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HomeMy WebLinkAbout02-0273Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estateof Madelon V. Oliver also known as , Deceased Michael W. Oliver and Marcia M. Noll Social Security No. 135-22-8061 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut ors the Decedent, dated 09/08/1989 and codicil(s) dated 08/'7_5/1995 not applicable named in the last Will of State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: not applicable B. Grant of Letters of Administration (c.ta.; d.b.n.c.ta; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last family or principal residence at 126 Strayer Drive, South Middleton Township, Carlisle, PA 17013 (list street, number, and municipality) Decedent, then 74 yearsof age, died 02/19/2002 at South Middleton Township, PA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 270,000.00 115,000.00 situated as follows: 126 Strayer Drive, South Middleton Township, Carlisle, PA 17013 Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Si~lnature Typedorprintednameandresidence IMichael W. Oliver 105 Leckford Way, Cary, N.C. 27511 Marcia M. Noll ' 5 Raylen Drive, Boilin~ Sprin~s, PA 17007 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) Commonwealth of Pennsylvania County of Cumberland Oath of Personal Representative 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 representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ~/~ L~, Michael' W. Oliver beforemethis 15t~yof ~ ~ ~ March 2002 Marcia M. Noll .MA~¥ ~b~ ]',EW i .~°r the Regis{'er ~ No. 21-2002-273 Estate of Madelon V. Oliver Social Security No: 135-22-8061 Date of Death: 02/19/2002 ?Deceased AND NOW, March 18th, 2 0 0 2,'in considera~n of the Petition on the reverse side hereon, satisfactory proof having been presented before me, "'-J IT IS DECREED that Letters E~ Testamentary [-'-1 Of Administration (c.ta.; d.b.n.c.ta.; pendente lite; durante absentia; durante minoritate) are hereby granted to Michael W. Oliver and Marcia M. Noll in the above estate and that the instrument(s) dated 09/08/1989 08/25/1995 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........... $ Short Certificate(s).. 10. $ Codicil Renunciation ........ $ Affidavits ( ) .... 305.00 30.00 10.50 Extra Pages ( 6 ) .... $ 18.0 0 Attorney: Robert C. Saidis I.D. No: 21458 Saidis, Shuff, Flower & gindsay Address: 2109 Market Street Codicil ........... $ Camp Hill, PA 17011 JCP Fee .......... $ 5 o O0 Telephone: 717/737-3405 Inventory .......... $ Other ........... $ TOTAL ......... $ 368.50 Call First, then put letters is Proth Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW- 1 (1991) Box SAIDIS, GUIDO, SHUFF & MASLAND 26 W. High Street Carlisle, PA CODICIL OF MADELON V. OLIVER 21-2002-273 I, MADELON V. OLIVER, the within named Testatrix, do hereby make and publish this Codicil of my Last Will and Testament dated September 8, 1989. FIRST I hereby make the following specific bequests prior to the distribution of my residuary estate: The sum of Five Thousand Dollars ($5,000.00) to each of my grandchildren living at the time of my death. If any of my grandchildren are under the age of twenty-one (21) years, this bequest shall be held by his or her parent as custodian for the grandchild under the Pennsylvania Uniform Transfers to Minors Act. In all other respects I hereby ratify, confirm and republish my Last Will dated September 8, 1989 together with this sole Codicil as and for my Last Will. IN WITNESS WHEREOF, I, MADELON V. OLIVER, have hereunto set my hand and seal to this Codicil to my Last Will and Testament MADELON V. OLIVER Signed, sealed, published and declared by the above-named MADELON V. OLIVER, as and for a Codicil to her Last Will and Testament in the presence of us, who have hereunto subscribed our names at her request as witnesses thereto, in the presence of said Testatrix and of each other. SAIDIS, GUIDO, SHUFF & MASLAND 26 W. High Street Carlisle, PA SAIDIS, GUIDO, SHUFF & MASLAND 26 w. High Street Carlisle, PA COMMONWEALTH OF PENNSYLVANIA: : SS COUNTY OF CUMBERLAND : WE, MADELON V. OLIVER, SALLIE PRIAR TRACIEMYERS , and , the Testatrix and witnesses, respectively whose names are signed to the foregoing or attached instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Codicil and that she signed willingly and that she executed as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix signed the Codicil as witness and that to the best of their knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. MADELON V. OLIVER Traci~i~/~I, .... ~ , Witness Subscribed, sworn to and acknowledged before me by ~DELON V. OLIVER, the Testatrix, and subscribed to and sworn or affirmed to before me by T~CIE ~ , and ,witnesses, this~-~day of~' SALLIE PRIAR , 1995 . ~"" NOTARIAL SEAL ! dOAN E. SMITH, NOTARY PUBUC I CARLISLE BOROUGH. CUMBERLAND C0., PA I SAIDIS, GUIDO & MASLAND 26 W. High Street Carlisle, Pa. LAST WILL AND TESTAMENTC3/-0 -o2'7C3 OF MADELON V. OLIVER I, MADELON V. OLIVER, of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, 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 the payment of my just debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. If there be no cemetery lot available for my interment owned by me at the time of my death, I authorize my personal representative to purchase such cemetery lot with a contract for perpetual care, using therefore funds from my estate in such amount as he shall consider necessary and desirable, and I authorize my personal representative to cause title to or ownership of such lot so purchased to be vested in such person as my personal representative shall designate. Further, I authorize my personal representative to expend funds from my estate, in such amount as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. SECOND I give, devise and bequeath all the rest, residue and remainder of my estate equally to my children, MICHAEL W. OLIVER, SAIDIS, GUIDO & MASLAND 26 W. High Street Carlisle, Pa. MARK V. OLIVER, MARCIA M. NOLL and MATTHEW R. OLIVER, per stirpes THIRD I direct that any and all inheritance, estate, and transfer taxes imposed upon my estate passing under this Will or otherwise shall be paid out of the principal of my residuary estate. FOURTH In addition to the powers conferred by law, I authorize any personal representative acting under this instrument, in his or her absolute discretion: (a) To retain in the form received, or to sell either at public or private sale any real or personal property; (b) To exercise any options to subscribe for stocks, bonds, or other investments. (c) To join in any plan of lease, mortgage, consolidation, exchange, reorganization or foreclosure of any corporation in which my estate or any trust may hold stocks, bonds or other securities; (d) To sell, transfer, convey, mortgage, pledge, lease or exchange any property, real'or personal, which at any time may form part of my estate, for the payment of debts or taxes, or for any purpose of administration or distribution, for such prices and upon such terms as my personal representative, in his or or sole discretion, may deem wise, and to execute and deliver deeds of - 2 - SAIDIS, GUIDO & MASLAND 26 w. High Street Carlisle, Pa. conveyance or transfer thereof; (e) To make settlements and compromises on such terms as my personal representative in his or her sole discretion may deem wise without the necessity of obtaining any court approval thereof; (f) To make distribution hereunder either in cash or kind, as my personal representative in his or her discretion may deem wise. FIFTH I do hereby nominate, constitute and appoint as Co-Executors, MICHAEL W. OLIVER and MARCIA M. NOLL, or the survivor of them. SIXTH I direct that no personal representative, guardian, trustee or other fiduciary appointed under this instrument shall be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, MADELON V. OLIVER, have hereunto set my hand and seal to this my Last Will and Testament, consisting of three typewritten pages, the first two of which bear my signature in the margin for identification, this ~ day of ~P,'~, 198 ~. Madelon V. Oliver Signed, sealed, published and declared by the above-named 'estatrix, Madelon V. Oliver, as and for her Last Will and testament in the presence of us, who have hereunto subscribed our - 3 - SAIDIS, GUIDO & MASLAND 26 W. High Street Carlisle, Pa. names at her request as witnesses thereto, In the presence of said Testatrix and of each other. SAIDIS, GUIDO & MASLAND 26 w. High Street Carlisle, Pa. COMMONWEALTH OF PENNSYLVANIA: : SS COUNTY OF CUMBERLAND : WE, MADELON V. OLIVER, ROBERT C. SAIDIS, AND MICHELLE L. LANDIS , the Testatrix and witnesses, respectively whose names are signed to the foregoing or attached instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she signed willingly and that she executed as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix signed the Will as witness and that to the best of their knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence.  /~er, Testatrix Rob~t C. Saidis, Witness Michelle L. Landis , Witness Subscribed, sworn to and acknowledged before me by Madelon V. Oliver, the Testatrix, and subscribed to and sworn or affirmed to before me by Robert C. Saidis, and Michelle L. Landis , witnesses, this ~day of ~~, 198~. ! N6tary Pub~6 / ~ REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: Madelon V. Oliver Date of Death: February 19, 2002 Will No. 21-02-0273 Admin. No. 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 beneficiary of the above- captioned estate on March 18, 2002. Name Address Michael W. Oliver 105 Leckford Way, Cary, NC 27511 (individually and as custodian for Kate Oliver and Lara Oliver) Mark V. Oliver 1120 Linn Drive, Carlisle, PA 17013 (individually and as custodian for Megan Oliver and Lindsay Oliver) Marcia M. Noll 5 Raylen Drive, Boiling Springs, PA 17007 (individually and as custodian for Olivia Noll, Helen Noll, Clinton Noll, Celeste Noll, Meredith Noll and Audrie Noll) Matthew R. Oliver 109 Garland Drive, Carlisle, PA 17013 (individually and as custodian for Kayla Oliver) Notice has now been given to all persons entitled thereto Under Rule 5.6(a) except none Robert C. Saidis, Esquire 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: X Personal Representative Counsel for Personal Representative JAMES D. FLOWER JOHN E. SLIKE ROBERT C. SAIDIS GEOFFREY S. SHUFF JAMES D. FLOWER, JR. CAROL J. LINDSAY JOHNNA J. KOPECKY KARL M. LEDEBOHM JOSEPH L. HITCHINGS THOMAS E. FLOWER FORREST N. TROUTMAN, II LAW OFFICES SAIDIS, SHUFF, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 TELEPHONE: (717) 737-3405 - FACSIMILE: (717) 737-3407 EMAIL: attorney@ssfl-law.com www.ssfl-law.com CARLISLE OFFICE: 26 W. HIGH STREET CARLISLE, PA 17013 TELEPHONE: (717)243-6222 FACSIMILE: (717)243-6486 REPLY TO CAMP HILL May 16, 2002 Register of Wills Cumberland County Courthouse Carlisle, PA 17013 Re,' The Estate of Madelon V. Oliver File No. 21-02-0273 Dear Ladies: Enclosed please find a check in the amount of $18,000 representing a payment on account of taxes at discount in the above estate. Kindly issue a receipt for payment at your earliest convenience. Very truly yours, SAIDIS, SHUFF, FLOWER & LINDSAY emy L. -~ngi/~, Estate Paralegal /sly Enclosure cc: Marcia M. Noll Michael W. Oliver Law Offices SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, Pennsylania 17011 REGISTER OF WILLS CUMBERLAND COUNTY COURTHOUSE CARLISLE PA 17013 i=0i3+33~2 02 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001193 SAIDIS ROBERT C 26 W HIGH STREET CARLISLE, PA 17013 ESTATE INFORMATION: SSN: 135-22-8061 FILE NUMBER: 2102-0273 DECEDENT NAME: OLIVER MADELON V DATE OF PAYMENT: 05/17/2002 POSTMARK DATE: 05/1 6/2002 COUNTY: CUM BERLAN D DATE OF DEATH: 02/19/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $18,000.00 TOTAL AMOUNT PAID: $18,000.00 REMARKS: MARCIA M NOLL C/O ROBERT C SAIDIS ESQUIRE SEAL CHECK//1006 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 002719 SAIDIS ROBERT C ESQUIRE 2109 MARKET STREET CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 135-22-8061 FILE NUMBER: 21 02-0273 DECEDENT NAME: OLIVER MADELON V DATE OF PAYMENT: 06/23/2003 POSTMARK DATE: 06~20~2003 COUNTY: CUM BERLAN D DATE OF DEATH: 02/19/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2,494.67 TOTAL AMOUNT PAID: $2,494.67 REMARKS: MARCIAM NOLL ROBERT C SAIDIS ESQUIRE SEAL CHECK//1066 INITIALS: CW RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 28O6O1 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001862 SADIS ROBERT C ESQUIRE 26 W HIGH STREET CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 135-22-8061 FILE NUMBER: 2102-0273 DECEDENT NAME: OLIVER MADELON V DATE OF PAYMENT: 11/19/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 02/1 9/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $500.00 TOTAL AMOUNT PAID: $500.00 REMARKS: MARCIA M NOLL C/O ROBERT C SAIDIS ESQUIRE SEAL CHECK# 1040 INITIALS: SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS JOHN E. SLIKE ROBERT C. SAIDIS GEOFFREY S. SHUFF JAMES D. FLOWER, JR. CAROL J. LINDSAY KARL M. LEDEBOHM JOSEPH L. HITCHINGS THOMAS E. FLOWER LAW OFFICES SAIDIS, SHUFF, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 TELEPHONE: (717) 737-3405 - FACSIMILE: (717) 737-3407 EMAIL: attomey@ssfl-law.com www.ssfl-law.com November 21, 2002 CARLISLE OFFICE: 26 W. HIGH STREET CARLISLE, PA 17013 TELEPHONE: (717)243-6222 FACSIMILE: (717)243-6486 REPLY TO CAMP HILL Register of Wills Cumberland County Courthouse Carlisle, PA 17013 Re: The Estate of Madelon V. Oliver File No. 21-02-0273 Dear Ladies: Enclosed please find an original and four copies of an inheritance tax return in regard to the above estate. Also enclosed is a check in the amount of $15.00 for the filing fee. Kindly return extra time-stamped copies to our office in the envelope provided. Thank you. Very truly yours, SAIDIS, SHUFF, FLOWER & LINDSAY × Shelley I/~/ingling, Estate Paralegal /sly Enclosures RiEV- 1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT, 280601 HARRISBURG, PA 1-/'128-0601 D E C OFFICIAL USE ONLY FILE NUMBER 21-02-0273 COUNTY CODE YEAR NUMBER CAPB HpRL EpIO CRAC KOTK ES c o M o REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT IDECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Oliver Madelon V. ~ 135-22-8061 DATE OF DEATH (MM- DD-YEAR) DATE OF BI RTH (M M-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 02/19/2002 01/31/1928 REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ ~ H (date of death 1. Original Return 2. Supplemental Return 3. Remainder Return prior to 12-13-82) 4. Limited Estate 4a. Future Interest Compromise (date of death after 1;~- 12-82) 5. Federal Estate Tax Return Required 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach copy of Trust) [--] 9. Litigation Proceeds Received ~--~10. Spousal Poverty Credit [~ 11. Election to tax under Sec. 9113(A) (date of death between 1Z-31-91 and 1-1-95) (Attach Sch O) NAME COMPLETE MAILING ADDRESS Robert C. Saidis FIRM NAME(If Applicable) 2109 Market St. Saidis, Shuff, Flower & Lindsay Camp Hill, PA 17011 TELEPHONE NUMBER 717/737-3405 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or (3) Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [~ 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 & 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. -0- 212,30,O~ 00 None None 147,296.67 None None 34,408.12 53,226.18 OFFICIAL USE ONLY (6) 359,596.67 (11) 87,634.30 (12) 271,962.37 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) (14) 271,962.37 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 14. X .0 0 (15) 241,462.37 x .0 45 (16) 30,500.00 x .12 (17) X .15 (18) (19) 0.00 10,865.81 3,660.00 0.00 14,525.81 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 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 19. Tax Due Copyright (c) 2000 form software only T he Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00) Decedent's Complete Address: 5~H~ ADDRESS ' 126 Strayer Drive CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A, Spousal Poverty Credit B. Prior Payments C. Discount 0.00 18,000.00 726.29 (1) Total Credits ( A + B + C ) (2) 14,525.81 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 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; ......................... r-~ ~] 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? ................................ ~'] r--x-] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............................................. r-~ [--] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ r--] ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 18,726.29 0.00 4,200.48 0.00 0.00 0.00 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on alt information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN a_7~%<x~ ~ ~~ Michael W. Oliver and Marcia 5 Ra len Drive m~O.~ Boilin~ Sprin~s, PA i~ .................. SIGNATUREOFPREPARE~HAN REPRESENTATIVE Saidis, Shuff, Flower & Lindsay DATE ~ ~ 2109 Market St. ~ ~ ~ -- ~--~liY ;- ~-- 17611- ......................... For dates of death on or after July 1, 1994 and before Janua~ 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 Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statuto~ require~nts for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficial. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twang-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(aXl)]. 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. Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) REV- 1507 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE A REAL ESTATE FILE NUMBER Madelon V. Oliver SSf/ 135-22-8061 02/19/2002 21-02-0273 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 exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowled, e of the relevant facts. Real property which is jointly-owned with ri~lht of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION 126 Strayer Drive, South Middleton Township, Carlisle, PA (property currently listed for sale - will submit settlement sheet as soon as sale takes place) TOTAL (Aisc enter on line 1, Recapitulation) NUMBEF (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH suspend 0.00 Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97) REV- 1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Madelon V. Oliver SS¢/ 135-22-8061 02/19/2002 21~02-0273 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 2,000 shares Equity Income Fund, First Exchange Series 106.15 212,300.00 TOTAL (Also enter on line 2, Recapitulation) 212,300.00 (If more space Is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-I,~03 EX (Rev. 1-97) REV- 1508 EX + (1-97) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Madelon V. Oliver SS# 135-22-8061 02/19/2002 21-02-0273 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 M&T Bank, CD #31003910977627 2 8 9 10 11 accrued interest M&T Bank CD #31003910977635 accrued interest M&T Bank checking acct. #1151738 M&T Bank Market Index Acct. #15004200982856 accrued interest M&T Bank, "In Trust For" Marcia G. Springer, (decedent's sister), accrued interest AIM Fund, "In Trust For" Olivia Noll (decedent's granddaughter) Household furnishings, based on sale prices #15004200222814 escrow funds refund Chase Bank, refund of Roaring Springs Water, Utility refund Car insurance premium refund TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) 22,240.48 791.63 22,247.22 794.09 11,461.87 44,168.01 8.37 30,686.84 5.09 13,903.66 702.98 85.44 5.25 16.54 179.20 $ 147,296.67 Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) REV-1511 EX +(1-97) SCHEDULE H ' CO,=vlMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Madelon V. Oliver SS~/ 135-22-8061 02/19/2002 21-02-0273 Debt: ITEM NUMBER A. 5. 6. 7. of decedent must be reported on Schedule I. DESCRIPTION AMOUNT FUNERAL EXPENSES: Hollinger Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Michael W. Oliver and Harcia M, Moll Social Security Number(s) / EIN Number of Personal Representative(s) Street Address 5 Raylen Drive City Boiling Springs State PA Zip 17007 20O2 Year(s) Commission Paid: Attorney's Fees Saidis, Shuff, Flower & Lindsay Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Marcia M. Noll daughter StreetAddress 5 Raylen Drive Ci~ Boiling Springs RelationshipofClaimanttoDecedent State PA Zip 17007 Register of Wills Probate Fees Accountant's Fees Tax Return Preparer's Fees OtherAdministrativeCosts Cumberland Law Journal, estate notice The Sentinel, estate notice filing fee for tax return Regis and Marcia Noll, cleaning, repairs to condo PNC Bank, check fees Marcia Noll, reimbursement cleaning supplies and for postage, telephone and misc. expen (If more space is needed, insert additional sheets of the same size) TOTAL (Also enter on line 9, Recapitulation) $ 8,826.35 4,000.00 15,700.00 3,500.00 368.50 205.00 75.00 113.27 15.00 1,260.00 55.20 289.80 34,408.12 Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1511 EX (Rev. 1-97) REV-1512 EX + (1-97) COMMONWEALTH OF PEN NSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Madelon V. Oliver SS,~ 135-22-8061 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS Include unreimbursed medical expenses. ITEM NUMBER 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 02/19/2002 DESCRIPTION Chase Bank,bal. of mortgage on real estate (estimate) First Commonwealth Bank, bal. on car lease Nationwide Mutual Fire Insurance Sprint Nationwide Mutual Car Insurance First Commonwealth Bank, car lease payment for March Forest Meadow Condo, condo fee South Middleton Muni Authority, water and sewer Judy A. Campbell, tax collector Sprint PPL, electric Forest Meadow Condo, monthly condo fee Chase Bank, mortgage payment for May thru Oct. Nationwide Insurance, insuranc premium PA Dept. of Revenue, income tax for 2001 3ack Brownawell, house painting Nationwide Insurance, insurance premium TOTAL (Aisc enter on line 10, Recapitulation) FILE NUMBER 21-02-0273 AMOUNT 43,000.00 3,880.23 237.00 42.72 275.20 270.08 82.90 198.00 230.93 85.82 549.31 477.65 2,937.34 24.00 146.00 765.00 24.00 53,226.18 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV- 1513 EX + (9-00) SCHEDULE J BENEFICIARIES CO~IMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Madelon V. Oliver SS# 135-22-8061 02/19/2002 21-02-0273 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE II. TAXABLE D ISTRIBUTIO NS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.Z)] Michael W. Oliver 105 Leckford Way Cary, NC 27511 Mark V. Oliver 1120 Linn Drive Carlisle, PA 17013 Marcia M. Noll 5 Raylen Dr. Boiling Springs, PA 17007 Matthew R. Oliver 109 Garland Drive Carlisle, PA 17013 Kate Oliver 105 Leckford Way Cary, NC 27511 s on s on daughter s on granddaughter 1/4 residue 1/4 residue 1/4 residue 1/4 res idue 5,000.00 ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B° CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) ZOO0 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9~00) Estate of: Madelon V. Oliver Soc Sec #: 135-22-8061 Date of Death: 02/19/2002 Continuation of Schedule J, Part I (Taxable Bequests) Item Name and Address of Beneficiary Relationship Amount or Share of Estate 8 9 10 11 12 13 14 15 Lara Oliver 105 Leckford Way Cary, NC 27511 Megan Oliver 1120 Linn Dr. Carlisle, PA 17013 Lindsay Oliver 1120 Linn Dr. Carlisle, PA 17013 Olivia Noll 5 Raylen Dr. Boiling Springs, PA 17007 Helen Noll 5 Raylen Dr. Boiling Springs, PA 17007 Clinton Noli 5 Raylen Dr. Boiling Springs, PA 17007 Celeste Noll 5 Raylen Dr. Boiling Springs, PA 17007 Meredith Noll 5 Raylen Dr. Boiling Springs, PA 17007 Audrie Noll 5 Raylen Dr. Boiling Springs, PA 17007 Kayla Oliver 109 Garland Dr. Carlisle, PA 17013 granddaughter granddaughter granddaughter granddaughter granddaughter grandson granddaughter granddaughter granddaugther granddaughter 5,000.00 5,000.00 5,000.00 5,000.00 5,000.00 5.000.00 5,000.00 5,000.00 5 000.00 5,000.00 April 30, 2002 RE: Estate Search The Estate of: Date of Death (D.O.D.) To Whom It May Concern: Identified below is the account information requested. 1. M&T Bank accounts in which the decedent's name appears: MADELON V OLIVER 2/19/2002 Account Account Number Account Title Opening Branch Type CHK 1151738 SAV 15004200222814 MADELON V OLIVER 4345 MADELON V OLIVER IN 4345 TRUST FOR MARCIA G SPRINGER SAV 15004200982856 MADELON V OLIVER 4345 $44,168.01 $8.37 CD 31003910977627 MADELON V OLIVER 4345 $22,240.48 $791.63 CD 31003910977635 MADELON V OLIVER 4345 $22,247.22 $794.09 2. Loans, Mortgages, or other obligations titled in the decedent's name Account Number Amount Owed D.O.D. Accrued Interest Balances (Includes Accr. Int.) $11,461.87 $.00 $30,686.84 $5.09 Account Description No Safe Deposit Box titled in the Decedent's name existed at our office. If you have any questions about the information provided, please contact our Records Department at (716) 635-4010 or 1-800-724- 2440 outside of the Buffalo, NY calling area. Thank you. Sincerely, M&T BANK CORPORATION BY: AuthoriZed Signature Manufacturers and Traders Trust Company ,, 1100 Wehrle Drive, RO, Box 767, Buffalo, NY 14240-0767 Historical Prices Page 1 of 1 FINANCE Search-Finance Home-Yahoo!-Help Historical Prices - ATF (Equity Income Fund First Exchange) As of 20-Feb-02 More Info: Quote I Chart I News I Profile I SEC I Msgs I Profile I Month Day Year ~ ~ Daily Start: ~ ~ 102 I CWeekly (' Monthly End: ~ ~ ]~ C Dividends Ticker Symbol: ]atf Get Data .] ADVERTISEMENT INSURANCE.COM FROM FliDELITY INVESTMENTS Download Spreadsheet Format * adjusted for dividends and splits, please see FAQ. Questions or Comments? Copyr ght © 2002 Yahoo! Inc. All rights reserved. Privacy Policy - Terms of Service Historical chart data and daily updates provided by Commodity Systems, Inc. (CSI). Data and information is provided for informational purposes only, and is not intended for trading purposes. Neither Yahoo nor any of its data or content providers (such as CSI) shall be liable for any errors or delays in the content, or for any actions taken in reliance thereon. http ://table. finance, yahoo, com/d?a=2&b= 19&c=02&d=2&e=20&f=02&g=d&s=at f 04/29/2002 NUMBER I ES 29109 29109 CERTIFICATE OF BENEFICIAL INTEREST THE EQUITY INCOME FUND (FIRST EXCHANGE SERIES -- AT&T SHARES) Z00O (A Unit Investment Trust) MADELON V'OLIVE~ 141 SHATTO DRIVE CARLISLE PA !7013-2120 80297856-9 This Certifies that CUSIP 294700 70 3 '; .,::~- .... _ is the registered owner af --TWO THOUSAND-- Unit(s) of fractional undivided interest In THE EQUITY INCOME FUND of the above Series created under the laws of the State of New York pursuant to a Trust Indenture a summary of certain of the pertinent provisions of which is set forth on the reverse hereof and the Sponsors and the Trustee of which have executed this Certificate as set forth below. This Certificate is issued under and is subject to the terms, provisions and conditions of the aforesaid Trust Indenture to which the holder of this Certificate by virtue of the acceptance hereof assents and is bound. Th is Certificate is transferable and interchangeable by the