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HomeMy WebLinkAbout02-0282Register of Wills of Cumberland COunty, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Colin C. Bender No~--~/- O¢~. - ~.~.2..., also known as , Deceased Social Security No. 161-34-0869 Petitioner(s), who is/are 18 years of age or older, apply(les) for: (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut ors [-~ Decedent, dated 8/28/01 and codicil(s) dated named in the Last Will of the State relevant circumstances, e.g., renunciation, death of exec,,tor, 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 incapacitated: B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascedained the 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 217 South Enola Drive~ East Pennsboro Township~ (Enola~ PA 17025) (list street, number and municipality) Decedent, then 60 years of age, died February 20 ,2002 , at Holy Spirit Hospital, East Pennsboro Township (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 ........................................................................................ $ Total ..................................................................................................................... $ Real Estate situated as follows: 240~000.00 87~560.00 327~560.00 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: / Signature Typed or printed name and residence Nelson C. Hart 8268 W.B. and A Road Severn, MD 21144 Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and 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, a,s personal re~sentative(s) of the Decedent,, Petiti°ner(s) will well and truly administer the estate ~law2 . ~ Sworn to and affirmed and subscribed Nelson C. Hart before me this. '15t,5 day of MARCH 2002 ' ~]~Y C~IS'-- Laud Beth Warrick DECREE OF REGISTER Estate of Colin C. Bender also known as Deceased No. Social Security No: 161-$4-Q~69 Date of Death: 2/20/02 AND NOW, NAR. CB 19, 2002 , , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [~ Testamentary I~ of Administration testam~_ntarv (c.t.a., d.b.n.c.t; pend~nte lite; durante absentia; durante minoritate) are hereby granted to N~,J_~SON C HART A~D ~z~,LTRI BETH NAR.RICK in the above estate and that the instrument(s), if any, dated 08-28-2001 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters .................................... Short Certificate(s) ............... Renunciation .......................... Affidavit ( ) ....................... Extra Pages ( ) .............. $ 305.00 $ 24.00 $ $ 9.00 Codicil ................................. $ JCP Fee ................................. $ Inventory & Tax Forms ............. $ Other ...................................... $ 5.00 Attorney: Kent H. Patterson I.D. No: 15307 Address: 221 Pine Street Harrisburg PA 17101 TOTAL ............................. $ 343.00 mailed to attorney on 3~19-02 Telephone: (717) 238-4100 DATE FILED: 3-15-02 RW-7A Colin C. Bender Continuation of Petition for Grant of Letters Page 1 List Petitioner(s) Requesting the Probate of the Last Will... Signature Typed or printed name and residence ILauri Beth Warrick 314 Sawmill Arch Chesapeake, VA 23323 H105.805 REV 9/86 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 8030 33 FEB 2002 No. Local Registrar Date ; 43 Rev 2/67 NAME OF DECEDENT (F ,rsL M.JOle. L~I COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH Colin C. Bender u.o~., ~I t.~o?, D~ 60 v,,. { 12/25/1941 Cumberland asr Pennsboro ~p Clerical Pa. State Police ~.~. ~o,~,. ,~ White Divorced 217 S. Enola Dr. _ o~ ,,~.~,~.~,~ East Pen~ ro ,~nola, Pa. 17025 Cumberland ,. Clair R Bender ~ ~ c,~,~ ~m~.~ ~ ~~rn~aryla~ 21144 .............. ~,~ al~ver a r' ~.~...~1,,~ ~?k~.~i.~.,..,~.~,.~ ..... ,~ ,~ .... n ~'... Z~ S Enola ur. Enola,Pa. 17025 -~ ~ ~.~. PERFORMED? OUt l'O[Ofl AS XCOi~[OOE ~E O~: ' ~ I,-'~- M. lace. Iaea. LAST WILL AND TESTAMENT OF COLIN C. BENDER I, COLIN C. BENDER, of the Township of East Pennsboro, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. I direct the payment of all my just debts and funeral expenses as soon after my decease as tb~e same can be conveniently done, and in this respect also, I direct that my personal representatives, hereinafter named, arrange to have the year of my death inscribed on my cemetery monument within thirty (30) days after the date of my decease. I give and bequeath the sum of Twenty-five Thousand ($25,000.00) Dollars to HOSPICES OF CENTRAL PENNSYLVANIA. -1- I give and bequeath all the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, to my following named nephews and niece, to wit, RANDY L. }~RT, NELSON C. }{ART, JEFFREY S. HART and LAURI BETH t~RT WARRICK, share and share alike, per stirpes. For the purpose of facilitating the settlement and distribution of my estate, I authorize and empower my Executors hereinafter named, to sell any and all real estate which I may own at the time of my decease, as well as my personal property and tangible goods, at either public or private sale or sales. LASTLY, I nominate, constitute and appoint my niece, IA~I BETH W^RRICK and my nephew, NELSON C. HART, Co-Executors of this my Last Will and Testament and direct that they be excused from posting bond or other security for the faithful performance of their duties in any jurisdiction. -2- IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ ~ day of August, A. D., 2001. Colin C. Bender .