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HomeMy WebLinkAbout02-1115PETITION FOR PROBATE and GRANT OF LETTERS Estate of Eugene R Elicker ~~_~~_ ~~ ~~ also known as No. To: Register of Wills for the Socia/Securrt No. ] 7 Deceased. County of Cumberland y -n1 _9L~~ in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executer in the last will of the above decedent, dated named and codicil(s) dated -----~g~temb r 0 1~~]` (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland his last family or principal residence at C~rch ~f ~„~ u,,,,,County, Pennsylvania, with x(11 t\T u..----- (list street, number and muncipality) Decendent, then 84 years of age, died _ n~t-obPr 1 1 at Church of God kome 801 N. Hanover St. Carli 1 '~~"" 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 pi operty with estimated values as follows: (If domiciled in Pa.) All personal property $ 242 , 816.90 (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: B tffal o T_ otin~hi D p rr r r„ $ 230 000.00 WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters~estamentarv theron. (testamentary; administration c.t.a.; administration d. b.n.c.t.a.) C / /-- ~,... J t j 1l ~, v Dana F 1 i rlrar ~.0 259 Hillcrest Rd. ~;, Camp Hi11, PA 17011 h0. - vw ~~ m OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1 COUNTY OF _Cumberland ~' ss 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 *.he knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well aa.d truly admi jster a estate ac~'ording to law. Sworn to or affirmed and subscribed ! •/ before me this 9th day of ;' ~4J~2J~S,c~X~/Regi er oo' c :; 0 NO. 21-OZ-1115 Estate of Eugene R. Flicker ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW DECEMBER 10 ~g~ 200~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_ September 30 , 1991 described therein be admitted to probate and filed of record as the last will of Eugene R. Flicker and Letters testamentary are hereby granted to Dana E . El i cker Register of Wills/~J G FEES Probate, Letters, Etc. ......... ~ 340.00 Short Certificates( ) .......... S 9.00 I~enPun~ta[ion ......... . ...... ~ 9.00 JCP S 10.00 TOTAL ~ 368.00 Filed .... DIrC~~Blg, 10, , 2002, , , , , , , , , . ATTORNEY ;Sup. Cc. I.D. No.) ADDRESS PHONE his is to certif}~ that the information here given is correctly copied froth ali otf ~# c Local Registrar "'lie original cetrificate will l7e forwarded to the State ~'tt1.~ i~e~o~~1_:. , - WARNING: It is illegal to duplicate this copy by photostat ~, f~~4~'/ ~., ~ , Fcr ±c>r this ccrtitic.~.te, S?.t]t~ '~~ `lam o i ,,. l a ~r i.s L~ __ __.. _ _...._ .rl _i"_- u~,i ,.- ____P_ 8629769 No. \,_MENT u[,,,IIII OCT 14 2002 i;.,,l. ~e, Rev. 2187 COMMONWEALTH Of PENNSYLVANIA • DEPARTMENT Of HEALTH • VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT IFrcy. Myode. ;asl SEx SOCIAL SECURITY NUMBER DALE OF DEATH Mcnm. Day, rparl Eu ene Robert Elicker _ ~ male ~' 172 01 - 09 x '' c~ / ~ d ;> I _ _ _ AGE (last evll+°ayl UNDER,VEM UNDE R1DAV DATE Of BIRTH BNTTHPUCE Ca xo PLACE OF DEATH Cn , _ . , . o _ y I ecw rwwy n•r .ee-yarywawe yv nn ~rney ,xwl Month r Dap /bws' .r MNwtsa Monm Dav reed Subaycregn CaurwN HOSPIUL. --_--____-_-_ OTHER---_--_ 84 M ay 20,1918 New Cumberland, ,,,p,,,a,,, ^ EFLOutpan.M ^ oDA ^ N Yra. i m a . R.sbarK. ~ ~~yl ^ s. e T _ . _ . ___p sa. COUNTY OF DEATH Cf(Y. BONG. iWP OF DEATH FACILITY NAME (11 nw nw~MyOn. gyve weel aM1 rwmoeri VMS D ECEDE NT OF HISPANIC IGIN? RACE ~ Amencan InOian, Bbca, Nmae. etc. ' ' ((' No p.~ He L~ N yee, apecfy CuOan, ISPeOayl Cumberland PuaneR¢a" Carlisle «~ PA (.(j~ /'/ M.a¢an k • , . j w b. 9 white . /0. DECEDENT'S USUAL OCCUPATION KIND OF BUSINESS/INDUSTRY VMS DECE DENT EVERW DECEDENT'S EDUCATION MARITAL STATUS-Mambo SURVIVING SPOUSE (Gyve M+rWd WrM OOna dw~ng r*yoN US. ARMEDfORCES? y ore m a" , e co ey1 Nsver Marrrq, WiOOwW, Ie was rry,o„,nyr,e a workrrte F/s; do na use refiretl 1 rea ® ~ ^ EbmeMay/5ecww7ary Cdbgs Drvarcea 1SpecN1 ~~ ' En ineer „e. Teleco unication s. ,, tO12j 12 "'ui5" "•~ Widowed ' , ,.. ,~. DECEDENT'S MAILING ADDRESS (Street. CayyTOwn, SUls.lq Cocel DECEDENT'S pennsvlvania 'T•.stat. ,Ta ~ YIN ascerbrvlrv oi Hampden TW ~ . . e n p ,,,,p 259 Hillcrest Road RESa~NCE ~ Camp Hill PA 17011 ~ N"e;r;e" """ '"'"' , , bw,wp? No, a.c.d.rN Ny.a Cumbe~l ,~- ,7e ca„M ~1d ,Te ^ wen l wl . y . r . a,ac e„asa_ ___ caY/e0ro FATHER'S NAME Ifrst. Mw,ole. La511 MOTHER'S NAME tFwsl. Mw101e. Mayoen Surnamnl ,~• Russell R. Elicker ,e- Nettie B. Smith INfORMANT'S NAME (TYpdPrIn11 INFORMANT'S MAILW(i ADDRESS IStreal. Cay/TOwn, Slab, Zip Cudel ,o.. D a sae. 259 Hillcrest Roa a 1 METHOD OF DISPOSITNON GATE Of DISPOSITION Burtel® Crematbn^ RemwalNOmSlate^ IMONh,Day,marl PLACE OF DISPOSITION - Name a Cemetery, Crematory LOCRNNa - CirylWwn, Stale, Zp Code wO1MrPlace °vn"'°"^ °'h"~0"^' ^ October 15 2002 Ham den TW P P• . Cumberland, Co ST. John's Cemeter . ' , su xm. ' y s,o. s,a. SICiFltO UR OfF NE RVICE NSEEORPERSONACTINGASSl1CH LICENSE NUMBER NAME ANDADORESSOFfAC14TV parthemore FH & CS, Inc. ' ,,,. ?e. FD 013 340 L ,x. P.O. Box 431 New Cumberland PA 17070-0431 Compbb oe 23ac ~~ty wean unyryeg Toth Wet of twigs, Death occwr tM hme. Wle arW pbce sraleo. LICENSE NUMBER DATE SIGNED phyaicsart a na availaDb at ums of Death b al _~ we e cerldy cauwaoealh. ~).~' / tMalet, read ~~ ~ I s,e. / BS /V ^ / Hama 2a-?e mwI W compbteo Dy IME OF DE H r~ GATE PRONOUNCED DEAD tMpyNy. Day, yeaq WAS CASE REFERRED TO MEDICAL EXAMINEWCORONER? ~ ti person wM prorbw,cn osaN. / / !~ ' ~ ~~ q O a9p~ Wa ^ pp /:7! M ,1 ~GK(1 4 4! C / -- -_ - . . . . . > 26. - -_ 27. PART I: Enter tM dseaaes, irqurbs w complcatrmta which uusao tM Death Do rbl Baer IM moos of nyaq, such as cardac a re story auesl, snocN or nean laaare i Appro.wnata PART N; OtMr agmlkara cwrQabrr coMrawtin0 b Wam Dot i ' . l p Only OM CiUSe M Ba1 A Nre. , WpvN Wtween na leaullNlg n Nb wdMlyug GrW given n PART 1. , orWl aM Meth HIYEDMTE CAUSE (Pout rLwuIXCIXrdlgfl c,~~(e re.,,.a.l ~; (~. ~ ; ? ..{a J A 1 I ~-~ Q L.s E~~ ~- (, :c ~ earingnoeaml-- a. [U 1W c .iJ s,sn ('I~rr1 _ DUE TO IOR AS A COONSEQUENCE OFI: r / 1 0 r l : I ~ S t ( :~ . w agbrabNy 6Y corrditlaa 0. <µ 1- l I arty, tsaoNtp b irrtrrredb,s DUE 10 (OH AS A CONSEQUENCE OF): - I cause.Emer LNIDERLYNaO ; CAUSE IObeaae or vgwy c. Ol1E TOIOR AS A CONSEQUENCE OFI: - I eeietg oeamllAST ' r ° WA$ AN AUNPSV WERE AUTOPSY FIN01NG5 MANNER OF DEATH DATE OF INJURY TIME OF INJURY INJURY AT WORK? DESCRIBE ttOW INJURY OCCURRED. PERFORMED? AWIIABLE PRIM TO IMaym. Oay. real COMPLETION Of CAUSE ^ OF DEATH? Na1wa1 ~ /bnr~Cytle Yea ^ fvo ^ AccdeM ^ PerrWrrg bveagalgn ^ ,Oe. _ _ _ ,Ob. M. ,pc, ,Od. _ Vp ^ No ® Vp ^ NO ^ $wcMe ^ COUb tax W oebrtnyneo ^ PLACE Of INJURY - AI h t I m n ums. ar . areal. adwY. o ce LOCATION (Street. Gay/Town, Sulel Weoap, wc. Specavl sw. see. zs. ,o.. Lm. --- - CERTIFIER ICnech or:v Orel IGNAIUR AN T L OF ER 1 F/~ 'CERTIFYNYG PHYSICIAN IPhysw;Hn ceruya.g caused°ean wnm•ananer onvsw:~an has paroonceo Jeam an°<um,releo ll 171 / TI J/ '//1 • >_ To Ule Wet of m lW Nno th d d d ~~ ~ . y w / ( ,te, ea occurre w b Ilre cauee(al arW manner a etateo .......................... ......................... ale. - / V f ~1 ~J . ~ - LICEN' M ER -- --- 0 E SIGNED tMCwym. OaY, vent 'PRONOUNCING AND CERTIFYING PHYSICtANIPnyyrcyan[x,m ay~wyouycyrwO Deem arW wcaelyyny m~ause Ol oeeml /`jJ~2 i>ry yL: 'L~ - (2 7 ' t., Z _ C To Iha eMt of my Irowbdge, oeaN oecwrad at tM tlme, oats, xW place, ano dw to IM cauaalal aM manner as staled ......................... !. ~ I ,IC _-.. _ _- ... _ ,Id _ NAME AND ADDRESS OF PERSON Wf/0 COMPLETED CAUSE OF DEATH (Item 171 Type a Pnn, ~. 'MEDICAL E%AMINER/CORONER (~ l 1,L1[i `.n s ~ -' On the basis 01 eaamtnetlon and/or invastigaeon m my opmron death occurred at the time data a d l d d : ~ • L+ ~' - I Y~ ~ y"' , , , , n p ace, an ue,o,he cauaep) and - 1/~ v mmnatasalatad ............. ... ^ ~ . ................................................................................. -„a Si 7.5 carl..cle. ~' ~ (~et~.