registered owner in person or by his duly authorized attorney at the corporate trust office of the Trustee upon surrender of this Certificate property endorsed or accompanied by a written instrument of transfer in form satisfactory to the Trustee and payment of the fees and expenses applicable thereto set forth on the reverse hereof. Witness the facsimile signatures of the Sponsors and the manual signature of an authorized signatory of the Trustee. Dated: OCTOBER 1/~t 1986 MERRILL LYNCH, PIERCE, FENNER & SMITH INCORPORATED, DEAN WITTER REYNOLDS INC., PRUDENTIAL-BACHE SECURITIES INC., By Sponsor By Sponsor By Sponsor man Presidenl Executive Vice President SHEARSON/AMERICAN EXPRESS INC,, THE BANK OF NEW YORK, By Sponsor By As Trustee ,,,BI FUNDS® QUARTERLY STATEMENT pg. 2 of 2 April 1, 2002- June 30, 2002 You are 100% invested in AIM Weingarten Fund -Class A Your Portfolio Allocation is 100% invested in the Domestic Equity Category Other AIM Investment Categories * Money Market * Sector E-qu tv * Domestic Equity and Income * Iht'l/El obal Equity * Taxab e Fixed'Income * Tax-Free Fixed Income About the information above: The information above shows how your AIM portfolio is diversified by fund and investment category Other AIM funds and their categories are listed on the back of your statement. Consult your financial advisor to see if other AIM funds may be right for you. AIM WEINGA~i-[:H FUND - CLASS A OLIVIA M NOLL TR MADELON V OLIVER TTEE Post Trade Date Date Value on 03/31/02 Fund/Account: O01/0001494111 Transaction Dollar Share Transaction Ending Description Amount Price Shares Shares $13,903.66 $13.00 1,069.512 No Activity From 04/01/02 To 06/30/02 Value on 06/30/02 $11,401.00 $10.66 1,069.512 AIM Fund Quarter (QTR) Dividends and Long Term Taxes Year-to-Date (Y'rD) ST Capital Gains Capital Gains Withheld AIM Weingarten Fund- Class A QTR i .00 .00 .00 YTD .00 .00 .00 Quarter-to-Date Total $ .00 .00 .00 Year-to-Date Total $ .00 .00 .00 AIM Fund Telephone Redemption Dividends Systematic Automatic Automatic TeFephoneExchange CapitaIGains Withdrawal Investments Exchange AIM Weingarten Fund- Class A No Reinvest Yes Reinvest No No No * G 2 2 4 I I 1 19 R L1 S 4 0 ~ o'~, o ,~ '~,~ 0001494111 003415 WY WY31 FUNDS~ QUARTERLY STATEMENT April 1, 2002- June 30, 2002 OLIVIA M NOLL TR MADELON V OLIVER TTEE 126 STRAYER DR CARLISLE PA 17013 YourFinancialAdvisor: GEORGE SNEED FIRST CLEARING CORPORATION C/O FIRST UNION SECURITIES 3401 NORTH FRONT ST STE 110 HARRISBURG PA 17110 Phone: (717)238-9636 Value on 03/31/02 $13,903.66 Additions $0.00 Withdrawals $0.00 Dividends & Capital Gains Reinvested $0.00 Change in Mariner Value - $2,502.66 Value on 06/30/02 $11,401.00 For More Information on this AIM account: Contact your Financial Advisor Visit us at vwvw.aimfunds.com Call our 24-hou~ automated information line at 800-AIM-LINE Talk to a Client Services Representative at 800-959-4246 from 7:30am to 7:00pm CST AIM News: Markets have been extremely difficult lately. In the enclosed AIM Investor, AIM president and CEO Bob Graham discusses current market conditions, with historical perspective based on his many years of experience in the investment business. We encourage you to read this informative discussion. Fund Name Value on Additions Withdrawals Dividends & Change in Value on Fund Symbol 03/31/02 Capital Gai.ns Market 06/30/02 Reinvested Value AIM Weingarten Fund- Class A WEINX $13,903.66 $0.00 $0.00 $0.00 - $2,502.66 $11,401.00 TOTALS: $13,903.66 $0.00 $0.00 $0.00 - $2,502.66 $11,401.00 * ~ 2 1 4 1 1 1 ~ A * ,IDIS, GUIDO MASLAND w. High Street Carlisle, Pa. LAST WILL AND TESTAMENT OF MADELON V. OLIVER I, MADELON V. OLIVER, of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, 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 the payment of my just debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. If there be no cemetery lot available for my interment owned by me at the time of my death, I authorize my personal representative to purchase such cemetery lot with a contract for perpetual care, using therefore funds from my estate in such amount as he shall consider necessary and desirable, and I authorize my personal representative to cause title to or ownership of such lot so purchased to be vested in such person as my personal representative shall designate. Further, I authorize my personal representative to expend funds from my estate, in such amount as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. SECOND ! give, devise and bequeath all the rest, residue and remainder of my estate equally to my children, MICHAEL W. OLIVER, IDIS, GUIDO MASLAND W. High Street Carlisle, Pa. MARK V. OLIVER, MARCIA M. NOLL and MATTHEW R. OLIVER, per stirpes THIRD I direct that any and all inheritance, estate, and transfer taxes imposed upon my estate passing under this Will or otherwise shall be paid out of the principal of my residuary estate. FOURTH In addition to the powers conferred by law, I authorize any personal representative acting under this instrument, in his or her absolute discretion: (a) To retain in the form received, or to sell either at public or private sale any real or personal property; (b) To exercise any options to subscribe for stocks, bonds, or other investments. (c) To join in any plan of lease, mortgage, consolidation, exchange, reorganization or foreclosure of any corporation in which my estate or any trust may hold stocks, bonds or other securities; (d) To sell, transfer, convey, mortgage, pledge, lease or exchange any property, real'or personal, which at any time may form part of my estate, for the payment of debts or taxes, or for any purpose of administration or distribution, for such prices and upon such terms as my personal representative, in his or or sole discretion, may deem wise, and to execute and deliver deeds of - 2 - conveyance or transfer thereof; (e) To make settlements and compromises on such terms as my personal representative in his or her sole discretion may deem wise without the necessity of obtaining any court approval thereof; (f) To make distribution hereunder either in cash or kind, as my personal representative in his or her discretion may deem wise. FIFTH I do hereby nominate, constitute and appoint as Co-Executors, MICHAEL W. OLIVER and MARCIA M. NOLL, or the survivor of them. LIDIS, GUIDO MASLAND w. High Street Carlisle, Pa. SIXTH I direct that no personal representative, guardian, trustee or other fiduciary appointed under this instrument shall be required to give bond for the faithful performance of their duties in any jurisdiction. iN WITNESS WHEREOF, I, MADEL©N V. OLIVER, have hereunto set my hand and seal to this my Last Will and Testament, consisting of three typewritten pages, the first two of which bear my signature in the margin for identification, this ~ day of ~k~f~< 198~' Madelon V. Oliver Signed, sealed, published and declared by the above-named rix, Madelon V. Oliver, as and for her Last Will and tament in the presence of us, who have hereunto subscribed our -- 3 -- names at her request as witnesses thereto, In the presence Testatrix and of each other. of sai1 .IDIS, GUIDO : MASLAND i w. High Street Carlisle, Pa. COMMONWEALTH OF PENNSYLVANIA: : SS COUNTY OF CUMBERLAND : WE, MADELON V. OLIVER, ROBERT C. SAIDIS, AND HICHELLE L. LANDIS , the Testatrix and witnesses, respectively whose names are signed to the foregoing or attached instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Wil.1 and Testament and that she signed willingly and that she executed as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix signed the Will as witness and that to the best of their knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. fIDIS, GUIDO MASLAND w. High Street Carlisle, Pa. blad e~-V.~/~ 1 iver, Testatrix Robert C. Saidis, Witness Hichelle L. Landis , Witness Subscribed, sworn to and acknowledged~ before me by Madelon V. Oliver, the Testatrix, and subscribed to and sworn or affirmed to before me by Robert C. Saidis, and Michelle L. Landis , witnesses, this .~'~'~day of ../~2/~-~~'~ , 198'/. klDIS, GUIDO SHUFF & MASLAND !6 W. High Street Carlisle, PA CODICIL OF MADELON V. OLIVER I, MADELON V. OLIVER, the within named Testatrix, do hereby make and publish this Codicil of my Last Will and Testament dated September 8, 1989. FIRST I hereby make the following specific bequests prior to the distribution of my residuary estate: The sum of Five Thousand Dollars ($5,000.00) to each of my grandchildren living at the time of my death. If any of my grandchildren are under the age of twenty-one (21) years, this bequest shall be held by his or her parent as custodian for the grandchild under the Pennsylvania Uniform Transfers to Minors Act. In all other respects I hereby ratify, confirm and republish my Last Will dated September 8, 1989 together with this sole ~ Codicil and for my Last Will. as IN WITNESS WHEREOF, I, MADELON V. OLIVER, have hereunto set my hand and seal to this Codicil to my Last Will and Testament this ~/?~ day of ?~'~c%.