(SEAL) -3- COMnMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS. I, COLIN C. BENDER , the testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for the purposes therein contained. Sworn and affirmed to and acknowledged before me by_._ COLIN C. BENDER , the testatol~ , this ~-/- day of AU.F, ust , A. D. ~ 2001. Colin C. Bender Notary Public COmmONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAJND ) SS. Ma,lyn E. Williams, Notary Public Mechanicsburg Boro, Cumberland Courmf My Commission Expires Nov. 6, 2001 Member, pennsylvania Association Of Not,3ries We, the undersigned, J. ROB}~T STAUFFER and KATHY S. LITTLE , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testatOr , COLIN C. BENDER , sign and exe- cute the instrument as his/k~r Last Will and Testament; that the said testato~ , COLIN C. BEND]~ , executed it as his/~ free and voluntary act for the purposes there~n expressed; that each of us, in the hearing and sight of the testat O~ , signed the Will as witnesses; and that to the best of our knowledge, the testat oP was, at the time, eighteen (i8) or more years of age, of sound mind, and under no copstraint, duress or undue influence. Sworn and ~ib::yt:fbefore/¢~ ~ /;'~ me this ' - August , ~001. Notary Public ...... ;Notadal Seal '" - '] Mafilyn E. WiUk~ms, Notary Pubic Mechanicsburg Boro, Cumberland Cour~ . My Commission Expires Nov. 6, 2001 Member, PennSylvania A3s~ciation ot Notariet~ REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of decedent Colin C. Bender Date of death February 20, 2002 Will No. Admin No. 00282-2002 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on August 1, 2002. Name Address Randy L. Hart 315 Grove Park Road, Brooklyn, MD 21225 Jeffrey S. Hart 7517 Old Coaling Road, Apt. 2 Harmans~ MD 21077 Notice has now been given to all persons entitled thereto under Rule 5.6(a). Capacity: Name Kent H. Patterson Address 221 Pine Street Harrisburg, PA 17101 Telephone (717) 238-4100 Personal Representative X Counsel for Personal Representative REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of decedent Colin C. Bender Date of death February 20, 2002 Will No. Admin No. 00282-2002 To the Register= I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on August 2, 2002. Name Address Lauri Beth Warrick 314 Sawmill Arch, Chesapeake, VA 23323 Nelson C. Hart 8268 W.B. and A. Road, Severn, MD 21144 Hospice of Central Pennsylvania 98 South Enola Drive Notice has now been given to all persons entitled thereto under Rule 5.6(a). Date: Signature Name Kent H. Patterson Address 221 Pine Street Telephone Harrisburg, PA 17101 (717) 238-4100 Capacity: Personal Representative X Counsel for Personal Representative REV-1500 EX ,~ (6-00) Z LLI 1,1.1 Z o O,. I.IJ o z z 0 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 2806O1 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAl. Bender~ Colin C. DATE OF DEATH (MM-DD-Year) 02/20/2002 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT IDATE OF BIRTH (MM-DD-Year) 12/25/1941 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY /7- FILE NUMBER COUNTY CODE YEAR SOCIAL SECURITY NUMBER 1 6 1 -3 4-0 8 6 9 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER r~l. Original Return [~4. Limited Estate [~]6. Decedent Died Testate (Attach c®y of E~9. Litigation Proceeds Received [~ 2. Supplemental Return []4a. Future Interest Compromise (dale of death alter 12-12-82) 7. Decedent Maintained a Living Trust (Attach c®y of tru.~) O 10. Spousal Poverty Credit (date of death belween 12-31-91 and 1-1-95) [~3. Remainder Return (date of death priorto 12-13-82) D5. Federal Estate Tax Return Required 1__. 8. Total Number of Safe Deposit Boxes ['"'~ 11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME Kent H. Patterson FIRM NAME (If Applicable) TELEPHONE NUMBER (717) 238-4100 COMPLETE MAILING ADDRESS 221 Pine Street Harrisburg PA 17101 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Properly (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (8) r'~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11 ) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 87~00.00 1[086.75 74t629.80 OFFICIAL USE ONLY (8) (11) 47t682.28 1 ~461.59 162~716.55 49~ 143.87 (12) (13) 113~572.68 25~000.00 (14) 88~572.68 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 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 20. X ~ (15) X ~ (16) X .12 (17) 88~572.68 X .15 (18) (19) 13~285.90 13~285.90 ' Deced6nt's Complete Address: STREET ADDRESS 217 South Enola Drive East Pennsboro Township, Cumberland County C~TY Enola ISTATE PA 7025 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits ( A + B + C ) (2) (1) 13~285.90 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. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE BUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ........................................................................... [] [] b. retain the dght to designate who shall use the property transferred or its income; ........................................ [] [] c. retain a reversionary interest; or ...................