~.,rrL ~~f{ (732`{ ,s. - -- REGISTRAR' 1GNATUREA ja BE ~-' --- ~J ~,l yR~..-. --~ - -' DATE FILEDfMwrm Uay, rear) ~~/ td~ LAST WILL AND TESTAMENT OF EUGENE R. ELICKER Date: 3L; ` l ~~~-~ ~. ~~~-d~~~ l LAST WILL AND TESTAMENT I, EUGENE A. ELICKER, of Upper Allen Township, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this to be my last Will and Testament, hereby revoking and making void all former wills, codicils and other testamentary dispositions by me at any time heretobefore made. 1. I direct my executor, hereinafter names, to pay as soon as practicable after my decease all my just debts and the expense of my last illness and burial. 2. I give, devise and bequeath all the rest, residue and remainder of my estate, whatsoever and wheresoever situate, unto my son, Dana E. Elicker. 3. Should my said son predecease me, then and in that event, I give, devise and bequeath all of my said estate unto my granddaughter, Danielle Lynn Elicker. 4. t hereby nominate, C:OI1SLli.l,it:e cYlt~ a~~~%lZt iuy "`-`~`~^ "~=~' n`"~"? E. Elicker, executor of this my last Will and Testament. Should my said son, Dana E. Elicker, fail to qualify or cease to act as executor, I appoint my son, E. Robert Elicker, II, executor of this my last Will. 5. I appoint my daughter-in-law, Susan L. Elicker guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so. Such guardian shall have the power to use principal as well as income from time to time for the minor's education, (including post high school education) support and welfare, or to make payment for these purposes, without further responsibility, to the minor, to the minor's parent or to any person taking care of the minor. Should my said daughtger-in-law, Susan L. Elicker fail to qualify or cease to act as guardian of said property, I appoint my son, E. Robert Elicker, II, guardian of any property which passes, either under this will or otherwise, to a minor as set forth above. IN WITNESS WHEREFORE, I, EUGENE R. FLICKER, the trestator have hereunto set my hand and seal to this my last Will and TeStciT~ent thi:~JVth duy O •` .c. .".~'~:t^~b~r, l Q~i . ~' ,~ Y .~- : ~T ~-- ~ ~ ~ G G E!%1~ ( SEAL ) Signed, sealed, published and declared by the above named EUGENE R. ELICKER, as and for his last Will and Testament in the presence of us, who, at his request and in his presence and in the presence of each other have hereunto subscribed our names as witnesses thereto. may. ter. ~_-~~ '" REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS (each) a subscribing witness to the law, depose(s) and say(s) that the testat ,sign the same and that present and saw signed as a witness at the request of testat in h presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19. Register (Name) (Address) (Name) (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS DANA E AND SUSAN L ELICKER (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that they are familiar with the signature of EUGENE R ELICKER , xxr~i~ testat or of (g~rx~tiKx>~xzs~ciixaaMtta~~~) the will presented herewith and codicil that they believes the signature on the will is in the handwriting of EUGE~; U R ELICKER to the best of _ trier knowledge and belief. j~ / _~_ J Sworn to or affirmed and subscribed before ~~~ ~~~~ ~( me this 9th day of /Name) DECEMBER )?$~ 2002 ~S~h~ZLLI~~~S~"',t~i}~ [" /~/~/~~~L/L, ~' . ~ J ~ ~~~ ~• ( ddre_ss) /~J ~/ ,~Q~euXj Register (Name) ~~ ~} ~f ~'/(~ to s-~ /~r1 . ~'<< ~., t~,~~~ codicil will presented herewith, (each) being duly qualified according to (Address) CERTIFICATION OF NOTICE UNDER RULE 5.6(al Name of Decedent: Eugene R Elieker Date of Death: October 11, 200 Will No. 2002-01115 Admin. No. 21-02-1115 To the Register: 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 nP~PmhPr 1 (L, X0112.-_~ Name Address Dana E Flicker (Sole Heir) 259 Hillcrest Rd., Camp Hill PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Date: March 17 2003 Capacity: ~_ Personal Representative Signature Name r~~„~ F R1 i ~kar Address 259 Hillcrest Rd. Camp Hill, PA 17011 Telephone 1717 761-6978 Counsel for personal representative o2I 002 - ~ ~ ~.~- Inventory of the real and personal estate of Eugene R ElickPr deceased Personalty: PNC Checking Account Wachovia Securities (Bond Funds) Lehigh County Lebanon PA Hospital Authority Oppenheimer Funds: Strategic Income Fund PA Municipal Fund New Momentum Annuity Policy Stocks: Lucent Technologies AT&T BellSouth Miscellaneous: Church of God Home- Security Deposit Refund Parthemore Funeral Overpayment Refund PPL Refund for remaining balance at Mountain cabin Real Estate: Buf alo Township, Perry County 829 Cherry Road, Newport, PA Tax Parcel Numbers: 030,029.00-029.000 and 030,039.00-003.000 A 172-acre tract of mountain land with a mobile home with a one-story frame addition Value as of October 11, 2002 as appraised by Larry E. Foote $5,61651 $4,974 53 $7,049 60 >51,596 84 X60,106 13 699,760 00 $33 ;$1,196 x$7,164 $4,563 $709. $45 64 00 62 73 40 90 230,000 X00 Person~~~~::~.~hc~yR~~.~. ~~tat~=Tot~l~' ~472,8Z&~.90 COMMONWEALTH OF PENNSYLVANIA '~ ss: COUNTY OF CUMBERLAND Dana _E_ Elicker __ - _- _ being duly ~wnrn _ according to law, deposes and says that he _is the Executor ___ ____ _ of the Estate of Eugene R. Elicker late of -- __Mddlesex_ Township. -_--_ __-_ ,Cumberland County, Pa., deceased and Chet the within is an inventory made by __ Dana E. Elicker _____ ____ __ _., the said Executor of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. Sworn to and subscribed before me, 19 Execu!or -Administrator Address Date of Death _~1.~~~n_th, October ,__ 2002 Day Month Ysar INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. , i 0 Z ~ w ~I xi ~' ~ 0 Z > Z = LL O ~ °' ~ ~ z ~ ~ Q N w Q W ~ o Z Q O ~~ ~I', WI '. x ~j ~I h~ ""f' W O a> J -~ m m a~ U d 0 o_ T c 0 U -o c ~o d E U I m ~ ~ i d C ! I~ I i i i ~ ~ ~ o 0 LL m COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 001928 FLICKER DANA E 259 HILLCREST ROAD CAMP HILL, PA 1701 1 Pold ESTATE INFORMATION: ssN: 172-of-os4s FILE NUMBER: 2102- 1 1 1 5 DECEDENT NAME: FLICKER EUGENE R DATE OF PAYMENT: 12/09/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 0/ 1 1 /2002 REMARKS: DANA E FLICKER CHECK#1408 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ $19, 000.00 TOTAL AMOUNT PAID: INITIALS: AC RECEIVED BY: DONNA M. OTTO REV-1162 EX(11-96) $19, 000.00 DEPUTY 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 REV-1162 EX~11-96) NO. CD 002523 FLICKER DANA E 259 HILLCREST ROAD CAMP HILL, PA 1701 1 fold ESTATE INFORMATION: ssrv: 172-of-os4a FILE NUMBER: 2102-1 1 15 DECEDENT NAME: FLICKER EUGENE R DATE OF PAYMENT: 05/02/2003 POSTMARK DATE: 00/00/0000 couNTY: CUMBERLAND DATE OF DEATH: 1 0/ 1 1 /2002 REMARKS: DANA E FLICKER CHECK#1422 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 51,229.36 TOTAL AMOUNT PAID: INITIALS: SK 51,229.36 SEAL RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE 7AX DIVISION DEPT. 280601 HARRISBURG, PA 17128-6601 DANA E FLICKER 259 HILLCREST RD CAMP HILL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX . .. DATE ` ESTATE OF DATE OF DEATH FILE NUMBER ~~3 ~IJ~ -2 ~t ~ Cp~NTY ACN REV-1547 EX ~FP (01-037 05-26-2003 FLICKER EUGENE 10-11-2002 21 02-1115 CUMBERLAND 101 PA 17011 t..r.::;i'f Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 R CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ _ ------------------------------------------------------------------------------- REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FLICKER EUGENE R FILE N0. 21 02-1115 ACN 101 naTE 05-26-~nn~ TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate ( Schedule A ) (1) 23 0 , 0 0 0 . 0 0 NDTE : To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this fore with o 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 11 4,975.33 y ur tax payment. 