~_:~--~ , 1995. MADELON V. OLIVER Signed, sealed, published and declared by the above-named V. OLIVER, as and for a Codicil to her Last Will and Testament in the presence of us, who have hereunto subscribed our names at her request as witnesses thereto, in the presence of said Testatrix and of each other. ADDRESS ,_./. 'miS, GUIDO, SHUFF & MASLAND !6 W. High Street Carlisle, PA ~IDIS, GUIDO SHUFF & MASLAND ~6W. High Street Carlisle, PA COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND WE, MADELON V. OLIVER, SALLIE PRIAR : SS : TRACIE MYERS , and the Testatrix and witnesses, respectively whose names are signed to the foregoing or attached instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Codicil and that she signed willingly and that she executed as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix signed the Codicil as witness and that to the best of their knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. !i MADELON V. OLIVER ,S~llie Priar , Witness Subscribed, sworn to and acknowledged before me by MADELON V. OLIVER, the Testatrix, and subscribed to and sworn or affirmed to before me by TRACIE MYERS , and SALLIE PRIAR , witnesses, this,.~5-(L~-~ day of 1995. BUREAU OF 'rNDZVTDUAL TAXES ~ INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 171Z8-0601 ROBERT C SAIDIS SAIDIS ETAL 2109 MARKET ST CAMP HILL PA 17011 COMMONWEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE ZNHERZTANCE TAX RECORD ADJUSTMENT REV-1695 EX AFP [01-03) DATE 04-25-Z005 ESTATE OF OLIVER HADELON V DATE OF DEATH OZ-19-ZOOZ FILE NUMBER 21 02-027:5 COUNTY CUMBERLAND ACN 101 Aeount Roeittad HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:5 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~.~ REV-1593 EX AFP (01-03) ## XNHERZTANCE TAX RECORD ADdUSTMENT ~# ESTATE OF OLIVER MADELON V FILE NO. 21 02-0275 ACN 101 DATE 04-25-200:5 ADJUSTMENT BASED ON: BOARD OF APPEALS REFUND VALUE OF ESTATE: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) $. Closely Held Stock/Partnership Interest (Schedule C) q. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) {1) O0 ($) (5) 212,:500 O0 O0 O0 147,296.67 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets DEDUCTXONS AND EXEHPTXONS: 9. Funeral Expanses/Adeinistretivo Costs/ Miscellaneous Expenses (Schedule H) 10. Dabts/Hortgaga Liabilities/Liens (Schedule T) 11. TotaX Deductions 12. Not Value of Tax Return (6) (7) O0 O0 (e) 359,596.67 (9) 33,148.12 (10) 10,226.18 (11) 4:5, :574. :50 (12) 316,222.:57 (13) . O0 (lq) :516,222. $7 1:5. TAX: 15. 16. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate Subject to Tax Amount of Line lq at Spousal rata Amount of Line lq taxable at LineaX/CXass A rate TAX CREDITS: i"AY fll'g I DATE 17. Amount of Lino lq at Sibling ra~e 18. Amount of Lino lq taxable at Collateral/Class B ra~e 19. PrincipaX Tax Due K~Z~I UX~UUNI {~J NUMBER INTEREST/PEN PAID (-) (1..q) . O0 g O0 = . O0 (16) 285,535.53 X 045= 12,849.10 (17) 30,686.8qx 12 = 3,682.42 (18) . O0 X 15 = . O0 (19) 16,531.51 CD001195 CD001862 826.58 .00 05-16-2002 11-19-2002 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. AMOUNT PAXD 18,000.00 500.00 TOTAL TAX CREDIT I 19,326.58 BALANCE OF TAX DUEI Z,795.07CR INTEREST AND PEN. .00 TOTAL DUE Z,795.07CR ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTZONS.) BOARD OF APPEALS DEPT. 281021 HARRISBURG, PA 17128-1021 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ROBERT C SAIDIS ESQ SAIDIS SHUFF ET AL 2109 MARKET ST CAMP HILL PA 17011 IN RE ESTATE OF: OLIVER MADELON V DOCKET NO.: TAX TYPE: APPEAL TYPE FILE NUMBER: ACN: APPRAISEMENT: PETITION FILED: EXAMINER: MAILING DATE: 0305717 Inheritance Refund 2102-0273 101 2/25/2003 3/17/2003 WILLIAM J ZDRADZlNSKI Direct Dial: (717) 787-5761 Fax: (717) 787-7270 Email: wzdradzins@state.pa.us April 10, 2003 : "~' DECISION AND ORDER ,i,:~i; ~ ;"~., In it,~:C~pprai¢~ment~ and assessment of the estate's inheritance tax return, the D~a~men.~tated..._.. -- t~at,,, the claim for the family exemption was being denied on the basis th~e de~ent~ the claimant were not members of the same household at the time of the decedent's death. Petitioner has submitted evidence to this Board that indicates that the decedent and the claimant of the family exemption were, in fact, members of the same household at the time of the decedent's death. Therefore, the claim for the family exemption is allowable. Administrative notice is taken that the Department did not subtract the $3,500.00 family exemption when valuing the allowable Schedule H deductions on the appraisement and assessment at $33,148.12. Therefore, no actual adjustment is warranted relative to the allowance of the family exemption. OLIVER MADELON V BOARD DOCKET NO. 0305717 Page 2 of 2 Accordingly, it is hereby, Ordered that the protest is sustained. FOR THE BOARD OF APPEALS JOSEPH R. SLEEK, MEMBER ANY APPEAL FROM THIS DECISION MUST BE FILED WITH THE ORPHANS' COURT WITHIN SIXTY (60) DAYS OF RECEIPT OF THIS DECISION. A STATEMENT OF ACCOUNT WILL BE MAILED TO YOU BY THE BUREAU OF INDIVIDUAL TAXES. IF YOU REQUIRE THIS INFORMATION IN AN ALTERNATE FORMAT UNDER THE PROVISIONS OF AMERICANS WITH DISABILITIES ACT OF 1990, PLEASE CALL (717) 783-3664, OR FOR SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND SPEAKING NEEDS: 1-800-447-3020 (TT ONLY) BUREAU OF TNDTV/DUAL TAXES TNHERTTAHCE TAX nTVISTDN DEPT. HARRTSBURG, PA 17118-0601 ROBERT C SAIDIS SAIDIS ETAL 2109 MARKET ST CAMP HILL PA 17011 COHMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE ZNHERZTANCE TAX STATEMENT OF ACCOUNT DATE OF DEATH '03 JUN 2O FZLE NUN~tER ACN 05-19-2005 OLIVER OZ-19-ZOOZ 11 02-0273 CUMBERLAND 101 A.oun'l: Reei'~'l:ed RE¥-1607 EX AFP (gl-OS} MADELON V HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ ~o your account, subel* *he upper portion of *hls fore wl*h your ~ax payeen*. CUT ALONG THIS LINE ~'* RETAIN LONER PORT*rON FOR YOUR RECORDS *~ REV-1607 EX AFP (01-03) ~ ZNHER'rTANCE TAX STATEMENT OF ACCOUNT ~ ESTATE OF OLIVER MADELON V FZLE NO. 21 02-0273 ACM 101 DATE 05-19-2003 THIS STATEMENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACM ZN THE NAMED ESTATE. SHO#N BELO# ZSA SUMMARY OF THE PRINCIPAL TAX DUE, APPLZCATZON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: Oq-Zq-2003 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 16,531.51 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 826.58 05-16-200Z 11-19-2002 05-02-2003 CD001193 CD001862 REFUND .00 .00 18,000.00 500.00 2,795.07- IF PAID AFTER THTS DATE, SEE REVERSE STDE FOR CALCULATTON OF ADDTTTONAL INTEREST. ( TF TOTAL DUE 1S LESS THAN $1, NO PAYMENT TS REQUTRED. TF TOTAL DUE TS REFLECTED AS A "CREDIT" TOTAL TAX CREDIT 16,531.51 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THTS FORM FOR TNSTRUCTTONS. JOHN E. SLIKE ROBERT C. SAIDIS GEOFFREY S. SHUFF JAMES D. FLOWER, JR. CAROL J. LINDSAY MATTHEW J. ESHELMANt KIRK S. SOHONAGE THOMAS E. FLOWER LINDSAY GINGRICH MACLAY JACLYN SMITH LAW OFFICES SAIDIS, SHUFF, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 TELEPHONE: (717) 737-3405 - FACSIMILE: (717) 737-3407 EMAIL: attomey@ssfl-law.com www.ssfl-law.com CARLISLE OFFICE: 26 W. HIGH STREET CARLISLE, PA 17013 TELEPHONE: (717)243-6222 FACSIMILE: (717)243-6486 REPLY TO CAMP HILL June 20, 2003 Register of Wills Cumberland County Courthouse Carlisle, PA 17013 Re: The Estate of Madelon V. Oliver File No. 21-02-0273 Dear Ladies: Enclosed please find a Supplemental Inheritance Tax Return in regard to the above estate. Also enclosed are checks for the filing fee and the additional tax due. Please return a time-stamped copy of the return in the envelope provided. Thank yOU. /sly Enclosures Very t~y yours, SAIDJ~,/~UFF, ~LOWER & LINDSAY yelby ~ 5 'ngling, Estate Paralegal Board Certified by the American B ....... oard of Certification tn Cre&tors Rtghts Representatton CAPB HpRL EpiC c=AC ~TK "-ES RE,~ .15'J0 EX + (6-00) cg R E C A P I T U L A T I O N C 0 M xl T I 0 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT, 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Oliver Madelon V. DATE OF BIRTH (MM-DD-YEAR) I 0 2~I,~/~ 0 2 DATE OF DEATH (MM-DD-YEAR) 01/31/1928 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INIIIAL) Odginal Return X 2. Limited Estate ~ 4;. Decedent Died Testate (Attach copy of Will) Litigation Proceeds Received U 1 0. OFFICIAL USE ONLY FILE NUMBER 21-02-0273 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 135-22-8061 REGISTER OF WILLS SOCIAL SECURITY NUMBER  1. Supplemental Return ~ f h 4. ~°~r~,m~t Compromise (date of death after 12-12- 6. Beqeitedt Maintained a Living Trust (~nf~asopy of Trust) [] 9. Spousal Poverty Credit ~ ~(tE(iP~f death between 12-31-91 and 1-1-95) NAME Robert C. Saidis FIRM NAME (If Applicable) 2109 Saidis, Shuff, Flower & Lindsay Camp TELEPHONE NUMBER 717/737- 3405 (dp. 3. Remainder Retum pn 5. Federal Estate Tax Return 8. Total Number of Safe Depo 11. Election to tax under Sec. 9 (Attach Sch O) COMPLETE MAILING ADDRESS Market St. Hill, PA 17011 1Real Estate (Schedule A) (1) 2Stocks and Bonds (Schedule B) (2) 