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ............................................................. [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................................................................................... [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? ................. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... [] [] 1 3~285.90 13~285.90 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 perjury, I declare that I have examined this retum, i~cluding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Decla~tion of preparer other than the personal representative is ba~ on all information of which preparer has any knowledge. SlGI~TURE {~F PERSON J~F~SPONSIJ~LE FOR FILII~J~'RETURN DATE ADEIRESS Nelson C. Hart 8268 W.B. and A. Road~ Severn MD 21 144 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS Lauri Beth Warrick 314 Sawmill Arch, Chesapeake DATE VA 23323 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 affer July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ,{9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ,{9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-~ 502EX * (1.-~7) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RErURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Bender. Colin (~, 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 right of survivorship must be disclosed on Schedule F. ITEM NUMBER VALUE AT DATE DESCRIPTION OF DEATH 217 South Enola Road East Pennsboro Township, Cumberland County Enola, PA 17025 settlement sheet for sale of property is attached) TOTAL (Also enter on line 1, Recapitulation) 87,000.00 87~000.00 (If more space is needed, insert additional sheets of the same size) A. Settlement Statement U.S. Department of Housing and Urban Development OMB Approval No. 2502~0265 8. Mortgage Insurance Case Number B. Typo of Loan 1. [] FHA 2. [] FmHA 3. [] Conv. Unins. 6. FiieNumbe, J7. LoanNumber 4. [] VA 5. [] Conv. Ins. I C. Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown, items marked "(p.o.c.)" were paid outside closing; they are shown here for informational purposes and not included in the totals. O. Name and Address of Borrower E. Name and Address of se,a~_.auri Beth Warrick Shirley M. Neibert Nelson C. Hart, Co-Executors Estate of Colin C. Bender 5245 Wertzville Road 8268 W.B. and A. Road Enola PA 17025 Severn MD 21144 G. Property Location 217 South Enola Drive East Pennsboro Township, Cumberland County Enola PA LOI: Block: 17025 iF. Name and Address o! Lender H. SeWement Agent Kent H. Patterson Place ol Settlement 221 Pine Street Harrisburg PA 17101 I. SetlJemant Date 6/19/02 Disbursement Date J, Summary of Borrower's Transaction K. Summary of Seller's Transaction 100. Gross Amount Due From Borrower 400. Gross Amount Due To Seller 401. Contract sales price 101. Contract sales price J 87,000.00 I 102. Personal property 103. Settlement charges to borrower (line 1400) 1,641.25 402. Personal property 403. 104. 4O4. 105. 405. Adjustments for items paid by seller In advance 106, City/towntaxes 6/19/02 to 12/31/02 142.07 107. Count,/taxes to 108. Assessments to 109. School 6/19/02 to 6/30/02 11o. Sewer 6/19/02 to 6/30/02 111. to 112. to 113. to 114. to 28.37 10.61 88,822.30 115. tO 120. Gross Amount Due From Borrower Adjustments for Items paid by seller in advance 406. city/towntaxes 6/19/02 to 12/31/02 407. County taxes 408. Assessments 87,000.00 142.07 to to 409. School 6/19/02 to 6/30/02 410. Sewer 6/19/02 to 6/30/02 ;411. to 412. to 413. to 414. to 415. to 420. Gross Amount Due To Seller 28.37 10.61 87,181.05 200, Amounts Paid By Or In Behalf Of Borrower 500. Reductions In Amount Due To Seller 201. Deposit or earnest money 8,700.00 501. 202. Principal amount of new loan(s) 502. 203. Existing loan(s) taken subject to 503, 204. 504. 205. 505. 206. 506. 207. 507. 208. 508. 209. 509. Adjustments for items unpaid by seller 210. City/town taxes to 211. County taxes to 212. Assessments to Excess deposit (see instructions) Settlement charges to seller (line 1400) Existing loan(s) taken subject to Payoff of first mortgage loan Payoff of second mortgage loan Adjustments for Items unpaid by seller 510. City/town taxes to 511. County taxes to 512. Assessments to 1,139.92 213. 214. to 215. to 216. 217. to to 513. 514. 515. 516. to 517. to 218. to 518. to 219. tO 519. to 220. Total Paid By/For Borrower 8,700.00 520. Total Reduction Amount Due Seller 1,1 39.92 300. Cash At Settlement From/To Borrower 600. Cash At Settlement To/From Seller 301. Gross Amount due from borrower (line 120) 88,822.30 ! 601. Gross amount due to seller (line 420) 87,181.0.~ 302. Less amount paid by/for borrower (line 220) ( 8,700.00) 602. Less reductions in amt. due seller (line 520) ( 1,1 39.92 303. Cash [] From [] ToBorrower 80,122.30 603. Cash [] To [] FromSo. er 86,041.1; SUBSTITUTE FORM 1099 SELLER STATEMENT The informatio.