA A. PERRY, on the date hereof, signed, published and declared by her to be her Last Will and Testament, in our. presence, who at her request and in her presence and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. -3- ~l~< WFl~i ~ AND PERKIN~ - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA. 17257 COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND : the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw CLARA A. PERRY, Testatrix, sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearimg and sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge the Testatrix was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by witnesses, this ~-I day of~ -  , 1990. / MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KIN(5 STREET - SHIPPENSBURG, PA. 17257 COMMONWEALTH OF- pENNSYLVANIA : : SS. COUNTY OF CUMBERI2kND : I, CLARA A. PERRY, the Testatrix whose name is signed to the 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 me by CLARA A. PERRY, the Testatrix, this.~ day of ~-L~ , 1990. NOTARIAL SEAL Ma~/E. Seavers, Notary Pubr= ShiPIm .~__~_,~1, PA Cumberland County lay Commi~sim e~oims Ju¥ 27, ~994 MARK. WEJGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA, t7257 STATUS REPORT UNDER RULE 6.17 Name of Decedent: Clara A. Perry Date of Death: February 25, 2002 Will No. 21-02-0267 Admin. No. 2002-00267 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. 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 d. Copies of ~eceipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of t'he Orphans' Court and may be attached to this report. Date: May~/, 2002 Signature R. Thomas Murphy Name (Please type or print) 239-B E. Main St., Waynesboro, PA 17268 Address .(717) 762-3170 Tel. No. Capacity: __Personal Representative ( MAH: rmf/AM3 ) X Counsel for personal representative BUREAU OF ZNDTVIDUAL TAXES INHERITANCE TAX DIVZSIDN DEPT. 280601 HARRISBURG, PA 17128-n601 R THOMAS MURPHY Z$9-B E MAIN ST WAYNESBORO COMHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSMENT OF TAX PA 1~68 DATE 06-2q-2002 ESTATE OF PERRY DATE OF DEATH 02-25-2002 FILE NUMBER 21 02-0267 COUNTY CUMBERLAND ACN 101 Amount Remitted REV-1E4? EX &FP (D1-D2) CLARA A HAKE 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-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PERRY CLARA AFILE NO. 21 02-0267 ACN 101 DATE 06-2q-2002 TAX RETURN #AS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERS~ APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (ScheduZe A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) ($) q. Hortgages/Notes Receivable (Schedule D) (q) $. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule O) (7) 8. Tote1 Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adc. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Tote1 Deductions 12. Net Value of Tax Return lq. Charitable/governmental Bequests/ Non-elected 9115 Trusts (Schedule J) Net Value of Estate Subject to Tax .00 NOTE: To insure proper .00 credit to your account, .00 subeit the upper portion .00 of this fore with your .00 tax payment. 6~916.85 215~602.$7 (8) .00 NOTE: 220,519.20 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) ZF PAZD AFTER DATE INDICATED, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL INTEREST. (15). 220,519.20 x O0 = .00 (16) .00 x Oq5= .00 (17), .00 x 12 = .00 (lB) .00 x 15 : .00 (19)= . O0 AMOUNT PAID reflect figures that include the total of ALL returns assessed to date. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ASSESSMENT OF TAX: 15. Amount of Line lq et Spouse1 rate 16. Amount of Line lq taxable at Lineal/Class A rate 17. Amount of Line lq et Sibling rate 18. Amount of Line lq taxable at Collateral/Class B rate 19. Principal Tax Due .00[ .00 .00 .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE TS REFLECTED AS A 'CREDZT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) If an assessment was /ssued prev/ously, lines 14, 15 and/or 16, 17, 18 and 19 #ill .00 (11) . no (la) 220,519.20 (13) . O0 (lq) 220,519.20