6. Jointly Owned Property (Schedule F) (6) 137,777.87 7. Transfers (Schedule G) (7) .0 0 8. total Assets (g) 482, 753.20 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (q) 10,803.8 0 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 186.56 11. Total Deductions (11) ) 0 .990 . j6 12. Net Value of Tax Return (12) 471,762.84 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 471,762.84 NOTE: If an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF 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) 471, 762.84 X 045 . 21, 229 .33 17. Amount of Line 14 at Sibling rate (17) .00 X 12 - .00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 1 5 - .00 19. Principal Tax Due (lq)= 21,229.33 TAY f`D C*1TTC. DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 12-09-2002 CD001928 1,000.00 19,000 00 05-02-2003 CD002523 .00 . 1,229.36 TOTAL TAX CREDIT 21,229.36 BALANCE OF TAX DUE .03CR INTEREST AND PEN. .00 TOTAL DUE .03CR * 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 Sr~F nF rurR cnow cno rucrenrrrn.~~ . R~".l,c'l~'.(l~~i j't COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 i7-/~7~/O REV-1500 OFFICIAL USE ONLY L! I- Z W C W o W C w .. :.::~Cf.I 0"'''' w"O ';1:og ufflll .. " INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER J,1-1.~ COUNTY tooe YEAR DECEDENT'S NAME (lAST, FIRST, AND MIDDLE INITIAL) Elicker, Eugene R. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 10/11/2002 OS/20/1918 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDLE INITIAL) None SOCIAL SECURITY NUMBER 172 - 01 OLLL5- NUMBER - 0943 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER NAME Mr. Dana E. Elicker COMPLETE MAILING ADDRESS 259 Hillcrest Camp Hill, PA Rd. 17011 [JJ 1. Original Return o 4. Limited Estate Iil 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds ReceilJed o 2. Supplemental Return o 43. Future Interest Compromise (data of death aflar 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copyofTI'lJSI) o 10. SpoiJsal PO'Jerty Credit (ceta 01 daath between 12-31-91 and 1-1.95) o 3_ Remainder Return {<late of d.ee.tiI pOOr \u 12-1Z-B2) o 5. Federal Estate Tax Return Required ..Q. 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch O} .. Z W C Z o .. .. w '" '" C o z o ~ ::I I- 0: <( o w a::: FIRM NAME (If Applicable) TELEPHONE NUMBER (717) 761-6978 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes ReceilJable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or l) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Unes 9& 10) (1) (2) (3) (4) (5) $230,000.00 OFFICIAL USE ONLY ::oiB' cPO lOO ---, ~Q ro$ -.0(0. a~~ ~fj ==<U WO - (7) 00 -m 3~ f,,,; """'; \~-:" J,;V ;,~J ~ B:~' "C;;- Po o J~ - ei (6) $114,975.33 $137,777.87 ~ I N a - (B) $482,753.20 (9) (10) $ 10,803.80 $ 186.56 (11)_$ 10,990.36 (12) $471 , 762 . 84 (13) 12. Net Value of Estate (Line a minus line 11) 13. Charitable and Governmental Bequests/See 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) (14) $471,762.84 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !ci: I-' ::I Q. :IE o o ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec, 9116 (a)(1.2) x.o_ (15) x.O_ (16) $ 21.229.33 x .12 (17) x .15 (18) (19) $ 21,229.33 16. Amount of Line 14 taxable at lineal rate $471.762.84 (100%) 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT . ."" , COMMONWEALTH OF .. ..' PENNSYLVANIA . . '! .$.. DEPARTMENT OF REVENUE . , DEPT 280601 ,,~ _ HARRISBURG, PA 17128-0601 RE\'" " '",.x" w >- ::.::S-(/') u"'" W~U ~oo u"'~ ~'" ~ " REV-1500 OFFICIAL USE ONLY INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER Cd L - Jl d- /2 / L1 5- COUNTY COO, YEAR NtMs'R- SOCIAL SECURITY NUMBER I- Z UJ o UJ U UJ o DECEDENTS NAME (LAST FIRST AND MIDDLE INITIAL) Elicker, Eugene R. DATE OF DEATH IMM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 10/11/2002 OS/20/1918 ,IF APPLICABLE) SURVIVING SPOUSES NAME (LAST FIRST. AND MIDOLE INITIAL) None THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 172 01 - 0943 00 1 Original Return "'-1 4.llmlleo Estate '-' [X] 6 Decedent Died Testate {Attach copy of Willi =:J g. Litigation Proceeds Received o 3. Remainder Return (dale 01 d€atn prior to 12.1H2: o 5. Federal Estate Tax Return Required ~ e. Tctal Number oj Sale DepoSIt Boxes o 11. Election to lax under Sec. 91 13(A) iA:lactl Scr 0' o 2. Supplemental Return o 48. Future Interest Compromise {dale of death after 12.12.82) 07. Decedent Maintained a Living Trust\fl.ttacl\~Y\l~T~\l~l D 10. Spousal Poverty Credit (dale ofdealh between 12.3J.!11 and 1.1.95) >- Z W " Z o ~ '" w '" '" o u Mr. Dana E. Elicker COMPLETE MAILING ADDRESS 259 Hillcrest Camp Hi 11, PA Rd. 17011 FiRM NAME ilfApollcablel TELEPHONE NUMBER (717) 761-6978 1 Real Estate (Schedule A) 2 Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) $230,000.00 ,- OFFICIAL USE ONLY El ~~ (~,,~l" ~2 ::3: ell !""i ~ {:r~~' ~:~,;:" I N Closely Held Corporatton. Partnership or Sole-Proprietorship )}G =- CT' 0-( -., CT~ ct) p'i -, E: 4 Mortgages & Notes Receivable (Schedule D) $114,975.33 $137,777.87 z o ~ ...J ::::l l- e: < u UJ e::: 5 Cash Sank Deposits & Miscellaneous Personal Property (Schedule E) 6 JOintly Owned Property (Schedule F) o Separate Billing Requested Inter.vivos Transfers & Miscellsl'leOus NOIl-Pmbale Property (Schedule G or L) 8, Total Gross Assets (total Lines 1-7) (8) $482,753.20 ('" b' 23 , - (6) "'e :. :J>,4 VI ;.:. (7) I L--.________.__ (9) (10) $ 10,803.80 $ 186.56 9 Funeral E~pel'lses & Administrative Costs {SChedule H) 10 Debts of Decedent. Mortgage Liabilities. & Liens (Schedule I) 11 Total Deductions (lotal Lines 9 & 10) 12 Net Value of Estate (Line 8 minus Line 11) (11)~ 10,990.36 (12) $471,762.84 (13) 13 Charitable and Governmental BequeslslSec 91 n Trusts tor which an election to tax has not been made (Schedule J) 14 Net Value Subject to Tax (Line 12 minus Line 13) (14) $471,762.84 SEe INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ I- ::::l Q. :::iE o u >< ~ 15, Amount of Line 14 taxable at the spousal tax. rale, or transfers under Sec, 9116 (a)(l.2) x.O_ (15) x.O_ (16) $ 21.229.33 x .12 (17) x .15 (18) (19) $ 21,229.33 16 Amount of Line 14 taxable at lineal rate $471,762.84 (100%) 17 Amount of Line 14 taxable at sibling rate '\ B Amount of line 14 taxable al collateral rate 19 Tax Due 200 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS ..- 801 N. Hanover St.. CITY Carlisle I STATE PA I ZIP 17013 Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) 2 Credits/Payments A Spousal Poverty Gredit B. Pnor Payments C, Discount (1) $21,229.33 $19.000.00 $ 999.97 Total Credits ( A + 8 + C ) (2) $19. 999 . 97 3. InleresUPenally if applicable D. Interest E. Penally TotallnteresVPenalty ( 0 + E ) 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 A. Enler the Interest on the tax due, (3) (4) (5) $ 1, 229 . 36 (5A) 5 If line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 8 Enter Ihe total at Line 5 + 5A. This is the BALANCE DUE. (58) $ 1. 229 . 36 Make Check Payable to: REGiSTER OF WiLLS, AGENT .....';..1.i'1:1"''rt!1\';it.'M.~'t.lt''1.1tl~t~_"lli_II&lJ:::.._~~~,,L.IJJ.~~l:1l1'1,;'l!'!iJ'f'C'!"I!:'"""""", PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 2 Did decedent make a transfer and: a. retain the use or income of the property transferred;.... b, retain the right to designate who shall use the property transferred or its income;.. c retain a reversionary interest; or...,. d. receive the promise for life of either payments, benefits or care?.... If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ,. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.. Did decedent own an Individual Retirement Account, annuity, or other non~probate property which contains a beneficiary designation? . Yes .......................0 ............0 .....................0 o No [j [] [] [] .0 o ...0 [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 3 4 [] KJ urdar penal'.es of perjury, I declare that I have e~amlned thiS relurn, Including accompanying schedules al1d stalemel1ls, and 10 lhe best 01 my knowledge and beliel, il is IrLle, correct and complete Declaration 01 pre parer other than the personal representative is based on all information of which preparer has any knowledge SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE DATE ADDRESS .::~,.