~ contained in Blocks E, G, H, and I and on line 401 (or, line 403 and 404) is important tax information and is being furnished to the Internal Revenue Service. It you are required to file a return, a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS determines that it has not been reported. If this real estate is your principal residence, file Form 2119, Sale or Exchange of Principal Residence, for any gain, with your income tax return; for other transactions, complete the applicable parts of Form 4797, Form 6232 and/or Schedule D, Form 1040). You are required to provide the Settlement Agent (named above) with your correct taxpayer identification number. If you do not provide the Settl~,ment Agent with your correct taxpayer ident~ication number, you may be subject to civil or criminal penalties imposed by law. Under penalties of perjury, I certify that tl~/nurnbe~/~hown on/Ih1 state/me~nt is mY ~°,~'ect taxpayer identificati°n number' . (Sell,Fa S'g ) ' L. Settlement Charges "~, 700. Total Sales/Broker's Commission based on price $ @ % = Division of Commission (line 700) as follows: 701. $ to 702. $ to 703. Commission paid at Settlement 704. Paid From BorroweCs Funds At Settlement Paid From Seller's Funds At Settlement 800. Items Payable In Connection With Loan 801. Loan Origination Fee % 802. Loan Discount % 803. Appraisal Fee to 804. Credit Report to 805. Lender's Inspection Fee 806. Mortgage Insurance Application Fee to 807. Assumption Fee 808. 809. 810. 811. 812. 813. 900. Items Required By Lender To Be Paid In Advance Exclude last day in calcs ~ line 901 961. Interest from to @$ /day 902. Mortgage Insurance Premium for months to 903. Hazard Insurance Premium for years to 904. years to 905. 1000. Reserves Deposited With Lender 1001. Hazard insurance months@$ per month 1002. Mortgage insurance months@$ per month 1~)03. City property taxes months@$ per month 1004. County property taxes months@$ per month 1005. Annual assessments months@$ per month 1006. months@$ per month 1007. months@$ per month 1008. A~l~re~late Accountin~l Adjustment 1100. Title Charges 1101. Settlement or closing fee to 1102. Abstract or title searcl~ to 1103. Title examination to 1104. Title insurance binder to 1105. Document preparation 1106. Notary fees 1107. Attorney's fees (Includes above items numbers: 1108. Title insurance (Includes above items numbers: fo to Cash to to Kent H: Patterson/Penn Attorneys Title Ins. Co. 1101-1104, 1108 1109. Lender's coverage $ 1110. Owner's coverage 1111. 1112. 1113. $ 87,000.00 2.00 4.00 740.75 1200. Government Recording and Transfer Charges 1201. Recording. fees: Deed $ 1202. City/countytax/stamps: Deed $ 1203. State tax/stamps: Deed $ 1204. Recorder of Deeds 12O5. ; Mortgage $ ;Mo~gage ;Mo~gage · Releases $ $ 870.00 870.00 $ 28,50 1300. Additional settlement Charges 1301. Survey to 1302. Pestinspection to 1303. Alicia D. Stine, Treasurer - 2002 county/towship taxes 1304. 1305. 1306. 1307. 1308. 1400. Total Se~lement Charges (enter on lines 103, Section J and 502, Section K) 1,641.25 285.92 1,139.92 CERTIFICATION I he, ye carefqlly reviewed the HUD-1 Settlement Statement and to the best of my knowledge and beliel, it i~-¢. true and accurate statement of all receipts and disbursements or~,~y acc(~b~ht or by/rn'~ in t~i¢ transa~ti'on. I fudher cedi~y ~at I have re~iv~ a copy of the HUD-1 Settlq~Snt S~tement. _ - __ ~ 'Nelson~0. H~, C~-Exe~tor~ ' S~y M. ~e~e~ Seller ~/ Borrower Estate of Colin C. Bender To the b~st of my knowledge the~UD-1 SeElement Statement which I have prepared is a ~ue and accurate account of the funds which were received and hsve been or will be disb~sed by the qnde[~ig~¢~ of the settlement of ~is .transacfi°n' Da t~ ~A~NI~ It is a cdme to knowi~¢~ mak~ [al~ s[at~m~nts to th~ United Stat~s on t~s or an~ ot~r ~imilar form. P~nalti~s ~pon convictio~ ~an ia~lu~e a fine an~ imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Bender. Colin All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 35 shares of MetLife, Inc. common stock at $31.05 per share TOTAL (Also enter on line 2, Recapitulation) VALUEAT DATE OF DEATH 1,086.75 1 ~086.75 (If more space is needed, insert additional sheets of the same size) ' - REV-15~8 EX,+ ~'~-97) j~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIBENI' DECEBENT SCHEDULE E CASH, BANK DEPOSITS, & UISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Bender. Colin (~. 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 o 10. 11. 12. 13. 14. 15. 16. DESCRIPTION Commonwealth of Pennsylvania - final pay check Commonwealth of Pennsylvania - accrued leave West Shore Oil Co. - unused prepayment AT&T reimbursement Patriot-News - refund Union Security Life Insurance - premium refund Erie Insurance - auto insurance refund Erie Insurance - homeowners insurance refund U.S. Treasury - 2001 tax refund PNC Bank Certificate of Deposit Account No. 31800155828 PNC Bank Certificate of Deposit Account No. 31800155829 PNC Bank Certificate of Deposit Account No. 31100156787 PNC Bank Certificate of Deposit Account No. 31000155035 PNC Bank Certificate of Deposit Account No. 31500156197 PNC Bank Certificate of Deposit Account No. 31000155037 PNC Bank Certificate of Deposit Account No. 31100156789 TOTAL (Also enter on line 5, Recapitulation) $ VALUE AT DATE OF DEATH 1,643.46 7,608.93 452.56 20.90 70.70 224.25 666.00 240.00 1,277.00 2,292.21 2,292.21 2,292.21 2,292.21 2,292.21 2,292.21 2,292.21 74~629.80 (If more space is needed, insert additional sheets of the same size) '- '" Continuation of REV-1500 Inheritance Tax Return Resident Decedent Bender, Colin C. Pa,qe 1 Schedule E - Cash, Bank Deposits, & Misc. Personal Property ITEM NUMBER DESCRIPTION 17. PNC Bank Certificate of Deposit Account No. 31500156201 PNC Bank Certificate of Deposit Account No. 31800155839 PNC Bank checking account Account No. 5080395868 PNC Bank checking account Account No. 5140110183 PNC Bank savings account Account No. 5000718445 1994 Buick 18. 