3Closely Held Corporation, Partnership or (3) Sole-Proprietorship 4Mortgages & Notes Receivable (Schedule D) (4) 5Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6Jointly Owned Property (Schedule F) (6) [--~eparate Billing Requested 7Jnter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8.Total Gross Assets (total Lines 1-7) 9,=uneral Expenses & Administrative Costs (Schedule H) (9) l(~ebts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1 fTotal Deductions (total Lines 9 & 1 O) 1;~et Value of Estate (Line 8 minus Line 11) 111,500,00 N°ne None None None None None 9,275.00 48,352.54 13Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) l~let Value Subject to Tax (Line 12 minus Line 13) OFFICI,~ U~ ONLY (8) 111,500.00 (11) 57,627.54 (12) 53,872.46 (13). (14) 53,872.46 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 150,mount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 16~.mount of Line 14 taxable at lineal rate 17Amount of Line 14 taxable at sibling rate lll0,mount of Line 14 taxable at collateral rate X .0 0 (15) 0.00 53,872.46 X .0 45 (16) 2,424.26 x .12 (17) 0.00 X .15 (18) 0.00 19Tax Due (19) 2,424.26 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) 'Decedent's Complete Address: ,ISTREETADDRESS 126 Strayer Drive IC~/Y Carlisle STATE ZIP ?A Tax Payments and Credits: 1.Tax Due (Page 1 Line 19) 2Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits ( A + B + C ) 70.41 (1) (2) 17013 2,424.26 3Jnterest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4Jf Line 2 is greater than Line 1 + Line 3, enter the difference, This is the OVERPAYMENT, Check box on Page I Line 20 to request a refund (4) 5Jf 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. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ......................... r~ b. retain the right to designate who shall use the property transferred or its income; ........... c. retain a reversionary interest; or .................................... d. receive the prom se for life of ether payments, benefits or care? ................... 2If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................ [] ~'~ 3Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? [] [~] 4Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ [---1 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 0.00 70.41 0.00 2,494.67 0.00 2,494.67 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING REIURN Michael W O1 iver ~ ~ ,)~~~ ~)~L~~' R.allen 6r and Marcia M. Noll 6//7/03 ~ Boiling Springs, PA 17007 SIGNATURE OF PREPARER OTHER T~EP_I~ES~'~TATIVE Saidis, Shuff, Flower & Lindsay / J ~~.. 2109 Market St:. '/2~/o~ ......................... : : t¥ ; : - - :: ......................... / For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age (~r 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. Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00) RE'~-1502'E)~ + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Madelon V. Oliver SS~/ SCHEDULE A REAL ESTATE 135~22-8061 02/19/2002 FILENUMBER 21-02-0273 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 exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with ri~lht of survivorship must be disclosed on Schedule F. DESCRIPTION iTEM NUMBER 126 Strayer Drive, South Middleton Township, Carlisle, PA (based on sale price - see settlement sheet attached) (If more space is needed, insert additional sheets of the same size) TOTAL (Also enter on line 1, Recapitulation) VALUE AT DATE OF DEATH 111,500.00 $ 111,500.00 Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97) REV-1511 EX + (1-97) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF Madelon V. Oliver SS~; 135-22-8061 02/19/2002 FILE NUMBER 21-02-0273 Debts of decedent must be reported on Schedule I. ITEM NUMBER 5. 6. 7. DESCRIPTION :UNERALEXPENSES: ~DMINISTRATIVE COSTS: Personal Representative's Commissions Nameof Personal Representative(s) Michael W. Oliver and Social Security Number(s) / EIN Number of Personal Representative(s) Street Address 5 Raylen Dr. City Boiling Springs State PA Marcia M. Noll , Zip 17007 Year(s) Commission Paid: Attorney's Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Regis and Marcia Noll, cleaning supplies in preparation for sale Filing fee for supplemental return and repairs to condo TOTAL (Aisc enter on line 9, Recapitulation) iS AMOUNT 8,000.00 1,260.00 15.00 9,275.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1511 EX (Rev, 1-97) REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Madelon V. Oliver SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SS# 135-22-8061 02/19/2002 FILE NUMBER 21-02-0273 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION Chase Bank, balance of mortgage on real estate sheet attached) Jack Bownawell, house painting nececessary for Costs involed in settlement of real estate: realors commission 6,690.00 transfer tax 1,115.00 pro-rated water and sewer 59.40 credit for taxes (254.36) (see sale settlement TOTAL (Also enter on line 10, Recapitulation) $ AMOUNT 39,977.50 765.00 7,610.04 48,352.54 (If more space is needed, insert additional sheets of the same size) Copyright (c)1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) R~V-15~3 iX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Madelon V. Oliver SS~/ NUMBEF 4 II. SCHEDULE J BENEFICIARIES 135-22-8061 02/19/2002 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY tAXABLE DIS I HIBUTIONS linclude outdght spousal di~dbutions, and tmnsfem under Ss. 9116(a)(1.2)] Marcia M. Noll 5 Raylen Drive Boiling Springs, PA 17007 Michael Oliver 105 Leckford Way Cary, NC 27511 Mark V. Oliver 1120 Linn Drive Carlisle, PA 17013 Matthew R. Oliver 109 Garland Dr. Carlisle, PA 17013 FILE NUMBER 21-02-0273 RELATIONSHIP TO DECEDENT Do NotListTrustee(s) daughter son s on son AMOUNTORSHARE OF ESTATE 1/4 of residue 1/4 of residue 1/4 of residue 1/4 of residue ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 181 AS APPROPRIATE1 ON REV 1500 COVER SHE~- ~ qON-TAXABLE DISTRIBUTIONS: %. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) $ 0.00 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) ' ·. A. Settlement Statement FINAL ' LAW OFFICES U.S. Department of Housing and Urban Development IRWIN, McKNIGHT & HUGHES OMB No. 2502-0265 B. TYPE OF LOAN VEESTPOMFRETPROFESSIONAL BUILDING 1. QFHA 2. ~]FmHA 3. ~Conv. Unins. 60 WESTPOMFRETSTREET 4. ~VA 5. [-JConv. Ins. CARLISLE, PENNSYLVANIA 17013-3222 6. FILE NUMBER I 7. LOAN NUMBER MARSTONS05/03 8. MORTGAGE INSURANCE CASE NUMBER C. Note: ~m~dfU.r~o,ch~.vtOweO~Y~ oau~t,,-l~l~'~,,~t_o, f .a,_ct.u.,a,l.eettlar-,,a?t c66,t~..A~ou, n.~ paid to and by the aottlemant agent are ehown, W&mNIM~. -,-u'-'2'-',''-'I ..... -P~" ~m"z?m~Gi~n~g~[neyare~n~wnn~mT~r~n~mtati~n~urp~ee$andaren~t~n~uded~nth~t~ta~ . .--.:.:;--. ,~ ~., ~..mm ~o_~nowl.r~y m. aKe mine ammments to the UnIMd States on this or any other sim#ar form. Penalties uPOn D. NAME OF BORROWER: SARAH A. MARSTON ADDRESS; 911 ENOLA ROAD.. CARLISLE, PA 17013 E. NAME OF SELLER: THE MADELON OLIVER ESTATE ADDRESS: 126 STRAYER DRIVE, CARLISLE, PA '17013 F. NAME OF LENDER: ORRSTOWN BANK ADDRESS; 77 EAST KING STRFFT. SHIPPENSBURG. PA. 17257 G. PROPERTY ADDRESS: 126 STRAYER DRIVE, Carlisle, PA 17013 South Midd!eton Township H. SETTLEMENT AGENT: IMH REAL ESTATE SERVICES, LLC, Telephone: 717-249-2353 Fax: 717-249-6354 PLACE OF SETTLEMENT: West Pomfret Professional Blde. 60 West Pomfret Street. Carlisle. PA 17013 I. si: 1TLEMENT DATE; 05/23/2003 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER: 101. Contract sales aries 111,500.00 401. Contract ;---::.a _aries i 111 , 500 . 00 102. Personal Pro~erty 402. Personal Pronerty 103. Settlement charaes to borrower (line 1400) 1,9 3 3.0 0 403, 104. 404. 105. 405. Adjustments for items DaSd bv seller i~ advance Adiustments for items DaSd bv seller 'n advance 107. Countvta~eE 05/23/03to12/31/03 136.56 407. Countvtaxe~ 05/23/03to12/31/03 136.56 100. SchoolTax 05/23/03to06/30/03 117.80 408. ScboolTax 05/23/03to06/30/03 117.80 109. 409. 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 113,6 8 7.3 6 420. GROSS AMOUNT DUE TO SELLER; 11 1 ~ 7 5 4.3 6 200. AMOUNTS PAID BY OR ON BEHALF OF BORF OWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. Dsaosit or earnest money 2,0 0 0 o 0 0 501. Exce~ Den,~_!t (sss Instructlon~) 202. Principal amount of new loans ~: 0,0 0 0 · 0 0 502. Sattlc.~.;~; chames to seller (line 1400) 7,8 6 ~:. 4 0 203. Exlstino Ioan/_s) taken sublect to 503. Exlstlna Ioan/s~ ~,~k~,~ sublect to 204. 504. Payoff:3117217073.403 39,977.50 CHASE MANHATTAN MORTOAGE CO~I'O 205. 505, 206. 506. 207, 507. 208, 50~. 209, 509. Adjustments for items un;mid bv sell .~r Adiustments for items unnaid bv sell :r 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 42,000 o 00 520. TOTAL REDUCTION AMOUNT DUE SELLER a, 7,84:1.90 300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SI=~ rLEMENT TO OR FROM SELLER 301. Groae arn~unt due fmm borrower (line120) 113,687.36 601. Gr6~ amount due to seller (llne 420~ 111,754.36 302. Lens a~-~,unts naid by/for borrower (line 220t 4 2,0 0 0.0 0 602. ! ,~=~ reductiDn amount due ~e!!