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Home My WebLink About02-0300REV-1500 EX + (8-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 28O601 HARRISBURG, PA 17128-0601 DECE- DENT CHECK APPRO- PRIATE BLOCKS COR- RE- SPON DENT RECA- PITULA- TION TAX COMPU- TATION REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Wyrick, Edna P. DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 09/17/01 I 12/04/1922 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY FILE NUMBER - COUNTYCODE YEAR NUMBER SOCIAL SECURITY NUMBER 196-14-0286 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF Wl~$ SOCIAL SECURITY NUMBER 1. Original Return 4. Limited Estate 6. Decedent Died Testate (Attach copy of Will) 9, Litigation Proceeds Received 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach a copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 3. Remainder Return F(date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes B 11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME Thc~as L. Bright, FIRM NAME (If Applicable) TELEPHONE NUMBER (717) 532-7388 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 COMPLETE MAILING ADDRESS 126 East King Street Shippensburg, PA 17257 None C~FFICI .A~ ONLY Property (Schedule E) 6. Jointly Owned Property (Schedule F) B Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (5) 19,836.22 (6) (7) 25,193.23 8. Total Gross Assets (total Lines 1-7) (8) 9. Funeral Expenses & Administrative Costs (Schedule H)(9) 1, 540. 00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 5,024.53 11. Total Deductions (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13, Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax (13) has not been made (Schedule J) 14. Net Value Subject to Tax (Une 12 minus Line 13) (14) 45,029.45 6,564.53 38,464.92 None 38,464.92 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (aX1.2) X .0 (15) 16. AmountofLine14taxableatlinealrate 38,464.92 X .0 45 (16) 17. Amount of Line 14 taxable at sibling rate 0 · 00 X .12 (17) 18. Amount of Line 14 taxable at collateral rate 0.00 X .15 (18) 19. Tax Due (19) 1,730.92 0.00 0.00 1,730.92 0 PA15001 NTF 29755 Copyright 2000 Greatland/Nelco LP - Forms Software Only Estate of: Edna P. Wyrick 21-2002- ~Y OF ALLOCATIONS TO BENEFICIARIES Taxable at lineal rate Carol M. Roberts JinmTfD. Burkholder Joyce D. Yocum Wilbur C. Wyrick, Jr. 9,616.23 9,616.23 9,616.23 9,616.23 38,464.92 PA REV-1500 EX (6-00) Decedent's Complete Address: Page 2 STREET ADDRESS Green Ridqe Village 658 Walnut Bottom Road ciTY I STATE imP Shippensburq PA 17257 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 1,730.92 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 0.00 C. Discount Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1,730. 92 A. Enter the interest on the tax due. (5A) O. O0 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 1,730.92 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; ....................................... I I b. retain the right to designate who shall use the property transferred or its income; ................. c. retain a reversionary interest; or ........................................................ d. receive the promise for life of either payments, benefits or care? .............................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ,., ~ Ft 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................ F1 I~l 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 return, ncluding accompanving schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on information of which preparer has any knowled,qe. SIGN,,ATURE OF PERSOJ.N._RESPONSIBLE FOR FILING RETURN DATE ADDR C) See ,gbhech.~e attachec~ SI GNATU RE,,~OF PrREP~I:{. OIHER THAN REPRESENTATIVE DATE ADDRESS~' ~ ' 126 East King~reet, S~p~~, PA 17257 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 is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P,S. ~ 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age 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(aX1.2)]. 