19. 20. 21. 22. 23. 24. 25. 26. 997 Chevrolet truck -Iousehold contents (receipts from auction sale - see auctioneers statement attached) I($17,455.75 less $8550 for autos equals $8905.75) PNC Bank refund for loan prepayment Tax proration - sale of real estate VALUE AT DATE OF DEATH 2,292.21 2,292.21 12,482.69 6,006.36 5,170.08 6,000.00 2,550.00 8,905.75 500.18 181.05 SUBTOTAL SCHEDULE E 46,380.53 GRAND TOTAL SCHEDULE E $ 74,629.80 · °o LITTLE IKE EICHELBERGER Auctioneering Real Estate - Antiques - Household - Farm Sales also Antique & Classic Autos - Parts Collections 150 Mt. Top Road Lic.# Au001954L Dillsburg, PA 17019 Office Phone: 717-432-0006 Statement of Public Sale }i&ld for EXPENSES Advertising ..................... Auctioneer's Commission /~- .~ ........... Clerks' Commission ................. Miscellaneous Expenses ~~~~ .... /~7, ~ Total Expenses .............. RECEIPTS Gross Sale ..................... /7,~'~O~'7 Less Expenses Less Uncollected Amount ............... Total Net Sale .............. I received $/~ffO.'73--from proceeds of the above-listed sale on & ~-/~O~ Signature · . REV.lS11E~+il'.97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Bender. Colin C, Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. FUNERAL EXPENSES: Richardson Funeral Home, Inc. James Gingrich Memorials ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) see attached Sodal Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: 2002 Attorney Fees Kent H. Patterson Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Register of Wills Accountant's Fees Tax Return Preparers Fees Lauri Warrick - reimbursement for mileage and travel through 3/25/2002 Erie Insurance Group - auto insurance premium Souder Tax Serivce - 2001 income tax preparation PNC Bank - check printing fee Nelson Hart - reimbursement for mileage, travel and misc. expensees 2/23 to 3/25/02 Alicia D. Stine, Treasurer - property taxes Pennsylvania American Water Company (PAWC) - service 3/14/02 through 4/12/02 Cumberland Law Journal - estate advertisement George Dilks - plumbing repair PP&L Nelson Hart - reimbusement for mileage, postage and misc. 4/13 to 5/1/02 Erie Insurance Group - Homeowners policy premium TOTAL (Also enter on line 9, Recapitulation) 5,944.00 75.00 15,989.00 15,989.00 343.00 628.34 624.00 50.00 53.00 297.03 260.61 10.69 75.00 105.00 19.97 163.28 247.00 47~682.2R (If more space is needed, insert additional sheets of the same size) " "~ Continuation of REV-1500 Inheritance Tax Return Resident Decedent Bender, Colin C. Pa,qe 2 Schedule H - Funeral Expenses & Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. PAWC PP&L Lauri Warrick - travel, mileage, lodging expenses for auction 5/19/02 through 6/03/02 Laud Warrick - phone expenses Lauri Warrick - Postage and misc. expenses Nelson Hart - travel, mileage, lodging and misc. expenses for auction 5/19 to 6/3/02 Patriot News - estate advertisement Register of Wills- short certificate Nelson Hart - mileage and travel for settlement on sale of property PP&L Nelson Hart - travel and expenses for inventory of safe deposit box and Bank Register of Wills - filing fees Settlement costs for sale of real estate Auctioneer's commission (see auctioneer's statement attached) Notary fees Recorder of Deeds - realty transfer tax Expenses for auction sale of personal property Little Ike Eichelberger - auctioneer's commission Runner's pay Miscellaneous - Battey - portable toilet Kent H. Patterson - reimbursement for postmaster Express Mail fees Reserve for costs 11.04 19.01 483.25 100.00 25.00 298.08 119.95 6.00 132.00 44.41 68.80 25.00 1,740.00 4.00 870.00 2,094.69 100.00 127.38 39.75 500.00 SUBTOTAL SCHEDULE H-B7 6,808.36 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAMEs DECEDENT'S SSN= DATE OF DEATHs Bender, Colin C. 161-34-0869 02/20/2002 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS B.1. Personal Representatives Commissions= Nelson C. Hart 8268 W.B. and A. Road Severn, MD 21144 Lauri B. Warrick 314 Sawmill Arch Chesapeake, VA 23323 The fees of the personal representatives and the attorney are based on the probate assets which are $432,954.48 pursuant to the inventory filed. REV-1512 EX + (t -97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT BECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER Bender. Colin (~. Include unreimbursed medical expenses. ITEM NUMBER 10. 11. 12. 13. 14. 15. DESCRIPTION Nelson Hart - reimburse payment for PAWC bill MCI - residential service East Pennsboro Township - sewer/sanitation PAWC PP&L AT&T Comcast Cable Peoples Bank Texaco Lehman & Radabaugh - landscaping and snow removal Pennsylvania Department of Revenue 2001 income taxes Good Hope Family Physicians P.C. Central Medical Equipment Co. - for wheelchair Pulmonary and Critical Care Medicine Associates VNA of Central PA - visiting nurse TOTAL (Also enter on line 10, Recapitulation) AMOUNT 21.92 54.55 87.75 12.09 59.94 20.90 17.45 85.73 22.25 25.00 12.00 56.00 100.00 75.00 400.00 1 ~461.59 (If more space is needed, insert additional sheets of the same size) ' ' Continuation of REV-1500 Inheritance Tax Return Resident Decedent Bender, Colin C. Paqe 3 Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER 16. 