_=r (line 520) 4 7,8.4:1.9 0 303. CASH FROM BORROWER 71,687.36 603. CASH TO SELLER / 63,912.46 TitlcExpress Sett~mcnt System Printed 05/22/2003 at 11:50 REV. HUD-I (3/86) U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT File Number: MARSTONS05/03 , . SETTLEMENT STATEMENT ]~^~E ::Z FINA~ '. ~.. SETFLEMENT CHARGES PAID FROM PAiD FROM 700. TOTAL SALES/BROKER'S COMMISSION based on Drice $111, 500 - 00 O 6.000 = 6,690.00 BORROVVER'S SELLER'S Division of commission (line 700~ es follows: FUNDS AT FUNDS AT 70t. $ 3,320.00 to EI~J~--NR'-r, INC. SETTLEMENT SETTLEMENT 702. $ 3,370.00 to WOLFE & SHEARER 703. Commission Bald at Settlement 6,6 9 0 · 0 0 704. TRANSACTION FEE to E~.A-NRT, INFO. 100.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan OrlainatJon Fee % 802. Loan Discount 803. A~oralsal Fee 804. Credit Reoort 805. Lender's Insnecflon Fee 806. Mortoaue Aonllcstion Fee 807. Assumotion Fee 808. 809. 8t0. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to ~$ Idav ~02. Mol'tn-n- Insurance Premium for to 903. Ha~ard Insurance Premium for to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Ha--rd Insurance mo. ~ $ Imo 1002. Mortna-~ Insurance mo. ~ $ /mo 1003. City Property T~--~, mo. ~ S /mo t004. Counfe Pro~ertv Taxes mo. ~) $ 18 · 6 3 /mo 1O0S. School Tax mo. ~ S 91.8 8 /mo 1009. A-_-_.,m]ats Analveis Adluetment 0 · 0 0 0 · 0 0 1100. TITLE CHARGES 1101. Settlement orcloairm fee 1102. Abstract or title se_~.,ch 1103. Title examination t104. TIRe Insurance binder 1105. Document PraBaration 1106. Notary Fees to NOTARY PUBLIC 10.00 1107. Attomav'sfees to SAIDIS, SRUFF, FLOWER & LINDSAY (POC) (includes above Items No: ) 1108. Title Insurance (Includes above Items No: ) 1109. Lender's Covaraae $ 40,000 · 00 t110. Owner's Covsi~'-e $ 111,500 · 00 - 111t. ATTORNEY CERT to IRWIN, MCE/~TIGRT & HUGHES 625.00 1112. t113. 1200. GOVERNMENT RECORDING AND TRANSFER CHAR~FA 120t. Recordina FeBa Deed $ 3 8 · 5 0 : Mortaaae S 44 · 50 : P-'--"* $ 83.00 1202. City/County tex/atemos Dead S 1,115 · 0 0: Mortaaoe S 1,11 5 · 0 0 1203. State Tax/atemos Deed $1,115.0 0: Mortoaae S 1, 115 · 0 0 1204. 120E. 1300. ADDITIONAL SETTLEMENT CHARGES 130t. Sur~v !3n? FINALW'rR/SWR~I010-~5-~ to BOOTH HTTtDLETON TWP. MUNICIPAL AUTH. 59.40 !303: HOME INSP. - BUYER P.adD fPOC~ 1304. TERMITE - BUYER PAID (POCI 1305. 1306. 1307. 1308. I 933 00 1400. TOTAL SETTLEMENT CHARGES (enter on lines t03. Section J and 502. Section K} · ' · ' ? 8 6 4 4 0 HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUD-1 Settlement Bt.ate .ment end to.t. he .b..es_t .of_m~...kno~?_d~? an_d_.bsllef, it It a true and accurate statement of all receipts and disbursements mede on my account or b in thi~ transaction. I further certify that I have recewee a copy of me Huu-~ ~en emsm ammmen[. THE MADELON OLIVER ESTATE By: MARCIA M. NELL, CO-EXECUTORS I MICHAEL W. OLIVER, CO-EXECU~O~[6 WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO 1~16 UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAJLS SEE TITLE 18: U.S. CODE SECTION 100t AND SECTION 1010. TitlcExprcss Settlement System Printed 05/22/2003 at 1 ! :50 The HUD-1 Settlement Ststsment which I have prepared Is a true and ac.cu.r.a, ta a.c.count .of this transacflo I have caused or will cause tho funds to be disbursed in accomance with tnts statemsn~ By: DATE REV. HUD-] (3/86) TO: SAIDIS SI-II_IFF, FLO~)"ER ~ LII~DSAY ATT~ 2109 Market Street Camp Hill, PA 17011 Register of Wills Cumberland County Courthouse Carlisle, PA 17013 '03 j~ 23 ? ~ :38 k ::?rk-' BUREAU OF ZNDZVZDUAL TAXES ZNHERXTANCE TAX DTVXSTON DEPT. 280601 HARRTSBURG, PA 17128-0601 CONNONHEALTH OF PENNSYLVANZA DEPARTNENT OF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSHENT OF TAX RE¥-ISI~7 EX &FP cnl-o5) ROBERT C SAZDXS SAIDIS ETAL 2109 MARKET ST CAMP HXLL DATE 08-0q-2005 ESTATE OF OLZVER DATE OF DEATH 02-19-2002 FZLE NUMBER 21 02-0275 ACN 101 Amount Rem'itted NADELON V HAKE CHECK PAYABLE AND REHZT PAYMENT TO: REGTSTER OF N]'LLS CUHBERLAND CO COURT HOUSE CARLTSLE, PA 17013 CUT ALONG TH'rS LZNE ~,~ RETAZN LO#ER PORTXON FOR YOUR RECORDS *-~ REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE OF BEDUCTZONS AND ASSESSMENT OF TAX ESTATE OF OL/VER HADELON V FZLE NO. 21 02-0275 ACN 101 DATE 08-0q-2005 TAX RETURN gAS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: 1. Real Estate (Schedule A) 2. (2) 3. (3) ~. (~) 5. 6. (6} 7. (7) 8. APPROVED DEDUCTZONS AND EXENPTZONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Deb~s/Hor~gage Liabilities/Liens (Schedule Z) (10) 11. Total Deductions 12. Net Value of Tax Return SUPPLEHENTAL RETURN NO. 01 (1) 111/500.00 O0 Stocks and Bonds (Schedule B) Closely Held Stock/Partnership Znterest (Schedule C) Mortgages/Notes Receivable (Schedule D) Cash/Bank Deposits/Hisc. Personal Property (Schedule E) Jointly Ovmed Property (Schedule F) Transfers (Schedule G) Tote1 Assets O0 O0 O0 O0 O0 (8) 9,275.00 q8,$52.5q (11) (12) 13. lq. NOTE: CharitabXe/Governeental Bequests; Non-eXacted 9113 Trusts (Schedule J) (13) Net Value of Estate Sub.~ect to Tax ]:~: an assessment Has lssued previously, lines 14, 15 and/or 16, 17, reflect figures that lnclude the total of ALL returns assessed to date. ASSESSMENT OF TAX: 1.;. Amount of Line Zq et Spousal rate (15) 16. Amount of Line 1~ taxable at Lineal/Class A rate (16) 17. Amount of Line Zq at Sibling rate (17) 18. Aaount of Line 1~ taxable at Collateral/Class B rate (18) DZSCOUNT (+) ZNTEREST/PEN PAZD (-) 9q7.37 .00 .00 15.q6- 19. Principal Tax Due TAX CREDXTS: PAYMENT RECETpT DATE NUMBER 05-16-2002 CD001195 11-19-2002 CD001862 05-02-200:3 REFUND 06-20-200:3 CD002719 · O0 x O0 = :3:39,q07.99 x Off5= :30,686.8~ x 12 = · O0 x 15 = (19)= AMOUNT PAZD 18,000.00 500.00 2,795.07- Z,q9q.67 XF PAXD AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 111,500.00 57.627.5~ 53,872.q6 .00 370,09q.8:3 18 and 19 #ill .00 15,27:3.36 3,682.q2 .00 18,955.77 TOTAL TAX CREDXT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE 19,1:31.51 175.7qCR .00 175.7qCR ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORM FOR ZNSTRUCTZONS.) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: Madelon V. Oliver Date of Death: Feb. 19, 2002 Will No. 21-02-0273 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. 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 receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be/a~ched to this report. Date: ~ f Si t Name: Robert C. Saidis, Esquire I.D. No. 21458 SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: Personal Representative X Counsel for Personal Representative BUREAU OF ZNDTVZDUAL TAXES INHERITANCE TAX DIVISION DEPT. 28060! HARRISBURG, PA 17128-0601 COMMONNEALTH OF PENNSYLVANIA BEPARTMENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT REV-Z607 EX AFP COl-OS) ROBERT C SAIDIS SAIDIS ETAL 2109 MARKET ST '.. CAMP HILL PA L7~11 BATE 08-25-2003 ESTATE OF OLIVER BATE OF DEATH Oz-zg-zooz FILE NUHBER 21 02-0273 COUNTY CUMBERLAND ACN 101 Amoun'k Remi~ed MADELON V HAKE CHECK PAYABLE ANB RENIT PAYMENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his form wJ~h your ~ex payment. CUT ALONG THIS LINE ~'~ RETATN LONER PORTION FOR YOUR RECORBS ~ REV-1607 EX AFP (01-03) xN~ INHERITANCE TAX STATEMENT OF ACCOUNT ESTATE OF OLIVER MADELON V FILE ND. II 02-0273 ACN 101 BATE 08-25-Z003 THIS STATEMENT 'rs PROV'rDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACN 'rN THE NAMED ESTATE. SHONN BELON TS A SUHHARY OF THE PR'rNC/PAL TAX DUE., APPLZCAT'rON OF ALL PAYHENTS.. THE CURRENT BALANCE., AND., .rF APPLICABLE, A PROJECTED INTEREST FTOURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-04-2003 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................ PAYMENTS (TAX CREDITS): 18,955.77 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID ~ SUMMARY OF 08-08-Z003 08-08-2003 .rF PA'rD AFTER TH'rS DATE, SEE REVERSE S/DE FOR CALCULAT.rON OF ADD.rTIONAL 'rNTEREST. ( 'rF TOTAL DUE 'rS LESS THAN $1, NO PAYMENT 'rS REQU'rRED. ZF TOTAL DUE 'rS REFLECTED AS A "CRED'rT" (CR), ~LL 005 PAYMENTS ~ 947.37 15.46- .00 18,023.86 TOTAL TAX CREDIT 18,955.77 BALANCE OF TAX BUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE S'rDE OF TH'rS FORH FOR 'rNSTRUCT'rONS. ) ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION D~T, 280~0]. HARRTSBURG., PA 17128-0601 CONHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT, ALLO#ANCE OR DISALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX REV-i~? EX &FP (01-ns) DATE 02-25-2003 ESTATE OF OLIVER DATE OF DEATH 02-19-2002 FILE NUHBER 21 02-0273 '~' : '~'~ COUNTY CUHBERLAND ROBERT C SAIDZS ACN 101 SAIDIS ETAL 2109 HARKET ST I Aaount Ramittad CAHP HILL PA. 17011 HADELON V HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTZCE OF INHERITANCE TAX APPRAZSENENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF OLIVER HADELOH V FZLE NO. 21 02-0273 ACN 101 DATE 02-25-2003 TAX RETURN HAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRA'rSED VALUE OF RETURN BASED ON: ORTGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) ($) ~. Nortgages/Notes Raca/vabla (Schadule D) (q) E. Cash/Bank DaposAts/N/sc. Personal Property (Schedule E) (5) 6. JoAntly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXENPTZONS: 9. Funeral Expensas/Adm. Costs/N/sc. Expenses (Schedule H) (9) 10. Debts/Nortgage L/ab/litias/LAans (Schadula I) (10) 11. Total Deductions 12. Net VaZue of Tax Return O0 212/300 O0 O0 O0 lq7/296.67 O0 O0 (8) 33,1r, 8.12 10,226.18 (11) (12) 15. 