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. a 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 si blings is 12% [72 P.S. ~ gl 16(aX1.3)]. A si bling is defined, under Section 9102, as an individual who has at least one parent in co mmon with the decedent, whether by blood or adoption. 0 PA15002 NTF 29756 Copyright 2000 Greatland/Nelco LP- Forms Software Only Estate of: Edna P. Wyrick 21-2002- The following person(s) Joyce D. Yocum 514 North Earl Street Shippensburg, PA 17257 are signing the return as representative(s) of the estate: REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Edna P. Wyrick FILE NUMBER 21-2002- Include proceeds of litigation & date proceeds were received by th e estate. All prop. Jointly-owned with rl~lht of survlvorshi ITEM NO. 1 2 3 DESCRIPTION Waddell & Reed Fund Account #32293020 Presbyterian Homes, Inc. - 09/30/01 Blue Cross/Blue Shield - 10/06/01 refund of premium at cancellation TOTAL (Also enter on line 5, Recapitulation) $ 7 CPA81 NTF 10908 Copyright Forms Software Only, 1997 Nelco, Inc. (If more space is needed, insert additional sheets of the same size) must be disclosed on Sch. F. VALUE AT DATE OF DEATH 17,493.61 2,130.31 212.30 19,836.22 REV-1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Edna P. Wyrick 21-2002- This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF EXCLUSION INCLUDE NAME OF THE TRANSFEREE, THEIR ITEM RELATIONSHIP TO DECD & DATE OF TRANSFER. DATE OF DEATH DECD'S (IF TAXABLE VALUE NO. A'I-I'ACH COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST APPLICABLE) 1 Allfirst Bank Checking Account 28,193.23 100% 3,000.00 25,193.23 #09502-8788-5 opened 10/13/00 FBO Joyce D. Yocum, daughter TOTAL (Also enter on line 7, Recapitulation) $ 25,193.23 7 CPA01 NTF ~09~0 (If more space is needed, insert additional sheets of the same size* Copyright Forms Software Only, 1997 Ne~co, Inc. REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Edna P. Wyrick FILE NUMBER 21-2002- Debts of decedent must be reported on Schedule I. ITEM NO. DESCRIPTION AMOUNT A. FUNERAL EXPENSES: None ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN No. of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees Name: Thomas L. Bright, Esquire Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Register of Wills, Return Register of Wills, Agreement Cumberland County - Cumberland County - filing PA Inheritance Tax filing Family Settlement TOTAL (Also enter on line 9, Recapitulation) $ 7 CPA11 NTF 10911 Copyright Forms Software Only, 1997 Nelco, Inc. (If more space is needed, insert additional sheets of the same size) 0.00 1,450.00 0.00 0.00 0.00 0.00 15.00 75.00 1,540.00 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER ESTATE OF Edna P. Wyrick 21-2002- Include unreimbursed medical expenses, ITEM NO. DESCRIPTION AMOUNT 1 Continuing Care Rx - 09/30/01 statement Allfirst Bank Checking Account #09502-8788-5, checks outstanding at date of death, clearing after date of death Allfirst Bank - service char~es on Checking Account #09502-8788-5 TOTAL (Aisc enter on line 10, Recapitulation) $ 7 CPA12 NTF 10912 (If more space is needed, insert additional sheets of the same size) Copyright Forms Software Only, 1997 Nelco, Inc. 24.00 4,960.53 40.00 5,024.53 REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Edna P. Wyrick FILE NUMBER 21-2002- NO. 4 I1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISThiBUTIONS (include outright spousal distributions) Carol M. Roberts 11430 Skyline Drive Orrstown, PA 17244 JiffrnyD. Burkholder 297 Springfield Road Shippensbur~, PA 17257 Joyce D. Yocum 514 North Earl Street Shippensbur~, PA 17257 Wilbur C. Wyrick, Jr. 6087 LindsayCourt Middletown, OH 45044 RELATIONSHIP TO DECEDENT De Not Uet Trustee(s) Daughter Son Daughter Son AMOUNT OR SHARE