\F't:;';}i(\&il!2\YiJl!'~~"'------ "II r' Ir~ ~ iiIII~ii.I(:i1;l::ihi;'k...;;,,,i.i"6;t:;'..;d..Ld.,,,,,.,, 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 PS 39116 (al (11) (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 PS. 39116 (al (11) (lIiI. The statute does not exempt a !ransfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child IS 0% 172 PS. ii9118(a)(1.2)]. The lax rate Imposed on the nel value of transters to or for the use of the decedent's Imeal beneficiaries is 4.5%, except as noted in 72 PS. 39116(1.2) [72 P.S. 39116(a)(I)1 The tax rate Imposed on the net vaiue of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 39116{a)(1.3)J. A sibling is defined, under Section 9102, as an individual who has al Jeast one parent in common with the decedent, whether by blood or adoption, , , Decedent's Complete Address: STREET ADDRESS 801 N. Hanover St. CITY Carlisle I STATE PA I ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) $21,229.33 $19,000.00 $ 999.97 Total Credits (A+ B + C) (2) $19,999.97 3. InteresVPenalty if applicable D. Interest E. Penalty TotallnteresVPenalty ( 0 + E ) 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 (3) (4) (5) $ 1,229. 36 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) $ 1, 229 . 36 Make Check Payable to: REGISTER OF WILLS, AGENT ~~~D;tNa4E"~'"" ~"~R"~flJ~r~I~~...Jre11~\)m.t,>'li~I~\~~ _,~~!;: ~"""''''''_ l.l ._1$T!~!~~~;/#"j;.'''WM_= ,,!~m"lI 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;.......................................................................................... 0 !9 b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 iU 0. retain a reversionary interest; or.......................................................................................................................... 0 iU d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 iU 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 iU 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 I8J IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and 10 the besl of my knowledge and belief, it is true, correct and complete. Declaration rer other than the personal representative is based on all information of which preparer has any knowledge. SIGN 259 Hillcrest Rd., Camp Hill, PA 17011 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS ~ll.'IOO''I'!.IIr;;'!~~iDi! L'~-OOi!W'if_"""'" ~-, iJ ~-"''''''''"''l<l.~VJ\1I1 ml 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. 99116 (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. 99116 (a) (1.1) (Ii)]. The statute does not exemot 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 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. 99116(a)(I.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficianes is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(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. 99116(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. '!, . ", :;. 'f:"';. ~, '~. .... , \ r' ;po , w ,." "" C :1: G) ;-\ "" r' z: t" t ~ ~ "" ?O 0 ;po !ls:~l'$ S': "l Z. . Cl .... ~ ~ ~ ~ %- 0 II "'" "" ,." ~"'i""f'~~ t" "" ~ ~ '>> \ >-l W "''''s'l\.i '){R () ,." ;0- ~ rJl \ a ?' ;po "" :; ';:;to.... ~ f:I ?O "" ~~'%. ~~ ~ \ z. 1 ~ ~ ,." \\ ~ ,- J LAST WILL AND TESTAMENT OF EUGENE R. ELICKER Date: ~/30/11_ {AJ;//If#VI J. 'SuVdt( Jflh'1 II. 5wv~ LAST WILL AND TESTAMENT I, EUGENE A. ELICKER, of Upper Allen Township, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this to be my last Wi 11 and Testament, hereby revoki ng and making vo id all former wills, codicils and other testamentary dispositions by me at any time heretobefore made. 1. I direct my executor, hereinafter namec, to pay as soon as practicable after my decease all my just debts and the expense of my last illness and burial. 2. I give, devise and bequeath all the rest, residue and remainder of my estate, whatsoever and wheresoever situate, unto my son, Dana E. Elicker. 3. Should my said son predecease me, then and in that event, I give, devise and bequeath all of my said estate unto my granddaughter, Danielle Lynn Elicker. 4. I hereby nominate, corlstitute al~d a~poi~t ~y c~id 80n, Dan~ E. Elicker, executor of this my last Will and Testament. Should my said son, Dana E. Elicker, fail to qualify or cease to act as executor, I appoint my son, E. Robert Elicker, II, executor of this my last Will. 5. I appoint my daughter-in-law, Susan L. Elicker guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so. Such guardian shall have the power to use principal as well as income from time to time for the minor's education, (including post high school education) support and welfare, or to make payment for these purposes, without further responsibility, to the minor, to the minor's parent or to any person taking care of the minor. Should my said daughtger-in-Iaw, Susan L. Elicker fail to qualify or cease to act as guardian of said property, I appoint my son, E. Robert Elicker, II, guardian of any property which passes, either under this will or otherwise, to a minor as set forth above. IN WITNESS WHEREFORE, I, EUGENE R. ELICKER, the tresta tor have hereunto set my hand and seal to this my last Will and Testament this 30th cny of Septembe~f 1991. -~-0~ iJ?4L/~ (SEAL) . Signed, sealed, published and declared by the above named EUGENE R. ELICKER, as and for his last Will and Testament in the presence of us, who, at his request and in his presence and in the presence of each other have hereunto subscribed our names as witnesses thereto. ~~~ ~ ~.C/~, / (7117 If ~ ~"''''''..''''. ' , . , , SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Eugene R. Elicker 2102-1115 All real property owned solely or as a tenant in common must be reported at fair market value, Fair market value is defined as tlle price at which property would be exchanged t-e\\roeen a willllrg buyer ana a W'Il\'lng seller, neither being compelled to buy or sell, both having reasonable knowledge of the reJevant facts Real property whicl1 is jointly-owned with right of survivorshin must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Deed from Eugene R. Elicker and Rachel D. Elicker, his wife, to Eugene R. Elicker dated September 6, 1991 and recorded October 1, 1991 in the Perry County Recorder of Deeds Office in Deed Book 636, Page 172. The said Eugene R. Elicker died October 11 2002 and was predeceased in death by Rachel D. Elicker on November 21, 1998. The attached legal description of said tracts of land are corrected to conform with Orders of Court of Judge Keith B. Quigley, Perry Court of Common Pleas, 41st Judicial District of Pennsylvania, entered on July 13, 1979. Said Orders arose out of ejectment proceedings docketed No. 157 June 1973 Civi and No. 75-372 Civil. The real estate is valued in accordance with an appraisal by Larry E. Foote, Certified General Appraiser (GA-00014-Ll for the estate of Eugene R. Elicker as of October 11, 2002. A copy which is attached hereto. $230,000 TOTAL (Also enter on line 1, Recapitulation) 5230,000 (If more space is needed, insert additional sheets of the same size) Description of Real Estate Tract 1 BEGINNING at a point on the summit of Berry Mountain at line of lands now or late ofL. Henry Hillard; thence along the summit of Berry Mountain, South 850 42' West, 1238.5 feet to a point; thence continuing along the same South 860 55' West, 1331.0 feet to a point at lands not or late of Good Engineering and Construction Company; thence along same North 40 West, 2927.0 feet to a point at lands now or late of John Clouser; thence along same south 89050' East, 977.5 feet