1~. NOTE: Charitable/Governmental Bequasts; Non-elected 9115 Trusts (Schedule J) (15) Net Value of Estate Subject to Tax (lq) :;f an assesseent was issued previously, lines 14, 15 and/or 16, 17, reflect flgures that lnclude the total of ALL returns assessed to date. (1.6) .00 x O0 = (16) 285,535.53 x 0~5= (17) 30,686.8~ x 12 = (18) .00 x 15 = (19)= ASSESSHENT OF TAX: 15. Amount of LAne 1~ at Spousal rata 16. Amount of L/ne 1~ taxable at Lineal/Class A rata 17. Aeount of L/ns 1~ at Sibling rate 18. Amount of L/ne 1~ taxable 19. PrAncApal Tax Due TAX CREDITS: PAYHENT RECEIPT DISCOUNT DATE NUNBER INTEREST/PEN PAID (-) 05-16-2002 CD001193 826.58 11-19-2002 CD001862 .00 AHOUNT PAID 18,000.00 500.00 TOTAL TAX CREDZT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE NOTE: To Ansure proper credit to your account, submAt the upper port/on of thAs form w/th your tax paymant. IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 359,596.67 ~3.37~.30 316,222.37 .00 516,222.37 18 and 19 ~ill ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT ZS REQUIRED. IF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) 19,326.58 2,795.07CR .00 2,795.07CR .00 12,8~9.09 3,682.~2 .00 16,531.51 REV-1470 EX (6-88) ' ~ INHERITANCE TAX COMMONWEALTH~OF PENNSYLVANIA EXPLANATION DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG~ PA 17128-0601 DECEDENq"S NAME FILE NUMBER Madelon V. Oliver 2102-0273 REVIEWED BY ANITA MCCULLY ACN 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES A The value of this item has been suspended from the appraisement of the return until the final value can be determined. A supplemental return must be filed when the value of the suspended item is determined. H B-3 The claim for the family exemption has been disallowed. The claimant must be a spouse or if no spouse, a parent or child living in the same household as the decedent as of the date of death. H B-7,4 Repairs to real estate have been disallowed. Repairs may not be claimed unless property has been sold. I 1 Estimated debts are not permitted deductions. I 16 Repairs to real estate have been disallowed. Repairs may not be claimed unless property has been sold. ROW Page 1 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT, 280601 HARRISBURG, PA 17128-0601 ROBERT C SAIDIS SAIDIS ETAL 2109 MARKET ST CAMP HILL PA 17011 DATE 04-25-2003 ESTATE OF OLIVER MADELON V DATE OF DEATH 02-19-2002 FILE NUMBER 21 02-0273 COUNTY CUMBERLAND ACN 101 Amount Renitte MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this fora with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS -~ ---------------------------------------------------------------------------------------------------------------- REV-1593 EX AFP (O1-D3) ~* INHERITANCE TAX RECORD ADJUSTMENT ~~ ESTATE OF OLIVER MADELON V FILE N0. 21 02-0273 ACN 101 DATE 04-25-2003 ADJUSTMENT BASED ON: BOARD OF APPEALS REFUND VALUE OF ESTATE: 1. Real Estate (Schedule A) (1) .00 2. Stocks and Bonds (Schedule B) (2) 212,300.00 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 4. Mortgages/Notes Receivable (Schedule D) (4) .0 0 5. Cash/Bank Deposits/Misc. Personal Property (Schedule El (5) 147,296.67 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets (8) 359,596.67 DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Administrative Costs/ Miscellaneous Expenses (Schedule H) (9) 33,148.12 10, Debts/Mortgage Liabilities/Liens (schedule I) (10) 10,226.18 11. Total Deductions (11) 43 , 374.30 12, Net Value of Tax Return (12) 316 ,222.37 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00 14, Net Value of Estate Subject to Tax (14) 316 ,222.37 Tax: 15. Amount of Line 14 at Spousal rate (15) . 00 X 00 = , 00 16, Amount of Line 14 taxable at Lineal/Class A rate (16) 285 , 535.53 X 045 = 12 , 849 .10 17. Amount of Line 14 at Sibling rate (17) 30,686.84X 12 = 3 ,682.42 18, Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = ,00 19. Principal Tax Due (19) 16 531 51 TAX CREDITS. , . DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 05-16-2002 11-19-2002 CD001193 CDOOI862 826.58 .00 18,000.00 500.00 COMMG'NWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT REV-1595 EX pFP (01-OS) TOTAL TAX CREDIT 19,326.58 BALANCE OF TAX DUE 2,795.07CR INTEREST AND PEN. .00 TOTAL DUE 2,795.07CR * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" [CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS,) BGAkD OF APPEALS COMMONWEALTH OF PENNSYLVANIA DEPT. 281021 HARRISBURG, PA 17128-1021 DEPARTMENT OF REVENUE ,. • . ROBERT C SAIDIS ESQ SAIDIS SHUFF ET AL 2109 MARKET ST CAMP HILL PA 17011 .~ _._ o 4.w IN RE ESTATE OF: OLIVER MADELON V DOCKET NO.: TAX TYPE: APPEAL TYPE FILE NUMBER: ACN: APPRAISEMENT: PETITION FILED: EXAMINER: MAILING DATE 0305717 Inheritance Refund 2102-0273 101 2/25/2003 3/17/2003 WILLIAM J ZDRADZINSKi Direct Dial: (717) 787-5761 Fax: (717) 787-7270 Email: wzdradzins@state.pa.us April 10, 2003 DECISION AND ORDER In it~ppraisement and assessment of the estate's inheritance tax return, the Departmentated that the claim for the family exemption was being denied on the basis _:~ th~t~e de~dent:~rT>±I the claimant were not members of the same household at the time of the decedent's death. Petitioner has submitted evidence to this Board that indicates that the decedent and the claimant of the family exemption were, in fact, members of the same household at the time of the decedent's death. Therefore, the claim for the family exemption is allowable. Administrative notice is taken that the Department did not subtract the $3,500.00 family exemption when valuing the allowable Schedule H deductions on the appraisement and assessment at $33,148.12. Therefore, no actual adjustment is warranted relative to the allowance of the family exemption. OLIVER MADELON V BOARD DOCKET NO. 0305717 Page 2 of 2 Accordingly, it is hereby, Ordered that the protest is sustained. FOR THE BOARD OF APPEALS JOSEPH R. SLEEK, MEMBER ANY APPEAL FROM THIS DECISION MUST BE FILED WITH THE ORPHANS' COURT WITHIN SIXTY (60) DAYS OF RECEIPT OF THIS DECISION. A STATEMENT OF ACCOUNT WILL BE MAILED TO YOU BY THE BUREAU OF INDIVIDUAL TAXES. IF YOU REQUIRE THIS INFORMATION IN AN ALTERNATE FORMAT UNDER THE PROVISIONS OF AMERICANS WITH DISABILITIES ACT OF 1990, PLEASE CALL (717) 783-3664, OR FOR SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND SPEAKING NEEDS: 1-800-447-3020 (TT ONLY) ;-; r ;,, ,~ ~.. ~, --< i ~_ 4_~ . G\ ~') - y~ %' \. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISIDN DEPT. 280601 HARRISBURG, PA 17128-0601 ROBERT C SAIDIS SAIDIS ETAL 2109 MARKET ST CAMP HILL PA 17011 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX pfP (O1-OS) DATE 05-19-2003 ESTATE OF OLIVER MADELON V DATE OF DEATH 02-19-2002 FIL,~,,~~ NUMBER 21 02-0273 ~U.~ -~~~'+ ~t. ''~COtiNTY CUMBERLAND ACN 101 Amount Remitted ~~~+;~ _ MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1607 EX AFP (01-03) *~~ INHERITANCE TAX STATEMENT OF ACCOUNT ~~~ ESTATE OF OLIVER MADELON V FILE N0. 21 02-0273 ACN 101 DATE 05-19-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-24-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 16,531.51 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 05-16-2002 CD001193 826.58 18,000.00 11-19-2002 CD001862 .00 500.00 05-02-2003 REFUND .00 2,795.07- TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. * IF PAID AFTER THIS DATE, SEE REVERSE I TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ~[ IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 16,531.51 .00 .00 .00 LAW OFFICES SAIDIS, SNUFF, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 JOHN E. SLIKE TELEPHONE: (717) 737-3405 -FACSIMILE: (717) 737-3407 ROBERT C. SAIDIS EMAIL: attorney@ssfl-law.com GEOFFREY S. SNUFF www.ssfl-law.com JAMES D. FLOWER, JR. CAROL J. LINDSAY MATTHEW J. ESHELMANt KIRK S. SOHONAGE THOMAS E. FLOWER LINDSAY GINGRICH MACL AY JACLYN SMITH June 20, 2003 Register of Wills Cumberland County Courthouse Carlisle, PA 17013 Re: The Estate of Madelon V. Oliver File No. 21-02-0273 Dear Ladies: CARLISLE OFFICE: 26 W. HIGH STREET CARLISLE, PA 17013 TELEPHONE: (717)243-6222 FACSIMILE: (717)243-6486 REPLY TO CAMP HILL -:; Enclosed please find a Supplemental Inheritance Tax Return in regard to the above estate. Also enclosed are checks for the filing fee and the additional tax due. Please return atime-stamped copy of the return in the envelope provided. Thank you. V ery t y yours, SAID HUFF, FLOWER & LINDSAY /, ~, ~/ e by ~t'. Yingling, Estate Paralegal /sly Enclosures t Board Certified by the American Board of Certification in Creditors' Rights Representation ~; _~:.