OF ESTATE 9,616.23 9,616.23 9,616.23 9,616.23 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17, 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 None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None TOTAL OF PART ~ -- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 7 CPA13 NTF 10913 (If more space is needed, insert additional sheets of the same size) Copyright Forms Software Only, 1997 Neico, Inc, Waddell & Reed Fund Families Statement as of: December 31, 2001 · Account Number: 32293020 Account Owner Edna P Wyrick (TOD) C/O JoyceYocum 514 NEarlST Shippensburg PA 17257-8603 W_-~L)L)ELL ~ F~nandal Services Investing. With a plan®. Year-to-Date Transactions 2 of 2 Page Fund Name (Number) Transaction Share Shares Share Effective Date Transaction Amount Price This Transaction Balance WR Advisors Cash Management B (150) 12/29/2000 Beginning of Year Balance Forward 01/26/2001 Dividend Reinvest $145.40 $1.00 145.400 02/27/2001 Dividend Reinvest $149.47 $1.00 149. 470 03/27/2001 Dividend Reinvest $134.14 $1.00 134. 140 04/20/2001 FWS/SWP Payment -Check $5,000.00- $1.00 5,000. 000- 04/27/2001 Dividend Reinvest $136.17 $1.00 136. 170 05/18/2001 FWS/SWP Payment -Check $5,000.00- $1.00 5,000.000- 05/25/2001 Dividend Reinvest $95.11 $1.00 95.110 06/20/2001 FWS/SWP Payment -Check $5,000.00- $1.00 5,000. 000- 06/27/2001 Dividend Reinvest $71.70 $1.00 71. 700 07/20/2001 FWS/SWP Payment -Check $5,000.00- $1.00 5,000.000- 07/27/2001 Dividend Reinvest $58.85 $1.00 58.850 08/20/2001 FWS/SWP Payment -Check $5,000.00- $1.00 5,000. 000- 08/27/2001 Dividend Reinvest $39.52 $1.00 39. 520 09/20/2001. FWS/SWP Payment -Check $5,000.00- $1.00 5,000. 000- ~1~ Dividend Reinvest $30.79 $1.00 30. 790 10/10/2001 Transfer To 35287663 $0.00 $0.00 3,131. 100- 10/16/2001 Transfer To 35289191 $0.00 $0.00 3,131. 100- 10/18/2001 Transfer To 35289284 $0.00 $0.00 3,131. 100- 10/26/2001 Dividend Reinvest $11.58 $1.00 11. 580 10/16/2001 Transfer To 35292519 $0.00 $0.00 3,131. 100- 10/26/2001 Decrease Dividend Reinvest $1.50- $1.00 1.500- 10/26/2001 Increase Dividend Reinvest $1.50 $1.00 1.500 10/18/2001 Increase Dividend Reinvest $8.98 $1.00 8.980 10/15/2001 Transfer From 35292519 $0.00 $0.00 3,131. 100 10/26/2001 Decrease Dividend Reinvest $11.58- $1.00 11. 580- 10/16/2001 Transfer To 35292519 $0.00 $0.00 3,131. 100- 10/18/2001 Transfer To 35289284 $0.00 $0.00 8. 980- 10/16/2001 Transfer From 35292519 $0.00 $0.00 3,131. 100 10/15/2001 Transfer To 35292519 $0.00 $0.00 3,131. 100- Market Value/Share Balanc~ Market Value/Share Balance 12/3172001 $41,663.25 $o. oo 41 663.25O 41 808.650 41 958.120 42 O92.260 37092.26O 37.228.430 32.228.430 32.323.540 27.323.540 27.395.240 22.395.240 22 454.090 12,493.610 52,52 4. 9,393.300 6,262.2O0 3,131.100 3,142.680 11.580 10.080 11.580 20.560 3,151.660 3,140.080 8.980 0.000 3,131.100 0.000 515117 1~:42p RLLFIRST CIS Alllitst Financial Ccmcr N.A. PO 8ox 900 Mitlboro. DF. 19966 February 15, 2002 allfirst Weigle & Associates, P.C. Attorneys _At Law 126 East King Street Shippensburg, PA I7257-1397 Re: Estate of Edna P. YYvrici~ Social Securi~..': 196-14-0286 ~ate of Death: September 17, 2001 Dear Sir or Madam: Per your inquiry dated Februao' 7, 2002 please be advised that at the time of death~ the above-named decadent had on deposit a4tlx this bank the follox~ng: Type of Account Account Number Ownership fWames o~ ~ing ~e Balance on ~e of D~ ~ed l~'t TotM Direct Deposit Checldng 0950287885 Edna P. ~Sn'ick, FBO Joyce D. Yocum, REP PA YEE 10/I 3/00 $28,193.23 $ 0.00 $2& 193.23 letter doe~' not include any nccounLt in which tlte deceased tray have been lis~ed a~ Power of Attorney. Cttstodian of Unifor~s Transfers. Representative Payee, or l'n~stee under a ft,'ritte, n ~Igreement. Forfiwther account informatioa, dosu~'es and/or retmbm~emeat offimd$ refer to below branch: WALNI~T BO'VI"OM ROAD OFFICE ~ VrbxLNL~'T BOTTOM ROAD SlllPPENSgIURG, PA 1725'7-9496 Sincerely, e .