to a point at lands now or late of John Hebel; thence along same South 140 15' East a distance of 580.5 feet to a point; thence continuing along same North 870 15' East, 1226.5 feet, to a point; thence continuing along same lands now or late ofL. Henry Hillard, North 880 45' East the distance of 800.0 feet to a point at line oflands now or late ofL. Henry Hillard; thence along same South 90 15' West, 2338.0 feet to the point and place of BEGINNING. CONTAINING One Hundred and Sixty Three (163) acres, more or less. Tract 2 BEGINNING at stones in line ofland now or formerly of John W. Clouser thence South 890 30' East 571 feet to stones; thence South 79030' East 405.3 feet to an iron pin and stones; thence by land now or formerly of Henry Hillard South 9045' East 369.25 feet to an iron pin and stones; thence by land now or formerly of Eugene R. Elicker South 880 West 800 feet to stones; thence by land now or formerly ofW. Evan Hebel north 140 West 534 feet to stones at the point of BEGINNING. CONTAINING nine (9) acres, more ofless, and is in accordance with a survey, dated March 1968, made by Earl D. Palm, a registered surveyor. BEING improved with a mobile home. APPRAISAL REPORT OF A In-ACRE TRACT OF LAND LOCATED AT 829 CHERRY ROAD NEWPORT, PENNSYLVANIA PREPARED FOR THE ESTATE OF EUGENE R. ELICKER AS OF OCTOBER 11, 2002 BY LARRY E. FOOTE DIVERSIFIED APPRAISAL SERVICES EAST HIGH STREET, SUITE 101 CARLISLE, PENNSYL VANIA 17013-3052 (717) 249-2758 COpy SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS LOCATION: 829 Cherry Road Newport, Pennsylvania TAX PARCEL NUMBERS: 030,029.00-029.000 and 030,039.00-003.000 DESCRlPTION: A I 72-acre tract of mountain land with a mobile home with one-story frame addition. PROPERTY RIGHTS: Fee simple interest. SCOPE OF THE ASSIGNMENT: The scope of the assignment included an analysis of the subject's area, an inspection of the subject property, an estimation of the property's highest and best use, consideration of all three approaches to value, and the application of those relevant to the valuation of the subject. OBJECTIVE: To estimate the market value of the subject property as unencumbered. EFFECTIVE DATE: As of October 11,2002. HIGHEST AND BEST USE: Continued use as a hunting camp. COST APPROACH: N.A. SALES APPROACH: $ INCOME APPROACH: N.A. FINAL VALUE CONCLUSION: $ 2 APPRAISAL CERTIFICATION I hereby certifY that upon application for valuation by: THE EST ATE OF EUGENE R. ELICKER the undersigned personally inspected the following described property: All those two certain pieces or parcels ofland situate in the Township of Buffalo, Perry County, Pennsylvania, bounded and described as follows: Tract No. I: Beginning at stone in line of lands now or formerly of Robert R. Stevens; thence by lands now or formerly of said Stevens south 7.5 degrees West, 148.5 perches to a stone at the top of Berry's Mountain; thence along the top of said mountain by lands now or formerly of Kerwin, Kumler, Black, North 84.5 degrees West, 296 perches to a stone at lands now or formerly of George Hebot; thence by lands now or formerly of said Hebot and lands now or formerly of John D. Bogar & Sons, North 9.5 degrees East, 212 perches to stones at comer oflands now or formerly of John Clouser; thence by lands now or formerly of John Clouser, East 59.5 perches to a chestnut and white oak stump; thence by lands now or formerly ofW.H. Hebel South 21 degrees East, 47.5 perches to a stone; thence by lands now or formerly ofW.H. Hebel and Robert Stevens, South 84.5 degrees East, 165.5 perches to a stone, the place of beginning. Less, however, outparcels of record, for a net area of 163 acres, more or less. Tract No.2: Beginning at stones in line of land now or formerly of John W. Clouser; thence South 89 degrees 30 minutes East, 571 feet to stones; thence South 79 degrees 30 minutes East, 405.3 feet to an iron pin and stones; thence by land now or formerly of Henry Hillard South 9 degrees 45 minutes East, 369.25 feet to an iron pin and stones; thence by land now or formerly of Eugene R. Elicker South 88 degrees West, 800 feet to stones; thence by land now or formerly ofW. Evan Hebel North 14 degrees West, 534 feet to stones at the point of beginning. Containing 9 acres, more or less, and being improved with a mobile home and a one-story frame additi on. To the best of my knowledge and belief the statements contained in this report are true and correct, and that neither the employment to make this appraisal nor the compensation is contingent upon the value reported, and that in my opinion the Market Value as of October II, 2002 is: TWO HUNDRED THIRTY THOUSAND DOLLARS $230,000 The property was appraised as a whole, subject to the contingent and limiting conditions 3 outlined herein. 4 L E. Foote Certified General Appraiser GA-OOOOI4-L PURPOSE OF THE APPRAISAL The purpose of this appraisal is to estimate the Market Value of the subject property as of October It, 2002. Market Value, as defined by the courts, is the most probable price estimated in terms of money which a property will bring if exposed for sale in the open market, allowing a reasonable time finding a purchaser who buys with knowledge of all the uses to which it is adapted and for which it is capable of being used. Frequently, it is referred to as the price at which a willing seller would sell and a willing buyer would buy, neither being under abnormal pressure. HIGHEST AND BEST USE Highest and Best Use is defined by the Appraisal Terminology and Handbook, published by the Appraisal Institute, as "the most profitable likely use to which a property can be put". The opinion of such use may be based on the highest and most profitable continuous use to which the property is adapted and needed, or likely to be in demand, in the reasonable near future. However, elements affecting value that depend upon events or a combination of occurrences which, while within the realm of possibility, are not fairly shown to be reasonably probable, should be excluded from consideration. Also, if the intended use is dependent on an uncertain act of another person, the intention carmot be considered. Based on the above definition and after seeing the site, neighborhood, and area, it is my opinion that use of the subject as a hunting camp is its Highest and Best Use. 5 SITE DATA ADDRESS: 829 Cherry Road TOWNSHIP: Buffalo COUNTY: Perry STATE: Pennsylvania LOT SIZE: Approximately 172 acres. SEWERS: On-site privately owned septic system. WATER: On-site privately owned spring. ELECTRICITY: Public utility. ZONING: None in this municipality. DETRIMENTAL INFLUENCES None. Pride of ownership is evident throughout the area. DESCRIPTION OF THE SITE The subject site consists of an irregular shaped tract of mountain land containing 172 acres, more or less. The topography of the site ranges from level to steep, and there does not appear to be any drainage problems. According to the Federal Emergency Management Agency map, the site is not located in an area which is prone to flooding. In the absence of core boring, it has been assumed that there are no mineral deposits of a commercial nature underlying the subject site. For the same reason, it is assumed that there are no unusual sub-soil conditions that would adversely affect the subject site. This tract of mountain land was timbered in 199]. Therefore, there does not appear to be any significant value attributable to the trees on the site. Access to the site is via a dirt road identified as Cherry Road, and visibility of the site from this roadway is considered to be average. Public utilities at the site include electricity. Water is provided by an on-site spring and sewage is disposed of by an on-site septic system. 