17. 18. 19. DESCRIPTION Peoples Bank Boscov's Credit Card Register of Wills Inheritance tax for Sylvia Bender joint account Quantum Imaging SUBTOTAL SCHEDULEI GRAND TOTAL SCHEDULE I AMOUNT 64.06 19.95 122.00 205.00 411.01 1,461.59 · REV-1515 E~( + (9.nm COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Bender. ~ ;olin C. RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE Il. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a)(1.2)] Nelson C. Hart 8268 W.B. and A. Road Severn, MD 21144 Lauri Beth Warrick 314 Sawmill Arch Chesapeake, VA 23323 Jeffrey S. Hart 7517 Old Coaling Road, Apt. 2 Harmans, MD 21077 Randy L. Hart 315 Grove Park Road Brooklyn, MD 21225 nephew niece nephew nephew 25% 25% 25% 25% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Hospice of Central Pennsylvania 98 South Enola Drive, P.O. Box 266 Enola, PA 17025-0266 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 25,000.00 25,000.00 (Ifmo~spa~isneeded, inse~additionalsheetsofthesamesize) LAST WILL AND TESTAMENT OF COLIN C. BENDER I, COLIN C. BENDER, of the Township of East Pennsboro, County of Cumberland arid State of Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done, and in this respect also, I direct that my personal representatives, hereinafter named, arrange to have the year of my death inscribed on my cemetery monument within thirty (30) days after the date of my decease. I give and bequeath the sum of Twenty-five Thousand ($25,000.00) Dollars to HOSPICES OF CENTRAL PENNSYLVANIA. -1- I give and bequeath all the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, to my following named nephews and niece, to wit, RAhrDY L. }{ART, NE!.SON C. HART, JEFFREY S. HART and LAURI BET}{ }{ART WAR.RICK, share and share alike, per stirpes. For the purpose of facilitating the settlement and distribution of my estate, I authorize and empower my Executors hereinafter named, to sell any and all real estate which I may own at the time of my decease, as well as my personal property and tangible goods, at either public or private sale or sales. LA.ST[~, I nominate, constitute and appoint my niece, [,~I BETH W^RRICK and my nephew, NELSON C. ~RT, Co-Executors of this my Last Will and Testament and direct that they be excused from posting bond or other security for the faithful performance of their duties in any Jurisdiction. -2- IN ~:~ITNE...SS WHEREOF, I [mve hereunto set my hand and ~ day of ^u~ust, ^. D , 2001. seal this ~ ~ . Colin C. Ben¢]er -3- COMHONWEAI/I'tl OF PENNSYLVANIA ) : COUNTY OF CUMBERLANI) ) SS. 12, CD_bIN C.__DENDER , the testator whose name is signed to tile attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Wi].l and Testament; that 1 signed it willingly; and that I signed it as my free and volun- tary act and deed, for the purposes therein contained. Sworn and affirmed to and acknowledged before me COLIN C, BENDER , the testator , this day of August , A. P., 2001. Colin C. Bender Notary Public COmmONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS. Notarial S~at Mt Ma.tyn E. Williems. Notary Public Mechanicsburg Boro, Cum~dand Cou~ Commission Expir~ Nov. 6, 2001 ~er, pennsylvania A~oCm~on of r. ota, We, the undersigned, J. ROBERT STAUFFER and KATHY S. LITTI~ , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testator , COLIN C. BENDER , sign and exe- cute the instrument as his/~[~. Last Will and Testament; that the said testator , COLIN C. BE]:,ID]L~R , executed it as his/3~ free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testat O1~ , signed the Will as witnesses; and that to tile best of our knowledge, the testat or was, at the time, eighteen (18) or more years of age, of sound mind, and under no coDstraint, duress or undue influence. Sworn and s~ub. fi~ibed to befor f/ .. _z me this _Oi~) day of ~ August , 2001. Notary Public Notarial Seal " Madlyn E. Williams, Notary Public Mechamcsburg Boro, Cumberland Coumy My Commission Expires Nov. 6, 2001 Member, Pennsylvania A~ociation ot Notarie~ KENT H. PATTERSON ATYORNEY AT LAW 221 PINE STREET HARRISBURG, PENNSYLVANIA 17101 TELEPHONE (717)238-4100 TRANSMITTAL November 1, 2002 TO: Register of Wills One Courthouse Square Carlisle, PA 17013-3387 FROM: RE: Kent H. Patterson Estate of Colin C. Bender Date of Death: 2/20/2002 File No.: 2002-00282 Enclosed for filing are the following: Inventory plus one copy Inheritance Tax Return plus 2 copies Check made payable to Register of Wills for $25.00 for filing fee Check made payable to Register of Wills, Agent for $13,285.90 for payment of inheritance taxes Would you please return one time stamDed copy of the inventory and one time stamped copy of the inheritance tax return to me in the enclosed self addressed, stamped envelope. Thank you. KHP/cvf Enclosure KENT H. PATTERSON ATTORNEY AT LA~V 2'21 PINE STREET }tARRISBURG, PENNSYLVANIA 17101 TO: Register of Wills one Courthouse Square Carlisle, PA 17013-3387 INVENTORY Estate of Colin C. Bender also known as , Deceased Nelson C. Hart, Executor and Lauri Beth Warrick, Executrix No. 2002 00282 Date of Death 2/20/02 Social Security No. 161-34-0869 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory, lANe verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. Personal Representative: . , Name of /~,.L~-- ~ Attorney: Kent H. Patterson . I.D. NO.: 15307 ~/ /-~.., O..,~-.'