-~ssistant I Cis Services, (302) 934-2909 allfirst FBO EDNA P VVYRICK JOYCE D YOCUM REP PAYEE 514 N EARL ST SHIPPENSBURG PA 17257-8603 I,,,lll,,,I.hhhhh,,ll,,h,lh,lh,,,,Ih,,,Ih h,hlh,I Page I of 3 Direct Deposit Checking August 25, 2001 thru September 24, 2001 lbo Edna P Wyrick Joyce D Yocum Rep Payee Acct No 09502-8788-5 O allfimt.com O 24-hour Customer Service 1-800-533-4630 Activity Summary Balance on 08/24 $29,93q. 23 Deposits and additions 5,259.00 Checks -5,960.53 Balance on 09~24 $23,252.70 Deposits and additions Date Description Amount 08/30 DEPOSIT $q,500.00 08/31 ACH CREDIT 759.00 US TREASURY 303 SOC SEC 196140286A SSA 3031036030JOYC E YOC U M FOR ED NA20012415181652 $5,259.00 Checks * Denotes missing sequence number Number Date Amount Number Date Amount Number Date Amount 147 09/18 $q,882.53 148 09/19 $78.00 149 09/17 .,.~1,000.01~ End of Day Ledger Balance Account balances are updated in the section below on days when transactiohs posted to this account. / Date Balance Date Balance Date / Balance / 08~24 $23,95q.25 08131 $29,193.23 09118 / $23,310.70 08/30 28,43q.23 09117 --Poi>- 28,193.23 09119~ 23,232.70 020164 3 0014-00290205198 050 LAST WILL AND TESTAMENT I, EDNA P. WYRICK, of Shippensburg, Cumberland County, Pennsylvania, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my legally enforceable debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give, devise and bequeath all my estate, real, personal and mixed, whatsoever and wheresoever situate, to my children, namely CAROL M. ROBERTS, JIMMY D. BURKHOLDER, JOYCE D. YOCUM, and WILBUR C. WYRICK, JR., equally on a per stirpes distribution basis. THIRD. I nominate, constitute and appoint my daughter, JOYCE D. YOCUM, to be the Executrix of this my Last Will and Testament; if she be unable to fulfill the duties of Executrix, I then nominate, constitute and appoint WILBUR C. WYRICK, JR., to be the Executor of this my Last Will and Testament. FOURTH. I hereby direct that all federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such taxes, shall be considered a part of the expense of administration of my estate and that such be paid out of the rest and residue of my estate. FIFTH. I direct that my personal representatives shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, EDNA P. WYRICK, have hereunto set my hand and seal to this my Last Will and Testament this [(e-~ day of ~"&)~¢ ,1999. This instrument was by the Testatrix, on the date hereof, signed, published and declared by her to be her Last Will and Testament, in our presence, who at her request and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as wimesses. COMMONWEALTH OF PENNSYLVANIA · COUNTY OF · SS. I, EDNA P. WYRICK, the person whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by EDNA P. WYRICK, the Testatrix, this /~,~ day of (~ ,1999. COMMONWEALTH OF PENNSYLVANIA · · SS. COUNTY OF · the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw EDNA P. WYRICK, the Testatrix, sign and execute the in.stmment as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix, signed the will as witnesses; and that to the best of our knowledge the Testatrix was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by ~l IAo~ta, s L~. ~¢.1(~/-{- 1- and ~-~,'~ Co-. ~'e~-oq(,x_~ , · ~ ~- ---- ,1999. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 000992 BRIGHT THOMAS L ESQUIRE 126 EAST KING STREET SHIPPENSBURG, PA 17257 ........ fold ESTATE INFORMATION: SSN: 196-14-0286 FILE NUMBER: 2102-0300 DECEDENT NAME: WYRICK EDNA P DATE OF PAYMENT: 03/25/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 09/17/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,730.92 TOTAL AMOUNT PAID' $1,730.92 REMARKS: SEAL CHECK# 152 INITIALS: SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS BUREAU OF TNDTVTDUAL TAXES INHERZTAHCE TAX DIVTSZOH DEPT. 18(]601 HARRTSBURG) PA 17118-0601 THONAS L BRZGHT 126 E KZNG ST SHZPPENSBURG COHHONgEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE P~i,~7257 NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSNENT OF TAX DATE ESTATE OF DATE OF DEATH FZLE NUHBER COUNTY ACN RE¥-15~17 EX &FP (01-0:~) i-, 05-06-2002 ; ~ gYRICK EDNA P 09-17-2001 210Z-O$O0 '02 5ii¥ i0 CUH~ERLAND 101 Amount Remitted I HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF NZLLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-02) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSHENT OF TAX ESTATE OF NYRICK EDNA P FZLE NO. 21 02-0500 ACN 101 DATE 05-06-2002 TAX RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORTGTNAL RETURN 1. Reel Estate (ScheduZe A) (1). 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Znterest (Schedule C) ($) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTTONS AND EXEHPTZONS: 9. Funeral Expanses/Adm. Costs/N/sc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 11. Tote1 Deductions 12. Net Value of Tax Return 0O O0 O0 O0 191856 22 O0 25119:5.25 (8) 1,5~0.00 NOTE: To /nsure proper credit to your account, submit the upper port/on of th/s form w/th your tax payment. 15. 14. NOTE: q5,029.q5 ZF PAXD AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. (].5) .00 X 00 = .00 (16) :58,q6q.92 X 0q5= 1,7:50.92 (~7) .00 x 12 = .00 (lB) .00 x 15 = .00 (1~)= 1,7:50.92 AMOUNT PAZD 1,7:50.92 TOTAL TAX CREDZT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE 1,7:50.92 .00 .00 .00 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REIaUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORN FOR ZNSTRUCTZONS.) ASSESSHENT OF TAX: 15. Amount of Line Zq at SpousaZ rate 16. Amount of Line 14 taxable et Lineal/Class A rate 17. Amount of L/ne 14 at Sibl/ng rata 18. Amount of L/ne 14 taxable at CollatereZ/CZass B rate 19. Principal Tax Due TAX CREDZTS: PAYMENT RECEZPT DZSCOUNT (*) DATE NUNBER INTEREST/PEN PA/D (-) 0:5-25-2002 CD000992 .00 Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15} . O0 Net VaXue of Estate Sub~ect to Tax (14) $8,q6q.92 Tf an assessment was issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~11 reflect figures that lnclude the total of ALL returns assessed to date. 5,0Zq.5:5 (x2) 38,q6q.9Z ESTATE OF EDNA P. WYRICK File No. 21-02-0300 FAMILY SETTLEMENT AGREEMENT THIS AGREEMENT made this day of 0A2,~,.~ ,2002, BETWEEN: CAROL M. ROBERTS, JIMMY D. BURKHOLDER, JOYCE D. YOCUM, and WILBUR C. WYRICK, JR., being the legatees under the Last Will and Testament of Edna P. Wyrick, late of the Township of Southampton, Cumberland County, Pennsylvania. WHEREAS, Edna P. Wyrick died September 17, 2001, testate, and under her Will left her estate to the parties herein; and WHEREAS, there were no probate assets in the estate so that it was unnecessary to present the Last Will and Testament of Edna P. Wyrick for formal probate in Cumberland County, PA; and WHEREAS, all assets of the late Edna P. Wyrick have been liquidated or distributed and all her debts paid in full, the said parties duty of the filing of a First and Final Account hereto desire to waive the with Proposed Schedule of Distribution for purposes of confirmation by the Court of Common Pleas of Cumberland County, Orphan's Court Division, AND FURTHER desire that a Family Settlement Agreement be executed, which Family Settlement will be duly recorded among the deed records in and for Cumberland County. WEIGLE & ASSOCIATES, RC, -- ATTORNEYS AT LAW -- 126 EAST KING STREET -- SHIPPENSBURG, PA 17257-1397 NOW, THEREFORE, WITNESSETH, that the parties hereto, in consideration of the premises above stated, and of the Accounting and Proposed Schedule of Distribution attached hereto and made a part hereof, and the receipt of their distributive shares as therein shown, do mutually bind themselves to the said Distribution and Accounting as set forth and further mutually release each other from all claims and demands whatsoever arising out of settlement