6 DESCRIPTION OF THE IMPROVEMENTS The subject improvements consist of a 1965 12-foot by 60-foot Marlette mobile home with a one-story 12.5-foot by 18.5-foot frame one-room addition, constructed upon a partial basement with concrete block walls and a concrete floor. The exterior walls of the mobile home are of metal and the exterior walls of the addition are of wood sheathing. Roofing is of the gable type, covered with shingles. The interior of this dwelling is divided into a living room, kitchen, dining room, two bedrooms, family room and a full bathroom with built-in tub and shower. The building is heated by an oil-fired forced hot air central heating system and an auxiliary woodbuming stove in the family room. Electricity is distributed by a modern circuit breaker electrical system. All improvements are considered to be in average to good condition on the interior and on the exterior, with mechanical systems appearing to be adequate and functioning properly. 7 THE APPRAISAL PROCESS Three approaches to value are generally included in an appraisal report. These techniques include the cost approach, sales comparison approach, and income approach to value. The cost approach to value is based on the assumption that the reproduction cost of a building plus land value, tends to set the upper limit to value. A key assumption is that a newly constructed building would have advantages over the existing building, therefore an evaluation focuses upon disadvantages or deficiencies (depreciation) of the existing building compared to a new facility. The sales comparison approach to value assumes that under normal conditions, a given number of parties acting intelligently and voluntarily, tend to set a pattern from which value can be estimated. Application of this approach relies on a comparison of the subject with a sufficient number of recent transactions of comparable properties in the market, based on a common unit, such as price per square foot of building area or price per acre. The income approach concerns itself with present worth of the future potential benefits of a property. The initial estimate involves the net income, which a fully informed person is justified in assuming the property will produce during its remaining useful life. This estimated net income is then capitalized into a value estimate, based upon the level of risk as compared with that of a similar type and class. Since the subject property consists of a large tract of mountain land with an older mobile home the cost approach to value is not considered to be appropriate and similar properties are not typically used as income producing properties. Therefore, in accordance with the departure provision of the Uniform Standards of Professional Appraisal Practice, only the sales comparison approach to value has been applied to the subject property and is subsequently presented. 8 SALES COMPARISON APPROACH In arriving at this conclusion of the value of the subject property, the appraiser made a survey of properties that have sold in the area of the subject property. Consideration was given and adjustments were made on each comparable sale as to time of sale, size, location, as well as all other factors that might affect value. A resume of some of the sales considered by the appraiser is as follows: SALE NO. I: Location: Parcel No.: Date of Sale: Deed Ref.: Sale Price: Size: Unit Price: Grantor: Grantee: SALE NO.2: Location: Parcel No.: Date of Sale: Deed Ref.: Sale Price: Size: Unit Price: Grantor: Grantee: SALE NO.3: Location: Parcel No.: Date of Sale: Deed Ref: Sale Price: Size: Unit Price: Grantor: Grantee: Route 17, Tuscarora Township 260,042.00-030.000 October 4,2002 Book 1559, Page 249 $271,075 151.41 acres with a 384 square foot frame cabin in poor condition. $1,790 per acre Howard P. Trego, Jr. Amos S. and Naomi F. Esh Notch Road, Watts Township 280,062.00-051.000 May 30, 2001 Book 1374, Page 272 $150,000 112 acres with a 540 square foot frame cabin in average condition. $1,339 per acre Harold W. Grove Gary W. and Chamette J. Wilt Route 850, North East Madison Township 141,093.00-029.000 July 17, 2002 Book 1530, Page 119 $72,500 47.27 acres with a 432 square foot frame cabin with screened porch in average condition. $1,534 per acre Melvin H. Bowman Ronald L. Cree 9 The appraiser, in addition to the sales listed, also considered several additional sales in arriving at his final opinion of value. On the Sales Comparison Analysis form that follows this page are dollar adjustments reflecting market reaction to those items of significant variation between the subject and comparable properties. If a significant item in the comparable property is superior to, or more favorable than, the subject property, a minus (-) adjustment is made, thus reducing the indicated value of the subject; if a significant item in the comparable is inferior to, or less favorable than, the subject property, a plus (+) adjustment is made, thus increasing the indicated value of the subject. After making all of the necessary adjustments, it is the appraiser's considered opinion that the indicated value of the subject property by the Sales Comparison Approach is $230,000. ]0 SALES COMPARISON ADJUSTMENTS The appraiser has analyzed comparable sales and has developed dollar adjustments, reflecting market reaction to those items of significant variation between the subject and comparable properties. If a significant item in the comparable property is superior to, or more favorable than the subject property, a minus (-) adjustment is made, thus reducing the indicated value of the subject; if a significant item in the comparable is inferior to, or less favorable than the subject property, a plus (+) adjustment is made, thus increasing the indicated value of the subject. SALE # I SALE #2 SALE #3 Sale Price $271,075 $150,000 $ 72,500 Land Size +24,700 + 72,000 +149,700 Improvements +19,000 +8.200 +10.400 Net Adjustment +43,700 +80.200 + 160,100 Indicated Value: $314,775 $230,200 $232,600 I] SALE NO. 1: Location: Parcel No.: Date of Sale: Sale Price: Size: Unit Price: SALE NO.2: Location: Parcel No.: Date of Sale: Sale Price: Size: Unit Price: SALE NO.3: Location: Parcel No.: Date of Sale: Sale Price: Size: Unit Price: SALE NO.4: Location: Parcel No.: Date of Sale: Sale Price: Size: Unit Price: VACANT LAND SALES E. Hominy Ridge Road, Juniata Township 100,044.00-048.000 February 7, 2002 $120,000 106.12 acres $1,131 per acre Boot Hollow Road, Saville Township 230,068.00-052.000 May 16,2002 $65,000 60.90 acres $1,067 per acre Millers Gap Road, Rye Township 220,167.00-013.001 July 31, 2001 $150,000 79.25 acres $1,893 per acre Route 4006, Tuscarora Township 260,043.00-043.000 October I, 200 I $90,000 76.11 acres $1,183 per acre ]2 CORRELATION Correlation may be defined as "the bringing together of parts in a proper relationship." The parts ofthis appraisal report are the following approaches to value your appraiser used: Value Indicated by Cost Approach Value Indicated by Sales Comparison Approach Value Indicated by Income Approach NA $230,000 NA These approaches are representative of the market value of the subject property. I have carefully reexamined each step in each method, and I believe the conclusions accurately reflect the attitude of typical purchasers of this type property in this neighborhood. It is my belief that this reexamination has confirmed the original conclusions. The Sales Comparison Approach was based on several recent sales of properties similar to that of the subject, all of which are located in the same general area. The adjusted sales prices are most consistent under comparison. This approach is the most reliable because it reflects the reactions of typical buyers and sellers in the market. Therefore, as a result of this appraisal and analysis, it is this appraiser's considered judgment and opinion that the Market Value of the subject property, as of October I 1,2002, is: TWO HUNDRED THIRTY THOUSAND DOLLARS $230,000 13 UNDERLYING ASSUMPTIONS AND LIMITING CONDITIONS SUBJECT TO THIS APPRAISAL I. I assume no responsibility for matters legal in nature, nor do I render any opinion as to the title, which is assumed to be marketable. The property is appraised as though under responsible ownership. 