~ ~ Address: 221 Pine Street Dated October: 23, 2002 Harrisburq PA 17101 Telephone: (717) 238-4100 Description 217 South Enola Road East Pennsboro Township, Cumberland County, Pennsylvania Enola, PA 17025 PNC Bank - checking account Account No. 5080395868 PNC Bank - checking account Account No. 5140110183 PNC Bank - savings account Account No. 5000718445 PNC Bank Certificate of Deposit Account No. 31800155829 (Attach Additional Sheets if necessary) Total Value 87,000.00 12,482.69 6,006.36 5,170.08 2,292.21 432,954.48 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 Continuation of Inventory Colin C. Bender Description of Inventory Description PNC Bank Certificate of Deposit Account No. 31800155829 PNC Bank Certificate of Deposit Account No. 31100156787 PNC Bank Certificate of Deposit Account No. 31000155035 PNC Bank Certificate of Deposit Account No. 31500156197 PNC Bank Certificate of Deposit Account No. 3100155037 PNC Bank Certificate of Deposit Account No. 31100156789 PNC Bank Certificate of Deposit Account No. 31500156201 PNC Bank Certifcate of Deposit Account No. 31800155839 Commonwealth of Pennsylvania - final pay check Commonwealth of Pennsylvania - accrued leave Prudential Financial Policy No. 091475 Monumental Life Insurance Company Policy No. MA1794039 Monumental Life Insurance Company Policy No. W95574664 Monumental Life Insurance Company Policy No. W72254806 Page 1 2002 00282 Value 2,292.21 2,292.21 2,292.21 2,292.21 2,292.21 2,292.21 2,292.21 2,292.21 1,643.46 7,608.93 35,000.00 2,010.60 2,000.00 2,029.45 Subtotal $ 68,630.12 Continuation of Inventory Colin C. Bender Description of Inventory United Security Life Insurance Policy No. 8005411574 Page 2 2002 00282 Description Value 335.87 State Employees' Retirement System Account 1994 Buick 1997 Chevrolet truck Household furnishings U.S. Treasury 2001 tax refund West Shore Oil Co. unused prepayment AT&T reimbursement Patriot-News refund Union Security Life Insurance premium refund 35 shares of MetLife, Inc. common stock at $31.05 per share 230,449.24 6,000.00 2,550.00 8,905.75 1,277.00 452.56 20.90 70.70 224.25 1,086.75 Subto~l $ 251,373.02 Grand Total $ 432,954.48 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISE~URG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001807 PATTERSON KENT H ESQUIRE 221 PINE STREET HARRISBURG, PA 17101 ........ fold ESTATE INFORMATION: SSN: 161-34-0869 FILE NUMBER: 2102-0282 DECEDENT NAME: BENDER COLIN C DATE OF PAYMENT: 11/04/2002 POSTMARK DATE: 11/02/2002 COUNTY: CUMBERLAND DATE OF DEATH: 02/20/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $13,285.90 TOTAL AMOUNT PAID: $13,285.90 REMARKS: NELSON C HART C/O KENT H PATTERSON ESQUIRE SEAL CHECK# 1049 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS Court of Co~Lon Pleas of Cumberland County In Or~hans' Court Division STATUS REPORT UNDER RULE 6.12 Name of Decedent= Colin C. Bender Date of Death= February 20, 2002 Will No. A~min. No. 00282-2002 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the a~ministration of the above-captioned estate= 1. State whether a~ministration of the estate is complete= Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the a~ministration will be completes 3. If the answer to No. i 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, ]oinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Attached to this report are copies of proofs of publication of legal advertisements in the Cumberland Law Journal and The Patriot News. Page i of 2 The estate was settled pursuant to an agreement for final distribution executed by the personal representatives and the heirs under the will. Date= Kent H. Patterson Name (Please ty~e or print) 221 Pine Street Harrisbur~ PA 17101 Address (717) 238-4100 Tel. No. Capacity: X Personal representative Counsel for personal representatives Page 2 of 2 PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 STATE OF PENNSYLVANIA : : COUNTY OF CUMBERLAND : SS. Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz: MAY 31, JUNE 7, 14, 2002 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are tree. Bender, Colin C., dec'd. Late of East Pennsboro Town- ship. Co-Executors: Nelson C. Hart, 8268 W.B. and A. Road, Severn, MD 21144 and Lauri B. Warrick, 314 Sawmill Pa'ch, Chesapeake. VA 23323. Attorney: Kent H. Patterson, Esquire, 221 Pine Street, Har- risburg, PA 17101. · ' tor ~- ~~nt~al, Edi SWORN TO AND SUBSCRIBED before me this 14 day of JUNE, 2002_ THE PATRIOT NEWS THESUNDAY PATRIOT NEWS Proof of Publication Under Act No. 587, Approved May 16, 1929 Commonwealth of Pennsylvania, County of Dauphin} ss Michael Morrow being duly sworn according to law, deposes and says: That he is the Asst. Controller of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealtl~ of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or Sunday/ Metro editions which appeared on the 2!st and 28th day(s) of May and the 4th day(s) of June 2002. That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for said County of..Da~.'phin/// in Mi~,cellaneous Book "M", Volume 14, Page 317. ~/:"~~"'~h ~'~.D.' PUBLICATION ....................... , ........................................ COPY Sworn to and s day Notariai Seal !//~ '/' // / - ~'/ f/ / ~ Terry L. Russell , Notan/P U151"~C~ . J //. ,:...'