of the Estate of Edna P. Wyrick. The parties hereto do further agree that should any liability come due to the estate of the said decedent after the signing of this agreement, we and each of us do hereby covenant and agree with each other that we will contribute pro rata our share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate after the signing, sealing and delivery of this family settlement agreement and final release. IN WITNESS WHEREOF, the parties have hereunto set their hands and seals the day and year first above written. WITNESS: 6/ ~r3[ M. Roberts (SEAL) urkho,d r e_ Wilbur C. Wyrick, 3f'. ~ WEIGLE & ASSOCIATES, P.C. -- ATTORNEYS AT LAW -- 126 EAST KINI3 STREET -- SHIPPENSBURG, PA 17257-1397 COMMONWEALTH OF PENNSYLVANIA · · SS COUNTY OF CUMBERLAND · On this, the -5''~- (~ day of ~ , 2002, before me, the undersigned officer, personally appeared CAROL M. ROBERTS, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Notarial Seal linda K. Klein, Notary Public Shippensburg, PA Cumberland County My Commission Expires August 15, 2004 -- day of ~ , 2002, before me, the undersigned officer, personally appeared JIMMY D. BURKHOLDER, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal· Notarial Seal !.Jnda K. Klein, Notary Public Shippensluurg, PA Cumberland county My commission Expires August 15, 2004 WEIGLE & ASSOCIATES, RC. -- ATTORNEYS AT LAW -- 126 EAST KIN(3 STREET -- SHIPPENSBURG, PA 17257-1397 COMMONWEALTH OF PENNSYLVANIA · · SS COUNTY OF CUMBERLAND · On this, the t./~ day of p~.4~-e_ , 2002, before me, the undersigned officer, personally appeared JOYCE D. YOCUM, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. (SEAL) Notarial Seal Limda K. Klein. Notary Public Shippensburg, PA Cumber!,and County My Commission Expires Augu.st 15, 2004 · SS COUNTY OF Cu~r36_cct-~,,, ~ . On this, the [ ~ ex- ~ ~ day of /.x.¥-,~ , 2002, before me, the undersigned officer, personally appeared WILBUR C. WYRICK, JR., known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. (SEAL) Notarial Seal Unda K. Klein, Notary Public Shippensburg, PA Cumberland County My Commission Expires August 15, 2004 WEIGLE & ASSOCIATES, RC. -- ATTORNEYS AT LAW -- 126 EAST KING STREET -- SHIPPENSBURG, PA 17257-1397 FIRST AND FINAL ACCOUNT FOR ESTATE OF EDNA P. WYRICK, DECEASED Date of Death: Accounting for the Period: September 17, 2001 September 17, 2001, to May 30, 2O02 Purpose of Account: The Estate of Edna P. Wyrick offers this account to acquaint interested parties with the transactions that have occurred during the administration. The account also indicates the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Thomas L. Bright, Esquire Weigle & Associates, P.C. 126 East King Street Shippensburg, PA 17257 717-532-7388 WEIGLE & ASSOCIATES, RC. -- ATTORNEYS AT LAW -- 126 EJ~ST KING STREET -- SHIPPENSBURG, PA 172S?-1397 ~Y O~ ACCOUNT Estate of Edna P. Wyrick For Period 09/17/01 Through 5/30/02 Proposed Distribution to Beneficiaries Page 6 Fiduciary Acquisition Value $27,180.39 Principal Receipts Net Gain (or Loss) on Sales or Other Dispositions Other Receipts Less Disbursements: Administration Expenses (Prin) Fees and Commissions (Prin) Other Expenses (Prin) Balance before Distributions Distributions to Beneficiaries Principal Balance on Hand Income Receipts Less Disbursements Balance before Distributions Distributions to Beneficiaries Income Balance on Hand 2 2 2 3 5 $ 1,820.92 1,450.00 10,084.53 $53,029.45 0.00 0.00 $53,029.45 13,355.45 $39,674.00 12,524.40 $27,149.60 $ 30.79 0.00 $ 30.79 0.00 $ 30.79 Combined Balance on Hand $27,180.39 RECEIPTS OF.PRINCIPAL Estate of Edna P. Wyrick As of 5/30/02 Page 1 Assets Listed in Inventory (Valued as of date of death) Fiduciary Acquisition Value Checking Accounts Allfirst Bank Checking Account #09502-8788-5, opened 10/13/00 FBOJoyce D. Yocum, daughter Deposit to checking account in transit at date of death Savings Accounts Waddell & Reed Fund Account #32293020 Refunds Presbyterian Homes, Inc. - 09/30/01 Blue Cross/Blue Shield - 10/06/01 refund of premium at cancellation $ 28,193.23 5,000.00 $ 2,130.31 212.30 $ 33,193.23 17,493.61 2,342.61 $ 53,029.45 DISBURSemENTS.OF PRINCIPAL Estate of Edna P. Wyrick For Period 09/17/01 Through 5/30/02 ~age 2' Administration Expenses (Prin) 02/26/02 Register of Wills, Cumberland County - filing PA Inheritance Tax Return 02/26/02 Register of Wills, Cumberland County - filing Family Settlement Agreement 02/26/02 Register of Wills, Cumberland County - PA Inheritance Tax Fees and Con~nissions (Prin) 02/26/02 Thomas L. Bright, Esquire - attorney fee Other Expenses (Prin) 09/17/01 Allfirst Bank Checking Account #09502-8788-5, checks outstanding at date of death, clearing after date of death 09/20/01 Waddell & Reed Fund - withdrawal in transit at date of death 10/11/01 Continuing Care Rx - 09/30/01 statement 05/30/02 Allfirst Bank - service charges on Checking Account #09502-8788-5 TOTAL DISBURSemENTS OF PRINCIPAL $ 15.00 75.00 1,730.92 $ 4,960.53 5,000.00 24.00 100.00 $ 1,820.92 1,450.00 10,084.53 $ 13,355.45 DISTRIBUTIONS OF PRINCIPAL TQBENEFICIARIES Estate of Edna P. Wyrick For Period 09/17/01 Through 5/30/02 ~age 3' To: Carol M. Roberts Distribution from Waddell & Reed Fund 10/18/01 Cash $ 3,131.10 TO: JiL~u~y D. Burkholder Distribution from Waddell & Reed Fund 10/18/01 Cash 3,131.10 To: Joyce D. Yocum Distribution from Waddell & Reed Fund 10/18/01 Cash 3,131.10 To: Wilbur C. Wyrick, Jr. Distribution from Waddell & Reed Fund 10/18/01 Cash TOTAL DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES 3,131.10 $ 12,524.40 PRINCIPAL BALANCEO~HAND Estate of Edna P. Wyrick As of 5/30/02 Page 4' Checking Accounts Estate Checking Account Less: Income balance on hand PRINCIPAL BALANCE ON HAND Current Value $ 27,180.39 $ 27,180.39 30.79 $ 27,149.60 Carrying Value $ 27,180.39 $ 27,180.39 30.79 $ 27,149.60 RECEIPTS QF INCOME Estate of Edna P. Wyrick For Period 09/17/01 Through 5/30/02 ~age 5' Dividends Waddell & Reed FundAccount 09/27/01 dividend Total Dividends TOTAL RECEIPTS OF INCOME 30.79 $ 30.79 $ 30.79 PROPOSED DISTRIBUTIONS TO~ENEFICIARIES Estate of Edna P. Wyrick For Period 09/17/01 Through 5/30/02 Page To: Carol M. Roberts Cash 05/30/02 The beneficiary will receive a 25% interest in the estate's residue, representing a portion of the following assets: Cash Total To: Ji,~,~LyD. Burkholder Cash 05/30/02 The beneficiary will receive a 25% interest in the estate's residue, representing a portion of the following assets: Cash Total To: Joyce D. Yocum Cash 05/30/02 The beneficiary will receive a 25% interest in the estate's residue, representing a portion of the following assets: Cash Total To: Wilbur C. Wyrick, Jr. Cash 05/30/02 The beneficiary will receive a 25% interest in the estate's residue, representing a portion of the following assets: Cash Total TOTAL PROPOSED DISTRIBUTIONS TO BENEFICIARIES $ 6,795.09 $ 6,795.09 6,795.09 $ 6,795.09 6,795.09 $ 6,795.09 6,795.12 $ 6,795.12 $ 27,180.39 ESTATE OF EDNA P. WYRICK, deceased File No. 21-02-0300 FAMILY SETTLEMENT AGREEMENT WEIGLE & AssoCIATES, EC. ATTORNEYS AT LAW 126 EAST KING STREET Sml'I'ENSBURG, PA 17257-1397 TEL~'HON~: (717) 532-7388 FAX: (717) 532-6552 REGISTER OF WILLS, CU~B~ C0~ STATUS REPORT UNDER RULE 6.!~. Name of Decedent: Edna-P. Wyrick Date of Death: 9/17/01 Will No. 21-02-0300 (No Letters) Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: State whether administration of the estate is completL: Yes X No - 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be .filed with the Cerk of the Orphans' Court and may be attached to this report. %~ogmna:tL~.~ Esquire Name (Please type or print) WEIGLE , & AS SOCIA_TES, _ P. C. i2'6' East King Street Address Shippensburg, PA 17257 ('717) 532-7388 Tel. 1',;o. (MAH:rmf/AM3) Capacity: Personal Representative X Counsel for personal representative