2. The legal description used herein is correct. 3. I have made no survey of the property, and the boundaries are taken from records believed to be reliable. 4. I assume that there are no hidden or unapparent conditions of the property, subsoil or structures which would render it more or less valuable. I assume no responsibility for such conditions or for engineering which might be required to discover such factors. 5. The information, estimates, and opinions furnished to me and contained in this report were obtained from sources considered reliable and believed to be true and correct. However, no responsibility for accuracy can be assumed by me. 6. This report is to be used in its entirety and only for the purpose for which it was rendered. 7. Neither all nor any part of the contents of this report (especially any conclusions as to value, the identity of the appraiser or the firm with which he is connected) shall be reproduced, published, or disseminated to the public through advertising media, public relations media, news media, sales media, or any other public means of communication, without the prior written consent and approval of the appraiser. 8. This appraisal was prepared for the exclusive use of the client identified in this appraisal report. The information and opinions contained in this appraisal set forth the appraiser's best judgment in light of the information available at the time of the preparation of this report. Any use of this appraisal by any other person or entity, or any reliance or decisions based on this appraisal are the sole responsibility and at the sole risk of the third party. The appraiser accepts no responsibility for damages suffered by any third party as a result of reliance on or decisions made or actions taken based on this report. 14 CERTIFICATE OF APPRAISAL Your appraiser hereby certifies that: I. The statements of fact contained in this report are true and correct. 2. The reported analyses, opinions, and conclusions are limited only by the reported assumptions and limiting conditions, and are my personal, impartial, and unbiased professional analyses, opinions, and conclusions. 3. I have no present of prospective interest in the property that is the subject of this report, and no personal interest with respect to the parties involved. 4. I have no bias with respect to the property that is the subject of this report or to the parties involved with this assigmnent. 5. My engagement in this assignment was not contingent upon developing or reporting predetermined results. 6. My compensation for completing this assignment is not contingent upon the development or reporting of a predetermined value or direction in value that favors the cause of the client, the amount of the value opinion, the attainment of a stipulated result, or the occurrence of a subsequent event directly related to the intended use of this appraisal. 7. To the best of my knowledge and belief, the statements of fact contained in this appraisal report, upon which the analyses, opinions, and conclusions expressed herein are based, are true and correct. 8. This appraisal report sets forth all of the limiting conditions (imposed by the terms of my assigmnent or by the undersigned) affecting the analyses, opinions, and conclusions contained in this report. 9. This appraisal report has been made in conformity with the Uniform Standards of Professional Appraisal Practice adopted by the Appraisal Standards Board of the Appraisal Foundation, and is subject to the requirements of the Code of Professional Ethics and Standards of Professional Conduct of the National Association of Realtors Appraisal Section. 15 10. No one other than the undersigned prepared the analyses, conclusions, and opinions concerning real estate that are set forth in this appraisal report. ~~S'94 Larry E. Foote Certified General Appraiser GA-000014-L 16 ,.' LARRY E. FOOTE REAL ESTATE APPRAISER EXPERIENCE: I 979-Present: Chief Appraiser, Diversified Appraisal Services, Carlisle, Pa, Principal Broker, LaRue Development Company, Carlisle, Pa. 1976-1979: Associate Broker, Colonial Realty, Carlisle, Pa 1972-1976: Realtor Associate, Jack Gaughen Realtor, Carlisle, Pa. Appraisal experience included undeveloped land, farms, building lots, single-family dwellings, mobile home parks, medical centers, nursing homes, motels, apartment buildings and complexes, office buildings, service stations, veterinary clinics, rehabilitation centers, retail buildings, daycare centers, warehouses, and manufacturing facilities. EDUCATION: Bachelor of Business Administration, Pennsylvania State University, 1976. Associate Bachelor of Business Administration, Harrisburg Area Community College, 1974. Diploma, Carlisle Senior High School, 1965. Certificate, Pennsylvania Realtors Institute, GR! I, GR! II, GR! 111. Certificate, Realtors National Marketing Institute, CI 101, Cl102, CI 103, Cl104, CII05. Standards of Professional Practice, American Institute of Real Estate Appraisers. Real Estate Appraisal Principles, American Institute of Real Estate Appraisers. Residential Valuation, American Institute of Real Estate Appraisers. Appraisal Procedures, Appraisal Institute. Principles of Income Property Appraising, Appraisal Institute. Case Studies in Real Estate Valuation, Appraisal Institute. Report Writing and Valuation Analysis, Appraisal Institute. PROFESSIONAL LICENSES: General Appraiser #GA-OOOO 14-L, Commonwealth of Pennsylvania. Real Estate Broker #RB-029729-A, Commonwealth of Pennsylvania. PROFESSIONAL DESIGNATIONS: GRI: Graduate of the Pennsylvania Realtors Institute, awarded by the Pennsyl- vania Association of Realtors. CRS: Certified Residential Specialist, awarded by the Realtors National Market- ing Institute of the National Association ofReaItors. CCIM: Certified Commercial Investment Member, awarded by the Realtors National Marketing Institute of the National Association of Realtors. PROFESSIONAL ORGANIZA nON AFFILIA nONS: National Association of Realtors Appraisal Section. Carlisle Association of Realtors. Pennsylvania Association of Realtors. National Association of Realtors. Realtors National Marketing Institute. 17 ."., , , h' PAST CLIENTS: Borough of Carlisle Keystone Financial Mortgage Cornerstone Federal Credit Union Pennsylvania State Bank Commerce Bank Cumberland-Perry Association for Retarded Citizens Carlisle Suburban Authority Members I" Federal Credit Union Pennsylvania National Bank Evans Financial Corporation Greenawalt & Company, CPA Smith's Transfer Corporation Carlisle Department of Parks and Recreation Executive Relocation Services Carlisle Area School District Messiah Homes, Incorporated ERA Eastern Regional Services Pennsylvania Turnpike Commission Chase Home Mortgage Corporation Defense Activities Federal Credit Union Pennsylvania State Employees Credit Union PNC Mortgage Corporation F&M Trust Company National City Mortgage Corporation Washington Mutual Home Loans, Inc. Prudential Relocation Services Lender's Choice Market Intelligence, Incorporated United Telephone Employees Federal Credit Union Cumberland County Commissioners Allstate Enterprises Mortgage Corporation Dickinson College PPG Industries, Incorporated Gettysburg College Redevelopment Authority of Cumberland County Record Data Appraisal Services, Incorporated First United Federal Savings Association Fulton Bank United States Marshall Service GMAC Mortgage Corporation Orrstown Bank Letterkenny Federal Credit Union BancPlus Mortgage Corporation Coldwell Banker Relocation Services, Incorporated Central Pennsylvania Savings Bank Mellon Bank Provident Home Mortgage Corporation Various law firms and individuals ]8 , ,. '.' <, ,- .\/; ~1 r ::~ !