/' X/~-~']/'/~- "'""'f~//~/~'/~ City Of Harrisburg, Dauphin Uoumy J/ -. .... ,~¢'... ~ C .... My Commission Expires June 6,2006 I INU I MfHY Estate Notices (West) Member, Pennsylvania Assock~ Of Nolaries My commission expires June 6, 2006 m ESTATE NOTICE LETTERS TESTAMENTARY In the Es- tate of Colin C.~Bender, late of East Pennsboro Township, Cuml:~rlond County, Pennsylva- nia, having been granted to the undersigned, all persons indebted to the said estate are re- quired to make immediate payment and those having claims or demands to present the same without delay for settlement to: NelsonC. Hart, Executor 8268 W.B. and A. Rood Severn, MD 21144 Lauri B. Worrfck, Executrix 314 Sewmm Arch Chesapeake, VA 23325 OR TO: Kent H. Patterscn 2~1 Pine Street Harrisburg, PA 17101 KENT H. PATTERSON ATTORNEY-AT-LAW 221 PINE STREET HARRISBURG, PA. 17101 Statement of Advertising Costs To THE PATRIOT-NEWS CO., Dr. For publishing the notice or publication attached hereto on the above stated dates Probating same Notary Fee(s) Total $ 118.20 $ 1.75 $ 119.95 Publisher's Receipt for Advertising Cost The Patriot News Co., publisher of The Patriot-News and The Sunday Patriot-News, newspapers of general circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have been duly paid. BUREAU OF INDIVIDUAL TAXES /NHER/TANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 KENT H PATTERSON 221 PINE ST HBG CUT ALONG THIS LINE ~ PA 17101 COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR D/SALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE 12-10-2002 ESTATE OF BENDER DATE OF DEATH 02-20-2002 FILE NUHBER 21 02-0282 COUNTY CUHBER LAND ACN 101 I Aeoun4: Rem/~4:ad REV-154? EX AFP COLIN C HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 RETAIN LONER PORTION FOR YOUR RECORDS ~ DZSALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF BENDER COLIN C FILE NO. 21 02-0282 ACH 101 DATE 12-10-2002 TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es4:a4:a (Schedule A) (1) 2. S4:ocks and Bonds (Schedule B) (2) 3. CloseZy Held S4:ock/Par4:nership Zn4:eres4: (Schedule C) ($) 4. Hor4:gages/No4:es Receivable (Schedule D) (4) 5. Cash/Bank Deposi4:s/Hisc. Personal Proper~y (Schedule E) (5) 6. Jo/n~ly Ownad Proper4:y (Schedule F} (6) 7. Transfers (Schedule G) (7) 8. To4:al Assa~s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Cos4:s/H/sc. Expenses (Schedule H) (9) 10. Dab4:s/Hor4:gage L/ab/li~/as/L/ans (Schedule Z) (10) 11. To4:al Deduc4:/ons 12. Ne4: Value of Tax Re~urn 87~000.00 1~086.75 .00 .0O 74~629.80 .00 .0O (8) 47,682.28 NOTE: To /nsure proper crad/4:4:0 your accoun4:, subm/~ 4:he upper por4:/on of 4:h/s form w/~h your 4:ax paymen4:. 13. 1~. NOTE: 162,716.55 1,461.59 (~) 49.143.67 (12) 113,572.68 25,000.00 (15) .00 X O0 = .00 (Zb) .00 X 045= .00 (~7) .00 X 12 = .00 (~8) 88,572.68 x 15 = 13,285.90 (~9)= 13,285.90 AHOUNT PAID 13,285.90 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL /NTEREST. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 13,285.90 .00 .00 .00 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT 1S REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) ASSESSHENT OF TAX: 1.;. Aeoun4: of L/ne 1~ a4: Spousal ra4:a 16. Amoun4: of L/ne 1~ 4:axable a~ L/naal/Class A ra4:e 17. Amoun4: of L/ne lq a4: Sibl/ng ra4:e 18. Aeoun4: of Line lfi 4:axabla a4: Colla4:aral/Class B ra4:e 19. Pr/nc/pal Tax Due TAX CREDITS: PAYHFNT RECETpT DTSCOUNT (+) DATE NUNBER TNTEREST/PEN PAI'D (-) 11-04-2002 CD001807 .00 reflect flgures that lnclude the total of ALL returns assessed to date. Char/4:abla/Governeen4:al Baques4:s; Non-alac4:ad 911:3 Trus4:s (Schedule J) (13) Na4: Value of Es4:a4:a Sub~ec4:4:0 Tax (1~) 88,572.68 Zf an assessment ~as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 ~ill BUREAU OF I'NDZVZDUAL TAXES TNHER'rTANCE TAX DT¥1*s'roN DEPT. 280601 HARR]'SBURG, PA 1712:8-0601 COMMONWEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT RE¥-i;O? EX ~FP (01-02) KENT H PATTERSON ZZ1 PINE ST PA 1710Z DATE 12-09-2002 ESTATE OF BENDER DATE OF DEATH 02-20-2002 FZLE NUMBER 21 02-0282 [~OUNTY CUMBERLAND ACN 101 Amoun~ Rem/~ed COLIN C HAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ ~o your account, submi~ ~:he upper por~ion of ~:his fore wi~:h your ~ax payment;. CUT ALONG TH'rS L'rNE ~ RETA'rN LOWER PORT'rON FOR YOUR RECORDS ~ REV-1607 EX AFP (01-0:~) ~ ZNHERZTANCE TAX STATEMENT OF ACCOUNT ~ ESTATE OF BENDER COLIN C FZLE ND. Z1 02-0282 ACN 101 DATE 12-09-2002 THTS STATEMENT IS PROV]:DED TO ADVI'SE OF THE CURRENT STATUS OF THE STATED ACM TN THE NAMED ESTATE. SHOI./N BELOW TS A SUMMARY OF THE pRI'NCI'PAL TAX DUE, APPLTCAT'rON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, TF APpLTCABLE, A PROdECTED 'rNTEREST FTGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 1Z-lO-ZOO2 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 13,285.90 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 11-02-2002 CD001807 .00 13,285.90 ZF PA/D AFTER THIS DATE, SEE REVERSE S/DE FOR CALCULAT/ON OF ADDITZONAL /NTEREST. { IF TOTAL DUE IS LESS THAN $1, NO PAYMENT 1S REQUIRED. ZF TOTAL DUE IS REFLECTED AS A 'CREDIT' (CR}, TOTAL TAX CREDZT 13,285.90 BALANCE OF TAX DUE .00 XNTEREST AND PEN. .00 TOTAL DUE .00 YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF TH'rS FORM FOR TNSTRUCTTONS. )