~~;~"~~tJ . ~. .' . - " ~ ~' >:0..:, .' ~~~Ij. ~-,-, PHOTOGRAPHS OF THE SUBJECT PROPERTY 19 .-::'~~.<~ <~, ." " ..".:~..-" ""'f,;-.y" ~~;: .::...~ , "I~/~~';:7*,: ..<YfoG...... OF ".' SU.,.CT .'0"'" 20 RE:"ISO"'X'\('-'I~~ ,.~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Eugene R. Elicker FILE NUMBER 2102-1115 Include the proceeds of litigation and the date the proceeds were received by the estate_ All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. OESCRIPTION VALUE AT DATE OF DEATH New Momentum Annuity Policy # 2100049256 2. Security Deposit Refund- Church of God Nursing Home 801 N. Hanover St. Carlisle, PA $ 99,760.00 $ 4,563.73 3. Pre-Paid Funeral Policy # PNPA002417 American Founder's Life Administrative Services $ 9,467.30 4. PPL Refund- Balance remaining on prepaid electricity for mountain cabin in Perry County $ 45.90 5. Federal Income Tax Refund $ $ 429.00 709.40 6. Overpayment Refund- Parthemore Funeral Home TOTAL (Also enter on line 5, Recapitulation) $114, 975. 33 (If more space is needed, insert additional sheets of the same size) . . ",RE\l-1509fX.11'97J~~ ..~ COMMONWEALTH OF PENNS' LVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTL Y.OWNED PROPERTY Eugene R. Elicker FILE NUMBER 2102-1115 ESTATE OF If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Dana E. Elicker 259 Hillcrest Road, Camp Hill, PA 17011 Son B. Susan L. Elicker 259 Hillcrest Road, Camp Hill, PA 17011 Daughter-In-Law c. 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 DECO'S VALUE OF NUMBER TENANT JOINT deed for joinUy-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 5/18/95 PNC Checking Account # 50-7009-9002 $ 16,849.52 33% $ 5,616.51 B. 11/7/97 2. A. 6/1/92 Wachovia Securities Acct. # 3021-7189 'Lehi9h Co. G.. Pur Auth Bonds C-524805J33 $ 9,949.06 50% $ 4,974.53 Lebanon Health Fac Auth Bonds C-522454BLO $ 14,099.20 50% $ 7,049.60 3. A. 9/27/95 Oppenheimer Strategic Income Fund Acct.2302303753211 $103,193.671 50% $ 51,596.84 4. A. 9/27/95 Oppenheimer PA Municipal Fund Acct. 7407400053284 $120,212.25 50% $ 60,106.13 5. A. 9/30/96 Lucent Technologies Stocks Acct. # 0005396700 116.008 Shares @ .58 (Close 10/11/02) $ 67.28 50% $ 33.64 6. A. 12/7/88 AT&T Stocks Acct. # 18333-5801 199.832 Shares @11.97 (Close 10/11/02) $ 2,931.99 50% $ 1,196.00 7. A. 6/11/92 Be11South Stocks Investor 10# 125402609815 613.1463 Shares @23.37 (Close 10/11/02) $ 14,329.23 50% $ 7,164.62 TOTAL (Also enter on line 6, Recapitulation) $ $137,777.87 (If more space is needed, insert additional sheets of the same size) . . ~E\"1~' 1EX. 1'-"1) - . '*' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDENT DECE ENT FILE NUMBER 2102-1115 EST ATE OF Eugene R. Elicker Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. American Founder's Life Administrative Services $ 9,467.80 Pre-Paid Funeral- Policy #PNPA002417 2 . Headstone Engraving- Gingrich Memorials $ 95.00 B ADMINISTRATIVE COSTS 1 Personal Representative's Commissions Name of Personal Representative (s) None Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City Stale Zip Year(s) Commission Paid: 2 Attorney Fees Deed research and preparation $ 426.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant None Street Address City State Zip Relationship of Claimanlto Decedent 4 Probate Fees + Short Certificates $ 377.00 5 Accountant's Fees 6 Tax Return Preparer's Fees Janice Atwood $ 80.00 7 Real Estate Appraisal- La.rry E. Foote, Appraiser $ 300.00 8. Filing of Deed- Perry County Recorder $ 39.50 9. Clean & Green Enrollment Transfer Fees $ 18.50 TOTAL (Also enter on line 9, Recapitulation) $10,803.80 (If more space is needed, insert additional sheets of the same size) .. . REV-!ST2EX.(1-971 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN R~SIDENT DECEDENT ESTATE OF Eugene R. Elicker FILE NUMBER 2102-1115 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. Mobile X-Ray Imaging, Inc. Ambulance Transportation 9/2 5120 Lancaster Street Harrisburg, PA 17111 $ 21.56 2. PA Department of Revenue- State Income Taxes $165.00 TOTAL (Also enter on line 10, Recapitulation) $ 186. 56 (If more space is needed, insert additional sheets of the same size) , . .. . REV-151~EX.11-97)_~ . .~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Eugene R. Elicker NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY [ , TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. Dana E. Elicker, 259 Hillcrest Rd. Camp Hill, PA 17011 FILE NUMBER 2102-1115 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Son AMOUNT OR SHARE OF ESTATE 100'/, ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTiONS 1. TOTAL OF PART n. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (It more space is needed, insert additional sheets of the same size) STATUS REPORT UNDER RULE 6.1 Name of Decedent: Date of Death:. Will No.: 2/-~j//~ Aden. No.: Pursuant to Rule 6.12 of the Supreme Corn10Chans' Cou~ Rules, I repo~ ~e following wi~ respect to completion of the ad~stration of the above-captioned estate: 1. State whether a~stration of the estate is complete: Yes 2. If~e ~swer is No, state when ~e personal representative reasonably believes · at the a~i~s~ation will be complete: 3. ~the answer to No. 1 is Yes, state the follow~g: a. Did the personal ~sentative file a ~al accost with ~e Co~? Yes _ No b. The sep~ate OCh~' Co~ No. (if any) for the person~ representative's accost is: c. Did the personal repj.~sentative state an account informally to the parties in interest? Yes ~ No ['-] c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this~r~ ~/~14~ C .... Date: ~/~6/ Signature Name Address / - :: .., Telephone No. C%r~acity: ~'ersonal Renresentative /--1 Counsel for personal representative JRD/June 30, 1992/17858 [40V 0 g 2004 In Re: Estate of Eugene R Elicker : ORPHANS' COURT DIVISION Late of Carlisle Borough : COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY Estate No.: 21-02-1115 : PENNSYLVANIA : : NO. 21-02-1115 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Dana Elicker Counsel for Personal Representative: Date of Decedent's Death: 10/11/2002 Date of Delinquency Notice: 08/11/04 The undersigned, Glenda Famer~Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on April 30, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 11/08/04 Glenda Farner Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Estate File A heahng is scheduled for at in Cou~oom No. 3. If the~tatus Reao~ is filed prior to the heahng date, the he~ing will automatically be cancel Geo~~f~r~.J. Glenda Farner Strasbaugh Register of Wills & ~ One Courthouse Square Clerk of the Orphans' Court Carlisle, Pa. 17013 Marjorie A. Wevodau (717) 240-6345 First Deputy FAX (717) 240-7797 Kirk S. Sohonage, Esquire Solicitor OFFICES OF egi t r of iliaill tgle of ®rp an¢ tgourt December 21, 2004 Ms. Dana R. Elicker 259 Hillcrest Road Camp Hill, PA 17011 IN RE: Estate of Eugene R. Elicker - 21-02-1115 Dear Ms. Elicker: It has come to my attention as solicitor for the Office of the Register of Wills and Clerk of the Orphans' Court in and for Cumberland County, Permsylvania, that the above estate has failed to file a report of the status of administration as required by Pennsylvania Orphans' Court Rule 6.12. Subsection (f) of Rule 6.12 requires that the Register of Wills notify the Court in the event the personal representative or counsel fails to file this notice after (10) days written notice thereof. You have already received written notice of this delinquency by the Register. Kindly accept this letter as written notification that unless the required 6.12 Status Report is filed with the Register of Wills Office within ten (10) days of your receipt of this correspondence, I will be compelled to file a Motion for Sanctions for Failure to Comply with Orphans' Court Rule 6.12. If required to do so, I will request that the Court grant counsel fees and court costs to be assessed against the offending party. Sincerely,~;~/~ ~ Kirk S. Sohonage Solicitor